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0312 NOTTINGHAM DRIVE
sE L! ., � m ';` 4 fin Appllcation number ... ...................... F h Date Issued: .. `.'. �....l. ...... ...... n 7s— ' ,. ... s Building Inspectors Initiais.:. N{ap�Parcel: Tod ` ..... TOWN OF B. "!W` :},. �". ' '`F EXPEDfiTED PERIVl<�T AP1}LICATION ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY*NF'ORMATION Address.-of Project:-Jf,a,_ _f yl Ar. . -0-1 il TNI$ER Y T :'VII.I,AGE :._. .. _._.._...... Owner's Name / Phone Number Q z Email Address: &rp -r Cell Phone Number Project cost$ � -! Check one:.Residential,_ Commercial As owner of the-.above property I hereby authoriz, &ZZ 4qn1-- ...,,.,.r. v... .+. .r .....c.:.. ., •. :ij a '" :='•��"y � - to make,apphcahon for a bu�lduig pemut in accordance vvith 78 MR Owner Sign'afore: Date: / 'W/ TYPE OF WORK Ell.Siding ❑ Windows(no headerchange)N# ,KInsnlahon/Weathenzahon ; ❑ .Doors (no header change)# Co»unercial Doors require an rnspector'sreview ❑ Roof not a 1 more than 1.la er of shin es .. PP Yg Y rw.. _ Construction Debris will be going to CONTRACTOR'S INFORMATION77, Mary Contractor's name - - Home Improvement Contractors Registration(if applicable)# / (attach copy) Construction,Supervisor's License# / y. (attach copy) ` /yi �• GflTn _ Email of Contractor Q ��'8%'`i?GL�IGtt)QAa�-1 /l. ?717ti. Phone numtaer �s'U� o7" vt�D ALL PROPERTIES`THATHAVESTRUCTURESi.OVER75 YEARS,OLD ORIF THE SUBJECT PR.OPER:7Y lS''lN A HISTORIC D/STRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE PERMIT CAN BE ISSUED APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does`the.tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am--9.30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date "PAICOT9S SIGNATURE Signature Date as All permit applications are subject to a building official's approval prior to issuance. � §„ Permit Authorization ass. SaMe Form Site 1D: 3585581 C tSt6mer Janice Hagberg oxivh&of the prop 11t located.at {Ovtirr►E'r's 1Nam�;:}�rir�xedj 31 Nottingham Drive Centerville, MA 02632 {ProperYyr street Address} ( . hereby authbeize tite Mass Save Home Erte'rgjr Services lzrograrn ass gsted Participating.Contractor listed below to act"oh ihy'behalf and obtain a'building -o"r iit to perfoi m insulation and/dr weather nation work on:my;prope ft. 1 Owner's SgnatuteJ FOR'OFFli4E USE ONLY'. We 5have assigned the following Miss,Save Home Energy.Services Participating.Contractor to the ,above referenced project l'ar-ci ating Contra.or. , DaW Name: RISE Engineering Phone: 401-784-3700 Email: Page 1 of 1 For.Office Use:Onty Re1f,Zo��l� • i The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston, M4 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): ALTERNATIVE WEATHERIZATION, INC. Address: 2 LARK STREET City/State/Zip: FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): 1.[D I am a employer with 16 employees(full and/or part-time).* 7. ❑New construction 2.[]I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.F�I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑ Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.a I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.❑We area corporation and its officers have exercised their right of exemption per MGL c. 14.❑✓ Other INSULATION 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ♦Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. 'Below is thepolicy and job site information. Insurance Company Name: LIBERTY MUTUAL INSURANCE Policy#or Self-ins.Lic.#: XWO(19)58867158 Expiration Date:6/8/19 / Job Site Address (/ City/State/Zip: 1 11e / Attach a copy of the workers' com a sation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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 S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u d ain a p lti s f perjury that the information provided above is true and correct. Signature: Date: a Phone#:508-567-4240 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#: " ' ® DATE(MMIDDIYYYY) AcoR17 CERTIFICATE OF LIABILITY INSURANCE 06111/18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED'provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Anthony F.Cordeiro Insurance Agency A/c°No Ell: 508-677-0407 FAX No: 508-677-0409 171 Pleasant Street ADDRESS: HSouza@Cordeirolnsurance.com Fall River,MA 02721 . INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Liberty Mutual INSURED -INSURER B: Ohio Security Alternative Weatherization INSURERC: Ohio Casualty 2 Lark St INSURER D: Fall River,MA 02721 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDPOLICY/YYYY MM DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Fx_1 OCCUR PREMISES Ea occurrence S 300,000 MED EXP(Any one person) $ 15,000 A Y Y BKS58867158 06/08/18 06/08/19 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE S 2,000,000 POLICY❑PRO ❑ JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) S B OWNED X SCHEDULED Y BAS58867158 06/08/18 06/08/10, BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XHIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY X AUTOS ONLY Per accident S X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE Y Y US058867158 06/08/18 06/08/19 AGGREGATE $ 1,000,000 DED I RETENTICEN$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STAT YIN UTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? nI NIA XWO58867158 06/08/18 06/08/19 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA its direct and indirect parents,subsidiaries and affiliates is added as an Additional Insured for General Liability on a Primary&Noncontributory basis per the terms and conditions of form CG2001 (04113),for Ongoing Operations per the terms and conditions of form CG2010(04/13),for Completed Operations per the terms and conditions of form CG2037(04/13)and Waiver of Subrogation applies per the terms and conditions of form MEGL0241-01 (04-11) Additional Insured for Automobile Liability applies per the terms and conditions of form SCA005(02/16) Excess Liabilitv is a following form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NGRID USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENT ! d .___..............� ! F ©191-2015 ACORD CORPORATION. All rights reserved.! ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD f ,sue 04 X x .a* qt, X 5y s•Y. k" '4, i a€ _, yx. -+ "n Z�� a: E x g g ;-, ,.�, ✓ p/ '../t,�"/�Lr1/(/�✓s''�i��t����?AC�'�2%Gl L! �`:%��1�1!.�,�aJSJ64i��Ar�18�, i���iJUJ' 1 eA Y ,� Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 . Boston, usetts 02115 Nome Improvernetractor Registration Type: Corporation ALTERNATIVE WEATHERIZATION,INC Registration: 175�83 r Expiration: 05128/2019 2 LARK ST FALL RIVER,MA 02721 o update Address and return card. Mark reason for change, 1�,�.� n {-'� ...............,. _._....�. ........ ._................................._._.....__.,..._..,...,,..,.,., ,.,.._ ,- iiir. ,..-L..P+�.i�}igwol...LY F"mDInV.VfMi nf.n ' Office o!Consumer Affairs&Business Regulation >' HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only . TYPE:Cawation before the expiration dat& if found return to: ` °{ ffi il2tl 1 1953 Office of Consumer Affairs and Business Regulation ; 05/2812019 10 Park Plaza-Sufte S170 �*'a ALTERIdATIVI WEAIER77AT#tJN,INC, n,MA 02116 -< TIMOTHY CABRAL 2 LARK ST v 0FALL RIVER,MA 02721 Undersecretary Ot 81i 8ti7rir' ALTERNATIVE % W'EAT H E R I ZATI O.N ha/Date: x �. QO Town-of Barnstable 200 Main St Hyannis,MA 02601 . .3`;a$:, :^` •'V llla .C�'S:,:?.r f.`:C: ,yh'•,;;• Re:Permit# f-r ' - g ' - ::k.,-:y�A4�':a'c:y�=�3✓i+' � ��`i`Yf r���F��7.�_:"':::�iA:k'e •%`{st'c )�;��x" �:;1. 'a,; �;n::..:ar'.h�'r '.�t•: ~its?..?c.-(:' ';1 :a,:e;�r. *::::<a}'�i:SjliyF:;d�iij,,t.• "•�'� %:;�Y''iti::;..i." �;j�::n�. .:rrv�'i'�i, i`F. ��'1v��.•���iq�5c�a:Pr,rt•. _`•��.�F: �� fiYr`rr:. � `'`';;irk a. ,'rii��.r`. �?1�e insulation/weatl '.'�o ��ar'k at�;?�,./.. w,....�., � ^:, -�,'- —r;'�• :^(, T•a b�,',r,.v..t;, .\� :�;::,:i•:x.� �y.:ld�•ii"'..�f':�y;r,;. .,t;:,);.,.< � en com let � } 7� � :�.y, e ;rr;;7•.,af_�4,.a.' ''•r<<i''r'-'%.'rai••t�' � ,.v�`�!�•i:i%�yr:r, .��; :.`1;:n. :'�C � ;`4`f<-^-�.i ''',r'�:8''iY:' 41�i _ '.:i� fP�::.j.•:Sc�rg;;':�-.,: ,ri�,'a Ji�r �'{.:'+ , •'�i.`.:,Gj'r irc`�'" '�'r":` '•:�I,.. ":��,tir}�, �•ii..-iai_+.{.'1':.I, .:/�',•!:,j.,.y..u.,.�?��• ' i:li:'r:..:4i:d°Y;G';':>_�!: '-•r�3:.•-,.:�,. :�;..a• `.k '9:'1J'% :i�:ai•;tiTr:. '..�:�.',a r.� 's:'.�•r:'Lh7.},LT,!.d'` l ';"N�.�..);•.;,.'•�'t �: r"�':?gin'?,:c';:, . ••�i=1:Y;;.,.gri1 ' '.'e:i;'.a>r^•;r,.;''.,r,'e?' ..• '"P„9:T r< ,f�'%{`^"ti .,�T' •' Regaris .J.c:s:: ' T``,,:.s,t,:!r. .<:.,.. ::a>i•;:.r:ar�;, _ _,,..a .,,ii�. k rv!IZN - i;l y.� ��� '�I ✓' i(! :,u.. .''Sa•>'i,:;!a::fi:.�`R: �F". 4. 't`}. .w�se<y:'.r:i"'+i_:s:� •r:_;`.,yi'::}''::'.r.•:�:nj.n; ;-:':9::''�':.<.1:::�. i lr.�r.y �"'i,! 1{r".`s%%, .. nl,!•e"'aini' r.,t. •,' �...:' Si' :.; r,. .•� .: is,! _m ¢•,• �"•u'� ' Timothy Cabral, President •CSL-105454 58 DIClC1NSON STREET I 'FALL RIVER.'M 02721 I (508)5¢7-4240: :.:ACfERP�A-flVEWFATtfFRRf7i?1Ot� G1�AAlL:COtvt:.•' TOWN OF BARNSTABLEE-BUILDING PERMIT APPLICATION - ff Map • _Parcel Application# 6d7Q�p f(o Health Division Date Issued 1 �� Conservation Division Application Fee Tax Collector Permit Fee Treasurer 1 oK I►'Iq u9 Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address N9k1ft M . Village C�Wu� Owner w►wyo a\a\ Address Telephone rim Permit Request -7-fy3��PAA. U.aN�.9.7� � SS�t S'[— F �e),c Square feet: 1st floor:existing��proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1��00 Construction Type Lot Size Grandfathered: ❑Yes 4No If yes, attach supporting documentation. Dwelling Type: Single Family ` Two Family ❑ Multi-Family(#unit ) Age of Existing Structure o Historic House: ❑Yes unit On Old King Highway:'s Hi hwa : ❑Yes No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing �_new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing $ new First Floor Room Count Heat Type and Fuel: *Gas ❑Oil Electric ❑Other Central Air: ❑Yes 4No Fireplaces: Existing New Existing wood/coal stove: ❑Ye's al No `- : Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑newt size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: c Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes QCNo If yes, site plan review# , � rn Current Use Proposed Use �o BUILDER INFORMATION Name ��� � Jl�� Telephone Number SOBS c�o\ 01�3 Address \0CyU*t,1. )t�. License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOtRNS � �N� S ►.� SIGNATURE DATE + FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED i - MAP/PARCELNO. i ADDRESS, VILLAGE OWNER ' ' ti- DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL �f :f z PLUMBING: ROUGH FINAL GAS: ROUGH FINAL d FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' i t^ �114Et � TOWN OF BARNSTABL utldin g Application Ref: 200706966 �'"m• BMWSTABLE, + Issue Date: 11/19/07 P e.I l , 1 It 9 MASS 1639• Applicant: DOHERTY,JAMES R Permit Number: B 20072858 Proposed Use: SINGLE FAMILY HOME Expiration Date: 05/18/08 Location 312 NOTTINGHAM DRIVE Zoning District RC Permit Type: RESIDENTIAL ADDITION/ALTERATI0 Map Parcel 171042 Permit Fee$ 25.00 Contractor HOMEOWNER Village CENTERVILLE App Fee$ 50.00 License Num Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND INSTALL EGRESS WINDOWS IN 2 1ST FLOOR BEDROOMS THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: DOHERTY,JAMES R BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL `Address: 112 HERITAGE CIR INSPECTION HAS BEEN MADE. E FALMOUTH, MA 02536 Apptintion Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET ALLY OR SIDEWALK ORANY ART THE„ HER TEMPORARILY OR PERMANENTLY.. ENCROACHEMENTS ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE MVST BE APPROVED,BY THE JURISDICTION: STREET ORALLY GRADES AS.WELL'AS DEPTH AND;LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM-THE DEPARTMENT OF•PUBLIC WORKS THE ISSUANCE OF THIS PERMIT DOES NOT,RELEASE`THE APPLICANT FROM THE CONDITIONS OF ANY,;APPLICABLE SUBDIVISION RESTRICTIONS . �. T. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LDLD;&IS A 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO ME SP O 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO L 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED OR ECT AL,P AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS EVE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CON T CTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health I of t�ram, Town of Barnstable BMW CAB , : Regulatory Services 9`bA ' : ,0� Thomas F. Geiler�Director TED MA'S A Building Division Thomas Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 October 23, 2007 Mr. James Doherty Nottingham Drive Centerville MA, 02632 Illegal Apartment: 312 Nottingham Drive Centerville, MA 02632 Map: 171 Parcel: 042 Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincere , �a s_A— nda Edson Amnesty Apartment Investigator Building Department gforms:zoning3 Town of Barnstable Building division 7-7 200 Main Street 24 OC-T' 200 Hyannis, MA 02601 0004606238 OCT24 200 MAILED FROM ZIPGODE 02601 V Mr. James Doherty Nottingham Drive Centerville MA, f„cz'ao ➢IXT.F, 029 DG' 1 OA i®1120 a A= RCTURN .TO SENDER - INSIJFFIG�F?�iT ACJORIa'Sa�' UNABLE TO, FORWARD s may, �trG1=%0104002 i Ili��� ,I;1,If"�110,;, IN -��.l�- - s Citizen Web Request Page 1 of 3 � w ,t s M w mar f" .�.• �%aa��`�,Qa`" 3� � ✓,y.G.t,F ��d _��.-c��'*��� �. t ..._ y� yr w^ ,��rar� �a Y- �t -ogged In As, MWN`Joconnet Citizen Request Management I! J q Request Information Request ID: 21334 Created: 10/1/2007 11:59:55 AM Status: Assigned To Staff Assigned To: O'Connell,Timothy. Health.Office Anonymous: No Request Category: Chapter 170 : Housing. Overcrowding - Night Only edit _...._...._............._....__._—_---..............___..___.__^___ Estimated 10/3/2007 Change Estimated 5ep October 2007 Nov Completion Completion Date: Date: Sun Mon Tue Wed Thu Fri Sat 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 1 24 125 26,27 28 ,29 30 31 1 2 3 4 5 6 7 8 9 10 Created By: Wadlington, Ellen Priority: Medium edit Health Office Citation Numbers:. edit Reuesfr Information Requestor Dean Smith Requ s�t� DETAILS: 324 NOTTINGHAM /LOCH i ON: 312 NOTTINGHAM DRIVE DRIVE t Centerville, Ma 02632 Centerville Ma 02632 508-428-0789 _ .. Request Parcel Number v Overcrowding, at night there are Map: 171 Block: 04? ;Lot: 000 ,000 . .k' at least five (5)cars. There are at least five (5) adults living in house, Parcel Lookup commercial vehicles parked on lot and lots of ladders and other work- related materials. i http://issgl2/IntemalWRS/WRequest.aspx?ID=21334 10/1/2007 f 1 l Citizen Web Request Page 2 of 3 e , Email: Edit_Requestor_Informatio_n Track Request Progress I 1 Request Work History: Internal Note History: System entry on 10/1/2007 11:59:55 AM: 3 Assigned to O'Connell, Timothy Enter work progress: Enter internal note: (dewed by everybody) (Viewed internally only) I i i i i s I A1; 3 i 4 1 1 ........ ........_.... ....... .. .. -, i I : Spell Check.. SpeN Ch ck0 i I I I i j ...................._..............��..__._..........._._.....__...__..__.............._._..._.._._.__ .............,_..__..__......__.___......_.____._.........__..__._._..._......._.__.w..............._............._........__......................... ___.____..v.._d._.___�._._._._.�.__.... -Add document or image link: .. _.. _..... .._.._..... . .. " Browse u i YOU can alSO type in a folder, name to see everything in the folder Current Links: I Time worked on request 10 _ Response time 0 Time entries are in lours. Examples of time entries: 1.25, 0.5, 0.75, 1, 3.5, 0.25, 0.1 * Response tirne: Measured from the creation date to your first actions on the request. Do not include nights, weekends,ends,, and holidays in response time for most depaftments. �% Save changes Check to notify town employee below to review this request. "- Save changes and notify citizen* Health Office • 0 Close request and notify citizen Agostinelli, Joan w •.._• __-••_* I __m�___...�....,..._ ._ Brief message to reviewer: *notify works if avail address was cniven - 3 http://issq l2/lntemalWRS/V,Request.aspx?ID=21334 10/1/2007 r - =1 i Citizen Web Request Page 3 of 3 � Update`. 1 ss"xixi Y n Speli'Check i Public Use: Printer Friendly Version i Internal._._Use:..._Printer._Friendly._Version http://issgl2/lntemalWRS/WRequest.aspx?ID=21334 10/1/2007 r AsBuilt Page 1 of 1 i ( TOWN OF BARNSTABLE LOCATION la 6�oni ewk awy "Dr- VILLAGE C� ��t� '. ASSESSOR'S MAP&PARCEL IN'q=Z15ERS NAME&PHONE NO-�rM k_Q�'o q/u t I, G• SEPTIC TANK CAPACITY o 00 LEACHING FACILITY:(type) t � (size) NO.OF BEDROOMS OWNER �Smy-efj ` �'- PERMIT DATE: C6iGR2EVEN@B-DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and�Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) ' Edge of Wetland and Teaching Facility(If any wetlands exist within 300 feet of leaching-facility) FURNISHED BY • i Nottingham Drive ,49 42 34 . i ( Fi".:#��Q;i`^`•`;iZ;INN+�X,<itl:c;'':'a,'T-:4�'''':�iri- - 1:,:-:�itti.',1,\?i\%"ii�.��fi;`/.3i'�i:>.*'�j•�i'.Sl;;i�t;�'s.+`: 17 5 30 25 http://issq 1/intranet/Propdata/prebuilt.aspx?mappar=171042&seq=1 10/1/2007 Parcel Detail Page 1 of 3 E i Logged In As: Pa rce I Detail cn Parce: i f vl*:uu Parcellnfo Parcel ID-171-042 Developer LOT 23 t ..... .. Lot. Location'312 NOTTINGHAM DRIVE Pri Frontage 125 _.. ., Sec Sec Road Frontage -. -_.._.._--.._......__ ---_. ----- village;CENTERVILLE Fire District!C-O-MM ,__----- .-_-----------_-------- -------------_-___________. -------- ----------------- _-_____-_-_. Sewer Acct Road Index'1 104 Asbuilt Septic Scan: Interactive : `' 171042 1 — Map � lti�I� ,. Owner Info owner 1DOHERTY, JAMES R Co-owner %SILVA, RENATA V ......... ..................................... ........ Streetl 312 NOTTINGHAM DR Street2 . ....... .. ......... . ..... ..._...... .......... city 'CENTERVILLE State MA Zip`02632 Country i Land Info .... Acres'0.36 use Single Fam MDL-01 zoning RC Nghbd 10105 Topography Level Road Paved utilities Public Water,Gas,Septic Location Construction Info Building 1 of 111, M.. Year 1972 Roof Gable/Hip Ext Wood Shingle Built Struct Wall Effect Roof._�...._..�_._...v AC .. .. 2435 As h�F GIs1Cm None Area -- _ -v Cover` p Type style Ranch Wnt Bed all Drywall Rooms 3yBedronms Int ....... Bath Model Residential Floor Rooms 2 Full Heat _ _. Total '-A Grade IAverage Hot Water 7 Rooms Type W Rooms' http://lssgl/lntranet/propdata/ParcelDetail.aspx?ID=l 1522 10/1/2007 Parcel Detail Page 2 of 3 w _...____ -------------- 1 ....... .. ,..._._... v\Biik stories Story Heat Gas Found- Typical Fuel ation 4 a Permit History Issue Date Purpose Permit 9 Amount Insp Date Comm 2/25/2007 Finish Basemen 200701058 $10,000 5/13/2003 Re-roofing 68713 $5,485 10/21/2003 12:00:00 AM 9/1/1990 B33975 $25,000 1/15/1991 12:00:00 AM CE SU - Visit History .........._._............".._..... Date Who Purpose 10/21/2003 12:00:00 AM Martin Flynn Drive by inspection only 1/20/2000 12:00:00 AM Paul Talbot Meas/Listed - Sales History._............. Line Sale Date Omer Boo ]Par e Sale P 1 12/14/2006 DOHERTY, JAMES R 21608/273 2 8/1/2005 DOHERTY, JAMES R 20108/217 3 11/14/2001 DOHERTY, PATRICIA A 14441/291 4 10/15/1983 DOHERTY, PAUL F& PATRICIA A 3899/023 5 1/4/2007 SILVA, RENATA V 21673/37 - Assessment History .......... ......_ ........................ ..... ... ..................... ..............._.._..... ... Sage# Year Building Value XF Value OB Value Lan;s Value Total Para 1 2007 $202,000 $5,200 $400 $148,400 2 2006 $184,300 $5,200 $400 $150,500 3 2005 $167,600 $5,100 $400 $136,400 4 2004 $136,100 $5,100 $500 $115,900 5 2003 $123,700 $5,100 $500 $45,100 6 2002 $123,700 $5,100 $500 $45,100 7 2001 $123,700 $5,100 $500 $45,100 8 2000 $90,900 $2,300 $200 $30,600 9 1999 $90,900 $2,300 $200 $30,600 10 1998 $90,900 $2,300 $200 $30,600 http://issgl/lntranet/propdata/ParcelDetail.aspx?ID=l 1522 10/1/2007 o-s.rr CSTIMATE - - Proposed Layout for PHONE:NO ESTIMATOR DATE �a Scale 1/4" _ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 1.8 19 20 2_1 22 23 24. 25 26 27 28 29 30 1 2 3 4 5 �� rr 6 7 8 �-; 9 ,E' 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Notes l�f�eCf:&1ST .:�� DC8511 .d- MADE IN USA T Bk 21673 P:E;37 � 811 II QUITCLAIM DEED O I, JAMES R. DOHERTY, of 112 Heritage Circle, East Falmouth, MA 02536 v ' l FOR CONSIDERATION PAID OF THREE HUNDRED TWENTY SEVEN THOUSAND and no/100 ($327, 000 .00) DOLLARS GRANT WITH QUITCLAIM COVENANTS TO: RENATA V. SILVA of 312 Nottingham Drive, Centerville, MA 02632 C Tha r r cel of lan t ce in to pa d together with the buildings thereon situated in Barnstable (Centerville) Barnstable County, Massachusetts, bounded and described as follows: LOT 23 as more fully shown on a plan hereinafter mentioned, - together with a right of way over the roads shown on said plan for all purposes for which ways are used in the -Town of Barnstable. Said property being shown as LOT 23 on a plan entitled "Subdivision Plan of Lumbert Mills in Centerville, Barnstable, Massachusetts for Peter G. Sheaffer, et al, Scale 11, = 1001 , May 28, 1971, Barnstable Survey Consultants, Inc. , 608 Main Street, West Yarmouth, Mass.", said plan 'being recorded with Barnstable County Registry of Deeds in Plan Book 247 Page 84.. Subject to any and all existing restrictions still in force and effect. Meaning and intending the premises conveyed to the Grantor by deed dated December 11, 2006 and recorded with Barnstable County Registry of Deeds in Book 21608 Page 273 . Also see deed recorded in Book 20108 Page 217. Bk 21673 Pg 38 #811 WITNESS My HAND and SEAL this 4°h day of JANUARY 2007 . amen R. Doherty COMMONWEALTH OF MASSACHUSETTS Barnstable, as JANUARY 4, 2007 On the date first above written,- before me, the undersigned notary public, personally appeared JAMES R. DOHERTY, as aforesaid, proved to me through satisfactory eviden a of. identification, which were (source of identification) w+i to be the person(s) whose name is signe�h�`?�hR e�,,�receding- or. attached document, and acknowledged t`gOJ@�;; i�q ��Jshe signed it voluntarily for its stated purpose. " '��7 Notary Publ C r RICHARDSON My Con ni s s ioifr� � r i .\`�.`` 12/8/2 011 r HASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS DuLt: 01-04-2007 D 03:34an CL11V: 1521 DULT: 811 Fe-: 0P11E.34 Curis: S327r000.00 BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Dat*: 01-01-2007 03:34om CL1;: 1521 Du 811 F,A;a: $715.56 Coos: $327r000.00 BARNSTABLE REGISTRY OF DEEDS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r� Map 1'� Parcel (� L{ � r Application# Health Division Conservation Division t Permit# Tax Collector Date Issued - _a —0 Treasurer Application Fee Planning Dept. Permit Fee I bo Date Definitive Plan Approved by Planning Board �L Historic-OKH Preservation/Hyannis Project Street Address1 Village Owner 1i"' � Address Telephone Permit Request Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio 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 4No On Old King's Highway: ❑Yes *o Basement Type: CA Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) r) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new x Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: *Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 4No Fireplaces: Existing New Existing wood/coal stove: ❑Yds ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new-', size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: 3 �s i Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ - r- Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name I Gy 14 Telephone Number `���—U1w Address N` License# 4� _ Home Improvement Contractor# Worker's Compensation# ` ALL CONSTRUCTION : BRIS R SULTING FROM THIS PROJECT WILL BE TAKEN TO +SIGNATURE ` DATE 6 ' FOR OFFICIAL USE ONLY 'PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER i y i DATE OF INSPECTION: � G E FOUNDATION FRAME !qL'?LO'1 INSULATION (S�► FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL I FINAL BUILDING 6114ls7,91L DATE CLOSED OUT ASSOCIATION PLAN NO. l The Commonwealth of lylassachusetts . • Department oflndustrial.�ccidenis ` Office pfbiyestigati'ons 7 • 600 lVashington Street.. Boston,MA 02111. ' W w-m ass gov/dia Workers' cortipensation Insurance•AMd$nt;.Biiilderg/Coritractors/Eiectricians/p ers .' A licant Information � � � .Pleas a Print L� 1 Name(Business/Orgamiatioidbdividual): AatrSs: City/Statelip: •Phone.#:_ ,Are you an employer? Check the appropriate boa: 1;Q I am a employer with 4. [] I am a general contradtor and I :Type of pigject{required);,. employees(full and/or part time),*. .have hired.the stab-contractors S, ❑Newconst mction . 2. I am a'sold proprietor or Partner.; listed OILthe'attached sheet 7.•[�Remodeling ship andhave no employees These sub-contractors have -Worlan for sne in 8, Q Demolition. g any capacity, euzployee�and have workers' [No workers comp.insiaarlce. comp,insurance.#' 9, 0 Building addition equized] $. ❑ We are a.porporation and its 10,❑filectdcal repairs oz additions ----.,3: I�nra homeowner-loing-a'Il=work'-•.. :_•--ofdoers-have exercised t'ueir 11:❑Plumbing rep'airs or - ` yself,[No-workers' comb, right 8f exemption per MGL additions insurance.required]t c..152, §1(4), and we have no'. 12,[]Roof repairs•. employees, [No workers, .• 5-0 Dther ' 4omp..insurance required,] . Any applicant that checI mnst also felt out the s ection below sbovring then workers'co}npensation p oHay informafien,t Homeowners,who submit this affidavit indicating they are doing all work and then hire outside oentractors must submit a new affidayitindicating such. $Contractors that oback this box must attached ea addih'malsheet shawink the name of the pub coons a cto and state whether w Rfadwit entities hate employees. If tbesub-contractors have employees,they must proVi d'e their workers'oomp,polidy number, I uni an employet,ihttt is providing yuorkers'campensativn insurani:e for my employees. Below is the policy and3ob site' infarmatzDn. , Insane Company Nabie' Policy#or Self-ins,Lid,A. . • Expiration D ate; �ob Site Address: ' City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and e ' . Failuze,to secure coverage as re • • x7?u'ation date), quired tinder Section 25A-of Iv1:GL c. 152 can lead to the imposition of criminalPe ties of a fine tip t6$1,500.00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP�!ORK•ORDER and a fine of up to$250.00 a day against the violator, Be advised that a•copy of this statement ma be forwarded to Inve8ti ations of fhe'DIA fox' coves e verification y , tbe'0ffice of I do hereby certify and he din d enaTtces o u that information provided above is true axis correct. _ fP�I r1' r Si tore: Date; Phone 44, Ofjtcial rise only. Do not write in this area,to be completed by,city or town o cis ' City or Town, .PermitUcenSe# . Issuing Authority(circle one): .1 Board of Health 2,Building Department 3, City/Town Clerk 4,Electrical Inspedtor 5, Plvmbia 6,Other r S Inspector . Insp r Contact person: Phone A• Massachusetts General'Laws 6bapter.l52requires a employers to pzovideworkeis' compensationfor'theii employees. Pursuant to this statute, an employee is defined as"..,e'e rypersoninthe service of anotherunder any contract ofhiie, express or implied, oral or wri en." An errcployer is defined as"an diyidual,partnership,assooia' a,corporation or other legal entity,or any two or mote of the f ga-for enged in a jo enterprise, and including the I jepresentatives of vdeceased employer, or the receiver or t Mstee•of anindivid , partnership,association or other egal entity,employing employees, However the owner of a dwelling house having otmAre than tbree apartments an who resides therein,o the occupant of the dwelling house of another wha a ays persons to do maintenance,co traction or repair wor on such dwelling house or an the.grounds or building app pant to ereto shall not because of su h employment be,"deo d to be an employer. IvLGL chapter 152, §25C also state that"every state or local licensing genc shall withhold a issuance or rend -1 of a license or permit to'op rate a business or to construct boil gs i the commonw a 1alth for any applicant who has not produced•acc'ptable.ev' _ence of compliance with a ins, -ante coverage required. . Additionally,MqL ohapter.152, §25C 7)staieieb�tl ajtheithe commonwealth n r any f its political Adiyisions shall enter into any contract for the,perfo a ofc•.workuniii•acceptable a nee the inzrrance requirements of this chapterhave been resen ' the contracting authority:' Applicants � Please fill out the workers'comptnsat on affida 't completely,by checking the bo 's that a ply to your srtaation and, necessary,supply sub-contractors) e(s),addr ss(es)and phone"number(s)along ;th the certificates of insurance. Limited Liability'Compani s(LLC) or invited Liability Partnerships(LL withn 'employees they than the members'or partners, are not required carry wo ers'compensation insurance. If an C or LP does hate employees, a policy is required. Bead iced that affidavit may be submitted to the ep t of Indust''al Accidents for confirmation of insuran coverage. so be sure to sign and date the a davit, The affida�``��'t should be retuzned to the city or town that the ppl cation fo the pemut.or license is being re ted,not a Department of Industrial Accidents, Should you hav any questions egarding the law.or if you are req' ed to ob a worlcelCs' comp ensation•policy,please call the D partment at the umber listed.below. Self-insured4 ompani shoutb self-insurance license number on'the propriate'Haned, City or Tow;i OfficialsPlease be sure that the affidavit is'co lete'and printed 1 gibly, The Department has provi led a spat at tof the•affidavit for yoit to fill out in event the Office Investigations has to contact you egarding Please be sure to fill.is the permit/Ii0 anumberwhich ' beused as areference number In.adi' n,that must submit multiple permit/lice a applications in y given year,need Daly submit onQ affidavi ind policy,information(if necessary)an under"lob Site Adccess"the applicant should write"all•loo4o in city'or town)."A copy of the affa.davit that. been of$cMy st ad or marl 0by the city or towvhmayba rovided to a applicant as proof that a valid affida 't is on file for Mwe ermits or licenses, -Anew affidavit must b faed out ach year.Where a home owner or citize is obtaining a license or permit not relatedio any business or co ercial v tuTe (i.e. a dog license or permit to bum eaves•etc,)said persb is•NOT required to complete this affidavit, The Office of Investigations woul like to thank you in ad"ante far.your cooperation and should you e-ny Q estions, please 3o nothesitate to givens a aIL The 1)eparf nent's address,telep e•and fax number:, . . = t tl rn 06 WStma BQ:$tan,.MA 0211,1 TO, 617-727.4k.0 Wt 406 or 1477- ASSAFE Revised 11-22-06. FAX#617- 7470 , 'JLV rT 11 V1 LKi JJ.}7 LKNAV Rregulatory Services Thomas T,Geiler,Director ss. Building Division Tom.Perry,Building Commissioner .200 Main Street, Hyannis,MA 02601 www.towrt,barnstable,ma.us Face: 508-862-403 a Fax:. 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW -SUPPLEMENT TO PERMIT APPLICATION MGL c, 142A requites that the`deconstruction, alterations,renovatiori,repair,taodernization, conversion, irBprovement,removal,demolition,or construction of an additior 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 1 such residence or building be done by registered contractors,with certain exception,,along with other requirements. Type of Work i � Estimated Cost 10,000 Address of Work;. lb 1� Oy,�er's Name NJ Date of Application (Oa I hereby certify that; \ Registratign is aot required for the following reason(s): []Work excluded by law ❑Job Under S1,000 Budding not owner-occupied Jwner pulling own permit Notice is hereby given that: OWNERS pULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTgACTORS FOR APPLICABLE HOME IlY.OPROVEMENT FORK DO NOT HAYS ACCESS TO THE ARBITRATION PROGRAM OR GUARANTYYM UNDERMGL c,142Aa SIGNED UNDER PENALIZES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contrac e. RegistrationNo. *Date * 0 e s Signature Q.,,,n,.fo;ms:homeaf iidzv Rev: Ofi4bOb ' Town of Barnstable Op THE 10� " Regulatory Services yP O� BARNSTABI.S, : Thomas F.Geiler,Director y MASS. q,A �639• �0 Building Division rEv �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: 2 rk-T JOB LOCATION: Nei Not %-\AA hf ck�M\ NkV9, jnumber street village q ' "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) s The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. ffi-atire/she-andentarids the Town of Barnstabi ailding Deparull=IA ——- - minimum ins ctio rocedures and requirements and that he/she will comply with said procedures and requirements/ ,. Signature.of meo 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)fdr hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt I, t ' 1MATE Proposed Layout for: : . `NAME ADDRESS PHONE NO. CfvZ;PjCa r. ESTIMATOR DATE Scale 1/4" 1 2 3 4 5 6 7 8 .9 10 11 1.2 13 14 15 16 17 18 19 20 '21.-22 23 i24 '25 26 27 28 29 30 1 ,2 ;. 3 m � <. I 4 5 U � NN I 7I I 8 � 9 � 10 12 13 14 15 ; 5 16 17 18 -Trig a7l 19 X _ 20 21 `. 22 23 24 25 � I Notes Materials Labor . A Tax Total DC8511 ad— MADE IN USA - - Town of Barnstable *11errnit# OFtHE Tp� Expires 6 montthss frow Issue date Regulatory Services Fee HnnMASS Thomas F. Geiler,Director e FO3 9 +0.' 13uiitling vivisiO><>< �-PRESS PER �T Tout Perry, Building Connrnissioner 200 Main Street, Hyannis,MA 02G01 MAY 13 2003 Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION ress l ESIDEN'l'� ARRISTABLE Not Vnlid ivithout Red. Map/parcel Number Property Address g� 00 Value of Work=✓� Residential Owner's Name&Address 21 (� Telephone Numbers Contractor's Name 12, .i Home Improvement Contractor License#(if applicable) applicable) Construction Supervisor's License#(if app ) �orkman's Compensation Insurance Check one: ❑ I am a sole proprietor [] I in tile Homeowner I have Worker's Compensation Insurance Ajc Insurance Company Name Workman's Comp.Policy# tU Permit Request(check box) pT je6 ( Re-roof(stripping old shingles) �1%,L0 3 z,, — a ❑ existing Re-roof(not stripping. Going over g l a ycrs of roof) ❑ Re-side ❑ Replacement Windows. U-Value ❑ Other(specify) t exempt compliance with oilier town department regulations,i.e.historic,Conservation,etc. *Where required: Issuance of this permit does no 6 Signature Q:forms:expmtrg STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, OWN THE PROPERTY LOCATED AT IN MASSACHUSETTS. I HAVE AUTHORIZED TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSTTS STATE BUILDING CODE. I GIVE MY PREMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER:. /-C lA 7, bo i OWNER'S ADDRESS: 3I 02 N 1416 OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 NEWTOWN ROAD COTUIT M.A. 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: I RESPONSIBLE OFFICER TELEPHONE: ` : The Commonwealth of Afassach usetis Department of Industrial Accidents llfllce 9119Ms19ativos 600 Washington Street Boston,Blass. 02111 Workers' Compensation Insurance Affidavit o ntin ti n: _ �,:_y-_ :v,.— name: p�' location ��� Nd���� �A� tic c;t, 9 — 1J5—77 I am a homeowner pert-b dng all work myself. ❑ I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. comnanv.na//me• T. add ress. I/b M!L—. s EWT0 x W. : RUAI-%� rih- �'C�'tt.IAT ;. phone tt: !16P" 419 �'�. ��..;•.;.;., r. .. .. .. tea.. - f- :T"r•"_. ..r.._i - .'::�•. .., 7—._ - - _ •_: _: [j I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following wort C73' compensation polices: comoany name: address* cin•' phone 9: insurance co policy comn'snv name: -- -- address city' phone insurance co policy'—' •Attach sdditional sheet if ac_ J. , .., _ '_.77 _77 - F'Alure to secure coveraac as re:,-ired under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to Sl—soo.00 and/or one.•errs' imprisonment as -efl as civil penalties in the form of a STOP WORK ORDER and a fine or sioo.00 a dzv against me. 1 understand thata copy of this state men t mnv be ror-2rded to the Ofrice of investigations of the D1A for coverage ve: iezcion. t do hereby ce rider tht :a:rs and penalties of perjuri that the information provided above ;s tr-ie and correct. Dar L Pint name t(. official use onh• do no. -. .:e in ;his area to be completed by city or town official E cin or tn,'n- permitilicense' Building Depart :it [ C.Licensin;Board C check if immediate r-s^;-se ;s required CSeleetmen's Oflicc e [Hcslth Department r t contact person: phone X;• r Other i iy f ��\ ��JC (00'JJNJtOfIII/ef.LIA/E O�� tudE� Board or Building Regulations and Standards �1 HOME IMPROVEMENT CONTRACTOR 1� Registration: 100740 Expiration: 6/23/2004 Type: Private Corporation CAPIZZI HOME IMPROVEMENT, IlGinas Capizzi,jr. 1645 Newton Rd. Cotuil,MA 02635 Administrator ✓fie 6o�»mron�uea�l/e n�J,/f�aakic%ueelte a BOARD OF BUILDING REGULATIONS `License: CONSTRUCTION SUPERVISOR Number: CS 057032 Blrthdato: 09/26/1963 5: .., Expires: 09/26/2003 Tr.no: 5790 ' n Restricted: 00 THOMAS X CAPI711 JR 200 PERCIVAL DR W BARNSTABL.E, MA 026613 - 7 Administralor Acoi Q CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MMIDWYY) APIZ-1 01/17/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Norcross & Leighton Cape Loc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE C.J.McCarthy Ins.Agency,Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 437 Station Ave ALTER THE COVERAGE AFFORDED BY-THE POLICIES BELOW. So.Yarmouth MA 02664 Phone: 508-394-0946 Fax:508-760-1407 INSURERS AFFORDING COVERAGE INSURED INSURER A: National Grange Mutual Ins. Co INSURER B: Safety Insurance Company Ca izzi Home Improvement Ind. INSURERC: Guard Insurance Group 1645 Newtown Rd INSURER D: Cotuit MA 02635 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. )LT TYPE OF INSURANCE POLICY NUMBER POLICY€FFECTIV -POLICY-EXPIRATIOFT DATE MMIDDIYY DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000060 A X COMMERCIAL GENERAL LIABILITY MPS02733 04/01/02 04/01/03 FIRE DAMAGE(Anyone fire) $ 300000 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 10000 PERSONAL&ADV INJURY $ 1000000 ' GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ B ANY AUTO 1601064 04/01/02 04/01/03 (Ea accident) ALL OWNED AUTOS I I BODILY INJURY $ 1000000 X SCHEDULED AUTOS (Per person) X HIRED AUTOS (Per accident) $ 1000000 X NON-OWNED AUTOS -- - (Per accident) PROPERTY DAMAGE E SOOOOO (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO. OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X TORY LIMITS ER C EMPLOYERS uaealTY CAWC401043 01/01/03 01/01/04 E.L.EACH ACCIDENT $ 100000 E.L.DISEASE-EA EMPLOYE $ 100000 E.L.DISEASE-POLICY.LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER: CANCELLATION -----1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL _10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Wellfleet 300 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF A IND UP THE INSURER,ITS AGENTS OR Wellfleet MA 02667 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Bob Lindquist ACORD 25-S(7/97) ACORD CORPORATION 1988 C.J.McCarthy Insurance Agency Inc. Permit #03 7/ 719 ��yofTxr>o�`o� FEE: $50.00 TOWN OF BARNSTABLE = s,aa"" DATE: November 7, 1994 'oo Mb 9. MASSACHUSETTS Solid Fuel Stove Permit DATE OF APPLICATION ............/1!.. .. �? .................................... FIRED PT'^IS`SUING PERMIT ........................................ .._ PCIO/ F. S! Q Q / Jf.l�Pi /rJ� NAME (owner) r ......... NAME (Installer) ......................................... ADDRESS .....:�/�? // ....Yi�,Gtu...;vl . ..: .. ADDRESS ...q........6....'✓dPh. L.u1..G' �V...vAc,tcr7�;.itJuy .....................r STOVE TYPE ....... .IV/.Al l P,,v,,,,, G1�6V �'I CHIMNEY: NEW EXISTING -/�-............ Manufacturer . 19e CHIMNEY: Masonry ...................:! .......................... .... (tR1 o�r�EJ Y. /J 11�1 19 Mass. Approval .... ..........................: ....................`.................................... CHIMNEY: Metal N........... a.......{.............,. -' This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed address in accordance with an application on file with the ......................................:.:.....:...................................:................ Fire Department, and subject.to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. IssuedBy: .............................................................................................................................Title ........................:........................................................... Date .......................................... Permit to install expires 60 days after issue date r �p n Stove .�... .........W ........ .. ��! .. ......:.....\:..... .lS............................................ :...................................... r� StoveClearance ...........1;.............. 5..1. o2 1: .................1..Y.. . ...,.�a.G............tn.5. .1`sQ................................................................................................. Floor � CX..........•.. L�C .................. .. ... ...... .:.. .....:..........:.................:.....................................:...... SmokePipe ..................... ........................................................................................................... .... ......................................................................................... SmokePipe Clearance .................... . ............. ......a..'r0k1.V....................................... ................................................................ ........................... Chimney ..............�. ,. Gra. . ..�.......................................................................... .................................. . ............................ ............ Smoke Detector ..................v..:............ The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au- thority.of permit dated ...................................................... has been made in accordance with provisions of the Commonwealth of Massachusetts State Building Code .now currently in effect and pertaining thereto .............................................:.......................... Installer INSTALLATION APPROVED :� Q!Sy y...(,�....�... ...�... .... ........... B : ................... Title: ........ . . .....11.�'101.�.a.. date WHITE: FIRE DEPARTMENT CANARY: BUILDING INSPECTOR — PINK: APPLICANT Assessors map,and lot number .... ..................................... 1 SEPTIC SYSTEM MUST g Q� �y NSTA of To THE Sew �.:.: . '��... LLED IN COMPLIAN Permit. number • •�a,�... t .: ENVIRONMENTAWITH L CODE Z Ba&aSTADLE, A "6 a �rlouse number ......................... ........ TOWN REGULATIONS O.a� 39• 0 'Fa NO tr, TOWN OF BARNSTABLE DUILDIN.G INSPECTOR APPLICATION FOR PERMIT TO ... .hQQ............. 1)r1 ... .V�..................................................... TYPE OF CONSTRUCTION ....... !`! .I ......r`-ekF V..V`.',1 .............................................................................. .....................19. 4i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: -� qq��� Location 3 �� 1 '�'j�'t.N ........ ........ ProposedUse ...... ...... ....... ..............t 10�C...:..........................................................................................:......................................... ZoningDistrict ...... . .... .:. ...........................................Fire District .............................................................................. Name of Owner .l"!! ®. .....D.42..tivlei.y............Address ..NOTTIN.-K�^'. Name of Builder ........... ,`.....�.Y !! .... �` ........Address . . .'7. ?.... ....go.....�.... .:.�.Q�... Nameof Architect ..................................................................Address .................................................................................... �ll Number of Rooms ..................................................... ..J.....Foundation .. o Exterior ........ ................. 4!.J..t .. -..... 1. ?N. ..............................Roofing ... .. ... 1......... /1� ! . ' �' .. Floors ................................................... ..................................Interior ......�....� L`... ............. ...................................................... Heating ��..`.... ...............................................Plumbing ............ .. ... .................................................... ....................... { O Fireplace ................. '..\:............................................. Approximate Cost ......��.�,Q......................................... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ............ `:..:'.......�q..!.T.. Diagram of Lot and Building with Dimensions Fees....... .. lerri...........:.... +SUBJECT TO APPROVAL OF IOARD OF HE H D�G�. kx�s�-�ry v 1��uSi� �v t 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 ...v.'.' `.. Cx ............................... I Construction Supervisor's License ld 1`,�`. ' DOHERTY, MR.-' & MRS. AD.D...SUN...ROOM.. '14_75.9 . Permit for ....... .. .. ..... ....... ..a "Sincrle Familv Dwelling . ............................................................9............... Location ..a.1.2...Nottingham Drive Centerville ........... . .. .. .. .... ...... ............... .... .. Centerville ............................................................................... Owner .. Mr. & Mrs. Dohe ty....:.......... ......................................... J Type of Construction ...Frame....................................... ................................................................................. Plot............................. Lot ...................!,:........... Permit Granted ....:September...1.8.,:.lg 90 Date of Inspection. ......................................19 Completed .............Date Com ....... /I/......-19 M ewe 5 4 7 r CC Al 0 M Y . i ,nf t x a'{ t. 9 w - _ F MINN}P � ^ G l�3�.ua ' 4' UM a im e t � AMR- .C�1.�u_ L�l�l _.. far. • - t�l� cRS_ E tY.- �"T t"a`lf L . n I _ I �RENL1 n DDR A-1 XfP, b hi N I- Lo- e -LIT et-- rC II I� V,tJVL SlOtsic'- pr i - ' f OTAL 22. sl- 5s 61y.ao - i CFJL AoEtvi-Y 6 �1 u= . Ate•=°3�� 2,off.. XRMA i EXAMPLE 1 . HOUSE. - HEATED5BY OIL _ GAS OR HEAT PU M P _. 3 PROPOSED HOUSE HEAT LOSS ' Y TRANSMISSION COMPONENT U-VALUE AREA "UA" y NET WALL •or7l G«. 2- WINDOWS - 31 122. 3 3? , 91 ROOF . 0-3 39 q DOORS . .25 3 . 5 2 , Y-7 FLOOR. . -- ----�Tr+ 1.1 1 • ,{ - * BETTER THAN=CODE :REQUIREMENT - . * DOES NOT MC ET •CODE REQUIREMENT EX. 1 "CODE HOUSE" HEAT LOSS TRANSMISSION COMPONENT U -VALUE AREA "UA" -- NET WALL . 08 6 �2. 41. 13 WINDOWS . 65 22 . '�� � 41 ROOF .033 . to - DOORS 014 `< < ',"FLOOR.-� .05 , 3 20 . _ C SINCE CODE 'UA' 1S GREATER, PROPOSED HOUSE PASSES 2.36