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0025 RIPPLE COVE ROAD
z � �i PPS£. C'o v� ----- C I � I �� �j z.�n� V i I 1 i �F1HE Town of Barnstable *Permit Expires 6 mo lis from issue PRO date artment Services sntuvsTesti':, � Florence,CBOMAM d 9`b i639. OCT O` 20 Building Commissioner jOrFn 60 Main Street,Hyannis,MA 02601 TOW�� '�' RNRI�i , 'town.barmtable.ma.us Office: 508-862-4038 ��� Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number; p� )7-—,('� Property Address zz 00k, 9S, j ❑Residential Value of Work$ 11-0 00 r Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) r"' Email: - - _ C p A tti 0 J" Construction Supervisor's License#(if applicable) �� �(v `�2 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 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) e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Let- vtd ' ❑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: . *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. . A copy of he,Home Improve ent Contractors License&Construction Supervisors License is required. SIGNATURE: r Q g AWPFILESTORMSlbuildin permit forms\.EXPRESS.doc 5 08/16/17 ?Ire Commorrivealth of Massachusetts D.epartrrrent cr,f Industrial Accideras - Of-ce ofInvestigations t600 Washington Street Boston,AM 02111 nninu nmmgovfdia Workers' Campensatian Insurance Affidavits BudldersiContractorslEIecfr clans/Plumbers Applicant IufarmatiGn > / / Please Print LegibIy Na= t�ti-C 1,1 �h 1 H L C�✓�°'7 L L° Address:/ h/L4 ✓ yyl. 14 . Are you an employer?Check the appropriate box: ' Type of project(required)_ 1. I am a em la oath�_ 4 ❑ I am a general contractor and I P � 6. ❑New construction employees(full andfor part-timed* 'have hired.the sub-contractors 2.❑ I am a sole prnprietof arparEuer- listed on the attached sheet. 7. ❑Remodeling SUP and have no employees -contractors have g•.❑Demolition worinnb ycapacity.g, far me in an employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp-insuranc& required-] 5. ❑ We area corporation and its 10❑Electrical repairs or additions 3.❑ I am homeoumer doing all work ofcen have exercised their 11-❑Plumbing repairs or additions myself[No workers'comp- right of exemption per MGL 12.❑Roof repairs insurance required]F c.152, §1(41 and we have no employees-[N o workers' 13-0 Other Io comp.insurance required.] *Any WKcsut d at checks boa 91 mast also fill out the sectionbaLo wshaming tii&woAers'compensationpoliey information. t Homeowners who submit this af5d2va mg5orting they are daing all wank and then him outside contractors most submit a new affidavit indicating such fC'anttactors that rhea this boa must attached as additiand suet showing the nine of the sub-comttactars and state whether or not those entities ham emplayees.Ifthezub-cant amrshave employees,they their workers'comp.policy number. I alrt an einplq-er that is pr4niding ivarke.rs'conrpensagaii iantranc-e for my enrploj ees Betoov is die pa cy and job site informatt:ors Insurance Company Name: Policy.-or Self-ins.Lic.9: Expiration Date: Job Site Address: City/Statelztp: Attach a copy of the workers}compensation policy declaration page(showing the policy number and respiration 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$1,50@00 andlor one-year imprisonment,as well as civil penalties.in the form of a STOP WORK ORDER-and a#sue of up to$250.0!0 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of-the DIA fori nuance coverage vetification- I do hereby cerfify riot or the �'rts andpalawes ofpeduty,fliattilre in fortualion prot ided aboiv is bw and correct Signature: Date: 2— Phone Official use only. Do itot write in this area,to be cainpieted by city ortown oficiat City or Town- Permitffikense 4 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityffown Clerk 4.Electrical Inspector 5.Plumbing Inspcxtor 6.Other Contact Person: Phone#: Information and Mstrnctions ; Massachusetts Geheaal Laws chapter 152 rmp±ns all employers to provide workers'compensation for their employees. p to this statute,an employee is defined as.'_.every person in the service of another under any contract of him, express or implied,oral or woftezO .An empfoyer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing=gaged is a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three aparfineuts and who resides therein,or the occupant ofthe - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurteuarrt thereto shall not because of such employment be deemed to be an employer." MGL chapter 1.52,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a Hemtse 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 in mxan m.coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commoavmalth nor any of its political subdivisions shall enter into any contract for the performance ofpnbho work until acceptable evidence of compliance with.the insurance.. raT,:,-Patents of this chapter have been presenir=dto the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply snb-contractor(s)name(s), addresses)and phonenumber(s)along with their c=tficafe(s)of ncrTrant�e. Limited Liabl7ity Companies(I LG)or Limited Liabr7ity Parinerhips(LLP)with no employees other than the members or partners,are not require to carry workers' compensation insurance. If an LLC or I.LP does have empIoyees,a policy is required. Be advisedthatthis affidayit maybe submitted to the Depa-traent of Industrial Accidents for confirmation of hon-an ce coverage. Also be sure to sign and date the affidavit. The affidavit should be retnnaed to the city or town that the anplicafion for the permit or license is being requested,not the Department of Accidents. Shouldyou have any questions regarding the law or ifyou are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials t Please be smr that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of true affidavit for you to fill out:in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permitllicrose number which will be used as a reference number. In addition,Ea applicant that must submit multiple p(-_mlitllicensa applications in any given year,need only submit one affidavit indicating current policy information Cif necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)_"A copy of the-affidavit that has been officially stamped or maimed by the city or town may be provided to the - applicant as proof that a valid affidavit is on file for fitare permit or licenses_ A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial veniine (i-f,-. a dog license or permit to buns Ieaves etc.)said person is NOT regtdred to complete this affidavit The Office of Investigations would lake to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number: The CGmmmwealth-of Ma.ssachuszt-,ifs ' Depa tneai<ciflidustdalAwidents Office of jhve&tkRtiO.= 600 WaSUIZQn S TeL 4 617 727-4900 ext 4-06 or I--a77-MASSAFE Fax 9 617-727-7M Revised 4-24--07 _m gavldi. I F �O EU) M _ m m m o r Z Z M 1 2 :q D Z Z Z X �• A p IT1 frl y 171.' Massachusetts Department of Public Safety ca s o °;3 .,o Board of Building Regulations and Standards w �, License: CS-086728 y{ ` 1 : . m S' Construction Supervisor \ II ++ w 3 N harn JOSEPH A RENNIE y N 1Z r ti m. 4 WAYSIDE LANE ,' O. 91 „7 z SANDWICH MA 02663 [ & a n X 0 1 Expiration: Commissioner 12/16/2017 .0 m p o _ J.A y A9 M M 5 C eP �•. C G S-6 1 r� 4, �� �is'rvrea�u�ea��o�,/�ct�sac�uGse�i ,Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TY.�forporation Registration valid for individual use only Re istr before the expiration date. If found return to: —�-- Exoix Office of Consumer Affairs and Business Regulation esatsbG — pg�11�2019 10 Park Plaza-Suite 5170 STEPHEN DUFF ON- IM''r' Boston,MA 02116 SUCTION,LLC STEPHEN DUFF 1586 HYANNIS BARNSTABLE IG1A 02 30 JC Undersecretary alid without signature I r ' r r C �.� ERTIFICATE OF LIABILITY INSURANCE DATE(MMIooIY I RODUCER 09l29I2017 .Owen Insurance Agency,Inc, THIS CERTIFICATE IS ISSUED As A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 59 Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Haverhill MA 01830 INSURED Stephen Duff INSURERS AFFORDING COVERAGE NAIC# 1586 Hyannis Road INSURER n: Assoclated FMINIftway.Insurance Com�an r� INSURER B• Barnstable MA 02630 ,N U.RER : INSURER 0: COVERAGES INSURER E:. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANOING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DO' POLICY NUMBER POLICY EPFECTfVE POLICY EkWRAT10N GENERAL LIABIUTY LIMITS COMMERCIAL GENERAL IABILITY EACH OCCURijt:NCE $ DAMAGE TO RENTED CLAIMS MADE OCCUR RISE&IEA.CCWUXIceJ g� MED EXP An one person R PERSONAL&AOV INJURY; g GEM%AGGREGATE LIMIT APPLIES PER; ' ER %G 'REGATE'----� g POLI PRO LOC P 0 UCL3•COMP/OP AGt� AUTOMOBILE LIABILITY ANYAUTO COMBINF•0 SINGLE LIMITS (Eel ecdd.", S AU-OWNED AUTOS ,. SCHEDULED AUTOS PeDILYf JURY HIRED.AUTOS P ,) NON-OWNED AUTOS BODILY INJURY >W (Perecoldaki 4 (PROePEcRTY DAMAGE P $ GARAGE LIABILITY e ) . ANY AUTO UTO ONLY•EA ACCIDENT OTHER THAN _EA A C EXCESS/UMBRELLA UABILITY AUTO ONLY: A Q $ OCCUR CLAIMS MADE RACCURRENCE AGGREGATE DEDUCTIBLE RETE ION $ WORKERS COMPENSATION AND EMPLOYERS-UAgILrrY x WC BTATU. OT}I- ANYPROPRIETORIPARTNMXECLir�Y/" WCC5009775012017 02/10117 OFFICER/MEMBER EXCLUDED? I•• U U210118 (Mand,rt0 In NH) E.L EAC_ H ACCIbEN 3100000 K as,IdoscrlDeV�mder E.L D SEASE_EA EMPLOYEE ¢100 000 OTHER L.DISEASE•POLICY IMIT $00 000 °SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS iuilding Dept 3r en contractor. ERTIFICATE HOLDER CANCELLATION SHOULD ANY O F THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE T"E EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 2DO ftin Street NOTICETO THE CERTIFICATE HOLDER NAMED TO THE LEFT,SLIT FAILURE TO DO SO SMALL IMPOSE NO OBUGATION OR LIABILITY,OF ANY K1ND UPON THE INSURER,ITS AGENTS OR MA 02601 Rr--PRURNTATIVq AUTH ATIVE 790.6230 CORD 25{2009u01) 01988.2009 ACORD CORPORATION. All rights reserve_d_ The ACORD name and logo are red marks,of ACORD �IHE Town of Barnstable Building Department Services ILMINSTKAS&"m'i' Brian Florence,CBO � Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section , If Using A Builder 1 I I. 1�e►t e— Gvt1 0 du ,as owner of the PAY Pro subject , hereby authorize SLQ pk-p.�1 .,1 1 jf:�'c r to act on my behalf, in all matters relative to work authorized by this building permit application for. ALYO wj (Address of Job) , **Pool fences and alarms areahe responsibility of the applicant Pools -are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. S• tore of er• e of Applicant Print Name Print Name Date „# , Q:F0RMS:0WNERPERNMSI0N;IWLS Rev-09/16/17 Town of Barnstable Building ]Department Services Brian Florence,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 sr 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: cityhown 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,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:\WPFaES\FORMS\bui1ding permit forms\EXPRESS.doc 08/16/17 �z Key- c,41 � . . 1 f I 1p5:4 I r i i a 7.o O ,� N n lll�9T F . vl i U V. s l; �11 U . 90�n o Jlo, i�Y O 14.8 i r/z yvK iC jil S a r J 147 .22 f 3k;z4 a NI i d 6 £� i3• c ` + . . p TA6'9c /9yL'f /'v�lyNX�LL:_ S7 , ��. � :_.�.____. J`•'k T /�i�c;Lr�. v7r'S'�'u/l.°'•'�.1, �7�f�G` �b -PLA/V SCALE _ALL COPE E-A1G1N4ERING. ¢! I/�� 4BOP Fc':OAD D.47',-- t S IO'�;8 x�7-CI-1 PLAA).. 0'rd . 1VD IN �F,/?Nsr�ar�E .._. vaAl e/ /VZOV7 a/ -e s _ • �. ; 73!�»:ira� /�,f �./'S� ''4't.� S.�iui.�.ri o,-� /.�,, /Cam.;-r.� 'r�l,�,.. 76/.�G. 7>NTi✓, N1"4 4 GnlT•;. ' /9/2N_5.r��t..'L£ F?i,/1�� zd ra /"'T ram;.... :Jhe':top o$ tou Lation: l _8' i4 -above � 100 N� ?too d.pta no She foundation ahown on �U ptcut vs Located orc ; .the cgCound a, �touwt -tA&zeo <, ►z r i i J A lij:� 1CD I a P# � . {{ $ �� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �1-6S- S Map 3C;)__-.5*cel- " Application # Health bivision W Date Issued l Conservation Division " ;4 Application Fee U Planning Dept. � •• �� Permit Fee Date Definitive Plan Approved by Planning Board Historic.- OKH _ Preservation/ Hyannis Proje_ccFStreetzAddress K%00�t C per Village g t�l �l�li� O-weer T Address Telephone_ Permit-Request`�o �,eSkoCp_ 'o a Si o `� i ernen� �� ch2n . RPnr �e Ccxb Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay �Proje-ct:Valuation 1500-DO Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new CD Total Room Count (not including baths): existing _ new First Floor Room Count r Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other_ Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stoves Yevl s ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑ existing L new r_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 On0-AC ll I S --Telephone--Numbers Addresses-t 1� �`)� License # 1�0,� cl- M0, Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE "` DATE , '1 FOR OFFICIAL USE ONLY 4 _ APPLICATION# DATE•ISSUED f MAP/PARCEL NO. _ h b ADDRESS VILLAGE OWNER ' t I DATE OF INSPECTION: M " FOUNDATION FRAME r ' ,,INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL b ROUGH FINAL _ J FINAL BUILDING- DATE CLOSED OUT y ASSOCIATION PLAN NO. f The Commonwealth of Massachusetts 4' Department of Industrial Accidents Office of Investigations' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leobly e(Business/Organization/Individual): i R . �Adctress: i City/State/Zip: 6k Phone.#: Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4�D.II m a general contractor and I employees(full and/or part-tune). . have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner listed on the attached sheet 7.. ❑Remodeling These sub-contractors have. ship and have no employees 8. ❑Demolition working for me in any capacity. employees and-have workers' [No workers'comp.-insurance comp.insurance. # 9. ❑Building addition E�,,��required.] 5. ❑ We are a corporation and its '10.❑-Electrical repairs or additions 3`M--I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions mys elf. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.) t c. 152, §1(4);and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the naive of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: city/State/Zip- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage_as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereb certify under t ai izndpen 'es of per' ry that the information provided above is true and correct . Si afirre T l 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.BuiIding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions W. Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the 9 dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." ) MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance nzth the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contcactor(s)name(s),address(es)and.phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not iequired to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy-is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."_A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture (i.e. a dog license of permit to bum leaves etc.)said person is NOT required to complete this affidavit:. The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: ,The Commonwealth of Massachusetts Department of Industrial Accidents 4f ee of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 i Revised 11-22-06 wvvw.mass.gov/dia �P�ae'THE r�o . Town of Barnstable Regul"atoty Services amwir.,BLF_ - Thomas F. Geiler,Director tbs¢ Building Division prEDj F Tom Perry,Building Commissioner 200 Mairi.Street,_Hyannis.MA_02601 www.town-b arnstabl a-ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOIN'IEOWNER LICENSE EXEmTTTON Pleare Print _DATE: ry=►,/7-4a/ i i number street page "HOMEOWNER': �� ` —Tna 'e home p c# work phone# �CURR ENC_1vfAILING.ADDRF-SS: 1 city/town runic zip code Tile 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_ DEFTIZI'I"ION OF HOMEOwh'ER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a bomeowner. 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/sbe understands the Town of Barnstable Building Department . Minimum inspection procedures an mcnts and that he/she wi1l comply with said procedures and ),,r, Si turc'ofHameo er`,� 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 bomeowncr performing work for which a building pernvt is required shall be exempt from'thc provisions of this section•(Seetivn ID9.1.1 -Licensing of eon action Supenisors);provided that if the homeowmar rngages a persons)for bin:to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption arc unaware that they are assuming the responsibilities of a supervisor(sec,kppendix Q, Ruics&Regulations for Licensing Construction Supervisors,Scction 2.15) This lack of awareness often TmIts in serious prob]crres,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot pmcccd against the unlicensed person as it-Would with a licensed Supervisar. The homeowner acting as Supervisor is ultimately responsible. To ensure that•the homeowner is fully aware of bis/hcr rrsponnbilitics,many communities require,as part of the permit application, that the homcowncr certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form cur=t)y used by several tDwnS. You may care t amend and adopt such a forTa/certification for use in your con-ununity. Q:for ns:homccxcmpt Tra�ti Town of Barnstable Regulatory Services %• uxxsus[.� ores g Thomas F. Geiler,Director °'Eo► Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstab l e.ma.us Office: 509-862--403 8 Fax: 508-790-6230 • v Property bier s t Complete,and Sign T s Section . If Us in A B ilder 4 as Owner of the subject.property hereby authorize to act on my behalf, m all matters relative to work auth rued by this buUdiag t application for. dress of Job) signature of Owner - Date Print Name If Property Owner:is applying for permit please complete the Homeowners License Exemption Form on the revers-e side-,. Q:FORMS:O WhIERPERMIS510N 1 Docket No. Commonwealth of Massachusetts !NOTICE OF PETITION FOR. The Trial Court M109P4585EA2 Probate and family Court APPOINTMENT OF ADMINISTRATOR WITH THE WILL ANNEXED In the Estate of: Aris E Manoloules i Late of: Framingham, MA 0.1702 Date of Death: 09/30/2009 to all persons interested in the above captioned estate,,a petition has been presented requesting•that a document purporting to be . the last will of said decedent be. Middlesex Probate and Family Court proved and allowed and that 208 Cambridge Street Irene M Manoloules of Natick, MA Cambridge, MA 02141 or some other suitable person be appointed administrator with the will (617)768-5800 annexed to serve Without Surety IF YOU DESIRE TO OBJECT THERETO,YOU OR YOUR ATTORNEY MUST FILE A WRITTEN APPEARANCE IN SAID COURT AT: Cambridge ON OR BEFORE TEN O'CLOCK IN THE MORNING (10:00 AM)ON: 11/30/2009 In addition, you must file a written,affidavit of objections.to the petition, stating specific facts and grounds upon which the objection is based,within (30)days after the return day(or such other time as the court, on motion with notice to the petitioner, may allow) in accordance with Probate Rule 16. WITNESS, Hon. Peter C DiGangi, First Justice of this Court. d Date: November 2, 2009 Register of Probate ORDER OF NOTICE It is ordered that notice of said proceeding be given: by mailing postpaid a copy of the foregoing citation to all persons interested Fourteen days at least before said return date. by publishing a copy thereof in Metro West Daily News, Framingham: publication to be seven (7)days at least before said return day. It is further ordered that notice thereof be given by delivering or mailing by registered or certfied mail'a copy thereof to the Attorney General, United States Department of Veterans'Affairs,Treasurer and.Receiver General, if interested, fourteen (14) days at least before said return day. WITNESS, Hon. Peter C D!Gangi,.First Justice of this Court. Date: November 2, 2009 Register of Probato Page 1 t Docket No. Commonwealth of Massachusetts NOTICE OF PETITION FOR M109P4585EA2 The Trial Court APPOINTMENT OF ADMINISTRATOR Probate and Family court WITH THE WILL ANNEXED RETURN OF SERVICE I hereby certify under the penalties of perjury that: have complied with the order of notice by: . serving in hand a copy of the citation as ordered. mailing O certified 0 registered postpaid a copy of the citation as ordered. causing the citation to be published in Publication was on which was at least Q days O month(s) before said return day Date: Signature: Page 2 r The Trial Court "v f f Middlesex Division Probate and Family Court Department Docket No. Administration With The Will Annexed )�ttlC Without Sureties Name of Decedent Aris E. Manoloules Domicile at Death 1500 Worcester Road, Unit 311 Framingham (Street and No.) (City or To Middlesex 01702 Date of death, September 30, 2009 (County) (Zip) Name and Address of Petitioner Irene M. Manoloules 3 Wellesley Avenue, Natick MA 01760 Status Sister Heirs at law or nekt_of kin of deceased including surviving spouse: Name - Residence Relationship_ (minors and incompetents must be so designated) `� ene M. Manoloules _ 3 Wellesley.Avenue iNatick,�MA�1760 .Sister �Treefon E. Manoloules 70 Flagg Road, Southborough MA 01772 Brother That said deceased left ® a will�KMIXMW herewith presented, wherein. Efthirniosi Emmanouilidis is named executor/ gg but Z has declined 1 serve ® The petitioner( here`)y certif ies that a copy of this document; along with a copy of the decedent's death certificate has been sent by certified mail to the Division of Medical Assistance, P.O. Box 15205, Worcester, Massachusetts 01615-9906. Wherefore your petitioner(4.pray(s)that® said will Umij=a(t may be proved and allowed,and thait5 lhe/ - i X (Street and No.) p. and (City or Town) (County) (Zip) be appointed Xc 1t�1fa minis nEy x with the will annexed, kR�RjKZ without sureties on Mpg/her bond, and certifies under the penalties of perjury that the statements h rein contained are true to the best of=/her/ 3MKYAnon.^..,ledge and belief. n Date L� ! / Signature(s) Ir a M. Manoloule The undersigned ereby assent to the foregoing petition and\the allowan f 4theillwit out to timony. ILL A' f Tree E. anolbul s ne M:Manoloules DECREE All persons interested having been notified in accordance with the law or having assented and no objections being made thereto, it is decreed that said instrument(s) be approved and allowed as the last will and testament of said deceased, and that. Irene M. Manoloules _ of 3 Wellesley Avenue, Natick, MA 01760 in the Count 'of Middlesex be appointed a ministratrix with-the will annexed of said es at firs:qivi:ngbond,.with sureties for the due pe or ance of said trust.Date J�STICE OF THE PROBATE ND FAMILY COURT CJ P3(11/01) f l r r n r 5 w 5 T r � e V i 3 ! C a ' A. Av 7.0 R) t a i ' N I , t. �xs (rl 90 uvtdgtron t 1129 Obw,- 1.1.8 Sews✓ !%ice . 2�f in i 3I,2C E /G' r\ F /4¢ -f ii�yfv�oC��'s� �-�s � j ; � --. '5'E'7" r�iv�[.r �f-s�•u/�13. t''�i�� . ' 7-0 �,�• wio�;) -PLAN SCALE I 4 .4 CAPE L"N .IIVCFRIN 4� %I17:f3C�r4 mow D , , T v,4 r� r S io 8 ' fly. Al lS,MASS : 0,, 6 Ot w_ z K7`C PI��IV. 4� L_ e�L7 I/I/ FiI?h/sT1f.31 E AQ :/V7a.rr o .:. �� rl� oaf �15,.� �� S.fioa�.-� an .���•,���G.:r�� /�1�.: 76/�s"L.; . I 1 • r %yreior'•s .� 9c� ern, `41 `.�,.C. Cam, Jra rc✓rrr.. . . , •?",�.' r-M. ghe: -top o? �oundc t-i;oa l._l,8 ,a above, the' l00 q ftoo d,pone P ' q tom► qto,n -Located on. the qAourld cd, aho wh ,tA,?A.o ` 7 - �Vtk cf OA y zy 7X I ;H. ; n� iAiRt3fE v, E I ' I , 1 � o Lor 7.0 p 40 W { j V v j.... _.....„ , - O _, w fcn, v, z L i floy - !0 t - . lbIT t,t � 8 � , -7 Sawe��ifa? 3o d.. ! i Q , 71 NJ TAG 96 G io A:c. SFw�� tu y R r ' TO FacrivprjFje� _ (40, wive, 'F'L IV ,ttAL,E ALL C A PE ENG//VEERING / 3 0 ¢� �ARf3Of? po YYAVN/S,MASS ._ ..02 b O'/ • x T�" ,AN_.oF' 1 a. t A: ti u.r� - z ov $� fs `irzJc� fof 70f S cts �ho!w.-� ©+-� �4•-��/�'o �.�l�. 7G�S'L 1 : �S Asp ca WILLIAM ys LA-io.Z7 fRRDIE • , Assessor's map and lot number .......................� .L / �oFTHETo� MUST CONNECT TO TOW 8 P Sewage Permit numbe#YZS/.. AK II HAHH9TODL , C� House number ................ ...........................,....... �� 9 MMa�pt63Y.a`00 MP TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO. ................... .........................................p.............................................................. TYPE OF CONSTRUCTION ..W..e f?.d....7.?O : ........ i.n J:c.�ed,-Ac?v�°.1... t l........................................ f .................19�lti5.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: N Location ^a. ..../5�.............11..!.�jt?.lc.....I�O..fv.e...... ........ . . 1.. :./. s.................................. ProposedUse ..�i/✓� .C..... Q.1�.'. l..Tl l........................................................................................I......................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner M.0717,,V.V L.....!.17. N.D / ...........Address � ..... Name of Builder V.t./?'.. vc? lJ........................................Addressls.Q.. P..syc���Ci ... P�/ oy�5w!c!f/l�/34�ff Nameof Architect ..................................................................Address .................................................................................... of Rooms ..&.... ......................Foundation �)mlrtWOoN6,rete- Number ............................ .................................................. Exterior C'e�er...C'.:/!........!7!l"� Roofing .Sjl1 ... !1.�.!v)/ .................. .... .... .............................. . .... Floors ,I 17�1'fQ'e.(.........................Interior off'.!'...&m.11........................................................ Heating .................................. .. .�.-�Ti�1.0 .........................Plumbing ........................................ .... .{.`?..................... Fireplace ................................. N ` .r.s.............Approximate Cost ........... ......................:...... . ...... Definitive Plan Approved by Planning Board ________________________________19________. Area .../� �... ............ .....- . Diagram of Lot and Building with Dimensions Feej' a SUBJECT TO APPROVAL OF BOARD OF HEALTH f SCP-0. V. wage � e iU1 � In OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable 7re :ngthe above construction. Name .....�.. � ......... Construction Supervisor's license ✓�............ f.A........ 1 MANOLOULES, EMANUEL A%325-64 No ..281.7.8.... Permit forl...StQJrV...sing1.d....... .............fami7 y..d el ling......................... ....... Location .....25-BIppla-Cova..Road ..............Iiyanna ................................................. _ y ,r Owner................... . t TyPedt Construction ...... .frame. .. S ....................................... ` ........................... Plot. ........................ Lot ................................ f - 1FLI �..-. }- — w►.t t 1-7 Per Granted ................uIy...}..........:.-1985 W st i -Dat4=of Inspection .......................... .... 99 Date Completed .q:7/�......... 'k a s .r i Hyannis homicide under investigation CapeCodOnline.com ; Page 1 of 1 Hyannis homicide under investigation By Gregory Bryant also by Jake Berry STAFF WRITERS October 01,2009 10:55 AM HYANNIS-Police and the district attorney's office today are investigating a homicide after police were called last night to a house at 25 Ripple Cove Road in Hyannis. Found dead in his summer home was Aris E. Manoloules,47,of 1500 Worcester Road,Apt.311, in Framingham, according to a press release this morning from Cape and Islands District Attorney Michael O'Keefe and Barnstable police chief Paul MacDonald. - Barnstable police went to the home last night after responding to a request for a well-being check. The circumstances surrounding the death were deemed suspicious and a criminal investigation was initiated,the- release said. Manoloules'body was taken to the Office of the Chief Medical Examiner early this morning and an autopsy will be performed today, according to the press release. Thus far, investigators are following several leads,O'Keefe said.in a brief interview this morning,though he declined to say whether they have identified specific suspects. "This does not appear to be a random act,"he said."This is kind of a targeted situation." Investigators could have more information to release by tomorrow,O'Keefe said. He declined to provide any more information. Check back here for updates on this story. Copyright©Cape Cod Media Group,a division of Ottaway Newspapers,Inc.All Rights Reserved. http://www.capecodonline.comlapps/pbcs.d,ll/article?AID=/20091001/NEWS 11/91001998... 10/1/2009 i Doc:831,749 05-10-2NI 2:27 Ctfk:161441 BARNSTABLE LAND COURT REGISTRY DEED I, FEVRONIA MANOLOULES,of 35 Parker Road,Framingham,Massachusetts, for consideration of one dollar{$1.00)paid, grant to ARIS MANOLOULES,whose mailing address is 35 Parker Road,Framingham, Massachusetts, with QUITCLAIM COVENANTS, The land situate in Barnstable(Hyannis)in the County of Barnstable and Commonwealth of Massachusetts, described as follows: Lot 155, Plan 7615-L as described in Certificate of Title 159967. Q For my title reference see Certificate of Title No. 159967 recorded in the Barnstable County cLand Registration Office. Witness my hand and seal this, day of e-✓ ,2001. ` I p} FEVRONIA MANOLOULES h to 41 N 'c ILETURN 7'0: a THE O'CONNOR LANV 1*'; J1 18 South Main Street 7*rlie]d,MA 01983 I.i COMMONWEALTH OF MASSACHUSETTS ss. 2001 Then personally appeared the above-named FEVRONIA MANOLOULES and acknowledged . the foregoing to be her free act and deed,before me. oe O otary Public My commission expires: u z�_ BARNSTABLE REGISTRY OF DEEDS P �� E � �rtie�� n /LQ �Q� �G 1 c: IMPORTANT MESSAGE For A.M. Day Time P.M. M Of Phone FAX Area Code Number Extension MOBILE Area Code Number Extension Telephoned Returned your call RUSH Came to see you Please call Special attention Wants to see you Will call again Caller on hold Message F �S.igned C�AL.48023 MADE IN U.S.A. 0. N 00G'-817',,S36 11-29-2000 10:26 CTF#:1S9992 HWNSTABLE LAND COURT REGISTRY COMMONWEALTH OF MASSACHUSETTS KM LAND COURT THIS AL DEPARTMENT OF THE TRIAL COURT COPY CASE NO. 7615-S-2000-11 Upon the petition of Fevronia Manoloules, et als,representing that Emmanuel Manoloules was the registered owner in Certificate of Title No. 28211 issued from the Registry District of Barnstable County; and representing that the death of said Emmanuel T. Manoloules,intestate, on July 10, 1994, and the administration of his estate by the Probate Court for the County of Middlesex, in said Commonwealth; and praying for a new certificate of title, after due proceedings,it is ORDERED: that said Certificate of Title No. 28211 be cancelled and a new certificate of title for the land described therein be issued as follows: An undivided 3/6th interest to Fevronia Manoloules; An undivided 1/6th interest to Aris Manoloules,both of Framingham,in the County ,d of Middlesex; ca An undivided 1/6th interest to Irene Manoloules of Wellesley, in the Norfolk; 0 a An undivided 1/6th interest to Trefon Manoloules of Northboro,in the County of Worcester, and all in said Commonwealth of Massachusetts. 0 vBy the Court. ; Attest: Charles W. Trombly,Jr. Recorder _ ATRUECto Dated:November 20, 2000 ATTLOV: RECORDER FM&AM: 35 Parker Road,Framingham,MA 017.01 IM: 15 Leewood Road, Wellesley,MA 02481 TM: 38 Milk Porridge Circle, Northboro,MA 01532 EAW/ef BARNSTABLE REGISTRY OF DEEDS �FTHE Tpk, Town of Barnstable O ~; Regulatory Services • EAMSTnsi.e. , 9 Mnas. $ Thomas F. Geiler,Director 16.39.TFOMe+" Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.xna.us Office: 508-862-4038 Fax: 508-790-6230 AFFADAVIT Now comes Aris Manoloules of 35 Parker Rd. Framingham, Massachusetts, owner of 25 Ripple Cove Rd. Hyannis, Massachusetts holding title under a deed recorded in the Barnstable Registry of Deeds Land Court certificate #161441 and being shown on assessors Map #325 Parcel#064, hereby attests to the following: The property at 25 Ripple Cove Rd. Hyannis, Massachusetts, will be used for family only and is not intended to be rented in any fashion. This is not transferable. The kitchen in the lower lever must be removed and the house returned to a single family home upon the sale of the property or the death of the owner. Witnessed my hand and seal this o7 November, 2006 Aris Manoloules BARNSTABLE, SS DATED Then personally appeared before me the above—named Aris Manoloules and made oath as to the truth of the forgoing instrument,before me. He identified himself to me by showing MA lic # ��U� /n Notary lc My Commission Expires IIMARY C,QRIFFITHS Notary F'ubllc G"ffit)"baith Of Maaaachusetts My G6himi49ion euplrea p®b,22,2013 - �F1HE Town of Barnstable ~O Regulatory Services '"RNST Thomas F. Geiler,Director i639. Mass.S. 9�A ,0� Te639. Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 AFFADAVIT Now comes Aris Manoloules of 35 Parker Rd. Framingham, Massachusetts, owner of 25 Ripple Cove Rd. Hyannis,Massachusetts holding title under a deed recorded in the Barnstable Registry of Deeds Land Court certificate #161441 and being shown on assessors Map #325 Parcel#064, hereby attests to the following: The property at 25 Ripple Cove Rd. Hyannis, Massachusetts, will be used for family only and is not intended to be rented in any fashion. This is not transferable. The kitchen in the lower lever must be removed and the house returned to a single family home upon the sale of the property or the death of the owner. Witnessed my hand and seal this November, 2006 Aris Manoloules BARNSTABLE, SS DATED Then personally appeared before me the above—named Axis Manoloules and made oath as to the truth of the forgoing instrument,before me. He identified himself to me by showing MA lie # Notary Public My Commission Expires TOWN OF BARNSTABLE BUILDING PERMIT PARCEL ID 325 054 $$ CEOBASE ID 23857 ADDRESS 25 RIPPLE COVE ROAD PHONE HY'ANNIS ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT Hy PERMIT 90805 DESCRIPTION NTER;OR PAIRS DUE TO STATER DAMAGE PERMIT TYPE B.EEMOD TITLE �ESIDENTI ELT/CONY CONTRACTORS: WI LL IAM WHALEN 'I ARCHITECTS: Department Of Regulatory Services 'DOTAL FEES: $255.00 i V BOND $.00 CONSTRUCTION COSTS $50,000,00 434 RESID ADD/ALT/CONV I PRIVATE '*.0 * sANVSTABE E, MASS. 039. A� FD MAt BUIL ING DRVISION DATE ISSUED 03/14/2006 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROMTHE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH it OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. ♦ III r i r 1 i 1 _ D :831,749 85-10-2081 2t27 Ctf*-.151441 BARNSTABLE LAND COURT REWSTRY DEED I, FEVRONIA MANOLOULES,of 35 Parker Road,Framingham,Massachusetts, for consideration of one dollar($1.00)paid, grant to ARIS MANOLOULES,whose mailing address is 35 Parker Road,Framingham, Massachusetts, with QUITCLAIM COVENANTS, The land situate in Barnstable(Hyannis)in the County of Barnstable and Commonwealth of Massachusetts, described as follows: Lot 155, Plan 7615-L as described in Certificate of Title 159967. Q For my title reference see Certificate of Title No. 159967 recorded in the Barnstable County CLand Registration Office. Witness my hand and seal this day of ARCS/ ,2001. qJ FEVRONIA MANOLOULES c 1Y N N Gl k I ETURN TO: 4 THE O'CONNOR LAW1 ;".: ' >1 16 South Main Street 7*field,MA 01983 la N fZ s., °Fo tNKE T Town of Barnstable Regulatory Services Ak_ 9sn M Le' AM. Thomas F.Geiler,Director e / rfp 39.,a Building Division Thomas Perry,Building Commissioner wv- �C 200 Main Street, Hyannis,MA 02601 J a www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 October 2, 2006 ,I Mr. Aris Manoloules 1500 Worcester Road Unit 311 Framingham MA 01702 Re: Illegal Apartment: 25 Ripple Cove Road Hyannis MA 02601 Map: 325 Parcel: 064 Dear Property Owner: Our records indicate that your house at the above-referenced location is currently being used as a multi-family home,which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincerely, Linda Edson Amnesty Zoning Enforcement Officer Building Department gforms:zoning3 I Town of Barnstable Regulatory Services 9IIAMSTABI MAS& '$` Thomas F.Geiler,Director A�Ep;o�A�e Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AFFADAVIT c0C� � '. (0 Now comes R i, owner if property situated at 141 Highland Ave in - Cotuit,MA, holding title under a deed recorded in the Barnstable Registry of Deeds-in— Book 164>4 Dam 9l and being shown on the Assessors' Map4t Parcel 04 2, hereby attests to the following. �� �� 30�� GCo�( The efficiency apartment abe � at tAh aforesaid property will only be used for family, is not intended for and shall not be used as a permanent, separate apartment for year round or summer occupancy and will not be rented in any fashion. Witness my had and seal this2 day of November, 2004 Ronald A. Tosti THE COMMONWEALTH OF MASS. BARNSTABLE COUNTY, SS Date Then personally appeared before me the above named Ronald A. Tosti and made oath as to the truth of the forgoing instrument, before me. Notary"Public* My Commission Expires Q:zoning5 Parcel Detail Pagel of 3 R VIVW� � # ,Lagged In As: Parcel etaII Monday, Octo Parcel Lookup Parcellnfo ... ......... ......... Parcel ID.325-064 developer.LOT 155 Lot Location ;25 RIPPLE COVE ROAD p Pri Frontage:80 Sec Sec Road Frontage ............. ..... ......... ......... Village HYANNIS Fire District HYANNIS ......... ......... Sewer Acct.2635 Road Index 1372 Interactive w r Map Owner Info ........... _... Owner MANOLOULES, ARIS Co-Owner z Street1 .1500 WORCESTER RD-UNIT 311 Streetz City FRAMINGHAM State MA zip 01702 Country Land Info ......... .... .. .. .. ........ ... ....... .:.._..... _....: Acres 19.26 use;Single Fam MDL-01 Zoning RB Nghbd 0113 Topography Level Road Paved .._... ...... _,, ......._._ .... _. _......... Utilities;All Public Location,Marginal View Construction Info Building of I Year Roo.. 1 Roof iGable/Hip ;Clapboard Built Ext = Struct Wall _ I Effect " 832 """ " f Roof{Asph/F GIs/Cmp AC None Area = �1 Cover Type ......... Bed style'Raised Ranch wall;Drywall Rooms 4 Bedrooms Int Bath Model Residential Floor= Rooms 2 Full Grade lAVerage Type Hot Water Rooms 19 Rooms http://issql/intranet/propdata/ParcelDetail.aspx?ID=27020 10/2/2006 Parcel Detail Page 2 of 3 x Heat Found- , �y3i3fi)3331(L/6 Stones 1 Story Fuel Gas . : ation Poured Conc T,NO � t �.. Permit History '' __.... Issue Date Purpose Permit# Amount Insp Date Corm 3/14/2006 Repair Work 90806 $50,000 L 7/1/1985 B28178 $60,000 1/15/1987 12:00:00 AM HY 1 Visit History Date Who Purpose 4/12/2002 12:00:00 AM Paul Talbot Meas/Listed-> 7/15/1988 12:00:00 AM ME Sales History _._ _...... Line Sale ®ate Owner ��....... _ . Book/Page Sale P 1 5/10/2001 MANOLOULES, ARIS C161441 2 12/4/2000 MANOLOULES, FEVRONIA C159967 3 MANOLOULES, EMMANUEL C28211 Assessment History ......... ..... Save# Year Building Value XF Value OB Value Land Value Total Para 1 2006 $154,400 $31,500 $0 $359,200 2 2005 $144;300 $31,500 $0 $324,900 3 2004 $117,200 $31,500 $0 $243,600 4 2003 $106,800 $31,500 $0 - . $100,100 5 2002 $103,600 $31,500 $0 $100,100 6 2001 $103,600 $31,500 $0 $100,100 7 2000 $84,500 $31,200 $0 $63,500 ; 8 1999 $84,500 $31,200 $0 $63,500 9 1998 $84,500 ' $31,200 $0 $63,500 ; 1.0 1997 $152,000 $0 $0 $39,300 11 1996 $152,000 $0 $0 $39,300 12 1995 $152,000 $0 $0 $39,300 13 1994 $133,500 $0 $0 $70,700 http://issql/intranet/propdata/ParcelDetail.aspx?ID=27020 10/2/2006 ,Parcel Detail Page 3 of 3 14 1993 $133,500 $0 $0 $70,700 15 1992 $151,500 $0 $0 $78,500 16 1991 $141,800 $0 $0 $88,300 17 1990 $141,800 $0 $0 $88,300 18 1989 $141,800 $0 $0 $88,300 19 1988 $71,400 $0 $0 $23,400 20 1987 $35,700 $0 $0 $23,400 21 1986 $0 $0 $0 $19,900 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=27020 10/2/2006 r V'METROWEST MEDIC AL CENTER Framingham Union Hospital • Leonard Morse Hospital CT, Ury October 20, 2006 w c To whom it may concern: Feuronia Manoloules has had Multiple sclerosis since 1987. She is being followed in the Multiple Sclerosis Clinic at MetroWest Medical Center. Sincerely, ; Arthur Saal.M.D. ti FRAMINGHAM UNION HOSPITAL P.O. Box 9167 115 LINCOLN STREET'-. FRAMINGHAM, MA 01701-9167• (5-08) 383-1000 LEONARD MORSE HOSPITAL ' 67 UNION STREET• NATICK, MA 01760-6099 (508) 650-7000 "'' www.mwmc'.com BRIGHAM ANDPIN WOMEN S HOSPITAL �jS rly Oy, � 4850 Boylston Street,Suite 530 Brigham and Wornen!s,Physician Group Chestnut Hill,MA 02467 Tel:(617)732-9901 Fax:(617)277-1581 Qf f Q Brigham and Women's Physician Group 850 Boylston Street MANOLOULES, FEVRONIA Chestnut Hill, MA 02467 05576616 617-732-9900 10/11/2006 HISTORY OF PRESENT ILLNESS: Follow-up for osteopenia/osteoporosis, hypothyroidism, venous insufficiency, probable coronary artery disease, and hypercholesterolemia. She discussed her concerns regarding her son. She states that her son has no home life, career, or relationships. She attributes this to herself and states"once I die, what will he do?'. 'She is limited by her MS. Receiving Avonex..She occasionally takes calcium and vitamin D. No recent pamidronate. Not exerting herself. She denied chest pain, shortness of breath, PND, and orthopnea. Intermittent leg swelling, always occurring after she sits in a wheelchair for a prolonged period of time. Not using compressive stockings. No fever, cough, hemoptysis, pleuritic chest pain, or evidence of PE. On combination of TriCor and Pravachol with no symptoms of rhabdomyolysis or hepatitis. Laboratory on 4/18/2006 demonstrated total cholesterol 176, HDL 26, LDL 119, and triglycerides 172. Exercise:As above. Cardiac risk factors: Postmenopausal and hypercholesterolemia. Laboratory studies on 4/18/2006 demonstrated glucose 102, creatinine 0.7, potassium 4.3, ALT 18, AST 25, and TSH 3.45. Last CRP on 11/8/2005 was 10.5. Homocysteine was 8.3 on 6/22/2001. Neurovegetative signs: Variable concentration and energy. On Paxil. 4 PAST MEDICAL HISTORY: r - MEDICATIONS: 1. Calcium, but intermittently. 2. Vitamin D, but intermittently. 3. Avonex. 4. Occasional pulse Solu-Medrol, 5. Occasional Mobic. 6. Pamidronate infusion gyear. 7. Paxil 20 mg daily. 8. Prilosec 20 mg daily. 9. TriCor 145 mg daily. 10. Pravachol 40 mg daily. 11. Occasional low-dose aspirin. She is not on a beta blocker. ALLERGIES: 'BACTRIM. HABITS: Tobacco - None. PROBLEMS: 1. Menopause. 2. Osteoporosis. 3. Possible CAD (status post PCI). 4. Diverticulosis. ,. 5. Hypothyroidism. 6. Venous insufficiency. REVIEW OF SYSTEMS: Cardiac: Denied chest pain, exertional SOB, PND, edema, palpitations, history of hypertension, coronary artery disease, cholesterol, or diabetes, or use of cardiac medications. Respiratory: Denied shortness of breath, cough, sputum, fever, chills, night sweats; weight loss, PND, DOE, orthopnea, hemoptysis, tobacco use, history of asthma, pneumonia, PE, pleurisy, or TB. (Limited by exercise). PHYSICAL EXAMINATION: Blood pressure 120/63. Pulse 92. Temperature 98.6 degrees. Weight 166 pounds. Integument: No rashes. Lymph nodes: None palpable.. HEENT exam: Grade 1 hypertensive retinopathy. No diabetic retinopathy. Pharynx: Slight crowding of the uvula and retrognathia,. Neck: Carotids full. No thyroid or JVD. Chest clear. Cor: S1 and S2 physiologic. Soft S4. Abdomen: No AAA, bruits, abdominal tenderness, or masses. Extremities: Calf girths 36 cm. Trace edema bilaterally. There were superficial varicosities. Pulses faint to dorsalis pedis. Neurologic: There was decreased strength of the lower extremities(4+/5). Using cane to ambulate. Deep tendon reflexes depressed distally. No tremor. No internuclear ophthalmoplegia or Marcus Gunn's. ASSESSMENT: 1. MS (remittive)with stable brain MRI on 812/2004. 2. ?Single-vessel coronary artery disease(status post failed PCI and on secondary preventive measures) with failure to achieve target cholesterol as of 4/18/2006. 3. Osteoporosis by QDR. Stable as of 7/13/2005. 4. Probable depression (unipolar major)without bipolar features. PLAN: 1. CAD. Discussed principles of secondary prevention. Discussed target LDL, blood pressure, etc. Recheck fasting lipid profile, LFTs, and CRP. Discussed escalating dose of Pravachol. Continue TriCor. Discussed symptoms of rhabdomyolysis and hepatitis. 2. Osteopenia/-porosis. Calcium and vitamin D. Check,1,25 vitamin d and calcium: Pamidronate. Recheck QDR. 3. Thyroid. Noted. Recheck TSH. 4. MS. Continue disease-modifying agents. 5. Discussed venous insufficiency. Discussed elevation, avoidance of salt, and compressive stockings. Reviewed indications for noninvasives.and risks for venous thrombosis. FOIL Follow up in 6 months. f Milo F Pul M. eScri tion document:4-p 8268940 SEeScription - DD: 10/11/06 . DT: 10/16/06 a I oFt�E r Town of Barnstable Regulatory Services 9&' . Thomas F.Geiler,Director 16. 1% Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 October 2, 2006 Mr. Aris Manoloules 1500 Worcester Road Unit 311 Framingham MA 01702 Re: Illegal Apartment: 25 Ripple Cove Road Hyannis MA 02601 Map: 325 Parcel: 064 Dear Property Owner: Our records indicate that our house at the above-referenced location is currently being Y Y g used as a multi-family home,which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincerely, Lin dson Amnesty Zoning -Enforcement Officer Building Department gforms:zoning3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 0�7 r Application# �((/ Health Division ¢` s Conservation Division '' J Permit# Tax Collector Date Issued Treasurer wry , Application Fee Planning Dept. - Permit Fee a6, 00 Date Definitive Plan Approved by Planning Board r) a e Historic-OKH Preservation/Hyannis ' 4�a � �D of J(0 uu�� lV Project Street Address Village Owner Address Telephone Permit Request A 1A PJ 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 ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: 0 Yes ❑No Detached garage:❑existing ❑new seize Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No__�If yes, site plan review# "" Current Use Proposed Use BUILDER INFORMATION Name ` l r°\ Telephone Number Address (N. r�L�i��/� License# AlclE-1 4411 Home Improvement Contractor# Worker's Compensation# WC. j S ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 'SIGNATURE DATE FOR OFFICIAL USE ONLY f "PERMIT.NO. - It DATE ISSUED MAP/PARCEL NO. - ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION �lC- 16 FIREPLACE ELECTRICAL: ROUGH +FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL _ L: FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO t °FtMEro�ti Town of Barnstable " Regulatory Services XA ss8 Thomas F.Geller,Director 019.� 10� Building Division. 5 Tom Perry, Binding Commissioner 200 Main Street, Hyannis,MA b2601 www.town.b arnstabl e.maxs t Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder I, n 1R IS E , M R NO LCC)UL t=S ,as.Owner of the subject property r hereby authorize P tT P I C K I)19 H,L C R 6 N to act on my behalf, in all matters relative to work authorized by this building permit application for: 2-5 RWPL.E Co\]E R`-81 , HYMOWS (Address of Job) t Signature of Owner Date Print Name Q:F0RMS:0 WNERPERNaSSION �v .I BOARD�f 8uKp1NePERViSOR ' Y . License. CONSTRUCTIE 082525. Numbm:,.Cs a g s 0712 _ ResOricted' m s ° PATRI K :Raministra _ 1 RW 01501 AUBURN. Wt ` ' • , �-. • ✓die�arrinnanure�il� a�✓G�adaae/u�aeCt� Board of Building Regulations and Standards License or registration.yalld for individul use only HOME IMPROVEMENT CONTRACTOR. before the expiration date.:.If:found return to: Re Board of Building Regulations and Standards :Expiration .7/:14/2G07 One Ashburton Place Rm 1301 Type Individual Boston;Ma.02108 PATRICK DAHL PATRICK DAHLGEN 1 RAVINE.DR AUBURN,MA 01501 � Adminis4rator Not valid without signature ,y��THET°y, Town of Barnstable Regulatory Services &MWSTAB''E Thomas F.Geiler,Director 1639. '°TEp Mptl s`�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF ` CHANGE OF LICENSED CONSTRUCTION SUPERVISOR I, P R i S E , M rAt�,I O L O U L E S , owner of property located at 2-5 R►P Pi. C Co uE ROR`D, , hereby certify that W 1 L L P g M W H R L L N is no longer'Construction Supervisor listed on the application for the project under construction as authorized by building permit# 9 O`8�6 , issued on 311q 200 6 . I understand that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. 0s I4�20or PROPERTY OWNER DATE q/forms/newcontr reference R-5 780 CMR rev:080102 The Commonwealth ofMassachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street , Boston, MA 02111 www.masagovldia, Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridans/Plumbers Applicant Information Please Print LegibIy Name (Busmess/0rn nization&&v1duan: Address City/State/Zip: - 141d0-,1 1t),¢ o�.s-� ' Phone M scof Are you an employer? Check the'appropriate box; Type of projecf(regaired): 1,�rI an a employer with off- 4. ❑I an a general contractor and I 6. ❑New construction employees (fall and/or part time).* have hired the sub-contractors 7. Remodeling 2.El am a sole proprietor or partner- listed on the attached sheet I g ship and have no employees 'These sub-contractors have SS ❑ Demolition working for me in any capacity. workers' comp.insurance 9. ❑ Building addition (No workers' Comp.insurance 5. ❑We are a corporation and its . required.] officers have exercised their 10.0 Blectrical repairs or additions 3.❑ I am a homeowner do ng all work right of exemption per MGL 11.❑ Phunbiag repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t . employees.(No workers, 13.❑ Other comp.insurance required.] *Any applicaat that checks box#1 mnat also fill out the section below showing their workors'onvensation poligriaRmnstioa: t Homeowners who submit this affidavit indicating they ere doing an work aad1hen hire outside contmotors mast submit anew affidavit indicating'such 1coatractors that check this boa must attached an additional sheet showing the name of the sub-coat ikon end their workers'comp.policy hfbrmadon. I am an employer that is providing workers'compensation Insurance for.my employees. Below Is the policy and job site information. . PP �+ •.'•�. Insurance Company Name: `L eyZ,:h / � C L0 ?olicy Ear Ste.Lic.i:: lob Site Address: City/5tate/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and W.iratlon date). Fatiure to securC coverage as required under Section 25A of MGL c. 152 m3i lead to the imposition of 44 1inal penalties of a fine up to$1,500'.00 and/or one-year iragrisozM=%as well as civil penalties in the-form oI a STOP WORK ORDER and a fine of up to$250.00 a day against flee violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties of perjury that the information provided above is true and correct. Si tore: Date: Phone 0 1 7 . a,Asp e y. Doi a."At a�a,to be e 6ed-b,.C4 or x� . I I City or Town: PermiVLItense# Isesuingo Authority(circle one); 11.Boa-rd of Health 2.Building Department, 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other CQii�LSi 13er5ot3: Phone#: Informs' tion and Instructions Massaqbusetts General Laws chapter 152 requires all employers to provide wbrkers' compensatibnfor-their employees. Pursuant to this statute, an employee is defined as"..,every person in the service of another under any contract of hire, express or implied,6W or written." An employer is defined as-"an individual,partnership,association,corporation dr other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the . receiver or trastee of an individual,partnership, association or oTher legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, cotstruction or repair wont on such dwtUing house or on The grounds or building appurtenant thereto shall not because of such employment be deemed tobe an employer," MGL chapter 152, §25 C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate it business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(1)states-Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the pm*rmanet ofpublic work urnd acceptable evidence of compliance wilb the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fM out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited,Liabiity Partaerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign sad date the affidavit. The-affidavit should be rimed to the city or town that The application for The permit or license is being requested;not the Depariment of Industrial Accidents. Should you have ate+questions regarding the law or if you are required to obtain a workers' compensatimpolicy,please call the Department at the member listed below. Self=insured companus&WId cuter their self-insurance license number on-the alrpropriate line. — City or.Town Officials . Please be sure that the afff davrt is complete and printed leginly; The Department has provided a space at the bottom.. of t�afddavk for you to fill=in the event the Office of Investigations has to contact you regarding the applicant . Pleasebe sure to fill in the pernudlicense n mzberwbich wi lbe used as a reference uamher. In addition,an applicant That must submit multiple permitnicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in _(city or town),"A copy,of the affidavit That has been officially stamped or marked by the city or town maybe provided to the applicantas proof that•a valid affidavit ism file for future permits or licenses. Anew affidavit mustbe filled out each year,Where a dome owner or citizen is obtaining a license or permit notrelated to any business or commercial venture (je.a dog license or permit to bun leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and sbouid you have any questions, please do tot hesitate to give us a call. The Department's address,telephone and fax amber: The Common ea1thofM- u&w1MSett3 Department of Industrial.Accidents Office of Inveftagm 600 Washington Street Boston, MA,02111 Tel. #617-727-4900 ext 406 os 1 o77-MA.SSAFE ' Fes{#617-727-7749 Revised 5-26-05 vw-v iaass.aov/dia �1HE r Town of Barnstable Regulatory Services BAMST"y MASS.LE'�,` Thomas F.Geiler,Director �ArfD Mp'l6. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date__ 'l JV"U G 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: Q_� Estimated Cost Address of Work: Owner's Name: AvA s C:. /v Y ci ei c)1,ock �S Date of Application: J / 0 b I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑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 th agent of the owner: (� ^I- Date Contractor NwN Registration No. OR Date Owner's Name Q:wpfi l es.forms:h o meaffi d av i Assessor's maP, and lot number ....................°..............l......./ pF THE TO Sewage Permit numbeTj#/.Fg�.. �,97y ..n�P.�.4 �G-7� (V,�. /�J`j : l I VC Z BAHHSTADLE, i House number ................ ..- '..................:................ ro Mass p t63q. `00 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ........................................:...................................................................................... TYPE OF CONSTRUCTION (!U o�:. l......ra?oK....... .!!!! . .t.. (' :. '!v,!„ .�......................... V. G......./A.................19�5.. . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followiiinng information: Location .q /Sv`'....... !.f�, .�......t... .1�.?�... �'A. ........1./... ! /.. .f. � . -.................:.........:....... ProposedUse ..�C!.NS�t'.... 'P. .'..a. a..................................................::...................................................... ZoningDistrict ........................................................................Fire District ,............................................................. Name of Owner;FN..j7.fixv.v�'.J......&&4� k (..P..�..........Address R..5... C:►.r.l�'�°d . �'�.:..7�C.�f.?tl.K!.��T�ifi�+���..... Name of Builder ........... ............./�.......................... Address .lo< . ?... ...... ..........5......4�.✓.../.�...�.......U/3�✓ Nameof Architect .........................................................'........Address ......................................................... ................. 6 •- M Number of Rooms .. ...........................�' 4.h. .............. .........foundation :�"C�.IJl'le ,. Exierior C"!Ae ��ft f" p/?.Y �l ........Roofing . `I.Alt..r...�?.!!.!..#?�g��'............................... �1r1' 7......................Interior \ j''.. ..... / ,.!Floors ... ...'�'. q ................................. ................. Heating � 1. ....: ..... �:Plumbind�.:'...................................... r .. �4 .................... `.. r s Fireplace ........................... L... :../r/ ..........:Approximate. Cost ........... QP .4..� ............:........ �::.. . �. Definitive Plan Approved by Planning Board ________________________________19--------. Area .......................................... Diagram of Lot and Building with Dimensions Fee a ;.......... ;4 SUBJECT TO APPROVAL OF BOARD OF HEALTH , s .. N, �� G� y 0 0 r.S �y s s"l of 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. l!% :/ ! 1 Name .. .... ...�.. ..... .��......!;�.�.,!�... .... Construction Supervisor's License t�Mo�......... r✓`t MANOLOULES, EMANUEL A=325-64 No 28178 Permit for ..hator. singl•e••• ............. .................... Location ......25..RIPLPle..Cove...Rd'. ...............Hyannis ............................................................ Owner ..................Emanuel...Ma.ncrloule.......... r Type of Construction frame...................... ................................................................................ Plot ............................ Lot ................................ ` Permit Granted ...................julY...g........19 85 Date of Inspection ....................................19 Date Completed ......................................19 a ; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ®(© Application# Health Division Conservation Division ® '' Permit# 1 �� Tax Collector x Date Issued 0 vl 6 r Treasurer _d Application Fee Planning Dept.' Permit Fee Date Definitive Plan Approved by Planning Board CONNECTED SEWER ACCOUNT Historic-OKH Preservation/Hyannis Project Street Address S f P 1. L -C 01 V l Z_o 19 a/ Village &5'' /V% Owner 12I,� �/9/YO),C/ V 16S Address90Y A 0EtiA_11g: Qie'/J_fw Telephone S L1/ ( — PermitRequesWA TCA— I4M)� 'G"e 11 ptCC V r emoVE- 4- QC-4t1Ciz- 6 fC6TrI.�-L_�—I 1AvSUL0 rlohi . rAA,P�,T -Veake-) %NyY,(,A— j n-(M, . P/t^f w � / I�/� 4- 41'���—�A NO Svc reffl OR W 62k— Square feet: 1 st floor:existing 66 proposed 0 2nd floor:existing 0 proposed C) Total new Zoning District Flood Plain Groundwater Overlay Project Valuation O ®G 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family y Two Family ❑ Multi-Family(#units) i f Age-of Existing Structure a Historic House: ❑Yes Flo On Old King's Hi hway: 65Yes ,-ap'U/N o Basement Type: fdFull ❑Crawl dWalkout OOther- Basement Finished Area(sq.ft) o�a O Basement Unfinished Area(sq.ft) '7 Number of Baths: Full:existing - new Half:existing new Number of Bedrooms: existing 6 new v Total Room Count(not including baths):existing Z C7 new First Floor Room Count Heat Type and Fuel: 0Gas ❑Oil µ0 Electric ❑Other Central Air: ❑Yes 014o'_ Fireplaces: Existing ✓ New Existing wood/coal stove: ❑Yes YNo 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# —4y---Current,Use-----___ _ _. Proposed Use BUILDER INFORMATION Name V/0 L 9—W f K5 T6 P G `V Telephone Number �� "` 760 1 !f I Address ),), 191gF_ 1164lu Wily License# `7 4 c/,2 Home Improvement Contractor# f C1 oZ Worker's Compensation# c�a::?1,2 06 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Y14Q SIG CU Pose , —�J p SIGNATURE IA � .2 ZAJA/L� DATE O(3 ---' / FOR OFFICIAL USE ONLY• f � 8 , PERMIT NO. to . DATE ISSUED MAP%PARCEL NO: ADDRESS VILLAGE OWNER' -sue r r 1 , DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL- GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I �- - - - . y2,� i Cb"�� � � ��� °FtNEr� Town of Barnstable Regulatory Services ` BAMSTABLFw ' Thomas F.Geiler,Director 9`�ArEp19.�p``MAM � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, 'improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: �� /n �l ������ Estimated Cost S-0, Address of Work: 25 A PA Lou,?_� &U Owner's Name: /9 Date of Application: o r7 — O I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law []Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME I PROVEMENT 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: X o3 - 7 - a t #04 E N as 7o&,,tr1o1y Date on for Name Registration No. OR - Date Owner's Name Q:forms1omeaffidav ti J. . "CepfY4®pxgkACl9 for dnL and 7wo-FaallY Regidgut 1 SIINIMP iffesta T rush' Glazta� GSaziaj cclung Wa1 door leas g askr F praeat d A:eaj�'/.' tT�d►�1u2 WIU R-VAu� �avelu® itevalu 101 to 4500 HOWICS,i0 D Ncrcw 12/a ® 33 13 19 !0 6 s 6 12`A M2 . '3® • '19 19 30 •i3 A S I2%' Q.50 39 13 19 I , 23 29 WA Atoa�1— - ----- 19 10 �,; •,•15Ya 0.44.- 38 ' t3 _ 23 NIA 't�A 91 Ani- W ' IS% O.SZ 30 t9 19 10 � l3'' ZS N/A NIA °rcul I�°le 032 ' 33 NIA Normal � • lea/• '' D.42• 38 '• t9:' 29 PUA , 33 19 1D 90 AFM •I>1°!• D,�2 39 14 19 10 D AFV AA 1Z-/• D.3Q 30 60V le-ADDRESS OF PI;OPERTY; -. Z, SQUARE FQOTAGF OF ALL MMMOR WAYLLS:; •-- 3. SQUARE FOOTAGE OF ALL'GLAZING, �Co.(� ' ,; ' ' • , °/®GLAWG AREA�03 DIVIDED BY#2): ' ECT PACKAGE(Q N AA-see chart above): , 5, SEL .. NCTE: OTIM MM, OLVED I MTHODS OF DETER tG EI�tBRG�I REQ �„ S ARE AykMAELE, ASK US FOR TES ngORMATION' EUIDINri RgSYECP'OR.APPROVAL; 'NO; q•tasgns���®3G3z no CAR'APp911diac 1 Lass doors, skylights, and Footnotes to Fable J2°2.1ba assemblies (including sUding-g wall a Glazing area is the ratio of the area of the glazing + windows if located in walls that enclose conditioned srp a m bubexcluding l from the U-value rem ement. basement V to 1�1a of the total glazing Y area;eXpressed as a percentage, pa building design example,3 of decorative glass maybe excluded tested and docurriented b�+themmanufacmr r In accordance with For P ea�g U-values inust be 3 After January 1, 1999, C test procedure, or taken from `Table J1,5,3a, U-values arA for ills National Fenestration Rating Council (NMQ ' whaI units: coffer-of-glass V=values cannot be used. - o e i :be sgbstituted for R-38 .R values do arot assume a raised or ovarslzod frust constnic�tr'on��.$a insula33oaz achieves the MI s ?he.ceiling the'exterior wills'without compresslon, R 3 insril'ation thickness over _ elation: GeiliagA�xalti�s p?'escn tie-sum• . en insulajon aa-6 It1'3'1�fnsu�a i'on icmay be"stil 'rEtited'for e bilin insulating shea%ini mu�t.b®placed between . that' F�+ '' insulation plus insulating sheathing(if.used):For v , the conditioned space and the ventilated portion of the roof' used).Do not Include' .aI1.R-values represent the sum.of 65 wall cavity insulation plus insulating sheatliiag'( W For example,an R 19,requb meet could'be met EIT1�ER exterior siding, structural sheathing,.and latenor drywall. ° vi insulation ®R R 13 cavity insulation plus R 6 rose atin® shaathiam.��9 ants to by R 19 ca ty Wall constructions,but d VP Y tc wood-frame or Glass(concrete,masarrry,lag) e nor r uiiamorrts apply to floors over unconditIdned spaces(such as uacaadidoned crawlsgaces;t5asetnents, The fl de must or garages),Floors over outside air must meet the ceiling requirements. conditioned I a satire opaque portion of any indri►4dua1 basement wall with as average depth less the 3�eras of grade , �' uiramint'as above-grade walls, Windows and sliding glass [Tmvalue requirement m,cet the sarne 'R=value req Easement doors must•taoet.'t o d, basarnants must be included with the other glazing. da-scri ed in Note b, Add as additional A 2 for heated slabs. oit loll to'install more The R.-Value requirements are for unheard slabs. use abm liance approach 3,h,'or S."If Y Plan , If the building irtitizes elgetrie resistance heating P ent with the lowest than one piece of he equipment or more than one piece of cooling equipment,the ®qA� efficiency mrist meet.or exceed the efficiency,requ st by ar seeTabla]5.2,1a e closest o ; NG�g° ' . .'slues are maximum acceptable levels.Insulation R-values are m��acceptable-levels. a)Glazing aroas and V v R.value requireriients are for insulation only acid do not include structural components,a 5 ]oor U-values must be tested b)ppaque doors in the building envelope must have a V-value no greaternot available, or U-,O the anted b the manufacturer in accordance with the NFRC te procedure o fan from the door U valuo ' and docum Y to U-value rating in?able J1,5.3b. if a door corrtalw glass and an agg"ga . the loot with your windoviI and use the opaque door Valuo�toter than ,35),mpliance of the door. ass area of ent i.o� may have a V v with be excluded from this requirem one doer may o crawls ace wall component includes two or more areas c)If s�ell`rr�g+wad,i1®or,basemer}twau+slab-edge, L p ulWon levels,the component complies if the area-weighted cam® the Wr I weight d av ge U• different ells or door componentscomply the R°value raquirerneat for that component.Glazing ®fall windows or dcors is Iess than or equal to the U=value requirement(0,35 for doors), , . value . rA Town of Barnstable W g---u---ra-,to--r- rvi ces 4 � n"Rr'ns �s Thomas F.Geller,Director 1 1639' ,`� Building Division. �A�BD MA'S A Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 62601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-79076230 Property Owner Must Complete and Sign This Section If Using ABuilder I, 4VI-C' NOV Wes ,as Owner of the subject property hereby authorize ��,1 to act on my behalf, in all matters relative to work authorized by this building permit application for ZS (Address of Job) S' afore f Owner D to Print Name Q TORMS:OWNERPERMISSION fY >, _ _- ✓fie �o�noreo�euiecz�C o�✓Y/Cae3ac,�zteae�Gx f BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR NumbeO CS4 074928_ : 1 Expires 08/10/20Q6 Tr.no: 1283.0 `s Restricted v00 ; WILLIAM WHALEILI 122 POND STREET' > BREWSTER, MA 02631 'Commissioner l ✓�ie -f�'anvnZan��ealt�i. 0�,/1/�a�acltu� Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 129244 ;,.Expiration:. 7/30/2007 _ - Type: Private Corporation Whalen Restoration Services Inc. William Whalen 22 American Ways South Dennis,MA 02660 Administrator • y ,