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Home My WebLink About0095 KEARSARGE AVENUE r�r��.. A ve.r,LA �.� , , , . a , t 1, . s _ �'THE Town of Barnstable *Permit# Expires 6 mon om issue date Building Department Services >"hs r f UM RuCommissioner lorence,CBO 1639, �� eo OCT 18 RMain Street,Hyannis,MA 02601 www.town.barastable.ma.us Office: 508-862-4dAWN O� 6AHNSMBLE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ZZ S 1 f Property Address f:27 tj C k Residential Value of Work$ 3 �- Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address l'n G-;;,:ortL M,4 10/92 N Contractor's Name ✓'I 2AA2 Telephone Number !a S `(ZS Z$2 S Home Improvement Contractor License#(if applicable) SS Email: "do^ 110 961-)44 _ ( o,�-. � CIO, Construction Supervisor's License#(if applicable) ❑W rkman's Compensation Insurance Check one: 21"I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name f)1b M f'A,r i Z l f - Workman's Comp.Policy# 0 > Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) \ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to F140�k Pam. ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: QAWPFILESTORNIMbuilding permit formslEXPRESS.doe 08/16/17 �"E Town of Barnstable ' Regulatory Services ` Richard V.ScaX Director. - ►`� Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder - EL2Da ' --cya of the subject property as Owner l P Pay hereby authorize on my behalf; in all matters relative to work authorized by this building permit application for. V . (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before.fence is installed and all final inspections are performed and accepted. Signature of er Signature of Applicant Print Name (� Print Name . /—/0 / Da QFORMS:OWNERPERMISSIONPOOT.S w Town of Barnstable Regulatory Services pFSHE Richard V.Scali,Director 4 Building Division Paul Roma,Building Commissioner w � 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: R� !D /� � JOB LOCATION: g S GS A JE CCN 9t�tzV:4,LZ number street village "HOMEOWNER": &Ak, ! 7 O 9 3 7_4&0 name home phone work phone# CURRENT MAILING ADDRESS: PRO p� 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 ., proce es aixd requirements and that he/she will comply with said procedures and requirements. Si a of meown 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit fonns\EXPRESS.doc 06/20/16 II 03/31/2017 14:42 5089572781 MARK SYLVIA INS AGCY PAGE 01/01 CERTIFICATE OF . LIABILITY INSURANCE DATE(MM/DDryYyy) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.1 HIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED $y THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ie3)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to tfie terms and conditions of the Poilcy,certain policies may require an endorsement. A statement on this certificate does not ConPor rights to the certificate holder In lieu of such endorsements_ PRODUCER Mark Sylvia Insurance Agency,LLC oNrncr RME: Kris Ko raski 404 Main Street PHONE lG.tl�Ext) 508 957-2125 rMt , E-MAIL 1!UC No• �08)957-2781 Centerville. MA 02632 oDRE33:mark marks lviainsurance.com INSURER 3 A.) FFORDING COVE NgrC R F INSURERA:FaRnFamllyCSSUSIty Insurance ome Groap LLC INSURER a: Street INSURER c: A 02655 JNINSURER O SURER E: COVERAGE$ INSU p; CERTIFICATE NUMBER; THIS A TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA REVISION NUMBER: ABOVE OR THE POLICY PERIOD INDICATED, NOTIMTI•ISTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIg CERTIFICATE MAY DE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED 8Y THE POLICIES DESCRIBED HE 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A 6 LTR TYPEOFINSURANCE POLI YEFF POLICYt3% A X. COMMERCIALOENERALUA9RITY POIICYNUMBER YYY M/oD �j 2001 L6914 12/4/2016 12/41 17 LIMITS CI,41MS•MADE I A I occur. EACH OCCURRENCE Is 1,000,000_ U P t(IISES(E9 t�„�ranc S 100.000 VIED rXP fAnY one rvon) E 5,000 OPrrL AGGREGATE LIMIT APPLIES PER; PERSONAL 3 AOV INJURY $ 1,000,000 X POLICY , r LJ LOC GENERAL AGGREGATE a 2,000,000 OTHER: PRODUCTS-COMP/OPAOG S 2 000,000 A AUTOM021LEUABILITr 200105913 S ANYAUTO 2/11/2017 2/71/2019 CO BINEDidon!IN+LE LIMrr 3 1,O0D,000 AUTOSOONLY x SCHEDULED BODILY INJURY(Par r9mon) a HIRED -AUTOS X AUTOS ONLY x AUTOS ONLD BODILY INJURY(Par wccl(Ignp 5 P OPERTY DAMAGE ' Pe acc UMBRELLA UAB OCCUR $ EHCE09 LIAR CLAWS-MADE EACH OCCURRENCE g OF D RETENTIONS AGGREGATE S A WORKER3COMPFNSATION 2001WBD29 AND EMPLOYERS•LIABILITr YIN 3/232017 312MO18 PER F EOTH ANYPROPRIETORIPARTNER/Fj EcuTIVF, OFFICER/MEMBEREXCLUDy07 N N/A MandptorV In NH) E41; .L EACH ACCIDENT g 1,000,000_ D'8 R PtrgW under n O balpw E.L.DISEASE-EA EMPLOYEE 1 1,000.000 E.L.DISEASE-POLICY LlMfr $ 1,000,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES(ACOR0 tor,Addldanel Remarks ScNodula,Dley be allaciled Irmorg apaoo la red) General Contractor Insurance coverage is limited to the terms,Conditions,exclusions,other limitations and endorsements. Nothing Contained in the certificate of insurance shall be deemed to have altered,waived or extended the coverage provided by the policy provisions. CERTIFICATE;HOLDER CANCELLATION (506)790-6230 3HO LD ANY OF THE Town of Barnstable THEUEXPIRATION DATBE VT EREOFIE BENOTICE POLICIES WILBL CBE CDELIVERED BEFORE IN Esuildmrtg Department ACCORDANCE WITH THE POLICY PROVt510N3_200 Main Street Hyannis,MA 02601 AUTNORR;6D REPRESENTATIVE 4CORD 26(2016/03) The ACORO name and logo are registered marks of ACORDORD CORPORATION. All rights reserved_ .77m Cammomveah%of1Massadrusetts �' k�erzt�rf�'ruir�striat�lccxderrtr - Orke af.£medigations . 600 Washington Street _ Boston,CIA 02112 fvFvtumass goPMa Nfficwlmrs' Cumpensafian.Insur-mce Affidavit BEgdex-./CuntractursMectiicians/PIumbers AppEcantInfmmutfign Please prin Eye Nztm 44rn AJZXZ Address: ';4A;j Si ' ciwstat-_�, 05 i,Ar11( rat Phone -50 -Y 4 Are you an employer?Checkthe appropriate bo Type of project(ruluired)_ '.X I am a employes veitfi 3 4. ❑I am a general contractor and I Io ees fiill aadfor a�#-lxme. * have Imed.the mb-condos 6. ❑Idetiv o oa �' y ( P � 2.❑ I am a sale prgp detas or partner- 'tided oa the attached sheet.. 7. ❑R,e modeHng ship and have ao employees . These sib-contractors hefie . 8. ❑De tolifiou w g fAr.me in employees andhave workers' �� Y 9. ❑Building addition. Lldo ttia�ars' comp.fid�ce comp.T„�rartmi ' 5. ❑ We are a�corporafien.and its M❑Electrical repairs or adt s retm a 1 officers have exercised their 3111 am.a homeowner doing all-work 1L❑Plutabiagrepairs araddititsns. self No W06=3' _ right of e$emgtion per MGL ; ncere�ed,]i c.152,§1(4kaudwe have no 1y. P.00frepairs employees.[Noworlress' 13.0 Other comp.insurance required_] �Amy ap BczmtdHstdbedcsbosftl must also Momitheswfianb9aw:sho►dagtfeatvozkedcompensatingpaRcyiafem2don. MmummuswhD submit dais af{da[ft they aregym'&Uw ak and&mYE H autadecrntmcmrsmact 5dhmitanewaffidseit indienriee sacTi ICaaunctastbstchec'kt16 boatmintattadr maddi6mal shed sUwingthem—ofOesub-c*a=bossatlstatawkedm"notthosea3ideshme -gAuees.If thesobtaahactaeshaceempleyw-%they mnstpmuid &ek warken'-comp.paHgn=bm I air[art elxpFoysr ticcrt isprataduig morkets'sotrtpertsrnimt insrirarics f'or MY earplayees $etoav istl1eprriiicy rMd jo€i sites iR•�OrRIaI7DtL .r -r —� ... _ • _`., _ _ .. I Insurance Company Nam: ''°'� "Paficy 44 or Self ins.IIC- Q o 1 w J✓ Z l=, nDate= Job 0e Addre= 9 S Kfti AS AG E ,4 Ve g Citp/StaPdrw: C'Q Nlev,✓,<� Affach a copy of the workers compensationpolicy-declaration page(showing the policy number and expi-ation date). Far7Ftre to secure coverage as regmred under Section 25A o€MGL c.157 caa lead to the imposit of criminal penah%es of a flue up to$1,SOa OU amVor cme-yearimpriso--nt as Krell as civil penalties in the fbm of a STOP WORK ORDERaad a free of up to$250.00 a day against the violater. Be advised fhat a copy of this statement maybe farwarded to the Office of Investigations ofihe DIAL.for insumace coverage mrificafion- .rtifo hereby Gerf�narder ' andpsaalfres epaycry flurtfim arforma#iwi ptm-&W abatis is,bare and carrmt. . signatare Date phone Ojgkial use anl}. Do aot wrrta in this area,tit be cmnpreted by city artomn officiall City or Town: Perzrbicense:g Issmng Autiority(car.Ie one): L Board of Health 1 Building Department 3.City1rown Clerk 4.Electrical Inspector S.Plumbing Inspector fi.Other Contact Person: Phone#: ormation and. Instrncti"Ons _ Masmc1 usetfs Gdaeral Laws cTiapfra'152 repo=all employ=tD provide work'co np=-sjion for flies eaiployees- P�saaiitto this ate,as�Iny�is defDaed ar"_.every pe rsonin:fie seavice of another undue say codract ofbnr., eRprew or finplie4 oral or wriffcaf An anpIoye-is defined as"au indiviffiA parta=Ni,assoCbdan,carPoradOn or other Iegal e tfty,or any two or more of tho foregoing=Wdgtd in a3oint=±eapr i=,and includsmg the legal sepresC13t8iives of a deceased employer,or the receiver Cr trustee of an hg&idnal,partnership,association or other Iegal entity,employing emPlOYecs- However the own=of a&MILing house having not more than three apartments and who resides therein,or the occopa d of the- dWd[ing house of another who employs pe&ans to do mabb=j=cc,consfrac on or repair work on such dwellmg house or on the grounds or bm�ldmg appurtenanftheretn shaIlnotbecause of such e�rploymedbe deemzedto be an employer. MOL chapter 152,§25C(6)also sit S that-every sfata or local licensing agency shall whhhold tiie issuance or renewal of a Hew a or permit to operate a business or to conSirnct buildings in the commonwealth far arty applirantwho has not produced acceptable evide ucm of cumpliiance with tire,issuannce.coverage requii AdditioiialIy,MGL Obpt I52,§25C(%)states fiTeifhealhe commanWealdi nor�y ofits political subdivisions shall enter into any contractforthep ofpublic Woi3rmmI acceptable evidence of compliancavdth the;rs�ce.. rergr>aenie s of this chapter have been preceded to the contacting aafhoizty." AppHa rrts Ple=ase:fill Obt the Wolkeas'compeamtion affidavit complefrlY,by d=Ymg&o boxes that apply to your sitn.ation anc�if necessary,supply sob-contractors)nine(s), addrtss(es)andphone==be:r(s)alongwiththeir=tficate(s)of insviance. Limited Liability Companies(LLC)or Lar iced Liability Pa tl=Ships(LLP)W no employees a . ea than the members or pmtams,are not regoned to natty w of lcers'compeasafron iaSMaice. If an LLC or LLP does have is . Be advisedthatthis affidavit maybe submitted to the Department of Iudustrial • employees,a policy _e�rpI Y , p �' wed. - should e affidavit e to and date the af�davit Th Accideuis for confIIination of insur�.ce coverage. Also be sur srga beret=ed to 1 e city or town that the application for the peunit or license is being requestA no t the D epartment of L st1iS1 A-cdds:L- Mum1clyou have any Questions regarding the Jaw or If you are required to obtam a Workers' compensation ease call the Department:e� number list the numb list d behw: Self-insm-cd companies should enter their PoIiey,please, self-;,,crzran ce Iicerse number on the appmpnafe Ime. city or Town Officials t . Please:be sore that the affidavit is complete andpri�edlegilily. The Depa tuenthas provided a space at the:bottom ofthe affidavit for youto,fi-Il outiafile eventthe Office oflnvestigations has to coaEactyouregardingthe applicant. Please be sure to fill in the pen�id/licease rnimbx which will be used as a reference immber. In addition,an applicant exa ear need.o submit one affidavit indtcafmg cogent that must submit multiple penaitlIicense appli�xons m ally gry y �Y . p olicy inl�rinatian(ff necessary)and under"Job Site A ess"tLe applicant should Write"aII locations iii (oily or town)."A copy of the affidavit that has bey officially stamped or marked by fhe city c r town may be provided to the applicant as proof that a valid affidavit is oa file for fu m peffiits or licenses_ Anew aflidavit iiiust be fiIle d out each year.Where a home owner or citizen is obtaining a license or permit not related in any business or commercial ved'Ill-0 (ie_a dog license or permit to bum leaves etc.)said person is NOT re:grrkcd to complete this affidavit The Office of JnVestigations Would like to thank you in advance for your cooperation and should you have any T=fions, please do nothesBafato give vs a call- The De partramf's a.ddtess,telephone and fax er: Cal*Of MRSMCh , T mMt c&1itdmtdd AwUCD:ta ' Ta43biD& n Strom �c�6o-r�I�4 FI�Il� Tel.9 617-T27-4900 eat 4€6 w 14 MASSAF . Fay#61'�-�'�'�'�� 1Zevised¢Za-o7 WW Mgg[dim , f A 1 s t, Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-094302 Construction Supervisor ADAM HOSTETTER r 770B1 MAIN ST WIT OSTERVILLE MA 021 Expiration: Commissioner 12/22/2017 } V /s License or re i Office of Consumer Affairs&business Regulation registration valid for individul use only >>HOME IMPROVEMENT CONTRACTOR 'before the expiration date. If found return to: i Registration 178455 Type: Office of Consumer Affairs and Business Regulation Expiration. 4/1.6/2018 LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 • j COMPLETE HOME GROUP,LLC ADAM HOSTETTER 770 ALMAIN ST ' OSTERVILLE, MA 02655 '..t --- - ------ j Undersecretary I Not valid without signature I w y 1HE Town of Barnstable *Permit# D C (D qcU r PERW Regulatory Services Expir s 6 monthsfromissue date * BARN hE, • �pl A1659�- �� Thomas F.Geiler,Director " BARNST BL Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 12 Property Address Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address ` Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ lam the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name' Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request eck box) ( p Re-roof(stripping old shingles) All construction debris will betaken to .N 1 f, � ❑ 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 not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building pe it forms\EXPRESS.doc Revised 070110 �oF SNe r�� Town of Barnstable Regulatory Services r BARNSTABLE, * Thomas F.Geiler,Director v MASS. g i639• �� Building Division Aren �A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 w•wiv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: .� number street vill e HOMEOWNER": p name home phone# work phone# CURRENT MAILING ADDRESS: I Tz city/town state zip co e 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 requirements. Signature of 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 °FtHEro,,, Town of Barnstable Regulatory Services • BARNSTABLE, » y MASS. g Thomas F.Geiler,Director �p 1639. 1Vr rF n 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 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION The Commonwealth of Massachusetts .� Department of Industrial Accidents Office of Investigations' ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly C Name (Business/Organization/Individual): Address: City/State/Zip: Phone #: lz��n_ T SLA Are you an employer?b4ck the ap ropriate 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.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑.Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working forme in any capacity. employees and have workers' . insurance.$ 9. ❑Building addition comp.[No workers' comp. insurance P• required.] 5• ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. a homeowner doing all work officers have exercised their 1 L❑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 13. Other employees. ❑ LN o workers comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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 isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. CSi ature: Date: Phone#: Official use only. Do not write in this area, to be.completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: FOR wJ DAT TIME P. M ' PHONED `:::i OF PHONE � Y RCALL' / - ® ��Tu�NEo` AREA CODE NUMBER EXTENSION LEASE CALL' MESSAGE WAGAtNILL CALL>:' �• .SEE YOU WANTS T0' SEE'YOU SIGNED �niversal 4E300 NOTES -- -_.---- r- P Arlington Street HYANNIS MARINE , Hyannis,MA 02601 Full Yacht Brokerage /�2 (508)775-5662 7 7 S_ b Fax:508-775-0851 ED KURKER Trojan Yacht Formula Cigarette 4 Winns 4 1� - TOWN OF BARNSTABLE,.BUILDING PERMIT APPLICATION Map a` Parcel Application # Health Division Date Issued Conservation Division _ Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved,by Planning Board Historic - OKH Preservation/Hyannis Project Street Address Village '6 Owner Address Telephone (�e Permit Request Square feet: 1 st floor: exis ring proposed 2nd floor: existing proposed otal new Zoning District �� Flood Plain Groundwater Overlay Project Valuation a Construction Type B Lot Size ✓q Grandfathered: J`Kes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .�e' Two Family ❑ Multi-Family(# units) Age of Existing Structure o Historic House: ❑Yes ❑ On Old King's Highway: ❑Yes Basement Type: ❑'Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) /y/i4 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing 19 new !� Number of Bedrooms: rl existing Onew Total Room Count (not including baths): existing _��new © First Floor Qgom Coun_t,�-? TZ� bait C� Heat Type and Fuel: C9'Gas ❑ Oil ❑ Electric ❑Others Central Air: 3'Yes ❑ No Fireplaces: Existing oQ_New �_ Existing wood coal stoy,@: LlYbs ❑ No r 0- Detached garage: existing ❑ new size_Pool: ❑ existing ❑ new size Barn: ❑ 0xisting new size= Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review; / Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) C Name < a-- - v D l Telephone Number 77'/-.T -115 } Address License# Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY (IPPLICATION# DAJ?'E ISSUED - MAP/PARCEL NO. j ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION q 61 .D" 0' qjVllt, FIREPLACE r ELECTRICAL: ROUGH FINAL 1 g PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. e �q Town of Barnstable ��ttte ram, Regulatory Services Thomas F. Geiler,Director t SAIW6'TABLE, ' - y� '039- Building Division i6J9. `��' °jeo htat 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: --3T� 1� JOB LOCATION: number street . village c �� o1gr+ �- _5�00 013NS-�9/-If/ao "HOMEOWNER": work hoot# name f home phone# p CURRENT MAILING ADDRESS:_ I ��OLTiI� 0 zi code city/town state P 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 requirements. Sig re — o eo er - 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 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 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 hdshe 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:\VyrPFILES\FORMS\homeexernpt.DOC �1HE„ � Town of Barnstable Regulatory Services + 1AMSTAUX, 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 Property Own r Must Complete and Si This Section If Usin Builder X� , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to authorized by this building permit application for. (Address of Job) Signature Qf Owner Date r Print Name If Property Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. Q:FORMS:OWN ERPER1vIIS SION The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 ` www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly El -� Name (Business/Organization/Individual)C Address: 11 City/State/Zip: �v1� e_ hone #: - 7 16 Are you an employer? Check the appropriate bolType 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 g,' ❑Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No rkers' comp. insurance comp, insurance.$ tred.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3'. , am a homeowner perk officers have exercised their 11.❑ Plumbing repairs or additions r ers co right of exemption per MGL 12.[ Oof repairs insurance rerniirEd,] t c. 152, §1(4),and we have no 1 W a8: employees. [No workers' 13. Other comp.insurance required.] 8 *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners wh submit this affidavit indicating the are doing all work and then hire outside contractors must submit a new affidavit indicating such. o g y g g 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 the policy and job site information. Insurance Company Name:' Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a.copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a 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 c ' u%elhepains and penalties of perjury that the information provided above is true and correct. Si nature: Date: Phone#: � � ` . Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2:Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: 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,constriction 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 agericy 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-contractor(s)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 permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this-affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts �r Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 6,17-7274900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax # 617-727-7749 www.mass.gov/dia 02/1:5/2010 MON 16:23 FAX 508 '564 5531 Bouchie Insurance 0001/001 ACORD CERTIFICATE OF LIABILITY INSURANCE °0211 5 201 0 ri C 02/15/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION " Robert E.Bouchie Jr. Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS .UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,.EXTEND OR 1352 Rt 28A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 400 Cataumet; MA 02534-0400 INSURERS AFFORDING COVERAGE I NAIC# INSURED John Cullivan *=RERA: ARBELLA INDEMNITY INS GO I P.O.Box 1267 wsuRERs: Granite State Centerville,MA 02632 - - 1 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR °D L' I POLICY NUMBER— } POLICY EFFECTIVE POLICY EXPIRATION 1TYPE OF INSURANCE —DATE(MM1000YY1 Low S — � .$ -- -.1-.000.EACH 000500033940 05/0 /09 05/08/10 7 q ERAL LIABILITY i °rbTaSD�� CoMdEa&GENERAL LIABILITY 3 190000- CLAW MADE �OCCUR� ! 'L------ 11EO EXP( One Person) 8 5,000- '--_- ! 'PE 1---j _ — --------1 � RENAL&ADV w3URY GENERALAGGREGATE__?$ __2,000�000 4 _ ! !GENL AGGREGATE LIMIT APPLIES PER { ? PRODUCTS-COMR/OP AGG '$ 2�000,COt). PRO AUTOMOBILE LIABILITY ! !COMBINED SINGLE LIMIT i ` ANY AUTO 1 ; (Ea accident) ALL OWNED AUTOS I ' _.. j i BODILYdLIURY is I 1 SCHEOULEDAUTOS . (per person) f� HMO AUTOS ! � `$ I BODILYINJURY , i €NONAWNEDAUTOS 1 (Per )__-____._ PROPERTYDAMAGE ! (Per amwent) y _WE LIABILITY AUTO ONLY.EA ACCIDENT $ _ r------- --'--, ANY AUTO i I :OTHER THAN ---------- ACC ; I AUTO ONLY: AGG "E .. . :.I.EXCESSAIMBRELLA LIABILITY ' i i EACH OCCURRENCE is OCCUR -` CLAIMS MADE, !AGGREGATE $-_ _ -- •OEDtICTIBLE - j i . _:I I RETENTION $ ` WC STATU- OTH- B WORKERS COMPENSATION AND � 004961812 i 9/10/09 9/10/10 ER.: EMPIAYERS'LlABttJTY EA-EACH ACCIDENT �$_ _ 100,000_ i"ANY PROPRIETOR/ RtEXECUTIVE i �E.L DISEASE-EA EMPLOYEE I$ 100.000 I OFyeFlsCEW EXCLUDED? MEMBER EXCLUOE07 U .dendbe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT ';S — 500,000 OTHER I € I i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBE°POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Falmouth Academy 95 TeafSUrge Avenue NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS.OR Centerville,MA 02672 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Attn Ellzabeth Ugouri Fax:978-453-5500 Of. 19404k . - ACORD 25(2001I08) 0 ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID 3S °A'0 i7Mt1D°' '") CHELL50 03/05 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Paul Cantiani Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 318 Plantation Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester MA 01604 Phone:508-791-2088 Fax:508-799-0663 INSURERS AFFORDING COVERAGE NAIL 9 INSURED - INSURER A: Preferred mutual Insurance co. 15024 INSURERa Hanover Insurance Company 22292 Chelmsford Landscaping Ser LLC Alan INSURER C_ Guard Insurance-Gro Liguori P-O. Box 904 MSURER D: North Chelmsford MA 01863 ---- WiSU ER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE)HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCE)BY PAID CLAIMS. ATION LTR NS 1 TYPE OF INSURANCE NUMBS DATE DATE(MI EFFECTIVE POLICY EXPIR) LIMITS GENERAL LIABILITY IEACHOCCURRENCE $1000000GEX -& , tv A X A -RI�(r ) S 300000 I CLAM MADE ®OCCUR MED ECP(Arty one person) $5000 i PERSONAL BADVINJURY $1000000:. --_- I GENERAL AGGREGATE s 2000000 GEN•L AGGREGATE LIMIT APPLIES PER I PRODUCTS-COMP/OPAGG s 2000000 — POLICY ,IBC LOC AUTOMWBILE LIABILITY B x ANYAUFO AFN8313159 06/09/09 06/09/10 COMBINEDSINGLELIMIT $1,000,000 (Ea a13INM ALL OWNED AUTOS BODILY INJURY �S X SCHEDULED AUTOS i (P-P—) HIRED AUTOS j BODILY INJURY NON-OWNED AUTOS (Per acddesu) $ PROPERTY DAMAGE $ (Per aft) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ --— ANY AUTO EA ACC S OTHER THAN AUTO ONLY: AGG S EXCESSJUMBRELLA LIABILITY EACH OCCURRENCE S_ OCCUR CLAIMS MADE AGGREGATE g DEDUCTIBLE $ RETENTION $ s WORKERS COMPENSATION AND ` x ITORY LIMITS ER C ANYPRORSLIa�LITM CHWCO28369 01/04/10 ! 01/04/11 E.LEACHACCIDENT $100 000 ANY PROPRIETOR/PARTNERlDCECUTIVE , r OFFICERIMEMBER-EXCLUDED? EL DISEASE-EAEMPlO $100,000 If yes,describe under - _ SPECIAL PROVISIONS delay 1 I i ;EL DISEASE-POLICY LIMIT S 500,000 OTHER i B Physical Damage � AFN8313159 06/09/09I 06/09/10 Comp $500.00 Coll $500-00 DESCRIPTION OF OPERATIONS I LOCATTONs!VEHICLES/ExCLUS10NS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Additional Insured AVL CO CERTIFICATE HOLDER, CANCELLATION LIGUORI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATTO DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3Q�. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAB TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHOR>�REPRESENTATIVE Paul F. Cantiani ACORD 26(2001108) 0 ACORD CORPORATION 1988 -`12/4%0,9" 10 47.; 45 4170 03/03. Aco& CERTIFICATE OF LIABILITY INSURANCE ` °A'�`"�"'°°""'"' 12/4/2009 PRODUCER (50.8)540 240.0 FAX:": (508.)289-4111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Murray 6 MacDonald Insuraac� services, Inc. ONLY AND CONFERS;:iV0 RIGHTS".:UPON THE CERTIFICATE HOLDER THIS:CERTIFICATE:DOES .NOT AMEND, EXTEND OR 550 MacArthur:Blvd ALTER'THE:COVERAGE AFFORDED BY THE POLICIES BELOW. Bourne MA 02532 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA::Tra9eZer5 Iad :.Co. OF. CT 25682 H.S. SETHARES CORPORATION IN�JRER B:�ratT2Ter5 Indemnity Of 25666 P.O. BOX 2210 INSURER C-.. INSURER 0- EMT P VM Ili 0253611 INSURER Er. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVEFOR THE.POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR:OTHER.DOCUMENT-WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE IMED OR. MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS_SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAID:CLAIMSINSR . LTR POLICY t611aBER oaTEMNm�VE DATTE E%PiRATION V� MMDMM GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES occurrence $ 300,000 A CLAIMS MADE QX OCCUR 6805304A944 6/16/2009 6/16/2010 MED EJe(Anyone�n) $ 5,000 PERSONAL 6 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENI.AGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) . B ALL OVMED AUTOS -2568N778-09-SEL 2/20/2009 2/20/2010 BODILY INJURY X SCHEDULED AUTOS (Per person). $ 250,000 X HIRED AUTOS BODILY IN,URY $ 500 000 X NOWOMED AUTOS (Per accident) , PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO - . . EAACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION VoCSTATU OTH AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNER/ ECUTIVE❑ E.L.EACH ACCIDENT $ 500,000 OFRCERf EMBE2 EXULIDE71 (Mandates In NH) IHUB2692IM24709 6/16/2009 6/16/2010 E.L.D -EA EMPLOY $ 500 Door If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION (978)453-5500 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFO RE THE EXPIRATION Elizabeth Liguori DATE THEREOF,THE ISS(ANG INSURHt1NILL ENDEAVOR TO MAIL 10 DAYS wmrrEN 95 Rearsarge Ave NOTICE TO THE CERTIFICATE HOLM NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Barnstable, MA IMPOSE NO OBLIGATION OR LIABILITY OF ANY I9ND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE S Harrington, CZC/SMH ACORD 25(2009101), 01988-2009 ACORD CORPORATION. All rights reserved. INS025(200901) The ACORD name and logo are registered marks:of ACORD 4639 r t„E r Town" of Barnstable *Permit# '4 p Expires 6 months from issue date/ 3' ^ Regulatory Services. Fee S + BARNSTABLE, ' MASS. $ Thomas F. Geiler,Director �'Arfo"wYA,� Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02.601 www.town.barnstable.ma.us Office: 508-862-4038 Fax.: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number VpeyAddressidential Value of Work 1S S�O Minimum fee of$25.00 for work under.$6000.00 Owner's Name& Address G`1 \ Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance IT Check one: ❑ I am a sole proprietor. MAR 9 6.2010 [�I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate.must accompany each permit. Permit Request(check box) - VRe-roof(stripping old shingles) All construction debris will be taken to ewf" ❑Re-roof(not stripping. Going-over existing layers of roof) E/Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum .44)#,of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note:"Note: Property Owner must sign Property`Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 090809 ... i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 't 600 Washington Street Boston, MA 02111 { wwmmass.gov/dia r Workers' Compensation Insurance Affidavit: Builders/Contractors%Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address:— City/State/Zip:b K� Phone #: ol_T Qe,� Are you an employer? Check the appropriate box: M Type of project(required): 1.❑ I am a employer with 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 These sub-contractors have ship and have no employees "rc� 8. ❑ Demolition workingfor me in an capacity. employees and have workers' Y9. ❑.Building addition [No workers' comp. insurance comp, insurance.t quired.] �5. ❑ Weare a corporation and its 10.0 Electricaf repairs or additions 3.EX I am a homeowner doing all work officers have exercised their l l.❑ Plumbing repairs or additions myself_-[No_workers'co_.mp, ?• right of exemption per MGL i� __< m12. r_Roof repairs . c: 152; 1 4 , and we have no P insurance required.] t § O� - • 13.❑ Other employees. [No workers' comp. insurance required.] r *Any applicant that checks box ft I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are'doing all work and then hire outside contractors.must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the namcbf 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: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penaltie`of perjury that the information provided above is tr a and correct. Signature: _ � Date: arcs Phone#: ` Official use only. Do not write in this area,,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: a 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,constriction 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-contractor(s)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-toc-a workers"coinpensation7i surance. If an LL C orLLP 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 permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-8777MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia Town of Barnstable " Regulatory Services 0 Thomas F. Geiler,Director * BARNSTABLE, MASS.039. Building Division PTfD �A Torn Perry,Building Commissioner j 200 Main Street; Hyannis,MA 02601 yvww.town.barnstable.ma.us. ' Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: I 1 JOB LOCATION: number street village .,HOMEOWNER": name h �.. work phone 4 CURRENT MAILING ADDRESS: r code * city/town state zip j The current eXemption for"homeowners"-was extended-to inclnd.e owner-occupied-dwellings-of-six-uniis_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) r. The undersigned"homeowner"assumes responsibility for:compliance with the State Building Code and other applicable codes,bylaws,rules and regulations: a The undersigned"homeowner"certifies that he/she understands the.To, of Barnstable Building Department minimum inspection procedures and requirements and that h�"e/she will comply with said procedures and requirements. s Signature Homeowner � . � • ` 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.statesthat: "Any homeowner performing for which a building permit is required shall be exempt from the provisions e of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages.a person(s)for hire to dq such, work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2,15) This lack of awareness often results in serious problems,particularly when.the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORM S\homeexempLDOG EVE roe Town of Barnstable Regulatory Services $^R'ST^ Thomas F. Geiler,Director Buildhag'Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-40 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This S tion If Using A Builde as Owner of.the subject property hereby:authorize to act on my behalf, in all matters relative to rk authorized this building permit application for (Ad ress of Job) Signature of Owner Date Print Name If Proyerty Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # 6�/� �� Health Division Date Issued ? Q Conservation Division Application Fee Planning Dept. Permit Fee �0(o Date Definitive Plan Approved by Planning Board ' . Historic - OKH _ Preservation / Hyannis Project Street Address Village e2e Owner l,/9 4 0 Address M� ,/,Z_ Telephone Permit Request p z, / dltz A4 r ' / kv � e �X e Square feet: 1 st floor. existing proposed N 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation PeV Construction Type Lot Size ✓i / , 0C, Grandfathered: @des ❑ No If yes, att ch support1Q9 documentation. W. vs� Pt %/� Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) �I Age of Existing Structure d® Historic House: ❑Yes 2'No On Old King's Highway: ❑Yes 344-6 Basement Type: ull ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new 0 Half: existing CS new Number of Bedrooms: '7 existing O new Total Room Count (not including baths): existing l C new First Floor Room Count Heat Type and Fuel: ❑J-G�-aas/s � ❑ Electric ❑ Other � Central Air: ❑Yes ��W�o Fireplaces: Existing�New 11 Existin wood/coal stove: ❑Yes a'No Detached garage: Ud'existing ❑ new `s^i +�ool: ❑ existing ❑ new sX/ rn: ❑ existin� 'size_ Attached garage: ❑ ex new size _Shed: ❑ existing ❑ new size _ Other:o i Zoning Board of Appeals Authorization ❑ Appeal # ItIlo, Recorded ❑ N A Commercial ❑Yes If yes, site plan review# Current Use i;c Proposed Use �� fie APPLICANT INFORMATION (BUILDER OR HOMEOWNE ) I Name C,��'��' Telephone Number �a I Address V License # t Home Improvement Contractor# V Y Worker's Compensation # -' ALL CONSTRUCTION DEBRI RESULTINQ ROM THIS PROJECT WILL BE TAKEN TO 4� i SIGNATURE DATE e F FOR OFFICIAL USE ONLY r , APPLICATION# r � , DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER {+ DATE OF INSPECTION: " < FOUNDATION I g e FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH _ / , l/ FINAL - FINAL BUILDING j:&QQ2 - l0a-- DATE CLOSED OUT ASSOCIATION PLAN NO. The Cotntnonwealth of Massachusetts Deparfineni of industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 t� 'y• wwl�.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumberg Applicant Information _ Please Print Legibl Name (Bu iness/Organization/Individual): Address: City/State/Zip: hone-#: Axe you an employ r? Check the 'propriate box: Type of project(required): 1.❑ I am a employer with 4. 1 am a general contractor and 1 6 F]New construction employees (full and/or part.tirbe).* have hired the sub-contractors listed on the'attached sheet. T. �odeling�� d�s ,2.0 I am a soleproprietor or'partrter These sub-contractors have ship and have no employees 8. ❑Demolition employees and have workers' working for me in any capacity. 9. ❑Building addition o w leers'•co insurance comp• nisurance.� comp. 5. [] We are a corporation and its '10.[] Electrical repairs or additions r ued j ' 3. am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right df exemption per MGL 1�.0 Roof repairs G. 152, §1(4), and we have no insurance required_] t 13.[] Other [/ employees. [No workers' comp. insurance required,i *Any applicant,thatchceks box#1 mustalso 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. tContractors that check this box must attached an additional shoot showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must providh their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic,#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration paL.ge (showing the policy number and expiration date). Failure io secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimirigl penalties of a fine tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations ofthe DIA f • urance covera e verification. I do hereby ce r er t e pains-and penalties ofperjury that tice information provided above is e a d correct Si ature: Date: — Phone#: 0ffccia1 use only. Da not write in this area, tb be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health '2.Building Departni ent 3. City/Town Clerk 4,Electrical Inspector 5.Plumbing Inspector 6. Other information and Ins tructiOns Massachusetts General Laws chapter 152 requires all employers to provide workers' compensatioa'for their employees. fined as "...every person in,the service of another under any contract of hire, Pursuant to this statute, an employee is de express or implied, oral or written." g An emplayer 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 hip, association or other legal entity, employing employees. receiver or tiustee of However the an individual,partners ee apartments and who resides therein, or the occupant of the owner of a dwell�nng house having not more than thr n or repair work on such dwelling house employs ersons to do maintenance, construction p another whop elfin house of dw g o'r on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an MGL chapter 152, §25C(6) also states that"every state or Iocal licensing agency shall withhold the issuance or too operate a business or to constru4buildings in the commonwealth for any renewal of a license or permit p ere aired. applicant who has not produced-acceptable evidence of compliance covera with the insurance g q AdditionaIly, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall . �dth the insuran enter into any contract for.the performance of public work until acceptable evidence of compliance ce 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-contractor(s)na nc(s),.address(es)and.phone numbers) along with their certificates)of insurance. Limited Liability Companies.(LLC) or Limited Liability Partnerships(LLP)with no'employees other than the members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Bp 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 zequested,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 penniVlicense number which will be used as a reference number..ln.addition, an applicant that must submit multiple permit4icense 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 locztions is-(City 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 ated to any business or commercial venture year. Where a home owner or citizen is obtaining a license or permit not rel (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 ladustrial Accidents Office of In-Vestigations. 600 Washington Street Boston, MA 02111 Tel. # 617-727-490.0 ext 406 or 1-877-MASSAFE Fax#'617-727-7749 Revised 11-22-06 wvww.mass.gov/dia Town of Barnstable Regulatory Services • Thomas F. Geiler,Director r LUiNSTAHL.E, • MA9.9. qq, 16yq- .�� Building Division prfD �a Tom Perry,Building Commissioner r 200 Main Street, Hyannis,MA 02601 ww-w.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB UDC vil a e number street ` , 9 P "HOMEOWNER": pho e# work phone Q name 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-fandly 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 4requi m Sig er_ Approval of Building Offoial 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 homeownerperforming 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/errtification for use in your community. i 0 �YHe,b,t Town of Barnstable Regulatory Services r BARNSTADLL, Thomas V. Geiler, Dfrector 1 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-62 Property Owner Must Complete and Sign This Section If Using ABuilder l , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorize bythis building permit application for. ( ddress of Job) Signature of Owner Date Print Name 'if Property Owner is applying for pernu p ease comp to the . Homeowners License Exemption Form on the revers side. � I September 26,2009 Barnstable Building-Department— Barnstable,MA To: The Barnstable Building Inspector Upon my inspection of the property located at 95 Kearsarge Avenue, Centerville, Massachusetts, I found no gas or propane service connected to the main house located at this address. The house is serviced by electric_and oil heat_ Thank-You, 4z Doug Lafond Q MA Plumbin and Gas Fitters License# g ,i k r I PLAN REFERENCE:B TABLE COONT-)�EGISTRY OF DEEDS PLAN BOOK 523,PAGE 47. \ 22.5-018 \ rr f - � �Sr iv1d�Qasenreot \ \ ` Winn Exist. 16000► Cone. Slab f h Garage,.\ O � 1 \ 1 Exts�Shed ,y j Proposed �b`�' ` eruuver \ 'Deck , X.e story 0 04. U 0.00, =\91g_ _ Addition Propose�li Remove Existing / � O• \ Covered Porch \ Deck „ / Existin '` �,bg .. •.28, ', w Remove& replace / g �6 y 7 bedroom dwelling-,, existing f undation #95 Kearsarge Ave with / W. z8¢ OOr1► �/k `�' Existing Edge of coastal dune as delineated \ v� done,steps / on plan by Sweetser Engineering revised.to 10/11/2000,job no.4314-00 and on file w/Barnstable Cons.Comm:' LOT 2 225-016 (225-017) << I_nrrnu-nrrnn F,aClSting C 13 n c n.8 ./ CI r. \ vc UARE � � � lx� � .i -e � ��i9 - -. �3+® 1 Ca CRETE ill a / } -tTZ - V-y i on— Sn man two Mom own i _`. } } Cqua c€ P44Ig t h + "f- x� � ��`� .�`-` �`�_3r;"^."�'�i Y,�.,.+-�r-.y � �� g s.-.�� 5-.�..,yt-k#�� yy�• x-.y 7 #µ� F-+'��+"`hm.k�:��.�. 3 +-�� •v..-c.Y'f' ..rt`.n,�' x&.Mi. l '_,�,f _ #3t3t„ � 9 F ru- 4 -v».6_a- 1 �'afi t.:�.ea...:�g 1 '!'1��"M'•""" 1 �.�� i.i� � � i --P. �' 'L , "m HOW "=`fir t y. : _44. -` ' .__:^✓._- ._..._ � ...moo::-: _ - -_ - :_---' - -- - - i�.• < .-ate ... r . is_'. "._�.• - - "" - pftAck 'C � . W �l st 1.) Ck5 W 'l x Vw ® elO a c-,> Fot+ ur °N; 230 Soulh Slreet _H yennis,Massach,►se Us 02601 . T01411 UI' UAR S I'ABLE Notice of Intent 'to•Demolish or Move an historic Building/Structure Tint :ill luk Date of Application: Building/Structure. Address: '95 Kearsarge Avenue r Hyem rt ►. Assessor's Map slid Lot Number Barnstable: 225 O17 F. Is building structure located in a local or regional historic dietrictt Y N If Yea► Protection of 1istoric Properties $ylaw does not apply and it is not X necessary to complete the remainder of t1li.s forma . i. Is` building/structure listed on the 11ational 'Register of historic Places or pending listing on the National Register of1istoric °Placesl 7-. N_X liox old is the buildittg/structuret approx. 89 ytAraliitectural style of building/s true ture, describe if not known12 storV, wood shin le Cape-Cod style single family, home Is- this building/Structure associated with one or more Historic events or persons, name and description No. Existing structure used as- single familv home 7• 'Type of Building/Structure attd Proposed 14Qrk: please see attached adden dum. 8. Zoning District: . RD-1 17I.re District : C.O.M.M. 9' Applicant's Name:Al & Elizabeth Liguori* c/o Patric I.`l• !j :508-790-5400 . But er, Esq, , Nutter, McClennen, LLP Address: . p,.0, Box 16�0 Hvannia MA n�tini 0• Owner's Name: Elizabeth Liguori 'f'el, jj Address: 15 proctor Road. Plmef,�,-r1 ran 1• Contractor: Northside Design Associates 'f'e 508-362-2210 Address i 141 Main Street Yarmout-hDort MA' O�F,75 ' Material of Building/Structure:wood shingled red cedar roof shin les cu stom aneling 3' flow is Building/Structure.Uccup-ied_:•sinQle family home_ y�1Jv:of S�tori es,Z-5�sed Lx.vlanaL-iou of Cfte. proposed use lv be made of OIL, slle : Please see attached addendum t )iagrarn of. Lot' slid Building/Structure wl.11► IJin►cnsiui►s; ' - Please see plans'attacl} l ' I 3' r Addendum to Notice of Intent to Demolish or Move an Historic Structure E i 95 Kearsarge Ave., Hyannisport 7.) The.existing structure is a two story wood frame building containing wood shingle exterior walls, pine wood floors, and a cedar shingle roof. The existing structure contains seven bedrooms, seven baths, and other associated living areas. it has sustained both exterior and interior damage of the walls caused by termites. In addition, the existing structure does not have a solid foundation and as a result, substantial portions of the house are rotted. In fact, the Applicant initially considered renovating the home but due to the level of deterioration and the.lack of a foundation, renovations and/or additions were deemed structurally unsound and/or cost.prohibitive. 14.) The Applicant proposes to demolish the existing structure and reconstruct a new home in the approximate foundation of the existing home. For the Commission's reference, a copy of the site plan is attached hereto as Exhibit A, with the existing footprint shown thereon in black.and the proposed footprint in red. As the site plan depicts, the existing and proposed home will have similar footprints, both in terms of size and location. The proposed home is designed in keeping with the original Cape Cod style. As shown on the elevations plans attached hereto as Exhibit B, the proposed home will be architecturally similar to the existing.structure, utilizing traditional wood shingle building materials to maintain the Cape Cod style of wood framing and a red cedar shingle roof. The new 2.5 story home will.incorporate 3 & '/2 inch crown moulding, as well as custom paneling around the first floor windows.near the proposed front door. A custom cupola is proposed to provide additional architectural interest and the chimney will be red brick. The front steps to the home are also proposed to be red brick. Based upon the foregoing, including the structural condition of the existing home and the limited visibility of the subject property, the Applicant submits that the existing structure is neither architecturally nor historically significant. Moreover, since the proposed home will utilize traditional materials and is designed to be architecturally similar to the existing home, the Applicant requests that the Commission issue a determination that the existing structure is not significant as defined in section 2 of.Article XLIX thereby allowing the Applicant to proceed with this proposal.' 1333204.1 '.It should be noted that the Applicant has obtained an Order of Conditions from the Barnstable Conservation Commission to allow for the proposed new home. In addition, since the lot contains less than one acre of upland, the Applicant will be appearing before the zoning Board of Appeals on September 1, 2004 for a special permit to allow for the proposed reconstruction. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2 Parcel (1) l 74 Permit# 7'73 Health Division Date Issued Conservation Division Fee Tax Collector •�I)AcrQ Treasurer `mom Planning Dept. 1 Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis �G V Lo Z Project Street Address Village Owner icg`'' ! Address Telephone Permit Request Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost -!�'v Olt Zoning District Flood Plain Groundwater Overlay Construction Type G�l � Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family tr_ Two Family ❑ Multi-Family(#units) - Age of Existing Structure r0 Historic House: ❑Yes On Old King's Highway: ❑Yes 3-N Basement Type: ❑Full ❑Crawl ❑Walkout ❑OtherJI ,�/ Basement Finished Area(sq.ft.) tasement 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 IV V Central Air: ❑Yes ❑No - Fireplaces: Existing -New Existing wood/coal stove: ❑Yes ❑No Detached garage: existing ❑new size Pool:❑existing ❑ne size Barn:❑existing ❑new size Attached garage:❑existing '❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Wr0 If yes, site plan review# Current Use ,JG� �rf roposed Use Q BUILDER INFORMATION Name 4ga ,� Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION-DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE t� =FOR OFFICIAL USE,ONLY PERMIT NO. - f DATE.ISSUED ' � • _ if +, k MAP/PARCEL NO. f H ♦ � ADDRESS •. _ Y VILLAGE OWNER , DATE-OF INSPECTION-t FOUNDATION FRAME INSULATION - FIREPLACE s ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL • - + GAS: ROUGH FINAL - FINAL BUILDING y DATE CLOSED OUT —' ? ASSOCIATION PLAN NO. r . f • The Commonwealth of Massachusetts r = Department of Industrial Accidents -"" � — Ofllceot/�estigatioos . 600 Washington Street Boston,Mass 02111. Workers' Com ensation Insurance Affidavit name. ®� r locations hone# -� am a ho P� work�e ❑ I am a sole etor and have no one woddrigin anvj/////%/%/%�/////%%////%/%%//, workers ensatioaformyempl°'gees.worlang on J-::.:.::•,:.:.:-.j:.............::::::}:..:.:::..:::.::::..;:..:.;•::::.:.:.::;.:.::::.;,.:.: I am an em �S ::.. :...:.+..:.:,,..:a..::.::::.:::::::......:.....:.:..:::::........::...:.................... v tid ....... ...................:::::n...........v:::nv::.v.......r............w,:w-4}:•:4:::x::••'• ..w..tv.,a•:.,:......... .....v.. "."......" :w::. 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OI�lY�.:..::•:•:::::......................... :-:::::.�:::.�:{r::::.:x:•:.�::....vvrXi•�:j'.iy^}:{i{v:�?}:�•y::�`vti•J�?:v:r::vq J.?w:: i:.•.w:T'•.::•:v•::::r.}:.:{?L- .. in3Di911t'e'rCO;:::;:>:z�s•:;:{}:�J.�....... e as ceder Seetien 25A of MGL iS2 eaa ba d to the of edmimal pataltles of a tine to 51,500.00 and/or that ao FaOnre to secure eoverag rw:gaieed one yam,irrtpriso�mt as well as dvn pendtla is the form of a STOP WORE ORDER and a Sae of 5100.00 a day against me. I m�derstaed t spy of this atatemmt may be forwarded to the OIDoe of Inoue of the DIA for coverage ve incatloa I do hereby c p ' mid parakia of ped M tl�the infoJnrratioJR provided above is and correct Date /- Signature Phme# Print name - ,,-C d(/� m otlicial use only do not write in this area to be completed by city or town o®dal city or town: permitilieense# E3Building Department (]Licensing Board ❑Selectmen's OtSce checkif immediate response is required (]Health Department contact person: phone#, . (]Other Ur4wd 9195 PJA) Information and Instructions •:- Massachusetts General Laws chapter 152 section 25 requires all employers provide rviceeof anothercompensation ena iorany for heir ontract employees. As quoted from the'law' ,an employee is defined as every person of hire, express or implied, oral or written. ' An employer is defined as an individual,PP� artnershi 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 construction or air work on such dwelling house or on the grounds or. another who employs persons to do maintenance, repair building appurtenant thereto shall not because of such employment be deemed to be an employer. renewal MGL chapter 152 section 25 also states that every state or local licensin �ommo w alth for any appcy shall withhold the licant e o who has of a license or permit to operate a business or to construct buildings in the not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the for the performance of public work until an contract . commonwealth nor any of its political subdivisions shall eater,into ��chapter P P acceptable evidence of compliance with the insurance regir�s r have been resented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and members along with a certificate of insurance as all affidavits may be supplying company names, address and phone Also be sure to sign and submitted to the Department of Industrial Accidents for confirmation,of insurance coverage. 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 Deparmicat at the mnnber listed below. WE ME City or Towns lete and printed legibly. The Department has provided a space at the bottom of the Please be sure that the affidavit is comp has to contact yon regarding the applicant. Please affidavit for you to fill out in the event the Office of ' be sure to fill in the peimidficense member which wM be used as a number. The affidavits may be reamed t^ the Department by mail or FAX unless odw have been The Office of Investigations would like to thank you is advance for you cooperation and should you have any questions. please do not hesitate to give us a call. IN rg, MEMO ME E IN The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of InvestlDations 600 Washington Street Boston,Ma 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 4069 409 or 375 The Town. of Barnstable °FtHE Tp�� Department of Health Safety and Environmental Services Building Division '►�� . ' 367 Main Street,Hyannis MA 02601 MASS. t; 1639. $�TED MP'1 61 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number / -O Itreet village "HOMEOWNER": �� !/` G i tj �®<� e ;Q '0aU name home phone# work phone# CURRENT MAILING ADDRESS: t 5- city/tow Vstate 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 an req ' ments. (SiFisture of Homeowner 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN he Town of Barnstable ? ansxsrll"LL �,� Department of Health Safety and Environmental Services �l 9F1% Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION f, 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: v� r Owner's Name: zrc � 2 Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building no er-occupied ey)vvffer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. 4 Date Owner's ame q:forms:Affidav Q . I V.� fifi 8 F i ��F H a i Ai n c8a 1 l T In lei ° .v. ARCH(-TECH A550CIATE5 ➢ � 1� G7A►2 AG E �t L I G o I-a Mz l f Z E 51 DE�1 GE �eP„yM e� u�ee arewge "'e*° Cv"htFmt-%on architectural design, inc. AcC of 1990./uy copy,firer � boibn of theea pWie Mtheur. the mq r"rattan w Omt or 1550 route 26,unit 4 tel: 505-771-3900 ou 1JDAT IJ pLQ N/ GT e nr.W-tech neee W-.me,ro centerVllle,Ma 02632 faX:50&-775-1945 en fnfhingement hd this ecr.. in d. O Lij 43 LU _T it � U � U N A• �f GftWl3 - � S_ � d1� . I tU - I N 11.1 hL � Q W W_ a N . I. vQrE k•a3 RL- PAWN T•J.L. i ��GoN� �Irvo�z pl.�.K 14 .A-2 U _ i U All i� cu 44 (IM 76 Ll U O� w I I W �/4' Y = G ❑t � y. � w o I-- v � ul -14a.5 ;Ah UnTEI! A-3 i L LLI CIO Eli S L U J Ill Al Z a 711 o p m 9L z W �iu4 E 6ti U ,1t V 7f2WN i S.P•t. A-4 I i ly I ' goe2 �KoW tl ze ell' - _-__._.-=- I 9 5 R�A r 32 - o ! I I s FOAJ i I I r I 4-Q , I I 1- I _ I I i 8-o IC �.� 1+-r-- l-0 I 24--Q e Y _ _� r JZ iZ rim j 1 EA 12 I=-L T I c2 , f � I AI-oll gl_vtl Ial_o� vl_ otl r ' m �lo 1 _ I ! I� I i ..-A-I3Gvo P.G.i GDI.1G1cE"f$ I'.�84v. I - _..3,4, - /F•G. kE14 Fo RcSHHUr- —.—..—._\ - -- --• __oU.-Go1+11�aGTED FILL _. 31;To POCK _.. aN7 ISM: Qi -14 TS I/25 h.P. FLo¢R'T}�yf�iFh �I !I soa!� �a ��7$JaX67yn I I I � _'•risy y��4o---�-I � I -pp — ! I .II li I _4x1o:hHgpFD I��Wevb - I � c4A-4NIzeU- � At x II -WReI-dEC W/�!x 1'luc . _p -- W/BehE�✓�E NULL!-�I11G li _ <tl_ou!' I. al_otl zl—�I �I_ol yl_o QI _oy yl,9 i ,gll-dd. I r�-'_off i — azl-op ' r I 8 GONG.FRogTWALL --- ON 1(0-10 LONG � RooTiNv w K��- �}�GONG. SLAB CA�ovEl L��L W/TOP�OF �O N UN F>cGAVATEo � � -o 4rGotiJc.SLA6�A�oaE� SLOPED y�x To QH Gbo2S YZ�ANIG HOR pOLTS _O -b2oP I�P of P`N rrrN. WAL L soNOTUo�;4�-OII MIN.6E ioi-�+ jODE 4� it-�A �I-Cod 11_�I gl_GII 1�-9n ell-o 0 24I-oH r �OUNDATI�N PLAN lr'` � WRIL TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 ,,// Map Parcel " J� Permit# 7�D �f� Q Health Division 9 � � - Date Issued Conservation Division Ck • 011111 a -�a^ 54. kztt Fee �T Tax Collector :° (,r' t�4GYSTEM � - Treasurer / " 1] 1,,ALI.LED IN Co . UANCE° Planning Dept. WITH T? EI�VII�O�IN1E °". CODE AND t Date Definitive Plan Approved by Planning Board .�+ TOWN :; {�a° ' �pg Historic,-OKH Preservation/Hyannis Project Street Address /°' G v (—bcffV- 1, T Village 6- c , Owner f g (/U' . Address �� J Telephone Permit Request G/-9gpA 4 d > �S s a c� 'c Square feet: 1 st floor: existing proposed 2nd floor:'existing proposed Total new Estimated Project Cost U �"sr Zoning District Flood Plain Groundwater Overlay { 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: 0 Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other ° Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full;existing new Half`.existing new Number of Bedrooms: existing `7 new —1 r , 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: O Yes ❑No Detached garage:❑existing ❑new .size Pool:❑existing 0 new size Barn:,❑existing ❑new size Attached.garage:❑existing ❑new size Shed:❑existing ❑new. size Other: Zoning Board of Appeals Authorization ❑ Appeal#, Recorded 0 Commercial -0 Yes ❑No If yes,site plan review# Current Use Proposed Use ' BUILDER INFORMATION Name • Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO - SIGNATURE DATE _ " FOR OFFICIAL USE ONLY p i PERMIT NO. DATE ISSUED MAP/PARCEL NO k ADDRESS ^a E -�, VILLAGE OWNER DATE OF INSPECTION:'' r _ t FOUNDATION r' FRAME 4". F f INSULATION FIREPLACE ELECTRICAL: ROUGH�` , : FINAL # i' ` nC 7, - PLUMBING: ROUGH '' s FINAL j i s - x i F '-°' -� .FINAL. -- ' • ,; i r• w ., } "" 4` - - i GAS: ROUGH _ - FINAL BUILDING •�r� :Z � ! DATE CLOSED OUT r x 9.4 ASSOCIATION PLAN NO., 0 f I P (� / 1 F ND).. N W 160 00 `V ?d, c N� FkIS71 .� o p NG �XaSr\ �Y(CFND) VN � � Cv 4� CB/DH (FND) �� j:2SS�O o • S F m 20 0 o. F rL0 fL O 4i . . O •� le° s \ 200 , Sgo F s04, �� PLAN OF LANO IN Al. l4,-/AQ '/'POP-T, MA55AGHU5ETT5 A 5 PREPARED FOR AL LIQUC)9-% PLAN REFERENCE- ON THE DA515 OF MY KNOWLEDGE PLAN SCALE- I"=50' INFORMATION, I FIND;, THAT AS A DATE DRAWN — RESULT OF A SURVEY MADE ON THE TOP OF FOUNDATION GROUND TO THE NORMAL STANDARD ELEVATION- 41A OF GARE 017..PROFE5510NAL LAND ELEVATIONS SHOWN ARC SURVEYORS PKAGTIGN6 IN THE N FEET`ADOVE MMA Q GOMMONWEA.-TH OF HU5ETT51 THE LOGATIO ° TION 15 A5 5HO N HE PAUL `y E a r FILE: I Z(oo- 04 sw 4 F.D. doa 22 9Cn, NOTES DATE PROFE , a SURVEYOR pis. . / 4FND).• N 7?0 /I.O � /60.0 0. ti.p o Nm. � ExIST/N �DQr.,h•. �� dVN y. (FND) � 0 V3 . •i0 n u�,E1r •30 00 •30. (FND) �, c hN S�S o/ 00. co '1p 0 pD` Mp / s ssLlo. o z o 0 5 S 0, S?o \ 00. s �a 1po. .� po F , I6s a p PLAN OF LAND IN Al. HVAw915PoZ, MA55AGHUSETTS A5 PREPARED FOR AL 1I000O9.-1 PLAN REFERENGE- TD: A5.. !.�CrtVOR.1 F1.•5K. zzo Pq- 57 ON THE BA515 Of MY KNOWLEDGE r L vw t)GAI-E- I"=SO' INFORMATION, I FIND,. THAT A5 A DATE DRAWN RESULT OF A 5URVEY MADE ON THE TOP OF FOUNDATION GROUND TO THE NORMAL STANDARD ELEVATION- u(p� OF GARS. OF .PROFESSIONAL LAND ,ELEVATIONS SHOWN ARC SURVEYORS PRAGTIGING IN THE IN FEET ABOVE MBA it r COMMONWEALTH OF HU5ETT5, 5�A . �� THE LOGATIO ` A L TION i IS A5 5H0 N HE ow E s . FILE: 1?-Go- 04 6 4 F.B.: 006 DATE PROFS Ta SURVEYOR NOTES �r�I LAND S _ _ epa men o -- , -- office of/�esdodi loss ,. - 600 Washington Street -••'• :; Boston,Mass 02111 �. //�///� Workers' Com ensation Insurance Affidavit �� //�////////////�� //�////� „.. ,...y . ;,,.,,,,r�rj/�//1////////j//�j�j//�� r�' - -- I////jjj//////jj////j//////��////////////////jjiiiij .� ' % P mane: 6- 0 -/ ,��,4069-C;�Ie zz�� - . location: city e �st hone# �� '5� co- am a homeoawpner erfo all work e�llfg• cap rietor and have no one worin acitv ❑ I am an employer providing workers'compensation for my employees_working on this job. company n .....::::::.�::::.......v.v:::::nv:w:.�::.v:::w:.v._:::•:v:::nv:.v::::::::::::•.v::::......v.........................................................................::::::...;...-..........................................k.,......:r.::•�:•.::: ..........:..::.:.....................:............:........................................... ::$: :;'::;:;::::: ?: ::r::is::s::::is r:r:::;::: is:is::: :?2:::::::;>:::iii� ;:i.'•;:::?::>::"..,.*::ri isi::}::ii;::?:;::}:;:::;::;ris::r:r;:::}:::;{::.:�:.:......::•:::::::::.�::::::::.�.....:...�.. ----..... .�:...::..:::::::....,................. »:' ::.b.::.v: " ..: :•::.:.::::..:..:..:: crty-.. hone#: .:';.;;;;}};:::;.:: :>:<>:}:::<:»:;:<::<:: »:;: _<:<:>.<>:> Insurance,co: ,.....>.:<':<.:;.::.:}..:....:.. olit v#:.> ».....::::. ::: ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have . . the following workers' compensation polices: tom anv:nae• D m ::,::::...::1.:::::::::.:...:::::........... ...... q. . .:...........:............:::..:............................:.::..:..::.::.:::::::::::.:;:.::.:._:::;;::::. :::::::.,.:::....:........................:::::;:.:.:.......:.:.::.:..:..::::.}..}.::.: ............................................ :: .. ::ass:::;;;;}!.§<:$:}:;;::<2:::ir;>:;: ::;?;::'., : ..+k. 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''� .:<:>?< . ... :+....:..:::::.:.............................................. ..........v♦.:*.*`. :............-.... ::::::::.::::.::::::::........................................................-......................... 1 . :•:::.::::::.:.:.........•:::::•:::•.:•::........:::::::::,::•::•::::•......::•:::................................. ....................... .......................................................r:.,•:::•:. 5. ......::.:..:.. ;•;;•:;•;:.....:. ::::::: :..::.:..:.:.::.::::::.:.:.. . .::.............. address- ..::.:::.:::.:.: .....:.::.:. :..:::..:::::::•....::........ :::::.:::::.................................. :,:. ..................... ..:::::.:.:::::::::::: :::::.::::................................ ...;.:.:-.,:;;.:-;:.;:::::..:. r. :::............... .... :.:.:... .I....:..:::..: ::::.::::::........................................ dtv:. ,.:,.,..............,.,........ }',,: ......:.............:..:...::.::.. .....:... ........ .................:..:....::.::.................:..:::................................:....::..... :.... ::.::............................................:...............::................. :...,.::......:.,:�..:.. r.:...:::..:.:........ :.�..--.........-,-,. r..... ........................................................................................::::.:::...... .................................................................... ........................................................... .::..:..:.....::.-........-:..............:.:........:..r...... ::.:....................,........................... :::::::::::::::::::::::::.::::::.:.................... :..::.::.:::.:..::::::::::..:::::::::.:......::::.:::.::.:::,:.:::.::-. .........................:+..::::::.:::.v.: ...::.::.:.::.r:.,.:......r:::•::.:.......:.:.::::::::::.:I.::::::::::.........::.:::r:::::::•:::::.:.:::::::.:::. MrsCV-* :..:: . :.....,..:,,..:.,........ .. ... ...:::..:. .... ....... .................... ......... olica# 111111911411111111111111 Fafiure to secure coverage as required under Section 25A of MGL 152 can Ind to the imposition of criminal penalties of a floe 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 5100.00 a day against me. I understand that s copy of this statement may be forwarded to the Ofitce of Investigations of the DIA for coverage verification. I do hereby certi sins and penalties of perjury that the information provided above is .and correct signature Date / � � r _ . Print name C Phone# > �t� official use only do not write in this area to be completed by city or town official • city or town: permit/llcense# • rIBuiiding Department O Board ❑check if immediate response is required ❑Selectmen's Ofifce • C3Hwdth Deparb mt contact person: phone#; - ❑Other (tensed 9193 Ply � i Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their;' employees. As quoted from the'law".an employee is defined as every person in the service of another under any ca&=. of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to.construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situatim and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. ---------------------------- City or Towns -- Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pecmit/license number which will be used as a reference number. The affidavits may be retuned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Ofllce of Inesugadens 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 The To wn of Barnstable • anfexsTasi.E, Department of Health Safety and Environmental Services prEo ''" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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: / /��e Estimated Cost Address of Work: Owner's Name: Date of Application: — I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied er 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 Name Registration No. Date er's Name q:forms:Affidav Department of Health Safety and Environmental Services Building Division rasa 367 Main Sant.HYaaass MA M601 _. Offices 5084162-4038 Ralph Crossen F= 508-790-Q30 Bolilflin8 CQM=LL�� BO1VlEOWNFSIUZ= � / Ames IM'M �(� JOB U0[.A'IIODi: emaba �� '�DAtEOW[1FW. C>a l � hema�e* wort # CMtRVrrMAnjNG AMRESs: zip code 'ihe cm:eat exc=don for"homemme was=murledto incmde ofsacunits or less and to allow boMWwnets to engage en mdh iduai for hiW wiO does not possess a llc= wayided that the Owner . z ON orsow persons)who owns apat+erl ofLand anwinch Ivdsba = ��Mc= A to be,anus otwo-ftY 8.attached or desacbed shannnsbecamsideredahoteeowner. Such P grhp mOtz than ame have in atwo•yearperiod ft� g helai� Anil be chaff soinuitto the Rmffi lag Official an a form 109.1.1) ' pho�eaarae�'at OM tzspon jWforcoonplianxwt&thc Starve B deudding Co and other applicable codes,bylaws,rules andtans. 'Zile undwi®ned"buulcownd' that helshe und=utuds the Town ofBaussiable BuiZdiag Department mit�imnm• aadr andtlmthdshe wt71 ►with said Pr'o and of AffMdafgNWft0 Now 7l=-f w*dwellings catuakdoix 3.1.M cubic fens or latgerwM be regained to compiY wi&ft Starve Budding Code SeWm 27.0 Consmic&m QnU& nil I M EUMUTM IMCad�esmr d= •A�Wi�ommwoaPa��a6m'ld 9FMkfS �sl�ilbecce��ttmmt�e ��thhaaeioa(Seedon 109.1.1•t3oea:mgofoSathatifffie6omeaw�te>�aP�al for 1ti�sodomehaadc.smtsad�Ha®eo�aas6dlastas�at�" �� ai�A��Q, MaQf inmeo�eaahoaaethhaoempoanasemawaetmtthe� RNes�Reeeisdo�forLlo®nst?o�oa '�0°Z13) �ladca�awameaa®entdaits maeeion:p�b� �ipa�tiiefiomee�oerhimtmlioemsdpeamas. Iath3saie.�� agem�tffienoiiae�edpeaoaas rt�d withaitoe�ed&*swim Meheamowearact UI-gnperiserisaitb�df� ofthepem�itapp�'�'00' Toemueet�cthafmaaownais5�► aaa�m�°f �;� tlatt6efio �thtt� ��afsSapen� Oathelattps�eofth�sissoeisafotmaateadY+sed by sad ta�na. Yon mar caa:to amend noel adopt surA a fmmlo farasc in yoas�mmity. U CLERK snlwsresLe, _ Town of Barnstable FILE COPY ONLY! Zoning Board of Appeals NOT RECORDED AT Decision - Notice of Withdrawals REGISTRY OF DEEDS Appeal Number 1998-128-Liguori ----- -�--- -- ---f Variance to Section 3-1.1(5) Bulk Regulations-Front Yard Setback Summary: Withdrawn Without Prejudice Petitioners: Alan and Elizabeth Liguori Property Address: 95 Kearsarge Avenue, Centerville Assessor's Map/Parcel: Map 225, Parcel 017 Area: 1.21 acres Building Area: House-4,000 sq.ft., Garage- 1,500 sq.ft. Zoning: RD-1 Residential D-1 Zoning District Groundwater Overlay: AP Aquifer Protection District Background: The property that is the subject of this appeal consists of a 1.21 acre lot commonly addressed as 95 Kearsarge Avenue in Centerville. The subject lot has frontage on Centerville Harbor and is located within an RD-1 Residential D-1 Zoning District which requires a minimum 30'front, 15' side and 15' rear yard setback. The locus is improved with three structures; a 4,000 sq. ft. single-family dwelling, a 400 sq. ft. shed and a new 1,500 sq. ft. garage. The applicant applied for and was issued a building permit(No. 14541) for the construction of a detached garage consisting of 900 sq. ft. on the first floor and 600 sq. ft. of unfinished storage space above. The garage was approved by the Barnstable Conservation Commission in February of 1996. The foundation was constructed in the winter of 1997 and the rest of the structure was completed in the late winter, early spring of 1998, according to the applicants. Due to a complaint made by abutters to the north of the subject site, the Building Division became aware that the new garage is not in conformance with the front yard setback required off Lincoln Street, being situated approximately 11.6 feet from the property line off Lincoln Street. The applicants were informed of this violation, as outlined in a letter from the Building Commissioner dated August 12, 1998, which states"I received your July 30, 1998 letter concerning the Liguori garage at 95 Kearsarge Avenue. I am sorry that I cannot agree with your position on Lincoln Street's status. Unless it is officially rescinded by Planning Board action, it is a way and the front setback must be honored. You must take immediate action to either move the garage to become conforming as far as setbacks are concerned or remove it all together." The applicants are appealing this decision of the Building Commissioner. In the alternative, they are also applying for a Variance to Section 3-1.1(5), Bulk Regulations, to allow the newly constructed garage to encroach 19 feet into the minimum 30 foot front yard setback required on the property. The following relief is being requested: • Appeal No. 1998-128-Variance to Section 3-1.1(5), Bulk Regulations, to allow a recently constructed garage structure to remain where it currently is; approximately 11.6 feet from the boundary of Lincoln street. Procedural Summary: This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on August 21, 1998. A 60 day and 180 day extension of time for filing of the decision was executed between Town of Barnstable Planning Department Follow-Up Staff Report Appeal Number 1998-12 -Liguori Variance to Section 3-1.1(5) Bulk Regulations - and Setback Date: February 05, 1999 To: Zoning Board of Appeals Petitioners: Alan Elizabet g on --f Property Address: C95 Kearsarge Avenue, Centerville Assessors Map/Parcel: Map 225;Parcel'017_ _ Area: 1.21 acres Building Area: House-4,000 sq.ft., Garage-1,500 sq.ft. Zoning: RD-1 Residential D-1 Zoning District Groundwater Overlay: AP Aquifer Protection District Follow-Up: At the Zoning Board of Appeals hearing on November 18, 1998, the Board requested the following information from the applicants: • an engineer plan showing all structures and features located on the site along with the location of the septic system and driveways, and the topography of the site, and • a schedule of work on the subject garage to demonstrate the Building Permit did not lapse. On January 6, 1999 the applicants submitted to the Zoning Board of Appeal's Office an engineer plan as requested (see attached copy). At this point in time,the applicants have not submitted a schedule of work done on the garage. The applicants should be prepared to address this issue before the Board in order to demonstrate that the Building Permit did not lapse. At the November 18, 1998 hearing, the Board also asked the applicants to check with the Building Commissioner about using the garage for storage of personal items, without an occupancy permit, while this case is being decided on. The applicants stated they would empty the garage. The applicants should be prepared to address this issue before the Board as well. Attachments: Engineer Plan Copies: Applicants/Petitioners January 5, 1999 Letter from Attorney Butler November 18, 1998 ZBA Meeting Minutes Building Permit Application 1 4 �, rf NUTTER, McCLENNEN & FISH, LLP ATTORNEYS AT LAW ROUTE 132-1513 IYANNOUGH ROAD P.O.BOX 1630 HYANNIS,MASSACHUSETTS 02601-1630 TELEPHONE:508 790-5400 FACSffVM:508 771-8079 DIRECT DIAL NUMBER (508) 790-5407 January 5, 1999 #100927-1 Debra Lavoie, Clerk R R a Zoning Board of Appeals l5 l5 Town of Barnstable 367 Main Street JAN — 61999 Hyannis, MA 02601 TOWid ofABARt4 APPLEEQ�c Re: Liguori - 95 Kearsarge Avenue, Hyannisport, MA Appeal No. 1998-128 Dear Ms. Lavoie: Enclosed please find revised "as built" plot plan dated November 13, 1998 prepared �rx by Sweetser Engineering with reference to the above matter. This plan depicts the exact location of the existing structures, the partially completed garage and the septic system components, together with topographic information, as requested by the Board members. Further, the plan depicts the portion of Lincoln Street discussed during the meeting and indicates the exact location of all structures and large trees. Please note that the distance from Craigville Beach Road to the northern boundary of the Liguori property is 775 feet, and that the enclosed plan is not to scale as to that distance. All matters shown within Lot 2 as shown on the plan are to scale as indicated. Would you kindly file the enclosed and provide appropriate copies to the members of the Zoning Board of Appeals. Ve truly yours, G Patrick M. Butler PMB/cam cc: Mr. and Mrs. Alan Liguori 562416_1.WP6 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map - -Zt.�! Parcel 0 r Permit# 3 Health Division �' . Date Issuedtj I, . Conservation Division Fee � �� O-J Tax Collector ' ��yf x 13EF7i,C, SYSTEM MUST BE h STALLED IN COMPLIANCE Treasurer �- t WITH TITLE 5 ENVIRONMENTAL CODE AND. TORN REGULATIONS by F - ' Project Street Address - - 'Village T Owner G� Address / Telephone P Permit Request - 57 Square feet: 1 st floor: existing proposed J 2nd floor:existing proposed Total new-� Estimated Project Cost Zoning District Flood Plainj_�v Groundwater Overlay Construction Type Zyzcro Lot Size fS�' Grandfathered: s Y6-s. ❑No If yes,attach supporting documentation. Dwelling Type: Single Family Or PTwo Family ❑ Multi-Family(#units) Age of Existing Structure !o o Historic,House: ❑Yes ❑ G-- On Old King's Highway: ❑Yes ❑No BA'ment Type: O full ❑Crawl ❑Walkout ❑Other C r t Basement Finished Area(sq.ft.) /V Basement Unfinished Area'(sq.ft) _ Number of Baths: Full: existing new f" y Half:existing c;2-- new Number of Bedrooms: existing . new Total Room Count(not including baths):existing new_CD First Floor Room Count Heat Type and Fuel: ❑Gases ❑ Electric ❑Other Central Air: ❑Yes o Fireplaces: Existing New 0 Existing wood/coal stove: ❑Yes 3-Ne-� Detached garage:016-is-ting ❑new size Pool:❑existing �O new size Barn:❑existing ❑new size' Attached garage:❑existing ❑new size Shed: exL isting ❑new size Other: Zoning Board of Appeals Authorization ❑ PAppeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Used BUILDER INFORMATION Name Telephone Number Address License# { Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRI , ESU NG FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE TZ!2 FOR OFFICIAL USE ONLY SwF � �? � _ , _ - ,'F T , r• ti . PERMIT NO. _ DATE ISSUED MAP PARCEL NO. , ADDRESS i _ VILLAG9 r ` - I .q�ay,n,. . •CS is i• , - .. i' 1 r • } r i OWNER DATE OF INSPECTION l FOUNDATION t -- t A # FRAME ri INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH - r FINAL + , ; z' ` l j '3• GAS: ROUE`-Hip FINAL FINAL BUILDING, d a* CDs - t saa -1 In5: DATE CLOSED OUT ;"" , � ! t ASSOCIATION PLAN NO.In 22 : The Town of Barnstable RAXA rAKZ 9MAM �m Department of Health Safety and Environmental Services Building Division 367-Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissione. Permit no. Date r 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: Owner's Name: o0< Date of Application: $ I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 C]Buildi owner-occupied bQVV6e_r 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 Name Registration No. C, OR Date Owner's ame q:forms:Affidav Table J3=b(condoned) Prescriptive Packages for One and Two4hmily Residential Buildings Heated with Fossil Fuels MAXIMUM MINIMUM GlazingGtaang Ceiling Wall Floor Basement Slab Hcaung/Cooiing r '�'(%) U-value' R-vaiue' R-value' R value' Wall Ptrimeter Equipment mc:cruy PackaIIe R valuer I R-value' $701 to 6500 Heating Degree Dare' Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 85 AFUE T IS%. 0.36 38 13 25 N/A WA Normal U IS% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 N/A WA IS AFUE W 15% 0.52 30 19 19 10 6 SS AFUE Xrflg%. 0.32 38 13 23 N/A N/A Normal Y 0.42 38 19 2S N/A N/A Normal Z 0.42 38 13 19 10 6 90 AFUE AA 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING. 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table J5.2.1 b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall o e total glazing area may be excluded from the U-value requirement. area, expressed as a percentage. Up to 1/o of the g g y For example, 3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accor dance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry, log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages). Floors over outside air must meet the ceiling requirements. ` entire opaque portion of an individual basement wall with an average depth less than 50%below grade must TheP Y meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more If the bwldtng u g P PP than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling, wall, floor, basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 :-�--_ - -- The Commonwealth of Massachusetts . -_� Department of Industrial Accidents ' ==_ aNce eflayestigations � 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit oii�R��C3nf�amiQiiirII IZD / �� iaii.,...... ,�,1 �� ame: ' U C) y� location/ city G'v r hone# ��✓s��t ICJ am a homeowner perfo all work myscif. ❑ I am an employer providing workers' compensation for my employees working on this job. comPnny name address: _ city phone#- insurance co. nolicv# r ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the folloning workers' compensation polices: companv name- . address: - city phone#- insurance cn. ohev#.. ..........:.,:..:..::.: .. company name- address. ciri: - phone#- . Insurance co. poliev# I e s �%:X 0:: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. 1 do hereby certify u "paid pen ies of perjury that the information provided above is true and correct Signatur deEn Date Print name Phone# official use oniv do not write in this area to be completed by city or town official city or town: permit/license ft Mudding DeQar�ttent ❑Licensing Board ❑check if immediate response is required ❑Selecanen's Office ❑Health Department contact person: phone#; ❑Other (revaea 9i95 PJAI Information and Instructions 'may Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any cc= 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 receive: c: 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. IMGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa: of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. , Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and < date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. the Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office 01 Invesugatl011s 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat 406, 409 or 375 TME The Town of Barnstable o Department of Health Safety and Environmental Services Building Division y MAss�'E'$` 367 Main Street,Hyannis MA 02601 vie 1639' ♦0 rFD MA'1 A Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: num er Or street village "HOMEOWNER": 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 ins n es and requirements and that he/she will comply with said procedures and requirem ignature of Honleowner 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXENQT V— c P � c c�. �xry oFTMe r Zoning Board of Appeals Town of Barnstable - Planning Department snMsrABM i 230 South Street, Hyannis, MA .02601 (508) 862-4685 Fax(508)790-6288 August 27, 1998 Ralph Crossen, Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Reference: Appeal of The Building Commissioner Letter of August 12, 1998 to Patrick M. Butler regarding Liguori garage at 95 Kearsage Avenue, Craigville, MA Map 225, Parcel 017 Dear Mr. Crossen, The above referenced appeal, filed under MGL, Section 8,was received at the Town Clerks Office and at the Zoning Board of Appeals Office on August 21, 1998. In accordance with Chapter 40A, Section 15, the Building Commissioner"shall forthwith transmit to the board of appeals all documents and papers constituting the record of the case in which the appeal[under Section 8] is taken." Please deliver said record to the Zoning Board of Appeals Office. Thank you in advance for your cooperation in this matter. The record will be returned to your office upon the Board rendering its decision. Xmmelftt you, Glynn, Chairman / II� U V cc: Thomas F.Geller,Director,H.S.E.S. Robert Smith,Town Attorney Zoning Board of Appeals File + THE The Town of Barnstable • L►arrer�,E. • �,$ Department of Health Safety and Environmental Services 11619. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-19oz(= Ralph Crossen Fax: 508-790-6230 Building Commission, PLEASE FORWARD THE ATTACHED PAGE(S) TO: TO: ATTN: FAX NO: FROM: DATE: ® " PAGE(S): (EXCLUDING COVER SHEET) �D &Lx, P i NUTTER, McCLENNEN & FISH, LLP ATTORNEYS AT LAW ROUTE 132-1513 IYANNOUGH ROAD P.O.BOX 1630 HYANNIS,MASSACHUSETTS 02601-1630 TELEPHONE:S08 790-5400 FACSIMILE:508 771-8079 DIRECT DIAL NUMBER (508) 790-5407 May 26, 1998 • 100927-1 DELIVERED BY HAND Ralph Crossen, Bldg. Commissioner Town of Barnstable Barnstable Town Hall Hyannis, MA 02601 RE: 95 Kearsage Avenue, W. Hyannis Port, MA Dear Mr. Crossen:: , This correspondence will serve to confirm that we represent Elizabeth A. Liguori, who is the owner of the above-referenced property. I am in receipt of a copy of correspondence from Attorney Bruce Gilmore, dated May 21,, 1998, addressed to you regarding this property. Please note that the correct owner of record is Elizabeth A. Liguori. I am also writing to correct a mis-statement contained in Mr. Gilmore's correspondence to you. Contrary to the information set forth in the last paragraph of his letter, the as-built foundation diagram submitted at the time of his application for building permit did, in fact, show Lincoln Street. We are in the process of researching certain title and factual information, and.will be providing this information to you shortly. We believe that the information will be relevant to your determinations and response to Mr. Gilmore's request for enforcement. In the interim, should you have any questions, please do not hesitate to contact me. Ve ruly you , Patrick M. Butler PMB/mka . The Town of Barnstable • anRrrsrns�, • 9cb .•� Department of Health, Safety and Environmental Services �EDNIe'�A Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner August 12, 1998 Patrick M. Butler Nutter, McClennen&Fish,LLP Attorneys at Law P.O. Box 1630 Hyannis,MA 02601-163 0 Re: Liguori Garage n,Q 95 Kearsarge Avenue, Craigville(225 017) Dear Attorney Butler: I received your July 30, 1998, letter concerning the Liguori garage at 95 Kearsarge Avenue. I am sorry that I cannot agree with your position on Lincoln Street's status. Unless it is officially rescinded by Planning Board action, it is a way and the front setback must be honored. You must take immediate action to either move the garage to become conforming as far as setbacks are concerned or remove it all together. Please let me know what you decide to do. Sincerely, Ralph M. Crossen Building Commissioner RMC/lbn cc: Attorney Bruce Gilmore g980812a 1 BRUCE P. GILMORE ATTORNEY AT LAW 1 1 70 ROUTE 5A WEST BARNSTABLE, MA 02668 (508) 362-8833 FAX: (508) 362-5344 Mailing Address P.O. Box 7 1 4 WEST BARNSTABLE, MA 02668 August 3, 1998 Ralph Crossen, Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Dear Mr. Crossen: Since my letter dated May 21, 1998, the building being constructed by Mr. Liguori has neither been removed nor relocated so as to comply with the zoning set back. We now ask you to commence whatever legal action is required to ensure compliance. Very truly yours, Bruce P. Gilmore BPG/cmr cc: V. Largay P. Butler, Esquire to ! r Al 'tom. 2 zoo c,�oc2K PSI) 3 "9 k- w j u v 'QGE1• ,.,�_''�' 1 S/7a'' 7 See /OAVIE p/o n I23r \ `l` ti LS AA � C a n NJ .� v r ti ,r � � ,..,�. .,. � ,�.';' t ',:• •r >>� \- tea, - '� °- \. , i 1 - ••1 � '1�`t;�1;�;,:� '. • o' ICJ L41 00- 52J/ • 'tip • •,vO`` `+�� X/ milt:� = sn• 2 �7 .� �: p:ivaT,S 3pFjw Wi 7, " SS.op �� .�-d/ •. �•` 6�'p o .rG ryJly i �L. a• /J i ri PRIVA-rS L I N C O L N 3o'w�pE a � T S1. OQ o�• .8ea ' D (A 199 . 0 3cn0 £ - M � tAIL LAI -o 4 0> Ij N 0fli \ r C 8 pi �\ a� ,�, -� ��/, ➢ •�i' � � , to � d S i F C� o Z83. 00 " S1 aW KEARSAGe -T O-1 ' 4 • . v C i PRIVATE 40' W S/O C • r r ar • as _ :1 /aa • a• gar / _ • ar :1�' • MINI IC� 01M."N M—1 ML war • ♦� I -%i �i .. ail• •_ . .1..r .. �i CL �. livid Joke C14, I BRUCE P. GILMORE ATTORNEY AT LAW 1 1 70 ROUTE 6A WEST BARNSTABLE, MA 02668 (508) 362-8833 FAX: (508) 362-5344 Mailing Address P.O. sox 714 May 21, 1998 WEST BARNSTABLE, MA 0266E Ralph Crossen, Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Dear Mr. Crossen: I have been retained to represent Vincent and Ann Largay of Kearsarge Avenue, West Hyannisport. The Largays are abutters to Al Liguori who likewise owns a property on Kearsarge Avenue. Mr. Liguori has recently erected a garage eleven (11) feet from the sideline of Lincoln Street, which abuts his lot to the rear. The placement of this building clearly violates the front yard set back from Lincoln Street. Please consider this letter a formal request under MGLA 40A §7 to enforce the front yard set back of.Linco,ri.S6eeef and ask that the building permit be revoked and the building either removed o'r relocated such that it does not violate the zoning set back. My client had been told by Mr. Liguori more than a year ago that the garage would not be constructed until the zoning issue was resolved. Notwithstanding that representation, the garage was in fact erected last week. My clients intend to pursue every legal redress available to see that the building complies with the zoning ordinance. Thank you for your anticipated prompt response. I understand that when the building permit was applied for, the applicant did not disclose the existence of Lincoln Sheet. Very truly yours, Bruce P. Gi 6re BPG/cmr cc' : ' 'V Largay s... R. Largay,Esquire Y. �< P. Butler"Esquire NUTTER, McCLENNEN & FISH, LLP ATTORNEYS AT LAW ROUTE 132-1513 IYANNOUGH ROAD P.O.BOX 1630 HYANNIS,MASSACHUSETTS 02601-1630 TELEPHONE:508 790-5400 FACSIMILE:508 771-8079 DIRECT DIAL NUMBER (508) 790-5407 July 30, 1998 #100927-1 By Hand Ralph Crossen, Building Commissioner Town of Barnstable Barnstable Town Hall 367 Main Street Hyannis, MA 02601 'Re: Elizabeth A. Liguori - 95 Kearsarge Road, West Hyannisport Lot 2 on Plan 220, Page 37 Barnstable Building Permit 14541 Dear Mr. Crossen: This correspondence is forwarded to you on behalf of our client, Elizabeth A. Liguori with reference to the construction of a garage on the above-referenced property (the "Property"). BACKGROUND . Mrs. Liguori purchased the Property in 1994 via deed recorded with the Barnstable County Registry of Deeds in Book 9476, Page 26 (copy attached as Exhibit "A"). The Property is shown on Assessors' Map 225 as Parcel 17, a copy of the Assessors' Map being attached hereto as Exhibit "B". I also enclose within Exhibit B a GIS mapping with existing trees, vegetation and structures superimposed. In December of 1995, Mrs. Liguori filed a Notice of Intent to construct a new garage in the northwest corner of her property and on January 23, 1996, a public hearing was held with reference to that application. Notice of the filing of the Notice of Intent and the public hearing was given to all abutters. A copy of the notice and the domestic return receipt (so- ' called "green cards") submitted to the Conservation Commission at that time is set forth NUTTER. McCLENNEN & FISH. LLP Ralph Crossen, Building Commissioner July 30, 1998 Page 2 within the attached Exhibit "C". On February 16, 1996, following the hearing, an Order of Conditions was granted to allow for construction of the proposed garage. At that time, there were no objections by abutters and no abutter appeared in person or in writing at the time of the hearing to raise objections or concerns. On April 16, 1996, a building permit application was filed for construction of the proposed garage which had been approved by the Conservation Commission pursuant to its Order of Conditions. On that same date Permit No. 14541 was issued. The proposed structure consisted of a first floor of 900 square feet and a second, unfinished storage area on the second floor of 600 square feet. Subsequent to the issuing of the building permit, during the winter of 1997, a foundation was constructed in accordance with the building permit, and construction of the garage itself took place in the late winter, early spring of 1998. On or about May 21, 1998, your office received an objection from Vincent and Ann Largay, owners of property to the north of the subject property claiming that the building violated front yard set back from Lincoln Street. CONFORMANCE WITH ZONING In accordance with our prior discussions and my prior correspondence to you, I am writing to provide your office with specific information to evidence my client's conformance with all dimensional and bulk requirements associated with the subject property. The subject property is located in an RD-1 Zoning District. Accordingly, it must meet the dimensional requirements set forth in Section 3-1.1 of the Barnstable Zoning Ordinance. That Section provides, in relevant part, for a 30 foot front yard setback and 10 feet of side and rear yard setback. We believe that the subject property conforms with these dimensional requirements for the following reasons: Section 7 of the Zoning Bylaw defines "setback" as: "The distance between a street line and the front building line of a principal building or structure projected to the sidelines of the lot. Where a lot abuts on more than one street, front yard set back shall apply from all streets." (emphasis added) NUTTER, McCLENNEN & FISH. LLP Ralph Crossen, Building Commissioner July 30, 1998 Page 3 We believe that Lincoln Street is not a "street" within the meaning of Section 7 Zoning Ordinance. The word "street" is not defined anywhere within the Zoning Bylaw. Accordingly, it is necessary that we look to the common usage of that word. Street is defined under Webster's Dictionary as "a paved road or a public road in a town or city, especially a paved thoroughfare with sidewalks and buildings on one or both sides." Black's Law Dictionary defines street as "an urban public way or thoroughfare; a road or public way...generally ap ved, and lined or intended to be lined by houses on each side.". We enclose additional copies of the photographs which we have previously shown to you indicating the current physical conditions and status of the area depicted on the Assessors Map as Lincoln Street. More importantly, the GIS print attached within Exhibit B obtained from the Town of Barnstable indicates the current location of vegetative cover and trees on the area depicted as Lincoln Street. Examination of the site absolutely confirms that the roadway has been abandoned for in excess of forty years and that the road is entirely impassable from the north. Further, structures have been constructed directly within the way, making it impassable. Examination of the Assessors' Map (Exhibit "B" enclosed), indicates that the portion of Lincoln Street shown on the Assessors' Map immediately abutting the subject property has a dotted line, confirming the impassable nature of the roadway and its unpaved condition. Clearly the spirit and intent of the definitional section of the Zoning Bylaw requiring that frontage be utilized on all areas of the lot abutted by a street are to provide for appropriate set back for public safety, visibility and aesthetic reasons. In 1975 Mass. Acts 808, Section 2A suggests that zoning regulations may be adopted to "lessen congestion in the streets." Accordingly, Section 2A specifically endorses local regulation of areas and dimensions of lands. In Gifford v. Planning Board of Nantucket, the Supreme Judicial Court endorsed a definition of frontage to insure that each lot "may be reached by the Fire Department, Police Department and other agencies charged with the responsibility of protecting the public, peace, safety and welfare." Frontage, (and concomitantly front yard setback) therefore, has a qualitative nature requiring practical access to the building site for fire, police and emergency vehicles. This is similar to the concept of adequate access in the context of subdivision control. The courts have upheld the denial of approval not required subdivision plans where the way serving the site did not provide emergency vehicles and ordinary traffic with adequate access. See Poulas v. Planning Board of Braintree, 413 Mass. 359 (1992). In SSpalke v. Board of Appeals of Ply, the Appeals Court defined the term "street" as "an accepted highway or town way. 7 Mass.App.Ct. 683, 689 (1979). In particular, the court ruled that a four-wheel drive "way" to the lot was not a public street. f x NUTTER, McCLENNEN & FISH, LLP. Ralph Crossen, Building Commissioner July 30, 1998 Page 4 In the instant case, none of the rationales associated with frontage and front yard setback apply to Lincoln Street in its current condition and physical status. In addition, Lincoln Street, in it's current condition, does not conform to any of the definitions of "Street" in the Subdivision Rules and Regulations of the Barnstable Planning Board. Also, a review of the deed into the current owner (see Exhibit "A") raises into question whether or not Mrs. Liguori has any rights of access or passage over Lincoln Street. Massachusetts General Laws Chapter 183, §58, enacted in 1971, provides expressly that merely bounding by a sideline is not enough to transfer the fee in the abutting way. While we have conducted additional title examination to determine the back title to the property, it is possible that Mrs. Liguori has no rights over Lincoln Street. It is arguable, therefore, that the application of the frontage requirement may occur pnly if the property owner has a right to ingress and egress off of the subject roadway. If Mrs. Liguori has no such right, the frontage requirement would be inapplicable as to Lincoln Street. Finally, as noted above, the objecting property owner was given clear and definitive notice of the intent to construct at the exact location where the subject garage is located. The objecting abutter failed to raise any objection or to participate in any manner in the Conservation Commission hearing process. Further, the objecting property owner failed to file any form of appeal. We are also informed by Mrs. Liguori that her husband (and the General Contractor) Al Liguori, had specific conversations with Mr. Largay subsequent to the issuance of a building permit, and at that time Mr. Largay raised no objections. SUMMARY We believe that the garage as currently constructed is in conformance with the applicable dimensional requirements of the Town of Barnstable Zoning Ordinances. In particular, in that the area depicted as "Lincoln Street" is unpaved, and has been abandoned and is unusable for vehicular traffic of any form or nature, and that the subject property has no rights of ingress or egress or to pass upon Lincoln Street, front yard set back is not applicable at that location. Only side yard requirement would apply, with which the garage structure fully complies. Accordingly, we are requesting a written determination from you that the provisions of Section 7 of the Zoning Ordinance relating to front yard setback are not applicable to the I NUTTER, McCLENNEN & FISH, LLP Ralph Crossen, Building Commissioner July 30, 1998 Page 5 property, and, therefore, the garage as proposed comports with zoning. Please contact me should you require any additional information. itruly your Patrick M. Butler PMB/cam cc: Mrs. Elizabeth Liguori Attorney Bruce Gilmore 517714_l.WP6 A o U r g A BPt09476-0026 94-12-08 3t59 #70665 Harold Brown, having an address of 39 Brighton Avenue, Boston (Allston Section), Suffolk County, Massachusetts, being unmatrrOd,for consideration paid $ 650,000.00 (Six Hundred Fifty Thousand Dollars) Brant to Elizabeth A. Liguori of 15 Proctor Road, Chelmsford, Massachusetts 01824 with tiuittiahn tg mensitts the land in West Hyannisport, Massachusetts (Description and encumbrances,If any) A certain parcel of land, with buildings thereon, situated in that part of Barnstable, Massachusetts, known as West Hyamisport, shown as Lot 2 on a Plan entitled "Plan of land in West Hyannisport, Mass., Property of Don S. Greer at ux, Scale 1 inch - foot, April 29, 1968, u Nelson Beerse-Richard Lew, Surveyors, Centerville, Mass." recorded In Book 220, Page 37, Cbounded and described as followss 0 to NORTHERLY by Lot 1 as shown on said plan one hundred sixty (160) feet; q N EASTERLY and Northerly by Kearserge Ave., as shown on said plan thirty-three (33) feet and p, thirty (30) feet, respectively; W EASTERLY by a 10•foot right of way as shown on said pion, one hundred seventy-six and 46/100 (176.48) feet; 3 SOUTHERLY by the same as shown on said plan eighteen and 9/100 (1B.09) feet; EASTERLY by the same as shown on said plan ten and 70/100 (10.70) feet; SOUTHEASTERLY by land of Peter S. Reed as shown on said plan a distance of about one hundred q forty-five (145) feet to mean high water; SOUTHWESTERLY by mean high water about one hundred twenty-eight (128) feet to Lot 3 as shown d on said plan; NORTHWESTERLY, SOUTHWESTERLY, NORTHWESTERLY and SOUTHWESTERLY by Lot 3 as shown on said plan, to ninety (90) feet more or less, thirty(30) feet, seventy and 2/100 (70.02) feet, and twenty- ►+ three and 11/100 (23.11) feet, respectively; m WESTERLY and NORTHERLY by lot 3 as shown on said plan, fifty-two and 11/100 (52.11) feet and ten and 73/100 (10.73) feet, respectively; and WESTERLY by Lincoln Street as shown on said plan eighty-five (85) feet. h Together with a right of way to said lot 2 over lot 1 as shown on said pion, as described and o� subject to limitations set forth in Deed dated May 10, 1966 and recorded with said Deeds in Book 1400, Page 801 of Don S. Greer and Charlotte M. Greer. q u Together with the right, title and interest, if any, of the Grantor in and to the land located a below meen high water and between the sidelines of the Grantee's premises at mean high water extended southwesterly so far as private ownership extends. i No interest, whether in fee, as an easement or otherwise, is conveyed hereby, expressly or by implication or otherwise, in the land adjoining the premises on the east marked 1110 Ft. Right of Way" on said plan. Together with a right of way by vehicle and foot over Kearserge Avenue and the right to use it for all purposes for which private streets are ordinarily used for the granted premises to Crefgville Beach Road, ell in common with others entitled thereto. for my title see deed to grantor recorded In the Barnstable County Registry of Deeds in Book 9350, Page 96. co VO M sec- STABLE - Q 5 8 Z. 0 0 (��/ ...J /08/94 C) v TAX 2230.00 '�' s CASH 2230.00 ;'j _...__._ ! =- go 0. 0 0 6905A000 16958 r.e'wer,:__..._�..� ✓�1L,_,,,-J., EXCISE TAX 1 BP,09476-0027 94-12-08 3:59 #70665 .�. �..... day of—December .......1994 WIttltlfg. hie,;,hand and seal this.. y ................................... Harold Brown ........ ........................................:. ........................................... i BP,09476-0028 94-12-08 3:59 970665 Zip Q4amatntiwta O St. AMWIAWtte ss. J�eC eM be(- (off 19 94 Then personally appeared the above named Harold Brown Qf of tiis�•.�) . and acknowledged the foregoing instrument to be his free act and deed s •�f CNN- 6 4S�47 = , before me ?a a14r. I s .....••'pt Notary Public—Justice of the Peace MY Commission expires ZRA,,*fY z 6�,A a oo! (THE FOLLOWING Is NOT A PART OF THE DEED, AND 13 NOT To BE RECORDED) r Chapter 183,Section 11, General Laws A deed in substance following the form entitled"Quitclaim Deed"shall when duly executed have the force and effect of a deed in fee simple to the grantee, his heirs and assigns,to his and their own use, with covenants on the part of the grantor, for himself,his heirs,executors,administrators and succes. stirs,with the grantee,his heirs,successors and assigns,that at the time of the delivery of such deed the Premises were free from all encumbrances made by him,and that he will,and his heirs,executors and administrators shall, warrant and defend the same to the grantee and his heirs and assigns forever against the lawful claims and demands of all persons claiming by,through or under the grantor,but against none other. ;7FtY p(10 �C�UNTy � FL GSTC� a � B i O U �' B /03 r• 1 - ..YA. F M his °\ '� tic' *�g ® +�" . ` 1•e �« �• �, o \i4 �w � J� � I t61� � • \ 4: 144 iI J I "At. w � • i ,,. \� \~� �£ «� a ;a I I.i•�' 1 1 . •+� 143 &Alr ae.uar0 tt 3 f _ ' REV.By AY/S ROAD ORIGINAL CSSVE: 44 � I i W Tb+'N OF HARNJTAQii - � COvCIL�i BLACH` 0 6 r- 'i.a . d' ie-1 1aAc n too4c . . n Il 274 © 2 e o C.0 .I -SZAC r N ti A - 20 �. � / us.a ao �t q to �N1L 25 uo Ac. v ©. �• Y 27-3 is es I O �\6.4 28-3 r 1-2 - \ /{28 �� 2 7 i 2 .5 11.0 - -=_ 14'6-2 3 13.5 12 -'~ 146-1 148, 1 .7 \/ 1 7.9 . 27.6 5. 147 2 ^26 35 ENNIS Ll 34 ----------- k\k 2 \ k 12.0 •9 kX 3 3.7 X .1 < k ' 3�'i x s; 9, 1 .2 I x6.5 t,— 9.0 _i a ;r , ( 6. t t � • X6.2 .. �� .815, t 1+ 2 i 1 i i �: 1 C 0 U . .. . i V 310 CMR 10.99 Form 5 OEOE Fite No. SE3-2982 ypi TrE tp` (To be provtoed by DEQEi Commonwealth City.Town Barnstable i MAW of Massachusetts = sAIRMSr = Applicant Liguori —_— t659. •'�'o rrwr�~ Order of Conditions Massachusetts Wetlands Protection Act G.L. c. 131, §40 TOWN OF BARNSTABLE ORDINANCES, ARTICLE XXvII From Barnstable Conservation Commission To Alan Liguori Elizabeth Liguori (Name of Applicant) (Name of property owner) 15 Proctor Rd. 15 Proctor Rd. Chelmsford, MA 018,24 Address Address Chelmsford MA 0182 4 Map Number 225 Parcel Number 17 This Order is issued and delivered as follows: ❑ by hand delivery to applicant or representative on (date) G by certified mail, return receipt requested on February 16, 1996 (date) This project is located at 95 Kearsage ,Ave. , W. Hyannisport The property is recorded at the Registry of Deeds in Barnstable Book 7051 Page 273 ' Certificate (if registered) The Notice of Intent for this project was filed on December 14, 1995 (date) The public hearing was closed on January 23, 1996 (date) Findings The Barnstable 'Conservation rnmmi nni nn has reviewed.the above-referenced Notice of Intent and plans and has held.a public hearing on the project.Based on the information available to the Commission at this time. the Commission has determined that the area on which the proposed work is to be done is significant to the following interests in accordance with the Presumptions of Significance set forth in the regulations for each Area Subject to Protection Under the Act(check as appropriate): ❑ Public water supply QT Flood control ❑ land containing shellfish ❑ Private water supply 12o' Storm damage prevention ❑ Fisheries ❑ Ground water supply 12"0' Prevention of pollution E Protection of wildlife habitat Total Filing Fee Submitted $55.00 State Share $15.00 City/Town Share $40 00 (�/4 fee in excess of S2.°) Total Refund Due S City/Town Portion S State Portion S ARTICLE 27 Only: (y4 tom) (1/2 total) ❑ Public Trust Rights ❑ Agriculture ezrosion control ❑ Aquaculture ❑ Recreational M T74 ct�ri n r1 xnai-he4 i n Issued By Barnstab!a Conservation Commission sl This 0 must be signed by a majority of the Conservation Commission. On this 16 th day of February 19 996 before me personally appeared James West . to me known to be the person described in and who executed the foregoing instrument and acknowledged that helshe executed the same as hisllur free act and deed. - MY COMMISSION EXPIRFS SFPT 27,2002 Notary Public MY commission expires The applicant.the owner.any person aggrieved by this Order.Any owner of land abutting the land upon which the proposed work is to be done or any ten residents of the city or town in which such land!s located are hereby notified of their right to request the Department of Environmental Quality Engineering to issue a Superseding Order. providing the request is made by certified mail or hand delivery to the Department within ten days from the date of issuance of this Order. A copy of the request shall at the same time be seat by certified mail or hand delivery to the Conservation Commission and the applicant. Detach on Dotted Line and Submit to the Iasuer of this Order Prior to Commencement of Work. Ti Barnstable Conservation Commission(Issuing.Authority) PLEASE BE ADVISED THAT THE ORDER OF CONDITIONS FOR THE PROJECT AT 95 Kea rsage Ave. , W--Hvannisport , FILE NUMBER SE3-2982 .,HAS BEEN RECORDED AT THE REGISTRY OF Deeds ON(DATE) If recorded land. the instrument number which identifies this transaction is If registered land. the document number which identifies this transaction is . Signed Applicant SE3-2982--Liguori Approved Plan=December 8, 1995 Site Plan,Paul Sweetser RLS Special Conditions of Approval: 1. General Conditions 1-12 on the preceding page are binding,and demand both your attention and compliance. 2. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein,General Condition number 8(preceding page)shall be complied with. 3. The applicant shall pay for their legal advertisement as invoiced. 4. The work limit for the project shall be along the 50' setback line from the`edge of the coastal dune' as shown on the plan. Sediment barriers need only be deployed from the north west comer of existing shed to the property line. 5. Prior to the start of work,staked haybales backed by trenched-in siltation fencing shall be set ' along the work limit line.Effective sediment controls shall remain until the site is stabilized with vegetation. 6. The project surveyor shall verify the proper deployment and location of sediment barriers in the field. Moreover,he shall report in writing in timely fashion to the Commission on the condition of the sediment barrier at the time of foundation construction,and also on whether any deviation exists between the foot print of the as-built foundation and that shown on the approved plans. 7. This approval is contingent upon the approval by the Board of Health of the,subsurface sewage disposal system. 8. Drywells or graveled trenches along the drip lines shall be installed to accommodate roof runoff. 9. Any new lawn area shall be underlain with at least six inches of organic loam. 10. It is the responsibility of the applicant, owner and/or successor(s)to ensure that all conditions of this Order are complied with. The project engineer and contractors are to be provided with a copy of this Order and referenced documents before the commencement of construction. The foregoing condition shall not be construed to exempt project contractors from responsibility for any work performed in deviation with provisions of the Order of Conditions or with the detail of the plans of record. 11. The Conservation Commission,its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. 12. At the completion of work,or by the expiration of the present permit,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Where a project has been completed in accordance with plans stamped by a registered professional engineer, architect, landscape architect or land surveyor, a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation, if any, exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance. Therefore, the Barnstable Conservation Commission hereby finds that the following conditions are necessary, in accordance with the Performance Standards set forth in the regulations, to protect these interests checked above. The Commission orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent, the conditions shall control. General Conditions: 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this order. 2. This Order does not grant any property rights or any exclusive . privileges; it does not authorize any injury to private property or invasion of private rights. 3. This order does not relieve the permittee or any other person of the necessity of complying with all other, applicable federal, state or local statutes, ordinances, by-laws or regulations. .4. The work authorized hereunder shall be completed within three years from the date of this order unless either of the following apply: a) The work is a maintenance dredging project as provided for in the Act; or b) The time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance and both that date and the special circumstances warranting the extended time period are set forth in this Order. 5. This order may be extended by the issuing5'authority for one or more periods of up to three years each upon application to the issuing authority at least 30 -days prior to the expiration date of the order. 6. Any fill used in connection with this project shall be clean fill, containing no trash, refuse, rubbish or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles or parts of any of the foregoing. 7. No work shall be undertaken until all administrative appeal periods from this order have elapsed or, if such an appeal has been filed, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Final order has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final order shall also be noted in the Registry,s Grantor index under the name of the owner of the land upon which the proposed work is to be done. The recording information shall be submitted to the Commission on the form at the end of this order prior to commencement of the work. 9. A sign shall be displayed at the site not less than two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection, File Number SE3-2982 ." 10. where the Department of Environmental Protection is requested to make a determination and to issue a superseding order, the Conservation Commission shall be a.party to all agency-proceedings and hearings before the Department. 11. Upon completion of the work described herein, the applicant shall forthwith request in writing that a Certificate of Compliance be issued stating that the work has been satisfactorily completed. 12. The work shall conform to the following plans and special conditions. , r o SENDER: is • Complete hems 1 and/or 2 for 9 ,{�o,na(serv9�ices �' 0 S 78 @�Ve118 xyaZ t. e z K • • Completeltems 3 and 4a&b Mi � O IOWI CA "•~Or�_ R 8Xt<'8 m r� Y ; •:Print Your hams and address on the reverse of this form 80 chat we +� g � • return this card to,you. y e r r � o •..Attach this form to the front of the mailpiece or on the bank if space + 'Addles"see$ d reSs N a` �� i+ does not permit;`',a .Sa, y,jr '3 .4 • Write"Return Receipt Requested one mailpiece below the article number S{riCt Alive �+` • The Return Receipt will show to whom the article was delivered and the date .fr ?11 �r v #gkt . , delivered ' "' "°1 r4F �., n 'tr• OnSUIt oStmaSt@r f0�e8: ti'2m 3 v 3 Article Addressed to:.. 4a. Article.KNUmbef"", r Wd � m /eft f l3e �e evk� t !o �:�?.Z t? S". _ . f a x' ;m� 4b.:Service.Type ,i r o k Ea r�arc, ¢�. r, t o �� 9 `� ❑ Registered iisured't�? 4, xx b r r Cernfied �r W ( _ Return Recei t for ' G El Express:Mall a❑ P Merchandise o 7. Date of Delivery w 5. Signature (Addressee• 8.`Addressee's Address(Only if requested Y 3 F1 Y and fee is paid) C cc 6. Signature (Agent) b PS Form 3811, December 1991 *U.S.GPO:1ee2�x3-4a¢ DOMESTIC RETURN RECEIPT lienea uin;aa Bulsn io; noA llueyl SENDER: r 1 also wish to receive the • Complete items 1 and/or 2 for additional services. m d m • Complete items 3,and 4a&b. following services (for an extra O • Print your name and address on the reve6 of this form so that we can fee)' > « tL m return this card to you. m m A_ m v Cr W m • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address t •�-) w w does not permit. o W T Z « • Write"Return Receipt Requested"on the mailpiece below the article number 2• ❑ Restricted Delivery y m E t e • The Return Receipt will show to whom the article was delivered and the date o 0 ;. cc delivered. Consult postmaster for fee. O m roGC2 �, F- 3. Article Addressed to 4a. Article Number t CC o a`r10' v o U a 4b. Service Type ja E ( r ca >_ a H o a;z �r �`ep /'�+r�tJ ��r ❑ Registered ❑ Insured Ci c z'K m m o H T w y p tc, R?�: . Certified ❑ COD V r w m o m w W , .J rC+�tlgdr�/ �/j.� ❑ Express Mail ❑ Return Receipt for m $ M a ff Merchandise E 9 Q f N ac ci w o ¢W t �l� � Date o G 7. uc ��❑ ❑ ^ _ Z 4,J ig u e (Add ess _O 8• an fe is es N Y if requested. c m re F�gen't) �d Y 1 a 1 a rf & 81 ` 991 *U.S.Gp0:1992--323Jo2 DO URN RECEIPT E o `\ 5 SENDER; e c as • Complete items 1 and/or 2 for additional services. I also wish to receive the t o • Complete items 3,and 4a&b. following services (for an extra $ c • Print your name and address on the reverse of this form so that we can a return this card to you. fee): m I ` • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address wo= m * H {� 4 O does not permit. y �`` r Write"Return Receipt Requested"on the mailpiece below the article number. a 3 in ( « p 2. ❑ Restricted Delivery n m � � • Thy Return Receipt will show to whom the article was delivered and the date 0-6 v Q Q e- -� i s delivered. Consult postmaster for fee. a m �E m 3. Article Addressed to 4a. Article Numbeerr p o¢9 ~ c c E p ✓ � /L 0 j� 2 4� - 3 = m S Q .6 L g' o - E / 4b. Service Type 3 4 m ri �AN N _ i �i Ut'r-Sl �� ❑ Registered ❑ Insured . .a ui ro a -t W fe XCertified ❑ COD 941 uo peleldtuoo SS3aaatl Nunn au moA sl LU �-Q c V!��G � 4- 1. �€r`- N C ) O 3 �� ❑ Express Mail - ❑ Return Receipt for. Merchandise 7 Date of DeliveN'rlE� •G� v Q Q U . 1J9 j 5. Signature (Addressee) 8. Addressee's Address(Only if requested and fee is paid) uj 6. g ature (Agent) n return this card to you j kh6+R4 R i "r v c � Attec rs Torm� he`front��` iece r on bac�C If�a ace F 1 ;❑ ddt sea ddre � 'r •Write RetumAeceiptRegues R` konhe�na�tpletre ow theart�e numk r +� ReStnG 1�@Ive s >,� •..The Return Receipt wiI(sho wlwntttie article was delivered and the data 3 1&�`Ii'di � delivered. _#;�`�'.arl•^ .; tit4��X!'�'d�3��' ConSu�t Ostmasfer."fof 88 c 3:_Artic a Addresse to 4a Article Number 72. ,. a ��l G �' E C/ /1� ° k 4b Service Type". t 'r ` 70 0�-i' <-. t ❑ Registered ❑ Insur ; O . f�.,,/ e w 71f t y :3 O 17 l ^'tiJ C �Certlfi@d 1� �❑CODS �" . Ila / If.. 4€� Yv ❑ Express Mail p R�tum Receipt for Y f� °3 r Merchandise 7, Data Ddli r� OQSk:r 33dy �l+ : ,F':>.. ignatur r � ,+ dressee's Address(Only if requested. and fee 6. Signs re (A rr +c �. PS Form 3811, D mb 1991 {rtfs r3Patoe2�2a�oz DOMESTIC RETURN RECEIPT rat ti SENDER: . ; yr Complete items 1 and/or 2 for additional services = I also Wish ' ,:. -m Complete items 3,and 4a&b following service.> • Print your name and address on the reverse of this form so that wecan fee) 0 return this card to you n:x " m • Attach this form to the front of the Tailpiece,or on the back rf apace 1 ❑ Addresse does not permit. r -. t • Write"Return Receipt Requested''on the mailpiece below the article number 2 ❑ ReStrlCte + • The Return Receipt will show to whom the article was delivered and the date ` o delivered. Consult ostmaster,. 3. Article Addressed t Y, :.4a. Article Number E /�Q - /eQ xI� 4b. _Service Type r ❑Aegistered ❑ Insured + y jjtf-/7 �J/!l�!1�/�� Oo 7/2 f Certified ❑ COD y. W ❑ Express Mail ❑ Return R Merchant Cs 7 .Date Deli erycc I' �cg�' 5. Signature (Addressee) 8. Addressee's Address(Only if i` and fee is paid) j 6. Signature,lAgent S PS Form 3811, Decemb r 1991 iru.s.GPO:te92-�ro2 DOMESTIC RETURN R* SENDER: • Complete items 1 and/or 2 for additional services. I. also wish to receive the ro • Complete items 3,and 4a&b. < > following services (for an extra CE • Print your name and address on the reverse of this.form so that we can fee): return this card to you. m • Attach this form to the front of the mail ace,or on the back if space 1. ❑ Addressee's Address does not permit. t • Write"Return Receipt Requested"on the mailpiece below the article number • The Return Receipt will show to whom the article was delivered and the date 2. ❑ Restricted Delivery c delivered. Consult postmaster for fee. 0 3. Article Addressed to: - 4a. Article Number o E �c� 4b. Service Type 0 d.o WeO- -eeol0 v ❑ Registered ❑ Insured 8�00 2 `Q�' , :Certified ❑ COD I/ 0` El Express Mail ❑ Return Receipt for Merchandise 7 Date of Deliv y Q / cc 5. Sin ress e 8 Addresse 's Address(Only if requested and fee is paid) pc 6. ature (Agent) PS Form 3811, December 1991 ,ruAQPo:/962--3234M DOMESTIC RETURN RECEIPT I Complete hems hand o or pd ona�serviceaS ' e� :.m • Complete hems 33 and; &b O IOwlitg Sere D 8 • Print ur name and atlress��e�° Yo verse tuts'tgrrn 4 can. eel retum this card LO W m • Attach this form t i o the fro ma,l ce ac a ce Aad�ess �e r does not permit, dre•'L -; r t • Write Return Recieq� an the Piece bw the arts > •' • The Retum!eJeipt will show M r LFe ertxda was delivered 2.—Restrict pervery_!' C delivered ?`' ta 'R{ few ` nx � iConsult ostmasterFo eea. 3. Article' 4dressed�to� � m 4a 'f1r'Ucle Nuber H L�/c rrlolg,� Qgc�erS �. 0CL A 02� ' 4b Service Type � .� � �! : c L 1 ��h Olt., i ; i '❑ Re istered „ t ❑Insured N Neuou��l' P,9 � q !oM , ; . ( ;certified � , ❑`coy `F h. W ,sw .i Q � ❑ Express M lli o Return Receipt for Merchandise 7 Date ofTeh IY. c 5. n r r s 4 8. dressee' Address(Only if requested fee is id) ul H Via: gn ure (Agent) .A . PS Form 3811,December 1991 ,►u GP0 1 DOMESTIC RETURN RECEIPT Y ID SENDER: .` a I also wish to receive the a • Complete items 1 end/or 2 for additional-services. ` o Complete items 3,and 4a&b. ' "following services (for an extra • Print your name and address on the reverse of this form so that we can feel' > return this card to you. m • Attach this form to the front of'the maiipiece or on the back if space 1. ❑ Addressees Address does not permit. t Write"Return Receipt Requested"on the metiptece below the article number 2 ❑ Restricted Delivery The Return Receipt will show to whom the article was delivered and the date a delivered. Consult postmaster for fee. 3. Article Addressed t Art 4a icle Number a �QrOJQI'GT ��'Y`^' p •'-3 7/K Q 74 6 jS' !/leer E ,�l :' ¢/off- •71 4b..Service Type /� 0_Registered ❑ Insured . Nm �jr►�ierrs � Certified ❑ COD f,. ❑.Express Mail :❑ Return Receipt for G Merchandise 7 Date of Delivery X2 S 5. Signature (Addressee) 8. Addressee's Address(Only if requested -.and fee is paid) Cc 6. Signature (Agent) q. PS Form 3811, December 1991 ,rus.GPO:190- DOMESTIC RETURN RECEIPT ti -- SENDER: I • Complete items 1 and/or 2 for additional services. I also wish to receive the o • Complete items 3,and 4a&b. following services (for an extra i •• Print'your name And address nn the-reverse of this form so that we can return this catd:to gou. , fee),: • Attach this form to the front of the;maupiecer or on the back f space' 1. ❑Addressee's Address m _ does not,permit: : - C Write"Return Receipt Requested"on the mailpiece below thi article number '' • The Return Receipt will show to whom the article was delivered and the date 2' Ell Restricted Delivery C delivered. - o Consult postmaster for fee. 0 3. Article Addressed to: 4a. Article Number /CL �Pdl+'yl..t /'� e �ietre ,�,�wQ6 37.1 97 ,,F-3 E G a ./NQ h e R� 4b. Service TYP 'i t� c ❑ Registered sr. N CkeAhLO fi /�� /yPl 0�Ily 7 Certified c OD UJI Express ig Qipt for cc C SE,7 Date of D Q ¢ 5. Signature (Addressee) 8 Addressee's Ad if requested and.fee is paid) Uj 6. Sign a (A tl ( . ;6i.1lf ail+ € 'I fi i 1 1 r tttiiit fit , > PS Form 3811, December 1991 u.s.GPD:1"2-4z"W DOMESTIC RETURN RECEIPT SENDER:. its p •,Complete items 1 and w monel services y �ik4) also i e e o • Complete item)ip and 48 tr g - following se Ce$ or �+ + Print yowl sand addso`n reverse_.of Is form a Cen; " ¢ return:this U. �yy�y fee) tl m • Attach this form to the fro of ma piece or on.the lac apace ' 7 �d_Iwootm-$ less r does not permit. s 3av: « • Write Return Receipt Fieq ow ma ilpiece ailpiece w article numberRestricted: elivery •, The Return Receipt will ahoW to whom the article was delivered and the date , fu, .Rt; n .' deliveredr.1d Tom* 4�3k� tf: �s.= COr1$Ult OStmaStBrOr 3. Article Addressed to . z*' '�" { + o $ _ 4 4a rticle Number t, ri 3 Rom I� r%bulS S 7 a $f.�` a,,x j•" 4b. Service T e trr r �� T YP o q7 � : ❑_Registered d Insured w` YGh7/.I� 1 � �, �` erUfied +y COD W c{' � s�< Ex less Mail ❑ Return Receipt for Merchandise o WEsr ti � 7 Date of Delivery r 5. Signature.(Address 9 8 Addr P. e's Address(Only if requested •fl ��'r b .Z sand palF. d) M 6. Signature (Agent) b a� PS Form 3811, December s.aPo:=2—m-4m DOMESTIC RETURN RECEIPT SENDER:_ I also wish to receive the a • Complete item$-tend/or 2 for additional services. m • Complete items 3;and 4a&b. following services (for an extra 02 • Print your name and address on the reverse of this form so that we can feel: 0 return this card to you. m • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address r does not permit; t • Write"Return Receipt Requested"on the mailpiece below h article number ., the • The Return Receipt will show to whom the article was delivered and the date 2. ElRestricted Delivery c delivered. Consult postmaster for fee. 3. Article Addre sed o 4a. Article Number i Pr; E /O 0• o x 3 a CL 4b. Service Type i � "�•i'71►ON4lf � Registered El Insured fA. j �/'�� Certified ❑ COD W ❑ Express Mail Return Receipt for GA Merchandise ate of Delivery cc 5. Signature (Addressee) 3 8. ressee's Address(Only if requested. I .j fee is paid)uj ' 6. Signature (A, ant) PS Form 3811, December 1991 •au" aP0:199 "DOMESTIC RETURN RECEIPT SENDER: y� • Complete items 1 and/or 2 for additional services. • also wish to receive the o • Complete items 3,and 4a&b.: following services (for an extra ` • Print your name and address on the reverse of this form so that we can feel return this card to you. - i . m • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address i does not permit. t • Write"Return Receipt Requested"on the mailpiece below the article number 2.•' • The Return Receipt will show to whom the article was delivered and the date ❑ Restricted Delivery c delivered. Consult postmaster for fee. 3. Article Addressed to: 4a: Article Number D eah f'SIVSO�t, 'Lai aY P ,,.2 6,4'-Y 7 -.2�-0 CL 4b. Service Type o f0 dr �vxV� ❑ Registered El Insured Certified ❑ COD ✓i// Nl ui ❑ Express Mail ❑ Return Receipt for Q��3� Merchandise 7. Pat fjaelivew Z ature ( dresseel 8. Addressee's Address(Only if requested, M and fee is paid) cc H - . Signature (Agent) i�. p i{ ;Fr riii ; rr i r„ PS Form 3811, December 1991 ,ru.s.GPO:1082--323-402 DOMESTIC RETURN RECEIPT 'o` ;r..;�.` '�'}"...�`.<w`uc4r t;`S�?3 ca• •;+k'.*'� .f.y�. ��i�.�" -'Psrm-` y--e..'fiY�:,R4: a"Y+wir SENDER: ; 4fitmY � 1 also wish to" �eceive'the • Com late items 1 and/or 2 for additional se ces �` yy o Complete items 3 and 4a&b ,� _`wU ' } Y a° •'r following services ttor an extra ` • Print your name and address on the reverse of this form so that we can fee) } ° m return-this card to you: s u :.z e u r* y' , ssra:� r'Y s, a .. m •,Attach this form to the front of•the i.mailpiece or the back if space, 1 '❑ Addressee's Address . does not permit. ` „ _ ' ..7?J r t Write"Return Receipt Requested"on the mailpiece below the article number 2 '❑ Restricted Delivery •.The Return Receipt will show to whom the article was delivered and the date C delivered. Consult ostmaster for fee. m 3. Article Addressed to '. 4a Article Number a t/rh Cep f P '37� .Q 43 4b. Service Type ..❑ Registered ❑ Insured C]CCertified ❑ COD Lu ❑ Express Mail ❑ Return Receipt for v 6 7160 2. Merchandise 7, Date of Delivery Q �a a S _ cc 5. Si nature (Addressee) . .. 8. Addressee's Address(Only if requested F'- and fee is paid) c 6. i a ure Age 1 PS Form 3811, December 1991 *U.S.GPO-1902-4234o¢ DOMESTIC RETURN RECEIPT -0 SENDER: `4 • Complete items 1 and/or 2.for additional services. I also Wish to receive th6 m • Complete items 3,and 4a&b. following services (for an extra 2 •- Print your name and address on the reverse of this form so that we can 0 return this card to you. fee): m • Attach this form to the front of the mailpiece,or on the back if space 1: El Addressee's Address � does not permit. ::: ..,. : ... , _ • Write"Return Receipt Requested"on the mailpiece below the article number • The Return Receipt will show to whom the article was delivered and the date 2, ❑ Restricted Delivery delivered. o Consult postmaster for fee. 3. Article Addressed to: 4a. Article Number wa a / o jf1tarS&6 e /T� 4b. Service Type ❑ Registered ❑ Insured W_#7640%dPI III 1*f/¢ p rK Certified ❑ COD O;d 7;z, ❑ Express Mail ❑Return Receipt for p Merchandise G of Delivery 5. Signature (Addressee) $�Ad e's Address(Only if requester Q P paid) H , cc 6..Signers,(Agent) 0 PS Form 3811, ecember 1991 *u.s.GPo:199 OMESTIC RETURN RECEIP Town of Barnstable R Planning Department Staff Report Liguori Appeal Number 1998-127-Appeal Decision of Building Commissioner Appeal Number 1998-128-Variance to Section 3-1.1(6) Bulk Regulations -Front Yard Setback Date: November 10, 1998 To: Zoning Board of Appeals From: Approved By: Robert P. Schernig, Director Reviewed By: Art Traczyk, Principal Planner Drafted By: Alan Twarog, Associate Planner Petitioners: Alan and Elizabeth Liguori Property Address: 95 Kearsarge Avenue, Centerville ssessofs IGIap/Parcrt -Wap 225,Parcet-017 Area: 1.21 acres Building Area: House-4,000 sq.ft.,Garage- 1,500 sq.ft. Zoning: RD-1 Residential D-1 Zoning District Groundwater Overlay: AP Aquifer Protection District Filed:August 21, 1998 Public Hearing:November 18, 1998 Decision Due:January 30, 1999(this includes a 60-day extension signed by the applicant) Background: The property that is the subject of these appeals consists of a 1.21 acre lot commonly addressed as 95 Kearsarge Avenue in Centerville. The subject lot has frontage on Centerville Harbor and is located within an RD-1 Residential D-1 Zoning District which requires a minimum 30'front, 15' side and 15' rear yard setback. The locus is improved with three structures; a 4,000 sq. ft. single-family dwelling, a 400 sq. ft. shed and a new 1,500 sq. ft. garage. The applicant applied for and was issued a building permit(No. 14541)for the construction of a detached garage consisting of 900 sq. ft. on the first floor and 600 sq. ft. of unfinished storage space above. The garage was approved by the Barnstable Conservation Commission in February of 1996 (see attached Order of Conditions). The foundation was constructed in the winter of 1997 and the rest of the structure was completed in the late winter, early spring of 1998, according to the applicants. Due to a complaint made by abutters to the north of the subject site, the Building Division became aware that the new garage is not in conformance with the front yard setback required off Lincoln Street, being situated approximately 11.6 feet from the property line off Lincoln Street. The applicants were informed of this violation, as outlined in a letter from the Building Commissioner dated August 12, 1998,which states"I received your July 30, 1998 letter concerning the Liguori garage at 95 Kearsarge Avenue. I am sorry that 1 cannot agree with your position on Lincoln Street's status. Unless it is officially rescinded by Planning Board action, it is a way and the front setback must be honored. You must take immediate action to either move the garage to become conforming as far as setbacks are concerned or remove it all together." The applicants are appealing this decision of the Building Commissioner. In the alternative, they are also applying for a Variance to Section 3-1.1(5), Bulk Regulations, to allow the newly constructed garage to encroach 19 feet into the minimum 30 foot front yard setback required on the property. The following relief is being requested: • Appeal No. 1998-127-the applicants are appealing the decision of the Building Commissioner as defined in a letter dated August 12, 1998 which states that the garage must either be moved to become conforming with regard to setbacks or be removed all together. Planning Department-Staff Report-Liguori Appeal No. 1998-127-Appeal Decision of Building Commissioner Appeal No. 1998-128-Variance to Section 3-1.1(5)Bulk Regulations-Front Yard Setback • Appeal No. 1998-128-Variance to Section 3-1.1(5), Bulk Regulations, to allow a recently constructed garage structure to remain where it currently is; approximately 11.6 feet from the boundary of Lincoln street. Staff Review/Comments: The Zoning Ordinance requires a front yard setback from all streets when a lot abuts on more than one street. .The subject lot has frontage on both Kearsarge Avenue and Lincoln Street. Access to the property is from Kearsarge Avenue, an improved 40 foot wide private right-of-way. Lincoln Street is an unimproved 30 foot wide private right-of-way. The applicants contend that Lincoln Street is not a"street"within the meaning of Section 7 of the Town's Zoning Ordinance, which defines"setback"as: "The distance between a street line and the front building line of a principal building or structure, projected to the side lines of the lot. Where a lot abuts on more than one street, front yard setbacks apply from all streets." This definition applies to all approved public and private ways whether paved or not. Although Lincoln St. has never been paved and consists of not much more than a dirt cart path, it is a legal right-of-way that has never been rescinded by the Planning Board. Lincoln Street was created in 1889 when this area of Town was subdivided. The subdivision plan was recorded with the Registry of Deeds in January of 1889 (see attached copy of plan). It appears that the original site plans for development of the proposed garage submitted to the Building Department did not identify the way known as Lincoln Street. The way, however, does appear on the foundation plan dated 4-22-96 by Paul E. Sweetser, Professional Land Surveyor. Variance Request Lincoln St. is a"dead end" street that is currently being used for access by two residences(Lots 144& 145), located over 200 feet north of the subject property. There is no use of Lincoln St. for access south of Lots 144 and 145. In fact, there is an existing shed and several trees located in the middle of Lincoln St. which prevent vehicles from going any further south. The closest residences are located on the abutting lots to the north and the northwest of the subject site. The house directly north is accessed from Kearsarge Ave. while the residence to the northwest is accessed from Magnolia Ave. Lincoln St. is not likely to be improved any time in the near future and may never be paved. If at some time Lincoln St. was paved, there would be negligible traffic using it due to the fact that it is a dead end street and has a very limited number of lots using it for access. However, the legal rights associated with any private way, such as access and frontage, still exist. Variance Findings: In consideration for the Variance, the petitioner must substantiate those conditions unique to this lot that justify the granting of the relief being sought. In granting of the Variance the Board must find that: • unique conditions exist that affect the locus but not the zoning district in which it is located, • a literal enforcement of the provisions of the Zoning Ordinance would involve substantial hardship, financial or otherwise to the petitioner, and • the relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent or purpose of the Zoning Ordinance. Attachments: Applications and Supporting Documents Copies: Applicants/Petitioners Building Division Records 1889 Subdivision Plan 2 Acrt�cenrc Map(lfina 11�+n -� Parcel f eTmlt# '//'- �'r / Conservation Office(4th floor)(8:30-9:30/1:00= 2:00) �W�IAA Date Issued Board of-Health(3rd floor)(8:15 -9:30/'1:00-4:45) 00 , /D (� �- Engineering Dept.,(3rd floor) House#Plan-;"Dipil dUANCE 19 AND TOWN OF BARNSTABLE Building Permit Appl. ation f Project' treet s� Village / ,Owner /�`i i y G/,Q / Address .Telephone Permit Request / 1 P 'First Floor square feet { Second Floor e<G o square feet Estimated Project Cost $ C> 4 0 Zoning District OeO— Flood Plain Water Protection Lot Size K,�0,z 00-0 Grandfathered? Zoning Board of Appeals Authorization y Recorded Current Use GI &57 Proposed Use ,Construction Type I/O d Gf Commercial /t/D Residential S Dwelling Type: Single Family Two Family Multi-Family 4(/ Age of Existing.Structure Basement Type: Finished Historic House P6 Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel P6 Central Air IV D Fireplaces 420 Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name !/ U /� Telephone NuIpber Address _ License O 3 6 Home Improvement Contractor# Worker's Compensation# 0 el NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUC1,10N DE IS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DE FOR THE FOLLOWING REASON(S) r FOR OFFICIAL USE ONLY 3 � 1-' PERMIT NO. � '• • DATE ISSUED - MAP/PARCEL NO..-3 ADDRESS ` a VILLAGE ' OWNER ; r DATE OF INSPECTION: y FOUNDATION FRAME r INSULATION r y FIREPLACE: ELECTRICAL: ROUGH FINAL s ' PLUMBING': ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ' s DATE CLOSED OUT,- i c t ry r ASSOCIATION PLAN NO! t ' The Town of Barnstable epa KABL $ Drtment of Health Safety and Environmental`Services Building Division 367 Main Street,Hyannis MA 02601 Ralph Cro = Office: 508-790-6227 Building C=mis. Fax 508 775-3344 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACI`OR LAW SUPPLEMENT TO PERMIT AiTui:AnON MGL c. 142A requires that the"reconstruction,aiterations,renovation,repair,modernization,conversion, improvement,.removal, demolition. or construction of an addition to any pra-cdsting owner occupied building containing at least one but not more than four dwelling units or to sauc=m which are adlaceot to such residence or building be done by registered contractors,with certain ecceptions,along with other Type of Work: Fst.Cost Address of Work: 0%mer.Name: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under SI,000 Building not owner-occupied c.-et r9�pulling oars permit Notice is hereby green that: OWNERS PULLING.THEIR OWN PERMIT OR DEALING r NOT 0 C'1' FOR APPLICABLE HOME IMPROVEMENT' WORK Do 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 name Registration No. OR n,.„ er s naIIle The Cunttnunwealth of Afassacbuseas Department of Industrial Accidents afeeof/BraslZ alloys ` ;# i•:�` 600 If ashingwn Street Burton.A1uxx. 02111 Workers' Compensation insurance.AMdavit locition• phone 0 ,to am a homeo ner performing all wort:myself. ❑ 1 am a sole proprietor and have no one working in any capacity ❑ lam an employer providing workers' compensation for my employees working on this job. comnam•nnme! address: , ciri'• nhone i#t insornnce ce. nnlics•!! ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comnam•name: address: ci •: phone If: insurance co. heifer# !��.1ii-- `«°_:--::_•• - - rs,.r✓:..c:..•.vaar?r�-�►-•i�-�''''f^"�DF'r� -- •a�=?"':r.+�!�a�►✓'•_�S"'-•_' .e�l4i�••+--•---�5 comnam•name• address- city: phone insurance rn_ nolicv a Attachadditid-al"sheet iftuewaryr'• 1 i A�';at'�'J� Cayrr�.:" •_=':'nt�i"�� .yft•°rn,. -='X-- - "rM`""• :mow Failure io secure coverage as required under Section'3A of AIGL I52 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or One Years'imprisonment as well as civil penalties in the form of a STOP WORK ORDI]t and a fine of S100.00 a day against me. I understand that a Copy of this statement maybe forwarded to the Office of investigations of the D1A for coverage verilleatioo. ' .,,Idea erc r cenifj•under die pacts and Wallies of perjaq•that th • n provided above is true and co ture. ate r nt name �� " G 6 one# official use only do not write in this area to be completed by city or tourn oMcial tits•or town: permit/lieeme R rnBuilding Department (3lrcensing Board check if immediate response is required 13Seleetmen's Office (311ealth Department contact person: phone#, riOther Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for theiremplo%•ces. As quoted from the "law", an emphtme is defined as every person in the service of another under any contract of hire, express or implied, oral or,%+Titten. An emplityer is defined as an individual, partnership,association.corporation or other ::;gal entity, or any two or more of the fore�:oing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership. association or other legal entity, employing employees. However the owner of a dweliino 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 dwellin, House or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 1'S2 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 in covernge 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 havf been presented to the contracting authority. .. ,-....rr.�.��.� w.,....•+•+.�. .�-a. f, i i.v«. �•�a:_ .y... ��t�: v:�,a s 9w:r+1:Y4r;.��,.y?'�r.:r�,�`•.7 •:_gj .. .c. . .777 Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying-company names. address and phone numbers 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. ......•..•«•. .. .,, .. - �s:<. � ::`_•yM.. ,,,saws :..y:. ,.w.'.�-, �< �. [�r.: �%j`=�.' Y:v;'•L":'i''•:Y Sid: t' .C�j� r: City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. ,•r.4�L . . •w�•� r�.::...:..r �`! . - •, '-«.fir :_rs.. ... .1 ,:1..::•tl..•'. The Department's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 •. phone#: (617) 7274900 ext. 406, 409 or 375 . TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE :... JOB. LOCATION en:, :1:( . Number Street address Section of town "HOMEOWNER" aelc Name Home phone Work phone PRESENT 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sy who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building 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 Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply ai procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if , Home Owner engages a person (s) for hire to do such work, that such Home Owne: shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarene: often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "dwner, acti: as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, ma communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last� p'age of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Assessor's office (lst floor): ofoZ: O/ 7 /^ i { vF: FtHET� Assessor's map and lot number. .......:................................ .... SEPTIC SYSTEM MUST BE ��°�O O♦� Board of Health (3rd floor): INSTALLED IN COMPLIANC2 E Sewage Permit number .....f .........1l.� ............. i 9E99T4DLE . Engineering 'Department (3rd floor! WITH TITLE 5 9, M�a House number ........ 91639. �r...., P.�° �e�l �9VIFiONMEIVTAL CO®E .�� oD YAY a\9 p/APPtlCATIONS PROCESSED 8:30=9:30 A.M. and: 1:00-2:00 P.M. ,only TOWN PEGULATI014S TOWN OF BARNSTABLE BUILDING ANSPECTOR APPLICATION FOR PERMIT TO . ................. P! C .f%.... ........: s . 5 �1�°. .... ..... i � i TYPE OF CONSTRUCTION /h[?. .:. ,'t c ............................. ........ . ........�Q.e.... a ................................196 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the .following information: ,p Location ....!... .......G/.6 P.-r�'1'!� ....... ..v .......:..............�kos-.7 .......<.j�,y$.✓/'�/f i oiP. pay Proposed Use ...... /'?/!-v.t.............�-pi a F................. =.... ....../ ! ... .?............... . .../ .......................................Fire District ........ ......1'.7: .l'� ....5 I Zoning District ..............a. f Name of Owner ../J r ...../..!..G. ..�.Q�.�...............Address .. � „S/ .�Q �s/�Q�,/./�al� /�/ . � O.. ...�iT:.... .. Name of Builder ........../....... ... r1...............Address//W,0! !.... .9.✓G�cP ..../v.f7 !—, Name of Architect �G�''� ......Address........................................................... Number of Rooms //� .....................Foundation ...!�./a� `�l........................ .................................................................. Exterior ...............................Roofing re.:1-4< `.( /�'.f............................. \..... Floors � � A.4..... ...................Interio. ......� r. .x.......................................... Heating ..... ....... .........C....... Plumbing ...G...P/ P T.... G.............................. Fireplace ........ /............................................................Approximate Cost . .............�..ft.... p........ ... .................... Definitive Plan Approved by Planning Board ---------- -- ---------19-------- • Area . ... — 62C Diagram of Lot and Building with Dimensioris Fee /D1... ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH of OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name /,/ .. ......... Construct'o upervisor's Lice e .................................... KEEZER, ROBERT No ..289.Z? Permit for ..Remodel Dwelling .... .... ......,.. i Single Famil Dwellin S, Location 95 Kearsarge Ave; _ Owner Robert. Keezer .. . . p ..................................._........ ....... f Type of Construction Frame i , ......................................... ,...................................................... Plot ..............- ...... Lot ............;..... Permit Granted .,.FebruarY... 27�.........19', 86 Tti Date of Inspection ................. ................19 Date Completed .`...... —�...... ...t.............19 atA _ Assessor's office (1,st floor): ^ " ;7,7. o/ .� �J �+� oF1 Ero Assessor's map and'lot number .................................:.......... d� ♦� Board of Health (3rd floor): Sewage Permit number ......-:.............. ............... Z 11A HM 11DLE, Engineering Department floor ( � ` '° rb 39• House number ......:.:.._... .'....:,.....r.,, A.!?A.?��!.Ok...... OYP-46" V APPL.I-O'ATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BA`RNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..................... �..`t'�. ..... tea..... TYPE OF CONSTRUCTION ............ .......... .... . ............................ ................................19.- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �S B�P ,.�'�� ' v"2 ....S ! �� Proposed Use .......: G1,f7. ?'P! ............ �-F...��/C'�P✓. ................ 1 ?./ �-... ?s 7rr'�... f� -Ed.................. ' r .. / Zoning District U ...../.......................................Fire District ............/..t Name of Owner ........./.!..G.f'. �.............Address Name of Builder ............ ....�............'......Address ........... ................................................. .......................... ..... ....:....... ............. Name of Architect ..� ......Address Number of Rooms ...................�°../........................................Foundation ... /......... ....................................................... ... Exterior /�c,� ....... .f.' s' '.�...............................Roofing .:....... F'. ......5!/l!' ....S�..r........................... /11r/. N ,: c�1� �...............Interior ......-5 ( Floors ......................................... ...:........ Heating �er�� ;�_ � 'c� ,t:..Plumbing ....._ t� "� ...L...G ....... ...... ...I..... . � o Fireplace ........ /(. ...........................................................Approximate Cost . .....1.... ... ........,...................... Definitive Plan Approved by Planning Board ________________________________19________. Area .: ...f......i!7.�/v Diagram of Lot and Building with Dimensions Fee ...�©!...-4...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH f OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..... .. . Construction-.Supervisor's Lic 6 .........:�:........................ N � . . (A } KEEZER, ROBERT A=225-017 Remodel D� 28971 aell'n, No ................. Per�rv'i,it for9�.. ......... ...✓ Single Family Dwelling .......................................................... ......... .......... Location 95 Kea rsarge Ave. e ce ............................................................................... Owner ....Robert Keezer ............................................................. Type of Construction ......Frame .................................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ....... .......19 86 ° Date of Inspection ....................................19 Date Completed ...................:..................19 t �. i �, .� ,; .ire': � '' . 1 l!_/.1�� _ rr. t �;�,- . . "��. y r Qti,. .. •.:,K. ., <�:F:" . ',,p': y. 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