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0487 SCUDDER AVENUE
�!� '7 Scud�e�- 1�ve, Town of Barnstable Certificate of Zoning Compliance Certificate No. 2021-45 Map 288 Owner Name as of 1/1/21: Parcel 14-003 Address 487 Scudder Ave ASHUR, GEORGE A & MARY LOUISE C Village Hyannis 182 ADAMS AVE MILTON, MA 02186 Zone Rf-1 Single-family Zone AP Water Overlay Year Constructed 1985 Lot Size 1.29 Acres Property Use: Residential Setbacks: Front Yard 30' Cert of Occupancy Issued: YES Side Yard 15' Rear 15' Date: May 14, 1986 Permit: 27947 Open Permits:None Code Violations: B-18-1226, E-18-1504, B-18-2570. TE-20-1243, P-20-825 (Permit Report Attached) All permits (building, electrical and plumbing) related to the interior freeze repairs (2018) have expired as a result of a failure to obtain required inspections. New permits are required in order to inspect and close out the open violation. Zoning Violations: The Building Division does not receive or maintain information regarding municipal liens. Municipal Liens - Tax Office 508-862-4054 Refer to the Planning Dept.for information pertaining to the Zoning Board of Appeals filings and decisions. Property Description: Map 288 Parcel 141-003 is developed with a 2 story, 4-bedroom, 3 bath Colonial style home constructed in 1986 under building permit 27947 (issued May 31, 1985). This single-family home consists of 7,712 gross sq ft.). Zoning Violations: No current violations on file. Reviewed by Title Date: Robin C. Anderson Code Compliance Manager 06/08/2021 Commonwealth of Massachusetts T11E Town ,of Barnstable � 1ASS. ok 200 Main Street(508)862-4038 ArEO MA'S PERMIT REPORT BY ADDRESS AddreSS: 487 SCUDDER AVENUE,HYANNIS 2.p(N Status Permit For Parcel IDk, A Ihcant Waric Descry tion,, Ins ect>Ion ^Ins ecfed on Ins; ect�on: Ins ecfion : P x p p p Q �`a "$tatUS Comment- BA871226 Inactive Building-Alteration.': 288-141-003 Jason Freitas Interior repairs to home Building Frame 7/26/2018 Pass MISSING NAIL INTERIOR Work Only- as a result of winter pipe PLATES; Residential freezes. This includes INTERIOR insulation,drywall, PENETRATION flooring',finish work etc. S NOT Mechanicals&electrical FOAMED.OK (plumber&electrician to. TO INSULATE. pull own,permits)is �egtaired.as as well. There is no structural framing required,,as home is gutted to the r studs. 4/17/19 Need.new Contractor New Contractor, 7/18/19Kevin Hamlin . 7%30/20 Kevin Hamlin removed see attached' responsbltYrD6 letter N616 assume B-18-1226 Inactive Building-Alteration 288-141-003 Jason Freitas Interior repairs to home Building Insulation 8/10/2018 PASS Need certificate INTERIOR Work Only- as a result of winter pipe from installer for Residential freezes. This includes spray foam insulation,drywall, flooring,finish work etc. Mechanicals&electrical (plumber&electrician to pull own permits)is required as as well. There is no structural framing required,as home is gutted to the studs. 4/17/19 Need new contractor New Contractor 7/18/19Kevin Hamlin 7/30/20 Kevin Hamlin removed see attached letter.Need contractor to assume responsibility.DB 1 of 3 Commonwealth of Massachusetts \ THE r°�y ° Town of Barnstable rtns4 ok200 Main Street(508)862-4038 pTfO MAC b`0 PERMIT REPORT BY ADDRESS .. .'•. s' von ',, InS on sec <...� Permit For Parcel ID �► IhcaSAN Work,Descn ton:: '; In ect ected I . .Ins ect�on PIIV Status Status n Co me t:.: B-18-1226 Inactive Building-Alteration 288-141-003 - Jason Freitas Interior repairs to home Building Insulation 8/10/2018 FAIL INTERIOR Work Only- as.a result of winter pipe: Residential freezes. This includes insulation,drywall, flooring,finish work etc: Mechanicals 8,electrical'. (plumber&electrician to:; pull own permits)is required as as well. There is no structural framing required,as home is gutted to the' studs; 4/17/19 Need new contractor. New.Contractor 7/18/19Kevin Hamlin u. 7/30/20 Kevin Hamlin removed see attached letter.Need contractor to il assume responsitiility.DB' B-18-2570 Issued Building-Smoke Detector 288-141-003 A.R.S.SERVICES LLC Smoke and CO upgrade -Fire Alarm Dection System change of contractor to Kevin Hamlin on 7/18/19 B=18-796,: Closed Buil'duig=Alteration,' 288.141,-003 Jason Freitas Iritenor removal&: Building Final 8/8/2018`# Pass see frarne INTERIOR Work Only: discarding of drywall inspection on Residential ' " ,', insulation,floor covenngs:'> 7/26/18 as a resuIt of'recent. s interior flooding No `✓ s structural demo is required.; B-2012-04733 Closed Tent 288-141-003 AMERICAN TENT AND 50 X 60, 10 X 15 TENTS TABLE INC NO SIDES FOR WEDDING RECEPTION TO GO UP 8/16/12 AND 8/20/12 13=77468 Closed Siding/Windows/Roof/Door 288-141-003 ASHUR,GEORGE A& REROOF STRIP _s - MARY LOUISE C REPLACE WIN. 2of3 Commonwealth of Massachusetts THE Tp�y Town of Barnstable BARNS ABLE..:. 9 MAS'4 ro 200 Main Street(508)862-4038 1639. ATfO MP'� `0 PERMIT REPORT BY ADDRESS =,. ,,,, a , W , a 'a . r,._.. Parcel JD .' x" / Ihcant Work D:escn tron' Ins ection `Ins ect" on ,:: ns ect�on, Ins ect�on PIN Status A PerMRt,Fo ,.. p L : R Pv P P F�. . .. a c � � . �, tatUS;S Comment E-18-1504 Issued Electrical-Add/Alter 288-141-003 James J Reilly rough and finish repairs Electric Rough 7/26/2018 PASS Rough electric for water damage - passed replace panel replace smoke and co detecotrs tel,ca tv outlets G,18-1422 Closed Ga§' 288-141-003 ALBERT CASSANO furnace,viraterheater, Gas Final` 7/9/2020 Pass cook stove and generator G-18-1422 Closed Gas 288-141-003 ALBERT CASSANO furnace,waterheater, Gas Rough 9/7/2018 PASS cook stove and generator G`=18=1422 Closed" Gas 288 141-003 ALBERY CASSANO furnace,waterheater, Ga`s Rough 9/7/2018 `: PASS All rough gas "cook stove and generator piping in - basement and° wallao the attic G-20-1016 Closed Gas 288-141-003 John Cloonan Install gas to cook top Gas Final 8/3/2020 Pass and connect G-20-1016 Closed Gas 2M141-003 John Cloonan Install gas to cook top Gas Rougl 8/3/2020 Pass and connect G-20-975 Closed Gas 288-141-003 Brian Hibbard install gas piping for new Gas Final 7/9/2020 Pass gas range in first floor kitchen G 20 975 . Closed, Gas 288-141-003 Brian Hibbard install;gas piping for Roughs new Gas 7/9/2020 Pass gas range in,first floor.., 4 r`' itchen> P-20-825 Inactive Plumbing 288-141-003 John Cloonan replace plumbing fixtures in all bathrooms and kitchen TE-20-1"243' Inactive" : .Electncal Add/Alfer'" 288=141-003=: adam lepire New plugs and switches;; c. appliances,:ceiling .r 5. <; - fixtures,arc-fault .. ," breakers Total Permits: 17 .465500 3516 3of3 j , SEARCH,Age NATIONAL LIEN LLC MA-69230 6/4/2021 To Whom It May Concern: Please find enclosed/attached our information request regarding 487 Scudder Avenue, Hyannis Port, MA 2647. Please return the results via the appropriate means: Phone: -(863) 698-7557 x1299 Email: research@nationaIliensearch.com Fax: 863-583-0397 Mailing Address:, 4250 S. Florida Avenue, Suite 2, Lakeland, FL 33813 If you have any questions or concerns, please do not hesitate to contact us. Sincerely, Pete Bishop National Lien Search, LLC 4250 S. Florida Avenue,Suite.2, Lakeland, FL 33813 1863.698.7557 Research@nationalliensearch.com E Parcel: 288-141-003 Location:487 SCUDDER AVENUE, Hyannis Owner: ASHUR, GEORGE A& MARY LOUISE C ;i Parcel Developer lot: Secondary road 141-003 LOT 3 Location Road type Road index � a 487 SCUDDER AVENUE Town 1440 Village Fire district Interactive map Hyannis Hyannis Y Y w §� Town sewer account No CWMP Sewer Expansion (subject to change with final engineering design) Phase 2 (11-20 years) Asbuilt septic scan 288141003 1 ✓_Owner: ASHUR, GEORGE A& MARY LOUISE C Owner Co-Owner Book page ASHUR, GEORGE A & MARY LOUISE C 13372/0056 Street1 Street2 182 ADAMS AVE City State Zip Country MILTON MA 02186 v_ Land ..... ................. ............. Acres Use Zoning Neighborhood 1.29 Single Fam M-01 RF-1 0109 Topography Street factor Town Zone of Contribution Level Paved AP (Aquifer Protection Overlay District) Utilities Location factor State Zone of Contribution Public Water,Gas,Septic Marginal View OUT v_ Construction .... y_ Building 1 of 1 Year built Roof structure Heat type F 1985 Gable/Hip Hot Water , Living area Roof cover Heat fuel t; 3206 Asph/F GIs/Cmp Gas Gross area Exterior wall AC type 7712 Wood Shingle, Clapboard None Style Interior wall Bedrooms �w Colonial Plastered, Drywall 4 Bedrooms Model Interior floor Bath rooms Residential Hardwood 3 Full-0 Half Grade Foundation Total rooms Average Plus 9 Rooms / Stories 2.4 I f[ i f1f t Permit History ..... Permit Issue Date Purpose Number Amount InspectionDate Comments I 05/22/2018 Restre to 18- $150,000 04/17/2019 INACTIVE Interior repairs to home as a result of Singl 1226 winter pipe freezes.This includes insulation, Fam drywall, flooring,wall, floorin finish work etc. Mechanicals & i electrical (plumber&electrician to pull own permits) is required as as well. no structural framing requi ..... _ _ ......... ............ E j 04/13/2018 Alt-Int 18-796 $5,000 06/30/2019 Interior removal & discarding of drywall, work-Res insulation, floor coverings as a result of recent interior flooding. No structural demo is required. 06/23/2004 New 77468 $19,000 08/13/2004 Windows _. .... ._._.__................ __ 05/01/1985 Dwelling B27947 $40,000 01/15/1986 HY 1 STOR j V_ Sale History Line Sale Date Owner Book/Page Sale Price 1 11/1.7/2000 ASHUR, GEORGE A & MARY LOUISE C 13372/0056 $429,000 t 2 10/08/1996 MONIZ, JOHN B JR &CLARE D 10428/0141 $1 3 04/15/1988 MONIZ,JOHN B JR 6221/0063 $1 4 06/15/1986 MONIZ, JOHN B JR& IRENE 5160/0304 $175,000 ................_......... ......... ........... _ ........ ..... ......... is 5 04/15/1983 FRANCO, NICOLAS D TR 3720/0227 $45,000 f Assessment History - - -- --- -... - -- - -- - - -- Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2021 $366,200 $52,800 $16,800 $268,300 $704,100 2 2020 $322,000 $48,500 $12,300 $269,200 $652,000 ......._ ......._ ___ _ .__ _. ...._. - .. .._._ . ................._ __.. ..____..._..........----............------ -- I 3 2019 $326,000 $49,100 $12,600 $280,900 $668,600 4 2018 $270,600 $48,600 $8,800 $283,400 $611,400 5 2017 $259,800 $49,600 $8,700 $283,400 $601,500 6 2016 $259,800 $49,600 $8,700 $276,000 $594,100 ( - - - ..........--.... _ . ... __........._ ....._..... ...... _.. --- -....__...................-_.....-- ..... ............ - -........ is 7 2015 $262,400 $46,300 $12,200 $280,600 $601,500 I 8 2014 $262,400 $46,300 $12,600 $280,600 $601,900 - --- -. _ ......... . 9 2013 $262,400 $46,300 $12,800 $280,600 $602,100 .._.. 10 2012 .' $268,400 $45,200 $10,200�- _.,. $406,800 $730,600 _ E ( Save# Year Building Value XF Value OB Value Land Value Total Parcel Value _..r.-.�.._.____ _._..___._.._. ...�.__.min_.._.._...w_.�._w.._�_._....�... ... ...�....... _.��._.-.-_... .....M.. ...�.._..._ ......._... .._ .. ,.. .��:.�...._.. _ '� 11 2011 $304,600 $3,700 $1,700 $406,800 $716,800 - ---..__ __....... - -_... __..___._ . ... - - __. ....._.- ...........-.... - --_. --------_ - ----.. 12 2010 $305,100 $3,700 $1800 $406,800 $717,400 ........-_. _....-_._ I 13 2009 $439,700 $2,700 $800 $350,900 $794,100 ....... . 14 2008 $451,200 $2,700 $800 $349,200 $803,900 16 2007 $449,800 $2,700 $7,700 $349,200 $809,400 _ _-.._ -- -..__ i 17 2006 $450,800 $2,700 $7,800 $361,100 $822,400 18 2005 $403,600 $2,700 $7,800 $246,200 $660,300 � 192004 � $372,100 $2,700 $7,800 $246,200 � $628,800 � . -_.-_._.. _ -_ ( 20 2003 $288,300 $2,700 $7,800 $104,700 $403,500 4 21 2002 $287,500 $2,700 $0 $104 700 $394 900 _.._ _ . ..... . 22 2001 $287,500 $2,900 $0 $104,700 $395,100 !' 23 2000 _ $267,200 $2,800 $0 $79,600 $349,600 24 1999 $267,200 $2,800 $0 $79,600 $349,600 25 1998 $267,200 $2,800 $0 $79,400 $349,400 26 1997 $265,700 $0 $0 $80,100 $345,800 27 1996 $265,700 $0 $0 $80,100 $345,800 ........._ . 28 1995 $265,700 $0 $0 $80,100 $345,800 29 1994 $215,000 $0 $0 $60,300 $275,300 30 1993 $215,000 $0 $0 $72,600 $287,600 I 31 1992 $244,300 $0 $0 $80,500 $324,800 4: 32 1991 $270,300 $0 $0 $74,900 $345,200 33 1990 $270,300 $0 $0 $74,900 $345,200 34 1989 $227,200 $0 $0 $74,900 $302,100 ` 35 1988 $165,800 $0 $0 $43,800 $209,600 is j, 36 1987 $165,800 $0 $0 $43,800 $209,600 w ........... .... 37 1986 $0 $0 $0 $37,300 $37,300 ....... . ......... _ .- ........-. 38 1985 $0 $0 $0 $0 $0 I Photos E 4 E' + i E ^ ura, � a u.T ! ii!jj 3ij7 �`wy t R 2 t }0 k I E p" <, , z E t 3 E r € "1 s 3 • _ n 1 � t I E � e 'h y k y �. ri ry r g i 1 i e 61) Town of Barnstable • �nnx�6zewetc t P.h.sF'° Uzn°xet,'si`1`„�F,:n" a.'I>.�In,s p�•v c ti�o�-n�.'H:a s:aB>ee n,�M`.a�de;*i .,� �3"','w's, Z�Yr' ,'- c g e<Fr ,",, fi��, `.,, - Building,. '; '��`�; 3R•":"t�.€_aa:':, Ar?us,:'�b e Kept� x.. ". vedP t °-Th�P.o ot MAE& ost Wee a Certificate of Occu anc .asRe ulred,sucfi`Butldmg sha1l,.Not be Uccup,ied urttilha Final I"nspectioni'has„been made �•' ' Permit NO. B-18-1226 Applicant Name: Jason Freitas Approvals Date Issued: 05/22/2018 Current Use: Structure- Permit Type: Building-Restore to Single Family Expiration Date: 11/22/2018 Foundation: Location: 487 SCUDDER AVENUE, HYANNIS Map/Lot: 288-141 003 Zoning District: RF-1 Sheathing: Owner on Record: ASHUR,GEORGE A&MARY LOUISE C Contractor Name: JASON R FREITAS Framing: 1 45 Address: 182 ADAMS AVE Contractor License: GS-103111 2 MILTON, MA 02186f Est Project Cost: $150,000.00` Chimney: Description: Interior repairs to home as a result of winter pipe freezes -This Permit Fee: $815.00 includes insulation,drywall,flooring,finish work etch Mechanicals Insulation: ,Fee Paid $815.00 &electrical (plumber&electrician to pull own permits)is�required Final: as as well. There is no structural framing required as home_is Datt?- ' S/22/2018 , gutted to the studs. ` - .h "' Plumbing/Gas Project Review Req: 5 �a " � Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work a hor ied by this permit is commenced within six months after'issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the:approved construction documentsif.which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall 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 inspect n for the entire duration of the work until the completion of the same. s Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the.BuiIdmg and Fire®fficials are fbvided on this permit. Minimum of Five Call Inspections Required for All Construction Work: 1 jk �• Rou h: 1.Foundation or Footing ', - :a,. F g 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection — Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Wor shall not proceed until the Inspector has approved the various stages of construction. Final: Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0. � -tyul Dhl i✓le �JIYWV}� s� any � �e��9 re,v�cwed J Town of Barnstable RECEIPT " 200 Main Street, Hyannis MA 0260F 508-862-4038 it639. Application for Building Permit _ Application No: TB-18-1226 Date Recieved: 4/23/2018 Job Location: 487 SCUDDER AVENUE,HYANNIS Permit For: Building-Restore to Single Family Contractor's Name: JASON R FREITAS State Lic. No: CS-103111 Address: , Taunton, MA 02780 . Applicant Phone: (617) 899-7635 Home Owner's Name: ASHUR GEORGE A&MARY LOUISE C Phone: 617 834- ( ) � ( ) 9802 (Home)Owner's Address: 182 ADAMS AVE, MILTON,MA 02186 Work Description: Interior repairs to home as a result of winter pipe freezes. This includes insulation,drywall,flooring,finish work etc. Mechanicals&electrical(plumber&electrician to pull own permits)is required as as well. There is no structural framing required,as home is gutted to the studs. Total Value Of Work To Be Performed: $150,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area,. I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Jason Freitas 4/23/2018 (617)899-7635 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $150,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $815.00 r 4/23/2018 $765.00 XXXX-XXXX-XXXX- Credit Card 3669T�nv Total Permit Fee Paid: $815.00 4/23/2018 $50.00 I -XX7O{-XX}IX- Credit Card 3669 � S S NO Town of BarnstableBuilding y ; Post this Card So T..hat it is3U�sible Fromthe Street ,�A roved Plans,Must be ttetamed on=ob and;this Card,Musa be Kep 4 p Posted Until Final Inspection Has;Been Made t � � �, �, � � fPermit Where a Certificate of Occupancy fs�Requred,such Bwldmg shall Not beQccup�ed un I4a na,lnspectionhas been made Permit No. B-18-796 Applicant Name: Jason Freitas - Approvals Date Issued: 04/13/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 10/13/2018 Foundation: Residential Map/Lot: 288-141-003 Zoning District: RF-1 Sheathing: Location: 487 SCUDDER AVENUE, HYANNIS ContractorNarne JASON R FREITAS Framing:' 1 Owner on Record: ASHUR,GEORGE A&MARY LOUISE C Contract�oric�ense CS-103111 - 2 Address: 182 ADAMS AVE EsINKt.Project Cost: $5,000.00 Chimney: MILTON, MA 02186 Permit Fee: $85.00 Insulation: : Description: Interior removal&discarding of drywall,insulation,floor coverings Fee Paid: $85.00 as a result of recent interior flooding. No structural demo is f' Final: required. Date 4/13/2018 Project Review Req: REMOVAL ONLY. NO STRUCTURAL WO Plumbing/Gas Rough Plumbing: ,.. .� .� " �' �:Building Official t Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved applic6boKand the,approved construction documents#or which this permit has been granted. All construction,alterations and changes of use of any building and structures,shall be in compliance with the local zoning by lawsand codes. Final Gas: 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. Electrical The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and Fire Officials are provided onthis permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 4 Rough: 1.Foundation or Footing a 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT OJV -y JE �►r}2Z- S£�'T f ZA- - ?/ Town of Barnstable *Permit# ? 1416JC- ypFtHE�Oly,� Expire 6 months front issue date O - � � Fee � • or Services �'�• . � Reg ulatory ' LA M es8 �g Thomas F.Geller,Director 16.19 nu�°'� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508--862-4038 X-PRIES PER .." Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL O ; 3 2004 Not Valid without Red X-Press Imprint TOWN OF BARNSTABLE Map/parcel Number Property Address — Value of Work I U� E R sidential Owner's Name&Address Telephone Number ( � � a - Contractor's Name W 'T ' Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) [1Workrnan's Compensation Insurance Check one: I am a sole proprietor CI the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workrnan's Comp.Policy# �> �� -� �L/.— Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to w. 0 Re-roof(not stripping. Going over existing layers of roof) [� Re-side replacement Windows. U-Value _ (maximum.44) i *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Not Property Owner must sign Property Owner Letter of Permission. e provement Contractors License is required. Signa e •~ri Q:Forms:expmtrg F,evise053003 `f 296111104 55 LISA LANE WEST BARNSTABLE MA 02668 (508)775-7763 (508)362-6654 FAX DR GEORGE ASHER 487 SCUDDER AVENUE TEL#(617)834-9802 HYANNISPORT,MA 02647 FURNISH AND INSTALL MATERIAL AND LABOR TO RE-ROOF HOME • REMOVE AND DISPOSE OF EXISTING ROOF. • CHECK ALL BOARDING AND NAIL WHERE NECESSARY. • REMOVE EXISTING DRIP EDGE AND SOIL PIPE FLASHING. • INSTALL NEW COPPER DRIP E _ •. . INSTALL NEW AND NEOPRENE SOIL PIPE FLASHING. INSTALL ICE AND WATER BARRIER IN VALLEYS. . INSTALL 15#FELT PAPER • ..NSTALL 50 YEAR GAF TIMBERLINE ULTRA SHINGLES. •. INSTALL RIDGE:VENT. • INSTALL 28 TILT-WASH REPLACEMENT WINDOWS(HARVEY CLASSIC PRO WELD LOW-E). • REPLACE TWO PICTURE WINDOWS (HARVEY CLASSIC PRO WELD LOW E). • NOTE: ALL DUMP FEES FOR REMOVAL ARE INCLUDED IN THIS QUOTE. HITCHCOCK CONSTRUCTION GUARANTEES LABOR FOR 10 YEARS. PAYMENT TERMS:$19,900.00. 113 DUE ON ACCEPTANCE; 113 DUE WHEN JOB IS HALF FINISHED; 1/3 DUE UPON COMPLETION OF JOB. ACCEPTANCE OF PROPOSAL: THE ABOVE P CONDITIONS ARE SATISFACTORY SPECIFICATIONS AND MADE AS OUTLINED ABOVE. HEREB CEPTED. PAYMENT WILL BE SIGNATURE OF CONTRACT �� DATE: SIGNATURE OF CUSTOMER: DATE: Z Z.l C)Y Hy C�ME.�t�PROL'.E� TLICE11rSE#�0&918 . . . . . . . . . Town of Barnstable BUlld111 , k . g "Post This Card Sohat it�s.V�sible From>the Street A ''„roved Plans Must-be'Retamed on:Job and;this Card Must be,Ke'`•t• rARN�3TweLB, �; i - t pp -, p Mum Posted Until Final Inspecfi'on Has Been Made s : Where;:a�Certificate':o£:Occu anc:a;istRe u�red�such`Bu�ldm sliallNot'be Occu ied until"aF.,mallns ectronhas been made Permit jjl�� � Permit No. B-18-1226 Applicant Name: Jason Freitas Approvals Date Issued: 05/22/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only Expiration Date: 11/22/2018 Foundation: Residential Map/Lot: 288-141 003 Zoning District: RF-1 Sheathing: Location: 487 SCUDDER AVENUE,HYANNISz ' Contractor-Name ; KEVIN M HAMLIN Framing: 1 Owner on Record: ASHUR,GEORGE A&MARY LOUISE C COntractortLicense C&104134 2 Address: 182 ADAMS AVE Est Protect Cost: $ 150,000.00 Chimney: MILTON, MA 02186 � s Permit Fee: $815.00 Description: Interior repairs to home as a result of winter pipe freezesThis Fee 815.00 Paid Insulation: includes insulation,drywall,flooring,finish work etc' Mechanicals - M,$E $ &electrical (plumber&electrician to pull ow permits)is required , Date 5/22/2018 Final: n as as well. There is no structural framing required;as home s , gutted to the studs. ' Plumbing/Gas Rough Plumbing: 4/17/19 Need new contractor Building Official New Contractor 7/18/19Kevin Hamlin r J s Final Plumbing: Rough Gas: Project Review Req: ; This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application a'id the",approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be.;n compliance with the local zoning by law and codes. Electrical This permit shall be displayed in a location clearly visible from access street or.road and shall bermaintainq, open for public tnspeefion for the entire duration of the work until the completion of the same. Service: The Certificate of Occupancy will not be issued until all applicable signatures:;bytheBuldmg"and Fire;Officials are provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: Final: 1.Foundation or Footing ' 2.Sheathing Inspection Low Voltage Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Health 7.Final Inspection before Occupancy Final: 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. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Town of Barnstable BUlldlil g P,ost�This Card So�That rt is�V�sible=From�the�Stceet A" rou.'ed Plans Must:be Reiamed on Job andthis Card�Must be"Ke t,• , .A�xSew83Jci � ..r :���� � � � - �• ` I?p �<. � -'` � � Y':..i - ` f � p M PostedUntil Final``ns action klasYBeen Made ±'` h e s � - .{ ' W,here a Certifieate of Qceu anc H s Re wired,such,B'ui dm shall Not',be Qccu red;until a Final I"�$,action has:b'een;made Permit Permit No. B-18-2570 Applicant Name: A.R.S.SERVICES LLC Approvals Date Issued: 08/13/2018 Current Use: Structure Permit Type: Building-Smoke Detector-Fire Alarm Dection Expiration Date: 02/13/2019 Foundation: System Map/Lot 288-141 003 Zoning District: RF-1 Sheathing: � - - Location: 487 SCUDDER AVENUE,HYANNIS ` Contractor Name ,KEVIN M HAMLIN Framing: 1 F Owner on Record: ASHUR,GEORGE A&MARY LOUISE C ' Contractor Lice se C5 104134 Address: 182 ADAMS AVE y "" E5ttProlect Cost: $0.00 Chimney: MILTON, MA 02186 Permit Fee: $70.00 Description: Smoke and CO upgrade �� i Insulation: f 3FeePaid, $70.00 �,.. Final: change of contractor to Kevin Hamlin on 7/18/19 Date 8/13/2018. Project Review Req: P — Plumbing/Gas 5, Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorizeii by this permit is commenced within six months aft .issuance. All work authorized by this permit shall conform to the approved applicatio6 End the approved construction documents-;for whi h this permit has been granted. Rough Gas: 'i' All construction,alterations and changes of use of any building and stnJ A res shall be in compliance with the local zornng by laws and codes. This permit shall be displayed in a location clearly visible from access street road and shall be maintained open for pubic mspec Joh for the entire duration of the Final Gas: work until the completion of the same. u Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the�Buildingiand Fire Officials are provided o inthis�Permit. Service: Minimum of Five Call Inspections Required for All Construction Work: £ , 1.Foundation or Footing £ E 2.Sheathing Inspection r ��._ ` �. Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "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 Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: i ��-� -�� sip IME Application Number......... ......................... 0 • BARMABLF, MM& Permit Fee.......................................Other Fee,........................ Ecs639. BUILD IN 1p T 11**� TotalFed Paid.........:...................................................... ...... JuLl 8 2019 1 TOWNQ49WSTABLE Permit Approval by.................................On........................... A V BUILDING PE9*ft S_ map......4;)...... ................:Parcel.:... 6(.--?....... APPLICATION Section 1 — Owner's Information and Project Location Project Address- Village L,:ZLJ'�_ Owners Name Owners Legal Address— city 224;�_ State MWZip O, Owners Cell#- E-mail Section 2 — Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet Commercial Structure under 35,000 cubic feet M'Single Two Family Dwelling Section 3 —.Type of Permit F-1 New Construction, ❑ Move Relocate E] Accessory Structure El Change of use El Demo/(entire structure) ❑ Finish Basement El Famiiy/Amnesty ❑ 'Fire Alarm Rebuild 0 Deck . ' Apartment ❑ Sprinkler System R Addition F� Retaining wall Fj Solar Renovation El Pool E2-.*Renov Insulation Other—Specify Section 4 - Work Description - ff CL2214e"Nk 84-1 k 4.Lvllkl� "ZI UAA� Last uDdated: 11/15/2018 Application Number.................................................... Section 5—Detail Cost of Proposed Construction , -!"-Square Foota a of ProJject 40� _ g Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics [Wiring ❑ Oil Tank Storage 2-9'moke Detectors N-Muumbing ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom j Water Supply alublic ❑ Private Sewage Disposal ❑ Municipal N-- n Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed - Side Yard Required _ Proposed } Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 Section 12—.Department Sign-Offs Health;Department Zoning Hoard('if required) Historic'District 0 Site Plan Review(if required) Fire Department Cl Conservation 0 For commerCid warpplease Wbyourplawareedy to the fire deparhnent for approval Section 13 Owner's Authorization as Owner of the subject pmpertyhereby authorize to act'on my be hall;in all matters relative to work authorized y this b ' permit application for:n 5C,- Wdress of job) Signature of date Print Name IMF Town of Barnstable Building Department Services a i Brian Florease,CBO Building Commissioner 200 Main Streo,Hyannis,MA 02601 www.town.ba rnsta ble:m n,us Office: 50s-962-4038 Fax: 508-790=6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR I, owner of.property located.at. hereby certify:that ONg 2 e,t. e- S is no longer Construction Supervisor listed on the::application for the-project under.construction<as authorized by `building permif# / o2(Q,issued:on � 2018 . I understand thatthe proiect under construction must cease until a successor licensed Construction Supervisor is submitted onrec theonls of the Building Dsvision 1�4 � i .� PA- PROPERTY OWNER DATE Q%VP,FOtt s pROPERTYOWNERREMOVINGCONTRAGTOR.DOC z i Town of Barnstable Building Department.Services srsrA�s Brian Florence,CBO a�nes Building Commissioner $a 200 Main Street;Hyannis,MA 02601 E www.towa.barnstable.ma.us Office: 508-862438 Fax: 508-790-6230 NOTICE:TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR I, V owner of property located at G F A) S pd ( ,hereby certify that ;. is no longer Construction Supervisor listed on the application.for the project under construction as authorized by building permit# ``"�5�� 'issued on! FL63 -201 g . i l I understand.that,theproject under construction,must.cease until.a.successor licensed Construction Supervisor,is submitted-on:the-records of the Building Division. r. PROPE OWNER:*- DA a- { -t f { I Q:WP FORMS:PROPERTYOWNERREMOVINGCON RA.CTOR.DOC. �oFIME r � Town of Barnstable Building Department Services sAMSTASLE. + Brian Florence,CBO 9 1639. Building Commissioner e �ArFD s 200 Main Street;Hyannis,MA 02601 www.to wn.b a r n sta b l e.m a.u s Office: 508-862-4038 Fax: 508-790-6230 us ��p1NG�EpT' NOTICE TO THE BUILDING DIVISION OF 2019 LICENSED CONSTRUCTION SUPERVISOR JUL`1 g ASSUMPTION OF RESPONSIBILITY_ _._____ _ ., -: _ TABLE . - BARNS - We,M h , Construction Supervisor License # ,hereby certify that I have assumed responsibility for the project under construction, as authorized by building permit issued to (property address) on , 2019. . The following documents are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration(if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit.. Road Bond(if applicable) LICENSE HOLDER DATE I q/forms/newcontrb rev:08/23/17 oFSHe ram, Town of Barnstable Building Department Services $axxsrns , : Brian Florence,CBO : 9Qj 6 q `0� Building Commissioner . ArED s 200 Main Street Hyannis,MA 02601 www.town.barnstableana. s Office: 508-862-4038 Fax: 508-790-6230 BUILDING DEPT. NOTICE TO THE BUILDING DIVISION OF :JUL-I g 2019 LICENSER CONSTRUCTION SUPERVISOR ___ASSUMPTION OF RESPONS1_ _T OWN'OFBARNSTABLE- Construction Supervisor License # hereby certify that I have assumed responsibility for the project under construction, as authorized by building permit# �'��"��U0, issued to (property address) �!C y 419 on The following documents are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration(if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond(if applicable) LICENSE HOL ER DATE q/forms/newcontrb rev:08/23/17 7/18/2019 Letters of Removal-shawmehillcorp@gmail.com-Gmail Kevin Hamlin<kevin@shawmehill.com> Wed,Jul 17,9:30 AM(1 day ago) to George George, We need two letters stating that you want James Reilly Electrician removed from your project at 487 Scudder Ave AI Cassano Plumber removed as well. Regards, Kevin Hamlin PH:774-413-9931 kevin@shawmehill.com www.shawmehill.com George Ashur Wed,Jul 17,11:19 AM(22 hours ago) Ok-to whom should they be addressed and can they be emails? Kevin Hamlin Wed,Jul 17,2:05 PM(19 hours ago) Town of Barnstable building dept Regards,Kevin Hamlin Shawme Hill Corp George Ashur Wed,Jul 17,2:53 PM(18 hours ago) to me To the Town if Barnstable Building Dept: Affective as of this date,James Reilly is no longer employed as an electrician at my home located at 487 Scudder Ave.Hyannisport,MA. George A.Ashur George Ashur Wed,Jul 17,2:55 PM(18 hours ago) to me To the Town if Barnstable Building Dept: Effective as of this date, Al Cassano is no longer employed and authorized as a plumber to work on my property located at 487 Scudder Ave.Hyannisport,MA BUILDING DEPT. JUL� 8 2019 TOWN OF BARNSTABLE r SHAWHIL-01 DBRIGGS ACORO` CERTIFICATE OF LIABILITY INSURANCE DATD/YYYI() `-� 7/181218/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 NAMEACT Diane Briggs Almeida&Carlson Insurance Agency,Inc PHONE FAX PO Box 719 (A/c,No,Ext):(508)888-0207122 A/C,No):(508)888-0550 Sandwich, D MA 02563 E-MpIDREL ,dbriggs@almeidacarlson.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:SENTINEL INS CO LTD 11000 INSURED INSURER B:AIM Mutual Insurance Company Shawme Hill Corp. INSURERC: 43 Water Street INSURER D: Sandwich,MA 02563 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR -LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE [X]OCCUR OBSBATP9228 8/5/2018 8/5/2019 DRAEM occurrence)GES ERENTE D 1,000,000 MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident AUTOS ONLY AUTO ONLYY (P OacEctlent AMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LWB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITYY/N WCC50050192562018A 8/6/2018 8/6/2019 T T TE E 1,000,000 ANY PROPRIETOR/PARTNERIEXECUTIVE —] E.L.EACH ACCIDENT $ (Mandatory In NH)EXCLUDED? N/A 1,000,000 E.L.DISEASE-EA EMPLOYE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE George Ashur THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ACCORDANCE WITH THE POLICY PROVISIONS. 487 Scudder Avenue Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constrq;6tl Aq§dj rvisor. ,j CS-104134 pp sx N� Tres: 02/07/2020 KEVIN M HAMLIN. 43.WATER STREET 1 . SANDWICH MA- 2 3cis" Commissioner fie�pomi.�eoaxusea`t�'lCJ d&aadwoe& Office of Consumer Affairs V Business Regulation HOME IMPROVEMENT CONTRACTOR -- TYPE:PartnershiD Re(istr Expiration 18469`4" a` 02/29/2020 SHAWME HILL,COF3 KEVIN HAMUN z_r 43 WATER ST. .ti 0"�` SANDWICH,MA Undersecretary The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly . Name(Business/Organization/Individual): al' 4On/4^ Address: 43 foJArA. 5tf— City/State/Zip: �, Phone#: !Qen jt(,- `- Are you an employer?Check the appropriate box• Type of project(required): 1.ElI am a employer with 4. EJ1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet• 7. ❑Remodeling These sub-contractors have ship and have no employees 8. ❑Demolition working for me in any capacity. employees and have workers' Z 9. El Building addition � [No workers'comp.insurance comp•insurance• required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions mysel£[No workers'comp. right of exemption per MGL 12.❑Roof repairs iinsurancereq�.� n]t c. 152,§1(4),and we have o employees.[No workers' 13.E]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. tCont actors 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 worker;'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: 04 awh► . — Policy#or Self-ins.Lie.#:�&4em-; snZaS'l/I Expiration Date: Jf-C- Job Site Address: 'x° City/State/Zip: APAC S Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u/nder the pains and penalties.of perjury that the information provided above,iss.true and correct: Sign Date: 12: Phone#: Official use only. Do not write in this area,to be completed by city or town offuiat 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 id the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for firture 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 barn 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 r Department of Industxiai Accidents Office of Investigations 600 Washington Street Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-774� www.maw.gov/dia • Application Number.................................. --Section 9- Construction-Supervisor Name /f�- ice. Telephone Number ,- `���- SZ Address �3 �,�,Q �. �. City _E j&2t cj� State Zip s. _ License Number. License Type Expiration Date Contractors Email ]�,//�, S ,J ,y�,i�,. Cell # ��'� I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. [Signature _ Date �r_ /7-/9` cSection 10=Home Improvement=Contractor i Nameiti �, Telephone Number _ Address City yw�))J l S:W State Zip 0,2!�S Registration Number Expiration Date .I I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signatur '4 .,, _ �2.�° Date 15 Section 11 -Home Owners License Exemption Home Owners Name: 6�Z A.(Ve_ a S kux Telephone Number (7 -r,5 q• jj'Qa Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature �PrintName_--_—, go-Voh, Wa tyl.(.r Telephone Number_ E-mail.permit to:__ lAri, (0-)) .S iQ��Jdyls�.:i�i .,; Co — -- _ __. • Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department Zoning Board(if required) Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ y For commercial work,please take your plans directly to the fire department for approval '.Section 13— Owner's Authorization i i as Owner of the subject property hereby authorize , .�l;L bn.ri�. to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name Last updated: 11/15/2018 . Town of Barnstable Building Post,This Gard SoKThat at IssVlsible>:From the,Street-Approved::Plans,MustbeRetarned onJ:obandthis GaTrd Must beKept, Pr 6 osted Unt I Final Inspectlgn Hash BeenNlade � r ? x �.tt 2 z ° CWhei'e�aCertificateof Qcc panty^�s Required;suchBu�ldmg shall Not be Occied`untit a Finahlnspection has been made Permit c , ,< Permit No. B-18-2570 Applicant Name: A R S SERVICES INC DBA ARS RESTORATION Approvals ' SPECIALISTS Structure Date Issued: 08/13/2018 Current Use: Foundation: Permit Type: Building-Smoke Detector-Fire Alarm Dection Expiration Date: 02/13/2019 Sheathing: System Map/Lot 288-141 0a03 Zoning District: RF-1 Location: 487 SCUDDER AVENUE,HYANNIS � h Framing: 1 Contractor'Name A R S SERVICES INC DBA ARS Owner on Record: ASHUR,GEORGE A&MARY LOUISE C h RESTORATION SPECIALISTS Contractor''Licens 106438 Chimney: Address: 182 ADAMS AVE MILTON, MA 02186 �� Est Project Cost: $0.00 Insulation: Description: Smoke and CO upgrade ,$ Permit Fee- $35.00 Final: Project Review Req: � - Fete Pard: $35.00 Date 8/13/2018 Plumbing/Gas } Rough Plumbing: � Final Plumbing: Building Official F Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterK suance. Final Gas: All work authorized by this permit shall conform to the approved applicafion,and,the approved construction documentsfor`whi h thls permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws acid codes. Electrical This permit shall be displayed in a location clearly visible from access street or;road andrshall bemamtaned open for public inspection for the entire duration of the work until the completion of the same. I Service: r tAl A1,41 The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officialsare provided'on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work:' ' 1.Foundation or Footing Final: 2.Sheathing Inspection All Fir Low Voltage Rough: 3 Fireplaces must be inspected at the throat level before firest flue lining is installed _ g g P P g 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection),, Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: 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. Fire Department "Persons contrac with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Town of Barnstable Building •. Post:Th�s�Cartl So That�rt�s�U�s�bleFrom the Street A roved,:Plans Must be:'Retained on Job and_�th�saCard Must�be Ke t=s-,-„ .. ee4 dPost 'Whre "a's��• '�- ��, � �� ::..r �•� ^,� '`� P�r Permit Building t _,>. „ c..,� ;..�a ,. ,... .., ..�•:; �., .. ,�� .,� �.�- ,,,,.� .�.�€ .r..,. .� . ..ash ..�,_< ..�. ,;;; �. „� . ,,�x..�. ,E ;�� �a-._ �, ,�.�� . _: � .. Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ➢ 'L n" re &E s x i -' i Applicadon N=ber.... ..... ... .. .................... r ° �e8s. Permit Fee.... .... ....................Other Fee........................ 6"3¢ TotalFee Paid..................................................................... TOWN OF BARNSTABLE Perms,�;Proval on.... ...�: .... BUILDING PERMIT .... . ..1................. :.... Map.... .. ..................Parc& �. APPLICATION Section I— Owner's Information and Project Location P jecf Address qq+ Sr-% dcUyr AVC vtilage- y�9wovu .PQ�T' 07MM-_ N mew e®r9 ���►v� Onm, gs�I egalA�ddress. C""> � ,State Zips } Owners Cell# F n 291 Cr A s Wte 'Y4 4 ors• c®w1 Se.--tion�,2�---Use=of-St v.ctare Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty Angie Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ ReWning wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify S�ch_'onRL4===Work-Description - s yft k,z ¢ c/o D e: J T sRct nndatni-919=19 ' 1 ' Application Number..................................................... } Section 5—Detail Cost of Proposed Construction Square Footage of Project Age of Structure Dig Safe Number 4 # Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Cliffm ` ' ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal "❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Usrimaar-i-2/9r2018 Town of Barnstable $ Regulatory Services . DARNSTUM ; Richard V.Scab,Director ` Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 wwvv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If UaWg A Builder I ar shy, ,as Owner of the subject property hereby authorize A R R e 7-c;: r J Iw S t c r rt l+J to act on my behalf, in all matters relative to work authorized by this.building pennit application for. 5c,�dde2 Ave (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signa Applicant G'I��e Print Name Print Name 0q1i:3/► Y, Date I Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Const rI!i§i;-)Frvisor _ CS-103111 x EADires:05/13/2020 JASON R FRCITAS, 5 MCINTOSH TAUNT ON MA 402780 f � Commissioner J �e�poarvi�eoixcueull/n��laoaacfe�ella _ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:;Surw1ement Card before the expiration date. If found return to: Regstr8tiont Expiration ration Office of Consumer Affairs and Business Regulation 106438==� 07/22/2020 1000 Washington Street-Suite 710 = Boston,MA 02118 A R S SERVICES`►NC Q), D/B/A ARS REST ORATION_SPECIAUSTS JAY FREITAS ;iry^ 38 CRAFT ST � `` Ey N valid without signature NEWTON,MA 02458 -�- Undersecretary g i ARSSERV-02 CWOODSIDE CERTIFICATE OF LIABILITY INSURANCE DATE / 03/2020l2018Y) 018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE.AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 endorsement(s). PRODUCER License#1780862 C MEACT Gretchen Houghton HUB International New England PHONE FAX 600 Longwater Drive A/C,No,Ext): (AIC,No): Norwell,MA 02061-9146 neORIEss•gretchen.houghton@hubinternational.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:LIO d.s of London 15792 INSURED INSURER B:Commerce Insurance Company 34754 A.R.S.Services,Inc. INSURER C:Hartford Underwriters Insurance Company 30104 38 Crafts Street INSURER D:Hartford Fire Insurance Company 19682 Newton,MA 02458 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR .ADDL SUBR POLICY EFF POLICY EXP L TYPE OF INSURANCE INS POLICY NUMBER MIDD DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE [X]OCCUR PGIARK07834-00 09/24/2017 09/24/2018 DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ X Pollution/Profession MED EXP(Any oneperson) $. 5,000 X $10,000 Ded PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 1XI jp"T D LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO 17MMCBGBJWM 09/24/2017 09124/2018 BODILY INJURY Perperson) $ X OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED Ix NON-OWNED P�OPERTY DAMAGE AUTOS ONLY AUTOS C NLY er acc dent) $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE PGIXS00660-00 09/24/2017 09/2412018 AGGREGATE $ 4,000,000 DED I I RETENTION$ $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY 6S60UB7H68400917 09/2412017 09/24/2018 T TUTE ER_ 1,000,000 ANY PROPRIETggOER/PARTNER/EXECUTIVE Y_1 NIA E.L.EACH ACCIDENT $ Mandatoryn NIj EXCLUDED?D E.L.DISEASE-EA EMPLOYEE $ 1 000 000 yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Excess Umbrella DCEXS00084-00 09/24/2017 09/24/2018 1,000,000 D Bailment 08UUMR06539 09/24/2017 09/24/2018 Blanket 950,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES JACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Restoration Services Agreement. General Liability: Primary/Noncontributory#PGI EL 020(2-10),Additional Insured ongoing operations CG2010(7-04), Additional Insured completed operations CG2037(7-04),Waiver of Subrogation CG2404(10-93). Contractors Pollution Liability Policy#PGIARK07834-00:Limits$3,000,000 Each Claim$3,000,000 Aggregate. Additional Insured PGI EL 018(2-10),Waiver of Subrogation PGI EL 019(2-10),Pollution Primary/Noncontributory PGI EL 020(2-10). Professional Liability Policy#PGIARK07834-00: Limits$2,000,000 Each Claim$2,000,000 Aggregate. Deductible General Liability,Contractors Pollution Liability,Professional Liability: $10,000. $15,000 Mold,Mildew and Fungus Deductible. Automobile Liability: Additional Insured and Waiver of Subrogation,per Commerce Insurance form Vs C133 and CIC957. SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Linear Retail Harwich#1 LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. c/o KeyPoint Partners,LLC 1 Burlington Woods Drive Burlington,MA 01803 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:ARSSERV-02 CWOODSIDE LOCH#: 1 A�/ D9 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY License#1780862 NAMED INSURED UB International New En land A.R.S.Services,Inc. g � 38 Crafts Street POLICY NUMBER Newton,MA 02458 EE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: Excess Liability$5mm Total Limits Policy#'s PGIXS00660-00 and DCEX00084-00 follow form Commercial General Liability, Contractors Pollution Liability,Professional Liability,and Employers Liability. Workers Compensation coverage noted above is for operations in Massachusetts only.Separate Workers Compensation policies in effect for states of Connecticut,Rhode Island,and New Hampshire. Fidelity Crime Bond $1,000,000 Limit w/5,000 retention through Twin City Fire Insurance, Pol#KB023651117-Term: 9-24-17-18. Linear Retail Harwich#1,LLC and KeyPoint Partners,LLC are additional insured per terms outlined above r i� l ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i The Commonwealth o assachusetts I)epavttment"ofdadustrigl Accidents Office of dnvestcga�tlons 600 Washingtonf Street k Rostom,MA 021�11 www mass.gov/did Workers'Compensation Insurance davit:Builders/Contractors/Electricians/Plumbers Applicant Information r- Please Print Legibly` Name(Business/Organization/Individual): ARS RESTORATION $PEGIALISTS,'LLC - _ 38 CRAFTS ST Address:. . r City/State/Zip..NEWTON, MA 02458 Phone#: 6"17=969-'1119 Are you an employer?Check th"e appropriate:box ✓ 4:. I am"a general cotitr ctor and I Type-of (required}i L f am a employer with 150' g 6., New construction employees(fuli:and/orpart-time):* have hired,fthe sub-contractors listed on the attached sheet. 7,;, Remodeling 2.. I am a:sole proprietor or partner- ;. ship and have no- employees These sub-contractors have. g, Demolition workin for me in.an capacity. employees and have workers' g Y p �' 9. Budding addition [No workers'comp.insurance comp:insurance.$ required.] 5: We are"a corporation and its; 10, Electrical repairs or additions: 3.. 1 am a:homeowner doing,all work:. officers have exercised their 11. P.lumbing repairs or"additions Myself [No workers'comp: right of exemption per MGL - t. 1'2. Roof,-repairs insurance required]t c 1'52,.§1(4),andt v1. t,have:no employees.[No workers' 3.. Other Dls�.sT aeaa►Rs comp.insurance required.] *Any applicant that checks box€11.must also fill out the section below shdiuing their worker;'compensation policy m ormahon., t Homeowners who submit this affidavit mdicatingthey are doing all"woik and then hire o tside contractors.must submit a new aff davirindicating;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 empii yees,they must provide their workers'comp..policy number: I am an employer that:as providing►wokers'cornpensad,dn M$u"rand r»iy employees. Below is*pplicy.an Jo. site inf017natlo& Insurance Company Name: HARTFORD UNDMWRIT:ERS INS CO`. 6S60UB7H68400917 09124/2018 Policy#or Self-ins.I;tc.#:" Expiration Date: Job Site Address: 434 SCUPPER AVE._ _ HYANNIS, MA 02601 _ ._ City/S:tate/Zip:... Attach'a-vopy of the workers'compensation policy declaration page(shovviog the policy'number and expiration date); Failure to secure coverage'as.required under Section 25A of MGL.c. 15Z can lead to the imposition of"criminal penalties'of- fine up to$1;500:00.and/or one year imprisonment,as well as civil peuattes"in"the fortn'of a STOP WORK ORDER and a fine: of up to$250.U0 a day against the violator. Be advised that.a copy of`th's statement"may,be forwarded:to the Office;of Investigations of the DU for insurance coverage verification. I do hereby ertify.0 ins nd penalties o perjury that;he information provided above is true and correct. Si afore Date: Phone M. Official use,only:. D®aot;write:in this.area;to,4e completed by caty or town official; City or Town: Permit/I icense Issuing Authority'(circle'one): t a 1.;Board of health 2.Building Department" 3L CityMOW Clerk 4.Electrical Inspector 5.Plumbing Inspector i .. 6.Other . - , Contact;Person:- Phone M -: . SMOKE DETECTORS R VIEWED : k 88ARRINISST1W BUILDING DEPT. DAT AUGO$ Zp' 60VV _ 8 FIRE DEPARTMENT ! DATE 641, BOTH SIGNATURES ARE REQUIRED FOR PERMITTING Y tTTF Q i ss F� 0. : a tvow ..h QWRP r R t3tilp fir :r T , / as Barnstable Bldg. Dept. Approved by:�� .�..�..�.. �� Y s'c c��cQe Permit :�� t IFIFIF t S f. b 7r t • ,An n5 • -:-s's�.:N ,.;.w� ,. ;� .�,;;i�».a-�,a.�r r-�.+r.�r++bn+a<�e��� • . Q f: lk jug ham..s I A m,� O /���'► 3e s •t:, _. • Y I } ;� 1 pwl ;q'7 � r cl3 JZN 1, _ `af e� v E j t i i Application Number............................................ Section`��— onstraction'Supervisor Name `T){s c)J R Fez iT PI S Telephone Nmber Cc f?- 'F9 q-?0 5' Address City I K vF,jbj / State la to Tip 62`� KO License Number_C$ -/C3 i] J License Type UTV Rt,5r Expiration Date 5-/l3/2 0 _ Contractors Email_ y 4� e- P*LSSe► V, Ceyyl Cell# (o1'-'SgR4- 35 I undmstand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and sP documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date S onr4O Home-mpr-ovement�C ntra�ctor Name /�} 5 5e rz i c€.s, 1 PVC.., Telephone Number • f 7- 16 Address CAA Prs .S 1- CityNe wft� `State �'►�� 'Zip �2 �3-6 Registration Number ID b L{3 Expiration Date ��/Z Z j2 C) I understand my responsibilities under the rules and regulations for Home Improvement Cont Mors m accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by d th Town of Barnstable.Attach a copy of your EUC... Signature Date 9 f Fjj 6 Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date Signature - Date 'Ff Print Name Q'q 50- Pre cn►- Telephone Number Gf?-899--X 5 E-mail permit to: 7j'/j y .e 4 rt 5 ,ee v r c apt r....F....q a- .�mnm-io Section 12—Department Sign-Offs Health Department © Zoning Board.(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ® Conservation - �❑ : For commercrzl'w Tk;pie take your plans directly&ihe fire department for`, 'approval -� i. Section 13—Owner's Authorization I, , as Owner of the-subject property hereby authorize to act on my behalf in all matters relative to work authorized by this building permit application for: (Address of j ob) Signature of Owner w :� �. r �,.� �:fir, �"•�,.� •. ,_ ; • - • Print Named k } t Last mdatuh 2I92018 A � t + ' TOWN OF BARNSTABLE Permit.No. 27947 {>�n a >" Building Inspector cash _ - OCCUPANCY PERMIT Bond ---_------- ___ Issued to Capricorn -Realty Trust Address Lot #3, 4870tcudder Avenue, Hyalnis , Wiring Inspector �" s�- z� Inspection date % ( Plumbing Inspectr o , Inspection date Gas Inspector fax l i^ r � Inspection date U =Engineering Department f�f P f �Jz , ��� �2 r A Inspection date Board of Health yl kf3 �,�1 `r�.� `,, Inspection date V Ajy �I THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY. COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .................................................. 19_.... ............................................................................................... � Building Inspector N TOWN OF BARNSTABLE k � °� BUILDING DEPARTMENT S SAEasr : TOWN OFFICE BUILDING rua� HYANNIS, MASS. 02601 �o ro l MEMO TO: Town Clerk FROM: Building Department- "" DATE: /'.`'` ✓ ',�, �" G An `Occupancy Permit has been issued for the building authorized by BuildingPermit # �2.�.r.�....r..���..............................................................::....................................................................................... issued to t... ...f�CO!". ...... ..... Please release the performance bond. Assessor's map and ••r mumber r /— cPr . /........ E r0� Sewage Permit nUri m r ......... .-..� ..�.��......::...... . s n 8 ' 9P4 S: q L'b D - C 'N` BARN STABLE,MAa .... . . ..... . . . ......House cumber � r� � 3 TWEE, Fr ■� �+�,E t Is���� TOWN, OF BARNS A �E � . BUILDING INRECTOR 'Construct Sin le Family Dwellin APPLICATION FOR PERMIT TO ............................................................... ....................... ...... .......... .............. TYPE OF. CONSTRUCTION .....Wood. Frame , r,. Setember..12�..........19:..83 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit,according•to the following information: Location .....Lot #• 3 „Scudder..Av,enue ...........:....................................:...... y�nx?�. . ...MA.......................... ProposedUse .... . ............. r......:. _ :.................................. ... Zoning District .R:B t.........................:...:................. Fire District H...anln s.i...? . .....:... Name of-Owner,Capricorn Realty. Trust Addressr�65 Falmouth Road,' Hyannis Name of Builder Franco Real Estate Dev.•• C9Acldress,7! .5...Falmouth Road, Hyannis•„•,,,,,,,,,, .................... ............ .Inc. ,....................... Name of Architect ....:..........................................:.................:Address ' . Numberof Rooms S1..X........................ ' ........... .... C............. ..........Foundation �',.. ..,...:..........:..::..:.............:............................ .. Exlenor Clapboard and/or••.shingles Roofing `....Asphalt„shingles„ Car et Floors ............�.?............................................:.:........................Interior ................:..................................... Heating Gas...-:..F.W.A. .:............:...Plumbing -:.. ...Two" ::Copper-..:..:..:.............`..............'. .................................... , Fireplace` .............None............ . .......... .Approximate Cost .....$.40.r.000..00. ......:...... .. ... Definitive Plan Approved;by Planning Board _____-_--__-__---_ -_19_____-__- Area - s...f... -• ..... . ... ... Diagram of..Lot and Building with Dimensions Fee ........A I SUBJECT TO APPROVAL OF,BOARD OF; HEALTH 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. 1 Name ... ............. ... .. ...........Pres�. •000989 . ' Construction Supervisor's License ................................... r � 'CAPRICORN REALTY TRUST t a 27947, One Story .. Permit for ' Single Familyr Dwelling r .......... ..... ..................... ................................. A Lot 3; 487 Scudder Avenize - Location +- :..... 'Hyannis .....:........................... Capricorn Realty Trust -�.- Owner ................ ........................... r , Type of Construction Frame ' /........................ +.................................................. , -^. . .� , . + - ' • . K Plot ............................ Lot ............................... G r. May 3.1, 85 Permit Granted. ........................................19 a Date of Inspection ....................................19 `: Date Completed`" ���. "......1Q . Assessor's map and lot,number .. .. .�. �!/,.....:. i 4.- OFTNfTO a Sewage Permit number ........: .-.� :. .(�.............: e``P ♦� ! Z BAHHSTADLE. i House number ... Maas i........................... .........................................., .: G s r✓ !�/JG i D��G3Ya�909 YP TOWN OF BARNSTABLE r B*UILDLHLG JAS,PECTOR APPLICAT4ON FOR PERMIT TO`::%..CQnstruct Single„Family Dwelling ..... ................................................................. TYPE OF CONSTRUCTION .......k�.lood r Dame .................................................................. ......................................................... September 12, 19 83 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information;__ { Location .....Lot..#..3.....Scudder„Avenue...............................................................T�vs?Y?.'>�,r: rT�.......................... i r f ProposedUse .............................................................................................................................................................................. Zoning District R.B..............................................................Fire:"District ......HyaraXL S,P... ...,............................ Name of Owner Capricorn Realty Trust Address 7�5 Falmouth„ zgad, Hyannis .... .. .............. Franco Real Estate Dev. CoAddress �65 )almout;h R6Ad,, Hvax?n Name of Builder ........ ...... . ............................... ......... Inc. Nameof Architect ..................................................................Address ............................:.............::........................................ �. Number of Rooms 0i.X........: r. Foundation ....P.,...,t................................................................ Exterior C1-apb.oard acid/gr...shinglq,s..................Roofing .......A phalt...ghiX1gXQs Floors ....Cdr.Pet................ ..............Interior .............. Heating` ...G'is .....F.W.A. .........:Plumbing 111vro Co-oeer - Fireplace ......... n Approximate Cost ....$4U.fANj 00. .................. ....... s f t. Definitive Pldn Approved`•by Planning Board ________________________________19_______. Area ................q',..................... Diagram of Lot and Building with Dimensions �� Fee .......a...�-!..... .." ............ ! Gtw•1 . SUBJECT TO APPROVAL OF BOARD OF. HEALTH } ��2 r 4 OCCUPANCY PERMITS REQUIRED FOR NEW .DWELLINGS - I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ,( ^' . .. 000989 Construction Supervisor's License t l CAPRICORN REAhTY TRUST A=22:-�— �1 7 No ... Permit for ,One StorX j Single Family Location Lot...3,, 4 8,7 udder/ .venue ...............HY.H.y.qn.n.is................... Owner .....Capricorn„Rea. Trust,. Type of Construction ..F.KAi e........................... Plot ............................ Lot ................................ Permit Granted ,,,,May 31, .19 85 Date of Inspection ....................................19 Date Completed ......................................19 e � 1 =t� C.�s 3 OG r ZN' iS.9 . iSTJN� �' 2 Al c .3 V% do jJ = 4, a ` „ o s Ilk 2• .� ;t FRONT 3 U 0 3 3 nww, siDF_ S f jZE/7X is, A4 Al, ®tA { n U �,- ASK 1l� CERTIFIED PLOT PLAN / sN _ •i n ° 07 3 c uDDE VE. ,. Yf/NIY!s P o RI t a`IN `e ••`` SCALE, y'o ' DATE S128 d'S L OREDGE ENg&gE•, / C0:l � '�� os nfi,,; �, ,�w��, �o������t, I CERTIFY THAT THE EG157ERED REGISTERED 82�� .�, � � Y z SHOWN ON THIS PLAN IS LOCATED ; 4 CIVIL LAND ON THE GROUND AS INDICATED AND �{ ,Y ot�} CONFORMS TO THE ZONING LAWS . ENGINEER SURVEYOR' OF ®ARNSTABLE MASS. # 712 M A I N S'T R E E T HYANRIS, MASS,. SHEET p!' , A E REG. LAND SURVEYOR r a . ..