The URL can be used to link to this page

Home My WebLink About0119 BAXTER ROAD 1 9 �-x4o jo — — — -- Town of Barnstable o 'Regulatory Services + + a + + BAMSfABLE, + v MASS. � Thomas F. Geiler, Director �AlF1639. 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 19, 2011 Mr. Richard J. Murphy Sr. - 310 Ocean Street Hyannis, MA 02601 RE: 11.9 Baxter Road, Hyannis Dear Mr. Murphy, As part of allowing Homeless not Helpless to-operate at 119 Baxter Road, Hyannis the Town requests that annually the educational program provided at this address shall be provided to this Department for :. review. Also the number of residents shall also be provided to this Department at that time. It is understood that the-number of residents at this property shall at no time exceed 8 individuals and 1 house manager. Thank you in advance for your cooperation. Respectfully, . �` .. / Thomas Perry, CBO Building-Commissioner TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �b Parcel , S Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee v Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address /I Blip X TZk D Village 9gAW!! Owner _S A9 Q7_ - 3 1f �'dress �6 ®G� ! 6 *xk,e, Telephone 76`73z.6- ,AE� AL. Permit Request CdS�AA)6A ® JC 6)-5 A A90 /It,544104 CW,97,.40!/CT1OA to oee Abeel lescApe- 2.)d AZM 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 41' Two Family ❑ Multi-Family (# units) Age of Existing Structure 20 Historic House: ❑Yes 3-Mn- On Old King's Highway: ❑Yes 111- r Basement Type: WfTur ❑drawl ❑Walkout ❑ Other �Z fyZ L L CteA k)L Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 2 new Half: existing / new Number of Bedrooms: 7 existing —new Total Room Count (not including baths): existing 11new First Floor Room Count q Heat Type and Fuel: J'U-as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes O-o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: 8<eisting ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: &65Jsting ❑ new size _Shed: existing ❑ new size _ Other:77 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Co Commercial ❑Yes ❑ No If yes, site plan review# ~b ram. >11 _7 Current Use Proposed Use Sw;J CO € � APPLICANT INFORMATION (BUILDER OR HOMEOWNER) `Name Telephone Number Address -3�DAMW IS% �YIQ' lS License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE a FOR OFFICIAL USE ONLY APPLICATION# r DATE ISSUED <7{ •i. <» MAP/PARCEL NO. ,r ADDRESS VILLAGE OWNER f DATE OF INSPECTION: `. FOUNDATION. - = 4 7 . FRAME 1 INSULATION ° FIREPLACE 4 ELECTRICAL: ROUGH FINAL II; PLUMBING: ROUGH FINAL 5• AS: ROUGH= .': "G - FINAL FINAL BUILDING l $. f 1 t j •. 41[JT DATE CLOSED OUT r h t ASSOCIATION PLAN NO. �s The.Commonwealth`of Massachusetts i 1 Department of Industrial Accidents ~M,L. r' Office of Investigations 600 Washington Street ,r..d Boston, AM 02111 ' r www.mass.gov/dia Workers' Compensation Insurance,Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: Zia 0-C, " S77, City/State/Zip: &yWA)/.S �2�� Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4.'❑ I am a general contractor and F1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors, 2.❑ I am a sole proprietor or partner- listed on the attached sheet:_$ . 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. workers' comp: insurance. Y P ty• 9. ❑ Building addition [No workers' comp, insurance 5. ❑ We are a corporation and its re fired:]. officers have exercised their • 10.❑ Electrical repairs or additions 3: 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 insurance required.],t employees. [No workers'.. ' comp:insurance required,]'` 131-1 Other *Any applicant that checks box 41 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 anew affidavit indicating such. $Contractors 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. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c y under th and penaltie f perjury that the in provided above i true and correct Si nature: L Date: :Phone#: SO -7 71� — 7j( ' 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. ) lectrical 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. Pursuant to this statute, an employee is defined as"...every person in-the service of another under any contract of hire, express or implied, oral or written. An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the owner of a dwelling house-having not more than three apartments and who resides therein,or the occupant of the '�`'.dwelling�hou a of bivother'whoteriiploys persons to°do maintenancd;'constr fiction 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`const<ruct•bu`ildin''gs:in the•eomm'onwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance,with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department.of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to.obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. .City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the,affrdavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn 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. •t The Department's addres's rte'lephone'and fax number: The Commonwealth of Massachusetts. Department of Industrial Accidents ` J = Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass..gov/dia f Tt-te ra Town of Barnstable '. Hoy o Regulatory Services • BARNSTABLE, Thomas F. Geiler,Director 9 MASS. 1639'. aim Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA.02601 wwNY.toA,n.barnstable.ma.us Office: 508-862-4038 Fax: 509-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: I ggge Q � / JOB LOCATION: �� Z3.VXTG IIOA 1AAY,1 1_c number street - village "HOMEOWNER": ,t1(mw1 &1oT„ &L,e4S/4?cAN.446 opnjt?o0A1Y Soh1-77 '-732�' name home p work phone# CURRENT MAILING ADDRESS: 310 ©Ce,4',)V -5 a I)OA)N15 04 o26a/ city/town state zip code N 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 Persons)who owns a parcel of land on which he/she;iesides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures: A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall,submit to the Building Official on a forni acceptable to.the Building Official, that he/she shall be responsible for all such work performed under,the building peimit. (Section 109.1.1) The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations, j`� The undersigned "homeowner".cei fies that he/she understands the Town of Bamstable Building Department minimum,inspection procedures and requirements and that he/she will comply with said procedures and, 4at eme S.ure of Homeowner Approval of Building Official Note; Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for.which a building permit is required shall be exempt from the provisions of this section(Section i om.) -Licensing of construction Supervisors);provided that if the horreowmer engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor. Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix.Q, Rules`&'Regu)ations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly. ./when the homeowner hires unlicensed persons. .In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowncr acting as Supervisor is,ultimate)y resp6nsib)e. 4 To e`nsure'thal the homeowner is fully aware of his/her responsibilities;many communities rcquire,as part of the permit application, that the homeowner certify that he/she undcrstands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by ,several towns-You-may care t amend and adopt such a form/certification for use in your community. 1 °FrNerow� Town of Barnstable regulatory Services , Y RUWS-MEQX HAS. Thomas F.Geiler,Director oca�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-62: k. ' Pro dY Owner. :must, p Complete and Sign This Section A'Bu1 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authAbyilding permit application for: ( dress of Job) Signature of Owner Print Name . If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION (Rev. CERTIFICATE OF COMPLIANCE M.G,L. CHAPTER 148, SECTIONS 26F, 26F1/s City or Town HYANNIS FIRE DISTRICT Date: This Certifies that the property located at- I r2Xf' has been equipped with approved smoke detectors, and carbon'monoxide alarms*and was found to be in compliance with Massachusetts General Law, Chapter 148 Sections 26F, 26Fih and 527 CMR 31, et seq. Inspection/Testing completed on: By: . Inspector Fee Paid: 1 � Head of Fire Department: CHIEF HAROLD S. BRUNELLE Note: This certificate expires sixty(60) days after date of issue. SELLER'S COPY PERMIT Doc: 1s15SY103 01-14-2011 2-32 Gtf=: 193414 BARNSTABLE LANQ, COURT REGISTRY DEED WE, JOYCE A. HOFMANN of 35 Gates Farm Road, Lebanon, CT 06249, MELISSA A. HOFMANN, of 41 Babcock Hill Road, Lebanon, CT 06249, and JASON C. HOFMANN, of 35 Gates Farm Road, Lebanon, CT 06249, all as Joint Tenants with the right of survivorship, In consideration paid of Two Hundred Eighty Thousand($280,000.00) Dollars, Grant to HOMELESS NOT HOP ESS�INC., 310 Ocean Street, Hyannis,MA 02601 4 WITH QUITCLAIM COVENANTS that land situated in Barnstable in the County of Barnstable and Commonwealth of Massachusetts, bounded and described as follows: LOTS 131-A AND 131-B (BLOCK A) PLAN 11519-B The above premises are conveyed subject to and with the benefit of all rights, rights of way, easements, restrictions and reservations of record insofar as the same are now in force and effect. For title see Certificate No. 163905 recorded with Barnstable County Registry District of the Land Court. Property Address: 119 Baxter Road, Hyannis,MA 02601 ;�'Y`#HE CQUeT GVv-TITLE,Ekk�`i F'rL W tJ1'- r I .Witness my hand and seal this day of 2010. r , /boy e A. Ho Witness my hand and seal this o2 day of/jl-,Ir7v65�K— 2010. Mel' sa A. Hofmann Witness my hand and seal this 2 VkI day of '� , ,e, ,,-2010. � /-7 Jason C. Hofmann State of Connecticut it Aoo_County Z 2010 On this 211� day of�&je ,2010,before me,the undersigned Notary Public,personally appeared Joyc A.Hofmann,proved to me through satisfactory evidence of identity,which was CT-7-1)rwf0s' cUnsc ,to be the person whose name is signed on the preceding or attached document,and acknowledged to me that she signed it voluntarily for its stated purpose. J C - 0 Notary Public My Commission Exp.Oct.31,2014. State of Connecticut iJLily-) County ' 2010 On this 2 day of ,2010,before me,the undersigned Notary Public,personally appeared Melissa A.Hofmann,proved to me through satisfactory evidence of identity,which was ('T�N eK ,cr ne,e ,to be the person whose name is signed on the preceding or, attached document,and acknowledged to me that she signed it voluntarily for its stated purpose. Notary Public My Com*sion Exp.Oct.31,2014 rx } State of Connecticut All ` 1 �C D Vbr\AOY-\ County r 2010 f � On this 2 day of Opvem2or ,2010,before me,the undersigned Notary Public,personally appeared Jason C.Hofmann,proved to me through satisfactory evidence of identity,which was CT7Dswer5 ,to be the person whose name is signed on the preceding or attached document,and acknowledged to me that he signed it voluntarily for its stated purpose. lkSeQ _ Notary Public My Commission Exp.Oct.31,2014 t 1 ' a Y . tit',`. i.j Ita I ti'M2, -NI101 �I s o JNorm -� GOU COU tsE FURwAr v, Y W OF MD000S TREES 10 310 MAP 3 EDGE OF BRIfSM 9 s ORCIURD.ORNURSEtt1' 1 3 4 # 1 0 P--v--V EDGE OF ODNIFEROUS,VM .. � . �. . AMIRSH AM EDGE Of WATER E MAP 310 R. .� ROAD AXTE DIwNAsE Drral PATH/TVA WINE MAP# w MAP 0 21 E HOUSL NUMBER P 310 MAP 3 *"`° NUMBER" 4 �q 2 FOOT CONTOUR UNE 66 1 '� ilf 10 FOOT CONTOUR UNE # 13 �s' Eteemta.t,amda�eNcvm� a1 r;(a.9 SPOT EQUATION o cx� STONE WALL —. — RETAIND�wAti .. MAP 310 IWL ROAD.TRAQ 4 6 \\ •� STONE IETIY ,„ � SWUMMIN6 POOL 0 Bultm"/SFRUQURE ° MAP 310 - P 310 62 .3 RW ., ..� .,, # 8V 6, VALVE O.: AWIIptE T O W N O S { A R N S T A R L E 6 E O O R A`.P M I C I N ! O R M A T I O N S 7 S T E M S Y N 1 T O, � OR �� ltlltl®SOMINFUT * lksmap��eldmpen.lNofa **NOTE the o SIGN, ® STORMtMtA81 w . 1•=lar snek map ald mq IqT Heel D Bros ore oeh DA1A SDURZ PloN wft 4w4rAdo fe k%*er.e 6Ne�eled 6aa 1995 o.lal papary boaadaiet they as rol mn kartont and W.Serali .TopepioplNr ow, rse tnkigWed$ae 1989 oerlel P bYThe Jmms 0 25 �. 50 Nalald Auaaq�Sbrdards d 11is donor actual la t�B�s 6/6�D � UIIIItT COTE n 1011Y9t °f kJgnlconservation.dgn 8/0210:09:38 AM mft%°"° �1A°� i r e f I is f I JV LQII ILEli GIs 1 F Q �c�•c'a�r� } �'��`Asp `; � ! ��!"( � � r 1-4 1 Homeless not Hopeless Inc. 310 Ocean-S N Of .7znsTAB.LE Hyannis MA 02601 508-957-23 3 li� 57 To: Town of Barnstable l SI$T c4 .T Regulatory Services Building Division Mr. Thomas Perry, CBO 200 Main St. Hyannis MA 02601 Dear Mr. Perry; Your letter of January 19, 2011 requested that Homeless Not Hopeless provide the Town of Barnstable with a report of the Education Program at 119 Baxter Road, Hyannis. , In order that the numbers in the attached report make sense I submit the following. A. The building was not inhabited until late February 2011 due to cosmetic improvements and the installation of a door and fire escape to the 2nd floor. B. 19 men lived in the house during the period covered by this report. C. No more than 8 men plus the house manager at any given time. D. 5 of the original 9 men still live there E. 6 moved into their own apartments F. 5 men were discharged for Infractions of rules Should you need additional information or have any questions regarding this report please call me at 508=776-7325. Thank You for your help in making this possible. Sincerely Rev, Deacon Richard . Murphy Sr.—Treasurer .v 1 g�l[. -` � A 1. - .( f,, fk i'•E,�.. Vie Offer A Land Up,..,lot'A Hand Out"' ' ` :�-- Homeless not Hopeless Inc. 310 Ocean St. TOWN OF RARW TA�!LE Hyannis MA 02601 713 210 J# 508-957-2334 DRI it �-3�;i t To: Town of Barnstable Regulatory Services Building Division Mr. Thomas Perry, CBO 200 Main St. Hyannis MA 02601 Dear Mr. Perry, w Your letter of January 19, 2011 requested that Homeless Not Hopeless provide the Town of Barnstable with a report of the Education Program at 119 Baxter Road,Hyannis. Attached please find our report.for the year 2012. Should you need additional information or have any questions please call me at 508-776-7325. Thank You for your help in making the HnH program possible. Sincerely Rev, Deacon ch J. Murphy Sr.—Treasurer "We�Offer A�'Hand'Up;=Not A Hand Out" Homeless Not Hopeless -- Education Tracking February 2011 —February 2012 Activity Number Trained Hygiene and Housekeeping Hygiene --Personal Appearance/Showers Etc. 12 --Personal Living Area Neatness 19 Housekeeping --Sweep/Vacuum floors 19 -- Windows 19 -- Clean Bathroom 19 --Food shopping list 12 --Prepare Evening Meal 12 --Mow Grass 8 --Rake Grass/Leaves 8 Social Skills -- Treating Others With Respect 19 -- Respect for Others Property 19 -- Community Dining 19 -- Negotiating TV Channel Preference 19 Projects -- Paint—Fill cracks, Prime, Finish coat, clean tools 5 -- Carpentry Repairs— Window and door Trim 6 -- OtherYard Projects—Planting Flowers &Shrubs 8 -- Other Projects -- Tile work, Install flooring 12 Business Training --Allocating Income 12 --Savings 12 -- Check Book Reconciliation 12 Fill Out Forms --Food Stamps 19 --EADAC 19 --SSDI 4 -- Application for Health Insurance 8 --Application for Medical Attention 8 --Job Applications 16 Computer --Basic Operation 16 --Internet 16 --E-Mail 10 --Job Search 10 --AANA Meeting Schedules 10 Homeless Not Hopeless -- Education Tracking Year 2012, House `119 Baxter Road Activity Number Trained " HousekeepingF --Sweep/Vacuumfloors 15 -- Windows 8 Y -- Clean Bathroom 20 " --Food shopping list 10 --Prepare Evening Meal 25 --Mow Grass 2 --Rake Grass/Leaves 5 Hygiene --Personal Appearance/Showers Etc. r 15 --Personal Living Area Neatness 10 e Social Skills -- Treating Others With-Respect 20 " -- Res ect or Others Property 20 -- Community Dining 20 -- Negotiating TV Channel Preference 20 Business Training --Allocatin Income 15 --Savings 11 -- Check Book Reconciliation 5 Fill Out Forms --Food Stamps - 20 --EADAC 20 --SSDI 5 -- Application,for Health Insurance 10 --Application,for Medical Attention: .6 --Job Applications 25 Computer --Basic Operation 15 --Internet 15 --E-Mail 15 - - - - ----- Job Search 20 --AA/NA Meeting Schedules 20 Literacy Required? YIN Program on next page Personal Needs and Addiction ' Meetin s ? 25 Study Big Book 10 ' 4rn Step Guide 10 Sponsor 15 Primary Care Doctor. . 25 k l P)t Town of Barnstable Regulatory Services BARNSTABI.E s � Richard V. Scali,Director- ' �� 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 February 4, 2016 Homeless Not Hopeless, Inc. c/o Attorney Peter L. Freeman c y 86 Willow Street Yarmouth, MA 02675 RE: Site Plan Review#001-16 !Homeless-Not Hopeless;Inc. '45_Newton Strdet;Hyannis, Map 308, Parcel 158 Proposal: Property to become a home for up to 14 men, plus a resident manager, who are or, have been recently homeless. The purpose-of the home is to teach the residents to live independently by teaching life sills and providing education. The proposal is to connect the cottage to the main house with an addition of approximately 484 sq.ft which will include 2 new bedrooms. .The existing premises will be renovated to provide 2 bedrooms in the cottage, 4 bedrooms in the main house second floor, and 2 bedrooms in the main house first floor for a total of 10 bedrooms. The entire . structure, as so connected,will be sprinklered as per fire and building code. Dear Attorney Freeman: At the formal site plan review meeting held Feburary 4, 2016,the above project received approval subject to the following: - • Approval is based upon and must be substantially constructed in compliance with the plans entitled"Site Plan of#,45 Newton Street,Hyannis, MA", prepared for Homeless Not Hopeless, Inc. by Down Cape Engineering, Inc., dated January 15, 2016, last revised January 26, 2016; and"45 Newton Street, Hyannis" Elevations and Floor Plans, Existing. and Proposed, 9 Sheets prepared by Fine Line Architectural Design, Osterville, dated 1/27,/16. y 7 f . k • Consultation with the Hyannis FD for fire safety alarm and sprinkler system equipment is required. Fire flow calculations and utility plan will need to be provided to the Hyannis Fire Department. • Drainage calculations for the site and the provision of one perc test in the area of the proposed dry well will require DPW approval. • Revised plans depicting the existing sewer lines and the relocation of proposed drainage and other utilities must be provided to the DPW and approved. • Existing domestic water line must be upgraded to a 2"line coming in from the main. A separate water line for fire sprinkler service will also be required. Consultation with Hyannis Water Supervisor,Hans Keijser for design is required. • Requires the determination of significance from the Barnstable Historical Commission. • A description of the educational program and activities provided by Homeless Not Helpless, Inc. will need to be included in the building permit application.. • Applicant must obtain all other applicable permits, licenses and approvals required. :r Upon completion of all work, a registered engineer or land surveyor shall submit a letter of certification, made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan (Zoning Section 240-105 (G). This document shall be submitted prior to the issuance of the final certificate of occupancy. A copy of the approved site plan will be retained on file. Sincerely, Ellen M. Swiniarski Site Plan Review Coordinator. CC: Tom-Perry,-Building-CommissionerY Amanda Ruggerio - DPW Health Dept. Hyannis FD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' Map 1� Parcel i� �� Application.# Health Division \ , �� Date Issued Conservation Division p,6�E Application Fee Planning Dept. 1gWN d�QP Permit Fee Date Definitive Plan Approved by Planning Board o Historic - OKH _ Preservation / Hyannis Project Street Address e. , Village \� �, -'�\ SS Owner o Me `eS Address a \6 Telephone Permit Request �a►-� �r 4 �c� ��v -� � l �-� Square feet: 1 st floor: existing 14ODproposed36 0 2nd floor: existing proposed O Total new (n� Zoning District Flood Plain Groundwater Overlay Project Valuation 'g ® Construction Typew! \A - 4m e— Lot Size \0, 000 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) _ pPXXA Age of Existing Structure 4smns Historic House: ❑Yes Z1 No On Old King's Highway: ❑Yes JIB No Basement Type: Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) C�(,219 Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing 0-new Total Room Count (not including baths): existing �,� new First Floor Room Count Heat Type and Fuel: )4 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ONo Fireplaces: Existing New Existing wood/coal stove: ❑Yes �4 No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:4existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes *No If yes, site plan review# Current Use-WVQC 1k,,a1!\ (�oiL Proposed Use SA-fn-e- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name SN4 J Telephone Number Address It Q�A License # ©�5SCO`S Home Improvement Contractor# Email S � 3 S°�, ' AAAta, Q6,M Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Lo FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME O-r �Ul INSULATION I-""O- . U,00 9!G A, FIREPLACE ELECTRICAL: ROUGH FINAL I PLUMBING: ROUGH FINAL OAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. A TprC wide to Wbad Carrstr-=t oa irr H'g14 ri recta:I10 Frzpfr end�arze I a ch�t�ef� CheckU3t fay' Comoa*nC:e(18b.ChIM moo; 11 Vira d S epd — _ 110 mph p {3-se¢gust}_ . Nlrind ExpQm CatexJory S Oneeang2egtl6e _- 12 APPL.ICR.B1L11Y - --- - --.I�1Lniiber ties ja iDofiurtndi exceeds Bin 12 slaps_W be-�onsidered a sib y)- -Swes-< - Rnof P -- - (Fig 2) _ 12:12 ' Mmm Rc of Height --- (Fig 2) -- — -`'33• Building WIdul,W (Fig 3) — c BD' aLddarg L angq L. _ _ Cqg 3) _ft s BD' Building Aspect RafD(LlYd} _ (Fjg 4) .s 3:1 ' Morainal Height of Tallest Dpening' _ (Fig 4) 5H' • 13 FRAMMG CONNECT[ONS GwIeral mraprianm w1h trarning cannacZms (raWm 2-) ---- 2.1 FOC NDATlaN FoundaAdn Waft meeffng re:qui=ercis of 7BD CMR 5404.1 - • Canes- --____._.___._.__._. .__..�------ .------ ----- ------ ----------•------ - -._._. CancrEb--Masonry 22 ANr_HORAGE TO FDLJNDATIDR 1,3 513"Anchor Bolfs•imbedded or SW PrDpjetdy Mechanical Anchors as an abinuffm in mngete aniy Bolt 5�c�tg-general._. - ----•_-• ----- (Table 4} in_ Batt spacu"g from endfjo'mt of plats (Fg 5) in_.5 G`-12'. _ Bolt Embedment-mncrete (Fig 5)_-- m y 7' _ BottEmbedment-masonry _' - _ (F)g5) i' _ 1n->1S, Pi-s Washer. (Fig 5) }3`x 3'x YT - 3,1 FL ODRS - Floorfr-aging mernberspa=checimd. (Pes 73D CMR ChapfEr 55) Maxanum FloorOpenlmg D'rmeermbn (Fig 6) IV Frig height Wall Studs at Floor Openings le-sm ifmn Z from Exte for Wan Fig 0_----------_. _...-__....-.. hrl'axIInimt FlonrSoist SetFcacks • • suppa M Laadbawbg Waifs Dr ShmnvaI! -(Fig 7) --- d f mdrnum Camlevered Roar Sotsfs Supporfkt Laadbearing Wails Dr SheatvaIl---(Fig 8) FlaorSradng Ehdwarle —C9g g)- - - Floor SheaEfilrig Type (per7S0 CMR Chapter 55} — Floor Siie:a�g INN imess -(Per no GMR ChaptEr 55) Floor She thing Fasts:mg (Table 2)-_d rimls at in edge/—in field , - cLt WALLS S � f_ Wall Height Lnadbealing walls - FFU 1V and Table 5)- fr 51 w rt Nc%hq aad5mubg waft- (Fg 10 and Table 5) —tt'S2D, wal Stud Spacing ., (Fj_q 10 and Table 5) .—_ire 5 24=o_m • Watt Story Diets -(F_cp 7&B) —ft d ' 4.2 8XIERlDR'-1 ALLS= WDDd Studs Laadbeariag raILs— _._ [Tai�l�?) . --..2x - it _ Felon--LDadbearing walls._--- -:(Table 51 Gable End Wag Bracing t Full Heig'htEndwA- $iWds --(Fg ID) WSP,Aff;-.FSapr Length 'Fig 11}'Gyssn CeSn9 Lengtr.[tf dSP nat us (Fr 11 ) $ D9W - _ abd 2 x4 CcutStruovs Leal Braie 9 B fr.cLE:--(19911)-----__-__. Dr 1 x 3 miling ftarmg sfa#Loy 1T spaying-rrral. 2 x 4 blDc g @ 4 ft spacing in end jnrst orhms bays D �rm,L (Fig 13.md Tabf.a 5) ' -- _ft _ Spnm CDmacgm (rin:of 15d mrfm on nails)' tTabie E) — A T-yC'Guide to Wood C gfr Wtkd it amy: II D Faph a'rfl d ZZMa - Massachusetts Check far CompBaace mo c viR_53ol z rsji Laadboming Wall ConnacSDns - - - - la (nD_of t Sd corranon earls) (Tables 7) - - HDcI-LUedbearing Wan CDnne`cSons L-Aeral(no.of 1 Bd common naffs) (Table a) Load Searing VVafi Openings(=Md WgeSt DPMWg but dzeck 82 Dpe=_9S for copipfrance to Takla 9) Header Spa-M (Table 9) —ft in.51 t` SM Phis Spans (Table 9) — FLA Height Shads (nD_crsfikL l (fable 9)_. Non_�d Bearing Wall Openings Cr=w d largest opening Wit check all Dpenmgs for campliance fa Table 9) Header Spans------ (Table 5). _ff_in-5 Iz SM Prate Spans-_ _ (Table 9) —ft_in 51T Full Height Studs(nD.of studs) (Table 9) _ 6deriorWalt sheathing is Resist Upfdt and Sheaf Sfmuffaneau V _ Wh imum 13dld-rng Dimension.W - MDmhrF4 Height DfTaliest Dpen!D2z •---_-_----- —5�� - sheathing Type (nots 41r - Edge Nail Spacilig (Tables 10 Dr note 4 iF less) fm Field Nall Spacing.— - (Table ID) fn_ Shear Connection(no_of 1 Sri common nalLs)(Table 10) Permnt Ful�-Height•Shea$►ing. - (Table- 10) 5'�Addr5oral Sheathing fot Wall h Opening>.S'a7(Design Concepts) f, a)jT ,m BuUdmg Dimension,L _ Nominal 5S`T Sheathing Type (nDt--4)-- �— • Edge Mail Spar ing— (7`able,I1 Dr nDis 4 if less) Field Nail Spacing (Table 11) m- Shear Connec6Dn(no_Df 15d common naR6-)(Table 11)—. - _ Parcent Full-Height (fable 11) 5%AdditlDrid Sheaffring fDr Wall with_Dpening Y S'a'(Desig Concepts)_ Vtfali Cladding - - RahA for Wind Speed? - - — - 5-1 FODFS _ Roof fi-am ng member-spans cheer? (FDr Ftn fPrs use AWC Span TDDI,See t3BRS Wei) kD6f Overhang -- --(Figure 19)—-- ft!9 smaller of 4 Dr LI3 Truss or Ratter Connec56ns at Loadbearing Walls - Propriet$ry ConnedDrs - _ _ ' Ups (Table 12)_ U= Pff i aigral. (Table 12)_ _ _ P� _ Shear (Table 12) S= .plf _ Ridge Strap CDnnecgDns,if cDllar yes not lrsed Per page 21-- (Tab)e 13) - T= pif _ - Gable Rake DADDke-r r._ (Fgura ZD)._ it s smaller of 2`Dr LIZ Tr jss Dr Rafter CannecflDns at Non4madbeMng Walls - Proprieiary Cormacbrs - Uplift_ (Tabu 14) [� m- Lateral(nD_Df I5d common nark)—(Table 14)------___.,______..___..—L= . lb. Roof Sheaftr g Typa (per 7B0 CANR Chapters 53 and 59)------------ Roofsheaffling Thickness— - —irL>_TI16'WSP RDDf&maff-dng Fastening -(fable 2) _ •1. - This Est&full be met in ft enS'eLY-exdudmg the specfrc exr:epfiDn nDted in 2,to comply With the nq&ePer t Df 7BD CUR53D121_1 !tern 1. ff the check sit is met in rls entirely fizen the fcAmng metal straps and hold dDwis xr-nDt requrteri per the WFCM t 10 mph Gdde: - a. Sfeel Scraps per FgLm 6 b. 20 Gage straps per Fagwa 11 - - c Upm saps per Frgrae 14 - d All Straps per RgLm 17 e_ Comer Stud Hold DD►Yns per Frgiae 1Ba and Figure 1Bb - - 2. -F tjD=Dpeizuzg freights Dfup.in a tL shaII be permitue.I when 5`�is added fn the percent fait height sf�titing •regain=rrierrt sho�sai in Tables 10 and 11. 3. The botbm StB plate in extidor wolfs shall be a minimum Z h nDminal thicim presmze iR ode_ f -AFFCGaidefo Wood Conrfruc6ort.rr1��f HrmdAreas_'119I ph H1TAdzGnz Massachusetts Cheer for Comp-`Hancc CMD CrCt53.012L I_I)r 4. _ a- From Tables ID and 11 and location of wall si eaflvng and gul!Ervig Aspect Rafio,determine Petrant FuII-Heigfzt Sheathing and NA Spacing requiremerft b. Wood Structural Panels slid be minm u m'fhidma=Df 7116'and be inslalled as follows: - - L Panels shall be hsblled W5 strangth a=s para al to suds. u. All horkmW joins shall o=rr over and be;nailed to framing RL Dn single stoty mnstruc@oN panels shall be attached b bottom plates and inp.tnember Df the double --- --- — -------- top -------_------.._-- --.—�z—Dn&ua.stnry_canslnrr_Son upper-PanelsshalLbeabached.todfretopmamber-of-fhe.upperrbublefnp plala and b band jorst at botforrr of panel Upper attachment of lower panel shall be made to band jorst and lower attachment made to lowest plate at first fioorframing. v. HoriznntW naH spacing at double top plates, band jo-rsts,and g"rrders shall-be a dDL61a now of Bd staggerad k 3 imdhe$on cerilar pet figures below:Vertical and Hod=ital Nar`I'rng far Panel Affaci ment S. Glazing PratPsfiorr a)new house orhorimrrfaf addition—required lfprojecfls 1 mule orciaser•in shore(gr=neralf r,soufh of Rfe.ZB or nDrfii of Rta.5) b)vertical addffian—not regL ed unless tfhere is e--bar renovation in$he first fiDDr ' c)replacemer>fwiridows—met=ds energy tansenratiDn�urripffarr�only(chap 93) ' E.Wood Frame CDnstrudion Manual(WFCM)for 110 MPH, F�,•postlre B may be obtainedfrorn the Armmricah Wood Councrf[ (AWC)webs - [i y Wj CS C2 IS K N cE Lp • - ii fl� ' F ' [ t - f[ t tl rt tl li. r[ < r r [t CL [ - I _ (�. l� _a �p,[ � [ F�F—j`dr73�r�[T•c - ,I Lf ra tl r y ■ 1 E xv Itttt qq 1 I j .o ,i if► i 1 t ` i i w f l t [ a s ht'rr g PARS- Sea Dal Dil Na:xf Page VerEd and HDr¢DrrH Nailing � DA ' � JJ rni�l Brat HoriMrrfaI Naifmg . - for Panel Afiarlhnteihi for Panel Aftsc.htrterii: - . .77m Camnromreath qf_ assadrusetls Depar rneut afrud s—&i Accide7ds Office ofins dfiens. 600.Wadiurgion meet ' -- Boston,? 4 02I71 " x*�vx'samas�g��i�ia • Workers' Cumpensaf n Insurmre AM avi-t:B•tildersICuntractur-JE ec&iciansJPhmhers Appliant Inform atigu Please Print F z Y Ns f. \ Address: City/StatelZig CQ v v`` qg . PhaM- � '�'� �a to Ca Are}au an employer? eckthe appropriate bad r„ Type of project(retlmired).: L 19,I am a employer with. 4. ❑I am a general coufmctar and I • employees(fall anNor part-i )-* �e lured Me sub-coaftactom 'o °a 2.❑ I am a sole prvprietot orpattaer- fisted aa.the a4ta6ed sheet 7_ RPmodeligg slop and have no employees. These nab-conhactors have ❑DemoliUoa woddng forme in any capacity eugloress andhare wo&ers' [No wadoftrs!MMP-insu =5 comp_imarany $ g- �Duildmg adciifion required-] 5. ❑ We are a coipmafim and its 10-❑ElecEFical repairs or adaions 3_❑ I ama homeowner doing all wwk offers have eseressed their 11-❑Plumbsagrepairs or addifizam nqze1f rif 8 workers' - rightrightof esempfton per MOL ;�+ requ rEdj i c.152,§1(4),andwe'haveno 1-7 El Raafrepasrs employ=[No workers' :13.0 Dtfier cam-msumnw requirefl •ltayapg& H�atchedsboxfl—sYalsoffia�thesectioabe�awshasvugs�eawadcess'compP,:�A•••poT+cpi�mmsao� fi�ameownerstrhosubmitcfiis�idacuin riti�g8�eyax�t3ai�slF�a�csadtbffi]gxzavtsidecoa��+��Stmlimitanewafdaa ;airsfirsacTL FCoatrscfaes3ut ehackiYs time mast attarhed saadditional dmd shoving thename of the mb-�mxmd stafe whadm arnatlbnre auktieshave employees.If emg gyea,tfiey'mnstgm-.*L-thA!'v trarkes'imp.gaIicg aumhez I am are erripL�r t7icrt is prat-�iriutg n�orJ€ers'caa �srrtirrtt ufsruartca�or�c�*e�rcFfn}�ees SeIaav is riTte paTicy ar¢d jab sif� �forrrsaffran ,p � Issuance CampanyI\rame: Palicy or Self-ms Lim_ �[ \�y '� ��(�tS FspisatinaDate \Q Job Site Addse= CitylstaW : • Attach a copy of the workers°compensationpolicy declaration page-(showing the poficy b and ezpaation date}. Faihm to secure coverage as requifedunder Se4cEica 25A of MGL a 1527 can lead to tIae imposition of criminal penalti s of a Eme up to$l,50D GD amVor ar>e-yearimprisonmmk as weIl as civil peualfies in the form of a STOP WGRK ORDERand a fine of up to$250_D Q a day against the violafnn Be adidsed throat a copy of this zbdement maybe f xwarded to the Office of Ivvestegafions ofthe DIA for insn=jff coverage y ou Ida hereby c r ul the s � ' 4R fFZ j UY thethe]kfarma6=proi•' abct�is bw and c arrect � Sia� a: Date_ \It [},ftfid use a7dfy: Do ilia write in fkfs irrerr,ter be completed by clip rart2wn 40jokiat Cky or Tawa: Perri icense:9 Issuing AufiariLT(drele one): . L Board of Healtfa ?:.BurTctiag Deparfn ent 3.#Ryffown aerk 4-IIectdcal Fuspertr S.Plumbing Inspecter 6.Other Contact Person: Phone#: Tuformation and Tnstmetioas `to Va¢i. &aampensation RE1heir eq loyees. I�+Lassac��e#ts ceueralra�s c Isz regah�es aII�I� 1�� " pursuant tu,this sue, Brrployee is defined m. .e =y pctsan m.die service of another uader aap ccmtract cfhi, , egpMss or mxplseCL Oral or w� An Mayer is de fined as-am �,p � as daf on c, mporafion or other legal entity,or anY two or mmr- of the foregoing etng m a3omt eoterpnse,and inclndmg the Legal�es�Yfafives of a deceased employer,ar t3oe receiV=or tryst=of an b&;v Zml,pip,association or oth.es Iegal entity,employng=apIopexs. Mowever the ownerofa.dwe mghousehavingnotmorethanthreeaparhnentsandwhoresides ortheoccupantofthe - dw Mag house of anDffim who e1nploys pecans to do m ee,�"„ r+'on or repay wff on sucFt dWeIlmg house or OIl the grounds or bmldmg appmftnart$ereto s6allnntbecause of shah emplopmm the deemed to be an enployea" GL cbapter Ih2,g25C(t7 also stafm that every state or local F.icensnag agency shall wrtlihQId ffie issuance or renewal of a Ecen a or permit to operate a business or to construct buuffdings n¢the commonevealfii for nag aPP&cantwho has notproduced acceptable evidences of c6mPEance with the Inca nce covexage regai7red.', Addrdonally.M(H-chapter 152.925CM stairs=Neither the==-mw=M nor ii3y ofifs poIHCal sobEvisians sbaIl e�inriutoanycoairartfurthep�rf� ceofpnblic Ozic�Zacceptableevidenceofcamplian=VMI.the;ncoranee. req=Mmeafs of this cb-a j �have been present�d in the Corkaccti g aofhoaty." A-ppIkzn-b Please f�oil the workrss'compensation affidayit complIy,by g t boxes aPPIY to your situation and,if s)name(s), addresses)and phonennmber�s) alongvitherrcert�cstr(s)of necessa�.Y,supply soj��s) wi(hno to ees other than.the insurance. LimitrdLiabMty Companies(LLC)or LimitmiLiabl7ity P p (LLP) �P Y members or pares,are not reqaH-rd to Cant'VMrkC& campensatcon Tnsm-an ce. If an LLC or LLP does have employees,a policy is requi ed. Be advisedthatfois affi&ykmaybe sahmi d to the Department of Industrial Aceideofs mr confr�aiion of insai'ance coverage- Also be sm-e to dga and date me affidavit. The aidavvit should be rst mned to ELe city Or town that the applicafion for the permit or license is being regIIest not the D epartment of ; hidmsfi i I Ac;ddent-, ShDUHYi ra hag0 any questions regmTmg fhe I-rw or ifyou are ret�to obtain a 710330 S' co�ealsa onpolieY,Pease can the DeParfine�at file numbmr HS ed below: Self-hmumd�panies should eA�S their self-msarMce license number am the appropziain Mina- CUy-or Town Officials_ Please be sore boat the affidavit is complete andprfirbedleglly- The Department has provided a space at the bottom of the affidavit for you th:EL or±in the evesut the Office ofInves6gations has to coact youreg-rdmg the applicant Pleas e b e sure to f M is the pen/l cense mnabcs wlh chwM be used as a re:fr=ce number. In"addiiiorL,an applicant fliat must sabmt 3aUbt PIe p=MitUcense appHtafims m. en any giv Year,need only submit one afdzda:�h indicating c nmt policy in Eb atiOn(if necrsarY)and under".lob Site Ad drtss"the aPplica should v e"aII Iacaticns in ( Y town)-""A copy of the-affidavit that has b=u o.ffiGially stamped ar mmi=d by tare city or town may be provided to fhe appHcmt as proof that a valid affidavit is on file for B:d= putts or licenses A new affidavltm ist be fined out mach year.Where a home owner or cbizen is obtaining a license or pmLit not related to any business or commercial vaOtam . tie.a dog lic:emc or permit to burro.leaves -)said P�cm is NOT regired to coMPIete,this affidavit TheOfaeoflnYestigdiMSwovldlketothanky Uinta&nice'furyonu:cocpeaz'ionandshousldyoubaveanygaesfrcms, please do not hesdatc to give-M a caIL i The Departmefs address,telephone and fax mnnbm-- CortbE of Massar,1in. s Departramt of Iiamtdal AmUent- ' - '' 64'Wn Baghu.MA Oil II Tt,-L.4 617-7 -4900 Q�±4€6 or 1-V-7-MA.S M Rev ed4-24-07 w tr Town of Barnstable Regulatory Services orIMERichard V.Scali, Director r: Building Division """p'• Paul Roma,Building Commissioner MAM 639. #A 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 '` Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": _ name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER . - �, .•r ` r Person(s)who owns a parcel of land on which he/she resides or intends to reside,,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use,and/or farm structures. A . person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. ,. N The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official "�'-• t ..' y 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. x" HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the-provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner eugages_a person(s)for hire to do such work,that such Homeowner shall act . as supervisor." ` ` ' Many homeowners who use this exemption are unaware that they are assuming the responsibilities of ' a supervisor(see Appendix'Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) . This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed• persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. ' To ensure that the homeowner is fully aware of his/her responsibilities, many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a. Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend 'and adopt such a form/certification,for use in your community. , • F Town of Barnstable Regulatory Services A& Richard V. Scali,Director. 39. Building Division Paul Roma,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 A Builder I, e A'u N Q �� , as Owner of the subject property hereby authorize S to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final spections are performed and accepte j Signature of f Signature of pplicant o r k� CA Print Name Print Name Date A QTORMS:OWNERPERMISSIONPOOLS ACC> CERTIFICATE OF LIABILITY INSURANCE 711/06/2015 TE(MWDDNYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING.INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Kathleen Geddis NORTHWOOD ESHBAUGH INSURANCE AGENCY, INC. PHONE , SOH 771-1632 a No: ADDRESS: kgeddis.north24@insuremail.net 540 MAIN ST. INSURERS AFFORDING COVERAGE NAIC9 HYANNIS MA 02601 INSURER A: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B: DEAN F STANLEY BUILDING CONTRACTOR INC _ INSURERC: INSURER D: 359 CAPT LIJAHS ROAD INSURER E CENTERVILLE MA 02632 FINIURERF: COVERAGES CERTIFICATE NUMBER: 10754 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPEOFINSURANCE POLICYNUMBER MM/D MMN LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAM AGE TO RENTED CLAIMS MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $, AUTOS AUTOS , � NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ TDED CESS LIAB CLAIMS-MADE N/A AGGREGATE $ I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N r X STATUTE ER -. ANYPROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT. $ 100,000 A\ OFFICERIMEMBEREXCLUDED? WA WA WA 7PJUB2E49857515 - 10/08/2015 10/08/2016 (Mandatory in NH) E.L.DISEASE'EA EMPLOYEE $ 100,000 If yes;describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $" 500,000 NIA DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration.date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN Of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 507 Buck Island Rd. AUTHORIZED REPRESENTATIVE W Yarmouth MA 02673 ,,\�� Daniel M.CroV ey,CPCU,Vice President-•Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) .The ACORD name and logo are registered marks of ACORD t Massachusetts Department of Public ' Board of Building Re gulations and StandardsSafety License: CS-035037 Construction Supervisor DEAN F STANLEY 359 CAPTAIN LIJAH ROAD y CENTERVILLE MA 02632 a I Commissioner Expiration: I, 01/19/2018 r for individul use e xu�er��z a License or registration vali If found return to'. ��, 00„�,r.a iration date Regulation before the exp j l Office of Consumer Affairs&Business Regulation Office of Consumer Affairs and Business OME IMPROVEMENT CONTRACTOR Type: I 10 Park Plaza'-Suite 5170 egistration: <.Z932149 Individual Boston,MA 02116 + xpiration =°;111281�016 _ I I ' DEAN F.S1. LEY ` = I r I STANLEY DEAN I o y I of valid withou signatu e 359 CAPT.LIJAH RD <; �- �- ` CENTERVILLE,MA 02632'- Undersecretary i _.--- I r Town of Barnstable Building Department - 200 Main Street * MULE ► " , • Hyannis, 16gq. s, MA 02601 MAS& (508) 862-4038 RFD MICI A Certificate of Occu anc p Y . . Application°Number: 201400103 CO Number: 20140082 Parcel ID: 310059 CO Issue Date: 07/02114 Location: 119 BAXTER ROAD Zoning Classification: RESIDENCE B DISTRICT Proposed Use: CHARITABLE HOUSING OTHER Village: HYANNIS Gen Contractor: RALPH CROSSEN Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: 2 � Building Department Signature Date Signed THE FOLLOWING IS/ARE THEBEST IMAGES FROM POOR ' QUALITYDRIGINAL (S) J L DATA TOWN OF ► T�,7``E oFt"E Building 2014.00,03 BARNSTABLE, " Issue Date: 02/03/14 Permit y MASS 1639. Applicant: RALPH CROSSEN RFD A Permit Number: B 20140221 Proposed Use: CHARITABLE HOUSING OTHER Expiration Date: 08/03/14 Location 119 BAXTER ROAD Zoning District RB Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 310059 Permit Fee$ 102.00 Contractor RALPH CROSSEN Village HYANNIS App Fee$ 50.00 License Num 70029 Est Construction Cost$ 20,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND• FINISH INSIDE OF EXISTING GARAGE ADD DORMER-INSIDE 3ED 00tIIS CARD MUST BE KEPT POSTED UNTIL FINAL S 2 BATHS INSPECTION HAS BEEN MADE. WHERE'A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH, Owner on Record: HOMELESS NOT HOPELESS INC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 310 OCEAN STREET INSPECTION HAS BE DE. HYANNIS,MA 02601 Application Entered by: PF Building Permit Issued By: , THIS PERMIT CONVEYS NO RIGHT TO OCCUPY"ANYSTREET' ALLEY OR SIDEWALK OR ANY PART THEREOF EITHER TEMPORARILY OR PERMANENTLY SNCROACHME _0aiWC1CfRPPERTY,NO1 SPECIFICALLY.PERMITTED UNDER THE BUILDING CODE;MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES A5 WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS-MAYBE .. OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS..THE ISSUANCE OF THIS PERMIT DOBS NOT RELEASB THE APPLICANT FROM THE CONDITIONS OF:ANY APPLICABLE SUBDIVISION'S RESTRICTIONS T, MINIMUM OF FIVE CALL INSPECTIONS REQUIRED 1.FOUNDATION OR FOOTINGS. // 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE T �P `' I APPROVED 4.WIRING&PLUMBING INSPECTIONS TO BE COMP TOWN OF BARNSTABLE 5.PRIOR TO COVERING STRUCTURAL MEMBERS( 6.INSULATION. CR GAS 7.FINAL INSPECTION BEFORE OCCUPANCY. G WHERE APPLICABLE,SEPARATE PERMITS ARE PLUMBING IQG STALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPE -� N. PERMIT WILL BECOME NULL AND VOID Iu - '___ IN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE? PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NO (as set forth in MGL c.142A). w . .115 , p BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS , ELECTRICAL INSPECTION APPROVALS.. q! /Y /Y 1 RIUAI, O/C L-A6-1Y4�5T/3 2 2 +. -a� ��, a 2 3 1 Heating Inspection Approvals Engineering Dept nal _30 r Fire Dep l v 2 ,�AZ. C A Board of He Ith — i PROJEC NAME: T 7 ►S ( �'1 G✓ - .L S -�. ADDRESS: : l Gt x4 r2 V1✓11 PERMIT# nn3 PERMIT DATE: l ?� M/P. o�0 LARGE ROLLED PLANS ARE SLOT Data entered '. MAPS program on: 3 DY: 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map. f'.� " Parcel Application #a�C�/ �)/d 3. Health Division Date Issued ^ � f F Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address - Village � �lif1�L S Owner � / d��` � �S Address Telephone .Permit Request l 1 . L Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new ^Zoning District Flood Plain /U14' Groundwater Overlay Project Valuation Construction Type-JG Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documei-lation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes kNo On Old King's Highway: ❑Yes dkNo Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 2 Number of Baths: Full: existing_ new Half: existing _ new Number of Bedrooms: J� existing✓-new c3 Total Room Count (not including baths): existing new First Floor Roq Count Heat Type and Fuel: Gas ❑ Oil ❑'Electric ❑ Other ., Central Air: ❑Yes ANo ; Fireplaces: Exi ting New Existing wood/c Jal stove:_r_❑Yeso ��z7 , Detached garage existing ❑ new size_ ool: ing ❑ new size _ Barn: ❑ e ❑ iw size_ Attached garage: ❑existing ;❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# J Current Use S f��l�� Proposed Use --- APPLICANT INFORMATION r (BUILDER OR HOMEOWNER) MIAName Telephone Number Address License # r�� &GW Home Improvement Contractor#1 c ) Worker's Compensation #kACf-1)�o05"v t T;�'Zb ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C� dv�,. SIGNATURE DATE `� G r c FOR OFFICIAL USE ONLY r APPLICATION# __DATE_ISSU.ED_ MAP/PARCEL NO. ADDRESS :VILLAGE OWNER DATE OF INSPECTION: `r i f-80-UNDABON= 1 ri° -,s:IJNDMILI,� F FRAME JNSULATIONdt�.Ai- FIREPLACE ELECTRICAL:. ROUGH FINAL ; r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING - } DATE CLOSED OUT r , ASSOCIATION PLAN NO. rt y Ike Corr moo walth of Massachusetts Deparment o,f liulusfr al Accidents - Office o,f inve'sfigations 600 Washington Street Boston,,MA 02111 wmv.rnass.gm,1dia Workers' Compe.nsafwnInsuranceAffidavit:Builders/Conti-actnrs/E'lectri:ciansMumbers APPlieant Infarmafian 'lease Print Legibly Name ouiness/Organization5adi z dnaD: Address: ` City/sta&zip:t� Phone g- D �� Are you an employer?Check the appropriate bow Type of project(required): LX—I am a eulpg. zorpart h�_ 4- El star s Viral contractor and i 6_ ❑New won employ ime)* havehtre/the subcontractors 2.El am a sole proprietor or partner- listed on the attached sheet +. Remodeling ship and have no employees These sub-contractors have g. ❑Demolition yr for m e in am c ci c employees and have workers' otjnrrg y spa. t5 - l 9. ❑Building addition �O workers' comp.insurance Comp-insuran 5. ❑ Vile area corporation.and its 10..❑Electrical repairs or additions required]3.❑ I am a homeowner doing all work officers have exercised their 11_❑Plumbing repairs or additions myself[No workers'comp- right of exemption per MGL 12.❑Roof repairs inmtranreregaked.]F c-152,§1(4),and we have no employees.[No��' 13_❑Other comp.insurance required-] aPP t that checks boa#1 mast also Till out the sectioa below showing Their wozlses''coarpensatiau nfa Policy irmafiM �Hn R.Ppi rs who submit this affidavit iudkxdng they are doing aII trade and rhea hie outside contnictars mash submit a nee:affidacit indicating mch =Contractors lbst check this bmr must attached as additional sheet shovemg the name of foe sob-moors and state whedw acnot these m ities hsve employees. If the mT,-contractors hare employees,they must pmade their workers'comp.policy number. Iam as employer that is providing workers'conipensado.n insurance f&my employees Below is thepaUty and job site information. Insurance Compare Name: —}—Polit y ff or Self-ins.Uc.,#: / qoq n L Expiiation Date: r 2 ` Job Site Address: City/State zip: Attach a copy of the workers'compensation polies declaration,page-(showing the policy numbd and expimflon date). Failure to secure coverage as requiredunder Section.25A of MGL c. 152 can lead to the imposition ofrriminal 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 maybe forwarded to the Office of Investigations of the DIA fior insurance coverage vacation. I do hereby certify it pains and Was of fury that the information pratided above is true rind.correct f� Date: Phone 9- (/T3 G?ffEcial use only. Do not trrite in this area,to be completed by city or town official City or Town: Pertmtucense# Issuing Autharity(circle one): 1.Board of Health 2.Budding Department 3.City-frown Clerk 4.Electrical Inspector 5.Plumbing.Inspector 6.Other Contact Person: Phone 9- 6 Information and Instructions r Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"__.every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or IocaI licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to constract buildings in the commonwealth for aizy applicant who has not produced acceptable evidence of compliance with the insurance.coverage required.' Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority" Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificatc(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 Uie 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 Of Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at tb e bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition;an applicant that must submit multiple permit/Ecense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be.provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i_e.a dog license or permit to bum leaves etc.)said person is NOT requited 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 Gonnmonwealth of Massachusetts Department of lndrtsttial Accidents off m of kwstigafions 600 Washington Street Boston,MA.02111 Tel.#617-727-4900 ext406 or 1-9 MAS E Revised 4-24-07 Fax#617-727-7749 W .mass govjdia I - rl f ` �'ME r, Town of Barnstable Regulatory Services MASS. Richard V.5cali,Interim Director i63q. 1� '�o►AP'�" 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 A Builder nn as Owner of the subject property hereby authorize �� C kz SS /1L to act on my behalf, in all matters relative to work authorized by this building permit. Ile? X 7—M 6X>—�, (Address of Job) ` **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or.utilized before fence is installed and all final inspections are performed and accepted. 4Sigaatute of er Signature of Applicant Print Name Print Name Dae Town of Barnstable -. Regulatory Services pFtt Tod Richard V.Scali,Interim Director s °-� Building Division a AeRxc-rARr.F S - Tom Perry,Building Commissioner MACS 9 16;q. �� 200 Main Street, Hyannis,MA 02601 ��EDt www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION ; Please Print DATE: JOB.LOCATION number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109A.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act,as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,.particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that be/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:IWPFILFSIF0RMS\bm7ding permit formslEXPRESS.doc Town of Barnstable Regulatory Services KAM � Richard V.Scali,Interim Director o R Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder 14F a- J—lwo IVI#Y ICA I, `�� 1�� 004t�/�CV as Owner of the subject property hereby authorize C to act on_my behalf, 4 in all matters relative to work authorized by this building permit. l (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final i ections ar performed and accepted. ignature o Owner Signature of App cant v I n tint Name Print ame ate Q:FORMS:OWNERPE SIO OOL -10113 . lUVVu vi Regulatory Services , V.Scali,Interim Director �IK Richard Building Division Tom Perry,Building Commissioner KAM .g 200 Main Street, Hyannis,MA 02601 a 139� A w www.town.barnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 HOMEOWNER LICENSE EXE ON Please Print DATE: JOB LOCATION: street village number "HOMEOWNER": ho one# work phone# name CURRENT MAILING ADDRESS: state zip code city/town sess a license, rovided that the owner acts as supervisor. The current exemption for"home ��' xended to include owner occupied dwellint75 of six units or less an to allow homeowners to engage an indsvidual for hire I 'does FINI"ON OF HOMEOWNER or two- e and/or farm structures. A person who constructs more than one Person(s)s who owns a parcel of land on which he/sh resides or intends to reside,on which there is,or is intended to be,a one a form fa () _ family dwelling, attached or detached structures acces ory to sac ed under the buildin ermit. (Section m a two-year period shall not be considered a ho eowne ble foha 1 such work')erfor shall m bit to e Building Official on homeonsi acceptable to the Building Official,that he/she shall be r - _ 109.1.1) 'ance with the State Building Code and other applicable codes, The undersigned"homeowner"assumes responsibility for com bylaws,rules and regulations. inspection "homeowner"certifies that he/she understands the To of Barnstable Building Department minimum The undersigned procedures and requirements and that he/she will comply with said paoce es and requirements. Signature of Homeowner Appioval of Building Official P Code Not e: Three-family dwellings containing 35,000 cub ic feet or larger will be r aired to,comy with ith the State Building Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION nstruction Supervisors •provided that.if the homeowner The Code states that: "Any homeowner performing work for which a building ermit is required shall be exempt ons of this section(Section 109.1.1-Licensing o act as supervisor.' the rovisi owner shall. from p engages a person(s)for hire to do such work,that such Home ors Section 2:th� his ack of awareness often . Many homeowners whouse this exemption are unaware than they vs re assuming the res nsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction P is cas s Supervisor is .its in serious problems,.particularlywhen the homeowner hires unlicensed The homeowner acting ur Board cannot resu proceed.against the unlicensed person as it would with a bce as art of the ultimately responsible. To ensure that the homeowner is fully°aw t he/she his/her rstandsithel responsibilities- me f amunlSupervisor.� On the last page permit application,that the hond owner certify that of this issue is a form currently used by several towns. You:may care t amend and adopt such aform/certification for use in. your community. ding permit forms\E)CPRESS.doc Q:\WPFILES\FORMS\buil 3. Revised 061313. :,, Mass. Corporations, external master page Page I of 2 William Francis Galvin Secretary of the Commonwealth of Massachusetts HOME DIRECTIONS CONTACT US Search sec.state.ma.usi ; Search ........... ........... ...... ...... Corporations Division Business Entity Summary ID Number: 260604808 Request certificate I New search Summary for: HOMELESS NOT HOPELESS,INC. The exact name of the Nonprofit Corporation: HOMELESS NOT HOPELESS, INC. Entity type: Nonprofit Corporation Identification Number: 260604808 Old ID Number: Date of Organization In Massachusetts:. 10-01-2007 Last date certain: Current Fiscal Month/Day: 09/30 Previous Fiscal Month/Day:09/30 The location of the Principal Office in Massachusetts: Address: 310 OCEAN STREET City or town,State,Zip code,Country: HYANNIS, MA 02601 USA The name and address of the Resident Agent: Name: Address: City or town,State, Zip code,Country: The Officers and Directors of the Corporation: Title Individual Name Address Term expires PRESIDENT JEFFREY HOWELL 144 ROUND COVE RD. CHATHAM, MA 02633 USA TREASURER RICHARD MURPHY 30 ARBOR WAY HYANNIS, MA 02601 USA CLERK RACHEL CAREY-HARPER 10 DOCTOR LORDS RD. DENNIS, MA 02638 USA DIRECTOR NANCY WOODSIDE 401 OCEAN ST. HYANNIS, MA 02601 USA DIRECTOR JOSEPH REARDON 132 PLEASANT PINES AVE.CENTERVILLE, MA 02632 USA DIRECTOR MATTHEW WATSON 650 BRIDGE RD. EASTHAM, MA 02642 USA Fj Consent Dd Confidential Data [A Merger Allowed ri Manufacturing View filings for this business entity: ALL FILINGS Annual Report Ej Application For Revival Articles of Amendment Articles of Consolidation-Foreign and Domestic View fi ings Comments or notes associated with this business entity: http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=260604808&... 1/24/2014 CROSS-2 OP ID: KM CERTIFICATE OF LIABILITY INSURANCE °AT 01/03114 01/03/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone:781-749-4310 CONTACT Walter J.May Ins.Agcy.,Inc. NAME: 230 Gardner Street Fax:781.749.1714 PHONE C No E t: A No Hingham,MA 02043 EMAIL Kevin McGrath ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A,National Grange Mutual Ins. Ralph Crosson INSURED Custom Builders LLC INSURERS:Associated Employers Insurance Ralph 18 Woodridge Rd. INSURER C: East Sandwich,MA 02537 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM$;,. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR POLICY NUMBER M/DD M/DD LIMA GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY MPT4290L 09/25/13 09/25/14 PREMISES Ea occurrence $ 500,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 10,00 X Business Owners PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY I PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acGdent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per acradent $ UMBRELLA LWB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X I WC STATU- I OTH- AND EMPLOYERS'LIABILITY TO Y LIMIT E B ANY PROPRIETOR/PARTNERIEXECUTIVE r/N WCC 500 5012492-2013 09/25/13 09/25/14 E.L.EACH ACCIDENT $ 100,00 OFFICERIMEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 PROPERTY 5,00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,N more space Is required) Carpentry-Residential Dwellings CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Life,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 550 Linclon Rd.Ext. Hyannis,MA.02601 AUTHORIZED REPRESENTATIVE Kevin McGrath ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD e �Gvrrorred�zurecr,ftf a� oe ofiCo*�sk cr E,ffairs$8us�aess fa'ac Reg ':at q OME IMPROV=fy1ENTC014TRACTOR e.2iscration: 136,72 Type: Expirs�ion. __9l23I201,4 D8A I RAt.P:;CROSSEN RALPH:CROSSEN .. DRIDGE RD 18 WOO E.SANDWICH,MA,0253 .- 4 t Undersecretary ` {" ftoz S m JauoIsswwaD uolfejldxg t L£SZO VA H WOWS 3 �Dum(loOM SI SSON7-HdIvg 6ZOOLOW -asuaol-1 losl uadns uo!lan.[tsu(EO spjepue;S Pue suoi;eln6aN 6ulpl!n8;o pjeoB 4afeS:)!lgnd 10 fuawpedao- sgasn4oessew 1 F .g i Cape Save Inc: I 1��itl 7-D Huntington Avenue iE South Yarmouth, MA 02664 UT6 21 4t. , Tel: 508-398-0398 Fax: 508-398-0399 DI 8/21/13 Town of Barnstable Thomas Perry COO Building Commissioner , 200 Main St. Hyannis,MA 02601 , RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for 119 Baxter Rd,Hyannis has been inspected by a certified Building Performance Institute (BPI)Inspector. Ceiling: R-30 cellulose Floor: R-19 fiberglass blanket All work performed meets or exceeds Federal and State Requirements. ; Sincerely,. ' William McCluskey' ' C , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 l o �Q 14 or BARNSTABLE Parcel �J Application Health Division 213tE _ _ ' Date Issued l.�l Conservation Division Application Fee -6-;;b Planning Dept. _�_ `��"- Permit Fee Date Definitive Plan Approved by Planning Board �r �-(�-! 3 Historic - OKH _Preservation / Hyannis Project Street Address Village q I S Owner �knmp,L�$S M e1 qp he Bess 1 Address 3 L Telephone_�iflR Permit Request 1�" 1 a�1 1�-3� L6111A�file 7f o *k, r , a SS -gyp -��,e �&,5C en+ CEi �i �c. �I rya' ��e Al L Square feet: 1 st floor: existing proposed 2ndffoor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation S 0 0 o 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 Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes W No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Q Name e dti� 4 W�I &kt#4L-e/J- TeIephone Number 5 8 3 TO 0319 Address 7_Dke 4V o License# yC 10a.4-7 6 36-0,T f Home Improvement Contractor# t 391 Worker's Compensation # 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO__`I A rnn 0144 113 SIGNATURE DATE FOR OFFICIAL USE ONLY A APPLICATION# DATE ISSUED ti MAP/PARCEL NO. f ADDRESS VILLAGE OWNER DATCOF INSPECTION: t - - FOUNDATION, c FRAME r J INSULATION f * FIREPLACE 3 ELECTRICAL: ROUGH FINAL • y r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING I� DATE CLOSED OUT ASSOCIATION PLAN NO. ti The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 T` Boston,MA 02114-2017 ,a 5 s =' www.mass.gov%dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aaalicant Information Please Print Legibly Name (Business/Organization/Individual): Cape Save Inc. . Address: 7D Huntington Ave City/State/Zip: South Yarmouth, MA 02664 Phone #: 508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): l. ✓� 1 am a employer with _ 4. ❑ 1 am a general contractor and 1 6.-❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole.proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ 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 I I.[] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 1.52, §1(4),and we have no employees. [No workers' 1�•❑✓ Other Insulation 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. ^Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance far illy employees. Below is the policy andjob site information. Insurance Company Name: Technology Insurance Company Policy#or Self-ins. Lic.M TWC3353968 Expiration-Date: 04/09/2014 Job Site Address: (^ G City/State/Zip: 11 S Attach a copy of the workers' compensation policy declaration page(showing the policy numb r 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 certi under the !ins and penalties of pei:' that the information provided above is true and correct. Si nature: Date Phone#: 508-398-0398 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#: ' cam CERTIFICATE OF LIABILITY INC NCE >o°fYYYY' �'" SU� 4/9/2/9/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPOWTHE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CO1 C Colleen Crowley NAMRisk Strategies Company PHONE (781)986-4400 1 FAC No:(781)963-4420 15 Pacella Park Drive Suite 240 INSURERS AFFORDING COVERAGE NAIC� Randolph MA 02368 INSURERA:Selective Insurance INSURED INSURERB:Safety Insurance Company 3618 Cape save, Inc INSURER C:Technology Insurance Company 7 D Huntington Ave INSURERD: INSURER E: South Yarmouth MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBER:CL134960509 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. LTRR - UBR TYPE OF INSURANCE S POLICY NUMBER POLICY FF MPMMI D EXP uMrrs GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMASE To RENTE5 100,000 PREMISES Ea occurrence $ A CLAIMS-MADE X]OccUR S199448001 0/16/2012 0/16/2013 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 " GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,OOO,OOO X POLICY PRO LOC $ AUTOMOBILE LIABILITY Ea a ix de SINGLE I 1 000 000 ANY AUTO r DILY INJURY(Per person) $ B ALL OWNED SCHEDULED 6208200 1/6/2012 1/6/2013 DIIY INi Y{Per accident) $ AUTOS AUTOS X HIRED AUTOS X AUTO WJED r OPERTMAGE $ amde X erinsured motorist BI split $ 100 000 A X UMBRELLA LIAB X OCCUR 199448001 0/16/2012 0/16/2013 EACH OCCURRENCE $ 1,000,000 4EXCESS LIAR CLAIMS-MADE = AGGREGATE' $ 1,000,000 DED RETENTION$ $ C WORKERS COMPENSATION Officers Excluded fromm NCSTATU- OTH- ANDEMPLOYERS LIABILITY YIN X T I IT S ANY PROPRIETOR/PARTNERIEXECUTIVE overage E L.EACH ACCIDENT• $ 500 000 OFFICER/MEMBER EXCLUDED? a NIA (Mandatory in NH) roqC3353968 /9/2013 /9/2014 E L.DISEASE-EA EMPLOYEE $ 500,000 if yee,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 ' a � DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,.Additional Remarks Schedule,If more space Is required) Issued as evidence of insurance. National Grid Corporate Services LLC d/b/a National Grid,- d/b/a Boston Gas Company, d/b/a Essex Gas Company, Action Inc. , and Housing Assistance Corporation are listed as additional insureds as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION ` (50 8)790-2425 SHOULD ANY OF TIME ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS. 484 Main Street Hyannis, MA 02601-3698 AUTIiORIZEDREPRESENrATIVE chael Christian/CLC -ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. r o0 'Hoysing �4 kiwi 4 Assistance . Corporation s Cape Cod HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THISFORM IFYOU ARE THE APPLICANT HOMEOWNER. hereby consent to and agree weetherization work m be t �' may done by the Weatherization Program of Housing Assistance Corporation ( hereinafter referred as "Agency") on the property located at: The weatherization work done wiil be based on programmatic priorities and availability of funding and it may 1ndudea I or some of the folIowing measures Weather-stripping& caulking of windows and doors, insulation of attics, sidewal is& basements; attic and other ventilation measuresand possibly replacement of badly deteriorated windows In consideration of the weatherization work to be done at my home I agreeto thefollowing: 1. 1 give permission to the"Agency" its agents and employeesto travel onto or across said property with such equipment.and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reservesthe right to inspect thefud or utility bill for the weatherized unit on an ongoing basisfor no morethan five(5)years after the weatherization work is completed. I have read the provisions of this agreement asjisted and freely give my consent. Home Owner: (Signature} `f Date: 2 2- Zy i? Agent: (signature) ° Date~ ! f # HAC approved Weatherization Company : a v e . 1. All Cape Energy Cape Cod insulation Cape Save Efficient Buildings, LLC Frontier Energy Solutions - Lohr,&Sons Resolution Energy arlrnent of public safety trow. Massachusetts DeQ utations and Siandards Board of Building Reg Construction 5upen-isor specialt, cense: CSSL-102776 \ . ' Li '-.` wILLiANi J MC C`LUSKEY ' 371 IAUSET ROAD ' West Yarmouth IRA 02673: J yi..i:4 f-xpiration for06128/2015 Commissioner Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 - Home Improvement C.gntractor Registration - Registration: 171380 - Type: Corporation Expiration: 3/1412014- - . Tr# 222184 CAPE SAVE INC. WILLIAM McCLUSKEY - o 7=D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. - - Address ❑ Renewal Employment Lost Card DPS-CA1 0 50M-04104-G101216 -, --------- ✓� TJa�rvnzareruea�! 0�✓l2'«a-saelzuoet>fa Office of Consumer Affairs&B siness Regulation License or registration valid for individul use only Qr- -_-.q HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration- --171380 Type: Office of Consumer Affairs and Business Regulation E � Expiration 3/14/2014 Corporation 10 Park Plaza•Suite 5170 Boston,MA 02116 CA7SAVE INC WILLIAM McCLUSKEY .= 7-D HUNTINGTON AVENUE SOUTH YARMOUTH MA 02664 Undersecretary Not valid with o signs Mass. Corporations, external master page Page 1 of 1 William Francis Galvin � a a Secretary of the Commonwealth of Massachusetts a HOME DIRECTIONS CONTACT US Search Sec State.ma.us Search Corporations Division Business Entity Summary ID Number:042516055 Request certificate I New search Summary for: THOUGHTFORMS CORP. The exact name of the Domestic Profit Corporation: THOUGHTFORMS CORP. Entity type: Domestic Profit Corporation Identification Number: 042516055 Date of Organization in Massachusetts: 03-29-1972 Last date certain: Current Fiscal Month/Day: 10/31 Previous Fiscal Month/Day:00/00 The location of the Principal Office: Address: 543 MASSACHUSETTS AVE: City or town,State, Zip code,Country: W,ACTON, MA 01720 USA The name and address of the Registered Agent: Name: CHRISTOPHER L. NOBLE Address: 1280 MASSACHUSETTS AVE. City or town, State, Zip code,Country: CAMBRIDGE, MA 02138 USA The Officers and Directors of the Corporation: Title Individual Name Address PRESIDENT MARK DOUGHTY 543 MASSACHUSETTS AVENUE WEST ACTON, MA 01720 USA TREASURER MARK DOUGHTY 543 MASSACHUSETTS.AVEN U E.WEST ACTON, MA 01720 USA SECRETARY CHRISTINA JARDINE 543 MASSACHUSETTS AVENUE WEST ACTON, MA 01720 USA DIRECTOR MICHAEL ROSENFELD 389 GARFIELD RD.,CONCORD, MA 01742 USA ' Business entity stock is publicly traded: fA The total number of shares and the par value,if any,of each class of stock which this business entity is authorized to issue: Total Authorized Total issued and outstanding Class of Stock Par value per share No.of shares Total par value No.of shares CNP $0.00 150,000 $0.00 1,000 Ili Consent r Confidential Data Merger Allowed 5 Manufacturing Note:Additional information that is not available on this system is located in the Card File. View filings for this business entity: http://corp.sec.state.ma.us/CorpWeb/CorpS earch/CorpSummary.aspx?FEIN=042516055&... 8/13/2013 f Mass. Corporations, external master page Page 1 of 2 ' h William Francis Galvin Secretary of the Commonwealth of Massachusetts d � HOME DIRECTIONS CONTACT US Search sec state.ma.us Search Corporations Division Business Entity Summary ID Number: 260604808 Request certificate i New search Summary for: HOMELESS NOT HOPELESS,INC. The exact name of the Nonprofit Corporation: HOMELESS NOT HOPELESS,INC. Entity type: Nonprofit Corporation Identification Number: 260604808 Old ID Number: Date of Organization in Massachusetts: 10-01-2007 Last date certain: Current Fiscal Month/Day: 09/30 Previous Fiscal Month/Day:09/30 The location of the Principal Office in Massachusetts: Address: 310 OCEAN STREET City or town,State, Zip code,Country: . HYANNIS, MA 02601 USA The name and address of the Resident Agent: Name: Address: City or town,State, Zip code,Country: The Officers and Directors of the Corporation: Title Individual.Name Address Term expires PRESIDENT WILLIAM BISHOP 200 STEVENS ST. HYANNIS, MA 02601 USA TREASURER RICHARD MURPHY 30 ARBOR WAY HYANNIS, MA 02601 USA CLERK JEFFREY HOWELL 144 ROUND COVE RD. CHATHAM, MA 02633 USA DIRECTOR RACHEL CAREY-HARPER 10 DOCTOR LORDS RD. DENNIS, MA 02638 USA DIRECTOR JOSEPH REARDON 132 PLEASANT PINES AVE.CENTERVILLE, MA 02632 USA DIRECTOR MATTHEW WATSON 1650 BRIDGE RD. EASTHAM, MA 02642 USA DIRECTOR NANCY WOODSIDE 401 OCEAN ST. HYANNIS, MA 02601 USA r Consent r Confidential Data r Merger Allowed r Manufacturing View filings for this business entity: ALL FILINGS Annual Report Application For Revival Articles of Amendment Articles of Consolidation-Foreign and Domestic MView filings Comments or notes associated with this business entity: http://corp.sec.state.ma.us/CorpWeb/CorpSearchJCorpSummary.... 8/14/2013 Mass. Corporations, external master page Page 2 of 2 New search ` William Francis Galvin,Secretary of the Commonwealth of Massachusetts Terms and Conditions http://corp.sec.state.ma.us/CorpWeb/CorpSearclVCorpSummary.... 8/14/2013 Town of Barnstable *Permit# ' Regulatory Services. Expires 6monthsfrom issue date 1 �$ Thomas F.Geiler,Director Xs PRESS 'PERMIT Building DIViSlOn Tom Perry;CBO, Building Commissioner AUG 13 ZgiZ . 200 Main Street,Hyannis,MA 02601 www.town barnstable.ma us ore: 508-862-4038 TOWN OFFRc ' EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number, ( D D 5 Property.AddressIq a V�- ❑Residential Value of Work Minimum fee'of$35.00 for work under$6000.00 Owner's Name&Address IA0rKe�,-55 U �nG 3� DG CGtiL Mu�� 5 9. Contractor's Name (� a `7 Telephone Number_ 7rL 7 2 = 1 Home Improvement Contractor License#(if applicable) �2 Construction Supervisor's License#(if applicable) C�S L l o5 9 5- ❑Workman's Compensation Insurance CKEI one: 1 1 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 accompany each permit. Permit Requ t(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping.'Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Co actors License&'Construction Supervisors License.is r uire i SIGNATURE: Q:\WPFdM\FORMS\building permit forms\EXPRESS.doc Revised 053012 3; The Commonn eaki o,f Massacku setifs Depwhnent ofIndushialAccidena, i` OJT"Of Invwtigalivns 600 Waskiagfoa street Boston,MA 02111 i� m�gtrvlditz. Workers'. Compensation Insurance Affidavit B erTlConbmckws/EkctricianstPhunbers ApyUcant Information Please PrlIIt Leidbly Na=(E1IsnaM'011;833i2:atioo/incliv dual}: Address: 422 i3, �, (-CK cityistata(zip:' ..5 D26 Are you an employer?t:hec7€the appropriate box: Type p of roect.r] { �Iuired)= I_❑ I a employer with 4. ❑ I am a general contractor and I 6: ❑New on loyees(fr�11 andfarpact-time),.* have hued the sub-contractors 2_E Ian a sole ietor ar - . listed on the attached sheet.. T .❑Remodelingelm �� ship and have no enVIcyees. Tie sub-contractors have 8. ❑Demolition o and have workers' working for mein any capacity. '� 9. ❑Building addition [No workers'COUIP.uISU anCe CAISY -msuranoe,.$ 5. ❑ We are a ctxporstion and its , 14_❑Elecuicai repairs or additions 311 iamah doing'all wo& .. officen#save esetrised their 11_0 giepairs ar.adrlitioas m3yself[No workm,'comp. fi&of e$empfiian per IwIGL 12. Roof repairs insurance ram].l c.152, §1(4),and we have no emPmSees-[NO Workers 1311 Other comp.insurance required_] �1�inyapplicantttatcheciesboa#lmar#alsoflio=treesmtkmbe3bwshovinj1bxdr aAerec mp mp� �9 *�m Homeowners arho submit this affdar*imdks&g they are doing all waat and then hire outside con wwn must sm miit a new affidavit indicatmg sacb. IContsctars lLat cbeck this box iow.stiached m additional street shaaing th zmne of iLe sob-�md:state whedw or=gme entities haves emptoyem.Iftbe mb-cnataootsbm muplayaes,they'-rsrpravide their warkeW tamp.policy nmaher. I am an empZgvvr that is ptm+ift worriers'compensad n inmrmece for icy sarptoj ee& Befaw is thepvlicy wWjeb sate: information Insurance Company Name: Policy#or Self ins.Litz.#: Expiration Date: Job Site Address: City/Stat&Zip: Attack 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 crimimal penalties of a fine up to$1,500.00 and/or one-year imprisortmeat,as well as civil penalties in the farm of a STOP WORX ORDER and a fine of up to$230-00 a day against the L3olat w. Be advised that a copy of this statesnient may be forwarded to the Office of hmestigatums of the DIAL far-irm;zrance caVerage yedrication . Irlrr ht►xatiy certify tkapar attrss th prbWA d a is. and correct Si Date: Phone#_ 72--2— 0&W cure anly.. Do not write in this:ara%Ao be compietesd by city ar town afrcrat City or Town: PerumtiIiicense# Issuing Anthority{tarrle one): 1.Board of Ekatfh 2.Building Department 3.Brown Clerk d..Bectrical Inspector 5.Plumbing inspector 6.Other Contact Person: Mane tt: 6 Massachusetts -Department of Public Safety Gf/,� �anv,�w�uuea/t/ o�v/�aaOac�ivaeaa Board of Building Regulations and Standards Office of.Consumer Affairs&B sinessRegulaHon Construction Supen isor Specialty S HOME IMPROVEMENT CONTRACTOR License: CSSL-105951 Registration ,5�172472 Type: Expiration: fj127),2014 Individual PATRICKC)LIFFQ)2D P "ICKCLIFFOR,00 i' 12 BALDWIN ROAD s Dennis MA 0263ff �_ � a i= PATRICK CLIFF( D= r s 12 BALDWfN.RDA 1 92 �. Expiration j DENNIS, MA 02638' ' � 8 =+ y' Undersecretary 06/02/2016 Commissioner i r License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation W Park Plaza-Suite 5170 i Boston MA 02116 C Not valid wi out signature _ z°F Town of Barnstable - ti Regulatory Services ybI'E Thomas F.Geiler,Director 16;q 10� 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 A Builder 41Y, (6/ a�-® , as Owner of the subject property 1 _ 1 hereby authorize �� c� \� l(� to.act on my behalf, in all matters relative to work authorized by this building permit: llq 13a�1-1c� � - (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are;performed and accepted. 4iqgnaeJofner C, ignature of App 'cant )74 Print Nam Print Name. Date Q:FORM&OWNERPERMISSIONPOOLS 6/2012 r: �t r Town. of Barnstable Regulatory Services • snxxsrAaLE, Thomas F.Geiler,Director Mass. �bp 1639• ,�� Building Division rFD MA'I A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a°homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other, applicable codes,bylaws,rules and regulations. The undersigned"homeowner".certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official r Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against.the unlicensed personas it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, " that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fora/certification for use in your community. Q:forms:homeexempt r The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 =. , The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth,Corporations Division - '' One Ashburton Place 17th floor, Boston,MA 02108-1512 Telephone: (617)727-9640 HOMELESS NOT HOPELESS, INC. Summary Screen Help with this form Request a Certdtcate. The exact name of the Nonprofit Corporation: HOMELESS NOT HOPELESS,INC. . Entity Type: Nonprofit Corporation Identification Number: 260604808 Old Federal Employer Identification Number(Old FEIN): Date of Organization in Massachusetts: 10/01/2007 Current Fiscal Month/Day: 09/30 Previous Fiscal Month/Day:09/30 The location of its principal office in Massachusetts: No. and Street: 310 OCEAN STREET City or Town: HYANNIS State: MA Zip: 02601 Country:USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: The name and address of the Resident Agent: Name: No. and Street: City or Town: State: Zip: Country: The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT WILLIAM BISHOP 200 STEVENS ST. HYANNIS,MA 02601 USA TREASURER RICHARD MURPHY 30 ARBOR WAY HYANNIS;MA 02601 USA CLERK JEFFREY HOWELL 144 ROUND COVE RD. CHATHAM,MA 02633 USA DIRECTOR GENE CAREY 32 RENOIR DR. OSTERVILLE,MA 02655 USA http://corp.se c.state.ma.us/corp/corpsearch/Corp S earchS ummary.asp?ReadFromDB=True... 8/10/2012 f The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 2 of 2 DIRECTOR JOSEPH REARDON 132 PLEASANT PINES AVE. CENTERVILLE,MA 02632 USA DIRECTOR MATTHEW WATSON 650 BRIDGE RD. EASTHAM,MA 02642 USA DIRECTOR NANCY WOODSIDE 401 OCEAN ST. HYANNIS,MA 02601 USA DIRECTOR ELIZABETH CURTIN 39 FOX HILL RD. MASHPEE,MA 02649 USA Consent _ Manufacturer Confidential Data _ Does Not Require Annual Report Partnership _ Resident Agent _ For Profit Merger Allowed Select a type of filing from below to view this business entity filings. ALL FILINGS (t I Annual Report l Application For Revival L Articles of Amendment Articles of Consolidation-Foreign and Domestic na' view'Fllings9 Comments ©2001-2012 Commonwealth of Massachusetts t7 All Rights Reserved Help http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 8/10/2012 . he Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 c The Commonwealth of Massachusetts William Francis Galvin t l Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor . Boston MA 02108-1512 1� Te Telephone: (617)727-9640 HOMELESS NOT HOPELESS, INC. Summary Screen Help with this form. a Request EPEE lcO The exact name of the Nonprofit Corporation: HOMELESS NOT HOPELESS, INC. Entity Type: Nonprofit Corporation Identification Number: 260604808 Old Federal Employer Identification Number(Old FEIN): Date of Organization in Massachusetts: 10/01/2007 Current Fiscal Month/Day: / Previous Fiscal Month/Day:09/30 The location of its principal office in Massachusetts: No. and Street: 310 OCEAN ST - City or Town: HYANNIS State: MA Zip: .02601 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the Iodation of that office: No. and Street: City or Town: State: Zip: Country: The name and address of the Resident Agent: Name: No. and Street:: City or Town: State: Zip: Country: The officers and all of the directors of the corporation; Title Individual Name Address ono Po Box) Expiration. First,Middle,Last,Suffix Address;City or Town,State,Zip code of Term PRESIDENT WILLIAM BISHOP 314 OCEAN ST.. HYANNIS,MA 02601 USA TREASURER RICHARD MURPHY 30 ARBOR WAY HYANNIS,MA 02601 USA CLERK DIANNE KAUFMAN 340 OAKLAND RD HYANNIS,MA 02601 USA DIRECTOR JANETDALY 68.CENTER ST:.` HYANNIS,MA 02601 USA DIRECTOR JOE REARDON 132 PLEASANT PINES AVE http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummar -.asp?ReadFromi)B=True... 12/16/2010 The Commonwealth of Massachusetts William Francis Galvin-Public Browse and Search Page 2 of 2 j ,CENTERVILLE,MA 02632 USA DIRECTOR ALANA COLLUCCI 41 FREEMAN ST .HYANNIS,MA 02601 USA - DIRECTOR JEFFREY'HOWELL 144 ROUND COVE RD. CHATHAM,MA 02633 USA DIRECTOR TOM SULLIVAN 329 OAKMONT RD. YARMOUTH PORT,MA 02675 USA Consent = Manufacturer Confidential Data Does Not Require Annual Report Partnership Resident Agent _ for Profit Merger Allowed.. Select a type of filingfrom below to view this business entity filings: ALL FILINGS Annual Report Application For Revival Articles of Amendment Articles of Consolidation-Foreign and Domestic n . ViewFngs** � NewSearchI Comments ©2001-2010 Commonwealth of Massachusetts All Rights Reserved Help http://corp.sec.state.ma.us/corp/corpsearch/CorpSea'rchSummary.asp?ReadFromDB=True..: 12/16/2010 Donations - Homeless not Hopeless, Inc. Page 1 of 1 Welcome to Homeless not Hopeless.Ina Home About Us Projects News&Events Housing w Love Financial Pages Donations Contact Us Homeless not Hopeless is a 501 C Non-Profit Corporation. We exist on Donations from our friends. Donations may be sent to: Homeless not Hopeless 310 Ocean St. . Hyannis MA 02601 Site Maintained by Homeless not Hopeless,Inc. http://homelessnothopeless.org/l 3.html 12/16/2010 the �omolnYneaith` of aa�hu�ett�rf FEE: $15.00 William Francis Galvin M.G.L.Ch.180 Secretary of the Commonwealth Corporation One Ashburton Place- Room 1717, Boston,Massachusetts 021084 512 Annual Report Telephone: (617) 727-9640 ANNUAL REPORT. 100007896 FEDE-�RAL�IIDDENNTIFICATI/ON�/ Filing for November 11 20 Iro 1z In compliance with the requirements of Section 26A of Chapter one hundred and eighty(180)of the General Laws:, 1.NAME: 0-M—e1e55_OL/J—'• + 2.ADDRESS: (number) (street) n 19` (city or town) (state) zip) 3.DATE OF THE LAST ANNUAL MEETING: QS1I 4.If the corporation is a cemetery corporation,it must-hold perpetual care funds in.trust and attach a copy of the written agreement(stab- lisping the trust. (check appropriate box) ❑The cemetery corporation certifies that perpetual care funds arc held in trust and a copy of the written agreement establishing the crust is attached. OR The cemetery corporation hereby certifies that.it does not hold perpetual care funds in trust: 5.State the names and addresses of the-president,treasurer,clerk,at least one director of-the corporation,and the date on which the'term`of office of each expires:(PLEASE TYPE OR PRINT). NAME OF OFFICE NAME ADDRESSES EXPIRATION Number,Street,City or Town, OF TERM OF State and Zip Code OFFICE ,fl�dr>r� �ish� 1N01h . St. Nar,n,s MA'Q�'dJl nor+P� - President: ✓�d�Q Treasurer. � •rlflC�l'd kurPh 30Ar� Vie.( �o1Y1ri►'S MA I -- " Clerk: ��y1nQi �.?tJl'1'y�11- . gnn!.5(yn nonce` Q�Cl (or Secrc RIc7 CONCC) �I Freern /) 51- Hw�rwicMr- 04A-c Directors: r JY� So 1�)Va �1 a4emar-f ral �7Y M t•(�1f}"/� 17.�i. - ra (or Officers having the Jde@of�� f Cg✓ 'T U11 powers of l7q'\t G' Caw 0 C 3 Direcrors) mfl oan3. now e J. LA V03? �o 1,the undersignedfn j� � being the ofthe above-named corporation,in compliance with General Laws,Chapter 180,hereby certify that the informarioi above Is true.and correct as of the dates shown. IN WITNESS WHEREOF AND UNDER PENALTIES OF PERJURY,i hereto sign my name on this ro. day of - 20 Signature: f�// QtV�'GIM Title: Conracr Person: ;1 s�11J.�Y T�L-V Contact Person Tclephone;!!:' 520 R- 7 75- f(a el 8' . �ea�r,orieioo MA SOC Filing Number: 200797783320 Date: 10/01/2007 9:41 AM sf The Commonwealth of Massachusetts t - �� William Francis Galvin y& € Special Instructions ar Secretary of the Commonwealth `' One Ashburton Place, Boston, Massachusetts 02108-1512 s 4 Telephone: 617 727-9640 a _ m. , RIM • 4 01 -WIM ,M, "EM I W- 49w r Federal Identification Number: 260604808 a . ARTICLE The name of the corporation is: HOMELESS NOT HOPELESS, INC. ARTICLE 11 The purpose of the corporation is to engage in the following business activities:, HOMELESS NOT HOPELESS, INC. IS A CORPORATION ORGANIZED BY THE HOMELESS AND FORMERLY HOMELESS OF CAPE COD TO ASSIST ALL SUFFERING IN THAT CONDITION TO ATTAIN A SUBSTAINABLE, SATISFACTORY LIFESTYLE. NE SHALL PURSUE THIS GOAL IN THE FOLLOWING WAYS: PROVIDE ACCESS TO THE MOST MODERN TECHNOLOGY AND METHODS POSSIBLE FOR PURSUING EMPLOYMENT, NETWORKING, OBTAINING HOUSING AND GAINING ACCESS TO ANY,AND ALL RESOURCES SPECIFIC TO CLIENT NEEDS. PROVIDE SHORT-TERM HOUSING AS BOTH A SHELTER OF LAST RESORT AND IN COOPERATION WITH OTHER ORGANIZATIONS SO THAT,NO INDIVIDUAL IS LEFT WITHOUT A RESONABLE OPPORTUNITY FOR SHELTER. PROVIDE FUNDING ASSISTANCE TO OTHER LIKE-MINDED ORGANIZATIONS ON A CASE BY CASE BASIS TO FACILITATE HELP TO OUR CLIENT BASE AND•GENERATE GOOD WILL. WE WHALL PURSUE THIS GOAL UNDER THE FOLLOWING.CONDITIONS AND GUIDING PRINCIPALS: IN ORDER TO ACHIEVE THE MEANS OF OUR NON-PROFIT, MAKE IT BE KNOW THAT WE MAY FUNDRAISE AND SOLICIT DONATIONS. ALL OPERATIONS SHALL BE FINANCIALLY AND METHODOLOGICALLY TRANSPARENT. EACH ELEMENT MUST REMAIN A SOURCE OF CORPORATE PRIDE. - ALL REQUESTS FOR ASSISTANCE FROM OUR ORGANIZATION SHALL BE GIVEN SERIOUS CONSIDERATION. ANY SUCH REQUESTS WILL BE ACCOMMODATED WITH REGARD TO THE SCOPE OF OUR MISSION, CORPORATE PRINCIPLES AND AVAILABLE RESOURCES. ALL ENDEAVORS.OF OUR ORGANIZATION SHALL BE CARRIED FORWARD WITH CREATIVITY, SCRUTINIZED FOR IMPROVEMENT OPPORTUNITIES AND MODIFIED TO EXCEL IN EFFICIENCY. IN:CONCLUSION, LET US, AS AN ORGANIZAITON COLLECTIVELY AND INDIVIDUALLY, NEVER FORGET THE CONDITIONS AND EXPERIENCES THAT REQUIRED THE FORMATION OF HOMELESS NOT HOPELESS, INC. ARTICLE III A corporation may have one or more classes of members. If it does,the designation of such classes, the manner of election or appointments,the duration of membership and the qualifications and rights, including voting rights, of the members of each. class, may be set forth in the by-laws,of the corporation or may be set forth below: rr EXECUTIVE COMMITTEE-SEVEN 7 BOARD MEMBER WILL EL E( ) S W L BELONG TO THE EXECUTIVE COMMITTEE. THESE WILL BE THE PRESIDENT, TREASURER, CLERK, DIRECTOR OF SITE MANAGEMENT, DIRECTOR OF DIETARY COORDINATION, MEDICAL ADVISOR AND ONE (1) OTHER MEMBER THAT WILL BE VOTED ON BY THE AFORE MENTIONED. SHOULD ANY MEMBER OF THE EXECUTIVE COMMITTEE CHOOSE TO RESIGN HIS/HER POST,THE REMAINING MEMBERS OF THE EXECUTIVE COMMITTEE WILL HOLD AN ELECTION FOR REPLACEMENT. EXECUTIVE COMMITTEE MEMBERS WILL HAVE LIFETIME BOARD MEMBERSHIP UNLESS EACH MEMBER CHOOSES TO RESIGN HIS/HER POSITION OR AN ELECTION IS HELD TO TERMINATE. DIRECTIVE BOARD-BOARD MEMBERS WHO WILL HAVE VOTING RIGHTS ONLY ON PROPOSED PROJECTS TAKEN ON BY ORGANIZATION. THIS COMMITTEE OF BOARD MEMBERS WILL BE VOTED IN BY THE EXECUTIVE COMMITTEE AND EACH MEMBERS TERM SHALL BE NO LONGER THAN 2 YEARS AT A TIME. ADVISORY BOARD-WILL BE APPOINTED AND DISSOLVED AS NEEDED FOR SPECIFIC PURPOSES: THIS BOARD SHALL HAVE NO SPECIFIC VOTING RIGHTS. PERSONS NOT CURRENTLY SITTING ON THE BOARD OF DIRECTORS SHALL BE ALLOWED TO BE APPOINTED TO THE ADVISORY BOARD, IF NO-" BOARD MEMBER HAS THE CAPABILITY-OF PROVIDING THE NECESSARY SERVICE. ALL BOARD MEMBERS MUST HAVE EXTENSIVE SERVICE WORKING WITH THE HOMELESS OR BEA MEMBER OF OR FORMER MEMBER OF THE HOMELESS COMMUNITY. ARTICLE IV Other lawful provisions, if any,for the conduct and regulation of the business and affairs of the corporation,for its voluntary dissolution, or for limiting, defining, or regulating the powers of the corporation, or of its directors or members, or of any class of members, are as follows: (If there are no provisions state "NONE` ANY AMENDMENT TO ARTICLES OF ORGANIZATION; MISSION STATEMENT, BY-LAWS OR VOLUNARY DISSOLUTION WILL REQUIRE A MAJORITY VOTE OF THE EXECUTIVE COMMITTEE BEFORE SUCH " AMENDMENTS ARE FILED WITH THE STATE OF.MASSACHUSETTS. Note: The preceding four(4)articles are considered to be permanent and may ONLY be changed by filing appropriate, Articles of Amendment. ARTICLE V The by-laws of the corporation have been duly adopted and the initial directors, president,treasurer and clerk or other " presiding,financial or recording officers, whose names are set out on the following page, have been duly elected. ARTICLE VI The effective date of organization of the corporation shall be,the date approved:and filed by the Secretary of the Commonwealth. If a.later effective date is desired, specify such date which shall not be more than thirty days after the date.of filing. Later Effective Date: ARTICLE VII The information contained in Article VII"is not a permanent part of the Articles of Organization a.The street address(post office boxes are not acceptable)of the principal office of the corporation in Massachusetts is: _ No.and Street: 310 OCEAN ST City or Town: HYANNIS State: MA Zip:02601 Country: USA b.The name, residential address and post office address of each director and officer is as follows: (A president,treasurer, clerk, and at least one director are required.) Title: MEDICAL ADVISOR Expiration of Term: None First Name:PAMELA Middle Name: Last Name: BALL Residential Address: 105 PARK ST City: HYANNIS State: MA Zip:02601 Country: USA Post Office Address: 105 PARK ST City: HYANNIS State: MA Zip:02601 Country: USA Title: CEO Expiration of Term: none First Name: MARK Middle Name: DOUGLAS Last Name: HALSTEAD Residential Address: 310 OCEAN ST: City: HYANNIS State: MA Zip:00601 Country: USA _ r Post Office Address:310 OCEAN ST City: HYANNIS State: MA Zip:02601 Country: USA Title: CFO Expiration of Term: None First Name: MARY Middle Name:ANN - Last Name: HAKENSON, Residential Address:310 OCEAN ST City: HYANNIS State: MA Zip:02601 Country: USA Post Office Address:310 OCEAN ST City: HYANNIS State: MA; Zip:02601 Country: USA Title: PRESIDENT Expiration of Term: none First Name: MARK Middle Name: DOUGL'AS Last Name: HALSTEAD Residential Address: 310 OCEAN ST City: HYANNIS State: MA Zip:00601 Country: USA Post Office Address:310 OCEAN ST City: HYANNIS State: MA Zip:02601 Country: USA Title: TREASURER Expiration of Term: None First Name: MARY Middle Name:ANN Last Name: HAKENSON Residential Address:310 OCEAN ST City: HYANNIS State: MA Zip:02601 Country: USA Post Office Address:310 OCEAN ST ; City: HYANNIS State: MA Zip:02601 Country: USA Title:VICE PRESIDENT Expiration ofTerm`None First Name: MARY Middle Name:ANN Last Name: HAKENSON v Residential Address: 310 OCEAN ST City: HYANNIS State: MA Zip:02601. . Country: USA Post Office Address:310 OCEAN ST City: HYANNIS State: MA Zip:02601 Country: USA Title: ASSISTANT CLERK Expiration of,Term: None First Name: DIANNE Middle Name: = Last Name: KAUFMAN. Residential Address: 340 OAKLAND RD City: HYANNIS State: MA Zip:02601 Country: USA Post Office Address:340 OAKLAND RD City: HYANNIS State: MA Zip:02601 Country: USA Title: DIRECTOR Expiration of Term:None First Name:WILLIAM Middle Name: Last Name: BISHOP Residential Address:340 OAKLAND RD City: HYANNIS State: MA Zip:02601 Country: USA Post Office Address:340 OAKLAND RD City: HYANNIS State: MA Zip:02601 Country: USA Title: CLERK Expiration of Term:None First Name:ALAN Middle Name:`R Last Name: BURT s Residential Address:338 PLEASENT PINES AVE City: CENTERVILLE State: MA Zip:02632 Country: USA Post Office Address:338PLEASENT PINES AVE City: CENTERVILLE State: MA Zip:02632 Country: USA Title: DIRECTOR OF SITE MANAGEMENT Expiration of Term:None First Name:WILLIAM Middle Name: Last Name: BISHOP Residential Address:340 OAKLAND RD City: HYANNIS State: MA Zip:02601 Country: USA Post Office Address:340 OAKLAND RD City: HYANNIS State: MA Zip:02601 Country: USA Title: DIRECTOR OF DIETARY COORDINATION Expiration of Term': None First Name: DIANNE• . Middle Name: Last Name:KAUFMAN . Residential Address:340 OAKLAND RD City: HYANNIS State: MA Zip:02601 Country: USA Post Office Address:340 OAKLAND RD City: HYANNIS State: MA Zip:02601 . Country: USA c.The fiscal year(i.e.,tax year)of the corporation shall end on the last day of the month of: September d.The name and business address of the resident agent,if any,of the corporation is Name: No.and Street: City or Town: State: Zip: Country: I/We,the below signed incorporator(s),do hereby,certify under the pains and penalties of perjury that l/we have not been convicted of any crimes relating to alcohol or gaming within the past ten years.I/We do hereby further certify that to the best of my/our knowledge the above-named officers have not been similarly convicted. If so convicted, explain: IN WITNESS WHEREOF AND UNDER THE PAINS AND PENALTIES OF PERJURY,I/we,whose signature(s)appear below as incorporator(s)and whose name(s)and business or residental address(es)are beneath each signature do hereby associate with the intention of forming this corporation under the provisions of General Law,Chapter 180 and do hereby sign these Articles of Organization as incorporator(s)this 1 Day of October,2007 (If an existing.corporation is acting as incorporator, type in the exact name of the corporation, the state of other jurisdiction where it was incorporated, the name of the person signing on behalf of said corporation and the title he/she holds or other authority by which such action is taken.) MARK D. HALSTEAD, PRESIDENT 310 OCEAN ST, HYANNIS, MA 02601 MARY ANN HAKENSON, TREASURER 310 ©2001.Secretary of the Commonwealth of Massachusetts All Rights Reserved 0 MA SOC Filing Number: 200797783320" Date:-'10/01/2007 :9:41 AM THE COMMONWEALTH OF MASSACHUSETTS I hereby certify that, upon examination of this document,duly submitted to me, it appears that the provisions of the General Laws relative to corporations have been complied with, and I hereby approve said articles; and the filing fee having been paid, said articles are deemed to have been filed with me on: October 01, 2007 9:41 AM WILLIAM FRANCIS GALVIN Secretary of the Commonwealth 0-6320-0 f Town of Barnstable 3/bo S y P�OFTHE 1p ( i�' : L'Regulatory Services 46 Thomas F.Geller,Director )-31,4 BARNSTABLE * ;; ! S j 9� MASS. Building Division / o Mpq a Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINVIN UIRY REPOR c, Date: Rec'd b Complaint Name: W6 6 Map/Parcel /�� /,3I,�-t/,3//3 Location Address: Originator Name: Street: Village: State: Zip: Telephone: Complaint Description: dYl� o c , FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: ' I Additional Info.Attached I Q:forms:complaint u � e p R�� i\ �� F� � � .� t ,,� "� '1s€i3 Yt r�� #L.�:�C �� ! Ili' �� ( � ''�\ 4 '�. '� •�'11 t 1N'Lsr�l��V� �t.r r 1 ' 0 5k\ What you CAN 'T see from the street ! • 7 Bedrooms!! • Bright open kitchen with cathedral ceiling! • Large family room off the kitchen! • Huge deck — great for entertaining! • Beautiful, private back yard! See the VIRTUAL OPEN HOUSE at www.lKathyVarjian.com e-mail: KathrynV(a,Remax.net 508-367-9085 i Pagel of 3 MLS Client Detail Report(294) Client Detail with Addl. Pics Report Listings as of 08/14/10 at 12:06 m Active 02/22/10 Listing#21001655 119 Baxter Rd Hyannis,MA 02601 Listing Price:$324,900 County:Barnstable Prop Type Single Family Prop Subtype(s) Single Family Town Barnstable - Beds 7: Approx Square Feet 2608 Assessors Records Baths(FH) 3(2 1) ' Year Built 1954 Lot Sq Ft(approx) 28749((Assessors Records)) Tax ID 310-59-0-0-BARN Lot Acres(approx) 0.660 See Virtual Tour �. AM 7 MMm ■a It MW gy 6 4 a a a q 3 .r 4 .. http://ccimisxapmis:com/scripts/mgrgispi.dll 8/14/2010 MLS Client Detail Report(294) Page 2 of 3 4 '4 `T 4 • i + t - µme.. _ 1i� •.. - .. Directions Barnstable Road to Baxter to#119. PubliclInternet Remarks 7 Bedrooms!This sprawling 10-room home lives large!There's room for everyone,with a spacious skylit kitchen with cathedral ceiling(the hub of the home),2.5 baths,3-car garage,and more.Three bedrooms and a full bath are on one side of the home- great for guests and in-laws-and the other 4 bedrooms, 1.5 baths and an attached one car garage are privately situated on the other side of the home.Some rooms need finishing touches,but once you're done adding them,WOW-what a home you'll have!.Bonus:24x24 2-car detached garage with amazing space above.Great central Hyannis location,convenient to downtown,Hyannis Harbor,ferries,shopping, restaurants and more.All this and Town Sewer too! Street Description Paved Listing Page Special List Cond. None General Page Zoning 101 Year Built Dose., Approximate Total Rooms 10 Total Levels 2.0 Lovell Baths 2.0 Level 2 Baths 1.0. Basement Yes Basement Description, Bulkhead Access,Full,Interior Access, Partial Foundation Concrete Foundation Width 54 Foundation Depth .26, Fndation Wing Width 26 Fndation Wing Depth 20 'Irregular Yes Topography/Lot Dose. Interior,Level, Association No A Garage Yes #of Cars #3 Garage Description Attached,Detached,Direct Entry,Door Parking Description Off-Street,Paved Driveway Opener,Storage Above + Year Round Yes Separate Living Qtrs Yes _ Sep Living Qtrs Dose Attached,First Floor Waterfront No Water View No: Convenient To Golf Course,House of Worship, In Town Location, Major Highway,Marina,Medical Facility,School,Shopping Miles to Beach 1 to 2 Water Access. Harbor,Ocean,Public Beach Description Ocean Beach Ownership Public http://ccimis.rapmis.com/scripts/mgrgispi.dil 8/14/2010 IV&S Client Detail Report(294) Page 3 of 3 Interior Page Fireplace No Master Bedroom 1412 Level: First Floor Mstr Bdrm Features CeilingFan Closet Wall to Wall r Carpet Bedroom#2 11x19 Level:First Floor Bedroom#2 Features Closet,Wall to Wall Carpet Bedroom#3 1.1x10 Level:First Floor Bedroom#3 Features Closet,Wall to Wall Carpet Bedroom#4 14x12 Level:Second Floor Bedroom#4 Features Closet,Other Floor Living/Dining Combo No . Living Room 25x12 Level:First Floor Living Room Features Ceiling Fan,Wall to Wall Carpet Kitchen/Dining Combo Yes Kitchen 16x16 Level first Floor Kitchen Features Cathedral Ceilings,Ceiling Fang Dining Other Room 1 25x15 Level:First Floor Area,Office/Desk Area,Pantry,Skylight, Vinyl Floor Other Room 1 Type Entertainment Other Rm 1 Features Other Floor,Vinyl Floor Other Rm 2 Features Other Floor Other Room 3 13x13 Level:Second Floor - Other Room 3 Type Bedroom Other Rm 3 Features Closet,Other Floor Appliances Dishwasher,Dryer-Electric,Microwave, Floors Other,Vinyl,Wall to Wall Carpet Range-Gas,Refrigerator,Washer Interior Features Dry/HU-E,HU Washer,Linen Closet, Exterior Style Colonial Pool No Dock No Energy Saving Feat Insulated Windows,Insulated Doors Exterior Features Deck,Exterior Lighting,Porch,Screened -Roof Description< Asphalt Porch,Screens,Yard Siding Description Barnboard,Shingle,Vinyl/Aluminium . Mechanical Heating/Cooling 2 Zone Heat,Natural Gas,Hot Air Water/Sewer/Utility Town Sewer,Town Water Hot Water/Water Heat Electric Warranty Available No Advertising Publish to Internet Yes Legal/Tax Annual Tax $2854 Tax Year 2010 - Land Assessments $118000 Improvement Asmt $213200 Other Assessments $34300 Total Assessments $365500 To Be Assessed Unknown Mass Use Code 101-Single Family Title Reference-Book C163905 Title Reference-Page 0 Land Court Cert# 0 Underground Fuel Tnk Unknown Lead Paint Unknown Asbestos Unknown Flood Zone Unknown Presented By: Kathryn Varjian RE/MAX Classic Primary:508-428-2300 x23 .167 Lovells Lane Secondary:508-367-9085 Marstons Mills,MA 02648 R Other. 508-428-2300 See our listings online: E-mail:KathrynV@Remax.net ,August 2010 Web Page:hftp://www.KathyVarjian.com hftp://capecodclassicrealestate.com Information has not been verified, is not guaranteed,and is subject to change.Copyright 2010 Cape Cod&Islands Multiple ' Listing Service, Inc.All rights reserved Copyright 02010 Rapattoni Corporation.All rights reserved.., { y I http://ccimis.rapmis.com/scripts/mgrgispi.dll 8/14/2010 _. .... r. ,.t f...µ♦a. .t.. �S .� ,. p:�ut'��v d.r=�Lam. xx .�n,t�'a�'M�..^�,,�// .J4,.�� a, �.. ��. s - .. x ,e•� a .. Ys�G•a"'o Assessor's office.Ost floor): ) Assessor's map and lot number ..,! 0. O�C1 Q THE ro` Board of Health 4(3rd floor):Sewage Permit number y.�.8'-g9 � � ......................�..>........................... � "" Z BBHdSTODLE, i Engineering Department (3rd floor): +o -YA°a House number 1639.o • `0 'Fo VIR Definitive Plan Approved by Planning Board ________________________________19________ , APPLICATIONS PROCESSED 8:30 9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE r^� BUILDING INSPECTOR APPLICATION FOR PERMIT TO C... S r11.0 �` 10W �(iS�l'h! Uw° "1 o `?.......... .................... ....e............... ............... . TYPEOF CONSTRUCTION ............�'J Q .�?........................................................................................................ ......... TO THE INSPECTOR OF BUILDINGS: • The undersigned hereby applies for a permit according to the following information: Q Y�J i Location � � ��......�..........�-,-. ..................................................................... ProposedUse ............... ^:.�' .....................................................................1................................................................. Zoning District Fire District .... '1...............y�a............. ........................................................ r l��.i�� QrJ1''. ... QTwsQ�nlvJ.Address �:L6xr1 ,2. `Jp� ...... .4�dvv�Name of Owner .� .. Name of Builder `1� � � /a)►/ASTtI�i� ��.......... ?.. ................Address ..,. . .........,.... . ,..<......,..,...... .<....�. ........ 1r .�l........... Name of Architect ....��............� .!N.E'�........................Address t&, Numberof Rooms .................... ...........................................Foundation .............................................................................. ` '� iExterior ............�l� Dc�.......................................................Roofing ................arm.. GL..........................................,... Floors ............� ).Q ..-... C "'v j h Qe� �_Oc=k Interior ........................................................I............................ Heating .....rP.:.Ca. .....`�C?' ..�'.�. ....................................Plumbing .......... '.... Fireplace �•p �® ..............Approximate Cost ................. C%OO �� Area � w� ��" Diagram of Lot and Building with Dimensions Fee ........; .............. 1_ -70 __ F,'X 1A St } ao75 3.9 ' ' 160 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to.conform to all the Rules and Regulations of the Town ofBarnstable regarding the above construction. / Name .... ..a..... .......... /..•................................... Construction Supervisor's License .�1 `. .ii`,� HOFMANN, CHRIS�LIAN & JOYCE lbS A=310-059 32849 Addi ion Garage No ................. Permit for ............... ........ ........... 1 ...... n.�le...F.ami.1v..dwell;....9......... Location ..1.19.. Baxter...Road....................... ...................HY.ann.i s........................... .............. Owner ......Chris.tian...&...Joyce...UQfmann Type of Construction . Fx acme.......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted -....Apr.] 1...28..............19 89 Date of Inspection ....................................19 Date Completed ...........19 q, 6 we� PERMIT COMPLETE® 1;1.1 �'� Assessor's office (1st floor):. r ft'` l i'\• . THE Assessor's map .and lot number ..:��.J Q......0 .�� e�Q�°� TOE♦� Board of Health (3rd floor): . MUST CONNECT TO TOWN SEWER` # iSewage, Permit number ....�f:.:a$^g9.. , .. ......... BAHd9TGDLE, i Engineering Department (3rd floor) °o rb 9• e� House number. ................... :.............................:............... a M03 a` t Definitive Plan.Appro'ved by Planning'Board _ _____________________________19________ . 3. APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-,2:00 P.M. only r TOW.N- . 'OF B-ARNSTABLE . BUILDING INSPECTOR { APPLICATION FOR PERMIT TO ....... I©!N.S��1�C-....:.. ►T 10W �O £�.. . ........ ..... ....... l R TYPE OF CONSTRUCTION ........ .!001.................... .................... . . ................................... a c� * . .........A....to t...�:$;..........19.R.q-_ , TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...................I...! '.-'. -. C'.........!.`.�.: .y: SN\... .:. ... ................ ..................... ProposedUse ............... ........................... .............:................. .................. ...... ....... .. ....;.......'.. Zoning District ............:... ........ ............Fire District .. ........ ..................:... 1 C� D�nR,0?v ��.a�,.s�a.SN.9 Name of Owner .. . . ...IS.....................� .....-.. . ..............Address `� Name of Builder ........ .... ..... ................Address5. 1fIST�lff�'.tl �. ...L,... S// f-?ctr!h......:.... Name 'of Architect ....4Y! L'....0. .!�?. ' ....... . .... ...................Address t ............. Number of Rooms .�+............ ` AAA,s coYoc � J ��0.!^'�.5...... .... b ..................Foundation Exlerior ...........•1J..QQ.... .................... ................. Roofing s QYIQ ................................. .. Floors ........... .Q :.^.....��C. ..�T\v.1 c.....lnterior .'.........CJ .�'�' ... C ...........l.......................... . .. . ... �O ...i Heatinga ........U:..... � .........._,... ................ ..Plumbing .........s .. ' Fireplace ..Q ........Approximate Cost � �%0�0®®n00.......... .... . Area. s /, ..... Diagram of Lot•and :Building with Dimensions w ". Fee . ! :..................:...: . ,�. Zo 50 horse 2�'• 60, 16 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town Barnstable r garding the above construction. Name'... . .............................. ..... Construction Supervisor's License 0 . G. ............ - HOFMANN, CHRISTIAN & JOYCE No 32849 ,Permit for Build Addition/Garage , Single FamilX...Dwellin.�J...... _ �*,,,..... ....... :A F 119 Baxter Road 5 Location - Hyannis ................ -- t ,'� �. U r, 6wner .. Christian & •Jov&e Hofmann- At �' '0 '� aaj...... s .. .......... z. Type of-Construction Frame...... ....... ............... ...`... ......... Plot Lot ...... 41. Permit Granted ._, Apri 1 2 8 ,. 71 a 9 89 *'. r , Date-of Inspection ..`a.. .. .. . . ........ ......19 Date Completed .....:.�!�'. � ,....19�� .� .• L ;� ,F - r 1,•t,J, -.,ate•, •' � � .:°.fi r. .. fi " �4• , Irra 3 •`"'°� `�} '" a +�.' - g ey. j + `~ _ CZ Ile l - " TOWN OF BARNSTABLE BUILDING PERMIT-APPLICATION 2 r Map Parcel Permit# 34 Kealtb-Bvien�- Date Issued Fee. 01 b�. 67J Tax CollectortALA-) . Treasurer - _ Yv Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street'Address �/� l�l Jr � �/✓ 'Village ` Owner Address Telephone Permit Request10, �� r r Square feet: 1st floor: existing proposed 2nd floor:,existing proposed Total new oa Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family a Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No 4 , Basement Type: O Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:O 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 214o If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address� � /�� ✓J s�i� -lit" License# 2&y/ Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO uir�r rIY� SIGNATURE l DATE t FOR OFFICIAL•USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE - - - OWNER DATE OF INSPECTION, { FOUNDATION ` FRAME INSULATION - FIREPLACE _ ELECTRICAL: ROUGH FINAL A "" `Lr t r PLUMBING: ROUGH FINAL f GAS: ROUGH' FINAL FINAL BUILDING ' r fl Al' S ' Co DATE CLOSED OUT r - ASSOCIATION PLAN NO. ` , L �,� . . ,.�. - — -_:� The Commonwealth of Massachusetts -ter., _ Department of Industrial Accidents - -= Otl/Ce Ott�YestiosmoOs - 600 Washington Street = . -" -` .. T Boston,Mass. 02111 - . Workers' Compensation Insurance Affidavit i name: �i l /C location Ky e�i ,ems r,t r r ��`C , city �zza 157-&.�/I .f /� pi /9�.<OI . phone# 7 .7,S" "7lJU . ❑ I a he&eowner performing all work myself. a sole rietor and have no one worki>i in ca aclty l ❑ I am an employer providing workers'compensation for my employees working on this job. :::>: comnsav n m . - ... .... ilaress ::>::>:=>::»: ...::;':;:::: 1. ........ . .::.:. :.::.:..: ...::::..::..:::::::::..:.: ::.:...::..... irce ...............::.::...:::::.:.:::.::.::. :.:..: insure ::.: . ...:....: al :::.:.::: ::.;>:::>:>:::::. :::>:::>:::.>::>•.:-....:::>::::::>::>:>>::::>::>::::>:::<:>::>::::>::::>::::::::>::::::::::::: r,:::::....:::,:::.::..::..:.:::::..::.::.::.:.. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have .. . the following workers'compensation polices: .,... :;> e ,,., _ ':X,:::': <; :*::'> ':'.:':: > < > > ...::::::: :::'.<�....::':>::: :.>::.>::<:.:: :::< »'< >< >> > ':« »` >< > >> ......... < ?> > > imoanv nam ::.;:;:.;::. :...:.. ..... .....::..:::..::::.. _. -::.:: ::.;;..".:::::::.::..:::::::::.::..:::.::.::.:.;.:::::::::::;.::::.::.::....:::.,:X-::::.;i;:.;;.::::..:.:...':: . ::...:......................:.:.:::.:::.:.;:::::::::::.::::.:..:..::::::::.:::.... ....................... ........................... ..................:..... w ....nx... rr.,..... A.:.:::::::.{ :.. ......::....:::::::.......... .......:... ....... :.............. ::::::::::.:::::::::::::::.:::..::::.....:...........:::.::..............:::::::....................:::::.:::::.::.:::::::::.::::::::,::......... M.?. .......................:.:::.:::..::::...::.:::::::::::.:............:..:.....................................:.::..:::::::::.::.::::::.:.........:................................................. i .... :...............................:... ..............................................:. : ..........:.....:.:::................ .......... .........................::::::::::.::..:::.:::.::::.:::.;•:::::::::::::::::::::-:: .--,."- ..,-. o eii; :::::::::::::::::.. ..............:.....:.:::::::::.::.. ..:::... ... ..:. .... ... ....,....:.;.. % :<::«<:>::>:>:.:'::::::::::»><::::>:<:>:<:;:>:«:»<<<` :»::»»':s:>:::'.>:'.»:::<..-.-.::::'.:'.:::>:::»?€:>>::::`."","::?:?;<:::>::::>€:>:::»»::::: <>:»><>><:>>> >`><`<: »:r>>:<:>: : :•i:i.:?•:^:i:•i:•iiiii>::.}}.....: :v'.:•::i:•: .....::::::::::::. ::::?::w:i:.::r.:::::::.::::::::'i4'•:G:•ii:7i:Y•`4iY.t`:Y •......................................... iiiiiiiii ............:..:...............;.;....... ?•i' :::::•:•i:iiiii:•::{•ii:vi::is iiiiiii: '�i:.:iiiiii::::::::.i:::i:ii:..:�:::.:�:::......:. ..:v:.:::::::::::::::::::::..........:....:............:::................ .......... :::.�:::::.�::::::rw:i::•::v::::::v:.::::::::::::::i:::?v}J:iii:^::vi?iiii:Jiii?i:->:-i:i^iif4i:v:: .................... ......................................... :• ..xwhvnvJA).4ZIty.n.xv:. ........... :::..:::::. .:.::::::.:::. = I ...- .P.W.. i.:;::. �////////� �. % ::::.::.:::::::.:::::.::::::::..:: ......i::: >: <"".::::: :4:•••. ...... ff ::tldress. ...:.ii.'.- • .. !. ..: .. .: t ��1 d11C: :'S?<` :? >:::'::: +:. f.. ': `.::' . :`? ` :::r? :: :'.:..:.:.:.:. ::::::::::::.::: ......:...............................................::::: :::::::::::::::: :.i::.::..;: :::::::..::::::........: ::..i:.ii:.i::::'>:' ...... ...................:... . .. . :...::.:::::::.:::::::::::...........................:.....:.:::..:::.::::...............................................................::::::•. .................i>:..:.: :�;::: ............................................................. :::::::::::.::::::..........................:::.::.........:,.............%........:.:.........�...:.......:..,.�.....{.:,. :::::.:::::::::•:?.::.:::::::::::::.::;;:.::::..::::.::::::::::::.:::::.:::::::::..;.::.::::.::::::::::::...:::::.::..::.. :.;:;:::{:::::::::::::::::.:::::.:-;:.i:..;::::??•:i::?{:•i:?.;:.:.::.i•.:.:::•?:?:{::.;:::::.;'.>::.;..;..i::.:.::.::::::r.ii':::::::::..:•.:::.: €a:<:>>:<:::>s.................... .. ................... . .. : v::::.:::Y::?::N::+:v.::.:::::::::::}:.,.. :?i::^i.::+..-..is::'+iiiii:::•:::-.............�:::v:::;:.;•,,,.::.�:::::::: iiY-..i:%:i:{h....•..ii':•:•- ......:v..N...................1.... �UranCt`.c0<..:. ....... ....... . .. ... ..... Oli :: .. ..... ... ::,:. .. ..1 // Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 81,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the into . n provided above is urn•.and correct Signature Date -//�/y5;� . - Print nameA 1- rz Phone# �7 r 700 official use only do not write in this area to be completed by city or town offidal . city or town: permit/ficense# ❑Building Department ClUcensing Board ❑ciuxkiffunnedlate response is required ❑selectmen's Office _ ❑Health Department contact person• phone#; .- ❑Other (wind 9/95 PJ/a Information and Instructions 4 Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any comr..c, of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver c. trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insur;u ce requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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 t . being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit fir 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. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents OMCC of ImtestigauOus 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat. 406, 409 or 375 . * WE�O . . : The Town of Barnstable * 1ARNS1'ABLE, • � Department of Health Safety and Environmental Services rFo °i Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: t° Estimated Cost eD Address of Work: Yam' [/ Owner's Name: D�/�l� c/✓ �'%'/g/ //N �� ✓ Date of Application:_ zL I hereby certify that: Registration is not required for the following reason(s): Work excluded by law ❑Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 9 Date Con ctor Name Registration No. OR Date Owner's Name g1orms:Affidav 'Y L'+ } "T4 S«riJC� �OO(IM�I/L� CYIfIOEYIO'`, I X jiOME IMPROVEMENT CONTRACTOR �Registratian 119483 " Ezspirat 0)t9/21/99 wr ON A SCHOFIELD HOME MAIN i i r�,�� °f 1SHON A SCHOFIELD � . - ��3'HAMPSHIRE j�(� JuIINISTRATOR '` a 2601 �,�y-`=�� f, X 2 Assessor's Office(1st floor) Map 3 ] a Lot ® Permit# _lQ O Fs� VU //Conservation Office 41h floor) Z2-j Date Issued Board of Health(3rd�floo_r)(8:30-9:30/1:00-2:00) Engineering Dept..(3rdfloo House#1` tHE ' Planning Dept.(1st floor/School Admin. Bldg.) RARNSTABLE. Defin;Plan\ proved by Planning Board 19 a9TOWN OF�BARNSTABLE Building Permit Application / Projeess Village N VC1 m W �S /Owner 1q r,ry-Ae,,&j c) v`�eo\k Address a /Telephone 4 S / ' /4ermit Request «� �„ X k e Total 1 Story Area(include 1 story garages&decks) ® square feet Total 2 Story Area(total of 1st&2nd stories) square feet stimated Project Cost $ j 5, 41 Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential is C-c\ Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms •' Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name —Telephone Number Address I q �� Q License# m :A Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR ,ter16ATE. 9`Z 9 Q S BUILDINGVRMIT DENIED FOR THE FOLLOWING REASON(S) i� G-* FOR OFFICIAL USE ONLY PERMIT NO. 10085 DATE ISSUED 8/31/9 5 MAP/PARCEL NO. 310 059 ADDRESS 119 Baxter Road VILLAGE Hyannis ' OWNER Armand A. Martineau 1` DATE,OF INSPECTION: FOUNDATION_ ' FRAME INSULATION FIREPLACE' ELECTRICAL: ROUGH FINAL PLUMBING:, ROUGH FINAL GAS: ROUGH 'FINAL n FINAL BUILDING DATE CLOSED OUT ! ASSOCIATION PLAN NO. TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. ZDATE /JOB LOCATION Number Street address Section of town "HOMEOWNER" A 7 �5 h0A,1fjeC,\A, 6 Name Home phone Work phone PRESENT MAILING ADDRESS , ` ez- T':_ _ ity town State Zip "code The current exemption for "homeowners" was extended to include owner-occupies dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to re• side, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm structures A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"- shall submit to the Building Offic: on a form acceptable to the Building Official, that he/she shall be responsi} for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes .responsibility for compliance with the Si Building Code .and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirement: and that he/she will compl with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICI Note: . Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 01 Construction Control. HOME OWNER'S EXEMPTION , The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that. ii Home Owner engages a person (s) for hire to do such work, that such Home OW shall act as supervisor. " J ' Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensingt,Construction' Supervisors, Section.'2. 15) . This lack of awaren often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person,-as- it •would with licensed Supervisor.- The Home"Owner*'act as supervisor is ultimately kesponsibl'e.' To ensure that the Home Owner is fully aware of his/her responsibilities,. m communities require, as part of,fthe permit application, that the Home 'Owner certify that he/she understands the responsibilities of a supervisor. On t' last page of this issue is a form currently used by several towns. You may care, to amend and adopt such a for for `use in your community. f . . The Town of Barnstable,�♦s Department of Health Safe► and Environmental Services Building Division 367 Main Sumer,HYattuis MA MWI Ralph Cm Off= 508-790-6227 Big Faye 508-775-33" � For affice use Daly , Permit no. Date AFFIDAVIT HOME nVIPROVEIVINT CONTRACTOR LAW SUPPLEMENT To PE nffr AFmCAIMN MGL a 142A requires that the"tecanstructim aria= renovaliM=04 Z oe eanvesa improverpent, remm-4 demolition, or mart of an addition to any pm-� Owner Doc cq building captaining at least one but not more than four dwelttng units or to s which are to such residence or building be done by regi =cd axn=ctm with certain cwt7dom along with cd rt~gttiremeats. - Type of Work: Est.Con � /Address of Work: t\ �� /Oaner.Nw= AVIV14,0A bfi 0 t`T1�9 ate of Permit Application: I hereby ccrtify that: Registration is not required for the to eg 11cming rrason(s): Work exdpded by law ' Job under=000 Building not awnar-aceapied 74 � cwn Notice is hereby giti'e:t that: CONTRACM OWNERS PULLING THEIR OWN PERMIT OR DEALING WTIH ZJNREGiSTF3Im FOR APPLICABLE HOME pApROVF.ME qT WORK DO NOT HAVE CESS M ARBrMTION PROGRAM OR GUARANTY FM UNDER MGL c 142A SIGYED UNDER PENALTIES OF PERMNY I hereby apply for a permit as the agent of the owner: - Ala D „ R. A f%W"iw c mate DEFT LAM AV-w 11:0_:'94 Ii:fl2 '$`81TiZi?1ZZ. -, • . C0132J�'LOIZWP.QLLiL O� /�Q�IQCIZLLIQ� .James J.Campbeq boa, ///aaiacA�ua 02f If commissioner Workers' Compensation ftmance Affidavit with a prindpai place (arn zm� do hereby certify under the pains and penalties of pwiurn that: () I am an employer providing^Workers' compensation Coverage for my employees this job. , Insurance Company Poficy Number ra O I am a sole proprietor and have no one working for me in any capat- 0 I am a sole proprietor, general coatraaor or hoateowner (drde one) and have f contractors asted below who have the following workers' =mpensadon pofiat~: Cantraaor Insia== CoananytFodc Contractor tasvcaace Ccmi�anY/Pofic Con =r Insurance Q=panYlPork ( t im a homeowner performing rill the work myself. I w1ee.^a:ise ss a CWI of tis S=ZgnMM will be fomwded to dx OIRM of 1nvadCM*M of the C"for aoM2F vadc2dwInd tt se r ge s rec:•.ed under 59CdCn 25A of MGL I:Z tmt teed to dfe lrnpoaiteoet elf a'ats nt p e ata tO S t re�-s rm�rto,-rzanc as tt as cm oenawas in the(am:e f a STOP WORK ORDER Md a ane e(JIM 00 a dal api=n!e Sign tfiis ' day of • t q censeelPertnittee Building Licensing Board • maimuftr aside Siding Mao D Pine Trim nTnm . MOM WME ftrasidr ding man PineTdm MOM , a #rN [ " al it MN4J' F F Cc "� x say # F yr i 0 � �L, w`a w„ r a 7L,+t ✓ �, iri} }-%raw �a�� `- I J.t+��'��.. -.+ Vg �z4 rNO, u [ [ g71 i '� "�� k� ��?;'.. , � afar _ -✓ s��'�� >v�I�4r h�,s (�S''-'ram-✓.. .- 0 �3 a,r •. i r, f C r� ,ft}e�,&��f��. .- � 1 �� ,�. ... s :..s {r I ,s'<< '.R �n �; � ?x. �,�;[• e�..�u.{ 4� ��"r ��af r"` S�t �-S ti: � 5 3 PP � ' 1 1 � �-�� I • 1� �� '� 1 f:t Ili • i Irv.. / •�• �` 1 � � I v� ice'a► , • �'-' ��`��)♦ � , A�^-ate-�a..�i) �� . •► ^►� ♦ � ;�I lei \,Q �'/ �.�" �, �•� -� .i 1 {I Q� '� � =k _ q as �_ �� / � �� 1' •� a � � \`;�1 , , �•` 1`_ fir, �1 �I /�� _ Ono 1 �y, .01/09/1995 00:33 91508790623( PAGE 01 'own of laarnstable Expires 6,nonths from Issue date I Legulatory Services Fee x"k T somas F.Geller,Director ++�+ auilding Division X-PRESS ' To As Perry, Building Coimmissl,oner 20)Main street, Hyannis.MA 02601 0 C T 1 8 2004 office:. 508-862-4038 Fax: 508-790-6230 T RNS j',-,:._ d >ta;XPItESS P II T PLT AT1!2N - RESIDE � Vol Valid tv0out Red X Pasts ImPrint map/parcel:Nuxuber �f� ® .� Property Address ID�csidential Value of Work Minimum fee 5.00 for work under$6000.00 Owncr's Name&Address l Contractor's Name Tclepbonc Number (J 7 rl Home hwrovement Contractor License# sf apl licable) Q 0 Constmc' crvisor's License#(if applicirk lc) or1anin'6 Compcusadon Insurance Chock one: ❑ I am a sole proprietor [] I am the Homeowner D I hay*Worker's Compensation 1w arancc Insurance Company Name Workmen's Comp.Policy#_ 41C 7 Copy of 1neurance Compliance Certiffca e:m ast be on file. Permit Request(check box) [] Re-roof(stripping old shingles) All construction debris will betaken to []Rc-roof(not stripping. Going over existing layers of roof) F ❑ Rani v. cplacemcut Windows. U-Value. 9 (maximum.44) 'lti`hcrc roquirod : taar� L3 Qt7is dp�> t c_ luau with other town deptu•ta=t rrgulrtioru,i.e.Mttoric,Con,crvston,etc. "* ote: Property Owner mu.1 sign Property owner Letter of Yer•miss on + Home Improvemerd Con ciors License is required. 1 Signature &16 h V I -- Q:F�mv:axpmtrs Roviw063004 a�n Board of Building Regina ons and Standards One' Ashburton Place Room 1301 Boston Massachusetts 024 08 Home Improvement Contractor Registration Registration 1 4098 a Type Priva[e Corporation r F�cPlr atlon 7/13/200ti NEW ENGLAND-SASH Kevin Wei is 1333 Grafton Street, Worcester; MA.01604 ` Update Address and`xeturn card 114arkreason`for Chang 7PS,CA7 �r SOM OM04 GI01216 Address..Q Renewal Q. Employment Q tCard Xe itomvziza�aaa ay� �t�a�rauselt4 Board of Suildrng Regulahoas and Standards r� L�censc or registration vabd:for indivwul use only HOME IMiPPOVENEENT¢(IA,TRACTOR.; before the.egplratton:dnte 1f'fnund;.return tf) Reg�stratj np 104098 Board iofBuddmg Regulations and$tapdards ' f?xpiratftrn 7/13/2006 One Ashbuton Place Rm 13A1 Type Pnvate Corporation Boston,Ma OZ108 y. NEW ENGLAND SASH;iNG. Kevin Wells 1331 Grafton Street ;Worcester MA 01604 _ Ad Im sd atgr.: Not valid;wit h6 t signature': l fly:0�/28@4• 'Ifl: 313 ' 7812 +. 7322tG.. gor c ORSO ORD. ot:can 'CERTIFICATE QF C;1 ABIL.IT`r' INSUFiAMC(7sl)27]-SZoa t-: ' e•+rtlwbaocnTYY) 1f%coma Insur■nce 4 �7a1)27J•OE00 T 15CEFZTIFICAT I51 g�ney T 13 ED S Of/51/200� Can6ridge 5tr4et• AND CONPRcRS.X0 RIGHTS UP t4 OF INFORMATION 0. lay 130 Z HOLDER.THIS CERTIFICATE DOES NOT THE CER71E p��o• ALTER THE COVERAGE AFFORDED g T JI E- rtl f ngLon, NA .gXld3 Y THE- RA 130-O y, ° N'If Eng7:and 5■sN Ine. & l+■stonal INSIJRER3-AFF0RDfNC COVERAGE 1333 Grafton Str■at En■rgy SYs3gma IN NAIC>) MA a '� Pinn-An4rica Insurance Camp■ny Horce7CeT•. �604• . INDIlREAy; An1eri4ap Home .Assuranca Camp■� r INSURrLR C. •ERAGES mIrtena:• E POUCIE9.OF+'INS URAQNCE LISTED BELOW HAVE Se Y RcQU[REhIENT.'. EFtM•OR-CONDITIOy OF r1,V(CQ EN.I SWED TO THE Y P_ERT4W.THE':►N3URgNC9_�AFFO�DED BY THE c'OR O URED•NAhIED ABOVE FOR THE POLI"Y pER cv hp• _ICIcS.gGdRECu�TE LI.HITS SHOWN lLIAY F aV(!aEEtiR�E�UCE[i®pa0 CCUMENT WITH RESPECT f+7 y;/f 0H'Ir'I Ci R..FICA M��vo�u • OE9CRIBEIJ HEREIN IS.3UBJECT TCALI-T1iE TERpsS•EYCL'.1s1oNs�� (TNSTANOIN.• Rlt ' TYPd•01!INiUAAHCQ L,INd9. - E gE ISS>1E0OR PoULYNuuaatTt to CO�OITi OF SUC-1 GENERAL LIAINLITY 0 e ' X. COMMGRCIALcBNERALLIAOIUTY PAC61lia7s' 0! to rTxwo ( uwrs / /too{ 03/IO/za01 dACHOC„CAC.-1z: CLL�Ms hVWE OCCUR J IP4 Mi., t 2r0a0',09C I 1III iiP JC`y 30 r 0 0 C �'• '.:.. (CENt aGGAEG+tTE IJLVT A7PUEs PER, .' P=RSJrL�a:Lv In,vRY 1, 3',0 0 0 1 • r,00'0.a c ?OUCY JZI.T G LOC ETI�4AL l.GFA. - 1 j AVTOMOta0.6.U4a31L1T7 P40=t'C TJ-CC-PfIP ACC I Z•do 0. �AHY•AGTO'. .. I 1 S++c in CA FLL,oIyNBDehUTos �u SING.g Lj.4r 1 8CNa0UCEC AUTos H?;:o AUT0,5 ao°lY ttiLFY. NOfI-OWWiD 11UTO3- • - OjDILYT�-ia't . i"v - + .CAnAoa.UAsILITY •. '/ZOP>:T1 i-r G1r A1,r,3.^^• I . MY AU TO ` IVrr'.c_ptr•, - I3 CXCEJyUMa7tr.LL-A*.IAjuU77 CT'Ia;ATrtr1 EAAcc -1 OCCUR a CLAIMS MADE + AIG 1 uc�at Q AG 4iD >REUHT10M i K93 COW.M.SATIOH Avq I 1 .or�ArLG►uLriY' HC973491Q6zHD .04/19/IOat Ot/29/Z005 _ rA0rR IETCR/PAnTNCIUEYr,Cl/TIVB CZN'M&MI fiAAtiCLUDCJT '•C2:: J"=Ibn•vrdsr' - ✓:L S.1C:i ACCC;?y 1 IAI PROVISIONJbe'aw E.: DIS1!t D4PLpYE I S 700,,000 ' A 50a:0aa .' . E.L OIS4V3•rCUC+UL:1T I 500.03.3 H T.ONS/LOCATIONS/.VFHICLE7l EXCL a1ONJAOD 8Y N qd �f• CA NCELL A TION - 3NOULp/yy„ORiNEADpvICE,SCA7l0P'CV1cIII UPIRA a[CaMCIICLdC�[f OfCQ TN6 . TIDN DATaTNCrtlOr TNQ L7SLIAC'�sL;R�y'AllEN0isv0�TCrd41C • - -DAYS WaUTTE,Y NOTICE TO-Hl c Em-tir-Ar< 7 TC YH!LHFr. e ■VT-#Lung io W VL 7 VCH MOJIC 7 Y 3H4LL:V"l NC OSUG4TOA•:wt 1:AlIL1:Y 1: ` OR ANY MM13 WON T1411 IN3UREII,:T3,�q E,Ka DA 4L+ItiG]i`If f lm.ns.sn,tr.ene....R17ri!F. r-6 Ajrm { Fix 2 74 ;CONTRACT made tayof in the year betweeri New England Sash, InC.and 0�*114 (HOME QWNE!RS) (HOME PHONE) (BUSINESS PHONE) of -(STREET) (TOWN) (S ATE) (ZIPIr As used in this contract,the words we,us or our refer to New England Sash,Inc.and the words you and your refer to the customer. We agree to furnish all labor and material necessary to install the following described windows at: Sc2-4 ( e CA Double H.P. Total Units: Glass Glass Grids: Y i1a indow Color: Material: Double Hung Units: °�� ^ We do not do any painting or staining. Installation: We are not responsible for conditions or circumstances p Picture Units: c-- beyond our control including condensation resulting from Total Contract: QZz or due to pre-existing conditions.Our limited warranty is Hopper Units: — �--7 herein incorporated by reference. PP Sales Tax: Sliding Units: 2-lite: 3-lite: Awning Units: 1-lite: 2-lite: Casement Units: 2-life: 3-life: 4-life: Total Bay/Bow Units: DH/CS 3-lite: 4-lite: 5-lite: Price: Garden Windows: 3-life: 4-life: 5-life: Deposit Cif Exterior Finish: Roof Soffitt Total Projection: Knee Brackets:Y/ N With Order: Entry Doors: Steel Fiber Style: Add Deposit Storm Doors: Alum W. Core Style: Due Date: Sliding Glass Doors: # Color: Z Balance Due PP Capping/N # ': � ' �LGS On Delivery: � fl3 Additional Notes: � r ,c`•�+:a .�a ��ti� i 1 k Irzaesj DEPOSIT WITH ORDER ❑ CASH ❑ CHECK# BALANCE DUE ❑ CASH FINANCE You agree to pay cash according to the terms shown above or,if your credit is approved,to sign a note provided by us for payment of the amount due.You also agree to sign a completion certificate upon completion of the work.If you fail to make payments when they are due,then we may immediately stop work.We may choose to not start work again until you are current with the payments and we feel secure in obtaining the remaining payments.If there is any stoppage of work due to the preceding,such delay shall automatically extend the date of substantial completion. Payments due and unpaid under this agreement shall bear interest from the date payment is due at the annual rate of 18%or at the maximum legal rate,whichever is less.In the event that we incur costs or expenses in collecting such payments due and unpaid,you shall pay such costs and expenses including reasonable attomey's fees.In addition,you understand that by failing to pay according to the ab ye to s,the seller may have a claim against you which may bee forced agai t your property in accordance with the applicable liens taws. The installation Will begin on or about �d will be substantially completed on or about ;I "is-understood by you that the following contingencies could materially change the estimated completion date stated above: customer's inability to obtain or qualify for financ g; inclement weather; strikes or other labor disruption; non-availability of materials;acts of God. We represent that we carry Workers'Compensation and Public Liability insurance in the amoun of. 100,000-�MAOSSACIH ALL RESIDENTIAL CONTRACTORS AND SUBCONTRACTS ARE REQUIRED TO BE REGISTERED WITUSETTS BOARD OF BUILDING REGULATIONS AND STANDARDS, UNLESS SPECIFICALLY EXEMPT FROM REGISTRATION. INQUIRIES CONCERNING REGISTRATION SHOULD BE DIRECTED TO: DIRECTOR, HOME IMPROVEMENT CONTRACTOR REGISTRATION,ONE ASHBURTON PLACE,ROOM 1301,BOST 0�18(817 727- t_f CONTRACTOR OR SUBCONTRACTOR IS OBLIGED TO OBTAIN THE FOLLOWING PERMITS: ( IF WE DO NOT OBTAIN THESE PERMITS,AND YOU OBTAIN THEM,OR IF WE ARE NOT REGISTERED WITH THE BbARE_Or_BUILDAG REG&ATIONS'YCVJ WILL NOT BE ENTITLED TO OBTAIN ANY BENEFITS FROM THE GUARANTEE FUND ESTABLISHED UNDER MASSACHUSETTS GENERAL LAWS,CHAPTER 142A. ANY DEPOSIT REQUIRED UNDER THIS AGREEMENT TO BE PAID IN ADVANCE OF THE COMMENCEMENT OF WORK SHALL NOT EXCEED THE GREATER OF ONE-THIRD OF THE TOTAL CONTRACT PRICE OR THE ACTUAL COST OF ANY MATERIAL OR EQUIPMENT WHICH HAS TO BE SPECIAL ORDERED OR CUSTOM MADE,WHICH MUST BE ORDERED IN ADVANCE;OF THE COMMENCEMENT OF THE WORK,IN ORDER TO ASSURE THE PROJECT WILL PROCEED ON SCHEDULE.NO FINAL PAYMENT MAY BE DEMANDED UNTIL THE AGREEMENT IS COMPLETED TO THE SATISFACTION OF BOTH OF US. YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN SIGNED BY A PARTY THERETO AT A PLACE OTHER THAN AN ADDRESS OF THE SELLER, WHICH MAY BE HIS MAIN OFFICE OR BRANCH THEREOF,PROVIDED YOU NOTIFY THE SELLER IN WRITING AT HIS MAIN OFFICE OR BRANCH BY ORDINARY MAIL POSTED, BY TELEGRAM SENT OR BY DELIVERY, NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FOLLOWING THE. SIGNING OF THIS AGREEMENT. BY SIGNING BELOW, YOU ACKNOWLEDGE THAT YOU OWN THE ABOVE PROPERTY AND THAT YOU AGREE TO ALL OF THE TERMS OF THIS - CONTRACT. YOU ALSO ACKNOWLE E THAT YOU HAVE RECEIVED A FULLY COMPLETED COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CA ELATION AND HAT YOU HAVE BEEN ORALLY INFORMED OF YOUR RIGHT TO CANCEL. DO N tSl N THIS CONTRACT IF THERE ARE ANY BLANK SPACES. t 1 IN WITNESS WHEREO parties have here to"'i their names this day of in the year of CL—/ 0 Signed Signe RKETING RE TATIVE q OWNER- ri - Signed Accepted:New'England'Sash;`Inc'" ~; c By Signed yw AUTHORIZED'SIGNATURE TITLE OWNER NOTICE OF CANCELLATION DATE(TODAY'S) YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map /G Parcel 154 _ Permit# ,0& N Mt Health Division ' / TO k OF Date Issued zq ', �r" I). f r 1 0^ ' Application Fee , 7,/�� • ��-�Conservation Division Tax Collector 0 ,Z-</ ��+ y � Permit Fee Treasurer If -"";;liviE l0N APPLICANT MUST 0$ TAIN A SEWER Planning Dept. ENGINEE�RINGDIVIS ONpWORlTo Date Definitive Plan Approved by Planning Board CONSMUCPIOIZ Historic-OKH Preservation/Hyannis Project Street Address "!Z Se,�-XTi Village �//fiYI yJ 1 5 Owner Address _ `L� /31t�'Z�PJ� /C D. Telephone 6-D F- 99,?- Sl�� Permit Request �4 ti' 19— d �ifG�lea� GU irTA D• 4 6- 0e k" Ablve-_1 Square feet: 1st floor: existing proposed� 2nd floor: existing proposed -2-J� Total new Zoning District Flood Plain Groundwater Overlay Project Valuation d (e 50 Construction Type S 8 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 c �2os�"Fo ufiJ/Jr�7 iet�l ��.�f'4� Basement Finished Area(sq.ft.) X e - Basement Unfinished Area(sq.ft) Number of Baths: Full: existing �--, new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gaffs ❑Oil ❑ Electric ❑Other nG;1 4e-,- Central Air: ❑Yes ETlo Fireplaces: Existing New Existing wood/coal stove: ❑Yes 9446-'_ Detached garage:❑existing Olew sizejPool:❑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 Cl Yes ®1qo If yes, site plan review# Current Use Proposed Use 0 e__ _., BUILDER INFORMATION NamejA/P�/c°S /2ol-i�.f'S Telephone Number Address IV,' 1,&eS7_ %U7 License# ®70 7S3 ez yA Home Improvement Contractor# /O 3 �7 5?3 Worker's Compensation# GU CG(o,F ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0 93 G,eeeO -3-0-l its y4 g � Z; o-aw SIGNATURE tl li�• (r�37-DATE FOR OFFICIAL USE ONLY PERMIT NO, DATE ISSUED MAP/PARCEL-NO. ADDRESS � VILLAGE OWNER .,,PATE OF INSPECTION: f ,-FOUNDATION ] Ito 'Roe A .cJ 0- A . t FRAME / !/• f , t J • INSULATION r J r FIREPLACE f ELECTRICAL: ROUGH FINAL-- PLUMBING: r J 1 i ROUGH FINAL,- GAS: ROUGH - FINAL" FINAL BUILDING DATE"CLOSED OUT r .r ASSOCIATION PLAN NO. �� RESIDENTIAL: SHEDS - POOLS -DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,detached garages,gazebos,eta >120 sf-500 sf $35.00 $ >500 sf-750 sf 50.00 $ >750 sf- 1000 sf 75.00 $ 2 � >1000 sf- 1500 sf 100.00 $ >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS x$30.00= $ (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) PERMIT FEE $ �J Q:forms:dkcost eff:092301 71 19 c /i ► ,4 �1 k O 9 WIT:trot oR srnbok 601E cmt%FURWAY 4J -•', EDGE OF DECIDUOUS MISS 10 10 MAP 3 - EDGE OF BRUSH 3 --; oRauRo oR NURsBO 9"1 : 6 v7-r-v EDGE OF CONIFEROUS TREES # 134 # 1 0 ED AAA GE MARSH AREA MAP 310 OF WAM __-= DIRT RDAD 5 8 DIUMAY PAWKINGLOr C' 0\ . # 111 � -PAVED ROAD l7( -- - DWUMA�DITQI AX T E _____ PATH/TRAIL _.. ..__ PARCEL UNE•• wutto - MAP# MAP O 2 T —PARCEL NUMBER � � HOUSE NUMBER P 310 MAP 3 Y FOOT�NfOUR 1lNE � � "� # 11 /Q —9 �— 10 FOOT ODNTOUR LINE 6 0 i ` Elevation based on NOW # 13 3� �I \/4.q SPOT ELEVATION crx� STONE WALL i-X—x- FENCE RETAINING WALL RAIL ROADTRAQ MAP 310 SIONEEIETTT (� SWulAUNG POOL i PORQI/DECK 0 BUILDING/SIRUOURE MAP 310 P 310DR N HYf 6 2 6 VALVE @ SWIDIE # ss . �_ 14 - O POST QA FUGPOIE T O W N O IF R A R N S T A 0 L R A R 0 6 R A'P N I C I N F O R M A T I O N S Y S T E M S U N I T v SIGN ® SIDBM DRAIN n rdNIFDSQIEINF&T s�..&.,modda **NOTE 1MpawRaesareonlygcopfdccepaneclolioca DATASOUR:P1wjmst(ean•m&butane)aero6deWeM6meIMaecblFI*jp,jI,brThewo lames o URUITFOIE ❑ TOW ZS SU Ny Sty of lads d bw ace L l W1mm and W.SeroB .TWepWhF aed sepelotion aero tnkignled*-meet Na9aid 1 a 5� f:\dgn\oonservation.dgn 06/18/0210:09:38 AM . ; ; MiTek MiTek Industries, Inc. 14515 North Outer Forty Drive Suite 300 Chesterfield,MO 63017-5746 Re:17697R Telephone 314/434-1200 WALLIS LUMBER Fax 314/434-5343 The truss drawing(s)referenced below have been prepared by MiTek Industries,Inc.under my direct supervision based on the parameters provided by Reliable Truss Co. Pages or sheets covered by this seal: I3097553 thru13097554 My license renewal date for the state of Massachusetts is JUNE 30,2002. STEPHEN CABLER m CIVIL 710 OhNAL E��\ April 12,2002 Cabler, Stephen W. The seal on these drawings indicate acceptance of professional engineering responsibility solely for the truss components shown. The suitability and use of this component for any particular building is the, responsibility of the building designer,per ANSU'TPT-1995 Sec. 2. russgw russ ypez, 309 653 5 sK 1769e 1�TOl i 7z r a c.i.�tNj ATTIC x- 1q 1 a r�t x` 4ZA 7. „M. --.f..3:t,3r.,4�x,__.; '£-.rM4..a,:` v+ - -,. .�+. ?_.:t •. - Y ::'�' s.��-ty .u-� ... > ..: "h« (opt onal) "', US1neS-.I c Fri Apr a N6* t ¢}�i} p ` OFOlO31-12 3,r57048812' t'12-0-0 153d r 18-1-12 ,`20.10� '24-0-0241Q-0`M T a �r x T1 u�r 0.10-0 3-1-12 p `-2-0-8 2 10-0 3,34- 3 3� 2-10 8 2 8 8 £: 3 1-12 0 1D-0! w i1f f '� '._iS. ; 3 5x6�i ` iq p.,r Scale 183.0 sit Q e"t• 7, wS :4 fl` 4,I ru' V h.. p _"5�..t "x'••.'` S. fl.. * it 'E •^e 8 's _» ' �._ ... �" tad ` ''•` s `- F� �• a�, t = ` 3x4 a a.. •sr- F' 12.00 12 •) 3x4 R `, q� �� ^s' �"*' r r i a5 3x12 II Thy s3 z Y 3 t 3.12 II i. # r :a , „'t isf �.`r ra ..10x10 8 r. _x "• y "4 K�,. ad Yn'- ...± '10x10\\- v y -a"t'"#,r� { y ,.r.'S 's�b• E •.'ii�m fY e x i1 1 e.. §r a a s «!. ` s _"' J3 a $ �. q'i 4x8= 14 13 12 - 4x8= 1ox10= 6x8= tOx10= x `,f 3-1-12 5.104 18-1-12 20-104 24-0-0 r 31-12 2-8-8 12 3 8 2 8 8 3-1-12 Plate ,-,Offsets e, LOADING (psf) SPACING '` 2-0-0 CSI DEFL in floc) I/deft - PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 0.81 Vert(LL) -0.46 12-14 >620 M1120 197/144 TCDL 7.0 Lumber Increase 1.15 BC 0.51 Vert(TL) -0.68 12-14 >421 BCLL 0.0•.' Rep Stress Incr YES WB 0.80 Horz(TL) 0.02 10 n/a BCDL 10.0 Code BOCA/ANSI95 (Matrix) list LC LL Min I/defl = 240 Weight: 169 lb LUMBER BRACING TOP CHORD 2 X 6 SPF 210OF 1.8E 'Except' TOP CHORD Sheathed or 4-2-11 oc purlins. 11-3 2 X 6 SPF No.2,9-11 2 X 6 SPF No.2 BOT CHORD Rigid ceiling directly applied or 9-2-5 oc bracing. BOT CHORD 2 X 8 SYP DSS WEBS 1 Row at midpt .5-7 WEBS 2 X 4 SPF No.3 REACTIONS (Ib/size) µ2=1967/0-3-8, 10=1967/0-3-8 y Max Horz 2=753(load case 5) Max Uplift2=-488(load case 6), 10=-488(load case 6) FORCES(lb)-First Load Case Only TOP CHORD 1-2=52,2-3=-2681,3-4=-2524,4-5=-1409, 5-6=211,6-7=211,7-8=-1409,8-9=-2524,9-10=-2681, 10-11=52 BOT CHORD 2-14=1803, 13-14=1438, 12-13=1438, 10-12=1803 WEES "; 5-7=-1737,4-14=1340;3-12=1340,3-14 535,9-12=-535 NOTES 1)This truss has been designed for the wind loads generated by 90 mph winds at 25 ft above ground level,using 4.0 psf top chord dead load and 1.0 psf bottom chord dead load, 1 mi from hurricane oceanline,on an occupancy category(,'condition I enclosed building,of dimensions 48 ft by 24 ft with exposure C ASCE 7-93 per BOCA/ANSI95 If end verticals or cantilevers exist,they are exposed to wind. If porches exist,they are not exposed to wind. The lumber DOL increase is 1.33,and the plate grip increase is 1.33 2) Design load is based on 35.0 psf specified roof snow load. 3) Unbalanced snow loads have been considered for this design. 4► 'This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas with a clearance greater than 3-6-0 between the bottom chord and any other members. 5)Ceiling dead load(3.0 psf)on member(s).4-5,7-8,5-7 6)Bottom chord live load(40.0 psf)and additional bottom chord dead load(10.0 psf)applied only to room. 12-14 7)One RT7 USP connectors recommended to connect truss to bearing walls due to uplift at jt(s)2 and 10. ��0� 8)This truss has been designed with ANSI/TPI 1-1995 criteria. ` Mks LOAD CASE(S) Standard _� S�EPNENW."6t, CASLER C;VIL .� �Na.31927: n April 12,2002 A WARNlNO Ve ft design parametsro and READ NOTES ON THIS AND REVERSE SmE BEFORE USE' d s � .>_ x yD;4jq volld for use ony wtlh MRek<eonnectori Tlik:desgn k based ony.upon parameters shown,and k for an Individual bu8cilnq component to be lnstcned and boded verticcfy*AppBe660y of design parameters and proper Incur atbri of component Is responslblBtyof building des ner_`not buss' ' qr _, f, Pa g b 2 aiva __� despiser Bracing shown k for lateral support of IndNidual web members ony.AddBbnal temporary bracing to Insure stability during construction k the "> responslbllliy of the erecta:"AddRbridl permanent brocing'of the overall structure k the responsibility of the building designer.For general guidance regordlnq fabrication,quality control,storage,delivery,erection and bracing,consuB QST-88 Quality Standard,DSB-89 Bracing Specification,and HIB-91 M 1Tek® Handling Installing and Bracing Recommendation available from Truss Plate Institute,583 D'OnoSb Drive,Madison,WI53719. o c Truss, x r ,�• russ ype �» x ry Y vLUMBER IV 13097554 ..-t-'+�:•' .,ti5-r£'�k.� e„-5'_ -uk. s,+.;u: _ ram" • _ �.. ^,��.,�.,� ate, '�'' � „ g " s r, 2 kAi ek lndustries,�,Ipc.. n Apr 12 07,,11:45a e x f .w�LO - r a#4 c w +�10 0 510 4 8 8 12 172'0 0 715 3 4 18 1-12 n +24-0-0 r .;24-10-:0 33-4� 5x8�334 f 2 pw5-100�4 ,.0.10.0 n. t i -fT , " - t • ` € ySgle 1.87.5 <t 1 g k". s x x M }, ac4 II 4✓ ? S t 2xa I I ' 2x4 11 2x411' 9 3 a k «. . 1200 12 � Qi&g t10xfst e - . e _ {ca t r. -,tertvL $€ ak, i e�.c -i 3� M =:.. +• 2u4 II t - }' ,{•2x4 w:.. y'- r� r Ls r s7 r gY II 1 s •i d t :� - -... .:•� -n r; i.� y d Cj.- ^'�a #•' 4 ,� 71 �' .3 - ° h :- =,.d z ;. r sa r° i .s2x4 II s •. 0 2x4 II z °4x6//�.8 T.4' ;� #.. 12�. 2,x4 Il i... 2x4 ll 4 +fir t y.`•' "'4 VT 4x8\\. . - i`7 y- •+s *.i } �i .. <. '' �° c w. t n q 14 a �, j. = 27 28 hro Ax8 .28 = _ u -K- - -25 24....v.23.-22 v-,.21..,.,.�20 •-"19-18 34 I 13x6 II 3x6 11 3x6 11 3x6 11 3x6 I 13x6 11 8x8=3x6 11 3x6 113x8 I I +"*' i 9�{'*✓�a�,:s x Act - - - 1 5.10.4 18-1-12 1 24.0.0 1 5.10-4 12-M 5-10.4 r Plate Offsets LOADING (psf) SPACING 2-0-0 CSI DEFL in floc) I/deft =. PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 0.14 Vert(LL) n/a - » n/a '«= M1120` 197/144 TCDL - 7.0 Lumber Increase 1.15 BC 0.03 Vert(TU -0.00 16-17 >999 BCLL 0.0 Rep Stress Incr YES WB 0.26 _. Horz(TL) 0.01 16 n/a BCDL 10.0 Code BOCA/ANSI95 (Matrix) 1st LC LL Min I/defl = 240 Weight:217 lb - LUMBER BRACING TOP CHORD 2 X 6 SPF No.2 TOP CHORD Sheathed or 6-0-0 oc purlins. BOT CHORD,2 X 8 SYP DSS BOT.CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. OTHERS ;�.2 X 4 SPF No.3 WEBS 1 Row at midpt 9-23, 10-22,8-24 REACTIONS (lb/size) 2=223/24-0-0,21=212/24-0-0, 16=223/24-0-0, 23=132/24-0-0, 18=209/24-0-0, 19=206/24-0-0,20=208/24-0-0, 22=194/24-0-0, 28=209/24-0-0,27=206/24-0-0,26=208/24-0-0,25=212/24-0-0,24=1 94124-0-0 Max Horz 2=753(load case 5) - Max Uplift2=-254(load case 4),21=-194(load case 6), 16=-183(load case 5), 18=-163(load case 4), 19=-176(load case 4),20=-173(load case 6), 22=-131(load case 4),28=-164(load case 5),27=-176(load case 5),26=-173(load case 6),25=-194(load case 6),24=-155(load case 5) Max Grav 2=365(load case 5),21=249(load case 3), 16=295(load case 4),23=196(load case 6), 18=244(load case 3), 19=241(load case 3), 20=243(load case 3),22=235(load case 3),28=244(load case 2),27=241(load case 2),26=243(load case 2),25=249(load case 2), 24=235(load case 2) FORCES(lb)-First Load Case..Only TOP CHORD 1-2=48,2-3=-135,3-4=-131,4-5=-72,5-6=-130,6-7=-130,7-8 -132,8-9=-122,9-10=-122, 10-11=-132, 11-12=-130, 12-13=-130, 13-14=-72, 14-15=-131, 15-16=-135, 16-17=48 BOT CHORD 2-28=52, 27-28=51,26-27=50,25-26=50,24-25=49,23-24=49,22-23=49,21-22=49,20-21=50, 19-20=50, 18-19=51, 16-18=52 WEBS 9-23=-92, 15-18=-163, 13-19=-168, 12-20=-168, 11-21=-172, 10-22=-154,3-28=-163,5-27=-168, 6-26=-168,7-25=-172,8-24=-154 NOTES 1)This truss has been designed for the wind loads generated by 90.mph winds at 25 ft above ground level,using 4.0 psf.top chord dead load and 1.0 psf bottom chord dead load, 1 mi from hurricane oceanline,on an occupancy category 1,condition I enclosed building,of dimensions 48 ft by 24 ft with exposure C ASCE 7-93 per BOCA/ANSI95 If end verticals or cantilevers exist,they are exposed to wind. If porches exist,they are not exposed to wind. The lumber DOL increase is 1.33,and the plate grip increase is 1.33 2) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind(normal to the face),see MiTek tj��Mks "Standard Gable End Detail"- 3) Gable requires continuous bottom chord bearing. 4)Gable studs spaced at 2-0-0 oc. r 9e, 5) •This truss has been designed for a live load of 2 .Opsf on the bottom chord in all areas with a clearance greater than 3-6-C .tom STEFHENW., yG between the bottom chord and any other member T p CrASTER m 6)One RT7 USP connectors recommended to connect•truss to'bearing walls due to uplift at ft(s)2,21;:116,23, 18, 19,20,22, V ;r vi` 28,27,26,25,and 24. y: L `,. 7)This truss has been designed with ANSI/TPI 1-1995 criteria. ,QNO 31927a eA LOAD CASE(S) Standard 15 .t ry _ .- ,j 1„'} '�f �,.q � P` +e�i. .. '-�; "_. f � wT � �^�B �_. �' q ' dI�' - •'7d; �� April12,2002G ,7'C'zevy"'Ity T+}'v e- rs yc'�'.• Vsr A'4N-'-R1Z'- 1.tMS'i y�r t +;, 0 warsrTnva Ver{fy design parometan arfd REdD NOTES ON Tffi3 AND REVERSE SIDS BEFORE USE ws :+::,r, '4 �:-. su Design-yard for use ony wMh MRek eonnectofs.Thk�desgn k based-ony upon paI meters shown,and Is fqr-an Indlvldual bu[ldlr component to be e` InsfaBetl and boded verfbapy"*°AppOToblBty of design perameters and propetfnoorpauflon of component k iesponslblAty of,bullding deslgnef-not truss designer.Blaolriq shown k for`Pateral;supporf o`IndNktual web'memberi on AddBlonal fem ly.` porn"ry brcckni fo'Insure itabBBy'dwing condructOn ts`m responsltiBBy'of_the ereetoi Addflbncl permanent bracing of the oveiatl structure Is the responslbBtty of the buBding designer.Fat general guksance _ regordlnp tabik afbn,qucllfy control storage,deMery,erectbn and bracln consA OST-88 CuaIR Standard,DSB-89 Bracln S ' g• Y g pecHbatbn,and HIB-91 MiTek® Handling Irutalling and Brxing Recommrandotlon avalbble Irom truss Pbte InstBute,583 D'Onohb Dive,Madkon,W153719. f FTHE ram, Town of Barnstable Regulatory Services 9B B 'g' Thomas F.Geiler,Director 1639.�A`0 Building Division Tom Perry;Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: ��¢�� +� Estimated Cost 9 3 -6-6 Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PE Y I hereby apply for a pen-nit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav - * . ...y COMMONWEALTH OF MASSACHUSETTs DEPARTMENT.OF INDUSTRIAI.ACCIDENTS ' = 6o0 WASHINGTON STREET BOSTON,MASSACHUSMS 02111 James J.Campbell WORKLRS'COMPENSATION INSURANNCEAFFID VIT:: (lieCritCClpetfiletc) with a principal puce of business/residence at: �c1y z pl do herebycertify,under the pains and penalties of perj ir1 I Oat art employer providing the foLlowin workers'compensation c S p oversge for my employees xvorking an this job. C - - Insuranc�co p=y Policf Number [ J I am a sole proprietor and have no one working for me. [ ) am a sole proprietor,general contractor or homeowner ccimle one) and have hired the contractcrs listed below who have the following workers'compensation insurance poEcies: Na.*ne of Contractor lmurzace Company/Policy Numbs Name of Contractor Irsrnace Comp;rrr/?OUC/Nus,btr Name of Comraer irsu:-ancc Compary/Fodc7 Nu:nbe; 1 1 i am a homeowre:pc.;or.:i.-tg all the wet'.:mysc! NOIr:Plcsc aware t a:• :-,:je homeswnC:.who e:Calev r":scat to do m-.at=.ar.cc,coast.-jcscn or rcpa t w ort on s dwelLag of;tot more than three unis is which the homeowner a.:o resides or on the graurds apgttrc:,art thccto arc:et :e: ;;Uy canzide cd to be cnplovcrs under L':e worker°'Cot ,=—valor.Act (C-L.C. 152,sec.1(5)),appuc-�c^. by a hc.r.,eoRner for a IEct ase or perti[tray eviccnce the legal status of an e nplcper u de:the lyorkcrs'Compcuaticr.Ar• I urwdersnad uired that a copy of this statcmer,t will be farxardcd to;t c DcP=--ic�t of IndustriaiAccidents'office of lanzw.ce for cov- e*25e> .f�ctiou and that ftilure to secure covc: ge a a req undc:Sc won 25.E of MGL 152 can lead to the impositiea of inal perLIlties corsisting of a Ene of uc to S15COM=d/or:raprsoa.,—nt cf up to ane yGr u•,d cit.I;,=Lln s is the fcrm cf a Stop 'orlc Order and a fuse of c 10b.C•0 a dzy ag2=- t me. clrme this Q' day of iiceasee/pezrrtittee licenser/Pertnittor �-- CERTIFICATE OF- LIABILITY INSURANCE ¢ A CORD DATE(MhUDD/YY) _<pw 1' r2 n fi 03/18/2002 PRODUCER (&06)237.-1378 FAX (S08)845-7443 ?THIS CERTIFICATE 13 ISSUEU AS A MATTE _ • ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE-0 ro Anast'asi. Insurance Agency HOLDER.THISCERTIFICATEDOESNOTAMENDEXTENDOR._- Business" Insurance Marketers ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW .ewsbur MA 01545 Box ''S 79 Shr INSURERS AFFORDING COV_ERAGEt, Shry. INSURED Guaranteed Builders & Developers Inc INSURERA:` Worcester Insurance Co 14 West Street INSURER R R B: Harleysville Worcester , East Douglas, MA 01516 INSURERC: Granite State Insurance INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY CB6E0212 01/19/2002 01/19/2003 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ 100,000 CLAIMS MADE M OCCUR MED EXP(Any one person) $ S,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY BMA893073 01/19/2002 01/19/2003 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 11000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) B X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO EA ACC S OTHER THAN AUTO ONLY: AGG S EXCESS LIABILITY BE6EO212 01/19/2002 01/19/2003 EACH OCCURRENCE S 1,000,000 OCCUR D CLAIMS MADE AGGREGATE S A 1000000 S 1,000,000 DEDUCTIBLE S RETENTION $ S WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE S E.L.DISEASE•POLICY LIMIT S OTHER BD 04/02/2002 04/02/2003 C DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS g CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL TOWN OF HYANNIS 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Paul Anastasi/MISSY c ✓fpp ie Lov�vn�.a�uaea� a�ililivae�a BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number:,CS. 070753 Expires: 11/11/2003 Tr.no: 8529 Restricted: .00 CHARLES W BROTHERS 119 VINE STD �o DOUGLAS, MA 01516 Administrator ;� ✓fze �om�naruueaflfc c�`•lf = \ Board of Building Regulations and Standards " HOME IMPROVEMENT CONTRACTOR -V Registration: 103793 Expiration: 7/9/02 Type: Supplement Card GUARANTEED BUILDERS&DEVE BROTHERS 14 WEST STREET E. DOUGLAS,MA 01516 � Administrator . 4� I r q rn 16 IRE r .;�-. � < fir. _ '• I I I i b � I jIr � . 1 ¢� All ( I I r S . f 7�- _ r ld f ;ij y \ Qj ,I v. Erb L I let i H '12lt RS r' v r !go 7., way". N ' c NW rt4 ` x _ ¢ ,r Nis . ..... RM W: A sh sit ,;; :. r II • 0 _p � I 1 ' r y x g v d +c 9, t III ' w . ' •� J F a.. x�t t '�, s� ¢ f` I ' �.i ✓taf°�' h'3s.�i�, 1 } sF FF5r$. t } Ro- AM, FF FFFF .c 3 75 71 Cw 4 Pon LA Z T i, rS. r 3C� I j' o ` QL�4' q$ T .W , I i cg ., _ I-o il it -12 i J r � r� a _h v jjz I i = i J J � ^�t �- �s �� , r 1 , I , Ir EX\()TITJ cl Cam.JUIJt'$, 0.49 1 NJC TIUti - ' �jiII ,.h- - is - 4I'FRrO�U_ti��V1 2T@nI�+2T oE�vvIcL£'}:1OVL.Qwti4.,.T-.q_E.\Gm.Ouu e¢lnJ l•_,�s_i1nc ie.w,a�._U4.�42..C4a.•c�_10*qn�!3E_._.1Er2.51.YiS\5�e�5e.:5._�._�c.ciaz_ �w'_><d V_s..pFb,- (eI�I f`�'�1I.sI�i,t�(I i�I�' I 1"Ii 6SU"x�Ii l(6 I I S1(I I-�I i-Sz JC`�C 1(-I u�I�tiaNII,cF-j S R•- � '3J E,/oaK4"(_sS r 7P6.wz.lSi-5v5vrue�E E�\u/r_ce'w_�oKID. L.v:osNe I N2.—OF=;GE _G TiluY O¢_ � - Fw 1Le Go L�.tR Ir 2ii5432 R� -- Cu �tCWi EIL\/A7lON REAR 2�- -_- . - q y of F,cC- WE 'De vlinBruce t� Ii - Designo 774•238-0773 ri : 1 I I i I I I _ n EK\STr..,. c._.�;JVlJCS.' - - -{1NE- P .� I I I I ; - IJFY R49-l1JJUL TtUN s ro: I — —'- — -- -- 2 1 , - Zr72:G.ir�iL..'�.. _ Ex(Sn�S SutERZGc:K - - II �<', I 'fyt_a K.:PLLX;$ - F_— l --oF c a �; I _. 3 �I -sub_ i f i (( f /4"T c�-S[ilY:h7-C LLR.0�2t10 iF�OR �. t �, :: I f+rael rti o.., j 2�In ISLci��G�'__ i,�12KCv_Citti�tf�-�_ R.3o INo�.�-\vN •. ..... ' i I i 1 _ a rs4 n t,- C Ra Ko4 3 ; �AAUt�G N:.:I]CxJC•.Slr'1.t 4,�i._— � f 1 co - 1 FROM eLcv�c\or Cwr Eu_�<\—lc�L R i _ �cut�ic�xscl 0 N w_;.•W BrucF�� Devlin 1_'UMeus5 aaz.Qj sCCp ess �.I'��.z DesignO icy; c'xrt 1 oh ...._ Q i e b 774-238-0773 I �- i I I I I I I , I I I 1 - i i i I II I I �_ .` � _ I�`�•. I _ I I I i I -I -r- - � - ' =.I I - - �. � L I 1 I 1 1 _ !---7- � I 7' I - I - I ; I _ T I J � ►�- i -1 I - i � I I I ' I i . . I I I cv .. r—T I � �— T_ I I -r•—�� s I � I - I