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Home My WebLink About0221 FIVE CORNERS ROAD t iX ti y • }fki- ."��}:. ♦Y { 3. `�k' y' j _ q -� , 0.4 ,�:4. 5 e. j.e rn s � �i�3�•:x, j s ,'.�� ek u _ � _ �^qr ,� {ji � n, 0 n. w , , rt r V c u > D a .r, r . a , UA 'er 3`o � V A t f,oo le, Barnstable Assessing Search Results �: Page 2 of 2 Appraised Value $ 160,100 Interactive Property Map: c , I have visited the maps before ' d Assessed Value $ 160,100 \ Show Me The Map April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: ASSIS, MARCELO T& May 1 2002 12:OOAM 15113/347 $ 100 TEIXEIRA,ADOLFO&ASSIS, M A N&M Oct 26 1998 12:OOAM 1 1 786/251 $ 157,500 POMYKALA, RONALD J Aug 15 1996 12:OOAM 10360/264 $ 1 POMYKALA, RONALD J Jul 15 1994 12:OOAM 9270/113 $ 135,000 MONEY STORE MASS, INC Nov 15 1992 12:OOAM 8300/225 $ 120,000 WOLLASTON CREDIT UNION Jun 15 1992 12:OOAM 8091/ 150 $ 118,000 EORDEKIAN, HOVEY& Sep 15 1988 12:OOAM 6437/135 $ 130,000 MCPHEE, NORMAN&PATRICIA Apr 15 1983 12:OOAM 3706/045 $58,000 GORDON, Mar 15 1983 12:OOAM $ 1,000 Extra Building Features - Code Description Units/SQ ft Appraised Value Assessed Value BFA Bsmt Fin-Aver 1500 $20,000 $20,000 FPO Ext FP Opening 1 $700 $700 FPL2 Fireplace 2 $5,300 $5,300 BGAR Bsmt Garage 2 $7,100 $7,100 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area UST Utility Area(Unfinished) (Finished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story (Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/Assessing/Assess06/displayParce106.asp?mappar=1680... 4/11/2006 Barry, Lois From: Whelan, Angela Sent: Thursday, October 28, 2004 11:01 AM To: Barry, Lois Cc: Dillen, Elizabeth Subject: FW: 221 Five Corners -----Original Message----- From: Dillen, El[zabeth Sent: Thursday, October 28, 2004 10:32 AM To: Whelan, Angela Cc: Traczyk, Art Subject: 221 Five Corners Hi Angela I spoke with Matteus Teixeira of 221 Five Corners Road, Centerville,regarding the construction of his accessory apartment unit. According to Mat, the unit is nearly complete,with the exception of kitchen cabinets and carpeting. However,he was "unsure" of the status of the plumbing and electrical work when I spoke with him. In addition,he still needs to perform a septic upgrade,which he has chosen to do at the end of the project rather than at the start (?).This has not been scheduled. I would be happy to set up a site visit with myself and Bob Shea to verify the status of the project if you think that would be helpful at this point. Thanks, Beth % —10-1- &aw A� F I Barry, Lois To: Dillen, Elizabeth Subject: RE: 221 Five Corners Beth, I've left a voice message for Mr. Teixeira to call Jeff Lauzon for building inspections. He has not yet called for any inspections (frame, insulation). Also, he has not had an electrician pull a wiring permit. I'll let you know if I get more information on this and hope you'll keep me informed if you learn anything. Lois -----Original Message----- From: Whelan,Angela Sent: Thursday,October 28, 2004 11:01 AM To: Barry, Lois Cc: Dillen, Elizabeth Subject: FW: 221 Five Corners -----Original Message----- From: Dillen, Elizabeth Sent: Thursday, October 28, 2004 10:32 AM To: Whelan, Angela Cc: Traczyk, Art Subject: 221 Five Corners Hi Angela I spoke with Matteus Teixeira of 221 Five Corners Road, Centerville, regarding the construction of his accessory apartment unit. According to Mat, the unit is nearly complete, with the exception of kitchen cabinets and carpeting. However, he was "unsure" of the status of the plumbing and electrical work when I spoke with him. In addition, he still needs to perform a septic upgrade,which he has chosen to do at the end of the project rather than at the start (?). This has not been scheduled: I would be happy to set up a site visit with myself and Bob Shea to verify the status of the project if you think that would be helpful at this point. Thanks, Beth r 1 Barry, Lois From: Whelan, Angela Sent: Thursday, October 28, 2004 11:16 AM To: Dillen, Elizabeth Cc: Barry, Lois; Perry, Tom Subject: RE: 221 Five Corners Hi Beth, The plumbing permit for the kitchen sink is finalized. They haven't pulled a permit as of yet for the electrical portion of the upgrade and have had no inspections at all on the building permit that was pulled to complete the basement. The septic upgrade is the jurisdiction of the health department. You would probably want to check with Tom P. regarding a site visit. Thanks, Angela -----Original Message----- From: Dillen, Elizabeth Sent: Thursday, October 28, 2004 10:32 AM To: Whelan, Angela Cc: Traczyk, Art Subject: 221 Five Corners Hi Angela - I spoke with Matteus Teixeira of 221 Five Corners Road, Centerville, regarding the construction of his accessory apartment unit. According to Mat, the unit is nearly complete,with the exception of kitchen cabinets and carpeting. However, he was "unsure" of the status of the plumbing and electrical work when I spoke with him..In addition, he still needs to perform a septic upgrade,which he has chosen to do at the end of the project rather than at the start (?). This has not been scheduled. I would be happy to set up a site visit with myself and Bob Shea to verify the status of the project if you think that would be helpful at this point. Thanks, Beth 1 Dillen, Elizabeth From: Traczyk,Art Sent: Tuesday, September 14, 2004 2:29 PM To: Dillen, Elizabeth; Weil, Ruth Cc: Perry, Tom Subject: RE: questions Beth: On 221 Five Corners: There is a building permit out on it- An application for a building permit would be considered implementing of the permit (its start). The Building Permit will extend the comp.permit issued- it's like "in the process". According to the Building file work is in progress,however still needs final occupancy permit. No issue here as long as he continues forward with the work On the refinance issue- I do not know were Today RE is getting the information- he should ask them to document that in writing from the financial institution. Also note that the use remains single-family.He can not try to get a mortgage for a two-family with the unit in place under the amnesty program You need more information , and to assure that the refinance is for that of a single-family before commenting or trying to address the issue- as there may not be-an issue. w I Town of Barnstable Zoning Board of Appeals P tJ111 9MANSTABM Planning Division ! 1639• 230 South Street, Hyannis,Massachusetts 02601 '' �£3 10rEn►��s (508)862-4785 Fax(508)862-4725 � C) In accordance with the attached request of Mateus Assis Teixeira, dated February 27, 2004,regarding Zoning Comprehensive Permit Appeal#2002-85,and upon the VOTE of the Zoning Board of Appeals taken at their public hearing on March 3,2004,I hereby grant a 6 month extension of this Appeal. The original decision on Appeal . , #2002-85 was certified by the Barnstable Town Clerk on March 3,2003 (after the:;,. Appeal period had expired). This 6 month extension is necessary due to a delay in the original funding for the project. The construction involved with this Comprehensive Permit is on-going(as per the Barnstable Building Department), and the extension is necessary to complete the construction in accordance with the Building Code and requirements of the Amnesty Accessory Affordable Housing Ordinance, Said Comprehensive Permit#2002-85 is hereby extended until September 3 -2004 ail C. Nightingale,Hearing Officer arnstable Zoning Board of Appeals Dated: 3 D February 27, 2004 F Gail Nightingale ZBA Hearing officer Planning/Zoning Department € Xr Town Of Barnstable 367 Main Street -- Hyannis,MA 02601 Dear Ms.Nightingale: This letter is in regards to my ZBA Comprehensive Permit,#2003-85 approved almost a year ago. I respectfully request an extension on the effective date(expiration on March 3, 2004)in order to complete the construction of the new unit.My property is at 221 Five Corners M road in Centerville. It is anticipated that my family will be able to finish with the structural requirements, plus, get tenants settled into the affordable apartment within the next six months. Therefore,I would like to ask for an extension to September 3, 2004 to exercise the Comprehensive Permit. Thanks in advance for your consideration. Sincerely, Mat us Assis Teixeira a,6rqll 2�' Mateus Teixeira 221 Five Corners Road Centerville, MA 02632 December 11, 2002 Ms. Gail Nightingale ZBA Hearing Officer Town of Barnstable 365 Main Street Hyannis, MA 02601 Re: Appeal#: 2002-85 Dear Ms. Nightingale, Due to a pending upgrade regarding the septic system at my property, I'm requesting another continuance on my Amnesty Comprehensive Permit application. I anticipate having all the necessary work completed within the next couple of weeks. Thanks in advance for your consideration. Sincerely, Tap teus Teixeira q ei eira • 221 Five Comers Road Centerville,MA 02632 , �„ � �a6„� �3:,, ".'i �a� „y� ;: �� t:z¢,v ,�;.�'. 5 e�. s� /� htx % z.�< •.w. '7 ar "�.,s.. July 24,2002 Gail Nightingle ZBA Hearing officer Amnesty Program Town Of Barnstable 367 Main Street Hyannis,MA 02601 Dear Gail: I would request a continuous process in order to upgrade septic system at my property T hank you for your consideration. Y� ^� Sucerely, F , z teus Assi 'ix j i . �NJ y. •`r'$` '- 'i . • . . . . . . . . . . . . . . . . . . . r � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION °ram® 68 0" ob Map Parcel To Permit# �779 3 Health Division 'r��/ �� TABLE Date Issued o 1 BAR Conservation Division 3 f; 12 Application Fee .� Tax Collector Pe�mlt Fee TreasurerIt�ISlQ9s SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board WiTMI TITLE 5 ENVIRONMENTAL CODE AND . Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address Ol I I �� L� �' �) ?� J �•(_ Village Owner MATI✓V!S �� ' API Address Telephone 5 4 ®' S a %o Permit Request —Tk)O I ► Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type IV Lot Size Girandfathered: ❑Yes No if yes,attach supporting documentation. Dwelling Type: Single Family'# Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: 0 Yes *No On Old King's Highway: ❑Yes o Basement Type: XFull ❑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 6 Heat Type and Fuel: A Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes > No Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes 4 No Detached garage:❑existing ❑new size N Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage: existing ❑new size-�?y° Shed:❑existing ❑new size k) Other: Zoning Board of Appeals Authorization O Appeal# Recorded l7 Commercial ❑Yes 4,No If yes,site plan review# Current Use Proposed Use S I t BUILDER INFORMATION Name M A fEU 5 Telephone Number Address ?,l_ ri v t- C o Y NE r S Pot License# C C 0 CF V'y i L. A4 ice- eL rem Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOF� SIGNATURE DATE 12 2 i5 .ate On' fr R� - \ JI.- v �. 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Geiler, Director RFD MA'1 A Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 October 17, 2006 Maria Furlan 221 Five Corners Road Centerville, MA 02632 Re: Proposed Accessory Affordable Apartment Dear Ms. Furlan: We have received the recorded Regulatory Agreement and Comprehensive Permit for the accessory affordable apartment to be created at your address. A building permit is required whether the unit is new or pre-existing. We look forward to receiving your building permit application for the apartment. Please call me if you have any questions regarding the building permit process. Sincerely, Lois Barry Division Assistant J040616a ' �� r- t67AF Town of Barnstable Zoning Board of Appeals Decision and Notice '10, VIAR 15 P 4 10 0 Furlan Comprehensive Permit No. 2006-062 Furlan Summary Comprehensive Permit No. 2006-062 is rescinded Applicant: Maria Furlan Property Address: 221 Five Corners Road Centerville, MA. �� o D Assessor's Map/Parcel: Map 168, Parcel 080-001 Zoning: Residential C Zoning District Recording Information APR 0 7 2010 Deed Reference: Book 20701 Page 236 Permit Reference Book 21411 Page 340 1 GROWTH MANAGEMENT Background: Comprehensive Permit No. 2006-062 was issued to Maria Furlan on August 31, 2006. The Permit was issued under the Accessory Affordable Apartment Program pursuant to Chapter 9, Article II of the General Ordinances of the.Code of the Town of Barnstable. The Permit was issued to convert an existing unpermitted one bedroom apartment located in the lower level of the dwelling into an accessory affordable apartment. The Permit and the Regulatory Agreement and Declaration of Restrictive Covenants were recorded on October 6, 2006 in book 21411 Page 340. On January 6, 2010, The Building Department issued.a permit to remove the basement kitchen located at 221 Five Corners Road Centerville. On February 5, 2010 a final inspection confirmed that the accessory apartment had been dismantled. The.Program Coordinator initiated the rescission of comprehensive permit 2006-062. Procedural & Hearing Summary: A public hearing to rescind Comprehensive Permit No. 2006-062.was duly advertised and notice sent to abutters and the property owner all in accordance with MGL Chapter 40A. The notice was published in the Barnstable Patriot on January 29, 2010 and February 1, 2010. The Public Hearing to rescind the permit was opened on February 24,2010. Ms. Furlan did not appear to speak. There were no comments from the public. , Findings of Fact: At the hearing on February 24, 2010 the Zoning Board of Appeals Hearing Officer made the following findings of.fact: 1. In January of 2010, a permit was sought for to remove the accessory apartment. The Program Coordinator took action to rescind Comprehensive Permit No. 2006-062. A final inspection completed by the Building Department confirmed that the Accessory Apartment had been dismantled. ' s ' Town of Barnstable,Zoning Board of Appeals Comprehensive Permit No.2006-062-Maria Furlan is.escinded Decision: At the hearing on February 24, 2010 the Hearing Officer ruled to rescind Comprehensive Permit No. 2006-062 Transmission: In accordance with Part If, Section 4.02 and Part Ill, Section 3.72'of the Town of Barnstable Administrative Code, the Hearing Officer transmitted the written decision to the Zoning Board of Appeals on March 1, 2010. As fourteen days have elapsed since said transmittal with the Zoning Board of Appeals taking no action to reverse the decision, this decision becomes final. Ordered: Comprehensive Permit 2006-062 is rescinded. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty (20) days after the date of the filing of this decision. A-copy of which must be filed in the office of the Barnstable Town Clerk. �M 'I Laura F. Shufelt, Hearing Officer Date Signed I, Linda Hutchenrider;Clerk of the Town of Barnstable, Barnstable.County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision had.been filed in the office of the Town Clerk Signed and sealed this �` day of aow under the pains and penalties Linda Hutchenrider, Town Clerk . 2 f CLP`� BAP1�1, TA 3L.E, sS. FEa 10 PX 4: E0 Town of Barnstable Zoning Board of Appeals Comprehensive Permit Decision and Notice Appeal 2002-85-Teixeira Applicant: Mateus Teixeira Property Address: 221 Five Comers Road,Centerville,MA Assessor's Map/Parcel: Map 168 Parcel 080/001 Zoning: Residential D Groundwater Overlay: AP Aquifer Protection Overlay District Applicant: The applicant is Mateus Teixeira,with an address of 221 Five Corners Road, Centerville, MA. Mr. Teixeira is the individual to whom this Comprehensive Permit is issued to create an accessory apartment unit within the basement of a single-family dwelling as an affordable rental unit in accordance with all conditions of this permit. Relief Requested: The applicant has applied for a Comprehensive Permit under the General Law of the Commonwealth of Massachusetts,(lapter 40B-§20-23 and in accordance with the General Ordinance of the Town of Barnstable Chapter III,Article LXV, "Pre-existing and Unpermitted Dwelling Units and for New Dwelling Units in Existing Structures," more commonly termed the "Accessory Affordable Housing Program." The zoning relief necessaryfor this Comprehensive Permit to be issued is that of a variance to Section 3-1.3 (2) of the Zoning Ordinance—Accessory Uses to permit an accessory apartment unit to asingle-family owner-occupied residential dwelling.The issuance of this Comprehensive Permit would allow for an owner- occupied single-family residence with an accessory affordable apartment unit located within the single-family. dwelling. Locus and Background: The property is a.45 acre lot that is developed with a 5-bedroom,3 1/2-bathroom, 5,336 square feet single-family,Colonial style home. The applicant bought the property four years ago and conceived of building an accessory unit someday.The applicant recently.heard.about the program through a.friend and decided to apply for it. The accessory unit is proposed to be added in the basement of the main house. It will be a two- bedroom unit at approximately 2,600.square feet The locus is in a Residential D,in AP Aquifer Protection Overlay District. Procedural Summary.- This appeal was filed at the Town Clerk's Office.and the Office of the Zoning Board of Appeals. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised and notice sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened on July 24,2002 at which time the Hearings Officer announced that the case would be continued due to program upgrades resulting.from-state-level changes in the Chapter 40B process:The case was continued to Augusp21, three more on September 25,2002 No 2002 and continued thvember 6.200*7 and f January 22,2003 at which time the Comprehensive Permit was granted. Officer,Gail Nightingale presided over the public hearing. Also present were Paulette Theresa-McAuliffe,Accessory Affordable Housing Program Coordinator,and Michelle McKinstry,Barnstable Housing Authority. Findings as to Standing and The Comprehensive Permit. At the January 22',2003 hearing,the Hearing Officer made the following findings of fact: 1. The applicant is Mateus Teixeira with an address of 221 Five Corners Road, Centerville. Mr.Teixeira has owned the property since October 26, 1998,as documented and recorded at the Registry of Deeds in Book 15113,page 347. Mr.Teixeira is requesting a Comprehensive Permit to create an affordable rental apartment to be accessory to the single-family owner-occupied residential dwelling. The applicant has submitted a copy of Certificate No. 39068,documenting his ownership of the property. 2. The applicant was issued a site approval letter dated January 17,2003 from Kevin Shea, Director,Office of Community&Economic Development,qualifying his application for the Accessory Affordable Housing Program. The source of the subsidyis the federal Community Development Block Grant(®BG)program 3. The rental unit is proposed for approxiinately2,600 square feet and will have 2 bedrooms. It will be located in the basement of the single-family Colonial style home. 4. According to the Assessor's record,there is a total of five bedrooms on the property. All are in the main house. The property is serviced by a septic system and the site is in the AP Aquifer Protection Overlay District. The Public Health Department approved the septic system at the site for a total of 7 bedrooms as per written approval by Thomas McKeon,Public Health Director dated January 16,2003. Prior to this approval from the Public Health Department,the applicant was granted special authorization to"add an additional leaching field,install a 2500 gallon septic tank,and convert his existing septic tank into a pump chamber"in order to handle up to but not more than a total of seven (7) bedrooms on the property. The approval from the Town of Barnstable's Board of Health is dated December 20,2002. 5. The Barnstable Housing Authority completed an inspection on June 4,2002 of the property where the unit is proposed to be created. The applicant is aware that an official inspection bythe . Building Division will be required before he is given an Amnesty Certificate of Participation. 6. .On August 12,2002,the applicant signed an Accessory Affordable Housing (Amnesty) Program Affidavit agreeing to comply with the programs requirements,including owner occupancy of the principal dwelling unit and further agreeing to comply with the provisions set forth in Article LXV(65) of the Town Ordinances that include their signing and recording of the Regulatory Agreement&Declaration of Restrictive Covenants. The subsidizing agency has determined that the signing and recording of the regulatory agreement qualifies the applicant as a"limited dividend organization" as that term is used under M.G.L.c.40B §§20-23. 7. The applicant understands that the affordable unit will be rented to a person or family whose income is 80% or less of the Area Median Income (AM) of Barnstable-Yarmouth Metropolitan Statistical Area MA) and further agrees that rent(including utilities) shall not exceed the rents established by the Department of Housing and Urban Development 8. The Barnstable Housing Authority has committed to the monitoring of this affordable rental unit. f 9. According to the Massachusetts Department of Housing and Community Development,as of October 1,2001,4.7% of the town's year-round housing stock qualified as affordable housing units. The town has not reached the statutory minimum under M.G.L. c. 40B 55 20-23 or its implementing regulations. Under the Town of Barnstable's Local Comprehensive Plan, the use of existing housing to create affordable units and the dispersal of these units throughout the town is encouraged. 10. Based upon the findings,the project is deemed consistent with local needs because it adequately promotes the objective of providing affordable housing for the Town of Barnstable without jeopardizing the health and safety of the occupants provided all conditions of the Comprehensive Permit are strictlyfollowed. Ruling and Conditions: Based upon the findings,the Hearing Officer ruled that the applicant has standing to apply for a Comprehensive Permit under the General Law of the Commonwealth of Massachusetts, Chapter 40B- §§20-23 and in accordance with the General Ordinance of the Town of Barnstable Chapter III,Article LXV,"Pre-existing and Unpermitted Dwelling Units and for New Dwelling Units in Existing Structures," more commonly termed the "Accessory Affordable Housing Program." The granting of this Comprehensive Permit is to the applicant,Mateus Teixeira.It is issued to permit the creation of an accessory aparttnent unit to a single-family owner-occupied residential dwelling of 2,600 square feet,subject to the following conditions: 1. The property owner shall occupy the principal dwelling as his year-round residence. 2. Occupancy of the affordable unit shall not exceed two adults or a family of four. 3. This unit shall not be occupied by family member. 4. To meet the requirements of affordability,the cost of housing (including utilities)shall not exceed the Department of Housing and Urban Development's (HUD) (or anysuccessor agenc� 80% rent limits as published from time to time. Eligible tenants shall have an income at or below 80% of the Area Median Income,adjusted by household size. Both the rent limits and income limits can be secured from the Barnstable Housing Authority or from the agent of the town implementing this program 5. All leases shall have a minimum term of one year. 6. The applicant shall have the unit re-inspected by the Building Division to assure that all necessary requirements are met according to minimum state building and fire codes. It shall also be reviewed by the Health Division to assure compliance with applicable on-site wastewater discharge requirements. 7. The applicant may select their own tenant(s)provided the tenant(s).meet all requirements of the program and provided that person(s) income is reviewed and approved bythe Barnstable Housing Authority as a qualified individual. The applicant will be required to work with the Housing Authority to provide information necessaryto document that the tenant(s) qualify. To insure that the unit is rented in an open and fair basis to an income eligible individual or family, the unit must be listed with the Barnstable Housing Authority(BHA) and the Housing Assistance Corporation(HAC) whenever a vacancy occurs. Also,the applicant must notify the monitoring agent of a vacancy whenever it occurs. 8. Every twelve months the applicant shall review the income eligibility of those individuals occupying the unit. No later,than a year from the date.of-issuance_of this:.Comp rehensive:Permit the applicant 1 . Q . T f . . shall file with the Barnstable Housing Authority an annual affidavit listing the rent charged and income level of the occupant(s) of the unit. The applicant shall provide the Barnstable Housing Authority any additional information it deems necessary to verify the information provided in the affidavit. Upon any report from the Barnstable Housing Authority that the terms and conditions of this permit are not being upheld,the Zoning Board of Appeals or it's Hearing Officer shall have the ability to hold a hearing to show cause as to whythis permit should not be revoked. 9. The Accessory Affordable Unit shall be affordable in perpetuity(as affordable is defined herein) unless this Comprehensive Permit is rendered void. 10. This Comprehensive Permit shall not be transferable to any other person or entity without the prior approval of the Hearing Officer or Zoning Board of Appeals. This decision,the Regulatory Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be filed at the.Barnstable County Registry of Deeds. If the ownership of the property is transferred, the Barnstable Housing Authority shall be notified within 60 days the name and address of the new owner. 11. All parking for the dwelling and accessory unit shall be accommodated on site,and no lodging shall be permitted on site for the duration of this Comprehensive Permit. 12. This Comprehensive Permit must be exercised and the unit occupied within 12 months of its issuance or it shall expire. Transmission of the Decision of the Hearing Officer to the Barnstable Zoning Board of Appeals In accordance with Part II, Section 4.02 and Part III, Section 3.72 of the Town of Barnstable Administrative Code,the hearing officer transmitted her written decision to the Zoning Board of Appeals on January 22,2003, and fourteen days having elapsed since said transmittal with the Zoning Board of Appeals taking no action to reverse the decision,this decision becomes the decision for this Comprehensive Permit application. Ordered: Comprehensive Permit 2002-85 has been granted with conditions. Appeals of this decision,if any,shall be made to the Barnstable Superior Court pursuant to MGL Chapter 40A,Section 17,within twenty(20) days after the date of the filing of this decision in the office of the Town Clerk The applicant has the right to app this decisi n as outlined in MGL Chapter 40B,Section 22. G ' Nightingale, aring fi er D to S gned I, da Hutche er,Clerk the Town of Barnstable,Barnstable County,Massachusetts,hereby certify that twenty(20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of.the Town Clerk . Signed and sealed this day of -under the pains and penalties of perjury. Linda Hutchenrider,Town Clerk A �a /bcTh Town of Barnstable Office of Community and Economic Development 230 South Street,Hyannis,MA 02601 I Office: 862-4683 Fax: 862-4782 eu►G& Email: comeodey town b stablamaus mUm M a owl, TO. Tom Perry,Building Commissioner OC. Lois Barry,Building Department FROM: Robert Shea RE: Inspection at: /yr Map/ Parcel I have conducted a Housing Inspection of a dwelling owned by.,M o f Te`S 1 c i )r e A 4 Phone: w z o E i r c address: /nu WAH=i Single Family OR Multi Family Unit Capacity. # Bedrooms-� Unit Capacity._ # Bedrooms Unit Capacity. # Bedrooms Unit Capacity: #.Bedroors This unit was found to be in compliance with the State Sanitary Code.Please arrange for the Building Department to do its final inspection of the property in order to grant a Certificate of Compliance for the urnt(s). Signed S'1w- Date Robert Shea - DA1"h MVIE - BY APPROVED REJECTED The following items need correcting: SIGNATURE: . TO 'd S80103dSNI 'A1INnww00 Wo 60: Z0 S00Z-t7T-A0W I � MAY-09-2005 10 :49 PM COMMUNITY. hNSPECT:ORS 5084132025 P. 01 NAM*01Z MILY SECTION 6.HOUSING INSPECTION'CHECKLIST PHONE NO, TENANT APPLICATION NOINSP NONE N c"n O OF INSPECTION TYPPECTION CO Audi( p Initial l]'i 6 c�YY peoial 17 Relnspectlon 0 Annual LAST I"9Pt;CroB; MIT i 8rP1EEt + Number of hildren �(�/ `'`` In family with HOUSING TYPE UNtT STATE ZIP Elevated Blood Level_ (Check as appropriate) ORADC +n R FAMILY COMP MALE FEMALE p Manufactured Herne A ❑ +� c0W Raoert+ P, ADULTS ❑ Single'Family Detached I S Q:FOeTO_ �Nrt v15vt Cr�o PHONE!�.1 S MINORS Duplex or Two Family 9 ❑ Y At P �' ❑ 3 Family House C p ADDRESS OF OWNER OF AGENT CHILDREN - ❑ Row House or Town House G p (UNDER e) ❑ Low Ries:3 or 4 Stories a. e including Garden Apartment a FAMILY SUBSIDY erz ❑ High Rise:5 or more etorles ❑ MUM Family 19�Pass O F II 0 Inponcluaive Date Passed ��}� N0'of 1Opme U°ed for eltlping oraoWnnevfed!!�r,ale:yaal' � . 1VING ROOM YES�fT�EM PASS FAIL CONC COMMENT 1.1 Living Room Present 01--22 Elecirioity Electrical Hazards Security Window Conditl n,Screens Calling Condition 1.7 Will Condition ti 1.8 Floor C.ondldonMilli .� I KITCHEN YES No l".. PASS PAIL cone COMMEW- Ate. 2.1 Kitchen Area Present 22 Electricity 2 3 Electrical Hazaras 2A Security 2.6 Window Condition,Scrsene N. 2.6 Call Condition 2 7 Well Conditon 2.8 Floor Condition \ 2.0 Stove or range with oven tTf) (.LL) 1 2.10 Refrigerator (LL) 2.11 Kitchen sink 2.12 Kitchen spade for storage&prep 2.13 Ventilation 3.BATHROOM red MO I" PASS PAL CCNC COMMENT 3.1 Bathroom Present 3.2 Electricity 3.3 Elenrical Hazarcia. 3.4 Security 34 Window Condition.Screens 3.8 Ceiling Condlllon 3.7 Wall Condition 3.9 Floor Conditon 3.9 Flueh Toilet In enclosed room In unit 3.10 felled wash0asin or lavatory in uM 3.11 Tub or Shower In unit 3.12 Sathroom ventliji loo rmm 4.OTHER ROOMS USED YES IN.. "o. FOR LtviNG.a HALLS PASS FAILCONC COMMENT , 4.1 Room Code*CM Room Location Check One) ❑ Ri l/Cenrer/GPt 4.2 Electric) Allumination Check One ❑ FronvCent®r/Rear Floor Level 4.3 Eleotrioal Matarde 4.4 Window-Condition 4.5 Secur a.e Calling Condition 4.7 Well Candllion 4.8 Floor Cdndltlon 4.9 Natural LI ht 'ROOM CODES.--1 s Bedroom or env rnrmr rnn,,,�,...�,.,,.,�;.�r^y.,mo..._•,��yr,�y .�e®nit ywn 2.pining Room,or OiNng Arne p noorn.Family Room,pen.Playroom,TV ROOM 5 c Admtlonal Bamn)om 7 0amge 9=Omar a a Entranoa HYIIe,Corridors,Halle.stalroeeea 6.A°IC White CO for Age, e.Laundry PY ® cy.-Yellow Copy for Landlord-pink Copy for T®Want- I 1 ,may i ��71,-2 �oFIMWE�� Town of Barnstable Regulatory�M�AB�, g Y Services 'b 639. ,0 Thomas F. Geiler,Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM TO: Tom Perry FROM: Lois Barry DATE: 1/21/04 RE: Amnesty& 221 Five Corners Road See attached memo. Jack Fitzgerald inspected the property and found that the construction is complete. They did not have a building permit or any inspections. At this point, if they took out a building permit, Jack would not want to sign off because he did not do any inspections. What do we do about this unit? In the past, I asked Paulette to include a condition in the Comprehensive Permit requiring the applicant to obtain a building permit before any construction or, in the case of an existing unit, a paper-trail building permit. She indicated that Legal feels the language "6. The applicant shall have the unit re-inspected by the Building Division ..." covers it. (See attached.) Also see the most recent Comprehensive Permit we have received: 295 Patriot Way, Centerville. This is for a new unit and it is not clear that a building permit is required— see No. 6. It is also difficult to explain to the property owners of existing units that they must pull a building permit and pay a$25 fee for the family apartment when the Comprehensive Permit does not require it. Do you think you might contact Amnesty/ZBA/Legal to get strong language in the Comprehensive Permits requiring building permits for both new and existing units? J040121a t �1 1r ct� gvt- " Iry eu ��' . � /��® y �� ? �� . � �� i ,�� :� { , : JB k 1 13IL PS211 1.2 - 1.:,J.-2130a 1,2-C 5.15 REGULATORY AGREEMENT " AND DECLARATION OF RESTRICTIVE COVENANTS THIS REGULATORY AGREEMENT and DECLARATION OF RESTRICnW COVENANTS is made this day of De-_�e4., t ,2003,by and between Marcelo T.Assis,Mateus A.Teixeira,and Wilma M.Teixeira of 221 Five Corners Road, Centerville,MA 02632,and its successors and assigns (hereinafter the "Owner"),and the TOWN OF BARNSTABLE (the"Municipality'),a political subdivision of . the Commonwealth; WHEREAS the Owner has been granted a Comprehensive Permit under Massachusetts General Law Chapter40B and local regulations llythe Zoning Board of Appeals to permit the creation of an accessory apartment in- an owner occupied dwelling which will be rented to a_Low or,Moderate Income Person/Family(hereinafter "Designated Affordable Unit";and NOW THEREFORE,in mutual consideration of the agreements and covenants contained herein,and other good and valuable consideration,the receipt and sufficiency of which is hereby acknowledged,the parties agree as follows: L_ PROJECT SCOPE AND DESIGN A. The terms of this Agreement and Covenant regulate the property located at 221 Five Corners Road, Centerville,MA, as further described in Exhibit"A"hereto annexed. B. The Project located at 221 Five Corners Road,Centerville,MA will consist of one accessory apartment unit which will be rented to an eligible low or moderate:income individual or family(the"Designated Affordable Unit" or the"Unit"). C. The Owner agrees to construct the Project in accordance with the terms of the comprehensive pennit, Appeal No. 2002-85 and any plans submitted therewith and all applicable state,federal and municipal laws and regulations (A copy of the comprehensive permit is annexed hereto as Exhibit"B"). D. The Owner agrees to occupy the principal dwelling unit located on the property as their year round residence in accordance with the terms of the comprehensive permit. II. THE OWNER'S COVENANTS AND RESPONSIBILITIES A THE OWNER HEREBY REPRESENTS,COVENANTS AND WARRANTS AS FOLLOWS: 1 In receiving the.comprehensive permit to create the Designated Affordable unit,the Owner agreed that the Designated Affordable Unit shall be set aside in perpetuity for the public purpose of providing safe and decent housing to persons of low.'income(herein defined as 80% or less of the median income of Barnstable- Yanmouth.Metropolitan Statistical Area(NISA) and that the Designated Affordable Unit shall be deemed to be impressed with a public trust. 2. The Designated Affordable Unit shall be rented in perpetuity to,a household with a maximum income of 80% of Area Median Income or less of the Area Median Income(AMI) of Barnstable-Yarmouth . Metropolitan Statistical Area(MSA) and that rent (including utilities) shall not exceed the rents established bythe Department of Housing and Urban Development(HUD)for household whose income.is 80% of the median income of Barnstable-Yarmouth Metropolitan Statistical Area. In the event that utilities are separately metered, the utility allowance established by the Barnstable Housing Authority shall be deducted•from HUD's,rentlevel. 3. The Designated Affordable Unit will be retained as permanent,year round rental dwelling units with at least one-year leases. - 4. The Owner has the full legal right;power-.and authority to execute-and deliver this Agreement. Town of Barnstable CAB . : Regulatory Services 9`b 69• .0� Thomas F. Geiler, Director ATED MA'S A � Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM TO: Jack FROM: Lois DATE: 1/13/04 RE: 221 Five Corners Road, Centerville Amnesty issued a Comprehensive Permit for an Amnesty unit at this address in February 2003. Yesterday, Paulette sent me a copy of the recorded decision with a note that the applicant may not have pulled a building permit for the apartment. I checked the file, didn't see an application, and called Mr. Assis. He didn't know they needed a permit, and will be-in this Friday or Monday to apply. He may ask you for help with his plan. At some point, we will receive a form from Amnesty to inspect the unit and issue the Amnesty Certificate. Monday,December 01,1997 8:10 AM To:Tom Perry From: Philip B.McLaughlin Page:2 of 3 MCLAUGHLIN CONSULTANTS 38 Homeland Drive Marshfield, MA. 02050-3510 Phillip B. McLaughlin 781-834--1089 fax 781-834-1001 phone ----------------------------------------------------- FILE# MS v Pomykala FIRM: Robert H. Greene P.C. Attn: Ann Marie Phone: (508) 5B8-7729 Date of Report: November 26,1997 Assignment: Follow up on report of 10/31/97 written 11/4/97 with Town of Barnstable. RE PORT: Subject(s) : Pomykala, Ronald Current Address:, 'l:lS�?c"t.1 7 of f1leS at. UilClln'7 de par t 1Clerlt, =o1gj Of L2LrStab Tl 71esdlay, iVC,JejYber 2:, 1' 9.7 at- 1 .?: �ni 'i y only rG to J..�,.i file _._yin_ C_��. i� m addressed to Prior (_�vfner Ho-4;-ev Earde-thi an dated Fel,- ual--r _._ 1 9E'9. Denial of apt='i_caLion to Ln.stall replacement septic system P,r.3SJn. Given:" lail,_ire to 1�_d,re ti,_._._7 t~Y'a-vTi i 1' a prCfessional P_r:�ineer, Lest holes not eYcaVa-Eed, a_-d a pc Cl t iOrl Lest `:daS .,(-It 3zerfcr-me._: for the prop_)sed add' Jo rr The-re _s a -:op1- of t'tie api l .cation _ol. a 10 rcd-rt addition and plan of the S.i to attached, -%,f` d.c r_ ',Jas apf_%r:'OVea, S "sial--j er-t. to Sept.Lcl ,yst----: ai=l=_o a in coimp-Lian_:e v,rith Code and form requ.lat.i�-r-�s. rr In a nl_1tshe'l c'p 1-l -2 tiaa :Jenied, wen- ahead d.n.d now Porto.-Vkal'a has .:Gnt'L_ Ued to ' C wi71`.. w t.h'oi t. ',-er i--1 S, or pla 7 erry at the 01-1i1'= inc,, Je-(D- .has =lot. been avai_'h.l e since it"il% phone COn\%crSctlC'T1 th `7i'_"[l c-i- 4, 1,997 . H-Ls po.sit.ion, at that time ,v,ia , t' Lat. it. ?i�L not matte-_,- -wl-iat any pri-or C'vJr_-:.e� had (:Lone, this is P,mykala' S ,rCbiem. ilir::. c'eY7 1; ,,ra,s Go` to 11reet J,iith hirt-( that da—,,7. T arr.. r alt.ili(7 a one ..;all f rora 1`'"_i .Perry art an po t to See -L. there is a curr-nt. inspection sheet, �_.- --as be-n workinq o_Jl . Tt ti_er'e iS a r'e-,7 I 511= L, 1t :^Jiyl cite ✓l(iiat.l'JT7S U7:1LCh 4•Je: can addre=;s in order _-t their apl-)earance a.n a Se'Jeritv. Monday,December 01,1997 8.10 AM To:Tom Perry From: Phillip B.McLaughlin Page:1 of 3 Name:Phillip B.McLaugh?vi Company:McLauglilui Consultwits Voice Niuiiber:'1818341001 Fax Ni.unber:7818341089 38 Homeland Drive 'Aarshfieid,MA 020S0-3510 Date: Monday, December 01, 1997 Total Pages: 3 Subject: 221 Five Corners Name: Tom Perry Company: Building Dept Town of Barnstable Voice Number: Fax Number: 1-508-790-6230 Note: i i I Monday,December 01,1997 8:10 AM To:Tom Perry From: Phi Q I McLaughlin Page::;of 3 The foregoing report as obtained j_-`v the consultant from public records, or data services. There .are no intentional additions or deletions in the body of the report. The following matters are Copies of identified credit -b,-,.Yea-ij. headers, post-al- traces, telephone record inquiries, Registry of Nktor Vehicle inquiries, Bureau of Vital Statistics searches, and as such are accessible to the general public. This report is provided for the benefit of the Client as holder of at debt, or agent attempting to Collect a debt. The-, consultant cannot warrant its in a court of latiJ, without. prior consent. Monday,December 01,1997 8:14 AM To:tom perry From:Phillip B.McLaughlin Page:1 of 5 Name:Phillip B.'McLau.Willin Company:I\IcLauglilin Consultaiits Voice Number:7818341001 Fax Number:^r 818341089 38 Homelar_d Drive Marshfield,VA 02050-3510 Date: Monday, December 01, 1997 Total Pages: 5 Subject: first report Name: tom perry Company: building dept Barnstable, Ma Voice Number: Fax Number: 1-508-790-6230 Note: thought you might look at this as well i Morday,December 01,1997 3 14 AM To:tom perry From: Phillip B.McLaughlin Page:2 of 5 NCLAUGHLIN CONSULTANTS 36 Homeland Drive Marshfield, MA. 02050-3510 Phillip B. McLaughlin 781-834-1089 fax 7B1-834-1001 phone ----------------------------------------------------- FILE# MS v Pcmykala FIRMS: Robert H. Greene P.C. Attn: Ann Marie Phone: (508) 588-7729 Date of Report: October 31,1997 Assimurtent: On 1'_riursday Oct.,ober 501 1'9'?7 .Zll'+`- io,-eer 'vas engaged t' ) condlUct a publi shed for'eclosiar- auctio_.n sa I e an b e h a i f of the attorneys c11,erit at 1 1:00 am at a s.'• to K.rlol"�-1 as _:'1 Five Cc r'.Hers Road, .;enterv'i1_e, tarns-i_a.'Die Coup..T=,,j Tiass:iGlSusetts. T'1 .:: sale was a( jour ?;=C d the clients reC"-lest. i iL -_ Decelllbel_ ice, 19 ?7 c' �v . _' 1 z1it, a :d the a,,icti(--,neer drove to read ai'--)d t.._lE I1rit�C? of ad j o',_zrmcLent to the ne,/a ate a---d t ii 1 7.� 11 01 =itthe a_ ,t iO"ee r 6vus a -prOac7ed X)V a aged i(t31e frG1T1 the pr0j%ertV W1'10 identi.f i ed h ra el_ as Pon Pcn-,A--a.la, and a.s.ec the 1T1'r'r1.Or of t.11e l r'O +=r" v� t liS .�:iein rattilei T1L'. La1, A:UteiiclY^ :seful to the client, to ;1a..; some act,-!al observati( :ci, the auctioneer' -11ov ed. ten _Tin-itesm t'o vie-w rile interior a_",d review r+olnts aro'._ind tr.e ext-r'' T '\pith =.lie Ply report. is as fo11.o a. REPORT• Subject Property: Originally this Str'_i.Ct.L<.= i:,,as a rattler ranch style dwellinct similar to the f,,-rul ,-,r five dozen that. Surrod .it !"?e.l( I"1bGrtZOGQ with `.^ _ .-,r�Y-'�r-,rr ', _"1C1 h `ns (_ d _:. the 1970's . The neighbc)r1!c .>d fo- t _e, f __Ypose of ._ Wort 1 ' .ta ieS of state roue 26, any s col r.d d westerly -j�v farrb rt t till Road, easte- 1 b— five C�,rne_s Road and southerly b_.,, the in_e_'s ct_orl of Lan-bert M-L-11 and Five ( '1)r1'er', Per--)ad. The: area 1s residential -vvitl: no rrli xec use o` coi-amercial c7P1_-Lcat-__;r. I'd! houses are bui- _t "'Tit}—in a Ewen-y five year perlo: ._L'olTi 1 1•-'_ .nroLtgh 19'97, ana' ha-,Je a ge:!eYal market ,a1i-le of tetW'e S1�U, 4_'l_.'•t� up to and including -�i 70, 000 Values Diary 'cased upon of living space_, lot SiZe, diSta-c'e frorti Pte GE( rii! !_ ta.' Tlol. =. _1T_ L�_cs: are public, i?iTn Ta ar and .Sewage disposal pr'' Va. .c l': _- an are._, 'Vlitii t0`v11"1 iYlalnt.ained roads. Public _-S T1Gt 1`.'ailallle ,,TlthaL—It a 1 le neicjhl:or'tlood is c_oSc: t aii convenlences, chopping educaL.=on Win"--1 central trar_spert :t.i crl hun to rn-t..r-- Current Address: 221 Five Corners Road . Centerville ( a township within the town of Barnstable) Barnstable County, MA. Original address: 210 Five Corners Rd Centerville, Ma Monday,December 01,1997 3:14 AM To:tom perry From: Phillip&McLaughlin Page:3 A 5 Physical Structure: The original ranch style has burl iT!Odifi :j, WWI I t.O, =iT7d ot.tle•rwisc over reproved since its riginal constructic:n. T';o additions at the ends have beei-i rilade, as we,_! as a t`on story addition to the Original structure have been begun a--,-i.c,. are s1_ibstar_tia.11l complete. !"here are now four bedrooms th.a',: ,:11d not exist in the Or i C'•i nal house, t':,e room configtiratio—ns is. :__ h that n+::+thing:, matches the original i•or:,_ginal foundation wall, and rear via_1 still eXi. t. Basement Level: There is a two c «_ 7arage, 1_lnder, a. fa-'i-i ly ro in, what -appears to be a Spare bedroom, he remains Of a bathroom, in a state of renovation . The ceiling have been cut Out to allow access to p1.1u-,k+1ng and heating pipes . Two tLa.r-naces hOt watFr I F-aters are on this floor. General debris anc clutter abC :nd First Floor: Spacious kitchen ?,,Tjth glalit r cab retry, a _,erter i.�land cook area. Note cabinet handles are aissina There is a grand foyer 1OOking up the equivalent Of three stories cathedral ceiling. R bathroom_ in disrepair 1S to the _ear of this floor, and a -.�Gs er suite added in the addit.iCn. The font dining room abuts the kitchen, a Formal Living room is . is:sing _Light fixtures and cover plates. The mad room, side entrance is .�f ._rlishrd. Second Floor- A Laundry area present., ti". e u_. e t bedroom's,-a oom� ,ea is -�re�,. ..., ast .r ;_t. bees ;rep r�_�- ,, and tUro baths, all in various stages Cf repair Or wisrepair. There are building materials scattered t _r ughout t.l.e _u=.e, sheets of wall board, w nC1o+'.Js, door's unhiniig, Z•,?1rinq 1S at beet hapha"yard. in Open Ceilings and vJa.il space, t:Xt+J:'!SiGn Cords have br?eri r'_;I7 tO k-Oxes . Telepho.e (--able abounds as coaxia_! Cable. Notes: TWO decks, or the evidence Of Sa.-cte with French Doors 'lead frCIT! the first f1OOr Suit', and second floor n,,aster SL:it�. There are no decks outside. A drop of I_,et.vseen ten arud thirty feet ;"�culd result in the irrprudei t Opening :.`f t_`iese doors for eO"ress. Site. is Sloping, street to house, drops behind house to 4vhat may be wet area in real" Of lot . (Flood Zone C W;* Federal Map) There is an evide'n ce Of septic per(_o i atd.oi--, at. least by s!uell, and on a clear. coo;_ day, an o+j -,r e� i_: ted. A. drive nraa entering from Westminster Road is paved to the site and str)uct"re. The incline up to the Street. is not urumanageab_e v; tFl con-,-eent oral autoIT"1:)iles. Monday,December 01,1997 8 14 AN', To:tom perry From: Phillip B.McLaughlin Page:a of 5 General Observations: S_J +I-.e a r s 4 1 1 C I anc-i. water 71.a-\.7 1-iave sc)me pro.blena but ,_it-Lng al7C cLtificaticn be n0ted 'a s 1:-_a a e.,-r ia.1- C)_L to i e LS v ol at i or lack of p�-Tlits, a w..-)ul,,:JJ'_ h-e prudent T-(7% enter it-Ito any won'-_ at 't--h 1_s s-L t-e, at th t Laie ..e.r e are fol-t--h !:)\,r in h' s A--h the COTiSlUlt-ant. as an ar:)praiser v,,01-ild not, Cornr'-'_e-'nt on. asKed tihat consultant prepare an ap',praisal_ re-oc%rt . This -v,,,.-s _" ned E, situation -)f ter'T_ -:,f e-.:-)_g=Creme_n+- as auctic)neeer, al-ld For ar:�,,- r,')j7bei of other ��,ctential i,.-!ay a r i s e iron, an- L-rovi e r In genes al tlll - O'pinlicjn of the crinsi_,.11ant, as, an appraiser tl- v'lould suggest n' c;,,,f e lri-Lprovement of t1he -e d=r-'rig th- ne.il The- -viork present `Ls c,eneral 17.,, adecivate, althc)ucTl-� incc,-T lete, ar_�d a---I c)ccupancy perrut from t'he =own a cl be Jiffic-,-,_ilt t.._-. -.)J.-.tain, -unclei current .,-a,-)c r and mat er al s Lc c.-:1---rLa-, ez.,e t,:-ie .--Ft ructure to mal,e 4L t. _J t 1-71,Ltd e proposing a I' I raat er.,_al,.I= on S 1 T_e- .37-a,e , cr site, n v,ereot n:aged wouLd conser'vati-veil -vr 11--e In ne arc*+.,_;ur.)t o f 0, 0 0 0 lov a cp_ialifiad ca-l-penter, pla-r-e-rer, a loui ldl inG inspector .Reco=mndations: To-v-,n of Ba_-Mstable Bu_-'; D_=ot: Tom Perry 508-790-62.27 F]'--les shciaid t)e reviie-wedi for comp_,laint_s, out_st.anding C)latio is pe_yir`ts issued, permits un iSs-aed, and lc'otrpli ance - s 2 . _71-t-le W 4 "n I'D 'e, D t i Companv, part cf problen I suspect is that s-vst-e'm has i-ot been :service-l'- 3. Structural r or tl"To rrLL S S _0Uj_a. ai._pear 1-hi--i iq-Rs there but either removed, or fel li flom "-cn+..a--t any trade syi.ien -who On pro-;ect over �_!,e years for nctes and clbs'_�rvz itioiis. T1111.s rc,.ay appear frolct eins at-. .-eQ.-istry of deeds, arl(_-� Pe=Ld ts- pulleck oi-i tllfte The for-E.--joinG ,,ias obtaine� lby the co? scitant 'rora public records, or data. servlces. There are :_io �nterit-Lo-inaL ad+diJtJLcn_s or deler-irns n T---Ie bOdy o� -c.,-,e re-,coy- . The If,-)I I rl q mar-ter-s are co-cies of idlent.ifiec,,' cre:Jit 'Dur.eau _e�aclers, Y_tosl�ai traces, telephcne record 1nquir-le-5s, R'.-e-g-L-tr-y of Ve_h_'LC_'-,e _1r.cjji_rie3, ED-ireau of V-1t.al Stat_is-L.icas, sears-i-les, and as suc.f. are acce�z`ble to the general uu-bl'! c. This re-ort is p_l,-_)',,'-'Lded_ fc-z the of the cl, ient- as 7 holder cf a debt, or agent at-teqpt.ng t1c) a del>'t -he Monday,December 91,1997 8:14 AM To:tom perry From:Phillip B.McLaughlin Page:5 cf 5 consultant cannot b:rr:ilk. its "Wssi ilit.,,i 1_rl a court Oi law, wit'f70L1t t--)ZiC,r CCi1SE�nL. NEW SMOKE DETECTOR REQUIREMENTS ARE NOW LAW. E Y=N THE ADDITION OF A NEW BE® ROOM WILL TRIGGER AN oFFiCS s UPGRADE OF THE SMOKE DETECTORS ��l��Y� ®Q w FOR THE WHOLE HOUSE. YOU MUST PLAN ACCORDINGLY AND HAVE YOUR 1p ELECTRICIAN TAKEOUT THE APPROPRIATE - PERMIT AT THE FIRE DEPARTMENT. 1-4 Glehe} t 5 Door- 4r k"4dow SMOKE DETECTORS O.K. ��n�k� 5��g ^�� '8�'�ctss • 4ifXjV6-UALD-1 -8 G DEP ClE"tEP,-V%LLe A �026�2 S-p&e IENT' j4PARTVWf-Wr LA -116Y Z RVR14I40 't 5osl 4 2-?,"?l q_ , c* Bk 18271 P0234 0114900 03-01-2004 a 02:OOv DEED RESTRICTION WHEREAS, MARCELLO T. ASSIS, MATEUS ASSIS TEIXEIRA and WILMA TEIXEIRA of 221 Five Corners Road, Centerville, Massachusetts 02632, are the owners of the land with buildings thereon located N at 221 Five Corners Road, Barnstable (Centerville) , Barnstable County, Massachusetts, more particularly described in a deed dated April 26, 2002, at Barnstable Registry of Deeds Book 15113 Page WHEREAS, Marcello T. Assis, Mateus Assis Teixeira and Wilma \� Teixeira, as the owners of said property, have agreed with the N Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works con- struction permit in compliance with 310 CMR 15.000 State Environ- mental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; In WHEREAS, the Town of Barnstable Board of Health, as a pre- v condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.000 State Environ- mental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single-family home on this property, is requiring that the agreement for the restric- tion on the number of bedrooms in any house constructed on the, lot be put on record with the Barnstable County Registry of Deeds by recording this document. NOW, THEREFORE, Marcello T. Assis, Mateus Assis Teixeira and Wilma Teixeira do hereby place the following restriction on the above-referenced land din-accordance with the agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title; 221 Five Corners Road,_Barnstable:(Centervillej;Massacfiu SYKES AND COLE ATTORNEYS AT LAW setts.,�may have_constructed upon The 1'o_t a_house containing_no _ 420 SOUTH STREET POST OFFICE BOX 1358 more thanSEVEN—(-7-)—bedrooms:] Marcello T. Assis, Mateus Assis HYANNIS.MA 02601 TEL.(SOO)T75-9147 Bk 18271 Pg 235 #14900 Teixeira and Wilma Teixeira agree=that-this-shallrbe_permanent= r------ — deed_restriction affecting-the subject premises_. Such restr c- tion may only be removed or modified by the Town of Barnstable Board of Health or its successor. For our title see a deed dated April 26, 2002, at Barnstable Registry of Deeds Book IS 3 , Page 14-7 . EXECUTED as a sealed instrument this 1st day of March, 2004. Marcello T. Assis Kates Assis Tel Mira i W lma Teixeira COMMONWEALTH OF MASSACHUSETTS Barnstable, ss March 1, 2004 Then personally appeared the above-referenced MARCELLO T. ASSIS, known to me to be the person who executed the foregoing instrument and acknowledge the same to be his free act and deed, before me tv` � 5j zg h 'S F Jo p V. Maruca Notary; My c mmission expires: Apr"11 ,,,. 00g SYKES AND COLE ATTORNEYS AT LAW 4ZO SOLMi STREET POST OFFICE BOX 1358 2 NYANNIS.MA OZ601 TEL.(508)77"147 BARNSTABIE REGISTRY 01 DEEDS I Page 1 of 1 Edson, Linda From: McLaughlin, Charles Sent: Wednesday, May 03, 2006 1:01 PM To: Edson, Linda Cc: Smith, Robert Subject: RC Zone Hi Linda, To your question, the RC zone does NOT allow for the renting of rooms. Therefore, unless the property owner can produce a building permit or certificate of occupancy or demonstrate a history of use that predates the ordinance and qualifies as a non-conforming use, then the renting of rooms would not be allowed. Let me know if you have any questions. Thanks. Charlie L 5/3/2006 I Barnstable Assessing Search Results Page 1 of 2 Home: Departments:Assessors Division: Property Assessment Search Results New Search 221 FIVE- CORNERS R1OAD Owner: 2006 Assessed Values: ASSIS, MARCELO T& Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $337,100 $337,100 168 /080/001 Extra Features: $33,100 $33,100 Outbuildings: $0 $0 Mailing Address Land Value: $ 160,100 $ 160,100 ASSIS, MARCELO T& TEIXEIRA, MATEUS A&WILMA M Totals $530,300 $530,300 221 FIVE CORNERS RD CENTERVILLE, MA.02632 Tax Information: Tax information is currently not available for 2006 Construction Details Property Sketch Legend Building Building value $337,100 Interior Floors Hardwood Style Colonial Interior Walls Drywall Model Residential Heat Fuel Gas Y- Grade Average Plus Heat Type Hot Water33 Stories 2 Stories AC Type None ' S. Exterior Walls Clapboard Bedrooms 4 Bedrooms Roof Structure Gable/Hip Bathrooms 4 Full + 1 H Roof Cover As h/F GIs/Cmp living area 3392 y Replacement Cost $378801 Year Built 1971 Depreciation 11 Total Rooms 9 Rooms Land Lot Size(Acres) 0.45 Map requires Plug in: http://www.town.bamstable.ma.us/Assessing/Assess06/displayParce106.asp?mappar=1680... 4/11/2006 w I �. �1�,� ��i �� pFIKE toy, Town of Barnstable Regulatory Services * BARNSTABLE, v MASS. Thomas F.Geiler,Director 0;. 1% Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4024 Fax: 508-790-6230 April 28, 2006 Ms. Maria Furlan 221 Five Conors Road Centerville, MA 02632 RE: Illegal Apartment-221 Five Conors Road Centerville, MA. 02632 Map : 168 Parcel : 080/001 Dear Ms. Furlan This letter is to inform you that you currently are in violation of Barnstable Zoning Ordinance 240-11. You must contact this office by May 25, 2006 to arrange to bring the above address into compliance or be subject to fines of no more than$300.00 per day of non-compliance. Thank you for your attention in this matter. By Order, Lin dson esty Zoning Enforcement Officer Building Department l Q:zoning5 iL THE FOLLOWING ' IS/ARE THE BEST . IMAGES FROM POOR QUALITY ORIGINALS) DATA l" + S °F1HETa,, Town of Barnstab :. ti w� Regulatory Services vBA MASS.x Thomas F.Geiler,Director 1639. �e t6. Building Division Thomas Perry,Building Commission;' 200 Main Street, Hyannis,MA 0260E www.town.barnstable.ma.us Office: 508-862-4024 April 11, 2006 i Ms. Maria Furlan 221 Five Corners Road Centerville, MA 02632 Re: Illegal Apartment—221 Five Corners Road Centerville, MA 02632 Map 168 Parcel 080-001 Dear Property Owner: Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincerel , Li Edson esty Program Zoning Officer Building Department yforms:zoning3 Amnesty Program Helping to Make Affordable Housing Possible TBarnstable WARM Certificate of Compliance This certificate indicates acceptable minimum habitable requirements per Massachusetts State Building Code and Town of Barnstable zoning ordinances in accordance with the Amnesty Program. Location 221 Five Corners Road, Centerville, MA. Unit Capacity One b orn not exceed two people Inspector M/P No. 168/080 001 6/8/2005 Town of Barnstable Office of Community and 'Economic Development 230 South Street,Hyannis,MA 02601 Office: 862-4683 Fax: 862-,4782 KAM �b�q• . Email: comecdeyC gN%%.b=stable.maus. N'110,00W, TO: Tom Perry,Budding Commissioner CO Lois Barry,Building Department FROM: Robert Shea RE: Inspection at: Map/ Parcel I have conducted a Housing Inspection of a dwelling . owned by. A r're us 1 c e R 4 Phone: xf 20 s a r c address: /W !/1S Srngle Family OR' Multi Family Unit Capacity. # Bedrooms Unit Capacity. # Bedrooms Unit Capacity: # Bedrooms Unit Capacity: #.Bedroors 'This unit was found to be in compliance with the State Sanitary Code.Please arrange for the Budding Deparm ent to do its final inspection of the property in order to grant a Certificate of Compliance for the unit(s). Signed SIUA_ Date Robert Shea I DA1Z fly /�s�' /rnv� By ��" APPROVED REJECMD The following items need correcting: SIGNAL' W: . �.- . • r�ri�r.t i•-•mar Cvr1t ^17JCLtT 1 1 T60 rY;-1 1.1 P1-1 1.11-1 CQ` 7Q CQQ7�isT�1HW Barry, Lois From: Dillen, Elizabeth Sent: Wednesday, June 08, 2005 10:23 AM To: Barry, Lois Subject: RE: 221 Five Corners Road, Centerville Yes, the Certificate should be for a one-bedroom, not to exceed two people. I will ask Art if there needs to be a minor modification to the decision. -----Original Message----- From: Barry, Lois Sent: Wednesday,June 08, 2005 10:19 AM To: Dillen, Elizabeth Subject: RE: 221 Five Corners Road,Centerville Do you want me to prepare the Certificate of Compliance for one bedroom? How do you want to occupancy to read - .,not to exceed two people"? Do we need an official amendment to the documents? Lois -----Original Message----- From: Dillen, Elizabeth Sent: Wednesday,June 08, 2005 10:02 AM To: Barry, Lois Subject: RE: 221 Five Corners Road,Centerville That's a good question - it looks as though Paulette drafted the decision to allow for the potential to make it a two-bedroom unit. However, the owner understands that his Certificate of Occupancy and Certificate of Compliance are what dictate the number of occupants allowed, and that he will need a building permit to do any additional work to the unit. Original Message---- From: Barry, Lois Sent: Wednesday,June 08, 2005 9:53 AM To: Dillen, Elizabeth Subject: 221 Five Corners Road,Centerville Beth, We actually have a floor plan showing one bedroom, so I can prepare the Certificate of Compliance, giving unit capacity of one bedroom. Do you need to revise your documents or send me something limiting the occupancy to two adults (rather than two adults or a family of four)? Does he realize that he will need a building permit before he makes that other room a second bedroom? We will then need a new Certificate of Occupancy and a revised Certificate of Compliance. Lois 1 Boa 18271 P 0 234 01.4900 03-01-20ip4 � iD2�t�t�o DEED RESTRICTION WHEREAS, MARCELLO T. ASSIS, MATEUS ASSIS TEIXEIRA and WILMA TEIXEIRA of 221 Five Corners Road, Centerville, Massachusetts 02632, are the owners of the land with buildings thereon located N at 221 Five Corners Road, Barnstable (Centerville) , Barnstable County, Massachusetts, more particularly described in a deed dated April 26, 2002, at Barnstable Registry of Deeds Book 15113 Page 3y7. , WHEREAS, Marcello T. Assis, Mateus Assis Teixeira and Wilma N Teixeira, as the owners of said property, have agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works con- y struction permit in compliance with 310 CMR 15.000 State Environ- �' mental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre- condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.000 State Environ-' mental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single-family home on this property, is requiring that the agreement for the restric- tion on the number of bedrooms in any house constructed on the. lot be put on record with the Barnstable County Registry of Deeds by recording this document. NOW, THEREFORE, Marcello T. Assis, Mateus Assis Teixeira and Wilma Teixeira do hereby place the following restriction on the above-referenced. land in accordance with the agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title; e C n r Ba SYKES ANO COLE ATTORNEYS AT LAW 420 SOVfH STREET 7. - POST OFFICE BOX 1356 Marcello T. Assis, Mateus Assis HYANNS,MA 02601 TEI..(508)775.9147 f i Bk 18271 Pg 235 #14900 Tei eira an Wi ma eixe ra agree tha thi sha"l bombe geVNI-11 1'�*a Qes icti•m af�eeti6n ale su�b'e t psSuch restric- tion may only be removed or modified by the Town of Barnstable Board of Health or its successor. For our title see a deed dated April 26, 2002, at Barnstable Registry of Deeds Book IS 3 Page 14 7 • EXECUTED as a sealed instrument this 1st day of March, 2004. ��llUCJ�IJ 1 Marcell0 T. Ass s ate s Assi-steixeira tE W lma Teixeira COMMONWEALTH OF MASSACHUSETTS Barnstable, ss March 1, 2004 Then personally appeared the above-referenced MARCELLO T. ASSIS, known to me to be the person who executed the foregoing instrument and acknowledge the same to be his free act and deed, before me Jo p V. Maruca Notary: 'T My c mmission expires: Apri`(q` F;`;O: g. Olt SYKES AND COL.E ATTORNEYS AT LAW 420 SOUTH STREET POST OFFICE BOX 1358 2 HYANNIS.MA 02601 TEL.(506)T75-9147 BARNSTABLE REGISTRY Of DEEDS f APR.11.2006 10:52AM BARNSTABLE COWECO.DEVELOPMENT NO.060i P.1/1 MASSA,CHUSETTS QUITCLAIM DEED T/We Marcello T.Assis, and Wilms A Teixeira,of 221 Five Corners Road, Centerville,MA02632 and MateusA.Teixeira, of 386 Cooper Road,Whitefield,NO 04353,for consideration paid,and in full consideration of Seven Hundred Ten Thousand and 001100 Dollar's(US$710,000,00),grant to Maria Fturlan,of-West Main Street, Hyannis,MA 02601 with QUITCLAIM COVENANTS The following property in Barnstable County,Massachusetts; The land with the building's thereon, situated in Centerville,Baimstabie County, Massachusetts,being.shown as Lot 22B oa a plan or land in Centerville,Barnstable, Massachusetts,propertty of Robert 1~leske and Robert Payton Scale 1"_30 feet September 1978 Whitney&Bassett,Hyannis,containing 19716 square feet according to said plan,being recorded in Bamstable County Registry of Deeds. Subject to a deed restriction dated March 1,2004 and recorded at B=stable County' Registry of Deeds Book 18031 Page 211. Being the same Premises conveyed to the herein nand Grantors by deed recorded with Barnstable County Registry of Deeds in Book 15113 Page 347. ! MAg CHUS T 3't' TEE S x gg �y TTpp D8. , BARN�TABti� ��t1NT� REG� �� flF D££ Date: 01-31-20�Ab a of:2�vt► ' Ulti 1260 Doe#t 6417 Feat $2f428.20 Cons: $710400,00 . ILWh K �D �4 £R Si1F K F DEEDS Date". .A1-31-2006 & 01.'13WA 41411 1260 DoW 6417 Feet 0418-80 ''Cons: $7113 CN-00 PROPERTY ADDRESS:'221 Five Corners Road,Centerville,.Massachusetts 02632 f Bit 20701 Ps240 =6418 01-31-2006 a 01=34v After Recording Return To: W14C MORTGAGE CORP. - POST CLOSING 1 RAMLAND RD ORANGEBURG, NY 10962 Attn: (Equity Services) Prepared By1 JESSIE MOSHIER WMC MORTGAGE CORP. 6320 CANOGA AVENUE LOTH FL (MAILROOM) WOODLAND HILLS, CA 91367 (Space Above This Line For Recording Data] MORTGAGE FURLAN S Loan #:11429835 ery #� 11429835 MIN: 100136300114299359 j DEFINITIONS PINT 168/8001 Words used in multiple sections of this document are defined below and other words are defined in Sections 3, 11, 13, 19,20 and 21. Certain riles regarding the usage of words used in this document are also provided in Section 16. (A) "Security Instrument"means this document,which is dated January 30, 2006 together with all Riders to this document. (B) "Borrower"is MARIA FURLAN Borrower is the mortgagor under this Security Instrument. (C) "MERS"is Mortgage Electronic Registration Systems,Inc.MERS is a separate corporation that is acting solely as a nominee for Lender and Lender's successors and assigns. MERS is the mortgagee under this Security Instrument.MERS is organized and existing under the laws of Delaware, and has an address and telephone number of P.O.Box 2026,Flint,MI 48501-2026,tel.(888)679-MERS. (D) "Lender"is WMC MORTGAGE CORP.- Lender is a Corporation organized and existing under the laws of CALIFORNIA Lender's address is P.O. BOX 54089, LOS ANGELES, CA 90054-0089 (E) "Note"means the promissory note signed by Borrower and dated January 30, 2006 The Note states that Borrower owes Lender Five Hundred Sixty-Eight Thousand'And 00/100 Dollars(U.S.$ 568,000.00 )plus interest. Borrower has promised to pay this debt in regular Periodic Payments and to pay the debt in full not later than February 1, 2036 (F) "Property" means the property that is described below under the heading "Transfer of Rights in the Property." MASSACHUSSETTS.-Single Fantilp-Fannle Mae/Freddle Mac UNIFORM INSTRUMENT Form 30221/01 (page 1 of l4 page,) DnCUKMAI DOCMM=.VTX 08/27/2005 *WMC* 0011429835KMA00101420060130125011V F y� Bk 20701 P9258 --6414 01-31-2006 a 01 =34g� Return TO: WMC MORTGAGE CORP. - POST CLOSING 1 RAMLAND RD ORANGEBURG, NY 10962 Attn: (Equity Services) FURLMORTGAGE roan # Servicing #: 11429837 .Loan :11429637 MIN: 100136300114298374 THIS MORTGAGE is made this 30th day of January, 2006 between the Mortgagor, MARIA FURLAN (herein"Borrower"),and the Mortgagee,MERS. "MERS"is Mortgage Electronic Registration Systems, Inc. MERS is a separate corporation that is acting solely as a nominee for Lender and Lender's successors and assigns. MERS is organized and existing under the laws of Delaware,and has an address and telephone number ofP.O.Box 2026,Flint,MI 48501-2026,tel.(888)679-MERS.WMC MORTGAGE CORP. is a corporation organized and existing under the laws of CALIFORNIA whose address is P.O. BOX 54089 LOS ANGELES, CA 90054-0089 (herein"Lender"). WHEREAS,Borrower is indebted to Lender in the principal sum of U.S.$ 142,000.00 which indebtedness is evidenced by Borrower's note dated January 30, 2006 and extensions and renewals thereof(herein"Note"),providing for monthly installments of principal and interest, with the balance of the indebtedness,if not sooner paid,due and payable on February 1, 2021 TO SECURE to Lender the repayment of the indebtedness evidenced by the Note,with interest thereon;the payment of all other sums,with interest thereon,advanced in accordance herewith to protect the security of this Mortgage;and the performance of the covenants and agreements of Borrower herein contained,Borrower does hereby mortgage, grant and convey to MERS (solely as nominee for Lender and Lender's successors and assigns) and to the successors and assigns of MERS with power of sale, the following described property located in the County of BARNSTABLE State of Massachusetts: LEGAL DESCRIPTION ATTACHED HERETO AND MADE A PART HEREOF AND KNOWN AS EXHIBIT 'A'. MASSACHUSETTS -SECOND MORTGAGE-1!80-FNMAIFHLMC UNIFORM INSTRUMENT WITH MERS RWVTr 08/23/.005 Page I of 7 Form 3822 lii nuumnunuunuununurmunuumnnnuunnnuunnunnunnuiumuuuunnnnnnuiiunnil *WMC* 00114298377MA00100720060130130139m MLS Page 1 of 3 Listing Summary Listing #21000948 221 Five Corners Rd, Centerville, MA 02632* Active (01/29/10) DOM/CDOM:52/52 0$M9,403 (LP) Beds:4* Baths: 3 (3 0) (FH) Sq Ft: 3392* Lot Sz: 19601 sgft* Town: Barn Yr: 1971* Remarks Picture Huge 4 bedroom, 3 bath bank owned colonial located in Centerville. Nestled on almost a half acre, this home boast over 3000 sq ft of living area. This house had a former - � legal apartment in basement under Town of Barnstable Amnesty program. New buyers would have to check with - Town as to future use of the apartment and verify all info. ` r Sold as is, where is. For special financing and incentives, .O Seller requests potential buyers contact your Chase Loan , r Officer. •"sa�.-.�.x,... �g . =:ram *g—�.:� ,: .,��,. a.a -- +sue* •ey. a. a Pictures(101 A'Y .y- I Location Description South of Route 28 Agent Kevin P Mikolazyk (ID:"U2895)Primary:508-548-3415 Secondary:774-526-6801 Other.509-444-3670 Office Foley Realty Group. Inc.(ID:FOLY)Phone:508-548-3415,FAX:508-457-4985 Property Type Single Family Property Subtype(s) Single Family Status Active(01/29/10) Town Barnstable Commission Sub Agent Comm. Buyer Agent Comm. Dual Agent Comm. Dual Var Comm 0% " 2.5% 5% No Facilitator Comm 2.5% Listing Type Excl.Right to Sell Owner Name U S Bank Na County Barnstable Tax ID 168-80-0-1-BARN Beds 4* Baths (FH) 3(3 0) Approx Square Feet 3392* Sq Ft Source Assessors Records Lot Sq Ft(approx) 19601* Lot Acres(approx) 0.450 Lot Size Source (Assessors Records) Year Built 1971" Listing Date 01/29/10 All Office Remarks call kevin 774-526-6801 to show,buyer to assume all inspections,no changes to banks addendum,bank will not sign offer,straigh to p and,s.buyer to assume any betterments if any Directions to Property 28 to 5 corners Listing Page Commission-Other none Special List Cond. Foreclosure Showing Instructions Call Listing Agent,Lockbox General Page Zoning R Year Built Desc. Actual Total Rooms 9 Total Levels 2.0 Basement Baths 0.0 http://ccimis.rapmis.com/scripts/mgrqispi.dll?APPNAME=Capecod&PRGNAME= 3/22/2010 MLS Page 2 of 3 w , Leval 1 Baths 0.0 Level 2 Baths 0.0 Level 3 Baths 0.0 Basement Yes Basement Description Finished Foundation Concrete,Poured Fndation Wing Width 0 Fndation Wing Depth 0 Irregular No Lot Depth 0 Lot Width 0 Topography/Lot Desc. Gentle Slope Association No Annual Assoc.Fee $0 Assoc.Fee Year 0 Garage Yes #of Cars #1 _ Garage Description Attached Parking Description Improved Driveway Year Round Yes Separate Living Qtrs No Waterfront No Water View No Miles to Beach 2 Plus ` Beach Description Ocean Beach Ownership Public Street Description Public Interior Page Fireplace Yes Number of Fireplaces #1 Floors Hardwood,Tile,Wall to Wall Carpet Exterior Style Colonial Pool No Dock No Energy Saving Feat None Exterior Features Fenced Yard Roof Description Asphalt Siding Description Shingle Mechanical Heating/Cooling Natural Gas Water/Sewer/Utility Septic Hot Water/Water Heat Natural Gas Warranty Available No Legal/Tax Annual Tax $4387 Tax Year 2009 Land Assessments $160200 Improvement Asmt $475600 Other Assessments $0 Total Assessments $635800 Annual Betterment $0.00 Unpaid Betterment $0.00 To Be Assessed Unknown .Mass Use Code 101-Single Family , Title Reference-Book 24184 Title Reference-Page 199 Land Court Cert# 0 Underground Fuel Tnk Unknown Lead Paint Unknown Asbestos Unknown Flood Zone Unknown "Denotes information autofilled from tax records. http://ccimis.rapmis.com/scripts/mgrqispi.dll?APPNAME=Capecod&PRGNAME= 3/22/2010 MLS Page 3 of 3 Information has not been verified,is not guaranteed,and is subject to change.Copyright 2010 Cape Cod&Islands Multiple Listing Service,Inc.All rights reserved Copyright©2010 Rapattoni Corporation.All rights reserved. Generated:3/22/10 1:45pm ' tup!!tt ►att I&A .S http://ccimis.rapmis.com/scripts/mgrqispi.dll?APPNAME=Capecod&PRGNAME= 3/22/2010 I Parcel Detail Page 1 of 3 � - y t , Ile, r w w 4 B,�$dri5THlipi�l i4 45 : 0711. �0. Logged In As: Parcel Detail Monday, March 22 2010 Parcel Lookup Parcel Info Parcel ID t 168-080-001 vI Developer LOT 22B Lot Location 1221 FIVE CORNERS ROAD I Pri Frontage 1128Sec I Sec Road IWESTMINSTER ROAD I Frontage`73 Village 10ENTERVILLE I Fire DistrictC-O-MM � Sewer Acct j ^^� I Road Index 0545 Interactive 1 Maps ' _ i Owner Info Owner IUS K NA _) co-Owner IC/O�WASHINGTON MUTUAL MTG �) Street l 7255 BAYMEADOWS WAY I Street2 L. City#JACKSONVILLE I State AFL _ zip i32256 Country Land Info Acres F0.45 _ use FSingle Fam MDL-01- �I zoning E _ I Nghbd 10106 Topography E eVel I Road �;PaVed^ utilities FSeptic,Gas,Public Watery I Location F � Construction Info Building 1 of 1 Year F971 �_� f Roof(Gable/Hip __ f Ext C1 b rd Built Struct; Wall p Effect�3744 I Roof IAs h/F GIsICm AC None Area cover p p I ..Type� Style(Colonial Int(D wall Bed 4 Bedrooms Wall I ry I Rooms ' p . Int _ . Bath Model Residential ICarpet I4 Full + 1 H I �� Floor- Rooms Grade Average Plus I Heat Hot Water _ I Total!9 Rooms Type Rooms *= Stories i2 Stories I Heat FGas I Found-rPoured Conc. Fuel ation http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10991 3/22/2010 Parcel Detail Page 2 of 3 `Permit History _ _ Issue Date Purpose Permit# Amount Insp Date Comments 07/30/2007 Residential 200703991 $0 EXIST APT 07/16/2004 Finish Basemne 77983 $15,000 06/10/2005 00:00:00 11/01/1988 1 632457 $43,000 01/15/1995 00:00:00 CE ADD'N - Visit History _ Date Who Purpose - 07/30/2008 00:00:00 Nancy Finch In Office Review 07/28/2008 00:00:00 Karen Perry In Office Review 06/10/2008 00:00:00 Paul Talbot Cyclical Inspection 06/10/2005 00:00:00 Martin Flynn Bldg Permit Completed 08/20/1999 00:00:00 Donna Dacey Meas/Listed-Interior Access 03/15/1990 00:00:00 ME Sales History Line Sale Date Owner Book/Page Sale Price 1 11/23/2009 US BANK NA 24184/199 $365,500 2 01/31/2006 FURLAN,.MARIA 20701/236 $710,000 3 05/01/2002 ASSIS, MARCELO T& 15113/347 $100 4 10/26/1998 TEIXEIRA, ADOLFO &ASSIS, M A N & M 11786/251 $157,500 5 08/15/1996 POMYKALA, RONALD J 10360/264 $1 6 07/15/1994 POMYKALA, RONALD J 9270/113 $135,000 7 11/15/1992 MONEY STORE MASS, INC 8300/225 $120,000 8 06/15/1992 WOLLASTON CREDIT UNION 8091/150 $118,000 9 09/15/1988 EORDEKIAN, HOVEY& 6437/135 $130,000 10 04/15/1983 MCPHEE, NORMAN & PATRICIA 3706/045 $58,000 11 03/15/1983 GORDON, $1,000 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2010 $327,400 $43,800 $0 $138,000 $509,200 2 2009 $433,000 $42,600 '$0 $160,200 $635,800 3 2008 $433,000 $35,100 $0 $171,500 $639,600 5 2007 $349,500 $33,100 $0 $154,300 $536,900 6 2006 $337,100 $33,100 $0 $160,100 $530,300 7 , 2005 $266,600 $25,900 $0 $128,000 $420,500 8 2004 $217,100 $25,900 $0 $96,000 $339,000 9 2003 $194,400 $25,900 $0 $43,100 $263,400 10 2002 $194,400 $25,900 $0 $43,100 $263,400 11 2001 $194,400 $26,800 $0 $43,100 $264,300 12 2000 $152,000 $26,300 $0 $32,600 $210,900 Lhttpl 1999 $144,300 $16,800 $0 $32,600 $193,700 1998 $144,300 $17,700 $0 $32,600 $194,600 1997 $149,300 $0 $0 $29,300 $178,600 112/intranet/propdata/ParcelDetail.aspx?ID=10991 3/22/2010 Parcel Detail Page 3 of 3 16_ 1996 $149,300 $0 $0 $29,300 $178,600 17 1995 $149,300 $0 $0 $29,300 $178,600 18 1994 $130,300 $0 $0 $20,500 $150,800 19 1993 $130,300 $0 $0 $20,500 $150,800 20 1992 $150,600 $0 $0 $22,800 $173,400 21 1991 $117,100 $0 $0 $58,000 $175,100 22 1990 $86,200 $0 $0 $58,000 $144,200 23 1989 $86,200 $0 $0. $58,000 $144,200 24 1988 $61,100 $0 $0 $26,800 $87,900 25 1987 $61,100 $0 $0 $27,600 $88,700 26 1986 1 $61,100 $0 $0 $27,600 $88,700 Photos r ` E yF a� av I T m I w http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10991 3/22/2010 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:l 1, MA. Date: _/0 Permit# Building Location5 -7- Owners NameA h//{Lajl Type of Occupancy: CommerciaI7 Educational ID Industrial o Institutional Residential New: Alteration: Renovation: Replacement: Plans Submitted: Yes No FIXTURES z z m o U (n co a Cl) w O m Of ❑ o. wt- CO � _X n L ❑ Y uJ p z IM. wZ ❑ aW i v a LL awIIIw U I— n- 0 r F- 0 0 z ZI- I- o to O O x _1a n << L: a m m ❑ o c� = Y g m rn W 1- D O SUB BSMT.` BASEMENT'_ 1 FLOOR._ 2 FLOOR - 3 KU FLOOR : 4 FLOOR ` 5 FLOOR 6 FLOOR 7 FLOOR 8 FLOOR FP Installing Company Name: Check One Only Certificate# Corporation Address: /D /Z�3 ,Ke un Liv, Ci !Town E=` ?Ln/ State: MA _ Partnership Business Tel: v'�_`Z� f l Fax: Firm/Company -� Name of Licensed Plumber: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes! No If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Other type;of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have.the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature'on this permit application waives this requirement Check One Only Owner (1 Agent Signature of Owner or Owner's Agent 1 hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under,the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the Genera Laws. BY[ ------------�------� Type of License: Title] _^ A + ✓, plumber ( _Signature of Licensed Plumber CityrrownF Master License Number: I /Z APPROVED OFFICE USE ONLY "'Y` Journeyman ,,,�� Barry, Lois To: Dabkowski, Cindy Subject: 221 Five Corners Road, Centerville Cindy, This property is now bank owned. A contractor came in today to pick up a building permit application to,restore to a single family. Lois 1 Parcel Detail Page 1 of 3 � ! 51 ntxtisY,�z;rg � Logged In As: Parcel Detail Wednesday,January 13 2010 Parcel Lookup Parcel Info Parcel ID 168-080-001 I DevelopeeY LOT 22B Location 1221 FIVE CORNERS ROAD I Pri Frontage 1128 —I Sec Road FWESTMINSTER ROAD I Sec Frontage 73 village!CENTERVILLE I Fire District FC-O-MM Sewer Acct I I Road Index i 0545 ti. Interactive Map ? 1 6.. Owner Info Owner BANK NA I Co-owner[C/O'WASHINGTON MUTUAL MTG Streetl 17255 BAYMEADOWS WAY Street2 L I City IJACKSONVILLE I State FL zip 132256 Country Land Info Acres 10.45 71.j use Single Fam MDL-01 ( zoning�RC I Nghbd I0106 TopographylLeyel I Road ,Paved Utilities I Septic,Gas,Public Water _ I Location Construction Info Building 1 of 1 Year 971 RoofGable/Hi Ext Built I Struct p I Wall ICla pboard Effect f Roof AC , Area 13744 -I Cover(Asph/F GIs/Cmp I .Type None ( ;" dKI �L'I style jColonial I Int(Drywall ( Bed 14 Bedrooms Wall Rooms , . Int Bath Model Residential �arpet I 4 Full + 1 H Floor Roomsp8u8 I Grade Average Plus Heat{Hot Water Total 9 Rooms g ( TYpe( ( Rooms--- Stories 2 Stories I: Fuel Gas I Fou ation Poured Conc.'I Permit History Issue Date Purpose Permit# Amount Insp Date Comments 07/30/2007 Residential 200703991 $0 EXIST APT 07/16/2004 Finish Basemne 77983 $15,000 06/10/2005 00:00:00 11/01/1988 632457 $43,000 01/15/1995 00:00:00 CE ADD'N http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10991 1/13/2010 Parcel Detail Page 2 of 3 Visit History Date Who Purpose 07/30/2008 00:00:00 Nancy Finch In Office Review 07/28/2008 00:00:00 Karen Perry In Office Review 06/10/2008 00:00:00 Paul Talbot Cyclical Inspection 06/10/2005 00:00:00 Martin Flynn Bldg Permit Completed 08/20/1999 00:00:00 Donna Dacey Meas/Listed-Interior Access 03/15/1990 00:00:00 IME Sales History Line Sale Date Owner Book/Page Sale Price 1 11/23/2009 US BANK NA 24184/199 $365,500 2 01/31/2006 FURLAN, MARIA 20701/236 $710,000 3 05/01/2002 ASSIS, MARCELO T& 15113/347 $100 4 10/26/1998 TEIXEIRA,ADOLFO&ASSIS, M A N &M 11786/251 $157,500 5 08/15/1996 POMYKALA, RONALD J 10360/264 $1 6 07/15/1994 POMYKALA, RONALD J 9270/113 $135,000 7 11/15/1992 MONEY STORE MASS; INC 8300/225 $120,000 8 06/15/1992 WOLLASTON CREDIT UNION 8091/150 $118,000 9 09/15/1988 EORDEKIAN, HONEY& 6437/135 $130,000 10' 04/15/1983 MCPHEE, NORMAN&PATRICIA 3706/045 $58,000 11 03/15/1983 GORDON, $1,000 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2010 $327,400 $43,800 $0 $138,000 $509,2 00 2 2009 $433,000 $42,600 $0 $160,200 $635,800 3 2008 $433,000 $35,100 $0 _$171,500 $639,600 5 2007 $349,500 $33,100 $0 $154,300 $536,900 6 2006 $337,100 $33,100 $0 $160,100 $530,300 7 2005 $266,600 $25,900 $0 $128,000 $420,500 8 2004 $217,100 $25,900 $0 $96,000 $339,000 9 2003 $194,400 $25,900 $0. . $43,100 $263,400 10 2002 $194,400 .. $25,900 $0 $43,100 $263,400 11 2001 $194,400 $26,800 $0 $43,100 $264,300 12 2000 $152,000 $26,300 $0 $32,600 $210,900 13 1999 $144,300 $16,800 $0 $32,600 $193,700 14 1998 $144,300 $17,700 $0 $32,600 $194,600 15 1997 $149,300 $0 $0 $29,300 $178,600 16 1996 $149,300 "$0 $0 $29,300 $178,600 17 1995 $149,300 $0 $0 $29,300 $178,600 18 1994 $130,300 $0 $0 $20,500 $150,800 19 1993 $.130,300 $0 $0 $20,500 $150,800 20 1992 $150,600: $0 $0 $22,800 $173,400 21 1991 $117,100 $0 $0 $58,000 $175,100 22 1990 $86,200 $0 $0 $58,000 $144,200 23 1989 $86,200 10 $0 $58,000 $144,200 24 1988 $61,100 40 $0 $26,800 $87,900 25 1987 $61,100 $0 $0 $27,600 $88,700 26 1986 $61,100 $0 $0 $27,600 $88,700 http://issgl2/intranet/propdata/ParceiDetail.aspx?ID=10991 1/13/2010 Parcel Detail Page 3 of 3 a. Photos 3n 6.1 s fi- 5 s t 'Y http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10991 1/13/2010 TOWN OF BARNSTABLE ypF P .. row o� OFFICE OF MAMSTIM NAM BOARD OF HEALTH`` 1639• `e�' 367 MAIN STREET HYANNIS,,MASS. 02601 ' February 23, 1989 Mr. Hovey Eardekian 210 Five Corners Road Centerville, Ma 02632 F ti t Dear Mr. Eardekian: f Your request to install a replacement septic system to enable you to add four x (4) bedrooms to your existing three (3) bedroom dwelling located at 210, Five x ' Corners Road, Centerville, is not granted. You appeared at the Board of Health's;Public meeting on February 7, 1989, with, 4± your, Disposal Works Installer, Donald Perkins, .to request,approval to install a .` y replacement septic system: You presented floor plans of---your existing dwelling and proposed addition. In addition to the four (4) labeled bedrooms, four (4) other 's', rooms including the "family room", "sewing room", "study room" and an unlabeled room (19 feet by 14 feet in size) were counted as,bedrooms, to a total of eleven F (11) bedrooms proposed within the dwelling:. r s The proposed septic system sketch plan which was not designed by a professional engineer, was designed to handle only seven (7).bedrooms: Also, test holes were not excavated and a percolation test was not. performed, at this site for the , proposed addition. ° Please contact Thomas McKean at the Health Department, (telephone:' 775-1120, extension 182) if you have,any questions. . r �.. Sincerely yours; r � t Ann Jane Eshbaugh - •' ; +' Acting Chairperson BOARD OF HEALTH " TOWN OF BARNSTABLE, , - t AJE/bs i y , e r To: FAX TRANSMMAL #of pages From: C Co. Co. Dept P1one# (508) 790-6227 Fax Fax# _(50$)775-3344 s / D r,e t r, a n r, r^, n r n ^r r n a ^5 i i 1 r��rr^--� t_3r��t:l�,-•yyt:?t:^?s MASS, ,1 l� r•i r� i' R A .� S A €� � I:• ��-t � r'� ��::��Y .:.t.e. ?._a ND BLIE-1 r E ATURE.S BU I LL?I NIGS N ;t'1BER ZN/FL=RC PCrt—�.t:?11 r-�..>�=00 S3:ZE= _ —'a�'2 JU T—VAL _._..._CCNtP ARIS0N TO CONTROL AREA :_, AC; TREND D EXCEEDS S^i"ANDARD NE I GHPORHOIOD :.-3,8AC CEINI ERV:€LLC PARCEI__ C::CJI~y"I"FN.31,L AIRE"- 1"REN D STANDARD 3.t:? L.ANrf..'TYPE _ .. ..A,w$_.._MFAN FIR 0"4- r LC?C_A"C'a:C I`d..^ADJ Al PL.Y....t,AL....STAT i LNR L.AN11) LFT/ L NP AWS/SF;:FCAl` STR STRUCTURE ARR AREA NOR ,NIO 'ES -_ _ COM rAnF-*::E`I'• T IyC l.144.rO E €f"IR PERM T"i'C'r GRR GRAPHIC + r h •� r+'T' "1 ^'\ '1 P^ hIr'� I^1 t r'. ••n'Y^n , T '1 F'U,,4C.:T I O i\l— STRUCTURE—CAF,,L[l CvO— ._(:-•: LEr; i A .. _. _.:.......:..:�.Iy, d/ ) �YIDY.I Mortgage Loan Inspection LAND SURVEYS INCORPORATED REGISTERED LAND SURVEYORS 410 BELMONT STREET BROCKTON, MASSACHUSETTS 02401 Date_ September_ 12, 1g88 (617)588.1877 Job No. 14702 Land in: Barnstable MA - Owner(s): Norman & Patricia McPhee Title Reference: ( Book 3706, Page 045 Registry District: Barnstable ti� Ot - - 57 L.CST . s ... zF. ± �1 tJ o o J\ 01 ��ti N� � � is � • L.=`T3.Ql ' ,.� T;=49.83' SCALE: , N STEr'�. -'® -- FOR MORTGAGE PURPOSES ONLY- Not to be used to determine property lines or to construct fences, or landscaping,4 aping, etc. _ I CERTIFY THAT THE BUILDINGS ARE LOCATED AS .K�!y' •'+;+Y i�}''` T} '+• ` SHOWN, AND CONFORMED TO T y. HE ZONING IN M EFFECT WHEN CONSTRUCTED EXCEPT AS NOTED. A 1 s ,r,'^j1.� 1. THE'PR OPERTY LIES IN , ZONE AS ' SHOWN ON THE NATIONAL t FLOOD INSURANCE MAP Assessor's office (1st floor): POTIC qVATEM M ftNEto p Assessor's map. and lot number U3T Be ° �o Board of Health.(3rd floor): 1 Sewage Permit number �f...r..... ...^ ..�ID........... � 31ALYSTABLE Engineering Department (3rd floor): i CODE! �•;� 'oo tNAM 3 m`E � as ,-�s f House number,. VViq R'E(iULATIONS �OYAVd. Definitive Plan Approved`by, Planning Board --------- ______________19________ . r APPLICATIONS PROCESSED .8:30'•9:30 A.M, and 1:00, 2:00 P.M. only TOWN; OF BARNS-TABLE BUILPIMU INSPECTORS l ; ti APPLICATION,:FOR 'PERMIT TO . '.... .. i�./.......... .....Al.. LL C ,,..................... ............................................ 3 - _ TYPE OF. CONSTRUCTION .... ............... ..................................... .................................................... u TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....................0z-pvtc..��V IJ/ ProposedUse M). . ..... .................................. .... ........................................ i Zoning District ......... .. ..... ............... ire District .. (/ �� .. ........ ��/. .. ....... .. Name,o.f OwnerQ�. , a. IG... .... o" e _� 1f.!.........Address ... ........ ........ ...I.!(......... . �a.�.. Name of Builder 9_11,ij.. � ',. ...Address ..Q �.P.)...... �`3.f.!!!S.d.. (V l Norne of Architect!YS......................................................Address ....................1......... Number of Rooms .... �Q 1N(�,�C Foundation ................................................ F EXlei'IOr ...... ff (n�1 �Qtl }R.. ......Roofing ` .. . Floors .....� ...................Interior ' rieat'in y ............. �. •. �-.��'i.....................................................Plumbing ............ .. ...•..: ......................................................... Fireplace ...........Approximate Cos Area ... .. . ....�a. �.....: S Diagram of Lot and Building with Dimensions Fee '�.........../... ............................ /0 �o i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of t4hT n of Barnstable regarding the above construction. Nam .... ..... ................................................ Construction Supervisor's License ..................... S { 19� EOR,.LKIAN, HOVFY & LILY R. ` 3�457 allo Permit for .... Single. Famil Dwellin = Y........................ Location 221 Five Corners Road _ .. 7r e, ftte-vil.le - Owner .....Hovey & .Lily R. .Eoredekian _ - - - a� Type of ConstructionFrame.. Yr ~y r p ......... t - P r11 Plot... .... Lour ... - ° Permit Granted Nove ,mber 2 3 19 8 8 Y .....19 A Date-of Inspection { Rate Completed .......... .....19 Of r r.. y Yx.T 711 � kz. TOWN OF BARNSTABLE '` y�F THE r0� OFFICE OF s, x e, SUM BOARD OF HEALTH .� MAS pp 1639. ` 887 MAIN STREET { CFO MAY M. HYANNIS, MASS. 02601 February 23, 1989 Mr. Hovey Eardekian 210 Five Corners Road Centerville, Ma 02632 Dear Mr. Eardekian: a Your request to install a replacement septic system to enable you to add four- +'<,._F. (4) bedrooms to your existing three (3) bedroom dwelling located at 210 Five ' Corners Road, Centerville, is not granted. You appeared at the Board of Health's Public meeting on February 7, 1989,'with, your Disposal Works Installer, Donald Perkins, to request approval to install. a replacement septic system. You presented floor plans of your existing dwelling and'proposed addition. In addition to the four (4) labeled bedrooms, four (4) other rooms including the "family room", "sewing room", "study room" and an unlabeled room (19 feet by 14 feet in size) were counted as bedrooms, to a total of eleven (11) bedrooms proposed within the dwelling. t The proposed septic system sketch plan which was not designed by a professional engineer, was designed to handle only seven (7) bedrooms. Also, test holes 'were not excavated and a percolation test was not performed, at this site for 'the proposed addition. Please contact Thomas McKean at the Health Department, (telephone: 775-1120, extension 182) if you have any questions. Sincerely yours, 6-t� Ann Jane EAbaugh Acting Chairperson BOARD OF HEALTH TOWN OF BARNSTABLE AJE/bs y , 1 If y oramcr Mortgage Loan Inspection LAND SURVEYS INCORPORATED f REGISTERED LAND SURVEYORS 410 BELMONT STREET BROCKTON, MASSACHUSETTS 02401 Date_ September. 12, 1988 (6171588•1877 ,lob No. 14702 Land in: Barnstable, MA Owner(s): Norman & Patricia McPhee Title Reference: Book 3706 , Page 045 Registry District: Barnstable NCO L, --------__ t 0 � Z 4.1 N� %U It L.=-i3•01' ,,O ;:�Z=49.63' SCALE: 1', - 3,b' �/�i v��I�I N sTEre. ® FOR MORTGAGE PURPOSES ONLY- Not to be used to determine property lines or to construct fences, or landscaping, etc. _ I CERTIFY THAT THE BUILDINGS ARE LOCATED AS SHOWN, AND CONFORMED TO THE ZONING IN EFFECT s cc WHEN CONSTRUCTED EXCEPT AS NOTED. A . � � { THE PROPERTY LIES IN -. r � C ZONE• AS SHOWN ON THE NATIONAL f FLOOD INSURANCE MAP Y 4 - ' � ;AiZ`,sor's office (1st floor): Rif,r M , aP 'THE T Assessor's ma 'and .lot number t` Board- of Health (3rd floor):' , Sewage Permit number �J.................,��..�,D... �,., A s-�*.�w�@�p . yp Z BJH39TADLE. �� t Fd'•L �rr:A[z[e te.4v SOD rb}9. \e� Engineering Department (3rd floor) House number •..... # aQ�.�.......` ..... .. ifr REGULATIONS o war Definitive Plan Approved by, Planning Board :______ _ _.______-19 _:_____ . APPLICATIONS' PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. ^only- TOWN "OF RARNST'ABLE BUILDIH ANSPECTO-R APPLICATION FOR PERMIT TO •...... .. > ........ .... ......LL ....!.v.: TYPE-OF CONSTRUCTION ...(00...C7C�... .......:. .......................................... ...................... TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for a permit according 'to the, following information: Location"...... r (,K..`..G�'�. f QS. . ........ -:�`!�.� �� ./..� . Proposed .Use ...... ......... .:1. ........ ........... :'........ti?....... .......................................... ....................... Zoning District ......... 1 Fire. District .C/. ../// /�.... E� � f , n ,q ! Name of OwnerO �.' _ �L. .• t. i[ ... .....�r.'o`!....Qddress �, C�. !Q. '.. . Name of Builder.,�1 .'.4>.1. ... ..1� � ... s..AddressLT.�,!J..Q ��c.l.!Y4� f/ ' �' Name'of Architect . .......... . .:. ... ........ ..::....Add.ress !`'J �1:�..h�.W t-'... . ....ffk�.•... N' k ........................................ Number of Rooms ... ...... ....Fo' n_dation . Exienor .....cfid• .::..: ......... ..................... :..... .......Roofing `.,`.... .....�f^?.....`� . Floors6.:A............... Interior ...... ............................................... --Fed _ Plumbing ...:...... .. .. : :� ........... ....... ...77.............. ... ..............•......................................... Fireplaces ::..: .. .... ....... ........... ...:....:...................Approximate Cos r�0� .. ............................, n h ' • Area ... /.. .�../:.5 /Diagram of Lot and Buildi'ng,`with Dimensions Fee .... ..................... 5 lit) 4-0 - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I .hereby agree to conform to all the Rules and Regulations of th Town of Barnstable regarding the above f construction. < Nam ..... ............. :. Construction.Supervisor's License . ................... E,a.R,;0"LKIAN, HOVEY & LILY R. No .. Permit for ........ '...::Single Family.:.Dwe•llin ...... r , • ' 221 Five Corners Road t�.' Location ....._.......... ................. .. _ ! Centerville Owner Hovey , & Lily R. 4Eoredekian ............. ' .... ......... Type of Construction .•.... ................... Plot%.......................... Lot �' • ' l µ �' - ------------------ = ' Permit Granted .•,• -Novembe•r 2 3 , '19 88, f. Date-of Inspection ...................................19 Date Completed ....... t..............19 1 G( 1y��• iX. ... �e .3- is�� s y� f - �._ • � ± . • � .; f - �. AL { Version*49.2 SolarCity. � E OF W6 August 28, 2015 x Project/Job#0261723 ' g SOa17 RE: CERTIFICATION LETTER Project: Huang Residence 5 Corners Rd Bar � ' O • Barnstable, MA 02632 ' To Whom It May Concern, { A jobsite survey of the existing framing system was performed by a site survey team from SolarCity: Structural review was based on ' site observations and the design criteria listed below: Design Criteria: -Applicable Codes MA Res.Code,.8th Edition,ASCE 7-05,and 2005 NDS - Risk Category = II -Wind Speed = 110 mph, Exposure Category C -Ground Snow Load = 30 psf - MP1A: Roof DL= 14 psf, Roof LL/SL= 21 psf(Non-PV Areas), Roof LL/SL,= 12.3 psf(PV Areas) t - MP1B: Roof DL='9 psf,.Roof LL/SL= 21 psf(Non-PV Areas), Roof LL/SL= 12:3 psf(PV Areas) - MP2A: Roof DL= 9 psf, Roof LL/SL= 21 psf(Non-PV Areas),Roof LL/SL= 12:3 psf(PV Areas) Note: Per IBC 1613,1; Seismic check is not required.because Ss=0.19069<,0.4g and Seismic Design Category(SDC) _$ < D On the above referenced project,.the components of the structural roof framing impacted by the installation of the PV assembly have. ' been reviewed. After this review it has been determined that the existing structure is adequate to withstand the applicable roof dead` load, PV assembly load,and live/snow loads indicated in the design criteria above. I certify that the structural roof framing and the new attachments that directly support the gravity loading and wind uplift loading from PV modules have been reviewed and determined to meetbr exceed structural strength requirements of the MA Res. Code,8th Edition.' Please contact me with an_ y questions or concerns regarding this project. . ':* :-1. - • Digitally signed by William A. �. Eldredge Jr. - . s k•...:1; - .. • Date:2015.08.29 13:05:27-04'00' • - k William A. Eldredge, P.E. 1 . . Professional Engineer •T: 888.765.2489 x58636 j email: weldredge@solarcity:com , 3055 Clearview Way San Mateo,CA 94402 T-(650)638-1028 (888)SOL-CITY F(650)638-1029 solarcity.com AZ ROC 243771,CA CSL;B 888104.oo EC 8041,CT HIC 0632778,oC HIC 71101486,DC HIS 7119148$,HI CT 29770;AAA HIC 188572,.MDMHIC 128948,NJ MH08160aW. ' OR COB 180490.:PA 077343,TX TDLA 2r008,WA GCL:SOLARC'91907;02013 SolwC'ityr All rightq resial ned. - 08.28.2015 ' SolarCityPV System Structural Version#49.2 Design Software PROJECT INFORMATION &TABLE OF CONTENTS Project Name: Huang Residence AHJ: Barnstable Job Number: 0261723 Building Code: MA Res. Code, 8th Edition Customer Name: Huang, Zhongchan Based On: IRC 2009/ IBC 2009 Address: 221 5 Corners Rd ASCE Code: ASCE 7-05 City/State: Barnstable, MA Risk Cateqory: II Zip Code 02632 Upgrades Req'd? No Latitude/ Longitude: 41.652186 -70.367880 Stamp Req'd? Yes SC Office: Cape Cod PV Designer: Cody Raber Certification Letter 1 Project Information, Table Of Contents, &Vicinity Map 2 Structure Analysis (Loading Summary and Member Check) 3 Hardware Design (PV System Assembly) 4 I Note: Per IBC 1613.1; Seismic check is not required because Ss = 0,19069 < 0.4g and Seismic Design Category (SDQ = B < D 1/2-MILE VICINITY MAP -7"N", 28 DigitalGlobe. MassGIS, Commonwealth of Massachusetts EOEA. USDA Farm Service Agency, 221 5 Corners Rd, Barnstable, MA 02632 Latitude: 41.652186, Longitude: -70.36788, Exposure Category: C r STRUCTURE ANALYSIS - LOADING SUMMARY AND MEMBER CHECK- MP1A Member Properties Summary MP1A Horizontal Member Spans Rafter Pro erties Overhang 1.07 ft Actual W 1.50" Roof System Pro erties San 1,,- 12.69 ft, Actual D,., _F9.25 Number.of Spans(w/o Overhang) 1 San 2 Nominal Yes Roofing Material Comp Roof San 3 A 13.88 in.^2 Re-Roof No Sean 4 S. 21.39 in.^3 Plywood Sheathing Yes San 5"' ""' I 98.93 in.^4 Board Sheathing None Total Rake Span 16.80 ft TL DefTn Limit 180 Vaulted Ceiling " Yes -0, 0" PVA'Start°" W'" "2.08 ft'`"s' @ Wood Species -SPF _��'4 Ceiling Finish 1/2"Gypsum Board PV 1 End 15.42 It Wood Grade #2 Rafter Slope- ,q, _x 5350 Z "PV 2 Start.,.__ n:: F .875 psi r° 7 Rafter Spacing 16"O.C. PV 2 End F„ 135 psi Top Lat Bracin } vM7 "IFull II R R, „ PV 3 Start 5 . E A, '11400000 psi Bot Lat Bracing Full PV 3 End . E,„i„ 510000 psi Member Loading mary Roof Pitch 9 12 Initial Pitch Ad'ust Non-PV Areas PV Areas ' Roof Dead Load DL 14.0 psf x 1.22 17.1 sf 17.1 sf PV Dead Load .x. - DL s PV- , a�� 3.0. sf_ m .y „. -x f�1.22:< ,_ a ,,d,�.; *.,%&3.7 psf,41a Roof Live Load RLL 20.0 psf x 0.78 15.5 psf Live/Snow toad ., LL SL",3 w - .- 30.0 psf tx 0.7,4,j j.,x;0.41 s , .. 2110 sf� ., .„,_ .,12.3 ipsf,, r Total Load(Governing LC TL 38.1 psf 33.1 psf Notes: 1. ps=Cs*pf;Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf=0.7(CO(CO(IS)pg; Ce=0.9,Ct=1.1,IS=1.0 Member Design Summary(per NDS Governing Load Comb CD CL + CL - CIF Cr. D+ S 1.15 1.00 1 1.00 1.1 1.15 Member Anal sis Results Summary Maximum Max Demand @ Location Capacity DCR Load Combo Shear Stress 29 psi 1.1 ft. 155 psi 0.19 D+S Bending + Stress,4k._ .'O i t 44 487.psiMR _ * ,47 5 ft . '' VW_'1273 psON 4 0.,38A 'Ir � D+ S R;, ,e 1 Bendin - Stress -24 psi 1.1 ft. -1273 psi 0.02 - D+S Total.Load Deflection�� iA, _ v0.27 in 691 _7:4 ft.; k� 1.03`in:� : 180w 1 � 0.26a�4 ak a D_+S �CALCULATION_OF DESIGN WINVLOADS-_MP1A Mounting Plane Information Roofing Material Comp,Roof PV System Type SolarCity SleekMount'" Spanning Vents No Sta ff Attachment Hardware Comp`Mount-Tvoe C Roof Slope 350 Rafter Spacing 7n 16'O.C. Framing Type Direction. Y-Y Rafters Purlin"Spacing- - X-X Purlins Only ` x_ NAB' ' Tile Reveal Nile Roofs Only NA Tile Attachment System Tile Roofs Only _ ' `=a_ N_A _ " Standin Searn/Trap S cing SM Seam Only NA Wind Desi n Criteria Wind Design Code ASCE 7-05 Wind Design•Method ' ^ _ `,Partially/Fully,Enclosed Method Basic Wind Speed V 110 moh Fig. 6-1 Exposure Category . _ lk _ ., 0,,g ection 6 5.63 Roof Style Gable Roof Fig.6-11B/C/D-14A/B - MeaniRoofHeight . i..^ , h x .mt. . :. _ .: ^__�m35ft77,Section 6.2. Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ 1.01 Table 6-3 Topographic:Factor ' K" " " 1.00 Section 6.5.7 Wind Directionality Factor Kd 0.85 Table 6-4 Im ortance'Factor. . I;, : 1.0_ Tabl 6 Velocity Pressure qh qh = 0.00256(Kz)(Kzt)(Kd)(V^2)(I) Equation 6-15 26.7 psf Wind Pressure Ext. Pressure Coefficient U GC u -0.95 Fig.6-11B/C/D-14A/B Ext.'Pressure°Coefficient' Down` -:GC"`'-°W '1' '` '` 0.87 :''. "� �'' ' "' Figi"6-116/G/D=14A/B Design Wind Pressure p p =qh(GC ) Equation 6-22 Wind Pressure U ° -25.4 psf Wind Pressure Down 23.4 psf ALLOWABLE STANDOFF'SPACINGS tt* '" X-Direction Y-Direction Max Allowable Standoff Spacing- Landscapes 64" 39" Max Allowable Canti lever. _Landscapes 24" NA Standoff Configuration Landscape Staggered Max Standoff ry Tnbuta Arrea Trib 3 '17 sf'" — PV Assembly Dead Load W PV 3.0 psf Net Wind.Uplift at Standoff_ ^`Tactual _ — 418Ibs Uplift Capacity of Standoff T-allow 500 Ibs Stanan ff D and Ca aci n. DCR 3 , :; Y, • 83.6°/� ow^ X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 32" 66" _Max Allowable Cantileyer� Portrait - 16 NA Standoff Configuration Portrait Staggered Max Standoff Tributary AreaTrib PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift_at Standoff T-actual =349 Ibs_ Uplift Capacity of Standoff T-allow 500 Ibs Standoff Demand Ca aci DCR • STRUCTURE ANALYSIS - LOADING SUMMARY AND MEMBER CHECK- MP1B a Member Properties Summary MPiB Horizontal Member Spans Rafter Pro erties Overhang 1.07 ft Actual W 1.50" Roof System Pro erties - 'S'an 1 "l.",WW '�5.85AN606i' '` '°'Actual D ,.;.� 1% ;50 y A4 -AD Number of Spans(w/o Overhang) 2 San 2 6.63 ft Nominal Yes Roofing:Material 4,T, Comp Roof I Span 3 ya" A i,f -.04A IZ5.25 m.^2 Re-Roof No San 4 S. 3.06 in,^3 Plywood Sheathing Yes. i, San 53.. fi- 4i5.36 in.A4 n Board Sheathing None Total Rake Span 16.54 ft TL Defl'n Limit 120 Vaulted Ceilin No PV 1 Start 1.75 ft Wood Species SPF. Ceilin Finish 1/2"Gypsum Board PV 1 End 15.08 ft Wood Grade #2 Rafter Sloe -ir 350 PV 2 Start Fti` 875 psi Rafter Spacing 24"O.C. PV 2 End F„ 135 psi Top Lat Bracing ' 4s"' Iw Full F" PV 3 Start - u .. ..,E :r,.., u x ,1400000 psi 'F, Pot Lat Bracing At Supports PV 3 End Emi„' 510000 psi Member Loading mary Roof Pitch 9 12 Initial Pitch'Ad'ust Non-PV Areas PV Areas Roof Dead Load DL 9.0 psf x 1.22 11.0 psf 11.0 psf PV Dead load PV-DL ;#, 3.0 sf .: a , x1.22. r L'- d •w 3J psf . . , Roof Live Load RLL 20.0 psf x 0.78 15.5 psf Live/Snow Load LL SL1,2 30.0 sf,. x 0.7.,.I,x 0.41 21.0:psf 12.3.psf Total Load(Governing LC TL 32.0 psf 26.9 psf }- Notes: 1. ps=Cs*pf; Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf=0.7(Ce)(Ct)(IS)pg; Ce=0.91 Ct=1"1,IS=1"0 Member.Design Summa (per NDS Governing Load Comb CD CL + CL - CIF Cr D+S 1,15 1.00 0.90 1 1.5 1.15 Member Analysis Results Summary Maximum Max Demand @ Location Ca aci DCR Load Combo Shear Stress 46 psi 1.1 ft. 155 psi 0.30 D+ S , Bendin (+ StressLL r717 si`.: 4 9.9ft. ' 1736 si : -t1 041' Yu. D+'S` Bending - Stress -992 psi 6.9 ft. -1567 psi 0.63 q D+ S Total Load'Deflection:� ._ K .•;4 .,0:231in. '`420 7.^9:6 ft." � P 40.81,ins1 120 A � �'0:29 `�� D+:`SY # y CALCULATION-OF DESIGN WIND_LOADS=MPIB Mounting Plane Information Roofing Material Comp Roof PV System Type > _ SolarCity SleekMounf -"" " _ _ °K Spanning Vents No Standoff; Attachment Hardware _;, MR 7 a7 rw ': Comp Mount l vpe C z ^" W 77777' Roof Slope 35° Rafter Spacing "'" fw ,aiW6kFoF.i frs Framing Type Direction Y-Y Rafters Purlin Spacing = a: X-X.Purlins Only. '" NA .� Tile Reveal Tile Roofs Only NA Tile Attachment System _ __Nile Ro fso Only NA .StandingSeam ra S acingSM Seam Only NA Wind Design Criteria Wind Design Code ASCE 7-05 Wind De isgn_Method Paitially/Fully:Enclosed Method Ms = Basic Wind Speed V 110 mph Fig. 6-1 Exposure Category - spy 'C _ __v Section 6.5.6.3 Roof Style Gable Roof Fig.6-11B/C/D-14A/B Mean Roof Height h 35 ft Section 6.2 Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ_ 1.01 Table 6-3 Topographic Factor - � - Krt _ 1.00 �Section.6.5.7 Wind Directionality.Factor Kd 0.85 Table 6-4 Im ortance Factor s--I Velocity Pressure qh qh 0.00256(Kz)(Kzt)(Kd)(VA 2)(I) Equation 6-15 26.7 psf Wind Pressure Ext. Pressure Coefficient U GC -0.95 Fig.6-11B/C/D-14A/B Ext. Pressure Coefficient Down GC w c 0.87 Fig.6-11B/C/D-14A/B Design Wind Pressure p p= qh(GC) Equation 6-22 Wind Pressure Up Nun) -25.4 psf Wind Pressure Down 23.4 pslf ALLOWABLE STANDOFF SPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing_ Landscape 72" 39" - - »--• �Landsca a 7, w 24., •,„ NAB Max Allowable Cantilever- _f _ __p Standoff Configuration �Landscape Staggered _Max_Standoff Tributary,_Area ; Z L TvTrib,"'= 1 ! ' " �: 20 sf PV Assembly Dead Load W-PV 3.0 psf NWt tandffetdUff actual _ r:;. -47QIbs <' 1 Uplift Capacity of Standoff T-allow 500 Ibs Standoff Demand Ca a ityDCR _. 94.0% X-Direction Y-Direction Max Allowable Standoff Spacing, Portrait 24" 66" Max Allowable Cantilever- _ - Portrait 16" NA Standoff Configuration Portrait Staggered Max Standoff Tributary Area ..? °% Trib 11`sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at StandoffT-actual: m Uplift Capacity of Standoff T-allow �500 Ibs Standoff-0Demand Ca aci .. . . DCR 4iNe , ,,.�,. w,' W 52 3% Qek__ ikg�, gfi� ,"iGk' �; STRUCTURE ANALYSIS -LOADING SUMMARY AND MEMBER CHECK'-"MP2A Member Properties Summary Horizontal Member Spans Rafter Pro erties MP2A Overhang 1.07 ft Actual W 1.50 Roof System,Pro erties _ S awl 5.92 ft , rt^ Actual D 4�- 3,50"_ Number of Spans(w/o Overhang) 2 San 2 . 6.65 ft Nominal. Yes Roofing Material'' '` Corn Roof ., . 'S an 3 ry ., A,O,.-. 5.25 in:^2 Re-Roof No San 4 S. 3.06 in.A3 Plywood Sheathing a r; .Yesk& - ,. San 5* �.. . ,. . I` °a ,. n< ffl5.36 in.^W,. Board Sheathing None Total Rake Span 16.65 ft TL Defl'n Limit 120° Vaulted Ceiling Now " PV 1 Start "` 1.67 ft Wood Species SPF Ceiling Finish 1/2"Gypsum Board PV 1 End 15.08 ft Wood Grade #2 Rafter Slope !,*4, 35° PV 2 Start �F .. V.; z 875. si sis'_ Rafter Spacing 24"O.C. PV 2 End F,; 135 psi Top Lat Bracing Full PV 3 Start E 1400000 psi Bot Lat Bracing At Supports PV 3 End Emi„ 510000 psi Member Loading mary Roof Pitch 9 12 Initial Pitch Adjust Non-PV Areas. PV Areas Roof Dead Load DIL 9.0 psf x 1.22 11.0 Psf 11.0 psf PV Dead Load PV-DL " 3.0 psf „zt x 1.22 3.7 psf. Roof Live Load RLL 20.0 psf x 0.78 15.5 psf Live/Snow Load , O NYLL SOl , s?� 30.0 s W 12.3fj':w id 0.7` ('z;0.41 sf, Total Load(Governing LC TL j 32.0 psf 26.9 psf Notes: 1. ps=Cs*pf;Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf.= 0.7(C.)(CO(IS)p9; Ce=0.9,Ct=1.1,Is=1.0 Member Design Summary(per NDS Governing Load Comb . CID CL + CL - CIF Cr D+S 1.15 1.00 0.90 1.5 1.15 Member Anal sis Results Summary Maximum Max Demand @ Location CapacitV DCR Y Load Combo Shear Stress 146 psi 1.1 ft. 155 psi 0.30 D+S Bendin ; + Stress P, : - ,J19; psi,- h ^ 10.0 ft: `:*.; 94.^1736 sp � 0.4 1 D+S ,Bending - Stress -1005 psi 7.0 ft. -1566 psi 0.64 D+-S Total Load.Deflection -0.23 in: 418 9.6 ft: 0.81 in. 120 0.29; D+S" CALCULATION:�OF DESIGN WIND_LOAD MPZA s � �. v . Mounting Plane Information Roofing Material Comp Roof PV System Type " _ SolarCity SleekMount'" Spanning Vents No Standoff Attachment Hardware ti" R. .,. CompiMount Type C w ; Roof Slope 350 Rafter Spacing . , . 24"o.C. ,r ti ,z Framing Type Direction Y-Y Rafters Purlin Spacing X-X Purlins Onlyy NA Tile Reveal Tile Roofs Only NA Tile Attach ment System" I - Tile- Onty� fix: � °" Standin Seam ra Spacing �SM Seam On NA Wind Design Criteria Wind Design Code . ASCE 7-05 Wind'Design Method- _ -_- ` _ PartiallyjFully Enclosed.Method Basic Wind Speed V 110 mph Fig. 6-1 Exposure Category ,;, xrL = ry " echo 5.S nib 6'3 a - _ Roof Style Gable Roof Fig.6-11B/C/D-14A/B Mean Roof Height w ram: h 35 ft w" Section 6.2t:' Wind Pressure Calculation Coefficients Wind Pressure Exposure KZ 1.01 Table 6-3 Topographic Factor Krt 1.00 Section 6.5.7 Wind Directionality Factor Kd 0.85 Table 6-4 Im ortance'Factor . s I7 F.y.; f 1:0 A Table°6-1 = k Velocity Pressure qh qh = 0.00256(Kz)(Kzt)(Kd)(V^2)(I)26.7sf Equation 6-15 Wind Pressure Ext. Pressure Coefficient U GC u -0.95 Fig.6-11B/C/D-14A/B Ext. Pressure!Coefficient Down GC" o.Wn _ 0.87 Fig.6-11B/c/D-14A/B Design Wind Pressure p p= qh(GC) Equation 6-22 Wind Pressure U „ -25.4 psf Wind Pressure Down Pfdownl 23.4 psf ALLOWABLE.STANDOFF SPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing Landscape 72" 39" Max Allowable_Cantilever Landscap a Tr— Standoff Configuration Landscape Staggered Max_Standoff Tributary''Area �° Tribes'. 4, 20sf. TM € PV Assembly Dead Load W-PV 3.0 psf -N-et a W.ndUp_if t-a-t S tandoff Tactual _ 7470Ibs a Uplift Capacity of Standoff T-allow 500 lbs Standoff Demand Ca aci DCR 94.00/. X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 24" 66" Ma"TALI owable1 - Portrait ' 16" ' ��NAB Standoff Configuration Portrait Staggered Max StandofTr-'Are .f� t PV AssembyDead Load _._ W-PV 3.0+psf Net Wind Uplift at Standoff J T-actual -262 Ibs�� Uplift Capacity of Standoff T-allow 500 Ibs dC ci Stndf Deman 7 52T.3-6% MAR. 04. 2005 (SAT) 13:59 CENTERVILLE FIRE 5087902385 PACE. 1 Fire Prevention Bureau 1875 Route 28 Centerville, MA. 02632 C.O.M.M. Fire District Phone: 508-790-2380 Department of Fax: 508-790-2385 Rescue Services Fax ro: Jack Fitzgerald From: Martin MacNeely Fax: 508-790-6230 Date: March 4, 2005 Phone: Pages: Re: 221 Five Corners Road , CC: O Urgent X For Review CI Please Comment ®Please Reply Confidentiality Notice:This Fax may contain confidential information belonging to the sender which is legally privileged and which Is Intended only for the use of the Individual or entity named above.Any copying, disclosure,distribution or dissemination of this information or taking any action based on the contents of this communication is strictly prohibited. If you received this transmission in error,please notify us Immediately by telephone and return the original transmission to us by mail or delivery at the above address,the cost of whioh shall be paid by us,Thank you. MAR. 04. 2005 (5AT) 14:00 CENTERVILLE FIRE 5087902385 FAGE. 2 CENTERVILLE-OSTERVII.LE•MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE &EMERGENCY SERVICES 1926 1875 Route 28•Centerville, MA02632-3117 508.790-2380•FAX; 508-790-2385 John M.Farrington,Chief Glen S.Wilcox,Fire Prevention Officer Craig E.Whiteley,Deputy Chief _ Martin 01.MacNeely,Fire Prevention Officer is March 4, 2005 TO: Building Department Jack Fitzgerald Town of Barnstable 200 Main Street Hyannis, MA. 02601 In accordance with MGL 148, Section 28A, the Centerville-Osterville- Marstons Mills Fire/Rescue Department brings to your attention the following potential violation(s) of 780 CMR: Massachusetts State Building Code for your review and/or interpretation of same. NAME/BUSINESS: Residential — Marcelo Assis ADDRESS: 221 Five Corners Road, Centerville OBSERVANCE: Illegal basement bedroom. Basement room being used as bedroom. No adequate secondary means of egress found. Thank you, Martin Mac Neely Fire Prevention Officer C,4.M. Fire District 1 "Commitment to Our Community" i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # /S`d S5 el Health Division Date Issued CY 2 Y r3" Conservation Division Application Fee 5 Planning Dept. Permit Fee .� Date Definitive Plan,A�pproved by Planning Board Historic - OKH IV D _ Preservation / Hyannis Project Street Address 0a 1 -F:Tl:c Cg-r-ncr Village e �y� k Owner Address Telephone g 1�1• �� a. '7�'� nierv� Permit Request Sp1&r 1 9 aF 2 i• , • h , ec S (a bL Square feet: 1st floor: existing — proposed — 2nd floor: existing — proposed — Total new Zoning District QC Flood Plain Groundwater Overlay Project Valuationb ov Construction Type_ Lot Size Grandfathered: ❑Yes ;if No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure r5. Historic House: ❑Yes ANo On Old King's Highway: ❑Yes UNo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other N'h- Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing •— new `— Half: existing i 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 ❑Others/ Central Air: ❑Yes ❑ No Fireplaces: Existing Nt New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new siz&Pool: ❑ existing ❑ new sizeff/�_ Barn: ❑ existing ❑ new size Attached garage: ❑ existing ❑ new siz�/&Shed: ❑ existing ❑ new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ C mmercial ❑Yes No If yes, site plan review# Current Use �rS IG�r_�la Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) T r Name GiL �, G6Im P/. Telephone Number Address d f �eS n vt ea� License# CS- OR6/ Home Improvement Contractor# ��$3 Email Worker's Compensation # T 01900 k _1� d ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WIL BE TAKEN TO 66(� 4 11.fi= y� nh SIGNATURE DATE �J FOR OFFICIAL USE ONLY t APPLICATION# DATE ISSUED - MAP/PARCEL N0. - ADDRESS VILLAGE " OWNER - 4 DATE OF INSPECTION: t FOUNDATION FRAME 4 INSULATION FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT " ASSOCIATION PLAN NO. S - ,SolarCi ty. OWNER AUTHORIZATION.- Job#: 61723 Dom: A Z 2 L ., Property Address: / . � �1�. C 0 A/ P f OAR R�I/Sr-,� � IQ �C� f� Nl)� Ul as Owner of the subject e property hereby authorize SOLARCITY CORPORATION to act on my behalf, in all matters relative to work authorized by this building permit application. _ t Signat a of.Owner: Date:., SOLARCITY:COM - AZ ROC V.377VIMC CAU0 6804,COZOW41;CTW,O&VMWO1253W,MYZI01+1WE00202W,mcr-26 ,,MANIC:Sawr&MAw omn,MQMKC12B0A8;_ TIJNJFt;CYt3uti0&79 43tE6073@TDgQR CSi8040WCSW/MI4M PA,tEKPAA M3.TS51fCJ.M&V`1n tll.l�1C' (1t1 96ARC'605P.0'20MsoLARCtTycmtvRATm,ALL RN3isFesewq:, a .. _ {5 Y JASON PATRY 321 STEWART DRIVB,- a Abingtoa MA Ow1 a '� 7. OT�B/Za1B - QTW of Counuier Athin&Qaeil nen Regsl�don + 9 ` ' HOME ITAPROVEMENT CONTRACT09 � • e Regtatr>;igoa .1R3572 Tyigi . >�,, ExpiratMn 4` ry _ 3f812017 Supptem a C SOLAR Ct111 CORPORA ION JASON PATRY «� r r,. 24 ST NUIR'iIN STREEY BLO ZUNI ��!�:s-. __ i k� l.Aki.BOROI G,"K MA 01IM Uederscercbry. ! , , •s • ,. 1, • - • w �`• axe - ,�, Vie Commonwen"of Massachusdts Deperbnent of Industrial Accldenic ..,:. 1 Congms Street,Sane IN Boston,lt"02114--201 T www.masrgov/d&i Workers'Compensation Insursom Attidarrrit:Builders!Contractors/Elt>etrictam/Plumbem. TO BE FILED WITH THE!'ERMIITING AUTHORITY. Agg icent InforMation Therese Print Leg b1,�ly Name(Tiavinoss/Drgpnizokott/tndi-�idtrut) Sol$tCity CorporafltNl '� Address: 3055 Cieatview Way City/State/Zip: Safi Mateo,CA W02 phone#: (888).765-2489 C Are ymran amployer?Ch"k the rsppropriate tMt: Y. Type a>s ptraject(required)., 1©t Din aemplayerwlth 12,500employecs(lbil`andro1rpnittime)' 7: ❑Newcbnstitidion a[]1 Mn a sale proprietor or patinenhip and hwo no cmployCQS%vorkiag for-me in 8. Rotntydaiittg any talme Y.[No vwrken'comp.insurance v quirod.j 3[�1 amahoa�orraadar��l work sayss$C jAirrnrorkers'camp,itisutancarequlrcd j t 9 -Q Demolition 10 4.[l l am a homeowner and will he hiring arntractors to conduct all ivork on my property t win 0 Building addition ensure thatWI axamtom either have wart crs'cmnpuamtiou iusurmta,*rare sole. �' I I.[:]Electrical repairs or additions proprietors with no ensployeca. - 12.[]Pluttibitrg repairs or additions 501 run a general,cmunictor and t have hired the suss-contrmtom 161ad an the attached sheet 13.01toaf.Cepaii S 'f b=sub-canlramn have employees and have workers'comp.inam nae: Iq.QOther solar pane% 6.[j We are a corporation and'tta officets haveesamised their right of exempilm per MM c. ,. 15Z§1(41 and we have no employees,[No wa&mV Carty.insurance�044hnd•1 *Any applicant drat checks box 91 most also rill out tine section blow shaving their workers'compean iutt policy ihfomntion It I lomeownem-wvM submit this aft;davit im ienting they are doing all work and then hire outside,contractors mist submit a new ni'lidivit iudieAting suck +Cootmoom that clronh this box nual attached an mkiltional sheet stwwing the name of this sub-contractors and state whether or not those entifles have .. 1 , tmnloyeas, if the sttb�rnractots have employees,they mast rovide their wdrkryts,wmp.policy mrris6er., Jam are Below Is Nee palky uad job site iafarmatloa. �� -_ American Zurich Insurance Company Insurance Company Name; _ � r Policy#or Self-ins.Lic.4: WC098269S-00 Expiration Qate:.9/1I2018 Job SiteAddrfss: 22lTive Corners Road Cityl$tatc/2ip Centerville,MA'02632 Attach a copy of the workers'co mpevantiou po f decla ration page(showing the policy am tuber and expiration date). Failure to secure coverage as required trader MGL a.152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/ar one-year imprisonment,is well as civil venajties inn the form ofa STOP WORK ORDER and a fine of up to$250.UD a day againstthe violator.,A copy of this statement may be€onaarded to the Office of investigations orthe DIA for insurFmce 4 coverage variflcation. ° 1 do hereby cer ' vn$w the pains aml penaltles of perjury!hut the lnformadon provided above is true and correct (Jason Pam) Se tember 11,2015 Phan Oklal use only. Do not write in this,urea,to be complet�by city or tower o�flclaL - , City or Town: PerwitlLicense# Inning Apthority(circUe one): 1.Board of Health x.Buiidintg Department I City/Town Clerk 4.Meetrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: ACCO CERTIFICATE OF LIABILITY'INSURANCE 08f1712015 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 15SUIMG iNsuRaR(S),:AUTHORI2.Eb 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 WANED,Subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not Conw rights to the certificate holder In lieu of such ando►semBnt(s). PRODUCER - - CONTACT MARSH RISK&INSURANCE SERVICES 346 CALIFORNIA STREET,SUITE 1309 PHONE ...... 1j! No}. CALIFORNIA LICENSE NO.0437153 EMAIL SANFRANCISCO,CA 84104 :a._oDR.4 . ... Alin:ShannonScolt4t57438334 :.:1NsuRER�s}nfFoxaN000VERAG£..:: _ NAlc.e 9M01-STND-GAWUE-i5.16 INIBURr=RA Zurich Amfidcanlnsura=Company " (16636 NIA INSURED --. Salar0tyCorpota0on INSUR s NIA.... -_ 3065 Clessfiew Way INSURER c NIA Ny--�- San Mt11eD,CA 94402 INSURER D:Amedcan Zurich Insurance.Canpany �10142_ INSURER E -- INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-00271383HO REVISION NUMBER`4 THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING 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. T...__ -- INSR, TYPE OF INSURMICE TAli6L OWN" 'POLICY EFF POLICY EXP I .: . I� I POLICY NUMB 1 - LIMITS A X l4 CO6rMERCIALGEN£RALLIABILITY GLOM82016430 09101I2015 09101r101fi EACH OCCURRE 000{�NCE S 3, 00 �..._ .I _ _ DAMAGE L I c1.AIMS-MADE n OCCUR %' . 3,00,0110 X ISIR b250,000 5,000 I MED EXP(Any one.pecson). S - - —-- PERSONAL&ADV INJURY S 3 000 ODO GEN'L AGGREGATE LIMIT APPLIES PER k GE14ERAL AGGREGATE $ 6 000.000 POLICY JJEEC O. .... LOG PRODUCTS.--COMPIOP AGG $_.. ... :__. 6,000.000 OTHER, go S A AuroMOsaEL1A lTY _ BAP8182017.00 ', 09I0tl2016 09101/2016 MBA Q N LIMIT $ 5000,000 x ANY AU70 I C BODILY INJURY(Per person) S SCHEDU NONONNED ! I,. i ....... ....... X... AAUUTOS ED X AUTOS LED BODILY INJURY(Par accident) S .. PROPERTY DAMAGE X wrtEo avros X... AU OS i I I i T.tuZM)... COPAPICOLL DIED S $5,000 UMBREiLALtAB OCCUR , f EACH OCCURRENCE $........... EXC£E&LIAB CLAIMS4dADE AGGREGATE. S - .... . CEO i RETENTIONS ? —. D WORKERS ION jWC0182014-00(At� OW12015 109/01 016 X PER oTH• AND EMPLOYERS'LIABILITY A ANY PROPRIETORIPARTHERIEXECUTI VE, YIN r=82015-00{MA) 09101/2015 IOBlD112016 E.L.EACH ACCIDENT ' S i 000 000 OFFIGER4MMRHtEXCLUDED? 111A�`" —.- (Mandatory In NN) WC DEDUCTIBLE$500,000 E L.DISEASE_EA EMPLOYE S' 1000 000 I,I dascrrbe under J RIPTIONO OPERATIONS El DISEASE-POLICY LIMIT $ 1100D,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VERgCLES(ACORD M,AddiBnnal R6nm*s Sehedut%may be atraahud IT more spsea Is t"Loredl EYldence of lnsuranse. CERTIFICATE HOLDER CANCELLATION ' SolmCdy CorporaYlon SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3055GearviewMy- R THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN San Meted.CA 99402 ACCORDANCE WITH THE POLICY PROVISIONS. $U MoRIZEO REPREEEWATIVk of Marsh Risk S Insurance Services CharlesMarmole)O 01OSB 2014 ACORD CORPORATION. AR rights reserved.- ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map pParcel F La Application Health Divisio rivision 06 �-12 Date Issued � � h d Conservation Application Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis o Project Street Address S v A Village Ce '41 'ey-OUME, I Owner We, ah tAkitxeL Address P-'�c d ` ©� - G" Telephone 9Q - ®® 0 Permit Request R n ki g- Vek&,1iN j A )D(1,-G Q LM G1A k aJ R es c x-e'7_ L Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new . Zoning District Flood Plain Groundwater Overlay Project Valuation)„;mo 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's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft)r Number of Baths: Full: existing new Half: existing s newer°" u= Number of Bedrooms: existing _new `n � . Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other `s 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 W No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ---- - Name Telephone Number 114"00 3 b-A 63'lip Address car tR License #�'� ti '' W - (X Home Improvement Contractor# 1� 1 Worker's Compensation # fv 3 ®`l ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO U ft - SIGNATUR DATE_X; _ I 4= _ FOR OFFICIAL USE ONLY } APPLICATION# r DATE ISSUED 5 MAP/PARCEL NO. <r ADDRESS VILLAGE k OWNER r DATE OF INSPECTION: FOUNDATION FRAME t _F INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH '`FINAL 1 FINAL BUILDING DATE CLOSED OUT F ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information pp Please Print Leilibly Name(Business/Organization/Individual): �Ty^ �� Address: •Z C & 1� City/State/Zip:N_Q�Wl.� -A c,, U6;3 L Phone.#:5 01 _)4 �4` 9 Are you an employer? Check the appropriate box: Type of project(required): 1.[ I am a Y o emP t er with_2 4. ❑ I am a general contractor and I — 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7.. ❑ Remodeling ship and have no employees These sub-contractors have 8. '❑ Demolition working for me many capacity. employees and have workers' . 9 ❑Building addition [No workers' comp. insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its '10.0 Electrical repairs or additions 3.El I ama homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *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. 1Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: GIf-cz -F Policy#or Self-ins. Lic.M (03 0 � 0 (p Expiration Date: Job Site Address:—A i)' % �a*y%.e V-S KCN City/State/Zip, 7PAszk�!kA e Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage.as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy-of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby7?4 under the pains a71fie of p rjury that the information provided above is true and correct Si ature. 9L Date: 'J Phone#: Official use only. Do not write in this area,to be completed by city or town offcciaL 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#: - 1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied,oral or written." . An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However.the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in__(city or town)."..A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permnit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel.# 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-77451 . Revised 11-22-06 www.mass.gov/dia iVass ich6i I D p il0 nt of Pul. lic Safch Boil d of Building Rm- Stand:wd, r CQnst uction Su�ervisbr}L cense , License CS 23320 F ' Restricted to",00 .: KENNET.H 18TUARTn �p 63 POCASSET sMA 02559 h � _ i5 l�xpira i �f'6J1812010 ' F, e ,tiz,nct rr. s nrt 2876 �. x{ r ,,';�� -s,f � s t ��'T' tao ttL�t � 'lt► I r �. '�r• ^r` ''� �CIt tt le - GIs � r S t5 �i .� 11L�� Utltltd jai? `� � '� � 7 �y 7✓�a"x t � �301r(t°� onYt' e £z max: _ ug (glt IU �� tfljt v q i3� N ,t '" tyY CG��`s j 1pn �t� ' t YjOt c MP 1�3Ga0 r ?79�0 $ �• R 91S �,. 11., lu WWI VIC I c'! �`e' t �r� Y � `4y41 i j� a; +'�{J L��'"^rz� ..0• ' e S�ri �.,. y ��' �.c� � :.�+.n{ ` 1 i��'P�� m,.•t t " y- -' .. �M�� V ' C jr Ei- ol glj .c y�'� l � •+t't' rr r"' �k§�'t':��?,`F"'�,�a n�+;'r +� £f 4 k •�1.. 1 et {� ..�r�`t✓ t��. '�"x �°a'{yfi'}l��`g tt��y 5��.�$C:�ir�'•`' �] �- GY yn'M l � � _ ' �h�Y z r .:, °qC'�c•'. - � `�tt5� ��`�'��rx'3'` �j�'.,,`. Y... � s. h DEC-21-2009 04:13P FROM: TO:915082760607 P.1/2 Doc 17 09 102% Brian Stuart 60NO= p.1 Town"of Ilarustable $ R.eg atory Services Ib mw F.Ceder,Dkwwr 0` BaUdIng Division 'llbm)Perry,]RvB tg Counlidoner 200 Main St eeg,*aonzs,MA 0=1 www.tawa barA4abbs,me.as Office: 508-9624038 FAX 508-7%-6230 Property Uw,u r Must Co eft and Sign This Section, If UsiM ABum' der hereby wa to an on mybehmH, in altmastets dative to�ro a by dzis permitwtion for. "ass ofjob)7 7/1 She s�err NKr uc n agent ror Bark as sefvano of P&t Name jf gmpMt {!V=is applying for pemxit please complete the Ho eownets Ucense Exemption Form on the M erse side. �sp�S;pWNFR2'B�MlfBStl�3 . 09-39-09 05:02pm From-AIG +9T3 331 0599 T-255 P.00.1/.002 F-645 ' y..77, ;.r.mata.. u-r_-t':k:"' •t•� in....tir.:..•'�+:::•• �� - ' `INEC?fZflAATIOi�t I Is IsSUI;D AS A mA'TTER OF PRODUC1 R CER?IFICATE IS 6 ONLY ANp CgNFERS 1�IQ RIGHTS UPON THE CERTIFICATE S CERTIFICATE GH punn Insurance ND OR H04�J �COVERAG AFFORDED BDoEs �TTHfc POLICIES 215 Main 5t ALTER suzzatds Bay,MA 02532 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE-COMPANY INSURED Stuart&Co I.t_C 175 Teatfcket Hwy,Ste 13 Teaticker,MA 02536 �.�i ��, •h:;'' -a! "=r :.�a". A:. =:.d '_.. • - •- - ED ABOVE FOR COWTms IS TO CERTIFY THAT THE POLICIES OF INSURANCE L ED RE�w HAVE BEEN ISSUED TO'ON OF INSUREDYCONTRACT ON NAM THE POLICY PERIOD INDICATED,NOT WITHSTANDING ANY REQUI ISSUED "TOR MAY PERTAIN, 111 INSURANCE AAFFOR D?H♦=R DOCUMOT Wes{RESPECT TO WHICH'fHIS CEt�t1FtCAT1:MAY BE N ISSLIB.IEOT TO ALL TERMS,pUCLtlSlONS AND CONDI110NS OF SUCH POLICIES.IINI(TS SHOWN PouclBs DEWROED I MAY HAVE BEEN REDUCED BY PAID CLAIMS co �cnvE aaTE PouC'r pcP11U►naN ATE . LTR 7yM��tsuwwCE PnLtGrNutA9EFi PO1.14Y CIMI1 Cgp�pExSATtQ1V ._--- ND EMP4aYST UAMUW PROPR; 1�t1flV6 : ATIKfJRY LIMITS :Y7.• ,.. _. �c�s�' F�37(37�a 9115P�DtI9 NCt 61 EXCL D $ 500,0 ER CRACCIOR�r Z3 500,00 rn etapo App{!en W MA Opals ONr• E PaI.ICY UNIT $ 50000 ��5E-TACK 6MPtn`!ES ESCRIPTL OF OPERATIANSIVEHICL �PECIAL ITEIAS E.NO PAKfNFE.RS ARE CARED BY-ME WORKERS COMPENSA710N POLICY. CERTIFICATE HOLDER pNCELLATION TOM OF FAL slip=ANY of lM ABOVE MGCRWM POIj=9E MASsACHUSETTS pr> ATtot+OATE ts�nve p0"E'A"��VAU TO WT'Wn 59 TOWN HALL 5QUARE oAYSWR�NOnCETOTHECERTIFICATEHOtA(MVIGAn 9 TOW 1TH,MA QUA pAt}�jtf TO MAIL=R WMCE Sn""PosE NC OBLIC�1T1oN OR t1ABtt R Y ANY 1QND UpW-ME COMPAW,US AGWM OR REPRESENTA'flV-& AU-Mo ftIZED REPRESENTATIVE DEC-21-2009 04:13P FROM: TO:915082760607 P.2/2 Jan-ca'UY Ub:U4PII rrw I"bbb r.uUi m m4d P.O.Box 44090 L�l Washington Mutual P.O. FL;�31.aoao HOME LOANS 904-181.3000 To Whom it may concern_ Please be advised that REO Experts,LLC is a designated Asset MaaagemedbehC alfm of Y for Washington Mutual Bank and is autborlxed to list and sell prowf m On Washington.Mutual Beak-Furthermore Washinpf m Mutual authonzes RECI Expert% LLC to awe ute puran /Sales mtmts on our Wild The prapMes sold could be titled to Long Beach Mortgage as Trustee for Deutsche Bank►or other entities that WAMU would provide POA for on an as needed basis. Washingtoa MuhW is the Bank Awned propettti and will AtU=q in Fad for tha tale own be signing ALL Deeds and HWS to Complete the title traashr of tbese pmpemg. The authorized Asset Managcxs of UO Experts.LLC that are approved to sign on our behalf are: Mike Sm e m Niebel Suxltt Bra Meffsse Riles Denise Tatra Michell®7j ler Steven Warten Steve Rieder James Crewbrd Path pono"n L nn Ce cuff, Kehl B8 eMtO4* Else Tomes emu Durbin Ken sahfuenz Ole Lam John Robinson Patt selemo Wend Wifson Dots Pond Charlie B usz John21,111" er 'Tillan Cam JanetVo es Ro L da Stre Julie an Susie T ant Diane Aitken Sheme Mall Dave Plum n Ed IQrmOn Kim Bran bras Mad n Sags Brian Danielson Thank you, Ully Livingston WSW . Washington Mutual Bank, FA mn is - Vassaehuseto;-Dep.il'iit?.ni Board of BW]dint-,Regulations and Standard-. l License: CS 233M Restrided W,-.00, .. . _. KEPtMEi H f WUAR T. 63 iMDY-RD -POCASSE-ri MA 02559 Expiiatiosi Isilawo t'omn Wanner T r#: 2B769 BOS�r(!Of lAi mng�oIIS An� flr S ifVW)M1'RwBWENT CONTRACTOR Registration:. 153684 > . . ExpirAuon..'IrM011 ` Tr# 279401 KENNETH I STUART' KENNETH STUART 63 HANDY RD. •POCASSET,MA 02359-- Administrator ,c 31 09 11:39a Brian Stuart 508-299-8320 P.1 FAR TOWN OF SiMNSI t: & COMPANY Building&Remodeling i;f� . Additions - Roofs - Siding:- Windows - Decks 1W. Complete Landscaping Services Maintenance&Construction cep[774.836.8985 Falmourli ofce 508:457.6495 Lirrusrd 8 (nsarrd Fax 508.299-8320 TO: �Rs��e.,��\�• p� .From: Stuart&Co.,LLC. Name: Date Sent: J-I- 31— CC: Phone: Number of Pages: � Fax: So�- 770- 6230 �u:.�\e � . �� 5 ,.ems ,��.c3� � �r�•r�- �e c'�`.`� , f c 31 09 11:40a Brian Stuart 508-299-8320 p.1. 12l31r2069 09:11 8172973118 DENiSEJATRO PAGE 01101 - Dec 17.09 10'2Ss Brian.Shlut 30 RegmhtWry 9Qr ices .. '_-�_Q J/�7YillLi �."'.^ax^_...� .Yrt:R-rNF'c°'v?,.. • ` �NY'KRYi> t q il XAMOWA s�rA�.town:�kn�bl�ma.m Office: 508-99-RQ3$ Pas.308-740•5230- i: P><tip�zty C3�+erTriu��t . Corr&-te and$ign 'his Sec��jt if ug $ 1der i 1 � 3c, "oFthe EY iF `�V G , 1 ut m a�z a�stieF* 621 auk==Welk=m wsffk *dva mg appb�at oa r. imp Vf- cefd-",,,I srfo� �3f Of Se16eTF . - , MRT REO[-Wperts LLC as agent for Washington MOM Bahr,as Servipng Agent for Owneref Record P,r�2�atrae ' If Ems►€finer is spP �'pC=Oitplease COMPIC ae the T 4 owe iaccoe.Exmvoa .ra=oa the=vmp side.' m. M. , ! =4 17 � rA 9'. C. Q 7 nA cv k a IIe� Jul G (' P�� ko l mot Iy n---------------- gr5 13 afAl • I3 ' Yf � vp i I OCL a' U U I G L) `,I TT 4 y FvcIle >y TOWN OF BARNSTABLE BUILDING PERMIT APPLI ATI4 , Parcel 00 4� Application o o ( l Map / to � pplication# Health Division Conservation Division Permit# Tax Collector Date Issued (P Treasurer Application Fee Planning Dept. Permit Fee *Z, °O Date Definitive Plan Approved by Planning Board pK (1 ZD(p Historic-OKH Preservation/Hyannis Project Street Address t r"f�Q Village C_0(9�Q P-IVIU0 14- Owner eC1 Aetg r��- h� Address )ZI FIVe, rs Telephone �� Permit Request ~�� J� ( V� � AA,G Square feet: 1st floor:existing - proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dyrelling Type: Single Family t Two Family ❑ Multi-Family(#units) 1 Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: 9 Full ❑Crawl �1 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 0 No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new) size:_` C Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: E3I > �n Zoning,Board of Appeals Authorization Cl Appeal# Recorded❑ Commercial ❑Yes ❑No rt If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name o r'l-A F"Oe L A VL) Telephone Number 1� `I 36. io Address �� F Cut Clow)) QS '- �2 License# 0abM_ Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .SIGNATURE DATE 6 1,s ,O6 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. 2 ADDRESS VILLAGE OWNER ` DATE OF INSPECTION: FOUNDATION FRAME INSULATION �! FIREPLACE I v ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDIN -7 W CG4f PL-k G TASP 7 400C P DATE CLOSED OUT - ASSOCIATION PLAN NO. the C;ommonweauft of lvlassacnuseus Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ` www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: '1 Z \ 1— e V T City/State/Zip: C 6 26 3V Phone#:_-7—T Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet $ 7. ❑ Remodeling ship and have no employees These sub-contractors have 8'. ❑ Demolition working for mein any capacity. workers' comp,insurance. 9. ❑ Building addition o workers' Comp.insurance 5. ❑ we are a corporation and its 10.❑ Electrical r o airs r additions ;,myself, quired.] officers have exercised their m a homeowner doipg all work right of exemption per MGL 11.❑ Phunbing repairs o-r additions [No workers' comp. C. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t R employees. [No workers' COMP.insurance required.] 13.❑ Other *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 their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: . Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation p.alicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 ca:lead to the imposition of criminal penalties of a fine up to$1,50Q.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 and the pains and penalties of perjury that the information provided above is true and correct. $Mat1ge: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2.Building Department. 3.City/Town Clerk 4.Electricsi inspector 5.Plumbing Insvector I 6.Other Contact Person: Phone#: ti TIME T Town of Barnstable 0 Regulatory Services f M 4 M � STABLE, v MASS. Thomas F.Geiler,Director 1639. ` Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. // Type of Work:4onoU� Si'it !fit- &.p"iTe_�s Estimated Cost ,5 Address of Work: C;t91 r1y _ er s �p Owner's Name: Date of Application: X2 Q L® a I hereby certify that: Registration is not required for the following reason(s): ❑Work 94cluded by law ❑Job der$1,000 []Bu' ding not owner-occupied WVner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Signature Registration No. OR ate Owner's Signature Q:wpfiles.forms:homeaffi day Rev: 060606 I • Town of Barnstable P��FTt/6 Tp�~O Regulatory Services S Thomas F.Geiler,Director • sniwsTasi.s, y MAss. g 1639• Building Division �PTfG Mpg a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-79076230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ' ��V r G JOB LOCATION: _ t ,� ll number street vt lage "HOMEOWNER": /lJ 50 e - home phone# work phone# CURRENT MAUJNG ADDRESS: city/town state zip code .The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units..or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and require ents. gn re eowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons.-In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns, You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt , �c�o� - -p 3 3 PIKE t Town of BarIlSt;able *Permit# Q)° '>✓ Expires 6 mo the from issue daie Regulatory Services Fee * BARNSTASLE, v� 1659. Thomas F. G.eiler,Director Building Division Tam Perry,CBO, Bull ding;Commissioner 200 Main Street, Hyannis,MA 02601 ww-w.town.barnstab l e.ma.us Office: 508.862-40 8 Fax: 508-790.6230 EXPRESS PERMIT APPLICATION = -RESIDENTIAL-ONLY Not Valid without Red X-Press Imprint. ' Map/parcel Number orner Property Address 2� , D .4 . Ill 1� .�. . , F1 Residential Value of Work��Q�� Minimum fee of$ for work under$6000.00,-. Owner's Name&Address 2I CAN f-1 Vk ©z 6�z Contractor's Name . Telephone Number / 7/ Home Improvement Contractor License# if applicable) p + P ( _ License if applicable) ,._ I Lt ns #Construction Supervisor's to . P P OWorkman's Compensation Insurance e� u Check one: Ch - I am a sole proprietor I am the Homeowner -TO\N OF BARN�J� A . El I have Worker's Compensation Insurance Insurance Company Name V Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each.permit. "Permit Re.qrspooefck box)(stripping old shingles) All.construction debris will be taken to : Re-roof(not.stripping. Going over existing layers of roof) ' Re-side #of doors ❑ Replacement Windows/doors/sliders.U=Value (maximum:44)#of windows *Where required: Issuance of this permit does no exempt compliance with other town department regulations,i.e.Historic,ConservaLon,etc. ***Note: Property.Owner must sign Property Owner-Letter,.of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is, required. SIGNATURE: - Q:\WPFILES\FORMS\building e nit forms\EXPRESS,doc` Revised 090969 . r Fq ` �44 The Commonwealth of Massachusetts Department`of Industrial AccideWs Office of Investigations 600 Washington Street c1c Boston, MA 02111 -11 y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information -Please Print LeVibly Nalne (Business/Organizatior/Indi iduai): �` G Cnl�y 1'I�l lit Address: ' l,I City/State/Zip: �' _ Phone #: ' Are you an employer?Check the appropriate box: Type of project(required) 4. I am a general contractor and I. 1.❑ I am a employer.with 6. ❑ New construction have hired the sub-contractors_ __ ernployees'(fulland/or part time). - 2:❑ I am a sole proptietor.orpartner- listed on the attached sheet. . . 7, ❑.Remodeling ship and have no employees These sub-contractors have g, Demolition workingfor me in an `ca aci employees and have workers' Buildin addition. y p ty.` . 9. El Building [No.workers' comp. insuranct comp.insurance:$ required.] 5. We are a corporation and its 10 Electrical repairs or additions 3. I am a Homeowner doing all work officers have,exercised their 1 1.0 Plumbing repairs or additions myself. [No workers' comp.' y right,of exemption per MGL 1,2.V Roof repairs insurance required.] t c. 152, §1(4), and we have no employees, [No workers' 13.❑ Other 5. comp.insurance requued.] *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 arc doing all work and.then hire outside contractors must submit a new affidavit indicating such: tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have.employees,they must provide,their workers'comp,policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is thepolicy and job site information. � . Insurance Company Name: " Policy# or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'.compensation.policy declaration page (showing the policy number,and,expiration date); Failure to secure coverage as required under Section 25A of MGL c..152 can lead to the imposition of criminal penalties of a . fine up to$1,500.00 andlor one-year imprisonment, as well as"civil penalties in the form of a STOP WORK ORDER and a fine of up to S250,00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for-insurance coverage verification. . I do hereby certify under the pains and penalties ofperjury that the information provided a .ove is true and correct. Date: �Si'nature: - Phone#: ' Offcial ttse only. Do not write in this.are a;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: ° P.hone#: m com Massachusetts General Laws chapter 152 requires all employers oinrlhe'sderv.i oce kof anoth P under oany contract oPlh fees. Pursuant to this statute, an emplo),ee is defined as '...every person express or implied, oral or written:" ern !o er is defined as ''an individual, partnership, association, corporatio lalives of aedeceased empl yegal entity, or any w ootheore An p Y of the foregoing engaged in a joint enterprise, and including the legal to legal.enti receiver or trustee of an individual, partnership, association or otherend who res des heroein, or hying peloccupant of they he owner of a dwelling house having not more than three apartments a air w dwelling house of another who employs persons to al maintenance,o ecase of sucth,employme.ction or nt be deeorkmed to be an neempl yerSe or on the grounds or building appurtenant thereto shall no L uance the i MGL_cha ter 152, §25C(6) also slates that "every state t local lruct b iladgens in the commonwealthsfor any r P renew a] of a license or permit to operate a business or to construct g applicant who has not produced acceptable evidence em he opminonwealth nor any ofl,aDcc With the nls political ce coverage shall Additionally,MGL chapter 152, §25C(7) states "Nei enter into any contract for the performance of public work until acceptable evidence of compliance with the ms�uance ` a ter have been resented to the contracting authority re quirements uirem ents of this ch p P . Applicants. ' . ur fill ou t workers' compensation affidaviCcompletely,by checking the boxes that.apple rtifiy to ocate(s)�of on and, if Please narne(s), addresses)and ph necessary,supply sub-contractor(s) one numbers)along un t insurance, Limited Liability Companies (LLC)or Limited Liability Partps if an membersor LLP does have with no employees her than the members or partners, are not required to carry workers compensation insurance. of employees, a policy is required. Be advised that this affidavit surge to signay be b nldtdated e the the affrdavi�t ntThe affiLdavitlshould Accidents for confirmation of insurance coverage. Also g be retuned to the city or town that the application foD the pennit or lacenD7e being required to obtain requested,not th 1a wo kers't of Industrial Accidents. Should you have any questions regarding the law you a cornpensaiion policy please call the Department at the number listed beloW..Self-insured companies should enter their icense number on the appropriate lint. self-insurance l City or Town Officials Please be sure that the affidavit is.complete and printed legibly. Investigationshe ) has lto contact yo�artrnfrit has aragarding the applotanm Of the affidavit for you to.fil] out in the event the Office Please be sure to fill in the.permit/]icenseuumber which will bVensedaTs need only submit one affidavit ndicatii.rtfMnoc; number, In addition, an ng'c tent thatmust,submitmultiplepermit/license applications in any g y _(city policy information (if necessary)and under"Job Site Address" heraprpked by Should cay ortiown may tb provided of the °r town).""A copy of the affidavit that has been officially stamped or YOut tach applicant as proof that. a valid affidavit is onizen is obtaining.a license or permit not related to any file for future permits or licenses. A newaffidavit s ness or commerc al venture year. Where a home o)vner or cit (i.e, a dog license or permit to burn leaves etc•) said person is NOT required !o complete this affidavit. ike to thank you in advance.for your cooperation and should you have any questions, The Office of lnvestigalions would l please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax 4 617-727-7749 o��HFroh Tow h of Barnstable ° Regixlatory Services uMsrAsLE Thomas F. GeBer, Director 9 $ Building Division �Eb MDR�' •. . ; Tom Perry, Building Commissioner ` 200 Main Street,Hyannis;M-A`02601; www.t own..b arnstable.ma.us Pax: 508-790-6230 Office: 508-862-4038 Troperty Owner Must Complete ancl:Sigri This Section if Usk A Builder I ,as Owner�of the subject property 3 n my behalf hereby authorize' a,... to act o , ' f in all matters relauye to work authorized by.this building permit application for: Aass of job) Signature of Owner Date Print Name ' o e Ovrier is a plying for permit please compete the zf PT P Homeowners Livense Exemption Form onthereverse side. y , r A Town of Barnstable �P Of T FIF.T�O Regulatory Services + + Thomas F. Geiler,Director + 1A.RN5'i'ABLE, Building Division s63g• p�F 39�a Tom Perry,Building Commissioner 200`Main Street, Hyannis,MA 02601 wwyv.t own.barns tab le.ma.us Office: 508-862-4038 Fax: 508-790-6230 H OMEO WNER LICENSE EXENITTI ON 1l y� Please Print DATE: 6 ID r 1�. D 11 B LOCATION: �. 1v� lAydf JOB village n��u��m//ber /'j p {,' 11�! street '•HOMEOWNER": 2HON a I .RW q0N h'n home phone If work phone a1 name CURRE TMAI NGADDRESS: CAI `„V'�'� 1 At l`D city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFIN7TTON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to' be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner, Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) with the State Buildmi Code and other �� nsibilit for compliance g The undersigned Homeowner"assumes respo y P applicable codes,bylaws,rules and regulations. The undersigned "homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and req irements. ' a r of H omeowner S i n to g I f Building ldin Ofircial Approval o g ee-famil dwellings containing 35,000 cubic feet or larger will be required to comply with the Note: The y g - State Building Code Section 127.0 Construction Control. HOMEOWNER'S,EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this.smtion(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." . Many homeowners who use this_exemption are unaware that they are assurrung the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly. when the homeowner hires unlicensed persons, In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. n�W4FiT F.S\FCIRMS�homcczcmpLDOC .. TOWN OF BARNSTABLE Y PARCEL ID 1.68 080 001 GEOBASE ID 9410 ADDRESS 221 FIVE CORNERS ROAD PHONE CENTERVILLE ZIP LOT 22B BLOCK LOT -SIZE DBA DEVELOPMENT DISTRICT CO k PERMIT 84281 DESCRIPTION APT #77983 PERMIT TYPE BAMNCO TITLE AMNESTY APT CERT. OF OCC. CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: $25.00 BOND $.00 p�F CONSTRUCTION COSTS $.00 '756 CERTIFICATEiOF OCCUPANCY 1 PRIVATE O I BARNSTABLE, . '►� Mass. �' FD MP'�A BUJDti I3ION BY�� n DATE ISSUED 05/20/2005 EXPIRATION DATE—,,`- - / r ' TOW, OF BARNSTABLE PARCEL ID 168 080 001 QEOBA.SE ID 9410 ADDRESS 221 'FIVE CORNERS ROAD PHONE CENTERVILLE ZIP �I LOT 22B BLOCK I,OT '°SIiE CE DBA DEVELOPMENT DISTRICT CO } PERMIT 84281 DESCRIPTION APT #77983 h PERMIT TYPE BAMNCO TITLE AMNESTY APT CERT. OF OCC. j CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: $25,00 r j BOND $.00 CONSTRUCTION COSTS $.04 756 CERTIFICATE :OF OCCUPANCY 1 PRIVATE 0 snRtlsraBi.E, l � •.�MA98, ( I BU D. ON !� a .BY II DATE ISSUED , 05/20/2005 EXPIRATION. DAT THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. A BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 ' 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCE ED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA TION. NOTED ABOVE. TION. Barry, Lois From: Taylor, Madeline Sent: Friday, June 29, 2007 9:29 AM To: Barry, Lois Subject: RE: 221 Five Corners Hi Lois, Tom McKean sent me a septic approval for 7 bedrooms. They just need to remove the garbage disposal. Thanks, Madeline 1 Barry, Lois To: Taylor, Madeline Subject: RE: 221 Five Corners I don't know what they were told (I had left for the day), but 1 believe they need the AMNESTY PROGRAM APPLICANT-- SEPTIC QUESTIONNAIRE in the file with Tom McKean's'approval. Do you know if that application was done for this property? Is there any way I can find out if these applications have been submitted to BOH for other Amnesty properties which have recorded documents but have not yet applied for a building permit? It would be helpful for this to be done in advance. What is your understanding of the process with BOH? Lois -----Original Message---- From: Taylor, Madeline Sent: Thursday,June 28, 2007 9:57 AM To: Barry, Lois Subject: RE: 221 Five Corners Hi Lois What kind of letter do BOH need? Thanks -----Original Message----- From; Barry, Lois Sent: Thursday,June 28, 2007 9:41 AM To: Taylor, Madeline Subject: 221 Five Corners Maddy, Have you heard from them? Apparently Board of Health sent them away to get a letter from you?? I will try to see Tom McKean to see of we can streamline the Board of Health sign-off process, but he is at Site Plan Review this morning. Let me know if you have any information on this. Lois �2 JL 1 �X ,off �� 27 PIP 1p ✓�' oe > �' 3 king 1 s] 77} - 10, 12 30 � G � r TOWN OF BARNSTABLE � BUILDING PERMIT fPARCEL ID f68 080 001 GEOBASE ID 9410 ADDRESS 221 FIVE CORNERS ROAD PHONE CENTERVILLE ZIP - LOT 22B BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO �e,.S i PEg I 77983 DESCRIPTION CREATE APT IN BASEMENT ZBA-2002-85 PERMIT TYPE BREMOD TITLE RESIDENTIAL ALT/CONY CONTRACTORS: PROPERTY OWNER Department of ARCHITECTS: P TOTAL FEES: $202.77 Regulatory Services BOND .00 CONSTRUCTION COSTS $57,344.00 , 434 RESID ADD/ALT/CONY 1 PRIVATE +► BMWSTABLE, MAM 039. BUILDING DIVISIO IN BY DATE ISSUED 07/19/2004 EXPIRATION DATE T,0W F BARNSTABLE � _ - BUILDING PERMIT , PARCEL- ID"168 080 001 GEOBASE; ID 9410 ,.ADDRESS_ f 221 FIVE CORNERS ROAD PHONE CENTERVILLE ZIP - � 1 LOT "' 22B BLOCK �;° 1 ' LOT SIZE DBA DEVELOPMENT-, DISTRICT CO PERMIT 77983 DESCRIPTION,'. CREATE Y'Alt APT IN BASEMENT ZBA-32002-85 PERMIT TYPE BREMOD TITLE RESIDENTIAL ALT/CONV CONTRACTORS: PROPERTY OWNER . k ` ' Department of ARCHITECTS: P Regulator TOTAL FEES: 202.77 , y Services BOND 4 $.00 CONSTRUCTION COSTS $57,344 00, 434 RESID ADD/ALT/CONV 1 PRIVATE � R u 4 +*► BAANSI'ABLE, *,. MASS. FD MPr BUILDING DIVISION I BY 6 DATE ISSUED 07/ 9/2004 EXPIRATION DATE C/ (ju' U THIS PERMIT CONVEYS-NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- I.. CROACHMENTS ON-PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF'FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF.000U ELECTRICAL,PLUMBING AND MECH (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. I OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 4 1 2 Dr 3 1 EATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPF%ems contracting with unregistered contractors � � v�At 1 do not have access to the guaranty fund (as set forth in MGL c.142A) �AA-�uLSrl=� f)5-c7'7-Q 5 C-O�wM►�.ta:rt WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. BUILDING I PhRMIT `tom TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map _ Parcel s TQ=< , Permit# Health biMsia,"i cgw`/ —/C9 C t4 �-j `!S TABLE Date Issued? 1-)1 Conservation Division AR 23 Application Fee 42�) Tax Collector Permit Fee *1"17-11 Treasurer Ql�'1510y S ' " SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPUANCE WH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis _ " `'� TOVM REGULATIONS Project Street Address r i \J[ bo F 1f-'5- A GL Village ---liG ul f'y Owner M81E U!s ��/ � 1��.>?�P1 Address Telephone 50 — 4 0 S aj� Permit Request `T0047 -- s L Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes J No If yes, attach supporting documentation. Dwelling Type: Single Family' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes No On Old King's Highway: ❑Yes o Basement Type: XFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) -4 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: A Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes i(No Fireplaces: Existing _ New n Existing wood/coal stove: ❑Yes 44 No Detached garage:❑existing ❑new 'size N Pool:0 existing ❑new size (J Barn:❑existing ❑new size 0 Attached garage:0l-existing ❑new size-,2_L2!!_'3 Shed:❑existing ❑new size tJ Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes j-No If yes,site plan review# Current Use i0'e-0J 67/04-- Proposed Use LX BUILDER INFORMATION p Name- A >EUS � �`al�i �F1 Telephone Number Address ,2 I l�►` E G o y NE r S pet License# C C- A)re-YL/f eqZ Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I.22/L - FOR OFFICIAL USE ONLY PERMIT NO. T{ DATE ISSUED _ MAP%PARCEL NO. t ADDRESS VILLAGE OWNER ' t DATE OF INSPECTION: FOUNDATION FRAME r 1, INSULATION ' FIREPLACE ELECTRICAL: ROUGH ' FINAL S { PLUMBING: ROUGH FINAL i GAS: ROUGNO S FINAL ' „ m FINAL BUILDING r-p,� m DC v DATE CLOSED OUTzi 1 , \ ASSOCIATION PLAN NO. N S " M- m Qt1 The Commonwealth of Massachusetts Department of Industrial Accidents' f168M1MW/ fM _ 600 Washington Street Boston,Mass. 02111 workersMensation.•Insurance Affidavit-General Businesses 22 area: •'� �5• ! � f :•�- address a011 .. Fi UE LQY U&r s cit C/U'�F K U 1 C-L state M ziy (D,T-Y32_phone# D� ork site location full address I am'a sole proprietor and have no one Business Types 0 Retail❑Restaurant/Bai/Eating Establishment working in any capacity. El Office❑ Sales(including Real Estate,Autos etc.) ❑I am an ere to er with . ere Tees(full& art time).. ❑Other %/ %/% %////%//%/% %/O%/�%�%%/%�%�%%////%�%/ %%/////%%/%%/ I aril an employer providing viorkers' comvensation for my employees working on this job. compan';name, , city pone:#.:'� �•'. # FT=rietor and have hired the independent contractors listed below who have the following workers' .compensation polices: cona... .. ♦.:... • ..1'y1 .. .. . - • n name::. .:. : ....:..•. . . • .. . address:. �' •�;+:.� ' oIIe.. - el! 1) Oil :t:•insurance"co. - - i %%%//G%%%/%i_ "C :`e:. ni coin.'ail. na ' . . •' : :phone#"s . . . •C 1 r � iIISllr Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that R copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby ce ify nder the pal s an penalties perjury that the inform ation provided above is true and correct Signature Date 2 a Print name M A TC U J �_-j<-i S i �1 X Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office []Health Department contact person: phone#; ❑Other (revised Sept 2003) • y Information and Instructions Massachusetts General I;aws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the f'law", an employee is.defined as every person in the service"of another under any contract of hire, express or implied; oral or.written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a�joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. *However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant,of the dwelling house of another who ernploys_persoiis 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 bean 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. y Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation.. Please supply company name, 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 andprinted legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill-in the permit/license.number.which will be used as a reference number. The.affidavits.may.be returned to the Department by.mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: . I The Commonwealth Of Massachusetts Department.of Industrial Accidents Bffice of ievestigatlons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext:406 o� Eras. Town of Barnstable Regulatory Services a, s aar,E, • Thomas F.Geller,Director Building Division 'OIFD MA•t a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, -improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work Estimated Cost Address of Work• �� .Vlk (�®hM f� Owner's Name:_— k f�U 5 �ici i S ►)C16_i y1Pr Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 ding not owner-occupied Kowner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FORAPPLICAB.LE HOME MROvEMENT WORK DO NOT H&VE ACCESS TO THE ARBITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY • I hereby apply for a permit as the agent of the owner: Date Contractor Name RegistrationNo. OR Date Owner' Name RESIDENTIAL BUILDING PERNUT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq. foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE ��• square feet x$64/sq.foot= 5 34 4 x.0031= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq,foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30,00= (number) Fireplace/Chimney x$25,00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost Town of Barnstable Regulatory Services MENSrABM ; Thomas F.Geiler,Director 9 Kas s. �,, 1639• Building Division rEn a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 1�0 1 F11 V e C�JC i( �D • 9 C(J,�1 t:c=V, J I Lj1 number street village "HOMEOWNER": Ad-. 60:s A, r Y�I'��- 50& y�o �2 5 6 name home phone# work phone# CURRENT MAILING ADDRESS: - city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and reqAteent Signa e KHdw6owner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt I Bk 18836 PS 331 -56706 l a e7-16-2004 & 02 o 5593-� .......... 34 C1 PRK BAR STABi Zfll3 FED 10 : E sDJq. `0� ED IM�h Town of Barnstable Zoning Board of Appeals Comprehensive Permit Decision and Notice Appeal 2002-85-Teixeira Applicant: Mateus Teixeira Property Address: 221 Five Comers Road,Centerville,MA Assessor's Map/Parcel: Map 168 Parcel 080/001 Zoning: Residential D Groundwater Overlay: AP Aquifer Protection Overlay District Applicant: The applicant is Mateus Teixeira,with an address of 221 Five Corners Road, Centerville, MA. Mr. Teixeira is the individual to whom this Comprehensive Permit is issued to create an accessory apartment unit within the basement of a sin le-famil dwelling i g y d ... gas an affordable rental unit n accordance with all conditions of this permit. Relief Requested: The applicant has applied for a Comprehensive Permit under the General Law of the Commonwealth of Massachusetts,Chapter 40B-§20-23 and in accordance with the General Ordinance of the Town of Barnstable Chapter III,Article LXV, "Pre-existing and Unpermitted Dwelling Units and for New Dwelling Units in Existing Structures," more commonlytermed the "Accessory Affordable Housing Program." The zoning relief necessary for this Comprehensive Permit to be issued is that of a variance to Section 3-1.3 (2) of the Zoning Ordinance—Accessory Uses to permit an accessory apartment unit to a single-family owner-occupied residential dwelling.The issuance of this Comprehensive Permit would allow for an owner- occupied single-family residence with an accessory affordable apartment unit located within the single-family. dwelling. Locus and Background: The property is a.45 acre lot that is developed with a 5-bedroom,3 1/2-bathroom, 5, 336 square feet single-family, Colonial style home. The applicant bought the property four years ago and conceived of building an accessory unit someday.The applicant recently.heard about the program through a.friend and decided to apply for it. The accessory unit is proposed to be added in the basement of the main house. It will be a two- bedroom unit at approximately 2,600 square feet. The locus is in a Residential D,in AP Aquifer Protection Overlay District. Procedural Summary: This appeal was filed at the Town Clerk's Office and the Office of the Zoning Board of Appeals. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised and notice sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened on July 24,2002 at which time the Hearings Officer announced that the case would be continued due to program upgrades resulting from state level changes in the Chapter 40B process. The case was continued to August 21, 2002 and continued three more on September 25,2002,November 6,2002 and December 11,2002. At each continuance,Mr.Teixeira asked for more time in order to upgrade the se f 4 ' January22,2003 at which time the Comprehensive Permit was granted. Officer,Gail Nightingale presided over the public hearing. Also present were Paulette Theresa-McAuliffe,Accessory Affordable Housing Program Coordinator,and Michelle McKinstry,Barnstable Housing Authority. Findings as to Standing and The Comprehensive Permit: At the January 22,2003 hearing,the Hearing Officer made the following findings of fact: 1. The applicant is Mateus Teixeira with an address of 221 Five Corners Road, Centerville. Mr.Teixeira has owned the property since October 26, 1998,as documented and recorded at the Registry of Deeds in Book 15113,page 347. Mr.Teixeira is requesting a Comprehensive Permit to create an affordable rental apartment to be accessory to the single-family owner-occupied residential dwelling. The applicant has submitted a copy of Certificate No. 39068, documenting his ownership of the property. 2. The applicant was issued a site approval letter dated January 17,2003 from Kevin Shea, Director,Office of Community&Economic Development,qualifying his application for the Accessory Affordable Housing Program. The source of the subsidyis the federal Community Development Block Grant(CDBG) program 3. The rental unit is proposed for approximately2,600 square feet and will have 2 bedrooms. It will be located in the basement of the single-family Colonial style home. 4. According to the Assessor's record,there is a total of five bedrooms on the property. All are,in the main house. The property is serviced by a septic system and the site is in the AP Aquifer Protection Overlay District. The Public Health Department approved the septic system at the site for a total of 7 bedrooms as per written approval by Thomas McKeon,Public Health Director dated January 16,2003. Prior to this approval from the Public Health Department,the applicant was granted special authorization to "add an additional leaching field,install a 2500 gallon septic tank, and convert his existing septic tank into a pump chamber"in order to handle up to but not more than a total of seven (7) bedrooms on the property. The approval from the Town of Barnstable's Board of Health is dated December 20,2002. 5. The Barnstable Housing Authority completed an inspection on June 4,2002 of the property where the unit is proposed to be created. The applicant is aware that an official inspection bythe Building Division will be required before he is given an Amnesty Certificate of Participation. 6. .On August 12,2002,the applicant signed an Accessory Affordable Housing (Amnesty) Program Affidavit agreeing to comply with the programs requirements,including owner occupancy of the principal dwelling unit and further agreeing to comply with the provisions set forth in Article LXV (65) of the Town Ordinances that include their signing and recording of the Regulatory Agreement&Declaration of Restrictive Covenants. The subsidizing agency has determined that the signing and recording of the regulatory agreement qualifies the applicant as a"limited dividend organization" as that term is used under M.G.L.c.40B §§20-23. 7. The applicant understands that the affordable unit will be rented to a person or family whose income is 80% or less of the Area Median Income.(AMI) of Barnstable-Yarmouth Metropolitan F Statistical Area(MSA) and further agrees that rent (including utilities) shall not exceed the rents established by the Department of Housing and Urban Development (HUD). 8. The Barnstable Housing Authority has committed to the monitoring of this affordable rental unit. 2 9. According to the Massachusetts Department of Housing and Community Development,as of October 1,2001,4.7% of the town's year-round housing stock qualified as affordable housing units. The town has not reached the statutory minimum under M.G.L. c. 40B 45 20-23 or its implementing regulations. Under the Town of Barnstable's Local Comprehensive Plan, the use of existing housing to create affordable units and the dispersal of these units throughout the town is encouraged. 10. Based upon the findings,the project is deemed consistent with local needs because it adequately promotes the objective of providing affordable housing for the Town of Barnstable without jeopardizing the health and safety of the occupants provided all conditions of the Comprehensive Permit are strictly followed. Ruling and Conditions: Based upon the findings,the Hearing Officer ruled that the applicant has standing to apply for a Comprehensive Permit under the General Law of the Commonwealth of Massachusetts, Chapter 40B — §S 20-23 and in accordance with the General Ordinance of the Town of Barnstable Chapter III,Article LXV,"Pre-existing and Unpermitted Dwelling Units and for New Dwelling Units in Existing Structures," more commonly termed the "Accessory Affordable Housing Program." The granting of this Comprehensive Permit is to the applicant,Mateus Teixeira.It is issued to permit the creation of an accessory apartment unit to a single-family owner-occupied residential dwelling of 2,600 square feet,subject to the following conditions: 1. The property owner shall occupy the principal dwelling as his year-round residence. 2. Occupancy of the affordable unit shall not exceed two adults or a family of four. 3. This unit shall not be occupied by a family member. 4. To meet the requirements of affordability,the cost of housing (including utilities) shall not exceed the Department of Housing and Urban Development's (HUD) (or any successor agency) 80% rent limits as published from time to time. Eligible tenants shall have an income at or below 80% of the Area Median Income,adjusted by household size. Both the rent limits and income limits can be secured from the Barnstable Housing Authority or from the agent of the town implementing this program 5. All leases shall have a minimum term of one year. 6. The applicant shall have the unit re-inspected by the Building Division to assure that all necessary requirements are met according to minimum state building and fire codes. It shall also be reviewed by the Health Division to assure compliance with applicable on-site wastewater discharge requirements. 7. The applicant may select their own tenant(s)provided the tenant(s).meet all requirements of the program and provided that person(s) income is reviewed and approved by the Barnstable Housing Authority as a qualified individual. The applicant will be required to work with the Housing Authority to provide information necessary to document that the tenant(s) qualify. To insure that the unit is rented in an open and fair basis to an income eligible individual or family, the unit must be listed with the Barnstable Housing Authority(BHA) and the Housing Assistance Corporation(FUC)whenever a vacancy occurs. Also,the applicant must notify the monitoring agent of a vacancy whenever it occurs. 8. Every twelve months the applicant shall review the income eligibility of those individuals occupying the unit. No later than a year from the date`of issuance of this Comprehensive Permit the applicant 3 c , shall file with the Barnstable Housing Authority an annual affidavit listing the rent charged and .. income level of the occupant(s) of the unit. The applicant shall provide the Barnstable Housing Authority any additional information it deems necessary to verify the information provided in the affidavit. Upon any report from the Barnstable Housing Authoritythat the terms and conditions of this permit are not being upheld,the Zoning Board of Appeals or it's Hearing Officer shall have the ability to hold a hearing to show cause as to why this permit should not be revoked. 9. The Accessory Affordable Unit shall be affordable in perpetuity(as affordable is defined herein) unless this Comprehensive Permit is rendered void. 10. This Comprehensive Permit shall not be transferable to any other person or entity without the prior approval of die Hearing Officer or Zoning Board of Appeals. This decision, the Regulatory Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be filed at the.Barnstable County Registry of Deeds. If the ownership of the property is transferred, the Barnstable Housing Authority shall be notified within 60 days the name and address of the new owner. 11. All parking for the dwelling and accessory unit shall be accommodated on site, and no lodging shall be permitted on site for the duration of this Comprehensive Permit. 12. This Comprehensive Permit must be exercised and the unit occupied within 12 months of its issuance or it shall expire. Transmission of the Decision of the Hearing Officer to the Barnstable Zoning Board of Appeals In accordance with Part II, Section 4.0.2 and Part III;Section 3.72 of the Town of Barnstable Administrative Code,the hearing officer transmitted her written decision to the Zoning Board of Appeals on January 22,2003, and fourteen days having elapsed since said transmittal with the Zoning Board of Appeals taking no action to reverse the decision,this decision becomes the decision for this Comprehensive Permit application. Ordered: Comprehensive Permit 2002-85 has been granted with conditions. Appeals of this decision,if any,shall be made to the Barnstable Superior Court pursuant to MGL Chapter 40A,Section 17,within twenty(20).days after the date of the filing of this decision in the office of the Town Clerk. The applicant has the right to apppq this decisi n as outlined in MGL Chapter 40B,Section 22. G ' Nightingale, Baring Ct er D to S gned I, da Hutche '-er,Clerk the Town of.Bamstable,Barnstable County,Massachusetts,hereby certify that twenty(20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of.the Town Clerk . Signed and sealed this day of under the pains and penalties of perjury. Linda Hutchenrider, Town Clerk, 4 I NEW SMOKE DETECTOR REQUIREMENTS ARE NOW LAW. EVEN THE ADDITION OF A ' NEW BEDROOM WILL TRIGGER AN UPGRADE OF THE SMOKE DETECTORS �1Y ®� v' FOR THE WHOLE HOUSE. YOU MUST PLAN ACCORDINGLY AND HAVE YOUR ELECTRICIAN TAKE OUT THE APPROPRIATE -- PERMIT AT THE FIRE DEPARTMENT. --.—_� ?-G 44' t — Rio E y �• VV1�y'lER�EDptoOv�. �. VIIW� �0�� c��zk ; '•� I N I ! I 5 'f- Door for _.fAidor uj+raow SMOKE DETECTORS O.K. F1�� 1,.AGF - (_�a=�T LE BUILDING DEPT. 21I FIVE CoQNEYt.0J IRORD C'EN#Ekv%LLE, TAA 026b2. SASeMENT' APhVQTVeN'Y TLANt .- -UY �. RbR��No :! 5os 4aStt8-t i Nurh ber of Bedrooms Total Rooms I 11 = 2 = 5.5 Rounded down = 5 Bedrooms Li v Bed Bth study Klt Family FDin Room a Foyer 5 7ciosBtI2 Lndry Bth B 3 l Bed Bed Bed Z 1101 F�- Test (^ Pit. 2 � z Town of Barnstable Regulatory Services THE T°� Thomas F.Geiler,Director Building Division BAMSTnai.e, v mass. $ Tom Perry,Building Commissioner 4� 163q. ,• 2000 JAN 16 PM 1: 17 CFO Nt °i 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 � if 'U 508-790-6230 Approved: 42=6-311 Fee: Permit#: e_ HOME OCCUPATION REGISTRATION Date: Name: e// ' /'7 %� �(/� ?^ Phone#: 56-W - l.20 , Oq- 5 :P Address: I V ' �(� �'1�� (1�� Village: /IC(�{�T/�(' U,C(( 6 3-2 Name of Business:_/G _-- Type of Business: (` GC911-k7 Map/Lot:'�(o� 00 I INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation "'Ithin single fanuly dwelluigs,subject to the provisions of Section 4-1.4 of the Zonrinig ordinance,provided that the activity shall not be discernible from outside the&elliig: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent-resident of a single family residential dwelling unit,located NVithinn that dwelling unit. • Such use occupies no more thani_,400 square feet of space. • There are no external alterationns to the dwelling which are not customary in residential buildings,and there is " no outside evidence of such use. • No traffic Nvill be generated m excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare;humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in,excess of normal household quantities. • Any need for parking generated by such use sliall be met on the same lot containing tine Customary Home Occupation,and not"«thin the required front yard. • 'There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet ii length and not to exceed 4 tires,parked onn the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,tine street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the &,yelling unit. 1,tlne undersigned,have read and agree mrith tlne- ove restrictions for my home occupation I'am registering. Applicant: Date: ��/ice Homeoc•.doc. Rev.01/ YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates [cost$30.00 for 4 you must d❑ by IVI:G.L.-it does not give you permission to ope.rate.] Business Certificates are available Years). A business certificate ONLY REGISTERS YOUR NAME in town [which Main Street, Hyannis, MA.026O1 [Town Hall) at the Town Clerk's Office, 1°` FL.,[which 67 mace wa mm V#x Zoo D s. Fill in ase: Fii-r..•f,,. APPLIGANT-s YOUR NAM E. YOUR HOM ADDRESS; F►V� CD�YIGr�S TELEPHONE # - i 1 Hom Telephone Number__C4 lb • h} - 5 NAME OF'NE BU511VE 7 a 15 THIS A.-HOME OCCUP,gTION? Y))6e ��Ccas TYPE OF BUSINESS: -__YES NO .: / Have you been given approval from the biiild,irng:drvisorj? 1C)=S NO 1 ADDRESS OF BUSIIME . ova I'1li'f� MAP/PARCEL NUM.BER_ j� 11C� QQ When starting a new business there are several things you must do in order-to 6e in compliance with the rules an Barnstable. .This form is intended to-assist you iri obtaining the information you d regulations of the Town of Rd. & Main Street),. to make sure you have the appropriate permits and licenses.re wired to le all Operate a y lay need. You MUST G�TO 20❑ Main St: - (corner of Yarmouth 9 legally P your business in this town. 1. BUILDING CONI R'S.OFFICE MUST COMPLY WITH HOME'OCCUPATION This individu ha b ir#or . d-of CCUPATION permit requirements that pertain to,this type of business. RULES AND REGULATIONS. FAILURE T®' Authpri d Si re** COMPLY MAY RESULT IN FINES. COMMENT la• J, _ y,)Z-—I- 2. BOARD OF HEALTH This individual has informgf the rmit requir is that pertain to this A `f� type of business. Au rized Signature`* SN0LLv7f1J321 S1b7a31HW co Sf10a21b�ZyH COMMENTS: . ` N� ' �'� 11YHtIMAldW001SPW 3 CONSUMER AFFAIRS ILICEN SING AUTHORITY This individual ha b n i f r of the lice s•, g r q it e is that pertain to this type of business. .,Authorized Signature.* COMMENTS n - 1 YOU WISH TO OPEN A BUSINESS? 17 e- For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission'to ope.rate.) Business Certificates are available at the Town Clerk's "` Main Street, Hyannis, MA.02601 [Town Hall) Offi P FL., 367 ,za:..i ar„x cRtnil .'—cm GATE. ,,, Y✓ •.• O Fill in please: 1 vw�'a via' m� q � � .. - APPLIGANT'S YOUR NAME:' E(1 /YY)A.�• D/1/ („� A BUSItiESs YOUR HOM ADDRESS:West . s' ' x ti TELEPHONE # Home Telephone Number -44 NAME OF NEW BUS1NE55 C (° C 16 Al TYPE O.F BiJSINESS: O IS THIS A HOME OCCUPATION?, YES. NO Have you been given app-roval.ff-brn the bui in,9*.divisjon? YES NO ADDRESS.OF BUSINESS a�-02� Gt I/ 60y1,M/e n S AP/PARCEL NUMBER G Yd# DOj When starting a new business there are several things you must do in order.to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information..you May need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. '& Main Street). to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM NER'S OFF CE MUST COMPLY WITH HOME OCCUPATION This individu I his efiri m f any permit requirements that pertain to,this type of business. RULES AND REGULATIONS. FAILURE TO Aut on _ignature* COMPLY MAY RESULT IN FINES. COMME S- 2. BOARD OF HEALTH This individual has been i e it requirements that pertain to this type of business. Auth rized Signa re* COMMENTS: . 3. CONSUMER AFFAIRS [LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type-of business. Authorized Signature.* COMMENTS: Town of Barnstable THE Regulatory Services pF 1p� Thomas F.Geiler,Director Building Division BARNSTABLE, y MASS. g Tom Perry,Building Commissioner t639. AIfD MA'S s 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 F x 508-790-6230 Approve Fee: Permit#: HOME OCCUPATION REGISTRATION Date: 1) '"t� � '� — OT Name: C e4(MA rL Phone#: 7 (; d'`I Address: �i V� ��N � GAG Village: Name of Business: 6bA/ L T l Q �V `lam— -VeQ /. . Type of Business: CO N 6 U C�k. 0 N Map/Lot: f� O�0 00 f INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat, glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials, or flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Hcme Occupation. • No sign shall be displayed indicating the Customary Home Occupation. e If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned, have read and agree with the above restrictions for my home occupation I am registering. Applicant: �d �— "O N ` Date: — t Homeoc.doc Rev.5/30/03 Town of Barnstable do BpRNSTAaLE, Regulatory Services 9 MASS. •1639 �� A'fo 39 Thomas F. Geiler, Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM TO: Madeline Taylor FROM: Lois Barry DATE: 8/6/07 RE: AMNESTY CERTIFICATE Here is the Amnesty Certificate of Compliance (original for applicant and copy for your records) for: 221 Five Corners Road, Centerville J030623a _ _ 1 6 W, %zy �0 a xol N., M W ;W AithbMv.', ram , Vc; t "iz Z -,6 ■ m- affordabae ;housin 0, .,e p t rmake,- e z L �j f:r' F e. 7 ®*wn D a S 4t t F T 'J F MON I 100.IP 1-1 �j� r 4 Certificate •. ance f C 6m" . , f L x, -Al T h certicate es�kcevtab e minimum This certificate indi6ai haibitable requi'66Fnents.per Mass taietOildin Code aclhuktms 9 n� th and Town of Barnstable zoning-ordinances ordinances in accorda ce wt eArnnesty'prograrn. Owner :. Miaria,Furlan : :.?,_ 'Location, 22l;Five Corners, Road 'Centerville,-MA o _qx -� RM, Unit i A One Wrooillnnot to exceed two People 2 Inspector. % MIP,No., '168080001 8/1/2007 pUtNE Top, Town of Barnstable Regulatory Services • snMSMBLE, v ninss. g Thomas F. Geiler, Director �p i679• �� lF163 Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 August 6, 2007 Maria Furlan 221 Five Corners Road Centerville, MA 02632 Dear Ms. Furlan: Enclosed is the Certificate of Occupancy for the Amnesty apartment at 221 Five Corners Road. We have prepared the Amnesty Certificate of Compliance and forwarded it to Madeline Taylor, Amnesty Program Coordinator. Sincerely, Lois Barry Division Assistant Enclosure amnco Town of Barnstable Building Department - 200 Main Street 9 LE. * Hyannis, MA 026O1 MAS&1639. ' (508) 862-4038 Certificate of Occupancy Application Number: 200703991 CO Number: 20070166 Parcel ID: 168080001 CO Issue Date: 08/01107 Location: 221 FIVE CORNERS ROAD Zoning Classification: RESIDENCE C DISTRICT Village: CENTERVILLE Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: AMNESTY APARTMENT ISSUED TO MARIA FURLAN Building Department Signature Date Signed '(NETpw TOWN OF BARNSTABLE Building. Application Ref: 200703991* BARNSTABLE, Issue Date: 07/30/07 Permit 9 MASS �ArFG 3�A�� Applicant: ASSIS,MARCELO T& Permit Number: B 20071804 Proposed Use: SINGLE FAMILY HOME Expiration Date: 01/27/08 Location 221 FIVE CORNERS ROAD Zoning District RC Permit Type: AMNESTY APT NO CONSTRUCT RES Map Parcel 168080001 Permit Fee$ 25.00 Contractor PROPERTY OWNER Village CENTERVILLE App Fee$ License Num. OWNER Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND EXISTING BASEMENT APARTMENT,NO CONSTRUCTION THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: ASSIS,MARCELO T& BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 221 FIVE CORNERS RD INSPECTION HAS BEEN MADE. CENTERVILLE, MA 02632 Application Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY T.T.STREET,ALLY,OR SIDEWALK GRAN ARHE / IT R•TEMPORARILY"OR,PERMANENTLY ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED.UNDER�THE BUILDING COD ,MUST"BE APPROVED BY THE JURISDICTION. STREET ORALLY GRADES AS WELL AS DEPTH AND LOCATION OF P,zUBLIC.SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC"WORKS:., THE ISSUANCE OF THIS`PERMIT DOES NOT RELEASE THE=APPLICANT FROM,THE CONDITIONS OF ANY APPLICABLE SUBDIVISION,RESTRICTIONS - MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO-LATH), 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS,DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). • D Oyu, y., BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health NEW SMOKE DETl'CFOR REQUIREMENTS ARE NOW LAW. Ev V-4 THE ADDITION OF A fi NEW BEDROOM WILL TRIGGER AN y UPGRADE OF THE SMOKE DETECTORS VWLY pOWt FOR THE WHOLE HOUSE. YOU MUST PLAN ACCORDINGLY AND HAVE YOUR ELECTRICIAN TAKE OUT THE APPROPRIATE — PERMIT AT THE FIRE DEPARTMENT. i Door o r 51 id.ec SMOKE DETECTORS OX 48 *L"EBUl LDI G DEPT. C'-'ENtepooLLe, YAA -02612 SASmEMT A-PARTM6 Wr T LAN t acme J:50 Number of Bedrooms :: Total Rooms 5.5 Rounded down = 5 Bedrooms Liv i . Bed LE th shay Mt Family Dln Room ` Foyer 57 -oc3 e ch Bth Lndry Bth -Bed to i3 i EM B " Bed f4 (98 ¢) Test Pit_ A? ral vw e u TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map /vl Parcel O 8 00 Application# Health Division ( Conservation Division Permit# Tax Collector Date Issued -7/3©/O `7 Treasurer Application Feeds Planning Dept. Permit Fee d Date.Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis �j�3o� l�1�J i?PAS J44— TL4 Project Street Address o�02 1 F i Ue V Gri 0o Village CQyi fB eU S LLe bi 4- Da2b3� Owner Ifln11✓l Y� %Fu P'LAw Address. Telephone J Permit Request e Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ® Two Family ❑ Multi-Family(#units) q ex; Age of Existing Structure L Historic House:, ❑Yes ❑No On Old King's Hig`fiway: ❑As ;�No _, ry Basement Type: ❑ Full ❑Crawl 41 Walkout ❑Other w tz Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 3 Number of Baths: Full:existing wr new Half:existing raw Number of Bedrooms: existing_ new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: 4 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 BUILDER INFORMATION Name 4 Telephone Number Address %vim coe-Y1(pa S p.) License# COY4--t r.'de MA ( 3�, Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY i PERMIT NO. DATE ISSUED MAP/PARCEL NO. L7 ADDRESS VILLAGE - OWNER `r'Y i DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL j PLUMBING: ROUGH FINAL f GAS: ROUGH '2 FINAL f r FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i z t 10-06--2006. a 08 _ 5 9a BARNSTABLE ' TOWN C!F,-pv BABNSfABE4 '�PrF 639.A'� '06 AUG 10 P 2 •18 Town of Barnstable Zoning Board of Appeals Comprehensive Permit Decision and Notice Appeal 2006-062 Decision - Chapter 40B Comprehensive Permit .Applicant: Maria Furlan Property Address: 221 Five Corners Road, Centerville, MA Assessor's Map/Parcel:. .Map 168 Parcel 080-001 Zoning: Residential C Zoning District Applicant: The applicant is.Maria Furlan, who resides at 221 Five Corners Road, Centerville, MA. Ms. Furlan was granted title to the property by deed recorded in the Barnstable County Registry of Deeds on January 31, 2006 as recorded in Book 20701, Page 236. Relief Requested: The applicant has applied for a Comprehensive Permit under Chapter 40B of the General Laws of the Commonwealth of Massachusetts, and in.accordance with Article II of Chapter Nine of the Code of the town of Barnstable,more commonly termed the,"Accessory Affordable Apartment Program." The zoning relief necessary for this Comprehensive Permit to be issued is that of a variance to Section 9- 14 of the Code—Amnesty Program to permit an accessory apartment unit within a single-family owner- occupied residential dwelling. The issuance of this Comprehensive Permit would allow for an accessory affordable apartment unit in the lower level of the principal residence. Locus and Background: The property at issue is a 0.45-acre lot,located at 221 Five Corners Road in Centerville. The lot was developed in 1971 with a single-family colonial style home. The effective living area of the main residence is 3,604 square feet. The accessory apartment is a one-bedroom unit located in the lower level of the principal residence. The square footage of the rental area is approximately 800 square feet. Ms. Furlan purchased the property on January 31, 2006. The former owners were participants in the amnesty program. Comprehensive permit 2002-085 issued to Mateus Teixeira, Marcello Assis and Wilma Teixeira was rescinded on June 2, 2006 to allow Ms. Furlan to apply for a comprehensive permit. The lot is served by public water and on-site septic, and is located within an Aquifer Protection Overlay District. The application was reviewed by the Health Department as part of the former owner's site approval process, and on December 20, 2002, the Board of Health conditionally approved a total of seven (7)bedrooms at the property contingent upon completion of an upgrade to the existing on-site septic system. The upgrade was completed on January 26, 2006. Procedural Summary: A site approval letter was issued for the property by Kevin Shea of the former Office of Community and Economic Development p on January 17, 2003, in accordance with MGL Chapter 40B and 760 CMR. Notice of the site approval letter was sent'to the Department of Housing and Community Development in accordance with the requirements of CMR 760. An application for a Comprehensive Permit was filed at the Town Clerk's Office and-the Office of the Zoning Board of Appeals. „ A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the Barnstable Patriot on June 30, 2006 and July 7, 2006, and notices were sent to all abutters in accordance with MGL Chapter 40B. On July 26, 2006 Hearing Officer Gail Nightingale presided over the public hearing. The applicant, Maria Furlan, was present at the hearing. Madeline Taylor of the Growth Management Department was also present. Ms.Nightingale reviewed the file with the applicant to assure compliance with all of the program requirements. Findings of Fact on the Comprehensive Permit: At the hearing on July 26, 2006 the Hearing Officer made the following findings of fact: 1. The applicant is Maria Furlan who resides at 221 Five Corners Road, Centerville, MA. She is requesting a Comprehensive Permit to convert an existing one-bedroom apartment in the lower level of the principal residence into an accessory affordable apartment. The conversion of the unit to an accessory affordable unit within a single-family owner-occupied residential dwelling qualifies for the "Accessory Affordable Apartment Program.” 2. Maria Furlan was granted title to the property by deed recorded in the Barnstable Registry of Deeds on January 31, 2006 as recorded in Book 20701,Page 236. 3. On January 17,2003 site approval letter was issued for the property by Kevin Shea of the former Office of Community and Economic Development of the Growth Management Department, in accordance with MGL Chapter 40B and 760 CMR. Notice of the site approval letter was sent to the Department of Housing and Community Development, in accordance with the requirements of CMR 760, and no issues were communicated from the Department on this particular application. 4. The proposed accessory affordable unit is approximately 800 square feet, and is located in the lower level of the principal dwelling. 5. The applicant is aware that the unit must meet all applicable building codes to be occupied and that the Building Division and Fire Department will also be inspecting the unit for compliance with all applicable building and fire codes. 6. The house is served by public water and private on-site septic and is in an identified Aquifer Protection Overlay District. The application was reviewed by the Health Department as part of the former owner's site approval process, and on December 20, 2002, the Board of Health conditionally approved a total of seven (7)bedrooms at the property contingent upon completion of an upgrade to the existing on-site septic system. The upgrade was completed on January 26, 2006, 7. On June 4, 2006 the applicant signed an Accessory Affordable Apartment Program Agreement Affidavit that commits,upon the receipt of a Comprehensive Permit, to the recording of a Regulatory Agreement and Declaration of Restrictive Covenants at the Barnstable Registry of Deeds. That document will restrict the unit in perpetuity as an affordable rental unit and requires that the dwelling be owner-occupied as her principal residence. 8. The applicant understands that the affordable unit will be rented to a person or family whose income is 80% or less of the Area Median Income (AMI) of the Barnstable Metropolitan Statistical Area (MSA) and further agrees that rent (including utilities) shall not exceed 30% of the monthly household income of a household earning 80% of the median income, adjusted by household size. In the event that utilities are separately metered, the utility allowance established by the town of Barnstable shall be deducted from rent level so calculated. 9. According to the Massachusetts Department of Housing and Community Development, as of July 26, 2006, 6.8% of the town's year round housing stock qualifies as affordable housing units. The town has not reached the statutory minimum of affordable housing under MGL Chapter 40B Section 20-23 2 or its implementing regulations. The Town of Barnstable's Local Comprehensive Plan encourages the use of existing housing to create affordable units and the dispersal of these units throughout the town. Finding Summary: Based upon the findings, the Hearing Officer ruled that the applicant has standing to apply for a Comprehensive Permit under MGL Chapter 40B and the Town of Barnstable's Accessory Apartment Program. The proposal is also deemed consistent with local needs because it adequately promotes the objective of providing affordable housing for the town of Barnstable without jeopardizing the health and safety of the occupants provided all conditions of the Comprehensive Permit are strictly followed. Ruling and Conditions: Based upon the findings, a ruling was made to grant the Comprehensive Permit in accordance with MGL Chapter 40B to the applicant, Maria Furlan. It is issued to allow for a one-bedroom accessory affordable apartment unit in accordance with the following conditions: 1`Occuparicy of the-affordable unit shall not exceed,two persons. 2. The total number of bedrooms on the property with the existing on site septic system shall not exceed seven (7). 3. The property owner shall occupy the principal dwelling as her principal residence. 4. This unit shall not be occupied by a family member of the owner(s). 5. All parking for the accessory apartment and the main dwelling shall be on-site. 6. To meet the requirements of affordability, the cost of housing(including utilities) shall not exceed 30% of 80% of the median income for a single individual for the Barnstable MSA. In the event that utilities are separately metered, the utility allowance established by the town of Barnstable shall be deducted from rent level so calculated: 7. All leases shall have a minimum term of one year. 8. The Growth Management Department shall serve as the monitoring agent for the accessory apartment. 9. The applicant must apply for a building permit for the accessory unit,whether the unit is new or pre- existing. Before securing an occupancy permit and certificate of compliance, the Building Commissioner must determine that the unit conforms with the approved plans as submitted with the building permit application and meets state building and fire codes. The Health Division must determine that the dwelling is in compliance with applicable on-site wastewater discharge requirements. 10. The applicant may select her own tenant provided the tenant meets the requirements of the program as . cited above and provided that person's income is reviewed and approved by the Growth Management Department of the town of Barnstable as a qualified individual. The applicant will be required to work with the town to provide information necessary to document that the tenant qualifies. The unit shall be rented on an open and fair basis to an income eligible individual or family. Whenever a vacancy occurs, notice must be given to the Growth Management Department and the unit must be listed with the Town. 11. Every twelve months the applicant shall review the income eligibility of the individual occupying the unit. No later than a year from the date of issuance of this Comprehensive Permit,the applicant shall file with the Growth Management Department of the town of Barnstable an annual affidavit listing the rent charged and income level of the occupant of the unit. The applicant shall provide the town any additional 3 information it deems necessary to verify the information provided in the.affidavit. Upon any report from the town that the terms and conditions of this permit are not being upheld, the Zoning Board of Appeals or it's Hearing Officer shall have the ability to hold a hearing to show cause as to why this permit should not be revoked. 12. This Comprehensive Permit shall not be transferable to any other person or entity without the prior approval of the Hearing Officer or Zoning Board of Appeals. This decision,the Regulatory Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be filed at the Barnstable County Registry of Deeds. If the ownership of the property is transferred, the Growth Management Department of the town of Barnstable shall be notified.within 60 days of the name and address of the new owner. 13. This Comprehensive Permit must be exercised and the unit occupied within 12 months of its issuance or it shall expire. Ordered: Comprehensive Permit 2006-062 has been granted with conditions. A written copy of this decision shall be forwarded to the Zoning Board of Appeals as required by the Town of Barnstable Administrative,Code Chapter 241, section 11. If after fourteen (14) days from that transmittal the Members of the Zoning Board of Appeals takes no action to reverse the decision,this decision shall become final and a copy shall be the filed in the office of the Town Clerk. Appeals of the final decision, if any, shall be made to the Barnstable Superior Court pursuant to MGL Chapter 40A, Section 17,within twenty (20) days after the date of the filing of this decision in the office of the Town Clerk. The applicant has the right to appeal this decision as outlined in MGL Chapter 40B, Section 22. In accordance with Chapter 214, section 11 of the Town of Barnstable Administrative Code,the hearing officer transmitted a written copy of the Comprehensive Permit decision to the Zoning.Board of Appeals on July 26, 2006. Fourteen(14) days have elapsed since the transmittal to the Board, and no Board Member has taken action to reverse the decision. Y ILI, ` , �� aoC, Gai ightingale, aring Of c r Date Signed I Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, her certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has een filed in ffice of the Town Clerk. Signed and sealed thi day o nder the in and penalties ofperjury. P J , Linda Hutchenrider, Town Clerk 4 Bk 21411 Ps344 *624 r 7 REGULATORY AGREEMENT AND DECLARATION OF RESTRICTIVE COVENANTS 7TWGULATORY GRFEMENT and DECLARATION OF RESTRICTIVE COVENANTS,is made this day ol'14WkOh4jkf,2006, by and between Maria Furlan,221 Five Corners Rd, Centerville, MA.02632 and its successors and assigns (hereinafter the "Owner"),and the TOWN OF BARNSTABLE (the "INunicipalit ' ,a political subdivision of the Commonwealth; WHEREAS the Owner has been granted a Comprehensive Permit under Massachusetts General Law Chapter 40B and local regulations by the Zoning Board of Appeals to permit the creation of an accessory apartment in an owner occupied dwelling which will be rented to a Low or Moderate Income Person/ Family(hereinafter "Designated Affordable Unit");and NOW THEREFORE,in mutual consideration of the agreements and covenants contained herein,and other good and valuable consideration,the receipt and sufficiency of which is hereby acknowledged,the parties agree as follows: I. PROJECT SCOPE AND DESIGN: A. The terms of this Agreement and Covenant regulate the property located at 221 Five Corners Road, Centerville, MA 02632 as further described in deed recorded herewith as Barnstable County Registry of Deeds Book 20701 &Page 236. B. The Project located at 221 Five Corners Road, Centerville,MA 02632 will consist of one accessory apartment unit which will be rented to an eligible low or,moderate income individual or family(the "Designated Affordable Unit" or the "Unit"). C. The Owner agrees to construct the Project in accordance with the terms of comprehensive permit Appeal No. 2006-062 and any plans submitted therewith and all applicable state, federal and munic,,ipal laws and regulation . Said permit is recorded herewith as Barnstable County Registry of Deeds Book ZJ Y &Page-J90_. D. The Owner agrees to occupy the principal dwelling unit located on the property as their principal residence in accordance with the terms of the comprehensive permit. II. THE OWNER'S COVENANTS AND RESPONSIBILITIES: A.: THE OWNER HEREBY REPRESENTS, COVENANTS.AND WARRANTS AS FOLLOWS: 1 In receiving the comprehensive permit to create the Designated Affordable unit,the Owner agreed that the Designated Affordable Unit shall be set aside in perpetuity for the public purpose of providing safe and decent housing to persons ealliing at or below 80% of the: area median;ncome of Barnstable Metropolitan Statistical.Area (MSA) and that the Designated Affordable Unit.shall be deemed to be impressed with a public trust. 2. The Designated Affordable Unit shall be rented in perpetuity to a household with a maximum income of 80% of the Area Median Income (AMI) of Barnstable MSA and that rent (including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that utilities are separately metered, a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent level. 3. The Designated Affordable Unit will be retained as a permanent,year round rental dwelling unit with at least a one-year lease. 4. The Owner has the full legal right,power and authority to execute and deliver this Agreement. f 5. The execution and performance of this Agreement by the Owner will not violate or,as applicable,has not violated any provision of law,rule or regulation,or any order of any court or other agency or governmental body,and will not violate or,as applicable,has not violated any provision of any indenture,agreement,mortgage, mortgage note,or other instrument to which the Owner is a party or by which it or the Owner is bound,will not result in the creation or imposition of any prohibited encumbrance of any nature. 6. The Owner,at the time of execution and delivery of this Agreement,has good,clear marketable title to the premises. 7. There is no action,suit or proceeding at law or in equity or by or before any governmental instrumentality or other agency now pending,or,to the knowledge of the Owner,threatened against or affecting it, or any of its properties or rights,which,if adversely determined,would materially impair its right to carry on business substantially as now conducted (and as now contemplated by this Agreement) or would materially adversely affect its financial condition. B. COMPLIANCE The Owner hereby agrees that any and all requirements of the laws of the Commonwealth of Massachusetts to be satisfied in order for the provisions of this Agreement to constitute restrictions and covenants running with the land shall be deemed to be satisfied in full and that any requirements of privileges of estate are also deemed to be satisfied in full. C. LIMITATION ON PROFITS ► 1. The Owner agrees to limit his/her profit by renting the Designated Affordable Unit in perpetuity to a household with a maximum income of 80% or less of the Area Median Income (AMI) of Barnstable . Metropolitan Statistical Area(MSA) and that rent(including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. 2. The Owner shall annually deliver to the Municipality and to the Monitoring Agent,as designated by the Town Manager,proof that the Designated Affordable Unit is rented,the tenant's income verification, a copy of the lease agreement and the rent charged for the unit or units. Such information shall also be forwarded to the Monitoring Agent within 30 days of the occupation of the dwelling unit or units by a new tenant. The Owner shall notify the Monitoring Agent,as designated by the Town Manager,within thirty(30) days of the date that a tenant has vacated the Designated Affordable Unit. III. MUNICIPALITY COVENANTS AND RESPONSIBILITIES 1. . The MUNICIPALITY,through the monitoring agent designated by the Town Manager agrees to perform the duties of verifying that the Designated Affordable Unit is being rented in perpetuity to a household with a maximum income of 80% or less of the Area Median Income (AMI) of Barnstable MSA and that rent (including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA.In the event that utilities are separately metered, a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. IV. RECORDING OF AGREEMENT: Upon execution,the OWNER shall immediately cause this Agreement and any amendments hereto to be recorded with the Registry of Deeds for Barnstable County or,if the Project consists in whole or in part of registered land,file this Agreement and any amendments hereto with the Registry District of the Barnstable Land Court (collectively hereinafter the "Registry of Deeds"),and the Owner shall pay all fees and charges incurred in connection therewith. Upon recording or filling,as applicable,the Owner shall immediatelytransmit to the 2 i Municipality evidence of such recording or filing including the date and instrument,book and page or registration number of the Agreement. V. GOVERNING OF AGREEMENT: This Agreement shall be governed by the laws of the Commonwealth of Massachusetts. Any amendments to this Agreement must be in writing and executed by all of the parties hereto. The invalidity of any clause,part or provision of this Agreement shall not affect.the validity of the remaining portions.hereof. VI. NOTICE: All notices to be given pursuant to this Agreement shall be in writing and shall be deemed given when delivered by hand or when mailed by certified or registered mail,postage prepaid,return receipt requested,to the parties hereto at the addresses set forth below,or to such other place as a party may from time to time designate by written notice. VII. HOLD HARMLESS: - The Owner hereby agrees to indemnify and hold 1-_armless the Municipality and/or its delegate from any and all actions or inactions by the Owner,its agents,servants or employees which result in claims made against Municipality and/or its delegate,including but not limited to awards,judgments,out-of-pocket expenses and attorneys fees necessitated bysuch actions. VIII. ENTIRE UNDERSTANDING: A. This Agreement shall constitute the entire understanding between the parties and any amendments or changes hereto must be in writing,executed by the parties, and appended to this document. B. This Agreement and all of the covenants, agreements and restrictions contained herein shall be deemed to be for the public purpose of providing safe affordable housing and shall be deemed to be, and by these presents are, granted by the Owner to run in perpetuity in favor of and be held by the Municipality as any other permanent restriction held by a governmental body as that term is used in MGL Ch. 184, Section 26 which shall run with the land described in deed recorded herewith as Barnstable County Registry of Deeds Book 20701 & Page 236 and shall be binding upon the Owner and all successors in title . This Agreement is made for the benefit of the Municipality and the Municipality shall be deemed to be the holder of the restriction created by this Agreement. The Municipality has determined that the acquiring of such a restriction is in the public interest. The Municipality shall not be subject to the defense of lack of privity of estate. The covenants and restrictions contained in this Agreement shall be deemed to affect the title to the property described in deed recorded herewith as Barnstable County Registry of Deeds Book 20701&Page 236. IX. TERM OF AGREEMENT: The term of this Agreement shall be perpetual,provided,,however,that the Owner of a Designated Affordable Unit or Units may voluntarily cancel the granted Comprehensive Permit and the terms and restrictions imposed herein. Such cancellation shall only take effect after: 1) expiration of the lease terms entered into between the Owner and Tenant occupying said unit and 2) notification by the Owner of said dwelling to the Zoning Board of Appeals of his/her desire to cancel the Comprehensive permit upon a date certain and the recording of said notice at the Barnstable County Registry of Deeds or Barnstable County Registry of the Land Court as the case may be,thus rendering said Comprehensive Permit void. Upon the cancellation of the comprehensive permit;the propertywhich is the subject matter of this'restrictive covenant shall revert to the use permitted under zoning and the restrictive covenant shall be rendered void. 3 X. SUCCESSORS AND ASSIGNS: A. The Parties to this Agreement intend,declare,and covenant on behalf of themselves and any successors and assigns their rights and duties as defined in this Regulatory Agreement and the attached comprehensive permit. B. The Owner intends,declares,and covenants on behalf of itself and its successors and assigns (i) that this Agreement and the covenants, agreements and restrictions contained herein shall be and are covenants running with the land,encumbering the Project for the term of this Agreement, and are binding upon the Owner's successors in title, (ii) are not merely personal covenants of the Owner,and (iii) shall bind the Owner,its successors.and assigns and inure to the benefit of the Municipality and its successors and assigns for the term of the Agreement. XI. DEFAULT: If any default,violation or breach by the Owner of this Agreement is not cured to the satisfaction of the Monitoring Agent within thirty(30) days after notice to the Owner thereof,then the Monitoring Agent may send notification to the Municipality that the Owner is in violation of the terms and conditions hereof. The , Municipality may exercise any remedy available to it. The Owner will pay all costs and expenses,including legal fees.,incurred by the Monitoring Agent in enforcing this Agreement and the Owner hereby agrees that the Municipality and the Monitoring Agent wI have alien on the Project to secure payment of such costs and expenses. The Monitoring Agent may perfect such alien on the Project by recording a certificate setting forth the amount of the costs and expense due and owing in the Registry of Deeds or the Registry of the District Land Court for Barnstable County. A purchaser of the Project or any portion thereof will be liable for the payment of any unpaid costs and expenses that were the subject of a perfected lien prior to the purchaser's acquisition of the Project or portion thereof. XII. MORTGAGEE CONSENT: The Owner represents and warrants that it has obtained the consent of all existing mortgagees of the Project to the execution and recording of this Agreement and to the terms and conditions hereof and that all such mortgagees have executed consent to this Agreement. IN WITNESS WHEREOF,we hereunto set our hands and seals this0 dayof Q �� 2006. OWNER BY: Printed:Maria n COMMONWEALTH OF MASSACHUSETTS County of Barnstaple,ss: OA/In tlu� day of 2006 before me,the undersigned notary public,personally appeared 1 ,� -M (,he Owner(s),proved to me through satisfactory evidence t of identification,which were ,y uli- ur L:?r %>✓� ,to be the person(s) whose name(s) is signed on the preceding or attache document and acknowledged to be that he/she signed it voluntarily for the stated purposes. Notary Public My Commission Expires: Notary Public 4 Commonwealth of Massachusetts My Comn-;issinn Escpiies TOWN OF BARNSTABLE BY: I AGER COMMONWEALTH OF MASSACHUSETTS County of Barnstable,ss: On this�day of 2006 before me,the undersigned notary public,personally appeared t �kn -KLi M m ,the Town Manager for the Town of Barnstable,proved to me through satisfactory evidence of identification,which were cim p)0Lydr , /50'gc-t� knaoo be the person whose name is signed on the preceding or attached document and ac 1 dged to b hat he/she signed it voluntarily for the 'stated purposes. Notary Publi' Printed: 4N OFFICIAL SEAL aEY My Commission Expires: NOTARY PUBLIC L MMONWEALTH OF YASSACHUSETTS My Comm.Expitm 31281Y008 5 OOL., 8.0 © s NEW SMOKE DETECTOR REQUIREMENTS ARE NOW LAW. E:.� s THE ADDITION OF A NEW BEDROOM WILL TRIGGER AN F�C� II UPGRADE OF THE SMOKE DETECTOR oom ,' FOR THE WHOLE HOUSE. YOU MUST PLAN ACCORDINGLY AND HAVE YOUR ELECTRICIAN TAKE OUT THE APPROPRIATE PERMIT AT THE FIRE DEPARTMENT. co Vtu BEN L vl�o� woo j T Glee' Ft i ►� poor- (Or flid.ee uU itrlclOu) SMOKE DETECTORS O.K. Pi we !kLtGw 22.1 FIVE coRNexL.ra ROAD 48048 4 6f�BUILDIG . C lEt4tEPV%LL e, YAA -02632. 0Y X. RDQlANn ! 60S 42-8ttl't � I Number of Bedrooms Total Rooms = f 11 = 2 = 5. 5 Rounded down = 5 Bedrooms v I - Bed LEth study l t Family Din Room Foyer 15T f`oo - c100 Bth Lndry Bth -Bed Op i BfCaY B6W T -Bed A5 f4 �1.T.S. • - (98. .yc� Test Plt, # i ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID—INTERTIED VIA A AC ALTERNATING CURRENT UL—LISTED POWER—CONDITIONING INVERTER: " s BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. CONC .CONCRETE 3. A NATIONALLY—RECOGNIZED TESTING. DC DIRECT CURRENT. LABORATORY SHALL LIST ALL EQUIPMENT IN _ EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WITH ART. 110.3. (E) EXISTING 4. WHERE ALL TERMINALS OF THE DISCONNECTING EMT ELECTRICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION; FSB FIRE SET-BACK A SIGN WILL BE PROVIDED WARNING,OF THE GALV GALVANIZED HAZARDS PER ART. 690.17. ; GEC GROUNDING ELECTRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF THE GND GROUND MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY HDG HOT DIPPED GALVANIZED PHASE AND SYSTEM PER ART. 210.5. CURRENT , 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER COMPLY WITH ART. 250.97, 250.92(B). Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENTER kVA KILOVOLT AMPERE BUILDING OR ARE RUN IN METALLIC RACEWAYS OR kW KILOWATT ENCLOSURES TO THE FIRST ACCESSIBLE DC , LBW LOAD BEARING WALL DISCONNECTING MEANS PER ART. 690.31(E): MIN MINIMUM 8. , ALL WIRES SHALL BE PROVIDED WITH STRAIN (N) NEW RELIEF AT ALL ENTRY INTO BOXES AS REQUIRED BY NEUT NEUTRAL UL LISTING. NTS NOT TO SCALE 9. MODULE FRAMES SHALL BE GROUNDED AT THE OC ON CENTER UL—LISTED LOCATION PROVIDED BY THE PL, PROPERTY LINE MANUFACTURER USING UL LISTED GROUNDING P01 POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 10. MODULE FRAMES, RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT-GROUND CONDUCTORS. S STAINLESS STEEL STC STANDARD TESTING CONDITIONS ` TYP TYPICAL UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT , Vmp VOLTAGE AT MAX POWER VICINITY MAP INDEX Voc VOLTAGE AT OPEN CIRCUIT W WATT 3R NEMA 3R, RAINTIGHT PV1 COVER SHEET _ P.V2 SITE PLAN P<V3 STRUCTURAL VIEWS J PV4 UPLIFT CALCULATIONS .. PV5 THREE LINE .DIAGRAM LICENSE GENERAL NOTES Cutsheets Attached 1. ALL WORK TO BE"DONE TO THE 8TH EDITION ELEC 1136 MR OF THE MA STATE BUILDING CODE. 2. ALL ELECTRICAL WORK SHALL COMPLY WITH _ THE 2014 NATIONAL ELECTRIC CODE INCLUDING $ MASSACHUSETTS AMENDMENTS. MODULE GROUNDING METHOD: ZEP SOLAR REV BY DATE . COMMENTS AHJ: Barnstable - REV A NAME DATE COMMENTS UTILITY: NSTAR Electric (Boston Edison) CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: PREMISE OWNER: DESCRIPTION: DESIGN: J B-0261723 00 CONTAINED SHALL NOT BE USED FOR THE HUANG, ZHONGCHAN HUANG RESIDENCE Alex PonizSO�a�C�t NOR SHALL I OF T YONE BEDISCLOSED IN WHOLE ORT SOLARCITY CIN COmG SM Unt T e C 221 5 CORNERS RD 11.925 KW PV ARRAY �� y r PART IZ OTHERS OUTSIDE THE RECIPIENTS [MODULES: BARNSTABLE MA 02632ORGANIZA710N, EXCEPT IN CONNEC110N WITH � 24 St. Martin-0rive,Building 2,Unit 11 b THE SALE AND USE OF THE RESPECTIVE (45) Hanwha Q—Cells # Q•PRO G4/SC 265 PAGE NAME: SHEET: REv DATE Marlborough, MA Building 2, SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: L (650)638-1028 F. (617 636-1029. PERMISSION of soLARaTr INC. SOLAREDGE SE1000OA—US'000SNR2 9173927571 COVER SHEET PV 1 8/28/2015 (BBB)-Sol—CITY 765-2489 j PITCH: 35 ARRAY PITCH:35 MP1 AZIMUTH: 135 ARRAY AZIMUTH: 135 MATERIAL: Comp Shingle STORY: 2+ Storie PITCH: 35 ARRAY PITCH:35 MP2 AZIMUTH:315 ARRAY AZIMUTH:315 MATERIAL: Comp Shingle STORY: 2+ Storie z"N LEGEND B n Q (E) UTILITY METER & WARNING LABEL m 8 INVERTER W/ INTEGRATED DC DISCO & WARNING LABELS © DC DISCONNECT & WARNING LABELS ® Front Of House © AC DISCONNECT & WARNING LABELS STRUCTURE— O — — STRUCTUR O DC JUNCTION/COMBINER BOX & LABELS CHANGE ANGE a Q DISTRIBUTION PANEL & LABELS A Lc LOAD CENTER & WARNING LABELS tttOF = O DEDICATED PV SYSTEM METER ?y1 (E)DRIVEWAY 0 WILLIAMA.Cr ,r, Q STANDOFF LOCATIONS ELDREDGE itN CONDUIT RUN ON EXTERIOR S Ko.500V N --- CONDUIT RUN ON INTERIOR GATE/FENCE Q HEAT PRODUCING. VENTS ARE RED �N1rAr Inv © O iF�` INTERIOR EQUIPMENT IS DASHED Digitally signed L 'J �� by William A. SITE PLAN Eldredge Jr. STAMPED & SIGNED Date:2015.08.29 Scale: 3/32" = 1' FOR STRUCTURAL ONLY 13:05:54-04'00' 01, 10, 21' J B-0 2 617 2 3 0 0 PREMISE OWNER: DESCRIPTION: DE9f;11: CONFIDENTIAL— THE INFORMATION HEREIN IMODUL.M- OB NUMBER: \fir SO�afC�t CONTAINED SHALL NOT BE USED FOR THE HUANG, ZHONGCHAN HUANG RESIDENCE Alex Poniz s _"as BENEFIT OF ANYONE EXCEPT SOLARCITY INC., OUNTING SYSIEM: �'."' NOR SHALL IT BE DISCLOSED IN WHOLE OR INCompMount Type C 221 5 CORNERS RD 11.925 KW PV ARRAY r PART TO OTHERS OUTSIDE THE RECIPIENTS f BARNSTABLE, MA 02632 ORGANIZATION, EXCEPT IN CONNECTION WITH24 St Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (45) Hanwha Q—Cells # Q.PRO G4/SC 265 PA( NAME SHEET: REV DATE Madborouo,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: T: (650)638-1028 R (650)638-1029 PERMISSION OF SOLARCITY INC. PV 2 8/28/2015 SOLAREDGE sE1000oa—us000sNR2 9173927571 SITE PLAN (886)-SOL-CITY(765-2489) �r.solarcitycom _ (E) 2x4 S1 : . S1 12'-8" 5-10" 1 —1 (E) LBW 7(�) LBW A SIDE VIEW OF MPIA NTs B SIDE VIEW OF MP1B NTs MPIA X SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES } MPIB X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES LANDSCAPE 64" 24" STAGGERED LANDSCAPE 72" 24" STAGGERED PORTRAIT 32" 16" PORTRAIT 24' 16" ROOF AZI 135- PITCH 35 ROOF AZI 135 PITCH 35 RAFTER 2X10 @ 16 OC ARRAY AZI 135 PITCH 35 STORIES:2+ TOP CHORD 2X4 @ 24 .00 ARRAY AZI 135 PITCH. 35 STORIES:2+ Comp Shingle BOT CHORD 2X4 @24"OC Comp Shingle (E) 2x4, — PV MODULE 5/16" BOLT WITH LOCK INSTALLATION ORDER G�ytH OF & FENDER WASHERS ate' LOCATE RAFTER, MARK HOLE ZEP LEVELING FOOT (1) LOCATION, AND DRILL PILOT $ �t HOLE. ZEP ARRAY SKIRT (6) si SEAL PILOT HOLE WITH POLYURETHANE SEALANT. ZEP COMP MOUNT C: ZEP FLASHING C (3) _ (3) INSERT FLASHING. (E) COMP. SHINGLE—lilt (4) PLACE MOUNT. E I RW E ROOF DECKING. (2) u O STAMPED & SIGNED . 6" (5) INSTALL LAG BOLT WITH FOR STRUCTURAL ONLY 5/lE LA STAINLESS (5) SEALING WASHER. SIDE VIEW OF MPIA NTS STEEL LAG BOLT LOWEST MODULE SUBSEQUENT MODULES INSTALL LEVELING FOOT WITH C WITH SEALING WASHER _ (6) BOLT & WASHERS. (2-1/2" EMBED, MIN) MP2A X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES LANDSCAPE 72" 24" STAGGERED (E) RAFTER S I.AIV DO F F PORTRAIT 24" 16" TOP CHORD 2X4 @ 24"OC ROOF AZI 315 PITCH 35 STORIES:2+ ARRAY AZI 315 PITCH 35 BOT CHORD 2X4 @24"OC Comp Shingle ' CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: J B-0 2 61 /7 2 3 00 PRBdI OWNER: DESCRIPTION: DESIGN:221 5 CORNERS RD KW PV ARRAY CONTAINED SHALL NOT BE USED FOR THE HUANG, ZHONGCHAN HUANG RESIDENCE Alex Poniz BENEFIT OF ANYONE EXCEPT SOLARgTY INC., MOUNTING SYSTEM: NOR SHALL IT BE DISCLOSED IN WHOLE OR IN - - - - - Comp Mount Type C 11.925 . olar - i�y' �_ "►�� , PART TO OTHERS OUTSIDE THE RECIPIENTS IMODULM. - BARNSTABLE MA 02632 ORGANIZATION, EXCEPT IN CONNECTION WITHBuilding 2;Unit 11 THE SALE AND USE OF THE RESPECTIVE (45) Hanwha Q-Cells # Q.PRO G4/SC 265 24 St Martin DriveSHEET: REV DALE: Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN [INVERTER: PAGE NAME T: (650)638oroug F: (617 638-1029 PERMISSION QF SOLARaTY INc. SOLAREDGE SE10000A—US000SNR2 9173927571 STRUCTURAL VIEWS PV 3 . 8/28/2015 (8110-SOL-CITY(765-2489) www.solarcity.com: UPLIFT CALCULATIONS SEE SEPARATE PACKET FOR STRUCTURAL CALCULATIONS. CONFIDENTIAL THE INFORMATION U J B-0 2 617 2 3 00 PREMISE0MER: DESCRIPTIOtk DESIGtt — USED HEREIN JOB NUMBER: \\ �SolarCity. CONTAINED SHALL NOT BE USED FOR THE _ HUANG, ZHONGCHAN HUANG RESIDENCE Alex Poniz �_ s BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: w�. NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 221 5 CORNERS RD 11.925 KW PV ARRAY , PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES BARNSTABLE, MA 02632 ORGANIZATION, EXCEPT IN CONNECTION WITH 24 St. Martin Drive,Building 2. Unit 11 THE SALE AND USE OF THE RESPECTIVE (45) HOnwha Q—Cells # Q•PRO G4/SC 265 SHEET: REV: DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME T. (650)638-1028 F.- (650)638-1029 PERMISSION OF SOLARCITY INC INC SOLAREDGE SE1000OA—USOOOSNR2 9173927571 UPLIFT CALCULATIONS PV 4 8/2s/2o�5 (886)—SOL—CITY(765-2489) www.solarcitYaam GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE. BOND (N) #8 GEC TO TWO (N) GROUND Panel Number:TM3220CCU Inv 1: DC Ungrounded INV 1 --(1)SOLAREDGE ##SE10000A-USOOOSNR LABEL:.A -(45)Hdnwho Q-Cells Q.PRO G4/SC 265 GEN #168572 RODS AT PANEL WITH IRREVERSIBLE CRIMP Meter Number:43 943 209 Downsizing Main Breaker For Tie-1n Inverter; 100'OOW, 240V, 97.59d w/Unifed Disco andZB,RGM,AFCI PV Module; 265W, 241.3W PTC, 40mm, Blk Frame, H4, ZEP, 1000V ELEC 1.136 MR Underground Service Entrance INV 2 Voc: 38.01 Vpmax: 30.75 a INV.3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER� - E 200A MAIN SERVICE PANEL - N) 175A/2P MAIN CIRCUIT BREAKER If1V('Ct2C 1 SolorCity (E) WIRING {. CUTLER-HAMMER - N)175A/2P Disconnect 6 SOLAREDGE A 5 A L DC+ _ SE1000OA-USOOOSNR2 Dc MP-2: (E) LOADS B --- --------- EGC Ll zaev ------ -- --�----- - 2 3--- ------- -- --� L2 DC+ I DC+ ~ r N DC_ i 4 DC- MP 2: 1x15 I ' 13 6OA/2P - --------------- --- --- MP 1: 1x15 I . . A _ . . _ GEC DG DC- B . .. GND EGC--- ---- --- ---- - -- ---- --=EGG -- ---------- -- J - N (1)Conduit Kit;.3/4"EMT - .. �GCLGE LC l i i TO 120/240V I I x• SINGLE PHASE UTILITY SERVICE i - i. i PHOTO VOLTAIC SYSTEM EQUIPPED WITH.RAPID SHUTDOWN Voc* = MAX VOC AT MIN TEMP POI (1)GE III THOL2160 PV BACKFEED BREAKER B (1)CUTLER-HAMMER g DG222UR6 �� = A' (1)Solorcit 4 STRING JUNCTION BOX �� y Breaker, 60A/2P, 2 Spaces Disconnect; 60A, 24OVoc, Non-Fusible, NEMA 3R ti 2x2 STR GS, UNFUSED, GROUNDED -(2)Ground Rod; 5/8" x 8'. Copper _(1)CUTLER-{1AMMER DG100NB Ground/Neutral d; 60-100A, General Duty(DG) PV (45)SOLAREDGE 04PP NA4AZS PowerBox ptimizer, 30OW, H4, DC to DC, ZEP . . nd 1)AWG$6, Solid Bare Copper -(1)Ground Rod; 5/8' x 8', Copper _ (N) ARRAY GROUND PER 690.47(D). NOTE: PER EXCEPTION NO. 2,1 ADDITIONAL ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF (E) ELECTRODE 1 AWG#6, THWN-2,Black 1 AWG /8, THWN-2, Black Voc* =500 VDC Isc -30 ADC 2 AWG #10, PV Wire, 60OV, Black Voc* =500 VDC Isc =15 ADC ©IgH(1)AWG 06,THWN-2,Red ® (1)AWG /8, THWN-2, Red - Vmp 350 VDC Imp=22.42 ADC O (1)AWG #6, Solid Bare Copper EGC Vmp =350 VDC Imp=11.21 ADC II LL(1)AWG 010, THWN-2, White. NEUTRAL VmP =240 VAC Imp=42 MC (1 AWG #10, 1HHN/THWN-2,,Green, EGC• . . . . . . . . . . . . . . . #8,.1HWN-2,.Green • • EGC/GEC (1)Conduit•Kit;.3/47.EMT, • • , , , , , , . (1)AWG #10, THWN-2, Black Voc* =500 VDC Isc =15 ADC (2)AWG 06, PV Wire, 600V, Block Voc* =500 VDC Isc =15 ADC O (1)AWG /10, iHWN-2, Red Vmp =350 VDC Imp=11.21 ADC O (1)AWG#6, Solid Bore Copper EGC Vmp =350 .VDC Imp=11.21 ADC ... . .. . . ..(1)AWG /10, THHN/THWN-2,,Green. EGC . . . . . . . .( . . (2)AWG�l10, PV Wlre, 600V, Black Voc* =500 VDC Is =15 ADC O L J (1)AWG g6, Solid Bare Copper EGC Vmp =350 VDC Imp=11.21 ADC CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: J B-0 2 617 2 3 00 PREMISE OWNER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE HUANG, ZHONGCHAN HUANG RESIDENCE Alex Ponir �Olar�' �. ; I'�e� BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MouenNc srsTEM: 11.925 KW PV ARRAY ►r NOR SHALL IT BE DISCLOSED IN WHOLE OR IN COnI Mount T e C 221 5 ..CORNERS RD e PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES: BARNSTABLE MA 02632 ORGANIZATION, EXCEPT IN CONNECTION WITH r THE SALE AND USE OF THE RESPECTIVE (45) Hanwha Q-Cells # Q.PRO G4/SC 265 24 St. Martin Drive,Building 2,Unit 11 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME ' REV DATE T.- (650)638-1028 F:Marlborou , A(650)638-1029 PERMISSION OF SOLARCITY INC. SOLAREDGE SE1000OA-USOOOSNR2 9173927571 THREE LINE DIAGRAM PV 5 8/28/2015 (888)-SQL-CITY(765-2489) wvmsolarcityoom Label Location: Label Location: '; �ky �Ap Label Location: (C)(CB) o �( �y (AC)(POI) CD (DC) (INV) Per Code: o 0 0 ° ° _ ` o Per Code: a r o " ° Per Code: 4R NEC 690.31.G.3 ^� NEC 690.17.E . o ° ® , m NEC 690.35(F) Label Location: o► :o • o e i °� . °�o .l ii " TO BE USED WHEN t o•n o �q`)' n _ i,l�-'o, o s • o„4', INVERTER IS (DC)(INV) Ip C°G'�'I'o Per Code: �,. = p..; UNGROUNDED NEC 690.14.C.2 Label Location: Label Location: o 0 0 -oy 4 (POI) � o - (DC) (INV) o Per Code: Per NEC 690.17.4; NEC 690.54 ' Code: -s o e o e m o e NEC 690.53 - o O� Label Location: o (DC) (INV) Per Code: -o s o o NEC 690.5(C) Label Location: -o 0 0 •'�i o` o p ;.. (Vol) Per Code: 0 0 0 NEC 690.64.13.4 Label Location: o - (DC) (CB) _ e n Per Code: Label Location: NEC 690.17(4) ' (D) (POI) - Per Code: NEC 690.64.B.4 Label Location: a.:. (POI) Per Code: Label Location: ° ' NEC 690.64.6.7 e o i „r a e p p p (AC) (POI) o 0 0 0 (AC):AC Disconnect p p Per Code: r �°n (C): Conduit QZ NEC 690.14.C.2 xr (CB): Combiner Box :_ . (D): Distribution Panel (DC): DC Disconnect (IC): Interior Run Conduit Label Location: - (INV): Inverter With Integrated DC Disconnect (AC)(POI) (LC): Load Center Per Code: (M): Utility Meter NEC 690.54 (POI): Point of Interconnection CONFIDENTIAL- THE INFORMATION HEREIN CONTAINED SHALL NOT BE USED FOR ��►��j 3055 Clearview Way THE BENEFIT OF ANYONE EXCEPT SOLARCITY INC., NOR MALL IT BE DISCLOSED �- San Mateo,CA 94402 IN WHOLE OR IN PART TO OTHERS OUTSIDE THE RECIPIENTS ORGANIZATION, Label Set ��►� T:(650)638-1028 F:(650)638-1029 EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE /�• O'a It (888)-SOL-CITY(765-2489)www.solarcity.com SOLARCITY EQUIPMENT, VATHOUT THE WRITTEN PERMISSION OF SOLARCITY INC. Next-Level PV Mounting Technolo �'n $O�afClty I ZepSDlal 9 9Y SOlafClty ZepSOlar Next-Level PV Mounting Technology Zep System Components for composition shingle roofs -" - '-_,Up-roof _ 6rauM Zep - tertock Ili silo stvrN - . - Leveling root - .. ,Zep Compatible PV ll"ulc •" - .. aeof attachment r a�F Description PV mounting solution for composition shingle roofs 0 °coMPpre Works with all Zep.Compatible Modules ro • Auto bonding UL-listed hardware creates structual and electrical bond • Zep System has a UL 1703 Class"A"Fire Rating when installed using V LISTED modules from any manufacturer certified as"Type 1"br"Type 2" • Comp Mount Interlock_ Leveling Foot . - ®I. . . - ,- ^ , , - Part No.850-1382 Part No.850-1388 Part No:850-130 Listed to UL 2582& Listed to UL 2703. Listed to UL 2703 Specifications - . Mounting Mou Block to UL 2703 Designed for pitched roofs • Installs in portrait and landscape orientations • Zep System supports module wind uplift and snow load pressures to 50 psf per UL 1703 Wind tunnel report to ASCE 7-05 and 7-10 standards • Zep System grounding products are UL listed to UL 2703 and ETL listed to UL 467 _ • Zep System bonding products are UL listed to UL 2703 Engineered for spans up to 72"and cantilevers up to 24" Zep wire,management products listed to UL 1565 for wire positioning devices Ground Zep Array Skirt,Grip,End Caps DC Wire Clip • Attachment method UL listed to UL 2582 for Wind Driven Rain Part No.850-1172 Part Nos.500-0113, Part No.850-1448 Listed to UL 2703 and 850-1421,850-1460, Listed UL 1565 ETL listed to UL 467 850-1467 zepsolar.com zepsolar.com Listed to UL 2703 - This document does not create any express warranty by Zap Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for This document does not create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for -each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. - - Page:.2 of 2 02 27 15 ZS for Comp Shingle Cutsheet Rev 04.pdf Page: 1 Of 2 02 27 15 ZS for Comp Shingle Cutsheet Rev 04.pdf- - � g r Solar - 0 0 � ' Solar - 0 p SolarEdge Power Optimizer Module Add-On for North America gr P300 / P350 / P400 SolarEdge Power Optimizer W-11t . . P300 P350 P400 r Module Add-On for North America Ate- � (for 60-cell PV (for 72-cell PV (for 96 reII PV modules), ..modules) modules) - sPt { _ INPUT l P300 / P350 / P400 Ra[ed Input DC Power• 300 350 400 W .Absolute Maximum Input Voltage(Voc at.lowest temperature) .... .48 .. ..60. ..... ..... ..80.: Vdc MPPT Operating Range 8-48 8.-fi0 . 8 80 Vdc - z`.F..- 3"' „ ................................................... ......... ... ................................... .... .................................. .... ... - ;, Maximum Short Circuit Current(Isc) 10 .. - .... ................................ Maximum DC Input Curren[.................................... ................................. 12.5 ................................ ...Adc.... .. Z0, z Maximum Efficiency.....,.... 99.5 %• F,.''� • ""r�...,. �" xr �s,`4f:;a� '�' ..x: Weighted Efficiency ............. ....................... .....................................98.8.................................. ....%...... ..... .. .... ... .... .......... .............. ......... ........... ...................... ...... ...... ...... Overvoltage Category 11 ' ' t �, [-OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTEDTO OPERATING INVERTER), }k p - Maximum Ou[put Curren[ .......... ...................... ............................................................15 ... .A .... r „jP4 ,-�. - Maximum Output Voltage 60 Vdc4_1 - - +�' !OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROMINVERTER OR INVERTER OFF) • [. ' Safety Output Voltage per Power Optimizer 1 Vdc "q 7. .t• 't"' _ (STANDARD of •yA� r; :•: x ••.Y Tx �i $,• y., EMC. ....... __ ..,,,,,,• ...,., FCC PartlS Class8 IEC63000-6)IF1'61 nnn-6a .... COMPLIANCE 1(class It safety)UL7741 .. .- yL. s •,,.h `..': ,.x,.p' n *`"w't' a�* RoHS ........ ............. ... .. ........ ......... .. .....Yes IEC62109 IINSTALLATION SPECIFICATIONS 1000 Vdc Dimensions(WzLx H) 141 x 212 x 405/555 x834 x159 mm/in+ L- y ................................ ................. .................. .. ................ .... ........ ....... ......... .• / - r. ^'' ? ti ................................................ ............................ ......... .......... ......... ,,, -� �:. Weight(mcluding cables) 950/2.1 gr/Ib Input Connector ,.,• ................... ...MC4/.Amphenol./.TYco_......•..., •.. , , ,� .... ....... ..................................... ....... ........... ' •c - Type Connector Doublelnsulated Am henol Output Wire T onnector.. .. .......................................... ....................... P................. .. .............. ... .. , :.. - •,,,'. a; a -1"G4 ..,km »,.}fl»*`�,, "+fyE" s,. z ,E.,4- Output Wire Length ...................................... .........................0.95/3.0 ..L... 1.2/3.9................... m Y, • w 4 ^.,.+.'ru ,..fir ..,'+ ...... ........... .......... .. ......... ..... ..... ... .. ... ,.. Operating Temperature Range -40-+85/-40 +185 ..:C/•P.. ...... ..... ............. ........ ......... .......... ............... .......... ...... ........ ............................ ........... .................................... .......... ............................... ......... ................. ... r Protection Rating IP65/NEMA4 „, b ,+�. ,�.n. N ................ .. .... .. 0-100.. ..... h - � x,}•{� �: �y�-�" -�'* *�i,� d- o�wmasrc o<w<.or m<moa<v`Mm�i<m�cm.sx ww<.tm<n<a mm„�<e � ��"ly$s r5�*x�a `�• �, ��",; �� r�,c yr 7 ,- ;3s m it«'�"i. "�,ad*,t•'«"^it "'I,�,' ._. ,, �.�,sr:.. ,• d;7 „''%s ,,t.f;,..' _. - ' PV SYSTEM DESIGN USING A SOLAREDGE � THREE PHASE� � THREE PHASE . INVERTER - SINGLE PHASESE 208V 480V - PV power Optimization at the rl'IOdUIe-level 3' - - . Minimum String Length(Power Optimizers) 8 10 18 - . . ...... ........................................... ......... .. ..... Maximum String Length(Power Optimizers) 25 25 50 - ................................................................................ Up to 25%more energy - Maximum Power per String 5250 6000 .I W Superior efficiency(99.5%) .................................... .... .,......................................................................... ........................... .......... Parallel Strings of Different Len hs or Orientations Yes _ Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading - ""•"""'."""""""""""""""•'...•'""."""""""""""""""""""""""""""""'•""""""""""""""""" - —. Flexible system design for maximum space utilization - . . — Fast installation with a single bolt - - - - ,{r Next generation maintenance with module-level monitoring - Module-level voltage shutdown for installer and firefighter safety USA - GERMANY - ITALY - FRANCE - JAPAN - CHINA - ISRAEL - AUSTRALIA www.solaredge.us �x t r MECHANICAL SPECIFICATION - Format - 65.7 in x 39.4 in x 1.57 in(including frame) (1670 mmx 1000 min x 40 mm) t Weight - 44.09 lb(20.0 _. -•'--- .. .mw.a.,,r�•.:maw - .. From Cover- 0.13 in.(3.2 mm)thermally pre-stressed glass ..._.._. . - r with anti-reflection technology - • Back Cover Composite film Frame Black anodized ZEP compatible frame ,o.. _ �-_.�� r,,�y..✓""^� ,_ , - Cell 6 x 10 polycrystalline solar cells ]unchon box Protection class IP67,with bypass diodes Cable -4 mma Solar cable;(+)2:47.24iin(1200 mm),(-)a47.24in(1200 rrm) Connector Amphenol Hellos H4(IP68) --� ��jy� • • 1 , ` ,� • 1 PERFORMANCE AT STANDARD TEST CONDITIONS(STC:1000 W/ma,25°C,AM 1.5G SPECTRUM)'. * tt - POWER CLASS(+5W/-OW) [W] 255 - 260 265 r Nominal Power -- P-, [W) - 255 260 ^~µ 265 ' ' Short Circuit Current IsrP [A] -9.07 -- 9.15 - 4.23 - - Open Circuit Voltage V._ IV] 37.54 37.77 38.01 - ._ Current at Pm„ - - le„ [A] - 8.45 8.53 8.62 _ - .. Voltage at P•,p T. - Veep IV] 30.18 _ 30.46 30.75 -The new Q.PRO-G4/SC is the reliable evergreen for all applications,with Efficiency(NominalPow ar) q [%1 a15.3 - a15.6� a15.9 - a black Zep CompatibleTM frame design for Improved aesthetics, opts- PERFORMANCE AT NORM AL OPERATING CELL.TEMPERATURE(NOCT:600 W/ma,as t3°C.AM 1.SG SPECTRUM) - # " ; th POWER CLASS - [WI .�._. � -255 260 265 ' mized material usage and increased safety.The 4 solar module genera- __ _ tion from Q CELLS has been optimised across the board: Improved output Nominal Power ] 17.31 1920 1744 --- __.�_ r • �� .Short C(rcult Current - - - I:C (AI 7.31 - 7.38 7.44 - yield, higher operating reliability and durability, quicker installation and - - --°- -- ` Open Circuit Voltage Vet IV] -34.95 35.16 35.38 more intelligent design. - f Current at P_ IaPP [A] 6.61 6.68 6.75 v . Voltage at P•„ Va,P IV] 28.48 28.75 _ 29.01 _ 'Measurement tolerances STC::3%(P,,,�);t 10%(I•,V-,II,V-) °Measurement tolerances NOCT:35%(Pm,);f 10%0I ,V,Im ,V_)- - INNOVATIVE ALL-WEATHER TECHNOLOGY PROFIT-INCREASING GLASS TECHNOLOGY D CELLS PERFORMANCE WARRANTY _ PERFORMANCE AT LOW IRRADIANCE •Maximum yields with excellent low-light •Reduction of"light reflection by 50%, '• -'. A[least 97%of nominal.power during and temperature behaviour. plus long-term corrosion resistance due , x n - firs[year.T Thereafter max 0.6%degra- _ ___ _�r„. ;• ___ "°""°' _ _ - dation per year. ffi , •Certified fully-resistant to level 5 salt fog to high-quality At least 92%of nominal power after c _ m _____- 10 years. " •Sol-Gel roller coating processing. At least 83%of nominal power after W ENDURING HIGH PERFORMANCE _F• 25years. •Long-term Yield Security due to Anti EXTENDED WARRANTIES' ® All data within antis measuremn t toter with then S°0 i0D I. '0° B0° 1p00 PID Technology', Hot-Spot Protect, •Investment security due to 12-year . "': warranty terms of the Q CELLS sales IeeABIANCEIWhn't _ „ organisation of your respective country. -and Traceable Quality Tra.QTm. product warranty and 25-year linear . o w m The typical change in module efficiency at an irradiance of 200 W/ma in relation Tams to 1000 W/ma(both at 25°C and AM 1.5G spectrum)is-2%(relative). - •Long-term stability due to VIDE Quality performance warranty2. - - Tested=the strictest test program'. .• .-_ - TEMPERATURE COEFFICIENTS(AT 1000 W/M2,25°C,AM 1.5G SPECTRUM) - OCELLS ;: -� Temperature Coefficient nt I,r" a� [%/K1 � +0.04 Temperature Coefficient of V. [%/K]� -0.30 SAFE ELECTRONICS TOP etwNo'Iro Temperature Coefficient of P•rr y [%/KI -0.41 NOCT [°Fl 113 t 5.4(45 t 3°C) o Protection against short circuits and e� "' '' ' a thermally induced power losses due to °2015 Maximum System Voltage V_ IV] y1000(IEC)/1000(UL) safety Class II. _ breathable jUfICtIOn box and Welded Maximum Series Fuse Rating (A OCI� '20 Fire Rating "C/TYPE 1 e Max Load(ULY fib./if,r 50(2400 Pa) Permitted module temperature- - -40°F up to+185°.F Cables. on continuous duty (-40'C up to+85°C) T _ Y Phntnn; I Load Rating(ULY - [lbs/ftal r 50(2400 Pa) see installation manua�e - - - (toasty Tested e OCEllS '( QUALIFICATIONS -i_.�D ny,-ov Bert potyeryatalllne a solar module 2013 -, UL 1703;VDE Quality Tested;CEcomplianq Number of Modules per Pallet 26 ""m""°°""0O - o•°RD°t Q� IEC 61215(Ed.2);IEC 61730(Ed.1)application class A THE IDEAL SOLUTION FOR: Io.40032597 MP oNpa is per 53 Container N 32 �....m �Nomher of Palle fig` Nu.her of Pallets per 40'Container 26 ' Rooftop arrays �. . . . . . ,. V ��® residential buildings - - p0 AT7e 4 E: C E CcUs Pallet Dimensioas.(L x W x H)- ..,._ 68.7 m x 45 0 in x 46 Oin g' tiQ !� -N W, (1745 x 1145 x 1170 min) Pallet Weight - 1254 Ito(569 kg) jFq 0v NOTE:Installation instructions must be followed.See the installation and operating manual or contact our technical service department for further information on approved installation and use of - - ' APT test conditions:Cells at-1000V against grounded;with conductive metal foil covered module surface, cOMPpt1 this product.Warranty void if non-ZEPcerbhed hardware is attached to groove in module frame. - - 25°C,168h - - a See data sheet on rear for further information. Hanwha O CELLS USA Corp. 300 Spectrum Center Drive,Suite 1250,Irvine,CA 92618,USA I TEL+1 949 748 59 96 1 EMAIL q-cells-usa®q-cells.com I WEB-cl-cells.us Engineered in Germany Q CE LS Engineered in Germany CELLS P •ai, ar,"a-� =oo Sin9le Phase Inverters for North America e ' esolar SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-USsoar o o Q � SE7600A-US/SE10000A-US/SE11400A-US SE3000A-US SE380OA-US SESOOOA-US SE6000A-US SE760OA-US SE10000A-US SE1140OA-US' - JOUTPUT SolarEdge Single Phase Inverters ..... .... ........... .. ..... ........ .............. ......... � §fir s 9980 @ 208V L3 Nominal AC Power Output 3000 3800 5000 6000 7600 10000 240V 11400 VA w, •. _ .............. ......... .. .. ... .. .. .. 5400 @ 208V... 10800 @ 208V. Max.AC Power Output 3300 4150 6000 8350 12000 VA _� ............... ....: ...saso,�zaoy........ .... @zaoy. ............................. For North America � � ... ...................... ........ ......... .........-.. '�r+ � " `� �'r•^- AC Output Voltage Min:Nom:Max.dat ! ! y..,. � 183-208-229 Vac - SE3000A-US/SE380OA-US/SE5000A--US/SE6000A-US/ ............ ................ ................................................ .................................. ............................. i. ,.... - ' ., AC Output Voltage Min:Nom:Max.i't ! ! ! ! ! ! ! SE760OA-US/SE1000OA-US/SE1140OA-US 4 21.. .... 264VaD ,,� =i; 1'�* - .t= AC Frequency Min:Nom:Max.(') - 59.3-60-60.5(with HI country setting 57-60 60.5) ..Hz. YP. ,.,:•. f _v k. ........................................... ... ........ ........... ..24 @ 208V ........... ... ...... ...48 @ 208V... ... ...... Max.Continuous Output Current 12.5 16 25 32 47.5 A ns �x;..Au :�•,.. r ,r;.:. �,j 21 240V 42 240V .............. ........... ........................................... ................I............... @ .......... .. .... .............. .�°@..... Threshold...... ..1. ....... .A.. ................... .... Utility Monitoring,Islanding Protection,Country Configurable Thresholds Yes Yes r,,,, kr.. � + '',i.x'?�' •*r'r. .;gt#i'°v µ` 'x `'i ''S .4k£ 4INPUT r,��p �`•• , ,:;„..�- Ka- -�'^a �;. '"�'''-ar}-u Maximum DC Power(STC) ..... •••4050••.•• .....5100.__....•••6750.•..•••,•,•8100 .•.10250. .....13500..._._.••••15350••.. •,W.•,•. _ ........................g.. .. ...... ...... .. .sips. t.. -. ,-- Transformervless,.Un rounded....... .......................... ......................... Yesa ....................................................... ... f�W, ..'&a' r:'- ...................... .... .. .......... u. i.. - n:: :Max.Inpu[Voltage .....500 Vdc m .................ut Vo....... .. xya-', +fi1,,3wr�.,- ,c ate, ,,;>, ,.�,� Nom:DC Input Voltage................. 325 @ 208V/350 @ 240V. .............. .Vdc.... .... «-"`-. -.=c,-+- - ^^•. „ .... ........... ..16.5 ...... . .. ..... . ...33 @ 208V... ✓� 9.5 . 1............... ....... 18 23 34.5 AdcMax.Input Current(2) 15 30.5.e.240V ............ . .... .................•...... .............. ....... Max.Input Short Circuit Current 45- Adc x '' ........ ........ ..................... .................................... ............... ................................................... ..... ......... '-- �` x * .r.' Reverse-Polarity Protection Yes - N, o w axt ......................................... ............................................... ....... ....................... ................................. ......... -Fault .. ........ .....9 7..5.9.8. ........6.0..0.k.o..S.e..n.s.i.ti.vGround Isolation Detection it.y ............ ... ........... •. •. ........ .. Maximum Inverter Efficiency 98.2 .... ........ .... .... .....8..... ... . .... ....••.. •.... ............ ..%...•................. ..... . ................................. ... ... ............. . @ 208V 97 @ 208V . - . s s .:.„°} ,>. Weighted...Efficiency . ....... .............. .................98.alp•240V.......... ....... .............. 240V.. .. ............. ... T .. .,„..... ,�,:•. ' :-" ^ate✓• st` 2 ..=.n fi- - - CEC d Efficie 97 5 98 97.5 97 S 97 5 % ....g.......... ..... .. .... .......... Nighttime Power Consumption <2.5 <4 W ADDITIONAL FEATURES Supported Communication Interfaces R5485,RS232,Ethernet,ZigBee(optional) ..Revenue Grade Data,ANSI C32.1.... .......... ............... ............Optionall'l..... ....... • r. _ '' ar.''. ".fix. pM'gv ........Functionality na .. enSo......SolarEdge .. .hutd..nkit isins.. ..... ................... ........ `� '� z 5,„,~k'+ `� 9 •� •r ;« Rapid Shutdown-NEC 2014 690.12 Functionalrty enabled when SolarEdge rapid shutdown kit is installed(4) I STANDARD COMPLIANCE -- f *- >h. �`�">` s ° •µ ':p==^<3"` ",-,�„'�, y�^'°' 'r' „+t ''� Safety UL1741 UL1699B UL1998 CSA 22.2 t•£>i.§mra.._ .. .... ............ ........... ........ ...... ......... .... ..... .. .... ......................................... l .,, ..'^. n.� r i_.,..:4 3 O '?ev=f .:.",v` .x, `�..• s ?:.ter.:. Grid Connection Standards IEEE1547 .................................... ........ . ........ .................... .._........... ......... .. . .... ............ ........ C Emissions ...FCC part15 class B t' 3r k ¢T„ k °., r/ _..° ¢1NSTALLATION SPECIFICATIONS- a"x °' 1. �' �' ", AC output conduit size/AWG ranpa 3/4"minimum/16-6 AWG 3/4 minimum/8 3 AWG .............................. .......4 .mini .. .. ..ring. ," DC input conduit size/#of strings/ 3/4"minimum/1-2 strings/ •e�,',l E+ "-3 ;6 'tdt r tia ... ,_:. .> °x . .; t. 3/4 minimum/1-2 strings/16-6 AWG a• z a •, AWGran a 14-6 AWG r n€ r &................ Dimensions with Safet Switch 30.5 x 12.5 x 10.5/ in/• .a tie +�, -,-*t •£t y 30.5 x 12.5 x 7.2/775 x 315 x 184 r ''�-•<` r s „ ' e..r=x,. .� �. 3 "`; '� ..(HzWzD) .......... ...... ...... ................ ........... ........775 x 315 x 260........ min .. n. w.: a .................... .. .. ............-... .... ................ ....-... ..... .. Weight with Safety Switch 51../23.2 I 54.7/24.7 ..........88 4/40 1.......... lb/kg ...... ..................................... ........... ....... .......... .. ... .. ..... .'�n. ,'1, "' r � � � P•" r� �r3✓N.>� .e •Natural ..W O :e>..iw= ..u,.,>...+:a..ro w '*` ,h` £. .dI' -,a r t ""a �a .F h ("6•'"•'�,' .+, '° y d' convection N• x Cooling Natural Convection and l Fa ns user replaceable) fan(user t The best choice for SolarEdge enabled systems ........................................... ................................................................... .r?nlaseable)...... ............................................. Noise <25 <50 dBA . ...pl. .................................. ......... ................. ......... Integrated arc fault protection(Type 1)for NEC 2011690.11,compliance Min.-Max.Operating Temperature 13 to+140/-25 to+60 -40 to+60 version availablelsl) `F - Superior efficiency(98%), P...g...... ......................... ................................................... .......... ............................................... ......... rotection Rating NEMA 311 ...................g .................................................................. Small,lightweight and easy to Install on provided bracket For other regional setting,please contact soiarEdgesupport. - Built-in module-level monitoringl'l A higher current ource may be used;the inverter ill limit its input current to the values stated. pl Revenue d inverter P/N:5Ex oA-USOOONNR2 for 7000W inverter:5E760DA-U5002NNR2). - _ - l°l Rapid shutdown kit P/N:SESWO-RSD-SI. , —.Internet connection through Ethernet or Wireless - RlAO version P/N:SE—A-U5000NNU4(for 760OW inverter.5E7600A-U5002NNU4). Outdoor and indoor installation - Fixed voltage inverter,DC/AC conversion only Pre-assembled Safety Switch for faster installation Optional—revenue grade data,ANSI C12.1 sunsaE ' USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THENETHERLANDS-ISRAEL Www.solaredge.us _*_ j •_ xN Pb� ¢ 4 I A