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HomeMy WebLinkAbout0099 PINEVIEW DRIVEr��7 'k ►ae �a Lt 1�17 b� n s , vv 1 , J �• V tilt c fzI f 6� �7Qs Assurant Use Only. PID#. 1341249 : AS.SURANT June 12,2018 Hello,; Assurant Field Services(AFS).is working on behalf of Mr.Cooper AFS previously registered a property located at: Street Address city State Zip 99 PINE VIEW DR BARNSTABLE Lr MA' _ 02635 _ This letter is to serve as notice that the property has either been sold to a new owner,the property is now occupied,foreclosure has been rescinded and/or borrower is no longer in default.AFS.does not represent the new owner and has not been.provided any further information or documents. Please de-register this property,and send confirmation of de-registration to the email address listed below or by mail. Thank you for your time and attentiorito this matter. Assurant Field Services GDS�yRE Attn:Property Registration fodeq�N�js 101 W:Louis Henna Blvd.,.Ste.400 Austm, TX 78728 afsvpr.®assurant.com. y--a C). 4 ASSURANT" Field Services e-� M 101 West Louis Henna Boulevard,Suite 400 Austin,TX:78728 Town of Barnstable Attn:Building Division . 200 Main Street Hyannis,MA 02601 . 1 i PID: 1341249/89910 REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3) or already foreclosed for which possession has been taken(section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law, please state the reason(s) and complete section 1 (property information) and the first paragraph of section 2 (foreclosing parry, court, etc. and foreclosing party representative, but not other representatives and attorney) so that the Town can review the exemption andupdate its f, records: C Section 1 -Property Information Property Address: 99 Pine View Dr. Cotuit, MA 02635-2412 0 Assessors Map #: Parcel #: 000040 - 000000 = 000117 Land area and description Single Family, 2, 192 square foot Building(s) description and contents 2 stories; Cape cod; 9 room Occupied: x Occupant(s)(if borrowers so state and include name(s)) In the Estate of Lopes Phone: n/a email: n/a other: n/a Vacant: n/a Date: n/a Anticipated Length of Vacancy: n/a Last occupant(s) )(if borrowers so state and include name(s)) n/a Phone: n/a r email: n/a other: n/a Has possession been taken n/a If so,please explain and complete and file the maintenance and security plan form(unless exempt'as stated above) n/a Section 2-Foreclosing Party Information Foreclosing Party (full name/title) Nationstar Mortgage Foreclosure Case Court: n/a Docket# n/a Date filed: n/a Current Status: n/a Foreclosing Party's representative(s) for property (entry, management, repair, etc.)(name, title,): Assurant Field Asset Services, c/o Company (if different from foreclosing party): NE- Property Management Address: 268 Mammoth Road, MA 01854 Phone: 978-821-9806 email: cindysilva@ outlook.comother: n/a If an exemption is claimed, please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure, please so state and do not complete contact information(i. e. "none" or"see above")). Name,title, other: "see above" Company (if different from foreclosing party): "see above" Address: "see above" Phone(s):"see above" email(s): "see above" other: "see above" Name,title, other: "see above" Company (if different from foreclosing party): "see above" Address: "see above" Phone: ."see above" email: "see above" other: "see above" Attorney representing foreclosing parry n/a Firm name (if different from attorney's name): n/a Address: n/a Phone(s): n/a email(s): n/a other: n/a I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: 09/09/2015 Name: Sara Mej is Title: AFAS Authorized Agent I I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: 9/9/2015 Building Commissioner, Town of Barnstable LICENSE OR Liberty Mutual surety 450 Plymouth Road,Suite 400 PERMIT BOND Plymouth Meeting,PA 19462 Bond 016066741 LICENSE OR PERMIT BOND KNOW ALL BY THESE PRESENTS,That we, Assu rant Field Asset Services, LLC as Principal,and the Liberty Mutual Insurance Company ,a Massachusetts corporation, as Surety,are held and firmly bound unto Town of Barnstable, MA as Obligee in the sum of Ten Thousand and No/100----- Dollars($ 10,000.00 ) for which sum,well and truly to be paid,we bind ourselves,our heirs,executors,administrators,successors and assigns,jointly and severalty,firnily by these presents. Signed and sealed this 8th day of September 2015 , THE CONDITION OF THIS OBLIGATION IS SUCH,That WHEREAS, the.Principal has been or is about to be granted a license or permit to do business as 99 Pine.View Drive, Cotuit, MA 02635-2412, PID: 1341249. by the Obligee. I r NOW,Therefore,if the Principal well and truly comply with applicable local ordinances,and conduct business in conformity therewith, then this obligation to be void;otherwise to remain in full force and effect. PROVIDED,HOWEVER; 1.This bond shall continue in force: ❑ Until ,or until the date of expiration of any Continuation Certificate executed by the Surety OR ® Until canceled as herein provided. 2 This bond may be canceled by the Surety by the sending of notice in writing to the Obligee,stating when,not less than thirty days thereafter,liability hereunder shall terminate as to subsequent acts or omissions of the Principal. . Assurant Field Asset Services, LLC Principal By 07 Liberty Mutual Insurance Company., By - 1 D-Ann Kleidosty Attorney-in-Fact S-0908/LM 10106 XDP i ,-.� .. I - .THIS POWER OF:ATTORNEY IS N0TV VALID PRINTED' RED BACKGROUND th s Power of Aftorn v limits.6 acts of those-named herein,-indAhei.havi.io authority to bind:the Company except in th manner to the extentherein stated ,�,,. ....­ .I_ -­-�_---- . - , Certificate-No 307696I 1- 1 - mercan e d Casualty L�66Mut 61 lfi§uran6e.Company-,- The Ohio Casualty In - ar Company I MistMercan]ns ranc�ComPEny - . - - _ : ...._,.-­ ­ �---_------�-­.-- ---_, .- � _.. .'.. . � .�.. .- ,. - - _ - POWER-OF ATTO­ . Y­ - - .KNOWNALL PERSONS BY THESE PRESENTS: hatAm dca Fire&_Casualty-CoffiOan and The Ohio Casualty are cbrporati6nsduly-qrganize underth61awsof - - �.- - ,heState of New a p ire;that Liberty Mutual insuranceComppny is.acorobratibnduly,'orgohzed-Un­6r 6,.-..1..�,-w.:iI—,-�6.-i t-h.�--,§I..t-a­i­,�.,.._6-f.M�.,-..a.�_., .�. s...j:..� an­.­­:o� e.-­­.s.-t­A,_�m..-----'­e-­-._r-'c-a`-,n--­'­--l­n_su�i-:r,_a`.I:,.:n� ,. I ceI­.-.­..C..-.o mp----a­ n y--1­---:.'­-I -- . :- -is a corporation duly organized uhderthe laws of the State 6f.f�di�ha.(her�i6� ilec661ydi6d�ihe"�6noi6iei7 urslan tc:and,pyAp!h6 tyhirein got faith;th; Joes ere name- ons tute""­.. ) p and appoint, Brooke-A.Sharp-:b A�h Kieidosty;-G6 -b.tklund�� torl-Poti;_Sylvia Willian Q`Mo0dy ­ - _. _- ..... . _�---- -I ' . . �. 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SU - ' - � . r , I _ 7he'0hid-Cas it Insurancec ppq y:- -_-_ ­ ,_ 1 ' ..1-..- .----`-- �-­ .M. - -,� m( A-M c0 1 - . _ F. ' �S -0 � -bety utual Insurance_q Company 0 1906 :: b1919 -:n 1 1 .e !� I -I - r 0, _t 0 0 . , � West mercah.Insurance-Company -,— 'A , ­­ . � . � _ By _m r STATE OF PENNSY2VANIA -ss -ayl J "istt� eto� 5 - S, COUNTY OF MONTGOMERY - Q-0 On this 20th .'day-d J 2015- before:me personally appeared bavid-V Carey-,who a6k 6 acknowledged himselfIftobu the Assistant Secretary of­Am American Fir6.and I,M ! L'_ J. CI-IIy_Company:Libeqy-Mutual Insurance Company ha Ohio Iniur666e.dorp66y,a4d West Am&h can Insurance-Cop any and that lie being authorized sot' _ 0 execute the foregoing-instrUmentfor he pdTo 0s therein contained bqiignirb on�ehdfof ifi6 corporations by himself as- duly buthbrk6d of_cer - . E aj-> -IN WITNESS WHEREOF,I-h6ve-hereunto-subscribedM home and affixed my notarial siala�Plymouth Meeting..PennS):Pennsylvania on the dayarl8_yea Ailrst boyq-wnuen 0- A- I. , , - ..., -.. _ -- ."- :. ­,I--7�_--­--.1. --­-­_ :--' -� 1 :-.- _­- .- _- _.-- 7 % -,-'" , -1 � :-,­­ -­ .M- ­ 14w-, ­-­ _.' -..- ­ ;.­_­­0 VM N PAS COMMONWEALTH OF PENNSYLVANIA 0 -1 0�w I .'Notarial Seal �- 4 M r_.A feresa�astella,Ncj�y5�&,C_ 6y Y - - Cq 0 -­ 4F: Ply otti TVp. Mont66 ney.C(Uny - i 1T&ePaMella .. PY, Jbl1 I-C, My c mmi�g Expires. Member PennsylvaniaAssoaado d &46es _ ­0 Ea -a0-4 - r_m This:Power of Attorney is made and executed pursuant loan, youthority ofjfi�following 9 db�sind A�zatio� k r.qan Fifeo46asqaIty Qompany,The 0 C _ _ V_4 company Liberty Mutual Insurance Co pany,and West American i sdranc0 to�paqy-qhicb-resgIqliooq�ar�now full and effect reading _ 0 0M a-'ARTICLE V­OFFICERS 7 Section12�Power ofAtomqAnyo eroroth&-ffb 6f.f t � oratior:authorized'for thpt'pu­os *n nt'n b�the Chairman of the 4nd-sQbj6ct: t .- p g - 0-c f'1­ `."i o such m4ati6n as the airm­nor1he-Or6sident may prescribe;shall appoint such atornevs-in�act as'may b0 necessary to ac�i 6e if q the'C rp ratba I - aka-execute-seal.j 9 o,.-: acknowledge and deliver as surety 6h�,and-all undertakings;&ing§,:bonds,r c86n6n6esand-8th6fsurety9bl. a on :Such attorneys meys�n-fact su ject o the Iimitat.ons_8et iofth njheirrespk tve-:-- - ) powers 0Vattorney-ffiall have full_6��rt�bindthe Corporation by.their signaburb and:w6ttiofi bf any such instrument and o- it c thereto seal of Corporation When-s =-� executed such instruments,shall be aS-binding as.if signed the President attested bythe.Secret?ryI-Any power orpyt�on .grantedto any rbprei66tative or attorney-inifi6t 66deF ->-I : -the-provisions o this articIemay.b revoked 6t 66y time �Ah6 Board he Chairm66 the President or by the�bffic r or oIficers­g granting Eycfi- 9weror. uth6Jly - ._-.0 ARTICLE IIII­-Exk Utioi'bf C6ntra6ti-S SECTION 5I$urqfy Bonds and Undertakings :officer of the:Qom authorized for that 4rposgL in by :q�airmanp�-thepres!opnt, 0jj Y. -y p g­ , ; , and subject to such-limitations.as the:0 irman-or eDresi ent may prescribe;s aIlattorneys ppoint.su -inact-as mb be necessary to act_b-behoif 6fthe Company to-makeexecute, ,_M _ - -5 : seal,acknowledge and d6liver -surety any and allundertakings bon�S-recOgnzances and othO sdrety'6bli obligations__§Uc�attorneys to-the Iffiitbtj6bS_s6t fofth In -0 Z resppctiv.'ppWers c4 attorney m6y shall hate full to Cdmpanyb theirs) nature and execution of an instruments tsand q:0ttaqh:ther C�te,sealoftti-C mbanv:-:Wh6n so 0�q -- _ - V_ executed such in-strumentss A te, dng d if signed by:the:president,�nd�.ftest6dby esecret - -1— UF...-. .L _ -LLCertifcate of Designation;-the President of the Company acting pursuant to-h6 b�jbwsoff66"Cbmpqny authorizes M Carey 491%a t Secretary Io-appoint suchattorneysin fact as ma yba necessary­to act on 14�d i ot _C6�pary..tq'make�xebute,S64-adk6owjp&ge�aqd7dq1i er as curet an::and a1�und ek196i bonds lecognizances.and other surety-:" _ Y �: obligations - - assistant - :: Authorization=BY unanim6 s consent of the:Company's:b6brd of Directors E the consents thatiacsimil or mechanically rp)roduce�signature of any a sistart secretary�f the_ Company wherever_appear,ng upon,a certified cbpy-bfaty�ow�f�f attorneyissued by_the'Company:in-connection-with surety bonds,shall be.ya1d'and:-.b.nding upon the-Comppnywit --- the:same�fdrce an effect asthough M6 6 �if jod.- Gregory W.D6verport,-th undersigned nir6an�Fi ��d 6b§U61jy:C6Mpany The Ohio Casualty.rnsu ance,.Compbhy,-Li:Liberty.Mutu6I.Insb Insurance Company and We�t Amehda�.-hsurdhce Co Odny do hereby:certify.ihat-ilhe prg.naI powor-0fatio, L.4 i6K the foregoing a:uii,trvQ Pna:P rfo..j p f t6e: we of executed bysaid-:- Companies is in:full force and effect has not-been revoked - : I TESTIMONY WHEREOF'I have hereunto and a ffix d-the seals of said Companies: i - day of r _ t- ­ 20I � ,11 I CASE`- I , � 1 t , a VP- 7 0 4C � 1 1906 r0 0 .19 ( 912 � 1991 0 'o � Gregory W payepport- s istant Secretary" S1 �"', .. 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RNIT 7-D Huntington Avenue ': "'9 South Yarmouth, MA 0266 ., ,; =E ' Tel: 508-398-0398 Fag: 508-398-0390 k . - iE i 05/24/12 Town of Barnstable Thomas Perry CBO ` Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for 99 Pine View Drive, Cotuit has been' inspected by a certified Building Performance Institute(BPI)Inspector.- Ceiling: R-19 cellulose Walls: R-13 cellulose(walls of converted garage only) All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey Parcel Detail Page 1 of 4 r B+t6l2ti'ST. ALES _ Logged In As: Parcel Detail M Monday,September 14 2015 Parcel Lookup Parcel Info per Parcel ID 040-117 Develo pot LOT 49 Location 99 PINEVIEW DRIVE �) Pri Frontage 1125 Sec Road ROUTE 28 _ I sec 125 Frontage Village rCOTUIT — I Fire District I COTUIT Town sewer exists at this address I No Road Index 1269 " Asbullt Septic Scan: Interactive 0401171 Map _ Owner Info Owner LOPES, PEARL W I Co owner %LOPES-POGUE, MARSHALL W& BENJAI _ Streetl I99 PINEVIEW DRIVE Street2 I City I COTUIT State MA Zip F02635 _____ Country Land Info Acres 0.53 _J Use ISingle Fam MDL-01 I zoning[RF � Nghbd 0105 Topography Level Road ,Paved Utilities I Public Water,Gas,Septic �. Location Construction Info Building 1 of 1 Year 11984 Roof Gable/Hi . exr[Vinyl Built I I Struct �-"•"-�`p yl Siding Wall � �J • Living 2296 Roof AsphlF GIs/Cmp AC None Area Coverer Type Bed Style Cape Cod I Wali Drywall Rooms 4 Bedrooms Int Bath Model Residential —I Floor Carpet l !3 Rooms Full-O Half _ zIU Grade Average Plus. ITot 'T pe Hot Water ��I Room l Stories�3/4 Stories I Fuel Gas ation- Heat F IPoured Conc. 1' Gross 3932 I, Area Permit History http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=2714 9/14/2015 Parcel Detail Page 2 of 4 Issue Date Purpose Permit# Amount Insp Date Comments 5/22/2012 Insulation 201202879 $2,900 AM/2012 12:00:00 AIR SEAL-INSULATE 12/8/2003 Addition 73443 $85,000 10/26/2004 12:00:00 1ST FLR DINRM-2ND AM FLR 7/1/1984 Dwelling B26708 $0 4/15/1985 12:00:00 CO 1ST - Visit History Date Who Purpose 8/27/2014 12:00:00 AM Jeff Rudziak in Office Review 9/24/2013 12:00:00 AM Robin Benjamin Cycl Insp Comp 3/6/2013 12:00:00 AM Geraldine Clark In Office Review 8/22/2012 12:00:00 AM Robin Benjamin In Office Review 3/5/2012 12:00:00 AM Denise Radley In Office Review 7/11/2005 12:00:00 AM Paul Talbot Meas/Est 10/26/2004 12:00:00 AM Martin Flynn Bldg Permit Completed 3/16/1999 12:00:00 AM Frederick Stepanis Meas/Listed-Interior Access 4/15/1985 12:00:00 AM FR Sales History Line Sale Date Owner Book/Page Sale Price 1. 2/27/2012 LOPES, PEARL W 261 1 1/1 51 $0 2 10/16/2003 LOPES, PEARL W&MICHELE P 17803/280 $1 3 1/15/1990 LOPES, PEARL W 7034/28 $112,000 4 5/15/1987 TRIPP, STANLEY I&JEANNE C 5726/2 $118,000 5 5/15/1987 SUDEROW, DETLEV 5726/1 $0 6 10/15/1986 SUDEROW, DETLEV P1118-El $1 7 12/15/1984 SUDEROW,ANNELIESE&DETLEV 4352/60 $67,200 LO - 3/15/1973 DENNIS STAR CONST CO 1822/144 $0 6/12/2015 LOPES-POGUE, MARSHALL W& BENJAMIN R 28934/25 $1 6/11/2015 LOPES, PEARL W ESTATE OF BA14P1301EA $0 Assessment History _ Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2015 $202,600 $39,600 $0 $112,000 $354,200 2 2014 $189,600 $42,000 $0 $112,000 $343,600 3 2013 $189,600 $41,500 $0 $112,000 $343,100 4 2012 $179,900 $40,700 $0 $112,000 $332,600 5 2011 $195,200 .$18,200 $0 $112,000 $325,400 6 2010 $194,800 $18,200 $0 $112,000 $325,000 7 2009 $203,300 $17,600 $0 $133,900 $854,800 8 2008 $219,000 $17,600 $0 $139,500 $376,100 10 20W $250,400 $17,600 $0 $139,500 $407,500 11 2006 $226,900 $17,600 $0 $145,800 $390,300 12 2005 $1,17,600 $15,000 $0 $132,500 $265,100 ; 13 2004 $95,500 $15,000 $0 $132,500 $243,000 14 2003 $86,300 $15,000 $0 $45,100 $146,400 15 2002 $86,300 $15,000 $0 $45,100 $146,400 hqp //issgl2/intranet/propdata/ParcelDetail.aspx?ID=2714 9/14/2015 Rarcel Detail Page 3 of 4 16 2001 $86,300 $15,000 $0 $45,100 $146,400 17 2000 $68,300 $14,900 $0 $27,700 $110,900 18 1999 $64,400 $2,600 $0 $27,700 $94,700 19 1998 $64,400 $2,600 $0 $27,700 $94,700 20 1997 $69,900 $0 $0 $20,700 $90,600 21 1996 $69,900 $0 $0 $20,700 $90,600 22 1995 $69,900 $0 $0 $20,700 $90,600 23 1994 $69,000 $0 $0 $24,900 $93,900 24 1993 $69,000 $0 $0 $24,900 $93,900 25 1992 $78,600 $0 $0 $27,700 $106,300 26 1991 $75,400 $0 $0 $50,000 $125,400 27 1990 $75,400 $0 $0 $50,000 $125,400 28 1989 $75,400 $0 $0 $50,000 $125,400 29 1988 $49,600 $0 $0 $21,600 $71,200 30 1987 $49,600 $0 $0 $21,600 $71,200 11 31 1986 $49,600 $0 $0 $21,6001 $71,200 Photos 711 �. . ` .. Zu v1- 1- i �7 I h tp:Hissgl2/intranet/propdata/ParcelDetail.aspx?ID=2714 9/14/2015 yu u ++ i 9/�12 ' 912012 K�-,, 1112912012` Town of Barnstable Geographic Information System September 14,2015 f. 040095 040 113 040091 098 #29 #22 2 #24 #29 ' CZ094 #,114 040086 , #23 040093 #102 G 040114 m #8 040092 #10 040115 #4120 -040085 o P� #9 .p 040116 #4130 * 040117 040084 #99 #58 . 040118 #87 ` 040036 #10 #75 e #75 ' 040035 . . #28 040120 #63 E ZS - 1 040034 p" #44 O0� 0 w 040033 'f vo 040046 �+' 40 F � #6D Ga• oaDoas 040032 040044 #21 #74 035, DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:040 Parcel:117 - '. boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:LOPES,PEARL W Total Assessed Value:$354200 Selected Parcel 1°=100'may not meet established map accuracy standards. The parcel lines on this map . are only graphic representations of Assessor's tax parcels.They are not true property Co-Owner.%LOPES-POGUE;MARSHALL W Acreage:0.53 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:99 PINEVIEW DRIVE / .•' such as building locations. Buffer �/� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION J. Map Parcel Application :3 1 Health Division Date Issued Conservation Division '; Application Fe (' Planning Dept. `- Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis h` Project Street Address 97 P 1 ne v i e w r,v e Villa9 Owner L' ckele Lo PeS Address, e Telephone Permit Request P41 Cell alai -io the aC;ftl c• A;M1� Seer 4r, 1c ne anc� 17asCM811�' w��',n c,�Da(Ic��n�l - �rn 'Dense nail ura,��c uuit�► 9V 13 ee 11 wla5C Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation q Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 10 Two Family ❑ Multi-Family (# units) Age of Existing Structure i 4 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ' ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new _ Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes aQ No Fireplaces: Existing New Existing wood/coal stove: .❑Yeses No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ wring ❑ new si-e_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ =m Commercial ❑Yes RNo If yes, site plan review —� Current-Use` Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name W:Nkm k0y-sv'ev Telephone Number 5 0 8-,3 q 8- 3 16 Address T-b wil1 "()56\ Nye - License # Solo Y0. SRO h b Home Improvement Contractor# 6 4 3 C� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO r SIGNATURE DATE '� k 1'. kr, 4 FOR OFFICIAL USE ONLY 'r � s APPLICATION# DATE ISSUED a MAP/PARCEL N0. ADDRESS VILLAGE ` OWNER DATE OF INSPECTION: x x g. FOUNDATION i FRAME INSULATION' t\J x, FIREPLACE ELECTRICAL: ROUGH FINAL ; PLUMBING: ROUGH FINAL t GAS:_ ; - ROUGH-.4;.- FINAL =FINAL BUi_LDINGi i x a DATE CLOSED OUT ASSOCIATION PLAN NO. :j - 6 Hoysing Assistance Corporation Cape Cod HOME OWNER WEATHERIZATION WORK PERMIT &FUEL RELEASE: PLEASE FILL OUT AND SIGN THISFORM IFYO.UARE TH EAPPLI CAN T HOME OWNER. I +N hereby consent to and agreethat weatherization work may be done by the Weatherization Program of H ousi ng Assistance Corporation (herein after referred as"Agency") on the property located at: n � � Y [1 IYa.6 3 5 Theweatherization work donewill bebased on programmatic priorities and availability of funding and it may include all or some of thefollowing measures: Weather-stripping& caulking of windows and doors, insulation of attics, sidewalis& basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of theweatherization work to bedoneat my home I agreeto the following: 1. I givepermission to the"Agency". itsagentsand employeesto travel onto or across said property with such equipment and materials as may be necessary to perform weat heri zati on work on said property. 2. The H ousi ng Assi stance Corporati on reserves the right to i nspect the fuel or utility bill for t he weat heri zed unit on an ongoing basisfor no more than five(5) years after the weatherization work is completed. have read the provisions of this agreement as listed and freely give my consent. Home Owner: (Sgnature)/'I Date Agent: (signature) Date: 1 HAC approved Weatherization Company . C'10L All Cape Energy Cape Cod Insulation Cape ve Efficient'BuildingssLLC :F Qllt fig Ll.c'f li �11 1Q'T]Se.-L,. v's loh.G4,,r% : �i z:.t�•:Rf 1 a#loG1. Energy w: ^ 4 a APE SAVEWeatherization j 508-.398-039 x August 22, 2010 To Whom It May Concern: William J. McCluskey is an employee of Cape Piave. He is authorized to negotiate contracts and building permits for our.company. + , Michael McCluskey Cape sage—Owner 919-593-9939 cell X Huntingtonn-A venue,South Yarmouth,MA 026" The Commonwealth of Massachusetts ' Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov1, is Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant Information Please Print Legibly Name(Business/Orgatvzationllndividual): AJI►r+ :r A Ct „5 i(awt DI t3 IA- C&-6, r tr . Address: �'2-Moy�TE,�n�` i ni to'Cd nj ►t �---- City/3tate/Zip: A Ma 67,(oWone Are you an employer?Check the appropriate box: Type of project(required): 1.IR I am a employer with 4. ❑ 1 am.a general contractor and l 6. ❑New construction eloyees(full and/or part-time). have hired the sub-contractors mp 2.❑ t ant a sole proprietor or partner-. listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition -working for me in any capacity. employees and have workers' 9 Building addition ,nce u insra : [No workers cotiip. insurance comp. 10.❑.Electrical repairs or additions required.] S: ❑ We are a corporation and.its 3.❑ I ant a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions right of exemption per.MGL myself.(No workers' comp. 1.2.❑woof repairs �••,1 insurance required.]} c: I52, 1(4).,and we have no 130 odic t{3�1 Q, Dil employees.(No workers' comp. insurance required.]. *Any applicant that checks box#1 must also fill out die 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 thateheck 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-oontractors-have employees,they must provide their workers'comp.policy number. I am on.employer.that is providing workers'compensation insurance for my employees. Below is the policy and job site information. .1. Com 0 ,. Insurance Company Name: P G t1 0 �A Tn faA q -7 Policy#or Self-ins.Lic.#: T W C� 3 a, 9 R' I T ck Expiration Date: ] 0 a i a` Job Site Address: 4 Q e y City/State/Zip: C+V1.1+ +l Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MOL c. 152 can lead to the.imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well.as civil penalties in the form of a.STOP WORK ORDER and a fine` of up.to$250.00 a day against the violator. Be.advised that a copy of this.statement may be forwarded to the Office-of Investigations of the DIA for insurance covcrace verification.. I do hereby cetWA under the pains and Penalties erjury that the information provided above is true and correct. Sig Datum: ' r Date: — Phone 'Official use only. Do not rdrire in this area,to be completed by city or town official City or Town: Permit/License# . Y Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#: Contact Person: A� l0/20 CERTIFICATE OF LIABILITY INSURANCE D /0/20/20112011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME CT Shannon Sperrazza Risk Strategies Company PHONE , (781)986-4400 FAX AIC o:(781)963-4420 15 Pacella Park Drive AnDRE IL .ssperrazza@risk-strategies.com Suite 240 INSURE S AFFORDING COVERAGE NAIC# Randolph MA 02368 INSURERA:SeleCtive Insurance INSURED INSURERB:Safety Insurance Company 33618 Michael McCluskey, DBA: Cape Save INSURER C:Technology Insurance Co an 7 C Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02644 1NSURERF: COVERAGES CERTIFICATE NUMBER:CL11102041451 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 TYPE OF INSURANCE D UBR POLICY NUMBER MMIDOYEFF MM pOY� LIMITS L R GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 IDAMAGE TO RENT X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 100,000 A CLAIMS-MADE a OCCUR. CPPS1994480 0/16/2011 0/16/2012 MED EXP(Any one person) S 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,0001 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 21,000,0001 X POLICY PRO-JFCT LOC $ AUTOMOBILE LIABILITY (Ea CBI eDtSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) S B ALL OWNED SCHEDULED 6208200 1/6/2011 1/6/2012 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS E AUTOS Per accident X Underinsured motorist BI split $100000 300000 X UMBRELLA UAB N OCCUR PPS1994480 0/16/2011 0/16/2012 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,OOO,000 DED I I RETENTION$ $ C WORKERS COMPENSATION . ecutive excluded X I WC STATU OTHER - AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN from coverage E.LEACHACCIDENT, S 500 000 OFFICERIMEMBER EXCLUDED? N/A C3297972. 0/21/2011 0/21/2012 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 r DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101.Additional Remarks Schedule,if more space Is required) Issued as evidence of insurance. National Grid Corporate Services LLC d/b/A National Grid, d/b/a Boston Gas Company, d/b/a Essex Gas Company, Action Inc., and Housing Assistance Corporation are listed as additional insureds as respects General Liability as required by written contract. - CERTIFICATE HOLDER CANCELLATION (508)7 90-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Housing Assistance Corp 484 Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601-3698 Michael Christian/SMS ACORD 25(2010/06) ©1988-2010 ACORD CORPORATION. All rights reserved. INS0251mmMSlni The arnian nama onrl Innn ora ranic4amoi marine of Annan ,vl�u c� I b 3 �L � I� O ce W onsumer AaiVand'�Bus"mess Regulation a 10 Park_Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 164432 Type: Supplement Card CAPE SAVE Expiration: 10/6/2013 WILLIAM McCLUSKEY 8201 S. HOURD CT CHAPEL HILL, NC 27516 = _ Update Address and return card.Mark reason for change. )PS•CAi is 5010.04104-G101216 ' Address Renewal 1D Employment ❑ Lost Card y3 ✓iae&M1v!)t¢9tuJ22l�¢�✓� udelYd Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ill-HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Re istration Office of Consumer Affairs and Business Regulation 9 169432 Type: Expiration 1U/6/2013 Supplement Card 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE WILLIAM McCLUSKEY 7C HUNTING AVE S.YARMOUTH,MA 62664.. Undersecretary Not valid without s7re '`' assachusetts- Department of Public Safety !� Board of Buildin.oRegulations _ and Standards Construction Supervisor Specialty License License: CS SL 102776 Restricted to ICE ' ?� y WILLIAM'MC CLUSKY 37 NAUSET.ROAD WEST YARMOUTH,<MA 02673 ' .Expiration: 612a12013 t+rnunisboner 7rT: 102776`rt r , Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map C0 L/® � Parcel Permit# 3��3 r _s i`0' Health Division 9,a:9 l-y�3y � 1 l 3 ���m Date Issued $'03 Conservation Division R ��/ /® µ'w'w_a ..r_ _ - w Application Fee Tax Collector Permit Fee Treasurer Ir� FPTIC SYSTEM MUST BE Planning Dept. 'E muo W COMPUANCE TITHE 8 Date Definitive Plan Approved by Planning Board 7,,0,�qMEmTAL CODE AND, Historic-OKH Preservation/Hyannis TOWINREGULN'IONS Project Street Address qg �,vtt ✓r�v �K Village Cd(u j Owner ?_e4&,e_L j v L,oa Address sAXt Telephone She - Lt2 P- -A?3 3 Permit Request ADD NA4d d -nitz. c c��-K k%,. Rt4n / ,/W,,,, &W ,Q A /K-44 . add PYXi6 D41 ;HS /?.k^ �c�sfi�nc �K A�e Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type !Ai'Oo r� Lot Size a� ! �� s Grandfathered: D Yes 2,Ko . If yes, attach supporting documentation. Dwelling Type: Single Family O Two Family ❑ Multi-Family(#units) Age of Existing Structure I 4K 0 s Historic House: Yes ff'N"o On Old Kings Highway: ❑Yes U-No Basement Type: O"Full D Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 1 U1 Y Number of Baths: Full: existing 2 new Half: existing new Number of Bedrooms: existing 2 new 1 Total Room Count(not including baths): existing S new .3 First Floor Room Count Heat Type and Fuel: (!1 Gas ❑Oil ❑Electric 0 Other Central Air: ❑Yes ZNo Fireplaces: Existing I New Existing wood/coal stove: ❑Yes Ol o Detached garage:0 existing 0 new size Pool: ❑existing ❑new size g g g g e Barn.D existing ❑new size Attached garage:Cf existing 0 new size 1 X2 Shed:O existing ❑new size Other: Zoning Board of Appeals Auth orization 0 Appeal# Recorded 0 Commercial ❑Yes o If yes,site plan review# Current Use e—s Pct­,tiG L Proposed Use Ifteta nW4 BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ` SIGNATURE DATE l�/4 143 1} I s FOR OFFICIAL USE ONLY t ° PE,BMIT NO. DATE ISSUED MAR/PARCEL NO. ADDRESS VILLAGE A OWNER r - ' DATE OF INSPECTION: FOUNDATION FRAME $F F OK,A C, INSULATION 7r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL • 4' FINAL BUILDING Y i DATE CLOSED OUT ASSOCIATION PLAN NO. } ti The Commonwea-lth of Massachusetts r Department of Industrial Accidents -= = Office of/o�estlg8t�ons �° t 600 Washington Street Boston,Mass. 02111 'Workers' Com ensation Insurance Affidavit name: FGICrt� tin L oLde-) Iocation! ?S ?:Ke city Co4v fIV k phone# S-OL Y�r-QQN 3 ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one worlds inairy capacity '�//%%///0/0001//% e o on o tion for e 1 sw co ensa 'din workers g J an em I er rovl mY mP ❑ I am P o3' g mP ..°.Y.,�.., i::}:��::::,:$ ];�•: .. ..................�... ... ...n,.,..:..nar.r..r.......,..... i.n......,..,..r...... ,:$.f:.:..::4.:.Y;:.},{.; ......n...n..r..r......r......F...n.....• , n........... ....... ..... .............::.•:.:..};••.w;v.::.r:..y.•:vn ,...::....:•..;:.,}+:•..':..i., .i.............:........... ........ ..i..... r .:....:.. ......}......,.............:.::.. .:::•:.......,........,.. .... ::xr...}>.4}:r.;.};.}}:•+}}]:•Y:;{:.}i::::.:•}:v;,..r. }:$4::;2}:•$::{;:+.•:•.. :.:r.: ...}. n w..•...r....... ti....;:::...:•:..T:. ..}.:•�S.ii: :•�$�;::a:4}:•`.r+}]i:}:? 3:•:. ir:r•:•:::•::+•r::n•::::.::3:Yr.•.:-n•:: t•:::nn::.•.,.:.::: :;...?.i,:•::-.�. ..... ..r ....:. w. ...:...... r.,, ......}:;?.]:•;ti:::..a.. ...r:.y:T:}>:.?r.o:;•:,•4:•r•:r...... ..i..niri.,....•.r::::;.:?•r•.y:%;.:..•{.,}.;:-.}.Y'4�??::]:••:., ,:{. .{v......., ,:{:... ...{... .:.}n..,:4,•.{:k•.v.:.,,\::,•n•T:.44::.�:::::}}•it-}?:;.::..•: .::.4:•]':•Tn �.:'.•:`•i: :.:4.,y;}.}:. :•::.++r:•n::•.,.}::f•.:•x•:::::::;:+:.,,•::-n,x:,r.:.l.••]..i•..::. ..r.4:•:.:. .....:•.: ,.}, XiN ...}..i.........n......r....,. ... w••..... v:.n. :::.:::v:n??•i:•}:4}}:•:•}}}4L....:.:?.:}'•}:r:.v,•]};.',•;.;.L•;:....r.lv 4 T: ..... ........n....+r... r..\.:: ::.�::w.: ..)tiv. •. :v..... •:+ ...:,..n•. �: ................. .:...?..•:::.+:v.n•..:.:.... ........r\•:T:::... ..r:.Olv:::nv:v:n:vn4i:4:v.....{y}'....n..{:;2•+.�:+::;itv.{:v:n..l:ivtiti:;i:>:.v{jX7:4•+.•:•i:•% :•::.:x:nv:;••;•...:......:...:.,•::n•:•v: ] vw::n•.:• , v;w:::::::•::::::,•.•.,.?}.•:::::v:::;:n•:•:.:.•::;::;;•,v•w:•:nw::::n:::•:.v.vn;, •:nr.•.vr••.}?}:::k}+::•wn:•, .r. n.4n........:•:.;.:... ., 4::::•:•v}::::.v;:.k.:......r..........?w::;v:..::..................... ...'f..::}Yi�:+.4:4::{?:S}}:S};?r:::..... ... ... ....... .. .. :. .... ......... .......r... ..n..v..v n v:... :':w::?::}. ..:;•::n.�:.;...:.vn;; ...... x...•}.4:}}.:r+...:::•.:.:. ....... ...............................:. .. .... ,...... ..:.. .................... ..........r...i......r.. .. ......}...........}:•:.;•..4...v:•:•}:C:v}:4'•.4:4:?4} ......::•:•.:........................ ....v.:..:{ •::.,........ ,..... ....... ..,...,: :n•.....:."Y........:....,•x. ...?... ...7..4 is Y:O v:?:.4:1••:.Yi•ry•,.,.:... .,r......r......r:.....r..n.:.ni.L .. ..:..? :. .. ......... .....5.....n.. ..n..• .... ...,......r....., .:`1•::.+.y...,:..,......•, .r:.{.::??•::::::::}:::: s.................. :............. .. .. .. ..... ...........t... .:.... .n.v...n.. .r...., :•:rra••s.:.. t. ..r:::•.'5:��.2't•.•.{...::.::•:.y:»rrr.:...:...4 ...,.r.,......::..i.:r}r... :.........x r. }. ::.•}.•:: ::...... ..... .. n. .....:..: .......n..i.:.....i.:::?..,-:.•}.4.4}:i-:.t•].y:>:•:%:t•. .::....,r.y:•r r.,.,•::. :..............3:.n...........:n:......7• .4...yn.+ r:{{.}•Y}>:••:+;•T••}+:n::t•}:-.:... ...;.....,.+}4:••SY" {.,x}-}••.r'.:{4;{+xr:. .Y.:. 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':%hk!?:+j::: hh .}.��•::'•{:'.•$Y•i}}} •:::•::::.:+y4;A}.}.}.::::r.::?:•:•:. r v. ••.:. .. v::.v:v.v}v:•••}} v.Tn+. .fi}:: R�•�.•:n _ .... :..., ...z. ?... ...... ,•r .,... .r.. :r.4:'17�IOIIt'r.'�•`•:.•::•:•'�����•'''••' .. }}:•:}x.zn �i 4 4 t z4 f Syr. �.ya. 4: 4 4,• n.4:,•. :..k. n4 a, r 4:. }. .. :.. ++•rtitiit$: nn.n +:a •6.,•.i. I• .i•(i{jn fur:.•. :.v:.• .}}': is... :. •. .....Y.............,.n.•::•::.,... r•xv{:. .t vYy}- f:{r:,•:i:}}:.:?:• .vC• ....:{4^+M•: ::•. :./.:.:�:i r,':•{i{;:}•� r;}:i;• E .F: . •} 'v;}:::+.:r.K.4i.}: ,.�, ?R•: .' {4•�•.}:::.:^����'.:.r•:it{}�?•ir� :•i.A%v:{3.} �nrap¢e.ca f:w.:.y,.,,�. � .... n.... :.:{?4}}] .�:f::>:: roll:::... ;:;.].• :: ��: FaMre to secure coverage as required under Section 35A of MGL 152 can lead!o the imposition of penalties of a Me up to$I,S00.00 and/or one years'bnprlsonmeat s,neIl as dull penalties in the form of a STOP WORK ORDER and a fine of 5100.00'a day against me: I understand that a copy of this statement may be forwarded fo the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of pedury that the information provided above it true and coorreat Signature Aio& Date _ ! - Print name Phone# 1115 55,211,51, Official use only do not write in this area to be completed by city or town otgcial city or town: pernzit/license# ❑Bniiding Department ❑Licensing Board ❑dheckif immediate response is required ❑selectinen's Office ❑Health Department contacipetson: phone#; r ❑other_ Oevued 9195 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any cortract express or lied, oral or written. of hire, P 7 ) Ar eiriployei:is defined corporation or other legal entity, o ;as an individual,partnership, association, r any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing;agency,shallfwithhold the issuance or renewal r s or to construct buildings m the commonwealth for any applicant who has to a business g of a license ar.permit to opera u.� ... .�.4� j+ * �f neither the not produced acceptable evidence of compliance with the insurance co veragexequired. Additionally, commonwealth nor any of its political subdivisions shall enter into any contract for the performance,of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been pies'entI d to the contracting authority. F. Applicants please fill in the workers' compensation affidavit completely,by checkin&the.box that applies;to your situation and supplying`company names;addressand phone numbers along with a.certificate,of insurance as.aU affidavits maybe ►..- . . confirrziation of insurance coverage. Also be sure to submitted to the Department of Industrial Accidents for sign and �z date the affidavit. The affidavit should be returned to the city�or towiitliat theRapplication foi the pemut or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you on policy;please call the,Depaztmrt}at�the number listed below. are required to obtain a workers' compensati City or Towns "' '" i »` (J # Please be su e that the affidavit is con- and printed legibly. The`Depaitment has.provided:a space at the bottom of the ..: affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permitlhcense number which will be used as a reference num_ber. The affidavits may be retame3 to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions• please do not hesitate to give us a call. t ;tom es The Departments ess,to ehhone and fax b . The Commonwealth Of Massachusetts Department of Industrial Accidents office of lavesfigatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 . E,�y Town of Barnstable Regulatory Services„ BARN rABM Thomas F.Geller,Director 9�A MASS, R,�$ lEo 9. 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: Estimated Cost ��� Address of Work: �g 1�-r�Nr l/�fGJ t7!/t Cafb /44 Owner's Name: ?Coles w• �,k4t1 Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 Q 'ding not owner-occupied YrOwner pulling own permit f Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME EW?ROVEMENT 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 ow Ws Name RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= 110194 x.0031= ��( �• plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) a square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00 (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 " Relocation/Moving u $150.00 (plus above if applicable) «� Permit Fee cJ 3• projcost Ti0 Wit Appca h 1 ' Table X6.,11b(continued) Foull Fuelf p�erlptive Packigcd for one Xad Tyro-FAmity R.esideatw Saildiagi]let ' MINIMUM Hcat9ng/Cooling Cbming MAX#MUmaang t"xtling Walt Floor' B w � Equil Eif"icirneyr Area'(Y.) U-valid R-valuer R-values R-value R,yaluei & %u7 PaeS!agr 3I01 to 65a0 Resting D Normal 6 12Y. 0.40 3S 13 19 IO 6 Nom3s1 Q 121/6 0.52 30 19 19 !0 6 a5 ASUE g 12% 0.50 38 13 1�f/A NIA Normal 036 3E 13 6 Normal T IS'/. 19 19 10 15 A m V 15'/6 0.46 31 19 29 N/A NIA y 15% 0.44 6 3E a5 AFUE 15'/8 0.52 30 19 19 IQ NIA Normal W 13 25 NIA X 18% 032 3E NIA Nannal y 19% 0.42 3E 19 25 N/A 6 90 AFCTE 0.42 31 13 19 10 6 90•AFCTE z 18/. 19XA 19 10 18'/. 0.50 30 1. ADDRESS OF PROPERTY: 2, SQUARE FOOTAGE OF ALL EX'IERiOR WALLS; 3. SQUARE FOOTAGE OF ALL GLAZING: 4. GLAZING AREA(#3 DIVIDED BY 92): 8 g, SELECT PACKAGE(Q" •see chart above): NOTE: OTHER M ORE INVOLVED METHODS OF DETERMINING ENERGY REQ�EMENTS ARE AVAILABLE, ASK US FOR THIS INFORMATION' BUILDING INSPECTOR APPROVAL: NO,. YES; q4orms-1990303a 780 CMR Appendix J Footnotes to Table J�.2.Ib: lass doors, skylights, and ; Glaring area � the ratio of the area of the glazing assemblies (including sliding-g basement windows if located in walls that oncldloas total d gap arm yube excluded frocluding m the U-value doors) to e the area, expressed as a percentage. Up to 1/o. f g For example,3 ft of decorative glass may be excluded from a building design with 300 fV of glazing area. After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table 11.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. The ceiUng•R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation,thickness over the exterior walls without Rh9 Purisulatio A Ceiling insulation R—values represent thee snm of cavity insulation and R-39 insulation may be substituted fo insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 4 Wall R.-Values represent the sum.of the wall cavity insulation plus insulating sheathing(if used). Do not include exterior siding structural sheathing, and interior drywall.For example, an R-19 requirement could be met EITHER by R-19 cayit}' insulation OR R-13 cavity insulation plus R 6 insulating sheathing. Wall requirements apply to wood-frarile it mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. S'nte floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'The entire opaque portion of any,indiv dual bas ument.wall with.an average depth less than 50%below grade must mce the same R-value requirement as above-grade waI]s.I Windows and sliding glass doors of conditioned basements must be included with the other glazing. Easement doors must meet the door U-value requirement d=scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes-el"ebtric-r`si tan heating tan one piece of cooiance ling equipmeproach 31- nt: than the equipment or S. If you l to install more with the lowest than one piece of heating equipm , efficiency must meet or exceed the efficiency required by the selected package, For Heating Degree Day requirements�of the closest city or town see Table 15.2.Ia NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. ested b) opaque doors in the building envelope mordanacee EL U-value nowith the NFR greater procedure or taken fraamuthe door es mustUtvaue ' oor U and documented by the manufacturer in in Table 11.5.3b.If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and the opaque have a U v-value to determine han 0 35)compliance of the door. One door may be excluded from this requirement c)If a ceiling,wall,floor,basement wall,slab-edge,fie area-weighted av space wall mponent erage includes two or more areas greater than or equal to insulation levels,the component complies ed average U. ui area-weighted' e en the az g ff r 1 if �di m orients co ue requirement for that component, Glazing or door comp comply the R val q e U-value requirement(0,35 far doors value of all windows or doors is less than or equal to th . I DFT Town of Barnstable ;Regulatory Services rB esi,E,$+ Thomas F.Geiler,Director s639• �� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder the.subject property... .........._... .. I, hereby authorize in all matters relative to work authorized by this building-permit.application for: T vNG V��iCGJ i7K-� (Address of Job) Signature of Owner Date qCa w aloes Print Name F Q:FORMS:OWNERPERMISSION Town of Barnstable Regulatory Services II Thomas F.Geiler,Director • sexrtsTASLa 9� MAM �. Building Division ABED Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 ice: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE JOB LOCATION: number street village . 11H01, OWNEW: ?eA AL �/!GS 4yotf-o?"s name home phone# work phone# CURRENT MAILING ADDRESS: c��+fY1G ASS G+ 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 require nts. 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 i several towns. You may care t amend and adopt such a form/certification for use in your community. The Town of Barnstable rMILL Department of Health Safety and Environmental.Services Building,'Division 367 Main Street,Hpahnis,MA 02601 , 18.8624038 i8.790.6230 PLAN REVIEW >wner: ���� ��' Map/Parcel: O LI O 1 l-7 �i roitet Address: q`� hQy► Or Builder: OW tNC� Che following items were noted on reviewing: w s L&MN4 e�" Oeuk3W ,� � ? 12,26 63 I2)y)03 Le ¢Rej "'V/ry rmr my ,I.OT 5 Nor Lour" /N FEDERAL FLOOD *vA".gp *� A5r 4WWN GW ME FCPE94L Fk00P-INSURANCE RATE AW FOR ME rOWN w` 25 /--. S 10-'4- COMAIU /TY PANE�G M0. 4'FFC�T/Y, ' l TE' E'RT RA I P, R 6►.�S NOTE: NORTH ARROW MOTTO 4 :BE USER FOR%9044R PURMSE3 y P007 E z 28 � � x 0 / oo � N �. 23/Z. 5 - 6,F .L-o 7" 4 -9 yR2 i 1 � a � � O y y n a o 14 39 a � a � c� o m1i poor A4AN' ,pus AVT At4JV fir FOUNDATION 4OC#47ZON X AN . INSTt/. NrWWYAA(P /.S FW rAW -,(,o T J f/�t1 '1//� �rei&L= USE OR THE 4dU*VK OV4Y. IUNOEA' AOO CIRCUMST.UNCES AMC OFF04FTJ MAC C a?"U/ T(4- ,�',�-M-574— B4�0 IV4t 410410 FOR f4FN",% * i AwP"isi x �tN OF MqS RO Gn ,4S� E.' FALA# rM A4. -O U E. -4 RAYMOND "' ' �i�{r •J / �l�+�rl ,p No.21583 ���_,� � c�U�/E 7����✓¢ �o F � ff `'v mQ ' IN Iva a_ TOWN OF BARNSTABLE Permit No. _ —_ ----------------- 1 Building Inspector Cash ,639 YAY a' OCCUPANCY PERMIT Bond .._ _ ��,I Issued to ,nni S Rt-ar r»r t-ix)n Address Wiring Inspector Inspection date Plumbing Inspector )^ \,\ Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date 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. ....................................................... ,9............ ......................................................_........._........................................... Building Inspector °jowFROM TOWN"OF BARNSTABLEE Mr. Fraricis lahteine BUILDING DEPOIL BNT Town,Clerk r. _; ' ` `"" '"3-67 MAIN STREET HYANNIS, MA 02601- Phone: 7 75-1120 SUBJECT: , .FOLDHERE DATE .x. • _ _ g MESSAGE Wbrkhas B&n �reted- r Please relea� Bond, - DATE �K•r� REPLY - SIGNED Ne7-RMI } RECIPI,ENTi RETAIN WHITE COPY,RETURN PINK COPY PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. m4wc IY awlrY rmr rNl p L.Or 5 No LOCATED /N FEOicPu FLOOQ HAZARD ztw "AS SliOWN ON THE FEDERAL. FLOOD-INSURANCE RATE A"P FOR THE rOWN Of COAIMU I rY PASM& 25a yl--. s EifecT/YE Awrc 6 Za g 19Rr Z. RWo J G, ~R.L...S� E NOTE: NORTH ARROW NOT'TO 0 ✓ dE USEf FOR SO4Af PURPOSES y 25 ° n 70570al y f' -j I � Z e 0 Boa 14 39 D � � G -S mis PLOr PAAa WO nor AtAW i^VN FOUNPATIOY /GOC#4TION PkAN. . IHSr",W*Vr%U~YAAry IS Fag rMS ,LOT 4 J f/ALit-w6w DJOj&5 USE OF ME AWXK 4V4Y. UNPEW AV CIRCUMSTANCES ARC OFFSETS rO BE C'C-rUI T(44k ,57 &,L5) 1`14',4• USED FOR FENCE,, NG "40 AWAW4631 of M4 .I�PyI'4IY E) EERl/Y6 /NC. EXIST 70,410iffAl� MrSH A Y per' ROB.' GN .4V7 FA�Wr* &.4. Osu E. 4 RAYMOND / EETj _ ,A No.21583 % �U/✓E PD 47? O i TI 'wy*= 4APQ QYr IIP"*V SEP-ric SY tz/i SZTEM 04 sessor's map' and lot number .....yQ..-.../..7........... tiST +" See Permit number ' ..`...�f 1 ... .. '�TS TITL VIRCd``P ♦� J'Y4Kib�iT � �� Z B9BBn98T�LE, i t House number `�....................................... ...�.. ?............... Tt)111+' �1LATI0r))s 9°o 039. TOWN OF BARNSTABLE IA t BUILDING INSPECTOR APPLICATION FOR PERMIT TO Construct .............................................................................................................................. TYPE OF•CONSTRUCTION Wood Frame ................................... ` November 30.r.................19.83. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ' Drive Location ..........Lot 49 Pinevi.ew... ...............................................................: ............... ..................... ProposedUse ...............Re.Sidential .................................................................................................. ZoningDistrict .............RF.................................................,.....Fire District .........:....... Sul. .............................................. S ero Theoharidis Name of Owner ...... ......P.........................................'.............Address24...G���t.....P 5?.x14�...�7�J�TY��...5......Yi�In�21,1t,�1.r MA Name of Builder' .........Same................................................Address ......................S.me..............: ..................................... Nameof Architect .......N&.....................................................Address ......................NA......................................................... Number of Rooms .................................................................Foundation ................T.'A.ur.e.d...Qonc ete...................... Exierior .........................Ge.dAr...Shi ag.le........................Roofing .......................Aspb.&1.t........................................... Floors ..........................P.�,YW.A.O.d.........................................Interior ......................SheetSQck...................................... Heating ........................FHW...-...Gas...................................Plumbing ....................2..Sath.............................................. Fireplace .......................Qn�...................................................Approximate Cost ......$ 5:.,.00.0........................... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area / ......... ......:. Diagram of Lot and Building with Dimensions Fee ��g....7 ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. NameG�.... /,� ....................... DENNIS STAR CONSTRUCTION 6708 One Sto o. .. ............. Permit for ..................rY.............. 1 J 4 Single FaiilY..D .e��inJ...................g............... ....... t Location ..fit...49.i.....99..R20Q.x -i4QW...D1 ve.... Y ..................9.Q.t t................................................ y Owner ....... ...... Type of Construction ..k'raIC>w........................ 4 ............................................................................ Plot ............................ Lot ................................ i . r R Permit' Granted .`Tiny..18!......................19 84 i Date of Inspection .....................................19 f� Date Completed ...Ja-/y' ��............19 # 4 C .b P i i l t, Assessor's map and lot number f..... ......::.`.....: .................... THE Sewage Permit number ....� .:.:'...�f� ....j/1 ...% n Z BAUSTULE, i House number ....................................... 9 :............... r rnoa pp i639 �00 �B0MAI TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO Construct TYPE OF CONSTRUCTION Wood Frame ................................................................. ..... November 30 , 19 g3.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Lori ve Location .........................Lot 4c9....PineView..Y��,XA&j.......Ccat.U1 .......................... ProposedUse ...............Residen i.a.l................................................................................................................................. Zoning District .............t'..F......................................................Fire District ................ 'c ........... f �j .. t�� .............................................. �eR ri r+ , J A(! l o w"`j71"i,'u C 7-)O Name of Owner ...........Spy=rd Th�Ohc2r1di5 Address VE, CT1 1i—h., A Nameof Builder- .........Same................................................Address ......................Sam,Q.................................................... Nameof Architect .....;NA........................................................Address ......................TM......................................................... Number of Rooms ....... .........................................................Foundation PnAlxq�d C;nnCY '(� t......................... Exterior � r :�,h.i..nrx7_a ...Roofing ......................Aq?.1 0?3.t............................................. ........................... ................................................ Floors .............pJYwgkl!3........................................Interior . p--x:ra rft Heating :....... .....FF+ ....... C a5......`:..........................Plumbing .................... ......... ................................................. Fireplace .......................(?nf?...................................................Approximate Cost ........ .............................. -" ............. Definitive Plan Approved by Planning Board ________________________________19________ . Area ``� 1 Diagram of Lot and Building with Dimensions Fee .....''' C � '...:..................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH h ti OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ,� f Name .. :.. ..................., ................/ ......I.................. _ - /17/g<<' C Y DENNIS STAR CONSTRUCTION /A=40-117 2.6708 Permit for ....Ot1e. Story No .. ....................... e T l Dwellin ..... . ?�xio1�................Y..................g...................... +t'cation ......;f t..4.9 r.....99 Pineview Drive ...................... QJ;at............................................ Owner ......... uzs„Star Construction Type of Construction FX7 ............................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ,,,,July...18., 1984 .... ................. Date of Inspection ....................................19 Date Completed ......................................19 710 Ll s El CN b c NEW SMOKE D= R REQUIREMENTS o t' AAy ARE'NOW LAIN. HE ADDITION OF A , NEioi//:' BEDROOM V!i L TRIGGER AN �:. I— I�y tz V t tz� �1 l.�v• A. M — UPGRADE.OF THE SPJIOKE DETECTORS '� _.: _ a,:__ -. � ..° FOR THE WHOLE HOUSE.- YOU: MUST PLAN' ACCORDINGLY AND HAVE�YOUR 'ELECTRICIAN TAKE OUT THE APPROPRIATE PERMIT AT THE FIRE DEPARTMENT. m i x _ Ni4KE DETECTORS O.K. s x d. a_ _ o- w . a " E BULL®INCx :y1'Et�T. t , , ♦ x — • a� I , i .c n ,. :.. .. a.. — `i s t , F I F- Al z , S 1+190G IF Zc •. • . ,.. .-. ...--.-'3 .__—..,c_ `f... ..._ __ - _ ( -... -__ _... a .... ' _..i 20 OF-- _- z .� - r F r Y r , c S - a r 5 _ : , v�L s i k . = 1 a , , 1! 4 Iz .Lj lZ�� EL V _ , - r - I ' - 10 b , IN r _ 17, l t l2XtSfl lu` , • Z., b •� � ` �,�.J�Y L.E F T s I D , l{ jj _ I i _ im IF w w ....,_... 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