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0641 MAIN STREET (HYANNIS)
�, ._ �� I I Anderson, Robin From: Thomas Lanman <tlanman@hyannisfire.org> Sent: Friday, January 11, 2019 5:10 PM To: Anderson, Robin Cc: Eric Kristofferson; Fire Prevention Subject: 641 B Main Street--". .. Good Afternoon Robin, Following up with our conversation earlier today regarding 641 B Main Street. I spoke with Scott Lowe (property owner) 508-264-5333 about some of the issues at this apartment. He informed me that the occupant is a Barnstable Housing Authority client. Apartment B is on the second floor and the resident has some apparent mobility issues. 1. There was no smoke detector in the unit.There was a mount and wiring present only. 2. There was a considerable amount of trash and other items that would suggest a hoarding situation. 3. The smoke detector outside Apartment D,while present,was not connected to its power source and had no back-up battery installed. 4. There was damage done to the apartment door when it was forced open by the ambulance crew, Barnstable Police were also on scene. This is not a property that the Hyannis FD inspects on an annual basis. Mr. Lowe stated that he will address the smoke detector issues. Is this a situation that requires the Board of Health to be informed of and/or investigate? Thanks,Tim Lt.Tim Lanman, Fire Prevention Officer Hyannis Fire Department Tel: 508-775-1300 Fax: 508-778-6448 ~ Direct Line: 774-368-1685 tlanman@hyannisfire.or� CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! i Town of Barnstable q REc �PT > KAMwa . ' 200 Main Street, Hyannis MA 02601 508-862-4038 'salsa. � Application for Building Permit Application No: TB-18-1516 Date Recieved: 5/15/2018 Job Location: 641 MAIN STREET(HYANNIS),HYANNIS Permit For: Building-Sign Contractor's Name: State Lic. No: Address: Applicant Phone: (781) 245-4800 (Home)Owner's Name: LOWE,BRADFORD W Phone: (508)992-6041 (Home)Owner's Address: 439 STATE RD NORTH DARTMOUTH MA 02747 Work Description: Replace existing sign with Eastern Insurance sign. To be non-illuminated and have the same dimensions as existing sign 24" H x 45"W double sided.To have acrylic letters mounted on HDF sign foam.To be painted PMS 541c blue. Lettering to be white and orange.Drawings attached r a Total Value Of Work To Be Performed: $2,000.00 Structure Size: 0.00 0.00 0.00'� �. Width Depth Total Area rn I n 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: Edward Batten 5/15/2018 (781)245-4800 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees LTotalroject Cost : $2,000.00 Date Paid Amount Paid Check#or CC# Pay Typeermit Fee: $50.00 5/15/2018 $50.00 XXXX_X}�-XXXX_I Credit Card ....................3369 Permit Fee Paid: $50.00 h Town of Barnstable op the rod Regulatory-ServiceTOW OFB RNIST B E , P� ti Thomas F. Geiler,Director • �� Building Division 2 ;i JUM 16 PM 4: 03 BARNSTABLE, t y� MASS. S. `�$ Tom Perry, Building Commissioner °tEo .e a 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.usfi Office: 508-862-4038 Fa �O8790-6230 Approved- Fee: r� , JPermit#. . HOME OCCUPATION REGISTRAT Date: b(0 Name: A1--[=XAl\1Dt2E A--, -SOU• ,0, Phone #: L,09)3�0 �2-leo, 6Zf{ m�i�l S( itP �F-f /ar)r�s�m�-o��'P Address: Village: Name of Business: t/J76kNtY()S TE64 W-0(0i� Type of Business: &oqA)TW W'_ 02K C ep'vre:ES Map/Lot: 2 O a" J� INTENT: It is the intent of this section to allow the resicleuts of the Toavn of Barnstaple to operate a home occupation iii[I1LLl SLiagle Family cicvellingS,subject to tlae provisioils-of;Sectiori ll-1,/1•of the�oliing ordinance, provicle.cl that the actia�ty shall not be discernible from outside the chiselling: there shall be no increase in noise or oclor;no Vasual altcr<ation to the premises avllich 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 (lie Building Inspector,a customary lLcxne occupation shall be perrinitecl as of right subject to the following conditions: • The activity is carried on by(lie permanent resident of a single Fanllly residential diwelling unit, located witlaiia that dwelling unit.. • Such use occupies no more than 4.00 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 call be generated in excess of normal residential volumes. • The use clots not-involve the production of offensive noise, vibration,smoke, clust or other partic•ufar matter, odors,electrical disturbance;heat,glare, humidity or other obiectionahle effects. • There is no storage or use of toxic or hami—clpus materials, or flammable or explosive materials, in excess of normal household quantities. • Any need foi-parking generated by such use shall be met on the same lot containing file Customaiy Home Occupation,auul not c6tliirr the required front yard. • 'There is uo exterior stor age oi•display of materials or equipment. •. There are no commercial vehicles related to the Customary Home Occupation, other than one tau-or one . pick-up truck not to exceed one toil capacity,and one trailer not to exceed 20 feet in lentn-h and not to exc•eecl 4 tires,parked on the same lot containing the Customary Home Occupation. • Nosign shall be displayed indicating the Customary Home Occupation. • If tile.Custonlauy Home Occupation is listed or advertised as a business,the stree(adciress shall nor be included. • No person shall be employed in tine Customauy Horne Occupation Idio is'not a permanent resident of(Ile dwelling Unit. 1, file ill rsi I and agree vlitil the above restrictions for illy home cx•c•upation I and registering. AppliFanf': bate: Or, ( (� r 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 (whith ..you.must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367. Main Street, Hyannis, MA 02601 (Town Hall) DATEP('0#-&f# Fill in please: ,Ir&It� tr APPLICANT'S YOUR NAME/S: � xl4r" C F}• SOcJA BUSINESS YOUR HOME ADDRESS: fP`f� /►I�i s��'� - ftf. f} - "ekr1 l iS11"A uZ12_�0/ �i staff R'�5 TELEPHONE # Home Telephone Number .36a -+Z-(ca i U425t.Ess I4'o NXX NAME OF CORPORATION: rNTE_R-N E X L)S NCH A/oC.o(---i ES NAME OF NEW BUSINESS ;1) Q/v'�Xv T��ffara�a�r 5 TYPE OF BUSINESS('QM C)Tom_ A4 fI?,iI[C IS THIS A HOME OCCUPATION? YES NO l 2 ) ADDRESS OF BUSINESS 641? Mrt�r% Sr. A-A q t ti'J✓�S%//1f1 oZloa! MAP/PARCEL NUMBER U �7 v (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. 1. BUILDING CO ER'S OFFICE This inc vi ual h s p.inf r of a y permit requirements that pertain to this tY"VLGbMP.LY WITH HOME OCCUPATION RULES AND REGULATIONS. FAILURE TO A on d igp6t.ure** COMPLY MAY RESULT IN FINES. COMMENT 2. BOARD OF HEALTH This individual has,,bbee or of the permit requirements that pertain to this type of business. l� . r ( MUST COMPLY WITH ALL Authorized Signature** HAZARDOUS MATERIALS REGULATIONS COMMENTS: 3. CONSUMER AFFAIRS (LIC NSIN AUTHORITY) This individual has be infor d f e licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: RI/ W-i Town of Barnstable regulatory Services * * • BARNSTABLE, 9 MASS. Thomas F. Geiler,Director i63q. ♦0 Public Health Division Thomas McKean,Director 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Certified Mail: 7006 0810 0000 3525 0205 April 17, 2007 Mr. Bradford W. Lowe 439 State Road North Dartmouth, MA 02747 EMERGENCY CONDEMNATION AND ORDER TO VACATE Finding of Unfitness for r Human Habitation and Determination of Immediate Danger In accordance with M.G.L. c.111, sec. 127A and 127B, 105 CMR 400.000: State Sanitary Code, Chapter I: General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chapter II: Minimum Standards of Fitness for Human, David W. Stanton,R.S., Health Inspector for the Town of Barnstable, on April 15, 2007 conducted an investigation of a dwelling unit located at 641 Main Street, Unit D, Hyannis. The,owner's name of this dwelling unit is Mr. Bradford W. Lowe. The tenants name is Joan Martin. Based on the results of that investigation, the Barnstable Health Department finds that the dwelling is unfit for human habitation. Pursuant to M.G.L. c. 127B and 105 CMR 410.831 (D), the Health Department further finds that the conditions . within the dwelling are such that the danger to the life or health of the occupants of the subject dwelling is so immediate that no delay may be permitted in making this finding. Conditions found within the dwelling, which give rise to the emergency finding of unfitness and determination of immediate danger, include: 410. 750: Conditions Deemed to Endanger or Impair Health or Safety 410.750 (I) Failure to comply with any provisions of 105 CMR 410.600, 410.601, or 410.602 which results in any accumulation of garbage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, Q:\Order Letters\Condemnations\641 Main Street Hyannis,Unit D.doc insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. The occupant, Joan Martin, had much animal (dog\cat) urine and fecal matter present in the unit, and a lot of clutter. Much dirt, feces and urine were present throughout the unit. This occupant has a condition known as "hoarding" and needs social and psychological assistance. The Seven dogs and one cat present in said dwelling unit were taken by Animal Control for their safety and well being until the problem is resolved. 410.600: Storage of Garbage and Rubbish The occupant of any dwelling shall provide as many receptacles for the storage of garbage and rubbish as are sufficient to contain the accumulation before final collection and locate them so that no objectionable odors enter any dwelling. The occupant has caused objectionable odors both inside her dwelling unit and emanating to the outside common area of the apartment hall and stairways. Based upon these findings any and all occupants are hereby ordered to vacate and the landlord/owner is ordered to secure the subject dwelling within 48 hours of receipt of this order. If any person refuses to leave a dwelling or portion thereof, which was ordered vacated she may be forcibly removed by the local Board of Health(Massachusetts General Laws C. 127B), or by local police authorities at request of the Board of Health. Furthermore, anyone who fails to comply with any order of the board of health may be subject to fines ranging from $104500. Each day's failure to comply with an order shall constitute a separate violation. Once vacated this unit may not be occupied without the written approval of the Board of Health. Note: This is an important legal document. It may affect your rights. Signed Cc: Joan Martin, Occupant Scott Lowe, Property Manager Captain Farrenkopf, Hyannis Fire Department Chief Macdonald, Barnstable Police Department Mr. Tom Perry, Building Commissioner; Robert Smith, Town Counsel Q:\Order Letters\Condemnations\641 Main Street Hyannis,Unit D.doc r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map ✓ Parcel Application # lc ?nyc)q 22 Health Division Date Issued O Conservation Divisions Application Fee �s Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner �i �,, sl�ceJ e— Address . e— Telephone 299F Z75— Permit Request C7 e� Al Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 5 (�® 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 Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No \ r Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ` --� cZE Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ = C� Commercial ❑Yes ❑ No If yes, site plan review# ` ' Current Use Proposed Use " fi APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � �� �� ��-e,?C e- Telephone Number Address License # �� c� a �' Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ! i° -. DATEa fo FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE s OWNER DATE OF INSPECTION: FOUNDATION w� FRAME } INSULATION FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH r FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The CofnlHonwealfh ofmassachusetts Depar- rmerxt of lltdustrial Accidents Office of investigations 600 Washington Street Bostdlx, A-L1 0211r '�• wwrs�.mass.gov/dia • Workers, Compensation Znslxrance Affidavit: Builders/Contractors/BIectricians/Plumbers Applicant Information Please Print_LeL-zblY Name (Business)Organization/Individual): �G�iGL Address:- City/State/Zip Phone.#: Are you an employer? Check the appropriate box; Type of project(required): 1.❑ I am a employer with ❑ l am a general contractor and l 6. Ncw construction mployecs (full and/or part_time),* have hired the svb-contractors 2. I am a•sole proprietor or partner- listed on the attached sheet ❑Remodeling ship and have no employees These sub-contractors have g, Demolition employees and have workers' working for me in any capacity. 9, []Building addition [No workers',comp.•insurancc imp• insurance.# required.] 5, ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑T I am a homeowner doing all work otplcers lzavc exercised their I I_❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs c, IS2, §1(4), and we have no in.snrancc required.]t employees. [No workers' I3.❑ Other . comp, insurance required.] *Any applicant that cheep box#1 mustako fill out the section below snowing their workers' eompcar4on policy information. t ElommvvncrC who submit this affidavit indicating they arc doing all work and than hint outside contractors must submit a nm afridavitindicating such. tConactom that check thin box nwst attached an additional sheet showing the name of the sub-conh-actm-s and state whether yr not those Mbdcs have employers. Ifthc sub-contractors have employ-s,they must pro-vidt their workers'comp.policy number. ram art employer turd isproviding,workers"compensation insurancefor my employees. Belotp is the policy aredjob site ' information. lwurmce Company Name: . Policy# or Self ins. Lic. #: Expiration Date- Job Sitc Address: City/Statc/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 Iead to-the imposition of criminal penalties of a flnc vp to S1,500.00 and/or one-year imprisomnent, as welt as civil penaldcs iu the form of STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. fie advised that a copy of this statemen m t ay bn forwarded to the Office of Investigations of the bIA for insurance coverage verification IZo hereby certify under the pains•andpen old,-S ofperjury,th.at the information provided shave is true and correct Sitrnature �i,' /•���'-� Date: %/�6 !e' _ Phone Official use only. Do not write in this area, to be completed by city or town official City or Totten: Pernilnicense # Issuing Authority(circle one); 1. Board of Health 2, Building Department 3, City/Town Clerk 4. Electrical Inspector S. Plumbing inspector 6. Other Contact Person: Phone tl: Infor ation and I���������n��� Massachusetts Gcneral Laws chapter 152 requires all employers to provide woe another P under any contract oMployocs, pursuant to this statute, an enaployee is defined as ...every person in the serve , express or implied, oral or written." two or more An ernployer is defined as"an individual, pa tacrship, association, corporation or other legal entity, or any of the foregoing cugagcd in a joint cntr-rprise,.and including the legal representatives of a dec eased eplHow verr, Or rhthe receiver or trustee of an individual,partnership, association or other legal entity, employing p y 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, constru m�o r_ ant be deemed to bcc air work on such dan employwriling er." or on the grounds or building aDDurt-rant thereto shall not because of such p yxn MGL cbaptcr 152, §25C(6) also states that "every state or local licensing agency shall iKthhold the issuance°r renev�al of a license or permit to operate a business or to construct buildings in the cornmonsvealth for any applicant who has not produced•acceptable evidence of compliance Witlx the my ounce coverage required." AdditionaIly,MGL,ohaptor 152, §25C(7) states 'Neither the commonwealth nor any of its political subdzvlsions shall Addsenter into any contract for,the performance of public work until acceptable evidence of cottzpliznce �zth the insurance rcquircmcats of this ebaptcr have been presented to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), addresses) and phone numbcr(s) along with their certificates) of insurance, Limited Liability Copanics'(LLC) or Limited Liability Partuczships (LLP)with no employees other than the mambos or partners, arc notrcqui red to carry-workers' compensation insurance. If an LLC or ALP does have employees, a policy is required. Be advised that this affidavit may be submittedDepartment of affidavit should ndustrial Accidents for confirmation of insurancc coverage. Also be sure to sign a date the be rehuncd to the city or town that the application for the permit ox license is being requested, nat the Department of Industrial Accidents. Should you have any questions regarding the law or if you arc required to obtain a workers' l the Department at the nurztber listed below. Self-insured copanics copcnsationpolicy,please cal should enter their self-insu=(n o license number on the appropriato line. City or Town Officials bottom .Please be sure that the affidavit is complete and printed legibly. The Department has Cprovidedt ar�gthe.a c licant. of the affidavit for you to fill out in the event the Off cc o f Investigations has to contact yp Please be sure to fill in the permit/liccnsc numbex which will be used as a rcfcrcncc number. In addition, an applicant that must submit multiple permit/license applications in any given year,nccd only submit onp affidavit indicating current policy information(if pccessary) and under"Yob Site Address tho applicaxit should write"all locations in (city or town)."A cbpy of the atdavit 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.Whero a home owner or citizen is obtaining a liccns e or permit not related to any business or commercial venture (he, a dog)iccnse ox'permit to burn leaves etc.) said person is NOT required to complete this affidavit. . The Office of Investigations would hke to thank you in advance for your cooperation and should you bavc any questions, please do not bcsitato to give us a call. The Department's address, tcicphoac•and fax number: The. Commonwealth Of Nlsssachus�tGs D,- ant Of Iadu 4 Accidents Offxce Of 7mvest.gati.an:s 600 Washington Stet Boston, MA 02111 . Tel; # 617 727-490.0 ext'406 or 1-877-NfASSAFE Fax# 617-727-7749 Revised 11-22.06 . wy�-y,,.rna-�s..gov/dia �0jHrro � Town of Barnstable i Regulatory Services ��➢ Thomas F, Geiler, Director .y huss � �p t679• r�Dµp�b Building ]division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 w�vw.town.ba rnsta ble.m�.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign. This Section If Using A Builder as Owner of the subject property ' hereby authorize C \-,\Cttl TVQ Ce C °lo to act on my behalf, , in all matters telative to work authorized by this building permit application for: (Address of Job) a re caner Date W . Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on th'e reverse side. Town of Barnstable w� 0F7HE 1p �� Regulatory Services ti Thomas F. Geiler, Director t HARNSTAHLE, Building Division Urfa ht�IA Tom Perry,building Cominissionet 200 Main Street, Hyannis., MA 02601 A Iyly.tovvn.barustable.m2.us Fax: 508-790-6230, Office: 508-862-4038 • IIOI,4EOWNER LICENSE EXEMPTION Please Print DATE: JOIB LOCATION: street village number ' "I-IOMEOWNER", home phone 9 work phone# name CURRENT MAILING ADDRESS: state zip code city/town The current exer' bon for"homeowner_ __ s"was extended to include ot owner-occupied a lis dwcUin of ided that the owner acts as to allow homeowners to engage an individual for hire who do possess sup eryis or. DEI•'IIVITION OB ROAfE01IVNER 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-fanuly dwelling, attached or detached structures aceesso o such red use aa h/o r farm styucr- Suchs, A person who constructs more than one home in a iivo-year period shall not be c "homeowner"shall subinit.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 buildiD9 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 "homeow�iez"certifies that he/she understands the Town of Barnstable Building Department zninimtun inspection procedures and requirements and that he/she ti,iill comply with said procedures and requirements. Signature of Homeowner Approval of Building Official ng 35 000 cubic feet or larger will be required.to comply with the Note; Three-family dwellings containi State Building Code Section 127,0 Construction Control. RO)yMoyrNER'S EXEKPTI ON The Code;states that:. ,Any homeowner performing work for which a building permit is required shelf be exempt from the provisions of this section (Section Io9.1,1 -Licensing of consnction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work, that such Homco)vncr shall act as supervisor," arti cuart l Many homeowners who use this exemption arc unaware that they are assuming the responsibilities of a supervisor(see Appendix , TCSUItSin Rules &•Rcgu.lations for Licensing Construction Sudpervis his e,sour Board anr;section )o This proceedoaga against thethe unlit nsed personsri s°us it would withp licensed when the homeowner hires unlicensed persons. Supervisor: The homeowner acting as Supervisor is ultimately responsible. To cnsute that the homeowner is fully aware of his/her responsibilities,many communilics require, parts the permit application, i that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this ssue is a form currently used by several towns. You may care t amend and adopt such a fom/ccrtification for use in your community. 't M "'Issachusetts- De Board Nlrtment of Public Satet, of Building Re, Construction:Supervisor and Standards 4242 License: cS pervisor License Restricted.to: .00 3 AEL T,.PARECE:# 338 OLD PLYMOUTH RD SAGAMORE BEgCH MA'02562 z (o...... loner Expiration: 9/16/201, ■nmu■ Town Boundary ,'� • QParcels FY2008 " 123 456 Parcel Numbers 308 053 y 308-120�CND #1234 Address Street Numbers Buildings ® Deck,/Patios Sp ®® Above Ground Swimming Pools �'P QQ in Ground Swimming Pools }308 04,9° ® Walkways Improved ---_-__ Walkways Unimproved - - - Paths T .. N 00 - \ Stairways P / /30�8#131 OQ1, Paved Roads F•`�� Unpaved Roads O 5� Sifi27� - - p �•'••:,•.•, Paved Driveways ---- \� ` Unpaved Driveways v' O +H* Painted Lines Paved Parking Lots ~ Unpaved Parking Lots K Bridg es , 308-131-OQ2, ' Railroad O Fences 0 Guardrails 308-132 O Retaining Walls #641 O O 000 Stone Walls P;pw QQ Sports Areas o ! C� Golf Areas \ " Docks/Piers 308-kA ;� Boardwalks : h `� C--L= Jetties - - Streams - #.69'S — — - Drainage Ditches CDMarsh Areas Water Bodies .pCn X spot Elevations(NAVD88) 0_8 135 Topo in It Contours(NAVD88) Topo 2 It Contours(NAVD88) y", 308-14�2 0 4;78 Wooded Areas 'Street Trees ®1 Catchbasins Lamp Posts Monuments 308-141 - #488 O Manholes � Towers 308-136 0 Utility Poles O Satellite Dish 308-270 Signs .F. . fi- 0❑Fuel Tanks a.e,, #496 N Flagpoles O Posts 0 Water Tanks 308 f 39,' Utility Boxes s„ °°x"' a • Pilings .. n§, TQNM Of flarnStetble Data.Source.. Disclaimer This map is for planning purposes only.It is oFr"E� .finch equals 40 feet N ade features,hydrography, .Parcel lines on this map are only : t adequate for legal boundary determination.. ,XY` .4, Feet .. } ' * �t .Humn-ma y graphic no equa ounary - GIS ld�t topography,and vegetation were interpreted representations of Assessor's tax parcels.They or regulatory interpretation.This map does not o 5 10 20 30 40 W E http://www.town.barnstable.ma.us from 20o8 aerial photographs. Parcel lines are not true property boundaries and do not represent an on-the-ground survey. MAC, 367 Main Street,Hyannis,MA 026oi were digitized from FY2008.Town of represent accurate relationships to physical .Enlargements beyond a scale of i"=ioo'may (508)862-4624 Barnstable Assessor's tax maps. objects on the map such as building locations. not meet established map accuracy standards. 'FD"`^� mxd 00/00/200 S • .. �ors?� '� �� �,��/l �`/��"'z��' s Ile, . VE Hyannis Main Street W ate�r'�froit ;� Historic District Commission g` T"gam ' 200 Main Street L659• Hyannis,Massachusetts 02 1 OjN 0. TEL: 508-862-4665/FAX: 508-86 -4715� ?4 Application to yannis Mam eefWater ront-Histcyric-Districit-C-onu=nissto-:� in the Town of Barnstable for a CERTIFICATE OF- APPROPRIATENESS-Application is hereby made, in triplicate, for the issuance of a certificate of Appropriateness under M. G. L. Chapter 40C, The Historic Districts Act for proposed work as described below and on plans, drawings or photographs accompanying this application for: PLEASE CHECK ALL CATEGORIES THAT APPLY: l: Exterior Building Construction: El New Building ❑ Addition Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercia ❑ Other 2. Exterior Painting: ❑' 3. Signs or Billboards: ❑ New sign . ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other 5. Parking Lot: ❑ New Building ❑ Addition ❑ Alteration (Please see the guidelines for explanation and requirements) TYPE OR PRINT LEGIBLY DATE r' ASSESSOR'S MAP NO. ASSESSOR'S PARCEL NO. � APPLICANTo�i� 0 TEL.NO. Sda 77,5'SAS% /. APPLICANT MAILING ADDRESSf ADDRESS OF PROPOSED WORK PROPERTY OWNER CS�ee r G/.9ye_ TEL.NO. OWNER MAILING ADDRESS FULL NAMES AND MAILING ADDRESSES OF ABUTTING OWNERS.Include name of adjacent property owners across any public street or way. This information is best obtained at the Town Assessor's c ad` ti I et if necessary). D u FEB .O A T W F BARNSTABLE HISTORIC PRESS �,, AGENT OR.CONTRACTOR �ii� r/ /, �/��CQEL.NO. ��/? ADDRESS /A HYANNIS MAIN STREET WATERFRONT HISTORIC DISTRICT COMMISSION ***SPECIFICATION SHEET*** ADDRESS OF PROPOSED WORK FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOW COLOR TRIM COLOR DOORS COLOR SHUTTERS GUTTERS DECK pL `IC1- GARAGE DOORS COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application,along with three copies each of the plot plan,landscape plan and elevation plans,when applicable.The Plot plan need not be"Certified",but should show all structures on the lot to scale. p E ' E -Z010 41 D FEB 0 1-2 TOWN OF BARNSTABLE `�C201C) HISTORIC PRESERVATION I r DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done, including detailed data on such architectural features as: foundation, chimney, siding, roofing,roof pitch, sash and doors,window and door frames, trim, gutters - leaders,roofing and paint color, including materials to be used,if specifications do not accompany plans. In-the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). < f i�P ����41c spa f® x is / ®�P� ��j'css l00 Zee Signed ✓�/. ,��/" ���//.✓�P.�- Owner(]�Agent (CIRCLE ONE) SPACE BELOW LINE FOR COMMISSION USE Received by HMSWHDC E C E V E 4Datel V This.Certificate is REB_ -L�7u?. Z y TOVWAjr HISTORIC PRESERVATION IMPORTANT: If this Certificate is approved,approval is subject to the 20-day appeal period provided in the Ordinance. CONDITIONS OF APPROVAL: m- n lid e� 3V, 01 I �lJ ut' r� 3�:-� elf ell 0leve p E C .E_-p._ use - \o T OWN.OF BARNSTABLE HISTORIC PRESERVATION -- L 1 77 Y� Will, k•ira�arar:,� ... LN ¢CC`. _ �, •Lth`�rlAu�x,_ r�� raii'��K "'�-+�LiiYi$6i�y�t '1I1 4l•{C CiAl4:Yar Lr... i r � a q •�a.� -�r '��� ^F4'��`�er.�'raotil'r';Eu:ieia Z-�%� Yli ..ww.ka. ica >.r3Weh.v wartlyi�n"'d `• 1,', F ,J � � I.. � +�Wr•r �,a;�i4561.cC�lllllllll�syy,�E �. `- � Y �.P. w �� �NY.CfS�yy�Mipiadiwiaa.W�Ryu�jy�4Y.iit '1Yu+•1ria14i jrEl �..h � �..�' w .4� ��•-�.+.�a�r.�r � +�•+�«:..�s•+sir�s°t��.re`�r.4. .�d: s+ I_ 14 , � ; � __ ...a --.ai.o•.Y.��vW+aYi�Y.as �•��+M._.•Wr. Ltsas•.r.� ' mr.a.L•i4 _ ar 4..�a. 1'+Y � .. � �, <� � +aW IW a'na+rr.i ..•�4 at. "�iw'-�—�.-'r+�a. 3�' � �r`C I,,1 Lilwl Ji.:iWW. k..il... R+bYY W+L.e. .sC. • _ � � .� _,� ,t � J� ;I tlCW rW.3rma.t .•iW,�ao/.ay+w:.+Y.- - j �..w'=--_.�----�_ � J 1 �/ � w' Via-•: r 1A s�o�•�s e-k It f p e Sin. r' Y4 v J e_ �o g r c r AUG-17-2000 09:50 BRRNSTRBLE HOiISING 15aB7799312 P.91 M�` Barnstable TeIerholic(508) ;7 f-T�72 uar Lcaseol Huosing! Dept. (508 771-72�)2 °Ja Housing Authority r I46 South Suter• Hyainni . N1,sz. O_'huf ZONING VERIFICATION TO: Gloria Urenas FROM: Robert Hooper, Leased Housing Coordinator RE: Legal Rental Unit Verification Date: �.�1�-��------------------ Address: C2 Village, Unit Type: Bedroom Size: 1 Map & Parcel No.: -3 Of— The owner of the above listed property is entering into.a contract with us for the rental of the property as listed above. Please verify by signing below that the unit is legal and meets all zoning requirements for a rental in the town of Barnstable. If it does not, please list reason .here: ' --------------------------------------------- •----•-------------------------------------------------- ank ,ou for yo Zrassistance in this matt Vnture /Print name Date------�..��_w__------- VIA FAX: 790-6230 MRVP Section a Rev.9%98 Equal Housing Oppurtunity Agency TOTRL P.v71 0, _ ypf7NETO�y TOWN OF BARNSTABLE 2 � i 13ARIST"LE, i "6um 9 BUILDING INSPECTOR A del vLe Goa ,w, ......................... APPLICATION FOR PERMIT TO �v�� .........A- v.......�.--� I �.�........................................... TYPE OF CONSTRUCTION �v ` �1�-�1` ..' L° '� �. .................................... ........................ ......................... TO THE INSPECTOR OF BUILDINGS: The' undersigned hereby applies for a permit according to the following information: Location 6Y1.......� '1. '" �- '7"�� �j r ProposedUse ....... ............................J).�.?:?�..''.`.r:��:.............................................................................................. ZoningDistrict .........................................................................Fire District .............................................................................. Name of Owner ... ........... ....Address .... .......... r.ti+......5 ..............A+A A.r Nameof Builder t1...................................Address.......:......................... .................................................................................... N Lr Nameof Architect ..................................................................Address .................................................................................... o-� Number of Rooms ....:....................... .................................Foundation ..........................................c ..�s.................. Exlerior /,>.LocLCu�cYe� CJ6� ...................................................................Roofing ..... .. Floors ....... ........................................................Interior .................................................................................... Heating ..........7. ............................................................Plumbing .................................................................................. Fireplace ) Approximate Cost .. .�� ........................ .................................................. ... ......................................................... Definitive Plan Approved by Planning Board --------------------------- Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH J r;_IE PROPOSED METHOD OF PROVIDING FOR SANITARY WATER SUPPLY, SEWAGE DISPOSAL �AND DRAINAGE IS HER BY APPRO'� G 7� t Q & TOWFOF BARNSTABLE, roa►& S BOARD OF HEALTH A LICENSED INSTALLER MUST OBTAIN SEWAGE PERMIT. AND INSTALL SYSTEM. I hereby agree to conform to all the Rules and Regulatio s of the Town of Barnstable regarding the above construction. Nam ....`... .. .T. .... .......... I`-gnuson, Joseph ? d 150 add to commercial. No ..... ........... Permit for .................................... building ............................................................................... Location .......... 41..Man.St.,reet..................... Hyannis .............................................:................................. Owner Joseph Magnuson Type of Construction ma.sonry. ................ .... . ......... ................................................................................ Plot ............................ Lot ................................ Permit Granted .......... ..11......... �19 72 Date of Inspection .............19 Date Completed .......19 9/6 8...... . ...... p PERMIT REFUSED ................................................................ 19 ................................ .......................................... F t, .................................................. ........................ i .................................. ......................................... { t Approved .................................................. 19 ............................................................................... 1 TOWN OF BARNSTABLE - {. 2ND FLR APTS CERTIFICATE OF OCCUPANCY PARCEL ID 308 053 GEOBASE ID 22025 ADDRESS 640 MAIN STREET (HYANNIS PHONE HYANNIS ZIP - LOT B& UNNU BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 71030 DESCRIPTION C/O FOR THREE APTS_2ND FLR_--BLDG_PMT#61555 PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of ARCHITECTS: P TOTAL FEES: Regulatory Services BOND $.00 CONSTRUCTION COSTS $_00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE * BARNSTABLE, HtABs. 059. BUILDI IVIS O DATE ISSUED 08/22/2003 EXPIRATION DATE Y JARh#,, TA BL s , -_... 1a AIS..CL's LA t i%f C7 G.EOBA'S,1', ID r".o202 b - I CONTRACTORS- "OSE H. I.)A LUZ Department of Health, Safety °_ ' and Environmental Services r x fl q y,R FE w tie' 1 13"1 ? 3 Bow l! IHE 1AI NSTABi.�, s MASS. 16��. �® i BUILDINGA)IVV I I 1DATE' 3�j q +�xy��,,Y� .i..#`30.34�.�9d..` ��fs A_)�,�a;{�I�i s 'EXPIRATION itf:lTI C.)N 5:1AJ<E C THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE;MUST BE APPROVED BY THE JURISDICTION.STREET OR { ALLEY GRADES AS WELL.AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL.PLUMEING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. AM BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSP N APPROVALS 1 1 1 eel Cc � ' GROG 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT t (03 (.,,P 2 3, ISro� BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL 7(03 WORK SHALL NOT PROCEED U L PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFIC/ TION. NOTED ABOVE. TION. ��AA 1L vt�oJ� P-101 )BUILDERINFORMATION Name MQ09NW COWS! 106- Telephone NumberC ® / ' `rt Address Z -AT Z9 S. Y✓}F A&_T_111 License# C S 0 66 2-� L/A/1 I -7 LAA 0 Home Improvement Contractor# 1 jq �3 G l Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO W y pl i 6 r SIGNATURE SATE 0 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION W)LL Map Parcel Permit# / n Health Division (9e P�. l�• j /Z/JS-000.5"ts 3 fi Date Issued '�i' Conservation Division Application Fee / Tax Collector Permit Fee Treasurer d Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address5:hce Village S Owner �. :.��(t��1' Address {!�� Telephone �K 7L.C) I S-T,,�� Permit Request a Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 07V AConstruction 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: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not'ncluding baths): existing new First Floor Room Count LU � Heat e an OFue1: as ❑Oil ❑ Electric ❑Other Centraj Air: es o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑exi[Cg ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached>gara :❑exist g ❑new size . Shed:❑existing ❑new size Other: 1 Zoning BE and o�Apppe s Authorization ❑ Appeal# Recorded❑ Commercial t4bs ❑No If yes, site plan review# Current Use Proposed Use BUILDER/INFORMATIONNameW/r/6 �i S () Kal-3 c�j014L)'Telephone Number Address .. '�.� _ �/�l�i.� ? License# 64 > Home Improvement Contractor# 162 2 3 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Lil P SIGNATURE DATE ;� • FOR OFFICIAL USE ONLY PE MIT NO. DATE ISSUED MAP/PARCEL NO. ' Y ADDRESS 1 VILLAGE • s , OWNER , r DATE OF INSPECTION: FOUNDATION FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL- � r PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL' FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION-PLAN NO. i Tayvn of_Barnstab e �pZFiE Tp .. . _ Regulatory Services ssn►ss, -: :Thomas F:Geller,-Director , . ... 9� 1699� �.• ,-,Building Division Asa taa'� _ ...:. . TomPerry; Building Commissioner ' . .. . - 200 Main Street, �yanms,MA 02601 - . www.town Barnstable;ma.us Fax: 508-790-6230 Office: 508-862-403 8 Property Owner Must Complete and Sign This Section if Using ABuilder as Owner of the subject property r7 < to aet on mybehalf, hereby authorize:�5 �Y�t�� +� ►Ul/S `i' � .n all rriatters relative to work authorized by this bung permit application for, D FAAfi�-- (Address of job) 10 0� S' na of r Date Fruit Name I The Commonwealth of Massachusetts =- Department of Industrial Accidents Office of Investigations 600 Washington Street, 7t Floor Boston,Mass. 02111 Workers' Compensation Insurance Affidavit-General Businesses lira t'lii tion -sawFOR name: ahmi W" 1 address: city 5- a state: zip: phone# work site location(full address): ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) ❑I am an employer.with employees full&part time). ❑Other I am an employer providing workers compensation for my employees working on tlusjob comtanviname address t.lk, ~ x l �}0- k fit• �1'�i'.r 3 ,.;u'� dy 3.,.{+5+.'`,K ci 4 i a ._t 'ar. 4 one# V �yAy�v' tfgyp, 8 2 �y ❑ I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices t•, 3 +. COnlpany, • e'€-^-a5.w p G -tt]�.y., e r.�. :xr&np�auY a v;. w .,t.:. ,A s .� :.-� - ( -.'� �i-? �j'k'.a ��a3�' +'�*Y�k �'CP•Y"�A�"'j'.a h`Y �i�J+YkH 7M{J'- 4 address g. €a `, - city_ _ ;. _ insurance.co.,r oLc # a CblilUaDV n.1111e.4 g4 het a>.sF 1 C.e, s#k:.r•.c K ti r ¢;v � f xzY s�l�?s '�xti $��� City- tfisurance�cot._�5_ ~";...�_;;<.�_w'��e, .�..,-_>.s•,�.�<-����r.�,..��_,��:�r:�.�- o is u#_o'.�. >� Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby c t&under the pains nd pe alties of perjury that the information provided above is true aid cor;ro Signature i& -I --J Date � Print name SS_!,Uy_t-(! �t7�Y®��-7 Phone# -1� official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑check if immediate response is required ❑Licensing Board ❑Selectmen's Office ❑Health Department contact person: phone#• ❑Other (mvised Sept.2003) r - - I Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law";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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any { applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. ` ^ Applicants -- I Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,address and phone numbers along with a certificate of insurance as all affidavits may be I submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and 'date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or cif you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom Iof -- 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. I The Department's address,telephone and fax number: _ 1 The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations "- { 600 Washington Street,7"'Floor { Boston,Ma. 02111 f fax#: (617)727-7749 I phone#: (617) 727-4900 ext. 406 I i I { . mw r C6, Flp 1t 2EOR� M ketr� q Q 7}•no. 46 8 I '267.3 AdmTh�strato r' i >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building penmt; square feet x$961sq.foot STAND ALONE PEI MiTS Open:Porch x S30 (number) Deck x$30 (number) Fireplace/Chimney x$25 (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) �' rajcast av;063004 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1" FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: Fill in please: APPLICANTS YOUR NAME: ALk�x Ate DIZiF_ A. So 02R BUSINESS YOUR HONE ADDRESS: 00 N ST A ppotn 2-+A4,gMrJ(S-mil- o2_001 LEPHONE # Home Telephone Number 5223 3 roo q 26 0 NAME OF NEW BUSINESS�I)S BOS c &J ASS c c�m P A N Y TYPE OF BUSINESS L J- IS THIS A HOME OCCUPATION? YES NO Have you been given approval from the building division? YES ✓NO ADDRESS OF BUSINESS 6144 mN St A (n2 u AN'NiS_ -a MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO 18SI ER'S OFFICE MUST COMPLY WITH HOME OCCUPATION This individ al ha n infor permit requirements that pertain to this type of business. RULES AND REGULATIONS, FAILURE TO Z!, COMPLY MAY RESULT IN FINES. ��Z�oriz_ed re* COMMENT 2. BOARD OF H LTH This individual has be nformed oft p mit r ements that pertain to this type of business. MUST COMPLY WITH ALL Authorized gnatu * __. US 7IALS REGULATIONS' COMMENTS: p u I p 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has b en informe of the licensing requirements that pertain to this type of business. COMMENTS: A oriz gnat re Town of B arnstable �'THE'►� Regulatory Services ti Thomas F.Geiler,Director i Building Division v kASs. 0g Tom Perry,Building Commissioner 200 Main.Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: W-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: l Name. ACEXAN it . �®l� / O� DI�� �-rl Phone#: \ (p :42— �OC� Address:6gj MO ST# illage: Name of Business: CPVS 3wS i tUr(�SS C'0(Y1 P A N y T e of Business: SELL 17J�Q IYW-D 1 A� YP Map/Lot:4��o(?-- � INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to the ' premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is 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 o€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 is 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 dwe I,the undersi an ee with the above restrictions for my home occupation I am registering. Ap —Date: Homeoc.doc evr 5 3 /03 TOWN OF BARNSTABLE 2ND FLR APTS CERTIFICATE OF OCCUPANCY PARCEL D 30 053 GEOBASE ID 22025" ADDRESS 640 MAIN STREET (HYANNIS PHONE HYANNIS ZIP LOT B& UNNU BLOCK - LOT SIZE DBA DEVELOPMENT a s' DISTRICT HY PERMIT TYPE BC400 TITLLERIPTION C/O FOR ©CCCUPANCY '--BLDG PMT#61555 CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: i BOND $.00 CONSTRUCTION COSTS $_00 756 CERTIFICATE OF OCCUPANCY I PRIVATE ''Q� +► * BARMSTABLE, * _ Mass. 1639. � i i BUILDI IVIS q!O�N i BY DATE ISSUED 08/22/2003 EXPIRATION DATE '7 a : rev, 4ARNS,' ABA 1, PEP .IT PARGEI, Tip 3C O ;.ti GROEASE ID _22025 DDRES.S r-4D A1:�,q STREET CHI"ANNI ? I%bll2 . 1 LOT - B80 UN J �3LOC'kT -D Dypp g� c tp LO aS u Y �1 y DF 47 d�,LOPME`N S,/ s 3..t t I ,. D J.�i7t. [i I(I .d. v D PERMIT' 1555 DESCRIPTION CONVERT .�DX � TI�dO ATTIC SPACE TO � A A.R'�t�l: . PERMIT TYPE BREMOD.0 TITLE COMMERCIAL ALT/C;ONV 1 CONTRACTORS: rflSEP I) L 1 Department of He Ith, Safety ARCHITECTS: and Environinentdl Services TOTAL FEES: $ ,232. IO BOND .00 i CONSTRUCTION COSTS $1.85,OW OO 4 f 'D 8 7 D - Yl L04 THREE/FOUR EA ILY HOU 1`v, 1 PRI�AZE, r.4� f` � STABLE, BUILDING 1visI� � DATE ISSUED 06/04/2002 EXPIRATION DATE; �. THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,, EITHER TEMPORARI.Y OR PERMANENTLY EN- CROA CHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE:MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTR!C?IONS. MINIMUM,OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL.PLUMEING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS,BEEN MADE. ANICAL INSTA!.LATIONS. A.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSP N APPROVALS i r OL S ° ti d 2 2 L 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT to- c,� C. . - ©� 2 'J►— I row BOARD OF HEALTH OTHER: _ SITE PLAN REVIEW APPROVAL , 7f03 A WORK SHALL NOT`P,ROCEED U ' L PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX � CARD CAN BE ARRANGED FOR BY VARIOUS.STAGES OF"CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TRLEPHOIdE OR WRITTEN NOTIFIC TION% f NOTED ABOVE. TION. r to ,l�t'� _ _�__ ��f= a v ,iy �vp — - - -. ` S k ir�:k.. .,s '� . ?" i .�. 4 5' � ;' �� E ,� ''f„''t i P n R �'. i T'" '��+, 4. �, non: S�. �� C S � • t i .� o l\ ;k �� �3 S �� �� ., � �� � '� � � ., `: \\ s.. Town of Barnstable �pFTHE Jay, Regulatory Services Thomas F.Geiler,Director w- 13:',R14 [A8LE BARNSfABM 9 MAW. Building Building Division 059. �'pIEDMAae Tom Perry Building Conunssioner 2007 SEP 17 PH 2: 09 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax'4�SOj8t7j-r790=636= COMPLAINVINQUIRY REPORT Date: qj 1 Rec'd by: Complaint Name: Map/Parcel Location Rm' n Address: tff-,T Originator Name: Street: Village: State: Zip: XI Telephone: Complaint Description: SMea� tkvo mu watcr on S fi M FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: ---V:PA A 0,M aditional Info.Attached I"AA Q:forms:complaint r YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1'FL.,367. Main Street, Hyannis, MA 02601 (Town Hall) 1 DATE: Fill in please: APPLICANT'S YOUR NAME: �`flNi BUSINESS YOUR HOME ADDRESS: 641 VV fnA O T n g 36o-122_.�G a nib- mA - OZ 0 NE # Home Telephone Number 5a�b 3t'oo�2.�0 i L p S NAME OF NEW BUSINESS 1I�6C-1` S MS TYPE OF BUSINESS Uod��dkJ.7 �S IS THIS A HOME OCCUPATION. YES _NO� Have you been given approval the building division? -YES NO V. c� ADDRESS OF BUSIN ES. �tic41 rnAt rJ �T ��pttisrJcS- R- �G2.�ol MAP/PARCEL NUMBERR �U 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. -_(ccrner of Yarmouth. Rd.&Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OF., IC This individual has been informe f any permit requirements that pertain to this type of business. Au horized Signat:ur COMMENTS: 2. BOARD OF HEALTH t This individual has e n in med f t e p mit requir nts that pertain to this type of business. AuNtharized Signature* . COMMENTS: 3. CONSUMER AFFAIRS (LIC SING AUTHOR ) This individual has be i ed of the lic n irre uirements that pertain to this type of business. rized Signature* COMMENTS: �/ Town of Barnstable Regulatory Services P Thomas F.Geiler,Director Building Division - - v KAK Tom Perry,Building Commissioner �PTEot°, 200 Main.Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ADDroved: Fee: Permit#: 6 _Lb HOME OCCUPATION REGISTRATION Date: 4 2 2'91 0G Name: k.r--K A 1\l pP-r-- Pt S OJ Phone#: (Z d&.)3 6 y 4 2-6 o Address- (VI VN AqP,Jlucs Village: Name of Business: GN `�orZfl SysN,S Type of Business: .COMP 0 tlE�2S Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies ne,maFe-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 tragic 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 is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling `I,the undersigned,hav th the above restrictions for my home occupation I am registering. Applicant: Date: �2'21&D 6 Homeoc.doc Rev.5/3Q/03 ,� "�-- a TOWN OF` BARNSTABLE BUILDING PERUMIT - PARCEL ID 308 132 GEOBASE ID 22101 ADDRESS 641 MAIN STREET (HYANNIS PHONE HYANNIS ZIP LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY ,E PERMIT 61657 DESCRIPTION RMVE &REPLACE,r'gIDEWALL PERMIT TYPE BSIDE TITLE BUILDING PERMIT SIDING CONTRACTORS: LEWIS E MASS Department of Health, Safety ARCHITECTS: and'Environmental Services TOTAL FEES: $50.00 BOND $.00 Ox t lbw, CONSTRUCTION COSTS $6,000.00 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE '#)P • BARNSTABLE, s ` MAS& 1639.. EO MA'S BUILDING DIVISION BY / �r--a--�^—�.. DATE ISSUED 06/07/2002 EXPIRATION DATE i r 4 TOWN OF BARNSTABLE ,.. }_ BUILbING. PERMIT om'f i� AARCK ID 308 "132�. a GEOBASE ID . 22101. ° ADDRESS .. 64AI i3 STREET . (HYANN I S a ' PHONE 1. IaI -- HYANNIS ZIP - TOOT '. _ BLOCK LOT SIZE _ DBA DEVELOPMENT DISTRICT HY ' PERMIT 61.657 DESCRIPTION RMVE &REPLACEwSIDEWALL - PERMIT TYPE BSIDE TITLE # BUILDING PERMIT SIDING CONTRACTORS: LEWIS E MASS Department of Health, Safety ARCHITECTS: . i and"Environmental Services TOTAL FEES: $50.QQ BOND $-00 pert CONSTRUCTION COSTS $6,000.60 -.753 MISC. NOT CODED ELSEWHERE 1 PRIVATE R P Ir + BARNSTABLF, MA83. ' I1659. I ED IAA�I A � BUILDI ; 'VISIO BY . Ij DATE ISSUED 06/07/2002 EXPIRATION DATE r i THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN A CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE gNICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. t + 4.FINAL INSPECTION BEFORE OCCUPANCY. e t I e �. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL IN§PECTION APPROVALS N,_ x ' 2 2 2 i 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH '. OTHER: SITE PLAN REVIEW APPROVAL I I WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 3 ` y> y w ° a> �< Ml 2 « m» 6 » IT � . � � . . � � r TOWN OF gARNSTABLE BUILDING PERMIT APPLICATION Map_ �D /.�o?� Parcel l� � Permit# 1 Health Division Date Issued �. Lo`� Conservation Division ��� r Application Fee cgs f-1) 00 Tax Collector '0 00 a 0 &L �q ���� Permit Fee Treasurer -- Planning Dept. Date Definiti a la Approved by Planning Board Historic-OK Preservation/Hyannis Project Street Addre s Mew f-1 7� Village A,(Ql l S Owner Address Telephone o Permit Request .�/C�� S C' A i <i A� rn V Vi Zdb o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total nevi Zoning Distria—PNQ Flood Plain Groundwater Overlay � r "Project Valuation GOM Construction Type `n Lot Size Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. a� Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes Cl No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:Cl 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 INFORMATION C Name {,�T S5 Telephone Number_ crW— Address q License# co V\,M0MZ> " Home`Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO (� SIGNATURE I, DATE �l(d 0 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL'40. .,k ADDRESS VILLAGE - OWNER DATE OF INSPECTION: FOUNDATION . k FRAME f, - INSULATION FIREPLACE _ ELECTRICAL: ROUGH FINAL,', PLUMBING: ROUGH FINAL f ' GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit i name: 0-vz, %AA location ci Dhone# 6`0`� 7: -S-S- ❑ I ama homeowner performing all work myself. ❑ I am a sole r rietor and have no one workin in an capacity % /%% %/ %%%%%%//%O%%%%%%////%%%%/%O%%%/%%/%%%/%%/%%%%%%%%%%%%%///%%%%%/�%�%%%/�/�%%/�%%�%%%%%%�/%/O%/ ❑ I am an employer providing workers',compensation for my employees working on this job: :: : .'..:.. e.:: .:. cc►m an' name...,.:....... >:::•'..>»::?::>::>:<•<;::>::::>: .:......... : ... .. Y.'.iii:v.::.i'.:.::.. ..i.... ........ ..: .. :. :. .. ::::::i:i::�:�::....:.':.:: _:::::?:::::::::::::::::::::::•:::•:::':•::::•'.::::;:::iiiii iiiii}:.::i::tii• i;.i n•.:.: is:: i:;_;. i::::'::::;:;:+::::C::�i:'%�i::;i:::: i:•i::•iii::•:ii:•:::•i:•i?::•:i::•:'':::.ism:::•iiiiii::•i:•i:•i:•::•::::.i:•:ii:::i':::•::•....::•i:•ii:::i::..:::i::i%::::.:.i:,�::::::::::: .::.:::i::::i::::::i.•:v:.•::•i'r'•'':•.i:•.. % .pp X. :::•iii}::?ii:i:.::•. y..:: ci *..:.: . .: . .::... .... . .:.. ;: _ :.:.... . ...... .. .:.._ hone.#._ .:: •>< �:::`.:`.;>:?< >::..... �nsutante:co:. ;.:.:, oh72` :.;•::>:: �� ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers'compensation polices: co anv'name• X. ............ i' C iS E i i>i......`Yjf %i%%F ^'% ' 2'i2 ii i <j>i >s? >''5`C'i! < i i'>i`iii i<? 'i.iiiii i tarsi% ii>ri >is'i i i ii i i i it ii ii iiY ii ' >[3# i% i aiy?_y i i... adslr s V one ......................... . ri#v: J� O'.. ....#�' i'�ii:.Y i',... :...... l� inHnran . . ::<;:;....:. ... a ddress :;:None>#f`:> >'<:> > > <>':': `? >;>< > ':< << � <»>< <'.«•»? .....::::: h XZ ranr . tl Failure to secure coverage as required wider Section 25A of MGL 15Z can lead to the imposition of criminal penalties of a Sue np to 51,500.00 and/or one years'imprisonment as weft as dvfi penalties in the form of a STOP WORK ORDER and a Sue oP 5100.00 a day against me. I understand that a copy of this statement msy be forwarded to the Office of Investigations of the DIA for coverage verIIIcation. I do hereby ee fy the pains and penalties of perjury that the information provided above is true and correct 6 Date � /® J Signature - Print name c S l Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ::00 Selectmen's Office Health Department contact person: phone#; ❑Other (revised 9195 PJA) - k Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all-employers to provide workers' compensation for their employees. As quoted from the"law", 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 g gJ 1P f an individual partnership, association or other legal entity, employingemployees. However the owner of a trustee o g , �P P 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 section 25 also states that every state,or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.- Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required,to obtain'a workers' compensation policy,please call the Department at the number listed below. City or Towns 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 perniitllicense number which will be used as a reference number. The affidavits may be ret uned bd . the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 Inllesduallons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 r -�o,�mo.uuealt�C_.o�� �w�uzc�yu BOARD OF BUILDI g i ' License REGULATI®N VONST Z,MTIONrSUP Nuful 075268 4} frda a ON 11671 75261}' R titcted ! LEWIStiE SE"\ 39 GEOF2GE ST I" HYANNIS, MA 02601 AdministraQ9r � 0" A 5A2 "Z4 Assessor's map and lot number ... �e...... ........ .............. 'It HE Sewage Permit number . =n........ House number ................................................... BARBSTLBLE, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...AO�2-0....... ................................................ TYPE OF CONSTRUCTION ............. ........ .............................................................................. ..........................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r Location ......41Y/..............4.......l..&..... ... ..-. .......... , r :�. .I ...............:................. Proposed Use ......... ......... ............... ............................................ ............................................ ..............;:;................ ZoningDistrict ........................................................................Fire District .......................................................................... Name of Owner).? .................J...........................�A�Address ............................ Name of Builder- .:W.......... U.....................Address 4............................................. ......... A16, .......................... Name of Architect -�`....... ..................Address .............................................................................. Number of Rooms ...... .....................................Foundation . /- 1; .............. . ...... ........Exterior ... ..............Roofing ..............:i� ........................................................................ Floors ...........47 .................................................Interior ........... .......... ................................ Heating .................... 7" ................................................................Plumbing ............?5�........ -:�Z.�..............A.�............................... Fireplace ..................................................................................Approximate Cost ..... ..................................................... Definitive Plan Approved by Planning Board -------------------------------19--------- Area .......................................... Diagram of Lot and Building with Dimensions Fee ......Z7,—e-::f ................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all-th6 Rules and Regulations of the Town of Barnstable regarding the above construction. Name. ..................................... .............................................. LOWE, BRADFORD W. A=308-132 No .................. Ad 2nd Permit for d .............. 1 ... Floor Apartment ; Location 641 Main Street .................................................. Hyannis ............................................................. Owner ..Bradford. . . ...W.. .... Lowe. ...................... ' .. ....... ....... .. .. . .. ....... c Type of Construction F.r...ame .. .. ........................... ..................... ......................................................... i Plot ............................ Lot ................................ Permit Granted ........,March 15, 19 82 Date of Inspection ....................................19 ! Date Completed 19 I -1 tooa � } 1;5sessur's map and lot `number ... •. � .. � QUO THE O�y Sewage Permit number Q.AJ.:...7-(.AJ.Jt....Ye-j e.e/1,, .... SEPTIC I�a ���7 SYSTEM �g�g��ii T BASBSTABLE, �� � 6ri Hoe number' . .OLI..:.................................................... �L � 1i CC�II,�dF��l4 A MABa House WITH i639 H TITLE 5 `gym ^rE'p MA-1 i TOWN OF BAR NS TABIj— ° ` RURDING 1 I• S`PECT APPLICATION, FOR PERMIT TO !A✓' . ,�' ,�� .7.11 . . ��....., .. . ............. ......................... TYPE OF,CONSTRUCTION ...........:./W.,� ....:...... ........:....... ............................................................. J . :��.......................19. 7. E NSPECTOR OF BUILDAGS: t lersigned hereby applies for a permit according to the follow••ng information: { /................ c......&.................. .. d. fi.................. ....... ./. ................. ........... ............ .. ... ...... . . . . .. . ........................... t ..... .......:... ......... ......... ......... .Fire District ................................. er /1. dd re . ' %'..`.��' ....1!z' ••d.... d Gl�'„ As .......... s/ .� . I•.a... � . " �.5�. _ der' �,�C .`�� ... Address .. .. .... ��/f�Y/ J � r A? Architect a5.................Address ...................'..4 ..... ........... ..... .... . ..... ... �—��� .............Foundation .......... r of Rooms . .... .............................................. �....�T..... ...... .................................... Tz�- ........ s��.o�T �G(.`✓.. ......... ... ...... ...........................Roofing .. .cr..��'t�/. ...:............. :................... ......., Interior ............ .�J.. ! ..1 !�C��.........:....:............... g .. ......���'r�C /.G............... .. �` �. .�.....Plumbing .....115&...4WR ! /..���jJ�/,.✓ epic €ems ................................... ........,..... ...... .... . ........Approximate Cost::... //dam . ......... .. Definitive Plan Approved by Planning Board _________________________ __ ,........... -- - 19--------. Area -• of Lot and Building with Dimensions � ............. Diagram g Fee ...... '��---.---,,............. SUBJECT TO APPROVAL OF BOARD OF HEALTH i OCCUPANCY PERMITS REQUIREDY FOR NEW DWELLINGS I hereby agreeto conform to all the Rules and Regulations of the Town of Barnstable gardi g t a ov construction. L No ........ .. .... ..... ...... ................................... llF'072� J W ��(/f AAIEW 23872 _ Add 2nd o ............%. . Permit for .................................... x Floor Apartment ��x 1, 5� _.......... ... ..................... . Location ..64.1.• a n.•.S,treet••.•.•... ..•.......... , r Hyannis Bradford v9 Lowe Owner ; J.........................Frame........................... Type of Construction .......................................... ,0+' 7 t.�a 46 .......................................................... ............ jr Plot.......................... .. Lot ................................ -` March 15, 82 t41 '�,oermit Granted ....:.... ........................ .19 !1 A. Y • Date of'Inspection .."1. .............................19 _ � �. '- - Date Completed A....5 ............. . l r c . } Southeastern insurance agency 641 Main Street•Hyannis,Massachusetts 02601•Tel.617-775-5154 Matcch. 12.. 1982 Mn. Joseph DaLuz Budtding Inspec tm Town o6 Bwuutabt e 367 Main Street Re: ..Apantmevit' 641 Malin. StAeet, Hyannis, Ma DeaA Joe: Due to being on vacation, J. am unable to. .cn tAoduce you to Mn: Biad6o,id W. Ldwe, who is both my buz ne z ".66-ct.ate and the ,new.ownen o6 my business bu tddng. At the time we got togethen; I mentioned I ways in the pnoces s o6 zeU ng the buitd,i.ng to Bna.d and that a new apa&tment wouf.d be built once he took ownetushd p. Again, Jae, I want to thank you bon aU the work you did on my beha 6. With best petusanat tega&d6, I %emain S.incene.2y, . Go,%don B. Lawny GBL:1m 5 - Y , 2i gaifdifj Comm tuionsr: EXT. 107, - t 3 a t. � II R 'TOWN . OF BARNSTABLE. s RJ Cis BVILDING ANSPECIOR. TOWN OFFICE BUILDING HYANNIS, MASS. 0260I d December 14,198 • ; ry Y-R �7 tir 1 rri x ' , a r E s• _ i lr o Gordon .Lawry 641 Main..Street. Y° jiyannls;. MA 02601 ,;> Dear Cordon After reviewing. your property.for an additional apartment, .I . find. that"an addition over 'the. existing: first. floor structure would canply with the lot coverage requirement as per our. zoning bylaw; Please keep'in mind that a-second means of egress. would. be re quiredo As we p:r ously discussed, the west wall would consist cif Masonry contructivn due to the closeproximity to the existin structureso Peace, aJph D. Da Building Canmissioner JDD/gr t _ - >. ., -. . . ,. _ I1,.�;I I L.,6.I I,.--I.�...I-I.�.I,-I.,...1.,�...A�:I I.��L�..,..,.I.��,I.I--..I.-�I.I.'...2-.L..'L"-,...L�...II,..,.-I,.I-I-..�.I�-II--.I.I I��'.�,.�L��-.I-:I.,%-�I;LL.,...'.-I�I�.I:,III II-�.I!,I IL.�5.,I-IL.,,.L�,..�..-.�I�.L.,"I.I'L,:,��......-I.I I.,I,,,I�L.-...,-L,IL..L��I.--I II�.I II.-I....II.IL-...,.I,...I,.II rL.:.I,,1I.--- -I.I.-L.;LI.1...�I�'1,I..-.I I I-- I�*t.1I.. ..l.. . 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