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Home My WebLink About0377 SEA STREET a, .00 �u k t 'i 4� � �o GU a2�: ./ �� j � �`I`'I / ` % /� �� I . . , a 5 i �. m U � �1 i `W f 6 j v l Z • V'f C 0 r � N ® W C I I <� nni I A A � Pays,WATER y , MAD/Par 43 g � ' t . Feet HU-CABLE BC►!Owrters PUBLIC` DRS INS W W ¢ISeynAJtll NATCAS k Park TVD,DRWYOT' VNODOCK';H, er i, Bsmt PARTIAL :Gar NONE 171^900Tx 2947 1897 Lead N U(fi N l OLarge home Set up as a two family,short w0 to Keyes New Ia§t lyear root vrrndows vinyl srdmg/aluminum k e anp much`more work Has lead certificate Surrounded b Acne Lowney rf :t Shw CALL OFC f J C=JOHNSON&CO ' Ph:(50817901647 CA7HERINE JOHNSON .•r'; Ph "'5 8 778.5245', rOSee street towards beach located on right,comer of _ akin on' , _ H -��►,• of i i K'MoI9184-3.i 05% 8812 ores t EfURMOT CALL -SM-421-ice Y.- r ,CFO y _ r z �GwsIlex .s •: u �` .. Yu_�5 -t 4,�'.� m� .y f � •+fie a ' �, { � i, f ien.,WATER * 4 k ariMl " C MeolPar 43 5 - NU•CABLE � BShOwne/r PUBLIC f 4�� r i 9NS DRS S W d NODOCI( TCNS;., roVDDRWYOT" »ffl0plk 89MI PARTIAL,G� f�NE -,: ' 1 2847 --log 7 N Uffl: New,hest t °P As a trvo fatuity eflat walJc to Keyes ' taq inuch'more wodc lead f�r{tMflcetpSum� k •�Lowney �r t� D JOHNSON-A.Co. i ti ti 5 d �� , �� _ _. �,i�.-c„c� �' � �— Jam' Via_ _._�CC�...�_c�C-� ��-----. .. ,, '��' �,, fi v� J TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION 3 �R Map `� `� Parcel 1 �(// Application # �d'J Health Division Da^�e-ssraed Conservation Division 1 10 'v Tow implication Fee Planning Dept. NOFQgR/Xermit Fee ,(f� Date Definitive Plan Approved by Planning Board AeL Historic - OKH _ Preservation/ Hyannis Project Street Address IV L Village ho Owner w Address Gla/ IaCV Telephone Permit Request 2 .T �. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuations Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) :•y Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION ---(BUILDER OR HOMEOWNER) Name P41 0 �-zo a," Telephone Number Address /d Q ��+�/` -lW V d-u-c WLicense # Home Improvement Contractor# Email 44MY03 snp !27 t l Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN NO. Ile Commompealtlt of-Mas4djusetts Deparament cif rndus-h id Accideids AX F.D. l,face ofim estigaiionsb00 Washi-xgion Street Boston,:CIA 0.7MI nvA nrrrss_govfrliri Mrorltere Campensafian Insm-ante Affidavit:Builders/Contractors/Electricians/Plumbers A13PUCant InfM.-Matitrn Please Print Legibly Nat= nFnP�ization7m�x ^ 9D A�b i z7 J ttj ? D,o , Address: . eityTfst.,t.(zip M v t mane-,u- 6 17 8 0�j $03 Are you an employer? eck.the appropriate bom Type of project(regmied): 1.❑ I am a employes with 4. ❑I am a general contractor and I 6. ❑New consfrut fora employees(full and/or part-time).* 'have]hired the sdb-contractors 2.❑ I am a sale proprietor or partner- listed on the attached sheet. 7- ❑Remodeling ship and have no employees. These stab-contractors have g_ ❑Demolition working for me in any Capacity. a Tloyees and have workers- 9_ ❑Building addition a wodoers'comp-i*+atra*+ce crying.insuranml regtured I 5. ❑ We are a corporation and its 10.❑Electucal repairs or amine 3. I am a lwmeowner doing all wad officers have exercised the& 11.❑Plumbing repairs or additions set€ o workers'comp- 12 right of eseatpdon per MGL aft ,insi=e required-]t c.152,§I(4k andwehaveuo .❑ epaxs employees.[go workers' 13_ tlier 2 camp-insurance required.) 'flapappBamr&atchecks box 9lm stalsoMoutthesectionbelowshnvdnzthe¢wodes'c=Venm&nparsgiaforzsaua3- #liameavvnem who submit this dfidavdf infcitng t3my ste doing all wa t and then hire aatside c=t=tmm amst mnbmit a new affidavit iad'�such. fC'aatrsn=that cbeck tYM bot must attached m[additional sheet shorting tha n=e of the sub-cnuttectas and state whether ar not fmse ettities baste eaapioyees Ifthesvb-taatactntshave empIoyers,the}'mvstpmuide their vsnrkexs'tamp.polity nimbtser. I am an evtp1gvr that isprav d&g workers'congwisirkan inmiraRcefor iry employees ffeIoov is fitepaUry med job site information. r It sumce:CompanyName Policy A,or^selfLiar_Iic-4: r FXpit$4ion Date_ Job Site Address: CitylStafel7.tp: Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c-1572 can lead to the imposition of criminal penalties of a fine up to$1,54a 00 and/or one-year imprisanmeut,as well as civil penahies.in fe form of a STOP STORK OADEKand a fine of up to$25QOO a day against:the violator. Be advised that a copy of this statement maybe forwarded to the Office of ' Ifavest gations ofthe DIA for insurance coverage verification. I do hereby certify eArdRr tFtR pains andpeAAaifi s ofperjuty iiAatftte itAfat arrafimApt nt f abmv is huA ar/Ad correct Signature: - � Date: Phone 6/? ge6 Official use drily: Do net tvrtte in d s.area,to be cvinpieted by c#artopm officzat City or Town: PeamitUcense ff Issuing An.9rar€ty(circle one): - L Board of Health.2.Building Department 3.City/rown Clem 4.Electrical Inspector S.Plu mbing Inspector fi.Other Contact Person: Maxie#: Information and Instructions hiaccar_lrasetts Geheral Laws chapter 152 re loi=all employers to provide wormers'compensation far thb r=IPIOYMS- pnisumatto this state,as milky=is def ned as.`--every person in the service of another under aiy contract ofhire, ezpress or iMplied,oral or wriiteu." An wTTgyer is defined as"an individual,partnership,a=dad6n,corporation or other legal entity, or any two or more of the foregoing engaged is a joint cut mprise,and inoTn�the Iegal Fepresenfa&cs of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartnents and who resides therein,or the occupant of the - dweIImg house of anofer who employs persons to do mamtenz cc,construction or repair work on such dwelling house or on the grounds or blIlading appurfenantthereto shall notbecause of such employment be deemed to be an employer." MGL chapter 152,§25g6)also states that"every state or local licensing agency shall wit5hold$ie issuance or renewal of a license or permit to operate a business or to constrict buildings in the commonwealth for nay applicant who has not produced acceptable evidence of cdmpIranm with the Insurance.coverage required." Additionally.MGM chapter 152, §25C(7)states"Neither the.commonwealth nor gay of its political subdivisions shall enter mto any contract for the performance ofpubho work until acceptable evidence of compliance with the insurance.. requirements of this chapter have been presented to the contracting aufaoityf APPficznts , Please 5Il o-ot the workers'compensation aEdavit completely,by checIcing the boxes ffizt apply to your situation and,if necessary,supply sub-contractor(s)nam(-.(s), addresses)and phone ntanber(s) along with their cerliEicate(s) of insruance. Lmiitrd-Liability Companies(LLC)or Limited Liability-Partammbips(I.LP)with no employees other than the members or partners,are not regtm ed to c8ry workers'compensation insurance. If an LLC or LLP does have employees, apolicy is required. Be advised that this affdayit may be suhmitt--d to the Department of Iudurstrial Accidents for confirmation of fimarance coverage. Also be sure to sign and date he'afffdavit The affidavit should be retuned to the city or town that the application for the putt or license is being requested,not the Department of Tn n strial Accidents. Should you have aay questions regarding the law or if you are recpaired to obtain a workers' compensation policy,please call the Departeot at the number listed below. Self-rewired companies should enter their self-insozance license number on the appropriate line. City or Town Officials Please be sore that the affidavit is complete and prkt--d.Iegfl)ly. The Department has provided a space at the boI±om of the affidavit for you to fill out i a the event the Office of Investigations has to contact you regm-dmg the applicant Please be store to fill in the pm� itllicense number which will be used as a reference number. In addition,an applicant that must submit multiple pennWHcense applizmdons in any given year,need only submit one affidavit indicating current p olicy in�zn ation(if necessary)and under"Job Site Ad_dre: "the applicant should wit--"all locations in (city or town).-A copy of the-affidavit that has been officially stamped or mmke;d by the city or town maybe provided to the applicant as proof that a valid affidavit is on f 1le,for future permits or licenses- A new affidavitmust be Bled of t each year.Where a home owner or citizen is obtaining a license or penult not related to any business or commercial vevfure (r_e. a dog license or pe®t to bum Ieaves etc.)said person is NOT reqaard to complete this affidavit The Office of Investigations would like to thank you m advance for your cooperation and should you have any,questions, please do not hesitate to give us a call. The Deparfinenfs address,telephone and fax rmmber: -ThL-Can Wa eaj- t of Massachnsj--� , Degarbmmt of ladusfdd Aoridents Of Of nn�est?g tioaa CG4 vlashivoa.s't=t Easton,MA U� I I I Tf,-1,4 617' -4900 C:t MG or 1-977-MASSAFE Fax 617 727 7749 revised 4.24--07 m2Z.E�agfdia ^ ` , � . . . . . . A WC Guide to Wood Construction in High ��m��no��y�u�m8 N�m��m - ^ ' ChecklistMassachusetts for ��# ��G��2X'1 ' _ � ' =� Cbvck � 1.1 SCOPE ' ' Wind .................................................................. .................................................110'mph WindExposure Category.......... ..................................................... ........................................................ 'B 1.2 APPILICABILITY ' . . Number of Stories .............................................................. 2)............................ _stories 152stories � RoofPitch ............................................................ _--. 2) ..........................................._� 512:12 �-� Mean Roof Building Width,VV...........................................................:.' 3).--_-_--_-._._-----ft �8T _-- au��ng ~ 8u��ngAape�Rodo (F�4)--'--.-�.---'----'-- 5 31 ` --- momma Height ofToUa�Open�g~ ...................................(Fig 4>................................................_ s618^ 1'3 FRAMING CONNECTIONS �� -- General compliance with framing connections....................(Table 2)................................................................ � . 2.1 FOUNDATION Foundation Walls meeting requirements uf7VOCMR54V41 � Concrete....................................................................................................n....................... �.. ConcreteMasonry.................................................................... ...................:....................................... . ' � 22ANCHORAGE TO FOUNDATION" 5/8^Anchor Bolts imbedded cn50^Proprietary Mechanical Anchors 000no8onrWein concrete only ' BoltSpacing ........................................... ......................................... in. Bolt Spacing from end8oIntofplate ............................ Bolt Embedment-concrete........................................ ...... in 2:7", � Bolt Embedment-masonry......................................... Plate Washer...............................................................(Fig 5)................................................2:21"i Y:Y4"' ' --- ' 3.1 FLOORS � Floor framing member spans checked ............................... Chapter ............. Maximum Floor Opening Dimension...................................(Fig U)............................__fts12'orU2ovVY/2 Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig V>........................................ Maximum Floor Joist SetbacksSupporting Loadbearing Walls o,Sheanmal|...............:(Fig 7)...................................................__ft 15d Maximum Cantilevered Floor Joists . Supporting Lmadbeoring Walls orGhoonwao................. ......___ft 5d Floor Bracing atEndwob.........................`........................ _-`-_ ' Floor ........................................................ ............................... _. _ Floor /n�xneoo----'- -- ___ �� Floor Sheathing Fastening..................................................(Table 2)'__d nails at—in edgn in field ' 4.1 WALLS Wall Meigh . ' . . ' / and le -_---._-'-�_� �Vy walls.... ......................................... and Tab 5)-_�-'- fts2� � Wall Stud --.-------------.�. V and Tab�{�---,-.-` in._-5 2 4"p.c. Wall Story Offsets --'_-'_-'---_��----'-p�gs7&O�.__________^____ � �d . . ~ 4.2 EXTERIOR WALLS" ' Wood Studs LoadbeorinQ walls.......... ............................................(Table 5)..............................2x__' It in.Non-Loadbearing walls -----.-(Tabla5)--.-':__.''-2x__^^ ft__in. Gable_'Wall�Bracing FullHeight ...........................................(Fig 1 YV8P Attic Floor Length................................................ 11 ............................................. 8evV0 Gypsum ................... 11 _-'_----_--'-�-_ft��9Vy ---� 2x4C�V�muo Lateral Brace G�o��.�(Fig 11' -----'-__--,,__--_- ---� Double Top Plate . . ' � Splice Length -_-_-_-__--- -_ ��13 and Tm�os)-_---- --. --'_ ft S�k��onnam�nhm.o[18U common neilo ..............(Table 6)........................ ......... ....................... __ . ' ' p . / � . . � � .| A WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301 Z.1.I)1 Loadbearing Wall Connections Lateral(no.of endnailed 16d common nails)..............(Table 7)..•.....•.......... _ Non-Loadbearing Wall Connections """"""'"""' Lateral(no.of endnalled 16d common nails)...............(Table 8)................., Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9} HeaderSpans ........................................................(fable 9).................................._ft_9) 511' Sill Plate Spans ............................. (Table 9).............. Full Height Studs (no.of studs).................................. -- Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans.............................................................(Table 9)..................... _ft_in.s 12' Sill Plate Spans..., (Table 9) ....................... _ft_in.s 12' Full Height Studs(no.of studs ..••..""'' )....................................(Table 9}.............:.................... ............. _— Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously" Minimum Building Dimension,W Nominal Height of Tallest Opening2 ............................................................... ..... Sheathing Type.......................•......................(note 4).............. ......... ........................................ Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................_ Field Nall Spacing..........................................(Table 10) ............. in. Shear Connection(no.of 16d common nails)(Table 10).................................... Percent Full-Height Sheathing...............•.......(Table 10):............................ . _— 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... Maximum Building Dimension,L Nominal Height of Tallest Opening2................. - Sheathing Type..............................................(note 4)................... —' Edge Nall Spacing ................................... Ed 9 P g.........................................(Table 11 or note 4 If less)........................ in. Feld Nail Spacing..........................................(Table 11)....................... Shear Connection(no.of 16d common nails)(fable 11).......:......... ......... Percent Full-Height Sheathing.......................(Table 11)....................... _ '— ................... Wall Cladding . 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..•.,•,,,,,,•, o ••••• — Rated for Wind Speed?.....................:.......................... ......... ..... ................................................................ _ 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) _ Roof Overhang ...................................................(Figure 19)..............__--ft s smaller of 2'or L/3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................•...............................(Table 12).......................... .......I......U=_Plf _ Lateral.............................................(Table 12).............•.......... =_P lf Shear...............................................(Table 12).............:........... S=_pit Ridge Strap Connections,if collar ties not used per page 21..... able 13 ........... Plf _ Gable Rake Outlooker............. ) ............................(Figure 20).............._ft ssmaller of 2'or L/2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)............................................U=_lb. Lateral(no.of 16d common nails)...(Table 14)............................... ................. .........4*.......L=1b. _ oof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59).................. _ Roof Sheathing Thickness................................. _in.a 7/16"WSP ........................................................ Roof Sheathing Fastening...........................................(Table 2).......................................................... Notes: - 1. This checklist must 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. Al Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a 2. 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. 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness.pressure treated#2-grade. F A WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (780 CMR 5301.2.1:1)t 4. a. From Table 10 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"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. riL 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 the Figure, Vertical and Horizontal Nailing for Panel Attachment 6 • I A WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)' W9 IEIY THIS EDGE REST ON FRAMW UM 8d NAL$ AT O'bim. 11 Y 1� it IF 1 11 11 I t _O N I F. 1 it W i 1i1 l l 1 C 1 0� fl 11 4F 4lu {� i �j ii ij g r µq 1 U 1+ 11 11 k 1 14 1 fi 11 1 44JLSPACWG 4 i See D&Wl on Next Page Vertical and Horizontal Nailing for Panel Attachment , s Town of Barnstable v� Regulatory Services Richard P.Sm i,Dkwbor ~$ Bw1dIng DIVM—on Tom rerry,BuMb3g,Commoner • 200 Main Street Hy=ds,MA 02601 W TV fro barnstahkma_us Offs= 508-862-4038 Fay 508-790-6230 Property Owner Mush ' Complete and Sign This Section If Us kg A Builder ,as Owner of the subject property be=elayaut3iorsze to act on mybgmlff in all nmm=mhtiye to work antbo&,ed bytlm bmllmg Pemit appEcat oa for. . (Address of job) ''`Pool fences and alarms are the responsibllit7of tie applicant Pools are not to be fled or ufflized before fence is installed and all final ' Mspections.are pedomed and accepted. • Signazzu:e of Owner ' , - Signatare of AppTi = Pri=Name Pii=Name D? . �Fo�:o ours I 'down of Bamstable Regulatory Services rcry Mr-hard V.ScA Director BuRanig Division Tom Pent,Em7dmg CD�oissimaer • - �a� 200 Main Sftzet Hya MA 02601 w�W MbarnatabTnmams . Office_ 508-�862-4038 _ Fma 509-790-6230 LTOMMEMOMIf PAKM O'>��( le JOB LO=C31z r 7 ? e,,a-- ` 5 _ 4-q U VU rCr s (42-Y, (zJ v al- 6(? A o b®Gpha=# :wm3cphcnc cZMRENT MAMn4GADDRES9: (© � Lot N W 4�AA.-'k _ eityfmre zip Coda Tho r**l t exemption for"homcGWneM"was endedto include ow=occvmied dweIIm.L-.of six nits or less md.to allow homeowners to.engage an individual for hirewho does notpossess a license,ptovided tliatffie owner act as sapeivisor_ DM NUMN OSHOIEOWNEEL P eson(s)who opens a parcel of Iand on which hedshe resides or intEnds to reside,on which th=is,or is fitended to be,a one ar twa- fmnily dwelling, atfa ched or detached structures accessory to such use and/or fazm stuct j A person who consftucts zo=than one home in s twc-ye�p=dod shaIl natbe=dd=r i,ahameown= Such`homwwnet".shaIl submitto fixe Bm'Iding Official on a:Ehna acceptable to the Building Glacial,that helsha shall be responsibly far all such wca5c p Wider bm7d�E pence (Section 109.L 1) The nndcn igned`hamamwner"assumes responsibly far compIim=wiatbc Slate Building Coln and other applicable codes, bylaws,role and reb ht-D c _ Thy�gt►Bd`•4�onicowner"sx�es thathelsbe ids the'Town ofBaznstab�.e B1nZding Departmcot�mspedinn pro=d=M modregaammenfs and$athelsbywill comply withsaidprocedmrs and rwpir meois. • Si eatenrs Approwl u BUMM9Of5cial •_Note. Threes mtTy dweIlings caniaining 35,000 cubic feet or lugcx wiIl be reqaked to comply with tiny Slain Building Code Serbian t27.0 CalgLm Ilion ConhuL AGNMINI-MIS IXEMrM Z The Code states that `gay homeowner performing work fur which a buzZdiag permit is required shall be exempt from the provisions of this section(Section 109-U-LiCeidng of contraction SapeW=rs);provided that if the homeowner engages a pwso*)for hire to do such work,that such Homeowner shall act as supervisor." bl1aay homeowners who use$xis exemption are mmware.ffiat they are s�—g tiie responsibITIN of a supe2v" or (see Appendnc Q,Rules&Regulations for Ling ConsEracdon Sipervisors,Section ZLS) This lark of awareness ofrrn results in serious problems,parfienlady when the homeaw=hires uorctr se persons. In t kis case;our Eoard cannot proceed ag2hcst the unli—sed person as if would with a licensed Supervisor_ The homeowner acting as Super visor is ul imately responsible. To ensure' the homeowner is My aware of hislher responsibffides,many commmiifies require,as part of the permit applic-, n,tl at the homeowner certify that helshe understands ffie rmpansibxTxtt'es of a Supervisor. On t he Iastpage of this issue is a form currently IIsed by,scieral towns You may rare t amend and adopt such a formlc-ertd 2fiDn for use in your commnaity- P A= Rzd=d 06 U 3-3 N 0 1 M 0 C--- � �s �� 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION iv Map (0 Parcel 'L Application # Health Division Date Issued Conservation Division Application Fe J� Planning Dept. Permit Fee 44; l')I y Date Definitive Plan Approved by Planning Board Hi�ti� - e�� ►� _ Preservation 7L�4s Project Street Address 377 S Wr4eej MAlk, Village Owner Alp_)o .81ZJ did- Address PQ.l.{Oaiy/va_,W Telephone e9 3 F Permit Request k-,4� 2 CJ At Square feet: 1 st floor: existing2l2yproposed 2nd floor: existi osed Total:new ..� Zoning District Flood Plain roundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family V Multi-Family (# units) VNo Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes Basement Type: ❑ Full Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing S7 new'- Half: existing new Number of Bedrooms: _7 existing new Total Room Count (not including baths): existing -it new First Floor Room Count Heat Type and Fuel: VGas ❑ Oil ❑ Electric ❑ Other Central Air: dJ Yes ❑ No Fireplaces: Existing r— New Existing wood/coal stove: ❑Yes V No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ti I Zoning Board of Appeals Authorization ❑ Appeal # Recorded 0 =' Commercial ❑Yes No If yes, site plan review # Current Use Proposed Use s= ' APPLICANT INFORMATION (BUILDER OR HOMEOWNER) + ' ��Name � �(�-Q.� Telephone Number Address 104 Paw',L4 A.;�Ar aw Li License # Home Improvement Contractor# Email 6 2 (ry P L- �l Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ®� g R2® 6 SIGNATURE DATE 1-� r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: C FOUNDATION FRAME INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL M1� , GAS: ROUGH FINAL FINAL BUILDING or/S oqK DATE CLOSED OUT ASSOCIATION PLAN NO. �.. -, - tea ' a� �ir • • ��-�•exs'•C�g�lsaf�Ia�ora�� a-�it��d�rsf�f�a--ciz�r� 'n-�,T4lP''F_�-r�er� Pte2mah� . Ida= ! �F'X 1 r Z�1 ec�+�/►� .dry � f g 61.71863 cSO-S2 �pr�a mf�Iu sr9 t erkf b T} of cri � -LEI I am a emplace .1;,ria ❑I=9 jai contffor=9 L ��{fill.andf�3-* 1�I��e 7❑ I$m a sole propiear orparf ler- Ezte-i on the aftached s met ship si61xm no eroployees T1c==b-c=&adoq have g ❑�r�„�. . ng for M,m any vav�wvrY�s' 4_ ❑BnIFmg adc£ififln �Fo•�r�s.�comp_*Fl�-� ' Camp- Ifl �te�tacal nradditians �1 _ ❑ We are a cozgara icaLand ifs. 3_ dMU,-211 vra� e�rxrs h ,�;sed heir I I p biag=Pais or F.&FAian Sri am a hs :6 I ofe on ger? 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Attach;E copy of fin wurk=e campensafirin pQricY SYiMg the p0+E)ZIM3B�=•Sga Fad 5a sccm�c�c�taga as reed uIIdes Secfsn>z SA ofLd.c L52 caa Lead iu ire izngiuu nfaimiaal perms of$ E=-op to OD-O6 and/or a=—yearim as wEn as c to gesaffia in fhe femi of a ST�I' OI ORU�and a fins of up.to�-50_00 a day mast f$e violate_ Be advised fad a c{rlsy afffii€staf==d maybe wed to-&e Office of Inr�s�lions of�DTI for in�i1�ca�aga I47Rsrebycart&rmder•ffirpiaius,mdpsaa�rer iup�tatf7t��fornra�zzrpraczcicr�a£z�ishisaadcnraxci: Phoe€#- . E tcitrl zrsa a* I�T rtat wribrin 9LET area ft bs=V49 w by CffF or f 7wil qffic&L Cay or Towa r 7;.cease fssn�gA.u�h�rifg{dirZe uue�: . - �• - • L&mod-ef$eihli[3.$ I3egar�?—mot t fprFQ�zt QsT� I�ec�icat erl�r .PI, u ��ecfnr t c �,� �� SSA, �as� b vo c� 0 Town of Barnstable r Regulatory Services , Richard V.Scali,Director Building Division BAHNSTABLE, " Tom Perry,Building Commissioner 9 MASS. g . 1639• A 200 Main Street' Hyannis,MA 02601 ArFD Mp'l www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Q Ln Please Print DATE: JOB LOCATION:__ -e ac 1� 1 number street village "HOMEOWNER": 'e p �Z J N� name f n home phone# work phone# CURRENT MAILING ADDRESS: ` ©% G l.0 eC QL A/C c926 6� city/town Z state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proc ores and equir ments and that he/she will comply with said procedures and requirements. Si re of Homeowner _. Approval of Building Official + Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community.- Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 .x' P�Of THE'�ti * •AMSrABLE, MASS. i639• Town of Barnstable ♦0 prFp Mp`l a Regulatory Services Richard V. Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 r roperty Owner Must; Comp to and Sign This Section I sing A Builder r as Ow r of the subject property 't hereby authorize / to act on my behalf, in all matters relative to work authorized by this building permit apph ation for: (Address of Job) t i 1 Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit forms EXPRESS.doc Revised 061313 �t r Town of Barnstable *Fermi # � Expires m hs o n issue da Regulatory Services Fe BnxivsTestc Thomas F.Geiler,Director Mass 1"- 99�,,r 1e1;9. A Building Division FD MA'S I Tom Perry,CBO, Building Commissioner. 200 Main Street,Hyannis,MA 02601 www.town.barns*table.ma.us. Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number (3 es ,6 O V tS Property Address -372 —<S� } ❑Residential Value of Work� 00—5 0 G Minimum fee of$25.00 for work under$6000.00 Owner's Name &Address es Pit✓ © 0j n)6= \/ A( 4772 k./ Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance PERMIT Check one: 1 ❑" I am a sole proprietor 071 am the Homeowner MAR 2 8 2008 ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) �Re.--mo " hilt les) All construction debris will be taken to Re-roof(not stripping. Going over existing layers of roof) Re-side t ❑ Replacement Windows/doors/sliders.U-Value (maximum.35) '*Where required: Issuance of this permit does not exempt compliance with other town depqrtment regulations,i.e.Historic,Conservation,etc." ***Note: Property Owner must sign Property Owner Letter of Permission: A copy of the Home Improvement Contractors License is requirde `---.._t.�C i, i/i,iri SIGNATURE: UJ � QAVvTFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 Y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): � Address: /,3&';__. 4-02E: 10f/A 7-0 Al lNzr—) o 9, City/State/Zip: fA. Tom Phone.#: Are you an employer?Check the appropriate box: Type of project(required): 1.El am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction .2.❑ I am a sole proprietor or partner-' listed on the attached sheet. 7...❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P ty• $ 9. ❑Building addition [No.workers'comp. insurance comp. insurance. 10.❑ Electrical repairs or additions r uired.] 5. ❑ We are a corporation and its 3.Lk I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date.. .Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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 statemerit may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Jr do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct r Signature:J '- Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department -3.City/Torvn Clerk_ 4.-Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in.the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or 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(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials ,Please be sure that the affidavit is complete and printed legibly. The`Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the 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"Lhe applicant should write"all locations in _(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston;MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia Town of Barnstable �0,*-W h y�P o� Regulatory Services t BARNSrABLE. % Thomas F.Geiler,Director 9 MASS. g �{,,, i639• p,� Building Division lFD MA'1 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 vt'ww.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print } DATE:? JOB LOCATION: 3 2 ? number street village "HOMEOWNER': ,ti- /, wN = le 7 _33q- �yav name h6me phone#- work phone# CURRENT MAILING ADDRESS: C'I lure Pj "6- 0 0 V city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. !. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use.and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such ` "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned,',homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner t 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 persons)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:forms:homeexempt �°FTHEToy� Town of Barnstable Regulatory Services �BA MAS& Thomas F.Geiler,Director 4iArFo;;;ram` Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 F 508-790-6230 Property Owner Must Complete and Sign This Sec ' n If Using A Builder as Owner of the subject property hereby authorize V to act on my behalf, in all matters relative to work/autho btibading permit application for: (Address of job) Signature of Own Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISS ION �1HE� Town of Barnstable Regulatory Services snxxsrAat.E ' MASS. Thomas F. Geiler,Director i6 9. Building Division erED MA'S A Thomas Perry, CBO Building Commissioner .200 Main Street, Hyannis, MA 02601 www.town.ba rnsta b le.m a.us Office: 508-862-4038 Fax: 508-790-6230 May 8, 2012 Mr. Ralph Crossen 18 Woodridge Road E._Sandwich, MA 02537 RE: 377 Sea Street, Hyannis Dear Mr: Crossen: This letter is in regards to the.proposed project located at 377 Sea Street Hyannis. The project entails converting an existing house to be remodeled and upgraded to another use. The reason I say another use that is this office's first question. What is the use? This needs to be clarified and documented. The second issue is the plans that were submitted. These plans are marginal at best. We need plans of sufficient detail and clarity to indicate the location, nature and extent of the work proposed and show in detail that it will conform to the provisions of the Building Code. The plans need to be drawn to scale showing cross sections of sufficient detail. Just floor plans is insufficient. Since this is an existing building a full evaluation of..this building needs to be performed under the provisions of the Existing Building Code. The plans need to reflect occupancy. In discussions it has been stated that some of the bedrooms will have multiple persons in them. This needs to be shown on the plans. Please address these items and submit for this office to review: Respectf `, Thomas Perry, CBO Building Commissioner l i City Hall BOARD OF HEALTH 45 School Street � � Brockton, Massachusetts 02301 Telephone(508)580-7175 Fax(508)580-7179 September 21, 2010 Jean Cherrie 99 Warren Ave.. Brockton, MA 02301 Re: 99 Warren Ave. (ENTIRE BUILDING) Inspected: September 21, 2010 Dear Mr. Cherries An inspection of the dwelling owned by you at 99 Warren Ave. -Entire Building, Brockton, ` Massachusetts, revealed violations of Article II,'Minimum Standards of Fitness for Human Habitation, as Amended, of the duly promulgated State Sanitary Code of the Commonwealth of Massachusetts, Department of Public Health. THE ENTIRE BUILDING, is hereby declared to be Unfit for Human Habitation and all persons are to be removed IMMEDIATELY. In accordance with CMR 410.831(D), it is the determination of the Board of Health that the danger to the life or health of the occupants is immediate based on the violations listed on the attached "Exhibit A". If any person refuses to leave a dwelling or portion thereof which has been declared unfit for human habitation and vacated and has been placarded in accordance with 105 CMR 410.830 through 410.950, may be forcibly removed by the Board of Health, or by local Police Authorities on request of the Board of Health. (See CMR 410.830 through 410.920). REOCCUPATION WILL NOT BE PERMITTED UNTIL ALL REPAIRS ARE MADE BY LICENSED CONTRACTORS AND THE CITY INSPECTORS SIGN OFF ON ALL NECESSARY PERMITS AND UNTIL SUCH TIME AS WRITTEN PERMISSION HAS BEEN RECEIVED FROM THE EXECUTIVE HEALTH OFFICER OF THE BOARD OF HEALTH. THE OWNER IS REQUIRED UNDER 410.831(E)TO COMPLETELY SECURE THE PROPERTY. Sincerely, BOARD OF HEALTH Michael Weydt Sanitary Inspector Declared Unfit for_Human Habitation due to: (SEE ATTACHED EXHIBIT A) P EXHIBIT A 4 To: Jean Cherrie Re: 99 Warren Ave. 99 Warren Ave. ENTIRE BUILDING Brockton, MA 02301 Inspection: September 21, 2010 x THE ENTIRE BUILDING is declared UNFIT FOR HUMAN HABITATION due to the following violations: 410.750(I)- FAILURE TO MAINTAIN BATHROOMS AND COMMON AREAS IN A CLEAN AND SANITARY CONDITION 410.750(0)(2)-FAILURE TO MAINTAIN BATHTUBS IN AN OPERABLE, CLEAN AND SANITARY CONDITION 410.750(0)(4)—FAILURE TO MAINTAIN SAFE HANDRAILS 410.750(0)(5) -FAILURE TO ELIMINATE INFESTATION OF COCKROACHES AND OTHER INSECTS/PESTS 410.750(8) - NUMEROUS OTHER VIOLATIONS OF 105 CMR 410.000 STATE SANITARY I CODES INCLUDING BUT NOT LIMITED TO APARTMENT 1R CERTIFIED MAIL#7009 1410 0000 6676 6414 COMMONWEALTH OF MASSACHUSETT HOUSING COURT DEPARTMENT THE TRIAL COURT SOUTH EASTERN DIVISION PLYMOUTH COUNTY CIVIL COMPLAINT NO. Statement of Material Facts Brockton Police Department Officer Scott D. Uhlman 7 Commercial Street Brockton Massachusetts 02302 Vs. Jean N Chery and Jean Francois Chery 11 Flint Locke RD Randolph, MA 02344 1. 1 Officer Scott D. Uhlman hereby submit the following Statement of Material Facts in . support of the issuance of a Temporary Restraining Order., 2. 1 Officer Scott D. Uhlman have been a Police Officer for approximately 25 years. The last 7 years I have been assigned as a part time code enforcement officer working with the city's code enforcement task force. For the past 2 years I have been assigned full time as the code enforcement officer and license agent. 3. The subject property is: 99 Warren Ave. Brocton, MA'02301 4. This Property is a lodging house with 43 units of living that share common bathrooms. ti 5. The Defendants Jean N Chery and Jean Francois Chery are owners of the real estate according to the online assessor's data base. (Copy Attached) 6. The Defendants Jean N,Chery.and Jean Francois Chery rent out individual living ' units inside this 3 story building of approximately 10,845,sq feet at 99 Warren Ave, Brockton, MA. 7. Because of the living arrangements the property is classified as a lodging house HOUSING COURT DEPARTMENT SOUTHEASTERN DIVISION A TRUE COPY a ATTEST CLERK DATE _ , 1 8. All lodging houses in the City of Brockton are required to be licensed annually by the City of Brockton License Commission. MGL Chapter 140 Section 24 Whoever conducts a lodging house without a license shall be punished by a fine of not less than one hundred nor more than five hundred dollars or by imprisonment for not more than three months, or both. Upon the complaint of an aggrieved party, the licensing authority or an officer of a city or town wherein such unlicensed lodging house is conducted, a justice of the housing court division or the superior court division of the trial court, may enjoin the conducting of any unlicensed lodging house and may make such other orders as the court may deem equitable to enforce the provisions of sections twenty-two to thirty-one, inclusive. 9. The Defendants in this matter failed to renew the license for this property, therefore on January 1, 2011 this property became unlicensed.. 10. The Defendants in this matter have continued to rent rooms without being properly not licensed as a lodging house (as of 3-14-11) for the past 73 days. 11.Five (5) Mass General Law 40-21 D citations have been issued to the Defendants for operating a lodging house not licensed and I have personally spoken to the owner and he has still not corrected his "not licensed" problem. 12.The property has not and cannot pass the City of Brockton's Board of Health inspection because it does not meet the state sanitary code for various reasons. 13.The Defendants continue to house tenants in the building despite not having a license to operate a lodging house and not being certified by the City of Brockton's x Board of Health as safe and sanitary. 14.The applications for renewal go out in October to be back by November to be placed on the license commission agenda in December for renewal to take effect on January 1st of the New Year. That is provided all the inspections are completed by the various inspectional departments and they are signed off with a clean bill of inspection. 15. The Defendants have had approximately 3 months in 2010 and 3 months in 2011 to come into compliance and they still have not. 16.Because so much time has-elapsed since his last renewal inspection the City of Brockton License Commission is going to require the building have new and updated inspections by various inspectional agencies. 17.The building was declared unfit for human habitation by the Brockton Board of health and the power and water were terminated to the building. 18.The City of Brockton wire Inspector authorized some of the power to be restored to the building to maintain the heat and the fire alarm system: 19. he Brockton Board of Health removed the declaration,that it was unfit for human habitation but has not signed off on the complete sanitary wellness of the building that would allow the Defendants to obtain its lodging house license. 20.Subjecting the unsuspecting tenants to live in a building that is unsanitary and in . unsafe conditions is-a serious risk to life and safety. 21.1 Officer Scott D. Uhlman hereby ask the court to issue a Temporary Restraining Order with the following prayers. 22.1 hereby ask the court for the following: Prayer One - Restrain the Defendants from allowing anyone from living in the building until a license is obtained for the building as a lodging house as is required by the City of Brockton and the City of Brockton License Commission. Prayer Two — That the Defendants as owners of 99 Warren Ave be made to place the current tenant(s) is suitable alternative housing until the property is properly licensed as a lodging house as required by City of Brockton ordinance and Mass General Law 140 Section 24 Signed under the pains and penalties of perjury this13th day March 2011. %fr &cott D. Uhlman #2 9 - 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued u Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ►` Historic - OKH _ Preservation/ Hyannis Project Street Address J77 569 St— Village � �.s Owner a 7--4 , ,��AM Address Telephone Permit Request � Y Square feet: 1 st floor: existing proposed'► G� 2nd floor: existing 0 proposed otal ne Zoning District ^� Flood Plain Groundwater Overlay Project Valuation /431G'L Construction Type Lot Size 10.2 ��7 Grandfathered: 2fYes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family_ ❑ Two Family JW Multi-Family (# units) Age of Existing Structure I 4 Historic House: ❑Yes % o On Old King's Highway: ❑Yes �eNo Basement Type: ❑ Full ACrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new _ �_ Half: existing new Number of Bedrooms: 6 existing /f new Total Room Count (not including baths): existing new First Floor Room Count T Heat Type and Fuel: XGas ❑ Oil ❑ Electric ❑ Other Central Air: KYes ❑ No Fireplaces: Existing New Existing wood/coal stogy. e: �'es ❑ No p -1 Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barre, existing❑ nei sizeCD Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ CO t. Commercial ❑Yes ❑ No If yes, site plan review # x Current Use l� Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name f' Telephone Numbers P B r C Address,(-.-Address,(-.-19 42 License# C Home Improvement Contractor# �J Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJEOT WILL BE TAKEN TO S6GNATUR DATE 7 — l FOR OFFICIAL USE ONLY r APPLICATION# BATE ISSUED MAP/PARCEL NO. r 1 1 ADDRESS VILLAGE OWNER :i DATE OF INSPECTION: FOUNDATION' • � �' . P } FRAME ' INSULATION; FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL F GAS:, ROUGH FINAL l;'FINAL BUILDING;n' DATE CLOSED OUT _ ASSOCIATION PLAN NO. f TOWN OF BARNrSTABLE BUILDING PERMIT/APPLICATION Map Parcel d T g Application # r f Health Division Date Issued Conservation Division Application Fee- Planning Dept. Permit Feed Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 377 5��4 �s. Village Owner� �DiiT-/I�%� ��f��5 Address Telephone Permit -� % Square feet: 1 st floor: existingq MV proposedU�� 2nd floor: existing proposed r' " otal ne - Zoning District # 1 Flood Plain Groundwater Overlay Project Valuation ConstructiowType Lot Size r ; s. _Grandfathered: 16 Yes ❑ No' If yes, attach supporting documentation. : Dwelling Type: Single Family 0 Two Family U Multi-Family (# units) � r a te_,, j,L Age of Existing Structure �� Historic House: ❑Yes J'No On Old King's Highway: ❑Yes o Basement Type: ❑ Full ACrawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Y Number of Baths: Full: existing_ new `Half: existing new FI Number of Bedrooms: existing // new # Total Room Count (not including baths): existing new -` First Floor Room Count Heat Type and Fuel: .4Gas ❑ Oil ❑ Electric ❑ Other Central Air: 14Yes ❑ No---Fireplaces:,Existing t .\ New Existing wood/coal stove: O Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: 0 existing ❑ new size _ Barn: J,existing—0 new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: y Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ , Commercial.` ❑Yes ❑ No— If yes, site plan review# � Current Use Proposed Use APPLICANT INFORMATION t; ' .... (BUILDER OR HOMEOWNER)..; Nynme li�� i� A Telephone Numbers Z r Address r'd �� 1 s61� License# t� � ° Home Improvement Contractor# f Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE/_.. y DATE I �` — FOR OFFICIAL USE ONLY w APPLICATION# DATE ISSUED MAP/PARCEL NO. -�� ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of.Industria[Accidents I Office of Investigations, 600 Washington Street Boston;MA 02111 www.mass.gov/dia . Workers' Compensation'.Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Name(Business/Organization/Individual): Address: City/State/Zip'l'� s4a—r.—ef � Phone.#: � '7- Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4.XI am a general contractor and I employees(full and/or part-tuns). *. have hired the sub-contractors 6. ❑New construction 2.0 I am.a sole proprietor or partner- listed on the attachedlsheet. 7..SRemodeling 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. 10 P Electrical repairs or.additions' required.] 5: We are a corporation and its X 3.❑ officers have exercised their I am a homeowner doing all 1 lX. Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 120 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required j "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. lContractors that check this box must attached an additional sheetshowing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing,workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration:page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A`of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office ofp Investigations of the DIA for insurance coverage verification. I do hereby certify u the pains a e ties of perjury that the information provided above is true and coJrrect Si ature: Date: Phone Official use only. Do not write in this area, to be completed by city or town official " .City or Town: Permit/License# Issuing Authority(circle one): r 1.Board of Health 2.BuiIding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instruction's Massachusetts General Laws chapteii 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person in.the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or tiustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs 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"eve_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-conttactor(s)name(s),address(es)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,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town),".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license of permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Cbrnmonwealth of Massachusetts Dgpar went of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 WWWmass.gov/dia ` RightFax C2-2 4/2/2012 6:28: 16 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MM1:2012 YY) T IFICATE 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 be endorsed. If SUBROGATION IS WAIVED,subject to he terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to he certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE LEONARD INS AGENCY FAX (AlC,No,Ext: A/C 683 MAIN ST,STE B PRODUCER OSTER VILLE,MA 02655-0494 CUSTOMER ID M 286XR INSURER(S)AFFORDING COVERAGE NAIC III INSURED INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA . BRENNAN,TIMOTHY DBA BLUEBOARD SPECIALISTS INSURER B: PLASTERING CO INSURER C: INSURER D: 117 SOUTH MAIN ST. INSURER E: CENTERVILLE,MA 02632 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: HIS IS TO CERTIFY A THE POLICIESOF 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 HERON IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. NSR ADD SUB POLICYEFFDATE POLICYEXPDATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MM1DmYYYY) (MMODIYYYY) LIMITS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE 0 OCCUR. EMISES(Ea occurrence) ED EXP(Any one person) $ ERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICYID PROJECT❑LOC ODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY OMBINED SINGLE $ ANY AUTO IMIT(Ea accident) ALL OWNED AUTOS ODILY INJURY $ SCHEDULE AUTOS Per person) HIRED AUTOS ODILY INJURY $ Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB F I CLAIMS-MADE AGGREGATE $ ' DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND X WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-0194N848-12 03/03/2012 03/03/2013 LIMITS ANY PROPERITOR/PARTNERIEXECUTIVE rN7 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatoryin NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 It yes,describe under E.L DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIRESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER A.FFECTINO WORKERS COMP COVERAGE, BRENNAN,TIMOTHY IS COVERED BY THE WORKERS'COMPENSATION POLICY. CERTIFICATE HOLDER CANCELLATION RALPH CROSSEN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 18 WOODRIDGE RD BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT_4y.VE EAST SANDWICH,MA 2537 (} ( . ACORD 25(2009109) 1988-2009 ACORD CORPORATION. All rights reserved. Sharen Rabesa MurrayandMacDonald (2/2) 02/28/2012 11 : 19: 30 AM -0500 2/28/2012 6:56:15 AM ?ST (GMT-8) FROM: insurancevis ions.com-T0: 15082E94171 Page: 2 of 2 ACC> .CERTIFICATE OF LIABILITY INSURANCE 7(MWDE)rMYJ2128/2Q12 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 poliry(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER MURRAY& MACDONALD INS SERVICES CONTACT NAME: 550 MACARTHUR BLVD PHONE Arc ro 508 0-2400 FAX C No): 0 28 - 17 BOURNE,MA 02532 EanAIL ADDRESS: INSURE 9 AFFORDING COVERAGE NAIC# NSURERA: Liberty MULUal Group INSURED NSURERB: DOUG MARVEL DBA CHAN KEL FOUNDATIONS NSURERC: 21 BRENTWAY DRIVE INSURERD: SOUTH YARMOUTH MA 02664 NSURERE: NSURER'F: COVERAGES CERTIFICATE NUMBER: 12481479 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 TYPE OF INSURANCE D SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MINDD! MMIDDIYYYY LETS GENERALLIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY PREMISES a occurrence S CLAMS4AADE DOCCUR MED EXP(Any one person) S PERSONAL BAOV INJURY S • GENERAL AGGREGATE S GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S POLICY PRO-JFCT LOG S AUTOMOBILE LIABILITY COM INE-D SINGLE LMIT (Ea exident) S ANY AUTO BODILY INJURY(Fer persor) S ALL OWNED SCII31ULEII BODILY INJURY(Fer accident) S AUTOS AUTOS HIRED AUTOS P NON-OWNED PROPERTY DAMAGE AUTOS er acudant) S S S UMBRELLA L1AB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAWS4MADE - AGGREGATE S DED RETENTION$ - S S 5 A WORKERS COMPENSATION YIN WC2-31S-344615-021 6/19/2011 6/19/2012 wcsL'M,T T AND EMPLOYERS*LIABILI TOFC( MRS ANY PROPRIETORIPARTNERIEXECUFIVE - E.L.EACH ACCIDENT $ 100000 OFFICERIMEMBEREXCLUDID? F NIA - (Mandatory in NH► - E.L.DISEASE•EAEMPLOYEE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIM T $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach AC ORD 101,Additional Remarks Schedule,If more space is required) r< THE WORKERS COMENSATION POLICY DOES NOT PROVIDE COVERAGE FOR DOUG MARVEL r Workers Compensation insurance coverage applies only to the workers compensation laws of the state of MA. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EAGLE EYE CONSTRUCTIONS THE EXPIRATION DATE THEREOF, NOTICE %MLL BE DELIVERED IN 18 WOODRIDGE ROAD ACCORDANCE WTH THE POLICY PROVISIONS. EAST SANDWICH MA 02537 AUTHORVED REPRESENTATIVE I � tA- L� Jeff Eldd e ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(201 D/05) The ACORD name and logo are registered marks of ACORD CCRT NO.: 12481419 CLIENT CODE: 1510238 Anne Chandler 2/28/2012 6:52:56 A14 Page I of 1 This certL f_cate cancels and supersedes ALL previous Ly issued certificates. MA_SOC.,..Ftling..N.ttmber 200808135610__,,.Date.:_02/04[2008.4:04 PM The Commonwealth of Massachusetts 1vIiniminmFee:$15.00 William Francis Galvin Secretary of the Commonwealth One Ashburton Place,Boston,Massachusetts 02108-1512 y4. Telephone: (617)727-9640 r., Federal Employer Identification Number.260604808 (must be 9 digits) We, MARY ANN HAKENSON President X Vice President, ' and DIANNE F KAUFMAN X Clerk _Assistant Clerk , of HOMELESS NOT HOPELESS INC. located at: 310 OCEAN ST HYANNIS,MA 02601 USA do hereby certify that these Articles of Amendment affecting articles numbered: Article 1 X Article 2 X Article 3 Article 4 (Select those articles i,2,3, and(or 4 that are being amended) of the Articles of Organization were duly adopted at a meeting held on 2/4/2008,by vote of 0 members,5 directors, or 0 shareholders, being at least two-thirds of its members/directors legally qualified to vote in meetings of the corporation (or, in the case of a corporation having capital stock, by the holders of at least two thirds of the capital stock having the right to vote therein): x; ARTICLE The exact name of the corporation, as amended, is: (Do not state Article I if it has not been amended.) HOMELESS NOT HOPELESS,INC. ARTICLE 11 The purpose of the corporation, as amended, is to engage in the following business activities: (Do not state Article 11 if it has not been amended.) HOMELESS NOT HOPELESS INC IS A CORPORATION ORGANIZED BY THE HOMELESS AND k FORMERLY HOMELESS TO ASSIST ALL SUFFERING IN THAT CONDITION TO ATTAIN A SUSTAINABLE,SATISFACTORY LIFESTYLE. A SAID ORGANIZATION IS ORGANIZED EXCLUSIVELY FOR CHARITABLE,RELIGIOUS, EDUCATIONAL AND SCIENTIFIC PURPOSES INCLUDII G FOR SUCH PURPOSES THE MAKING OF DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE,OR THE CORRESPONDING SECTION OF ANY FUTURE FEDERAL TAX CODE. i WE SHALL PURSUE THIS GOAL IN THE FOLLOWING WAYS: PROVIDE ACCESS TO THE MOST MODERN TECHNOLOGY AND METHODS POSSIBLE FOR I PURSUING EMPLOYMENT,NETWORKING,OBTAINING HOUSING AND GAINING ACCESS TO l ANY AND ALL RESOURCES SPECIFIC TO CLIENT NEEDS. PROVIDE SHORT-TERM HOUSING AS BOTH A SHELTER OF LAST RESORT AND IN COOPERATION WITH OTHER ORGANIZATIONS SO THAT NO INDIVIDUAL IS LEFT WITHOUT A z' REASONABLE OPPORTUNITY FOR SHELTER I PROVIDE FUNDING ASSISTANCE TO OTHER LIKE-MINDED ORGANIZATIONS ON A CASE BY CASE BASIS TO FACILITATE HELP TO OUR CLIENT BASE AND GENERATE GOOD WILL. WE SHALL PURSUE THIS GOAL UNDER THE FOLLOWING CONDITIONS AND GUIDING PRINCIPALS: IN ORDER TO ACHIEVE THE MEANS OF OUR NON-PROFIT MAKE IT BE KNOWN THAT WE MAY FUND RAISE AND SOLICIT DONATIONS. -! ALL OPERATIONS SHALL BE FINANCIALLY AND METHODOLOGICALLY TRANSPARENT.EACH ELEMENT MUST REMAIN A SOURCE OF CORPORATE PRIDE. " ;. ALL REQUESTS FOR ASSISTANCE FROM OUR ORGANIZATION SHALL BE GIVEN SERIOUS CONSIDERATION.ANY SUCH REQUESTS WILL BE ACCOMMODATED WITH REGARD TO THE L SCOPE OF OUR MISSION,CORPORATE PRINCIPLES AND AVAILABLE RESOURCES. ALL ENDEAVORS OF OUR ORGANIZATION SHALL BE CARRIED FORWARD WITH CREATIVITY =[ SCRUTINIZED FOR IMPROVEMENT OPPORTUNITIES AND MODIFIED TO EXCEL IN =g EFFICIENCY. UPON DISSOLUTION OF THE ORGANIZATIQ ,ASSETS SHALL BE DISTRIBUTED FOR ONE OR MORE EXEMPT PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE OR CORRESPONDING SECTION OF ANY FUTURE FEDERAL TAX CODE OR SHALL BE DISTRIBUTED TO THE FEDERAL GOVERNMENT,OR TO A STATE OR LOCAL 1 GOVERNMENT,FOR A PUBLIC PURPOSE. ANY SUCH ASSETS NOT DISPOSED OF SHALL BE DISPOSED OF BY THE COURT OF COMMON PLEAS OF THE COUNTY IN WHICH THE PRINCIPAL OFFICE OF THE ORGANIZATION IS THIN LOCATED EXCLUSIVELY FOR SUCH PURPOSES OR TO SUCH ORGANIZATION OR ORGANIZATIONS,AS SAID COURT SHALL DETERMINE WHICH ARE ORGANIZED AND OPERATED EXCLUSIVELY FOR SUCH PURPOSES. IN CONCLUSION LET US AS AN ORGANIZATION COLLECTIVELY AND INDIVIDUALLY NEVER FORGET THE CON-DTTIONS AND EXPERIENCES THAT REQUIRED THE FORMATION OF HOMELESS NOT HOPELESS,INC. ARTICLE III R A corporation may have one or more classes of members. As amended,the designation of such classes,the manner of election or appointments,the duration of membership and the qualifications and rights, including voting rights, of the € members of each class, maybe set forth in the by-laws of the corporation or may be set forth below: ! EXECUTIVE(BOARD)COMMMEE THE EXECUTIVE COMMITTEE SHALL BE MADE UP OF SEVEN( )MEMBERS.THESE SHALL BE THE PRESIDENT,TREASURER,CLERK,ASSISTANT CLERK AND THREE ADDITIONAL BOARD MEMBERS WHICH SHALL CARRY THE DESIGNATION OF DIRECTOR.ALL EXECUTIVE COMMITTEE MEMBERS SHALL HAVE LIFETIME TERMS OF OFFICE UNLESS A SPECIAL ELECTION IS CALLED AND THE REMAINING MEMBERS VOTE BY TWO-THIRDS(2/3)MAJORITY TO TERMINATE,OR THE MEMBER CHOOSES TO RESIGN HIS/HER OFFICE. SHOULD ANY MEMBER OF THE EXECUTIVE COMMITTEE CHOOSE TO RESIGN HIS/HER i OFFICE,THE REMAINING MEMBERS WILL HOLD AN ELECTION FOR REPLACEMENT. DIRECTIVE(BOARD)COMMITTEE: MEMBERS OF THE DIRECTIVE COMIVIITTEE WITH HAVE VOTING RIGHTS EQUAL TO ONE-HALF 5r (1/2)OF AN EXECUTIVE COMMITTEE VOTE.THOSE VOTING RIGHTS WILL ONLY BE AVAILABLE TO BE USED ON PROPOSED PROJECTS TO BE TAKEN ON BY THE ORGANIZATION. MEMBERS OF THIS COMMITTEE SHALL BE VOTED INTO OFFICE BY THE EXECUTIVE � COMMITTEE AND EACH MEMBERS TERM SHALL BE NO LONGER THAN TWO(2)YEARS AT A TIME. ALL MEMBERS OF THE EXECUTIVE AND DIRECTIVE BOARDS MUST BE CURRENTLY OR PREVIOUSLY HOMELESS,OR HAVE EXTENSIVE TERMS OF SERVICE IN THE HUMAN SERVICES I FIELD,PREFERABLY WORKING WITH THE HOMELESS. ADVISORY(BOARD)COMMITTEE- WILL BE APPOINTED AND DISSOLVED AS N-EEDID FOR SPECIFIC PURPOSES ONLY.MEMBERS I i OF THIS BOARD SHALL HAVE NO SPECIFIC VOTING RIGHTS.PERSONS NOT CURRENTLY SITTING ON THE EXECUTIVE OR DIRECTIVE BOARD SHALL BE ALLOWED TO BE APPOINTED TO THE ADVISORY COMMMEE IF NO CURRENT BOARD MEMBER HAS THE CAPABILITY OF PROVIDING THE NECESSARY SERVICES. �I ARTICLE IV i`i As amended,other lawful provisions, if any,for the conduct and regulation of the business and affairs of the corporation,for its voluntary dissolution,or for limiting, defining, or regulating the powers of the business entity, or of its "'" directors or members, or of any class of members,are as follows: (If there are no provisions state"NONE") The foregoing amendment(s)will become effective when these Articles of Amendment are filed In accordance with f' General Laws, Chapter 180, Section 7 unless these articles specify, in accordance with the vote adopting the amendment,a later effective date not more than thirty days after such filing, in which event the amendment will become 1 E effective on such later date. t' Later Effective Date: { t Signed under the penalties of perjury,this 4 Day of February,2008,MARY ANN HAKENSON ,its President/Vice President, I DIANNE F.KAUFMAN,Clerk/Assistant Clerk. i �1 -:a ©2001-2008 Commonwealth of Massachusetts All Rights Reserved ..................... _-c.�';..+.'S::Tom-,.=g�s_�� 3'—F-- <•5�.ca'..F3*-..'. .�>.�'�`'"• m...m...A.......o. R MA SOC Filing Number. 200808135610 Date: 02/04/2008 4.04 PM THE COMMONWEALTH OF MASSACHUSETTS I hereby certify that, upon examination of this document, duly submitted to me, it appears that the provisions of the General Laws relative to corporations have been complied with, and I hereby approve said articles;and the filing fee having been paid, said articles are deemed to have been filed with me on: February 04, 2008 4:04 PM WILLIAM FRANCIS GALVIN Secretary of the Commonwealth M - I o-25so-0 I, Homeless not Hopeless Inc. 31.0 Ocean St. Hyannis NU 02601 508-957-2334 To: Town of Barnstable Regulatory Services Building Division Mr. Thomas Perry, CBO 200 Main St. Hyannis MA 02601 Dear Mr. Perry, Your letter of January 19, 2011 requested that Homeless Not Hopeless provide the _ Town of Barnstable with a report of the Education Program at 119 Baxter Road, Hyannis. In order that the numbers in the attached report make sense I submit the following. A. The building was not inhabited until late February 2011 due to cosmetic improvements and the installation of a door and fire escape to the 2nd floor. B. 19 men lived in the house during the period covered by this report. C. No more than 8 men plus the house manager at any given time. D. 5 of the original 9 men still live there E. 6 moved into their own apartments F. 5 men were discharged for Infractions of rules Should you need additional information or have any questions regarding this report please call me at 508-776-7325. Thank You for your help in making this possible. Sincerely Rev,Deacon Richard J. Murphy Sr. —Treasurer "We Offer A Hand Up,Not A Hand Out" Homeless Not Hopeless -- Education Tracking February 2011 —,February 2012 Activity Number Trained Hygiene and Housekeeping Hygiene --Personal Appearance/Showers Etc. 12 --Personal Living Area Neatness 19 Housekeeping --Swee lVacuunc oors 19 —Windows 19 -- Clean Bathroom 19 --Food shopping list 12 --Prepare Evening Meal 12 --Mow Grass 8 --Rake Grass%Leaves 8 Social Skills - -- Treating Others With Respect 19 -- Res ectfor Others NWerty 19 -- Community Dining 19 -- Negotiating TV Channel Pre erence 19 Projects -- Paint—Fill cracks, Prince, Finish coat, clean tools 5 -- Car entry Repairs— Window and door Trim 6 --Other Yard Projects—Planting Flowers& Shrubs 8 -- Other Projects -- Tile work,Install flooring 12 Business Training --Allocating Income 12 --Savings 12 --Check Book Reconciliation 12 Fill Out Forms --Food Stamps 19 --EADAC -19 --SSDI 4 -- Ap plicationLor Health Insurance 8 --Applicationfor Medical Attention 8 --Job Applications 16 Computer --Basic Operation 16 --Internet 16 --Email 10 --Job Search 10 --AA NA Meeting Schedules 10 FIEDFItALIDENTT TION NO. 260-6046081 William Francis Galvin Secretary of the Commonwealth One Ashburton Place, Boston, Massachusetts 02108-1512 RECE V D 2 4 IM CERTIFICATE OF CHANGE OF DIRECTORS OR Ft,1FICERS OF NON-PROFIT CORPORATIONS rE(`IJ UOTI �t (General Laws, Chapttt 190, Stetion 6D) CART - •- I, Jeffrey Howell 'Clerk l Irrlr of Homeless not Hopeless,Inc, e' (Exact name of corporation) having a principal office at 310 Ocean Street,Hyannis,MA 02601 F (Street address of corporation in Massachusetts) certify that pursuant to General Laws, Chapter 180, Section 6D, a change in the directors and/or the president, treasurer and/ or clerk of said corporation has been made and that the name, residential address, and expiration of term of each director and the president, treasurer and clerk are as follows. NAhM RESIDENTIALADDR1r SS WIRATION OF TERM OF OFFICE President; William Bishop 200 Stevens St Hyannis Ma 02601 none Treasurer: Richard Murphy 30 Arbor Way Hyannis Ma 02601 none Clerk: Jeffrey Howell 144 Round Cove Rd.Chatham Ma 02633 none "Assistant Clerk: Directors: Gene Carey 32 Renoir Dr.Oste Wlle Ma 02655 none Han.Joseph Reardon 132 Pleasant Pines Ave Centerville Ma 02632 none Tom Sullivan 329 Oakmont Rd Yarmouth Port Ma 02075 none Matthew Watson .650 Bridge Rd Eastham Ma 02642 none SIGNED UNDERTHEPENALTIESOFPERJURY,this . day of Y ,20 Z , "Clerk. 'Delete the i apP 1akle mordr. —Please Provide the name and residential address of the assistant clerk if hdthe is exreuting this tertiftwe of rbange. teowm ersiw -ti-yJ Homeless not Hopeless Inc. 310 Ocean St. Hyannis MA 02601 508-357-9334 . Educational Curriculum Although HnH houses men and women the primary goal is to teach them to live independently. HnH is not a Program rather it is a family where all members help one another. A good gardener can teach gardening, a cook can teach others to prepare and cook meals, a computer whiz can teach computer skills. It is in this supportive role that family members find their sense of self worth. House Managers do not need to do all the educational work. They do have to ensure that needs are identified and that the person in need is matched with someone who has that particular skill. In many cases documentation will be all that falls to a House Manger. The following skills are taught to all members of the HnH family through regular, structured topic specific conversations either in a group or one on one. Our classroom in many cases is the kitchen table where the community meets to discuss the days progress and difficulties. These sessions embody five basic agreements; 1. Be present(physical, mentally and emotionally) 2. One person speaks at a time. 3. Pay attention to whomever is speaking 4. Respect the speaker and his/her subject 5. Be open to learning from one another House Managers Role House managers meet with each new resident to determine his/her needs. The house manager will evaluate the new resident to the best of their ability and fill out an Education Tracking form. This form is not meant to limit the subjects to be reviewed and taught but is a"Get Start" point. As each person coming into HnH is different, each set of Educational subjects will be different. Some will.require-all those listed while others may only need a minimal amount and others will need subjects that are not listed at this time. Our social worker can offer training guidelines for those not covered herein. The house manager will then assign housekeeping and cooking duties. Housekeeping. - The resident is to be shown the location of supplies and taught how to accomplish the task. If done well they are to be congratulated if poorly then they are to be taught again. Simple tasks such as cleaning a bathroom or washing windows must be taught. Do not presume that any particular task is understood until you see it done. It is a lot easier to teach the first time than to embarrass an individual when he/she has not done it well. Cooking-Each resident according to ability will be taught to prepare meals. Including but not limited to the assembly of ingredients, cooking temperatures, recipes,etc. Health precautions are to be stressed especially when poultry is being prepared. I Lawn and Garden -chores will be assigned with the person being shown where the tools are stored, how to operate the lawn mower safely and how to cut grass and shown where to dispose of grass clippirig, etc. ' Hygiene --Each resident will be taught how to keep their own area clean with all personal property stored away neatly. For some this will be a simple one time check for others it will be a weekly or daily training session. If required personal hygiene is to be politely addressed. Constantly dirty clothes and/or body odor issues are unacceptable. Some will need to be trained on frequency of showers and how to wash and dry clothes. Social Skills--One of the subjects to be taught weekly and more often if necessary is respect for others property in their personal area, the refrigerator or lying around the house. "Finders Keepers, Losers Weepers" is not a slogan accepted at HnH. Making noise when others are sleeping or sharing the TV are skills to be taught as the individual situation calls for. Each meal time is an opportunity to teach the basic skills of table setting, sharing food with others and helping to clean up even if it is someone else's job. Communications are to be taught and encouraged during community meal times. This is a lead by example issue as many of our residents come from families where family meals were not shared and if they were, conversation was not a part of the process. Of all that we teach this is probably one of the most important. Business Training—House Managers will teach each resident to allocate their income. Lesson 1. Money per day until next check. Lesson 2. A few dollars each month put into savings adds up. Lesson 3. Having an extra few dollars in pocket doesn't mean it isn't committed for a future bill. Lesson 4. Check Book reconciliation. Value of entering information in check book accurately Monthly statement. Enter outstanding checks, deposits and ATM withdrawals. Does Statement balance and Check book balance agree? If not check each entry in check book against those in the statement. Make corrections. Filling Out Forms—For many men and women filling out basic forms is confusing and • something to be avoided yet in order to function independently they must learn to overcome the challenge. Forms are one line at a time even if there are 50 or 100 lines on a particular form. A. Assign a time to sit down with the individual. B. Fill in the information that can be filled in Social Security#, DOB, Etc.. C. Make a list of information that is not known D. 'Make a list of what has to be done to get the missing information. E. Set a time to follow up on obtaining the missing information F. Have the resident fill in the information, sign, date and mail or deliver Some men/women may have great difficulty with this training. If the problem is reading then contact our Social Worker to make arrangements for a tutor or assign someone in the Community to work with them. Computer Skills- Lesson 1. Power on and Log In(user has notebook and records each step) Lesson 2. Word processing and how to save document Lesson 3. How to access the Internet and do a basic search _ Lesson 4. How to write an E-Mail and send to a friend Lesson 5. How to retrieve E-Mails and read them and delete them Lesson 5. How to access and search Comm. of Mass Jobs database Lesson 6. How to search the Internet for AA and NA meetings Personal Needs and Addiction Many of the men and women who come to HnH have neglected their health because of addiction. Sobriety is the key to good physical and mental health as each go hand in hand. We teach Sobriety by: being good models of sobriety. encouraging others to get involved in a 12 step program. offer to take them to a meeting. studying the Big Book in groups or privately.' helping with a good fourth step guide. sharing a"Thought for Today" at meals. pointing out the many resources available on the internet such as Hazelden available at http-//www.hazelden.org/web/public/thought.view Meal times provide a perfect setting to discuss AA/NA activities and to witness to their positive effect on our sobriety. It's a simple process. Some education is taught sitting at a desk and other lessons are caught by association. Much like catching a cold. The same goes for health. Each resident should be encouraged to obtain a Primary Care Doctor of their choice or at the Duffy Health Center. Again meal times are a perfect opportunity for a discussion of the benefits of taking care of ones health issues. As with sobriety in many cases it is fear of the unknown that keeps us from visiting our Doctor. Our open discussion of our fears and how we faced them is a positive way to teach good health care. Homeless not Hopeless Inc. (HnH) 310 Ocean St. Hyannis MA 02601 508-957-2334 March 22, 2012 t . Our Mission Educate and advocate for the needs of the Homeless Community. Help Homeless Men and Women get off the street by providing food and shelter. Train them to deal with medical, psychological,spiritual and addiction issues. Help them to connect with available resources. Urge those who are capable to find employment or volunteer their time. Facilitate acquistion of financial assistance for residents. Teach goal setting,occupational and life skills that will lead to independent living. How it Works Bill Bishop our President who lives at"HnH"is a formerly homeless man and spends part of each day reaching out to the homeless community.He is the point of contact along with Dianne Kaufman our clerk.People apply directly or are referred from Duffy Health or other programs.An interview is arranged which is conducted by Bill Bishop,Dianne and the appropriate male or female House Manager. Once accepted into our family a contract is signed so that the new resident understands what is expected of him/her and depending on the person special conditions are specified,i.e.: X amount of AA meetingstweek,Physical check up within X weeks, Medication to be supervised by House Manager,etc.,etc. Most men and women coming in off the street need medical attention so an appointment is made at Duffy Health. Urine Screens for Drug and/or alcohol are required before anyone comes into the program and are administered on a random basis thereafter. Releases for medical information are required so that we know first hand what medical and/or physiological issues that need to be dealt with.A period of rest, usually a couple of weeks is allowed,living on the streets tires people out. Each resident is encouraged to go to work or volunteer their time.A strong emphasis is put on cleanliness all members are assigned specific chores and are held accountable.We are teaching pride in one's self and pride in their home. Personal areas must be kept clean and neat as well as personal hygiene.As most do not drive, transportation is provided for Doctors appointment,Recovery meetings, etc. Each man or woman depending on their skills is taught basic computer usage,how to manage savings and checking, how to plan, shop with coupons and cook meals. Maintaining a personal calendar for Doctor Visits etc. is a new habit for most of our newcomers. Weekly community meetings deal with basic social skills and interpersonal relationships. Sometimes something as simple as setting the dinner table can be become a very teachable moment or asking another what TV channel they want to watch Often times a mentor is assigned to a particular man or woman who is having a hard time adjusting to community life.Mentoring provides our stronger residents with the responsibility of being a big brother/sister, a teacher,which is a good thing for them as well.A social worker visits each week and is available 24/7 to deal with crisis situations. He sits in on weekly resident's community meetings as well as the House Managers meeting.A Registered Nurse visits on a regular basis who provides care and recommendations to residents with special medical needs. At the House Managers meeting each resident is evaluated on their progress and problem areas noted. Sometimes resolution of a problem is simply bringing it to that person's attention, other times it requires intervention by Bill Bishop or our social worker. In some cases they may be referred for professional evaluation. Anyone who is suspected of using drugs or alcohol is given a urine screen and if the test is positive they are referred to alcohol/drug detox program. Their bed will be held for 30 days and if longer term treatment is required they will be placed at the top of the waiting list once their program is completed.Emphasis in both situations is on "Completed". Residents once stabilized are encouraged to move on to their own housing yet there is no time limit set for them to stay at HnH.They are free to leave at any time as this is not a locked facility.At present we have three people who will probably stay with us for an indefinite period as they are very limited.All of our residents have to be able to take care of their personal needs. Residents pay community fees of$425 for the men who share a room and women who have single rooms pay$450.In addition each resident contributes $100 to defray the cost of food/utilities.In this way the program is self sustaining and provides a sense of ownership to the HnH family members. The payment of the community fees and fees for food and utilities prepares residents to understand how to budget and plan their finances in the present but also for the time when they may choose to find their own apartment or return to their families. Our focus on personal responsibility,shared chores and becoming part of a family supervised by formerly homeless men and women has resulted in an 85% success rate over the four years of HnH's existence. Our program is well respected by the other human service programs as we have become a valuable resource for getting the homeless out of the shelter and off the streets. A Attached is a copy of our Education Tracking Form - R_ Homeless Not Hopeless --Education Tracking Month Year House Community Member Name Activity Date Notes Hygiene --Personal AppearancelShoivers Etc. --Personal Living Area Neatness Housekeeping --Swee lVacuum oors -- Windows -- Clean Bathroom —Food shopping list --Prepare Eve ning Meal —Mow Grass —Rake GrasslLeaves Social Skills — Treating Others With Respect -- Res ect or Others Property — Community Dining — Negotiating TV Channel Pre erence Projects — Paint—Fill cracks, Prime, Finish coat, clean tools — Car entt /Re airs- -Other Yard Projects—Planting Flowers&Shrubs -- Other Projects -- Business Training —Allocating Income —Savings — Check Book Reconciliation Fill Out Forms —Food Stamps —EADAC --SSDI — Applicationfor Health Insurance —Applicationfor Medical Attention —Job Applications Computer —Basic O eration —Internet I —EMail —Job Search —AA/NA Meeting Schedules Town of Barnstable Regulatory-Services MAE&�$ Thomas F. Geiler,Director - �i 61-9L. J6�6 Building Division Tom Perry,'Building Commissioner 200 Main Strect, Hyannis,.MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property. Owner Mnst . .Complete and Sign This Section - If UsinLy ABuilde as Owner of the subject ro e P P nY , hereby authorize A�o� � � � � to act on my behalf, in all matters relative to work authorized by this building permit application for.. 77 (Address of Job) Signature of Owner/ate Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on.the reverse side: Q:FORMS:O WNERPERMISSION P�af Y�ray Town of Barnstable yam. o Regulatory Services Thomas F. Geiler,Director Building Division PrED � Tom Perry,Building Commissioner 200 Mairi.Street,_Hyannis.MA_02601 wwfv.to wn.b arnstable_ma_us Office: 508-862-403 8 Fax.: 508-790-6230 HON EOV NER LICENSE EXEMPTTON Please Print DATE: JOB LOCATION: number street viltage "HOMF,OWNW" name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor_ DEMIIION OF HOMEOWWER 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 bomcowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that br/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undcrsigncd"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. r R� ; a y Signatiire of Homeowner Approval of Building Official Note: Three-family dwelliags containing 35,000 cubic feet br larger will be required to comply with fhe State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that "Any bomeowner performing work for which a building permit is required shall be exempt from the provisions of this scctign.(Scetian l D9.1.1 -Licensing of construction SupcnZsors);provided that if the homeovyner engages a person(s)for hire to do such wort,that such Homeowners shall act as supervisor." Many homeowners who use this exemption arc unaware that they are assunvng the respormbilities of a supervisor(sec 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 Mrould with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsriMe. To ensure that the homeowner is fully aware of his/her icsponsibilitics,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the Iasi page of this issue is a form currently used by several towns. You may care t amend and adopt such a fonn/certificadon for use in your community. Q:forrM:hom=xcmpt f i - Saetaiaasrapan `-1670 VW'H01M0NVS•3 Aa 30018000M 81, s. N3SS0NO HdlV2i N3SS0210 H-cRV- t V80 ZLOZ/£Z/6 :6ol;endx3 :ad¢1 ZL69£4- :uo4ei;sl6ab �. 11010V81N001NEIMA011M 3WO14� ugracin3i3 ssanrs g V sneBV aamnsuo0 JO 33030 Iassaehu:setts- Department of Public`�:ifetN Board of Building Rv,,ulittiuns.an4 St tndarc}t Construction Supervisor License License: CS 70029 RALPH CROSSEN 18 WOODRIDGE RD E SANDWICH, MA 02537 Expiration-. 11/15/2012 <'+mmisimer Tr#: 5205 .w License,or registration valid for individutt use'only before the expiration date. If found return,to: p Office of Consumer Affairs and Business Regulation; I to Park Plaza Suite 5.170 B'oston;MA 02116 of valid without"signature ` C• i ZONE: RB MAP: 306 PARCEL: 43 LOT COVERAGE CALCS. FLOOD ZONE. NON-HAZARD C LOT AREA = rasa at Panel No. 250001 0006 D (712192) EVS77NG STRUCTURES ITA n. PLAN REFERENCE., L.C. PLAN 1013 B ZJOO a -21.84 X BENCHMARK DATUM. ASSUMED U WIND EXPOSURE CATEGORY B as md. " NANTUCKET SOUND LOCUS MAP aadc 1-2000' N/F JUDITH A. NOTZ BENCHMARK., 70P OF HMRANT ELE✓. Ja78' 0 /APPPROX. --��57876ypE� �,`CYET LOT Bl 20 s CESSPOOL COrvG` N F TERRENCE J. DUGGAN ^ h m o a i 28— ?e�• f2. � b• ae. Jo 30 h �(�_ y� �' I LOT A / l.A fin d tZ. a fin` B !�Y �4 ry I 10,533 sf. m a ?a2rQ ��za__ 0 4�M CB. tnd. S�734SE. Ba DO' CAS -.rc71 � I pY GAS GASLINE N PEE FLAGGED FR.2z15C �� N7973' ��l�q�Ogj BY OTHERS CA TCH BASIN STREET ° GOSNOLD `- STREET EVVING COND177ONS MR CAPE COD BLUE SKY PROGRAM "PLAN REVISIONS" 377 SEA STREET HYANNIS BARNSTABLE, MASS. Scole: 1"--20' Date. 312312012 _. NO. DATE DESCRIPTION BY PA/PR Warwick & Associates Inc. DRAWN B»Gst DAB J/21/2M2 GRAPHIC SCALE 63 County Road Box 801 North Falmouth, Alas 02556 (508) 568 - 7777 PILodPrgjw&2W4%OWR—Wd»vl d»v IN rm) STAY ORGANIZEDL Holidoy Inn ( ,-OFT o zizk zcoo---,3 �- S 4:�� . .• EIFI F I Parcel Detail Page 1 of 4 • 4 77 . n °" ._•...:_..fir _- .,-�... . -' - -a_., ...._.gym.,.. a,, �is_.xm. " Logged In As: Tuesday, May 1 2012 Pa rce l Deta i l Parcel Lookup Parcel Info Parcel ID 306-043 I DevelopeoY LOT A Location 377 SEA STREET Pri Frontage 65 Sec Road 'NORRIS STREET: I Sec 163 Frontage village JHYANNIS . . . . " " I Fire District, HYANNIS Town sewer exists at this address. Yes I Road Index 1447 I Asbuilt Septic Scan: Interactive 306043_1 Map Owner Info Owner LOWNEY, IRENE Co-owner Streetl 1234 HYDE PARK AV I Streetz City I HYDE PARK state MA I zip 02136 Country Land Info 'Acres 10.29_� use Two Family i zoning RB Nghbd 0109 Topography Level Road Paved Utilities Public Water,Gas,Septic Location Construction Info http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=24200 5/1/2012 Parcel-Detail Page 2 of 4 Building 1 of 1 Year Roof II Ext Built 1900 Struct Gable/Hip I wan Vinyl Siding LivingRoof AC " 2298 Asph/F GIs/Cmp None Area Cover Type In t Bed Style lConventional Wall all Plastered . Y Rooms ms 7 Bedrooms �hTO 22.1 Modell Residential Floor In H th 5ardwood Rooms Full Grade Average I Heat Hot Air �I Total 14 Rooms Type Rooms Stories Fi Story F A Heat Gas Found- (cone. Block' �y Fuel ation i" Gross Area 5295 . _.........._) Permit History Issue Date Purpose Permit# Amount Insp Date Comments 10/7/1996 New Roof: 18431 $2,000 8/15/1997 12:00:00 AM Reroof 12/5/1995 New Siding 12064 $20;000 1/1/1997 12:00:00 AM Visit History. _ Sales History Assessment History Photos - http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=24200 5/1/2012 w a t T Aw 0J4;�I 11010 171"MAT on im M. . • l l Pvxcel,Detail Page 4 of 4 ml t { http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=24200 5/1/2012 Message Page 1 of 1 '.Anderson, Robin r To: Gallant, Therese Subject: 377 Sea Street Hi! Welcome back - I hope you are only reading this when you return from vacation and NOT BEFORE! :,'FYI*. Just.spoke to Alex (4/28/17 4:05 PM) concerning the graffiti (new and old) on his fence at 377 Sea Street. He will attempt to stain over it this weekend to render it invisible. Alex indicated that he will review his security tape to see if he can identify the offender(s). egarding the complaints: I spoke to 3 or 4 different parties today complaining about the `eyesore of graffiti. During our discussion, Alex asked me to pass on a message to those.. ... :.:calling to complain - to please notify the BPD in the event that they see someone defacing or destroying his property. I advised the last caller (Linda Lord 508-776-4313) accordingly and asked her to make the others aware. Apparently, this fence & graffiti will be the :subject of another article in the Times. I am told there was one 2 weeks ago (I missed,it).;I also told Alex that I would make you aware so you could,add this latest episode to your log as well. Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis,MA 026o1 5o8=862-4027 4/28/2017 s F -4 F se . LL �y 5 tnf � n IW k 4Wi .. .�, TOWN OF BARNSTAB cE 8. a J� ju. 0 „.�”�_ +��..�..,.— .' -��-",}}} fir s� ,r 3•.`�.ysi+ T � ov a S I e PIN v p € � W 1i ,• F p � r � 1 1 a F � r `ice" CTi^Lir a'4 F L O I � TOWN OF t" ? 4 7 •air � a�'r:�� _ P � '�. N �.: �. °�'`-.�� s r 4 Np i •� { � � ,�ilr' 'q �,N�1 �. love f� t ru - e MR 1y, , y r rd -n� i s- OAR r , litjil L+Jc i a "'Y 1 A lit Ak vs FIR r F , , �"f CC) , g 65 mow_ IN Jnn t� Q Q-S 1 f r. .-7- �t t Town of'Barnstable *Permit# Expires 6 months from iss a date �7 Regulatory Services Fee • 1ARNSTABM i 9� hrnss.1639. Richard V.Scali,Interim Director ,otED MA't� Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION. - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 306 =-. L Property Address -3 7 �� S'-�7' e eV .4�,I1/Q✓f , Residential Value of Work$ / Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address /t l e �S f 2 L..,,vi O `r- Contractor's Name Telephone Number 6/7 c?o 3 -9o,3 2- Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) X® SIS ENT Workman's Compensation Insurance APR _ 4 2014 Check one: ❑ am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BA,RNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to VRe-roof(hurricane nailed)(not stripping. Going over 1 existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#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,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: QAWPFILESTORMSUilding permit formsEXPRESS.doc Revised 061313 2'11e Comarroarrealth qfMassachuseta Deparhnent of l'ir dmsftial Accidents - t�, e n�Irrrresti 'iQtrs 600 Washington&reef Bosf r4 MA 02111 wrv►v.txnassgoVdirl ' ar�re -s' Campensafaun Insurance Affidavit:B.11ildersf ntractnrsfE.ectricianslPTumbers ant Information Please Print h Nara f G ) Address: ? GYtyfStat&Zip_ Q iV lV t Phone47 CU /7 A9 Are you an employer?Check the appropriatr bGx: T o#; o'ect r uire : 3'Pe P�' J �e9 ' 4 . contractor and I 6_ ❑Ne,iv won I-El I am a employer with � I am a � employees{full and/or part-time * havehiredthe sub�antracfors 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 many capacity- employees and have workers' 4_ ❑Building addition Wo worms'comp.insimanre comp-mctvart;e., ] 5. We are a corporation and its 10.0 Electrical repairs or additions 3_ 1 am a hcr..ecrwn�er doing all work officers ImT exercised their 11_.Q Plumbing repairs or.additions myself[No workers'comp- right of exemption per MGL 12171 Roof repairs fim anrer-erinirect]f c-152,§1(4) and wehWena employees-[No�' 13_- Other comp-insurance required.]; *Any appEctatffixtchecksboaglmastalsoflloutt5esecfioabelowshowingiheavro&us''compensationpaliLTinlbrmatton- �Hnmeoaners who submit ffiis affidavit ificzdq they are damg a]I�xA n d rhea hire outside contractors— submit a mear afdavit meteating mch- tmctors that check this boat mmt attached an additions)sheet dow-mg the name of&a mtr-oohs and sista,whether ornot thaw entities have emvlayees- If the sob-cantmctambase empIoyees,they naul provide tlir workers'comp.policy number lam an e.mpLGywiliatisprmidkgttorke-rs'couilmrLvatioa zrmir=ce for my empZgyeas Be,Taty is the paTicy and job site informaliart. Insurance Company Name: Policy#or Self-ins-Lie. Expiration Date: Job Site Adclress city/statelzip: Attach a.copy of the workers'compensation policy declaration page(showing the policy trambe-r and expiration date). Failure to secmrecoverage as required uuder Section25A of MGL c. 152 can lead to the imposition ofaiminal penalties of a fine up to$1,500.0a and/or one-yearimpr sottment,as well as civil penalties in,the fonn of a STOP WORK ORDER-and a fine cafup.to$250.00 a day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for inset-arice coverage veeffication- I do hereby cie,t6 r the nit naIfiss ufperjury thatthe�irzfor mat&n provided abov bus td correct siPnature: _ Date: Oft Ce Phone#: © l use oti£y. Da not writs in this area,to be completed by city or town ofic-iat City-or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfro n Clerk 4.Electrical Inspector S.Plumbing inspector 6.Other y l - Town of Barnstable -. Regulatory Services Ot Toryti Richard V.Scali,Interim Director Building Division ReRNSEARr.u, Tom Perry,Building Commissioner 1 �� 200 Main Street, Hyannis,MA 02601 'O�Fa lrw� www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6290 HOMEOWNER LICENSE EXEMPTION DATE: L( Please Print ' ' JOB.LOCATIQN: `77 n ber p street nllage `HOMEOWNER.,: j� ��Z c�� 6 t name home phone# work phone# CURRENT MAILING ADDRESS: C O Q P 0�,W �c_ez V W Tv citya 4- U,,O u , kk k c9 2 61 � state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use'and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. t The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proce an eme d that he/she will comply with said procedures and requirements. SignV&7e ofHomeowmer Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." � Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,.particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of'a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFnM\FORMS\buildingpermitfm-ms\ENPRESS.doc . �TME rti Town of Barnstable Regulatory Services 1ARMABM MASS. $ Richard V.Scali,Interim Director i6gq. �0 Building Division Tom Perry,Building Commissioner 200 Mafia Street,Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must lComplete-and Sign'Th s Section If Using A Builde"r I, CZ`J VJ as Owner of the ro subject l property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit Iv (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 r inspections are performed and accepted. r r etmener Signature of Applicant Print Name Print Name � 4 0� Date BARNSTABLE LAND COURT: REGISTRY QUITCLAIM DEED I, IRENE LOWNEY, now of 1234 Hyde Park Avenue, Hyde Park, MA for consideration of Two Hundred Seventy Thousand ($270,000.00) Dollars; paid, grant to.Alex Bizunok and Valentina . Bizunok, now of 109 Pawkannawkut Drive, South Yarmouth, MA 02664, as Joint Tenants, with Quitclaim Covenants, the land, in the County of Barnstable and Commonwealth of Massachusetts, bounded and described as follows: EASTERLY by Sea Street, sixty-five and 24/100 (65.24) feet; SOUTHERLY by land now or,formerly of Ernest B. Norris, one hundred sixty-three (163) feet; WESTERLY by lot B, sixty-four and 23/100 (64.23) feet; NORTHERLY by land now or formerly of Frank E. McCabe, one hundred sixty-three (163) feet. All of said boundaries are located as shown on subdivision plan 10013-B dated June 2, 1930, drawn by George F. Clements, C. E..and filed in the Land Registration Office at Boston, a copy of which is filed in Barnstable County Registry of Deeds in Land Registration Book 10,Page 168, with Certificate of Title No. 2378 and said land.is shown thereon as LOT A. For Grantors title, see Foreclosure Deed dated February 1, 1995 and filed with the Barnstable County Registry District of the Land Court as document Number 634074 , as noted on Certificate of Title No. 136412. Grantor herein and Charles W. Lowney on oath declare they are a married couple and join in this, Quitclaim Deed,.waiving all rights of Homestead, if any, created. PROPERTY ADDRESS: 377 Sea Street, H annis, MA Date: 04-04-2014 a 09:30aa y CtlAV: 161 Doc*. 1243203 Fee: $923.40 Cans' $270POOOiOO WITNESS my hand and seal this 2'"0�ic ay of April, 2014. Irene Lowney 01 /Charles W. Lowney COMMONWEALTH OF MASSACHUSETTS On this�ay of April, 2014, before me, the undersigned Notary Public, personally appeared Irene Lowney,proved to me through satisfactory evidence of identification, which was personally known to me, to be the person &Aose name is rSigned on the preceding or attached document, and acknowledged to me s nEd iintarily for its state purpose. r�',RYfiei`ti'� 06. fff y s W y:J4az F FIB! .••' Commission Expires: A.IsG IaOat HM COMMONWEALTH OF MASSACHUSETTS On this day of April,.2014, before me, the undersigned Notary Public, personally appeared Charles W. Lowney, proved to me through satisfactory evidence of identification, which was personally known to me, to be the person(s) whose name is signed on the preceding or attached document, and acknowled E mw4 signed it voluntarily for its state purpose. tary:Jane F �' v fires: ,2c v/Commission Ex OC p Return To: `•.;!qr we��°off ••.. �►y0 off$us,,�o, BARNSTABLE COUNTY EXCISE TAX Hill BARNSTABLE LAND COURT REGISTRY Date. (34-04-2014 3 09:30am . Mar: 161 Dot T: 1243203 Fge= $729.00 Cons: $2704013.00 BARNS TABLE COUNTY REGISTRY OF DEEDS A TRUE COPY,ATTEST J0 iN F.MEADE,REGISTER BARNSTABLE REGISTRY OF DEEDS s ' G�61463� a� of rq�, Town.of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee_ * r * BARNWABM + v '""SS' $i639• Richard V.Scali,Director �� ArE p�.t A Building Division . Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 3oto dc-C 3 Not Valid without Red X-Press Imprint Map/parcel Number IqProperty Address Residential Value of Work$ � '®.t" Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address /d[Z.v Vol (0 gfli Pa-W k 41-N.pa Lu A_,� Q_4�V 92,q� Contractor's Name Telephone Number 47rVQ3 --dOZ, Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance RMIT Check one: MAY 15 ��14 .,❑�m a sole proprietor `bd I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side /�Q placement Windows/doors/sliders.U-Value /'� gir'v (maximum.35)#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,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit fonnsTXPRESS.doc Revised 061313 �a The Commonwealth of Massachusetts Department of Indrestrial Acade a. Office oflnvestigations - 600 Washington,Sftwet Boston,CIA 02111 wwfttrnasxgoVfdia Workers'Compensation Insurance Affidavit Builders/ContractorslElectiicians/Ph nnbers Applicant Information. Please Print Leeibly Name(Busineecmrzanizationtlndividnal}: / `�PAD P 140 City/Sta&Zipc Phone 47 1`? Are you an employer?Check the appropriate box: Type of project(required): 4. I am a contractor and I 1. I am a employer with ❑ gen�eaal 6_ ❑New construction employees(full audlor part-time).* have fired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. I- ❑modeling ship and have no emp ogees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance-1 �. ❑Building addition d.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3_ I am a homeowner doing all work. 1l.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roofrepairs insurance required]t c. 1.52,§1(4} and we have no employees.[No workers' 13.0 Other comp.insurance required.]' -Piny applicant that checks bees#1 mast also fill out the se€tionbetaw showing their wa&ere compensation policy information- Homeowners who submit this of idasdt inficatiog they are doing all we d and then hie outside contractors nmst submit a new affidavit indicating such tContmctors that check ibis bat must attached an sdd tinnal sheet showing the nsme of the sub-cow and state whether arnot those entities have em loyees. If the sub-contractors have employees,dLe}'must provide their workers'comp.policy number. I am an employer that is pratiding workers'compensation insurance for trty employees. Below is the p licy and jab site information Insurance Company Name: Policy#or Self-ins-Lie.#: Expiration Bate: Job Site Address: CitylStateMp: 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 ofMGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andfor one-yearin4xisoamtt,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 Irrvestigations of the DLL for insurance coverage verification. Ida Hereby cer#ifi,under thepains andpenaMes ofp 'wry that the inforotadonprovidedabom is true and correct Si Lure: Date: Phone#: Offifial use only. Do not write in this area,to be completed by city or town official City or Town.: PermitlLicense If Issuing Authority(circle one):. 1.Board of Health 3.Building Department 3.City(Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact.Person: Phone#: Town of Barnstable Regulatory Services �oFtlu rOiy,� Richard V.Scali,Director Building Division snxrrsTaai E Tom Perry,Building Commissioner MASS. 039. 200 Main Street, Hyannis,MA 02601 TED N1AY A www.town.barnstable.ma.us Office: 568-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: Q /, JOB LOCATION: _GL !/�/` �I At number to street V / village "HOMEOWNER": T� C Z�C! ref U lfL/ tfo 2 name home phone# w(o�rJk�phone# CURRENT MAILING ADDRESS: t® �'t-�c I� �✓ � vim/ ®2— city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides.or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) l 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 procedur d re it ents and t4t he/she will comply with said procedures and requirements. Signs re o eowner V ' Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. 'To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last'page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. ' Q:\WPFILES\FORMS\building permit forms\EXPRESS,doC • ' r ' Revised 061313 F THE Tp� * R&PNS'fABM + ,' ,�� Town of Barnstable ptf0 N►ptl A Regulatory Services Richard V. Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable ma.us Office: 508-862-4038' ', '} �, Fax; 508-790-6230 M . ` P perty Owner`Must Comple e and Sign This Sec on I Using A Builder I �e—"ry 4J- as O er of the subject J property hereby authorize to act on my behalf, in all matters relative to work authorized by uilding ermit application for: A (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. Q:\WPFILES\FORMS\building permit fonns EXPRESS.doc Revised 061313 g � � � ,�� , �� Q ��> Rec, BankBoston, N.A. f/k/a BayBank MiddleE of a mortgage from RICHARD T. MCDE' SEPTEMBER 30, 1968, recorded with Document No. 124465 on Certificate of Book 347, Page 100, acknowledges satin a Property Address: 861 SEA VIEW A J OSTERVILLE, MP. Witness the execution hereof by 1999 A.D. By Z\t) J Office of Consumer Affairs & Business Regulation- M The Official Website of the Office of Consumer Affairs&Business Regulatio Consumer Affairs and Business Regulation Home .Consumer Home Improvement Contracting Home Improvement Contractor Registratio You can search/filter the registration list by any of the Search by Registration Number Search by Registrant Name HITCHCOCK Search by City �� Z Search Registrants ' Click on the registration number to view complaint history. Y history. The list is current as of Tuesday, June 19, 2012. Search Re P()NSIRLE RMSTRATION '�311P" k a 4�t, 0 I o `C .f -- OQTfI 00 i i� t W � t At \ tC g 1cr Qj. C=Eq vWL0*4 cg j !+ `1�t�r'Nf1444F �s� V $:. eILK Q { � o `� 0 ' � �,� _ � `�^ Q� r„ ;,� —za � � � � '' `;p .� � c Message Page 1 of 1 Anderson, Robin To: Parsons, Roger Cc: Roma, Paul Subject: 377 Sea Street- Important Fence Matter r HI Roger, have been directed to you in your role as official Fence Viewer. If you are not the appropriate party please redirect me accordingly. I am requesting that the corner property at 377 Sea St/Norris be viewed and assessed for compliance with the corner lot regulation for fencing. Apparently, the property owner or the agents have not been receptive to our efforts to resolve and improve the matter. Paul Roma has deemed this to be a hazard. He has spoken to someone regarding the diminished site distance resulting from the new stockade fence. It is difficult to see when pulling out onto Sea Street. We are most concerned with bicycles and pedestrians crossing in front of Norris along Sea. Drivers are no longer able to view down Sea Street and clearly see pedestrians or vehicles as they approach the intersection. Staff has been out to this site at least a couple of times for this very matter. The workers cut the fence down some what but not enough. Paul states that it is now 39" high (was at least 6' prior). I would like an official determination concerning not only the height of the unit but the actual impact on site distance and if any other measures should be taken. Please advise. Thank you. 0�g61n Robin C.Anderson Zoning Enforcement Officer ' 200 Main Street Hyannis,MA 026oi 5o8-862-4027 6/2/2016 w � Oo begin dup type/dicttype eq {clonedict}if dup type/arraytype eq {clonearray}if def } forall currentdict end- }bdf • /DeviceN_PS2 { /curreritcolorspace. AGMCORE_gge }bdf /Indexed_DeviceN { ? .. /indexed colorspace_dict AGMCO dup/CSDBase known{ /CSDBase get/C pop false }ifelse 'pop false }ifelse }bdf /DeviceN_NoneName { /Names where{ POP false Names is + � ;„11�•tr'rf!T�,"�j,'�.p ems, 4 tta` s , v� r� `^ a# �` +�'� } yr_r P r�". w �� • a`.1. r, i _Aya;e x ."yrr w ALP cn n i TZ r N''I ( �t N � �77 Se'a Street, Hyannis � �:. : � T~ • 7/2 5/12 f s w-W w • ^ �IV Y s..r B u . . t i► I1 pp i i I " { p i Yg P� � � � TO p�/TT «7'FROMVlk OF kH COn 1V11MR gig a LU a C SIGNED H�'C�1RIiED fiiAEE tYIEE CREt PHONED WAMS�'C WA�i 'UA6Eblft ClU E aac �anlN y ] [ s xeu 1N AMPAD NO.23-176-400 SETS NO.23-376-200 SETS The Town of Barnstable B" NAM Department of Health, Safety and Environmental Services e39. �.� Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner Fax: 508-775-3344 November 8, 1994 John M.Lovely,Esquire Gelerman and Cashman 270 Bridge Street Dedham,MA 02026 Re: 375 Sea Street,Hyanms,MA Dear Attorney Lovely: of a complaint regarding the Property located at 375 Sea Street,Hyannis, This office is in receipt Massachusetts, ro as a five The attached advertisement from the November 8, 1994 Cape.Cod Times advertises the property building. This office no record of a building permit authorizing five units. unit apartment Please contact me immediately regarding this matter. My office hours are 8:00-9:30 a.m. and 3:00- 4:30 p.m.,Monday through Friday. Very truly yours, Gloria M.Urenas Zoning Enforcement Officer GMU/km enclosure CERTIFIED MAIL P 015 496 592 RRR aY,, Q941108A P 229- 805 - 3.04 w . US Postal Service Receipt for Certified Mail No Insurance Coverage Provided.. Do not use for International Mail See reverse Se to Street&Number Post Offi te,&ZIP Code 96 Postage $ Certified Fee Special Delivery Fee Restricted Delivery Fee rn Return Receipt Showing to Whom&Date Delivered Q Return Receipt Showing to Whom, Q Date,&Addressee's Address 0 TOTAL Postage&Fees $ S th Postmark or Date u- U (L I; Stick postage stamps to article to cover First-Class postage,certified mail fee,and i charges for any selected optional services(See front). 1 1.If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached, and present the article at a post office service m window or hand it to your rural carrier(no extra charge). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the m return address of the article,date;detach,and retain the receipt,and mail the article. 2 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee, or to an authorized agent of the C addressee,endorse RESTRICTED DELIVERY on the front of the article. coo M 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. to 6. Save this receipt and present it if you make an inquiry. d - The Town of Barnstable BAMSTAB Department of Health, Safety and Environmental Services s6.19. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner May 7, 1996 Charles and Irene Lowney 52 Whittier Road Milton, MA 02186 Re: 377 Sea Street, Hyannis, MA Dear Mr. and Mrs. Lowney: This is to inform you that, unless we hear from you within seven(7) days from your receipt of this letter, no building permits will be issued for the repair of property at 377 Sea Street, Hyannis. We have tried several times to reach you to no avail. All mail has been returned. Very truly yours, Gloria M. Urenas Zoning Enforcement Officer GMUIb cc: Barnstable Housing Authority CERTIFIED MAIL P 229 805 304 LAWRENCE READY MIXED CONCRETE CO. 888-8002' TOLL FREE 1-800-633-8889 J-j t ( i I t { { t l t 3 -L- j- �t SERVING CAPE COD TOWN OF BARNSTABLE • L`Ji� '•• ti ' �' < aatT*Qru4 ' P' BUILDING DIVISION 367 MAIN STREET D' �L C @` '� �x, HYANNIS,MA 02601 1 0 (+P R ; .� , 6R , P 22905. 3p2 L - - - I . >iHND REA�NECKED un*km Refused XVvlhittiad y Ist Notice "' °t k"01v" Z0noticeNo such sired number_ etjr,7 No such office in state Do not remail in this envelope h m SENDER: I also wish to receive the wu, ■Complete items.1 and/or 2 for additional services. following services(for an rn_ ■Complete items 3,4a,and 4b. I an return this extra fee) H ■Print your name and address on the reverse of this form so that we c y l .. card to you. ! I d •Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address I permit. ■write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery U1 C ■The Return Receipt will show to whom the article was delivered and the date Consult postmaster for fee. aj I C delivered. I 3.Article Addressed to: 4a.Article Number o. �I I. 4b.Service Type E Charles and Irene Lowney dl a 80 Whittier Road Registered ❑ Certified tn. N ❑ Express Mail ❑ Insured E cn Milton, MA 02186 �I 1 cc ReturnReceipt for Merchandise ❑ COD . I o °1 7.Date of Delivery 0 i a 1 ! Z T 5. Received By: (Print Name) 8.Addressee's Address(Only if requested C' W and fee is paid) g 6.Signature:(Addressee or Agent) l :P� X I Domestic Return Receipt PS Form 3811, December 1994 _..- SGJc o N ern_ s ! D%�3 z 1 Z o z3— CD i CA Z c n'Cn Y N ' 07) n rrm IT �i \ IT r� c� ;s \ , ` (� �� ,. `\ � ��. �� G �, � 4: �� ' � ��= �- � � � � �. � - ,� �' �� `� _� � � a � ;o � � �� ;,, R306 042. A P P F.' A 1 S A L D A T A KEY 213682 SOUZA, PHILLIP R & MARIE M LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 46, 80-D 135, 600 A-COST 182, 400 B-MKT 165, 100 BY co/ BY /00 C-INCOME PCA=1041 PCS=00 SIZE= 3063 jUST-VAL lS2, 400 LEV=400 C 1011�4 S,*7." C 'C' TO CONTROL AREA 60AC --------- --- ------- ----- --- -- NEIGHBORHOOD 60AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 1 C_� 10 LAND-TYPE 4680,") 'L-Al�4l:f-- 182400 114319 iMPROVED-NEAN +19% 25% FRONT-FT loo DEPTH/ACRES TABLE 02 100% LOCATION-ADJ APPLY-VAL-STAT 1 LAR LAND LFT/IMP ADJS/SB/FEAT STR STRUCTURE ARR AREA-MEASUREMENTS NOR NOTES, COM MARKET INC INCOME PMR PERMITS GRR GRAPHIC F 1.J l';!C 1"I STRUCTURE-CARD NO- 000 DATQ- XMT ? :;.;:,_Y(. 043 o t' t:= t't M 2 "F ACTION R CARE 00"' KEY a 1 _.... 00000000 Or-pp`MIT NO l..O YR TYPE VALUE 1"'�.:'_.[[`__Y MO Vrr % >._ P hIP'•f.ffr!EMO( � r•+�zt,n�_irttii_i_ �"�_..l��.!�11 t •.••!yJ 1 !41 ! (�\ 1 ! I�•Ir� v'Y^i i...•y:.._ t_r1"•. S.F 1 t�-I�.J t i"'l 1��..:! 1! !k!:...'i'v i� .i.•i._i lL..i i.:i..ii fi',i_i'i , l • f J _.TO _ t =DATEFROMOF LLJ �•N W SIGNED h ; �f1GEHf1 � ��iar{� .a M Aaa�� rt wariT��o� Ytns s AMPAD NO.23-176-400 SETS NO.23-376-200 SETS �� .� :` . � ` � lC '�� , , -�- : The Town of Barnstable iAP?WABiZ i6 Q. � Department of Health, Safety and Environmental Services " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner November 8, 1994 John M.Lovely,Esquire Gelerman and Cashman 270 Bridge Street Dedham,MA 02026 Re: 375 Sea Street,Hyannis,MA Dear Mr.Lovely: This office is in receipt Gf a complain!regarding the property located at 375 Sea Street,Hyannis, Massachusetts. Please note that the attached advertisement from the November 8, 1994 Cape Cod Times advertises the property as a five unit apartment building. This office has no record of a building permit authorizing five units. Please contact me immediately regarding this matter. My office hours are 8:00-9:30 a.m.and 3:00- 4:30 p.m.,Monday through Friday. Very truly yours, Gloria M. Urenas Zoning Enforcement Officer GMU/km CERTIFIED MAIL P 015 496 592 R.R.R. E Shipping: ' Qo 601V 3$5 Sea Street B Phone: (508) 775-04 Hyannis, Massachusetts FAX: (508) 775-78 Massa ? 5 _ U451 Mailing: P.O. Sox 486 Hyannisport, MA 02647 F A X TRANSMITTAL DATE: TIME: ATTN: FAX NUMBER: � REF. NO.- OUR REF. NO: SUBJECT: TRANSMITTED: _ as requested for your Information for your action for your immediate action COMMENTS: FROM: COPIES TO: NUMBER OF PAGES SENT, INCLUDING TRANSMITTAL: .. _ Please notify us of any discrepancies-immediately. .4 N. ac m -Q ireagram� ��e(1 a� CD�Fe -- .yFioa-�.+cry1Pi;.rs.-a••.:a�a��i�=sisw?",r�.'vJltsalP."^k"�s �� L.=�.- riA i � _ ORTG I ,. 3 . t ? se ■rl Hyannt menwt A' uln CnV�la :a�".s••: L,sa7 � eta',. �� io �_- k In u '� ��7 }�VV� iL,/��Y ■" •.is 1. i >�< Jt nixi 3`�� : =.:.• ...... - .sr. 1�. '' �"1✓y'a....'.._ C Y-a w rc x:10;39&sfi��i�and�alkfngd�ance iabea� �. �i •.f- 2 2 t>edroorn �; 2 ° ; e Ze'.P. iag' ' streef ctig 8�Sit ,#�aS o� �. Pa: .� w groom �i ,effia � �. �.. -�,� ,.� .� ,. n101�3t��AMs�a�e� y�t4� gu�e}� fe�d ;, a v •.a Zqc- ?` ,� �.. y�'`. i�'�•�Q'J�LR� '�,L�'•Is.0f!it i l03I L - biddersafi� IVlort a Retere ,iJ1/�w. 4 ..n 4�� 99. :,� Of Ba�nstable Reg-#}' t O�The `•r � n� i�•s.•��„•wu'e'. lea1eslCd i•�x.�+V^:�.r ••`$-a �" r :a " 5 u M_.�q V�i jddZ!�, .r„'n/�„per: N �yq. . -q,� t� �F Vie+ ,� i i .y 2. �j}.IS � �61`LG �. 9� aistrierScr;i a ifibim9ace-a sai a witt�iri f _ '�;a�..r•ai,�•Y,•.:-" .r;:;rg�.i.'i'•, ac'.�f �°'+'Se ��M. 30 aysr Al!a eG terms io�e am,ouLO rioeii a sale. -- LomVp Esq.; Gelecmar? Lnsao. AA EST 'T ko LO -- 4 str EatmouthM. q•.otr Lt „$a�agr ! co R'CIL F� d�t 139.4` t TO BARNS iA'S 27SEn -6 11 ` xq 3¢I hl~+' Y<Y"y*.H• ._.�.;.3•+Y.3ei 4 . F !O.U _ _a , August 26, 2012 , Mr. Tom Perry, CBO Building Ccr—mmissioner 200 Main Street Hyannis, AMA 02601 RE: Lowney Property, 377 Sea Street, Hyannis, MA''. . , Dear Mr. Perry: It is my understanding ttaat there has been some �. confusion regarding , the status .uof, ,my property at 377 Sea ' Street 1. in Hyannis. I have,,, been'.,-under the 00 ampress on "`.for 'many years that -it zsF: <a two'., . f,ami' ., ,)Q `=, . o house, It was rented as ,a two family house !. We have applied fo`r construction 'permits several; times as a two family house. We have paid real estate taxes as a two family house and there have been two to three electric f meters as well as furnaces because the house was split into ,two and .three .units at one time. — I understand that you wanted to know the names•-.of ' the parties ,who. have rented this dwelling in the 'past three years. I can verify that P_pt. #1 at 377 Sea_ Center was occupied from January of 2003 to February of 2010 ' by Mrs. Marcia Hawley. She resided there until, her death. The other •tenant 'who resided there from January of 2004 to. August of .�2010 :was Mrs. Hatsteat.• Mrs . Hatsteat is legally, blind and' had to be moved to another facility.. There. was also •'a , third party in Apt . #2 that resided there until 1996, , along with the two above-mentioned names; a. Rodrigues.. She ,left, because•,;there was ' a ` problem where she had r:el.atives coming with--a pit' buIT, $' do`g and, it. was frightening area- residents. It is :m un of aiiding "that. , this is,- ade•quate:.:- establish the property .as a _twos-famil house. -,,' g, @Bed O LL V099-809 uo4diJDsuel a3W Wb£Z L Z lOZ 0£ 6ny Mr, 1'o. Perry, ,tBo } RE; Lownev ?rcpe y ..' w Page lwc r r If you need any other information, please. contact me at . the enclosed address. Thanking you in advance, , ?(• pal. , , Mrs. 'Irene- Lo-o iey /met I If n r 9 a6ed 0 Q V099-K9 uor}duDsuei 03W wvE-e:L Z z OE 6ny UNITED STATES POSTAL SERVICE First-Class MailPostage&Fees Paid USPS Permit No.G-10 •Print your name, address, and ZIP Code in this box • TOWN OF BARKSTABLE BU I L D I N G D 1 V I S I ON 367 MAIN ST H'YANNI S Mk' 02601 i i i I I i i jSENDER: �t7 ■Complete items 1 and/or 2 for additional services. I also Wish to receive the M m aComplete items 3,4a,and 4b. following services(for an I 4) ■Print your name and address on the reverse of this form so that we can return this extra fee): .. card to you. d d ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address M permit. ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N ■The Return Receipt will show to whom the article was delivered and the date a C delivered. Consult postmaster for fee. 0 v 3.Article Addressed to: 4a.Article Number d i d P 229 805 304 cI N Charles & Irene Lowney 52 Whittier d qb.Service Type «' i 0 ttier Road 0 Milton- , MA 02186 ❑ Registered ffkertified M 1 i N 0� i ❑ Express Mail ❑ Insured ❑ Return Receipt for Merchandise ❑ COD 0 7.Date of Delivery g 7 i 5 5.Received By: (Print Name) 8.Addressee's Address(Only if requested c W and fee is paid) t C ¢ � I r.a ature:(Addressee orAgent) X I ,P-9*o 'f, Decembe 994 Domestic Return Receipt Iowa The Town of Barnstable RARNRUBM KAM Department of Health, Safety and Environmental Services " Building Division 367 Main Street;Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner May 7, 1996 Charles and Irene Lowney �Ihittier Road Milton, MA 02186 Re: 377 Sea Street, Hyannis,MA Dear Mr. and Mrs. Lowney: This is to inform you that, unless we hear from you within seven(7) days from your receipt of this letter, no building permits will be issued for the repair of property at 377 Sea Street, Hyannis. We have tried several times to reach you to no avail. All mail has been returned. Very truly yours, Gloria M. Urenas Zoning Enforcement Officer GMUnb 07 cc: Barnstable Housing Authority C CERTIFIED MAIL P 229 805 304IVA- / L i Gov P 229 805 302 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail See reverse Sentto Lowne Street&Number Post office,State,&ZIP Code Postage Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to Whom&Date Delivered a Return Receipt Slowing to Whom, Q Date,&Addressee's Address o TOTAL Postage&Fees s CO)co Postmark or Date 0 LL rn M Stick postage stamps to article to cover First-Class postage,certified mall fee,and charges for any selected optional services(See front). 1.If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipf,attached, and present the article at a post office service y window or hand it to your rural carer(no extra charge). In 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the 9) return address of the article,date,detach,and retain the receipt,and mail the article. uO 3. If you want a return receipt,write the certified mail number and your name and address rn on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee,endorse RESTRICTED DELIVERY on the front of the article. 00 ch 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. ko 6. Save this receipt and present it if you make an inquiry. n. °F WE The .Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner April 10, 1996 Charles and Irene Lowney 80 Whittier Road Milton,MA 02186 Re: 377 Sea_Stree-�t,Hyannis;MA Dear Mr.and Mrs.Lowney: This is to inform you that,unless we hear from you within seven(7)days from your receipt of this letter, no building permits will be issued for the repair of property at 377 Sea Street,Hyannis. We have tried several times to reach you,to no avail,all mail has been returned. Very truly yours, Gloria M.Urenas Zoning Enforcement Officer GMU/km cc: Barnstable Housing Authority CERTIFIED MAIL P 229 805 302 R.R.R. R306 043 . TAX ACCOUNTING 22062- 213682 RECEIPT NO . PAYMENT TAX YEAR/B .G . AMOUNT DATE TYPE PID 0 1ST DUE 9501 1 ,076 .00 110894 1 00000000 FULL DUE 9501 1 ,076 .00 110894 F 00000000 OWNER------ TAX DUE 1 ,076 .00 OUTSTANDING 1 ,076 .00 SOUZA , PHILLIP R & MARIE M TAX CODE 400 CITY 07 DISTRICTS HY -----••--JANUARY 1 OWNER------ ACTION MORTGAGE CODE 0000 SOUZA , PHILLIP R & MARIE M ----CERTIFIED VALUES----- --___--_..CURRENT OWNER--------- TAX EXEMPT .00 SOUZA , PHILLIP R & MARIE M TAXABLE .00 50 WINTERGREEN CIRCLE RESIDENT 'L 152 ,300 .00 OST ERV IL.LE MA 02655 'TAXABLE 1.S2,300 .00 0000 OPEN SPACE .00 TAXABLE .00 -LEGAL_ DESCRIPTION--••-— COMMERCIAL, .00 #LAND . 1 46,800 TAXABLE .00 #BLDG( S )-CARD-1 1 105 ,500 INDUSTRIAL .00 #PL. 375 SEA ST HY `1'AXABL.E .00 #DL LOT A LC 10013-B #RR 1447 0065 1093=0163 LEGAL DESC CONT 'D *'LATEST ACTION 1994 q2- yi-/ >1 XMT ? 'ROPERTY ADDRESS STATE. - - ZONING. 'DISTRICT CODE ``SP-DISTS-(DATE PRINTED(CLASS I PCs I _� NBHD I oiEy IJO 0377 SEA STREET 07 IRS 400 07HY. 9 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS TY - UNIT ADJD.UNIT Lana ay/Dale - Sze Dmenslon - ACRES/UNITS VALUE - Dcpo S QU2" 'H I L L I P R' $ -ARIE M� . ADJ. COND. P.E PRICE iCD. LOCiYR SEC CLASS PRICE #LAND 1 _ 42,200 r-- ,CARDS IN ACCOUNT 10 113LDG.SIT 1 X' .2x =10 224 -64999,9 145599.9 .29 4220049LDG(S)-CARD-1 1 • 121,P300 01 OF' 01 A #PL 375 SEA ST HY COST 163500- N ISATHS 2.1 U X j C= 100 I 9500.10C 9500.0 1100 I 9500 '3 #DL LOT A LC` 10013-B MARKET '165100 D IFIRErLA[E U X i C= 100 3100.0d . 3100.0 - 1.00 I 3100 .3 #RR: ;1447 0065 1093 0163 IINCOME AI i - i I I, #SR NORRIS STREET IUSE p I I . I 1` I (APPRAISED'Vi4L1€` !A 163.500 r U., I I I f (PARCEL`SUMMARY AND LDGS 121300 -42200 hh I I I 0 IMPS = E I I I I - i I" (TOTAL 1635007 IN CNST DEED I j BREFERE T ,aII DA Rwa RIO R YEAR VALUE ' . �,o YID - S.;_Po-r 8 J AND 42200 C103121 OLDGS C855 12130D 52. ^010C ITOTAL 163500 _ � I I BUILDING PERMIT - Number . Ole Type - -Amount 42200 LAND LAND-A DJ . i INCOME I SE i SP-OLDS i FEATURES( BLD-ADJS UNITS I 12600 a Class Const Total Year Built Norm, DDs� I Un Is Units Rase Rate I Adj.Rate A 1 Age Depr, Cono. CND Lot 14p R G Rep[ Cost New Aol.Repl Value Stories Height I Rooms Rms Babe A Fi.. I 02C+ 000 110 110 60.25 66.28 DO 70 24 7n4 95 69 175843 121300 1.4 12 6 2.1 10.0 Description Rate Squara Feel Repl,Cost MKT.INDEX: 1.D0 IMP.BY/DATE: SCALE: 1100.28 ELEMENTS CODE CONSTRUCTION DETAIL 3 SAS . 100 66.28 90D 59652 GROSS AREA 3063 TWO FAMILY DWELLING- CNST GP-00 i FOP 35 23.20 119 2761 , *--22-* STYLE 10 LD STYLE 0.0 1S8 100 66.28 91 6031 ! ES.IGN ADJMT_ 02DESIGN ADJUST 10.0 1 FSF 90 59.65 468 27916 32 32 E_XTER.WA_LLS 01 OOD FRAME O.fl ' 1UA,. 105 69.59 704 48991 : ! 1UA ! EAT%AC TTPE 04 IL---------------0.0 614 30 19.88 900 1 7892 *--22-*12* - ---- - ---------------0.0 f NTER.FINI5N 00! _' NTER.LATOUT 61 p=0 --------------- -- i ; FSF! INTER.QUA LTY 02'AME AS EXTER 0.0 39-39 FLbVR STRUtT -i10 ------------------ 0.0 D W ! ! E LOOR IaVER-- -00 ---.---- -.---------- - E T0191 Areas Au,. 119 ease_ 216 3 ! ! 0 0 F-TYPE---- 00 0.0 - ----------------- 0.0 T BUILDINGDIMEN$IONS ! ± - LtCTR A ICL--- _00 ------------------p-.0 SAS W30 FOP W07 N17 E07 S17 .. *-*10*12*-* OUA(DAT=14�1- --------- A ------�q�g SAS N30 1SB W07 S13 E07 N13 .. 13! B14 ! -`_------------ -- --------`--`---------- 8AS E10 FSF N39 1UA W22 N32 E22 1S8 BASE30 L -----NEIGHBORH000 60AC NIS HTAN - S32 .. FSF E12 S39 W12 .. SAS 17± LAND TOTAL: MARKET E20 S30. .. 614 N30 W30 S30 E30 3 ± ! PARCEL 42200 163500, FOP---30--X AREA - : 10396 VARIANCE +0 +_1473 STANDARD 25 °F THE T°� The Town of Barnstable • BARNSTABLE, • 9� MAW. Department of Health Safety and Environmental Services i°rFc eno't" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner J April 10, 1996 Charles and Irene Lowney 80 Whittier Road Milton,MA 02186 Re: 377 Sea Street,Hyannis,MA Dear Mr.and Mrs.Lowney: This is to inform you that,unless we hear from you within seven(7)days from your receipt of this letter, no building permits will be issued for the repair of property at 377 Sea Street,Hyannis. We have tried several times to reach you,to no avail,all mail has been returned. Very truly yours, Gloria M.Urenas Zoning Enforcement Officer GMU/km cc: Barnstable Housing Authority CERTIFIED MAIL P 229 805 302 R.R.R. r r jKRr "9f r y rp•- w..:,..a 1 q i �, t :4x v' .Ma .:.a ,� ty .x, s e�' i. s •s'w4 ':_.. Y / x #S. {�y.p x i hh+R' u r s� 4,i a YS t' t.+`is -W •; ,e ,,r,'f r.. n dp s -. •� 6• -' s '� x '' :Ir r.n M�1� ra -Yr �{� -.4v0±r a .F'.� •`�ry'$isi'f`•�,'aa',�',Lt�,s.'re. '.; rsi.l >' S¢ :, a ✓ x4 t. w ,. 1� .,� '4 ,:3 - ?'°�.' ij' ." fY 7°' z�y 4}�.';,?L •S. r Sx r§rP >,Jn tS",riy� J.STGi sue' >.'s: .,•i: Y,0Xs S: r.:� i •x -,, rt -•'..' +',.,.- -4- f ,The Town of Barnstable_ M� t :Department of Health Safety an'd Environmental ' '' . s .4 Service Building Division sst d 367 Main Street,Hyannis,MA 02601 4 r - r r p„ Office: 508-790-6227 508-790 z Ralph Crossen s 6230 Building Commissioner r Inspection Correction Notice72 - z,* r t q r h t Type of Inspection y Location �"� SL 'ST. - , Permit Number -0 �— Owner l—O ��4 Builder rnE1�1C1�1J r' 0�'�= Y One notice to remain on jobsite, one notice on file in Building Department The following items need correcting ra y At�lt� fS // `.A S k� J61 ' v C 2-Z`' ,� - ate `1� me „ iTC , Please call: 508 790 6227 for reeinspection. Insi ected b � 2 - rf: P Y C Date STATE PROPERTY ADDRESS I I ZONING I DISTRICT CODE 'SP-DISTS.I DATE PRINTED I CLASS I PCS I NBHD FICEL IDENTIFICATIQbI NUMRERKEY NO. 0377 SEA STREET 07 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS TY UNIT ADJ'D.UNIT S O U Z A♦ P H I L L I P R & M A R I E M M A P- Laatl By/Date s:e amenson LOC./Y R.SPEC.CLASS ADJ- COND. P PRICE PRICE ACRES/UNITS VALUE Desctiptlon CD. FF.De ,Acras E #LAN D 1 4 6 i 8 0 0 CARDS IN ACCOUNT - L 10 18LDG.SIT 1 X .29 =10c 224 71999.9S 161279.9 .29 46300 #BLDG(S)-CARD-1 1 105P500 01 OF 01 A #PL 375 SEA ST NY N BATHS 2.1 U X C= 100 8156.1 8156.1 1.00 8200 3 #DL LOT A LC 10013-B MARKET 165100 D FIREPLACE U x C= 100 3069.5 3069.5C 1.00 3100 8 #RR 1447 0065 1093 0163 INCOME - #SR NORRIS STREET USE A APPRAISED VALUE A 152.300 A A i PARCEL SUMMARY T S BLDGS 105500 46800 A T - 0-IMPS M TOTAL 152300 F E N CNST E N DEED REFERENCE Type DATE J0 Ra dgitl PRIOR YEAR VALUE A T Boots 9a '":' p sales PNoe LAND 46800 MO. Vr. T S C1031 P a 211 I108/85 175000 BLDGS 105500 U C85552 :00/00 TOTAL 152300 R E BUILDING PERMIT S NumDer Data Type Amount LAND LAND-ADJ INC ME SE SP-BLDS FEATURE BLD-ADDS UNITS 46800 11300 Con st. Tol al Vear Built Norm. OOsv. Class Units Umis Base Rate Atll.Rate Ai 11g Age Dept. Contl. CND. Loc. %R.G. Rapt.Cost New Atlj.Repl.Value Stones Heig"I Rooms Rms.Bats .Fia_ Pertywall F.c. 02C+ 000 110 110 53.10 58.41 00 70 21 78 90 68 155163 105500 1.4 12 6 2.1 10.0 Descriplion Rale Square Feel Repl.Cost MKT.INDEX: 1-00 IMP.BY/DATE: / SCALE: 1/00-2$ ELEMENTS CODE CONSTRUCTION DETAIL S BAS 100 58.41 900 52569 GROSS AREA 3063 TWO FAMILY DWELLING CNST GP:00 T FOP 35 20.44 119 2432 *-- 2-* STYLE 1 OLD STYLE, 0. R 1S8 100 58.41 91 5315 ! ! DESIGN A6JMT 0 DESIGN ADJUST 10. F S F 90 52.57 468 24603 32 32 E)( ER-VkCLS _01W066---FRAME---------------- 0.- C 1UA 105 61.33 704 43176 ! 1UA ! HEAT/AC TYPE 0 0_IL 0. T 814 30 17.52 900 15768 *--22-*12* I NYE R.FINISH 0 - - -------0.- ! ! INTER.LAYOUT 01- - 0. U L FSF! INTER_QUATY 02SAME AS__EXT_ER. 6. R 39 39 fL60R STkUCT 00 0. A -- ----= - - L p W ! ! EFLOLOOR COVER- -- 0 ----------------- 0. Total Areas Au.- 1 1 9 Basa 21 6 3 ! ! R 0 tF F T Y P E 0 0._ E BUILDING DIMENSIONS 1 1 E L EC T P-1-C A L- - -U T SAS W30 FOP W07 N17 E07 S17 .. *-*10*12*-* BAS N30 1S8 w07 S13 E07 N13 .. 13! 814 ! -------------- -- --------------------- BAS E10 FSF N39 1UA W22 N32 E22 1S8 BASE30 -9E-1 GHBOIF OOD 60A2 HYANNIS L S32 FSF E12 S39 W12 BAS 17! ! LAND TOTAL MARKET E20 S30 .. 814 N30 W30 S30 E30 ! ! ! PARCEL 46800 152300 .. FOP---30--x AREA 10396 VARIANCE FO +1365 STANDARD 25 S TOPOGRAPHY 1 LEVEL * TOPOGRAPHY * UTILITIES 2 PUB WATER * UTILITIES 4 GAS * UTILITIES 6 SEPTIC ST FEATURE 1 PAVED * ST FEATURE 6 SIDEWALK * ST FEATURE * ST. COND. * TRAFFIC 1 LIGHT DWELL LOC. 2 MIDDLE * LOCATION * AMENITIES * AMENITIES * NUISANCES NUISANCES * LAW PCE READY MIXED ZONCRETE CO. 88-8002 TOLL FREE 1-800-633-8889 }_ ! 171 I � i I ji ��,r I i =APR 16 a� _ _4 SERVING CAPE COD N E:�0 00NE CALL.:. I F,OR DATE TIM �� M OF PHONE YOUR CALL: AREA OOE NUMBER EXTEN - i 5 EASE CALL: MESSAGE WILLCALI` i �AGAlN GAME T0,>'. C � 4NANTS•TO`•, SEE YOU SIGNED OfljllVerSar 4;00; r ' " ,� ..� ..",.. \ 4 '- � '�~ ;` .. :, The Connnronwealth of Alassachusetfs Department of ludt(strial Accidents t ' Office ofiffvesUyaUons . 600 Washing-ton Street Boston,Alas. 02111 Workers' Compensation Insurance Affidavit A.�nhcant Informations Please PRINT......' name•`:�Gi 1�� t-J i tic— e. 4,n S location s t;,�Y� ��2 c•t, a,-n V1 a--S 12hone# I am a hYmeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity a?�yc�•mrva+crpv: •, gA�..., ?r'"xP�r..:teM� .. Sa.L fiw_� '9.:y"'°r '..,, a•,.ace '�.:a.+uiii..�.rSiasa...ouaw. Ert am an employer �providing workers' compensation for my employees working on this job. company name: `�lam address: c�JS Ste' city e\`S phone#: insurance o � /�— Z^I cu,,45 Ijolicy# 60qf71-f� ,-,.. ..,, e»:• ... �trr.. -.at s.,,_..yDp-•eyfr !.roiw+*-tien++awril..ws.a-� .,s,.. 'tau' ;.'"!!t..,�f+...�,>+..... 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: - address: may: phone#: insurance co. policy# i_...,.. a irc:nz«:.;• ?1�cu��•-r Y'.... „Ht7.1 "1c,^,xre•"+?R+'7w.=^. 'F7'.+',r iynw�ar�_ :.^K., s •--•.'vU'f�aL,x,2 r..Ce... ., �.190o�it�-�c�'•-.:.�...j�...._..�s_. art' •Sri�'�',�^•�'tti5+tl• '4�:a:.ita±w company name: address: city: phone#• insurance co. policy# :Attach additional sheet if necessg L.—i "+r" ».* r af- ._ ri�i _•_ pt'r°'x, "+ - , F c�i, Fstilure to secure coverage as required under Section 25A of 11iGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NYORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the D1A for coverage verification. 1 do herebt•certify under the pains and penalties of perjure that the information provided above is true and correct. Signatures r�� — Date _ �7/9 6 Print name 15v`tL 5 �' �' �--�— An!5- Phone# 175 1560 A..* ?official use only do not write in this area to be compacted by city or town official city or town: permit/license# nBuilding Department Licensing Board check if immediate response is required QSelectmen's Office plicalth Department contact person: phone#; nOther -u -::�_--r-�.,-��:�• .. __.,-:W .:tea. . ... _.. (revised 3/9;PJAj Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted tom the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An en►pinrer 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 emplover, or the receiver or trustee of-an individual , partnership, association or other legal entity, employing employees. However the owner of a dwellina, 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 emplover. MGL chapter 152 section 25 also states that even,state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for an, applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of industrial Accidents for confirmation of insurance coverage. , Also be sure to sign and date 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. - - - # �11 77 Y Cltv-or Tov%,ns Please be sure that the affidavit is complete and printed legibly. Tile 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. r.- awa.c-rr,�• .,...... .—•:•vn -.--�rrwagr-rw ,.,..w...s :-ce.. �---esn. '4'�.^—�^"''."' x"�w:.ra..s•Yas'+rn..rrK"n" *w+"+'+rTsw+'s> The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 , phone#: (617) 727-4900 ext. 406, 409 or 375 °F VE t ' -•'Y°� The Town of Barnstable MAM Department of Health Safety and Environmental Services '�Eo ram" Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner Fax: 508-790-6230 For office use only Permit no. Date_-----. AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building a adjacent o� i such residence or building be done by registered dwellingt not more than four arontracto with structures which are add certain exceptions,along-with other requirements. Type of Work: L Est.Cost �r Address of Work: -p3 Owner's Names Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded bylaw Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that:OWNERS PULLING THEIR I ABLE PERMIT HOME lMPRO MENT WORK. D OR DEALING WITH ORNOT HAVE CONTRACTORS FOR APPL ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. P � k f�-✓ Registration No. Date Contractor Name OR Owner's Name ~ Assessor's Office(1st floor) Map Lot C Permit# 1� .3 Conservation Office(4th floor) Date Issued n° 21606 'V>P40 . Sc-'WeK A cc7 th(3rd floor)(8:3b-9:30/1:00- 2.00) 7 g Y�� )gee eid Engineering Dept.(3rd floor) House -3-2 7 e-b " Planning ept.(1st floor/School Admin. Bldg.) BARNSI'ABLE. Definiti proved by Planning Board 19 b q TOWN OF rBARNSTABLE Building Permit Application Pr 'ect Address 377 Sea Street C1:>0,1 LoT A Village Hyannis Owner Irene Lowney Address 123.4 Hyde Park AvP , Milton , Ma . Telephone 617-364-2420 ' Permit Request repair and replace roofing materials k-5—cZ • —4 Total 1 Story Area(include 1 story garages&decks) square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ Q p,,�q . Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use rental property Proposed Use Gam P Construction Type wood frame Commercial Residential Dwelling Type: Single Family Two Family yes Multi-Family Age of Existing Structure 19 0 0? Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Douglas L . williams dba/ American Telephone Number 775-1500 lfvuM • Address 35 Winter Street , Hyannis License# V Home Improvement Contractor# Worker's Compensation# tA)C o��d 151 q'-7. NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r 1rn`5 SIGNATURE DATE `7 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 5 b 1 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL �. GAS: ROUGH FINAL FINAL BUILDING ) DATE CLOSED OUT J 4 - ASSOCIATION PLAN NO. -! ,: t t /� G� _ , �� a - �: ,� I ''�_�„�_ k ,o(I RESIDENTIAL PROPERTY .P NO. LOT NO. FIRE DISTRICT SUMMARY STREET 375 Sea St. Hyannis �L 3 LAND - V �3 H 01 BLDGS. OWNER TOTAL „^ LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. * L B p TOTAL LiiYIerr- 'Rcrjsster •278 LAND � BLDGS. TOTAL FLAND Lowney, Irene & Charles 5-22-81 Ctf. 5552 ($45,0 _ p ) 0) /� Q 7—O ,j �t D 1 S(� TOTAL LAND BLDGS. TOTAL L.. LAND BLDGS. O) TOTAL — LAND ERIOR INSPECTED: f BLDGS. TOTAL rE: ADGLS /3 7� ACREAGE COMPUT/�fffb�- LAND TYPE # OF ACRES PRICE — - _T TAL DEPR. VALUE •—� a-� LOT LAND 5y /o .o? o©� �'io-a P� ED FRONT.` BLDGS. 0) REAR TOTAL ! l! >S&SPROUT FRONT ' LAND REAR BLDGS. t - rn FRONT TOTAL REAR LAND BLDGS. TOTAL is LAND . i BLDGS. { LOT COMPUTATIONS LAND FACTORS TOTAL NT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE ,..TOTAL DEPR. COR. INF. VALUE HILLY, TOWN SEWER LAND ROUGH TOWN,WATER BLDGS. ; /Pj{7 HIGH" GRAVEL RD. TOTAL I( LOW. ' DIRT RD. t rK .LAND. 1 I. SWAMPY NO RD. - *:'� BLDGS. TOTAL' _ `..t.r -. NITEATOWN OF BARNSTABL , TFORD ;uM. ..- . -.,......- ;r,... ... - ... KToilet :r - +.. �. , :�., . : ra ;aFOI�NDATION �.: TBSMT &, TI . .,,- .a �a ... ,. - ,.. ", •. A[`ID,exL 'C ,.. Y.. 'kwet•<; ,^ +, x: .f ,+ .ems..a-3 a: a y m, Fln'Bsmt Are cox 2:-Walls , .t,i'"£ � .. fi". Riw� S #;'&BLDG;'COST1�Xti ..,., �. . ..,• - -� i^v;„ ♦�x.y„4'', �. $ n sett... YC,,.Walls . =a Bsmt Ree;Raom rr Bath- Bsmtx * ;` �f DATEr " m.Gara e: er Ext c" y � 4 ConcrSlab„ r Bs t H Walls yi, 'PORCRBrick Walls Attic FL&Stairs om ' Roof` RENT • '�'fit: - }� ff f- Stone Walls Fin.Attie r=' ,,, Two Fist.Bath s• w r Floors Piers INTERIOR FINISH Lavatory Extra y e? Bsmt F •, 1' 2 3 Sink ' f• Attie s/i 1/x , 1/4 Plaster Water Cie.Extra s 1 EXTERIOR.WALLS Knotty Pine Water Only " Double Siding Plywood No Plumbing - Bsmt.Fin. Single Siding PlasterKoard Int.Fin. — .Q ShinglesL000, TILING Iva Con..Blk. G, F P Bath FI. Heat - /�o Q .2 11/• GL. Face Brk.On Int:Layout Bath FI.&Wains. - Auto Ht.Unit Veneer Int.Cond. Bath Fl.&Walls Fireplace 12 �. Com.Brk.On HEATING Toilet Rm.FI.,-' _ Plumbing '-Solid Hot Air Toilet Rm.FI.&Wains. I 30 — Tiling Steam' Toilet Rm.FI.&Walla .j Blanket Ins. Hot Water St-Shower - , Total �// Roof Ins. Air Cond. Tub Area ' 9-Floor Furn. 3 G ROOFING COMPUTATIONS. 1,� Asph.Shingle Pipeless Furn. -S.F. v?3©� 1 /7 / Wood Shingle No Heat S.F. QQzz Asbs.Shingle Oil Burner C0AA1 �/� S.F. _ Slate Coal Stoker G 561 Tile Gas S F OUTBUILDINGS ROOF PE Electric S.F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 516 7 8 9 10 MEASUR Gable . Flat Hip Mansard FIREPLACES S.F. Pier Found. Floor Gambrel Fireplace Stack Wall Found. 0.H.Door LISTEC FLOORS Fireplace Sgle.Sdg. Roll Roofing <u j Conc. LIGHTING Dble.Sdg. Shingle Roof Earth No Elect. ATE Shingle Walls Plumbing j Pine ' Cement Blk. Electric Hardwood ROOMS n Brick Int.Finish PRICE[ 7 Asph.Tile Bsmt. 1st •>' L7 TOTAL (D � /) Single 2nd 3rd FACTOR O 3 (e f REPLACEMENT ' I OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. j DWLG 4 C LIN V .Z S r-A /4 , } 3 26 I o ..i 2 i 3 4 i — 1 5 6 i — } 7 :I 6 9 i _ s TOTAL UNITED STATES POSTAL SERVICE i Official Business PENALTY FOR PRIVATE USE TO AVOID PAYME US MAIL OF POSTAGE,$300 J I I Print your name, address and ZIP Code here • Town of Barnstable • I Building Division I 367 Main Street Hyannis, MA 02601 I I C t 41 SENDER: y • Complete items 1 and/or 2 for additional services. I also wish to receive the y Complete items 3,and 4a&b. following services.(for an extra • Print your name and address-on the reverse of this form so that we can feel: > 0) return this card to you. m • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address y does not permit. t • Write"Return Receipt Requested"on the mailpiece below the article number. a 2. ❑ Restricted Delivery • T-`a Return Receipt will show to whom the article was delivered and the date V c delivered. Consult postmaster for fee. cc •a 3. Article Addressed to: 4a. Article Number '= — P 015 496 592 d John M. Lovely, Esq. ► 4b. Service Type E Gelerman & Cashman ¢ p ❑ Registered ❑ Insured 270 Bridge St. 10 Certified ❑ COD c Dedham, MA 02026 El Express Mail ❑ Return Receipt for p� Merchandise 7. Dante of Delivery w- a IN mr o 5. Signature (Addressee) 8. Addressee's Address(Only if requested x and fee is paid) H t cc 6. 'gnature (Agen ~ 0 PS Form 3P 1, December 1991 *U.S.GPO:1993—W2-714 DOMESTIC RETURN RECEIPT P 015 496 592 Receipt for.. is rtifie,&Mm 5L*. No Insurance Coverage Provided Do not use for International Mail (See Reverse) Sent to o n M. L v l ES Street St2x}7�0�,,dBr-Td e Street P.O.,-UCQIlc3tC.dMA 02026 Postage Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing p) to Whom&Date Delivered m Return Receipt Showing to Whom, C Data, and Addressee's Address 7 TOTAL Postage C &Fees C Postmark or Date M E O U— tn a i STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address ' leaving the receipt attach'bd and present the article at a post office service window or hand it to your rural carrier(no extra charge). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date,detach and retain the receipt,and mail the article. N 3. If you want a return receipt,write the certified mail number and your name and address on a I return receipt card,Form 3811,and attach it to the front of the article by means of the gummed < .� ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. O O 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. E 6 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL return receipt is requested,check the applicable blocks in item 1 of Form 3811. a 6. Save this receipt and present it if you make inquiry. 102595-93-Z-0478 The Town of Barnstable snMMABM ' C Department of Health, Safety and Environmental Services 16539. " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crosse Fax: 508-775-3344 Building Commissioner November 8, 1994 John M.Lovely,Esquire Gelerman and Cashman 270 Bridge Street Dedham,MA 02026 Re: 375 Sea Street,Hyannis,MA Dear Attorney Lovely: This office is in receipt of a complaint regarding the property located at 375 Sea Street,Hyannis, Massachusetts. The attached advertisement from the November 8, 1994 Cape Cod Times advertises the property as a five unit apartment building. This office has no record of a building permit authorizing five units.. Please contact me immediately regarding this matter. My office hours are 8:00-9:30 a.m.and 3:00- 4:30 p.m.,Monday through Friday. Very truly yours, Gloria M.Urenas Zoning Enforcement Officer GMU/km enclosure i CERTIFIED MAIL P 015 496 592 RRR Q941108A INIMIIIIIIIN n ter: ,a S"ptaceotsaid'Batas�que imn�cw�.�� ,I + �. RatIN up, wrence, ,„ ,. • cs e��, , �220 8�., .S Ches4�wt�'I� MA .<�t OAR �� -.•;�� •.,,.. �.TSW�FEifw'�or_"n�(.- at•Y.'Oi:��••Y � - ti �� *� :C:�Y� `�' - "`'`-`�k;+YtfyF;'�: : �`=-°'� �.. �`�:`•�'�'`� Y�,'s.�.J,.� �" !i 'Y' 1 r^1•^''• - -,. 1 � ;��'"`-t;�at+u!,�[:��S:Y.p".,'�=4��"i':aaiC��:�a.�`•�::4�sJ':<�•r•' '7.'�,a•ii�'. w:;:� is�.. . Naveb_er-22=1994'a 1 AM=_,: •' i. '•Z y }lpprox • •f- k"�hZ- .i.g•'ji_be' t.§..b. .a.ch�e;rsi039s tnd al .a& l eod s-wz>.73n_V o swN @• - .. _ •f . - 6f area 3rz loved tij a 2 5 stojyyen buif�ir�g&,' Is- '� �' ". '"�"^` ' l bias oft strut pa. .rig _ 1 w Mw. room & OE�'.yp�'� "+�3c��i��+k� ♦r'W ) �.>.•�S 2'�"tw� C+ty.� F• i 4 .. Located a resrest arear~, 10.3Q:Ahr1 saw, Y� q� ''�.. No 372874'�Cert.t?f Tine 103i21 s : �iidderM N�ortgag' Reterer�ce�Doc .�.,_p� ,.1:A ,.. � ...N,t--= a MYerms Of SeW A d o - _ ° ti° p� ^�j_}� jjy7.�LrnrP R y�:.ram M� 1 y�y ►rca� i .�•-. ��• Ty y4T"�'.MY..!�ti�1�•/!a-.'. 1�. i..saY_•�'L �� $5 p �equ :by certii'ied bare.treas �s�or� _,. . :., s�Che�cft`atjimd&t9ac�oiSa�:Ba f _ . d y Ai!o er terms toffs an ,our�oed aJ qe.John Lo ` Esq Gelman � Casmas� 274 6LO .ndge,St 00 - -�. A •D.,edtia�.t�� .a .��.The M§rtgag (�1��-�' , . .. . x A FE'S'SALE TAT w 'LO S �Iil.Str � '',i `¢� -,• r � `'`'� 66 MPTpRi Fcda � overnber;�819g��.ro i r 1 ! i p � i d ----- ( z� 1 Z. 17 _ --- -o C C� i cca -Vti%tJ -� 0 b-H�'� t' , r Mr. Ralph Crossen Building Commissioner Town of Barnstable - Main St. Hyannis, MA. 02601 12/8/95 Dear Mr. Crossen, Regarding the property located at 375 Sea St., Hyannis. It is my observation and opinion that the property in question is not legally permitted as a 5 unit, multi family dwelling. At best, the property may be considered a duplex, although it's established date of conversion is most likely around1969, and probably was never actually permitted. The property was originally owned by Matty Shaunessey and Frederick Mycock, at which time the back building was a barn/work shop with an unfinished interior. They converted it to a summer crash pad and rented it to a bunch of kids from the Mill Hill and the Backside Saloon. They sold the property around 1978, by which time it's use had become accepted as duplex. (I am sure that there is no paperwork on this). The building was converted to a 5 unit apartment around 1986-7 by the current owners. The work was done by Gil Raposos, a family member of the current owners: I brought the situation to Joe DaLuzes attention that time, but nothing was done about it. I did not submit my objection in writing at that time (as Joe suggested), which I now regret. Per a later conversation with Joe, I was surprised to find out that the building inspector has no powers of enforcement unless the complaint was reported in writing. (Is this really true?) The issue that brought the 5 unit conversion to my attention was the installation of a 5 meter electric service, and that may provide a hard and fast date of conversion. When the property was advertised for auction, during the spring, it was advertised as a 5 unit rental. I protested to o a woman, 1 believe her name was Claire, in your office. At that time I followed up the phone call with a letter and a copy of the advertisement, that you should have in your files. The result of that call/letter was, I believe, the advertisement was amended to disclose the property as a two family, with three separate "rooms to let" in that they did not have kitchens. I did attend the auction and the property was "bought back" by the then and current owner. Now I find that the rooms have kitchens, and I am told that the owner has an agreement with the state for subsidized housing units. I feel this will continue to obligate the neighborhood to change. I feel that this has been a known infringement for a long time, and the owner should not be entitled to a hardship variance if applied for. This has been a deliberate illegal conversion and there should be no obligation on the town or neighbors part to allow continued use. As the only full time occupying abutter, I have discussed this property with the other neighbors. I know that my opinions expressed herein represent those of the other immediate abutters. This property has been a problem for years due to the unsupervised nature of its absentee ownership. If you wish to check with the Barnstable Police, I am sure you will find that this house has been a source of crack and other drugs. I have offered my house as a point of observation in the past. My wife and I became used to nightly traffic with cars in and out every 20 minutes or so, and I have had several confrontations with people parking in my yard at all hours of the day and night. I am keenly interested in this matter and would like to help if possible,.in any way. The dates that I refer to are quick recollections, but if required, I will be glad to do some research and confirm them more accurately. I would greatly appreciate it, if your office could keep me informed of any developments or changes in the status of this property. Sincerely, • J Craig Ashworth Ernest B. Norris& Son Inc. 385 Sea St. Hyannis, MA. 02601 775-0457 Assessor's Office(1st floor) Map Lot Permit# Conservation Office(4th floor) J l&,,�ILA ' '.A, 42 Date Issued Board of Health(3rd floor)(8:30-9:30/1:00- 2:OO�w Al Z.w" Z-05�*ee ` Engineering Dept. (3rd floor) House#1 zz �z� ac Planning Dept. 1st floor/School Admin. Bldg.) w II� MTO E BARNSTABLE. • O� Definit' Plan Appr v d by Planning Board 19 °'A . s6s9• • J' lE0�� TOWN OF BARNSTABLE ' 377 Building Permit Applicati on Project' reetA ress -' owen 4 21 31 V o Village ' /}rid U 1 S OwnerAfmS'J f-OW4151 Address 1�31 iz. dA. yyl iL7- ✓ RA Telephone f Permit Request V i O l C- `�`' //1��`- f .��i �/O JT �Uj��ttR�S� M 15 'TfL��n •-- .0 ��t►nf:��rn��—i>zi�z��'�� Z�l '��s�� fc�j�✓�� t- �r✓J � A M 1. --- -1-WIin Cx&eAb&-- 4-07 02 tie f 0 S . G is 2�t Total 1 Story Area(include 1 story garages&decks) square feetx1� � Total 2 Story Area(total of 1st&2nd stories) square feet C0 frfff V �j4 7-11 '? Estimated Project Cost $ Cop �� //);', flltyry- Zoning District `Z 3 Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals.Authorization Recorded Current Use 'TeSf-Daw77 -C-. Proposed Use UNC tWe cj- Construction Type WowD ;-ZA-rh� Commercial Residential Dwelling Type: Single Family Two Family Multi-Family tr o v iM Age of Existing Structure JL>0+ %/L7'112.S Basement Type: Finished -- Historic House Unfinished e'l elob CRAVO L_ Old King's Highway 0 Number of Baths 5 06 No.of Bedrooms 5�'1J�15 Total Room Count(not including baths) / First Floor---- Heat Type and Fuel - Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached'a Barn None tV&V4 Sheds Other —" Builder Information Name 6Z `CA-J ft WE�, ;JNC Telephone Number 715-1 S06 Address OS -License# CS• Gl (0 9 6 / � 1NlS, Nit � �u� Home Improvement Contractor# //l y5' Worker's Compensation# bi C Pm 1 Si y q NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L60,1Y. 4 I f --mom r& W maP 4 °�'" f�/�Zf G� tC* 6T&EK IDCA IFAIS z SIGNATURE L DATE / a?V BUILDING PERMIT DE IED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY ,PERMIT NO. DATE ISSUED MAP/PARCEL NO. - ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: 0UGH _FINAL ry ca� GAS: O. q t.j:GH FINAL . FINAL BUILDIN&.8. ��a I • -53 _ DATE CLOSED �w ASSOCIATION Pt-l�TsTO. o e Town of Barnstable � � I rvlces at ta DUALDepartment of Health Safety and Enviroo '6?9' Biding Division . 367 Main Steger,Hyannis MA 02601 Ralph Crosses 015 508-790-6227 BWIding Cotumission Fax: 508-775-33" For office use only Permit no Date / `( AFFIDAVIT HOME E"ROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,rmovation,mpair,modetai2tion.conversion. improvement..remmal. demolition. or eonsauction of an addition to tray preadsimg owner o=upied bnitding containing at least one but not more than four dwelling units or to SUaCtures which are to such residence or building be done by registered contractors.with certain=Vdo%along with other hazazdu�posal-------- Lead paint removal siding,windows,repair ESL Cost $20,000 Type of Work 377 Sea Street,Hyannis,units 1,2,3,4,5. Address of Work: Irene Lowney, OR•w Namm Date of Permit Application: December 1, 1995 I heezb<•certify that: Registration is not ret;dmd for the follming reasoa(s): Work excluded by law Job under S11000 Budding not owner-oowpied Owner palling own pw= Notice is hereby gi<rn that: _ OWNERS PULLING THEIR OWN WORK DO NOT HAVE ACCESS TO�THE FOR APPLICABLE HOME IMPRO ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the 0"*m : N IL Date Contractor name Registration No. OR Y Tile conintallli'CO11lln 11tasracltttxc�m . l Dpartnrrnt of laolAcridcnls i Met et• �t ,; "'•; 600 11 asilin Knn Street Bosion,Alma 02111 _ Workers' Compensation Insurance AMdavit ARp11can I nfpt7nation Aliases PRINT �lv ,' Douglas L. Vv unwilb s� es� sus a�ssess�i��e ■ r+®nrae��e+�+�+ei� name: locatLiNelson Lane,Marston Mills,Mass 02648 775-1500 city phone 0 ❑ 1 am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity m an employer providing workers' compensation for my employees workingon this job. Douglas L. Williams emmnany name: 35 Winter Street, atrdrese: t. eiri•: Hyannis,Mass phone 775-1500ft . to Eastern Casulty Ins ,,li.,PC Poo15147 ❑ 1 am a sole proprietor,general contractor,or homeowner(circle one)and have hired the.contractors listed below who have the following workers' compensation polices: i ddress- eltVi Rhone vity: phone r Insurance co- ;A .1iaSkaddItr'oosl-sbeei friiie n1;,i.•N'r•�••,�_�••:•: :R••+•.; tin , Failure to secure core. peas required under Section 2SA of AtGL 152 an lead to the imposition of criminal penalties of s tine no to Sid00•U0 and/or PO one Fears'imprisonment as well as civil penalties is the form ofa ST NVORK ORDER and a tine ofSIOOAo i day am 1 Untlerstand that a COPY of this statement may be forwarded to the Office of larestigations of the DIA for coverage veriQatiio& I do herebr cerr&tinder the pains and penalties ojperyerr tkat the injom mion proWded above is true oad emmtt Print name 1 L,to I L.-L. , ,4-�-Yz. Phone 1i olticial use only do not write in this area to be completed by city or town official city or town: permit/licease d milluiiding Department Ouceasiag floard Q check if immediate response is required ElSeleetmen's Office (311eaith Department contact person: ptoselh. clOther- a.,�v s s Yfsveeg3,gtt'JA1 � a „ a rt r s �' information and Instructions Massachusetts General Laws charter 152 section 25 requires all employers to provide workers' compensation for the employcrs. As quoted from the"law", all e»rplitme is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An emplitrer is defined as an individual, partnership,association, corporation or other legal entity, or any two or m-0 • the foregoing engaged in.a joint enterprise,and including the legal representati�•es of a,deceased cmphyer, or the • ' receiver or trustee of an individual , partnership, association or other legal entity, employing employees. HOwe!'et , owner of a dweiIin 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 1v or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employa MGL chapter 152 section 25 also states that even,state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compli2nce.4with,the,insurance coverage required. N Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public'work: until acceptable evidence of compliance with,the insurance requirements of this chapterM been presented to the contracting authority , t.�.•.,.,Vrw�..�.--. r �w.�....r�w _ '}_' •• !.'y• • .`'+a'.•t. •• ,M^�.,�1.s ....w..''.pp,11♦ .. .• �:::i:1Y.:r,.w�a�-. iv`. '. •a .u..,.. Applicants Please ill in the workers' compensation affidavit completely,by checking the box that applies to your.situation prig€ supplying company names.address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date 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 requir.. to obtain a workers' compensation policy, please call the Department at the number listed below. City orTatims Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom'c�� the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pler. be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returnedn: the Department by mail or FAX unless other arrangements have been made. The Office of investigations would like to thank you in advance for you cooperation and should you have any questiow. please do not hesitate to save us a call. ' :i :yi.• The Department's address.-telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents x Office of tnvesdgadons 600 Washington Street a� Bostoa,Ma. 02111 fax#: (617)727-7749 .,6 n 44. t4 r 406. 409 rig,37fi. t ' Eastelfi Casualtjl-Insuza-*nce Company- WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE NCCI Carrier 16942 Risk I.D. # 085618R Policy No. WC P0015147 Federal I.D. # 1. The Insured/Mailing address: © Individual Partnership DOUGLAS L . WILLIAMS DBA DOUGLAS L. WILLIAMS CUSTOM BUILDING El Corporation or 14 NELSON LANE MARSTONS MILLS, MA 02648 Other workplaces not shown above: 2. Policy Period: The policy period is from 1 1013/95to" '`09/ 13/96 12:01 A.M. Standard Time, at the insured's mailing address. 3. Coverage: A. Worker's Compensation Insurance:Part One of the policy applies to'the Workers Compensation taw of the states listed here: Massachusetts 7x'' B. Employers Liability Insurance:Part Two of the policy applies to work In each state listed in item 3.A. The limits of our.' liability under Part Two are Bodily-lnjuryby{Accident i00.00o each accident Bodily InJgry by:Q*Ase 500.000 policy Ilmit Bodily Infuryb Dssease IbO,000 each employee" C. Other States Insurance Part:Three_af the polar applies to the states, if any, listed fietre;AtlflQtl(tit9!tlt)iGi!4paXbk1681 X 1t wd�*%xiq tA?111gAlillOd:KI1WXD1�1 1 I, AIArr)1�(Vt� X See Endorseai�rs't�WC�.2O3 03 06A, i D. This policy includes these endorsements aril schedutes. 1)l�zJpxWC242, WC332;,WC350 WC367, WC441," M � See Information Page HI for other applicable endorsements / '- s te " Total Estimated Annual'Premium'$ Pro Rata Premwm(If Applicable):$' 1 . 1 r a llt 11 Countersigned GOODSPEED iNSURANCE'AGCY P.O. BOX 329 OSTERVILLE, MA 02655 JO Date 1 1-1 3-9 5 By _. ARC: 37.62 uthorized Represen tive THIS INFORMATION PAGE WITH THE WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY AND ENDORSEMENTS,IF ANY,ISSUED TO FORM A PART THEREOF,COMPLETES THE ABOVE NUMBERED POLICY. INSURED COPY 1 �� O�PNER ASHBURTEONP PLA�E,'RME 1301 � - BOSTON, MA 02108-1618 CONSTRUCTION SUPERVISOR LICENSE D Number: Expires: Bir .hdate.. CS 016981 03/07/1996 03/07/i947 Restricted To: 00 x = DOUGLAS L WILLIAMS SR <•=`. -.: Detach bottom, fold sign on b 14 NELSON LNack< ` and laminate license card. MARSTONS MILLS, MA 02648 Keep top for receipt and change of`--'address notification. r y r f N +^ _ r 1?O.ntmc lM'9 enic,41c.I`4 026 I Fula!{t+d�ii5 8ucl$N+� • (� ON SPECIAL ItCP.ORti&4'ION r• �4_...�.._4 t�. �'�-� ..:lam• �l� m _.:. _ Z CAt.2. iRiB AHOYE:BII�SHER_TF'TI�RB 3$-A '£'Rki�Sf[I-SSIt>�l f'AElB,8�1-. ti T-bim tsahmissiaa is intended: ogle for t e... se Q the individual �t1C'-$at:tr-#a-v4�£c2r:.-i�,-is Feeaed-,-a -�al�sosiai-a-fnfasaa'tinn —.- t'is�sslvide8 cL+Nfi�[tts2 atsd =-€roa c2isc3osu€e-aQt3ec' ajp-• - � ,. :3 .#�s3s�: 77 E8 $7J:CP3R 's� L°8 .r If®1�- t4BC8�_71pitS' :any, Si' g8E8d'� QB - IF ]YiOII_�A� �' e1r�F ,i.'�ss 1e �-�a9L. -p2sats$ .not-i-C;tC q}T h: To w n :Of B* -, }' I tt �I I•J , 4:z �e*atme�nt O f Health Sa tFl:UH Nil, y d .s• 1 e , .It I I' i.43 it i�iil' 'tJ-'1-1 j .�i g}7l.,;'I;r• I. i. 17ul1[1 g {' 'i i 'lt• 367 Main Street,Hyain>�S, HA 0260Vyl i I I F Nk I I I I Ii;illl� � is ii tt � 66F 66t 4 , 1 I inspection'Correction Notice: ,I I T I il� I 1 I E. t1 l J'y ¢I` ,• .,� 1 i.'11F� pptx , r3.. � I , I. til if 1 I ! II F" 1.{ I dP9 i J � r R�a;�.'..11 44 Of Invootion ± Its ' ` tYfJflj 6- 1 Permit N` *btr 7-7 t 1tl { Wy 'i� , C aae r vtace ore a.--n o rn obsite, one notice on file in BM"1dirig 1 + t p►t+ I I s I } �� ; •I :III I I f11�E't met ally ingl Ater is need correcting: u p 11' i i I :J kT a i.i � �kt�i f�p. i i¢kl'S' a ? 9 i 3' ' Ifle Igfi I! 'i I t SI CtlAF k: N '' q t t , i 9 ,n i J lil a � i y � ��. ' I [�+ � �." i I r I•, ,f I,��I�njpjy�'� Ij to 3 I i i,I t :1Am k IN t. 'A_a.++{y illi i '�I r I ) i I { k ! � ^�►y�l�� !{, +y�'�' l { ./yam V.�'l l I k I I e r' , '' S I - II ]I. 1 V "�. V }sMY.. '•FC fta.}. 1 i 1 0 tt1 'I +.�w"�, 4 l tilf ! i , 17 I 1•r i i .: 1 ; t'I I.; ,. � � I I r ii'va .1 I L.✓' a+i' . ..++."+:�. b .i. _ '• rl 'lease call 15 790- �27 for reeinspection; t i t Lti l i ; f I I:,II I1 Iplljp:,, I .n i lt� I_: I I:I Irll7li. j i .:I � , i fi _ r.rii iC, i '{[i 1.• � i � -.. I I t � C I I f ff;; J i ( JlfiEit i •I• I j 4 i i; i� ��,�� x'9a.'�M "� � i�,. .,) rR•�rgrp ',ly�; ;� �'�� E0t �9 fit3 1t p ° cs �'A'�1g9 .) spYYT +¢ rir r}yla�ARTT +'F$xi4 — 7 ^ � N r 4 t i fi ,ISI;I (,•i f 'I II ii ` 1 ( J dl I { {d1� �I$�il# � t I j! i t ' I �fdlr °' . ✓ tad J r 1 e j;r I I� ul ia> I I I } lL �1l .J - ( �t �J V�W�'•P ' /V/l/aws��"+"irr,('Y'f j , .. `JO '�• ,r�+tt. �K•l4"Y' + ! �.\7&�K) .+'r tt.t.t?t M t) IAd I I y� 02/0 i �t a ien i yy� ��'A}>tl{'�l�' � �•. I I i �. i I a�b.��,� � w. � �y �I �1'(•�y♦'�i,:{ I � I ��I 0 ,: i�� I I �'��i�i � � I ' 7NlIF,111��:1Y�)1bfi:7L'1 1 I�I • tt I t w Y ad WWI p t I I I ` 1 'Mfl ► � } � rrtt tvy t�pr,uersatton regarding rcpiaccment windows. .. aa�ept tkia 'fgfSa��ti�r� i I I I I { , 'I '.,, 51 �p,� Iatiltts �ate�fttadrtl •:fde governs the re air, alteration, Addition'andChaate cti use.�tfXtStt�g p but;etrteatis of this articleYwhich_ ma n`tatn'�t ttic e e pweftc-saftr, �{ i t u °�' n� full rrt iBrEC.e '� �lk;t:C�'d4. iu}�Ymy�pj tttinn;:>re�pat(r� v�th ��py�ie �Y� ,Alt3�ati h the ��y{ b •, i �1F Ai�ri,f Jt ema It[• R1✓1 Vli.x. Y��rly�5 'Y�V9 r* , ��, y,q +.yi�v�bltttlANfyi?'i7Lwl..:w.:-.A �, ifltstYYlV ice with current re_ulatp ae,vait P. ` fib conform wirid4�' 1 ith r pr t'tC,�a it 4,tskign of repf c�erii r wipdov+s; )f one is *rtsly a of the ivindau opening, taw sash f rr s s t arr ro mate acc ry tfi�coriais and ts,not tame n s.�.3x s +.rb , . IMP yy the code does not WIS. tie { � � te; dt mot. , thepres.. t a ~. ...,..... ��5 WAD hp;t(te. Ho�e�er,.the code dce5�nat wtsb ><o avarCmo6, matters af�.p�ubt)c osrz;g tat strii6 tirc, be real tt f #`� trt r �i ; rti<j i't" rfore, tfireittri� the.entire wtndow�unit, G?�P `sla, t cOMO t~ #1 t�werr�e"nc.climensicirLs for emergency e5c3pery sl }h 1�'7I 1 M } p y p'r.p /p n I h3vC �nC1C4sCd a c3D of oui a^en4ieC CODIENVO�tD ptt)bltt..3t�.Gn f TCi IN it✓ `:I f"�i��# I:.S fi��hA '�i.3�1.Ii U/d,} :1 rl r..g��s��•7'+rt� I.1,,�.6. . ,. �} is ah n#ofrbh$tbt al=r alt tih sent to bisiiding and fire aff)cials tnrtia hots# the rtirtttn�3rf��itft, if iri f �,n� Ifln . ' ��iatd::iforttf 4Yt tint'cpmrnunit�°on issues that may be sincl�,f in th3 coelp, and ... ..r. t4J ! 4it � ,, � �1� tsf of the boa ►�sf� r Mite. 'Uftcn iirri we address issues s7snt�ar to tht;situation i'rirp� Ai I be:)nt.eesird s t �:�yy tt}�lgy'kQ' ttx Otto helps lot f w ui� Ir.�nfuston voU`rray be experiencing tgarding this rnati r If you raQ:vire art} V. , a gt t'EiTI f' �I 1 1 ! 1 ♦� F i} _.I t l I,,q.j�l'-' ' .. . .. I-, 4�F I blfi Fl ly 1'.I {il R ,I CAN HOME F �,hll" I RO P 0 : a_•X t .�.� 11F 4, 1pJlEF? t t'TCfi? 1'C �11 t r�1�.)+ Tf , . ;> I ! '1 I. �1�f+tE y. ti I s A '.f ,4. F MI ME ' ' NVI R I;I:I I r � 'I I I 1 I Ski 4 ' E . B X- 1069 CCntmille Massachusetts 02632 �� 4�� ' >. I ri ; a Renxadeling Fstviconmentai Inspections i d Flllii � � l i l i ;, ); ;I; .I I Bt# c�tQ $C[�Csign: •Lrad Paint Retroval iIIE I ItII 'IIIIIII � I IiIIi 1 G ITT.li 'I'k.p i•r LF. f I , P'I 1111 I}I i V I V � d1�1t9i. I�i`� l 1�1 I F F CFI 1 I�1 I I I I � i i a 1 P. :c. . •I. ,4 i i�i i r i I I i i t sign the,building permit on.botb ruts tee 317TSeft. I P 1 P ' •^y I s,Co e�E $ t+a;all bildixag departments Clsxfg the placement of E t t u �. Iur�e were.not aware of this policy dire to your ne*tortf the dC+I FOR lfilmewsash sizes: I w©uldplire�iaate a calf'as sow a (toll free) is 617=226-2149 or office phone 775 1500 E' T i I > itw':I1 111'iia 1'I tl f kt ,QQOr r Y 1 .may, d01 t$d F l y 6 i atse Irani wit to unit and it has been t # F.. r rtd:cx F b icersi.. This aside;ttte issue is for the Work I cad nat the status for:w a hlllhs t inVolves�nt nor clicl I change The Mid=; Of ism e�sied prior to pour department issuing a pemnit tb:do work i i Fh3I Ili�l�l ( { i l " I h.fll- .t. [TO I •��r i i.{ F v C� ;) I E.I�I .I I � , ! C �: .S d.i". IIr ' 1 Iilll 1 , I �1 t ( r u R 1 I I I y i t h u � 1.:1•I•, , } I r ' 1 F.L. I IIf It d.�yylp}kl�la9;l f b }:( s I 4 t FiYMIRI#It�.a I. rxi iot ;Itx,pei a vr�•1*«tI 1 a •Fo riWde-hyde•Asbestos New Construction•Water rty 7jF;ia• d;rOn?'QriP.Q• �_T?? F'7_it�Ul"- '^ 23-A't 24'I01 t 9(7-G't " t� CTj❑ N O ' - (CX15T)NG) (CXI5TING) (FX15TING) (EXISTING) _ g O • O.JI IL C)0 5p 4' 1 T-T 3 1 1• T-3' 2'1 a 12'-T L L�w w z= Z r-f- mQF-U m o • - IRT nH TPJXIST. r•-4 T-T 2W 68" " Ir � I � ao EXPANDEDII y; Wo T DE I BEDROO-NU'tI BAITIH Q O ODEL. — u Z W a BATH�� S. x II /-- O --i /III xl �� GL II. I 11 - "- I I 1 ,,,•••III"` III Q g II jREMOpFLED I sp DINING RE AO REMODELED I I BEDROOM I I (VCRIPYCABINer �� '• Q _ K ° I I RE LAUNDRY� ` )AYOUr W OWNl3� I -- g �+,66 y f BEIDRbOM W E" 91-FOLD 1� �, M E ANDERSEN NCW / �( • "" "" FWG'6D68 3'6'C. i•. '4'S" 2 q_ 1� x _ LIVING / Ilr,, kJAI �_ x III '``JI I r-s• T-6° z'-I a r-I a a° ;t 5T. =—�I tj 54P x G'8 JJ 8I-FOLD BATH _-i' /' LI V NOGDELED A rxlSnNc BeA�n o RerluuN is . - GSNFRA u N RE-LOCATED ,{' BEDROOMup r - Z( K�IT60EN TEE: 'l e t p { r i I — — — • I I l l i I I I % _ _ —,REP. I •;, _ _ " � r • 91NK I —i-- I m , D 34'-41t 43'-9 1 13'•T± le-1 I't (IXI9T)NG) - - (E(I5TING) - _(IX19TING) •, (IX15TING) FI RST FLOOR PLAN LEGEND = W EXIST.FIRST FLOOR(UNIT#1) _ '1094 S.F. C EX15TING WALL CONSTRUCTION TO.REMAIN GENERAL.NOTES: 0 E DET TORS REVIEWED EX15T.SECOND FLOOR(UNIT#1) = S.F. ® NEW WALL CONSTRUCTION 1.)CONTRACTOR 15 TO VERIFY EXISTING CONDITIONS AND EXIST.FIRST FLOOR(UNIT IT = 1030 9,F, E 3 EXISTING WALL CONSTRUCTION TO BE REMOVED DIMENSIONS IN THE FIELD PRIOR TO THE START OF WORK �..( EXIST.SECOND FLOOR(UNIT#2) 440 S.F:. ' ' NEW 5MOKE/CARBON MONOXIDE DETECTORS �. 2.) CONTRACTOR TO REMOVE EXISTING DOORS,WINDOWS. _WALLS,8 ROOFING AS REQUIRED FOR NEW CON5TRUCTION. SCALE BARNSTABLE BUIL ING DEPT. DATE 3.) ALL NEW CONSTRUCTION TO MATCH EXISTING IN MATERIAL, I' DETAIL.AND FINISH. 1-0'� S 4•) STATE OBUILDI G CODE LATEST EDITION)AND ALL OTHER DEPARTMENT DATE WINDOW SCI-i EDU LEDATE „TK APPLICABLE LOCAL CODES TYPE MANUFACTURER'S UNIT ROUGH OPENING REMARKS 5.) ANY D15CREPANCIE5,ERRORS AND/OR OMISSIONS'IN THE NOTES, 2/6/20 15 " �'=&'ARE REQUIRED FOR PERMlTING A ANDERSEN TW 244G r-G 1/8"x'4'-8 7/8" DOU13LEMUNG DIMENSIONS,AND/OR DRAWINGS CONTAINED ON THESE DOCUMENTS I SHALL BE BROUGHT TO THE ATTENTION OF THE DESIGNER PRIOR TO -., B' A 251 2'-4 7/8°x 2'-0 5/8" AWNING ) COMMENCEMENT OF CONSTRUCTION.PROCEEDING WITH CONSTRUCTION PROD. NO. C " A 21 2'-O 5/8"x 2'-0 5/8" AWNING ; CONSTITUTES ACCEPTANCE OF THESE DOCUMENTS AND ANY DI5CREPANCIE5',. D " TW 2032 2'-2 1/8"x 3'-4 7/8" DOUBLEHUNG ERRORS AND/OR OMISSIONS BECOME THE RESPON5I5ILITY OF THE 20 1'4-G 5 10 BUILDING CONTRACTOR. E TW 204G 2'-2 1/8"x 4'-8 7/8" DOUBLEHUNG F TW 2432 2'-G 1/8"x 3'-4 7/8" DOUBLEHUNG DWG. NO. : G TW 243 10 2'-G 1/8"x 4'-0 7/8" DOUBLEHUNG H ' TW 2442 2'-G 1/8"x 4'-4 7/8" 1 DOUBLEHUNG NOTE#I:CONTRACTOR TO VERIFY ALL QUANTITIES AND SIZES OF NEW WINDOWS WITH OWNER AND I ©COPYRIGHT 2O 15 ROUGH OPENINGS WITH WINDOW MANUFACTURER PRIOR TO ORDERING OF WINDOWS 0 5 10 15 20 1 BY THOMA5 A. MOORE DE51GN CO. ' �ilrnnlnn. �. .•lanw.. �� ,' ��' 6umm�unu. � �nunri•. ' nnnn.unuunw.��imnnim. _; . n ; .linleauu;mnlrnm \ �mm�umll. - i.n!ran•Irlu•Ic9ulrmil► \�IIIIIrlilel■IIO� • • •'ir11111r111/I■IIIIr1P11r111/Ir. 9i1r11111■Iln iilinrl••• ■�^nun�t.��nlnulun • '1111r111111= B 1i911/Irl.. \�IIIr fie 11r1 i aimnrlm= B� lel■:II/IrnI �71■IIIII .nulrnnmr= -nn!ranum \aum �� nlrnuunnlrl= =rum■l '.•Im IP' .,in111rn11uluen= =urn111r u:!1 I I111 n �lu1,. -,.tlllt' .III■IIIIIrllllrllll= B Ilrlllelrllelr:!IIi. -- :..- /.,•IIIIIrI� drn111r111/Irlllll■II= ■ =I11IrI111r11111■IL:11� - - I1 IIX \ �• - � .a■1 Ilr 1 dil/r1111 1 1 — — a Ir 1 11■Ii11 rl— —■I1111 1 111ir1111 rI11E°. 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In IIIIIIr11111r111/Irt.. ,rI1111r111/le • I — —III I I 1 1 II I rlm i I I I I 1 I I l e' I■I■III— Ilr 1 Ir 1 Ilr I t■•I■••mI rill, III I I I 1 1 I t I I I I i l 1 ® 1 I I I I 1 1 I I 1 1 I I I I I I I I i t I Milli I III/r111/ IIII' rll 11■II I r1111 rl i IIII rlll�r11e1■I Ilr 1 11 �I�I I m Ir 1 Iu ul nnnr 1 m•n■■.I■I.II I m mm�anm trrnml/ ulrinnnt nnu runmulm m t m I Ir t Ir I m t m 1 ■1 Ir 1 m t IIr t m 1 nr I m I Ir I I I ! tr IIIIIIrI'_ -IIIe1lLilllnrll1111 0/IrI1111rI1111rn1eIrI1111r111Irt1111r111/tram rlueumllmnirlunrnn 1`(IIIIII■IIII!I 1 1 I It r1111 rill " IL::e:allnllru...1....1../Irlll/Ir1111 rlll/Ir11111rnlnrllnrlulumelrn mnulrnnlrnuunllrmnrnnunmrmllrnn " ilrnlnrnmrlum nnrinllrnnlrnnlrinnrm - - u IL>_I, = I I�If.,.., .i a nr � lll�iL I l I t .. - I■IIIIII= nrlllrl1111■IIII IIII■IIII■Ihll■III•Iritll■i•1■Yfu•illu■n11/IIII rllle/IIII/IIII rlll .. ..._. _L..1.76J !ao./Ills VI /IIII rill•/IIII r111•rlOe rllit/IIII■IIII rI1111r1111 rlllll■IIIIriU/rlllll ItI■nlel■IIII/IIII rlllll■IIII■IIIII■Ill lrIll lrll III■IIIII■III•Ir1111 IIII■IIIII■III■■111•I■Illnrll I I I I L 1 1 ' - -• • It rill/ 1 ill rill/rlllll/1 II■IIIIIr111/Ir11111r111I rll ■1 Ir 111■IIIII■111 I I I I 1 1 , .I ' -- �-- I I I 1 1 1 1 I I 1 1 1 1 1 1 1 1 1 I I I I 1 Iel 1 I Ilt 1 Ilr 11eIrt1llr111/I■IIIllrll/I■IIIII111 1 r11U1r Ir t IIr11111tIt111■IilIr111IrIlIlr11111■IIII rlllll■II4/rltl/I■IIIIIr111111 11■111Ir1r/I■Il/■111/I■1111I■111t1■IIIIr11111r 1 N 1/Ir I/Ir 1 Ir I Ir 1 t !IIII■niiiii IIII■III/Ir 1/Ir 1 Ilr 1 Ilr 1 Ilr ! 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IV a I a,FLA • • • . .. t1 � mono ^ ' II - ^ r r rll , EXPANDED n BEDROOM Li �S! v II . I� DATE � A2rJ i • Fff M •O-me vr. - - ,urn... ner/�ul, • % •Inn1u1•... niinnlr' amnnm, \ —Nr.W ROOF SHINGLES /�� :rnnlrmtl... 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