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0050 BLACKBERRY LANE
so ��,�C� ���� � — - - - - - - --- -- ., i Town of BarnstableBuilding 7ZM r r Post,This GardSo;That;.�t�s Visible From tferStreet Approved PlansMust be Retamedxon Job and;this Card)Must'be Kept NAB&wtase ..� . i .Haven IVlad`er ,f � sr " • a Posted Until Final-Ins ect o s M � Permit ear ° Where aCertificateof Oecu,pancy is"Required,suchBu�ldmg shall Not be Qecupied until a Final Inspeetionhas4been,rnade T Permit No. 13-18-3875 Applicant Name: Approvals Datelssued: 12/06/2018 Current Use: Structure Permit Type: Building-Stove Expiration Date: 06/06/2019 Foundation: Location: 50 BLACKBERRY LANE, HYANNIS Map/Lot. 249-078 Zoning District: RB Sheathing: g",::. Owner on Record: SAJDAK,MATTHEW&LORI g Contractor N Framing: 1 Address: 50:13LACKBERRY LANE � Contiactor Licensee 2 HYANNIS, MA 02601 Est Project Cost: $0.00 Chimney: Description: Radient Centennial Permit Fee: $35.00 Descri P I Insulation: (Used) Fee Paid , $35.00 Project Review Re Date 12/6/2018 Fina 7/�,�✓ c� J q rp r, Plumbing/Gas g Rough Plumbing: Building Official. m Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authonzed:by,,this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the`,approved construction documents4- hich this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning°by laws and codes. This permit shall be displayed in a location clearly visible from access street br,'road and shall be maintained open.for public inspection for the entire duration of the work until the completion of the same. ': Electrical f�� Service: The Certificate of Occupancy will not be issued until all applicable signatures,by the Building and Fire Officials are`provided,on this permit. Minimum of Five Call Inspections Required for All Construction Work:l' >` Rough: 1.Foundation or Footing y; 2.Sheathing Inspection Final:. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r 4, Town of Barnstable Pen., FINE r0 Building Department Services I j ate: / �[ Brian.Florence,CBQMAS& D. ` RAMSTAMA Building Commissioner ee: K �) yF039. ���� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FU L STOVE PERMIT Owner: Phone: T# Install at: E Village: N vo Map/Parcel: "l V Date7 X; : l Stove A. New Used v B. Type: a lant irculating C. Manufacturer: Lab.'No. D. Model No. r Chimney A: New/Existing (If existing, Dlease note date of last cleaning) !� B. Flue Size C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer E. Masonry' Lined/Unlined Hearth A. Materials: B. Sub Floor Construction: t c/— Installe44tleci S� Name: Address: M Phone: ;�v �— Location of Installation: c cc e H.I.0 Registration# Construction Supervisor# OR check_Homeowner Installing, no license required LICENSED INSTALLERS.SIG APPLICANTS SIGNATURE: APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev:08/16/17 T ke CowwomveaIth of-Vasyadjrrsetts Department&f Inrustrid Accidmz& - -e Of L"m3figadons 600 Washington Street Boston,41A 02HI wisn1i.fltasmgorldtft Workers' Compensation Insm-ance Affidavit Builder-dContractursMec icians/Phimbers Applicant tY[TI1afE0II Please hint Na=� Addresw eityf tel Q Phone 77 Are you an employer?Check the appropriate bum,' Type of project(regnu ed)- 1. I am a employer with 4. ❑I amp a general contractor and I 6. ❑New construction employees(fish am&or part-ime)-* have hired the sub-contractors 2.❑ I am a side gropiietos arparbxw- listed on the attached sheet. I ❑Remodeliag ship and have no employees These sub-can ractars have g. ❑Demolition wortrinfor sa for in any capacifg. emp1om andhave wo&ers' 9. ❑Building addition wod mS' comp.immtrance comp.insurance$ 5. ❑ We zre a corporation and its" 18.ElElectrical repairs or io s required-]3.ElI am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions . myselt[No workers'camp- right of esem4360n per MGL � 12.❑Roof repairs' insurance required.]T c.152,§1(4�and we hme rro employees.[No w 13.0 other coca p.Mstzrance required.] ',day app fttcbecksbos#11— als=IM=ttbesecdanbelowsb dngdmkwoffcmecomppusati poliryiafinumdorL H=eownm who submit dds.affidavit inTratiag they axe doing ahh wo$and then}ire outside contacmm mast moErmit a new affidaeit indicating sacb- fConuactostbadebedc this box mustx"ach d=additional shad sluncing the nameofire and statewhetherornottbaseeditksham eapinyees.Ifthe ut-c ,+.± ctwsbave employees,tfieymarstpmv a dm&worker'camp.policy.numbeL lam an eitiplo7rsr tlerztis prmdding n�arkers'tompmsaalI irrsrirance fbr my enrpZG ewes $eTow is the parity and job site informafiors Insurance Company Name: , Policy A or Self-im Lit-4: Fxpiration Date: Job Site Address: City/State zTp- ' Adtach a copy of the workers'compensitiompolfcg det:Iaration gage(showing the policy number and expiration.date). Failure to seeme coverage as required under Section 25A of MGL c.152'can lead to the imposition of crim cal penalties-of a fine up to$1,50aOD and for one-y-earin3prisorment,as well as civil penalties.iat the form of a STOP WORK ORDERand.a fine of up to$254_00 a day against the violator. Be advised tat a copy of this statement maybe foswnded fn the Office of IQvestigatiom of the DIA Er insm=e coverage v'erification l do hereby a the ' s annd r aLf ' rye thatMe infbrmationproutdt d a ra iv c arred Simatare. Phone# Ojciai am anfy. Do not omits in this Area,to be campWad by city a town o fjicrat City or Tcnm: PermiNLuense;ff Issuing Authority(tdrele one): 1.Board of HeAth 2,l3uiltlmg Department 3.afyfrown Clerk 4.Electrical Inspect0i S.Plumbing Inspector' 6.Other Contact Person: Phase#� laformation and Instruct ons Massachuse#ts Geb=ml Laws chapter 152 req=es all employees to provide workkers'compensation for their empIayees- p this sfttojj;an mnpLo yee is defined as.¢_.ev my person in the service of another under any contract of hire, express or implied,oral or wlhtn-°' Air ezrPIoyer is defined as"an individual,parfnmrsb�p,association,corporation or other legal entity,or any two or more of the foregoing engaged is a Joint mfzprise,and including the legal repmsen atives of a deceased employer,or the receiver or trastee of an individual,per,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 occqxmt of the - dweT�house of another who employs persons to do mai�cm,constraction or repair work on such dwelling house or on the g�ounds or budding appurbua t thereto shall not becanse of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local Dzenssurg agency shall withhold ffie issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for airy applicant who has not produced acceptable evidence of compliance with the k surance.coverage required_" Additionally,MCrL chapter 152,§25C()states"Neither the mimilaawtalth nor any ofits political subdivisions shall an min anycontract for tinepetfomaa wafpublioworikmmlacceptab It,evidenceofcomp Han ce with the;,,cm-a„c6 remi mein ems of this chapter have Been presented to the contracting ardhozity_" App1icair-& Please fill out the workers'compensation affidavit completely,by checlong the boxes that apply to your situation and,if necessary,supply sob contracfnr(s)name(s), address(es)and phone numbers)along with their c rbflcat-e(s) of nmira„ce. Limited.Liabiiity Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or pai tu=-s,are not regtmed to carry worlce s'compensation iasm'ance. If an LLC or LLP.does have employees,a policy is required. Be advised that this affidavit may be submitted to the Departmea of Industrial Accidents for conf=afion of insurance coverage Also be sure to sign and date the affidavit The affidavit should be retnmed to the city or town that the application for the permit or license is being requester not the Departmentt of Turin stri al A-_c-ci ents- Should you have any questions regarding the law or if you are regvaed to obtain a workers' compensation policy,please call the Department at the number list$d below. Self-insured companies should enter their self-insurance license zmmber on the appmpriate,line. Cif or Town Officials f Please be sore that the affidavit is complete and pruned-legibly. The Department has provided a space at th.e bottom of the affidavit for you to fill out in the event the Office of lavestigaflons has to contact you:regarding the.applicant Please be sure to fill in the permit/license mnnber which wM be used as a reference number: In addition,an applicant that must submit multiple permt/license applications in.any given year,need only submit one affidavit indicating current policy information Cif necessary)and under`lob Sire_Address"the applicant should write"all locations in (may or town):'A copy of the-affidavit that has been officially stamped or mark._d by the city cr gown maybe provided to the - applicant as proof that a valid affidavit is on file for futnre penni!2--or licenses. A new affidavit must be filled out each year.Where a home owner or ui-fizm is obtaining a license or permit not reIatcd to any business or commercial venue (i e. a dog license or permit to ben leaves etc)said person is NOT rcqcdred to complete this affidavit The Of of Investigations would him to thank you in advance for your cooperation and should you.have any questions, please do not hesitate to give W a ca1L The Department's address,telephone and fax number: 'Tattt> of Ajassachusttb; Ilegarbn=t c&Ri-daddal Aocidenta office of jtvegQgatioas� ��4�ashi�.gtQn� Bwtw�MA 01 111 Tf,-1.4 617727-4900 cmt 4-06 or 1-&-MA�, � Fax f l'-'2"-7M . Revised 4-24-07 Q. ho is responsible for makingapplication forth -- -- __ permit?] --.--q Application for a permit is required to be 'made by-the owner or lessee or their agent of the building (e.g.; the HIC registrant). 1f application is made other than by.thhe owner, written authorization of the owner must , accompany the application. Such written autborzation shall be signed by the owner.and shall include a statement of owhership and shall identify the owner's authorized agent, or shall'grant permission to-the lessee to apply for the permit. The full names and addresses of the owner, lessee, applicant and the.responsible.. possible officers the owner or lessee is a corporate body, shall be stated in the application Please note; It is the responsibility of the registered HIC tb obtain all permits necessary for work covered by the Home Improvement . Contractor Rectistration Law, M G L c 142A. An owner who secures his or her own permits.fbr such shall be excluded from the guaranty fund provisions as defined in 11JI.G,L. c- 1.42A. Back to Top Q. My contractor fold me l need to--- - - --- .- _ -- obtain the permits fo construction. May I obtain the relevant permits frorri;- ;r�ylocafbuildingdepa.rtrnen_t, o �j� t4e contracto�required to do that?l - ---'-_-� While you may certainly obtain your own permits, be aware that if you do, YOU �yill fall into a homeowner exemption that will disqualify you from being eligible to receive recourse through M.G.L c. 142A the HIC Law, or the statutorily authorized Guaranty Fund, should a'problem arise.. it is the responsibility of the registered HIC to obtain all perrmrffs necessary for work covered by the Home Improvement Contractor Registration Law M. 142A. If the HIC you are contracting with refuses, you may wish to reconsider using that contractor's services. Town of Barnstable Building Department Services "•4"i4'• Brian Florence,CBO � r 163C��� Building Commissioner 200 Main Sheet,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 Builde"r as Owner of the subject property hereby authorize '" S to act on MY bebA in all matters relative to work authorized by this building permit application for. (Address of ob) Pool fences and alarms are the responsibility of the applicant Pools 4- are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Own Signature of Applicant - 1 Print Name Print Name ate,. QFORMS:OWNERPERMISSIONPOOLS Rev:09/16/17 Town of Barnstable Building Department Services Brian Florence,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 MAW www.town.barnstable.ma.us 6 Nip— Office: 508-862-4038 Fax: 508-790-6230 q / HOMEOWNER LICENSE EXEMMON / Please riot DATE: JOB LOCH ON: _ �� numka village -HOMEOWNER" ��t - � a2. name' V e phone# / work phone# CURRENT MAILING ADDRESS: �r city/town state yip code The current exemption for"homeo ers"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. DEFINTITON 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 buildinpermit (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 proc and q is d fat a will comply with said procedures and requirements. Si 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 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 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. Q:\WPFUM\FOFMS%uilding pemrit forms\EXPRESS.doc 0&/16/17 r— - Parcel Detail Page 1 of 4 MAW Logged in As: Parcel Detail Monday,November 26 2018 Parcel Lookup Parcel Info _ .. . .... ..... .... _ _.. Parcel ID 249-078�m I Developer Lot .LOT 12 l Location r BLACKBERRY LANE Pr Frontage 100 Sec Road Sec Frontage I Village jHyannis ,., I Fire District W Ni4IS Town sewer exists at this address;NO W .. <I Road Index 0129 Asbuilt Septic Scan: - F Interactive 2490781_ m ice, Owner Info owner 11CABRAL, DUSTIN R W 'owner %SAJDAK MATTHEW&l� Streetl 31 LAUREL AVENUE (Streetz i utySWANSEA .,. I stare MA .,I zip 2 77 I country Land Info ......... .............:. ......... IuseSingleFaMDL01 zoning IfilB Nghbd;0105 Topography Level,:,__,. �.I. Road rPa�ved,,::rH: Utilities Se Public Water,Gas pticl Location - Construction Info Buiild'ancg 1 of 1 year 1960 Roor @@GablelHi E'�IVinyl Siding Built Struct S p Wall LArea 2460 cover=Asph/F GIs/Cmp Typpe Style .�... 'nt D wall T Bed 6 Bedrooms T Colonial Wall ry Rooms .<. Model�Resldential Floo Carpet Rooms ,'2 Full-0 Half r , Grade Avera_e Heat Hot Water Total 9 Rooms g Type Rooms Heat ' Stories�2$tOr18S Fuel Gaund- S F anonPOUred COnC. `r Gross Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 5/12/2015 Insulation 201502609 $4,000 12:0/201500:00 AM WEATHERIZATION 2: 2/28/2014 Dwelling Rebuild 201401212 $15,000" 7/2/2014 DEMO/REPAIR MR 12:00:00 AM- DAMG http://issgl2/intraneVpfopdata/ParcelDetail.aspx?ID=18062 11/26/2018 Parcel Detail Page 2 of 4 5/9/2006 INew Roof I20060325, 1$8,500 16/30/2007 62 00:00 AM INR R WINDOWS OF, RESIDE, 1 J Visit History Date Who Purpose 9/11/2015 12:00:00 AM - Geraldine Clark In Office Review 8/18/2015 12:00:00 AM Jeff Rudziak Sale Review 9/23/2014 12:00:00 AM Anne Leonelli Change of Address 7/11/2014 12:00:00 AM Mike White Bldg Permit Completed 5/12/2010 12:00:00 AM Paul Talbot Drive by inspection only 3/12/2009 12:00:00 AM Tony Podlesney Sale Review 1/11/2001 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 9/15/1989 12:00:00 AM ML Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 8/21/2014 CABRAL, DUSTIN R 28337/85 $349,000 NOWAK, GREGORY.W&TRAYWICK, SAMUEL 2 2/25/2014 C 28001/210 $1 3 2/25/2014 NOWAK, GREGORY W 28001/207 $215,000 4 1/31/2014 SANTANDER BANK, NA 27965/110 $279,200 5 10/30/2009 DOBRIENT, ANN F TR 24130/202 $1 6 6/16/2008 DOBRIENT, ANN F - 22983/295 $375,000 7 5/9/2006 BARSNESS, ERIC A 20982/326 $333,000 8 5/2/1978 HUGHES, ROSE L 2699/27 $1 9 9/10/2018 SAJDAK,MATTHEW&•LORI - " " 31517 - - LL $439,000 Assessment History ...... ....._. Save Building Total Parcel # Year Value XF Value OB Value Land Value Value 1 2018 $183,600 $32,000 $12,600 $108,200 $336,400 2 2017 $176,200 $33,000 $12,200 $108,200 $329,600 3 2016 $176,200 $33,000 $12,200 $109,600 , $330,400 4 2015 $201,000 $31,700 $12,800 $105,700 $351,200 5 2014 $191,600 $29,900 $13,600 $105,700 $340,800 6 2013 .$191,600 $29,900 $14,000 $105,700 $341,200 7 2012 $196,000 $29,200 $12,700 $105,700 $343,600 8 2011 $216,400 $3,400 $10,100 $105,700 $335,600 9 2010 $216,800 .$3,400 $10,600 $105,700 $336,500 10 2009 $237,000 $2,500 $8,100 $156,700 $404,300 11 2008 $237,000 $2,500 $8,100 $167,700 $415,300 13 2007 $236,100 $2,500 $8,100 $167,700 $414,400 14 2006 $209,900 $2,500 $8,500 $150,500 $371,400 15 2005 $186,600 $2,400 $8,900 $136,400 $334,300 16 2004 $151,600 $2,400 $9,100 $115,900 $279,000 http://issgl2/intranet/propdata/ParcelDetail,.aspx?ID=18062 11/26/2018 Parcel Detail Page 3 of 4 17 2003 $134,500 $2,400 $9,500 $41,600 $188,000 18 2002 $134,500 $2,400 $9,500 $41,600 $188,000 19 2001 $134,500 $2,600 $9,500 $41,600 $188,200 20 2000 $104,600 $2,300 $9,500 $27,200 $143,600 21 1999 $104,600 $2,300 _ $7,600 $27,200 $141,700 22 1998 $104,600 $2,300 $7,600 $27,200 $141,700 23 1997 $93,300 $0 $0 $27,200 $124,400 24 1996 $93,300 $0 $0 $27,200 $124,400 25 1995 $93,300 $0 ' $0 $27,200 $124,400 26 1994 $86,500 $0 $0 $30,600 $121,500 27 1993 $86,500 $0 $0 $30,600 $121,500 28 1992 $98,600 $0 $0 $34,000 $137,600 29 1991 $122,600 $0 $0 $47,600 $181,400 30 1990 $126,200 $0 $0 $47,600 $193,300 31 1989 $126,200 $0 . $0 $47,600 $193,300 32 1088 $82,700 $0 $0 $21,000 $116,600 33 1987 $82,700 $0 $0 $21,000 $116,600 34 1986 $82,700 $0 $0 $21,000 $116,600 Photos Y mr, x3 �x F http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=18062 11/26/2018 Parcel Detail Page 4 of 4 ' 7 � ti w era. v a p�r g Z R ^�f�y http:Hissgl2/intranet/propdata/ParcelDetail.aspx?ID=18062 11/26/2018 BLE N S U L A T I O N� ' liFel ® it FIM GLASS HS LISS SPRAY FOAM SUSP6NU10 YITTf OUTTIYS INSULATION C61LIN07 1-800-696-661f Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and'weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute '(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village Cabe�� ✓� 3/•a�.��<.c., /w,,, Xly.4.4.ft Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls 466`7C ry A ( ) ( ) ( 020) ( ) ( ) �N�ror� WQr 17prror'4'e'o/ _ A, Sincerely 2rHE ssi r, President Ins ation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION l�q n 5bZ �6 Map � I ( Parcel v� � - Application # P 1 Health Division Date Issued Conservation Division Application Fee✓"�-�J 0• d 0 2� Planning Dept. Permit Fee D , Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project A dress �-- -eV ' / Street Village .f,� M V, Owner. 0 FVA Address Telephone 7 �' Permit Request ldoy, (A 11 crpwhm Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain � A W Groundwater Overlay Project Valuation ,gOO6,0 U Construction Type I0 O Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Qr/ 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 0--new—size 2, - Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 72 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ =°.:: Commercial ❑Yes a mo If yes, site plan review# Current Use Proposed Use �— APPLICANT INFORMATION (BUILDER OR HOMEOWNER)- Name v�� `�� --- Telephone Number Address I � �U� License # 0 U Home Improvement Contractor# Email Worker's Compensation # Vvc 6 ?qj" ALL CONSTRUCTIQN DEBRIS RESULT NG FROM T4S PR JECT WILL BE TAKEN TO SIGNATURE 4 DATE FOR OFFICIAL USE ONLY APPLICATION# .� DATE ISSUED ti MAP/PARCEL NO. ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: FOUNDATION FRAME f INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. w Massachusetts - Department of Public Safety ...Board of Building Regulations and Standards Construction Superviscilr License: CS-10Q988., HENRY E CASSPV 8 SBED ROW r aa WEST YARMOU'rH 0. B Expiration Commissioner 11/11/2,015 a Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration, 153567 Type: Private Corporation Expiration. 12/15/2016 Tr9 259188 CAPE COD INSULATION, INC HENRY CASSIDY - — — 18 REARDON CIRCLE --- -- S0. YARMOUTH, MA 02664 Update Address and return card, Mark reason for change. :CA I ?i 20M•05111 Address Renewal Employment Lost Card ' ✓V/ze IpaI9U�iz0�lzcuerrt/t~�a�CJ/vGCCAJuc�Gr�eC�ii C\ Orrice of ConsumerAffnlrs& Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date, If found return to: egistratlon: 1.53567 Type: Office of Consumer Affairs and Business Regulation xplratlon:--;.1;21:15/201.6 Private Corporation 10 Park Plaza -Suite 5170 Boston,MA 02116 ;APE COD INSUL.ATI;Q:N:;;INC'.`::`` -1ENRY CASSIDY 18 REARDON CIRCLE'*.`.'.t`.:. ;. 5o.YARMOUTH,MA — Undersecretary N valijwi kit sign e The Commonwealth of Massaeh usetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/C o ntractors/EIectricia ns/P I urn bers APRlicant Information Please Print Le4ibl � 1 Name (Business/OrganizadoafIndividual): a, Address: �� V 61 m, GVC/,& City/State/Zi AV II�Ld U t M& Phone #: Are you an employer?Ch ck he appropriate box: 1. I am a employer with �i'j 4. ❑ I am a general contractor and I Type of project(required): employees (full and/or part-time).* have hired the sub-contractors . 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp, insurance comp. insurance.: 9• ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 Roof re insurance required.] t c, 152, §1(4), and we have no 3a.❑ I am a homeowner acting as a employees. [No workers' 13. airs pOther ��{ general contractor(refer to 94) comp. insurance required] Any applicant that checks box#1 must also fill out the section below showing their workers'compensacioti pogry 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 boz 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 for my employees. Below is the policy and job,site information, rr� 'Insurance Company Name: 6V OGtY(,,���/ Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: ''XJ l� ✓u-l'1-eVV ��� Ci /State/Zi GJ ,{_ tY P f Attach a copy of the workers' compensation LjoUcy declaration page (showing the policy nu be 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 viplator. 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 Gerd un the pains and penalties of perjury that the information provided a ve is true and correct Si a Date: Phon #: Official use only, Do not write in this area, to be completed by city or town ofciaL City or Town: Permit/License# Issuing Authority(circle one): .y I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: t From:Rogers&Gray InsuiaFax: To:+15087785736 Fax: +15087785735 Page 2 of 2 03/3012015 10:04 AM CAPECOD-27 BDELAWRENCE ACORO CERTIFICATE OF LIABILITY INSURANCE DATD/YY`!'(, 3130/230/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CO T CT NAME: Rogers&Gray Insurance Agency,Inc. (A/C,NE Ext: A X No: 877 434 Rte 134 E-MAIL ( ,816-2156 South Dennis, MA 02660 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURER B:SAFETY INSURANCE COMPANY 39454 Cape Cod Insulation,Inc. INSURER C:Endurance American Specialty Ins.Co. 18 Reardon Circle INSURER D:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth, MA 02664 INSURER E: INSURERF: 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR — LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM DD/YYYY - LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE OCCUR CBP8263063 04/01l2015 04/01l2016 PREMISES Ea occuWence $ 100,000( MED EXP(Any one person) $ 5,000 PERSONAL&ACV INJURY $ 1,000,00C GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,OOC IRO- X POLICY jECT LOC PRODUCTS-COMP/OPAGG $ 2,000,00OI OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,0001 Ea accident) B ANY AUTO TBD 04/01/2015 04/01/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( I NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 2,000,00 C EXCESS LIAR CLAIMS-MADE EXCl0006635000 04/01/2015 04/01/2016 AGGREGATE $ DED I X I RETENTION$ 10,000 Ag re ate $ 2,000,00 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY - Y/N STATUTE ER D ANY PROPRIETOR/PARTNERIEXECUTIVE WCE00431900 06/30/2014' 06130l2015 E.L.EACHACCIDENT $ 1,000,OQO OFFICERIMEMBER EXCLUDED? � NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 1 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY iLIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additlonal Remarks Schedule,may be attached if more space is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under thb General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULDANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE MATH THE POLICY PROVISIONS. South Yarmouth, MA 02664 AUTHORIZED REPRESENTATIVE 141 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at: r ; reV (Property Address) r ,0 (Property Address)' ' 'CO t,� 4 U v r p hereby authorize (� 7 (Subcontractor). ' an authorized subcontractor for RISE Engineering,to tact on'my behalf to obtain a building'; permit and to perform work on my property. This form is only val'id•with a signed contract. Owner's Signature # Z7QS Date RISE Engineering 5 Dupont Avenue South Yarmouth, MA 02664 LOfficial 0We�•bsite o/f The nTown of Barnstable - Property Lookup Page 1 of 5 V ry Assessing Division Property Lookup Results - 2014 367 Main Street,Hyannis,MA.02601 / «BACK TO SEARCH<< Prin Frie Owner Information - Map/Block/Lot: 249/078/- Use Code: 1010 Owner Owner Name as of 1/1/13 DOBRIENT,ANN F TR Map/Block/Lot G/S MAPS 7 OAK HILL ROAD 249/078/ HYANNIS, MA. 02601 Co-Owner Name ANN F DOBRIENT REVOCABLE TRUST Property Address 50 BLACKBERRY LANE Village: Hyannis Town Sewer At Address: No GIs Zoning Value: RB Assessed Values 2014 - Map/BIoek/Lot: 249/078/- Use Code: 1010 2014 Appraised Value 2014 Assessed Value Past Comparisons Building $191,600 $ 191,600 Year Total Assessed Value Value: . Extra $29,900 $29,900 2013-$341,200 Features: 2012-$343,600 Outbuildings: $13,600 $13,600 2011 -$335,600 Land Value: $105,700 $105,700 2010 $336,500 2009-$404,300 2008-$415,300 2014 Totals $340,800 $340,800 2007-$414,400 Tax Information 2014 - Map/Block/Lot: 249/0781- Use Code: 1010 Taxes Hyannis FD Tax(Residential) , $759.98 Community Preservation Act Tax $93.24 Fiscal Year 2014 TAX RATES HERE Town Tax(Residential) $3,108.10 $3,961.32 Sales History - Map/Block/Lot: 249 / 078/ - Use Code: 1010 History: Owner: Sale Date Book/Page: Sale Price: DOBRIENT,ANN F TR 10/30/2009 24130/202 $1 DOBRIENT,ANN F 6/16/2008 22963/295 $375000 BARSNESS, ERIC A 5/9/2006 20982/326 $333000 HUGHES, ROSE L 5/2/1978 2699/27 $1 Photos 249 / 0781 - Use Code: 1010 http://www.town.bamstable.ma.us/Assessing/propertydisplayscreenl 4.asp?ap=0&searchpar... 1/2/2014 �40 Blachberry Lane annts Hy t � &_4 IE 1 is�2, -Harvey Premium Vinyl Insulated Tilt Windows with Low-E energy efficient treatment -Azek PVC trim.No rot,insect Infestation or maintenance HardiPlank Fibercement siding—15 Year paint warranty -Certainteed 30 Architectural Roof Shingles -Newly Rebuilt chimney from roolline up -Composite decking material—No rot, no maintenance • o -All new aluminum gutter system -New brick front step and walkway -Newly sealed and treated driveway _ �.. -AR new light fixtures -Fully vented attic for energy efficiency and mold prevention. New ThermaTru SmoomStar Fiberglass insulated entry doors. T . Will not corrode or dent. ,T -New garage doors with new remote control openers• -Newly installed and painted bulkhead door• -Trees trimmed away,from house. New plantings and mulch Seaport Village Realty 128 Main St. Hyannis,MA 02601. ` 508-7754440 Direct f" 508-778-9778 Fax y # Margo@MargoSells.com t Margo Pisacano www.MargoSens.com �r3 i 50 Blachb erry Lane, r ¢, } �k. 4 ROME -All new light fixtures. Ali rooms have ceiling lights with recessed lighting kitchen and second floor. Dimmer switches In master bed- room. Lighting In closets. Extra outlets in all rooms with provisions made for installation of new circalts or audio or video lines -New stair banister -New baseboard heaters throughout with 4 zone heating -2005 barely used Well McLain boiler and brand new Well McLain Indi- rect water heater. Extra Capacity to support 3 full bathrooms -All fixtures and KraftMald Cabinetry In bathrooms are brand new s a Granite countertops In bathrooms Ceramic bathroom floors. Bathroom floor and wall grout is Spec- u,� W £ ' w . traLOCK. B19W stain resistant and color stable. Won't crack or lade -Solid core and wood doors throughout �Ilk -Premium Behr and,Benlamin Moore paint - -Crown molding and chair ran in living room -Newly relinfshed oak floors. Newly Installed and finished oak floor in dining room/famfly room - -Maple KrafiMafd cabinets with Crown molding and Blumotfon drawer slides Check it out! Lazy Susan,pop out sponge drawer,dual trash/ recycle Cabinet,2 tier utensil drawer, spice rack drawer,sliding pot/ pan drawer and more -New Kenmore stainless steel microwave hood,Kenmore stainless steel range,Kenmore stainless steel dishwasher -Duraceramfc flooring. Warmer than ceramic tile. Easy care. Lifetime wear warranty -Granite countertops with breakfast island l Presented by Eric Barsness A ;� `; Member of www.MargoSells.com Team at Seaport Village Realty { Cell Phone:508-959-6838 Email:Eric@MargoSeus.com Town of Barnstable *Permit Expires 6 mgnths om issue date 915% MA p Regulatory Services Fee Thomas F.Geiler,Director . oNWA OF 6�+ � Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 Q www,town.bamstable.ma.us Office: 508-862-4038 Fax. - 0-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY � Q179 � Not Valid without Red X-Press Imprint Map/parcel Number Pa [ 1 1 O l! 9 Property Address Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Er 1 G gG,r'S I1 CS S - Contractor's Namegao4e_ Telephone Number Home Improvement Contractor License#(if,applicable) f Lll 2 78 Construction Supervisor's License#(if applicable) 77YV 9workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation I'Insurance �/ Insurance Company Name �,t h��C? *jei .TnSct r22 VX G� Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ���� R �� � ��� ►n�J�' ❑Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. SIGNATURE: lif,G� /Lys — Q:Forms:expmtrg Revise071405 f °FISE 1p� Town of Barnstable Regulatory Services 9 MA LA Thomas F.Geiler,Director • Building Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable..ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder as Owner of the subject property hereby authorize (A C to act on Amy behalf, in all matters relative to work authorized by this building permit application for. J. ahn (Address of ob) Signature of Owner Date Er C' �'�z �� /I (Z5-3 Print Name Q:FORMS:0 W NERPERMM S ION i r� i ✓fie�am�nwmcuea o�,/�aaoazcffircaefd i 00 Opp" en.,otosed space BOARD OE HUFL�1bGt2E�tLNTtIS , E (MGL c tt :5 so1,) . License:`CO�1STR TION SUPERVISOR 1A Masonry on x Number� ±rS,, 079883 t6 1&2&amilyhtomes s Faiiute to possess a Curren#edition of the " :Birtlf BhM--967 _ Massachusetts State Bwlding Code i is cause.for revocation of fhis license. Lires,0f27Jt7 Tr.no: 240,8;.0 ; i BR#CA BRSNEy� sf �� ` ' 54 AGUS WAY i O N P-A lItLEi MA Eommissior$r t D1�S;APE=CAt;�.�CEf`�€Ta.�R �$;�,�j�8���33` J {