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Cape Save Inc.
7-D Huntington Avenue
South Yarmouth, MA 02664
Tel: 508-398-0398 Fag: 508-398-0399
` SUILo D
4/27/16 �pP
APR 28 2016
Town of Barnstable It TOWN OF BANST
Thomas Perry CBO A,9�
Building Commissioner
200 Main St. Hyannis,MA 0260f,
RE: Building Permit#B-16-830
TO: Building Inspector(s),
This affidavit is to certify that all work completed for 153 Bacon Road,Hyannis has been
inspected by a third party Certified Building Performance Institute(BPI)Inspector. '
All work performed meets or exceeds Federal and State Requirements.
f
Sincerely,
William McCluskey
i
'.OWN-0F BARNSTABLE BUILDING PERMIT APPI.ICAT ON
Map 310 Parcel '�3 b Application # ���I ��
Health Division ''Date Issued
Conservation Division Application Fee
Planning Dept. Permit Fee _
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address i S3 a;c0 I -6 A.
Village iA d an il is
Owner V Address
Telephone g o t a$ o o a 5
Permit Request (�d,1 R- i 9 f2-. 0. r_P,�lr��o sf �n '
-to -Ale a i�, eA5t Qae�. +I,e i„ro%((s
r su( t e d 6,S C,fA III W 1-f &-X 1&AJ(14t it#
Square feet: 1 st 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: ❑ 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
-a
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other u
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 YNo If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
- - I - (BUILDER OR HOMEOWNER) - -- - - --
Name 1i m 1A Cor Y -11,C.Telephone Number 508 318 0319
Address -�-I) 4r, A Tyr& License # G to&T7,6
1�. Y�rn►ow-� I ' l �� `�'L� Home Improvement Contractor#
Email Worker's Compensation # WW e 313 6A 44
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE L t
* FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
` MAP/PARCEL NO.
1
t
!ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
(,PLUMBING: ROUGH FINAL
ti
s
,,GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
f
s # .�:'l'is i
.,,t' ��t; The:Cominonwealtli�ofMassachusetts.4 x .. �; +��,, .-�.. " '_ •
a = `�;Depart»ient oflndustrialAccidents.� ' `l' Ir -
" t7r[. -. .j„r ... .�:'- ,t. r.[...,.• .*. ;. .,.. .,1 ,�' " .et i .. , t ?l �.«3 • � J .
1 Congress Street;;Suite 100 , tr;l,.,' �, •.¢. y
Boston,MA 02114-2017:
' f d.1 e"' `J �.'7i?t-'' r„! fTcai +.`a. „ .- [s R Y t :, ,, _•f pit v . ,
www massgov/dia
"Wdrkers'Compensation Insurance davit:Builder's/Confractors/Electricians/Piu"' 6 s.
X,1.1 ' ••TO BE FILED WITH THE PERMITTING AUTHORITY. � ,
+Ayoticant Information Please Print Legibly
Name (3usiness/Orga aion/Individual):Ca `e Save Inc
, - `•
.Address:7-D Huntington Avenue
City/State/Zip:South Yarmouth,MA 02664 = '�, {.Ylphone#::508-398 0398
Are you an"employer?Check the appropriate box
_ _ ,� q?•,1 _ Type of project_(required) 1
1.❑✓ I am a employer with 2 µemployees(full and/or part-ttime)e - c
.0 New construction '
,ri` �� r,�i«i i ��T in ti?'.,.+ i7 r `
2.E]I am a sole'.proprietor or partnership and have no employees_;working for me in D , r
an ca aci o workers'co insurance required.] 4 4 r , i 8:"7 Remodeling '
Y. ,P ty II`I � r - .. •1 � `'.
fi' ? r,x; ,ra =T i!.:, < l. ?9: Q Demolition�i '
3.a I am a homeowner doing all work myself.[No workers comp.,msurance required.]t- - « '
f. r 3 10 0 Building addition _ .t
4.❑I am a homeowner and will be hiring contractors to:conduct all work on my property_I will
1
ensure that aft contractors either have workers'compensation insufance,or are sole 1 L. Electrical repairs or additions •° - , }
proprietors with no employees. I I - ' -
12.❑Plumbingrepairs or additions _
a These sub-contractors have.employees and have workers'comp..insurance.'. t 13QRoof repairs « r
5. I am a eneral contractor and I have hired the sub-contractors listed on the attached sheet.
14.[aOther Insulation °
6.0 We are a corporation:and its officers have exercised their right of exemption per MGL c. {
152,§1(4),andwe have no employees:[No workers'comp.insurance required:] -^ '
F *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.
;Contractors'that check this box must attached'an.additional sheet.showing the name ofthe sub-contractors and state whether or not those;entities have "
employees. If thesub-contractors:have employees,they must provide their workers'comp.policy number; 'Y° '
I am an employer that;is providing workers'compensation insurance for my employees.' Below is the policy andiob.site _
information. _.. _ • « ...
:Insurance Company Name,Wesco Insurance Company z .�!• .A
Policy#or Self ins Lic: , ,a `s Exp l
�. a ion Date:04/Q9/2016'*
P
Job Site Address: 153 Bacon Road• , ,a '
City/State/Zi HYariri1S
- ,... _ , policy era _ _p � i t
,Attach a eopy of the workers.compensation policy declaration page(showing the ohc number and ex irahon date)
Failure to secure coverage as required under MOL Q. 152,§25A is a criminal violation punishable by a fine up:to$1,500.00
and/or one-year imprisonment,:as well as civil penalties in the form of a.STOP WORK ORDER and a fine of up to$250.00.a
day„against the.violator.A_copy,of this statement may forwarded,to the Office of Investigations-ofthe DIA:for insurance-
coverage verification. , ., .r a' rr +:. •• ti rf- c ,,» -._ -K ,
I do hereby certify under th pains.and Penalties of perjury:that the information provided above is true and.correct. f
Si ature: Date: 4/5/16 t
508-.398 0308,
' Phone#: • - �;
Official;use only.,Donot write in this area;to be completed by city or town ofJ�ica�-
nfM°.R. -., i.�,.,-»^wuew+.w,.....h.-.. ...-.pup. r.,MY..,++PwY• .+-.r: M ..... . .� , o... . .,.e-u:wrw+M.,raw..a,+H,,,,+':«rwr.....:yyr., .e.f.....iw.....m•Vrt. �„•_M,, w... . :
City or .own.} - Permit/License#
° do fir zq o•c.�ta W" K*x yxa t ,.a a t, .>,i. .
Issuifi ng Authority(circle one).'rc4 4
1 Board of I3ealth 2.Building Department 3 City/Town Clerk 4.Electneal Inspector 5.Plumbing.Inspector, „,
---I w-- ri-- -
Contact Person ' i
Phone#: ..__...,
., ` C1�ft,..r°'i[. p3: i ,�;-r°S�t.:,.P';0-",t..f*E- �:•'r5 ri,.,'s''t'.�ti.. ;�:'"" - ,pL•�tr��`44, p»��
��� • �:
ACC)R o® CERTIFICATE OF LIABILITY INSURANCE FDATE(MMlD°"YYY'
10/14/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. .
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy()es)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 NONE:NTACT Colleen Crowley
Risk Strategies Company PHCOIH E : (781)986-4400 FAC No:f781)963-4420
15 Pacella Park Drive nol�SS:ccrowley@risk-strategies.com
Suite 240 INSURER(S)AFFORDING COVERAGE NAIC#
Randolph MA 02368 INSURERA:Selective Ins. of America
INSURED INSURER Allmerica Financial Alliance Ins Cc 10212
Cape Save, Inc IPSURERC.Wesco Insurance Co an
7 D Huntington Ave INSURER D:
E INSURER E:
Sough Yarmouth MA 02664 INSURERF:
COVERAGES CERTIFICATE NUMBER:CL15101402127 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,TERRA 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.
INS TYPE OF INSURANCE POLICY NUMBER MPM�POLICY EFF M POLICY EXP
LTR LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED-
A CLAIMSWADE Fx—]OCCUR PREMISES Ee occunence $ 100,000
S1994480 10/16/2015 10/16/2016 MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY ACT LOC PRODUCTS-COMPIOPAGG $ 2,000,000
OTHER: $
AUTOMOBILE LIABILITY EMBINEnt L I $ 1,000,000
B ANY AUTO BODILY INJURY(Per person) $
ALL OWNED Ix
SCHEDULED
AUTOS AUTOS AWBA46796600 11/6/2015 11/6/2016 BODILY INJURY(Per accident) $
,
NON-OV NED PROPERTY DAMAGE $
X HIRED AUTOS AUTOS Peraccident
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000
DED RETENTION Nil S1994480 10/16/2016 10/16/2010 $
WORKERS COMPENSATION Officers Included for X PER OTH-
AND EMPLOYERS'LIABILITY YIN STATUTE ER
ANY PROPRIETORIPARTNERIEXECUTIVE Coverage E.L.EACH ACCIDENT $ 500,000
OFFICERIMEMBER EXCLUDED? N❑NIA
C
(Mandatory in NH) ii_ 1e1SC3136274 4/9/2015, 4/9/2016 E.L.DISEASE-EA EMPLOYEE $ 500,000
If yyes,describe under „
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 50O 000
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more apace is required)
National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and NStar
Electric are all included as Additional Insureds with respects to the General Liability coverage of Named
Insured as required by written contract.
CERTIFICATE HOLDER ' CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Housing Assistance Corporation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
460 West Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
Hyannis, MA 02601
AUTHORIZED REPRESENTATIVE
Michael Christian/CLC
O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
I NS025(201401)
14, The Parties acknowledge that this Agreement is under seat. it is intended by the Parties that the Tenant or any
successor Tenant is the intended benefloiary of the Agreement and shall have a right of enforcement.
Property Owner's Signature:
Phone: A a&)-(ae2
Address: n
Tenant Signal aid r
r ,
Agency Appro4' . rization Company
Adam T. Incorporated/ All Cape Energy ! Alternative Weatherization ! Building Science, Construction
Cape Cod tnsulaton 1 Cape Save / Frontier Energy Solutions / l ohr Home Improvement
Resolution Energy / Tupper Construction
Agency Signature Dat®
•
- i
Office of Consumer,.Affairs an! in Busess;Regulation.:
- 1-0 Park.MPlaza Suite S t70
Boston, assachusetts 02116
Horne jm: _ nent Con tractor..Re 'irk if .
_ Reg+strat+on: 1.71380.;
i - Type. Corporation . -
t Expiration: 31.14/2018 1 r# 419291
tit tom,
CAPE SAVE INC rs
WILLIAM McCLUSKEY
7-D HUNTINGTON.AvtNUE
tF
SOUTW=YARMQU.TH, MA 02664' 9 : � ,
.
ti 4 Update Address and return card Mark reason far change: .
;. _.
Address CI;Renewa, Employment ❑ Lgst Card
SCA 1 ES 20M-05/11
re 'a»zccra�ttue«ll�o!F?illiutccctu e
_Office of Consumer Affairs&Business Regulation License or.<registratron valid for mdi�+d4l use only:
^ T bfore th Iffouneturn toHOME IMPROVE M CTOR t rn
p Registration y 71380 Types Office of Consumer Affairs and Business Regulation
r Expiration 3/14/2018 Corporation. 10 Park Plaza Suite 5174
Boston,MA 62116
CAPE SAVE INC. `t r
r
WILLIAM McCLUSKEY
7-D HUNTINGTONrAVENUE 1
SOUTHYARMOUTH MA 02664
F Undersecretary Not valid;. 11hAsignature .
Massachusetts -Departrrlent df Public Safety
t ,/! Board of.Buiiding l2egul;ations and Standairds
l~./119t1{1 LtIli11 Jlll'1[:1-Y 1.1111 JrICl.I41LY" �"�+q,� -
License CSSL 102776
WHILIAM,J MC
37 NAUSET ROAD (�
West Yarmouth rdA
Expiration
Commissioner wii812017
d , '
, 4
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$4D.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you t�
.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 bylaw:
s r, r e DATE: D C� Off ' Fill in please:
n APPLICANT'S YOUR NAME/S`
BUSINESS. w w YOUR HOME-ADDRESS:'-/''S3 13Ac ,nj l
a �
TELEPHONE .# Home Telephone Number C" l962
40
NAME OF CORPORATIQN .; - _.
NAMEbF NEW BUSINESS�, TYPE OF.BUSINESS .C�-Q. l
IS THIS:A HOME
OCCUP 77
ADDRESS OFBUSINESS ;1 _,./V� ' MAP/PAAcEL'NUMBER (Assessln.g)
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.
MUST COMPLY WITH HOME OCCUPATION
�. BUILDING COM ER'S OF IC RULES AND REGULATIONS. FAILURE TO
This individu I h s enSnfo of n ermit requirements that pertain to this type of
Y _9 i P tYP b3 I�:Y MAY RESULT IN FINES;
iz d-S1 na e*
QVIMENt
11A !u"cli&�:4d/1 —
2. BOARD OF HEALTH
This individual has.b n info d f th p mit req ments that pertain to this type of business.
Authorized ignature** UST 1;OMPL.`Y WITH ALL -
COMMENTS: ,. T
3. CONSUMER AFFAIRS.(LICENSING.AUTHORITY)
This individual has TIn info 6ed�/t�e licensing requirements that,pertain to this type of business.
x. Authorized Signature
COMMENTS:
r
Town of Barnstable.
t�
Regulatory Services
Regulatory
Thomas F. Geiler,Director
• Building Division,
MAS& Tom Perry,Building Commissioner;
t�Mpt 200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Approved:
Fee:
Permit#:
HOME OCCUPATION REGISTRATION
Date:
Name: 2� UtJ Q.� J• Phone
Address: �'3 6l.V �/ n Village:
Name of Business: t` aOY21J G COAS TRt Jr,?)[ ?1 ' -,4 ()Z4?�)y✓4-)
Type of Business: r � Map/Lot: lV1
DVTF.NT: It is the intent of this section to allow the residents of the Toim of Barnstable to operate a home occupation
Within single family dwellings,subject to die provisions of Section 4-1.4 of the Zoning ordinance,pro`ided that dne acdility
'
shall not be discernible from outside the dwelling. there shall be no increase Iin noise or odor;no usual alteration to the
premises which would suggest anything other than a residential use;no increase m
traffic
above normal residential volumes;
and no increase in air or groundwater pollution.
After registration riith the Building Inspector,a customary home occupation shall be'pernutted as of right subject to the
follo,Aang conditions:
• Tlne activity is carved on by the permanent resident of a;siigle family residential dwelling iuiit,located Naathin
that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not'customary in residential buildings,and there is
no outside evidence of such use.
• No traffic will be generated ii 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 f=""fable or explosive materials,.it excess of
normal household quantities:
• Any need for parking generated by such use shall be met on the same lot containing die Customary Home
Occupation,and not Azthin the required fi-ont 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 vari or one
pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation. I
• If the Customary Home Occupation is listed or advertised as a business,die street address shall not be
included. .
• No person shall be employed in the Customary Home Occupation ivino is not a permanent resident of the
dwelling unit.
1,the undersigned,have read, -ee with die re ctions for my home occupation I am registering.
Applicant: Date: 7/v l7)
Honieoc.doc Rev.01/3/08
Town of Barnstable
T
Regulatory Services
�t
Thomas F.Geiler,Director ;
r
Building Division
w IMMSTABIA ti
v MASS. Tom Perry,Building Commissioner
�gEp 9. ► 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 i Fax: 508-790-6230
Approved:
Fee: 5—
Permit#: � —
HOME OCCUPATION REGISTRATION
Date: 1 ( -7 )
Name: ,N` Qql o A, Phone#: S o B"'3
Address j �t)� 111 Village: Y� /l)
Name of Business:
Type of Business Map/Lot: f C) v �
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 dwelluigs,subject to the provisions of Section'4-I. 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 m air or groundwater pollution.
After registration AZth the Building Inspector,a customary home occupation shall be pemnitted as of right subject to the
follortiung conditions:
• The activity is carved on by the permanent resident of a single family residential dwelling unit,located raithinn
that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings,and there is
no outside evidence of such use.
• No traffic Ncnll be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or otlier 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,ii 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 Aitlihi the required front yard. 9
• There is no exterior storage or display of materials or equipment.
• 1'lnere 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 ii length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
`• If the Customary Home Occupation is listed or advertised as a business,the street address shall not,be
included:
No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
1,the undersigned,have read and rrnth the above restrictions for my home occupation I"arn registering.
Applicant Date: j 7 U
Homeoc.doc Rec.01/3/08
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAM
you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office
E In town [which
Main Street, Hyannis, MA.02601 (Town Hall) 1°` FL.,367
ig7s,vp,MSYx 8',' Fffl LATE-
, �n'ppl��s�: ,,A .
PPLICANT'S YOUR NAME: ` (� (ij
u`��"�G uz`": 3 .t BU51NES5
F�\
YOUR ADDRESS:
_ ,
-
� c21�>.
TELEPHONE #.
Home Telephone Number
NAME OF NEW BU�rINESS C T
1S THIS A.-HOME OCCC7PATIDIV?__YES. _ p .
TYPE
OF Bl'151NESS:
Have you been given approval from the-b t and.-divisio NO
ADDRESS.OF BUSINESS l SJ � C�1V'
MAP/PARCEL NUMBER-
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 T
Barnstable. This form is intended to assist you in obtaining the information you own of
Rd. & Main Street).to make sure you have the appropriate permits and lice
nses.required to'legally operate y0our business (corner
this of Yarmouth
town.
I. BUILDING C0 SS NER'S O IC
This indivi al h s in ed- y permit requirernen ertain'to,this type of business:
u hpriz i ; ur
C MMENT d t
2. BOARD OF HEALTH
This individual has b infor ed of th er quirements that pertain to this type of business.
uth zed Signature**
COMMENTS: . ✓� a� S. S/f�ccc.� 7/// (_[pe;S
3: CONSUMER AFFAIRS [LICENSING AUTHORITY
This individual han infor• f t elide e uir fnents that pertain to this type of business. _
Authorized Signature.*
6COMMENTS: .
TOWN OF BARNSTABLE Permit No. ___23110
Building Inspector
Cash
161 .
OCCUPANCY PERMIT Bond N/A
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 Nancy Johnson 'Address
Lots 10 & 11 154 Bacon Road, Hyannis
Wiring Inspector. Inspection date
Plumbing Inspector Inspection date
Gas Inspector Inspection date
Engineering Department ' _ Inspection date
THIS PERMIT WILL NOT BE V AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
19_........ ................._.............
Building Inspeetor
TOWN OF BARNSTABLE 2 3110
• , Permit No. _�---_—�
1n
Building Inspector
�; Cash# _vN/A
OCCUPANCY PERMIT Bond
"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 i' ancy Johnson Address
Lo 10 & 11 154 Bacon. Road, Hyannis
Wiring Inspector �! Inspection date
Plumbing Inspector ,/ Inspection date
Gas Inspector �`± r` _4 �v, 1,% Inspection date f�
Engineering Department
Inspection date
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.
»................»».»»...» ..».».»».», 19»....».». ...............»..........................
»
Building Inspector
TOWN OF BARNSTABLE Permit No.
Building Inspector
i s,urr Cash
OCCUPANCY PERMIT Bond __ / _
"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 - i`Fs' ncy Johnson Address
Tjot s 10 & 11 154 Bacon Road, Hyannis
Wiring Inspector Inspection date
Plumbing Inspector _ of _ Inspection date
Gas Inspector Inspection date
Engineering Department Inspection date
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.
_................ ._..__ . _�._._, 19. . . ...... .......... .... ._ ......
Building Inspector
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'Assessors map and lot number ✓/1� .. . +r� .C..pp:
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t� INSTALLED IN COMpf�iAN P�o�T"ETo�y
Sewage Permit number . . C?. ....6.6..3............... ....... WITH TITLE 5
ENVIRONMENTAL CODE s
9HBSTABLE, •
� TOWN REGULATIONS 90 M6 a
House number +! ... ........................
O 39. `e
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TOWN OF BARN-STABLE
BUILDING INSPECTOR
APPLICATIONFOR PERMIT TO ..:....................:.....................................................................................................
TYPE OF' CONSTRUCTION ...........
Jr �. .........................19. f.
t TO.THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .....�.�. ..� !l.........................�A C.Pjm..... U.:...... k s..........h��+A rUcv f:.. .... ......................
Proposed Use ..........cs..lY►.l—k........FA-.M.f.I?�' .........
Zoning District ..............):.........................................................Fire District ...........................
Name of Owner ......./.!/..o: C. .... 6..rvzO. .........Address ...a.`7- . (� 2/f'...�1Qc�:...vY..f.. TtV4
Nameof Builder .......... t .E...............................................Address ....................................................................................
Nameof Architect ................Address.................................................. ............... . ..................................................................
Number of Rooms ...... .................Foundation ... .... �!�
.............................. ...........................
Exterior ................ .................:�T..�:.!.u......_....... .. .........Roofing ....,:.............7 �X=—.._ .............................
Floors .................. D! ,(............................................Interior ..............0,0..060.
...... ...............................................
>. .,Heating.. .:.... ... ....... ..."Y.<TP�-.....:......................Plumbing ....... / ....................
Fireplace ..:............... ......Approximate Cost
` Board - --------. �..�Definitive Plan Approved by Planning ------------------------------�9 Area .......... V.....�..
. ..........
Diagrdm`of Lot and Building with Dimensions— Fee Cps.. t
f
SUBJECT TO APPROVAL OF BOARD ,OF. HEALTH ;
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I hereby agree to conform.to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ......... ................
JOHNSON, NANCY
2.3110 MOVE FRAME
No ................. Permit for ....................................
'SINGLE FAMILY DWELLING
. ................................................ ......................
Olt 'Lots 10 & 11 bW Bacon Rd. Ext." "
Location .................................................................
Hyannis
...............................................................................
Owner „Nancy..................................................oh n
n
.. .... .....
Type-of Construction .....F.r.ame.......................... .. .......
.................................................................................
Plot ........................ Lot .................................
Ma 13, 81
Permit Granted y........................................19
Date of Inspection ........................19
Date Completed ......................................19
PERMIT REFUSED
4
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......... .......... 19
...........
............ ..............................................................
..............................................................................
o.
...........................................................................
................. .................
Approved ................................................ 19
.............................................................................
..........
.......... ................................... ...................
Assessor's map and lot number ....!.`.�.........1 .. .. .... .�;.;✓<!�
J yOF TM E TO
/7 C Q i
Sewage FNarmit number . .,::�a, .......�...,:..:...........................
Z IDARMTSDLE,
r
House number ..................... Mj................................................. 90 roes
" � p t6}9• \0�
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATIONFOR PERMIT TO ..............................................:..............................................................................
.... ...... r.?n': ::.
TYPE OF CONSTRUCTION ........ ...............................................................................
................................................1.9........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ..... .. ?:T...:!i� ........................ 't.t..ci':1)....�:!`^:......�.?.I............�� �;:_ .... �:.....:......................
.. .. ... . .... . .. .. ..�. ... .... ..
ProposedUse ......... r n?`............................r r cl.......j li> 1 :.:i `.F..................................................................................
ZoningDistrict ..........,...............................................................Fire District ..............................................................................
Name of Owner ....... ,)A tv r.......... ry n d ..........Address ... `..`.rf ' .: ..............................................................
Nameof Builder ..........1407�...............................................Address ....................................................................................
Nameof Architect ..................................................................Address ............�.. ..:.........................................................:.....
t� �J 1� c
Number of Rooms ....................................................................Foundation ...,............�..........................................................
Exterior ......................................:�/... !I. G ...Roofing.... .................................... ............................. . ....................................
Floors C /,d4 0�
....................................r...- r.......................................Interior .....................................................................................
Heating :' --?. .....L'.l ?.. . .. ...........................:.Plumbing ...:.:.:........... -:. � :T%1......-..........:...................
Fireplace ..................1..............................................................Approximate Cost ............: �'""C! �c.1........................
Definitive Plan Approved by Planning Board --------------------------------19--------. Area ..........................................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH -
•
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ....... °° ... .. ..........................
..
-
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23110
No ................. Permit f0=9y
SINGLE FAMILY DWELLINQ
PERMIT REFUSED
-
Approved ---------------... l9
---------'---~--^^^—'-----''
--------`--~------^'—'--^^—
. ��
s � Towx of sBaNsTAsLE
REPORT S LEMENTAHY/CONTINIIATI REPORT
NAME (LAST, PIRST, MIDDLE) � {3� `�5� �� VLc' DIVISION /Uspgo" i �1r
NOTE DETAILS L OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL I5 ETC.
PAGE
SUBMITTED BY '
s
TY ADDRESS I ZONING IDISTRICT CODE 'SP-DISTS.I DATE PRINTED CLASS I PCS I NBND KEY NO.
0153 BACON ROAD 07 RB 40C 07HY 07/09/95 1011 00 63BC R3
LANDIOTNER FEATURES DESCRIPTION ADJUSTMENT FACTORS T
V UNIT ADYD.UNIT
..m BylDm. s"D�mens�on LOC./YR.SPEC.CLASS JADJJ. P PRICE PRICE ACRES/UNITS VALUE JOHNSON• NANCY. TRUSTEE 8 MAP-
CD. FF.De I"rACres ' 1 21.300 CARDS IN ACCOUNT -
10 18LDG.SIT 1 X .41 =10 29999.9 51899.9 ..41 21300 .'(S)-CARD-1 1 5IP400 01 OF 01
PL 9ACON .RD HY COST 72700
BATHS 1.0 U X C= 3500.0 3500.0 1.00 3500 3 #RR 0060 0092 MARKET 61COC
FIREPLACE U x C= 3100.0 3100.0C 1.00 3100 a INCOME
USE
APPRAISED VALUE
A 72.70C
PARCEL SUMMARY
AND 21300
LDGS 5140C
0-IMPS
TOTAL 7270C
N CNST
DEED REFERENC Ty DATE'"` R.corUq PRIOR YEAR V A L U
epe. P.ge MC
- B""° ' LAND 213 0 C
1546/71 10/71 BLDGS 51400
TOTAL 7270C
BUILDING PERMIT REFUSED SEVERA
Nume„ D.1. T_ TIMES..........
LAND LAND-ADJ INC ME SE SP-BLDS FEATURES BLD-AOJS UNITS ..............
21300 1 1 6600
Class Cons1. To1a1 Bas.Rate AOI.Rate year Built ARe Norm OD.V, CND Loc b R 0 Repl Cosl New ACI Repl Value Slpries Repnl Rapm. Rm.B.II1. •Fia. P.tyw.q F.c.
Units Units A 1 OeDf COn,.
01C 000 100 100 61.00 61.00 35 75 19 80 90 70 73358 51400 1.3 8 4 1.0 4.0
Descr�0non SRuare Foes epl.Cost M%T,INDEX: 1.00 IMP.BY/DATE. ME 1 D/H7 SCALE. 1/OO.92 ELEMENTS CODE CONSTRUCTION DETAIL
8AS 100 61.a0D 720 R43920 R AREA 4 SINGLE FAMILY DWELLING CNST GP:JO
818 52 31.72 720 22838 •---------24--------* STYLE 10 LD STYLE O.D
--- --- ----------------------
818 ! ESIGN ADJMT 00 0.0
! EXTER.WALLS 11 OOD SHINGLES__ 0.0
! ! EAT%AC TYPE L7-9 IL-HOT WATER 0.0
! !
NTER.FINISH 05 LASTER 0.0
! ! NfiZ AY6UT 12' VER.%NORAAI 0.0
! ! IN TER.lUALTY _02 AM_E AS EXTER. 0.0
! ! �LbOR §TAUCT 02 D JOIST/BEAM 0.0
W 30 BASE 30 EkL00i2 COVER 04 IRET 0.6
�A.. ease. 720 ! ! _0U TYPE --01'ABLE-ASP_H _S_H_-- 0.6
_ BUILDING DIMENSIONS ! ! LECiRICAL _ J1 VERAGE _ 0.0
AS W24 N30 E24 S30 .. 818 N30 ! ! OUN�ATION 02 ONCRETE BLOCK 99.4
W24 S30 E24 .. ! !
- ------ - --------
! ---
NEI�HdORH00D 638C HYANNIS
I ! ! LAND TOTAL MARKET
! ! PARCEL 21300 72700
*---------24---------X AREA 2325
VARIANCE *0 •3027
STANDARD 20
I '
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1
RESIDENTIAL PROPERTY
MAP NO.-r- LOT NO. FIRE DISTRICT SUMMARY
r- STREET BeCori Rd. Hyannis LAND
3t..10 36. H „ -1000
01 BLDGS.
OWNER TOTAL -1 000
LAND
RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS:
� BLDGS.
TOTAL
1-lent Tel- .,.Jennie..M.:. �tw.. an L' �_P.2tiV f] 30 65,._., -1'3e 1. _185,_......__ LAND
Wentzel Jennie M. & Johnson Nan L. Trs f 10/22/71. 1546 71 , 5V ALI TOTAL
' TOTAL
LAND
BLDGS.
TOTAL
LAND
BLDGS.
_ O1
TOTAL
LAND
01 BLDGS.
TOTAL
LAND
BLDGS.
TOTAL
LAND
INTERIOR INSPECTED: rn BLDGS.
TOTAL
DATE: LAND
ACREAGE COMPUTATIONS (' i BLDGS.
LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL
HOUSE LOT 1 I. u00 -'t 000 LAND
CLEARF FRONT OI BLDGS.
Im EAR TOTAL
WOODS&SPROUT FRONT LAND
REAR Ol BLDGS.
WASTE FRONT TOTAL "
REAR LAND
0) BLDGS.
TOTAL
LAND
/ 0) BLDGS.
LOT COMPUTATIONS LAND FACTORS TOTAL
FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND
ROUGH TOWN WATER m BLDGS.
HIGH GRAVEL RD. TOTAL
LOW DIRT RD. LAND
SWAMPY NO RD. FIG) BLDGS.
TOTAL
51k. Walls Bsmt.Rec.Room St. Shower Bath Bsmt. '
----- PURCH. DATE -
Slab Bsmt.Garage St. Shower Ext. Walls PURCH. PRICE.
n-Walls Attic Fl.&Stairs Toilet Room Roof RENT
e Walls Fin.Attic Two Fixt. Bath ,
--- Floors
INTERIOR FINISH Lavatory Extra
.At. F 1 2 3 Sink
Attie
t/2 1/4Plaster Water Cld. Extra
'XTERIOR WALLS Knotty Pine Water Only
.ble Siding Plywood No Plumbing Bsmt.Fin. .
Ic Siding Plasterboard Int. Fin.
Y Shingles TILING
61k G F P Bath Fl. Heat
[irk.On Int.Layout Bath Fl.&Wains. Auto Ht.Unit
Veneer Int.Cond. Bath Fl.&Walls Fireplace
Brk.On HEATING Toilet Rm. Fl.
` Plumbing .
A Com. Brk: Hot Air Toilet Rm:Fl.-&Wains.
-- Tiling
Steam Toilet Rm.Fl.&Walls
.:ket Ins. Hot Water St. Shower ,
i Ins. Air Cond. Tub Area Total
Floor Furn.
ROOFING COMPUTATIONS
Jh. Shingle Pipaless Furn. S.F.
,I Shingle No Heat - S.F.
Shingle Oil Burner S.F. '
ra Coal Stoker S.F.
Gas S F OUTBUILDINGS
ROOF TYPE Electric
S.F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED
.,ie Flat
Mansard FIREPLACES S.F. Pier Found. Floor
.nbrel Fireplace Stack Wall Found. 0.H.Door LISTED
FLOORS Fireplace Sgle.Sdg. Roll Roofing
c. LIGHTING Dble.Sdg. Shingle Roof
u - — No Elect. DATE
-- Shingle Walls Plumbing
:.'Iwood ROOMS Cement Blk. Electric
PRICED
h.Tile Bsmt. 1st TOTAL Brick Int.Finish
.,ale 2nd 3rd FACTOR -
REPLACEMENT
OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL.' Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL.
1•/LG.
I
ss
J
0
TOTAL
M
[ ] [R310 036 . ]
LOC] 0153 1 BACON ROA610 CTY] 07 TDS] 400 HY KEY] 226071
----MAILING ADDRESS------- PCA11011 PCS100 YR100 PARENT] 0
JOHNSON, NANCY, TRUSTEE & MAP] AREA] 63BC iv] MTG] 0000
WENTZEL, JENNIE M TRUSTEE SP1] SP21 SP31
M R S TRUST UT11 UT21 .41 SQ FT] 1440
245 PARKER RD AYB] 1935 EYB] 1975 OBS] CONST]
W BARNSTABLE MA 02668 LAND 21300 IMP 51400 OTHER
----LEGAL DESCRIPTION---- TRUE MKT 72700 REA CLASSIFIED
#LAND 1 21, 300 ASD LND 21300 ASD IMP 51400 ASD OTH
#BLDG (S) -CARD-1 1 51, 400 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE
#PL BACON RD HY TAX EXEMPT
#RR 0060 0092 RESIDENT' L 72700 72700 72700
OPEN SPACE
COMMERCIAL
INDUSTRIAL
EXEMPTIONS
SALE] 10/71 PRICE] ORB] 1546/71 AFD]'
LAST ACTIVITY] 12/13/88 PCR] Y
R310 036 . • P P R A I S A L D A T KEY 226071
JOHNSON, NANCY, TRUSTEE &
LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB
21, 300 51, 400 1 A-COST 72, 700
B-MKT . 61, 000
BY 00/ BY ME 10/87 C-INCOME
PCA=1011 PCS=00 SIZE= 1440 JUST-VAL 72 , 700
LEV=400 CONST-C 0
----COMPARISON TO CONTROL AREA 63BC -----------------------------
NEIGHBORHOOD 63BC HYANNIS
PARCEL CONTROL AREA TREND STANDARD
101 10 LAND-TYPE
213001 LAND-MEAN +0%
727001 61720 IMPROVED-MEAN -1701 2001
] FRONT-FT
] 100 DEPTH/ACRES TABLE 02
10001 LOCATION-ADJ APPLY-VAL-STAT 1
LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES
COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC
FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?]
R310 036 . P E R M I T [PMT] ACT*[R] CARD [000] KEY 226071
000000001
PERMIT-NO MO YR TYPE VALUE CK-BY MO YR oCMP NEW/DEMO COMMENT
M