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4741 FALMOUTH ROAD/RTE 28
A7E 28 12407V17 (f:g 't SINE TOWN OF BARNSTABLE B raj jng Application Ref: 201102845 Permi BARNSTABLE, + Issue Date: 06/06/11 t 9 MASS. 1639• Applicant: TONELLO,JEFFREY R Permit Number: B 20111132 ArFD 1%P'1 A Proposed Use: SINGLE FAMILY HOME Expiration Date: 12/04/11 Location 4741 FALMOUTH ROAD/RTE 28Zoning District RF Permit Type: RESIDENTIAL INSULATION Map Parcel 009020 Permit Fee$ 35.00 Contractor TONELLO,JEFFREY R Village COTUIT App Fee$ 50.00 License Num 53202 Est Construction Cost$ 1,500 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND WEATHERIZATION,AIR SEALING,WEATHERSTRIPS,DOOR SWEET S THIS CARD MUST BE KEPT POSTED UNTIL FINAL LATTIC INSUL,DENSE PACK UNDER FLOOR TO CAP R-18-20 INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: SYLVIA,MANUEL O BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 338 PLEASANT PINES AVE INSPECTION HAS BEEN MADE. CENTERVILLE, MA 02632 Application Entered by: RM Building Permit Issued By: .THIS PERMIT CONVEYS NO RIGHTTOOCCUPYANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHERTEMPORARILY OR PERMANENTLY. EN.CROACHEIvIENTS ON PUBLIC.PROPERTY;NOT SPECIFICALLY PERMITTED UNDER`THE'BUILDING CODE',MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLY GRADESAS WELL:AS;DEPTH AND LOCATION OF PUBLIC SEWEM MAYBE OBTAIN.ED FROM,THE DEPARTMENT OF PUBLIC'WORKS.` THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS'OF"ANY APPLICABLE SUBDIVISION RESTRICTIONS. . MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS.TO BE COMPLETED PRIOR,TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map eog Parcel Application # 6�)q-1 Health Division Date Issued Conservation Division Application Fee -sd ot> Planning Dept. Permit Fee 3 Zt� . Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address Village _c- c-'. Owner o, a.at Address 33fi Telephone3�a- Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new a C5 Zoning District Flood Plain Groundwater Overlay Project Valuation* t��m . Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Lid' Two Family ❑ Multi-Family(# units) r°"( Age of Existing Structure v4 y Historic House: ❑Yes ❑ No On Old King's Highway: Q Yes=U No Basement Type: ❑ Full 3.65awl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: k existing —new Total Room Count (not including baths): existing ,I new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil U'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 0 new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name c,u ® . Telephone Number a ot- `$vi- o Address License# 4 3 ze 7 Home Improvement Contractor# xso Z s �8 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ��S w �2�Z ►.i ce �ewa� �oa1 tt� .Z�S �a . SIGNATURE DATE ' t 4 FOR OFFICIAL USE ONLY APPLICATION# + DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION s FRAME ,p s INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) IM A , DATA n�V, ._ 21 SM yni �.i i�� SS: -,,�1i1 ARP _ iERF :J +dry C ` , qq [[ r , phi Of ��;. /:+ i { L;:�LiN� iV,i. h%� n�bC vf��n�� f:��_'141 VJ� ��`�- { : P you k'��14 'ALL °41 R f3 Y HES PhI, T, S, I ]Lk, of CEALLit, col:16 1Lt'e and appoint DliW Ak BU'T, !;1' (_,t'P.'!C!Z'.il..l�, iV1ilaSCtCzil.S' ttS 1T11� ttl.)l i:Tlil 1c7.V tli l:tolncy �'or Me EN !iln!IMnd,t hlc:e "Ilki 5ti::1Cl sf.ated 1JC:T;JJ IJ,. I. '�>i'rrTs Convev '�1. T heri'l� !£Till". t IIly will af:t()mcy h"I., o'i"�e-r bili wbg POW, :1IiC'_ illl'i}1,E)�i1C'•]" to Ci(i necessary in, cxc-c!siaf� `iiy of f to po• =s ON n 111.teCi S I ili i T 11; ;'11t l; Persotiaily r;T. ..estn OX Coll. a. in gP.}pg)f: i0 Cr:C;TCI:; : ()1 �)'r1C]ill C+SJ�' :• 1?plZrrol'y C!':t}'., 1'J. }1! C.)1,' ;Vlitsoi:,Vcl i•_ha—, 1]1ov,, haVC 67 T-.14y!)�Cer1I$;i' ilC�ill c•TC'1'lllTl.i; 1`} Liii , pff;'soia, i1 at4e;r; t)'c 11}:I J PD'TILTly, 1-eal or prc.rson.,iiti3', t rinit'�{c{.r intL&LgibR, pres&;P!_, (.t}i1.h-agoem Ui <.y IL{:I.:illb, UDIN possessed or el-00 4- acCf'11red by me, 217."•ludiL ' hi PvfT,'11QU1 H"laitatlli;l, to TOM.;l}' t:.ticlrner�t�.d�cwe.t;s�rrsc]ic.il li���;-eil�l�_'lI�J, `. �{7T4it?JS L?J 'C1Z%ECllGri, �iLti717G7'iT .''nLi £''rljorI -,,-,m 'rf: To CYraar_d, sur, GCliCit; cC?JllpTiT.nist, recover and rCt:;t:be all debts, !i_vnoj's, 151ope.;t.,)7 li]tC'CCsi;,, i'i,�17 j: ."T(i Ciellcl:'_ 5 MEOW now he oi• tiiat i y h 7'tiltte r:u T be or become due t1; int, YIYi'"111(iiT]'' ilia' .rigll+ to I:istltutc a.-, ltg'2:,1. )r eg1ll:11bl,,: prCDce.;dil1i fl`!P..'4: C1 «I;�. tC7 �. �'1 1It'. lrl CiPRVC; (IIl rl:.)r �7Ljli' a id in. my )lanje, ,'-q! caPiu at IItCl(17,ic1.i.enh, EGt! U% MUM, Tt,Ml-JK O CI1Sch �c Tnr ti r..• «:l i b't Sole it t o ) �I r ,t..« aUAZ Cf•�Cd' ,t1...1 Of ri7� :•ul.� t•. S 1PY�tJ17 jJi!T1•E.''.$: .41 ill3c^ lC1i.t' dt.' 've` =1 lack `r: ' t.ry ='C:(i'-"Ica-tes of d-,posh and (;7'r3 ,. (C}j hjl° r'���lll .[]t of ?Ilt?JItV w 01. to ifY'" iTi . .. , to f� :C- n l:i ft•_ .0 1'. 5�'!(:ll he"', fiaaL;^. ill iIl3tltiltl+:.:"ti i0l.Illy }'tihe 1 of"4 Request for Proposal Massachusetts Residential Conservation Services(Mass Save)Program 4.2 DOER Program Data Requirements The Cape Light Compact Page 32 of 42 V Pan 21 2011 2:53PM HCUSING ASSHTUCE COU ENERGY IN 7954 1 3/5 A= to acquirm manage, leam anci,50 Toro.akt, e.-WULAC� L111d C1C1iYC;r rc-,Icu:�cs; corivcyancc; Ases, sabloases; and milt acts of every iiaiurc: ill rclatioL to both rcal and pc;,sonul propr;ity, inciudin, borids, Options, contrams cf hidermlity and ina+Lrance., on such tenns and coadkdoiis as my aterney shall &,m proper; to ol- Lo become involvtd ill tht of awy sDoh property, including,Vie operaMi of any )ll5i.Dess in.Ahch 1 We a nibstantleal intere:7,t, nice 'Lo caiTv OL11 ?MY act of_niEn;agTer,'.ien'1:which inn be appioprialt to tiucb i-n v(',.!verricrii. A ME' s Vkh re'SPec.r TO ';fL... insurance conSocs: To have fill. a1'lli0ri,.'__y to dual whii any poikits or cwitrciCts Of aiululqt, Jul.ciemlliLy oT. on iny life;. or contracts of polides on tLe HE or Am of Men bi AID I nw havc, any imcrest, i"Icl-udiag, but not 'C, the nighL L in-evocal,]e assig-w.ionts Hereof, to surreador, borro-w agaList, -)T UQ.T7,N'&-L arly 311ch pul.icies and to 111d ben�J`Jiuiirrie Vhi:F of, or to take ally ogler action g-vith resptc--, to sush contrq.�!s or policies ai..: my said. attoriicy shill deem proper. f Powers over safi- deposir boxes: To have acems W L11 my sate' (1ep4S.-'.T boxes,whetherihi riayrj.am� aloae 9- MOW as 1C, Se(-U"'J' XS: 'fo Muchase, sell, uunsk :4 athery4se deal 0, Orly 'x'av +Wi#1 cell forals to act as zMj Imoxy with power of sux)stitation.; to, voto a]J stcc'iLs CIE otl't.r SGCurdtiaLs' in 17-,+Y nalflo in,"&a:ion to anY iadiVidli it `)7, '0TOrait lu cicpos'it Slocks 0'2 otber!,cctor-"tics ia Nritll.my plain OfI)T(ACCtiVe UT to purch'93', "%" qpi Or rigrhts to suhsuiibe kir sccurhies L,.-nd'L.,) '5tll th--, sam,_-; to cndors; smAks of aq, agreemm& relatiq tBreto on my to creaft- 11617.4{r, It)- J"Iljn.ALt' dT!d "Nritb. UCC.Ount.i (including UCCOLMIS)1Yi111.SeC.'Lhtiew Wokers. h. powev as fe incuine: T(.-. reeciV, ajid ghe r6c "ill' foi-, all, rents, dlividends, ANT9 aad An- hwome U) which T am or rs,.zty bEcorac; �-jalj.Otd; and to Pay t.1).e.'refroni, all, litetssLiry exptnses for the mainbzu-.aface, uqj*E:.up, 0 u(" inaproverreux, and prolection of rah. pmgmity, To pay -Obe nct. ine.orne thUftfi-0,111 T'J'0111 Lil-M' LO tillIC 10 111C,Or ill SUch ll_larin�,r as 1�,-',Ilall diroct, or ill tine absence of such pquas Lo me oi- -.W:,1r1 io iir,,es'l: fl-iL I'll att S pe tit tsl judpne.nt. L Use CCq'C-. In the e.-Vent of.my ill!'T-jt'i:s, incapac�h-, oj.- otb.c,7 o iu=4 pay a,d.satisfy such expanses a lblg farayd oiat s ' comhw, braht and cam, and obligations of a n3tlJrC cu-,Wintrily incurred by .01c, as Illy al.toiaiey uray con"57.4,-'r Or desirable oT MUR lay WAS. Page 2 of'4 c Tier 2 Required Data Format Date Thru Date #of HEAs Completed audits Completed audits Completed audits completed b receiving a thermal receiving a Completed audits Completed audits P Y 9 9 with Thermal category of lead and/or refrigerator receiving a thermal receiving a Thermal Thermal Contracts Completed g ry g refrigerator Contracts Signed type recommendation recommendation recommendation Contract through date Number Rate Number Rate Number Rate Number Rate Number Rate Number Rate Number Rate From All Sources of Leads From Bill Inserts From Direct Marketing From All Other Sources From Outreach From Utility Referral From Word of Mouth T A N'C E G R P CLCnCY 4 J'ojv��!-,v U,Y to taxes: To prer.l=., exeCl-jtz L"cl file federal o;, stare illcclne, of Othcr txx rctuirls, aad oChcr real a 17cy tc.,C Tt. Urns ()I s?aienl,nt,s L111d c-")pa 'o L'Ally a T Uxes or apply 1 x,cui.d :v compromis all sud. TIS Or�, 11.1,V ba)aI4,Or_��fjjCjj.T arly CuC I-o mak-c any ax elc;ctl,C. ina em io make. r u, rship and related a-F-v!fir a es 1P tcmirmtt 011e OT MOTe, 11711S t- T1 x ;,rpcllratiom, Co-tenancics 0,7 any other fiorm (11'DN',7c.rSylp tbi t1je,Purpose, - -V J)ature, friat I 1.1-lay of dcaliT,21, NViffi L111Y PrOPeTLY Or FTOP 17ty ilitel`tSl 0f .Ul have or iicreaD.,--r Ill der sucli tell-ni and with sash pT,Jvisions 95 -LTly t Tjtj�r_ T-Ilysel V TTIV TaTrdll�. 111. 11,11S le,zal .qS, 0 ,jttC)TTIC-V d�=S IT11 the bCS J. - d,I[Ile f,-j,cj at prty said atWiTiq may bt a SI�ITIC I*oj LiCr 01 a T)rnejicimy of'ani .rich entity j-, with auy suoll transfer here judo sliail jsot affect the v2lidilllv tbcrcof, nor, b� cortstj+,utc abreiich of,'rhv ALXDE�'s fidadar�y djjj�, hc:reund3r; to trfmsl_C! 'A dC Ilay hav�! any pTC)perty, hit*an,,Ible or real, Lo. it -I]Sis,whelhor cl-tatcd by 111+1 0.r by my'S211d, attorllc5 i_ I r�t 1,) 4 b-LISt Or tit -Licli ra -e c: w.edb�for�; or alto,, 011.Tiy b ehalff. and wbrth'�-! OT ridt. s I sts WLI re t`J, f Ltoul.tv O ,orto ,v,,.Y this datable pourer O ClIti i,v or o-Kaer;)-Rp,iDd 11diD Yl c_tUY 1*()rlrl of CQ-teA3llcy. 1. Power to mck- F, o JR5 Of my prone"-Lv to ,frs: To jr,�� -atriplit. or in.trast g.. or trot the b_-nef'I L of Bach Pe3-�cljjs ulao.. iii the Ypinicrl Iff M Y sIII d a tton icy, I t }laving, In rMilid tbe both Public a.13c1 Pli:VaLe, 3-VL11ft&.e kr my c_,re +,er',the Ir.ajjj;g of such gj fts, and bavulg, it', Inini the obiectliv". (.)('Preserving the largest tt 11C?_LTIi of 11-,3, 1)10ptTt'y fOT MV fUTTILY zi� a vLhole. J S11011 Power tc amploy age,7m: , To emplov, Compensate and dIiscla agc.nv as my attonicy i.mras ap�iropiiate to carry out any aots autholl"u,� of c.,.mitcm.plaiLed he-.rcunntr. V) f g 1)11 S i- Wild Contr[buLte Yowers 1M1,jjjj respect to refirement,nlxv: " - it, 1 1, L any form of SO-called 1-etir'fl.11ca pIL:ul f(.)T my bon i j)c1udb7g bw not IiLnjjr,j toInkijvid:ual P,,�fi m remt Accounts, and any caller fox1r, of peTIs:OIl or c127 e 11 - to hOTTO-W against (W witladrim", froJJi a-)p u r a pr� t to ii,.,v plan accourAs oii such t-�j.-ms as TrY OMOY teems , i()1 1) have. t 9 , -� I --; C)pt 'IF, I TII, L forIn see paymept o,)t ou or to modil aet.anybf -f . v 0am , b.half aiid to m l, h o y "roll-elver' any siic,11 Sits on my Inchalf. Page of 4 Request for Proposal Massachusetts Residential Conservation Services(MassSAVE)Program 4.3 Audit Delivery and Instant Savings Measure Pricing RCS Audit Delivery Price a) 'Site Visit b) Comprehensive (Class A)Audit c) Walk Through (Special Site Visit) d) Blower Door Test(Advanced diagnostic service) e) Infrared Scan (Advanced diagnostic service) f) Duct Leak Test(Advanced diagnostic service) g) Test of HVAC airflow and/or charge (Advanced diagnostic service) h) Bill Disagregation (AES) i) EEI or Renewables Work Order j) Rebate processing Fee (CAP) k) Health and Safety Inspection 1) Heating System Combustion Efficiency Test m) Fuel Switch Analysis n) Immediate Savings Materials Installations Caulking Silicone (premium, all weather) Siliconized acrylic latex-clear Siliconized acrylic latex-white Rope Caulk Window Weatherstripping Preformed (V) '/2" (tan/white) Preformed (V)1 5/4 " (tan/white) V-Seal (clear) Pulley Seals (pair) Clamshell Window Lock c. Windows The Cape Light Compact Page 31 of 39 J 7fa ;l� /.' c �til (�i�i) :(i r,t- iit.= r.i�:j - '/ i, •n r t t vl, _ ti'' .a.. ' �"�"" iIE:I'(:11j1,i:�;i"lihlor' TB}V 1)�i:-.5�i1 7il-:- �.�i:a:.tl);r .. �.«Li.�_iv.., .. n'r -1 i i;1 T'Th(' I1� Clil tlEl.l; )1""1 iiot :ouk 'o 1}ic 'dl?1�1I(:21�'li)' tl.tael, ol; �i�. i.Ilt_;._1'T'y . � '- I i2' j,1T(?i•C:('S 11(fi L'.'C'. FlIo}oflt:y' or illu :Cllij r]::t()7a1(:W a "o ally action ii+l.(.-" j)C'iSilTl 1'I?ay iD c Ooc.; .iC1`til act 7T.1 r:'11?Ilc ti};•'s)'.'l ).t1C tt'I1.Cs;:i;T1'sifillll,;; ii{�I y I;:fiTet:} OI' tllt iil(�i1�tTlt�/ art"rifil.;_:1 Il�'i�l.LTILI :' SLta)l '_<1Ct17 il?iV ::11j!LiiVto mt1 i.)1'''1'Iti•' ''St9i. 2i`; 'Li fvStLt0} In SRC; :t C.14.2}u.!16,-)I?.!4'f h,i.l 1E1 a r C(.)ur!10r;.he it 7t C 1 ,T I'i; 'll';,)'.1liTliit�: ve'1;ili _,�l'11' T;� C�.'�. Io'�i.iv ;.1 II ;I'.J:LC. L}7G1 � . ... r'li.�; tip+P[lt,' ii`1 :�114'1� ra1�(?C;:1CC, ;dJ(}t'.Tl}�lil '`IY t11Ct S.ix�l�l (`,CiI�yT11JkC1 25 El tli 2i :ili:'12 ?2 peiJion. b i:11c-d of c21::�' '_i�P'01:1'.TCI�TIi �'t' j1 adf." iil'_d. it is 'my" cxpI'i'sS i.ti J:i';GIl act i C'tl �!!I ,-, L).•7 41'.)ien:ili-y .. =h + f ' )l ('. m, {�C �.u.t l�li il_ i 7 '1(� ti�_ittC_Y" i=�.L:i:i�.y 4. Z[:i'i'i!'�.:.,. i:'1 C(JlJE.'S i)r�,irra':S./�+�•K'f.7` iC YT_!v i/`_ iTCrit':(1 i,:. :117 UT24'1.22(]l. p('•Wolf'l'_1':i'•'!)' t y a-Uo1( IIl fa:t Ilds Of ,-kf.b::tTi1CV ari:si-.,aIt.; f: *' ) ) ,- a d<}2 It ' t. 1 e— aft .cted by Tly Si)l;;?>�il tC.7lC i no _ ,Ile: _ scut-, :i le.rri.f, Itl > I.o r1. 1'�CIC'1'<' ) 1` iLf)Yyi.E'V EGG': 1 .�.EJ'eDv ra— and •o_L).11Ti v,ha`CVt-1: 'fi j' `--t(C{ Gii`1..ii fl TCt-n;:ie1'a'i lll io,"O.U1l f:O 1-i.7dtl` til'.Si'h.C�:�E•11=5. VIA OF-!M.ASSACfJTTSETTs JT't W�'11'"tFS�, V,11�-t:IZ'�U� 1 ��I ej�'. t.crc•.t:t` i , � ' .. 1�t _ t day of Ap;-)'. "1( QS, btf'017ti,e iClr: ?:+ 1"ti.)Tiiiii`j rlj'.,iEiill:(.� :�' t� VI..�N:L, 0 ���,�1:'.'Wi, ,:.Cli} p'1'oZ'ed to Ale Chro t�l filiirfl�i t(�2',, El')iICI '. Of ?:iti.l'ti_lCl:i-ii�I"l. V,(.;::f: 1.:1 Ir:lincritt, and Ii: riit�±yr��CJ�'t'1 :ti I r-, UiAt Ilc til}':1��•� VS"1� L,ii:zlr111 ._- ... / � - •- ,rti;�`t+��{�f���J1f� µxxA eL� rr, 1 i r ;r fi 1�C) 11 I6f 2 .`•fir., ;,''r;esf�o'�°(���\�� pit► t a T agQ l o v e t` Request for Proposal Massachusetts Residential Conservation Services(Mass Save)Program 4.3 Audit Delivery and Instant Savings Measure Pricing MassSAVE Audit Delivery Price a) Site Visit b) Comprehensive (Class A)Audit c) Walk Through (Special Site Visit) d) Blower Door Test(Advanced diagnostic service) e) Infrared Scan (Advanced diagnostic service) f) Duct Leak Test (Advanced diagnostic service) g) Test of HVAC airflow and/or charge(Advanced diagnostic service) h) Bill Disagregation (AES) i) EEI or Renewables Work Order j) Rebate processing Fee (CAP) k) Health and Safety Inspection 1) Heating System Combustion Efficiency Test m) Fuel Switch Analysis n) Immediate Savings Materials Installations Caulking Silicone (premium, all weather) Siliconized acrylic latex-clear Siliconized acrylic latex-white Rope Caulk Window Weatherstripping Preformed (V) '/2" (tan/white) Preformed (V)1 5/4 " (tan/white) V-Seal (clear) Pulley Seals (pair) Clamshell Window Lock c. Windows The Cape Light Compact Page 33 of 42 HOUSING 460 west Main street a ,.. Hyannis, MA 02601-3698 ENERGY & HOME REPAIR ASSISTANCE r (508) 771-5400 F (508) 790-2425 CORPORATION �s ~ � TTY on all lines t« , www.ha cancapecod org a�&rpe ead LANDLORD TENANT A �)041t — _�`/n :Rat ' let 51K- qr5 - 11KV 04 PHONE PHONE S c — a3a—Sa3 i Dear Landlord, Your tenant is eligible for services through the Weathenzation Program. Program regulations permit us to spend an average of$5,000.00 in materials and labor per dwelling unit Program regulations require us to weather-strip and caulk doors and windows; insulate attics, sidewalls and floors. All work is professionally done by established private contractors. We will conduct a final inspection to make sure that all work is completed to specifications. Prior to making the inspection and doing the work we must have your permission. If you want your tenant to participate in the program, please sign the agreement and return the form to me. This agreement states that: 1. You will not raise the rent because of the Weatherization work or for one year from the time the work is completed. 2. You will not evict your tenant for one year following work completion date except for good cause related to the tenant's failure to pay rent or serious or repeated violation of the terms of tenancy. 3. If you sell the property during the specified period,either the new owner must assume the obligations under the agreement prior to sale, or you must refund to us the entire amount of materials and labor we spent in weatherizing the unit. If you request,you will be informed of the estimated measures before they are done and provided with a list of the actual measures and costs following the completion of the work. We also need proof that you own the property., A copy of a CURRENT TAX BILL OR DEED fisting you as the owner will satisfy this requirement. Please fill in all blank areas of the enclosed agreement and return with the proof of ownership as soon as possible. Failure to fill out the entire form will result in a delay in processing the application. If you have any questions please call Michael Sartori at 508-771-5400,'ext. 105. Sincerely, / r82;�'IV Ruth BechtoldAssistant DirectorEnergy and Home Repair Department ,V , g lL�-trrl.i-��'.'ll',tl$cl'�+'•17fSartCirl'�IS' l7lZCL1111ZI11 •Rt\"15t' Latidlord Tett-:'i1 cCT;tr��ci`cI'1 rr (2 ---— TENANT/PROPERTY OWNER/AGENCY WEATHERIZATION AGREEMENT 1. The Parties to this Agreeme Lpre the following: 7:n Vh e t G . L , (hereafter known as Tenant), (print your tenant's name) (hereafter known as Property Owner) (print your name) and Housing Assistance Corporation(hereafter known as Agency). In consideration of the mutual promises hereafter stated,the Parties agree as follows: 2. The date of Agency's signature will be the effective date of this Agreement. 3. Property Owner and Tenant consent and agree that the Agency may do the following with respect to the property located at(street,town) N unit# and currently leased or rented to the Tenant: a) . Enter the premises for the purpose of performing a Weatherization inspection. b) Enter the premises to perform Weatherization work which the Agency determines in its discretion is necessary and appropriate as a result of the Agency's inspection of the property and in accordance with the appropriate priority list for the type of dwe!ling. The Agency and the Agency's contractors may also enter the appropriate common areas of the building for the purpose of accomplishing the Weatherization work. The Agency and representatives of the Commonwealth of Massachusetts, Department of Housing&Community Development(DHCD)may further enter the property to inspect any and all work hereunder. The Agency will provide reasonable notice of the timing of the Weatherization work and inspections. The Weatherization work will be performed in accordance with the Property Owner's co, sent as furthe=OLLO INITIAL��Y N OG� X I consent to performance by the Agency and its contractors of any Weatherization work determined necessary and appropriate by the Agency as a result of its inspection of the property. I understand that the Agency will provide a detailed statement of the actual work performed and the associated value at the completion of work. I will provide a separate consent to performance by the Agency and its contractors of Weatherization work following my receipt of the Agency's inspection report and a statement of the estimated work and associated value. This additional consent will be sent under separate cover as Attachment A. I understand that the Agency will provide a detailed statement of the actual work performed and the associated value at the completion of the work. 4. The Property Owner understands and agrees that any and all work,including related repairs for which the Property may also be eligible,will be performed at the Agency's discretion. The Agency estimated completion of the Weatherization work by the end of 2010. 5. If the Property Owner is required to make repairs to the property prior to the commencement of Weatherization work by the Agency,the Property Owner will be notified by the Agency and will be required to make the repairs as soon as possible. Except where the Property Owner receives a written extension from the Agency,time is of the essence in the performance of repairs by the Property Owner. i 6. The Property Owner and Tenant authorize the Agency to receive a statement from the fuel supplier/utility supplier as to the quantity of fuel/utilities used at the above address in each of the past three years and the future three years. The information is to be used only to determine the cost effectiveness of the Weatherization improvements. 7. The Property Owner agrees that the rent for the dwelling.unit will not be raised because of any increase in the value thereof due solely to the Weatherization work performed. 8. In consideration of the Weatherization work hereunder,the Property Owner further agrees that upon the effective date of this Agreement and during a period extending through 2999f10,.approximately one year from the time the work is completed,. a) The present rent$ �U per month will not be raised for any reason. (The rent amount must be filled in). However,this Paragraph (8a)will be waived by the Agency in writing if, and only if,the premises are leased under a state or federal rent subsidy .program,in which case the actual rent charged by the Owner shall conform to the standards of the rent subsidy program Please state which Housing Subsidy program your tenant is on and through which Agency: b) The Property Owner will not institute any summary process action for possession except in the case of non-payment of rent or other good.cause related to the Tenant(or any successor Tenant). c) In the event the Property Owner decides to sell the premises, Property Owner shall comply with one of the two requirements below: --The Property Owner shall not sell the premises unless the buyer agrees(with a copy forwarded to the Agency) in writing prior to sale to assume all obligations of the Property Owner set out in this Agreement; or --The Property Owner shall pay the Agency an amount equal to the cost,as certified by the Agency, of the Weatherization materials installed and labor performed in the premises as of the date of sale. Said amount shall be paid to the Agency immediately upon sale. 9. (Applicable only if Tenant's heat is included in rental payment and blanks are filled in) At the end of the period set forth in Paragraph 8 above, the rent shall not be raised more than__ %per for an additional period of one year, and the provisions of 8b and 8c above shall continue in effect for such period. However, the rent provisions of this Paragraph 9 may be waived by the Agency in writing if, and only if, the premises are leased under a state or federal rent subsidy program, in which case the actual rent charged by the Owner shall conform to the standards of the rent subsidy program. 10. The Parties agree that the terms of this Agreement are incorporated into any other lease or agreement between the Property Owner and the Tenant, and between the Property Owner and any successor Tenant, and if there is any conflict between the provisions of this Agreement and the provisions of such other lease or agreement, the provisions of this Agreement shall govern. However, if such other lease or agreement, including without limitation a lease or agreement under state or federal rent subsidy program, contains stronger protections for the Tenant, such stronger protections shall apply. y 11. For breach of this Agreement by the Property Owner, the Property Owner shall reimburse the Agency in an amount equal to the cost, as certified by the Agency, of the Weatherization materials installed and labor performed on the.premises, as well.as attorney's fee and court costs. The Property'Owner may also be liable for damages to the Tenant in accordance with applicable law; in such instance, the Property Owner shall reimburse the Tenant for attorney's fees and court costs. Without limiting the foregoing, the Agency may at its option terminate this Agreement, by providing written notice to the Property Owner and Tenant, in the event of breach by the Property Owner or Tenant. 12. Performance of the Weatherization work hereunder by the Agency is contingent upon the availability of funds to the Agency from the commonwealth of Massachusetts and the federal.government, as well as the eligibility of the Tenant under WAP aprogram requirements. The Agency may terminate this Agreement, by providing written notice to the Property Owner and Tenant, if the Agency determines that the unavailability of funds or ineligibility of the Tenant warrants termination. 13. The Parties acknowledge that this Agreement is under seal. It is intended by the Parties that the Tenant or any successor Tenant is the intended beneficiary of the Agreement and shall have a right of enforcement. Property Owner'LazL.,e Signature: O Date— Phone: Address: Tenant Signature �`� Date L Agency Signature Date i t Agency Approved Weatherization Company: All Cape Energy Caliber Building&Remodeling Cape Cod Insulation Cape Save Creswell Construction Frontier Energy Solutions Lohr&Sons Peter Smith Resolution Energy Rock Solid Construction Sprinkle Home Improvement This Agreement becomes Effective as of the Date of the Agency's Signature. The Agency will sign, and return copies of the Agreement to all parties,upon completion of the proposed Weatherization work. The Agreement shall remain in Effect for one full year from the Effective Date. Agency Signature Date The Commonwealth of Massachusetts Department of Industrial Accidents w Office of Investigations 600 Washington Street a Boston, MA 02111 www.mass.gov/dia Worker's compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): z.E o E w Q by Address: ` S ra.a A S m ce City/State/Zip: ;*,,t-iza Q:b% 'aa. A Phone#: sow- 144-•�� Are you an employer?Check the appropriate box: Type of project(required): 1. LTI am a employer with 3 4.❑ I am a general contractor and r have 6. ❑ New construction employees(full and/or part-time).* hired the sub-contractors listed on 7. ❑ Remodeling the attached sheet.$ 2. ❑ These sub-contractors have $ ❑ Demolition I am a sole proprietor or partnership and have no employees working for employees and have workers'comp. 9. ❑ Building addition me in any capacity.[No workers' insurance.$ M ❑Electrical repairs or additions comp insurance required.] 5.❑ We are a corporation and its 11. Plumbing repairs or additions officers have exercised their right of ❑ 3. ❑ I am a homeowner doing all work -exemption per MGL c. 152§(4),and 12. ❑ Roof repairs myself. [No workers' comp. we have no employees.[No workers' 13. insurance required.]t . comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attach 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.#: %Ae L-z1A- S-4os z"3-03S Expiration Date: S-S L — 7-0IN Job Site Address:.` l 4 0"`%"' `' 1 City/State/Zip: Cam"�v Z . r•• w 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 'hereby certify under the ainss ai dip,en lties of p ry that the information provided above is true and correct. Signature: _ � /' Date: - Phone#- —I 4 - �a Official use only.Do not write in this area,to be completed by city or town official City or Town- Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Otler Contact Person: Phone#: l . !�9assachusctts - Dcpar.tmcnt of Public `tfct� — ✓ l � Board of Building Rc!�ulati��ns and Standards arz�,zorz z a� wac -119 �L\ Office of Consumer Affairs&Business Regulation I Construction Supervisor License — (d3.HOME IMPROVEMENT CONTRACTOR License: CS 53202 � Registration:;• '162158 Type: Restricted to. 00. ti —-. Expiration:----'- Individual J " JEFFREY R.TONEL� JEFFREY R TONELLOt.O r I PO BOX 1516 E' SAGAMORE BEACH, MA 02562w JEFFREY TONELL'D 4 60 STATE RD. j SAGAMORE BEACH``MA 02562 Undersecretary Expiration: 7/14/2011 C:,,aunisimcr Tr#: 19157 Restricted to: 00 I - - Unrestricted r-1 Z liamily Homes I... .. iilure to possess a current edition of the 111 [assachusetts State Building Code cause for revocation of this license. efer to: WWW.Mass.Gov/DPS A 460 West Main Street 40 HOUSING Hyannis, MA 02601-3698 � T ENERGY & HOME REPAIR ASSISTANCE T (508) 7.71-5400 F (508) 790-2.425 t_ CORPORATION T s ,� T1Y on all line www,haconcapecod. org afz arpe ead LANDLORD RMkad. 5ajttt TENANT _.�. �10 - e`/n ?x"T Ai4' 4 5 PHONE PHONE �oSc - a3a-4a3t C�� Dear Landlord, Your tenant is eligible for services through the Weatherization Program. Program regulations permit us to spend an average of$5,000.00 in materials and labor per dwelling unit Program regulations require us to weather-strip and caulk doors and windows; insulate attics, sidewalls and floors. All work is professionally done by established private contractors. We will conduct a final inspection to make sure that all work is completed to specifications. Prior to making the inspection and doing the work we must have your permission. If you want your tenant to participate in the program, please sign the agreement and return the form to me This agreement states that 1. You will not raise the rent because of the Weatherization work or for one year from the time " the work is completed. 2. You will not evict your tenant for one year following work completion date except for good cause related to the tenants failure to pay rent or serious or repeated violation of the terms, of tenancy. 3. If you sell the property during the specified period,either the new owner must assume the obligations under the agreement prior to sale, or you must refund to us the entire amount of materials and labor we spent in weatherizing the unit. If you request, you will be informed of the estimated measures before they are done and provided with a list of the actual measures and costs following the completion of the work., We also need proof that you own the property. A copy of a CURRENT TAX BILL OR DEER .listing you as the owner will sadsfythis requirement Please fill in all blank areas of the enclosed agreement and return with the proof of ownership as soon as possible. Failure to fill out the entire form will result in a delay in processing.the application. If you have any questions please call Michael Sartori at 508-771-5400, ext. 105. Sincerely, Z"�2829,3,01 R)L .. P 7 Ruth Bechtold N Assistant Director ! Energy and Home Repair DepartmentCb usc`r+'d7isart-)rT'•�-1 11l�CLU17211C� �:L�-is�'d Landlord_T'r, :11t_' Qt-..tr-3 <I.el1 r }'I, TENANT/PROPERTY OWNER/AGENCY WEATHERIZATION AGREEMENT 1. The Parties to this Agreement are the following: (hereafter known as Tenant), (print your tenant's name) (hereafter known as Property Owner) (print your name) and Housing Assistance Corporation(hereafter known as Agency). In consideration of the mutual promises hereafter stated,the Parties agree as follows: 2. The date of Agency's signature will be the effective date of this Agreement. 3. Property Owner and Tenant consent and agree that the Agency may do the following with respect to the property located at(street,town) unit# and currently leased or rented to the Tenant: a) Enter the premises for the purpose of performing a Weatherization inspection. b) Enter the premises to perform Weatherization work which the Agency determines. in its discretion is necessary and appropriate as a result of the Agency's inspection of the property and in accordance with the appropriate priority list for the type of dwelling. The Agency and the Agency's contractors may also enter the appropriate common areas of the building for the purpose of accomplishing the Weatherization work. The Agency and representatives of the Commonwealth of Massachusetts, Department of Housing&Community Development(DHCD)may further enter the property to inspect any and all work hereunder. The Agency will provide reasonable notice of the timing of the Weatherization work and inspections. The Weatherization work will be performed in accordance with the Property Owners - sent as further '** �d el E FO GiPl I consent to performance by the Agency and its contractors of any Weatherization work determined necessary and appropriate by the Agency as a result of its inspection of the property, i understand that the Agency will provide a detailed statement of the actual work performed and the associated value at the completion of work. I will provide a separate consent to performance by the Agency and its contractors of Weatherization work following my receipt of the Agency's inspection report and a statement of the estimated work and associated value. This additional consent will be sent under separate cover as AttachmentA. 1 understand that the Agency will provide a detailed statement of the actual work. performed and the associated value at the completion of the work. 4. The Property Owner understands and agrees that any and all work,including related repairs.for which the Property may also be eligible,will be performed at the Agency's discretion. The Agency estimated completion of the Weatherization work by the end of 2010. 5. if the Property Owner is required to make repairs to the property prior to the commencement of Weatherization work by the Agency,the'Property Owner will be notified by the Agency and will be required to make the repairs as soon as possible. Except where the Property Owner receives a written extension from the Agency,time is of the essence in the performance of repairs by the Property Owner. ACORD-, CERTIFICATE OF LIABILITY INSURANCE 09/O1/201 (781) 344-8578 THIS CERTIFICATE IS ISSUED AS A MATTER .OF INFORMATIOt PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATI NOT C.L. Hollis Insurance Agency Inc HOLDER �ERES T•HE CIOVERAGEIAFFORDCATE OED BY THE POLIJCIES BELOW. , EXTEND OI 27 Glen Street Stoughton MA 02072 INSURERS AFFORDING COVERAGE NAIC# .INSURER A:LIBERTY MUTUAL INSURED - INSURERB:ALLbIERICA INSURANCE RESOLUTION ENERGY INC. 43 Fieldwood Drive INSURER'c: INSURER D: PO Box 1490 — $a amore Beach MA 02562— INSURER E: COVERAGESABVE FOR THE POLCY,PERIOD INDICATED. No THE POLICIES OF AONW HAVE BEEN ISSUED TO THE INSURED Y CONTRACT OR OTHER DOCUMENT WITH REDSPECOT TO WHICH THIISICERTIFICATE MAY BE ISSUED O UCH PIERTA REQUIREMENT,TERMRM OR CONDITION OF THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND .CONDITIONS OF SUCH POLI CII AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECT1vE POLICY EXPIRATION LIMITS INSR ADD'L TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) '— LTR INSR T D EACH OCCURRENCE .$ — GENERAL LIABILITY - DAMAGE TO RENTED $ PREMISES Ea occurrence COMMERCIAL GENERAL LIABILITY MED EXP(Any one person) S CLAIMS MADE D OCCUR PERSONAL 8 ADV INJURY S GENERAL AGGREGATE $ - PRODUCTS-COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: - PRO- I JECT LiLOC O2/27/2010 02/27/2011 .COMBINED SINGLE LIMIT $ 1,000,� $ AUTOMOBILE LIABILITY AWN5092655 - (Ea accident) ANY AUTO - ./ BODILY INJURY $ ALL OWNED AUTOS .(Per person) X SCHEDULED AUTOS BODILY INJURY S HIRED AUTOS - (Per accident) NON-OWNED AUTOS / / I PROPERTY DAMAGE . $ (Per accident) AUTO ONLY-EA ACCIDENT $ GARAGE LIABILITY OTHER THAN EA ACC $ — ANY AUTO AUTO ONLY: AGG S — EACH OCCURRENCE EXCESS/UMBRELLA LIABILITY $ AGGREGATE $ OCCUR CLAIMS MADE DEDUCTIBLE S RETENTION $ WC STATU- OTH- A WORKERS COMPENSATION AND WC2-31S-370523-039 09/02/2010 09/012/2.011 TORYLIMITS ER EMPLOYERT LIABILITY I E.L.EACH ACCIDENT $ 500' ANY PROPRIETOR/PARTNEWEXECUTIVE 500" OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ If yes,describe under - E.L.DISEASE-POLICY LIMIT S 500,' SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESIEXCLUSIONS'ADDED BY ENDORSEMENTISPECIAL PROVISIONS NATIONAL GRID CORPORATE SERVICES LLC DBA NATIONAL GRID, ACTION INC. , COLONIAL GAS COMPANY AND N-STAR ELECTRIC ARE LISTED AS ADDITIONAL INSUREDS. CERTIFICATE HOLDER CANCELLATION ( ) _ (508) 790-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 ATTN: MIKE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO M. 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,E HOUSING ASSISTANCE CORD FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON I 460 WEST MAIN STREET INSURER,ITS AGENTS OR REPRESENTATIVES. _ AUTHORIZED REPRESENTATIVE HYANNIS _ MA 02601-3698 ACORD 25(2001/08) ©ACORD CORPORATION ELECTRONIC LASER FORMS.INC.-(800)327-0545 Page ,.�INS025 pim).06 II 4741 Falmouth Rd , Cotuit 1 /27/11 -- C C I L I f r T 4 G i - i '�T �y JOUQn SRIY',P-s ?i a r-z.;A-Le- Town of Barnstable Barnstable ZNE ..Board of Health B"NSTABLF, 200 Main Street,Hyannis MA 02601 MASS.1639. 2007:• fD MA'I� OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. BOARD OF HEALTH MEETING MINUTES Tuesday, December 8, 2009 at 4:00 PM Town Hall, Selectmen's Conference Room 367 Main Street, Hyannis, MA A regularly scheduled and duly,posted meeting of the Barnstable Board of Health was held on December 8, 2009. The meeting was called to order at 4:00 pm by Chairman Wayne Miller, M.D. Also attending were Board Members Junichi Sawayanagi.and Paul Canniff, D.M.D. Thomas McKean, Director of Public Health, and Sharon Crocker, Division Assistant, were also present. I. Hearing — Housing: A. Scott Crosby and James Peacock, owners 257 Pond Street, Unit C, Osterville, Map/Parcel 119/032, variance from ceiling height. Mr. Crosby and Mr. Peacock were unable to make it and asked fora postponement. The building is,a one floor, one bedroom cottage. As the building existed in 1940, prior to the building codes of ceiling requirements, the Board determined an approval for the variance. Upon a motion duly made by Dr: Canniff, seconded by Mr. Sawayanagi, the Board voted to approve the ceiling height for the bedroom. (Unanimously,, voted in favor.) B. GaryCaruso;.owner of 24 Pen Lane, Centerville; Map/Parcel 193-205, hearing requested"by owner in regards to violation letter dated October1`3,2009 — POSTPONED Until January 12, 2010. The Board will postpone until January 12, 2010, as requested. The Board expressed concern of continued use of too many bedrooms for the design of the septic and are anxious to resolve as soon as possible: C. John Rodrigues, Trustee, owner- 36.Oak Neck Road, Hyannis, Map/Parcel 308/203, requesting 3 variances from ceiling height., Mr. John Rodrigues was present. He explained the dwelling has been re inspected by the health inspector and all other items on the violation letter have:been corrected and he has received an occupancy permit for all units. Board of Health Minutes 12/08/09 Page 1 of 5 The dwelling was built in 1900, pre-dating the 1950's building codes for ceiling heights. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to approve three variances for ceiling heights. (Unanimously,- voted in favor.) D. Dawn M. Burt, owner 4741 Falmouth Road, Cotuit, Map/Parcel 009/020, requesting variance from ceiling height: Mr. Alan Burt was present. His house dates back to 1941, prior to the building code on ceiling heights. He currently is caring for the house for Manual Sylvia, an elderly gentleman who has lived there in the one-bedroom for over 40 years. They have done some major repairs to the house.and Mr. Sylvia has decided to rent it out to recover some of the repair costs: The bedroom has a ceiling height of 5ft 9 inches. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the j Board voted to approve the ceiling height variance. (Unanimously, voted in favor.) II. Hearing — Septic Failed (Cont.): - Michael Santos, owner— 26 Bishops Terrace, Hyannis, Map/Parcel 251-215, septic failure. Mr. Michael Santos was unable to make the meeting and hoped for a continuance. The Board had requested a septic inspection be done. The recent inspection was reviewed at the meeting. It stated the system passed. A' prior inspection in 2004 had showed the level in the leaching pit was at 4 feet and the pit is 6 feet in total. Mr. McKean expressed concern that the system was showing signs of age at that time. Dr. Miller requested it continue to be.pumped and would like the following information: 1`) what is the zone the lot is in,.2).what is the anticipated use of the building, 3) is sewer anticipated in the area soon. If the unit is to be used for rental, the septic may Likely endure heavy use. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to Continue to the January 12,"2010,'Board of Health meeting. (Unanimously, voted in favor.) III. Variance — Septic (New): Dan Ojala, Down Cape Engineering, 'representing Mark.Fazio, owner, , .36 Deacon Court, Barnstable, Map/Parcel 300-054, 1.73 acre lot, (4) variances, reduction in set backs to wetlands, new construction: Board of Health Minutes 12/08/09 'Page 2 of 5 Dan Ojala and Marie Fazio were present. Dan reviewed the plan and summarized there is an isolated wetland, currently,a sharp pitch,down towards the wetland which will be leveled off. There is blue clay down to 12.. feet, then good sand. The Conservation Commission approved the plan last: week. Dr. Miller recused himself. Mr. McKean noted the plan does not show 10 feet separation,on the leaching facility (infiltrators). -Mr. Ojala noted the type error on the plan and will have a proper one submitted. The plan should show 42.5 as the bottom of the leaching system, There are no issues with the floor plans. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff,`the Board voted to approve the four variances of setbacks to wetlands with the following conditions: 1) a revised plan be submitted'with the correct of the base of the leaching system to 42.5, and 2) a 3-Bedroom Deed Restriction be properly recorded at the Barnstable County Registry of Deeds, and 3) a proper copy of the Deed Restriction be submitted to the Public Health Division. (Unanimously - 2 voted in,favor, Dr. Miller had recused himself.) IV. Variance -Food (New): Louis Capolino, Caffe "E' Dolci —430 Main Street, Hyannis; grease trap variance previously granted, addition to menu. Mr. Louis Capolino was present and had the most recent grease recovery device inspection (August 4, 2009) with him and his current expanded menu. He requested an increase in his restricted menu-to include additional types of lasagna and more meatball dishes. He has currently been operating with the extended menu. The Board reviewed the'prior variance approval and stated the applicant was restricted to the submitted menu of 2007 with the one grease recovery device (GRID) in place.-The GRD is not designed to handle the expanded menu. Upon,review of the grease trap inspection report, it appeared the level of grease going into the sewer is 4.0 instead of the required maximum of 1.0. The Board receives a clearer picture of the situation when a daily log is kept of the amount of grease actually removed and requests this to be done using the Health Division's Log form. The Daily log must be by the GRD and easily accessible to the .Health Inspector. The dual sink/refrigerator equipment was discussed. The sink is used to dispense water and.is not.as a prep sink. Mr. Capolino said the equipment was purchased in Italy-and came as a complete unit, along with. the PVC pipe used to drain sink: Board of Health Minutes 12/08/09 Page 3 of 5 Dr. Miller and Mr. Sawayanagi stated the piping does not meet the plumbing codes which require a trap plumbed with copper for the drinking water. Provided the applicant properly blocks off the waste pipes under sink and brings the plumbing up to code, the Board will allow the left side of the refrigerator Unit to be used for storage. For the increased menu: "1) the applicant will need a second Grease Recovery Device (GRD), and 2) instead of the independent test every six months, the Board would want.a log maintained of the amount of grease removed. For the refrigerator/sink unit, either 1) remove the entire refrigerator/sink unit or 2) the refrigerator located under the sink must be rendered unuseable, 3) the Plumbing Inspector must approve the'plumbing of the sink and the section of the refrigerator that the waste pipes are above must be blocked off, then the refrigerator section without waste pipes may be used as food storage. The Board said the pictures the Health Inspector provided showed inadequate cleaning. Mr.. Sawayanagi noted the pictures show a leak in the ceiling. Mr. Capolino said it was due to the air-conditioner and is not over the food prep area. The Board stated the approval of an extended menu will be based on satisfactory inspections by the Health Inspector over the next two years. The Board will give the applicant one month to clean up the establishment before any license suspension. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted on the approval of the extended menu. '(Unanimously, voted to DENY with the following.requirements to avoid suspension: 1) Caffe "E" Dolci must return to the original approved menu, 2) clean up health inspection violations, 3) repair leak in ceiling and replace ceiling tiles, 3) bring waste pipe up to code and block off front section of refrigerator with piping, or close off refrigerator entirely, and 4) return to the Board at the January 12, 2010 meeting. If all items are satisfactory, the Board will approve the increased menu provided an additional GRD is installed. V. License: Disposal Works (Septic Installer): Jeffrey K. Morse, Marshfield, MA Jeffrey Morse was unable to attend. The Board reviewed his passing grade on the septic exam and his references as an exemplary contractor. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to approve Jeffrey Mors_e`as a septic installer. (Unanimously, voted in favor.) Board of Health Minutes 12/08/09 Page 4 of 5 t wi VI. Proposed 18 bedroom Development: Stage Coach Residence —70 Stage Coach Road and 151 Oak Street, Centerville —Sandee Perry, Barnstable Housing Authority, determination of whether a shared IA system shall be required. No one was present from the Barnstable Housing'Authority, nor the engineer for the project. The Board reviewed the project which is an 18 bedroom affordable housing project (6 one bedroom and 6 two bedroom) with 4+acres dedicated to Conservation. It is not in a ground water protection zone and does not require a septic variance and has town water. Lot# 151 has a two-bedroom home and shed which will be demolished and removed. This project is a single-owner renting out units. It is categorized as a multi-family.unit. There are three separate building and the code considers it a shared system. MA State Code 301 requires the septic system to be inspected at least once every three years. (If there were five or more buildings, the regulation would have required inspection every year.) Mr. Traczyk said the basements will not be available for use by the tenants. Art Traczyk, Regulartory/Design Review Planning for Growth Management Department Service to assist the Zoning Board of Appeals, participated in the discussion with the Board. It was determined an°innovative/Alternative System was not required and determined the engineer must identify any private wells within 150 feet of the septic components. In addition to the Board of Health's November 27 email correspondence to ZBA, the Board of Health will add: 1) the attic space under the roof line is not habitable, and 2) provide screening at the vent pipes to the septic system, the seven page . checklist must be completed by the engineer at the time of the septic permit, VII. Old Business/New Business: A. Budget- submitted request for additional funds to manage an escrow account for septic repairs. B. Flu Vaccine Clinics—final Seasonal Flu Vaccine Clinic will be Wed December 0, 2009 at the Senior Center. The H1 N1 Vaccine continues to be distributed as quantities are received in. Board of Health Minutes 12/08/091 Page 5 of 5 1 Town of Barnstable *Permit# Fxplres 6 months from issue date Regulatory Services, Fee 1c, S Thomas F.Geiter,Director Building Division Tom Perry,CBO, Building Commissioner ` 200 Main Street,Hyannis,MA 02601 www.town barnstable.ma.us, Office: 508-862-4038 Fax: 508-790-623 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X--Press Imprint Map/parcel Number l C-Q •' ; T Property Address. a Minimum fee of$25.00 for work under$6000.00 U� (eesidential Value of Work , r^ �� Owner's Name&Address Telephone Number Contractor's Name �� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's mpensationInsurance S PERMIT Ch one: I am a sole proprietor MAY I I am the Homeowner ❑ I have Worker's Compensation Insurance j � qF ARNS A Insurance Company Name. Worlozian's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request check box) . - � be taken to /�, Re-roof(stripping old shingles) All constriction debris wi71 7— 1 ----� ❑Re-roof(not stripping. Going over existing layers of roof) ; ❑ Re-side Replacement Windows/doors/sliders. U-Value (ma ) • h required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Were ***Note: Property Owner muss sign Property Owner Letter of Permission. A• opy of me Impr,vement Contractors License is required. . SIGNATURE: - O:Forms:exnmtrg ; r a ✓fie. eat/ ",o✓�aaaac�ivaela �f License or reg►stration valid for i�lmdul use only z Office of ConsumerAffairs'&Business?Ife�af 3 ioz6 HOME IMPROVEMENT CONTRACTOR � ✓�� before the expiration date. If found return_to - `_w �> Uffice of Consumer Affairs and Business Regulltio(r Registration e�114813 Syr 10 ParkPlaza Suite 5170 Exp�ra10/�_7J?011 TrE '88Q � Boston,MA 02116. + Type—Indivi- to , JAMES D DANFORTN-ftEMOp J4MES DANFCRSTLIit 1 05 OLD POST RDc- q J f COT�IT; MA 02638 i}ndersecruz c of valid a s afore ;x' rP �....: _. ._, ivt►ssuchusctts'-Dclia►-tmeiit of Public SufetN As Board of Buildin�ty Re,aul:ttions and,Standai Construction Supervisor License . License: CS 826T Restricted .to:"00 JAMES D DANFORTH - PO BOX 973, COTU IT, MA 02635 Expiration: 6/20/2012.. ('ummisiiinci Tr#: 26124 a b The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations " 600 Washington Street f Boston,MA 02111 ' www.mass.gov/dia ' Workers'-Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Please Print Le 'bl ' A licant Information _ _ Name(Business/Orgmization/Individual): • •Address: i � L��� � • .City/State/Zip: Phone.#: Are you an employer? Check the appropriate box: -Type of project(required):. 4. Q I am a general contractor and I 6• El New construction . 1.❑ I am a employer with h hired sub-couutractore ❑Remodeling ' loyees(full and/or part time). have 7. 2, a'sole proprietor or partner- listed on the-attached sheet. These sub-contractors have. 8, Q Demolition ship and have no employees employees and have workers' addition comp.insmma=.$ worldng for me in any capacity. . 9. Q Building [No workers' comp'insurance 5• ❑ We are a corporation and its 10•❑Electrical repairs or additions . required.] officers have exercised their 11.Q Plumbing repairs or additions 1.❑ I am a homeowner doing ell work right 6 f exemption per MGL 12.Q Roof repairg amyselL[No workers'comp- insurance 152, §1(4),and we have no insurance segtured J t to es o workers' 13.Q other employees.[N COMP.insurance required.] applicant that checks box#1 must also M Out the section below showing theirwmi=s'compensation policy mforanattm* `AnYapp g I_ t Homeowners who sssbs;sit this off davit indicating they are doing all work and flsen hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet sbowing the uame of the sub-contractors and state whether or not those entities have employees. ff the sub-contractors(save employees,they must providb their workers'comp.policy number. .ram an employer that is providing workers'aompensadon insurance for my employees Below isa'he policy and job site information. Insurance Company Name' Policy#or Self-ins.Lic•#: Expiration Date: City/State/Zip: Job Site Address: Attach a copy of the workers' compensation policy declaration page(shosvfng the policy nnnuber and expiration date).: Failure.to secure coverage as required tinder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine iip 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 statemerit may be forwarded to the Office of Investi ations of the DIA.for insurance covers verification 3 do hereby certify,under th and pen es of perjury that the in provided above,is trite and coi rec Sienatvre Date• Phone Offtcial use only. Dv not write in this area,to be completed by city or town official City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector" 6.Other Phone#: Contact Person:_ _ /a (� i 'r Gva� .... 3-7 5 G 8?s Z Construction Supervisor � GL,- �?�� _G 5•3 eIYG-7 :. Home Improvement License Number#068267 Contractor Registration#114813 Home Phone#508 420-5131 'CELL PHONE.#508 280-0802 ESTIMATE JAMES DANFORTH w P.O.BOX 973 COTUIT, MA. 02635 1 wile/l 4741 RT. 28. 33' May 5, 2010 Work to be completed on the rear lower pitch roof area, as follows. Remove the existing roofing shingles, also remove shingles 18" up onto the steeper pitch roof. Replace up to 30ft. of 1x8 boards that need replacing. Install high density fiberboard fastened down over roofing boards, using plates and screws. Install EPDM membrane rubber roofing glued down over fiberboard, with bonding contact adhesive. L Install a white metal drip edge on all sides; cover tape will be used over,metal edging. Removal of rubbish. Material and labor $2,350.00 If any additional roofing boards need replacing over 30 lineal ft. it will be cost of time plus material. All materials are guaranteed to be as specified.All work to be completed in a workmanlike manner according to standards practice.Any alteration or deviation from above specifications involving extra cost will become an ,extl d � charge above the estimate. Our workers are fully covered by Workman's Compensation Insurance. / DATE OF ACCEPTANCE;,i-,, CUSTOMER SIGNATURE CONTRACTOR SIGNATU Town of Barnstable *Permit# .ZO6 1005 Z -P E S S PERMIT Expires 6 mon hs from issue date FEB 7 2009 Regulatory Services Fee Thomas F.Geiler,Director TOWN OF BARNSTABLE Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS_ PERAUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address 1-/ 7 W Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name KJ Z 4,."Z Telephone Number � d G oZ - % 7 2 Home Improvement Contractor License#(if applicable) la if lq Construction Supervisor's License#(if applicable)—42 7 6 MWorkman's Compensation Insurance Check one: FA I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name _ Workman's Comp.Policy#&ZC 31,5 J/ I✓UGC 03 7 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to A) Re-roof(not stripping. Going over W existing layers of roof) Re-side XReplaceme Windo s/doors/sliders. U-ValueodtA Kmaximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. 3IGNAT URE: at 3 Z:Forms:expmtrg tevise061306 ,. ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' www.mass gov/din ' 'Workers'Compensation Insurgmce Affidavit: Builders/Contractors/Electricians/Plumbers A, licant Information Please Print Leal 1 ' Name(Business/Organizatiorubdividual): Address: /A% hit City/State/Zip:��,,��r��� GG��'�: /` Phone. 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 6. ❑New construction . ••employees(full amdlor part-time).*. have hired the sub-contractors . 2)o I am a'sole proprietor or partner- on the'attached sheet 7. ❑Remodeling ship and have no employees . These sub-contractors have 8. ❑Demolition '*orking for me in any capacity. employees and have workers' P t3'• 9. ❑Building addition [No workers' comp.Insurance comp.Msuranca t' required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumbin repairs or additions '3.❑ I am a homeowner doing all-work . ❑ , g P myself[No workers' comp. right bf exemption per MGL 12.❑Roof repairs insurance.required.]t P. 152, §1(4),and we have no employees.[No workers' 13.❑Other camp.insurance required.] *Any applicant that checks box#1 must also Sll out the section below showing their workers'compensation policy fnfaanation. t Homeowners who submit this affidavit indicating they are doing all work and tlien hire outside contractors must submit anew affidavit indicating'such. tcontraetors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp,polio number. I am an employer that is provlding workers'compensation insurance for my employees. Below is the policy and job site' information. Insurance Company NaSme. 99�� 7 Policy#or Self-ins.Lic.# , P(f '"3��3�Q "` G`�/_ 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 tb$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 maybe forwarded to the.Office of Inyestig tions of the DIA for insurance coyeratra verification. I do hereby certify under the pains and penalti f perjury that the information provided above•is true andcorrect Sim, a. Date: _ Phone Official use only. Do not write In this area, tb be completed by.city or town:officiaL City or Town: ' Permit/License# Issuiag Authority(circle one): J.Board of Health 2.Building Department 3. City/Towu Clerk 4.Electrical Inspector 5•Plumbing Inspector 6.Other Phone Confect Person: #: • Town of Barnstable Regulatory Services MASS. $ Thomas F.Geiler,Director 1639. �m �FDMa'IA Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax:, 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 0. y�v/d� ,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. (Address ofjob), 7. f Signature of Owner/ Date P ' t Name If Property Owrier is applying for permit please complete the Homeowners License Exemption Form on the reverse side. QTORMS:OWNERPERMISSION Town of Barnstable SHE tp��� Regulatory Services ` Thomas F.Geiler,Director • BARNSTABM MASS. �•� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Kmv.town.b a rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 procedures and requirements and that he/she will comply with said procedures and requirements. 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:forrns:homeexempt ¢isaror Bui uig Yegur�iis aOwl I ar s License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 104499 Board of Building Regulations and Standards Expiration 7/14/2010 Tr# 276539 One Ashburton Place Rm 1301 ff Type Private Corporation Boston,Ma.02108 ART DOLGOFF B, ILDING%IREMQDELING.INC Arthur Dolgoff 19 McCormick Dr. W. Barnstable,MA 0266"8_r` �'' Administrator Not valid without signa re � i Bo o w mg egu a�o�Ss an an ar s 3 �t C �:F I �;onstruction Supervisor License Lic�eliSe CS 4276 ' ication.==/11/2009 Tr# 11676 l: t` es_ low:QIr ARTHUR L DOL tFF„ W BARNSTABLE Mb26B` Comm�ssioiier . y j '.��T.J. �.,•y&"" � '"�".F'�a"£ z—".— —�—r=r—s--^s— _� .;�,r—..�.' 2. ! x Dec 14 09 02:34p p.2 °fti Leased Housing Dept: 508.771.7292 i Barnstable Telephone 508.771.7222 Wesr.a� FAX; 508.778.9312 Housing b�v y AUt�Orlt 146 South Sheet•Hyannis,MA 02601 k a ZONING. VERIFICATION TO: LindaiRobin FROM: Kim Gomez, Leased Housing Coordinator . PHONE NO#: 508-771-7292 FAX 50.8-778-9312 . RE: LEGAL RENTAL UNIT VERIFICATION DATE: ADDRESS: VILLAGE: �C 7 - f, U � UNIT TYP C BEDROOM SIZE MAP & PARCEL NO: O 6 q—OP-0 The owner of the above listed property is entering into a contract with us for rental of the property listed above. Please verify by signing below that the unit is legal and meets all zoning r requi ements for a rental in the town of Barnstable. If it does not, please list the reason below: air you for your assistance in this matter. d 1 C r Y f;M3 C� Sig ature Print name ra Date: �2j / D M VIA FAX: 508-'790-6230 Equal Housing Opportunity Agency P, 1 Communication Result Report ( Dec, l$. 2009 3: 46PM ) ' 1,) 2) Date/Time : Dec. 18. 2009 3:45PM File Page No. Mode Destination Pg (s) Result Not Sent ---------------------------------------------------------------------------------------------------- 7110 Memory TX 950$7789312 P, 1 OK Reason for error E. 1) Hang' up or line fail E. 2) Busy . E. 3) No answer. E. 4) No facsimile connection E. 5) Exceeded max. E—ma i I s iJe DGc 14 09 0294p - _ -- p.2 - le _ - 1.rnsedB in.Dept 50B.771.T193 j� (Jj cpM=50&7717222 _ FAX:509.770.9312 - ,5n Housing Authority 146 South Streit-HYMU26 MA 02601 - ZONING VERIFICATION TO: Linda/Robin FROM:Kim Gomez,Leased Noosing Coordinator PHONE NO#:508-771-7292 FAX 508-778-9312 RE: LBGAL RENTAL UNIT VERIFICATION DATE: 1-2-- l 09 ADDRESS: VILLA6E:11D fU f f UMT rYP N r am,Y✓ BEDxoorISIZE MAP&PARCEL NO: O 6q tom© The owner of the above listed property is entering into a'contract with us for rental of the property listed above.Please verify by signing below that the unit is legal and meets all zoning r�qu vats for a rental in the town of Barnstable. If it does not,please list the reason below: o c you for your assistance m this matter. Sighature Print name __ s � N Date:i=zl � f VIAFAX:508-790-6230 -