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HomeMy WebLinkAbout0181 FOREST HILLS ROAD a 8�.- -�,�-eS-j- �-,1� �Cr .v t �.,� F'rl. 2634aa P:9 305 ; 27 . _ OCLIME rq� Town of Barnstable Regulatory Services swxtvsrns[E. ; Thomas F.Geiler,Director 9 eiass Building Division ArEG N10�s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR ACCESSORY USE OF RESIDENTIAL BUILDINGS ASSOCIATED _ WITH RESIDENCE We,Adam J. Hostetter and Janine M. Hostetter, (Hostetter Realty Trust)the undersigned,being the owners of property situated at`1293. Santuit-Newtowne-Roadjn, Cotuit.MA_holding:title tinder.a-deed:recorded-.with the ; Barnstable County District Registry as Book 23266 and Page 3,being{shown on Assessors' Map 026 as Parcel 039, hereby agree, certify, warrant and represent to the Town of Barnstable that the finished space in the basement of the residence located on the same parcel as above-described, which contains living space, is not intended for and shall not be used as a permanent,separate apartment for year-round or summer occupancy,for rent in any fashion. The intended and authorized use is for our personal use associated with the residential use on the same premises. This finished°basement space shall not be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require application and approval of a special permit and compliance with the Family Apartment Rules and Regulations. This finished basement space shall not be rented as an apartment or as a singlew room, or in any fashion,which rental would be a violation of the Ton of Barnstable's rules,regulations,and zoning ordinances. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the.property of this binding Agreement concerning the use of the property as herein stated,which shall run with the land and binding future owners. The consideration'for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this / day ofaC.77/Dt TOWN OF BARNSTABLE OWNERS: By: Adam J.Hostetter omas Perry Janine M.Hostetter THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY,SS Date0. 0 vrG�• ak 4rO,e ,�i,. Then. personally appeared the�above-named �ANiea(owner), f /1uJ-7£77f 1Z made oath as to the truth of the foregoing instrument,before In � . a= D'✓tee--. ���� ��'1��±�'�I�O�.�r': fe�.• �:"� No Public '',:� # co'l ; M Comn]ission Expires: t. 4)ell f,/;nIPL,( Ii Q:word/accessoryagreement BARNSTABLE REGISTRY OF DEEDS d.���2 vi� f �►(a U 2 L �' q TOO not IS.: Ito1 `.:• ,= ��' �� � _ tag'�`� . ;;; , ' Bk 2634 S PS305 =28327 12 :Town'of Barnstable Regulatory Services • Thomas F. snaNSTns�. : Geiler,Director MAW 039. p.� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 o Office: 508-862-4038 n Fax: 508=`f90-62--0 r AGREEMENT FOR ACCESSORY USE OF RESIDENTIAL BUILDINGS ASSOCIATED WITH RESIDENCE We,Adam J. Hostetter and Janine M. Hostetter, (Hostetter Realty Trust)the undersigned,being the owners of property situated at 1293 Santuit Newtowne Road, in, Cotuit MA, holding title under a deed recorded with the Barnstable County District Registry as Book 23266 and Page 3,being shown on Assessors' Map 026 as Parcel 039, hereby agree, certify, warrant and represent to the Town of Barnstable that the finished space in the basement of the residence located on the same parcel as above-described, which contains living space, is not intended for and shall not be used as a permanent,separate apartment for year-round or summer occupancy,for rent in an y fashion. . The intended and authorized use is for our personal use associated with the residential use on the same premises. This finished basement space shall not be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require application and approval of a special permit and compliance with the. Family Apartment Rules and Regulations. This finished basement space shall not be rented as an apartment or as a single room,or in any fashion,which rental would be a violation of the Town of Barnstable's rules,regulations,and zoning ordinances. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use e of the property as herein stated,which shall run with the land and binding future owners. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this / day of aC y7/!f $ ,t 201 TOWN OF BARNSTABLE OWNERS: By: Adam J.Hostetter - omas Perry Janine M.Hostetter THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY,SS Date6 c , /.. �. tole Then ersonally appeared the above-named (owner), made at o the truth of the foregoing instrument,before gARNS :. p J,� q EG/S T01et 1 �COp�y OEVNTy No Public - 'y,. '..co, SOH `R 'q�FSS M Commission Expires: FO a r qp Q mord/accessoryagreemen BARNSTABLE REGISTRY OF DEEDS t CO Town of Barnstable rPermit# Expires 6 months from issue date R Regulatory Services Fee . + * BAMSTABLE, QMASS, e�� Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 AUG 14 2014 www.town.barnstable.ma.us 38 Office: 508-862-4 EXPRESS PERMT APPLICATION e RESIDENTIAL ®FBAR2309LE 6 ��3 Not Valid without Red X-Press Imprint Map/parcel Number Property Address �` ?L'S T %//J /?D 0�y/ &Residential Value of Work 1 1! P>00' U Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Lei I i 4 01 d&0 r,P to G/ G' Contractor's Namel�✓�/'>271,fs �Teleplione Number 3�U� yak �/� - - � w7-1v Home Improvement Contractor License#(if applicable) At / 0 0 7 YO. Construction Supervisor's License#(if applicable) CIS ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor �I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name f f(�C.t.�>'2 LG � ��©ye4✓ �a�����Ce Co Workman's Comp.Policy# W`C,Ot7 ro 7 R Copy of Insurance Compliance Certificate must accompany each permit. Permit RegAst(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 #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ 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. ti ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&,, t as#sruc€ton Supervisors License is { SIGNATURE: 57 1 C:\Users\decollik\P,r ata\Locar6�Microsoft\Windows\Temporarymrerue,,,.es\Content.0utloo16QRE6ZUBW-\PAI Y, Revised 053012 } Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT w lli4m 6�� OWN THE PROPERTY LOCATED AT M1�e qr Klea9 llilll �i w IN � ���I'- _-- - a, MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS.STATE BUILDING CODE. SIGNATURE OF OWNER: OWNER'S ADDRESS:. OWNER'S TELEPHONE::: LESSEE'S SIGNATURE: _ LESSEE'S ADDRESS: LESSEE'S TELEPHONE: - - APLLICANT'S SIGNATURE: .. . APPLICANT'S ADDRESS: . :: 1645 Newtown Rd., Cotuit, MA 02635 - APPLICANT'S TELEPHONE: 508-428-9518 - RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: , RESPONSIBLE OFFICER TELEPHONE: I Off" ��e cporycunca�uucalC�a��ioaacl u�e� ffice of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation egistration: 100740 Type: 10 Park Plaza-Suite 5170 Expiration: 6/23/2016 Supplement Card Boston,MA 02116 CAPIZZI HOME IMPROVEMENT;INC. JOHN STRUMSKI 1645 Newton Rd. Cotuit, MA 02635 Undersecretary Not valid without signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor, 1; License: CS-064817 JOHN T STRUM3jd r 18 ALDEN AVE q Buzzards Bay MX 02532 Expiration Commissioner 06/18/2016 C a wad A - CAPIHOM-01 APELL DATE(MMIDDmw) CERTIFICATE OF LIABILITY INSURANCE E(MMID IY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS 'CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 AIC No Ext: AIC No):(877)816-2156 South Dennis,MA 02660 E DDR ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC S INSURERA:Main Street America Assurance Co. INSURED INsuRERB:Associated Employers Insurance Co. 11104 Capb7i Home Improvement,Inc. I,ISURER c: Capri Enterprises,Inc. 1645 Newtown Road ���° Cotult,MA 02635 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SU POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSO POLICY NUMBER MIDD UNITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE OCCUR MPB1075H 0610&2014 06/08/2015 DAMAGE TO RENTED PREMISES a occurrence S 500,0 MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY a 1ECT a LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ a accident A ANY AUTO M1 M28044 06/08/2014 06/08/2015 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ 500,000 AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 A EXCESS LIAB CLAIMS-MADE CUB1076H 06/08/2014 06/08/2015 AGGREGATE $ DED I X I RETENTIONS 10,000 Pem 8r Adv Inj $ 5,000,00 WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N B ANY PROPRIETORIPARTNERIEXECUTIVE CC50050106472013A 12/25/2013 12/25/2014 E.L EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$ 1,000,0 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601-0000 AUTHORED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. A11'rights,reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD L The Commonwealth of Massachusetts Department of Industrial Accidents Y Y Office of Investigations d I Congress Street, Suite 100 .` Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Capizzi Home Improvement Inc Address: 1645 Newtown Road City/State/Zip:Cotuit, MA 02635 Phone#:508-428-9518 Are you an employer? Check the appropriate box: Type of project(required): 1.M I am a employer with 40+ 4. ❑ I am a general contractor and 1 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 : g p ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp. insurance comp. insurance. 9. ❑ Building addition required.] 5. ❑ We area corporation and its 10.❑ Electrical repairs or additions -3E-ham.ahomeowner-doingallwork officers..have:exercised,their .__.,, :, .._1.1.:❑.Plumbing�repairs-or-additions l myself. [No workers' comp. right of exemption per MGL 12.02/Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.❑ Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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:Associated Employers Insurance Co:. Policy#or Self-ins. Lic. #:WCC50050105472013A Expiration Date: 12-25-2014 Job Site Address: /6P/ /"d1•ey /'hf�/ f�/� (149 City/State/Zip:. . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerd er tl a pa n r en Ides of perjury that the information provided above is true and correct Si ature: Date: c . Phone#: 28-951 Official use only. Do not write in this area,to bed completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector.5.Plumbing Inspector 6.Other Contact Person: Phone#: TOWN OF A DNS ABLE F -- C CTv � D 1 NOV` 03 2011 _ 6-d - sewOH jeiie soH' d6£:£0 L L LO A ;71. a� Town of Barnstable Regulatory Services 7 apRsaarur� Thomas F.Geiler,Director 2 U8 MAR -5 All 9: 48 _ 9. �. Building Division - - PD Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4036 Fax: 508-790-6230 REQUEST FOR ELECTRICAL INSPECTION - ELECTRICAL YE1iML"x NUMBER a1)'+A (Permit required in order to process inspection) Todays Date Requested Date of Taspection 3LS 00- 3/1 1. HoSk, - hereby request an inspection under Massachusetts General (Electrician) Law chapter 143.section 3L and 231 CMR 4.02(3). The installation will be ready for lnspection q at f 3 S�' i i A1C-1' T7-'vA1 (Property Location) CvN f r Type of inspection requested; ❑ Temporary Service Service Re-inspection ❑ Excavation Rough Re-inspectlon ❑ Service Inspection ❑ Final Re-inspection Rough Inspection for ($50.00 Re-inspection Fee) ❑ Final Inspection for Other Owner or tenant �m Licensee's name,address,and phone License number- Licensee's Signature 21A section to be camp ® srasta a Inspector of Wires Inspection date pproved ❑Not Approved This workrwas not approved for violation of the following Articles and Sections of the MA Electrical Code: Q;WFR1cs:fornwx1 a7ogaest Riv;102604 Z0 39VJ Ai-1dMi'1 a3113iSOH bL61-8Zb-805 8b:b0 800Z/6T/Z0 .1� Town of Barnstable VUE P � Regulatory Services t Thomas F. Geiler,Director • ewaxsres�.e. + . - . i639. .�� Building Division RFD Mfg� Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 509-862-4038 Fax: 508-790-6230 REQUEST FOR ELECTRICAL INSPECTION ELECTRICAL PERMTT NUMBER Zc;o 4�(a (Permit required in order to process inspection) Today's Date j 0 Requested Date of Inspection Z//f/0 I, �u0 lb-3 hereby request an inspection under Massachusetts General (Elecfrician) Law chapter 143,section 3L and 237 CMR 4.02(3). The installation will be ready for inspection at I Z 9 3 S�"'Ty�T h71'w Tye/ R-D' edN )T (Property Location) Type of inspection requested: ❑ Temporary Service ❑ Service Re-inspection ❑ Excavation ❑ Rough Re-inspection ❑ Service Inspection 0 Final Re-inspection". (� Rough Inspection for e 4 fe``�'+e ($50.00 Re-inspection Fee) • ❑ Final Inspection for - ❑ Other Owner r tenant_T�I(` Licensee's name,address,and phone h� -I_ClYlt U711t7— wCvSvw License number Signature This section to be completed by Barnstahle,.Inspector o Wires Inspection dat6_ FEB 1.9 20AC 'e kof � , sp proved of Approved' This work was not ap rove or violati�o of<the,follllo g Artic es and Sections of the MA El trical Code: :'t d: , f Q:WFFiles:forcm-61=t mqu est Rev:102604 1fommonwea&o f Maajaclwetb Official Use Only cc� cc77 Permit No.� a[ padwd of-%.Serviced Occupancy and Fee Checked J BOARD OF FIRE PREVENTION REGULATIONS [Rev. ]/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: 3#feA/57711BLE To the Inspector of Wires: J By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) IZ 3 5/-Yt71/1r AIV--IT01-Al COV t T— Owner or Tenant A-M }9I;4 Re Telephone No. Owner's Address SAS Is this permit in.conjunction with a building permit? Yes © No ❑ (Check Appropriate Box) Purpose of Building 13u -,+ r`n Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd Q No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feedi ts and Ampacity ncatig and Na lure of Proposed Electrical Work: �titl. �'��h f /d��e / -5 i1 f3 Completion o the following table may be waived by the Inspector of Wires. 10. o.of Recessed minaires .6 No.of Ceil:Sus No.of Total p.(Paddle)Fans nrY4 Transformers KVA oftuminai Outlets Na.of Hot Tubs N, Generators KVA 1 : ;No.oguminailes Swimming Pool Above ❑ In ❑ o,o mergency ig mg _ rnd. grnd. Batter Units No.oecepta eROutlets 8 No.of Oil Burners Ai FIRE ALARMS No.of Zones No.of Switches No.of Detection and. No.of Gas Burners ✓� Initiatin Devices No.of Rariges No.of Air Cond. /✓ Total /✓ No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Total "' ''"""""""""""""'""""''' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Other Connection Securi y * o No.of Dryers Heating Appliances KW No of Devi es or Equivalent No.of Water No.of No.of z Heaters KW Data Wiring: S2 Signs Ballasts No.of Devices or Equivalent UJ� = No. Hydromassage Bathtubs No.of Motors Total HP i,S Telecommunications Wiring: No.of Devices or Equivalent Z Z o Q OTHER: oo Attach additional detail if desired,or as required by the Inspector of Wires. ji� Estimated Value of Electrical Work: d (When required by municipal policy.) O � W Work to Start: PC, Inspections to be requested in accordance with MEC Rule 10,and upon completion. LL Win'- i5d INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless z Q. the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The ® w, <' undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. w,- -. LU o Q CHECK ONE: INSURANCE [YJ BOND ❑ OTHER ❑ (Specify:) o I certify, under the pains and penalties of perjury,that the information.on this application is true and complete. `n FIRM NAME: a STz'1T LIC.NO.: ¢o Licensee: X g Signature LIC.NO.: (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: Address: SA--NLTr NCryN-.,— 0-16rc- Alt.Tel.No.:. *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) owner ❑owner's agent. Owner/Agent -t-7 9-83c-3 ale Signature Telephone No. PERMIT FEE: $ r .��;. _, The Commonwealth of Massachusetts en Departmt of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' wfdw.mass.gov/dia ' Workers"Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizationadividual): •Address: L"I�1 `�`u IT fIrL City/State/Zip: 6x`N v` - 026 3 S Phone.#: ?-7`( Are you an employer? Check the appropriate bog: .Type of project(required):. I am a e 1.❑ employer with 4: [] I am a general contractor and • �to Y * have hired the strb-contractors 6. ❑New construction . me . . employees(full and/or P art ti ) listed on the-attached sheet. 7. Remodeling 2.❑ I am a'sole proprietor or partner- ship and have no employees These sub-contractors have g, ❑Demolition avorkin for me in an capacity. employees and have workers' g y P ty. $. 9. ❑Building addition [No workers' comp.insurance Comp.insurance. 10. -Electrical repairs or additions required.] 5. [] We are a corporation and its ❑ officers have exercised their 11. Plumbing repairs or additions ' '3.� I am a homeowner doing ill-work . ❑ . g p • myself.[No workers'comp. right bf exemption per MGL 12.❑Roof repairs insurance.required]t c. 152, §1(4),and we have no 13.❑Other ' employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowncrs.who submit this affidavit indicating they are doing all work and ttien hire outside contractors must submit a new affidavit indicating'such. tContractors that check this box must attached an addiflonal sheet showing the name of the sub-contractors and st ate whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. Tam 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: Z S Tv IT /V(--L✓T15� Rp. G`ity/State/Zip: CC-(V 1 � 6.3S 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 tip 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 thq violator. Be advised that a copy-of this statement may be forwarded to the.Office of Investigations of the bIA for insurance coverage verification _--__ I do hereby certify er the pains and penalties of perjury that the information provided above is true and correct • . Date• # Z^ `� —� � • Si afore — Phone##: 3 6 9 Official use only. Do not write in this area, to be completed by.city or town official City or Town: ' .Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: �clGl c�7�Lc(`C�J� �° / �4la — TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION µ Ma �` Parcel Application p Health Division _ Date Issued' I6 1 61 sr i Conservation Division Y Application Fee - , Tax Collector - Permit Fee* Treasurer " Planning Dept. Date Definitive Plan Approved by Planning Board ' Historic-OKH Preservation/Hyannis Project Street Address � _,c / � ��7Z w^� �• Village C©n/ ! 1'- '. Owner 11VAM /A S fie. Address 17- 3 14-v7V 17— ' Telephone ? ? �V 974' 3 0 ?9i Permit Request -n N r JC W .4, love Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 01 00 0 Construction Type V 6a D Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family >( Two Family ❑ Multi-Family(#units) Age of Existing Structure Z() °/ " Historic House: ❑Yes SNo On Old King's Highway: ❑Yes 4No Basement Type: U(Full ❑Crawl XWalkout ❑Other Basement Finished Area(sq.ft.) UJ Basement Unfinished Area(sq.ft) go® st /Y. Number of Baths: Full:existing Z- new 10 Half:existing new _ Number of Bedrooms: existing 3 new Total Room Count(not including baths):existing S new First Floor Room Count Z_ Heat Type and Fuel: ❑Gas Qd Oil ❑Electric ❑Other 117, Central Air: ❑Yes J'No Fireplaces: Existing New Existing wood/coal stove: Yes; ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑-new size Attached garage:[existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ —Commercial _❑Yes _ -LJ No. If yes, site plan_review-#— -?urrent Use Proposed Use i BUILDER INFORMATION /) Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION BRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED t MAP/PARCELNO. ADDRESS VILLAGE OWNER t i, DATE OF INSPECTION: y FOUNDATION E FRAME � �'Yt `f���'� l��?? INSULATION &INS FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING W DATE CLOSED OUT ASSOCIATION PLAN NO. ' F: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street Boston,MA 02111' - www.mass.gov/dia ' Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers _Auplicant Information / o .Please Print Legibly 1Name(Business/OrganizatiozUdividual): &1h2 + •Address: j�- °I S 0 'l"'l1 4 1—. Av'k� a Lz.+✓ /: `1. City/State/zip: y71/ IT--. A-V , oa � Phone.#: s-a 9- � 1 Are you an employer?Check the appropriate bog: :Type of project(required):. I.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction . employees(full and/or part-time).* have hired the sub-contractors , 2.❑ I am a'sole proprietor or partner- listed on the'attached sheet. ? ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition employees and have workers' working for me in any capacity. t, 9. []Building addition [No workers' comp.insurance i comp.insurance. 10❑Electrical repairs or additions --- -required.]-..- -�- -' 5. ❑ We are a corporation and its -3: officers have exercised their 11.[]Plumbing repairs or additions I am a-homeowne 'doing all work . ' myself.[No-worker-C comp:""' ; ;- right of exemption per MGL 12.❑Roof repairs d]t" c. 152, §1(4),and we have no insurance.require 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 Homeownen.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating'such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.polidy number. I4m an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure,to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the MA for insurance coverage verification. I do hereby certify Eder the pains•and penalties ofperjury that the information provided/above,is true and correct. Si" at - r-Date: 77 Phone#: F only. Do not write in this area, to 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 6. Other ' Contact Person: Phone#: PROF THE Tp�� Town of Barnstable Regulatory Services �BAM LF� Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 • 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: yp Estimated Cost Address of Work: M I I 3A Jly )I— Owner's Name: Date of Application: 101 ) R l v 7 I hereby certify that: ; Registration is not required for the following reason(s): E]Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied 199wner 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 er s e Q:forms:homeaffidav TiC1[JS.Z1C(eaamsneci) ' prmcrfptive Packages for06 and Two-Family Residaatlal SaildlnpaRested Witb•Fos*0'i'nels 144AX;�h1UM huNm M Glazing Glazing Culling Wa11 Flout 9a3er:srat Slab p, mtiag/caoli ll Arran Cla) U-valae2 R-Yakut R-valuer R-Yaluc, wall Pes'iract P=hge R-value' R-valves 5701 to 6500 Heating Degree Days' ' 12% 0.40 38 13 19 10 6 Nomsml R 12% 0.52 30 19 19 10. 6 Normal S . 12% 0.50 38 13 19 10 6 15-AFUE T 15% 036 38 13 25 N/A NIA. Normal U 15% 0.46 38 19 19 10 6 Normal y 15% 0.44 31 13 25 N/A N/A 13 AFUE W 15Y. om 30 19 19 10 6 15 AFVE IS% 032 31 13 23. NIA N /A Normal y 18Y,. 0.47 38 19 25 N/A Normal Z ISY. 0.42 38 13 19 10 6 90AFn hA I'm 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 3 � ? 1. T EXTERIOR WALLS: +� O 2. SQUARE FOOTAGE OF ALL 3. SQUARE FOOTAGE OF ALL GLAZING: 4, %GLAZING AREA(#3 DIVIDED BY 42): 5. SELECT PACKAGE(Q--AA-see chart above): ; pTE; OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION, BUILDING INSPECTOR APPROVAL: YES:. NO: q faros-E/50303a . II ' THE Town of Barnstable �oF ,� Regulatory Services 1ARNSTABLE, Thomas F. Geiler,Director � 6 g 9• .�� Building Division AT f0 A Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 —---------- HOMEOWNER LICENSE EXEMPTION J p Please Print DATE: / 0)l O I0 7 JOB LOCATION: I1,9_3 Syt)-70 l _ Alt 1^i r7--V_ ��/ /7 - number street village "HOMEOWNER / /be*Ln 1 N S/r—#1C _ 5�)8—yZo6"18 Z� name home phone # work phone# CURRENT MAILING ADDRESS: f A3, WdVC 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 insp ction procedures and requirements and that he/she will comply with said procedures and requiremen . Sign ure 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 ofawareness 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 ofa Supervisor. On the last page ofthis 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. 1293 • • Cotuit 1 81 ForestR• Cotuit G� � TAYLOR DESIGN ASSOC., INC. SHEET NO. OF T P.O. Box 1313 �.T FORESTDALE, MA 02644 CALCULATED BY_��_ L DA TEL./FAX: (508) 790-4686 CHECKED BY SCALE ._...__.._..........._............. --- .........._1 _. . _..._-tit- A - :... ....:.... :..,.... .. : s.. erJ ... ..._ L C -T« ..........___...._... --... ............. P ' i .... . � .. . ._; t �t oil Q s.C — --- .. ............... -- — ... .. ....................... J +r7/. ................ .._....._................_. ..._.. C t �.r..L-g.._.._a=ss w±��J...__.."Lr? � .. ..... ... ......... ...:.. .......... isr � -- -.. _ _... .._. .... i 3 ..Z- C..�x..8 Z... _ �,�. .. Z.� 4. 38..E 7 �.� _....:.... ... ...._.. .. ... �.: a --...UJ ...;.-Lal ..... ........................... ...... ......... ..... ..... ... J �, — 's _._...- ........... .._ _..: __._ .._ ..b._..__ ........... ............ .... ... �._ .... ..k g.._....... := .'7._�......2__._... ..__.. . u - --- ..... . - .... ....__.......�..__.......... .... ........... - - 1_-._ G.. s e�3 N Z c . ............ _........ . r-t.. .- _..._.....C ::. .._t....__..__��.3.. .. 4.4_. ................. 1 _4....f�_...._.._._..c ..t ..._. Opp —� - ---- ---- s - cs sue= ,tea .--...._: ...... ---. _..........._......-..............._.........___..._-....-,.._........ --- ..... ..... ... ....:... ._.... i € �= - - :SGe` OFG a" ..... - - . M s � - .... ........ - - ....................................... .._.... ... ......k.a ........_.......... --- . ......_... : - a" JOB TAYLOR DESIGN ASSOC., INC. SHEET NO. OF P.O. Box 1313 FORESTDALE, MA 02644 CALCULATED BY— G�Z T DATE 67 TEL./FAX: (508) 790-4696 CHECKED BY DATE G.. ` Js�.�rJT 1 T �tJTOedN R® SCALE t ii ----- --- ..... ..... ...... ...- --.. .--- ...._ - __. ._.. .... -._. i 'C ............ ................... . .................-.-_.._. V15- - - _. - --..._..-_..�. - <.._....-_._..__..._......__...<...__.... -........_........ ......................._...-. _. �� Eo 3 -- --- _ -- - _.. - ----------- .3 t�c.�.... - 4 O : --- .... ... . ........_-.........._--... __.-._.... ----- _.---------- - -. --- -- -L - --- --- - ... - _._.._... c�...�._..._... -..,..... _� .._.......Ca�.z_ -.. . .- ...4. - - -- _.. - ............................-- ......_---.._... _ ....-.......--------.......__.....__..,... 4..... ......... --:....-... .............. - - - - - .... ...................... _._ ...... _ . ----- --- ---.- .... --- - 4 ira - ..... ---. - �37 --- t_ _. ---------------- _.._.. .........._.-........ - - ----- - ._-. --- - -- _._. -- 1_.-. . .. ..................................... ..,,a.. --------------.----. ------ ----- ----- ----- - - - - - -- - - -=---. . -------_;------._........ -- - - ---- _. - T _.._.._ _ . = --- -- w , - -- __e sk3 �� m �T cv -- ,� - t Q.. - --- --._ -_.... --- ...... K- - - .... .... -- - - ------- -- -- - ---------:. -------- :._. .. - -- : .... -. PADDUCf 204-1�e J 2�ri(PadAed) ov� J V uS (greater than 120 sq. ft.) c District - Certificate of Appropriateness is needed ssessor's dept. J y nce Compliance Certificate must be on file.- it Improvement Specialist's License From:Cheryl Stazinski Fax: +1 (508)224-3618 To: Building Dept Fax: +1 (508)790-6230 Page 2 of 2 0211012015 8:28 AM DATE(MM/DDIYYYY) ACC? CERTIFICATE OF LIABILITY INSURANCE `.� 2/10/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE.AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IM PORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions ofthe policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT B111 Nolan Nolan Insurance AgencyHONE FAx Arc xt • (508) 224-3600 CAI Nq): (508) 224-3618 PO BOX 938 E-MAIL Manomet, MA 02345 ADDRESS: billnolanjr@nolan-insurance.com INSURER(S)AFFORDING COVERAGE NAIC 0 INSURERA:Vermont Mutual Insurance Co INSURE INSURER B:Utica National Insurance Group Douglas C Kaake .II, INSURER C: I , Electrician INSURER D: 66 Barnf ield Dr. INSURER E: Plymouth, MA 02360 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN ADDL SUER LTR TYPE OF INSURANCE INSR WVD POUCYNUMBER (MM/oO/YYYY) (MM/DDIYYYY) LIMITS A GENERAL LIABILITY BP11035053 9/10/14 9/10/15 EACH OCCURRENCE $ 1,000,000 $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 50 000. CLAIMS-MADE ®OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG $ 2,000 000 $ POLICY ACT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLELI T (Ea accident) $ ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS araccidenq UMBRELLALLAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ B WORKERS COMPENSATION 4764280 6/16/14 6/16/15 WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN NIA E.L.EACH AcaDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERA DB 1 IVEEi gWSS (Attach ACORD 101,Additional Remarks Schedule,if more space is requ red) L- � 3CAM it�:i.-f CERTIFICATE HO1rD.ER, } CANCELLATION i L 1 .Y a- q m b is .mot SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 367 Main St Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Cheryl Stazinski © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: (508) 790-6230 E-Mail: �t Town of Barnstable Regulatory Services uuvsr,�ate, Thomas F.Geiler,Director �b Building Division Arm Tom Perry,Building Commissioner _ 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: .568-790-6230 AGREEMENT FOR ACCESSORY USE OF RESIDENTIAL BUILDINGS ASSOCIATED WITH RESIDENCE We,Adam J.Hostetter and Janine M. Hostetter, (Hostetter Realty Trust)the undersigned,being the owners of property situated at 1293 Santuit Newtowne Road, in, Cotuit MA, holding title under a deed recorded with the Barnstable.County District Registry as Book 23266 and Page 3,being shown on Assessors' Map 026 as Parcel 039, hereby agree, certify, warrant and represent to the Town of Barnstable that the finished space in the basement of the residence located on the same parcel as above-described, which contains living space, is not intended for and shall not be used as a permanent,separate apartment for year-round or summer occupancy,for rent in any fashion. The intended and authorized use is for our personal use associated with the residential use on the same premises. This finished basement space shall not be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require application and approval of a special permit and compliance with the Family Apartment Rules and Regulations. This finished basement space shall not be rented as an apartment or as a single _ room, or in any fashion,which rental would be a violation of the Town of Barnstable's rules,regulations,and zoning ordinances. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated,which shall run with the land and binding future owners. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this day of 201 TOWN OF BARNSTABLE OWNERS: By: Adam J.Hostetter omas Perry Janine M.Hostetter THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY,SS Date Then personally appeared the above-named (owner), and made oath as to the truth of the foregoing instrument,before me. Notary Public My Commission Expires: Q:word/accessoryagreement �y t7 ssesso� offioe (1st floor): /1 �/ Assessor's map and lot number ...a��...^v .`......... �� ® � d-� _ Hof THE Toy Board of Health (3rd floor): WITH `TITLE 5 Sewage Permit number .....CI!. �1'�". 7 �`$? �1R®N-MENTAL. CODE At'`5 U i BAUSTABLE, . ...................... MAM Engineering Department (3rd floor): /oZ�13 �JSTOWN REGULATIONS +00�0 9.a\e� House number .............................................. APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only R 0 V L L r rnstabic .,,,.-._ervation f[."nOs N -OF B A R N S T A B L E .. /-�' ILDING INSPECTOR good "to �� _/ APPLICATION FOR PERMIT TO / E�-L-�/U TYPE OF CONSTRUCTION ... I�OL7 '�/Y!E TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �r, h�.4 ..........�-�T...�.( ........................................................... Location ..!�..l�T........................�G.{1.......�................a....L7. .......� Proposed Use ...1' ' il/�r� �FS�Z�E,r�C ............................................................................................ ..................... ... .... ........................... �� .....................Fire Distract .. ..t�'-t� 'T Zoning District ..../........... `/ ................................................... Name of Owneref5i 0 @C� �t�f t�L ... (J ddres�......T. . ..../f��l®......�'...... ...........a. /C /��?� 41 /�efo% Name of Builder 7 ..... ...... /..�1........................Address .o . ...!' .:........,Z�...................7........ .�............... ............ Name of Architect�LLE .............�J .v0b.........Address e�,.. ...�)64FIZ ab..4wn................�•..� LIJiGf� Number of Rooms ..............5..............................................Foundation S=�i!C/C�'SET ............................................... Exterior cl'....r-el-0 z .... L IaL. ....Roofing ..'45:7 �T� ....... ....................................... Floors ..............................�....................................................Interior SA:C /o 061 .....�.....I........�......................................................... Heating CJi L�...GUf�4. .�e.. i'7t'!.C.... .8 !1 erlumbing ........g!tY.1'1�.!.: ' '..................................................... Fireplace ..........................................Approximate Cost .........Q© DDl� Definitive Plan Approved b Planning Board __:______ __ pp Y 9 � !�' 19 (T Area ./.. �V.................. Diagram of Lot and Building with Dimensions �O-t,L<r �6 Fee 12�d � SUBJECT TO APPROVAL OF BOARD OF HEALTH "2� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Tower Barnstable regarding the above construction. fir' ���� Name :'......................... .......... .................... Construction Supervisor's License .. ..J ��.......... BUEHLER, GEORGE & CA16LYN .... Permit for ... o Story I'W r ...................... Sin %11 ............ 111A........I�15............. -512-0 h4 1,--- .1 Location ....Lot #8 , 1293 Newtown Road ..............................r.............................. tdit ......................co......... '........................................ Owner ....George' .&*..C.a.rdo.1Vn...B.u.eh.l.e.r .. ....I r%e Type of Construction ..F.... . ..................................... ........ ............................... Plot ....................... Lot ................................ • Permit Granted ....October... .......��.jq 87 Date of Inspection 1�Date ompte, .............19 ELI' n 0o L00 u 7 G y 7.1�5, S 4 -�;5 L 191 .1� J ,0.10 J� v O SANTiT-NEWTOWN ROAD r;� Z�►�� '. �f FOVNDATLON CFRTIFZCATYoN Towns PLAN REF. 3k 39`r �► DATE IUD/ i 18-7 SCALE V`:Yo ' I HEREBY CERTIFY THAT THE ABOVE FOUNDATION IS LOCATED ON aF Q�(.GE E '� SU.RVE L THE GROUND AS SHOWN. AND ,���H n�gkf y COnGULTdY1TS S ITS POSIT-IO" DOES PAnUL tiJ CONFORM TO THE ZONING V MERITHEW Z7 70 RA5P5ERvt LN, LAW SETBACK REQUIREMENT No. 32098 e� y OF 9�� o ��� MARsToN 5 N1 )LLS NSA LArOc 0 z 404e PA L A. MERLTHEW R.P.L.S. i SCD O i'rw �"�y�..::�t.��•r•�1Eryy�.e.. -"nab , .. .�.��-,k;.e^q..:,:.: a�+yllt..:� .i�.a.+i�'+�.,��Ss:+n .r�'�q�ara-- .-.c:'-�.?^'rrN�!r'A'.6'.�".: �.v,,. ,.-, o'-G �:t{ s'�` ''�.7''� R �F1 �INC TOWN-OF BARNSTABLE 31 � Permit No. ........2 62..... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .wa i6y9• , HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to George & Carolyn Buehler L Address Lot .#8, 1293 Newtown Road Cotuit, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. May10, 88 W............, 19................. ....... ..... ........��............... Building Inspector _ yr 110VAtlLt, MASSACHUSETTS "� F� t$UILDINVm PERMS I . � DATE 19 PERMIT NO. > APPLICANTe V �4 � L� ADDRESS - IN0.) (STREET) (CONTR'S LICENSEI & NUMBER OF PERMIT TO ' (_) STORY � DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) �oT O EIIITDCIJA/ /�� ZONING. ul�= DISTRICT— (NO.) (STREETI s BETWEEN # AND �( (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE : 4 BUILDING IS TO BE FT, WIDE BY_ FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION x. TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION 't { ITYPEI. REMARKS: g., 3 AREA OR s PERMIT VOLUME ESTIMATED COST $ FEE _ }' (CUBIC/SQUARE FEET) f OWNER BUILDING DEPT. ADDRESS BY 3 3' THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET. ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- g PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED .F 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 THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOP, „ ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. ". 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL .s MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3, FINAL INSPECTION BEFORE OCCUPANCY. - POST THIS CARD SO IT IS VISIBLE FROM STREET BBUUUILxDD;NNGG INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1,2 _- 2 r. z z � 3 HEATING INSPECTION APPRO ALS ENGINEERING DEPARTMENT Sui3,j tc WA (-vti_ OTHER BOARD OFFHEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND VOID IF C 0 N S T R U C T 10 N INSPECTIONS INDICATED ON THIS CARD CAN BE i TOR HAS APPROVED THE VARIODUS STAGES OF LPE�RMIT K IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. IS ISSUED AS NOTED ABOVE. NOTIFICATION. -„',y*'t'��kV'e' av�«l-.,.+-s^�'a.,...�r,,•it�ti '''+!t «.al:�Tiwti �^'tiC'+Y'i ��?�'�e+`'v �r% "":^isr^" "'wy;�=+a►'E�:+�«.o-r^C•. '.�;;�i.•ra•v,;,..�:«'ss_ Town of Barnstable « BARNSTABLE, Regulatory Services p• 9� MASS. prFt 639. Building Division 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection d Location - 4f�A.i-rr- &16,7 � Permit Number Owner 642 57'e---f7ZJ , _ Builder One notice to remain on job site, one notice on file in Building Department. The followingitems need correcting: rd7/ P 41/�-77 T/Olt C2 1� Please call: �508-8624M-for re-inspectio Inspected by C Date y /l-�q I v Assessor's offioe (1st floor): Assessor's map and lot number ...® �.. r OFTNE>o` . .. ................. Board of Health (3rd floor) _ Sewage Permit number ' Engineering-Department; (3rd floor): � �a� - o 16 9 �o .House number ............................................................. J...S'... APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only . TOWN OF BARNSTABLE " BUILDING INSPECTORJ <1 0 _. ��%� ��-, • 'APPLICATION FOR PERMIT TO ��r.................. ................................. ............ TYPE OF CONSTRUCTION .... {. �� ... x ..�U.!..................... .....19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location � T ......./../ .T,..W A/....... o.A.�........... _ 7. v.�7' ........................................................... Proposed Use ir � /��S /Z�Ei✓C ............................................................................................. ................................... ........... _ .................... /f T Zoning District .........� ........................................Fire District ..�-,d.TIJ/...................... - �jE4�2C-� y�'� 2v ?//(�...��(� `�, Cl..................................... Name of Owner ........... ddress ...... .. . .. . �E7�,P /�� E .—v�►� , 4 i�IWDS u-l;gV Name of Builder ....................................../............................Address .. Name of Architect P1 .p�-�E/!/OU .....�• .. " E /o/.....Da�C.C)!»..'.......Address ....... .... ............ • r Number of Rooms ................�5..............................................Foundation ................................................ Exterior .(.T�..... 1)/.'I1�....���C!(1.��ES...Roofing .��S�i�i4G7.._........................................... Floors :..........................�....................................................Interior ......... i UGC ............. ............................................... " Heating G Of�L ... .. L G/"��( ...1�.�[!'Jq lumbing ...... !• Fireplace ........................Approximate Cost DOC� ............. ...................................'T' Definitive Plan Approved by Planning Board "_ !�'_�O------19 Area ..... 71................... Diagram of Lot and Building with Dimensions Fee '. ............................................. SUBJECT TO APPROVAL OF BOARD OF ,HEALTH f r y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules'Farid Regulations of the Town of Barnstable regarding the above ' construction. • ' - - Name ..:........... !.. ..... --:w/ !f .........��+ .................. / V/ i Construction Supervisor's .License ......... BUEHLER, GEORGE & CAROLYN A=02'60039 No .312 6 2 permit for ,Two Story Sine�le Family Dwelling Location ...Lot #8 � 1293 Newtown Road .......................................... Cotuit ............................................................................... Owner .....George & Carolyn Buehler Type of Construction .......;Frame... ............................ Al Plot ............................ Lot ................................ •4 1 Permit Granted October 6 , 87, ~ Date of Inspection ....................................19 Date Completed ......................................19 i i ' 1 �'�O�vLvvS I.�/OA�tI�I d.61 so•k�od... �`�'9 jam•b� � , -PL n v o o M, oj T , MCI, r Li 91, Al r z a i . �f