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PERMIT GRANTED DATE I^ 19 9 7 GAS INSPECTOR Town of Barnstable oFtHe, Building Department Services Brian Florence, CBO Building Commissioner BARNS TABLE * MRNSTABLE, +% MASS. n�roR,"say° 1639-2 4 we"suu 9 $ 200 Main Street, Hyannis, MA 02601 1639.2019 s63q. �0 plFD MBA www.town.barnstable.ma.us �� Office: 508-862-4038 Fax: 508-790-6230 January 3, 2018 Christine A. Jenness, Esq. Sarah F..Alger, PC Five Parker Road P.O. Box 449 Osterville, Massachusetts 02655 Re: 586 South Main Street, Centerville Attorney Jenness, Thank you for your written zoning opinion regarding your client's property. I have determined based upon your opinion and supporting documentation that the Property is a pre-existing legal nonconforming lot with two (2) dwellings. That the lot was created before subdivision control regulations and the structures and their use pre-date zoning and are therefore"grandfathered". If you have any questions please feel free to contact me. R e Aards, Brian Florenc , Building Commissioner Florence, Brian From: Florence, Brian Sent: Wednesday, November 22, 2017 5:00 PM To: 'Christine Jenness' Subject: RE: 586 South Main Street, Centerville Attorney Jenness, Thank you for your well written zoning opinion regarding your clients property. I have determined based upon your opinion and supporting documentation that the Property is a pre-existing legal nonconforming lot with two (2) dwellings. That the lot was created before subdivision control regulations and the structures and their use pre-date zoning and are therefore .."grandfathered". If you have any questions or require a more formal response (letterhead) please feel free to contact me. Regards, Brian Florence,-Building Commissioner Building Department I Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4038 Brian.florence@town.barnstable.ma.us w... . ................. .. ._._ ...__ ..... _,.. ,_..w?...., w ........... .. __. _._.v._ ... .. ..._...... .._....... From: Christine Jenness [n1ai.lto,ca' sfapc.comJ Sent: Friday, November 17, 2017 2:01 PM To:.Florence, Brian Subject: RE: 586 South Main Street, Centerville Dear Mr. Florence; Our office.represents, Richard and:Grace Gallo,the owners of 586 South Main Street, Centerville. Attached please find my cover letter, zoning opinion, and attachments. Thank you in advance for your assistance and please contact me with any questions or if you should require any additional information. Best regards, Christine Jenness Christine A.Jenness, Esq. Sarah F. Alger, PC Five Parker Road P.O. Box 44 . Osterville, Massachusetts 02655 Telephone: 508-428-8594 Facsimile: 508-420-3162 1 Email: cal@sfapc.com From: Florence, Brian ma�Ito;Brian.FEorence town.barnstable.m-1 Sent:Thursday, November 09, 2017 8:57 AM To: Christine Jenness<ccai@sfapc.com> Subject: RE: 586 South Main Street, Centerville Attorney Jenness, Usually when E get a request for determination like this the attorney renders an opinion with historical details, zoning ordinance or M.G.I. 40A citations in support of their opinion. You have submitted the historical detail but no opinion. If you would like to submit an opinion I would be happy to review it and make a determination. Please feel free to contact me if you have any questions. Brian Florence, Building Commissioner Building Department I Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4038 Briars.florence@town.barnstable.ma.us From: Christine Jenness [MAi_ito_c Sent: Wednesday, November 8, 2017 3:06 PM To: Florence, Brian Subject: 586 South Main Street, Centerville Dear Mr. Florence, Our:office represents, Richard and Grace Gallo;the owners of 586 South Main Street, Centerville. The Gallos have asked. us to contact you to request a zoning determination for their property. Attached please find my cover letter and attachments. Thank you in advance for your assistance and please contact me with any questions or if you should require any additional information: Best regards,, Christine Jenness Christine A.Jenness, Esq. Sarah F.Alger, PC Five Parker Road P.O. Box 449 Osterville, Massachusetts 02655 Telephone: 508-428-8594 Facsimile: 508-420-3162 Email: caj@sfapc.com 2 SARAH F.ALGER, P.C. ATTORNEYS AT LAW FNE PARKER ROAD•POST OFFICE Box 449 OSTERVILLE,MASSACHUSETTs•02655 TELEPHONE:508-428-8594 FACSIMILE:508-420-3162 IOHN R.ALGER 1931-2007 SARAH F.ALGER Two SOUTH WATER STREET sfa@sfapc.com NANTUCKET,MASSACHUSETTS•02554 TELEPHONE:5 08-228-1118 CHRISTINE A.)ENNESS FACSIMILE:5 08-228-8004 caj@sfapc.com November 13,2017 Via email Brian.Florencena town.Barnstable ina us Mr. Brian Florence Building Commissioner Town of Barnstable 200 Main Street Hyannis, MA 02601 Re: Zoning Opinion Relative to Request For Zoning Determination 586 South Main Street,Centerville Owners: Richard and Grace Gallo Map.186 Parcel 045 Dear Mr. Florence: Our clients, Richard and Grace Gallo, owners of the Property located at 586 Main Street, Centerville, (the "Property") have asked our office to contact you to obtain a zoning determination that their Property is a legally non-conforming lot with two dwellings. Relative to that request below please find information concerning the Property along with our zoning opinion. The Property, which has been owned by my clients' and their family since the early 1950's;is approximately 1.22 acres, located within a RD-1 zoning district, and consists of two structures: a main, two story home, with four bedrooms and approximately 2,486 square feet, and a one and story cottage/carriage house, with three bedrooms and approximately 1,033 square feet. Both dwellings are located in close proximity to the other and each has its own separate on-site septic system. (Copies of the assessor's information cards and map for the property are enclosed along with the most recent Title 5 inspection reports). As for some background information to the Property, the main home was constructed circa 1870 in the Second Empire style which was an architectural style typically constructed- from 1860 to the mid 1880's. A copy of the Massachusetts Cultural Resources Information System(MACRIS) inventory sheets concerning the Property have also been enclosed. The SARAH F. ALGER, P.C. Mr. Brian Florence Building Commissioner November 13, 2017 Page Two. Property has been known as the Joseph D. Crowell House, the Anabel Thorne House and Mildoc's. The MACRIS inventory sheet also lists a converted 1 '/2 story structure which was converted to a cottage which appears in same architectural style but no exact date was given as to when the conversion occurred. However, main house and cottage/carriage house have been rented throughout the years. Copies of guest registry book entries are enclosed. Our clients have several guest registry books dating back to 1947 and would be happy to provide them to you if you would like to review them, Relative toour clients request for a zoning determination as stated above, please accept the following as our zoning opinion to the Town of Barnstable with respect to the Property. In. 'rendering this opinion, I have relied upon the following: A. The provisions of the Zoning By-Laws of the Town of Barnstable ("Zoning Code"); B. The Zoning Map of the Town of Barnstable, as amended as of this date, in the possession of the Barnstable town Clerk ("Zoning Map"); C. The provisions of Massachusetts General Laws c. 40A ("Zoning Act"); D. The Town of Barnstable Assessor's Map and Assessor's On-Line Database; E., A copy of the Massachusetts Cultural Resources Information Systel (MACRIS) inventory sheets and online database; and F. A fifty year title examination of the Property based upon the deeds and records available at the Barnstable County Registry of Deeds. Based upon the foregoing, it is my opinion that the Property is a legally non-conforming lot with two dwellings. This opinion is informed by the following facts: 3 1. The Property has been owned by my clients since 1994: A copy of their deed is attached. 2. The Property is shown as Parcel ID 186-045 and according to the Assessor's records.and is approximately 1. 22 acres. E - r . SARAH F. /ALGER, P.C. Mr. Brian Florence Building Commissioner November 13, 2017 Page Three, 3. The Property is assessed at$529,100,00 with an Assessor's Use Code of 1090, ("Multiple Houses"), 4. The Property is shown as Parcel 186-045 on the Town of Barnstable Assessor's Map. 5. Review of the aerial maps on the Town of Barnstable Assessor's website shows that the Property had multiple dwellings since at least 1952; 6. The Town of Barnstable Assessor's information card for the Property states "year built" 1900; however, according to the MACRIS inventory sheet for the property;the main home was constructed circa 1870, z , 7. M.G.L. c. 40A §6 protects structures and uses lawfully in existence at the time zoning is adopted, exempting them from certain subsequently adopted zoning provisions. 8. The intent of§240-90 of Article VIII is to protect property rights of owners of preexisting legally created nonconforming lots, uses, buildings or structure 9. The Property is situated in an"RD-1" residential zoning district. The current minimum standards/requirement set forth in the Bulk Regulations, §240-11-E, are the following: lot area 43,650 square feet; minimum lot frontage 20 feet,minimum lot width 125 feet; front setbacks of 30 feet and rear and side setbacks of 10 feet. 10. The prior zoning requirements of this zoning district were as follows: At a special Town meeting on June 14, 1929, the Town of Barnstable divided the town into two districts: residential and non-residential, with non-residential being all land use for business or farming. 11. Zoning District A was later adopted under Article 38 of the March 6, 1950 annual Town of Barnstable town meeting, permitting only one single-family dwelling as-of-right on a lot with a minimum area of:7,500 square feet and a minimum width of 75 feet. 12. In accordance with §240-91-A, The Property (lot) was not held in common ownership with-any adjoining land,had a,minimum of 5,000 square feet of area and the minimum required frontage-in the zoning district in which it is located, conformed to the existing zoning if any(pre-dated zoning), and has been separately owned at the time of every zoning change thereafter. SARAH F. ALGER3 P.C. Mr, Brian Florence Building Commissioner November 1') 2017 Page Four. 1:3, The Property (lot)and buildings legally existed and predated the zoning changes. Based upon the foregoing, it is my opinion that the Property (Parcel ID 186-045)is a "pre-existing legally created nonconforming lot" within the definition of§240790 and it satisfies the criteria set forth in §240-91(A). This lot was created prior to subdivision regulations, and.is therefore "grand.fathered." Furthermore, the structures o.n.the Property, based upon MACRIS inventory cards, the architectural style and materials, language contained within the deeds in.the ,record title stating"the buildings thereon", the earliest online aerial maps from 1950's showing both structures, and guest registry books in my clients possession, it is my opinion that the structures existed and pre-dated the effective date of the adoption of the town of Barnstable Zoning Ordinance and By-Laws and that the Property should be determined to be a pre-existing legally non-conforming lot with two dwellings. I have limited our opinion to those matters herein, and to the Town.of Barnstable "Zoning Code as it relates to the items specifically mentioned herein and accordingly our opinion.is so limited. We express no.opinion relating to the laws of any other jurisdiction, nor the laws or regulations of the Commonwealth of Massachusetts or the Town of Barnstable except as referenced in this opinion. . We specifically exclude, without limitation to such.exclusions, laws relating to the environment, wetlands, building codes, permits issued by the Executive Office of Environmental Affairs, Conservation Commission,Department of Environment Protection, Department of Public Work, except as referenced herein. Please contact me if you should have any questions or require any additional information. Thank you very much for your assistance. Very Jtruly yours, ;r (,Y" , Christine A. Jenn4s;_,, cc: Richard.and Grace Gallo Enclosures f Print Page Page 1 of 4 r............................................................................. y I Print this page • Owner Information - Map/Block/Lot: 186 /045/- Use Code: 1090 Owner Map/Block/Lot , 1 A PS GALLO, RICHARD M & 186 /045/ Owner Name as of GRACE E Property Address 1/1/16 586 SO MAIN ST 586 SOUTH MAIN STREET CENTERVILLE, MA. 02632 Co-Owner Name Village: Centerville Town Sewer At Address: No GIS Zoning Value: RD-] • Assessed Values 2017 - Map/Block/Lot: 186 /045/- Use Code: 1090 2017 Appraised Value 2017 Assessed Value Past Comparisons Building Value: $ 204,200 $ 204,200 Year Assessed Value $ 7,700 $ 7,700 2016 - $ 529,700 Extra Features: 2015 - $ 579,100 $ 1,200 $ 1,200 2014 - $ 579,200 Outbuildings: 2013 - $ 579,300 2012 - $ 573,900 $,316,000' $ 316,000 2011 - $ 603,200 Land Value: 2010 - $ 613;500 2009 - $ 810,600 S 529,100, 2008 - $ 793,700 2017 Totals $ 529,100 2007 - $ 793,700 Residential Exemption Received= $90,532 • Tax Information 2017 - Map/Block/Lot: 186./045/-Use Code: 1090 Taxes C_.O.M.M. FD Tax (Residential) $ 645.50 Community Preservation Act $ 125.52 Tax Town Tax (Residential) $ 4,183.94 Fiscal Year 2017 TAX RATES HERE S 4,954.96 littp://www.townofbarnstable.us/Assessing/printI7.asp?ap=0&searchparcel=186045 8/29/2017 Print Page Page 2 of 4 • Sales History - Map/Block/Lot: 186/045/- Use Code: 1090 History: Owner: Sale Date Book/Page: Sale Price: GALLO, RICHARD M & GRACE E 1994-04-15 9165/302 $1 GALLO, EMILIO & MARDELL D 1990-03-16 7093/243 $1 DOUGHERTY, ANTHONY & MILDRED 1952-04-28 809/522 $0 • Photos 186 /045/- Use Code: 1090 • Sketches - Map/Block/Lot: 186/045/-Use Code: 1090 { this property contains multiple sketches. Please use the navigation below the sketch to browse sketches. 1-13 Additional Sketches 12 Click.Hare for.print version that displays all sketches at once AsBuilt Card N/A • Constructions Details -Map/Block/Lot: 186 /045/- Use Code: 1090 Building Details Land http://www.townofbarnstable.us/Assessing/printI7.asp?ap=0&searchparcel=186045 8/29/2017 Pj,int Page Page 3 of 4 Building value $ 204,200 Bedrooms 4 Bedrooms USE CODE logo Replacement Cost $236,584 Bathrooms 2 Full-0 Half Lot Size Acres) 1.22 Model Residential Total Rooms 10 Rooms Appraised $ Value 316,000 Style Conventional Heat Fuel Gas Assessed Value $6,000 Grade Average Plus Heat Type Hot Air Year Built 1900 AC Type None Effective Interior Pine/Soft depreciation 40 Floors Wood Stories 2 Stories InteriorWalls . Plastered Living Area sq/ft 2,254 Exterior Walls. Mood Shingle Gross Area sq/ft 2,486 Roof Gable/Hip Structure Roof Cover Asph/F GIs/Cmp • Outbuildings & Extra Features - Map/Block/Lot: 186/045/- Use Code: 1090 Code Description Units/SQ ft Appraised Value Assessed Value WDCK Wood Decking 80 $ 1,200 $ 1,200 w/railings ' FOP Open Porch-roof- 152 $4,200 $ 4,200 ceiling FOP Open Porch-roof 132 $ 3,500 $ 3,500 ceiling • Sketch Legend Property Sketch Legend B2N Barn-any 2nd story area FPC Open Porch Concrete Floor• REF Reference Only BAS First Floor, Living Area FTS Third Story Living Area SOL Solarium (Finished) BMT Basement Area FUS Second Story Living Area SPE Pool Enclosure (Unfinished) (Finished) $RN Barn GAR Garage TQS Three Quarters Story CAN Cano (Finished) py GAZ Gazebo UAT Attic Area'(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ http://www.townofbarnstable.us/Assessing/printI7.asp?ap=0&searchparce1=186045 8/29/2017 Print Page Page 4 of 4 Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine, Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Openjor Screened in PRT Portico WDK Wood Deck Porch PTO Patio Microsoft VBScript runtime error'800a01a8' J Object required: " /Assessing/print17.asp, line 153 http://www.townofbarnstable.us/Assessing/printI7.asp?ap=0&searchparcel=186045 8/29/2017 • a e �rt k x � 3 Y a4r Cif k(!-• i-�I�S` � ��! 5� � L,y'g �i klEyZ,. �' � Y�� aye a�.. �� y �� s��.- '`�•�a.r•�� jay.• t � •".� �a ., a� as �� r ,; i °-,� � _ ��.'� � �.� ��R �€ s"��"'�'i�� '„ n � '� tr_, £r?_�c �"a" � •9'0 �i\ �"`t 5 � t � :. ,,� ., >'�, ;:��aa+�,, � �. �' - � �� r� �X" tS 1�9� •z3�tslD�`.s*� � �a«a�� \�3v z<,� 'i.� \� �� '� i littp://townotbarnstLible.us/propertyiinages/00/01/53/08.jpg[8/29/2017 2:45:48 PM] _ Legend t, Road Names >s \ ENTF MIR, 51��11 ;V 7 .y. t a: � r a M; Map printed on: 11/7/2017 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet 'regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 02601 0 83 167 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 508-862-4624 reflect current conditions,and may contain such as building locations. 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'� Ic A",,v � / + `.E� �`^�! �) •�. :J-'} �_itiC� -_1 .e`er`_ G�� ` C�C� :.._t Lv'l ��-�.� r�� `l-�('C�+' � \1t ,,,��,4t�j �.._�.� �-. r . �AIg ik 77— a � \ a ads ` �r e r 3' C p um Iv gib WI WR 3 hup://to\v11ofbarnstahle.us/propegimages/00/01/53/1O.jpg[8/29/2017 2:46:37 PM]' fowil of Barnstable Go Back y Building Details Land Building $252,200 Bedrooms 4 USE 1090 value Bedrooms CODE Replacement $219,328 Bathrooms 2 Full Lot Size 1.22 Cost (Acres) Model Residential Total 10 Appraised $ Rooms Rooms Value. 303,700 3a Style Conventional Heat Fuel Gas Assessed $ Value 303,700 Average =IMI Grade Plus Heat Type Hot Air Year Built 1900 AC Type None M Effective Interior Pine/Soft depreciation 25 Floors Wood D Stories 2 Stories Interior Walls Plastered Living Area Exterior Wood sq/ft 2,254 Walls Shingle Gross Area 2,486 Roof Gable/Hip sq/ft Structure Roof Asph/F Cover GIs/Cmp Building Details Land Building $252,200 Bedrooms 3 USE 1090 value Bedrooms CODE Replacement $93,598 Bathrooms 1 Full Lot Size 1 22 Cost (Acres) Total Appraised $ s Model Residential 6 Rooms , Rooms Value 303,700 qt Assessed $ Style Cottage Heat Fuel Gas n Value 303,700 } Grade Average Heat Type Hot Air Minus Year Built 1900 AC Type None R s Effective 15 Interior Pine/Soft r depreciation Floors Wood Interior ' Stories 1 Story Walls Drywall Living Area 901 Exterior Wood sq/ft Walls Shingle Gross Area 1,033 Roof Gable/Hip sq/ft Structure Roof Asph/F Cover GIs/Cmp http://N%�wN\'.townotbarnstable.us/Assessing/printsketch.asp?mappar-186045[8/29/2017 2:47:15 PM] r Town of Barnseable littp://w\wNN,.townofbarnstable.us/Assessing/printsketcli.asp?mappar=186045[8/29/2017 2:47:15 PM] i Massachusetts Cultural Resource Information System Scanned RecordCover Page Inventory No: BRN.2337 E 'Historic Name: Crowell,Joseph D. House Common Name: Thorne,Anabel-Hargreaves,James House Address: 586 South Main St pt City/Town: Barnstable Villaget ighborhood': ; Centerville ,Local No: f Year.Constructed: r 1870 Architect(s): Architectural Style(s): Second Empire Use{s}: °:Single Family Dwelling House Significance 'Architecture Area{s} w BRN.X:Centerville Main Street Area Designation{s) � - } Roof:Asphalt Shingle;Wood Shingle Building Materials(s): i Wall:Wood;Wood Shingle Foundation:Granite;Stone,Cut The Massachusetts Historical Commission (MHC) has converted this paper record to digital format as part of ongoing projects to scan records of the Inventory of Historic Assets of the Commonwealth and National Register of Historic Places nominations for Massachusetts. Efforts are ongoing and not all inventory or National Register records related to this resource may be available in digital format at this time. 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Commonwealth of Massachusetts Massachusetts Historical Commission 220 Morrissey Boulevard, Boston, Massachusetts 02125 www.sec.state.ma.us/mhc This file was accessed on: Thursday, October 19, 2017 at 10:52 AM FORM B — BUILDING Assessor's Number USGS Quad Area(s) Form Number MASSACHUSETTS HISTORICAL COMMISSION 186045 MASSACHUSETTS ARCHIVES BUILDING 220 MORRISSEY BOULEVARD Town: Barnstable BOSTON, MASSACHUSETTS 02125 Place: (neighborhood or village) Centerville Photograph Address: 586 South Main Street E ? Historic Name: Joseph D.and Hulda S. Crowell House Uses: Present: Single-Family Residential Original: Single-Family Residential Date of Construction: 1860-1880 y" Source: Style Style/Form: Second Empire Architect/Builder: Unknown 4 Exterior Material: Foundation: Granite s Wall/Trim: Wood Shingles 1 Topographic or Assessor's Map Roof: Asphalt Shingles/Wood Shingles 3eo4E* Outbuildings/Secondary Structures: �. A converted one-and one-half story outbuilding is located northwest of the residence. N g5e8 IS8047 Major Alterations (with dates): 'l fY= I£eOCC j' 1574 r Condition: Good reeD45 �,; r q57, - - Moved: no x yes Date Acreage: 1.22 acre f 188050 g^z. 1 , fjj g5S5 �'" Setting: The building faces southwest and is set back 1ae039003 18BD43 2 eOC approximately twenty feet from the road on a level lot. 186038002 ^f ad S 12 5 Feet 88b5'�- 3 00095 - III a 1e RECEIVED, Recorded by: Geoffrey E Melhuish,ttl-architects MAY 05 2011 Organization: Town of Barnstable MASS.HIST.COMM. Date(month/year): August 2009 i Follow Massachusetts Historical Commission Survey 49anual instructions for completing this forn7. i INVENTORY FORM B CONTINUATION SHEET BARNSTABLE 586 South Main Street MASSACHUSETTS HISTORICAL COMMISSION Area(s) Form No.2237 220 MORRISSEY BOULEVARD,BOSTON,MASSACHUSETTS 02125 X Recommended for listing in the National Register of Historic Places. I f checked,you must attach a completed%National Register Criteria Statement./brut. Use as mach space as necessary to complete the following entries, allowing text to flow onto additional continuation sheets. ARCHITECTURAL DESCRIPTION: Describe architectural features. Evaluate the characteristics of this building in terms of other buildings within the community. 586 South Main Street(BRN-2337) is a one-and-one-half story wood frarne residence constructed in the Second Empire style. The three-by-four bay building faces southwest and is set back approximately twenty feet from the road on a level lot. The building terminates in a mansard roof. The top plane of the roof is clad with asphalt shingles and the lower plan is clad-with wood shingles. Typical of the style, dormers are featured on the lower plan of the roof. Three gable roof dormers on the south elevation each feature a single 2/2 double-hung wood sash window marked by a simple wood surround. An interior brick chimney pierces the upper plane of the roof and an interior end wall chimney pierces the roof of the rear ell. The exterior walls of,the residence are clad with wood shingles. A central entry on the south fagade provides access. The opening is marked by a shallow hipped roof supported on decorative wood brackets. A single 2/2 double-hung wood sash is located to each side of the •opening: A one-story bay window is located along the west elevation. A one-and-one-story ell projects from the east elevation of the residence. Like the principle block,the ell terminates in a mansard roof. A one-story entry porch is featured on the east elevation of the ell. A converted one-and one-half story outbuilding is located.northwest of the residence. The building terminates in a front gable roof sheathed with asphalt shingles. Sliding track glass doors protect the paired entry. The 586 South Main Street retains the form and details that identify this house as a Second Empire. HISTORICAL NARRATIVE Discuss the histor�r of the building. Explain"its associations with local (or state) history. Include uses of the building, and the role(s) the owners/occupants played within the cbminunity. According to tax assessor's records,the house at 586 South Main-Street(BRN-2337) was built in 1900; however the.Second Empire style was constructed typically from 1860 to the mid 1880s. Deed research indicates that the property was owned by the Crowell family during the mid-nineteenth century. Olive Crowell purchased several tracts of land in the area in the 1.830s. -By 1888,the property was owned.by Hulda S. Crowell who.received the property through the will of her husband,Joseph D. Crowell (B. 1812) Hulda S. Turner is shown on the 1910 map. For much of the early twentieth century, the property was under the ownership of Anabel Thorne. In 1944,the property was sold to James and Edna Hargreaves. The property is currently owned by Richard and Grace Gallo. BIBLIOGRAPHY and/or REFERENCES Barnstable County Registry of Deeds. Fam i IySearch Map of Barnstable. Published by G.H. Walker& Co. 1880. Map of Barnstable. Published by Walker Lithograph and Publishing Company, 1905. Map of Barnstable. Published by Walker Lithograph and Publishing Company, 1910. Town of Barnstable. Assessors Records. U.S. Commerce Dept. Census"Bureau, 1840-1930. Continuation sheet I INVENTORY FORM B CONTINUATION SHEET BARNSTABLE 586 South Main Street MASSACHUSETTS HISTORICAL,COMMISSION Area(s) Form No.2237 220 MORRfSSi=Y BOULEVARD,BOSTON,MASSACHUSETTS 02125 r, Continuation sheet 2 f - - W t091bS-0302 94-04-28 12r15 #2B116 MASSACNUSETTS QUITCLAIM DEED SHORT FORM (INDIVIDUAL, 881 Etttilio Gallo and Mardell D. Gallo, husband and wife, of 418 South Mail,, street, Centerville, 'Barnstable County,,hUssachusetts, being)wuuarried,for consideration paid,and in full consideration of One Dollar grant to Richard M. Gallo and Grace E. Gallo, husband and wife, as tenants by the rr entirety of 586 South Main Street, Centerville, Imassachusetts with Jfuftrlalm rattruanto thclandin Barnstable (Centerville.), barnstabl.e Country, Massachusetts with buildings thereon heing bounded and described as follows: [Description and encumbrance,if any) - Beginning at the Northeasterly corner of the premises at a point in the ci Northwesterly line of the state Highway, which said point is the Southeasterly corner of land now or formerly of Henry S. Loomis; Thence South 300 50' 20" West in the Northwesterly Line of said State Highway, one Hundred Thirty-Three and 98 100 133.9A feet to a a y / ( ) point and land now or formerly U of Andrew N. Patterson et. ux; Thence North 83039' 40" West in line of said Patterson land, Fifty-lour and 75/100 (54.75) feet to a point; 1 Thence North 110 1.7' 30" East, still in line of said Patterson land, Forty-Five'and 76/100 (45.76) feet to a point; n_ . Thence North 710 17' 40" West, still in line of said Patterson Land (in part by a line of old fence posts), Two Hundred Twenty-One (22.1.) feet:, tuore or less, to land now or formerly of Charles L. Ayling; (a swamp); 0 Thence Northly, Northeasterly and Easterly by various courses in line of said swamp 10 (by land of said Ayli.tig and land now or formerly of Francis N. Lewis), `ftvo Hundred. co Ninety-Five (295) feet, more or less, to land now or formerly of Loomis; Thence Southeasterly in line of said Loomis land, Thirty-Two and 32/100 (32.32) feet, o more or less, to a point; Thence. South 260 39' 10" East by said Loomis land, .Twenty-Eight (28) feet to a point; 0 a Thence South 49° 04' 10' East still by said, Loomis larld, Fifty and 13/1.00 (50.13) :feet to a.point; and Thence South 480 .38' East by a wire fence and still. by land of sa:id'l.aomis, One Hundred Forty-One and 33/100 (141.33) feet to a point- of beginning. Containing one and 22/1.00 (1.22) acres, more or less. For our title see deed .to us from Anthony F. Dougherty and Mildred M. Dougherty dated March 15, 1990', recorded Barnstable itegistry of Deeds March 1.6, 1990,. Document No. 13448. a...day of,.........ZI; hilic, Gallo Pfardell. L). Gallo t�f+x (2ntntnnuulettlah of �ttr�ttrEluslrtts ig Then persorWly appeared the above narned ago a c�Cgowly�e�cl.t ie fare�aul�iristrunsent to be� '�/(to v? free.act and deed before me C. Notary Public enro-ission expires //j/ Ile (;'Individual--joint Tenants—Tenants in Cortulion.) CHAPTER 183 SEC.6 AS AMENDED BY[RAPPER 497 OF 1969 Every deed presented for record shall contain or have endorsed upon it the full name,residcrce And post office address of the grantee and a recital of the amount of the full consideration there"f in dnllars or the nature of the other consideration therefor, if not delivered for a specific monetary sum.The full consideration shall mean the total price for the conveyance without deduction for any liens or enctrrhrances assumed by the grantee or remaining thereon: All such endorsements and recitals shall he recorded as part of the deed_ Failure to comply with this section shall not affect the validity of any deed. No register of deeds shall accept a deed for recording unless it is in compliance with the requirements of this section. BARNSTABtE RG151RY op n>;>:ne y � < a `' s ;* a a .. .r ,{ :x r � 7 r 'k c a r 4 kOctobet 2020 �"'i WedneSda QctOberA14 LdO�Oar> MS S M ,T W T F S ° ti} � -} 4 K fr tY i xi xx �' rtx,J 3,.ry,rt z,r7 vt x 5+ h sff 7Z&3, „ y 6 7 u89,10 11 r1 b 2 13 14 M 16 7,.„ , 18 19 20 21 22 23 24.; ,, 3 +aw b'eyb ' r aJ �y >xdr .y1 }.;s y r F"'.` ' 1' "v�" -�,+e. ..s trr •r �. 25 26 27y28 29k 30,,31 NIA �a e < ^� r s. %4 ,?d" ♦+a. a•y„�....,,,. ,.. ra „y�° s'. .'^°* .�«, ai '�°`"rre r,...n.'.""'", r -• *.r=vie:•.^. . a �.w �`�'a ,� , .� Wetlnesday October'14 202Q S4i'95 N.3 N .� X q, 'fit a.rat „,a ga r fee #t00 final at(555 MAIN STREET(CENT.),CENTERVILLE)for(E 20-1795) 1 «F. trench at(163 BAYVIEW CIRCLE OSTERVILLE)for(E 20 1915) q-9�30 1 O�O0 '�3�eu',:r.. .,��., •n��,�"'�s.�} .w: k�r 1 m i�:`a.�''� k�aY r��+�. a�� .y'�3 a! .L�`�"�^'}°, *� .-�� ""�5'� '«��:>�re r .ae:'J��,,+3 d,;°''.�i'.4��' �'�3�:`.�^t3�x,,s�k";�' i rough,master bed at(163 BAYVIEW CIRCLE,OSTERVILLE)for(E-20.-1916) $' ' P h final genetrator at(201 BRIDGE STREET OSTERVILLE)for(E-20-457) � 00} 1'�' �1y "q .:: , ; .. ,•a , „a, w.az 4. r . 1 . : 7: rough remodel at(201 OYSTER WAY,OSTERVILLE)for(E 20-1945) �0 ate:,.rr.:� pm rough at(89 SEAPUIT RIVER ROAD *OSTERVILLE)for(E 20 1331) 1 0 _ /0 3 tl d ''.." ,.,„.,.-`a,.d,s %'aax- ,.t.''." furnace at(18 CALICO LANE,MARSTONS MILLS)for(E 20 740) JD 0 'a rough workshop at(208 EISENHOWER DRIVE COTUIT)for(E 20 1929) rough bath at(33 GROVE STREET COTUIT)for(E 20-1975) //.// 3 0 b a final generator at(107 SHELL LANE COTUIT)for(E 20 1973) �r 00 44 .: h final addition at(39 MEADOW LANE WEST BARNSTABLE)for(E 20 1675) 0 Hr;sciu k 1. trench at(2240 IYANNOUGH ROAD/RTE132 WEST BARNSTABLE)for(E 20 1429) ( 3 I 4", trench at(69 CAPTAIN LORING LANE BARNSTABLE)for(E-20 1686) 4a rj final kitchen at(172 BRAGG'S LANE BARNSTABLE)for(E 20-861) o 1 � e �xE `;° .��•~.`'��:r,�.,3_�,± :.: M, k ,: �` >S: .��': ,-.,.za .„'"` .,..1:= x. ;�aa�s.18,i �'_� �.3F�s�T. `��i"1t',".a S i�`.as„�w", a,� ' y rough low volt controls at(25 BENJAMIN FRANKLIN WAY BARNSTABLE)for(E 20 1169) e2-a2 '34U. f fJnal,A C at(97 BREAKWATER SHORES DR,,HYANNIS)for(E-20 1971) _hg00 ' r 5 oaf � OO�x t 1 9/1/2009 FORM B- BUILDING Assessor's Number USGS Quad Area(s) Form Number MASSACHUSETTS HISTORICAL COMMISSION. 186045� MASSACHUSETTS ARCHIVES BUILDING 220 MORRISSEY BOULEVARD Town: Barnstable BOSTON,MASSACHUSETTS 02125 Place:'(neighborhood or village) Centerville Photograph - T _w 1 fi Address: c_- 1-,_586,South Main Street '=s Historic Name:,Joseph D.andHulda&Crowell House s.v + c Uses: Present: Single-Family Residential - Original: Single-Family Residential Date of Construction: 18604880 Source: Style .� Style/Form: Second Empire Architect/Builder: Unknown is Exterior.Material: Foundation: Granite _..:._ Wall/Trini:p Wood Shingles Topographic or Assessor's Map Roof: Asphalt Shingles/Wood Shingles Outbuildings/Secondary Structures: A converted one=and one-half story outbuilding is located ' D70 n northwest of the residence. Major Alterations(with dates): /374 Condition: Good .57., Moved: no x .ffia �' yes .Date Acreage: 1.22 acre 0 Setting: The building faces southwest and is set back � 03910°' 18604° y' ga approximately.twenty feet from the road'on a level.lot: /Boo,. �a3o3uooz 125 Feet: Recorded by: Geoffrey E Melhaish, ttl=architects Organization: Town of Barnstable Date(month 1 year.): August 2009 Follow Massachusetts Historical Commission Survey Manual instructions for completigg this form. INVENTORY FORM B CONTINUATION SHEET BARNsTABLE 586 South Main-Street MASSACHUSETTS HISTORICAL COMMISSION Area(s) Form No.2237 220 MORRISSEY BOULEVARD,BOSTON,MASSACHUSETTS'0212S Recommended:for listing n the National Register of Historic Places' If checked,you,must attach a completed National'Pegister Ct rteria Statement form Use as much space as necessary to complete the following entries,:allowing text to flaw onto additional continuation sheets. ARCHITECTURAL DESCRIPTION: Describe architectural features. Evaluate the.characteristics of this building in terms of other Buildings within they community. 586 South Main Street(BRN-2337)is a one-and-one-half story wood frame residence constructed in:the.Second Empire style. The three-by-four bay building faces southwest and is set back'approximately twenty,feet from the road on a,level lot.: The building terminates in a mansard roof. The top plane of the roof is clad with asphalt shingles and the lower plan is clad with wood shingles. Typical of the style,dormers are featured on the lower plan of the roof. Three gable roof dormers on the south elevation each feature a single 2/2 double-hung wood sash-window marked by a simple wood surround. An interior:brick chimney pierces the upper'plane of the roof and an interior end wall chimney pierces.the roof of the rear ell. The exterior walls . . of the residence are clad with wood shingles. A central entry on the south fagade provides.access. The opening is marked-by a shallow hipped roof supported on decorative wood brackets. A single 2/2 double-hung wood sash is located to each side of the opening. A one-story bay window is located along the west elevation. Alone-and-one-story ell:projects from.the east elevation of the residence. Like the principle block, the ell terminates in a mansard roof. A one-story entry porch is featured on:the east. elevation of the ell. A converted one-and one-half story outbuilding<is°located northwest of the residence. The building terminates in a font gable roof sheathed with asphalt shingles. Sliding:track glass doors protect the paired entry. The 586'South Main Street retains the _ form and details that identify this house,as a Second Empire. HISTORICAL NARRATIVE Discuss the history of the building. Explain its associations with local(or state)history. Include uses of the building,and the role(s) the owners/occupants played within the community. According to tax assessor's records,the house at 586 South Main Street(BRN-2337) was built in 1900;however.the Second Empire style was constructed typically from 1860 to the:mid 1880s. Deed research indicates that the property was.owned by the Crowell family during the mid=nineteenth:century. Olive Crowell purchased several tracts of.land in the area in-the 1830s.. By 1888 the property was owned by Hulda°S.Crowelfwho<received the property through the will of her husband,Joseph D. Crowe]l(B. 1812)Hulda S.Turner is shown on the 1910 map. For much of the early twentieth century,.the property was under the ownership of Anabel Thorne. In 1944,the property was sold to James and Edna Hargreaves. The property is currently owned by Richard and Grace Gallo. BIBLIOGRAPHY and/or REFERENCES Barnstable.County;Registry of Deeds. FamilySearch Map of Barnstable.Published by'G.H. Walker&Co. 1880 Map of Barnstable.°Published,'by Walker.Lithograph and Publishing Company, 1.905, Map of Barnstable.Published by Walker Lithograph and Publishing Company, 1910: Town of Barnstable. Assessors Records. U.S. Commerce Dept. Census Bureau, 18.404930: Continuation sheet l I ' 1 ' 1 i 1 : • r • : :� N 20 30( Ro.d Aerial BvrPs eye Labels -,.�. � cf W 54' tiW��,f+ , �' !Vajr f{', rff t r� i t e ti' 3 .rX tF ine, w P a lj Ix �� w 7f,tAlf °' � .6 "�� 'A 5.d � 4• r 'h^'� 11`. '"G ,� i jf { �Yj++i5jf � J � 5 '1• !t ,� ` dt�'�.c� '"; _�(r f�'T.'M;,,� �1 rt.: a p �� 44�g , c `�"- l�� ,•''r��A��t,�� st 1�� I t `r';iy, r'C 1�".a rJ �f�'J1` F• �r+`� 'fs { f ty -� /p r fix$ t •rti(.�1 if}�r�5't'i t ,,�` YX+f r�'_, �, e= 2 Sa r ""K!i y ' :..' IF d; ;n o'A f• 3 iJi��F 'SIL r ,�^ *x', kd^ er + 'a 1 � r' � � s' . rt `hft r �J I, SY V.:+�! �; NV"v� k y't' v l; } s�' i ! i ex�1 .t e,,yr*, t'q Jy,' f "fit' " i' �•-* 9's- t':`N } p� AK r. .4r}� rL 1' �. i /r;• irt -r .,t e .�@ f ,cF :1 `.'.') ( �f,c' � �lyp i e Y �J t �✓n,� r h �� +� }'#�^fq '�'e�}�'F�¢^'- r�. px.. _ � {�;i1�4 1.AP t ( 1 y� 1{p � f {'..t��`+A`�y w •a. - n"'k / k Y � >i ,r r a r5 1 Jd• -'".r( }"! 9+a"' �y f '... (r ' /,.o^aJ•ia^mtra-carp ra9-n o vw ra td�.�k Fy� M�4f 3 f��' i 11 '�`/ TYk��td 5M ��`d/ 'Ch� ✓ C Nwe'}�^F�{elJ1RYI'f r' a `;S,' 3 ',• s pti, rp i ' f.., l•" r �Jt a s ,+�•.(9 d,�' 4. 7 1'+��_'."�dt ` ',',.,. P} a f@rCs, l,11,4A Official Website of The Town of Barnstable - Property Lookup Pa e 1 of 4`. A Y P g I Self— -ect Language Assessing Division Property Lookup Results - 2017 V 367 Main Street,Hyannis,MA.02601 <<BACK TO SEARCH« Print Friendly Owner Information-Map/Block/Lot:186!045/-Use Code: 1090 Owner Owner Name as of GALLO,RICHARD M& Map/Block/Lot GIS MAPS 1/1116 GRACE E 186/045/ 586 SO MAIN ST Property Address 586 SOUTH MAIN STREET I CENTERVILLE,MA.02632 Co-Owner Name Village:Centerville Town Sewer At-Address: No N `3 GIS Zoning Value:RD-1 t r; {Assessed Values 2017-Map/Block/Lot 186/0451-Use Code:1090 ;, 7 2017 Appraised Value 2017 Assessed ValuePast Comparisons 4 Building $204,200 $204,200 Year Assessed Value Value: I Extra $7,700 $7,700 2016-$529,700 Features: 2015 $579,100 i 4' 2014-$579,200 t 1.'. • 2013-$579,300 "r Outbuildings:$1,200 $1,200 2012-$573,900 2011 -$603,200 Land Value: $316,000 $316,000 2010-$613,500 2009-$810,600 1 2017 Totals $529,100 $529,100 2008-$793,700 ` 2007-$793,700 'Residential Exemption Received-$90 532 r p _ Tax Information 2017-Map/Block/Lot: 186/045/-Use Code: 1050 s Taxes s ' s r CI C.O.M.M.FD Tax(Residential) $645.50 Fiscal Year 2017 TAX RATES HERE Community Preservation Act Tax $125,52' b :x Town Tax(Residential) $4,183.94 , : t $4,954.96 Sales History-Map/Block/Lot:186 1 045/-Use Code:1090 . �History: Owner: Sale Date Book/Page: Sale Price: http,,-//www.townofbarnstable.us/Assessing/propertydisplay screen l 7.asp?a:.. 10/20/2017 ' Official Website of The Town of Barnstable - Property Lookup Page.2 of 4 GALLO,RICHARD M&GRACE E 1994-04-15 9165/302 $1 GALLO,EMILIO&MARDELL D 1990-03-16 7093/243 $1 ` F DOUGHERTY,ANTHONY.&MILDRED1952-04-28 809/522 $0 Photos 186/045/-Use Code:1090 Sketches-Map/Block/Lot 186/045/-Use Code: 1090 This property contains multiple sketches. 1; Please use the navigation below the sketch to browse sketches. F 13 ri a 7,' . . FUSZ n, ( `161 Q FUj 6-'' Additional Sketches 1 2 :~ i Click Her for print version that displays all sketches at once AsBuilt Card N/A ry Constructions Details-Map/Block/Lot. 1867 045/-Use Code: 1090 1. , . Building_....,..__...._ __.Details _ —_ _.._.,..__._Land Building value $204,200--�Bedrooms 4 Bedrooms USE CODE 1090 Replacement Cost $236,584 athrooms—B 2-Full_'0_Half Lot Size 1:.22 `.. 1 fi (Acres) Model Residential Total Rooms 10 Rooms Appraised $316,000 Value z Style Conventional Heat Fuel Gas Assessed $ 4 Value 316,000 Grade Average Heat Type Hot Air r Plus Year Built 1900 AC Type None Effective 40 Interior Floors Pine/Soft Wood depreciation Stories 2 Stories Interior Walls Plastered http://www.townofbarnstable.us/Assessing/propertydispIayscreen l 7.asp?a... 10/20/2017 r ' Official Website of The Town of Barnstable Property Lookup Page`3 of 4 r 1 .Living Area sq/ft 2,254 Exterior Walls Wood Shingle Gross Area sq/ft 2,486 Roof Gable/Hip Structure . I Roof Cover Asph/F GIs/Cmp ti•_^ Outbuildings&Extra Features. Map/Block/Lot: 186/045/-Use Code:1090 ' Code Description Units/SQ ft Appraised Value Assessed Value ` i WDCK Wood Decking 80 $1,200 $1,200 j w/railings II FOP Open Porch-roof- 152 $4,200 $4,200 ceiling FOP Open Porch-roof- 132 $3, 500 $3,500 _ - ceiling Sketch Legend jProperty Sketch Legend 621N Barn-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 i (Finished) BRN Barn GAR Garage TQS Three Quarters Story(Finished] CAN Canopy GAZ, Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS- Half Story.(Unfnished) FAT Attic Area(Finished)} GXT Garage Extension Front UST. Utility Area(Unfinished) i FCP Carport KEN Kennel UTQ 'Three Quarters Story' (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) 4 ti FOP Open or Screened in Porch PRT Portico WDK Wood Deck - PTO .Patio PrPrilnt Friendly Contact Director Edward F.O'Neil,MMA P 508>862-4022 F 508-862-4722 http://www.townofbamstable.us/Assessing/propertydisplayscreen 1,7.asp?a... 10/20/2017 r Official Website of The Town of Barnstable - Property Lookup Page 2 of 4 GALLO,RICHARD M&GRACE E 1994-04-15 9165/302 $1 I GALLO,EMILIO&MARDELL D 1990-63-16 7093/243 $1 DOUGHERTY,ANTHONY&MILDRED1952-04-28 809/522 $.0 Photos 186!0451-Use Code:1090 1 i'C Aar$ Sketches.-Map/Block/Lot: 186/045/-Use Code: 1090 , This property contains multiple sketches. Please use the navigation below the sketch to browse sketches:` 1 -FOP ; s o- Current Building ID=13005 details below I Additional Sketches 1 121 Click Here for print version that displays all sketches at once AsBuilt Card N/A Constructions Details-Map/Block/Lot:186/0451-Use Code:1090 r Building Details Land i Building value $`204,200 tlroom �BedroomsUSE CODE 1090 Replacement ' _ - �..f 4 _ Cost $103,606 Bath 1 Full-0_Half� (Acres) Model Residential Total Rooms 6 Rooms .Appraised $316,006 ; { Value Style Conventional Heat Fuel Gas Assessed $ Value 316,000 Grade Average Heat Type Hot Air " Yea -Built "-"T900"` —\ AC Type None # i �( Effective 40 Interior Floors Pine/Soft Wood I 4 depreciation http://www.townofbarn stable.us/Assessing/propertydisplay screen 17.asp?a... 10/20/2017 Official Website of The Town of Barnstable'- Property Lookup Page 3 of 4 Stories 1 Story Interior Walls Drywall ILiving Area sq/ft 901 Exterior Walls Wood Shingle i Gross Area sq/ft 1,033 Roof Gable/Hip Structure € Roof Cover Asph/F GIs/Cmp t i 'Outbuildings&Extra Features Map/Block/Lot:186/045/-Use Code: 1090 Code Description Units/SQ ft Appraised Value Assessed Value WDCK Wood Decking 80 $1,200 $1,200 w/railings FOP Open Porch-roof- 152 $4,200 $4,200 ceiling 3 . . FOP Open Porch-roof- 132 $3,500 $3,500 ' ceiling Sketch Legend " 1 Property Sketch Legend - - i B2N Barn-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) - i CLP Loading Platform GRN 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 jFHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) 1 FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio i I 1 'Print Friendly t. Contact Director Edward F.O'Neil.MMA P 508-862-4022 http://www.townofbarnstable.us/Assessing/propertydisplayscreen l 7.asp?a... 10/20/2017 r FORM B— BUILDING Assessor's Number USGS Quad Area(s) :Form Number • ,186045. .: _ _.. � � 2337 MASSACHUSETTS HISTORICAL COMMISSION MASSACHUSETTS ARCHIVES BUILDING 220 MORRISSEY BOULEVARD Town: Barnstable BOSTON, MASSACHUSETTS 02125 Place:,(neighborhood or village) Centerville Photograph Address: 586 South Main Street Historic-Name: Joseph D.and:Hulda.S.<Crowell House e Uses:, Present.: Single-Family Residential _s , Original: Single-Family Residential' Date of Construction: 1860-1880 Source: Style ' Style/Form: Second Empire Architect/Builder: Unknown kN Exterior Material: Foundation: Granite Wall/Trim: Wood Shingles Topographic or Assessor's Map Roof Asphalt Shingles/Wood Shingles Outbuildings/Secondary Structures: A converted one-and one-half story outbuilding is located northwest of the residence. B686 IB8047y :. "°°' Major Alterations (with dates).: 1W8 Condition: Good Moved: no I x yes'I Date Acreage: 1.22 acre Setting: The building faces southwest and is set back .Iseoae683 188043 Q ...12 . - approximately twenty feet from the,road on a level lot. Bn 125 Feet: �.. Vie `} l B 18� Recorded by: Geoffrey E Melhuish,ttl-architects Organization: Town of Barnstable Date(month/year): August 2009 Follow Massachusetts Historical Commission Survey.Manual instructions for completing this form. Anderson, Robin To: Renie Hamman Subject: RE: Compliance question Hi Renie, I have found nothing that clearly identifies when that secondary structure was constructed and/or converted to a second dwelling unit. I also checked the historic listing you referenced and as a result all I can say is that both structures are very old. Unfortunately,there is no real permitting history and no documentation on which to base a definitive determination. I might add that there is also an absence of complaints concerning zoning violations,which is a good thing—nothing illegal was noted on record. Ultimately,..I do believe that the sheer age of both structures (supported by its t Te of period construction and appearance)will assist the building commissioner in declaring this property to be a legal non-conforming property with two dwellings. I must leave this determination up to the building commissioner, Brian Florence. You may submit a written request for a determination from him. Please reference the subject address. C&Ohin Robin C.Anderson Zoning Enforceent Officer m 2Q9,.Main:Street ; Nyiii nis;=I' 'A 026oi 508-862-4027 From:,.Renie Hamman [mailto:rhamman@freemanlawgroup.com] Sent: Thursday, October 19, 2017 11:19 AM To: Anderson, Robin Subject: Compliance question Hi Robin:, ,.:,.. It's_been.a:while; hope all is well! Hey, I was wondering if you could help us on a question. If you don't have time, that's perfectly fine just let me know. You guys must be so busy. Anyway;; 04 'a;nd`Phave`a client that owns property in Centerville which has been owned by his family for generations. It has a house and a cottage in the back,both built circa 1870. The Assessor's record states 1900 but the historical inventory states 1870. It's inventoried as the Joseph D. Crowell house. I have not yet had time to go to the Assessor's office to pull the old As-Built cards (I wish they were online!). But given the historical nature of the buildings;.Lwould assume that they are legally pre-existing non-conforming. Anywa',the family has been renting the back cottage seasonally every year since.at least since 1947. The owners of the property have'now put it up for sale and we are trying to determine if the property is legally pre-existing and'' that the`back cottage can be rented. Mea Culpa,the owner did now know he was supposed to have registered the rental w.ith;theBoard of Health. Peter stopped by and looked at the.building file,but said there wasn't anything in it but he+may not have.looked very closely as he was probably in a rush. The Assessors-Record lists the property as Use Code 1090 (Multiple housing on one property). 8o after all that.1 guess my first question is whether or not you have any information on whether this is a•legally. pre-existing two family. And then I guess I would need to look at the zoning bylaw in effect in 1947. Any thoughts? Thanks!.,. ;...... ROR'Offamman,Paralegal gee man:Law Group LLC ` 86'V611ow Street Yarmo'dih Port, MA 02675 rhamroangfreemanlawgroup.com 1 .l Ij- (Ail E i r r 1 t ,[j j f ce�'Oil �1�y (17 C;?D) V07q � Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee 1-3 o 0 t�►antAM 1639. Richard V.Scali,Interim Director Building Division Tom Perry,CBO,Building Commissioner OCT 2 7 200 Main Street,Hyannis,MA 02601 TO I- ,�I 1014 www.town.bamstable.ma.us I/i/tU 01 g Office: 508-862-4038 F AsT A"SPE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number - Property Address �. S. VVI tq /dU S l_ (2 CA)Te, 3-y 1 0 [> Residential Value of Work D� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address G. A u_o c,�e q-c L (:S, A-L co Contractor's Name t) 4" Telephone Number Home Improvement Contractor License#(if applicable) A)A Email: Construction Supervisor's License#(if applicable) A)kt ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor Q'I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit: Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value ©- t'{ (maximum.35)#of windows -TN&R_4j A 7-2U #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department.regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is r uired. $NATURE: TAKEV][N—Muilding Changes\EXPRESS PERNIMEXPRESS.doc Revised 061313 f The Commonneakh of Massachusetts Department.of Industrial Actddents O re of Inver igadons if 600 Washington Shwet Boston,AL4 02111 wmitntass gov/dia . Workers'Compensation Insurance Affidavit:Budders/Contracbn%Tlectricians/Plumbers Applicant Information Please Print LeObly Name C 1V-1Cu Actress: S, (/!/l l/t City/State/Zip: Phone# SO Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with. 4. I am a general contractor and 1 6. New construction employees(hill and/or part-timee" have hired the sub-contrwtois 2.❑ I am a sole proprietor or partner- listed on The attached sheet 7. ❑.Remodeling ship and have no employees 'These subcontractors have 8. Demolition working for me in any capacity. employees have wodws' 9. �Building addition [No worhess'Comp.insurance comp. required-] 5. ❑ We are a corporation and its 10:❑Electrical repairs or additions 3-VI am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions: myself[No workers'comp. right g152 f l tend we have 0 MGL 12.F]Roof repairs insurance required.]t § ( ) l3.RU-'tither/U�1lI %�OC9li_ ' employees.[No workers' comp:insurance required:] *Any sppticam that checks box 81 most also fill out the section below showing their waders'compensation policy infornodam. T Homeowners who submit this aunt iothcat ng they ae doing all work and then hue oawde cofactors most submit a new aMdw t indicating such lCoanactas that check his box IDast attached=additional sheet showing the tame of the std}caunacoors end rune whether at not those entities hm employees. If the ntb•COntraLton bm employees,they ttmttptoctde rhea waekers'comp.policy nsanbu: I am an employer that is protift nwrhers'compensation insurance for my employees: Below is the po►iey and job site information. Insurance Company Name= Policy#or Self ias..Lic #: Expiration Date: Job Site Address: City/Stat&Mp: 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 MOL 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 hers certi u the pains and allies o �e is true and correct by fy poi pen f perjury that the inforrrtadion provided abo► CWWal use only. Do not write in this area,to be completed by city or town official City or Town: PermitilAcense Issuing Authority(circle one): 1.Board of Health 2.Bwlding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 0: 6 Town of Barnstable Regulatory Services of Richard V.Scali,Interim Director Building Division nAaMARX ' Tom Perry,Building Commissioner MM& 63¢�� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ------------ -------------�---- -------------------------------- HOMEOWNER LICENSE EXEMPTION DATE:- Please Print _-- C' �^ JOB LOCATION: J S.�/�//(J > number`'// /_ street j village "HOMEOWNER": 1d H1z , , & �S� Atla S -77J �&2&2' 6—ar-373'Y//S name home phone# work phone# CURRENT MAILING ADDRESS: l ��/f;lc, S city/town state zip code The current exemption for"homeowners"was extended to:include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proced res and requirements p9d that he/she will comply with said procedures and requirements. Sigi azure of Homcowncr Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. T:%KEVIN D\Building Changes\EXPRESS PERM171EXPRESS.doc Revised 061313 I i � - i r b/6 b �oFrru>gf Town of Barnstable *Permit# ti ' o Regulatory Services Erpires 6 inadhs from issrre dare X3cA,rjvsrXBLE, Fee s 72`57-. pgSs. 1619- Thomas F. Geiler, Director (OR 1 (/611-7/ p� l' J Building Division Tom Perry, CBO, Building Commissioner 200 Main Sheet, Hyannis, MA 02601 www.town.barnstable.rria.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Nnl Val""rvilllorrl Red X-Press lmprinl Nlaplparcel Numberr'S.� S Property Address 9Y6 Residential Value of Work_ Minimum fee or$35,00 for work under$6000.00 Owner's Name & Address sM oy Al Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor P"'I'am the Homeowner ❑ I have Worker's Compensat ion Insurance _PRESS PERMIT Insurance Company Name NQV 2 11 0 Workman's Comp,Policy f{ TOWN OF ��N�T�� Copy of Insurance Compliance Certificate must accompany each permit. t ; Permit Request (check box) I[� Re-roof(hurrkane nailed) (stripping old shingles) All construction debris will be taken to fg; 1� � ❑ Re-roof(hurricane nailed) (not stripping. Going over existing layers of roof) . Ej Re-side #of doors ❑ Replacement Windowsldoors/sliders. U-Valtie (maximum .35)#of windows *Where required:. Issuance of this permit does not exempt compliance with other town department regulations,i.e. Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission, A copy of the Home Improvement.Contractors License & Co red, nstruction Supervisors License is 3IGNATUIZE: )'�WPRII cc1C(1BMClhnilAino n�n.fr f�,,.�lCvoDccc.�__ r. .i2 y. The Contruorrwe.ahh ofAfassachusetts — --- Department of Industrial_Accidents Office ofLTnestignlions 600 Wash n ton Street t=- Boston, .rV-1 02111 ^ems 11.11VW.runss.gow'dia 'Workei-s' Compensation Insurance A.ffi.da-6t: Builders/Col:t.trlctorsJElectrici.ius/Pl:ianbers Applicant Information Please hint Legiblti ti��e(Busri�}Orgaui�afiau.�Individctal): �l C-G��-� �.d ' QC. LPlione #: -7 Are you an emp.loyer?Check the appropriate.box:: Type of project(requit-ed): I.❑ I am a employer with `4. ❑ I am a general contractor and I eivployees{full and/or part-tiu�e)- have hired the sub-cont—actors 6- ❑.Alevvconstnrction I❑ I am a sole proprietor orpartner- listed on.the attached sheet, 7. 0.Remodeling ship.and have,no employees These stab-contractors have & ❑:Demolition working :for.me in any capacity, employees and have workers' p.,❑Builclin,g addition [No workers, comp,insurance comp_insurance.. fired.] 5 ❑ We are.a corporation.and its 10.❑Electric:al repairs or additions "3. I ani a.homeo-",ner doing.,/1 work officers have exercised their 11.❑.Plumbing repairs or additions t� :myself. [No workers'comp. riglit of exemption per iE�IGL 12.[]Roof repairs insurance:required.]I c-152 §1(d)„ and.give have no etup.loyees.'[No workers' 13..❑ Other carrip.:insurauee:req:nued.] ' 'Any appficaut that checks box#1-Hurst also fill.out the section below sbazving Their worker,'conrpensobon poh..cy informatiam- t 11ameovi ers who submit this_affidavit indicating they are doing all-wor&and then hire oirtside.contraciors mast submit.a new affidavit indicating sutli. "Contractors that cbe�k this box must attacbed an addition,[:sbe.et showing the rosnre of the sub-eon'tMctbrs anal anie whe&er or not those eotiries have employee$. If the sub-contractors:has+e employees,they.urust provide their workers'comp.policy number. I ust all eVFPZoyerr drat is pro vic ng workers':contpertsrtdon i tsuran.ce for arty r?rtrpla)••ees. Below'is the p.oltcy and job site igformiatiolt, Insurance Company Name: Policy#or.&elf-ins-Lic.-9: Expiration I}a_te: Job Site Address: city/State/zip- ---Attach a copy of.the lrorkers'compensation policy declaration page(s:hoiiing the policy number and expiration date). Failure to secure coverage as requited under Section 2.5A of MGL c.. 152 can lead to the imposition of crinunal penalties of a fine up to$1,500.00 and/or one-year.imprisonment,as well as cisal penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the vioLa.tor. Be advised that a copy of this statement may be.fortis aided to the Office of Investigations of the D.IA for insurance coverage vexif cation. " I do ItertPb certi t er E in gppeat at 'es of e ,try that the is forntrrtion prvuidad above is true and correct. t 5L afire.. Gpat � /L O�cial use only. Do not write in this area,to be contpLded by citiy or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 3.Building Department 3,City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Plione#: 0 K*E Town of Barnstable ' Regulatory Services M 'aAj(AssBLE, Thomas F. Geiler, Director = °639' Building Division' Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstabile.ma,us Office. 518-962-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print SATE:, number street village "PION"[:O W_NE R' .K— name home phone N work p one tl CURRENT'MA'1-LNG'ADDRESS:�.:Aj3 i( 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-yearperiod 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 The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. I undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pro r a re i ents rid tha e she will comply with said procedures and requirements. �ignature of Hom owner Approval of Building Official Note: Three-familydwellings.containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section.12T.0 Construction Control. HOMEOWNER'S L PA1P TION 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" 109t 1.1 -'Licensing ofconstn.ctiomSupervisors);provided that if the homeowner engages person(s)for Hire to do such work,that such Homeowner shall act as Supervisor." Many homeowners who use this exemption are unaware that'rhey are assuming the responsibilities of a supervisor(set Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. ` To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify thathe/she"understands the responsibilities ofa Supervisor. On the last page of this issue is a form currently used.by several towns. You may care I amend and adopt such a form/certification for use in your community. Q:IWPFILESIFORMSIbuilding pennil formslEXPRESS.doc pF IHE Tp� # ■ BARNSrABLE, MASS. Town of Barnstable pTFD MA'S A Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 026 l www.town.barnstable.ma.it Office: 508-862-4038 Fax:(508-790-6230 •,, Property O wne must Complete and Sign his Section If Using A uilder r, Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by t b ding permit application for: (Address of Jo ) Signature of Owner Date Print Name If Property Owner is applying for permit, please complete the Homeowners License Exemption Forma on the reverse side. QAWPFILESIFORMSlbuilding Permit formslEXPRESS.doc 6/Z7ljq Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee • lARNBTABLB. • . MASS Richard V.Scali,Interim Director Building Division Tom Perry,CBO,Building Commissioner ®�Mo 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us gI '�9 Z � Office: 508-862-4038 Fax: 508-706"-60230 EXPRESS PERMIT APPLICATION - RESIDENTIA� t�Y`a Map/parcel Number �� Not Valid without Red X-Press Imprint �V Q - &Z Property Address J � � I-�( l j ok, l�.1*-v L—LE [Residential Value of Work$ ��_ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 12 d kkl> A U_Q Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) _ o � ❑Workman's Compensation Insurance Check one: proprietor 3t1,t 2 jat4 I am a sole ro netor [�]'I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name TOnn��gp�tlo�OW:B��NWABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ (check box) ,�''``e-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to1 y'j i71--_ ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) LA-63tj -Fc U— ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is e ed. SIGNATURE: TAKEVIN MBuilding Changes\EXPRESS PERMITAEXPRESS.doc Revised 061313 Ile Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1P 600 Washington Street Boston,MA 02111 r4hmv.n#ass gov/din Workers' Compensation Insurance Affidavit:Builders/Contractors/ElectricianslPlumbers Applicant Information '/� Please Print Lezibly Name(Basinesslorganization/lndieidoal): VC Ir- � e: 4 LLO Address 6 AID, &t f,(-(Lo S City/StaWZip: l-J--(5 Phone#: Q S— cG Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have S. Demolition working for me in any capacity. employees and have workers' insurance.t 9- Building addition c [No workers'comp.insurance �P- ed.] 5• ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.VI am a homeowner doing all work officers have exercised their I L❑Plumbing repairs or additions myself[No workers'comp_ right of exemption per MGL 12.❑Roof repairs insurance required.]T c.152,§1(4),and we have no employees-[No workers' 13.❑Other comp.insurance required_] ;Any applicant that checks boa#1 mug also fill out the section below showing th&workers'compensation policy information. Homeowners who submit this affida rn indicating they are doing all wok and then hue onside coumcmrs must submit a new affidavit indicating such. 'Connectors that check this box mast aMChed an additional sheet showing-the name of the sub-camzacmrs and state whether at not those entities bare employees. If the sub-contractors have employees,they mist provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name` Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 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 here cell,rti It d pains andpenelties of Perjury that the information provided above is.true and correct Si ture: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Town of Barnstable Regulatory Services coF Richard V.Scali,Interim Director Building Division Tom Perry,Building Commissioner taass. �1639 �1� .200 Main Street, Hyannis,MA 02601 f p www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION q: �7 Please Print DATE:JOB LOCATIOb ��, (ICU ( � �_h�J�L�(JZ` ( L 1.L; number street village "HOMEOWNER": r44a i-ml> (H. & LQ name home phone# work phone# CURRENT MAILING ADDRESS: S ` city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section . 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pro e d re is�he/she l comply with said procedures and requirements. Signature of Home caner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. TAKEVIN D\Building Changes\EXPRESS PERMITTMRESS.doc Revised 061313 � Town of Barnstable *Permit# C90`-� Expires 6 months from issue date Regulatory Services Fee_ ?� � Thomas F.Geiler,Director 63,>. �. �9/4113�. Building Division Tom Perry,CBO, Building Commissioner. 200 Main Street,Hyannis,MA 02601 ✓ www.townbamstable.ma.us Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY r O( ➢ �ot Valid without Red X-Press Imprint Map/parcel Number Property Address LJ�sidential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name P LA— Telephone Number Home Improvement Contractor License#(if applicable) ±�1 A Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance PER Check one: '� I ❑ I am a sole proprietor STP 2-1 am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name TOO OF Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ZRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to VOLJQ lDUA1P/& *&-)- P4ct-eFt ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (msxrnum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: QAWPFILES\FORMS\building permit forms\EJPRESS.doc Revised 060513 Ykii Consrrrorrivealth of Vassachuseffs Dep arf rent of lnduskial Accidents _..-.- Office-of Invest gations s ... . ' 600 Washington Street Boston,MA 02111 wmi mass govIdia Workers' Compensatian Insux-auce Affidavit:Baders/Contractors/E ectricians(Plumbers Applicant Information n Please Print Leeibly Na=MusineWOfganizalioaUdMdnal7: pc,(CaAIPJC� 04 @'7k(-_.L- Address: S,2Y(c, 9Dc�` V� m-A-(o� CitylStat&Zip: C&TZEaV I LL_G Phone 4-- Are you an employer?Check the appropriate box: T . of project r 4_ I am a contractor and I 3'1� � 1 (required): 1_❑ I am a employer with ❑ g�� ti_ ❑New construction employees(full andlor part-time).* have hired the sub-contractor_ 2❑ I am a sole proprietor or partner listed on the attached sheet 7- ❑Remodeling drip and have no employees These sub-contractors have g. ❑Demolition working forme in any capacity- employees and have wodcers' g_ ❑Building addition [No workers' comp_insurance comp.msuranmi required-] 5. ❑ We area eorporati>ffiand its 10..❑Electrical repairs or additions 3_Elam a homeowner doing all work. officers have exercised their 11.0 Plumbing repairs or additions myself [No workers'comp_ right of exemption per MGL 12�Ro of repairs insurance required_]T c.152,§1(4X and we have no employees-[No workers' 13_❑Other comp-inm anm Mquired-] *Any appliicant that chedks boa#1 mast also fill out the:section below showing their wodkere compensation policy fu�rmatiob T Homeowners who submit this affidavit indicating they are doing all wcA and then hire outside contractors Est submit a new affidavit indicating such- tCantacrors that check this boa mast attached an additional sheet shaming the name of fe sab-cautrxtors and state whether ornot those mmtit have employees. if the sub-contracurs have employees,they must provide their workers'comp.policy number. .firm an employer that is providing workers'cot gwmadan insurance for my amplayem Below is the policy and job site information. Insurance Company-Name- Policy#or Self-ins.Lie. : Expiration hate: Job Site Address: City/Statelzip: Attach a copy of the workers'compensation policy declaration page(showing the police 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$1,50G.00 and/or one-yearunpnsaumeat,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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification_ I do-wire certi re thepains andpenal es ofperjuty that the information prini4ed above is hue and correct Si tare: Date: Phone#: 01kial iue only. Do not write in this area,to be completed by Gity or town official. City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.CiVrown 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. Pursuantto 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 includmgthe 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." r MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has,not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL'chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificatc-(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or.partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum 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: 11 ' The Commonwealth of Massachusetts Depai went of Industdal Accidents Office of Javestigatioas 600 Washington Street Boston,MA 02111 T(�-I.#617-727-4M W 406 or 1-977 MASWE Revised 4-24-07 Fax#617-727-7749 - W .mass_gov/dia i BIKE Town of Barnstable * Regulatory Services RAJOW9 w. Thomas F.Geiler,Director ► 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 HOMEOWNER LICENSE EXEMPTION /za Please Print DATE: JOB LOCATION: CM, cSn eSay Imo —0 P LS— number r street village "HOMEOWNER": � VA-Luo S �- 77S 26�? AR 8? Ell 5 name home phone# n work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pr d re is d ti /she will comply with said procedures and requirements. Signature of Home weer Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&ReguIations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\ContentOutlook\QRE6ZUBN\EXPRFSS.doc Revised 053012 E T Town of Barnstable Regulatory Services saxx I'E Thomas F.Geiler,Director 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 l}' ' ' l' Property Owner Must t - { 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 (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS 62012 rt Town ®f Barnstable Erpires 6 months oru issu Regulatory:Services Fee . v w BAMSrsa;r // 1 R` Thomas F.Geiler,Director ( idt5WO Building Division Toro Perry,CBO, Building Commissioner, 200 Main Street,Hyannis,MA 02601 www.town.ba.rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPILICATION - RESIIIEN TUL ONLY Not Valid without Red X Press Imprint Map/parcel Number Property Address �� Residential Value of Work �' �� 1111inimuin fee of$25.00 for work sander$6000.00 Owner's Name&Address JZ, Contractor's Name4 Telephone Number J 0 Home Improvement Contractor'License#.(if applicable) bCp 7 6737 Construction Supervisor's License#(if applicable) J"�5~ X�PRESQ =01 M I . ❑Workman's Compensation Insurance APR 2010 Check one; :. I am a sole proprietor 0 I am the Homeowner TO M OF BARNSTABLE ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction'debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) q: Re-side #of doors Replacemcn Window oors/sliders.U-Value_ . (maximum".44)#of windows 1 ;m Where required: Issuance of this permit does not exempt compliance with other town department regulations;i.e.Historic,Conservation,etc. **Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction,Supervisors License is required SIGNATURE: a C:\Users\decollik\AppData\Local\Microsofi\Windows\Temporary Internet Files\Content Outlook\4STGU5QO\EXPRESS.doc Revised 090809 The Commonwealth of Massachusetts Department of Industrial Accidents 4 ;µ� Office of Investigations �•/ 600 Washington Street % k=77 '„` Boston,MA 02111 1711, Www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lesibly Name(Business/Organization/Individual):� �� /P� Address: o City/State/Zip: Phone#: Are you an employer?Check the appropri a box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I . employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.,,I am a sole proprietor or partner- listed on the attached sheet. 7. E]Remodeling ship and have no employees These sub-contractors have g, []Demolition working for me in capacity. employees and have workers' an3' ap ty• t 9. �Building addition [No workers'comp.insurance comp.insurance. required] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c.152,§1(4);and we have no employees. [No workers' 13.0 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 sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic #: Expiration Date: n Job Site Address: 0 .�� GI City/State/Zip: A-7� 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 s and penalties perjury a information provided above is true and correct Si tore: Date: Phone#: Official use only. Do not write in this area,to be completed by caty 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# °'lu& Town of Barnstable Regulatory Services „ Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.bamstablema.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder (srt U-6) ,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: WA - (Address of Job) I Z11 �l Signature 4 Owne ' Date C(-fry-�2► Cr�4 L-L- Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppDataU"aDMicroso8\Windows\Temporary lnt=et Fgcs\ContentOutlook\4STGU5QOW-XPRESS.doc Revised 090809 ✓/ze �o�n awouoealtl � ,�; License or registration valid for individul use onl • Office of Consumer Affairs&Busiuess Regelation Y HOME : IMPROVEMENT g VEMENT CONTRACt(� before the expiration date. If found return t0 t Office of Consumer Affairs and Business Re ulation Rdblstration 164505x, 1 Expiation10/13/2011 Ti 289749 s 10 Park Plaza Suite 5170. , IntlividUal Boston,MA TYp �116 � AN DREW REED it ANDREW REED , i i00 SETH GOODSPEED WAY`, ;l .. OSTERVILLE, MA 02F_° Underz7 c&-ia- 4 r' — hot valid without si atu s - Massachusetts—Department of Public'Safet Board of Bu.ildin- Regulations and Standards Coristructlon:Supervisor:License License: CS 102575' ` Restricted.to 001u fr 4.1, , " x ti ANDREW.}REED 4.P � Y �•- , 1 1.00 SETH`-GOODSPEED WAY'° �'� i'' OSTERVILLE' MA;02655 Expiration: 7/13/2012 r...».,,:.�•:,...o. T.rr• �mates TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION e Map g� Parcel © Application# ®� 7� Health Division " Conservation Division. Permit# Tax Collector Date Issued a� d Treasurer sti Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved b Planning Boards Historic-OKH Preservation/Hyannis Project�Street-Address�.�'R� �©y`t��f- �1�-tl�, S'a` Vill . f t�l Uri �d O �7nefr2(G �DD G��B�C�I.� Address c� -W( Telephone 9DW — e r feet: Square eet 1st floor:existing proposed 2nd floor:existing pr�po a Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ��"' 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 3 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: C= CD Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If es, site. Ian review# - - __. .Y _p .. C; Current Use Proposed Use t ft)llJE—(,@_ B- UIL'DER INFORMATION .. c Name Telephone Number r 1: Address License# ,Home Improvement Contractor# Worker's Compensation# ALL CONSTRU TION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY Y Y PERMIT NO. DATE ISSUED MAP/PARCEL NO. ti A �y ADDRESS a VILLAGE OWNER DATE OF INSPECTION: AA DD,s FOUNDATION SONosI owl 1316-2 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL " FINAL BUILDING a .. DATE CLOSED OUT ASSOCIATION PLAN NO.-" t �+ ( \ 1N.c vj lIlWOJf+WiwJGrw o� Department of Industrial Accidents Office of Investigations 600 Washington Street' Boston,MA 02111 www.mass.gov/dia ' Workers" Compensation bisurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibiy Name(Business/Orga3ization/Individual):1�1Cf' t IR� . 04 &A-LUD •Address: ,�16 �C>Ue F AAA^'� C� City/State/Zip: t Lim Phone A Q0 Q- 7 S—�f--------------- Are you an employer? Check the'appropriate box: 4. I am a general contractor and I Type of project(required):. . 1.❑ I am a employer with ❑ g employees(fall and/or part time).* have biped the sib-contractors 6..❑New construction i 2.❑ I am&'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. $ quired] 5. ❑ Vice are a corporation and its 10.[]Electrical repairs or additions officers have exercised their 3. I am a homeowner doing.all work 11.❑Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12,❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 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 affmdatit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. check this box mu a additional Contractors thatch must ttached an dihonal sheet showing the name of the'sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employges,they must provide their workers'comp.polidynumber. . I4M an employer that is providing workers'compensation insurance for my employees. Below is.the policy and jab 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). Failurejo. secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fire up to$1,500.00 and/or one-year imprisonment,as we'll 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 maybe forwarded to the Office of Investigations of the 1DIA-for insurance coverage verification. ldoherzbycertifyu. e the p' ' d penalfes f erjury that the information provided ab ve is tr and correct,' Si afar Date: OS Phone#: FBo only,. Do not write.in this area, fa be completed by city or town offciaL n: Permit/License# hority(circle one); Health 2.Building Department 3. City/Town Clerk 4,Electrical Inspector 5.Plumbing Inspector rson: Phone 9: InforM ation and. Insttucti®n : 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 hiie, 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 zec�vPr or tr�tee of an individual,partnership. association or other legal entity, einploying*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." MOL 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-W.ho has not produced-acceptable evidence of compliance with the insurance coverage required" c l MGL chapter 152 � 25C 7 states Neither the commonwealth nor any of its political subdivisions shall Additionally, p , § ( ) enter into any contract forthe performance of public work until-acceptable evidence of cflmplieuce with the in—surance 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), addresses)and phone numbers)along with their certificates)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other.than the ' members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that thus affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or.license is being requested,not the Department of Industrial Accidents,' Should you have any questions regarding the law-or'-if you are regiurea 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 appropriateline. City or Tows►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 cbpy'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 ventute (i.e.a d-0g license or pernut to brim leaves-etc.)said person is NOT required to.complete this affidavit. The Office of Investigations would like to thank you in advance for your co operation and should you have any questions.�— Please do not hesitate to give us a call. The Department's address,telephone•and fax number: 7be Cm=c> alth of MassaoI Depatmmt of ladusWal Aoci.donts Office Qf In-yestigations Bastcm,ILIA U-111 TeL # 617-727--490-0 ext 4.06 or 1-017-M4SSAFE Fax 61'�-7�' - f4 ° Revised 11-22-06 www.mass.gavl6a i °pSME, Town of Barnstable Regulatory Services yasTAsi.e,� Thomas F.Geiler,Director �p 039. re0M p Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. . Type of Work: 4e)lZ C-�j e- Estimated Cost Address of Work: to St,P 19(1+W'en Owner's Name: C6��- Q Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []Building not owner-occupied [✓]Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name Q:fonmhomeaffidav I Town of Barnstable Regulatory Services Thomas F.Geiler,Director * BAMSCABLE, 1639. ,� Building Division pTED �p. Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION l Please Print DATE:sl�l©-7 r JOB LOCA TION: 6 �Sl� i4i 0-��TMV I LL j�(pnu�,mber /f �'�A street // t�villag�e p� `/ "HOMEOWNER, ULLC� � l��.� ��g 6Z "Z�b ,Q0 q C.,ar-7®Y 5 name home phone# work phone# CURRENT MAILING ADDRESS: S lA"GK�C city/towm 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 >3 Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance-with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department um inspectio rocedures and requirements and that he/she will comply with said procedures and re e Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner.shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt 2 3-4 SFoc3z 6'v l�(AiLlt SG!5 3S �PfP��S x g,CS�� 1R!i LS 32 P� TO 'rop i --�- / �}d�+dA t�c �R-K oaf' 4. � j i ff I ia l sT g P(b`R ef 4k r>EE� ovC-aAL �� st�dJ: SIG xlZo" A a i 3 a 40A a r j R . Ab�9a 11 5 ockos Fronk A/. Lewis ��)� S 52`03, l0"r- -' /yes• Newry L00177iS 3�7 (11 'S FENck 20"E PlCKET E 14 soft \ \ -Q , 200.1 i 61 o Or1 , I\ N . 5 ockus ° I A b'9a Po 7'SE I S52°p3' 10 N � yrs. Hear S Loomis 3/7 t q I . - • . ��, to �p 38.2o.. FE,)CE .. 50.13 36 3G0°t :ol7 N 2� 204 ' 67 .00-NI 0 9 f c I�rPir • w is - PLAN oF LAND 0 o C E TE RVIL.L F. MASS. PROPERTY OF . AjvrHoivvF MILDRED Y. DovaHEATY . Scale . I inch= 40.PeJ - Sept 26, 1952 • �3edr'Se � lie.//aC�� — Ci`vi•l �i7�'�1�H�r's • � C`ENT��?1/lLLE