Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0074 CAMP STREET
��/� `� � t��r���� b� r ,t, � cam' �\��� i *�,. �i ��� �- -.. y7 ,. � L1 y .. , ; '1 ,� �� �i �, a I I� �! OAn r F r bw-f-' Az` L� t r 6C_ Date: March 12, 2018 To: Building File RE: Complaint:Tenant Issues Address: 74 Camp St, Hyannis Originator: Jeanette Bearse 30 Terry Court, Hyannis Complaint: Overcrowding,trash, unreg vehicles Enforcement Process Steps 1. Initiate local investigation: Jeff 13 2. Document/enter into system Yes 13 3. Contact \ 13 4. Property Owner Jeanette Bearse-508-775-0430 r 5. Seek access to subject property 6. Seek administrative warrant(if necessary) NA 7. Notify state authorities of findings NA ® 8. Document conclusion A13 9. Referred Health & PD Property—328-178 Property is developed with a 2 family dwelling containing 3 bedrooms and 3 baths(1920)on 0.13 acre located in the MS zone. 03/12/2018 Request for service referred to Health for overcrowding, rental registration and trash complaint. Referred to PD for unregistered vehicles. t 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel j TOEIrN OF BARNSTABLE Application — -7 —"/YYJ Health Division 2 7 1_ , Lt. n Date Issued Conservation Division l Application Fee Planning Dept. � Permit Fee V Date Definitive Plan Approved by Planning Board - Historic - OKH Preservation/ Hyannis Project Street Address —7 4 CcAm e T Village lWA rA 11 i Owner 9��;� �Gt`(� 1e�(e 1 I Address Telephone O Permit Reques ILMO �� / o ® S 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 If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family Multi- amity (# units) Age of Existing Structure Historic House: ❑Yes—iAo On Old King's Highway: ❑Yes 1�J0 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: LU-G-a's ❑Oil 2-Electric ❑ Other Central Air: ❑Yes Ao Fireplaces: Existing New Existing wood/coal stove: ❑Yes to Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: f 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 Ra 6(a' l L(�c,/ Telephone Number Address raw License# Home Improvement Contractor# c_a wa S q i [Cori Ema' p Worker's Compensation # ALL CONS UCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIG — _.`' DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER d DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ? h-2 PK- DATE CLOSED OUT ASSOCIATION PLAN NO. I 2Ti,-Commompeaith of fassadzusetts Deparhrreut of lud-u-aid Acciderds Office af1m.,Tsiigafians 600 Washington,9treet Bastou,AM 02111 Workers' Cornyens3sanlnsm-ance Affidavit:Bmldex-s/CuntractursMectdcian.s/Phmihers Applicant Infat mafreII Please Print I* ffif Na=(BCrsiaessl�Otganiiati - Address- (?QA,M V 02 City/st-telzig1'hdno ' Are you an eurployer?Chi the appropriate bom ' Type of project r L❑ I am a employer with 4 ❑I am a general contractor and I e J (required): P� 6. ❑New consirucfiio¢ employees(fish amVor part-fime).* have luredAe sub-conb actor 2. I am a sole proprietor orpartner- listed on the.attached sheet.. �. ❑RemodeHng These sub-conftac#orshave ship and have as eragloyees . $. ❑Demolition and hare wodcers w o forme in employees aup capacity: �b 9. ❑H,uildiag addition. . ' camp.ir�stisance comp_men=M3 - 5. ❑ We.are a corporation and its 10❑ElwEcal repairs or additions. 3 "" officers have their 1 L Plumbic re airs or additions am a homeovmer doing at1 wodc ❑ P myself-[No vkkers'camp- �t of exemption per 14IGI. I-❑Roof repairs fnctriance required-]Y c.152,§1(4)6 aadwe have no employees.[No wodcers' 13_❑Other cozp.insurance required_] •Any&"icmtdsrcbedcsbasftimxLs alsafillottthesectionberawshoningiieanroaerecampe satiaapaHUixffoemsrnm. &ameoamE=who submit dds imd'iratingtbvyaxedaia�aIFcsaoi�sacdfheahireoutsidecoaimcmrsnmstsabmitanewaffida�tindicatin.satc5 rCantracfostTazt checYihis boat must zttarhed=additional sheet sboumgthemame of the sub-con sraa.sml sWewhethes ornat•lnse en itiesbare empk yeas.Ifthemb-can- actumbave emptayees,theymustpmw-detheir worken'comp.palicy numben I acrt an eutplgvr flint is pam di, workers'compensa aan inmirance j'or my*emplayees. Mow is triapv&7 curd joh z&R informcrdom Insurance Company:Name: 'Po-ficy,or Self-ins..Lic-A RxpiradonDate: Job Site Address: city/State/Tv: Attach a COPY of the workers'compensationpolrcv-declaration page((showing the poRcy number and expiration.date). FaR=to secure coverage as requiredunder Section 25A of MGL c<157-can lead to the imposition,of cdrninal penalties of a tine up to$U00 Oa and/or one-year imprisoumeuf,as Drell as civil penalties.in the fo=of a STOP WORK ORDERand a fine of up to O-OO a day against the vialainr. Be adzdsed that a copy of this zWemmtmayba£a:warded to the Office of Imves4igatiow of the DIf4 for-MStmalCe Coverage I'Mrification_ y cet1ify rurdgr dteprrirts m 2ahi ex o.fperjtr}'f urti�lis iriforma imi.pro tzdkd a5ary' .liars artrl rrect i R,- �` Iyate:�•� t � � III, phone ik Offichd use wily: Da curt o-Frtts i flies curio,t�be rnangleted Fiy city aarfon n o;�rciril City or Town: Permifff cease;9 Issuing AMilmrk)T(circle one): L Board of Health Budding Department 3.City rower Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other contact Person: Phone#: — -- - —- 6 'ormafion and Tas tcf o�as ` MassachosefLs General Laws cfiaptt:r M req� all erPloye3s to IMM&worker'compensation for their employees_ Pmsaantto this sf�e,an e�Ioyee is defn ed as-"._.every person.M ifi a service of another antl act ofhim, er any coafr CXPress or uuplied,'oral or wry" arEn associafivn,oorparaiion or other legal entity,or any two or more An Ivyer is defined as man ind�idual,P the I se rves of a.deceased employer,or the is a joint enterprise,andmclndmg egalrepm of the mg er the ��° � Howev receiver or frustes of as indrvidaal,paltoershrp,association or other Iegal verify,employing emp y - sidesth�or the occupant of1he- owner of a dweIImgl�onsa havmgnotmare three apazfrae andwh o re dweMag house of another who employs persons to do maintenance,construction or repair wow on sack dwelling house or on tha grounds or burldmg n appur therefo sfiZnotbecanse of so"eniploymentbe desmedto be an employees" MGL cfiapi�r I52,§25C{6)also states 1lizt"every s�nr Ioral Iicea�agency shall witlihoId$ie issuance or renewal of a f cease or permit to operate a bossiness or to constrict bmldmgs is the commonwealth for my appTrcantwho has aatprodnced acceptable evidence of compfiauce with the amurance.coveragerequire AdditionaRy,MCrL chapter I52,§25 states¢I�Teifher$ie te r,rrr�wealtTi nor a'r<y of ifs political sobdivisians shall meter mt3 any contcad for the performance ofpubli kc wor uohl acceptable evidence of compliance-with the MST11`ance'•. Pcp�e -enfs of this ahaptr�Xhavalieenpresentedin the cmnfracdng.anmofy:' APPhra'rEs Please fal o:U± the wo�=-,'compensation affidavit completely,by cEe ki g the boxes that apply to your sift a on and,if necessary,supply sob-mntactor(s)name(s)' addres (es)a.dphone numbers)along withtheir certficste(s)of �Eoce Limited LiahU4 ComP�eS�C)or L=tedLiab�itY Par[nen hips(LI P)'�eithno employees other fiian the members or parae rs,are not rbgmzed to carry wort-C&compensation iasIIranca- If an LLC or LLP does have empIoyees,apoIicyisrequited. Beadvisedthatt��isa$xdayitmaybemhmiYndtotheDeparimentOflndimfrial Accidents for confirm tron of imsm-mce coverage Also he sure to sign and date the affidavit. The affidavit should be•retvmed to$e city or town that the application for the pezM or license is being requested,not the D epar{mcat of LnOnyEri al A.odder. Shonldyon have any questions regd-g the lave or ifyou are reqair�to obtain a workers' co3npensationpoIic9,p Imasm call tho DeP a dment at the nib rr listed beIow Self-insured companies shavld a `er their self-msmr�ca license number on the appmpriata Imo. City or Town Officials t Please be sole that the affidavit is complete andprinted legibly. The Department has provided a spaces at the bottom you fill out m the event the office oflnvesfigafrons has to contact you regardmgthe applicant of the affidavit for y applicant Please be sine to f ll m the petmidIicense mrnba which wM be nsed as art-,ar- .ce Umber.In addition,an aPP Rut that must sabM,,L multiple perm&Hcense applir aiions Many given year,need only submit one affidavit indicating policy mforLiatiaa(if n�'���;)and under"lob 55te Adsese the applicant should wa---au locaid, n (may or town)."A copy of jhr affidavitthathas bees officially s upped or marked bythe city or town may be provided to the appHcazt as proofthat a valid affidavit is ou file for fahn 'petm4s or Bemuses. Anew affi.davitrmrat be fIle .otit earth year.Where a home owner or citizen is obtaining a license or permit not related:D any business or,commercial via D. a dog license or permit to burn Ieaves etc.)said person is NOT reTih-ed to complete this affidavit would bike to thank you m advance for your cooperation and should you.have any questions, The Office ofInveSagzffi= please do nothe:&RatE to givaus a call TED Departin=fs address,telephone and fax number: CG=IQtWeA*of Massaah-nset#s t � Ile�mf�aflad�zalA��n� . FQG woman -T(�-L1611' -49-00 cxt 4€6 car 14M-MA&�A� Fax #617 727 7749 Rovised4-24-07ww 9PZr[diM' I • r - AWC Guide to Wood Construction in High Wind Arens:110 inph Wind Zone • Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 Q Check Compliance 1.1 SCOPE WindSpeed(3-sec.gust)....................................:..............................................................................110 mph WindExposure Category.................................................................. .............................................................B 1..2..APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) stories <_2 stories RoofPitch ..........................................................................(Fig 2) ........................................ 512:12 MeanRoof Height ..............................................................(Fig 2)................................................._ft <_33' BuildingWidth,W...............................................................(Fig 3)................................................ _ft s 80, Building Length,L ..............................................................(Fig 3)................................................._ft <_80, Building Aspect Ratio(LW) ...............................................(Fig 4)................................................. 5 3:1 Nominal Height of Tallest Opening2 ...................................(Fig 4)................................................ <_6'8" 1.3 FRAMING CONNECTIONS General compliance with framing connections..............:.....(Table 2)................................................................ 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.............................................................................................................................. ConcreteMasonry................................................................................................................................... 2.2 ANCHORAGE TO FOUNDATION" 5/8"Anchor Bolts imbedded or 5l8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general................................. ........(Table 4). ............................................. in. Bolt Spacing from endloint of plate ............................(Fig 5)..................................... in.<_6"—12" Bolt Embedment—concrete ...............(Fig 5).......................................... Bolt Embedment—mason ........(Fig 5 >_ " Plate Washer........................ ...................................(Fig 5)......................... .......z 3"x 3"x'/s" 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension....................................(Fig 6).................................................. ft 512' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)..........................I............ Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall.:..............(Fig 7)..................................................... —ft s d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)....................................................._ft 5 d ' FloorBracing at Endwalls.................................:.................(Fig 9). .................................................................. Floor Sheathing Type ........................................................(per 780 CMR Chapter 55).................................... Floor Sheathing Thickness ..............:.................................(per 780 CMR Chapter 55)....................... . in. Floor Sheathing Fastening..................................................(Table 2)..._d nails at in edge/_in field 4.1 .WALLS Wall Height Loadbearing walls................................................:.......(Fig 10 and Table 5)...........................—ft 510' Non-Loadbearing walls................................................(Fig 10 and Table 5)...........................—ft 5 20' Wall Stud Spacing ........................................................(Fig 10 and Table 5)..................._in.5 24"o.c. Wall Story Offsets ........................................................(Figs 7&8)............................................ ft _<d 4.2 :EXTERIOR WALLS Wood Studs Loadbearing walls.........................................................(Table 5)..............................2x - ft_in. _ Non-Loadbearing walls........: .....................................(Table 5). .......... .............2x -_ft_in. Gable End Wall Bracing' Full Height Endwali Studs............................................(Fig 10).................................................................. WSP Attic Floor Length...............................................(Fig 11).............................................. it zW/3 Gypsum Ceiling Length(if WSP not used)..................(Fig 11)............................................_ft?:0.9W and 2 x 4 Continuous Lateral Brace @ 6 ft.o.c. ..(Fig 11).............................. ............................... or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4.blocking @ 4 ft.spacing in end joist or truss bays Double Top Plate Splice Length .............................I..........................(Fig 13 and Table 6)....................................._ft Splice Connection(no.of 16d common nails) .....:.......(Table 6).......................................................... AWC Guide to Wood Construction; in Sigh Wind Areas:110 mph Wind Zone p ° Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)' Loadbearing Wall Connections Lateral(no.of 16d common nails) ..............................(Tables 7). .................................................. Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)...............................(Table 8)........................................................ Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans ........................................................(Table 9). .............................. _ft_in. <_11' .................. Sill Plate Spans ........................................................(fable 9).................................._ft_in.5 Full Height Studs (no.of studs)...................................(Table 9)........................................................ Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans.............................................................(Table 9).................................._ft—in.512' Sill Plate Spans...........................................................(fable 9)........................ .......... ft_in.512" Full Height Studs(no.of studs)....................................(Table 9)........... ...................... ... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously, Minimum Building Dimension,W Nominal Height of Tallest OpeningZ ' " SheathingType.............................................(note 4)........................................................ Edge Nail Spacing.................................:.......(Table 10 or note 4 if less)....................... in. Field Nail Spacing.........................................(Table 10)................................................. in. Shear Connection(no.of 16d common nails)(fable 10)..................................................... _ Percent Full-Height Sheathing......................(Table 10). ...... .......................................... _% 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... Maximum Building Dimension,L Nominal Height of Tallest Opening2. ..............:........................... 5 6'8" SheathingType....... .................................(note 4).................................................... Edge Nail Spacing..........................................(Table 11 or note 4 if less)....................... in. FieldNail Spacing ........................................(Table 11). ............................................. in. Shear Connection(no.of 16d common nails)(Table 11). .................................................... _ Percent Full-Height Sheathing. ... .................(Table 11). .......... ...................................... _% 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... Wall Cladding Ratedfor Wind Speed?............................ .. ............................................................................................ 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ........(Figure 19 ft s smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)............................................U= plf Lateral.............................................(Table 12).............................................L= plf Shear..............................................(fable 12)..............................................S= pif Ridge Strap Connections,if collar ties not used per page 21... (Table 13)...............................T= plf Gable Rake Outlooker.........................................(Figure 20)............._ft 5 smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift. .(fable 14)............................................U= lb. Lateral(no.of 16d common nails)...(fable 14). ......................... .......L= lb. Roof Sheathing Type........................................... . ...(per 780 CMR Chapters 58 and 59) ........... Roof Sheathing Thickness....................................................................................... _in.Z 7/16"WSP Roof Sheathing Fastening...........................................(Table 2)....................................................... _ . Notes: 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e: Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11, 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. AWC Guide to Wood Construction in Sigh WindAreas:110 inph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength.axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment -1iVHEN THIS EDGE REM ON _ FWSAAING EJSESd NAILS AT6-bim - u 11 11 Ir It 1 !I n 11 1 • 11 11 11 11 1 r I 11 11 1 11 11 tl ,[ 1 1 1 11 i t •5 1 1 11 1 C t 11 Il ' N i t O t/ jry It F 11 11 4 1 , it IL • i/ d u ii � 1 u It II oQ it ii � 1 . 41 =t 1.1 n 11 It W it 11 � t • It Z 11 1{ q t It Q tl Ir Y.! 1 II -4 li 1j 1 U I1 t 1.FIU„ i ii ii 7s i i vi II It-��__-11 _ 1 it t y JL _ err DOUBT E SDGE `------- �% tIAN SPACW6 r� ► P14fiiEt "..•"il a See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in Sigh Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(7so CmR 5301.2.1.1)1 ► w I Io ► L ► ZQ ► t (► I I FRAMING MEMBERS Ba EI I' I EDGE E[TERMEDIATE I► i t ► I L . S18• ► i I f ► � ► � � M ► i STAGGERED 3'MNI- HAIL PATTERN PM1EL PAIVH_EDGE DOUBLE NAIL EDGE SPAMG DUAL Detail Vertical and Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in High Wind Areas:110►nph Wind Zone Massachusetts Checklist for Compliance(7so CMR 5301.2.1.1)1 FAQ ': WFCM Checklist Question: I understand if a new home is built in a town in a i10 mph wind zone then the American Forest and Paper Association (AF&PA) Wood Frame Construction Manual can be used to prescriptively design it. I also understand that in some cases the home can be framed'per the WFCM1oo mph Guide, if it meets certain requirements including but not limited to aspect ratio, roof height, number of stories, and exposure category (B). I have heard that Massachusetts has a "modified" checklist that can be used instead of the checklist at the end of the Guide. Is this true and what can you tell me about this "modified" checklist? . Answer: You are correct on the items that you have noted. MA has modified the checklist in several important ways. The MA version allows a roof with a pitch up to and including 8 in 12 to not be "counted" as a story. Further it does not require steel hold downs and straps in many locations if full height sheathing is used as defined in the MA checklist. Further, if the building will have furring strips installed in the ceiling abutting the gable wall then 2 x 4s installed on top of the ceiling joists are not required. There are other changes as well that.were not noted here. The MA version of the checklist was formulated in recognition of the highly regarded framing methods used in MA for many years and wood framing that has been used in North Carolina over the past 10 to 15 years which has performed well in severe hurricane weather'in that state. Answers to FAQs are opinions of the BBRS Staff and do not reflect official positions or code interpretations of the BBRS. Town of Barnstable Regulatory Services Richard V.Scali,Director ~o Building Division s,►mvsrwsca Paul Roma,Building Commissioner sMAS& 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION j DATE: Please Print ` � � . � - JOB LOCATION: �� i2 v ►1�� r� um e / street village "HOMED ' t name home phone IF work phone# CURRENT MAILING ADDRESS: c ty/to state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection roc�� d end that he/she will comply with said procedures and requirements. ` omeown 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:\WPFILES\FORMS\building permit fonns\EXPRESS.doc 06/20/16 �'THE Town of Barnstable ; Regulatory Services M- 98. Richard V.Scab,Director. 639. 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 Usuzg A Builder -014 04 � t' , as Owner of the subject rrorcttJ hereby authorize to act on my behA in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not e—fi-]Iodor utilized before fence is installed and all final spections are p Ormed and accepted. Signature of Owner Signature of Applicant Print Name ' Print Name Date QTORMS:OWNERPERMISSIONPOOLS BARNSTABLE 17 15 Pfj q: �00 tA' .......... _ -�w--..�-..-�.....�..�.,�....�...�.... �..�..�.._..r....e...,Y�.�r.,.,r.....,s_..� �, ...tom .- , ._.�....� ++a�+�.-�.--_..�..... .....�- _ - _ _ .ter.. �...`. _-- _ __ .......�w....�.r�.M � .�..,. y � t ....�.« �,,.e�,`�,,..�..v..........,�...-.�...w...... :�..mow+-..-... �..... •-..- _- _ -ter. �.....a�.�.r..�-�..�... ......� f � J � J e � �' - F ( I � r 1� . i _r...t_ �.����w- -�-�-�-«.rw_�..,�. __ _.._— - �.._...�..�.__.�_._.....�._ ........__�,.._. .T..�.___�_......�...__..__......-- r . � ._�_�_....._....__.__.�.......�..............e.........,�.�..,....,_.._�.�..� .._�.._..�,.w,. --- - -- --. ti.._w. �� _....._r _ �..�.� .� -- ---- i -- -- - - ......... - - -- .p.__ - --�.._� ��.._.. _..�.�. I I i i .�.� �..A�_.-J+.�r ..w..v�«n....�.�m•w...�...........a..... —_- — ..�.+..�+.��-.w�.-.>...h�.....ram. ..�.�.r..r....�w�r.......�,u�. _ _ --_ .�.e .4- __ ___r+. ..��.e.�..� l r�n+��-�..�.n�.�.er��r�s.��-rsr�fa�wr��nu�a��.-�vw��r++.++.r�.+s. �,...�-�--r�rw�-��.n.�r.�....�.n.��+.rrv��r+�w.�.��fw�..��w+�rr+a.�.w�..a-....�r.......�..-r..r�n�.�..-n�.�.rv�..•r 'r+..mar _- __ -_-.��.�+�. E r.......,�.t�a mw.rr..r�..�=w.r.+.as4a.o�..r+n��-a��a..r.-r-.��n��.w.-+�r�ru���n�-.�..-w�..r..s��r�.w-.w .�.��r��—�r��..�..+�.�.v..� +..rw---+�u.a��.r..�r�w�..��.�..+.� .�.��r�.�-�+..�n++r ��,�.�:.. .....ti.�.�� - .._ +�ww.�.�v�.�...._.F.�r�..e.++.�w.r.ra.t..n...�... w.,.�r�..w.-v+..�w-..�..+�-.r.����rwr�a�.+....u��«�r,�...�.r....��.i��-w�a.rr� r��s�.f��...v.«� --T-� .�� 1 �.���.. .. ......rr++r.�.—.�.�+��:�.w-�w..�...�e..��..r.w�... r ��..-r...�.�.�-........�..�....w,��.....r�...����.a �e�...�.�.s....� ..._�.���.�»..��..� ,� _�.-�«..��.�.� ..ae..w.r�.... i ' 4 TOWN OF .,NSTAB 15 PH 4: � . Ilif I i, 1 1 . ._._.t_____..__.�.,...._ � a_...�._,v.. .�...�..__.._ __ ._..._...... ._.__._._,.. . . � — — — �-- ._..�.._._._.__._.�._.. E I ,e.. � _ �.. ...�..�._...._._..e — — --.--. � i ... � -----.�— ��__.____._.....� — �..._....... .a..._._.�..... _ i �- ,, p - _. � ' r _ . , .,� f t �. I' _.___ . [� I r .i. i .__....._._...._,... I �. i ' I A i ti.,._._ _ TOWN OF BARNSTABLE 3 C. IAJ _ V r• z �1 1 4 , 4 j qj SMOKE DETECTORS REVIEWED 1 'FIRE KP DEPT. DAT y S� ,. DAT BOTH SIGNATURES ARE REQUIRED FOR PERMITTING b z ; CARBON MONOXIDE ALARMS �� F MUST BE INSTALLED PER C I t f I to S� z i r p f"l I 4 Camp Street, Hyannis 7 / 14 /16 .. +-s a i i r o a U +r cJ - H y � p r i t A r� 4 F,' -. ,,+r; A' - - 'la T:� !�a '1Y� Y v .1 ��.. +�� i .` _. .. F�. 1.�; :M .� '.y:': t ,4 .k* s ,p,'` :_� �, �. .. �..� , .. a. 4 Camp Street, Hyannis 7 / 14 /16 4 � x# ISO 41 lei ^3: r - 4 h It S�..i «� d1j tf •� �l fJ ` 4� jtjt{{ff yy } Yr og�a�:. ry:. i k 1 t ticyl2k _".5�a.r i a J L r „yam d".t" �YBn fr�i F� r�K+.. a'!� ^' -.,y � � ^v;-�' >..^' k" .�� , y T 7`wk 3 .,"-J`- `uµ •. �, } � e 4 . z r 41. ,r, x cq e - ;;` a � say '�� � � ... .,• � .�, o e t o u 1 `h f t r t r - f 74 Camp Street , Hyannis 7 / 14 / 16 �Y I IIJJJ \ i 9 f J� 4� .1 i �r a.11 \ / Comn St£eet ■ . Hyann\ 2 . \ 7 / 14 /16 \ ` * � � . � kk« 74 Camp anMid .` c him >Y A r `..5 .• _ �.�5i�^�•v i Y.. Vl a 4 4�3 �s r C' ,� �1 � �} � •..fir+.^.` S R5 � b t x? t� of 74 Camp Street , Hyannis 7 / 14 / 16 Y t \ - 1\ j-No 71 vo � 4 y' t� 74 Camp Street , Hyannis � . 7 / 14 / 16 '' Sk o� .x, x e e i e A , 4 I O` kr 1 r ' f r r <y f ` I�r�MYfl t r. r w� S ! �4 1 �1 .f x t ` M I� tl h R 1Ar' �k � y s C� t {Y1 w� ca' I < F { 1, ul�_. �. 4 Camp Street, i t I r Y a ,w II i r i i 1 i I 1 I A 74 Camp Street , Hyannis 7 / 14 / 16 ,, m A< Pk V �► �d ; v.7 e, - pi ri s Yg - j'y 4 P 7 4 Camp s WL 440 _ � r J' ` Y t .IN 4 � ,I ®� k F M 3 � e --- ` .. __ _ _ - -�+ -..rt_-�'��._ ' � _-�.°.a - A �C ..�, ate' `+4 �'� i-' •S - y R a _ Y� .n r u - - y a - i 1 - . k S dim- 71, Lka� 1y.,ia+rj _y ^s"'"'p`�k'it. '_1 -•," + T Syr' �M 4rr as sr:r� Y o ' t -MsIA } y '� ' ,• '�f^,,<f, .1` 4��" /�`.'f~ 4�A� d"'`.��a3 � �'r ax �.C'A}< "Z�-v"q+� ,� , - - , 1Ft''e' f• � Se f �M1 l;qµ � j ^'T 't'..t. 1;'d^. � `� .�� r Town of Barnstable "Permit# — / tiD Expires 6 mondrs fronz issue date Regulatory Services Fee_4gO& � 1ARNSTABLE, • . v$ i ,0$ Richard V.Scali,Interim Director Alb MA't p Building Division �® IFF- 1 Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 J U N 0 7 2011 ' www.town.bamstable.ma.us Office: 508-862-4038 ro WN O� :�� )�A3� EXPRESS PERMT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprim Map/parcel Number Property`Address S /,)/ (Residential Value of Work S t 0 7 Minimum fee of S35.00 for work under$6000.00 , Owner's Name&Address5qfb&6q_.-/e-rj-jo / -7y4ADuo Contractor's Nam eT �OflelepcT> may,Telephone Number lol-7/y`43$f Home Improvement Contractor License#(if applicable) 112-7 8 5 Email: Construction Supervisor's License#(if applicable) C 0!0 a 7 Workmen's Compensation Insurance �� \\ Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name /y,TT x/1AL (iL IVeD AJ //V 6 . Workman's Comp.Policy# " S Copy of Insurance Compliance Certificate must accompany each p mit. Permit Req st(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum 35)A of windows ;#of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i_e"Historic,Conservation,etc. ***Note: Pope wner must six Property Owner Letter of Permission. o y f the Home Improvement Contractors License&Construction Supervisors License is SIGNATURE: Revised 061313 building pe f�X['RES/S.dgc Revised 061313 Hometopo#Contractor License Numtiers MA Home Improvement Contractor:Reg #%126693 Salesperson Name and Registration Number: Christopher G:: Re"ad R I-073-1.3-0,0 '24; Home Improvement Agreement Home Depot U;S A: ,Inc ("H;ome'DeppV) or, Service Provider named below w10`:fu -hish, install and/or, service the equipment listed`below at the price, terms-and conditions as outlin.ed'on this:form: .Customer Information- Barbara Terrell. Banc Nam I�lorth;Boston °10019995 First ameLa st Name e. Lead 74 camp,st HYANN,IS tCustomer Address. ate; ZI 508 2 _. Home Phone# Work Phoned .. :Cell Phon.e#` kelesto71 @gmail.corn Customer Ema11 Address" NOTICE OF RIGHT TO CANCEL:,YOU'MAY GANGEL"`THIS AGREEMENT INITHC}UT PENALTY"OR' OBLIGATION`BY—DELIVERING WRITTEN NOTICE TO H,aME'DEPOT'AT 908 Boston Turnpike;:Unit 1 Shre":wsbu`ry MA: 01`5:45 t Address Cdy State Zip or Email ;:CustomerCancellationNorthE qt@homedepot corn BY MIDNIGHT ON "THE THIRD "B:USINESS DAY" AFTER SIGNING UNLESS" HE STATE -SUPPLEMENT PROVIDES A different `CANCELLATION PERIOD; THE STATE "SUPPLEMENT 4 Ct3NTAINS,A FORM TO USE IF ONE I,S SPECIFICALLY,PRESCRIBED.BY'LAW IN YOUR:STATE YOUR PAYMENT("S)`,WILL, B"E :RETURNED WITHIN TEN (101 BUSINESS: DAYS AFTER: HOME DEPOT'S AEC'EIPT OF Y1 VR :NOTICE.-YOU ,MUST MAKE,AVAILABLE ;:F.OR PICKUP BY HOME DEPOT OW PROFESSIONAL, AT'YOUR SERVICE ADDRESS,AND IN.SUBSTANTIALLY THE.SAME; CONDITION .AS. WHEN DELIVERED, ANY MERCHANDISE "OR MATERIALS: DELIVERED'TO YOU, OR YO.0 MAY CONTACT HOME`DEPOT FOR INS. CTIONS REGARDING RETURN SHIPMENT AT ,HOME DEPOT.$ EXPENSE. THE LAW REQUIRES THAT THE CONTRACTOR°GNE YOU.A NOTICE EXPLAINING:YOUR<RIGHT TO CANCEL. PLEASE. SIGN BE' OW TO ACKN0IMLEQ'GE;THAT"YOU HAVE BEEN GIVEN ORAL -AND WRI" E' OT. E OF'YO - . IG'HT TO,CANCEL. Ackn ged Guatomar'sSignature^ .Data' -- " t I I. 4 I. `k i L3c� s fSL��1m27 R�NALY�OSOL _. 463 WAVERLY S7RE�f R4Att91V HART MA A170�; �2�i3�t24�67x� s Department of Industrial Accidents Office of Invesdgadons I Congress Stree4 Suite 100 Boston,MA 02114-2017. Vwww.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name(Business/Organization4ndividual): Ej Address: k e , City/State/Zip: IAA A 61764 , Phone#: Are you an employer?Cher the appropriate bog: 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. 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling shipand have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have.workers' insurance.# 9. ❑Building addition coin [No workers' comp.insurance P• required.] 5:❑ We are a corporation and its 1011 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs 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 c u Si ature: e t e ains a allies o er Wry that the rn ormation provided above is true and correct _.- -_... ...... .._ -.. __ Date• ^ Phone#: �E' 31% _43 Il S Official use only. Do not write in this area,to be completed by.chy 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#: The Commonwealth of Massachusetts Department of Industrial Accidents 11n Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Insurance Affidavit: Builders/Contractors/Electnc><ans/plumbers Workers' Compensation Please Print Legibly Applicant Information The Home Depot At-Home Services Name (Business/Organization/Individual): Address: 908 BOSTON TPK City/State/Zip: SHREWSBURY, MA 01545 Phone #: (508)942-6942 Ar ou an employer?Check the appropriat b x: Type of project(required): am a employer with 200+ 4. I am a general contractor and I 6 New construction employees(full and/or part-time).* have hired the sub-contractors Remodeling listed on the attached sheet. ❑ 2.❑ 1 am a sole proprietor or partner- These sub-contractors have g. Demolition ship and have no employees employees and have workers' 9 Building addition working for me in any capacity. comp. insurance.: [No workers' comp. insurance 10.❑Electrical repairs or additions required.] 5. � We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 ZfRoof repairs c. 152, §1(4),and we have no 13�❑`Other insurance required.] + employees. [No workers' comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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:NATIONAL UNION FIRE INSURANCE COMPANY 65831 45 (QSI) Expiration Date: 03 01/2018 Policy#or Self-ins. Lic. #: XWC � S City/State/Zip: Job Site Address: Attach a copy of the workers' compensation policy declaration page(showing the policy numb r and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day aga e violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D r in ce coverage verification. I do hereby certify un he sins a d f perjury that the information provided above ' true and correct t ♦ `7 � Date: Si-anature: 00.1 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 Phone#: Contact Person: i E_ Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement.Contractor Registration Type: Supplement Card Registration: 112785 HOME DEPOT USA INC Expiration: 04/22/2019 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 30339 Update Address and return card. Mark reason for change. ❑ Address ❑ Renewal ❑ Employment ❑ Lost Card Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Suoolement Card before the expiration date. If found return to: 1 Registration Expiration , Office of Consumer Affairs and Business Regulation 1._12785 04/22/2019 10 Park Piaza-Suite 5170 HOME DEPOT USA INC Boston,MA 02116 ANDREW SWEET 2455 PACES FERRY,RD C-11 HSC —411ih—Oul signature ATLANTA,GA 30339 Undersecretary ATE(M ACCO CERTIFICATE OF LIABILITY INS1. RANCE D021712017 MIDD,YYY� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER..THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE,OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CO TACT MARSH USA,INC. PHONE FAX T'h0 ALUANCE CENTER IAIC.No.Extk I.C.No): 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA,GA 3D326 ADDRESS: t INSURERS)AFFORDING COVERAGE ! NAIC� 100492-HomeD-CAW%17-18 INSURER A:O:d Republic Insurance Co 124147 INSURED INSuRER 0:Agri General Insurance Company 142757 THE HOME DEPOT,INC. HOME DEPOT U.S.A.,INC. INSURER C:New Hampshire Ins Cc 123841 2455 PACES FERRY ROAD INSURER D: BUILDING C-20 A T LANTA,GA 30339 INSURER E: I INSURER F COVERAGES CERTIFICATE NUMBER: ATL-M3746387-14 REVISION NUMBER:2 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 CONTRACTOR 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. ILjR I TYPE OF INSURANCE LAD ( B I POLICY NUMBER I MMO1UDCDn-M PMNWUtt^m i EXP I�t� A X I COMMERCIAL GENERAL LIABILITY iMWZY 310022 03101/2017 0310112018 EACH OCCURRENCE Is 9,000,0D0 CLAIMS4Y,AOE X OCCUR I DAMA ET wRENiEG 1,OaJ,O'a(1 i PRcMISES Ea c ,rtence s J 1UMITS OF POLICY XS u ED EXP IAny are p-arson) i S EXCLUDED IOF SIR S1M PER OCC I r--`RSONAL 8 ADV INJURY IS 9,OOD,OOG GEN'L AGGREGATE LIMIT APPLIES PER: I I I I GENERAL AGGREGATE Is 9,00D,000 i X POLICY PRO- `• 'ECT 'LOC i I PRODUCTS-COMPIO G PAG S 9,000,000 � OTHEP,: I IS A AUTOMOBILE LIABILITY I IMINTB310021 03/01/2017 031OV2018 COMBINED SINGLE LIMIT I s 1.000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) I I ALL OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Peracddent)I S AUTOS AUTOS HIRED AUTOS AUTOS�EO Para d O.,MAGE I IS UMBRELLA LIAB OCCUR I -I I I EACH OCCURRENCE is , EXCESS LIAB I I CLAIMS-MADE I I AGGREGATE I s i I DED I RETENTIONS I Is B IWORKERSCOMPENSATION VJLR c49112300 rM 0310/12017 03MI 018 I X PER I OTH- AND EMPLOYERS'LIABILITY STATUTE ER C IANYPROPR)ETOPPARTNER/EXECUrIVE YIN WC 023102423(AK,NH,NJA 031012017 63101.2018 I EL EAG-(ACCIDENT I S I-ODQL4}J r OFFICERIMEMBER EXCLUDED' �'' N 1 A ((Mandatory In NH) WCO23'E02424(WI) �0310112017 03i0i12018 EL DISEASE EA EMPLOYEE s i3OD0,000 If yes,describe under Cenfinal:d on Addi6ortal Page , 1,000,0D� DESCRIPTION OF OPERATIONS below :E_JISEASEI POLICY LIMIT I S i 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD tot,Additional Remarks Schedule,may be attached IN more apace Is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL HE DELIVERED IN ATLANTA,GA 30339 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of 1l8arch USA Inc Manashi Mukheriee _T LAusow I ©19BB-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and loco are registered marks of ACORD AGENCY CUSTOMER ID: 100492 LOC#: Atlanta AC0 ADDITIONAL REMARKS SCHEDULE Page 2 of s AGENCY NAMED INSURED MARSH USA,INC. HOME DEPOT U.S.A.,INC. D1BIA THE HOME DEPOT POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C•20 ATLANTA.GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE Certificate Of Liability Insurance - Workers Compensation Continued: Cartier.Indemnityy Insurance Company of North America Policy Number.WI R C49112294(AL AR,FL.ID,IA,KS,KY,LA.MS,MO.NE NM,ND,OK,SC,SD,WV,WY) Effective Date:0310112017 Expiration Date:0310112018 (EL)Umit$1,0(10,00D Carver.New Hampshire Insurance Company Policy Number.WC 023102422(DC,DE HI.IN.MD.MN,M T.NY,RI) Effective Date:D310112017 Expiration Date:0310112018 (EL)Limit S11,000,0W Cartier:ACE American Insurance Company Policy Number.WCU C49112282(OSI)(AZ,CA,IL NC,OR,VA,WA) Effective Date:03101QM 7 Expiration Date:0310112018 (EL)Limit S1,0MAM SIR$1,090.000 SIR for Me states of AZ,CA,IL,NG,OR,VA,WA Carrier.National Union Fire Insurance Company Policy Number.XWC 6583144(OSI)(CO,CT,GA,ME,MI,NV,OH,PA,UT) Effective Date:0310112017 Expiration Date:03101/2018 (EL)Lim t$1.000,000 S1,0D0,000 SIR for the states of COME NV,MI,OKPA,UT S750,000 SIR for the state of GA S350,000 SIR for the suite of CT r CarFNaonal Union Fire Insurance Company er.XWC 6583145(OSI)(MA) ^ E y Effective Date:O'J01R017 /1 Fop ration Date 13101RD18 (EL)Limit S1,00o,000 �Slit S5o0.000X Employers XS Indemnity: Carrierllfinics Union Insurance Company Policy Number.TNS C48613202(TX) Effective Date:03/01/2017 Expiraion Date:03101/2018 (EL)Limit S10,000,000 SIR S1,DDD,000 ACORD 101(2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD YOU WISH TO OPEN A BUSINESS? >, For Your Information: Business certificates (cost$40,00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed.form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE:6b mL D Fill in please: APPLICANT'S YOUR NAME/S: ` BUSINESS YOUR HOME ADDRESS:Lov �L( Cckryfl0 R+ II +8 �� . TELEPHONE # Home Telephone Number NAME OF CORPORATION: K6� NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION. Y NO GtZ9 . l V\ an I, ADDRESS OF BUSINESS MAP/PARCEL NUMBER [Assessing) koy When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. —��� n r r o Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally opeMt4"& r Pn4s°iff (9L, ibpATION RUDE AN© I E( ULA b@ F'AILUHE TO 1. BUILDING COMMISSIONER'S ICE COMPLY MAY R WLT IN SINES. This individual has been info ed of an r quir nts that pertain to thi type of business. I Lye** COMENTS /7 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: IUWII Ul DUJEIIS-LaUle Regulatory Services �pTHE Jp o Richard V. Scab,Director t FIARTR : Building Division g Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us' Office: 508-862-4038 Fax. 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Data: t Name: Phone#:ti n 8-2Zb-24'b F Address Village: I Name of Business: SS Type of Business: --Map/Lot UTrENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,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. _ Amer registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carved on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit' • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involvelhe production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical 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 front yard, • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and n6t to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating.the Customary Home Occupation. • 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 undersignedhav ad and agree with the above restrictions for my home occupation I am registering. Applican / Date D �J Homeoc,doc Rev.06/20/16 Town of Barnstable ME r Regulatory Services Richard V.Scali,Director �vszesra. Building Division MAS& Paul Roma,Building Commissioner ib3q.°TEo a 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us' Office: 508-862-4038 Fax:. 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: o S J I Na Phone#:me: Address: 7 Viaage: Name of Business: W as 1,rV me i,, rye�` I Type of Business: /li - Map/Lot: L V 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 dwellings,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 right subject to the 'following conditions: The activity is carved on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. Such use occupies no more than 400 square feet of space. • 1 There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. . r • No traffic will be generated iu excess of normal residential volumes. • The use does not involve xhe production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical 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 1 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 front yard. . • There is no exterior storage or display of materials or equipment • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-"up truck not to exceed one ton capacity,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 Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • 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 I,the uadersi a ead and ee with the above restrictions for my home occupation I am registe ' g. ' Applicant: / Date: Homeoc.doc Rev.06/20/16 ' 4 x � . YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 ,. Main Street, Hyannis, MA 02601 (Town Hall) DATE: S a01 b 1 Fill in please: 0, APPLICANT'S YOUR NAME: BUSINESS YOUR HOME ADDRESS: CAM10 ` TELEPHONE # Home Telephone Number O O� NAME OF NEW BUSINESS lil TYPE OF BUSINESS LApiK IS THIS A HOME OCCUPATION? YES NO Have you been given approval rom the building ision? YES NO ADDRESS OF BUSINESS MAP/PARCEL NUMBER When.starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate ermits and licenses required to legally o e i �r►��1 YP q 9 Y P � � �AI609"OCCUPATION 1. BUILDING COMMISSIONER'15e OFFICE RULES AND REGULATIONS. FAILURE TO This individual has been ' for d of an per quirements t at pertain to this e of business. COMPLY MAY RESULT IN FINES. Authorized Si na ure** COMMENTS: n t� v � d 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: I YOU WISH TO-OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: S o Fill in please: / ' APPLICANT'S YOUR NAME: BUSINESS YOUR HOME ADDRESS: ' C TELEPHONE # Home Telephone Number O O— NAME OF NEW BUSINESS Ll TYPE OF BUSINESS ►� LAO IS THIS A HOME OCCUPATION? YES NO Have you been given approval rom the building ision? YES NO ADDRESS OF BUSINESS MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and re ons of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 a ati in St. — (corner of Yar o Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate y r business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Q Authorized Signature** COMMENTS: . 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this ty of business. r�� V Authorized Si nature** ' 9 \ COMMENTS: b 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: rr cn tJ�r� 6cr� Vo � � i Town of Barnstable Reg i latory Services Cf THE Tp�� Richard V. Scali,Director BARNSTABLE ; Building Division BARNSTABLE Paul Roma BAx 10MIQ•¢RAVt .00 0• aNnES HIA$tU45 tlllu•OStEFYItIC•W:SBnf45EaPtE 1639. `0 , IG39.2014 A�ED1��A Building Commissioner 57 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us July 27, 2016 Mrs. Babara Terrell 74 Camp st. Hyannis MA, 02601 RE: Basement bedroom Dear Mrs. Terrell, The use of the basement area as a bedroom cannot continue and must be ceased immediately. All work in this area must also be stopped, and a building permit obtained to correct the situation. If you have any questions I can be reached at 508-862-4035. Sincerely, Patrick Franey Local Inspector i Hyannis Fire Department (MA) 95_ High(School Road Hyannis, MA 02601 Fire Dept Violation Notice July 15, 2016 RESIDENCE 74 CAMP, X 2 Hyannis, MA 02601 An inspection of your facility on Jul 15, 2016 revealed the violations listed below. ORDER TO COMPLY: Since these conditions are contrary to law, you must correct them upon receipt of this notice. An inspection to determine compliance with this Notice will be conducted on Jul 15, 2016. If you fail to comply with this notice before the reinspection date listed, you may be liable for the penalties provided for by law for such violations. Violations 31.01 Failure to comply Note 2nd floor co alarm has broken test button unsure if it works 148-SECT 26E No Approved smoke detectors and locations Note Basement smoke detector missing 1st floor smoke in kitchen had batteries in backwards NFPA 28A Violation of State Building Code Note Town of Barnstable building inspector Paul Roma on scene It appears and it is reported by other occupants that people are sleeping in basement. Inspection Note Health Inspector Stanton and Zoning Officer Anderson on scene. Owner Barbara Terrell is on location and lives in 1st floor bedroom. She was advised to get all smoke detectors and CO detectors back to working status. She was advised no open burning in her yard. a ' 198704 William Rex Terrell on scene Inspector F .J' DATE: October 2,2014 TO: Building File FROM: R. Anderson RE: Illegal Unit LOCUS: 74 Camp Street,Hyannis ZONE: Medical Services District The subject property is a two family home. That use is permissible under the current MS zoning which allows for single and two-family homes as a matter of right. A pre-sale discussion in 2009 revealed that a third unit had been created by segregating the rear annex of the first floor. Although there is currently a provision for multifamily in the governing ordinance,the property owner failed to secure the necessary approval or permits required to create a multi-family (2+units). As an aside, it is unknown whether. or not a proposal could satisfy the dimensional and density requirements associated with the governing MS District per Chapter 240 Section 24.1.4. The former owner, Joan Ellsworth admitted that the offending unit was not original. I also found that our street file contained no reference to a third unit but clearly noted the 2 family use. Joan Ellsworth cooperated with the enforcement order and took corrective measures to revert the dwelling back to a two family. Building permit#200906177 issued to her on 12/10/2009. The work was subsequently inspected and the permit was closed out accordingly. On Jan 22, 2010,the Camp St property conveyed to Greg Anderson in its proper configuration as a two family dwelling. On August 27, 2014, 1 was summoned to the Building Division counter to answer questions raised by a tenant of 74 Camp Street. Although, I was unable to assist with the matter at hand, Michael McNally reviewed the Camp St floor plan with me and identified 3 separate units. According to his statement, the dwelling contained a first floor unit that consumed most of the ground level, a second story apartment, and Mr. McNally's unit- a segregated rear annex on the first floor. The next day Mr. McNally returned to provide me with a copy of his lease (see file)which identifies a 2 room, 1 bath rental. Based on this information, I issued a citation to Greg Anderson for the creation of illegal third unit. Mr. Anderson is known to me as I had issued an enforcement order to him for an illegal basement apartment in a rental property he owned at 14 Pepper Lane in Hyannis. He also went through the same process to restore his rental to a duplex in 2012. Town of Barnstable oFtHElp�, Regulatory Services O Thomas F. Geiler, Director • RA LE, 9 MASS' $ Building Division i639• ♦0 Ma+° Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER DATE. �?—Z`� ( G LOCATION: 661 vq S4 , UNDER THE PROVISIONS OF 780 CMR, THE STATE BUILDING CODE, SECTION 3400.5.1, YOU ARE HEREBY ORDERED TO IMMEDIATELY DISCONTINUE THE USE OF THE CELLAR/BASEMENT AREA FOR SLEEPING PURPOSES. LOCAL INSPECTOR SIGNATURE OF RECIPIENT ODEM DE SAIDA DATA: LOCALIDADE: DE ACORDO COM 0 PROVISORIO 780 CMR, CODIGO DE CONSTRUCAO DO ESTADO, PARAGRAFO 3400.5.1, VOCE ESTA ORDENADO DE DEIXAR DE USAR, IMEDIATAMENTE, A AREA DO PORAO/BASEMENT PARA 0 PROPOSITO DE DORMIR. INSPETOR LOCAL ASSINATURA DO RECIPIENTE Message Page 1 of 1 Anderson, Robin From: Stanton, David Sent: Friday, July 15, 2016 7:47 AM To: Anderson, Robin; Gallant, Therese Subject: 74 Camp Street, Hyannis FYI< I have e-mailed Kathryn in our office to send an order letter to the owner of 74 Camp street, Hyannis, to register the rental. Once they register it, she will find a couple of potential dates\times that work for one of the housing inspectors and will touch base with both of you to see if you are available for any of those times and then hopefully the time will work with the owner\tenants for the inspection as well. She will let me know if she does not hear back from the owner in a timely manner about getting it registered. Thanks, Dave 7/15/2016 - UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender. Please print yoUramee, add ZIP+4 in this box TOWN UrFB �bt 13UILDING DIVISION 200 MA • 02601 i 1IXANNIS,MA i I I i SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. ' ure item 4 if Restricted Delivery is desired. 11 ❑Agent ■ Print your name-and address on the reverse X ' c ❑Addressee so-that We,can return the Card to you. eived by P` ted Name) C°a�of Delive ■ Attach this card to the back of the mailpiece, re. � or on the front if space permits: D. Is delivery address'different(from item t. '❑Yes 1. Article.Addressed to: a d i If YES,enter delivery.address below: f]No- C. � j— I I co ayy�'py /'Y � 3. Service.Type �` 1(Certified Mail 01 ;Express_Mai c.(o ❑Registered ';&Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2: Article Number 7 012 1010 0000 2851 1470 (transfer from service lab s PS Form 3811; February 200d Domestic Return Receipt +02595-02-M-1540 IA y S . ti ® 0 s e • • s ® Complete it ms 1,2,and 3.Also complete A. ure item 4 if Restricted Delivery Is desired. X ,.. ❑_Agent ® Print your name.and address on the reverse, �f4! `<p Addressee so that we,can return the card to you. eived by ted Name) C.l at of Delive ® Attach this card to the back of the mailpiece, r a \ " or on the front if space permits: !S r �/ D.'I6 delivery,address dfferentffrom item 1? ❑Yes 1.. Article Addressed to: if YES,enter delf(ery.address below: 111 Nc -/ 'n c �� 3. Service Type �` 1E(Certified Mail Q preSs,Iylai� C,lo 7b ❑Registered Return Receipt for Merchandise Insured Mail ❑C.O.D.. 4. Restricted Delivery?,(Extra Fee) 0 Yes 2. Article.Number (Transfer from service lad 7 012 1010 0000 2851 14 7 0 P.S Form 381.1.February 200A Domestic Return Receipt 1.02595.-02-M-154, 1 NAME OF OFFENDER TOWN OF ADDRESS OF OF,f,E DER, '+t». / �i 'B BAR 7 � 6r 4 a BARNSTABLE'' clrv,sraTE,zlP,po E. ' I _ l� , !.• (\ ( r' MV/M REGIS IRA[ION NUMBER FFENS 1k, 76)q..�0$ •�/ P( /:J'�,.l Y.;Y+••..f [ !" 'n ,r A p7 r 1 ../� yp r(/i( . J - ....,«.• 1�� � �����'��� �:$� �•ry"'yy f � yj� -TIME'AND DA E"OF yJOLATION t f 6 W NOTICE:OF 1f ocAJIDN oF'YIo�ATION f Z r „M G 20 d itF9d r l �' � W VIOLATION t GN¢TOREFERFORCIN P RS ' `,^,,, ENFOfl@(NG DEPJ. r ,.� ' <W t.; °!" (�. •' irAA�Td .o• 1 } '; BADGE N0; W n.N en j OF TOWNACKNOWLEDGE RECEIPT OF CITATION X �"6.1 t 1: ,' ORDINANCE ®'Unable to Dbtaldisi nature 'f off nder. a Date mailed f_.cI' THE NONCRIMINAL FINE FOR THI$pFFENSE..IS ~ OR d r try .." W , YOU HAVE THE FOLLOWING ALTER ATIAS WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)lJR DPTION,(2j'WIL¢OPERATE AS A FINAL a DISPOSITION WITH NO RESULTING CRIMINAL RECORD. LLA REGULATION r W(1)You may elect to pay the above fine,either by appearing In person between 6`.30 A.M.and 4:00 P..M.,MondaUU--through Friday;legal hogdays excepted, before:The Barnstable Clerk,.200 Main Street,Hyannis,MA 02601,or byy mailing a check,money.order or post2T riots to BamataWe Clerk)P.O.Box 2 led, W Hyannis,MA 02601,WITHIN TWENTY ONE(21)DAYS OF THE DATE OF THIS NOTICE. l (2)If you desire to contest this matter in a noncriminal proceeding,yyou mayy do so by making written request to IJISTRICT COUA l DEPAEITMENT,FIRST RNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02690,Attn:21D Noncrirrllfial'Weadngs`and'enclose a copy of this (... citation for a hearing: (3)If you fail to pay the above offense or to request a hearing within 21 days,or If you fall to appear for the hearing or to pay any floe determined at the ( ' hearing to be due,criminal complaint may be issued against .,you 1, 0!HEREBY ELECT the first option above,confess to th,a offense charged,and enclose payment in the amount of$ r.. L _ Signature i j U.S. Postal Service," CERTIFIED MAILTM RECEIPT (Domestic'Mail,Gnly;rW.Whsurance Coverage Provided) For delivery information:visit our.website at..usps,como "• i or PO Box No. PSForm'3800,August 2006 ' See'Reverse for Instructions' Certified Mail Provides: ■ A mailing receipt o A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ® Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. e For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. ® For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the art,- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT-Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 NAME OF OFFENDER A TOWN OF ADDRESS OF OF5 D R, ► C y , BARNSTABLE Illy,STATE.ZIP r E 5 +' ,,,► �, y, ) �'� l 7HE tp� � ,� MV/MffREGISTRATION NUMBER krl`NSE i " f 1 HAR\STARLE.p' t (`f}/� �[j j y ( / / // £r dJ 4y'/ 11ASS. O L.F ,G,✓"'"'*1 •e ♦ L• ,�1 '°I R i✓/ ED A1►r 'ry J LLJ UJI ,TIME.A d DA1E F IOLA ION �, T,ION'OF Y�OLATION ,,,✓ W NOTICE OF r/ a (A.M. P.M))ON 20 f� I S GNA�IIRE OP FOpCIN E S „/,,•` ENF01}4M G DEPTs. �' `. BADGE N0. W VIOLATION ' .� � �" � �.w-"•�'' � � ff � �;� o OF TON ►— I HER�E,B,.Y ACKNOWLE GE RECEIPT OF CITATION X a ORDINANCE all'nable1 obtair��i'nature 'foffe!'nder. 11_7, ►a— THE NONCRIMINAL FINE FOR THIS OFFENSE IS S � J Date mailed w w - OR YOU HAVE THE FOLLOWI ALTER ATIV S WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL DISPOSITION WITH NO REIULTING CRIMINAL RECORD. w REGULATION a (1)You may elect to pay the above fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, w before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 2430, Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. (2)If you desire to contest this matter in a noncriminal proceedt'ng,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET BARNSTABLE,MA 02630,Attn:21 D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ 1 HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature f NAME OF OFFENDER _ --]BAR C J 2 1 1. I TOWN OF ADDRESS OF OFF OERWJ BARNSTABLE C a &CITY,STATE,ZIP �. . I I j WE MV/MtjKtbDIRAfION NUMBER Q Lj ;SE� LLI r I DA F VIOLATION 0 OF OJATION 5 - W NOTICE OF P.M)ON 120 V ��' I NER E "RCIN E S ENFO EP p BADGE NO. - - LU VIOLATION 0 1 = OF TOWN ACFta�ii WLE GE RECEIPT OF CITATION X Q ' ' e to atur f off der.ORDINANCETHE NONCRIMINAL FINE FOR THIS OFFENSE ISDate maile w OR YOU HAVE THE FOLLOWI ALTER ATIV S WITH REGARD.TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL aLLJ s i DISPOSITION WITH NO.RE LILTING CRIMINAL RECORD. cn REGULATION (1)You may elect to pay the above fine,either by appearing in person between B'.30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, w before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money.order or postal note to Barnstable Clerk,P.O Box 2430, -1 Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. a R(2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST R LE DIVISION,COURT COMPOUND,MAIN STREET ARMS ABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy this I citation for a hearing. _ (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay arty One determined at the hearing to be due,criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ I y k Signature - - G y " _ ......'.. l( a .. v14 , °PA; '� THIS IS A LEGALLY BINDING CONTRACT.IF NOT UNDERSTOOD,SEFjK.COMPETENT"ADVt Cape Cod &.Islands Association of IEALRN�R, I> C. LU REALTOR' Lease Lease,made this 1 day of August ' ` 20 '13 By Greg Anderson of 147 Lakeside Drive Marston Mills, MA 02648 (name) (address) hereinafter called LANDLORD.And Micheal McNally of 302 Whistleberry Dr Marstons Mills, MA 02648 (name) (address) hereinafter called TENANT. Witnesseth,That the LANDLORD above hereby leases to the TENANT above,the premises located at 74 Camp Street Rear Unit Hyannis, MA 02601 Massachusetts (Street address and Town) consisting of(describe real and personal property)2 Rooms, 1 Bath The term ofthis lease shall be 12 months commencing at noon on August 2 2013 and ending at noon on August 1 -20 14 And for such term,the TENANT agrees to pay$ 8400.00 Said rent shall be payable-in Installments of$ 700.00 on the - 2nd day of every month,in advance. so long as this lease is in force and effect. During the lease tern},the following charges shall be paid by the LANDLORD or TENANT as checked: LANDLORD TENANT: A. Oil ( ) ( ) B. Gas ( X ) C. Electricity ( X ) ( ) D. Real Estate Taxes ( X ) { ) r E. Water ( X ) ( ) F. Water Overages(unless the parties execute ( X ) ( ) G. Telephone water/sewer addendum) { -) ( X ) H. Trash Removal ( ) ( X ) I. Lawn Maintenance ( ) { X )` J. Snow Removal ( ) ( X ) K. Cable T.V. ( ) ( X ) L. Condominium Common Area Charges ( ) ( ) The LANDLORD hereby acknowledges receipt from the TENANT$ 700.00 as payment of the first.month's rent, And the LANDLORD hereby acknowledges receipt from the TENANT$ 700.00 as payment of the last month's rent (calculated at the same rate as the first month's rent).The TENANT hereby acknowledges receipt of a written Last Month's Rent Receipt with. . reference to said last month's rent as required by law.. And for the heretofore described term,the TENANT further agrees to pay$ 700.00 (an amount not to exceed one month's rent)as security deposit,receipt of which the LANDLORD hereby acknowledges,it being understood that said security deposit is not to be construed prepaid rent, but nor shall any damages claimed(if any)be limited to the amount of said security deposit. Said security deposit shall be deposited in escrow as required bylaw.The TENANT hereby acknowledges receipt of a written statement of conditions with reference to said security deposit as required by law,which statement must be returned to the LANDLORD or his agent within fifteen days of •commencement of tenancy. ' The LANDLORD hereby notifies the TENANT that BASS River Propel'tieS. (name) of. 150 Main Street West Dennis, MA 02670 508-394-4446 (street and mailing address) (telephone) is the person who is responsible for the care,maintenance and repair of the heretofore described property. The LANDLORD hereby notifies the TENANT that BASS River Properties (name) is the person authorized to receive notices of violations of law and to accept service of Process on behalf of the OWNER. Page I 1 The parties hereto,in consideration of these presents,agree as follows: (1) ONE persons will occupy the premises. 1. That no more than 2. That no alteration, addition, or improvement to the leased property shall be made by the TENANT without the written consent of the LANDLORD. Any alteration, addition, or improvement made by the,TENANT after such consent shall have been given, and any fixtures installed as part thereof, shall at the LANDLORD'S option become the property of the LANDLORD upon the expiration or other earlier termination of this lease;provided,however,that the LANDLORD shall have the right to require the TENANT to remove such fixtures at the TENANTS cost upon such termination of this lease. 3. That the TENANT shall maintain the premises in a clean condition and;the TENANT will be responsible for all damage;breakage,waste, and/or loss to the premises,except normal wear and tear and unavoidable casualty which may result from occupancy;and upon termination of general and good and habitable condition as found upon entry. this lease the TENANT will leave the premises in the same 4. That the LANDLORD agrees to supply fixtures and household furnishings, equipment or other personal property only as specifically described within this agreement,and/or in accordance with the statement of conditions to be incorporated by reference herein. c 5. That the words "LANDLORD" and "TENANT" as used herein shall include their respective heirs, executors, administrators, successors, representatives,assigns,and/or agents. If more than one party signs as TENANT hereunder,the agreement herein of the TENANT shall be the joint and several obligations of each such party. _ 6. That the LANDLORD and TENANT agree that should the premises be destroyed by fire or other personal casualty so as to become unfit for human habitation that these presents shall thereby be ended,with refund to the TENANT for any rent term unused. 6A. Subject to the conditions of paragraph six(6),the LANDLORD agrees that should the premises acquire a condition which amounts to a violation of law which may endanger or materially impair the health, safety,or well-being of the TENANT, or become unfit for human habitation;upon proper notice to or discovery by the LANDLORD thereof,the rent or a just portion thereof according to the nature and extent of the condition shall be suspended or abated until the condition is remedied, if such a remedy is reasonably possible during the lease term; provided, however,that said condition or violation of law was not caused by the TENANT or others lawfully upon said premises. If such a. remedy is not reasonably possible,during the lease term the LANDLORD shall so notify the TENANT within thirty days after proper notice to or r such notice to the TENANT by the LANDLORD.either party may terminate the lease discovery by the LANDLORD of said condition;and afe by written notice to the other party. 6B.That the LANDLORD and TENANT further agree that should the premises be taken for any purpose by the exercise of the power of eminent domain that these presents shall thereby he ended with refund to the TENANT for any rent term unused, and that the TENANT does hereby assign to the LANDLORD any and all claims and demands for damages on account of any,such taking or for compensation for anything lawfully done by a proper public authority in pursuance of such a taking. 7. That the TENANT agrees that it shall be the TENANT's obligation to insure the,TENANT's personal property and the keeping of said personal property shall be at the sole risk of the TENANT. 8. That the TENANT agrees to indemnify and hold the LANDLORD harmless from any and all liability, loss or damage arising from any nuisance made or suffered on the leased premises by the TENANT,or the TENANT's family,guest,licensees,and or invitees,to and from any negligence,or illegal or improper conduct of any of said persons.Neither the TENANT or any of the heretofore described persons shall make or . suffer offensive us of the leased premises, nor commit or permit any nuisance to exist thereon,nor cause damage to the leased premises,nor create any substantial interference with the rights,comfort,safety,or enjoyment of the LANDLORD or other occupants of the same or any other apartment,nor make any use whatsoever thereof other than as and for a private residence. , 9. That the TENANT agrees that no articles of personal.property shall be placed in common areas. 10.That any notice by either party to the other shall be in writing and shall be deemed to be duly given only if delivered personally or mailed by registered or certified mail,addressed to the TENANT at.the building in which the leased property is located and to the LANDLORD at the address noted on this lease;unless either party has notified the other party in writing of a change of address for the purpose of notice. 11.That during the lease term the LANDLORD will keep and maintain the leased premises in such good repair,order and condition as the same unavoidable casualty are at the commencement hereof,reasonable wear and tear and damage by alty excepted.And the LANDLORD shall make all rders,or regulations of any public authorities having repairs,changes,alterations,and additions which may be required by any laws,ordinances,o anges,alterations,and additions required because jurisdiction over the leased property except that the TENANT shall make all such repairs,ch any use made of the leased property by the TENANT other than the property and lawful use as a private residence,or because of any unlawful action or any negligence of the TENANT or any breach or default by the TENANT under this lease. 12.That TENANT agrees to allow the LANDLORD to enter and view the premises,both inside and outside:: A)to inspect the premises; B)to make repairs thereto; C)to show the same to a prospective TENANT or PURCHASER;mortgagee or its agents. D)pursuant to a Court Order;and E)to protect the premises if it appears that said premises have been abandoned by the TENANT; Page 2 F)to inspect,within the last 30 days of the tenancy or after either party has given notice to the other of intention to terminate the tenancy, the premises for the purpose of determining the amount of damage, if any, to the premises which would be cause for deduction from any security deposit held by the LANDLORD pursuant to law. 13.That if the TENANT defaults,breaches and/or otherwise fails to comply as regards any of the terms,conditions,covenants,obligations,or agreements,expressed herein or implied hereunder,the LANDLORD,without necessity or requirement of making any entry may terminate this lease by A)a seven(7)days written notice to the TENANT to vacate said premises in case of any breach except only for nonpayment of rent,or B)a fourteen(14)day written notice to the TENANT to vacate leased premises upon the neglect or refusal of the TENANT to pay the rent as herein provided. Any termination under this section shall be: C)without prejudice to any remedies of the LANDLORD which might otherwise be used for arrears of rent use and occupancy or other breach of any of the said terms,conditions,covenants,obligations or agreements;or D)without prejudice to any remedies of the TENANT which might otherwise be authorized and/or required by the applicable laws and Regulations of the Commonwealth of Massachusetts. E)but nothing herein shall be construed as the application of interest or a penalty for the TENANTS failure to pay rent until thirty(30) days after such rent shall have been due. .14. That the parties agree that in case of any termination of this lease by reason of the default of the TENANT, then at the option of the LANDLORD: A)the TENANT will forthwith pay to the LANDLORD as damages hereunder a sum equal to the amount by which the rent and other payments called for hereunder for the remainder of the term. , B) the TENANT will furthermore indemnify the LANDLORD from and against any loss and damage sustained by reason of any termination caused by the default of,or the breach by,the TENANT.LANDLORD's damages hereunder shall include,but shall not be limited to,any loss of rents,accrued but unpaid prior to termination;reasonable broker's commission for the re-letting of the leased premises advertising costs;the reasonable costs incurred in cleaning and repainting the premises in order to re-let the same;moving and storage charges incurred by LANDLORD in moving TENANTS belongings pursuant to eviction proceedings; legal costs and reasonable attorney's fees incurred by the LANDLORD in collecting any damages hereunder.or in obtaining possession of the leased premises by summary process or otherwise and to any and all other remedies provided by law.. C)the LANDLORD may remove the TENANTS goods or effects pursuant to a Court Order and the LANDLORD shall not be liable or responsible for any loss of or damage to TENANTS goods or effects and the LANDLORD's act of so removing such goods or effects shall be deemed to be the act of and for the account of TENANT,provided,however,that if the LANDLORD removes the TENANTS goods or effects,he shall comply with all applicable laws,and shall exercise due care in the handling of such goods to the fullest_ practical extent under the circumstances. 15.That no animals,birds,or pets of any description shall be kept in or upon the leased premises without the LANDLORD's written consent;and consent so given may be revoked at any time.. 16.That no surrender or acceptance of surrender of the leased premises shall be valid unless so stipulated in writing by the.LANDLORD. 17.That the TENANT shall not assign or sublet or permit the leased property or any part thereof to be used by others(except the TENANT named. herein,the TENANT's spouse,children,or quests for temporary visits),without the prior written consent of the LANDLORD in each instance.If this lease is assigned,or if the leased property or any part thereof is sublet,or occupied by anyone other than the TENANT,the LANDLORD may, after default by the TENANT,collect rent from the assignee,subtenant,or occupant and apply the net amount collected to the rent herein reserved. No such assignment,subletting,occupancy,or collection shall be deemed a waiver of this covenant,or the acceptance of the assignee,subtenant, or occupant as TENANT,or a release of the TENANT from further performance by the TENANT of the covenants of this lease.The consent by the LANDLORD to an assignment or subletting shall,not be construed to relieve the TENANT from obtaining the consent in writing of the• LANDLORD to any further assignment or subletting. 18.That the waiver of one breach of any term,.condition,covenant,obligation,or agreement of this lease shall not be considered to be a waiver of that or any other term,condition,covenant,obligation,or agreement or of any subsequent breach thereof. 19.That if any provision of this lease or portion of such provision or the application thereof to any person or circumstance.is held invalid,the •remainder of the lease(or the remainder of such provision) and the application thereof to other persons or circumstances shall not be affected thereby. 20. That the LANDLORD acknowledges that provisions of applicable law forbid a LANDLORD from threatening to take or taking reprisals against any TENANT for seeking to assert his legal rights. 21.LEAD PAINT:Whenever a child or children under six years of age resides in any residential premises in which any paint,plaster,or other accessible materials contain dangerous levels of lead as defined pursuant to section one hundred and ninety-four,the owner shall remove or cover said paint,plaster or other material so as to make it inaccessible to.children under six years of age,with the provisions of Massachusetts General Laws,Chapter III,Section 197. Page 3 22.UREA FORMALDEHYDE INSULATION-UFFI:A LANDLORD of a residential dwelling containing UFFI shall disclose or cause to� r A } disclosed to all prospective tenants and to all existing tenants the presence of UFFI in the dwelling. In the case of a prospective TENANT,'a� LANDLORD aware of the presence of UFFI in the dwelling shall make the disclosure before entering into a lease or rental agreement with the TENANT.The disclosure shall be made in.writing,and shall be in the form of the disclosure set forth in 105 CMR 651.011(3)or as amended and shall be signed by the LANDLORD or its agent as well as by the prospective or existing TENANT..The LANDLORD shall keep a copy or a second original of the signed disclosure as proof of its delivery to the prospective or existing TENANT.As part of the disclosure,the LANDLORD. shall also deliver or cause to be delivered to the prospective TENANT or existing TENANT at the time of the disclosure the current UFFI•, Information Sheet developed by and available at the Department. 23.That the LANDLORD agrees to pay a BROKER'S fee of %of the total rental hereof to upon receipt of the rental payment for this lease from the TENANT. . OPTIONAL PROVISIONS(Complete or delete if not applicable): 24. The LANDLORD agrees to pay a broker's fee of 5 %of the total rental on any subsequent rentals of the premises to the TENANT upon receipt of the rental payment from any subsequent rental to the TENANT. 25.In the event of a subsequent sale of the premises to the TENANT by the LANDLORD during the term of the tenancy or within 180 days after the expiration of the tenancy a BROKER'S feel shall be'paid bythe LANDLORD based upon an amount of fee to be reasonably agreed upon between the BROKER and the LANDLORD,but such TENANT/BUYER shall beheld harmless as to any dispute and/or litigation between the BROKER and the LANDLORD as to the determination of said fee. -uan d 26.Additional Provisions: No auto repairs or unregistered vehicles on property, no smoking or burning can dles; nopets orpevl g y'," - sifting, no satellite dishes, no grease down drains tenant is to use a`•fat'cahjonly toilet,pp-- daown toilets tenant is to abide by town noise ordinance. BRP into responsible., galneaccess ,tenant s to calm �_ � locksmith, if BRP is able to assist a $35+ charge will be requested at tiro service LLlis noty §ponsible , : .'.;"V 57 for the repair or replacement of washer/dryer/fireplace or a/c if provided',— a r . q k" X, u C S k ''/'"}..tiM' e+F.*"C•rs�.,u;��t`, 5. � �-"� Y �r �r � „�1' '���'u�� . .F" g n U-"Y Yak, � - ;:( .i t ,.* e 3, .w.w ;:s +•wr�- Y^. S'i€. 'FS'' ;.k .� €fl,Sa t xA : ` 3 t -51 A, 4;• 2 11 n ....%ram: b 4'•,�. L'"f' 6"x a'...a,-Y t.+.,y'.�ayy :Fd i +•.r� .s , '" °sx^� �iU' 3 ',.: ,,:r '� ,.aa.d j3 `w '+� t :.•, ,@° .a 3 '� ',�'� ..� ,�.y'$,x3' „# y;� fir � ; � 46,w,, - - - n n� m � 4 x' ti sr � a i } , Z ju- x Y< - f haw �� _,�^ d I..r � �,�g{ �� � �Y �,� tr�:�» "'�..+n'M`F•i � 'r Page i 4 ;yr, IN WITNESS WHEREOF,the said parties hereunto set their hands and seals o the day and year first above written. LANDLORD Greg Anderson TENAN SIGN Micheal McNally BRO HERE / The TENANT hereby acknowledges the receipt of an executed copy of this lease from the LANDLORD on 20 which is within thirty(30)days of the signing of this document by said TENANT. TENANT Micheal McNally RENT RECEIPT TO: RE: (Tenant) (Address) (Description of Leased Premises) UWe hereby acknowledge receipt of the following on this 2 day of August 20 13 1. First Month's Rent $ 700.00 2. Last Month's Rent $ 700.00 LAST MONTH'S RENT ' Any Landlord or his agent who receives,at or prior to the commencement of a tenancy,rent in advance for the last month of the tenancy from a tenant or prospective tenant shall give to such tenant or prospective tenant at the time of such advance payment a receipt indicating the amount of such rent,the date on which it was received, its intended application as rent for the last month of tenancy,the name of the person receiving it and, in the case of an agent, the name of the Landlord for whom the rent is received, and a.description of the rented or leased premises,and a statement indicating that the tenant is entitled to interest on said rent payment at the rate of 5 percent per year or other such lesser amount of interest as has been received from the bank where the deposit has been held or in accordance with M.G.L.Ch. 186 Section 15B as may be further amended, payable in accordance with the provisions of this clause, and a statement indicating that the tenant should provide the Landlord with a forwarding address at the termination of the tenancy indicating where such interest may be given or sent. Any Landlord or his agent who receives said rent in advance for the last month of tenancy shall,beginning with the first day of tenancy,pay interest at the rate of five percent per year or other such lesser amount of interest as has been received from the bank where the deposit has been held or in accordance with M.G.L. Ch. 186 Section 15B as may be further amended. Such interest shall be paid over to the tenant each year as provided in this clause:provided,however,that in the event that the tenancy is terminated before the anniversary date of such tenancy,the tenant shall receive all accrued interest within thirty days of such termination. Interest shall not accrue for the last month for which rent was paid in advance.At the end of each year of tenancy,such Landlord shall give or send to the tenant from whom rent in advance was collected a statement which shall indicate the amount payable by such Landlord to the tenant.The,Landlord shall at the same time give or send to such tenant the interest which is due or shall notify the tenant that he may deduct the interest from the next rental payment of such tenant. If, after thirty days from the end of each year of the tenancy,the tenant has not received said interest due or said notice to deduct the interest from the next rental payment,the tenant may deduct from his next rent payment the interest due. If the Landlord fails to pay any interest to which the tenant is then entitled within thirty days after the termination of the tenancy,the tenant upon proof of the same in an action against the Landlord shall be awarded damages in an amount equal to three times the amount of interest of - which the tenant is entitled,.together with court costs and reasonable attorneys fees. If the Landlord transfers his interest in the dwelling unit, any advance rents received hereunder are to be handled in accordance with Massachusetts General Laws C. 186 sec 15B(7A). LANDLORD. Greg Anderson LANDLORD's AGENT Tenant hereby acknowledges receiving a copy of the within rent receipt. Dated: Receipt (Tenant) Page 15 STATEMENT OF CONDITION ASSACHUSETTS ASSOCIATION of REALTORS* This is a statement of the condition of the premises you have leased or rented. You. should read it carefully in order to see if it is correct. 1f it is correct you must sign it. This will show that you agree that the list is correct and complete. If it is not correct, you must attach a separate signed list of any damage which you believe exists in the premises. This statement must be returned to the lessor or his agent within fifteen days after you receive this list or within fifteen days after you move in, whichever is later. If you do not return this list, within the specified time period, a court may later view your failure to return the list as your agreement that the list is complete and correct in any suit which you may bring to recover the security deposit. Landlord: C�g_ Tenant: �c�.�c4c Rental Premises: 74 Camp Street Rear Unit Hyannis, MA 02601 Landlord's Statement. The condition of the Rental Premises has been examined and is as follows: [describe condition and note any problems] "In Like new condition" SIGN Date: . ..HERE Greg Anderson Tenant's Statement. I have examined the condition of the Rental Premises and have reviewed the Statement Of Condition. I agree that the Statement of Condition is complete and accurate and I agree to it. rSN t tMichea c ally Date Date A j��rOT* �nr(MSTM ©1999 MASSACHLISETTS ASSOCIATION OF REALTORS@ F+ Page 1 of 1 ®_ Statewide Standard Real Estate Forms -HOUSING OPPORTUNITY Form No.411 i WIN RECEIPT FOR FIRST MONTH'S RENT M4SS.Y.C.HLSETI'S ASSOCIA'['.ION R&1LT025 LAST MONTH'S RENT AND/OR SECURITY DEPOSIT [attach copy to rental agreement] Funds totaling $ were received from the tenant(s)-on the date identified below: Tenant: Micheal McNally Tenant: Address: 302 Whistleberry Dr Marstons Address: Mills, MA 02648 The funds are for rental of the property at 74 Camp Street Rear Unit Hyannis, MA 02601 and are to be applied by the Landlord,. as follows: First Month's Rent: $ 700.00 Last Month's Rent: $ 700.00 (not to exceed first month's rent] t +(� Security 700.00 U 7 Deposit: $ [not to exceed first month's rent] Purchase And Installation Cost For Lock And Key $ Fee To Rental Agent $ Name Of Person Receiving P yment(if other than Landlord) Ronald Bourgeois Date: Signat of Pers n Rec Ing Deposit NOTICE TO TENANT Security Deposit. If a security deposit has been received, the Landlord is re iced to hold the security, deposit in a separate interest-bearing escrow account and give the tenant a receipt, identifying the bank and account number. The Landlord is also required to provide the Tenant with a. Statement .Of'1 Condition of the rental property at the time of receipt of the security deposit or within ten days after: commencement of the tenancy, whichever is later. The Tenant has the right to review the Statement Of Condition and indicate agreement or disagreement. If the security deposit is held for more than one year, the Landlord must pay interest each year to the Tenant. Upon termination, the Tenant should provide Landlord with a forwarding address. Within thirty days after termination the Landlord must return the security deposit with interest, less lawful deductions which include unpaid rent. If the owneej . deducts for damage to the premises, the Landlord shall provide the Tenant with an'itemized list with written evidence of actual or estimated repair costs. No amount shall be deducted for damage listed in the Statement of Condition. Upon transfer of the premises, the Landlord shall transfer the security deposit with accrued interest to the new owner. Last Month's Rent. If the fast month's rent has been received,the Landlord is not required to hold that. rent in a.separate escrow account, but is required to pay interest annually.to the tenant at the rate of five percent per.year annually (pro-rated for shorter rentals) or pay such lesser interest as is actually received from the bank (if the last month's rent has been held in escrow). Upon termination, the Tenant should provide Landlord with a forwarding address. AA AFORMS- ©1999 MASSACHUSETTS ASSOCIATION OF REALTORS@ Statewide Standard Real Estate Forms Page 1 of.1 - Epum.u- - crccanwrty Form No.410 TGWIN 0 BAANS"l3 1 if 2 7 t..t 1 RECEIPT FOR FIRST MONTHS RENT, MASSAC14USMS ASSOCIATION ox REALTORS- LAST MONTH'S RENT AND/OR SECURITY DEPOSIT_ [attach copy to rental agreement] Funds totaling $ were received from the tenants on-the date identified below: Tenant: Micheal McNally Tenant- Address: 302 Whistleberry Dr Marstons Address: Mills, MA 02648 i The funds are for rental of the property at 74 Camp Street Rear Unit Hyannis, MA 02601 and are to be applied by the Landlord, as follows: First Month's Rent: $ 700.00 Last Month's Rent: $ 700.00 (not to exceed first month's rent] Security Deposit: $ 700.00 (not to exceed first month's rent] Purchase And Installation Cost For Lock And Key $ Fee To Rental Agent $ Name Of Person Receiving P yment (if other than Landlord) Ronald Bourgeois Date: 1� Signatyff of ers n-Rec Ing Deposit NOTICE TO TENANT Security Deposit. If a security deposit has been received, the Landlord is re iced to hold the security deposit in a separate interest-bearing escrow account and give the tenant a receipt, identifying the bank and account number. The Landlord is also required to.provide the Tenant with a Statement Of ',Condition of the rental property at the time of receipt of the security deposit or within ten days after commencement of the tenancy, whichever is later. The Tenant has the right to review the Statement Of Condition and indicate agreement or disagreement. If the security deposit is held for more than one year, the Landlord must pay interest each year to the Tenant. Upon termination, the Tenant. should provide Landlord with a forwarding address. Within thirty days after termination the Landlord must return the security deposit with interest, less lawful deductions which include unpaid rent. If the owner deducts for damage to the premises, the Landlord shall provide the Tenant with an itemized list with written evidence of actual or estimated repair costs. No amount shall be deducted for damage listed in the Statement of Condition. Upon transfer of the premises, the Landlord shall transfer the security - deposit with accrued interest to the new owner. Last Month's Rent. If the last month's rent has been received, the Landlord is not required to hold that rent in a separate escrow account, but is required to pay interest annually to the tenant at the rate of five percent per year annually (pro-rated for shorter rentals) or pay such lesser interest as is actually _ received from the bank (if the last month's rent has been held in escrow). Upon termination, the Tenant should provide Landlord with a forwarding address. cc n. , MASSFORMSTM C 1999 MASSACHUSETTS ASSOCIATION OF REALTORS@ statewide Standard Rea!estate Farms Page 1 of 1 Q Form No.410 Serial#:068045-000137-5367838 ` Prepared by:Ronald Bourgeois 1.Bass River Properties Ron@bassriverproperties.com DATE:Nov.2,2009 RE: 74 Camp Street,Hyannis ,7 From: R Anderson History of Terry`Court is'currently marketed as a three family. The house at 74 Camp St on the corner Our street file references units A,B &C,however,my research shows that this was formerly a cottage colony called Terry's Court. The cottages were broken off and subsequently sold individually. A subdivision plan is in the file. Apparently,references noted in the file concerning A,B &C refer to these units and not units contained in the primary dwelling fronting Camp Street. This has been a source of confusion. Looking at the map, it is clear that there is one structure to a lot. This subdivision occurred sometime around the 1930's. The primary dwelling located at 74 Camp Street was a single-family home that later had the benefit of a lodging license. This house had three bedrooms on the second floor and a master bedroom on the first. The upstairs bedrooms were rented and were never individual units. All lodgers in these three bedrooms shared the common areas of the house. The dwelling only had a single kitchen located on the first floor. According to Lt. Don Chase, the grandson of a former owner,this house was a single-family home up through the 1960's and early 1970's. After that point, it was sold to others unknown to Lt. Chase. Inquiry I advised a potential owner that it is not clear from the evidence in the file that the accessory units were legally established and therefore its status as a multi-family is in question. Nov. 2,2009 The deceased owner's wife came in to discuss how to market this property. During our discussion she advised that they owned this property for 14 years and it was purchased as a three- family. I explained that unless it was legally created and I don't see that it was they don't have rights to a three-family. She countered with the fact that she has been assessed as a multifamily. I explained that they assess what they see and it has no bearing on the legal status of the accessory units. At this point she broke down and noted her husband recently died. She stated she is trying to sell the property. She was very emotional at this point and exited the building before I add anything else. Previously, this location was zoned PRD which would have allowed for multi-family use by special permit. Currently, it is zoned MS. Density requirements outlined in the MS District are no more than 6 units per acre or 12 bedrooms per acre. This lot is 0.13 acre, severely limiting the ability to accommodate a multi-family at this site. As a result of a review with Art Traczyk, it was determined that a one or two-family would be allowed as a matter of right but having a third unit would offend the density requirements and could not be allowed as a matter of,rig4t. ` �� � a `� � �� �� i --�.._ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3P Parcel. Application # d- , Health Division Z O3 Date Issued Conservation Division Application Fee Planning Dept. i Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address �1`� Cam n �" Village Ova ng Owner J vw� �19's Address 7 ' � S4 14.Ya -1,if Telephone 17 to " Permit Request e nov-t e XIS Ki-k),t C bier } in flej Q I Kilek(,-i �o vet�.el h�� �rW o Vi eyes' 0S' e:�-.-ac Res-o r.. bac I:f 4 C, -�%Ij ® emsd y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1360.06 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) 3 Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: r ,D Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# •0 � Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name lu Telephone Number Address N3 N�' e5 /�d License # C"-�G�✓i�� ��6�.� Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE :? FOR OFFICIAL USE ONLY Y APPLICATION# DATE ISSUED MAP/PARCEL NO. -a t ADDRESS r VILLAGE l 1 OWNER. s DATE OF INSPECTION: FOUNDATION FRAME INSULATION F FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL F . FINAL BUILDING DATE.CLOSED OUT ASSOCIATION PLAN NO. I E 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): d Address: /y 3 /4 c%1' � City/State/Zip: ( 4irvl'lU M4 0A"' Phone.#: _f66 6Y _ tls� 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 mployees(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. T. ❑Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp.insurance.$ required.] 5. ❑ We area corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs 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. tContractors 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.M 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 statemerit may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains 9#pfnalties of perjury that the information provided above is true and correct Sgn i ature• Date: lad �6 D 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.BuiIding Department 3.City/I'own.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)name(s),-address(es)and phone number(s)along with their certificate(s)of insurance. Limited.Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than 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 pernut(license number which will be used as a reference number. Iri addition,an applicant that must submit multiple permitflicense 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 Fax# 617-7277774 Revised 11-22-06 www.mass-gov/dia Town of Barnstable r r Regulatory Services EARNSTABM r r MAE& ` Thomas F.Geiler,Director 1639. 10 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize 5 &I,%- �UG to act on my behalf, in all matters relative to work authorized by this building permit application for: Cal� S I 4'V40njS (Address of Job) 7` la �� o Signat& of Owner' Date Print Name If Property Owner is applying for permit please complete the .Homeowners License Exemption Form on the.reverse side. Q:FORM&O WNERPERMISSION Town of Barnstable ~ THE Tp� 'Regulatory Services anxrtsTnsM Thomas F.Geiler,Director 9q, 16.19. 6,�4 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508_862-4038 _ Fax_508-790-6230 HOMEOWNER LICENSE EXEMPT N Please Print DATE: I G JOB LOCATION: 41 Wr"7 ..k d y �►/ number street village i "HOMEOWNER": name ome phone# work phone# CURRENT MAILING ADDRESS: , ity/town state zip code The current ex tion for"homeowners' was ex nded to include owner-occupied dwellings of six units or less and to allow homeowners to engage an ind' 'dual for h'\strucs not possess a license,provided that the owner acts as supervisor. D FINIEOWNER Person(s)who owns a parcel of 1 d on whic f he/s intends to reside,on which there is,or is intended to be,a one or two-family dwellin ,attached or detacs accessory to such use and/or farm structures. A person who constructs more one home a tw all not be considered a homeowner. Such "homeowner"shall submit tct the Building Officialcepts le to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"hom owner"assumes responsibility for compliance with the State Building Code and other applicable codes,by ws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he)she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC i } � ✓lie -�anvmouuea� ����ivaelda j . Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration,�`164440 Expirat!o 10/6/2011 TrII 289575 Type 'Indivitlual rfih SHANE PACHECO�=-,�"! , SHANE PACHEGP 0_� •�,:f i �� S 143 HAYES RD. CENTERVILLE, MA 02632 ¢ Undersecretary Ii 1 E � License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Not valid without signature j - I pcpu►-tmcnt of Public Safct •` NJ,Issachtusctts- f Regulations and standa�'d` Board o Bu f ilding ervisor License Construction.Sup se: CS License: x r 92958 Restricted to: 00 �7 SHANE PACHECO i 143 HAYES RD 02632 CENTERVILLE, MA Expiration: 1011712011 —y Tr#: 4144 .. ('ummisiuner j Office of Consumer Affairs&Business Regulation ' HOME IMPROVEMENT CONTRACTOR j Registratio42-464446 Expiration 10/6/2011 Tr# 289575 Type,:,.tl al p, SHANE PACHEC `` -Yrl 4=� SHANE PACHEt OFJ 1 143 HAYES RD. CENTERVILLE,.MA'02632 Undersecretary I i License or registration valid for individul use only j before the expiration date. If found return.to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 j Boston,MA 02116 j i Not valid without signature ,�•_ Njassachusctts- Ocl ),u-tmcnt of Public S da,r� r Rc!�ulitions and Standards. Board of Buil(linl� ervisor License Construction Sup t License: CS 92958 M :t Restricted to: 00 SHANEPACHECO 143 HAYES RD }j. MA 02632 CF _rERVILLE, Expiration: 1 011 71201 1 , TO 4144 ('un�n�issiuner i CfAV' L�lvin EV or, coola be, C'I oSe� Exl4 -io m��S"y de ono 5ec®n� IF 60 ro0on Li M R oorn ��s=rs�de 0 . cr r =,n}0 G� L �I ®psi 0 -a , mow )o�� �) f'o �1'-� CCA✓r►p S} B.eolcoorn c�con m C'gb`rn�s CO r L Dv"`S�&a o , M � Vin1 Boor" or off�� i o v n cr- � � ,A•a u r� �� , V�\kc Y 2e o m Cu � v lose, ExJ -to jr , gr ���» Roos _ FOR _ DATE 1 TIME y M. r. M of OF PH€lNE©. Ll FAX PHONE-❑MOBILE AREA COD NUMBER EXTENSION a MESSAGE �I L 0 \ VUlLL CALL #SIN _.. A �To SIGNED i OPS, FORM 4003 - � rt, s e4_ '.t I _ Message Page 1 of 2 Perry, Tom From: Gallagher, Angela (DEP) [angela.gallagher@state.ma.us] Sent: Wednesday, October 05, 2011 2:53 PM To: Perry, Tom Subject: RE: 74 Camp St Barnstable NOAFNON 4-0010287 Several years ago (circa 1995), an oil tank that serviced the home had leaked. The spill was cleaned up, but an Activity and Use Limitation (AUL) was implemented at the property. The AUL is put in place to limit potential exposure to any residual petroleum in the subsurface. In this case, the AUL restricts removing the easterly addition of the house. Permitted activities include "any lawful use of the property which does not involve removing the easterly addition of the existing house..." * All properties in Massachusetts with AULs are required to be inspected intermittently (approximately every 3-5 years or so). This property was last inspected in 2004, 1 believe (I don't have the file in front of me). This most current inspection (2011) was a routine inspection. Angela Gallagher Massachusetts Department of Environmental Protection 20 Riverside Drive Lakeville, Massachusetts 02347 Phone: 508-946-2790 Fax: 508-947-6557 Follow MassDEP on Twitter: twitter.com/MassDEP Subscribe to the MassDEP e-newsletter: mass.gov/dep/public/publications/enews.htm Visit our web site: mass.gov/dep From: Perry, Tom [mailto:Tom.Perry@town.barnstable.ma.us] Sent: Wednesday, October 05, 2011 2:39 PM To: Gallagher, Angela'(DEP) Subject: RE: 74 Camp St Barnstable NOAFNON 4-0010287 What is the limitation and why did.you folks get involved?Was there an oil spill or something of that nature? -----Original Message----- From: Gallagher, Angela (DEP) [mailto:angela.gallagher@state.ma.us] Sent: Wednesday, October 05, 2011 2:37 PM To: Perry, Tom Subject: FW: 74 Camp St Barnstable NOAFNON 4-0010287 Hi Tom, This is a public notification that we are required to send to you. Basically, this is a Notice of Noncompliance because the previous owner failed to reference, within the deed to the new owner, the presence of an Activity and Use Limitation on that property. The previous owner is required to file additional paperwork to correct the omission. Please feel free to contact me if you have any other questions. Thanks! 10/5/2011 i Message Page 2 of 2 Angela Gallagher Massachusetts Department of Environmental Protection 20 Riverside Drive Lakeville, Massachusetts 02347 Phone: 508-946-2790 Fax: 508-947-6557 Follow MassDEP on Twitter: twitter.com/MassDEP Subscribe to the MassDEP e-newsletter: mass.gov/dep/public/publications/enews.htm Visit our web site: mass. oq v/dep From: McCloud, Nadine (DEP) Sent: Wednesday, October 05, 2011 2:34 PM To: Gallagher, Angela (DEP) Subject: FW: 74 Camp St Barnstable NOAFNON 4-0010287 Angela can you contact him regarding this please?? He is from building dept Thanks, Nadine r From: Perry, Tom [mai Ito:Tom.Perry@town.barnstable.ma.us] Sent: Wednesday, October 05, 2011 1:29 PM To: McCloud, Nadine (DEP) Subject: RE: 74 Camp St Barnstable NOAFNON 4-0010287 In plain language what does this mean? We've never seen one of these. -----Original Message---- From: McCloud, Nadine (DEP) [mai Ito:nadine.mccloud@state.ma.us] Sent: Wednesday, October 05, 2011 1:20 PM To: Klimm, John; Health; Jenkins, Elizabeth; Perry, Tom; Goodine, Lara (DEP); Simpson, Deneen (DEP) Subject: 74 Camp St Barnstable NOAFNON 4-0010287 Nadine McCloud 508-946-2845 Follow MassDEP on Twitter:twitter.com/MassDEP Subscribe to the MassDEP e-newsletter: mass.gov/dep/public/publications/enews.htm " Visit our web site: mass.gov/dep 10/5/2011 ,509 -�. A11111t all Mtn thm pusfuts ....... 0..,...E °�. ...Iia ........ ...m .............. . ............................... \ .... ..... .. ......... IN UONhIDIPHATION OF.....� ............... .......... d.Aph,....... n 0Q� _�pp \\ pnid Ly... . . �.tt:M............ d9.,.,., ......�o.A.�....... .. ...' .. ..,...... o v............................................................. ............... ................... ....... ';l ad,,dn h nby giv grind..LnrE[nin,.�..,............................. ...... .....................,.,.. the rorA!Ipt•n•hrrrof is hcI•nhy a(:kno 6 e ,and oe vcy unto thoeaid....,,. .,. , ¢s� ^ .. .....V.� .... .. ......�..R..... p / ..... �JV�A............ ... ..,...,, ......... .. • . ... ....... ......... . ' ..... . . . . . . . ,...... CLl . �.. .L9. ...y.........ta A,,d........ .o%....... a .....a.�+.a,....,., y. ►..i_................................................................. .......:............:..............................................:....................................... ................................. ,a.. . ........................... .......................................................... ........................................................................................................... .. .......................................... . . ., .. ..............................................................................:.............................:..... .... . ................................................................................................................. ......,.,,.... .................................... . .... ................................................................................... ...................:............................ ...... .. . ............ TO IIAVIe, AND TO 1011) Ulm. granted prohrlAoN with nil tt�he privilogeM nul apparterlmlees thereto holonging to t.ho rigid ..... .. Qi.9....... .. .. ..gaaniYs sell.....yu,.....................llOrs Hell Amigm to their ewe nsn and hoh(Ni[fornvrtr. • ..ryl,� ...........m mild An(1.......0..............................lie oby...........................................,..,.......................................................................:....for..........Q...............�....'.Y.v..,�,,rc.nnl nud....'.1rv.(+,(��, ..................LLoiIA, T:xr.Oulors and Adeiltvtrn4NM, (wvmiant with the Biel gnullA!e and.w.bOL..............u......... G'il'A MiH A-aigllrr, LIIriB.,..,.., ...C�+.�.!.................. . ........lawfully scised ill feo-simple of to gmuLod promius: that they aro hrn Gam all inciunbrau(:on.......................................................................................................................................... ....................,... ...........................................................,..................................:..........................,.........,.................................,..,....................................,..........I...................... rhat .h...........�Cl........................ nvn good right to Hell and.mrivoy , tile an o as aformut I............................................. ...............................,......................... that Ieirn. Executors, and ................ ................,. ............I.............. : end ..............will, and AdministrntnrN shall WARRANT AND DEF1:NJ)the same Eu tho Mlmd grantee and...............................X.K.V:.................11nirN and Annigu9 JmY:vor t Ilgainnt the lawful clot is and doutan(k of all perAnnN. ..................................................................:..............................................................1....................................................................:............................................................... i .............•........................................................................................... IN WITNEISS WMIALF.OF.......'...... ...........the 6,•lid........1..(.1 ,.,, .....d.fV A. ,.....1�wnvd�9 ).............................. b ................................................................................................................................................................................. !�....,.... Jew.hereunto Not......... ...........handy sell t mt Urie.... ..J�A,n d.............flay�nf......JC:t � .......... U...... in the, year one '1'hnuNnnll Niue Jlandrod end........d�.tx�AIJ.iU.�AG............................................................................................................................................. Sigund s drd illl"cAunao oftp TIC t . ................................................................................. .................. ....................... ... ...................... ,. ........ ............... Coal Alr N1v (IN illAMIIAGIIUMM.T•rM. .................... hon Irt!rarllrally apponrad tho niwvn-nnm(d .................................... .. _ _ ��.Q,... . ... .. .. .. ... ...... ...................................................:..................................................,....-..............,...,..............................,....:... a9nd a(.•kn�!+IdiodgaQ tho [urcgoin hmLnunnat to Ile ...................................................................:...........................•..........................:....................................,......... -�'*i.7.V.......... .......fr.n nc4:uld(Ile I,before ma. ......................:..........................:.................................... ........................ IIANNNTAnI•r•1,MM. Ilral•ivPd h ...G.'l.S ~M.............1g1� ,and is reomicd and Imepnnal........................................................................................ n S TillrN OFi, I STABLE BUILDING DEPT MAY, 8 [1995 NOTICE OF ACTIVITY AND USE LIMITATION p� M.G.L. c. 21E, §6 and 310 CMR 40.0000 L Disposal Site Name: TQS p Street;Hyannis;Massachusetts —may DEP Release Tracking No: 4-10287 This Notice of Activity and Use Limitation ("Notice") is made as of the 28th day of April, 1995,by the National Credit Union Administration Board,as liquidating agent for Barnstable Community Credit Union,together with their 1 successors and assigns, (collectively "Owner"). WITNESSETI-I: WHEREAS, National Credit Union Administration Board,as liquidating agent for Barnstable Community Credit Union, are the owners in fee simple of that certain parcel of land located in Barnstable, Barnstable County, Massachusetts, with the buildings and improvements thereon, ("Property'); WHEREAS, said parcel of land, which is more particularly bounded and described in Exhibit A, attached hereto and made a part hereof("the Property") is subject to this Notice of Activity and Use Limitation. . WHEREAS; a portion of the Property comprises all of a disposal site as the result of a release of oil and/or hazardous material. Exhibit B is a sketch plan showing the relationship of the Portion of the Property subject to this Notice of Activity and Use Limitation to the boundaries of said disposal site. Exhibit B is attached hereto and made a part hereof. WHEREAS,one.or more response actions have been selected for the Disposal Site in accordaice with M.G .. e.21E("Chapter 21E")and the Massachusetts Contingency Plan, 310 CMR 40.0000 ("MCP'). Said response actions are based upon the restriction of certain activities occurring under the Property. The basis for such restrictions are set forth in an Activity and Use Limitation Opinion("AUL Opiuon'),dated 28 April 1995,which is attached hereto as Exhibit C and made a part hereof; NOW, THEREFORE,notice is hereby given that the activity and use limitations set forth in said AUL Opinion are as follows: 1. Permitted Activities and Uses Set Forth in the AUL Opinion. The AUL Ophiion provides that a oondition of No Significant Risk to health, safety, public welfare or the environment (such condition being defined in 310 CMR 40.0000),exists for any foreseeable period of time so long as any of the following activities and uses occur on the portion of the Property: (a). Any lawful use of the Property which does not involve removing the easterly addition of the existing house on the Property,thereby potentially exposing the soil beneath it to rain water, which could cause.leaching of Contaminants into the groundwater, and (b). Such other activities or uses which, in the Opinion of an LSP, shall present no greater risk of harm to health, safety, public welfare or the environment than the activities and uses set forth in this paragraph.. r 2. Activities and Uses Inconsistent with the AUL Opinion. Activities and uses which are Inconsistent with the AUL Opinion, and which, if implemented at the portion of the Property,may result in a significant risk of harm to health, safety, public welfare or the environment are as follows: (a). Any activity that would involve removing the easterly addition of the existing house on the Property. 3. Obligations and Conditions Set Forth in the AUL Opinion. If applicable, obligations and/or conditions to be undertaken and/or maintained at the portion of the Property to maintain a condition of No Significant Risk as set forth in the AUL Opinion shall include the following: (a). Prevent any activity that would involve removing the easterly addition of the existing house on the Property. 4. Proposed Changes in Activities and Uses. Any proposed changes in activities and uses at the portion of the Property which may result in higher levels of exposure to oil and/or hazardous material than currently exist shall be evaluated by an LSP who shall render an Opinion,in accordance with 310 CMR 40.1080 et seq., as to whether the proposed changes will present a significant risk of harm to health, safety, public welfare or the environment. Any and all requirements set forth in the Opinion to ensure a condition of No Significant Risk in the implementation of the proposed activity or use shall be satisfied before any such activity or use.is commenced. 5. violation of a Response Action.Outcome. The activities, uses and/or exposures upon which this Notice is based shall not change at any time to cause a significant risk of harm to health, safety, public welfare, or the environment due to exposure to oil and/or hazardous material without the prior evaluation by an LSP in accordance with 310 CMR 40.1080 et seq., and without additional response actions, if necessary, to achieve or. maintain a condition of No Significant Risk. If the activities, uses, and/or exposures upon which this Notice is based change without the prior evaluation and additional response actions determined to be necessary by an LSP in accordance with 310 CMR 40.1080 et seq., the owner or operator of the portion of the Property subject to this Notice at the time that the activities,uses and/or exposures change, shall comply with the requirements set forth in 310.CMR 40.0020. 6. Incorporation Into Deeds, Mortgages, Leases,and Instruments of Transfer. This Notice shall be incorporated either in full or by reference into all deeds,easements,mortgages;leases, licenses, occupancy agreements or any other instrument of transfer, whereby an interest in and/or right to use are Property or a portion thereof is conveyed. Owner hereby authorizes and consents to the filing and recordation and/or registration of this Notice to become effective when executed and sealed by the undersigned LSP, and recorded,and/or registered with the appropriate Registry(ies) of Deeds and/or Land Registration Office(s): f WITNESS the execution hereof under seal this .2�fh day of A I-M-i�_, 19 9J Owner_ /CP/Yfe 14o-*eS i COMMONWEALTH OF MASSACHUSETTS 11;; Then personally appeared the ve named G aclrnowledged the foregoing to be s free as and deed before me, -- . .1®I11E t�A JONES Notary Publi N� q NOTARY PUBLIC r,; State of Texas My Commission Expires: 7��/�� .Foft� Comm. Fxp.07.07.96 The undersigned LSP hereby certifies that he executed the aforesaid Activity and Use Limitation Opinion attached hereto as Exhibit C and-made part hereof and that in his Opinion this Notice of Activity and Use Limitation is con%,.14.9vQ s set forth in said Activity and Use Limitation „ ; ' Opinion. LELAND GM / Date: J. l� FIGGINS,1J13P NO(M SE FGIST EQ` COMMONWEALTH OF MASSACHUSETTS 19 Then personally appeared the above named A 9 ��� ��P_ and acknowledged the foregoing to be LS free act and deed before me, Notary Public My Commission Expires: i, i I 17 -7 -7,I 77 .+4 oa s 3�/e Z STY / 32 rrs 7 i i PREPARED FOR: 74 CAMP cSr JOAJIJI f 4 JJ .2EF5,e,--,L cE: C if7,4) .d fJOC1A1 S 2 /-�/E,CE6Y CE.eT/FY TH�4T T.4E 8CJ/LD/.VF � } No:vu o.v 7"N/S .PLX?A�l /S LOCogTEa OA/ T/NE G I Geoc%Vn AS ENO W.�/ NEeEGiI/. �. 1G c�owr� cam en9ir-recrir�9 `�° ` , Ci�/iL ' E�C/G/.VEELS LAND 3C./lV6Y4C>Q3 �OCJTE G,q^-` eMOC/Tf-/, A4,P5�, l_ Basement Extent of Excavation Concrete Floor Crawl Space (Addition) .Porch H w Brick Foundation Supports Original Structure Inaccessible Impacted Soil asta El1017TURNPIKEST. • CANTON,MA02021 ❑ 1240 PAWTUCKET AVENUE ASSOCIATES INC E.PROVIDENCE,RI 02916 Exhibit B: Site Plan 74 Camp, Street Hyannis, MA DATE: SCALE: JOB NO: 28 April. 1995 1" 30' +/- C941003 EXHIBIT C !tdv F ENVIRONMENTAL RESOURCE CONSULTANTS ASSOCIATES, INC. 28 April 1995 Ms. Julie Hutcheson Massachusetts Department of Environmental Protection Southeast Regional Office 20 Riverside Drive Lakeville, MA 02347 RE: 74 Camp Street Hyannis, Massachusetts Release Tracking No. 4-10287 CISTAR Project No. C941003 ACTIVITY AND USE LEMTATION OPINION Dear Ms. Hutcheson: CISTAR ASSOCIATES, INC. ("CISTAR") is submitting this letter as an .Activity and Use Limitation.(AUL) Opinion for a limited portion of the property located at 74 Camp Street in _Hyannis, Massachusetts. This portion iv hereafter called the "Site". On 18 February 1994 a partially.buried 275 gallon #2 fuel oil storage tank "tank" was removed from the crawl space area under the easterly portion of the structure on the property. ' The subject tank was partially buried and installed on its side., After removal, a pinhole perforation was observed on the tank. As a result, the subject tank was found to have released product ar_d contaminated surrounding soils with TPH at levels above the relevant Reportable Concentration, RCS-1, of 500 parts per million (ppm). A confirmatory subsurface investigation of the Site was performed which included soil borings, monitoring wells, and laboratory analysis. The results of this program revealed that the extent of soil contamination was limited and that groundwater was not found to be impacted by the subject release. All soil contaminated above the RCS-1 standard of 500 ppm was removed from the Site except for some inaccessible contaminated soil located under a portion of the north foundation wall of the structure. After a Method.3 Risk Characterization (310 CMR 40.0990) was conducted relative to contaminant levels in soils present,under a portion of the building foundation at the Site, it ~:—was"deemed by,CISTAR that a'Permanent Solution under an.Activity and Use Limitation `(AUL 310 CMR 40.1070) was the optimum solution. This decision was based on a Benefit- 1017 TURNPIKE STREET CANTON,'MASSACHUSETTS 02021 617-821-4142 F " 1240 PAWTUCKET AVE. ;EAST PROVIDENCE,RHODE ISLAND 02916.401-431-9044 ti A Cost Analysis which found that the incremental cost of conducting the remedial alternative to achieve or approach background levels would be substantial and disproportionate to the incremental benefit of risk reduction, environmental restoration, and monetary and non- pecuniary values (310 CMR 40.0860). It is the opinion of CISTAR that once the AUL is in place, the TPH will not "present a significant risk of damage to health, safety, public welfare, or the environment during any foreseeable period of time,' in accordance with 310 CMR 40.1005. As such, any lawful use of the Property is permitted which does not involve removing the easterly addition of the existing house on the Property. If said structure were removed from the Property then the contaminated soil shall be remediated pursuant to all applicable regulations. Therefore, it is the opinion of the undersigned that a Class A-3 RAO has been achieved for the Site, pursuant to the MCP. Please call if you have any questions or comments regarding this Site. Very truly yours, Gs� � INS,JR. � 1 J. g , Jr., LSP No.9370 Principa F ST E - CISTAR ASSOCIATES, INC. : 6 2.10036P.WP r - astae' r _ a C� + cistar ASSOCIATES, INC. -- — ! a FF - - -- — � 3li���� ENVIRONMENTAL RESOURCE CONSULTANTS 1 1017 TURNPIKE ST. • CANTON,MA 02021 ❑ 1240 PAWTUCKET AVENUE Z 3 2 083 8�2 ` 7 E.PROVIDENCE,RI 02916 - t r• MR. RALPH CROSSEN BUILDING COMMISSIONER 367 MAIN STREET -, HYANNIS, MA 02601 f. z a /. 5 - -�� �' f (/ 1• _. Y -- cistar ENVIRONMENTAL RESOURCE CONSULTANTS j ASSOCIATES, INC. May 4, 1995 Mr. Ralph Crossen Building Commissioner 367 Main Street Hyannis, MA 02601 CERTIFIED MAIL: RETURN RECEIPT REOUESTED Dear Mr. Crossen: Pursuant to 310 CMR 40.1099, the Massachusetts Contingency Plan, we hereby notify you that a Notice of Activity and Use Limitation has been recorded for the property known as 74 Camp Street in Hyannis, Massachusetts. A copy of said Notice is enclosed for your file. WLeIan �5� ly yours, LELANDM o J. FlGGINS,JR. � No.9370 J. s, Jr., We, L GIST Principal ' CISTAR ASSOCIATES, INC. Enc. 2.1003NOTTF.WP i 1017 TURNPIKE STREET• CANTON, MASSACHUSETTS 02021 • 617-821-4142 1240 PAWTUCKET AVE. 9 EAST PROVIDENCE, RHODE ISLAND 02916.401-431-9044 I GeoSite Environmental, Inc. Consultants • Scientists • Engineers 26 September 2003 Mr. Tom Perry Code Enforcement Official Barnstable Town Offices 200 Main Street Hyannis, MA 02601 Amendment and Rat' 1 tion of Notice of Activity and Use Limitation 74 Camp Street Hyannis, MA 0260. Pursuant to the requirements of 310 CMR 40.1403 (7), a copy of the Amendment and Ratification of Notice of Activity and Use Limitation, which was recorded at the Barnstable County Registry of Deeds on September 12, 2003, is enclosed for your files. If you have any questions please contact our office at your convenience. Thank you. *EO$ E , J LSP IRONMENTAL, INC. attachments cc: Barnstable Town Manager - John K.limm Barnstable Health Director - Tom McKeon Barnstable Zoning Official - Tom Broderick MADEP - Southeast Regional Office 1017 TURNPIKE STREET • CANTON.MA 02021 4 TEL 781-82 t-8588 • FAX 781-821-8688 1i�i 1 AMENDMENT AND RATIFICATION OF NOTICE' OF ACTIVITY AND USE LIMITATION AMENDMENT AND RATIFICATION OF NOTICE OF ACTIVITY AND USE LIMITATION (for amending and ratifying a Notice of Activity and Use Limitation recorded on or before October 29, 1999) W'ITNESSETH: This Amendment and Ratification of Notice of Activity and Use,Limitation ("Amendment and Ratification")is made as of this 12th day of September,2003, by Philip J.Ellsworth of 257 South Sea Avenue, West Yarmouth, Massachusetts 02673,together with his successors and assigns(collectively "Owner"). WITNESSETH: WHEREAS,Owner is the owner in fee simple of a certain parcel of land located in Barnstable (Hyannis),Barnstable County, Massachusetts("Property"), pursuant to a deed recorded with the Barnstable CCounty Registry of Deeds in Book 9676, Page 30. WHEREAS,the Property comprises a disposal site, or part of a disposal site, as the result of a release of oil and/or hazardous material("the Disposal Site"). Response actions have been selected for the Disposal Site in accordance with M.G.L.c.21E("Chapter 21E")and the Massachusetts Contingency Plan, 310 CMR 40.0000("the MCP"). Said response actions are based upon(a)the restriction of human access to and contact with oil and/or hazardous material in soil and/or groundwater,and/or(b)the restriction of certain activities occurring in, on, through,over or under the Property or a portion thereof. The Department of Environmental Protection has identified the Disposal Site as Release Tracking Number 4- 10287; WHEREAS,on April 28,1995,National Credit Union Administration Board- Kempe C. Hayes, Liquidating Agent, filed a Notice of Activity and Use Limitation with the Barnstable County Registry of Deeds in Book 9648,Page 30 imposing an activity and use limitation on a portion of the Property("the Original AUL"). The portion of the Property affected by the Original AUL and this Amendment and Ratification is hereinafter referred to as"the AUL Area."The AUL describes activities and uses that are permitted within the AUL Area, and defines obligations and conditions that must be maintained within the AUL Area. The AUL also describes uses and activities which,.if carried out within the AUL Area,could result in Significant Risk to health, safety,public welfare or the environment due to potential exposure to residual contamination.' WHEREAS,the following amendments to the Original AUL are necessary to ensure that a condition of No Significant Risk is maintained at the Disposal Site. WHEREAS,the basis of the Original AUL and this Amendment and Ratification is an Activity and Use Limitation Opinion prepared by a Licensed Site Professional and attached to the Original AUL. NOW,THEREFORE, Owner hereby amends the Original AUL as follows: AUL Area The Property(Disposal Site) is bounded and described in Exhibit A while the AUL Area is bounded and described in Exhibit A-1,both attached hereto and made a part hereof. Both Exhibit A and Exhibit A-1 replace and supercede any descriptions of the AUL.Area contained or referenced in the:.Or-i inal:AUL. The Property is shown on a Certified Plot Plan in Exhibit B -while the-AUL.-Area-is`shown=ona Site-Plai m-Exhibit-e i;,bothattached hereto and made a_p.a rt hereof A` a Both Exhibit B and Exhibit B-1 replace and supercede any plans of the AUL Area contained or references in the Original AUL. Except as expressly amended herein,the Original AUL is hereby ratified and confirmed. Owner authorizes and consents to the recordation and/or registration of this Amendment,which shall be deemed to be effective as of the date the Original AUL was recorded and/or registered. WITNESS the execution hereof under seal this day of 120 Name of Owner COMMONWEALTH OF MASSACHUSETTS r ' ss ,20 Then personally appeared the above-named and acknowledged the foregoing instrument to be his free act and deed before me, Notary Public' My Commission Expires: The undersigned Waste Site Cleanup Professional certifies that, in his opinion,the terms of the Original AUL, as amended herein,are consistent with the AUL Opinion attached to the Original AUL, and .are appropriate to maintain a condition of No Significant Risk at the Disposal Site. Date: Name of LSP LSP SEAL -i , 337 K C{ IYlvr{��1WEALTH OF MASSACHUSETTS ss ,20 Then personally appeared the above-named and acknowledged the foregoing instrument to be his free act and deed before me, Notary Public: My Commission Expires: Upon recording, return to: r ' Massachusetts Department of Environmental Protection BWSC-114S Bureau of Waste Site Cleanup Release Tracking Number >k ACTIVITY & USE LIMITATION (AUL) OPINION FORM ❑4 - 10287 COMPLETE THIS FORM AND ATTACH AS AN EXHIBIT TO THE AUL DOCUMENT TO BE RECORDED AND/OR REGISTERED WITH THE REGISTRY OF DEEDS AND/OR LAND REGISTRATION OFFICE. A. LOCATION OF DISPOSAL SITE AND PROPERTY SUBJECT TO AUL: Disposal Site Name: Residential Property Street: 74 Camp Street Location Aid: Map 328 Parcel 178 City/Town: Hyannis ZIP Code: 02061 Address of property subject to AUL, if different than above. Street: City/Town: ZIP Code: B. THIS FORM IS BEING USED TO: Provide the LSP Opinion for an Amendment and Ratification of a Notice of Activity and Use Limitation, pursuant to instructions provided by DEP in a Notice of Audit Findings issued to: r Name of Organization or person: Mr. Philip Ellsworth...............................................:......................... Date issued: January 27, 2003 C. LSP OPINION: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this submittal,including any and,all documents accompanying this submittal. In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisions of 309 CMR 4.02(2)and(3), and(iii)the provisions of 309 CMR 4.03(5),to the best of my knowledge, information and belief. The Amendment and Ratification of the Activity and Use Limitation that is the subject of this submittal is being provided in accordance with instructions provided by the Department of Environmental Protection in a Notice of Audit Findings issued to.: Name of Organization or person: Mr. Philip Ellsworth Date issued: January 27, 2003 1 am aware that significant penalties may result,including, but not limited to,possible fines and imprisonment,if I submit information which know to be false,inaccurate or materially incomplete. Check here if the Response Action(s)on which this opinion is based,if any,are(were)subject to any order(s),permit(s)and/or approval(s) issued by DEP or EPA. If the box is checked,you MUST attach a statement identifying the applicabie;proVm0ns-thereof. I Leland J. Fi ins, Jr. LSP#: 9370 LSP Name: gg Stamp: �.-:-•,�; ";..sN 0 Telephone: 781-821-8588 Ext.. {`f FAX: 781-821-8fiA8, LSP Signature: i i fence ! Date: . Se be 1 J2 ,. - s YOU MUST COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY FIND THE DOCUMENT TO BE INCOMPLETE. Revised 4/2/2001 Page 1 of 1 EXHIBIT A A certain parcel of land with building thereon situated on the East side of Camp Street in said Hyannis, bounded Westwardly thereby sixty-six (66) feet; Northwardly_by land now or formerly of Edith F. Terry and Abbie K. Bearse one hundred fifteen and one-half (115.5) feet; Eastwardly by land now or formerly of Donald H. Chase and Patricia T. Chase fifty-eight (58) feet; and Southerly by land now or formerly of John L. Terry one hundred fifteen and one-half (115.5) feet. Being a portion of the premises conveyed by Mary A. Terry to John L. Terry by Warranty Deed dated September 23, 1914 and recorded in the Barnstable County Registry of Deeds in Book 332 Page 509. EXHIBIT A-1 This Activity and Use Limitation ("AUL") covers a portion of the parcel which has previously been fully described in Exhibit A (attached). From the northwesterly corner border of the aforementioned parcel heading eastwardly seventy two (72) feet, then southwardly thirty two and one-half (32.5) feet, the point of origination of the AUL commences.. Beginning at that point, which is currently the southerly corner of the northeast entry stairwell, then extending northwardly four (4) feet, then westwardly ten (10) feet, then southwardly seven (7) feet, then eastwardly ten (10) feet, then northwardly three (3) feet to the point of origination, encompasses the entire AUL- area. For further description, please refer to Exhibit B-1: Sketch Plan (attached), which delineates the AUL area. EXHIBIT B I - hCL. /.77 RCI- . 7�- '1,I C 19 cf� ;r;VD. (C1,1/�E�ic/E� r`�i t/1r7'� r K/.4 P)e E PAR E D Fo R r eCEFE.ecv 3 O / aArc: �'IS7,4) .AJJ`OC/4 CC S /AlG, --s'S7c oL S f�IAP 32, /7S I /!E.eEBY GEeT/FY T//FaT TA/E aUIZ-0/.VG 5/-/ow.v O.t/ T/--//S 0-s:.4.V /S LOGATEZ� O.V THE G ' .:..., ,...:._->.......:......��;...,,_.�_...� ....tea �..,.: — - - Udls c�cun cam en9ineerir�9- � ciViL E.vGi.VEECS L AND SULV6 YO B3 � Z, TC- .e EXHIBIT 13-'.1: SKETCH PLAN 4.. 72, rf - �!' - r; 32,6"- ,C , a i FI ='� 10, I I h 7,i - 1 �I I 13 , itt t t' G e o S ite' l nvironmental, Inc. r - = AUL AREA Consultants • SS eatists a Engineers 1017 Turnpike St. Canton, MA.02021 L_-_-_J = CINDER BLOCK.HALL EXHIBIT B-1: SKBT Vi PLAN = CONCRETE .RETAINING WALL Dial} eat Area = CONCRETE WALL FOUNDATION 74 p Streetllya� — = SITE BOUNDARY ji �� 8-18-03 JOB: C941003 = REFERENCE OF AUL AREA TO SITE BOUNDARY MLS Page 1 of 3 Listing Summary Listing#20906391 74 Camp St#3, Hyannis, MA 02601 Active (07/21/09) DOM/CDOM:80/80 $229,900(LP) Sq Ft: 1746* Lot Sz: 5662.000ac* Town: Barn Yr: 1920* Remarks , Well priced 3 family close to-the hospital. Long Picture _R eport L9stUMg V,io_ term excelent tenants �M � ..t � Additional Pictures a .r Pictures(4) Sc Se Agent Ronald D Bourgeois (ID:U281)Primary: 508-394-0485 x1 Secondary: 508-400-45 Office Bass River Properties (ID:BASR)Phone: 508-394-0485 FAX:508-394-4819 Property Type Income/Multi Family Property Subtype(s) 3 Family Status Active (07/21/09) Town Barnstable Commission Sub Agent Comm.' Buyer Agent Comm. Dual Agent Comm. Comments .Dual Var Comrr 0% 3% 3% 4.5%BRP Yes Facilitator Comm 3% Listing Type Excl.Right to Sell County Barnstable Tax ID 328-178 0=0-BARN Year Built 1920* Year Built Desc. Actual Approx Square Feet 1746* Sq Ft Source Assessors Records Lot Sq Ft(approx) 246636720* Lot Acres(approx) 5662.000 Lot Size.Source (Assessors R( Listing Date 07/21/09 Owner Name Philip J Ellsworth All Office Remarks Please call Ronnie @ 508 400 4567 for appt as tenant occpied Directions to Property Main St Camp st to 74 Listing Page _ Commission-Other n/a Showing Instructions Appointment Req.,Call Listing Agent General Page Zoning Res' ' Number of Units 3 httn-//nnimlc ranmlc r.c m/cnrintc/mornicni fill 9A PPMA MF=( .nnennr`l Q-PR(`rMAT\AP= 1 fl/Q/�MQ 4C IOCO MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:I. MA. Date:F 12. I l_I�`t ermit## Building Location_1 �t ttit,Q }�(.Z¢,} Yit Owners Name I J CXi.�1 �j S�t)c7f`I� NipType of Occupancy: Commercial o Educational Industrial Institutional Residential IF New:L] Alteration: Renovation:Ej Replacement: Plans Submitted: Yes Noo FIXTURES L Z .� z rn j O Of rn U) Q U) � _ w rn a oC z F- Y U) a H U) Q rn O m u w °� a W rn >- LL rn z Cl) C7 0 d X LLJ ¢ Y h xO x Q u_ a - z¢ =rn FwO z U v) I— > O O O Z a -j ¢ o ¢ ¢ u_ wx O SUB-BSM , BA5. EN-T_ 1 �-LOOK. 2 LOOiR. 3 FLOO,R. 4 -LO(3R 5 FLOOR 6 FLOOR 7 FLOOR 8 FLOOR Check One Only Certificate# Installing Company Name:U .t�;h I I Corporation Address: Q � 9 �ee City[Town ' YIIJ a State: ' Partnership I Business Tel: ZZEi Fax: — � Firm/Company -Name of Licensed Plumber.FEW--V\ EW--V\ INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.-142 Yes If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy&� Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,'and that my signature on this permit application waives this requirement Check One Only Owner Agent Signature of Owner or Owner's Agent El Li I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my . Knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By f-- Type of License: Title _ ( ✓ Plumber Signature of Licensed Plumber . _ f Master City/Townj_ APPROVED OFFICE USE ONLY Journeyman License Number: Bic 17628 P9333 106236 rClr9-12-2ib�3 r� 11 _2ga AMENDMENT AND RATIFICATION OF NOTICE OF ACTIVITY AND USE,LIMITATION AMENDMENT AND RATIFICATIONT 1 N (for amending and ratifying a Notice of Activity and Use Limitation recorded on or before October 29, 1999) WITNESSETH: This Amendment and Ratification of Notice of Activity and Use Limitation("Amendment and Ratification")is made as of this 12th day of September,2003,by Philip J.Ellsworth of 257 South Sea Avenue,West Yarmouth,Massachusetts 02673,together with his successors and assigns(collectively "Owner"). WITNESSETH: WHEREAS,Owner is the owner in fee simple of a certain parcel of land located in Barnstable (Hyannis),Barnstable County,Massachusetts("Property"),pursuant to a deed recorded with the Barnstable County Registry of Deeds in Book 9676, Page 30. WHEREAS,the Property comprises a disposal site,or part of a disposal site,as the result of a release of oil and/or hazardous material("the Disposal Site"). Response actions have been selected for the or Disposal Site in accordance with M.G.L.c.21E("Chapter 21E")and the Massachusetts Contingency Plan, (_ 310 CMR 40.0000("the MCP"). Said response actions are based upon(a)the restriction of human access to and contact with oil and/or hazardous material in soil and/or groundwater,'and/or(b)the restriction of certain activities occurring in,on,through,over or under the Property or a portion thereof. The Department of Environmental Protection has identified the Disposal Site as Release Tracking Number 4- 10287; g WHEREAS,on April 28,1995,National Credit Union Administration Board-Kempe C. Hayes, Liquidating Agent,filed a Notice of Activity and Use Limitation with the Barnstable County Registry of Deeds in Book 9648,Page 30 imposing an activity and use limitation on a portion of the Property("the Original AUL"),The portion of the Property affected by the Original AUL and this Amendment and Ratification is hereinafter referred to as"the AUL Area."The AUL describes activities and uses that are permitted within the AUL Area,and defines obligations and conditions that must be maintained within the AUL Area.The AUL also describes uses and activities which, if carried out within the AUL Area,could result in Significant Risk to health,safety,public welfare or the environment due to potential exposure to residual contamination. WHEREAS,the following amendments.to the Original AUL.are necessary to ensure that a condition of No Significant Risk is maintained at the Disposal Site. WHEREAS,the basis of the Original AUL and this Amendment and Ratification is an Activity and Use Limitation Opinion prepared by a Licensed Site Professional and attached to the Original AUL. V NOW,THEREFORE,Owner hereby amends the Original AUL as follows: AUL Area C The Property(Disposal Site)is bounded and described in Exhibit A while the AUL Area is bounded and described in Exhibit A-1,both attached hereto and made a part hereof. Both Exhibit N A and Exhibit A-1.replace and supercede any descriptions of the AUL Area contained or referenced in the Original AUL. The Property is shown on a Certified Plot Plan in Exhibit B J while the AUL Area is shown on a Site Plan in Exhibit B-1,both attached hereto and made a part v hereof. Both Exhibit Band Exhibit B-1 replace and supercede any plans of the AUL Area Jcontained or referenced in the Original AUL. i j i I Bk 17628 Pg 334 #106236 Except as expressly amended herein,the Original AUL is hereby ratified and confirmed. Owner authorizes and consents to the recordation and/or registration of this Amendment,which shall be deemed to be effective as of the date the Original AUL was recorded and/or registered. WITNESS the execution hereof under seal this /—'l day of .2t 20�0.8 .. Name 6fVwner COMMONWEALTH OF MASSACHUSETTS ss 203,..„.r...,,,,� Then personally appeared the above-named /�� t1 £/�s�w 1'�i and acknow ed' the foregoing instrument to be his free act and deed before me, Notary lic: �•`' O..h J ,:,,:o c .. My Commission Fa�p� +j>TrJ; The undersigned Waste Site Cleanup Professional certifies that,in his opinion,the terms of the "'*"" ����•', Original AUL,as amended herein,are consistent with the AUL Opinion attached to the Original AUL,and are appropriate to maintain a condition of No Significant Risk at the Disposal Site Date: r /z ,v3•: , '"" e .LSP SEAL WEALTH OF MASSACHUSETTS ss f• /Z 20 cs Then personally appeared the above-named d acknowledged the foregoing instrument to be his free act and deed before me, Notary 6XFiF My Commission Expires: u , e.3 007 "t Upon recording,return to: ' s Leland J. Figgins, Jr. U' GeoSite Environmental, Inc. 1017 Turnpike Street Canton, MA . 02021 or.Z ..�, •':y'�. l: i .41I,� Bk 17628 Pg 335 #106236 Massachusetts Department of Environmental Protection BWSC-114S Bureau of Waste Site Cleanup Lf i), Release Tracking Number ACTIVITY& USE LIMITATION (AUL) OPINION FORM •'•-•--- a- 10287 COMPLETE THIS FORM AND ATTACH AS AN EXHIBIT TO THE AUL DOCUMENT TO BE RECORDED AND/OR REGISTERED WITH THE REGISTRY OF DEEDS AND/OR LAND REGISTRATION OFFICE A. LOCATION OF DISPOSAL SITE AND PROPERTY SUBJECT TO AUL: Disposal site Name: Residential Property Street: 74 (' mp SrrQet .Location Aid: Map 328 Parcel 178 City/Town: Hyannis ZIP Code: 02061 Address of property subject to AUL,if different than above. Street: City/Town: ZIP Code: B. THIS FORM IS BEING USED TO: Provide the LSP Opinion for an Amendment and Ratification of a Notice of Activity and Use Limitation,pursuant to instructions provided by DEP in a Notice of Audit Findings Issued to: Name of Organization or person: Mr. Philip Ellsworth............................................ ...................................... Date issued: __ January 27, 2003 C. LSP OPINION: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this submittal,including any and all documents accompanying this submittal. In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisions of 309 CMR 4.02(2)and(3),and(iii)the provisions of 309 CMR 4,03(5),to the best of my knowledge, information and belief. The Amendment and Ratification of the Activity and Use Limitation that is the subject of this submittal Is being provided in accordance with Instructions provided by the Department of Environmental Protection in a Notice of Audit Findings Issued to: Name of Organization or person: Mr. Philip Ellsworth Date issued: - January 27, 2003 I am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,If I submit information which I know to be false,inaccurate or materially incomplete. Check here If the Response Action(s)on which this opinion is based,if any,are(were)subject to any order(s),permit(s)and/or approval(s) issued by DEP or EPA. If the box is checked,you MUST attach a statement identifying the applicabl8 provW6ns thereof. LSP Name: Leland J. Figgins, Jr. LSP#: 4370 Stamp: `•-. i Telephone: t Y'4 p 781-82I-8588 Ext.: 781-821-8 �'.. Fi; �:. �c.•�. FAX: 8 " F{�'•�'� n ? LSP Signature: Date: $ 7&a `7`{i�• YOU MUST U T COM PLETE ETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY FIND THE DOCUMENT TO BE INCOMPLETE Revised 4/2/2001 Page 1 of 1 i i Bk 17628 Pg 336 #106236 EXHIBIT A A certain parcel of land with building thereon situated on the East side of Camp Street in said Hyannis, bounded Westwardly thereby sixty-six (66) feet; Northwardly by land now or formerly of Edith F. Terry and Abbie K. Bearse one hundred fifteen and one-half (115.5) feet; Estwardly by land now or formerly of Donald H. Chase and Patricia T. Chase fifty-eight (58) feet; and Southerly by land now or formerly of John L. Terry one hundred fifteen and one-half (115.5) feet. Being a portion of the premises conveyed by Mary A. Terry to John L. Terry by Warranty Deed dated September 23, 1914 and recorded in the Barnstable County Registry of Deeds in Book 332 Page 509. i i i i Bk 1762.8 Pg 337 #106236 - i EXHIBIT A-1 This Activity and Use Limitation ("AUL") covers a portion of the parcel which has previously been fully described in Exhibit A (attached). From the northwesterly corner border of the aforementioned parcel heading eastwardly seventy two (72) feet, then southwardly thirty two and one-half (32.5) feet, the point of origination of the AUL commences.. Beginning at that point, which is currently the southerly corner of the northeast entry stairwell, then extending northwardly four (4) feet, then westwardly ten (10) feet, then southwardly seven (7) feet, then eastwardly ten (10) feet, then northwardly three (3) feet to the point of origination, encompasses the entire AUL area. For further description, please refer to Exhibit B-1: Sketch Plan (attached), which.delineates the AUL area. I I k 17628 Pg 338 #106236 IEXHIBIT B f I i AC . 177 Ll V ` 3�if Z s7y l �` I � ice5 OWD. P,d�4Tz5, wsty) i I I 96 LocAr 0A. 1. �'4' CAMP JT /-�OM�.//f l�sl PREPARED FOP-.* �EFE,ecrvc E: C Ar7-,4)C ,4 JJ49 C/4'C S I AIC_, �9.II�S7o,�f' 'A7AP '32� OAA Z NECE6Y CFCT/FY TFIgY TiCIE BC//LD�.t/�i .:ssaow.v o.v rs../is PLq,v /S LOCgTEa O.v TJ�E c�o�un c8� cn9/n�ecrir�9 I CiViL E.t/Gi�tlEEts L.4a/a Surv�hp,E iL M N lD O -'XIMBIT B-1.: SKETCH PLAN M 72' _ Co w to 1 131 this Ul i Geo lte Environmental, Inc. r-----� Con*Wt"ta • Salent1xU • Ragineers 1017 Turn L——`—_J = AUL AREA plkeSL Canton, lIA ORflEI - = MtETCH EzBIBr! B-1: Dinp,ma PLAN CINM BLOC[ TAIL o s CONCRM RE7ADMG TALL Dlspwal Area 74 Camp Stint = CONMEM TALL YOUMA7ION V• HA 8-18-03 708: C"1009 817E BOUNDARY OUNDARiJLY AREA j TOWN OF BARNSTABLE , . BUILDING DEPARTMENT 'COMPLAINT/INQUIRY REPORT Date Rec'd B Assessor's No. - ` y Last Name A First Name Vy r•� Tr eat ORIGINATOR Stree c CA Village AI-AL) A-) / 5 State A Zip o, (? 6,) Telephone: Home ��'T�E c)43 6 Work 1 Description: AG� /97' COMPLAINT ` Ntii P <�t�r-5Lo•e�-f/1 S e.: '7 N9 U -. -yw le 41,0 7W /"?AC77 07°J R GPa«J77 eP lI A) s , pv, ��. INQUIRY uN�'FIl77 -� DI,SCD,UtiJ�tr�Zi7 Pl�?SCTA S ' �L�C��JC%�t S csMF�'/4+� Requestor's Signature �k�3 COMPLAINT Street Address �'�!� (_.A S—r. �'a �7 4 A�S� LOCATION A= OFFICE USE ONLY INSPECTOR'S Date - Inspector ACTION/ COMMENTS z=Z�je-1 4107 FOLLOW-UP ACTION ADDITIONAL INFO. ATTACHED COPY DISTRIBUTION: WHITE — DEPARTMENT FILE YELLOW — INSPECTOR PINK — INSPECTOR (RETURN TO OFFICE MGR.) MISCI o .J /4 4) /O� Q C C� ��r e�✓ �; �yN��r^�� S � P z�y>�j>r til 61 Li A4 P s5 NA[/� DJ�� ,�, 7- C� JP; �T /,9 N L �r r IZ L::r U4-� F'7 Ad _ 6-A S 14,0157 ✓3Z�� p�sca C)nJ a C7-;� C rye U L E:s A7' tA� N 7 y /�1►2�5 l�re9g p ^' �eeso� � � y e3 6-7 6 S a s+' tuU ;.,tyry� dS q;-J✓ n;Q, .,v,,� �' a+4rSf k p' 23 d. fir � a y MAF'/PAR A- - 4t,+1 102/204 r✓ zE7¢#� , w ✓ + # 555 �S REET FLINT STR MARSTONSMILLS - -*N k ` ,r35`kz._. _:i,+�.'X�nY' R�r�tl�" ,'3yv;�'sC � d x��f;f � KN.e � Zr A•�i' cm YO GI` o a 4 �M .... Tl � urn �� a�wG INSPECTOR, �. DON 2 cNEELY_C OMM FIRE DES,TIM �E �NGu GEC RRIER, HER \� Eof L T2�,�uSIN LEAN HOUSES FOR ALIvNG. \ G I N } CHARGE. ADVISED HE\O G \ HER HAIR. NO SUB! � �\ \\ \\ \\ \\ \� Parcel Detail- Page 1 of 3 w7-7 f A �< TAt Logged In As: Parcel Detail Monday,November 2 2009 Parcel Lookup Parcel Info Parcel ID 328-178 Developer Lot Location;74 CAMP STREET ) Pri Fronta a 50 _I Sec Road Sec F `'_,_..--...-�_..._ .µ,.�__.. ............Y._-_....�.._-_.�.,___...� Frontage - - Village 3HYANNIS Fire District jHYANNIS Sewer Acct!2303 �� Road Index j0 9 �_a t Interactive Map Owner Info ......... _._. ........._. _..._ _. --- — . . ........-- owner ELLSWORTH, PHILIP J&JOAN � ) Co-Owner _ ..... __ .......... 1 Streets i257 SOUTH SEA AVE ( Street2 City I EST YARMOUTH _ State MA zip 02673 _ Country IUSA - Land Info ..... ......... ..........._........... ... . . .. ............_......... _............................................... ....... ----- Acres 10.13 Use Three Fame zoning MS � Nghbd 0106� ........... ----..._ ................. _ Topography Level I Road Paved Utilities;All Public Location - Construction Info --- ......... ....... ......... Building 1 of 1 Year Roof i""_�_.. Ext .. .....""... Built1920 Struct!Gable/Hip ,w ( Wall Vinyl Skiing Effect I....-....._ --.._ - 1961 Roof(Asph/F..GIs/Cm - AC None_ - ...-.. x Area Cover P ( Type I , Style jConventional 16 Wall Drywall Bed 14 Bedrooms I e K Rooms "3 ` Bath Int "� �^ Model!Residential 3 Fully Floor Rooms .............. s �* Grade,Average ' Heat Hot Water Total 9 Rooms ' Type Rooms - Stories 12 Stories Heat{Gas Found- Fuel lcal Fuel ation yp Permit History Issue Date jPurpose I Permit# jAmount Insp Date Comments http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=27924 11/2/2009 f Parcel Detail Page 2 of 3 Visit History _ _.__.. .. ............... [Date Who Purpose 0/30/2009 00:00:00 Nancy Finch Drive by inspection only 5/07/2002 00:00:00 Paul Talbot Meas/Listed-Interior Access - Sales History -.._ __................... Line Sale Date Owner Book/Page Sale Price 1 05/15/1995 ELLSWORTH, PHILIP J&JOAN 9676/030 $115,000 2 09/15/1993 NATL CREDIT UNION ADM BOARD 8770/107 $110,850 3 12/15/1988 SELBY, GERALD L&SUSAN 6561/313 $1 4 04/15/1986 KENNEY,JOHN W TRS 5007/173 $105,280 5 12/15/1985 1 TERRY,JOHN L ETALS 4284/019 $0 Assessment History ----------------- --__..._. .........__.._---- ............._.._ ....... ... ................._ _ .............._...... ue Save# Year Building Value XF Value OB Value Land Value Total Parcel Val 1 2009 $203,000 $0 $0 $144,700 $347,700 2 2008 $182,300 $0 $0 $154,900 $337,200 4 2007 $181,600 $0 $0 $154,900 $336,500 5 2006 $166,300 $0 $0 $159,500 $325,800 6 2005 $133,600 $0 $0 $121,900 $255,500 7 2004 $108,700 $0 $0 $73,100 $181,800 8 2003 $89,700 $0 $0 $25,800 $115,500 9 2002 $89,700 $0 $0 $25,800 $115,500 10 2001 $89,700 $0 $0 $25,800 $115,500 11 2000 $70,600 $0 $0 $20,500 $91,100 12 1999 $70,600 $0 $0 $20,500 $91,100 13 1998 $70,600 $0 $0 $20,500 $91,100 14 1997 $69,600 $0 $0 $20,500 $90,100 15 1996 $69,600 $0 $0 $20,500 $90,100 16 1995 $69,600 $0 $0 $20,500 $90,100 17 1994 $73,300 $0 $0 $36,900 $110,200 18 1993 $73,300 $0 $0 $36,900 $110,200 19 1992 $83,500 $0 $0 $41,000 $124,500 20 1991 $87,700 $0 $0 $51,200 $138,900 21 1990 $87,700 $0 $0 $51,200 $138,900 22 1989 $87,700 $0 $0 $51,200 $138,900 23 1988 $57,000 $0 $0 $36,000 $93,000 24 1987 $57,000 $0 $0 $36,000 $93,000 25 1 1986 $57,000 $0 $0 $36,000 $93,000 Photos I http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=27924 11/2/2009 r Parcel Detail Page 3 of 3 � � 2 v i y �C .y http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=27924 11/2/2009 cistarENVIRONMENTAL RESOURCE CONSULTANTS ASSOCIATES, INC. a May 4, 1995 Ms. Gloria Urenas Zoning Enforcement Officer 367 Main Street Hyannis, MA 02601 CERTIFIED MAIL: RETURN RECEIPT REQUESTED Dear Ms. Urenas: Pursuant to 310 CMR 40.1099, the Massachusetts Contingency Plan, we hereby notify you that a Notice of Activity and Use Limitation has been recorded for the property known as 74 Camp Street in Hyannis, Massachusetts. A copy of said Notice is enclosed for your file. Very truly yours, LELAND � S;a r J. FIGGINS,JR. land . H , Jr., MGe, LSP No.8370 0 Principal GIST CISTAR ASSOCIATES, INC. Enc. 2.1003NOT11F.WP 1017 TURNPIKE STREET e CANTON, MASSACHUSETTS 02021 • 617-821-4142 1240 PAWTUCKET AVE. • EAST PROVIDENCE, RHODE ISLAND 02916.401-431-9044 NOTICE OF ACTIVITY AND USE LIMITATION M.G.L. c. 21E, §6 and 310 CMR 40.0000 Disposal Site Name: 74 Camp Street, Hyannis, Massachusetts DEP Release Tracking No: 4-10287 This Notice of Activity and Use Limitation("Notice") is made as of the 28th day of April, 1995,by the National Credit Union Administration Board, as liquidating agent for Barnstable Community Credit Union,together with their successors and assigns, (collectively "Owner"). WITNESSETH: WHEREAS,National Credit Union Administration Board, as liquidating agent for Barnstable Community Credit Union, are the owners in fee simple of that certain parcel of land located in Barnstable, Barnstable County, Massachusetts, with the buildings and improvements thereon, ("Property"); WHEREAS,said parcel of land, which is more particularly bounded and described in Exhibit A,attached hereto and made a part hereof("the Property") is subject to this Notice of Activity and Use Limitation. WHEREAS,a portion of the Property comprises all of a disposal site as the result of a release of oil and/or hazardous material. Exhibit B is a sketch plan showing the relationship of the Portion of the Property subject to this Notice of Activity and Use Limitation to the boundaries of said disposal site. Exhibit B:is attached hereto and made a part hereof. WHEREAS,one.or more response actions have been selected for the Disposal Site in accordance with M.G.L. 0.21E ("Chapter 21E")and the Massachusetts Contingency Plan, 310 CMR 40.0000 ("MCP'). Said response actions are based upon the restriction of certain activities occurring under the Property. The basis for such restrictions are set forth in an Activity and Use Limitation Opinion("AUL Opinion'),dated 28 April 1995, which is attached hereto as Exhibit C and made a part hereof; NOW, THEREFORE,notice is hereby given that the activity and use limitations set forth in said AUL Opinion are as follows: 1. Permitted Activities and Uses Set Forth in the AUL Opinion. The AUL Opinion provides that a condition of No Significant Risk to health, safety, public welfare or the environment (such condition being defined in 310 CMR 40.0000),exists for any foreseeable period of time so long as any of the following activities and uses occur on the portion of the Property: (a). Any lawful use of the Property which does not involve removing the easterly addition of the existing house on the Property,thereby potentially exposing the soil beneath it to rain water, which could cause leaching of contaminants into the groundwater, and (b). Such other activities or uses which, in the Opinion of an LSP,shall present no greater risk of harm to health, safety, public welfare or the environment than the activities and uses set forth in this paragraph. OF r 2. Activities and Uses Inconsistent with the AUL Opinion. Activities and uses which are Inconsistent with the AUL Opinion, and which, if implemented at the portion of the Property,may result in a significant risk of harm to health, safety, public welfare or the environment are as follows: (a). Any activity that would involve removing the easterly addition of the existing house on the Property. 3. Obligations and Conditions Set Forth in the AUL Opinion. If applicable, obligations and/or conditions to be undertaken and/or maintained at the portion of the Property to maintain a condition of No Significant Risk as set forth in the AUL Opinion shall include the following: (a). Prevent any activity that would involve removing the easterly addition of the existing house on the Property. 4. Proposed Changes in Activities and Uses. Any proposed changes in activities and uses at the portion of the Property which may result in higher levels of exposure to oil and/or hazardous material than currently exist shall be evaluated by an LSP who shall render an Opinion,in accordance with 310 CMR 40.1080 et seq., as to whether the proposed changes will present a significant risk of harm to health, safety, public welfare or the environment. Any and all requirements set forth in the Opinion to ensure a condition of No Significant Risk in the implementation of the proposed activity or use shall be satisfied before any such activity or use is commenced. 5. Violation of a Response Action Outcome. The activities, uses and/or exposures upon which this Notice is based shall not change at any time to cause a significant risk of harm to health, safety, public welfare, or the environment due to exposure to oil and/or hazardous material without the prior evaluation by an LSP in accordance with 310 CMR 40.1080 et seq., and without additional response actions, if necessary, to achieve or maintain a condition of No Significant Risk If the activities, uses, and/or exposures:upon which this Notice is based change without the prior evaluation and additional response actions determined to be necessary by an LSP in accordance with 310 CMR 40.1080 et seq., the owner or operator of the portion of the Property subject to this Notice at the time that the activities, uses and/or exposures change, shall comply with the requirements set forth in 310 CMR 40.0020. 6. incorporation Into Deeds, MortaaL Leases. and Instruments of Transfer. This Notice shall be incorporated either in full or by reference into all deeds,easements,mortgages,leases, licenses, occupancy agreements or any other instrument of transfer, whereby an interest in and/or right to use the Property or a portion thereof is conveyed. Owner hereby authorizes and consents to the filing and recordation and/or registration of this Notice to become effective when executed and sealed by the undersigned LSP, and recorded and/or registered with the appropriate Registry(ies) of Deeds and/or Land Registration Office(s): WITNESS the execution hereof under seal this�day of , 19 q� ----------- Ile /Jct yes, os s�-Owner t . � COMMONWEALTH OF MASSACHUSETTS Then personally appeared the ve named G _ acknowledged the foregoing to be �)• � _free act and deed before me, J®DIE MjONES Notary Publi � e NOTARY PUBLIC �7 State of Texas My Commission Expires: 7// 9� 'lEof�E} Comm. Fxp. 07.07.96 The undersigned LSP hereby certifies that he executed the aforesaid Activity and Use Limitation Opinion attached hereto as Exhibit C and.made part hereof and that in his Opinion this Notice of Activity and Use Limitation is consis#navglis set forth in said Activity and Use Limitation Opinion. �/� LELAND G� Date: J. FIGGINS,URP G q � E �GISTEQ`� SiryE . COMMONWEALTH OF MASSACHUSETTS /der& k 1A Then personally appeared the above named t4&6,11 ffwm9 - �QP. and acknowledged the foregoing to be �free act and deed before me, Notary Public My Commission Expires: y 1 t�GL: / 7 -7 44 Ll / 7 !CB �it/D. �[1.VDE,�i.�/E� �r✓f17'LC r W¢s'� i 1 C�,e /F/E-D .oL OT OL SUM PIeE-PARED FoR: LOf.4T/O.t/: 74 L CAMP Jr. 141/.4AIVIJ 1414,W T— { scq c. J a 3 0 aATc: 40�A5 6s6 P67 3/3 ! 2 f-/E.eE6Y CE,QT/FY TN.47' .T!-/E 8(//LD/.VG Horvv O.L/ 7-f•,11-5 PL.4a/ /S L.00A477E0 O.1/ T/VE M G ' �.L OvtJL.� AS ENO WN HEeEO�t./,' M. i i down came en9/necrir�9_ `"M° IC/V/L E•VG/.t,/EELS L.4.�/D SC/LV6YOQ� � o uTE Gq--Y�4.eMOC/Ts-,I, M�753, aATt .e Lq,va suev�tiro.e L_. Basement Extent of Excavation Concrete Floor Crawl Space x H (Addition) Porch � '� Brick Foundation Supports Original Structure s = Inaccessible Impacted Soil astar ❑ 1017 TURNPIKE ST. • CANTON,MA02021 ❑ 1240 PAWTUCKET AVENUE ASSOCIATES INC E.PROVIDENCE,Al 02916 Exhibit B: Site Plan 74 Camp Street Hyannis, MA OATL SCALE: JOB Na: 28 April. 1995 1", 30' +/- 9941003 EXHIBIT C ENVIRONMENTAL RESOURCE CONSULTANTS ASSOCIATES, INC. 28 April 1995 Ms. Julie Hutcheson Massachusetts Department of Environmental Protection Southeast Regional Office 20 Riverside Drive Lakeville, MA 02347 RE: 74 Camp Street Hyannis, Massachusetts Release Tracking No. 4-10287 CISTAR Project No. C941003 ACTIVITY AND USE LBUTATION OPINION Dear Ms. Hutcheson: CISTAR ASSOCIATES, INC. ("CISTAR") is submitting this letter as an Activity and Use Limitation,(AUL) Opinion for a limited portion of the property located at 74 Camp Street in Hyannis, Massachusetts. This portion is hereafter called the "Site". On.18 February 1994 a partially buried 275 gallon #2 fuel oil storage tank "tank" was removed from the crawl space area under the easterly portion of the structure on the property. The subject tank was partially buried and installed on its side.. After removal, a pinhole perforation was observed on the tank. As a result, the subject tank was found to have released product and contaminated surrounding soils with 'IPH at levels above the relevant Reportable Concentration, RCS-1, of 500 parts per million (ppm). A confirmatory subsurface investigation of the Site was performed which included soil borings, monitoring wells, and laboratory analysis. The results of this program revealed that the extent of soil contamination was limited and that groundwater was not found to be impacted by the subject release. All soil contaminated above the RCS-1 standard of 500 ppm was removed from the Site except for some inaccessible contaminated soil located under a portion of the north foundation wall of the structure. After a Method 3 Risk Characterization (310 CMR 40.09.90) was conducted relative to contaminant levels in soils present,under a portion of the building foundation at the Site, it was deemed by CISTAR that a Permanent Solution:under an Activity and Use Limitation (AUL, .310 CMR 40.1070) was the optimum solution. This decision was based on a Benefit- 1017 TURNPIKE STREET CANTON,MASSACHUSETTS 02021 • 617-821-4142 1240 PAWTUCKET AVE.•:EAST PROVIDENCE,RHODE ISLAND 02916.401-431-9044 ; Cost Analysis which found that the incremental cost of conducting the remedial alternative to achieve or approach background levels would be substantial and disproportionate to the incremental benefit of risk reduction, environmental restoration, and monetary and non- pecuniary values (310 CMR 40.0860). It is the opinion of CISTAR that once the AUL is in place, the TPH will not "present a significant risk of damage to health, safety, public welfare, or the environment during any foreseeable period of time," in accordance with 310 CMR 40.1005. As such, any lawful use of the Property is permitted which does not involve removing the easterly addition of the existing house on the Property. If said structure were removed from the Property then the contaminated soil shall be remediated pursuant to all applicable regulations. Therefore, it is the opinion of the undersigned that a Class A-3 RAO has been achieved for the Site, pursuant to the MCP. Please call if you have any questions or comments regarding this Site. Very truly yours, D Cs� � J. INS,JR. eincipa J. g , Jr., LSP NNyo.9370 + FGIST CISTAR ASSOCIATES, INC. '�` 2.10030P.WP .* E astar Department of Environmental Protection - -�o ��= 20 Riverside Drive -- Lakeville, MA 02347 Ps fArT SIR Building and Zoning Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 •1i+'rsir-%.. I of (t�t�,i�l,e�ilrl /. —�- _�:� , J--_— / '"—�_ —' .� ``� / \ F �` � • i i e i� iiii j i iiiii s � ii iii ii� i�ii ij i } i �t i 3i ?%il t i } FbIIi F trf JIt Ftt i!?1 tF € i ! COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL FFATRS DEPARTMENT OF ENVIRONMENTAL PROI FCOPy SOUTHEAST REGIONAL OFFICE 20 RIVERSIDE DRIVE,LAKEVILLE,MA 02347 508-9 MITT ROMNEY Governor ELLEN ROY HERZFELDER Secretary FERRY HEALEY Lieutenant Governor LAUREN A.LISS_ Commissioner January 27, 2003 Phillip Ellsworth Re: BARNSTABLE--BWSC/ASM 257 South Sea Street Residence W. Yarmouth, Massachusetts 02673 74 Camp Street RTN 4-10287 AUL NON-SE-03-3A-007 NOTICE OF NONCOMPLIANCE Dear Mr. Ellsworth: A review of records conducted by Massachusetts Department of Environmental Protection (Department)personnel demonstrates that you are not in compliance with one or more laws, regulations, orders, licenses,permits, or approvals enforced by the Department. On August 21, 2001,the Department issued a Notice of Audit Findings (NOAF)that identified errors in the Notice of Activity'and Use Limitation(AUL) filed in support of a Response Action Outcome (RAO).for the above-referenced site. The NOAF established an Interim Deadline of February 17, 2002 for submitting documentation of the required corrections to these errors, accompanied by a Post-Audit Completion Statement. This is an enforceable Interim Deadline issued pursuant to M.G.L. c. 21E, 310 CMR 40.0167 and 310 CMR 40.1140. As of the date of this letter,the Department has not received the required submittal; therefore, you are in violation of the requirements of the MCP. The activities that are in noncompliance and the additional actions the Department wants you to take to come into compliance are described in the Notice of Noncompliance (Attachment A). The Notice of Noncompliance describes: (1) each activity identified during the audit which is in noncompliance, (2).the requirements violated, (3)the action the Department now wants you to take, and(4) the deadline for taking this action. If you fail to comply with this Notice an administrative penalty of$1,000 may be assessed for every day that you remain out of compliance. If you fail to come into compliance by the This information is available in alternate format.Call Aprel McCabe,ADA Coordinator at 1-617-556-1171.TDD Service-1-800-298-2207. DEP on the World Wide Web: http://www.mass.gov/dep �� Printed on Recycled Paper Barnstable,RTN 4-10287 2 Notice of Noncompliki e prescribed deadline, or if you otherwise fail to comply in the future with requirements applicable to you, you could be subject to legal action. Such action could include the assessment of civil administrative penalties,the commencement of a civil action in the court(s) of competent jurisdiction, or the commencement of a criminal prosecution in the court(s) of competent. jurisdiction. Please contact Mark Wood at(508) 946-2874 if you have any questions concerning this notice. Sincerely, Deborah A. Marshall, Chief Audit and Site Management Section M/MW/rr Attachment A: Notice of Noncompliance CERTIFIED MAIL# 7001 0320 0001 4832 2155 cc: Barnstable Town Council 367 Main Street Hyannis, MA 02601 Board of Health Town of Barnstable 367 Main Street Hyannis, MA 02601 Building and Zoning Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Mr. Leland J. Figgins, LSP-of-Record GeoSite Environmental, Inc. 1017 Turnpike Street Canton, MA 02021-0156 DEP-Boston Attn: Thomas Potter,Audit Coordinator (E-copy) DEP-SERO Attn: Enforcement Office (2 copies) Data Entry: C&E NON M nstable,RTN 4-10287 Notice of Noncompliance Attachment A—NOTICE OF NONCOMPLIANCE NON-SE-03-3A-007 ENTITY IN NONCOMPLIANCE Philip Ellsworth 257 South Sea Street W. Yarmouth, MA 02673 LOCATION WHERE NONCOMPLIANCE OCCURRED OR WAS OBSERVED 74 Camp Street Hyannis, MA 02061 DATE WHEN NONCOMPLIANCE OCCURRED OR WAS OBSERVED February 17, 2002—Interim Deadline established in Notice of Audit Findings : DESCRIPTION OF NONCOMPLIANCE Violation of 310 CMR 40.0167 (1)=The Department may establish and enforce reasonable Interim Deadlines consistent with M.G.L. c. 21E and 310 CMR 40.0000 for the performance of, response actions, and the furnishing of information and provision of access to documents and . other information to DEP, including,but not limited to, deadlines for compliance with Requests for Information, applicable orders,permits and other requirements. In correspondence dated August 21, 2001,the Department established an Interim Deadline for,; provision.of documentation that the required corrections to the Notice of AUL have been ; performed.No such documentation has been provided as of the date of this notice. - ACTIONS TO BE TAKEN AND DEADLINE Within sixty (60) days of the date of this notice, you must implement an Amendment and Ratification of Notice of Activity and Use Limitation, using the form and instructions provided with the Notice of Audit Findings (NOAF). The corrective AUL must address the error outlined in the NOAF. Alternatively, you may submit a new Response Action Outcome (RAO) Statement documenting the achievement of a Class A-1, A-2 or B-1 RAO at the site (i.e., an RAO that does not rely on an AUL to maintain a level of No Significant Risk). Please indicate in writing within 14 days of the date of this notice whether or not you intend to undertake the required actions. If you fail to correct the violation identified and provide documentation of such action to the Department, you may be subject to enforcement action by the Department. If the Department finds that the violations have not been corrected,then the Department may issue a Notice of Intent to Assess a Civil Administrative Penalty(PAN), administrative enforcement order,Notice of Responsibility(NOR),Notice of Intent to take Response Action(NORA),Administrative Consent Order(ACO), Unilateral Order, or seek a Judicial Judgment as appropriate. ,T 1/27/04 Re: 74 Camp Street, Hyannis See attached complaint. Is this a legal multi-family? If so, should be have a Certificate of Inspection? Please let me know. Lois t At Cori e� �2 f Town of Barnstable *IHETpk, Regulatory Services Thomas F.Geiler,Director * B"M Building Division 9 MUMS.9. 0q sbgq' ♦0 1°iFo Mp a Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINUINQUIRY REPORT Date: /L2 2/0 tj Rec'd by: z� Complaint Name: Map/Parcel 3 d - 7 Location / Address: 7y Originator Name: Street: Village: State: Zip: Telephone: 7 7,5�-" Z2, o� �6 a /�� J Complaint Description: ZA.�1�� AL FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: Additional Info.Attached a Q:forms:complaint i --_ rnstalale Assessing Search Results Page 1 of 2 �� �'43E ��- _: trw...�, •ice' w, f.����, 0 $ AL dA � x -Wr m= Home: Departments:Assessors Division: Property Assessment Search Results 74 CAMP STREET Owner: ELLSWORTH, PHILIP J &JOAN Property Sketch Legend Map/Parcel/Parcel Extension 328 /178/ { Mailing Address ELLSWORTH, PHILIP J &JOAN Al 257 SOUTH SEA AVE ; WEST YARMOUTH, MA. 02673 2004 Assessed Values: .' Appraised Value Assessed Value F �N Building Value: $ 108,700 $ 108,700 Extra Features: $0 $0 Outbuildings: $0 $0 Land Value: $73,100 $73,100 Interactive Property Map: ap requires Plug in: Or Totals:$ 181,800 $ 181,800 1 have visited the maps before 11 Show Me The Manor: April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: ELLSWORTH, PHILIP J &JOAN 5/15/1995 9676/030 $ 115,000 NATL CREDIT UNION ADM BOARD 9/15/1993 8770/107 $ 110,850 SELBY, GERALD L&SUSAN 12/15/1988 6561/313 $ 1 KENNEY, JOHN W TRS 4/15/1986 5007/173 $ 105,280 TERRY,JOHN L ETALS 12/15/1985 4284/019 $0 2004 Tax Information: Tax Rates: (per $1,000 of valuation) Town Tax $ 1,201.70 Town Fire District Rates Other Rates 6.61 Barnstable 2.01 Land Bank 3%of Town Tax Hyannis FD Tax $369.05 C.O.M.M. 1.10 Cotuit 1.52 Land Bank Tax $36.05 Hyannis 2.03 http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/... 3/2/2004 4Krnstable Assessing Search Results Page 2 of 2 West Barnstable 1.36 Total: $ 1,606.80 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.13 Year Built 1920 Appraised Value $73,100 Living Area 1746 Assessed Value $73,100 Replacement Cost$ 144,912 Depreciation 25 Building Value 108,700 Construction Details Style Conventional Interior Floors Pine/Soft Wood Model Residential Interior Walls Drywall Grade Average Heat Fuel Gas Stories 2 Stories Heat Type Hot Water Exterior Walls Vinyl Siding AC Type None Roof Structure Gable/Hip Bedrooms 4 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 3 Bathrooms Total Rooms 9 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area (Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area (Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area (Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story (Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story (Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/. 3/2/2004 o£Barnstable WebMap Page 1 of 1 Q 2�0 1.�^32819 `#rW —1,� 'Id 15 'Pi e #se '��r328172 ,..k Y 1 „ d 328192. _ s T1 Il 328171 #877 3#28481 m 328191 328179�#20 v ��•, � � 328190 328178-\ % #74 �URTw Y 328189� #75 _ 328184 8487--- ..,, � #62�#88 � � #69 3281 § �.�3i81880011 1 i I wFull,Screen.Map '.;��l Magnifier Zoom InZoom O Print Map` k . r http://www.town.bamstable.ma.us/Webmap/assessorsK/TOB WebMapmedresK.asp?action=... 3/2/2004 Leased Housing Dept: 508.771.7292 _ Barnst e Telephone 508.771.7222 BAaNaAMA • ,? FAX. 508.778.9312 Ho �� tJ 146 South Street•Hyannis,MA 02601 rED MKS� TENANT: LANDLORD: DAVID JENKINS,,,,,,/' A / PHILLIP ELLSWORTH 74 CAMP STREET % 257 SOUTH SEA AVE. HYANNIS, MA 0260 WEST YARMOUTH, MA 02673 NOTICE OF CHANGE 11/21/2003 Based on information received by this office the rent will be adjusted as follows: CURRENT AMOUNTS: NEW AMOUNTS: TOTAL RENT: $825.00 TOTAL RENT: $825 Tenant portion: $205.00 Tenant portion: $176 BHA portion: $620.00 BHA portion: $649 This change is effective on 12/01/2003 OTHER CHANGES (if any): If you feel that this adjustment may be wrong, you may dispute it. In order to do so,please contact me IN WRITING within 10 days of this notice. Please remember that if there are any income, deductions of_family composition changes the tenant is obligated to report the change to our office within thirty(30) of the change. Sincerely, Robert Hooper , PHM Leased Housing Coordinator Cc: file Equal Housing Opportunity Agency 01 N • oznsz .x IAKE M A' '� /.A I , Mn Y3t_ 77 IVY %��.� _,►_I I �. i r � �o l • -1 _ ` M15 - _ r / _ •� _ � 1 I�GnI� r Aga i ' V 1 ai rlL�+ ��J 06 i AWA po- ' i F—It .�. sib .� ..� ,. � � tom. • .� I�- �,_ �► ♦!�,� • . fin__ .. ., ! APH �i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL .kFFAT'RR DEPARTMENT OF ENVIRONMENTAL PRO y SOUTHEAST REGIONAL OFFICE 1 20 RIVERSIDE DRIVE,LAKEVILLE,MA 02347 508-9 MITT ROMNEY Governor ELLEN ROY HERZFELDER Secretary KERRY HEALEY Lieutenant Governor _ LAUREN A.LISS Commissioner January 27, 2003 Phillip Ellsworth Re: BARNSTABLE--BWSC/ASM 257 South Sea Street Residence W. Yarmouth, Massachusetts 02673 74 Camp Street RTN 4-1028.7 AUL NON-SE-03-3A-007 NOTICE OF NONCOMPLL4,NCE Dear Mr. Ellsworth: A review of records conducted by Massachusetts Department of Environmental Protection (Department)personnel demonstrates that you are not in compliance with one or more laws, regulations, orders, licenses,permits,or approvals enforced by the Department. On August 21, 2001,the Department issued a Notice of Audit Findings (NOAF)that identified errors in the Notice of Activity'and Use Limitation(AUL) filed in support of a Response Action Outcome (RAO)_for the above-referenced site. The NOAF established an Interim Deadline of February 17, 2002 for submitting documentation of the required corrections to these errors, accompanied by a Post-Audit Completion Statement. This is an enforceable Interim Deadline issued pursuant to M.G.L. c. 21E, 310 CMR40.0167 and.310 CMR 40.1140. As of the'date of this letter,the Department has not received the required submittal; therefore, you are in violation of the requirements of the MCP: The activities that are in noncompliance.and the additional actions the Department wants you to take to come into compliance are described in the Notice of Noncompliance (Attachment A). The Notice of Noncompliance describes:.(1) each activity identified.during the audit which is in noncompliance, (2).the requirements violated, (3)the action the Department now wants you to take, and(4)the deadline for taking this action. If you fail to comply with this Notice an administrative penalty of$1,000 may be assessed for every day that you remain out of compliance. If you fail to come into compliance by the This information is available in alternate format.Call Aprel McCabe,ADA Coordinator at 1-617-556-1171.TDD Service-1-800-298-2207. DEP on the World Wide Web: http://www.mass.gov/dep L� Printed on Recycled Paper L w Barnstable,RTN 4-10287 Notice of Noncompliance Attachment A—NOTICE OF NONCOMPLIANCE NON-SE-03-3A-007 ENTITY IN NONCOMPLIANCE Philip Ellsworth 257 South Sea Street W. Yarmouth, MA 02673 LOCATION WHERE NONCOMPLIANCE OCCURRED OR WAS OBSERVED 74 Camp Street Hyannis,MA 02061 DATE WHEN NONCOMPLIANCE OCCURRED OR WAS OBSERVED February 17, 2002—Interim Deadline established in Notice of Audit Findings 4 DESCRIPTION OF NONCOMPLIANCE Violation of 310 CMR 40.0167 (1)The Department may establish and enforce reasonable Interim Deadlines consistent with M.G.L. c. 21E and 310 CMR 40.0000 for the performance of response actions, and the furnishing of information and provision of access to documents and , other information to DEP, including,but not limited to, deadlines for compliance with Requests for Information, applicable orders,permits and other requirements. In correspondence dated August 21,2001,the Department established an Interim Deadline for provision of documentation that the required corrections to the Notice of AUL have been performed.No such documentation has been provided as of the date of this notice. ACTIONS TO BE TAKEN AND DEADLINE Within sixty (60) days of the date of this notice,you must implement an Amendment and Ratification of Notice of Activity and Use Limitation, using the form and instructions provided with the Notice of Audit Findings (NOAF). The corrective AUL must address the error outlined in the NOAF. Alternatively,you may submit anew Response Action Outcome (RAO) Statement documenting the achievement of a Class A-1,A=2 or B-1 RAO at the site (i.e., an RAO that does not rely on an AUL to maintain a level of No Significant Risk). Please indicate in writing within 14 days of the date of this notice whether or not you intend to undertake the required actions. If you.fail to correct the violation identified and provide documentation of such action to the Department, you may be subject to enforcement action by the Department. If the Department finds that the violations have not been_corrected,then the Department.may issue a Notice of Intent to Assess a Civil Administrative Penalty(PAN), administrative enforcement order,Notice`of Responsibility(NOR),Notice of Intent to take Response Action(NORA),Administrative Consent Order(ACO), Unilateral Order, or seek a Judicial Judgment as appropriate.. Bamstable,RTN 4-10287 Notice ofNoncopliance Attachment A—NOTICE OF NONCOMPLIANCE NON-SE-03-3A-007 ENTITY IN NONCOMPLIANCE Philip Ellsworth 257 South Sea Street W. Yarmouth, MA 02673 LOCATION WHERE NONCOMPLIANCE OCCURRED OR WAS OBSERVED 74 Camp Street Hyannis,MA 02061. DATE WHEN NONCOMPLIANCE OCCURRED OR WAS OBSERVED February 17, 2002—Interim Deadline established in Notice of Audit Findings DESCRIPTION OF NONCOMPLIANCE Violation of 310 CMR 40.0167 (1) The Department may establish and enforce reasonable Interim Deadlines consistent with M.G.L. c. 21E and 310 CMR 40.0000 for the performance of response actions, and the furnishing of information and provision of access to documents and . other information to DEP,including, but not limited to, deadlines for compliance with Requests for Information, applicable orders,permits and other requirements. In correspondence dated August 21, 2001,the Department established an Interim Deadline for provision.of documentation that the required corrections to the Notice of AUL have been . performed.No such documentation has been provided as of the date of this notice.. ACTIONS TO BE TAKEN AND bEADLINE Within sixty (60) days of the date of this notice, you must implement an Amendment and Ratification of Notice of Activity and Use Limitation, using the form and instructions provided with the Notice of Audit Findings (NOAF). The corrective AUL must address the error outlined in the NOAF. Alternatively, you may submit a new Response Action Outcome (RAO) Statement documenting the achievement of a Class A-1,.A-2,or B-1 RAO at the site (i.e., an RAO that does not rely on an AUZ to maintain a level of No Significant Risk) Please indicate in writing within 14 days of the date of this notice whether or not you intend to undertake the required actions. If you fail to correct the violation identified and provide documentation of such action to the Department, you may be subject to enforcement action by the Department. If the Department finds that the violations have not been corrected,then the Department may issue a Notice of Intent to Assess a Civil Administrative Penalty(PAN), administrative enforcement order,Notice of Responsibility(NOR),Notice of Intent to take Response Action(NORA),.Administrative Consent Order(ACO),Unilateral Order, or seek a Judicial Judgment as appropriate. Barnstable,RTN 4-10287 Notice of Noncompliance Attachment A—NOTICE OF NONCOMPLIANCE NON-SE-03-3A-007 ENTITY IN NONCOMPLIANCE Philip Ellsworth 257 South Sea Street W. Yarmouth, MA 02673 LOCATION WHERE NONCOMPLIANCE OCCURRED OR WAS OBSERVED 74 Camp Street Hyannis, MA 02061 DATE WHEN NONCOMPLIANCE OCCURRED OR WAS OBSERVED February 17, 2002—Interim Deadline established in Notice of Audit Findings DESCRIPTION OF NONCOMPLIANCE Violation of 310 CMR 40.0167(1)=The Department may establish and enforce reasonable Interim Deadlines consistent with M.G.L. c. 21E and 310 CMR 40.000.0 for the performance of response actions, and the furnishing of information and provision of access to documents and other information to DEP, including, but not limited to, deadlines for compliance with Requests for Information, applicable orders,permits and other requirements. In correspondence dated August 21, 2001,the Department established an Interim Deadline for provision.of documentation that the.required corrections to the Notice of AUL have been, performed.No such documentation has been provided as of the date of this notice. ACTIONS TO BE TAKEN AND DEADLINE Within sixty (60) days of the date of this notice, you.must implement an Amendment and Ratification of Notice of Activity and Use Limitation, using the form and instructions provided with the Notice of Audit Findings (NOAF). The corrective AUL must address the error outlined in the NOAF. Alternatively, you may submit a new Response Action Outcome (RAO) Statement documenting the achievement of a Class A-1, A-2 or B-1 RAO at the site (i.e., an RAO that does not rely on an AUL to maintain a level of No Significant Risk): Please indicate in writing within 14 days of the date of this notice whether or not you intend to undertake the required actions. If you fail to correct the violation identified and provide documentation of such action to the Department, you may be subject to enforcement action by the Department. If the Department finds that the violations have not been corrected,then the Department may issue a Notice of Intent to Assess.a Civil Administrative Penalty(PAN), administrative enforcement order,Notice of Responsibility(NOR),Notice of Intent to take Response Action(NORA), Administrative Consent Order(ACO),Unilateral Order, or seek a Judicial Judgment as appropriate. EUILD;ttdG DEPT MAY 8 (1995, NOTICE OF ACTIVITY AND USE LIMITATION M.G.L. c. 21E, §6 and 310 CMR 40.0000 Disposal Site Name: 74 Camp Street, Hyannis, Massachusetts DEP Release Tracking No: 4-10287 This Notice of Activity and Use Limitation ("Notice") is made as of the 28th day of April, 1995,by the National Credit Union Administration Board; as liquidating agent for Barnstable Community Credit Union,together with their successors and assigns, (collectively „Owner") WTTNESSETH: WHEREAS, National Credit Union Administration Board,as liquidating agent for Barnstable Community Credit Union, are the owners in fee simple of that certain parcel of land located in Barnstable, Barnstable County, Massachusetts, with the buildings and improvements thereon, ("Property'); WHEREAS,said parcel of land, which is more particularly bounded and described in Exhibit A, attached hereto and made a part hereof("the Property") is subject to this Notice of Activity and Use Limitation. WHEREAS,a portion of the Property comprises all of a disposal site as the result of a release of oil and/or hazardous material. Exhibit B is a sketch plan showing the relationship of the Portion of the Property subject to this Notice of Activity and Use Limitation to the boundaries of said disposal site. Exhibit B is attached hereto and made a part hereof. WHEREAS, one.or more response actions have been selected for the Disposal Site in accordance with M.G.L. c.21E ("Chapter 21E") and the Massachusetts Contingency.Plan, 310 CMR 40.0000 ("MCP'j. Said.response actions e are based upon the restriction of certain activities occurring under the Property. The basis for such restrictions are set forth in an Activity and Use Limitation Opinion("AUL.Opinion"),dated 28 April 1995,which is attached hereto as Exhibit C and made a part hereof; NOW, THEREFORE,notice is hereby given that the activity and use limitations set forth in said AUL Opinion are as follows: 1. Permitted Activities and Uses Set Forth in the AUL.ODi_nion. The AUL Opinion provides-tluat.a condition of No Significant Risk to health, safety, public welfare or the environment (such condition being defined in 310 CMR 40.0000),exists for any foreseeable period of time so long as any of the following activities and uses occur on the portion of the Property: (a). Any lawful use of the Property which does not-involve removing the easterly addition of the existing house" on the Property,thereby potentially exposing the soil beneath it to rain water, which could cause leaching of contaminants into the groundwater, and (b). Such other activities or uses which, in the Opinion of an LSP, shall present no greater risk of harm to health, safety, public welfare or the environment than the activities and uses set forth in this paragraph. 2. Activities and Uses Inconsistent with the AUL Opinion. Activities and uses which are Inconsistent with the AUL Opinion, and which, if implemented at the portion of the Property,may result in a significant risk of harm to health, safety, public welfare or the environment are as follows: (a). Any activity that would involve removing the easterly addition of the existing house on the Property. 3. Obligations and Conditions Set Forth in the AUL Opinion. If applicable, obligations and/or conditions to be undertaken and/or maintained at the portion of the Property to maintain.a condition of No Significant Risk as set forth in the AUL Opinion shall include the following: (a). Prevent any activity that would involve removing the easterly addition of the existing house on the Property. 4. Proposed Changes in Activities and Uses.' Any proposed changes in activities and uses at the . portion of the Property which may result in higher levels of exposure to oil and/or hazardous material than currently exist shall be evaluated by an LSP who shall render an Opinion, in accordance with 310 CMR 40.1080 et seq., as to whether the proposed changes will present a significant risk of harm to health, safety, public welfare or the environment. Any and all requirements set forth in the Opinion to ensure a condition of No Significant Risk in the implementation of the proposed activity or use shall be satisfied before any such activity or use is commenced. 5. Violation of a Response Action Outcome. The activities, uses and/or exposures upon which this Notice is based shall not change at any time to cause a significant risk of harm to health, safety, public welfare, or the environment due to exposure to oil and/or hazardous material without the prior evaluation by an LSP in accordance with 310 CMR 40.1080 et seq., and without additional response actions,if necessary, to achieve or. maintain a condition of No Significant Risk, If the activities, uses, and/or exposures upon which this Notice is based change without the prior evaluation and additional response actions determined to be necessary by an LSP in accordance with 310 CMR 40.1080 et seq., the owner or operator of the portion of the Property subject to this Notice at the time that the activities,uses and/or exposures change, shall comply with the requirements set forth in 310 CMR 40.0020. 6. Incorporation Into Deeds, Mortgages, Leases. and Instruments of Transfer. This Notice shall be incorporated either in full or by reference into all deeds, easements,mortgages; leases, licenses, occupancy agreements or any other instrument of transfer, whereby an interest in and/or right to u the Prot ty or a portion thereof is conveyed. Owner hereby authorizes and consents to the filing and recordation and/or registration of this Notice to become effective when executed and sealed by the undersigned LSP, and recorded and/or registered.with the appropriate Registry(ies) of Deeds and/or Land Registration Office(s).. .. . WITNESS the execution hereof under seal this-2?5t:h day off Owner COMMONWEALTH OF MASSACHUSETTS Then personally appeared the dove named G acknowledged the foregoing to be ;free act and deed before me, JODIE M,,JONES Notary Publi * * NOTARY PUBLIC �, � State of Texas My Commission Expires: 7�7��� FoftE Comm. Exp.07.07.96 The undersigned LSP hereby certifies that he executed the aforesaid Activity and Use Limitation Opinion attached hereto as Exhibit C and-made part hereof and that in his Opinion this Notice of Activity and Use Limitation is consist set forth in said arvity and Use Limitation Opinion..n " �s Date: plc LELANDM J. FIGGINSAP NO(M O. �GISTEQ`� COMMONWEALTH OF MASSACHUSETTS 19 Then personally appeared the above named '( � ��� _ and acknowledged the foregoing to be i S free ac r and deed before me, Notary Public My Commission Expires: I j hGL. / 77 RCI-• 171 -7,1 .�1 770o + J, 19 W.¢Y) i j , 9s i4� .aL OT / =PL j4Uti/ PRE-PARED Fo/2. Sr 140,4XIVIS 114,W 4-5cA.Z-E: J 3 aATc .AC G'l F7-,4). 11 JJ oC/4 nC S /A/c, tI.ST�S7o�,s' A-7AP 32-f- � Z /-�EeEBY GEQT/FY TK,4T' T.NE 8GJ/LD/,CJGr HoWV O.1/ Tf-//S LOG,97-EL> OA/ T.NE j Geoc/.VI� '.qS --.T/-IO WA./ HEBEOA/. N. O y ft 3 c�ou�r7 cam en9/necrir�9 �° C/�//L E,tJG/.VEEts� 111q/q/// L/a.t/a SG/tV6YOQ3 �Oc�TE Gq^-Y��eMOCJT</� M�75�. 1tq,;r /Ly'yy .e 44wa scir r�+�,e Basement Extent of Excavation Concrete Floor Crawl Space x (Addition) Porch H td Brick Foundation Supports Original- Structure = Inaccessible Impacted Soil ®� ❑ 1017 TURNPIKE ST.• CANTON,MA02021 ❑ 1240 PAWTUCKET AVENUE ASSOCIATES INC E.PROVIDENCE,Al 02e16 Exhibit B: Site Plan 74 Camp, Street Hyannis,. MA DATE: SCALE: JOB NO: 28 April. 1995 17. 30' +/- C941003 EXHIBIT• C r W-Ah aw ENVIRONMENTAL RESOURCE CONSULTANTS EN UL ANTS ASSOCIATES, INC. 28 April 1995 Ms. Julie Hutcheson Massachusetts Department of Environmental Protection Southeast Regional Office 20 Riverside Drive Lakeville, MA 02347 RE: 74 Camp Street Hyannis, Massachusetts Release Tracking No. 4-10287 CISTAR Project No. C941003 ACTIVITY AND USE LBUTATION OPINION Dear Ms. Hutcheson: CISTAR ASSOCIATES, INC. ("CISTAR") is submitting this letter as an activity and Use Limitation.(AUL) Opinion for.a limited portion of the property located at 74 Camp Street in Hyannis, Massachusetts. This portion is hereafter called the "Site". On 18 February 1994 a partially.buried 275 gallon #2 fuel oil storage tank "tank" was removed from the crawl space area under the easterly portion of the structure on the property. The subject tank was partially buried and installed on its side._ After removal, a pinhole perforation was observed on the tank. As a result, the subject tank was found to have released product apd contaminated. surrounding soils with TPH at levels above the relevant Reportable Concentration, RCS-1, of 500 parts per million (ppm). A confirmatory subsurface investigation of the Site was performed which included soil borings, monitoring wells, and laboratory analysis. The results of this program revealed that the extent of soil contamination was limited and that groundwater was not found to be impacted by the subject release. All soil contaminated above the RCS-1 standard of 500 ppm was removed from the Site except for some inaccessible contaminated soil located under.a portion of the north foundation wall of the structure. After a Method 3 Risk Characterization (310 CMR 40.0990) was conducted relative to contaminant levels in soils present under a portion of the building foundation at the Site, it was deemed.by CISTAR that a Permanent Solution under an Activity and Use Limitation (AUL; 310 CMR 40.1070) was the optimum solution. This decision was based on a Benefit- 1017 TURNPIKE STREET•.CANTON, MASSACHUSEfTS 02021 617-821-4142 1240 PAWTUCKET AVE. •;EAST PROVIDENCE,RHODE ISLAND 02916.401-431-9044 e Cost Analysis which found that the incremental cost of conducting the remedial alternative to � Y achieve or approach background levels would be substantial and disproportionate to the incremental benefit of risk reduction, environmental restoration, and monetary and non- pecuniary: values (310 CMR 40.0860). It is the opinion of CISTAR that once the AUL is in place, the TPH will not "present a significant risk of damage to health, safety, public welfare, or the environment during any foreseeable period of time," in accordance with 310 CMR 40.1005. As such, any lawful use of the Property is pem-dtted which does not involve removing the easterly addition of the existing house on the Property. If said structure were removed from the Property then the contaminated soil shall be remediated pursuant to all applicable regulations. Therefore, it is the opinion of the undersigned that a Class A-3 RAO has been achieved for the Site, pursuant to the MCP. Please call if you have any questions or comments regarding this Site. Very truly yours, Gs� cs INS,JR. Cn l J. g , Jr., LSP No.93-700 Princip 9FG�STE�' � d` CISTAR ASSOCIATES, INC. 210030P.WP costae' (2,4 L C. 1✓ n 6) A) i� X) ©C(: ,4 5 l a�✓ 5+ /3�N eU(,,� S�;A r; r;{�l ti! r �a,pPr� � r f�c:laL`r'f-f rJ6 o LFD 17v,yPs�' � s7 �� CaP VS� 13y a .3/�P,:���✓1E,�17' 1'`loJSt✓S �.�r.7� 7'N�S �ao S.Vt s�AJT)PiOk JP'-c , �r o A..) s� 4,9 nj tl L G ".4 4 T--7 E 1j AfJ r s J 51 nj 6 P�o rej,v f C—A 5 4,05 f3j!�C—� �71 v ,v v5 � Cra�vi7LE5 A r51A� LiGJ > tiZ: Al�5. X-.. y ,o� Ca.uC1:��� c�JFOr A) -66 Af F a 1' p C�Al c ��.N � ��� �-� N r It- h co I-7 321 t 1� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or T e) Mass. Date 1945 Permit # "J s Building Location °, Pr �{�Q e�_Owner's Name e_ 111 Q E•�'(.73UV Type of Occupancy_ New Renovation ❑ Replacement ❑ Plans Submitted: Yes 1] No FIXTURES Z N Z Y < N N 0 O Z F '• UA W Y J 0 < U O - W 1- uJ y H U ¢ < N W r H U 2 m N H ¢ } < F y Z C d Q d C ; X 2 W O 7 ¢ < N ¢ I < W H O Q J Z ¢ S ¢ J W W O O W S < _ ; 3 O Z = 3 Y S 1- < Y d W LL Y W a r O 3 N IL r' z o O z z W W J u = < ~ < < S - - < < O < J J < ¢ S ¢ < C < M- 3 Y J m N aim J 3. X H N L► t7 O 7 .( 3 ¢ m O SUB-BSMT. BASEMENT 1ST FLOOR 2NO FLOOR 3RO FLOOR 4THFLOOR STM FLOOR 6THFLOOR 7THFLOOR 8THFLOOR Installing Company Name SNnwl S PT.umuNr, F. HRATTN(_ Check one: Certificate Address P_0. BOX 39 ❑ Corporation W. BARNSTABL.E. MA 02668 ❑ Partnership Business Telephone 362-9111 CA Firm/Co. Name of Licensed Plumber Christopher Snow INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which moets the requirements of MGL Ch. 142. Yes 2 No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy 1 Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142.of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted jor entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations perfor n r the permit issued for this application will n compliance with all pertinent provisions of the Massachusetts State Plumbing r f t,ener La B 'Signature ol Deens2edr Title Type of License: Master IX Journeyman❑ City/Town U NL License Number 10 7 0 5 TOWN OF BARNSTABLE PLUMBING PERMIT PARCEL ID 328 179 GEOBASE ID 24553 ADDRESS 74 CAMP STREET PHONE Hyannis ZIP — LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY ' PERMIT 5232 DESCRIPTION 1 WH PERMIT TYPE BPLUM TITLE PLUMBING PERMIT s CONTRACTORS: SNOW'S PLUMBING ARCHITECTS: TOTAL FEES: $10.00 BOND $.00 CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE OWNER NAIL, CREDIT UNION ADM BOA ADDRESS 35 BRAINTREE HILL OFFICE PK SUITE 206 BRAINTREE MA DATE ISSUED 06/13/1995 EXPIRATION DATE i I Department of Health, Safety and Environmental Services �0- BARNSTABLE, 9 MASS. $► 1639. a`� Fp Mp► BUILDING DIVISION BY i F r GENERAL.DOC REVISED 4/26/95