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HomeMy WebLinkAbout676A YARMOUTH ROAD 0 I i A MM DD yyyy ❑Delete NFIRS -1 101922 1 U 1 011 1 12 2018 U 1 18-0000250 1000 ❑Change Basic FDID State* Incident Date * Station Incident Number * Exposure * ❑No Activity ❑Check this box to.Indicate that the address for this incident is provided on the Wildland Fire Census Tract I20 I I I BLocation* Module In Section B "Alternative Location Specification". Use only for Wildland fires. 1�J ®Street address 6761 IYARMOUTH ROAD U ❑Intersection Number/Milepost Prefix Street or Highway Street Type Suffix [-]In front of IA I IHYANNIS I IMA 1 102601 -1 ❑Rear of Apt./Suite/Room City _ State Zip Code ❑Adjacent to ❑Directions - Cross street or directions as applicable C Incident Type El Date & Times Midnight is 0000 E2 Shift & Alarms 111 Building fire I Check boxes if Month Day Year Hr Min Sec Local Option dates are the Incident Type same as Alarm ALARM always required In D Aid Given or Received* Date' Ala * of 12 Shift 2018 123:22:54 1 �( u or Alarms District Platoon 1 QMutual aid received 011 351 I ARRIVAL required, unless canceled or did not arrive I I 2 ❑Automatic aid recv. Their FDID Their ® Arrival * 01 12 I 20181 23� 29 c 31� E3 State CONTROLLED Optional, Except_ for wildland fires Special Studies 3 ❑Mutual aid given p 4 ❑Automatic aid given I El Controlled U J I Local option 5 ❑Other aid given Their LAST UNIT CLEARED, required except for wildland fires l� N ❑None Incident Number Last Unit InI 1 Special Special ❑ Cleared _J t --I 20181 01� 11.35 Study ID# Study Value F Actions Taken* Gl Resources * G2 Estimated Dollar Losses & Values Check this box and skip this LOSSES: Required for all fires if known. Optional section if an Apparatus or 11 (Extinguishment by fire I Personnel form is used. for non fires. Non Primary Action Taken (1) Apparatus Personnel Property $1 1 , 010 000 ❑ - 51 Ilventilate I Suppression 1 0001 0006 Contents $1 005 , 000 ❑ Additional Action Taken (2) EMS L� PRE-INCIDENT VALUE: Optional 12 JlSalvage & overhaul 0008 Property $1 , 000 000 ❑ - � other � � U Additional Action Taken (3) - ❑ Check box if resource counts I ' include aid received resources. Contents $l , 000 , 000 ❑ Completed Modules Hl*Casual ties®None H3 Hazardous Materials Release I Mixed Use Property QFire-2 Deaths Injuries N El None NN Not Mixed I 10 Assembly use Service X❑Structure-3 Fire I� u 1 []Natural Gast slos lea:, no e a assort or samat actions 20 Education use ❑Civil Fire Cas.-4 2 ❑Propane gas: <zi oar sa lb. tank (es in he grill, 33 Medical use ❑Fire Serv. Cas.-5 Civilianu L I 3 ❑Gasoline: vehicle fuel tank<r'portable container 40 Residential use ❑EMS-6 4 ❑Kerosene: fuel burning equipment or portable storage 51 Row of stores ❑ HazMat-7 H2 Detector 53 Enclosed mall Required for Confined Fires. 5 ❑Diesel fuel/fuel oil:vehicle fuel tank or portable 58 Bus. & Residential ❑ ❑Detector alerted occupants ❑ ce Wildland Fire-8 6 Household solvents: hoer/offi spill, cleanup only 59 Office use 1 - QApparatus-9 7 ❑Motor oil: from engine or portable container 60 Industrial use ❑Personnel-10 2E]Detector did not alert them 63 Military use 8 ❑Paint: from paint caws totaling<_55 gallons 65 Farm use []Arson-11 U E]Unknown 0 ❑other: special sarMat actions required or spill>55gal., 00 d0ther mixed use Please couplete the HarMat faze J Property Use* Structures 341❑Clinic,clinic type infirmary 539 ❑Household goods,sales,repairs 342❑Doctor/dentist office 579 []Motor vehicle/boat sales/repair 131❑Church, place of worship 361❑Prison or jail, not juvenile 571 ❑Gas or service station 161 [:]Restaurant or cafeteria 419® 1-or 2-family dwelling 599 ❑ Business office 162 ❑Bar/Tavern or nightclub 429❑Multi-family dwelling 615 ❑Electric generating plant 213 ❑Elementary school or kindergarten 439❑Rooming/boarding house 629 ❑Laboratory/science lab 215 ❑High school or junior high 449❑Commercial,hotel or motel 700 ❑Manufacturing plant 241 ❑College, adult education 459❑Residential, board and care 819 ❑Livestock/poultry storage(barn) 311 ❑Care facility for the aged 464❑Dormitory/barracks 882 ❑Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 ❑Warehouse Outside 936❑vacant lot 981 ❑Construction site 124 ❑Playground or park 938 ❑Graded/care for plot of land 984 ❑ Industrial plant yard 655 ❑Crops or orchard 946 ❑Lake, river, stream Lookup and enter a Property Use code only if 669 ❑Forest (timberland) 951 ❑Railroad right of way you have NOT checked a Property Use box: 807 ❑outdoor storage area 960 ❑other street Property Use 1419 919❑Dump or sanitary landfill_ 961 ❑Highway/divided highway 1 or 2 family dwelling 931 ❑Open land or field 962 ❑Residential street/driveway y g NFIRS-1 Revision 03 11 99 Hyannis Fire Department 01922 01/12/2018 ' 18-0000250 Rl Person/Entity Involved I I . U 1J 1 Local Option Business name (if applicable) - Area Code Phone Number ❑Check This Box if same address as Mr.,Ms., Mrs. First Name MI Last Name Suffix incident location. I� 1� I • _ ,I U Then skip the three duplicate address Number Prefix Street or Highway _ Street Type lines. Suffix Post Office Box Apt:/Suite/Room City State Zip Code - ElMore people involved? Check this box and attach Supplemental Forms (NFIRS-iS) as necessary R2 Owner Same as person involved? — — Then check this box and skip The rest of this section. Local Option Business name (if Applicable) I ' Area Code 'Phone-Number ❑ Check this box if Mr.,Ms., Mrs. First Name MI Last Name. - Suffix same address as incident location. Then skip the three duplicate address Number - Prefix Street or Highway - Street.Type Suffix lines. Post Office Box Apt./Suite/Room City u I I=I I State Zip Code - L Remarks Local Option - Caller Name VZW CALL 800-451-5242 Caller Phone (774) 368-3903 COID=VZW cad 2018/01/12 23:29:31 - 826 AT EVENT MANNING IS 4 cad 2018/01/12 23:31:51 - 829 AT EVENT MANNING IS 0 cad 2018/01/12 23:36:24 - 807 AT EVENT MANNING IS 0 cad 2018/01/12 23:37:46 - 801 AT EVENT MANNING IS 0 cad 2018/01/12 23:37:49 - 802 AT EVENT- MANNING'ISr1 cad 2018/01/12 23:39:35 - 823 AT EVENT MANNING IS 6 cad ; 2018/01/12 23:43:58 - 42 YAR ENG AT-EVENT MANNING IS 0 cad ; 2018/01/12 23:56:48 - 296- WBFD TANK AT EVENT MANNING IS 0 cad 2018/01/13 00:06:46 - 105 DEN AMB AT EVENT MANNING IS 0 cad 2018/01/12 23:48:30 - REQUESTING ELECTRICAL INSPECTOR 911 2018/01/12 23:22:54 Time of Call 23:21 01/12 Phone Number (774) 368-3903 COID=VZW Caller Name VZW CALL 800-451-5242 Street Number. : 49 Street Name : OCEAN STREET Service Municipality : HYANNIS ESN : ESN= MTN: - - Longitude -70.2822018. L Authorization I2017-2 I ( Burke, Peter II-CHIEF/EMT I I I 1 011 13 2018 Officer in charge ID Signature - Position or rank Assignment Month DayChe Year Box if FJ 1199102 '-I I Storie, Mark D. I I CAPT/EMT I I 11 011 U 2018 same Position or rank Assignment Month Day Year as Officer Member making report ID Signature . in charge. - Hyannis Fire Department 01922 01/12/2018 18-0000250 f MM DD YYYY 01922 U 1 11 12 2018 18-0000250 000 complete •.FDID State Incident Date Station - Incident Number Narrative fj * * *. Exposure Narrative: Caller Name VZW CALL 800-451-5242 Caller Phone (774) 368-3903 COID=VZW cad 2018/01/12 23:29:31 - 826 AT EVENT MANNING IS 4 cad 2018/01/12 23:31:51 - 829 AT EVENT MANNING IS 0 cad 2018/01/12 23:36:24 - 807 AT EVENT MANNING IS 0 cad 2018/01/12 23:37:46 - 801 AT EVENT.MANNING IS 0 cad 2018/01/12 23:37:49 - 802 AT EVENT MANNING IS 1 cad 2018/01/12 23:39:35 - 823 AT EVENT MANNING IS 6 cad 2018/01/12 23:43:58 - 42_YAR_ENG AT. EVENT MANNING •IS 0 cad 2018/01/12 23:56:48 - 296 WBFD TANK •AT EVENT MANNING IS 0 cad 2018/01/13 00:06:46 - 105 DEN AMB AT EVENT 'MANNING ISA cad 2018/01/12 23:48:30 - REQUESTING ELECTRICAL INSPECTOR! 911 2018/01/12 23:22:54' Time of Call 23:21 01/12 Phone Number (774) 368-3903 COID=VZW Caller Name VZW CALL 800-451-5242 Street Number : 49 Street Name : OCEAN STREET Service Municipality : HYANNIS ESN : ESN= MTN: - - Longitude -70.2822018 Latitude +41.6516590 Position Distance 4042 Position Confidence 100 cad 2018/01/12 23:34:13 829 CAPT HAS COMMAND cad 2018/01/12 23:35:01 SINGLE STORY 15X30 1 3/4 IN OPERATION cad ; 2018/01/12 23:40:07 FIRE IN A PARTITION WALL cad ; 2018/01/12 23:41:58 OPS 2 C6 cad ; 2018/01/12 23:50:28 REQUEST ELECTRIC INSPECTOR cad ; 2018/01/12 23:51:01 INSPECTOR NOTIFIED cad ; 2018/01/12 23:55:41 FIRE IN ATTIC APPEARS TO BE UNDER CONTROL cad 2018/01/12 23:55:50 Hyannis Fire Department 01922 01/12/2018 18-0000250 01922 U 1 L12 2018 18-0000250 1 000 complete ,:DID State Incident Date Station Incident Number Exposure Narrative Narrative: EXTENSIVE OVERHAUL cad ; 2018/01/13 00:30:41 RELEASING 823 AND 42 Received a call for the reported structure fire at the above address from the occupant Joann Crippen (508-775-1789) . Fire Alarm transmitted a first alarm assignment E-826 and-L-829 from the station. Car 801 and 807 responded and 802 823 were released from fire in 'Centerville also responded. On arrival E-826 reports smoke showing met with BPD officer Spencer Jackson who was -with tenant Joann Crippen they confirmed to Lt. Pike that no one else was in the building. Lt. Pike proceeded to porch and checked inside saw a light smoke condition along with a small pocket of fire burning in the ceiling where'it met with an interior wall. FF Morizio emptied contents of a PW extinguisher into the burned opening. They secured. door. FF Morizio then went and pulled 1 3/4" hand line off front bumper to the front door. Lt. Pike then went and completed 360 of the building. I arrived on scene on L-829 and met up with Lt. Pike, he gave me an initial report of a petition wall fire possibly up into the attic. I took command of the fire and had fire alarm upgrade response to a working fire. FF Yefko and FF Simkins secured water supply via hydrant on Yarmouth Road 100' of 4" supply line. into E-826 pump side 4" intake. During my 360 of building FF Marshall secured the gas. Light smoke condition visible from the vents coming out of the roof. Capt. Kenney, Lt. Pike, FF. Morizio and FF Marshall made entry into side A door with 1 3/4" hand line and started pulling the ceiling and extinguish the remaining fire in the attic. E-823 was assigned as the RIT. Yarmouth 42 assisted in final extinguishment and salvage and overhaul. Fire was contained to a small area in the attic. s Miss Crippen reported that there was new insulation that was blown into the attic space earlier in the day. During her interview she reported that she was reading in bed heard a popping noise and lost power. A half an hour later she started to smell an electrical odor. She 'spotted the fire and tried to put it out with dry chemical extinguisher. She then left the building and called 911. While investigating notice a burned electrical junction box with exposed wires. Called for the electrical inspector. Significant depth of char in collar ties and rafter where they met, along with charring of the sill plate. This is the area where the junction box was found. Electrical Inspector Mr. Amara agreed this is a plausible explanation. Checked the breaker panel there was one tripped circuit not labeled. Note found no operational smoke detectors. BCI was also called to scene to take photos. Property was turned back to the owners which is a family owned building. The occupant Miss Crippen is part of the family. i Insulation Contractor: Frontier Energy Solutions Inc. 502 Harwich Road Brewster Mass. 02631 1-800-939-1379 Hyannis Fire Department 01922 01/12/2018 18-0000250 MM DD YYYY 01922 U 1 11 12 2018 18-0000250 000 complete ",FDID State Incident Date Station Incident Number Exposure Narrative Narrative: Captain Mark D. Storie Hyannis Fire Dept. Hyannis Fire Department _ 61922 01/12/2018 18-0000250 MM DD yYYY Delete NFIRS -2 01922 U 1 011 1 121 1 20181 ( 118-0000250 000 Change Fire FDID� State* Incident Date * Station - ' 'Incident Number * Exposure * No Activity $ Property Details C On-Site Materials[]None complete if there were any significant amounts of commercial,industrial, energy or Or Products ' agricultural products or materials on the Property, whether or not they became involved Enter up to three codes. Check one $1 0001 RNot Residential or more boxes for each code entered. 1 Bulk storage or warehousing Estimated Number of residential living units in ' I I 12 Processing or manufacturing building of origin whether or not all units On-suite material (1) 3 Packaged goods for sale became involved 4 Repair or service 1 Bulk storage or warehousing $2 001 RBuildings not involved 12 Processing.or manufacturing Number of buildings involved On-site material (2) 3 Packaged goods for sale 4 Repair or service $3 I ) ®None I I. 1 Bulk storage or warehousing �l �F Acres burned 12 Processing or manufacturing (outside fires) Q Less than one acre On-site material (3) 3 Packaged goods for sale 4 Repair or service Cause of Ignition Human Factors D Ignition E1 ❑Check,box if this is an exposure report. Contributing To Ignition Skip to section c Check all applicable boxes D1 174 lAttic: vacant, crawl I 1 ElIntentional 1 Asleep ®None Area of fire origin * 2 ®Unintentional 2 Possibly impaired by 3 Failure of equipment.or heat source alcohol or drugs D2 13 (Electrical arcing 4 []Act of nature 3 ❑Unattended person Heat source * 5 Cause under investigation 4 Possibly mental disabled U Cause undetermined after investigation 5 [-]Physically Disabled Factors Contributing To Ignition 6 ❑Multiple persons involved D3 18 (Insulation within E2 Item first ignited* 1 ❑Check Box if fire sprea None 7 E]Age was a factor was confined to object 3L5_I jArc. from faulty., of origin I Estimated age Of 1 ' Factor Contributing To.Ignition (1) �J D4 60 lWood or paper, person envolved Type of material Required only if item first - first ignited ignited code is 00 or <70 �J Factor Contributing To Ignition (z) 1 Male 2 Female F1 Equipment Involved In Ignition F2 Equipment Power . G Fire Suppression Factors [--]None If Equipment was not involved,Skip to Enter u to three codes. Section c 11 jEl'ectrical P ®None 1210 JElectrical wiring I Equipment Power Source Equipment Involved F3 Equipment POrtabili.ty INM lNOne .Fire suppression factor (1) Brand I 1Portable '�JI Model I I 2 ®Stationary Fire suppression factor (2) Serial #I I Portable equipment normally can be moved by one person, is designed t I be, use in•multiple locations, and Year I requires no tools to install. Fire suppression,factor (3) Hl Mobile Property Involved H2 Mobile. Property Type & Make Local Use Pre-Fire Plan Available None Some of the information presented in this report may be based upon reports 1 [:]Not involved in ignition, but burned Mobile property type from other Agencies 2 FlInvolved in ignition, but did not burn Arson report attached 3 0 Involved in ignition and burned I I Police report attached Mobile property make _ Coroner report attached Other reports attached I I Moblie property model Year - i LJ I License Plate Number - - State VIN Number a ; NFIRS-2 Revision 01/19/99 Hyannis Fire Department 01922 01/12/2018 18-0000250 I1 Structure Type * 12 Building Status * 13 Building* 14 Main Floor Size* NFIRS-3 If Fire was In enclosed building or a fbr'sab),e/mobile structure complete Height Structure the rest of this form Count the ROOF as part Fire 1 ®Enclosed Building 1 ❑Under construction of the highest story 2 ❑Portable/mobile structure 2 ®Occupied & .operating 3 ❑Open structure 3❑Idle, not routinely used 001 u , �J r 600 4 [-]Air supported structure 4 ❑ Under major renovation Total member of stories Total square feet at,r above g,,,dle 5 ❑Tent 5❑vacant and secured �R 6 open platform 6❑vacant and unsecured P (e.g. piers) 7 ❑Being demolished Total number of stories 7 ❑Underground Structure(work areas) below grade 03 •gy 020 8 ❑Connective structure O Other , , (e.g. fences) '- 0 ❑Other type of structure U❑Undetermined Lenght in feet Width in feet J1 Fire Origin* J3 Number of Stories K Material Contributing Most Damaged By Flame To Flame Spread ' ❑Below Grade Count.the ROOF as part. of the highest story • Ski To 0011 ❑ Check if no flame spread P Story of fire Origin OR same as material first ignited Section L Number of stories w/ minor damage OR unable to determine (1 to 24% flame damage). _ J2 Fire Spread* I Kl I Number of stories w/ significant damage 1 ❑Confined to object of origin (25 to 49% flame damage) Item contributing most to flame spread 2 ®Confined to room of origin I Number of stories w/ heavy damage Kn I - 3 ❑Confined to floor of origin + (50 to 74% flame damage) � l Type of material contributing Required only if item 4 ❑Confined to building of origin most of flame spread contributing Number ofstories w/ extreme damage 5 ❑Beyond building of origin (75 to 100%-flame damage) code is 00or<70 L1 Presence of Detectors * L3 Detector Power Supply L5 Detector Effectiveness (In area of the fire) I Required if, detector operated N ®None Present Skip to 1 ❑Battery .only section M 2 ❑Hardwire only 1 ❑Alerted Occupants, occupants responded 1 ❑Present 3 ❑Plug in 2 [:]Occupants failed to respond U ❑Undetermined ❑ 4 ❑Hardwire with battery 3 There were no occupants 5 ❑Plug in with battery 4 ❑Failed to alert occupants 6 ❑Mechanical U ❑Undetermined L2 Detector Type" 7 ❑Mnitple detectors & power 'supplies L6 Detector Failure Reason 1 ❑Smoke 0 ❑Other' Required if detector failed to operate 2 ❑Heat U❑Undetermined 1 ❑Power failure, shutoff or disconnect 3 ❑Combination smoke - heat L4 Detector Operation 2 ❑Improper installation or placement 4 ❑Sprinkler, water flow detection 1 ❑Fire too small 3 [:]Defective to activate 4 ❑Lack of maintenance, includes cleaning 5 More than 1 type present 2 ❑Operated 5 []Battery missing or disconnected O rlOther (Complete Section L5) 6 []Battery discharged or dead 3 ❑Failed to Operate (Complete Section L6) 0 ❑Other , U[]Undetermined U❑Undetermined U ❑Undetermined M.Presence of Automatic Extinguishment System * jNj3 Automatic Extinguishment ] Automatic Extinguishment N ®None Present System Operation System Failure Reason Required if fire was within designed range Complete rest Requires if system failed 1 ❑Present 1 ❑Operated & effective (Go to M4 of Section M Type of Automatic Extinguishment System 2 ❑Operated & not effective (M4 .1 ❑3ystem shut off Required if fire was within design range 3 [:]Fire too small to activate 2 ❑Not enough agent discharged' ge of AES 1 ❑ pipe� P Wet sprinkler 4 ❑Failed to operate (Go to M5) 3 ❑Agent discharged but did not reach fire 2 ❑ 0 ❑Other Dry pipe sprinkler V 4 ❑wrong type of system ❑Other sprinkler system U[:]Undetermined 3 P Y 5 ❑Fire not in area protected 4 ❑Dry chemical system M4 Number of Sprinkler 6 ❑system components damaged 5 ❑Foam system Heads Operating 7 ❑Lack of maintenance 6 ❑Halogen type system 8 ❑Manual Intervention 7 ❑Carbon dioxide (CO 2) system Required if system operated 0 Other 0 ❑Other special hazard system U❑Undetermined Number of sprinkler heads operating U Undetermined NFIRS-3 Revision 01/19/99. Hyannis Fire Department 01922 01/12/2018 18-0000250 Hyannis Fire Department Department Journal (Modified) :01/12/2018 to_01/12/201f 00:00 to 24:00 Units:. 806�. NFIRS Incidents, EMS/Search 6 Rescue Incidents, Occupancy Activities, Non-Incident Activities Time Type Record Id Description/Location Staff Hrs Fri Jan 12, 2018 10:00 OCCUP • 1026 INSPECTION - .Assembly - Churches 0.00 Station 1 Shift E Unit806 ST FRANCIS' XAVIER CHURCH, 347 SOUTH STREET 11:00 OCCUP RESI2550 INSPECTION - 26F - Resale 0.00 Station 1 Shift E Unit806 RESIDENCE,. 35 SEABROOK ROAD 11:30 OCCUP RESI2551 INSPECTION - 26F - Resale _ 0.00 Station 1 Shift E Unit806 RESIDENCE, 40 FIRST AVENUE 14:30 OCCUP 1256 INSPECTION - General Annual 0.00 Station 1 Shift E Unit806 BARNSTABLE AIRPORT TERMINAL BLDG, 480 BARNSTABLE ROAD Total Entries: 4 Total.Staff Hrs: 0.00 t 01 /11 /2f11 R 1 3:1 5 Page 1 - • i �d • TOWN OF BARNSTABU BUILDING PERMIT APPLfCATION ' Map r 9 .� Parcel © Application # Health Division Date Issued Conservation Division Application Fee T Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street AddressR: —� Village Owner Address(o7614ei/I 'l( ►c�h Telephone tI Permit Request Square feeO st floor: existing proposed 2nd floor: existing proposed Total new _ 5 �P Zoning District Flood Plain Groundwater Overlay _ Project Valuation 00 1 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family m- Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑•-fro' If yes, site plan review# Current Usf�� Proposed Usgo�� - - - APPLICANT INFORMATION � BUI DE OR HOMEOWNER)� � ) 00- Namel2e ja c, c�Z,, wt +prt, Telephone Number —77t/,J 7-041 Addres:3ClQ)M,Q +4�, License # rn A Home Improvement Contractor# Email k Qga/ftpensation 0) ALL CONSTRUCTION DEBRIS RESULTING FFVM THIS PROJECT WILL BE TAKEN TO (� , - I SIGNATURE . -<v' DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. f i ADDRESS VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE µ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. f r------ The'C`otnmonrwe'n11h o,f Massaeh`tis��ts. r 1)e p.artr►rerrt af. :Intlitrirrl.,,ccactrttls . 1`.CnttressStreet,Suite 100 Boston; MA 02114-20,1 WWW tmus.:zovIdia Wovkcrs' C66ipcn8.ti jn lasuran"Affidavit:,-1 wilder/CoatracforstEle:etricianSIPtiithb:ers. •#'�;i3[:t�ILE1)W("C`#37'FTE,P�R.��II-"r•i'IVt.�II;THi1121'1"1.; ilicant�iiforrna(ion Please Print Legibly Name(}3usinessfC>rgan�at�nfl tdtvtduai 7: t f j2I' t✓ Address: �. ( � CityI.Statef7t C2//. s Are you an employer?Ctirck ctte'ciliprnpn tie;fit>z � (�l Type of protect(required),: l. am aemployer wits. 1 ....cmpiv}ee ff411;ntrJTorpart-=lire/,' 7: i✓eW CJnStttit ttpn >n i am a sole proprictor or partnership and hirve nv zm.ployees wurkina stir me lit $: © Remodeling any capacity,IN040'rketa cvfnp insurance eqi free] .101 am a hOMCOWM iloing all work myklf;tNa.corkers'comic:i uuraner Izquimd:J:r 9• ❑'Demulitton i am a htFineown .an3 wait be htr:ng.contractors to con 3uct dIi idurkvn m ry tv. !tPsl! I.C.[]'L3uilding adtJition k P per i- ensure i iat ail one actor other hov i:v r>rkcrs'camii2n5ativn inspiarice.nc are sole. 1,I;1]<Elzcric3) repairs,OC dddttttlS € p oprietors witf•+nn'cinployces 1 1 IC)Ptunibi"tg repairs<or additions i':0,1 ant a gcrccaP et7ntiaetvr rnrJ iMaua h re'iE ,u rcur3lrastvrs ii fed v�i t 'tiuched Sh€ct; 1 hest Bub-comr'aeiors haxve en ployces and have worker5 comp,itt,ut.t t:� 1�:.❑!Zn(1f Cc palfs S:Owe area comoration and its Of!'icUf0tiv.c cxertrse i#1 i u t! �Fe.cem ioti'per YifIL c. 1 #: Eher as _ p+ 152,§t(4J.and--Ae have net employees [No woikets'comp msinnee requited.j °Any appttcant-thot t hccks:t>o txi meal dsa t1!out ttie se icin below+showing their workers'con pcitsation paitcv information, Wurni adwners who submit this zt"ciavii indicating thev are d.(4if 1 work and titer hue nti siie cunt actors me i,W6mtt a rsew..-affidavi indicating such.. tCon trr ors EhatttteC his.box must aitartled an additional shcnt shows tig the name of the auks=cwtttractacs urd state:whether or not those entities have erq iloyees lf.thc 34bl ,ontYactncs havc.emply}e :they malt::providt their wurkee'temp.prltcy 1 uM.an emalitnyer that.u provirlui workers`compiensation insurance far my employees: Below is the p ilicy itnd jrzh;site information, i T t lmsurance Company dame�_ �"� \ ^S"" r r� (:..sip c�: l^ l�✓t i Policy#or Self-ins,t.ic.H` ' q; I k ;rntrcaiZ late Job Site Addres City/State Zi .__ ... Attach a cups°of the w•orkerscompetr ation police d'eclaraticin pate(showing the policy numhe:r a der i.at yin:date)r Fa"ilure to secure cover4ge aS required under M.GL 152,;§25A is a criminal viblat nri pun shable'by a title tip to�I;50().UC and/or rune-year imprisonment;'as well=a5 civil penalties i i the<form,cif a STOP W0:m,(,,Ar.)r-A a td'i fine of up to S256,0( a day aamsithe viEa!akor. .4 ctjpv of this Stvkeitienk,tna} be iTnvarded•to the Office l tuestia t'ti<,ns ofhe Dl 1 for uturarce i coves, ucrit'��aiign. 1 _ .,. I do faereby 4 ritjv under,tite pains a ties,of perjury chat the infgrinati, provided rihnve is trul aitrl correct' 5ienaturc Date_ ' nfftcitil use.nrtty: Uri not write in this area,,an lie conyleted by-cit)�or limn off¢ittt City or T,u vnc. y Permit/Lken§e 9 Issuing:Authority{circhc:otic}> 1.'Boird o ` i4ith 2.Building Department 3 (iiv;±Town Clerk 4.Electrical Nspector Plumbing r Inspector G.Other Contact Person: Phone K: „'. .lfPd! tif3lft F3rf etf('f?(tflP7 few/�(<r,.;FPtJIfd2<�la ? C: , Otfice of Consumer Affairs S Business R enlanon License:or registration gaud for individual use only F before:the expiration date_ If found return to. Office of Consumer Affairs and Business Regul n HOME IMPROVEMENT CONTRACTOR ation t Registration 160854 Type [ �lOParki'laza-Suite 5,1i0 Expiration 9/8/2018 LLG Boston,'iviA02Lt.6 € FRONTIER ENERGY SOLUTIONS°` i 3 r FRANCIS SHEEHAN 502 HA I .............-- I $REWSTER,tJtA`62631 [1�iticisecretary' { tN twat' ithou signature; 1 a: Construction Supervisor Specialty Restricted to: fvlass,acliusetts U.epartmer t:of Public,.S.afety ..» CSSL-IC-Insulation.Contractor 50 rd.of Susidiny Ftegulatitrns Ahdc S#andards License: CS,SL-105941 Construct do su: &Visor Specialty FRANGIS S SH,EEHAN l 502 HARWICH:RD BREWSTER MA 02631,E Failure to possess a current edition of the Massa chusefts State Building Code is cause for revocation of this license. 1. !^� t u' Etp§ratlQtl: DPS Licensing information visit: WWW.MASS.GOVfDPS rxnlssio0er 02117/2018 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 03/16/2017 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 .CONTACT NAME: Rogers and Gray Processing ROGERS & GRAY INSURANCE AGENCY INC a/co"N EMI: (508)398 7980 a No E-MAIL il ADDRESS: mail@rogersgray.com 434 ROUTE 134 INSURERS AFFORDING COVERAGE NAIC# SOUTH DENNIS MA 02660 INSURER A: AIM MUTUAL INS CO 33758 INSURED _ INSURER 8 FRONTIER ENERGY SOLUTIONS INC INSURERC: INSURER D: 502 HARWICH ROAD INSURER E: BREWSTER MA 02631 INSURERF: COVERAGES CERTIFICATE NUMBER: 134675 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW.HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ . CLAIMS-MADE ❑OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A - PERSONAL&ADV INJURY '$ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO ❑ JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ - ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED - _ PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ - $ WORKERS COMPENSATION - X STATUTE EORH AND EMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT s 1,000,000 A OFFICER/MEMBER EXCLUDED? NIA N/A N/A VWC10060153152017A 03/14/2017 03/14/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000.000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1.000,000 N/A. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. 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. Frontier Energy Solutions Inc. , . 502 Harwich Road AUTHORIZED REPRESENTATIVE Brewster MA 02631 Daniel M.Crow}ey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORd CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE-AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER.. I hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping;.air sealing; attic&basement insulation; exterior wall insulation;ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to Housing Assistance Corporation to access the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an tangoing basis for no more than five (5)years after the weatherization work is completed, I have read the provisions of this agreement and give my consent. Home Owner(signature) i Home Owner email: J b tt 4 4 6 'L Date: 417 Agent:(signature) `� bate: Weatherization Contractors: Adam T Inc Cape Save All Cape Energy ns _ Alternative Weatherization Lohr Home Improvement Building Science Construction Tupper Construction Cape Cod Insulation 9/22/2017 Barnstable Property Maps w Search... f ""moray ' r r 345 �1 TOOLS ......._ ..._ i 345 4t�5 r 4 1 ., k r ,r, Vff c o ' u 57 K� � f 345M `k vo >; Wl- INV E 1 'f o,, .=,3�S13ft� ,, t S #. . k �' ' r �" 345 Q3 15t t W "I" pow � � � y .� 34 F" y� 7aR 1�.. ..y�1. I „. s 5015002 r � ' 160 Basema P 44ft https://gis.townofbarnstable.us/Html5Viewer/lndex.htmI?viewer=propertymaps&run=FindParcel&propertylD=345012&mapparback=345012 1/1 9/22/2017 Barnstable Property Maps r. Search... Parcel Details I want to... .. ,__,_ - .. _� _.... ,.. _._ Tools r € I Location < 1 Parcel: 345012 ' x Address: 688 YARMOUTH � r� < I ROAD I Village: HY € ,` Acreage: 0.73 ' 329003i f ' g Full Property Info :) #48 4a 15, r 689 Property Photo 3 h 32 € ,3' i T7Uf ( r OWN, QE al'W t i _, _..___..... ..._._..._....,.,.. ....._......_..___._ ._._....___.._.... 'r ` Owner& Mailing Address j r " 72 Owner: MORRIS, SANDRA L { #57 BRITO, CRIPPEN, 10 r' i E I ANN, BRITO, PETER M , JAMES M &JOSEPH M III E :�1En SSE f �a Mail Address: 688 YARMOUTH ROAD i i w r 4 i5Q02 HYANNISf f €I � I 345 0 n MA 02601 w4 `ii i Assessed Value (FY17) ;" . 15 i Building Value: $157,000 i Extra Features: $22,000 Outbuildings: $300 Land Value: $78,900 Total Value: $258 200 _,..., _,....._ _.'.... ... .�.. .. Residential Exemption F No exemption. .................,.. ......... E £ Building Details E E Select Building • ® _ Basemap,H, Han)e Ui VCrsrcr.l... Parcel... l __ 100ft .._..., �. https://gis.townofbarnstable.us/Html5Viewer/lndex.htmI?viewer=propertymaps&run=FindParcel&propertylD=345012&mapparback=345012 1/1 9/22/2017 Print Page Print thas„pag • Owner Information - Map/Block/Lot: 345 /012/-Use Code: 1090 Owner Map/Block/Lot GIS MAPS MORRIS, SANDRA L BRITO, 345 / 012/ Owner Name as CRIPPEN,JO ANN, Property Address of 1/1/16 688 YARMOUTH ROAD 688 YARMOUTH ROAD HYANNIS, MA. 02601 Co-Owner Name BRITO, PETER_M JAMES M & Village: Hyannis JOSEPH M III Town Sewer At Address: No GIS Zoning Value: B • Assessed Values 2017 -Map/Block/Lot: 345 /012/-Use Code: 1090 2017 Appraised Value 2017 Assessed Value Past Comparisons Building Value: $ 157,000 $ 157,000 Year Assessed Value $ 22,000 $ 22,000 2016 - $ 256,200 Extra Features: 2015 - $ 280,500 $ 300 $ 300 2014 - $ 280,600 Outbuildings: 12013 - $ 229,300 2012 - $ 225,600 $ 78,900 $ 78,900 2011 - $ 231,800 Land Value: 2010 - $ 240,500 2009 - $ 226,100 2017 Totals $ 258,200 $ 258,200 2008 - $ 249,700 2007 _$ 249,500 • Tax Information 2017 - Map/Block/Lot: 345 /012/-Use Code: 1090 Taxes ' l Hyannis FD Tax (Residential) $ 632.59 Community Preservation Act Tax $ 73.90 Town Tax (Residential) $ 2,463.23 Fiscal Year 2017 TAX RATES HERE $ 3,169.72 • Sales History-Map/Block/Lot: 345/012/-Use Code: 1090 History: http://www.townofbarnstable.us/Assessing/printl7.asp?ap=0&searchparcel=345012 1/4 i 9/22/2017 Print Page Owner: Sale Date Book/Page: Sale Price: MORRIS, SANDRA L BRITO, CRIPPEN, JO ANN, 2016-05-23 29669/318 $0 BRITO, SANDRA L, PETER M & CRIPPEN, 2016-05-23 29669/311 $0 BRITO, DOROTHY M, SANDRA L, PETER M & 2015-04-09 28789/340 $1 BRITO, DOROTHY M & SANDRA L TRS 2013-06-19 27472/196 $1 BRITO, JOSEPH M JR& DOROTHY M 2008-12-04 23297/87 $1 BRITO, JOSEPH M JR & DOROTHY M 1953-11-18 859/90 $0 • Photos 345/01.2/- Use Code: 1090 • Sketches- Map/Block/Lot: 345 / 012/- Use Code: 1090 This property contains multiple sketches. Please use the navigation below the sketch to browse sketches. MW Additional Sketches 1 1 2 13 1 Click Here for print version that displays all sketches at once AsBuilt Card N/A • Constructions Details - Map/Block/Lot: 345/ 012/- Use Code: 1090 Building Details Land http://www.townofbarnstable.us/Assessing/print17.asp?ap=0&searchparcel=345012 2/4 9/22/2017 Print Page �r Building value $ 157,000 Bedrooms 3 Bedrooms' USE CODE 1090 Replacement Cost $131,007 Bathrooms I Full-0 Half Lot Size (Acres) 0.73 Model Residential Total Rooms 6 Rooms Appraised Value $ 78,900 Style Ranch Heat Fuel Oil Assessed Value $ 78,900 Grade Average Minus Heat Type Hot Water Year Built 1940 AC Type None Effective depreciation 40 Interior Floors Carpet Stories 1 Story Interior Walls Drywall Living Area sq/ft 1,390 Exterior Walls Wood Shingle Gross Area sq/ft 2,179 Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp • Outbuildings & Extra Features -Map/Block/Lot: 345/ 012/- Use Code: 1090 Code Description Units/SQ ft Appraised Value Assessed Value GAR Attached Garage 528 $ 9,000 $ 9,000 BMT Basement- 240 $ 6,800 $ 6,800 Unfinished FOP Open Porch-roof- 21 $ 900 $ 900 ceiling SHED Shed 196 $ 300 $ 300 FEP Enclosed porch- 96 $ 5,300 $ 5,300 roof,ceiling • Sketch Legend Property Sketch Legend 1132N 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) SPE Pool Enclosure BRN Barn GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area (Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story(Unfinished) FEP Enclosed Porch MZ1 Mezzanine, Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story(Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Microsoft VBScript runtime error'800aOl a8' Object required: " http://www.townofbarnstable.us/Assessing/printl7.asp?ap=0&searchparcel=345012 3/4