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0105 SIXTH AVENUE (HYANNIS)
__ __ __ /,/off �_�� �� R �....�w.�. .. �-. .._ .. _... - S _ _ __ f V �. �F{� f; ��.� J . Town of Barnstable w �n. Building a Post This,Card So That it-is Visible From the'Street,-Approved Plans Must be'Retai ied on Job and this Card#Must be Kept Posted,Until'Final Inspection Has Been Made. € ° =es _ -g a. Where a,Certificate irermit of Occupancy is Required,such Building shall Not-be Occupied until a Final'.Inspection has been made Permit No. B-18-3758 Applicant Name: Neal Holmgren Approvals Date Issued: 01/02/2619 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 07/02/2019 Foundation: Location: 105 SIXTH AVENUE(HYANNIS), HYANNIS Map/Lot 245-066 Zoning District; RB Sheathing: Owner on Record: DURCAN,JOHN J& MARTHA L Contra ctor,Name: ,NEAL F HOLM_ GREN Framing: 1 Address: 14211 HELMSCEY`ROAD < Contractors-License: CS-088921 2 MIDLOTHIAN,VA 23113 Est Protect Cost: $17;391.00 Chimney: Description:_ Installation of 17 Panasonic 330watt solar modules to be flusht ,Permit Fee: $ 138.69 mounted on rear of the building i l :` Insulation: -).,,,Fee Paid:, $ 138.69 Project Review Req: Date r 1/2/2019 Final Plumbing/Gas Rough Plumbing: w Building Official Final Plumbing: i i Rough.Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after'issuance. r Ali work authorized by this permitshall conform to the approved application and the'approved construction documents for which this permit has been granted. Final Gas: ` ' All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or'' d and shall be maintained open for`public inspection#or the entire duration.of the work until the completion of the same. Y r Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are:provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: P q .�, `' 4 � „ �' Rough: 1.Foundation or Footing ,,.,: .. _ 2.Sheathing Inspection v Final:. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection - Low Voltage,Rough. 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has app roved r ved the various stages of construction - Fire Department ,� P. Persons contractingwith unregistered contractors do not have access to the guaranty fund" asset forth in MGL c.142A . g g Y � ) Final: Building plans are to be available on site Ori�-X-4J All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable *Permit#g-I YF- -3 y6 BuNing Department wee 6 monthsfrom issue date wsrr s,a ,, E' Biian Florence,CBO v i63 � Building Commissioner E1p - f 200 Main Street,Hyannis,MA 02601 H www.town.barnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY y`— O mot valid without Red X-Press Imprint Map/parcel Number J Sv Property Address/O Y $, X i s e va m t/ 3 PO esidential Value of Work$ , SAD L) Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address "Ya.� 5/rr " AVM Contractor's Name f/•(m e/ go-ra yylh n Telephone Number SO$—771( - 2 q O c) Home Improvement Contractor License#(if applicable) Email: ycpot�Lot�<Xrod�et 4 ug9�c� Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance ` Check ama•sole proprietor ❑ I am the Homeowner❑ I have Worker's Compensation Insurance OCT 1 21018 . Insurance Company Name B C>t A N 0BARNSIABLF Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Rauqt4check box) [ e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Yc/� roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: ope er must sign Property Owner Letter of Permission. c the Ho I provement C ntractors License&Construction Supervisors License is ferloi •SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\W indows\INetCache\Content.Outlook\9NNOKXYW\RESIDENTILONLYEXPRESS.doc 09/26/17 " - c ' i the Commonwealth of Massachusetts Deparhnent of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ivmv.mass gov/dia Workers' Compensation Insurance Affidavit Builders/Contractors/E.leetticianMumbers Applicant Information n Please Print Legibly Name(BusinenIOrganizafiawbdividual): 42 Pill► -- Address: Fi 7 S ecv City/StatelZip: & y h i 1 U®'I Phone#: 29 0 y Are you an employe ?Check the appropriate box: T 4. am a general contractor and I 3'Pe of project(required): 1.�a employer with ❑ Y g 6. ❑New construction employees(fall and/or art-time). s have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g- ❑Demolition wo for me in an capacity. employees and have worloers' rlwor nec insurance.1 9. ❑Building addition [No workers'comp.insurance. °mP• required.] 5. ❑ We are a corporation and its ME]Electrical repairs or additions 3.❑ I am a homeowner doing all work' officers have exercised their 11. ping repairs or additions myself [No workers'comp. right,of exemption per MGL 12. oof repa insurance required.]f c_ 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required] 'Any applicant that checks box-rl ttrrts;.also fill our the section below showing rhos workers'compensation policy information- Homeowners who subunit this affidat t indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tcoutractars that chock this box must attached an additional sheet showing the name of the sub-contsac ors and state wbethar at not those endues bare employees. If the sub-contractors have employees,they imtstprnide their workers'comp.policy number. lam an employer tliat is prm rig#Porkers'compensation insurance for rqy employees. Below is diepoM7 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(shoving the policy number and expiation date). , Failure to secure coverage as required under Section 25A of MGL c- 152 can lead to the imposition of criminal penalties of'a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. l do hereby cetWfv an lie ► and penalties fpeduty that the information provided above is true and correct Si tore: Date: Phone#: O 0 7 7 - PC,C , Official use,only. Do not n4i'te 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/foam Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: The Roofers " 67 SEA STREET APT#A4, HYANNIS MA 02601 PHONE 1 - 508 - 7 7 5 - 8 2 4 0 n CERTAINTEED LANDMARK LIFETIME ALGAE RESISTANT ARCHITECTURAL STYLE . RE - ROOFING PROPOSAL _August 13,2018 JACK DURCAN 105 SIXTH AVE. EM:jackd@tech2smb.com HYANNIS PORT,MA Tel: 781-439-5471 COREY & COREY herebyproposes to perform the followin sei vices in a neat iprofessional p p p g a id manner and in accordance with the manufacturer's specifications and local building codes. Remove and Haul Away All of the Old Asphalt Roofing Shingles(One Layer) from the Whole House. Re Nail All Plywood Sheathing as needed. Supply and Install CERTAINTEED LANDMARK AR: LIFETIME WARRANTY, 10 YEAR SURE START PROTECTION, CLASS A FIRE RATED, COPPER/CERAMIC STONES for a FULL 10 YEAR WARRANTY AGAINST ALGAE CONTAIYIINENT, 240 POUND,EXTRA HEAVY WEIGHT, 130 MPH WIND WARRANTY,CATEGORY III HURRICANE,STORM/HURICANE NAILED (6 NAILS PER SHINGLE), MULTI-LAYERED,LAMINATED ARCHITECTURAL S YLE,FIBERGLASS BASED ASPHALT SHINGLES. COLOR. e`Es�o Supply and Install 8"WHITE ALUMINUIVI/HICK'S VENTED DRIP EDGE on All of the Eaves. Supply and Install CERTAINTEED WINTER-GUARD (Ice& Water Shield)WATERPROOF UNDERLAYMENT SY"STEM on Roof Eaves'& Valleys Under the Step Flashings, on the Skylights and Chimneys. 100% WINTER-GUARD COVERAGE ON THE ENTIRE REAR SECTION OF THE ROOF Supply and Install CERTAINTEED'S"ROOF RUNNER" SYNTHETIC ROOFING PAPER Supply and Install AIR VENT SHINGLE VENT II RIDGE VENT on the Entire Ridge. Supply and Install NEW ALUMINUM & I NEOPRENE SOIL PIPE FLASHINGS Clean and Remove Debris from work area after job is completed. TOTAL INVESTMENT ------------- $59500.00 " The Roofers " POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing,Missing Metal Flashing, Side Walling or Any Other Carpentry Needing Replacement will be done and charged for as an Extra: Matdrials Plus Labor at the Rate of$ 60.00 per Hour. PAYMENT SCHEDULE: A Deposit of One lHalf is'due at the Signing of this Roof Proposal and the Final Payment for the Balance is Due Immediately Upon Completion. WORK SCHEDULE: All Roof Work is Scheduled for Completion Within 90 Days of Acceptance and Deposits Received are Non-Refundable After a Three Day Cooling Off Period from the Date of signing. Please 1Vlake Checks Payable to• CORE, Y & COREY COREY & COREY Warranties the Shingles and Labor for 5 years. CERTAINTEED Warranties the shingles and Mbor 100% for the First 10 Years and the Shingles your LIFETIME if the shingles becomes defective. CERTAINTEED Warranties the Shingles up t 11 a CATEGORY III HURRICANE-130 MPH WIND WARRANTY. CERTAINTEED Warranties the Shingles to bi Algae Resistant for a Full 10 Years. i CORE Y & COREY carries Workman's Compensation and Public Liability Insurance on the above work DATE OF ACCEPTANCE: ACCEPTED BY: SUBMITTED BY: JACK DURCAN ARMEN SAFARYAN HOMEOWNER COREY & COREY P.C.. Paz 4 G 3 HIC # 183202 West au"P14) CSSL# 106102 O 2-1.I 2 Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvemel� Contractor Registration Type: Individual XT Registration: 183202 ARMEN SAFARYAN zi W Expiration: 09/13/2619 67 SEA ST APT A4 m ti HYANNIS, MA 02601 e Update Address and return card. SCA 1 0 2OM-05117 ✓A,e c�a�zrrea2urea,�l�o�iOl�aJJac�eri>e1�1 . Office of Consumer Affairs&Business Regulation + HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:individual before the expiration date. If found return to: Office of Consumer Affairs and Busine Regulation Registration Expiration Office Park Plaza-Suite 517 .�f8320. —f09/13/2019 Boston,MA 02116 ARMEN SAFAR AN' DB/A CORE`Yi:�1ND°CO ( :., ARMEN SAFARYAN- 67 ' SEA ST APTFA4,` HYANNIS,MA 02601 Undersecretary Not valid without Anyure Massachusetts Department of Public.Safety Board of Building Regulations and Standards -License: CSSL-106102 Construction.Supervisor Specialty fir, ARMEN SAFARYAN t i 67 SEA STREET APT,A4/ HYANNIS MA 02601 ; Commissioner Expiration: 10102/2020 I DATE(MMIDDNYYY) A o® CERTIFICATE OF LIABILITY INSURANCE 09/13/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT Ashley Paiva NAME: Eastern Insurance Group PHONE o (508)997-6061 A/C No): (508)990-2731 439 State Rd. E-MAIL SS: apaiva@easterninsurance.com ADDRE P.O.BOX 79398 INSURER(S)AFFORDING COVERAGE NAIC W North Dartmouth MA 02747 INSURER A: Arbella Protection Insurance 41360 INSURED INSURER B Armen Safaryan INSURER C: DBA:Corey and Corey INSURER D: 67 Sea Street UnitA4 INSURER E: Hyannis MA 02601 INSURER F: COVERAGES CERTIFICATE NUMBER: 2018-2019 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE 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 INSURANCEAOULSUBR POLICY EFF POLICY EXP LTR INSD WVO POLICY NUMBER MM/DD MMIDD - LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE ®OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A , 9520046441 04 09/18/2018 09/18/2019 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY❑jC7 0 LOC PRODUCTS-COMPlOP AGG $ 2,000,000 OTHER: � $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accd. $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION r PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETORIPARTNERIEXECUTNE YIN 1,000,000 A OFFICERIMEMBER EXCLUDED? NIA °952004644104 09/18/2018 09/18/2019 E.L.EACH ACCIDENT $ ' (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) . 3 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Display Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ©� Application # o/.S rW Health Division "Date Issued Conservation Division Application Fee Planning Dept. Permit Fee / Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis � I Project Street Address Village y.ic►.., . P')-- Owner Address S.n Telephone -+i- y'1)- Permit Request /S I Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family CY Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: O6�isting U�newzj_�size_ J d Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other t 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 Milie MeCarthy eonst.action _ Telephone Number Address PO Box 52 License # Cell (508) 280-6964 Home Improvement Contractor# Email 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 • F DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ` ASSOCIATION PLAN NO. Town,of Bamstable g Regulatory Services ft�g Division Tom Parry,BiO&ng Commwonw 200 Main S6t+eet Hyannis,MA 02601 vnmlowoa barnstab[e m a. Office: 508-862-403$ Fax: 508-790.6230 Property Owner Must Complete.and:;Sign This Section If UsnaABuilder .l. 1 Y, l a k t1 T b l�, h o ,as Owner of the nb*t property hereb authorize p.- . 'c kd�' to acx oia myb�alf,, is A mamrs relative to work authorized by this binding pent application for. (Address�ofob�. "'Pool fences and alarms are the r+espons3b qof�h�applicant Pools are-not to be fled oruulized before fence is.insmUed-and all-fmal inspections are pedomned and accepted. '--John J_O can(Jan 16,2015). Sipatute of Owner Signatm.of'APPbcarm Front Name Print Nance Date v Q:F0Ras;0wrnER?ERbns40NP00ts lob 6q4/i (�-t k re6 re,-,� uc n (,cli-d�e-�-oL2N� � I Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction supervisor License: CS-058633 MICHAEL J MCC BOX - 52 W DENNIS MA 1671 i Expiration Commissioner 04/10/2016 Office of Consumer Affairs and Business Regulation U 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169393 Type: Individual Expiration: 6/16/2015 Tr# 238121 MICHAEL MCCARTHY M I C H A E L M C CA RT H Y -----___..�-----_.__---__--.- --. ---------.. P.O. BOX 52 ------- -- WEST DENNIS MA 02670 -------------.---.—__ _ ____ Update Address and returh-card.Mark reason for change. Y SCA 1 Co 20M-05/1 t t� � I_�Address Renewal 'EmP to ment Q Lost Card .'! t—I r The Commonwealth ofMassacltusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,AM 02111 wiinp mass gov/dia - Workers' Compensation Insurance Affidavit:j3uilders/Contractors/Elechicians/Plumbers Applicant Information Please Print Le 'bl ike McCarthy Construction Name(Business/Organizationffndividual):_ PO Box 52 Address: West Dennis, MA 02670 City/State/Zip: C91pa§Q3 IIIC-169393 Are y u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 1 4. El am a general contractor and I employees(full and/or part parttime).* have hired the sub-contractors 6. ❑New construction 2.El am a sole propridtor or partner- listed on the attached sheet t 7. ❑Remodeling Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity, workers'comp,insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its I O.❑Electrical repairs or additions required.] officers have wwoised their 3.❑ I am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself.[No workers'comp. c.152,11(4),'and we have no 12.❑R f repairs insurance required.]t employees.[No workers' 13. er comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy informadon. t Homeowners vrho submit this affidavit indicating they are doing all work and then hire outside contmoors must submit a now affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy kh matioa. lam an employer that isproviding workers'compensation insurance for my employees Beiaw is the polky and job site infonnatlon. Insurance Company Name: Policy ti or Self ins.Lic.ff: V WL Iuo-GO i 1G5 -1"i`1,4 Expiration Date: Job Site Address: City/State/Zip: t 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 ofcriminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of j Investigations of the DIA for insurance coverage verification. - I I do hereby certify rt d pa a enalltes ofperjury that the information provided above h true and correct. i Signature: Date: Phone P Ojj'leial use onr. Do not write in this area,to be completed by city or town officlaL }i City or Town: Permit/Llcense# Issuing Authority(circle ane); Y 1.Board of Health 2.Building Department 3.City/'Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M. r ;A6c�Re CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) .i 07/10/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 01962-001 520JpCT Bryden&Sullivan Ins Agcy of Dennis Inc IUC.No.Eat: (508)398-6060 �j ,No„ (508)394-2267 PO Box 1497d�"Sssc So Dennis,MA 02660 — INS RER AFFORDING COVERAGE _NAIC# INS RE A: A.I.M.Mutual Insurance Company_ _—_ 26158 INSURED INSURER B: Michael McCarthy Construction Inc — -- INSURE C: P 0 Box 52 INSURER D: West Dennis,MA 02670 — INSURER E: _ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO-s WITHSTANDING ANY REQUIRENIENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 1h1-IICH 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. 1Cq TYPE OF INSURANCE � � POLICY NUMBER 9098 ANS LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED Is PR MIS I E Ea occurrence _ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES`PER: PRODUCTS-COMP/OP AGG $ �OLICY I UECT AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ E accident ri ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident)) $ IF AUTOS �_AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED I I RETENTION $ $ 'A"rNByd�1IR6��P�iROMARR��Cpgs��TI1N4EfRr�X X �tAi�T14-S O - A OFFICER/MEMBER EXCLUDED?ECUTNE Y� NIA VWC-100-6017656-2014A 7/17/2014 7/17/2015 E.L.EACH ACCIDENT $ SOO,000.00 (Mandatory In�e NH)P E.L.DISEASE-EA EMPLOYEE $ 500,000.00 � TCRP�'�ON OF 9PERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,6G0.00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION Thieisch Engineering 195 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010106) The ACORD name and logo are registered marks of ACORD Official Website of The Town of Barnstable - Property Loo... Page 1 of 3 Assessing Division Property Lookup Results. 614 367 Main Street,Hyannis,MA.02601 `� V «BACK TO SEARCH« c�lPrint Friend y Owner Information - Map/Block/Lot: 245 / 0 Use Code: 1010 C---- - -- -- - — Owner4-114 Owner Name as of 1/1/13 DURCAN,JOH &MARTHA L oc /Lot MAPS �D PO BOX 276 245/066/ ��.�� WEST HYANNISPORT,MA.0 2 L Property Address Co-Owner Name 105 SIXTH AVENUE(HYANNIS cc Village:Hyannis Town ewer At Address:No + GIS Zoning Value:RB v As :essed Values 2014 Map/Block/Lot 245 / 066/ - Use Code 1010 0- ............ -... ................. ...... ......... Qi 2014 Appraised Value 2014 Assessed Value Past Comparisons Buird t""Value: S 77,700 $77,700 Year Total Assessed Value Ext a Features: $23,100 $23,100 2013-$331.100 l C:s r»- 2012-$329,700 \,{� t, Ou b ings: $5,000 $5,000 2011 -S 331, 00 �C Land Value: S 225,100 $225,100 2010-$336,100 2009-S 340,100 J 2014 Totals S 330,900 S 330,900 2008-$417,700 2007-$417,100 Tax Information 2014- Map/Block/lot: 245 /066/ - Use Code:1010 Taxes Hyannis FD Tax(Residential) $737.91 Community Preservation Act Tax S 90.53 Fiscal Year 2014 TAX RATES HERE Town Tax(Residential) S 3,017.81 $3,846.25 Sales History- Map/Block/Lot: 245 / 066/ - Use Code: 1010 1 History Owner. Sale Date Book/Page: Sale Price. DURCAN,JOHN J&MARTHA L 1995-12-15 9995/264 $110900 DEMARCO,LEO P 1980 10-03 3165/129 SO ... ........... .... .. Photos 245 / 066/ - Use Code 1010 � s O!N N'77'".-j— Sketches-Map/Block/Lot: 245 / 066/ - Use Code 0 �Uf - ...,....._ ....... .._ .__. ..,.-... .. v r � \ 0- P e� \VUVf„ /V► f As Built Cards:Click card #to view:Card #1 I xull / Constructions Details-Map/Block/Lot: 245 / 066/ - Use Code: 1010 .............- --- - - - b http://www.townofbamstable.us/Assessing/propertydisplayscre... 11/20/2014 Official Website of The Town of Barnstable - Property Loo... Page 2 of 3 r Building Details Land V Building value S 77,700 Bedrooms 3 Bedrooms USE CODE 1010 Replacement Cost $91,397 Bathrooms 1 Full Lot Size(Acres) 0.18 Model Residential Total Rooms 6 Rooms Appraised Value $225,100 Style Ranch Heat Fuel Gas Assessed Value $225,100 i Grade Average Heat Type Hot Water Year Built 1950 AC Type Central Effective depreciation 15 Interior Floors Hardwood Stories 1 Story Interior Walls Drywall Living Area sq/ft 972 Exterior Walls Wood Shingle Gross Area sq/ft 2,336 Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp -- ----..........----- —__—._.....-..---___............. -------_.............—......---.._.....__............_..............-------..........-...... -----.._...---- Outbuildings&Extra Features- Map/Block/Lot: 245 / 066/ - Use Code: 1010 - ---.. . . __. ..... - _ Code Description Units/SQ ft Appraised Value Assessed Value WDCK Wood Decking 392 $5,000 S 5,000 w/railings FPLI Fireplace I story 1 $3,500 $3,500 BMT Basement-Unfinished 972 $ 19,600 S 19,600 I Sketch Legend Property Sketch Legend B2N Bam-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished)FUS Second Story Living Area SPE Pool Enclosure (Finished) BRN Bam GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLIP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio .......... ......... Print Friendly iContact 1 Director of Assessing Jeffrey Rudziak P508-862-4022 F508-862-4722 8:30a.m.to 4:30p.m. Helpful Links to Downloads Abatements SALES LISTINGS Barnstable FD Residential C.O.M.M FD Residential i Commercial-Ind ustrial- Mixed Use , Cotuit FD Residential Hyannis FD Residential Townwide Condominium http://www.townofbamstable.us/Assessing/propertydisplayscre... 11/20/2014 Official Website of The Town of Barnstable - Property Loo... Page 3 of 3 W.Barnstable FD Residential Department of Revenue Exemptions Parcel Consolidation { (. Questions about values I Town Tax Rates Town Land Use Codes 'Helpful Maps All Town Maps { Flood Insurance Maps Property Maps ................ r ..._.. ......__ - ;Contact i Director of Assessing FJeffrey Rudziak �P508-862-4022 11508-862-4122 8:30a.m.to 4:30p.m. Related Boards Board of Assessors TOWKPIMPIERTY DATABASE On f5MAPS, Owned and Operated by The Town of Barnstable-Information Technology Home I Departments&Services Boards&Committees I Residents&Visitors I Doing Business I Town Calendar I Phone Directory I Employment I Email Town Hall http://www' .townofbamstable.us/Assessing/propertydisplayscre... 11/20/2014 ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application adt q6 -o Health Division Date Issued h Conservation Division Application Fee 150 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address )0<�- Village �c,�- ��•i ...�:� Owner Address s�r,L- Telephone ?_�l-4'55 Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain' Groundwater Overlay Project Valuation 6�' _Construction Type `:'"' Lot Size Grandfathered: ❑Yes ❑ No If yes, attach sup'po ing documentaon. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) f ` : Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑"Yes 0?No. OI 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_ r 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 Telephone Number Mike McCarthy Construction Address PO Box 52 License# West Dennis, MA 02670 Cell (508) 280-6964 Home Improvement Contractor# CSL-58633 HIC-169393 Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE wwj l ci FOR OFFICIAL USE ONLY y APPLICATION# •DATE ISSUED MAP/PARCEL NO. i �. ADDRESS VILLAGE '. OWNER DATE OF INSPECTION: f FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r.T.lt4 _ J OWNER AUTHORIZATION FORM I, John J. Durcan , owner of the property located at 105_Sixth AVe, West Hyannisport, MA 02672 --- hereby authorize C.� 'J 5 1 (Subcontractor) an authorized subcontractor for RISE. Engineering, to act.on my behalf to obtain a building_ _ permit and to perform work on my_property: . =--- oh J. Due 14 11 Helmsley Rd Midlothian; VA.23113' (781)439-5472 jack.durcan@vetdg.com Date { , SEP` - got .2014 F J 1? y Massachusetts -Department of Public Safety Board of Building Regulations and Standards .. Construction Super%isor License: CS-058633 MICHAEL J MCCAR PO BOX 52 W DENNIS MA 02674 p � i "t ` Expiration Commissioner 04/10/2016 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169393 Type: Individual Expiration: 6/16/2015 Tr# 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY P.O. BOX 52 - WEST DENNIS MA 02670 Update Address and return-card.Mark reason for change. SCA Ca 20M-05/11 ❑ Address Renewal 'Employment ❑ Lost Card 1 / The Commonwealth of Massachusetts Department oflndustrurlAccidents Office of Investigations 600 Washington Street Boston,MA 02111 ivivw.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciamffllumbers `. A licant Information Please Print Le ' I Mike McCarthy Construction Name(Business/Organization/Individual): PO Box 52 Address: West Dennis, MA 02670 City/State/Zip: CS1pMQ3 HIC-169393 Are VU an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ i am a general contractor and I 6. ❑New construction employees(full and/or part-time).• have hired the sub-contractors 2.❑ I am a sole propridtor or partner- listed on the attached sheet;_ 7• ❑Remodeling ship and have no employees Theso sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp•insurance. 9. ❑Building addition [No workers'comp.insurance 5. [1 We are a corporation and its I0.❑Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑Plumbing repairs or additions myself.[No workers'comp. a 152,11(4),'and we have no 12.❑R of repairs insurance required.]t employees.[No workers' l3.[�}'�ther comp.Insurance required.] *My applicant that ebccla box 11 must also fill out the sealon below showing their workers'compeasatlon policy lnlbmtadoa t Homeowners who submit this afdavlt indicating they are doing all work and then hire outside contractors must submit a new aid"indicating such. IContraetors that check this box must attached an additional sheet showing the name of the sub•contmotom and their workers'comp:policy Information. I am an employer that Is providing workers'compensatlon Insurance for my employees Below Is the policy and job site Informatlon. Insurance Company Name: P •n• ���N-� Policy 9 or Self-ins.Llc.M VW(. too- Expiration Date: Job Site Address: )c�� �'xt i_. City/Stateizip: Attach a copy of the workers'compensation policy declaration page(showing the poiicy number and expiration date). Failure to socure coverage as required under Section 25A ofMGL c.152 can lead to the Imposition ofcriminai penalties of a fine up to$1,500.00 and/or one-year Imprisonment,as well as civil penalties In the form of a STOP WORK ORDER and a fine, of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for Insurance coverage verification. I do hereby certO r! d e 7fa eealtles ofpedury that the Information provided above Is true and correct Si lure: Date: 10 1 Phone M. 01'leial use only. Do nat write In this area,to be completed by city or town offlclaL } City or Town: PermlMeense# i Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector i 6.Other Contact Person: Phone#: r. 7 ® DATE(MMIDDIYYYY) A o CERTIFICATE OF LIABILITY INSURANCE ' 07/10/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER 01962-001 RaOJ/►CT Bryden&Sullivan Ins Agcy of Dennis Inc AtlEI.Ext; (508)398-6060 �.Ne,; (508)394-2267 PO Box 1497 �i;�Ess: So Dennis,MA 02660 INMFP _43)AFFORDIRG-00YEEA.GE _ AIC N SURER A: A.I.M.Mutual Insurance Company _ 26158 _ INSURED Michael McCarthy Construction Inc u P 0 Box 52 3� West Dennis,MA 02670 — iNSURER COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 'R9-IICH 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. ILTR TYPE OF INSURANCE yp� POLICY NUMBER �1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ nvrre CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ �OLICY �UECT I �OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Me accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE 9 _ AUTOS (Per accident) UMBRELLA LIAS OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ WORKDEERDg CAM RETENTION $ yy�STg7U TH $ ANNyD EMPLRO�YEETRoSR��UpABILNIETRY�x yyyy�I�I INN�SI X TORY LIMITS OER A OFFICEWMEMBER EXCLUDED9 ECUTNEVA NIA VWC-100-6017656-2014A 7/17/2014 7/17/2015 E.L.EACH ACCIDENT $ 500,000.00 (Mandatory IIne NH) ef uu E.L.DISEASE-EA EMPLOYEE' $ 500,000.00 DESCCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space Is required) Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION Thlelsch Engineering 195 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD I�.�,. _.e--y-:..r""�rs�...,.�w.-`....n�-•....,.-�..-..,..,�rr i+-•�r'.:.;cw�•t.+-.r'7.:Az+ir.P'7.•.c(r•-+'fi"lv�-�'�_�"✓h!�-+:.�h-.-�...•�i.31is..rititi*'V"'4r'.^,+`„r-fr',+r'�'w•" ` �'-•-` '"`•0-�v.-,...,-..,.�"-•r^.-,.�.-.. IWKE The Town of Barnstable BARNSTABLE,$` Department of Health Safety and Environmental Services ` MASS. I � �639• �0 Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice lyp e of I n C 1y < i a on C)5 p s k- V ; f-' Permit Number ` Owner Builder ` .` One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 4 ' r, 41 �. RSA i k( i �J( o �- -- Am yi° J } V Please call: 508-790-6227 for re-inspection. Inspected by 'tY,�, Date - I{ t Parcel o6 jG Permit# House# 0 Date Issu d �� �� Board of Health(3rd floor)(8:15 -'9:30/4:00-4:3z_ C Fee onservation Office(4th floor)(8:30- 9:30/1:00-.2:00) + SEPTIC SYSTEM MUST BE Planning Dept.(1st floor/School Admin. Bldg.) _ INSTAL MPLIANCE Definitive Plan Approved by Planning Board 19 E 5 1GIR - CODE AND TOWN OF BARNSTABLE01 AT-IONS lei R � .,�Building Permit Application ; Project Street Address ' t 0 6 AV-V_ Village r f Owner Address Telephone 7 Z c7 j I, fOXaO.7' x/a �oXyo Permit Request T'10 �wto i �''w -a � a^xo? First Floor square feet Second Floor square feet Construction Type l.,o oCQ 1 pk_55•rllka�• Estimated Project Cost $ S 0 0 0 ^ ! Zoning District Flood Plain M✓0 Water Protection ✓ Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Er Two Family ❑ Multi-Family(#units) ge of Existing Structure 1 yyx . 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 No.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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) " ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 6No If yes, site plan review# Current Use P^lve Proposed Use i?Q RIGv�e. - Builder Information p Name TQ l' K e'wl�)-L'X Telephone Number 0 f,( 3 Address 7W,57_kL0 n) l�}!( l�t-� License# D Y 0/ �Z �''Q—�_ V`'1✓� D ?mob '3 J Home Improvement Contractor# Worker's Compensation# /Y�� s�/� P_a. 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 TOre SIGNATURE DATE BUILDING PERMI DE IED FOR THE O�L W G REASON(S) 01 . , A FOR OFFICIAL USE ONLY PERMIT NO., DATE ISSUED MAP/PARCEL NO. Al ADDRESS " } f VILLAGE. 'OWNER DATEOF.INSPECTION: FOUNDATION FRAME , INSULATION FIREPLACE' � s .� - ` z, -• 's -, ELECTRICAL: ; ROUGH FINAL a P PLUMBING: ROUGH FINALS s { GAS: 'ROUGH ' F FINAL FINAL BUILDING-y o ' - DATE gl,OSED' ASSOCIATION,PL ®� °. The Town 'of Barnstable, j�gj�gjlAf e 9$ 17 9. ,e�' 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 Commission: For office use only ; Permit no. Date ' i AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW- SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization. conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: Est. Cost t'D Oo Address of Work: Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c, 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. t�_,)T1- 6r2.-I Date Contractor Name Registration No. OR Date Owner-s Name The Commonwealth of Massachusetts Department of Industrial Accidents Office ol/nyestigations 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name:' location city 0 Q t.t. � phone# ❑ I am a homeowner performing all work myself. �I am a sole proprietor and have no one tivorking in any capacity „,,,, ❑ I am an employer providing workers' compensation for my employees working on this jab. com anv name: address: city phone#- insurance co. oiicv# ❑ 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: phone#• dW. insurnnce co. oiicv# cam anv name: address. hone#. city insurance co - Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/ one yeah'1mQruonment as well as civil penaltiesin the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement m&y Op forwarded to the OfIIce of Investigations of the DIA for coverage verification. 1 do hereby eertif r t awns and penalties of perjury that the information provided above is true and�eo/rred signature Date 7 _7 d _ Print name fret Phone# 3, ofIIdal use only do not write in this area to.be completed by city or town official d or town: permit/license# (]Bullding DeQarnnent t city ❑Llceruing Board • ❑Selectmen's OMce ❑check if immediate response is required Q$edW Department contact person: phone# ❑emu (revues 9,95 PIA) Information and Instructions r Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from 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 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 section 25 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,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 along with a certificate of insurance 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. City or Towns 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 pernl license number which will be used as a reference number. The affidavits may be retuuned to 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 questions. please do not hesitate to give us a call. FV The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Oftice of Imlesugations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat. 406, 409 or 375 DECKS' If located in OKH or Hyannis Historic District-Certificate of Appropriateness is needed Map/parcel number Sign-offs from: Health Conserva ' Tax Collector Owner's name&address Deck Dimensions ✓ Estimated Cost Complete dwelling information for the Assessor's dept. •� Applicant's telephone number Plot Plan Two sets of plans with cross section r Workman's Comp. form ✓ Home Improvement Contractor's Affidavit -1/ Construction Super's License AND Home Improvement Specialist's License OR Homeowner's License Exemption form. / Check expiration date on license(s). ✓ ration date on license C�e q-forms-PERMITS i Rev 6/2/98 r r ilk LOT LOT 472 58�3 � I l coo _ LOT LOT ff""C A" ' 117 4 5f�1 � ... — &ON OLD L op LoT LO.71 5 79 47(514, 100 " LOT 577 LOT 478 0WNI'R.• MARCAh'FT S do LL'o P. DEM4RC.'U, 77?U TES,5' o!', t L=t T' RE:4l,T}' RE5' zolvE.. This PLC'I N ,`�'�{� f'iRn ih TOWN: 11,',FT .�,. 3:I-.I, r.:sP o,! DEED P.E F r�,� y UST _ .... — Rr�,�t ?P,'r G WNEH: � � DATIJ: Z6/v5�•�_ — e E'LYER: � J. . _/ice%1�3. G—��c'.L?G 4- — - - AN REEF: F T. I HEREBY CERTIFY ` O �4:9 �_� �1L'.-L �_--- __ - - _ _ __ _ lc�v__ . --- �- —. ..—THAT r THE BUII,DI G L��� YANI:EE SUHVEY SHGwN ON THIS PLAIT 1S 1-0(-,�TED ON THE GROUND � � ``�O►';L � T s HU'+�'IV AND 'r D w. L�L'1 a>N`I S THAT ITS PO._ITION Dt]E`i CotiFi-)i?�I : ��� TO THE ZONING LAW SETBACK RE:Q(..'IXEMFNT3 OF THE •1�':;( i�:-':�qF4, , '1.013 (SUM'F; 1) TOWN OF SaRLti.51:=1f���' _AND THn'I' �'::\ h�: :,�+r : ' INDUSTRY ROAD IT DOESWF IE WITHIN THE SPFC:IAL FLOOD Hr17.a,RL� r.:.,•��`/.<, MAPS TONS A S SHOWN ON THE If. U.D. MAF' i)A'1'�D_7 '� � aTONS A!lt.LS, �1A O�tl.c8 �517001 0008 J ,�/ !'IiIS P r1�S -I:?U-,5`)'j (1 n h .tt F? w• --- LAN NOT 1�1,1U: r'.U1! AN !I�>STRUMLN''r tit;R�'1<1'• NOT TQ r1t: l"�k: FUR F":N•.FS. i fi7�!GTY�'• r���.� -u�..a�a�su sr .r.r r+u.i cjcseGl_� 215 Run Hill Road Brewster, MA 02631 (508) 896-5333 Jeff Hennemuth STc �� ova .. 13U 1 v 37 bVe— �- q d o� C9 "Vj 6 0 j\.o.►��, ri ►I x � x � g M✓4x - ;r IG O"I G.. Fo on rJ _. i 'J r ; r t V jgt LA 9-3 G . Ly GDcq llllil Zx� to r Q "�aaa�� aQa 215 Run Hill Road "•r-Brewster, MA 02631 (508) 896-5333 ; FJeff Hennemuth' vb� • J rj , t � x y a 1' 9 } r a , w- m o Y d a ✓FX F to u a s e i . x.r • li •�� Bey V Ar P �y Gv oy)f �- r�------ Zz36 -----^� y n j f :h � �A*.✓� IVO�n1lINJU//e�6�✓I�LQ [QCN9 1 'e',p. � � w ri _HOME IMPROVEMENT CONTRACTOR "Re91stration I06821 �_ Typex ;;PRIVATE CORPORATION Et lon 07/27/00 zpira :! > L . DECK HANl�INC x �' � leff re yC Hennemuth 2 G� �o7� Run H111 Rd. k -� € ADMINISTRATOGR� c t i 4 Brewster MA 02631 n��� „ � �} i - � ✓fie Uanvi�raruuea� a ./�,craoac�uteCGi\4,� ,0.' DEPARTMENT OF PUBLIC SAFETY '•. } T; CONSTRUCTION�SUPERVISOR'IICENSE Humber '_ Expires: pp N 4 Restri id j OD ` G+ . 2Is RUN...III RD " 'BREWSTER,. NA 02631 r a e . r a r n i t To- F Yet:ix F 6--"� �. d v: 'r` '� is S •'•F + .r�. � !�R. sessor's'Office(1st•floor) Map L/5 Parcel �6 Qic Pefrmit# Date Issued 3 =9,57_� Fee C,/6ngineering Dept. (3rd floor) House# BIKE, BARNSfABLE. • . IA 19 BB t6.9..�•� rEo rAt•+ 4 TOWN OF BARNSTABLE Building Permit Application ,/'Projec dress /B fj��` sl xr" CVigu Lor7G illage t oS' k • '6 er Xddress //"elephone D Xermit Request ST�1<° `� ��s'✓`¢�f-�4 �5,�44 } j First Floor square feet Second Floor square feet Z-Estimated Project Cost $ �-SO,b D Zoning District Flood Plain . Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type ! Commercial Residential Dwelling Type:. Single Family Two Family Multi-Family Age of Existing Structure 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 11c, e, �elephone Number 2 0— 0 c '4// dress eG /7,4% Z.,4. __License# 00 9�?� 1;/1?1U4_1J4 ✓iYV, G a1-c o f Aome Improvement Contractor# 114w, 62 Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ✓ 1, `cam DA �� BUILDING PERMIT DEN ED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERM N DATE SU D MAP/ AR EL NO. ADDR SS' VILLAGE _ OWN DATE F I SPECTION: ' 1 FOUN TION FRAME' INSULATION FIREPLACE ! ELECTRICAL: ROUGH FINAL j } 1 PLUMBING: ROUGH 1 FINAL - F GAS: ROUGH }° FINAL Y FINAL BUILDING ��yIda , DATE CLOSED OUT ! ASSOCIATION PLAN NO. The Commonwealth of lfassachusetts Departnumt of Indttstrial Accidents .. .. 6l1(l Washington Street Boston,Mass. (12111 Workers' Compensation Insurance Affidavit ,0,iFwltc5nt,—nformation� Please PR1NT`ledibl :� c//name GS' �6• �� ��s MEam,a omeowner performing all work myself. Z a sole:proprietor and have no one working in any capacity 1 am an employer providing workers' compensation for my employees working on this job. company name' address: — city: phone#: insurance co policy# 171 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: csJm�J•an•n•amc• iddress• city• phone#: i surince,co policy# I.�:�:`.ry_- ,- -_ _ �c,yu.-•.5::.,::�a�o.s'z-�"•y.;•—r.ee•�s=-•*g�:+4;,••s•--�-�JVras+lrTr�i••*,�n:�c;•.•..•t, ri�;�,�+q^-•w+.°'i�;=aw'r-.•-.•:'^ss rrS company name: ^ddrecs- city phone#• insurnce co policy# :Attach additionalshtietifnee 141'v.tlt^ia� ..:_:_.; ? rt� i_;._`c'!£_^�"'•.�.� ? --'� .^'`S",•,T''_ w.wMw .�'S Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1�.500�.00 and/or one%•cars'imprisonment a.well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do Irerehr ccrtij) tinder tl •pairs and peas/ties of per)un•that the information provided above is true and correct. Si_nature Date l� p� Print name l �L ` � Phone official use oniv do not write in this area to be completed by city or town official city or town: permitAicense# Buildin g Licen O check if immediate response is required Selec �11calcontact person: - - � � phone#;. nUthe The.Town of Barnstable �g Department of Health Safety and Environmental Services �e� �e ,• Building Division 367 Main Street,Hyannis MA 02601 " Ralph Crossen Office: 508-790.6227 Building Commission! F= 508 775-3344 For office use only Pcnnit 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 ptz-existing owner Occupied building containing at least one but not more than four dwelling units or to savctruzs which arz adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. �yPe of Work: Est. Cost Z- !!r6, PP Address of Work: ner.Name: W-el'C'0 /date of Permit Application: I herby certify that: Registration is not required for the following reason(s): s Work excluded by law, 3 Job under S1,000 -occupied Building not owner Owner pulling own permit . Notice is hereby given that: CONTRACTORS OWNERS PULLING.THOR OWN PERMIT OR DEALrNRICG WITH N E LESS TO THE FOR. APPLICABLE HOME IMPROVEMENT' OT HAVE AC ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c..142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit asthe agent of the owner: M '' Date Contract r name Registration No. OR Date Owner's name . Assessor's map and lot number J �� /� — //2 1//7 !r Sewage Permit.number .......... -'•.. ��.-....................:.... . i TH E �Q ♦� TOWN OF BAANSTABLE, o� i BARNSTADLE, i Mb BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... ... .. ..................................... ........................... TYPE OF CONSTRUCTION ..................:5;�-�- Z 7-1�......77��Xjq......... ............................. { 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .............�(J;e................................(N•!..... a??��t !1�� ................................................ t................. 1 / ProposedUse ....................... C. ......................................................................................................................:1........... Zoning District '........................................................................Fire District ............T...".'!.(�.. ...h..�.S........................................ II�� Name of Owner ..[�'e 4...... e... (il Y'�a................Address . 7 /:T � :fie 3` : ....... ..... .......... ...... ................. ..... . .. Name of Builder! � ! r W' r.........Address ........! � .................�W w........ .......... ... ....... ............ ............... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ............Interior ........:.......................................................................... ........................................................................... Heating ..................................................................................Plumbing .................................................................................. .................................................................................. /nn� Fireplace Approximate Cost ............./A.V.!!........................................... Definitive Plan Approved by Planning Board ________________________________19________. Area ......... v. ............... v (� - Diagram of Lot and Building with Dimensions Fee / SUBJECT TO APPROVAL OF BOARD OF HEALTH _ I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name' C ..... ....... ...................... DeMarco, Leo;,- � 172afi add deck to r No ................. Permit for .................................... single family dwelling ............................................................................... Location10 .6th Avenue .................................................... ................... West Hyannisport Owner Leo DeMarco Type of Construction frame Plot ............................ Lot ................................ Permit Granted .........July..24...............19 74 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ............................................................................... ............................................................................... Approved ................................................. 19 ............................................................................... ............................................................................... ` Assessors: map and .lot •number // `�.......�: ' ` �'` ���� 7/2 :5A OPTIC SY�T '1 MUST BE ,NT UE t4� Cam^Ai CE Sea Permit number �v . AF. y 00DE AND TO N r a Qy�FTHErO�y =� . a To .11 OF BARNS ALUgT% .._, ` i HA" ADL4 0 1639. �•� BUILDING IHSPlECTOR AE MPY a'G i, t, APPLICATION FOR'PERMIT TO ......`. .................. .. QC .....................................................:................. TYPE OF CONSTRUCTION .......== /.n / ,�Q... .. '�rLt. ................................... .......... 4LYX ..7�: ......19��� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information. Location ..........................4�............k4.v!!�r...............................f01...... ... .. !YIm . . * ...................................... t ProposedUse .................... -oc.......................................................................................................:............................ ZoningDistrict .................. `..........................................Fire District ............j.q n.j..4........................................ Name of Owner .f� 4....... 2....Y..C.I���1!Cb................Address ... 7./7. .... ........ ✓'... .. Name of Builder .... `.....: . Y.... ° .—r�...........Address 1?� W� �_ ...... ........... . ..... .. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ...................................................................Foundation .............................................................................. Exterior ....................................................................................Roofing .................................................................................... ................Interior ......................................................... Floors ..................................................................... ........................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ............./�.......................................... Definitive Plan Approved by Planning Board ________________________________19________ . Area . .. ................. Diagram of Lot and Building with Dimensions Fee /. ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH O t �ee I hereby agree to conform to all the. Rules and Regulations of the Town of Barnstable regarding the above construction. Name le:l!;?��.... ..... ..................... DeMarco,. Leo JW add deck to No ..... Permit for .................................... sj�gleJamil Y dwelling................................ Location" ........6th Avenue ........................................................ West ............................... .................. dk Owner ..........Leo .................................. . .. ............... Type of Construction ...............f r.a.me................ ............................................................................. Plot ............................. Lot ................................ Permit Granted ..........July 2t�/...................I........4.19 74 Date of Inspection .......r.... 19 Date Completed . 3 .... 9 PERMIT REFUSED 4 .......................................................... . ......................!........................................................ ............................................................................... ........................ I................................................... ............................................................................... Approved ................................................... 19e�� ............................................................................... V,- ................ ......... ..................................................