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HomeMy WebLinkAbout0131 RUDDER ROAD /\\/�_ �f _ T— r a� C,/�\� v , .. 0 L '� �//\\f -�J S� � � � b � � � � t � � --' ,o C' Y � � V 1 �. A ..._�. .. ����� � �� --. 1 �> "�. r� ,, � i YI d_..�..,._«..._�... ., r.�.._... 7,4) CO -�c 2 c Q �KP e z cy (s o' --Po.J IM 2 2�! `1 1 n c. � �,.�.,,— i �..¢_- f•3.e�2ma� � -t�Ito-�-- �-C� IC) S: rZ(2r "0 cA)Ws { �2 tZ C hA-g Pe p� 'DooZ —Pc.c( r `rc q 2, r,-To Y� 0 2�Glf}�- C f9J !iU`� GT02� AAQ-r &0� oc�vP/✓ ¢l��? Z- L(occr< 2•c- �JQ ,grt2 C{..�'4(��0�"� T� c7lPw �!}-'� Ce9�I" r✓ -�k� G�'(��'�, ce��4'(. ��rJ ! tZe r - (k C �oTP' D 1N l4 lace JQ/li 1�70-L C7 W!{`1cQZjc� AQ ? S ® ©�'v P 2� S i� S �C,k Adp r A CW.Q g,-S ��e ��oa`-�5 C- 4S� coo m1, r r � U14A-p✓ �J�e,P\)�,,.,e 4�L -�-® ��e� p i,.� Q.Q.R.-. `'6 t��3z we...-� "� Q`A�)'� �n P✓ �� Two `�Q<<y>�i.��- �-e�-2�o�-,.,� o� � .-C'�25 T -t10o ti ,� .2�-�� q-� ow•a C�-2® f�w,r 7�5 -r7 ` -10 Kr CQ �p,, i,a . t` 2 �va— 1 O C 6L a"�`� I rI ��o f D C��� O 0 -eA— J . F R r 4c Cey-.s, 1 1 a} y. 4 e . d : A� d s i Don Murray Service Supervisor Colonial Gas Company COLONIAL ' 127 White's Path South Yarmouth,MA 02664 i T 508-760-7534 800-548-8000 ' Fax 508-394-2564 E-MCH dmurray@colonialgas.com I a r e f a s . a • i t i __.. i _. _ _.. . .:.. L_M. ..r_._ _ I I i � r `. � �� PHONE: (508) 432-3304 FAX: (508) 430-8662 E cJAMES B. STINSON ATTORNEY AT LAW �l 72 MAIN STREET. P.O. BOX 665 WEST HARWIGH• MASSAGHUSETTS 02671 { X Zl�t ' *: glreering Dept. (3rd floor) Map Parcel /7.j Permit# 4 House# I / Date Issued IF Board of Health(3rd floor)(8:15 - 9:30/1:00-4:30) Y� G/3 /,Gi/2;%?p �`'33 Fed Conservation Office(4th floor)(8:30- 9:30/1:00-2•"00) . 3 �a a. oor/School Admin. Bldg:) # OfTME 3 by Planning Board 19 , SEPTIC', , BE g . `y 6 • INSTAD I CE., TOWN OF BARNSTAWH �ONIUf�1�TAL DE AND' Building.MinitAp l cati�ori REGULATIONS ( p ,. TOW,N� Project Street ss f `yoUr� 14 W Village Owner PJ P��r✓iC-".`�. ,� �- /� Address Telephone Permit Request Pc -�" tax First Floor�_�,j�g `5 f rY�.� /square feet Second Floor " 's`q uare feet *. Construction Type �_Q 3-0 Estimated Project Cost $ � Zoning District Flood Plain µ Water}Protection Lot Size Grandfathered p Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House p Yes f 10 On Qid King's Highway ❑Yes o Basement Type: Full Xrawl ❑Walkout •0Other 'PLAJS ��R5 C '�i t • Basement Finished Area(sq.ft.) Basement Unfinished Area'(sq.ft) f g New { Number of Baths: Full: Existing � New Half: Existirig ' Ago. of Bedrooms: Existing G New. s. Total Room Count(not including baths): Existing -T' New . First 1716or Room Count Heat Type and Fuel as Oil Electric YP •� ❑ ❑ ❑OtherP." Central Air J<Yes ❑No Fireplace : Existing I . New _ Existing,,wood/coal stove ❑Yes XNo . Garage: Detached-(size) �7 Other Detached Structures: ❑Pool"(size) Attached(size) ❑Barn(size) t - ? ' ,❑None d(size)❑ e - , __ _--- =_� - _- r-- = ._ - - '❑O�t$er(size) Zoning Board of Appeals Authorization ❑ Appeal'# v Recorded Commercial ❑Yes No If yes, site plan review# Current Use r- - f',, % � ,..�'; , `Y r /i wt.t- Proposed Use ��_ ''l 1. 2 C / r.:`"L�Iw" Builder Information Name 6--2Ag-<_ -Telephone Number > � AddressLicense# s Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO s AIIGNATURF,, _ .�` ''� ' DATE UILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED. MAP/PARCEL NO. ADDRESS VILLAGE, OWNER k i OF INSPECTION: _ , DATE FOUNDATION FRAME INSULATION ? FIREPLACE - F ELECTRICAL: ROIJQB FINAL PLUMBING: ROIu FINAL GAS: ROLJ FINAL . o.� ` rn a FINAL BUILDING too DATE CLOSED OUT ASSOCIATION PLAN NM 1 Anderson, Robin 1 From: Smith, Tracey c _ Sent: Friday, July 02, 2010 11:16 AM To: Anderson, Robin Subject: Cloutier Court called on Annette Cloutier, no payments have been made complaint will issue. rase y/.�.�rriif./�a, _.I-Yrlmirl_..'/.n�/Ioo t lu? 2iredo - Jown�oq�U�arnatab[e (�onsumer qq�q /a'ir9 eLJivi9ion • # 200 ///ain Sfreet, yann s r�/JJ 02601 011ice: 308-862-4772 Jax: 308-778-2412 �FIME i Town of Barnstable fig'' ti� Regulatory Services snxtvsrnai a Thomas F. Geiler,Director � '— Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 March 26, 2010 Barnstable First District Court Clerk Magistrate Robert E. Powers PO Box 427 Barnstable, Ma 02630 Re : Annette Cloutier, 131 Rudder Rd, Hyannis, MA, Docket No: 1025 AC 001217, 0925 AC 005220 Dear Magistrate Powers: Be advised that Ms. Cloutier's refusal to admit us for the mandated property inspection in February resulted in additional citations at your suggestion. I became aware today that our scheduled hearing date was postponed to April 16, 2010 with the subsequent citations to be heard on May 7th. I respectfully request that the entire matter including all the aforementioned citations be heard on the same occasion if possible. Hopefully, this can be addressed on April 16`h as I believe the conditions to be so egregious that it warrants more immediate attention. Please advise me accordingly and thank you for your kind consideration. cerely, Robin C. 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I, rrr•!ry y. � rr9,i.. ,w •>p'.. .:w.,:. �'yNy�,^ dl,':i. ,q' ». p•'F'.p t,,z .YF', 31 rVtlah �" ,a"Y ;•:'ly 6x" da:.Y:• �dl":9 �;'�::f 'b,.�'. ,�Y",N,A^: uA iA F:� 1 'k '1�"'� :�� >�e,� t^" :Y'S 6,.1 h/µ,.r �..rc.•' �y,y, ��:hl J•y:� A ]r;'', : r �r„I J •r, ,y }�a.}b+r 4;p >�q :'.: ,cs:J-. `"` "��� � 'S ,r�u'""^ " .„�� `r�r 'm. � V 'r •,,�I' �. r:m!�,,r{' ,& � +.t ,��t .r� ; �dela:y '� ✓,... ;'� �w '� �� ;M' :�: m� a,.fir �y ��+4t h `" '!�: ,4 � .� «1 ``���� � , --. „�,•„s.-.t....,. e.... ,w, r. �.;.;i''4:-r �.4.3+11,'. 'v. H�.l... $",,,.:.i. ryV 4i9 .}:: y,'�ykk.'.:�` "N.,�„'al.' ��W'�'-� �y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- �• Parcel- Application # �cz Health Division 9� _4 i 3 3 a '191",S vJ'7 " Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan`Approved by Planning Board m, Historic OKH- Preservation / Hyannis Project Street Address l 3 Ru_ddeav- Rocr� -- Village hi Li," Owner 1/q✓l n��t� �l� �`�� Address Telephone 5 0�r' 7-T 0 :2- Permit��R,,equuest Op -arm `�7_0 -S - P-u� _0 L-d-e— Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood'Plain Groundwater Overlay Project Valuation,$ 17-�� Construction Type Lot Size Grandfathered: ❑Yes ❑ No' If yes, attach supporting documentation. Dwelling Type: Single Family l' Two Family ❑ Multi-Family (# units) Age of Existing Structure _ Historic House: ❑Yes 134,16 On Old King's Highway: ❑Yes ❑ No Basement Type: 2 ull ❑ 2 Crawl 'alkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)_ Number of Baths: Full: existing new Half: existing l new Number of Bedrooms: existing --new ---s Total Room Count (not including baths): existing _ new First Floor Room Count" Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other T.. e� Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/,coal stoyei ❑Yes ❑ No 1-i a 7' 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 n e��� ( ��— Telephone Number Address License# Home Improvement Contractor# _ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAT E r �� DATE l rZ// F Ilk a FOR OFFICIAL USE ONLY APPLICATION# i; DATE ISSUED ...MAP./PARCEL NO. t i ADDRESS VILLAGE 5 s OWNER DATE OF INSPECTION: 1 k p FOUNDATION FRAME "INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:,,, , ROUGH _ FINAL r FINAL BUILDING_ :- f r DATE CLOSED OUT ASSOCIATION PLAN NO. r The Commonwealth ofMassachusetts 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 PIease Print Les?ibly Name(Business/Organizatioa/lndividual): Address: City/State/Zip: Phone.#: Are you an employer? d6eck the appropriate bog: Type of project(required); L❑ I am a employer with 4. 0 I am a general contractor and I - employees(full and/or part-time). «. have hired the stub-contractors 6. ❑New construction .2.0 I am a'sole proprietor or partner- listed on the attached sheet. T. 0 Remodeling ship and have no employees These sub-contractors have g, -0 Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers' comp.-insurance comp.insurance.$ .--' r uired.] 5. 0 We are a corporation and its -10.0 Electrical repairs or additions 3.A I am a homeowner doing all work officers have exercised their' 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.) t c. 152, §1(4),and we have no employees.[No workers' 13.0 Other comp.insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam 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 S 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 maybe forwarded to the Office of. Invesdizations of the DIA for insurance coverage verification I do hereby certify under the ains andpenalties of per'ury that the inforrnation provided above is true and correct .. �© Si afore: A Date: Phone#: S� ���'� l•2��. - Official use.only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions �.. Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their.employees. ~ Pursuant to this statute,an employee is defined as"...every person in.the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or tiustee 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 person's'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,E§25C(6):also-states4hat"every state or local licensii;►g agency shall withhold the issuance or renewal of a license or permit to`operate a business or to construct'biiildings in the cor'Hrn hwealth,for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),addresses)and.phone number(s)along with their certificate(s)of >`� insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance.coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials .Please be sure that the affidavit is complete"and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."_A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to 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:r.Wmber: The Commonwealth of Massachusetts Depaztrnent of lndustz al Accidents Office of Investigations 600 Washington Street Boston, MA 02.111 Tel. #617-727-49-00 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www.mass.gov/di a I J �r y i I l _ _:- €; -- � i ___ -v:_ r 1 I j I1 I i j I ` Message Page�a of 1 Anderson, Robin 4 f From: Anderson, Robin Sent: Tuesday, July 19, 2011 8:34 AM To: McLaughlin, Charles as «` Cc: Perry, Tom Subject: Update Request Hi Charlie, I was wondering where we are in the enforcement process for 131 Rudder(Cloutier) and Uncle Willies (Sheinis). Can you please give me an update or otherwise direct me with,regards to next steps x . As you recall the court found in our favor on the Cloutier matter: Sheinis just pays his tickets and"- continues the behavior without remorse or interruption, I'm at a loss unless you obtain an injunction of some kind to prevent the use of the lower level.. l believe I have exhausted all remedies directly available to me. Please advise. Thank you. Win Robin C. Anderson �¢ Zoning Enforcement Officer , " 2"own of Barnsta6Ce 200 -'Alain Street Hyannis, 'A4A 026oi 5o8-862-4027 I , � I ,t a e . r 9/26/2011 I Message Page 1 of 1 N Anderson, Robin From: Anderson, Robin Sent: Tuesday, August 02, 2011 9:46 AM To: McLaughlin, Charles; Perry, Tom Subject: FW: Update Request Charlie & Tom, I respectfully request additional guidance on the next step with regards to the Clouiter and Sheinis matters identified below. Please advise. Thank you. P,96in Robin C .Anderson Zoning Enforcement Officer Town of BarnstabCe 200 Main Street Hyannis, 7vl.A .026o1 5o8-862-4027 -----Original Message----- From: Anderson, Robin Sent: Tuesday, July 19, 2011 8:34 AM To: McLaughlin, Charles Cc: Perry, Tom Subject: Update Request Hi Charlie, I was wondering where we are in the enforcement process for 131 Rudder(Cloutier) and 14 Uncle Willies (Sheinis). Can you please give me an update or otherwise direct me with regards to next step? As you recall the court found in our favor on the Cloutier matter. Sheinis just pays his tickets and continues the behavior without remorse or interruption. I'm at a loss unless you obtain an injunction of some kind to prevent the use of the lower level. I believe f have exhausted all remedies directly available to me. Please advise. Thank you. IR96in Robin C. .Anderson Zoning Enforcement Officer Town of BarnstabCe 20o slain Street Hyannis, AdA 026oi 508-862-4027 9/26/2011 Message Page 1 of 1 Anderson, Robin From: Anderson, Robin Sent: Wednesday, August 17, 2011 11:41 AM To: McLaughlin, Charles Cc: Perry, Tom Subject: Update Hi Charlie, I'm just going through my list again. What is the next-step with Annette'Cloutier of 131 Rudder and Phil Sheinis of Uncle Willies? I don't know what else to do. Should we all have a meeting to discuss our options? Please advise. `Rq&n Robin C Anderson Zoning Enforcement Officer Town of BarnstabCe 200 plain Street Hyannis, NA 026oi 5o8-862-4027 9/26/2011 Message g Page 1 of 1 Anderson Robin From: Anderson, Robin Sent: Wednesday, September 14, 2011 8:43 AM To: Perry, Tom; McLaughlin, Charles Subject: Rudder& Uncle Willies Just following up on a proposed meeting to discuss what to do next with these two properties (Cloutier&F Sheinis). Now that summer is over, I was wondering if a meeting could be arranged to discuss the next step. Please advise. W,96'n Rodin C. Anderson Zoning Enforcement Officer Town of Barnsta6Ce 200 34ain Street Hyannis, NA 026oi - 5o8-862-4027 9/26/2011 r Message Page 1 of 1 Anderson, Robin From: McLaughlin, Charles Sent: Tuesday,August 02, 2011 10:40 AM To: Anderson, Robin; Perry, Tom Subject: RE: Update Request Thanks, Robin. I'll get back to you Monday when Pam gordon returns. SHe has the latest info. Charlie -----Original Message----- From: Anderson, Robin Sent: Tuesday, August 02, 2011 9:46 AM To: McLaughlin, Charles; Perry,Tom Subject: FW: Update Request Charlie&Tom, I respectfully request additional guidance on the next step with regards to the Clouiter and Sheinis matters identified below. Please advise. Thank you. 4Zy6in Robin C .Anderson Zoning Enforcement Officer ':town of Barnsta6Ce 200 Main Street Hyannis, MA 026o1 5o8-862-4027 -----Original Message----- From: Anderson, Robin Sent: Tuesday,July 19, 2011 8:34 AM To: McLaughlin, Charles Cc: Perry,Tom Subject: Update Request Hi Charlie, I was wondering where we are in the enforcement process for 131 Rudder(Cloutier)and 14 Uncle Willies (Sheinis). Can you please give mean update or otherwise direct me with regards to next step? As you recall the court found in our favor on the Cloutier matter. Sheinis just pays his tickets and continues the behavior without remorse or interruption. I'm at a loss unless you obtain an injunction of some kind to prevent the use of the lower level. I believe I have exhausted all remedies directly available to me. Please advise. Thank you. &6in Robin C .Anderson Zoning Enforcement Officer Town of Barnsta6Ce 200 Main Street Hyannis, NA 02601 5o8-862-4027 9/26/2011 Message Page 1 of 1 Anderson, Robin From: McLaughlin, Charles Sent: Wednesday, August 17, 2011 1:55 PM To: Anderson, Robin Cc: Perry, Tom Subject: RE: Update Thanks, Robin, for your followup. I will draft a complaint and affidavits during the week of August 29th and will contact you both for a short meeting as soon as they.are ready for review. Charlie -----Original Message----- From: Anderson, Robin Sent: Wednesday, August 17, 2011 11:41 AM To: McLaughlin, Charles Cc: Perry, Tom Subject: Update Hi Charlie, I'm just going through my list again. What is the next step with Annette Cloutier of 131 Rudder and Phil Sheinis of Uncle Willies? I don't know what else to do. Should we all have a meeting to discuss our options? Please advise. Wg6in Robin C Anderson Zoning Enforcement Officer Town of Barnsta6Ce zoo Main Street Hyannis, NA 026oi 5o8-862-4027 9/26/2011 r L �-•..ly, I Aw/, MASSA USETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING CitylTown_. 13A6LnlST4gL_, MA. Date:[ i ;%;Permit# Building Location:l Iit�r4(Z �^ (Zd Owners Name: niT C[ Ot7�I Type of Occupancy: Commercial Educational Industrial Institutional Resid ential I L New: Alteration: Renovation: Replacement: Plans Submitted: Yes�j Noo� 1. 'N 1 �M G�h' U U ORES. O 7? I- z P. t- o O q tagLL I af rn Q fn J = F N- W j rn a.• m _z 1- Y q to a a . W c� d ddZ wCl) wr ~Cn ui v) XO m DWa zO z t v n Q Q aw U) [�Qa = " " _¢ O to v o p p z z qe7► LU. SUB BSMT.. BASEMENT X. > 1 FLOOR 2 FLOOR 3 FLOOR • 4 FLOOR 5 FLOOR 6 FLOOR. 7 FLOOR ,. 8 . FLOOR Check One Only Certlfipate i Installing Company.Name:LSAYM.0,ND SCAQ-S PLA ATb Corporation I �1 Address: jQ FIMt GrJ 2 . j City/Town CL_%4W 0 V4%C 14 State: [MA, Partnership Business Tel: '-ii3. Sti1?S Fax: �» ...�. Firm/Corr%'pany .? 3 I { — �1�1L- Name of.Licensed Plumber:[ _S o�eSINSURANCE COVERAGE: I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YesgNo� If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity Lj Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General.Laws,and that my signature on this permit-application waives this requirement Check One Only Owner Agent -Signature of Owner or Owners Agent I hereby certify that all of the details and information I have submitted(or entered)-regarding this application are true and accurate to the best of.my . Knowledge and that all plumbing work and installations performed under th mit issued for this-application will be incompliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapte 147 f th Ge Laws, By Type of License: Title I- Plumber Signature Licensed mber City/Town; — Master ; APPROVED OFFICE USE ONL ..._ a Journeyman .r License Number: � 3 fi 5 o Y 9 o - q = 3 r ka r s x 0 M K too vi la 1'T! Lx . Rk ✓ ok 611 10 w� a cA Cl� Town of Barnstable oft nor,_ Regulatory Services W� Thomas F.Geiler,Director Building Division -- - - E AAxSrABLE. t Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www,town.barnstable.ma.us Office: 508-862-4038 Fax;,,508-790-6230 Approved: �✓ Fee: Permit#: Clor7 ,a HOME OCCUPATION REGISTRATION Date: 0 Name:- Ul r/l�iC/�Ci-1.�19 Lf. Phone 0. Address: 3 Village: �%'lK S. Name of Business: Cam- 2 COA-. G2`{J1�� b11�65+rLG�S Type of Business: e4r Map/Lot: C2 W t'� I INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the �t premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering v Applicant: Homeoc.doc Rev.5130103 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL.,367 Main Street,Hyannis, MA 02601 (Town Hall) DATE: O,6 Fill in please: APPLICANT'S YOUR NAME: /40y'.et ee�—&—_ BUSINESS . YOUR HOME ADDRESS: /3 TELEPHONE # Home Telep one Number 67-0 r' 7L-/ " ! ZL NAME OF NEW BUSINESS 04vo e.' osvt es TYPE OF$USINESSX/ S Itt C-0 5 i IS THIS A HQME OCCUPATION? YESN. Have you been gjven.approval from.the building division. YES NO ADDRESS OF BUSINESS MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the_Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You.MUST GO TO 200 Main St. - (corner of Yarmouth . Rd. &Main Street) to make sureyou have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This in.dividual.has been informed o ny permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type-of business. �.r Authorized Signature* COMMENTS: i L�pQIME t0 Town of Barnstable Regulatory Services MMSTnsLE, MA & g Thomas F. Geiler, Director i639. ♦� �rFo �a Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Certified Mai1:7006 0810 0000 3525 6542 October 5, 2011 Annette Cloutier 131 Rudder Road Hyannis, MA 02601 EMERGENCY CONDEMNATION AND ORDER TO VACATE Finding of Unfitness for Human Habitation and Determination of Immediate Danger In accordance with M.G.L. c.111,sec. 127A and 127B, 105 CMR 400.000: State Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chapter II: Minimum Standards of Fitness for Humans, Timothy B. O'Connell, R.S., Health Inspector for the Town of Barnstable, on October 4, 2011 conducted an investigation of a dwelling unit located at 131 Rudder Road Hyannis, MA. The owner's name of this dwelling unit is Annette Cloutier. Based on the results of that investigation, the Barnstable Health Department finds that the dwelling is unfit for human habitation. Pursuant to M.G.L. c. 127B and 105 CMR 410.831 (D), (E) the Health Department further finds that the conditions within the dwelling are such that the danger to the life or health of the occupants of the subject dwelling is so immediate that no delay may be permitted in making this finding. Conditions found within the dwelling, which give rise to the emergency finding of unfitness and determination of immediate danger, include: 410. 750: Conditions Deemed to Endanger or Impair Health or Safety 410.750 (C) Failure to provide electricity. Based upon these findings any and all occupants are hereby ordered to vacate and the landlord/owner is ordered to secure the subject dwelling within 48 hours of , receipt of this order. If any person refuses to leave a dwelling or portion thereof, Q:\Order Letters\Condemnations\1 3 1 Rudder rd hyannis 10-4-11doc which was ordered vacated she may be forcibly removed by the local Board of Health(Massachusetts General Laws C. 127B), or by local police authorities at request of the Board of Health. Furthermore, anyone who fails to comply with any order of the board of health may be subject to fines ranging from $10-$500. Each day's failure to comply with an order shall constitute a separate violation. Once vacated this unit may not be occupied without the written approval of the Board of Health. Any person needing access to the inside of the.dwelling must get permission from the Board of Health prior to entry. Note: This is an important legal document. It may affect your rights. PER ORDER OF THE BOARD OF HEALTH MTh as A. cKean; CHOIRS Director of Public Health Town of Barnstable Cc: Genworth Financial Home Equity Access, Inc.: Mortgagor Q:\Order Letters\Condemnations\131 Rudder rd hyannis 10-4-11doc TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a ` Parcel T Application # C;)& Health Division Date Issued Conservation Division Application Fee 56 Planning Dept. Permit Fee w Date Definitive Plan Approved by Planning Board ` Historic - OKH Preservation/Hyannis Project Street Address 1 31 V,,d er g. Village �J a.n11 Owner �nqe' pA,�Icf Address Telephone 1 Permit Request o ce, 1O C czfN 46 A-3D re r4 Vil+ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation S 0 0 Q Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:-. o Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ O Commercial ❑Yes XNo If yes, site plan review# Current Use_ Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) �Name ' Telephone Number fa nQ 3 q(1O Address k4,onflwLicense # b o a 6 VI Home Improvement Contractor# Worker's Compensation # t w C 3 3,93 1 b R ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1 nfN�rnA SIGNATURE DATE 1 .4 - S FOR OFFICIAL USE ONLY APPLICATION# e DATE ISSUED MAP/PARCEL NO. i r ADDRESS VILLAGE ~ ti OWNER DATE OF INSPECTION: L FOUNDATION, FRAME INSULATION ` FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL I GAS: ROUGH FINAL FINAL BUILDING f i i DATE CLOSED OUT t ASSOCIATION PLAN NO. 10/sIll OL 2V#*i21VBf r . The Commonwealth of Massachusetts Department of Industrial Accidents 14 Office of Investigations I Congress Street, Suite 100 Boston,MA 02114-2017 - www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AvOicant Information Please Print Legibly Name (Business/Organization/Individual): Cape Save Inc. Address: 7D Huntington Ave City/State/Zip: South Yarmouth, MA 02664 Phone #: 508-398-0398 Are you an employer?Check the appropriate box: I am a general contractor and I Type of project(required): 4.1. ✓❑ 1 am a employer with ❑ b employees(full and/or part-time).* have hired the sub-contractors 6. 0 New construction ` 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8• Demolition working for me in anycapacity. employees and have workers' - [No workers' comp. insurance comp. insurance.++ 9. Building addition required.] 5. We are a corporation and its I0.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doingall work officers have exercised their 11-n Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL ` c. 152, ( ), 12.0 Roof repairs insurance required.] t §1 4 and we have no employees. [No workers' 13.0 Other Insulation comp.insurance required.] - *Any applicant that checks box#] must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'_compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Technology Insurance Company Policy#or Self-ins. Lic. #: TWC3353968 Expiration-Date: 04/09/2014 \ ` p 1 Job Site Address: � � 1 �,kC 0 e c V k(\ \i • . " City/State/Zip: G1 t1"1 lS Attach a copy of the workers' compensation policy declaration page(showing the policy numbe 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. 1 do hereb certi under the .ains and penalties o er' that the in ortnation provided above is true and correct. Si nature: Date b Phone#: 508-398-0398 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#: AC ® DATE(MMIDDM-nl -- CERTIFICATE OF LIABILITY INSURANCE I4/9/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pol(cy(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 lieu of such endorsements. PRODUCER CONTA NAME:cT Colleen Crowley Risk strategies Company PHONE (781)986-4400 MAX.No:(781)963-4420 15 Pacella Park Drive AI Suite 240 INSURE S AFFORDING COVERAGE NAIC# Randolph MIL 02368 iNSuRERA:SeleCtive Insurance INSURED msupmne:Safety Insurance Company 3618 Cape Save; Inc iNsuRERC2echnology Insurance Company 7 D Huntington Ave INSURERD: INSURER E: South Yarmouth MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBER:CL134960509 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �TRR TYPE OF INSURANCE POLICY NUMBER MPMOI ICY EFF MPOM/�EXP YYYJ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY Eu— PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE aOCCUR 5199448001 0/16/2012 0/16/2013 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 OLOCX POLICY PR $ AUTOMOBILE LIABILITY Ea COMBINED SINGLELi 1000,000 �_ B ANY AUTO BODILY INJURY(Per person) $ ALL AUTOSULED 6208200 1/6/2012 1/6/2013 BODILY INJURY(Per accident) $ X HIRED AUTOS H NON-OVMIED PROPERTYOAMAGE AUTOS Peraccident $ X Underinsured motorist BI split $ 100,000 A X UMBRELLA LIAB X OCCUR S199448001 0/16/2012 0/16/2013 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION $ C WORKERS COMPENSATION Officers Excluded from VICSTATU- OTH- AND EMPLOYERS'LIABILITY YIN X T I t ER ANY PROPRIETORIPARTNERlEXECUTIVE F3353968 erage E-L.EACH ACCIDENT $ 500,000 OFRCERfMEMBER EXCLUDED? Q NIA (Mandatory in NH) /9/2013 /9/2014 E-L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 t • i DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Issued as evidence of insurance. National Grid Corporate Services LLC d/b/a National Grid, d/b/a Boston Gas Company, d/b/a Essex Gas Company, Action Inc., and Housing Assistance Corporation are listed as additional insureds as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION (50 8)7 90—2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS. 484 Main street Hyannis, MA 02601-36980 AUTHORIZED REPRESENTATIVE chael Christian/CLC �5' ACORD 25(2010106) O 1988-2010 ACORD CORPORATION. All rights reserved. INCI19r,inn�nncn+ TLC AI►/1�f1�.,�_ _..J 1_-- - -____._._�_____ _r e�i�w� t Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen isor Speci-,141 .. _icense: CSSL402776I Is WILLIAM J MC C-LUSKEY.. _ 37 NAUSET ROAD West Yarmouth NIAoor 02673 Commissioner 06I28/2015 Office of Consumer Affairs and2usiness Regulation 10 Park Plaza -,Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 -- _ -- Type: Corporation Expiration: 3/14/2014 Tr,I 222184 CAPE SAVE INC. - WILLIAM McCLUSKEY- 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 = Update Address and return card.Mark reason for change. - Address j7 Renewal Employment ❑ Lost Card DPS-CA1 Co 50M-04/04-G101216 _ ✓�ze "°"t»°'u"PaZ ° "l�a�sac�u``sea License or registration valid for iodividul use only ' Office of Consumer Affairs&B siness Regulation g HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: t Office of Consumer Affairs and Business Regulation 1 Registration 171380 Type. :, Expiration 3/14/2014 Corporation 10 Park Plaza-Suite 5170 qlgkBoston,MA 02116 C SAVE INC. WILLIAM McCLUSKEY s 7-D HUNTINGTON AVENUE 7 C i SOUTH YARMOUTH MA_02664' Undersecretary Not valid wit o signa i - 0 'Soo& 4-60 West 142in Stieet O US.i g.-- - nni�,t � fl2bo -3b98 Assistance,, T �598 7,1-54-00_F(50-8)T5-7�_A ..3 I'Y on aIl�nes _ Cor oration hacoxwPecod HOME OWNER W ATHERI.ZATION WORK PERMITS FUEL RELEASE: PLEASE FII-L OUT AND SIGN TJMS.FORM IF YOU ARE. THE APPLICANT HOME OWNS_ _ I / —herebyconsent to and , ee that weatherization work may be � done by the Weathetimfion Program of Housing Assistance Corporation (herein after,refesed as "Agency-) on the property looted at W/T.'a a�vl L n. . 01114 7. The weatherization work done will be based on programmatic prioxities and availability of funding and it may include all or some of the following measures: Weather--stippmg &cauh=g of windows and doors,insulation of attics,--sidewalls&basements,attic.. and other ventilation measures and{possibly replacement of badly deteriorated windows_la . consideration of the weatherizatio .work to be done at my home I agree to the fo!1owing- 1- I give peunission to the "Agency"its-agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said pro-Pertp_ 2_ The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatheozed unit on an,ongoing basis for no more than five (5)years after the weatherizaiton work is completed_ I have read the provisions of this agreement as listed and freely give W consent- Home O ac _ (Signature Date_- LI Agent(signale) Datc 6 - 17f . HAC approved Weatheuzation Company ca' e Cali-ber Building&Remodeling Cape Cod Ls„latiort: fS!th CreswellConstmCdon Frontier Energy Solutions L-ol'rr&Sons F Resolution Enemy Rock Solid Coxa struction All gape Insdation Town ®f Barnstable Building Past'- :�►.A�xv'blt��rwyu.'�s.....:. �P 9..hf e'rT oste W e u a.s ntl,b.-,,e.`,�p-.':<.R eta`r�n�`�,'�.e.�d�.�'��o.,n�u��;3J.o"i. a',.nd.,"i,t hi sw�C-,a•r"d�.M��u, s�tb�e,`Ke�P':t , Permit ' Permit,No. 9-16-2130 Applicant Name: Cheryl Gruenstern Map/Lot:. 247-179 Date Issued:` 08/18/2016 Current Use: Zoning District: RB Permit Type: Building-Solar Panel-Residential Expiration Date:' 02/18/2017 Contractor Name: SOLAR CITY CORPORATION Location: 131RUDDER ROAD,HYANNIS Est Project Cost:. $ 13,000.00, Contractor License: 168572 Owner on`Record: CLOUTIER,ANNETTE " � unit F e R S $ 116.30 p e Address: 131 RUDDER RD Fee Paid s ;-$116.30 T HYANNIS, MA 02601 Date. 8/18/2016 Description: . Install solar panels on roof of existing house,wth anyupgrades,if applicable,as specified by PE In Design;To be interconnected with home electrical system. 5 3 kW 20Panels JB-0263177 n 1q, F, rl Project Review Req : Install solar panels on roof of ex sting`h'k` ,wrth any upgrades,if applicable,as�specified by PE in t Design;To be interconnected with home electr.11111 ystem 5 3 kW 2 Panels JB-0263177 Building Official This permit shall be deemed abandoned and invalid unless the work authorized by thi"s permit?s corrimencedwithm six months after issuance: _ All work authorized by this permit shall conform to the approved appilcati6 and the approved construction documents for'wh chthis permit has been granted. \ All construction,alterations and changes of use of any building and structuresshall be in compliance with the local zoning by laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. g The.Certificate of occupancy will not be issued until all applicable signatures by the Building and.Fire Officials are prouJded uon this permit. Minimum of Five Call Inspections Required for All Construction Work- 1.Foundation or Footing rc; v. 2.Sheathing Inspection a t - 3.All Fireplaces must be inspected at the throat level before firest flue lining i"s installed . 4.Wiring&Plumbing Inspections to be completed prior to Frame Insp coon ' \ 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. ONE "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site All:Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �' ' /c.f ski b y Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 10-1-13 f Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 w C. RE: Building Permits ;Aco Dear Mr. Perry, This affidavit is to certify that all work completed for 131 Rudder Lane.Hyannis has been inspected by a certified Building Performance Institute(BPI)Inspector. Ceiling: R-30 cellulose . Floor: R-19 fiberglass blanket All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey y_. 121 . MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING. 7! u . : n/S"L,��, MA. Date: i'1 I I ermit#ation:i �31Owners Nme. A N CL.Oupancy: Commercial��f Educational Industrial Institutional 0 Residential New: Alteration:[_j Renovation:, Replacement: Plans Submitted: Yes. No 0 � . FIXTURES Z z F z w cn. (n cn z ui 10 a. z Y } -� U w w z �' a o w aa Cn � . z w z I— a CO z .� o . if =Q Q UJ Uaa Z LL ~ O W. w z ww U (L O Cn i U wa W ° a ° ° z aaaW a s =. w 'vr Q m m 0 u_ U' = Y J _l m cn I- D O ""�a SUB BSMT. BASEMENT 1, FLOOR I 2 FLOOR 3 FLOOR 4 FLOOR 5 FLOOR 6 FLOOR. 7 FLOOR' 8 .. FLOOR Check One Only Certificate# Inst alling Co mpany Name: AyMON ,'•(Lt� PLCi ��Tlo �.tS C Corporation Address: lb3 JaV City/Town� � fl r C bF State: MA �� Partnership. Business Tel: 5Db ya-0�_ Fax: — Firm/Company Name of Licensed Plumber:t..,.= 1L,. 1CS ._ INSURANCE COVERAGE: - I have a current liability insurance policy or its substantial equivalent which meets the,requirements of MGL.Ch. 142 Yes NIthe If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurarice policy Other type of indemnity Bond OWNER'S INSURANCE WAIVER:1 am aware that the licensee does not Have the insurance coverage required by Chapter 142 of Massachusetts General.Laws,and that my signature on this,permit-application waives this requirement. Check One Only Owner Agent.� Si nature of Owner.or Owners A ent I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations pertormed under the pe t issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing_Code and.Chapter 14 of he Geri aws. Byl :m TYPe of License: Title _ ^� i ✓ Signature o icensed Plumber Plumber ----- .-0.t ,r City/Tovirn � Master APPROVED OFFICE USE OWL'""..».. Journey ran (� .License Number:: ! ) q37 Engineering Dept. (3rd floor) Map Permit# '. 2,0q0 ,z House# I Date Issued j 30�_ ;. .� Board of Health(3rd floor)(8:15 -9:30/1:00-4:30)�� ,�C3 a&-w �'' N'ee , J. ? Conservation Office(4th floor)(8:30,- 9:30/1:00-2--00) oor/School Admin. Bldg-) �TME by Planning Board 19 SEPTIC SYS BE INSTALLED I CE . TOWN OF BARNSTA WITH R©NAAENTAL DE AND, Building Permit Application TOWN REGULATIONS Project Str7ts c� ` I�UbIJ�,� ' Village K) - Owner Ac �Z. ( - Address 'L f0' Telephone '! 56f- -171 _4�A A AVA Permit Request �� CK-PWS-- bP to WC, -too First Floor ;' r1; -� square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#unitE): Age of Existing Structure Historic House ❑Yes o On Old King's Highway ❑Yes Basement Type: Full Crawl ❑Walkout Other QC CDft5s� OF b�; (,R01_--�F0)00 CL_ Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 02 New Half: Existing New ,No. of Bedrooms: Existing _�New 3 ��----77 Total Room Count(not including baths): Existing T New First Floor Room Count Heat Type and Fuel:�as ❑Oil ❑Electric ❑Other Central Air�(Y( s ❑No Fireplace :Existing New _ Existing wood/coal stove ❑Yes �'No Garage*etached(size) Other Detached Structures: ❑Pool(size) fiAttached(size) �+ ❑Barn(size) ❑None ElShed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes No If yes, site plan review# - Current Use R AAWV .W E�W Proposed Use Builder Information1 Name d G Telephone Number Address License# , Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. - ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CSIGNATURE- �:,_.�� ��- _ - - DATE UILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 'i i . — FOR OFFICIAL USE ONLY ` PERMIT NO. _ 1�. DATE ISSUED A E - MAP/PARCEL NO. ADDRESS VILLAGE — - OWNER DATE OF INSPECTION: FOUNDATION '� ��l� L, —,C; 777 / FRAME 'Z��9 INSULATION FIREPLACE ELECTRICAL: ROUG� FINAL 'r03 Imm PLUMBING: ROU M O FINAL , GAS:' R(5,t M '�" FINAL 4U t - s FINAL BUILDING .y e in LAC go t DATE CLOSED OUT — S y � _ ASSOCIATION PLAN NOS y ,. �C Engineering Dept. (3rd floor) Map. ,J�Z7 "Parcel Permit# �o House# Date Issued S 9 Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) Fee cZ5 i o7J-•: Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) Planning Dept. (1st floor/School Admin. Bldg.) 1HE Ip; De rti Plari Approved by Planning Board 19 • • BARNSTABLE. MAMIL 019. TOWN OF BARNSTABLE '. uilding Pe it Application ct Street Address 0 v Village 1 P2_0::7 Owner - / C1-0yltobt Address Te1ephone1� Permit Request 0 0- Fa AHOt First Floor square feet Second Floor square feet Construction Type ' Estimated Project Cost $ Zoning District �— Flood Plain Water Protection Lot Size Grandfathe es ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes No On Old King's Highway ❑Yes o Basement TypeXedelau ' rawl ❑Walkout ❑Other Basement Finis (sq. t.) — Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing c3L_ New Half: Existing New No. of Bedrooms: Existing 3 New Total Room Count(not including baths): Existing� New ✓—First Floor Room Count Heat Type and Fuel, as ❑Oil ❑Electric ❑Other Central Ai*es ❑No Fireplaces:Existing New �� Existing wood/coal stove ❑Yes 5�f Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) M ` ttached(size) ❑Barn(size) ❑None ❑Shed(size) - ❑Other(size) Zoning Board of Ap als Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes o If yes, site plan review# - Current Use Proposed Use Builder Information Name. Telephone Number Address License# ` Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE C BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) / -Z;6, FOR OFFICIAL USE ONLY ° PERMIT NO. DATE ISSUED « MAP/PARCEL NO. t . ADDRESS VILLAGE OWNER _ DATE OF INSPECTION: FOUNDATION FRAME r INSULATION FIREPLACE ELEC_'TRICAL: ROUGH '� � FINAL PLUMBING: ROUGH FINAL a — GAS: ROUGH FINAL FINAL BUILDING c t i DATE CLOSED OUT � ASSOCIATION PLAN NO. F . S • r TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Pl ease print. lc /JOB. LOCATION Number Street address Section of town "HOMEOWNER" Name Home phone Work phone PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occupie( dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(s)' who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Offic: on a form acgeptable to the Building Official, that he/she shall be responsil for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the St Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner' certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35 , 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER' S EXEMPTION The code state that: "Any Home Owner performing work for which 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 Home Owner engages a person (s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix- Q;'Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "dwner actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/bier responsibilities, man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the la--t page of this issue is a form currently used by several towns. You may pare to amend and adopt such a form/certification for use in your community. � T The Town of Barnstable Department of Health, Safety and Environmental Services : .,,RIW„B : Building Division t� 367 Main Street,Hyannis MA 02601 • Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commission-,: Home Occupation Registration Date: Name: ee. P ne #: Address: 131 Ou( fen vrlIage. 1 - Type of Business: Map/Lot: LI`I ! Z 9 i INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater Pollution. tomary home occupation shall be permitted as of tight subject to the After registration with the Building Inspector,a cus following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • 'Iliere are no external alterations to the dwelling-which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for panting generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the mgtured front yard. • There is no exterior storage or display of materials or equipment • There is no commercial vehicle related to the customary Home occupation,other than one van or one pick-up truck not to exceed one ton capacity, one trailer not to exceed 20 feet in length and not to exceed 4 tires,panted on the same Iot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shalt not be included. � • in the Customary Home Occupation who is not a permanent resident of the No person shall be employed dwelling unit. I,the undersign have read and agree with the above restrictions for my home occupation I am registering: y.�j 0� THE TOWN OF BARNSTABLE 11AUSTAXLE, ob 9.N BUILDING INSPECTOR APPLICATION FOR PERMIT 'TO X. ...dt'.'g- TYPE OF CONSTRUCTION ....................................................................................................... ........................... ..............1q..,7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ ........4'.62 x. ....... C ............................................................ ................................... ProposedUse ......7.'.-.- ...... ......................................................................................................... ZoningDistrict ........................................................................Fire District ............................................................................... Name of Owner ddress .... ........zecl� ............................. Name of Builder Y,/,A"ddress ....0'�IWWA.la-1 Nameof Architect ....... .....................................Address ..................................................................................... Number of Rooms ............ A,,'..6!�................ ....................Foundation ........... ..... .... . Exierior ..:X:�7 a./ !:PSe..... .0/..Roofing ...... .......................... Floorswas �T :........Interior .......... �............. Heating .................................................................................Plumbing ................ .................................................................... o Fireplace. .................................... .........................................Approximate Cost .......... .................................... ......Definitive Plan Approved by Planning Board ----------------—--—----------- Diagram of Lot and Building with 'Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH r\ L) z 0 Ld �_� Cn CL z: n (j) :2i 0 LIJ yi LLj Uj w (j) La cr- M < < _3 Z CL N t < //v LJ z co — ,A c6j� I hereby agree to conform to al] the Rules and Regulations Of the Town of Barnstable regarding the above construction. Name .................. Stewart, Lester � No — Permit, for ......9P%r-�P................. --------------------------. / I�I Location --'�on = Road°=������—...._------ ...................... | ' Owner ------____.���������������_ Type ofConstruction ------- --- ' --------------------------' - ' plot ---------.. Lot ----------.. . � ' | . . � Permit Granted .......... �����—.�7�---- �� ..lA '~ ' ` Dote of Inspection ............. lA ' � ���� uoro Completed , . �- , —. r �_ | - ---- 7p PERMIT REFUSED � ---.—,--.---,_._.------' lo .------------------------- � _ '~___,____________.________. i —.------------------------- � 1-3 . ' . � --------------------.-----.. � ' � Approved ................................................ lg � '__________________________. l ' . � � , -------------------~^~^'—^^'' | / | Oro two Ofui 3• . AW a j z e d Ito k - - r rTim i J.r - d'{� � E XI i? } �� - •kE. w j"Ej4 ' r AE _ . C • /h. r 'a to Y r�X • n a lit, � ''� y t; n i 74 11 r vl D 13uoLp orLC'"- MA7[ V J U V_ /3..U.. I «i i I fVi Elyy ri�%91c I - M:iA - 2 O 6 ! i- - i ZE 0 m �5 i o�V Q XI t i e ; 1 tit �. qq fill it `�,► l � !i 1 �/ i * I ��► � tea►_ � s e ► Lis � � � • i .1 l` WE The Town of Barnstable snxxsensM 9 `""M Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. j Date y , 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: AD Est.Cost 30 Q6Q Address of Work: Owner's Name Date of Permit Application: 30 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 wner Fulling 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 permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name a TOWN OF BARNSTABLE N BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB. LOCATION - Number Street address Section of town rrHOMEOWNER" AAN�� clzu Name Home phone Work phone - - PRESENT 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(s)• who owns a parcel of land on which he/she resides or intends to re- side, on whic-h= 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 acgeptable 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 Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner' certifies that he/she understands the Town of Barnstable Buildi g Department minimum :inspection procedures and requirements and that he/she wi 1 cojly with said procedures and requirements. HOMEOWNER'S SIGNATURE V` � r / =f =�-�`�' APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to. comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which 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 Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix 0, Rules and Regulations for licensing Construction* Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly P P rly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicens ed person as it P would with licensed Supervisor. The Home Owner actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/Ater responsibilities, . man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for. .use in your community. y r ' The Commonwealth of.4fassac•husetts •�.� �;_- Department of Industrial Accidents ` y l - Office o11nyeS&921/nns ,vi \, '_' 600 Washitrrtun Street = Boston, Ma.Y.Y. 02111 Workers' Compensation Insurance Affidavit ---Plc;t— L1pPltrtnt information• se PRINTIebi�l,jY name location• city � "�`' (� hone# � am a iomeowner performing all work myself. I am a sole proprietor and have no one working in any capacity .,..-.. .,.r.+.•,.,.,-- o• ._.�+ -� .or +,.rir..'r� +»s'R r!..�..r..*.".+.•....,�„!T�:*e�.w -•.+..�w.gew..+. ,.:...T..+.....rr..+r...w..—. _......_� ._. [1 I am an employer providing workers' compensation for my employees working on this_job. comminv name: address: — cite: phnne#- in Curnnce co. policy# I am a sole proprietor, neneral contractor, or homeowner(circle one) and have hired the contractors listed below who have ft the following workers' compensation polices: cornnnn name: — address: city: phone#• incur,ince co Policy to compam• nnntc' address: rite: phone#: insurance co nolicy# Attach additional sheet if neccssa ..r �r,ry.:,: -—•i..n,eSi�j,,.. :_ .:,a..e,+o�=___.Y.,�_ •:sar:>..........-.,.x - ="'%r-,.-... :au'e�.r.::�u..:r.:>:,... Failure to secure coverage as required under Section 25A of 11GL 152 can lead to the imposition of criminal penalties of a lineup to$1.500.00 andior unc scars' imprisonment as well as civil penalties in the form of a STOP WORK ORDER ands Gne of S100.00 a day against me. 1 understand that a cop} of this statement maA be forwarded to the OlTice of Investigations of the DIA for coverage verification. I do herehr certify tinder the pains and penalties of perjure'th$y the information provided above is true and correct. Siena[un Datelod Print name Phone# 1 Z. official use only do rent write in this area to be completed b-, city or town official city or tntvn: permit/license# rIBuilding Department - CLiccnsing Board check if immediate response is required ❑Selectmen's Office t' '. C311ealth Department , contact person: phone#: MOther 1r: _r. Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers* compensation for their employees. As quoted from the "law an enrploree is defined as every person in the service of another under any contract of hire, express or implied. oral or written. An enrp/urer is defined as an individual. partnership, association, corporation or other legal entity. or ally two or more the forc�_oin�- cnLa�- in a joint enterprise, and including the le-al 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 dwellin�� 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, hou. or on the �srounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even, 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 anv applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither- the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter hL been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date tlu affdavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or-Towns Please be sure that the affidavit is complete and printed legibly. The Dcpan-meat has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investiaations has to contact you regarding the applicant. Plea, be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned tc the Department by mail or FAX unless other arrangements have been made. The Office of investigations would like to thank you in advance for you cooperation and should you have any question! please do not hesitate to give us a call. r'sv..---..._.... _..._.,�.....:........ .-„-.+:p,.._^..en..�._.s....-r.+.a�....-•......+err...-.+++-.:a....swrrw...nw�..n+++-v-..w.e..+..—.-.�.+rw..-.s..r swnJ�`.":r.•v-�.�wrw,.�oa.., .. .... ............ Tile Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidentss: Office of Investigations 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 - -- - m� ��j —,ov.�-� - — ��� �r'��. : Ir-vr�rl� _ ���n ��-%ckJ 5 a �yc < a 4!j-w1a • r r . i 1,06 N .. ".may a. �. • - r a r _ a c � o � � � � � � � o Fc,I��� � PROJECT NAME:_ �l t�r�'yc�c i(�y! O�1 �. 1 YYl e zd ADDRESS: 13 I 7tydolx- -Rd '�Va yl n -3 PERMIT# PERMIT DATE: (� — c D j M/P: LARGE PLANS ARE FILED IN: BANKER BOX -41' FILED ALPHABETICALY BY STREET INFORMATION SHEET FILED IN STREET FILE q/wpfiles/forms/archive/BANKERSBOX I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE v IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN N THE M O WEALTH OF MASSA CHUSETTS. ----- 7 UL A. ME EW, P.L.S. TE _p TD 0PAUL �9 A. t. � �� ' LOCUS ' ML3PT"aF � G AS/LOT 115-3 o LOCUS MAP ASESSORS: r EXISTING MAP 24 7, PARCEL 179 GARAGE PLAN REFERENCE 2321125 LOT 16 �O RES. ZONE.' "RE" (20110110) AS/LOT 179 FLOOD ZONE "C" 1 AREA = 10093- SQ.FT 91 PROPOSED ADDITION o - HSE - - `�� PLO T PLAN -_- _-- #131 = --- OF LAND EXISTING L0CA TED IN. \� , HOUSE BARNS'TABLF, MA PREPARED FOR: ANNET-1 -L CLO UTIER FEBRUARY 3, 1997 AS/LOT 180 GRAPHIC SCALE YANKEE SURVEY CONSULTANTS 10 y 5 10 20 40 UNIT 1, 40B INDUSTRY ROAD MARSTONS MILLS, MA. 02648 ( IN FEET TEL 428-0055, FAX 420-5553 I inch = 10 ft. JOB# 51185 DCB IL 50 - V I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE IN ACCORDANCE WTH THE PROCEDURAL AND TECHNICAL STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN THE O WEALTH OF MASSACHU3F=.. 0 7 DUL A. ME EW, P.L S. TE .r.._.ru 4- To gam' PAUL A. �y� LOCUS y MERITH98 I . G No. 3209g ��.�� r' � fG!STERtO i.,�= jl Lob AS 115-3 i O LOCUS MAP ASESSORS: r� EXISTING I MAP 247, PARCEL 179 GARAGE PLAN REFERENCE: 2321125 LOT 16 RES. ZONE.- "RE" (20110110) AS/LOT 179 FLOOD ZONE: "C" l AREA = 10093_-i� SQ.FT / , N PROPOSED ADDITION 5 � PLOT PLAN il"31 OF LAND — — - -- -- - moo, L0CA TED IN., EXIS7INC 4-�. — — HOUSE -_ _ �0 sue. Np. - - -- --- ��- (1. BARNSTABLE; MA. — --- - PREPARED FOR. ANNETTE CLOUTIER FEBRUARY 3, 1997 AS/LOT 180 GRAPHIC SCALE YANKEE SURV 10 EY CONSULTANTS 10 5 20 40 UNIT 1, 40B INDUSTRY ROAD MARSTONS MILLS, MA. 02648 ( IN FEES' ) TEL 428-0055, FAX 420-5553 1 inch - 10 f t. JOB# 51185 DCB