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0098 KENNESAW AVENUE
1 l in t `� R'll"ll 1�: }y� �r 21105V-�— r 9 . ,° e 6 ^ . . . " s � n Town of Barnstable - 3",w.`t a "'� N *?.r ?.',` "z ` 3"� . - Post:This CardSoThat it is Uisrble From,the,Street ;ApprovedPlans,Must be Retained onlob and,th�s;Card;Musi be Ke' t , ..;;z h,.. r,,, a ;: `/ rq.#;�° fir',; n. °x 4 16 �Vh,ere sted Until Final InspectionHas;Been Made ° a Ce,"ctificate'of Occupancy rsRequ�red,such`Bu�ldrn shall,Notbe Occu �ed,unt�t a Final lns' ection has"beemmade ,:' Permit .. ,., .,.,,: a �, ..,;�7,; .� �.�•• r'r ag,.d�,: .>,m� .. ., p,_ ,,..? _ ,,>:,t p a F»M H,» s Permit NO. B-18-1524 Applicant Name: SOUTHERN NEW ENGLAND WINDOWS LLC. Approvals Date Issued: 05/17/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date:.. 11/17/2018 Foundation: Location: 98 KENNESAW AVENUE,CENTERVILLE Map/Lot 249 023 Zoning District: SPLIT Sheathing: Owner on Record: DUCHESNEY,LEONARD I&ANN E 4 4; tContractorNarne BRIAN D DENNISON Framing: 1 z i Address: 98 KENNESAW AVE w. U Contractor License 4CS 095707 2 ,x„ �3 CENTERVILLE, MA 02632 t EstProfect Cost: $3,812.00 Chimney: F � Description: 1 WINDOW.29 VALUEk Permit.Fee: $35.00 Insulation: Pain $35.00 Project Review Req: Final: Date �' 5/17/2018 Plumbing/Gas F Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authoriiediby this permit is commenced within six months fter issuance. Rough Gas: All work authorized by this permit shall conform to the approved appl anon and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and st uctures shyall be in compliance with the local zoning by-taws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public'Jnspectiin for the entire duration of the work until the completion of the same. h E Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Buildm nd'Fire Officials are provided aUmns permit: Service: '• Minimum of Five Call Inspections Required for All Construction Work: , � < -r Rough: g 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT i f DF '�wti Town Of Barnstable =Permit,# ,4 p Expires 6 monNrs front issue dare Regulatory Services Fee S: aAMsM r ,0� Richard V.Scali, Director sAli Building Division Tom Perry,CBO,Building Commissioner MAY 15 2018 200 Main Street,Hyannis, \/[A 02601 (� pp� G I www-town.bam O stable"ma_us TOWN � bAHNS I BU Office: 508-862-4038 rax-508-790-6230 EXPRESS PE&VUT APPLICATION - RESIDENTLAL ONLY. Nat Valid without Red X-Press Imp►int b[ap/parcel Number ;_�l q 0" Property Address ee,/I e" W i l i�/ _ CPn�Gfu Residential Value of Work S J& IL Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Zena 4 lF . Ann I J�iG h e S✓1 e 5/ �i 8 K���e sa 1 P �'�.,1 yt ilP Nl a 7 Contractor's Name Y 'n�v,,,j 2Zir rip ( Telephone number��{o I Z [-tome Improvement Contractor License f(if applicable)= Email: Construction Supervisor's License#(if applicable) 06 7 O 2<y'orkman's Compensation Insurance Check one: ❑ I am a sole proprietor Xle Homeowner ve Worker's Compensation Insurance Insurance Company Name F; r P mf-- nS Z-)_Stj ra,1 C ra Workman's Comp. Policy# W C A 31 S 8 :]Z 9 — 2 o Copy of Insurance Compliance Certificate must accompany each permit_ Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping,o(d shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roofl side ❑ Replacement Windows/doors/sliders.U-Value 2. (maximum.32)#of windows #of doors: ❑ Smoke/Carbon NNIonoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical& Fire Permits required. "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc" ***Note: Property caner must sign Property Owner Letter of Permission. A copy the Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: C:\Users\Decollik\AppData\Locaf\t\rticrosoft\Windows\Temporary Internet Files\Content.0utlook\2P10I DRR\EXPRESS"doc Revised 040215 Renewa lAgreement_ Document a:. �n PaYm t Term s byAndersen. dba:Renewal By Andersen of Southern New England' Leonard&Ann Duchesney ALACEMENT Legal Name:Southern New England Windows,.LLC, 98 Kennesaw Ave RI#36079, MA#173245,CT#0634555, Lead Firm#1237 Centerville,MA 02632 WINDO 10 Reservoir Rd I Smithfield,.Rl 02917 - '- - H:(508)737-1.733• - - Phone:866-563-2235 1 Fax:401-633-6602 l sales@renewalsne.com C:(508)775-1809 Buyer(s)Name: Leonard &Ann Duchesney Contract Date: 05/01/18 Buyer(s)Street Address: 98 Kennesaw.Ave; Centerville, MA 02632 Primary Telephone.Number: (508)737-1733 Secondary Telephone Number::(508)775-1.809 Primary Email: annlennie222@gmail.eom Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions.described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorpporated herein by reference(collectively,this"Agreement'). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $3,012 By signing this Agreement;you acknowledge that,the:Balance Due;and the Amount Financed must be made.by personal"check,bank check,credit card,or cash:. Deposit Received: $1,270 Balance Due: $2,542 Estimated Sfart Estimated Completion:. Amount Financed: $0 7-9 7-9 Method of Payment' Cash/Check We schedule installations based on the date of the signed contract and secondarily on ' , the date in which:we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date..Rain and extreme weather are the most common causes for delay. Notes:. 1/3 deposit;1/3 at start,1/3 at completion Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the.parties and that.there are no verbal- understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will:be valid without the signed,;written consent of both the Buyer(s) and Contractor.Buyers)hereby acknowledges that Buyer(s) 1).has read this Agreement, understands the terms of this Agreement;and has received a completed,signed,and dated copy of this Agreement,including . the two attached Notices of Cancellation,on the date first written above and2)was orally informed of Buyer's right to cancel this Agreement. NOTICETO BUYER: Do.not'sign this contract if blank.You are entitled to a copy of the.contract at the time you sign. YOU,THE BUYER,.MAY CANCEL THIS TRANSACTION AT ANYTIME NOT LATER THAN MIDNIGHT OF 05/04/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER:SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.': Legal Name:Southern New England Windows,LLC. dba-Rer vaI y Andersen'of.Southern Nm.Englmd Buyer(s) Signature of Sales Person Signature Signature Paul Sandrey Leonard Duchesn,e y � .. Ann.Duchesney ' Print Name of Sales Person Print Name':' ':: Print Name UPDATED:.05/01/18 Page 2 / 10.. Office of Consumer Affairs and Business �eguiation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home improvement Contractor Registration Registration: 173245 Type: Supplement Card Expiration: 9/19/2018 SOUTHERN NEW ENGLAND WINDOWS LL BRIAN DENNISON - 26 ALBION RD LINCOLN, RI 02865 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card _'.=Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the expiration date- If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration: 17.3245 Type: 10 Park Plaza-Suite 5170 Expiration: 9119/201 S Supplement Card Boston,11N1A 02116 SOUTHERN NEW ENGLAND WINDOWS LLC. RENEWAL BY ANDERSON ~� BRIAN DENNISON 26 ALBION RD �. n LINCOLN,RI 02865 kXudeisecreiary Not valid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-095707 C"t3�i iiC it l SuDervi,sor BRIAN D DENNISON 7 LAMBS POND CIRCLE i . : : CHARLTON MA d 1607- Expiration'. . l Commissioner 09/0812018 The Commonwealth of Massachusetts d Department of lndustrial_Accidenis o I Congress Street,Suite 100 Boston,MA 021I4-2017 _ www.mass.gov/dial 11 oi-kers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. Applicant Information TO BE FILED WITH THE PEILMMIIVG AUTHORITY. Please Print Le 'biv 1\I3II7rr (Bisinessl0r�anizaiietL'IndiN6dual): p E-- e f owz Address_ j 1124] r City/State/Zip: p Phone Pit: ,Ej _ 2>-g= FEW _ Are you an employer?Check the appropriate box: Type of project(required): i 1I am z employe with ZO femployee<(lull and/or part-rime).* I r- ❑New cons�uction 2.�I am a sole proprietor or partnership and have no employees working for r*te in any capacity.[No workers'comp.insurance reouired.l 8. Remodeling I i �.a I am a homeowner doing 2i work myself.[tJe workers'comp.irsuzrtce repuired.;; 9 El Demolition i 4.�I am a homeowner and will be hiring contractors to conduct all work on my prppe,�}. 1 -:iji 10❑Building addition ensure that all contractors either have workers'compensation insurznce or a,sole 1.1.❑Electrical repairs or additions i proprietors with no employees. 12. Plumbing repairs or additions 5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet f These sub-contractors have employees and have worke-`comp.insurance.t 1-1-❑Roof repairs i 6.7 R'e area corporation and it officers have exercised their right of exemption per 1vIGL c. 14.D6ther W t✓1 „f h 15=,E 1(4) and we have no employees.ilvo workers'comp.msurnce required.; /'pr Ik 'Any applicant that checks box;".must also fill out the section below shoeing their wor}:ers'compensation policy Ulforma-ior_ 7 Homeowner who submit this a$ndavit indicating the are doing all work and then.hire outsiae contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractor and state whether or not those entice=have employees. lithe sub-contractors'nave employees,they must provide their worker`comp.policy number. _ I am an employer that isproviding workers'compensation insurance for my employees. Below is thepohey and job site information. Insurance Company Name: �1rf P149 In Sj Policy f or Self ins.Lic. : Z. Expiration Date: ! ! I Job Site Address: 9 /�,P 114 e.SQ c,/ �P City/State/Zip: (fe)�✓,'/� ,�- Attach a copy of the workers'compensation policy declaration page(showing the police number and expir ou date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00 and/or one-year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine ofup to S250-00 a ` day against the violator.A copy ofthis statement may be forwarded to the Office oflnvestigations ofthe DLA for insurance coverage verification. I do hereby certify under th ¢ins and penalties of perjun,that the information provided above is true and correct Sienature: Date: 5 - /6 —! Phone#: CIO 1- ZZ e—T . Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License f Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.ElectricaI Inspector_ 5.Plumbing Inspector b.Other Contact Person: Phone r: A�oR�� CERTIFICATE OF LIABILITY INSURANCE DATE(M9/2017 Y) 1212s12on THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE R(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the*certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: CoBiz Insurance, Inc.-CO PHONE FAX 1401 Lawrence St, Ste. 1200 N •303-9884)446 JAIC No,303-988-0804 Denver CO 80202 ADDRESS: COMaiI cobizinsurance.com INSURE S AFFORDING COVERAGE NAIC B INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURER B:Firemens Insurance Company of WA,D.C. ' 21784 Southern New England Windows, LLC. dba Renewal by Andersen of Southern New England INSURER C:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1252851165 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR' ADDL SUBR POLICY EFF POLICY EXP UMn� LTR I TYPE OF INSURANCE POLICY NUMBER ! MM/DDIYI'YY ( MM/DD A X I COMMERCIAL GENERAL LIABILITY CPA3158726 I 1/112019 it12019 EACH OCCURRENCE S 1.00D.000 CWMS-MADE �OCCUR i DAMAGE TORENTED l+ I PREMISES(Ea omlrren.) s 3DD•DW I MED EXP(Any one person) S 10.0D0 I I PERSONAL&ADV INJURY S 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER ! GENERAL AGGREGATE 52.000.000 Xi POLICY I ECT 7i LOC I I PRODUCTS-COMP/OP AGG I S 2.00D.000 OTHER: I I S A AUTOMOBILE LIABILITY i N CPA3158728 I 1112018 1/12019 COMBINED SINGLE LIMIT 5 tEz accidentl 1 000 DOD ANY AUTO I BODILY INJURY(Per person) S ALL OWNED SCHEDULED I BOOBY INJURY(Per accident)I S X .AUTOS AUTOS I X NON-OWNED I I PROPER OracddentDAMAGE S HIRED AUTOS AUTOS s I A I x UMBRELLA LIAB I X I OCCUR (CPA3158728 I 1112018 1/1/2019 EACH OCCURRENCE $10.000.000 EXCESS LIAB I!—�I CLAIMS MADE I AGGREGATE S 10.000.000 DED X RETENTION$ I f I 15 B WORKERS COMPENSATION VVCA315872a20 1/12018 1/72019 'X I STATUTE ER _ AND EMPLOYERS LIABILITY Y I N 10 ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT 151.000,000 NIA A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E-L DISEASE-EA EMPLOYEd S 1.000.000 0 yes.describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT 51.000,O0D C Pollution Liability 7930073340000 1112018 1l12019 Each Occurrence S1.000.0D0 I Claims-Made Policy Aggregate S1,008.000 Retroactive Date 06202013 Deductible S10.000 i DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE r' I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD The Town of Barnstable Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: Name: Phone#: 77 S—/�d Address: gY tlAl I Village: Name of Business: a p Type of Business: r Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity shall not be"discernible Trom outside-the-dwelling:. there shall be no increase in noise or odor; no visual alteration to the premises'which would suggest anything other than a residential use; no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise, vibration, smoke, dust or other particular matter, odors, electrical disturbance, heat, glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials, pr flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard.. • There is no exterior storage or display of materiars or equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed 4 tires, parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. If the Customary Home Occupation is listed or advertised as a business, the street address shall not be included. . ' No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I, the undersigned, have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: / dD Homeoc.doc �7y BRUCE P. GILMORE ATTORNEY AT LAW 1170 ROUTE 6A WEST BARNSTABLE, MA 02668 (508) 362-8833 FAX: (508) 362-5344 Mailing Address E-MAIL: gllmores@glS.net P.O.BOX 714 www.capecodlawyer.com WEST BARNSTABLE, MA 0266E October 26, 2000 Gloria Urenas, Zoning Enforcement Officer Town of Barnstable 367 Main Street Hyannis, MA 02601 RE: Leonard Duchesney Dear Ms. Urenas: Please be advised that I represent Leonard Duchesney. He is in the process of locating space for the relocation of his commercial activity. As you are aware, the real estate market is tight, but knowing Mr. Duchesney as I do, I am confident he will be successful in locating a facility in the not too distant future. Thank you for your courtesy and understanding. Should you have any questions, please do not hesitate to contact me. Very truly yours, 6 _ . Bruce P. Gi 4 more BPG/cmr 11-06-2000 10:0.5R1l CENT OST FIREDEPT 5087302395 P.02 Centerville-Ostorville-Marstons Mills INCIDENT REPORT .none:kDuo!tyU-card-I Dept.of Fire,Resgue&Emergency Services Pax: (508)700-2380 1875 Routh 28,Centerville,MA 02632 COMM REPORT 19A FOID#01220 i Ty of .Service Call not.classified ab Date: 10/27/2000 Alarm 00-F-0805 Shin: 1 District: 1_3 Catl'� . - --. - 1%___ -.__ _No.- —rya -.-,,; -_ - - -_- Pg.1 of_ Reporting FPO MACNEELY _.__-_ Location: �98 KENI ESA"ENUE Deny' - a ck Locaton (508) 775-1809 Business! oirWctler: Crosby, Robyn Tel.M. 7e1,A: call Read on: Direct report to FD(verbal) Apparatus/Personnel Response: infra mat on CHECK FOR.IMPROPER S70RAGE OF HAZARDOUS MATERIALS ENG$02 0 ENG 305 0 RES 324 0 Commentz: ENG 304 0 LAC)314 0 RES 325 0 ' rme i 5.07 n 15-07 n 15:13 Rot. 15:24 I" 15:43 ENG 315 0 $RH 317 0 RES 326 a Rec'tl: Air: Lac: Qrts: Serv; ` Weather: OVERCAST Temp. 66 wind NW 9 0-2 mph BT.300 0 SRK$16 0 BOAT 0 i Area! 'HF 30'1 0 DPT 320 0 SC 3Z1 BRUSH: Class: Cost: 0 0 Size: Cause: Gther. 309 1 j BUILDINGS: ype° caupancv: One-family dwelling: year round use Total#of Personnel- 1 I l owner. Leonard Duchesney ner's 98 Kennesaw Avenue Owners(508)775-1809 Address: Tel.A enan: enan.s lenon s i Address: Tei,tt; I u ma tC HCe AIRMI M E-Form 962 N/A i Glaseirmation Cotla:; Leff with/At: r ajar ous ens s Yes No Substance. I Present? EQUIPMENT: 1�,Pe: N/A Location. P?ear Make: Model: Serial No. Type; E: Make: Model: Reg, State: i ?i. VIN d: Color: l Owner: Address&Tel.# Operator: Address$Tel.# f OTHER A ES'NOTtFIED: Contact Person: Phone: Time: y: Building Department ! Ralph Jones 12:00 MACNEELY i Board of Health Ed Barry 12:00 MACNEELY E; NARRATIVE REQUIRED ON ALL,CALLS. i 309 on investigation t0 above listed address based on anonymous complaint received by phone at Headquarters and also relayed via fax from Building Department. On location with owner who stated painting business with approx 30 employees operating out:of property. All hazardous materials are stored outside away from residential dwelling or in approximately 20x20 storage shed located on the property. Shed has storage for 100 or.more 1 gallon paint cans, approximately 50% , latex and 50%oil based paints. Exterior storage consists od 2/3 55 gallon drums of new and waste paint thinners. Owner states BOH has visited site and all storage cornplies with their regulations. Owner also states that they have a legal agreement with the Town of Barnstable that states the business will be located to a commercial zone within 1 year do to zoning issues. I _ t LIST ITEMS NEEDING FOLLOW UP: 00100/00 Fire Prevention-will follow-up with the owners on above listed items RE Martin MacNeeiy,FPO D8� 11;0112000 FIRECHIEF ate: BY: RECEIVED: SIGNATURE: TOTHL_ P.02 1 _ 11-06-2000 10:05RM i_ENT 0 5 T EIREDEPT 5087902395 P.01 a Fire Prevention Bureau 1875 Route 28C.00A. Fire District Centerville, MA. 02632 ' Phone:508-790-2380 Department,-of Fax: 508-750-2385 - - : Emergency ces SerW FAft%ff i Am ai . I I S To: Building*atph Jones— From: FPO. Martin MacNeely � Fax: 790-6230 Date: November 6, 2000 i Rhone: Pages: 2 Re: Investigation cc: i i I 0 Urgent X For Rev iew ❑ Please Comment ❑Please Reply � 3 i 1 1 i I I E l i - l Confidentiality Nobce:This fax may contain confidential infontiation belonging to the sender which is legally privileged and which is intended only for the use of the individual or entity named above.Any copying, disclvsure,dist6burion or dissemination of this inforrnation or taking any action based on the contents of this communication is strictly prohibited. If you received this transmission in error,pease notify us immediately by telephone and return the original transmission to us by mail or delivery at the above address,the Cost of which shall be paid by us.Thank you. � J lV 2 Z !v 10 ir l!� Y 4 v IBo, 17 2l0 158 S.F. �- oc x� d W -f r p- Z R�SIp��CC ,�, �A R. m � p Z — U'e e Q �' N _ OV6-prop , w 0. �S �J�P ND W' PERRY PREPARED FOR LEONARD ": DUCHE5NEY E7 UX CERTIFIED ;`PL 0 T PLAN ;I Y L06ATION.—: CENT ER V 1 L LE, MAS5. SCALE _.�� DATE APRIL,,6, I REFERENCE LOT P B. 15 3.- p. 37 FLOOD ZONC.. "C q4 I HEREBY CERT/FY THAT THe BUS c_DING SHOWN ON .THIS PLAN IS LOCATED ON THE JR. GROUND AS SHOWN HEREON, 1 7807 H. Is . sUR�. L OW & WEL L ER, INC. 7/4 MAIN STREET oo' 'f .Z_ g YARMOUTH, MASS. DA TE 81.087 �r's office(1st Floor): �/y SE f Yi C SYSTE�`i a;7 n? THE Lessor's map and lot number 7 7J o� >o INSTALLER IN COMPLE"'i 29— Board of Health 3rd floor: �5 o Sewage Permit number ) d ENVIROP AL CODE AND s BAHd9rOBLL Engineering Department(3rd floor): road Hodse number �� TO REQtlL�1TIONS °o 1639• ®� pefinitive Plan Approved by Planning Bo d 19 �o MAr d ` APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR . APPLICATION FOR PERMIT TOD TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned herebyapplies for a permit according to the following information: Location "L g /�e lit h e.S Gt.W Q `xiy\/ U t Proposed Use t/ � YN Zoning District Fire District Name of Owner o G S Address ke-h ki P_ 5:td .'4' ye Name of Builder Address !Pr! WodA c .2 1. m 1 S Name of Architect ,— 41 Address 7.1:r � 0,1-4-7—, AlA 6�1()c k Number of Rooms / � Foundation i Exterior�'�11�A` Roofings ✓��?� A c / m ) —7Floors �00[�— OA ��� l l� lG[rA AA,D�lM4, Interior �l Q ely.d eating Err J ot )1 V 0 S • Plumbing � 1 Fireplace Q Approximate Cost -7�1iAt u SR y d1 Area / Diagram of Lot and Building with Dimensions Fee ® I 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 constructio Name Construction Supervisor's License �� g FNEY, L. I. ANN E. JR. ` 0 3321.6 Permit For BUILD ADDITION E r Single Family Dwelling 98 Kennesaw Avenue ` Location , Centerville Owner L I Ann E Duchesney,—Tr. Type of Construction Frame Plot Lot t Permit Granted September 18 , 19 89PI Dateof Ins 4ection 19 9 - Date'.Compp!eyed 19 t• ICE ; arm • F r s a l� a • t f Assessor's office(1st Floor): /y Assessor's map and lot number �{`7 oF TM E Board of Health(3rd floor): 9 SA . wage Permit �j r • • _ Z MMUSTAXLE i Engineering Department(3rd floor): /i rnaa tse number eruinitive Plan Approved by Planning Board 19 �Fp rpr a• APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTO APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION % rr �� t + 19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: R Location �lti P— In h 2 S Gl Lj lit Proposed Use k I T--r y1% `! Zoning District }f l Fire District ` P 1�`— o3- .� Name of Owner U S 2� ✓^ Address 7 0 ��2 �, �,� S.t_WAY ck� lk , Name of Builder P /„ / Address marQ S d. -,/d /Il a I S� Name of Architect Address l/ v i n,i �J�, � Y, � 1 Number of Rooms Foundation Exterior . 2 Roofing �S }!� Z • Floors )0,) O A �! rr a I�, �ia 1 �f Interior Heating 1: 11-f' 1A 1/1 A Q Plumbing Fireplace A/0 Approximate Cost •S n _ l u Sa h r�l Area Diagram of Lot and Building with Dimensions _" Fee ©, i 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 License y i UCHESNEY, L. I . ANN E. JR. s A=249-023 0 33216 Permit For Build Arld i t; nn Single Family D�lling Location 98 Kennesaw AVPnj1P Centerville Owner L I Ann F DI-1chesne-y, Jr. Type of Construction Frame Plot Lot Permit Granted September 18 , 19 89 Date of Inspection 19 Date Completed 19 Lr A sessaF`y map and lot :number SEPTIC SYSTEM MUST BE. ../ INSTALLED IN COMPLIANCE ��� 4. r Sewage Permit number � ` � "' - WITH ARTICLE II STATE iT AND. TOWN r OFTHET0�1 f_ - TOWN OF BARNS 9 MARNSTLIBIL MASI 9 BU14LDIHG ' INSPECTOR cq 0 MPY Or• '1 " ul• ��q �..t' yr, ,t. PIG A"LICATIONq FOR6'PERMIT TO .............'h;��.a ..... 1 ..............................................................:........ a; I r TYPEOF CONSTRUCTION .................11lleo ..:...................................................................................................... ............2 q.4........9...............19..7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...................�r .. ..../7 s...............1� % f� :�' :.............................................................................. ProposedUse ............. ... ...... .............. ...................................................................................... Zoning District ................... ... . .. ................................Fire District .......... . . . . . ... ............... ........ . Name of Owner ....p� > ..... t :......Address ..........,j�. �/yJ4f Name of Builder ... 1 ..:. . .... . .. .............Address ....... .....tCol..:......... *tLM.4................ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .................. ................................Foundation ti W Exterior ......... �......�����-J.......... Roofing ......... �� ��/O ..� . .... ..r..... .......... {... ? &/............ Floors ..............ez..1lu ......................................................Interior ................ ..... 67...... Heating ...............!!.....e/.....................................................Plumbing .:................Vn• ................................................. Q 4, a® Fireplace ..................................................Approximate Cost ............................... Definitive Plan Approved by Planning Board ---------------_---------------19--------. Area 0..T........................... Diagram of Lot and Building with Dimensions Fee j.©� . ..................................... SUBJECT TO APPROVAL/OF BOARD OF HEALTH \3 re r y c 0004 A,9 , �O I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... �!.�.. ................ � Duchemney° Leonard Jr. ` . ^ f ~ � ' + t) � 19871 `| --gNo Permit for ...................... ' ..��---._--------.`�-----.----~. . . 98 Kennesaw Ave. ' Location ---.—_-------^----.---- ` ^ . . � �wm���������- . � —.'--.—.--.,.-.---..—..--------. � � ^ � � � Owner ----Leonard.. ..jr,_.. Type ofConstruction ...........fKg*441�.................... � � . . . ..-----.,----------~--.---.. ' - . ` - Plot Lot . ' ' -----.�,_—.. ----------.. ' . � � ^ � � Permh Granted --' .�--.—..]q 78 . D� - . ' "^.= of Inspection ----.. —lV -_ �� �u/� 'Dote Completed -----� /��. —lQ ' . / . ' � . � PERMIT REFUSED ^ - .__.'..—_—..-_......--,—.—~... lg ~ . ....'�----...._—~..-^--.—..--_---.,' - .......................... � � � ..—��-�.'�..._-.--..,—.-~~_.--.—~..--.^. '. .......... . . ' . . . . ' ` ~ ` lV �rr~ � ------'^------'--'' ' ' .~ .................... ......................................................... ' ' . ` . . ----------,.—.----.-----.--..—. ^ � � | ' | ... 1 D As sso; 2 � map and lot number ...: . . ..:...... .. r......�- Sewage Permit number ,!�� � 7HEtp�o TOWN OF BARNSTABLE n EARISTADLE, i "6 9 BUI'LDING INSPECTOR 0 M a. APPLICATION FOR PERMIT TO ............ :..'!%..:/./.............!. ............................................................................... TYPEOF CONSTRUCTION ................... . ........................................................................................................... .................a:............................19.. .... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......................`...... .................................................... .....�: •%l:......................................... ................................... ' ProposedUse .............................. k. ....' J...........f:?.... ...............................................................................I......................... Zoning District ................:.(.. ' :.: :.//............................Fire District .........rt �, +r....�f...................:.........:.....:.......... Name of Owner ....................:...........� .......Address ......... ..? .. « :.`."........::/P........!....j:...!........ / .. Name of Builder t ......`....... .. )....:!................Address A�� . ..... Nameof Architect ..............:.....................................................Address .................................................................................... Number of Rooms ice.. . .�.................................Foundation .............!. ..::.: ............................................ ................................. Exterior .. ...........: '.6:.� ........Roofing ............a........!!:�1�..........:�:...... ......................... r ! r i Floors , ........................................................Interior �f Heating ........................0 .....................................................Plumbing ..................r?' .. .................................................... Fireplace ................:r. .: ...................................................Approximate Cost ...................!,.' ... .....r....{.......................... Definitive Plan Approved by Planning Board ________________________________19--------. Area ..�. �."...:6.`......................... Diagram of Lot and Building with Dimensions Fee ,�..'"....... SUBJECT TO APPROVAL OF BOARD OF HEALTH , a i � c i} vey4 N� G V4 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / �l Name ... �!.......?............,r. ..t:"�l.'.?.. N................. Dmchmmney° Leduard Jr. A=249~23 ^ ~� m��� 19871 �azage ` ~�N�d —.—.--- Permit for -----..------ '/w � ---^'-------~-------^-----' ' ` �� ��mmx�me� J�r�° Location —.----------.—.---.----- , Centerville —.------~------~—.----.—~--.. ����ard Dpche Jr C�vvner --.---------.—.������--.�--.' � frema� Type of Construction —.------------.. . . '= `"' J uary 4 78 InspectionDate of Date Completed ' " ER REFUSED 7 lA ` —' -------' —' - - '—'--'---` . . .--.._-----_......--':._—.--..._.—.' � Approved } � ---------------- l9 � ' ` ---.----.------~—.—.--.....—..- -------------^------^^^^^^^^^- � � | � � | TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2IJ Parcel Permit# 3 r S-q' Health Division '7�� , � w Date Issued Conservation Division �,y�a.�� Fee Tax Collector .IL A. h9�/�zfl� SEPTIC SYSTEM DUST BE INSTALLED IN COMPLIANdE Treasurer YF q` Q WITH TITLE 5 ENVIRONMENTAL COD@ AND Planning Dept. ,` _ TOWN REGULATIONS' Date Definitive Plan'Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address e_,� Village ' _ e Owner e QLcGf lj - Address A'aft neJ4,J 'L-C Telephone Permit Request tA,&nrh + a Square feet: lst floor:existing/S� proposed 1716 2nd floor:existing proposed Total new 7 Estimated Project Cost Zoning District R 10 Flood Plain Groundwater Overlay Construction Type /A "d 414-*—e . Lot Size t 2S LIP Grandfatliered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family 0 Multi-Family(#units) Age of Existing Structure Historic House: O Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: �II ;dCrawl ❑Walkout Cl Other- Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Z 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 Q Other Central Air: ❑Yes /o Fireplaces: Existing j/e New Existing wood/coal stove: O Yes ZZ7 Detached garage:❑existing ❑new size Pool:O existing ❑new size Barn:O existing ❑new size Attached garage:O existing ❑new size Shed:zxisting ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes Flo If yes,site plan review# Current Use ��f�Geyk rf Proposed Use BUILDER INFORMATION �p q Name �r Telephone Number Address License# 1 3 Home Improvement Contractor# a� 7 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO fl SIGNATURE DATE f .Y • FOR OFFICIAL USE ONLY PERMIYNO. = ys• _ 4 __ T DATE ISSUED'- MAP/PARCELTNO.. = _ ADDRESS r E VILLAGE t ; OWNER DATE OF INSPECTION 4 ` d f - FOUNDATION FRAME J)- INSULATION • 3 9 ': FIREPLACE ELECTRICAL: ROUGH- FINAL L 1. i r'4 •`• � i PLUMBING: ROUG-H r! FINAL GAS'- TROUGli rs ¢ FINAL FINAL BUILDING Ic s DATE CLOSED OUT Y- :X_ M n ' { ASSOCIATION PLAN NO• I '_ , t ' . . ,.era � � _ � + • L e own of ldarnstaDle . a�anrsr�►st.E. s 9 �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'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)a&4� Estimated Cost l Address of Work: L" ,V Owner's Name: � Q-7e-�- Date of Application: / — —95, I hereby certify that: Registration is not required for the following reason(s): Work excluded by law [3Job Under$1,000 Building not owner-occupied [30wner 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 ap ly for a permit as the agent of thCowne . De Con clot Na0e Registration No. OR Date Owner's Name q:fomu:Affidav . Table.LSZ2b(esedaaed) N prescriptive Package for One tad Two�Famill►Reridmdal HaiWlap Mated with Foaar2 Fast MAXIMUM MINaVIUM Wall Float Boom= Slab N��inB Arr+m''((%) U.�� R-value R valua'- Rrvaluo' Wall p� Wd� p� Ilrvabma' &valud 5901 to 6500 HeadaS Deersa DAW Q 12Y. 0.40 33 13 19 10 6 Normal R 12% am 30 19 19 -10 6 Normal S 120A 030 38 13 19 10 6 fS AFUE T 13% 03 ma 6 38 0 2S WA WA Norl U 15% OA6 36 19 19 10 6 Normal V 13% a" 38 t3 2S WA WA SS AFM W 15% U2 30 19 19 10 6 S AFUE x IVA an 38" 13 2S WA WA Normal Y 13% O.42 3E 19 25 WA WA Normal Z 12% OL42 38 13 19 l0 6 90 AFUE AA ISIA eO 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY. 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING. I ro 1 4. %GLAZING AREA(93 DIVIDED BY#2): S�0 S. SELECT PACKAGE(Q—AA-see chart above): c 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 Appencrrx J Footnotes to Table J5.2.1b: In ts,'and Glazing. area is the ratio of the area of the glazing assemblies (including sliding-glass doors, sky'gh . basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage.Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 if of glazing area. 2 After January 1, 1999,glazing U-values must be tested and documented by the manufacturer in accdrdance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-i alues 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 R-49 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 EPI'1•iER by R 19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall mquirerents apply to wood-same or mass(concrete,masonry,log)wall constructions,but do not apply to metal-flame 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. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade wails. 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. •If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more 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.la 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 035. 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 J1.53b. If a door contains glass and an aggregate U-value rating for that door is not available,include 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 035). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wail component includes two or more areas with different insulation levels,the component complies if the area-weighted avenge 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(035 for doors). 43 ___-_:.._:= The Commonwealth of Massachusetts _� _: !'� Department of Industrial Accidents Office offnyestioaaoos --UF ;`?' 600 Washington Street Boston Mass. 02111 Worker' Compensation Insurance Affidavit name: location city phone# -776--I ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worlu in any capacity 7 am an employer providing wogs' comp nsation for my employees worki g on tllu�job. co m any name: address: /TU 7 Div city: C�tJJ /u'�'Z� phone#: insurance CO. /�.� oliev# c/ ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors Iisted below who have the folloi ing workers' compensation polices: company name: ........ address: city phone#: ....... insurance co. .. oiicv# 4. company name- address: city- phone M imprance co. -..;:.... ,.;.. olicv# / / % /% //% Failure to secure coverage as required under Section 25A%%M of GL I52 can lead to the imposition of criminal penalties of a tine up to S 1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a tine of S100.00 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. I do hereby eertij' the pains and penaltiesry th the information provided above is tru•an correct per Sitmature / ✓ A; Date `7 Print name Phone# F `' q e' ?--- ofttcial use only do not write in this area to be completed by city or town oMcial city or town: permit/license tl ❑Building Department ❑Licensing Board ❑check it immediate response is required ❑Selectmen'so Office ❑Health Department contact person: phone q; ❑Other (mvea 9i95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any coatr,.., 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. 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. .. cc-mmonwealth 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 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 Deparunent's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents 0mce of Im18sugations 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext 406, 409 or 375 fi'-911c' SILL5�-�-P2 of i 1-�.... _ .(--ti•G� o6c�. r��fi+v� 1'1 , PLpp�c.��^M1;� "dTE PL AhI OI�i } Z Q `_... rc!gGa Va NT err.a. —..............._....... ...,...-. .\ .' r AaRy�LT a{+pr—•..•_ 12 c•aV 0141 OG. � ]O lV � ew,Ne.�as T..-r a ..., \� l v'�- wwr�noy—..... •' 2 ITCy lse(...).►!.a--- �� .. .. -�,.\�4h%; Tr-.a� �. 0 M I Q{ c.a a 14r ec p ,1 1 RA roue .• w. • O 4'-O'Oo.. � ?le C.cA L.a NOTap t•IV•HI 1: J.A.I. O G .G.F1apiTFV.4.�.. Psr•. �:a j alp Nam. qua .o an— — T;I p` {r----_-]i� 1 1lQn_._ _•�cW"'�-1 I ! a�•r'4 HOUp1 I 1_ � q�L I L'--t__J I 1 /// I 1 ~oi i (_�•_ ___ 'f_-y�G" b6c1` r�µ pu 1 I II 1 —__- ►4N-T I . I � II :+.+:nu•ooL . I eHrL. y I I ��.1---_- i 1 w I�Loor-�l.�rN1 s�ITE PL AhI - � ... i } W .. 7 Z FIVCIr TM.r. __..-_.�........... ........._.,__� IA G�r1.Y1•IOIPV T.M.r.-.._....-.. .. ....� � YI , It .eP.o Ivy ac. AOR4ALT iGpr � \\ ,1�' ............... I,r4'I�D(u)RArr- ��\-�.. � .. ,�..\��h�; T.-Ir• u ., •f 0 la Ip�l W Rb• -�.. � Ic 'I 1p`Ro.�vsul-.f(j■b) � � h • ' I i 4•e�oo��G � 1 i' .. �. 1 rc 4(./-:.%u9n.ld Trl E^'�+. -... � ��� I r-_ _•• � I ?' L 1 '.. _ �F �� R6.THOUL.(R•Ie1 AL�ca.l %"V �I Iz Cri►�rw..aG roumo.•_m. O(i'-O' C.. CaGAL6 NOTro t•IV-WII: J.f�.L. ' T cv�'u• w wY OI L 1: � � 1 to„�. out+»r R- -.. •. Ails TOWN OF 'BARNSTABLE • BARNSTABLE. i aAO&a \•�� BUILDING INSPECTOR ' a' e 4 . APPLICATION FOR PERMIT TO ............. ... ... . ..... ........ .......... ............... .. .......................... TYPE OF CONSTRUCTION......... ::..... ., ................... ..... ... .......................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �,�s d w Location ............ . .f.71......:...................... _:...............C.e:!:... v vt..�.. .`.. ....................................................................... ProposedUse .......�f . .... ../.�`:dd(10^........................................................................................................... Zoning District ........: .�.......I....................:...........................Fire District .Craz�r" /. �• ........ Name of Owner cat ' { 4 Y....Address ......�...: M. :S:.�4:!^ ...... :V e............................. Name of Builder .. . !.'e.!:):».:,ik......./..7. `'Y!:Y`�..................Address ..�1..�Y nw� :. .JT: ' :........(..! '.?.?9.�!:5�............... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .......... ......................................................Foundation ....... ? ::?.... ;........................................ ExieriorW C..e.Ckx•....................................... e4sp.�? t' .................... ..............Roofing ..... .. .........................................:.................... Floors ........ . . .....................A.................................Interior ....... ........�I T -.fl............ Heating M. wele m I �. ................. Plumbing ...... ]..... ........................................................................... Fireplace ..................................................................................Approximate Cost ......6e>t..O ....................... .. . ...... Definitive Plan Approved by Planning Board -------------------_-----------19________. ®Z�'0 Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH_ !► Ct RC - 0 ..___...__......_...._._.._.........—_.._..- ....- W.._..__._..._....__..__ o 3. /(/ I I hereb. agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... ...... . ..... .. ...................................... lumcheozmyy^ Leonard Jr. � No -. . Permit for —.—.��..��. ' . —__������..�����g�V.................................... ' / 0 Kennesavr Ave. . ----'_n —.—.,—..----...—~..—.-----' ent rvill ----.---������.........�---...—.----.-. - ` . Owner ........Le.ozard. `che=�=` n_J�°___ ' .. I�..........`������� -- . ^ ` � Type of Construction —..-------.�)����._ / ` � - \ \ —' ----'--------'-~'------''.--'' . \ Plot ............................ Lot ................................ ��r�� �� �� v Permit Granted ^ l�' ^ � � ' ' ---'---------'' /�/ ~ �rJ< \ ' . | PERMIT REFUSED -----.--_—.....-------.--. lV —'--'----------'~^—'--^---'---- i /r� / v —__—.-...—.--.------,--.—..—.---. . . . -^—~^'-------^'~^^'----^'—^—'''--^' / -- '----'—^—'—'`---'--^^'----^^^---^''' { , � App,ove6 ,-------------.—.. lQ '-------'-----'—'----------'`— ' . / ............................... . / ` CENTER VILLE E 28 � Ro�T V3 LONG POND �b r y� ST REED N/F PIN LOCUS KENNETH A. & LINDA G. KIPNES DEED.' 37571145 A.M. 249114 LOCUS MAP C.B.ID.H (FWD) PLAN REF.- 149113, 153137, 166125, 18411145, DETAIL o, 2191111, 236165, 314144 & 351193 .� NOT 719 SCALE o RES. ZONE.- "RD-1" FLOOD ZONE.- "C" C.BID.H. ! (FWD) 0.07' � I M N/F l HAROLD RUSSELL & j BETTY MARSHALSEA J DEED: 34161135 A.M. 249113 SHED � k >HE 1 C.B.1D.H. ( D) PLAN OF LAND /D H LOCA TED IN: � SET 11. 50 CENTER VILLE. MA. PREPARED FOR: EDWARD B , JR & MARIA NNE 0. .f SULLIVAN AND , -Q N/F, 4 t=j E ELIZABETH L MARSHALL LEONARD I. & ANNE E DEED.- 14031453 A.M 249/12 D UCI-HESNE Y w � p 18� AUGUST 8, 1998 . �C.BID.H. i o (FWD) DETAIL. A NOT 719 SCALE 1 � ( GRAPHIC SCALE CB./PH FND) 30 0 15 30 60 120 E. F COTTER 11�z2632 ( IN FEET ) 1 inch = 30 ft. �. 4 YANKEE SURVEY CONSULTANTS UNIT 1, 40 INDUSTRY ROAD P. 0. BOX 265 ILE MARSTONS MILLS, MASS. 02648 TEL: 428—0055 FAX 420—5553 if 51578E GM t B.R.B. (FND) ' BR B. • j ("FND) DA VI DE A. g 8,25„ LOT 10A t� A.M 249/22 FOR. REGISTRY USE ONLY N/F EDWARD B., JR & ►1, MARIANNE 0. SULLIVAN DEED: 54171142 AREA=21,107t SF 30. p p• ;;::H. o�Ci jj c� 0 NOT Are R=12.87' L=21.ll (PLAN) a B R B B R B L=19.32(CALC.) i (FND) (FND) 0 31.25'(PLAN) B R B. 31.19'(CALC.) (FND) _ 160. 4 s B.R.B. B.R.B. N7153 00 E' 18017' (FND) i (FND) ' N/F LOT 11A LAWRENCE W., JR. & BEA TRICE SMITH A.M 249123 DEED.- 92221192 N/F LEONARD I. & ANNE E. A.M 249/9 DUCHESNEY DEED.' 1100190 AREA=25,48114 S.F. �cll ,.. CB./PH (FND) "::.........................� c�,..,... HSE............. DETAIL- ,w o;;::::;:;:;;::;;:::: �...\ .calla MNOT TO SCALE � ••••••ca.•.•••••• h •� , � ..18 6 • �j; _. DECfr ! C(SETj O B C.B./D.H. � N gE"1') MICHAEL & CHERISE COX C.B./D.H. 610 '�' ' C.B./D.H. ,, .fz1 DEED.- 48751040 (SET) 62 64' (SET) A.M. 249/10 . C.B.ID.H (SET) �rr CERTIFY THAT THIS PLAN HAS BEEN PREPARED CONFORMITY WITH THE RULES AND REGULATIONS F THE REGISTRY OF DEEDS OF THE COMMONWEALTH N/F F MASSACHUSETTS. EUGENE R. BIAGI DEED.- 65481104 g A.M 249/25 t UL A. MERITHEW, P.L S. DATE fp, f if r k fi a CERTIFY THAT THE PROPERTY LINES SHOWN ON THIS PLAN ARE THE -" NES DIVIDING EXISTING OWNERSHIPS AND THAT THE LINES OF STREETS o o¢ D WAYS SHOWN ARE THOSE OF PUBLIC OR PRIVATE STREETS is WA YS ALREADY ESTABLISHED AND THAT NO NEW LINES FOR VISION OF EXISTING OWNERSHIP OR FOR NEW WAYS ARE SHOWN o-:Lg UL A. MERITHEW, P.L S. DATE