HomeMy WebLinkAbout0018 BROOKSHIRE ROAD l� "�-�,rS(sh�r-e
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Town of Barnstabl Building
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PostT:his Card So That it is•Vis�ble From theStreet,, Approved QlansMust beRetamd„.o"n lob and;this Card Must;be Kept ;_
{�LMSFP ,; r,., ., .,3 {° Y err £,," VEr-
14sa Posted Until Final Inspection Has,Been Made '
R Permit
+ Wh'"-re a"Certificate of Occupancy is Required;hsuch�6u ldmg shall Not be Occwpied unt�I a Final InspectionF has been made
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Permit NO. B-18-659 Applicant Name: Craig Bishop Approvals
Date Issued: 03/29/2018 Current Use: Structure
Permit Type: Building-Insulation-Residential Expiration Date: 09/29/2018 Foundation:
Location: 18 BROOKSHIRE ROAD, HYANNIS Map/Lot 328 045 Zoning District: SF Sheathing:
7
" Contractor me s Craig P Bishop. Framing: 1
Owner on Record: CARNEIRO ' Na
PETHRA B&DESAOMIGUEL�",
:
Address: 18 BROOKSHIRE ROAD � '7, ?i Contractor License-: CS--109777 2
HYANNIS,MA 02601 Est Project Cost: $ 1,081.00 Chimney:
Description: Air Sealing&Weatherization # Permit Fee: $85.00
y Insulation:
" Fee Pa id $85.00
Project Review Req: uF
Final:
b Date " 3/29/2018
11
r, Plumbing/Gas
y
y L
a Rough Plumbing:
Ab
A.1_ u x .Building Official
Final Plumbing:
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This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas:
�g�
All work authorized by this permit shall conform to the approved application§and theapproved construction documents.for�wfiich this permit has been granted.
Final Gas:
All construction,alterations and changes of use of any building and structures shall b'e in compliance with the local zoniing by laws and codes.
This permit shall be displayed in a location clearly visible from access street or,road and shall be maintained open for,6public inspection for the entire duration of the
work until the completion of the same. Electrical
v
Service:
The Certificate of Occupancy will not be issued until all applicable signatures by the Bwldihl antl Fire Officials are provided onthis permit.
Minimum of Five Call Inspections Required for All Construction Work Rough:
1.Foundation or Footing Y m
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.
Work shall not proceed until the Inspector has approved the various stages of construction. Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
Building plans are to be available on site Final: .
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
C4'h A
gl�4 J,,
-Com eaith..of.1M[assach-us.etts_.._.....
at Permit
Parcel
Ma'
� s �_',lk -,
Date: "00/AJFp l �.. ftoPermito , — —]Soot .1
Estimated Job-Cost: $
Plans Submitted: YES -NO `P s Reviewed. YES NO
Business License# Applicant License# 7'7�J
Business Information Property Owmer/:Job.,Location.Inforn.adon:
' ev/..ej C Name: M acl
Street: �3_a �1�1/r� S/ Street: I �5 'g nno 1C SYlt I-e
City/Tovrn_ eU k /c City[rown 6�jaxiv. ' 601
. -
Telephone: 77 ' 7LZ °J/ZG Telephone:
Photo I.D.required!Copy of Photo.ID. attached: YES . TRIO
s6xinwal
S 1/M4-unrestricted-license
d to dwe 3-stories or less and commercial -to 10,'000 sq. ft /2-stories or less
J 2/M-2 restncte lliags up
-to
1-2 family Multi-family Condo/Townhouses, Other
Commercial: Office Retail Industrial Educational
Fire Dept. Approval •.. Institutional_ Other
Square Footage:'under 10,000.N.ft._79- over 10,000 sq.ft. Number of Stories:
Sheet metal workto be completed: New W rk: - Renovation:
HVAC Metal'Watershed Roofing. Kitchen Exhaust System
Metal.Chimney/Vents Air Balancing
Provide detailed description of work to.be done:
� Ulu-� Ar '5,&��xk�, ,�
o
• • F
-INSURANCE COVERAGE:
1 have a current Habilitv.insurance policy orits.equivalentwhich-meetsthe requirements of NLG:L Ch.112 Yes No ❑
If you have checked ,:indicate the type-of coverage:by checking the appropriate box,below:
I A Habiiity insurance policy Other type of indemnity•❑ Bond ❑
OWNETS INSURANCE WAVER:'1 am;aware-that the licensee does.-not have fire insurance coverage required by Chapter 112 of the
Massachusetts General laws,and that my:signature on'this-permit applidation-wafyes requirement:
Check One Only
{Owner ❑ Agent El -
&igrr re of Owner or-Owner's Agent
By checking this•box,I hereby certify that all of the details and Information-I have submitted(or entered)regarding this application are true,aod
accurate to the best of•my knowledge acid•thafall sheet metal work arid installations•performed under"the permit issued forthks,application wM be
In compliance with all pertinent provisiori-of the Massachusetts'Building Code and Chapter 112 of the General laws,
Duct Inspection required priorta'insulatiori installation:YES NO
Fro rsr.ess.Inspgctions
Date Comments
Final Insyection
Date Comments
Type of-Ucense:
BY Master
Witte ❑Master-Restricted
'hylTown , - ❑Joumeyperson .
Sig re of Licensee
'e[mit
❑Joumeyperson-Restricted Ucense.Nurf ber
=ee
Check-at www.rmss,g2v/dI2I
nspector Signature of Permit Approval
' � rrrorcte �f•��sr�ehus�
t r�� tAEudexr�s
C hMM*ada95
60:0 Wm*aWan Street
Be-dju,HA d2
• tvn�rv.a,�us�.go���a
'W urker,, CGm2pensafiuuLm.n-Ance Affidxvit Emlders/Contra-c T►rsfEledriri3ns/Plumbers
�n�I�m�ift�a Ptease I�r�f L��
Name - ✓1
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ire tau anempla er7 ChwktW aggrffpriafabtr T ofElrolect(,gFmc)=
��c(r a�1� _' 4_ El ataa g�$1 C=fmctor xna I �N=�,st„�;
* have the mom
�xployePs(full and/or gazt-time.
2;0 1 am a sole pmpfietar orparfaer- Listed on the attached sTieet 7- ❑RpTn
deliag
ship and have no employees Thesesub-contractors have g_ 0 Demalifiou.
QQo2liirl for me in any capac ty employees and have Waticers'' g_ ❑Building addition
[Nowoda=,'Comp:fiwzrance Eat' ,,,`�,�$
require-6-1 5.0 We are a c�rporaf cnand ifs 10� cal repasts or additions
3_❑ I am a homeowner doing all work - officers have a ixdsed their I LD glambing repairs or sddifions .
•�ofe�fionperh+m Roofkmra,Wit€ �:7o worl�ra�camp- �15�..,§I{4},and use fsave n* �"�Ro
�I emP -INCr W06M& 13 0 t3fher
EOM-in=anm required]
"daymgb thechedcsboz#I�rmstalsofllrnrtt sQttiaabcTosysh�sr $ a 'compeassfsrn��a3sp
#Ilrl.y .wbo mbrft Isis sfs&Vi i3�they arz&mg lava&ndfflm ae aaiade cm�csorsamstsnbnrita�r sffidacit mpg smcTz
^^-*�thgF cF�erk this b�mast sttsrhe�as addifiansl si�eet sbbsrmg tine�e of�e s mds�ia trhet�e[pnsvi$s�se dies Eater
MpkuEes Ifthe sull�ct=B=4---PIC5-%fneymast g on&their wu& tamp.paUcy-M ber-
Turn an eurp7r7yes that75.Vrrrt UlOrf era'caMrrsrrt=WsrIFMC-as far MY cm4�Iayees .Belvtp is fhepalycy ar:d jab aitr
irtfbrrriattan. ,� 0 ,
Insarance CeompauylIame:
Pow ar Sel ina Ii� /0 Q
Iola Sift i dd ' //`� / l CiigfSb&erTig: Ce•�✓�j�. /���
tech ak oDpy of&0 workers'enmpensation pa&cy duration page ag the-pu cy •arrd a zps lu date).
Fasilnm to mcare-ca-erage:as n quire under Sectk a SDI of MGL c- 152 can lead to the impositicta ofcrimmai p=xa ies of a
fTt7 P-up to S1,50D:0a zrWar on-yearimpri as wen as civil penalties in fhe fibm of a STOP WORK ORDFRand a fins
ofup.b$2$0_00 a dajagainst the violator; Be advised that a copy of Ibis st d=m t mnay be ceded to tben Offim of
ETcesfigatiorrs of the DIA€or mi mrancg coverage verffication_
I efii hereby crrft,:{p Under And panotftes ufpedkry A at injbrxcatraa pratidgd a&ue is hzce and correct:
Date- JWZIZZ
•
PhD,-- ..i
OUD:arL use•urII,}., Eta not write in LES.area,to be wmplew by city or town offidaL
City or Tows- Pgrnritj.e=JE
Es-ning Aulharity(drde one
L Saard 4f Healtt 2.Binding ELTzrtment I CUYTI Ewa Qe rk 4-Electrical Inspector S.Plumbing lnsprcter
.6.Oth W
Canfact Persna: Phone f#:
Tzformation and instructions
Massachusetts General Laws chapter 152 requires 0 employers to provide workers'compensation for their employees.
Pursuant-to this statute, an etnpLoyee is defined as".-_every person in the service of another under any contract ofhim,
express or implied, oral or written."
An employer is defined as"an individual,partnership,associations corporation or other legal entity,or any two or more
of the foregoing engaged in a joint m tezprise,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 therein shall not because of such employment be deemed to bean employer."
MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or
•renewal of a Iicease or permit in operate a business or to construct buildings in the commonwealth for arty
applicantwho has not produced acceptable evidence of compliance with the Insurance:coverage required.." -
Additionally,MGL chaptei 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the,nsilrance
requirements of this chapixs 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)nzme(s),addresses)and phone number(s)along with their cert-ificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)wiihno employees other than the
members or partners,are not required to carry workers' compensation filmn-ance. If an LLC or LLP does have
employees, a policy i required. Be advised that this affidavit may be submitted to the Depa-tnent of industrial
Accidents for confirmation offiinuance.coverage. Also be sure to sign and date the affidavit The affidavit should
be returned to the city or to-,vn that the application for the permit or license is being requested,not the Department of
rndustial Accidents_ Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call y'he Department at the mrmber 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 nIl out in the event the Office of Iuvesligations has to contact you regarding the applicant
.Please be sure to fill in t&e pemalicense number which will be used as a refizence number. In addition,an applicant
that must submit multiple permit/license appIi>;ations in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Yob Site Address'the applicant should writes"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or maaked by the city or town may be provided to the
applicant as proof.that.a valid affidavit is on file for fuizlre permits or licease, 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
CLe.a dog license or permit to bran leaves etc-)said person is NOT required to complete this affidaYZt
The Office.of Investigations would Ece,to thank you in advance fur your cooperation and shouldyou have any questions,
please do not hesitate to give us a call.
The Department's.address,telephone and fax number:
'Fho COM=nweatth of Massachu&4-tts
Depajt=at Qf Ynd�al Aoaide nt
4ee of Xue� gans
600-Wan Simi =
I�astmn,Mai G2I Ik
TeL 4 6I 7 727-49-00 W 4-06 or 14 MAC
Revised 4-24-07 Fax A 6I7-727-TI-49
grivIdz'a
AWE Town •of.Barnstable
Regulatory Services
s Richard V.Scali,Director
0„9. &A Building Division.
Paul Roma,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.'
I !'yt l//�`' , as Owner of the'subject property
hereby authorize �li�G �� / yC to act on ray 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
Y .
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
QTORM&OWNERPERMISSIONPOOLS '
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CAPE CDC E TR,AL.
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Sally Shea/Town of6arn table Building Dept`
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Hello, , letter i to verify Timothy O'Brien iEmployment at Cape Cod;
Cen'trai Heating and Coo;hng Timoth Es' current) em Io ed; with,us at
:
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this;' ime Any iuestions'call o'r email anytime
Employment StI.art Date 6j1.8/16 to present
,.k...:.yI.you
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Glen I'llDuguay.
President
Cape Cod Central Heating and'Cooling lLC
774', 722 9126 ::
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GOMMONWE`ALT.K-.OF MASSACHUSETTS
soA13o-of
SHEET NIETAL•WORFCERS
�$���g'C}1E FOLL011111NG LICENSE=-,,` �
1111ASTER UNRSTRfCTED _ �` �fa
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APT-32
H�IANNIS;MA 02601-45g�#
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MT. NNIS MA 02§01 45k.
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IMPORTANT '
If your license is lost,damaged or destroyed Is inaccurate;or
needs to be corrected,visit our web site at mass.
i instructions to ensure the proper mailing of your Re9eWadpI for..,.
.Application and-any other correspondence..
I"-This license is subject to Massachusetts General Laws and
regulations.Your license is a privilege,and cannot be lent or-
.assigned to any person or entity under penalty of law.Keep.t is-
1 license on your person or posted as required by law an
h
1 regulations.
MA
www.NA 02-1 011W v
I{r 02d2.1S72 MA 02-iB-017
CLASS-
D:h(p S=llvhicle less than 26,001 •I �l
n ,lle s
9
'Y ENDORSEMENTS ""
NONE.- RESTRICTIONS•
I NONE :..•kS
l �
. e•rks
I ,- CHANGE OF ADDRESS.PRINT RELOW.PERMANENT INK '
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Sh ee/- Inel--9/ A,G kv&IArey�s I�r
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Town of Barnstable *Permit#9-/7-/66 7—
fires 6 months from issue date
Regulatory Service Ei ee ;� ,-�
i ' iawse Richard V.Scali,DirectorA
039.
Ep ` Building Division A14Y
Paul Roma,Building Com r 4
200 Main Street,Hyannis,MA N Vo 1J
www.town.barnstable.ma.us �� <®pp,,
Office: 508-862-4038 %8 , ,qE,ax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL Mfy -
,,JJ Not Valid without Red X-Press lt*rint
Map/parcel Number
G r �
Prop rty Address O � �U � '� , G1�n Is r
000 OD
Residential Value of Work$ r Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address �i Gl'\R_ 1 C�--� �, `F
Vy �,C- 1-�
Contractor's Name '-`� IZ� \ Telephone Number S0g —'16y
Home Improvement Contractor License#(if applicable) 1 1 :z L1 R L Email: �l1 z c, 60. C9'Y►I
Construction Supervisor's License#(if applicable) 1
❑Workman's Compensation Insurance
Chec one: A
am a sole proprietor
❑ I am the Homeowner {
❑ I have Worker's Compensation Insurance
Insurance Company Name F
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit:
Permit Reque (check box)
Lg'Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to i
Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ e-side
Replacement indow doors/sliders.U-Value e Z (maximum.32)#of windows
#of doors:
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE:
Q:\WPFILESTORMS\building permit forms\EXPRESS.doC
01/25/17
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):
e
Address: 6 CQ��
City/State/Zip: (w'k S Poi MA O Z 6`3 Phone#: �O 8 3� G f 2-
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
employees(full and/or part-time).* have hired the sub-contractors 6. New construction
2. dam a sole proprietor or partner- listed on the attached sheet. 7. V 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.t
required.] 5. We are a corporation and its 10. Electrical repairs or additions
3. 1 am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12. Roof repairs
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 insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct:
Signature: Date: �� -
Phone#: �J — y C 2--9
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#:
FIDUCIARY DEED
KNOW ALL MEN BY THESE PRESENTS"THAT:
LORRAINE B. CABRAL, of Hyannis, Massachusetts, is the duly appointed and qualified
Personal Representative of the Estate of IDA M. BROWN in the Barnstable County Probate and
Family Court,Docket: BA16PI 149EA, and further,
`—' by the power conferred by a certain License to Sell Real Estate granted by said Court, on April
110 21, 2017, and by virtue of every other power of the said Personal Representative,her hereto
enabling,
for consideration of one hundred forty-two thousand($142,000.00) dollars, grants unto DIANE
M. RICHE, of Cotuit,Massachusetts, an individual,the following lands and property,together
M with all improvements located thereon, lying in the County of Barnstable, in the town of
Hyannis, in the Commonwealth of Massachusetts, bounded and described as follows:.
Cd
WESTERLY by Brookshire Road Fifty(50.0) feet;
NORTHWESTERLY by Lot 17 as shown on hereinafter mentioned plan One
03
0 Hundred forty-six and 20/100 (146.20)feet;
EASTERLY by land now or formerly of Kenneth Dottridge and land
now or formerly of Ernest S. Bradford One Hundred fifty-
five and 37/100 (155.37) feet; and
OSOUTHERLY by Lot.19 as shown on said plan Ninety-nine and 02/100
pa (99;02) feet.
00
Being shown as Lot 18 on a plan entitled"Subdivision of Land, Hyannis, Barnstable,
v; Mass. as surveyed for Ralph M. Johnson,Jr., Scale i"=40 feet,May 1948, Whitney&
Bassett, Engrs.,"recorded in Barnstable County Registry of Deeds,Plan Book 85 Page
'.0
101.
Title Reference: see deed from Fern Louise Mascia,Individually,to Roger E. Brown and Ida M.
Brown,husband and wife, as tenants by the entirety, dated March 29, 1961, and recorded with
the Barnstable County Registry of Deeds in Book 1108,Page 571.
SAID LAND, PROPERTY, AND IMPROVEMENTS ARE BEING TRANSFERRED
WITHOUT ANY COVENANTS' 11_
WITNESS my hand and seal on the day of
4L+aine B. Cabral as Personal epresentaWThe Estate of Ida M. Brown ni
1
Town of Barnstable
Regulatory Services
KAMAe` Richard V.Scali,Director
4639.
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I Diane Riche ,as Owner of the subject property
hereby authorize Mohhmed Rahman to act on my behalf,
in all matters relative to work authorized by this building permit application for:
18 Brookshire Road,Hyannis,MA 02601
(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
. , Massachusetts bepartment of Public Safety
Board of Building Regulations and Standards
License: CS-105918
Construction Supervisor
Corlstr MOHHMED S RAHMAN
Restri ucfic�S 66 CENTER STREET,
U�restri t t0. uperl�isor. UNIT 2�
DENNIS PORT MA 02639
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I 1. HOME IMPROVEMENT CONTRACTOR
Individual
ftstration Expiration10/08/2018
� .. . —;92
Mohhmed Rahm
D/B/A All dape� enra
Mohhmed Rahmar
66 Center St Un' 2;3-
Dennis Port, Undersecretary
r .
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION,,,Q
� � Parcel b � f j �- r, Application #
Map T � N 'F BARI�STABLE
Health Division Date Issued
Conservation Division f Application Fee
Planning Dept. Permit Fee l q&, <I
Date Definitive Plan Approved by Planning Board ''3Q°,_`,TEi
Historic - OKH _ Preservation/ Hyannis
Project Street Address ( roe Cg r�
Village
Owner ► �l (,`'-� ` Address�S h a►" \. COJN I
Telephone . 01� "1 2 9j-- G 9 6 0
Permit Request pc oo S S' ``-o fw ef- S:k I 1 r1
n
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 01, 000 .Ua Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing St2ull
re Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ 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 8/0II ❑ Electric ❑ Other
Central Air: ❑Yes LNo 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 0 44 Map 1 N M Telephone Number �0
f
Address ( C C24e-� &V r U�- � Y Z-1 License# 105919-5
r\ \5 Po tt M �A 0 Z 6 Home Improvement Contractor#
Email U G O° P 7r,Koa• Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY
APPLICATION #
DATE ISSUED
MAP/ PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
i
600 Washington Street
Boston,MA 02111
UV www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): MOA)A M�F_f) Os
Address: 6 Car-4e.0- U r I 2_�
City/State/Zip: A Por (W 0Z Phone#: �� 9 3� �'� i 2
Are you an employer?Check the appropriate box: Type of project(required):
1. I am a employer with 4. 1 am a general contractor and I
employees(full and/or part-time).
have hired the sub-contractors 6. New construction
2. dam a sole proprietor or partner- listed on the attached sheet. 7. VRemodeling
ship and have no employees These sub-contractors have g. Demolition
working for me in any capacity. employees and have workers' 9. Building addition
[No workers' comp.insurance comp.insurance
required.] 5. We are a corporation and its 10. Electrical repairs or additions
t- 3. 1 am a homeowner doing all work officers have exercised their It. Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12. 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#I 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 insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct
Signature: � Date:
�-z
Phone#: Q [ 2—(a
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#:
Town of Barnstable
Regulatory Services
ism ` Richard V.Scali,Director
m A. Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
Diane Riche ,as Owner of the subject property
hereby authorize Mohhmed Rahman to act on my behalf,
in all matters relative to work authorized by this building permit application for:
18 Brookshire Road,Hyannis,MA 02601
(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
_9 Massachusetts bepartment of Public Safety
Board of Building Regulations and Standards
License: CS-105918
Construction Supervisor
Constr MOHHME D S RAHMAN
Res 66 CENTER STREE
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} _ - HOME IMPROVEMENT CONTRACTOR
of pew Individual
— Registration Expiration
T� 492 10/08/2018
Mohhmed RahM
D/B/A All Cape,1ea ►a
Mohhmed RahmaME cC --
66 Center St Unit, = U
Dennis Port,MA 02639 Undersecretary
1
FIDUCIARY DEED
KNOW ALL MEN BY THESE PRESENTS THAT:
LORRAINE B. CABRAL, of Hyannis, Massachusetts, is the duly appointed and qualified
Personal Representative of the Estate of IDA M. BROWN in the Barnstable County Probate and
Family Court, Docket: BAI6PI149EA, and further,
^� by the power conferred by a certain License to Sell Real Estate granted by said Court, on April
21, 2017, and by virtue of every other power of the said Personal Representative,her hereto
N enabling,
O
for consideration of one hundred forty-two thousand($142,000.00) dollars, grants unto DIANE
M. RICHE, of Cotuit, Massachusetts, an individual,the following lands and property,together
Cn with all improvements located thereon, lying in the County of Barnstable, in the town of
Hyannis, in the Commonwealth of Massachusetts, bounded and described as follows:
c�
WESTERLY by Brookshire Road Fifty(50.0) feet;
NORTHWESTERLY by Lot 17 as shown on hereinafter mentioned plan One
CIS Hundred forty-six and 20/100 (146.20) feet;
O
y EASTERLY by land now or formerly of Kenneth Dottridge and land
now or formerly of Ernest S. Bradford One Hundred fifty-
rA and 37/100 (155.37) feet; and
OSOUTHERLY by Lot 19 as shown on said plan Ninety-nine and 02/100
(99.02) feet.
00
r—+ Being shown as Lot 18 on a plan entitled"Subdivision of Land, Hyannis, Barnstable,
Mass. as surveyed for Ralph M. Johnson,Jr., Scale 1"=40 feet, May 1948, Whitney&
Bassett, Engrs.,"recorded in Barnstable County Registry of Deeds,Plan Book 85 Page
.5 101.
Title Reference: see deed from Fern Louise Mascia, Individually,to Roger E. Brown and Ida M.
Brown, husband and wife, as tenants by the entirety, dated March 29, 1961,.and recorded with
the Barnstable County Registry of Deeds in Book 1108, Page 571.
SAID LAND, PROPERTY,AND IMPROVEMENTS ARE BEING TRANSFERRED
a WITHOUT ANY COVENANTS. 1_
WITNESS my hand and seal on the day ofMAY ,2ol
/Xafze
o aine B.-Cabral as Personal epresentat` f
The Estate of Ida M. Brown n �
1
COMMONWEALTH OF MASSACHUSETTS
LF , ss.
On this day of , 2017,before me,the undersigned
notary public, personally appeared the above Lorraine B. Cabral, Personal Representative of the
Estate of Ida M. Brown, proved to me through satisfactory identification, being a
to be the person whose name is signed
on the!preceding or attached document, and acknowledged to me that s/he signed it voluntarily for
its stated purpose as:Personal Representative.
SETH D. KLOTZ Notary Public
e Notary Public
COMMONWEALTH OF.MASSACHUSETTS My Commission Expires: ��•q. 2 Z
My Commission Expires rr
December 9, 2022
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Assessor's map and lot number ................... �:��'
•Sowage .:Permit nur,iber ....:.... .....:... ...:. ........ ........ .
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;House number ... ...f ....................................................... a sa
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TO OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ...:....:. V..................... .......oT 0,��'1...................... .....................................
TYPE OF:CONSTRUCTION ........ W'JO r� .' FiE'Ar"i .................................................... .......................
...................................... .
................................................19........
TO ,THE.INSPECTOR OF BUILDINGS: e
The undersigned hereby applies for a permit accor'ding to the following information:
Location ...... ..... ! �? .K,� .��r.4.F. .1 it�.!.......... .-� /)v S.............:3l f'........................................................
vc
ProposedUse .............................................................................. ..................................................................
Zoning District ................................. ........Fire District .. :11iA.1.. ................................................
Name of Owner 111°S � A.... r'cp.(d ......................:Address .��5 /-lit'm9! ! ..'� .....Aa°. ... yA!`!^^.
Name of Builder ... �� Iv .......g.........Of4MX.............Address .... . ...t+vk"0.!....f,.®a..`......�................ ....P 'IVn+i� haft
Nameof,Architect ................................................................:.Address ....................................................................................
.......13 ..........Foundation ? ..:....... ..... ...., ...............................................
Exierior ........... .!.:n7o'2 ..... ^`T.......................Roofing ......(�S,/��? ..
.............S/i,.!`'�ci.�.�.�...................
fSnrfi. c...... ...............................
Floors j ii L.T� .................:Interior ....... c
.................................................................... ...............
Heating f o2C Fla i /� ' Plumbing ......
................................. ........`.. .................
Fireplace ................................................. .............:...............Approximate. Cost_ ....... .7r .....®'.0....................................
Definitive Plan Approved.by Planning Board ________________________________19____ . Area 1.
Diagram of Lot and Building with .Dimensions
- ............1�...........................te Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH `
Alto
1119
H-0Vs�
o
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS `
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
0
Name `'` ..... ........................
Construction Supervisor's License ..: ®.�. .6.�..........
BROWN, IDA
No 26669 . Permit for ..Addition. '
ti Single Family Dwelling......................
Location 18 Brookshire Read
..................X..........................................................
Ow C Qua l........................................ }i y; �:; •� ' ' V
Ty f Construction ........Frait ....................... �- ✓; .Ke
�. ....................................4.... _ `� i �_ w� .. ►
Plot........................ Lot ...............................
Per" - Granted .JulX..9%...�......:::Y.....�19 84 cs y r 1
Dat Inspection ..................:r`...... 9
Datet'Completecl . C✓i'i'. ...... ...... 191?
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NV
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Assessor's map and lot number ........................ .........C74?_�
Sewage Permit number ...........................................
DAWSTAMLE.
House number. .........../. ...............................................y MU&
6 39.
am
TOWN OF BARNSTABLE
BUILURG INSPECTOR
APPLICATION FOR PERMIT TO ..........AA P...........A f 01T0.0.....................................................................
TYPE OF CONSTRUCTION ...............WOO9 r AMC
.................... .........................................................................................
...............................................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ... ......R..0 Yh ,IAJ
I.......................... .......... ..... .....................................................................................................
(14S E-0
Proposed Use .............................IRO M..................)
......Q. .... ..............................................................................................................
Zoning District ........................................................................Fire District t J�Y.Am�.t,f ................................................
Name a _4 14
f Owner M*11?4' 72 ....)MfV��.......................Address
................ ......
Name of Builder ...r!KANK......Is,.........arjeX.Y............Address .... ....1M'9V . i44TA
............ „SO pEN�if�gtjfr
...........
Name of Architect ..................................................................Address
A OP. T.b)V
Number—of—Rooms .........t3 jr 0 e0o rn Foundation .....................................
I .................................. .srl,
Exterior ......... n)ovt S 'A S-PA A 4 7 .......................................:.;, .............................Roofing .... ...................... ..........................
%
Floors .............. i l..I:..............................................................Interior ........25.'.A.Kk7t.49.S�................... ..........................
Heating .�RC...KP.......f.1.%..7...... A
.Plumbing ............. . .............. .............................................
Fireplace ..................................................................................Approximate Cost ........
... ..................................................
Definitive Plan Approved by Planning Board --------------------------------19--------- Area ........../.............................
Diagram of Lot and Building with Dimensions Fee ............AQ..........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
c.
Alc 0 0 k 5�,
S
6V
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of 'Barnstable regardingI the above
construction.
Name ................................. ....4��........................
Construction Supervisor's License ...00 .. 1,
........ . ... ...... .... ...