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0020 FOURTH AVENUE (HYANNIS)
Town of Barnstable Bunaing a xBAMSTA Post This Card So.That it is Visible From the Street-'Approved Plans Must be Retained on Job antl this Card Must be Kept Posted Until final Inspection Has Been Made. Permit � Where a'Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspectign has been made. Permit No. B-19-3552 Applicant Name: RetroFit Insulation Approvals Date Issued: 10/22/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 04/22/2020 Foundation: Location: 20 FOURTH AVENUE(HYANNIS), HYANNIS Map/Lot: 246-109 Zoning District: RB Sheathing: Owner on Record: TRULL, MICHAEL SCOTT&JANICE Contractor Name.RETROFIT INSULATION INC. Framing: 1 Address: 13 GARNET DRIVE Contractor Licenser 160461 2 FRANKLIN, MA 02038 � Est Project Cost: $ 11,374.00 Chimney: Description: Air Sealing, 10 ml poly in open crawlspace, kneewall slope 2" rigidi Pe.�mrt Fee: $ 108.01 board,Walls: Blown Fiberglass,Crawlspace Wall.-R10 rigid`board, Insulation: Kneewall Slope-6" Fiberglass R19,Attic Flat-10" Open Blow. Fee Paidz`� $ 108.01 Final:Cellulose, Propa Vents,4x16 Soffit Vents,Attic Damming, Insulated • ,•,�,__, - Date 10/22/2019 Bath Exhaust Hose,Attic Hatch-Seal & Insulate a Plumbing/Gas Project.Review Req: ? L Rough Plumbing: i_ i�. " --',,,Building Official , Final Plumbing: This permit shall be deemed abandoned and invalid'unless the work authorized by this permit is commenced within six months afte issuance. -- All work authorized by this permit shall conform to the approved application and the approved construction documents for whicH,,-tliis permit has been granted: Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning°by laws�and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public mspeetion for the entire duration of the work until the completion of the"same. l ' - Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building andr Fire Officials are provided on Wh hermit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection - � g 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for.Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not'have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Lt�� Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT OP S;G � 5�1� 4 b � � 1.,�< -- x}�;. y �<� „ y. �`-��� F .> ��=: ® , � �� i ��-r, � w .!"1�✓'�d"�,r� �a,ti.R�.� -��a•.,.3 v+ � `�i' r k _,.,,,X."' i���Yi��i�'��Gya."a" �. '� r4 s rif;��`s.! 't.�t''i R�,�' sw }" yE-T,y,�'^Q`.i"�'`��:•1�.�41e.:�„�..,� i� „'�.- �/T.{..jKv� ..,...,i•:t.^� .a:$w cy+Ci. s `�Y %�•� :"'• '",..�(�"{y�v`3"',�i"`��.ta�w""*�.. �9�"f'! ` T..r aw+�• r. w �=•. .wad .. �w...tiy �•.. `+'?y �f 7. ��.j/ Y.. � f riRplf, Y.y }� .�+,.�.� Y'{�t�� y�• � �.u�yj � \T ��ir i� �v1lw � �A �� Y. T.L.T��� t ..,v.��,s`~��:JN^�:.="Y'r�/rT..:� ��1R1���t'.< y ✓ ,� W+ 1 1, I 1 J h �T r ✓ J I„ Jr `�"�t••�J 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r. _t Map a Parcel l`o� Application # Health Division " "" Date Issued Conservation Division Application Fee Planning Dept. ' Per`mit Fee exo Date Definitive Plan Approved by Planning Board }Q' Historic'- OKH Preservation/ Hyannis v ; Project Street Address Village Owner Address 1 � _ Telephone t Permit Requesti r�.�E,�..� i►.�o �`o� Square feet: 1st floor: existing87o proposed 2nd floor: (existing 7aAD proposed Total new 0 Zoning District Flood Plain Groundwater Overlay Project Valuation'Soo Construction Type w 1W Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family:: 0"' Two Family ❑ Multi-Family(# units) Age of Existing Structure 1`?5c> Historic House: ❑Yes tt-No On Old King's Highway: ❑Yes dNo Basement Type: 0 Full O(Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing t new 1 Half: existing a new Number of Bedrooms: 3 existing o new Total Room Count (not including baths): existing new o First Floor Room Count S Heat Type and Fuel: dGas ❑Oil ❑ Electric ❑ Other 4 Central Air: ❑Yes YNo Fireplaces: Existing INew O Existing woodkcoal stov_ea., ❑Yes O'tio Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ®-new"size_ Attached garage: ❑ existing ❑ new size _Shed: 8"existing ❑ new size _ Other: ; Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes OrNo If yes, site plan review# Current Use Q tip. lr, Proposed Use �� g—APPLICANT-INFORMATION (BUILDER OR HOMEOWNER) Name C p, LYJLPJQA�'� Telephone Number '��"� o� `'�6QrJ L ��Address .� 1�rs� (,�( License# 11 OD Home Improvement Contractor# 'J�� Worker's Compensation # Vh`IV. l{ -� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .a-, ,6 SIGNATURE _ DATE _ i ` Q ti FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. .r . `ADDRESS VILLAGE OWNER DATE OF INSPECTION: I '> FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLANINO. F m lice L unzmuuweuuu ud lvlussucuuseus Department of Industrial Accidents Office of Investigations IR t 600 Washington,street ' Boston,MA 02111 c }� �,.--- www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/fndividual): �Q( �, ¢� f _ Address: JDq& rnaIj(► S'l. llf� 3 " p.®.f601 111 City/State/Zip: Itk , MA 62,&V; Phone #: 08 q:zB'?,o Are you an employer?Check the appropriate box: 'Type of project(required): 1. I am a employer with 4. ❑ 1 am a general contractor and 1 employees(hill 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 ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' y p �'� 9. ❑Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑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 till 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. A Insurance Company Name: G5 � Policy#or Self-ins. Lic.#: C &4907' "[L^'T 2— Expiration Date: ®&[zz/Os Job Site Address: (T� � O.A"_ 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 of der the ai s and penalties oj'perjury that the information provided above is true and correct. Si nature: -Q'��'� Date: �I 6 a Phone#:�I- ` NZ Ito 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 h Contact Person: Phone#: t. `License: CONSTRUCTION SUPERVISOR n Number:CS 094500 Expires: 07/2212010 Tr. no: 94500 Restricted: 00 JAMES S PEACOCK e PO: JY 171 OSTEVILLE, MA 02632. � Commissioner _ y Board of Building Regula ons and Standards tl One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor'Reg.istration Registration: 151853 Type: Private Corporation Expiration: 7/7/2008 SCOTT PEACOCK BUILDING & REMODELI JAMES PEACOCK PO BOX 171 OSTERVILLE, MA 02655 Update Address and return card. Mark reason for - Address ' Renewal_. cri Employment Lost U �:ry I i�+ 501N-051U6-I'C8490 - v 5 ✓ar l^cirra�coaacoFccrl>� r�,_(lrJJrrctzcc6r,1�6 13uard or 13ui1diug Re;;ulatious and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. 1f found return to: g ': Registration: 151853 Board of Building Regulations and Standards Expiration One Ashburton Place Rm 1301 :--_ . Boston,Ma.02108 Type: 7/7/2008 Private Corporation SCO T T PEACOCK BUILDING& REMODELING INC ;AMES PEACOCK 1046 MAIN STREET SUITE 7 �� �,� T sg,rut� OSTERVILLE, MA 02655 Deputy Administrator Not valid without signature { - , „I I; I r, II' ,I, 1 (�.�lilHl 11'':i I� ., i l f{ Val, !`i H :::����.11 '(`•�-`i!:.i; __ Ib _ "'rtt pt 1'I1 ( Ir..,, ";. I' II j I t'I� M 2D07nt ,I GATE�., , . -... ; :,. . ,;,1-• . ]�}nr!.1!E::r;:n� : ._. —THIS CERTIFICATk I INII)r,...,., ..+,,:,;�s_r.�sli,TL•hLtu,.b;;S�l;r.�::..6_�. '-i`11�T: i:L: ; R OF INFORMATION • s`Iluv-L•, ,;,; ::•:;;c,./:Ic.._' _ a..,lt�_ �'i1 S'ISSUED AS A MATTE PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE GERMANI INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 908 iVlAlld STREET °- a ALTER'THE COVERAGE AFFORDED B TYFIE POLICIES BELOW. pSTERVlLLE,MA 02855 _ . = COMPANIES AFFORDING COVERAGE COMPANY SAFETY INSURANCE ' INSURED COMPANY AIG AMERICAN HOME ASSURANCE CO. SCOTT PFACOCK BUILDING 8, REMODELING' " . .---" PO BOX 1.71 COMPANY OSTERVILLE, JVA 02655 C COMPANY tiD -! { I,LI ,?a{"qt�'; '711:n1' 7u:ai(fa'1;:L:i�_�jli°!�' •;tl;< i;n!gi!s:�' jn. .. .. ....-, ,,.,,.�,.:,:^r: :•a 'i rx; .JP I .a.r., :.p., .•i ,h[. `till ritJ: _'.:J.dlJ.'+L•':;.4:c3iiN:lnL''ei; I ,l, .,1:4'k7„.) •',:11,.� .,lr: ...,.r :.: •. :.i:'{ ,S' -a,!!U•,„[•.{ {:. :{I,k:, ...I.: .,., :,a• I, .._:-n.I,�:Ill,rs,I,NLIr:, u1i�..:.d..S:,=:u�,:;'.:.._L;1.�:aifaG: ,u o a. l.-_..... S ,.��_•7Jlar�i .L..,_,.,....,:-._,...._::_.,,_::{,ida.•...::ra,N:::c;arB, THIS IS 70 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN I6SUED 70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS 1 SUBJECT TO ALL THE TERMS, TIDNS OF SUCH POLICIES,LIMITS S HOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDI _ __•••. _..- _.. -- —7" . �LT POUCY EFFECTIVE POLICY 1=riPIRATN)N LIMITS R TYPE OF INSURANCE POLICY NUMBER DATE(MMIDWYY) DATE(MMIDD/YY) GENERAL AGGREGATE ?A00,OOD GENERAL LIABIRITY $—_ A CP00001152 07105/07 07105/08 _ PRODUCTS=COMPIOP AOG s _... x COMMERCIAL GENERAL LIABILITY - PERSONAL 8 ADV INJURY _ S CLAIMS MADE IF—I OCCUR --- --'EACH OCCURRENCE - OWNEA'S 8 CONTRACTOR'S PROY ' (Anyone Pre).FIRE DAMAGE _.. ---.... . _— -- MED EXP (Any one puraon) S rAUT LIABILITY COMBINED SINGLE LIMIT l S ' OED AUTOS BODILY INJURY(Par person)LED AUTOSUTOS BODILY INJURY(Pvr pecidenl)NED AUTOS —— . - , PRQPERTY DAMAGE S AUTO ONLY-EA ACCIDENT 9 GARAGE LIA51UTY - __ ,. , ' • � � OTHER THAN AUTO ONLY!� ---• _••,•• ANY AUTO • - EACH ACCIDENT 3 •_ 4) AGGREGATE 6 EACH OCCURRENCE 3 ..—_,.._ ---• , EXCESS LIABILITY -- - — E AGGREGATE ........ � -- .. UMBRELLA FORM $ OTHER THAN UMBRELLA FORM yyC STATLt OTl4 OBI22/07 OF,J22/08 R TOa. IMlra _• R. B WORKER'S COMPENSATION AND WC-687-44-42 - EL EACH ACCIDENT - 6 1001000 EMPLOYERS°LIABILITY EL DISEASE-POLICY LIMIT S THE PROPg1ETOR! INCL 500,000 PARTNEi&EXECUTIVE - - EL D13EA9E-EA EMPLOYEE 6 1 OO,000 OFFICERS AIRE H EXCL OTHER , s DESCRIPTION OF OPERATION3ILOCATION$NEHICLESISPECIAL ITEMS ._ :.. •.'71 •;4!'"r''tf:P4 pG,,:..,4,,r'I'r:;,;;r;u...,,,„1'.'r U:::•J'r I:iiil,:� �w ',i,,r:�r�lLi::'Pd .�i�":..: .. ..... .... .... , :,:c„�,::• rr„"..�:-:-:{r:! 1Tr,r ,.,�yl,,:,�,�i:�s�6� �1 .F'•a`t)_nt•�_.,,,14y.,..,.,_ :....: :_ .. - �•�•:, .,. ...�r,te:._-� �;� .... .�..l•1.{.Lr.a,•,.{„r..1:ar�:e'+1 rl.r — I:��I;IQpp•I�/I. d1.�IC1:::1'.I II:lY'111:IIaNui•..,.,! ;1!. - -. I. „�.,l..,J!y-l. .....ror IJ,I,-:Irll'�..p!::aV:•.:11� ,•,[• _ "..:�,y.v�i: :;rvlur.Icc_'"M^'.I`.:., .-._,..)._,_'L:.d .,._.,�d�ia!,:d�•� I - - �1� f�nhICA78!N_tl,rArti_rFll:r}f:l..l'I,U.«1A'::. CANCELLED BEFORE 7HE SHOULD ANY,OF THE ABOVE DESCRIBED POUGES BE ° JAPIRATION DATE THEREOF; THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ° TOWN OF BARNSTABLE 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE;NO OBLIGATION OR LIABILITY FAX#.508-428-7625 OF ANY KIND PDN THE COMPANY ITS AGENTS OR REPRESENTATIVES. . � AUTHO REN,e•+aTATIV�{irlodl . VIt/bv�'IW �i//'{/�'/i'6'6'' r p r•t r i.,,,: ( I,I i I� rri 1L1r'I"� - ,. •..,.- , p „„ i , ; I ,,�e- N { nn�gT ;Ik �IV,jlj�fi I:alf f"�I'�flfIIIN't��P�(II��I•,!�III�I!�I��1_I'�I 21:'�JW�+S7Rp�.t� e-I � - -it Pslilx'4 ,r.,,i`:n,:,:Lt9l.:'�(:e�:'I;;1�_'1�'1) i:!,!�H?i�i?�ii�{I�!ft.i,:'•'j!waPrll•{��illi.:!;:,�:!•�'������{I�..1�'���.,. � ,[, .._L a,,�:,/ ;;L� 1�1,?e:{.-.. e. a II � Yap F, Apr 01 2008 1 : 31PM HP LkSERJET FAX p. 2 _ oFzlE, flown of Barnstable Regulatory Services SARNS ARM y uaes �, Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www,town.b arnstable,ma,us Office; 508-862-4038 Fax: 508-790-6230 Property Owner Must Cornplete,and Sign This Section If Using A Builder I as Owner of the:subject property,. hereby authorize to.act on my behalf, in all matters relative.to work authorized by this building pernzit application for: (Address-of job)• ; Signature of Owner Dat Print Name a If Property Owner is applying for permit please"complete the Homeowners License Exemption Form on the reverse side. a Q:FOR[v1S:OWNERPERM ISS ION, *Permit g�� t r Town of Barnstable # Og61 'b Expires 6 mon s rom issue date Regulatory Services Fee 61a,6 mxwsTABLE, : ThomasF..Geiler,Director � S PERMI MA89 ii��99 9�A XPR 1639• ,�� Building Division rf�"ara APR 0 Tom Perry,CBO, Building Commissioner 12008 200 Main Street,Hyannis,MA 02601 www.town.bainstable.ma.us TOWN OF BARNSTABLE Office: 508-862-4038 - Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address 6 7 o�/� f ` 1��i �-/�/`$'� s�p ' (prResidential Value of Work (TV ' Minimum fee of$25.00 for-work under$6000.00 Owner's Name&Address �" t Contractor's Name !l� �ln� Telephone Number,C Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance Chec Ei'l am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box). . Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going ovei existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic Conservation,etc. ***Note:.. Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required, ti SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doe Revise020108 r' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations: d 600 Washington Street t� Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly.. Name(Business/Organization/Individual): /L,i9'� Address: City/State/Zip: Am)164 d94 tt4t- Phone.#: Are you an employer? Check the appropriate box: Type of project(required):. 1.❑ .I am a employer with 4. ❑ I am a general contractor and I loyees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction .2: a sole proprietor or.partner- listed on the attached sheet. 7...❑Remodeling ship and have no employees' These sub-contractors have g• ❑Demolition 'Workingfor me in an ca aci employees and have workers' Y P tY, 9. ❑Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑. We are a corporation and its 10.0 Electrical repairs or additions q ) ' 3.❑, I am a homeowner doing all work officers have exercised their I l.❑Plumbing repairs or additions P� 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. L / Insurance Company Name: Policy#or Self-ins:Lic. #:. -33 f D Expiration Date: Job Site Address: City/State/Zip: 174'� ltZ4 70— 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 tip 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the a s and penaltie perjury that the information provided above is true and correct. Sijznature: c Date: Phone [6.Other al use only. Do not write in this area,to be completed by city or town official, r Town: Permit/License# g Authority(circle one): rd of Health '2.Building,Department 3°City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector ct Person: Phone#: Information and Insttuctions 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 bean 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-contractors)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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in_._(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.),said person is NOT required to complete this affidavit. The Office of Investigations would like to-thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-774 Revised 11-22-06 wwWmass.gov/diet i Town of Barnstable MUMSTABca, MAM. � Regulatory Services '0rfn '�s Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis;MA 02601 www.town.barnstable.ma.us . Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject subjproperty.J hereby authorize D �� �, n�.�,-,z,��(, to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) -0 ignature of Owner Date l��e ('60 Print Name Q:\WHFILESTORMS\building permit forms\EXPRESS.doc Revise020108 Town of Barnstable Regulatory Services sAxtvsrABcE, ; Thomas F.Geiler,Director ' AM 1659. .�� Building Division AtFp�� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Officer 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners.to engage an individual for hire who does not possess a license,provided that the owner acts as Z 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 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 form7certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC 1 s Pa ��yx. ��2wuzcl Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR �1 Registrar oi�,.1.25868` _Expiration 317/2010 1 ;r, TrrX 263004 t� �T �e 1gtlii i�dual ' K.A.HOWARD !' ----J! x�, r RICK HOWARD rQ + i 405:QUEEN ANN RD, Jrf i HARWICH,MA 02645 y" ,; __ _i Administrator Au j License or registrat►on vali It found return to: idul use only before the exp►ration date Board of Build►ng Regulations`and Standards d One Ashburton Place Rm 1301 1 Bostcn,Ma:0210$ J i Not valid'without signature G `r . License or registration-valid for individul use.only ore the expiration date_.If foun bef d return.to: a Board of Building Regulations and.Stndards One Asliburton Place Rm,1301 Boston,lVla 02108. j Not valid without signature • Will �eM v 1 � r r 1 i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a `I 0 q Parcel Application# Health Division 1113 6& z f�yIy,., Conservation Division Z_ ��3 � �G� Permit# Tax Collector Date Issued Ps O (0 _ Treasurer Application Fees CJ Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board EXISTING SEPTIC SYSTEM LIMITED TO�_#OF BEDROOMS Historic-OKH Preservation/Hyannis Project Street Address Village a- Itil�.l 5 T" (�,D IZ-I 1 Pr O X 6 4 0^U Owner LA-S Q. `b L-+,DY TE Address 10 Ate° Telephone 5-606 — �IO2l � $ -- Permit Request Square feet: 1 st floor:existing }0 proposed 2nd floor:existing 60,Q proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1•Soo.dp Construction Type 'Deck Lot Size - 1 4 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwvelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure S_-S Historic House: ❑Yes 8o On Old King's Highway: ❑Yes Yl o Basement Type: ❑Full Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) C rLCA -r-)I Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing -3 new Total Room Count(not including baths):existing 7 new First Floor Room Count _5` Heat Type and Fuel: ®Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes trNNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes 81q—o— Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing Qsew size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: 2 Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ 3 w � L Commercial ❑Yes 6 No If yes, site plan review# =P 7, Current Use Proposed Use BUILDER INFORMATION Name AL � LA"0 if I Telephone Number Address License# l J` �=1qxxtx,Wo y 7 1 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE iD FOR OFFICIAL USE ONLY r • 4 PERMIT NO. _ DATE ISSUED % MAP/PARCEL NO. `. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION J FIREPLACE ELECTRICAL: ROUGH R= FINAL X to PLUMBING: ROUGH cy FINAL GAS: ROUGH O FINAL FINAL BUILDING 0 ct rr W c` rn DATE CLOSED OUT 0 ` ASSOCIATION PLAN NO. f 4 � Er Town of Barnstable Regulatory Services Thomas F.Geller,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www,town.barnstable.ma.us Office: 508-862.403 8 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c.142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or constructipn of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type.of Work: 0 � � Estimated Cost Address of Work: a 0 44A, Ul Q L4� -Q t Owner's Name: AuA 4,g�" M,0-f3 q l P Date of Application: D I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied .Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH.UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a ermit the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name QIb ms1omeaffidav Department of Industizal Accidents Office.of Investigations' ' . a 600 Washington Street Boston,MA 01111 y�y www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ]Please Print Legibly Name (Business/organization/Individual):_/�1 1� 8 t%A.o u rrz: Address: 010 : �l d - Uy e, f l u i o7 r 00o 6 -7- City/State/Zip: Phone a i-6 Are you an employer? Check the appropriate box:. Type of project(required):• 1.❑ I am a to er with . 4. El am a general contractor and I ' � y * • have hired the sub-contractors 6. ❑New construction employees(full'and/or p art-time). 2.El am a sole proprietor or partner- listed on the attached sheet# �• ❑ Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition workin for me in any capaci workers' comp.insurance. 9•g capacity. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑Electrical sired.] officers have exercised their repairs or.additions 3.B I am a homeowner doing all work right of exemption per MGL ME] Plumbing iepaas or additions myself;[No workers' comp. c. 152,§1(4), and we have no 12.0 Roof repairs insurance required.] t 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-contrabtors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the pollcy 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 andexpiration date). Failure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminalpenalties of a fine up to$.1,500,.00 and/or one-year imprisonment, as well as.civil penalties in le form of a STOP'WORK ORDER and a fine of W to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under he pains and penalties of perjury that the information provided above is true and correct Sim' i ature: A Date:-. Phone#: c�.c�-(4J .68 6 al Official use only. Do not write in this area,to be completed by city.or town official City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.•Building Department 3.City/Town Clerk 4..Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires`all employers to provide ww r f an compensation their ebVloyct of hire, ' Pursuant to this statute, an employee is defined as ...every person in the se other and any express or implied,oral or written."' , association,parporation or other legal entity,or any two or more An employer is defined as:. indivi¢xa1,:ParkpershiP 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. Howr er:-%e- occupant of the owner of a dwelling house having not more than three'apartnients an��hnouresides otheremwr�the tin such dwelling house maintenance, repair e of another who employs persons to do _ � „ dwelling boos k appurtenant thereto shall not because of such employmentbe deemed to be an employer. or on the grounds or building 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." ter , 7 states"Neither the commonwealth nor any of its'political subdivisions shall Additionally,MGL chap .. 152 §25C( ) eater into any contract for the performance of public work until acceptable.'evidence of compliance with the insurance iequirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by cheddug the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone numbers) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(L•LP)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 inn rarce coverage. Also be sure to sign and date the affidavit. The affidavit should Accidents for confirmation of be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Shouid 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 then 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 boom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be saviure to fill in the permit/license number which will be used as a reference number. In addition, an applicant le permit/license applications in any given year,need only submit one affidavit indicating current that must submit multip policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in L(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 liceases..Anew affidavit must be filled out.each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The office of Investigations would I&e 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 �. ofee g .investigations . ,. .600•Washingfon Street . Boston,MA 02111 `Tel.#617-727-4900 ext 406 or 1-377-MASSAFE Fax#617-727M49 Revised 5-26-05 www.ma'ss.gov/dia f oF'THE,o,,, Town of Barnstable Regulatory Services BARNSTABLE, : Thomas F.Geiler,Director 9 MASS. �p 1639• A,� Building Division rFD MA't . 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 EXEMPTION Please Print DATE: 0(' In� V/�6 JOB LOCATION: ,� �l ��lse,�c.t .I // el"T Nc�, number / street 'llage "HOMEOWNER": A1.�'�� (�J� ��� !c�4 , 5-0,P—,Z 6e664- name n ]CJhome phone# work phone# CURRENT MAILING0 ADDRESS: R': ' 9 4)a'fT— A�Unkt y R O.2 LQ�2-6),;2� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as su ep rvisor. 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 procedures and requirements and that he/she will comply with said procedures and requirements. Signature of omeowner 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:forms:homeexempt 10/13/200.5 10:35 5084205553 YANKEE SURVEY PAGE 01 .r 1_r' LGT_A C F �LSTLCTION APPLICANT A MA GLAD? TE TO W.N.' TYLTST ,14 YANJVTSFORT a - LOT 2131 LO T 198 100,00' LOT 215 Qz LOT 196 ___, 1 t --_------ -9a— — o LOT _ - o LOT .194 a 1 /i 100, 00' LOT 219 LOT 192 A 1 6 < SiSPHrPd 1 J. n R 4 CUYL� P A r1,00D FAIVEL, 50001_0008_D FLOOD ;,'orVF• Da�En. r/021�199 P� I hCMby- certify that t.b s 1]fort�gaqe inspert..it�.rz plan was prcpr�rerl fpr; Plan, in For FIRST IIO,T�IZON HOME LO!I,NF Bank Use Only IT12c locratJo.n of U7.e bulldine shown d2Ps ,,,,AD-f fall Witbi.n a spocial flood 1,7.s7ard zone, FLAN REF, = 34 Aer taped inspect.Joo it appears the lacotten of dIMIliog does ------ conform to the local by—lA�ns —�----- in effect at the demo of construction wall .re$Pect to horfacnt.al dimensional setback rrryuire.,M. .s SCr�JF Z = �( __ F7' or ig rxr,.r77pt frtlrn vioiabon rneo,rrrmrnt activn crrrdrr .dins, (:rn�ry=I LaMtr Ch. 40A —.;rr, Date. pl. 114"FE NOTE. The structurrr an thm inspection *err lorerd br tape not .ins2rr,mrat nad ore approximate only. An actual survres,Is necessary for n nr0oise dete)minauon of thr 75udding location erid rnrroochments, Y Any exist, richer wav across property lines. This inspection must not hr vsed for recording purpn:n..q or.for use in pmparing dnAd descriptions Ar,d mrapt not be used for variaDce or bedldinq plan purposes. 9nis itl.:pr,rtion must not be us Cd to .tncete property lines. yrrilirnuon of building laentions, propertv.line dimension.-, frncw.7 ar lnl rnnflgrn'9t.tr,u Can 071,y be nccamrlighrd bJ�an accurate JnFtn,.nrnt Tupw- pOich may rrfbwt different informntinr than w17nf• Js 9170trn hel'P.Cn. Tbi.� in^prrtinI is not to hr, used for any pmp&,rer othr,r thhenn mortggsg7ee... Ynhlmr .Sarv;?;, a/rceepptsT no rr_sponsit>.;litf Cfor damages resul�unR from .snid reliance. rr-N)VE 50B—4,W-00,55 '�.J. "�If, L', SUP k�,�, 1 CO-Al ti?Y�T�d �1� ���~ F.9 Y sOQ,ezO—,5t5,,3 UNIT 1, 40 IND913TIFY RD MARSTOJVS MIT,T.,S, .MA. 0?,546 38005 'Af �.• s ON Ce*AA-Ievt boo AWt -- Me V uu � - I OCJL OVE Is 0/ e � a x l a k�G Ae3e76 I a • • As&essor's 'maps-and.,lot number /;I" a;9. ...... A0, 7, SEPTIC SYSTEM MUST BE c +`t • �:' .. . _ Gt�� -��� INSTALLED IN COMPLIAI� •- f 0 Sid,age a it,number .......... .... .... ........'..... V�IT nn ��.. � ARTICLE II STATE �„ z�ANITAZY THE COD D. OWN T B A It k : r, r. T O N RTA.B CO i BAU TSDLE 1639•a.0� ��XASL .x. D�UILLDING INSPECTOR a MPY t {;i` w of APPLICATIOWFORwPERMIT TO.. ...witJi..tuss...roof.- c.l.ose...i.n..s.creen..porch.. and,res-i de 'house with Vinyl clapboards;. TYPE OF 'CONSTRUCTION .... ............................ ... ........ ..................... lJoOd o ;• �• , ` .... E.eUb.ry.. ................. ....19.7..6.... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the. following information: 215 4 th. ave. West hyannis Location'.............................. ................................................................................................................................................. Sleeping area. ProposedUse ................................................................. ........................................................................................................... "Zoning District ..........Fire. District ............... 4 ......:............................................ ............................................................... Name of OwnerTT���!?/ :...1'lC� j! .. /..Address Name of BuilderVicto.. Dormer Company. ••••.••Address 255 Union street, Braintree= 848-2627 ................................. .................................................................. Name of Architect Donald Roe...........................................Address :.255• Unign street•,••Braintree, Mass; .. Number of Rooms One is exi ti n Foundation ..........................g.r................................................. Exterior Vinyl clapboards. ...Roofing .240 1 b. seal tab roof shingles.•••••......•,••• Floors 3/4" boards as sub floor. .Interior ' .... ...... Heating ..Exi s ti:nA..... Plumbing .�.Xi<2n4I...xen. ..p.i.p� ..................................................... ..... Fireplace EXi sting-• R4i s2 ch•1n111��...tWQ...f.��t...d�A.V.6�pproximate Cost . the ridge. .... ..................." ...v... r...... • Definitive Plan Approved by Planning Board ----------------_--_-----------19________. Area '- . ®... .`........... Diagram of Lot and Building with Dimensions ` �a ,�[ �" Fee .............. ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH s ge 6101— r bo 4' �{df�s c/C/ e ase/IV qpaq N A D • he agree to conform to all the Rules and. Regulations of the Town.of Barnstable regarding the above construction. Nam ... .......... ...... ................. Tamita Realty Trust 1'8196' add find floor No ..... "Permit.for .. ............................... to dwelling ............................. .................................................. Location .. + 215 4th_Avenue - �= :.......................West Hyannisport.... ^ .......... Owner ' ; Tamita Realty Trast r ,. Type f..Construction....................frame �........... Plot , ...... ti. ..... Lot ................................ Permit Gran"ted ...........February 26 19 76 f _ -. 41 Date of'.lrispection ...... ... ......................19 ; Date .Completed �.( ... .....:..... .19 PERMIT'REFUSED - -- n � ,..n.... .. ...................................... 19 r. ..M .. ............ ............................. � i ^r :.t. ..... ..........................................................r Y' ., � �� . f r• � • ems, - `�. y. Approved .................. ...............:.. 19 . ...................................................... �•t', : , .................... ......................................................... • `'t, Assessor's map,and lot number �'"'.0 ' ... ...... ''` 4� � — .2 -;z li'— 7 G J Stwage Permit number QyofTHEro�♦ ,TOWN OV BARNSTABLE L BARNSTABLE. i "b 9 n w - BUILDING ' INSPECTOR aY a ' APPLICATION FOR PERMIT TO` AO 1 ri„car nnrll nyPl„with +iiSc Yon _ rl nco„i n' cz*rv^oan„nnv-` and reside house with .Vinyl clapboards. TYPE OF CONSTRUCTION' .......... ................................................................................... ^- ........................ Y; .ry_ t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 215 4 th. ave. nest hyannis Locaiion ....................................................................................................................................................................................... Sleeping area. ProposedUse ................................................................................................................................................................................ ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner7 / `li./s� 1.7�/ 7fa�`SlAddress `�D �/�,%!LJ 1i� ice/ /Os7,�.c�,r1� . ........................................ ..... .... ...... 'WI Name of Builder Victor Dormer Company '......Address 255.5.. n?,on street, Braintree- 7 ........................................ ................................................................... Name of Architect Donald Roe Address .. `5..Uni.on street, Braintree. Mass....... ........................................................... Number of Rooms one ....Foundation ..... S eXi t1 na. .............................................................. ...,................................................................. Exterior Vinyl clapboards. ...Roofing 2!1:I�?..lb. seal tab roof shin�lps. c.l.a.pboa.rds................................................ ............................ .......... . .. ....... Floors 3/4" boards as sub floor. ,..,,.,...Interior .�%'' ..................................................................... ....................................................................... Heating ..EXi s ti nq = Plumbing FXipnd vpnt rii nP ...................................... ................................................................................... Fireplace EXistinQ-. Raise. ch mnpv wo fpet a�?n'Approximate Cost ........... ........... the ridge. � Definitive Plan Approved by Planning Board -------------------_-----------19--------. Area �r Diagram of Lot and Building with Dimensions g g "' � Fee ........._...._...!.��..'�...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH " D 1�.�1'i5�e 4 _T �r P /Q 6 a JC. Y�rin s N I !_ A) 07- la { I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. � i� Name ........................ .. ... ............................. ...... ..... ..,....... ........ Tamita Realty Trust A=246.-109,' 18196 add 2nd floor + .... Permit-for to dwelling G�0.4th A uelocation ... .. .... .... West HyannispoNt ` Tamita /!R�ealTrust Owner ............................. .......... Type. of Construction .... ...................... ...... ..... .... ..................................... T Plot ............... ... Lot ................................ . s P e—rurNry 26 76 Permit Granted ......................... ..............19 Date of Inspection .................... ...............19 ' Date Completed .............. PERMIT REFUSED ........................ 19 ............. . ........... ........... ......... .... Approved ................................................ 19 .............................................. Y ............. • yyyjjj Y ,% b y .............. .. ............. ................................... _ . ........ . ...... 52 r..... i mill 1 1 u :. t. ... :::.. ................................. .................:::..::...::...::.:...:..................... ...........::.......:.... .............::::.::.::::: .:.. RTH::>::: :>: OU AVE. ::::::::::. :: :: ..... . ...ate........>..Z.E —B.H.A. ............................. ........... . € . allies ...:.:•:;r;ii :.SEARCHHis TOWN OF BARNSTABLE REPORT S PLEMENTARY/CONTINUATI EPORT NAME (LAST, FIRST, MIDDLE) �j�''� ( �/:y�A_p�1• " "�n DIVISION /DHP7 NOTE DETAILS 6 OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL 1S ETC. U/ c SUBMITTED BY � �-���s PAGE Y "t,i yes r«..._.....�.-..._. _. _ t ., } jPROPERTV ADDRESS I I ZONING I DISTRICT CODE SP,-DISTS.I DATE PRINTED I CSTATE LASS I PC I NBHD KEK'NO. 0020, FOURTH AVENUE 09 RF-1 , 400 09HY. 07/09/95 1011`'00 58AC R246.109.- 150419 J LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS Lana ByfData - s o enaion Y UNIT ADJ'O.UNIT ACRES/UNITS VALUE Deaefipnon K OU C H AK D J I A N. -GE O R G E 'M pp / co. FF D th/Acres LOC./VR.SPEC.CLASS ADJ. COND. P PRICE PRICE #LAND .1 E 53.000 ; ` CARDS-IN ACCOUNT` L i0.;18LDG.SIT:1 X .1 =10 328 89999.9 295199_97 .18 53100 #BLDG(S)-CARD-1 1 + 67.600 01SI CUIN #PL 0020 FOURTH AVE W HYPT s, N BATHS 2.0. U : X C= 100 7000.0 7000.00 1.00 7000 a #DL LOT 215 &. 217 ARKET °85000 } D FIREPLACE U X C 100 3100.D 310D_00 1.00 3100 B #RR 0564 0080 INCOME '. t SE A PPRAISED 'VALUE D D 120,70O A U ARCEL SUMMARY" T S AND 153100.s A T LDGS 676001 -IMPi E OTALS •120700.1 F E CNST j E N - DEED REFERENc Type .DATE RK«cw R I 0 R YEAR VALUE S A T .. Book Page Irm1. MO. Yr.D sale.Prioe AND 5 31 00- T S 3939/112,, I, 1/83 56500 LDGS 67600 U V�1/83 30000 OTAL '120700 R E I BUILDING PERMIT ESTIMATED-83 S Number Data Type Amount LAND LAND-ADJ . INC ME t�ISE SP-BLDS FEATURES BLD-ADJS UNITS 53100. I 10100 Class Co its Unit, Base Rate Adj.Rate ,B'll Aga Norm. Obsv. CND Lac %R.O. RBPI Cost New Ad RePI Value Stories Haight Rooms Rma Botha •Fia. Partywall Foe. Units Units A I f Dapr. (`fond. 1 g 01C . 000. 100 ,100, 61;00 . 61.00 50 70 24'74 105 100 77.7 86943 67600 2.0 7. 4 2.0 7.0 1/01.00 Description Rate Square Feet RePI.Cost MKT.IND X: 1.DD M B /DATE: / SCALE: ELEMENTS CODE CONSTRUCTION DETAIL 8AS ' 00 61.00 750 45750 :. • S FMP 55 5.50 130 715 *--------------30-------------*----10---* STYLE 06 OLONIAL 0_0 C T FSF 90 54.90. . 120 6588 818 ! FMP ! ESTGN-AZfJMT- -00 ------------------`0-.-0 R B18 5 2 31.72 750 2 3790 ! • XT`E-R.wAi-�s-- -06 urMrvntrrt-------rr.D U 13 13 EATtAC-TYPE- -02 AS----------------�-O C NT7 REFINISH- -GO ------------------U=O T ! i NT`cR:LA�OUT- lit ------------------`0-.O U ! ! ! NT-E-R:OU7tLTY-: 02 AM@-Ar`EXTFR:--�:fl R - 25' BASE *----10---* LOVR-STlWCT- 30 -----------------IMX q ,._ Y E tOtYR-COVER-- -Dp ------------------�:fl D � • L E Tata Areas Aax 130 Base_ 870 ; ! ; Off--TYPE---- 3D ------- -------�JD BUILDING DIMENSIONS -L E-L`fRIS-At---- 00 ------ -------.-`0-�O - T - :. ! 12 .12 OU D'ATiU-N--- 30 -- ------- -----94:/ -. A S12 W10 N12 E10,.. FMPrW10 N13 !' _ _ _ ____ _______ BAS. S25 -818 N25•W30 S25 F I -- -----NE G-WBORN D -58-AC-1tYANN-M ---- L E30— ! FSF. ! BLAND TOTAL MARKET PARCEL 53100 120700 AREA 5265 VARIANCE +0 • +2192 STANDARD 25 s ;�. a•r.:'S .. r f ` p rj ,, - , �,.� � t � � .an o'� r.,.x� f aWi: "w �"�+�i" '� F. yf _ NTIALz .(�I jY� � ".1llY._;��,��� • r• :RESIDEA .�PROPERTY�. ^^q N•ilF W� .°r,.'Y[_.. P '. ^.;; •µ 14 'q:d.wr'rn`n- ws-.tft � 2'J.y�4' ..:Sdn- '.13�73.x� : r ..', ,s .FIRE'D�ISTRICT LOT NO �. �F'.ti�r MAP,NO: : STREET2O F''bUTtYl AVE. it W.µ H�7dT1TL1SjJOT"t� - f� 4� SUMMARY'= �i P 26�cit 1�9 3R. r.,' Y ,c r rit" 4 H cta 73 LAND, ��.?s£ art BLDGS al OWNEF2 GUlra , r q. , a a I ' "-"`� t TOTAL v 7 *yc - • -, 'ir LAND +� RECORD' OF TRANSFER DATE erc I' ac i.Ra. REMARKS X.a 75 w /S r �i �o - Z' _ •�... . BLDGS;- � }.r- n+.x.t - fdiv _• D Q -..TOTALS e B1821• BLAND � Uegnani,,:Anne. V ,� Tr: 'Tamita:.RltTrust 6-16-75 2196 298 $16 9 (f BLDGS; 2 3S6t or N � ;►O S PF.L L"Y�°,/3;11I'12 A. Y1LR ©3CJ 0 t' 1 I 4 s TOTAL �f`�'t ej `•' r :., 79 '•LAND.: a„ r1 rr i rot BLDGS: s :. '� 'TOTAL�+. ,ka+ LAND °K t c.-.,� fl':• n * �' .eti kw S -�.. .r '� .'� *s i- r'�- .,F .� "�•FF"".x s Z 'BLDGS x : ';: � $ a +'. � "•-� s J.,'# c ,?•Y?.i#s�^�:sr�j*a- .t .. r.$.r+.i}•a'9$-_Ra "a ayft.z`sue •�7 .ET..,, ; .. :. '°r` 'TOTAL Ez :. •+�twc',; F� ..rt: {6F.• {;.'a#, '` ^• .' '` �' Gp•/N �- C 1 �•"=•r= IP131e�1�'?�'���/g(/� � :� a��xN, ,.•.�{ aLA Ds,�� � ��� t, i, 9 � �r rTTy. '/'� ''c+'•' `.BLDGS. r•k .,, „H.w:h*r••.w:•�x^g � ,-0) N. i•.� t ,upM :,?a Y•{d r i :,yi i;' .ra:: ."#�a.=•�p-,_ w.d '4. rest TOTAL- :c._. - ',.xf. m. e a». .,:...,....•e ..'.. e, .dt rm 2@ - 's,i'.':,'> • x, ,"• 'dr....,.. -...i.-a{. .ak r,. ,.. ,j_.: 4111. '.tr.... fr. writ ",..:� •3'n+.'� � ,. .hL... h,L��::. � Y.,•,...... .;. „t.au ,.+,:.. :: .,. 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'L : ... r.. vn 4. , §�: .h � a3" 'ia ��.,�,A..r•`_:�:•�' .•r� r�, ;�, k�`.:t ,. .._ ,., . ,,. x. ..-.r.. ... -.,. .... .0 :y. ..:+ .. f:, br•-�.,.,^wta- .. 4'X.t"':+,k 'i.•.•+rn'.':...,a.r•5,i+r «• v"`•a' >r•`LAND, �u :d3� . +,..,., e-4 .. P,2 v,. :,. r ::. _ •, ..„,.,.,. it i k W, ¢•,�' '_ "ili g•',p t sRr :r q'� ,., S. ^?5- �:`!'+, Yy'M ^�+}:.wx.. eR"5'¢� n7'R ia+. d _ rt ..?ti'iQcst .:Y.u,,3.+t.,.,'... rs+,. T,i..w y. '.:..c•. F. -... - ,�.. ,..t,r :+a5r *_,.. ., f`ej; � i ,u.,,,r j ,q: "in..p,�;+,;g-9�`.t.$: .r $'F.., ,.�S ,a,s. C6-a.,,.s-- F•"lY.a� '� - -:s.�g ..ra ::aan>u. ..... .:,:..w •.. i,..,._., .4. - .>:. . .x .r.,, . • , ,yl s.,[>_ h [rti,,... s .r-',.r. .: .d• ;: _. , ,..:, ron,y :. v.Z. t:' h• ) N G t - 2k`,R' :ti:.' u BLDGS., .. a„ 1 � PELTED:^, :< .�. '�. .-4,.. �i,.r I �� �„ �t t-r `��`• :s,:,�'�`�r >�„' t _ax,x �IN.T,ER.OR.INS y � . ,;:. .,� .H ly,n, x ., II �'x ., ,p., ,�;' s'"�..r �1!':.+•..•�, �.aT � �*�-rz' s� •�, � - r�:;.,.., .•, .• . s n, ys, .,?F: S�,e. " •}fir rY jm ?..%:y."s�``s'-.2�+k"`=3!$a'A{�, :"ra�S'I} `-•r-" E ,t....9% OTAL..;' ,.t .fr yf �F �F,q ,R�_ Bit 53,.:n f.7'..,, _ •".'4. s':. k. :/`i ;" '.,a,�Qyi` ;- _ x ! : c naic. :#1. r4• :a + u, dre ..LAND>>:' I .';:.' a:.d 3.�1is-3.- ,.-..f.�t t[i�l -.+'� }i'n:J Y� :L"� 4 tt{4 lr$Fju' •..� _���� :[• =r. +-.5.s. a ,d. ti =r`: � � :� 3$' "•�"�+"3r �"''"�s" �., �r � "V' - le �cka ACREAGE COMPUTATIONS' .� 3iBLDGStt1z, t' w r _ Y'• '.,�„ :,.. t ...n'1-. 1 LAND..TYPE '#�.OF'ACRES ".�•; �-PRICE- . TOTAL•, .: DEPR. ; i Vt'. '`^, .c""_.r•. tom`'+�+�' '"" �*'' L'' s w edi#V VALUE TOTAL :,. vJA"4o ww4 S' - _ ; §y l .,•'s 3 N ma's >fi\.+ ,[. p- 4.. .^c: �44 �. .."-. a : •: �. - el. 't,,.n -F.«.. L'[ „`2a�i2ei X..vs,.".e+e97&•:�1: ��"... .wN»�': "xs`;, 'i" w ..:t - •IiOU$ Al s h rz. C'J00 / �ly �i '*x r,: pr in q rBLDGS +*;: CLE;4 ONT =• ,,w t ,... , . , �_ >a� ij ��6 � c"+ t'�`rw �,� -: 7,0 .i - i4- ` _.z �}� � �&� ,..t��i. r �' x•. ,vy.. e^}s•c� �,- yFOI+. ( ": . EAR r 4: R + i t e;'•Kt31 ' t d , : 'i TOTAL r w- t ;•v L „, .7 t 'i� q ty ii. qs X r Y 0' » ;a+Tf,•Ba-ate, �. r' t WOODS&-SPROUT FRONT - r F, §Y#s";a. i .s " .,�fi v d � ..« i�„ r k ,.�• ''LAND ,. :'J.. kt''!,, ,,%,., ,-t, a r j, + Yd:_ ,w 3'�,Lr 'w:�:3 ..z. ct,. Rit�€`�isStigst .., �:;. .',REAR.» :_Az�« r Y 1L., r. a. ...�.,,_.,,.. .:. c n,. ,. ,;a �,,r •%s„ i. i't. '�a. �t� �� Q164 B � WASTE 4RONT '`LAND' ` -.pyyhnC+gy. .v " k • REAR ., w, t -se L• H c: s " t•"'i, ':fy.+°1: '$.. ti' .3'x tr `ate ,n, t ..a +"..BLDGS`';: iLTOTAL !/:. `•'Y .. .f .t 4 ib"'E # .ti .^� Lyk?" ::.Y .:T•..i"'fw MC, .. �• r#+, � `:i r i��e: 1 ^., � .•- ,> LAND tt 'Sari^ `rt O 'Q,�#..�' ~O Or ''a:, % o +, .w- F # ,BLDGS:- �i # r'' dam+ LOT COMPUTATIONS' +':_tf," A r. ` z -i 'LAND FACTORS' FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR iINF: er,':'+'VALUE " ? cr ' "LAND t p HILLY< TOWN SEWER_ ra `TROUGH F` TOWN WATER'-' , *BLDGS" K A3• �: c+ GRAVEL RD. t,. To t" ;,,; -'DIRT,RD. .LAND t`m,uix 4asAitS+''«Rt i BLDGS.. ..;a�l'•f3 t, a;r F SWAMPY , NO w : 'Sp a°c.} D !4^1':' r •} i ss6 '� c s s �. { t Ol. —TOTAL .I ; 'r''t a'^[i''•fw ;..44alis � firr,Bslilt Area a Bath Room4 Base r _ _ :B Cones=.BIk.,Watis. _- ,. 6rnt.rtReC Room - St.1Shower-Bath-. r <-r �" �.. Bsmt. F3 L t - - _,,. PURCHCDATE * y�i �,«;' + "' "":Ifi• `�-` t a . ... 3 z .Bsmt.Gara e:-,ik h.,,>>_,.� ., .St:t-Shower'Ex z�,:- r �.. -:,.�xi.�t,> µ:a•v;,. �-u:Frsr� _ +- 8:.:._ t• -.r-, :. `+•y W8115 _ ;"'s rr: t r , ^3:`�,'-•• '� , : e 'tea, - x... ; Brick.Walls. x -.s.. :;AttieFl.&Stairs Tmlet Ro �> URCH PRICE. .-t a..,-. x ! 5 xf om r k, �.. .,. _ .: � ,. � _ s.-.. ,Roof °..; - - •• � .:� t ,_: ....,_ _ _� �,.. .., ;. ` kt� .,:RENT Stone W fls-, .. �s::s F '°Attw fi;-�,"�a �..�. .. $ - _ - r.. a ` .,a ..^:. wa,,,, z m, ,.>s:. _- _...,,, �., , ..Two Flxt::Bath ,...�-- •,� . _,_.> f- --„� _ ,: Floors-•o��`� "' -r r ,�: �.'. . .-,rw.' .,kf,c.,. ..::.., ._. m- '.rM „F :+ins t.' �; - k Piers'- +may: ?�,, }„> ;*INTERIOR�¢FINISH '. Lavatory:Extra � k- -•. x - k` y Lr: �� 'i'' 2'.,'v. >�":,'p+,3A .�' rti:i„^.. _::,•,:31: � :' ,' ... -,1 , : .,� a.k:-• ka '�1 I 1 Y':. - Tn $ c-? s L Bsmt: ^.F=*.y �$. :- ,.- ..,. .h ;�; " 1.: :2• .,3:.-•.Sink a:*,. ..t`;� e S'Ya,: r..1 �: �„�s� s• €;. * �' tcx, r; .t ; . .: ,. � >.,- ,. ... _.x, r{. z. Attie�+ ;:# .^I- :r , , �k Plaster r' ..h., .� � t ,�/ •r,r/x-.r,.�na;/a.�rt .. .... v+ Y:�g ,� � ,.: "WaterClo.,.Extra,:,'� .'s �,iS4 r ,J... , .. E 10 a A Knot .P ne of ..�. XT.ER R>�W LLS .. b, i �«gin„ -_^� � vY_,. Water0 y.. �k�:..,.,, _� ' + y �y :3`- I.a,. ,, rt•: �t�� ,,..v -..,.. JG -;., ., µ:..mr_.,� � :,r # ,,�- - Y,-r Bsmt.Fin iding-> .: � „r< Plywood,+= a . ..,, 'No Plumg,,. ..: � ,. r le-SidmB,,� ..:>- -<- � �'taI^ .«,x .. M`>= ,y..., - -. �;'.. . .rn, ,., i - � ` -f'xti � TLLINry- ,, "���ki_ P.. � , .,.4h,Fla Auc3f. "4 :u �:-VeneerBath.FL&Walls,. +d a ,, .. ,.. Fireplace. �� ="r .; � x I:.�a�• Corn.Brk 4 ._6 4Y k A k"3 ;G On HEATING , ,Toilet Rm:Fl , ., T..,.-.. _:.f ... :. :.....M:- ...a .,'+...,� .:..,.-`•.-. a i_ ;r': 5 a'!:. r_ Yes` ..r,. _.,. . 'Plumbing '�'•..r'S. g„{ r•.azc.A 3xy".t�, a.s y1f. jg. Rk *.'4: ' :st •:u, �,w s .,, .,k. 4 ^`r F 'i•:.- ;a#gsT' •i!g:.><. Y ,> ,,..xr s w teF.u' r. '.:"4,,•:.y ._.� - :,,?Ih, §. -' ,`.. - Y`:• ..1 .-boo,.,A, .,,'"C ,,Solid¢om.;Brk. .. _ HotAics... Toilet Rm.FI.;&Warns -vx - '., Tilm -,: r,.§'" ,; `Y< ` ,r -..:r .r:-; ,00 :: ..e= r n .r., 4,r Steam . ._.,n.. Toilet Rm.FI, *.. ....,, ,aa-_.., �.:e,:. +. 'S-.. ., : .. .......:... ,-,,....,-,-.,._.,..'... aE ,.., - BlankebiWit Hot Water. ='u: ✓r.. :St::Showera>r �.. .I: ��g •� -M+°`�� :�� >' �" �+� u9 �� � `?' f _ •,.:..,r w.-. �, ,.f'r Total. .; ,;.5�. 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'�'�az. ,,"�'6=_�.+� :'���,.r„�t?t��.. .�'ir";;,.• .° ,+'„� �;-„, ,sue,: ,,�,�.,x;, � :��tr' ca,,.L 1 ,� � ��,'� - ;K -',. i:�e�-�--� i*"'-'� ..r'�,�•.:'7.:.F:_ ,-� ^�' ,;.'q. ,-3; �2 _ :rx 'fv ifk+_. - 6 'art x 1.,•,.r �r��g e� eN�a� •.4:� '.Y-a .,aa+.1`exs 1z+ `�..:r _,�*'wsg:t4,t- t>, w�.r :-'rg e a� .o- �-. r .a:r; ...,:•y ,af:,r�: },,` _ _ ,3'.. �..�3�4A`-$u-. r �' `..3 .T^`^ .w i44es .t'aiX"t�`3s,'X't^`•�Ntfx41 t�,�. ,N::: ..,�. ,�� .., _ .�+{..`..:.�5� 3- ke•.' P TOT.: t .� ,�,:�1• :>` ..•, •,. s e' ..s 5 0.` t `'} v'..s,' ' y., y:?+.!dx. ,� a•' :„,a "' _r... '};,'+•4 xa• ^Y -,. Cs.. .h-4 as � 9. ?J� _ _ •� i BARNSTABLE %� HOUSING AUTAIRITY LEASED HOUSING DEPARTMENT TELEPHONE(508)771-7292 146 SOUTH STREET-HYANNIS MA 02601 ZONING VERIFICATION TO: Barnstable Building Inspector FROM: Leila R. Bruce, PHM, Leased Housing Coordinator RE: Uerifying legal rental unit Date: DRAFT Address. G C Village: Unit type: Bedroom size: The owner of the aboue listed property is entering into a contract with us for the rental of the property as listed aboue. Please uerify by signing below that the unit is legal and meets all zoning requirements for a rental in the town of Barnstable. If it does .not, please list reason here: Tha k you for your assistance in this matter. e ignaiure Print name Date . �1 1 Section 8 u s [ ] [R24.6 109 . ] LOC] 0020 FOURTH AVEiv'QE CTY] 09 TDS] 400 KEY] 150419 ----MAILING ADDRESS------- PCA] 1011 PCS] 00 YR] 00 PARENT] 0 KOUCHAKDJIAN, GEORGE MAP] AREA158AC JV1294684 MTG10000 KOUCHAKDJIAN, KAREN G SP1] SP21 SP31 12 ORDWAY RD UT11 UT21 . 18 SQ FT] 1620 HUDSON MA 01749 AYB11950 EYB11970 OBS] CONST] 0000 LAND 53100 IMP 67600 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 120700 REA CLASSIFIED #LAND 1 53, 100 ASD LND 53100 ASD IMP 67600 ASD OTH #BLDG (S) —CARD-1 1 67, 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 0020 FOURTH AVE W HYPT TAX EXEMPT #DL LOT 215 & 217 RESIDENT' L 120700 120700 120700 #RR 0564 0080 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE] 11/83 PRICE] 56500 ORB] 3939/112 AFD], I LAST ACTIVITY] 07/27/87 PCR] Y R246 109 . •P P R A I S A L D A T KEY 150419 KOUCHAKDJIAN, GEORGE LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RF- 1 53 , 100 67, 600 1 A-COST 120, 700 B-MKT 85, 000 BY 00/ BY /00 C-INCOME PCA=1011 PCS=00 SIZE= 1620 JUST-VAL 120, 700 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 58AC -- TREND EXCEEDS STANDARD NEIGHBORHOOD 58AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 531001 LAND-MEAN +0% 1207001 94770 IMPROVED-MEAN -290-o 250 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 10001 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R246 109 . • P E R M I T [PMT] ACT*[R] CARD [000] KEY 150419 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR oCMP NEW/DEMO COMMENT