HomeMy WebLinkAbout0027 KITSY LANE y
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App lication number .y�9 - ......
Fee ..............................................................................
JUL 25 20�9 11
7��1..�.q
� - Building Inspectors Initials.............. ....�J'.-.
Date Issued.:.....:... ..�ZS... .................................
Map/Parcel.............:....
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION `
PROPERTY INFORMATION
Address of Project: ./ 1/ZP
i NUMBER STREE VILLAGE
Owner's Name• E G7�D.� Phone Number (SeS> 300 /D,&
/�/EmailAddress: Cell Phone Number
IProject cost$ ,Z000. d® Check one Residential X_ Commercial
OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize
to make application for a building permit in accordance with 780'CMR .
Owner Signature: Date:
TYPE OF WORK
;atJ Siding ❑ Windows (no header change)# ❑ Insulation/Weatherization
❑ Doors(no header change)# Commercial Doors require an inspector's review
❑ Roof(not applying more than I layert,shin es) ,-�/
Construction Debris will be going to i"s �/�'
CONTRACTOR'S INFORMATION
Contractor's name
Home Improvement Contractors Registration(if applicable)# (attach copy)
I
,Construction Supervisor's License# (attach copy)
Email of Contractor Phone number
ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS 1N
A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED.
APPLICATION NUMBER............................................................
*For Tents Only*
Date Tent(s)will be erected Removed on number of tents total
4
Does the tent have sides?Yes No ' (If yes please attach floor plan with exits marked)
Dimensions of each Tent X X X
Additional tent dimensions can be attached on a separate piece of paper.
Purpose of Event
Check one: this event is a: for profit non-profit event
Check one: Food served Yes No
Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent
Fuel source being used LP tank 20 lbs. or>Yes No____,if yes, a gas permit is required.
Natural Gas Yes No ; if yes, a gas permit is required.
If food is being served at your event please obtain a Health Department approval between the hours
of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval,
*WOOD/COAL/PELLET STOVES
Manufacturer# Model/I.D.
Fuel Type Testing Lab
Offsets from combustibles: front back left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name: 4
Telephone Number Cell or Work number
I understand my responsibilities under the rules and regulations for Licensed Construction
Supervisor in accordance-wit 0 CMR a Massachusetts State Building Code. I understand
the construction inspectio rocedures,sp cific inspections and documentation required by 780
CMR and the Town
Signature Date /9
AP ICANT' SIGNATURE
Signature Date 29�IZ5�.y
All permit ap61i n a subject to a building official's approval prior to issuance.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass.gov/dta
Workers' Compensatiodldsurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Informatti�ion�%' Please Print Legibly
Name(Business/Organ ati n/Individual):
Address:
City/State/Zip: �'J�i`LJ Phone#: -F(o0 —1100
Are you an empl e . Ch the appropriate box: Type of project(required):
I.❑ I am a employer wit 4. ❑ I am a general contractor and I
6: ❑New construction.
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7R ❑Remodeling
ship and have no employees These sub-contractors have g. ❑Demolition
workin ,-for me in an capacity. employees and have workers'
g Y P n' 9. Buildingaddition P
[No workers'comp.insurance comp. insurance.t ❑
required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.1I 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#I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
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.Lie.#: 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 again a viola eF. Be advised that a copy of this statement maybe forwarded to the Office of
Investigations of the D or insurance coverage verification.
I do hereby certi er 'ns and pe of perjury that the information provided above ' true d correct.
Si �
� e: Date:
Ph #:
Official Je,
only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
?.Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)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 bum leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington.Street
Boston,MA 02111
Tel.#617-727-4900 ext 406 or 1-877-MASSAFE
Revised 4-24-07 Fax#617-727-7749
www.mass.gov/dia
e
Parcel Detail �`� Page 1 of 3
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Logged In As: Thursday,May 18 201
Barrows Parcel Detail �� j
n/l(, ca'-yLX a` P k rr)I4- 4b
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1 Par I Info ___. J
Parcel ID 251- 5 - Developer tot LOT 56
Location 127 KITSY LANE Pri Frontage El83
Sec Road BISHOPS TERRACE W 4j sec Frontage 112
Hyannis
Village '✓t � "lr- Fire District HYANNIS C.
Town sewer exists at this address No S ( Road Index 0845
-� � u ��
Asbuilt Septic Scan: OJLA.0 C �' fir_
251185_1 �teracuve Map
251185_2
Owner Info
Owner TORRES,CESAR RAMC) Owner ner %KINGSLEY,HECTOR
-
streetl YSMEL MARTE street2 27 KITSY LANE CA Gnl
city HYANNIS state MA zip F2601 country
Land Info „(
......................._......._....__..............................................._.............................................................................._..........._................................................_............................................................................................... f.M n.
_ _ _ ... ... ................ ........... ........... t�
Acres 0.50 �use Single Fam MDL-01 zoning RC-1 Nghbd fOl05
Topography Level Roadaved - J
Utilities Public Water,Gas,Septi fl Location —1
Construction Info
Building1 of 1 mm 777, _ lti
Year�197 Roof Gable/Hi Ext Wood Shin le� (Yl�tln /
Built B Z ___._�___� struct p wall 9 P
Living � Roof � AC '"
Area 2183 cover Asph/F GIs/Cmp Type None l _
Style Cape Cod wall Drywall Rooms 4 Bedrooms _
Model Residential Flog lCarpet Room 2 Full-0 Half
Grade verage Type a
Hot Water Rooms 8 Rooms
Sctio��
Stories 1 1/2 Stories He F elun
Gas F atl n Poured Conc.
Gross 3996
Area
w Permit History
Issue Date Purpose Permit# Amount �Insp Date Comments
6/27/2012 Insulation 201203687 1$5,000 6/30/2012 12:00:00 AM INSULATE
Visit History
Date - S�G1 �� Who Purpose
http://issgl2/intranet/propdata/ParcelDetail.aspx.ID=18530 ` 5/ /2017
Parcel Detail Page 2 of 3
.� 8/13/2014 12:00:00 AM Jeff Rudziak In Office Review
8/28/2012 12:00:00 AM Geraldine Clark In Office Review
1/13/2001 12:00:00 AM Paul Talbot Meas/Listed-Interior Access
6/15/1990 12:00:00 AM ML Meas/Listed-Interior Access
• Sales History
_...._., _,._ _ .. ..........
Line Sale Date Owner Book/Page Sale Price
1 7/6/2011 TORRES, CESAR RAMOS C194679 $235,000
2 7/12/1999 DUPEE, CLYDE M &GERALDINE C153961 $149,000
3 7/12/1999 SPANO, SUZANNE M EXECUTRIX #D772207 $0
4 9/19/1994 DIYESO, JULIA #D624201 $1
5 11/12/1971 DIYESO,ANTHONY A&JULIA C53018 $0
6 1/6/2017 1 KINGSLEY, HECTOR LUIS & RAMIREZ, C211797 I $240,000
Assessment History... i
.......... ..__..... ........ ........
Save Building Total Parcel
# Year Value XF Value OB Value Land Value Value
1 2017 $159,300 $27,600 $1,800 $111,400 $300,100
2 2016 $159,300 $27,600 $1,800 $112,500 $301,200
3 2015 $163,700 $25,900 $2,300 $110,300 $302,200
4 2014 $126,600 $22,800 $2,300 $110,300 $262,000
5 2013 $126,600 $22,800 $2,400 $110,300 $262,100
6 2012 $129,400 $22,700 $1,900 $110,300 $264,300
7 2011 $169,500 $3,500 $1,100 $110,300 $284,400
8 2010 $169,100 $3,500 $1,100 .$110,300 $284,000
9 2009 $168,300 $2,600 $500 $162,100 $333,500
10 2008 $174,900 $2,600 $500 $173,600 $351,600
12 2007 $204,800 $2,60.0 $500 $193,500 $401,400
13 2006 $178,500 $2,600 $500 $203,600 $385,200
14 2005 $175,700 $2,600 $600 $145,400 $324,300
15 2004 $140,100 $2,600 $600 $145,400 $288,700
16 2003 $124,800 $2,600 $600 $45,000 $173,000
17 2002 $124,800 $2,600 $600 $45,000 y $173,000
18 2001 $124,800 $2,700 $600 $45,000 $173,100
19 2000 $91,600 $2,500 $300 .$30,000 $124,400
20 1999 . $91,600 $2,500 $300 $30,000 $124,400 1
21 1998 $91,600 $2,500 $300 $30,000 $124,400 I
22 1997 $83,900 $0 $0 $30,000 $114,600
23 1996 $83,900 $0 $0 $30,000 $114,600
24 1995 $83,900 $0 $0 $30,000 $114,600
25 1994 $78,000 $0 $0 $33,800 $112,500
26 1993 $78,000 $0 $0 $33,800 $112,500
27 1992 $88,700 $0 $0 $37,500 $127,000
28 1991 $102,800 $0 $0 $52,500 $155,300
29 1990 $102,800 $0 $0 $52,500 $155,300
http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=18530 5/18/2017' '
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CAPECOO w; a
INSUL `U
,1BER OU44 Sf A' i5S SPRAT IOAM SVSPENq€q ��Fx-, .y.
RATi4IN4.IAM. Gig1IL0
1-800 696-6611
Town of Barnstable
Regulatory Services
Building Division
200 Main St
Hyannis, MA 02601
Date:
Dear Building Inspector
Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed &
completed the insulation and weatherization work at the property listed below. Cape Cod
Insulation did this in accordance to the specifications listed on the building permit
application. All work has been inspected by a certified Building Performance Institute
(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements.
Property Owner Property Address Village
660't' 'e0ma) 7&zap-b ;� 9KI-ts Z&lie, '6
Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted
Ceilings
Slopes ( ) ( )~ ( ) ( ) ( )
Pro P`k 04.1 fif X,
Floors 6 16 t X)
Walls ( ) ( ( ) ( ) ( )
Air S C Gt L t.r
Sincerely
JeCod
Ca sidy r, President
sulation, Inc.
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel Application #
Health Division Date Issued o?
Conservation Division Application Fee Cd
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street Address
Village srj ,&J2&
Owner Ctz�x4Q2, fl Address
Telephone (I'D-9 1�D //,� 7—
Permit Request ���� ,1'� i ,�14 � �� 6�Y /l✓�il1q,�/ _ �! ���Q��
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation c�r M 0 Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes .8'IZ6 On Old King's Highway: ❑Yes Q ll�o
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new Half: existing n —�
Number of Bedrooms: existing _new ,:
Total Room Count (not including baths): existing new First Floor Room Count--
Hnn
eat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove:-_❑Yet ❑ No
Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ Aisting 03newi-nsize_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning-Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use.- _ Proposed Use:...
APPLICANT INFORMATION
�+ (BUILDER OR HOMEOWNER)
Name ! Telephone Number 0 7Ld z
Addresst` 11 al License # , le:9 d 9 ?611�
Home Improvement Contractor#
Worker's Compensation # � dD. - 1, �` 1
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
j
t ADDRESS VILLAGE
'.t OWNER '
{
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH ' FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
E
DATE CLOSED OUT
l
ASSOCIATION PLAN NO.
The Commonwealth of Massachusetts
Department of Industrial Accidents
m Office of Investigations
A w 600 Washington Street
F
F Boston, MA 02111
7cfo y�0wm
www.mass.gov/dia
Worker's compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Cap P Cod n e t G,
Address:
City/State/Zip:--j !xa Yl(S_ eA a Phone#: '7
Are you an employer?Check the appropriate box: Type of project(required):
1, I am a employer with.. . 0 4. ❑ I am a general contractor and I have 6. ❑ New construction
employees(full and/or part-time).* hired the sub-contractors listed on 7. ❑ Remodeling
the attached slieet.$
2. ❑ I am a sole proprietor or partnership These sub-contractors have 8• ❑ Demolition
and have no employees working for employees and have workers' comp. 9: ❑ Building addition
me in any capacity. [No workers' insurance.$ 10. ❑ Electrical repairs or additions
comp insurance required.] 5.❑ We are a corporation and its
- officers have exercised their right of 11. ❑ Plumbing repairs of additions
3- ❑ I am a homeowner doing all work' exemption per MGL c. 152§(4),and 12. Roof repairs
myself. [No workers' comp. we have no employees. [No workers' 13. Other
insurance required.] t 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 attach 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: A a otar he r v rO�4C f .
/p96 Inn
A �:`z
Policy#or Self-ins.Lic.#: W—CA 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 ma e forwarded to the'Office of Investigations of the DIA for insurance coverage verification.
I do here c under the&ains and penalties of perjury that the information provided above is true and correct.
Signature- Date:
Phone#:
Official use only.Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Date: 4/19/2012 Time: 10,13 AM To, Cape Cod Insulation, Inc 1508-778-5735 Rogers 8 Gray Ins. Page; 002
Client#:4597 CCINSUL
ACORM CERTIFICATE OF LIABILITY INSURANCE FD TE9MIDDYYYY)
2012
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).
PRODUCERCONT
.NAMEA Margaret Young
Rogers&Gray Ins.-So.Dennis PHONE 508-760-4602 FAX
A/C No,6ct: (,q1C,No: 508-258-2102
434 Route 134 ADDRESS: youngma@rogersgray.com
P.0.BOX 1601 _ PR DU ER
South Dennis, MA 02660-1601 CUSTOMER ID C_
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURER A:Peerless Insurance 18333
Cape Cod Insulation Inc INSURER B:Ohio Casualty Insurance Company
455 Yarmouth Road INSURER c:Atlantic Charter Insurance
Hyannis, MA 02601 INSURER D:Commerce Insurance Company 34754
INSURER E i
INSURER F
COVERAGES' CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN SR TYPE OF INSURANCE DOL UBR POLICY EFF POLICY EXP
POLICY NUMBER MMIDDIYYYY) (MM/DD/YYYYJ LIMITS
q GENERAL LIABILITY CBP8263063 0112011 04/0112012 EACH OCCURRENCE $1 000 000 '
X COMMERCIAL GENERAL LIABILITY' PREMISES a occurrence).. 8100 000
CLAIMS-MADEOCCUR - • MED EXP(Any one person) $5,000 "
" c' PERSONAL 8 ADV INJURY $1,000,000
• ` GENERAL AGGREGATE $2,000,000 _
GEN'L AGGREGATE LIMIT APPLIES PER: - - a PRODUCTS-COMP/OP AGG $2,000,000
POLICY PRO- LOC $
D AUTOMOBILE LIABILITY 11MMBCKVMK 4/01/2011 04/01/2012 COMBINED SINGLE LIMIT
ANY AUTO - ,, `t (' (Ea accident) $1,000,000
ALL OWNED AUTOS
BODILY INJURY(Per person) $
� ,
X SCHEDULED AUTOS
BODILY INJURY.(Per acadent) $
..
PROPERTY DAMAGE
X HIRED AUTOS - - (Per accident) $
X NON-0WNED AU f05 f _ $
B UMBRELLA LIAB X OCCUR 0001254514645 04/01/2011 04101/2012 EACH OCCURRENCE $1,000,000
EXCESS LIAB CLAIMS-MADE : AGGREGATE - $1,000,000
DEDUCTIBLE +
$
X RETENTION 10000 - $
C WORKERS L COMPENSATION WCA00525902 6t3O/2011 06130/201 X T sTATu- EOTH-
ANDEMPOYERS'LIABILITY Y 1 N ANY PROPRIErORIPARTNER/EXECUTIVE - - + E.L.EACH ACCIDENT - $500 000
N/A
OFFICER/MEMBER EXCLUDED? -
(Mandatory in NH) R I( E.L.DISEASE-EA EMPLOYEE $500,000
yes,describe under
DESCRIPTION OF OPERATIONS below - - E.L.DISEASE-POLICY LIMIT $500,000
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,.Additional Remarks Schedule,if more space is required)
Workers Comp Information Included Officers or Proprietors
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE'
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
< 01988-2009 ACORD CORPORATION.All rights reserved.
ACOR.D 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD' +
#S805521M68179 WE
-S
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 153567
Type: Private Corporation
t f „ Expiration: 12/15/2012 Tr# 206433
CAPE COD INSULATION, INC
HENRY CASSIDY -
455 YARMOUTH RD. rats s
HYANNIS, MA 02601
r
-Update Address and return card.Mark reason for change.
El Address Renewal Employment Lost Card
DPS-CA1 0 50M-04/04-0101216 -
Off-ice o---kC%��m��er Affairs us ne. ReguI tion License or registration valid for in dividL!use en!y
H; 9fWreA before the expiration date. If found return to:
Registration: 153567 Type: Office of Consumer Affairs and Business Regulation
Expiration: 1.2l15/2012 Private Corporation
10 Park Plaza-Suite 5170
Boston,MA 02116
=OD INSULATION INC
HENRY CASSIDY
455 YARMOUTH RD_y g B,per_
HYANNIS,MA 02601 T Undersecretary t alid ith t si tune
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I1fisachusetts-department of'Public Safer
Board of Building- Regulations and Standards"
Qonstruction Supervisor License
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License: CS 100988
HENRY CASSIDY
8 SHED ROW '
WEST Y-ARMOOTH,`MA 02673
Expiration: 11/11/2013
('ummis,i uicr Tr#: 7620
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OWNER»AUTHORIZATION FORM
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Owner's Name) '
owner of the property located at
(Property Address) '
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(Property Address)
hereby authorize p P ,p�
(Subcontr c or)an authorized subcontractor for RISE Engineering, to act on'my behalf to obtain a building '
permit and to perform work on my property. _
Owne s Signa re :
Date
EEC; Sp� � [EGIE0
JUN , 1`'2 .2012 d,° , ,,JUN' — 8, 2012
Town of Barnstable
' .� Regulatory Services
Thomas F.Geiler,Director
,� M^ . mg Building Division
Tom Perry Building Commissioner
200 Main Street, Hyannis,MA 0260.1
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508=790-6230
COMPLAINTANQUIRY REPORT
Date: o�✓�' / Rec'd by: �
Complaint Name;/ Map/Parcel o3,s/
Location
Address:
Originator Name:
Street:
Village: State: Zip:
Telephone:
Complaint Description:
x-
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FOR OFFICE USE ONLY
Inspector's Action/Comments Dater Inspector:
Additional Info.Attached
Q:forms:complaint
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it pj OF B' INSTABLE
Oct. 12,2011
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Dear Sirs,
Has 27 Kitsey Lane in Hyannis been turned into a duplex? Aren't the surrounding neighbors supposed
to be advised of this change? New driveway has been cut on the Kitsey side as well as using the
Bishop's Terrace side driveway.There are 4 and at times 5 cars parked there overnight. Could you please
check and see how many families have taken up residence.
Thank you
t
Town of Barnstable
�+► c
�"'E' r.� Regulatory Services
Thomas F.Geiler,Director
RMN` ffr"BM 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
COMPLAINVINQUIRY REPORT
Date: o?✓�' / Rec'd by:
Complaint Name;,� Map/Parcel o�•s� l�'�
Location
Address
v
Originator Name:
001
Street:
Village: State: Zip:
Telephone:
Complaint Description:
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FOR OFFICE USE ONLY
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Inspector's Action/Comments Date: -ed —/ Inspector:
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Additional Info.Attached -Q-er� r ��
Q:forms:complaint '
BI_RST INSPECTIONS. JUNE 30,2011
Inspectors: James Parziale (BOH), Jeff Lauzon(Bldg). LT. John Cosmo (HyFD),
Robin Anderson(ZEO)
BPD: Officer Paul MacDonald
Hyannis
79 Linden Street
• Reported by Health Inspector Tim O'Connell
• A tenant advised him there are 5 units here.
• Common hallway door open.
• Admitted by tenant in rear unit first floor.
• Found unit to be a single bedroom with Kingman unit.
• Bathroom entry had makeshift sink area.
• Occupant complained about window falling in.
• He was able to demonstrate this by removing a block of wood holding window in
place.
• Glass has failed.
• Occupant had a cat and he paid an extra security fee for his pet.
• The owner apparently has reserved the opposite unit for her own use.
• The on site manager"Michael"resides in the other single room unit on first floor.
• The manager was not home during this inspection.
• The second floor had two large units.
• A woman with a housing voucher from Falmouth resides in one unit.
• She was very nervous about being displaced and stated her sister was murdered a
number of years ago and she moved from the city to escape,the guilty parry. He is
now in prison after 18 months on the run.
• The owner had three trash containers outside.
• Disposal has been an issue in the recent past.
• The on site manage is supposed to take of the dump runs.
• A walk around the property revealed other windows with:failed glass.
• The owner lives off Cape.
,r27 Kitsy
• ResidentYare squatters.
• The bank foreclosed on property.
• Some occupants have already relocated.
• The remaining occupants are leaving next week.
• This is a single family home:
• Basement is primitive.
• Individuals locked their rooms to.secure their belongings but for the most part all
appeared to share and rely on the one primary kitchen:
• Trash issue in the rear yard.
1
• Tenants will remove if they can.
• Informed that trash is the result of a former occupant who already relocated.
• Business (landscape/construction)trucks have ben noted here.
• The occupants are workers for another company and take the trucks home.
• No enforcement will be pursued as occupants were clearly relocating soon.
194 Bishops Terrace
• House in disrepair. Worked started without permits but property is vacant.
Centerville BIRST 6/30/2011
22 Meredith
• Reported to site and was greeted by Shawn Benson.
• He was squatting in the garage smoking a cigarette.
• I identified myself as an agent of the town and stated we were there to do a follow
up compliance inspection.
• Mr. Benson asked if we had a search warrant.
• He refused to take us around because he is not the owner.
• He identified himself as Shawn Benson.
• I asked if he is a tenant.
• He said he stays here off and on.
• He stated he is married to the owner.
• I asked him the name of the owner.
• He replied that her name is Lynn Benson.
• He advised he was uncomfortable and suggested that we return in an hour when
Lynn was due back.
• I agreed and we departed.
• We returned an hour later to find that Mr. Benson was no where around.
• Lynn and her daughter Lily were in the driveway and had apparently just
returned.
• I advised her that we were still receiving complaints about the activity at this
property.
• Lynn replied that her neighbors just don't like her.
• She said her daughter has problems and displays inappropriate behavior and
language. `
• On occasion they would fight and her daughter would swear loudly and run downy`
the street.
• She explained that Lily just started working at Stop and Shop.
• She was fired her first week earlier this month but RFK(a youth program)
intervened on her behalf.
• Stop & Shop agreed to give her a second chance; today was her first day back.
• Lynn admitted that Shawn"stays"here for a while but doesn't pay rent.
• She does not charge rent for anybody that comes to visit.
• She said she knows she cannot rent to anyone.
2
• I asked her about the three Husky dogs in the window.
• She informed me there are four dogs; two are licensed in another town off Cape.
• Those two belong to Shawn.
• She asked if that was a problem.
• I told her I was not there because of the dogs; I needed to see the house:
• Lynn was dispatched to secure the dogs before admitting us.
• Lily waited with us and I asked her who Shawn is.
• Lily stated that Shawn and Lynn married last year but they have been on and off.
• She stated Shawn is drinking again and they don't get along.
• Lynn returned to admit us into the house.
• We entered via the front door behind Lynn.
• The entry opens into a living room with a staircase directly in front of the door.
• French doors in the living room open into the kitchen/dining area,
• A short hallway to the right contains a bathroom, 2 bedrooms and access to the
basement.
• One bedroom is Lily's and the other is Lynn's.
• Lily's room was in disarray with clothing and miscellaneous items strewn about.
• Lynn's room was more orderly.
• On the other side of the kitchen area is another living room/den.
• A small area just outside of the kitchen and den area provides access to the
garage.
Second Story Room
• The second story is accessed by a staircase directly in front of the front door.
• At the top of the stairs is a locked door.
• 'We waited for Lynn to find the correct keys.
• Lynn reported that she is not getting along with Shawn right now.
• She clarified that Shawn needs his own space right now so he stays here.
• Shawn and Lynn are not getting along right now and he needs his own space.
• The door opens into a room equipped with a microwave and small refrigerator.
• The room also included a bed and a couch.
• There were personal effects in various places in the room.
• This is where Shawn is reported to stay.
• There is no bathroom on this floor.
a
• Lynn advised again that Shawn has relapsed.
• He is drinking according to both Lily and Lynn.
• There appeared to be drug paraphernalia(roach clip) on the coffee table.
• No drugs were visible.
• The refrigerator contained some food items including Grey Poupon mustard,
margarine, a lemon and some kind of instant meal.
• There was a can of soup on the TV stand.
• Nearby on a shelf were a banana and another instant meal package:
• A coffee maker, coffee filters, a toaster and an electric toothbrush were found on a
small table beside the bed. r,
3
• Another locked door opens into a large storage room.
• Lynn indicated that her daughter previously used this area to hang out with her
friends.
• She no longer uses this area except for storage.
• For some reason they are compelled to secure the area with a keyed lock.
Basement
• The basement stairway is located in the hallway.
• The basement is mostly an open space with two segregated storage areas on the
left side of the stairwell.
• One of these areas was previously used as a bedroom the other was obviously
storage.
• An exit order was issued for the bedroom use during a prior inspection.
• The open area contained a washer and dryer.
• The room is unfinished with exposed cement walls.
• A couch and TV was set up facing a small alcove area.
• Behind the couch was a makeshift storage unit containing a small microwave and
a refrigerator with food items.
• A mechanical room was located on the other side of alcove area.
• Two young adults, one male and one female were seated on the couch.
• There is no bathroom on this level.
Conclusion
• I advised Lynn Benson that I found nothing to cite her on.
• I told her the activity with people coming and going (according to Lynn's own
admission) may be cause for concern for her neighbors. I suggested that this may
be one reason the complaints continue.
• Lynn told me she would ask Shawn to leave.
• Lynn stated the couple downstairs is visiting.
o Even though their hosts were not home when I arrived, the "guests were
found seated on the couch together watching TV in the basement. This is
not at typical environment for visitors to entertain themselves while their
hosts are otherwise occupied.
• Lynn stated that this couple drives Lily to work.
• She credits them with getting Lily out of bed to do go to work.
She claimed Lily did not leave her room for the past year.
• I recommended professional assistance and help.
• Lynn stated that she already benefits from available resources and people that
come to help.
o I am confused about why she feels it necessary to "rely" on this visiting
couple as Lynn admits she has professional help especially in light of the
continuing complaints.
July 1, 2011
• My first call of the morning was from Lynn Benson.
• She was concerned about what I was going to do.
• I noted I would be writing a report.
4
♦.ram..
• She wanted to know who would be getting a copy.
• I advised her that the copy is for my records and I would provide a copy to BHA.
• She became upset and informed me that Shawn is gone. He left this very.morning
and won't be back. Lynn said Shawn is drinking again and she doesn't need that
in her life. This is all too much for her to handle. Her mother is sick with cancer
and she doesn't need this either. She stated she is overwhelmed.
• Lynn also stated that the couple in the basement is gone, too;they went to her
mother's house.
• This is the same couple who although they "don't live there" (only visiting)they
are now moving out.
• She insinuated that when Lily loses her job because that couple is not here to help
her, it will be my fault.
• She also stated that she is afraid she will lose her housing voucher as a result of
this report.
• The complainant called to inform me today that there is no change.
• The caller stated the same people still live there including the couple in the
basement.
• The caller explained he knew that the couple lived in the basement because one
day a woman came by and was unable to get anybody to answer the door.
• She apparently remarked to the reporting party that she simply wanted to talk to
her daughter who lives in the basement.
• I was also informed that another man; larger and heavy set arrived an hour after.I
left the site.
• This may be the man who really resides in the room upstairs if one'assumes that
Lynn is sharing her bedroom with her husband, Shawn.
• I asked the caller to provide me with photos of people and vehicles with plate
numbers.
July 5, 2011
• Complainant contacted me to say there are no changes except that after my
6/30/11 another large man showed. It is believed that this man also lives there.
The caller is concerned because a sex offender lived there last year and the people
that enter and exit the house do not appear to have jobs and the behavior and
appearances are indicative of substance abuse.
Demeanor of Subiects
• Lynn is very thin and appeared to be nervous and distracted.
• She was unable to focus or remain on any one subject for long:.
• She kept reiterating and repeating information.
• Lily seemed more together than Lynn and overall was healthier in appearance.
• Lily did spout off at the end of the inspection when I had to interrupt Lynn to
redirect the conversation to focus on the matters at hand. I was not sure if Lily
was upset with me or her mother but she commented that someone was rude and
stormed off.
5
94 Monomov Circle
• Found five vehicles parked in front and on lawn.
• One vehicle also parked in rear yard.
• Admitted to property by two tenants, a woman and adult daughter.
• Three bedrooms on first floor were located.
• Tenant was able to open 2 rooms.
• Found basement apartment restored again.
• The tenants that admitted us reside in the basement.
• One bedroom has no egress or windows.
• Evidence of a 5' cased opening was apparent.
• It was obvious that the opening in the wall was closed again.
6
NST
Chief Paul MacDonald 'nibf''i ' ` °
Mr.Thomas Perry
Mr.Tom Geiler EN AA 11
Iv ,
May 23, 2011
Dear Gentlemen,
May the residents of Bishop's Terrace, Flyannis point out-that there is a house at the corner of Kitsy Lane
and Bishops Terr.(#27 Kitsy) where 8 unrelated men reside.They are currently running 2 or 3 businesses
out of the house. Several dump trucks and multiple vehicles are parked on the lawn and corner of the
street. Several of the 8 are picked up by different vendor trucks throughout the morning.
The house is a rental and was owned by a Clyde Dupee (?). Recently there was a for-sale sign on the
property but it has been removed.The lot is in deplorable condition. Do long time home owners in the
area have any recourse to a situation like this? If any ordinances could be enforced to improve this
situation it would be greatly appreciated. People have a right to rent a house, of course, but to trash a .
property with no regard to the neighborhood is downright.sad.
The health department may want to check 128 Bishop's Terr�We sincerely hope that no children live at
that disaster site !!
Many, many thanks for your attention. We realize there are many pressing concerns in the town of
Barnstable at this time.
DATE: May 27, 2011
TO: Building File
FROM: R Anderson
RE: 27 Kitsy, 128 Bishops Terrace, 20 Kent&27 George St—Hyannis
CONDITIONS: Warm and muggy,-first sunny afternoon in days
�27 Kitsy,Hyannis�--
Property has a sign indicating is under agreement (Margosells.com).
Found 2 unreg trucks in driveway off of Bishops Terrace.
One Chevy pick up parked on Bishops terrace commercial plate K95-283.
House looks neglected. Didn't notice trash on this occasion.
128 Bishops Terrace,Hyannis
Property located on the circle end of Bishops Terrace.
ILarge garage—overhead door was open.
Building materials were stacked on the side of the drive way.
Property looks used and abused.
No activity during afternoon
27 George Street, Hyannis
Found evidence that several people reside here.
Two driveways.
Lawn mowers and trailers on left side driveway.
Found older male tenant on bike just departing.
He advised this is a single family and he is sole tenant.
I left my business card and asked him to have owner call me.
I said Tuesday would be fine as today is Friday (Memorial Day week-end).
20 Kent Street,Hyannis
Found Two Brothers Flooring sign posted on.front of lawn.
Also noted another sign(exact sign) stored onside of house.
Non-English speaking woman answered the door.
I left my card.
She stated her daughter speaks English and will have her call me-
Town of Barnstable Buildin
Hs" Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept
s6�P
t6l Posted Until Final Inspection Has Been Made. ' ��Zy. j�� I 11
o Luc+' Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. 1L
Permit No. B-20-2296 Applicant Name: Matt Markham Approvals
Date Issued: 09/02/2020 Current Use: Structure
Permit Type: Building-Solar Panel-Residential Expiration Date: 03/02/2021 Foundation:
Location: 27 KITSY LANE,HYANNIS Map/Lot: 251-185 Zoning District: RC-1 Sheathing:
Owner on Record: KINGSLEY,HECTOR LUIS Contractor Nam e:".Freedom Forever Massachusetts Framing: 1
LLC
Address: 27 KITSY LANE 2
Contractor License: 198080 '
HYANNIS, MA 02601 ) Chimney:
Description: Install residential roof-mounted PV Solar System(22 Panels-7.26 Est. Project Cost: $5,599.00 T
kW) Permit Fee: $85.00 Insulation:
Project Review Req:
Fee Paid: $85.00 Final:
( ,
Date: 9/2/2020
Plumbing/Gas
Rough Plumbing:
Building Official Final Plumbing:
1
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas:
All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted.
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 inspection for the entire duration of the
work until the completion of the same. Electrical
The Certificate of Occupancy will not be issued until all applicable signa[tures by the Building and Fire Officials are provided on this permit. Service:
Minimum of Five Call Inspections Required for All Construction Work: Rough:
_ --
1.Foundation or Footing s_...._._...._�._... _ ,
2.Sheathing Inspection
Final:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Final:
7.Final Inspection before Occupancy
Health
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
Building plans are to be available on site Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT