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HomeMy WebLinkAbout0192 SKUNKNET ROAD z i s a' ,{ * a y Y Il G 1 ° ° 0 � � ��� klv aaka�' �,1q � i / �s.�n b CYO vMe�n , 1(3 any Knew Town of Barnstable Building t PostThis Cacti So That it is U�isible From;the Street ?Approved Plans.Must be Retained on Joband;this4Card MustAb�e�Kept . �nRNSTABi.C, „� '% Permit M Posted Unt>l final Inspection Has Been MadeIF " � " ' ° Where a Cerf�fic16 ate:o cyas R f Occupanequtred,sychBdmg shall NotHbe Occupieduntil a Final=glnspe has beenfmade . ., -,. t Permit No. B-19-3912 Applicant Name: Neal Holmgren Approvals Date Issued: 12/06/2019 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 06/06/2020 Foundation: Location: 192 SKUNKNET ROAD;CENTERVILLE Map/Lot: 171-009 Zoning District: RC Sheathing: Owner on Record:. MALCOLM,WAYNE R JR&ERICA L Contractor:Name':..Solar Rising.LLC Framing: 1 Address: 192 SKUNKNET ROAD Contractor License,175578 2 CENTERVILLE, MA 02632 Est. Project Cost: $30,784.00 Chimney: Description: Installation of 26 Lg 370 watt modules to be flush mounted on rear Permit Fee: $207.00 of the building. , Insulation: Fee Paid.n $.207.00 Project Review Req: Q'ate .; 12/6/2019 Final: �p1 jam r ter- Plumbing/Gas - Rough Plumbing: ff This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced"within six months afte i� a' icia Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents"for which this permit has been granted. All construction,alterations and changes of use of any building and structures,shall be in compliance with the local zoning by laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public irispection for the entire duration of the. Final Gas: work until the completion of the same. PR, The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and.Fire Officials arevprowded on this;permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: - 1.Foundation or Footing " Service: ^; 2.Sheathing Inspection ' 3.All Fireplaces must be inspected at the throat level before firest flue lm rig°_installed �, „ , _ Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: 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 must 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 FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: qb Ido, Fill in please: V, APPLICANT'S YOUR NAME/S: i,J lr� 1 BUSINESS YOUR HOME ADDRESS: "N idyl N-tiS �5 j 'LOAN TELEPHONE # Home Telephone Number �COMMAND, , NAME OF CORPORATION: GCC I q 9 NAME OF NEW BUSINESS —TYPE OF BUSINESS S ,e6S c c e _ eS IS THIS A HOME OCCUPATION? ES NO ADDRESS OF BUSINESS 9 3L _5 MAP/PARCEL NUMBER 60 9 (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 make sure you have the appropriate permits and licenses required to legally operate your business in this town. ti � (' r 1. BUILDING COM ISSIO ER'S OFF CE PAS 60,a& �I�(6 E�PATION This individu I h in or a of a)y,per t re uirements that pertain to this type of business. RULES plU REGULATIONS, FAILURE TO ut oriz�,ed Si nature** COMPLY MAY RESULT IN FINES. COMMENT 2. BOARD OF4ALTH) v� V J �aA41 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: i uwu ui Darastawe Building Department Services .rr �cSHE ip� . o Brian Florence,CBO Building Commissioner � F ST • ' 200 Main Street,Hyannis,MA 02601 9 MASS. � 039• �� www.town.barnstable.ma.us plE � Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: l �/ rJ / Z Name: �► I v l Gti l `�---� Phone#: � 7 'qy(—(�pj/ Address: g ' �► Village: Cda.4<, ((�- Name of Business: G 2(�C ' Type of Business: k(as yff e�, CQ c: Map/Lot: G 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 residentiaf buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. v • 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. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess J lv of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home 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 sha g employed' the ary Home Occupation who is not a permanent resident of the dwelling uni I,the undersigned,hav ad d a e the above re ctions for my home occupation I am ren*st3l.• Arr licant: Date: cf( Homeoc.doc Rev.06&0116 Town of Barnstable Building 1� "� • ', oThat rt is V,is�ble From;the,,5treet A roued:Plans Musti be.Retained on Job an d this Ca v, rdM�ist be Kept Post This Card S mm Posted Untll Final l4nspectpon Haas Been:"Made " � F x. y� " Where.-aMCert�ficate of Occu anc �s Re uired,,suchKBurlding shall Nat be®ccupied;until a FI<nal Inspection has,„been made e t �� Permit No. B-16-1956 Applicant Name: Richard Carl Map/Lot: 171-009 Date Issued: 08/01/2016 Current Use:,.. Zoning District: RC Permit Type: Alteration INTERIOR Work Only-Residential Expiration Date: 02/01/2017 Contractor Name: RICHARD T CARL Location: 192SKUNKNET ROAD,CENTERVILLE Est Project Cost: $27,275.00 Contractor License: CS-098967 i r Owner on Record: MALCOLM,WAYNE R JR&'ERICA L _Per�mlt Fee $ 189.10oi, . Address: 192 SKUNKNET ROAD g ' FeerPaid �$ 189.10 CENTERVILLE, MA 02632 Date. s 8/1/2016 Description: Adding kitchen cabinets with sink and two burner electric"stove to legal in-law apartment Repl'acing shower with new enclosure. New flooring in bathroom. Adding—washer/dryer hookups. r.; Project Review Req : Adding kitchen cabinets with sink and twoldrner electric stove to Legal in law apartment. Replacing shower with new enclosure. New flo ng m bathroom Adding washer/dryer hookups. f Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this perrTiWis commenced with n six months after issuance. x All work authorized by this permit shall conform to the approved applieation9andetheapproved construction documentsfor which this permit has been granted. All construction,alterations and changes of use of any building and structd',Ashall be in compliance with the local zoning by la,v Qsnd codes. This permit shall be displayed in a location clearly visible from access street o road and shall be maintained open for public m p coon for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable sig aturey the Building and Fire Officials are provided on thi"s per°mit Minimum of Five Call Inspections Required for All Construction Work. Az 1.Foundation or Footing r 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining i- installed � x 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection € 5.Prior to Covering Structural Members(Frame Inspection) ` '' x". " ' .`° 6.Insulation 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. dw 4X-J� "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). L— Building plans are to be available on site AZT All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT " y Town of Barnstable Building Department - 200 Main Street BARNSTABLE• * Hyannis, MA 02601 9 MASS ib3�- , 1508) 862-4038 - '0)'FG Certificate of Occupancy _ Application Number: 201408268 CO Number: 20150040 Parcel ID: 171009 > CO Issue Date: 04123115 Location: 192 SKUNKNET ROAD Zoning Classification: RESIDENCE C DISTRICT Proposed Use:. SINGLE FAMILY HOME Village: CENTERVILLE Gen Contractor: PROPERTY OWNER Permit Type: -RC00 CERTIFICATE OF OCCUPANCY RES Comments: FAMILY APARTMENT FOR NANCY CALLAHAN - MOTHER"INLAW. r Building Department Signature Date Signed TOWN OF BARNSTABLE Building 201408268 BARNSTABLE, Issue Date: 01/20/15 0'e-i r m i t y MASS. �pr16 339. A,� Applicant: STANLEY,MARK H&BONNIE K Permit Number: B 20150094 Proposed Use: SINGLE FAMILY HOME Expiration Date: 07/20/15 Location 192 SKVNKNET ROAD Zoning District RC Permit Type: FAMILY APT W/NO CONST Map Parcel 171009 Permit Fee$ 35.00 Contractor PROPERTY OWNER Village CENTERVILLE App Fee$ License Num OWNER Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND FAMILY APARTMENT NO CONSTRUCTION FOR NANCY CALLAHA THIS CARD MUST BE KEPT POSTED UNTIL FINAL MOTHERINLAW INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: STANLEY,MARK H&BONNIE K BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 192 SKUNKNET ROAD INSPECTION HAS BEEN MADE. CENTERVILLE,MA 02632 Application Entered by. JL Building Permit Issued By: THIS PERMIT CONVEYSNO RIGHT'TO OCCUPY ANY STREET ALLEY;OR SIDEWALK OR ANY PART THEREOF,EITHER PORARILY E Y ENCROACHMENTS ON PUBLIC PROPERTY,,NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVEI)BY THE NRISDICTION:` STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS-'.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM.THE CONDITIONS OF ANY A PLICABLE SUBDIVISION RESTRICTIONS. `� MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1' 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL.BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION).• 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). c .. , BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 13 F�;i Itb f 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board/of Health l �� , `• a.�. �/ '� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1pap I+ i Parcel d 6 1 Application # I K Health:Division 2ZCo Y LY& Date Issued L-6h Conservation Division ''` °` J Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street_Adddress 1 I K Z+ J d Village c�i ✓-I Owner, - `� f� G� �(�(Q /"i 4 1 It, L'`- Address Telephone 9Jq - 154 -6�q .cPermif.equest , 6A Q r •0 K se- � 5 �8vt-pV '�' G- WC t_L /�A) Wko )S r41 Square feet: 1 st floor: existing l proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size a`t Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure aC Historic House: ❑Yes ❑Ao On Old King's Highway: ❑Yes ❑ No Basement Type: C= Full ❑ Crawl Lp alkout ❑ Other Basement Finished Area (sq.ft.) ia Basement Unfinished Area (sq.ft) � ® Number of Baths: Full: existing new ® Half: existing new a Number of Bedrooms: existing new Y Total Room Count (not including baths): existing new f First Floor Rohm Count,",., L 1'; Heat Type and Fuel: /Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes CYNo Fireplaces: Existing New Existing wood-coal stove: s. ❑.No Detached garage: ❑/existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing `CJ new size_ Attached garage: O existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeal7Nio thorization ❑ Appeal # Recorded ❑ Commercial ❑Yes If yes, site plan review # Current Use _._ Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Narne—,---��% Address(912 ��� �e b\ License_# � Home Improvement Contractor# Email io-gt y YU6t I Co yhJ.0^S„N I CIO A— Worker's Compensation # ALFCONSTRUCTION DEBRIS RESULTING FROM THIS PROJEGT WILL BETAKEN TO IVA SIGNATURE "` DATE-~~�1�e a L4 I )`'k FOR OFFICIAL USE ONLY 1CATION# DATE ISSUED MAP/PARCEL NO. I , k ' ADDRESS VILLAGE OWNER r DATE OF INSPECTION: �i FOUNDATION i FRAME I!a INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 9& ` 1/641S DATE CLOSED OUT ASSOCIATION PLAN NO. In i 05i `� ➢ j Y ' T03 ;f N I Iw fAU ; _ . • - i ra 5 f Ir I SR lov JO f On P-G., it 54/ ' QJ ttz-t- I-N 2�0 � I dol5ov PT I � GN � I �Ij�r-H i ✓` Sim �3qµI -�, � fit. � 53o �r Q, Town of Barnstable OFTHE T ' - Regulatory Services . � 'Richard V.Scali,Director BARNSTABLE, P l< 2.3609 F'�2 u 9 �3 7 MAMR• g Building Division jFo Ma't Tom Perry,CBO Building Commissioner g 200 Main Street,Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT We, the undersigned, being the owners of property situated at 192 Skunknet Road Centerville, MA holding title under a deed recorded with the Barnstable County Registry of Deeds in Book 28381,Page 339, being" shown on Assessors' Map 171 as Parcel 009 , hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment, which contains living quarters, is intended for use as a family apartment,for year-round occupancy. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. The family apartment unit must be occupied only by the property owner or a member(s)of the property owner's family as accessory to an owner-occupied single-family residence. ' Occupants of Main Residence: Wayne and Erica Malcolm Relationship to Owner: Owner Resident of Family Apartment; Nancy Callahan Relationship to Owner: Mother-in-law t This unit shall not be rented as an apartment or as a single room,or in any fashion,which rental would be a violation of the Town of Barnstable's,rules, regulations, and zoning ordinances. Prior to occupancy of this,unit, affidavits reciting the names of occupants are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for.the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated.. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this day of �JC�C "VL 'r 20 l`� TOWN OF BARNSTABLE: OW R : By: ay e Malcolm lye T omas Perry,CBO Erica Malcolm Building Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date*aw Then personally appeared the above-named (owp / �%/ and made oath as to the truth of the foregoing instrument, fo e /e Notary Pub,1Y DELLA SATTIN. Notary Public BARNSTABLEREGISTRY OF DEEDS My Commission Expires: ry Commonwealth of Massachuset'�. gsample My Commission Expires June 12,2Ul.:• John R.Meade, Register �vew �P�O'n TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 Map Parceppprietion # Health Division Date Issued 73D Conservation Division Application Fee 44- Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address nc ri Village 6_1/�"*L Owner „ )14d�-/.N Address Telephone -779-4SLI-G 1-ti 3 Permit Request 4: ro a' c jL L If 4"C Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation /yam Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Gr 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.ffy _ Number of Baths: Full: existing new Half: existing r f new C70 Number of Bedrooms: existing _new ^+^ r c� Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other S. 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 —�A4ike McCa¢ltyOe ern Telephone Number Address .PO Box 52 West License # • 9 MA 02fr7O Cell (508) 280-6964 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME .3 1 INSULATION .1 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. = lo" y' r Town of Barnstable Re Y4to y Services MAIER Jucnaia v.sc4 n rector. s639� �0 •�. r 39. l3aMlhg:DiviIsion Ps riT#T - Tom Perry,)3uq ling Commissioner 200 Main Street;Hymwis,MA 02601 wive A6wn.barnstabie.ma:us, Office: 508-862-4038 ,. Far: 5O$=790-6230 Troperty`'OWnex N wi— Covgpletie,and�Sigu This Section, f Usm#',t Al .a.�.. � ..... . r44.w,wa...wHw.Wa♦,e♦.....r�..+.-�_ «..�.�.�...�.�a.,...+.r...i itrxq wr.,, s.. .,tom ....�._._� �..�.__..... .._.-�-.,.......`..e...�. -. . +� w.R. a�rO�yt ~ T; I t� t - ,as Qwner cif the`subject propcny y �r yr nn heiiebp authonze, / t C. ` ' S "(V i ou inpehalf m A matters.relative:to:work authorized bythis bdding',permit application for. 4 4-erLlif {Address 0 ..ONi ' d $t .ass: ,; „g; , Poa firtces and alarms are the responsofheapplcaiit. Pools mot;t` e.filled'drsutilized'before.fence isiLstalled azid�ll dial` pe o: arep rf4rmed:acid accepted., S gnaruze of u. 4 .4_Signaixm of Applicant' d 04-Aer M ;cOL ♦ y Priht Naive: x,Print Name_: [ECIEUVE Date D DEC 1 8r 2014 J0 QT-ORMs:ow'NERPERMIssioNPOOlS Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-058633 MICHAEL J MCC,AR PO BOX 52 W DENNIS MA 0267 � Expiration Commissioner 04/10/2016 R Office of Consumer Affairs and Business Regulation _ 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169393 Type: Individual Expiration: 6/16/2015 'Tr# 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY -"---- --- ------- P.O. BOX 52 - --------- — ---- WEST DENNIS MA 02670 — ----- - Update Address and return�card.Mark reason for change. j SCA 1 Co 20M-05/11 ❑ Address Renewal ❑ Employment Lost Card �•, R' The Conmmvealth of Massachusetts Department oflndustrurl Accidents Office of Investigations 600 Washington Street Boston,MA 02111 , )vmP mass goVklia Workers' Compensation Insurance Affidavit: Btdlders/Contractors/Ii lectricians/Plumbers Applicant Information Please Print La ' l ike McCarthy Construction Name(Business/Organizatiorulndividuai):- PO Box 52 Address: - West Dennis, MA 02670 City/State/Zip: CSC§Q3 HIC-169393 Are y u an employer?Check the appropriate box: Type of project(required): 1,Eql am a employer with 1 4. El 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 propridtor or partner- listed on the attached sheet,t 7. 0 Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity, workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10T1 Electrical repairs or additions required.] officers have exercised their 3.[] I am a homeowner doing all work right of exemption per MGL I LE]Plumbing repairs or additions myself.[No workers'comp. c.152,§I(4),'and we have no 12.E]R f repairs insurance required,]t employees.[No workers' 13. er comp.insurance required.] *Any applicant that checks box A mast also fill out the section below showing their workers'wmpeasation policy inforotadon. t Homeowners who submit this affidavit indicating they are doing all.work and then hire outside contractors must submit a new affidavit indicating such. tCoutractm that check this box must attached an additional shut showing the name of the subcontractors and their warkers'comp.policy lnfimnation. lam an employer that is providing tporkers'coutpensadon insurance for my employees Below is the policy andjob site Information, Insurance Company Name: Policy#or Self-ins.Lic.#: VWL 1W-Gd't16 ;10:HA Expiration Date: Job Site Address: City/State/Zip: i 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 ofMGL c.152 can lead to the imposition of criminal penalties of a ' fine:up to$1,500,00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine � of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of i Investigations of the DIA for insurance coverage verification. I do hereby cenyy e pa a enalties ofpedary that the information provided above is true and correct. Si sture: Ditto: o t.r Phone Offlctal use on y. Do not write ut this area,to be completed by city or town off ciaL } City or Town: Permit/Ltcense# i Issuing Authority(circle one): 1.Board of Health 2.Building Department 3,CiVrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: J r ® DATE(MMIDD/YYYY) ,d►`�o� CERTIFICATE OF LIABILITY INSURANCE 07/10/2014 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()es)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 01962-001 NRTACT Bryden&Sullivan Ins Agcy of Dennis Inc A/C.No.Ext: (508)398-6060 � ,No,: (508)394-2267 PO Box 1497 �"Sss: So Dennis,MA 02660 INSURER(S)AFFORDING COVERAGE _NAIC# INSURERA: A.I.M.Mutual Insurance Company 26158 INSURED INSURER B: Michael McCarthy Construction Inc IN U ERC• P 0 Box 52 West Dennis,MA 02670 INSURER D INSURER E: I 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. NO i WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR O T HCR DCCUMENT WITH RESPECT TO 'AI-IICH 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. ILTR TYPE OF INSURANCE POLICY NUMBER MM/DDm% N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES R MI E occurrence) _ L- CLAIMS MADE OCCUR MED EXP(Any one per $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ -POLICY _UE� F—�.00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO r— BODILY INJURY(Per person) $ AUTOMOBILE OWNED11 ALL I SCHEDULED BODILY INJURY(Per accident) $ �— NON-OWNED PROPERTY DAMAGE AUTOS HIRED AUTOS AUTOSaccident) $ _ $ - UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS MADE AGGREGATE $ DED I I RETENTION $ $ AtBd��I���io INS�CiMOF X T'ORY LADS ��' _ A ANYICROPRILJQR/PARTNSWRECUTIVE YN NIA A VWC-100-6017656-2014A 7/17/2014 7/17I2015 E.L.EACH ACCIDENT $ _ 500,000.00 (Mandatory in N�nH))RcettE�Xc�CLI/uDttuu rr E.L.DISEASE-EA EMPLOYEE $ 500,000.00 6ESsCRI MN'OF OPERATIONS below E.L.DISEASE-POLICY LIMIT j$ 500,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION Thielsch Engineering 195 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD s a t zr w A `L qJ .Z i k 1! „ Lnet Rd, , ti a r :d a � mot Cz � t i R t f a - r 19�2 S ku n knet Rd, Centervill le-'' k y;. f t._ - 1 i a ti 192 Skunknet Rd, C&fff'ry i I I e ( 11 /21 ar � tr 9 r pl`B • 192 Skunknet Rd, Centerville 11 /21 /14 w r Y •: w s `n yj I _ •E.rc` a.,......,� 'r � - x ry ' a - _ r 192 Skunknet Rd, Centerville 11 /21 /14 192 ; kun knot Rd, Centerville 11/ 1 • t a. «wce aa.J.+*n+o•.war..a a �, .. '. ,.�. :Asusw .usMyyf*, «+ +t.s tkteb.. ...ask. ,•o oi � 3 y �� 'k, .. '� � ._., "'VLM13; .R:, ,;. �.• r �AI�RY+FY+�Nxilq lkW max.V n .w! i 192 Skunknet Rd, Centerville 11 /21 /14 r: r. f 192 Skunknet Rd, Ce ille 11 /21 /14 „z ry ry t 1 <, t �° r. �r j_ - � r t ' 4 Ate`•.. s'yy..-•._ S: �i i �f W ' Cr.vAw _ m _ 1y92: Zkunknet-Rd, Centerville 11 /21 /14 Anderson, Robin From: McKean, Thomas Sent: Thursday, November 06, 2014 4:29 PM To: Anderson, Robin; O'Connell, Timothy Subject: FYI- NEW PAVEMENT FOR NEW SECOND DRIVEWAY 192 Skunknet Road just had a new second driveway paved/installed today or yesterday for the basement apartment. The property was recently purchased approx. three weeks ago. Was this apartment grandfathered for use as an "in-law apartment"only? 1 1 �TNe r Town of Barnstable Regulatory Services • anxxsTnai,e, MASS. � Richard V. Scali, Director i639 ♦0 1639n• Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.tow n.ba rn sta b le.m a.u s Office: 508-862-4038 Fax: 508-790-6230 November 13, 2014 Wayne and Erica Malcolm 192 Skunknet Road Centerville, MA 02632 Re: Basement Apartment Dear Mr..and Ms. Malcolm, This letter is to inform you that you may currently be in violation of Barnstable Zoning Ordinance 240-11; any use other than a Single-Family home is prohibited. You must contact this office by December 4, 2014 to arrange to bring the above address into compliance or be subject to fines of$100.00 per violation, per day. Sincerely, Robin C. Anderson Zoning Enforcement Officer /blc S � , I Parcel Detail Page 1 of 4 ... - s r: p t Logged In As: Pa rCei Deta I I Thursday, November 13 2014 Parcel Lookup Parcel Info Parcel 171-009 Developer LOT 19 ID Lot Location 1192 SKUNKNET ROAD Prn 100 Frontage Sec Sec Road Frontage Village ICENTERVILLF Fire C-O-MM District Town sewer exists at this Road 1494 address No �� Index Asbuilt Septic Scan: Interactive , , 171009 1 Mappia ` Owner Info Owner ISTANLEY, MARK H&BONNIE K % Owner MALCOLM,WAYNE R JR&ERICA L Streetl 1192 SKUNKNET ROAD Street2 ' City ICENTERVILLE State FM_A__j Zip 02632 Country 0 Land Info Acres 10.40 Use ISingle Fam MDL-01 Zoning IRC Nghbd 10105 Topography Level Road Paved Utilities IPublic Water,Gas,Septic Location Construction Info Building 1 of 1 Year 1989 Roof Gable/Hip I Ext Wood Shingle Built Struct Wall Living Roof AC 2085 � Asph/F GIs/Cmp None Area Cover Typea1 Be Style Cape Cod Wale jDrywall Rooms I'Bedrooms Model lResidential Floor Carpet Rooms 3 Full+ 1 H Grade jAverage Plus Heat Hot Water J Total 8 Rooms J Type Rooms Heat - Found- stories 11 3/4 Stories Fuel Gas ation Poured Conc. Gross http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=l 1489 11/13/2014 Parcel Detail Page 2 of 4 Area 15116 Permit History Issue purpose Permit Amount Insp Comments Date # Date 5/13/2005 Finish Basemnt 84094 $25,000 4/24/2006 12:00:00 AM 6/10/2003 Wood Deck 69389 $3,800 10/17/2003 12:00:00 AM 8/1/1992 Out Building B35280 $500 1/15/1993 CE SHED 12:00:00 AM 5/1/1989 Dwelling B32922 $85,000 1/15/1990 CE 11/2 S 12:00:00 AM Visit History Date Who Purpose 10/21/2014 12:00:00 AM Anne Leonelli Change of Address 8/18/2014 12:00:00 AM Jeff Rudziak In Office Review 4/15/2009 12:00:00 AM Tony Podlesney In Office Review 8/8/2008 12:00:00 AM Paul Talbot Cyclical Inspection 10/20/2006 12:00:00 AM Denise Radley Change of Address 4/24/2006 12:00:00 AM Martin Flynn Bldg Permit Completed 10/17/2003 12:00:00 AM Martin Flynn Bldg Permit Completed 12/31/2002 12:00:00 AM Paul Talbot Meas/Est 2/7/2000 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 3/15/1990 12:00:00 AM IME Meas/Est - Sales History Sale Sale Line Date Owner Book/Page price 1 10/18/2006 STANLEY, MARK H & BONNIE K 21444/110 $426,000 2 4/22/2002 SCHMITT, STEPHEN H & 15070/334 $345,000 DEBORAH L 3 5/15/1996 FOGARTY, PAUL R& KIMBERLY 10230/87 $170,000 J 4 12/15/1988 PIRES, DONALD J & DONNA M 6575/122 $55,000 5 8/15/1986 MARKARIAN, CHARLES J 5250/74 $50,000 6 5/15/1965 BARNARD, JOHN E JR 1290/638 $0 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=l 1489 11/13/2014 Parcel Detail Page 3 of 4 7 9/15/2014 MALCOLM, WAYNE R JR & 28381/339 $390,000 ERICA L - Assessment History Save Building Land Total Parcel # Year Value XF Value OB Value Value Value 1 2014 $176,200 $57,100 $13,900 $107,000 $354,200 2 2013 $176,200 $57,100 $14,200 $107,000 $354,500 3 2012 $188,200 $56,800 $11 ,400 $107,000 $363,400 4 2011 $219,900 $20,700 $4,400 $107,000 $352,000 5 2010 $219,400 $20,700 $4,500 $107,000 $351 ,600 6 2009 $223,500 $13,700 $2,100 $158,300 $397,600 7 2008 $236,100 $13,700 $2,100 $169,400 $421 ,300 9 2007 $274,500 $13,700 $2,100 $169,400 $459,700 10 2006 $236,300 $13,300 $2,200 $174,100 $425,900 11 2005 $215,700 $13,300 $2,200 $139,000 $370,200 12 2004 $174,800 $13,300 $2,300 $139,000 $329,400 13 2003 $152,200 $5,600 $2,300 $46,200 $206,300 14 2002 $152,200 $5,600 $2,300 $46,200 $206,300 15 2001 $152,200 $5,700 $2,300 $46,200 $206,400 16 2000 $116,200 $2,900 $1 ,300 $31 ,500 $151 ,900 17 1999 $116,200 $2,900 $1,300 $31 ,500 $151 ,900 18 1998 $116,200 $2,900 $1,300 $31 ,500 $151 ,900 19 1997 $127,700 $0 $0 $28,000, $158,800 20 1996 $127,700 $0 $0 $28,000 $158,800 21 1995 $127,700 $0 $0 $28,000 $158,800 22 1994 $118,500 $0 $0 $31 ,500 $153,100 23 1993 $116,200 $0 $0 $31 ,500 $147,700 24 1992 $132,300 $0 $0 $35,000 $167,300 25 1991 $125,300 $0 $0 $56,000 $181,300 26 1990- $0 $0 $0 $56,000 $56,000 .27 1989 $0 $0 $0 $56,000 $56,000 28 1988 $0 $0 $0 $17,500 $17,500 29 1987 $0 $0 $0 $17,500 $171500 30 1986 $0 $0 $0 $17,500 $17,500 Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=11489 1 113/2014 Parcel Detail Page 4 of 4 k, http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=11489 11/13/2014 f-B-09 r A nstable ervices r,Director vision ing Commissioner nnis,MA 02601 table.ma.us Fax: 508-790-6230 tl Addition Or Remodel Or Dock )n application. proval required prior to construction/demolition th of the Mid Cape Highway) District(See map for boundaries) i for Project): -d at the Registry of Deeds w/in one year of red and can be obtained at 200 Main St.: 3:30—4:30 PM {as of March 2nd, 2005) 3:30—4:30 PM) ling Department) iartmentl Town of Barnstable OF 1HE rp� Regulatory Services P� o Thomas F. Geiler,Director Building Division . * BARNSTABLE, y MAC g Tom Perry,Building Commissioner �° i639. ♦� 0tfotA _ 200 Main Street, .Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax8�0-6230 Approved: ' Fee: — Permit#: cX/l10//'� HOME OCCUPATION REGISTRATION Date: �� Nauhe: Phone #: � � � ci1-6 2—3. Address: S Z Village: � 9�tt�{�,K�o+ CS?la4 3;—VNVC. n Name of Business:-- Type of Business: ( 09 r Map/Lot: INTENT: It is[lie intent of this section to allow the residents of the Toivn of Barnstable to openite it home occupation within single family(hvellings,subject to the provisions of Section 4-1.4 of tile Zoning ordinance,provided that the activity , shall not be discernible from outside the Jewelling: there shall be uo increase in noise or odor;no visual alteration to the premises which avould suggest anything other than it residential use;no increase in traffic above normal residential volumes; and no increase in air or grounchvater pollution. After registration�aritla 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 periaanenf resident of a single family residential dwelling unit,located within that dwelling unit.. Such use occupies no niore than 400 square feet of space. • There are no external alterations to the dwelling ivlhich are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes., • 'riie use(toesuot.ihivolve the production of ottensive noise,Vibration,smoke,(lust or other particular-matter, odors,electrical disturbance,heat,glare, humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flananaable or explosive materials, in excess of normal household quantities. • Any need for-parking generated by such use shall be met on the same lot containing tile Custonia y Home Occupation, uul not«�tlhin the required front yard. - •' Tlhere 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 )rck-up truck not to exceed one ton capacity,and oihe trailer not to exceed 20 feet iu lent,�th and not to exceed 4 tires,liarked on the saine lot containing the Customary Home Occupation. No sign sliall be displayed indicating the Custoirhary Home Oc•c•upation. • If the.Customary Home Occupation is listed or advertised as it business,the street address shall not be r included. • No person shall be enaploy-e(1 in tlh Customary Home Occupation hvho is not it permanent resident of tlhe chvelling unit. I,the undersigned,have read and agi mtl ie above restrictions for nay home occupation I aril registering. Applicant: Date: C7 tfomeoc•.doc• t2cv.01/3/08 YOU WISH TO OPEN'A BUSINESS? For Your Information: Business Certificates COST $30 00 for 4 years. A Business Certificate ONLY REGISTERS YOUR. (WHICH YOU MUST DO BY M:G:L. - it does not give you permission to operate), -You must firstobtairi the necessar snatu es �_n the Town at 200 Main St., Hyannis. Take the completed form to the Town'Clerk's Office, 1'' Ff. 367 Main bt Hyannis,. es 026 signatures on this form the Business Certificate that is required by law. (Town Hall) and get ^� Fill in:pleases DATE: :', APPLICANT'S YOUR`NAME: K t ` Ni BUSINESS YOUR HOME ADDRESS y TELEP # C�w, NAME OF NEW BUSINESS Home Telephone Number: 64 _ TYPE OF BUS IN ESS YES N OS IS THIS A HOME OCCUPATION? , Have you been given approval from the building division? YES , NO ADDRESS OF BUSINESS S �� c MAP/PARCEL NUMBER When starting a new-business there are several things you 'must do in order to be in.compliance with therules and regulations Barnstable. This form is intended to assist you in obtaining the information you may,need. • You MUST GO TO 20 � 'of the Town of Yarmouth Rd. & Main Street) to make sure you have the-appropriate'permits and licenses required to legally operate your business. (corner in of town. -4 is I. BUILDING COMM]SS1"0'NERIS OFFICE MUST COMPLY WITH HOME OCCUPATION This-individual has`been ir�£or an RUB S; dND REGULATIONS. FAILURE TO - p rmit requirements that pertain to this type of business. COMPLY MAY RESULT IN FINES; Awt oriz d Signa . re** COMMENTS 2. BOARD OF HEALTH This individual h b infor ed e ermi r uirem is that pertain to this type of business. Authorized Si ature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual hasAbp *no 4arce the lig requirements that pertain to this type of business. A i ** COMMENTS: a� l9z TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map— Parcel •- - Permit# 4 094 %alth Division — / , I Date Issued Conservation Division /—P S /l l®� TOWN OF BARNST BLE Fee 2 5 � Tax Collector 20015 MAY I I AM 9: 35 Application Fee � Treasurer Planning Dept. DIVISION----eirecked in By Date Definitive Plan Approved by Planning Board Approved By EXISTING SEPTIC Historic-OKH Preservation/Hyannis I IMITED TO L-1 0 OF BEDROOMS Project Street Address I` 2 S A 1 L( L Lad La AE' Village ce, n _ Owner 6:kA& ()lIw Address Telephone MR _7 2 IR a(4_�_q 1 - Permit Request &mocUA QXI I' d Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family V/ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 2'No On Old King's Highway: ;Q Yes &No Basement Type: dFull ❑Crawl �lalkout ❑Other Basement Finished Area(sq.ft.) 5DO Basement Unfinished Area(sq.ft) 400— 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: US Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Q'Nlo Fireplaces: Existing New Existing wood/coal stove:. 0 Yes VIN o Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:510'e"xisting ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ®'NutIo If yes, site plan review# Current Use Pert - - Proposed Use----- BUILDER INFORMATION NameJ� Swee,,,L Telephone Number 6_)� 1 2.,b 3b ao Address. I MO License#A R114 1 (4 q l.M4e,rVI A_t_ Aa 02ta-3 Z Home Improvement Contractor# � Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOdl.lYVl,e- ��GY SIGNATURE DATE lb 6 .I t FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED - 1 MAP/PARCEL NO. ADDRESS - VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH ~'t FINAL PLUMBING: ROUGH ? m FINAL GAS: ROUGH . 0. FINAL , FINAL BUILDING DATE CLOSED OUT A) m ASSOCIATION PLAN NO. _ "r s c no CMR Appeadti 1 Table JS.Llb(continued) Prescriptive Packages for One and Tw4xmilr Residential Buildings Heated with Fossil Fuels MAXIMUM MINI&fU141 Glaring Glazing Ceiling Wall Floor Hasemeat . Slab Heming/Cooiing 13 � Wa11 Perimeter, Equipment E1Baeacyr Area'(%) U-value= R-value' R-value R value' R-v all R , Package , 5701 to 6500 Heating Degrte D 6 Normal Q 12% 0.40 38 13 19 10 Normal R 12% U2 30 19 19 10 6 S 12% 0.50 38 13 19 10 6 85 AFUE -- - -- T------=--15%. __._._..036.-- ..._._._38 13 v AJA N/A Norma! 13 '15%, 0.46 38 19 19 10 N 85 AFUE V 15% 0.44 38 13 23 N/A 6 W 15% om 30 19 19 10 6 �� N/A . Normal )( 18%, 032 38 13 25 N/A Normal Y 18% 0.42 38 19 25 N/A N/A Z 18% 0.42 38 13 19 10 6 90.AFUE AA 19% 1 a-so 30 19 19 10 6 90 AFUE i. ADDRESS OF PROPERTY: . n L "" F 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: -3 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): I �! 5. SELECT PACKAGE(Q--AA-see chart above): r " NOTE: OTHER MORE INVOLVE D METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-for= 980303a w 780 CMR Appendix J Footnotes to Table J$.2.1b: • + of the area of the glazing assemblies (including sliding-glass doors, skylights, and area is the ratio g g Glazing ar basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area, expressed as a percentage.-Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 f'of decorative glass may be excluded from a building design with 300 fl of glazing area. i After January 1, 1999, glazing U-values must be tested and documented by-the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table JI.5.3a. U-values are for whole units:center-of-glass U'values cannot be used. ' The ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation tray be-substituted-for R-49-insulation. Ceiling R-values-represent-the sum of cavity--- insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example,an R 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces (such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement d::scribed in Note b. The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes eleetric resistance heating use compliance approach 3;4, or 5.• If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package.. 'For Heating Degree Day requirements of the closest city or town see Table JS :Ia NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels 11 R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater.than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 _ 1 The Commonwealth of lllassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street, i h Floor ` r,; Boston, Mass 02111 Workers' Compensation Insurance Affidavit Building/Plumbing/Electrical Contractors Applic'ant`lnormaton °ykYa9� i i �G y �i��kfip'(C S@.PRIla)!C4'� �Y � fit7hnQx�p�€ yavt� `i ' ,a,.�e„;. � ;¢ r name: 5hn LC, address: 1 i1VR -1 f�l/`t " ►ou y f t oCil city NnAncu o L9_ state: ( / 3 �(� / te. zip�.X�(G�.J�phone« (�.?'C ��'lP i�l.�Os-� work site location(full address): ❑ ]yam a homeowner performing all work myself. Project Type: ❑New Construction []Remodel l am 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. company name: address: City: phone#: insurance co. pohcv# 4'.".��,5�`fa:ai�t`w' A ' 'w "mw�r�'"Wl'ai,,�.�,.�,.'+."7rU'}'.r".€a:}�.25X��n.a"",eh'`�a�`^.� ;hbsyt.tri x.2ui.��; i� n r,f<..St" 7�u`iaieik✓e��'.o.tltt"�igtzlwth��,' ^. .,, lei ,4: ,3 ,.'.,.aVw uµ,.,.a.t eik�.`tSi's ❑ 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: city- phone#: insurance co. poiicv# ...)Pe` _ company name: address: city: phone#• insurance co. policv# attack adblfional` }teectt necea33alY, k„ra klt 'a§ w . . � y �"s ,.,; 1� .e�: kE.�t�ra:<r , Failure to secure coverage as required under Section 25A of MG 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP N`ORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may a forwarded to the Office of Investigations of the D1A for coverage verification. 1 do hereb}!certi er the ns u natti perjury that the information provided above is true n�jd co rect. Signature 4 Date ! �� Print name y �C Phone#V 0 0 official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is"required ❑Selectmen's Office []Health Department contact person: phone#; ❑Other frmscdScpt 2W3) _ i 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. Hove ever 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 per,ormance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. ��� `����"�u:+ � �#S��'�i t��tgr"- � � .Ya: :�, ,� �. �3 '�3�'+'+ s�����' •.°� s�r.+�r�� =A�, ?�}i.�St „x'�'�r�;���v� �y1�y.��`��� ' *'a�irw��4:�,..;� �, L° 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. r. ` m ��sa"' �w:s�re:e �Z�• ��r; d, �"�:x '.e^-. �"�n �r� e{��k p�`c� �'� ��_ry{tt k '� r.�':. x '�f�, " ,a'u a ''r+" . �� 4 ..�LL w H ��C�!u�'�A?�YW^�k�`�a�iw'�.0 .�4+�ari�tr�n`��',"�� ^"��a° b��� '�, .� •��� � ,`''Y, a , a,"� �'r�C` S"i,�v�i` 1 ,�U 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. ki > 1 .n i •A" x a>-^� uy� tt^^ m F ^e n r �c x va F x 9tn f .:fn �' r arP`T r a l ,fix. a ���• .�������, ��,a��•��",��t�' �`���E�`,s��`�r�'4'�;ts.`Sri,°,Rp"'k';9'•u�'��+a�'�'.�"rYF�+y�`^K' .�'+k4��', & 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 9: (617) 727-7749 phone#: (617) 727-4900 ext. 406 ���► rgti Town of Barnstable Regulatory Services BMMSTABMAS&''E Thomas F.Geiler,Director �A 1 39. ,0 rEntut° Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 ro www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Dates AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. ' Type of Work: ` Estimated Cost 2,5-0 00 Address of Work: I Z n f . �� Owner's Name:�SkAge 60i rn t It OqDate of Application: seJ (�� I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ` ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: e OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE t ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL.c. 142A. r t SIGNED UNDER PENAL IES OF PERJURY I h eb apply for a permit as the agent o e o Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav Board of Building Regulations and Standards I. HOME IMPROVEMENT CONTRACTOR Registration:._145819 Expiration `3%2/2007 Type DBA i` SWECK BUILDING+REMODELIN @HANE SWECK 1808 FALMOUTH RD::_ <'G CENTERVILLE,MA 02632 Administrator. ,.a�/�w.5-sS:-3 � i 3� k�, C`* ✓JGG ����7�.�1 h�.UP.�'I.L/CIIVG���r-"""_- �. .. .. BOARD OF i3UILD REGU.LATfONS I License: 'CONS1`RUCTION SUPERWS`O.R3 ;I o i! Number: CS 0841:49 q Ii n Expires: 66/29/2006 Tr.no: 84149 Restricted: 00 SHANE P SWECK 1808 FALMOUTH RD CENTERVILLE, MA 02632 Administrator 4 , Y Town of Barnstable Regulatory Services BARNSTABLE, 9 MASS. $ Thomas F.Geiler,Director `b 1b3g• ,0 �f0 gnat" Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, `Z R wiV�l �C \-N YX \ , as Owner of the subject property hereby authorize S to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 4 Signa e of Owner Date Print Name Q:FORMS:OWN ERPERM ISSION f ' vim!' • .. k p`pFTMfTpy_O� The Town of Barnstable SA.%fAS&L& _ Department of Health Safety and Environmental Services MASS w ' t679• ,m0 . Building Division 367 Maim Street,Hyannis,MA 02601 are: 508-8624038 rt: 508.790-6230 PLAN REVIEW Owner-: e.AYh Map/Parcel: �.0 Projecf'Address: �_��L S�y Builder: The following items were noted on reviewing: - - C Y l 1 l 0 4. Cf S , 2 . i ski Q , ran �Z� e 'A- 5 40- e� 'P lr- u, ► Y1 a, l � r . m s - Reviewed by: Date: oFIHETpy� The Town of Barnstable BARNSTABLE. ` Department of Health Safety and Environmental Services Y MASS.' 0I i63 q �0 pjEUMP�N. Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location / 9 2 6 hV? V\ Permit Number (0 R �1 Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: SU1(0 ttl., + loP G -i M 1A lrr 2 7 0vex Please call: 508-862-40A8 for re-ins ec'ti6n. Inspected by Date / 2 �l/ C� NI a �] � p 1 v (�� / n 9 v �' 1 's I �--, N c� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION a Map Parcel Permit# >b'1'' 0 i3AF�F S TABLE Health Division ,� D.a ]��Ci Date Issued Conservation Division (o =0-113 J'-Ij rjf� -Application Fee Tax Collector - _ � Permit Fee . Treasurer fldiJf . SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board 'TITLE 5 ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGUL A.TIONS Project Street Address sx- tZ, Village _ l "Pw > r yt //�e Owner 7Z��� Ve S kk iT/ Address / 9 2- Telephone -7 7 L/ Permit Request FD G' Deck: 7— / r Q 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 Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes . ❑No Basement Type: Y 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: Cl 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 ,....�.�-----:. 11,4,rle / UILDER INFORMATION Name�1 S / F--e—rullo Telephone Number 0U 9 Iko Address 20 C-r-DC90 C 1 rcl-e. License# _ 7 C/a ' L' N Nl.S 44 ff Home Improvement Contractor# DZ(0( Worker's Compensation# 7 2 711Q WO 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0.r-'V S -4 � SIGNATURE DATE Zl G FOR OFFICIAL USE ONLY PERMIT NO. x DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: FOUNDATION i--' - �* .'.j"�' Q_'�1•' FRAME \ 7— INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH C �i x= -, s� FINAL FINAL BUILDING rs DATE CLOSED OUT : t ASSOCIATION PLAN NO. i . ; , _-..-. . , � . � 1. r "' `—�` The Commonwealth o�Massachusetts N__ _ Department of Industrial Accidents -= Office of/nrestigations . 600 Washington Street -• . Boston,Mass. 02111 `�--5 Workers' Compensation Insurance Affidavit i name: r`/YS / ( 7 �--1-fJ1/0 location r�l Z S�U,, /� 1V— ,eo city �'N rt1l</� �/4 phone# cK?:?f-—e:,-�Z9,?eJ ❑ I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one workii in an ca aclty /%/��%%%% /%%%/%%%%F/////�OZ//////G��%%�%%/%/%///%O%%//%%%/%/G%%%%���%%%%%%%%%%/%/��%/�%�/G%%%%%%��/G%�%%%%��/ I am an employer providing workers' compensation for.my employees working.on this job. '::....:.. :..:..... ........ r:::::.:::::::::::::.::::::::::::..::<::::.:.:.:::::,::::::::::.:::::::::.:::.:::..::::.::::.: y,/! .>:.:..:..::0. :.;i;::::i::::::::i:::::::i:::::i:::::::>::::i:::::::.: ::::::.:<::%.:ci:;:::;:.:::'::::>'iiii::<.;::.>:.::.>::;:.>:;.>:.::.:::::!•::c:<•:>:: :. ,:: 5!!.::::::::::::::..: :'.:::: .::>:?::::::::.::..:::::::.�:::.:.�:::::: ::.:::::::::.�::.�:;::.:4:i::.:ii::{v::•liv;::::;r:v.i'.:i.:.i:.i:a?::.y} ?::"::: ":i::.. .. ... ....... .......... .com an :name:.. ... .. ... . : M::::::: ;::i'7S: ;:yy;: 5:.:.. :;: is G:i::::::::::::::;:::i:_`:>:4;::;:;::::%:1....S::..,:: <5::.-.:..:-*-.X.X.X'X.. ':v:::<:is�i!::::::: ::' ::::is i:::::::i:::::::::i:::::i::::::�:::: :::J::::::::::: :?:::i:::::•i:::'isi''::::i'��•:{.....::•.....::::::::::::::::?:;:!::•,: ... .::':::.:ii':i::: 11 ...':: ::::i':" f:''..:v:i'::.:::::::: jv;:i;:i;:i'): ,.;yi i'.,..•. ::i::ii:'.:::i' :" ailditss:. n '� ' . . .. �_� . .. .. .. '..:'..... ':'.. :.;':' '!ii..:.:'.:': ::..: .j:":::,::..: is.: ,. .::'.,.i.:..:..::is .. . •..:':':� '. .*,::»:::: :::: ,,... hone#.. ;. ;. ': :'.: <::<,: <:> :.«: "z cl ...... i. . .. .;;::'<.> :.:::>::::::>>::<:>:: :::»:::<::::><:>iKj>;;>;:. <•>:.;.:......::.>:.::.:::.;.::.::.;::::::i�i. - --::«.;:.;:.;.;".:<.' :.<.;".::,::::.:::: .:.::;;,;;.:::'<;.;:.;:.>;:.;;;:.><:.:;:.;:;:.»;:.;.>:<.;;:.;:<.;'.;:. :.:<.::'.:;::<: ... .:;:.:;:.';;.;:;.: :'::' anstl>:anca>co.::..:,;::':;. .:.::::. :::. ..:ii . . oL. . # :: :: _::::: .: �� :: .. ❑ I am a sole proprietor,general contractor, or homeowner(circle one) and have hired the contractors listed below who have . g workers' compensation police the following n s: name;: »::::;:::<: ii . .................................................. :a. RIC.....; ....... ..... a .:,:. •::...:.:...:... .:....:::•;..:::.;:. ......:::.:..:.::.:.......:..... .:. ...............::........::.::::::.::::::::.:::.::.:.:::::::::::: .:.::.....:.:::::...... <::i<:»;::: :.:>::.::.:::..::::::.::........... ..........: :.:; >. citvx ::': a :::*- aiiiiirance //.,'/l////l///Ii. ......... j11e '< ;fi ± '`'} ; :::: : :- . .: .... : Y;; G ' 2:2'>'f�2 :�%' ��:: "r ;:;: :; 5`` ''G:> %: 2:'::: �y 6: :%% >` : >:> = ` . :::::::....<:....:;:;. c arl n : .. . .:.,.:,,- ..... Y., .,. ::: -...,-.-... .�,` :;.j..:.;:::::;ii::::..:.::i:i::::<ti:i:::isL<:::>ii?i i':`:v i?::::isi}:';: ::::::{::::i:::::::::`:::ii::j::::::}::::::::::::<:v:::::'isi::i:::::ii::::::i::::i:::;::::i::::::::::i::::::::::.:: .......�;:......# i:::::i::::i::::::::::ii:::::::isi::::::::i:::::::::::::is�::::'::':::: ::i:::iv:::::i::::2i:i::<:i:ii:ji::i::i:i:}:::i::!i:: !: .:>:>::>::>::>:.;:.;:.;:.;:.:::..::::•;:. ::: hone#: ... CL .... ... .......... ....... . :..... :.......::•:: :::.... .......................:...:......:.........'........:........:..:..........,....:.......:::.:....::.::..:...:::..-.....:....::............:...........:..:..........:::.:.:.......:....................::::::... :::..: % aral ee �M. 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 fine 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 eerd under the pains and penalties of perjury that the in ormation provided above is truo and c reef Signature 'e:�— x Date � . � 0 3 // �— Leo 2� ��-- Print name G� l�r � / ./"41 Ila Phone# `.7��^ official use only do not write in this area to be completed by city or town official . city or town: permit/license# OBuilding Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office 0HealthDepartx ent contact person: phone#; ❑Other (revised 9/95 PJA) t 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. 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 rebumed"tn 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. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Investlgatlons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 �OpTHE pow Town of Barnstable ti Regulatory Services BARNSTABLA " Thomas F.Geiler,Director HAM 16;p;�A`°� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax:' 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. /' a � Type.of Work: toeC/< 7�`S��� Estimated Cost ��49a' Address of Work: ) 9 Owner's Name: .S 4,---e SC_XI 12ni Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 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 of the owner: 2 3 0,g/ Date Contractor Name Registration No. Date er's Name L 0F11IE lof, Town of Barnstable Regulatory Services + BARNSTABLE, * Thomas F.Geiler,Director MASS. `bpre1639. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, �-5 , as Owner of the subject property hereby authorize CI`T�r/�S /��C�C�/� to act on my behalf, in all matters relative to work authorized by this building permit application for (address of job) Signatur f Owner Date Print Name Q:FORMS:O WNERPERMISS ION \•. . ( i p • l- m C}Y E y� No.'19334 �Q Np SURF 7.,Zki4,-TT 7741 IMAM E F LU VA Cx - a.� Tf-f�" T�«�/ c»,�' �,�}��/�zli3L.� �.,.:•✓�: � �a...�'�l"/C.�t/ C-��7_-7�//C1C x BOARD OF SUJILDING REGULATIONS License CONSTRUCTION SUPERVISOR Numbe t:tS\ 079281 Expirs,1�t)�Qfi��004 Tr.no: 79281 + 7 +' RestM, CHARLES M FERLLO fir; _ 1 20 CROSBY CDRCLE / SO DENNIS; MA 02660- Administrator Board of Building Regulations and Standards HOME IMOV EMENT CONTRACTOR Reglstra roT► 1 4401 ;AR F= SYpe-6A CARPENTRY+RM�D f CHARLES FERUL'F /`% 20 CROSBY CIR.. S.DENNIS,MA 02660 Administrator T E M P O R A R Y ,fTN�>o TOWN OF BARNSTABLE 32922 .Permit No. . BUILDING DEPARTMENT I TOWN OFFICE BUILDING Cash �>arnv HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Do',`nald & Donna Pires Address. LOt #19, 192 Skunknet Road Centerville, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. November 20, 19 8 9............................ .......... ....... ........ Building Inspector TEM --P0RARX D�THE TOWN OF BARNSTABLE .Permit 'No. ..32.922..... BUILDING DEPARTMENT { ' } TOWN OFFICE BUILDING Cash bso. �c Wr HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Donald & Donna Pires Address Lqt #19, 192 Skunknet Road Centerville, Mass. 4y USE GROUP FIRE GRADING OCCUPANQY LOAD „ THIS 1ERMIT WILti THEfBUILDING NOT BE'VALID, AND ;SMALL_NOT BE OCCUPIED UNTIL SIGNED BY TI41 BUiLDING4❑�NSP)'CTO'R :UPON'`SATISFACTORY ;COMPLIANCE WITH TOWN: REQUIREMENTS'AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. November 20, 19..89........... Building Inspector d .r"r,r—.'y:rs-.E'axeia�r�..y tre!,r.�-'�ry�(at�F�-vim,-r�,W ,; J(..�� � ^�i ig`iwtk:^,i;��ri+�F'.;:hc'g°+,.^fainpy.?�',ef+"RfS�"^s"ts+KV's�.N"Mre'i".i'�.ti.^�^ca K.jt�rt -�V 7 rt 75�7"'v`...:y., ;r.�.•�,+a«.��.s.,�r..��:�ra�;�•+-R ^.� ,FTMc TOWN OF BARNSTABLE Permit No. .a?.922 BUILDING DEPARTMENT q Cash �.5.4UQ•®•t7,0) I1��1 9. TOWN OFFICE BUILDING HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Donald & Donna Pires Address Lot #19, 192 Skunknet Road Centerville, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID,AND THE BUILDING SHALL NOT BE OCCUPIED.UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December 12, I9......8 9....... ' �.. ;Z.......... Building Inspector .......... T I �x Fin TOWN OF BARNSTABLE, MASSACHUSETTS BU HE, ER m i Am171-009 Ma n DATE y 23 89 19 PERMIT NO.�"TAD e 2, r APPLICANT Donald J. Pires ADDRESS 43 Sheffield Rd. , W.Yarmouth 044383 (N0.) (STREET) (CON7R'S LICENSE PERMIT TO Build dwell ing ( ) .STORY Single family dwelling NUMBER OF UNITS 1(TYPE OF IMPROVEMENT) N0. (p(iOPOSEO USE) 'AT (LOCATION) lot #19 192 Skunknet Road, Centerville ZONING (NO.) (STREET) DISTRICT—"l I BETWEEN h (CROSS STREET) AND { (CROSS STREET) (, 56BDIVISION LOT LOT k BLOCK SIZE t - 'BUILDING IS TO BE FT, WIDE BY -i FT, LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCT l TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) ffREMARKS:, eWaPe 4�89-175 (Donald J. Pire,-) $400.00 AREA VOLUME 1600 sq. ft. , ESTIMATED COST $ PERMIT 114..5(_; (CUBIC/SQUARE FEET) FEE' OWNER Donald & Donna Pires 43 A cl ,ADDRESS: S eY ie• Roa , West. Yarmout i MA BUILDING DEPT. BY MINIMUM O F THREE71R LINSPECTIONS REQUIRR APPROVED PLANS MUST BE RETAINED ON JO ALL CONSTRUCTION : CARD KEPT POSTED UNTIL FINAL INSPECTION HAS AN BEEN WHERE APPLICABLE REQUIREDSEPARATE FOR ti I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCC PERMITS ARE R 2. PRIOR TO COVERING STRUCTURAL UPANCY IS RE- MECHANELECTRICAL INSTALLATIONS. MEMBERS(READY TO LATH). QUIRE D,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL PLUMBING AND 3, FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE, OCCUPANCY, POST THIS CARD SO IT IS VISIBLE FROM BUILDING INSPECTION APPROVALS STREET PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 ----- 01 $ . z ---___-_-__----- 3 Gds HEATING INSPECTION APPROVALS 1 �� ENGINEERING, EPAflTMENT �- OTFIEfl _`3 9 ROARU OI III Al I I I 'aAte-7-L- WORK SHALL NOT PROCEED UNTIL THL INSPEC PERMIT WI P LL BECOME NULL AND VOID IF CONSTRUCTION TOR HAS APPROVED THE VARIODUS STAGES ES OF WORK !S NOT.STARTEO WITFI'IN SIX MONTHS OF DATE THE IN'SPE(JIONS INDICATED ON THIS CARD CAN gL - J ` PERMIT !S ISSUED AS NOTED ABOVE, ARRANGED FOR BY TELEPHONE OR WRITTEN NOTIFICATION. I /9y , 0 { Yi �i : I 7/ _ \ . : i /��L/�f� ✓tom I'S4 22¢b Z-,n7 n DESIGN NTA TE57 PI T DRTA: P- S887 S,rrr;9.ic family��}..__f3cc➢rooms ,_L1�4__..Ga�bu9C Grinder Date. ', . T�ly 18,198( Dest Flow:._ 4 x I10 _-�Qp_GPC Tc6r Scette- T*nK t-�X JSO1's =._�(a[�.._G .Ilohs l�Ii-ness;1' YY1cKc�v� US E ; I UD C) GALLo►.l 1-AN K 'A � �-eac►� Pit:__-6� dl�z x3.(.7cf{,cc'�v^C d.a P�1 w t-t1� stbn e. 5tJcuxAI1 :11i-L- 5F x Z.S Gpot/SIC = 90 GP D To,o._e 130t6rjj : /54--Sr-K I,O GPd /SF =154. _G P D S✓b_... _31S_ 5 P" s'S7 G PD x x z G 30 S F I I 14 G PD s/P,-e 01 evnsfrvehor� /.30.7 y 76 fx C 0v -A Urri fy f�a t rt_gCot1s}cr...IS_not c elwai-�ov� S.1 _..o.r LU_o aJa>Er .. lop o /Jjust Inlet e-ov+er Foundato.N 10 one •foot below finish 9r,,aoft— FG. = yy INV "310-VIC> �DoXSya,r� gin t 4i UFAgq�s 7�nkP�tN (F �;` :.. �0 STEPHEN �G\ . a d J> X ALLYN RICHAPO v WILSON P o too w, o f a1. G�..>. 85�I Leach Pi t 19AXTERNo.30216 No.2404E3 ^r= � �sTE� S�sTEM PROF-ILE 3. ?a big' L LE1ZT1 FY T't-IAT THE ..1-12,,CoP../IQ� - SEPTIC SYSTEM D£SIGN "SHdW N HERFOW COMPLKS WITH THE LOCg_77OA/ Go r/9, SkvniScnc Rea„/ SIbEL,I1JE AND SETQACI�( R�.QUIr26111E►JTS of- THE I-OW N SC,4LE _ '�=20� DA7Z:/71Aa, 28, /?of 1rJ NOT L.OGATED WITH1A1 A �LOo3af�L141� CLAN /?Ef"ERE/1/CE: L-« 35435, ZB"$q APPL T .__.Z)onalc1 ✓. Pi%'Gs •AATta , THiS ►F%-AQ IS NOT PASEp 0"i A&) QAXTGR lt NYE , ZNC, 1�15TRUrr�ENT SUFRIl/C� AND THE OFFSETS R- e-j heed 4anl -5vrveyorz 5HOW'iQ HERE OW �5►4OULD NOT' 3f USED Civi/ E�7i/1 r�rs Tb CSTAeLISH LIJ'T LINES. L-4F //lrhSS , r 15 ?oaf •:.. �unPavcd "•' �- ry I 41 P n• ( � lo 4. C3cgQt�o.n , a.+, v�►J' 1 30 Topl.o' 'OVA 1S L Iv RICH!, u »• 1 BAXTER \ R.+ A Na.24048 , r> r \ t\ fCISTER x s of �. qs 4 STEPHEN �rG L8' —— 5 r I ALLYN ut 1y WILSON 1 1 No.30216 Q CISYE k y ( I 3/zs/may 1 ° ro Lc r l 1 I 1714. 0 "s,= ( I I ( I ( I I 5calc: 1"=20� ���(o SNEET 2 of r r Assessor's office(1st Floor): / OQ Assessor's map and lot number a � SEPTIC SYSTEM M UST •, Hof1ME Board of Health(3rd floor): ✓"'/�� � INSTALLED 111 COMPLUTA Sewage Permit number a K, = : Engineering Department(3rd floor): 0,/6 T dLflYfO TITTLE J Basa9?ADLL,/ (� ENVIRO�1C�9r ER4TAL Ci�DE A MAXa 9 House number `[ Yar a� Definitive Plan'Approved by Planning Board 19 TOWN REGIiLATI®NS p APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO I U I(,C)s lZ �%�\� l,c/(z(-C—)d"h TYPE OF CONSTRUCTION 'FQ',A n'!r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Proposed Use 1,^'�'i L F I V `Jw(c L(/ Zoning District Fire District Name of Owner y_)�)/y` q 1J0 Dolvm, F1 Xrcc-: Address °f� J/1�7�1 f�f of �4I`f�3 G'V• �1 � Name of Builder�)C)•NnLCV Address—, �'Alnrc_ Name of Architect U: +'� �JNI Lf Address J rt�/� (,/" �Q l f��✓1't QUA f r Number of Rooms Foundation 3 �U�c�r� Exterior C�.C� ��►�N� Roofing Floors f l(�C�Gt! r� ��r f Interior Heating F. l ',�J, Plumbing 2yZ Fireplace �� W&O(� -7,0✓5= Approximate Cost U S Area /460 S. �iagram of Lot and Building with D•mensions-- A Fee z4ej-,-46 =� rV 7 Irw 0 � 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. Name \ �✓ Construction Supervisor's License ©LIq__?�� r PIRES, DONALD & DONNA 1 No 32922 Permit For 11, Story , Single Family D�1_ 1 ,' ncr Location Lot #19 192 gkunkne$; Road Centerville Owner` Donald & Donna P; res Type of Construction Frame - i Plot Lot Permit Granted May 23 , 19 89 _ Date of Inspection / 19 yr ` Date Completed r do 19 r' e?A `a e rolt� 0 f ti Assessor's office(1st Floor): Assessor's map and lot number Conservation sfrpnc SvS�� Board of Health(3rd floor): Sewage Permit number I � � ee.tsraP4 Engineering Department(3rd floor): �NVIRON .-- House number TOW ���' Definitive Plan Approved by Planning Board APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOW F N O BA�RNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 13 ,s�— TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according t the following information: r Location Z S VN Proposed Use ��o Z-!! Zoning District Fire DistrictDI Name of Owner O/L! Address Name of Builder Address Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing ,!ll Fireplace Approximate Costw Area 22�/ � a® Diagram of Lot and Building with Dimensions Fee r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstablb regardinrh7nstruction. Name li Construction Supervisor's License _Dc( 3�2 PIRES, DONALD J. t No 35280 Permit For BUILD SHED s Accessory to Dwelling Location 192 Skunknet Road - `Centerville - Owner s 'Donald JJ P-ires , + Type of Con,sfruction .Frame - 2 Plot' Lot s August 13 , 92 � Permit Granted 19 , Date of Inspection 19 ~ Date Completed 19 -� 4 �' I I i c i'• i f✓ I t i ' `�^ .�..e.....,..,..,.:�«,..».....�.��.—.r.s.....�.w.......,. .,,.,...,.....r..,..�.=--..,_......�..W,.+.+.+.....r.orry.�...... � ....ter....._. ��VL3,::�dot— _ V.�4eat7 20 L` r �R N W dfq / WUTA w P.G �}Y E CA No. 19334 Q by FQ/BTE��•�,°`,f• '77-1.41- 'TW,. 15 .,(� r^` �J `2C �J "7L9r, C •-_/�/ Dry � -- , yC' __ V/Ll_C'--/LI,gS� /� 4S I. ri {I t F i II ✓IM T009YNlNNtU/¢QCYR ✓/� 1 1`01H UPI,GVELMEN i CONTRACTOR C�iJvl�i,LVii iv J%S1 pisai;on 07;20;"r4 Jfjn2i J. _i pUiiuiny • INI TRATOR J:uS !JJ1Cnet Road S en,ar.:11e MA 026a2 DEPAFrrM:ENT OF PUBLIC SAFETY COMMONWEALTH — OF 1010 COMMONWEALTH AVE. BOSTON ;MASS:02215 MASSACHUSETTS , r L lC:ENE ENCLOSE CHECK OR MONEY ORDER vs c08/:_;1/1' OR REQUIRED FEE, �_FEFwS EXPIRATION DATE S $ MADE PAYABLE TO EFFECTIVE RE��JICTIONS 358 6 VE DATE LIC N0. o c�,_,% 6"-,11 iA4:1 -�,:; "COMMISSIONER OF PUBLIC SAFETY" • D0iuAi_EI ._I P T RE:,.'..* U✓ _ Vii-12 RD EN:.I..EFiv T LLF' I'fA CI; �._2 PHOTO(BLASTING OPR ONLY) FEE: 100. 0 SEP Z S1991 7' HEIGHT: NOT VALID NTIL SIGNED BY LICENSEE AND OFFICIALLY D STAMP OR•SIGNATURE OF TH COMMISSIONER/ D THIS DOCUMENT MUST BE SIGNATURE OF LICENSEE « SIGN NAME IN FULL-ABOVE SIGNATURE LINE -. - CARRIED ON THE PERSON OF THE HOLDER WHEN ENGAG- OTHERS-RIGHT THUMB PRINT ED IN THIS OCCUPATION. COMMISSIONER 200M•2.87.81429 "7 + S yy ,d•Wr'•T^.'\'.Pl�( :M J 1 ��.,a � i . • -t"Kw':.^;r.. �� .. `� - •F'4 r�~K ...6r;`yw, Jr...,f 38i+r'`z r`�' ..,.T Assessor's office(1st Floor): Assessor's map and lot number �' as y^ F THE Tod c Board of Health(3rd floor): Sewage Permit number 7"''/ �.,7 Engineering Department(3rd floor): ���!�I('i�. ` = BAM NAB& L J rasa House number �° i639. Definitive Plan Approved by Planning Board 190 MAY d APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE . BUILDING INSPECTOR I APPLICATION FOR PERMIT TO �j U�(, /Z `7"�GZ-� b W(Z I.L.I 0A)r\ 1 TYPE OF CONSTRUCTION T-KA/1 e ttn2 1 ? 19 V1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location L-67 * UA1 (J5-T 9b A --EA TitZ Ji t L fz-_ Proposed Use �!N�r F A rr'I 1 DL k Zoning District �` `� c Fire District Name of Owner T--A,1191 DII(VA F1a2( Address 1-/3 �h c�Trl f /�4/`�� !/y• �I r�t��y1�11 ,t Name of Builder 06A1 2 E Address J A rnrr- Name of Architect Jjj. Address Pf(�Ie y Number of Rooms � Foundation eo(Rk o 0dNct1r1r,;7,--% Exterior �--C'Cdf1X� ��11NP)�fL Roofing S�h�C7 Floors �faKr�GUL(a(X t�,� ,2F ( Interior Heating I+ ' ` f , Plumbing Fireplace .100 ' ✓�- Approximate Cost 6- �- 1 �- 70 Area Diagram of Lot and Building with Dimensions Fee 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. Name d,G'X4 -�� •� Construction Supervisor's License L/I/~=?�E\„ Y PIRES, DONALD & DONNA A=171-009 No 32922 Permit For 12 Story Single family dwelling Location Lot #19 , 192 Skunknet Road Centerville Owner Donald & Donna Pires Type of Construction Frame Plot Lot Permit Granted Mayes, 19 89 Date of Inspection 19 Date Completed 19 i h U. a ° I I � I 1 I I i t _ u i Town of Barnstable DFSHE l� o Building Department Services Brian Florence, CBO MAC $ Building Commissioner39. : ` rg ppii STABU 200 Main Street,Hyannis, MA 02601 � www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Town of Barnstable Family Apart&bi tkAffidavit ` I;being on'oath, depose and state as follows:. MY name is yy A: 1 AL't t7 L I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owner: f*4-IT G� Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing: I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. Other Sworn to d r the a s and pen of perjury this. day of 2019. � b6119 Signature Phone Number Print Name .t 11 y)&A�_ M4-C 06 "- q:f6 rm s/famaffid.do c rev 11/08/13 Town of Barnstable Building Department . .� Brian Florence, CBO Building Commissioner i0ri r�� 200 Main Street, Hyannis,MA 02601 �' www.town.barnstable.maxs Office: 508-862-4038 F1 508-79Q 62V co M Town of Bamstable Family Apartment Affidavit I, being on oath, depose and state as follows: A NE® ii \\ My name is w� I am the owner/resident of the property located at: �'^ ''� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: ��, pp Name & relationship to owner: A) Name ' ���"�'^ ►1'�a+t-er s 1�:�✓ Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn o e pains d penalties of perjury this day of _T1M0'Ac('7 2018. - 3415-q 45 3 Signature Phone Number Print Name ����� (LA/j'L4-z� q:forms/famaffid.doc rev 11/22/2017 Town of Barnstable n ` Regulatory Services Richard V. Scali,Director °* Building Division IMMMABIX ` Paul Roma,Building Commissioner -a 1639. 200.Main Street, Hyannis,MA 02601 Cl a www.town.barnstable.ma-us Office: 508-862-4038 Fax, 08-790-G30 Town of Barnstable Family Apartment Affidavi I,being on oath,depose and state as follows: My name is I am the owner/resident of the f property located'at &A 0 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: 4Y le _N� Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family.members: In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit,annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-4Z 1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no.longcr,u:Farlily Apartment at this,lacation,please explain; The apartment has.been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. Other w , Sworn to un r th p penalties o er ury this l �-t� day of G�„�� 2017. Signature Phone Number Print Name QAYI`� "� q:forms/famaffid.do c rev 11/08/12 { y Town of Barnstable i Regulatory Services deter r+q Richard V. Scali,Director Building Division M sUs1'ABIA ` Paul Roma, CBO,Building Commissioner MAW �A o 9. �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:' 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: _ MY name is mc- t I am the owner/resident of the Q property located at: 8 g SKI The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address-, �c,,-. Name &relationship to owner: Name,&relationship-to owner: Y � cam. The Family Apartment will be the primary year-round residence for the above-identified family members. In the'event that the listed relatives vacate said apartment;Twill immediately note the Building Commissioner in writing. I understand that no sublettingbri subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants 'n said Family Apartment v I also, understand that I am required to comply with all conditions imposed by the ZBA Speciai Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments I agree to note the Building Commissioner immediately in the event of the sale of this property. zo If there is no longer a Family Apartment at this location;please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ' ) Other Swo and 4rthel' penalties perjury this' 15 day 2016. Signature Phone Number Print Name ✓�' �! Lw , q:forms/famaffid.doc rev 11/08/12 • r Regulatory Services cam, Richard V.Scali,Director z EAMIMMAXUE� • Building Division 6 �• Thomas Perry;CBO,Building Commissioner 260 Main Street, Hyannis,MA 02601 www.town.barnstable,ma.us Office; 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, de ose and state as follows; My name is wrl (U'60�V - I am the wne resident of the property located at: MIA OdBal The following members of my family will be the sole occupants of the Family-Apartment_at the; aforementioned address: Name&relationshipto owner: �� '� 1447--'6 � -",. 00 Name &relationship to owner: The,Family Apartment will be the primary year-round residence fort above-id gnti of family members. In the event that the listed relatives vacate said apartment,I ill immediately notify the Building Commissioner in writing.I understand that no subletting or subleasing of skid Family Apartment is permitted I understand that am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that am required to comply with all conditions imposed by the ZBA Special Permit 'and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no Ionger a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other P Sworn to de p and pen 'es of perjury this day of—d& 2015. Signature Phone Number Print Name q:forms/famaffid.doc F rev 11/08/11 "a - S IMPORTANT UPGRADE REQUIRED SMOKEYECTVIV ._ STATE :BUILDING CODE REQUIRES THE UPGRADING OF 5 =��SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED.; ® r ual PT NOTE; A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS-THE ELEETRICAL. --- PERMIT DQEJT SATISFY THIS REQUIREMENT,, BQPN'loAIATU1110 AN ROUND€+gip d€IiYftil�� O Cc ZY ztl �. o � �cv o r i W � 0 � c c C tAo r _ , n 4.zl -cc ca � y nil 4k Li r O I:L � Ih n Ln NP7 ` C i � N Ln I r u 4 ,f l PP_ V rl�l_- �! _. 199. .. i I _l p Cro a Fm 71, i In / ri v