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0225 SCHOOL STREET
1 rACTIVE Assessor's map and lot number .. ......- ...;..... ti SEPTIC-SYSTEM MUST BE C� INSTALLED IN COMPLIANCE Sewage Permit number ........ WITH ARTICLE II STATE �f "', SANITARY CODE AND TOWN y�i YHE OWN �..O N F BAR AWE E 47 Z HAHBSTABLE, i 7.y` �,� f•'"` "b` 0N RU ;L.DIHG INSPECTOR O'FPY r_i APPLICATION FO n PERMIT TO c �.fit.........:.... rrv,. TYPE OF CONSTRUCTION ... ................................ ... ............................................ XA............. .�X..r.... .... ...?..� �a TO THE INSPECTOR OF BUILDINGS: w r The undersigned hereby applies for a permit according to the following information:. ` Location ......... .. ......S.C.4.o.o.-C........1.7-.......... `........ .5"S.r................................................................ . . Proposed Use ......... ...y........;l�..c.�u.. .. ,.C ..<., .....................................................I......................... ZoningDistrict ................I .....................................................Fire District .............................................................................. Name of Owner 7'74.Address J.5ea.a. .C.���....�f.r. �. ... .!'b' Name of Builder ... T......A,1. ./.v.ti-?.r..................Address S-.W.......67..s,.e. S-7.................. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ....f .! .. : ................................................. Exterior ................. ....... ................Roofing .........:' .. ....4 71...................................... Floors ....................C..,...,.... v. ....................Interior f .. .... '� Heating . �.Q.T... ! ....Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ... C?. ..(,9.C2.0.....Gv.............................. Definitive Plan Approved by Planning Board -------------------_------------1 9--------. Area � � .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH - • f i i O C 60 kI N r �U VT I hereby agree to conform to all the Rules and Regulations of the Town'of Barnstable regarding the above construction. Name ....... ..... '. �.....:....... ....... Cincotta" John B. ^ ` \ . No — Permit for ......04.��..�we1l��o ' . l ------------.—.------------.. Locution ---�2 2 5..B.cbOALIAt�.amat................. / ----.—.—..�obat—.—.----------.. ^ ' . - ` . Jw}�� B. ��m����a Owner ~ ' —^—^-----`---------''—^—' \ ' . - \ ) ^ frame Ty�m of Construction, .-------------.. � ' ' � | '-----.-.~-^,,~^.—,.-.~.--..----_— � � / \Pk ................................. � .__------ �� . . . . ^ � ! ' . ' March 31 78 ,Permit Granted .. lg ~ � Date of Inspection ��m*�' ~w" � Date � Completed . � . PERMIT~ REFUSED. ' 19 - / '-'`'�`'—'=''`�°�'~-'a�'—' ' ................ = ^ '—'---^~— ....—'---^-~^^^—^`-'~--~^'' . . ' . . . Approved ' ~ --------`------- 19 —^r--------^---^'-------'—'-- ................ ........... ........................ —^--''--^^^ \ . . - � � Assessor's map and lot number ... ....... ... ••.•.......•• ���---- ire Sewage Permit number .••�...tm.!!!....... y0,*THETo�° TOWN OF BARNSTABLE P i BJHB9TAIILE, "6 9 BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........:��-:... .f'�..... ... �. '. °.....�..''`. �............ .................. TYPEOF CONSTRUCTION r ' —..................................................................................................................................... .................... .........................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..........1...L.. .....: .. ....:+..G........(-7-..........r .'.'........?>........ ?,' > C-s............:............ ' Proposed Use ... .n �...:........ ........ ............... ............. ZoningDistrict ..................4......................................................Fire District .............................................................................. Name of Owner .:tj.'.... '............ ��: •.. :�..:r::.%.' '.Address ..f?..:..... ....�........ .... .�: r..... ::..." ............ �:. � h Name of Builder ..........':..:..:.r / g..................Address /t„ r ., ,. = .................. .............................. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .................. ................I.........................Foundation ..........................:.................................................. Exlerior 'r%<z -r ...................t............. .............?.:......%...........^.............Roofing - Floors `.^'.'..:: ................................................Interior ......................................................c .............................. Heating ............................................:.........G................ ...Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ............................ ......... ............................ ti -----19--------. Area ...'* Definitive Plan Approved by Planning Board __________________________ ............................. Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I D r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .:...: .:.:.....'.. .. 1............:...<<.l...r�`. : ............ Cincotta, John B. A=2 8 �79 No .......�.q958 Permit for ...444.4..W.Axelling 1W 41 .....................:�........................................................ Location ...............22,5-School-Strepat........... Cotuit ............................................................................... John B. Cincotta Owner .................................................................. Type of Construction ...............f ................ ................................................................................ Plot ............................ Lot ................................ March 31 78 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUS D REF ........ ....... 19 ..... .......... ....... . ........... ............. ...... .... ..... ...................... ................................................... ........................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and lot number .......14-5.� ...... ` SEPTIC SYSTEM MU T 'If NETo�f Sewage Permit number ..4.74 . . INSTALLED IN COMP .1 _ .... WITH TITLE 5 t BasasTnnLMAGIL E; House number ..........c ................................................... ENVIRONMENTAL CODE .9 W 039 TOWN REGULATIONS 11M0"�e� TOWN OF BARNSTABLE BUILDING JI'SPECTOR APPLICATION FOR PERMIT TO ��C L O`s c �0 2 .......... ..... .................. ............................. TYPE OF CONSTRUCTION GC C �I .......`.............%........................ t � " ' ................... 1.. ...............19. / TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a .permit according to. the following information: .Location ......... .............................T.J.O�/..............:..............:.................................................................. ProposedUse .......................... ...........................................................................................:...................................................... ZoningDistrict ........�.................................................................Fire District ...........................:.................................................. Nameof Owner ............................. .............................:.........Address ....................................:............................................... Name of Builder• ... ................. ........................Address ..... Name of Architect ..............................:..................................Address .................................................................................... . Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ...Roofing ..................................................................................... Floors ......................................................................................Interior ....................... ..................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ......................................... ......................... co ,� Definitive Plan Approved by Planning_Board -----------_______------`----19________. Area ... ..............�..................... 0 Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Q �— OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and- Regulations of the To n of Barnstable regarding the above construction. . Name .... �.'..-�...:..�.�1.............�....G.......................... CINCOTTA, JOHN B. 23708' ENCLOSE PORCH No ................. Permit for .................................... .......S.inq.le....Fam.i1v...Dw.ellin.g.............. ....... .... Location ...2.2.5...S.c.ho.o.1...S.t r.e.e t................... .. .... .. .. .. .... .. .... Cotuit ............................................................................... • John B. Cincotta Owner ................................................................... Frame Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted PIP.9.9Yn.1;)Qx...1.7..........19 81 Date of Inspection ...................... 9 10 Date Completed ........ U � � t L/i j,J� Assessor's map and lot number L... �QypG 7N E Sewage Permit number ..q........, ...... d House number ...........: c .................................................. 9�33JHB9TADLE,raga _ pow 039. 9� 'E p R-1 a TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO vc 0 S ...... ................................/ .. . . ... TYPE OF CONSTRUCTION .................. � :J. C... .......�'.d �.�..f........ (J.......................... 1 ............................ ] 19. / TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..............................:(;f o ?.�:........................ �TcJ/.................................................................................................... ProposedUse ........... .�..../DES/C�.............................................................................................................I......................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner .......�l�✓ .�. L. . ..................Address ...........................................................`......................... Name of Builder' 3/4.u�..... :...r ?M �15 ....Address J `-� l� 6 //. d`�w/. ...... ................. r ............. ............................................... �! Nameof Architect ..................................................................Address ....................................:............................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ...Roofing I - Floors ......................................................................................Interior .................................................................................... Heating ...........................................................:......................Plumbing .................................................................................. Fireplace ............................................................... ....Approximate Cost .................................................................... .. f� Definitive Plan Approved by Planning Board _______________________:________19________ . Area `.........................................�` ' Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I ��V f a r`*z..tf A �2V OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. f Name �L . . G ... �� �. .�r.- .................... CINCOTTA, JOHN B. 23708... Permit for ....ENCLOSE...PORCH No .............. .... ....... ..... ....... ... .........Single..Ec-AMi.1Y..Z)W.e1..U.Ug........... Location ... ................. ..................C.Q.t. -ui.t.............................................. Owner ....iTQ)ATA..J3......Cin.CQ.t.ta ................... Type of Construction Frame .......................................... ................................................................................ Plot ............................ L .......................... Permit Granted ce4e 17 !� ........19 81 .... ....... .......... Date of Inspection ... ... ..... ......................19 Date Completed ............. ........................19 Assessor's map: and lot number:.Q! (',a..:.........©9- „ SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE F THE rot Sewage Permit number ........: .��.�".�l.�... .. .. ..�... WITH TITLE 5 ENVIRONMENTAL CODE AN f = BAHH9T4DLE, Hbuse number ..... ::::.;,..................... ............ TOWwNgfi ,TIN :o roes ........... i,'�� �' c�Q,-llar w a l' p i639• \0 -AND f'Y V)a S 0 YPY a' TOWN OF BARNSTABLE"'9`" 'nec� � BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... f/!�!U/ ....... ................................... ........................... d000/�_/�??�9?7 TYPE OF CONSTRUCTION .:.................................... .......................................................................................... ......... . ...t3..............19.g TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followingfollowing information: Location ......� ..... � .m..A.... 7.wa.....1.. .:......................................................................... ProposedUse ................rc.! .............................................................................................I......................... ZoningDistrict ..............h F..................................................Fire District ..... . .!L.....:'................................................... Name of Owner ...1.4!4..k.�4JL5. .1�..:`,�c!� ............Address .4. .� �0�\ �3T � P� .. :........... Name of Builder fmL. 1�!.....1..!'.lOn.N�...................Address ...� .�..... . ` ..:...................... Name .of Architect tdirm. .�...: .tA.& .0.................Address .... i�61....... Number of Rooms ©19� ....Foundation �LOC. �.coa p—A .............................................................. ............. .... ................................ Exterior ... .................................................................Roofing ......�..1 .- & ....................................................... Floors W.40� .................Interior ... . .................................................... Heating r'A.W .................................Plumbing ....... ° QC? Fireplace ......pw t..........:.................................................Approximate. Cost ....��.).QQ©.°.off. Definitive Plan Approved by Planning Board ----------------------_---------19________. /Area ............................ ......... .. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH fiwLs-rI 1-�,rotk �1 'lib s OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. C� Name ..... ... .... !.".:.`. ...................... Construction Supervisor's License .................................... CINCOTTA, JOHN B. No ..2.a427.... Permit for .....AvLDj.T. .jGq4............. Single Family Dwelling ................................................................................ ri Location 225 School Street................................................................ f"V Cotuit ............................................................................... Owner ....r.,'John B. Cincotta .......................................................... Type of Construction Frame.......................................... Plot ......................... Lot ................................ it 4 ee'rmit Granted ....$.e.ptpm er...16"......- 9 85 Date of Inspection . ................ . ..... 9 Date Completed ...................... 9 M Cr -m6 CU M >. M 01 4CC M (A lei q Q - Assessor's map and lot number .��............ „1. .:... oFTHETo Sewage Permit number ............ I BABBSTABLE, i House number ..... ......................................... 9 Maea �nvCf ce_Ii r wal ppo,163q. `00 � TOWN OF BARNSTABLEAte,'yea BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..........hdd, �dJ.................................................................................:.. TYPE OF CONSTRUCTION ..........GU..../,,/ ......................................... .................................................. .........� .....3...............�9.g.s TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... �� ..... c�G. �...�-5 .:........ Ti,. c .... ...+�a5:...........................:.............................................. ProposedUse .................�!= /GUL`. ................:.........:............................................................................................. Zoning District .............. .......................................:..........Fire District fit '...................... Name of Owner ...M. �.�..-.0 .QrCrO .............Address .C9 .�6CA.. ..................... ......T?.:........... Name of Builder ...................Address A .................. w.ld( T .....'.!............ ..... . Blame of Architect L�rt'►P�(Z t 5... .�`�"�.0................Address .... ., ,��V.....�.t� �: �U..1.S. _ `. ..... .............. Number of Rooms ................. Foundation ....................C C...C.�..a..�.C...R..C.................................. Exierior ...i ............. .Roofing Floors ...... 067 .........................................:....................Interior ...5 ��� � Heating ...rA. ..................................................................Plumbing ....... .................................................... Fireplace ......Q(� Iq ......................................................:........Approximate. Cost � Definitive Plan Approved by Planning Board ------------------------- -----=-l 9--------. Area .�................... ......... .. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ao' X f�l�/I l'4D Pl2�J L.i�tl/ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. !j . '' Name ........ ..................................... Construction Supervisor's License .................................... CINCOTTA, JOHN B. A=020-098 No ..... Permit for A011.1.0................. ..........S.'j'ag I e...Family..DW.P'.Iliag.................... Location ....22.5..Scho.Q1...S.trea.t...................... ......................C.Utui.t............................................ Owner ...........J.Qha..B..X.:Wr-.Q.Ua.................... Type of Construction .......Er-arae......................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ...........September 1.6?..19 85 Date of Inspection ....................................19 Date Completed ......................................19 _ Town of Barnstable_ _ Building, saawsrn re Post This Car So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept M^ �p Posted Until Final Inspection Has Been Made. We p�ym�� 1639, Permit m 1 Where a Certificate of Occupancy is Required,such Building shall Not be Occupied,until a final Inspectipnshas°been m; Permit No. B-19-1557 Applicant Name: ALEKSANDROV B KONSTANTIN Approvals Date Issued: 05/21/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 11/21/2019 Foundation: Location: 225 SCHOOL STREET,COTUIT i Map/LotY020,-098__ -_ Zoning District: RF Sheathing: Owner on Record: LOGIE,ANDREW T&SARAH E Con-tractor Name:; _ALEKSANDROV B KONSTANTIN Framing: 1 Contractor.License: CS`093798 Address: 12 CREEK DRIVE 3 2 NORFOLK, MA 02056 Est. Project Cost: $65,342.00 Chimney: Description: REPLACE FRONT.PORCH AND REPLACE REAR DECK REPLACE 2 Y Permit Fee: $383.24 SLIDERS OUTBACK CHANGE 3 FULL VIEW GLASS PANELS ON SIDE OF Insulation: i i Fee Paid:` $383.24 HOUSE WITH 3 WINDOWS TO MATCH FRONT3SIZE NO HEADER Final: CHANGE. i �, Date: 5/21/2019 Project Review Req: J j� Plumbing/Gas Rough Plumbing: a Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within'six months after`issuance. All work authorized by this permit shall conform to the approved application°and the approved construction documelnts for which this 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-lawsAand codes. r Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open f rpublic inspection for the entire duration of the work until the completion.of the same. j Electrical The Certificate of Occupancy will not be issued until all applicable signatures by.the Building and Fire Officials are provided on this=permit. Service: Minimum of Five Call Inspections Required for All Construction Work: ` 1.Foundation or Footing Rough: 2.Sheathing Inspection g 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.lnspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (asset forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT / Application Number. ... ...... .I.. ........ ' BUILDING' ' * EPT. MA88. � G D Permit Fee.......................................Other Fee........................ 16,1 Fc ° MAY O 8 20195 ....Total Fee Paid............. . .. ............ ...... TOWNOF BAR ��L'i6Ll'�ARNSTAB EPermitApprovalby.................................on...... BUILDING PERMIT .( . .0.................. arcel.......11.. .. .... . ' APPLICATION Section 1 — Owner's Information and Project Location Project Address �2 c,G -o'er Village °Owners Name , Owners Legal Address City .� State Zip A � Owners Cell# �2 3�j E-mail Section 2 —Use of Structure Use G2oup ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild Deck Apartment © Sprinkler System ❑ Addition Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify. Section 4 - Work Description tv 71 a e- t Application Number.................................................... Section 5-Detail t:o c, Cost of Proposed Construction ( � Square Footage of Project ry Age of Structure2qDL�5 Dig Safe Number. #Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6=Project Specifics 4 ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire+Suppression • ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water SuPP1Y _ Public Priva ��t Sewage Disposal ❑ Municipal . On Site _ a Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility �11�1(1957 �_ 1e p ty: I am using a crane ❑ Yes rNo Section 7—Flood Zone Flood Zone Designation . Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required - Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No iac+n A tP+ 17/TS/7n1Q J A ti � � ,►`��+ ���,� �j��-"�off, _„ �'�.. . .. .,� _ter �r �y.�i 4�FC•,'7' ' � '� • - _ ��` _��are. �3��!�� ;�. ••� �r -- r71 } rt F l 1 l o r (k .d } t k S E , _ e A+" ,� � ,_.. `.'-Y,��--ram"`• k C { 4 r t 1 I it .. "' Flun J r §a lit- k x q��'` �t IS, �S y 5 ��° '� � (� •-`fSr�' �d - 7f t k` .�e.�'�»- ,`�, P� s ,k!` ,. - s � o '�,j��h' . - ,�*` � � �" o�'� ♦ .�`� �;.t° .Ly.�yx'lh �:y.� '{ r x r q� e ,u••�`,,,e.. a...t {� �� '�.• 4 '�w'n1M,VF t 'r+: `M# -rp f✓ sA M`F� q 4��, �'. ��� ,F � �'9 ti L{ R F• w:' �r �lx Ma��--t%� �}�� ,' �+�x� 4;Y�,�r ym:i ,� w`Y $: N•v. i i;�a6,�`j'Nx x t,�'� ,�" a4 s r �'.: '� ".- ,° .N _ a• r& ° t J dv aF ak.Ar' A.` a .,+^ k :., s• P4ytr. s r f`0. ����✓ V V `�"l �-.ter.,......._. .�.w - �......_.._ -a. _ fL � , n � � ..- � { N gm ml jr, � J s iA i�; _ _ � � ��t ' _ �,� � �� g r - ;, � y .. ���� � � �.� "' �� �� ,� w. - s � �• k� #_ }_......- -k� �' ►� _' E�t� ` r, a � <. _, ... � � � �s � � �� �� � � �. �� ,, .�,�� �.' � -� �. � �3 , "'ems M 'e :.°�""' --tia'.`v� ,--mwrnsr ..w.�cesa}+•k�F 6�: .�� e m � Vie• ' - E'. i F t iME �-Pi 577 �L�r r _ f ,v s. 3 1 .fir.. t 9 - s x � f 4 r Y � � l If Y. t q ? F{F d .4nofvl KIIROY g,WARREN,p,G, ` UNltl Ct1'19S12RD LANE Ocrd fttMk 16008.:. ,Hn /,ender: /'/nn RnaA- 257 P„,e.26 Ll.J s Oµ ner: ao0earalW,R ,GARCT ORLANOO, ItEGICI'EItEU.1.AN11 R .llnok .Slrcef Lnf(s): /)mr 6k7/20t6 •' Cerrr ,e-areo Till'! ' rl terccnr:e Ilia 20 R/A Lot e9 �Census.Tin f - � 1 x ` 1tl'ORT,CACE INSPL"CTION Pi 4N Scale 1 =So'A 225 SCHOOL ST/ZEET COTUIT, BSA ' N/f GIFFORD t45.00' f 1 F ra 'D. o LOT'23 1 * , � l o LOT ✓o GAR' CU 25 v 9 DK' t a 225 I E.T o W BUILDING DEFT CCRTIF/C 4T/ON _ I CERTIFY TO THE ABOVE ATTORNEY,RANK,ANDTHEIR'I TLEINSURANCECOa1I'ANYTIIATTIr I IN�2(lX 1{ - NDATiONbR DWELLING WAS IN COMPLIANCE WITH THE.LOCAI;ZONING BYLAWS INEFFil WOE NCONSI'RIiCTGU' VI7 IR TO UCTURAL SETBACK REQUIREMENTS ONLY)OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS.GENERAL LAW TITLE V11 CHAPTER40A SECTION7. TAW ' OF NOTE LOT CONFIGURATION IS BASED ON DEED,ANDJORASSESSOR'S MAP B OCCUPATION.A MORE ACCU� LZSEA/d& ON WILL REQUIRE AN INSTRUMENT SURVEY. a FLOOD DE.TERA4l1v,,tTJON BY SCALE,THE DWELLING SHOWN I IERE DOES NOT FALL WITHIN A SPECIAL FLOOD HAZARD ZONE AS DELINEATED ON A MAP OF COMMUNITY 025001CO752J ASZONEX DAT] l6-14 BY THE NATIONAL FLOOD INSURANCE PROGRAM. k y � is rt'C 1NOF4I4s�� ey GA Olde Stone Plot Plan-Service;LLC •., o, LABFlIE, 4 P.O.BOX 1166 y 'W,N0 4U039 v Lakeville, MA 02347 9o�E Ao�,e Tel:r8001 9934302"'. S Fax: 8001 993-3304 a , 4 PLEASE NOTE.-'This inspection is not the result of an instrument surrey.The structures as shown are approximate only. An instrument survey would be required for an accurate determination of building locations,encroachments,property fine dimensions,fences and lot configuration and may MOW different Information than shown here.The land as shown is based On client furnished information only or assessor's'map& a.ci0tibn end may be subject 10 further out-sales,takings,easements and rights of way. No responsibiiity is extended to the landowner or all or ocarpnnt. This is merely a mortgage inspection and is not be be recorded. l t+s Za.)y v fkee'nr ix` !=A- f i',v a LSFs t..� x i �sY.. .+� .�,d'�. �l,;t1�¢u.�. Quinn 12 Jon - i .. r1'1. "Ei- -�1.�.. "r`L.�--r--+"• .. a us�^.F3t"�1,.s:�o G, subj`�'� fi r«7efl,,`: I'- x«.2...3•�'� J a��� .�. � `�U�t�a Vl.+r ,�•��'.�'t.�.. �1�•..�., +,.www,..+ �j�� 5�,4*,--K.-Fn,.���,.A�' ���q.'-�x�d.dw.E eM. EA5 ,tb F ' E x F a Aco CERTIFICATE OF LIABILITY IN D"TE ONYM �..� SURANCE 09 07/1 8 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICI�TE HOLDER.T AS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLCCI BELOW..THIS CERTIFICATE OF INSURANCE-DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS),AUTHOPMD REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provl�lons or be enc orsed. If SUBROGATION IS WAIVED,subject to the terms,and.conditions of the policy,_certain policies may require an endorsement: A stateme it on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ' NAME: JIM HINDMAN Schlegel&Schlegel Ins Brokers,Inc. PHONE 508-771-8381 34 Main-Street Alc No: 508-77 -0663 West Yarmouth,'MA 02673 ADDRESS: schlegelinsurance@gmail.com INSURER(S)AFFORDING COVERAGE NAIC g INSURER A: NGM INSURANCE INSURED INSURER s LM INSURANCE COMPANY I KREATIVE BARNS INC INSURER c 159 OLD MAIN STREET SOUTH YARMOUTH,MA 02664 INSURER D: 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 FORTH POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPEC TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO THE TERMS, . EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. nw LTR TYPE OF INSURANCE H&WVQPOLICY NUMBER MM/DD po M/D ; LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE] $ 1,000,000 CLAIMS-MADE OCCUR - PREMISES Ea occurrence $ 500,000 i MED EXP one $ 10,000 A MPP5983J 08128H8 08/28/19 PERSONAL&ADVINJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER GENERALAGGREGAIE $ 2,000,000 POLICY❑PRO-JECT LOC OTHER: PRODUCTS-COMPIOPAGG $ 2,000.000. " $ AUTOMOBILE LIABILITY C BIN D S NGLE UM $ Ea accident i ANY AUTO BODILY INJURY(Per Person) $ OWNED SCHEDULED_ AUTOS ONLY AUTOS BODILY INJURY(Per aWderd) $ .HIRED NON-OWNED PERTY A MA GE, AUTOS ONLY AUTOS ONLY Per PRO accident $ UMBRELLA LIAB EACH OCCURRENCE!OCCUR i s. $ EXCESS UAB HCLAIMS-MADE � AGGREGATE $. DED RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS LIABILITY YIN x 3 ATUTE 'ER ANY PROPRIETORIPARTNERIEXECUTIVE B OFFICERIMEMBEREXCLUDED? FN I N/A WC-1185197 E.L.EAC HACCIDENTI $ 100,000 (Mandatory In NH) 08l30l18 08/30H9 Ir yS describe under E.L.DISEASE-EA EMPLOYE $ 100,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500;000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addltkmal Remarks Schedule,may be attached If more space Is re"Ired) CORPORATE OFFIERS HAVE ELECTED TO BE.COVERED UNDER THEIR CURRENT WORKERS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEI i'BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BEIDELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. j AUTHO=P11VE 1933-ZOW=ORD CORPORATION. All rig reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information _ J 'Please Print Legibly Name(Business/organinflon/individual):�91/j'2G�-� �'e S t?ii.C . Address• City/State/Zip: '���'^✓Lcg'1.��� X Phone#• j4w A1119% Are you an employer?Check,the appropriate box: Type of project(required): I PI am a employer with 4. I am a general contractor and I 6..❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g• Demolition workingfor me in an capacity. employees and have workers' Y aP n'• 9. El Building addition [No workers'comp.insurance comp•msurance•t ram] 5. We are a corporation and its 10.El Electrical repairs or additions 3.El I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required,]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing an work and then hire outside contractors most submit a new affidavit indicating such. tCont actors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: lN�•-- / 7'� Expiration Date: � G2 Job Site Address: /�7 �) f/�� Yl City/State/Zip: / / —tl Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a, fine up to$1,500.00 and/or one-year'imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and i fine of up to$250.00 a day against the violator. Be advised 13iat a copy of this statement may be forwarded to the Office of Investigations of the DIA for instmance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true andcorrect: S Date: / Phone#: Ojj` Iat use only. Do not write in this area,to be completed by city or town ojj"iciai City or Town: Permit/Liceuse# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,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,§25C(6)also states that"every slate or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to constrict buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public workuntil acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." , Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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. In addition,an applicant that must submit multiple permit/license applications in any i en year,need o 'submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future 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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would Me to thank you in advance for your 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 fMce of I.nvestigatim 600 Washington Street Boston,MA 02111 - Tel.#617 727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www;mm.gov/dia 9® Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Const\ieti'1iri�SiSpervisor CS-093798Empires: 07/0712019 Nim FYI ALEKSANDROV B KONSTANTIN P.O.BOX 842 WEST YARMOU:TH MA 02673, a , 461 -S=T_il��` j Commissioner s&Business'Regulation :NT CONTRACTOR Registration valid for individual use only idividual before the expiration date. If found return to: Expiration Office of Consumer Affairs and Business Regulation 12/15/2019 10 Park Plaza-Suite 5170 Boston,MA 02116 HEY'j Undersecretay J40t vali ithout signature I /memesiepu fl ! aanjeu6is;nO4jjM- !jeA IO £L9ZO ` lN'Hinovgljvk 3AVAIJU39 LL AOlja SN-31;d'9 NI1Nb'1SNO71 1dglp ENO11.0,n j1SNOO A v W d/9/O ' ;tea, �� ,nO8 5JI3yd NIlNt/1SN0Ji 9LLZ0 vw`uo}sos OLLS 931nS-ezeld Ted OL 610Z/91./Z1. -- 9bZ6bl i uol;eIn6aa ssaulsng pue sjlegt!jawnsuoO;o aalO uol;e�3x3uol;e�3sl ay :o;ujn;aj puno;;l •a}ep uol}ealdxa ay}ajo;aq lenpwpul 3dl Aluo asn lenptnipui jo;P11enuol;eJ}sl6aa i HO1OVH1NOO 1N3W3AOadWI 3WOH uolteln6ay ssaulsng s sneuy aawnsuoo;o eoillo . Diam' 6ndPaer, FOUNDATION SYSTEM L RESIDENTIAL DIAMOND PIER LOAD CHART IAS Accredited Third-Party Bearing, Uplift, and Lateral Field Tests2 Minimum 1500 psf Sllts/ClayS (CL,ML,MH,CH)' Model/ Pin Bearing Load Equivalent Cylinder Frost Uplift Load Lateral Load No. Length Capacity., . Base Area Comparison Zone,. Capacity Capacity DP-50/36" 2700# 1.8 sf 18"dia 24" 600# 600# DP-50/42" *3000# 2.0 sf 19"dia 36" *900# *600# DP-50/50" 3300# 2.2 sf 20"dia 48" 1200# 600# DP-75/50" *3750# 2.5 sf 21"dia 48" *1400# *600# DP-75/63" 4200# 2.8 sf 22"dia 60" 1600# 600# Equivalency to Traditional Concrete Footings Minimum 2000 psf Sands/Gravels (SW,SP,SM,SC,GM,GC)3 Model/ Pin Bearing Load 0 Equivalent 0 Cylinder Frost Uplift Load Lateral toad No. Length Capacity Base Area .Comparison Zone., Capacity Capacity DP-50/36" 3600# 1.8 sf 18"dia 24" 600# 600# DP-50/42" *4000# 2.0 sf 19"dia 36" *900# *600# DP-50/50" 4400# 2.2 sf 20"dia 48" 1200# 600# DP-75/50" *5600# 2.8 sf 22"dia 48" *1400# *600# DP-75/63" 6400# 3.2 sf 24"dia 60" 1600# 600# Equivalency to Traditional Concrete Footings *Interpolated from field test values. Notes: 1. This load chart is intended for simple structures supported by columns, posts, and beams loaded up to, but not exceeding,the stated capacities. It is not intended for structures with asymmetrical, rotational, overturning,or dynamic forces. Intended uses are described in section 2.0 of ICC-ES prescriptive bearing evaluation report ESR-1895. For projects that exceed the capacities or limitations defined herein,or the intended uses described in ESR-1895, contact PFI for additional information or site-specific capacity evaluation. See also the Use and Applications download at www.diamondpiers.com. 2. Capacities shown are tested to a Factor of Safety of 2,and are applicable in properly drained, normal sound soils only, with minimum soil bearing capacities as indicated. Copies of the field test reports are available from PFI upon request. 3. See IRC Table R401.4.1,"Presumptive Load-Bearing Values of Foundation Materials,"for a full description of applicable 1500 psf and 2000 psf soil types. For soils below 1500 psf,or soils with unknown characteristics,additional site and design analysis is required. For soils above 2000 psf,the values in this chart shall apply. 4. All capacities use four pins of the specified length per foundation. Pin length includes that portion of the pin embedded Within the concrete head. See"Check Your Layout"in the Diamond Pier Installation Manual for more information on pin/pier layout and spacing restrictions. 5. For professional engineers designing for short-term transient loads,contact PFI for further information. ©2017 Pin Foundations,Inc.All Rights Reserved.D000008/01.2017 4810 Pt Fosdick Dr NW,PMB 60 PIN FOUNDATIONS I N C Toll Free: 866-255-9478 Gig Harbor,Washington 98335 Main Office: 253-858-8809 www.pinfoundations.com General Email: info@diamondpiers.com BEACON Complete Measurements 225 School St, Barnstable, MA 3D+ p PHOTOS I- t� a r y}'ems. C . per. �'z+�_i 'OF^._y.'e•d i!{+`•L•,^ R FAsy<•:;w Y 5 h,�,r�s'�s„` w _ � ^ ©2019 HOVER Inc.All rights reserved.This document and the images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark of Hover PROPERTY ID:1065523 . Inc.All other brands,products and company names mentioned herein may be trademarks or registered trademarks of their respective holders. ®•• : by • ER Use of this document is subject to HOVER's Terms of Use and is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or implied,arising by law or CAPE otherwise relating to this document or its contents or use,including but not limited to,quality,accuracy,completeness,reliability,or fitness fora particular purpose. _ 01 MAR 2019 Page 25 BEACON Complete Measurements 225 School St, Barnstable, MA 3D+ PHOTOS j # � a i F..,.. ....w,,..-.. ..-..,w.....�aa..mm...�i ,.ra e..+..wmt:...�. ",...,�.2.W..,r+.,�e4�=+i;.:rz.,..+N,..� a+oM•.<.r.;. ©2019 HOVER Inc.All rights reserved.This document and the images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark of Hover HOVERPROPERTY ID''1065523 ' Inc.All other brands.products and company names mentioned herein may be trademarks or registered trademarks of their respective holders, 1 Powered by Use of[his document is subject to HOVER's Terms of Use and is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or implied,arising by law or CAPE otherwise relating to this document or its contents or use,including but not limited to,quality,accuracy,completeness,reliability,or fitness fora particular purpose. 01 MAR 2019 Page 26 a nth-e e e t .._..•NSF .� ��` ' t w,e���} to t �'' y....,,_•— �� � EPPv�wvvv� 1 } � ! _ .era- �'t ,>}I#e �,�• i ♦ r R � . • s r A e. .G� yJ{ w• t �Zr..r.�,.r.vY:aGw.,b...�..�, �r».,e.�s. �—'fii......... ..... .... 51��..�� _ .`a�� �... r• ,..,.e-.�-�.-�...�W��:.�...�.�_� Ihttp://www.m Th s.gov� is is an official application of the Commonwealth of Massachusetts as Office of Consumer Affairs&Business Regulation (http_//www.mass.gov/ocabrtj #tome.Imprrovement •c CGnbactor,Program (http://mass.gov) My Registrations • Your company Registrations and/or Applications with their statuses are displayed in the list below. • To manage or view any Registration, click on the appropriate Task button. • To register a new company as a Home Improvement Contractor, click the Start New Application button. Start New Application VHIC/Register/Checklist?contractorld=0&applicationld=0) . ,Contractor HIC tRegistration:Effective Expiration'Application`ApplicatiomCreate I Name Number Status Date Date Type Status bate 'Task Kreative _ . ..__._.�.. � � . � • ~elnitiat � 'Barns Inc. None _ Submitted D5/20/20191view A s p{ Application z cation 1 :....N..::u... -✓...ariwewa....A..-w w..,.w :+..e.um ..," ...._..w,w w. .....w..',.b .,....xv"Y4 .M ".l }5: .,aha+r•r Lv..:.iws...ul+w.dsuf :.....i'cuP....v....up © 2019 Commonwealth of Massachusetts 1 r Application Number........................................... Section 9- Construction Supervisor Name S�aQ'e 14 Telephone Number J 4® ?t57, Address �� ���/`��� ity Gt?'G �7�� State Zip License Number License Type Expiration Date I' Contractors Email A�314 JZ/VS f N CV C,�til l/z. CDA-t Cell # Iunderstand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature - - Date' Section 10—Home Improvement Contractor ! Nam l?',' /OI s~114WTelephoneNumber 47Q Q j� Address_ ��� r1w. OV,-A City k�At ` State AIIAZip e"_a9�� Registration Number Expiration Date_12- /5 I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code: I understand the construction inspection procedures,specific inspections and - documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date Print Name Telephone Number _!5;_0c3 POA q E-mail permit to: ��, /US' Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation / For commercial work,pleas/a take your plans directly to the fire department for approval Section 13 — Owner's Authorization i as Owner of the. subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: i (Address of job) Signature of Owner date Print Name 1 i i - i i I Cape Save Inc. 7-D Huntington Avenue 4, South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 1 4/16/18 I Brian Florence CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 err � • RE: Insulation Permit' ,18=274) t- ZE C Dear Mr. Florence: " w This affidavit is to certify that all work completed for 2 hooLStreet;Cotuit°h s been � m inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCloskey . -30- 18, Town of Barnstable RECEIPTS " 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-18-274 Date Recieved: 1/29/2018 Job Location: 225 SCHOOL STREET, COTUIT Permit For: Building-Insulation-Residential Contractor's Name:. WILLIAM J MCCLUSKEY State Lic. No: CSSL-102776 Address: West Yarmouth, MA 02673 Applicant Phone: (508) 398-0398 (Home)Owner's Name: LOGIE,ANDREW T& SARAH E Phone: (508)259-5233 (Home)Owner's Address: 12 CREEK DRIVE, NORFOLK,MA 02056 Work Description: Dense pack walls with R-13 cellulose. Add 2" rigid insulation to the basement. Air seal the basement with expanding foam. General weatherization. NO S7O 70 Total Value Of Work To Be Performed: $5,000.00 can o A Structure Size: 0.00 0.00 0.001 *� t� M. Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor, subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent.to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: William McCluskey 1/29/2018 (508)398-0398 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost $5,000.00 Date Paid Amount Paid t Check#or CC# Pay Type .............. ._.__. ..,,._......... .:.. ......._,. _....,,_, , _...___... _ . __ _.... .. Total Permit Fee: $85.00 1/29/2018 i $35 00 X)M-X)M XXXX Credit Card 0299 Total Permit Fee Paid: $85.00 1/29/2018 y$50.00 X)00C-}CY7O{XX0{- Credit Card 0299 �. � f` �-1�2 3.�� .Z '� F '.•°g s 11� � .`T a' Y',f'�.F'"$''fi �'S "�"` xTIsIS IS N,®T APERMIT i Wells Fargo Bank,N.A. 1 Home Campus MAC: F2303-04J / Des Moines,IA 50328 Ph:877-617-5274 7/13/2016 Town of Barnstable Attn: Robert McKechnie _ Building Department 200 Main Street Hyannis, MA 02601 Regarding Property Registration at: 225 SCHOOL STREET ' �COTUIT MA 02635-3239 Tax ID/Parcel#: 020-098 ada Dear Sir Ma s v-� ,. / m The property above has been paid in full and the lien released;therefore,Wells;Fargo no longer 3 has interest in the property and is no longer the responsible party.Please update your registration ;records. Thank you for your assistance in this matter. Sincerely, Angela Pryor Research/Remediation Associate Wells Fargo Bank,N.A. OS � Angela.l.pryor@wellsfargo.com b�° J" Wells Fargo Bank,N.A. *� E MAC F2303-04J One Home Campus Des Moines,IA 50328 Ph:877-617 52.7 c May 26,2016 , Town of Barnstable r Attn: Robert McKechnie M Building Department 200 Main Street Hyannis,MA 02601 Completed Property Registration for: 225 SCHOOL STREET COTU 5 39IT MA o2 2 Y _.., �, .._ ,.3 3 - ....... ,... . ... �$ . ... . TAX ID: Dear Sir/Madam: Please see the attached property registration form for the above property and use the below contacts to expedite any future.requests. Thank you for your assistance in this matter. Code Violations: CodeViolations@WellsFargo.com Property Registrations: Registrations@WellsFargo.com General Property Preservation: Property.Preservation@WellsFargo.com Call Toll Free: 1-877-617-5?74 For questions regarding purchasing a Wells Fargo property please contact 1-877-617-5274• 'Smceiely ,.. " ten: x� E Angela Pryor Research/Remediation Associate WPllc Farpn Rank N A ,� An'gela:L:PryoT@wellsfargo con One Home Campus,F2303-04J Des Moines,IA 50328 I 4 Z Town of Barnstable, 367 Main Street, Hyannis, MA 02601 REGISTRATION AND CERTIFICATION FOP:M FOR FORECLOSING/FORECLOSED PROPET.TY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 22.4-4. Please complete one form for each proprrty.in foreclosure (section.224-3) or already foreclosed for which possession.has been taken(section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law,please state the reason(s) and complete section 1 (property information)and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party representative, but not other representatives and attorney) so that the Town can review the exemption and update its records: N/A , Section 1 —Pro e Information Property Address:225 SCHOOL STREET.COTUIT MA 02635-3239 Assessors Map#: n/a Parcel#: 020-098 L Land area and description lot of 28,749 sqft (or 0.66 acres) Building(s)description and contents,single family horde is 1,924 sqft - Occupied: yes Occupant(s)(if borrowers so state and include na.me(s)) Margaret Orlando c/o Wells Fargo Bank, N.A. 'Phone: 877-617-5274 email: codeviolations@wellsfargo.com other: fax: 866-512-0757 Vacant: n/a Date: 5/26/.16 Anticipated Length of Vacancy: n/a Last occupant(s))(if borrowers so state and include name(s)) n'a Phone: `877-617-5274 email: codeviolations@wellsfargo.com other: fax: 8,66-512-0757 Has possession been taken no If so,please explain and complete and file the maintenance and security plan form(unless exempt as stated above) see attached vacant building plan Section 2—Foreclosing Party Information Foreclosing Party (full name/title) n/a Foreclosure Case Court: n/a Docket#. n/a Date filed- n/a Current Status: n/a Foreclosing Party's representative(s) for property (entry, management,repair, etc.)(name,title,): n/a Company(if different from.foreclosing party): Wells Fargo Bank, N.A. Address: 1 Home Campus, MAC F2303-04J, Des Moines, IA 50328 (877)-617-5274 Codeviolations@WellsFargo.com fax:866-512-0757 Phone: email: rer: If an exemption'is claimed,please do not complete the remainder. Other,representative(s) (if foregoing representative is primarily.responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information(i.. e. "none"or"see.above")). Name,title, other: see above Company(if different from foreclosing party): n/a Address: n/a Phone(s): n/a email(s): n/a other: n/a Name, title, other: n/a Company(if different from foreclosing party): n/a Address: n/a Phone: n/a email: n/a other: n/a t Attorney representing foreclosing party Orlans Moran PLLC Firm_name if different . n/a ( t from attorney s name). Address: P.O. Box 540540 Waltham , MA 02452 Phonefs): 781-790-7800 email(s): info@orlansmoran.Com other: n/a I acknowledge that the information provided is accurate and correct. I also understand ' that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. Angela Pryor,Research/Remediahon;Digitally signed by Angela Pryor,Research/ Associate,Wells Fargo Bank,N A Remediation Associate,Wells Fargo Bank,N.A. T� 5/26/16 Date:2016.05.26 11:02:12-05'00' Date: . Name:Angela Pryor - Title: Research/Remediation Associate f I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Bi ildin Commissioner Town g of Barnstable ry 1 MAINTENANCE AND SECURITY PLAN FORM FOR FORECLOSING/FORECLOSED PROPERTY Town of Barnstable General Ordinances, Code section 224-4,requires a mortgagee taking possession of a property before or during foreclosure, or after foreclosure if the mortgagee becomes the owner,to bring the property into compliance with the maintenance and security standards contained in Code subsection 224-4(B) within thirty (30)days of a notice from the Building Commissioner. Please either complete and file this form or another containing the same information with the Building Commissioner within thirty(30) days of the notice. If a mortgagee claims an exemption from the provisions of Code sections 224-3 and 224- 4,please explain, leave the remainder blank, sign at the end and file this form or letter of explanation and also complete and file the applicable sections of the registration form for foreclosing/foreclosed property N/A Town of Barnstable, 367 Main Street, Hyannis, MA 02601 (1) Registration date: 5/26/16 If not registered, please complete the registration form and-state date of filing or anticipated filing N/A (2)If commercial property, describe space utilization floor plans required by the Fire Chief and filing date (actual or anticipated)N/A (if in possession or ownership must be certified as accurate twice annually in January and July). (3)Describe any hazardous materials on the property as that term is defined in MGL c. 2 1 K and the date(s)and method(s)for removal as approved by the Fire Chief UNKNOWN (4)Method(s) and date(s) all windows and door openings secured(air will be secured) UNKNOWN If left secured,name, address, and contact information of security personnel providing twenty-four-hour on-site security personnel on the property WELLS FARGO BANK,N.A. F2303-04J, 1•HOME CAMPUS, DES MOINES IA 50328, 877-617-5274 (5)Location(s) and date(s) "No Trespassing" signs posted or to be posted on the property UNKNOWN (6)Name(s), address(es) and contact information of person(s)responsible for maintaining: structures, lawns and shrubs in sound condition free from excessive growth and the property generally in accordance with the Barnstable Zoning Ordinances the . definition of"maintenance"in this Ordinance; any other provision of this Ordinance; and for disposing of trash, debris and pools of stagnant water as provided in Chapter 54 of the Town of Barnstable General Ordinances WELLS FARGO BANK,N.A. F2303-04J, 1 HOME CAMPUS, DES MOINES, IA 50328 t (7) If the Fire Chief of the Fire District in which the property is located has approved turning off the water or electricity,please state: Date of approval UNKNOWN Date(s) electricity turned off UNKNOWN on if applicable UNKNOWN Date(s)water turned off UNKNOWN _on if applicable UNKNOWN (8)Name(s), address(es)and contact information pf person(s)responsible for maintaining all existing fences around swimming pools and spas or installing fences as required by Chapter 210 of the Town of Barnstable General Ordinances WELLS FARGO BANK,N.A.,F2303-04J, 1 HOME CAMPUS,DES MOINES IA 50328 (9)Name, address, telephone number and email address of person who can be contacted in case of emergency if different from the person named above or in the registration under section 224-3(A) (name and contact number to be posted on the front of the property if required by_the Fire Chief or Building ComLmissioner_._ WELLS FARGO BANK,N.A.,F2303-04J,1 HOME CAMPUS,DES MOINES IA 50328,877-617-5274 (10)Date(s) certificate of liability insurance on the property filed with the Building Commissioner SEE ATTACHED EVIDENCE OF INSURANCE (11)Date(s)cash or surety bond of at least$10,000.00 filed with Building Commissioner to remunerate the Town for any expenses incurred in inspecting, securing and making the premises comply and continue to comply, a portion of which shall.be retained by the Town as an administrative fee N/A (12)Date(s) scheduled for inspections with the Building Commissioner and.Health Director, who may at his or her discretion include the Fire Chief, in order to confirm that the land and structures comply with the provisions of this Ordinance,- UNKNOWN or to identify the provisions with which the property does not comply and establish a program to bring the property into full compliance UNKNOWN (13)Date(s) when the property was sold, or is anticipated to be sold,to the foreclosing party., If neither,please explain UNKNOWN _. I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. Angela Pryor,Research/RemediationY.Digitally signed by Angela Pryor,Research/ o Bank,N.A.01 .•Remedlation Associate,Wells Fargo Bank,N.A. Associate,Wells Fargo Date:2016.05.2611:05:56-05'00' Date: 5/26/16 Name: Angela Pryor Title: Research/Remediation Associate I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-4 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town of Barnstable _ 2'174 c CERTIFICATE OF LIABILITY INSURANCE DATE25/201YYYYI ............ 3/25/2015 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 endorsers. If SUBROGATION IS WAIVED,subject to the tel'ms 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 Wells Fargo Certificate Service Center Wells Fargo Insurance Services USA,Inc. PHONE 404-923 3719 FAx 1-877-362 9069 IAIC.No.Ell: (A/C,No): 3475 Piedmont Rd E-MAIL wfis.certificatereotlest wellsfar o.com ADDRESS: G g Suite 800 _ INSURER(S)AFFORDING COVERAGE NAIC# Atlanta,GA 30305 INSURER A: Old Republic Insurance Company 24147 INSURED INSURER B: Wells Fargo Home Mortgage INSURER C: a division of Wells Fargo Bank,N.A. INSURER D: 90 South 7th Street,14th Floor INSURER E: Minneapolis,MN 55402 INSURER F COVERAGES CERTIFICATE NUMBER: 8901677 REVISION NUMBER: See below 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 T4E TERMS,„ EXCLUSIONS AND CONDITIONS Or SUCH POLICIES.'LIMITS SHOWN MAY HAVE BEEN REDUCE[!BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY A MWZY 304056 04/01/2015 04/01/2020 EACH OCCURRENCE $ 10,000,000 CLAIMS-MADE FxIOCCUR DAMAGE PREM SESOE( ..."'."C. ocRENeur ence $ 10,000,000 i MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X PRO- ' POLICY PRO- JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 10,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAB OCCUR d 1 EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ A WORKERS COMPENSATION MWCs02638 04/01/2015 04/01/2020 x PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE 1,000,000 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If as,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Insurance CERTIFICATE HOLDER CANCELLATION ss Wells Fargo Home Mortgage, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE,.EXPIRATION pQATEt THEREOF, NOTICE WILL BE DELIVERED IN a division of Wells Fargo Bank,N.A. t' ''ACCORDANCE'WITH THE4401-1CY PROVISIONS. 90 South 7th Street, 14th Floor Minneapolis,MN 55402 AUTHORIZED REPRESENTATIVE ((" 7e�µ �- The ACORD name and logo are registered marks of ACORD ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25-(2014/01) i 1 d% Barnstable, MA Vacant Building Plan Current status of the Building: The building is secured; all doors and windows are locked. If the property,utilities are on when we-find the property abandoned, we will transfer the utilities into our name and leave active. If we find the property to not have any utilities we winterize the property according to investor/insurer guidelines. Plan of action for exterior building maintenance: We inspect and maintain our properties. We work to keep the property secure and free of any health hazards and/or debris. Wells Fargo also schedules our grass cuts twice a month. What improvements are planned? If the property is in need of repair to avoid a code violation, we will review and take any appropriate action. If there are insurable damages, we will file an irjsurance claim and review for repairs. What is the scheduled date of re-occupancy? Approximately 90 days after the foreclosure sale is confirmed. Building to be sold or rented? The building is to be sold. _ Certificate of Occupancy: The buyer will be responsible for re-certification and occupancy inspection with the city. Is property to be demolished? There are no current plans for demolishing the property. The city will be notified if there is a change of action. WELLS FARGO RANK, N.A. CONTACT INFORMATION For questions or concerns regarding a property registration issue please contact the Property Registration Department. Property Registration Department Registrations@wellsfargo.com For other inquiries please route applicable requests to: Building and Code Compliance Department CodeViolations@wellsfargo.com Utility Bills ConvUtilityPmt@wellsfargo.com. HOA or Condominium.Dues or Fees HOAPmtReques'tFH@wellsfargo.com Tax Related Requests: TaxGatekeeper@wellsfargo.com REO property inquiries PASAPinguiries(i)wellsfsargo.com Insurance Claims HazardClaims@wellsfargo.com General Property Preservation Property.Preservation(a@welIsfargo.com ' For questions regarding purchasing a Wells Fargo property pleas(:! contact 1-877-617- 5274. You may also contact our dedicated property preservation call center at 1-877-617-5274 Monday— Friday from 8:00 AM—9:00 PM EST. Please note all legal documents should be sent to our legal mailing address below: .Wells Fargo Bank, N.A. 1 Home Campus MAC# F2303-041 Des Moines, IA 50328 q pFTHETp Town of Barnstable *Permit#,76 <9S p� Expires 6 months from issue date 1A STAIDIA = Regulatory Services Fee v Mess.i639. 0� Thomas F.Geiler,Director �A TEDNt°'`� Building Division ��77 Peter F.DiMatteo, Building Commissioner d,A ` 0 367 Main Street, Hyannis,MA 02601w Office: 508-862-4038 X-PRESS PERMIT Fax: 508-790-6230 EXPRESS PERMIT APPLICATION N O V 2 2001 Not Valid without Red X-Press Imprint TOWN OF BARNSTABLE Map/parcel Number a)-o zo Property Address aaS J01-,LODE c - • Ce TUB r CAo [BIR"'esidential OR ❑Commercial Value of Work / ,�JO Owner's Name&Address �'EG�L�fI �i/�(/CD TTJ"9 Contractor's Name Telephone Number J22�— �07 JP` �2�9 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor the Homeowner r I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) 2r"Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where required: Iss7eopermit does not exempt compliance with other town department regulations,i.e.Historic.Conservation.etc. Signature Q:Forms:expmtrg:re v-070601 Engineering Dept. (3rd floor) Map, Parcel © L% %�i`�permit# House# Gad Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) v^ �_Fee Wr y Conservation Office(4th floor)(8:30-9:30/1:00- 2:00) S` ,�► �� Planning Dept.(1st floor/School Admin. Bldg.) Definitive,' ro d by Planning Board 19 • `®A ss. j l�- � 's�t TOWN OF BARNSTABLE Bui77— Permit Application Project Street Address r .5� � �� Village ' Owner ddress AV5 ,��/Di_ � ��r�r6✓ Telephone :!�er-z g st',-ky . Permit Request' First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ oZi 4�t" Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family p Multi-Family(#units) Age of Existing Structure Historic House ❑Yes On Old King's Highway ❑Yes io 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 No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric 0 Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: p Pool(size) ❑Attached(size) ❑Barn(size) p None ❑Shed(size) ❑Other(size) Zoning Board of AppealX0, orization p ❑ Appeal# Recorded Commercial p Yes If es, site plan review# - Y Current Use Proposed Use Builder Information Name _ � JZz� �/L- Telephone Number ��� Address ��/� ��n License# ` 04w,41 Home Improvement Contractor# 110e7,V.0 Worker's Compensation# "/,y 7-7 tea..L NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -21 SIGNATURE ,z- DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE OWNER DATE OF INSPECTION: F FOUNDATION "' FRAME INSULATION', — FIREPLACE ` ELECTRICAL: ROUGH FINAL! PLUMBING- ROUGH FINAL GAS. s*' vZOUGH FINAL , FINAL BUILDII[G DATE CLOSED OUT _ \ ASSOCIATION PLAN NO. s \ t ' I_ � -�; I -� ='OME . It-tPROVEriENT CONTRACTORS REGISTRATION I '��oard of Euiiding Resulations and Standards -- One Ashhurtor, Place - ftooc 130E t .Boston, t•tassachusetts 02106 . IuPROVEMENT CON—MACTOR I s tr a_ion 100740 Exp i ration C6/23198 �� G%.�l,fr- --=-• -- PRIVATE CORPORATION Plp,-VEiErl Ca`tTRnCTCR ^rr C I77 �•;OI-`, Imp", OVEMENT, INC. Tea , 1CapE r .iz , yg I [yamiT T i CO" ?t (•tA 02635 DEPARTMENT S'1PE<VIS0R LICENSE t Expires: , IIirtlzc'�t� f�:103C'niQ9jI5I1S57 ,t .OSIL�rIg( ;• : :d , �54. 4v=r�"'.fir r rE The Commonwealth of Massachusetts ( Department of Industrial Accidents �'�= �- r — - Ofllce a//oyest/gatlons 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit Z2 zE d' �vicl ca i G�/ Cir e D;!//T I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. COM122rty nam addre city phone# insurance co �f �C � policv;4 I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name- address: cit< phone#: l noli insurance co. y#c IL 7 company name: address: nhone insurance Co. 11 v ,'Attach additional sheet if nectis_ary_ _' - Failure to secure coverage as required under Section 25A of�tGL 152 can lead to the imposition of criminal penalties of a fine up to sisoo.00 and/or one years•im risonment as'A ell as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. 1 understand that a p copy y of this statement may be for%arded to the Office of investigations of the DIA for coverage verification. 1 do hereby certify u7pains a penalties of perjury•that the information provided above is true and correct Sienatuce Date c_S2,/,9 Print name /CO�� ^ �� ��—��� Phone official use oni_y do not M rice in this area to be completed by city or town official cin or town: permit/license 9 f]Building Department C)Licensing Board check if immediate response is required [,]Selectmen's Office Health Department hone P: —Other contact person: P . • oFsr+e r� : . The Town of Barnstable • Luexsr,�sr,E. - 9eb � Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date .S 2-1-- �9 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: �9Td ��M 72, Est.Cost o?.eco Address of Work:_ Z � �✓ ///� Owner's Name_ Date of Permit Application: _ j--Z/ I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied ' Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE " ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply,for a permit as the agent f the owner: ®D7 9D Date for Naide Registration No. ` OR Date Owner's Name r• TOWN OF BARNSTABLE„BUILDING PERMIT APPLICATION Map Parcel l�` 'Application #._ t Health Division Date Issued 6 Conservation Division ` Application Fee I � Planning' t `;.Permit Fee; 1 9 p Date Definitive Plan_Approved by Planning Board Historic = OKH — Preservation/Hyannis 0 Project Street Address 2_ 2 S <;C%I.1 0 0 Village C 4-v t 4. Owner w✓1 l a41%, Address S Telephone rZ:Permit-,Request"\ V= n la C P 6 o ar✓4 S.. a 6 CA c Ic jc c.�e Square feet: 1 st floor: existing o O proposed 2nd floor: existingS-bV proposed Total new Zoning District. Flood Plain Groundwater Overlay Prgject Valuation , In m W Construction Type Lot Size 8 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 H1ghway--_- ]Yes ❑ No C� Basement Type: ❑ Full Crawl ❑Walkout ❑ Other 21 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq:M 2 c Number of Baths: Full: existing / new Half: existing o ne �. � ram, Number of Bedrooms: _3 existing _new - .. Total Room Count (not including baths): existing new First Floor Roo Court; Heat Type and Fuel: ,�d'Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: , xisting ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing U.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 -7 8 l 5 Address G bt-o 01 S+Ye f License# l,v � , A= 02 � 3 � Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I-M P SIGNATURE DATE 0S d FOR OFFICIAL USE ONLY R APPLICATION# DATE ISSUED MAP/PARCELNO. R ADDRESS VILLAGE OWNER s DATE OF INSPECTION: r" FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Tlie Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 • �� www.mass.gov/din • Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Let?ibly Name (Business/Orkmizationandividual): ��U �p ✓ oy l0.+,A o Address: S C'L'0 a S City/S tate/Zip. C-o ' ` O Phone.#: 5 � g Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I 6. ❑New construction . employees (full and/or part-time).* Svc lured the sub-contractors 2.❑ I am a•sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling • ship and have no employees These sub-contractors have g• Demolition working for me in any capacity. employees and have workers' 9 Building addition comp•insurance.t o workers' comp.insurance 5. �] We are a corporation and its 10.El Electrical repairs or additions equired.] . 3. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 of repairs c. 152, §1(4), and we have no insurance required]t 13. Other rye 4cKS 60a-_JS° employees: [No workers —�—� comp,insurance required_] dt'G k "Any applicant that checks box#1 must also R out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outsidt contractors must submit a new affidavit indicting such tcontractors that check this box meat attached an additional shett showing the name of the sub contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must pravidt their workers'comp.policy number.. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy nuinber and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to-the imposition of criminal penalties of a fine tip to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the bIA for insurance coverage verification. I do hereby ce and the p ns n en ' s of perjury that the information provided above is true and correct Si mature: y Date: D S 20 _ Phone#: r F/ Official use only. Do not write in this area, ib 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#: Information and. Instru.ctiOns Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for thcir.employees: Pursuant to this statute, an employee is defined as "...every person in the service of another under aby 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 appiirtcnant thereto shall not because of such employment be deemed to be an employer" MGL cbapter 152, §25C(6) 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,MGL ohapter 152, §25C(7)states '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." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if . necessary, supply sub-contractor(s)name(s), address(cs) and phone numbers)along with their certificates)of insurance, Limited Liability Companies*(LLC) or Limited Liability Partnerships(LLY)with no employees other than the members or partners, arc not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required Bq advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavlt 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 nurgber listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Tomp Officials 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. In addition, an applicant that must submit multiple permit/licensc applications in any given year, need only submit one,affidavit indicating current policy information(if pecessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A ebpy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Whero a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (ie, a dog license or-permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,tclephone•and fax number. The.Commonwealth of MmSachusf,-tts Department of Iaduskr 4 Accid=tS Office of Investigations 600_WashinP,,tQn Street Boston, MA 02111 Tel. # 617-727-490.0 ext 405 w 1-M-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www,mass.gov/dia Town of Barnstable Regulatory Services " Thomas F. Geiler,Director • swtuvs-rwHt.E. . • '�w� Building Division ��7 ibJ9• ��� FIFO RA Tom Perry,Building Commissioner 200 Main Street, Hyannis., MA 02601 —A mY.town.barnstable.ma.us Office: 508-862-4038 Fax: 508_790-6230., ' HOAJEOWNMR LICENSE EXEMPTION Please Print DATE: JOB LOCATION: S,C number street village ": ✓ Q:)r (P', HOMEOWNER name home phone# work phone# CURRE14T MAILING ADDRESS: city/town state zip code z 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 HohlEOWNER Pcrson(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&Io-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 perrnit._(Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code.and other applicable codes, bylaws,rules.and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department mini tun inspection p dunes and requirements and that he/she will comply with said procedures and J_ re eme S ature of Homeowner Approva_I 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 lam-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)forhire to do such work, that such Homeowner shall act as supervisor." Many homeowners who use this exemption areunawarc that they are assuming the responsibilities ora supervisor(sec 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 it 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, tha-t 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 forn✓certification for use in your community. oFYH5T Town of Barnstable ~` Regulatory Services Thomas F. Geiler, Director �p t63q r�059. 16 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.toiYn.b2rnst2ble.mi.us Office: 508-862-4038 Pax: 508-790-6230 Property Owner Must Complete and Sign. This Section If Using A Builder r , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Narne If Property Owner is applying for permit please complete the Homeowners License Exemption Pori on the reverse side. I , I f i ,Whelan,Angelaw From: Schlegel, Frank Sent: Tuesday, February 03, 2004 2:23 PM To: Whelan, Angela , Subject: Road Open Permit for Garage/Map 020 Parcel 098 Hi Angela. The gas company is taking out a permit to connect gas to the garage at 225 School Street, Cotuit. 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