The URL can be used to link to this page

Home My WebLink About0363 SEA STREET i r` t L ;\a lie �\ I r 1 t n v 4 .{mot ' r� �' }'♦ �A _ - wr: r ' S Y w w. o ; — •4Y. - „ 2 . Town of Barnstable *Permit# 4-4-/y6S Expires 6 nmrdhs from issue dam ` Regulatory Services Fee XAM • �.o.+QyRTs . - ¢ Richard V.Scali,Director Building Division NO Tom Perry,CBO,Building Commissioner. MAY 2 6 2010 200 Main Street,Hyannis,MA 02601 TOWN www.town bam .m stablea us TO p v N OF BA R N S I AB LI Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X Press Lapriw Map/parcel Number 3 06 Property Address 52(Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) E-mail: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor . I am the Homeowner ❑ I have Worker's Compensation Insurance j Insurance Company Name Worlmtan's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit.' Permit Re st(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to yA�inv '- �rs�P/ ❑Re roof(hurricane nailed)(not stripping. Going over existing layers of roof) 7P..,e-side ❑ Replacement Wmdows/doors/sliders.U-Value (maximum.32)#of windows #of doors: Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,Le.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the.Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFMES\FORMS\buUding permit forms\EXPRESS.doc Revised 040215 The CmnoiTweaM of ana&use& wiment rf ft a[Acxdkz& Boston.,MA 02111 tivrvw�m� �sa WCAMts' Compensate I ce Wdayi-$ t0•nt=WrSM ers AIpfficant Info n Please Print Ad&e= 26 3 SPa yre e-1 • . CstglStaU!VZ* AlYaglVS AAF a-26-01Ph e4, S0g-77,6 -76 rf Are you an employer?Checkthe appropriate ba= - Type ofproject(mod}- L❑ I am a esnploYw*i& 4. ❑I am a feral coaftactcr and I- 6. ❑Neva eon , emplQyew(fan andkr part-time)* bave hiredi fie suFr-camhsactazs 2.❑ I am a sole prapdetor orpartaer- Tilted vathe attached sheet- 7. ❑RPcnndedsag slip and bane sic eel These si -caatracam hwe �P� b t 8. ❑Demalifrvsz wades for me is any capacity_ employees andbave w®ri= q_ ❑Builc&ag addifion [No wmdmm'comp imsmzme warp.ksar _JmFked-] 5. ❑ We are a=gxxRfioa and its 10-❑Electrical repairs or amens 3.LM I am.a bomeaumer doing aU vm& o hm exercised their 1L❑pinmbiagrepairs ar�dditioms myself[No warlmrs'comp- right of eMM3p1i=per M(M 1,❑Roafregaits „orm. nc rid.]i C.M§1(4 aadwe bane no employees.[No woA ms' I3.❑ Qffier cam.k==ce regmred.1 "Any xVpficmtdLscdmtksb=#1umst BImmouttlewrfl=bgow fiAwwaska ema porgy; � I Wb0 SIIb.*skis 2S'7E they emtlom.-aU vm&lead 6mbm:out d&eemtmeimcamst suit flnew sffidstad maicz.�SUCI fC==ct= =rhydr Fs box m� e�ffi add sheet eh the of @�e acid sdrtevrhe aravt these ham emPIayees.If MqpIoyem%dLey==pmvide Ihw sroda!&camp party mmnbez I era an Burp year Stotts prauFdiraa workers'congwaafiml iU=raasa jor UJY etrrpiaj.wm SCraw is tT ffPVZacy Md jab site kfvrma*ma. Iasuraace CempaagName TdRcp 44 cr Self-ins.Iic.t Espir abate= Job Site Addre= 9 F' Attach a COPY Of the WOrkere compesrsalioapolicy declaration page(shawi 3 g the poficp number and expo at:ion date). Failum to secure~coverage as requiredunder Section 25A of MGL c.157 can Imd to the imposition of rAmi nai penalties of a fine up to$L50D Oa anNar one-yew imgfisozmtent as wa as civil peaalbes in the fame of a SIW WORE O ER annd a floe Of uP to$250 Ml a dap aggamst:the violator. Be advised tbaf a cappy of this statement sway be fos warded to the Office of Invest oai a Ofthe DIA for ins=w coverage va ifrcation- I do Iaersby csrf*amder the paint and penalfces qfpadW7 that the info r=E&aprmfiW abmw is true and carrect Sio ntam Date- t Phase ik 776-76.ff,P Offid d use arn£p. Da oat e4 rlta in fi s.area,.fa be wwpfeted by city or-town oJoicial Cky or Town: Pex-mft'License# Issuing Authority(circle owj: L Board of Health Ruffc&ng Departuteat 3.CRyfroma Clerk. 4 Electrical I'zpectoc-S.Phimbing fimpectur 6.other Cart Ferson phone 0: _ �#' 6 1�_v.•.: .•..w�aR a a• - .■:••la! �•■■.:•. I i:,aat■ • �F la al ■ .- •1■Aal.. •tn.■�■Y:t.•1■ \•1 [■' ■ rt.l• • �- n .rnl ■■ .■ w r_mu ..■ �.n •- w�. - - - ••!F•■ 11 i■a ■ a..i■� n■■� :n rn.n :Iv • m ��n a•.w .l ■■n• �• ur. a ••■u■�• • ■ �.I, • •i •a■n�• : -_u a•■ ou: ua ■•�tF■/l• _•..■wn•.n ru •• _n w u •n 1 -_ a�•.n c :n ••• •1 a•r - • ■.- 1.1 - -•n- �.■•r-•�• n : • ul a1u■ar n■I.�- _... n, a■m_ u �_ - .1 �.a•Irn•�.. . : •a f �• arms ••�. a i.- - •� • t ■ •v . al u u u.r ■_■ n a1F• 1• .w.••Nru m a •i■ti •r- a,.nt a+nu •• n: a+nu ■•► :•••- •� i.- •T. ■�, • •- lu• ■L■ ■_•u• 1• na n_n iu � a.:. u.�uR a.• -•a• wY■i•+ i.a+ an a is •««.u..n • ■. •• -1 u• ■•. • .0•it a; ••■• arms •• 1 a;■-a■ 1. .• [■.nu1:�■.n« •n v■ t.•••I■ u r.0 -•... w n . ■- Itn_ ■..w" ■1 •1 ••1. \■ J sense • •.. •It• -■•.•I .ai..[/1 t■ai a�1• • 1 •• •a«:■■ . ■«. aillt• ••..% ■- •��.■�• .I •- :.■ �..1• ••�! • YY_/i" I ".✓- I Y•. - i i - I ■1 lMr. `• _ . .1:111:�,.. • ■1 a1a• • I•I ■ It • It ■I •. - r. a1..1 • ■ ■l • ..• • .�i1 r' I •■i ■ - I� .1 .I- 1. • •- - �. ■ ■ as • •• u•■_ 1 / Cr ■-u[�+ r.:. arn■.r n «nnu■•n ••r.In a• .0• • /R •• u r. 1•.■ Y n■ ■. afn•ai u u a•• .•l.MY-.' 1.1 i/ - •a;•tan..0 r • ■■•1 •••lr. u■n rra•r.• - ■.w. - • •n.n a.n In it u n _n i• •■■ ■.a±.IR • ■■ ..:.•.a• •-` ■anal■ •1 ai■am-. 1• t■ r•I■n «•l■ :Itn•..rt •••■.•a!F .......a•.r..•. ...■ • 1 r•nt• ■- • MI .■1■_ 11- ••►,• ■■.1 .1.• [• ••■1 YI■■_n•■ .n• •�, - .. •.■. •■ r•nl■ :wu1 ■.m� .•n a. - .n a .••1•- nuu•a : N.: n u 1 r� ■■.r_ua• • ■■ .• :■. .■[ •a• Y.• [I ■1■at•.■.t a.. •1 1.■/1■�• • 1 ■•ai•.•a! • •-t .•�! :. - •• �■•■. a• l• .�.■ ••.•.�� rNn1•af■Y■•1. ■. n :..r" :[■ •1 - ■■- ■ - �..t• • •- _ •• a.aLl -■ • -• •■. It w ■•■. I .■ • •\I■[It1a•■ t• •.� ��._I n/a?•1 • ■■It ./_ •' -•rl•■a•• .• to wI �•11 to•'■ .t.. la -1•.■✓-••Il ■1 n- .�•■.1 • .rat. .a1t■ ■.wYt�l I • t. ■ll■ •■ N.�.■R 11 a . •[ ■: .■I• ■..�••1. - :I •11. •. • ■ •■ :■ - �•ar.�L 1• •.•:.n •'•..e�1 •1•■•�.Y.••l. ■•1 • - •':I ■■ ��•.I .I•a!•1 - \■_ ■.al•.I� w .�. • •• - It 1 a. r•Irn.-.■ ■■■ • �'..L" n- t a■ •. .a■ 1 •r■ - 51.■..•a? •1■ an- -n 914 •.1■.1■- 1. �■ • • ••. on • am - •- n i■_I u- .li■■.•1 r•n.n "r- a.• •.Ilea• - J. rt- �•a m.ru ■. n •- .a• _ •. .I ■■ ••Il•In • u son. -I • •■ is all ■n n .. .85 a �l'u. • .•- ■_a.•u ■: a wm■: ••• ,_. • u_ ■■ .■.Ir.. - ■- as - u 7 .. .. •a!u. - .1 r.■■ ••Val . •• I • •l�• _ Ia a:. .luu•'� • _■nn•a :u v■• «:nl \•.. ■. ■ ■•[■( 1. 1•./ - •a:■■•1■ �!■ :t■• r:••1. .. :t. J �. •�:I ■ram• aI• ■t/t•1 al. ■.• 1 .•■ •'.:■1• .l1 a. _ wl • •• 1■ •I•t■ t.. .ar.. _• :[•• ■..•.i •• �1." � l■1 aa. t.� .Ia• K..I ••■ • •'•t■- .•"■ •• • ■[- ■•.. 1 ■• •- •a:!. • ■•w.I• r.■./■�. •I n.n Aa.• •• n- MI •] ■•`Jl n ■- • • •�• 1• I■" _.•• r_n - •1 •• \•.1 : • : ■\•:• •t 81 1.1 tt(na •wrn R • ►af. .� ■' •m,•w - : ■•.. - •". • w1■ f:+■ •a Y[.■tn_ ►a!a el •ai••■ 1 .• :■a■ l■ .n ■• n••.`.. •1 .•.•n■ w •at•Ita1 _ ■• rar• • .�•u 1 ■• • vt .,[ w1. •.: •1/ f a.u[ a• n r•ntn a..- ■[ it•: I _Cp ■ • . •:+Y••:n•r■ ^•. • .•- r■ n.n. ••1 u :••.n r- n ■n w•■� .0 m :n■ ■•• ■ •■ .. -u •■a.■m loll • - - •• ■• ■w••Irn" a •J• •w r. I ■ �a.awa■ :•a . r ■.•n u• r.. •(lest.: �!i �T.Ltir n• ■ ■ ■ mac. SIMS WE NAM Town of Barnstable �'°rtb max' • . Regulatory Services Richard V.Scali,Director ; Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.ns 01fice: 508-862-4038 - Fmc 508-790-6230 Property Owner Must Complete and Sign This Section. ' If,Using A Builder L .12s Owner of the subject propetty hereby authorize to act on my,bebA in aH matters relative to work authorized by this building petmit application for. t (A.ddress of Job) Signature of Owner Date.. Print Name M ,. If Property Owner is applying for permit,please complete the Homeowners License Exemption Form�on the ' reverse side. QIVJPM ESTORMSNbuild ng peniit fbrms\EXPR,ESS.doc Revised D40215 Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division aAnvsrAMM Tom Perry,Building Commissioner MASS. 1. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fax 509-790-6230 HOMEOWNER LICOM EX CKMON Please Print DATE- XLA6•-16- JOBLOCATiON: 63 .SP-r .S ee- - l 4nni S number sheet village "HOMEOWNER": ,T-M A. nlnTz s"OY-7-76-76ff name home phone# work phone# . CURRENT MAJIJNG ADDRESS: 19-v►tc_ - city/hown state zip code The ctarent exemption for"homeowners"was extended to include owner-occupied.dwellft uc of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFRI)MON OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or famt structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signahue Homeowner Approval ofBuilding Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION. The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. . To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q.%WPFH.ESIFORMS\building permit fmzns\EMRESS.doc Revised 040215 TOWN OF BARNSTABLE BUILDING PERMIT„APPLICATIONy_„ r, Map Parcel ® "Application # Health Division '''Date Issued Conservation Division ;.;Application Fee Planning'Dept; ',Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village //S Owner Address :d 3 ` Svc ST Telephone 77/- 41211 Zz Permit Request Square feet: 1 st floor: existing proposed '2nd floor: existing proposed Total new ✓ Zoning District, Flood Plain Groundwater Overlay Project Valuation Construction Type bD Lot Size "67 9> Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family O 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.p Number of Baths: Full: existing. new Half: existing 'new 3;v- .r Number of Bedrooms: existing _new % z _< Total Room Count (not including baths): existing new First Floor ITB m Cow C) Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑Other w Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woo coal se: ?Yes ❑ No a% m Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION —� (BUILDER OR HOMEOWNER) Name �/l WW /,�� /�/��,� Telephone Number S��` Address License# 6 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE � G - fir � � DATE FOR OFFICIAL USE ONLY *APPLICATION# DATE ISSUED MAP/PARCEL NO. $ ry r ' ADDRESS VILLAGE OWNER e . 5 DATE OF INSPECTION: FOUNDATION FRAME INSULATIO N FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. l I The Commonwealth of Massachusetts Department of Irtdustrial Accidents Office of rnvestigations 600 Washington Street Boston, 1MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A.pplicant Information Please Print Le 'bl Name (BusinesslOrkanizafion/Individual): C/�i A1,01 Address: 3&3 -A �iiric City/State/Zip: `S O Phone.#: 54� .271 `Ml Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I 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 ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp.-insurance comp•insurance.t required] 5. ❑ We are a corporation and its IQ.El Electrical repairs or additions 3. r am homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. IS2, §1(4), and we have no 13.❑ Other employees. [No workers' COMP.insurance required_] `Any applicant that checks box#1 rnust also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they ere doing all work and then 1 irr outside contractors must submit a new affidavit indicating such. xConteactors that chock this box must atbzhed an additional sheet showing the name of the subcontr actors and state whether or not those entities have employees. if the subcontractors have employees,they must providt their wwkml comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the polity and jab site information. Insurance Company Name: y Policy#or Self-ins.Lie.#: 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 S250.00 a day against the violator. Be advised that a copy,of this statamerit may be forwarded to the Office of Investigations of the bIA for insurance coverage verification. I do hereby certify under the �pains•and penalties ofperjury that the information provided above is true and correct. Signature Q�aaL!:A� 4 e Date: Phone# -0?( '77/- V 1 Official use only. Do not He 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.Buildi.ng Department 3, City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Insttnctions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their_employees: Pursuant to this statute, an employee is defined as "...every person in the service of another under,any contract of hire, express or implied, oral or written." An employer is defined as"'an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing,engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the 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 form the performance of public work until acceptable evidence of compliance a2th 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, iIf necessary, supply sub-contractors)name(s), address(cs) and phone number(s) along with their certificates)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, n6t 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 Towp 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/licensc applications in any given year, need only submit onp affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A cbpy 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.Whero 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 number: The Commozwea b of Massachusetts Department of Ind-u t al Accidents Office of luvestigatiGus 600 Washin&tQn Street Boston, MA 02111 Tel. # 617-727-490.0 ext 4.06 Qr 1-M-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia r Town of Barnstable �opTHtS Tp�y Regulatory Services BARWSTABLE. = Thomas F. Geiler, Director MAss. 1619. ,m� Building Division PLEA �n Tom Perry,Building Commissioner . 200 Main Street, Hyannis., MA 02601 wmy.town.barnstabl e.ma.us Office: 508-862-4038 1 24 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: �e2 z,,CS number ¢/1 street J 9 // village J "HOMEOWNER': 1 l/��/!� /UD�Z Sd�/ 7-2 —`�'� �L/ name 2/ a home phdne# work Oone# CURRENT MAILING ADDRESS: /,/C/J ✓�� -s� c' /town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OFHOMEOWNER Person(s)who owns a parcel of land on•which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on.a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1,1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules.and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature gfl4omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that, "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for-hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix IQ, Rules&Regulations for Licensing Construction Supervisors;Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fomi/ccrtification for use in your community. �FTF{ETO Town of Barnstable Regulatory Services BARY i MAC ' Thomas F. Geiler, Director 059. y lFo �a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. a x- { 1�1 t p 1 i e � j 'A it Y d 1'ti i f �. _� I�_� _ � �. � � � �, ,: -� - . : \ i.�\ { ._ . .+' c. • ; -. �, 3. i i �' ,..�.�_,_•---....-..-:...---_.....e.,..._..- ram.». �, W �° A �x t , NOV 22 c ) 2 ; I ? M YfANK'fEE LRND SURVEY 1 mG • 1 `;fD�3-�r20-555� .l�.f!II�,.a=�.I: .•'C•1?ITf-lr :1i(Jlr_,• r 7 /,� n. �.m-.:.l.h.�:..-.�..,n�ry. J��/tfj�i�' .lf�rf11UNl,✓ - u�l ./ {e SHETLOT NV NUTl" PRE, -E_�7,�7rrbrG" G+'•`'g5'4Y''�`,{�.°� ��-d,Jazi'��l�1VC � (��,�'��, •i'f° )P4, LOT Ail adra®9te4a ` . ,Loon x�hx;e _SlGU1 Jt1rJb'C zoo', _ r I)VIr. ATED 8,119"B6 l f,�i'rsi:r �e�rr.�.ry e/')r,) Pt„_s ;7Cu c�ttt3,�e J72a'�ECLIDA Y�rF n -— %'� 41JVa1S FAAW f 'vim pre�sre for Plan Bank Oxe C,r Thr ivoa G_icn of Ehr^ ,rn_:lirng rlac�r.: _ _ �_� — �a 11 nillJlc+ ❑ r� --"'— /� snc--cJrd: (ion ' �'1r rxrd JJ1,, J-LAJV haF-Y lrlrlc rJ/ COtJk f.TUE'lrvrj k'71% i'RNAFG': kt f,'rP pi-m tod�OB3 F'ri. O.1.r,•; S�ii �. r �B! zvrvt�c= by'-»Itr a+,^ !r! tftccf � �,JJf".rCCr77[,,L Ocfio» t119[fE; ldt'a<S GenersJl I rvcf.reguir;rrex°fr.L Sea j•, _ ��---._.j' 0� J'." ! ,otc:','', fir•:,. '�i'^�t••IJ6A >Pa�AC. 1rx'R Pad C Y rrvinnRic:` ., Cl.rr Luiidrnf� /n nt -�• �?" t:Ct 1LsPrumon: s —^--. GE 1 eC Y{-,^ reeUrlPir f }Dd1 =iJ•d tlnc'reC Ch�crJl,'/'l On A/qr A�Ory Y7R)�+fF cra ty. A, act-n j +6 Gi!rpere: ar>'rr' trsc >fD �-tpLrrr�+ �lrtd dr. !' err_s[, ei tte,^ R%3' OCT'D.Si r f., rnrcr,..,sntr insnr,r±iz� r,;z.r= ror tr uAcG 4<. :!a•.'v /'mF s^J•J�.U'an.� nrd p+brJ�'rty'hares, alit: irraonritlnn rnusi nit n.:l,'�- r,r7 Jr.rr�r1; 1,4'•ht+e,' u, !c' ert�7' tine-�', �'. !X]sRd oaf J,+c a+•e••1 fryr rorrar,r:r. er kuJlrliq,C. ry)pn � � 1 rn .rcrr_,rr.±r. rn.rirrrnJ6J7� FL!'[R yt avhr Ffrm„y yfm u!Ja/L�/< OCr:.�101/t �"rA��'-`rr� Ji.:r_ tiirrrncJn n,a Icrr�7F of=J4i � �$�r. � to �3r ,c5't_� I r :,:;r yv;r�r,.yy.s r,r,�fr J¢y, !°Mc�l dll vrrnl ic1�n4+(Ol, ad!Rr} rqp, +�t4'Iri'n(roh' car.�.....,. t, mcr�r;Grz, J;a r,A rr: .Bert tt ix .rhexn hereon. TJ!tar ilrap:.t,:�n .• nnr yaJ' NC•:^r+p d,a iru rrm nnrrr hiJ'P,v ( J r k. rc card rrh:•nsa, 1011 ;T1 3 HPr.T,?Ti1@ q,TMK''VXU TTcc• inn, r w6 AIVC Garde to l•Vood Construction.in Hi,h'IVirzd Areas: 110 tflph Witid Zorze Massachusetts Chock ist for Con-i0iiance (780 CnIR 5301.-2.1.1). At nind 0 Check Compliance E peed.(3-sec. gust).......................................................::......... -- ............................................. 110 mph xposureCategory....:.........:.................::...:.....r...................... .....:............::.................................. ......B t� Wind Exposure Category................Engineering Required For Entire Project.......:......:................:.......0 1.2 APPLICABILITY Number of Stories (a roof which exceeds 8 in 12 slope shall be considered a story) / stories <2 stories RoofPitch ...........................................................................(Fig 2) :.................:........................) a 5 12:12 MeanRoof Height .....................................................:........(Fig 2).............,............................... L ft <33' Building Width,W ......................................................_.........(Fig 3)..........................:...... ................. Ib ft <_80'. t/ Building Length, L ..............................................................(Fig.3).....................................................!!Y-f.530 Building Aspect Ratio (L/W) ................................................(Fig 4).............................:................... :1 Nominpl Height of Tallest Opening2 .............................::....(Fig 4)................................................ !� <6'8" 1.3 FRAMING CONNECTIONS General compliance with framing connections.:..................(Table 2).............................. 2.1 FOUNDATION Foundation Walls meeting requirements of 780-CMR 5404.1 Concrete..............................................................................T...................... ....P.._.. Concrete Masonry .................................................................... .....In 2.2 ANCHORAGE TO FOUNDATION"" J L 5/8'Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as al ernative in concrete only Bolt Spacing—general ..........................................(Table 4)......._..................................... . ' in. Bolt Spacing from end/joint of plate.............................(Fig 5)..................:................. in. s 6"- 12" Bolt Embedment—concrete.........................................(Fig 5)............................................:.... in. Bolt Embedment—masonry....:....................................(Fig 5)............t........................... in.>_ 15" 'x 5 > PlateWasher.................................................... (Fig ).............................................._3"x3 l 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55)........ ......................... Maximum Floor Opening bimension.................. ................(Fig 6)................................................... ft<_12' Full Height Wall Studs at Floor Openings less than 2'f_rom Exterior Wall(Fig 6)....................................... Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7).................................................... ; ft 5 d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)............................................... _ft <d FloorBracing at Endwalls................................................... (Fig 9).......................................................,.:;........ -u Floor Sheathing Type .........:..............................................(per 780 CMR Chapter 55).................... Y...:... ° Floor Sheathing Thickness ........................................... .. (per 7B0 CMR Chapter 5)_in edge in. r Floor Sheathing Fastening ( n field 4.1 WALLS Wall Height Loadbearing walls..........:....................................:........(Fig 10 and Table 5)........................... ft 10' w ✓� Non-Loadbearing walls....::....................................:.....(Fig 10 and Table 5)......................... ft _20' - Wall Stud Spacing .....I....................:.............:...............(Fig 10 and Table.5)..................._in. 5 24' ..c. Wall Story Offsets ...::...............:................... ...............(Figs 7&8)............................................_ft d f e•. 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls................... ................ ........ (Table 5)..............................-2x�- ft 9 in. Non-Loadbearing walls ....................................... ....................... ......... .........:('table 5)...............................2x_q_- in. v Gable End Wa11 Bracing Full Height Endwall Studs.............................................(Fig 10)....................:.. ....... .'. WSP Attic Floor Length................`.......................:.....:.:(Fig 11)............................................. ft_W/3 'Gypsum Ceiling Length(if WSP not used)..................:(Fig 11)............................................_ft_0.9W and 2.x 4 Continuous Lateral Brace @ 6 ft. o.c. .. (Fig 11).........................................::.................. or 1 x 3 ceiling,furring strips @ 16'spacing min.with 2 x 4 blocking @ 4 ft..spacing in end joist.or truss bays . Double Top Plate Splice Length ...,.................................:..................(Fig 13 and Table 6)...........:...........,............f2 ft Splice Connection (no. of 16d common nails)..............(Table 6)........:................................................ A If"C Guide to Wood Construction in High 1,Vind Areas: 110 mph l'Vi»d Zone Massachusetts Cheddist for Compliance (780 Ci1'IR-5301-2.IJ)' -r Loadbearing Wall Connections Lateral (no. of 16d common nails)................................(Tables 7)............... •-•..••..•• ............................. Non-Loadbearing Wall Connections Lateral (no. of 16d common nails)................................(Table 8)....................................................... oL _ Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ..............................:...:.....................(Table 9)..................................—ft 7 in.511' v Sill Plate Spans ........................................................(Table 9).................................._f, ft % in.5 11' Full Height Studs (no. of studs)....................................(Table 9)............................,.......................... Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.............................................................(Table 9)..................................Z ft!' in.5 12, Sill Plate Spans...........................................................(Table 9)....................................7 ft i in.5 12" Full Height Studs(no.of studs)....................................(Table 9)........................................................ �/- Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension,W Nominal Height of Tallest OpeningZ ...............................................................................��6,8" Sheathing Type..............................................(note 4)....:............ ��. Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................ Field Nail Spacing............................:.............(Table 10)..............-.....-............-•-•..-.-......._'(" in. _tom Shear Connection (no. of 16d common nails)(Table 10)....................................................... .AlS' Percent Full-Height Sheathing...................:...(Table 10).................................................... % _ 5%Additional Sheathing for Wall with Opening> 6'8"(Design Concepts).................... Maximum Building Dimension, L ,i Nominal Height of Tallest Opening2.........................................................................L%5 6'8" Sheathing Type..............................................(note 4)....................................................._Tu_ShIfby, Z/ Ed e Nail Spacing ........ Table 11 or note 4 if less ........................I'in. _Ll- Field Nail Spacing :.. Table 11 ...............................................:. P g............. . . .. . ( ) -�- Shear Connection (no.of 16d common nails)(Table 11)................................................. ...... ,�/� Percent Full-Height Sheathing.......................(Table 11).......:............................................. Z°l° 5%Additional Sheathing for Wall with Opening> 6'8"(Design Concepts).................... ` Wall Cladding Ratedfor Wind Speed?.............................................................. ............................................................... 5.1 ROOFS. Roof framing member spans checked?........................(For Rafters use AWC Span Tool, see BBRS Website) Roof Overhang ...................................................(Figure 19) ............. ft 5 smaller of 2' or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)......:.................I...................11=4 o3 pif J/_ _ Lateral...........................:.................(Table 12).............................................L=_If plf V Shear...............................................(Table 12).......:....................................S= �1 plf V Ridge Strap Connections, if collar ties not used per page 21... (Table 13)...............................T= plf Gable Rake Outlooker..........................................(Figure 20 ft 5 smaller of 2' or Lit Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)............................................U= lb. Lateral(no. of 16d common nails)...(Table 14)........... -.................. .........L- . -lb. Roof Sheathing Type.......:...........................................(per 780 CMR Chapters 58 anO 59) ............ Roof Sheathing Thickness.....................................:..... . ........................................ in. >_7/16"WSP Roof Sheathing Fastening............................................(Table 2)..................... ............. ..................... Irw Dotes This checklist shall be met in its entirety, excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b Exception: Opening heights of up to 8 ft. shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade. i . l I AIVC Guide to Wood C'ons•tr-uetion hi fliph IYind Arens: 110 nip/r 17'iirif Loire ' . Massachusetts Cllecitlist f'ox- Collipliance (780 CNIII5301.2 1 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio, determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7116"and be installed as follows: L Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment 5. Glazing protection: a) new house or horizontal addition—required if project is 1 mile or closer to shore (generally, south of Rte.28 or north of Rte. 6) b)vertical addition—not required unless there is extensive renovation to the first floor c) replacement windows—needs energy conservation compliance only(chap 93) 6. Wood Frame Construction Manual (WFCM)for 110 MPH, Exposure B may be obtained from the`American Wood Council (AWC)website. •-WHEN THIS EDGE RESTS ON r F�SAr,11NG USE&!NAXs ATG'oi 14 ii ii •ii i 1 � ' 1 II 11 1 ; t I I 1 1 1 I 1 1 ¢2 - tl. 11 11 1 II 11 1 D } 1 z Q 1 lrl IA 1 1 1 i a 0d 1 w. 14 ii 1 1 a 1 11 i i NG i i •r7i 1 / 1 FRAMI MEMBERS "'y I l i I.1 i 1 EDGE RfUE iMEDMIE 1 1 1 1 1 J 1 I I II.W ii it -k r t - 1[ � 11 11 Ll .. .. 1 I •. L.._� d IJ rc I I .S I I i t ItJ 1 * I II 1 1 U I/ 1 1 1-• 1 1 - 1 _ 1 1 j i 11 1 1 '� / I ♦ 1 1 • > �. 11 J1 ___-J ---------r--� _-- - - F_9 11 ti 11 STAGGERED DOUBLE:EDGENAILSPACkJG I i 1,WLFATTEAN PANEL PANEt_ — ��' 'PANEL EDGE DOUBLE NAIL EDGE Sr'AC7NG DETAL See Detail on Next Page Detail Vertical and Horizontal Nailing Vertical and Horizontal Nailing for Panel Attachment for Panel Attachment f �s� E °T®®i'11 ®f Barnstable *Permit# ITS 1 C �D S DEC 1 4 200J_j� Re •,lcltor F•xPires6monthsfromtssuedate p, ThomasUF.Geiler,D ectoVr1CeS Fee '. U -T�t,UQR��STALB E BuildingDivision ion Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508=862-4038 "ww.lown.barnstable.ma.us EXPRESS PERM-1 'APPLICATION Fax: 508-790-6230 Not Valid without Red X--Press Imp SIDENTIAL 0 Y Map/parcel Number ��® - Properly Address Ze esidential Value of Work /)�) Minimum fee of$25.00 for work under$6000.00 )wner's Name&Address Is — :ontractor's Name :ome Improvement Contractor License# applicable if a Telephone Number��.-7�i ( ) ons ry iso-rs�ieense#f �a 3 ]Workman's Compensation Insurance Check one: Ma sole proprietor the Homeowner I have Worker's Compensation Insurance urance Company Name ulman's Comp.Policy# py of Insurance Compliance Certificate must be on file. mit Request(check box) ❑ Re-roof(stripping old shingles) All constructi Go on debris (n9t stripping. Go debrisis will be taken to ,�� ing over existing layers of roofl 11d Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this Permit does not exempt compliance with other town d' epartment regulations,i.e.Historic,Conservation,etc. ***Note: , Property Owner must sign Home Improvement Contractors License is req�ed of Permission. UTURE: ns:expmtrg 071405 1 IZ4 \ Department oflndustrial flccidentsY " Office.of Investigations' " t a 600 Washington Street Boston,MA 02111 " y www;nass.gov/dia Workers' Compensation Insurance Affidavit: B�ders/Contractors/Electricianss/Plumbers Applicant Information Please Print Legibly Name (Businessiorganization/Individual)*. "TF,� Address: 36 3 S Z� Sr City/State/Zip: AC- Aylnl rn Phone#: Spy- 777) —.Vg�r Are you an employer?Check the*appropriate box:. Type of project(required): 1.❑ I am a-employer with 4. ❑ I am a general contractor and I ' 6 ❑New construction employees (full•and/or part-time).* have hired the sub-contractors 7. Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet. I ❑ g ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any'capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' comp.insurance 5. El we,are a corporation and its 10.0 Electrical repairs or.additions 3.V ��] officers have exercised their IeZn a homeowner doing all work right of exemption per MGL 11.❑ Phunbing iepairs or additions myself:[No workers' comp. c. 152,§1(4),and we have no 12.[3 Roof repairs insurance required.]t employees. [No workeW 13.❑ Other camp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: 1t t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tcontmaomthatcheckthis boamust attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information, I am an employer that is providing workers compensation insurance for my employees.*Below is the policy and job site information.Insurance.Company Name: Policy#or Self-ins. Lie.#: 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 cati 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 STOPVORK ORDER and a fine of .p to$250.00 a day against the violator. Be advised that a copy of this staternenf maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct: Suture: i_ �l gp�,, Date:*- /1 V V-p Phone#: .50$ 71-411 Of cid use only. Do not write in this area,to be completed by city.or town officiai City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health L.Building Department 3.City/Town Clerk 4..Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Information and Instructions sachusetts General Laws chapter 152 requires all employers to provide workers' compensation�for ct their Cnnp hire Massachusetts person in the service-of another under y , Pursuant to this statute, an employee is defined as"...every express or implied,oral or written." ' d association,gmporation or other legal entity,or any two or more An employer is defined aS..an?� •:Parinersitrp,: 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- .e- occupant of the owner of a dwelling hous a having not more than three apartments and nstru do o � wo aeon s dwelling house dwelling house of another who employs persons to do maintenance,co eP . 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 ot produced acceptable evidence-of compliance with the insurance coverage required." applicant who has n Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its-political subdivisions shall for the performance of public work until acceptable evidence of com th pliance wi th enter into any contract e insurance requirements of1his chapter have been presented to the contracting authority. Applicants Please fill out the workers' co�ensation affidavit completely,by checking the boxes that apply to your situation and,if. necessary,supplY sub-contractors)name(s),addresses)and phone numbers)along with their certificates) of • insurance Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the to carry workers' compensation insurance. If an LLC or LLP does have members or partners; are not required . employees,a policy is required. Be advised that this affidavit maybe 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 , complete and printed legibly. The Department has provided a space at the bottom Please be sure that the affidavit is mp P g applicant of the affidavit for you to fill out in the event the Office of Investigations has to contact you re arding the app Please be sure to fill in the permrt/hcense 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 maxked by the city or town may be provided to the applicant as proof that.a valid affidavit is-on file for.fixture permits•or'liaenses..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 odracvolmmercialveuture y T required to complete this affidavit ' . ado license or permt to bnra leaves etc.)said person is NO eg mP i.e g . ( �e to thank you in advance for your cooperation and should you have any questions, The Office of Investigations would hl please do not hesitate to give us a call. The Department's address,telephone and.fax number: The Commonwealth of Massachusetts . Department of Industrial.Accidents �. �fce of f nvestagations f. 600-Washington$�reet� . Boston,MA 02111. :`Tel.#617-727-4900 ext 406 or-1-877-MASSAFE Fax#617-727�7749 Revised 5-26-05 www.mass.gov/dia Town of Barnstable ��pTME Tp�, Regulatory Services P p Thomas F.Geiler,Director sa MASS.. � Building Division y nss. �* i6;q. ♦0 �''°tEc Mpg A Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230. T/INQUIRY REPORT Date: ZlO S� Rec'd by: his' Complaint Name: Map/Parcel .' O � �y p _ Location Address: ��e � �� f• Originator Name: Street: Village: �,�s .State: /''lit Zip: D2 / Telephone: g �?"� — S -2 Complaint Description: FOR O ICE USE ONLY Inspector's Action/Comments Date: Inspector: r Additional Info.Attached - Q:forms:complaint �r r 'q-Rn ' �rs �, a Jy �a fyIC1I I . ... _....... _.^ ....._. .... . .........I _.._. :J7 1 f � f � r The Town of Barnstable BARN&FABM : '�9 Department of Health, Safety and Environmental Services '°rEv.,�►�" Building Division. 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner MEMORANDUM TO: Jack Gillis Consumer Affairs FROM: Gloria Urenas Zoning Enforcement Officer RE: 363 Sea Street 306 044 DATE: 4/21/99 This site consists of a single-family dwelling used as a 4 room lodging house with a capacity of 8 and a cottage with a capacity of 2. g990421a f °F THE The Town of Barnstable 9� " �e� Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner MEMORANDUM TO: Jack Gillis Consumer Affairs FROM: Gloria Urenas Zoning Enforcement Officer RE: 363 Sea Street 306 044 DATE: 4/21/99 This site consists of a single-family dwelling used as a 4 room lodging house with a capacity of 8 and a cottage with a capacity of 2. g990421a THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA NUMBER FEE - THE COMMONWEALTH OF MASSACHUSETTS 38 $�_00 TQ-W........... of ............BARNSTABLE................................... LODGING HOUSE LICENSE This is to Certify that a Lodging house License is hereby granted to -------------------------------------- LOis..M_Nelsou...�..G..T._s_.,.Whit ehead..d/bA..T$E._sa�r�--ors--s�---ST R 2 ET at .......................3.5.3...Sea--.Street.-------------Hyannis.,...Ma_...................................................... in said .........MyAaaig............ and at that place only and expires December thirty-first 19.9.6.. unless sooner .suspended or revoked for violation of the laws of the Commonwealth of Massachusetts relating to the licensing of Lodging Houses. This license is issued in conformity with the authority granted to the licensing authorities under section twenty-three, of chapter one hundred and forty, of the General. Laws, and is subject to the provisions of sections twenty-two to thirty-one inclusive of said chapter. In Testimony Whereof, the undersigned have hereto affixed their official signatures, this...............31st..... day of......... �" December.................... A. D. 19.95 7- ............................. ...................................... Licensing Authorities .................................... ...... ................................................... I FORM S 547 A.M.SULKIN,INC.-BOSTON (617)542-5858 (OVER) NUMBER 38 THE COMMONWEALTH OF MASSACHUSETTS FEE TOWN nn .................... BARNSTABLE ............1.111,11'.. Of LODGING HOUSE LICENSE This is to Certify that a Lodging House License is hereby granted to ............... Lois M. Nelson ...................... .........tm............................In & C.J.B-Whitehead ...........................................................Ae�4/ at .......................................3.63...S ... eet QN...q insaid . .................*---------.................... .....fly-az1X11.s------------_-- and at that place only and expires December thirty-first 19...9L.7.unless sooner -suspended or revoked for violation of the laws of the Commonwealth of Massachusetts relating to the licensing of Lodging Houses. This license is issued in conformity with the authority granted to the licensing authorities under section twenty-three, of chapter one hundred and forty, of the General . and is -two to thirty-one,inclusive of said chapter. subject to the provisions of sections twenty, Laws, In Testimony Whereof, the undersigned have hereto affixed their official signatures, this_31st .............................. day of.......December -, - - - .................. ........................... ......11................... ............ .......................... Licensing . . . ....................... ........ -- --- ,7! . ... ..... ........ Authorities ... .......................... ................ .... ..................................................................... FORM S 547 A.M.SULKIN.INC.-BOSTON (617)542-5858 (OVER) NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS 38 $75.00 TOWN of BARNSTABLE ._._..... ...---•------ ................................................. LODGING HOUSE LICENSE This is to Certifyy that a Lodging House License is hereby granted to ...................................... Lois M. Nelson & C.J B. Whitehead d/b/a TIDE...INN..ON...REA••,S-TREET---42......................................................................... at .......................3.63...Sea...Stxeet_______----_____.______--__--•-•-------_______-----_-_________-_-------•----------_____---•-----••-•-- in said ................H_y-annis...... and at that place only and expires December thirty-first 19__95. unless sooner -suspended or revoked for violation of the laws of the Commonwealth of Massachusetts relating to the licensing of Lodging Houses. This license is issued in conformity with the authority granted to the licensing authorities under section twenty-three, of chapter one hundred and forty, of the General Laws, and is subject to the provisions of sections twenty-two to thirty-one inclusive of said chapter. In Testimony Whereof, the undersigned have hereto affixed their official signatures, this._•-------3.rd..............day of.................Nayw.................... ...........__-.......... A. D. 19__95. ...................... -- ........ -- - .. ...... Licensing --•-•--•-------• ............. Authorities ................. ............ FORM S 547 A.M.SULKIN,INC.-BOSTON (617)542-5858 (OVER) - NUMBER FEE _ THE COMMONWEALTH OF MASSACHUSETTS -R - $79 00 ....................l.'-Q..WN..--•--._.. of ............BAPWTA)ALE................................... LODGING HOUSE LICENSE This is to Certify that a Lodging House License is hereby granted to ...................................... Lois..M_Nelson...&.-•C_3•_B.-...Whitehead --TJiS---III N---GN•--SE1A---STREET at _..----••..............3_6.3._.Sea...Street..............Hyannis.,__.Ma_...................................................... in said.........Hyannis............ and at that place only and expires December thirty-first 19.2A. unless sooner -suspended or revoked for violation of the laws of the Commonwealth of Massachusetts relating to the licensing of Lodging Houses. This license is issued in conformity with the authority granted to the licensing authorities under section twenty-three, of chapter one hundred and forty, of the General Laws, and is subject to the provisions of sections twenty-two to thirty-one inclusive of said chapter. [ ] [R306 044 . ] LOC] 0367 SEA STREET" CTY] 07 TDS] 400 H KEY] 213691 ----MAILING ADDRESS------- PCA] 1091 PCS] 00 YR] 00 PARENT] 0 NELSON, LOIS M MAP] AREA] 60AC JV] 307849 MTG] 0000 358 SEA STREET SP1] SP21 SP31 UT11 UT21 . 98 SQ FT] 2152 HYANNIS MA 02601 AYB] 1860 EYB] 1970 OBS] CONST] 0000 LAND 80500 IMP 121300 OTHER 5400 ----LEGAL DESCRIPTION---- TRUE MKT 207200 REA CLASSIFIED #LAND 1 80, 500 ASD LND 80500 ASD IMP 121300 ASD OTH 5400 #BLDG (S) -CARD-1 1 109, 200 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 5, 400 TAX EXEMPT #BLDG (S) -CARD-2 1 12 , 100 RESIDENT'L 207200 207200 207200 #PL 363 SEA ST HY OPEN SPACE #RR 1447 0137 1686 0315 COMMERCIAL #SR SOUTHGATE DRIVE INDUSTRIAL EXEMPTIONS SALE] 11/92 PRICE] 140817 ORB] 8314/351 AFD] I N LAST ACTIVITY] 03/01/93 PCR] Y R306 044 . �P P R A I S A L D A T A� KEY 213691 NELSON, LOIS M LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 80, 500 5, 400 121, 300 2 A-COST 207, 200 B-MKT 223 , 600 BY 00/ BY /00 C-INCOME PCA=1091 PCS=00 SIZE= 2152 JUST-VAL 207, 200 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 60AC -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 60AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 805001 LAND-MEAN +0 2072001 114359 IMPROVED-MEAN +6% 250-. ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1001 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R306 044 . P E R M I T [PMT] ACTIOR] CARD [000] KEY 213691 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR oCMP NEW/DEMO COMMENT i r i �� 116 SyI1p =J UPC 68021 NO. SF11 SA ppsr.co -M1 - HASTING N RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET 363 Sea St. Hyannis H �3 LAND 0) BLDGS. OWNER TOTAL 36 LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: DV lot 7 BLDGS. B. TOTAL LAND DeVincent,,- Catherine A1 128173-.--1984—ZI8nI3Blocs. 2 D.S TOTAL LAND BLDGS. ai .ssa - TOTAL LAND 01 BLDGS. TOTAL LAND O1 BLDGS. TOTAL LAND BLDGS. TOTAL LAND INTERIOR INSPECTED: f � J� O BLDGS. 3 TOTAL DATE: 7/ LAND ACREAGE COMPUTATIONS 0) BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL H LOT g o- 8 / T / S LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. 0I -_. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND BLDGS. -- LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT Fr.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND / ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. Fin.Bsmt.Area _ LAND COST Beth Room Bass <' `j�� SLOG. COST �''� i lconc elk Walla Bsmt.Rec.Room St.Shower Bst Bsmt. �— V Cone*Slab' �i` ; ? Bsmt.Garage St. Shower Ext. PURCH. DATE Br1ek Walls "" *' Walls PURCH. PRICE. t �, .-?� Attie Fl. &Stairs Toilet Room Roof RENT ' r'Stone Wellath,, Fin.Attie Two fist.Bath D Floors �- INTERIOR FINISH Lavatory Extra BsmL7.` F '1' 2 3 Sink s/a :E r/ Plaster Water Clo. Extra Attic EXTERIOR WALLS Knotty Pine Water Only s {� Double Siding Plywood No Plumbing Bsmt.Fin. U Single Siding Plasterboard Int.Fin. F7 Shingles TILING Cone.Blk. G F P Bath Fl. `3 Heat Face Brk.On InL Layout Bath Fl.&Wains. Auto'Ht.Unit Veneer Int.Cond., Bath Ff.&Walls 3 L X Fireplace Com. Brk.On HEATING Toilet Rm.Fl. ,JD Plumbing 7 Solid Com.Brk. Hot Air Toilet Rm.Fl. &Wains. Steam Toilet Rm.Fl.&Walla Tiling .p p J� •: Blanket Ins. Hot Water St. Shower D A Roof Ins. 7V Air Cond. Tub Area Total Floor Furn. 3 (, k F /z• 3 V �y ROOFING COMPUTATIONS 7 Asph.Shingle Pipeless Furn. S.F. B W a� Wood Shingle No Heat S.F. Asbs.Shingle Oil Burner S.F. Slate Coal Stoker , G� S.F. Gam. > u<.3/ Tile Gas S F • '1 �� OUTBUILDINGS ROOF TYPE Electric Gable Flat S.F. 5- SO 3 S 1 2 3 4 1 5 6 7 8 9 10 1 2 3 4 516 7 8 9 10 MEASURk Hip Mansard FIREPLACES S.F. Pier Found. 1.01 Floor C F Gambrel Fireplace Stack Well Found. O.H.Door LISTED FLOORS Fireplace Pry 9Stile.Sdg. Roll Roofing _ Conc. LIGHTING Dble.Sdg. Shingle Roof e , Earth No Elect. DATE Pine Shingle Walls Plumbing Hardwood ROOMS Cement Blk. Electric / v' Asph.Tile Bsmt. 1st 6 1 TOTAL 3 3 3 7! Brick Int.Finish ICEG Single 2nd i J 3rd FACTOR �t7 333 REPLACEMENT c3 G 7/ ,7 A/EFr OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. DWLG. 36 7/ 7 O /J 3Jr S z X yo =�6D "�?:' 60 "Verr, 30:7 3' 4 ". S , 6 7 _ 6 — 1.0 �9OJ�t'3 • TOTAL _. 7 =i �' RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY -- STREET 6 Sea St. Hyannis LAND 44 H 73 BLDGS. 6 3� OWNER TOTAL LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. 0) _.-3�35/48 —689- B TOTAL --- LAND _- DeVincent, C therina A. 12/28/73 1984 218 at BLDGS. TOTAL LAND BLDGS. '" TOTAL Admk LAND BLDGS. (3) TOTAL LAND BLDGS. TOTAL LAND BLDGS. O) TOTAL LAND -/ BLDGS. INTERIOR INSPECTED: r''�•( 'n l i (3) .�. /�/t� �1 TOTAL DATE: , /� '/ 1.. ;� •u_ 1 \ LAND ACREAGE COMPUTATIONS BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL {i_OUSE LOT LAND AEARE ONT Ol BLDGS. AR TOTAL MOODS&SPROUT FRONT LAND REAR BLDGS. •BASTE FRONT TOTAL REAR LAND 0) BLDGS. TOTAL LAND BLDGS. 01 LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL - LOW DIRT RD. LAND SWAMPY NO RD. 0) SLOGS. TOTAL Conc. Blk.Walls Bsmt. Rec. Room St. Shower Bath,A�t Bsmt. 7 PURCH. DATE Conc. Slab Bsmt.Garage St. Shower Ext. Walla PURCH , Brick Walls Attie Fl.&Stairs Toilet Room . PRICE. Roof RENT Stone Walls Fin.Attic Two Fixt. Bath Floors — Piers INTERIOR FINISH Lavatory Extra 2`7 d — Bsmt. F T 2 3 Sink ' 'h 1/4Plaster Water Clo. Extra Attie EXTERIOR WALLS Knotty Pine Water Only Double Siding Plywood No Plumbing Bsmt. Fin. Single Siding Plasterboard Int.Fin. 1ryJ Shingles ? TILING Conc. Blk. G F P Bath Fl. Heat Face Brk.On Int.Layout Bath Fl.&Wains. Auto Ht.Unit Veneer Int.Cond. Bath Fl. &Walls Fireplace Y ' Com. Brk.On HEATING Toilet Rm. Fl. Plumbing Solid Com. Brk. Not Air Toilet Rm.Fl.&Walns. -------- Tiling ' Steam Toilet Rm.Fl. &Walls Blanket Ins. Hot Water St.Shower Roof Ins. Air Cond. Tub Area Total , Floor Furn. ROOFING COMPUTATIONS t' Asph. Shingle Pipeless Furn. g 78 S.F. Wood Shingle No Heat a d S.F. Asbs. Shingle Oil Burner S.F. ' Slate Coal Stoker S.F. Tile Gas S.F. OUTBUILDINGS ROOF TYPE Electric S.F. 1 2 3 4 5 6 7. 8 9110 1 2 3 4 5 6 7 8 9 10 M AF SUREC Gable Flat trip Mansard FIREPLACES S.F. Pier Found. Floor Gambrel Fireplace Stack Well Found. 0.H.Door LISTED. FLO RS Fireplace Sgle.Sdg. Roll Roofing Conc. LIGHTING Dble.Sdg. Shingle Roof Earth No Elect. DATE Shingle Walls Plumbing Pine / Hardwood ROOMS Cement Blk. Electric 7�' Asph.Tile Bsmt. 1st 3 TOTAL 7 3(0 5 Brick Int.Finish PRICED Single 2nd 3rd FACTOR �-�(' 7 3 -7. IL—1-1— REPLACEMENT —1) OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phhy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. OWLG.C �. !' 4,6 .2) 6- 2 3 - 4 5 6 .. 7 8 _- t0 - - ,TOTAL ROPERTY ADDRESS ( I ZONING I DISTRICT CODE SP-DISTS. DATE PRINTED I STATE I PCS I NEIHD IDENTIFICATION NUMBER CLASS KEY NO. 0367 SEA STREET 07 RB 400 07HY 01/04/96 1091-- 00 60AC R306 044. 213691 LANDIOTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T,, UNIT ADJ'D.UNIT. Lana eylDale _ S1ze D�mens:on p ACRES/UNITS VALUE Deseripron N ELS O N, �LO I S M MAP- CD, FF De InlAc:es LOCJYR.SPEC.CLASS ADJ. COND. E PRICE PRICE #LAN D 1 80,S D O CARDS IN ACCOUNT - 10 1BLDG.SIT 1 X .9 =10 101 125 64999.9S 82094.9 .98 80500 #13LDG(S)-CARD-1 1 109,200 01 OF 02 #OTHER" FEATURE 1 5,400 IB^ 'S 3.0 U X B= 100 1320O.00 13200.00 1.00 13200 3 #BLDG(S)-CARD-2 1 12,100 MARKET 223600 1 6SMT S x B= 100 7.2c 9.07 884 8000-3 #PL 363 SEA ST HY INCOME IFIEPLACE U x 8= 100 3900.0 3900.00 1.00 3900 a #RR 14 47 0137 1686 0315 USE D ;RG1 DETGAR S 26 X 281 195 C= 38 14.2 5.41 728 3900 F #SR SOUTHGATE DRIVE APPRAISED VALUE D ;SHED S 9 X 40 195 = 43 9.4 4.0 360 1500 f A 207,200 J :U PARCEL SUMMARY I LAND 80500 Sj BLDGS 12130C T ,s I 0-IMPS 5400 E I TOTAL 207200 IN CNST N RIOR YEAR VALUE 'T I DEED REFERENCE Type DATE R-.,d- S Book Page Insl. MO. yr.D Sales Prio. A N D 80500 8314/351, I,11/92 N 140817 BLDGS 126700 7609/188JTI:07/91 230000 TOTAL 207200 19841218: I00/00 BUILDING PERMIT �LAND ADJUST- F O R Number Dale Type nmc;;.-.t USE.. LAND LAND-ADJ I INCOME SE SP-BLDS FEATURES BLD-ADJS UNITS *RG1 CLASSED AS 80500 5400 9100 A TO REFLECT C is ss Units Units Base Rate Atll.Rate A Year Buil' Age Oe pr. Oontl. CND. Loc. 9b R.G. Repl.Cost New Atlj.Repl.Value Stories Meig hl Rooms eC Rms Baths .F;s. P.nywau Fx. CONVERSION TO SEASONAL APTMNT. �0 000 110 110 72.15 79.37 60 70 24 74 90 64 170697 109200 2.0 7 5 3.0 10.0 *SEA WITCH INN._ Ue sc::-on Rate Square Feel Repl.Cost MKT.INDEX: 1.DD IMP.BY/DATE: / 1/00.54 D SCALE: ELEMENTS COE CONSTRUCTION DETAIL •• •••••••• .•. 6AS 100 79.37 884 70163 GR REA R OZVI HOUSE . CNBT GP: FO.P 35 27.78 656 18224 *--8--* N STYLE 1DOLD STYLE 0_ FFB 650 65.00 32 2080 *-FOP-*--31-------* 6EST6N ADJMT 020ESIGN ADJUST 10. 1SB 100 79.37 320 25398 ! EXTER.JALIS 0iW00D- FRAME K- FOP 35 27.78 56 1556 10 1SB 10 HT/LAAC' TAPE 040IL----------------0. FFB 650 65.00 32 2080 _ BZO 60 47.62 $84 42096 *_ � NTER.FINISH _04DRrYALL 0. -'-----32-------* 1 NYE R.LAYOUT 12 AVE R.FNORMAL 0._ INTER.�UAITY 02SA1IE AS EXTER. 0.0 ! 15 FLOOR STRUCT 02WO JOIST%BEAM 0.0 D W 23 ! EFLOOR COVER 00 ---- E Tplaln:eas Ao. 712 Base= 1204 *-9--* BASE !*-9-* --- OOF TYPE _07MANSARD-ASPH 0.0 T BUILDING DIMENSIONS ! *-* **-* ! LECTRICAL 01 AVE RAG_E 0.0 BAS W34 FOP NO3 W04 N08 E04 NO3 ! 8 8 8FFB ! FOUNDATION 00 ------- 99.9 A W09 S23 E52 FOP N23 W09 S03 E04 23 FFB **-* 23 -------------- -- --------------------- L S08 W04 S03 W34 FOP .. BAS NO3 ! *--------34-------*X ! NEZSHOi)i2N05D 60AC KYANNTS L FFB W04 N08 E04 S08 BAS N23 ! ! LAND TOTAL MARKET E01 1SS N10 E01 FOP N07 E08 S07 ! FOP ! PARCEL 80500 207200 W08 . . 1SB E31 S10 W32 BAS *-------------52------------* AREA 10396 E33 S15 FFB E04 S08 W04 NOB .. VARIANCE +0 +1893 BAS 111 - STANDARD 25 1OPERTY ADDRESS I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CSTATE LASS I PCS I NBHDPARC KEY NO. 0367 SEA STREET 07 RB 400 07HY 01/04/96 1091 00 60AC R306 044. 213691 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS TY UNIT ADJ'D.UNIT Lano By/Dale size D�menson LOC./VR.SPEC.CLASS ADJ. COND. PE PRICE PRICE ACRES/UNITS VALUE oescripron N EL S 0 N.-L OI S M MAP— Co FF�De IWAcres CARDS IN ACCOUNT - BATHS 1 .0 U X D= 100 2700.0 2700.00 1.00 2700 B 02 OF 02 NO BSMT S X D= 100 7.85 6.12 .378 2300-8 COST 207 • MARKET 223600 INCOME A USE D APPRAISED VALUE i t A 207P200 PARCEL SUMMARY S Uj LAND 80500 T BLDGS 121300 M 0—IMPS 5400 E TOTAL 207200 N N CNST DEED REFERENCE Type DATE RecO,tleO P R I O R Y E A R V A L U E T Book Page ^al Mo. Yr.D sale'P"e- LAND 80 500 S BLDGS 126700 TOTAL 207200 BUILDING PERMIT Number Date Typo Amount LAND LAND—ADJ INC ME SE SP—BLDS FEATURES BLD—ADJS UNITS 400 Class Con st. Total Year Built Norm. Obsv. Units Unns Base Rate� AOI-Rale AA vat 1l� Age De pr. COntl. CND. Loc. 9b R.G. Re pl.Cost New Adj.Repl.Value Stories Heigbt Rppms Rms Balbs I Fi,. Perrywell Fac. 0 000 100 100 53.45 53.45 50 60 34 56 10056 21577 y 12100 1.0 4 2 1.0 4.0 Dascriplion Rate Square Feel Reel.Cost MKT.INDEX: 1.00 IMP.BY/DATE: / SCALE: 1/01.4 8 ELEMENTS CODE CONSTRUCTION DETAIL BAS 100 53.45 378 20204 GROSS AREA 378 SINGLE FAMILY DWELLING CNST GP:00 FEP 65 34.74 28 973 *---------------------30--------------------* STYLE 09COTTAGE 0.0 ---------------------- ESIGN ADJMT 00 _XTER.WAL _ ___ _Q 0.0 LS O1 OOD FRAME .0 - ! EAT/AC__ _ TYPE 03ELECTRIt 0.0 9 ! INTER.fINI-S OD ---- --------- -- 0.0 BASE ! INTER.LAY 6U- 12 VER./NORMAL 0.0 INTER.3UALTY WSAME "_EX_T_E_R_.___ 0-6 15 -- fL00R STRUCT 01WOOD JOIST 0.0 - --------------- --- D —� ; Ef_LOOR_ COVE__R__ OU _ ___ 0.0 E Total Areas Aux. 28 Be-= 378 60F TYPE 01GABLE—ASPH SH 0.0 _______________ ___ ________-------------- A U IL DING DIMENSIONS � � LECTRICAL__ _ _U1 A_V_E_R__A_G_E__________ 0.0 BAS W07 FEP SO4 W07 N04. E07 .. 6 � FOUNDATION 00 99.9 1 BAS W11 N06 W12 N09 E30 S15 -------------- - --- ---------------------- L ---------- ---- --- -------------------- � *— *-11-7----*----7-----X LAND TOTAL MARKET 4 FEP 4 PARCEL AREA *----7----* VARIANCE +0 +0 STANDARD i ' RECYCLEp 116 UPC 68021 No. SF11 SA ppsr.coNs�` HASTINGS, MN .« .x.,.�._. _•.—w eyitl3akJld'Pe�aua�.ti..¢L..�.vuSs�J.. ,. �..,...._ �, .,.:._ ., ..,. - TOWN OF DA INSTBSLE SDP08T SII DMDNTABY/CONTINIIATIrW DPOST NAME (LAST, FIRST, MIDDLE) DIVISION /DSP7 NOTE DETAILS i OBSERVATIONS—ITEMIZE EVIDENCE, SERIAL IS ETC. -L,3 ' = -�� PO C'f an QIA LVA�� 40A669 1A d9 _ 14 gYL42L.7,& Alal 2YIel 12112 ad sig�2" Goa SUBMITTED BY PAGE t 1 �� ! ,� r - E, l 116 SIlII J�RECYCLfp co UPC 68021 NO. SF11 SA Aosr.Co, HASTINGS, MN