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0418 MITCHELL'S WAY
,'fc-A Il s `• AUTIVE moos 1 i � Application number..ff...�....d—.....q y.... Fee..................... .: ........................................ s +► ,i nrs`1 � �R1�iT$TABLt„ � 1 Building Inspectors Initials. . ................................ Date Issued...lh.hn Map/Parcel .4..'..Qt..R....... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: Q1 P1 i 4C4 13 -41 anli,`5 IN 026 Q NUMBER STREET VILLAGE Owner's Name: Lv s C e-Ke, Phone Number Email Address: v;r,I�-g 914 rq y G 4o d. Cell Phone Number Project cost S L OJ yy Check one Residential °' Commercial � OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application f a accordance with 780 CMR 1 Owner Signature: Date: 2 I////q TYPE OF WORK "Sidg 0 Windows ( change)header char e)# E-1 Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION . Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No_____, if yes, a gas permit is required. Natural Gas Yes No ,if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Lc,,� Telephone Number Cell or Work number a-7H-616�-O- I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction ins ection procedures,specific inspections and documentation required by 780 CMR and the To le. / Signature Date 2-/►l/4 APPLICANT'S SIGNATURE Signature - Date All permit applications are subject to a building official's approval prior to issuance. f 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/PIumbers Applicant Information Please Print Legibly 7_�Nanle(Business/Organization/Individual): (.-(/(.) CC.(le, Address: C1 1 /State/Zip: �� Gnu �� DZGa( Phone#: q — �L7- 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New constriction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY 9. ❑Building addition [No rkers'comp.insurance comp.insurance. \, ' ed] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions J� 3: I am a homeowner doing all work officers have exercised their 1 L E]Plumbing repairs or additions / myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs ur insance required.]t C. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the for insurance coverage verification. I do hereby certi a the an enalties of perjury that the info 'on provided above is true and correct. Si afore: � Date: 7i/ Phone#: Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector_ 6.Other Contact Person: Phone#: Information and 'Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written:' An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced'acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to-your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone mumber(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'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+�+ �{� y� ``p^�''llSSll,, _ have. 3_' '_____....._,a' 4-1,ara=;ratj to nlitain a WOrkers' Indu vial P cwdens. U11OWU you.nave.auy tfUG'Uons ra6=1ii- 1— compensation policy,please call the Department at the number listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant town)." should write"all locations in provided to(they or ."A co of the affidavit that has been officially stamped or.marked by the city or town may be applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hike 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: „ na Commonwealth of Massachusetts Aegartmetnt of Tndustdal Accidents Office of Investigations 60(1 Waslwagton Wr d Roston,MA 02111, Tel.#617-7274900 ext 4.06 or 1-977-MASSAFE Fax#617-727-7749 Revised 4-24-07 www mass,gov/dla I Town of Barnstable *Permit# - ` tres 6 months rom issue date Regulatory Services Fee Richard V.Scali,Director INN1639. ♦ ^ „ Building Division , Paul Roma,Building Commissioner DEC 200 Main Street,Hyannis,MA 02601 �W lAj ' 0 6 ?016 www.town.bamstable.ma.us �11 Office: 508-862-4038 Fax: 5�0�8,�7�9i0=6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number c;�'J/ Q 0 54 66 Property Address ❑ Residential Value of Work$ 15,00-0 1 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ky y-0A 1 0 , Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) . ❑Workman's Compensation Insurance _ X Check one: ❑ I am a sole proprietor ['I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to -roof(hurricane nailed)(not stripping. Going over existing layers of roof) Ej Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. � e ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors.License&Construction Supervisors License is re4,, fired. SIGNATURE: ` 0 QAWPFILESTORMS\building permit forms\EXPRESS.doc 06/20/16 ' The Coaxutom1peaM ajfl#fiwadr=eft. Deparhmew of 1n4- &7d Acddem& Offike 1mvs*adom ' _ 600 WashhTtwt Street Bastvn,A4 02111 F kPFonmassmgorldia Wcwlc:e& Cun3penia[1iTo:n Insurance Affiffiwit:BiildeIs/Cont actors ect claIIS/Pkmbers Appliczut In{or tarn Please Prim y Na= Address: a,�. f e 6, W O V r 4 M-�o2b10(line I� 00�;Z Are you an employer?:Check the appropriate ban Type of project(required)-- am a metal coaf=sctor and I equu-ed}: I-❑ I am a employer with. ❑I g 6. ❑New eonstiuctson exrqAoyees(fall andfor pant-time)-* lave hiredihe=b-contwtozz 2.❑ I am a sole proprietor orparfuer- listed on the attached sheen 7. ❑Remodeligg. shz p and have no employees. . Mese sub-cm1mctors hate 8- ❑Demolition waging forme in any rapacity_ employers and bnre workers' 9- .❑S.uilffing addifian o warps'camp.ff,©Hance comp.inmrance 1 doing all work officer have exercised ibeir .5- ❑ We are a Corporation and its 10:❑Electrical repairs or ad& ons 3. regm.ntred 1 s 1L re airs or additions I a a hatneoumer ❑Plumbin� P myself[No workers'Camp- uZU of esempfion per iS (M 11❑RIoofrepairs insizarwereqaived-]1 c.152, §1(4).and we have no employees-[NowoA=s' 13-0 Other co=p_ksarance rule&] &AnygPidrots6atCbeCUb=isltffi.St Rho flloutthesedtioabelowshavdEgt6i!-wvm 'cen;compeasafiaapo&yiufDrmatiCm- _ #SameDvnw vft submit this sudL ZCan=cmas flit,b,dr f Fs b=mast e3tach =addidi l shert d mwhig the name of the and state whatm ar notthuse entitiesbAve employees lfthemih•ca shm employees,1heymustpmvAtthxn wadma'comp.parley in ar_ lam an hwzrauce for wy ea v&yee-L Setoev is file pa cy road jab sfte' irzformaiinn. Insurance Company Name: Pahc1*4- or Self-ins.IiC- k Expiastion Date ., Job Me A&dre= citplStawz�p: - A Each a,cupf of the workers'camaipensationpolicy declaration page(shaving the policy mrmber and respiration(late). Far7um to sew coverage as required under Section 25A of MW-a 157 can lead to the imposition of criminal penalt%es of a fine up to$1,50t)00 asdFor oxio-yeir imprisonment,as well as riAl pe dfies in the fon n of a STOP WORD ORDER and a$ne of up to -M a dap against the violator. Se adsnsed't3at a copy of this statement maybe farwarded t a the Office of Investigations of the D iasuramce coverage verffcahnn- ynFa I�►-Riry c r affiu sfpe$ury ifiattha informa=ptm•-ided abm a i v bw and correct Simafure: 46.Dare: � Phone OJWd am anly. Da zest write in ibfs own,to be cmnpleted by city artatvn aoeial City or Town: PerroiflLiceuse Issuing Au&or4(drele One): L Bowd of Health I Buiffifing Department 3.MpTmm Clerk 4�Flectrical Fuspertor S.Plumbing Inspector C.Other Contact Person: Phone#: r Information and Instructions Massachnseffs Geheaal Lams dmpfrr 152 req=m all employ=to ode wozkeu;'OOmpeusal=far fuel=employees. PMMMZ0ttD fhis StSlIft,an MnPkYrZ*is&fined as.eveTypeasoam dxe seavice of another under'any camfn t ofhue, empress or implied,oral or weft " An.WW&ym-is defined as ran in&vidnai,partnership,associidian,coiporafion or ofhea Iegal crthy,or airy two or more of the foregoing engaged is a Joint use,and inchidmg fbe legal segreseofat Ves of a deceased e�pluyer,or the receiver or tustee of an individual,partnership,association or other legal eufity,employing er¢Ployexs. However fhe owner of a.dwej mg horse having not more than three apa dmenEs and-who resides therein,or the occ4mnt of the - dwmaing house of another who employs persons to do maintm==,rrn sftucti on or repair work on such dwelling house or oa the grounds or building app tlaereto shal1notbexanse of such employmcuf be deemedtn be an employer." MOL chapter 152,§25C(6)also sues that"every state or local Iicensb3g agencg shall withhold fife issaance or renewal of a hcenLse or permit to operate-a bassmess or to constract buildio-gs is the commonwealth for any applicant-Who has notproduced acceptable evidence of cdm Pr=ce W' n the ius-axance.coverage required.." Additionally,MCrL chapter 152,§2.5CM sus-Tefth=the r-m=mwealtiinor a'uy ofitipoIitical subdivisions shall an iab any contract for the pmfou mace ofpubho wont umtil acceptable evidence of compliance with file fiL=aam.. cuts of finis chapter have been presented' to the cmftacd g andhoi 3'=' Applicants Please fit oil tine wor}reas'compensation affidavit completely,by chug the bores that apply to your situation and,if necessary,supply sub-confractzr(s)name(s):addtms(es)andphone Tr= er(s) alongwiththtz cetffficat*) of k=ance. Limited Liability Companies(16 or Lmated.Liability Parto hips(I I P)wi&no eMrpInyee$other than the members or parb=s,are not requmed to rmry warke re ccuupemsat<on insurance. If an LLC or LLP does have employees,'apolicy is required. Be advisedthatthis afda-vkmaybe sabmrtisd to the Department of Tn ic-frial Accidents for conEmnafm of ins rmaze coverage. Also be sure to sign and date the of davit The affidavit should be retrn red to the city or town that the application for the permit or license is being rEquesbA not the D epartiaeut of L dmsfris1�=&=fs. Should you have any gaesti s regardmg tfie law or ifyon sie regmred to obtain a wormers' cpmp=sat on.policy,please call f m Depar:.eat at the nrmbea listed below. Self-ism-Dd companies should eater their self insurance license nmmber on the appropriate lime. City or Town Officials Please be sin a th at the a$davit is complete and priatrd legibly. The Department has provided a space at the bonnet of the affidavit for you to fill out in the event the Office ofInvestigations has to conh3c.•tyouregardmg the applicant: Pleas a be sure to f l in the pennit/licease rnr.nber which will be used as a r-Df:b=ce nmnber. Tn-addition;an applicant $iat must submit mvubiple pe=WRcaose applizaiions m may given year,need-only submit one affidavit indicating cent policy fiIE3 a iion(if necessary)and under`rJob Site Ad&m&*the applicant should mdte call locations in (may or- town)_'A copy of the;-affidavit that has been officially stamped or maxIced by the city or town may be provided to the applicant as proof:that a valid affidavit is on file fhr f din pm=dP--or Iicensem Anew affidaviYmust be Med nit each year.Whew a home:owner or citizen is obtaining a.license or permitnct related�D any business or commercial (ie.a dog license or peonit to bum leaves etc.)said person.is NOT regrfted to complete ibis affidavit The Office of Investigations would lie to thank you in advance for your cooperaiim and should you have any qu oins, please do not hem to give us a call. The Department's a ddr= telephone and fax number: • ',Departmmt oflnd lAGcidenia f of j, ti0)3.� ' T I.#617' -4 c�ft4-06 car 1-&77 MA�� Fag"617 727 7749 Revised¢24-07 WW d� TWHE Town of Barnstable Regulatory Services , KAM Richard V.Scali,Director Building Division, Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 #` Fax: 508-790-6230 Property Owner Must r,i Complete and Sign This Section If Using'A Builder I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building 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 QYORMS:OWNERPERMISSIONPO0I.S Town of Barnstable M Regulatory Services `.. pU Richard V.Scali,Director Building Division y • a�xrts�atE. •' Paul Roma,Building Commissioner ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: Please Print. , �2 /� JOB LOCATION: '1 �� WU Ch�'�� W o� / '[- /�InN11 c q,A C) 60 1 number street village �V 4z Q� � Le)OS Z "HOMEOWNER": � - name home/phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINMON 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 undersign ` omeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures i quirements and that he/she will comply with said procedures and requirements. Signature of omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall-act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 Town,of Barnstable *Permit#i" Expires 6 months from issue date Regulatory Services o Fee RAMSTAJIM KAM Es 16,lg6 ,� Richard V.Scali,Director : I'V t p Building Division //� ✓UNO fl Tom Perry,CBO,Building Commi aw/V OF 2�16 200 Main Street,Hyannis,MA 02601 �jf� �A . www.town.barnstable.ma.us ' LL ' Office: 508-862-4038 Fax0790-6230 EXPRESS PERNIIT APPLICATION - RESIDENTIAL ONLY (�, /'�,t Valid without Red X-Press I not Map/parcel Number I(�Z O��I't/�tr nW r operty Address L8 94 I • O Z6 (7 ❑Residential Value of Work$ ® �nimum fee of$35.06 for work under$6000.00 Owner's Name&Address �' cam. ( � ° Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance + s Check one: ❑ I am a sole proprietor [fir am the Homeowner y ❑ I have Worker's Compensation Insurance a Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ t(check box) =' eET Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) �� ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy o the Home Improvement Contractors License&Construction Supervisors License is r SIGNATURE:'r% elk, a Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 ' Tzm CG=O.Tnvmkh 4A&Esrfdrmyetts �e�r�lr�e�t t� shzai`1�ccir�TeF� � ." — Offl4M afh"-W&igati= 600 WadirgionStreet Boston,MA. 021-11 nupluma- garld a Warlmrs' Canpenkfiminsur-mce Affi f avit-Biers/ nutractmcslT edTicia mTh6inbers Hcard Iufmrmai uu n Please Print_Le .Na=(BncmR rm�GnriJ rtx7 (\1 Ad&e= 0 � fit Owl NA 0 7-b O> Pl.,,, Are ym an employer?Checkthe appropriate ban Type of project(required)c / L❑ I am a employes vd& 4. ❑I am a general confmctar and I * 1=e l�edfle mb� cmftactoaz �- ❑Dery amsfrnction ` employees(full a�lor Bart time)_ ' 2.❑ I am a sole propaetar arpmtaw listed orLtlse att6ched sheet. 't- Re o&Hng y s and havens i ees. TE=e-sus-ccmfractor=hz.vm � ffiP� $ Demalifian t c&-ing forme in any cgmcafy. en3ployees mulhave wo&ere [No odom&cam 'sur p_" ance comp_kwonce$ g- ❑ atlidiiies tti eqximd 1 5. We are a corpmz ian and ifs 16-❑Mech ical repairs or adrrious II am.a hzmeomer doing att wa&- officers have exercised tii�ir 1L0 plumbsagrepsim or adcliHcm my [Noworkers'gyp- Tigbt of esemptiou Per MGL ��ri�e rid�Y a M.J1(4k and we have no L.O Roafrepairs emplaym,INowodoe& 13.0€?ther comp.immu ce required_] •$ap apg���at cbeclsboz ffil mast 9m Mang seciioabeIowshmdag ffiekwu&Eme a=pmmff upmy imffimrsga _ #�araersteba sabm�t has sf�daris tiwg m�dain�¢lf�ea3c��daeahaP autsid�rm++*�re,,•ramst sabaDt anemaffid�est:"��+ � . =Ca�ctrirs cTaecYiL¢s bmcmast shed ear sddi6�al suer shammgl3sEn�xae of the —�d st�ewf+effi eraatfihese eaffffml; c emnlope�.Ifthe R, e,9 ,•�bsSe empIo�e�s,t5eg,,•,+ gms�de tb�ir u arEs'toatP.gafcF m�}rEr- I are[ma izmzraura fbr ivy enqAoyzm. Harm is fitapa cy tm3 jah sits ir�armaiic+n. - . Tasnr=re:ComganyJ\r=e= ' O&T4-or Lit:. rtI3afe_ Job Site Addre= Ciigl5 Af ach a copy of the w&rkm?mupensationpoRncy ded2wation page(showing the policy number and expiration date4. Fail=to sew coverage as requireduackr Section?SA of MM m 157—can lead to tfie imposidoa of rsininal penalties of a fine up to$L50 D OG andP'ar one-yearimpFisonment as w62 as dvil penalties is the fans of a STOP WORK ORDERznd a ffne of tip to 0.00 a day against the viafatsr. Be advised ffid a cczpy o£this stab=Fn{maybe fars m&d to the Office of Ia4esst�afioas ofthe D.TA for a covmg5>vmdficdina } I do hemby cerizfy uard &C ' s ads afpedWy 9a As irrfbrwai7u proti&d abore is trim and rarrect Simm_ature: hate Y (9 �j Phone ik,._ . 00�2 t3,OW aL=w w* Do not wrke in ff6 aFea,to be cmpleted by city artomm skint City or Town: PermdtlLuense:9 Issming (cilz one): L B d of El•eal& r.RuMmg Dqm ment 3.tity1rcrim aerk.4.Electrical Ikspeclor 'a.Pig Inspector b.Other Comact Person: Phone-P: ! 1 11 11 • 11 1 1 11 .....� :.....w _1 :3.a. .•iiw aI si .- .- ••.,..i!/. ►.I•n■.1t :n.lo 1■1 n . a■(1. . - 't■ ■a:lol n ■\ 1. .:L.IL .■t %I lI r r NIa-• -•Y ..+w•• .. i■- r • • .t.•\s i •7.. _O • -■Isis _r • ■O �Lu7 - .. . ■sin a.� •1■: a ••■Inita ■�30.�t .■a t■■f n•Y ..■ ■■�R■I.a _ •AY.■..■ ►.1 .• .tt.l. . ■O:+ -�. �\Ila- \t _.■. ..• • •■•1 " t �•u • •i - n i■ - -• - .1 w cur.■•:. • _ .� :r �■ O.O.S. ■•r • u- n• -•.t■• a■�:;�■ n - •n Win■:+ ■l./:: _le• u u sin• at �_ on - - - • ■ ■ -- • :n n■ mr ■..n■.!R uu .la...f..n. n .u� -_r -alo1 �uu ■ n: :;uu •• •w.■� • /� _ ,•.. ■\. ■ •1\• ■• .t•1 ■■JI .It i- J•:1 a..i�.a1l :ta■ •'•• -Y•- ■•.• - tt al ■•- • M.n_,al • .■- ■••-� tt• ■.. - • :t/■ .�. •'.• �t.l. •• t wR•1. t. /• .•..lo 11.!1.n. •1\ . ■r■\■ .1 ■..l -'\■. •1\ ■I . ■•• l■■.� ■••/." ■ ■/ .. 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I ■1 0•• u. ■ . •• ■ ■ a u .gap ■rn. • .• as. / f;■■_•I •f 7 loI loan, a.I■.■ IL -.• �•.i1 _ ■..■ ••'. . silt /:!■ /: ••Y ntsi ■■1 a• .■i■ n .lo .•YO ■ .■7■.a\ w_ •if.1.■1 " •- • O - ■ ■ •...��.•a■m ••■■ ■ .� n n.n. ••. n .••.n r: n ■n rr.• - ..■m J■• .■• . ■. ■_• J■ •■:�.w r. ■■rnr.■_r . - n . ww. r ■�.■�. ZI i �.�...ten■.• ... ■ �� �•1.1 caa ' 1. •. , �. - � ..... ■r.,. •-. • sir- BARN6TA T4 MAM s639• Town of Barnstable " �� Regulatory Services Richard V.Scali,Director - Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA-0260L # www.town.barnstable.ma.us t Office: 508-862-4038 ' ` t - ,i`�r � Fax: 508=790-6230 s Property Owner Must Complete and Sign This Section If Using A Builder I, as Owner of the subject property. hereby authorize to act on my behalf, e in all matters relative to work authorized by this building permit application for: F N, F (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. F - Q:\WPHLES\PORMS\building permit forms\EXPRESS.doc Revised 040215 Town of Barnstable Regulatory Services opt Richard V.Scali,Director Building Division Tom Perry,Building Commissioner MAM �A ►��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION / Please Print r DATE: (•p b / JOB LOCATION:? numberl tl street village "HOMEOWNER"� f, (/ 1 �'y 0 0 name (� home ph(o�ne# ,gyp work phone# CURRENT MAILING ADDRESS:, y Cyc rl 0 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 buildingpermit. (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 undersign me owner"c fies that he/she understands the Town of Barnstable Building Department minimum inspection procedure re a at he/she will comply with said procedures and requirements. V Signature Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0.Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is . ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 �- Town of Barnstable tHE Regulatory Services 1p� do Richard V. Scali,Director �* Building Division ■nnxsrABLE, « } 9� $ Tom Perry,Building Commissioner iOrFo rear a 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: it I '�O 1/ Name: at" e— Phone#: q-7"61-110 -6 1 - Address: G 4, ✓14.--I-AC I 1'5 vc`l/ Village: _ N-t w/t:S .Name of Business: Ca((-Q—_ C&,1Stk it�o Z��• Type of Business: C o . ,/-'vx YP s ~�K1�"�J�zit Map/L,ot: ��` �''a" a-( I - �z1 0 d,-.l . . INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carved on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • 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 pickup 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. I,the undersigned,have read and ®agree with the above restrictions for my home occupation I am registering. Applicant:__ Date:. /( I 3 a/ /5- Homeoc.doc Rev.103113 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates [cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you. must do by M.G.L.-it does not give you permission to operate.) You must-first obtain the necessary signatures on this format 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 6'usiness Certificate that is ' required by law. ;. DATE: Fill in'please APPLICANT'S YOUR NAME%S: Z CC, ��e BUSINESS YOUR HOME ADDRESS U c q may:f-ch 11's ww ^ul► TELEPHONE # Home Telephone Number N MEOF CORRORATIO :- ,{� ::,.•' :. .�.• :C ' � 1: NAE.OF'.NEW BUSINESS r tr Cyc �U�S .y� ,uy, f►'G-.TYPE.�F=,BUSINESS M C"o S. ✓ o :'. '�:...,:: : v.. ..., •.,:,: if.. CC D E •'• -N Y •L. ass'"U �R S 1.,, - CEL.N IViB _.' :,A[]CRESS:OFa'Bt�51NESS...,-:._::�.: ''�!'. '.c�:� - - ---- . � 1 �` When starting anew business there are several things you must do in order to be in compliance with the rules a6 re ) ions of B To�wnn'o 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 ISSIO ER'S OF CE This individ al h s i o a y pe i r quire ents that pertain'to this type of business.. MUST Q0-M0LY WITH HOME OCCUPATI>DN.. RULES AND REGULATIONS.' .FAILURE. ut oriz i atCl ** r^OMPLY.MAY RESULT IN FINES MM.ENT % 1 1 2. BOARD F H LTH This indivl ual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** 'COMMENTS: S CONSUMER AFFAIRS LICENSING AUTHORITY This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: . =- _� 7 9/14 4 _ 4. r n t Y ^ _. _. ;y�:'...eM r+ti�a+-w'r"n':.;.e-d�•w'e"'.rr-s P�.M _ - "i �.,..'�L'� �:;"'�'1"+�#"'..��drr�=M.`�; `"""-w�'y, ��+. - _ _,,,,,.,� ...-- - ,. .F ., �.,� �'''° ,` • � - „ -= � �. � ,�-t. ,tea � „� a T . d •r X" i } _,:.W �` - - �7 ,.., �� •; r='"-y��' �'�".., - .. =,y"`'�w,�.,,, a,�'' aft- '°,��s ,e 011- � � - _ ..i: t .,� r p-+P_ .• iY -•�. � ..�ra"ao"e}^+ :.-�', A -.i. �^ r M ♦ _^�,+-,¢, pid , ' 'x1 3�•y.s '�. :.mac,,,,.' .�*� A n y$� #�� �� o S q•��� -,�+ cr.�,- .,, .a�� - '� '.fir-�"Qt����© n >' `� '7�� ,p `�- .��xc� 1�. a em „r -'d. 14` -.-0'st,s� N tF }y E-It AS i ��::0�xC9 r._O �" "t;t, �T",y ' yw3„+ ...b n''1 f,�-'1-- c'• `? - �' mot '"- '�'i•,'4� � ''..f - �' �4 �wd J=-g G r�{"..i 7 � ��.:? �� � � tY� `� � iE'1-SAY• O � � �-,�"" b >�f.4 - 'a� �ag-y ���y, +y. �,,. n qy }f' w vm:iki 418 Mitchell's Way, Hyannis F/14 �A®r Dish _ a418- ,tEh Way,.. Hyannis , � ' 7/2 9/14 r0 x c r: a 1r1 � 1y . � i .. w^uWWw✓w:+xw-.m.�- v.+i t.+�+R •++Wu.��-+v��vss .may pM �• y �i 03 � '""� _ _ _ .._ a.•�..r.,�.4�.�. - . � ��i III 1 e a k y - a Y`" K '; 7/2 9/14 418 Mitchell's Way, Hyannis 7/29/14 3 � 3 . w+.,. c c � 7-7 lk c q I r _ 3 iA S ¢u� 418 Mitchell's Way, Hyannis � L9/14 Ar Aft 9.0 rx-1`7 IV i s M1 rr e i _ -P 00 CD N iU i� F e i N C9 I F L a r e t _ �•.w�.. tip. .,IAwµy�y +Rg'91. .' '` f..S. Y' �� �wu✓IL���- +n�^+4_ ��� l Y; ro I _z _x r dAr &+3•ilv,. ^ Yr"Y ,�'t III _Y�� '��- _ w _ a ' ' ✓u _ I y a T {M e 18 Mi +/ /14 u s �r. 3 tt a �t e u SS r,�•r. �-- 418 Mitchell's Way, Hyannis 7/29/14 aw T' 418 M.itchell's Way, Hyannis 7/29/14� � ~ 4 1 6 j ^ 5. f@ r '•�, ,�" ��'� ; mil` � � � � � 4Pi9r, 1 Pe.....�,.,,�,��„�J r; x M., Afl. l O •a �. AW. r P , i r�s - y 418 Mitchell's Way, Hyannis /14 rs � x }-0 aa , F �.y x l Y « r r. Y n � y r Y._ - ��•. par 3�J .s gk �.:. Y� 5. .t is . r4 r fi 418 Mitchell's Wa PH a 7/29/14 j F f. f s<. I • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION '.7 Ma ( Parcel UZ Application Health Division ��lo !/`-'" Date Issued Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address !41S Mi"11C 2vsa.V Village 43,&AA; Owner Ca, Address Telephone Got _ ---�� . Permit Request Ax yee, a s"Lr, ��►."� e..&Aurr, klar4a^ 2:-d p aor,yt&gwr,- all �r,��� �b��,►+c���GCD ,o ,n •.d b Square feet: 1 st floor: existing proposed 2nd floor: existing-propose ) I Total new«- Zoning District Flood Plain Groundwater Overlay i Pro1ject Valuation �• Construction T e { Yp >.a ;�. Lot Size Grandfathered: ❑Yes ❑ No If yes, attach s pportingdocumentation. 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 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 L64 -c,- Telephone Number T31-04 z r. Address :t.1 ` n�k;_ c �'S 't��a� License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE •�\ �1 DATE P 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. I ADDRESS VILLAGE OWNER A F : DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL I GAS: ROUGH FINAL-' s: FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 1 The Commonwealth of Massachusetts Department of Industrial Accidents. - - Office of Investigations 600.Washington Street = Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): jif/fiS CC, Address: w 4 Ot/l fr�2�l SSG / City/State/Zip: 441�- 02-�01 Phone#: S °� ® 6'2 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.[`'1 I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152'§1(4),and we have no i3.❑Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ti Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: _ghe- 1l 1 A ;�' AZaarvr 1evAe_ Z 8 City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u ains- nd penalties of perjury that the information provided above is true and correct. Si mature: Date: 6' I Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the, dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents CQffGe of Investigation's 600 Washington Street Boston,MA.02111 Tel, #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia Town of Barnstable Regulatory Services oFt �tyy Richard V.Scali, Director Building Division BAMSTABLE. * Tom Perry,Building Commissioner 9� 1639. ��� 200 Main Street, Hyannis,MA 02601 ArEo � www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: Please Print � ��+�-1 ���'I . JOB LOCATION:lh &eA r1f ,49oo.n number street village "HOMEOWNER": L 1775 CS 1 7 71-7 r-66Z name home phone# work phone# CURRENT MAILING ADDRESS: U &L y µ-YA- C5Z6d 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.pgrmit. (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 minimurn see ion p ores and requirements and that he/she will comply with said procedures and requ' n . Sign a ome wrier Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. „ BARNSTABLE, • MASS. Town of Barnstable 9� z639. t ,0� . Regulatory Services Richard Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 ;! www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must C7as Sign This Section g A Builder I, , Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorize by this building pe 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. QAWPFILESTORMSIbuilding permit forms\smokecarbondetectors.doc Revised 050412 v 1S a OWN it RNI ^ � 5 t i C iQ t r -------------------- 3N� � 1 ioo I I j L L =bPlyG I d Cl3J' 3zf 319VjSfp6n"Iq JO Nm01 ay Oid �pSUILE Mm Vic nvlvi "vvi�,.n� I � � , i F i c� � 4 � qj rS � `OISIAIG n � r (-A'JkT M lY77ATnTT Mn'AWT'llf I ST) IuS mQ:1 TOWN OF B 'iRNSTt.19LE T)T MAIR I. 1 AM 9. 27 DIV15'10 Nf I I I i i i 1 I � i r 1 f r � i f i TOWN OF BARNSTABLE 1 j 7'l 0 MAR I I RIB 9: 27 i DIVISION .n, �2 � t b I _ i 1 1 i I i .. i { i + F lA1 1 ; ttJP Cl fit;d �-n I 4 CD _ Q t a Y � -nipLO i "a CD . j 1 ui 1 3` 14 l \- TOVO4 I L Os tpl 17 rµ.l 8; t i Z C ° � � %Rj' 4 \r �nwealth of usetts T t of Public ty lace, Room,4301) flo setts 021.08-1618 -Y ) 727-3200 727-5732 O 727-0019x. .gov/-dps to the address listed abb-e. PROPRIATE BOX(ES)) '' CHANGE DUPLICATE LICENSE ./� �� � � - . F c �oFIKE� � Town of Barnstable P o Regulatory Services Thomas F. Geiler,Director BAMSrABLE, 9 MASS. $ Building Division �A�FD MA'S A`0 Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 568-790-6230 December 22,2005 Mr.Luis Calle 418 Mitchell's Way Hyannis,Ma 02601 Re: Agency Notification of Illegal Apartments Location: 418 Mitchell's Way,Hyannis Map 291 Parcel 024-002 Dear Mr. Calle: A review of our records, including the permitting history and the Zoning Board of Appeals database, indicates that the present use of your property located at 418 Mitchell's Way is limited to that of a single-family home; any other-use, specifically additional independent accessory dwelling units, is illegal. This office has received information indicating that the subject property has three fully equipped apartments. Any work performed in order to create these units was done without the benefit of proper permits and municipal inspections. The resulting liability issues are serious and should be of great concern to you as the new property owner. Please contact me directly at 508-862-4027 in order to discuss this matter and all legitimate options available to you. Sin cerely, Robin C. Giangregorio Zoning Enforcement Officer JAIllegal Apartments\418 Mitchells Way Calle.doc TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a0 Parcel _�� : Application # . Health Division Date Issued,. Conservation Division Application Fee Planning Dept. Permit Fee` J: - Date Definitive Plan.Approved by Planning Board �I— Historic - OKH _ Preservation/Hyannis Project Street Address `�' V"l A, Village Owner %�.l Address Telephone fo V fir\\ -- 2 3 10 Permit Request k43 5��►�t e �"� ��1 1,�o�.P v ���P��a •w�; l �c�c:��� �, `�ire Y��-��n.g�,��P�� �-� �— cti v1 i ,A (VI 9 Square feet: 1 st floor: existing +jS" proposed 2nd floor: existing ®U proposed 2v Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 4 IWO -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 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl J3 Walkout ❑ Other Basement Finished Area (sq.ft.) 'Z,43° 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: 4AGas ❑ Oil ❑ Electric ❑ Other Central Air: Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new .size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: r Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ '51. CID Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Ct' S� 062 � Name Lu•s Telephone Number �o �Yl l 'L`�) O Address Lk l A l w lks `►j 1 L;eewse-- ( S —0,1 6 ® ( Ho Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO V o r-i S U1.1^ SIGNATURE e DATE &0/�r� t ti FOR OFFICIAL USE ONLY k e APPLICATION# k DATE ISSUED t t MAP/PARCEL NO. ADDRESS VILLAGE OWNER ` DATE OF INSPECTION: w FOUNDATION FRAME INSULATION j i t r FIREPLACE ELECTRICAL: ROUGH FINAL = r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The.Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 5� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl t-Name(Business/Organization/Individual): Address: City/State/Zip: oWeil Phone.#: ��� '7/ 0,93 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a Y emP to er with 4. I am a general contractor and I 6. ❑New construction employees.(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner listed on the attached sheet. T. 0 Remodeling ship and have no employees These sub-contractors have g• ' Demolition workingfor me in an capacity. employees and have workers' Y P tY• � 9. ❑Building addition [No workers'comp. insurance comp.insurance. r quired.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions . 3. am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per'MGL 12.❑Roof repairs insurance required.] t C. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] "Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site. information. Insurance Company Name: Policy#or Self-ins. Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section,25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator..Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIAlor insurance coverage verification. I do hereby ce s and penalties of perjury that the information provided above is true and correct Siznature: Date: 3, Phone#: Official use only. Do not write in this area,to be completed by city or town official .City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health_ 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 m..the service of another under any contract of hire, or express implied, oral or written. P P An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal'representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the . owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer. MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or too opera a business or to construct buildings in the commonwealth for any renewal of a license or permit g P P applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-con6actor(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 confnmation of insurance.coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at.the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in__(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof thata valid affidavit is on file for future pern its or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02.111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 �.. Revised 11-22-06 www.mass.gov/dia Town of Barnstable Regulatory Services BARNSPABLE, ; Thomas F.Geiler,Director MASS. 1639: `0� Building Division ArEO MA'I s 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: JOB LOCATION: �L/ / ( C' T� 4 number street a� village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as 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 To of Barnstable Building Department minimum in tion procedures and requirements and that he/she will comply with said procedures and re Signature.f Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for:Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities;many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor: On the last page of this issue is a form currently used by several towns. You may.care t amend and adopt such a form/certification for use in your community. Q:\wPFILES\FORMS\homeexempt.DOC ' °F'THE r° Town of Barnstable, Regulatory Services BARN9 AS& E Thomas F. Geiler,Director 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 er Must Complete and S' n This Section If Usin A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorize by this btiflding permit application for. (Add ss 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,:OwNERPERM IS S ION ...... f a , 3 � 3� -- -- 4 , a: A. Cf r Ic umy, s r w r TOW � i Lt I 27 _ D Vag I, y I , ti'^t/tir�'a.- _ .`..ryy yam' '�♦ J.- �y, 1{{ � x.}[[ x "- "-1:.y,v=n-' .y?_;'v 'y've..'.Jt�`i i- .yt-•z },R.y.«^y ' .[Y, ry ,•. M.��..i-.� ��`.. .'Y^.Ft `y Y „F .}..,��l C,y",.1.},��Y1lw S.°"'. . a..:...-F,! tir µid:j�...ti �,11 r Town of Barnstable - pF SHE Tp� ti Regulatory Services , Thomas F.`Geiler,Director • BARNSfABLE, MASS. $ Building Division: . '°rFcunA�" Thomas Perry, CB0, Building iCommissioner . 200 Main Street,:Hyannis,MA`02601 - www.town.ba rnsta ble.m a.us Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER DA TE: 7 r 16 LOCATION: ('4 1 ` C II C.�C _ 14G4'. � UNDER THE PROVISIONS OF 780 CMR, THE-STATE BUILDING CODE, SECTION 3400.5.1, YOU ARE,HEREBY ORDERED TO IMMEDIATELY DISCONTINUE THE USE OF THE CELLAR/BASEMENT AREA FOR SLEEPING PURPOSES. /�� • LbF T- LOCAL INSPECTOR o7- SIGNATURE OF.RECIPIENT - ODEM DE SAIDA DATA: LOCALIDADE: DE ACORDO COM O PROVISORIO 780 CMR, CODIGO DE CONSTRUCAO DO ESTADO, PARAGRAFO 3400.5.1, VOCE ESTA ORDENADO DE DEIXAR DE USAR, IMEDIATAMENTE,'A AREA DO PORAOBASEMENT P.ARA 0. PROPOSITO DE DORMIR. •INSPETOR LOCAL ASSINATURA DO;RECIPIENTE , Mid Ar _ Aw let- quay. - "Ot5 "k '-W _ __. -. _ ....•.:».� . . ,. ,. :tea �� .�,X t V x x t- l d y� 7 PTZ^ A,� yf -'TY : N�g / 17/2010 18 Mitchells 2/17/201 _ 4 - =h 418 M itch H r� Al 1 010 itchells V-1 : 1.4 AMW Oka . } rw . � . «> . - - - - - . F� 1 7TPF R � Y F, Jw&r f� 3 AM 2/ 17/2 010 �. . t -- ,- 418 Mitchells Way, Hy. 2117 .. m r, r 41 itsv4 : y ,I f k � I i� .. '� 2/ 17/2010 418 Mitchells Way, Hy. 2/ 17/2010 '' 418 Mitchells Way, Hy. 1 � t �H VF 2/ 17/2010 418 Mitchells, Way, 7/2010 8 Mitchells Way, Hy. t t ,P%lr;W2 0 10 418 Mitchells Way, Hy. : � u_ 1 1 f: fi t a - F. 2/ 17/2010 418 Mitchells W H I mow. ,,�.<,,- __� 'Yi ! / 1 �2;01 4 .11;�48-:-*. , ch.ells, .e ' 1 t I: IF , � 3 ' � Alt,;`'�� � � �• � w r ` tP v •, e , y 1 i 4 2/ 17/2010 t 418 M4chells Way, Hy. Ai WL 46 r r y$ ._ R 3: e 5 N+R 1 A 2/ 17/2010 = _ 418 Mitchells Way, Hy.;' E, 2/17/2010 418 I MIR WWII vlF t .V. "a r� %�"�„ "a��... .r+.,IIa'?'Y t r �'��.�Y'r_�� ilp_'•r�� .ti"�y! : „y,�:9 ?" 1 {y y'y 1.."^�arFtMit.4F.ra. 1 , �1 ��F 3�v F<� 'ba � 'i++� +`�tZ�1��� ^ .>✓' . � •.. r. N � f Y?� ..-; �r� ram! < FF 1 'J 7'✓�-'j •te: l.Nd p# �o75y r. F r„ q ,}1 r , .s 5 I x:a jOlAr cf ko Al � r M � � F •TMk k T p OKA y�y k 00 A,, TOWN OF BARNSTABLE DI.110 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA Ra .5 �° ., � ,. fir• :'Aw."k.1r��- -ot ..,___.,e,...._ MI , lzl .... i4 l ap HAil 4 ; AM AeL u ,6 7 � kv < ha'ky,LM 1 � , ry k. a � ISTABLE TOWN OF BARIN 13 L- _ F: 1 {IS$� . _ -zIVz g*. � �My •�py I.� ""'.� •'ik;`r#„ ••M':I, -. �.. .may ,I l' y i y f F' e ,ew !K; TTiM a F B A lot NS)6A �I 0"9 FEE9 16 PPt D V "S if0 1 1 E 2 TOWN OF BAIRIIIISTABLE . I 'Ir"M Fro 16 ail 1: 1 Di'v9. i.' �s ! -ftk t _ tL WWII ti. �' TOIVIN OF '"STABLE Ff113 AOL TOW M OP BV, STA`5 16 PM 1. 13 BIRST INSPECTIONS DATE: Feb. 17, 2010 Weds. Morning 9:30 AM PRESENT: Local Inspector Paul Roma, Health Inspector Tim O'Connell, Building Commissioner Tom Perry,Lt. John Cosmo,Hyannis Fire Robin Anderson, ZEO 418 Mitchell's Way - History This property is a 3 bedroom single-family home. 1,500 gallon septic system replaced in 2006 without increase in capacity for additional. bedrooms. This property was the subject of earlier inspections resulting from overcrowding complaints. Previously found bedrooms in basement with primitive kitchen and second floor apartment. Both of these units accessed by side door in common hallway as well as through primary unit. Previous data submitted claimed all residents are related by blood or marriage. Bedrooms and kitchens were removed on an earlier occasion as directed. 2/17/2010 Arrived at 418 Mitchell's Way at 9:45 AM. Found 9 cars in driveway. Admitted by owner Luis Calle. FIRST FLOOR Found 4 sleeping quarters on first floor(including loft area in kitchen). All 4 areas were set up for sleeping with mattresses. The loft area accessible by ships ladder had toys strewn about the floor. Two other bedrooms had French style double doors. The third bedroom appeared to be a typical bedroom but was locked. No one had the key even though we were told the room is vacant and used only occasionally for guests. A door in the kitchen that I assumed to be a closet actually opened into a black abyss of basement space. Upon closer inspection I found there to.be a submarine type ladder leading into the storage side of basement. Advised owner of danger-NO LANDING and any emergency response personnel would assume there is a landing and normal stairway here. Owner responded that they double lock the door for that reason—(one sliding lock at hand level and one at eye level). 1 r GARAGE/FIRST FLOOR STORAGE AREA Found garage area to be converted into convenience store. Canned and dry goods as well as spices, frozen food, fresh produce, refrigerated items and sneakers were for sale. (See photos) All items labels with prices. A desk and simple calculator provided. Owner says he makes trips to NY and buy in bulk to save money and sells to his family only. Appears that they roll up bay door and fill orders. Also found at least eight 100 lb sacks of rice on first floor just outside of retail area. BASEMENT Basement area contained a full kitchen minus a stove. Found three bedrooms without egress. A storage area on other side of kitchen(also containing 2 former bulkheads blocked off and the submarine ladder to the first floor). SECOND FLOOR Found full kitchen on second floor. Found four bedrooms. BEDROOM COUNT 11 bedrooms/sleeping areas. RESIDENT NAMES Luis Calle and spouse, Zoila Fernandez, child Brian Calle. Rolande Calle and spouse Mara Maldoudo Raul Fernandez and s\spouse Nube Calle, child, Drayan Calle Martin Calle and child, Wilson Neiva Izaura Nurbacd 8 adults (three couples) 4 children 2/18/2010 Luis Calle came into 200 Main Street. Advised him to obtain a building permit to restore to a three bedroom single-family home, eliminate three bedrooms in the basement by opening walls up with 5' cased openings, removing basement & second floor kitchens and reducing sleeping areas to three as dictated by the septic capacity. Also advised that a plumbing permit is required and utilities must be capped behind a finished wall. Work to be done ASAP. Owner suggested that he might just walk away. I told him only after this work is done. 2 . i Ll Health Complaints , 30-Jun-06 Time: 3:00:00 PM Date: 1/5/2006 Complaint Number: 18619 Referred To: DAVID STANTON Taken By: DAVID STANTON Complaint Type: CHAPTER II HOUSING Article X Detail: ILLEGAL OPERATIONS . Business Name: Number: 418 Street: Mitchell's Way Village: HYANNIS Assessors Map_Parcel: 291-024-002 Complainant's Name: Zoning-Robin Address: Telephone Number: Complaint Description: went to said location on a zoning complaint. Awaiting them to come in with list of all people living in said house, and will let health know to go over with them. Assessors has it as a 1 bedroom home, but 8 bedrooms were observed. Very large home. Actions Taken/Results: ON 1/11/06 THE OWNER CAME IN WITH THE LIST FOR ROBIN. DS SPOKE WITH HIM FOR A WHILE, AND ASKED IF HE COULD VISIT HOUSE ON COMPLAINT. AFTER A WHILE OF THINKING ABOUT IT, HE SAID OK, AND WILL LET ME INSPECT ON 1/18/2006 AT 1:00 PM. SEPTIC ON FILE IS FOR 3 BEDROOMS. LOCATED IN A ZONE II. DS MET WITH.OWNER (LUIS CALLE) ON 1/18/06. DS CONDUCTED A WALK THROUGH WITH THE OWNER. ONE BEDROOM WAS OBSERVED ON THE FIRST FLOOR. THERE WERE 3 ROOMS IN THE BASEMENT, BUT DID NOT HAVE WINDOWS\EGRESS, AND THERE WERE NO. BEDS PRESENT. ACCORDING TO THE OWNER, HIS COUSIN WAS THERE TEMPORARILY UNTIL SHE MOVED INTO ' f Health Complaints 30-1un-06 HER NEW HOUSE JUST AFTER ROBIN WAS THERE. DS OBSERVED 4 BEDROOMS ON THE SECOND FLOOR. ACCORDING TO THE DOCUMENT REQUESTED BY ROBIN, THERE ARE 4 ADULTS AND 3 CHILDREN LIVING IN THE HOME. DS WILL SEND ORDER LETTER WHEN HE FINDS SOME TIME, STATING IT MUST BE REVERTED BACK TO A 3 BEDROOM HOME. AN ORDER LETTER WAS SENT. DS FOLLOWED UP AT A LATER DATE, BUT THE OWNER WAS CONFUSED, AND INSTALLED A DOOR BETWEEN THE BEDROOMS, AND NOT A 5 FOOT CASED OPENING. HE SAID HE WILL GET TO IT ASAP, BUT HE WORKS 80 HOURS A WEEK, SO IT IS TUFF FINDING TIME TO DO IT. ON 5/18/06, DS, ROBIN AND RALPH WENT TO SAID LOCATION TO FOLLOW UP. OWNER NOT HOME. HIS COUSIN WAS THERE OUTSIDE FIXING A FLAT TIRE. DS SPOKE WITH OWNER AND WILL GO BACK ON 5/19/06 BEFORE 3 PM. ON 5/19/06, DS AND ROBIN WENT BACK TO SAID LOCATION AND MET WITH THE OWNER. THREE ROOMS IN BASEMENT STILL, HE WAS REMINDED AGAIN, NO ONE IS ALLOWED TO SLEEP IN THE BASEMENT AS THERE IS NO EGRESS,AND HE CAN'T BECAUSE OF THE SEPTIC LOADING RESTRICTIONS. ON THE FIRST FLOOR THERE IS ONE BEDROOM (IN THE FORMER DINING ROOM, AND HE IS SWITCHING THE FORMER BEDROOM INTO A DINING ROOM NOW) HE WAS TOLD HE WILL NEED TO INSTALL A RAILING\WALL ABOVE THE KITCHEN WHERE IT IS USED FOR STORAGE SO NO ONE FALLS DOWN. ON THE SECOND FLOOR THERE ARE TWO BEDROOMS. ONE WAS 2 BEDROOMS, BUT NOW HAS A 5' CO BETWEEN THE TWO, MAKING IT ONE BEDROOM. THE FRONT SIDE ALSO HAS A BEDROOM. ONE OF THE OTHER BEDROOMS THAT WAS UPSTAIRS NOW HAS A 5' CO. HE WAS REMINDED HE CAN ONLY HAVE 3 BEDROOMS AT SAID LOCATION. ON 6/29/06 DS WENT BACK FOR A FINAL INSPECTION OF THE PROPERTY AS THE OWNER CAME IN ON 6/28/06 AND SAID IT WAS ALL SET NOW _2 • r % Health Complaints .30-Jun-06 AND THAT HE ADDED THE WALL SO IF THE KIDS OR ANYONE ELSE WENT TO THE OFFICE AREA ABOVE THE KITCHEN THEY WOULDN'T FALL. DS LET ROBIN KNOW, AND WILL CC HER ON THE LETTER HE WRITES TO THE OWNER OF THE PROPERTY. Investigation Date: 1/18/2006 Investigation Time: 1:00:00 PM 3 J D4x Town of Barnstable Regulatory Services s�+a + Thomas F. Geiler,Director °rF Public Health Division Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Mr. Luis Calle June 30, 2006 418 Mitchell's Way Hyannis, MA 02601 Property update re2ardin2 418 Mitchell's Way,Hyannis. The property owned by you located at 418 Mitchell's Way, Hyannis, was re-inspected on June 29, 2006 by David W. Stanton R.S., Health Inspector for the Town of Barnstable, to view compliance with previous orders issued by the Town of Barnstable Health Department. Your property is now in compliance with the Town of Barnstable Health regulations and Title V, the State Environmental Code. The property was observed with 3 bedrooms total. The office loft area with the low ceiling height above the kitchen was observed with the protective wall to help prevent someone from falling from the office loft area down into t he k itchen. A n ew s eptic system has also been installed at said location. Thank you for coming into compliance. Should you have any quest' s,please feel free to contact our office. t Thomas A. McKean,R.S. Director of Public Health Town of Barnstable Cc: Robin Giangregorio,Zoning Enforcement Officer . QA Order letterMousing violations\418 Mitchells way.doc yoFSHE��,, Town of Barnstable � Regulatory ServYces • ; Thomas F. Geiler,Director Building Division Thomas Perry,CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PLEASE FORWARD THE ATTACHED PAGE(S)TO: TO: ATTN: FAX NO: FROM: DATE: • ----(INCLUDING COVER SHEET) Town of Barnstable y , Regulatory Services Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Mr. Luis Calle June 30, 2006 418 Mitchell's Way Hyannis,MA 02601 Property update regarding 418 Mitchell's Way,Hyannis. The property owned by you located at 418 Mitchell's Way, Hyannis, was re-inspected on June 29, 2006 by David W. Stanton R.S., Health Inspector for the Town of Barnstable, to view compliance with previous orders issued by the Town of Barnstable Health Department. Your property is now in compliance with the Town of Barnstable Health regulations and Title V, the State Environmental Code. The property was observed with 3 bedrooms total. The office loft area with the low ceiling height above the kitchen was observed with the protective wall to help prevent someone from falling from the office loft area down into t he kitchen. A n ew s eptic system has also been installed at said location. Thank you for coming into compliance. Should you have any ques ' s,please feel free to contact our office. c Thomas A. McKean, R.S. ~ Director of Public Health Town of Barnstable Cc: Robin Giangregorio,Zoning Enforcement Officer QA Order letters\Housing violations\418 Mitchells way.doc ... .� 7 3 � �a4� '�` `�'Y' �, ,b >r � � C z �� -7K .� c.� `� .ems �, � ' � fix ` �����.. 3 �e� �-�, & � ��� s _ �,� ��;` �¢� � ��;x ��v x i ^c � -5 ,. _. s � � ;. � ., a t R� tt§ 'r'�s, ,.� a :,� �r - vu' � ��� ��'� a �.� ��� ;- � .� �.„a aye,- H 1 "�� ��. �1 � � � {� aka% � � � �§�yRT�' �"i"� 1a JF �r>� � V I T�c't�{r �" �r � T a. S �}t� �f� Yl III�'' - Yj � '�`st s-� 1r I �' _L � `�a a ,� l, � .�. rx '�ayc >� ,. � . g�� � �� s�s -� ��e� �� � r'. *�� �' �� -r�$. �� � "''='.� - ..�� w, E, .. :. <_ Y J Town of Barnstable .oEt HKE Regulatory Services o� Thomas F.Geiler,Director N R f BARMSfABM " Building Division MASS, 1639• Tom Perry,Building Commissioner �fD MA'S A 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 February 6,2006 Mr.Luis Calle 418 Mitchell's Way Hyannis,Ma 02601 Re: Illegal Apartments Location:418 Mitchell's Way,Hyannis Map 291 Parcel 024-002 Dear Mr.Calle: This office has-recently been notified by the Hyannis Fire Department of a cooking incident that occurred on Jan.20,2006. During my inspection on January 4,2006,I did not see any additional,functionally- equipped cooking facilities. However,I did note that there were two areas,one on the second floor and one located in the basement that could easily be converted into a functioning kitchen. If such a conversion occurred since my visit on January 4a`,it occurred without official approval or permits. You will recall that I specifically discussed your inability to create a second kitchen under the current zoning ordinance;this applies even if the actual conversion is limited to the simple installation of electric appliances. At this time I am compelled to remind you that any use other than that of a single-family is illegal. You will recall that I advised you accordingly on Jan.4d'. Because of the living arrangement with your extended family,I cautioned you that common areas must be open to all household members and the household itself is limited to a single kitchen. Due to the nature of this living arrangement involving multiple adults,it is imperative that you avoid even the appearance of having un-permitted apartment units.You indicated to me that you not only understood this but would cooperate completely. It is my understanding that you are now working with Health Inspector,Dave Stanton to resolve the septic issue regarding the maximum number of bedrooms allowed on this property. He indicated that he has provided you with a Title 5 definition of a bedroom and subsequently ordered you to reduce the number of bedrooms to a total of three within 30 days. He also advised you that the basement area cannot be used as living quarters and is limited strictly to storage and mechanical uses. Be assured that your absolute compliance with all of these issues is imperative. You must immediately remove all cooking equipment from the second floor and revert to sharing a single kitchen in addition to making whatever changes are necessary to satisfy the Board of Health. Failure to comply may result in fines. Please feel free to contact me directly at 508-862-4027 in order to discuss this matter. S' erely, nn Rob .Giangregorio Zoning Enforcement Officer JAUlegal Apartments\418 Mitchells Way Calle.doc Certified Mail#7003 1680 0004 5458 2322 Town of Barnstable Regulatory Services Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 l_�z5-06 Luis G. Calle err- 418 Mitchell's Way Hyannis, MA 02601 j NOTICE TO ABATE VIOLATIONS OF 310 CMR: 15.000 THE STATE ENVIRONMENTAL CODE TITLE V: MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF SANITARY SEWAGE The property owned by you located at 418 Mitchell's Way, Hyannis was inspected on January 18, 2006 by David W. Stanton R.S., Health Inspector for the Town of Barnstable, because of a complaint. The following violation of the State Environmental Code was observed: 310 CMR 15.214: Nitrogen Loading Limitations: 5 bedrooms were observed at said Iocation which is located within a Zone 2, Wellhead Protection Area with less than one acre of land. On September 8, 1994, Septic repair permit 94-528 was issued for three bedrooms. You may have no more than three bedrooms total at said location. You are directed to correct the violation listed above within thirty (30) days of your receipt of this notice, by eliminating the two extra bedrooms so that a total of only three bedrooms are present at said location. The Town of Barnstable Health Department has a policy to eliminate the privacy of being considered a bedroom by installing a minimum five (5) foot cased opening with no doors, and no beds or people sleeping are allowed in the room. The other option is to eliminate a wall between two bedrooms and make it into one large bedroom. It is noted that there were three rooms_observed in the basement. These rooms in the basement cannot be used as bedrooms, as they do not have adequate windows or means of egress. Please call Health Inspector David W. Stanton, RS to schedule a re. inspection of the property when the two extra bedrooms have been eliminated at (508) 862- 4647. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. QAOrder letters\Sewage violations\418 Mitchells way.doc PER ORDER OF THE BOARD OF HEALTH Vmas . Mc ean,R.S. Director of Public Health Town of Barnstable Q:\Order letters\Sewage violations\418 Mitchells way.doc � �►� eher ' o y y � Dc� r1�� 771 2 0( r�>O S 6 � � Qy) c -� C> 4 Cam► //e-- A4 /V 0 rhea . n 0/0 c One C/� of Ile, :r 3 v ' 2/13/2005 10:24 5087786448 HYANNIS FIRE PAGE 02 i v.,. �. .. ................ I ......... ..... ..__.._.. .r_ _.._._._............... „a s.;;"' �!'•u`[S` � ��t ,:�. 4. . 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'�f e'14e1 .1 e��,' '.ri•e.. i.,l Iw+r 1 �1 1� I��,.,r. rl+•„nnr 1•eu:r.•r•nnni rl•' q 11. �.r ��i:�::i: 'it�lii , �'rl• P :,ii i.,e r.�eiei:`i' er'9Y/�'i�ii:i�•; f' •y6' .litre 1'':1�1u •I: ,r• fl:i. •el: trl e•I.r yell r,ilij...l' ::y oe /r11.ir,,, i.ir+I J•��.n,.,.rr. II..�y'•r . �'.• •IP I' ''" i:w,' 'IM'Iri i.. :.It/li.'I a 11 '16•.Ir rr• r r� '.i •'• 11� rr.. i •• •r r.. ',' •� ����.: �Ey� ..��, �: � —..oue ,t�Far P6•!D!.i:rrr roa � 'r�a"•'631 a,. hul ytdn•. .. . .� •tt+y: $d64•!y'i:..'ae. a,el >SE�.. P e •.v.., ;w:. .. ..1e;'^nr, wi.r..'-ti:V•.4 .;r�'yt;; r.' .!ae. •1..:•.Lctti "�• .. .e. I1.. rile r, is '�' ..1 a.11;•. .. ., r sire 1 hi;,'i,'•,'± i1ir,: .•,.,..,' : r. rewaC 'l , a44 SENDER: RETAIN CANARY COPY RECIPIENT:REPLY ON PINK COPY—RETAIN WHITE COPY I 12/13/2005 10:24 5087786448 HYANNIS FIRE PAGE 01 ' EMANNIS FIRE DEPARTMEriff ;1 85 Hli3H SCHOOL RD. EXT,HYANNIS,MA.02601 { AL HAROLD S. BRUNELLE, CHIEF FIRE PREVENTION BUREAU BUSINESS PHONE:(50)775.13W FACSIMLE PHONE.(508)77�1�8 LT DONAW 1L CHASIE4JIL,CPT LT.9VdC W.ERMLER,C;FI OFFICIPt FINLE PREVEgmtDN AGENCY NOTIFICATION ..---.-Building , HeSM v4irwv Gas Corr Affairs pumm"t.to,Nhasmaeneral Law, ChWer 148:28AAM 52-7 CMR 1.00, the above SigeriCy is may. :' notlfied:that a hUwd or'Wd is belie. ved to exist101118fiktg tD,ft abOW agercY'elUnW n. . . k The hazard-of.vloWdon noted is not wNhin the Wispectors-oDde ctlerforcement®r jurlsdiction. The Wiming has.been reottad p in Or on this`date: pi for Vw �pet#y�lc d at: in Hya ie: 1) 12 ` 2) _ ✓ _ 4) Owner of record: -22 h � r phone: . ' Fire Prevenfion tffloe cc:street Me rev. I iM i 1 12f13/2005 10:24 5087786448 HYANNIS FIRE _ PAGE 03 � �� I { C1 Delete NPIRS-1 00119.22 •; tl v A 1 1/26/2005 001 A251 192 I 0 0 CNo hange — 13tivity Basic state �r Incident Date ._ tom+ trcKar+hln++txBr ill,. E�osn,�,,,y IWWv check this box to Indrcate that the address for th a iravant is proviamG ,n the widland lira Lv B Location ® Module in section B'AlterrratNa Location Spoor wlw,Use only for wlldland fires. CeMlts Fred 30 ®Street Address 1 41 S I I IMFr Ci-ELL'S WAY #244 - 437 I WAX l I I ❑ Intersection tNurnoerrr,mapost J Lprob straetorHlpmaay eei"� r� "�+rn< ElIn front of ❑ Rear of 1 Hyannis - �. MA_I L_. 0260t� J ❑ Adjacent to npusvaroom code ❑ Directions Megan road _..J Croaa sVae1 or dltadlom,as applicable Jill c incident Type Et Dates&Times fvAdnom is000D E2 hitm&Alarms 1744 � IDetectoir activation, no fire I Local Check boxes 0 Month Day Year Hour loin InademTypa uni t�anal 1 dates are trio ALARM*ways rapuired �A s t i 11 Aid Given_ReGeived [same ea Alarm �J -� Am or Ne Ot AlerrOtstnct D Alarm i 11 26 � 2005 119:00 p91- 1 ❑ Mutual aid received ARRIVAL reQulred,v"o canotied or d10 nar 0", 2 M Automatic aid recv. T�UL.—FDic 1 I� Arrival 1 1 L26 J 2005 1 19:06 E3 Swlal Studies Their3 [3 Mutual aid given State �°�°�°" CONTROLLED W110++al,exmp:PorruWtendtlNs I 4 [3 Automatic aid given I I 5 ❑ era given I ❑ Controlled J L. �I I � N ® None `tr Incidam INILMDer Last Unit LAST UNIT OLEAUD,raavued except wridlava SM Si aym VaAls Cleared 11 1 26 112005 19:161 slaty F Actions Taken G1 Resources A I G2 Estimated Dollar Losses&Values ChWK this t*A 2nd skip thin sectlen If ar. I LOSSES: Required for 0 Mas if known. Doonal for non tires.• $6 I Investigate APoeratua o•parson-4 f&ftl is used. Nork NrnaryA 6onTaken(1) Apparatus Personnel property I I La . Suppression L—IL-1 L 3__J Contents AO�tkyralAdiPlrTakant�) - EMS I._ 0 J L. 0J PRE-INCIDENT VALUE: opuaut I''� Other Q J 1 0 Property 1 ❑. AdtStione PCtlpt Taken f3) Check wx rl❑ resaura co nts invum sic m receivedraur�. Contents We Completed Modules H--i i�Casualties QSJ None H3 Hazardous Materials Release. Mixed se Property , Fire Deaths Injuriets N 01 None I NN Fire-2 ® Not mixed ❑Structure.-3 Service L 0 I I 0 1 ❑ Natural gas:slow leek,noevaaationorHmmstactions 10 ❑Assembly Use ❑Civilian Fire Cas.4 2 ® Propane gas:K21 D.tank(as in home 880 011) 20 ❑ Education use 3 Gasoline:vehicle fusi tank or poribWe container 33 ❑ Medical use ❑Fire Serv, Casually•Civilian 0 0 ❑ 40 ❑ Residentiafuse i ❑EMS-6 �- �----� 4 Kerosene'reel otunlrre aq ripmeM or porlabk stara8a 51 ❑ Row of stores ❑tlazMat-7 --� 5 ❑ Diesel fuel/fuel oil:vehicle rwai bmx or Portable stcrag 53 Enclosed man Detector 6 Household solvents:HomBIOMW Spill,cleanup airy 558 O g e%s resklential []Wildland Fire-8 j H2 RagLkadforoornnnaonra,. ❑ T © Motor oil:from&vrw or ponable ooniatrrer ❑Apparatus-9 eq Industrial use I ❑Persor)nel-14 1 t7etectoralertedoccupants 18 ❑ Paint:ham palmcans totetrtpatiaoatons fi? PMilitary use 2 EJ;Detector did not alert therm 0 ❑ Other:5paclel HatMat actions required or aplll,5s oaL, 65 Farm use U❑t Unknown i Please ccmplets Me HazMat form OD ❑ other mixed use J Property Use structures 341 ❑ Clinic,Clinic Type infirmary ii39 ❑ Household goods,sales,repairs 31 Church,place of warship 342 ® Doctortdendst office V2 (3Motolr vehicla/boat saleslrepairs 1 11 ❑ Restaurant or cecafeteria 361 ❑ Prison orJall,notjuvenile 671 13 Gas or servicestillon 162 ❑ Bar/tavern or nightclub 419 El1•or 2-family dwelling i988 ❑ Business office❑ 429 ❑ Multi-famlly dwelling 1115 ❑ Electric generating plant 213 ❑ Elementary school or 14tndergarL 439 ❑ Roomingthoarding house 829 ❑ Laboratorylscience lab 215 ❑ High school or junior high 00, ,b49 d Commercial hotel or motel 700 [3 Manufacturing plant 311 ❑ College,adult for the aged 40 ❑ Residentlal,board aril Care 819 ❑ Livestockipoultry storage(barn) 91 [3 Care facility fort 464 Q Dormitory/barracks 682 ❑ Non-residential Hospital . 619 ❑ Food and beverage sales i1191 ❑ Warehouse Parking garage 331 ❑ Outside 2M ❑ Vacant lot 901 ❑ Construction site 655 155 ❑ Playground or park gag ❑ Gradedleared for plot of land W4 ❑ Industrial plant yard see ❑ Crops or orchard Forest(timberland) W ❑ Lake,river.stream . 807 (3 Outdoor storage area 961 ❑ Railroad right of way 919 Dump or sanity landfill t� 13 tither street Look w and enter a preoerty use ❑ sanitary 961 13 Hi !divided highway isryparty use coca ony 0 ,_..o� 4;29J hway 9sJ1 Open landorfleld g � y yo'.rnaveNOT�,eckada ^-�y ❑ Residential v r 962 ❑ antler atreeUdn away P operfy use box: 4 J1Vlultifamily dwellin,sJ tnina.rR mn�r+ A2S1192 EXP D, 1112612005 PAGE 1 OF 2 HYANNIS FIRE DEPARTMENT.- MFIRS REPORT i 12/13/2005 10:24 5087786448 HYANNIS FIRE PAGE 04 :.t Q1922 Al del 11/26/2005 001 L A251 l92 ( 0 ❑ Delete NFIIZS-9S smote a ❑ Change incm Date Da _. .sm, �nGOernNwnbet �, ; N� . Supplemental K2 gemaft We received a call from Seaside Alarms reporting an alarm activation at 418 Mitchell's Way. They also report no fire just are unable to reset. We responded with E-823- Kristofferson, Puna, and Lawrence. Upon our arrival there were no alarms sounding. We entered and there was a language barrier. We investigated and found a cooking incident. House was smoke free prior to our arrival and the alarm was reset. We called Seaside alarms and they stated. the alarm had reset. E-823 returned to qtrs. Captain E Kristofxerson 11/26/05 1 a i 'Note - 1 sent a FYI to Eire prevention wondering if these apartments were legal. :i iI I i 1 ;f a i . i i 1 A2S1192 - EXP 0, 1112612005 HYANNIS FIRE DEPARTMENT MFIRS REPORT PAGE I . • 12113/2005 10:24 5087766448 HYANNIS FIRE PAGE 05 Active Listing#20503182 418 Mitchell$Way yonnis,MA 02601 LP 9j000 Prop Ty Single Fami y Subdivision County arras Town Barnstable 1 Zoning Residential Sq.FUSource 3,5301 Field Card ` Rooms 7 Lot SizeiSource 0.35ac I(Assessors Records) Beds 3 StylelDesc Colonial i Baths FiN 2/ Levels 2.0 j Year Built 1998/Approximate,Renovi Tax! - -BARN Remarks: A rare find of 3500+-sq ft with a floor plan to suit many different lifestyl .A possible In-law,arti is delight&spacious, light rooms for whatever you need, Nestled on a low maintence lot with a private feel,conveni es,the airport,school, restaurants and other services.The original home was updated&a large addition added in 1998&the septic done in 1994.The foyer leads you to a terrific Great room,then formal dining with French doors,cathedraled eat-in kitchen/family room, a sunny front room w/window seat 8 bow window,a loft room,a 1st floor oedroom, bath&laundry,a huge fabulous master bedroom or studio with a bath up,skylights,calling fan4 Tennessee fir floors throughout,AC,alarm,attached garage,2 driveways&front porch.if you are looking for not run of the mill,this is it! Directions: Pitchers Way between W.Main and Route 28 to Mitcheils Way to 2nd home on left. No yard sign, Showing Instr., Appointment Req.,Call Listing Office General Information Gaarragei#Cars Yes i 1 Gar Desc Attached, Direct Entry,Door C Parking Paved Driveway,Stone/Gravel BsmtlBsmt Desc Yes/Bulkhead Access, Finished,Full, Interior Acc Foundation 1 1 Block,Concrete Sep Liv Otrs]Desc Na Wing Width/Wing Depth / Irreg Yes Lot Desc Level' Year Round Yes Zoning Residential Lot Width/Lot Depth / Street Description Paved Room Sixes & Levels Living First Floor Ceiling Fan, French/Patio Door, Walk in Closet, Wood Floor i Dining First Floor Ceiling Fang French/Patio poor, Wood Floor Family Kitchen First Floor Beamed Ceilings, Cathedral Ceilings, Ceiling Fan, Dining Area, Skyligi Mstr Bedrm Sacond Floor Ceiling Fan, Private Master Bath, Skylight, Wood Floor ®drm2 First Floor Closet, Wood Floor i Bdrm3 ®drm4 i Laundry First Floor Foyer First Floor Bedroom Loft Beamed Ceilings, Cathedral Ceilings. Skylight; VV811 to Wall Carpet Sun Room First Floor Bow/Bay Windows,'Wall to Wall Carpet Interior Amenities Bsmt Baths Lev 1 Baths Lev 2 Baths Lev 3 Baths i interior Features Linen Closet, Walk-In Closet i Floors Wall to Wall Carpet,Wood EquipmentlAppliances Dryer-Electric, Range-Gas, Refrigerator, Security Alarm, Washer Living/Dining Room Combo No Kitchen/Dining Room Combo No Fireplaces No #of Fireplaces Exterior Amenities Pool/Pool Description No/ Dock/Dock Description No/ Exterior Features Porch,Yard Siding Vinyl/Aluminium. Roof Asphalt,Pitched Assoc Fee/Fee Year / Assoc/Membership Required No I i Amenities WatertrontlWaterfront Dose Not WaterviewlWaterview Dose No/ Miles to Beach 2 Plus _Water Ace Ocean; Public Beach Own Public Beach Desc Ocean BeachlLake/Pond Name Craigville Beach;'Kalmus Beach Convenient to Golf Course,Major Highway,Medical Facility,School,5hcpping _ School District Barnstable Neighborhood Amenities - Printed by Linda Hiller 8 Company on 05/24105 ai 2.27pm i information has not boon verified,is not guaranteed,and is subject to change.copyright 2005 Cape Cod&Islands Multiple Listing 5arvica;Inc. All rights reserved (Reeldential Client Detail} j 12413/2005 10:24 5087786448 HYANNIS FIRE' PAGE 06 Listing#20603182 Page 2 Mechanical Amenities HeatinglCooling 3+Zone Heat,AC Central, Natural Gas,Hot Air Water/Sewer)Utii Private Sewerage,Cable, Electricity,Gas,Telephone,Town Water Hot Water Tank Legalllrax Irformatlor -- Improvement Asmt 3273,800 Land Asmt $136,700 Other Asmt 0 Total Asmt $409,500 Annual Taxes/Tax Year. $3,174/2005 Annual Betterment 0 Unpaid Betterment 0 Title Ref-BooklPage/Cert 1 1 427/253 Plan To Be Assessed No Spec Assessment Mass Use Code/Definition 101-Single Family Asbestos Undergrnd Fuel Unknown Flood Zone Unknown Lead Paint Unknown Presented By: Linda,. L Hiller Linda Miller &,Company Office 508.428-9000 x101 8 West Bay Road Ostervilie, NAA 02655 508-428-9600 Fax ; 508-428-88 7 6 E-mail: LindaDHiller t@comcast.net See our Ust/ngs on the Internet.- Web Page: http://LindaHillerRealrtstate.com http:l/www.LindaHiiIorRealEstate.com Printed by Linda IHIller&Company on 05/24106 at 2:27pm Information has not been verified,is not guaranteed,and is subject to change.Copyright 2006 Cape Cod&Islands Multiple usting Service,Inc. All rights reserved (Residential Client Detail) Bk 20199 Ps 29U �59793 03-26--2005 of 03=33p Quitclaim Deed I,Adrian M.S.Piper,of 419 Mitchells Way,Hyannis,Massachusetts 02601 in consideration of Four Hundred Sig Thousand and 00/100 Dollars($406,000.00)Paid grant to Luis G.Calle, of 418 MitcheIis Way, yannis,Massachusetts 02601 with QUITCLAIM COVENANTS Parcel 1 A parcel of land with the buildings thereon in Hyannis,Barnstable County,Massachusetts,being shown on a plan entitled"Plan of Land in(Hyannis)Barnstable,Mass.Prepared for Adrian M.S.Piper Scale 1"-301 Dated 4/3O/98,All Cape Engineering 49 Harbor Road,Hyannis,MA 02601"(referencing Pl.406/77 and 440/44)which plan is recorded in the Barnstable Registry of Deeds,Plan Book 541,Page 36. Parcel 2 A triangular parcel of land being 1,53750 square feet,more or less,with the buildings thereon,if any,in Hyannis, Barnstable County,Massachusetts,being shown on a plan entitled"Plan of Land in Hyannis,MA for Adrian M.S. Piper Scale 1"=30'Dated 9/23/98,All Cape Engineering 49 Harbor Road,Hyannis MA 02601"which plan is recorded in the Barnstable Registry of Deeds,Plan Book 549,Page 9. Said premises are conveyed subject to and with the benefit of rights,easements,agreements,reservations and restrictions of record,if any,insofar as the same are now in force and applicable. For Title see deed from Adian MS Piper, Dated May 14,1998 and Recorded with the Barnstable Registry of Deeds on May 14,1598 at Book 11427 Page 253. Executed as a sealed instrument this 26th day of August,2005. I3ASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 08-26-2005 O 03:33po Ctl*: 166E Doc.: 59793 Fee: $IP388.52 Cons: $406r000.00 Adrian M.S.Piper BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 08-26-2005 .1 03:33pm Ctlaw: 1668 DocT: 5Q793 Fee: $925.68 Cons: $406400.60 . Commonwealth of Massachusetts Barnstable,ss: On this 26th day of August,2005,before me,the undersigned notary public erso a geared Adrian .S.Piper,proved to me through satisfactory evidence of identification,which were / to be the person whose name is signed on the preceding or attached docume and a nowl ed to me th a/she/they signed it voluntarily for its stated purpose. ' Notary public Commwoalth of Naumboft Notary Public , n ;,u,, ',,• Commleeioa FiXp My Commission Expires: ,•°��p�e1�t••P /V�•rL�- Februg 8,2001 BARNSTABLE REGISTRY OF DEEDS Barnstable Assessing Search Results Page 1 of 2 w mi g-n P7� .. .. Home: Departments:Assessors Division: Property Assessment Search Results 41 I IJS WAY . Owner: PIPER,ADRIAN M S Property Sketch Legend Map/Parcel/Parcel Extension 291 /024/002 s, y icy Mailing Address !3 PIPER,ADRIAN M S P O BOX 753 y HYANNIS, MA.02601 a / a � S 2005 Assessed Values: Appraised Value Assessed Value Building Value: $273,800 $273,800 Extra Features: $0 $0 Outbuildings: $0 $0 Land Value: $ 135,700 $ 135,700 Interactive Property Map: Ma -re uires Plug in: Totals:$409,500 $409,500 1 have visited the maps before 011, !l 1 Show Me The April 2001 photos availabledi Sales History: Owner: Sale Date Book/Page: Sale Price: PIPER,ADRIAN M S 5/14/1998 11427/253 $ 1 PIPER,ADRIAN M S 9/15/1995 9828/337 $ 1 PIPER, OLIVE S& 9/15/1986 5284/008 $ 1 PIPER,OLIVE S 10/15/1985 4824/269 $40,000 PIPER, OLIVE X"DC 11427/250 $0 PIPER,OLIVE S 676/143 $0 2005 REAL ESTATE"fax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $74.32 Town Fire District Rates Other f $6.05 Barnstable-Residential $2.12 Land B. Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $622.44 C.O.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $2,477.48 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 http://www.town.bamstable.ma.us/Assessing/AssessO5/displayparce103.asp?mappar=291... 12/21/2005 Barnstable Assessing Search Results Page 2 of 2 W Barnstable- Residential $1.44 W Barnstable-Commercial $2.10 Total: $3,174.24 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.35 Year Built 1961 Appraised Value $ 135,700 Living Area 3530 Assessed Value $ 135,700 Replacement Cost$322,078 Depreciation 15 Building Value 273,800 Construction Details Style Colonial Interior Floors Pine/Soft Wood Model Residential Interior Walls Plastered Grade Average Plus Heat Fuel Gas Stories 2 Stories Heat Type Hot Air Exterior Walls Vinyl Siding AC Type Central Roof Structure Gable/Hip Bedrooms 1 Bedroom Roof Cover Asph/F GIs/Cmp Bathrooms 2 Bathrooms Total Rooms 6 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/Assessing/Assess05/displayparce103.asp?mappar=291... 12/21/2005 f COMMONWEALTH OF MASSACHUSETT'S Z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONYIENTAL PROTECTION NIAR 1 2005 TITLE 5 _ y OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY'ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION _ Property Address: V ? , An (� Owner's Name Owner's Address: r 7 a Date of Inspection: Name of Inspe (please print)` Company.Na ' Mailing Address: 1� v. CiT` Telephone Number. CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information rep c-fted below is true, accurate and complete a= of the time of the inspection. The:inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.0100). The system: t� Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority, . s ails Inspector's Signature: Date: 1? fsl The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments _ ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form- 6115IM00 page 1 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE-SEWAGE DISPOSAL SYSTEM INSPECTION-FORM PART C SYSTEM INFORMATION r Property Address:: / Owner• .Date of Inspection: i9.1 117 / FLOW CONDITIONS RESIDENTIAL i/ Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310,CMR 15.203 (for example: 11.0 gpd x'of bedrooms): e: Number of current residents: Does residence have.a garbage grinder{yes or no):(-/,OS Is laundry on a separate.sewage.system(y s or no):,Yo f if ves.separate inspection required] Laundry system inspected(,,y5� or no):IVO , Seasonal use: (yes or no):XA) Water meter readings, if av�jilable(last 2 years usage (gpd)): Sump pump (yes or no):/l�J Last date of occupancy: / COMMERCIAL/INDUSTRIA0110 Type of establishment Design flow(based on 310 CMR 15.203): . gpd Basis of design flow(seats/persons/sgft,etc.):_ Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings. if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:' Was system pumped as part of the inspzctio (yes or no): If yes, volume pumped: gallons--How was quantity pumped determined?, Reason for pumping: TYPE OF SYSTEM t./Septic tank, distribution box, soil absorption system _Single cesspool . _Overflow cesspool _Privy _Shared system(yes or no) (if yes,zttach previous inspection records, if any) _Innovative/Alternative technology-Attach a copy of the current operaton and maintenance contract(to be obtained from system owner) —Tight`tank _Attach a copy of the DEP approval. Other(describe):. r xig age of all components, date installed(if known) and source o=information: J ADO Were sewageodors detected when arriYing at the site(yes or no�4a 6 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION `Map Z Parcel �- Permit# Health Division a I"S�t� C1 D`- SAr�nS'A`BL� Date Issued ? 0 n Conservation Division g /� l® � 3 J1) 4 12 P 1 ,1 3 6. Application Fee . Tax Collector ' ` Permit Fee 40' __ SEPTIC SYSTE MUST EE Treasurer MUL� 0IVISIA, STALLED IN COMPLIANCIE Planning Dept. IAIITH TITLE 6 ENVIRONMENT&CODE AM Date Definitive Plan Approved by Planning Board TOWN REGUU.TICNS Historic-OKH Preservation/Hyannis BChv�� P jiM�no �q I Kv (yJ,M/1cW- Project Street Address A4 A n M'k11 V4AI f-S V !A Nj Village Q Ted Owner _ Cd�r�' _ irb�.lr' Address �-s WkA-.,p Telephone Lspg�Jag- U,,qI,-+ Permit Request &V%J"A,Val�14,.►��D.�-�ti �v ,r pL& =.o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new D Zoning District Flood Plain Groundwater Overlay . Project Valuation l D,aQ0-- Construction Type �- Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family d Two Family ❑ Multi-Family(#units) Age of Existing Structure 574 y 4CC) Historic House: ❑Yes T(o On Old King's Highway: ❑Yes Flo Basement Type: eFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing Z new 1 Half: existing new Number of Bedrooms: existing 'I- new Total Room Count(not including baths): existing new ® First Floor Room Count _ Heat Type and Fuel: 3Gas ❑Oil 0 Electric ❑Other Central Air: dYes ❑No Fireplaces: Existing © New Existing wood/coal stove: ❑Yes UNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:IO/existing ❑new size — Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name_ A"]?Lw& Telephone Number Address li4Ig M iArtA QAA'9 A�1/ License# g �AA �'Z-foal Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 4 LA4,--g Qc. t/ DATE (d1 1 D3 r1 � FOR OFFICIAL USE ONLY PERMIT NO: ♦ - }-- jr s A;;, DATE ISSUED MAP/PARCEL NO. Y - E ADDRESS ~` VILLAGE ' • i OWNER DATE OF INSPECTION: FOUNDATION FRAME - �/Q/�'l 71 /O 3 /h1 D �C INSULATION A/N S 0 -?LII ' 3 FIREPLACE - ,3 r ELECTRICAL: ROUGH FINALT, PLUMBING: ROUGH FINAL GAS: ROUGH "� - FINAL- -� FINAL BUILDING e1• t ' _ L.001 Y .� DATE CLOSED OUT; I{ ` ASSOCIATION PLAN NO. i �F�HE rot Town of Barnstable Regulatory Services sAxxsresr.E, • Thomas F.Geiler,Director KAM 039.j a�`� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 • r f ' Permit no. Date s 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 requirementsell Type.of Work: Estimated Cost ICJ.0e O p Address of Work:'A1oo �ti�P �il��� tiVe►�./ �`a�Kwti� Owner's Name: k' Date of Application I hereby certify that: Registration is not required for the following reason(s): MWork excluded by law ❑Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNEb UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: , Date Contractor Name Registration No. OR T, �e Owner's Name The Commonwealth of Massachusetts = - Department of Industrial Accidents Office oflovestigadoos _ 600 Washington Street Boston,Mass. 02111 -- Workers' Cam ensation Insurance Affidavit name A location:-4l$ W�tAARAk�� V y city WIr4 i MA Dn,lv®l phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole *etor and have No one wort u m' ca achy I am an em 1 rounding workers' compensation for my employees working,on this job. :::: .....:::::::::::::::::::::}::::::::: ❑ P .P............................:...:::::.:::::::............................::.::::::.:::.:::....:.................::.::..:.:.: .:,..:.. :.: ::.................:...::.::::::.:::::::::....:. :con an nam c►tw n t insuran <:�`•`Xx ollcv I am a sole proprietor,general contractor,or omt:owne (circle one)and have hired the contractors listed below who have the followin workers' compensation polices; .................. g :.: :.::: ::.:.::::.:::::::.:::::.:.,::::.:.,,.::n..,,.,:.,::.:,:.: con► an name :. .: :.� a��se .......................:....... ..............:....... e. iiYl iii iii•J'>isi$?::::w�::::::A:::ii;:};}}}i:ti .'frii:'^:!iiiiii:titi!:Yi?viiiii:i::i?iii}}:is f:ijv?i:{.}:?i}};ti{tiff?i:ii ti'i:vi:'H}i:•i:L}:::}i}:•i;4: ''::AB�:'kY i'.•l ,�s ##���.,,.yi.. `'' a yr>z:;tii;: 1L <i ::::n: •tV w6}•}....... ±::2�iI' ::{;:y;:i,Y•ti�t . i�F�}i:•}:•F. :RnV„ ....................... 1. {:,:�iiiiij:viii:Si�itiii�i:�i ti�:ti:i:�i:�:tititi .::.:.:::.;:•r.}}•:.:•isis{::v:;• :•...,:5::::::.: .:::::.;wpm �yJ{ ::v:::..........:.:::•:.::i:;.y.;ii}}}}}}i}:^}ti:?:ii:jinn:4itiii>}i::;i:;isisi4;{::i:v:::?j:;;:;i:%}ii:v?ti!;i�'iY:ii::: .........:. l`�M.:Si:::::.::Liii�i::i::<:>j::; : ':::::::::::: L::tii:::«F:L:}:::iry::ii:j'i:.�:.i::.::::::::::!is{:: nsnranee:ca:z:.:;;ti•: :•::;:.:.........;:.:i:.::;::.,':::.:.: ;.;:.;•.:::::::.:.::::::::.. .::::<:::<>:;::<:>.<>>::. . .. 8 ...:.....:.........:.. ii:i::t:::i:::}�n„•�i:.�.`ii:i ti'i{:::;y; :::�}::ti•.�:::::• .:.}}•::ti•}}}}::i}?}:S}}}:ti•<•}:ititi^}:•}}:•:�::titi•:}}}iii:^:i:-0}}:�}}}};:•i:•.j;:}•:ti}�::i:i'::i:}i:i:}i}}i::� i}}:{;}}i:4}}}:�}:5;}i:titi?::ti:4:;}:iii;: •:.:::�'•}}};}:•:,:ti:..::Q:::::.}:}}i:•:=::}:'� is� L;:.:;i::i:::ii:i�:'�in:i}i:?i:-<}}?'; :.;:::•::::'<.>i iiR:G i?>:C:}"':?G>'ii:%:y:'r: .?'•ii ;. ;::S ::.:. ti•;.:' y: .•.' ::. . �adtfres Ct . .::::.::::............... ................ _. liG :...... .:::::::::.::. r»:>: aturanceca>:::.»> :::::<:;>:; :.i:,:.:i<.i»:<.i;«<;i;.>i:.;i:,...:::.:.::.::.:,.::::::.:.:.:::...,.:::::::.....,.:. . 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$1400.00 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/e�rtiffy under the pains and penalties of perjury that the information provided above is truo and coned Signature V °• •� r, Date . Print name AD 12.l,kkA1 � ���� } Phone# �� � � $� 4p� official use only do not write in this area to be completed by city or town official city or town: peradttlicense# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office (3Health Department contact person: phone#; ❑Other (devised 9/95 PIA) 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'ortother legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, ortthe receiver or trustee of an individual,partnership, association or other legal entity, employing employees. IHowever 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. i 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 incnrance 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 c V" overage. Also be sure to sign an d'. 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 Peraut/license number which will be used as a reference number. The affidavits may be reamed it 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. F , The Department's address,telephone and fax number: + The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lavesugallons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 { RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 AS-6 a Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq. foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 14+$ square feet x$64/sq.foot= x.0031= plus from below(if applicable) 0 GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf:500 sf $35.00 >500 sf-750 sf R 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) r Ingroun&Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee pd nrojeost The Town of Barnstable Regulatory Services Thomas F. Geller, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE (f►�ll � JOB LOCATION: /-419 0 4 119 V=?LAZ number street �.p ..�� p/ village "HOMEOWNER": AA"2 •" 1 CSt/Q��-� 0'1�1 t7 �al�t/t'�.� name Q� home phone# -work phone# CURRENT MAILING ADDRESS: �• 1�BX �3 b�Vav�w,i� MA ity/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. DEFINTPION OF HOMEOWNER Persons)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 B arnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors),provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q.Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed-Supervisor. The homeowner acting as Supervisor is ultimately responsible. 'r„—oirP thor tha hnmenwner is fullv aware of his/her responsibilities,many communities require,as part of the permit i t i i e -rmaw -- F `sOF jt — 7 7 d AJr woom 13 VJ Oct o � gMA 62-,(ob -, 3 i i ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■ !�! ! !�!!■■■■■■ ■■■■■■I'�' !�! �:l�'■■■■■■■ ■■■■■■■ER ►to promm rT7►_1►;m■■■ ■■■■■■ TsJ1►l- ■■■■■� ■■■■■■■■■'■■_■_�■■ �■■■■■■■■■■■■4 i"■■■■■■ ■■■SEEM■®;■■""Pm mamm�11�m nil=■■■■■■■M■■■■■■■■ �/ ���° ��f ■■■■■■■■®!■■ ■fir■®®■� 11■� � ■■■1�!:��■EE■E■■■■ NEEMENEMEME NWANi ■■MME■EME■■RWIM;INica■m ■■ IME■■■■■■■■■■■■■ ■■■■■■■■■■■t ■■1rw m■l � I■■■■EE■■EM■M■E■■■E MEMENEEM ■■■■■■■■■■ l m ■i■■mo■, ONE ■ ME■E■EM■MMEME■E ■■■■■■■■■■■MOMMEEMEMENCEIMMINWA EII■Ilir ■�■■■ ■■■■■■■■■■■■■■ ommmem • ,. , I � I I .• i � i I I i �` I i II � i i I L• I , i I � - -+ - -j--r- -- - --- - -- �- : II I f I T I I : f ' I , I I : I I I , I� I I 1 I I j I i I I i i I -T---r--- -- . _i. -f._- ...-__'-__,�_._i_-I.-�__- I__._ �_--_1 -I•-_--I.-1-_4_.__-' - -_ I,_ _- Ali i - I- I --�-I - ------ - - - - i I - - i i I 1 f i - I I 1 I I j i j j i. TOWN OF-BARNSTABLE BUILDING-PERMIT APPLICATION. Map Parce r -- Permit# Health Division ®� �� �'' `! I Date Issued [ 2 Conservation Divisions �' Fee . .C)6 Tax Collector SEPTIC S°fSYE Treasurer-� ( �—°pr /J� 7 INSTALLED 11�4 ��tt��'' �:���CE t.;:r WITH TITL €a Planning Dept. ENVIRONUE mAL CODE AND Date Definitive Plan Approved by Planning Board TO = ��',A on Historic-OKH Preservation/Hyannis } Project Street Address -041$' WOO � � L,S 1,"ON t 00 Village Vk,4 cNN 15 Owner ADQ-t ZN m,g.Tweia, Address 'P.®-�0►�► �'S3, l�`/�d�lN t� Telephone Permit Request 'U? Bw wD V-Ak-0T_:'fK1_'?,DW_ A ONT® V�1DNT O�E rtEW Square feet: 1 st floor: existing IR " proposed i TO 2nd floor: existing proposed Total new ?0 Estimated Project Cost'"'&g'00.00 Zoning District Flood Plain Groundwater Overlay Construction.Type Lot Size 1'5 $Z -3 i Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family d Two Family ❑ Multi-Family(#units) Age of Existing Structure mks Historic House: ❑Yes 4 No On Old King's Highway: ❑Yes WNo Basement Type: ;4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 11,00• Basement Unfinished Area(sq.ft) 6 in -Sg: Number of Baths: Full: existing 2 new 0 Half: existing O new a Number of Bedrooms: existing � new C7 Total Room Count(not including baths): existing new First Floor Room Count s Heat Type and Fuel: )<Gas ' ❑Oil ❑Electric ❑Other Central Air: Yes ❑No Fireplaces: Existing 0 New 0 Existing wood/coal stove: ❑Yes ;d No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garageXexisting ❑new size IS cIS� Shed:❑existing ❑new size 'Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes XNo If yes,site plan review# Current Use Proposed Useit�rv-�t,�� BUILDER INFORMATION Name Al*4AN' 9�-p yE�1LR� (OCAS Oe-4--Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. i DATE ISSUED €wx ```� I r' <• w MAP/PARCEL NO. ADDRESS "` ' VILLAGE s OWNER -•.-.. �. - t`,� ,-�, �... L�. '(; r , _ r DATE OF INSPECTION: F FOUNDATION C— / FRAME INSULATION ' FIREPLACE t ELECTRICAL: ROUGH Y FINAL r '� PLUMBING: ROUGH'- ;"" FINAL GAS: ROUGH ' FINAL " FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. _ M 1 . �° The 'Town of BarnstableUAS& r • ar+aivsrnei.E. ,0 Department of Health Safety and Environmental Services 1659. TEo► '' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commission 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 preexisting owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain_exceptions,along with other requirements. ' Type of Work: ,` To RZ};}- Estimated Cost` 'Coey Address of Work: Z'4$ M iy&t4le1,-L=3 k)A-f �qAK3 K)V 1 Owner's Name: &P-,AN 121,Tt�P, Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 ❑Building not owner-occupied XOwner 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. 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I��t>tat a one years'itnptvomnmt as wen as civil penald" afftDIkf0rC0VMzeTedn=d= copy of this statmmnt may be forwaeded to the OMW of Iavatlldians radar the toes mid panaltias of Palury ad the information provided above is ow.and correct 1 do hereby certify P Date - Siffiamm / PhMe# 64 Priat name Il NIWMl or town oIDdal ofndai we only do not write in this am to be cua*ted by city p{tmlt/llceme# ❑Building Depatwnes<t city or town. ❑Licensing Board ❑Selecttnen's 0Mce ❑check if immediate response is reunited ❑Health Department — ❑Others� phone 10*1 contact Person' Information and Instructions efts General Laws chapter 152 section 25 requires all employers to provide workers' com heme pensation for t massachus erson in the service of another under an"' co.--- employees. As quoted from the law , an employee is defined as every p of hire. etpress or implied, oral or written. �n em lover is defined as as individual,partnership, association, corporation or other legal entity,or and•two or more C P the le representatives of a deceased employer. or the recer,-z- the foregoing engaged in a joint enterprise, and including , association or other legal entity, employing employees. However the,oxner of a trustee of an individual partnershiphous dwelling house hating not more than three apartments and who resides the work on such dwelling house or on the groin'c_ another who employs persons to do maintenance , construction or repair building appurtenant thereto shall not because of such employment be deemed to-be an employer. GL chanter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or retie;;a . in the commonwealth for any applicant whe r. of a license or permit to operate a business or to construct buildings neither the not produced acceptable evidence of compliance with the insurancecover a requr the performanAdditionally, e o Public work u commonwealth nor any of its political subdivisions shall enter into Y p have been resented to fire cow . acceptable evidence of compliance with the insurance requirements of this chapter - authority. :applicants - b checking the box that applies to your situation and Please fill in the workers' compensation affdavrt completely, y _ . . _ � with a certificate of insurance as all affidavits maybe supplying company names,address and phone-numbers along �of insurance coverage. Also be sure to sign ar. submitted to the Department of Industrial Accidents for c�nfirmati hcation for the ermit or license is date the affidavit. The affidavit should be returned to the�'or town that the apP • P Industrial Accidents. Should you have any questions regarding the being requested,not the Department "Iaw"or if- of '�y,plea callthe Department at the member listed below. are required to obtain a workers' compensati it se on p o /////////oME City or Towns rented legibly. The Department has provided a space at the bottom of the Please be sure that the affidavit is complete and P ns has to contact you regarding the applicant. Please affidavit for you to fill out in the event the Office of brvestigalo be returned t^ be sure to fill in the peimidlicease number which will be used as a reference number. The affidavits may or FAX unless other arrangements have bees made. the Department by mail The Office of Investigations would Ike to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Deparunent's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of InvestlDallons 600 Washington Street Boston,Ma. 02111 fax*: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) square feet X$115/sq.'foot (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) . square feet X$251sq. foot= PORCH ��� square feet X$20/sq. foot=4":SG 0 D, O 0 DECK square feet X$15/sq. foot OTHER square feet X$??/sq. foot= Total Estimated Project Cost (Coa O, C)c The Town of Barnstable F'THE T •.° , Department of Health Safety and Environmental Services Building Division sAsrrsTJ LE, ' 367 Main Street,Hyannis NIA 02601 M+ss. 9 i639. Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: I�/ Yli /I?��GV1/g �y 0-At4t,4 number - streetp village ..HOMEOWNER": ALLAM"'VIPEV, name home phone# work phone# CURRENT MAILING ADDRESS: city/town state _ zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as 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.andlor,w 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-sucliyork performed under the building permit.— (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes;bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a. person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. - To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a fonu/certification for use in your community. Q:FORMS:EXEMPTN , jI r Dkl rtE �w/aowu - + ugN t i dX 10 PT. Lt.Dbte- F,ig�Z % a£USe ncyt — 1 Gruwuc,2nc.E x Gut 0 M i rler J d$x r.8� a q�j QPT.{P u o i 4x4.91.POSTS 1-VI�r yL Q.: 1/Level W,HD.DyE 1-ar.lo Lo rr(• d-dX fJ RT• x ATOP /- DAMP PhCO'F Non n 9 la". soelA 7u' cS )/'H/b(J 4n0� _AuL(1'D R..bov"f ( t toDE PLAa &a)n ) PLAn - - - lSt�.yELT av -,ya,GDx GprjTlyowy, 3OFFi.T' UEIJT . .M:YrNf VllurA.-.6J D/.N.�..3"T.Y.ru• S - /Y!hfaJf ALL. ' - ,...ALUM. 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Lit,• 5 F/JUIMA270 r1 PLAN + g ,/ i , QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 11/13/98 PARCEL ID 000 000 118 GEO ID LOT/BLOCK DBA PROPERTY ADDRESS OWNER PIPER 418 MITCHELL' S WAY ADRIAN HYANNIS PHONE DISTRICT DEVELOPMENT STATUS CAPACITY (NOTES) ZONING DIST/ZOC SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? # BEDROOMS ZBA DECISION FAMILY APT LOT SIZE OPER/MGR NAME WET LANDS MULT ADDRESS USE PROTECT DIST (N) EXT / (P) REVIOUS / NO (T) ES / PER(M) ITS / (V) IOLATIONS / (G) EOBASE / (E) XIT This value is not among the valid possibilities QUERY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 11/13/98 PERMIT NUMBER 31969 PARCEL ID 000 000 118 418 MITCHELL' S WAY PERMIT TYPE BADDI BUILDING PERMIT ADDITION DESCRIPTION ADD TO EXISTING CONTRACTOR PERMIT FEE 439 . 89 VARIANCE STATUS A ACTIVE CONSTRUCTION TYPE 434 GROUP TYPE 1 APPLICATION 07/07/1998 EXPIRATION VALUATION 141900 . 00 DATE ISSUED 07/07/1998 COMPLETED DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR (0) PERTY/ (I) NSPECTIONS/ (H) ISTORY/ (F) EES/ (A) RCHITECTS/ (V) IOLATION/ (E) XIT QUERY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 11/13/98 PERMIT NUMBER 31969 PARCEL ID 000 000 118 PERMIT TYPE BADDI BUILDING PERMIT ADDITION DESCRIPTION ADD TO EXISTING MASTER PERMIT INSPECTION REQUIRED REQUESTED SCHEDULED INSPECTED RESULT INSPECTOR BFIN BFOD 07/14/1998 A AMAR BFOD2 07/28/1998 A RJON BFRM 09/01/1998 A AMAR BINSU 09/01/1998 A AMAR PRESS ESCAPE TO END DISPLAY QUERY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 11/13/98 PERMIT NUMBER 32915 PARCEL ID 000 000 118 418 MITCHELL' S WAY PERMIT TYPE BELEC WIRING PERMIT DESCRIPTION WIRE ADDITION AND CHG SER TO 150-AMP CONTRACTOR PERMIT FEE 60 . 00 VARIANCE STATUS A ACTIVE CONSTRUCTION TYPE 753 GROUP TYPE APPLICATION 08/26/1998 EXPIRATION VALUATION 3000 . 00 DATE ISSUED 08/26/1998 COMPLETED DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ (F) EES/ (A) RCHITECTS/ (V) IOLATION/ (E) XIT QUERY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 11/13/98 PERMIT NUMBER 32915 PARCEL ID 000 000 118 PERMIT TYPE BELEC WIRING PERMIT DESCRIPTION WIRE ADDITION AND CHG SER TO 150-AMP MASTER PERMIT INSPECTION REQUIRED REQUESTED SCHEDULED INSPECTED RESULT INSPECTOR BEFIN BEREIN BEROU 08/26/1998 A RWES BESER BETEMP PRESS ESCAPE TO END DISPLAY La " .... 000 Map p- Parcel Permit# � 9 ` House.# 0 - Date Issued ' ^� Board of Health(3rd floor)(8:15 -9:30/1:00-4r39) - � 7 ee Conservation Office(4th floor)(8:30-9:30/1:00-2:00) —�- S EM MUST BE INST'. .-,E I PLIANCE 19 E1;;',,0N E • DE AN- TOWN OF BARNSTABLE 10 W Building Permit lication Project Street ddress Village Owner Address,2 1A brGku '1�G LA->� -Telephone (p 9 Permit Request First Floor 'i a-2"S square feet Second Floor A Ltd square feet Construction Type i Estimated Project Cost $ C> Zoning District Flood Plain Water Protection Lot Size Grandfathered XYes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes `ANo On Old King's Highway ❑Yes XNo Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ` t i S Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing i New Half: Existing ® New 0 No.of Bedrooms: Existing New Total Room Count(not including baths): Existing y New First Floor Room Count Heat Type and Fuel: >(Gas ❑'Oil ❑Electric ❑Other Central Air NNes ❑No Fireplaces: Existing 0 New O Existing wood/coal stove ❑Yes ANo Garage: ❑Detached(size) Other Detached Structures: ❑Pool(si ) Attached(size) l S x i R ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ yAppeal# Recorded❑ Commercial ❑Yes 14 No If yes,site plan review# Current Use Proposed Use 4 NL �j - ►���. 1��lB�$t2ll� 6 1�1G� M �10 tion Name^, Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN tO SIGNATURE,, Vow✓ ���,�3� DA BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) ,� , x, FOR OFFICIAL USE ONLY PERMIT _ ER NO. , DATE ISSUED Z ; MAP/PARCEL NO. tii - ADDRESS :r i" VILLAGE" OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ' r ELECTRICAL: ROUGH E FINAL t w i r PLUMBING: ,,YOgGH � FINAL C GAS: ROUGH - FINAL FINAL BUILDING ' '.sak :. _ DATE CLOSED OUTS , ASSOCIATIO PLN 10-. t it ......... The Commonwealth of Massachusetts Department of Industrial Accidents == Office 011805080115 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name 1klDrz.l,�tl, M �Q� /�location•�F� �1'����LL� VV� ci NV� � 'shone# r0 ���-�m�lc I am a homeowner performing ill work myself. lamas I d have no one workin in any capacity ❑ I.am an employer providing workers' compensation for my employees working on this job. comaanv name address. city. Aene#: insurance co. olicv# ❑ I am a sole proprietor, general contractor, o omeowne (circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name � �;5 lo address �Z �'Cy \ city . TALtVtdt l"4/ f7"1. ��0hone#: oranceco t/ olicv 50 �com anv name. e address.• ct J hone# Q insurance co:. Roliev#` « '"` 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 S1,500.00 and/or one years'imprisonment as well as civil penaides 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 certify under the pains �and^penaltt ies of perjury that the information provided above issttrue and correct Date'.Y Print name A ARtAl-,L Phone# C 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 ff immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (noised 9/95 PJA) 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 Please fill in the workers' compensation affidavit completely;.byAchecking 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 ofmsurance 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 obtairi-a woiker"S'i 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 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. "The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investlgadons 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 ACORD WsuE�?4li}�' �$ wrc{aameuwrtl S J02. 07/07/98 ..:. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF HNFORIUTATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Paul Peters Agency, Inc. HOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P 0 Box 669 ALTER THE COVERAGE AFFORDED BY THE POMES BE<.OW. Falmouth MA 02541-0669, _ COMPANIES AFFORDING COVERAGE Michael C. Lynah '"""' WeomNw 508--548-2500 Fax Ha A NORTHERN ASSURANCE COMPANY INSURED CgMPAh1V B COMPANY Joseph A. VAcha C 12 Scotty Lane COMPANY East Falmouth MA 02S36 A THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS. CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSUR/WCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POL+CYtILlNB£R POLIC:Yt3FWYrVE POLICYEXi1RATlON LIMITS �e . LTR DATE(MMtDD1YY) OATE(MeNOOWh GENCRALLLIBIGTY GENERAL AGGREGATE. S 600 000 A X COMMERGTAL GEN RAL LIABILITV NBFB40295 4 10/11/97 10/11/SS PROOUCTS.COMP/OP AGG $600,000 CLAIMS MADE t XJ OCCUR PERSONAL a AOV INJURY s 30j,000 OWNE"SCONTRACTOR•SPROY EACH OCCURRENCE s 300,000 _ FIRE DAMAGE(Any one fire) $ 100,000 MM EXP(Any one aerwo $5 000 AUTOMOBRE LIABILITY ANY AUTO COMBINED SINGLES LWIT S ALL OORM AUTOS BODILY INJURY S SCHEDULED AUTOS ( ram) HIRED AUTOS BODILY INJURY NON.OWNEO AUTOS (P--ad-1) s PROPERTY DAMAGE S GARAGELIABWTY AWOONLY.k,AAc:tVENi S W.. ANY ALTO OTHER THAN AUTO ONLY: EACH ACCIDENT S. AGGF40ATE S EXCESS UAMUTY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE ; OTHER THAN.UMBRELLA FM S WORKERS COMPENSATM AND T AjTUIT^ O R EMPLOYERS LIABILITY HL EA04 ACCIDENT _ S THE PROPR&TOW INC:L EL i116EA5E T'OLUW UMrT $ PARTNERS1EXECkMvE ._ ..__.-_.-...._..._ . OFFfCCAS ARE: EXCL EL DISEASE-EA EMPLOYEE S OTHER - - fTIOF IIER/S - Installs form - concrete CE4t?jF1CAIE :::;.:. _.. ...: .:: •... .....,.. _... .CANCEt3cATiOKf:. PIPPAD1 3KVLD ANY OF THE A80NE DESCRIBED POLICIES BE CANCELLED BEFORG THE EI"ATION DATE THEREOF,THE ISSUING COMPANY WILL ENOrAYOR TO MAR 10 GAYS WRITTEN NOTICE TO THE CERTIFICATE NOLOER NAMED TO THE LEFT, 418 Adrienne ell way BUT FAILURE TO MAR SUCH NOTICE SHALL IBFO$E NO OBLIOATION Olt LIABILITY 418 Mitchell -Nay Hyannis MA 02601 OF ANY THE coMP ,+Tt&I&T3OR ESENTATNES. AUT AflYE ACOkt325-'fit ... f ...........:... ::. .A ' CORD:CORPORATtON.19� L -d iV96 0V9 SOS AON3°JV Sb3:13d -nvd WOLI3 WVSV:8 866t-LO-L r ADRHAN ,,Ma So PHPTRR ]P.O. Lott 753 Hyannis,MA 02601-0753 W./fax Q500D770-6967 Town of Barnstable 7 July 1998 Building Division 367 Main St. Hyannis,MA 02601 Attached please find my application for a building permit for an addition onto my house at 418 Mitchell's Way, following demolition of 420 Mitchell's Way. I will continue to provide subcontractor information as it becomes available. Thank you for your attention. Yours sincerely, LAA r 780 CMR Appuw&I Table.f MIb(cannoned) perscriptive Packages for One and Two-Family Residential Buddlap Acted witb Fonii Fueb MAXIMUM MINIMUM Glazing Glazing =R�-vadltwl Wan Floor Basement Slab Heating/Cooling �'(0%) U-value= value' R value Wan Perimeter EgWpmm Efaci xmcy' Package Rrvalue� R vafnet 5/01 to 6500 Hating Degree Dare' Q 12% 0.40 38 13 19 10 1 6 Normal R 1251* 0.52 30 19 19 .10 6 Normal S 12%. 0.50 38 13 19 10 6 85 AFUE T 15% 0.36 38 13 23 WA WA, Normal U 15% 0.46 38 19 19 10 6 Nomud V Is% 0.44 38 13 25 WA WA IS W 15y. 0.52 30 19 19 10 . 6 8S AFUE X 19% 032 38 13 25 WA N/A Normal Y 12% 0.42 38 19 25 WA WA Normal Z 19% 0.42 38 13 19 10 6 90 AFUE AA 18•1. 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: L �� >G L�e,�N Nth 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 80,0', -%--L 'M"3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): h o,i ' 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPRO AL: YES:. NO: q-forms-080303a 780 CMR Appendix J f Footnotes to Table J5.2.1b: - ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value regi i ement. For example,3 W of decorative glass may be excluded from a building design with 300 W of glazing area. Z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions, but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces (such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. ' `'" ' -)I '} _A 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. tom ' If the building utilizes electric resistance heating use{complian:cel approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requiremenis'of the closest city or town see Table J5.2.1 a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION lease print. DATE_ Z- JCOB/LOCATION I�Number Street address Section of town /"HOMEOWNER" PUAN . 6 ._W`Z •��g'C C�`3 �AcM .... . . Name Home phone Work phone . PRESENT MAILING ADDRESS MA 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, 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 Officiz on a form acceptable to the Building Official, that he/she shall be resnonsib_ for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the Stz Building Code and other applicable codes, by-laws, 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. HOMEOWNER'S SIGNATURE/, LJlsl .� APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35 , 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which i"'luilding permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person (s) for hire to do such work, that such Home OwnE shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix 0, Rules and Regulations for . licensing Construction' Supervisors, Section 2. 15) . This lack of awarene often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home " wner acti as supervisor is ultimately responsible. To ensure that the Home Owner is fully 'aware of his/vier responsibilities, ma: communities require, as part of the permit application, that the Home Owner 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 to amend and adopt such a form/certification for use in your community. T he Town of Barnstable . _ . 9 ,ram Department of Health Safety and Environmental Services q'�1659.•`° Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissione For office use only 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 drone by registered contractors, with certain exceptions,along with other requirements. L Type of Work: 'OV11 n 014 -Va 'l'�'�a Est.Cost ,/Address of Work: i� =e■ a P w,.." �iPc�l4 /Date Owner's Name ■ -■A of Permit Application:I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under SI,000. Building not owner-occupied Owner puffing 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. OR Date Owners Name a .e n t 4 p • s Y r r r. S 4 .m a - a •. e . � e r x x n e e r � a • r �p , .e. n- r. AD21AN Pi P4.9- ADAw7doA), PLAay xxe:/ __'-Oq KVRDVW OY; r BI M owYE:s•a8-9) ��•. s' REYL9W $� SNA2pdJ MALONL-JOH^VfON Sob-77.F-66711 REAR iEL-E-V T-10d a v HAIFFH EEFI FIB HHE , LEL T E LEV fcT1 D r� 1 R I(�+rT ELE yA7�l n.J /i V.... .. ... .._.... _.........------- . G Jam �846xa E r � i T 141C I I •. , DIM&, 2ooM 'b m tf a8 4bn iRF.raG i s c tcf� /�P T. STEM _ �Le 07-7-7 �j 4 o , h � �4 a �ExJ d846 x 3 aaac F 0 MA Fd"Ie ^A A] al JtIPP it, �.�GAIE /�4°_I_h' 77S FLODre SoryTf. 2- 0 -7eV o� © ® O 10 Elf, oPFRA L w'X N k J)( � 1X10�?A FT F_24 l�JEC 1 ag��yblx 3 (/�l V v SLAT �C lL.,.oUg2 OVER �FLOnID F/.IJOQ PL1F/� a oZgi�v><a s� 35- Y" ASPNAi.T ,2ooG '� /SGfEL% OOC2 jd"CZK PLy GONT. SOj>=IT VENT EX fT.72�.M MATCH .ALvn..�v/.vyL S/DiNG }TQ�M 7xV .E"x AACE..-NEw]_...1xg I13 �X f'T NO W/N DOW 7R/M .wAT<H - Ex)r Ex yF NO Fnye,M`..D t.foLF/T Orlo 9i` 4 - - A)E:k)-1.3.-.FA 21 17 LaYa /�la - Ex,y- Na FKI EE2S NEW Ix b F.21EEZ£ MAT[N ALUM 6tl01:,,E,�A r-�U/NyY�7 od .2-ax4 TOP PLATES ALL IZ aa_G�P�b.:OC_-f7vD W+/Lf-L > Z /a cnt.PLy SHEATH//.16 nw 1 � �JO V ly Z 12n W .. C � 2g"3V0 FL. a-ax4 70P PLATE 77s F-T, /d"s- ff�,FVVNOAV to AN FOR yPANS ? ' • 1 - 0 91 W � SBSYb 1%L ax6PT..gI«uJ�.S L - ax ^C "COWL WALL T->•= G.T /a`s-SEE TpuNaATfoA LA.J FOa,y PA'N _ 8�/o"Q4pR HEIGHT ...dXb B+.SELL N�/G'SC S"LOn1T.=T6. ti-O"H/vH &"LaAI. . DAMP PkCOP7 1&ELOW IJALL V//6"x&'/ 6 RA'D'E LONT. FTG W - c P7RAM IA)G �/z£G77 DIJ WINDOW, E 7aal A-Ao.-,5GNEOV.4E. / or//P.0 - 9 d8'/bxZ G 3Yx6 7boR TEEL F, .xLB,p/O,e.STEEL. . f_ 9X7 O .GA a.-DoaQ dfe 6JELV%SK _ S I" - ®Ilto bO LK BArd /Fa EA I W t - y"coez. 5LA8� K o NEW ttEATIA&- . j D.RS CT'yE'NT _ _...3p'k 3o"xIo"GDac.. PADj E` E:OnL'./,a L.TILLED 3-dXla612 h - h m _ m ' &T7 p Lauer Z-? �J V 'wro 86"N/6N d"Con1C, h� �� =44 v' •elb 8'COA X. . .WkLLS W Ib"x$" (odi. t�c.C�R� P)UAMA-M)XJ PLAN 9"GOn7C. tA8 I o" 3 � - 11/18/98 Eric Hubler gave ok for CO on 418 Mitchell's Way,Hyannis=by phone. tC4 Ict 0 0 'eS 'loot C.I�+'PMh N C i �TQ ,,�,,.----,- J ,. r i ,� a �' �FTFIE .saMsrnBz.E, The Town of Barnstable i • 9eb ' `0�' Department of Health Safety and Environmental Services ArFD nna't1659. " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner PLEASE FORWARD THE ATTACHED PAGE(S) TO: TO: U _ RE: FAX NO: 7 7 F to FROM: c2 DATE: PAGE(S): PAGE(S): a- y17 912 �.� � _ -J" Engineering ngineering.Depti.(3r�000r) Map c�; y Parcel.6/,..;;� Permit#ngine House# Date Issued 0 Li \-,iB Boa of H6Alt'h(3rd floor)(8:15 -9:30 1:00-4-30) e ee Conservation,Office(4th floor)(8:30-9:30/1:00-2:00) INS Definit-i-ve.P4an,-Approved+y-Planiemg-Bioard 19 BARNSTABLE. MASUL EO s639. TOWN OF BARNSTABLE Building Permit Application Project Street Add ress, elL E- Village Owner Address Telephone Permit Request 'Second Floor I LA-21s square feet First Floor I §qyarp feet-. Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection 1,tl-f Lot Size Grandfathered El Yes Ll No Dwelling Type: Single Family Two Family Ll Multi-Family(#units)_ Age of Existing Structure Historic House 0 Yes 14No On Old King's Highway Ll Yes �No Basement Type: /LFull 0 Crawl L)Walkout 0 Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing I New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: gGas Ll Oil LJ Electric L]Other Central Air Yes Ll 0,No .J�Yes LJ No Fireplaces: Existing C New 0 Existing wood/coal stove Garage: Ll Detached(size) Other Detached Structures: LJ Pool(si* ],,Attached(size) I j -x, LJ Barn(size)"", 0 None LJ Shed(size) Ll Other(size) Zoning Board of Appeals Authorization Ll Appeal# Recorded Ll Commercial L]Yes No If yes, site plan review# Current Use Proposed Use 1 y�rv,--4 t. 1D I N j IQC.-, ,-A, 1:'4 Builderinformation Name.I l (,Y Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ,,-" DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 7' . IPA a C6 2t A4 AC, Ito- / L 23 qOA 23 T . Z4 - 1Al v 44AE. NZ _j . 334C_ B00, . PAGE FRE.� E A`D77yT 61g7F , ' �DrT►Ort. �� ` t $1aca . 00 ./o �- D]ZZ 7GT3:.PIAF.14 V ,q • ,o,:ate •• � Ny' ". •, __ ,r . -•L'3?.a j�,, ^' .., O . . "'�^' �M. '1r.'.'1,1-?O� as C(O q'4 � ,1Z _ a L • ,� = 14 33. 3 0.. Q�652•a�' . L= I�05• o s < ?► ca o'-P 1 0 1 D" A0 1TCHE'L L.�3-- Wpy r c lo` 44-cr. �- B.R.e. Fhrp 9• FN O z / PL At 0 P Lei A.1b 1IV i C ER71 FY. IWNT TN 13 PLAN WAS MADE IN •6• r - ' ACCQAOANCE WITH TUC RM STRY OF DEEDS (N Y A N N 1 S ) 8 A st M ?A !3 L E MASS • ILEGVLATIDNS EFFECTlI/ Tau ) _ VATS KNpit S. i�yPR E PAR. E ID s=o R a 101r ' Sam ADR/AN M. S PIPER 14 RUBY PERT,I,FY THAT •rmc PRG PE RTY L'I N E S 3t10MNON:..TNI,S 1. -PLAN ARE THE LINES D/ YID/NG 4 . S�AIL. E: 1"= 3D` 4•-•7.•-'1g— EKIS• lm; QWAkRSHIPS, AKO THE LAVES OF THE STREETS AMD WAYS SHOWN ARE THOSE OF ROBLI C z. DR PAI VATS STREETS OR WAYS ALREADY FSTA04.1 SHED, 3a t5" 0 3Q 00 - AND 'THAT NO lJEW ,UP4aS FOR 011/151,014 OF EX15T1N4 ' OWNERSHI P Oft FOR W-W WAYS ARE SHOUIM. ALL CAPE EN GI N>`E 21A1 S Sc^i..E w FEET 4 0. (./i _ y Ya/V N/S MASS . g OHO ll 1ER.DATE • rar.:. v(.d:«C ..., _ .r„ i ' v..'n' •... ':.:. ^IQ -yT 4F W • A S S E 5$ORS, MAP PARGE L.f 't. .. .. . - - � .. .+ -- -ice,r• . -4 IPAGE -- BOO"' - ___--_ A-��-- • ® C f • ;-sue _ - •.'' F� o New ( et a N �o%ob o & iW Z.MAUJET to 0 ysl�trt tti dR7A1hr.3: 0 L �w_ as �jj. 4 doCbo,�•a• lie tic �5�� 1 3► o�..p � A " t4 33 3 o Q=r'SZ•n v 1D ' o 0 c`Iwio 1 A o ]VIITCHELL�3 Wpy _ o r o I o44 f �� f �� B.R.e.Fldh - 9•a'8• FN� P L A IV O P LA Al D I&I 1 CERT I FY 7WMT IW 13 PLAN WAS MADE 1 N •b ACCQROANes wITN TN1L RgGI STRY OF DEEDS ► �NY A ICI N is ) 8 A Et N S?A S L. E , MI IQ .S S • CACl/LATIOMS EFFECT/ A J PATE Amw Pi I LwFr R.L. S. �, PRE PARE 0 P-o R ADRIAN M T. PIPER - I •HERBY _CERTIFY THAT -rME PROPERTY LINES-Uowm 01 7NIS PLAN ARE THE LINES DI YIDING f S�►L E: !M= 30 4••-i•-1g EXISTh�lC QWNERSH I PS j AMV THE Ll NES OF THE ' STREETS AItDD Wq YS SNOW# ARE THOSE OF Pl/BL/t DR PRl me STREETS OR WAYS MLREADY 45TAB4,I SMED, ; 3o C5- 0 3 AND THAT NO MEW LINES FOR DIVIS14014 OF EA15TIN4 QWHERSHI P OR FOR NEW WAYS ARE SNOWM. ALL CAPE EN(,I N>`E,P-lN 4 � SCA.,E IN FEET 44 M ARAc R R O. ' MYAMNI S , MA S S . DATE JONN ri 1 LeIE R.L.S. � REF : .. ,�.� �I� • ( ASSESSORS WI A p IN- PARCE I-10 L 94•5