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0071 SPRING STREET
1. II �I II i ki 9 G `I I 1 �I E i i i ' Town of Barnstable �� r 200 Main Street, Hyannis MA 02601 508-862-4038 a Application for Building Permit F a Application No: TB-18-940 Date Recieved: 4/2/2018 " Job Location: 71 SPRING STREET,HYANNIS � off? C7O Permit For: Building-Insulation-Residential CIO Contractor's Name: State Lic. No: Address: , Applicant Phone: (508)775-1214�,N3 m (Home)Owner's Name: DEJESUS,OSCAR Phone: (774)368-0114 (Home)Owner's Address: 71 SPRING STREET, HYANNIS,MA 02601 Work Description: 9" layer R30 unlaced fiberglass to 320 sq ft attic space,2 hours air sealing,crawlspace 180 sq ft R21 closed cell spray foam to perimeter wall w ignition barrier over all exposed foam" b Total Value Of Work To Be Performed: $1,700.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership,may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is-the-subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Henry Cassidy 4/2/2018 (508)775-1214 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost $1,700.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 �� � ._.._....,._.. ; . Total Permit Fee Paid: $0.00 F;'57, T &IS IDS0APE I'I' r cQA �iHE Tp� Town of Barn able 1 *Permit# ires 6 months from issue date Regulatory Se 1 � fee f y M,►ag. $, - , Richard V.Scali,Director_ �yi� �•v /y 1639• ♦0 �/'/� H A'F� �" p Building Di. � -l. � l Paul Roma,Building CommISS olur �r 200 Main Street,Hyannis,MA 02601� ��) e - www.town.barnstable.ma.us Office: 508-862-4038 ` Fax: 508-790-6230 EXPRESS PERMIT APPLICATION = RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Residential Value of Work$�I��DO Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name ,--U�L/✓ Telephone Number Home Improvement Contractor License#(if applicable) �'S Q��j Email: i,' awc5 s—; dP—p� Construction Supervisor's License,#(if applicable) e',' C ❑Workman's Compensation Insurance Che one: [)., II'am a sole proprietor LJY P P ❑ I am the Homeowner, ❑ I have Worker's Compensation Insurance Insurance Company Name k24eZ5` 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 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof): - 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,Le,Historic,Conservation,etc. ***Note Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&,Construction Supervisors License is or, equired. SIGNATURE: Q:\WPFILESTORMS\building permit fonns\EXPRESS.doc 01/25/17 ` i 1 600 WashhWon Street _ Boston,M4 02111 tPPVtf3.#lJl �[iTIR . WarlmrSs C Insarance Affidavit:BbildeI-JCtmhuctursMec&iciaIIs/Phun ers AppHcantInfwmiafiGn Please Fxint V Addrei; IIG Are appropriate T project I. I oat a employes nth 4 ❑I am a general contractor and I 0 of p ro7 {r etluired}: . employees(full an&or par"me * have lured the sub-contmctors 6- ❑, ,,��°0 °� 2.❑ I am a sale "etor or partner-_ Ested on the attached sheet~ I- E?Remodeliug. 1m � Mese sub-contractors have ship and have as employees 9_ ❑Demolition w forme is employees and have workers' o�g �9 _ � 9..❑B,ni1�addition Wo yy�g'comp,in©zance comp-msmmnf required-] " 5. We are a corporation and its 10-❑Electrical repairs er addikons 3_❑ I am a hameouner doing all work' officers have esem-sed fear IL❑AmEngrepairs or addilioms right of on per MGL myself[No w�oskers'oomp- � §I{ �.dwe haareno 1�❑Roofrepairs , insurance required-]1 employees-[No worms' 13.❑other s camp.insurance mquired.] 'Axp apg�6=t c iedmbos#1 mmst 9m Moulthe sm iaabeiaa shearing&e¢wodcess'campeasatiaspaIiiCyirrty=Kam #TRameownerswho submit dris sffidasil imiRrwhn Spey mEdoiag gHwa&sadthenlase cutude c,.urrarem— mikmit anewaMda&india Ong sacb. fCarmtsc I 1hzt check this bmc mast wftdw sa addilinoal sheet showing the"—of die sub-c�sad stsfe whether"not those entitiesh.we employees. lfthesdb-cmtmc km employws,&epmustpmmdetheu wodma'immp.paliyatnabm lam an $erviv is the paHey and job she' irzfornxafian. _ Insurance Company Name: P4ficy�or Self-izes.Iic.�: ff��/✓�O���- c��/� �piratioa I3afe:�� ,`� .., Job Sit�AA&e= �//� Cdgl5tafe� A t ach a copy of tfie workers'comzpensationpoIicg declaration page(chewing the policy num er and espi mtioa(late). M Failure to secure coverage as required under Section 25A o€MGL m ZVI can lead 10 the imposition of criminal penabaes of a fine up to$1, OD.00 andror one-year impdsm==3k as well as rivil penalties in the fare of a STOP WORK ORDER and a fine of up-to$2f&0t7 a day against the violator- Be adiised that a copy of this statement maybe forwarded to the Office of Investigatiar s of the DIAL for insurance coverage verification. T do he rgby cer4#under die pains andpenabVes afperjury that the informaff rprovided abmw A trus and correct Date- Phone ik- - Ojoisid use aWy, Da iwtwrite in tars area,ter be camplited by city artswn try`rciat City or Town.: PemiffAcense Issuing Authority(mrie one): L Board of HeaItiiTsng Depar-tn> at 3ioiea Clerk d FJeetrical Insper �.Plumbing Insgectz►r &.Other Com#nct Person: Phone#: haformation and 11astr.ctions Masmc aseft Geheral Laws chapfra M reqokEs all=ploy=to la avide wozi=:e coa1peuusati6n for tbeiF employ=. pursmmt to•Ibis sty,an nnp&y=is de5.ed as.=every pers6n in ffie service of another under any co*t ct o fhf, t express or iiuplieCL Dial or writh=v" A.Moyer is defined as"an indxyidnal,per,association,corporation or other legal ena ,or any two or mare of the fuxegoing emgaged is a joint euprise,and including the legal represyes of a deceased employer,or$ie receiver or tmstee of an kuffV1dmA per,association or ofherlegal entity,employing employers. However the owner,of a.dweMhg house havinggnot mcse tbm three apa dmemrts and who resides$herein,or the c)=q mt of the - dwPj,mg house of mlof=who employs persons to do mamf mmm,cm*action on or repair wo&on such dwelling house or onthe grounds orburijdmgappmt=P-&Ihereto shallnntbcamse ofsach employmentbe deemedto be an employ." MGL chapter 152,§25CC6)also states ffu±"every sfafe or local Rcensing agency shaII withhold$ze issuance or renewal of a Tcense.or permit to operate a business or to construct buildings is the cocumonwealth for any applic=twho has not produced acceptahle evidence of crimpHance with the insurance coverage requires Addhionally,MCM chapter 152,§25C(7)states-Neither the nm=a wralth nor any of its poIitical subdivisions shall enter into any contract for the perfimnauc e ofpublic wm kuatil acceptable evidence of compliaAcewith$ie.i mmancce.. heqazem, eu s of this chapt=have beenpresentcdto the contracting mdhouty." A ppTicanis PIease fill o:ct the wort =,compensation afhdavrt completely,byd=cIdugfhe bores�apply to your situation and,if nmessatY, Ply SOD s)nme(s), �)andphonennmbe�s)aIongwithfherr certifrcate(s) of insurance. Limit Dd Liability Compames(LLC)or LimitndLiabilityPextaershrps CLEF)wr&no employees other fhan the members or partners,are not reamed to cry vworke&campensafion i saxs ce- If Eu L LC or LLP does ha:Te empIoyers,apolicy is required. Be advised that this affidaykmaybe s¢bmittedto the Department of Iudnsbrial Accidents for confmmafim of i sm-m=coverage. Also be sure to sign and date the zF=dayt The affidavit should be mt=med to!he city or town that the application for the permit or license is being requested,not the D ep artm.eat of ; Indnsftial Ac,mdms. Should you have any gnestious regarding the law or ifyou are regm'ed to obtain a woiers' compensation policy,please call the Department at the number listed.below. Self-k=ed companies should entLr their self ins=mc6 license number on the aPprespriafn line. City or Town Of Please be sm;a that the affidavit is complete and primed legibly. The Depa tnert has provided a space at the bottom of the affidavit for you in f 0I out is the event the Office ofInveti t orts has to coact ycu regarding the applicant_ Please be sure to fill in the permi Vlicense nmober wbich will be used as a ref rr nco number. Iu addition,an applicant that must sabmit m_uhiple per ,;+/ .C=se applit stions in may given year,need only submit one affidavit rn dicating eunzent policy information(-if necessary)End vmdea'Job Site Addre&*the applicant should wades"an locations jn Cry or town) ,A copy of the-affidavit that has been.officially stamped or madced by the city or town may be provided to the - • applicant as proof that a valid affidavit is on file for furore peunits or licenses A new aiidavit must be filled out earh year.Where a home owner or citizen is obtaining a license or permitnotrelat!;d to any busmess or commernial Cie.a dog license or permit to bum leaves eta.)said person is RIOT requa-cd to complete this affidavit The Of of Ind would Ifim to thank you m advance for your cooperation and should you have any gaesiions, please do not hes>tE�to give us a caIL The Department's address,telePh=and fax number The *of Masmchmeftg - ' went of lid lAcoidenta Of CL=of IuVe&tkMti0= 64"WnStmd Btu MA 02111 Ta 4 617' -4 QExt 4-06 car 1477-MAS E Fax#617 72'-7749 Revised 424-07 MaS59DVARM , Town of Barnstable Regulatory Services KAM Richard V.Scab,Director. i639. � Nua� Building Division. Paul Roma,Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I ,as Owner of the subject property hereby authorize_�/"d ���tP/ to act on my behalf, ,in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature-of Owner ZS' ttare of Applicant r .:`a���1 Print Name Print Name Date QTORMS:OWNERPERMISSIONPOOIS Town of Barnstable Regulatory Services ` Q1Ft b Richard V.Scali,Director Building Division i BARNSTAB . : Paul Roma,Building Commissioner sip. 039• �� 200 Main Street, Hyannis,MA 02601 ° p www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ..JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occgRied 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 - 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. t 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 this issue is a form currently used by several towns. Nou may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doe 06/20/16 ^ y - i .w Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-085363 a Construction Supervisor .� NK JOHN A MACKENZIE 248 CAMP'ST.1-4 ®M1z, WEST YARMOUTH MA f02673 'Expiration: µ { on: Commissio er 01/03/2019 -------------- Ni 33 M C n k' :. . t - _ Office of�AAonsu Affaiis&Business Regu ahpn OME,;IMPROVEMENT CONTRACTOR � f s a Registiafion Ype tExpitation- 1p 0/28/204? Individual �JOHNMACKENZIE = �eg'JOHN MACKENZIE , Y gw �p 248 CAMP ST ro r..,gv, #WI,�YARMOUTH MA 02673 _ x ' - Undersecretary r ACORO® CERTIFICATE OFIIABILITY�.INSIJRANCE 1�TE(MM/DDYYYY) 9/19/16 FTHIS 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 GT 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 doe`s not confer rights to the certificate holder in lieu of such endorsement(s). ' PRODUCER NAME: United Insurance Agency, Inc.- PHONE 199 Main Street (508) 759=6595 FAX Na; (50e) .7s9-3s22 ., EMAIL A P.O. Box 1013 � <' :. DDRESS: Buzzards Bay, MA 02532 INSURE S AFFORDING COVERAGE NAIC# INSURED INSURER A:Atlantic'Casualt - . John Mackenzie INSUkERe:Travelers Indemnit INSURERC c •248 Camp Street ' L 1 INSURER D ' West Yarmouth, MA 02673 - INSURER INSURER F c 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS w' 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 8Y,PAID CLAIMS. INSR im SUB R POLICYEFF POLICY IXP LTR .TYPE OF INSURANCE POLICY NUMBERMM/DDVYYYY - LIMITS -A GENERAL LIABILITY 1./17002318 9/23/16 9/23/17 FAMAOCCURRENCE= As00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED` PREM E Ea occurrence0 CLAIMS-MADE OCCUR. MED D(P(Any one person) 0-- PERSONAL&ADVINJURYQ GENERALAGGREGATEI'" 0 GEN'LAGGREGATELIMITAPPLIESPER PRODUCES-COMP/OPAG0POLICY PR0LOCAUTOMOBILELIABWTY OMBINED IN LE LIMITa accident - ANYAUTO , ALLOWPED BODILY INJURY(Per person) $' AUTOS SCHEDULED .. AUTOS BODILY INJURY(Per accident) $ - HIREDAUTOS NON-0WNED AUTOS �. PROPEREY DAMAGE $ " Peraccident LEE A LIAB OCCUR EACH OCCURRENCE $ EXCESSAR CLAIMS-MADE AGGREGATE $ RETENTION$ j B NORKERS COMPENSATION E$ "-' AND EMPLOYERS'LIABILITY 6HM0632289116 -9/24/16 9/24/17 X' WCSTATU-ANYPROPRIETOR/PARTNEED?. UTNE Y/N E.L.EACHACCl1:ENr0,QQQ (Mandatory in ER IXCLIDED?, N I A (Mandatory in NH) ` If yes,describe under E.L.DISEASE-EA EM0,000 DESCRIPTION OF OPERATIONS below E.L:DISEASE-POLIC0 000 ' F DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Rerrerks Schedule,if more space is regri red) Carpentry Workers Compensation y g policy does not include coverage for John Mackenzie L - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I THE EXPIRATION DATE THEREOF, NOTICE' WILL BE .DELIVERED IN John Mackenzie ACCORDANCE WITH THE POLICY PROVISIONS. 248 Camp St 1,1 AUTHORIZED REPRESENTATIVE West Yarmouth, MA 02673 Kris. Dexter ©198872010 ACORD CORPORATION'. All rights reserved. 25(2010/05j The ACORD name and logo are registered marks of ACORD Phhone:one: Fax; E-Mail:"di-j on55 @ho tmai l:.com ,o I, t It � of E t i i i d �_ , _ .� - { � }, .� ,t, n! r . i �. 4 + t .. - �'� 9 :� � _ i R'L'�"'" .�� 7. 1: Y _��` rJ1�i11R�1 -- .. 4-,: G�.� `� J..� � .. jI) - 1 I I ` I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION n TOWN OF BARNSTABLE Map 3 a & Parcel D a O Appli cation s �� 2011 FF� .19 PM 2: bate Issued Health Division Conservation Division Application Fe . r Planning Dept. Q Permit Fee � Date Definitive Plan Approved by Planning Board _Z o "'-1 Historic - OKH Preservation/Hyannis Project Street Address Village 1A o an n i s Owner stevf-n Y\\ is Address Sa,M� Telephone C-�OR - 3 5 - 6 N .V+ Permit Request Adl �-11 an J lk - 31 CA%%`0 t-6 t�t OLi c. D n walls and b"eMeAA w, � ex.Qgrt��ng �o�m. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 4 5 00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. 1 Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 9 3 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: I$Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes 1f 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 n . W�1 1`, �&66y Telephone Number Address - D 14 4 n+,'n 11 avt License # Sa . V-,rrMk , d 9,�6�� Home Improvement Contractor# Worker's Compensation #7W f, 331 �00 �-- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO�gcmpy � SIGNATURE DATE 'g `3 FOR OFFICIAL USE ONLY i 'APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION r FRAME INSULATION c FIREPLACE ELECTRICAL: ROUGH FINAL . PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL t S ' FINAL BUILDING DATE CLOSED OUT t i ASSOCIATION PLAN NO. 4 r -- INIassachusetts- Department of Public Safet. Board of Building Regulations and Standards Construction Supervisor Specialty License License: CS SL 102776 Restricted to: IC x ', WILLIAM MC CLUSKY t. 37 NAUSET ROAD WEST YARMOUTH, MA 02673 t. P Expiration: 6/28/2013 l Cummisciuncr Tr#: 102776 1 ` Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 _ Type: Corporation Expiration: 3/14/2014 Try 222184 CAPE SAVE INC. - WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 _ _ - - Update Address and return card.Mark reason for change. - ; Address l Renewal 7, Employment Lost Card PS-CA1 0 5041.04/04-G101216 J1e �a�rm�toozraea c���ljasaac/urelta License or registration valid for individul use only Office of Consumer Affairs&Bdsiness Regulation HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: .171380 Type: Office of Consumer Affairs and Business Regulation Q - 10 Park Plaza-Suite 5170 '4WRW Expiration: 3/14/2014 Corporation Boston,MA 02116 CAPE SAVE INC.`. WILLIAM Mr-CWSKEI':' .;=== 7-D HUNTINGTON AVENUE SOUTH YARMOUTH.,MA:02664: Undersecretary Not valid wit o signa DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12 11/9/20 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICAT OES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. YAIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRES#NTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pol(cy(ies)must be endorsed. If SUBROGATION IS WANED,subject to the terns 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). 1 PRODUCER CONTACT Shannon S errazza NAME: P Risk Strategies Company PHONE (7$1)986-4400 F No:(781)963-4420 15 Pacella Park Drive A[MResS•ssperrazza@risk-strategies.com Suite 240 INSURERS AFFORDING COVERAGE NAIC0 Randolph MA 02368 INSURERA:Selective Insurance INSURED INSURER B:Safety Insurance Company 3618 Cape Save, Inc INSURER C-Technology Insurance Company 7 D Huntington Ave INSURER D: INSURERS: South Yarmouth MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1211954576 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 ADD ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVDPOLICY NUMBER M/DDNYYY) (MMIDDIYYM LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) S A CLAIMS-MADE ❑X OCCUR S199448001 0/16/2012 0/16/2013 MED EXP(Any one person) S 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 JECT X POLICY PRO- LOC S AUTOMOBILE LIABILITY EO aBccidentSINGLE LIMIT S 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 6208200 1/6/2012 1/6/2013 AUTOS AUTOS BODILY INJURY(Per accident) S X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per.. X Underinsured motorist BI split S 100,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE S 1,000,000 A EXCESS UAB HCLAIMS-MADE AGGREGATE S 1,000,000 DED I I RETENTIONS S199448001 0/16/2012 0/16/2013 S C WORKERS COMPENSATION Officers excluded X WC STATU LIMIT7S O R r AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN FC3'318007 o coverage E.L EACH ACCIDENT S 500,000 OFFICERIMEMBER EXCLUDED? ❑ N/A l (Mandatory In NH) /9/2012 /9/2013 E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,describe under DESCRIPTION OF OPERATIONS bet ow E.L.DISEASE-POLICY LIMIT $ 500,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Issued as evidence of. insurance. Issued as evidence of insurance. National Grid Corporate Services LLC d/b/a/ National Grid, Action Inc. , Colonial Gas Company and NStar Electric are listed as additional insureds as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE r THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 427/SCH 3195 Main Street AUTHORIZED REPRESENTATIVE - - Barnstable, MA 02630 Michael Christian/SMS - ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. IN3025 oninnca ni The Arnion name onel Inn^mre ranieforeel mmrlec of Af'nDh �,,,e ?" '�!'�"" / /�f--� i"' � ,i ems_.. ��r r `y� 5 le, / s��� �zs�- �1�-� � � . C91 Town o Op7"E r Regulat Thomas T. BABNSTABLE, ► y MASS. Buildi t6gq. ArEo�►�16 Tom Perry,Bui 200 Main Street, Office: 508-862-4038 Buildin2 Permit Pro 1. If lot does not comply with minimum lot siz attesting to a title examination of the abutting 1 with any subsection(1 - 6) of Section 4-4 . 2 a subsections available upon request) 9- -- Plat- uh.a !n� G�;�..�,���1�s `� � ,. �" ��- �- �- �, �� ��� � '� pU7HE role, Town of Barnstable Regulatory Services ' ASS.Mnss. ' Thomas F.Geiler,Director y �►, �FOMars Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 August 29, 2005 Mr. Steven Ellis 71 Spring Street Hyannis, Ma. 02601 Re: Illegal Apartment—71 Spring Street Hyannis, Ma. 02601 Map 328 Parcel 020 Dear Property Owner: Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal two-family home. Please contact this office immediately to tell us what direction you wish to take. Sincerely, Linda Edson Amnesty Program Zoning Officer Building Department gforms:zoning3 oFtHE r Town of Bar *Permit . 4 Expires 6 months froin issue date P Regulatory Services P i SBARNSTAB PER as.F. Geiler, Director � 9 MASS. �Ar i6�9• A,� �' Building Division fD MP'� OCT I Q 200jom Perry;CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 TOWN OF SARNSTAf3LCww.town.barns table.ma.us Office: 508-862-4038 Fax: 508-790-6230 . EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid ivithoul Red X-Press Imprint .Map/parcel Number3, LOT /0 Property Address --.�_L1. �.� �y�Pl�12 t 44 A IK'Residential Value of Work �(000- __ Minimum fee of$25.00 for work under$6000.00 O\vner's Name & Address S't e-Vr-n g__CL.LjS Contractor's Name - --- -._ ___-- Telephone Number ( 7 7L- 7 I tome Improvement Contractor License#(if applicable)_ Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance ,Check one: ❑ I am a sole proprietor �M , am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name -- Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on tile. Permit Request(check box) [l'Re-roof(stripping old shingles) All construction debris will be taken to yQ A M01"IX Q✓V`i P ❑ Re-roof(not stripping. Going,over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum .44) Where required: !ssuance of this permit does.not exempt compliance with other town department regulations,i.e. Historic,Conservation,etc. ***Note:, Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required: SIGNATURE: Q:`.WPFILLiS'd-ORMS\building permit forms\EXPRESS.doc Revised 100608 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gav/dia Workers' Compensation Tnsnrance A.ffdavit: Build ers/Contractors/EIectricians/Plumberr, Applicant Information Please print I,etri blY Maine (BusintS6/O is i7Afion/ln[EviduB-]: 1 j�t--Ile k? FZ 1j S Address: ZZ City/StatclZip: �}yy v► 5 m:& o 26o I Phone*: 775 1 :0 7 Are you an employer? Cheek the appropriate box: Type-of proj ect(required): 4. [� I am a general contractor and I 1.❑.I am a employer with e aon c ctDr nd 6. ❑New construction * have hired th employees(fall.and/or part-time). 7. Ramodelin 2_❑ I am a sole proprietor or partner- �� °n thc attached sheet ❑ g ship and have no employees These sub-contzactors have g, ❑ Demolition worldng far me in any capacity. Cloyec, and have workers' g. ❑Building addition [No workers' con p.-irrcrnanre comp.insurance.$ S. ❑ We arc a corporation and.its 10.❑Electrical rcpans or additi �t quires] officers have exercised tbra 1L❑Plumbing repairs or addtt' 3. I am a homeowner doing all work myself [No workers' comp_ rigbt 6f exemption per MCL 12 ❑Roof repairs t c. 152, §1(4), and we have no insurance r employees. [No workers' 13.❑ Other comp.insurance rcquircd_j '`Any applicant ffrat th=I=box#i must also 5U out thc r=6on below tbowing their wmi=t'cony arsation policy information t Homwwnat who cuhaat this afEda t indimt g fey are doing all work and then hire outaidc conhmcdors must submit anew zABLvitindirafing such t--Mtractors fiixt cb=lc this box mast atf AM an additional chest showing thc name of the sub ronliattrna and sfatr whctlia ar not$host entities have employees, if thc sub eantrretrns have enoployntr,they must prvvidt thcir wari=s'camp.pAry number. I am an emplayer that is providing workers'campensat on insurance for my employees BeLaw is the policy and job site - information. • . lnsuianca Company Name: Policy#or Sclf-ins.Lie.#: Expiation Date: Job Site Address: CityIStafc/zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and e=piration des Failure to sceurc eovetage as rcquirt d under Section 25A of MGL c. 152 can lead to the imposition of criroiri.al pmaltics c firer:tip to 51,500.04 and/or onr-year mprison=nt, as wcII as civil penalties in.the form of a STOP WORK ORDER and of tip to$254.00 a day against thc violator. Be advised that a copy of.this statrmcrit may be forwarded to thc Office of Invcstiga,tions of thc DIA for t'nsu ancr.coves o veri5.eation.. I do hereby certify under the pains-andpenaLdes cfperjury that the information pravided/above /Iss true(imd correr-L Phonc# 7 l 7 O use only. Do not write in this area, tb be completed by city or town bfficiaL City or Town: Permit/.License# Tsnda ff A,uthority(circle one): 1.$oard of Health 2.Building Department 3. City/Toym Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Town of Barnstable mop IHE ray Regulatory Services swtuasixsce Thomas F.Geiler, Director Y MASS. Building Division PTFD '�a Tom Perry,.Building Commissioner 200 Main Street, Hyannis, MA 02601 RVww.to ivn.barnsiable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 101��—��/ 0� } / JOB !LOCATION: I 5 t' r t h q 617• 1 Y'r H h 1 S number C street 7 villager) "HOMEOWNER": S°t-�ir>un 2 GL-Z,i� S©,5 / 7S— k Z7 �j�U � Sy�j 5 83L1 name home phone# work phone# CURRENT MAILING ADDRESS: 7/ f- Ycr h vx 1 5 MA 02bo 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 HOMEONVNER Persons) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to- be, aone or two-family dwelling,attached or detached structures accessory to such use and/or farm stvctures. A twa-year period shall not be considered a homeowner. Such person who constructs more than one home in a "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) 4 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: �Sz r7L ��� • Signature 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 perm t is required shall be exempt from the provisions of this section(Section Iog.1,1-Uccnsing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner_shall act as suprsvism Many homeowners who use this exemption are unaware that they arc assuming the responsbilides of a supervisar(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 homcownrx is fully aware of his/her responsibilitics,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the responsibilitics of a Supervisor. On the last page of this issue.is a form currently used by several towns. You may cart t amend and adopt such a form/ccrtification for use in your community. °pYHerti Town of Barnstable Regulatory Services f Y aAHSrABLE• Y Thomas F. Geiler, Director rEDµp�h Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner MUSt Complete and Sign This Section If Using A Builder I , as Owner of the subject property hereby authorize to act on my behalf, in altmattets relative to work authorized by this building permit application for: (Address of job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on th'e reverse side. f C2 MyList Print Page Page 1 of 1 Click here to go back. Category: Rentals Description: Apartments - ?? CENTERVILLE: ?? Studio, Ideal for one, non smoking, $125 per week.. (508) 771-9041 ?? Location: MA Date: 8/C2 Source: Capepe Cod Times cription: Apa tments - HYANNIS ?? 2 all new cozy .studios w/ki chenette . .$175weekly ?? 1 bedroom cottage near beach $900 incl heat/e ect 'c Charlie, MCP (roperties 508-778-9777 Locatio MA Date: /2 005 o ce: Ca a od Times �. Description: Apartments - ?? MARSTONS MILLS: ?? Efficiency. Ideal for 1, $800/mo. includes all but phone. Angela 508-292-4407. ?? Location: MA Date: 8/21/2005 Source: Cape Cod Times Descri tion: Apa ments - ?? HYANNIS: ?? large 1 Br apt, no pets, good location, $925+, 08) 7 -8397 ?? Location: Date: 8/26 00 Source: e Cod Times Description: AprtmentsZ- ??—HYANNIS-s"?`?"Saud=i apt,pt, newly r-enoVated, $850 includes & a, (508) 775-62, Location_ ��� Da:t�e,- 8/'2 6s/-2-0:0-5 �- Source: Cape Cod Times �� S s I✓ 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map -Parcel Application l V Health Division Date Issued 61 Az Conservation Division Application Fee Planning Dept. Permit Fees r Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 7/ S P2.�wG sTT^ Village Y!747VAlls Owner SSE Ez.c_i s Address 7/ SP2i�✓G S7X7E�' Telephone Permit Request 1RmT1.-u _ Vj tt,E '0A-m, e c— -N- I►vs Kc.s► �.J S{f�F/t-fFm� rG.Ws Q.h'aP7'6�1+s, �Z.��'ct.�G�4'L S -Iry /wx-c v'— rc�2,w� Square feet: 1 st floor: existing /VSgproposed o 2nd floor: existing a• proposed o Total new a Zoning District Flood Plain Groundwater Overlay Project Valuation's t Scoo^ Construction Type r wp FX&IC Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family U- Two Family ❑ Multi-Family (# units) Age of Existing Structure Z'8 Historic House: ❑Yes ONo On Old King's_Highway: ❑Yes �o Basement Type: J'Full ❑ Crawl ❑Walkout ❑ Other N- -y Basement Finished Area (sq.ft.) a Basement Unfinished Area (sq1 I61Sf1i` _> do � Number,-of Baths: Full: existing - new o Half: existing _new, o Number of Bedrooms: 3 existingX new ;, rrr � Total Room Count (not including baths): existing new o First Floor Roi Count"* 6 i_=; :n Heat Type and Fuel: WGaS . ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes )drNo 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 >rNo If yes, site plan review# Current Use 'R.�i QM^,r-W Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address Sxay.t;v License # 62So7 7 Home Improvement Contractor# /(P t)o? 7 Email ?t>M,�z 6) Worker's Compensation # u►r3 '+'It S - P Y77- t V ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE S S. r r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED r MAP/PARCELNO. _ ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME >, INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH - FINAL FINAL BUILDING ! I,I DFT-CLOSED OUT AS=_SO�Ma►TION PLAN NO. ` r.. Depwfinerrt vflnd=ft ialAcdden& ' Office vftrrvesegadons ' _ 600 Washington Street �` '. 4•' Boston MA 02111 www.nuw gavlika y Workers' Compensation Insurance Affidavit Bi lders/Contraclors/IIectri. h>mbers Aloplicant Information Please Print Legibly' , Name(Bm±=ss/0rgm3izafi �,� c s t` S Y o t :3 u� Adds: q o x O Z City/State/Zip: 8/I s w Phone#: Are you an employer?Check the appropriate box: z Type of project(required): 1.91 am a employer wi& 2. 4- Q I am a general corhactor and I employers(fuII and/or part time). * have hired the sub-contactaas 6• ❑New camstractiDn 2.❑ I am a sole proprietor or partner listed an the atached sheet 7. ❑Remodeling ship and have no employees Them sob-cm3fractors have 8, Q Demolition worlong for mein my � workers' capacity. =PY [No workers'cold.mCitranrP comp.inem•ancr t 9. O Building addition �j 5. Q We are a.•corporation and its 10.Q Electricalrepairs or additions 3.Q I am a homeowner doing all work officers have exercised their 11.Q Phzabing repairs or additions myself [No worlon'comp. right of exen4dm per MGL 12_E]Roof repairs fio n-mmce regal rd.j t a 152,§1(4),and we have no employees.[No wmkers' I3.Q OfEer- comp-ios=nce required-I *Any appUcaatthaich=k3 box#1 amstalso fM omttc section beIowshowmgthcswMi0='CaMTeasEion polcy mdnMMEM t Homemwnea who submit this affidavit mdicatiag fhey ale doing zH work and thin him ontsidc catacma must submit anew afdavit iodinating rock #Cnntrjrfr, that check this box mmt attached an additional sbxt showaig tfio name of the and slam whether m-not tbose cu•ties have- aaploy=s.If tha salt-its have conployecs,they mast provide fhcs WM3o='ramp.policy msmbc I am an employer that is providing workers'compensation znruranre for azy ern ploye= Bdow is thepa&cy and job site . ixformatian, Inso ance Company Name: -k 2$t•tk/Ll ► Cdyel Policy#or Self-his.Lic.# LA 3 y.4 S(n'P H7"7 ExpiratiaaDate: rob Site Address: V S.PIL j'rJ Cr S'r. Cry/Sia�lTp: n/�/i Attach a copy of the workers'compensation policy dedarafion page(shownag the policy number and expiration date). Fa'ltae to secure coverage as required tinder Seciion25A of MGL c.152 can lmd to the imposition of criminal penalties of a fine np to$1,5GO.00 and/or one-year imprisonment;as WMU as civil penalties in the from of a STOP WORE:ORDER and a fine of i p to$250.00 a day against the violator: Be advised that a copy of this stdmn=±may be fi r wm-dzd to the.Office of Investigations of the DIA for msmmmm coverage va:f cation. I do hereby certi,fy under thepaws mtd penalties ofpm jmy that the hiformadon provided above it Xrzce and correct Phone# Official use only. Do not write in L%' area.to be con pkfe l by city,or io=a f 2ciaL City or Town: Perm;t/r.;�P„�e# Isstang Amthority(circle one): L Board ofHeaLEh 2.BmldingDepartment 3.G�ty/Town Clerk 4.MeeficallwPectUr 5.PlumbingLispector 6 Other Contact Person: Phone#; 14 Information and Instructions mal Laws I5Z all to provide workers'compensation for their employees. . Maecar}rt7celfS Geri �� �q� �oY� PSI Pr m=t-to this statute,an employee is defined as`:..every person in the service of another under any contract ofbfir, espy=or hnplied,oraI or writhz An employe'is defined as"art individual,partnership,association,corporation or other legal erdidy,or any two or more of the Exegoi ag engaged in a joint enterprise,and including the legal represenbdives 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 dweling house grounds or zn� thereto shall not because of such employment be deemed to be an employer." or on the gro burgling app also states that'every state or local lit shall withhold the issuance or MGL ter I52 25 ery licensing agency renewal f a license or permit to operate a business or to construct buildings not the commonwealth for any applicantwho has not produced acceptable evidence of compliance with the i mx ante,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 ofpubhG work until acceptable evidence of compliance vMh the insur-ance.. regturameuts of this cbaptrr have been presented to 111e= acting adhoiity." Applies Please fill oot the workers'compensation affidavit completely,by checIdng 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)withno employees offer than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have empIoyees,apoIicy is rmpircd. Be advisedthatthis affidpitmaybe submitted to the Department of Industrial Accidents for confirmation ofiasu arce 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 lime. City or Town Officials Please be sure that the affidavit is complete and put ford legibly. Mr.Deparbneat 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 permiillicense number which will be used as a reference number. In addition, au applicant that must submit multiple permitEcense applimfions 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 is (city or town)"A.copy of the affidavit that has be=officially stamped or marked by-the city or town may be provided to the applicant as proofthat 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 EL license or permit not related to any business or commercial venture . (i.e. a dog license or permit to bum leaves etr-)said person is NOT required to complete this affidavit The Office of Investigations would MCC to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Departmenfs address,telephone and fax number: The CIM�Wwlth-Of Ma&achusetts . IIepartment cuff Inds Actadents �iCe c>,f.Xnv'e�ghtio� 600-Wasbi it Stream Boston,MA t2111 Tel.#61'-'27-49Q0 cut 4€16 or 1•-M-MASSAFE Fax#617-727 7744 Revised 4-24-D 7 W W _gavIdia Rightfax C2-1 2/19/2015 6: 46: 37 AM PAGE 2/002 Fax Server DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE T. 11FICATE 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 and endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such end orsemen s. PRODUCER CONTACT NAME: THE INS AGCY OF CAPE COD PHONE FAX P O BOX 960 (A/C,No,Ezt): (A/C,No): E-MAIL EAST SANDWICH,MA 02537 ADDRESS: 77GBG INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: AMERICAN ZURICH INSURANCE COMPANY SUNRISE RESTORATION COMPANY INC INSURER B: INSURER C: INSURER D: P O BOX 802 INSURER E: , EAST SANDWICH,MA 02537 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS ISTO 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 PAm CLAIMS. PISR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MM\DDIYYYY) (MM,DMYYYY) LIMITS ' GENERAL LIABILITY EACH OCCURRENCE. $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR. REMISES(Ea occurrence) ED EXP(Any one person) $ ERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY F]PROJECT❑LOC RODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ , (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAR 0 OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $' RETENTION $ $ A WORKER'S COMPENSATION AND WC STATUTORY OTHER EMPLOYER'S LIABILITY Y/N UB-4956P477-14 11/29/2014 11/29/2015 X LIMITS ANY PROPERITOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,00() It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 D DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. l CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE-BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 200 MAIN STREET IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR AVE a� HYANNIS,MA 02601 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. r A Y �TME rti Town of Barnstable Regulatory Services # BARNRPARiR # Huss -Richard V.Scali,Interim Director i6gq. 1� Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 www.townlarnstable•maxs Office: 508-862-403 8 Fax: 508-790-6230 Property Owner.Must Complete.and Sign This Section If Using A Builder I,�� eve � El L j S ,as Owner of the subject property heteby authorize S LAAJ AA s& ?'. ;b'zoeno' to act on my behalf, in all taattets relative to work authorized by this building permit 71 Spmt ve. .5;r W1 A Nti� S (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or.utilized before fence is installed and all final inspections are performed and accepted. Sig acme of Owner Signature of Applicant Print Name Print Name u�is` Date _ Town of Barnstable - Regulatory Services ' t Richard V.Scali,Interim Director of Qiy ti BIIlldin DIvWon R�RNCTrR_T.R t Tom Perry,Building Commissioner MASS 200 Main Street, Hyannis,MA 02601 en www.town.barnstable.ma.ns Office: 508-862-403 8 Fax: 508-790-62-40 HOMEOWNER LICENSE EXEMPTION ; - Please Print DATE: JOB.LOCATIOT<l rnmiber street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip bode 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 Appioval 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 EXE4IMON 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 belshe 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. r..�.rmrrrr_cmm��rc�t 7.i:......-....hF...,..IFYPRRC.Q A—. . dne (COM OnweerAlt rr 7:gu'1-a't"i0/'-' ffice of Consumer Affairs&Business R ME IMPROVEMENT CONTRACTOR = e istration: 1600 9 � 160037.j . Typer. Expiration: 611.9/2016',• Supple!nett SUNRISE RESTORATION'COMPANY ti { PETER MEOMARTINO., P.O.BOX 802 c.SANDWICH, MA 02537 Undersecretary 1 r� Massachusetts -Department of Public Safety ij Board of Building Regulations and Standards Construction Supen•isor W License: CS-025077 i PETER C ME0M"tT1IN 29 BOARDLEY RO Sandwich MA 02363 # Expiration Commissioner 04112/2016 ,.°4 ARNSTBIBIr � I {" '.� :�. -n...j..e. •t,c.�..._ J '. �... �.'�';.r~ .�� , r • r �! yet .� - '1 r ... ' .r f '4 `tA•' f 9- Y 1} 21 IN IL ol jLC Vh LI i li —_ rM _ >. ',, �_ F ~^ i• � • + � � .t � � •�, -�— 41 -- -� a �. i t �• � � �• } - � ' �. ., � - !. 5�.�jv/V�/11� -�- '�-'r. } ... [{;_ .�. �-_. • --ir. _,. .__r._ y-- E - - i. " � - r. .. ..' t_ ! - . " -,, , i � y' r OC/v, /`/y/( � t � - �1.._—J•t- r�•i. �r .3,. .. �_ I ..may i � ....! r .,t� i _i ' `. -. 1 i.-�..' ' +i41 + c � __' •� _ _-r � ", ' r 1 � v'. � `r + - • !; t .;,i. .. i• - ..� �t_.y� F-- r w, t r—i !� __I ��, F�c �• ,. I ! RESIDENTIAL PROPERTY j MAP NO; LOT NO. FIRE DISTRICT SUMMARY I STREET 71 Si)ring Sty Hyannis 328 20 _ -2a LAND j J H BLDGS. (o U 01 OWNER b TOTAL a1 LAN D RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: Lot 10, Blk. B &Pt. Of 9 BLDGS. rn TOTAL I Fi•; r�r-�. �3ax'bara .J. _ . ____ . ___ _�1� 1 (j..- .._. 'Z. . H LAND 18 Ol BLDGS. • TOTAL '• Peterson.-Daniel W. & Ruth D. Ten. E t. 1-21-77 2458 307 ($-32, 7"O _ LAND .� � .� 5 U v _ 7 �o 0 BLDGS. coZ TOTAL LAND I BLDGS: TOTAL LAND BLDGS. TOTAL I 1 LAND BLDGS. TOTAL 'LAND INTERIOR INSPECT-�D: TOTAL DATE: K cJ /^ "�/ % � � ✓'%, ',,i' .. -- LAND ACREAGE COMPUTATIONS /. BLDGS. LAND TYPE # OF ACRE-.( PRICE TOTAL D PR. VALUE TOTAL HOUSE LOT /�'.,u' l r `� :^ i� j V LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR Ol BLDGS. WASTE FRONT TOTAL REAR LAND 01 BLDGS. TOTAL LAND BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH % FRONT FT. PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LAND LOW DIRT RD. FOUNDATION BSMT. & ATTIC PLUMBING PRICING LAND COST Conc.Walls Fin. Bsmt.Area Bath Room Base BLDG. COST St. Shower Bath Bsmt. Conc. Blk.Walls Bsmt. Rec. Room i PURCH. DATE Conc. Slab Bsmt.Garage St. Shower Ext. Walls PURCH. PRICE . Brick Walls Attic Fl. &Stairs Toilet Room Roof RENT Stone Walls Fin.Attic Two Fixt. Bath Floors Piers INTERIOR FINISH Lavatory Extra Osmt. (F,7 2 3 Sink Attic -�•- I % yx 'A Plaster Water Clo. Extra F / S EXTERIOR WALLS Knotty Pine Water Only � c� � •f' G � � � � � � � • Double Siding Plywood No Plumbing Bsmt.Fin. Single Siding Plasterboard Int. Fin. -- Shingles TILING Conc. Wk. G F P Bath Fl. Heat Face Brk.On Int. Layout Bath F.&Wains. / Auto Ht.Unit Veneer Int.Cond. Bath Fl. &Walls r �26 Fireplace � �'J /� Com. Brk.On HEATING Toilet Rm. Fl. Plumbing Solid Com. Brk. Hot Air Toilet Rm.Fl. &Wains. -- Tiling Steam Toilet Rm.Fl.&Walls Blanket Ins. Hot Water St.Shower Roof Ins. V V Air Cond. Tub Area Total Floor Furn. / ROOFING I COMPUTATIONS Asph_ Shingle _ Pipeless Furn. 7 Y O S.F. Wood Shingle No Heat / S.F. /Y190 Asbs. Shingle Oil Burner 7 2, S.F. 1/0 13 5� 7 ' Slate Coal Stoker S. F. Tile Gas S. F. OUTBUILDINGS ROOF TYPE Electric Gable Flat S.F. 1 2 3 4 6 6 7 8 9 10 ' 1 2 3 4 51617 8 9 10 MEASURED Pier Found. Floor Hip Mansard FIREPLACES S.F. ;'_r Gambrel Fireplace Stack Wall Found. 0.H.Door LISTED FLOOR Fireplace / Sgle. Sdg. Roll Roofing / Conc. LIGHTING Dble.Sdg. Shingle Roof A 'Earth No Elect. g DATE Shingle Walls Plumbing i Pine Hardwood ROOMS Cement Blk. Electric Asph.Tile Bsmt. lstj 1 B TOTAL ,f (/��O Brick Int. Finish P ICED Single 2nd 3rd FACTOR i! REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND.. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. OWLG. �)' �•� s `�S o�a SV %� I /.3 /.7/.i O I- 1 2 _. 3 4 5 - 6 8 9 10 • - TOTAL RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET _ 1 Spring St Hyannis7� LAND x BLDGS. � 0 0 328 20 OWNER _ b TOTAL i LAND I RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. TOTAL f � B .�.. .. _. LAND � Peterson, Daniel W. & Ruth D. (Ten. Ent.) 1-21-77 2458 307 0, BLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND j BLDGS. m + - TOTAL HLAND JA.U,INTERIOR INSPECTED: rn. � t DATE: LAND ACR AGE COMP TATIONS BLDGS. LAND TYPE # OF ACR PRICE TOTAL DEPR. VALUE TOTAL -HOUSE LOT �l ',r LAND -.CLEARED FRONT /� f — m BLDGS. REAR TOTAL !W.00DS&SPROUT FRONT LAND REAR a) BLDGS. WASTE FRONT TOTAL i REAR LAND 0) BLDGS. TOTAL LAND BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL i FRONT DEPTH STREET PRICE DEPTH % FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER rn BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND FOUNDATION BSMT. & ATTIC PLUMBING PRICING - • LAND COST Conc.Walla Fin. Bsmt.Area Bath Room / En. — O BLDG. COST Conc. Blk.Walls Bsmt. Rec. Room St. Shower Bath . PURCH. DATE Conc. Slab Bsmt.Garage St. Shower Ext. PURCH. PRICE. Brick Walls Attic Fl. &Stairs Toilet Room RENT —5- - Stone Walls Fin.Attic Two Fixt. Bath Piers INTERIOR FINISH Lavatory Extra Bsmt. F 'T 2 3 Sink i s/x y, r/4 Plaster Water Clo. Extra EXTERIOR WALLS Knotty Pine Double Siding Plywood No Plumbing Single Siding Plasterboard /90 W'' �� Ll JiJ TILING �S.y Shingles Conc. Blk. G F P Bath Fl. Heat Face Brk.On Int. Layout Bath Fl.&Wains. Auto Ht.Unit Veneer Int.Cond. Bath Fl.&Walls Fireplace - Com. Brk.On 'HEATING Toilet Rm.FL Plumbing Solid Com. Brk___— Hot Air Toilet Rm.FL&Wains. Tiling. Steam Toilet Rm.Fl.&Walls Blanket Ins. Hot Water` St. Shower - Roof Ins. Air Cond. Tub Area Total - D.v •) Floor Furn. ROOFING COMPUTATIONS Asph. Shingle Pipeless Furn. ? H S.F. 7�2 G Wo Shingle No Heat /G S. F. 0 /12 �p AsZbs.od Shingle Oil Burner - iy0 S.F. 0 /.2(531-0 Slate Coal Stoker S.F. Tile Gas S.F. OUTBUILDINGS ROOF TYPE Electric _ S.F. 1 2 3 J 4 1 5 1 6 1 7 8 9 10 1 2 3 4 5 6 7181 9110 MEASURED ! Gable Flat S F Pier Found. Floor Hip Mansard FIREPLACES Gambrel Fireplace Stack i Wall Found. 0.H.Door LISTED i FLOORS Fireplace Sgle.Sdg. Roll Rooting Conc. LIGHTING Dble.Sdg. Shingle Roof DATE Earth _ No El _ ect. Shingle Walls Plumbing A7 Pine _ _ Cement Blk. Electric 7 Hardwood ROOMS PRICED ` Asph.Tile Bsmt. lst'3 / TOTAL S S/ Brick Int. Finish 61 Single 2nd 3rd FACTOR REPLACEMENT 7.7 —7 OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. r „ 77 t' s f S 5� 0 6 DWLG. ..l I 1J rrs t_ ..S:7 I 1 2 3 4 5. 6 7 B 9 10 TOTAL ' J Barnstable Assessing Search Results Page 1 of 2 Home: Departments:Assessors Division: Property Assessment Search Results 71 S NG S RE Owner: ELLIS,STEVEN Property Sketch Legend This property contains multiple ; Please use the navigation below the sketch to brc Map/Parcel/Parcel Extension 328 /020/ Mailing Address �. ELLIS, STEVEN 3; 71 SPRING STREET € 3 y. HYANNIS, MA.02601 2005 Assessed Values: � � Appraised Value Assessed Value Building Value: $ 157,800 $ 157,800 Additional Sketches 1 121 Extra Features: $2,400 $2,400 Click Here for print version that displays all ske Outbuildings: $0 $0 Land Value: $ 106,200 $ 106,200 Interactive Property Map: ap requires Plug in: Totals:$266,400 $266,400 I have visited the maps before , . Show Me The Map April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: ELLIS, STEVEN 4/15/1995 9638/015 $20,000 PETERSON, RUTH D&ELLIS, 4/15/1993 P0149EP1 $ 1 PETERSON, DANIEL W 2458/307 $0 PETERSON, DANIEL CTFM-792 8490/250 $ 1 DOUGLAS,ANNE M CTF 9951/329 $ 1 PETERSON, RUTH CTF 9951/331 $ 1 2005 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $48.35 Town Fire District Rates Other I http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing... 8/29/2005 Barnstable Assessing Search Results Page 2 of 2 $6.05 Barnstable-Residential $2.12 Land B. Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $404.93 C.O.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $ 1,611.72 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial $2.10 Total: $2,065 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.18 Year Built 1935 Appraised Value $ 106,200 Living Area 1653 Assessed Value $ 106,200 Replacement Cost$ 147,827 Depreciation 20 Building Value 157,800 Construction Details Style Cape Cod Interior Floors HardwoodCarpet . Model Residential Interior Walls Drywall Grade Average Minus Heat Fuel Gas Stories 1 1/2 Stories Heat Type Hot Water Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 3 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 2 Bathrooms Total Rooms 6 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL2 Fireplace 1 $2,400 $2,400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area (Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeS ervices/Finance/Assessing... 8/29/2005 Barnstable Assessing Search Results Page 1 of 2 ME y„ U Home: Departments:Assessors Division: Property Assessment Search Results 71 S NG STREFET Owner: ELLIS,STEVEN Property Sketch Legend This property contains multiple Please use the navigation below the sketch to brc Map/Parcel/Parcel Extension 328 /020/ Mailing Address ELLIS, STEVEN f� //// �i: y3 F3 III333 71 SPRING STREET 3�j33333�� C HYANNIS, MA.0260133 x 2005 Assessed Values: Appraised Value Assessed Value Building Value: $ 157,800 $ 157,800 Additional Sketches 1 12 Extra Features: $2,400 $2,400 Click Here for print version that displays all sk( Outbuildings: $0 $0 Land Value: $ 106,200 $ 106,200 Interactive Property Map: ap requires Plug in: Totals:$266,400 $266,400 1 have visited the maps before Show Me The Map April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: ELLIS,STEVEN 4/15/1995 9638/015 $20,000 PETERSON, RUTH D&ELLIS, 4/15/1993 P0149EP1 $ 1 PETERSON, DANIEL W 2458/307 $0 PETERSON, DANIEL CTFM-792 8490/250 $ 1 DOUGLAS,ANNE M CTF 9951/329 $ 1 PETERSON, RUTH CTF 9951/331 $ 1 2005 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $48.35 Town Fire District Rates Other f http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing... 8/26/2005 Barnstable Assessing Search Results Page 2 of 2 $6.05 Barnstable-Residential $2.12 Land B Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $404.93 C.O.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $ 1,611.72 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial $2.10 Total: $2,065 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.18 Year Built 1935 Appraised Value $ 106,200 Living Area 1653 Assessed Value $ 106,200 Replacement Cost$ 147,827 Depreciation 20 Building Value 157,800 Construction Details Style Cape Cod Interior Floors HardwoodCarpet Model Residential Interior Walls Drywall Grade Average Minus Heat Fuel Gas Stories 1 1/2 Stories Heat Type Hot Water Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 3 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 2 Bathrooms Total Rooms 6 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL2 Fireplace 1 $2,400 $2,400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area (Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing... 8/26/2005 Die Cominonwealtlz of ll1assaclursetts Department of Industrial Accidents Office of Investigations 600 Washington:Street Boston,-41A 0-7111 lUW1U.tnass.,ov/dia _ Workers' Compensation Insurance Affda-vit: Builders/Contractors/Electricians/Plumbers Applicant Information Please PrintLeaibly Name(Business/Organization/Individual): Ca Qe S &%-e- y rt Address:_ - D H mil'nO-on Nvemc, City/State/Zip.-5e%&:1r'+ Yaj Mov_t , MR Ck_Q4 Phone t: 50$-' 0 3 9 g Are you an employer?Check the appropriate box: I am a general contractor and 1 Type of project(required): 4. 1.9 I am a employer with rAj) ❑ g 6. M New construction employees(full and/or part-time).'. have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7.. ❑ Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in:any capacity. employees and have workers' .. 9. []Building addition [No workers'comp.insurance comp.insurance.* ` required.] 5• ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their . 11.[]Plumbing repairs or additions 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 �'n,s N,t M ,i on comp.insurance required.] {Any applicant that checks box rl 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 affidaNit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant att employer tliat is providing workers'compensation insurance for my employees. Below is the policy and job site information. 1 Insurance Company Name:' T e-C,�n 0 t o an cC C n Policy 9 or Self-ins.Lie.r: T WC 3 313 --� Expiration Date: Job Site Address: S ri S+ City/State/Zip:�4 I'll !'l Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to-secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine . of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investisations of the DIA for insurance coverage verification. I do hereby ccrtifi,tinder the pains and penalties of perjure°that the information provided above is tru and correct Signature: Date: 1 Phone: - 3 g Official use onli} Do not ivrire i►t.this area,to be completed by cite or toivrr offrciaL City or Town: Permit/License Issuing Authority(circle one): . 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone E• HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THISFORM IFYOU ARE THEAPPLICANT HOMEOWNER. hereby consent to and agree that weatherization work may be done by the Weatherization Program of H ousing Assistanoe-Corporation (herein after referred as N Agency") on the property looted at: , The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of thefollowing measures: Weather-stripping& caulking of windows and doors, insulation of attics, sidewalls& basements, attic and other ventilation measuresand possibly replacement of badly,deteriorated windows. In consideration of theweatherization work to bedoneat my home agree to the following: 1. 1 give permission to the"Agency' itsagentsand employeesto travel onto or acrosssaid property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing AsdstaneeCorporation reserves the right to inspect thefuel or utility bill for the weatherized unit on an ongoing basisfor no morethan five(5) yearsafter theweatherization ' work is completed: , I have read the provisions of this agreement as listed and freely give my consent. - g, Homeowner: (Signature) - Date % Agent: (signature) t% ` Date: HAC approved Weetherization Company : �� J n L A• r , q � g ' n yF „ •. r f _ s ri n n F m a " _ P W .rt e r . w - i _ q A , , M lF r _ rj 1 nN i ATTENTION: n g MASSACHUSETTS LAW R QUIRES a CARBON MONOXIDE DETECTORS IN ALL RESIDENTIAL DWELI JNGS.' A v IN/ AD � M INSPECTIIONNN,, THE INSTAL TION'OF CO DETECTORS, IN ACCORDANCE WIT!4 1. 00 WILL BE VERIFIED PRI,Q�TO SIGNING.THE �--- r8lliILDEIG T' FI ' ` . � � ' SMOKE DETECTORS REVIEWED ° S � � o . rt � , • - ����i5�aa�',� ��� ��,��t��._- Pam- _ ('z`�'is-- BARNSTABLE BUI NG DEPT DATE FIRE DEPARTMENT _ DATE,' ROTH S NATURES ARE REQUIRED FOR PERMITTING J I-Z7 � f f pUtHE Tod, Town of Barnstable �O Regulatory Services ea MASS. ' Thomas F.Geiler,Director y Mass. � �A t63q. �� rF039 i Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis;MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 August 29, 2005 Mr. Steven Ellis 71 Spring Street Hyannis, Ma. 02601 Re: Illegal Apartment-71 Spring Street Hyannis, Ma. 02601 Map 328 Parcel 020 Dear Property Owner: Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal two-family home. Please contact this office immediately to tell us what direction you wish to take. TSinely, gram Zoning Officer Building Department gforms:zoning3 f C2 MyList Print Page Page 1 of 1 Click here to go back. Category: Rentals Description: Apartments - ?? CENTERVILLE: ?? Studio, Ideal for one, non smoking, $125 per week. (508) 771-9041 ?? Location: MA b Date: 8/12/2005 Source: Cape Cod Times Jn� g cription: ;A�p/atments - HYANNIS ?? 2 all newcozy studios w/ki chenette . .$175weekly ?? 1 bedroom cottage near beach $900 incl heat/e ect 'c Charlie, MCP {roperties 508-778-9777 Locatio MA Date: 21 005 o ce: Ca a od Times Description: Apartments - ?? MARSTONS MILLS: ?? Efficiency. Ideal for 1, $800/mo. includes all but phone. Angela 508-292-4407. ?? [p Location: MA Date: 8/21/2005 Source: Cape Cod Times Description: Apa ments - ?? HYANNIS: ?? large 1 Br apt, no pets, good location, $925+, 08) 7 -8397 ?? Location: Date: 8/26 00 Source: ape Cod Times Description: Apartments - ?? HYANNIS: ?? Studio apt, newly renovated, $850 includes, 1st & last. (508) 775-6127 ?? Location: MA Date: 8/Cape 05 Co Source: Cape Cod Times r http://www.capecodclassified.com/c2/mylist/print.xml?marked=1339754981DELIMITIRR... 8/26/2005 i Barnstable Assessing Search Results Page 1 of 2 .44 Home: Departments:Assessors Division: Property Assessment Search Results 71 SPRING STREET Owner: ELLIS,STEVEN> Property Sketch Legend This property contains multiple Please use the navigation below the sketch to brc Map/Parcel/Parcel Extension 328 /020/ Mailing Address ELLIS,STEVEN 3 71 SPRING STREET HYANNIS, MA.02601 2005 Assessed Values: _ Appraised Value Assessed Value Building Value: $ 157,800 $ 157,800 Additional Sketches 1 1 z 1 Extra Features: $2,400 $2,400 Click Here for print version that displays all sk( Outbuildings: $0 $0 Land Value: $ 106,200 $ 106,200 Interactive Property Map: Map requires Plug in: Totals:$266,400 $266,400 1 have visited the maps before Show Me The Man April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: ELLIS,STEVEN 4/15/1995 9638/015 $20,000 PETERSON, RUTH D&ELLIS, 4/15/1993 P0149EP1 $ 1 PETERSON, DANIEL W 2458/307 $0 PETERSON, DANIEL CTFM-792 T 8490/250 $ 1 DOUGLAS,ANNE M CTF 9951/329 $ 1 PETERSON,RUTH CTF 9951/331 $ 1 2005 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $48.35 Town Fire District Rates Other F http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeS ervices/Finance/Assessing... 8/29/2005 Barristable Assessing Search Results Page 2 of 2 $6.05 Barnstable-Residential $2.12 Land B. Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $404.93 C.O.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $ 1,611.72 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial $2.10 Total: $2,065 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.18 Year Built 1935 Appraised Value$ 106,200 Living Area 1653 Assessed Value $106,200 Replacement Cost$ 147,827 Depreciation 20 Building Value 157,800 Construction Details Style Cape Cod Interior Floors HardwoodCarpet Model Residential Interior Walls Drywall Grade Average Minus Heat Fuel Gas Stories 1 1/2 Stories Heat Type Hot Water Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 3 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 2 Bathrooms Total Rooms 6 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL2 Fireplace 1 $2,400 $2,400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) hq://www.town.bamstable.ma.us/tob02/Depts/AdministrativeS ervices/Finance/Assessing... 8/29/2005 Barnstable Assessing Search Results Page 1 of 2 0-1 V Home: Departments:Assessors Division:Property Assessment Search Results 71 S P R1 NG STREET Owner: ELLIS,STEVEN Property sketch Legend This property contains multiple ,, Please use the navigation below the sketch to brc Map/Parcel/Parcel Extension 328 /020/ Mailing Address ELLIS,STEVEN 71 SPRING STREET HYAN N IS, MA.02601 rt 2005 Assessed Values: : Appraised Value Assessed Value Building Value: $ 157,800 $ 157,800 Additional Sketches 1 2 Extra Features: $2,400 $2,400 Click Here for print version that displays all sk( Outbuildings: $0 $0 Land Value: $ 106,200 $ 106,200 Interactive Property Map: Map requires Plug in: Totals:$266,400 $266,400 1 have visited the maps before Show Me The Mao April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: ELLIS,STEVEN 4/15/1995 9638/015 $20,000 PETERSON, RUTH D&ELLIS, 4/15/1993 P0149EP1 $ 1 PETERSON, DANIEL W 2458/307 $0 PETERSON, DANIEL CTFM-792 8490/250 $ 1 DOUGLAS,ANNE M CTF 9951/329 $ 1 PETERSON, RUTH CTF 9951/331 $ 1 2005 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $48.35 Town Fire District Rates Other I http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing... 8/26/2005 Barnstable Assessing Search Results Page 2 of 2 $6.05 Barnstable-Residential $2.12 Land B Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $404.93 C.0.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $ 1,611.72 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial$2.10 Total: $2,065 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.18 Year Built 1935 Appraised Value$ 106,200 Living Area 1653 Assessed Value $ 106,200 Replacement Cost$ 147,827 Depreciation 20 Building Value 157,800 Construction Details Style Cape Cod Interior Floors HardwoodCarpet Model Residential Interior Walls Drywall Grade Average Minus Heat Fuel Gas Stories 1 1/2 Stories Heat Type Hot Water Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 3 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 2 Bathrooms Total Rooms 6 Rooms Extra Building Features Code Description Units/SO ft Appraised Value Assessed Value FPL2 Fireplace 1 $2,400 $2,400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area (Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeS ervices/Finance/Assessing... 8/26/2005 C2 MyList Print Page Page 1 of 1 Click here to go back. Category: Rentals Description: Apartments - ?? CENTERVILLE: ?? Studio, Ideal for one, non smoking, (�) $125 per week.. (508) 771-9041 ?? +off\ Location: MA p Date: 8/Cape n j Source: Capepe C Cod Times cription: Apa men - HYANNIS ?? 2 all .new cozy.studios w/k1 chenette . .$175weekly ?? 1 bedroom cottage near beach $900 incl heat/e ect 'c Charlie, MCP {roperties 508-778-9777 Locatio MA Date: /2 005 �o ce: Ca a od Times Description: Apartments - ?? MARSTONS MILLS: ?? Efficiency. Ideal for 1, $800/mo. includes all but phone. Angela 508-292-4407. ?? �p Location: MA Date: 8/21/2005 Source: Cape Cod Times Descri tion: Apa ments - ?? HYANNIS: ?? large 1 Br apt, no pets, good location, $925+, XOO 8397 ?? Location Date: 8/ Source: Times Description: Apartments - ?? HYANNIS: ?? .Studio apt, newly renovated, $850 includes, 1st & last. (508) 775-6127 ?? Location: MA Date: 8/ C �,/1� Cape � Source: Cape Cod Times Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 3-5-13 Town of Barnstable •' � w �„° Thomas Perry CBO ""' , Building Commissioner , 200 Main St. Hyannis,MA 02601 -za RE: Building Permits - � O Dear Mr. Perry, This affidavit is to certify that all work completed for 71 Spring Street,Hyannis has been inspected by a certified Building Performance Institute(BPI) Inspector. Ceiling: R-19,R-38 and R-49 Cellulose Walls: R-13 dense pack cellulose Basement: R-19 Fiberglass in the box sill Floor: R-19 and R-30 All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey I of t Town of Barnstable *Permit# Expires 6 months from issue date BAMSPABL&. » Regulatory Services Fee s.00 M 9 1639. `0� Thomas F.Geiler,Director Building Division Elbert C Ulshoeffer,Jr. Building Commissioner Xo 1 367 Main Street, Hyannis,MA 02601w �M Office: 508-862-4038 E E RS 0 8 2001 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION TOWN OF BARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number d P, Property Address l S 10l^) Yj S esidential OR ❑ Commercial ' Value of Work .'. lJ©C7 Owner's Name&Address 71 H5Pr)rt 5�` ;1/a�:�ti v s Contractor's Name Telephone Number T 7-5 j 2 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) F�Workman's Compensation Insurance Check one: [�f Iam a sole proprietor am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# F Permit Request(check box) Re-roof(stripping old shingles) Re-roof(not stripping. Going over existing layers of roof) E�'Re-side Replacement Windows. U-Value (maximum.44) ' Other(specify) J:t t vv-) A c,?rc cC✓t Leo R $ *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. t Signature L expmtrg