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Home My WebLink About1493 SANTUIT-NEWTOWN ROAD 002 Town of Barnstable Building Post•This Gard So-That rt,�s Visible From the Street<"ApprovedPlans Must be,Retamed on,Job and this Caid Must be'Kept , .i �A�Nt?PABi:6. • `• .,, .r� ,` �..,,r<. ,'� fig, i 7 ' '�i` `�'� �. 3 'I, r� e� 3 r n • M" d Poste �UnttilFinalelnspect�on Has Been Made „ W,here�a.Certificate'.ofg Oecu anc'yis Rennuiretl such"Buildm shall Notbe Occu ied untU a,rFrnal lnsectron;has kieenrnade ermit 4 Permit No. B-19-2218 Applicant Name: JOSH GOVONI CONSTRUCTION LLC Approvals Date Issued: 07/10/2019 Current Use: Structure Permit Type: Building_Siding/Windows/Roof/Doors Expiration Date: 01/10/2020 Foundation: Location: 1493 SANTUIT-NEWTOWN ROAD,COTUIT Map/Lot: 025 003 Zoning District: RIF Sheathing: Contractor Name"R JOSH GOVONI CONSTRUCTION Framing: 1 Owner on Record: PERRY,SHAY A&JENNIFER L LLC Address: 1503 SANTUIT-NEWTOWN ROAD 2 COTUIT, MA 02635 "" Coritractor•;L�cense; 154279 Chimney: Description: Siding and Roof il, u Est Project Cost: $4,500.00 ��° Insulation: Permit Fee: $35.00 Project Review Req: x " Fee Paid: $35.00 Final: KV Dated 7/10/2019 _ Plumbing/Gas _;.•�f1 Rough Plumbing: Building Official Final Plumbing: This permit.shall be deemed abandoned and invalid unless the work a horizecl byth*it permit is commenced within six months aftWlssuance. Rough Gas: All work authorized by this permit shall conform to the approved application i the approved construction documents foe which this permit has been granted. All construction,alterations and changes of use of any building and str et ue mall Be in compliance with the local zomngby aws anted codes. Final Gas: This permit,shall be displayed in a location clearly visible from access stre or road and shall be maintained open for publlic inspection for the entire duration of the a work until the completion of the same. _` Electrical- _ z Service: The Certificate of Occupancy will not be issued until all applicable signatures by<the Buildrng and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work 1_ ax = Rough: 1.Foundation or Footing - -. - •.'� -_. •�- 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application numb ....... Fee ...........4202 ..........4202,.. .. ........................................ MAM Building Inspectors Initials....................................... 163 JUL 10 2019 Date Issued........................ NSTABLE Map/Parcel........ . / 5............... TOWN OF BARN STABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project:�� C 0�� NUMBER STREET VILLAGE Owner's Name: Phone Number Email Address: Cell Phone Number,,-7, Project cost Check one Q�esidenti l Commercial OWNER'S AUTHORIZATION As owner of the abov 0 perty I here thorize to make applicati for a building permit i accordance with 780 CMR Owner Signature: ,- Date: TYPE OF WORK \9—Siding Windows (no header change)# ED Insulation/Weatherization Doors (no header change)# Conzmerci<Door�,requgf an inspect ar s review- D!Qzoof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name ,,16:5 &,6tto�i Con S-1 ru o['r-,,6 A Home Improvement Contractors Registration(if applicable)# 15 (attach copy) Construction Supervisor's License# C S - 0 q&7 3 ';1, (attach copy) Email of Contractor C one number P •Gs-k ALL PROPERTIES THAYHAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. iX r> APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exit r ed) Dimensions of each Tent X X , X Additional tent dimensions can be attached on a separate piece o er. Purpose of Event Check one: this event is a: for profit no ofit event Check one: Food served Yes No Flame Spread Sheet of each to ust be attached. Provide a site plan with the location(s) of each tent If food is bein rued at your event please obtain a Health Department approval between the hours Of 8:00 -9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Mo I.D. Fuel Type T�ing Offsets from combustibles: f back left side right side HOMEOWNER'S LICENSE Homeowner's Name: Telephone Number �+�� ' _ or Work number -- � -- I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the constru ' n inspection pi dures, specific inspections and documentation required by 780 CMR an the Town of Barnstabl . Signature Date PLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. I °FIKE Town of Barnstable Building Department Services BAMSCABM ` Brian Florence,CBO MAS& 9 i639 ,�� `bArEp�,�A Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, cam _ ' ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: i (Address of Job) -Z \ **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final spection e performed and accepte . Signature of Owner Si ature of Applicant Print Name Print Name ate I Q:FORMS:OWNERPERMISSIONPOOLS Rev:08/16/17 r` Commonwealth of Massachusetts ® Division of Professional Licensure Board of Building Regulations and Standards Const`, tl4rfAijo ry isor ,p CS-096732 _ 4pires: 06/17/2020 • j l� v� ,yk.x JOSHUA A G0VONI, 2 POND VIEV1tVE . /' C MASHPEE MA 0 §49d� `�OISS'T3v�s, Commissioner ---- ------ Office of Consumer Affairs&Business.Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE LLC before the expiration date. If found return to: Registratien `, Ex iration Office of Consumer Affairs and Business Regulation 15 '2, ,-- il 02/25/2021 1000 Washington Street-Suite 710 - JOSH GOVONI CONSTRUCTION'LLC Bosto 2118 JOSHUA A.GOVONI 2 POND VIEW AVE. MASHPEE,MA 02649 Undersecretary . ` of valid without signature l� - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map._.. Parcel V / Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH `Pr ery tion / Hyannis Project Street Ar4dress 1v-) Village Owner '`I Q�iV Address Telephone Permit Re uest Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain I Groundwater Overlay Project Valuation bO6 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Y�__Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq Number of Baths: Full: existing new Half: existing ? new -3 Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Ro Count �'M UY Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other W 8 Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove. ❑Tes ❑ 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 , uthorization ❑ Appeal # Recorded ❑ Commercial ❑YN es o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION k f�(i`�vjEj'u, UILDER OR HOMEOWNER) NameAll"MyuCAITIAU Telephone Number Address License# -5 �� Home Improvement Contractor# Email Worker's Compensation # wooi Z`J ALL CONSTRUCTION DEBRIS RESULTING FROM THIS P�ROJE T WILL BE TAKEN TO SIGNATURE DATE �� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAPI PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ' FRAME _F r; INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING, DATE--:CLOSED OUT ASSOCIATION PLAN NO. r- Massachusetts - Department of Public Safety :,Board of Buildi6g Regulations and Standards Construction Superliscir License: CS-100988., �:.I 1 HENRY E CASSro 8 SHED ROW WEST YARMOZFrH B Expiration Commissioner 11/11/2015 a Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C:ntractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Trtt 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE --- SO. YARMOUTH, MA 02664 Update Address and return card. Mark reason for change, 3cA1 t; 2OM-05n1 Address Renewal Employment Lost Card N//ae ipa»�rzaiuuer��C�a�C�/�/Z�ruJJccc�crJeCti .:\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 153567 Type: Office of Consumer Affairs and Business Regulation xpiratlon: .::12/:15/20:1.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATI,'Q.N:;-jNC"%%. ' HENRY CASSIDY Y 18 REARDON CIRCLE— SO, SO• YARMOUTH, MA 02664 Undersecretary VN, valid t sign -e r The Commonwealth of Massachusetts Department of Industrial A cciden ts W Office of Investigations a I Congress Street, Suite 100 a W� Boston,MA 02114-2017 , www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders-/Contractors/Electricians/Plumbers Applicant Information ` Please Print Lellibly Name (Business/OrTzvhvt n/IndividuaH\\/( 6, i Q `(, Address: _ City/State/Zip: WWK� L Phone #: Are you an employer? Check jhe appropriate box: Type of,project(required); 1,$i'I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time),* have hired the sub-contractors . 6• '❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet, 7, ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp, insurance comp, insurance,t 9. [1 Building addition required,] 5. ❑ We are a corporation and its ME Electrical repairs or additions 3,❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12,❑ Roof repairs - insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.� Other ('( f 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'd'ffidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors 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; b' Cr V -- 0v _ Policy#or Self-ins, Lic, #; C��d Q �( Expiration Date; Job Site Address; J Y O,II� City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date), Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator, Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereby certify n r pains and penalties of perjury that the information provided 6 bove i true and correct. Si nature; Date; t. Phone#: 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#: r— �.�. y / r CAPECOD-27 KLIGETT AC7C�l2L7� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DOfYYYY) 76 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE H /13/2014 OLDER.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(les)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 Ro ers&Gray Insurance Agency, Inc. NAME: Barbara DeLawrence PHONE 43 Rte 134 /C a/c No: (877) 816-2156 South Dennis,MA 02660 A DRESS:bdelawrence_@rogersgray.com INSURERS AFFORDING COVERAGE _ NAIC d INSURER A:Peerless Insurance COm an INSURED INSURERB,COMMERCI INSURANCE COMPANY Cape Cod Insulation Inc INSURER C:Evanston Insurance Company 18 Reardon Circle INSURER D:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 INSURER E INSURER F: CO' ERAGES CERTIFICATE NUMBER: REVISION NUMBER: T IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS C RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN ISSUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE —AU—DLSUSR POLICY NUMBER ID Y MmYMIDDY E YY LIMITS A X COMMERCIAL GENERAL LIABILITY MMD EACH OCCURRENCE $ 1,000,000 I CLAIMS-MADE � OCCUR CBP8263063 64/01/2014 04/01/2015 PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 51000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: X POLICY❑PRO- ❑ GENERAL AGGREGATE $ 2,000,00 I JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B Ea accident $ _ 1,000,000 ANY AUTO 14MMBCKVMK ALL 04/01I2014 04I0112015 BODILY INJURY(Per person) $ O X AUTOSWNED SCHEDULED AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE $ Per accident X UMBRELLA LIAR X OCCUR C EXCESS LIAR CLAIMS-MADE 1 XONJ453514 EACH OCCURRENCE $ 1,000,000 04/01/2014 04/01/2015 AGGREGATE $ DED I X I RETENTION$ 10,000 Aggregate ORKERSCOMPENSATION $ 1,000,000 ND EMPLOYERS'LIABILITY PER OTH- D NY PROPRIETORlPARTNERlEXECUTIVE Y/N WCAOO525904 STATUTE ER FFICER/MEMBER EXCLUDED? ❑ N/A O6/30/2014 06130/2015 E.L.EACH ACCIDENT $ 1,000,000 I(; andatory In NH) yyes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation Includes Officers or Proprietors. pAdditional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the CertIficateiz Holder. I i CER rIFICATE HOLDER CANCELLATION Massachusetts - 06partment.of public Safety _Board of Building Regulations and Standards Construction Superriscir License: CS-100988.. HENRY E CASSHA 8 SIZED ROW WEST YARMOLurH 3 " w Expiration Commissioner 11/11/2015 z Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C&h!tractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY ^- 18 REARDON CIRCLE ---- SO. YARMOUTH, MA 02664 Update Address and return card, Mark reason for change. 3cA1 0 20M•05/11 Address Renewal ❑ Employment Lost Card �e ipai��rnaratuea�C�c�C�/�/l�cular�c�u�etGi Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date, If found return to: egistration: 1.53567 Type: Office of Consumer Affairs and Business Regulation xpiratlon::<_:::121:15/20A.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULA7I:Q:N;;;'INC" HENRY CASSIDY 18 REARDON CIRCLE" SO. YARMOUTH,MA 02664 Undersecretary ANVvalid 5signe The Commonwealth of Massachusetts• Department of IndustrialAccidents _ Office of Investigations a d 1 Congress Street, Suite 100 ,W= Boston, MA 02114-2017 . www,mass.gov/dia_ Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information s Please Print Le ibl Name (Business/Or!ZV n/Indivi w duab\( [s� tl Address: �� hv� City/State/Zip: t L � Phone #: Are you an employer? Check Jhe appropriate box: Type of project(required); I.�'lam a employer with 4• ❑ 1 am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6•. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet, 7. ❑ Remodeling shipand have no employees These sub-contractors have working for me in any capacity. employees and have workers' 8, ❑,Demolition insurance. � 9. ❑ Building addition coin [No workers' comp, insurance P• required.] 5. ❑ We are a corporation and its 10,❑ Electrical repairs or additions 3,❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself, [No workers' comp, right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no 12.0 Roof repairs employees. [No workers' 13,[ Other �( comp, insurance required,] // { *Any applicant that checks box#] must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this1ifiaavit 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: #Li S#Polic or elf-ins, c, : Moo , y �"�'-`� �✓�""✓yl�� Expiration T ► Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date), ` Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator, Be advised that a copy of this statement may.be forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereby certify n r pains and penaltles of perjury that the Information provided above is true and correct. Si nature: Date: Phone#: Official use only,'Do not write to flits area,to be completed by citylor,lown 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#: I w I r CAPECOD-27 KLIGETT CERTIFICATE OF LIABILITY INSURANCE 7I611 (MM/°°IYYYY)3/20144 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 p011cy(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 Rogers&Gray Insurance Agency,Inc. PHONE Barbara DeLawrence 434 Rte 134 Q. FAX No): (877) 816-2156 South Dennis, MA 02660 A DRESS: bdelawrence rogers ra .com INSURERS AFFORDING COVERAGE _ NAIC q INSURER A:Peerless Insurance Company INSURED INSURERS:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C:Evanston Insurance company 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth, MA 02664 INSURER E INSURER F: CO ERAGES CERTIFICATE NUMBER; REVISION NUMBER: TJ11FS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 133 S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE n R POLICY NUMBER MMIDD�YY MM DD YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I CLAIMS-MADE a OCCUR CBP8263063 04/01/2014 04/01/2015 PREMISES(Ea occurrence) $ 100,000 MEO EXP(Any one person) $ 51000 GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ 1,000,000 X POLICY RO LOC GENERAL AGGREGATE $ 2,000,00 OTHER PRODUCTS-COMP/OP AGG $ 2,000,000 ' : — AUTOMOBILE LIABILITY $COMBINED SINGLE LIMIT B Ea accident $ _ 1,000,000 ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE $ Per accident X UMBRELLALIAB• T OCCUR C EXCESS LABCLAIMS-MADE y XONJ453514 EACH OCCURRENCE $ 1,000,000 04/01/2014 04/01/2015 AGGREGATE $ DED X RETENTION 10,000 ORKERSCOMPENSATION Aggregate $ 1,000,000 ND EMPLOYERS'LIABILITY PER ORH D FFICER/MEMBEER EXCLUDED?PROPRIETOR/PARTNERIEXECUTIVE Ya N/A WCA00525904 0613012014 06/30/2015 E.L. STATUTE EACH ACCIDENT $ 1,000,000 Mandatory In NH) f yyes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) Workers Compensation Includes Officers or Proprietors. Additional Insured status Is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder, CER rIFICATE HOLDER _ CANCELLATION K I S E eHci�i�irc OWNER AUTHORIZATION FORM 1, .. (Owner's Name) owner of the property located at: (Property Address) Co 4.�- 4 li4x Od'6 3-.5T77 (Prope—rty Address) hereb authorize O't / � (64;0 1 1 y I1S' (Subcontr ctor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property.This form is only valid with a signed contract. Owner's Signature tc3 r�n•�, Date CSZL RISE Engineering 6 Dupont Avenue South Yarmouth, MA 02664 SYKES AND COLE ATTORNEYS AT LAW 420 SOUTH STREET POST OFFICE HOX 1358 HYANNIS,MASSACHUSETTS 02601 DAVID BRUCE COLE TELEPHONE(508)775-9147 OF COUNSEL FACSIMILE(508)775-5682 PETER M.SYICES cTOSEPH V.MARUCA September 17, 1996 Mr. Ralph Crossen Building Commissioner Town of Barnstable Town Hall Hyannis, MA 02601 Re: 1493 Newtown Road, Marstons Mills Dear Mr. Crossen: Attached is an affidavit of Charles Rogers swearing that the property currently owned by Saul Gershkowitz at 1493 Newtown Road, Marstons Mills, Massachusetts, was a two-family residence prior to the enactment of any Town of Barnstable Zoning By-Laws or ordinance. Also attached is a copy of the earliest available Town of Barnstable Assessors field card dated June 15, 1972, indicating that the property has been assessed as a two-family residence. In light of these documents, it is my client's (Saul Gersh- kowitz) opinion that this property is a "grandfathered" two-fami- ly residence and that it may continue to be used legally as a two-family residence. A prospective purchaser has been found for this property, but the purchaser requires that we obtain evidence from you that they can continue to use the property as a two-family residence. In order to accomplish this, please indicate that you agree with the foregoing by signing and returning a copy of this let- ter. Sincerely, JVM/ms yeph V. Maruca I concur with the above. 23 r�� Date Ralph Crossen Building Inspector, Town of Barnstable P � a r` SYKES AND COLE ATTORNEYS AT LAw 420 SOUTH STREET POST OFFICE BOX 1358 HYANNIS,MASSACHUSETTS 02601 DAVID BRUCE DOLE TELEPHONE(508)775-9147 OF COUNSEL FACSIMILE(508)775-5682 PETER M.SYKES JOSEPH V.MARUCA September 17, 1996 Mr. Ralph Crossen Building Commissioner Town of Barnstable Town Hall Hyannis, MA 02601 Re: 1493 Newtown Road, _ Marstons Mills Dear Mr. Crossen: Attached is an affidavit of Charles Rogers swearing that the property currently owned by Saul Gershkowitz at 1493 Newtown Road, Marstons Mills, Massachusetts, was a two-family residence prior to the enactment of any Town of Barnstable Zoning By-Laws or ordinance. Also attached is a copy of the earliest available Town of Barnstable Assessors field card dated June 15, 1972., indicating that the property has been assessed as a two-family residence. In light of these documents, it is my client's (Saul Gersh- kowitz) opinion that this property is a "grandfathered" two-fami- ly residence and that it may continue to be used legally as a two-family residence. A prospective purchaser has been found for this property, but the purchaser requires that we obtain evidence from you that they can continue to use the property as .a two-family residence. In order to accomplish this, please indicate that you agree with the foregoing` by ;signing. and returning a copy of this let- ter. Sincerely, Yieph V. Maruca JVM/ms I concur with the above. 9- 23-?ol Date Ralph Crossen Building Inspector, Town 'of Barnstable ti . AFFIDAVIT I, CHARLES ROGERS, of '300 Baxter Neck Road, Marstons Mills, Massachusetts 02648, am familiar with the real estate and buildings at 1493 Newtown Road,; Barnstable (Marstons Mills) , Massachusetts (Barnstable Assessors Map 25, Parcel 003) in that I was born in said house in 1939 and resided there until 1957. My father, EMIL ROGERS, owned the house during that entire period. During, the period I lived in said house, ,I remember it to be a two—family house. Signed under the pains and penalties of perjury this l� day of 5`pko 1996. AharlXogs COMMONWEALTH OF MASSACHUSETTS Barnstable, ss 1996 Sworn to .before me on this l /' day of 1996. j 9t Joe h V. Maruca Notary Public, -. ,- Commission expires: April 3 ",1998 SYKES AND COLE ATTORNEYS AT LAW " 420 SOUTH STREET POST OFFICE BOX 1358 HYANNIS,MA 02601 TEL.(508)775-9147 - d,,,'a x�ty.__'R.i..as+^, �i''±"re��r' k'i1'nA'..af -.t.r - n.a'". ....�• x-_a ±e•pf n- •d+v-'r` ;�' , , x:y+. _ w,. r. ..(f �,. `•.h� f. r h.+:.15 r .:i., y,,'�'{:.. as.'o<�.,,:u� ,,1.: =z �.s `^i¢��_ •,-l„a. {+, .w,N�.r .K¢a��';':;a..,•'�-a. �at',�4 _a`':. »Ri x. yy'.cl.w�'+. 'r-. �+. .�., n^ •:1•a.i•"{.. .,,, � '' Il:�. ) Vie: rr, tr L �' •.\. �r_ ,.>a: -� 7�. '*-•r, :+F•:i9a :+k=. :.rig' {.-r,e:k. ri�., ., .- .,•'., ,n^., xr.� ,. ',c ._:.�, ,w. :: 5{•. '.a. ',... i.t1, � t� ,.t ... .A .r� '1! 1r.', � +.:- ':� T ,s»'''��" •,Ea, :�Yvk 'z•M'�S r �,<.,.-x- X. K�.v. X eM9^"..IL `,o.. .. .. .r .. P - +.., i -'ig.,. .:s`.....e. r .,,.,.•Y,. ,, � ,.., n: ij. {. .s k^G.- ?i`r�!,.r� •...F"�:•ria. '...�, t: ,., ;t.,•+, ,:�...-:,i�.'.m `'�{,.....-rr a ,-.. d .r r 2s r p. r. >F. t I` :- �� c,,S�t .r:.-3..., w, " - .t• ., -.; , an°� ...,a.l+>,., •-. F• a: .., t� i� r j fi.Y s••oo •k ,?: 9 ,k:. .-sS ?r nC 4 ,,. , . v+. ...,#t:,�.. . '»�.ww .. [et. a,.. .. ,l.,A:,. ,; >, .t e_ .,i ••r. e1� P,�E �..• -:>�M :.g. c RTP, r '.�: .. .::• •.,.. - fi.n. ,./-..-w. _ ,: 'E'rP.. ..__. ,...: r r,, :. ... .r 't' },.�l_�V I I� F�� r .4:��V9"t�4.��:s ,�...,A.�:.. T....:..5 v. ':;::d-N•�rl {x'.'jA. <i TI A` ,MAPaNO. �}.. " ,' # ,. +: REDISTRICT; P� . ,r. r. y.. ..y • ,Y„'- ts;,- bS x , v yF'1 MMAR yf•p%: "' .. x §.NeWtoWri ,Rd" .Santuit v : 93 { , ey '.�:._.4A..w` •-' .F..,n'•' ..,§td. .. .•:: ;+Wa .,•>, s.�-k ,4T LAND •s. a y ti 2s .3 .;cA ,. '�-.i. a .r.r•+. y..,. ... •:�,.,' S ,..,�.,+ , .. '.-.. ..y'::@i, � s a 'i': bz "'+= r r«.P '•>' a, s t• '.:Y y.aA,- a •yt�•k,Yal.'c .t4k --<r::. �. l - k. t: p -.L r • ,.,. i„{" x R'BLDGSi� 5y ry ;OW,NER a�� r., f+,, •?d ,t„ 'tf. ,o _aS, G.•i-!"':.. �'lif:"`J"'• >E`..'t. :?' v 7 r ;_ ,rR a� x y cesii r :`TOTAL:,�.x , f BLAND " F RECORD OF;TRANSFER' DATE I.R.s MARKS t au :x•'L Tyr k. 'a sa j, °� _ G wa r 3.1 t't qyKcBLDS' Ro ers Grace 6 2 6 LAND 12-22=77 . 2637 276 41-A)' BLocs: TOTAL 'LAND `k Y 'Y, .. ' i ✓ rBLDGS.� "G ,x„e. r4 smxfi s �• kx ,S�•�'�� Y •' :.'.A .' ...� � G. { f:e^ y �r T t _ •:TOTA L.{- r LAND t t t BLDGS.' a -" r , , Y , • , , � c t.s TOTAL'' LAND s , 7 �� BLDGS s'�,, ,k• Y" , L I £r .t. TOTAL:' }, r '.t e ♦ LAND '' L F t ! K WILD :.NTERIOR INSPECTED DATE , �/✓`7 ..: 1G C c` t'�•L�G'� x. LAND a•h ACREAGE COMPUTATIONS _' ,. . .- BLDGS vat •t" ,.v � �•° "LAND TYPE 2, '#k OF ACRES .PRICE' TOTAL" -' DEPR. '"'. VALUE" µ,' Tj ° _ •'z� 'TOTAI.,r HOUSE LOT_ , 7S .wwr -, x , r o�7 pCLEA'RED;F.RONT t _ ' i BLDGS", M " ry�tC�'�] as M',-v'y^�w.'REAR - :r . . s. :- ,' R, s, ;' y r. �r - . ' N;. a ..,...•kr'k ?-r:, wrp ti kc c TOTAeja rr ' '�1rr-x fi Y` q., - - „� �. zr,w I . r• .- a�+a.,,,«' pA xa -',�,R T{3A`'". cH�•F•'. I` 66S' SPROUT FRONT gy `t i•'r Cad x �> t,a•'+m r... iLAN HLA r w+ u r r v, 7 , r A r,.:.:sf'd Y'•' , ,':.... ; : ._r,. f t� t'•i'Y Yt��ip -Ag L":':ay .,.. ,.f.,4.,.;: •..d,1,.�,. ., ,.,....a - : 4 %I;? .isx t$;'... ,..'fix,o<"'X4 N ,r..',t. ,•¢t, af ..,� '+,.. .i - �....,_..G;:�i._� �_ .,REAR -� � ; .. e= ,: �' y-', t§ .r � 4 '' g'tK I.1±r ,� .�<,,» :. ...,.../'� - ,''*•+ `F.s .'?7k��i.'' , .:tm., •t: d^x.. . •{�;e +... ln is %i34 .REAR;:: ;.r� -"., �' «er.x to kf;; o - s�1 '•. r:LANDt. wi .1'• A -: �J '•:'.. .Ili .., h• - F } r ''it?"..'§'h.!'�.•J h a' Y '{ts 3•�+•'t� �.�t• t � .�; s, % a' ,�1+,�.• r r:..,..+�, +•-".+ � h I� BLDGS 71 Y c 3vh i'+:i',�t',�,y�t,» :;: A •t''•t :a':',: -<• +. .>''-{.. s f. ^.!?s .. 1•I,: _s3 n� "'+ ;TOTALa. � w>A t{ f 1.G„-rr '^F „s,• 'ar.` �r J:� ,,S" k7`�,rl'` T,•G�,.: a., ..4'b'r• d r,. ., tiLAND.i.. .`•l'',�`�` _wyr�,d�;;Fd �, J; Ys _.,,'f • ...: `• ... ', . .*: f � i t 32 t5 a- is r t r.,�sfry Yi e�>4�.N'cs ...,i..:r+. •e,. '. ..+..•{. , ''(: ,;� •.ql �.,:a rh r., 4� r i�•,7 '..,r� .y � �'r J �� k: xy LOT'COMPUTATIONS ;�, t1 i r tt LAND:FAt a tp tt . CTORS �. , '3f�tONT DEPTH` STREET PRICE 'DEPTH% FRONT FT."PRICE TOTAL '.f DEPR. COR. INF. ;VALUE. ' fi3:P4+ '• .,7 t >r t w : r' M HILLY,.. t.+i r :.,1 � LAND ?u :. +. £ W x a «n t. E E � - - TOWNS R•�A, x{ �`� v s* ROUGH rig £.�:� ff'.�; TOWN;WATER .'°� �'-�� '.BLDGS `rr�-t r"'•�<r:;,�°' yay •i. s +rs r <. Y" y ` In:J.� l q°,• `� '- `ni , 4• cp• 'taw Z e. €1 G HIGH RAVEL RD >r +xj'c:n'+v •.!' * i '' ',.4.., ! ;e• LOW ' '•+.t, ,..- y. n'_. O"• DIRT RD x`'ESWAMPY w NO RD.` •e h s - s e"�'T'''�`n..+��- w ------ - _ _ 8 -- - ----- _--..�.-_.�..� Base a_,�-.rau �:vo+ Wall i/ Fin.Bsmt.Area atb Room __ (] SLOG. COST i.z �`^a^'"'•' Cone Blk Walls+., y 'Bsmt.Rec. Room St. Shower Bath Bsmt. } PURCH. DATE ContISlabt` " ` Bsmt.Garage St. Shower Ext. Walls - _Roof_ PURCH. PRICE. Bnck'Walls , Attic Fl.&Stairs Toilet Room --- —v RENT �'a `` rs�G r.c t• r.:r, r {yi;:S Stone Wallsr Fin.Attic Two Fixt. Bath — -- d t�;< Fioors 2 t„ ers , '• Pa ^!+" s INTERIOR FINISH Lavatory Extra _ �j_ y Bsmt r'i�• ,F t 1' 2 3 Sink - ./ _----- � O 1/4' Plaster., — Attic y I Water Clo.Extra IEXTERIOR''WALLS' Knotty Pine (/ V Water Only r r { )ouble'Sldmgr Plywood, No Plumbing Bsmt. Fin. ' �a ,r <.. Fi 1 ii4le'Sidmg + Plasterboard Int. Fin. �� I } wl9hmgles !/ TILING. a15 _ 2 one Blk c G F P Bath Fl. Heat 3 ace'Drk.On Int:Layout-, ! Bath Fl.&Wains. i fix. Auto Ht. Unit 3 Veneer:k Int.Cond. Bath Fl. &Walls t+ Fireplace :om. Brk On , S A A it = HEATING Toilet Rm.FL , I Plumbing f-' „ ,. iolld Com Brk r. ' ` { HotAlr• u/ ✓ Toilet Rm,FI.&Walns. . s '" + # r Tlling -Steam .Toilet Rm:Fl. &Walls - - ifanket Ins -Hof Water St. Shower f + S: # � "+ !' 4 f a M :t„ m "r a t"+ p loaf Ins:# Air Cond. Tub Area y Total a a r x it f, c A!,;. tv .£ Floor Furn. yl !"',ROOFING COMPUTATIONS lsph Shingle a ,a v Pipeless Furn. of S.F. 0: 0 ) ti 8, a(U `0 i Vood Shingle No Heat / ! � tsbs Shingle Oil Burner ` Y } Isla s, Coal Stoker 07 S.F. vr'rle r,...,ir x Gas � •ROOF TYPE Electric S. F' z«:='OUTBUILDINGS able,; e; 'Flat S.F. ± 1 2 3 4 5 6 ,7 8 9 10 1 2. '3 4: S 6 '7 8 9. 30 "MEASURES Mansard `FIREPLACES S.F. y, Pier-Found. Floor'ambr w of -----? •,.. Fireplace Stack Wall.Found d 0.H.Aoor ' "" LISTED,, 'FLO RS• Fireplace r _ •Sgle.:Sdg Roll Roofing (// n „i one p s LIGHTING arth, No Elect. DbIw Sdg:' Shingle Roof, hr a+w Shingle Walls i `+DATE=t-4 me} g Plumbing':' lardwood'.:'' ROOMS Cement Blk, Electric. _, 6 /f• �Zs Bsmt. 1st TOTAL " T � Brick Int. Finish. PRICED angle j` 2nd 3e-Q 3id FACTOR 77 r »}t REPLACEMENT •. t •�',�r 2 m• K. 'tf rOCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. ':REPL. VAL. Pity.Dep. PI-{YS.`VALUE Funct.Dep. ACTUAL VAL., ool �9 CS /74`Sf,'' /7D'SO �FZ r .yam �-- — b a � .'w"CF ., ---- f . ,F �y F .� +(-4.. '�,Ire+•zw`x f+.k� r�yrY.eucL art., t aA i s +, va l g a ». t w 'b r L , •sa A g»M ^`zg�var«�r a�rw fk '9.•• ' a.:': 4 ¢ •! tl '� t .t sy8 „Q a-L-,� -rt.: "�"g,;G ".3t'£h+ •S':3`t t:&�}"�, fig,^: alOrkk.':1.r.x"?. _` u>• .; .tk.'s. :_: e'g ,.:-x...•.a e .r•S ] $'ts. ;4a'1 a � t. e >*' +> �.i C;?P.y - tc f. - at..'. f �s a:`,:: '�- `�r� 'Y`'j "1 �� .,* i •._r� +,rlJ7� �.-'h�c,$'i[f�^+,. ...� - " �:. :.;. '} e...'.< +. l f.. 'zF,. -'? .;... ti•}sr". f ,.."t.? f'. „.t s !' ! t•,t +'. Yi'r•' >. •n• r<r r a. +... r 4s '+ �{.[,•°e� u' 33a�.' '�" 7'� �� •:a '•'.;�`:' �' ^-5s^^ .?.. :rfi _t�s...„ _ ..+x`a' y:..: 3:. ., ..,. - �: ..: •:..-,,a. _ ,...., s� - ..r ..t.a.,a yr,., :3. -... : .- y. .r"� ._ )�: � e,.:°...'� •,�. t 3"' � .1 ,i?` .^e.;.y,y''�°' is ry. iy �,: .t. t'C 2�'' Zt*b� •.�.: .+ S.Y.� � ''& L N i;:'-4_a.•J�t•e t [. 4:Y„• �I Y t W X '4 d� •. �� .. ti w+`",.�'�.+:^. ,r;J, pt.. .a � a �4 .�.•-:5d� s �:.; ,a� � *� "a.1'.'x+o �,':- s_ ; • •r< :;:.'3«j t, { '_„F(1•�17i.;-#' , p,. :.. dr r#• , a'#;' `IfiaP',�i+ d. r g ?�: S ..,....,;9�„5,<i,d2'.w'.r.•:1,..,,,,��.:,.; >,o..+,.�a,�.:._.......,....._..,ems;.' :. ::..�:. ......._ ab... '4r ._.:.�:� ... ... �l .., ., .. '1 .. .- c..sa C.._•L:r.. r._,..�;s:.,.....x:se.k;:,en'i.:..s,�.,S.,..�....5.�._•e+-._u..:..-eY...�._._..�, .._.i..ai..�� '�.,V' ':.s-Aw+rS k.-_ ..,v_:'• ,i. SEP-13-1999 10:22 BRRNSTRBLE HOUSING 15OB7799312 P.01 Barnstable Telephone(505)771-722' FIX(508)77S-93 1 i ,.uwr i man* Leased Housing Dept- (50b)771-7294 • .e3a Housing Authority 146 South street-Hyannis,Mass.02601 ZONING VERIFICATION TO: Gloria Urenas FROM: Robert Hooper, Leases! Housing Coordinator RE: Legal Rental Unit Verification Date: jzaza Address: iY5, ,v��a -o�.� �u��,•� w Village: t �_ Unit Type: :2 le-u Bedroom Size: Map & Parcel No.: The owner of the above listed property is entering into a contract with us for the rental of the property as listed above. Please verify by signing below that the unit Is legal and meets all zoning requirements for a rental in the town of Barnstable. If it does not, please list reason here: 041 T u for your assistance in this matter A Ir-t r � O / i nature Pint name ... = ---------_ mats VIA FAX: 790-6230 MRVP Sermon 8 Rev.9/98 Equal Housing Opportunity Agency TOTRL P.01 ry .. S r -e. J � _ - - hF i Town of Barnstable *Permit# Regulatory Services F�xpires 6 mon fr m issue d g ry Fee BARnsrest E, MAM Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 0 Property Address t" TS. Residential Value of Work ("6 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address VV1vylrc� Contractor's Name Telephone Number TVK c7 27 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable). X, pRF-SS PERMIT ❑Workman's Compensation Insurance Check one: APR 2 7 202 '� I am a sole proprietor -I am the Homeowner ❑ I have Worker's Compensation Insurance TOWNOF BARNSTAgL-E Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑.Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is qu ed. SIGNATURE: Q:\WPFILESTORMS\building pe it formsT3TRESS.doC Revised 051811 The Commonnwakh of Massackusetts lhiartment o,f Industrial A ccidenft QOke o,f Investagadons 6W Win, ington Street Boston, M 02111 »vkt ma rl ssgovldiu Workers' Compensation Insurance Affidavits Btilders/Contractors ectricians(Ph mbers Apphcant Information Q Please Print Lembiy Name(Eusme3S11D izatia®lla,diaianaU: D Q r Address: City/State/Zip- Cj Phone ik Are you an employer?Check the appropriate boa: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 6. []New won employees-(full anWor part-time}.* have hired the subsub-contractorssub-contractors 2.❑ I am a sole proprietor or parbw- listen on the attached sheet. 7. ❑Remodeling ship and have no employees. These sub-contractors have 8. ❑Demolition working far r>ie in any capacity. employees and have woikers' [No workers'comp.insu ntace comp.msuramr �. ❑Bnr7dtng aaldrtitm mod_] .5. ❑ We are a.corporation and its 10.❑Electiical repairs or additions 3.�I am a htnueowtuer ala ill wow o��have exercised their 11.❑Plumbing repairs of addititans myself P. warlaers°comp- right of emotion per MGL. 12.❑Roof repairs insurance required_]F c.152, §1(4h and we have no 13.❑Other employees.[No workers' comp.insurance required.] `hey appfic�d dw checks boa#1 must also fill out the section below showing their aeorke rC�p on policy infermatiou- Iioaeena�ners who submit this of ul-ff indicating they are doing all wort and then hue oo Wde contiwurs nma submit a newamdsvit indicating such. (Contractors that check this boot must attached an additional sheet shoring the name of the sub-comazctom aed:state whet3aar or oat those entities have employees. If the sub-contractors have employees,they ants[piovide their workers'romp.policy muriber. I am an employer that is prow+d4 w workers compmtsadon insurance for my employees. Bebiv is the policy and Job site i►rformatiaan. Insurance Company Name: Policy#or Self-ins.Uc. Expiration Date: Job Site Address::. CitylState)Zip: Attach a copy of the workere 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 imprisonmeut,as well as evil penalties in the form of a STOP WORK ORDER and a fine ' of up to$250.00 a day against the idolator. Be advised that a copy of this statement may be h warded to the Office of Investigatiams of the DIA for insurance coverage verification. I do hereby c the pains andponaies ofperfuty that the informationproa ded above is bue and correct Date: Phone A. af"rcia use only. Do not aurae in this arm to be cOmpiete+d by CY or town affciai City or Town.: PermitfUcense 5 Issuing Authority(d rde.one): 1.Board of Health. 2.Building Department 3.C ityy/rown Clerk d.Electrical Inspector 5.Plumbing hapector 6.Other Contact Person: Phone#• 6 �11N 'Town of Barnstable Regulatory Services � i�$' Thomas F.Geiler,Director 1639.` ♦0 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA.0260 T www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION, y Please Print DATE: JOB LOCATION: l -1 O1 nu ber street village t� "HOMEOWNER": name )) home phone# work phone# CURRENT MAILING ADDRESS: �-J 5, 0.) city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellines 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 su ervisor. 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. dersign " eowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection oced and requir ments and that he/she will comply with said procedures and requirements. Signatur f Homeowner - Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building-Code - Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as'-supervisor. Many homeowners who use this exemption are.unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15).This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC Revised 051811 dF� 9 6", Mass. MUMSTABLK 059. ,� 'Town of Barnstable ATBO MA'l a Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO. Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us ' Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section - If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date - Print Name If Property Owner is applying for permit,please complete.the Homeowners License Exemption Form on the reverse side. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 051811 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) M A� DATA � l RESIDENTIAL PROPERTY MAv' NO. LOT NO. FIRE DISTRICT SUMMARY STREET1493 Newtown Rd. Sa.ntuit 25 3 - c 73 LAND fir, . BLDGS. �7 5-5 OWNER i 0) f'1 TOTAL /1 -Q LAND RECORD OF TRANSFER DATE SK PG I.R.S. REMARKS: � BLDGS. Rogers, Grace 6/23Z 56 TOTAL LAND 12-22-77 . 2637 276 41-A iZyY 6 0) BLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND 0) BLDGS. TOTAL LAND BLDGS. TOTAL LAND TERIOR INSPECTED: 0) BLDGS. i TOTAL i ATE: LAND ACREAGE COMPUTATIONS BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL USE LOT �� i' •l3 ( � Jr LAND ARED FRONT BLDGS. REAR TOTAL ODS&SPROUT FRONT LAND REAR � BLDGS. STE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND JL at BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER m BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. rn BLDGS. UNDATION BSMT. & ATTIC PLUMBING PRICING LAND COST ' Is v" Fin. Bsmt.Area Bath Room - Base / /—,/ BLDG. COST - Walls Bsmt. Rec..Room St. Shower Bath Bsmt. PURCH. DATE - Bsmt.Garage St. Shower Ext. Walls s Attic Ff.&Stairs Toilet Room _ PURCH. PRICE. Roof RENT cr'�'-_ ,:r -. - • Is Fin.Attic Two Fixt. Bath -- — � INTERIOR FINISH Lavatory Extra Fioors F ✓. 1 2 1 3 Sink ✓ — r/= 1/4Plaster // t/ Water Cie. Extra Attic - IOR WALLS Knotty Pine Water Only ing Plywood No Plumbing Bsmt. Fin. ng Plasterboard Int. Fin. 7I/ . hingles v -- TILING 6 GC ' Li G F P Bath Ff. /Heat 0 a c 37 g 6 n Int.Layout Bath Ff.&Wains. Auto Ht.Unit --I— -- enser Int.Cond. Bath Ff. &Walls Fireplace n HEATING Toilet Rm. Fl. Plumbing C D Brk_ Hot Air Gv li/ ✓ Toilet Rm.FI. &Wains. Tiling Steam Toilet Rm.FI.S Wails ` Hot Water St. Shower Air Cond. Tub Area 7— Total Floor Furn. .2 °1 OFING COMPUTATIONS to // Pipeless Furn. d S.F. 8 a O G i to No Heat S.F- Is le Oil Burner rfoS.F. JJc:L ��Coal Stoker a S.F. Gas S.F. OUTBUILDINGS F TYPE Electric Flat S.F. 1 2 3 4 1516 7 8 9 10 1 2 3141 5 61 7 8 9110 MEASURED Mansard FIREPLACES S.F. Pier Found. Floor "� Fireplace Stack Wall Found. d 0.H. Door LISTED LO RS Fireplace Stile. Sdg. Roll Roofing v LIGHTING Dble.Sdg. Shingle Roof v r> No Elect. DATE — -- Shingle Wells Plumbing — ROOMS Cement Blk. Electric Bsmt. 1st f-i TOTAL Brick Int. Finish PRICED 2nd 3rd FACTOR =' REPLACEMENT -UPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. TOTAL I— . 20C GICT 0 7/09/95 1011 PE UNIT ADJ'D. UNIT ACRES/UNITS VALUE Description riERSHKOWITZ, . IRMA 9 SAUL TR MAP— PRICE PRICE #LAND 1 35j,100 CARDS IN ACCOUNT — 39999.99 46799.99 .75 35100, #BLDG(S)-CARD-1 1 40.600 01 OR C1 #PL 1493 NEWTOWN RD COT , EOST 75700 7000.00 7000.00 1 .00 7JO0 3 #RR 1425 0083 MARKET 61100 INCOME SE PPRAISED VALUE 75,700 ARCEL SUMMARY AND 35100 LDGS 4C600 —IMPS OTAL 75700 CNST DEED REFERENCE Type DATE Recorded R I O R YEAR VALUE Book Page Inst. MO. rc l saga Prior A N D 35100 7440/276: I,02/91 A 1 LDGS 40600 6202/027- I04/88 A _ 1 OTAL 75700 4510/295; I04/85 A 1 BUILDING PERMIT Number Date Type Amount SP—BLDS FEATURES BLD—ADDS U=PITS 7000 d. CND Loc 4t R G Rep[ Cost New Adl Repl Value Stones Height Room Rma Baths V M Fia. Partywall Fac. 100 56 72490 40600 1.4 8 3 2.0 7.0 P.BY/DATE: / SCALE: 1/00'.63 ELEMENTS CODE CONSTRUCTION DETAIL 48 SINGLE FAMILY _ DWELLING CAST GP:00 *--10—* -STYLE 10 LD STYLE 0.0 _ _ 1SB8--* 8 $ ESIGN ADJMT 00 --------------------0.0 3 FSF ! ! EJ(TE�t.WALLS 0i OOD FfiAAE------ 0.0 5-1 3--24---*-- --# EAT/AC TYPE 02 AS ---------------0.0 ! AlTER.FINISH ' a0 ------------------0.0 NTER.LAYDUT 114 -------------------- IN7ER.at1ALTY DZ Ah1E -AS fXTER. 0.0 L0OR STitUCT- 10 ---------------- SASE 28 E LOUR COVEit-- -00 ------------------- 0.0 OOE TYPE ---- 00 ------------------0-A -L FZ_f A.itAC--- 00 --.-------------- -0.0 = Oi1MDATIDW-- - {IO - 99.9 ---------- _-- ---------------------- *-----24----*—* -----NEIGHBORHOOD 12ACIARSTOAIS MILLS 8 FEP 8 LAND TOTAL MARKET PARCEL 3si00 75700 *— 20----* AREA 5378 VARIANCE +0 +1307 STANDARD 25 Property Location: 1493 NEWTOWN RD COT MAP ID: 025/003/// Vision ID: 1444 Other ID: Bldg#: 1 Card 1 of 1 Print Date:09/16/1999 14 Al � 1411�4�m"10 U,P� VIVI KtAKOUN,rAUIL beve u is water Description (-ode Appraisea value I Assessea value %BOMBELLI,MARK P as I P—av-eil— RES-EAND— IU40 35,IUC 35'ru 801 342 COTUIT RD ep ic RESIDNTL 1040 35,OOC 35,00 SHPEE,MA 02649 C E DATA-Barnstable, X, ffQ A I MA �f,��J� lA —% �, U, ccou►i )/n Plan Rer. VIM Tax Dist. 200 Land Ct# Per.Prop. #SR Life Estate #DL I Notes: VISION #DL 2 GIS ID: Tola� 7(1,10 7U,10 U KL-CUKD,' B Ilk, —7;�7 ula�e �,EXYHLF— ALXPRIC LA WM Aff!�Z , " KEAKI]VIN,rAUL b It)!14J/U1 1 U9/uv/l!)Y q2 I su'u0c uo Yr. Coae Assessed value Yr. f-ode 4yseysed Value Yr. e Assessed Value GERSHKOWITZ,IRMA&SAUL TR 7440/276 02/15/199 U 1 1 A IY95 MU 35110(ITA-Tow lull 75, GERSHKOWITZ,SAUL&IRMA 6202/027 04/15/198 U 1 1 A 1999 1040 29,00(199 1040 29,00 GERSHKOWITZ,SAUL&IRMA TR 4510/295 04/15/198 U 1 1 A GERSHKOWITZ,SAUL 4504/214 04/15/198 Q I 70,00C ROGERS,CHARLES D .4404/147 01/15/198: U 1 1 A 6 4,10 -Fo-I-H.- 4,10 is signature acTnow tedges a visit toy avala Collector ssessor I h Year ypeZuescription Amount (;Ode Description Number mount Comm.Int. Appraised Bldg.Value(Card) 35,000 Appraised XF(B)Value(Bldg) 0 Appraised OB(L)Value(Bldg) 0 Appraised Land Value(Bldg) 35,100 Special Land Value Total Appraised Card Value 70,100 Total Appraised Parcel Value 70,100 Valuation Method: Cost/Market Valuatio Net I otal Appraised Parcel Value 70,100 BUf Permit ID Issue Date Iype Description Amount Inso.Date �;'b Lomp. Date Comp. Comments Date ID Ca. A PurposelKesulf --'27rU79'9— FS 00 Meas/Listed All "'P- H# Use Code Description Zone D 11,rontage Depth Units Unit rice actor I Tacror .3.1. C.Tactor Nbhd. Adj. Notes-AdjlSpectal Pricing A df. Un t Price an Value Tw---F U.'/t AL T.UC 5 --G.R S] 1 1040 0 -am--IFy— I 117,0U0.01 IM es:TO 35,10C lotal an Unih 0.71 A(: ToTaTl-afia vau q ---35,iuu Property Location: 1493 NEWTOWN RD COT MAP ID: 025/0031// Vision ID:1444 Other ID: Bldg 1 Card 1 of 1 Print Date:09/16/1999 7 T "VA,a Element Cd. Ch. Description C-ommerciatVara Lientents Sfy Element Cd. Ch. Description leype )b Conv—e-5fi—ofial Model 1 Residential Heat&AU Grade )C C Frame Type 13AS W Baths/Plumbing Stories 1.4 1 Story w/Fin 8 ccupancy )0 Ceiling/Wall Rooms/Prtns Exterior Wall 1 14 Wood Shingle %Common Wall A AIS u zu 30 2 all Height 3 Roof Structure 03 Gable/Hip BM Roof Cover 03 Asph/F GIs/Cmp AM HUMLW, interior Wall I D3 Plastered 2 ETe—ment Code Llescription tactor Interior Floor 1 14 Carpet Complex 2 Floor Adj Unit Location 8 26 Heating Fuel )3 as Heating Type )4 of Air Number of Units AC Type )i one Number of Levels %Ownership edrooms 3 3 Bedrooms Bathrooms 2 Bathrooms I(-U, WtTIVALVA44 V&S 0 2 Full X E —AR 24 nadj.Base Kate 45.uu Total Rooms 8 Rooms ize Adj.Factor 1.15501 3rade(Q)Index 1.01 2 Bath Type kdj.Base Rate 55.99 8 Kitchen Style 3ldg.Value New 76,034 fear Built 1930 20 ff.Year Built G)1968 ,4rml Physcl Dep 29 'uncril Obsinc 0 --con Obsinc 25 4"MIIYL'D U Condo Code ipecl Cond Code Description ercentqLe )verall%Cond. 46 _1`04W-Two Family 11 u Deprec.Bldg Value 35,000 Ou"'m VIL U"'LAV", -j1tATUjWS(ff; "Y 'W ARM W '4 '777' 'W F�777 Coae Liescription L-Iff units Unit Price Yr. Lip Rt %Cnd Apr. Value Code Description Living Area I G, -al Lff.Area I unituost undeprec. Value HAS First t]?or 77b 77( R 20.yl 4J,44; FAT Attic,Finished 336 67 33( 28.0( 18,81- FEP Porch,Enclosed,Finished 0 16( ill 39.1( 6,27 UBM Basement,Unfinished 0 67: 134 11.1( 7,50: It/.Gr�oss LivILease Area 1' g Vak 76,03� r •�,� ;:�1,.��.}.dG�^.'.s...re..^?�r.w_'�le..... v�.'t..,a,1., .>Y....,`Y::h'w�1•..ww.idKr..c ^.�..` :.__� '.' TOWN OF B R K S T A B L E t BU ILO ING DIVIS ION 367 MAIN ST HYANNLS MA 02601 _ V l 14 USPS 1995 f ..„..:a�h'c+cv"�..k.`�"H'..�:6J:,::Y.w_:-f .trcT�'.:-Y:,7t.....1+.:.....s�i.41w.:C.r:..•.i.+.� .�1:'�:rv.+..::h ..� 93 / ,l x