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Town of Barnstable *hermit b t Expires 6 months from issue date Regulatory Services Fee Thomas F.Geiler,Director S .p ��+ Building Division V r ,CBO, Building Commissioner t_ NOV Street,Hy A°Hyannis,M02601 + l 5 Z006 www.town.barmtable.ma.us Dffice: 508-862�403- \1 CJp Fax: 508-790-6230 EXPRE ob VU.&PPLICATION - RESIDENTIAL ONLY A7671041id without Red X Press Imprint /parcel Number �O r )erty Address v kA,6� �G Zesidential Value of Work �y`* Minimum fee of$25.00 for work under$6000.00 Cpn�I ier's Name&Address o_,K .cknk S? z)e'' w. 31g C P.z/O-nu k iac- �-m o'er��— ;tractor's Name C,y (_ � Telephone Number 9el 6 76 a-'+ ne Improvement Contractor License#(if applicable) ense*{fapphtzblej Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance trance Company Name rkman's Comp.Policy# )y of Insurance Compliance Certificate must be on file. rtit Request(check box) t. Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement ontractors License is required. NATURE: )mis:expmtrg se061306 The Commonwealth of Massachusetts ,; Department of Industrial Accidents tf E Office of Investigations I 1 � 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers '. Applicant Information Please Print Le 'bl Name (Business/Organization/Individual): ?ryj - Address: 3 City/State/Zip: .,ey�'��V I\C - 1 Phone#: Are you an employer?.Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the'sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. $ 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp:insurance. g, ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.F Electrical repairs or additions 3 I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions . mysjelf. [No workers' comp, c. 152, §1(4),and we have no 12.[]Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp.insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp,policy information. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si afore: `�`�— Date: Al 06 Phone#: 5 Official use only. Do not write in this area,.to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: -Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual;partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)_of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance, If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Deparlment.of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy.information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. , The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MIA 02111 Tel, #617-727-4900 ext 406 or 1-8.77-MASSAFE Fax#i 617-727-7749 Revised 5-26-OS www.mass-gov/dia f ;Barnstable Assessing Search Results Page 1 of 3 10 • of • • ' 2006 Property Assessment Lookup aaauTau; Home: Departments:Assessors Division: Property Assessment Search Results New Search 314 SOUTH MAIN STREET Owner: 2006 Assessed Values: SETZKO, RICHARD S&SNELL, Appraised Value Assessed Value NANCY S Map/Parcel/Parcel Extension Building Value: $294,700 $294,700 207 /061/ Extra Features: $ 10,400 $ 10,400 Outbuildings: $20,100 $20,100 Mailing Address Land Value: $234,800 $234,800 SETZKO, RICHARD S&SNELL, NANCY S Totals $560,000 $560,000 38 CHURCH HILL RD CENTERVILLE, MA. 02632 2006 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $87.06 Fire District Rates Town Barnstable-Residential $1.90 $6.31 Barnstable-Commercial $2.51 Commei C.O.M.M. FD Tax(Residential) $593.60 C.O.M.M. -All Classes $1.06 $6.54 Cotuit FD-All Classes $1.33 Persona Town Tax(Residential) $2,901.97 Hyannis-Residential $1.61 $6.49 Hyannis-Commercial $2.50 Other R; W Barnstable-Residential $1.60 Commur W Barnstable-Commercial $2.46 Total: $3,582.63 Construction Details Property Sketch Legend Building Building value $294,700 Interior Floors Wide Pine This property contains multiple Please use the navigation below the sketch to I Style Cape Cod Interior Walls Wall Brd/Wood Model Residential Heat Fuel Oil Grade Average Heat Type Hot Water • http://www.town.bamstable.ma.us/assessing/assess06/displayparce106.asp?Mappar=207061... 5/3/2006 Barnstable Assessing Search Results Page 2 of 3 Stories 1 1/2 Stories AC Type None Exterior Walls Wood Shingle Bedrooms 1 Bedroom Roof Structure Gable/Hip Bathrooms 1 Full Roof Cover Asph/F GIs/Cmp living area 840 Replacement Cost $93106 Year Built 1800 Depreciation 15 Total Rooms 3 Rooms Land _ Lot Size(Acres) 0.68 Appraised Value $234,800 Current Building ID= 15034 details c Additional Sketches i Click Here for print version that displays all Assessed Value $234,800 Interactive Property Map: Map requires Plug i I have visited the maps before IIC >:'F.O Show Me The Map ' April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: SETZKO, RICHARD S&SNELL, NANCY S May 25 2001 12:OOAM 13869/260 $350,000 HAYES, EST OF IRMA E Dec 15 1994 12:OOAM 9484/203 $1 HAYES, STEPHEN P& IRMA E Jul 29 1947 12:OOAM 676/500 $0 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value BRN4 Barn w/Bmt&Lt 636 $ 19,700 $ 19,700 SHED Shed 90 $400 $400 FPL1 Fireplace 2 $5,100 $5,100 FPO Ext FP Opening 4 $2,700 $2,700 FPL2 Fireplace 1 $2,600 $2,600 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area UST Utility Area(Unfinished) (Finished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) http://www.town.bamstable.ma.us/assessing/assess06/displayparce106.asp?Mappar=207061... 5/3/2006 _,Barnstable Assessing Search Results Page 3 of 3 FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch ' TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assess06/displayparce106.asp?Mappar=207061... 5/3/2006 Town of Barnstable WebMap Page 1 of 1 ■■r: � � rf1 � . ��1a r a9r < <} �-6/ �► Full Screen Map Magnify Zoom In Zoom Out I Print Map http://207.190.197.68/Webmap/assessmapO6/TOB WebMaphiresK.asp?action=Zoom+In&m... 5/3/2006 FTNET��y� e TOWN OF BA1� NSTABLE BAHBSTAIILE, i 9� um 0 pY�,��� DUItDING . INSPECTOR APPLICATION 'FOR PERMIT TO ... .. .. .......... ...... ...... . ..V.,/.,�.�.. ....... ........ .��.. . ........... TYPE OF CONSTRUCTION .......... .. %. / " ...........y ,�. ..........19.7z/ TO THE INSPECTOR OF BUILDINGS: _ A The undersigned hereby applies for a permit acc o ding o th ollowing formation: Location ...C��. .... ,C� �.. ........ . .. ......... ... ..(' e. - ........ 1 ............. ProposedUse ..........:... _ ................................................... .......................... Zoning District ......... ... .....B............................................Fire District .� . .......... L l/ ........................... Name of Owner �� � .J � 6' 640..��</G/��C��....lL��i' 1 �/�• ...... ss ..... Name of Builder ...............•U•'�,r ..... ..` �.Wress .......V..LZe� ...... ...... d(1.. � ......... t .............Address .::................................... Name of Architect ................. .... .... .............................................. Number of Rooms ................. .......................................Foundation ....... .. VAQotne . Exterior .... . . 1�� CX .< �• ••� �1�� �. ..... .,,.......................Roofing .......�!% ••......... �✓" G Floors ................ —.. �,�..................Interior ........ ,.!'. 1F............................................. Heatingj � �.. 1 ..... �Plumbin ......... Fireplace ................. /......�.. I.... .... .. .. ........Approximate Cost ......... / .� ............................ VV Difinitive Plan Approved by Planning Board ________________________________19________. Diagram of Lot and Building with Dimensions � Jrd ll C, C � ' HE PRO SED MET . OD OF PROV!I! lG I uh SANITAR AND DRAINAGE IS HER r rp TOWN BA NSTABLE. BOARD OF H A LICENSED INSTALLER�MliS , AND 1(45ALL Sy,e� PERICE l � ,----� ,oln of o Vr _ I hereby agree to conform to all the Rules and Regulations of the Town of Ba nstable regarding the a ove construction. � � v Name ... . . . .... ..... Hayes, Stephen P. & Irma 14908 , 9 add to sin le No -....-Permit for .. family dwelling z ..... ................... .... / TcJ• O!104,FN-Y-IS' •M/9 is Location .......�8 Chip .... ... . . `I l �nterville`. .��••'U ................... ..... .1.......�.f..... Owner ...:j.... tephe.n..:P.'..&..Irma Haye s ......................... Type of Construction frame ............................ ..................................................... ....................... r Plot ............................ Lot ................................ Permit Granted April 6 72 as dU8 -- Date of Inspection .. ...... ......................... Date Completed i PERMIT REFUSED--- �. ..... ... ...... ... ...................................................................... ��77.. ............ .. .................... ...... ........................ ............................................................................... r ............................................................................... y ~ ✓, . l Approved .,.............................................. 19 , r ............................................................................... .................... ......................................................... /5 Rook i �'' � � s IV? 5208 TowN � �F BARNSTABLE, MASS. 19 3 E THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO (PROPERTY OWNER)• """'»'"`•'•» ,/ /� TO ...f. _/�. / •••• -•i A CY...... ` ' (BUILD) " (TYPE OF ................ .._.........». BUILDING) """""••'•••^•• LOCATION O ,G �•RO.IMAr,S,,..... ^/ (APPRO .»:_..»...»..... _�....... t SIZE) �Tl ' (STREET AND "" � ,T r;✓� NAME OF BUILDER OR CONTRACTOR ..�,("Q (VILLAGE) APPROXIMATE COST . D Q ° ..... ;, t HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF BA'pNSTABLE, REGARDING T ONS VE ABOVE CONSTRUCTION. t OF THE TOWN :../ .. ..lizol ili y I , (CONTRACTORI ..... » ..........»......__..._. - .. _. �.(.�r�M1 r ems.• ,�� .: ��� � BUILDING INSPECTOR - TOWN OF. BARNSTABI.E.• MAA TOWN . OF BARN STOLE, MASSACHUSETTS •' -' . . , , '. ASSESSORS MAPS ' i ASSESSORS MAPS + . �spi' • 'Sp •e_too tom✓,.' Ails 39 pC `N 1 s.i' !'1 i 4 4�Og4 • I �b ' 49 op 10Y. 143 Ac Wso r At4tr '` l bt°c• °r b�q ° _ 1 *01 42 ' •t z� •- : t1 pis �� �. 1 y.' 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