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0414 OLD STAGE ROAD
r. 1� y r� r 7 Cf � C O t 1 I i YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town [which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. §� .s DATE: r( Fill in please: W am APPLICANT'S YOUR NAME/S: C- A yV O K o A V- 0 WE M BUSINESS YOUR HOME ADDRESS: '�f l Lf p( h S F1gC- ►^D C E ti F� 1 L C fi►� TELEPHONE # Home Telephone Number NAME OF CORPORATION: - NAME OF NEW BUSINESS t4 l I1 V 1 4(tuf co 5 0 TYPE OF BUSINESS V 4I NT I (V O IS THIS A HOME OCCUPATION?^LYE -NIIJ ADDRESS OF BUSINESS -+^ j ..r b. F7V fC✓,UiLLc- MAP/PARCEL NUMBER (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Mai t. - (corner of Yarmouth Rd. &Main Street) to a sure you have the appropriate permits and licenses required to legally opera usmess in this town. 1. BUILDING CO MI SI0 ER'S OFF ' MUST COMF�LY 'NI�H HOME OCCUPATION This individ al - e inform d�nyr m i require ents that pertain to this type of businessULES AND REGULATIONS. AILUR TO ut orize ig atuce' * COMPLY MAY RrSULT jhj FLIES. O M NTS C ""n2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: IUWU Ul DUrnSLaDle THE Regulatory Services p Richard V.Scab,Director CTAR?y s Building Division MAM Paul Roma,Building Commissioner i634• �� '°TEo 16 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma us' Office: 508-862-4038 Fax:. D8-190-6230 Approved: Fee: Permit#: j6_f Z HOME OCCUPATION REGISTRATION Date: 07 2S j 17. Name: C E A'j b e,, (3 A 6 D Os Phone 3'3 8 Address: /44 OL D 54 A� F r 0 Village: Name of Business: Type of Business: . f A t ti-f1 N!9 j 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 from outside the dwelling. there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes.and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carved on by the permanent resident of a single family residential dwelling unit,located within that dwelling Tmft. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. " • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,.glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such-use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet 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. t Applicant l A ��O lAr P,�� / Date: Romeoc.doc Rev.06/20/16 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map /`�'0 Parcel f I Application # J 1 Health Division Date Issued Ub A Conservation Division Application Fee Planning Dept. Permit Fee �� •� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address all Village lfkezT�n-e 6- Owner 4T % 12 f/ Address Telephones Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation go Construction Type-1G�'J�%. ,�� 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 Xo On Old King's Highway: ❑Yes No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new c»r n Number of Bedrooms: existing _new b Total Room Count (not including baths): existing new First Floor Roo'W Count = Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove'.�-©Yesz❑ No Cn Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing LAew ize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Curren Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name-m C�v/ %���, z,�fa,� Telephone Number ,:2,2,5''f / Address Zl,'�AIA,44,W �'Ti� License # i '0 c 9 ® L) Home Improvement Contractor# Email Worker's Compensation #��c'��6 6 4 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# r �' DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL L t GAS: ROUGH FINAL FINAL BUILDING i�. DATE CLOSED OUT F ASSOCIATION PLAN NO. _ f Town,of Barnstable f .}t lato Services . �egu xY. �a amUassM Richard V.Sea%Director �• Building Divisio " a , r r Tom Perry,};niiding Comminioner. 200 Main Street,Hyannis;MA.02601 wwwAmmbarnstablemm-us Office: 508=8624038 k Fax 508-790-6230 Property Owner Must torsi.Iete=and Sign Tin Sea-ion, If Using�ABYiXder rpYS ft 4 ct.propeny a . here bp.authorize co act on my behalf, in alI'matters relative o . rk authorized bytlus building pernzt application for.: . r - ( ddress of;iob) _ . "1?00l fences and alarms are the msponsibility of the applicant. Pools , are notto:be:filXed or'utilied before fence is installed"and all'final imspections are performed and accepted: OT Ll_MQLQ $ignature:of Owner Signature otApplic=t Pxiat.Naine'. - PiintName 15 Date ; QsoxMs:owrlERPERWsstoNPOO.Ls EJ/ # .., Mass�tctnlSetts • Depar`tment.of Wublic.Safety. ..Board of Building Regulations apd Standards , Construction'Supervisor License: CS 100988 "HENRY E CASSmv 8 SHED ROW WEST YARMoLrTH -w" N i N.,V Expiration Commissioner 11/11/2015 Office of Consumer Affairs and Business Regulation l0 Park Plaza - Suite 51.70. Boston, Massachusetts 021-16 Home Improvement Contractor Registration `Registration: 153567.` Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO, YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. SCA 1: 20M•05/11 ❑ Address Renewal 'Employment Lost Card' ex, iQai�rn�aoai�ueaGC�"a�C���C(iJdCGC�lGr1B�.4 , Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 133567 ` Type: Office of Consumer Affairs and Business Regulation ;7 xpiration:;::1;21:1:5/2.016 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATION,.INC HENRY CASSIDY 18 REARDON CIRCLE g — SO.YARMOUTH, MA 02664 Undersecretary -NM valid wi ut sign e +' The Commonwealth of Massachusetts ` . Department of.Industrial Accidents Office of Investigations 600 Washington+Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleciricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �/ Address: City/State/Zip: V14 L M, .Thorie #: Are you an employer? Check th appropriate box; Type of project (required): l. .I am a employer with 4.,❑ I am a general contractor and I * have hired.the sub-contractors 6. ❑ New construction employees(full and/or,part-time), a • 2.❑ I am a sole proprietor or.partner- listed on the.attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity, employees and have workers' 9. Building addition [No workers' comp, insurance comp. insurance.$ g �equired.) 5. We are a-co oration and its 10.7 Electrical repairs or additions r - ❑ . 3,❑ I am a homeowner doing a]1 work ', officers have exercised their. 11.0 Plumbing repairs or additions myself. o workers' comp. ,right of exemption,per MGL E Y p 12.❑ Roof repairs c. 152 insurance required.] ? , §,1(4), andme have no employees. [No workers' 13, Other ' r comp. insurance required.] "Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors.that check this box must attached an additional sheet showing the 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. Belo.iv is the policy and job site information, Insurance Company Name: \ , �oy kvAl Policy # or Self-ins, Lie. #: :✓ id' ,A. Expiration Date: Job Site Address:��/tL f�f ,J City/State/Zip:�'�� �/, � ,�6�,1YL Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL' . 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year irrhprisonment, as well as civil penalties in the form of a STOP WORK-ORDER and a fine of up to $250.00 a day against,the violator: Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurarLet covera e verification. I do hereby certify d the pai an penalties of perjury that the information provided above is true.and correct. Signature: Date: Phone#: S 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`i5. Plumbing Inspector 6. Other. ? CAPECOD-27 BDELAWRENCE ,oEzo 'CERTIFICATE OF LIABILITY INSURANCE DATE,MM,°°IYYYY) 6/3012015 AS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS 6ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES f' BELOW. THIS CERTIFICATE OF INSURANCE DOES NOTCONSTITUTE A CONTRACT. BETWEEN THE ISSUING INSURER(S),AUTHORIZED r'• REPRESENTATIVE OR PRODUCER,'AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED;the policy(ies)must be endorsed:-If SUBROGATION IS WAIVED;subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements), PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 INC.No.E * ac No:(877)816-2156 - South Dennis,MA 02660 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURER a;ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. 'INSURERC: 18 Reardon Circle INSURER D South Yarmouth,MA 02664 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 SUBJECTTO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES:LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS., ' INSR TYPE OF INSURANCE ADDIL SUER POLICY EFF, POLICY EXP LTR .-. POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS A. X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ 11000,000 DAMAGE To RENTE07--' CLAIMS-MADE M OCCUR CBP8263063. 04/01/2015 04/01/2016 PREMISES Es occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JEC LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO + BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTO S AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS $Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ OED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE WCE00431901 06/30/2015 06/30/2016 E.L.EACH ACCIDENT- $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It Yes,describe under DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation Includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required-by'written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS. South Yarmouth,MA 02664 ' AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD (J*COD INSULATION IIp., SS SIAMI$5 SAT SUSNSNGSO BATTS GUTTIp$ INSULATION CSIlINOS - 1-800-696-6611 _ - Town of Barnstable Regulatory Services Building Division . 200 Main St -�- Hyannis, MA 02601 _ Date: Dear,Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed;& = r completed the insulation and'weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit, application.All work has been inspected by a certified Building Performance Institute '(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) O (35 ) Slopes Floors Walls ( ) ( ) ( ) ( ) ( ) ivy e,.01 Gvo r.l- /7er Jro rye l 4 Sincerely a 2H -'y E ssi r, President Ins ation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map MParcel Application W � , Health'Division Date Issued Conservation Division Application Fee O Planning Dept. Permit Fee '��' Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Addre e Owner Address 'k>Telepho e77 CPe-r-mit�Request D ✓ C �'i1 �v 'J/ Sk� Square feet: 1 st floor: i`sting proposed 2nd floor: existing pr posed Total new Zoning District Flood Plain Groundwater. Overlay rProjecfValuation Construction Type n Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)f Number of Baths: Full: existing new Half: existing _ —new-- Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Roo as Count—' Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other ;A/ it Z33 Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stoves ❑�s ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) r am.e � . C1L ,I �'��1 5 Telephone Number Address '1 �, S' ��� t License # C ", - � i 10 �MA- Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUREM �'�LG,- , DATED V -0 3— ����, z k FOR OFFICIAL USE ONLY 1 , APPLICATION# a DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH /I FINAL FINAL BUILDING �OIS DATE CLOSED OUT ASSOCIATION PLAN NO. ' rA Dep,mftent af-h&rurtH&Acd6&nris' ` Office of Inva hki am 600 WashbV&U Street BastM AM 02I1I , www MM govlifia Workers' Compensation I is rance Affidavit:Ikalders/Contractors/IIectri lmnbers Applicant Information PIease Prmf Legibly Addm—s s�` W - -�- CR3y s atedzi�: kI A o,;6�p-hone#: Ai-you an employer?Check the appropriate bo:c `' Type of project(regttrted): 1°❑ I am a employer wiin ,4 E]I am a general cautr'actor and I employees(fuII and/or port the).* have hnsd the sob-mniractms 6 0 Nc*construction 2.ElI am a sole proprietor or partner- ks•on the afiarhed shed 7. El Remodeling ship and have no corployees mese�ban 8. []Demolition _ woridng for me i a my capacity. emPloYees and have wot$ets' . ' [No workers'CoMp.mcitranrr. 'Con1P.ile�tranrrj 9._❑Building addidion" �) 5. E We are a corporation and its I0.❑Electricalrepans or additions 3_[ I am a homeowner doing an work officers bane exercised their IL[]Phmibing repairs or additions myself [No Wa3m s'comp. right of exempticm per MGL° IZ Roof r_Pairs ,tee re4rmed-I t o.i52,§I(4),and we have no mq £[No workers° I3.❑Other cot Zp.msoran=regoiced_] *Any applicaatthe checks box#1 mnst also fill outtbe section beloW shawmgthen-Warkea'compensation policy fi fonoatim t HomeoWncrs Who sabmitihis affAvk iadiraf mg they are doing ell Work and thin hue orh idc canhactnrs mast mbmit ancw afndavit iadieatmg sock_ tconhaatms that cbeak this box most aitsched an additoaal shed showi c6rdw nano of the sub-wnhaemrs and shy whetha or not those entities ham employecs.If the snh-mntmctnrs have auploy-s,they mast pnni&then Worio;a'nomp•policy manbm. I an an emplvyer that ispTirA ing}vorkers'compensation insurance for my eaplaye= Below it thepoticy and job site u:formadon, Insmaum Company Name: ! Policy#or Self-ins.LCict.# Fhpiralidn Date: �Job_5 ass: �I s ' L LAWN � Y/Slllp:-_�- !u ✓� v Attach a copy of the workers' compensation policy declaration page(showing the policy mmnber and expiration date). Faihme to secmm coverage as required under SectimZSA of MGL c,152 can lead to the imposition of criminal penalties of a fine 13P to$I,500.00 and/or one-year noprisomment;as well as civil p®alties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this sfa=mt may be forwarded to the Office of Investigations of the DIA for*nsmanoc,coverage vaifcati a , I do hereby catjy Wuk7 the pacers and penalties.o.fPeJmy that the iaformafion providkd above it riwe and tarred Phone# Q�al use only. Do trot write in this area;to be corrrpleted b1'city fed fawn n�rciaL City or Town: Permit/1,;rPh�e# ' Issr�g Authority(circle one): L Board of Health 2 BmldingDepartment 3.CityfTown Clerk. 4.Electrical Inspector 5.Pltnm 6,Other bingInspector Contact Person: Phone#f; ° W6rmation and Instructlons hiks,sachusetts Geheral Laws chapter 152 requires all employers to provide works'compensation for their employees. , Pmsuantto this sfaitiix,an employee is define d as"...every person' the service of another under airy coact of hire, express or h3phect oral or written." An enwplaye'is defined as"a a individual,partnership,association, oration or other legal entity;or any two or more of the foregoing engaged in aJoint enterprise,and including the le representatives of a deceased employer,or the er'receiv or trustee of an individna.L partnership,association or other egal entity,employing employees. However the owner of a dwelling a having not more than three apartments an who resides therein,or the occupant of the dwelling house of an who employs persons to do maintenance, on or repair work on such dwelling house or on the grounds or appurtenant thereto shall not because o such employment be deemed to be an employer." MGL chapter 152,§25C(t7 o states that"every stare or local tic agency shall an withhoId the issuance or renewal of a license or pe to operate a business or to co buildings in the commonwealth for any applica.ntwrho has not prods acceptable evidence of wimp ' ce wiffi the insurance,coverage required." Additionally,MGL chapter 152, 25C(7)states`Neither the comm nor any of its political subdivisions shall enter into any contract for the p ce ofpublic work until table evidence of campliancewith the insurance.. regriizrunents of this chapter have b presented to the Contacting ority." Applicairts Please fill Ott the workers'compensatio affidavit completely,b checking the boxes that apply to your situation.and,if necessary,supply sub-contractors)nam ), address(es)and ph a number(s) along with their certficate(s)of insurance. Limited Liability Companies C)or Limited Partnerships(LLP)withno employees other than the , members or partners,are not requ�ed to workers'cow 'on insurance. If an LLC or LLP does have employees,a policy is requited. Be advised this affi ' maybe submitted to the Department of Industrial Accidents for confirmation ofmsuraTce co Also b sure to sign and date the affidavit The affidavit should be rd=ed to the city or town that the appl for the ermit or license is being requested,not the Department of Industrial Accidents. Should you have any ions re the law or ifyou are regal ed to obtain a workers' compensation policy,please call the Deparhnent the er listed below. Self-insured companies should eater their self-insurance license number on the apprtsprisiE ' e. City or Town Officials Please be sure that the affidavit is complete and - legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the of Investigations has to contact you regarding the applicant Please be sure to fill in the permidlicense number will be used as a reference number. In addition, an applicant that must submit multipIe peffiit/Ecense.applit a' any given.yc ar,need only submit one affidavit indicating current policy information(if necessary)and under"Job S' "tLe applicant should write"all locations in (city or town)."A copy of the affidavit that has been.offi ' ped or marked by the city ortown may be provided to the applicant as proofthat a valid affidavit is on file firtre rmits or licenses. A new affidavit must be filled obt each year.Where a home owner or citizen is obtaining license permit not related to any business or commercial vent= (i_e. a dog license or permit to burn leaves etc.)s Cl person is OT required to complete this affidavit The Office of JIL7=figafiwins wound hke to ou in advance your cooperation and should you have any questions, y please do not hesitate to give us a caI L The Departments address,telephone fax er: e omalmweattll of Massachusetts . cut of hi6mtdal Accidents Mice of Ivvew9atio= 600�asb�ingtan Stet $ostomn MA 02111 Te,1,#617 727-4900 at 406 or 1-M-MAMAFE Fax##617-727 7749 Revised 4-24-07 �g� a - -1-own onsarnstaub Regulatory Services 'ME rOyy Richard Y.ScaIt Director Building Division Tom Perry,Budding'Commissioner MASS zG3g �m 200 Main Street; Hyannis,MA 02601 w WOw town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 = HOMEOWNER LICUM E7tMM MON DATE.--3 QOBW�L� number�� /s red village name home P k wor hone# hone r P CURRENT MAILING"-ADDRESS: cityhown state rip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor_ DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"cues that he/she understands the Town of Barnstable Building Department minimum inspection proce es a ents and that he/she will comply with said procedures and requirements. �y L-ignaium-of-Homeowncr' Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Budding Code Section 127.0 Construction Control " HOMEOWNER'S EXF11 MON The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a Iicensed 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.IWPFME.S\FORMS\buildmg permit fo=1EXPRESS.doc Revised 061313 o�TME ,ti Town of Barnstable ; Regulatory Services ,�8 Richard V.S ' Director i639. '�a Nua Building Division Tom Perry,Building Commissioner....._.. ...... 200 Main Street Hyannis,MA 02601 www.town.barnstable maxs Office: 508-862-4038 Fax: 508-790-6230 Properly Owner Must Complete and Sign This Section If UsinLy A Builder 4 ,as Owner of the subject property herebyauthorize / / to act on my behalf, in all matters relative to work authorized bythis permit application for. (Address of Job) ''Pool fences and alarms are the respons' tlity of the applicant. Pools are not to be filled or utilized before.fence is installed and all final inspections are performed and accepted. Sknatum of Owner Signature of Applicant Print Name Print Name Date QTORM OWNWERMISSI01Voors 0. 05e �►�� - t, p, _ Page 1 of 1 Anderson, Robin From: Grossman, Michael [mg rossman@commfi redistrict.com] Sent: Tuesday, March 17, 2015 9:06 AM To: Anderson, Robin Cc: Lauzon, Jeffrey; O'Melia, Robert Subject: 414 Old Stage Road Centerville Hi Robin, I was verbally informed this morning by the crew that responded to an ambulance call at 414 Old Stage Road Centerville on 3/16/15, that they observed what appeared to be an illegal apartment in the basement. Access to the basement was through a bulkhead. They observed (2) bedrooms, a living room and a kitchenette area. Please see the attached incident report for incident 15-0000893. Let me know if you have any questions. Mike Michael G. Grossman, Fire Prevention Officer Centerville-Osterville-Marstons Mills Dept. of Fire-Rescue & Emergency Services (508),79072375 ext. 1/Fax: (508) 790-2385 3/17/2015 COMPLETES ENDER.- • • • • DELIVERY • ■ Complete items 1.,2,and 3.Also complete A. Signatu item 4 If Restricted Delivery is desired, X ❑Agent •, •" ru 0, Print your name and address op the reverse ❑Addressee �- so that we can return the card to you. B. Receiv by(Printed Name) C. Date of Delivery I rU " ■ Attach this card to the back of the mailpiece, co a F or on the front if space permits. Ln Postage $ D. Is delivery address different from item 1? ❑Yes I Y f. a 1. Article Addressed to rTI If YES,enter d ❑low: No �/ _/;i ��' 1 Certified Fee. . '/r a � �i �f`\ y (.t P[�/ p_k `. S c0�0 C3 Return Receipt Fee ark S J Heostrre ,~' �Q S /—e��5I e � o�f Q 2��'J t7J C3 (Endorsement Required) air N n G Restricted DeliveryFee 0 (Endorsement Reuired) } °•.,,., c9� `� �� � �Z!L S 3. Service Typ ®Rceipt n-j Total Postage&Fees •• ,_,_ t J BRlTfle �/ I�%P��r ❑Registered for Merchandise �- Sent To / r ❑Insured Mail ❑ oliect on Delivery;r i +'a --------------------------- 4. Restricted Delivery?(Extra Fee) ❑Yes I L7 Street,Apt. o.; _ r f r— or PO Box-No. . S f ry, e S " 2. Article Number , Q lSu� 7014 1200 0001 .0358 2424 �,� c;ry StaiP+d (1Pansfer frorn service 7abe1) i{' PS Form 3811,JUIy 2013 Domestio Return Receipt _ J a MUM AUW ( ; # � NAME O sx s ,. . ,A r • h F }Lti nv7+�". ,•'�: ynR,j w `<:4-,a - .t .p;3 !� , z r TAR E- 1 ADDR% ITY STATE 'C OF }'t r a t c t s t» + ,� 3 Y� `� FFENDEflBAR STABLE ' f bs p1i &. d 14�s 6 `a 0 E E gr ✓�`+se ` 4 'r+2 u�'`` ,,�z 7 Wv { xnH1�"I�au •ray au s} '�+'N tC`. S ^•.�' `k'tie o a. '�s- � s Iwt�+ '�... ti y�L c A � ,�"s �Urfa� t TIM,EdAN ATE. LN ON ly R e, a�' t�}w, La'prf 41 7�4 L T 0}OF V- A ON - A a. J. +a y✓ rHr".f n�,� a$ P r'rr4 IPnI « '+ .r �f`-kkb , tl `+: f,�.;i �r, � NOTICE OF �r: z to / P M.-oN p/ ENF N d .�r•' r`.Q+ "'' 7 BEN BADGENO: •y. VIOL"ATION: y, ## Y,�t"�'.x �i 4.-F"`��'„�,y*it Ta�>kw.: w �,`i v�;'� �' ��:,W•✓. .«t.>�Y'*•'.»�49 OF �n•'�.r#:ION 9s' �TUWNI HEIE�Y-ACKNOWLEDGE RECEIPT'OE,CITAT� X H- ia'�+'OR;©;�INANG,E I ,a,, �•,� a' > - ,a a,THE NONCRIMINAL,tFINE FQR THIS UFFENSE'IS i`� �i �L 'Unable to obtain oat f often �* J y� �' y.�� 'ri'_�.en d, fju XOU HAVE THE�FOLLOWING ALTERNATIVES WITH REGARD.O OISFOSITION OF'THIS MATTER EITHER;I)PTION(1)OROPTION(2►WILL'OPERATE AS AFINAL�, u DISPOSITION'WITH NO RESULTING _ F' EG,U`LATIUNa, pe ,' " ;30 A Mend 4 00 PM:;!Monda;through FriEay,IIe9Glerkid s excepted, w, + m xl "�,t (, r elect to,pay'tbe above;fine either b appeariri m rson,bo"w n 8 t)Vou may Y g y --(� �.,. ti teTore.The,Bernsta¢le'Glerk„200:Meirn8treet,":Myannls,,MA�02801;�or,, mailin�gacheck moneyorder:orpostal�notetoBarnetab JP�BoX243D ,�`t xy Hyannis MA'0260t WITHIN T�WENTYONE(21)DAYS OF THE DATE�F THISiN0110E x t( srl t+t y, x 4 fix,.._ - 4A fi;Krr pr� i ,•r' .�(2 If you desire to contest this matter in a noncriminal pioaeedyng y"ou�may do sorby makin'written. ""quest'to DISTRICT.COURT DEPARTMENT,FIRST B RNSTABGE DIVISION COWFIT.COMPOUND MAIN STREET BARNSTABLE MA 026S0:Attn 2tD Noncriminal Hearings�,and endow a copy of'this A��� Q 1�"'Ii"i✓$�j1 c1T9tIWlfOC4k,hearing-,eq: .'R'�a' ah9 �:'z'S:. If you feihioipay the above oflen`se or to,request a:heating wfthin�;21 days;of H you tall to appear for;ffie hearing or to,pay.any floe determined at. S6 +�M}-y� ly p;".�..�4 '4 i��,�•. �i 3 s�;5+'"�`k�}m ,w.a S. �S� +r g � , d r,. �N�+},,,°����, ..,�r"L',rT 1,�,I,�11�HEREBY ELECT�the first optioynzabove;conless to he aHense:char edQland enclosepaymeM3{in;the amoun;,�f S I � �?�• YYYY. ❑Delete NFIR8 (.0.1920 I U 03 16 1 2015 ( [1 I 115-0000893 I Q00 ❑ -1 Change -BaalC :EDID. State Incident Date - - ,�* p * t * *_ *_ 'Station; Incident Number Ex osure - .:.. ... No rActil�ity _ Ch k this.box to Inds ata.thnt"the address for this-lncid t 1w provided on theeildl nd Fire ,CenSUS Tract I BLocation* ❑Module In:-Section B "Alternative:Location s ecificatio Use only f r wkkjl nd fire.__ E)Strers address I I u 4"14 L� IOLD .STAGE RD I Int@S2CtiOn Number/Mi;l'eposj Prefix Street or Hi hwa ❑In front of. y Street Type suffix ❑ .. I (GENTERVILI�E, (: ,+�' 62632 -_1 i Rear of ❑Adjacent to Apt./Suite/Room City State 'Zip Code-. I ❑Directions I Cross.stree-,�or"directions, as a licable :. _ .:.. Type eft Midnight is 0000' C 'Eil Date & Times E2.Shxft .& Alarms 321 IEMS call excluding vehicle I check boxes iS' Monti Dag Year Rr:Min Sec' W61;Option Incident T as Alarm ALAR e dates,arel the .. - , "-same : ti.always required 1 I 1 Corm, Date.. Alarm,* 0 16 2015 20. O1 Sihiift or Alarms District D Aid Given or Recesved*, �� ,�J U( I 'eldtoon.. ARRIVAL required,ipu less oanceled oc did not arrive. 1 ❑Mutual aid received 1 Arrival * � .0 5�I20:29" 59__-I E3 0 16, 20 2 ❑Automatic aid recv. ifheir, FUZD Their 3 ❑Mutual aid given State. ;CONTROLLED Optional, Excp ,:for wildland fires e`+- Special Studio's 4 Automatic aid given, Controlled Loca"1 Soptoil ❑ g�_ I I ❑ 5 ❑Other .aid given Their LAST DNIT;CLEARED,:re ❑ired except,for wSldland hies �� U N g None Incident Number bast Vriizt Special Special ❑ U ;I 2o.i5i 20I 36 s 54 I Study IUii Study Vaiue ❑ Cleared. t�l 03�• F Actions Taken* Gi Resources_* G2 Esti"mated Dollar Losses.&;Values � .Check this box and skip;l"'his Lo8"9:,.'Re Requited for aDl fires iFkn6". ` section if an Apparatus;or - q :. _ Optional for non fire's. 33 I Provide advanced life I` Personnel farm is used. None Apparatus Personnel "propety $L y OQO , 000 ❑ Primary Action Taken 111 � � - suppression `I, Contents $L. 1000 . 000 ❑• U I I , ' Additional. Action Taken (2) EM3.Ir. :..J ,I Q003I PF _3:kCIDENT VALUE: "Optional U o'ther 0001 I I ---� =J " 0 Additional Action Taken (3) pr 0 �0 ❑ DCheck"box if"resource counts -' - include aid received resources `,Contents $t 'Q00 , 000 ❑ Completed Modules' $1*,Casualties❑None': 3 Hazardous Materials Fte'lease I, Mixed Use; Property ❑Fire-2 Deaths Injuries N QNone NN Not Mixed Structure-3 Fire 1 Natural:Gas la„,rank 10 Assembly use no evau ti "or�BarMar�aatiopa ❑ ❑ 2,p Education"use Civil Fire. Ca's.-4: 3ezvice 2 ❑Propane gas.. �r 1b. tank:(aa, n�heme son gri11Y 33 Medical :use; ❑Fire.Sere: Cas.-5 �� LJ 40 Residential use Civilian 3 ❑Gaso11Z1e Vahiale'fuol can)i or portablo_aontainer ❑EMS-:6 *� 4" ❑Kerosene::;:fuel burning eguiptr t;or portabl c rogu: 5.1 Row of stores' HazMat-7 H2 Detector 53 Enclosed mall ❑ 5 Diesel-_filel/fuel oil:vat soio fuoi tank or .:tobio Requ red Yor<Genfined,Eires. ❑: eor 58 Bus. •& Residential ❑Wildland.Fire-6. 1❑Detect6r`alerted occupants `6 ❑Ho-..hold isolvents4 home/office spin, oioanup oniy 5.9 Office use O Apparatus-9 '.7 ❑Motor oil': froo z no or pottabio oont inae. 60 Indus trial; use Personnel-l0' 2❑Detector aid noti aert them 63 Military use $❑ []paint.: Pifrom paint cans Ctotaling,�55 gallon. Arson-ll 65 Farm use ❑ V�y❑unknown -0 ❑Other epoeial aazHat,'aati na required or epili>ssg6i., 0.0 Other miXed use Please etc'"the R rMat form J Property Use* structures 341❑Clinic Iclinic type 'infirmary '539 [3]ffousehold.<goods;sales,repairs 342❑Doctor/dentist office 579 ❑Motor vehicle/boat sales/repair Church, place: of worship ❑Prison or ail ilot uvenle ❑ 131 ❑ 361 j '_'r 7 571 Gas or service-station: 161 Restaurant or cafeteria"; 1-or'-2-famil div@llin Business offir ❑ 41 R9 Y 9, 5,9'9 ❑ ce 1,62 ❑Bar/.Tavern or nightclub- 429[1 Multi fam ly;dvrelling. 615 ❑Electric generating. plant. 213 ❑Elementary school or;ka,nde,rgarten 439❑Rooming/boarding house, 629 ❑Laboratory/science 'lab 215 ❑High school or.:junior high: 449❑Commercial:hotel or motel 70.0 ❑Manufacturin An gp 241 College adult:education ' " "" ' 45;9.❑Re idential:,, board and:care 819 ❑Livestock/poultry storage(barn) 311 Care facility for' the' aged: ❑ 464❑Dormitory/barracks, $82 ❑Non-residential. parking garage 331 Hospital Food and bevarag a sales ❑ ❑' 519 g $91, warehouse Outside 936❑vacant lot", 981 ❑Construction site 124 ❑Playground ,or park 938 ❑Graded%care. for plot.of land 984 ❑ d Industrial•plant yar 1 655 ❑crops or."orchard 946 ❑Lake; "river-;. stream' 669 Forest (timberland) Lookup and,enter Property Use code;only ifs ❑ g 960 Other stye t f way"` you'have'NOT checked a Property -.box.❑. 951 ❑Railroad ri'ht o 807 outdoor storage area; pzoperty Use 919'❑Dump or sanitary landfill 961"QHighway/divided highway en land or field 11 Or °2 family "dwelling 931 ❑dp 962 []Residential street/driveway NFIRs-1 Revision 03 it -.. C" Fire'District 0191N '03/16/201,5 15-6Q0,099, MM .DD YYYY. Complete 0,1920 U U' 11 4015 L. 1 [ 15=0000893; 0.00 Narrative PD1ti. * $gate,* 'Incident%Date *; station .Incident Number *: Exposure *; - Narrative: Caller 'Name BRI:S i1 Caller' Phone (`774) 994-2205 `COID=VZW Caller Address .SAA OIC OMELIA Pats. : 1. AGR : NINone lmotte 2015/03/16 20. 29.59 32T AT EVENT` MANNING IS'> 3: 911 ; 2015/0.3/1:6 20:26.01, Time of Call -2:0.15/03/16 20 25:57 Phone Number (774) 9,.94 2205 COID VZN t Caller Name, ; VZW CALL_ 1 8,0;0 8,52-:2671 !i Street Number : 345 Street. Name : OLD "STAG RD Service Municipality CENTERVILLEt ESN; ESN=6'04 MTN:'508-51_1-'7.991, ) Longitude : -070..352025 Latitude +0.9.1.,658.332 _ lmotte 2015/03/16 20 27;0.'6 } POSS CARDIAC lmotte" 7 20.15/03/16, 20..36;01. COMMITTED; STA 1 COV-,OSGOOD,H,UNT.ER,,ARRASCU)E, � II 9 1 ( i # I I t i I i E COAfM.Fire Dist i.et _ 01.920 03/16',/?015 15-0000993 .1 Person/Entity Involved 11 Local-Option Business name-'l f apol ca, ok.f Area•Code Phone Number u Check This tax if 'Mr ,Ms., Mrs 'First Name: MT .Gast-Name Suffix` same. address as irCn ski location The Tuen sate the,three; I duplicate address -- Ili J' I�J Number, �- - Prefix; Street"dr Kr4hway� SfL :.. --_... ... ... .... .... . - ...-_. .. ree ;T . lines.. - - _.. �: .. .. .. .._ � YPe� Post Office,:➢ox:; _ `Apt./SUS to%Rodin: City -- u I-[ i • State. zip Code• More"people 'involved? Check: this box aiid.attach Sti pplete ta3 Forms "(DTI S Is) as necessary R2 Oe6ner Same'as:Person involved i Thenresto this,box and skip The rest of this.sectian., ,...,.,,. ,..,,..., -•_. .. •,J �J Local Option I - IIusi:neaa name '(1f Applicable)'" - Pirea Code Pfione'.Number, u I L.U_J ' �-Check this box if Mr.,Ms.,:Mrs. Firsc Name_.:. - Mf: L 'N st• ame Suffix same address as _ .i:ncident location.:- Then kip the three i u u duplicate address. Number, -Prefix 3 reet:or Highway - - - - - - Street Type- Suffix lines. Post Office.Box Apt./Suite/Room City -.State _. .,Zip gode4 L 'Remarks Local option: Caller,'N'ame BRIS` Caller Phone (:774:) .`994=2.205 COID=VZW., Caller Address : SAA OIC : OMELIA Pats. 1 AGR : :N`l None lmotte ; 2015/03/16' 20 29:59'•- 327 AT ;EVENT MANN=hNG.:IS 3 911p :2015/03/16;420 26.01 Time :of Call 20.15/03/16 20 25:5`7 ! Phone, Number (7'74) 9;94-22d5 COID VZWr' Caller :Name VZW. CALL 1 80.0 852=2:671 ! Street .Number, 345, Street Name OLD STAGE RD Service Municipality CENT;ERVILLE ESN : ESN=6Q.A MTN 5Q8-511-7941: Longitude ; -071.0.35Z0'25 Latit,ude : +041.65833''2, lmotte ; 2015/03/16 2027':0.6 ` FOSS CARDIAC lmotte 2015/03%16 20:36 01 COMMITTED, STA l• COV=OSGOOD;HuNT:ER,-AARASCUE. 77 11 L Authorization ! 83.751 ) I0`;MELIA,;, •ROBERT: V. (FF/EMT'.,... I .i � 0.3> 16 , • 2 is . .. : _:...,..� _ _............ .. .: .. Position or rank: �AssignmeiIt...- - Month.... Day, -fear -..._: .Of£icer.in c?iarge ID Signature: --_. .... Check ;8375: OMELIA;, ROBERT F FT/ � _ •03 16 2015 , Box if®.I. _.._. . ... _I. I _ .I.;I. I• .I. as - 'Position,ox rank;, Assignmerii Nb.-Eh Da' `Yea'r as Officer Member making report:ID;.. Signature ?' in charge.: . . COMM Fire t)istr'ict •0'1920t OV 6/201" . 15-00008.93 Official Website of The Town of Barnstable - Property Lookup Page 1 of 4 �f Assessing Division Property Lookup Results - 2015 367 Main Street,Hyannis,MA.02601 .. <<BACK TO SEARCH« *Print Friendly ` Owner Information -Map/Block/Lot: 190 / 115/ - Use Code: 1010 1.l Owner Owner Name as of 1/1/15 POITRAS,CATHERINE&ADAM Map/Block/Lot G/S MAPS V 805 FELLSWAY WEST 190/1 1 S/ Property Address ►7 I� MEDFORD,MA.02155 414 OLD STAGE ROAD Co-Owner Name �( ,11/ I Village:Centerville Town Sewer At Address:No O" GIs Zoning Value:RC Assessed Values 2015 - Map/Block/Lot: 190 / 11 5/ - Use Code: 1010 2015 Appraised Value 2015 Assessed Value Past ComparisonsV��1, Building Value: $92,300 $92,300 Year Total Assessed Value I V �[ Extra Features: $48,200 $48,200 2014-$245,600 111 n 111 2013-$245,600 Outbuildings: $0 $0 I/V 2012-$243,400 I Land Value: $105,100 $105,100 2011 -$242,400 2010-$242,300 r 201 5 Totals $245,600 $245,600 2007-$311,300 D I Q (J 200 -$31 , 00 Tax Information 2015 -Map/Block/Lot: 190 / 11 S/ - Use Code: 1010 Taxes C.O.M.M.FD Tax(Residential) $380.68 c���� Community Preservation Act $68.52 Fiscal Year 2015 TAX RATES HERE 1 Tax 1 J// Town Tax(Residential) $2,284.08 2,733.28 � ^ Sales History-Map/Block/Lot: 190 / 11 5/ - Use Code: 1010 Vv � History: Owner: Sale Date Book/Page: Sale Price: POITRAS,CATHERINE&ADAM 2014-03-31 C202993 $10 POITRAS,CATHERINE 2011-05-25 C194337 $150000 SECRETARY OF HUD 2011-04-11 C194018 $1 CHASE HOME FINANCE LLC 2010-03-09 C190858 $281211 KLAZER,ALDOJ 2003-09-30 C170751 S270000 BENT,GEORGE D&MALENKY,M KATHLEEN1992-07-15 C127379 $11 5000 FLYNN,JANEP 1971-02-18 C50634 $0 Photos 190 / 1 1 5/ - Use Code: 1010 http://www.townof bamstable.us/Assessing/propertydisplayscreen 15.asp?ap=0&searchparc... 3/17/2015 f Official Website of The Town of Barnstable - Property Lookup 4 Page 2 of 4 Sketches - Map/Block/Lot: 1 90 j 11 S/ -.Use Code: 1010 J f ��[8.s 2 �AR �4�f AsBuilt Card N/A Constructions Details - Map/Block/Lot: 190 / 115 -Use Code: 1010 Building Details Land Building value $92,300 Bedrooms 3 Bedrooms USE CODE 1010 Replacement Cost $111,186 Bathrooms 2 Full Lot Size(Acres) 0.34 Model Residential Total Rooms 7 Rooms Appraised Value $105,100 Style Ranch Heat Fuel Gas Assessed Value $105,100 Grade Average Heat Type Hot Water Year Built 1965 AC Type None Effective depreciation 17 Interior Floors Hardwood Stories 1 Story Interior Walls Drywall Living Area sq;ft 1,272 Exterior Walls Wood Shingle Gross Area sq/ft 2,904 Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp Outbuildings& Extra Features- Map/Block/Lot: 190 / 115/ - Use Code: 1010 Code Description Units/SQ ft Appraised Value Assessed Value BMT Basement-Unfinished 960 $ 19,000 $19,000 BFA Bsmt Fin-Avg 800 $ 12,000 $12,000 FPLI Fireplace 1 story 1 $3,400 $3,400 GAR Attached Garage 572 $ 12,700 $12,700 UST Utility Storage- 100 $1,100 $1,100 " attached Sketch Legend Property Sketch Legend B2N Bam-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished)FUS Second Story Living Area SPE Pool Enclosure (Finished) BRN Barn GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLIP Loading Platform GRIN Greenhouse UHS Half Story(Unfinished), FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic hftp://www.townofbamstable.us/Assessing/Propertydisplayscreenl 5.asp?ap=O&searchparc... 3/17/2015 Official Website of The Town of Barnstable - Property Lookup Page 3 of 4 FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Print Friendiv Contact Director of Assessing Jeffrey Rudziak P508-862-4022 LF508-862-4722 8:30a.m.to 4:30p.m. Helpful Links to Downloads i Abatements I SALES LISTINGS Barnstable FD Residential C.O.M.M FD Residential Commercial-Industrial- Mixed Use Cotuit FD Residential Hyannis FD Residential i Townwide Condominium W.Barnstable FD i Residential ' Department of Revenue Exemptions Parcel Consolidation .Questions about values i Town Tax Rates Town Land Use Codes I Helpful Maps # All Town Maps ( Flood Insurance Maps y Property Maps t Contact Director of Assessing !Jeffrey Rudziak j IP 508-862-4022 E{( (F 508-862-4722 11 8:3 Oa.m.to 4:30p.m. I Related Boards I Board of Assessors (4 I ! http://www.townofbamstable.us/Assessing/propertydisplayscreen 15.asp?ap=0&searchparc... 3/17/2015 f Official Website of The Town of Barnstable - Property Lookup Page 4 of 4 'W" FY1 5 Tax Maps Owned and Operated by The Town of Barnstable-Information Technology Home I Departments&Services I Boards&Committees I Residents&Visitors I Doing Business I Town Calenda(,I Phone Directory I Employment I Email Town Hall e hftp://www.townofbamstable.us/Assessing/propertydisplayscreenl 5.asp?ap=0&searchparc... 3/17/2015 oFIME, ,Town of Barnstable � Regulatory Services * • BARNS[ABLE, r 9 MASS. �. , Richard V. Scali, Director i63p. ♦e Consumer Affairs Division Elizabeth G.-Hartsgrove,Consumer Affairs Supervisor 200 Main Street, Hyannis MA 02601' Tel:508-862-4668 Fax:508-778-2412 Poitras, Catherine Notice Date: 07/16/2015 805 Fellsway West BAR No: 79043 Medford MA .02155 Fine: 100.00 Balance.Due: 160.00 Please return this section with your payment SECOND NOTICE L Be advised that full payment has not been received for the fine issued against you on 03/17/2015 for a violation of the Town of Barnstable Ordinance or Regulation as described below. Violation of: " Chapter 240: ZONING 13a RC, RD,RF-1, and RG Residential Districts Principal permitted uses. (1) Single family residential dwelling (detached). Bar No: Violation Date: Enforcing Department: Location of Offense: 79043 03/17/2015 Building 414 Old Stage Road Centerville Fine: Payments: Balance Due: 100.00 0.00 100.00 You are hereby notified that if you fail to pay the fine in full within 10 days from the date of this notice,that a CRIMINAL COMPLAINT may be issued against you. Fines may be:paid by appearing in person between 8:30 AM and 4:00 PM, Monday through Friday, except legal holidays, before : The Barnstable Clerk 200 Main Street, Hyannis, MA 02601 OR by mailing a check, money order, or postal note payable to: Barnstable Clerk P O Box 2430 Hyannis, MA 02601 This will operate as a final disposition of the matter with no resulting criminal record. I� i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map V. o Parcel 4 1 io # Health Division Date Issued y�Z�ly Conservation Division . Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address I r I_. 6 Village Owner f 1 fJ( Q.. Address Telephone " /f� .Permit Request r�1 R - �v" 0 !? o7k )+ Square feet: 1 st floor: existing proposed 2nd floor: existing - proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 4�?DQ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas , ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing. ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ;❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# 50 Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ¢� r , v Name �� � � � Tele hone Number / �� Dl L- _ -� l Address?— mAticInse# Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURECA t ATE t f FOR OFFICIAL USE ONLY j APgPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME L� INSULATION I FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i I FINAL BUILDING �12,1DOYI 'F lie- DATE CLOSED OUT ` ASSOCIATION PLAN NO. A l T`he Com momt:tgaWi ofHassachuseffs Aepurhumt of hrd=trcrd Accidents. far e o .f Traver aiioxrs ' 600 Was? gVba meet Boston,MA 02111 WFOV ifaamgmldia ',orkers' Compensaif axilumm-ace davit~Burltiers/ContractorsMecizicianMumbers Applicant Tnfarmatian Pease F int Legib Nagle ahsineBs/ nizafi_on/Trtrlividna : P� O Adziress= � l�4-4 'f o-� O/.3 City/statr zip_ �� Phone me g� �' .'!�5 /lire you an:employer?Check the appropriate box: T of project r 4•. I atrt s confractor and I 33� P¢' .I (�exItrire'3}: L❑ I am a employer with ❑ 1 6- ❑Neu crostn c ioa ernpioyees{fill andlarpart times* havehiredthe sub-rontrwib 2,❑ I am a sole proprietor orpartnes- listed on the attached sheet +- ❑Remodeling slug and hate no employees These sub-aontactors.bave $- ❑Demolitiarl wodci ng for me in any capacity employees and have workers' 9- ❑Building addition c.WQrIcm.COffip_i'nvrranr9 cam-insuran l ed] 5. ❑ We area corporation and its 10.0 Electrical repairs or additions 6 1 am a homy awner doing all work of Iim m exercised their 11.0 Plumbing repairs or additions myseM[No workers'0DI]V_ right of exemption per MGL 12.0 Rnofrepairs insurance required]F c-15Z §1(4),andwehwanD employees_[Nowodcers' -0 Qther comp-insurance require& *Amy sppb'=9 tlut checksbm-91 tnnst also U old the section belowshaveing ihekwaacee maapensadwPORcp infiffonifft- t Ho-meov .s v,h wbaut this ffidvit ir,is mg they are doing allvrcak end then hire trxrtside coutractms mmst 5tib¢l1 Q a neu:affidatst mddrmtin snob_ tCbat mcmm that check this brut u mt attached as additional sheet sboumg themone af•ffie MbL-m3ft:KIrs and suhL whether or=t th osta earthier hare -aploye-• Ifthesub-caatractntsbareemplop a they-astprovidetlmk warl--'camp_policyiLlaca— 1`am atr empfnyex that fspm idifrg workers'compenfavrtion ansnrarfce for rift'm g7loytees HaZgw is thepoHc}avid fo b ante informa6uIL ' Insurance Company Name: Fol]cy t9 or Self-ins-llc.4: I xpiiatibn }ate- Job Sifx.,-Address: cityl statelT-ap: Attach a copy of the-workers'compensation policy d eclaratiou page(shown the policy number and elation date). Failure to securecowrage as regairedunder Section25A o€MGL r 152 can lead to the imposition ofcriminal penalties of a fine up t4$1,500.00 and/or one-year impusonmerk as well as civil penalties in the farm of a STOP WORK BORDER and a fine- of up to$250.00 a day against the violator. Be advised that:a copy of this statement may be forwarded to the Office of Investigations of fhe DIA far jusmanct coverage wrification- .I do hereby cadA under thepains andpenatfees o icty thattha information prai2dRd ah��ci��ve is hate und.correct Si tore: Bate: 1013 00ki rl use artly. Da trot wit a in tiffs area,to 5e cOufpieted by city or union afficiaL City or Town: PernritUCChse# Issuing Authority(tdrele one): 1.Board of Health 2.Biding Department I cityll"own Clerk 4.EIerhical Inspector 5.Plumbing Inspector 6.Other contact Person: Phone ti: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto ffiijsta an employee is defined as"._.every person in the service of another under any contract of hire, express or imp oral or written_" An employer is fined as"an individual,partnership,associafion,corporation or other legal entity,or any two or more of the foregoing e aged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee af an individual,partnership,associations other legal entity,employing employees. However the owner of a dwelling b,,ouse having not more than three ap eats and who resides therein,or the occupant of the dwelling house of ano m who employs persons to do in • tenauce,construction or repair work on such dwelling house or on the grounds or b appurtenant thereto shall n because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) o states that"every scat or local licensing agency shall withhold the issuance or renewal of a license or permu to operate a business or to construct buildings'in the commonwealth for any applicant who has not produc acceptable eviden of compliance with the insurance coverage required." Additionally,MGL chapter 152, § 5C(7)stafes"Ne' er the commonwealth nor any of its political subdivisions shall enter into any contract for the perfo ance ofpubli work until acceptable evidence of compliance with the incirrance requirements of this chapter have bee presented to the contracting authority." Applicants Please fill out the workers' compensation da t completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),a ess(es)and phone numbers)along with their certficatc-(s)of insurance. Limited Liability Companies(LLC) Limited Liability Partnerships(LLP)with no employees other than the members or partners,'are not required to carry o ers'compensation insurance. If an LLC or LLP does have employees,a policy is required. De advised tit' davit may be submitted to the Department of Industrial Accidents for confirmation of incnranc6 rove e.• o be sure to sign and date the affidavit The affidavit should be returned to the city or town that the applic 'on for permit or license is being requested,not the Department of Industrial Accidents. Should you have any estions re g the law or if you are required to obtain a workers' compensation policy,please call the Dep ent at the nzun r listed below. Self-insured companies should enter their self-insurance license number ou the appropriate line. City or Town Officials Please be sure that the affidavit is comple and printed legrbly. Th Department has provided a space at the bottom of the affidavit for you to fill out in the e nt the Office of Investigati has to contact you regarding the applicant Please be sure to fill in the permit/license umber which will be used a reference number. In addition;an applicant that must submit multiple permit/limnse plications in any given year, only submit one affidavit indicating current policy information(if necessary)and un r"lob Site Address"the appIic t should write"all locations in (city or town)."A copy of the affidavit thaf has b n officially stamped or marked b the city or town maybe prop ided to the applicant as proof that a valid affidavit is on file for future permits or licenses. An affidavit must be filled out each year_Where a home owner or citizen is o taming a license or permit not relate o any business or commercial venture (i.e.a dog license or permit to bum Ieave,Ms etc.)said person is NOT required to co plete this affidavit The Office of Investigations would I&ff-tqi thank you in advance for your cooperation\and should you have any questions, please do not hesitate to give us a caIL The Department's address;telephone and fax number TIL Commonwealth of Massachusetts Dii az �t clf 7ndustdal Accidents QMQe of jaw�orims 600 Washington stl,=t BoAon=MA 02111 Tel,A f 17-727-4900 ed t 406 or 1-9 MA�WE Revised 4-24-07 Fax#617-727-7749 .Es3,gov1dia r Town of Barnstable Regulatory Services Fsxe roy� Richard V.Scali,Interim Director °-� Building Division RdRxcrA ILY : Tom Perry,Building Commissioner - �� i63. � 200 Main Street, Hyannis,MA 02601 www.tow•n.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION _ Please Print (DATE: [JOB:LOCATION. gi o/d --`` - nurnberl street village "HOMEOWNER": &%(&wey PIC)f` � / S I ��- name ' k; ` home phone# work phone# CURRENT MAILING ADDRESS: crty/town state zip code The current exemption for"homeowners"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 sL+aLl 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 reponsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance-with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pr, edures and requirements and he/she will comply with said procedures and requirements. •.,,Signature of Homeowner - Appi-oval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities*of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness-often results in serious problems,.particularly when the homeowner hires unlicensed persons. In this case;our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. z 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. �'ME=okti Town of Barnstable Regulatory Services ar�ss $ Richard V.Scali,Interim Director '���„A�► Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office; 508-862-4038 Fax: 508-790-6230 Property Owner Must Co . fete.and Sign This Section. f Us' A Builder as et of the subject ptopetty heteb7 authorize to act on my behA in all mattets telative to work authorized 7by ' wilding etmit X7d of Job) **Pool fenceshe responsibility of the a plicant. Pools are not to be fi . fore fence is installed and finalinspections areccepted. Signature of Own Signature of Applicant 'z Print Name Print Name Date gfil 58 en -116 - Y • / I/ti/� � it 0I� g 1 OU � e ��4 i 3 46 �al i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ' Application #Q61 � Health Division M' Date Issued ,t- Conservation'Division , Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project-Street Address Village'_ Owne- c _Address C_ 5 rZra. CCD- 'niTequest "l✓I i> > U,( -AE E,/tIl, R>J�kA Square feet Est floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay �- _ P_rL _ojeet Valuation-- DM cm Construction Type . Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family i Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 1 No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:'existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal shove Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn ❑ exist O thew, size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Othe': Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ' co � E Commercial ❑Yes ❑ No If yes, site plan review # ca1 s a a Current Use Proposed Use APPLICANT INFORMATION • t (BUILDER OR HOMEOWNER) Name s Telephone Nu erZA'?� �U�— 10 � ?i QAd_"dress License # �.A --Cyz.eQ ®-c.a- p 1 .5�5 �_ Home Improvement Contractor# 1 Worker's Compensation # ALL CONSTRU�57, `NE EBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO za,,)—DATE-Y .,,C ff T FOR OFFICIAL USE ONLY t APPLICATION# DATE ISSUED i MAP/PARCEL NO. ADDRESS VILLAGE OWNER t t DATE OF INSPECTION: D FOUNDATION t I; FRAME INSULATION' �. FIREPLACE y ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS,' ROUGH , - FINAL ,�FINAL BUILDING-' -_ c , t DATE CLOSED OUT s ASSOCIATION PLAN NO. The Commonwealth of hfassachusetta Department of-1 ndus&W Accidents 09we of1hvestigafions 600 Washington Street Boston; MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: BuRders/Contractors/Electricians/Plnmbers Applicant Information Please Print Le ' l Nam s ass/orga�zation/lndivitival); �'�.'�T. Adddr-ess:JeJrS— (City/State zij u-A An �P hone#: --. (� j O Are you an employer? Check the appropriate bar. / I.❑ I am a employer with 4. ❑ I am a general contractor and I Type of project(required?: - employees(full and/or part-tile);* have hired the sub-contractors 6. ❑New construction 2.D I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g Demolition working for me.in any capacity. employees and hake workers' [No�rorkers' comp, jn ,ce comp•insurance,$ 9• ❑Binding addition . required_] 5. ❑ We are a corporation and its I0.❑Electrical repairs or additions =I am a homeowner doing all work affic=have exercised their I L Phnnbin {� el£ [No workers' camp. right of exemption per MGL g repairs or additions insurance required]t c. 152, §1(4), and we have no 12•❑Roof repairs employees. [No workers' 13.❑ Other corrnp,Insurance requited.] *Any applicant that checks box#I must also f Il out the section below showing hies workers'compensation policy iafurmation t Hameownore who submit this affidavit iadicabag they are doing all work and then hire d canhaclmrs must sabaut a new affidavit indicating such $Conhactars that check this box mast a-r),rd an additional sheet showing the aeme of the employees If inc sub-contractive have employees,t1�c} must sub- °s and state whether or not those entities have provide their workers'camp,policy number, lam an employer that is providing workers'cotrepemation insurance for informaton my employees Below is the poFicy¢red job site Insurance Company Na=: Policy#or Self-ins.Liu# Expiration Date:- Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). FeaUre to secure coverage as required under Section 25A of MCrL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year M19Msonment, as yell as civil penalties in the form of a STOP WORK ORDER and a fine Of up to$250.00 a day against the violator. Be advised that a copy of tbis statement may be fmwardsd to the Dffice of Investigations of the DIA m_r for insune coverage verification. I d0 hereby c . ' under the pairu andPsaalU=ofperjwy the information provided above is true and correct S'Phone-#- [Contact use only. Do not write in this area, to be completed by city or town official or own: PermitUcense# uthority(circle one): BoArd of Health 2.Rnilding Department 3. Cify/T`own Clerk 4.Electrical Impectnr 5.Plumbing Inspector erson: Phone#: Town of Barnstable Regulatory Services Thomas F.Geiler,Director MASS. p,1659. Building Division TomTerry,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;_�A, !AlqCAI �4. aA JOB LOCATION: number s t village "HOMEOWNER":epN��N-_ name home phone# work phone# C—URRENT MAnJNGjADDRESS: (> 5 � C4_1A-e%+ city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period'shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner'.'assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that fie/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. 11 cij) r_—S ignature-of-Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person"(s)for hire to do such . work,that such Homeowner shall act as supervisor." " Many homeowners who use this exemption are unaware that they are assuming the rospons�bilities 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 unUcensed personas 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 • v oFTMEra,� Town of Barnstable " Regulatory Services 9 $ Thomas F.Geiler,Director i639• '�B Mai Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 wwwAown.b arnstab le.ma.us t Office: 508-862-4038 t� Y - Fax: 508-790-6230 x T NProperty Owner Mus t ,. Comp ete,and Sign'This Section If Us.in ]Builder 4f l as Owner of the subject property hereby authorize { to act on my behalf, in all matters relative to work/uthorized by this building pern it applicationr.for (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. QTORM&O WNERPERMISSION ;. . - ��� �� �, ���``' °� a �hA�� p e lr r +L V �� ,��" �� Parcel Detail Page 1 of 4 r Logged In As: Friday, March 23 Parcel . Detail . 2012 Parcel Lookup Parcel Info Parcel; Developer ID i190-115 I Lot,LOT 8 . -----__ __ Pri LOCatIOn 414 OLD STAGE ROAD120 Frontage , Sec ........ Sec Road ( Frontage ........................ Fire ........... Village.CENTERVILLE District C-O MM Town sewer exists at this Road_ - 1174 address lNo — - --- -- Index� -.__-.._.•� Interactive L-zk Map E �~ Owner Info Co-i owner POITRAs,CATHERINE ) (" Owner' Streetl 1805 FELLSWAY Street2 � city(MEDFORD � State�MA zip j02155 country Land Info Acres 0.34 C USe�Singlefam MDL-01 Zoning RC Nghbd 10105 Topography Level Road'Paved Utilities Public Water,Gas,Septic ( Location; Construction Info Building i of 1 Year 1965 Roof Gable/Hip I Ext Wood Shingle 1 Built Struct Wall Living - --- _:-- Roof --- - ACi-. Area�1272 CoveriAsph/F GIs/Cmp Type(None Int _ ...... _- Bed; . . Style�Ranch WalllDrywall I RoomSi3Bedrooms. .... Model Resid 1.ential IInt Bath IHardwood I �2 Full Floor Rooms' Heat Total � � II http://issgl2/intranet/propdata/ParcelDetail.aspx.ID—13195 3/23/2012 Town of Barnstable Regulatory Services �"E Thomas F.Geiler,Director Building Division snuvarnai Tom Perry,Building Commissioner � 200 Main Street,Hyannis, ,MA 0.2601 Office: 508-862-4038 Fax: 508-790-6230 September 2, 2011 Catherine Poitras/Occupant 414 Old Stage Rd. Centerville, Ma. 02632 RE: 414 Old Stage Rd., Centerville, Map: 190 Parcel: 115 Dear Ms. Poitras/Occupant: As you may recall, a permit was issued by this office for mold remediation in the basement. Now that the permit for mold remediation is complete,permits are needed for the construction in the basement. Building, electric, and plumbing permits are needed to bring the property into compliance. Thank you for your prompt attention in this matter. Please call this office with any questions. Respectfully, **a n J Local Inspector (508) 862 934 Ce�rlo� �I' sSA6 Gam.— � Q Q:zoning5 f17111 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 712E��� Map -/ Parcel k Application # �.03-t o-f r Health-Division "'Date Issued t0AI V� F Conservation Division r Application Fee 0 C) Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address / �� _ � �a _ Village C-e ry-rer v 1 f f Owner J!!A--1 '/�e,1x 1&-2- PC) I T'&AS Address c'� O 12 A Telephone �o �O & !v -7-0 Permit Request O mote t a- 77o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay �,'rcject Valuation 0 Construction Type �� ``L6t Size Grandfathered:. ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure _ Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq f X1 Number of Baths: Full: existing new Half: existing °` negz r� € _n Number of Bedrooms: existing _new i> Total Room Count (not including baths): existing new First Floor Room Count =' Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove:°❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) LL _ 3110 Name �e�a��f° �"� Telephone Number Address b"l- License# 3 114 .r/A.,,I Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS SULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �`f FOR OFFICIAL USE ONLY { _APPLICATION# I' t d 'r DATE ISSUED MAP/PARCEL NO. g ADDRESS VILLAGE OWNER-- DATE OF INSPECTION: ` _FOUNDATION FRAME 'INSULATION I FIREPLACE ELECTRICAL: ROUGH FINAL x PLUMBING: ROUGH R FINAL GAS: ROUGH - FINAL h V. _ DATE.CLOSED OUT +: _ ASSOCIATION PLAN NO. � { ' f :T The Co nrnonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I a , tit I',� ` 600 Washington Street f , \ i Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: 4 �.t Phone #: +� Are ou an employer? Check the appropriate box: z. Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7• ❑.Remodeling ship and have no employees . These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp, insurance. 9. 0 Building addition . [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work 'right of exemption per MGL 1 1,❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t. employees. [No workers' comp. insurance required.] 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. ' I Homeowners who submit this affidavit indicating they are doing all work and than hire outside contractors must submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet showingthe name of the u c _ s b- ontractors and their workers'com policy information. p p ey don. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information R Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: . Job Site Address: l L / Z40— City/State/Zip: Attach a copy of the orkers' compens aition policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c..152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that.a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert�u t pains and penalties of perjury that the information provided above is tr a and orrecL Si afore: Date: . Phone#: Official use only. Do not write in this area,to be completed by city or town offecial City or Town: Permit/License# Issuing use (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5, Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "..,every person in the service of another under any contract of hire, express or implied, oral or written." !' An employer is defined as"an individual, partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the Legal representatives of a deceased employer, or the receiver or trustee of an,.,individual,partnership, association or other 1,gal entity,employing employees. However the owner of a dwelling house having not more than three apartments d who 'resides therein, or the occupant of the dwelling house of another o employs persons to do maintenanc , construction or repair work on such dwelling house or on the grounds or building ,ppurtenant theieto shall not becau of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also s es that"every state or loca licensing agency shall withhold the issuance or renewal of a license or permit too erate a business or to co struct�buildings in the commonwealth for any applicant who has not produced acc-\trablevidence of co pliance with the insurance coverage required." Additionally, MGL chapter 152, §25C( "Neither the ommonwealth nor any of its political subdivisions shall enter into any contract for the performublic work til acceptable evidence of compliance with the insurance'requirements of this chapter have been d to the con acting authority." Applicants Please fill out the workers' compensation affidavit ompl ely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address s) d phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Lim e Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' mpensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affi it may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Als be ure to sign and date the affidavit The affidavit should be returned to the city or town that the application for th pe it or license is being requested, not the Department of Industrial Accidents. Should you have any questions re arding a law or if you are required to obtain a workers' compensation policy,please call the Department at the umber li ed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printe legibly. The D.ep ent has provided a space at the bottom of the affidavit for you to fill out in the event the Offi e of Investigations has o contact you regarding the applicant. Please be sure to fill in the permit/license number whi h will be used as a refer ce number. In addition, an applicant that must submit multiple permit/license applications r nrahy kiven year, need onl ubmit one affidavit indicating current policy information (if necessary) and under"Job Site Address"the applicant shout rite"all locations ins (city or town)."A copy of the affidavit that has been official�tm�stamped or marked by the city town may be provided to the applicant as proofthat a valid affidavit is on file for fure permits or licenses. A new davit must be filled out each year. Where a home owner or citizen is obtaining a 1.1 nse or permit not related to any bus ess or commercial venture (i.e. a dog Iicense or permit to bum leaves etc.)said pson is NOT required to complete this davit. The Office of Investigations would like to thank you ' advance for your cooperation and should',,you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-8,77-MASSAFE Fax # 617-727-7749 Revised 5-26-OS www.m..ass..gov/dia ' Client#:23059 OCEAINCI ACORD. CERTIFICATE OF LIABILITY INSURANCE D7/7/1M�/DD/YWY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Rogers&Gray Ins. Plymouth PHONE 508 398-7980 341 Court StreetE-MAIL Exc: Alc,No ADDRESS: P.O.Box 3700 PRODUCER CUSTOMER ID#: Plymouth,MA 02361-3700 INSURER(S)AFFORDING COVERAGE NAIC# INSURED Arbella Protection Co 17000 Oceanside Inc INSURER A: 217 Thornton Drive . INSURER B:Insurance Company of the State Hyannis,MA 02601-8105 INSURERC: INSURER D: 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. NSR TYPE OF INSURANCE DDL BR POLICY EFF POLICY EXP LIMITS LTR NSR D POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY 8500029947 01/01/2011 01/0112012 EACH OCCURRENCE $1 000 000 A AGE To RENTEIT- X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100,000 CLAIMS-MADE I Al OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION WC007442785 01/01/2011 01/0112012 X WCSTATU- OTH- PR AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N E.L.'EACHACCIDENT s500,000 OFFICER/MEMBER EXCLUDED' �N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE s500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) E}.I CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 387 Main St. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of I The ACORD name and logo are registered marks of ACORD #S68727/M62167 Sip oFtHE MENSTABM MAW. ,.� Town of Barnstable ATED MA'S A Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize. to act on my behalf, in all matters relative to work authorized by this building permit application for: /Noo "e- (Address of Job) tee . Signature of Owner a Date ��rtI�EP�1 0E ?(DjtPA-S Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.OUtlook\DDV87AAZ\EXPRESS.doc Revised 072110 Jt Office o.�Consumer A airs s��ess egu ahon: HOME IMPROVEMENT CONTRACTOR o Registration. ,A00121 Expiration: 112 Privat& Corporatio f b 1 m e A O , C'�Q . 0 NSIDE, IN N ' Y'11 �.: _ = o I Richard Clark CD o 0 217 Thornton Dr Hyannis; MA 02601 - Und'erseer�tary o I CD i• � Massachusetts - Department of Puhlic:Safetj Bo.trd:.pf.Building Regulations and Standards - Construction Supervisor License. License: CS 43 Restricted to: 00 Y RICHARD W CLARK 65 ACRE HILL RD - BARNSTABLE, MA'02630 ti ��- ---o- Expiration: 1/21/2012 "Commissioner Tr#: 11887 e ,r l , n 0 M�-� ,�*yCE 50. 33 "i3al 8 fN�P14I�' 4.aI Pr UP 'pecmiall's- i MA 4 ,56 M,T.,M� film �, ► 414 Old Stage Rd. , Cent 7/18/2011 ,PJ e� Y 414 Old Stage Rd. , Cent 7/18/2011 r I 2 � " I M 414 Old Stage Rd . , Cent 7/18/2011 ,X .f fin`._• g .. ; , As Old St2np, Rd - C,P.n t 7/18/2nil -'ate! '�+�.n� � �,���•� �'�� ,.S_ `� ��..r.. �'� '�� �.+� �� .:.�� � - �I �.�w-. .n. ,� • cJ„ + 4 1 t ,� y r � • �J w 1 � Yq a �. .a YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1s` FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: 10'05 Fill in please: � �/ r ,z .< APPLICANT'S YOUR NAME: VVCI59 ✓ S S(3009N AGv BUSINESS YOUR HOME ADDRESS: 01-a S7fiG&_ Rd fly EN ' TELEPHONE # Home Telephone Number TI e 15al NAME OF NEW BUSINESS Vq Al TYPE OF BUSINESS 63CAefw L COdV7Rl9�l�� LA IS THIS A HOME OCCUPATION?--,------- YES > NO PA 40 Have you been given approval from n—Y-E-S----- NO-�� I qD ADDRES BUSINESS�.z = - - 3 MAP/PARCEL NUMBER SyV -When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. -(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING C ISS NER'S OFFICE This indiv ual h s era-infne any permit requirements that pertain to this type of business. Authorized gnature COMMENTS: v - C� Cam, i<VA__3 S�2 4-- 2. BOARD OF HEALTH This individual ha a informed f rmit re uirerrl" that pertain to this type of business. AA J Authorized Sign� r�J'*" COMMENTS:R�� w 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual hagl re n inform f�the lice o r ents that pertain to this type of business. Authorized Signature" COMMENTS: r— - Town of Barnstable Regulatory Services oF� {. Thomas F.Geiler,Director Building DivisionNAM HnRtasi`asre. � ' Tom Perry,Building Commissioner 200 Main Street, Hyannis;MA 02601 EDMA� www.town.barnstable.ma.us Office: 508-862-4038 �F : 08-790-6230 Approvead. Fee: Permit#: HOME OCCUPATION REGISTRATION Date Name UIAKY;2Z/✓ FALcr7-A` Phone# '/ Will 6,�ZLljt'Address: ��"T � �d�� �: Name of Business: Type of Business• 02N&R A L C-ntx -,R igc-k 12 Map/Lot L 2 0 l INTENT-. It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter; odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home . Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup of to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed tires,par ed on the same lot containing the Customary Home Occupation. 0 No sign hall be dis layed indicating the Customary Home Occupation. • If the Gas mary ccupation is listed or advertised as a business,the street address shall not be included. • No s e employed in the Customary,Home Occupation who is not a permanent resident of the I,the rsign ,have a and agree with the above restrictions for my home occupation I am registering. _ plicant: Date: Homeo . o Rev.5130103 t y �Ru:. Town of Barnstable Regulatory Services tia Thomas F.Geiler,Director ; Building Division -- - anxxsTas�e. v Mn� g Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 F t: 508-790-6230 Approved. Fee: Permit#: a' HOME OCCUPATION REGISTRATION Date: Name: k/d50 of FRp_e nj Phone#: 5a 16`7 Address: 0tJ STAc1(2 1CG� Village: &UJi Name of Business: In Type of Business: 60i'U(PR A L C otTt R Aclo 12 Map/Lot: 1 L 1N7ITNT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,'in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home . Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup of to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed tires,par ed on the same lot containing the Customary Home Occupation. • No sign hall be dis layed indicating the Customary Home Occupation. • If the Cus nary H ccupation is listed or advertised as a business,the street address shall not be included. % • No -s e employed in the Customary Home Occupation who is not a permanent resident of the e ' 'um I,the rsign ,have ea and agree with the above restrictions for my home occupation I am registering.;. plicant: Date: Homeoc. o Rev.5/30/03 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A`business certificate ONLY REGISTERS YOUR NAME in town (whichyou must do by,'M.G.L. - it does not give you permission to operate.) -Business Certificates are avalable.:at ttie Town Clerk's Office, 15t FL., 367 Mama` Street, Hyannis, MA 02601 (Town Hall) DATE: Fill in please: f APPLICANT'S YOUR NAME: WcfejoAlF s - BUSINESS YOUR HOME ADDRESS: OLd S /y Cc 0TOR VU La MA 0 9,6-116Z moon TELEPHONE # Home Telephone Number-. Ti al NAME OF NEW BUSINESS TYPE OF BUSINESS C�AL'Ot°•w L Cnw'fR19 KS/4,9 549M6 IS THIS A HOME OCCUPATION?---- YES N.O. �>4IA" Have you been given approval from ht0'y gD S shy ADDRE BUSINESS MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You.MUST GO TO 200 Main St.—(corner of Yarmouth Rd.. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING C ISS NER'S OFFICE This indiv ual has er4 of a any permit requirements that pertain to this type of business. Authorized gngture"* , COMMENTS: I — d Udam- 2. BOARD OF HEALTH This individual ha a informed f rmit re uirert� that pertain to this type of business. 14 Authorized Sign r `" COMMENTS: �-� Gt { 3. CONSUMER AFFAIRS(LICENSING AUTHORITY r This individual,h`` n inform Pthe lice r re ' ents that pertain to this type of business. Authorized Signature** 0, COMMENTS:: :t �FIHE Tn_ Town of Barnstable &UMSrABLE, ; Regulatory Services 039. 'OtEDMA'�61 Thomas F. Geiler,Director Building Division Tom Perry- Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Fitzgerald,John Tuesday,February, 17, 2004 _ r Request for Court Report Re: Aldo J. Klazer, 414 Old Stage Rd., Zoning Violation 1. 11/12/03, Complaint from neighbor reguarding beauty parlor being operated out of home. Mr. Klazer was told to cease anf desist on this date. 2. 11/26/03 complaint same as above from Marie S. Devlin. 12/03/03 stopped @ above residence it appeared no one was home. 3 01/09/04 Sent letter to Aldo Klazer to cease and desist Beauty Parlor operation @ 414 Old Stage Rd. Received no reply to letter. 4 01/28/04 Began to issue notice of violations. 5 02/09/04 upon Inspection of above address, Beauty Parlor had been removed. Jack Fitzgerald I- Q Local Inspector 1 Town of Barnstable 'I"ET .°� Regulatory Services Thomas F.Geiler,Director ` B" w. MAS3 Building Division 9 �q '0�en 39. p Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 ffice: 508-862-403 8 Fax: 508-790-6230 COMPLAINV NOUIRY•REPORT Date: ® ®� �Rec'd by: Amplaint Name: Map/Parcel Acation Address: l` fceh4 t f 16> jriginator Name: Street. Village: State: Zip: p: Telephone: '-omplaint Description: t,+.-h h t 1.�, L ' FOR OFFICE USE ONLY :nspector's Action/Comments Date: l 13 0 s Inspector- FA 4 S additional Info.Attached In 0 11 111` Town of Barnstable °FtME,�ti Regulatory Services r Thomas F.Geiler,Director 9B B`E,�q Building Division 39. 16 Tom Perry Building Commissioner :'1 10H 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINUINQUIRY•REPORT Date: tL;zL, G Rec'd by: Complaint Name: LA'I V-" Map/Parcel U ,i ,,,� Location Address: 'f14 OM 3kn Ce (, Rf� Originator Name: %A 2.5 Street: Village: C�-A-�e�- V.-t State: H Zip: b-a, Z Telephone: � �� 147-7- b H-6 CD ComplaintDescription: T r�e,. ( a �2 vl avtG� 1/��. 1 s 1�✓ � E c4e A 90(mil re--Ae oc-p-- of T Lf 014 aA +('-e,r- TT 1 i mVI ���;yes �� �>� �,s �;�� �� +�C �Lre �e �u�� s JrL 4� . FOR OFFICE USE ONLY t I Inspector's Action/Comments Date: 2 ^ 3 U ?, Inspector:_—1, F aqQ y-Q i r-1 , 12^ 3— U 3 N)b cin Q to e, S -� \r� 11 - 1 v 3 c, l Additional Info.Attached -a Town of Barnstable Regulatory Services 'Thomas F.Geiler,Director Building Division sAxxsTAs Tom Perry,Building Commissioner MASS. 039• � 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Notice of Zoning Ordinances Violation(s) and Order to Cease, Desist and Abate: Aldo J Mazer.and all persons having notice of this order. As owner/occupant of the premises/structure located at 414 Old Stage Rd.Map 190 Parcel 115 you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,January 9,2004 to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinance Home Occupation Section 4-1.4 2. COMMENCE within seven(7)days,action to abate this violation. SUMMARY OF ACTION TO ABATE: Remove beauty parlor from premices And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable,a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). If,at the expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires will betaken. By order, Javk Fitzgerald Local Inspector c Q/FORMS/viozonel Town of Barnstable yam.,°Ft"E' Regulatory Services Thomas F.Geiler,Director U SS, ` Building Division 9 MASS. �q 16 9. �0 At�o M Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 )ffice: 508-862-4038 Fax: 508-790-6230 COMPLAINUINQUIRY REPORT Date: 9 O Rec'd by: Complaint Name: �- c� C\ ✓t 2 Y Map/Parcel Location Address KA Originator Name: Street: Village: State: Zip: Telephone: Complaint Description: FOR OFFICE USE ONLY , [nspector's Action/Comments Date: 2— 9/ — o-q Inspector: 14aQavQ 'VAS C_ oY (2:__ 'F 1, lv a S, �o_.-e IJ additional Info.Attached Ml ADDRESS DF P TQWkOF�:� ,A 4 E . CI COD BARNSTABLE. tHE5 % ot. L'� OFFENSE.,� 'SASS 0: e4 .1,f-q. v. ;L&Z i IME-AW DATEOF VIOLATION LRCA11ON,qF VIOLATION Y Jf "Ar. ]�NOTICE;QF,' I t'n-4�n A, BADGE N( NAT E,OF, C 9G'PERS ENFO RCING FICIN T ........... ....... EREBY AG ElPT'0F0'CITATION o, —A NONCRIMINALTINETOR-T IS- �."ORDINANC� Date mailed -0-T-10" ION OF.jHIS-MAT.,TER!i EITHER P Wopm 2 YOU_fl'iV�E'THE j-V.1 OPERATE AS .'FO.L�LO,WING,ALTERNATIVES".WITH�REGA50JO�IDISPOSIT DISPOSITION WIT NO RESULTING-CRIMINAL RECORD. bove fine,,;eith&_.by,ap .60 P.Pj.',jV6Q @y 0 ay earing.in_�p _ . . L� �.r-, -. q� 016"t Clerk P:-f 1,; ``. before:The'Barhslable Clerk;230,South;Street,Hyar�ms'MA 02601{o�by,m'alhng a cheek money order ff0.b9ta1,note-Id 6qrhsta1 .g T T4 FIRST I BARNSTABLE DIVISION COURT COMPOUND MAIN STREET;„BARNSIABLE MA 02630 q enclose, co -0, this L2,1 'on-im,in"if Hear s' --f he determined'at,the'beanow ��fbrl e earing,pr-to Fay�on i y om is d t-y'b A11111 11 Taint e sue against y,; Q I HEREBY ELECT the first option above confess to the offense charged and enclose payment m the amaunt7of$ , --]! .s !�JZ�COYE.CITYerr Y,S Axr:k REGISTRATION M ° -Z;-1, YIMB TARS' W 4 VIOL ' LOCA ON'OF-VIOLATION TIME AND OATE;OF 'NOTIC A 7 SIG V ,MY< Lu OF TOWN�`Z-'-;THER1 EBY.-ACKWWL bd 17� Unable to obtain, :S signature of-o en 8 r. .I-r a. ORDINANCE S-0, T'HE'�16N--C�RIMINAL-.F.INE,FOR�THI - — ..11. "'T Be a ed,. dLkik AliJ6 OPTION Tm 66`44'HE�F INWTIVES DISPOSITION I)_FTHIS MATTER If:OR 0 TEAS XFINAL - y D TO Lu DISPOSITION WITH 10 NO RESULTING N CRIMINAL ddff 8:30;gg pthroubh�Fhddy,legai d'�a e�cepte REGULATION Monde I hold Me BIB etw.,I. -24 money order or postal Obtelo-Bar6stabli C14rk,-- Box .30;t wn1s,,.M_02 01,or In%_a_,c'heLc�, nsthle _-�y mai (bl$,Oy�0 -THIS NOTICE:DAYS.OFJHLE.PATE.017 'M 02601 Oj� H !.[ _? ;,W y_n I --do:soiby.'r�6k!ng-wdhen.r6qU6st�t6 DISTRICTc ARTTMENT,_1FIRST -honcrimina prbdeieding',-,buqn- OURTiDEP '9241111gu desjreto�,contest'.th' mattvih-a you _7 6 Wdn--7�210 NdficHinid-41�OqqA#`� is' LE,VA 0263 , ncloie4copy of tm� T UND�,MAIWSTREET, BARNS AE ST DIVISION,COURT COMPOUND 01 n-j6r' hewing— at!the:heafi.ng -(3)!Wyou4a!I-Ioip AD,ap.06qr.J6r.t0s�edqin )r top iwtheIbove,bhnie,oi� iln1f�Oqys,�ohfj6u _6�.:any fine determined fg1l. — kofnplain due�,Crlmjna j miyte1isued4dainstioitl!t �0 -A�sy,E�ECT--the�first,.-option above 7 offense�EIIHE ,,confess.to:Ji��Ii�'oi In the amount of Signature, A,""A C_T OFFENSES ON.( NAMa F OFFE DER". ' �BiAR'• � A .� POD OF OFFEND R' y ' r f if- TOWN OF CITY.S ATE ZIP CODE r - - BARNSTABLE . Cr t. , MVIMB REGISTItATION�NUMBER �F�HE.r _ y x`,-' P � - OFFENSES r - ° •lil ,.I PARNSIABLE 9A PASS g F ` f �• t - J.-•-, y p" `0 r"s r - LOCATION:OF VIOLATION. LLI '- M1 r: TIM AN DATE OF VIOLA N r - ,r NOTICE OF , `_ y F.M)oN ° ?o D x Q i ,'SI ATUR OF E IN ERSON .` _ ,�• ENFO .D PT y. BADGE.NO _U10L•ATION - o_ 'OF TQWN rCL I HEREBY ACKNOWLEDGE RECEIPT OF CITATION-X ❑ Unable o obtain signature of offender 1 ~ ORDINANCE -THE NONCRIMINAL FINHOR THIS OFFENSE IS ""Ito,®, W Date'ma:I d w . OR YOU HAVE THE.FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER EITHER_OPTION'(1)OR OPTION(2)WILL DPERATEAS A FINAL w DISPOSITION'WITN'NO RESULTING CRIMINAL RECORD. I -;REGULATION h You may eIe_ct'to pay the above lime;either-by appeanng;in person,between 8:30 A.M.and 4.00 P.M:,Monday through•Friday,legal'hohdays excepted i ,,'LJ before: QL The Barnstable;Clerk,230'South Street,Hyannis,MA 02601 or by mailing a check,money orde'ryor postal notelto Barnstable Clerk P oQ.Bo><-2430 Hyannis MA 02601,:VVITHIN TWENTY-0NE(21)DAYS OF TIiE_DATE-OF THIS NOTICE. _ ' (2)II,.you desire to contest this matter in•a noncriminal proceeding,you may do'so by,making,written request to DISTRICT COURT;DEPARTMENI,FlRST BARNSTABLE DIVISION,COURT`COMPOUND,MAIN STREET,BARNSTAB LE,'MA 02630 Attn:21D Noncriminal Hearings and enclose a copy of This citation.Iora hearing. . ' .- (3)rll you fall to pay the above offense or to request a:heanng within_21 days-or it you,(ail to appearlor the heanngror to payany fine determined At the tieaang to'be due,criminal complaint may be,issued against you.. 'r F ❑ I HEREBY ELECT the first opton above contess+to the offense charged and enclose payment m the amount of$ ( j Slgnat trey 1 i _y�G� F +. 1�e�N6M 0 0�E,UEp� �B•IA�Rt [ rTQWN flF r 'ADDR 5' FfENDER r" 1 �. v DITY i TE .IIR CODE ,- e * ' ,..,.w r -� � BARNSTABLE : `( �. x r f ti tHE ipw },aft J r•.' f MV/MB REGISTR'ATION NUMBER' r• NS - 1 O.�. Q_., n Z': u !� ANO pA7E�tfF VtOLA710 vi -WCATION OF;VIOLATION - r �.. .LuA.•. NOTICE OF t a: Cf .gIG ATU b: NFAH P RSON�•r;.,Z ` ENFO$Gy - BADGENO �. V10LATIU LU f • "o: OF TOWN p EREBY,ACKNOW EDGE RECEIPT OF ITATION X ¢ 'Unable to obtaln>signature of offender ~ ` f ORDINANCE THE NONCRIMINAL FINE FOR THIS�OFFENSE.IS S h ; r Date marled i f r- , -r w �. OR ?y,OU HAVE:THE FOLLOWING ACT:ERNATIVES WITH REGAF)O TO DISPOSITION OF THIS MATTER EITHER OPTION(1)OR OPTION(2)WILL OPERATE A, A FINAL I..i,!.r`S, DISPOSITIO.NWITHNORESULTINGGRId. MINAL�REGORD '�'yf_ � ;.'+ r.` w r N'a �R'EGULATION: - earn In erson between 830 AM.',and 4.00 P.M. Mondaythrough.Friday legatholiPaysBxc ptp, r(11)You`may eleot toipaythe atldvellne,'eilher by.:app g p_ 00 Tlie'Barnstaoie' Jerk-236 South,Slreet Hyannis;-MA )260i,'-or by mailing a cheek;:;money older or postal note[0 6arnstable Clerk, 7 �.,. Hyanms;'MA 02601,;yVITHIN TWENTY-0NE(2,I)DAYS•OF,THE DATE OF THIS'NOTICE. �• ' (2)II you desire to;contest'this matter in a noncriminal proceedmg,,you may do,so by making written request to DISTRICT CQURT DEPARTMENT FIRST _- •BARN$TABL'E DIVISION COURT'COMPOUND MAIN.S7REET BARNSTABLE, MA 02630 Atln:-21D-Noncnmmaf F(eanngs antl encloses copy'ofahls citation for a hearing. " ;(3)I(-you tail to pay above offense or to request a hearing within 21 days or ilyou lad to appear torthe hearing or to pay Ain ylir a determined at the'hearing i to be due,criminal coin laintma be issued a amstVOL. ❑ I-HEREBY ELECT the first option above,confess to•the offenO.charged and enclose'payment m the amount of$ l ' \ �' V Signature ~r r ' l yq r NAME OFFEN i� 'i' ;�� 'r• , t i.. e. +-Y- _ RA.`.R r am' J tL Y l r �- TOWN OF ADDRE S O OF ENDER - [' i � , t r BARNSTABLE c`TM sT TE.ZIP CODE IKE tD�� Y MVIMB REGISTRATION NUMBER u�Na indl r. "SE i r- Uj t99- QED MPS ' LOCAT,ION OF VIOLATI N I _ 'e W 1 TIME, NI DATE OF'YIOLATION 20 A-- -A, I "• NOTICE OF ' .( fv:raj oN .` a SIGN TUPE F 6(iiFOR G RSON _ i ENFOR6 T( BADGE NO w VI'OLATIO'NCD ` OF TOWN P REBY AD O t LEDGE RECEIPT+OF CITATION X w v a ` 'Unable to"obtain si nature of'bffendet': FIN ~ ' ORDINANCE 8I. THE NONCRIMINAL E FOR THIS OFFENSE .Date mailed ` t { CUj L GOU•HAVE THE;FOLLOWING;ALTERNATI,VES-WITH REGARD JO;DISPOSITION OF THIS MATTER EITHER OPTION{t)OR.OPJION(2)WILL OPERATE AS A FINAL w ; DISPOSITION WITH NO RESULTING CRIMINAL RECORD . REGULATION y�.may sleet to pa the above line either tiyaappearn'ln peraon betw- 830:AM and;4:00 PM 1_M1 ndagahrough Fnday legal'holida s excepted; w 1 1.. y gg yy . before The:Barnstable Clerk 230 South Street,Hyannis MA'02601 or by=mai ing•a checK money order or postal note to BarnsCaole.Clerk P 0;Box 2430' Irk Hyannis MA 026b1 WITHIN TWENTY ONE(21y DAYS OF THE DATE OF,THIS NOJIGE s •• �•• -;,- :f ` a-} s r: 1f 'oti esihe to corite'st lhis.matter;ip a rbricrimmal,proceedmg you'ma do so b.¢making,written request tQ pIST,RI¢T COURT';DEPA'8TMENTI FIfRST�; �2). y 41 ..- y A'RNSTABCE,DIVISION-GOURACOMPOUND'MAIN STREET BARNSTABLE f�A 02630 IAt(n 21D Noncriminal He'anngs and enclose�a copy oLthl's �cdahon for a heari� ^ - ., r (3)•11 you lalf to.,pay the,ab0a offense of io request a heanng wlthm}2i flays of d you„fatl to appear for(he heannt0 to pay any b e determlped at{he to be due crlmmal com IainNma be.Issued a ainst ou Cr' ;',r - z.�� "'7❑ 4+HEREBY ELECT the ilrstfoptrpn„above contess�to the offense g„h�rged and enclose payment In the amounfi of S ' f f '} e��'v t f .J; I UU - A �4.. �a+�li� r� �/` � - r•` � t;'.t-;4 �f. ��. i` \ . I ter. Mkt �-' C�,�t-'tl 4�!•a Z 'v r. '1s t•fi_+'.::. �'t `"+.'3' sr -";- - -�,,r1� Sighatureb;t-r'tf �iea°�c' ' :NAME F OFFEND R. RA' R TOWN.OF ADD SS OF-OFFENDER '- J BARNSII ADLE CITY, T TE Z_IP CODE - - _ S - T" +' 1} ! 6. -�{-IMEI - - _ r MV/MB REGISTRATION NUMBER -. L OFFENSE W..i.. 1 p'r `': 'r•. 4TIMA . ATE OF VIOLATI N LOC TIONO VIOLATION _ •w: NOTICE b:F 10. U�I . ' t ON SI• -0F E _ R I GI DE y "BADGE NO r N is -VIOLATION - •OF TOWN—, � '. .. ',I ..,. •. .. _ :• �� - - � ,-;- � , I` I` REBY�ACKNO LEDGE'RECEIPT-OF CITATION X ` a :. Unable to obtain si nature of offender '' ` ORDINANCE g THE NONCRIMINAL•FINE FOR THIS OFFENSE�IS S:/ I� w f. Date mailed c] _ .7 w rr OR YOU HAVE THE FOLLOWING-AL TERNATIVES WITH REGARD TO DISPOSITION OF TF(IS MATTER-EITHER OPTION{1)OR OPTION!(2),WILL OPERATE AS A:FINAL �'• I, DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w REGULATION Lu:. (1)You may elecPto,pay the above line,either by appearing in person.between 8:30 A-M.and 4.00 P:M.,Monday through Friday,legal holidays excepied ,.w - _ before:The Bemstable Clerk,230 South Street,Hyannis„MA 02601;or by mailing a check,money order or postal note to Barnstable Clerk,P: Box2430 � - Hyannis,MA 02601,WITHIN TWENTY-ONE(21)-DAYS ORTHE DATE-OF•THIS NOTICE. a a . (2)1f you desire tacontest this m8tter_in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT;FIRST \ I c BARNSTABLE DIVISION,COURT,COMPOUND,MAIN STREET;BARNSTABLE, MA 02630;.Attn '21D.Noncriminal Hearings and enclose a,copy of.this \ ( citation for a,hearing:. I. (3)IFyoulail to pay the"above'offense of to request a hearing within 21 days or i(you lad to appear forthe hearing or to'pay any tine.determmed.at the hearing to be due criminal com lams ma be issued against ou'' '❑ l HEREBY ELECT the first option above confess todhe offense charged and enclose,payment m"the amount of$ Signature_ air OFFNDE } , y �y,, � r tK � s1 F TOWN OF ADDR S F FENDER ' , BARNSTABLE 61T ATE ZIP CODE Y } 4 p z t r SIR r_ . f r .ic - t F+\ ~ \ x - 44r• + jMVIMB REGISTRAT ION NWBER `;s..'� i. l.r�P� ,1'� i •. .q. 1 } r^ �- L 7 � ! f....L .r y '. t r i _ ` F r r r. W:. Ti 'r � ir. �Y��i.Y'1Ci �.saki�'r�ti �• v'" .d U� Gf�. � r k R 4 � LO VIOlAT104 TME ND ITICE OF f6mrIAM roN ( Q. BADGE twos 0 S REOF 1 PERSON _ /' .�y t' i� d• ,. c ,I >. T •s- �.cn )VIOLATIONti k 7�` 1, r .'r E , a; < ,�_?�s, t nr� �z pro Y. �O,F�TOWN( . ''XEREBY ACKNO LEDGEECETOF CITAION z � 'MATT ORDINANCE Unable tD dbta n stgna �e of otfelider t , T,HE NONCRIMINAL FINE FOmail OFFENSE;fIS - Date rnalled ;yOU HAVE^THE,_FI L'LOWING ALTERNATIVES WITH REGARD TO DISPOSITION�OF THIS MATTER EITHER OPTION(1)OH OPTION(2)WILL OPERATE A�A FINALt 1 0.DISPOSITION WITH NI]yR-C'OL,TING:CRIMINAL_RECORD s+ REGULATION I t to a ahe>`above hne;'elther,b appearing m pePson betweeri$30 kM;andsgz00 P<M_ Monday'lhrough`Fnday legal holidays excepted ra: m . _xYhe BarostaglerClefk,� 30;Sbulh Sif@et Hyann�s,:'MA 0260,1*or by m`.ailing a cheek,;money orde�or postalsnbte tO rPjox2;MA 02601;WITHIN TWENTY-0NE.(21)DAYSlOF THE DATE OF THIS NOTICE• = ., L' :.re to coriteshihis:matter in a'doncrlmlhahproceeding;:.you may-:doao by,makiq jvritten request Io,DISTRICT GOURTDEPARTMENT,FIRST rI(ryou'des BARNSTABLE DIVISION COURT COMPOUND MAIN STREET BARNSTABLE MA 020 A(in 21DrNoncnminal Hearings and enciose�a copy of this Ar>yrl r= cl(ahonior-a heann9 r*•>,r r�-�s II c (3)I{lyou,fall?to pay the above (eh es orlto4request a hearing wrthln 2.1Tdays or d;you+lad to appear for the hearmg W pay any brie determmed at the hearing k {� s n r z r to be due crlminal com lamt ma;tie Issued a amst ou `-t 1 € ti;( 's - c-Tn tih-.,^ --+ Y ,..t'P` c ,•jam \ r :toyr ..s;, �' n f. t' a t x 1 r r shN. n1 '! `:❑ I HEREBY ELECTtthe Irs option above,confess to,the offense charged and enclose.payment m the amount DI S s! '71 .,i .�wt 'a4. .f R , , 1 �r3 '^�tT: ;� :-YSlgnature: , ,:r �, •, t f, „w ,. c✓,:, Town of Barnstable £li n Y a, ,r n a S IAB E PpF'THE'°wti Regulatory Services a Thomas F.Geiler,Director H" M 'MASS. ` Building Division y A35 0q 039. p�0 °rFo Mpi Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 V, rn Office: 508-862-4038 Fax: 508-790-6230 COMPLAINTANQUIRY REPORT Date: O 5 0 .2� Rec'd by: Complaint Name: C�itQ 'Q Map/Parcel Location Address:' d.G 5-r 0.263.2 Originator Name: �X G, Street: Village: State: MS,S Zip: 0 '2) (S O L Telephone: Complaint Description: S m 10 U 1z ce 5L Q Qzn 0 t& ka1 uj a- al f 5 am To IfzR FOR OFFICE USE ONLY 4. Inspector's Action/Comments Date: Inspector: Additional Info.Attached Q:forms:complaint / 00 �44 o� �7 ' �+a ,• r� n f �\6�s Of O st oof IN W . f �:` ��� Assessor's map and lot number .......................... ........,..... SEPTIC SYSTEM MUST �oF?HE rep Sewage Permit number .29c.-....>/. ............................... . INSTALLED IN COMPUA -n� r /���9�!ITH TITLE 5q t 5FI1�NlY�I�Y1�7�dT6�iA� Lr9,��� B" MAO& House number ....... .. '` ` A8-9 .r- dp t639. \009 TOWN, REGULATIONS B mix Ar t TOWN OF . BARNSTABLE BUILDING I SPECTOR APPLICATION 'FOR PERMIT TO .....................�� �X,d � TYPE OF.CONSTRUCTION r ...... ........................19........ _t�_ l TO THE INSPECTOR OF BUILDINGS: (: The undersigned hereby applies for a permit according to the.following -information, Location ... ........... ......... .....ri...: .. .`.::., .........::.......:. .. ... ...... ....................... . ............. ProposedUse .... ............ ............ ..... ............................. ...: ........... .......................... Zoning District ..../.`...f.. .................................................... Fire District .. .......... ..................... Name of Owner !!!.!f.'... !'P tP!. ..�'i�('!J.�..`... Address .. �`� .aq.`.... J`` '.... ��......................... ... . ..... ..... Name of Builder"...... Cape Cod Home lmprov.Specialists,InG .........'........ ....... ................................ "We Dolt All Name of Architect ... ..... ............. .................... 25 byanough Rd. ,Rt: 28 Hyannis;Ma. ""' "" Phone 775-2815'�.' Number of Rooms ........ ...............:............ Exterior ... � 'j I G .......................... ........ Roofing 5 ........ mnc=-(� ... ................... WD - Interior' T /ts FloorsP� F /7 w r } ........................ ....Plumbing ...� E ..� Heating ............................................ ;.. ................................................ Fireplace .................U.. �.................................. ..... ........Approximate..Cost ...... . Definitive Plan Approved by Planning Board. ___----------------_-----------19-------- Area ... `I.., .. �............. and Diagram of Lot and Building with Dimensions Fee ..................... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Y_ � 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 ... ... FLYNN, JANE PATRI E 23317 DDIT 10, No ................. Permit for ... ............................... Single Family. elling Single Location 414 Old Stage Road Centerville ..................................................................... Owner ... Jane Patrice Flynn.................................... ................... Type'of Construction Frame .......................................... ................................................................................ Plot ............................. Lot ................... .......... February 17 82 Permit Granted ................................. .....19 Date of Inspection ...................... .19 < Date Completed ....... .....27.. ............. ....... 9 C f 4- C N. 7- ^yt 'Y�. ...♦ftS-. ..},;,. �fJ-.; '..,. r. ,�ryaj� n�'.b +'y ..y• � x 1P :•:�{" .(:. r'C���y,`,4.f+ �S. .,� ,•'L_ F.7, ;:'.. - M:�. � ..!k'..:: .:•- .f ��:'x '�L y..� � _JMytk. � P...`jib : } �'.:w'p art y��?. �i a,r': a1) �`! +}f'� 4 �� �`• . y d�.V„ �nxr?�•��P vl,;?.;` ir,r I�� > �'.`.�S fi�a _-.� y f4 . ,J' ` :ve. .: 1T ,_ .. - .,.... ,. . .. a r: �: ,�/. �,i�:fat. .•iCr,s�1�._�.. j S 775 IS 5 "_ _. y� __ a., r. .: o n S7� Fv.�� f �tr _.. 1 1 �ao i/}; `Sir la k41 A� 1 /o.st•' s ��,•'s.��'lVn�' to (�,,,s«�fc wY.ytF) S Ql)t�u CT`' LNcW w ,�_LOT- tdOd*W a f----------- ' —�1 jbnt f bGd.�'c1+1 ' -• '1-n l.,i,. .t .. _ Ciafd J , s� _.. _ - Q>.oc¢..`•+�ML►�s�� ((t. ��, y�y �� , Q. ,�e�� r - i�1ri' tae..+t7u�- ��.�Aw� G„ 5����!'}'t' �+ /X y - � lP�:E.S�� �La-......{.��_�1.•?�.Z�l�-iiE_:.7L !r"^'�.�.'� `� /�irf .3 .�J�vi twY.. l x fili«aC axe�/oor5 k� y•'Trs,� �-- � p , t1r+_..�s�!P�fi*L�A t�J:L _. � �+.�.�.•�-.,,...a..._� Y�.�2.T f_r lb.�R�-�i�'e_ { r � � r�',p��.p„ � � Y.,,.� , '.♦ -.mil L�-�/�L`S!x�Bl�_l�/�7 j►� �te.±c_.._ .... -._ i.1 1_... � � [ 1 M1 � . �Y I �tiJ<111.1 ttOA� G rlAyrs 31�:ig As /;x t�irr •,Owe _��4t_.rcl�o��� ��•c1Y�tf.r f Ad4 ..... fit, ._ J