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0107 LINDEN STREET
/.d � \ ��� -- ,.� _ ---- - -- i s, �. ` � �,_ Town of Barnstable . >. r1---trfl "" -Duildina f PostWThis Card SoThat itistU�sible From.theStreet-�A roved Plans Must beRetamed on J,ob and;th�s CardwMust:be,Ke t ,�'S �. '�-.a �s',^:�..�. $ ,�<. 6" Posted Until-Fnal InspectionHasiBeen Made t H z ° Where a.Cert�ficate;-of.Occu anc ;is.Re u�red suefi Bu�ldmshall Not be Oceu �ed:;untif a Final Insperermit ctionhas,been rnadei .o � m-• "3°6z � yus�c„3¢. .pr,�.: ,. ...»M '. �,� rt.e. :. .� i! •<' ,.;""3,. `,�''".. , ,.-.:r Permit No. B-18-932 Applicant Name: Mark Mordini Approvals Datelssued: 04/02/2018 Current Use: Structure Permit Type: Building Siding/Windows/Roof/Doors Expiration Date: 10/02/2018 Foundation: Location: 107 LINDEN STREET, HYANNIS Map/Lot 310-452 Zoning District: RB Sheathing: iS , Owner on Record: HELMS MATTHEW&TIFFANY Contractor Name: .MARK E MORDINI Framing: 1 Address: 107 LINDEN STREET Contractor License: CS 057645 2 HYANNIS MA 02601 s Est Project Cost: $ 14,112.00 Chimney: ,. Description: strip roof shingles and re-roof per GAF specs(147 square),ite and Permit e: $71.97 water shield 6'from fascia and 3'from rake boardsand iri valleys, x Insulation: install soffit and ridge ventilation >t FeQ Paid ° $71.97 DateY Final: 4/2/2018 Project Review Req: ° M` Li Plumbing/Gas r T � Rough Plumbing: a.l 7 �= Building Official s w � final Plumbing: This permit shall be deemed abandoned and invalid unless the work authon ecl by this permit is commenced within six months aft-",J nce, Rough Gas: All work authorized by this permit shall conform to the approved application"and the-approved construction documents for wMi this permit has been granted. All construction,alterations and changes of use of any building and st uctures shall be in compliance with the local zo I by laws�and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street orgroad�and shall be maintained open for public'inspection for the entire duration of the work until the completion of the same. " p s Electrical The Certificate of Occupancy will not be issued until all applicable signatures by,the Buildmgiand Fire Officials are+provided on�th°is permit. Service: Minimum of Five Call Inspections Required for All Construction Work � Rough: 1.Foundation or Footing ' , l•, _, 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 Town of Barnstable eREcE � 200 Main Street, Hyanr is MA 02601 508-862-4038 9. Application for Building Permit C Application No: TB-18-932 Date Recieved: 3/31/2018 �� iu Job Location: 107 LINDEN STREET,HYANNIS ( z Permit For: Building Siding/Windows/Roof/Doors co m Contractor's Name: MARK E MORDINI State Lic. No: CS-057645 Address: North Attleboro, MA 02760 Applicant Phone: (508) 280-0156 (Home)Owner's Name: HELMS,MATTHEW& TIFFANY Phone: (508)367-3357 (Home)Owner's Address: 107 LINDEN STREET, HYANNIS,MA 02601 Work Description: strip roof shingles and re-roof per GAF specs(17 square), ice and water shield6614'from faAc a andIf from rake boards and in valleys, install soffit and ridge ventilation t tsJ m Total Value Of Work To Be Performed: $14,112.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Mark Mordini 3/31/2018 (508)280-0156 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $14,112.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $71.97 3/31/2018 $71.97 ]CXX3C 7 �XX} Credit Card ..................................................... ......... ......_. .z ......... 4147 .. .........f. Total Permit Fee Paid: $71.97 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma , �J Parcel I Application N : HealthDivision Date Issued. Conservation Division Application Fee Planning Dept. Permit Fee /c02_ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address lU-7 o �r Village n^f.AM-s. Ownerf�A( S_ ( Address_�. . h�il�-\ Telephones Permit Request G V I C, h S Square feet: 1 st floor: existing proposed 2nd floor: existing proposed rr Total new Zoning District Flood Plain ` Groundwater Overlay /VG Project Valuation 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 ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other i Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) y Number of Baths: Full: existing new Half: existing new i Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: $ "= e.� Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ nY Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - 0 Name �r l os Ar C I o Telephone Number C7-71 9 3�1-x- ® 3 `1 Address 9 ; 4) I� l�ll V License # d� r \ ��-'"'" ► ��� ��`'� Home Improvement Contractor# ! !6 3 Email Worker's Compensation # W /1"3tq3q ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i DATE SIGNATURE. FOR OFFICIAL USE ONLY } APPLICATION # 4 DATE ISSUED � i MAP/ PARCEL NO. ` w ' ADDRESS VILLAGE 'y OWNER - DATE OF INSPECTION: FOUNDATION 'FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH ' '` ` FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I J:j• v �Wr° ti Town of Barnstable Regulatory Services MASS $ Richard V.Scali,Director ' 16396 � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, � e``'' t� L ,as Owner of the subject property 4 , , hereby authorize� d� , a 6 ,A to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted Signature of Owner Signature of Applicant Print Name Print Name Date QFORMS:OWNERPEP=SIONPOOIS, die Camrrrarnveallh of—Massaclrnsetts Departrrrewt arfl dustrial.A.cciderdr - Offize OOMWs6900M 600 Washington Street Boston,MA 02II1 mov-ma3y.govIdia Wurke& Campensaf afn,Insurance Affidavit:Brfilder-dCnntracturs/Biectr ciaustT umbers ApplicantInfarma.tian Please Print E,el��ily Name(Busiiiessf4rganrzatioalfnt�t3na1} �a�rG Sc� Address: �c Do� ec,,* Er e e- 1V k O d717 City/St atetZ*- Phone 41-- Are yoru an employer?Cfiet:kthe appropriate bow Type of Project(required}_ L g I am a employes urith . t j 4- El I am a general contractor and 1 6- []New construction employees(full andlor part limed* have hired.tlxe sub-contractors 2.❑ I.am a sole proprietor or partner listed on the attached.sheet 7- ❑Remodeling ship and have no employees: These sub-contractors have ❑Demolition w g fw.rrre in any employees and iwo&ers' �o nY capacity. 9_ �Building addition. . [NO worms'-comp.insurance comp-insurance I reg3ked I 5. We are a-corporation and its 1oL❑IIectt cal repairs or a dditious 3_❑ 1 am a homeouner doing all work officers have exercised their 1 L Q Plumbing repairs or additions myself[No workers'oomp- ri&of exemption per MGL 12.[1 Roof insurance required employees.[No workers' 13_❑o&L, comp_insurance required-j -any app€it=dwtChedsbox rl nt also Mc=th�e secdonbeTowskauinng thekvo&ed campersafiaapolicyinfRMSUmi 1Hame vinemwhosubmaiteBisaflidavifiad3rathgtheyaredaisalIwc*andthenhueoutd&contractorsm stsubmitanewaffidavitkdi(wnc sack tcan.tractorstCat check this boat must attacked mx additianst sheet showing the nmze of the sub-ccutuctors and state whether ornot those eniides ham employees.If the Sul-caatzactms have empleyee-%they natsrpmr-:de-tb&1r umrke&comp.polkynumber Iam an euepk-wr that is prim ding it arkers'cart perfsatiart iwwzranca f or my empty-ees. .Selorp it fheprrHcy and job site infiormatbm InsuranceCompaaTlifame rmLe. co -Po,lic1*4,:,LorSelf-ins.Lit.- (06, 4 1 — EepiradoaDate: Job Site Address_ I VI �i,,SC \ CScity/statel�.ap�ter 1�. �G Attach a copy of the work-ere comapensationpacy declaration page(showing the policy and expiration date). ' Failure to secure coverage as re9quired.under Section 25A o€MGL c 152 can lead to the imposition of criminal penaHses.of a f=up to$1,50G 00 and.''ar one-year imprisonment,sawed as civil penalties.in the form of a STOP WORX ORDER and a fire of up to$250-00 a tray against the violator- Be ad-iised that a copy of this statement maybe forwarded to the Office of Investigations of the DIAL for insurance coverage-mrificatioa. I rfo hereby GfiCtt rder tits pairs m perta s o perjttr}'fliatf�lts Ilifarm >i prmVW abate is..bars arm correct „ Si2natare- Date: Phone 3 rr �cial tags onry€y or Town Permitfl-kense#n ? nflro�(circleone): L Soard of$eaIth BurTdinz Dep=tumt 3.QtkIrmm Clerk d:Electrical Tampector S.Plumbing Emsgector' t ` 6.Other, - .a e Contact Person: ,; Phone#: 6 P4 F E R Alas tics inc . 4 4 9 41 Ao- OjIft '50, Ak 02 W, tp 40 10 .:A 10Z 0A, 2�,Z A-11 A E, Model 7200 Convertible to Inpool Ladder ' Rollguard'A=Frame Safety Ladder #CK7200 Kit sold separately. Standard features of the Rollguard Ladder: 3 • Aesthetically pleasing contemporary design in beautiful warm 1 f gray color to complement today's brown or gray tone pools t 7 • Large 5 inch z 18 inch wide Comfortreads f h 4 • Curved side rails designed with strength in mind �� ., • Inner side rails include integrated side barriers - G7200 Roll guard Gate= to prevent entry behind the ladder Attached easily;to our;Rollguard 4 I • Easy assembly with minimal hardware Ladder to provide added security #' `-- • Adjusts to fit pools 48"to 54"tall Self-closing and self-latching Satisfies most building inspector mow., • Lockable Rollguard Barrier(lock included) requirements t" p J' F • Extra-large top platform Latch�locafed well out of reach of Ij • Just fill side rails with water to prevent floating small children no sand or bricks needed p g' contoured design;Hugs ladder ste sRend resfridcess t • # •Weight limit: 3001bs. Fits pool top seats up to 14 inches wide Pawlockincluded • ig , • Five year warranty 444r --- , . .. _ Model 7100X ' Convertible d ,EvolutionA Frame Safety' �I ongad Ladder �• t npo - us #CK7100 Kit- • NEW!Warm gray color to complement today's brown sold separately. . f" a or gray tone pools • Economical yet full-featured A-Frame Ladder • Adjustable to fit 48"to 54"high pools t • Each side adjusts independently REQUIRED � 4� r • Snap-lock treads for quicker,easier assembly m, BARRIER • Five treads on each side ` • Swing-up outer treads for safety • Outer treads can be padlocked (padlock included) • Full 16"inside tread width F` • Strong sturdy design • Large top platform 'r} • Minimal hardware • No sand or bricks required;fills with water • Five year warranty • Weight limit: 300 lbs. M ..-__- d� � .. . • - a Model 7000B Eliminator AFrame Safety Ladder t _ e , • Eliminator A-Frame Ladder for 48"to 54" pools � •- M Heavy-dutyconstruction Convertible I t u • Outside treads swing up into an upright to Inpool Ladder position for security using J M • No sand or bricks required to prevent sold s#CKe0 ait- q eparately. floating;fills with water ,�'' ► • Outer treads can be padlocked Includes t (cable lock included) REQUIRED • a F., • Weight limit:300 lbs. BARRIER • Treads measure 5"x 18"wide • Five year warranty w '14 P 0 0 L T E oodNx- D Model PES Pool Entry-System An excellent system for safety and . .; convenience. .4i • Meets ANSI/APSP standards • Adjusts to fit 48"to 54"pools and decks ? • Adjusts to fit most uneven or dished-bottom pools r - ". � l 4 (4 • Top step covers the pool top seat in most installations t 4 '` • Easy assembly; no metal parts ` • Does not attach to pool • Side openings help to reduce algae growth under unit ; rP�'-••-='" "' ` r +' • Excellent for elderly, slightly handicapped,or heavy swimmers ,la 1:� • Non-slip step surfaces • Large,flat steps each with 270 square inches of surface �` -' ,t: ' t • Includes deck connector i f ' ' .. • Fills with water to prevent floating; no sand needed .` .�:, tt • Weight limit:400 Ibs. $f ! t ,�: • Five year warranty • Includes Automatic Gate Closer , s ffi Pool Entry System'Sl ifications: Gate Specifications: fi Projection into pool 36 ar r ` . . ,a Height of gate* 58" W'dth 31' ` t Y - Step dimension N 10"x 27" gat Width of gate. 27" : , Riser height 1 V. g Height of latch 57" t J " , 'Handrail Height 32'from top step Gate is self closing self latching +, (all specifications are approximate) # �. • Specifications subject to change without notice. j° (all specifications are approximate) 41 n h I Available to following configurattor-il Model#PES 1,.IndiwdualEntry System,for use off of a deck , ® Model#PES-DBL-Two Entry Systems with gate for use on pools without a deck a t » Model#PES G Gate only -. r - '.,v, `�'k�A' M'N '"man'ia+, .'_ ON �•y mot: ' . t , Step-1 "Safe and. Secure" System 'Confer-Step ModeIS:1.G. = - } - s � A �,�. '` Satisfies most building inspector and_ Designed for easy pool entry insurance requirements in most states • Inpool Step for 48"to 58" pools and decks �.�• `_i c�r Self-closing,self-latching gate • Easy,snap-together assembly - restricts access to pool 4, t` f`= • Large,flat steps each with 270 square inches •• i I • Gate includes self closing mechanism ;i I. of surface area (see inset photo)fora - — ' • Compact packaging—can be shipped r sure close everytime by UPS-FEDEX Gate includes padlock forj • Includes mounting brackets to fasten to deck I complete security >. a dw .. Inpool ladder takes up Now with • Side openings hel to reduce algae growth Automatic Gate Note The Confer Step isp g g minimal space inside pool Closer! designed fo-usein flat-bottom under unit ° I • Steps and ladder can be separated t.pools only four,Pool Entry,. • Weight limit:400 Ibs. and used individually if a deck is built ` System can lie tt • Inpool ladder features - most dished-bottom-bottom pools. fit Five year warranty s 4 Requires 40 pounds of sand for installation anti-entrapment barrier � F z - . w f I0, IN P� OVS E T P Y T 1VI S S �11 -a- as Inpool Step System •.Available-in four configurations;two for Above Ground 'an'd two for Inground • Start with the base step unit and then expand into a complete system at any time " • Four tread unit for Above Ground Pools • Three tread unit for Inground Pools ' I/ Above Ground base unit treads can,be-instal�d curving r" inwards or outwards as custo a desires" 't ' - • Eye-catching,graceful sloping handrails-* • Two tone color treads with.warm gray,(beige)Al " sidewalks and handrails to complement any pool" Above Ground Stair Case Oversize deck mounting brackets to ea h across any ' I' top seat a 'Above Ground,Gir re System &. •:"Adjustable base pads tocompensate for slightly dished " hW, , izz pool floor 0 Ships,by UPS or,Fedex ' Easy assembly-with no'hardware required Z Inground Curve System Inground Stair Case I _ 'I �♦ "T�,r.w, � �' - �� ,� .-.`• �,, mow.,_ i a p ` W, tov, ` f ,1 I w � "Oks Up, t Curve Step Specifications: t • Weight limit lb' " Z400 .Height to top tread-Inground 36" Tread width !127"- -Above ground 47" ^ Tread depth 10' Mountirig bracket length 24" ' �. . x Riser height 3 r 11 ' loverall outside width 38" Unit depth32 Complete Curve System width 58" ) Handrail height(from top step) 30 po " 'Availabke in followin cq onfiqurations: R . ` Model#CO(AGe CONFER CURVE BASE INPOOL 4 Step for Above Ground- Model#CO(AG-2 CONFER CURVE ABOVE GROUND Add-On Unit for Above Ground- a " VANModel#CCX I fit CONFER"CURVE BASE INPOOL 3 Step for Inground 1*Model#CO(IG-2 CONFER CURVE INGROUND Add-On Unit for Above Ground- , " I POOL, LADD ARS �d AK Model 6000B Model 635-52 Eliminator Heavy-Duty Economy a Inpool Ladder. ijppool Ladder. • Five large treads _ D , • Straight Up and Down Inpool ( • Treads measure r . Does not require barrier -13 5"x 18"wide - • Adjusts to fit deck heights • 22" high handrails E 46"to 56" 9-1/2"span • 18"Width; • All-plastic construction ; 22" High handrails • Weight limit:300 lbs. :_ • Weight limit:250 Ibs. • Adjusts to fit deck heights • One year full warranty 42"to 56" • Optional EB100 extension • ,- • Five year warranty kit available • Optional #6000-EXT • Platform not included y - Extension Kit available r, i with ladder - � a•. �, • Optional latform available able_ 00 pi . , Model 610OX Model 8000 Evolution In ool Ladder r Ent "0 R: - p ,a I .--. rryy + t Ladder A ►. r • NEW!Warm gray color r '` • Economical,full featured inpool ladder Economical I • Fits decks up to 54"high Entry/Exit Systeny ~ _ . • Snap-lock treads for quicker, ' • When combined with - easier assembly #Step-1 it forms an 1 • Five treads economical Entry/Exit • Full 16"inside tread width System for 48"to 54" pools • Strong sturdy design • Outside treads swing up • • Minimal hardware into an upright position } • No sand or bricks required; y for security w = " ' • 0 fills with water - • 18"wide: 22"high handrail, • Attaches easily to deck; no 9-1/2"span extra parts required t Weight limit:300 lbs. • Five year warranty To make`the complete Entry/Exit System you will. • Weight limit:300 lbs. need to purchase both: • Optional #6100-EXT (1)#8000 Entry„Ladder, Extension Kit available f (1)#Step-1`�"�(total of 2 cartons) y Model LAK Model 8100X Wider Adapter Kit Ground,to (' ` Step Entry`, For use with the Confer Plastics " ladder models 7100B, 7100-X, Ladder i 8100X, 7000B and 7200 r For use with the Curve • Easy assembly Step to make a complete • Warm gray color g Y entry/exit system • Minimal • Easy assembly-snap lock treads � Hardware • Large top platform � • Warm gray color coordinates with Curve Step.- " ` ' r ` • Outside treads swing-up and LAK KIT lock for safety,padlock included CLO-SLJ �YSTEM-' . x Confer=Step Enclosure °Systei'n The Enclosure System provides security first, by enclosing the steps with pickets, �. and secondly, with its self-closing, `+ I self-latching gate. It meets current BOCA codes and satisfies most building inspectors. Allows two #Step-1 units to be joined V g together, enclosed, and gated to restrict access by small children. Kit consists of ;A ,/ �_ connecting step, connecting rails, enclosure pickets and rails, and a self- � r closing, self-latching gate(includes automatic gate closer). Note: For best results place outside ' step units on level patio blocks. ,To make the,complete System you wiI need: �(2 cartons)if , ,2 cartons) f$ s (1)„#Ste -ENC kit w/gate 3' (total of 4 cartons) ..;,. "S' k. ", y, kf�e�. ..#�• 'fie. �Kr�+w'•,.Y tt� Tski 8 x � vk- • Increases skimmer efficiency • Attaches easily to most skimmers without tools fs • Low cost, easy to use • Blade is easily removable when swimming Important: Consult your local building department for installation of your pool and equipment. For safety, all of our products should be used with competent supervision. LL n - M1 l , pI sties i ' c: ... a_.., ik ,t 4,97 Witmer Road North=Tonawanda, NY USA,14120-2421.. 2 R1 800-635-3213 • Fax 716=69413102° A 'PRounw _ wwwconferiadders.com MADE IN e email: ladders@ .ferplasfics.com --THE_USA__ , Product and_specificati5ns subject to change without notice PRINTED IN USA 03YI5 1717, 12:20p Pool and Spa Design 5087781230 p.1 Th,r Corntrronwealth ofmusacltusetrs Department ofUduT&MIAcdden& Offtre of bzVesfigatiotu 600 Washington Street Horton,AM 021JI www_rnnss gov/dia Workers' Compensation Insurance Affidavit: Builders!ContractorA]ectrieiansiplumbers AppiiCaut Itifortnation Please Print Legibly Name(13tuincssiO%aniiz tttion![ndividunl)_L,'tI Rc-f'�,` ��,`i j �.,5�S u , Address: -city/state/zip: Phoue#: Are you an employer'Check the appropriate box: - - Tvpe of project(required): l.[� l fur:a employer with _ 4. ❑ 1 am a general contractor and I employees(firll and/or time have hired the subcontractors 6• 0 New construction 2.❑ 1 atn it sole proprietor or pumcr- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have. g. ❑Demolition working for me-in any capacity. employees and have workers' LNo workers'corny.insurance comp. insu mca.x g• ❑Building addition t required.) 5. ❑ We are a corporation and its 14.❑ Electrical repairs or additions• 3.❑ It am a homeowner doing all work officer have exercised their 11.0 Plumbing repairs or additions myselL[No workers'comp, right of exemption per MGL I2_[] Roof t,epairs insurance required.]t e. 1 S2,§1(4),and we have ao employees.INo workers, 13_0 Other COMP.insta-dace]required] ��Y aPP[ieant t6a[r,,bcdcs boxiti im:,a also fdl out the soedon blow Aowk%their workers•compmsatioa policy informarioa t liatr�wncrrs who subtttic dray afFiduvir indiratiug the;sue doing aU wo*and Ihm[Lira outside comrat:tom muse submit a nwv affidavit indicating suer rCoaaacwrs dul check this box mast ltfuc ad m addiri)oal shoot showing dic nwwc of the sabconoactots WW AMC whathrr or act rhoso:unties hen c r»IpJoyo¢s. If the sob-conuacsors nave rnsploye;:S,thry muse miwide thaa workers'comp.policy eumbar. I arrr an employer flirt is proviJuzg coo leers'cow wmarion insurance for rrry employe= Below Is thepoucy esrd job site Lrformatton. i f FITS InSurance Company Name W (�,i Policy 0 or Self-ins.Lic.= L:� �'L1 � � / � �Z Expiration Qate: Job Site Address: City/Statdzip: Attach a copy of the workers'compensa6)u-gplicy declaration page(showing the policy number and expirrtien dare)- Failure to secure coverage as required under Section 25A ofMC L c. 152 can lead to the imposition of critninal penaltics of a fine up to 31,500.00 and/or one-year uapr'tsc.nmen;as well as civil penalties in the forn of a STOP WORK ORDER and a fore of up to,$250M a day against the violator. %advised that a copy of-this statement may be forwarded to dw Office of Investigations 0MO DIA for insurance coverage vetifcation. Ida Jbereby cerli arrder the port ernr%pert rlb�es of lay tbatb [lri/orroR provided above is true and correct / �� Date: Phone#• , 0or icial use Onk Donal write in r/dis err a&,to be C,,7Mpiefed0y city or town e f ejot ,l ' oy ' o -2y 0 0 F MANUFACTURING "0 U H 0 L A'00%,fE-G 'M' L4 • {4 a� r r � r � ♦ r � 1� 1 1 U 217 S p IJ r r n� _ r t 217 D r � Choosing the Trevi 217 Krystal Innovation pool', means choosing the best pool on the market! Like the 209, this pool offers unparalleled stability -- r thanks to Trevi's exclusive Secure-lock bottom track. And that's not all! Its 9-inch wide, high quality resin top seat and reinforced uprights add superior robustness and a touch of elegance. Another fantastic product of exceptional quality by Trevi! iiiiiiiis IT— r lipp- w:b mow• " v,�l 7,77 j a• � • =:t � � a �� i�� ,fir �. , �. i � e i i a DO s M ern MANUFACTURING 0 0 C,0 V � a MANUFACTURING Easy to install and easy on the budget, an above-ground pool is a wise choice. It makes the whole family happy! Jump, splash, dive... the fun of summer is right there in your own backyard! Thanks to a wide ra-)ge of shapes, materials and finishes, you and Tirevi can create the pool that's right for your family, no matter your needs. Want a pool for fun= For the kids? I For relaxing at the end of a busy day? With Trevi, you will create a delightful, relaxing refuge in your own backyard. I TREVI, THE SENSIBLE CHOICE! It r _ a - x i p S' . 0. TECHNICAL DETAILS SPECIAL FEATURES Corrugated steel wall - Superior quality resin top seat Bottom resin ' features uniform calibration, UV E safety track (11/4')(3.zocm) treatment against discoloration and a molecular memory to prevent warping. Plus it's scratch-resistant! h Resin top and bottom joint A unique Trevi design, the double q'plates pool support post and stay 'Resin upright assemblies for the oval model are ',Galvanized Steel support post. designed for superior strength d! For oval pool as well as aesthetics. The bottom { ASupport leg for additional Secure-lock safety track, made of r GG strength.For oval pool resin, provides greater stability. r STEEL WALL COMPONENTS 1. Plasticized SP coating 2. Molten zinc coat 3. Primer coat r 4. Application of an alkaline solution to cleanse the oxides i' x• 5. Galvanized steel wall core ' 6. Chromate anti-rust coat k'. 7. Heat-hardened inlay 8. Ultra-resistant polymer STRUCTURAL ELEMENTS 1. 9" (23 cm) polymer top seat 2. Polymer and steel coping ` 3. Resin seat cap 4. Resin joint plate 5. Resin upright 6. 52" (1.32 m) wall t � a F I u .t TREVICLIP: EXCLUSIVE LINER Overlap «U-bead» LOCKING SYSTEM Prevents liner setback in case of movement caused by freezing or thawing, and increases overall -� pool stability. (Available only with 411lastic coupler(nafncluded) "U-bead" liner) Liner Round metal stabilizer Inner Wall AVAILABLE STYLES Round: 12' (3.66 m), 15' (4.57 m), 18' (5.48 m), 21' (6.40 m), 24' (7.31 m), 27' (8.23 m), 30' (9.14 m) Oval: 12' x 24' (3.66 m x 7.31 m) 15' x 24' (4.57 m x 7.31 m) 15' x 30' (4.57 m x 9.14 m) 18' x 33' (5.48 m x 10.06 m) 1 WALL SELECTION b 4 y p t Java Superior (quartz Vitro (5231') (52") (5211) (5211) 110 r i i a �. "`�'—..;;T,,.,•`k+w ems+-__,__._ -- � t� � gyp, � �. � a � i i ,Y � •�_ CEO a� trevifab.com I' 1 � _ F diµ I 4 � � { v t 217 When you purchase a Trevi pool, you also acquire peace of mind, I unparalleled manufacturing quality and safe materials. When you purchase a Trevi pool, you will be satisfied. THAT'S THE TREVI DIFFERENCE! y s r pbbb ,M/� O O I Y e V O e ■ MANUFACTURING ■ N trevifab.com _0 ■ ti ■ � 0A t Office of Consumer.Affairs and Business Regulation 10 Park.Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement'Contractor Registration Registration:. 117031 Type: Private Corporation - Expiration: 8/17/2018 Tr# 419291 NARCISO ENTERPRISES, INC = ._ CARLOS NARCISO f.^ P.O. Box 680 = - tx t EAST FREETOWN, MA 02717 — - �.. Update Address and return card.Mark reason for change. — ❑ Address j; Renewal L Employment F Lost Card sca i C. zoM-osni t i j . 1 W Ao�� I. r U�. nl p � Y ri 014 a Lo 3 1 � � T 3� ► r y . 31 V OF ROBERT• \ P. 1jAl o )BUNIKIS ate$ S13o A ��O 22162�0 \ 3 3 N $ i ASS,+pNA� Jy i v LEGEND CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION OxO EXISTING CONTOUR --- 0 --- Lp 2 /_//�c`/✓ -571 , FINISHED' SPOT ELEVATION �-/j%� Al/t/"/ 5 FINISHED CONTOUR 0 - . .h'.. .. IN APPROVEDt BOARD OF HEALTH DATE AGENT - SCALE: / -=^3 0 DATE t 7 /?S��B/ L®RE®GE ENGINEERING CO. !N CLIENT PA CdE A CERTIFY THAT THE PROPOSED EGISTERE REGISTERED JOB NO.��08'3�3 BUILDING . SHOWN ON THIS PLAN CIVIL LAND. �. �_ CONFORMS TO THE ZONING LAMS NGIN ER SURVEYOR DR.BY OF BARNS BLE, ASS: 712 MAIN ST. CH. ®Yt R •T',�3 • 7 �.y ��HYANNIS, MASS. SOEET OF DATE REG. LAND SURV CERTIFICATE OF LIABILITY INSURANCE 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 j the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements) RODUCER CONTACT PaychexInsurance Agency1nc PAYCHEX INSURANCE AGENCY, INC. PHONE 26 150 SAWGRASS DRIVE ;_(AIC.�N4 EXiI:__ 877-266_6850 ------- _.----.__.SIC,No)—__---3E9_7ri ROCHESTER, DIY 14620 E-MAIL Cerls@)paychex.com paydlex.com INSURER(S)AFFORDING COVERAGE NAIL M dSUREO INSURER A: Wesco Inswanc Company 25011 - -. NAF,'CISO ENI'ERPRISES INC. INSURER B: I PQ BOX 640 ..__.__.------'-------- ------- EAST FP,EETOWN,PAA 02717 ( INSURER C: I INSURER O: j INSURER E: INSURER F: :OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TH(S IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEtJ ISSUED TO THE INSURED NAKED ABOVE FOR rHE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMEidT,I ERiA OR CONDITION J OF ANY CQNTR,ACT OR OTHER 00CULIENT VVITH RESPECT TO Vi iICH T}iiS CERTIFICATE PRAY BE ISSUED OR MAY PERTAIN.THE`..INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE.T 7FiNIS. EXCLUSIONS AND COND LITIONS OF SUCH POLICIES. NIITS SHO:NN ABAY HAVE BEEN REDUCED BY PAID CLAIMS. --.. — _ ....._..._.._.-,.-_....- — ------...__—. SR: TYPE OF INSURANCE DDL!SUBRi POLICY NUMBER POLICY EFF ! POLICY FXP °I LIMITS R ;NSR WWVD I(r,1IBIDD/YYYY)I(b1MiDDlYYYY) GENERAL LIABILITY Ij E.CN GCCURREhJCF ...-- `.iS„ttAEC E:!P(Any I PERSONA BUILDING DEPT GENERAL- AL r.GGPECh TE - PER —Py, CqTS-GJFPli"s GGu".IIr W} iS ° ` ` dr COMBNED SINGLE a 'I AUTOMOBILE LIABILITY ®YY i} N E OF I I ilRo i : : : EACH V r}rC UFI 41=t't � i U y.l Qit+ i VI(1PKi'rrS.t\LiPEti�AT7Gri MID !.crel+s LI::I1!ur i VJVJG i1 Y:4_'2 104/04/2017 1 04/04/2018 ' Y ! !..b.C.1A ..0 ;?Ef•IT 1oJ.UL10.CIU i rL DIst-ti H •.:._ _�,- ,y,N I F r cl c rr... 5 W NIP E.L.D!sEns POLICti;ltal: ?S Sod 0oo.(i — -*r it 4-, -- 1 I : ESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(AUach ACORD-101.Additional Remarks Schedule.it more spite is rcquiretl) l j ( I ;ERTIFICATE HOLDER CANCELLATION PROOF OF COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NO1"ICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVeS- AUTHORIZED REPRESENTATIVE ` \,CORD 25(2010i05) 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �q S�N �ers +�1 � ��„�l� / ID�- Iiha� n S '� . r�annW U U , 11:31a Pool and Spa Design 1087781230 PA T tl NARCENT-0b - rrl� I ASANTOS DATE(MMMDIYTYY) CERTIFICATE OF LIABILITY INSURANCE 0611612017 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 have ADDITIONAL INSURED provisions or be endorsed. it SUBROGATION IS WAIVED, subject to tho 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(si — CONTACT PRODUCER NAME: liveiros Insurance Agency Inc. PHONE FAX :ommercial Insurance Center (Afc,No,Ext): (844) 898-9.151 (arc,Noi:�508) 324-4533 175 Airport Road ADDRESS: 'all River,MA 02720 INSURERIS)AFFORDING COVERAGE NAIC k IN SURER A:Atlantic Casualty Ins.Co. 421346 INSURED INSURERS:Arbella Protection Ills CO 41360 Narciso Enterprises Inc INSURER C: 9 Edna Circle INSURER0: East Freetown,MA 02717 INSURER E: 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 VAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERNS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1r.J7T�R POLICY NUMBER ADOL SUBR POLICY£FF POLICY EXP TYPE OF INSURANCE IN5D y8 D INLMIDDNYYYI IMMInDLYYYYI LI MITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLr,Ih15-A1ADE XOCCUR L205001669 06l1412017 06(1412018 DAMAGE TO RE:i reD PR.Er--ASEs&a 1OO,OCO- occu.ranc,c S + I•.9ED EXP f.Any one pu::on) S 5,000 PERSONAL SADVINJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,00,000 X -:AICY JEC LGC PRODUC-S-COMP?OPAGG S Included OTHER: AVTOMOSILELI.ABIIJTY (EaMnccritlrDiUING..ELIMIT - i,NYALITO 1020018472 05107i2017 0 510 71201 8 BODILY INJURYIPerpersorl S 100,000 CANNED ONLY X SCHEDULED_ BODILY INJURY IPcrarddwil S 30O.D00 A1JTFIR=D 'AUTOSNON-OW --D PP,OPERTYCltaaGE - 100,000 AUI OS ONLY -AUTOS4NL,f (P•�r accident) o c UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS•1,1ADE AGGREGATE S DED ___RETENTIONS 5 WORKERS COMPENSATION ----- PER O N AND EMPLOYERS'LIABILITY YIN STATUE ER _ ANY PRO:�RIETO?1PARTNER:EXECUTIVE y I A £.i..EACH ACCIOENT OPFICEPAIEMBER EXCLUDED i (Mandatory in NHI E.L.DISEASE•EA EN'PLOYEE E II y:s,describe under DE'SCRIPTIOV OF O=ERATIONS below DISEASE-P7jLICY LIMIT -- DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 1D1.Addilional Remarks Sehedulo,may be attached if more space Is required) Swimming pool install CERTIFICATE MOLDER CANCELLATION _ _------- Ill SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Narelso Enterprises,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. 9 Edna Circle East Freetown, MA 02717 - ----- AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserve.-I. The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ipolication # Ma (6 Parcelp Health Division Date Issued Conservation Division Application Fee LA Planning Dept. Permit Fee �.L Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis �Project1StreetsAddress JQ 4- Villas g�e Owner_ �� S4 I U"al5 ��� -� �- � � Address A I Teteph-one----_ 6 ' b a - ` ' a ,+ Permit Request Y ok. �o� c�� r�n r�C Ix �► Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuatifonRl 915co Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach sfpporting documgnlation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family'(# units) Age of Existing Structure Historic House:. ❑Yes ❑ No On Old King'skighway:-0 Yes,"❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other - Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) ,_,,j 5�21 Number of Baths: Full: existing new Half: existing new_ M Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 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 of A(� &� Telephone,Number-,J- ��rT Address •-,I()+ �(c�l�Q� �'� License # NCWMS MA 0 �0 I Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO l SIGNATURE"' fs i-A-DATE--�1-=�� : FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Conwzonwealth ofMarsachusetls Department oflndustrifdAr-czdents Office of Trrvestigatzonr t- 600 Washhwon,S`treet ; .Boston,MA 02111 www.mass govldia Workers' Compensation Insurance Affidavit.BOders/Contractors/Electxicians/Plumbers Appliccaan- I-n-foormation Please Print Legibbr' �N3 e-(B-ILS3IlCSS/Org3Il7zah ndivirina T) '6 �r--1 —�� IT� l Rims _ .Address: ��'� ��P1� St.� • ���' `1 . [ City/StaW,Zip: [n S Phone#:you an employer? eck the appropriate bow ' T eof -o"ect re4_ I am a contractor and I pI ( fled): J�L6re . I am a employer with �� 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole propiietor'or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have ' 8. C]Demolition working for me in any capacity, employees and have workers' [No workers'comp,insu^ante comp.insurance. 9. Butldmg addition required] 5. We are a corporation and its 10_❑Electrical repairs or additions ng C3' I a homeowner do all work :officers have exercised their 11• Plumb" t ` right of exemption per MGL repairs or additions myself [No workers comp. . 12.0 Roof repairs insurance required_It I c. 152,.§I(4),,and webaveuo i employees. [No workers' 13.❑ Offie- comp.insmaacerequiied_] *Any applicant that checks box;#1 mnst also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractna must submit a new affidavit indicating such. �Contracb=tbat cbeck this box must attached an additional sheet showing the name of the sub-contradnis and state whcti�cr or not those entities have employca If the sub cnutraetnrs have employees,they must provide their workers'comp-policy nsmbcr, l-am an employer that is providing vorkea'compenration bzrur-ance for my ernplayees. Below it the poVky and f ob site information. Insurance Company Name: Policy#or Self-ins.Lic.# Expiration Date: Job Site Address: City/St a&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 e, 152 can Icad to the imposition of criminal penalties of a fine up to$1,50-0.00 and/or one-year imprisonment as well as civil penalties in the foam of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification_ I do hereby c under the pams Rzdpenahies ofperjury that the information provided above it true and corrert Si Date:VF Official use only. Do not write in this area,to be completed by city or town ooYda7 City or Town: PermitlUcense# Lssuing Authority circle one): 1,Board of Health 2.Building Department 3,City/Town Clerk 4,Electrical Inspector S.Plumbing Inspector 6.Other i Contact Person: Phone Information and Instructions Massachusetts Geheral Laws chapter 152 requires all employers to provide workers'compensation for their cmploypes. ParsTan 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 wriifem-" An dryer is defined as"an individual,partnership,association,corporation or other legal entify,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 - use of another who ein Io s persons to do maintenance construction or repair work on such dwelling house dwelling house P Y P - or on the grounds or building apprrtrn ant thereto shall not because of such employment be deemed to be an employ er MGL chapter-152, §25C(dalso 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 insurance coverage re required-" a Iicaut:who has not produced acceptable evidence of compliance with theq gp F F Additionally,MGL chapter IS2, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the in saran ce. remnrpments of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by ch(--ckiqg 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 wormers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also he sure to sign and date the affidavit. The affidavit should be returned to;he 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 Iaw or ifyou 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 r . 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 permi license number which will be used as a reference number. In addition, an applicant that must submit multiple pmnitllimnse 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 maybe provided to tb e 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 (ie_ a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would hkr-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 Cammaawealth-of MassachustM Department of lndmtdal A(Y-Oenta Office ref Xnvestigatio-wi 600-Washington.Strut Boston,MA G2I 11 T(J.#617` 27-49W e)ft 406 or 1--977 MASS.E4FE Fax#617-727-7749 Revised 424-07 w .mass_go�f dLa I Town of Barnstable Regulatory Services �oF Rce roriy Richard V.Scali,Director Building Division * F F ` BARNSTABLF. " Tom Perry,Building Commissioner �$ 1MA39c 200 Main Street, Hyannis,MA 02601 www.town.barnstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 3.r I1 ,�If - -�#.P-[easc.PrinY.,�' DATE:. l 1 J , JOB LOCATION: l yT bAAl lf\--J T - number, �^ ..,street _ 'HOMEOWNER": ftqV UV-+:A , 1005 i�y ! ^��r,*/�"home-phone# `^ work phones#firr CURRENT MAILING ADDRESS: l®A U �[: LCA1 lam""S lt) wn state `5�', a '""zip code The current exemption for"homeowners" up was extended to include owner occied''dwellinf si�s o x units or less and=to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. - DEFDaTION OF HOMEOWNER Person(s)who owns a parcel of land oa 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 require ents and that he/she will comply with said procedures and requirements. Yaitireof.flom&ners, .w 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,RuIes &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:\WPFII.ES\F0RMS\building permit forms\EXPRFSS.doc Revised 061313 I �zHE To,4y Town of Barnstable Regulatory Services F MBAR IAATS.CBLE� Richard V.Scali,Director �A 16;y �� � 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 Complete and Sign This Section If Using A Budder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work autl o�ized by this building permit application for t j! (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be,filled or utilized before fence is installed and all final inspections{are performed and accepted. Signature oftOwner Signature of Applicant Print Name Print Name Date Q`.FORMS:O VJNERPF-RMISSIONPOOL.S S� [OOV s s G CD L _ � k�uuj("A did �o�v ,,,� o I� I�� n 1S—� I �0� � 3 ���� �c����� ����� ��`s"'a s s ` o�'�' �� InSulahM � S�;pktn(� THE o HAHA9TOHLE. i 7 1639. MA60. \� %/%PC CEO MAY 36 7 Main Street, -,/ yanni,, ///am. 02601 M E M 0 TO: Joseph DaLuz, Building Inspector Zoning Board of Appeals FROM: Board of Selectmen �. DATE: May 9 1985 SUBJECT: Possible` zoning Violation nden Street _. !Mould you please forward your comments regarding the attached copy of a letter regarding the possibility of a zoning violation on Linden Street, Hyannis May l Cn� Setectmen Town o% Sannstabte ���� Town 06j ce Buit-ding 3 1085 Hyannis , MA 02607 Dean Si.PL6 : Sevenat tettenb o6 comp.°a,int have been sent to the Suitding In,�pectoA' o6 the Town ob BaAnstabte tegatding a Day Cane Nutzety Sehoot bung operated by Mth . AQat,ie JH cLa chetn at 107 Linden Stteet, Hyannis . To this date we have not teeeived any rep°y bnom the Su.itding In.peetots . . On Deeembet 10, 1984 Mts.. McBachetn ways granted a tieense by the 066ice von Ch,L.Ldten, Lakevitte, Ma.6,5; but .the schoof had been openat,ion Got ,sevetat months ptioA to ticensing . I have been told by Mtz . McBachetn that the schoot w.outd operate with of without a ticenee of vaA.iance and that there is nothing that eoutd be done about .it. The tieenze is to care Got not mote than six eh.i.2dten .inctud.ing hen own under the age og twetve ( 12 ) . Most ob the time there ate seven oA eight ch.itdten at that address . These chi dten ate dropped o�6 at het house as eatty as 7 :45 A.M. We, the home ownets o6 this area ate eoncetned oveA the baet that the eh.itdten ate attowed to play in the ztteet, which .is heay.i°y tAavetted most o6 the time and has bf..ind cotnets jtom oncoming tta66.ic . Thi,,, is a Residence "B" Zoning D,istAict without a vat .ance having been granted oA tequested . We beet at this time the Town o6 Batnz•tabte Buitd.ing InApectot '4 066.iee has had ample time to Ae�spond to out tettetz and 6ee.- that we may be UoAced to take tegat action to en6oree the Town By- LawA Got out ptotection. bnctosed ate copies oU tettets and Aeg.isteted ma,it Aeeeipt.5 sent to the Bu ix ding I nos pectoris 06 tic e. S ' etet yio If/S R Ict—h,L_.—S� m_p=�s_a n �1 j 3 tne Linden S _et_—Bax 1 1 3 Hyannt.z5,MA 02601 Copies to : Building Inspectots 066.ice Appeat6 Boatd December 21 , 1984 .� Town of Barnstable Building Inspectors Town Office Building Hyannis, MA 02601 Attn. : Mr. Richard R . Bearse Assistant Bldg. Inspector . Dear Sir: We, the undersigned, are strongly opposed to the operation of a Day Care Nursery School which is being operated at the home of Mrs . Marie McEachern, 107 Linden Street , Hyannis . First of all it, is being operated in a Residence B Zoninc District without a variance having been granted or requested. Secondly, this Day Care Nursery School is being operated without a license from the Commonwealth of Massachusetts , which is required by law. The above named conditions have been going on now for several months which your office is aware of, but nothing seems to be done about it. We now feel that if action is not taken by your office we shall be forced to persue stronger actions from a higher source. �erely o rs , Ralp L. Simpso 113. Linden Street, Hyannis, MA 02601 � e y� V/t . i S 1 1 jommY Nwni3w OUS31000 Evet Mnl 'L LBE wJo j Sd W " X 01 X OD �Q A - W N 71 O< m p m• C D p N Ur I�9 mn��'CCm 1 D. 0si 4a o ° O� � �� • "OJQIO� y as02, ccp ,. " , t7 «' 1 • 0.<3 to a � NsiQTa o c '?• v] a 3 c� » Ds Oc a j • 3 aA O a pO } . s r O ; a 0O '� Y '0 70 0 3n alA n os� 0 � C 3 cL 711 o o =Z a , 8o °tRD � N O M o f !< q mTIZ i _ v> > o me 0 N O 0 7 m CL EAJ m O. m { • < Sa • n7 � 03 '0 3 0 S 6,q UNITED STATES__POSTAL S 1W.M D, OFFLAL BUStN IAfI ^v .�•..,M t 6fiP.0ER I><S7AUCTTONS" .� IL Print your name,address,and ZIPS f ..••- �' ® apace below. • Complete Rears 1,L 3,and 4 on the rwarsa. • Arleen to lronl Of artfofe ff space perinlM PEI"TY FOR PRIVATE ctAeewMe atfla to back of article. USE.S300 • Endorse artkte"AG't-.-n li3rofrt RfiqueatVX' to nMnrbar. ++ 11 n n P. O . of Sendw) ' �, / 0 / t(�T� v x. 11 ,3 - �(N .and Street,Apt,Suite,P.O.Boir w R.O.No.) K� Hh ;S- ,i 1'?A dZGv ! (Clty,Stsia,end ZIP Code) 1 May 1 , 1985 Seteetmen Town o6 Sarns.tabte Town Usst.ce Bu.i-eding Hyannis , MA 02601 Dean Sits : SeveAat tettets o6 compta.int have been sent to the Bu4'tding Inspectots o6 the Town o6 Batnstabte Aegatding a Day Cate Nutsety Sehoot being operated by Mts . Matie ",4cBachetn at 107 Linden Street, Hyannis . To this date we have not tcece.ived any tep°y SAom the Su,itding Inspectots . . On Deeembet 10, 1984 Mts . McEachetn was. granted a ticense by the Uss.ice Sots ChitdAen, Lakevitte, Matsu; but the schoot had been opetation Sot sevetat months ptiot to Zicenzing . I have been toad by Mts . McBachetn that the schoot would operate with of without a License of vaAiance and that there is nothing that eoutd be done about .it. The Y..icens e is to cafe Sots not mote than six ch.itdten ,inctud.ing het own under the age o6 tweZve ( 12 ) . Most os the time there ate seven of eight chitdAen at that address . These chi. dten ate dAopped oss at hen house as east y as 7 :4 5 AA,- We, the home owners os this atea ate concerned oven the Sact that the ch.itdten ate attowed to ptay ,in the street, which is heay.i°y ttavUted most of the time and has blind cornets SAom oncoming tra66ie. This .is a Residence "B" Zoning D.isttict without a variance having been granted on tequested . We Seet at this time the Town o Batnztabte Bu,itd.in Ins eetot 's U / "e S p ti e has had ampt.e time to tespond to out betters and See. that we may be Sotced to take tegat action to ensotce the Town By- Laws Sot our protection. Bnctosed ate copies o6 tettets and teg.isteted ma,it Aeceipts sent to the Bui.P_.d.%ng T nh nectotc,c S,�,4V etezy o 6 , . A�" R kph L. Simpson 113 Linden Street, Box 113 Hyannis , MA 02601 Copies to : Buitd.ing Inspectors Ussiee App eatz Board f December 27 , 1984 s' Town of Barnstable Building Inspectors Town Office Building Hyannis, MA 02601 Attn. : Mr. Richard R. Bearse Assistant Bldg. Inspector Dear Sir: We, the undersigned, are strongly opposed to the operation of a Day Care Nursery School which is being operated at the home of Mrs . Marie McEachern, 107 Linden Street, Hyannis . First of all it is being operated in a Residence B Zoning District without a variance having been granted or requested. Secondly, this Day Care Nursery School is being operated without a license from the Commonwealth of .Massachusetts, which is required by law.. The above named conditions have been going on now for several months which your office is aware of, but nothing seems to be done about it. We now feel that if action is not taken by your office we shall be forced to persue stronger actions from a higher source. A rely o rs, L. Simpso 113 Linden Street, Hyannis, MA 02601 f + H ® SENDER: Complete items 1,2,3 and 4. a �tCC fit Put your address in the••RETURN TO"spaca on the � 40 0 reverse side. Failure to do this will prevent.thiscard frombeing returned to u 4.W o .The return recei f Y pt ee will rovlde Oou h - p t e name f o t a arsond liv r P e e ed to and the date of J Foraddruonal feee the following services aret 5 � '0 , i L. available.Consult postmaster for fees and check box(es) n p o < foIS, ce(s)requested.1. how to whom,date and address of delivery. •.. �� O a ` N W fp �� _ ! 2. ❑ Restricted Delivery. ( fit ,, $ a • o i E 11; (a s 3. Article Addressed to: %dw1. a $ 13QI.4vsVia,61� ?fir,<;_ 8!4'. �t�s j8c.fo2s o Kam- a F F;c 3 a �kKls, �l0 02601 w , 11 r 4. Type of Service: Article Number. �Q Registered ❑ Insured ''` �d.b o o Cr Certified COD O/ (y Q �/ Jl zS1 5 a.p� Express Mail ,6 6 / ," bri b +o Always obtain signature of addressee or agent and DATED LIVERED. a a o pop 5. Sig ur A dr e 3 x i on X Signature—Agent ,, �� O to `` $ • " I. C 7. Dat@ of Delivery � -8S g5 0 o A ci4o3 �� Z 8. Addressee's Address(ONL �eett ��f \ �'O 4 4 • e • a. t. 44 } s � I i y to w'.'_ §. .�. s .,A;•::h > >.rti;*w• ,,.:t:• ,', iS„«' a:- ;#� #,.«• •tJF .dei "p«. ...;.. .� x'� �,. t ;. �F-a +.>. , ,,.:}' f Ta, x c�:a� �.l„ 3`'.•,.�;r s n�rS#:. - * ,,. wit ��'1�•F� �� ,s, r'''�r" ,•�:w��, *,Y, �atae,.l.„.„�*�fir��« -.�t�.a<�, r�zr,.,�:.st;�.-:a a;�r � _ .L ::_ .c k,:_,,.. L.ti•: t '-- -Y...: �. .-.. �..: .:.ri :... 6;�, t>�� F.-' {^y 't, .^z.#. .t: s„'., ,:•k"`,,.v`+'�' ,:'�' <.!. #:r•'4: �tr .stir ` �,:� ,i s ;.,- - - .:.-^+s,... ,, , *,ta"r"�' -`�.. �' ,( � # .r: #t• <..p., +'N"su't! ;.€ t p��, _- a: ..-t�r�.. -:x' a� t+. ? 4. �.. �a5.� •..�a .s ,k �.,.4 i•��_:`� ..'�Ka is : a:�t i F�l` •e:r:. .n+tr�,,wM`..5.>+�--..� # +�, ^t+ ���v� V�rYf .J, `.4` •�,.. + t"fr4 3f t�r, '3„ { , ;:* -r,4.t. •»!,, 1 v„ f .a-: x�,-�i u• � t.' `�.t*a,:"^7%?.` �^' 25� �:.1,. tr,�+�. 1:r3' 1 � 1 a„ Sk`�' - ,., ^. .yj'- j„ � , -. r �,j. �++ fi a> „ iy. � [ �,� ��"S+r•'�`„4;Ne�1,�j"%lk� °t'+p„x•x��m.� ::':'. ty`} tiq o na , - „�. -iaf' r 5 r,; •Sti, S> "`''1` n.1'4J5. ! PS..z, �. ,s3r'' A`{ ,?; '{ }I�r^k.,,-. + g w wac# r' {'1 c�. ,,$�,ak "s4pz-. ^J`' , s.'R.- .. gCrc,:, �- ,�.',y`*" .,�'ts'.::, 3 3r "av,��'�1'ny+''[ �' THE COMMONWEALTH OF MASSACHUSETTS '�''AR `" n.. (,•/�A�� h,'rf'.',^'T� .V"1, ,: .. � ';.*t I� .::.•a ,:: v'.,�; ,.. ,> {...,.. �. .;,_: 4 .t'a,3,_q t _ "�•i,.�i�j-•� -r. r",ai-sc ts'r�."�"#.x�" '.1"+hl.^..i�i't-i^ j 'ti.:. k�"'3%` :»a`1hs`S`''>- a, gg �:. Y tet,r.,# r.-.., ,,ti.+. s v.• .:...._+. _..yc1 7:w t -::cf :-" .ro..' L Xi: �' .f;.��.�- �� ?'- '�� "�� f �� ,t t .,x t .r.,.�:t .4 ..';�t• NX "" -:i: " ty`•I +�}. t,a.+•: a:'..s. ''"'ram.'l` fe `t.. t "ti•ij .;? !✓r an,,; ., .+ -e:= t z: •# Y? �:�,. .?s.kry {+s -«" ,fer .x••"m4..Rg7,, ^fr<i1x ''OFFIC��:FOR CFiI'LDREN ;,�� , ,,��.. �,� .�.� :�� keg„a � � +f "� sty �R: "�;, .4r:�. k., -t Fk, i:: � '-#,'PaS >�r a s'.- ✓* #v 1' ?:,` a "�^. 1 .r e:;. t ,� t c ;#;,4 ts""�: ..✓ ',�:.i y, �!xr is ;� iCtl� +.- ' Sdq.'" X '7. 4� z#. .'fi Y. a ,,. ry ''#•- 1u!. 's�. E ff'r', p...i^ t -'�k * ''FH?l Jr .. r. x tf G. 4. a•..#3., •rY' ..�,. -31 u.c 1� `� 3` 'i„�,.,���. �rwc"'t3,:�. *r '!"sr^FSz<z ..�+`a'"t�.. }, - ?• �! t.r�-,i� �'1, }. :.#nr.t•. e.^• .j;: � 'is. ..�� .,9- "•~'''- 'ii•,.. S..><4. ��i,n �-',. a i ,.4 {;� .), �. .��, •.ti�i?`i'� � 3. i �` t:�.� 1'£, >d T� �.: :Y lam`' ��°a^� � tix � -:1•ry; , „ . n ty - ,J �; � r. '�,� r xL: �r,�t� n 'i'i`ti�ty{':r ++a Sa� aAi,, •5d•-r,.. "sue_ �'t � ��a�v"`z• Y. <:cil``�1 .2.�Cv'.".. 7 ,, t Y t.;�,# .1 :6,5,�„q •:�.i a.�,. .�S�i, t'i� s.> .J r ;, 3 •s; ."r1,, t.x :•,4 .k,r 4,� -;CERTI�'ICATE''OF ItEGI$TItATION �ri x,. J.f,i�... ,, S. .,... '.7�.. ,.�, ;^�. ,..". ` `� tr>b,.-1 i. .".r. f r:.,.Y�s„ .+._.. 1 3 :Y t, n ,t"i.:#t 'XfM+^ 1 :3'.;, 1 `,�•' Y"' ?# 1 r'<.:a �, .: s ,,.: ..� :. ..g;' ^ .:. +, ,;.�. !i,.-•4' �y. r `r'. - �. ,rfJ?,.. J#..5�,. t5 3.Y;j��. a�: -� 3�e.;1- !. t•.a--} '3 # .n" .t M,-:Y ^{t,✓' .r:=� #. - t'rc. ++ a K: r�.t: r}': E ,a.'� '.�{t. .�•i+ '-•5�'.. ..i�r'•e. _€r` �� r�:t �� wx 1h:i +�`j .� + I ;n � � s t?c 1 1'1,,s•,. �� v.H.,�i7'''' 'd%t�'�4"�:f' .,^�j,� '�,--• .�w�i„` 'z -._2 t s:M fill'. t .:i "i >`�, 1#�_ of nKJ St: yanris', MA02601 # ��, �: g MARIE McEARCHERN 107 Linde H r (name) rt 4 +, . t, ':(address)di? .7d, gs .itk' * �4 �;: # '� 1 t•• :r,, t:vr ,J 3�','' n , �. _e- � -<..5' J -i a.. a �''- a .� t "#, ',-, X 1 0'�`;+ a ai, '-r a w�. ,a u r =E�,+G�t;,•V a 'a-�,.yti ct,'y� +q. ... �,`...2�. {. S, ., _.. •. , ' t:,t+` h,?J: r s ! y;" t -3: a• k,s!x '�+r,s,.:arz 3,��'�('is u.. ?tit• d •r a ,.-,... . :::: - t. .: ..•:^*:.-+ .ti :xt_ di: r _.�• + i�r f `_3' .a.-rrtj 1 �.. ..,,•.; , :. ,,r:,',:. • r. u,.. {'�yy"yam }.. z;i6. has registered with the Office for Ctiildr'en:to provide'jfamilylday'care'services tor no;more Phan t' FOUR hildren'atithe '+,-:... « . .t.'" ,°•`�"'=` .,-�..F,• iir ., ,:,z 'Aim;;.; -'�' above address, as require b Cha ter'28A°of the Massachusetts General Laws He/she has certified�n wrxtiri that"he/she _ • x q y p g a *�> .;x<; •. s". ...>..:;d.t-.•„ n.,: .i. t.�:�"rt S :ii"tf?✓-`,?-:- .; ;ret n•^ rOMi;,4taa;'r*> ~ +j � t has read and is in compliance`with the Office for Children Rules and Regulations for operating a famny,day_care:home 1 a'.>_y r , ,tit;. ,sf>.`r.• e � #: ¢ .! tl t - :i `•:Y' _3.:-.1 '" i... at i''. ?rs.c,X."c? F•.'%r F dl}�Ft"i rT' W. ✓'+..-- r5,+:.•_``�` ;..s�� �,r. �,.,n���;.:. '��,._,,:;•'b�r. This'compliance'does not"certifyithit this'I milt'°day care home is free'`of lead paint'hazards.,.kIherefore-, the'�Offrcetfor ,: r. .i�'r..iy.,"•9' ?*,t *tw :fit V �'"t�. is i ` Children strongly recommerids thatparerits withichildren'under the age of six'should have theirchildrerneste�dPoyr'"le,yay,.,,d5 �A,,...;,;,..,w 6+ a- +tiw�E4 •SN'�3Yrd�'N5''pi-�i ky.?y.'..9" ¢~ ..,t, # poisoning at east a year. Parents are"also advised to become informed`about childliood le d p ison�jn""g'anaab", i.x.....<..F.r„; `ar4^•tsz"'ri*Jt�s4gs; r^�}�"^�a.-at. � 4 additional measures to protect their children(0-6)from sources'of lea", ead poisoning ,w -Vn, < : , „ .. .Lf� /'s`���-.•�±� `u - ' ws x Coptes of the Rules and Regulations'and information about preventing lead`poisoning-may be obtained`upon request fro },� t the Office for Children,':Day'Care Consultation°and Licensing Uni 150 auseway Steet,l3oston _IVlassachusetts'02I14 ..�`- '.; `:.:: ' "�' v .-:. ' S,..:.:i a;,:R. .>.� n•:;m..,:r.�-. .•, y.+a1'a:". y>a.,,e;>�..��,/ ;fit y '"+_, }ktiyF1+.=j;�'!�. rf �"�sr^r..??'�j{*-�1� ro i.*.r,q; a y ,,,a- '.,'. ,:-+ .,.., , � i>, i:.� y y.. E„ �7 y d:.tS 1»�s } �..•t�� s' 'y,-i > °>Z;. .J a '"' -.s°3.8`v a�:n•�.....v yt4� .,fx.. Diu % 1s�k' H.X"<»-^' ,:..- - .,.•....::..... ...: '., .�,._ :,...: ..-�c,, :..,� -,'"c #a„v.r:q-:�. ,y'. s -:i". }{� -ac.�^�,>i i--x �.�,t�'••s. ''J«s'A.e� r«°,:;.;.,fro .' `:Ft'*:. .'*�. u.:W a .,, ,.: ".r ::.., is -•, a., '"'�'; _ .?'. .,,» .,fi., s *,.:�_.s" ✓. O✓ ��6- 'i'{i -x � "(•"s 'k Certificate Number „T } T Mj ., 10 1984,+� r M ill TMtJ✓ a� ' >,:Date of Issue: °i"' ,^ ►_ t s:: a: a.:i�` 5f s7s''t+ k, w araa t lM:os a i� r �Y k aC" Dec., r 1986'` ,gas >`, x{ d„, .� , �? :, � •. 1 " :Date of Expiration ��,';p`:''x-F# r;, �,.�?�� `t r art s ;?;.s� 5 ,�,�.u,� 3• tjt#*`'a* ,.z• #;':�° s:.� u (Q'actor;Office.(or.Children2 t. t '` .'a #�• ,:Y r tJ J t '>..s,`t +v.: A�,��. ..A2 '+.t"• ',&'' '! #< E ,�:�a ,#^t''Fa .s+ rp (� v{.ra:t ,E � �`= '(�# ."��c�. � tab. Sx �v�,•tom - r 3 t a.'F i v ` T,+I« i o` .3 i '�i'rl`• `�'' ' �u`.� .. ' «,� R,r -#a` ,A.. e� S:r• gip'• #� rj ,� x 4f�tF'. 2. r5 ! '�, Mf"w, .s ygat, r�:�„�� $-r��. '�� �� ,•�' 4. '�`. i'- �` x i��t>tk f•'°'` ¢j +,.u«'"4 �4.t ..+..hit � r"3 x� ';•-��"„ ,s K tit..." r ><a •w.,r: •>,:'°l.:,y.s1 ,.:, !. "•-^# *'k>, -24}a t.p.• .: ' �-#4, Yj'ryi . .. t• ' •'x �` 'db ;',:YH�' .. t''•t a �. ^« w#=.,� kr7 .,� :,L � ty:t..:�" �y- ,..� ,.°,n:. �yf'�•mq. �,�,, >, � .�„2�` ry �` 'ra C, ^A.. s `AF y ; ;.<• f w.�5 Y {� 'th i'.''r w:'P,q `a'. t••' i•t - ' K i; n i r *;%-? •, 1 __lt xa�«..,; .4 3 .,•C;` +':'F.+ee1 '§4a rf' .r#.." 1''fa. �'�"h °- ' µ ar •�;�kwn, PLEASE POST CON SPICUOU LYE* :Ytr. lays $ styes`' �n a• , L�N_� .+ 2 JOFEPH� DALUZ TELEPHONE: 775-1120 Bailding Commissioner EXT. 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS. MASS. 02601 MEMO TO: Town Counsel FROM: Joseph DaLuz DATE: February 8, 1985 RE: Family Day Care Homes Attached please find a copy of a letter I received from Mr. Kim Yasutake, Family Day Care Coordinator from the Office for Children in support of family day care homes in the Town of Barnstable. T....,„ 9 s 1 t , ' s I F E B 1 2 . 1985 ' THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF HUMAN SERVICES "t OFFICE FOR CHILDREN REGION V Gloria J. Clark Charles Sullivan DIRECTOR REGIONAL 727-8900 DIRECTOR 947-1231 February 5, 1985 Joe DaLuz, Building Commissioner Town Office Building Hyannis, MA 02601 Dear Joe, I am writing in support of the continued operation .of family day care homes in the town of Barnstable. As you may be aware, Massachusetts General Laws Chapter 28A defines a family day care home as.- "Any private residence which, on. a regular basis, receives for temporary custody and care during part .or all of the day children under seven years of age, or children. under.sixteen years of age. if such children have special needs.; provided, however, in either case, that the total number of children under sixteen in a family day care home shall not exceed six, including par- ticipating children living in the residence. Family day care home shall not mean a private residence used for an informal cooperative arrangement among neighbors .or relatives, or the occasional care of children with or without compensation therefor." The key words to note here are "private residence." As you can see, under this law, family day care must occur in a private residence and should not be confused with a group day care center. Chapter 28A also requires family day care homes to register with this Office under threat of criminal penalty. This being �.the case, Any. effort (however well-intentioned) to exclude family day care homes from resi- dential areas, ultimately forces those providers to contemplate violating the law as defined by Chapter 28A. Additionally, family day care homes are clearly limited, by law, to providing care for no more than six children (including participating children who live in the residence.) A family day care home need not have any greater impact on its neigh- bors relative to sewage, traffic or noise, than would any home housing i family with six children. In terms of community impact, a family day care home bears much less resemblance to a'full-fledged group day care center than to a-person selling mail-order Christmas cards from his or her kitchen table. Finally, I am sure you are aware of the pressing need for child care in' the Human Services Building, Lakeville Hospital, Lakeville, Ma. 02346 Joe DaLuz, Building Commissioner February. 5, 1985 Town Office Building, Hyannis, MA Page 2 Barnstable area. This Office attempts to-ensure that family day care homes are safe, healthy., and stimulating: environments for children. Our task would be made all the more difficult if zoning barriers discourage providers from operating openly, legally, and in full compliance with the law. Thank you for your interest in this issue. Please call or write me should you have any questions. Sincerely, 1 � • Kim Yasut e Family Day Care Coordinator KY:tn J YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you t must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form 'at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office,.1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is -required by law. DATE: Fill in please: APPLICANT'S YOUR NAME/S:_ M w tj fi w T;�'f�h 14 e w�3 " k "' k BUSINESS YOUR HOME ADDRESS: .to l.�n�l�h S+✓�f r i � ra�r'lR1Etii [� O AI . LLC�Of! .. TELEPHONE # Home Telephone Number 50 8 _ '9 Z1- +74 KEG�,V"Gr N10, j.)..` Krr h Y9 NAME OF CORPORATION P Z e_S hv�s Fti tars LLC. NAME OF NEW BUSINESS TYPE:OF BUSINESS �e 5-( Loh o IS THIS A HOME OCCUPATION? ✓' YES NO ADDRESS:OF BUSINESS 0. .> hde. 5 .:: ;, w 02 ,n MAP/PARCEL NUMBER I: o. [Assessing] When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. MUST COMPLY WITH HOME OCCUPATION. 1. BUILDING CO ISSIO R'S OFF nt E LES AND REGULATIONS. FAILURE TO This individ al infur e a y per it r quirem s that pertain to this type of busin MPLY MAY RESULT IN FINE- ; I Aut on Si tur OMMENT jV© I 1 c,t 2. BOARD OF ALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: Town of Barnstable Regulatory Services .�1.� Richard V. Scali,Director • Building Division uxrasresr.E. v� 1MASS. Tom Perry,Building Commissioner 'OlEp Mp`t a 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 F 508-790-6230 Approved. _ Fee: Permi0r L I L£O G HOME OCCUPATION REGISTRATION Date: I ln�n-' --7-,/— -----___.___.._------------ Name; 1", w '1&w e JA 3 Phone#:S0l?'3?S-Jao� Address: 1 h�Gt? s-�re-e6 Village: Name of Business: �.� • 1 �J�`� LVI Ve ST'��,f o�S. Type of Business: Map/Lot: 1 c) I INT'ENr: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersigned,have read and agree with the above restrictions for my home occupation I am registering.. Applicant " '`� Dater Homeoc.doc Rev.103113 i L S Vee, f~ , employes Chd vn c�►e-N9 ;Cti14 �fe � r � ir, c�;, F,Ci( %A� 90 .01 WV b- 130 bl % lo-- L haZh �wv,*- e-m x 5 ��� c�►e C t �S ��� �fa � Y r d 90 :01 WN 6— iJG bl .. The Commonwealth ofMassachusetts Department oflndustrial Adcidents ; Office of Investigations 600 Washington Street Boston, MA 02111 , www.mass.gov/dia Workers" Compensation Xnsurance.Affidavit;,Builders/Contractors/EIectricians/Plumbers Applicant Information _! __• Please Print Legibly +Name (Business/Organization/Individual): •Address::i (0-T U14Atl 144Wti4's City/State/Zip: _ - �� C l Phone.#: Are you an employer? Check the appropriate box: - Typeroject(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/orpart;iime).* have hired the su'b-contractorsw construction . 2.❑ I am a•sole proprietor or partner- listed on the•attached sheet. modeling ship and have no employees These sub-contractors have molition workin for me in an ca aci employees and have workers'g Y P tY $ ilding addition [No workers' comp.insurance comp.insurance. •re uired 5. ❑ We are a corporation and its ctrical repairs or additions RI n a homeowner_doingyall work officers have exercised their mbing repairs or additions m 1£ o worker a right of exemption per MGL Y �— P 12.❑Roof repairs insurance required]t c. 152, §1(4),and we have no employees. [No wor]Cers' 13:[(OtlierG�: , comp. insurance required] . ''Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet sbowing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors tzve employees,they must providb their workers'comp.poHcynurnbcr. Iam an employer that isproviding workers'compensation insurance far my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: "City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date),. Failure•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violat6r. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. Ido hereby certify:ender the pains•and penalties ofperjury that the information provided above is true and correct cS�nature— �-� Date:--� Phone #: c 7/ -�2.3`/'-7— Official use only. Do not write in this area,'fo be completed by city or town ofj'lclal City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6: Other Contact Person: Phone#: THETp Town of Barnstable Regulatory Services B"NSM LF,$ Thomas F.Geiler,Director Ep; `` Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 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 construction 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'Woork: —1 Estimated Cost e 6A:44ess-of-wor S Date..of Application: 10(t�C�� Lhereby-certify that: Registration is not required for the following reason(s): nWork 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 permit as the agent of the owner: Date Contractor Name Registration No. Date Owner's-Naive Q: rimhomeaffidav f - Y� �pF1HEt Town of Barnstable Regulatory Services HAMSr BM : Thomas F. Geiler,Director MASS. c v.+" � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 HOMEOWNER LICENSE EXEMPTION Please Print DATE: D o JOB'LOC ON: ^number street vi ige HOMEOWNER':;: '"W� M�C�� /�W ��I_ ?13T5_ ��o�Zc� Z work phone# CURRENT-MAILING'ADDRESS: C—>:� L-Ls,fc.Qj 0�(("4m S IMF. C7ZQa-� i 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 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. &SilofHomeo_wnei Approval of'Buildirig 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. f `S f "* TOWN OF BARNSTABLE BUILDING PERMIT.APPLICATION. Map Parcel ' I v Application#' 7-5 Health Division Date Issued' - O eb 0-7 Conservation Division Application Fee ° Tax Collector Permit Feb 5 Treasurer ��-- Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project-Street�Address a McVAt Viler I g'1 HUC"A41 S =Owe k�1� N,C�Qc Q,.� fl) Address Tell epho e [PermitvRequest ti w'vSkw< (wo.,'L Pqimp sLI deAe- Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new S Zoning District Flood Plain Groundwater Overlay P-roject Valuation- ' Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 4 Two Family ❑ Multi-Family(#units) Age of Existing Structure alo Bien r s Historic House: ❑Yes No On Old King's Highway: ❑Yes 41 No Basement Type: W Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) F Number of Baths: Full:existing I new Half:existing new" Number of Bedrooms: existing 3 new Total Room Count(not including baths):existing q new First Floor Room'-Count 5) 7 Heat Type and Fuel: 4 Gas ❑Oil ❑ Electric ❑Other f �, Central Air: ❑Yes Q No Fireplaces: Existing New Existing wood/co �I stove: 0 Yeses; ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:®'existing ❑new size Other: Zoning.Board_of Appeals Authorization ❑ Appeal# - - _ - Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER&FORMS N Name lydr/-e C� Vrjbgte Telephone Number L:�O� n2c39�S`__ Address X� �,L/� �/V �T-' License# eI&W Home Improvement Contractor# dZ 0 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S Gt N_TU.RE ' FOR OFFICIAL USE ONLY - a APPLICATION# Y - DATEISSUED MAP/PARCEL NO. ADDRESS 4 VILLAGE OWNER P. ' DATE OF INSPECTION: FOUNDATION �t FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL z, GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT 4 ASSOCIATION PLAN NO. P 00 t December 21, 1984 Town of Barnstable Building Inspectors Town Office Building Hyannis, MA 02601 Attn. : Mr. 'Richard R,. .Bearse Assistant Bldg. Inspector Dear Sir: \� d We, the undersigned, are strongly opposed to the operation of a Day Care Nursery Schoolxhich is ,being�.operated at the home of Mrs . Marie McEachern, 107 L ;dPn ,_S:tr,eet ., Hyannis . First of all it is being operated in a Residence B Zoning District without a variance having been granted or requested. Secondly, this Day Care Nursery School is being operated without a license from the Commonwealth of Massachusetts, which is required by law. The above named conditions have been going on now for several months . which your office is aware of, but nothing seems to be done about it. We now feel that if action is not taken by your office we shall be forced to persue stronger actions from a higher source. AlpRa rely yo rs, •L. Simpso 113 Linden Street, Hyannis, MA 02601 l � 3 P.O. BOX 113 _ — HYANNIS, MA ( U.S.POSTACE K 02601 0'F DEC29'84 I a " Zi . 35 'pia s5' P.8.3,sTi — bo UP RECEIPT ; TOWN OF NSTARLE a13A`` BUILDING INSPECTORS TOWN OFFICE BUILDING HYANNIS, MA 02601 p P 644 068 394 ATTN. : Mr. Richard R. Bearse Assistant Bldg. Inspector 1 F y C6 j y�1 �- TOWN OF BARNSTABLE,,BUILDING PERMIT APPLICATION Map Parcel J"Z Application # 8 Health:Division Date Issued Conservation Division ` Application Fee • Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic = OKH _ Preservation/ Hyannis Project Street Address Village \�arnh\S Owner Address L—InAe-YI Si Telephone olgs - Permit Request 1660, do +. eX15 q Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District: Flood Plain Groundwater Overlay Project Valuation 42,®C Construction Typed Lot Size 7-(D acT QJS Grandfathered: ❑Yes `1i No If yes, attach supporting documentation. Dwelling Type: Single Family 1A Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes %No On Old King's Highway: ❑Yes YNo Basement Type: '*Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (s`q.ft) �(ES Number of Baths: Full: existing ' new Z- Half: existing 1U new Number of Bedrooms: Ll existing') new Total Room Count (not including baths): existing (0 new First Floor Room Count `t 1L3 Heat Type and Fuel: *Gas ' ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ,No Fireplaces: Existing New Existing wood%coal stpye: O-Yes J&No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: �existing❑ new size_ jj Attached garage: ❑existing ❑ new size _Shed: existing ❑ new size _ Other.C) w Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ rn Commercial ❑Yes %JL No If yes, site plan review# Current Use Proposed Use T _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �A�VAA dr ?d!Ls A CA Telephone Number Address 10 1 by& ` S+ License# 02�i 0 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -A:W!5;t,C, SIGNATURE DATE (Q �ld� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION ` FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING e 1 DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts . Department of Industrial Accidents Office of Investigations' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): l Address City/State/Zip: a�h �- � d 0 Phone.#: Cr 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 6. 0 New construction employees(full and/or part-time).* have hired the sub-contractors 2.0 I am a soleproprietor or partner listed on the-attached sheet. T. E]Remodeling ship and have no employees These sub-contractors have 8. 'o Demolition worldng for me in any capacity. employees and have workers' 9 Building addition [No workers'.comp.-insurance comp. insurance.$ required.] 5. F] We are a corporation and its 3�I10.❑Electrical repairs or additions am a homeowner doing all officers work ocers have exercised their I I.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.❑Other employees. [No workers' comp.insurance required.] Any applicant_t1w 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. xContractors 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 andjob site information. z Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimirial penalties of a fine tip to$1,500.00 and/or one-year imprisomment,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 foc insurance coverage verification I do hereby ce fy under the nd pen ties of perjury that the information provided above is true and correct Si attue: Date: _ Phone#: 0 Official use.only. Do not write in this area, to be completed by city or town offtciaL 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 Iocal 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, §25g7) 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 zth 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-contiactor(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 e 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" fhe 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 InvestigadQns, 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www.mass-.gov/dia i ram, Town of Barnstable EVE o Regulatory Services ' Thomas F.Geiler,Director swBNMBr.e,MASS I 94,p ,�� Building Division rFa MAt° 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:A1 n 17 J -3 1 10B LOCATION: 0-1 1.91Y11 ka Ali 1� number street (� village W"HOMEONER": I qo� (O 31-o —(- name home phone# work phone# CURRENT MAILING ADDRESS: �� LA V R W os � 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 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 cedes,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 re uirements. pot A ig r Ho e Approval of Building Official Note: Three-family dwellings containir-ig 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC Town of Barnstable Regulatory Services " L►xr a• MAS& Thomas F.Geiler,Director nss. F1 Ma's►`�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Usine A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building pen-nit application for. (Address of Job) Signature of Owner Date Print Name If Property, Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION MOH TGA G-E INSP-EC TION PLAN 4 APPLICANT: WOOD TOWN: HYANNIS 4-s>' i 00. o° 1 s.00' LOT 1 1' 96.04' �� LOT 3 LOT 2 ol'P ... SHED N/F PARENTE K 44.89' ` ... N/F FLAHERTY / y r F c` STEpy= DOYLLIBM � A to FLOOD PANEL: 250001 0005 C FLOOD ZONE: "C" DATE MAP REVISED: 08/19/1985 I HEREBY CERTIFY THAT THIS MORTGAGE INSPECTION PLAN HAS BEEN PREPARED FOR: DATE: 11/15/07 SCALE: 1" = 40' STEVEN J. PIZZUTI DEED REF: 15226-201 PLAN REF: 355-51 THE LOCATION OF THE DWELLING SHOWN DOES NOTFALL WITHIN A SPECIAL FLOOD HAZARD ZONE. PER TAPED INSPECTION THE DWELLING APPEARS TO CONFORM TO THE LOCAL ZONING BYLAWS IN EFFECT THE STRUCTURES SHOWN ON THIS MORTGAGE INSPECTION PLAN ARE LOCATED BY TAPE SURVEY AT THE TIME OF CONSTRUCTION WITH RESPECT TO HORIZONTAL DIMENSIONAL SETBACK REQUIREMENTS ONLY. NO INSTRUMENT SURVEY WAS PERFORMED AND LOCATIONS SHOWN ARE APPROXIMATE- OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MA GENERAL LAWS CHAPTER 40A AN INSTRUMENT SURVEY IS NEOCESARY FOR PRECISE DETERMINATION OF BUILDING LOCATIONS SECTION 7. REFERENCE DEED SUBJECT TO AND WITH THE BENEFIT OF ALL RIGHTS, RIGHTS OF WAY, AND ENCROACHMENTS. IF ANY EXIST, EITHER WAY ACROSS PROPERTY LINES. YANKEE LAND EASEMENTS, RESERVATIONS A14D RESTRICTIONS OF RECORD. IF ANY THERE SHALL BE; AND INSOFAR SURVEY COMPANY INC, SHALL NOT BE HELD LIABLE FOR DAMAGES RESULTING FROM ANY USE AS THE SAME ARE OF LEGAL FORCE AND ERECT. IOF THIS PLAN FOR PURPOSES OTHER THAN MORTGAGE INSPECTION. TELEPHONE: 508-428-0055 YANKEE LAND SURVEY COMPANY INC FAX: 508-420-5553 40 Industry Road, Marstons Mills, MA 02648 yankeesurvey®comcast.net Iwww.yankeesurvey.comF 39396 SH i l o _ ► s -__ M-e� 2 ,� Coy 14 1 41 '1 -k Ld Rb - a - C i l e1u , � ,- ., y } /�)� �- •(yr.�{r _�'L./V�J5 i .,fin ,� ,� ,�. � ., -�f is map and lot number ......... :.. !,..... , ypi T��y ?HE Permit number A4A.11.....�.... ..... , Z BARNSTABLE, i ' 90 se number ............ D...................................................... a 039. CEO my A,. TOWN OF BARNSTABLE BUILDING INSPECTOR C APPLICATION FOR PERMIT TO ............... a,..�`!`�..'... .:......... �..................................................... TYPE OF CONSTRUCTION .... �'d...........................................................�. 1................19.. .!� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a--permit according to the following information: Location ....................... �.��. ..... . .l..► '`�..P. ... .� .......................... ................................ Proposed Use ................................................ ................. ........................................................ ........ ...... .... ........ Zoning District .......................:!:` ,.... ..,a................................Fire District ....................... ... Name of Owner A.+ "....L!!.'...,�e.t('Z.: -'.........Address ...... .................. .... ....................................... ............. �. Name of Builder .........«......: ............ ............................Address ........................................ ......... ........................... Name of Architect ...................................................................Address .......................................................... --x��, / Number of Rooms ......................... ........................................Foundation ..,;. • ...........(h.. ........c,..!fl?��.... Exterior .............�..1 ~..��.I......................................,.......Roofing .........l R.../....,/.,! K ....................................... Floors ( .,. / ,Kv.....................................Interior. ...............:.............................................:. ...................... Heating ...........Plumbing ............................................... Fireplace ..................................................................................Approximate. Cost .. ... .................................... ................. Definitive Plan Approved by Planning Board ________________________________19________. Area ..... �!�...' "!................... t Diagram of Lot and Building with Dimensions Fee SUBJECT TO .APPROVAL OF BOARD OF HEALTH I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name ....................v... ................................................... ...... { Construction. Supervisor's License .................................... ANDREW A7-310-452 Permit for ...Enclose Porch ............................ .....ing.1.e Family...Dwelling........................... ....... . .. ............. ........ . ...... Location 107 Linden Street................................................................ Hyannis ............................................................................... Owner Andrew bbEachexn .................................................................. Fraim , Type of Construction .......................................... ................................................................................ Plot ............................. Lot ................................ ......... ... Permit Granted ......June...lf...................19 84 Date of Inspection ....................................19 Date Completed .................................. ....19 sor s map'and.lot number...............................:... ........ ..r ri j e �pf tp� THE ge .Permit number �,�4.-I...� '�.. " d ♦°►... > BASHSTADLE, i use number Me ....... .................. ) n 9 ....<.Y .. �O,o�19. 9 .. "_.• � { t -' ... 1 CEO YPY a� *r TOWNn OF 'B:ARNSTABLE " � BUILDING "IN&P E C R APPLICATION," fOR ;PERMIT TO ,mm . / ..••.•.•.•••.•••...••..••....•••. ....... .. !/ l� 'S TYPE OFi.CONSTRUCTION -./ .f.G /�'\...° .. .. r pp. a .19..Q...� TO THE INSPECTOR OF BUILDINGS:' The undersigned hereby applies for a.rper/mit according to the following information:.. ' ? Location ................. �.�.�... .1.tlCd.. ...S.I ...... ...... ........ ...............................:... ProposedUse ............................ ............. ........................................... ZoningDistrict .............. ..................... .Fire District ............. ......:.............................................. Name of Owner l,.... ,! Address .......... .:.... Name of Builder . ..... �.... ....... ..Address .......... .. '^ .................... . . ............................. Nameof Architect ...............:..................................................Address •.................................................................................... Number of Rooms ..........I...............1:........... ..........Foundation. .. `�51/.1 /..... L. ............................. 9 Exterior .....................�.. /.J............:...................:...........,.....Roofing :...`.... ,/. ..`� .......................................... � �:�C�.. Floors ...............................:....Interior .........................::..............:.......................................... Heating ............... .................................................Plumbing ................................... ` .................... . ................... . Fireplace .... ...............................................Approximate. Cost .. �� . ................................................. Definitive Plan Approved by Planning Board _;___________ _________19 Area ... .. .................... Diagram of. Lot and Building with Dimensions : 1 Fee J SUBJECT, TO APPROVAL OF BOARD OF HEALTH 17 41 OCCUPANCY PERMITS REQUIRED FOR NEW"DWELLINGS I ,hereby agree ,to conform to all the Rules and Regulations of the To n of Barnstable regarding the above construction. Nam ............ ....................................................... Construction. Supervisor's License .................................... >;Oa, Permit for close..Pos~?a...... Single Famil . ....ell .Ag...................... R ..........f... ................... * Location - 10.7 Linden S ................. f Y .....Hyannis...................... .....:...... r. Owner Andrew MCEacher.. :........... Type of Construction ....Frjzum........ .. ...... .. A r. ....................... Lot ...... ......... .... .; June 1, gq ,� } Permit-Granted ..................:......................1.9 Date of-Inspection ............... .....19 " I� Date Completed .i ..1' of HO 2-Y r ,o x s�►er ODIC ftoo'SIE- M CIE I�c�E�e �f21� /01 tIAOFFN sT Py04kS N6 O260 , Assessors map and lot numbe ,_,� ......... / ypF THE Sewage Permit number � ... t ..: ., SEPTIC SYSTEM MUST INSTALLED IN COMPU�� aaBSTdu B LE, House number ... ....?�07.....:.........................................:...... „ 90 Ar TOWN OF BARN.STABLE JA BUILDING INSPECTOR APPLICATION FOR .PERMIT TO .. ........................... ..v`( (-� ::. .. ........... Q.L./. � ........... TYPE OF CONSTRUCTION ...� ^..............................:` ......... ..... �. .... ........1917 TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for a permit according to the following information: J Location ......................�.. .............�-�/�:�"""`.. 1..!...:.................:. ................................................................................... Proposed 'Use .. .... 11 f``^.�:. .( ...........��tl i n ....................... ............................................................... 1�.1..J Filrle District ....... .. . f Zoning District .......................... ................../. l ... .N. ..............:................ Name of Owner ....4�,C4.ol_n...�F' i) v� l C+�?hf ��.�,4ddress ......� �....:1 N ::.° ....t/r,. ................... A!. �:..�/ ,� f ' y ; Nameof Builder G�r .'.^.,-........v.....�........... Address .......�...........................�.......................... .. ....... Ue ...Name of Architect ' ' /t ....... �^'` ......Address .................................. G�6� ...:... ............................................. Number of Rooms ..........................10...............................Foundation PO vr^e � .cl�..G �. ................ .... . ... Exterior .. .` .Rlkc�-L !` ;i.... .S..C"PGI�•5u,49oofing ......... .:......................................................... Floors ..................I......2............�.....�.w.. .G..1..1.....✓..I......�. .�. .° . .Interior ......... j ,trt.. ............. Heating '. .� .�`!....... 10 . ....................................Plumbing ........C.Q.j.j... ........:..... :1. .a.�. ............"`........ /1� 0 �0 .. �+��A roximate Cost !1 ��' Fireplace ..:.................................. ........�1:�.d....�.�.... pp ��. �.. ............ . .f............... / Definitive Plan Approved by Planning Board - ----_L__I________19_____ Area . Diagram of Lot and Building with Dimensions Fee 3.... ............. SUBJECT TO APPROVAL OF BOARD OF HEALTHY G49 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �me ...........I ...................................... F "i OCEAN BLUE BUILDERS, INC. 23610 One 1/2 Std � No ---..-- Permit for ----..�:-----�� Single amd' Dwelling ---------...----.------..'----- . Lot �2 107 I,iodeo St�eet ' Location --'--------------.----' ia ^ . ----.--~—.-----.------------. ^ 06e -' Blm- Builders, Ino ' ^ ~ Ovvner, —...—.��!._:--.—..----.'�� ---..^ �� Type °. Construction .��������............................ ' � . � . ------.---�'---------------.. ' � Plot —'-------- Lot ----------.. November 4 81 ' ` 'Permit"Granted --_— ..................... ' / bate of Inspection ............................ .—JA Date Completed .........................^�-��^�lg ��� ` ^-PERMIT REFUSED �� , ...............~' '—' ---� --.------- lA . / .. .. / . ....... � r� ............................. , - ^ ' -�k-- .��������...��----. ` ^ ~ , . ' —..`------------.. l9 � ^ Approved . � . � � !\ \ ----'--'----~~'~^-----^'—'---' � -- -,... . —.---.. . ..--... \'-----' � . — . —,. . . L L ,i II � li I Q I Zsgo / • a 5`I a3 - 0 o 0 LI=.I' 1 JJ \ / 1 , 2 -7O S, F AP-�A Io,ocoo S.F.'` O oS , wiDTH : IocO /FF F-LA I-J ELN�I �� F L.C.C .IJ� Ig32 / A OFM,�ssgo .,JOHN ti CERTIFIED PLOT PLAN ROSER1! OT 2 L 1 I.J DE IJ ST(Zr=1=T NEW CONSTRUCTION ONLY TOP OF FOUNDATION IS 2. F R�y�� IN su ABOVE LOW POINT OF ADJACENT AJ1h tA111.a 11i AASS ROAD. SCALE: I " = 30' DATE, 10 3c) ELDRE'DGE ENGINEERING CO.IN �,CE,,, I CERTIFY THAT THE EOULID/L722 CLIENT_ SHOWN ON THIS PLAN IS LOCATED EOISTERED REGISTERED J08 N0. � 10g3 ON THE GROUND AS INDICATED AND CIVIL I LAND J.ja- --- CONFORMS TO THE ONINO LAWS ENGINEER SURVEYOR DR.BYE �. OF BARN STA E , SS. 712 MAINST. CH'By' 10.l0,�! HYANNIS, MASS. SHEET!OF i DATE _RtG. LAND SURVEYOR 2 = /osJ s W A' iX-6 Jo 9 6, Lo o Zb `. a �.dT Z Af �o POSERT: P. v rtd 9 t o 13UNIK.IS ,t.3o �t No:22162p 41 , ►v v o3. t s ONAL E� LEGEND ;� CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION Ox0 � ` EXISTING CONTOUR -- -- p:,FINISHED SPOT . ELEVATION 407- FINISHED CONTOUR 0 y s / S APPROVED $.BOARD OF HEALTH IPAABSTASLgo MASS DATE AGENT SCALE: / �,-�3.t ' DATE t 7/2-41B/ } COREDGE ENGINEERING CO. IN CLIENT AA cry CERTIFY THAT THE PROPOSED , EGISTERE REGISTERED J08 NO.�� F�'3 BUILDING . SHOWN ON THIS PLAN , 1 CIVIL LAND- CONFORMS TO THE ZONING LAWS DR,BYt� ./� GIN ER URVEY R - •-,--- OF BARNS: RLE' AhSS: ka, ?I2 MAIN ST. CH, 8Y= HYANNIS, MASS. SWEET� OF � DATE REG. LAND SURV t W, ,4 y,. TOWN OF BARNSTABLE :'Permit No. l »n� i Building Inspector cash _ � rua p OCCUPANCY PERMITS ` Bond _- �27oC No building nor structure shall be erected, and no land, building or structure shall be- used for a new, different, changed, or enlarged use•without a Building Permit therefor, first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Ocean Blue Btl lders, Inc. Address i lot #2 107 Linden Street- Hyarizs ` �� -` Wiring Inspector Inspection date Plumbing Inspector�( 41, � �i Inspection date Gas Inspector i aInspection date Q /Engineering Department ��1 � � �7 ;'Yinspection date/- THIS PERMIT WILL NOT BE VALID/AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGN_ED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. 1 C,; _, Building Inspector f'�Or � ,r � [Jim 2��• )�a��J Assessor's map and lot number ............ .. �/�7...1�........ Sewage Permit number ........................`�-- — ,Sq,,� ....... �THE ........... I�IOUSe number 'f r = 33MUSTADLL, i • ..�..•../.�.!........................................... M fl M . vpop,i639 e0q CEO YPY p� -TOWN 'OF BARNSTABLE RUILD,IHG I:NSPEPOR 0. 1 APPLICATION FOR. PERMIT TO ...�? !.'....................11 .:( ':o f. i r'� ' .�ti ��i.. JP.`!/��.. ............. .. V TYPE OF CONSTRUCTION U A ( / A w .......................O.................. ..............................................:...............:............................ : .�. 7 19.. ... ; TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .............................................................. . ................................................. Proposed Use ..:,i h.:..l..............! .."::.:..�ti r.�.,J .. ..............................................................................a.......... Zoning District ....................... . ....?.......................................Fire.District .......!..J: ..!T./J.N. ............................................ ) + . ... Name of Owner ��r'o.'?: ^....+i�.l.".{'....��v.' ('Cj r�'.f .�fiv [Address ....../C).w( jP . . 1:...1 .�livrv�_I fla ..... .......... ...................... .. .. � Name of Builder )l0.,`/1•�,...�✓( YSv, �c /'J 1 r�Address .......................................J L ��.lfL1..'�...� /:....�'J�l I..)......../..... / /� [ Name of Architect ....1.............................1 ✓,1 UVtn ��(�. ?........ �fv/G9t .... ..../ Address ............../�..}...... .. .................................. Number of Rooms ........................... ...........:...:...............Foundation /171 ✓i P.S{:.....(l.t.!?^...C u o Y C ...... ......... ........................... Exterior ..C. ,�I I.�V4 tu,tL �� ry ....... iJ ,. `�IF Q ,IoRoofing ......: // f.(7�IA I .. ..... ... .. ..: .............! ..,1l.......V.......................II..........f................................. Floors / 117 . tJ/wcrl/�l S_/'arl� m( �1 I iv Er. CL ue � !1 .....::......... ............................ ......................Interior ........................................................... :.................... Jlg Heating ....... .1.j L.� . f1'S .....!....:..Plumbing ............ ....1 r� rl,11� ........ Fireplace U J....IA.Al. �.1(.�... /..iIh.,i/0S„1,C�PAPProximate Cost ..... ........? ? n���.. ......'.............................. ................................ .... . ........ . u•- .. ly Definitive Plan Approved by.Planning Board ___;_?_/ 19_____ s �� Area �� 7 /yU Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all, the Rules and Regulations of the Town of Barnstable regarding, the above construction. Name' �r. ��`' `� ` � OCEAN BLUE BUILDERS, INC , ^ 8=jlu No '336.IO— _' Permit 'Oue..I/3Story........Siool��''F.aozilv—I�v��l.l.i__.__._._ ' Location ......107 Linden Street ..................Hy.�Jl]A.s—.-------------.. Owner .....}g!:�4g..8loe_BuiIde�o�_Z�o. Type of Construction .....����!�-------- �^ � � --~—'—^--'---'—''—'------^----- � Plot ............................ Lot ................................ � � � Permit Granted ....November .4 �__]q OI ' ' Date of Inspection .................................... Dote Completed ...................................... ` � PERMIT REFUSED � ......................................... ...................... 19 � .----.---...... ..—..~----.----... , 19 ---,...—..---. _ � --^^^—^^'~^^^— � . 1 '