HomeMy WebLinkAbout54/56 MURRAY WAY J
i
N E SSMEAD
KEEPING YOU ORGANIZED
No. 10230
H163
SUSTAINABLE
FORESTRY MIN.RECYCLED
INITIATIVE CONTENT 10 e
Certified Fiber Sourcing POST-CONSUMER
-fipmgram.org
--_SFI-01290 -_
MADE IN USA
Town of Barnstable ' - *Permmit#�- "j
Tres 6 months from issue date
' Regulatory Services ' ee
MRMUABM
Mass. Richard V.Scali,Director
Building Dlvisionr ®
,�� 6C '
Paul Roma,Building Commissione ���y �
200 Main Street,Hyannis,MA 02601 C/
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
' �%��J! �I _ Not Valid without Red X-Press Imprint
Map/parcel Number (/ r }
Property Address
residential Value of Work$ l Minimum fee of$35.00 for work under$6000.00
,
Owner's Name&Address
Contractor's Name c ,'VJJ 0 42, `' Telephone Number L{a, ��!X �
Home Improvement Contractor License#(if applicable), Email:
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
Iam the Homeowner
have Worker's Compensation Insurance
Insurance Company NamerlvJ/�/e?�
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Req st(check box)
` 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 coy of the Home Improvement Contractors License&Construction Supervisors License is
re red
SIGNATURE:
i
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
06/20/16
4
The Commornveah*qfMarsadimsetts
Dgwhyrent of rarusin-d Accidaxts
owe Of
600 wasuir;G MI&Met .
Boston,MA 02HI
- wFin Lmasmgo9Idia
Wcr.Iors' Ca mpensaftan Iusrcrazce Affidavit:Bmlders/CantracturslEIectrxmns/Phtinbers
AppHcant Infmm.afiGn Please Pat E,e IIy
Are you an employer?Checkthe appropriate bass: Type of project(require4:
1P I am a employer with 4_ ❑I am a general contractor and I ❑
employees(fia11 andforpart-dime.* have fired the sub-contractors 6_ New owns on
2.❑ I am a sale proprietor orpa%taar listed on the attached sheet I ❑RemodeHag.
sbt p and have no employees These suli,- u2ractars have 8. 0 Demalifiou
wading forme in any capacity: employees andhave wodoers' 9..Q Build addition
INN WO&MM'Mp np.imsuzzone Comp.%ner mn�I
require—] 5..Q We are a cocparsti=and its 1OL❑Electrical repairs or a damns
3.❑ I am a homeoumec doing all work officers haveexercised their 1L❑Plumbing repairs or addifions
of on per MQ.
ffipsel€[LtTo workers'oomg. �§I{ �a have na L [i'�ioofrepaus '
insum=e required_]Y
employees.[To ems' 13_❑other
'cam- )
•nay a fi=atdst cbedmbaa K mast slm Mo ithe sw icmbeiowshuVdnz&e¢wa&m`cnmpeas&fi=pa5cpiaf=Mx imL
#hers who submit d&d5d2[ir im g they are dming mU wale and then hire outside cant 3ctmmnst snTfmit a new afdavit indi—inn sack.
rCaut w==1ff=dbeckthis boa mast attadted sn zmiti�sl suet sbowiag the name of the and state whether arnatf wse entities bay
employees if thesabt xshm mnpicyvzs,dwy=isr ymvide&w wM*2W=zP•pdr=Y—eL
lam arr erliF r flint is prQuidittg�aarl{ets'comperrsatian giszirarxca f ar m errrplv}�ees Scrota is the prrliry arrd jQb site
informadam
kmamm Company Name: i f/
Poficg 41 or Self-in€Iic_ /.�f�'l/) o % .
Fxgi�on,Date: /
Job Site Address: � � ` �/�� citylstawZip:
Attach a.-copy of the workers'comapensationpolicy declaration page(showing the policy n=aber and ezpu anon date).
Failure to semm coverage as required.under Sezlion 25A of MGI.m 15-7 can lead to the imposition of criminal penalties of a
fine up to$UOD.OQ andlor aria-year impism=:enk as well as rivil penalties in the foam~of a STOP WORK ORDER and a Kane
of-up to$25100 a clap 2gainst the violator_ Be adtdsed that a copy of this statement maybe fkwarded to the Office of
Investigations o€the DJA for iasn mw coverage ti .a
Ida[wrAy cer* prrirrs d pm � . thatthe informadwiproi•�d abmw true and correct
Phone g: (52)
t3okial am aWy. Do swt aw ite in f ih area,to be arrupfeted by city artatrn affZdaL
r
City or Toww Perm iftlLicense 9
Andwrity(cane one):
L Board of$ealth I BuffaRng Deparment 3,CRy row clerk` d Electric-al hapettor 5 Phrmbing Inspector
6.other
Contact Person: Phone 9:
--- - 6
-Iformation and Inst`nCfionS
h f&ssarjX=e#ts Geaeaal Laws ffiVber 152 regrares all ezmpIoyers b provide wozlo as'CQ3np saiion for theiF employees.
p to this stag,an C2nPIay='is defamed as"_.evezyPeasoninthe sm vice of another Muder any cozract afhira,
engress or implied,oral or wifth=f
Amz er�play�is def and as-an mc$vi&ML Part ='*,association;corporatton or other legal entity,or any two or more
of the faregomg engagr-d in a Joint enterPdse,and incladmg the-legal re�P=smhdivw of a dwZased=Player-or the
receiver or trustee of an individual,pazfn�,a"' cigdm or otheslegal entity,e�oy�employees. However-the
owner of a.dweIIi ng horse having not mare than tb=apartments and who resides therein,or tine occupant of the -
dweIlimg house of ano$er who employs p=S=to do matt naam,= truCti on or repair wow an.such dwelling house
or on.the grounds or bmldmg appurteaaant thereto shallnotbecanse ofsarh esrploymentbe deemedin be an employe."
MCH,chapter 152,§25C(6)alSo StdPC'that¢everystate or local Iiceasarg agency shall withhold ffie issuance or
renewal of a Ecense or permit to operate a business or to consfract buildings:in the commonwealth for any
applicant Who has not produced acceptable evidence of complmance with the insurance.coverage required."
AdditionaIly,MGL chapter 152,§25C(7)states-Nmthmthe co®anwealthnor jay ofits political subdivisions shall
enter info any contract for thepez-f=mance ofPnbho woricunta acceptable evidaam of compligncewith tha insurance._
requhemets of this dupter have been presented to the C=ftW ing MIthOUty."
ApPlica�s
Please Ell ohm the workers'compeasation affidavit completely,by chccRiag the boxes that apply to your sitnation and,if
nmessary,supply sab-contmct6r(s)nmn*), des)mad phone numbers) along with.their=tCacat-.e(s) of
insurance. L=itnd Liability Companies(LLC)or L5i=ted L.iabilityPmtnexshigs q- P)wi$ino employees other than the
members or parbaexs,are not regmm-ed to eany workers' compensation insoumm If an LLC or LLP does have
employecs,a.policyisrmxlafiTZ Be advised that this afdayk may be submitted to the,Depmtnentoflndvsfrial
Accidents for confsmaiion of iice coverage Also be sure to sign and date the a-mdavit, The affidavit should
be retxrneh to the city or town that the application for the permit or license is being rEquest>A not time Department of
ICI A zi ents q onld you have aay gncst cros regardmg th a law or ifyon aim: u red in obtain a wozio rs'
compensation policy,please call ties Department at the number listed below. Self-i mm� d canpanies should entz their
s elf;n sm-an ce lic mso nm nber on the appropriate Ime
City or Town Officials
t _
Please be scare that time athdavit is complete mad pramirdlegibly- The Departmentim provided a space at 13ie botl=
of the affidavit for you in fll out in the event the Office of 1avesdgations has to coact yomregm dmgthe applicant-
Please be sure to fill in the pemmitMcense number which wM be used as a reference number. In-addition,an applicant
that must submit multipIe p�i.VEce n ee appliiaticros in any given year,need only sahmit one affidavit indicating cat
policy information.Cif necessary)and mmder`Job Site A:dthess"the applicant shouldwry-aH locations in (may ar.
town)-'I A copy of the-affidavkthat has been officially stamped or madc--d bytime city w town may be provided to the
applicant as"proof that a valid affidavit is on file for fatm: permits or licenses Anew affidavitmust be filed out each
year.Theme a homeowner or citizen is obtaining a license or permit not related iD any bn ain=or commercial vtmt=
(Le;-a dog license or pert to bum leaves etc-)said person is NOT regn red th complete this affidavit:
The OfficeofiuTeshgonswould.13mtoffum.kyoninadvm=for your coopm4anandshould yam have any ques'dons,
please do not hesitate to give M a ca1L
The Deq amtnenfs a d telephone and fax number:
Pepartamt cif�Aocidents
Bosom I&02111
TQL 4 617 -4 Mft4fl6 or 14771lA ..
Fax 9 617 727 7M
Revised 4-24-07 qVldia
Town`of Barnstable
Regulatory Services
KAM Richard V.Scali,Director
Nua 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 -
Complete and Sign This Section-
If Using A Builder
as Owner of the subject property
hereby authorize to act on my,behalf;
in all matters relative to work authorized by this building 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
inactions are performed and accepted.
Signature Owner Signature of Applicant
Print Nam Print Name
Date r ,
, r '
J
Q:FORMS:OWNERPERMISSIONPOOLS
Town of Barnstable
Regulatory Services _
dF b Richard V.Scali,Director
Building Division
> . t Paul Roma,Building Commissioner
i639. ��� 200 Main Street, Hyannis,MA 02601
p www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occuP 11 ied 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
P.-rson(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
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 bf 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
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
Massachusetts Department of Public Safety
® Board of Building Regulations and Standards
License: CS-063537
Construction Supervisor '
10
DAVID R COX
PO BOX 401
SOUTH YARMOUTH+M02
Expiration;
Commissioner 1011612017
License or registration valid for individut use only
Office of Consumer Affairs&Business Refutation before the expiration date. 1f found return to:
OME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation
egistration: 100497 Type:
Private Corporation 10 Park Plaza-Suite 5170
n- xpiratlon: 3125/2018. Boston,MA 02116
DAVID COX, INC.
David Cox 1
19 LAVENDER LN _ .�=•,�:^,.,r.-..w...-. _ �-..' _ _ _
W.YARMOUTH,MA 02673 Undersecretary Not valid without signatu
AC b® DATE(MMIDOIYYYY)
�, CERTIFICATE OF LIABILITY INSURANCE 0613D/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such andorsement(s).
CONTACT
PRODUCER NAME, Kathleen Geddis
NORTHWOOD ESHBAUGH INSURANCE AGENCY, INC. PHONE 46M,Na Fin (506)771-102 Arc No:
eddis.north24 insuremaii.net
540 MAIN ST, INSURERISI AFFORDING COVERAGE NAICe
HYANNIS MA 02601 INSURMA. TRAVELERS INDEMNITY CO OF AMERICA 25M
INSURED INSURER S:
DAVID COX INC INSURERC:
INSURER D:
PO BOX 401 INSURER E:
S YARMOLITH MA 02664 INSURER F:
COVERAGES CERTIFICATE NUMBER: 65977 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSLTR TYPE OF INSURANCE POLICY UM3ER P I P Y EXP LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE TO RENTEIV—
S _
CLAIMS-MADE OCCUR ) $
MED EXP M one S
N/A PERSONAL&ADV INJURY S
GEN L AGGREGATE LIMB APPLIES PER GENERAL AGGREGATE S
POLICY❑jC LOC PRODUCTS-COMP/OP AGO $
OTHER: I S
AUTOMOBILE LIASILrY i ( 310LE MIT $
Ea eoddentf
ANY AUTO i SWILY INJURY(Petparaorl) S
ALL O\NNED SCHEDUUT LED N/A I I BODILY INJURY(Par ecdoent) $
AOS
NON OV+MEO ( S
HIRED AUTOS AUTOS
a
UMSRELLALIAS OCCUR I EACH OCCURRENCE S
EXCESS LIAS CLAIMS-MADE N/A AGGREGATE S
DED I I RETENTION S S
1MoPxvw COMPENSATION �( T
AND EMPLOYERS'LIAMUTY
UTE ER
ANYPROPRIETORIPARTNER/EXECLMVE N N I
E.L.EACH ACCIDENT S 100,000
A OFFICEWEMSEREXCLUDED? WA NIA NIA 6HUB91OX742216 D711612016 07/16/2017 --
(Mandatory in NH) E.L.DISEASE•EA EMPLOYEE S 100,000
Ifys�dasebe under
DESCRI ON OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S 5M,000
NIA
I
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Addldonal Remarks Schedule,may be adached It more spa Is required)
Workers'Compensation benefits will be paid to Massachusetts employees oniy.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay
claims for benefits to employees in states other than Massachusetts if the insured hires,or has h1red those employees outside of Massachusetts.
This certificate of Insuranoe shows the pollcy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the
issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification
Search tool at wwrw.mass.govAwd/workers-compeneation/investigaUons/.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Town Of BamStable ACCORDANCE WITH THE POLICY PROVISIONS,
230 Main Street AUTHORIZED REPRESENTATIVE
Hyannis MA 02601 Daniel rC y.CPCU,Vice President—Residual Market—WCRIBMA
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD
o �>o The
=Town Hof Barnstable
Health Department.
�a
367 Main Street, Hyannis, MA 02601
Office 508-790-6265 Thomas A. McKean
FAX 508-775-3344 t 4��or of f u,blic�Health
BUILDING DEPT.
April 7, 1995
`71
j-: APR 111995,
Jack&,Elizabeth Dilsizian Cape Realtly,w-Manager i- ,:;. ( ,
185 Common Street 299 Main Street
Watertown, MA 02172 W. Yarmouth, MA.02673
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY
CODE H, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51
The property owned by you located at 64 Murray Way, Hyannis was inspected on April 5,
1995 by Christina Kuchinski, Health Inspector foc the Town of Barnstable because of a
complaint. The following violations of the Town of Barnstable Rental Ordinance
Article 51 were observed:
410.500: Kitchen ceiling is cracking and peeling and stained due'to water damage
from leaking pipes in second floor bathroom.
410.500: Kitchen floor linoleum is torn near the basement door.
410.501: Window in first floor bathroom is not weathertight due to cracks between
the storm window frame and the prime window frame.
410.500: First floor bathroom linoleum has.several cuts and pieces missing.
410.501: The oven door handle is missing and the broiler door is bent.
410.500: The front entrance storm door handle is not secured to the door.
410.504: The wall areas above the bathtub do not form a weathertight joint with
each other and the tub causing water damage to walls and subfloor of
bathroom and ceiling of kitchen on first floor.
410.500- Ceiling paint in second floor bathroom is peeling.
410.500: Severe dampness in basement due to broken water pipe. "
1
J ,
•{a'n s �5�, .*��'��u � xs t �F t j r i. y''� x �'. � t ti'�. " k o s� �;�- t
.: a
You are directed to correct the above listed violations within seven (7) days of
receipt of this notice.
You may request a hearing if written petition requesting same is received by the Board of
Health within seven (7) days after the date order is received. However, this'violation
must be corrected regardless of any request for a hearing.
Please be advised that failure to comply with an order could result in a fine of not more
than $500. Each separate day's failure to comply with an order shall constitute a separate
violation.
You are also subject to non criminal citations of$40.00 for the first violation and $15.00
fi r narh a.�r�;F:nr,al rin�74inn 7rirtrn4C Nql be issued daily until the violations are corrected.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
TM/ls
cc: Samantha Hedley, tenant
cc: Al Martin, Building Dept.
-Engineering Dept. (3rd.floor) Map Parcel 0 y SS `" „,,Permit# J J
House# /*
a.r yd �
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) - ri d G® � by' - 0;7,
Conservation Office(4th floor)(8:30-9:30/1:00-2:00) - 01 Alp-,p,
Planning Dept.(1st floor/School Admin. Bldg.) � `���®�,4 1141
Definitive an proved by Planning Board 19
BARNSTABLE
6
i ".
TOWN OF BARNSTABLEE°"��' '
Building Permit Application '
/ ,1- �
Project Street Address -, %_:$!,,/- (� � 4/
Village
Owner 1iV—Zr f �D�y �.P13 Addressor
.Telephone 34E 2 - 3 (o�
Permit Request ,o "OA-) l&&►V71 -,rya aw
13 d77-1- �✓ 5 >Na7Aic A&K)gRzA- A a Z4V 2 w
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
ao �&
Dwelling Type: Single Family ❑ Two amily 21' 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
No.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
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) e ❑Barn(size)
❑None ❑Shed(size) -
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes 2<0 If yes, site plan review#
Current Use Proposed Use
Builder Information
Name 0/77 C,` Z� 7� Telephone Number
Address /le S— /"00 icense#
1 Home Improvement Contractor# /goo 74,/G
Worker's Compensation# o9GU 1313 Z o2 9 2._
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
y.
SIGNATURE DATE 'g —J/.- f
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
n�
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED '� +
MAP/PARCEL NO. r-
ADDRESS ., VILLAGE
t
OWNER ' - ;•.;— -�, ;} � ' -. 1 x..
{
DATE OF INSPECTION: x -
FOUNDATION
FRAME f i
s r ,
INSULATION - -
r FIREPLACE .
C CTR ELEIAL: ROUGH h} FINAL f
`r•, e �
PLUMBING-� ,ROUGH 1 FINAL.1 ? ;
GAS: vA'' EROUGH FINAL'
FINAL BUILDINGe�
DATE CLOSED OUT ASSOCIA/TION PLAN NO.
1
i -
1
✓7GG
T � i
E HOME IMPROVEMENT CONTRACTORS REGISTRATION
Board of Building Regulations and Standards i
One Ashburton Place — Room 1301
i
Boston , Massachusetts 02108
-.. HOME IMPROVEMENT CONTRACTOR
Registration 100740 Expiration 06/23/00 i
Type — PRIVATE CORPORATION j ✓ � ��>
HOME IMPROVEMENT CONTRACTOR
�` Registration 100740
CAPIZZI HOME IMPROVEMENT , INC . I ;1
Thomas Capizzi , S r . Type - PRIVATE CORPORATION
1645 Newton Rd .
Expiration 06/23/00
Cotuit MA 02635
CAPIZZI HOME IMPROVEMENT, INC
o� 'yas Capizzi, Sr,
1645 Newton Rd.
Cotuit MA 02635
i ..�/tC L67JM7LdJW/CQtlll p/ i����y .
Z.
DEPARTMENT OF PUBLIC SAFETY
I COMSTP•UCTION SUPEF.VISOR LICENSE
Number: Expires:
Restricted To: It
THOMAS X CAPIZZI JP, t
1 t. 288 PERCIVAL OR I
:::` ' W 8AP•NSTULE. MA 1?sss
The C[JII7ITICIIlti'CQ111! llf.1f4risachusc.7s
;,_i -. _ _ t•;_ Dc�lczrrrrrc::rt of lizrtiuzrialccidc.^.rs
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War:crs' Catnricr-sztiart Insur-nc_ --
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The Town of Barnstable
EAWMABL&
Department of Health Safety and Environmental Services
'°TEo ram'' Building Division
367 Main Street,Hyannis MA 02601
Office: .508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
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 done by registered contractors, with
certain exceptions,along with other requirements.-
Type of Work: %^1 1 Est. Cost I��000
Address of Work: .��1�� �'y/�/s�l�� i9'�J � l1elJ .
r
Owner's Name
Date of Permit Application: 8—,31 9�
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under 51,000.
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 PROGZAM 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 Co i !!acto Name Registration No.
OR
Date Owners Name
i
r-
L ] [R307 246 . ]
LOC] 0054 MURRAY" WA10 CTY] 07 TDS] 400 DIY KEY] 219301
----MAILING ADDRESS------- PCA] 1041 PCS] 00 YR] 00 PARENT] 0
ERB, MARION F TRS MAP] AREA] 61AC JV] 408071 MTG] 2012
MURRAY WAY REALTY TRUST SP1] SP21 SP31
25 OLD PHINNEYS LANE UT11 UT21 . 22 SQ FT] 1092
BARNSTABLE MA 02630 AYB11966 EYB11975 OBS] CONST]
0000 LAND 21300 IMP 80200 OTHER
----LEGAL DESCRIPTION---- TRUE MKT 101500 REA CLASSIFIED
#LAND 1 21, 300 ASD LND 21300 ASD IMP 80200 ASD OTH
#BLDG (S) -CARD-1 1 80, 200 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE
#PL 54 MURRAY WAY TAX EXEMPT
#RR 1050 0100 RESIDENT'L 101500 101500 101500
#DL LOT 4 OPEN SPACE
COMMERCIAL
INDUSTRIAL
EXEMPTIONS
SALE] 05/86 PRICE] 1 ORB] 5060/328 AFD] I A
LAST ACTIVITY] 09/20/89 PCR] Y
R307 246 . • P P R A I S A L D A T KEY 219301
ERB, MARION F TRS
LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB
21, 300 80, 200 1 A-COST 101, 500
B-MKT 80, 300
BY 00/ BY ML 5/88 C-INCOME
PCA=1041 PCS=00 SIZE= 1092 JUST-VAL 101, 500
LEV=400 CONST-C 0
----COMPARISON TO CONTROL AREA 61AC -----------------------------
NEIGHBORHOOD 61AC HYANNIS
PARCEL CONTROL AREA TREND STANDARD
101 10 LAND-TYPE
213001 LAND-MEAN +Oo
1015001 74880 IMPROVED-MEAN +70 250-o
] FRONT-FT
] 100 DEPTH/ACRES TABLE 02
10001 LOCATION-ADJ APPLY-VAL-STAT 1
LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES
COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC
FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?]
R307 246 . P E R M I T [PMT] ACT* [R] CARD [000] KEY 219301
000000001
PERMIT-NO MO YR TYPE VALUE CK-BY MO YR 'iCMP NEW/DEMO COMMENT
] ] [R307 246 . ] TAX ACCOUNTING , [ ] 10316- [ 2193011
RECEIPT NO. PAYMENT `'Z`A.X YEAR/B.G. AMOUNT •DATE TYPE P I D 0
------CERTIFIED OWNER------ TAX DUE 1, 544 . 84 ] OUTSTANDING . 00
ERB, MARION F TRS ] TAX CODE 400 ] CITY 071 DISTRICTS HY
------JANUARY 1 OWNER------ ACTION ] MORTGAGE CODE A20121
ERB, MARION F TRS ] ----CERTIFIED VALUES----
-------CURRENTOWNER------- TAX EXEMPT . 00 '1
ERB, MARION F TRS ] TAXABLE . 00 -1
MURRAY WAY REALTY TRUST ] RESIDENT' L 101, 500 . 00 ]
25 OLD PHINNEYS LANE ] TAXABLE 101, 500 . 00 ]
BARNSTABLE .MA 026301 OPEN SPACE .,00 ]
00001 TAXABLE . 00 ]
-----LEGAL DESCRIPTION----- COMMERCIAL . 00 ]
#LAND 1 21, 3001 TAXABLE . 00 ]
#BLDG(S) -CARD-1 1 80, 2001 INDUSTRIAL . 00 '1
#PL 54 MURRAY WAY ] TAXABLE . 00 ]
#RR 1050 0100 ] ]
#DL LOT 4 ] ]
fR>.
,s `. Y. .. 7, .;..e.
LCeno.'B II eC. Room^�• Ik:;.Wa s , Bsrnt. Rf}..' ;St.,Showar- {+.•... .:_, ",,,.£. :: -','�,�• ,., a
.. .. .. y, f• Beih.R".,;, J 7i,,, i Bsm s.„ ,sn r..y t r r! ,I + U x e ;- .,t ae
... t:.�-..�',.. ilY-11':•1C$,;[ $5 Cf ..e�.,,..1'.f..'+'.. Y ��^��yy ; .a."Y'�s. Y+,7sk ��•.';y6 i1"` � �- 'R.yx
,
E. {, y fI PURCH.:DATE
§§Coot:Slab Bsmt:Gara a K .r:. «• d#
7 { g.,'., .i ..St..Shower Ext:;{{ s o;: w 'a x{.,. 'nu ax i mk y 4 ss J' x
h 4... ,(aS:yr Walls .i, f* %.. r`..,.fy'..{ ,+{,... �, +i + PURCHt PRICE
.`' ..�' ':'' w r Fvr '+"'Y'*a'r,"' ti'nF- ,':a,��yss ''<•;::: ••-,` •
-. y, .k." •y., :Y:7(t K,s.:-:�;£+• 3;; �"r"a,✓@ 4.i }.]rl':`Ut rz�
;Bripk Walls, Attic Fl.. Stairs J TaiiletRoom a "Y}. a F r t•rg siT
r
Roof;_., ; ;j,•E rl :( .� ,sR �;rL r r=«� '-f4.�s. r�c^*,., ..!.
'a• P :,r .,! ,�tENT9,e;:.t. r" -'I.',F a -x- r-e '"`'�.y,r'• ;,• •�"'zat,'tt" . fit-`+`
Stane,Wails,; Fin.Attic ta: } ,`.Two,'Fitt:Bath Ya Y «,
•
.. , '.... r :u , .t a `t,: r- -r�a '•x,• _ w .xd k a Y,, •s^!k ,sx� .SF,.?.
Floors
..:::ia' •„ .... a ..�: .,, �. r. :..:;- y. ... 'i., IWd'.: - C-C4�Tjj,. §.., ,�.Y,s: .ii-s. ,rF �•" ?a, .,,a+ Y , ',, <. ;,. ^` ��;
Plertyjla.4, i:r INTERIOR,FI'NISH: Laveto Extra a' c� '' Mr a''. ! F >• pa.µ{ '+... � _,. ry ': v. 4n., -j, y. p _ t�'., a { fi 4 «;i.� +`t �e s9c�iY+,....4. Via,.. •,r}`t.'�x,�1.�
r: t Q'S'
1"t 2. '3 .Sank. »/ �'• fJ'.5�0 ;rs,t {�, 3'' r' >x r:a t - d ,r:f,
J '1Misters„ „, Attie r , � _ •' i:t. ti• #` rr ` 1� �t
r/r Y/x' •%' Water Clo.Extra
>' 3
tix �/Lt �'�
EXTE.RIORWAL'LS Knotty Pine.,': r� t Water Only Dduble Siding '• ' ' Plywood #ra No Plumbing, Bsmt.Fin f.
Single Siding, Plasterboard is Int.Fin. C — , y? ' Y ' 1 "a.'•f rfY` ''.'t a
�'
ps< Shin les W x < y
6 .,xs.,.. TILING` s r' 3:`v r ` s+ <xcs. rzC ` a rA tv
fu
C E �- (.o o' NE a t t .4 r �<r„ '� fir, S;M kt
°zConc:•.Bik"% 'x ^n r.• m .al•' t s .?'.,t r '.
G' `F: P Bath FI. Heat "
Face:Brk On Int.Layout Bath Fl.&Wains.
Auto Ht.'Umt
".7ssa :Veneer e'` Int.Coad. Bath Fl.&Walls
,..
_
Fireplace
Com::.Brk On- _ Fl.' 4 ry t F sY�+
' a `HEATING Toilet Rm. z #�3
Plumbing i 0 s s ,
{Sohaf,Com Brk «r* •> :Hot Aar `lf°• Toilet Rm.Fl.&Wains. f itc
Tiling 1 o ar£t x ni <r r a�Y ,s
Staam Toilet Rm.Fl.&Walls f 5
Blanket Ins y Hot Water` St. Shower X y o2
Roof Ins. x Air-Cond. _r'" Tub Area Total .: �, f
Se °;i ks m Floor Furn
5.
e*r(+a ROOFING COMPUTATIONS r w
AsPh:,Shingle" Pipeless Furn. 0 C S F p�� 9.G U ti• ifs` p y� 5 ��i a
Wood Shingle l`,§5 ''', ,Y No:Heat 0 f S.F: l U / '3 1 cl
Asbs�Shmgle4xcr y OII,Burner S.
" ; � •,
Slate{I d F Coal Steker' 1%
{ , :' S.F:
TIlO9C{ C dJ s Gar t 4 p
rwz ,.:ROOF:'TYPE';; Electnc 4 S.F.
INGS
;, .•
OUTBUILD
K
Gablert �3[ - aFlat S.F. 1 2 13 .4 5 6 7 8 9 10 1 2 3 4 5 61,7 @. 9. 10 MEASURED !
rMansard"+ 3 _:FIREPLACES S:F. 3'' Pier Found. Floor
Ga`rnbrel �` '' !�.. "^. r r Wall Found.•' r 0.H.Door ." "
1 <Fireplace Stack. / ✓ s 'Y
a r LISTED-
r}•fs FLO RSA"—"a* ., Fireplace ;P r' t .a »s,a mac,
7 ? + Sgle Sdg Roll Roofing to
,« LIGHTING #y F@ 9 'wtsr �
,.
sag:::= Ingle
Earth§: > ' r?�s No.'Elect'N'" d%w DATE
,•_:
Shingle
4 : in le Walls' Plumbingo .Jr n
Plna" .mow s w7 axx i3� vG 4'. t ;" Shi Wa ,j ,; r o r^ ;, k c 2 r' .,•r'r
k
.,:,�.xc. - .:a. .-: ,x.. C ' _ '::: :,.a,: n ,;t�',•.`+ •..,':t - }y: ,� +r§.h ',:. W7ra n tBL.. R... e.. .
... .,.a ,,•. v,: ,•. S Q ...... .7.. ..'. h,9 Y Ca{nent:8 ec yz ,rf Electnc a§ .„;i;-
°«,.x•ROOMS: t ., ... c;•tc h 's '#
s ram- ik c
Asph;Tale ,:? !� Bsmtr„' .f lst> TOTAL` x u a</ 4 s Brick E Int.Finish p
t a
v
SingleLxgf ssY ntb -2nd 3rd FACTOR "` r >ux
_ .
K
.,r'�}•• , ...,« .,: ,...,. „a .t- Y 4.,, ,{' 'ui • ar3. : , .w, p
41 .e'v-+•?h s , ..:;.ti. �,.,wJ..;, ..� a. :- s:.:,. s•REPL:ACEMENT -�....i: ,>. r., R .kG' y� L'....; .r `Tt.r r oa - - "''%- NI. i... ..
s .t^{,LOCCUPANC, _w, '"4ti�•,CONSTRUCTION '. ?'- SIZE � AREA - -- CLASS ,a'AGE,� REMOD. COND. REPL. 7.
VAL ^'', Phy.Dep.-� PHYS. VALUE' �Funct.Dep: ACTUAL'V,4L- -
�,
i•
�Si;,.:r+£�+l -"u+• 2'-°e`l_:: 't.': J.',..r' `f. _., .�. �. _, ,r ,.. ,,y,.y t - M, f:9 }Fi h:4' -N _
...•w.�.,.��. ....,°§�. >.... r, �. '.'4. ....'^::: :._ .. r.'. ... ��' .,.+:.r�,, .p.: f' i, s �$:. F., ^t, R;',_ �,..;, �''� 4�. dab;,>.
•.uxr.Ys: ...�� .` `,'� �t q.;:_-,. '...:. .?:. � r.., '. .. �. ; t l"a�,. -, ,/�. .,,z -.� rii- i�. -'ti,sx a .ri;.. �-l..:x� t":a+,;F �,.. ,ww.t/z<
r. �rh. ,....rx.. 4. ... .., +„ ,.. ,: -, -. _ :.. r ,•*.:, `.: � �. '. �'.y�'# x ,.y: :r,•..:_,..r,C��, e-kan5ib
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'L3 ;� A., k s-.t, ar r ..t; z~ _.` y 1 ;,y a• ,t`tea x M, o•r.
i
.ui.. 1� r 7
.^•r s4 ix S?, »i _ - ..Y �c""t.. %Fi F s z t� 4 a9 ,? X t a.
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:5 r� a";, .,r. "t' .h, +��r.• '�'.. �.f ,;, , r' r •m -,.- r- :..y,,.,x�Fr,t 9,.l.�, ir�� �'' 't;',
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a
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y,.`^L9 Y,:"'W'S':M ".� C S .. _ ♦ - - � • \I_ , � ,'� 1 ` { rj J d iIh Yi,e' f.
xn lOtySr,•,. ., .�,,i.• k?s�y r'-. _ ,,... .. ,,.,", .,. -, ,. ,. a: _,r,t;. ,,4�. .$.a tNi.=_ � - -. ..t _,. w..'�1?..ax fY: :F'm.:r,x-,riXi"r(�a;"'P�ta�,i ✓f�a:�.
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TOTAL
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t` .i,:' •irk r:l. ..n
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- 1. ,cs ,t,-' �Y ".-'he,r,• -'^ ,:'` rt %a.
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RESIDENTIAL PROPERTY
* s::MAP:NO`.` LOT NO. ��--y 5 FIRE DISTRICT
1 2 STREET SUMMARY
Murray Way Hyannis' 73 LAND
-. `307 H BLDGS.
OWNER 0) 01 2,L5"
TOTAL 3 S 3 S
LAND
RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS:
BLDGS.
Reagan, James T. 1 15 69 1425 406 TOTAL
LAND
V. _ BLDGS.
e
TOTAL
LAND
_ BLDGS.
'— TOTAL.
LAND
BLDGS.
TOTAL
LAND
BLDGS.
TOTAL
LAND
BLDGS.
TOTAL
LAND
INTERIOR INSPECTED: BLDGS.
DATE: / �7/ Q TOTAL�I 11�'��1�I X�I� LAND
ACREAGE OMPUTATIONS
� BLDGS.
LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL
- HOUSE LOT 7 Z Z_ �jc�b 7 "a 7 S-O a LAND
' CLEARED FRONT rn BLDGS.
REAR. �
TOTAL
WOODS&SPROUT FRONT LAND .
' REAR
WASTE FRONT BLDGS.
TOTAL
REAR
LAND
BLDGS.
Ol
TOTAL -
LAND
i Z Z_ BLDGS.
LOT COMPUTATIONS LAND FACTORS TOTAL
' -FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR.,INF. _ VALUE
HILLY TOWN SEWER LAND°
ROUGH TOWN WATER BLDGS.
HIGH GRAVEL RD. ' TOTAL:.
r. LOW LAND
- - -. DIRT RD.
SWAMPY- NO RD. BLDGS.
... Y -
._ ..� . . _ TOTAL
i
PROPERTY ADDRESS $
ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I STATE I pCS I NBHDPARCEL KEY NO.
CLASS
0054- MURRAY . WAY. 07 R8 400 07HY . 07/09/95 1041 00 61AC
I _307
LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS _
Ldno By/Date Size Dimension v UNIT ADPRiCE IT ACRES/UNITS VALUE De-iption ERB, MARION� F TRS) MAP-
219301
CD. FFDe m/Acres LOC./YR.SPEC.CLASS ADJ. COND. PE PRICE PRICE #LAND` - - 1 - ---21,300 CARDS IN ACCOUNT -
L 10 18LOG.SIT •1 ; X .2 =10 277 34999.9 96949.9 .22 213U0 #BLDG(S)-CARD-1 1 80,200 01 OF 01
A #PL 54 MURRAY WAY COST 101500
N BATHS 2.0 U x C= 100 7000.00 7000.00 1.00 7000 B #RR 1050 0100 MARKET 80300
D BLA SSMT RM S X C= 100 41.65 41.65 880 36700 B #DL LOT 4 INCOME /
A FIREPLACE U X' C= 100 3100.0 3100.0 1.00 3100 B USE
D APPRAISED VALUE
D J A 101,500
A U PARCEL SUMMARY
T S LAND 21300
A T BLDGS 80200
M -IMPS
OTAL 101500
F E N CNST
E N DEED REFERENC Tyvl DATE gepp,� PRIOR YEAR. VALUE
A T Book Page Inst. MO. Vr.D Seim Price LAND 21 300
T S 1 5060/328: 105/86 A 1 BLDGS 120000 TOTAL U 4943/089i 102/86 , 200
200
R 1425/406 00/00
E
BUILDING PERMIT
S Number Date
Type Amount
LAND LAND-ADJ : INC ME SE SP-BLDS FEATURES BLD-ADJS UNITS
21300 46800
Class COn St. Total gale Rate Adj.Rate roar Built Age Norm. Obsv. CNO I- 4b R G Rapt Cost New Ad, Rapt Value Stories He'of Rooms Rms B.tbs I Fix. Part
U nitS Unils A t Depr_ Cone. P I P re y..11 F.c.
102C 000 100 100 63.60 63.60 66 75 19 80 90 70 114623 80200.1.0 10 6 2.0 8.0
�-Description Rate Sgeare Feet Repl,Cost MKT.INDEX: 1.00 IMP.BV/DATE-^ML-5/_88-SCALEi'_„1/01.00 ELEMENTS CODE CONSTRUCTION DETAIL
S SAS 100 63.60 1008 64109 GROSS AREA 1092 TWO FAMILY.DWELLIN6 CNST GP:00
UFO 6t0 I38.16 84 3205 *----- k'-- --=----------
STYLE 17 0
FFU 25 15.90 32 509 ! ' S - - UPL------------- .01
R I I ESIGN ADJMT 00 O.QI
O i ! -XTER.WALLS 11 OOD SHINGLES O.O
C ; EAT/AC TYPE 07 AS-HOT WATER 0.0
_
T N TER.FINISH 07 RYWALL/PANEL_ 0.0
NTERLAYOUT 12 VER./NORMAL 0.0�
! ! LNTER.
R RUALTY 02 AM_E AS EXTER._ .0.0(
R 24 BASE 24 FLOOR STRUCT 02 D JOIST/BEAPq O.Oi A
L D W ! ! E_LOUR COVER U6 ARPET & VINYL_ 0.01
E T t tar a5 Au=a 32 Base s 1008 ! ! OOF TYPE D1 ABLE-ASPH SH O.O
BUILDING DIMENSIONS ! ! _L E C T R I C A L_ _L71 V E R A G_E_ _____ 0.0'
T BAS W42 UFO S02 E42 NO2 W42 ..
A � OUNDATIUIV 01 OURED CONC 99.9I
HAS N 24. E42 S24 .. ! --------------- --- ---------------------
NEIGHBORHOOD 61AC -k-f ANNIS
L *-----------------___42------------------X LAND TOTAL MARKET
*-------------------UFO-------------------* . PARCEL 21300 101500
AREA 2848
VARIANCE +0 +3463
STANDARD 25
}
]BUILDING V
-..gut...:..::.::::::::::::::::::::::: 403 ........... SER ICES
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ILL TRY A GAIN
G OWNER WORKS
O KS AT
HYANNIN.
S P. O.
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De 7 23 96 l= 307 246
of ' MURRAY WAY REALTY TRUST
ME
54 s MURRAY WAY
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Receipt for Certified Mail x.
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Sent to F-r
Street&Number
Post Office,State,&ZIP Code
Postage $
Certified Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing to
Whom.&Date Delivered
n Return Receipt Showing to Whom,
Q Date,&Addressee's Address
0 TOTAL Postage&Fees is
Go
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Stick postage stamps to article to cover First-Class postage,certified mail fee,and
jcharges for any selected optional services(See front).
1.If you want this receipt postmarked,stick the gummed stub to the right of the return
address leaving the receipt attached, and present the article at a post office service
I window or hand it to your rural carrier(no extra charge). 12
M 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the. Q)
return address of the article,date,detach,and retain the receipt,and mail the article.
P rn
3. If you want a return receipt,write the certified mail number and your name and address
A on a return receipt card,Form 3811,and attach it to the front of the article by means of the
gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article
RETURN RECEIPT REQUESTED adjacent to the number.
4. If you want delivery restricted to the addressee, or to an authorized agent of the
addressee,endorse RESTRICTED DELIVERY on the front of the article. M
5. Enter fees for the services requested in the appropriate spaces on the front of this
receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. ro
6. Save this receipt and present it if you make an inquiry. a
ai SENDER: I also wish to receive the
:o ■Complete items 1 and/or 2 for additional services.
rn ■Complete items 3,4a,and 4b. following services(for an
H ■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you. ai
j ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address
permit.
y ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery to
« ■The Return Receipt will show to whom the article was delivered and the date a
° delivered. Consult postmaster for fee. B
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E f 4b.Service Type
° W C� t ❑ Registered [3—Certified ¢
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p 5.Received By:(Print Name) 8.Addre ee's Address(Only if requested
and Me is paid)
6.Signature:( dressee or Agent)
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PS Form 3811, December 1994 Domestic Return Receipt
UNITED STATES POSTAL SERVICE R 0, ' ----- ^-�'Fitst Class Mail
oJ' �� - xPstaggA Fees Paid
PM o �- USPs__
Pifmit No.G=10
• Print your name,,address, and ZIP-Code In
Town of Benbble
Buildip Dillon
WMdn
Hyamis�MA OW
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liit{Hi M liiilli mli}}ill}11311111111d i11A ll11 Will till
�"�IE tp� • .�Ite Town of Barnstable
snxxsrnai,E, •
9q� 1659. `0�' Department of Health Safety and Environmental Services
ArED�n►'t° Building Division
j 367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
March 7, 1997
Marion F.Erb,Trustee
Murray Way Realty Trust
25 Old Phinneys Lane
Barnstable,MA 02630
Re: 54 Murray Way,Barnstable
Dear Property Owner:
A recent inspection revealed that your building at 54 Murray Way in Hyannis is a lawful two family
structure but is currently being used as a rooming house. Please contact this office as soon as possible to
discuss this situation.
Sincerely,
Ralph M. Crossen
Building Commissioner
` I
RMC/km
CERTIFIED MAIL P 339 592 275 R.R.R.'
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MESSAGE i
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YY�cb-r to OPERATOR:
7 23-024-4 0 SET 23- 27-200 SETS
TO TIME DATE
• ����i .E Y®Q..� ���E �1["'�" (�IlR6EAT!' [�telephoned
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; your call sge you'' <.
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PHONE ❑ WUttallJ You7l
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MESSAGE
OPERATOR:
23-024-400 SETS 23-027-200 SETS
TOWN OF BARN STABLE
-�'"J REPORT S EMDNTASY/CONTINUAT;��PORT
NAME (LAST, PIRST, MIDDLE) � � � DIVISION /DaP7
NOTE DETAILS i OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL /S ETC- C`�Ji`✓1
Lc e---)c- a-v
aSUBMITTED BY /\ �—— PAGE t
__
Engineering Dept.'(3rd floor) Map Parcel -G # �S
House# Date Issued
- 0) Fee
s
Conservation Office(4th.floor)(8:30- 9:30/1:00-2:00)
Planning Dept.(1st floor/School Admin. Bldg.) INS
Definitive Plan Approved,by Planning Board 19
-- - BARNSTABLE.
MARFL
TOWN OF BARNSTABLE
Building Permit Application
Project Street Address 4Z611?.Z,A U Ul A k I
Village
Owner Address a,L P 115711,,' v e- ,�,,, e—
Telephone
Permit Request /7' sUd C—
First Floor square feet Second Floor square feet
Construction Type S %v�% Z,v Gad S/,
Estimated Project Cost $ �
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure 3 PASS Historic House ❑Yes )S�No On Old King's Highway ❑Yes �JNo
Basement Type: )bffFull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing 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: Q Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes , No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review# -
Current Use Proposed Use
Builder Information �7
✓ivame y D,�SltYiV 1?19 �,,��Tlelphone Number
_,--'Address/? /=As 7' License# 0 3 �;
Nome Improvement Contractor#
�,s c��✓ C/,/��A�� Worker's Compensation# WC 62-Cj/ .3 S-J d
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 ��5i��P._
LB��ILDING
GNATURE DATE
PER T DENIED FOR.THE FOLLOWING REASON(S)
n -
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1
= FOR OFFICIAL USE ONLY "
PERMIT INTO.
DATE ISSg1ED
MAP/PACEL NO.
} ' . �z
ADDRESS VILLAGE
OWNER `
DATE OF INSPECTION:
FOUNDATION _
FRAME
INSULATION -
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
dF WE r
The Town of Barnstable
• asr�arE, •
9 'G 10� Department of Health Safety and Environmental Services
1 Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
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 done by registered contractors, with
certain exceptions,along with other requirements.
Type of Work: S'd��h� o �/���°' �SEst. Cost S ��
,.__Address of Work: 41V r S 17
Owner's Name I'LIZ
�ateofermit Application:_ 9
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000.
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Da Contractor Name Registration No.
OR
.._._ (lwnPr)c Name
• The Cunrntunseculth of Jhr.,rsuchusctts
_~1.-- Departmemt ojlndustrial Accidents
r. O�cEa//mrest/gativns
6011 If ashing-wir Street.
Bttstutt.,Huss 02111
Workers' Compensation Insurance Affidavit _
AlPlc�se PRINT '""""..._"_"""'_..._-..,,—._-r.�__-- —•- -
vlvliFi t inforntati6i :' _,.. 1 W
/JZ 4 (1
,,. •>y s-
❑ 1 am a homeown r performing all wort- myself.
,_& ' am a sole proprietor and have no one working in any capacity _
.. �F..•�_/.F•rI_..��..._ .A:7MrII.�t�R7- �7�wa�T�P - _ _ __ _ .�.�t�..F•....�.i__M.R..�..���-
❑ I am an emplover providing workers' compensation for my employees working on this job.
entominv name- 9^ b &U
ndtlrccc• li`O�S� //l�/�V
/sue a
city. �� i�' e-� hone
incurnnrc rn Z�6d !f /e14 AJ �f��//i�.[, �✓ ""He•# G p o --2S—,2 6)
❑ I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have
the following workers' compensation polices:
cmmrnn,%• nnmc• -
:ttitirccc•
phone#-
incurnnrc ro "nliev#
cmmmnnv nntnc• - —
adtlresc-
rite "hone#•
incurnnrc Co.-- Policy#
Attach additional Sheet if necessary_ _ "' -= -•• ~`�w: ��:'�`�
_ __ Y.% i��V it y„•_•�itil•r..—•..ML'wssL
Failure to secure coverage as required under Section ZSA of t11GL 152 can—lead to the imposition of criminal penalties of a line up to SI.500.00 andiur
une�cars* imprisonment:I. .•ell:ts ciVil Penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a dad•against me. I understand that a
cope of this statement mac be 1'urn'arded to the Mice of Investigations of the DIA for coverage:verification.
I r/o herchr certrft to the punts at ruattics of perjure•that the information provided above is true
and correct Si2natom' Date
Print name .���, t� .g Phone# �� U
Wrrir t�
f official use univ do not write in this area to be completed by city or town ofticiai
' permitilicense# r7lBuiiding Department
gin or tm�n: (]Licensing Huard
(] check if immediate response is required (]Selectmen's Wier
l]11calth Department
contact Pen-on:
phone#• rJOIltcr_ g.
Information and Instructions
Massachusetts Cc:neral laws chapter 152 section 95 requires all employers to provide workers* compensation for th
employees. As quoted from the "laW_- an en"Plnree is defined as every person in the service of another under an%
contract of hire. express or implied. oral or written.
An emPlnrcr is defined as an individual. partnership. association. corporation or other legal entity. or any two or me
the foregoing ens:a`_ed 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 t!
owner of a dwelling house fraying not more than three apartments and who resides therein. or the occupant of the
dwclf ing house of another who employs persons to do maintenance , construction or repair work on such dwelling he
or on the ;,grounds or building appurtenant thereto shall not because of such employment be deemed to be an employ
MGL chapter 152 section 25 also states that even-state or local licensing agency shall �wiililiuld flue issuance or
of a license or permit to operate a business or to construct buildings in the commonwealth for an•
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
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 as all affidavits may be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tire
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 require
to obtain a %vorkers' compensation policy. please call the Department at the number listed below.
City or'I"o�yns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. PI:
be sure to fill in the permittlicense number which will be used as a reference number. Tile affidavits may be returned
the Deparnnent 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 questic
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. O2111
•� fax #: (617) 727-7749
phone #: (617) 7?7-4900 est. 406, 409 or 375
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CONSTRIfC'TION SUPERVISOR.LICENSE
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P 0°BOX 321
HUHPEE, NA 02649 .
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