HomeMy WebLinkAbout0015 BROOKSHIRE ROAD ! � �
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Application number......
Date Issued.......................................I
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1 ` 0 9 Z018 Building Inspectors Initials........ ... ...
IN 0-� b-AHNS IABL Map/Parcel.......�.a............��.�..�� .... _
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION
PROPERTY INFORMATION
Address of Project: 0 S� Apry9k S dI I P � �-® ��/,;¢N�v► r S ^�
NUMBER STREET VILLAGE
Owner's Name: r1, 9 44�f-1vAoe-N ice' Whone Number S:ea_ 91156 y 7�o
Email Address: Cell Phone Number
Project cost $ Check one Residential_� Commercial
OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize
to make application,for a building permit in accordance with 780 CMR ,
Owner Signature: Date:
TYPE OF WORK
Siding Windows (no header change)# _Insulation/Weatherization
Doors (no header change) # Commercial Doors require an inspector's review
Roof(not applying more than 1 layer of shingles)
Construction Debris will be going to --T—n V01"I o F t1-4ew. 76
CONTRACTOR'S INFORMATION
Contractor's name
Home Improvement Contractors Registration(if applicable) # (attach copy)
Construction Supervisor's License# (attach copy)
Email of Contractor Phone number
ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN
A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED.
APPLICATION NUMBER............................................................
*For Tents Only*
Date Tent(s) will be erected Removed on number of tents total J
Does the tent have sides? Yes No (If yes please attach floor plan with exits marked)
Dimensions of each Tent X X X
Additional tent dimensions can be attached on a separate piece of paper.
Check one: this event is a: for profit non-profit event
Check one: Food served Yes No
Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent
If food is being served at your event please obtain a Health Department approval between the hours
of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval.
*WOOD/COAL/PELLET STOVES
Manufacturer# Model/I.D.
Fuel Type Testing Lab
Offsets from combustibles: front. back left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name:(6040,41,p 44A,42-A( o f�/�� A, Q��(
Telephone Number T� Cell or Work number
I.understand my responsibilities under the rules and regulations for Licensed Construction
Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand
the construction inspection procedures,specific inspections and documentation required by 780
CMR and the Town of Barnstable.
Signature Date
,APPLICANT9S SIGNATURE
Signature Date QR -
All permit applications are subject to a building official's approval prior to issuance.
i
0. OMB Approval No.2502-0265
A.Settlement Statement (HUD-1)
I,J-
B.Ty a+of Loan
1.❑FHA 2.❑RHS 3.0 Conv.Unins 7.File Number: 8.Loan Number: 9.Mortgage Insurance Case Number:
4.❑VA 5.❑Conv.Ins 6.❑Other 2018-659
C.NOTE:This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked
p.o.c."were aid outside the closing,the are shown here for informational purposes and are not included in the totals.
D.NAME AND ADDRESS OF BORROWER: E.NAME AND ADDRESS OF SELLER: F.NAME AND ADDRESS OF LENDER:
Guadalupe Amaral and Nuiza Baroso Amaral Michael G.O'Neil,Jr.,Esq.,Personal Representative of the Cambridge Cape Cod Realty Associates,
The Estate of Kenneth Loader LLC
11 Market Street,Cambridge MA 02139
G.PROPERTY LOCATION: H.SETTLEMENT AGENT I.Settlement Date:
15 Brookshire Road,Hyannis MA 02601 Dubin&Reardon 08/09/2018
1645 Falmouth Road,Suite 4A,Centerville MA 02632
(508 771-0330
Place of Settlement Disbursement Date:
1645 Falmouth Road,Suite 4A,Centerville MA 02632 08/09/2018
J.Summary of Borrower's Transaction K.Summary of Sellers Transaction
100.Gross Amount Due From Borrower 400.Gross Amount Due To Seller -
101.Contract sales price 155,000.00 401.Contract sales price 155.000.00
102.Personal Property 402.Personal property
103.Settlement charges to borrower(line 1400) 3,885.75 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for Items paid by seller in advance
10 .City/town taxes 08/09/2018 to 09/30/2018 329.66 406.City/town taxes 08/09/2018 to 09/30/2018 329.66
107.County Taxes 407.County taxes
108.Assessments 408.Assessments
109. 409.
110. 410.
111• 411.
112. 412.
120.Gross Amount Due From Borrower 1 99,215.41 420.Gross Amount Due To Seller 155,329.66
200.Amounts Paid By Or In Behalf Of Borrower 500.Reductions In Amount Due To Seller
201.Deposit or earnest money 1.000.00 501.Excess deposit(see instructions)
202.Principal amount of new loan(s) 50,000.00 502.Settlement charges to seller(line 1400) 47,780.91
203.Existing loan(s)taken subject to 503.Existing loan(s)taken subject to
204. 504.Law Office of Michael G.O'Neil,Jr.,P.C. 28,351.65
205. 505.Commonwealth of MA-Mass Health 78,844.81
206. 506.
207. 507.Town of Barnstable(Sewer bill) 59.00
208. 508.Hyannis Water 28810
209. 509.
Adjustments for Items unpaid by seller Adjustments for Items unpaid by seller
210.City/town taxes 510.City/town taxes
211.County taxes 511.County taxes
212.Assessments 512.Assessments
213.Sellers Unbilled sewer usage 5.19 513.Sellers Unbilled sewer usage 5.19
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.20.2 Total Paid By/For Borrower 51,005.19 520.Total Reduction Amount Due Seller 155,329.66
300.Cash At Settlement From/To Borrower 600.Cash At Settlement From/ro Seller
301.Gross Amount due from borrower(line 120) . 159,215.41 601.Gross Amount due to Seller line 420
( ) 155 329.66
2.Less amounts paid by/for borrower(line 220) 51.005.19 602
30 .Less reductions in amount due seller(line 520) 155,329.66
303.CASH From BORROWER 108,210.22 603.CASH To SELLER
The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting,reviewing,and reporting the data.This
agency may not collect this information,and you are not required to complete this form,unless it displays currently valid OMB control number.No confidentiality is
assured;this disclosure is mandatory.This is designed to provide the parties to RESPA covered transaction with information during the settlement process.
*Items marked"(POC)"were paid outside the closing by the indicated party(Key:B=Borrower;L=Lender;M=Broker;S=Seller;O=Other)
Previous editions are obsolete Page)of3 form HUD-I(1/09)
I
HUD Settlement Statement Signatures
We,the undersigned,identified in Section D hereof and Seller in Section E hereof,hereby acknowledge receipt
of this completed Settlement Statement on August 9,2018.
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I
have caused or will cause the funds to be disbursed in accordance with this statement.
d Borrower(s)
n
Xy
=`r Gua u'a Amaral Nuiza 134droso Amaral
Seller(s)
Micha eil,Jr.,Esq. Personal ,
esentative of the The Estate of
Kenneth Loader
Settlement Agent: • Date:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): ������
Address:F50Qt9 k 1555
City/State/Zip: Phone#:
Are you an employer?dheck the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
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
workingfor me in an capacity. employees and have workers'
Y P h'• � 9. ❑Building addition
[No workers' comp.insurance comp.insurance.
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.V I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
tl�/ myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' 13.❑Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
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 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 insuranc
,ef overage verification
-
I do hereby certify and he pai d penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone#:
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
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 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 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
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)mme(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 the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
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 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 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.
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
Revised 4-24-07 Fax#61.7-727-7749 A
www.mass.gov/dia
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 3 a ® Parcel 4 k Application # L�
Health Division Date Issued
Conservation Division Application Fee 4g
Planning Dept. Permit Fee J
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis ;
Project Street Address ' cro0 V S�-r
1 '
Village an n s
Owner Kennp_+} L c ad er, Address Sa.iyn e
Telephone 50$ - I C'.3 It
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Permit Request e-S v �
vIn a akisa a-seC 0`C; a -vl'R-221 . l/e,nS�e_ p12sG)c a+4-i cL.!�earl Wa 5 C R-I .
a v\ nl e-,n ?CC,. Nee )DoJ!t :5 % �l cap.,(exa-`
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units)
Age of Existing Structure 17,50 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(s:.ft
Number of Baths: Full: existing new Half: existing ( new
Number of Bedrooms: existing —new s
Total Room Count (not including baths): existing new First Floor Room Count-?!
Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other a
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 No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name �'I I:O1,M M x tLS�e /C! g Sage Telephone Number )
1 22
Address nti nq�n Y� License # C �• "T
's0 VA, 1 &r rn 0 CA , m tI 0� � b�I Home Improvement Contractor# I 6 q q 3 d..
Worker's Compensation # 7" 9 3 0 9 5
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Yn�t MO(ht n
SIGNATURE DATE L? 1 J
1f4
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FOR-OFFICIAL USE ONLY
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APPLICATION#
DATE ISSUED
MAP/PARCELNO.
S ,
ADDRESS VILLAGE
i
OWNER
i
DATE OF INSPECTION:
r FOUNDATION
` I
t
FRAME
t INSULATION
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FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL `
y
t
GAS: ROUGH FINAL
i
FINAL BUILDING
x
x
DATE CLOSED OUT
ASSOCIATION PLAN NO.
r
Y
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
Aunlicaat Information Please'Print Ledbly
Name(Business/Organization/Individual):_,., �� *
Address: -C._, u to it tvr=-m& Aim-
City/State/Zip:_ 7Aa4'1 nskTu A &URone#: -
Are you an employer?Check the appropriate box:,
Type of project(required):
1.(K I am a employer with I 4. [] I am a general contractor and I _
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 $: Demolition
working for me in any capacity. employees and have workers'
insurance. 9• ❑ Building addition
cote
[No workers' coibp.insurance p• ,
required.] We are a corporation and its I0.❑ Electrical repairs or additions
3.01 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself.[No workers' comp: fight of exemption per MGL 1'2•❑ Roof repairs
insurance required.] c. 152, 51(4),and we have no
employees. [No workers' 13.® OtherTnAd AM
comp. insurance required:]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
Homeowners who submit this affidavit indicating they axe 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. ifthe sub-contractors have employees,they must provide their workers'comp,policy number.
Ian an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: r( T[,"-> t�y S�,k C—E
Policy#or Self-ins.Lid.#: 113 ( S-] Expiration Date:
Job Site Address: 15 ro o�:S h i(`E
City/State/Zip: k n 11 i S -(n A_ .
Attach a copy of the workers'compensation policy declaration page(showing the policy nnnn er 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$250.00 a day against the violator: Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance'covera e verification.
I do hereby certnfy under the pains d enalties erjury that the information provided above is true and correct
Si mature: Date:
Phone 3 9&-
Official,use only. Do not write in this area,to be completed by city or town official.
City or Town: PermitlLicense#
Issuing Authority(circle one):
1.Board of Health.2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#•
I
CERTIFICATE 4F LIABILITY INSURANCE "A'�1Mwuy "'i
11/1/2010
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
'CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed, if SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements).
PRODUCER }NAME: Shannon Sperraz$a
Risk Strategies Company ,PHONE (781)986-4400 FAX ---
.(781)963-4420
15 Patella Park Drive Ai,t>R�sS:saperrasza@risk-atratelgiras tom
Suite 240 !PRODUCER pfl018476 "---
RSURED ph MA 02368 INSURER($)AFFORD►NGCOVERAGE
INSURED NAiC#
j INSURER A:Seneca Specialty Insurance CO
-------------
Michael McCluskey, DBA• Cape Save !INSURER a:Keating Group Ins Services 7 C Huntington Ave —
INSURERC:Chartis Insurance
INSURER D: ---
South Yarmouth MA 02644 INSURERE. _^
INSURER F: —.-
COVERAGES CERTIFICATE NUMBER:CL1011132675 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
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREI INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERN{OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEN
WI T WITH RESPECT TO WHICH THIS
N IS SUBJECT TO ALL THE TERMS. i
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR i — —
L7R: TYPE OF INSURANCE POLICY NUMBER M�AAlLICY EF MA4L/DOY>YYri LIMITS
GENERAL LIABILITY
EACH OCCURRENCE 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES(Ea oocasrenceY $ 50 0001
A i CLAIMS-MADE 10
X i OCCUR >3AG1002608 /16/2010 10/16/2011 j MED EXP(Anyone person) $ 10,000
L— !
( I PERSONAL&ADV INJURY $ 11000,000
irGENERAL AGGREGATE s 1,000,000
�GEN L AGCiREC,�ATE LIMIT APPLIES PER:PRO PRODUCTS-COMPIOP AGG ;$ 1,OOO,000
X?POLICY; - LOC
AUTOMOBILE LIABILITY ;
$
COMBINED SINGLE LIMIT
t ANY AUTO �6208200 '11/6/2010 il/6/2011 I(j Ea accident) $ _ 1,000,000
ALL OWNED AUTOS ! 1 80DILY INJURY(Per person) S
X;SCHEDULED AUTOS ffi I BO INJURY{Peraax3enl)'$
X HIRED AUTOS I PROPERTY DAMAGE
! !Per accident}
!X;;NON-OWNED AUTOS
I S
l X 'UMMLLA LIAR i ! $
_ OCCUR ` EACH OCCURRENCE $ 1,000,000 EXCESS UAB CLAUNS MADE
—z I AGGREGATE _��5 1,fl00,000
DEDUCTIBLE j ! ;$
B ; RETENTION $ i 1023578601 �0/16/2010 10/16/2011:
C WORKERS COMPENSATION 1 I �4lchael McClusk $
AND EMPLOYERS'LIABILITY i WC STATU- OTH-
Y/N ` !X'TORY LIMITS'
ANY PROPRIETORIPARTNERIEXECUTIVE ;is excluded from coverage;
j OFFICER(MEMBER EXCLUDED? y !N I A I f E.L.EACH ACCIDENT $ 50O OOO
(MandaRory in NN) 9930951 10/21/2010 10/21/2011'
if yyes despiyeunOer EE.L.DISEASE-EA EMPLOYEE$
DESG�RlPTK)N OF OPERATIONS below S(1QL000
I 1 El DISEASE-POLICY LIMIT{s 500 000
f
DESCRIPTION OF OPERATIONS/LADCA71ONS 1 VEHICLES jAttach ACORD 101,Additional Remarks Schedule,if more space is required)
Issued as evidence of insurance. Contractors-Executive Supervisors or
Executive Superintendents.
CERTIFICATE HOLDER CANCELLATION
(508)790-2425
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Ruth
460 West Main Street AUTNORIZEDREPRESENTATIVE
Hyannis, MA 02601-3698
chael Christian%SMS
ACORD ZS(2009t09)tNS025(xooscsl 0 1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Massachusetts-Department of Public Safety
Board of Building Reg
ulations and Standards
Construction Supervisor Specialty License,
A of use: CS SL: -102776> ,
Restricted to IC
;All
,WILLIAM RMC`CLUSICI'
„37 NAUSET�ROAD z; t
WEST YMWUT,H MA 02673°`
Expiration: 6/28/2013
CO)III IIissirmcr' Tr#: 102776
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CAPEP SAVE
Weatherization
508-398-0398
August 22, 2010
To Whom It May Concern:
William J. McCluskey is an employee of Gape Save. He Is authorized to negotiate
contracts and building permits for our.company.
Michael McCloskey
Cape Save--owner
919-595-5959 cell
X Huntington Avenue,South Yarmouth,AAA 026"
TENANT/PROPERTY OWNER/AGENCY WEATHERIZATION AGREEMENT
1. The Parties to this A regiment are the following:
A„/n� 4 (hereafter known as Tenant),
(print your tenant's name)
-eA (hereafter known as Property Owner)
(print your name)
and Housing Assistance Gorporation (hereafter known as Agency).
In consideration of the mutual promises hereafter stated,the Parties agree as follows:
2. The date of Agency's signature will be the effective date of this Agreement.
3. Property Owner and Tenant consent and agree that the Agency may do the following with
respect to t e prop rty IgWted at(street, tov n)
�j A 4S , unit# , and currently
leased or rented to the Tenant:
a) Enter the premises for the purpose of performing a Weatherization inspection.
b) Enter the premises to perform Weatherization work which the Agency determines
in its discretion is necessary and appropriate as a result of the Agency's
inspection of the property and in accordance'with the It
priority list for
the type of dwelling_ The Agency and the Agency's contractors may also enter the
appropriate common areas of the building for the purpose of accomplishing the
Weatherization work. The Agency and representatives of the Commonwealth of
� Massachusetts, Department of Housing &Community Development(DHCD) may
further enter the property to inspect any and all work hereunder. The Agency will
provide reasonable notice of the timing of the Weatherization work and
inspections. The Weatherization work will be performed in accordance with the
Property Owner's consent as further specified below:
It bir
I consent to performance by the Agency and its contractors of any
Weatherization work determined necessary and appropriate by the Agency as a
result of its inspection of the property. I understand that the Agency will provide
a detailed statement of the actual work performed and the associated value at
the completion of work.
I will provide a separate consent to performance by the Agency and its
contractors of Weatherization work following my receipt of the Agency's
inspection report and a statement of the estimated work and associated value.
This additional consent will be sent under separate cover as Attachment A. I
understand that the Agency will provide a detailed statement of the actual work
*` performed and the associated value at the completion of the work.
4. The Property Owner understands and agrees that any and all work, including related
repairs for which the Property may also be eligible,will be performed at the Agency's
discretion. a Agency estimated completion of the Weatherization work by the end of
/ 2011.
5. If the Property Owner is required to make repairs to the property prior to the
commencement of Weatherization work by the Agency, the Property Owner will be notified
by the Agency and will be required to make the repairs as soon as possible. Except where
the Property Owner receives a written extension from the Agency, time is of the essence in
the performance of repairs by the Property Owner.
6. The Property Owner and Tenant authorize the Agency to receive a statement from the fuel
supplier/utility supplier as to the quantity of fuel/utilities used at the above address in each
of the past three years and the future three years. The information is to be used only to
determine the cost effectiveness of the Weatherization improvements.
7. The.Property Owner agrees that the rent for the dwelling unit will not be raised because of
any increase in the value thereof due solely to the Weatherization work performed_
8. In consideration of the Weatherization work hereunder, the Property Owner further agrees
that upon the effective date of this Agreement and during a period extending through
s pee ,
,- -ar month will not be raised for any reason. (The
rent amount must be iillei)jri 'X
However,this Paragraph(8a)will be waived by the Agency in writing if,and
only if,the premises are leased under a state or federal rent subsidy
program, in which case the actual rent charged by the Owner shall conform to the
standards of the rent subsidy program
Please state which Housing Subsidy program your tenant is on and through
which Agency:
b) The Property Owner will not institute any summary process action for possession
except in the case of non-payment of rent or other good cause related to the
Tenant(or any successor Tenant).
c) In the event the Property Owner decides-to sell the premises, Property Owner
shall comply with one of the two requirements below_
--The Property Owner shall not sell the premises unless the buyer agrees(with a
copy forwarded to the Agency) in writing prior to sale to assume all obligations of
the Property Owner set out in this Agreement; or
--The Property Owner shall pay the Agency an amount equal to the cost,as
certified by the Agency, of the Weatherization materials installed and labor
performed in the premises as of the date of sale_ Said amount shall be paid to
the Agency immediately upon sale.
9. (Applicable only if Tenant's heat is included in rental payment and blanks are filled
in) At the end of the period set forth in Paragraph 8 above, the rent shall not be raised
more than % per for an additional period of one year,and the
provisions of 8b and 8c above shall continue in effect for such period. However,the rent
provisions of this Paragraph 9 may be waived by the Agency in writing if, and only if,the
premises are leased under a state or federal rent subsidy program, in which case the actual
rent charged by the Owner shall conform to the standards of the rent subsidy program.
10. The Parties agree that the terms of this Agreement are incorporated into any other lease or
agreement between the Property Owner and the Tenant,and between the Property Owner
and any successor Tenant, and if there is any conflict between the provisions of this
Agreement and the provisions of such other lease or agreement, the provisions of this
Agreement shall govern. However, if such other lease or agreement, including without
limitation a lease or agreement under state or federal rent subsidy program,contains
stronger protections for the.Tenant,such stronger protections shall apply.
' 11. For breach of this Agreement by the Property Owner, the Property Owner shall reimburse
the Agency in an amount equal to the cost, as certified by the Agency,.of the
Weatherization materials installed and labor performed on the premises, as well as
attorneys fee and court costs. The Property Owner may also be liable for damages to the
Tenant in accordance with applicable law; in such instance, the Property Owner shall
reimburse the Tenant for attorney's fees and court costs. Without limiting the foregoing, the
Agency may at its option terminate this Agreement, by providing written notice to the
Property Owner and Tenant, in the event of breach by the Property Owner or Tenant.
12. Performance of the Weatherization work hereunder by the Agency is contingent upon the
availability of funds to d je Age,iuy fro,n thes cui i n i iourwealth of Massachusetts e
federal government, as well as the eligibility of the Tenant under WAP program
requirements. The Agency may terminate this Agreement, by providing written notice to
the Property Owner and Tenant, if the Agency determines that the unavailability of funds or
ineligibility of the Tenant warrants termination.
13. The Parties acknowledge that this Agreement is under seal. It is intended by the Parties
that the Tenant or any successor Tenant is the intended beneficiary of the Agreement and
shall have a right of enforcement.
P" �Owners .. ln��i i #� z
Phone: k-7 2l_e; 3l o
Address: 5
O0✓
Tenant Signature Date do
Agency Signature Date
460 Nest Main Street
µy �-JUS� Hyannis,MA. 0260I-3698
ASSISTANCE ENERGY & HOME REPAIR
T (508) 77I-5400 F (50$)790-24425
RATION 'STY on all lines a t .baconcapecod.wX
HOME OWNER WEATHERIZATION WORK PERMIT&FUEL RELEASE:
PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE
THE APPLICANT HOME OWNER.
IJ hereby consent to and agree that weatherization work may be
done by the Weathe on Program of Housing Assistance Corporation ( herein after referred as
� g rP
"Agencymo located at:o
1A
The weatherization work done will be based on programmatic priorities and availability of funding and
it may include all or some of the following measures:
Weather-stripping &caulking of windows and doors,insulation of attics, sidewalls &basements, attic
and other ventilation measures and possibly replacement of badly deteriorated windows. In
consideration of the weatherization work to be done at my home I agree to the following:
1. I give permission to the "Agency" its agents and employees to 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 reserves the right to inspect the fuel or utility bill for the
weatherized unit on an ongoing basis for no more than five(5) years after the weatherization
work is completed.
I have read the provisions of this agreement as listed and freely give my consent.
Home Owner. (Signature) �'
Date: l
Agent: (signature)
Date: A
HAC approved Weatherization Company :
2
Caliber Building&Remodeling Cape Cod Insulation Cape Save Creswell Construction
Frontier Energy Solutions Lohr& Sons . Peter South Resolution Energy
Rock SolidConstruction All Cape Insulation
t,_iL'"WO..i Pc^ntT T-e l'r: A'7
Engelsen, Jennifer
From: Callahan, JoAnna
Sent: Friday, December 02, 2011 12:53 PM
To: Engelsen, Jennifer
Subject: Parcel 328.042
Please be advised the Treasurer's office will allow a building permit to be issued for 15 Brookshire Road Map Parcel 328
042 in spite of it being in Tax Title.
JoAnna Callahan
Assistant Treasurer
Town of Barnstable
joanna.callahan@town.barnstable.ma.us
1 .
� r The Town of Barnstable
Department of Health, Safety and Environmental Services
�uUWAata : Building Division
14Ty. ,0 367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph M.Crossen
Fax: 508-790-6230 Building Commissioner
Home Occupation Registration
Date: / 24/
Name: �/1/ o O
Phone #:
Address:� � Village:
Type of Business:C � -,/ L1 - Map/Lot:
INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwelling,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual
alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential volumes;and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of tight subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential divelling unit,located
within that dive fling unit.
• Such use occupies no more than 400 square feet of space.
• Tliere are no external alterations to the dwellingnwiuch are not customary in residential building,and
there is no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular
matter,odors,elecaical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess
of normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required from yard.
• There is no exterior storage or display of materials or equipment.
• There is no commercial vehicles related to the Customary Home Occupation,other than one van or one
pickup auck not to exceed one ton capa=y,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Oearpatfon.
• No sign shall be displayed indicating the Cutstomaty Home OcctzQanon.
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
I,the undersigned,have read and agree-with the above restrictions for my home occupation I am registering:
C� Date: l0`17-7 �
Applicant:
TOWN OF BAI:ZNSTABI.S
ozf_,!5i 7/ BUILDING DEPARTMENT-
COMPLAINT/INQUIRY PtPORT
F
e 4Rec'a B Assessor's No.
st Name Q First Name
ORIGINATOR Streets
Villa ef'2c�L State JZi a i o'
Telephone: Home 7 Work 3/�
Descri ti.on:
COMPLAINT
INQUIRY / Q2�QISh
74l
Requestor's Signature �p ,
COMPLAINT Street Address 3 17 f
LOCATION CL
OZG.0'/
OFFICE vsE ONL7
FACTION/
OR'S Date /� Ins ector
COMMENTS ; ? .�� _
FOLLOW-UP
A
CTION
PDDITIO::i.L
I24F0. ATTACEED),,/
COPY DISTRIBUTION: WHITL' - DEPbRT}_'l:T FILE YELLOW - INSPECTOR .
PINK - INSPECTOR (RETURN TO OFFICE FGR.)
fascl t
I KEY 244499
PCS 0C YR OC PARENT 0
AREA C004 JV MTO 2021
SP2 SP3
UT2 1 . 12 SQ FT 14379
EYE 1975 OBS CONST
900 imp 451500 OTHER 9000
- - - -LEGAL DESCRIPTION --- TRUE MKT 10400 REA CLASSIFIED
OLAND 00 ASD IMP 451500 ASD OTH ��00_' �
`" ��' ` '~` ^~~ �'`~ - � � � |�
3 451 ,500 CESCnlPTICN TAX YR CURRENT EXEMPT TAXABLE ,
#OTHER FEATURE 3 9, 000 TAX EXEMPT
PL 379 1YANOUCH ROAD HY RESIDENT'L |
DL LOT A OPEN SPACE
RR 1300 0270 COMMERCIAL 710400 710400 71C4��
INDUSTRIAL
'
EX[MPTIONS
SALE 12/86 PRICE 1250000 OR8 5500/153 AFC
LAST ACTIVITY 0O.'20/87 PCR y
,
`
`
^
'
'
'
' .
TOWN OF BARXSTABI,E '-
BUILDING DEPARTMEXT•
COMPLAINT/INQUIRY VtPORT
Date /� Rec'd B 29
Assessor's No.
st Name G{ First Name
- ORIGINATOR Street_ `-- - -'-
Villa a �2c�L State Zi a G a
.Telephone: Home 71 Work
Description
COMPLAINT / c
i'Ia}Cio vs
INQUIRY '
A 7
Requestor's Signature �p ;
COMPLAINT Street Address 3 //;l,
LOCATION
pZGo.�
OFFICE USE ONLY
INSPECTOR'S Date Inspector
ACTION/
COMMENTS
-Y�L���.
,/
FOLLOW-Up
ACTION )�
7 DDITIOt:c-L
INFO. ATTACHED
COPY DISTRIBUTION: WHZTL' - DEPARTYW'NT FILE YELLOW - INSPECTOR
PINK - INSPECTOR (RETURN TO OFFICE HGR.)
KISCI t
The Town of Barnstable
-J. Health Department
{ '�"�11 367 Main Street, Hyannis, MA 02601
f6�q.
fice 508-790-6265 Thomas A. McKean'
AX 508-775-3344 Directot 6f Public Health
TO: Alfred Martin
Building Inspector
FROM: Thomas McKean`EEW.
Director of Public Health
DATE: May 11, 1994
RE: Potential Zoning Violation/ Units 6 and 7, . 379
Rear Iyanough Road, Hyannis
r{
On May 11, 1994, the Health Department received 'a coinplaint
from a neighbor regarding odors of fiberglass resins and
ketones at the above referenced address. Health Inspector
Jerome Dunning went the site and verified there is a
fiberglass boat business.
Attached are copies of. correspondence sent to thebuilding
Department regarding this property during the past two
years.
We would appreciate it if we could receive, a response }as, to
what action will- be taken, if any.
k
If an inspector is sent to unit 7, please be aware of the
large dog; Health Inspector Jerry Dunning was quite
surprised by the 280 pound attack dog which charged toward
him. The dog is tied, but the rope is 30 feet long.
- ;he Town'of Barnstable
Health Department
367 Main Street, Hyannis, MA 02601
y �190-6265 Thomas A. McKean
S 8-775-3344 Director of Public.Health
�• TO: Joe Daluz, Building Commissioner
" FROM: Donna Miorandi, Health Inspector
RE: 379R Iyannough Road, Hyannis
DATE: January 11, 1993
j On January 7, 1993 Donna Miorandi observed a potential zoning violation
at 379R Iyannough Road, Hyannis. Owner of the building is Skip McAndrews.
~ ' In Unit 5 I spoke to a gentleman by the name of John Pollock who was
doing"'bondo"work on a vehicle. The "bondo" is a polyester resin which
r-.
y is a hazardous waste. In addition, there was antifreeze in an open contain-
er and signs of spillage on the floor of the unit.
Unit 5 and 6 have had complaints of this type of activity as well as
spray painting of vehiclesi
T r
r
;:4
®WI ®f Barnstable
-`j Health Department
` 367 Main Street, Hyannis, MA 02601
a08-790-6265 Thomas A. McKean
508-775-3344 Director of Public Health
TO: Joseph DaLuz, Building Commissioner
FROM: Thomas A. McKean Director of Public Heal
t�G
�w¢ r
DATE:
November 24, 1992
{
SUBJECT: Potential Zoning Violations
y
�-10 The following businesses may be in violation of the PROHIBITED
s USES Zoning Ordinance or in violation of Building Codes:
t " " „>
� r + ; 7. 379R .Iyanough Road, Unit 4 - New England Auto Polishing;
washing cars.*
379R- Iyanough Road, Unit. 6 - Spray painting of automobiles.
�
'3� 97 y' t Road; Unit 7 Furniture stripping andithough
spraying business.*a
73 kThornton 'Drive';`'Hyannis, Left side: Arthur Staab -
Occupied apartment utilized for sleeping and living purposes
located upstairs.
73 Thornton"Drive, Right side: Vieira's Auto Repair: No
toilet facilities provided in this shop causing people to
utilize the outdoors for defecating and disposing human
waste onto the ground.
* These units were recently occupied by these businesses.
1
Please advise whether these businesses are in violation of any
zoning ordinances or building codes.
"Thank you.
a'
I fie Town ot' Banistable
Health Department
367 Main Street, Hyannis, MA 02601
*, 'r W,
=6265 Thomas A. McKean
775-3344 Director ill
o of Public Health
t TO: Joseph Daluz, Building Commissioner
,
FROM: Donna Miorandi, Health Inspector
RE: New England Auto Reconditioning, Dana Woodman, tenant in Unit #4 of
379 Rear Iyanough Road, Hyannis (behind Fleet Bank)
j
DATE: January 30, 1991
This memo is being written as a complainthnquiry regarding the above stated business.
Dana Woodman, New England Auto Reconditioning is doing business in the Groundwater
Protection Overlay District and believe this is a zoning violation for this
:a business at this location. Mr. Woodman was ranted g permission by the Board of
Health to do business on Perserverance Drive, Barnstable with certain requirements.
(see attached) .
He currently is also in violation of Article 39, Town of Barnstable 's Control of Y
Toxic and Hazardous Materials.
Upon inspection of the property on January 29, 1992 there was also evidence of people
living upstairs in the unit. -
Attached are copies of Zoning Board of Appeals documents. ,
Please keep this department informed of this problem.
Thank you. y
t
a:
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PAR ] Real Estate System - General Property Inquiry] Help [ ]
Parcel Id: 328 071- - Account No: 244499 Parent:
Location: 379 IYANOUGH ROAD HY . Neighborhood: C004 Fire Dist: HY
Devel Lot: A Lot Size: 1. 12 Acres
Current Own: MCANDREW,E &MATHEWSON, WB & State Class: 322
RYPKEMA, TJ TRS No. Bldgs: 1 Area: 4379
P 0 BOX 165 Year Added:
ACCORD MA 2018
Deed Date: 120186 Reference: 5500/153
January` 1st: MCANDREW,E &MATHEWSON, WB & Deed MMDD: 1286 Deed Ref: 5500/153
Comments:
Values: Land: 249900 Buildings: 451500 Extra Features: 9000
Road System: 379 Index: 780 (IYANNOUGH ROAD/RTE28 ) Frntg: 270
Index: ( i Frntg:
Control Info: Last Auto Upd: 09.1292 Status: C Last TACS Update: 0820-87
Land Reviewed By: Date: 0000 Bldgs Reviewed By: Date: 0000
Tax Title: Account: Taken: Account Status: Hold Status:
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Parcel Number [328] [072] [ ] { l [ l
TOWN OF BARNSTABL
BUILDING DEPARTMENT•
COMPLAINT/INQUIRY f?±PORT
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Description:
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INSPECTOR'S Date
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COMMENTS
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INFO. ATTACHED
COPY DISTRIBUTIOZ;: NHITv - DEPhRTJZl;T FILE YELLON - INSPECTOR
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