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0005 UNCLE AL'S WAY
;� I'. 1 I/�^v\J i' v 2 4 �� t I Cape Save Inc. . . . TOVIN p a -4. f�}fi1. f F�/ 7-D Huntington Avenue ] gi �` ''# - South Yarmouth, MA 02664 L l � , . �6 Tel: 508-398-0398 Fax: 508-398-0399 DIVISIVq 10/02/14 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for 5 Uncle Al's Way,Hyannis has been inspected by a certified Building Performance Institute(BPI)Inspector. Ceiling: R-18 cellulose e All work performed meets or exceedsFederal and State Requirements. Sincerely, s William McCluskey SENDER: COMPLETE THIS SECTION ■ Complete items 1,2,and 3.Also complete A. Sig re 2 e ❑Agent item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. Rec ived by(Printed Name) V/J le livery ■ Attach this card to the back of the mailpiece, ) or on the front if space permits. "D. Is deliyery address different from item 11 ❑ es 1. Article Addressed to: a If YES,enter delivery address below:., JKNo 3. Service Type a��'4/ 7n'r ` Certified Mail ❑Express Mail ❑ Registered A-Return Receipt for Merc6dise ❑Insured Mail ❑C.O.D. � 4. Restricted Delivery?(Extra Fee) Yes 2. Article Number (Transfer from service label) 7 012 1010 0000 2851 0299 i PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-tsao FUNITEDATES POSTAL.SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 ender: Please print your name, address, and ZIP+4 in this box • TOWN OF BARNSTABLE BUILDING DIVISION � MAIN ST 200 M . HYANNIS,MA 02601 I I I i I f .o (DomesticCERTIFIED MAILm RECEIPT Er Ir Iv 0 OFFICIAL USA4 -1 UI CO N V/S fU Postage $ US f3 Certified FeeM Retum Receipt Fee NQ (EndarsementRequired)Restricted Delivery Feep (Endorsement Required)r I aTotal Postage&Fees s !1J Sent T-o --- ---- --------- ---u/ _`_ "'--"-"--"--"'""'O Seet,Ap.No.; POBox-No.--- City,State,Z-P+ - '--___-"' :ri 006See Reverse for lnsir6ctions Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please'eonsider Insured or Registered Mail. y a a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or . addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery'. ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 90 W'Iilr- r Town of Barnstable - Regulatory Services pUTMEv Richard V.Scali,Interim Director Building Division * snxwsTABt.E Tom Perry,Building Commissioner �� 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Notice of Zoning Ordinances Holation(s) and Order to Cease, Desist and Abate: J� Guadalupe & Niuza B. Amaral & Paulo F. Silva and all persons having notice of this order. As owner/occupant of the premises/structure located at5 Uncle Als Way,Hyannis,MA 02601 Map 292 Parcels-003-001 ,you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,Sept. 10.2013\ to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinances: Chapter 240 Section 11 (A) 1 RF Residential Zone-Single Family Zone 2. COMMENCE immediately,action to abate this violation. SUMMARY OF ACTION TO ABATE: 1) Operation of a power washing company& landscape & tree service business (dba Champion Tree Work/Champion Power Washing), staging, dispatching, employee parking,storage of material& equipment including all related services and activities and advertisement on or identifying residential address. 2 Any and all uses other than a single family home. REMEDY 1)Relocate business uses and all associated material and equipment to appropriately zoned commercial location. 2)Restore property to a single family home with permits & inspections And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable,a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). If,at the expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires will be taken. ZRo bin C.Anderson Zoning Enforcement Officer viozone i, Town of Barnstable Regulatory Services of Richard V.Scali,Interim Director Building Division BAMSfABIA * Tom Perry,Building Commissioner 639. �0� 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 r Notice of Zoning Ordinances Violation(s) and Order to Cease, Desist and Abate: Guadalupe & Niuza B. Amaral & Paulo F. Silva and-all-persons-having-notice of this order. As owner/occupant of the premises/structure located at �90 Uncle.Willies-Way, Hyannis,MA 02601 Map 292 Parcels 328-001 ,you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,Sept. 10. 2013\ , to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinances: Chapter 240 Section 11 (A) 1 RF Residential Zone-Single Family Zone 2. COMMENCE immediately,action to abate this violation. SUMMARY OF ACTION TO ABATE: 1) Operation of a power washing company & landscape &'tree service business (dba Champion Tree Work/Champion Power Washing), staging, dispatching, employee parking,storage of material& equipment including all related services and activities and advertisement on or identifying residential address. REMEDY 1)Relocate business uses and all associated material and equipment to appropriately zoned commercial location. And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable,a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). If,at the expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires will be taken. / By o er, Robin C.Anderson Zoning Enforcement Officer SENDER: COMPLETE THIS SECTION "WIV UIV UCLI V&K Y ■ Complete items 1,2,and 3.Also complete A. Sig ure item 4 if Restricted Delivery is desired. X 2 ❑Agent'■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. DO of livery ■ Attach this card to the back of the mailpiece, ` or on the front if space permits. D. Is delivery address different from ite 17 Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No 3. Service Type r7 /� ❑Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. r 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7 012 1010 0000 2851 0282 (Transfer from service lab PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 i UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No.G-10 I • Sender: Please print your name, address, and ZIP+4 in this box • i I TOWN OF BARNSTABLE I I I BUILDING DIVISION i I I 200 MAIN ST I HYANNIS,MA 02601 1 i f I file ti iii.. . . pj tS si Will I_}}i iiS} }� f U.S. Postal ServiceTM' CERTIFIED MAILTM RECEIPT (Domestic Mail.Only;No Insurance Coverage Provided) For delivery information Visit our website at www.usps.com® 1 i PSForm 3800,August 2006 See Reverse for Instructions_ Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. ■ Certified Mail is not available for any class of international mail. - , ■ NO INSURANCE,COVERAGE IS PROVIDED with, Certified Mail. For valuables,please consider Insured or Registered Mail. s For an additional fee,a Retum Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS F?orm 3811)to the article and add applicable postage to cover the fee.Endorsemailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate teturn receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 k Pnht Page Page 1 of 3 �Print,this p � • Owner Information - Map/Block/Lot: 292 / 328/ 001 - Use Code: 1300 Owner AMARAL, - Map/Block/Lot GIS MA 'S GUADALUPE & 292 / 328/ 001 Owner NIUZA B Property Address Name as of 5 UNCLE AL'S 1/1/12 ROAD 90 UNCLE WILLIES WAY HYANNIS, MA. 02601 Village: Hyannis Co-Owner Town Sewer At Address: No (1 t Name GIS Zoning Value: RB . Assessed Values 2013 - Map/Block/Lot: 292 / 328/ 001 - Use Code: 1300 2013 Appraised Value 2013 Assessed Value Past Comparisons Building $ 0 $ 0 Year Total Value: Assessed Value Extra $ 0 .$.0 2012 - $ 77,300 Features: 2011 - $ 77,300 Outbuildings: $ 0 $ 0 2010 - $ 119,OOC Land $ 77,300 $ 77,300 2009 - $ 127,40C Value: 2008 - $ 136540C 2007 - $ 136540C 2013 $ 77,300 $ 77,300 Totals . Tax Information 2013 - Map/Block/Lot: 292 / 328/ 001 Use Code: 1300 Taxes Hyannis FD Tax $ (Residential) 154.60 Community $ 20.31 Preservation Act Tax Town Tax $ Fiscal Year 2013 TAX RATES HERE (Residential) 677.15 http://www.town.bamstable.ma.us/Assessing/printl 3.asp?ap=0&searchparcel=292328001 9/9/2013 i r--Prfht Page Page 2 of 3 852.06 • Sales History - Map/Block/Lot: 292 / 328/ 001 - Use Code: 1300 History: Owner: Sale Date Book/Page: Sale Price: AMARAL, GUADALUPE & NIUZA B 7/26/2012 26531/218 $3700, BRYANT, WILLIAM P 6/15/1985 4573/257 $3000 NEW TESTAMENT BAPTIST CHRCH 11/20/1978 2825/250 $0 . Photos 292 / 328/ 001 - Use Code: 1300 There are not any photos for this parcel • Sketches - Map/Block/Lot: 292 / 328/ 001 - Use Code: 1300 A sketch is not available for this parcel. .. AsBuilt Card N/A . Constructions Details -.Map/Block/Lot: 292 / 328/ 001 - Use Code: 1300 Land USE CODE 1300 Lot Size (Acres) 0.69 Appraised Value $ 77,300 Assessed Value $-77,300 Construction details are not available for this parcel. . Outbuildings & Extra Features - Map/Block/Lot; 292 / 328/ 001 - Use Code: 1300 There are not any extra building features on record at this time. . Sketch Legend Property Sketch Legend http://www.town.bamstable.ma.us/Assessing/printl 3.asp?ap=0&searchparcel=292328001 9/9/2013 -Print Page Page 3 of 3 B2N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor, Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished) FUS Second Story Living Area(Finished) TQS Three Quarters Story(Finish( BRN Barn GAR Garage UAT Attic Area(Unfinished) CAN Canopy GAZ Gazebo UHS Half Story(Unfinished) CLP Loading Platform GRN Greenhouse UST Utility Area(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UTQ Three Quarters Story(Unfinis FCP Carport KEN Kennel UUA Unfinished Utility Attic FEP Enclosed Porch MZ1 Mezzanine, Unfinished UU$ Full Upper 2nd Story(Unfinis) FHS Half Story(Finished) PRG Pergola WDK Wood Deck FOP Open or Screened in Porch PTO Patio I http://www.town.bamstable.ma.us/Assessing/printl 3.asp?ap=0&searchparcel=292328001 9/9/2013 Print Page Page 1 of 4 •.Print this Page • Owner Information - Map/Block/Lot: 292 / 003/ 010 - Use Code: 1010 Owner S Map/Block/Lott ILVA, PAULO GIS MAPS F 292 / 003/ 010 Owner Name 5 UNCLE AL'S Property Address as of 1/1/12 WAY 5 UNCLE AL'S WAY HYANNIS, MA. 02601 Village: Hyannis Co-Owner Name Town Sewer At Address: No GIS,Zoning Value: RB . Assessed Values 2013 - Map/Block/Lot: 292 / 003/ 010 - Use Code: 1010 2013 Appraised Value 2013 Assessed Value Past Comparisons Building $ 89,000 $ 89,000 Year Total Value: Assessed Value Extra $ 30,500 $ 30,500 2012 - $ 191,50( Features: 2011 - $ 201,10C Outbuildings: $ 3,200 $ 3,200 2010 - $ 237,40( Land $ 6700 $ 67,600 2009 - $ 320,80C Value: 2008 - $ 316520C 2007 - $ 315,50C 2013 $ 1909300 $ 1909300 Totals Residential Exemption Received= $88,785 . Tax Information 2013 - Map/Block/Lot: 292 / 003/ 010 - Use Code: 1010 Taxes Hyannis FD Tax $ 3 80.60 (Residential) Community Act $ 27.08 Preservation ct T Tax Town Tax http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292003010 9/9/2013 Print Page Page 2 of 4 5 (Residential) $ 902.77 Fiscal Year 2013 TAX RATES HERE 19310.45 • Sales History - Map/Block/Lot: 292 / 003/ 010 - Use Code: 1010 History.- Owner: Sale Date Book/Page: Sale Pi SILVA, PAULO F 11/28/2008 23288/346 $16000 DE CARVALHO, SIRLENE 2/28/2007 21810/307 $38500 AGUTAR, ELIZEU V & SIMARI R C 9/28/2004 19077/300 $32000. ST GEORGE, ALBERT L III ET AL 7/30/2003 17365/268 $1 ST GEORGE, ALBERT L JR & 4/15/1993 8527/170 $73500 NORTHEAST SAVINGS, F A 7/15/1992 8131/051 $10500 GOLD, RANDY R & JANIS R 2/15/1986 4940/089 $79900 LAMOTHE, PAUL G & TOBIE S 5/15/1985 4555/002 $76500 SHEALEY, GLEN E 2/15/1985 4422/117 $76500 PETRONI & SON BUILDERS INC 5/15/1983 3736/209 $10000 . Photos 292 / 003/ 010 - Use Code: 1010 There are not any photos for this parcel . Sketches - Map/Block/Lot: 292 / 003/ 010 - Use Code: 1010 MR, � •§ ° (u wP ifi£a http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292003010 9/9/2013 Print Page Page 3 of 4 As Built Cards:Click card# to view: Card #1 . Constructions Details - Map/Block/Lot: 292 / 003/ 010 - Use Code: 1010 Building Details Land Building value $ 89,000 Bedrooms 3 Bedrooms USE CODE 101 Replacement $95,695 Bathrooms 2 Full + I Lot Size Cost (Acres) 0.3 Model Residential Total 8 Rooms Appraised $ Rooms Value 67,E Style Raised Heat Fuel Gas Assessed $ Ranch Value 67,t Grade Average Heat Type Hot Water Year Built 1984 AC Type None Effective 7 Interior Carpet depreciation Floors Stories 1 Story Interior Drywall Walls Living Area 1,104 Exterior Vinyl Siding sq/ft Walls Gross Area sq/ft 2,282 Roof Gable/Hip Structure Roof Cover Asph/F GIs/Cmp • Outbuildings & Extra Features - Map/Block/Lot: 292 / 003/ 010 - Use Code: 1010 Code Description Units/SQ ft Appraised Value Assessed Value Wood WDCK Decking 120 $ 3,200 $ 3,200 w/railings BMT Basement-Unfinished 1058 $ 22,700 $ 22,700 Bsmt Fin- http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292003010 9/9/2013 I Print Page Page 4 of 4 BFA Avg 464 $ 7,800 $ 7,800 Partitioned . Sketch Legend Property Sketch Legend 62N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor, Living Area FTS Third Story Living Area'(Finished) SOL Solarium BMT Basement Area(Unfinished) FUS Second Story Living Area(Finished) TQS Three Quarters Story(Finish( BRN Barn GAR Garage UAT Attic Area(Unfinished) CAN Canopy GAZ Gazebo UHS Half Story(Unfinished) CLP Loading Platform GRN Greenhouse UST Utility Area(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UTQ Three Quarters Story(Unfinis FCP Carport KEN Kennel UUA Unfinished Utility Attic FEP Enclosed Porch MZ1 Mezzanine, Unfinished UUS Full Upper 2nd Story(Unfinisl FHS Half Story(Finished) PRG Pergola WDK Wood Deck FOP Open or Screened in Porch PTO Patio http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292003010 9/9/2013 Message Page 1 of 2 Anderson, Robin To: Deputy Chief Dean Melanson (dmelanson@hyannisfire.org) Cc: O'Connell, Timothy; Perry, Tom Subject: 92 County Seat/6NE Cape Crossroads/5 Uncle Als/26 Pine Grove Hi, I was out at the aforementioned locations this morning with Paul Roma & Pat. Tim from Health joined us at Cape Crossroad and Uncle Al's as well. 92 County Seat I spoke to MS Gould, the daughter of the owner of 92 County Seat. Mrs. Higgins. The property was greatly improved since the last time I was out there. The dumpster is gone but the storage containers remain. The debris and and items formerly littering the side and rear yard have been mostly removed. I told Ms Gould that I would stop by when I was in the area to check on her progress. She agreed to this and stated her goal,is to continue to sort out the storage units and get rid of them and beautify the. property. The significant improvement is a good sign. 6NE Cape Crossroads We had previously received complaints concerning the condo owner and tenants. The owner resides here with his elderly mother. They speak Portuguese but very limited English. I called my translator who convinced the owner to admit us. We found a two bedroom condo with a door at the end of the hallway blocked by decorative items. The owner would not allow me to open that door and indicated that someone was on the other side. He gestured to me to follow him outside on to the deck and knock on the slider. The tenant emerged and allowed us inside. He had a bed &couch, TV, microwaves, and a mini fridge: There was no smoke detector and no second means of egress. The door to the rest of the condo was blocked off. I contacted my translator again who explained to the owner that he is unable to wall off a portion of the unit as a separate unit. My translator will assist the owner in complying with our directive to restore the condo to its proper configuration and register it as a rental. Written orders will be sent to the owner directly and he will contact my translator accordingly. C L 5 Uncle Al's ,Responded to this address as the result of photos provided to me by Lt John Cosmo. Apparently, the HFD responded to a cooking event on Monday and found a separate apartment in the lower level. The owner was not home but 1.spoke to the cousin of the owner's wife, who was replacing hardwood flooring upstairs. We walked around the property and Tim checked for evidence of septic failure as was reported. Tim advised me that he will research the septic records when he returns'to the office. The bulkhead has been replaced with a doghouse entrance and a separate drive was noted to this rear entrance from Uncle Willies. I.advised the cousin that I must speak to the owner today or tomorrow or otherwise I must issue citations each day in the amount of$100.00. 1 left my business card with him. He assured me that the owner would contact me today. Arrangements have been made for the owner to come into the office tomorrow,morning. (9/6/12). 26 Pine Grove A stop work was issued for new windows. I arranged an inspection to confirm whether or not there is still a zoning violation before a permit is issued. At the counter yesterday the owner assured me.it is a SF home, it is vacant and claims he intends to move in himself. I was surprised to hear this so I'questioned j his intention to relocate from Dolphin Lane to Pine Grove and he once again declared that was in fact his intention. When we arrived this morning I found the downstairs center entrance to a Cape style home opens to a stairway and keyed locked door on the left. This unit is being renovated. There was no kitchen -all cabinets and appliances were removed. The unit was being painted. Multiple keyed locks were piled in the rear first floor bedroom. The interior basement door was locked and the owner was unable to open it- it was noted to be unusually secured-extra precautions to keep the door locked. The two rooms at' the top of the stairs were also locked. He had no keys for the two bedrooms on the second floor and at that time admitted that they were occupied -allegedly by his"girlfriend" in room and'a"distant relative" in the other. We walked around the property to the rear entrance. A door opened into a small alcove with 9/5/2012 Message -Page 2 of 2 two doors-one on the right and one on the left. He was unable to access either space but also admitted the space was occupied. He argued that the property is a single family home and everybody in residence is related to him but his girlfriend. At this point I simply advised that he could argue his position before a judge because the property is clearly not a SF; no interior access to a (now removed) common kitchen, keyed deadbolts on all doors, not owner occupied and the same story he always presents. I did not see any,smoke detectors in the area under construction - unable to confirm the provisions in the secured areas. Robin C Anderson Zoning Enforcement Officer 7'own of Barnstable 200 Main Street Hyannis, NA 026oi .508-862-4027 9/5/2012 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel rce I opp 0 0/'0 A lication , z.7 C Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee V. Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address nG S a Village a 4 6�� Ot Owner d U l /y/ �� Address 10 a-S qJ&0r Telephone ,_�ZJ51 Permit Request ,-P- Ca Q IC G 6--07 ex Q_pd/.-2 �o ce CC&lose , —3 c-e (Z�-7 _l) jC Square feet: 1 st floor: existing proposed - 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation-fc2 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 ❑ No On Old King' 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 CouR;t 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 I. + ( (BUILDERS'OR HOMEOWNER) q► Name t�0 64I �tv�t ► i `C(.f4jSey/6% t'`-'etw) `elephone NumberCSJcJ G 03 ?6— Address License # Home Improvement Contractor# f b J 9 i Worker's Compensation #-rvL o 3 3S 3 j t/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO l' p'�411� SIGNATURE DATE /a/// FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE _ 4 k OWNER t r DATE OF INSPECTION: FOUNDATIONS FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. F The Commonwealth of Massachusetts " Department of Industrial Accidents v.. _ Office of Investigations ; I Congress Street, Suite 100 Boston,MA 02114-201 7 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizatiordlndividual): Cape Save,Inc. Add ress: 9 7D Huntington Avenue City/State/Zip: South Yarmouth, MA 02664 Phone #: 508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): 1.F/I I am a employer with 17 4. ❑ I am a general contractor and I 6 ❑New construction have hired the sub-contractors employees(full and/or part-time).* �, Remodeling listed on the attached sheet. . ❑ 2.❑ I am a sole proprietor or partner- These sub-contractors have g. ❑Demolition ship and have no employees , employees'and have workers 9 ❑ Building addition working forme in any capacity. comp. insurance.t [No workers' comp. insurance 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its 3.❑ 1 am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] c. 152, §1(4),and we have no 13. ✓❑ Other Insulation 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. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the.sub-contractors have employees,they must provide their workers'comp.policy number. compensation insurance for my employees. Below is tite policy and job site I am an employer that is providing workers' information. Insurance Company Name: Technology Insurance Company TWC 3353968 Expiration Date: 04/09/2014 Policy#or Self-ins.Lic.#: � Job Site Address: 1�►L(� l'l/ City/State/Zip: Attach a copy of the workers' compensation policy 6eclaration 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 under the pains and penalties o erjury Al at the information provided above is true and correct Si ature: - - - ate ----- --- - - D Phone#: 508-398-0398 - 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#: F ® p� �+ DATE(MMIDDIYY'M CERTIFICATE OF LIABILITY INSURANCE 4/9/2013 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(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 lieu of such endorsement(s). PRODUCER NACOMME:A Colleen Crowley Risk Strategies Company PHONE E (781)986-4400 FAC No,:(181)963-4420 .15 Pacella Park Drive -MAIL Suite 240 INSURER(S)AFFORDING COVIERAGE NAIC* Randolph MA 02368 INSURER A:Selective Insurance INSURED INsuRma:Safety Insurance Co=anV 33618 Cape Save, Inc -LN-SURERC.Technology Insurance Company 7 D Huntington Ave INSURERD: INSURERE: South Yarmouth MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBER CL134960509 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. IR TYPEOFINSURANCE ADD`SUB POLICY NUMBER MPMIM 'r POMLICYFXP YY LT LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AMAGETOR D 100,000 X COMMERCIAL GENERAL LIABILITY, PREMISES(Ea ocwaence $ A CLAIMS-MADE a OCCUR 199448001 0/16/2012 0/16/2013 MED E(P(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,0001 X POLICY PRO- LOC $ BINED AUTOMOBILE LIABILITY Ee ccidentSWGLE LIMIT) 6NIT $ 1,000,000 BODILY INJURY(Per person) $ B ANY AUTO ALL OWNED SCHEDULED 208200 1/6/2012 1/6/2013 BODILY INJURY(Per accident) $ AUTOS X HIRED AUTOS X AUTOS -AUTOS PROPERTY $ �{ Undeonsured motorist 81split $ 100,000 A X UMBRELLA LIAB X OCCUR 199448001 O/16/2012 0/16/2013 EACH OCCURRENCE $ 1,000,000 EXCESSUAB CLAIIAS-MADE AGGREGATE $ 1,000,000 DIED RETENTION$ $ C WORKERS COMPENSATION fficers Excluded from JL RYLIMITS DTR AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERE XEcLITIVE Y I N overage E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? ® NIA /9/2013 /9/2014 (Mandatory In NH) rWC3353968 E.L.DISEASE-FA EMPLOYEE $ 500,000 it yes.describe under DESCRIPTION OF OPERATIONS be;ow E.L.DISEASE-POLICY LIMIT $ 500 OOO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACach ACORD 101,AddiHanal Remarks Schedule.if more space is required) Issued as evidence of insurance. Issued as evidence of insurance. National Grid Corporate Services LLC d/b/a/ National Grid, Action Inc., Colonial Gas Company and NStar Electric are listed as additional insureds as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cape Light Compact PO BOX 427/SCH AUTHORIZED REPRESENTATIVE 3195 Plain Street Barnstable, MA 02630 Idichael Christian/CLC '��'''"` ACORD 25(2010I05) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).0l The ACORD name and logo are registered marks of ACORD 1 of alassacnuseL�s -Ceoar_mertk Fublic Safefy Board of Building Regulations and Standards - Construction Supervkor Specially icense: CSSL-102776 WILLIAM J MC CLUSIKEY..:_ 37 NAUSET ROAD West Yarmouth MA 0Z673.i.mrt; Commissioner 06/28/2015 oa j Office of Consumer Affairs and eusness Regulation i w y J 10 Park Plaza - Suite 5170 Boston; Massachusetts 02116 Home Improvement Contractor Registration' - - Registration: 171380 " Type: Corporation Expiration: 3/14/2014 Tr# 222184 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. OPS-CAI"0 50ra-0v04-GI01216 '; Address i.7 Renewal F 1, Employment j I Lost Card ✓fie"t�a�rvneanc�ea`f� c�•l�aaxccfuufe� • \ Office of Consumer Affairs&Bddsiness Regulation License or registration valid for individul use only ' HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: i� Registration 171380 Type: Office of Consumer Affairs and Business Regulation Expiration 3/14/2014 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CA SAVE INC.: :-- { WILLIAM McCLUSKEY \ 7-D HUNTINGTON AVENUE SOUTH YARMOUTH MA 02664' Undersecretary Not valid wit o signa I f Building Permit Authorization r I, Paulo Silva �M, asowner hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Office:508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 5 Uncle Al's Way Hyannis, MA 02601 Signed Date 6F Am 1Ran, ti cr �� �as�h�a orate ;, Inc— h5 � wit, Pp � ¢ a 3Go }sS S uNcLc Ills w �gr lf ¢,gww , r- rnW T.A.. 16814E IN BARNBTABLZ 1 Engineers �953 h —. s:.:• ioo.rP yeti h b h o 'S 5. Uncle Al 's Way, Hyannis 9/5/12 - lode! A T yann ,, 5. Uncle Al 's Way, Hyannis 9/5/12 41 'w " t rtY r-P Official Website of The Town of Barnstable - Property Lookup Page 1 of 3 Select Language Assessing Division Property Lookup Results - 2012 367 Main Street,Hyannis,MA.02601 «BACK TO SEARCH« Print Friendly Owner Information-Map/Block/Lot:292/003/010-Use Code:1010 I Owner I Owner Name as of 1/1/12 SILVA,PAULO F Map/Block/Lot GIS MAPS 5 UNCLE AUS WAY 292/003/010 HYANNIS,MA.02601 Property Address Co-Owner Name 5 UNCLE AUS WAY i Village:Hyannis f ' Town Sewer At Address:No i .. ........... ......... ......... ......... ........ Assessed Values 2012-Map/Block/Lot.292/0031 010-Use Code.1010 2012 Appraised Value 2012 Assessed Value Past Comparisons Building Value: $92,200 $92,200 Year Total Assessed Value Extra Features: $29,200 $29,200 2011-$201,100 Outbuildings: $2,500 $2,500 2010-$237,400 Land Value: $67,600 $67,600 2009-$320,800 2008-$316,200 � 2007-$315,500 2012 Totals $191,500 $191,500 2006-$286,200 `Residential Exemption Received=$88,785 —. .........-- .. _. .............. -....-------.... ................. Tax Information 2012-Map/Block/Lot:292/003/010-Use Code:1010 Taxes Hyannis FD Tax(Residential) $428.96 ' Fiscal Year 2012 TAX RATES HERE Community Preservation Act Tax $25.95 Town Tax(Residential) $864.86 $131977 ...... .... ..... ...... Sales History Map/Block/Lot 292 10031010-Use Code:1010 I......,..",,.,--..,..","","". History: _ Owner: Sale Date Book/Page: Sale Price: SILVA,PAULO F 11/28/2008 23288/346 $160000 DE CARVALHO,SIRLENE 2/28/2007 21810/307 $385000 AGUTAR,ELIZEU V&SWARI R C 9/28/2004 19077/300 $320000 ST GEORGE,ALBERT L III ET AL 7/30/2003 17365/268 $1 ST GEORGE,ALBERT L JR& 4/15/1993 8527/170 $73500 NORTHEAST SAVINGS,F A 7/15/1992 8131/051 $105000 GOLD,RANDY R&JANIS R 2/15/1986 4940/089 $79900 LAMOTHE,PAUL G&TOBIE S 5/15/1985 4555/002 $76500 SHEALEY,GLEN E 2/15/1985 4422/117 $76500 PETRONI&SON BUILDERS INC 5/15/1983 3736/209 $100000 ..... .......... .. .......... Sketches-Map/Block/Lot:292/003/010-Use Code. 1010 i i I i , �.`5Ri1 .4 _ i AS Built Cards:Dick card#to view:Card #1 i http://www.town.bamstable.ma.us/Assessing/propertydisplayscreen 12.asp?searchparcel=2... 9/10/2012 Official Website of The Town of Barnstable - Property Lookup Page 2 of 3 Constructions Details-Map/Block/Lot:292 1 003/010-Use Code:1010 .__ ..... Building Details Land Building value $92,200 Bedrooms 3 Bedrooms USE CODE 1010 Total Improvements Value $99,150 Bathrooms 2Full+1H Lot Size(Acres) 0.31 Model Residential Total Rooms 8 Rooms Appraised Value $67,600 Style Raised Ranch Heat Fuel Gas Assessed Value $67,600 Grade Average Heat Type Hot Water Year Built 1984 AC Type None Effective depreciation 7 Interior Floors Carpet Stories 1 Story Interior Walls Drywall Living Area sq/ft 1,104 Exterior Walls Vinyl Siding i Gross Area sq/ft 2,282 Roof Structure Gable/Hip Roof Cover Asph/F Gls/Cmp ........ Outbuildings&Extra Features-Map/Block/Lot:292/003/010-Use Code.1010 ......... .,,........ G Code Description Units/SQ ft Appraised Value Assessed Value i WDCK Wood decking 120 $2,500 $2.500 w/railings BMT Basement-Unfinished 1058 $22,700 $22,700 BFA Bsmt Fin-Avg- 464 $6,500 $6,500 Partitioned 1 Sketch Legend Property Sketch Legend 132N Bam-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished)FUS Second Story Living Area TQS Three Quarters Story(Finished) (Finished) BRN Barn GAR Garage UAT Attic Area(Unfinished) CAN Canopy GAZ Gazebo UHS Half Story(Unfinished) CLP Loading Platform GRN Greenhouse UST Utility Area(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UTQ Three Quarters Story (Unfinished) FCP Carport KEN Kennel UUA Unfinished Utility Attic FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUS Full Upper 2nd Story i (Unfinished) FHS Half Story(Finished) PRG Pergola WDK Wood Deck FOP Open or Screened in Porch PTO Patio i i4rint Friendly Director r r of Assessing Jeffrey Rudziak ``P 508-862-4022 3F 508-8624722 lIII!8:30a.m.to 4:30p.m. 3Helpful Links to Downloads Abatements Department of Revenue Exemptions Parcel Consolidation Questions about values I Town Tax Rates-FY12 Town Land Use Codes 'Helpful Maps All Town Maps Flood Insurance Maps Property Maps http://www.town.bamstable.ma.us/Assessing/propertydisplayscreen 12.asp?searchparcel=2... 9/10/2012 Official Website of The Town of Barnstable - Property Lookup Page 3 of 3 Director of Assessing Jeffrey Rudziak i P 508-862-4022 P 508-862-4722 8:30a.m.to 4:30p.m. (Related Boards Board of Assessors i Owned and Operated by The Town of Barnstable-Information Technology Home(Departments&Services Boards&Committees I Residents&Visitors I Doing Business Town Calendar Phone Directory Employment I Email Town Hall http://www.town.bamstable.ma.us/Assessing/propertydisplayscreen l 2.asp?searchparcel=2... 9/10/2012 f r i� '��M1 f f � 7�"�"� �aF}y�� �� t���. i y 4�. 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" - � a. m _ � . . � . � : _ ^ � ` \} \` � ` � � \d®/^ � � _ \ \ .. �»® . , � � - � , © � :§�\��\ \ /« ql�10� W - :1 t I �v ��, r?:��, -' __ `.a� �- .; �� .,. ... 3� y: ':� .� _ _ - c' _ ___ 1� � � � _ �-' � +� r. .� � — -,- 1v r. SFr ts: F h A S� i yl I 1 i t� �r ItItjjr V '^ • t i IWO, dql x TOWN OF BARNSTABLE permit No. _______26527 _______ - D , , r Building Inspector AUSTAU Cash ------- - - OCCUPANCY PERMIT Bond �4__� Issued to Petioni & Son Builders, Inc-Address 10"`t-410 5 Uncle Al's Way. Hvannis Wiring Inspector / Inspection date Plumbing Inspector Inspection date Gas Inspector v r' Inspection date--, Engineering Department -/V� 0,,� Inspection date... ( } Board of Health Inspection date THIS'PERMIT WILL NOT/BE VALID, AND`THE BBUILDIN- :SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR --UPON SATISFACTORY COMPLIANCE WITH TOWN . REQUIREMENTS AND IN ACCORDANCE WITH•SECTION 119.0 OF THE MASSACHUSETTS STATE t,ZUILDING CODE. .'.. �(Y 4 . ........................ Buildina Inspectors� 1 ..� '�•� TOWN OF BARNSTABLE BUILDING DEPARTMENT _ �T = TOWN OFFICE BUILDING rur. HYANNIS, MASS. 02601 "�a rnr►. MEMO TO: Town Clerk FROM: Building Department DATE: 1 "J .An Occupancy Permit has been "!issued ° for the building authorized by BuildingPermit, ..........................„... .......................................................................................................... » .... ......._._. issued to`.��... .'../1` .............. -ca't. .. ....:G(�^'�............._........ _. . Please release the performance bond. ell As sgssoP� ma and lot number ........ p �IN- / y CF?N E tO �� Sewage Permit number .......... � w�Q� ♦� / ' SEPTIC 1� ��°•I r p� Z BASBSTABLE • . House number [u ' 9 MUST + "aea ..... .1..�........................... br WALLED G;`� C I�i��'^4,1A,-C ,. . AjigY a : PYa` TOWN OF BARNSTAI"BLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO LY.I. �1X..1 1111�� .t�.•�....-�...1a4... . ..... .............................. TYPE OF CONSTRUCTION ...SLCX.I.a.`7..�.''.C.�...... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r Location ..."'art../.0........... .!.[.S.FL. ........Y ..�. 1 5........Ylt.lt" ........... yt 1Y.�Jl ................... Proposed Use ...... ��� ...�.1�..!../..r..` .......!tl. .f ................................ ....................................... T Zoning District . .:'.. .................................................Fire District ....A1111A. Name of dddress ...(. .. I�/� ,Bail.' ..Lr./.�........�1d.?.. �i� �,� y� r Name of Builde Aly. r..��L!�l}�.�JDJINR—..�.I�e-.Address AK.�if.&P.�Ae./.1.a...el.(f.........�d.Y..�.�.��.�,� Name of Architect de ll.✓1���/..l.l!��L�....Ile --7.�...Address ../.k.!�:.�1T..�.�..�....k.�E!..�.?.............................. Number of Rooms ................. ...............................................Foundation ./.•4t ...1�Q.�1.>..�' .Q. . Exterior .....W.0.0..Q.......... iLP W?. .........:.............:.........Roofing ....! .��1 .................................. Floors ..... .v` ......�'f"... .. ...../��r��..........................Interior ..... � %���4..�/�............................... Heating ....................................Plumbing ....... .. .. . `1 /... ................................... Fireplace .............. ........................ .................................Approximate Cost ...............e.J. J..�®.®`................... ..... Definitive Plan Approved by Planning Board Area .s Diagram of Lot and Building with Dimensions Fee S � . .... ....... SUBJECT TO APPROVAL OF BOARD OF HEALTH la;1- Z07`6 0 " 13' 6,3 $de o a 110 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. y � 1�j ar j 94 Name .... ... .. .. ...i A Construction Supervisor's license ?ETRONI & SON BUILDERS, INC. 265 7 N6 ......... ..... Permit for One.Atqa............... Single Family ..................... ............... . ............. Location ..... ....... s Way - Y � } ................ Yannis .......................... ............ Owner ...PetrOni...&...Son..Builders,..Inc . . ...... .................. Type of Construction ..ZKOM................ ........... ............................................................... ................ ....................Plot .... Lot................... .......... June 84 Permit Granted .....19 ...................... Date of lnsp4ction ............................;,:%...�19 F. w�Dat6 Car 71t Id .....a 9k. .... ...... L4 IA 71 4L r Assessors-,map and lot number Tp� Sewage Permit number '� d�Q � ♦� House number / 1 e�aMis, S ....................................... �T....�....................... Epp t639 M a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �': �:/.✓.�.�.:�!�, .:��.�..�..,��............ .. :.:................:....................... TYPE OF CONSTRUCTION ..(P ...4',A..M,,.., ......,t9!, I� f (s/. ...... .....................19.49 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...4 .../. ............ . '>'. ........ ............ , ^1...'! ................... Proposed Use ..... .......! ! ................................ ....................................... i .,. ZoningDistrict ...... ....... .......+..........................................Fire District ........................................ Name of Owner �!c, ® ��..r�.? ! !/�, �� !It�ddress ... .. � 1. S.'�. f a.,� Name of Buildepr./A/A ..t , `i ,P!;:-tn1,f .Address /.��...r i d .,. ... ��!.........,�.e.:e.AF., W Name of Architect dedo 1 44�;/°�. r1 .... "'w., ...Address ...9...V..!` .5#..Qka....N!.R.".............................. Number of Rooms ................ .............................................Foundation . ............... .............a................... .....,�....�.-........ PX?Exterior ..... ..4A. .........:�>� ............ Roofing ...f .'. #.:� . !....................................... _ r Floors A... .. 'a..........�!. !. �!f..... Interior ... . 1��" 1 . ..4:.! ............................... Heating .... �� ....................................Plumbing .1147 #. D...................................................... Fireplace ....................P//�.......................................................Approximate. Cost .> ./.ro„00o,..... ................... Definitive Plan Approved by Planning Board 19_ r Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH V A I I } 6 a ?aA.WL ca x OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above},,�� construction. 13 ,E 7►' ' Name ..7, �. ' !!P„�„!�!+1s:..� r !.c.. d Construction Supervisor's License ... �F..� l,... PL--RDNI & SON BUTLDEFS, INC. ,):--292-3-10 No 14_26.5.27... Permit for P]N.At2-KY.............. „Single Farm ly..Dwell' ......................... Location ... WWY ................UY.W.AA11P............................................... Owner ...R=P ...Inc. Type of Construction ...FXAM............................ ................................................................................ Plot ............................ Lot ................................ Permit Granted .....June...1, 19 84 Date of Inspection ......................................19 Date Completed ......................................19 -�� �� � - E� �e,�' i1/�.. f i Town of Barnstable Regulatory Services 84 :� Thomas F.Geiler,Director 20 MAW.'" `�' Building Division y MASS' 0a 1639. ♦0 A�Fn 3y a Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 t • Office: 508-862-4038 Fax: 508-790-6230 COMPLAINTANQUIRY REPORT Date: Rec'd by: Complaint Name: Map/Parcel Location r Address: Originator Name: Ann a A I l .s- � Street: In Village: ? �`7State:_ _Zip: UZ�o Tele • °hone _ P e Complaint Description: U� _ L4 aA-5' � —Ckfa 3-AQ+ FOR OFFICE USE ONLY Inspector's Action/Comments' -.Date: Inspector: _ Additional Info.Attached n:fnnns:complaint �pF Towti Town of Barnstable *Permit# Expires 6 months from issue date BAMSTABM Regulatory Services Fee =� � 9Q MASS. OA %6 Thomas F.Geiler,Director A Building v in Division ion g s Tom Perry, Building Commissioner X^PRESS PERMIT 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 - JUN O 6 2002 Fax:.508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAIY'DF BARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number 2 ;7,�2 r 1Cf 0 r Property Address _y , yc_ G c ,' G zG ,Residential Value of Work Owner's Name&Address A T Contractor's Name S��- - /_= Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) r .�)� Other(specify) .�n *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg Revised121901 /�.�`U /0 l __ �.G�r-�'�i �_� eaten- �,�� o � ✓� � �� _ � i ������ _ Y. . .t µ _ .. �- __ _ i - � _ � - Y' Town of Barnstable_ *Permit# Expires 6 months from issue date fARNSTABLE : Regulatory Services Fee . 9 MASS. cb 039.. ,0 Thomas F.Geiler,Director A'ED1A°�`A Building Division Tom Perry,. Building Commissioner .,PRESS PERMIT 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 - JUN 0 6 2002 Fax:,508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAICAF BARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number G� e6� 2, -,-Ti O 1 Property Address Residential rr;1✓ oc G� Value of Work Owner's Name&Address to 7" S7-, C-4-61,1Py Contractor's Name C-/"� Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance , Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to s ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) Other(specify)]gy r&0, S[/&f—. ae�& *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg Revised121901 ��V J y po'gci)4 T 3 .Srt/'5 r'y � ��s � F ) c L-�r&AINC �A, 5CNLN% �e z O n/ jNlSift D �'T't A Expires 6 months from issue date '` r� l eguIatory Services Fee • IAIiNSrAIU s - vMAIM � abs 9. Thomas F.Geiler,Director.� Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 'PR PERMIT 167 Main Sheet, Hyannis,MA 02601 w ° Office: 508-862-4038 "- A P R U 4 ?_001 Fax: 508-790-6230 EXPRESS PERMIT APPLIiCATIONTOWIv OF E3A NSTF,EII Not Valid without Red X-Press Imprint Map/parcel Number Property.Address U Residenhal OR M Commercial Value of Work Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) f',Worlmian's Compensation Insurance Check one: I am a sole proprietor a I am the Homeowner I have Worker's Compensation Insurance ; Insurance Company Name Workman's Comp.Policy# Permit Request(check box) r Re-roof(stripping old shingles) ® Re-roof(not stripping. Going over existing layers of roof) Re-side , Replacement Windows. U-Value (maximum.44) Q Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations;i.e.Historic,Consen•ation.etc. e a Signature expmrrg �S+ ( N-li Cry I € Al � r 1, rom issue dau Expires 6 on mths f O� „Sr,, Regulatory Services Fee �sr 9� 659. 1e$ Thomas F.Geller,Director 'z 515`—� CE0 Building Division Elbert C UIshoeffer,Jr. Building Commissioners ^ ' 367 Main Street, Hyannis,MA 02601w. Office: 508-862-4038 aP. r Fax: 508-790-6230 EXPRESS PERWr APPLICATION OWN OF BARiJ;if;o Not Valid waout Red X-Press Imprnn Mapiparcel Number ZI" . _e,57% Property Address 16 L L.5 ?/ ` n v ,Residential OR 7 Commercial Value ofWork 101'!i v y 3 e Owner's Name&Address Z �2; C 1�T ��7 Contractor's Name �t L Telephone Number a; Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) Workman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) Re-roof(stripping old shingles) Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Windows. U-Value (maximum•4 ) y' Other(specify) : _ %:.G . �� �� c c=//�•L ,�1c 4-� 7`Y *Where required: Issuance of this permit does not exempt compliance with other town department regulations.i.e.Historic.Conservation.etc., Signature expmn i Engineering Dept. (3rd floor) Map Parcel 6103, Q/O Permit# 7 3 House# Date Issued `/D �oard of Health(3rd floor)(8:15 -9:30/1:00-43@) e �,S . O t>- fn eonservatfautgfiee(4th floor)(8:30- 9:30/1:00'a2:00) -1 -•I � ✓✓ O P 1st floor/School Admin. Bldg.) 1HE Z Z 0-0 rr t4.+ -' e � pproved by Planning Board ! 19 � � ��p m _. • SARNSTASLE. I ■•• Z C11.' MASS � an'7 TO `OF BAR STABLE r r ` > C) M R Building Permit Application p O cn •� Project Street Address ,A/,K L�-4�4 C� Village A yA4tifVie=4. � Owner 1 �j- A' -e®l2a P. Address Telephone(Ok) 77Z (9 Sn Permit Request ��'m a s,P l/t Z-1,-K r- L f}/0/?D"131, A �l 4 i3 G 41 /' Cd�i4) `Z IA-��i a 111 c' �44-Z? 4 ;d a, 2,y j, First Floor 0(go square feet Second Floor square feet Construction Type ,z-"' Estimated Project Cost $ 700 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 2Io If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Numbe f i-a b ) 7 7/ . 03e,'ef Address lm- e /:t'w - n1 License# coy � � l//�?/•y/ y Home Improvement Contractor# / Worker's Compensation# �— NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR yC DATE BUILDING MIT DENIED FOR TH OLLOWING REASON(S) � l FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED. TTT MAP/PARCEL NO. -14 ADDRESS VILLAGE { _ OWNER :< DATE OF,INSPECTION: — + FOUNDATION FRAME ,INSULATION .t FIREPLACE ' i - • ' - _ c ''-� ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL s t GAS: ROUGH FINAL - W FINAL BUILDING o : DATE CLOSED OUT t �N—OQA EVIANOM imir CODS VVI The Town of Barnstable • tnsrrsreat� • 9 �16 9��,�' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph CrossenBuilding Commission: Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION. , MGL tc 142A requires that the "reconstruction, alterations, renovation, repair, modernization. conversion,.improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work:-/ Est.Cost —7 7 0 0 Address of Work: f l A.(iG� li S C�/,4 y ,� ���S Owner's Name*4-L 7` �T Date of Permit Application: 1 hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under SI,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROG-AZA51 OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. y rC ate Contractor Name Registration No. OR Date Owner's Name "'a` The Commonwealth of Massachusetts --_-� Department of Industrial Accidents �.�>� 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: �7(4 l /l 1,-ol9e-7 location z2n?a a.42r— 06e yL--'L✓L/� �7� citv phone# S d� —7,7/_' ❑ Lam a homeowner performing all work myself. I am a sole pro rietor and have no one working in any ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. company name:. address. citv:; phone#. insurance co. - oliev ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comoanynamer address. city shone#. insurance co olicv# campanv'name — address: city- `phone#. o. olicv#nsurance c / Failure to secure coverage as required under Section 25A of MGL 152 can lead to the Lnposition of criminal penalties of a tine 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 tine of$100.00 a day against me. I understand that a copy of this sta ent may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby under t pains and penalties of perjury that the information provided above its truo and correct Signature ✓e Print a Phone# C se only do not write in this area to be completed by city or town official own: permittlicense# ❑Building Department ❑Licensing Board k if immediate response is required- ❑Selectmen's Otflce ❑health Department person: phone#; ❑Other (revised 9/95 PJA) — I 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. to er is defined as an individual partnership, association corporation or other legal entity, or any two or more of employer g � P Y �P P rP 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 reduned 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 Me of Imlesduatfons 600 Washington Street f Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 e i . yQ /N' TOOMAIO .I�J�ZQO kgfOOAao(�/bi Ofl JNPR9VENEKT EONTRACIOR pif O'er 7/99 s NOS CONSTRUMOM OWN I AOPEZ r � VA NUT SIDEWALLING If located in OKH or Hyannis Historic District-Certificate of Appropriateness required unless same color/same materials specified on application. Sign-offs from: Health [' Tax Collectors' Office Treasurer Owner's name& address Estimated Cost ® Complete dwelling Information for the Assessor's dept. Correct square footage OR number of squares of shingles (times 100 sq.ft.) Applicant's telephone number Signature [� Workman's Comp. form 0� Home'Improvement Contractor Affidavit Home Improvement Specialist's License OR Homeowner's License Exemption Fee q-forms-PERMITS 1 Rev 6/2/98 The Town of Barnstable NAM � Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Grossen Fax: 508-790-6230 Building Commissioner SHED REGISTRATION Y Location of shed(address) A1,4,A) 7— 5�7-, -77 Property owner's name Telephone number �® X / A Size of Shed Map/Parcel# e Signature Date Hyannis Main Street Waterfront Historic District? � Old King's Highway Historic District Commission jurisdiction? O Conservation Commission(signature required) THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedmg �3A _ po LOT 9 DRAINAGE/� o EASEMENT \ 'p HSE DECK pfp LOT 8 LOT �10 0 , S82 5352W 84.12' :CI pCL ' ST FHANC15 x P1-00iVE.CALL FOR DATE TIME M ' PHONED OF RETURNED;_ PHONE YOUR CALL AREA CODE NUMBER EXTENSION #LEASE CALL. MESSAGE c 1Nlt L GAI L (, .J (j�1�� AGAIN CAME TO SEE YOU, WANTS TO Y.OU. .. 5 GNED O Iveisal" 48003 i NOTES `OFIHE i The Town of Barnstable BA MA'gA LE. MASS. • Department of Health Safety and Environmental Services 7 �p 1639. �0 lFOMP�a Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice 1 ` Type of Inspection Location �p t I�JC f .\ Permit Number r Owner 642,e> r, 6-e Builder nwy\,.,,Q,J\ One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: C.- I C tL \6� 0 S s Please call: 508-790-6227 for reeinspection. Inspected b , Date ra ..f l i Assessor's Office(1 y/y _ Parcel j Permit# r J 3 1 Conservation Office(4th floor)(8:30- 9:30/ 1:00�-2:00) �VSG?1y1,Ay q6' Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) $ — Fee Engineering Dept.(3rd floor) House# t KE n A—:— STABLE. 19 TOWN OF BARNSTABLE a Bu'lding Permit Application p`s - Project Stree Address t ge f ` Address Telephone 7 -71. 06-1 /Permit Request X /o� First Floor square feet Second Floor square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type / Commercial Residential Dwelling Type: Single Family L'� Two Family Multi-Family Age of Existing Structure AZ Basement Type: Finished Historic House /vd Unfinished Old King's Highway /V d Number of Baths /A/ No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None r./ Sheds Other Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE /' DATE — BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) r -FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED } 1' P/PARCEL NO. ? ' ? i ADDRESS ' VILLAGE OWNER i - , DATE OF INSPECTION: �- FOUNDATION F ; FRAME - (• a INSULATION — FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: FINAL — — FINAL BUILDING~ r , DATE CLOSED OUT ASSOCIATION PLAN NO. i To Date S Time V1 H E YOU WER ®UT M of Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALLA Message 0,:� xlz MICA Operator AMPAD 23-021-200 SETS �� EFFICIENCYe 23-421-400SETS CARBONLESS w TheCummun>N'caltli of Atassachusctts -- $,:i ;_��+ Dc part,ncnt of Industrial Accidents 600 11 axiti»gion Street Barron.Afaa-s 02111 Workers' Compensation Insurance Affidavit dRnlle"..''—i"........:.:..._. Please PRtRrI ,b�v - �... t:........o .. :.- name* ZIM nhene# irff 771 -OSf3 1 am a homeowner performing all wort:myself I am a sole proprietor and have no one working in any capacity ...�. ❑ 1 am an employer providing workers' compensation for my employees working on this job. cn�nan}•nnmc• address• citt•, phone#� • insurance co noffer# Cl I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who the following workers' compensation polices: comn,Inv name! - ttddrcse- • ei4v vhene iticurnnce rn velitw# • • _ �.. '�+ ..• -- sman..+�..•.a�+rner,!?:��Grwsegt��s ---�^------ - :Y?�'T.�rgr+l�Rslk?-_---="-- — -"- comnanr name!address- city: phone#i insurance co volley Al 'Attach 11 116ea" ei rn'i risa :�+»: w�� -�� 's"•�'•'R-•'`•: :'�Y''•� :, �'" Failure to seenre coverage ai regnircd under Seetioa 3A of 111GL 1S2 ntt lad to the impasitioa otcrimioai peaaltiea ota Ilne np to 51.500.00 and une years'imprisonment as welt as eirii penalties is the form ota STOP��'ORI:ORDER and a Bae otS100A0 a day against m� 1 nodetitaad the cop}•of this statement mar be forwarded to the Ogee otlavatigatioas otthe D1A for coverage veritieadoa. I do lrerrbr certify under the pains and ppfenalller of perjury that the infonumion pimyded abotx is hire and conam , '� ✓ "cal 3 z - c./� �7 T �� G one#ame f�T D Ph � T otliCi21-use only do not write in this area to be completed by city or town aMdal city or town: permMicense# riQuilding Department pUcensing Board check if immediate response is required (3seleetmea's OtRce (3ficnith Department • contact person: phone#; nOther•_,_� � F _ r information and Instructions Massachusetts General laws chapter 152 section 25 requires all employers to provide workers' compensation for t etnplo%ees. As quoted loom the "1aw", an emplmyee is defined as every person in the service ofanother under any contract of hire. express or implied. oral or written. An emplurer is defined as an individual. partnership, association. corporation or other legal entity, or any two or m the fora=oing 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 owner of a dweiline house havin- 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 1 or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an emplo, MGL chapter 152 section 25 also states that every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for an,% applicant who ltas not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into anv contract for the table evidence of compliance with the insurance requirements of this chapter erformance of public work until acce p P P been presented to the contracting authority. ` -...n�- .. ...►�.+mow '7• .. 'i�t::f.t i . .�^°•� , .y.... �% .. .. _ `__ 'fr;7M 77 4 3� Applicants `S�•:...r.V:Yf.r•.ti.�tY•�.!"�li�_.`��.!:.v Please `;II in the workers' compensation affidavit completely, by checking the box that applies to your situation anc supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tite 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 require to obtain a workers' compensation policy, please call the Department at the number listed below. Cin• or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pl be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retttrnec 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 questic, please do not hesitate to give us a call. ,r.,�y�s�— �r.�.•. ..:. «M�i:.6. Y�aa lr � r'� :fir: :.i•f The Departments address. telephone and fax number. The Commonwealth Of Massachusetts ` Department of Industrial Accidents r Office of investigations 600 «'ashington Street Boston,Ma. 02111 r fax#: (617) 727-7749 : . s The Town of Barnstable • P Department of Health Safety and Environmental Semces Building Division 367 Main Stream Hyam is MA 0M01 Ralph Crtsssea off= 508 790-6227 wain g Cammi: F= 508-775 33" For office use only Permit no. Date AFFMAVrr SOME MWROVEMENT CONTRACTOR LAW SUPpLEMEW TO PERKM APPLICATION MGL c. 142A requires that the"reconstruction,aite:atians;renovation,repair,modem a ==M impiwemeat,.rznro�al, demolition. or aonstraction of an addition to any VA sting owner 00�� building containing at least one but not more than four dwdling units or to soya==whOM �:ch ong with other to such residence or building be done by tugrstemd ooatractors,with emtarn� requirements. Type of Work 4JL��— � o x i ESL Cast 2/ 119�1 Address of work: V G 4-L� 14 �/V/s �Oc-ncr.Name: ri 1-0 c n Date of Permit Application: I hereby certify that: Registration is not required for the follcming rrawn(s): Work coduded by law Job under SLOW ,wilding not owner-oocupied Owaapwlling own perunt. Notice is hereby ghren that: OWNERS PULLING mim OWN PERMIT OR DEALING�N ACCESSOr HAVE . TO�T!ffi FOR APPLICABLE HOME MdPROVE?dENT WORK ARBrIRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PE UMY I hereby apply for a permit as the agent of the owner. Contractor.name Regisuation No. -5� - ME : Date / p� TOWN OF BARNSTABLE rx BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION P ease print. DATE JOB LOCATION A4,_5 V'15?,z Number Street address Section of town 'HOMEOWNER"� �� T' '� - D 77/ Name Home phone Work phone . . PRESENT MAILING ADDRESS SA)/I/ Y/V� City town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sY who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 Officiz on a form acc ptAble to the Building Official, that he/she shall be responsib" for all such work performed under the building permit. (Section 109. 1.1) The undersigned "homeowner" assumes . responsibility for compliance with the Stz Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will com y with said procedures and requirements. HOMEOWNER'S SIGNATURE ' APPROVAL OF BUILDING OFFICIAL , Note: Three . family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. gw �1 HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a persons) for hire to do such work, that such Home Owne shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This lack of awarene often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "dwner acti as supervisor is ultimately responsible. To ensure that the Home 'Owner is fully aware of his/her responsibilities, ma. communities require, as part of the permit application, that the Home Owner 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. I LOT 9 0� DRAINAGE, o EASEMENT \ o 0 ==-HSE _ _-_===#5===--- p I � � DECK � O b LOT 8 LOT 10 O R 3�. S 82°53'52"W 84.12 A C FACjj?CLE , ST RES. ZONE.- "RB" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Bank Use Only TOWN: HYANNIS _ - REGISTRY OWNER: NORTHEAST SAVINGS _ DEED REF: 4940 089 BUYER: ALB-.EET & AIVTOIN.ETTE--&ST. GEORGE_ DATE: _4Z7/93 - PLAN REF: 34g56 _SCALE:I"= 30 FT. I HEREBY CERTIFY TO PLYMOUTH MORTGAGE CO_____ `�N OF Mqs YANKEE SURVEY ___THAT THE BUILDING �y�� CONSULTANTS SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS o PAUL �s :HOWN AND THAT ITS POSITION DOES _ CONFORM o MEFI A. THEW N 40B (SUITE 5) THE ZONING LAW SETBACK REQUIREMENTS OF THE No. 3209B e INDUSTRY ROAD 'IN OF BARNSTABLE-------------AND THAT 9 P `OES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD �'� '�tCIS1E��`� �,` MARSTONS MILLS, MA. 02648 t AS SHOWN ON THE H.U.D. MAP DATED. 919/� _ � ONAIIANpSJ TEL: 428-0055 ,nunit -Panel 0 250001 0005 C FAX: 420-5553 THIS PLAN NOT MADE FROM AN INSTRUMENT t l.1001 13LS � rn.�i�•iir.- I'�,S ----- 5iiRVh'Y, NET TO rir risr,n FOR rrNrrs, rrc. , • l t/,A/G z1�- A L S s om —� � C _ .�70t7 R ce`�c�►2 �va� . I. � PoR C c yxY pnesSUr� o� CA, Y�-- 5 r - c 37 /s V ND ER SoNo� Idi3tS /•o PLAN VIEW : SCA L E � 3O � rp cj f.. } i ..✓' ,s" .ram^.(�q"�`, \-.� _-� '`� 1- a0� g2XI PLAN VIEW SCALE : / "z u IV C4 AC 9,4 4L IT 7 121 d9l