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0016 SYLVAN DRIVE
Ap August 24, 2019 Town of Barnstable Mr. Ells,Town Manager 367 Main Street,Town Hall Barnstable,MA 02601 cc:Town Councilors, Health Department Director, Public Works Dept., Police> Dept, Dear Mr. Ells, Manager,Town of Barnstable, My.neighbors and I are writing for your awareness and assistance in the following,and have cc:d other parties that should also have awareness, oversight authority and/or responsibilities pertaining to below. State and condition shared below has been ongoing for at least 6 months but in nearly all instances for years at these properties. It is a growing trend negatively impacting family, residential properties below in our neighborhood, and perhaps more importantly,neighboring residential properties and the neighborhood as a whole. • Residential properties being used as a central point for business, including business/commercial vehicles/equipment on the property as well as advertising signage of the business • Residential properties that appear vacated,abandoned,or otherwise are not maintained;overgrown brush/vegetation overtaking the property and structures in some cases;Same obstructing abutting sidewalk/walkway in some cases • Residential properties being rented short-term and frequently, in part(e.g.a room)or whole; sometimes as many as 5-7 vehicles parked in driveway, roads or in yards;Concern of exceeding occupancy limits Properties below have been observed to have at least one of above conditions: -230 Scudder Ave 245 Scudder Ave 5 Sylvan Dr�/ 16 Syl na Dr' 78 Pitchers Way 20 Arbor Way 52 Pitchers Way 53 Arbor Way 65 Sylvan Dr 73 Sylvan Drive 7 Briarwood Ave 142 Pitchers Way 93 Arbor Way It is my understanding that Town regulation%code touches on one or more of these conditions,nuisance,violations at these addresses,though is not limited by just these: Chapter 170, Rental properties 160, Problem properties,chronic 192, Signs 224,Vacant&foreclosing properties 54, Building Premises Maintenance 240,Zoning Several neighbors and I have discussed selling our properties and moving to another village or town presumably where these conditions are not the sustained/growing issue they are here before things continue to worsen the neighborhood and property resale values. If one cannot afford to own a single-family, residential property/home: without a turnstile of renting rooms;or because they cannot afford the most minimal/basic upkeep and maintenance of that property;or without operating and advertising business services from that residential property,than perhaps one solution they should consider is renting themselves and leaving home ownership to those who can,and who are interested in all the responsibilities that go along with property ownership-rather than cutting comers and skirting laws/code,and ultimately adversely impacting the neighbors and slowly dragging down our (once)quiet residential community, never mind the property values from resale perspective. Additionally,I wanted to call your attention to the increasing and persistent traffic issue in our neighborhood.I am told that neighbors have submitted complaints,and have visited the Barnstable Police Department in the past to request relief in some form. Vehicle traffic on Pitchers Way and Scudder Ave regularly experiences dangerous speeds,and far exceeding that for the population density that exists in our neighborhood,and for the pedestrian traffic that area children,bikers and dog walkers use it for. From Scudder and Marston Avenues intersection to the West End rotary& Pitchers Way and West Main Street intersection to Scudder Ave,traffic more often than not reaches and exceeds 45-50mph!While it may be significantly worse during peak season months, it exists all year long. I think it's reasonable to understand that these are primary roads that see a lot of traffic, but the consistent traffic speeds we experience is both absurd and dangerous for our neighborhood and the people who live and visit here. May we make a suggestion of 1)increased police, speed trap monitoring presence 2)speed bumps/tables(either permanent or temporary)and/or 3)the traffic study resources needed(if any)to install solar powered signage with speed limit with real-time speed alerts of traffic to drive proactive behavior changes by drivers-like in Hyannisport,Osterville and South St in Hyannis Any other solutions or suggestions are needed and welcome toward the goal of improvement and safety. I welcome your review of the matters,and know you will find status as described. I hope that the Town can assist with addressing and responding to the matter such that conditions above are curbed and prevention of reoccurrence such that this community can be safely maintained. Sincerely yours, Voting neighborhood residents Town of Barnstable Building . �e ,;, , ,...�� `2, >? � ,��, a„ � ,<';��,'� ,s" sae„ '= Post This Gard,SoThatrt�s UisibleFrom fhe Street " A ' roved Plans Must be�Retamed on Job and this Card;-Must be�Ke t�� pp p E Mh'£3C`A(!t$ y ✓ .ems `, 3 I g t» s '' _ k�, n • 9 M Posted Unt�l''Final Inspection Has Been Made - 5 t '€ a639 . !d LI A j'�'� R Where a Certificate o�Occupancy is Requred,�such Building shall Noe Occupied until a Frnal Inspction,has been made Permit Permit No. B-18-452 Applicant Name: John Vreeland Approvals Date Issued: 04/13/2018 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 10/13/2018 Foundation: Location: 16 SYLVAN DRIVE,HYANNIS Map/Lot 289 055 Zoning District: RB Sheathing: Owner on Record: GOLARZ, PATRICK&EVA �� = Contractor�Name JOHN VREELAND Framing: 1 Contractor License. CS 107947 2 Address: 16 SYLVAN DRIVE , HYANNIS, MA 02601 ' 1Est Project Cost: $31,384.00 Chimney: Description: Installation of a 10.325kW roof-mounted solar PV system E"` Permit Fee: $210.06 Proposed system consists of 35-295w modules connected with Insulation: r Fee Paid: $210.06 microinverters k p l�l Date 4/13/2018 Final: Project Review Req: ENGINEER TO REFERENCE CORRECT WIND VAEUES-FR,51�11OM 41 TABLE 1604.11 FOR BARNSTABLE RISK CAT II z �` �;r Plumbing/Gas ,tu ;fxp €fits v�u � r Rough Plumbing: Building Official Final Plumbing: "•: .. This permit shall be deemed abandoned and invalid unless the work authorized,by tlis permit is commenced within six{rnonthsd�after Rough Gas:-issuance. g All work authorized by this permit shall conform to the approved applicationhand th�approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zon g by laws an'd codes. Final Gas: 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. ' Electrical M% .. -: R k - ' s Service: The Certificate of Occupancy will not be issued until all applicable signatures by'the Building and Fire Offic s al are prowdedfon this permit. Minimum of Five Call Inspections Required for All Construction Work. g Rou h: 1.Foundation or Footing r: A„ 4 - •; - 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. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT gg Town of Barnstable Buildin tThisrd "o That itis Visible„From:,Lhe Street-A roved Plans us "be Retame on,JobYandthis CadMust be Ke t • Pos . S P .enxsrwrsa� • � �y � � PPS � �: f� M! Posted Until:Final'Ins�'ecton�Has Been Ma` e � �' � � � � � *'' Permit Where,.a Certificate of Occu anc .,is Re u�red,.such Bu�ld�n -shall Not be Occupied,unto aK,F�nalAnlnspecttoa has�been�made � Permit No. B-17-579 Applicant Name: GOLARZ, PATRICK&EVA '( Approvals Date Issued: 03/10/2017 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 09/10/2017 _ Foundation: Residential Map/Lot: 289-055 Zoning District: RB 'Sheathin g: Location: 16 SYLVAN DRIVE,HYANNIS Contractor Narne Framing: 1 Owner on Record: GOLARZ PATRICK&EVA `Contractor Ucense 2 Address: 16 SYLVAN DRIVEProtect Cost $700.00 HYANNIS,MA 02601 _ Chimney: � Permit�Fee: $85.00 Description: Skylight(2) Bathroom, Living room (front side- the house) Fee Pad $85.00 Insulation: z ` Project Review Req: Skylight(2) Bathroom,Living room(front side oaf the house) ' y^ ®ate 3/10/2017 Final:N g Plumbing/Gas �. Rough Plumbing: " Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzedby this permit is commenced within siz rnonths after issuance. � ,9 'for I Rough Gas: All work authorized by this permit shall conform to the approved applic ion<and the approved construction documents whch this permit has been granted. All construction,alterations and changes of use of any building and structures shall�bae in compliance with the local zomby I- codes. codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open forpuublic inspection for the entire duration of the work until the completion of the"same. Electrical' The Certificate of Occupancy will not be issued until all applicable signatures b he Buildmg and Fire Officials are provided on thispermit. Service: Minimum of Five Call Inspections Required for All Construction Work.' 1.Foundation or Footing -W Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) - Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage.Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in.MGL c.142A). Fire Department Building plans are to be available on site" Final: -All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION -7-5-71 Map_, J Parcel O_S , Application # Health Division 0* Date Issued Conservation Division 1.10 O � Application Fee Planning Dept. p Permit Fee Date Definitive Plan Approved by Planning Board ? a Historic - OKH _ Preservation/Hyannis 1V Project Street Address & . U 0 Village �11 Owner N m�, Address �b U . Telephone_ Permit Request �? Square feet: 1 st floor: existing V proposed 2nd floor: existing proposed Total new Zoning District ] Flood Plain Groundwater Overlay Project Valuation ID V 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 Historic House: ❑Yes XNo On Old King's Highway: ❑Yes XNo Basement Type: IGFull ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 111 A- 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: 4Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes 0 No Fireplaces: Existing I New Existing wood/coal stove: Q Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: Lp existing ❑ new size _Shed: ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 0,No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name w ' J Telephone Number �7� Address ` \UOUA ovy License# Home Improvement Contractor# Email Worker's Compensation # ALL CON RUCTION DEBRIS SULTING FROM THIS PROJECT WILL BE TAKEN TO a SIGNATURE DATE t FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. .Le Cammamfeafth of- adF" ep=rmeut afradm tr d Academ& Offwe-ufrmcs f axrs 600 Wad6Vtmr S6eet Basf�ar�, A 02111 Wurke& CumpensafimtInsm-arice Af Edavit Sm��e E ct rsJF,Ier€�d ns **____hers AppUcardYmfarmathm Please•Frird Are you an=plover? cktbe apprapriafe baa± L❑ I am a 4..❑I am a geaeral ca�sctor and I Type of €r�� - * hmi e hhed'tha suer-ca ps 6 ❑Neew w oau=sfrgcfi e . �l���.�B�Of part-#mm). ' 2.❑ I am a sale pn4uigtns orparbaw- _ fisted cathe aftarh ed sheep '- ❑Ran s! and have ga� s Thew smb-con2xactn have & ❑7�ew�ldsfl� a fatm.eia e>eplayee�aadhavewa�ers' wa�ab aay g i $ 9. ❑$niter add�iou ■ ,.su= c - lLP�To w = �P. e _ omp_ ' f 1 5. Wawa a cmpomfiaa.and ifs Imo❑Elegy repaimor adQiaus oifcers have emmcised tunic f 3_ F amaeor dcugg atl tad€ 1L❑Piumhmgrepaus ar ad�Stians MYSCIE END • of � L per MGL ❑Roofrepaim im=a F- M kl( we'haveaa enelayem[No WOAO=s' a Of er - •�ay 8�at Ell esboz Est e]sa fiIlot �soa hcTas� �cue-s mv�es'ammpP.ter;,..poy� � t arrest mlme ffir.xTul=t day smEdrdz6wzuwcacuA&mlmout;i&r nta rnrx , rCo�6vxst t3�eckel&b= 231:sd sheet shmiagthe»of the sul-catsdas m d slime wheemm m-motifime a hWye ' ' e�I�2es.Iffi�e5vb-�R,,.+•s•�t�,•�htca e�xgTnf�s,H�egffiestgmvzde-ttzeQ,�'�mP•FoI'icg�bez ' I am @e erripril t7�ispraviriu ivcrkers'cacr rrsatfarr irrsnra>mca�vr empfu� er, �eFnty is ficalxr&cp azrd jaFi ai,�orazatiort. ' Bumme Company yt hma: P�ficy or Self jnL Uc_47 �- aDaftw Job safe Address Ciiy/Staf�t g- Aftach a copy offhe voarlxme cbngmmsadioa.poliey declusafion pagt(showing the policy nMoE3er and expo ation&te). - Baibm to sec me coverage as mquinAuude:r S=fi=25A of MGL c.15 ma lead to the imposati=of catixal peualiies of a fine ug to$I 4�OQ aadfor one-geerimpFiso as vcr l as c r1 pe�aliigs sss ffie;fa=of a STOP WORK€}RDERaud a:Ene of up to$250-M a clay aomkd the violater. Be advised the a cagy-of this stattm . =aybe fmvarded td tie Office e Isivest funs of D:FA fnc m=nm cavemp Ida bemby m tits pains andpauffirs zfpedkq f&atffae&fbr ma6=prm:&-zi abate is true and correct Now ik 17 Oact um a* I?a oat write in f ds area tit be-cmpfetd bg city art aim anal City or To."= 9 L�atg arefy[car-ie owl: . 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I nt1 .- 71.• . 1 - -I go 95. _n• rn_ - •■ •• ■■J ■ ■■■r_ 1 ■• it U Pun - ■am R • ►wI •auuu a i�/� ■• II ■••■r •t Mat/.+■ ■•r•n1■._ r.�I� •7 •nn■ 1 I• .u./ [• .n• ••Yn�.. • I•nau■r .e- - I• /r.0 • I Mtt 1 1■ ■tl■■ K• it •r••a •wR■n /- � .I■■■./ n r■■■1■ mil' ■•. -■i■ ■ ■ If •■ • a -•►• :n•It •'•■ ■ ■.� t• n.n •■. tI ■ .Ia. 1■I ••■■ ■•...! .t■•la .■I■ ■r a • ■I ■ • _■■ •■w■•1■ - ■• ■• I VII:/■ a■ 'J• II. K 1 /■- �.�••1 ■n.J/a r u �. t :•r■•n .n■ r_■ nnu•r fail .- . . • a. Ilk Bit' toll Proposed plan for installation of 2'x 4'Velux skylight in existing truss roof 3 2Z `' 4" t I �xY 131611 k Cl 1 OF f v :X New 2x4 frarning, a Town of Barnstable • -3 Regulatory Services - oIF Richard V:Scali, Director Building Division n EENIMAMM : Paul Roma,.Building Commissioner >a� 165q. � 200 Main Str� H ,MA 02601 - � � yannts Md www.town.barnstable.ma.us . Office: 508-862-4038 F Fax: 508-790-6230 HOMEOWNER LICENSE EX PION Please Print DATE JOB LOCATION: U numb '- strut village name home phone#. work phone CURRENT MALLING:ADDRESS: I cesmU. i c /town state zip code The current exemption for"homeo rs"was extended to include owner-occupied dwelliines 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-fimiily 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 resonsible for all such workperformed 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"h eowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspecti oceduaes and requirements and that he/she will comply with'said procedures and requirements. - Signature of Homeo w 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 EXnWnON 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.d_o 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 to amend and adopt such a form/certification for use in your community. a - TOWn of Barnstable F Regulatory Services Richard V.Sca%Director Building Division • PaulRoma,•Building Commissioner 200 Main street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 509-790-6230 Property Owner Must Complete and Sign This Section If Usin.Q'A Builder I ,as Owner of the subject property hereby authorize to act on my behal� in all=natters relative to work authorized by this building permit application for. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final . inspections are performed and accepted. Signature of Owner Signatose of Applicant Print Name Print Name Date Q:P0xMs:0WNMPERMISSI0xP0oLs i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 ors- Map Parcel �� Application Health.Division Date Issued _2(— S� Poe) Conservation Division Application Fee ` Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village �v Owner 60k�7, Address <,^�l Telephone Stk- 665--sstiri Permit Request C"' L If 4- 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 U;r 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 6- Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft,-)a _ Number of Baths: Full: existing new Half: existing new, s Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Roo 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 4ike A4eCar-thy Const -a etlon Telephone Number PO Box 52 Address a�,_st Dennis, r 670 License # Cell (508) 250-6964 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. Massachusetts -Department of Public Safety Board of Building Regulations and Standards C'onstrUction Supervisor License: CS-058633 MICHAEL J MC4gAR PO BOX 52 s W DENNIS MA 6267; '1 _ Expiration Commissioner 04/10/2016 ��� �� G�i��2 d C��C 1�:1�J•�CI?iGG!�•��- Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169393 Type: Individual Expiration: 6/16/2015 Tr# 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY ---- — -- --- P.O. BOX 52 ------—------ — WEST DENNIS MA 02670 Update Address and retui'mcard.Mark reason for change. j Address 0 Renewal F]''Employment Lost Card SCA 1 Ci 20M-05/11 �. z: J • The Commonwealth of Massachusetts Department oflndustrurlAccidents Office of Investigations 600 Washington Street Boston,MA 02111 ivtvtv.mass gov/dia Workers' Compensation Insurance Affidavit: Btlilders/Contractors/Eleetriciaus/Plumbers A 11cant Information Please Print Le ' I ike McCarthy Construction Name(Business/Organizagordlndividuai): P® BOX 52 Address: • West Dennis, MA 02670 City/State/Zip: CSI §§#3 HIC-169393 Are u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 1 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.t 7. []Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity, workers'comp.insurance. 9. []Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required,] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL I L[]Plumbing repairs or additions myself.[No workers'comp, c,i52,§1(4),'and we have no 12.[1 R of repairs insurance required.]t employees.[No workers' comp.insurance requital 13. ther *Any applicant that checks box#1 must also fill out the section below showtog their workers'compensation policy informadon. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a now affidavit indicating such. lContmetors that check this box must attached an additional sheet showing the name of the sub•conbactors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance for my employees ,Below is thepolicy and fob site information. Insurance Company Name: - •77• J6.1 Policy#or Self ins.Lie.#: V W L ]w-tad t 165G " -10"1'4 Expiration Date: Job Site Address: C City/S`tate/Zip: Attach a copy of the workers'cor6pensailon policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL c.152 can lead to the imposition ofcriminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I I do hereby certyy Me pa a eeala"ofperinry That the information provided above is true and carrecb Si sture: Date: Ir Phone P . 1 Of)4etal use only. Do not write in this area,to be completed by city or town offlclaL (t City or Town; Permit/License# ! Issuing Authority(circle one): E 1.Board of Health 2.Building Department 3,CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ,ac RO o' CERTIFICATE OF LIABILITY INSURANCE DA 07IYYYY) 07/101200/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE'DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 01962-001 520J/LCT Bryden&Sullivan Ins Agcy of Dennis Inc A/C.No.Ext: (508)398-6060 ,No,: (508)394-2267 PO Box 1497d�"Sss: So Dennis,MA 02660 — INSURER(S)AFFORDING COVERAGE NAIC# NS RE A: A.I.M.Mutual Insurance Company 26158 INSURED INSURER B: Michael McCarthy Construction Inc West Dennis,MA 02670 INSURER C: _ P 0 Box 52 INSURER D: INSURER E I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO i JVITHSTANDING ANY RECtUiRudENT, TERM OR CONDITION OF ANY C014TRACT OR OTHER DOCUMENT WITH RESPECT TO 'A1-IICH THIS. CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE 1 POLICY NUMBER MMlDD/YYYY MM/D[j LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAG E Ea oc currence)RENTEDPL $ <-- CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ pOLICY I VECT I �OC — AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ I ANY AUTO BODILY INJURY(Per person) $ ALL OWNED r SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS -(Per accidentl UMBRELLA LIAR H OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED I I RETENTION $ $ �N'�4d�9l���o��sRE ��Ci�1°�'{t4fR4 X T&�I4trT -S O R'- A AFFIMMEMBERXCIUDED7 YIN Y NIA VWC-100-6017656-2014A 7/17/2014 7/17/2015 E.L.EACH ACCIDENT $ 500,000.00 (Mandatory in NCH))) E.L.DISEASE-EA EMPLOYEE $ _500,000.00 � D� b IM N OFZPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,0G0.06 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION Thielsch Engineering 195 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD r a 1° Town of Barnstable z Regalatory Services • '"esMWB=Mg Richard V.Scali,.Director Builtliiag Division Tom Perry,Building commissioner 200 Main Street,Hyannis,MA 02601 wwvv:tov m,.barnstabie ma.us Office: 508-862-4038 FM 508-790.-6230 Property Owner Must Complete and.Sign This Section If Usmg�. Builder I, ����I L�\ (�G/Gi✓Z ,as Oavner of the subject property hereby authorize ✓ io to act.on iibehalf, in all matters.relative:to work aut-16MI by,this building permit application far. (Address*Of *Pool fences and alarnos are the responsMity of the applicant. PoolS are not to be filled or utilized beforefence is installed and all final inspections are performed and accepted. Sighafm of Owner Siguailue of Applicant K Print Name Print Nave Date Q;F0RMSv0%VN "MtMISS10NP00IS -�.� CCARTHY k r x JV�C � '°si' t�aCand Commercial Builder{ T _I�ZAy770N SPECIALIST, QU` tO CCARTHYC WWI October 21,2014 Town of Barnstable Thomas Perry CBO Building Commissioner _ . 200 Main Stret Hyannis, MA 02601 ; 1 RE: Insulation Permits ; . e, Dear Mr. Perry, This affidavit is to certify that all work completed for permit application#0 at 16 SYLVAN DRIVE has been inspected by a certified Building Performance Institute(BPI) inspector.All work performed meets or exceed Federal and State requirements Sincerely, �j II Michael McCarthy McCarthy Construction