Loading...
HomeMy WebLinkAbout1514 SANTUIT-NEWTOWN ROAD Ol1-ou--.,4ounc Anur IVE I I i LISPS TRACKING# Fitsf=Glass Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 S06 7305 4464 45 United States •,Sender:Please print your name,address,and ZIP+4®in this box* Postal Service TOWN OF 13ARNSTABLE BUILDING DIVISION 200 MAIN ST HYANNIS, MA 02601 s F f tt�►l1Jflftj�flff'�1rf1if7tl�f11'1��!!'=jli�ljllfliF�!'ltilrfe�i �C • • • COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3. A. Signatur ■ Print your name and address on the reverse X ❑Agent so that we can return the card to you. Addressee ■ Attach this card to the back of the mailpiece, B. Relceived by(Printed Name) C. Date of elivery or on the front if space permits. / 2� 1. Article Addressed to: *, D. Is delivery addriTag different from item 1 ❑ es S� If YES,enter delivery address below: ❑No I m19 6 to S i III'IIII IIII ICI I III I III I II I IIII I III I II I III 3. Service Type O Priority Mail Express® ❑Adult Signature ❑Registered Mail*M � Vdult Signature Restricted Delivery �❑RReegistered Mail Restricted 9590 9402 3630 7305 4464 45 ❑Certified Mail Restricted Delivery Return Receipt for ❑Collect on Delivery Merchandise 2. Article Number((ransfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmatlonT - fired Mail ❑Signature Confirrnation 7017 1;10 0 0 0 0 6 7 5 7 3.2 416 `•: ?red Mail Restricted Delivery Restricted Delivery ;r$500) PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt j Postal CERTIFIED oRECEIPT Domestic Mail • ru (Tl For delivery information,visit our website at www.usps.com". C� ' 13 U 1 Certified Mail Fee � $ n tog Extra Services&Fees(check box,add fee as appropriate) a O ❑Return Receipt(hardcopy) ❑Return Receipt(electronic) $ D p;Postmark, O ❑Certified Mail Restricted Delivery $ ,*Here D O ❑Adult Signature Required $ ❑Adult Signature Restricted Delivery$ ,c O Postage $ tl, rq Total Postage and Fees ` � Sent T ------------------------- Street an A t. o.,or Pd Box No. S;ri S00, tep+y ¢y' = :.1 1 11 111•1• Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label), for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. f USPS"stmarked Certified Mail receipt to the ■A record of delivery(Including the recipients retail associate. 1 signature)that is retained by the Postal Service- Restricted delivery service,which provides 'for a specified period. delivery to the addressee specified by name,or 1 to the addressee's authorized agent Important Reminders: Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mails,First-Class Package Service®, available at retail). or Priority Mails service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age International mail. and provides delivery to the addressee specified ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail).of Certified Mail service does not change the is To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on is For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records. PS Form SHOO,April 2015(Reverse)PSN 7530-02-000-9047 First-Class Mail _... Postage&Fees Paid USPS Permit No.G-10 9590 9402 3630 7305 4668 56 United States •Sender:Please print your name,address,and ZIP+4®in this box• Postal Service a OWN 01i 13ARNSTABLE BUILDING DIVISION 200 MAIN ST i HYANNIS, MA 02601 i i �T i •M'PLE-TE,THIS SECTION COMPLETE • ON DELIVERY ■ Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse X 0 gent so that we can return the card to you. IZAddressee Attach this card to the back of the mailpiece, B. Received by Kfited Name) C. D to of Pelivery or on the front if space permits. C i. Article Addressed to: D. is deliv€r�� ss different from item 17 0 Yes if Y nter de' ery address below: �QJo �j F 3 � II I IIIIII IIII III I III I III I II I I I II II III III I II I 3. Service Type ❑Priority Mail Express® 0 Rdnit-Si nature ❑Registered Mail 2 dull Sign lure tricted Delivery ❑Registered Mail Restricted 9590 9402 3630 7305 4668 56 /Cdit ,De 'Restricted Delivery Return Receipt fot ❑Collect on.Delivery Merchandise _9 ArtiNp_Nt imher_(Transfer_from_service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM sured Mail ❑Signature Confirmation 7 017 1000 0000 6757 3208 i1sured Mail Restricted Delivery Restricted Delivery ver$500) PS Form 3811,July 2015 PSN 7530-02-000-9053 1 ;Domestic Return Receipt Postal CERTIFIED oRECEIPT CO 'Domestic Only rU O m fi r` ` I Sa - Ln Certified Mail Fee ' Extra Services&Fees tcheckbox,add fee as ,�Mpdajg) e, O ❑Return Receipt(hardcopy) $ 1 O ❑Return Receipt(electronic) $ {? �ost%ark E3 ❑Certified Mail Restricted Delivery $ "" wP Here E:3 ❑Adult Signature Required $ 4-z, ❑Adult Signature Restricted Delivery$ E"a r' CO OPostage \ ` U- "J, / O $ 7� r 3 Total Postage and Fees $ r Sent To �� // � 1_r[ ktdG.SL----___________ ________ p - and APt.No.,or PO Box No. - - ----- Street ---------/5=4.4��'� - o rn= ------ City,State IP+4� .,?613 _ 5 :11April 201511 10 •1 Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. ' USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service.`,,.r Adult signature restricted delivery service,which ■Certified Mail service is not available for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified ■Insurance coverage Is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following service3: td4` postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(Including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt,attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7530-02-000-9047 Town of Barnstable Of tHE T� Building Department Services x 1 Brian Florence, CBo [;BA#R7NhSLEBa.RN5T.ILE,MASS. °' Building Commissioner 6e200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 February 8, 2019 Mr. Michael Shea 1514 Santuit Newtown Road Cotuit, MA 02635 Re: Cotuit Center of.Fine Arts . Dear Mr. Shea, Y Thank you for your most recent email dated 2/8/19 regarding the Cotuit Center of Fine Arts (hereafter the Center). .In your email you asked about ownership disclosure as it relates to Site Plan Review. That issue was addressed in my previous letters to you beginning November 13, 2018. Please be advised that I have entered your email into our file containing your previous requests for enforcement. In accordance with M.G.L. c. 40A § 7 1 am hereby notifying you that I am not required to act upon your request. My reasoning and determination is that the basis of your request is essentially the same request as the one I declined to act upon on November 13, 2018 (please reference my previous letter(s) to you). You may recall in my November 13, 2018 letter that I informed you of your right to appeal . my determination under M.G.L. 40A § 15 within 30 days of my denial. As of this afternoon it does not appear as though you have taken advantage of your ability to make an appeal. Please reference M.G.L. for any iremedies that may be available to you. I hope that this information has been helpful if you have any questions please feel free to call me. 1 . Re ards, Brian Florenc Building Com issioner w Anderson, Robin From: Florence, Brian Sent: Thursday, December 20, 2018 2:30 PM To: Anderson, Robin Subject: FW: Savinelli Road From: Florence, Brian Sent: Thursday, December 20, 2018 2:30 PM To: 'Michael Shea' Subject: RE: Savinelli Road Hi Mr. Shea, Thank you for your email. I am not engaged in an action at this property so I would have no reason or cause to enlist the help of Mr. Perry. I hope that this information has been helpful, if you have any further questions please feel free to contact me. Thanks, Brian Florence Building Commissioner Town of Barnstable 200 Main Street Hyannis, MA 02601 (508) 862-4018 Brian.florence@town.barnstable.ma.us From: Michael Shea [mailto:mshea1011@yahoo.com] Sent: Wednesday, December 19, 2018 9:18 AM To: Florence, Brian Subject: Savinelli Road Brian, attached is a photo that illustrates where Savinelli Road used to end (where the old and new asphalt meet). The Cotuit Center for the Arts has admitted to laying asphalt that transverses the entire property at 40 Savinelli Road and connects to a corporate parking lot at 4404 Falmouth Road' . Both properties are owned by Cape Cod Foundation Incorporated so I guess they were okay with the idea,although none of the area residents were notified of any change to the road . The new asphalt has been described by the Cotuit Center for the Arts' legal representation Michael Princi as a new driveway design or a walking path . Could you enlist the help of Michael Perry Sr. of the highway division and ask for his professional opinion as to whether Savinelli Road has been altered or if the new asphalt is part of a driveway design that runs right past all entrances to the " home " . I am going to file a suit soon and want to understand the Town's interpretation as to whether the road was or wasn't altered . Thanks-Mike Shea i Anderson, Robin From: Florence, Brian Sent: Thursday, December 20, 2018 2:42 PM To: Anderson, Robin Subject: FW: Cotuit Center for the Arts blow out For inclusion -Brian From: Michael Shea [mailto:mshea1011@yahoo.com] Sent: Wednesday, December 19, 2018 9:38 AM To: Jessica Rapp Grassetti Cc: Florence, Brian Subject: Cotuit Center for the Arts blow out Jessica , over the weekend the'' home" at 17 Savinelli Road ( that has been designated as having a charitable services use code and'a commercial structure by the Town of Barnstable despite maintaining an address in a residentially zoned area)served as a corporate parking lot for events held at 4404 Falmouth Road once that parking lot and the new satellite lot/ historic building at 4418 Falmouth Road became full to capacity . Could you ask the Town of Barnstable to revisit the logic in putting individual attendees of Cotuit Center for the Arts' sponsored events on the honor system when arriving for events . I am once again taking on the role of traffic and parking enforcement . I am not sure how I am supposed to respond when cars start piling in at 17 Savinelli Road and the patrons then walk over to,activities at 4404 Falmouth Road . Thanks-Mike Shea f f Anderson, Robin From: Florence, Brian Sent: Thursday, December.20, 2018 243 PM To: Anderson, Robin Subject: FW: Savinelli Road For inclusion. -Brian From: Michael Shea [mailto:mshea1011@yahoo.com] Sent: Wednesday, December 19, 2018 9:50 AM To: Florence, Brian Subject: Re: Savinelli Road Oh......and I should mention the new" driveway was poured when the parking lot at 4404 Falmouth Road was extended in the back . I have plenty of pictures if it helps Mr. Perry . On Wednesday, December 19, 2018 9:17 AM, Michael Shea <mshea1011(a),Yahoo.com>wrote: Brian, attached is a photo that illustrates where Savinelli Road used to end (where the old and new asphalt meet). The Cotuit Center for the Arts has admitted to laying asphalt that transverses the entire property at 40 Savinelli Road and connects to a corporate parking lot at 4404 Falmouth Road . Both properties are owned by Cape Cod Foundation Incorporated so I guess they were okay with the idea,although none of the area residents were notified of any change to the road .'The new asphalt has been described by the Cotuit Center for the Arts' legal representation Michael Princi as a new driveway design or a walking path . Could you enlist the help of Michael Perry Sr. of the highway division and ask for his professional.opinion as to whether Savinelli Road has been altered or if the new asphalt is part of a driveway design that runs right past all entrances to the " home " . I am going to file a suit soon and want to understand the Town's interpretation as to whether the road was or wasn't altered . Thanks-Mike Shea 1 I Town of Barnstable SHE t Building Department Services Brian Florence, CBO • BARNSTAI LE, � RN�"� BLE y M^ss Building Commissioner 4YARN'= 1639. �0 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 January 3, 2019 Mr. Michael Shea 1514 Santuit Newtown Road Cotuit, MA 02635 Re: Cotuit Center of Fine Arts Dear Mr. Shea, Thank you for your email regarding the Cotuit Center of Fine Arts (hereafter the Center). In your email you made a request for zoning enforcement for alleged zoning violations by the Center. Please be advised.that I.have entered your request for enforcement into our code compliance system. In accordance with M.G.L. c. 40A § 7 1 am hereby notifying you that I am not required to act upon your request. That is because the basis of your request is essentiallyithe same request as the one I declined to act upon on December 13, 2018 (please reference my previous letter to you). You may recall in my December 13th letter that I informed you of your right to appeal my determination under M.G.L. 40A § 15 within 30 days of my denial. As of this afternoon it does not appear as though you have taken advantage of your ability to make an appeal. Please reference M.G.L. for any remedies that may be available to you. I hope that this information has been helpful if you have any questions please feel free to call me. Regards, Brian Florence Building Commissioner 1 M 3I� Anderson, Robin From: Florence, Brian Sent: Thursday, December 20, 2018 2:22 PM To: Michael Shea Subject: RE: lease agreement/contract Hi Mr. Shea, Thank you for your email however, I am really not sure how to answer you. You appear to be making a request for enforcement but your email does not read like one. It is little more than a series of statements,assumptions, innuendo and accusations leveled at the Town and the Cotuit Center for the Arts. In my last email to you I advised that, "If you are going to make a credible request for enforcement...you will need to be more specific and provide me with citations... as well as supplemental information to substantiate your argument". I removed the Dover amendment references above for clarity but any request for enforcement should include credible facts, code and/or general law citations,supplemental information and a specific request. This latest email does not do any of that. If you would like for me to respond or take some sort of action you need to be clear about why your concerns are an issue and what it is that you are requesting. The only comment I was able to formulate a response for was your question: "could you provide me with a copy of the lease agreement or contract...". The answer is: no,we generally do not request or require copies of lease agreements or contracts made between private parties. If you require such information you will need to contact the property owners of the lease agreements and/or contracts and ask them for copies. With that said, I am not sure if we have any information in our files that may be useful to you but they are public record and you may feel free to view them at your convenience. Our office is open Monday—Friday between the hours of 8:OOam and 4:30pm. Staff will be more than happy to provide you with our files for review while you are here... if you need a document or so copied from our file we will do that for you...if you need a large amount of documentation copied we may ask that you complete a FOIA request and pay a nominal fee. ` I hope that this information has been helpful, if you have any further questions please feel free to contact me. Thanks, Brian Florence Building Commissioner Town of Barnstable 200 Main Street Hyannis, MA 02601 (508) 862-4018 Brian.forence@town.barnstable.ma.us From: Michael Shea [mailto:mshea1011@yahoo.com] Sent: Tuesday, December 18, 2018 2:53 PM To: Florence, Brian Subject: lease agreement/ contract Brian, when you have a minute could you provide me with a copy of the lease agreement or contract that allows the Cotuit Center for the Arts to use properties owned by Cape Cod Foundation Inc. (40 Savinelli Road and 4404 Falmouth Road) for office space,live entertainment, the procurement of alcohol to patrons, dance instruction for a fee, classroom education and so on as part of a single site plan ? If I have to come down to town hall and request it in person that is no problem . Both parking lots filled up over the weekend at 4404 Falmouth Road and the new satellite parking lot/historic 1 building at 4418 Falmouth Road .The overflow parked at the house/commercial building at 17 Savinelli Road over the weekend to attend whatever event was going on afthe main building .Shockingly, putting each attendee on the honor system in order to regulate how patrons come into events isn't going so hot. The issue has now morphed from how patrons.access 17 Savinelli Road to how they arrive for events at 4404 Falmouth Road/ Rte. 28 . Thanks-Mike Shea 2 To Richard Scali July, 11,2016 From:Michael Shea 1514 Santuit-Newtown Rd.Cotuit MA Re:cease and desist request Mr.Scali,please allow the attached correspondence to serve as a last attempt on the partof my family and I,at an informal resolution to stop the Cotuit Center of Performing Arts from infringing upon us.To date I have had no less than 24 individual correspondences with local town and government officials in an effort to protect the rights of my family and I,with little success.There have been few positive developments from my family's perspective since March of 2015 when I first notified the town about the negative impact the Center's activities were having on me and my family.Since then,town officials have only given us a verbal assurance that the illegal bypass created by the Center connecting Rte. 28 and Santuit-Newtown Rd. will not be used,although its continued presence is mystifying.The Center had no prior authorization to build it,they connected Savinelli Road(a private dead-end street built and paid for by its residents) to their main parking lot,and the by-pass created is not on the town map. On April 281h,20161 asked you to look into why the by-pass still exists and you told me you would "look into it". I am still waiting for you to get back to me.You told me that the Center will only be allowed to utilize the residence at 17 Savinelli Rd.for art classes,office space,and a single tenant which has proven to be untrue. On the evening of July 5`h,20.161 counted 22 individual cars come up and down Savinelli Road. This used to be an unusual event, but now has become commonplace.There are only 3 homes on the road and it is a dead end street on the town'map(not in reality due to the Center's illegal road construction).I took the time to videotape the traffic coming in and out.A quick check of the Center's website(see attached web page)indicated that the Center is now advertising a Musical Theatre Dance Workshop beginning July 5`h,2016 for$275 and lists 17 Savinelli Road as'the location. It is being held on Tues.and Thurs. nights for almost the entire month of July and concludes with"two exciting final - performance"to be held at the same location according to the Center itself over the phone.So now the Center is using this single family home on a private dead-end street for art classes,office space,dance instruction,and live performances despite the fact that the address at 17 Savinelli Road is no more a part of the Center than'my home according to the town plan. I respectfully request that the Town of Barnstable issues a cease and desist order immediately prohibiting the use of 17 Savinelli Road Cotuit MA from any and all Cotuit Center of the Performing Arts activity.My family does not wish to be negatively impacted any longer by an unauthorized illegal expansion of the Center into a residential area.We did not purchase a home in a commercially zoned area or theatre district. If no action is taken by the Town of Barnstable,then we will be forced to seek redress not only against the Cotuit Center of Performing Arts,but also against the numerous town officials who failed to enforce their own ordinances and by-laws and protect our private interests.Thank you for your anticipated cooperation and timely response to this request. i CC Attorney Timothy Burke Cc Thomas Lynch Cc Mark Ellis Cc Jessica Rapp-Grassetti Michael P.She 1514 Santuit-Newtown Rd Cotuit MA 02635 i A Cotuit Center for the Arts Page 1 of 1' COTUIT EDUCATE CENTER roen�e .i— ENTERTAIN ILLUMINAT10 INSPIRE Attention Membersi Don t forget to sign in first to get your discounts on tickets. Just click"sign in"or"register"at the tap of the screen to get started. Order your tickets In the Adult or General Admission Category(or"Student"if you are registering for a class)to get your mem your discount automatically reflected in your shopping cart. Musical Theatre Dance Workshop Summer 2016 Tuesday July 12 10:30 AM 3:00 PM Other dates... Musical Theater Dance Workshop-Summer 2016 YOUTH Ages 6-18 with Michele Colley and Kris Hill Students practice and hone their singing,dancing and acting skills in a fun and supportive environment.They will learn basic voica r1e ' of sets,costumes and props,integrating these Into two exciting final performances.' ing age who have a true interest in theater. website www.MusicalTheaterDanceWorkshop.com for more informal ays and Thursdays,July 5-July 28(8 Sessions) AM-3:00 PM at 17 Savinelli Road233.75 dent Register , DO IT, AT COTUIT. https://webfonnsrigOIbo3.blackbaudhosting.com/48291/Musical-Theatre-Dance-Worksho... ` 7/11/2016.' i From:Michael P.Shea 1514 Santuit-Newtown Rd. Cotuit Ma.02635 To: Richard Scali Town of Barnstable Ma. July 25,2016 Re:cease and desist request Dear Mr:Scali, I respectfully request that the Town of Barnstable Immediately issues a cease and desist order prohibiting the Cotuit Center for the Arts' use of the single family home at 17 Savinelli Rd.and Savinelli Rd. itself(a private dead end road according to the Town of Barnstable plan)to promote and facilitate its activities. Furthermore,it is my contention that the use of said home and road by The Cotuit Center for the Arts,constitutes an unlawful expansion and is an infringement upon me as a home owner in a residentially zoned area,and as an abutter of the Cotuit Center for the Arts.As I have mentioned to you previously on a number of occasions,Savinelli Road was'built and paid for by the residents of the street at the time of its construction,and the Cotuit Center for the Arts has no legal rights of access or easement.The Cotuit Center of the Arts illegally connected Savinelli Rd.to their main parking lot at 4404 Falmouth Rd Cotuit Main 2011 without any pre-approval from the Town of Barnstable or the residents of the road.While I understand the financial structure and philanthropic nature of the Cotuit Center of the Arts will allow it to operate with less oversight than commercial business,this in no way mitigates the negative impact the Cotuit Center for the Arts'illegal use of Savinelli Rd.and the single family residence at 17 Savinelli Rd.is having upon me. f I have a.r€ght to remain free from all Cotuit Center of the Arts activities that are being facilitated through the illegal use of Savinelli Road and property at 17 Savinelli Rd.Cotuit Ma.,and I will pursue any legal remedies available to me should they continue.At this time I am not filing a civil suit against the Cotuit Center of the Arts or any Town of Barnstable officials,as I hope we can resolve this matter without authoritative involvement from a Massachusetts court.I am not under any circumstances however,waiving any legal rights I have presently,or future legal remedies by sending this letter.This order acts as ONE FINAL CHANCE for you to take appropriate action and protect my rights as the ' v ' property owner of a single family home,on a private road,in a residential neighborhood. Please respond to this request within 10 days or I will consider It a sign on your unwillingness to accommodate my request. Sincerely, t Michael P.Shea 1514 Santuit-Newtown Rd. Cotuit Ma.02635 Cc Attorney Timothy Burke Cc Thomas Lynch Cc Mark Elis Cc Robin Anderson Cc Elizabeth Hartgrove / '" / 1 7 message Page 1 of 2 Anderson, Robin To: Scali, Richard Cc: Perry, Tom Subject: Cotuit Center for the Arts Richard, I reported to the Cotuit Center for the Arts on Friday afternoon with Bob McKechnie. We drove around the entire site, exited the property, drove up Falmouth Rd to Santuit- Newtown, turned and drove up Savinelli Rd to the gate. There was no evidence of any new pavement or readiness to pave. There were no prisoners or manual labor to be found. The area in front of both sides of the locked gate (barring the access from the Center's property onto Savinelli) was undisturbed and piles of leaves and debris remained in place, the result of plowing during a previous winter snow storms. The house on Savinelli that abuts the Cotuit Center for the Arts property had a single car in its driveway. There were sections of old fencing piled in the front/side yard. These sections appeared to be have been taken from a small.area running the property line between the water department parcel and up to a couple of sections of fence ending with the Savinelli gate. It also appeared that some fencing may have been taken from in front of the residential property as well.. _ . During this inspection, I was trying to ascertain if the alleged paving was a footpath running between sites including the another residential property fronting on Falmouth Road (just down from the gas station). We made another loop to see if there were any signs of activity. On the second loop, I was able to speak to the director's assistant. She admitted that a group of prisoners were performing some work on site and reminded us that they are a valid non-profit and as such they are entitled to obtain that service. She was worried that the complaint involved behavioral issues. I assured her that that was not the case and she told me that all of the prisoners were well behaved and respectful.. I inquired about the nature of the work and she stated that the are to be re-roofing the house on Savinelli and relocating the fence. She said the relocation effort was to provide better and improved screening between their property and the neighbors. 1 asked about paving and she said that is not part of the proposal and they understand that any access change is subject to review and approval by the town beforehand. She also advised that the residential dwelling is occupied (currently by one artist) but occasionally by actors or artists. The upstairs is used for educational purposes as allowed by the non-profit educational status afforded to them. , Ultimately,.and in the absolute absence of any evidence concerning the intention to pave or create a new access, I have to table the complaint for the time being. It was. obvious from the email that the complaining party may not fully understand the non-profit educational exemption that the center operates under. I, therefore would suggest that if that party believes paving is imminent or in progress, we should be notified immediately and while the workforce is on site. This would allow us to confirm the activity, document it and issue a 3/14/2016 i Message Page 2 of 2 } cease and desist order as necessary. �obin Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis,MA 026ol 508-862-4027 3/14/2016 t 11 2017 07:12AM Tupper Construction Co. 15087785010 page 1 TUPPER CONSTRUCTION CO. LLC 546A Higgins Crowell Rd,wEST YARMOUTH,MA 02673 PHONE: 508-778-0111 FAX: 508-778-5010 WVVW.TUPPERCO.COM Date: I w Town of Barnstable :yZm Thomas Perry CBO ' 200 Main Street Hyannis, Ma 02601 ` (508) 790-6230 fax Re: Insulation Permits Dear Mr. Pent' This affidavit is to certify that all work completed for permit application # Issued on L Del V has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets . or exceeds Federal and State requirements. ..Sincerely, Cff U "' -, ►' . Richard Tupper License # CS-69058 Town e of Barnstable A� Buildin ' g�,, _ 0 "�" SorrUntil,Fina tns ection Has Been.Made. .,.: ., s 5r .,.,z ..:v mat Permit �x .W.here�a Certificate oft..Occu an tsr.Re, u>Ired such Bu�ldm -shall Notbe Occu �edunt�l a F�nat Inspection�has been made Permit No. B-17-2453 Applicant Name: EGER, BRYAN D&CATHERINE J Approvals Date Issued: 08/10/2017 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 02/10/2018 Foundation i Location: 57 ANGELA WAY,WEST BARNSTABLE Map/Lot: 133 072 Zoning District: RF Sheathing: /�Db fLZ yrllc Owner on Record: EGER,BRYAN D&CATHERINE J rContractur Name. Framing: /O Address: 57 ANGELA WAY Contractors Licensees 2 WEST BARNSTABLE,MA 02668 Est P�oJect Cost: $70,000.00Chimney: Description: Addition to the left front of house to enlarge[ mgwroo�rri _Permit fee: $407.00 Insulation.• Project Review Re Addition to the left front of house to en'1 -g living room fee Paid $407.00 1 4 ba#e , 8/10/2017 Final a r. If Plumbing/Gas Rough Plumbing: .':.._.. Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authors ed?b ty his permit is commenced within sa months after issuance. All work authorized by this permit shall conform to the approved appl canon ndthe approved construction documents for whichthis permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by lawsand codes. Final Gas: This permit shall be displayed in a location clearly visible from access stteetr road and shall be maintained open for public i peet�o, for the entire duration of the work until the completion of the same. �� R F" Electrical.. The Certificate of Occupancy will not be issued until all applicable signatures�'by'the�B�ild Building and Fire flffi als a�re,pr"oviderl on this permit. Service: TICMinimum of Five Call Inspections Required for All Construction Work ` \ C\ C < g 1.Foundation or Footing Rough: a .. 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health 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 Buildingplans are to be available on site p Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ��J �� Application # ILI 5S Health Division Date Issued !9 1117 . Conservation Division r^ Application Fee JJ Planning Dept. Permit Fee -1 00 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis `� G�G Project Street Address S 7 i Village Owner r� Address /) Telephone L 1( G/ q q 5-g1� 7 L� 7 U y 5 7v2 Permit Request F)�- b�-nr 0-/ h 0 ten la rqC LI'Y'I' Square feet: 1 st floor: existing proposed 2nd floor: existing 10�proposed Total new Zoning District Flood Plain Groundwater Overlay 17 x tL/I Project Valuation Ni 009, Construction Type Lot Size /•go a G Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi ftr&h#fi units) Age of Existing Structure U YtS Historic House: ❑Yes No O Old King's Highway: Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other AUG 0 2201, T � Basement Finished Area (sq.ft.) Base�in/q 061 t,Unfinished Area (sq.ft) Number of Baths: Full: existing new 0 Half: existing I new Number of Bedrooms: existing _new 0 Total Room Count (not including baths): existing LP new / First Floor Room Count Heat Type and Fuel: 4 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ?'Yes ❑ No Fireplaces: Existing New Q Existing wood/coal stove: ❑Yes No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:0 existing ❑ new size _Shed: ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION ,/ (BUILDER OR HOMEOWNER) aName ( ath, (:� 6 Telephone Number�� q`� rJ ,5 Address e�� �� License# /� Home Improvement Contractor# Email (� CO m�� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATEfJ/7 ~ FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED _ MAP/ PARCEL NO. f ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ®K FRAME D ��Db/'7 R INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. . T7z,-Commorriveafth of Afassadiusetts Aeprartineut crf1jru arstrial'Accidrari<s o ce of�i"_Wd94#W s 600 Washi rgtt`o -treet Boston,LEA 02111 ; -- twviiLm tsygaWia ` War.lers' Camgpens3flma Insurance Affidavit;13.w'lde:slCantracturs/EecftkianslPiumhers AppHcant Infw=fsant Please Print CNaa�en ,rr= anv�4i4nlFntdnal ! dies: APa&A ccity-Istat,i IN r Phan Are you an employer?Checktheappropriatebam ' T of ro eel r I_❑ I am a 1 wifh am a general contractor and I Type P ] (required).: employer 6- Q New consrraction employees(full arEdor part�ime�* flare hired.Sne sib-caakiacfos . 2.❑ I am a sole proprietor orpartner- listed outke attached sheet~ 7- ❑Remo&-.hng ship and have no employees These sib-cadractors have 8_,[j Demolifiba worming for.mri is any capacitg. a employees and have woAners' 9. ❑S.uildiag addition r Lldo vupdm ' comp.insurance comp-insurance I required� 5. We are a corporafien.aid its la[:]❑Electrica repairs or a,dcr -ns 3_❑ I am fiomeovmer doing all work offceashave exercised their 1L❑Plumbingrepairs or additions. f" myself No yokkers'gip- rigbt of exemption per MGL U❑Roofrepairs insli-nce repaired-]i c.152,§1(4)6 andwe have no employees-INN workers' 13-❑Other comp-insurance requinA] '-x "8ayappricmtdistchedlaboaftlt�rstalsaSIlath�secHoabeIawnzdageirsuozjcers'compensa5nupa&cyiaformsao� ' ~ fi Homwwnersvrlo submit Ehis dfi&v"u kffiC .g they lynching RUWa k=46M M autddeeantmetnrsamst MbmitanewsffidaVt iadia6ug sacs- fCaattscfursffa.%tehectf}risboormaststtRd, tar.addiii—ilsheetffiawinglicenseeofthesub-coutAozrssurdstyewhether.oroatflaresiti&sh&ve empatr}eas.Ifffiaml-cantisfIncs3ucetmiployees,they xffistgmv-idethek srorken'-mmp.palkynamber_ lam art ,SoNv is the poficy curd joh the €rr•jarnzat€ n. Insurance Company Name: Policy-441 or Self-ins-l icAt ExpisationDate: Job Mtn Address City/Stafe/Ew: Attach 2 copy of the warkere compensationpolicy-declwation page(showing the policy number and expirafion date). Failure to secure coverage as requiredunder Section 25A of MGL c-157 can lead to the imposition of criminal penalties of a fine up to$l,SOQOQ andfor one-yearimprLisonmen as well as civil penalties inftie farm of a STOP WORK ORDER-and a$me of up to$250-00 a day against the violator. He advised that a copy of this statement.maybe forwarded to tlne Office of Itrestigahons of the DIA for insurance coverage imriflmdon_ I*kera6y c atdar tjue paws and iabY r a,�ger cr flu&tTis irrforeur&nl?rm d a€rots fs bars arrd carrect (Sit ie� I Date- Q j"zciid use wiry. Da not write is t ds am;to be compfeted by diy artomri of j`rciat City or Town: PernatEicense L Board of Health 12 Bui ing Department 3.CitytTown Clerk 4.Electrical Fnspector S.Plumbing Euspector :' 4 6.Other Contact Pierson: Phone#: c0111S Mae General Laws chi M reques all eropIoy=to provide w013'campensation for flies eanplaT= this ,an errplQyee is defined as";eveaypessonin the seavice of another under any contact ofbhe, empress or mTlimc oral or vrith .." dal,Parf a=bip assoc tco3.corParafron or other IegaI easy,or any two or more An emplrryer 3s defined as an m eaves of a deceased employes,or the of.ffi:foregoing= gd m a joint ,mmdinchrdmg$ne legal recees ustee;iv or tr of as individnal,p��,association.or other legal entity,e mploying ho resides therein,or the r thf-_occupantof the- yam- However the owner of a dWMMI g house having not more than three apartments and dweIIing house of another who employs pem=to do mail ce,conSIracrf_i on or repay woik on such dweIIing house or OIL ttie grotmds or burldmg appt�lherefn shallnotbecanse of sash employmeantbe d=nedt o be an employer_" MGL chapter 152,§25C(6)also states that¢eyergstate or local licensing agency shallwithh.old•fie issuance ar renewal of a Ticer r r-or permit to operate a buskess or to construct btuildmgs in the commonwealth for any. applicantwho has notpradnced acceptable evideu"of compliance wjM tbr-insurance.coverage r-egnh�df tionaIIy,MGI.�#152,§25�sus'N6itfi=the caa¢aanwealih nor airy ofits political subdivisions shall Addi eater min any contract for Elie p ofpubhu woEk marl acceptable evidence of compliancewith the iasm`� ._ reginreanents of this rlrapterhave iieen.preser�d.in the coniracting.anihority." - APPIica'its Please fill o-ct the wodmms'compensation affidavit completely,by chwidn.g th a boxes'&at apply to your situation and,if ly sah-co =(s)name(s), a&hr-ss(es)and phone n�ber(s)along withtheir c�cste(s)of n suraacY, Ljj pmtm�h' s ono Io ees other than tine in3�fmce. LmmitedLiabdity Compame$(LLG)or j..�itadLiabr7ity- erg (�) �P S' members or parfnea-s,are not rbgkrd fn cazry wart::&caarpensatian insurance. if an LLC or LLP does have employs,a.policy isr�red. Be advised that this affda-vitmaybe snhmit�dtatheDepadment of Tnd„strial Accidents for conErmaiion of�mce coverage. Also be sure to sign and dafe;re affidavit the affidavit sTiould be•re nmcd to fine city or town that f e,application for the pewit or license is being rcq'uestA not tLe D eparfinenf of Lnd r,ct,tat Act Slionldyotr have any gnas'tions rega�mg the law of ifyon are rvpmrd to obtain awor£ccrs' comp=sationpolicy;please call theDeparimentattbenumb=listed below Self-mscr��Paniesshonlde rhea self-insnr-�ce jice�se number on the approgaafe Ime:" C�ity or Town Ofbccials. _ Please be sure that tho affidavit is complete andprin_Eed legibly, 'he Department has provided a space at the bottom of the affidavit for you ort in fat)event the Office oflnvesfi, ag has to cor±actyouregardmg 1tie applicant Please be sore to fill in the peamh/licrose comber which will l be used as a reference nnmbes In addition,an applicant that,must sabmit mull ple pesrohUcrose appEtalions in any given yew,need only sabmit Me affidavit mdir. ti g coseat Or policy information(if nay)and under"Tob S'RrAddreseite applica.1t shotldwrite-all locations in ( ' town)_"A copy of the-affidavitthathas been officially stamped or malced bythe city or t owa may be provided to the applicant as pmofthat a valid affidavit is on file for fidrme•peunits or licenses Anew affidavitm ist be filled Ott each year.Where a home owner or cfti=L is obtaining a license or pe nnit not related in any business or commeacW (ie_a dog license or permit to bum ltaves etc_)said person is NOT rcqaked to complete this affidavit e Office of Invesfg s would 1-km to thank yo-a in adrmce for your cooperation and sbovldyou have any questions, please do not hesitato to give us a call The gepazimm rs address,telephone and fax earr Dupactmeat C6f A oDideutt IL BadMA,R111 TeL 4 617— -49W cxt 406 car 1-977 MA W3-� Fax#617 72'-7M IZevised424-07 p €rri e Idl Town,of Barnstable Regulatory Services ' °1FjHKE rq` Richard V.Scali,Director Building Division sAnNsrAl= •' Paul Roma,Building Commissioner Hasa. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION ' Please Print DATE: JOB LOCATION: � w �— � number/' �'�Y i street village / "HOMEOWNER": %J"-, /� name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The under ' "homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proce ur uirements and that he/ c�om with said procedures and requirements. Sign of Hom wner 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 �"E Town of Barnstable Regulatory Services ` RAIDGMAME.PIAM ' Richard V.Scali,Director. Building Division. Pant Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 \ Fax: 508-790-6230 J V Property Owner Must Complete`and Sign This Section If Using A Builder w as Owner of the subject property hereby authorize to act on,ray behalf, matters relative to work authorized b this building ermit application for. � in all y �P PP (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant I Print Name Print Name P Date QTORMS:OWNERPERMISSIONPOOIS 8/2/2017 6:59:05 PM PST (GMT-8) FROM: 100005-TO: 15088885184 Page: 2 of 2 ACOC ® DATE(MMIOD /YYYY) CERTIFICATE OF LIABILITY INSURANCE 8/2/2017 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 have ADDITIONAL INSURED provisions or 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 endorsements . PRODUCER BYRNE INSURANCE GROUP INC NAME, PO BOX 1908 PHONE FAX 114A STATE ROAD UNIT 2 EINI "�Noll: SAGAMORE BEACH, MA 02562 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# PISURERA: LM Insurance Corporation 33600 INSURED INSURER B: B& B EXCAVATION INC 14 TEABERRY LN INSURERC: FORESTDALE MA 02644 wsURERD: INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: 37098583 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 DDL SUER POLICY EFF POLICY EXP LIMITS LTR WVD POLICYNUMBER MMIOD MMIDD COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE MOCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 0 PRJECT ❑O LOG PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY - COMBINED sirTGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLALIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION WC5-31 S-385112-017 4/8/2017 4/8/2018 STATUTE I I ER AND EMPLOYERS'LIABILITY " YIN ANYPROPRIETORIPARTNER/EXECUTIVE - E.L.EACH ACCIDENT $ 100000 OFFICERIMEMBEREXCLUDED? N/A - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION KATHY EGAR SHOULD DXPIRAATION DATEDVE THDESCRIBED EREOF, N0710E POLICIES MLL BE DELIVERED ELLED BEFORE IN 57 ANGELA WAY ACCORDANCE WITH THE POLICY PROVISIONS. WEST BARNSTABLE MA 02668 AUTHORIZED REPRESENTATIVE d LM Insurance Co oration ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) Tht:ACORD ndtnt:and luyu die It:yibtt:It:d uem ha of ACORD 37098583 1-385112 17-18 WC n0270258 8/2/2017 6:57:28 PM (PDT) Page 1 of 1 DPFUCCI-01 KALLIETTA ACORD" DATE CERTIFICATE OF LIABILITY INSURANCE FE(MMIDDIYYYY) 07/31/2017 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 have ADDITIONAL INSURED provisions or 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 CONTA E:CT NAM Almeida&Carlson Insurance Agency,Inc PHONE FAX PO Box 554 (kcpp��No,E�ct):(508)540-6161 (A/C,No):(508)457-7660 Falmouth,MA 02541 RANESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:ARBELLA PROTECTION INS CO 41360 INSURED - - INSURER B:Hartford Underwriters Insurance Co D P Fuccillo Const Inc INSURERC: 548 Thomas Landers Rd INSURER D: E Falmouth,MA 02536 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ?N DLTRDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR 8500045173 10/20/2016 10/20/2017 DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ X BLANKET ADD'L INSURE MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 7GL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑j�T LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ AUE ParOacEciRdentDAMAGE $ TOS ONLY AUUTO�ONLDY $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY 5B659382 10123/2016 10/23/2017 TAT TE ER 500,000 ANY PROPRIETORIPARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $ QFFICER/M�M EXCLUDED? ❑ N I A �(MMandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Ti DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached it more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CATHY EGER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 57 ANGELA WAY ACCORDANCE WITH THE POLICY PROVISIONS. WEST BARNSTABLE AUTHORIZED REPRESENTATIVE "at� ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A6ev CERTIFICATE OF LIABILITY INSURANC E E DATE(MWODYYYY) llk.� 07/18/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT _NAME: _Fred Pas$aro _ PASSARO LEVERONE&BUCKLEY INSURANCE AGENCY INC _(A/CC,N o..Ext): (508)398-2223 ^� ^j am: E-MAIL ADDRESS: fred@plbinsurance.com 239 ROUTE 28 INSURER S)AFFORDING COVERAGE NAIC# DENNISPORT MA 02639 INSURER A: ACADIA INS CO j 31325 INSURED INSURER B: BRIAN SHANAHAN INSURERC: -[ DBA BRIAN SHANAHAN CONSTRUCTION INSURERD: (( 32 GOFF TERRACE INSURER E: CENTERVILLE MA 02632 INSURERF: COVERAGES CERTIFICATE NUMBER: 174154 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ,ADDLISUBR POLICY EFF i POLICY ERP LTR+ TYPE OF INSURANCE 1 POLICY NUMBER MMIDDIYYYY 1 MMIDDIYYYY 1I LIMITS COMMERCIAL GENERAL LIABILITY [EACH OCCURRENCE S DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence S �. MI ED EXP(Any one person) Is _ N/A PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: 'GENERAL AGGREGATE It$ POLICY❑JECOT LOC I - PRODUCTS-COMP/OP AGG 1 S. i OTHER: I is AUTOMOBILE LIABILITY l (COMBINED SINGLE LIMIT S • e(Ea aceident)r ANY AUTO 1 BODILY INJURY(Per person) Is ALL OWNED SCHEDULED - AUTOS AUTOS N/A BODILY INJURY(Per accident)'S NON-OWNED �PROPERTY DAMAGE HIRED AUTOS AUTOS ( 1((Per accident IS I 1 is i UMBRELLA LIAB I OCCUR I I EACH OCCURRENCE Is EXCESS LIAB CLAIMS-MADE N/A - �.AGGREGATE Is DED 1 1 RETENTIONS S I WORKERS COMPENSATION - ! SPER TATUTE I I OTH.AND EMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNEWEXECUTiVE E.L.EACH ACCIDENT I$ 1,000,000 A OFFICERIMEMBEREXCLUDED? NIA NIA. NIA MAARP301005 01/03/2017 01/03/2018- (Mandatory In NH) I E.L:DISEASE-EA EMPLOYEE $ 1,000,000 If yes•describe under DESCRIPTION OF OPERATIONS below - ' E.L.DISEASE-POLICY LIMIT S -1,000,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) III Workers Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts.' This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/invesfigationst. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CA-T'HY EGER ACCORDANCE WITH THE POLICY PROVISIONS. 57 ANGELA WAY AUTHORIZED REPRESENTATIVE F� WEST BARNSTABLE MA 02668 t—''"'t t( Daniel M.Cro4vJey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD LEGEND �� _��,, ` - NOM 1i7.` V LOCUS MAP } l SITE PLAN 57 ANGELA WAY WEST BARNSTABLE, MA ��` j '•+�; w�` °"� BRYAN EGER DC8 i 17 159 T Barnstable Old Kings Highway Historic igtrid ® tte 200 Main,Street,i-lyannis:MA 02601- TEL. 508-862-478T Fax`508 862-4784 ��Fp NtP��`� ,• , APPLICATION, CERTIFICATE ®F APP OPRIA.'TENESS' Application is hereby made,with four(4)complete,sets,for the issuance of a.Certificate of Appropriateness under Section 6 of Chapter, 470.Acts and Resolves of Massachusetts, 1973,for proposed work as described below,and.on plans,drawings,o hotographs accompanying this application for: Check aQ categories that apply;. 1. Building construction: ❑ New'' Addition Alteration „ 2 Type of Building: Yp �House ❑ Garage/barn ❑ Shed . ❑ Gommercq�� her 3. Exterior Painting,r�oaf ❑ new t6of ❑ color/material change,of,trtm;siding,widow,door..;�'1J . T 4: Sisn : ❑ 1\ew, Sign '❑ Existing Sign ❑ Regainttng Exasttng Si 5. Structure: ❑ Fence ❑ Wall:' ❑ Flagpole ❑ Retaining wall, ❑ Tennis court 0. Other 6..Poo( ❑ Swimming ❑. Other,man made pool ❑ .Solar panels ❑ Othee Type or Print Legibly: Date /�! a NOTE AU applicadons must be signed b�:the:curr-enl owner. Owner(print): l�� 9 "`\ /f. i Telephone#.' Address of Proposed Work:� Ci a •Village ��b ar�S��LVtap Lot#: Mailing Address(if different) Owner's Sigatature Description of Proposeq Work: Give particulars of work to'be done: �' . d�-� P v s��d fy i a d. Agent or Contractor(print): / !/��f " ephone.#.. ) Address: v s !!)y fm �-- Contractor/,Agent:'signature: D •``2' O For comnitittee use,only. .This Certificate is hereb PR0V /DENIE i I1aYe v IVternbe rs,sagnatata es ^ APPROVE MAY 1. ,0 2017 Town of Barnstable Old King's Highway . Committee Q:1&mrdc and Connniatrianb4Qld Kingv Highi ai10K11 ApplicationsWK11 DRAFT 2011 CerrAppropriateness DRAFT.doc 1 f .. CERTIFICATE OF APPROPRIATENESS SPEC;SHEET Please submiit.5.CopaeS Foundation Type: (Max. 127 exposed)(material-'brick/cement,other) Siding Type: Clapboard shingle =other. Material: red cedar Pwhitece'dar other Color. Chimney Material: :Color:' Roof Material: (make&style) T�GLf 1'L' 7" Color: Roof Pitch(s): (7/12 minimum) I (specrfe on plu�zs fnr ne.►r huilcicngs, i�rajnr.arldrlinr�s) e / Window and door trim nznlerial: wood W other material specify Size of'cornerboards- size of-'casings(1 X 4 min.). Rakes Ist member 2." member_ Pep. of overhang Window: (make/model) � material color ?�tr (Provide irin&m, schedide(ih plait jar:hew buildhigs;:ntitjur rtddruons) �Q A ��� !Window grills(please check all that all). true divided,lights_ exterior glued grills- grills be tote n Rlass removabfe interior_ done Door style and make: material Color. Garage Door,Style Size of opening, . Matenal C61or Shutter Type/Style/Material:,o Color. GutterType/Material: N VV Color. Deck material: wood\ other material,specify { Color Skylight,type/make/modeU material Color: Size:' Sign size: Type/Matenals:' Color:. Fence Type(max 6')Style material: Color Retaining wall: Material: Lighting,freestanding \ on building illuminating sign OTHER INFORMATION: THE ATTACKED CHECK LIST MUST BE COMPLETED AND'SUBMITTEII Please provide samples of paint colors,:ma ufac brochure of windows,doors,.ga rage.moor,frencestattap.posts etc Signed: (plan prepares) 1'nnf Name, 4/1 QA#oxi -and C omndssiomiWld Kin High o"gKfl Appii an oqqql DS4FT2011 Cert,{tppropriplcmess DIL4FT der r e_ Town of.Barnstable Old Kings Highway Local'Historic..District:Committee CHECKLIST -- CERTIFICATE OF APPROPRIATENESS., Pleave check the applicable categories; This check list must be completed mul submitted wiih your application. 1. ALTERATIONS(new paint:color,changes to siding,roof shingles,windows or door.etc.)­ Application for Certificate of Appropriateness,-4 copies;, - Spec Sheet,4 copies;brochures and color samples, Plans of building eleuatioWphotographs 5 copies,.ONLY.'IF there;is a change to'the location and size of window(s),or doors j. Fee according to schedule:.. 2. MINOR ADDITIONS e.g.decks,shed (over 12&sq:feet) Application for Certificate of Appropriateness,`5.copies., Spec Sheet,5 copies;:brochures,and color samples, ' Site.Plan,5 copies,ONLY if there is a change to the building footprint: A site plan drawn on.a.mortgage survey plan or GIS map�may be used for minor additions,UNI ESS the.porch,deck, pool,or shed etc.is close to:l:ot lines,.zoning setback.lines,or other buildings,in Whichcase a certified site plan must, be submitted,see requirements as.applicable,see 4-Site Plan,below. Photographs(I copy);of all,building,elevation affected by anyproposed,alterations:..; Plans: 5 copies plus 1 at reduced scale to fit 8.5 x:L1 or 1.1 x 17 paper. Company brochure of manufacturer's;shed OR to-scale sketch,ofaffectedstructure, orbuilding elevations. 3. STRUCTURES,,NEW/ALTERED(fences,new: tonewalls or changes ao,retainmg iwalls,•pools:etc) Application for Certificate of Appropriateness Spec Sheet,brochures or diagram. Site plan,see Instructions 2" Site Plan,,.above. . R&O Photographs of any existing structure that will be affected.'by change. .�'TTW173 Fee according to schedule. 4R) , �, 4. NEW HOUSE,ADDITION OR A COMMERCIAL Rt)ILDIN �V � j Application for Certificate.of Appropriateness,(4 copies). Spec Sheet,5 copies,brochures and samples of colors NT Site Plata,5 copies,at an appropriate scaie.' 5 copies of site plans at a reduced scale,to fit 8.5"x I 1 or 11 x 17 paper. Site Plans shall contain the following: Name of applicant,street location,map and parcel: _Name of architect,engme.er,or surveyor;:original'stamp and signature;,date of plan and revision dates:; _North arrow,written and drawn:scale. Changes to existing grades shown with one-foot contours. Proposed and existin91 footprint.of the'building and/or structures,and distance;to lot lines. Proposed driveway location. Proposed limits of clearing for building(s),accessory structure(s),"driveway and septic.system: Retaining walls or accessory structures(e,g..pool,tennis court,,cabanas;barn,garage etc.)- wilding Elevations:' 5 copies:of plans at a:scale of,1/a"=`l foot;a written and.drawn scale _5 copies of plans at,a reduced scale to fit 8.57k i l or l l x-1 paper ... f. QABoardt:andConunissiu&5\Old.Kings liiBhway\OKHAP lrc.ationsOK1IDRAF2011 Ceri APProPriatenessDRAVraoc � '. Plains shall,include the.following: Name of applicant;street location,map and parcel. —Name of Builder Designer,or architect;original signature,of.plan preparer:and stamp,plan`dace,and all revision dates: ALL NEW:HOUSE OR COMMERCIAL BU1LDiNG:PLANS MUST HAVE AN.ORIGINAL. SIGNATURE AND STAMP;IF ANY,,BY A REGISTERED ARCHITECT,MEMBER OF AIBD,.OR A LICENSED MASSACHUSETTS HOME IMPROVEMENT CONTRACTOR,LINT LES$71tS REQUIREMENT IS WAIVED-BY THE OKH DISTRICT COMMITTEE. A written and bar drawn scale. Elevations of all(affected)sides of<the building with dimensions:.including height frofn the naturalgrade I. adjacent to the building to the top of the ridge• location and elevation of fmished'Qrade.roof Aitch(s)dormer setbacks-,trim style window and door styles.'Chanees to existing buildings must be clouded on drawings. _Window schedule on plans. Landscaping plan,S copies drawn on a certifie&perimeter plan containing the following.A Name of applicant,street address,assessor's map and parcel.mumber APR Name,.address.and telephone number of"the'plan preparers plan date and daterevIsions; ' 7 —The-location-of existing and proposed buildings and`structures,-and lot'lines. ,r,..w `Q r iG Natural features of site.(e.g.rock outcroppings,streams,wetlands,ete) : : EL1Jr _Existing buffer areas to remain.. . is Location and species of trees'outside;ofbuffgr areas'`greater;than 12"caliper to be:retamed:or removed s — : _The location;number,size and name of proposed new trees and plants.:-,,:,, Driveway;parking areas,walkways,and patios indicating materials to be used x.. -Existing stone walls ,aad proposed walls includingretainingvalls"for slope retention or septic systems. (for 7, removal of stone walls;file:Demolition Form). - _All proposed exterior lighting and signs. ' 1; `Sketch or photos of adjacent properties,(i copy only).. W. .., A sketch(s)to scale or photographs of nearby'adjacent buildings,where present,along both sides of the street frontage;showingthe proposed new house orcommereial building in scale and in relationship to the existing., buildings. Please discuss with,staff if you do.not think this is relevant.to your application. Photographs of ail sides off existing buildings to remain,or being added to(1'set only] Pees according toschedule. Please complete the following; n r 1 't nh,,:.:. Existing building,foot print: Building 1 sq.ft. Building 2 Existing Building,gross floor area,including area off finished basement B:uilding.l sq.ft. Building New building or addition,foot print: Building I sq.ft. Building 2 New Building or addition,gross door area,.inclaading area of finished basement -� Building 1 q ft :,Building 2 4 Q:\lboards and ronuwsiwu\Uld" a H, hway\11KI1 A lirxions\OKI/DRAFT 2011 Cerl A ro iwwness PRAhfidPr } s,,, g PP PP P, P •.�{'"' -'� sty ,,+ '�atf' r `�!:i ,+1'• `ffr � tip• TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map -2 Parcel VApplication # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address ' ";y4 AV� t Village p / Owner / Address f S-/5� ���i�•1U l7 f -�l Telephone v I Permit Request /�'I�/ // �/! �llf� `lave ae CJ Me.1' _blo yee. r dim e�� rr�1lJ'�C � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation• Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family �iK Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing ` new Half: existing new Number of Bedrooms: .— existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas W-Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Othec, : Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ v -" v� Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION F (BUILDER OR HOMEOWNER) Name �D� �� r�� Telephone Number Address 1fis Id License # VLlZ 1?W Of?613 Home Improvement Contractor# -2� J( lh/rl (2 �kc& Od-122 Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM T�S PROJECT WILL BE TAKEN TO 'Almi'Ut SIGNATURE DATE (. FOR OFFICIAL USE ONLY I' t APPLICATION# DATE ISSUED r i� MAP/PARCEL NO. ,s i I ADDRESS VILLAGE OWNER Ii I f DATE OF INSPECTION: j;;<FO.UNDATI.ONt�.'.*-�t.����:_ .�,.Fs:.•�; r�;u,. f - FRAME i k INSULATION FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL .t GAS: ROUGH FINAL y FINAL BUILDING _DATE CLOSED OUT r ` ASSOCIATION PLAN NO. t� r - . . ra Torn of Barnstable O Regulatory Services Richard V.Scali,Director %6;9. Building Division Tom Perry,Budding Commissioner 200 Main Street,U aanis,MA 02601 w�rw.town.barnitable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section Xf Using,:,_A�3uilder 7,_ tc.�u,c S e g, — -_ _--,as Owner of the subject propert)r hereb authorize �1 * 4'y aA to act on my behalf, in all matters relative to work authorized by this budding permit application for: JSI�f Sc,�fi,� - Q-A AV* -M-A 0 2 G 3S (Address o TJ 0b) "*Pool fences and alarms me Lhe responsibilky of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted- igna of Owner Signature of Applicant ��crG�C�I ��►C'ti�., _ _ Print Narne _ Print,Name r Date Q:Fot�s:ow:�.xpe.�t.+�sstoNvcx�is - � '` ��C�'� �E�T1F�C�4T� CIF L1�►B�LITY �IVSUI�ANCE w �at�fzo�sr THIS Ci~R7IFIGATfi'tS ISSUED AS A,RAATTEftt OF INFQRMATIpId ONLY AND COAIFERSr NO RIGHTS 1)POtd THE CEEtTTFiCATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMAtIVELY.OR NEGATIVELY AMEN© EXTEND OR ALTER THE'C.f3VE.RAfiaE AFFORDED BY THE,PQL►GIES $FLOW ''THIS CERTIFICATE: OKItaSURANCE DOE$:NOT DO I5TITi�TE A GOFI7RACT,'t#ETY1 l:,THE,i55WMO INSt1REftlS) AUTHORi�ED REP-RESENTATiVE-OR Pft0000,12R;ANtl THE CEtiTIFI GA fE tl01 17ER AMP.ORTANT.-Af tho cortificate hoider;is an ADDIT'10NAL.INSURED,.ttie poLcy{iesj must he`rendDrsed if$tiBROGATION 13:WAtVED,subject to the terms and conditions of the Policy,certain°pofigles day require arrendorsemet%t A statement an;;t certf9cate does not earlferrights to the; cerGFCateholderiro u66 cf such endorsom®nt[s}: PRODUCER REACT S:ori F1tk"* a .CL Southeiastern Zissuraiice Ageaq, Inc,.- (505;99? SD61 'FAX t5na1� �t91r zti31 439 State Rd €fstz@southeasternlris roan ADDRESS P..a $ t, 79395 INSI)RER{S)AFfDRDING00VERAGE PIAtCA 1NSUREii:a l3rlselia xPrbtaat ori' surarice 41350 vasuRERe•Boston;':Snsuraace Brokera`e 2nc � � Tupper Cgnstruction'Go TaLC? saSUttC:: - - 5e6A iii gga ns Crowell•'RdadT. ': a4ISURER Ei , VfeSt Xarr4o407 tA-i :02673 INSIrMMF. 5 R:: COVERAGES CERTiEICAE NtfA�BER�o5-ao7"s- REW510N�iliM�ER: 7Ht$IS�O=CERTIFY THAT THE POLiCFcS flP INSIIRANGE LISTED BELOW HAVE BEEN iSSUEO j0 TNg INSURED NAMED ABOVE FOR:TIiE PODGY PERIOD:, INDICATED; NOTUVITHS-TANDiNG ANY_f2EQU1RWXftT,TERM OR CaiVDITiON QF ANY CONTRACTOR OTHER DOCUMENT WITH RESP€GT TO Wt11CH THIrs` CERTIRWE A+IAY;SE ISSUED OR MAY.,PERTAIN,...THE INSURANCE`:AFFORDED SY THE POLICIE$ DESCRBED HEREIN IS SUBJECT TQ ALL THE TERMS EXCLUSIONS'ANDCOND1710NSOFSUCHPOLC(CS UMITS:uHDft1+NMAYW'"-.; EEN_ FEl?UCEU"BY-RAID'CLAiMS; y""`' `` iN- _.,,,r._. A ._. .� L. OF;iMSURANCB' POLICY:?ll9A8ER -.._., I f TPdiSYiYYP IJMiTS' :- E X CO?iQRC7Al f?F{dER91 UABftnY _.. �. EAe�e eccuR�I �s 1'oao,gett A CI@AS�nA�iE X acCUR ; 3` oa,o00 { —i—t PR isEs Fts acovtehct,� .5 9S2nOdS299; 2015 ;11/1I2a1'6M t3EXP Anyanepedsen} S S.00D >` PERSONAL&ADVINJURY9 1:OOD 004 $GENL AGGRE -fim�l L MijAFP-UgS PER 5 y GENERAL AGGREGATE S 2u O00,OQG $ POLICY j E» J 4 LQC tJCiS CONtF?Qip AGG ` 2�.OOO t000 ¥AUTOMOERLE UMUTY .- - .. .... .. .. CO I ile aoNED - e — A I SC � �D4ynv. JUG(?8t¢e ��UD I A C an3 S 1020i30S3II9, 12/1I2015 12I1J2©3:6 tHOD1t.YIn9URY Pereta )�S X _ g NCWLOWNED mY pRDPERTY DAPoSAGE - Fit ttDAUTOS 1'�AUTOS {Pe�rardflSn 1 5 _i >_:_> ., r...._ _ u t)nitrestce6irotoiluBl !}hial -5 2Sfl,000 _. UMBRELLA UAB - - OCCUR €: EACH OCGURRENC S .A _ a ELAIM5JAADEi r .j I AGGREGATfi $ z i +'QED' RE 1N710NE >,. #fi0005E368,„.,:.. . 1°ili/2015 °111;1/2 al. 5;;'. q$:. YIDRKEitSCOMPEMSATiON c a ;AND E&iPLOYER$LUiBIUTY Yr , STATiITE' ZANY PRppRIET4$tPARiNERtE MMVE }i L EACHpCCED>tr"t S 1 QOd OIIQ Ii7FFICERtAAE!l6EREJ(CLUDED? telA � w> •w B' IMandatory in NHIwcr,S005S9302Z015A bR/ /29'S :In/SI$Q1G E L-DtSEASE EA E90$LOYEI S 1 000 OOO it yes.CEsrs utYSEi .,..Y - - w--.-- _DEsctrP71DNDF,oPERAfiONs:bsiev, __ ,. .. rl.L:t?iSFr1SE=P0I+GY.uP4t1 :s _....•f ooa, a00. I t a � x e� OESCRIPTtON GF OPERA7IpN51�OCATIONSt VEHICLES(ACORD 74l Ad0IIIw�aI RcmliAca 8chndulS,may Do spRshetl if(nvra S9Eeo u:�equke6j_-::: .:• CERTIFICATE HdL.dER' _ Al1ICELlATlON t - SHtridti3 ANY OF.THE ABaVE DESCRIBED POLICIES 8E CdNCELLEtD BEFGiRf; )r i "6tmat10F1A� purpQgHs o>dly' `rHE,.EXPiRATtOA DATE THEREOF; han V ii1nLL eE t>raiVE >rD {W Tuppe `, ACCdRDAPICE WYTH THE PDLICX PROVISIONS : ' r Construet:ion.Co ,-2�C•. ,r�.... .k. . .�.-.y.. .,.>�..z._. Wr 546A Iia ggins Croraell Road' - W �Yaxmoutts, MA 0 2673."_,._�,� `A!lTHORQED'Ri=PRESENRA7IVE<". _.. : fora F�tzOezaldj��; „ C�7"I988 2494AC(3�20.CORPaRAT10N tAlt rigtatsTel�erved_" ACORD ZS;(2t114t4t)' The.ACOR[y iitameriii togo-erereg"rsleredlearks of AOt3ttD z ,3 2 y�p ppp �s ¢ w. - k Office of Consu er.Affa�rs and i�siness, �gulafi06 IIosion, lVEassaf�husetts Homy I�nPravemn + oiacto Reg�stra#or� Rilistrstror TYPE LLC Eitpfr2;�on ; 4118l2U1S< 'Try a'if283 `TUPPER GONSTRUOTIO GQ, RICHARD TUPPIER 548 A-HIGGiNS CFtQ WAL1,. iD K VI! YARMO:UTH MIA 02673E , update Ad�r antl rnrn sandUl taeIt eacn fob chsa�e sct€j. 2fitAa5l j Address �:_^ Renewal ^fiRnployment ¢:,`bostCerd ' fir Y r urilrr.rtjriff+t�fr{r,JrlPml , __•�� Qftienol`Coasuwer Aft�ira&'tinsweas R utadon` "" Tense or "strahoa valid fartnflfr�dael use on x y € HOdAE iMt'ROVGNIENr COtaTTRACCOR ti8fora the s attorn date! if foend rmr to Registra>bon �7g�34 OfficeufjConsitn,erAf#afisandgeainess_Re uiatiup` °fxptratton 4l1f#12018; LLC t4f' ` �ut!$t65�79 TiIPPV2 CC3NSTRtJCT10Td C ;-f 1 C RICHARb:;T11PPEt2::: S46AHIGGI'NS blio ELLRD' ;Y YARMOtfTM MA'd2673 .s. iTsders'�oret�ry .: f�Tot i Wiithdut sf�eature . .a° 'ensAa°`y.N�-H YmY��'wF24hfc-.tu%4' - 1fl7�emtes t3aacf Su_ife_210 '�� Mai#a, UY 1202q ;�8T.7}27d.1294- - • avvvar�pl arg s F. Gh W Tu r. *; a � ouao .i 7,71 "ss���rs,�son �raT�tsaS.nsu�tP�AatoN: � :>- il�rosirieted Buildings ofo}'use group wlueh aa€da + � _. confaui Less than 35OUtf aic feat°(�913)of ' e enclosed space. nae GSi9�48�°` s AJER WestYarsuout��7IA i Failure�possess a wtrent edhian of the M�assachisetts ;. ,o ., ����s Mgt � ; � State Bifi�ding bode is cause for revacat}4n of t#t�s IIC+e�se :. 1.,�,...�►,,,�r �P r ,�� t�orDPSilte�uinginfotmidanVlSit, an�vWMass.Gov�HPS.,. '�' +�o���i� ` y, ��� el wowwon W �,f lt�lussa�hatss 3eprrrtme�tl of tdustrr41A4 fde%ris Oc�:o,fitv �igatarrar l ostar �42- 114-1 01 wWwtM ass gaol x Warkers'Competns�to;nt�ns>grance A�t�u�at �iic�erslC�ntr��it�r�sl.�le��ric��s�l�affilrrer� A1� 1rc�ntkinfortnAtiom._ �_�'leaseJPtt tle Ibl �; Natt a usirie s�t�r aattata!Ir dn;tdt,at} SUPPER ,_. UCTI0 Adcltess=546A Htt;tINS eRa RD Gi . /StatelZ WEST YAptIVtOtJTti MA Q2673 P €lne, . 508 78- t 1;1 Are-you ant emntoyer�.Chec i tl,e appr"opa gate Taox -l _ £ __ ypaOli"ojd�1't�iet�llirPA1?,.® t ain s employer with �� ❑ 1 am s'geod'a ontrat:tor and t em tos #all and/or : haver ,b tied#he,st contractors ❑New corlstctcr,an p } ( partrt,me) ` tts£edy;tan tlt aktached sheet . 7 lternodeltn 2'.❑ ,am a Sole,proprl-o or or pdirinea- ship and hay+e my employees � :;� b�! cta :b $ i?etnoltttn; ��orktng fvr the tn:alty capacity otsers'` ❑ eom `tnsutnee`. 9 Qwlding;adtltt�ot% INd workers' compµ tnsut?ance 1?. requu ] 5 ❑ We arp a corpctaatton and ris 1't)❑Electrical° pours 9r additions 3 ❑ I am a hame�wtier do,ng all wvC officers have �cerc,sed their ' .I 1 ❑T�1;utntneepatts or adtlittns ,. n t ct exem� do er MCt.: thyself �o yvorkers' eti,a}p l P I2[�Rtiofrep l's ,nsi}ranc reuareci e i 5 , t{ ?,attd s have ttb 1NA`I"HERtZ1�TIQt et»pto�ees ( o tivoters.: t`3�:C3t'ner lttsurane required _ Pa,}applicant that also hli out the seaxstm bett►w stit>mng tteetr wnti�ers.catensatton poi, xaforrnatmn t:FiomeAVF-iteis rho submit yhu`affidav,iirid,eabnp tf3py etu c#ofng att i3ort,and thenlure outst8e contracto3s m�t��s�bmd a ne�v�l1'a�Jue7t�nJrsatnS suc#l:, ;contractors-tbatch�ek th,s box=must atmcbed an adthtoaate�t stx,v±uig the aaaie of'thc sub cot�tracEors tad siaatC whether nratoi Asti c,�fttles have. �mployeec,lf`tt�sut>-co,ttrasttis h,,v4 c�i tov '� .•,... .iWA -- ,t) �a:;t}iCy must.�tnwtte the,r iv©,leis cons p fwlicy numhet � _.._w ._ I am an�ntployer that�s prowttln�,t+urkers'`eo>�etttati�n i`,�trsuce,/t+r�aa eny��cryees ;_Below is the poke�tx�Jaib . tnsurance:Comp any Natnts: 1?oltc}�r{�or$elFns Lic..# WOCOt155S32�15A trahonDatr013t16:_.. _ xob Site Address; . 1514 Santutt Newtown Rd CttyJStatrlZ,p�oflt MA 02635 A tttch a?etipyt old the wo #tears'compedsi tto,v palace der aratto� ae s co fu `cl number"An ex .., taon gate}ptrt}. Facture#a secure coveragc`as iequiacd under Seehon 2SA of MGL c xI 52 can lea;i t©the tmpos►ttoti of crttrrtnat peaialiles cif a fist©up t<s;$t,5(}0 t10 bndlai one year�Ynprsolnneiit,trs wel#'as stvit penatt,es to the farm oFa STQI?W 4EtK C?RDFR and_ fjne: of up to"$254 d(I a d-ay against the violator: Be adv,sec$iharapy.of thi ;�atetrn't stay tie fan�ardetlo ttte flfftce of. Irvesttgtiot�s.of err DIA'# cttt;rage verification /y ptians3 tattres;n er 1 , tlraate an arntativn rov�tte!gt5oyca:rs trace..and evrrec t3ate 7/.11 Phone#: 508-778-01 Dff icegE use�nTy Do,n©t tvrrtc do than;rreu,to be cvmpleteD by era3+ui to wit a.. r a� Gty or"t own t'eriitlLl<c$n �ssu"iugAitth6tity{cerete oae)> . A Board of lE3ettP� 2 Build►ngFllept 3,CotyJ'i'o�i+n Ck 4 yEltrctreeai Pastor tPl �tsing Ins #pad: :> 6.U"they C oataPet I'crsoin TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION' 1 , c it@3 nr C` Map `f Parcel I BARN S'j ABLE Application # Health Division }, Date Issued 'J Conservation Division Application Fee sd Planning Dept. Permit Feej c &C -..." wrv"I,prme^.kti�✓Yfv,7 ,11R:�'1 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address ��� � �-�a' �1 1 ' 01O-AA) V �' Village l flN i r _ Owner I�t`� 1�rV'� i�C Address l 114 11 ' G/ Telephone 9 r7 q Permit Request 61)1 , %G v fi 6Yl dear- I-- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District �) Flood Plain Groundwater Overlay Project Valuatio# 19 (� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout /yp a kout ❑ Other i Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 1 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 ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �/� ✓ � �n � � / i�'���� 6 �tt'C Telephone Number 7 )3?- .�7dO Address �� ` - License# CAU l4— MA to Z0 Home Improvement Contractor# Email �V hS .! V f 10 CM Worker's Compensation # ALL CONSTRUCTION DEBRIS RE LILTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �l L k FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. 4 ADDRESS VILLAGE OWNER d a DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ?Tie Coma:auivealth of Massadiusetts t Deparhnent o,f Ind istriat Accidents Q, ce oflkiwstigations 600 Washington Street Boston,CIA 02111 wisn..nrasmgrrvIdia Workers' Campensation Insurance Affidavit$:uildersiContracturs/EIecEr tianslPlumbers Applicaut Infonnat an Please Prim Leg bIX Naffi (j3u=w )rganizatianfF &wduai): 6c- L' C AA GAAOPhone *Old Are you an employer? eck the appropriate box: Type of project(required): I.❑ I am a employer with 4. ❑I am a general contractor and I employees(fish.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-con vac#ors have g.,❑Demolition_ w°fib g for me in an capacity. employees and have worms' y �t3`. g. ❑Building addition [No nw-orkm' comp.insurance comp_insurance.# required-] 5- ❑ We are a corporation and its 10.❑Electrical repairs,or additions 3_41 am.a homeaumer doing all-workofficers have exercised their '11_❑Plumbingrepairs or additions mys&f,[No workers'camp_ right of exemption per MGL 12-[:1 Roof repairs immmnrerequired.]i c.152, §1(4Xandwe have no ' employees.[No workers' 13.❑Other comp.insurance required-] 'tlayap lkznt Mat chedmbos#lBmst also UaaflLesectioabelowshmsingdmirworkeiecompensatian policy idbimadmL #H m wnen who submit this of hnif indicating rh-y are doing att waak sad then bim outside contractors mast submit a new aSdat it inrticatiag sa h- fCantramrs that'bad this boat must attached as addiGnna2 sheet shovdng the name of the sub-camtwA s and state whether or not those entities hose employees.Ifthesnb-contactors have employees,theyrmstpmvide their workeo'romp.polky;numher. I ant an eneployw that is preniding yvarkers'cortgwisadan insurance for my enrpLo3wes Below is the policy and jab site information Insurance Company Nance: Policy#or Self--ins.Lic_lk Expiration:Date: Job Site Address: Citylstatel r: Attach a copy of the workers'compensation policy declaration page(showing the policy number and g=piration date). Failure to secure coverage as required.under Section 25A of MGL c- 1572 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andlor one-year imprisonmenk as we11 as civil penalties in the form of a STOP WORK ORDERand a fine of up to 0.00 a day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the D1A for insurance,coverage verification. I do hereby certt,fy�itrtder be 'es as penalties ofper,jury that the itefbrmadvn p�rmir-I-ed abmwj is true and carrect Datl e: Phone a� (1✓ 1 �l tr Official rise only. Do not write in this area,to be campletesd by city rartown o frciat City or Town: Permit/License# Issuing.4.uthOrity(circle one): 1.Board of Health 2.Building Department 3.CitytTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Lnformation and instructions Mzssachmee&.Geheaal Laws chapter 152 requires all employers In provide workers'compensation for their employees. purs Lim at ti,this s t a t af p,a a emplyee is defined as"_-every person in the service of another under aay contact of hire, express or implied,oral or wrifiruf An errrpLayer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a Joint a tmprtse,and including the legal representatives of a deceased employer,or the receiver or trustee of as individual,partnmship,association or other legal entity,employing employees. However the owner of a dwelling horse having not more than three apartments and who resides therein,or the occTa at of the - dvlelling house of another who employs persons to do maminnance,contraction or repair work on such dwelling house or on the grounds or building appun ten art thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a licen a or permit to operate a business or to construct buildings in the commonwealth for any applicant Who has not produced acceptable evidence of cdmpliance with the higux n ce.coverage re-quired." Additionally,MGL ebaptrr 152,§25C(7)states"Neither the commonwealth nor iay of its political subdivisions shall enter into any contract for the performance ofpubho work u fil acceptable evidence of compliance with the insuranc8.. regmrr,mauts of this cbzpter have Been presented to the contracting anthozity_" ' ApplicasLs Please fill out the workers'compensation affidavit completely,by checIdag the boxes that apply to your sifnation and,if necessary,supply sub--contractor(S)name(s), addresses)and phone numbers) along with their certficate(s)of hinzrance. Limited Liability Companies(LLC) or Limited Liability-Partnerships(LLP)with no employees other than the members or partners,are not required to carry wormers' compensation insurance. If an LLC or UP does.have employees,a policy is recuired. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of h urz ce coverage. Also be sure to sign and date-the affidavit The affidavit should be retomed to the city or fawn that the application for the permit or license is being requested,not the Departmeaf of hadurstrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-msar ce license namber on the appropriate line. City or Town Officials f Please be sure that the affidavit is complete and primed legIly. The Department has provided a space at the bottom of the affidavit for you to fill out i a the event the Office of Investigations has to contact You regarding the applicant Please be sure to filll,in the penmit/license number which will be used as a reference number. In.addition, an applicant that must submit multiple permit/he-ease applications m any given year,need only submit one affidavit mdirat;ng current policy infb=tion(if necessary)and under"Job Site Address"the applicant should write"aIl locations in (cry or town)-"A copy of the affidavit:that has been officially stamped or madred by the city or town may be provided to the applicant as proof that a valid affidavit is on file for f xb=permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The of of Investigations would like to thank you m a&mca for your cooperation and should you have any questions, -please-do not-hesiiaf-=togive-us a call- - — - ---- --- —. - -The Dce arimenfs address,telephone and fax 1 uT 'Cr. je Commanwealtil of Massachus-rM Dtpaitm mt cif Iidustdai Accidents ice cf fl vestigatio-= Bostoio�MA G�I I I Tf,-L 4 617. 27-4}QO Qxt 4€6 or 1477-MASSAFE Fax 4 627-727-7M Revised 4-24-07 p W .mass-gov/dia Town of Barnstable Regulatory Services oF*fE rosy Richard V.ScaIi Director Building Division Tom Perry,Budding Commissioner mass 200 Main Street, Hyannis,MA 02601 wwwtown.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXF.NIPITON Please Print DATE: JOB LOCATIOM V n number stred *Map "}3oMFAW1dER -. name cc c _hom�e,/phonc# woic phone# CURRENT MAILING ADDR_SS: c._�4,,Mk C4S f'I 1� Al-e— cityhDwn F state _up 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_ DEFTNMON OR 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 ofBamstable Building Department minimum inspection rocedures and requirements and that he/she will comply with said procedures and requirements. Signahue of omeowner ^ Approval of BuildingOfcial% - Note: Three-family dwellings containing 35,600 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control ` 'HOMEOWNER'S EXEWTION ' 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 109.11-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 lolly 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 Iast 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:MPFIILESIFORMS\bufldmg permit fo=\=RESS.doc Revised 061313 Town of Barnstable Regulatory Services $ Richard V.Scali,Director � i6s9. .m jDrFp,1►.t A. Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property. Owner Must Sign This Section Complete and If Using A Builder . as Owner of the subject property hereby authorize M' =M-Ii)or to act on my behalf, in all matters relative to work authorized by,this building permit application for. (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date . QTORMS:OWIQER PERMISSIONTOOLS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0,4 BARNSIM8 �0 L/ Map %33 Parcel aj,'L Application Health Division ' "� "'`" Date Issued 2 Conservation Division Application Fee .Planning Dept. Permit Fee ..UIVIISION Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address a--% Village %_5 F.-aZ Owner Address S'i Telephone so%-CM,.% — S v 5 Permit Request ..�►<w: ... z. Z A':.©�► ' �„�— �.-o �, �- c. o o�e,� ,,c:� c. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation A r od , Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0' Two Family ❑ Multi-Family (# units) Age of Existing Structure t Qv%*t Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: mull ❑ 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: q existing —new Total Room Count (not including baths): existing k k new First Floor Room Count Heat Type and Fuel: ❑ Gas CdOil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed-Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number $off • `�33 •�3 V Address -%-A% azc %%o License # %.oz.,VtMk$ 14"w .&-5..a..r. tn .r.3 Home Improvement Contractor# %-A�i � Worker's Compensation # 4,c��3 cs,3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE f DATE 1 bq FOR OFFICIAL USE ONLY APPLICATION# 4 DATE ISSUED j w MAP/PARCEL NO. , E ADDRESS VILLAGE 5 OWNER t k • + k x « DATE OF INSPECTION: { E ,t FRAME t — — rs-e INSULATION'Lri. FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL= GAS: ROUGH FINAL' y , FINAL BUILDING- - { DATE CLOSED OUT- ASSOCIATION PLAN NO. • a Massachusetts-Department of Public Safety Board of Building Reguiations and Standards C'unartiieti�n�uitcn i�r�e•ilz��iz�lt� � �. License-CSSL-102776 CONOR D MCINE-RNEY ' 39 SIASCONSETZRtV�`. SAGAMORE BEACH ME,r�, 62 �a4' �y, t- si fti'•:6. Expiration Commissioner 08/19/2016 ':Rk ir _Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: �gistration: 171251 Type: Office of Consumer,affairs and Business Regulation Expiration: 3/1Q616 Partnership 10 Park Plaza-Suite 5170 Boston,MA 021.16 CON-SERVE ENERGY CONOR MCINERNEY 376 ROUTE 130 SUITE G SANDWICH,DW CH,MA 03563 Undersecretary Not valid without signature SSIX The Commonwealth of_Massachu>>etts Department of Industrial Accidents Office of Inrestigations kv 600 Washington Street Boston., MA 02111 w111w.111ass: ut=/dia Workers' Compensation Insurance affidavit: Bu:.i d.ers/Contractors/Electricians/Plumbers Applicant Information Please Print Letribly Name (BusinesslGrgrtnizationflndividual): ConserVlsion Energy Address: 376 Route 130 Suite C City/5tatelzip: Sandwich, MA 02563 Phone#: 508-833-8384 Are you an employer?Check the appropriate box: Type of project(required): 1.[l i am a employer with 8 4. ❑ i ant a general Contractor and I � 6. ❑.Ne:�y construction employees(full and/or part-time.l. have hired the sub-contractors 2.❑ 1 am a sore proprietor or partner- listed on the attached sheet. * 7. (Q Renaodel,ing ship and have no employees 1, ese sub.-contractors have' S. ❑ Demolition working for me in any capacity, workers'. conip. insurance. q: Building addition [No workers' camp. insurance 5. ❑ We area corporation and its required.] officers have exercised their 10. Electrical repairs or'additions 3.❑ 1 am a homeowner doing all work, right of exemption per MU l LE] Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4),and we have no i 2.Q.Roof repairs insurance required.] employees, [No workers' 13.{M Other WeatherrZation comp. insurance re quire.d.j - ✓any appliranr tltatchcr ks btrx 111 mustalso tilt out the section below zht>cving.theu'wotkcr^, compensatiort palicy information. t Homeowners who submit this affidavit iodi-cating they arty doirig all work and then hire outside contractors inkist,ujimit a new affidavit indicatitit"srtcti tCantractors that check this box must attached an additional sheet:showing the name of the sub-contractors and their workers'comp.policy inforination. l ant an employer that is providing:corkers'compensation insurance.for my employees. Below is the policy curd job site. inprtaation. insurance Company Name: CS&S/WORKCOMPONE Policy#or Self=ins.Lic.#: 6011316349 Expiration.:natc` 03/11/2015 Job Sitc Address: Cityistate/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 MG'L:c.1.52 can lead to.the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the.fortn of a STOP WORK_MDER.and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement mayr be forwarded to the Office of Investigations of the DIA for insurance coverage verification,:. T do hereb t fy t der th p 'its tnr penalties of'perjury that the inforntatirm provided above&trite and correct. Signature: ' --"'..-,. ''. Date: 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#: i ncc v� E(MWbDWYY) CERTIFICATE OF LIABILITY INSURANCE °AT 0311712014 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 BELOWe THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE.A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER;AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder is an ADDITIONAL INSURED,the policy(►es)must be endorsed. N 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). CONTACT' - PRODUCER NAME: - CSSS/WORKCOMPONE PHONE FAX PO BOX 946580 (AIC,No,Ext): (A/C,No MAITLAND,FL 32794-6580 ADDRESS: Phone-877.724-2669 INSURERIS)AFFORDING COVERAGE i fC 9 Fax-877.763-5122Continental Casualty Company 443 INSURER A:INSURED .INSURER B:,CONSERVISION ENERGY INSURERc:376 ROUTE 130 Continental Casualty Company 443 SURE C INSURER O: SANDWICH,MA 02563 INSURER E,Continental Casualty Company 20443 INSURER F: - COVERAGES CERTIFICATE NUMBER; REVISION NUMBER: THIS IS TO CFRTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BFEN ISSUED TO THE INSURED NAMED ABOVE FOR THE FOLICY 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,TH.E 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. SR L G L - LIMITS LTR TYPE OF INSURANCE INSR NVO POLICY NUMBER MMIOWYYYY MWD GENERAL LIABILITY EACH OCCURRENCE $1,000,000 _ COMMERCtAI.GENEPALLIABtIiT'r DAMAGE TO RENTED $300,000 PREMISES(En awunance) CLAIMSWADE ®C>CCtlR MED EXP tAri onn pta-An $10�,000 A Y N 6011316335 03/1112014 0311112015 $1000,000 PERSONAL ADV INJURY I _ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER', PRODUCTS•COMPIOP AGG $2,000,000 POLICY R LDC COMBINED SINGLE LIMIT $1,()00,000 AUTOMOBILE LIABILITY (Ea awdeit _ BODILY INJURY(Per person) ANY AU10 - ALL OV1N£D SCHEDULED BODILY INJURY(Per acdileiio A AUTOS AUTOS N N 6011316335 0311112014 0311112015` HIRED AUTOS NUIO (Par- PROPER OAAfAGE AUTOS if'8r amdeni) . UMBRELLA LIAR OCCUR .EACH OCCURRENCE. 110001000 D EXCE.S5 AB GLAIhiSMADE N N 6011316352 03111/2014 03/11/2015 AGGREGATE. ��000;000 U DED RETENTION S 10,000 - - . - We STATU-• OTH- WORKERS COMPENSATION - TORY LIMITS ER - AND EMPLOYERS'LIABILITY ANY PROPRIETOR,'PARTNER/EXECUTIVE. YIN, F.L.EACH ACCIDENT $100,000 E OFFICEFIAAEMSER EXCLUDED? j N N 6011316349 03/1112014 0311112015 $100,000 (mandatory in NN) - E..L.DISEASE•EA EMPLOYEE it yes,desvit:*under $500 000 DESCRIPTION OF OPERATIONS below E..L:DISEAS&-.POLICY LIMIT + DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AttachACORDiOi..AddltlablRerrwrksSrltetluki,ilpiorapac�:isra4)Mred) - Certificate Holder is added as an additional insured as provided in the blanket additional insured endorsement. CERTIFICATE HOLDER CANCELLATION Ise ng neering SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1341 Elmwood Ave THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Cranston,RI 02910 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE p 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORd name and logo are registered marks of ACORD d$55 0 0 ConsurVision a, e n e c g y vvv OWNER AUTHORIZATION FORM I, Catherine Eger: Owner of property located at: 57 Angela Way, West Barnstable, MA 02668 hereby authorize ConserVision Energy, to act on my behalf to obtain a building permit to perform work on my property. Owner Signature Date f cam/ � o -6L ���+�o fiL L3 L� I`—./ 4 ��� � � �U�� k � { ; u,f� �� �<!� Cl�� f c�J1�, - s8 z.z.� _o��l _. �. - �: r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �J Parcel A/ Application # AO (IMT Health Division Date Issued 0 Conservation Division Application Fe Planning Dept. Permit Fee a Date Definitive Plan Approved by Planning Board ' Historic - OKH Preservation / Hyannis — Y Project Stre Address Village Owner VC71A T—e AAddress P x 9a taw]1CM Telephone_ 3 uo Permit Request l �b"-:L-h ,tf:a.6 Square feet: 1 st floor:existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Qj 000 IV Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: 4/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 �IVumber of Bedrooms: existing _new 11 Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other ,;Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woo*Z1coal stogy: ❑ s ❑ No c Detached garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn:9 xisting l nem size— w ttached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: oning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Qg co Commercial ❑Yes ❑ No If yes, site plan review# vwi Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone NumberrXM' Jkt— � c ✓KJ Address License #� —�� U 7 la) iAn )c l�n C�S Home Improvement Contractor# (Z �� Worker's Compensation # D 6_"ebb ALL CONSTRUCTION DEBRIS RESULTIN OM THIS PROJECT WILL BE TAKEN TO o;12 -ve-1v44e r - a SIGNATURE DATE 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION a -r ! �f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING R DATE CLOSED OUT ASSOCIATION PLAN NO. i Barnstable Old Kings Highway Historic District Committee „ ,yM4 : 200 Main Street,Hyannis,MA 02601,TEL: 508-862-4787 Fax 508-862-4784 °"" APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply; 1. Building construction: El New ❑ Addition Alteration r. 2. Tyne of Building: ❑ House ❑ Garage/barn ❑ Shed ❑ Commercial ❑ Qther 3. Exterior Painting,roof ❑ new roof ❑ color/material change,of trim, siding,window,doorzZ , 4. Sipes: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign ; 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall. ❑ tennis coup`''❑ Other gay 6. Pool ❑ swimming '❑ Other man-made pool Type or Print Legibly: Date: `` ,, r Address roposed work: House# Street: [� W Village sessors Map Lot# Description of Proposed Work: Give particulars of work to Agent or Contractor(print . Telephone f Address: `�f AJ B Contractor/Agent'signature: NOTE All applications must be signed i6t4urrent owner Owner(print): )� Telephone#`:��,.©� ���pe2 —q��T_ Owners mailing address: o �(J��(� n Y Owner's signature: For committee use on This Certificate is hereby APPROVED/DENIED Date `Z a Members signatures D � . NOV 17 2009 N .11% fill TOWN OF BA STAB c�or HISTORIC PRESERVATION V\A APPROVE® .F DEC-0 9 2009 »4 C:IDocwnents and SettingsldecolliklLocalSettingslTemporarylnternetFileAOLK110KHCertAppropriateness07.doc � Town of Bamstab e Old?l H y Town of Barnstable Old King's Highway Regional Historic District Committee CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 4 copies Foundation Type:(Max. 1S"exposed)(material.-brick/cement,other) Siding Type material: Color: Chimney Material: Color: Roof Material: (make&style) Color: Trim material Color: Roof Pitch:(7/12 minimum) LPd C 01 ech. —� Window: (make/model) �(?p�e IiY�ateriat color ( ^~� l 1 a �/ o �h Size(s): - c o.ro�- ?ndo�� Door style and make: material Color: Garage Door, Style Size Material Color Shutter Type/Material: Color: Gutter Type/Material: Color: D Decks: material Size Color: Nov I Skylight,typelmake/model/: material Color: . 'ze:TOW�OF BARNRVABILON Sign size: Type/Materials: Color: Fence Type(max 6')Style material: Color.: Retaining wall: Material: Lighting,freestanding on building illuminating siga Please provide samples of paint colors and manufacturers brochure of style of windows,doors,garage door,. fences,lamp poets etc R � ADDITIONAL INFORMATION: Town of ms a Committee Signed:Aplan preparer) print name - -- tcl.no. d- ]Location of application: S t no. Street Village 2 C.'00cumerrPr an d Serdnp1deea1YekV vca►SecAr�slTcVorary In term i Filesl OLKI I OKH Ca rt 1(ppro 7.prlawm.ty 0doe Town of Barnstable Old King's Highway Regional Historic District Committee CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please sulbmit 4 Copies Foundation Type:(Max. 18"exposed)(material-brick/cement,other) Siding Type material: Col Chimney Material: Color: Roof Material: (make&s e) Color: Trim material C or: Roof Pitch:(7/12 minimum) _ \ - Window: (make/model) D LU _Vaterial ) 14 color. Size(s): . V3 X 34 / 2�� 911,611 / - Door style and make: ate ' 1 Color: Garage Door,Style D E Material Color Shutter Type/Material: N O V 1 7 2009 Color: Gutter Type/Material: BARNSTAB Color: HISTORIC PIES R Alt Decks: material ize Color: Skylight,type/make/modeU: material Colo Size: Sign size: Ty e/Materials: Color: Fence Type(max 6' )Style material: Color: Retaining wall: Material: Lighting,freestanding on building illuminatin ign Please provide samples of p ,nt colors and manufacturers brochure of style of windows,doo ,garage door, fences,lamp posts etc ADDITIONAL INFO TION: 4 , Signed: (plan preparer) print name tel.no. Location of application: Street no. Street Village 2 C.(Documents and SettingsldecolliklLocal SettingslTemporary Internet FilesiOLK110KH Cert Appropriateness 07.doc 4. SIGNS Diagram of sign, showing graphics, size,design and height of post, color and materials. Spec sheet. Site Plan on a GIS map or mortgage survey, OR photographs OR to-scale sketch of building elevation showing location of proposed sign; and any tree to be removed near a freestanding sign. Fee according to schedule. 5. FOR LIST OF ABUTTERS: PLEASE SEE OKH STAFF SIGNED (plan preparer) Go h 410 Print L'_iV� �G� Date: -C I Tel. Phone no'(� ) NOTE E C V D DEC 0`9 2009 O N 0 V 17 2009 Town of Barnstable The Old Kings Highway His ric i Y ENYINCOMPLETE APPLICATIONS : Old Committee Way TOWN OF BAR NSTABL ATTENDANCE AT MEE TIN H1 VA 1.0 epresentative is not present daring the hearing is scheduled, the application may be either CONTINUED OR DENIED APPEAL PERIOD APPROVED PLANS PLAN PICK UP There is a fourteen(14) day appeal period for approved plans. This is necessary for each Certificate of Appropriateness and/or Certificate for.Demolition issued by the Old King's Highway Committee. Plans approved by the Old King's Highway Regional Historic District.Committee may be.picked up at Growth Management,Regulatory Division, 200 Main Street,Hyannis, after expiration of the 14 day appeal period. If the 14"'day falls on a Saturday, your plans will be available the afternoon of;the following business day. DENIALS Applications that are denied may be appealed to the Old Kings Highway Regional Historic District Commission within 10 days of the filing of the decision with the Town Clerk. For more infonnation, seethe Bulletin of the Old Kings Highway District Commission. BUILDING PERMITS, OTHER AGENCY CONTACTS In most instances, before commencing work, a Building Permit is required. The Building Division will require a certified plot plan for new construction and/or demolition. Commercial work may require Site Plan approval. Demolitions: the applicant should check with the Building Division as to conformance with Zoning requirements. Other Regulatory Agencies at 200 Main St, Hyannis MA'02601: Building Division 508-862-4038 Conservation Division 508-862-4093. Health Division 508-862-4644 QUESTIONS ABOUT YOUR APPLICATION? PLEASE CALL THE BARNSTABLE OLD KINGS HIGHWAY OFFICE AT 508 862-4787 5 QAGMD-Groups101d Kings Higlnvay10KHNewAppI0KHCert Appropriateness 07.doc -Page 7 of 7 CAPIZZI HOME MTROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT PAUL&JEANNE RODLIFF,OWN THE PROPERTY LOCATED AT 57 ANGELA WAY IN INSTABLE,MASSACHUSETTS. iVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR UILDING PERMIT IN ACCORDANCE WITH 780�CMR,THE MASSACHUSETTS STATE BUILDING )E. VE MY PERMISSION TO / LESSEE APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS .TE BUILDING CODE. NATURE OF OWNER: VER'S ADDRESS: 57 Angela Way Barnstable,MA 0 �i 51 VER'S TELEPHONE: (508)362- SEE'S SIGNATURE: SEE S ADDRESS: NO TOWS OF BARNSTABL SEE'S TELEPHONE: �,pBESERVATVN" LICANT'S-SIGNATURE: LICANT'S ADDRESS: 1645 Newtown Rd.,Cotuit,MA 02635 LICANT'S TELEPHONE: 508-428-9518 PONSIBLE OFFICER: PONSIBLE OFFICER ADDRESS: PONSIBLE OFFICER TELEPHONE: y , '3r _.���� ..' C!'i � ,fir,• fhxA �'s \., � ����� { �' lr Y�3fyin..✓t'�'` lQdl]A-a ;jam`, ��q,��j' u } � ECEI TOWN OF . PRESERVATION` Client#:47298 CAPIHOM ACORD- CERTIFICATE OF LIABILITY INSURANCE FDIAITOE 5/10° Y) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers$Gray Ins.-So.Dennis ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O.Box 1601 South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Nat'l Grange Mutual Insurance Co. Capizzi Home Improvement,Inc. INSURER B: ACE Property&Casualty Ins.Co. Capizzi Enterprises,Inc. INSURER C: 1645 Newtown Road INSURER D: Cotult,MA 02635 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD1 POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM/DD LIMBS A GENERAL LIABILITY MPB1075H 06/08/09 06/08/10 EACH OCCURRENCE $1 000 000 li X COMMERCIAL GENERAL LIABILITY DARMIAGE TO RENTEDoccurrencel $SOO OOO CLAIMS MADE 5_1 OCCUR MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1 000 000 - - GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 00O 000 POLICY JEC PRO- El LOC A AUTOMOBILE LIABILITY M1 M28044 06/08/09 06/08/10 COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $500,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) X Drive Other Car PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY, AGG $ A EXCESS/UMBRELLA LIABILITY CUB1076H 06/08/09 06/08/10 EACH OCCURRENCE $5 00Q 000 X1 OCCUR CLAIMS MADE AGGREGATE s5,000,000 $ DEDUCTIBLE $ X RETENTION $10 000 $ B WORKERS COMPENSATION AND NWCC45843208 - 12/25/09. 12/25/10 X WC sLIMITTATU oEH- _ EMPLOYERS'LIABILITY - . . E.L.EACH ACCIDENT $1 000 000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1 000,000 If yes,describe under - - SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1 000,000 OTHER . 6 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S48108/M48107 KW © ACORD CORPORATION 1988 P CAPIZZI HOME IMPROVEMENT INC. Page 7 of 7 SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT PAUL&JEANNE RODLIFF, OWN THE PROPERTY LOCATED AT 57 ANGELA WAY IN INSTABLE,MASSACHUSETTS. ,VE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR jILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING )E. VE,MY PERMISSION TO 7 LESSEE APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS TE BUILDING CODE. vATURE OF OWNER: ,TER'S ADDRESS: 57 Angela Way Barnstable,MA 0 u �I dER S TELEPHONE: (508)362-9989 f . 5EE'S SIGNATURE: j ' I 3EE'S ADDRESS: ')EE'S TELEPHONE: -ICANT'S-SIGNATURE: ,ICANT'S ADDRESS: 1645 Newtown Rd., Cotuit,MA 02635 ,ICANT'S TELEPHONE: 508-428-9518 'ONSIBLE OFFICER: 'ONSIBLE OFFICER ADDRESS: 'ONSIBLE OFFICER TELEPHONE: Lyzassacnuseiis Department of Industrial Accidents ` v Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers Applicant Information ;-� Please Print Legibly Name(Business/Organization/Individual): . Address: City/State/Zip: Phone.#: L Are ou an employer? Check the jap �qpriate box: Type of project(required):. I. a employer with 4. [r I am a general contractor and I employees(full and/or p -time).* have hired'the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the'attached sheet. 7. Wj 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.$., 9• ❑Building addition required.] 5. 0 We are a corporation and its' 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall 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' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing;their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work andthen 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 es:employe 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. t Insurance Company Name: Policy#or Self-ins.Lie.#: V4G Expiration Date:- Job Site Address: City/State/Zip: L Attach a copy of the workers' compensation policy declar on 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 advi"sed that a copy of this statement may be forwarded to the Office of Investigations of the DIA for ce coverage verification. I do herby ertify - -dc t�i ins aid- nalties-*paxjury-that-the-information-pr-avided-abave-is-true-and-cozrec t Si afore.: Date: Phone#: Official use only. Do not write in this area,to be completed by city or townO:ical official City or Town: Permit/License Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electr .Plumbing Inspector 6.OtherContact Person: Phone# • ✓2ae COorrvrna�xu�va`uz o�✓lGacarzc�Zutel76 . Board of Building Regulations and Standards License or registration valid for individ.ul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Stand,irds Reglstritj:Qp{ 100740 One Ashburton Place.Rm 1301 123/2010 23 Boston,Ma.03108 .,plement Card CAPIZZI HOMES/, Nl' 1T1�� p� � ^ bARY GUSTAFS. •-:_—�;; 1645 Newton Rd. Cotult, MA 02635 -2_. ) Administrator No vali itho, nature 'via�.+:ii itti.sctts- Delmi-tit.1vAt of I~ublic S.t'1' l�. -- Board of Buiitlin'—' Rt4;'ttatitirt tint Statiita+ds .r� Construction Supervisor License License. CS 74640 Restricted to: 00 GARY .GUSTAFSON it 8 SHORT WAY - SANDWICH MA 02563 � a& a Expiration: 11/29/2010 t:uttitti.Ai ttct {;4; 7755 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) You'rnust first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take.the completed form to the Town Clerk's Office, 1 st A., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: Y IL-f Fill in please: ,::.. APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOIyIE ADDRESS- 5 —_77 23Q-0,7 zD Mt-Of IVI 1�j b Cy �t TELEPHONE # Home Telephone Number 7 7 y = 73 r- e,' 7z O ,NAME OF CORPORATION: NAME OF NEW BUSINESS C e ni .- TYPE OF BUSINESS C` e'Q rn� IS THIS A HOME OCCUPATION? YES NO) ADDRESS OF BUSINESS / a-J MAP/PARCEL NUMBER d�—`I— I ! [Assessing] When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street] to malce sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO MISSIO ER'S OFFICE This indivi,ual h n d f any r it requirements that pertain to-this type of businesM UST COMPLY WITH HOME OCCUPATION ULES AND REGULATIONS. FAILURE TO Au or' e Signatu e** COMPLY MAY RESULT IN FINES: OMMENT wu r 2. BOARD OF EALTH This individual has.been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this'type of business. Authorized Signature** COMMENTS: Town of Barnstable Regulatory Services Richard V. Scali,Interim Director Bu ilding Division 639, �mg' Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved. Fee: Permit#: HOME OCCUPATION REGISTRATION Date: r Name:_ �1 n S�tPt Phone#:_ 2-7 Address:����'�/ —�GG� "1 o��Q/L^� Y(Ji/1 te� Village:_ Name of Business: lealnj Type of Business: Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity, shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit • Such use occupies no more than 400 square feet of space. - • There are no external alterations to the dwelling which are not customary in residential lul" ' no outside evidence of such use. r cgs,and_ ere ism- No traffic will be generated in excess of normal residential volumes. t • The use does not involve the production of.offensive noise,vibration,smoke,dust or other'particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • Ig There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of ,. normal household quantities. • An need for parking fi _= Y p kuig generated by such use shall be met on the same lot containing the Customary Home M Occupation,and not within the required front yard. • There is no exterior storage or display of materials or.equipment • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation.. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be . included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I,the undersigned,have read and'agree with the above restrictions for my home occupation I am registering, Applicant: l / eq Date: �- Homeoc.doc Rev.163113 Town of Barnstable FT"e Towti Regulatory Services Thomas F.Geiler,Director BARNSTABLE,HASS. ' Building Division 1 639- `0� Tom Perry,Building Commissioner ED MA A a 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# IN16 0y��� FEE: $ SHED REGISTRATION 120 square feet or less J i i C V I Location of shed(address) Village Property owner's name Telephone number, lox" _-7: Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? - Old King's Highway Historic District Commission jurisdiction? Conservation C�'ssion(signature is required) --Sign off trours for`Conservation 8:00=9r30-&3 3`0_4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BVA PLOT PLAN Q-forms-shedreg REV:042506 ,P.0 s9 /J r'O C .�lO C�"6,�f G E .T!/�e�lJs•G'.S vI�G y ?� o � � o w 2 c�.0 Tify ro AW Nib G A.JYO T.'YE T/T•C L� /iI SO.IA�YC E c-D�fi°.9.v1� r�..iT r Vi s .crdic.o.rMG / s -ZOCAT.c'O d-v YHA d-,edv1vo AS T VDMv.0 .!Alp CD,(JF'O,C.'J�GSO TO Ti+'E 2O N/ifl�r .QY-.[�!!✓S ./ti ti fF.t cT. �YyC�V fD.VsT.,e!/GT.C-O� l/Nt.r S.f ..r0 r.C,d DTN.c t W/J.r. t •�"!/�C T.Y .�' c.C"-E'T/fry Tis�A Y T'�!t`�'.e .o a d' �"-9 J d'f,I.C".vTS o,e �-"�t/L'.Q d.¢c iY�!•c'•IJTS .E X c.�/9 r AS ss+D`v.v� .:9�s/p T.vq�' Tf/E P,BOP� .P rf' L/.0 s i.Y /Y.y 7�'/O.v./.0 .�',LODO i�►^.11ie.9 .Y'c.c- �q r� �f-!f' � cD�!�'p-�Ji>t' ��I�IJ.C.G �.tEO BOD.f( /45 00 SAG E' 2l0 7� "yiG' 'Re,$.t', z 7,3. 'CG.-PI D _ SSEL C: ALLAN O.COT' /S/ HE LEY, No.24397. Q _.-,•c.'� to ., `'9�D �� ,,Sti.Z 3: �+ r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel I Permit# '34 13- Hbalth Division _ c 9 --���<, ) Date Issued w b Consbrvation Division 6 "a Fee 1*30, (S 0 Tax rollector Application Fee Treasurer Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address /) Village rA Owner ,�` el P J�"(l.' Address SAA&i N&41A Telephone c� Url = Permit Request s 0 ---------------------------- s Square feet: 1 st floor; existing proposed 2nd floor: existing proposed T_ ToW newt Valuation Zoning District Flood Plain Groundwater Overlay c �< -� Construction Type j Lot Size Grandfathered: ❑Yes ❑No If yes, attach supportinga cumentat&n. `X_ Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) ,, - __J rn Age of Existing Structure Historic House: ❑Yes o On Old King's High ay: ❑Yes ❑No Basement Type: *uII ❑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 ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# --Current Use - - Proposed Use - - BUILDER INFORMATION Name t Telephone Number Address ro ✓ icense# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULT G FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY b PERMIT NO. - DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE OWNER DATE OF INSPECTION: E FOUNDATION } FRAME F .. _ 1 f INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 1 i GAS: ROUGH FINAL FINAL BUILDING t • DATE CLOSED OUT ASSOCIATION PLAN NO. JI oFtHe roy, Town of Barnstable y � Regulatory Services 13APJ scABr.B, � Thomas F.Geller,Director k asass. FD �a`�� Building Division Tom Perry,Building Commissioner I `200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date l0 r 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. rp , / Type of Work: ���� ( �IU.� � r>1 I Estimated Cos Address of Work: Owner's Name: r I i Date of Application: I hereby certify that: Registration is not required for the following reason(s): (]Work excluded by law ❑Job Under$1,000 E]puilding not owner-occupied Owner pulling own permit Notice is hereby given that:' OWNERS PULLING TAEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENTYWORK F��ERMGL cc..142A. ACCESS TO THE ARBITRATION PROGRAM SIGNED UNDER PENALTIES OF PERJURY I hereby apply for permit as the agent of the owner: Date Contractor Name egistr No. _ R Date Owner's Name Q:fomis-.homeaffidav The Commonwealth of Massachusetts -_— Department of Industrial Accidents Office of Investigations =Y 600 Washington Street, 7`h Floor c� Boston,Mass. 02111 Workers'Compensation Insurance Affidavit:Buildin ltimbin /Electrical Contractors { name: c address: city �U` � state: zip: O 1 J phone# �1�)V� `(•������� —s to location(full address): �`��� ( f�l�'44/ d �� ( ��IV�pI (/Z(Q5j, �`dam a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel ' Lrn a sole proprietor and have no one working in any capacity. ❑Building Addition ❑ I am an employer providing workers'compensation for my employees working on this job �. � -_a7 x % .a�FK'r;'•r�`�� "r�`�.'�F..,¢.�Y:} .�„ ro }n_ .-,'c-�d .r s T` -b� t. .;,. t t x r - +, tTz.c z�-...'�r�'+,F�F�� ,gr;Y 3 zap-'..xT- r, 4. -- . � '� �7... i • �,i Y : , -$�QT�S3r r t s) '�S � .� �.•rri..e �� �y� g�z:•3v � ,e ..=r� t ''.:n r s' .l F..r'" t,..��.sPk.-..,x.a_,,: 1,.._,..,:.. b, :t,'..I�,TrOl1�JY.,...r:. _l t .z ,fG #'•eM;s�7+1 r"5*+ `s 1 d .r,- `P�,.= '•r• + ` A.�`_ Q ❑ I am a sole proprietor,general contractor,; r homeowner ircle one) and have hired the contractors listed below who have the following workers' coin ensation polices E#• t, fl'l. :i Mi. VALE. � �pw rAsxm 4 r)y li `tit r raX ° Y r S f ' _ "N., � ,z �•I !_. L 1 g� i-h, {Y gY�,t.} ✓ � f q C'� 'i P : t t i ` ( �� ��� �✓�rJ - - . �nSIIY:B' CB.Ctva-�FF.e,.r L,yj`? v,,1. ._�,�...�...� W --�,..'. .m$'",..a::k:,,s,s.�, ,n�1� ,.._:�rt,.k �rG� r#S t..- ^.,:[,.: r. •._. ,., + . 4' -'� � fa`.•'r a+-; S kYA - Tlap r •a t .� tP>•4 z4 are r .,� _t; r., i � r e S xdBreSs f _xY, '?." _xZ. ,z �w �r r� ,��t.M. �}y�� ��iw � r:� .ti��yd x,..��:•' t' f r r 1 - tri � r� x,. r . Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify u t p and penalties of perjury that the information provided above is true and correct. Signature Date -42 ID . Print name ' Phone# official use only d:one this area to be completed by city or town official city or town: permit/license# ❑Building Department oard ❑check if immediatequired ❑Selectm nBs Office contact person: phone#; ❑Health Department ❑Other (revised Sept.2003) 6 4 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 contract of hire,express or implied,oral or written. An employer is defined as an individual,partnership, association.,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and 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 shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Inwk WIN i:i III Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. NMI,IORRAR REP City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned 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. I PRIME The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7 h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext. 406 Cp�E TOh, Tovn;.of.Barnstable .yo ' ' Regulatory Services as F:Geiler � �asrns� � • - - . ;. 'Tp,om... : ,-D ector- 9� 1639. ��•� Bui-Ift9 Divislon TonxPeizy; Building Commissioner 200 Main Street, T4yanmMA 42601s, • _ . .to_.-arnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 Property Owner Must Complete and Sign This Section If Using ABuilder PIS' ,as Owner of the subject property ran►' ) to act on my behalf, hereby authorize min Uatters relative to work authorized by this binding permit application for: L�- _ (Address of Job) 0Y ae -g Date i . MAO 1 print Name THE Town of Barnstable CF Tp� ` Regulatory Services xsTnst.>w : Thomas F.Geiler,Director MASS. 1639• ,�� Building Division - ArfD MA'1 a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION � Please Print DATE: !"'n JOB LOCATION: MI ! numbei street village (� J vviiillage(� "HOMEOWNER": Ard� '7�0 " 7 �O'�i � og J�� name 4ome phone# ,p work phone# CURRENT MAILING ADDRESS: I ` te® 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 J.,l) 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 procedi and requirements and that he/she will comply with said procedures and requirements. Signature of Hom66wner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt i Lo ♦a'.-..,''w +FY13s.A3u{?if-NGr'T ,&'.-. Jt �lftl. 6 t S Y.]�L �6C 3.hYv IN tivUxsa a. �pa .y�}. 1. "n a �•ao-iw w�aiT 3 . .v.� r+.�,+=•r u�c Fes•,...� wn„c s w.a•..-, i..> uw�:.eu� _ -.away.-• ..xw:ro Cl 04 co X.�w.a. n:ate,�:,a�a� etv.�!-,' �Ky,ron(.lr�.�� -•m,µ�acrs� rs mx.�sei�r's ,d1... w�r T..m•. �- _,-: "`. ����"�r DECK ; /\ .,r. ^,. ,.evc..na.� �.vsin.✓M _FMw i."w',q•CwYi �. 'i co ., u�":..•h'�e , � iF.F .......nn..,.rowT•anm ,.n_n..w«w.mmm-.y. �- ..- vtw.tl� I � Wsa�.w .T,v..r.wa a.4A:arA.. .a+-�.-..t..ep�v..w...ls � ..¢ah»•�.. -JV.Ae:"rrR..�Y++•✓/,.s..,-FshM 1SY.Y.:aY Y•.......r �� y m.iwsTres:aYauata. •WB .�....u.-m„.�.•..v,rr,�..'..,.,:wu..:«n�,...,.•i.Y«w...:ua..«.<...,.,.,4�'E.S� 7rL.b.. ' sw.,+.tlwa.v.x.-....-:-..+r-••rn.,,c.�;.uwr+eaie:c.M,.y:ro.na� - w.ri.::waaaw � � I 92=0"(Rail) AT HOU.S� ANO sNA« ,✓DT .dam' Used f'oe 9,VY . 07 /S � ZDo'.2 .� G s.� r � `•.WS t i s t/► / I • - y., � E yr • ... +y,* --,. x 2 , 4,. p. t „ s eft r/.may r0 .0.4N/E.6 ,GJ,C,e.�%E,DO� tt�'tSq�� fjeSr, ya�izoy oy.F .Go.9!�.S rr.��0[�9r/1��✓ A JYO T/Y.E' T/>•C.L� //1'.f 0.l A�NC.E <O M/°A.✓f� ., T.f�AT- Tis�/-J.'' .Q d/1�O•�Mli /.f :: .e0C147.0 AS ,TIVOAIAI ,"i4IVO Cd-VFO.e�'9C�'0 TD TA'E 20N/ifl0r ,Cfy-.C./!✓S ./.0 •G fF.c'GT lf/y.Cti- CD.VST,e!/CT+c'-:4� &,Vc e'J.f :'Ore Tt-b ; OTif'.E.t W/J.O'. t �'!/.0 Tif� .0 ; c'�C'-!'T//�y Ti!'A T' Ti�+t'.e.E• ./.0.Q' .,vo v/J/B.0•E �' .E•9J EMI{-"s/1S o.0 �`�V l'.P d.s C h'�1•C ITS .F X t,E/�T AS sX4 H/.fJ. AiV p 7NE- p e0 Pt,P Ty .L/,e.f OoW 'A ' R2 G. " C` __--4.f Ap-"/�AIIA r.N-o`, iYq F/O Al 4,C �V4 D,0 p /.1'J 4/.e A i1!c.c' .E•4 Y-e' I/.!. 4-4 AIO'I'G 4//_ ,;P'01" PA.t/.Cr.L yv��f.t:E zS0400/ W. D.eeO &00le /46-04) ,PAGE2(o7_.' SSEW-i ALLAN� AJ:f.IFS.SO.CJ -VA A .Z le- WHEATLEY" 7, s: -.. No.2439 Q .3 • - r�- ,:"j.: Cfr�A/P.G,EJ ✓. /g'A�E'y�,4JS0�'/AT.ES .FWCrJAI I67h ,e5' .SURY.CYDRS y. ,� 1'Ga .OEDFORO sT. AQ/N�rjON �l.0, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map D� Parcel Permit#- Health Division Date Iss Conservation Division I 0 Fee Tax Collector Qtg I SEA PS MUST BE D 0 Treasurer INSTALLED IN COMPLIANCE WITH TITLE S Planning Dept. ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/ Irannis Project Street Address 16 1 f 9�f ha l! / Village1 Owner1�y � ��� J � Address Telephone Permit Request Square feet:Ist floor: existing 7i proposed 5AM?y 2nd floor: existing 3 proposed Total new Valuation r� e.j 00 ZoningDistrict Flood Plain Groundwater Overlay — y Construction Type Lot Size Grandfathbred: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes o On Old King's Highway: ❑Yes ❑ No Basement Type: tdFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) �6 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing ( new Half: existing new Number of Bedrooms: existing_ newt Total Room Count(not including baths): existing Jr new First Floor Room Count 3 Heat Type and Fuel: ❑Gas O Oil ❑ Electric ❑Other 1�11�C (r� A-r Central Air: ❑Yes - V�No Fireplaces: Existing - New Existing wood/coal stove: ❑Yes ErNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn: ❑existing ❑new size Attached garage:❑existing ❑new size Shed:Cl existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO '� SIGNATURELLUIAArb_ATE FOR OFFICIAL USE ONLY :A I t . PERMIT NO. +. DATE ISSUED i MAP/PARCEL NO. i ADDRESS VILLAGE OWNER y S DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE E ELECTRICAL: ROUGtr°- FINAL G' I PLUMBING: Ricitio Y+ FINAL GAS: ROUGH' ;., '# tZ FINAL _ (t) j: � FINAL BUILDING'-' #' t= 0 00 DATE,,CLOSED OUT ASSOCIATION_PLAN NO. J RESIDENTIAL BUILDING PERMIT FEES. ' APPLICATION FEE G •0 q New Buildingi,'Additions $50.00 Alterations/Renovations $25.00 K Building Permit Amendment. $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= L x.0031= plus from below(if applicable) ALTERATIONSMENOVATIONS OF EXISTING SPACE t �� square feet x S64/sq.foot= � x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.1' >120.sf-500 sf S 35.00 - >500 sf-750 sf 50.00 - >750 sf- 1000 sf 75.00 >1006 sf- 1500 sf .100.00 >1500 sf-Same as new building permit: square feet x S96/sq.foot= x.0031 STAND ALONE PERMITS Open Porch x$30.00= . (number) Deck x$30.00= - (number) Fireplace/Chimney x S25.00= (number) Inground Swimming Pool`. $60.00 z, m Above Ground Swimming Pool $25.00 - Relocation/Moving S150.00 (plus above if applicable) Permit Fee ` Pmjcost ' *; The Commonwealth of Massachusetts ,. ems._ .�- ........ Department of Industrial Accidents '� -= OflICC Of/OYeSI%g8t/'OOS - 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit 1n .�lr��Y•f�l�� .�EtiY!% name �'°' location- RA city Cu' �1�f7 yy��7 phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one worldn in ca acity % / %% �%%%%/%------ %/ I am an em to er roviding workers' compensation for my employees working on this job.:....:.:. :.. . : ❑ P..3'.....P.......................................:.::::::::.:::::.:::::,.:.:.........:::.:::::::::::::::.::::::.:.:..:.......:.::::::::::::.:::::::.:::...................:::.:::.:::::::::::::::::..............:::::::::::::::::::; ..:..:...: coma nam c e> hn n oltcv isuranc I am a sole proprietor,general contractor,o omeowner( 'cle one)and have hired the contractors listed below who I have the following workers compensation Polices: :<:»>::»::>:.»: ;::.::: . BMW :;:;:.:.....;.::..::;:;:. So an .>name:: t n :< ,.. .:. .....::..... :�:. olrcv hsnranc c sn .r address:::: . ..:..:................... »ibn ::::............. M����'<#:;>�::.;:;':}:F:.:iiki:{: ?i'?;:: i�:i?:i'i:::::::::':?:::::.::;iY'i:.;:{�ii;:•'.i;:yj p:::::::::::y:}.�_::::. .. nC `1 •anrace Q` Falbm to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as dva penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investignts of the DU for coverage verification. I do hereby certify under the pains and pen es p ' at the information provided above is ow.and coned Signature t Date Print name Phone# - oiBdal use only do not write in this area to be completed by city or town official city or town, peradtilicense# ❑Building Department ❑Licensing Board ❑checkHimmediate response is required ❑Selectmen's Office []Health Department contact person: phone#; ❑Other _ Oevind 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 contract of hire, express or implied, oral or written. o or more of association, corporation or other legal entity, or an tw An employer is defined as an individual, partnership, as rp g Y the foregoing engaged in a joint enterprise, and including the 1�gal 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 I dwelling house having not more than three apartments and wl}o resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, constructioi 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. eve state or local cal licensing agency shall withhold the issuance or renewal MGL chapter 152 section 25 also states that every g g. Y of a license or permit to operate a business or to constructbuildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the i� surance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enteiinto any contract for the performance of public work until acceptable evidence of compliance with the insurance requira nents of this chapter have been presented to,the contracting authority. Applicants Please fill.in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. .The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retuaied to the Department by mail or FAX unless other'arrangements have been made: _.._.:__.._..._.__..:............:.....aw _..._...._._._.._,. ._.. 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. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investlgadons 600 Washington Street Boston, Ma. 02111. fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 °` The Town of Barnstable g Regulatory Services Thomas F. Geiler, Director Building Division Peter F. Dullatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 ce: 508-862-4038 Fax: 508-790-6230 Permit no. D CO Date --3—:- I--'j- AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction:alterations,renovation,repair.modernization,conversion, improvemem 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. nn TYP e of Work: 1� . 1(: Estimated Cost Address of Work: 5 Owner's Name:. kv Y . W h i r ku Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law Rb Under$1,000uilding not owner-occupied Owner pulling own permit ,. 1, Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED. CONTRACTORS FOR APPLICABLE HOME IMPROVEMEW WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL.c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's amce Tabis M=b(a tlzn Prneripttre Padoge for O6 and Twos-Family Ra*6s xW Baiidhw Heated with Fad Falb r MAXIMUM { MIMMIIM GIaamg Glazing Ceiling Wall F7oot 13ssmsm Mab B ' '('/•) Q-valim, R-value, R valus, R.valud Watt FMd=Cy' Pacimse. W"h at Rwslosr 5"1 to 650013 Deaesn Dam'. . Q 12!4. 1 0.40 1 31 13 19 10 6 Normal R 12%. 032 30 19 19 10 6 Normal S 12•". 030 31 13 19 11). 6 25 An T 13%. 036. 38 13 . 21 NIA . WA- Normal U 15% 0.46 32 19 19 10 6 Normal V iS'/. 0." 31 13 23 NIA WA t3 AnM w im 032 30 1 19 19 10 6 13AnM X 11%. 032 31 13 23 WA WA Normal Y 19% 0.42 39 19 21' NIA WA Normal Z IE•/. 0.42 32 13 .19 . 10 6 90AF AA 11•/. o so 30 19 19 10 6 90 AF L ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q ' AA.-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-fo=4980303a , �0* The Town of Barnstable * BARNSTABLE - 9 MASS. �q Regulatory Services c°ArEo39. Ma't aim Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 200 Main Street,Hyannis MA 02601 . .ce: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION_ Please Print ' - DATE: /� JOB LOCATION: lJ i4 f/holliy ('� ]4 I number In P street village „HOMEOWNER": Pe J� f V'I�1 i name y� C/� �►n home phone# work phone# CURRENT MAU—ING ADDRESS: CUft4 WK 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 j 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 Depart um inspec p cedures and requirements and that he/she will comply with said pro edures nts. Signs 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 helshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEIviPTN . ' i SMOKE DETECTOPI..' BARNSTABLE BUILDING D nsc.Y�iJT 7. .. 11 ----- . — - _ Ly u7;aT-sulac�t;y � �. Sr/1i,t.k'vCl':I—. I ,. - '' -- '—--- .: f r ✓ i ` ' J 1 I • IL I_I. � � -� � - �K!'7ChEll..UrS..A! t'.. .... .. �_� � 11 I , : 1Zt7hLIVn T��N - -71 77- I 1' I C.U)"Iz_'.SG v I 7WLa. _ :.: 08.428 5 r - � ,, w I, I (Levi i n sign s4 7 �e s ! 1 _ ' ese _ 001 Iv 1 II Rights copyrightR rvea _ _: ...- .. r-.2ola� e�v.�T�k�N 7, t- 0I b ti i7 f26 -a `5 Preliminary plans and layouts by OC O.are for the use of [heir cuseomerz only Any other use is s[nc[ly prohi Di[e c QI :_BIl�PUC31J 7. - 12—RRAfr-Rs , c — z r j 4 ... rvl ./ �houcvrnlv�"eR ,sl?, � I za `. U� Jv s ;rr(t��ricr Ex 15i41 t9 1 /24 �.—_.. _ -- F 77 SN tAct - ._ .. .. Z,icri:JOISI� JIG,,... . I 4'1Lw �:I .._ ..._._ a _' A!.-4N.•_osiTTF1Z�L:'L�:.. .I e ... rl - 1 M1[2Ue1au Tp — —. • - IA-ITKICGr•-::_ - L �U1^ 7 DE- 1 I-.-T',..1 I,JI_T/� C n IE No uncr 5 08.448•6191 _... .I Mevl i n @UstOM i; designs copynghrc,2001 f t All Rights -, Reserved i 41,N -HLIMP I � 5 �..'L _1: T0.CC.'2eF.�cr�J .. I CNn2:fiPtsL115tU&Tl13sq .. �^ � . • "� NOSY..(_C)IJ JT ttN TtVW ... ., -. ... � , U 4'L f� n ' .c61aTL.r•fG4L�b Vt21F'L17s'lu�!�Sa'ONU UIJ4�!7 ..:- -"-."""` • Pr eliminary plans and layouts by'DC'.D are for the use of their customers ohly.Any gther use is strictly prohibite NOTE:These plans are for the sole purpose ': ' and use of Capizzi Home Improvement and are not to be distributed or used for construction other tha d by Capizzi Home Improvement. `i1 lQ l l ` — C � C E Co U ` K I Ln Lo• ; ! I , i T CD N f N�t�•,�(��. �) �ttC�T I T'l o�� , � � � � � w � o �-- - -- , -. xIST INS To � I�Ir��t i I I � ono 70 N O LLI .�. a) CD0 a � c� CO U ?3-3 C.) Z , 1/ W Ln - - N U U 00 --. — Ln CL H I VT o:p hI I.NG� krlFT -� �- 6; (WIN C7 i?od �Y -�,- -1 _ �Y oWN L - -- - F,W , • CC� EONIC aw, te NOV 1 7 2009OW - - TOWN OF BARNSTABLE 1' 9 HISTORIC PRESERVATION 1'2- Iq APPFtOVED DEC 69 Z009 f �Y Town of Barnstable y Old King's HighwY a ` 1 Comnn�ee -- p T`` T(TAI OF BARNSTABLE SVf SIQ i i 16� )Gd PT - f i 5a u5 p,@�v/d le. • �bs1� qx.� ( Tois7 /&gcrsjj Y POST - j �kY•nT , ' ' '. h i"ll n� SysTem i TO . OF BARNSTA LE •' r P N { q _ rszz�rr-*angina-;..gcuca.�m,.se:scasca�m�€ f�� , � 10 a �-o °t9- Z,u 1 F { 1 x i i r r � f i xg PT LA ( t�s ( i ( JOIST h&,q ers I Avs1� � j qkl-PT °id. 13�l�sTe�- 1?e�/aCcfn&-.n�� woo > > E Jell nj Sy5fem