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HomeMy WebLinkAbout0035 SUFFOLK AVENUE `. -R46 V-Le� I C� ^� b�Y� bp J ' I I! I v v l Oxford NO. 7521/3 ESSEL`TE 10% , ® o 0 J66 H3-�r I A SF C bj.� s� sh To Dete .2- Time 3 30 W ILE YOU WERE �OUT of Phone — 4(y t� S(3 All+ Area Code Number` Extension TELEPHONED 1,KLEASE CALL CALLED TO SEE YOU WILLCALLAGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Message . Operator AMPAD 23-021-200 SETS EFFICIENCYe 23-421-400 SETS CARBONLESS oFtME ram, Town of Barnstable *Permit# x�Tres 6 months Irom issue date Regulatory Services E Fee + SARNSTABLE, Richard V.Scali,Director 039. A ]BuildingDivision 9- , g yoV 2 , Paul Roma Building Commissione ' 200 Main Street,Hyannis,�N1A�y0�-601 _ 9 2016 8,4 www.town.barnstable.ma.us Office: 508-862-4038 V M&LFdx: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint -- Map/parcel Number __ Property Address.. 6O FFO e �VE I % 0)&) J ffi Residential ` Value of Work$ "boo® Minimum fee of$35.00 for work under$6000.00 - Owner's Name&.Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one:. ❑ I am a sole proprietor I am the Homeowner° �. ❑ I have;Norker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) " ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris Will be:taken to i 1 ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side ` �'Replacement Windows/doors/sliders.U-Value ®•`2"1 (maximum.32)#of windows 2 #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked.with red S and inspections required. Separate Electrical'&Fire Permits required. , *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: ` Q:\WPFILES\FORMS\building permit forms\E SS.d 06/20/16 it • The Corr;mornvealth q,f Maisach=etts E Dopartrrrerzt cr,f rn-d-fslrial Accidents Office ofhawstigadam _. Bast ul?-A 02111 k4�tv�s?rrrrrssgu�Icifin -+ - ` . Wark-ers' Cumpensatian Immn-ance Affidavit Btatdel nntractGrsJElec€ricianrJPlnmbers pi licant 1nfG=affgn Please Print Nam(Basiness�drgan oaffnd�szival} �,Qi�(t 1G F � Address ` �ity tcz 1� 3t�F T �Cno� � Are,you.au employer?.Che&the appropriate bGx: Type of project(resumed): L❑ I nut a employer with 4 ❑I am a general contractor and I P � 6:_❑New construction ;employees Gull audfor part time * Hoge hired the sub-contractors Yisfed ozlthe a4#acfred shet tti ❑7 Remodeling 2.❑ I am a sole proprietor or partner- s�and lmave no employees r. 'Mese sub-contractors haVe 8_ Q I]euwlifioa la es and hay:a wa�ess' W g ftrr nie in air end hl'S y � `- `.- - 9..❑Building addition. [No lvMi 2 comp_rrasr=e comp;m raIIt&.$ dstlnus` 5. Q We are a`corporation need its 1 Q 0 ElectrdcaI repairs or ad . 3. I amafiomeowner doing afl iYork »v' `�` x ofceis have eserctsed ffiiiir' 1 L Q Plumbsilg repairs Or additions rim of exempfiou per MGL mysel€'[Nowoxkeia vamp. ° 1y_F�Roofrepairs ' inmm ncerecuued]i R.~ c_,152, §I(4 andwe have no_ employees:[No WtlrkP+c 13 .� PS • comp_1nS mane required_] •AnyW5c=tdhstchec1mbos AlmastalsoSllovFtfi�sectiaabciowshmEiagi6e¢wor7ces'compevsatiaapayepi�ocrosuo� #Fiameacuaers�r}sosulu tchis'sffidaru;r y gii�vysxedain�slFwo�csadtfieal�eantsider +.arr,rsnmstsubmit auP-WgMdxwitmdiadn-.wrl ` rCamt<aetDm tbst check this box must attached=ad&6=2l sheet sbovriag the name cf the sub-cemu=baa_and state vrhether ar not those eafrtks base employees.TftheSnbto-ahactacsI>aceMnPICTee.%theym xsrp i&thek wadEmlcamp.palir:ynumber --------------- I am an euiployer tletrtispra�zduig ti�or�ers'cvsrpertsrcfiort i�isziraiice for m}*entpinyees Setory it fli�paLic}�rcr�,3 jeFa site informer on: Insurance Company NTaxne: F. 6. 4 Po�ricp 4A or self-ins-Lie_, . 1=p�rattaa I?ate_ . Job Sire Addse Citylstate111.tp: Attach aropy of the vorl-ers'campensation.policy declaration page(showing the policy,number,and expiration,date). Failure to secure~coverage as required under Section 25A of Y-GL c_'1527 can lead to the imposition of criminal penalties of a fine up to$I,SQU:Oa and.P'ar aae-yearimpFi'onmeaf,as well.as civ2 penalties a`fbe fans of aSTOP WORK ORDER and a�e of up-to$250_00 a dayagainsf#fie violator. Be ad-dsed`flmt a:copy of this statement maybe forwarded to thro Office of Isrvesdgations of the DI&for insurance coverage v�frca ion I do ifere&y aarkf3�ruidter din 'is andpen 's a]Verjusy feint Me ui}ormafivaproti&dabmv li trug and correct d. . Siffiature_ ri Date_ a a phomik t y t7, trial uw aril}: �Ua imt irrite t�i flame area,tii be coaapleterL�y arton�i a f aL Chy or Town: Ferimf -kense# Issning Authority(circle ene): L Board Of Health 2.BuiITing Department 3.Gityfrowa Clerk 4 Electrical Inspector 5.Plumbing Iospmtor 6.Other Contact Person: Phone#* Information and last motions hfms r]- ,-_t4 General Laws chapt=152 rcqaaes an emplay=to provide wo.6-,e2s'compensation for then£employees. p -to this sfntniu;,an mprapee is defined as."_.eve person in the service of another under any contract ofhire, express or hmplied,oral or vwtitfP An ernproy,�U-is defined as"an ind'vidnA p=ta=shi .association.corporation or other legal entity,or any two or more ofthe foregoing engaged>a a joint enterpa ,and including the legal representatives ofa deceased employer,or the receiver or tnlstee of an individual,partnership,association or otherlegal entity,employing employees. However the owner of a.dwelling house having not more thml three apartments and.-who resides therein,or the occupant of the- dwelling house of another who employs persons to do mainfman ce,consUnction or repair work.on such dwelling bourse or on the grounds or building appurtenant thereto shall not because of sash employment be deemed to be an employer"" MOL chapter 152,§25C(6)also states flirt"every sfata or local licensing agency shall withhoId fhe L"Mance or renewal of a Tic— a or permit to operate a business or to construct buildings in fhe commonwealth for any applicani who has not produced acceptable evidence of compliance with the insur-anre.coverage required_" Additionally.MCrL chapter 152,§25CM states"Neither the conuannwealth nor any offs political subdivisions shall enter mt o any contract for the pmfmananco ofpublie wodc until acceptable evidence of compliance with the insm-an ce._ MrDi euiems of dais chapter have been presented to the c nfra_�a aufh oity. : Applicants Phase flI out t!ae workers'compensation affidavit completely,by checl�g ihe boxes apply to yours siinatiOn and,if necessary,supply sub-contractors)name(s), addresses)and phone nummber(s) along with their certi acate(s) of amnance. Limitf dLiabilky Companies(LLC)orLinitedLiabl7ity Partaeships(LIP)wi['hno =aployees ofEer than.the members or partners,are not rbgo:a-ed to carry wo=1ce&compensation ins❑rance. If an LLC or LLP does have employees,apolicy is required. Be advised that this affida�maybe snhmitted to the Department of Industrial Accidents for confirmation of insmanb coverage_ Also Tie sure to sign and date the affidavit-The affidavit should be retamed to the city or town that the application for the pemrit or license is being requested,not the D epatmeat of LT�strial Accidejs. Sl ovld you;have any questions regarding the law or if your a e required to obtain a workers' compensation policy,please call the Department at the unmber listed below. Self-hm=d companies should enure i3ieir self-insm=ce license nmmber on the appropriate line. City ar Town Officials Please be;snre that the a$tdavit is complete and printed legibly. The Depaxftnenthas provided a space at the bottom of the affidavit for you to fill out in the event the Office ofluvestigation a has to coact You regarding the applicant Please be sure to fill in the penmWlicense nu mbm which will be used as a reference number- In addition,an applicant • one affidavit indicating cvn-ent ih.at moist submit multiple pennitlltcense applications in any given-year,nee.�d.only submit CafI11g policy, inforaation(if necessary)and under`Job Site A ddmse e applicant should write"all locations tux ( Y or town)-"A copy of the-affidavit that has been officially stamped or mz6ce;d by tlae eify or town may b e provided to tjae applicant as prooft hat a valid affidavit is on file for fntu a pezra#s or licenses_ A new affidavitmvst be,filled out each year.Whe=a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (La. a dog license or pemit to burn leaves etc_)said person is NOT required to complete this affidavit The Office of Invesdgad=would like to thank you is advance for your cooperation and shoulld you have any questions, please do not hesifz e to give m a call The Depart =fs address,telephone and fax number: , Fh� a an t3 of Masschnsze�#s Depaxta t of ludnfial A cgent� - �o�an=l�E1�11� Fax 9 61772-7 7749 Revised 4-24 07 � sea .�gfdi2 • - � Town of Barnstable. Regulatory Services oFt1HGE yr Richard V.Scali,Director Building Division r swar►srnsue, ' Paul Roma,Building Commissioner Mass. 1639. 200 Main Street, Hyannis,MA 02601 prED www.town.barnstable.ma.us , Office: 508-862-4038 Fax: 508-796-6230 HOMEOWNER LICENSE EXEMPTION i �` Please Print i DATE::O 1 o6 1 1 l6 1 JOB LOCATION: 1r:a>51 F Ly w3c— number street (�[�(` villages` \ •`HOMEOWNER": ���T\R O)E JOU 2 �q�A l J CSI�I�UG 1 name ry� \ home phone# work phone# CURRENT MAILING ADDRESS: 1 . city/town state zip code The current exemption for"homeowners"was extended to include owner-occgRied.dwellings of six units or less and tolallow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINPPION 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 an that he/she will comply with said procedures and requirements. i � • Signature o omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. - HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work;that such Homeowner shall-act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor, (see Appendix Q,Rules&Regulations for Licensing.Construction Supervisors,SectidW2.15) 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: s 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. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit<forms\EXPRESS.doC ; 06/20/16 1 Town of Barnstable � r Regulatory Services s"R"m'`'m'E.MAM Richard V. Scall,Director. #A 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 grid Sign This'Sectiori "r a If Using:A=Builder I� tkg,:`;N' vs. to 60U2% , as Owner of the subject property hereby authorize EGLE to act on my behalf, in all matters relative to work authorized by this building permit application for: (Addy ss 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 er - Signature of Ap lic p, fp„ c ' U..Itic ";Cox c ax21 Print Name Print Name Date QTORMS:OWNERPERMISSIONPOOLS I Roma, Paul To: Cadrin,Arden Subject: RE: 35 Suffolk Ave'Hyannis Hi Arden, 35 Suffolk has two rooms in the main house which lack required emergency escape-work had been done apparently under a previous owner without permits.A verbal EXIT ORDER was given to stop using them as bedrooms and to obtain a permit to correct the situation.The owner indicated she wanted to change doors/windows in the main house and so all of this work could be done under permit#1—the main house bedroom windows need to be corrected whether the owner goes into the AAAP program or not.This permit is to legitimize/correct existing conditions. If the owner wants to continue entry into the program, she needs to obtain a second permit to make required.changes in the basement area—after the first permit is inspected and closed out. Information about proper emergency escape size and smoke detector upgrades and locations were provided to the owner with the letter I wrote.There were several uninstalled windows on site that may or may not be properly sized for emergency escape. In short,two permits are needed because there are two separate, unrelated issues to be addressed and/or corrected. Lastly, the Health Department controls the number of allowed bedrooms.The owner needs to check with them as part of the application process. f, Thanks, Paul From: Cadrin, Arden Sent: Monday, November 21, 2016 10:57 AM• To: Roma, Paul Cc: Buntich, JoAnne Subject: 35 Suffolk Ave Hyannis Hi Paul, I would like to get your clarification on the letter you sent to Ms. DeSouza Of 35 Suffolk Ave. Your letters says: . i. "two permits will be issued, one for doors windows - does this mean the doors and windows of the main house? Will she be able to pull a building permit for this work prior to having a comprehensive permit? 2. "Windows and smoke detector upgrade will b e part of(AAAP) application. Which windows is this referring to? As 1 think Ms. DeSouza mentioned to you, she is having difficulty getting a permit for the door/windows of main house for some reason. Does this letter now allow her to pull the permit for work on the main house? � 1 Regards, Arden .Arden.R. Cadrin Housing Coordinator A=Q*11 GROWTH MANAGEMENT. Town of Barnstable 367 Main.Street Hyannis, MA 02601 a.rden.cad.rin@town..barnstable.ma.us (508)862-4683 , 2 ' Town of Barnstable mot , r #� ��-� Regulatory Services Fee 6 mnnFap m'sue SAatvsMAM TASL6, Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town.barmtable.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 so t F 0 L a 'P�V C V1l S r Residential Value of Work JO,0O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address I�AElf Contractor's Name Telephone Number_ 0 � Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor APR 24 2012 EK I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name TOWN.OF BARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit... Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders.U-Value & 1)l (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e..Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy.of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms XPRE - Revised 051811 The Commionweah*of Massachusetts' Lkepwbnent o,f I strial Accidaift _LVO ff we o,f Investigations 600 Washington,street Boston,MA 02111 wwkk:mamgovIdin Workers'.Compensation Insurance AffidavitmldersJGantractorsJEtriciansJ!'"luffi1 Applicant Information Please Print Lel ibly Name Musi u_ hP f A U = IY— U'VZ4: mess: 4 3S C 0 PFO —V( Vic— city stater_ -D Phone 4-- Are you an employer?ChWck the appropriate boa: Type of project(required): I. 4. I am a contractor and i El I am a employer with ❑ �� 6. ❑New construction employees(furl andfor part-time).* have hired the sub-connactors 2.❑ I am a sole proprietor or-partner- listed on the attached sheet. 7. ❑Remodeling. These:sob-contraetars have ship and have no employees. 8_ E]Demolition, working for me in any capacity. . employees and have workers' [No workers'comp.msurance comp.insurance.$ 9_ Building addition required] 5. ❑ We area corporation and its 161. Electrical repairs or additions 3. I am a homeowner doing all work officers exercised fir. 11.0 Plumbing repairs or additions myself [No workers'comp. tight of exemption per MGL 12.❑Roof repairs. insurance re1uire&]E c.152, §1(4) and we have no employees-[No workers' 13.❑Other camp.insurance required.] •A ay applicant that checks boa#1 must also fill oat th a section below showing:they worltere compensation policy inf mm ion_ 13aauenwwers Wlm submit dus affida=indicating they are doing all wcak and then hire outside contractors must submit anew affidavit indicating sncIL ZCastractors that check this box must attached an additional sheet shaving the same of the sub-ca=xtor s and state Whetter ornbt those entities have employees.If the nab-contractors have employees,they nmst provide their workers'comp.policy uasaber. I am an employer that is providing workers'compensation insurance for my amploy eas. Below is the policy'asd Job situ infotmatimL - Insurance Company Name: Policy#or S,e1f-ins-Lic.#: Fxpim#on Datte: Job Site Address: Civlstatelzi% Attach a copy of the workers'coutpensationpoficy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL a 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprison as well as civil penalties in the form of a STOP WORK ORDER and a fine ofup to$250.00 a day against the violator. Be ad-wised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for irmumce coverage verification_ I rda hereby car i,fy under the pains and ,naNes of pedU)Y that the informataan prouided�apbmw is true and corm Signature. Date Phone#: official use only. Do not write in this area,to be compiete d by city or town official City or Town: PermitUcense# Issuing Authority(drele one): 1.Board of Health 2.Building Department 3.'Cityf£own Clerk #..Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 �t Town of Barnstable Regulatory Services Z i��" Thomas F.Geiler,Director 1659. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 HOMEOWNER LICENSE EXEMPTION Please Print DATE: c i� (� JOB LOCATION: J l V ITII'CJ L V'i �U�IV��V"�v&C nun bu Ter— street ` village "HOMEOWNER!': � �i') 09S) ��J Qq name home ftone# work phone# CURRENT MAILING ADDRESS: �� O s �XJ `) t 5 Ova oho city/toww state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildingRermit. (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 req ' eme is that he/she will comply with said procedures and requirements. Signature of omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION - The Code states that: "Any homeowner performing work for which a building permit is required shall be ezempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as"supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when.the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for.use in your community. -Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC Revised 051811 snarlsrest.E. • ,.� Town of Barnstable °�c nner Regulatory Services Thomas F.Geiler,Director Building Division ti Thomas Perry,CBO 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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date - Print Name If Property Owner is applying for permit;please complete the Homeowners License Exemption Form on the reverse side. QAWPHILESTORMS\building permit formsUMMS.doc Revised 051811 [FIN .,���T�. �.� C E' C® , INS ULATI''0 [j7 G 17, APR I,/ b", 10: 11-9:.., FIFER GLASS SEAMLESS SPRATEOAM SUSPENDED 1 BATES GUTTERS INSULATION CEILINGS 1-800-696-6611 QIVI 4 €' YY Town of Regulatory Services Building Division Address - Address 2 - v Date: Dear Building Inspector , Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed& 7 completed the insulation�and weatherization work at the'property listed below. Cape Cod Insulation did this in accordance to the�specifications listed on the building permit W application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address.. Village Insulation Installed: Fiberglass.. Cellulose R-Value Restricted , Unrestricted Ceilings Slopes Floors Walls (P() ( ) ✓0..• .scar 6..: ,� a�. I ' , f:r g X `rely Hen E.0 si Jr, re ident Cape od I Isulatio Inc. - ' r - DATE: August 31, 2007 TO: Building File FROM: RCG RE: 35 Suffolk Ave, Hyannis The tenant (Romulo Eustaquio Ferreira) currently residing in the illegal apartment at 35 Suffolk came in with DBA form for a painting company(Exotic Painting) and attempted to register as a home occupation. I refused to sign the form or register the home occupation as the property owner has not yet resolved the status of the illegal apartment and LE has issued non-criminal citations on 8/20/07. oFr�rr 'own of Barnstable F©�i( O�O�(`(C� # E.r . 6 ma Barr .Regulatory services p rs r to x a.Rvsrxsts. + Fee Q� 1619- ���q Thomas F. Geiler, Director,or� b Building Division �— Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www:town.barnstable,rna.us Office: 5 08-8 b2-403 8 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY ax 508-790-6230 /Vol Yrtlir1 lvitliorrl Red X:Press lrtrprinl Map/parcel Number •pPq 7 Z Pro erty Address 3S So O \ tiv /J �/Vj� Residential Value of Work a IKitiimum fee ofS35.00 for work under S6000.00 ` Owner's Name & AddressSOU'Z Contractor's Name 17Li #4r!e Seiv&eS (� Tele hone Nutnhe p r Sods ERME ZWWorkman's mprovement Contractor License#(if applicable) g9 3 ' ction Supervisor's License#(if applicable) /700Z7 ,,, �' ¢. Compensation Insurance Check one: DEC — :`- 2011. ❑ Tani a sole proprietor ❑ I am the Homeowner t 1r1( 1: OF B,'�RNSTABL�-, ❑ I have Worker's Compensation Insuranc Insurance Company Name e Workman's Comp.Policy,# O� 3 Copy oSIrrsurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricanenailed) (stripping old shingles) All construction debris will be taken to ❑ Re-roof hurricane nailed)(not stripping. .Going over ' existing layers of rood R ide #of doors ' Replacement Windows/doors/sliders:.U-Value O, (maximum .35)#of windows _ *Where required: Issuance orthis permit does not exempt compliance with other town department regulations;i.e. Historic,Conseriation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is required, ;NATURE: _ —. IPl-ILES1f0RMSlbuildingpe„nii for Zs't£XpR.Sr s.doc The Commonwealth of tllassachusetts • ,. Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/ContractorslElePlease Print Legibly A licant Information Name (Business/Organization/Individual): 5 �t'iP—ram tom`' Address: -b�`7 5l� City/State(Zip: �(A� - � � �0 3 3 y Phone#. Type of project(required): FEI mployer? Check the appropriate b 1 am a general contractor and I 6 construction mployer withf ____� have hired the sub-contractors ees(full and/or part-time).* listed on the attached sheet. 7, Remodeling ole proprietor or partner- These sub-contractors have g. []Demolition have no employees employees and have workers' 9 Building addition g for me in any capacity. comp. insurance.xrkers' comp. insurance 10.❑Electrical repairs oradditions 5 (� We are a corporation and its required.] k officers have exercised their 11.❑ Plumbing repairs or additions 3,❑ I am a homeowner doing all work. right of exemption per MGL 12.0 Roof repairs myself. [No workers' comp. c. 152, §10),and we have no 13.0Other insurance required.]t employees.[No workers' ` comp.insurance required] nsation policy information. *Any applicant that checks box#1 must also fill out the acre dontion elow showing their all work and then hire outside contractors must submit a new affidavit indicating such. t 1{omeowners who submit this affidavit indicating they 8 the name of the sub-contractors and state whether or not those entities have tContractors that check this box must attached an additional sheet showing policy number. employees. If the sub-contractors have employees,they must provide their workers'comp.po Y er that is roviding workers'compensation insurance for my employees. Below is the policy and job site I am an employ P /7 information. y � �. -- Insurance Company Name: '01W 1 J - Expiration Date: -- Policy#or Self-ins.Lic. �U 'T Cl City/StatefZip: N' Job Site Address: Showing the policy number an expiration date). Attach a copy of the workers'compensation policy declaration page ( lead to the imposition of criminal penalties of a Failure to secure coverage as required under Section a 5w of a civil penalties in the foam of a STOP WORK ORDERf d a fine fine up to$1,500.00 and/or one-year imprisonment, be forwarded to the office of up to$250.00 a day against the violator. Be advised that a copy of this statement may Investigations of the DIA for insurance coverage verification. certify under the poi and penalties of pe1.Iu the the information provided above is true and correct I do hereby c fy Date: Si ature: Phone official use only. Do not write in this area,to be completed by city or town o,gkid . . Permit/License# City or Town: n Issuing Authority(circle one): De artment 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 1.Board of Health 2.Building p 6.Other phone#- •:•:. C;'r.=Of CGUmmar.Afmirs&Sw tz.-S3 Rcbuiattioa 4 HOME tMPROVENENT CONTIiAC:DQ ti Registration..12G8a3 Expiration:'a+katz Suopiema�:t The Home Dew A:-Nome Services UARREN DEMERS � 2690 CUMBER(AiND PARKWAY S AM GA 30339 [nderseeretarf License or registration valid for individul use only be'[ore the expiration date. If found return to: office of Consumer Aft'airs and Business Regnla 94 10 Park P1223-Suite 5170 ;ard Bomon,MA.02116 Not valid without signature The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Letdbly Name (Business/Organization/Individual); Address: City/State/Zip: ` y t' • a �r 0)3 Yt Phone #: AYlam employer?Check the a propreate box: Type of project(required): 1. employer with 4. ❑ I am a general contractor and I PI (full and/or part-time).* have hired the sub-contractors 6. ❑ w construction 2. sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. ❑Building addition 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 I L E]Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12 ❑Roof repairs insurance required.]f c. 152, §1(4),and we have no 13.❑Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insur nce for my employees. Below is the policy and job site information. �} .,,,„, Insurance Company Name: e�"/00ivl U%Cl Vs Policy#or Self-ins, Lie.#: !_� �� Expiration Date: Job Site Address ) J V f d�Y� � City/State/Zip: t �9N/Vj 5.All Attach a copy of the workers compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify .+ o.t n 'ze information provided afio?ue is tr a and correct Signature: / may_ Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Ae offioe of Cars�mez At'fa�0 C ark plazu Buie 5:' Boston,M- wsac*Msetm 02116 Home Lnprovementntractor Registrauan Re11$ "d#w. 132349 Typw 2P992013 T19t 207392 J & J Remodeling Joseph Duarte = 4 5 Fart St. Wareham, ma 02571 _- U1s Address and Ord.basic wreeai4a cud Lj Mepwaftt. .Al 7ot2s� pt f $ Ra bdare a Aso 3fC CONTRACTOR Dofofe 4Aa 6ta.tw s rto��IAAPROYEIAEMt CONT Ottice 4tCoasotnef Regls VWQn: - 1 M,49 ZYpe IO p$rts plM-Soft 5176 Expinetion: :i./11i20f3, Partnership Sostaa,'►flA R2126 - - smadtling - asepR �TuasYe dareham,r1a 02671'. 1,4decaccntary 08 eriffiont rg tla•:r�hu•cta•- UrtPaR iit"(PUbl>t:�:►fci� ! 4t g<utrd or Buiiltip�Rr wakallllt►e god,(,Maras CatisYala Sup*" Lie�et: ,iflSE)H G MAR TE 15 FALL ST WARES MA02571 Fawns: 1f2 - Tr*- 700 Dec 07 11 08: 40p Michael Bedard 1-401-246-2865 p• 1 HOMEDWROVEMEN•1C CONTRACT PLEASE READ THIS Sold,Futtrished and installed by: Nate: THD At-Home Services,Ino. �. Branch Names•Bosiort �� �S.! 1 4wa•lie Home Depot At-Home Scrvil —J—J 345A Gteenwgod Street,Unit 2.Worcester,NIA U1( Top Free(800)657-5182;Fax(509)736-8923. 31 Fextorst iD#75-2699460;ME Lie 11 C 02439:RI Cunt.T.of 16427 Branch Number Cr Li,;S WC•05655=MA Hume Rnpm--i=nl untnx Wr Reg.A 126ttR'1 Tnrtallation Address: Stal Z,iP NtrClars¢rtS}: WmA PMarr Home Phone: (;dl Plume: Home Address: City State zip (If different from lastaUtion Address) Co F mnil AMre=(rn MPAVI'rrnjPm rmmm.n.ir.tinnc anri Home flni r t t,tvi.e•a)- ❑T 1�NOT wish to receive any m iijodrng ernails from The Home Depot P o'tut Iirforn inn: TJnder sls;tled("CUSWmec°).Ehe owntxs of the prvputy locatexl at the above iwlnllaliun adekcss,agiczs tv buy, and TH At- oma Services,Lx ( The Home Depw")agrees to ftumsb,dcltvcz and amsngc fvr the instuIIativn('Iust�tlativn") c- all materlais described on the below arrd an the referenced Spec Stieet{s),all of.which are ttwo►porated into itnis Contract by this ntcremro,uiong with any applicable Stara Supplement and Payment Summary attR�bed hereto and any Change Orders(collectively, "Contract"): Job�: trout aca>�cW Products g 8• Proiect Amount Roofing Sid' Windows Insulation [3['sattets/Covers Ennry Doors ❑ ` Roofing Siding windows ❑lasularion $ QGutiers/Covers©Enuy Doors Q Roofing siding Windows ❑ln�lation $ ❑Gutun:/Covers OEntryDom0 ORootlno[]Siding O Windows Insulation OGurmrx/Covets oHntry Doors 0 vm25% tofContractArmuntdueuponexcwtianofildscanttact- TeudCwttram4Amuunt $ Nblitc puodw$m+my not depubit more than aue 4bird ofthe Contract ArrmmnL Customer agrees that,immediately upon completion Of the work for each Product,Customer will execute a CompLedon Cettificaeu (one for each'Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each Customer under this Contract agr es to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included he man.at it,;discretion,if The)tome Depot or its authorized service provider determines that it cannot perform its obligations due to a structural pmblem with the home,environmcnul hazards such as arold,asbestos or load paint,other safety concerns,pricing ettars or because work required to complete the job was not included in the Contract. FRvment Sitmm®try The Payment Summary# included as part of this Contract, sets Rath the total Contract aluount and payments required for the deposits and final payments by Product(as applicable). NO.1•ICR TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the Hint you gig. Do not sign a Completion Certificate(nute: tlwro io ono Completion C crti[iaat¢for sods fisted Product ay detaned Tay indiriduud Spec Slxact+)lreFur a+.ueh wr tlreet Poulos t Is complete 3r.•sir��ar>t•o°•Eo.mirrzbjas•a`•?hi.,autr�acC,•^itRtraal-ugrz�'7t.'I�y`a'let.�[tlltre'Wit..'tuttueit+sfi-nr.9te*itfta,'tptirttl.tX{nteaa and services provided by The Home Depot or Authorized Service Provider through the date of termination,phis any other amounts set forth in this Agremuent or.allowed era Ilcshle law. TM,1ION1L DEPOT MAY WITHHOLD AMOUN l ti OWED TO THE HOMR DEPOT FROM THE DEPOSIT 1+AYNIENT OR OTHER. PAYMENTS MADE, WITHOUT I,IIYIIT1NC THE HOVE DEPOT'S OTHER REMEDIES FOR RECOVERS'OF SUCH AMOUNTS. . AcfCU_LSIItCC 82tCl�AntllOrl73110n' CUSLOIIieY agreCS Rod RIIdcishntds that this Agremeat is the Cnn7C a9dement between C"lom" and The Home Depot with regard W the Products and installation services and supersedes all prior discussions and agreements either, Drat or written,rotating to said Products�ddIIns�tal�wled es anlation.This aS��ntbat Customer hi.cannot be as read cd or unnd� dsed �voibuniarily xcxgeptsthe by Customer and The Home D B agree* lain of aml has received a copy of this.Agreement. red Y: sub by: Cu.iornee Signature Sates ultanes Si X Tel hai{e Nq• � t'�,,L'G3`� 8 X � Customer's Signature Dale Sales Consultant Ldcense No. - CANCELLATiON: CUSTOMER MAY CANCEL THIS (acettpti noisy AGREEMENT WITHOUT PRNALTY OR OBLIGATION BY DELIVERiNG WRITTEN NOTICTi.TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINEW DAY AI TER SIGNING, THIS AGREEMENT. THE STATE SEXPLEMM ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPLCMjCA,LT.Y PMCR13ED BY LAW' IN CUSTOMER-8 STATE NO11Cg:-ADDITIONAL T FnZ AND CONDT IMS ARE STATRdI Odl TllB REz'ERSB SRDB AND Attl pAR r OF TNiS CONTRA Cr 12.210p C.SC whlte�-&anchRe Yellow-Customer un TLi'Zi'9�t30S: 'ON Xdd piswel. Wow Ld t•Ii5Z.9 SOOZ ZI f i .� P&cel Detail Page 1 of 3 e i „ Logged In As: Parcel Detail LI Monday, Octob Parcel Lookup Parcellnfo .... ......... ......... Parcel ID 291-122 neveloper'LOT 1 Lot Location 35 SUFFOLK AVENUE Pri Frontage 108 Sec Road IBRISTOL AVENUE Sec 99 Frontage ....................... ........ ......... .......... ........ ........ Village'HYANNIS Fire DistnctHYANNIS ......... ................... .......................................... ......... Sewer Acct Road Index 1553 Interactive k Map { Owner Info . ...................................... ... ............................................ .. . .. ......_. ......... owner DE SOUZA, MARTA MARIA& Co-ownerAVELINO, OSEIAS . . ......... ......... ........ Streeti P O BOX 2131 Street2 _�......: _ ........ .. .... ......._ __.... _ _m _,_...... . city HYANNIS State`MA Zip ,02601 Country Land Info ....... ......... .. ... ............. .. _, .. .._....,,.._„_,.,,.... _ _. m.... , ,.. .m. Acres 0.26 use;Single Fam MDL-01 zoning RB J Nghbd 0105 ..,.::::.... Topography;Level Road Paved . ......... ........,..,. .._......., utilities=Public Water,Gas,Septic Location Construction Info Building 1 of I Year;... Roof? Ext I Built 1963 1 struct=Gable/Hip wall Pre-Fab,Woo Effect Roof AC Area F078 Cover Asph/F GIs/Cmp I Type None I Wall .rY __ . _...._� Rooms Style;Raised Ranch O Int D wall Bed =4 Bedrooms Int s..,, Bath Model ?Residential Floor£ Rooms`2 Full Grade!Aver age Plus Heat Hot"Water Total 10 Rooms Type Rooms http://issql/intranet/propdata/ParcelDetail.aspx?ID=22675 10/16/2006 I Parcel Detail Page 2 of 3 ff Heat; Found- Stories 1 Story 1 Fuel`Oil ation;Typical Permit History_ _. ._.._ Issue Date Purpose Permit# Amount Insp Date Coma 3/27/2003 Repair Work 67709 $3,500 4/14/2004 12:00:00 AM Visit History Date Who Purpose 6/8/2006 12:00:00 AM Gary Brennan Data Mailer 12/19/2005 12:00:00 AM Jason Streebel Meas/Est 4/14/2004 12:00:00 AM Martin Flynn Drive by inspection only 10/31/2003 12:00:00 AM Paul Talbot Meas/Est 3/7/2001 12:00:00 AM Paul Talbot Meas/Listed Sales History Line Sale Date Owner Book/Page Sale P 1 12/28/2005 DE SOUZA, MARTA MARIA& C178901 2 9/9/2005 DESOUZA, MARTA MARIA C177877 3 7/17/2003 MARQUES,AMARILDO C & RAQUEL A C169869 4 4/1/2003 CAMMARANO, DOMINIC A JR C168746 5 7/17/2000 MICHAEL, JOHN C158401 6 11/15/1993 NG, KIM HOK-KIN &ANNA Y C131964 7 4/15/1992 BANKERS TRUST COMPANY C126287 8 12/15/1988 RUFO, BRUNO & ROSEMARY A C116238 9 6/15/1986 CAMERON, DONALD F & MARY E C106727 10 3/15/1984 REDGATE, RICHARD L ETAL C95815 11 MINITER, MICHAEL F & ROSE C784490 Assessment History __......, ..._ Save# Year Building Value XF Value OB Value Land Value Total Pare( 1 2006 $169,700 $23,700 $0 $143,700 2 2005 $155,300 $23,500 $0 $110,500 3 2004 $106,300 $23,500 $0 $97,500 http://issql/intranet/propdata/ParcelDetail.aspx?ID=22675 10/16/2006 Parcel Detail Page 3 of 3 4 2003 $97,300 $23,500 $0 $29,400 5 2002 $97,300 $23,500 $0 $29,400 6 2001 $88,400 $22,000 $0 $29,400 7 2000 $73,000 $20,900 $0 $18,900 8 1999 $73,000 $20,900 $0 $18,900 9 1998 $73,000 $21,700 $0 $18,900 10 1997 $96,400 $0 $0 $15,700 11 1996 $96,400 $0 $0 $15,700 12 1995 $96,400 $0 $0 $15,700 13 1994 $83,800 $0 $0 $22,700 14 1993 $83,800 $0 $0 $22,700 15 1992 $95,400 $0 $0 $25,200 16 1991 $120,800 $0 $0 $40,900 17 1990 $120,800 $0 $0 $40,900 18 1989 $120,800 $0 $0 $40,900 19 1988 $64,700 $0 $0 $18,200 20 1987 $64,700 $0 $0 $18,200 21 1986 $64,700 $0 $0 $18,200 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=22675 10/16/2006 r TOWN OF BARNSTABLE BUILDING PERMIT APR ICA-*ION Map Parcel I Application # Health Division Date Issued. 17 7 BUILDING DE�r Conservation Division Application Fee Planning Dept. DEC 2 Permit Fee Date Definitive Plan Approved by Planning Board -rn�Ayo(Y--PARNSTABLE Historic - OKH _ Preservation/ Hyannis EM Pa�L S�� Project Street Address 3s' Village 46:�,?, WY-4 Owner 7'9 Address Telephone_A;2W _J,,1,_7 Ze,g '- Permit Request /��si�/� �Z1- o�,_'.,S/N 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 A Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes WNo On Old King's Highway: ❑Yes ANo Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new. Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use __-APPLICANT INFORMATION- -- (BUILDER OR HOMEOWNER) Name r�JI&,&1,�,W7� Telephone Number 5 Address /� ,� �,� � License # fcFc ` Home Improvement Contractor# Email «�i r ('s��°�'�0��.�/✓y�fj �O, Colw Worker's Compensation #�/�e l>��✓� ®� ' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� /�G FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE y ti ELECTRICAL: ROUGH FINAL c PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I _ The Corrvnonwealth ofMassachuset#s `9 . Depadmnt oflndustrial.Accidents 1 Congress Street,Suite 100 Bostory MA 02.U4-2017 www.mass gov/dia Workers'Compensation Insumce Affidavit:Builders/Contractors/Eledridau&Tlumbers., TO BE FILED WITH THE PERIVZMVQ AOTE(ORM. Applicant Information / Please Print Letdbly Name(Business/orl n/lndividuan: 'eq Address:/,f ,���i9 c le t l ' 4 j2' VA 12 ili G rJ � City/state/Zip: ,dh 4 Phone*: : 7s Areyou an employer?Check the appropriate bore: Type of project(required)- 1.®Iamacmployawith4_LemploYers(hU=d/orpact-timCJ* 7. ❑Newcanstructicta " 2.❑Iama sole proldctororp ipandbavenaemploycawaddngfmrmein- R. Remodeling anyeapecity [No wmioas'" fostaaaco rupw.ed-1 9• El3.❑I am a h® awn oer doing all wr dcmyself(No pvdmrs'comp.inmmcc required]t Building nti 10[] tnlding addition A.pI am a homeowner and will be hirnrg cm&zdmes to conduct all wodc an UT property.I WM ensmre tbatall caah-a.••tors eithabavo wodcea'compensation insmamce or are sole 11.[]Electrical repairs or additions Folnicmrs with no emplayees 12.QPfimb1ng repairs or additions S.Q I sm a general contractor and I have hired the mjr -caatractms listed an,the attached sheet 13.E]RobfreP airs • Thse suh-confractors have employes sadbave wcrdaa'comp.iavtazrea= 14.❑��, J� '%�Jul 6.❑We m e a carpmation and ib cff=bave cicrsisM&::right of ommpgcm peiMGL e. 1(41 ffirdwe have na employes.[No wadms'comp.fim=ce regmrcd l *Amy applimntthatebecloboxil must also IMoutthesectionbelowshawiagtheirwodcers'eozapmsatioapolicyt om t Homeowners who submit this affidavit indicating they are doing all wade and then ac oatside=dri ct=must submit a new affidavit indicating such tCmrhactors that cbeek this box must attached as additional shod shawing the—me of the suh-canimdms and state whether or not dune mi— have employees If the sub-co�have rm:ployeM they most provide their wa3=s'comp.policy mrmbcr. I am an employer iliac is providing workers'compensation buuz=ce for my erirplayem BdoW is the pokey card job site infonrra>Yon. � Insurance Company Name: ���41-1 f jG ( r�&L2�f� _— Policy#or Self-ins.Luc. eP ©t� j�©1 Expiration Date: fi d Job Site Address:, %D�� � City/Stafe!Lip��=�j Q z�®/ Attacha copy of the workers'compensation policy d'ecl 6tion page(showing the policy number and expiration date). Failure to secure cavera&e as inquired under MGM e.152,§25A is a arnnfi3al violafion punishable by a fine up to$`1,500.00 and/or ono-year impdsoameut;,as well as cavil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for issuance coyetage verification. I do hereby certify under the pains and penalties ofperjury that the infonmtion provided above is true and correct Signature: z2w Date: G one#: Q,tidal use only. Do not write hr this area,to be completed by city or imm offmid City or Town: Permit/License# Issuing Authority(circle one): L$card of Health 2.DuRdingDepartment 3.CityNown Clerk 4.Elec6rical inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i-' - CAPECOD•27 DEATON CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 7/2912016 THIS CERTIFICATE 18 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 endorsements. PRODUCER CONTACT IAMIL Rogers&Gray Insurance Agency,Inc, PHONE PAX 434 RIO 134 AIc Nob 877 816.2166 South Dennis,MA 02680 E-MAIL ADDRESS!mall ro ers ra .com INSURER 9 AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company INSURED !NSURERe.-Safoty Insurance Company 39454 Cape Cod Insulation,Inc. INSURER c:Endurance American Specialty Insurance Company 41718 18 Reardon Circle INSURERD:Atlantic Charter Insurance Company 44326 South Yarmouth,MA 02664 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY,PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE POLICY NUMBER MMILDICO FF MMIDD P LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS•MADE M OCCUR CBP8263063 04/01/2016 04/0112017PREMISES( EMI E occurrence) $ 100,000 MEO EXP(Any oneperson) $ 6,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT ❑LOT Z _ PRODUCTS•COMP/OP AGO $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY EO a I I EO SI GLE 13 $ 11000,000 B ANY AUTO 6232707 COM 01 04/01/2016 04/01/2017 BODILY INJURY(Per person) $ ALL OWNED �( SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIREDAUTOS X NON-OWNED PR ROP D AUTOS P r e $ X UMBRELLA LIAR X $ OCCUR EACH OCCURRENCE $ 2,000,000 C 7 EXCESS LIAR CLAIMS-MADE EXCIOOO6636001 04/01/2016 04/01/2017 AGGREGATE $ —TOED I X I RETENTION$ 10,000 Aggregate g 2,000,000 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY TA TE E Yl D OFFICERIMEMBER/EXCLUDED?ECUTIVE �N NIA WCE00431902 08130/2018 08/30/2017 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 11000,000 If yYea describe Under DESG�RIPTIONOF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 L I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,maybe attached If more apaoe le required) Workers Compensation Includes Officers or Proprietors, Additional Insured status Is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder, CLEAResuit,Eversource and National Grid are listed as Additional Insureds on this policy on a primary,noncontributory basis. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988.2014 ACORD CORPORATION. All rinhta rARarvari I Massachusetts Department of Public Safety� "^^•°�^^^ i I,�ji Board of Building Regulations and Standards License: CS•100988 Conatructlon Supervisor. HENRY E CAS-SIDY� 0 SHED ROW �, ►�'� WEST YARMO'U;`�H Expiration: Commissioner 11/11/2017 w,l W0/immowtvl� 0 c ,r^ Office of Consumer Affairs and Business Regulation 10 Park Plaza'.'-Suite 5170 Boston, Ma usetts 02116 Home Improvemew btractor Registration Type: Corporation CaCape Cod Insulation Inc w '. - : «, Registration: 153567 p , n: _ � ; _ w Expiration: 12/14/2018 18 Reardon Circle , > So. Yarmouth, MA 02664 _ A1'Z�f yvOy�Z t ri 20M•05/11 Update Address and return card. Mark reason for change, � ' ----..._...------._i ..___.__._..—_.-----...---.:_._._.---_._�__._....[�_Ads'�:3�s-f�-Ginn.c.4:al_nF� la:yr�ent•.1'�-.t..n.4t..C.�r�i.... �s�a»vr�aarLtuea�r�oy�C�aoaa�uaetb • Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only T-!. ea Corporation before the expiration date. If found return to; t ,; �eglst:fatton Iretlon Office of Consumer Affairs and Business Regulation 10 Park Plaza•Suite 5170 i�� a) 12/14/2018 .,, r l=. Boston,MA 02116 Cape Cod Insu ��`.n ' Hen sld t>I, ry CasY =`, h` ti .i 18 Reardon Clrc � s So.Yarmouth,M C;;, $ �Y�j Undersecretary Not valid without signature Town of Barnstable o Regulatory Services Richard'V.ScA Dime for 6 A�0� BuDding Division Torn perry,B'4"ng GomWsdmaer 200 Mam Stredt Hyannis.-MA 02601 wwW.toWn.barzustab.Fe ma.os Office: 50,8462- 4038 Fax 5018.-740-6z36 Property Owner Must Corxrp:Xetq-and Sign This Sectio Z__..,: iP Beer nAnr+ct DeSvuz as j�ctpxoE y x: hezebpa onze Capt. Od 141s oa h oo Co act bn ft7bebalf, in Z matters mWivt to work authorized.by dis bu ld ng.permit application for. 35 SU FF-o I k ) vc, N w a h n i s (-Address'.ofoii) Pool fences and alarms are The responsib ybf e-apphb=t. Poor are ndto:t be--'@W* orvrifized`before:fence is i!nsmUed"and ail final 1 upections are pex-ouned and accepted, Sigture of Signature of Applicanx Fri=Name P intNann ,�al��lao16 Q Date Q:FOxms:oWAR?M.tNirsWor-noes TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION MOM I Parcel Application ! Health Division Date Issued 2 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project StLWAIC? ddress Yy �r Village Owner f/ PV 6 Za Address Telephone S® _ Permit Request It'-- 6L 6��; �li" 50-6 ir J r26 bA�� C� �tGlb�ie All " h4 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain j� /G.roundwater Overlay Project Valuation 0 40b Construction Type hlila��tt�- Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ll" 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:�Yesg❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing anew Sze_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ,> Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ .. Commercial ❑Yes C3eo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name d� Telephone Number 77�7- 12f Address �5� vt License # 46 U �"l� Home Improvement Contractor# 3 6b Worker's Compensation # 004+00,5 2- ALL CONSTRUCTION DEBRIS RESULTING IT THIS PRI/OXCT ILL BE TAKEN TO SIGNATURE DATE 'i FOR OFFICIAL USE ONLY �a ' 4 APPLICATION# k _ . DATE ISSUED k • MAP/PARCEL NO. ADDRESS VILLAGE k OWNER DATE OF INSPECTION: FOUNDATION ' FRAME INSULATION t FIREPLACE k ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT ,k ASSOCIATION PLAN NO. i 10 Park Plaza.- Suite 5170 Boston, Massachusetts 02116 Home Improvement Cajlltractor Registration-Registration: 153567 Type: Private Corporation Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INC % )Wm ` Ar HENRY CASSIDY ,',j t 455 YARMOUTH RD. do HYANNIS, MA 02601 1 1 `Update Address and return card.Mark reason for change. •,,,y .,� v,-�J, is .� � Address Renewal Employment. LostCard DPS-CA1 0 50M-04/04-G101216 Office o``�mer Affairs us ne RA^e�gu,�l lion License or registration valid for in dividu!:use en.!y HOMR ��f �tu before the expiration date. If found return to: Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration: 12/15/2012 Private Corporation .10 Park Plaza-Suite 5170 Boston,MA 02116 OD INSULATION�INC,„ l'HENRY CASSIDY. `�� , 455 YARMOUTH RD HYANNIS,MA 0260t1' � ith Undersecretary z JtKali d t si tune Massachusetts- Department of Public SafetN, - Board of Building Reaulations and Standards Construction Supervisor License - License: CS 100988 HENRY CASSIDY 8 SHED ROW WEST YARMOUTH,.MA 02673 71, Expiration: 1 1 11 1/201 3 Commissioner., Tr#: 7620 k The Cornirlonl'vealth of Massachusetts Departmv,7t of Xndccstrial Acciden,(s n�= �1 Qf ice of Investigations �'� 600 WashinVon Street. Boston, MA 02111 C 5� wwrv.rnass.gov/dia. Workers' Compensation Insurance Affidavit: B3uilders/Contractors/Electt'icians/l.'lurrtbers A1_?_I iUurit Information Please Print Legibly Name (Business/Organizatiordlndividual): g 2Q � Address: y ------- --- — . City/State/Lip: Phone #: 0 (� 7 you un employer? Check th .appropriate.box; Type oi'project(required): 1. 1 am a employer with 4. 0 I am a general contractor and I New consti-ucticm eiiIployees(full and)or pact-lime).* have hired the sub-contractors . _ 1 aizt a sole proprietor or partner- listed on the attached sheaf. 7. [] Re 1.nzod�ling ship and have no employees These sub-contractors have, g, o Demolition workers' ' working for rrtr. in auy capacity. employees and have, . 9: �] Building addition [No workcrs' comp, insurance comp. insurance.$ rtiquircd.I ` 5. We are a corporation and its 10.❑ Electrical repairs,or additions 3.❑ I am a homeowner doing all work officers have exercised their l l.❑ Plt.izrtbing repairs or additions myself:. p to workers' comp. ; right of exemption per MGL 12:� Roof repairs insurance ref.uir�d. t . c. 152, §1(4), and we have no - 1 ] 13.❑ 0tberG1,op,4 r�14Q employees. [No workers' - -- f h comp. insurance required.] _ ''Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information. t homeowners who submit this affidavit indicating they arc doing all work and then hire ouiaide contractors must submit a new affidavit indicating such: ; iContractors that cheek this box must attached art addition&)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 workcrs'comp.policy number. f am an employer that is providing workers' compensation insurance for my employees. Belory is the policy and job site Insurance Policy # or Set[ ins. Lic. #: ' _ Z 0 — Expiration Date: _ Job JItG 1lddteSs` a . 'e. Citylstate/Zip: Attach a copy of the workers' compensation policy declaration page-(showing the policy n ber and explraClon date). Failurc to secure coverage as required under Scction.25A of MGL c. 152 can lead to the imposition of crUnibal penalties of a fu'le lip to T1.,500.0Q and/or olle-year i priscnunent, as well as civil penalties in the form of a STOP WORK OB-DERand a fine of up to T250.00 a day against the violator. Be advised "that a copy of this statemept may be forwarded to the Office.of l> vcsdgatio'ns of the DXA for insurance coverage verification. �!do hereby certify ur e pa and penalties ofperjury that the information provided a over.s trice and correct. 5i*nature Date: �� —, Phorie Official rese only. Do riot write in this area, to be completer)by city or to)vrl official City or.ToWn: issuing A.uthorily (circle one): . ' r 1. 13o.ard of-Health 2. Building Department 3, Cif),/Town Clerk 4. Electrical lnspectar S. Plumbing lhspcctor o. Other Contact Person: Phone : CllanrtF: 4597 7CQFC'�d,,. �p�� GGIIVSUL ._.._..— - QF LIABILITY INSURANCE TO1rk rIY Y11UUIY,,,1 I—NI CER(IFICATE I_—Ij ISSUED AS A MATTER OF INFORM ATIgN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE hiOt_Qk R/Thll9 i;ckflFu:A7E DCIL, NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDC,0 BY THE V`0i_ICIFS tscLONi.7iil CERTIFICATE OF INSURANCE pp@S NOT CONSTITUTE ACONTRACT m-1'RESENI-AlIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. BETWEEN THE ISSUING INSURER(S),AIJThIORI'E.D ItIPOR7AN7 If[hc cnrtn'iCBte huld ',is an ADDfTION 'II t•, n .,Ilcl n lltiu I r AL INSURER,the policy(ies)mustUe Kndul�ed.l1'5UE3Rg1 A—,IT N IS WA1Vl p u jc t jaT-- ol tr,c: n,lrry r.�rt�in policie=l may rewire an cndonarncm.A sca[ement on this eartifieatu etnes n,it eu I 1 l i tll In ul,: �,I I��.,tl:,lu41.r ui li�•u <:,1 o;uch �ncJuracnli:nt(5). ( t ly Illa. 50. Udlurl, aAn1[ACT: Mart4relY"aunq . PHONE — _�.�_ -_ I r•r .VL N kx1.54$^1bU^46U� =I I_AX__'_ .. Iuul .+unKta� Youn0lna(i+radGrs�ray,(:cJnl PROMCER — �'.u.+tli IVI r'1 U't i, ...._....._. �L:U Il,O'I �� CUSTOMER 10 o� •� I ' (fV12r.lINCs • -.—.-•_ . ..._, NAIL it t:..lil\c (�Irl In,ul,ria cln Inc; uJwrteRA'pearlass InsurinCe Its331 It WRERii Ohlo Cdsual[y Incuran u company . I:�� 'f.unlcJulll F�,Uacl . __ AHan[ic;ChaR�r If1SlJI'dr1C0 ---- ------- � - IVIA U2ijU1 - • waureR c i IUSuRkIC(1 Commerce I(IS LIf[1(14V CQ fll f)[I rly 347!`I - c-C_RfIFICATE NUMBER,F L)r I W 0 LL.UV O REVISION Nl1M1l IVN5110EL$T6 NUI:ED NAKED AGOVE FOR THC r�)OCY I't_hI\.Z --- I It:l r1llLill ll, ^11VY NE(,1UIk Itlf_NT 'I EhAI Qn CONDITION OF AN1'CiiNTRA;T OR O'rriE(i DOGUI\'IEIV7 WI f Fl IaESI)FCT TC11NhIICH TFIIS Of.I\IAY PEH 1 qIN. THE INSURANCE AFFORDED SY THE POLk:IES OFSCRIDED HEREIN IS SU13JEC:T TO ALL I VIE'(L-_HKI i' 'NI 101,10l I IONS OF SUCF(r'ULILIE.J.L.IM(T5 SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS, I,',, rc cJr a aulvuvut OLIGI'f[PF POLICY'ERP �—5R VV!] NOLICY NUINdER n,wrfl einlNUlYYYI NM00imY I-WilI , CBP8263063 OV0112011 Q41011201 eAaluccuKr«NGr vl UODUOtI, \ <_,.�„L-r:...,, ,cr+clvu tu,clnlL'i -laAlvlf\Gt•.�fC)FtfNTFl1��-__... ._._L____e __._ _.-._ .I , 4,1 1 I Pl X Ewna_lIl auifPiir,.l)__ t_I UU UUU . .�,.:cun - � C -_� (rV-TWIN IlVIJ1J11( y.l DL)t) nl-urxr• _.._......................._.._.__-__._.... I'CKSONAL41kA0VINJUIR)' yI,UOU;000 tNsFUAccr,�ar1L ),000104U j ---•--— I _ �I:L�uucrs cone c)r \\ri, t° UUU UQU U Inul InunLLIADu.nY 11MMBCKVMK 04101I2011 04101)201 I • 9 LOfvI81NEOtiIIVGII IINIII `1 •'•�I I .,,I l;tj - 10011-1 INJ IJRY fl'uw un) ti i \I J_ •.;1.:, - r'POPLsr I Y LIAMACIL ^ - j Al n IL11—in 11 L.Ir,q X^ L1l.l l h � UUQ 1254514645 ' 410112011 041011201 2 CACH 00I ut re=N a m I UUO 00Q 1 cts(INU)n,Wue y l UGO UUU I � I ODUU r —• V.I�K41 �.:Verll'LNSAIIU(J y .1i .� ' •. ,I 5 uAuu rl l WCA00525902 6/30/2011 0613012U1 X yV C rATu OI11 1 'r V N r 11 1 LIIJ ti al. s rr\I IIIvI'-�tIN�I�,t:nr-(.trII�C_ ... , r..lK urlll 't-.�l Lullt'tn CNI NIA NL PAI,IINL l-1llEIV1 i50D,U1)U _..-. . —.,uo__. ... .."., 1v^ I'°,I,•II", l k r..l J15LA4(--VA L MI I III $,500,U00 ..._..__ ..__.__ .._: -...... �A -- r.l_ulsr.Asr-POLICYunlrr 1;5U0,000 I - C""` I�' \ eltnUVNAVL-lJUiq 1I0Nj/VEIi1CLE5.(Alractl ACQk01U1,kla6ional Rcrnark Sen,uvi,u nwer)paca rar%qulrpGt - ^'-- 'rl''O,ni11�t.0111P Intormatlon Inckldod Offic ra or Proprietors - I I r jr5e�c�1l[dt:ht:ili)C:iL:rlFJtltarls� � � - � - . 1_c,'tI1f1CA l t u0L:0E1` CANCELLATION 10 Days for Non-Pa rnent _ •j SHOULD ANY OF THE A90VE DESCRILIEO POLICIQ I BF CANCELLED DEFORC, THE EXPIRATION DATE THEREO F, o I ,N I IGL•,WILL FJt I]l-:LIVE'RL-.D IN ACCORDANCEWITH THE POLICY PROVISIONS. - AUT11QW;EU IREPRESLNIATIVk T.�_'...^�•� F� n U1988-20U9 ACORD CURPo A'll_C)N,All righis lusi:rvr,l.i.I of 2 Thu ACORD name and 1090 and registered nlailcs of ACORD iiJ(id 57]NVltitt l i'9 ML.Y I _ Y ` PERMIT AUTHORIZATION FORM . �`- - owner of the property�located at: (Owner s Narrre,printed _ + ' ?'>- '�•:�.1f•-tee �L� �-=Lf:4 y r� '�._'.. � °; ' {Property Street Address) (City/Town) hereby authorize the Mass Save Home Ene*Services Program assigned Participating t Contractor listed below to act on my behalf and obtain a building permit to rm i µ and/or weath • Perk nsulation enzabon work on _ • property. , Owner's Signature t 1 Date .' .FOR CSG OFFICE USE ONLY♦ , Conservation`Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: ' F Participating Contractor r Date Rev.12132011 ` i - Y W . Regulatory Services tKE Thomas F.Geiler,Director Building Division R�RN.rZI R s . 9 Maes. .� € s;c Tom,Perry,Building Commissioner �A�D►wa't°�� it MO 1' t.tuks. 200 Main Street, Hyannis,MA 02601 fy `° .town.barnstable.ma.us 7rj!2 KIPOffice: 508-862-4038 Fax: 508-790-6230 Approved• ^� D1Vr:Si 1,)11 Fee: 4193S's r -O Permit#. HOME OCCUPATION REGISTRATION Date: Name: J003 CA-54,K 41,?n 41-2C Phone#: 6-6 Address: 3 43 _ S U 0"al( %yC . I V t`til S .-1-,4 village: -HY4NNI S Name ofBusmess: Now ViCC BC= Type of Business: Map/Lct: INTENT': It is the intent of this section to allow the residents of the,Town of Barnstable to operate a home occupation ,viithin single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discennible from outside die dwelling: there shall be no increase in noise or odor;no visual alteration to the. premises which would suggest anything other than a residential use;no increase in traffic above normal'residential volumes; and no increase in air or groundwater pollution. After registration writh the Building Inspector,a customary home occupation shall be permitted_ as of right subject to the follo-Aring conditions: • The activity is carried on by die permanent resident of a single family residential dwelling unit,located«at in that dxvelling unit. • Such use occupies no more than 400 square feet of space. . • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential%lumen. • The use does not involve die production of offensive noise,vibration,smoke,dust or other particular matter, odors, electrical disturbance,beat,glare,humidity or otier.objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any.need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard.._ o There is no exterior storage or display of materials or equipment. • There are no commercial velnicles_related to the Customary Home Occupation,'odher than one vari or one pick-up truck not to exceed one ton capacity,and one.trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on tie same lot containing the Customary Home Occupation. • No sign sliall be displayed indicating die Customary Home Occupation. • if the Customary Home Occupatioin is listed or advertised as'a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation 1•1,110 is.not a permanent resident.of the dwelling unit. . I, the undersigned,have read and agree with die above restrictions for my Home occupation I am registering. Applicant: crc4-,a` Date: Hoineoc.doc Rex-.01/3/08 YOU WISH TO OPEN A BUSINESS? For Your Information; Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. -it does not give you permission to operate.) You must first obtain the.necessary signatures on this form ��.t.200 Main :St , Hyannis.. p st FI'., 367 Main St., Hyannis, MA 02601 -(Town Hell) and get the.Busir)es5 Certificate'tliat is.. Take, the coin is tc d fonn�to the town Clerk's Offic:e,,1 ,. , required bylaw. r'gc}s�gc sr�srxi7+ , _DATE: I �.' Z�G' Zfl 17J Fill in.please: " P �FEL�rI1fY 1 +rt APPLICANT'S YOUR NAME/S: ' .� S'1/1 S ,. 4� 1Z p ro�I2C 1 f +' ¢"' m' BUSINESS YOUR HOME ADDRESS: q_ S Urpo K _fir/ PlL MF} c� a 601 F�gl�Ij'� d Nn}ar0vt iiPj —TT^— .4 F d r r 6'0 6 TELEPHONE # Hom e Telep hone Numb er r 9 SPAil;7!f1P aA .9k':y.u. cFd'� . . � NAME OF NAME OF NEW BUSINESS ItIF ` W V!� Hr;E �.9n�USCI�(/✓(::' PE OF BUSINESS :(AwS c'/a1�1 NG' IS THIS.A HOME OCCUPATION? ' YES NO MAP PARCEL NUMBER 2 I -I.2 Z Assessln ADDRESS;OFBUSINESS.: � _''- S:GifFGLfi. rarr 1t/Y �"N(Si• aG° (.. 9) When starting a new business there are several things you must+do in order to be in compliance with the rules and regulations of the Town of information you may need.. You MU ST GO TO 200 Main St. - corner of Yarmouth Barnstable: This form is intended to assist you in obtaining the inform y y _ ( Rd, & Main Street) to,make sure you have the appropriate permits and licenses required to legally operate your business in'this town. 1. BUILDING COMMISSIONER'' . FFICE. ST COMPLY WITH HOME E OCCUPA TION TION This individual has b I f mec of y permit requirements that pertain to this type of busine U RULES AND REGULATIONS. FAILURE TO Authorized i nature** COMPLY MAY RESULT IN FINES. COMMENTS: 2. BOARD OF HEALTH This individual has heei for of the permit requirements that pertain to this type of business. MUSY,,:OMf'LYINITH ALL ; r • (� 'r-� RDOUS MATERIALS REGULATIONIS f r Authorized Signature4 I,'yrx�,4 COMMENTS: !i, i• 3. CONSUMER AFFAIRS (LICENSING AUTHORITY)_ a1 This individual has been informed of the licensing requirements that pertain to this type of business. a ° Authorized Signature COMMENTS: x ,, It A W,, 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION s 1: Map Parcel Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address ,B 6 IT 4c"ll/ Village d i k Owner Address Telephone 2� p Permit Request t (, ajd6 46 Ib O 1.( ��-r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ��� Construction Type2'� Lot Size / Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family`(❑ 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 riths: Full: existing new Half: existing new Number of Bedrooms: existing —new - Our) Total Room Count (not including baths): existing new First Floor Rdbm Count� ID Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood :coal sto\Fe ❑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�AWN thorization ❑ Appeal # Recorded ❑Commercial ❑Yes o If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C�,/�zB CU� Z1g4r dAl Telephone Number' ;7, 5— f Z / Address / r,L��,.y/2d��/�' License # /�G/� IiJGJ f Home Improvement Contractor# /j'�?j­0' Worker's Compensation # DD_3 2_�C ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# w, r DATE ISSUED �• MAP/PARCEL NO. ADDRESS VILLAGE h OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING S DATE CLOSED OUT ASSOCIATION PLAN NO. h Massachusetts -Department of Public Safety y Board of Building Regulations and Standards Construction Supervisor License: CS-100988 HENRY E CASSDO [� 8 SHED ROW t8 WEST YARMOLFM 4 � Q2 I . Expiration Commissioner 11/11/2015 s 'owr, wr..�ar•rr7JJ<�L/`l.rflt?l� J l'r Ji1 C)111Ce 0I:'C..onsulzaec Attairs and Busuzess Regt.11atl'on 10 Park Plaza - Suite S 170 Boston, Mass lchusetts 02116 1-a.ome Improvement'C:ontrutor Registration Registration: '15M67 lv1)e: Privrt[c Corwaiation Expiration., 12/15/2,t)94 .'I'l-M 2JwJI COD INSULATION, INC I if=NRY CASSIDY _..-._-._ 16 '\E ARDON CIRCLE `;t_?. YARMOUTH, MA 02664, ,- UpJatc Address and rehir11 Card. 11'lurtt rcuson f cl allgi, . Addicss Renewal :I li:nit.tluyntunt ( I LuslC,ud 1_:] L I L Uu]u III c1, uu ti &; Itusutess Reg u III uu„ Liiense of registration valid for indivitlul use,oniy + �agN�ntlJmr IMNKOVEMe:N7- CONTRAM-OR belUIU the espiratiun d tie. If f0UILII l'uturu lu: - � oylrotruUun 15a567 Type: Oflicc of Consumer Attnn's and l3usiucss ltu:6ulufiuni ' 2 IQ I'irk PI„za-Suite 5170 � �,faplr�(uui, I5l�U'14 t nvale CorporaUcn tiuslun,MA 02116 ui;y 110N..IN( �l i«iN i.irt(a I Jntli,(sccrcl„r�- of ;I I' fvitho t ❑,tl re The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.Mass.gov/dia Workers' Coelrupeusatiorx )lusurance Affidavit: Buuilders/Contractors/IElectricians/]P'Iumbers �LUL)licaat Information Please p'riart Le ibis N;nic (BusinesslOrganizaaon/Individual): Address:_��" Cir !State/Zi G . � Y ram. r� : Phone Z :err yuuY as eutploy r? Check the appropriate box: Type of project (required): 1.0,1 urn a employer with. j 4. Q I am a general contractor and I rt7tployecs (full and,tP'e part-time).* have hired the sub-contractors 6• ❑ New construction ❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have $, Q Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurances . 9• �] Building addition required_] 5. Q We are a corporation and its.' 10.❑ Electrical repairs or additions .Q I am a homeowner doing all work officers have exercised their ,1 1.❑ 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 3a.Q I am a homeowner acting as a ., employees. [No workers' 13.MrOther Z,u general contractor(refer to #4) comp,insurance required.] JI 'A,uY appliwut that checks box#4 must also fill out the section below showing theirworim'compensxtiotip licy iaforrnadon. r Homcowucn who submit this affidavit indicating they,are doing all work and then hire outside contractor must submit a new affidavit indicating such. tCoutnecton that check this box must attached an additional sheet showing the came of the sub-coutn c=3 and smw whether or not those entities have cuiptoyces. if the sub conmxetors have employees,they must provide their wotkern'comp,policy number. 1 urn an employer That is providing workers.'compensation insurance for my employees, $'elow is Ilse policy and job site Injr rmadom Insuralicc Company Name: ���,r/ G Policy#or Self-ins. Lic. #: vG / ExFiratioa Date: fig Job Site Address: City/State/Zip: .Xrrach 2 copy of the workers'.com,penxatiou policy declaration page(showing the policy nu M* b r.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 tine up to S1,500.00 and/or one-year imprisonment,,as well as civil penalties in the form of a STOP WORK ORDER and a tine Of up to S250.00 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: 1 dv hereby certify rider the nd penalties of perjury that the inforination provided above is true and correcX J Date: 0 ;OA'ia!rues only. Do not write in this area, to be completed by city or town official City or f owu: Perniit/Llcense# Issuing Authority (circle one): 1.Board of 1lealth 2. Building Department 3. City Torwn Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Ut4Cr Contact Persou: Phone#, r CAPECOD-27 MYOUNG �z�tl CERTIFICATE OF LIABILITY INSI RANCE R 718/2�AT718/2 DnYYYJ � 013 _ I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS 1 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES I 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 LicenseTk PC-514062 NA- CONTACT ME: Margaret Young Rogers&Gray Insurance Agency,Inc. PHONE -"---- 434 Rto 134 (AIC No.Ex(: South Dennis,NIA 02660 E-MAIL — ADDREss:myoung@rogersgray.com INSURERS)AFFORDING COVERAGE - NAICI; _. __ --.....-----__._.---•--_------' ------_-.-- INSURERA:PEERLESS INSURANCE COMPANY.. INSURER 13:COMMERCE INSURANCE COMPANY Cape Cod Insulation,Inc. INSURER C:Evanston Insurance Company 10 Reardon Circle INSURER D ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 INSURERS: .... ..._...._.....-.__. INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF.INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TIils 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., AT56LSUEfR"-",. POLIC EFF PO'LICYEXP . _-------- L(R TYPE OF INSURANCE _ V POLICY NUMBER MM"I _,YY (MMIOD/YYYY LIMITS - GENERAL LIABILITY EACH OCCURRENCE $ - 1,000,000 MAGETO RENTEC IA X COMMERCWLGENERALLIAB DR ILITY CBP8263063 4/1/2013 4/1/2014 PREMISES Eaocnlnence) $ —^ 100,000 . 'I CLAIMS•MADE I-K OCCUR MED EXP(Any one peryan) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 __.......--_.--.'-- GENERAL AGGREGATE $ 2,000,000 UEN't AUGREGATE LIMIT APPLIES PER: -- - PRODUCTS-COMP/OP AGG $ 2,000,000 I OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accida it) ------'$ 1,000,000--' • Is- ANY AUTO 13MMBCKVMK- 411/2013 4/1/2014 BODILY INJURY(Per Person)- $ ALL AUl"OS OWNED X AUTOS BODILY BODILYINJURY(Peracddanl) $ -' X. NON OWNED PRbPERTY)SAGE -T-- . MIRED AUTOS x AUTOS $ PER ACCIDL=NI' X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 C esuAe CLAIMS-MADE XONJ45352 4/1/2013 4/1/2014AGGREGATET—' 1,000,000JIxc UEU:I—XXXX]RE ENTION$- 10,000 WORKERS COMPENSATION T - - M STATU• O_TI1- - ANDEMPLOYERS'LIABILITY LIMITS D ANY PROPRIUORIPARTNER/EXECU FIVE YIN WCA00525904 6/30/2013 6/30/2014 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? u NIA ----- — i (Manddlory In NH) - - i E.L.DISEASE-EA EMPLOYEE $ 1,000,006 ItyS doscruo under - --- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT' $— 1,000,00 DESCRIPTION Or OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Workers Compensation includes Officers or Proprietors. Addtional Insured status is provided under the General Liability when required by written contract or agreement with the Certificate Holder. 1 I CERTIFICATE HOLDER CANCELLATION _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod I sulation lrlc THE EXPIRATION DATE. THEREOF, NOTICE WILL BE DELIVERED IN n • ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE - @ 1988-2010 ACORD CORPORATION. All rights reserved. I ACORD 25(2010105) The ACORD name and logo are registered marks.of ACORD r f CAPECOD 27 MYOUNG CERTIFICATE OF LIABILITY INSURANCE DATE,MMIDDlYYYY) -- _ 7_18/2013 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). __............ —------...__ _---— — <onuceR License#PC-514062 d NTACT NAME. _ Margaret Young Rogers&Gray Insurance Agency,Inc. PHONE — FAX'----- �-— 434 RID 134 AIC o Ext: South Dennis,MA 02660 n oaEss:myoung@rogersgray.com INSURER(S)AFFORDING COVERAGE - - NAIC N . . _------------__...------_---___..-! INSURER A:PEERLESS INSURANCE COMPANY ursulte° INSURER B:COMMERCE INSURANCE COMPANY Cape Cod Insulation, Inc. - INSURER C:Evanston Ins Lira nce.Company.. . 18 Reardon Circle INSURER D:ATLANTIC CHARTER INSURANCE-GROUP_ _ South Yarmouth,MA 02664 wsuRERE:` - INSURER F: _--- COVERAGES _ _ _ CERTIFIC_A__T_E NUMBER: REVISION NUMBER: _ PHIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA 1 ED. 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. IINSk- -- ATSOL STJ9R r41112013 POLICY EXP LIMITS�- --___-- LfR T _TYPE OF INSURANCE T WVD POLICY NUMBER MM/DDIYYYY GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000 DRMAGETO R[NTEDA X COMMERCIAL GENERAL LIABILI rY CBP8263063. 4/1/2014 PREMISES(Ea occurrence) 100,000 CLAIMS-MADE I-XJ OCCUR MED EXP(Any one porWn) $ 5,000 PERSONAL a ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GfiN't AGGREGAI E LIMIT APPLIES PER: - - PRODUCTS-COMP/OP AGG_ $ 2,000,000 POLICY E q PRO- ( LOC _ $ - AUTOMOBILE LIABILITY - . - - COMBINED SINGLE LIMIT 1,000 000 Ea acddeMl T— $ '____ B ANY Auru _ 13MMBCKVMK 4/112013 4/1/2014 BODILY INJURY(Per person) $. ALL OWNED - SCHEDULED - -- — - -`---- AUTOS X AUTOS BODILY INJURY(Per accident) $ X HIRED ADIOS X .NON-OWNED PRCPERT�IT?AMAGE_ $ AUTOS ? PER ACCIDENT X. UMBRELLA LIAR X OCCUR EACH OCCURRENCE. $ 1;000,000 ~ kXCESSLIAB CLAIMS-MADE XONJ453512 4/1/2013 4/1/2014 AGGREGATE $ 1,000,000 _LX�RETENTION$_ 10,000 $ .WORKERS COMPENSA TION - W'C STATU- .AND EMPLOYERS'LIABILITY L _ 1 D ANY PROPRIETOR/PARTNER/EXECUTIVE YIN -' WCA00525904 6/30/2013 6/3012014 E.L.EACH ACCIDENT $ 1,000,000 ' OFFICERWEMBER EXCLUDED? u NIA - - -- •— j (Mandatory In NH) E.L.DISEASE-EA EMPLOYEC $_ 1.000,000 Ir vas,descnoe under i DESCRIPTION,OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000- UES:RIP110N OF OPERATIONS I LOCATIONS I VEHICLES-(Attach ACORD 101,Additional Remarks Schedule,it more space Is required) - Workers Compensation includes Officers or Proprietors. Addtional Insured status is provided under the General Liability when required by written contract or agreement with the Certificate Holder. t I _ ----------- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - - - AUTHORIZED REPRESENTATIVE , ©1988-2010 ACORD CORPORATION. All rights reserved. I ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD t OWNER AUTHORIZATION FORM (Owne s N e owner of the property located at:JA6 0 (Property Address) U1A�II�JJ15 - OA (Property Address) hereby authorize Tr�(/ 1a layf (Subcontracto ) an authorized subcontractor for RISV Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Owners Signature Date Town of Barnstable o4 +E,ew Regulatory Services Richard V. Scali,Director BARNBTABLE, * Building Division BARN.STABLE. 9 MASSws"*csesiwsQw�vew�miuv.""a-:wi Paul K. Roma 1639-2014 - pr'�°'" A Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 November 3, 2016 Ms. Marta De Souza 35 Suffolk Avenue Hyannis, MA 02601 CRe: Amnesty'Apt.,35 Suffolk Ave. y Dear Ms. De Souza, Po The purpose of this letter is to clarify what needs to happen for the amnesty apartment to proceed at the above referenced address. Each bedroom in the house must comply with the requirements of emergency escape (attached page), and the house must comply with the requirements of today's code for smoke detectors (attached page). The Health Department will tell you how many bedrooms you are allowed in the house. Two permits will need to be issued—one for the windows/doors we talked about; after it has been inspected and closed out, the process can continue for the apartment. The apartment application will need to contain complete floor plans of before and after the proposed construction. Windows and ` smoke detector upgrade will be part of that application and it cannot be issued until acceptance into the. Amnesty Program has been achieved. If you have any questions;please do not hesitate to contact this office. Sincerely Paul Roma Building Commissioner ' Town of Barnstable Building Post.This:,Card<SoyThat tt�s Visible-From the Street A • ,roved 1?I�ns,Mlust,be Retained on Job andthis Card Must be„Kept a s eueNxcAQLB, • x� -.�r� �"'`� ,J''" $. ;� Tk ,,, °` asx=. pp- R./� ��«: � L� �„rr ;'s .� '� „� � �41 Posted Until Final Inspection Has Been Made 64 may, i.l; •,. .; ,u�;, : ' f. ` p yam R °'ry F� anc',:s Re erred such Buildin sh'all`Not be'Occu ied until a Final Ins 'ect�on„has,=been made 1 ej mit Where a Cercae ofOccup y q_ v g _. P , _ Permit No. B-18-2682 Applicant Name: Brien Langill Vivint Solar Developer LLC Approvals Date Issued: 08/29/2018 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 02/28/2019 Foundation: Location: 35 SUFFOLK AVENUE,HYANNIS Map/Lot: 291 122 Zoning District: RB Sheathing: Owner on Record: DE SOUZA;MARTA M �C ntract r Names X BRIEN LANGILL Framing: 1 61, � _ Address: 35 SUFFOLK AVE oritractorLicense CSC 106675 2.. HYANNIS, MA 02601 •i � EstProfect Cost: $29,700.00 Chimney: L i " Description: Installation of roof mounted photovoltaic solar systems 45�panels PermitjFe,Ixe: $201.47 13.5kW Insulation: Fee Paitl $201.47 ( Final Project Review Req: 8/29/2018 Date �� � Plumbing/Gas Rough Plumbing: F -Building Official F Final Plumbing: µ Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized bythis permit is commenced within six months{after issuance. All work authorized by this permit shall conform to the approved application" , d thekepproved construction documen 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 road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ; - r Electrical �. �`. : � Service: The Certificate of Occupancy will not be issued until all applicable signatures byheBuilding and dire Officials areprovi77 dedOn this permit. Minimum of Five Call Inspections Required for All Construction Work: `z �� '° Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final' Work shall not proceed until the Inspector has approved the various stages of construction. "Person on r with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Page 1 of 1 Coyle, Brenda From: Cadrin, Arden Sent: Monday, October 24, 2016 3:04 PM To: Roma, Paul Cc: Buntich, JoAnne; Coyle, Brenda; Puckett, Carol; Jenkins, Elizabeth Subject: 35 Suffolk Ave Hi Paul, The owner Of 35 Suffolk Ave (Extension?) will be contacting you to schedule an inspection as the first step in the accessory affordable apartment process. , Once the inspection is complete, please forward me the site inspection report. Regards, Arden Arden R. Cadrin Housing Coordinator ....GROWTH Nil'NA*EMEfi1T car€�r��rrrar. Town of Barnstable 367 Main Street Hyannis,MA 02601 arden..cadrin@town.barnstable.m.a.us (508)862-4683 r r 10/24/2016 Town of Barnstable Regulatory Services '"R'', `'E Richard V. Scali, Director 16390. 1% Building Division rF0 MA'S Paul Roma,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town,ba rnstable.m axs Office: 508-862-4038 Fax: 508-790-6230 August 4, 2015 Marta DeSouza 35 Suffolk Avenue Hyannis, MA 02601 Re: Apartment 4 Dear Ms. DeSouza, This letter is to inform you that you ma `currentl a inviolation y y y y b of Barnstable Zoning M Ordinance 240-11; any use other than a Single-Family home is prohibited. You must contact this office by August 18, 2016 to arrange to bring the above address into compliance or be subject to fines of$100.00 per violation,per day. Sincerely, ' Robin C. Anderson Zoning Enforcement Officer /blc t - Application numbe Y L Fee ................................�l,�.W !i...✓.... .......... ® f :.'. Building Inspectors Initial .............. .: .. ............... sk 15 MP� 5C? Date Issued..................::. . .ZY. J..................... TOWMap/Parcel. l... ....Q..l..... ......................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 5 R-011 vc V� 0 vs NUMBER STREET VILLAGE j Owner's Name: 13\. bC \500 2V1 Phone Number Email Address: 0,v�WG IAO%% .Cell Phone Number 5 Project cost$= Check one Residential V _ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK Siding CO Windows (no header change) # Insulation/Weatherization 0 Doors (no header change) # Commercial Doors require an inspector's review XRoof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable) # (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. I APPLICATION NUMBER r *For Tents Only* .Date Tent (s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name:'( �• ��� \ Telephone Number ' �� 9 Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnsta le. Signature Date • I APPLICANT'S SIGNATURE Si gnatuie Date All permit applications are subject to ilding official's approval prior to issuance. i' f The Commonwealth of Massachusetts Department of Industrial Accidents — Office of Investigations ' 600 Washington Street - Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individuai): % C 6DO 2 Address: �� l�lx. iwx City/State/Zip: Phone#: Are you an employer?Chec a appropriate bow Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp,insurance comp.insurance.$ 9. El Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3X I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself~[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *My applicant that checks box#I 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 contactors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state vybether or not those entities have employees. if the sub-contactors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fne 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 coyemgp verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: l �I Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Perminicense# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector,5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. ' Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced*acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill,out the workers' compensation affidavit completely,by checlang the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is required_ Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should ur be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant, Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permitJlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or ' town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fume permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtain a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a calL The Department's address,telephone and fax number: The Gommonwealtla of Massadhusetts Department of hdastcial Aoddents Office of Uvestigatlous 600 Washi]40n Feet Boston,ILIA 02111 Tel.#617-7274900 ext 446 cvr 1-977-MASSAFE Fax#617-727-7749 Revised 4-24-07 www,mass,gov/dia l` 1 rn bZ e-Y� � F t e 1 , w " r £f 1 q mF e3 F` , �° a. d'C i�A, .d i�• s � 44 . . - �• °4 k iµV, ...yy, y mS ¢'^ p'y�.�9p/.R�� �, '.. ; �r "k •!�f �;. .. ya �v � .fie m mny$ ".� '�' •^yT , '�a $ 4W. � �h. �� r '9 _ ` 4 h , ` �• } Y m ` m 41 . M } 1 g 9' s S �. y. ��.,h> r- .A w.►r.,, '` `'"�."'p�p"R"�se+*i�„x_�:.w.,,,.0 4t ','"'?� "� '�� ��' �,.. �*.�'r' ,r �OFTHE loy, Town of Barnstable Regulatory Services rBA MASSS. Thomas F.Geiler,Director �'OrF1639. 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 April 5, 2006 Ms. Marta Maria De Souza 35 Suffolk Ave. Hyannis, MA 02601 Re: Illegal Apartment—35 Suffolk Ave. Hyannis, MA 02601 Map 291 Parcel 122 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 multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincere da Edson Amnesty Program Zoning Officer Building Department gforms:zoning3 NAME FF.ENDFA Dnn D(�D .76331 TOWN OF AODREgrDF'OFF DER 1 'njTT BARNSTABLE CITY,S, .E. IP CODE A44A)d - , 4 A 4 -� ��7NE► MVIMBR GISTRA OlfNUMBER OFFE E r HAe\til'ABLE. • (..pyUJI CL ,679• ♦ O ►EO/A1d �� �,yf �r erg .r,�,,rLAJ TIME AND DATE OF yIO ATI 1 / LOCHION O'ATI0 w NOTICE OF Ii M, M 20 'M. .. ✓ A SIGNAL.URSflPr FORCIN'PEIi -' ENFO Cl G PT. r BADGE N0. H VIOLATION - r _-•. OF TOWN EA BY ACKNOWLEQGE RE fEIPT OF CITATION X UJI a ORDINANCE linable to obtainssi now o offend t a tf �,� , THE NONCRIMINAL FINE FOR THIS OFFENSE IS S/ , ~ Date mailed � I " w OR YOU HAVE THE FOLLOWINGy ALTERN*IVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL 0- DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w REGULATION 1 You ma elect to a the above fine,either b Q ( ) y pay y appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, ly before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk,P.O Box 2430, J Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. a (2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST UNSTABLE DIVISION,COURT COMPOUND,MAIN STREET BARNS'ABLE,MA 02630,Attn:21 D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature l L)c - V Ly o e , i f(fY 1 _ y y m t r x f � s - _ry M� a M r e 1aj #3��'� ` �� .��ir 1 rya' 'F.. _ ,. ti•. �_ ���'•} l � -t+l����` a�i:~�•vi��` fad , �k Y► a < v / a �: P aet t ,+ � .sue ,4J` � ,i � # '; �.•.• -"*:. .•, µ+ Sf;t i_(i � -}" +' 3r�:i` + 1r�2r•s � , 1 il'> ;. r � prrhr , ,��' s4 •'• E tt t ''�f s f 'k 1 ' d C ...,' t � r ,��.l{ - ..t t t yr by ♦ i 1�5 t�� ��".� .1 �}I v( i� �a E,��,t a''s fr'd 'a��: M-. i } a5 .: al l',--•� i , g6��F7S,1 �. t{ .}�i y q�'b�iaQ.�'��`r`�" a O''t OW MR r• 1 1 t�, 1 ' R 'S j �,• ' ; t a s��r 6 �i`�(tt� t.Xi�t''94 J e�}j$�(-"•�5 `� -'��A►A� �ba -`` "��Y F �"' ; '�` +f •.Y o \ * i pX ! il" . ��1 t !t .a�,c�. k R• _ i�� \ r N5f• . . z 5 •- [ t��r'�., rti' � `t s �;�. y � i r,� l � ({ �:z yr,> .;, � i• �1� ,r �+. � S- y;tt a a°>t ( #�- y'�t4 •.r ffa' .�� i I(�..�i� '� 't �aw! 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' ,�,�, 1 A..t��r?��,:i.fi�n��'�'�kg:'''`�\SYA �i' F '� 'q•fi�.,• r �, �� q�� � r��l �i r' ���. a � '.E,A. �5"'U��',t�t��.b•�'a;tiufd+..r,.:.. ,•�, - •. r�. �!l �•YI,'� l�ltt'4••r � '® �l� �/ 9 I '/fit• COY ti�i' r I�, ,.� .S b ei•�k`r �� n Gi + �• �,•/, fi,�t� � rye; t � t ��•� v — ,,y r fp • I • ,f - _ _. ��� �� •�fih-:. ..°.ti `:a pr�� �y�3� ��� Y� � 1` ,� `f1� �i�, 71 • z4' j� .. 7 lit, " •&M mwp t }t•1�r Y`S�r :. � _� a Parcel Detail Page 1 of 3 ,;RM r Logged In As: Pa rce I Detail Wednesday, A Parcel Lookup Parcellnfo Parcel ID 1291-122 Developer Lot SLOT 1 Location °35 SUFFOLK AVENUE Pri Frontage i 108 _.... ._._. ..___----- Sec Road BRISTOL AVENUE Sec Frontage 99 VillageHYANNIS Fire District'HYANNIS Sewer Acct Road Index 1553 Owner Info Owner rDE SOUZA, MARTA MARIA& Co-Owner AVELINO, OSEIAS Streets 35 SUFFOLK AVE Street2 _. ._ ..... .......... _._.__.. ._. _. _ ... _._.... City;HYANNIS State 1 MA zip 02601 Country Land Info ........ ......... .. ... ......... ..................................... ......................................................................... . .... Acres 0 26 Use Single Fam MDI zon€ng RB Nghbd 0105 _... Topography Level Road Paved ___._.. _._ _... _.- _._.w__x......... Utilities Public Water,Gas,Septic Location Construction Info Building Year 1963 Roof;Gable/Hip ac None Built'. ... Struct L_,,.. Type Effect ..... Roof ,. _ Bed 1960 Asph/F GIs/Cm `4 Bedrooms Area Cover. Rooms'---, ,—-- Style Raised Ranch wall Drywall Rooms Model Residential Rooms 10 Rooms 3,; �s zprn _ m Int Bath . Grade Average Plus Floor Style y Kitchen Stories ;1 Story Style g ia Ext....... Heat ., Bath ,, J , Wood Shin le Wall g Fuel Split Heat,Hot Water".... Found Oil _...._.,... Type ation http://issgl/intranct/propdata/ParcelDetail.aspx?ID=22675 4/5/2006 Parcel Detail Page 2 of 3 Permit Issue Date Purpose Permit# Amount Insp Date Coma 3/27/2003 Repair Work 67709 $3,500 4/14/2004 12:00:00 AM Visit History Date Who Purpose 4/14/2004 12:00:00 AM Martin Flynn Drive by inspection only 10/31/2003 12:00:00 AM Paul Talbot Meas/Est 3/7/2001 12:00:00 AM Paul Talbot Meas/Listed Sales History Line Sale Date Owner Book/Page Sale P 1 12/28/2005 DE SOUZA, MARTA MARIA& C178901 2 9/9/2005 DESOUZA, MARTA MARIA C177877 3 7/17/2003 MARQUES, AMARILDO C & RAQUEL A C169869 4 4/1/2003 CAMMARANO, DOMINIC A JR C168746 5 7/17/2000 MICHAEL, JOHN C158401 6 11/15/1993 NG, KIM HOK-KIN &ANNA Y C131964 7 4/15/1992 BANKERS TRUST COMPANY C126287 8 12/15/1988 RUFO, BRUNO & ROSEMARY A C116238 ; 9 6/15/1986 CAMERON, DONALD F & MARY E C106727 10 3/15/1984 REDGATE, RICHARD L ETAL C95815 11 MINITER, MICHAEL F & ROSE C784490 � Assessment History ......_ Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2006 $169,700 $23,700 $0 $143,700 2 2005 $155,300 $23,500 $0 $110,500 3 2004 $106,300 $23,500 $0 $97,500 4 2003 $97,300 $23,500 $0 $29,400 5 2002 $97,300 $23,500 $0 $29,400 6 2001 $88,400 $22,000 $0 $29,400 7 2000 $73,000 $20,900 $0 $18,900 8 1999 $73,000 $20,900 $0 $18,900 9 1998 $73,000 $21,700 $0 $18,900 10 1997 $96,400 , $0 $0 $15,700 11 1996 $96,400 $0 $0 $15,700 12 1995 $96,400 $0 $0 $15,700 13 1994 $83,800 $0 $0 $22,700 14 1993 $83,800 $0 $0 $22,700 15 1992 $95,400 $0 $0 $25,200 16 1991 $120,800 $0 $0 $40,900 17 1990 $120,800 $0 $0 $40,900 http://lssgl/intranet/propdata/ParcelDetail.aspx?ID=22675 4/5/2006 Parcel Detail Page 3 of 3 18 1989 $120,800 $0 $0 $40,900 19 1988 $64,700 $0 $0 $18,200 20 1987 $64,700 $0 $0 $18,200 21 1986 $64,700 $0 $0 $18,200 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=22675 4/5/2006 r 09/06/2005 15:49 5087786448 HYANNIS FIRE PAGE 01 HYANNIS FIRE DEPARTMENT AN 96 HIGH SCHOOL AD. EXT,HYANNIS,MA.02601 KM)CAL HAROLD 8. BRUNELLE, CHIEF sw BpaE� INDK f, FIRE PREVENTION BUREAU N7�WARKNKfNOrunico/cin'ui 7�V BUSINESS PHONE:(508)775-9500 FACSIMILE PHONE;(508)778-6448 LT. DONALD H, CHASE,JR,,CFI LT.ERIC F.HUSLER,CFI FIRE PREVENTION OFFICER FIRE PREVENTION OFFICER FACSIMILE TRANSMITTAL SHEET THIS FAX IS GOING TO: T4bs•.PERR� :R..B>ZLL�tG..IIEFAttTMEE�IT........................ THIS FAX IS BEING SENT BY: FIRE PREVENTION OFFICE SUBJECT OF THIS FAX: F.Y.I SEE PROPERTY INFO THAT HAS BEEN CIRCLED ) DATE: FAX NUMBER: NUMBER OF PAGES: ................I...........-......,. ........I....................... (INCLUDES COVER) T V I NO ES. ...........................................................,........................:............,........................................... c 09/05 2005 15: 49 5087786448 H`(ANNIS FIRE PAGE 02 Deriding Listing d 20501533 �16r nnis,MA 0260 1-26 56 LP $379,900 -: Prop T e Single Family Subdivision County Town Barnstable Zoning Residential' Sq.Ft-!Source 1.7401 Field Card Rooms 10 Lot Size/Source 0.26ac/(Assessors Records) Beds 4 Style/Desc Raised Ranch/ 4..` Baths F/H 2/ Levels Year Built 19531 Approxim R -P for quick sale!Nice 4 bedroom, 2 bat ith full finished basement with a bath and four rooms, eat house for a "bir�nily wit f potenti New windows and a lot of upgrades.Very wel maintained. ota+ quare oo ge oes not irtGude 884sq ft of asement are fees Way to Bristol Ave to corner of Suffolk Ave Showing Instr•: Appointment Req.,Call Listing Office,Yard Sign General Information Gara Gar Desc Attached,Direct,EtiU_U"ird Parking Paved Driveway asemsntfBasem�nt De a Access,Walk Out 1fQfi �ITeI t 40 Concrete Wind Width/Wling Depth 1 Street Description Public Interior Amenities Interior Features Floors Tile,Wall to Wall Carpet,Wood EquipmentlAppliances Living/Dining Room Comb Kitchen/Dining Room Combo. Firezplaces/#Fireplaces Yes l Exterior Amenities Pool/Pool Description No/ Dock/Dock Description No/ Exterior Features Deck,Fenced Yard,Yard Siding Shingle Roof Pitched Assoc Fee/Fee Year / AssoclMembership Required No! Amenities WaterfrontANaterfront Desc No,' Waterview/Waterview Desc No/ Miles to Beach 1 to 2 Water Acc Beach Own None Beach Desc ocean BeachlLake/Pond Name Convenient to House of Worship,In Town Location, Major Highway, Marina,Medical Facility, School,Shopping School District Neighborhood Amenities Mechanical Amenitim Heating/Cooling Oil Water/SewerlUtil Private Sewerage,Electricity,Town Water Not Water Oil Legal/Tex Informatior Improvement Asmt $155,300 Land Aamt$110,600 Other Asmt $23.500 Total Asmt $289,300 Annual TaxestTax Yes $2,242/2005 Annual Betterrnant0 Unpaid Bettermen 0 Title Ref-Book/Page/Cer C189 an - To Be AssessedUnknown Spec Assessmeni Mass Use CodelDefinition Single Fami Undergrnd Fuel lJn Asbestos Unknown Lead Paint Unknown Flood Zone Unknown Printed by Elite Real estate on O/08/06 at 10:042m Information has not been verified,Is not euarantood,and is subject to change.Copyright 2005 Cape Cod&Wan&Multiple Usong Service,Inc. A N TOWN OF BARNSTABLE kBAIMST:n 2639. MASSACHUSETTS 2n l .� 2 Solid Fuel Stove Permit DATEOF APPLICATION ..................... .................................................... F-I-R.—" .�.�..... ERMIT ............... ........... NAME (owner) I✓AAJJJ IN............ .............................................. NAME (Installer) .......................... ADDRESS 1ADRESS ................................. ................................................................... ..........................6....... ...... . ..... .... ...... .... 4no STOVE TYPE ..............P— ..................... CHIMNEY: NEW ........................ EXISTING ........................ ........................................ ..... Manufacturer ............................. .......................................................... CHIMNEY: Masonry ............................................................................................ ...... ..... .... .... .... Mass. Approval ..................41..)....... .................................................. CHIMNEY: Metal .............;........................................................... .... ... .... ....... This is to certify that the above installer has permission to install a lid fuel burning appliance at the listed application on file address in accordance with an with the 4S RA t, and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. IssuedBy: .................................................................................................................................Title L H—.5 ........ Date. ........................ . ...... Permit to install expires 60 days after issu date Stove ...................... .......................................................................................................................................................................... .. ......... ........... .......................................................................... StoveClearance ................................................................................................................................. ........................... ...... ........... ..... .......................................................;............................. Floor ............................................. 7................................................................. ....... I........ ....... .............. ........I....................................................................................... SmokePipe .................................... .............................................................................................. ........................ ........................................................................................................ s u ..d..a..e ...... . ........... .................................. ............ ... ........ ............................................ Smoke Pipe Clearance ........................... ............ .............................................................................. ........ ........................ ................................................................................................................. Chimney N e .......................................................................................... . ............................ ..................................................................................................... ll SmokeDetector .............................. ....?.............. .......................................................................................................................................................................... The undersigned hereby certifi s that the installation of solid fuel burning stove and equipment made under au- thority of permit dated ........... has been made in accordance with provisions of the Commonwealth of Massachusetts State Building Code now currently in effect and pertaining thereto ........................................................................ Installer /U 04— INSTALLATION APPROVED A/ 3 By:........ ...... ......................... ....................... ...................... Title: date WHITE: FIRE DEPARTMENT CANARY: BUILDING INSPECTOR - PINK: APPLICANT ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 7 G � Parcel / Z2 Permit# 7 0 1 YN O F-B�RNI TABLE Health Division �3 ID3 3 2 a3 Date Issued 3 a a Conservation Division Z 0� , dui M: 00 Application Fee �• (_/z Tax Collector Permit Fee$ 00 Treasurer Y fa v Is1DN ' SEPTIC SYSTEM MUST BE Planning Dept. WSTA:.LM IN COMPLIANCE V=TITLE i Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGUL.91.10NS Project Street dress hy(f'l Village Owner -'; G Address Telephone _ ��SJ Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater_Overlay Project Valuatio (1L� Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 'Z910 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 2 new First Floor Room Count Heat Type and Fuel: ❑Gas Oil ❑ Electric ❑Other Central Air: ❑Yes XNo Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size x _ Attached garage: existing ❑new size Shed:❑existing U new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes XNo If yes,site plan rev w# Current Use ` r Proposed Use BUILDER INFORMATION Name IA Telephone Number Address i License# OA6,�& Home Improvement Contractor# V Worker's Compensation# C f 15 —. 1 1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `. FOR OFFICIAL USE ONLY PERMIT NO. r i DATE ISSUED MAP/PARCEL NO. 'r '�J r ADDRESS i VILLAGE ' OWNER . DATE OF INSPECTION: r ' FOUNDATION { FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL -' PLUMBING: ROUGH FINAL )a > ' GAS: ROUGH FINAL FINAL BUILDING -; ' DATE CLOSED OUT-' ° v* cS w i r` l fa 0 a.. ASSOCIATION P LAN NO..,, � - D The Commonwealth of Massachusetts s. Department of Industrial Accidents Office 01/11yesti9alivns r 600'Washington Street r I Boston,Mass. 02111 ` Workers' Compensation.Insurance Affidavit a IM ...� •tea 4 r x name: location: hone# city [] I am a homeowner performing all work myself. ' [] I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees workingon this job r r -u Tz 7"t ¢�' 'if�d'' 1i '��., .;rr{c,.�? x � x� Y 1 -fir � } �S5 +M r,.1�1 �,,. ,�"'f "`rx'�� �'� •r',r rr.. com an name e, xt. T' V. 42,.-k5�,� �'+.:i r��g- -� r�r"° �', K� s�sa , � r ,u•*'3 t �v 7 � .., r t - F"� � �`�r',irt�i YCI ,rr'x.�t' .<q.s4 � '' 3 xR X r7 '�tl..`�rf+a ,,. !a a '�b.'�c*�,+�:"u' •,.c '.j, `L1 ,.-' aS.�s:,t'i'r'•vw'x� r f"• t rt �.:� ;'"�� �a'� '� + 7f: 2 i �,vr -yt c'-•„'''�_ �rllsuranee [� I am a sole propri r,general contractor, homeowner(circle one) and have hired the contractors listed below who have the following workers n polices yTv 'r'2t 1i,t.s'�9�+!n a+i+i-Ylk`,�.7 w 7`�"^�r ±G�'iCE�'Ca.rfi rr•rev a�4*[�,F ^�,�•S„.r- °j2w'r 3 e:�rti}�r,'pFa i> <frF. MINN. ryHS p'C",t1°�nd 4ri."sSF`5,E"'i' ry 4r ti• i'; com an Name n 5�ii't.. r add reessFM e -- e( -..- r r a '1 S 't .tryt a t r -s --•;-',+Yi .,a(' sP3f'y '.&' 7•''�-'.�� �54 � 4, c�,.�ilen s,•�F.,ca>r.r`�.fi:�a3*,':.r�.o�'-x.cw�`s�'�eh+,+4`�3x��dc,"W a'�S's''�*.^�w'sr:��'7"i��}�ti�'Mis���i„`';.ti,,I�!Y�.aa��'�'�t -$w£��d„7J>.�.y_i r y�x�_�'S_-tr:,''�Y n``.�tiFr"�iT',s�a�..�!�'�+.'������r,rS�'T.t�}J a_a.u�;f'+rdF s #Y sc� �t'"to L4Y-2 t t��1:C`d'a�o lir�tc3,ryc.r;�T'i#.�'r 7L l`��tr',��+>ih!`.`t{yy:'`Ysr>Y�•�'t"r,a.e,!Fc'h_r+b`s�,a-t.r:a'•'a'•iL:•-sr.Y s'�h�-r!�.J•d::�-}�•v�;VsS'� ��Y I'll RISEN.tfi i My.<.*'•,H i< '{% rc :$ i " "'<"+S'R-'sn7 ? x , f"t' `" Jr :t si �5.,3 ..^-u >�`�ryN'+.Y p,;Aztvi•;�.,�Z,C��•�?�,}�^c rts.��3 4�.+:j} 1,i1 i � � '' -,� x r`J`,Yrr �`k'L i7, fy 4 s J�,`..: r.+fi ,.q`45�''X."'`y,��i���,_{c� .$"F��,in�,yy�' Ft it�5�"��+r[S�.�S�",_S,1„''3_' 1�Xl �i'c'�tu r•% a ic'��+ '1 _._ ,�, �r- y"}�''h y.- e r} t'r t I s S��i �M'r �2 S��.ri'1`�r fi�X� rcollL art`name''•}hg�'.+sr[�,,��7�TC�.s�t� i �e#• 1r`�t'�S'r !* co-y r a 74 ^.s...- �rrt(k"+t<'' �f,,rr�r*�__ �'',7„vnid:'4q;.{.t.x. �, .�'p r} i a. �•�' .r,, r Sa�1" `st r x '` * � •�r tl `� 5 'xL,'.?,:. gloom y l.r d LO,.0 -01 4t C-..,�t e tilt jiy f v 4 a t t'.kq Y� +. k-• ss5,,-sss tr'It:..ti�,�i r ru sa.,gt ,�,1 'F,(,� i`>k+" yhra Y' "'rA r j":. Ad' rIr�S9.S'• ���'.n"�'�w.i tGi u�^5-,.ati r 'a.,t � �,+�ti,,�.�a�1��M,x<�.2�t�e.^�ys.�+y, (�?sr�'� �F �' t= a ' 'r� r , , � x;,ct i���ter y,'t •:�s r �� F�•�-'t �,i���(kRt}� e v < m z ••r t 2. ast a a- r` e xi a ' a: i x r is�,,s-.r �.'' �.�,y t �i �, - .. 3v, �Y t' "f r• sue— 2'.. s e. ./' Nt t t a',M''tY+riS�d t c r ;! 4 Gw ss'2.esd.�g n:ata} r,,lS.yir . i�[� .Yu 7�.,-1��•$ r'�r.r-�R "�"c.,s'�•Fr `'� rL p �l ., r [ y ''"-+'''- .+r'� .�,+°{-,�' �a .:,�.� t rsr ^x ti xt.• i,t.. r i v;. a a-`^ <7i sue. t 1 *rk .h-.c r5i •,1 ,'t. � jr` r ,.x.7�<. : �r �, .�s`c` -.y � ,..:!t�>x.X;,x .f. r�•. -:F_...,., ,a. .#..., arifYF...�.z.w.L �' X s mSlllSairCe-CO.,a ..,e...,t ..__..9"9-,.5�._._�.... ,•, .,, ,. 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 years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for coverage verification. f I do hereby certify nder the pains and penalties o perjury that the information provided above is true and rrect. Signature Date � Print n 7 Phone# official use only do not write in this area to be completed by city or town official city or town: permittlicense# r-IBuilding Department [3Licensing Board []check if immediate response is required []Selectmen's Office ❑Health Department phone#; MOther contact person: (revised 9/95 PJA) + ' Information and Instructions 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 permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. 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. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 �optNerofy Town of Barnstable Regulatory Services BASS aLF� ' Thomas F.Geiler,Director KAM 9 r 1639. �•� Buildin Division �pE�MP A g Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"'reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building 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: �(?_ �7T �5 Estimated Cost C a t-2d Address of Work: _2 /i 0 7 A Ia=, Owner's Name: c2 Date of Application: 10 .� I hereby certify that: Registration is not required for the following reason(s): ork excluded by law ❑Job Under$1,000 QBuilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I here y app y for a permit as the agent of e owner: A Da 'to—utra—cfo&a11 Registration No, OR i Date Owner's Name �oFYHe ray, Town of Barnstable yP tiO.* Regulatory Services + BARNSrABLE, � MA$S. % Thomas F.Geiler,Director 9 $ f16 9. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder n C)f-0 I V/ °`��x e �`'���""-_� " � , as Owner of the subject J property hereby authorize C,C"�C./C—G� 66 -�i,-Q to act on my behalf, in all matters relative to work authorized bythis building permit application for(address of job) �L/ cl Si e er ate Vt ncc� Print Name I Board ot:Bull�dla$Regulations and Standards . Y ' HOMIS ¢�V NiENT C NTRACTOR . V .Re�g`t�tr_E�on��1-fib56 - • Eicpira on 1��b� . Corporbtion A TAACtO1� C4 rrJ�� rns Romer , s f� \yam r a«- ✓..: �J69 Main.St. Millis,MA fl�P54 :Sdministrator ... _ I BOAiRD OF BUILDING REGULATIONS License .QNS.T-RUCTION SUPERVISOR it N3u�n6c �S 026682 i 00 Tr.no: 6018 I f —-- Resnted4 0 t j k 1 r .. JAM'ES M HOMER"\ NKLIN;.MA 02038 Administrator 3/24/03 4 :31 PM 915087906230 002 ACORP - CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DCIYY) 03/24/2003 PRODUCER �.(SO8)620-6200 FAX (508)620-0227 THIS CERTIFICATE IS ISSUED ABA MATTER OF INFORMATION Fitts Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR "}0 Union Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. `4P.O. Box 565 Framingham, MA 01704-0565 INSURERS AFFORDING COVERAGE INSURED Alaska Construction Co. Inc INSURER A: National Fire & Marine 6 Short Street 1NSUR�— Franklin, MA 02038 1NSURERC INSURER 16JSURER E. COVERAGES 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,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RI EFFECTIVE 110 LTR TYPE OF INSURANCE POLICY NUMBER DATE MMIOD/YY 00.TE M 11,RAT ON Y - LIMITS -GENERAL LIABILITY 172LPE684176 02/17/2003 02/17/2004 EACH OCCURRENCE S _11000 000 - COMMERCIAL GENERAL LIABILITY FIRE OAAAGE(Any one Ilre} $ 50,000 CLAI MS MADE 11 CCCUR MED EXP(A-v one person) S 5,000 A - PERSONAL E ADV I NJURY $ 1,000 000 -- - GENERAL AGGREGATE $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 1,000,000 POLICY F7'jE 7 7LOC - AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ ANY ALITO (Eaarcidentl ALL OWNED AUTOS _ BODILYINJURY I SCHEDULEO.A!JTOS (Per person) $ HIRED AUTOS ' BODIL'r INJ'JR`!' $ NON-GJvP1ED AUTO_ , - (per accident) PROPERTY DAMAGE $ (Per acrldent) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AIJ70 EA ACC $ P, I i OTHER THAN AUTO ONLY AGO $ EXCESS LIABILITY - - EACH OCCURRENCE . $ OC'lJR CLAIMS MADE _ AGGREGATE $ Ir�—�' $ I DEDUCTIBLE - $ �--� RETENTION $ - $ WORKERS COMPENSATION AND u TORY Li 7%I ER EMPLOYERS'LIABILITY EL EACH,?OCIOENT $ E.L.DISEASE.EA EMPLOYEE $ E.L.DISEASE•POLICY LIMIT S OTHER - DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY CNOORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER AODITIONA'_INSURED;INSURER LETTER! CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENOEAVOR TO MAIL Town Of Barnstable .�DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT., - ATT; Building Dept., BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 200 Main Street OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE IGeoffreX Fitts ECF � ' ACORD 25-S(7197) FAX: ` (508)790-6230 ®ACORD CORPORATION 1988 Town of Barnstable Building Department Complaint/Inquiry Report Date: a O qi' Rec'd by: s Assessor's No.: qo� I, 12 a Complaint Naine: k r\ A-ny-,C. Locationtt� K ° - ° Ad(dkess "-" 6/k_ _ cv : a ►5 e i M/P Originator Naine: Street: Village: State: Zip: Telephone: D/E Complaint Q Description: Y\ 4 '-A c.e j a 4-) l7 h 6Ltfi o ae r Inq� A Sl >�d t r� e� e Ic,�QoP area - Description: For Olicc Use On/v ' Inspector's Action/Comments Date: /� 3��� Inspector: u-- Follow-up Action Additional Info. Attached' Copy Distribution: Mite-Department File 3 ello w-.Inspector Pink-Inspector(Return to O/lice,llanager) Town of Barnstable Building Department ComplainVInquiry Report Date: Rec'd by: Assessor's No.: Complaint Name: A47 Location Address: -?z5— -Sle Q o 24 Wove M/P X442� Originator Naine: 4 ;-a Street: y7 Y,,,e�74vLZK' 2-572C- Villa State: Zip: OZeoo/ Telephone: D/1; Complaint F� . Description: Inquiry 0 Description: For Office Use Only Inspector's Action/Comments Date: /.z - S Inspector. 2IV T Follow-up Action l� Additional Info. Attached Copy Distribution. Whiie-Department File 3 ellow-Inspector Pink-Inspector(Return to 015ce illanamr) Town of Barnstable Building Department ComplainVInquiry Report Date: %Y0— Rec'd by: Assessor's No.: Complaint Name: Location Address:- MVP Originator Naine: - Street: Village: State: Zip: Telephone: D/C Complaint / Description: v� Inquiry F Description: For Office Use Only Inspcctor's Action/Commcnts Date: Inspector. Follow-up Action Additional Info. Attached Copy Distribution: 6L7d&--Department File I'Mow-Inspector W-I. r 117<"Ym M(7fll-re Ahmowrl � 4 I I I yro r WX ., 1` _ y* ; sae ,,� y i . eke: s jyy its r Cl.R ,iii A: < x w a 'd -. "' �I" a' a r".r`a 6 .rr` a'' �aM'� .'. „ , i b i .a r ', }�'*�•;�, s� ..,`' ,e.y r ,• +.•y �+� �",�"�i�'�.+ Z��ga�a �4�y �•F�s��} �'4� �,°�`"t�"{ hi �'��a d -- s:_ a, FM _ ,q Vill ,$'b"f�aA' I yip k" d` a.. T' 4�^ �b , 1, i EYE. J§ y+:•,Ri Tl. '�;P`? ''Y y,',{,d} w �;a `� RM@ WK— p.f gY..•4 S 1i''dy�v i"}'�rM�Yk °a' ii � .f .. 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A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission'to operate.) Business Certificates are available at the Town Clerk's Office, 1'FL„ 367 Main Street, Hyannis, MA.02601 [Town Hall) PS Fill in please: pew 3� APPLIGAN /�`%s,,:.:.••.'�Ma a �' TS YOUR NAME' �rlilt ���61 f�A�lrl��') �1Z/r(";l�/� ✓ �✓jU� L BUSINESS YOUR HOME ADDRESS: •_S maw kllryl TELEPHONE # Home elephone Number NAME OF NEW BU511VES5 SINES_ BU .S i IS THIS A HOME OCCUPATION? YE NO . Have you ADDRESS OF BUSINESS - . — h GLc�� -QZW MAC/PARCELNUMBERI When starting a new business there are several things you must do in order.to be in compliance with the rules and regulations of the Town of t Barnstable. This form is intended to assist you in obtaining the information-you [nay need.. You MUST GO TO 200 Main St. - (corner of Yarmouth , Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this to. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed-of any permit requirements that pertain to,this type of business. Authorized Signature** l COMMENTS: (y 2. BOARD OF HEALTH J This individual has been informed of the permit requirements that pertain to this type of business. /1 Authorized Signature** COMMENTS: . i 3: CONSUMER AFFAIRS [LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature.* COMMENTS: Town of Barnstable ZHE Regulatory Services . CF 1p� P� o Thomas F.Geiler,Director Y Building Division * BAMSfABLE. Y } v MASS. g Tom Perry,Building Commissioner i639. �0 AlfD MAC A 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us . Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: -�' Permit#: HOME OCCUPATION REGISTRATION Date: Name;/�»7d�c7 !t=�j?/Ze//7.4 Phone#: Z?7-";�oP274 Address: . S SGIF/5D z9V_ Village: Yi),yiy/S Name of Business: L:X0 l / PA//L% / JA' Type of Business: /1//1/ /�///� Map/Lot;:::O- Z� INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4.of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit.. • Such use occupies no more than 400 square feet of space, • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors, electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials, or flammable or explosive materials, in excess of normal household quantities: • Any need for parking generated by such use shall be met on the same lot containing the Customary Home ` Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Hcme Occupation. • No sign_shall be displayed indicating the Customary Home Occupation., (� • If the Customary Home Occupation is listed or advertised as ibu'siness,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the / dwelling unit. I,the undersignedAave read and agree with the above restrictions for my home occupation I am registering. Applicant Date: Y 31 Homeoc. oc Rev.5/30/03 a DOo: itD59PS25 03-26-2007 12:41 Ctf T= 182657 BARNSTABLE LAND COURT REGISTRY QUITCLAIM DEED WE, MARTA MARTA de SOUZA aka Marta M. de Souza, and OSEIAS AVELINO, as Tenants in Common and •not Joint Tenants, of Hyannis, MA 02601 4� FOR CONSIDERATION LESS THAN ONE HUNDRED and no/100 ($100.00) DOLLARS NO DOCUMENTARY STAMPS REQUIRED GRANT WITH QUITCLAIM COVENANTS J TO: MARTA M. de SOUZA of 35 Suffolk Avenue, Hyannis, MA 02601 That land with the buildings thereon now known and numbered as 35 Suffolk Avenue, Barnstable (Hyannis) Barnstable County, Commonwealth of Massachusetts being shown as LOT 1 (Block 1) on Land Court Plan #14034-D (Sheet 1) . Subject to all matters set forth on plan filed with Barnstable County Registry District on Plan No. 14034-D. Subject to all matters set forth on Certificate of Title No. 16869 filed with Barnstable County District of the Land Court. Together with and subject to all rights, restrictions, reservations, easements and rights of way of record as set forth in Certificate of Title No. 178901. FOR TITLE: SEE CERTIFICATE OF TITLE NO. 178901. r p�pFTHE T Town of Barnstable Regulatory Services 9anxxnste'$ Thomas F.Geiler,Director yea+°i Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4024 Fax: 508-790-6230 October 16, 2006 Mrs. Marta Maria De Souza 33 Suffolk Ave. Hyannis MA 02601 RE: Illegal Apartment: 35 Suffolk Avenue Hyannis , MA. 02601 Map : 291 Parcel : 122 Dear Property Owner, This letter is to inform you that you currently are in violation of Barnstable Zoning Ordinance 240-11. You must contact this office by October 30, 2006 to arrange to bring the above address into compliance or be subject to fines of no more than$300.00 per day of non-compliance. Thank you for your attention in this matter. By Order, da Edson Amnesty Zoning Enforcement Officer Building Department Q:zoning5