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0024 NEWTON STREET
r �� ��� r, �f j I�- ��� / ��� � m #,2 43 319142 . ,s . / • . 319037 a - ���/ , x �\ � y �•►+� Town of Barnstable Building Department Brian Florence,CBO z63q. A�� Building Commissioner �D MIS 200 Main Street, Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 John Throckmorton ' 615 Quaker Rd. North Falmouth,MA 02556 6/5/19 Re: 24 Newton Street, Hyannis Dear Mr. Throckmorton, The Building Commissioner has reviewed the subject property information and has determined that we do not have sufficient information to grant your request for a separate service. I am returning your application as previously discussed along with your payment. WSinc ly, Sa ly Shea Town of Barnstable Assistant Zoning Admin/Lead Permit Tech. 508-862-4031 signs/signrequ&app revised: 9/22/17 r p t t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application #a 6 L� I 1 Health Division Date Issued—7 Conservation Division „ Application Fee Planning Dept. Permit Fee I� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner Address Telephone W 5 -le`�3 `/ Permit Request i�L�l t9T 1 v� 0.1% %I� -2 f 14 TeR y L L4) .Square feet:.1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 2el Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other t�oflcT 4-L Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing l new Half: existing new Number of Bedrooms: / existing Zaaew Total Room Count (not including baths): existing 2— new First Floor Room Count Heat Type and Fuel: Q'Gas' ❑ Oil 219lectric ❑ Other v S2 ZE Central Air: ❑Yes Flo Fireplaces: Existing New yl Existing wooV coal stots ❑ es W446 Detached garage: xisting ❑ new size—Pool: ❑ existing ❑ new size _ Barn:19L3 existing nevi 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 O'rN Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ��� alpec k r Telephone Number 775--4? z3 �X' Address License # Home Improvement Contractor# Email 47 K'—' t��/K F�c Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L� j �Z--e , ,r-2c VC 1 c j SIGNATURE � DATE —2yf FOR OFFICIAL USE ONLY t APPLICATION# DATE ISSUED MAP/PARCEL NO. .µ i ADDRESS VILLAGE P 4 f ' OWNER c DATE OF INSPECTION: FOUNDATION FRAME s INSULATION FIREPLACE ELECTRICAL ROUGH FINAL T PLUMBING: ROUGH FINAL k GAS: ROUGH FINAL "., AL BUILDING D/4TEZLOSED OUT ASQCATIQN PLAN NO. z , I 77je Commonwealth of Massachusetts De-pasrtrneitt of Industrial Accidents 09we of Investigations , 600 Washington Street Boston,ALA 02111 "m7.mas&gm,1dao Workers' Compensation Insurance—Affidavit:Bunlders/Contractors/Electrician/plumbers , Applicant Information Please Print Legibh7 Name Musinesslorgsnimtionibdividosil: Address: Gityi'StatelZp: ��/?� � � t ` 77 3 Are you an employer?Check the appropriate boa: d I }� of t project t l I Type �. am a genera contractor an p ]ect(required): 1..El I am a employer with ❑ 6. ❑New o nastntction loyees(full and/or part-time).* have hired the sub-contractors2..2 Ma a sole proprie.tar or partner- listed on the attached sheet. 7. odefing ship and have no employees Thee sub-contractors have S. ❑Demolition working for me in any ci employees and have woz s' capacity. I 9. ❑Building addition [No workers'comp.insurance comp.insurance. required-] 5• ❑ We are a corporation and its l0. (ectriml repairs or additioiis 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑'ll'umbing repairs or additions myself (No workers-co-op. rightt of exemption per MOM 12.[�Ioof repairs insurance required.]l c..152,§1(4),and we have.no employees.[No worm' 13_❑Other comp.insurance required.] 'Any appic=thai checks box IN earl M o fill out the section belo ,showing theirwoikers'compensation policy ioformaieon. Homeowners who submit this affidn-ft m&zstng they nee doing all wotis and than hire outmode contactors amst submit a new affidard indicating snrh Contractors thst check This box must attached au additional sheet slowing the name of the sub-contm.,tors and state whethea oa not those end s hEve enrpioyees. If the subdontracturs hn-e employees,they must provide their workers'camp.policy number. lain an empdoyer that isprosiding workers'compeasadan insitmne4 for gray ernpdr/yee& Below is flea,policy+road job site inforaaaraE an. Insurance Company Name- Policy 4 or Self--ins.Llc.#: Expiration Date: Job Site Address City/Statelzip: 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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the farm of a STOP WORK ORDER and a fine of up to S250.00 a day against the violatar. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage.verification. I do faereby c r`aanader the pains andpenatiies e�,j',peditry that the inforinartiorlpr oWdedabove is trrw and correct Simature.: %" Date: Phone#: 5V IR 77 Y-- 6 Z 3 y' Official aura only. Do not avrite in this meat,to be completed by ciO3 or town offiiaaat City or Tower: Pernat/License f Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector h.Other Contact Person: Phone# Town of Barnstable Regulatory Services of Richard V.Scali,Interim Director Building Division BARNWABLL ` Tom Perry,Building Commissioner MASS. ' r� 1639. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508462-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: .,�./ JOB LOCATION: Z `V 4?kl L *e 'ir_ number -/ n street village "HOMEOWNER": T(�/ (S alzeCA-/ name home phone# work phone# CURRENT MAILING ADDRESS: �e[ov C2+ city/rown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection propodures and re trements and that he/she will comply with said procedures and requirements. Vfnature 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 t amend and adopt such a form/certification for use in your community. T:\KEVIN_D\Building Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 Parcel Detail Page 1 of 3 HE fq 07 s Logged In As: Parcel Detail Thursday,July 24 2014 Parcel Lookuo Parcel Info Parcel ID 308-166 ( Developer PA CR EL 'EDNA B FREEMAN" Loth I Location F24 NEWTON STREET I Pri Frontage80 I Sec Sec Road ! v Frontage! Village[HYANNIS ( Fire District HYANNIS Town sewer exists at this address Yes I Road Index Interactive ^y Map Ii 1 - Owner Info r_ __. Owner[OTOOLE, MARY L ESTATE OF _I Co Owner'' ._%GORECKI,JON Streetl 24 NEWTON STREET ( Street2 City[HYANNIS I State iMA Zip j02601 Country 11 - Land Info Acres 10.27 Use Two Family I Zoning F RB Nghbd 0105 TopographylLeyel I RoadIrPayed , Utilities All Public Location Construction Info Building 1 of 1 Year(____ StructRoof Ext MT 2 Built I1925 Gable/Hip Wall[Wood Shingle I �f Living("'"��741"" —'— Roof As h/F GIs/Cm AC on " Area I1 I Cover p p Type Style iConventional I Int Drywall I Bed[3 Bedrooms I s 4 Wall Rooms Bath Model Residential Floor Carpet I Rooms F2 Full I Grade Tol Average Minus I Type Hot Water I Rooms 8 Rooms stories[1.3 I Heat Fuel Oil Found ation Conc. Block oP Gross Area r2235 i Permit History _..... http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=25025 7/24/2014 4 • Pa a#18 of 28 Building Sketch Borrower Jan GoredA 3. Property Address 24 NeMon St city H annts Colm Barnstable State MA Zip Code 02601 Lender Hingham institution for Savings " 15' 11' 2' N Unit#3 Bedroom/Living/Dining [730 Sci ft] . N r ath B Laundry Kitchen ; Q 6' IC, o 8 Foyer Q 3Y 28' r. Unit#1 ip [3064 Sci ft] ¢ath 3 First Floor Bedroom Attic / Kitchen 00 M - Bedroom [] Unheated, but a Second Floor ` -+ Finished [224 Sci ft] Living Dinin 16 28' i Porch /,I� rarusrsr y•6.xa.•`x Area Calculation Summary Ca kuta'tion Deta[tc - _ _;....�......e:-..�ec1.u...�_ Unft o l 1054 Sq ft 28 x 38=1064 . Unft82• - - 730Sgft .28x22= 616 9 x li = 99 - _ 3x5 = 15 Second PA w 224 Sg ft 14 x 16= 224 Total Living Area(Rounded): - as 2018 Sq ft Form SKT.BIdSkl—'WmTOTAL'appraisal sofhvam by a la mode,inc.—1-800•ALAMODE s � bc� r - M V)c 1'i' IS IS VA%, p 2� . C � I F gee r o s � r 5 ` Printed Ong 6l5/2019 . Complaint Gall e,port � ° 24 NEWTON STREET, HYANNIS 9 ?lABR 0q 67q. �0 rfD MAya _ Cdse4w lr^1.7 72 T "4 3 Case#: C-19-472 Address: 24 NEWTON STREET, Date: 6/5/2019 HYANNIS Owner Info: Property Info: GORECKI, JON MBL: 189 WELLS AVENUE 308-166 NEWTON MA 02459 Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Zoning, Low Priority Phone Complaint Summary: New owner requesting separate service to second unit in a sf home constructed in 1925 but reported as a SF in 1982 when they created an addition. Action History: Action Taken Date Description Fee Inspector Inspector Assigned to Complaint: amaraw Filed by. andersor Comments: Comment Date Commenter Comment 6/5/2019 andersor Owner must prove NC rights to additional unit prior.to receiving approval for 2nd service per BC on 6/5/19. r ': ary t'wtiza'�Ip ri;a i+ uw!, cb�777 Date. 6112019'' ,,, Town of Barnsfalile r !-f 65H Town of Barnstable Permit# Expires 6 months from issue dale `7 Regulatory Services Fee B MrrsrAsi.E. : Q� 9� Mass.16;q. Richard V.Scali,Director �0 ATED MA'1� Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us IM®F� Office: 508-862-4038 ` "5 -' WE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number-3 Q g I �P-roperty-Address_-.:?V "Vaccl—JOxj ❑Residential V-alue-of=Wor-k-$_b-_,��`�' / Minimum fee of$35.00 for work under$6000.00- Owner's-Name&Address-—, 6 d'2�G�/ 2-1 Cbntzactor's Name-"'4r- Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance e�'he one: m a sole proprietor ❑ I am the Homeowner x ❑ 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 Y ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors:- .� 3 Smoke/Carbon Monoxide detectors 4'floor plans marked,witti red S and inspections required. Separate Electrical=&-F►re Permits requtredY`'"` *Where e requiredrIssuan ec 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 of the Home Improvement Contractors License&Construction Supervisors License is uire . Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 Town of Barnstable Regulatory Services �snxiUS& Richard V.Scali,Director ��EDMA�A,O Building Division ---- TemTerr-y,-Building-C-smmissioner -- 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Most _ --Complete and Sign This Section If Using A Builder I, Qtttj b creCl- 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. ' nature of Owner Signature of Applicant t Print Name Print Name 7-W * . Date Q TORMS:O WNERPERMISSIONIPOOLS Town of Barnstable Regulatory Services 1HE T°y Richard V.Scali,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 CFO www.town.barnstable.ma.us Office: 508-862-4038 Fax: S08-790-6230 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-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. 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,RuIes &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,a.s 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:\WPF1LES\F0RMS\building permit fonns\EXPRHSS.doc Revised 061313 i o The CamynairzywaMi of-missachmsevs Depart_wmt ofhxrlruaial Accidents - - - -- - — ---_ -- (# r'r�s i to Street------- -------- - — - - - - - Workea-s' Calampensafiuxxlusnm-ac davit:BaiilderslConh-a_Efnrs/EiecfriciarnsTlumbers Applicant Infermation Please Print LejriblV mffndtvidnaq_ Phojae 4 Are you au-employer?Check the appropriate bes�c: T 'ect t r 4-_ I a3ri a:general contractor and I Yl�of�'o J ���, L El I am a employer with ❑ $ 6_ ❑New ocrostiis_6o. loyees{full andlorpart-time}* li?vehired the sub-contractors. I a n a sole proprietor orpartaer- listed on the attached sheet 7- odeliag slstg have no employees ThEne sub-contractors have S_ ❑Denwlition- -,-AmA ag for me in any c c+ r_ employees and have workers' � � - 9- ❑Building ad'ditiou comp-ms ra o-wa± err' comp:i�v,ran�e rx�I e� 5_❑ �5ie are a corporationand its i{1_.❑Electrical repairs ar additions �. re�urr officers have exercised t3heir 11_. piumbin airs or additions 3_❑ I am a homeou ner doing ail work ❑ g� myself [No workers'cone- right of e�aptionper MGL try❑Roof repairs insi rA e regotred_]I C_152,§1(4} and wehav j2o employees_[No wtirkers' l _.❑O#hear comp-in ct ice requ'md-1, Any spilt f t checks boo rl mist Oso,91 o'at the section below<t:rt�.-;�v ih&wo:kers'coupensadogi policy nndumm6o3 t Anon_s Who subznt mic amdsvrE immcst>ng they ate rlomg.1T'e�sad thEn hire outside contractors nmst skit a nL:rffidsvit mrstin snrT, ICbmacmrs 6-t rF+ork this box mist sttschrd as arkbri nsI sheet shocrmt; hen of$�sds x�m3 stub whemec oenut ti~nse 02hieS TZVa employers_ Ifih°5-LI—cDntaactms lyre empIoyees,thV must provide shier wn€kem'comp_policy number I o�ari arrtg�r thrct is prr�nn�ic��rt�or�e-rs'conrparrsrrfivn arrartFrutcr�f at-mar e. y��, $slvtF is fate pa&c}artd�ob ait� informato:z Insurance CompaName. Policy 4 Cr Self iap-l ic_:k Expi ratiort Date: Job Site dffi-ess: City/StatelTsp: Aitach acopy of the workers'compensation policy declaration page(showing the policy rfumher and Expiration date). 1 ailum fx)secare coverage as mquiredunder Seetsosx 25A o€MGL c. 152 can lead to the imposition ofcrimival penalties of a fine up to$1,50t1_Qa and/or one-year impriVD=n=t_as well as civil penalties in floe farm of a STOP WORK ORDER and a fine of up to$250-00 a day against the violator_ Be advised that a copy*of this t rmy be forwarded to tb e Office.of Inrestigxtions of flae DIA for insmmce coverage:verification_ I dd hLzreby certify rr Lss afpedwy hhat the informaftan prataded above fr hiss and correct c.� f"�I3ate;_-•'', phone, "" Z�, tJ S `( ` w Of Ec iaL use anly. Eta ire,sprite in this area,:a bs completed by cita:or town off-iciaL titer or Town: _PerrrFitll icesue# Fssuiag Autharrty(arcle one}_ 1•Board.of$ezdtl Buif&z g Department -k GitWTawn Clerk 4.Electrical luspec#or S.Plumbing LTector 6.Gher Contract Far::un. f phone#: 6 information and Instructions x Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 Iegal representatives of a deceased employer;or the receiver or trustee of an individual,paTtriershilp,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 appu Tenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also s ass thhat"every state or Iocal Licensing agency shall withhold•tlie 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 requi eCi." Additionally, MGL chapter 152, §25C()states"Neither the comuzonwzat_h nor any of its political subdivisions shall enter into any contract for the per-iormance of public work until acceptable evriderice of compliance vriL`r the ins=ace requirements of this chapter have been presented to the contracting au horny." Applicants Please,fill out the workers' compensation a,1i davit completely,by checcin.g the boxes that apply to yr,LIr Sinai on and,if necessary,supply sub-contractors)name(s), addresses)and phone nxraber(s)along with their cerri:fic;se(s) of insurance. Limited Liability Companies(LLC) or Limited Liability Pa,-tne„hips(LLP)veith no e1mnloye s other than the members or partners,are not regrired to carry workers' compensation iLsirrance_ if an LL.0 or LLP does have employees, a policy is requil-ed_ Be advised that$_is affidavit may be s.binifted to the Depar'Lment of industrial Accidents for confirmation of insmance cove_oge. AIso be sure to sign and date the affidavit. Die affidavit sbo��ld be returned to the city or town that the application for the permit or license is being requested, not the Department of Indusb-ial Accidents. Should you have any questions regarding ule iavz or if you are required to obtain a workers' compensation policy,please C2:d ill=-Depz-tm mt at the number listed below. Self-inc xi d companies world enter their self-;nc,,,�nce license number on t;•e anpropriaie line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Depar'unent has prodded a space at the bottom of the affidavit for you to Ell out: ahe event the Office of investigations has to contact you regarding he applicant Please be sure to fill in the pern;it/Lcense number which-,,U be used as a reference number. In add itiaa,mo applicant that must submit multiple permit1cense applications in any given year,need only submit one arffidav it indicating cu,_rent policy information(if necessary) and under"Job Site Address"the applicant should vi rite"all locations in _(city or town)."A copy of the affidavit that has been officially stamped or marked by use city or town may be provided to the applicant as proof that a valid affi:33vit is on file for fUtarre permits or Licenses. Anew affidavit must be'Eled out each year.Where a home owner or cia en 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 ajii da�,•-it The Office of Investigations would IL,ce 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 hx number: Thet Con-imo rwm-an of M�machus�tts - De aztcnent Qf hidustial Aocid�; s Off((e of kvesldotiaus Bostou,MA G2III Ttl,,4 6I7 72749-GG(xt 406 or I-977 N-LkSSATE Revised 4-2 -07 Fax#' 6I7-727-�1 9 j Bulling Sketch Borrower Jon Gorecki Properly Address 24 Newton St City Hyannis County Barnstable State MA 7jP Code 02601 Lender Hingham Institulion for Savings ®KE WRS REVISED FIRE DEPARTMENT BOTH SMATURESARE REQUIRED FOR RERMITIAO 15' 11' 2' O(1 N unit#2 Bedroom/Living/Dining [730 Sq ft] N ' N Bath Laundry Kitchen 6' L/,L o. 8' Foyer 3' ' 28' 11 Unit#1 � [1064 Sq ft] Ba First Floor dr Attic en w 16' µ" w om ❑ Unheated, c but Second Floor Finished ° [224 Sq ft]. Living Dining 3 16' 28' Porch a TOfALSk-i'4•m 10.,"` Area Calculations surnrnary . Unit 01 .`a. 1064 SCI ft 28 x 38�=1064 - - Unit#2 730 Sq ft 28 x 22= 616 ' 9 x 11 = 99 3x5 = 15 Second Floor 224 Sq ft 14 x 16= 224 Total Living Area(Rounded): 2018 Sq ft Form S0.6101—'WinTOTAL'appraisal software by a la mode,inc.—1.800-ALAMODE Assessor's map and lot number .. . ... A� SEPTIC SYSTEM MUS' Qy°F7 ETO�`f °S wage Permit number ........� _..33.L I�1 I STALLEI�. J C}MPL14 s lB . 9TdD E •� Mouse number. ................................:.............:t......................... r 0 WITH TITLE 5 M�a - ENVIRONMENTAL CODE . .1 39*A,�m TOW hpfCVIATIONSY TOWN OF , -BAR.NSTA RUILDINO INSPECTOR ,. APPLICATION FOR PERMIT TO .... v ( .` •� TYPEOF CONSTRUCTION ..............:�j�1,�.... .......... ...... ........:.................................................................... . 1 r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby / applies for a permit according to the following information: Location ,I1�.Q.!k'...1..�..St .......................................................................................:::... .3....... �........ ...... Proposed}Use ............... .►.t>..7. Zoning District ...........r ..................................................:Fire District Name of Owner...... .:(..hka .�..... ....To.2./.c.............Address . r► > Name of Builder" ..../5..f::! .....� M. ...............................Address .......' ` 2.?)'t.!..4............... Nameof Architect ..................................................................Address .................................................................................... It J Numberof Rooms ................ .................................................Foundation ...... ................................................ Exterior Q �' SIB 7 ...........Roofing .......kuka ( Floors ......................................................................................Interior .................................................................................... Heating0�.:!a:...Y:.......................................:..............Plumbing ...F.`.'.. . .:.6.. ................................................:... " Firp ... e lace ...........................................�......................................Approximate Cost ....................� .............. . . Definitive Plan Approved by Planning Board -----------_-_____------------19=______. Area ............. ......��... ....... Diagram of Lot and Building with Dimensions Fee f. .................. .... ..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH C N - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name ............ ....... O' TOOLE, MARY ' 24IL ADDITION No Permit for Single Family Dwelling Location Newton Street { .......................................... Hyannis { ................................. ............................................. ...Mary.. O...Toole............................... s Owner Type of Construction Frame c 1 `. + rti j jv F•r F � + Plot .............:.............. Lot;- ............................... Permit Granted .....Jurie...2.8.t...............19 82 1t rl r• IT Date of Inspection �. / 9 j # j ;d`� '�•` -�^;, } Date Completed ........... .19 t � (. } � -e, _ i • to � - _ ,,� { i ' , u�^^� / �� �` . Assessor's mop and |o* number Z<.��---�.e/^/�' !Prwage Permit number --.. ................... \W�wue number '-----------------------'` | � r0��-���'7l�T �-��� ��v � �� l�T�3r�� � ��l� �� --- . . TOWN��� |"� � ��� ��� �� ���|"� �� ]� �� �� ����u _~ ` BUILDING � NN N N �� � . �� N0 N 0-NN N N ' -r . APPLICATION FOR PERMIT TO -..����� .--...�:|.-..-.--.---'^..-... |� TYPE OF CONSTRUCTION ................!-L/��//^.iL-'�'�/-.�..�-..�--.--.--.--.--.--.-------_ -,....��.��.�-...��.--.l��..... - � * ' TO THE INSPECTOR OF BUILDINGS: ` The undersigned hereby applies for o permit according to the following information: Location . �� ��........... /,��-+.���-.Lr .............. ` ��.��/J�n....................................................---� — -� � - ' / �.---..-----.-.---. ProposedUxe ...............................e.�---------.-----------------_..------.-.--------- � i� � Zoning District -.�--�-k�--.:.��.m..^�—�.'�..���-.-R[�'��h�� --��..........���z.��.....-.^..-, � ..---'--`.. ~' � ' . / [� Name of Owner ..... l /l ----.A66res ---------......................................................... | � ' Nome of Builder' !l-. .----------A66res �^T���J>���/e�� �~��--../.`�����l�r�.L.---, . ' � Noma of Architect ----. -----------------�A66re� --.� . .. - . .. . .. - .. .� Nnm6er of Rooms ----'~�.---------------.�Foundohon --�^-�./���.��.-.---..------_-__ � ' Euehor --.. T-....f%....�...J����--------------- | ' ,0'[��.�..�../..� ..................................................... . . - Floors ------`-------.-------------. Interior --------____________________ Heohng --F/...') ...�.!....------------.---- m6ing -. .............................................................. o Fireplace ---..~--------------------..--ApproximateCos .______../�mo � � Definitive Plan Approved 6v Planning Board 19----. Area ---- A� / ^ ~ Diagram of Lot and Building with Dimensions - Fee ............. ---' SUBJECT TO APPROVAL OF BOARD Of HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLAGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above | ' ^ } ' ~ v" ------'--�� � ~^ ) 1 , =a ! ' > | | / ` - [ � - } ' '_- ... /�%Z� --.----.—..-------��--------. � | O'TOOLE, MARY A=308-166 241I7 Addition No ................. Permit for .................................... Single Family Dwelling . ................. .............................. ............................ Location� Newton St...reet ................................................................ Hyannis ............................................................................... Owner Mary O'Toole .................................................................. Type of Construction ........Frame .................................. ................................................................................ Plot ............................ Lot ................................ June 28, 82 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 s—Ar's map and ;lot numbert-� �1'.:.:/. ...............7.��� I ®OFtHEtO z:�EpflC SYSTEM MU S wage Permit number l,Ct..� ..��G : INSTALLED Ely COMI House number; =....:.........................:..:.....................::.... .... #` / O I�N a e 11DLE,� TITLE AsasT - B MABa TOWN REGUL ATII0S� m a. I O W l� OF ,--BARNSTABLE S s BULDI INSPECTOR APPLICATION' FOR PERMIT TO' ..... .. ......................................................................... TYPE•OF CONSTRUCTION ... ..... I ......... "y' , ........... ....................19� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby �applies�foorr;a permit according to the following information: Location ........ ✓.. Q"" l (3. $ .v .��.......... ProposedUse ......... ..............................:.........:.......:.......................................................... ................................... Zoning District .........,�. ..................� ........................................Fire District ...... .� ..C`�:h: rya,:... .........................0............. Name,of Owner ..... ...........�7.....C /........ ... .. 2.:Address .................................................................................... Name of -Builder' ..-kl :ra....�1... .!r}.�C.!. ..............................Address /� V?»�.,s�• ..1.!Ve.s,i... � � ?.h'!!.d j. ........... Nameof Architect ..................................................................Address ............:.........:'.................................:....:.....'.................. Number of Rooms .......... ......Foundation .........: . i r..........Roofing Floors ......CY.i.?.Iixtk)............................................................Interior ...S� ce,P!w .........:::...................:................:......:.. a - i Heating .........................Plumbing Fireplace .............................................................. Approximate Cost �� ........... Definitive Plan Approved by Planning Board ----------------------- C-pIV t 9--------• Area ............ Diagram of Lot and Building with Dimensions Fee ...................................:........: SUBJECT TO APPROVAL OF BOARD. OF HEALTH ' 4 7-/ - a . 7 qpp go .{®>gg��`�Ce, Saw OCCUPANCY PERMITS REQUIRED F NE OR W DWELLINGS i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... ........................... ........ O' TOOLE, MARY 44, 2 c II�Permit for ..��u.i.ld. ...o.rme.rs .. .. .... .. ....... .... .......... r .u-1.1d . 0 /�3per r�)we 1 ng............. ............... S t Location ....�.4..AqKto.. ....S. ....ee.t.................. ...Hyannis.. ................ ......... Mary L. O' Toole t, Owner,.................................................................... Frame Type of Construction .......................................... ................ ................... ................ ............................ Plot ............................ Lot .......... Permit Granted ....April 13, ...19 82 .................... Date of Inspection lkr� ........ ................19 Date Completed ........... ..19 —.1 ....... ,' Assessors map and lot number .. �F TN E t0 sewage Permit number�+.!a.. ,�,... �r� Z EAUSTABLE, i Ause number ........................................................................- ro MM& p i6}9• 6� ti 0 NO Or TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....l a�C.. � ;f.( .... l.; 'Y'!'! J .................................................... TYPE OF CONSTRUCTION 4.. t .. 19� , ..................... TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby/applies for a permit according to the following information: Location ....... ................. ................................................................. ...................................................................................... ProposedUse ........ .,.,. ............................................................................................................I......................... Zoning District .......D!. ..... .................................................Fire District /+'t r �� / f ..... .�:...y. .................. ........................ Name of Owner / ! °r .!.. v f @ Address � f ............................ ry Name of Builder' . !�.P. ...d ..!�?. ..! 1I...............................Address t �!u�w,.�c. 3 !„tk,{�.....'....�'��: .. .............. JName of Architect .......................................................:..........Address .......................................................:............................ : Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ..........................:........................................................Roofing ... ..................................................................... Floors .... .Y.1 1 In#eriorr - !� �.........�...... ........... ........... .......................... Heating .......................... .................... . .................. ........PI,6mbing .....�.. f ............. Fireplace ..................................................................................Approximate.Cost k . ..............................:....................... Definitive Plan Approved by Planning Board ________________________________19_ . Area !..�!! ......�a� ".............s Diagram of Lot and Building with Dimensions Fee ........ •................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH .� . —7 f 3Q, f OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of`the Town of Barnstable regarding the above construction. Name `...J ;......... � ....................... O'TOOLE, MARY L. .17 No 2395 Permit for Build„Dorz� Single Family. Dtite]„lg,,,,,,,,,,,, Location .24...Newton Str� „-,,,,,,,, Hyannis ............................................................................... Owner ..Mary...I:�...0 T...... ........................ Type of Construction ................................................................................ Plot ............................ Lot ............................... , Permit Granted ......April. . ...13. ..r-„-,,,,,.19 82 . .. .. .. . Date of Inspection 19 1 Date Completed ......................................19 rnr �� 00 `alp CAPECOD INSULATION F14f0.Yu77 3[Anl[S3 f10.AT FOAM 7Y7I{nP4P _ 4ARi uu Riii INfY431pN Cf141NYi t ' 1-800-696-6611 'T'own of Barnstable Regulatory Services Building Division 200 Main tit Hyannis, MA 02601 Date: 1/4-4 .Dear Building Inspector H Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. perfornied . completed the insulation and weatherication work at the property listed below. Cape Cod `v ; Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BRI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Villagve cr• M IKP�y Gv/{ y N I(iJUlat 0n Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Slopes Nulls . cti A-JL-n k^-► r Sincerely He ry L Gas y Jr, President (' e Cod .1 ulatiori, Inc. . : ,, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel. plicatiAn # Health Division Date Issued ?-3` Conservation Division Application Fee Planning.Dept. Permit Fee Zo 1116 Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address aZ AZ zfk,)7 /1 Village Z/s Owner 7�,Al oz e�G Z/ Address If Telephone _J� 9 Z It- Permit Request ���4-7 .f �,i�Z/ �'����� ' �c�� ���r971 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new. Zoning District Flood Plain Groundwater Overlay Project Valuation i 0 Construction Type TQ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ,4No On Old King's Highway: ❑Yes &(No w —1 Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Q =' a 1 6 Ze Basement Finished Area (sq.ft.) Basement Unfinished Area (sco Number of Baths: Full: existing new Half: existing ;a 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 �� �'® �l jh/�L/���f�D Telephone Number C �����5/ Z- Address �� 'l�r� l�O'O� �i�i License# le-0/_9 �2 �' D U7 Home Improvement Contractor# /c5 Y 7 Worker's Compensation # �/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE��4L-- " FOR OFFICIAL USE ONLY. � e ti APF,I:ICATION# P i . --DATE.ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ti r OWNER k DATE OF INSPECTION: M FRAME — >I rINSULATIONJUt t, FIREPLACE ELECTRICAL: ROUGH FINAL -- 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 Y 600 Washington Street ` Boston; MA 02111 -www,mass.gov/dia- Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Ay211cant Information Please Print Legibly Name (Bus'mess/Organization/Individual)' 4 Address: i" ��� City/State/Zip:Are you an employer? Check the appropriate box: ! 4. 0 ,.� I am a employer with�_ I am a general contractor and I Type of project(required): 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 g• ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp, insurance comp. insurance't 9. ❑ Building addition required:] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3•❑ 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 3a.❑ I am a homeowner acting as a employees. [No workers' 13. Other/�,/'1,� �G,b_i igeneral contractor(refer to#4) comp,insurance required]. "Any applicant that checks box#1 must also fill out the secdon below showing their workers'compcnsatioifpolicy information. It Homeowner;who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, tContractors that check this box must attached an additional sheet showing the name of the sub-conmwtors 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. y Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: � A Job Site Address:Of 7 ,f�/L°a�J' S� / City/State/Zip:)_4,& p 'Z G 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 cer* un the pains and penalties of perjury that the information provided above is true and correct � r Si a � Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4° Electrical Inspector 5. Plumbing Inspector 6,Other Contact Person: Phone#• I1V.r A'�- + -'�R '" GAPECOD•27 KLIGETT _ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 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 AbDITIONAL INSURED,the policy(les)must be Endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies-may require an endorsement, A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement s), 'RODUCER :ogers&Gray Insurance Agency, Inc, NAMEACT Barbara DeLawrence 34 Rte 134 outh Dennis, MA 02660 (AI .No xt F A/C No; 877 816 2156 o REs ;bdelawrence ra ers ray.COM � �� INSURERS AFFORDING COVERAO6 -- Loa NAIC p-' INSURER A;Peerless Insurance Company INsuRERB:CUMMERCE INSURANCE COMPANY pe Cod Insulation Inc 771NsuRERc:Evans_Insurance Gomp nay 6 Reardon Circle INsuReRD:ATLANTIC CHARTEouth Yarmouth, MA 02664 R INSURANCE GROUP INSURER E; OVERAGES INSURER F I CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NREVIAMOED ABOVE FOR THE POLICY PERIOD IODICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS C R;TIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E Cj_USIONS AND CONDITIONS OF SUCH H POLICIES,LIMITS SHOWN MAY-HAVE BEEN REDUCED BY PAID CLAIMS. WDDTR TYPE OF INSURANCE FOLIC EFF POLICY EXP X COMMERCIAL GENERAL LIABILITY POLICY NUMBER M IDD YYY MMI D/Y LIMITS 1 CLAIMS-MADE II X OCCUR CBP6263063 EACH OCCURRENCE $ 1,000,000 ( - L--� 64/01/2014 04/01/2015 To TE -- _.:. PREMISES(Ea occurrence) — $ -_100,000 MED EXP(Any one parson) $ 6,000 G fiN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURYT_ $ 1,000,000 POLICY l!a PRO- JECT LOC GENERAL AGGREGATE• $ 2,00.0,000 OTHER PRODUCTS•COMP/OP AG , G $ 2,000,000 AUTOMOEILC LIABILITY � -'- $ .�-'-- T COMBINED SINGE LIMIT ANY AUTO 14MMBCKVMK Ea accident $ 1_1000,000 ALL OWNED X SCHEDULED 04/01/2014 04/01/2015 BODILY INJURY(Per person) :$ AUTOS AUTOS HIRED AUTOS X NON•OWNED. BODILY INJURY(Par accident) $ AUTOS PROPERTY DAMAGE _— - Per accidenl $ )( UMBRELLA LIAR X OCCUR $ J-EXCESS LIAR CLAIMS-MADE XQN.14$3514 EACH OCCURRENCE $ 1,000,000 DED X RETENTION 10,000 04/01/2014 04/t)1/2016 AGGREGATE "—-- $ WORKERSCOMPENSATION Aggregate _ 000000 AND EMPLOYERS'LIABILITY $ ) ANY PROPRIETOR/PARTNERIEXECUTIVE Y 1 N WCA00525904 STATUTE . ER (Mandatory EXCLUDED? NIA 06/30/2014 06/30/2015 E,L..EACH ACCIDENT (Mari.d ory In NH) $ 1,000,000 II Yos,describe under DtSCRIPTION OF OPERATIONS below. E.L.DISEASE•EA EMPLOYEE $ 1,000,00 1 E.L.DISEASE•POLICY LIMIT $ 11000,000 RIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) ero Compensation includes Officers or Proprietors, :10'al Insured statue Is provided under the General Liability and Auto Liability when required by written contract or agreement with the CErtificate Holder, l TIFICATE HOLDER • CANCFI I ATInN - r y Kassachusetts -'pepat`tm'#'nt of P4iblic Safety *'jHoard of Building Reg ulafons p•nd Standards f. Cunstnrlitiun Suputwisyr License: CS-100988 III 1•.1ENRY.R CASS1-, $Z 8 Si•1.�,A.ROW � ;, • W LST YA.':2JYt01•P;t'tl ✓. J�,,dc r�. ,I n, Expiration Commissioner 11/11/2015 Office of Consumer Affairs and Business .Regulation 10 Park Plaza Suite 5170 Boston, Massach�jsetts 02116 Flome Zmprovement,Cq. t actor Registration 'Al . Registration: 153507 r' �I .:.r +`,. .::.:: :il Type: Privrqte Corporation , . CAPE CODINSULATION, .:::"t : Expiration; 12/15/zala 1'i 23a$3'I . ING HENRY GASSIDY `•' `�Ik , I - a.. 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 " .. ........ Update Addross ntld rotttrn curd. Mill-It reusun 1'01,chnugc, (] Address Dl�l pCWAI l J L llll)IUynlent „�.1,USt Cnr(1 1/41140/6caarrr!!� cC•�l�aldctde'e"0M Office ol'Cultstim:r Afrnlrs& Business 12eguluriull License or registrntioo voiid for individul use only ;rr�OME IMPROVEMENT CONTRACTORbeforo the axpirntion dnta. if found return to: epistration: 153. 67 Type; omceorCoosumerAffnirs nod Business ltebulrrtion - Zxpiration: 12/1'S/201 g Private Corporalioil 10 Park Plazn-Suite 5170 Boston,MA 02116 'E t1t.1D INSULA-1-10NII,jI(rJCr = IIRY CASSIDY !EA 'DON Clf3CLE- YA NIOU111, MA 02664 IIIIl1el'5l't'1'l`l'tll'y at vai' Fvitho t ' not re r OWNER AUTHORIZATION FORM ,, JON GORECKI (Owner's Name) owner of the property located at 24 NEWTON STREET (Property Address) HYANNIS, MA 02601 , (Property Address) hereby authorize CAPE COD INSULATION (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. an Gorecki(Aug 20,2014) i Owner's Signature Date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �C/`C _ Application # 2 15011 �(a Health Division Date Issued ZJ Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project St re t Address Village Mot^ e Owner ko-, 6,oveckjAddress Telephone v U y s -71 . Permit Request C4 C1Ww L I� Gl �ll� z7�,{�1� ` � p Y Square feet: 1 st floor: existing proposed 2nd floor: existing proposedf J Total nevv- 7,2 Zoning District Flood Plain Groundwater Overlay a Project Valuation Construction Type cx� Lot Size. Grandfathered: ❑Yes ❑ No If yes, attach supporting docurntation. 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 Au horization ❑ Appeal # Recorded ❑ Commercial ❑Yes c If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address License# [0 bq Home Improvement Contractor# Em I Worker's Compensation # lJ" 4 ®i ALL CONSTRUCTION DEBRIS RESULT NG FROM THIS PROJE ,kWILI, BE TAKEN TO SIGNATURE DATE//f 7V X e- �� y FOR OFFICIAL USE ONLY APPLICATION# t S } DATE ISSUED { MAP/PARCEL NO. ADDRESS VILLAGE OWNER r a DATE OF INSPECTION: FOUNDATION F FRAME t INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING. DATE CLOSED OUT ASSOCIATION PLAN NO. K , Massachusetts - Department.of Public Safety :.Board of Building Regulations and Standards Construction superlislir License: CS-100988.. '4 n HENRY E CASSP 8 SITYD ROW r WEST YARMOLFrH 0 ✓,�..� " �`� Expiration Commissioner 11/11/2015 a Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY ---- 18 REARDON CIRCLE - -- SO, YARMOUTH, MA 02664 Update Address and return card, Mark reason for change. :CA1 +.; 20M•05/11 Address Renewal Employment Lost Card _...... _.._.._...__.._............. de 1par�rrno-7aeueceMlt 111Q41K1jd cc1ee4e0 :C'-\ Office of Consumer Affairs& Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistratlon: '1.53567 Type: Office of Consumer Affairs and Business Regulation xpiration:;.- .121:15/201,6 Private Corporation 10 Park Plaza-Suite 5170 U90 Boston,MA 02116 -APE COD INS ULATI:Q:N`INC'.:'.;`.,` iENRY CASSIDY 18 REARDON CIRCLE" 30. YARMOUTH, MA 02664 Undersecretary VNVvalid t sign e Fr The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations d 1 Congress Street, Suite 100 ,- Boston, MA 02114-2017 www,mass,gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Or 'zation/Individual); �Z W Address; a0V �V�. V �I A GCity/State/Zip; Uk" `�flL (0 Phone #; Are you an employer? Check he 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 listed on the attached sheet, 7. Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have g. Demolition working for me in any capacity, employees and have workers [No workers' comp, insurance comp, insurance.i 9, El Building addition required.) 5, We are a corporation and its 10,0 Electrical repau-s or additions 3,❑ I am a homeowner doing all work officers have exercised their I I.❑ 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' 131� 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'Uffidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 subcontractors 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 tile policy and job site —Information. Insurance Company Name; Policy# or Self-ins, Lic, #; CEO Expiration Date. 1 � Job Site Address; City/State/Zip; !Gj ' Attach a copy of the workers' compensation policy declaration page(showing the policy numb r 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 cerllfy n r pains and penaltles of perjury that the Inform atlon provided bove Is rue a correct, Si nature: Date; t Phone#: Official use only, Do not write In this area, to be completed by city or town officlal, 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#; r 1 CAPECOD-27 KLIGETT �- CERTIFICATE OF LIABILITY INSURANCE DATE(MIS M/DD/YYYYI 6/13/2014 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 INSURERS ,AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ( ) ED IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER CONTACT Rogers&Gray Insurance Agency, Inc. NAME: Barbara DeLawrence 434 Rte 134 PHONE FAX South Dennis,MA 02660 E-MAIL A/C No): 877) 816-2156� ADC Ss: bdelawrence ro ers ra .tom_ 9 9 Y _ INSURERS AFFORDING COVERAGE -- NAIC d INSURE •P —"----- R A earl ' INSURED ass Insuran ce Compan INSURERe;COMMERCI: INSURANCE COMPANY Cape Cod Insulation Inc INSURER :Evanston Insurance Company 18 Reardon Circle South Yarmouth, MA 02664 INSURER D:ATLANTIC CHARTER INSURANCE GROUP INSURER E; 00 ERAGES INSURERF: '------- CERTIFICATE NUMBER: T IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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, 4SRAM ----------- NCE n n POLICY NUM8ER POLICY EFF POLICY EXP — _ L LIABILITY MM/DD/YYYY MM/DD/YYYY LIMITS OCCUR CBP8263063 EACH OCCURRENCE $ 1,000,000 04/01/2014 04l01/2015 PREMISES Ea occurrence $ _ 100,000 MED EXP(Any one person) _ $ 5,000 GENT AGGREGATE LIMIT APPLIES PER: PERSONAL 8 ADV INJURY $ 1,000,000 X POLICY PRO. GENERAL AGGREGATE $ 2,000,000 JECT LOC OTHER: PRODUCTS-COMP/OP AGG $ 2,000,000 rv TOMOBILE LIABILITY $ — I COMBINED SINGLE LIMIT ANY AUTO 14MMBCKVMK Ea accident $ _ 1,000,000 ALL OWNED X SCHEDULED 04/01/2014 04l01/2015 BODILY INJURY(Per person) $ AUTOS AUTOS _ HIRED AUTOS X NON-OWNED BODILY INJURY(Per accident) $ AUTOS PROPERTY DAMAGE ----'—" ----- Per accident $ X UMBRELLALIAB• X OCCUR $ EXCESSLIAB EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE XONJ463514 04/01/2014 04/01/2015 — - - DEC) X RETENTION 10,000 AGGREGATE $ ORKERSCOMPENSATION Aggregate $ 1,000,000 ND EMPLOYERS'LIABILITY PER OTH- NY PROPRIETOR/PARTNER/EXECUTIVE Y/N WCAOOS25904 STATUTE ER FFICER/MEMBER EXCLUDED? N/A 06/30/2014 06/30/2015 E.L.EACH ACCIDENT Mandatory In NH) $ 1,000,000 f yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 ESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $ 1,000,000 I SCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) /rkers Compensation includes Officers or Proprietors, ditlonai Insured status Is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. i :R IFICATE HOLDER CANCFI I CTInM • � T s 'Town of Barnstable Regulatory Services Richard V.Scali,Director i63A ♦0 Building Division Tom Perry,Building Commissioner 200 Main Street,I'lyannis,VLA 02601 www.tow n.harnstable.ma_us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Scction If Using A Builder I, TM G O V aK l _ _ ,as 0%-ner of the subject propcil:y herehy authoizzx _ IgJI'Oto act on my behalf, in all matters relative to work authorized bythis bolding perriut 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. 'a,Qoeell�� 'jorl(arecki(Nov 28.2014) Signature of Chvner Signature of Applicant Print Name Print Namc Date Q:F0RI%4S:0IL- 'FRPh7kMISS10NPWIJS w o CB TOP BROKEN LrNxHo SITE s �� a w cn � MA O 4 ML. POLYETHYLENE PRECAST RISER RINGS OR CONCRETE BRICKS Q CATCH BASIN FRAME & GRATE TO GRADE FOR ADJUSTMENT TO FINISH GRADE. 12 X 12 MINSINGLE SHEET , o COMPACT GRAVEL BACKFILL O w RKING LOT PAVEMENT U VENT 4' PEASTONE 20" DIAM. OLES _ .. 24' DIA r STREEJ IN W s �2 `-0.p�E AIAE -.. aaaaaaaaaaaa I) MASS. STANDARD °�xf v ,y p p p p p p vvvvvv SMH po p vv'b `bv8, vvvvvv p S D / CATCH BASINS O p O p O p _ I R=31,51 d vvvvvv vvvvvv I a to 0) I'v v v v vvvv` O O O , oavavav°v vvj °D CO / B' DEPTH pvvvvvv' O O O vvvvvv / (vvvvvv O O O ;. avaaaad 6• I Toaaaaa: O O O ;. vvvvvv (,vvvvvv O O O :•avvvvv� LOCUS MAP / vvvvvv, p p p vvvvvv z �vvvvvv - vvvvvv vvvvv , pppOpp vvovvvv l 32 ' -- -- Z. N.T.S. vvvvvv O O O • vvvvvvaL.IL 1 O / /F / CATCH BASIN `� -z �" -� I PROJECT UATA TABLE: H. W E S L EY C 0 L E M A N ET U X NO SCALE 3' 3/4" To , ,/2• 3' / EpGE Jr _ _ IMPERVIOUS 50%,/ 4F WASHEDp ` � LOT COVERAGE ALLOWED: BUILDING 25�; o STONE � qV M�Nr` 4D ACTUAL LOT COVERAGE: BUILDING - 17%; IMPERVIOUS - 48% 1000 GAL. / / N/F L�lp // / PARKING REQUIRED: OFFICE - 1 + 1/300 S.F. (9 REQ'D.). 31 .7� I- oAO�Nb APTS. - 1.5 SPACES/UNIT (3 REQ D.) LO R!A N E MARBLEPARKING PROVIDED: OFFICE - 10 SPACES LEAIT / o� -•- 31 :1' APTS. - 3 SPACES STOCKADE FENCE -- ~ Uj w OF 001 d ' POST & RAIL FENCE o I CB/ DI� z 1 30.6 Jj 900A10PPntr' or►t.Y `- - ,0 QZ PROPOSED USE: EDGE=ACE N� `\ _ 073 I�/Mtt4'nl� Cl,6N ( j n'�� S .. I BUSHES �. ~�-� o DP � / '�/ FIRST FLOOR: PROFESSIONAL DENTAL OFFICE - _ 5 PLANTING 85*14 10 E -.._... \ p6 ,© SECOND FLOOR. TWO APARTMENTS PENDING SPECIAL PERMIT APPROVAL 0.50 172.1 o o� ZONING DISTRICT: PRD / WP 1 + - / 30.66 CONC. PAD WITH SCR N FE CE / 1 31 .2' BUILDING SETBACK REQUIREMENTS CHAIN LINK FENCE �J GATE \ - �¢ - / / �; 31 O FRONT- 20' SIDE= 7.5' REAR= 7.5' 1 -L I GATE i x 31,2' .01ti ._, STEP o" .0' ;' TR CANS a I •0. OVERGROWN AREA 31 .5' x \ / LOCUS I 7 -.� �� 3 31 .0 ASSESSOR'SPMAP: ( 3270MPRIPARCEL: 196 6 � r c� Q DEED REFERENCE: PROBATE 313,179/21 S I 0 �I 31.00 1 / PLAN REFERENCE: COMPILED FROM RECORD PLANS • 0 p o 30.34 \ R!V WAY j 30.2� \ COMMUNITY PANEL NUMBER 250001 0005 N P B C LOT AREA " �I F.LR.M. MAP ZONE : C \ . ; . • �;� -x 30,. ' 18"MAPLE 0.28 r-- \ PROP X 31 .4' 12,781 SF f � ' PROfsOSED GRAVEL A 30,9' PROPOSED BUILDING PARKING BUSHES (fin. flr. - O� 0.29 Acres 3 �W PROPOSED,PAVM -LLJ _ 1- 31.00) / \ �Q / I DATUM: N.G.V.D. PARKING AND DRIVE :L V"� - _ y�' \ 8, I � ENCCOSep 01� / y 30'8' ALL UNDERGROUND UTILITIES ARE APPROXIMATE AND � PORCH -- _� �o / o /� SHOULD BE VERIFIED IN THE FIELD PRIOR TO ANY 1 ( ;- --. -- 31 1' s CONSTRUCTION BY THE CONTRACTOR O I 0 10 i / 6' x 6' LIP ' r : / J TOWN WATER & SEWER ARE AVAILABLE TO SERVICE THIS SITE. z 24'"MAPLE ITH 3' OF STONE �\ I $ ULk 1 STOPy 1 112 SrO r -- -- -- �? 0) / ALL RUNOFF TO BE CONTAINED ON SITE. LL 29.88 (�, STORY BUSHES 00© FRAME ' _ AREAWAY C� i �-- FE.- BRIC 10 MAPL Q ■ Z 0 . = 32.24 STEPS Z \ CB, Rim 29.70 -- N 0 QQ ® GB office Building For \ Z 30.24 / 0.90 '� R=30.10 3 : 30.40 P�� Barnstable Dental Associates O � Z � xQ:9 x 30.7' ROPOSE 15 Cedar Street oy - H annis Massachusetts 30.7' Q y y setts \ 0 `V PREPARED FOR I ' - Brown Lindquist, 0 02 0.20 x 30.7 0.80 CB �, ■ PROP. CAPE COD BERM Qti 6"C H ER Y � ® R=3Q'17 Fenucclo & Richmond Architects 31 7• STOCKADE FENCEb / TITLE 144.11 ' 5' PLANTING BUFFER `' -- °pos o / Site - -- / 0 / Proposed Site Plan ti Fo L / N 86*50' '\ rn / x 30.6' r- 158-1 z � / Baxter, Nye & Holmgren, Inc. Q (� / o Registered Professional 1`-- ° I o 30.5' o Engineers and Land Surveyors 01 /� 812 Main Street,OstervMe MA 02655 w ' � {x `� Phone- 508 4 ( )t ��� � ( ) 28-9131 Fax- 508 428-3750 10 0 10 20 \ 0) / / SCALE IN FEET 30- _ J �\ / N/I` 1 SCALE:1 =10 1/30/02 A U G U S TA F. C 0 N N 0 L LY 30.5 REV. DATE: REMARKS 1 02/08/02 Rev. Footprint 2 04/03/02 Rev. Per S.P.R. Col 'p 4 � Oy Karl. fts. S. p' �, DRAWING NUMBER H: 2000 2000-82 surve wrksht 2000-082SITE3A.dw Job #2000-82