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HomeMy WebLinkAbout0055 BETTY'S POND ROAD 12e-<- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,-Map Parcel -Permit# K( 0 7 Health Divisio -7)a-6j® pate Issued d S Conservation Division S �� r' � TIg�O �pTIC S Fee 10 SYSTEM Tax Collector LIMITED CF BEDR00 ' Treasurer Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address �� �•��T/ r�/�od� l� Village Owner Address �, /�i�fi1-Y i_)OfJ Telephone Sef 7 Z Permit Request 7O 3:A)STALL f),CC ®y�E/2 Pobxi fit^ COeC?_I' C PAe boo ACA ou A OJ 12 9€AGAcC- C- AIS, >ourr Wr_'4AZ.L ?D ReMda 4; W, w bac..J A QN 7:A sA, c L 16 .", ' rRF�c/� od?g Square feet: 1 st floor: existing C o() proposed ' 0 2nd floor: existing q06 proposed. 0 Total new 0 Valuation Zoning District Flood Plain Groundwater Overlay r Construction Type WooD Lot Size 7 yD T Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W Two Family ❑ Multi-Family(#units) Age of Existing Structure Y95 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: )kFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new 0 Half: existing 0 new 0 Number of Bedrooms: existing_ new 0 Total Room Count(not including baths): existing new 0 First Floor Room Count Heat Type and Fuel: ❑Gas ILOil ❑ Electric ❑Other Central Air: ❑Yes %4.No Fireplaces: Existing 0 New 0 Existing wood/coal stove: ❑Yes *R-No Detached garage:❑existing ❑new size- Pool:❑existing ❑new size_)Barn:❑existing ❑new size Attached garage:_❑existing Cl new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# _ Current Use Proposed Use - r BUILDER INFORMATION Name Telephone Number Address . License# VA Home Improvement Contractor# iVA Worker's Compensation# N _: ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A P�STA 3L —LAN0 LL SIGNATUR DATE l FOR OFFICIAL USE ONLY 4.� i! PERMIT NO. DATE ISSUED MAP/PARCEC'NO. ADDRESS VILLAGE OWNER l DATE OF INSPECTION: + FOUNDATION 0 K 6 —O 7 �� FRAME INSULATION i sl FIREPLACE ELECTRICAL: ROUGH FINAL w t � PLUMBING: ROUGH FINAL GAS: ROUGH FINAL h FINAL BUILDING 4 DATE CLOSED OUT ASSOCIATION PLAN NO. r QW-1 16( J re 44 V-V QIQ > A � 2f SR,D,5 Forves fa�4le SAW- ���" ` The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Appucant Information A Please Print Le 'bl Name(Business/Orpni-zationadividual): Address:` City/State/Zip _ Phone#: Jf Are you an employer?Check the-appropriate box: .- Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 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 working for me in any capacity. workers' comp, insurance. g, ❑ Building addition o workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions ri t of exemption per MGL 11.❑ Plumbing repairs or additions 3. I am a homeowner doing all work" I myself. (No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' �l ]. 13_r\71 Other p FiC comp.:insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy-information. - I am an employer that is providing workers'compensation insurance for my employees. Below is the poTiiy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: A if Pf Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500;00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under tranalties of perjury that the information provided above is true and correct Si afore: ,1`2 079 Dater 2 Phone#: Official only. Do not write in this area,to be completed by city or town official. n: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector rson: Phone#: ][nformation 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, 1 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 deceasede employer, or the However the receiver or trustee of an individual,partnership, association or other legal entity, employing 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'deerTt--fie woyer-" MG states L chaptei 152, §25C(6)also that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate-a business or to construct buildings in the commonwealth for any. applicant who has not produced acceptable evidence of compliance with the'insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants - ut the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if Please fill o ' certificates of neces d hone numbers along with then ( ) name(s), addresses)an phone ( ) supplysub-contractor(s) - - insura ary, Limili Partners • s LP with no employees other than the •li Companies LC)or Limited Liability Partnerships(L ) insurance. Limited Liability mp (L. ers are not required to carry workers' compensation insurance.'If an LLC or-LLP does have or arts , members p is re quired.uired. Be advised that this affidavit may be submitted to the Department of Industrial a policy q 't h1. uld employees, p Accidents for confirmation of insurance coverage. Also be sure to sign and_date the affidavit.. The_a davi s o 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' the number listed below. Self-insured companies should enter their compensation policy,please call the Department at 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 . ( tY 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. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial.Accidents 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 ' tip, h Town of Barnstable Regulatory Services Thomas F.Geiler,Director DAWgrABM MAC s63 Building Division 9. `0� Tom Perry,Building Commissioner 200 Maia Street, Hyannis,MA 02601 www.town.barnstable.ma.us 11ce: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION p� Please Print DATE 7-Z6-�C 7E JOB LOCATION: 55 9�77`��� �1V� number street village y� xoM>rowNlx: 1�� 8 name home phone# work phone# CURRENT MAILNG 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 buildiU 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. ectio procedures and requirements and that he/she will comply with said procedures and requirements. e Signature of H i Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may cam t amend and adopt such a form/certification for use in your community. Q:forrms:homeexempt tHE T°� Town of Barnstable Regulatory Services BAMSTA IX ' Thomas F.Geiler,Director atnss. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: I� � 1 find LL /ZrP�ACE-_Estimated Cost 35-00 Address of Work: D--52 &rff Y,�5 :ILJ L-),k�� Owner's Name: Date of Application: ?/ 6� 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 Vwwner 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 u - ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav Y . r Min.—ea— 005 91 :39 PM P.01 MORTGAGE INSPECTION PLAN FILE N0: UNREGISTERED LAND 005 ADDRESS: 55 'S PO D STABLE. MA DEED BOXED.PACE: 26 ATTORNEY LAW OFFICES OF RDNA D P PASS NpO 20D3027 PLAN BOOK: 60 PACE i LO 2 LENDER: OWNER:ROBEAT�HIrLS�CREEK MORTGAGE CROUP �"" s0) PLAN NUMBER: OF D. TUWS, JR, APPLICANTI_MILARIO MAPECHEM REQIST,E'RED LAND DATE: 09 003 SCALE:_ "=201 REGISTRATION BOOK: PAGE: CERTIFICATE OF TITLE FLOOD HAZARD IWORAIA77ON PLAN NUMBER: vn(s):_ FLOOD MAP COMMUNITY NO,: 250001 T_ ZONE: C ASSESSORS NAP PANEL: 00069 DATED; _07102/1992 MAP; BLOCK: ^� PARCEL:�� LOT 4 B3BS, LOT 2 7,640 SY, LOT 3 1 1/2 STORY Lp 0• D.. 4 O 73,76' BETTY'S POND ROAD MORTGAGE LENDER us_ E ONLY rOFAN RESULT OF TAPE MEASUREMENT, NOT THE RESULT COMP NY ANDRUMENT ABOVE LISTED Y AND Is TATTORNEY AND IFIED TO THE LENDER. �■ . ,LI� Trc� THERE ARE NO DEEDED EASEMENTS IN THE ABOVE REFERENCED aD KENWOOD CIRCLE, SUI� KA MALIN �] . DEED OR ENCROACHMENTS WITH RESPECT TO BUILDINGS SITUATED TFL:(800)287-8800 FAX.:(508)52"11 ON THIS LOT EXCEPT AS SHOWN, THE LOCATION OF THE DWELLING SHOWN DOES NOT FALL WITHIN ZH OF A SPECIAL FLOOD HAZARD ZONE. NTHDNY THE LOCATION OF THE DWELLING AS SHOWN HEREON EITHER DEI,ORCO EFFECT IN COMPLIANCE WITH THE LOCAL ZONING BY-LAWS INWAS STRUCTURAL NO, 34303 SETBACK REQUIREMENTS ONLY), OR SWHEN CONSTRUCTED (WITH �EXEMPT PECT OFROM VIOLATION ~ENFORCEMENT ACTION UNDER MASS. C.L. TITLE VII. CHAPTER 40A,SECTION 7. GENERAL NOTES; (1) The dedora9One Tode above am an the boats of my knoNedgq I�fafllO9aa, and heGe1 all The.Rul1 of o mart me M to Me normal standard Of card of raglatsred land lurveyda pnn In Y (3)This plan sae not mod, far rneadtn a9 tte, (2)Dacla eml an mode to U+e aba.a namrrd eve"' �laps LneY mode offsets, fenen ar lot con0 B WNeloa,for use M Pn�n9 deed decal UM3 a for aonetruatim, (e) to thoUoae of only ae of IN,date, gurallon may to oecanpgehed ey an aa+aete Inetmment eons I�atY line dlrnevelM%traldhg 1~ (S)No nugens611fy b aeeamed hmelo to the land Dana a aNPanL Barnstable Assessing Search Results Pagel of 2 Horne:Departments:Assessors Division:Property Assessment Search Results New Search ; 3 y. New Interactive Maps>> a�a Owner: 2009 Assessed Values: BROWN,STEPHEN F JR C/O COUNTRYWIDE HOME LOANS 55 BETTY'S POND ROAD Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $118,100 $118,100 290 /124/ Extra Features: $1,100 $1,100 Outbuildings: $0 $0 Mailing Address Land Value: $133,900 $133,900 BROWN,STEPHEN F JR C/O COUNTRYWIDE HOME LOANS Totals $253,100 $253,100 65 SUOMI ROAD MAIL STOP:SV-35 HYANNIS,MA.02601 2009 REAL ESTATE Tax Information: Tax Rates:(per$1,000 of valuation) Community Preservation Act Tax $52.39 Fire District Rates Town Residential Barnstable FD-All Classes $2.37 $6.90 C.O.M.M.-All Classes $1.08 Town Commercial Hyannis FD Tax(Residential) $450.52 Cotuit FD-All Classes $1.43 $6.12 Hyannis-Residential $1.78 Town Tax(Residential) $1,746.39 Hyannis-Commercial $2.77 W Barnstable-All Classes $2.11 /) Community.Preservation Act 3%of Town Tax �l Total: $2,249.30 - VVV Construction Details , Building _ Property Sketch &ASBUILT Cards Building value $118,100 Interior Floors Hardwood jerty Sketch Legend Style Cape Cod Interior Walls Drywall Model Residential Heat Fuel - Oil Grade Average Heat Type Hot Water �Pyr+ rir{i{3 ' i0y �' J�13 o3u�9 Stories 1 Story F A AC Type None t \ Exterior Watts Wood Shingle Bedrooms 4 Bedrooms Roof Structure Gable/Hip Bathrooms 2 Full - ma' Roof Cover Asph/F GIs/Cmp living area 1092 Replacement Cost $140586 Year Built 1966 Depreciati 16 Total Rooms` 7 Rooms x La cv ODE 1010 Lot ' A s 0. 7 As Built Cards I httpJ/ town.bamstable.ma.us/assessing/2009/displayparcelO9map.asp?mappar--290124 1/28/2010 _Barnstable Assessing Search Results Page 2 of 2 Appraised Value $133,900 z View Interactive Maps > Assessed Value $133,900 q 1 Sales History: Owner: Sale Date Book/Page: Sale Price: FEDERAL NAT'L MTG ASSOC Sep 16 2008 12:OOAM 23158/317 $329,852 DE MACEDO,JOSUE LISBOA Apr 6 2007 12:OOAM 21921/183 $380,000 OSTAPACHEM,HILARIO Oct 27 2003 12:OOAM 17846/023 $228,000 TULLIS,ROBERT D JR Nov 15 1992 12:00AM 8289/226 $39,780 FLEET BANK OF MASS N A Jun 15 1992 12:OOAM 8079/064 $30,000 KAROLCZAK,ZYGMUNT R May 26 1972 12:OOAM 1657/282 $31,500 Extra Building Features Code Description Units/SQ fit Appraised Value Assessed Value DOR Dormer 8 $1,100 $1,100 Property Sketch Legend BAS First Floor,Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/2009/displayparcelO9map.asp?mappar=290124 1/28/2010 f OFIME Tp Town of Barnstable " Regulatory Services B"NSTABLE, �$ MAS& `0$ Thomas F. Geiler,Director A,E1639. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 September 4, 2002 Robert Tullis 55 Betty's Pond Road Hyannis,MA 02601 RE: Illegal Apartment Map/Parcel: 290-124 Dear Property Owner: A review of our records,including the permitting history of 55 Betty's Pond Road, Hyannis, as well as Zoning Board of Appeals records indicate that the use of that address as anything other than that of a single-family home is illegal. You are hereby ordered to discontinue the use of the above-referenced property as it is now being used and restore it to a single-family home. You are to accomplish this work and notify this office to inspect within fourteen (14) days of receipt of this letter. A building permit must be applied for to redesign the layout to accommodate the conversion. You must do this before you make any changes. You have the right to appeal this decision. If you so choose, we will be more than happy to help you. If we do not hear from you,within the 14 days, we will be forced to seek criminal action against you. Very truly yours, r . Gloria M. Urenas Zoning Enforcement Officer GMU/lb Q020904d oF1NE ro,,; Town of Barnstable " Regulatory Services 9sn MASS.� MASS. '�• Thomas F. Geiler, Director o� �p i639' ♦0 rFo w►a�" Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER DATE: a y LOCATION: `�� Ac—rr Zotm K,-wo a� Under the provisions of 780 CNIR, the State Building Code, Section 3400.5.1, you are hereby ordered to immediately discontinue the use of the cellar/basement area for sleeping purposes. LOCAL INSPECTOR SIGNATURE OF RECIPIEN Date: Jan 28, 2010 To: Building File From: R. Anderson Re: 55 Betty's Pond Rd, Hyannis M&P: 289-139-001 Zoning: RB Overlay: WP Received a complaint on this date regarding an alleged basement apartment, a large dumpster in the driveway and some stolen tools. The caller claims a resident of 55 Betty's Pond has stolen some tools. Reported to site with Raul Roma, BI and Lt. John Cosmo, Hyannis Fire Dept. A man answered the door and stated that he is staying there with his wife until his other place is ready. When asked, he stated that he would be moving into his own place in a few weeks. He indicated that 4 adults and 4 children under the age of 21 reside here in total. This number includes the male tenant I spoke to and his wife. I asked if we could come in and look at the basement as a follow up to a previous complaint on file. He admitted us without incident The basement was studded into 2 areas on one side. The opposite side was being used for mechanical and exercise equipment and laundry space. The smoke detector was lacking a battery. Lt. Comos instructed the tenant to install one. He agreed to do so immediately. It was noted that a new patio door was recently installed: Paul Roma noted there was a problem with the header and a permit would be difficult to obtain for the current installation. He asked the tenant to have the owner call him and not do anymore work without a permit. I asked the tenant for his name in order to include it in this report. He refused. He subsequently started complaining about how I don't do my job,political connections and favoritism, harassing people, etc. This change of demeanor was sudden and occurred right after I asked for his name. His attitude was very argumentative and caustic after this question. I exited the dwelling with Lt. John Cosmo through the house. Paul Roma walked around the side house. I started recording the plate numbers on the vehicles, two tow trucks (Trucks numbered 15 & 11, one plate 2674C) and a residential van (MA 39KE85). The same tenant came out and demanded to know why I was doing that. I sis not get the third plate number. Startled by his shift into direct attack mode, I simply replied that someone may operating a commercial use/business from this location. I was actually referring to the possibility that someone was dropping, storing or repairing cars that had been towed here. He called me a bitch (one of several times) and became verbally abusive and stated that I asked a"dumb ass question". Paul & John tried to calm him down. He then accused us of trespassing. Paul advised he was standing in the public right of way. The unnamed man noted I was standing(on the edge of the) driveway(waiting to open the passenger door). There was a little stand off. The tenant continued to be very belligerent and used a lot of profanity. The situation was quickly escalating. John and I advised Paul that we should leave now. A woman came out and yelled for the tenant to come into the house. We left. Later that morning, Lt. Cosmo received a call while we were at the site of the Iron House fire checking on the delivery of an office trailer. Lt. Cosmo relayed to us that a call was received at the station complaining about inspection at 55 Betty's Pond Road. It later occurred to me that perhaps the unnamed tenant is not supposed to be home or otherwise have trucks here. Maybe he was supposed to be at work and this is why he was so upset when I wrote the plate numbers down. . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ` 0 Parcel Application #QX�'Z U Health Division Date Issued 77'f l Conservation Division Application Fee Planning Dept. Permit Fee c-35- Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address pc,'. Village 940L p k S Owner Addresses p5,Ao<A R�zk Telephone ��"ZS©-go7s Permit Request &64)& UJM9 in�I46Y M" <0 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation O Construction Type Lot Size oR,%rd Use, Grandfathered: ❑Yes f to If yes, attach supporting documentation. Dwelling Type: Single Family C9' Two Family ❑ Multi-Family(# units) Age of Existing Structure Y • Historic House: ❑Yes A?'kl'No On Old King's Highway: ❑Yes 4No Basement Type: Rfull ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area(sq.ft.) ®g� Basement Unfinished Area (sq.ft) Number of Baths: Full: existing Z new Half: existing new Number of Bedrooms: u existing _new Total Room Count (not including baths): existing U- new First Floor Room Count Heat Type and Fuel: ❑ Gas U-10iI ❑ Electric ❑ Other • Central Air: ❑Yes 3 o Fireplaces: Existing New Existing wood/coal stove: ❑Yes 3lo ` 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 Q"sa }t _ Commercial ❑Yes 11 L 2"N"o If yes, site plan review# Current Use Qff bOSI ` '- Proposed Use L_1\'A o ose.a, 3 Stfox room APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name -5roJ_W Telephone Number _- Address 5b t3e (� 'pot- License # F�� _ �+ oz6a Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEB IS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Dwn 0�- 2&V_)ftW,,Ta�Sfe� SIGNATURE DATE_/0 If.41 cf— FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. " ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: _ FOUNDATION • i FRAME INSULATION FIREPLACE .r„ ELECTRICAL: ROUGH FINAL F . PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING , DATE CLOSED OUT ASSOCIATION PLAN NO. o k The+Commonweal&of Massachusef#s D4parhnmt of fidmo-h Accidents - 600 Waykingtow Street, Boston,MA 02 UI YVF4rt1r.��F2�7.S o F}/d a _ W,orkers' Campensafian Insurance Affidavit:$i-iilders/Contractorsl echiciansMumber's Ap Ak-ant Infarmatiun Pteaise Prof Le>;ibly Name{�smeasl tionlfndividnal):��f�ZIZiI� l�(o r�� ' Address: City/'Stat&Zip: Q p i 5 /J DZ'cq t Phone 47- ;-50 2-Z Are you an employed emplayed Check t&appropriate bay: T • of o'ect r 4_ I am a contractor wind i 3� � � {���- 1.❑ I am a employer with ❑ 1 6_ ❑New txtnsfruc#ion " emplagees(€ult and/or part-iime�* ha�ehire�the suli�on#racfors.listed on the attar - 2_❑ I am a sole proprietor or partner- sbip and h2are no emplay-ces These sob-contractors have g_ ❑Demolition w for me in an capacity employees and have woticers' �� Y � �• 1 4_ ❑wilding addition �o orkets' comp_insurance comp_insurance -I ❑ We are a corporation and its 10-.0 Electrical repairs or additions _ „I am a homeowner doing all work officers have exercised their 11_0 Plumbing repairs or additions myself[No workers'comp_ _ right of ex-emptio-a per MGL 12_0 Rnof repairs rnmsrance regaired_I I c. 152,§1(4),and we ha^m na , 13_❑Other employees-[No workers' comp tnsorance required-1, *Amy al Homt that checks boa 91 mtnst also fill out the se ctioa below showing rhea woo3kt�s'compensatioat pali�inf ar my_ T Home .mers arho submit this affidavit in&-d-g Olay are doing sI vim*a.d dim hag outside contractors mast smbm3t a new affidavit mrracshn such- M tCantractnrs that check this box must attached art additional sheet sbuw-Mg the Warne aYthe inch ootrtrc�n and sty uhetLec Drool fhuse c hies Save My uyen Irthe suh cantiacffltshsz a emnployeen'they must pmMae tlew workers'comp policy aimobez Tian art employer fliedisptmidiV workers'compansrrlion in vira nce for rny emmplyress. Hdats is fhepoHzy artd,}ob site infotmat&IL Insurance Company Name: Policy a or Self-ins-l ic-a Expiration Date: Job Site Address-. City'StatelZip: Attaclt a copy of the workers'compensation policy declaration page(showing the policy n-amber and ezpn-ation date). Failure to secure coverage as mT iredunder Section 25A of M-GL c 152 can lead to the imposition cfrritrtinal pertaffies of a a fine up to$1,500.Oa andlor one-yearin3prisonnxmt as well as civil penalties in the form of a STOP WORK ORDER and a fine ofup to$250_00 a day against the violator- Be advised drat a copy ofthis statement maybe forwarded to the Office of Investigations of"IA for inc,�ce cm-erage verffio°ation_ l do hereblr cerfr it. spidhs ttr WIGS flfpedmy t hatthe innformid6m prenidRd abinre is,frue trnd correct Sign Bate: ✓D ✓y / Phone g: City or Town:. PerraitUcense# Issuing Authority{circle one}: 1.Board of Health 2.Building Department -3.Cit TTown Clerk 4.Electrical Inspector S.Plumbmg Iupector 6.Other * Contact Person: Phone#: 6 Information and Instructions 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 local licensing agency shall withhold the issrxance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for al-ly 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 politicaf subdivisions shall enter into any contract for the petonmance,of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),addresses)and phone number(s)along with their cer bificatc-(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with a o er,,'ployees 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 Deprmtment of Industrial Accidents for confirmation of in uiance coverage. Also be sure to sign and date the affidavit '11_e 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. Sell insured companies should enter their self-ias ranee 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 permitllicense 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 ilz (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 fixture 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 cornet ial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: h The Commonwc,�al&4f Massachusetts Depaitme.nt of hidustrial Accidents Y OffiQe of lavf tgdotiom GGG Washington Str(-,ef BGsfou=MA 02111 TeI.A 617-727-4900 W 406 or I-& MkSWE Revised 4-24-07 Fax# 617-727-7 749 wW W.Ma ss gov1dia Town of Barnstable Regulatory Services ��afzxe r � Richard V.ScaIi,Director Building Division * RAIMSTASM * Tom Per Building Commissioner rye g v� Mkss. .�� 200 Main Street, Hyannis,MA 02601 QED MA'{a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 C5 4--eD(A� F- wUQ HOMEOWNER LICENSE EXEMPTION DATE: ��/� / N Please Print JOB LOCATION: cS� RCrAs l_>®� 1 K-y" l J q sUrV number /� street p village "HOMEOWNER":_11,pA.e,0 r gapo/V�M n e home ph�one# work phone# _ CURRENT AILING ADDRESS: _ / Pf�o / e / 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 IIOMEOWNER 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 unde ' ed"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proced an equirements- d that he/s 1f comply with said procedures and requirements. ign r omeo t Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code.states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109-1.1-Licensing of construction Supervisors); provided that if the homeowner j 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&ReguIations 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 Iicensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. QAV,TFILF_SIFORMSIbuilding permit fom1slEXPRESS.doc Revised 061313 �1HE ro„y Town of Barnstable yew Regulatory Services 9anxx is Richard V.Scali,Director o;A.ca 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 as Owner of the subject property hereby authorize to act On my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM&O WNERPERMISS IONPOOLS S E DETECTORS REVIEWED }9U V � n9 BARNSTABLE BUILDING DEPT. DATE FIRE DEPARTMENT . DATE BOTH SIGNATURESARE REQUIRED FOR PERMITING S s ,b l f (e)o s ��� r5. I � _ T= NtTi,19 100 5 y � I TOWN OF BARNSTABLE DEPARTMENT OF HEALTH SAFETY AND ENVIRONMENTAL SERVICES BUILDING DIVISION STOP WORK THIS STRUCTURE AND/OR PREMISES HAS BEEN INSPECTED AND THE FOLLOWING VIOLATIONS OF THE BUILDING CODE AND/OR ZONING ORDINANCE HAVE BEEN FOUND: 1) M R, w o r- to �a 2) _0 ,j t 4A t 0 �.� s w ® k- w1f o PEP-M 1 1 3) 4) YOU ARE HEREBY NOTIFIED THAT NO ADDITIONAL WORK SHALL BE UNDERTAKEN UPON THESE PREMISES, OR THE PREMISES OCCUPIED UNTIL THE ABOVE VIOLATIONS. ARE CORRECTED. ANY PERSON REMOVING THIS NOTICE WITHOUT PROPER AUTHORIZATION SHALL BE LIABLE TO A FINE OF NOT LESS THAN FIFTY, NOR MORE THAN ONE HUNDRED DOLLARS. Address 8 -�- 7PON� ' Pb Date '7 0-5— :k oal X Building CommuWaster- ' Town of Barnstable Regulatory Services Thomas F.Geiler,Director + )AMSTASIE, • MASS. g Building Division 1639. �0 ArF p Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINT/INQUIRY REPORT Date: 4,io 2- Rec'd by: Complaint Name: `/ Map/Parcel Location. Address: s �. Originator Name: Street: Village: State: Zip: Telephone: G / Complaint Description: FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: Additional Info.Attached Q:forms:complaint 7 .�wN Sewer .t...�Ne 900M3 r - �o I�/A Ca k doom GO f GO c° co _ R04 H W bf co i Dow N L� FT S: DE 5 5 BE7 T YL -POND RD , PROPo5CD.-)&A-5E MEN T HY�N NlSf MA _ FLOOR PLAN Oz O t- l/`, SU LF.