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0591 STRAWBERRY HILL ROAD
-9i a o e e o - ° a o o � 4 H-oL,v 5, Vr� �. ti 4 b c4-sE BACK �{ea Smd K45 � � 12/09/2020 19:11 FAX 7742282109 simplycape 0 001 i I i r Town of Barnstable Building Department Brian Florence,CBO Q, Building CotiaIDlutoner r , t 200 Main Streak Hyannis,MA 02601 M.SMAK www.towo.barnstable.ma.us a0�q j Fax: 508-790.6230 office: 509-862-4038 Approved; — Fee: ` Permit#• HOME OCCUPATION RLGI TRAT-M i Date• � � � ones R 3b Name: Address: Name of Business: IS Type of Business• • INTENT: It Is the infest of this section to allow the resldcnts of the Tows of Barnstable to operate vhobi�odon within single wily dwellings,subject to die Provisions of section 4.1.4 of the Zoning ordinance,ltr noise or*don no visual activity$bell cat be discernible from outside the dwelling: "�1 DO i° Onential useo increase In tra>8c above uosmal a terldon to the premises wMcb would suggest emrythiag residential volumes;end no iocrea$in air or groundwatery h�W ration shall be permitted ea of right�ubjeot to the After regigtrada with the Building peter• following conditions: • The activity is carried on by the pormanom resldeot of a single family residential dwelling u>it,located within that dwelling uaK • Such use occupies no more then 400 square feet of space, in residential bulldlraes,and thorn Thera are no external alterations to the dwelling whleb are not customary is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibmdoa,smoke,dust or other particular matter,odors,electrical disturbance,host,glare,humidity or other objectionable acts. ibis,is exows • There is no storage of use of toxic or hazardous matoriala,or flemmablo or exp ei of normal household quantities. the Gary Home • Any need for oarless generated by such use shall be met on the soma lot Containing omgn don,and not within the requirod front yard. There is no exterior storage or display of materials or equipment aQioa,other than otu van or one 'lbeare are no commercial vehicles related to the Glhstomary Hama Occup sad not to pick-up truck not to axeeod one ton capacity,and one trailer not to exceed 20 feet is length. exceed 4 tires,parked on the some lot containing'he Customary Home Oocupatian. No sign shall be displayed indicating the arstomary Horse OecupstiolL • •' Ifthe Customra7' Rome Occgsdon is flamed or advertised u a business,the street address sW not be inch►ded. Home occupation who is not a pertnan®t resident of rho No person shall be employed in the Customary dwelling wait. h e o on I am regista'�mg. 4 the tmdarst@►ed,have reed d e8oe with the above rcicdo hay home �+rP°d / c• Date: Applicant: Tie, w.doo Rev.lat7 b r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 9 Parcel t©I 6 Application:;Q2Q Health Division Date I [�1 Conservation Division A licon Fe pp Planning Dept. Permit Fee s Date Definitive Plan Approved by Planning Board gp wk , ,Historic OKH _ Preservation/ Hyannis 0 tte k a Project Street Address 591 Village e - Owner ' Address Telephone Permit Requestine4a (22 S lnslailto Square feet:'1 st floor: existing 1WYroposed 2nd floor: existing proposed Total new Zoning District A Flood Plain Groundwater Overlay r Project Valuation onstruction Type Ldt ize �(7rn�� �� Grandfathered:. ❑Yes ;KNo If yes, attach supporting documentation. i Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure 644:Historic House: ❑Yes ANo On Old King'sH1ighway 0 Yes ❑'No Basement Type:"XFull ❑ Crawl ❑Walkout ❑Other t ,' Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft)[ , Number of,Baths: Full: existing new Half: existing t neu Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count ' Heat{Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other - Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal"stove: ❑Yes io ,o 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 X No If yes, site plan review # i 11 Current Use f1 Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) --.. Name° ' : 1 Telephone Number 4 , Address As License Home Improvement Contractor# ��3 Email Pakk' A11' fQItf1Q.00O'� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C. SIGNATURE � DATE'... t _, r .. FOR OFFICIAL USE ONLY APPLICATION # `? DATE ISSUED - �- MAP/ PARCEL NO. p ADDRESS VILLAGE OWNER , DATE OF INSPECTION: FOUNDATION SOON)' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL u GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT T , ' ASSOCIATION PLAN NO. F, ' - y y " • 1 he Commorrrrealtih o,f-Vassachusetts Depiarttnent o,f Industrial Accidera s - - Office of Investigations Investigations . 600 Washington Street Boston,41A 02111 wton mass govIdira Workers' Campensation Insurance Affidavit:Suijders/C,ontractors)Electri,cians(Phmbers App$cant Inform,atron Please Print Le�bIy Name(Business organ zationJIn Rddaal} Address: _. , D Citylstatelzip:BAUaADAs Phone % 794t A0Z3P Are you an employer?Check the appropriate ox: ' Type of project(required}: 1.❑ lam a employer with s 4. ❑I axe a general contractor and I 6. ❑Nprl consfr(required): employees(full and/or part-time)-* have hired.the sub-contractors 2.X I am a sole proprietor orpartner- listed on the attached sheet. 7. ❑Remodeling These sub-contractors have ship and have no employees $:•❑Demolition . woAin. far me in an c i . employees and hate workers' b t3` 3. El Building addition [ldo a-orloers' camp.insurance comp- insurance-1 required-] 5. ❑ We are a corporation and its M❑Electrical repairs or additions; 3.❑ ]am.a homeoumer doing all work officers have exercised their ILL]Plumbing repairs or additions sdf o workers' right of exemption per MGL m3' � - 12-❑Roafrepairs . insurance required.]F c.152, §1(41 andwe have no- employees.[No workers' 13.❑Other cammp.insurance required.]: 'Any S"Ncaut that checksbos if1 toast also filloutihe section belmshuwing dLeirwadere compensa8an policy iaformstian- t Homeowners who submit this.affidasdt indicating they are doing all weak and then hire outside contactors amst submit a new affidavit indicatag sacb_ fContcacturs that eheck This boat must attached mt additional street showing the name of the sub-cwtscto-rs'and state whether or not those entities have eupitryees. Ifthemb-contra,ctots have employee;dwymotst•pxovidetheir workers'camp.palicjn=ber. i I aril arz errtpLoyer that;isproiLidirrg yworkers'cot gwisatrori irLnirance for arty*eirrpiny,ees Betoav is tlre�paticy arrd job sits irtfornzatiorL Insurance Company Name: Policy,A,or Self-ins.Lic.4 Expiration Hate: Job Site Addt-e m- City/S#atiel .tp: 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$1,50G 00 anctliar one-yearimprisormettta as w611 as ci%il 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 Invest gatirmc of the DIA for insurance coverageveriffcation. I rl'o hereby c taer%t# and awe peduty that the information pro i&d ohm d correct Sietiature_ Date: Phone Official use ortly. Do prat wrke in this area,to be completed by city or town officzai City or Town: PerrmtUcense 4f Issuing Authority(circle one): q' 1.Board of Health Budaling Department 3.Cityi Town.Clerk d.Electrical Inspector S.Plumbing Inspector- 6.Oither F Contact Person: Phone#: Information and lnstructious ` Massachusetts General Laws chapter 152 regairm all employers to provide workers'compensation for their employees. p tD this statute-,an employee is deed as."_.every person in the service,of another under a¢y contract ofhi , express or implied,oral or written." An employer is defined as"an individual,par[nership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint entezprdse,and including the legal representatives of a deceased employer,or the receiver or trustee of an mdividaal,partnership,association or otherlegal entity,employing employees_ However the owner of a dwelling horse having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do mat ntc ce,cousfracti on or repair work on such dweIIing house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25g6)also stains 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 airy applicant who has not produced acceptable evidence of cumplianr_e with the uismance.coverage requ>z ed_" Additionally,MCrL chapter 152,§25C(7)states"Neither the commonwealth nor`a'ny of its political subdivisions shall Cuter into any contract for the performance ofpnblic wokiioE acceptable evidence of compliance.with the Tn�ce.. requirements of this chapinr have been presented to the contracting authority_" ' Applicants Please fill out the woikers'compensation affidavit completely,by cher.Trin�c the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), addresses)and phone umber( along with their certdicate(s) of a crrrance. Limited Liability Companies CLLC) 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, apolicy is regnired. Be advised that this afbtdayAmaybe submitted to the Department of Industrial Accidents for confnmation of insurance coverage Also be sure to sign and date the of davit. The affidavit should be returned to the city or town that the application for the peunit or license is being requested,not the DePutneat of n , 'a Accidents. Should you have any questions regarding the law or if you are reqcded to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insm-ed companies should enter their self-insurance license number on the appropriate line. City or Town Officials f Please be sore 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 permitlliceose mnnber which will be used as a reference number. In addition,an applicant that must submit multiple pennitllicense applications in any given year,need only submit one affidavit mdiratuag cuumt policy it l roation Cif necessary)and under"Job Site Address"the applicant shoTIId write"all locations in (cty or town)-"A copy of the-affidavit that has been officially stamped or marked by the city or tovtn may be provided to the ' applicant as proof thatavalid affidavit is on fle,for future permits or licenses A new affidavit must be filled out each year.Where a homeowner or citizen is obtammg a license or permit not related to any business or commercial venue (i.e. a dog license or pemut to born leaves etc.)said person is NOT rvFdred to complete this affidavit: The Office of Investigations would hke 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; Ike Canxaiwgira lh-of 142ssachti s . Department cif lidusttial ACCZe'nta .v Office of jvestigatio.= , *L s Bastcku,MA G1 I I I Tf,-L 4 617-727-49QO�xt 4€6 or I-977-MA5 E Fax#617-727 7749 Revised 424--07 w mass-gavIdia A DIME Town of Barnstable Regulatory Services MAM Richard V.Scali,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 5087790-6230 I Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: . . .(Address o Job). - r **Pool fences and alarms are the responsibility of the apphcant.-Pools p ' are not to be filled or utilized before fence is installed and all final E inspections ar performed and accepted. igna a o S a e of Ap cant s /--,Print Name Print Name Da i 4; Q:FORM&OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services o� Richard V.Scali,Director Building Division '• s�xxsz�stc. ' Tom Perry,Building Commissioner nsnss. 039. lk 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as su ep rvisor. DEFINITION OF HOMEOWNER ,� Person(s)who owns a parcel of land on which he/she resides or intends to reside,on whicli there is,,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"h m e 'gne o eown r'.assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. ; The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control., HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." . Many homeowners who use this exemption are unaware that they are assuming the responsibilities of,a supervisor (see Appendix Q,Rules&Regulations for,Licensing Construction Supervisors, Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that.he/she understands the responsibilities of a Supervisor: On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFl1ES\FORMS\building permit forms\EXPRESS.doe Revised 040215 , �a, C��ie �por�vr�zaazuseaCGl _. __.. , Office of Consumer Affairs&Business Reg ulation' License or registration valid for mdiv�dul use only = OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration 183597 Type: Office of Consumer Affairs and Business Regulation Expiration 10/2812017 Individual 10 Park Plaza-Suite 5170 T -�; KEITH DU — ..wry. ,MA 02116 " QUETTE, ? �.,• Boston .. Y 1_I KEITH DUQUETTE,_u ,. 8 ROLLINGS WAY BUZZARDS BAY,'MA0252 _ �..., Undersecretary of valid out signature , Massachusetts Dep ar3ment of Public Safety �'-� "• ,� Board of Building Regulations and Standards Construction Supervisor License` CS-008169 ; KEITH DUQUETT- GIs r > 8 ROLLINS WAY _ Buzzards.Bay M 02 i Ex ' n Commissioner Expiration . . . : 05/09/2016 , .. , i • v _ 5 ' � l �Y Town of Barnstable Regulatory Services • ■naivsTnsr.E, Mnss. Richard Scali,Director, 039. Building Division . Tom Perry, CBO,Building Commissioner. \ 200 Main Street, Hyannis,MA 02601 �J www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Building Permit Procedure for Residential Addition Or Remodel Or Dock ❑ Determine map and parcel number and enter it on application. - ❑ Historic District Commission,200 Main Street, approval required prior to construction/demolition for any properties located in a Historic District: • Old Kings Highway Historic District(north of the Mid Cape Highway) • Hyannis Main Street Waterfront Historic District(See map for boundaries) • Historic Preservation(if applicable). ❑ If ZBA relief(Special Permit or Variance is required for Project): ❑Copy of ZBA decision ❑Documentation proving that.decision was recorded at the Registry of Deeds w/in one year of ZBA decision date ❑ Approvals from the following departments are required and can be obtained at 200 Main St.: ❑Health Department (8:00-9:30 AM&3:30—4:30 PM {as of March 2°a,20051 , ❑Conservation Department (8:00—9:30 AM&3:30—4:30 PM) ❑Tax Collector {can be obtained from Building Department} ❑Treasurer {can be obtained from Building Department} ❑ Permit must contain complete owner information,full description of project, correct square footage of project,valuation of project(must agree with Total Cost from Project Worksheet), building detail for Assessor's Office, complete builders information, including signature and date of application. ❑ 5 sets of reduced house plans measuring 11"x 1711,scaled 1/4"=1' &fully dimensionalized are required. Plans must include a foundation, cross section, framing schedule, insulation detail & floor plan showing location of smoke detectors(located with a Red `S'.) ****** IF USING ENGINEERED LUMBER AND/OR STRUCTURAL STEEL,ENGINEERING DATA MUST BE PROVIDED****** ti ❑ Plot plan or mortgage survey required for any addition. ❑ Home Improvement Contractor's Affidavit ❑ Workers Compensation Insurance Affidavit form must be submitted for any workers hired. In the event the homeowner takes out the permit, subcontractors hired must supply this. Copy of Insurance Compliance Certificate must be on file. ❑ Energy Compliance Form a ❑ Construction Supervisors License&Home Improvement Contractor's License OR f ❑ Homeowner License Exemption Form must be submitted if homeowner is acting as general contractor or builder for the project. ' ❑ Property owner must sign Property Owner Letter of Permission. ❑. A NON-REFUNDABLE Application Fee must be paid upon receipt o f application number. . ` All checks should be made out to the Town of Barnstable ❑ CEMVINEYS: Need'Home Improvement License,no plot plan required. ❑ PIERS AND DOCKS:Need Construction Super License AND Home Improvement License. OWNER CANNOT PULL OWN PERMIT. ❑ Projects requiring the use of a crane must complete the forms issued by the Aeronautics Commission 4 !2/1612015 Assessing As-$ullt Cards Pi ZX TJJV loot �¢ SMOKE DETECTORS REVIEWED Lie , b1C� S L BUILDING DEPT. DATE FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING f dfvcA at�A w o e - ' �a� ao @AS t1��►�,-eh s�--s O2 4y-, I 12/16/2015 tlfficiel Website of The Towa of Barastabie-Property Lookup Photos 249 101-61 Use.Code: 101-0 i a 51cetchez -• Map/Block/Lot.'249 10161 -•UFM CO-IC: 101.0 14PT4 2< 17 F " 4 - 4 8 PAS 2 . 0 BM7 12 WR 14 �a P T 12 . As Built Car+ds:Cllck card#toview:.0 r:dA a�Faard-12-I t=c r°'i s,;e Qir is Details tall/`dock'/L+t:249 / 016/ -- Uw C:c de4 1010 t'sbitYSAird .« l?l;iwiil.�s .. - Lit7r3 - •. Building value $72,700 Bedrooms 3 Bedrooms USE CODE 1010 Replacement Cost $132,195 Bathrooms 2 Full Lot Size(Acres) 0.23 Model Residentlai Total Rooms 6 Appraised Value $65,600 Style Ranch Heat Fuel Oil Assessed Value $65,600 Grade. Average Heat Type Hot Water Year Built 1961 AC Type. None Effective depreciation 13, Interior Floors Hardwood } Stories 15tory Interior Walls Drywall Living Area sq/ft 1,576 Exterlor Walls Wood Shingle Cross Area sglft 3,170 Roof Structure . Gable/Hip Roof Cover -As ph/FGIs/Cmp Ott B xrl€%or;, S L;rsr;a f=� tsth�E Rla;s/i3Yratls/La1x:,249 /0161 Use ,pile: 103.0 Code Description Units/SQ A Appraised Value Assessed Value FEP Enclosed porch- 48 $2,500 $.2,500 roof,ceiling ' FOPC Open Prch-roof, - 16 $Soo $500 telling BMT Basement-Unfinished 1096 $13,700 '- $13,700 L IDC Wood Deck wlo 200 $2,800 $2,800 callings _ BRR Bsmt Rec Rm- 800 $3,300 $3,300 Average PAT2 Patio-Good; 234 $1,600 $1,600 v Z 12/1612015 Assessing As-Built Carda 1 TOWN OF BARNSTABLZ LQCATIO]i M1 4Prul iSirEt f JG Od- SEWAGE 11 VILLAGE ngMwr iA i Ile. ASSESSOR'S MAP&PARCEL QqQ 14 INSTALLERS NAME&PHONE N0;���B>Rc�t1ATy'na1 �?lg_y7Z�GS� y' SEPTIC TANK CAPACITY �lsQQ gal LEACHING FACILITY.(type)Xn ';4r? d= CZ0 (size) No,OF BEDROOMS OWNER- Z'mnrAeff; PERMbT DATE,'^ COMI'WANCE DATE: y Sepaianon Distpme.Between the: . Maximam Adjusted droundwdW Tabie to the Bottom of Leaching Faaility Feet Private Water Supply Woll and Leaching Facility(If any wells exist on site or within 200 feet of leaehin faeili Fe Edge of Wetland and Leaching Facility(if arty wctlands exist within 300 feet of leaehing'facility) Feet FURNISHED BY Ai- tG; a .�.G' 182-' C3� 9 y 134 cs-rf. P-.4 s A j C'.at9 tb . O t f 12l1612015 Assessing As-Built Cards ASSESSOR'S MAP NO. pARCEI O fG,_____( �E - LDCATION SEWAGE EoeM9{1 ND• V LLACE iNS Atttl'S NA�E A IDDRESS BUILDER OR OWNER W NyE�RR DATE PERMIT ISSUED DATE COMPLIANCE ISSUED�ZQ 02 L-jojoafojdLB£aZ LLOLP00L86S 6/XWui#/O/n/I!ew/woo•9j6006•I!e w//:sduy z ?C 41 w;, 7 r 1f Ow OV x - _ Cil ro g x � � ` ..� � � � .- ♦ �. .ter...r• +}.. j � ^ ♦`P" r t 5# ate' - . °• _ q1f o- {•`R z �_ 4 ! t • t 00, ma 4�F ' a " r" 6df Wd M8 9IOZ'8 39a lo4ueoS SIOZ/62I V41'OF BARN STABLE t.M 9 � `ISi0 x l . i 4 L 12/9/2015 Scanbot Dec 8,2015 8.52 PM.jpg �• �•.^aM��ilrtAMMRn�^�:W"r a.+.rM1+�Nir,:yr...r, aN r F.I t v) r a.,ww t "� F at li+y tr " r r i yy sr 6•• / �t t it �h r ap i}a 1 •^ '1i 1 4 a9 w!i y d. » 5f W, py l � 41rj� vi •l�juC � YM4I a ip 1^ t b i ♦ r t; f Ir https://mail.google.com/mail/u/0/tNnbox/151870089fd3l9af?projector=l 1l1 o i r t RNS ry A f r .� J O Ck- �--.� 1W a cc Lo co �� (ter_:•:+. � �',„. _ '� va G' i211612015 17c" An,easingAs-BiiitCards 0'� ¢ SC TIC% bo SMOKE DETECTORS REVIEWED - R L BUILDING DEPT. DATE _FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING Lp tyA o't`l ^' 4 4y '�L�' l�5 t f2116015 T AssuaingAs-BuittCanis L vs +ire bIC21 SMOKE DETECTORS REVIE ED sh t L 2 17L O R UILDING DEPT. DATE FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING f. . ,f • i . , pie.✓�pf r(� � "l l� � �^�` ' l �"�c�of �oy1 io1� �t (M�AS��-z.-�h s-�—s G�2 �'h� '`�%►vL�' h 5 t or oFTME Two, Town of Barnstable *Permit# Expires 6 months om issue date Regulatory Services Fee s �� snnivsTtsre, t6;q 163 Richard V.Scali,Director . �� ------ -------- ' — 1P1S1OI1 _-_ Tom Perry,CBO,Building Commissioner X-PRESS" PERMIT 200 Main Street,Hyannis;MA 02601 www.town.barastable.ma.us Office: 508-862-4038 �C Fax:o508 790-6230 EXPRESS PERMIT APPLICATION - RE SIDENT!AME 0`&BO N S TABLE �^ o Not Valid without Red X-Press Imprint Map/parcel Number `7 pp (,, ®n Property Address _59 S JCS �-� V l t hLV c,, v'� 1 V Q Residential Value of Work$ C500- Minimum fee of$35.00 for work under$6000.00' Owner's Name&Address (/I Contractor's Name Telephone Number Spa Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side U- �W_� Replacement Windows/doors/sliders.U-Value 0_ I• S (maximum.32)#of windows #of doors: ❑ Smoke/Carbon.Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property 0 must sign Property Owner Letter of Permission. A op o ome Improvement Contractors License&Construction Supervisors License is r qui SIGNATURE: Q:\WPFILES\FORMS\building p rmit o \E RESS.doc Revised 040215 Ile Comm-on7veakh of-Vassachusetfs DeRarbuetit a,f lndrtctrial Accide7ds - ;, 0 of i�m�estigations 600 Washingion Street _ r _ trarvr�a;fltas�guv�dirt ~ Workers' Compensatian Insurance Affidavit: Bu ilders/Contractars/EIect cians/Plumbers Applicant Infcsrmafion Please Print 'b Name(Busiaeoforg IIinfiionmiaywrmi): Address: 0 S �"ram` u/ , U city/ 33 Are you an employer?Check the appropriate box: Type of project(required): I.❑ I am a employer with. 4. ❑I am a general contractor and I ' 6. ❑New construction employees(full andfor part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor arpartnt;r- { listed on the attached sheet. I- ❑R.eModeling ship and have,no employees. . These sob-contractors have g. ❑Demolition wow far me in any capacity. employees and have workers' [No world-W comp.insurance comp.insuranmi 9. ❑Building addition required-] I ; 5. ❑ We are a corporation and its 10_❑Electrical repairs cr additions officers have exercised their 3:�-I am a fiomeoumer doing all work - ' 11_❑Plumbing repairs or'additions, eel€ o workers' right of exemption per MGL m3' � c0iffiF- � - 12.❑Roofrepairs immraneerequire&]Y c.152, §1(41andwehaveno employees.[No workers' 13.0 Other ` camp.insurance required.) *Any applicant fat cheft box#1 must also fill out the section below shnwmg their wozkere ca®pevsati mpolicy inf rmaiian- Homeowners who submit this of uLn!imdhk=9 they are doing all wcd and then hire anmde contractors aamct submit a new affidavit indicating sash. Zcautractars that check this boat must attached an additional sheet shouting the name of the sub-cwtr attar and stare whether or not those entities hie employees.Ifthe nub-contnictorsI=e employee%theyrarstpmuide their workers'comp.policy number. I ant an employer thatisprorzdirrg workers'coagwmalllora inuirauce for my eiripluyves Below is thepoTicy and jab site itlfor'iitatiom Insurance Company Name: Policy 4 or Self--ins.Lic.;�: Expiration Date: Job Site Addre= City/State/2sp: 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 imiposifiion of criminal penalties of a fine up to$1,500.OQ andfor one-yearinTrisoutuenk as well as civil penalties.in the form of a STOP WORK ORDER and a Rme of up to$250-00 a day agains=C'e ' tor. Be adirised that:a copy of this statement may be forwarded to the Office of Invest gations ofthe IA fo coverage verification. I do hereby certz er e 'e andperrabYes ofvelury tlrattlie in fbrmatiorrpm i&da 'e is mid correct Signature: I" I3ate: Phone#: �0 — (I 0 t Official use only. Do not rtrr&r in this axea,to be carnpWod by city or totrn officiaL City or Town: PerrnitfLicense# Emning Authority(circle one): 1.Board of Health 3.Building Department 3.City—frown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Confact Person: Phone#: — ..-- --- ---- ---- 6 Information and Instructions I&Lccachasetts GdamEl Laws chapter 152 rimpirm aII employers Im provide workers'compensation for their employees. p �this s-t�rzte,an.emlaloyee is defined as."-.every person in ijie sedvice of another under airy co�xact of hire, '° express or implied,oral or wriffem" Ail anpToyer is defined as"an individual,paalnership,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 mdividnal,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apa[imenfs and who resides therein,or the occapant 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 budding appurtenant thereto shall not becanse of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also sines 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 chapter 152, §25C(7)slate's"Neither the commonwealth nor any ofits political subdivisions shall enter into any contract for the performance ofpnblic work until acceptable evidence of compliance with the insurance.. ce. r ents of this chapter have been p=ented to the contracting authomty_" Applicants Please fill out the workers'compensation affidavit completely,by cheak the boxes that apply to your sitnation and,if necessary,supply sub-contactor(s)name(s), address(es)and phone number(s)along with their certificates)of incr=ce. Limited Liabrlky Companies(LLQ or Limited Liability Part am bips(LLP)withno employees other than the members or partners,are not mqumed to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is regII.ired. B e advised that this aff davit may be subm•tk-d to the Deparment of Indus Accidents for confirmation of msm-aace coverage. Also be sure to sign and date the affidavit The affidavit should be retuned to ffie city or town that the application for the permit or license is being requested,not the Department of Ind a5trial Accidents. Shouldyou have any questions regarding the law or ifyou are required to obtain a workers' compensation policy,please call the Department at the n=ber listed below Self-insured companies should enter their s elf-m=ran ce license nummber an the appropriate Im e. City or Town Officials f . Please be sine that the affidavit is campletu and prh ted legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Iavesti cations has to contact you regarding the applicant P leas e b e sure to fill i a the pemmitllicense number which will be used as a refern-uce number. In addition,an applicant that must submit multiple permitllicense applications in any given year,need only submit one affidavit indicating current p olicy bafbmation.Cif necessary)and under"Job Site Address"the applicant should write"all locations is (may or town)_"A copy of the affidavit that has been officially stamped or marked by Ahe 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 fi11ed out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le. a dog license or permit to burn leaves eta.)said person is NOT req=ed to complete this affidavit The Office of Investigations would at to thank you in advance for your cooperafim and should you have any questions, please do not hesitate to give us a call. `Ihe Department's address,telephone and fax number: r Camman• eajtij of Massachn zt ' Dtegaitmant cif 1uctu&-cLiak Accidents (�ff'itce of�•ve�tig�tio� Soo,Washin.zQn Stmd T(,-L 4,' 617 727-4}00 cx- 06 car 1-977-MA.S AFF, Fax 9 617-727-7M Revised 4-24-07 .mass-gavlrid• t RAMMA R4 9� MAS& }Town of Barnstable :. ArED MA't� - Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner , 3 200 Main Street, Hyannis,MA 02601 ` www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 y_ Property Owner Must ' Complete and Sign This Section. If Using A Builder I, ;as Owner of the subject property w` hereby authorize to act on my behalf,, . t, in all matters relative to work authorized by this building permit application for: 1 (Address of Job) a , Signature of Owner Date t Print Name e:. If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on-the reverse side. Q:\WPHLESTORMS\building permit forms\EXPRESS.doc Revised 040215 1 Town of Barnstable Regulatory Services Richard V.Scali,Director iI Building Division * ELCMsTABM t Tom Perry,Building Commissioner MASS. 1639. 200 Main Street, Hyannis,MA 02601 ArED www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 1 `�O Please Print DATE: ✓ r (�(y�� r JOB LOCATION: number �) J street 2? village "HOMEOWNER":��/� � Y '�� 5—"—J ) Z — "CN name �Jq home phone# work phone# . CURRENT MAILING ADDRESS: (/ / N&a Im"WI- - c° ity/town` state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigne leowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures_._d a ements and that he/she will comply with said procedures and requirements. Signature of Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. . To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 i NIASSACHUSLTTS ASSOCIATION of HCALTOBS' STANDARD PURCHASE AND SALE AGREEMENT[#503] (VVth Contingences) make this Agreement this 24th day of September , 2015 This Agreement supersedes es all obligations made in any prior Contract To Purchase or agreement for sale entered into by the parties. .4rties. OLPH V GIANNETTI LUCY GIANNETTI NANCY A GIANNETTI [insert name], the"SELLER," agrees to sell and Moura Property Acquisition LLC [insert name], the "BUYER," agrees to buy,the premises described in paragraph 2 on the terms set forth below.BUYER may require the conveyance to be made to another person or entity ("Nominee") upon notification in writing to SELLER at least five business days prior to the date for performance set forth in paragraph 5.Designation,of a Nominee shall not discharge the BUYER from any obligation under this Agreement and BUYER hereby agrees to guarantee performance by the Nominee. 2. Description Of Premises.The premises(the"Premises")consist of: (a)the land with any and'all buildings'thereon known as `. 591 Strawber Hill Road Centerville MA 02632 as more specifically described in a deed recorded in the Barnstable Registry of Deeds at Book ,Page , [Certificate No, 1 ],a copy of which❑ is❑.is not[choose one]attached;and (b)all structures, and improvements on the land and the fixtures,including,but not limited to: any and all storm windows and doors, screens, screen doors, awnings, shutters, window shades and blinds, curtain rods, furnaces, heaters, heating equipment, oil and gas bumers and fixtures, hot water heaters, plumbing and bathroom fixtures, towel racks, built-in dishwashers, garbage disposals and trash compactors, stoves, ranges; chandeliers, electric and other lighting fixtures, burglar and fire alarm systems, mantelpieces, wall-to-wall carpets, stair carpets, exterior television antennas and satellite dishes, fences, gates, landscaping including trees, shrubs, flowers; and the following built-in components, if any: air. conditioners,vacuums systems,cabinets,shelves,bookcases and stereo speakers, and s ► but excluding (insert references to refrigerators,dishwashers,microwave ovens,washing machines,dryers or other items,where appropriate] 3. Purchase Price.The purchase price for the Premises is$147 000.00 dollars of which $ were paid as a deposit with Contract To Purchase;and $ 100.00 are paid with this Agreement; $ are to be paid ;and $ 146,900.00 are to be paid at the time for performance by banks,cashier's,treasurer's or certified check or by wire transfer. $ 147,000.00 Total 4. Escrow. All funds deposited or paid by the BUYER shall be held in a non-interest bearing escrow account, by Jason Paul White Esq. ,as escrow agent, sub' t to the terms of this Agreement and shall be paid or otherwise duly accounted for at the time for performance. If a BUYER'S Initials BUYER'S Initials BUYER'S Initials SELLER'S Initials SELLER'S Initials SELLER'S Initials MA.SSFORMS- ©1999,2000,2002,2006,2007,2008,2010,2012 MASSACHUSETTS ASSOCIATION OF REALTORS@ Form No.503 Keller William Realty,1600 Falmouth Road suite#2 Centerville,MA 02632 Strawberry Phone:(508)934-6745 Fax: (508)771-1984 Juan Marichal Produced with zipFormS by zipLogix 18070 Fifteen Mile Road,Fraser,Michigan 48026 www.zipLoaix.com ecnvc,.�u�, --_.__ boat >:ne R and SELLER and each of their resp b a written agreement executed by s intended to benefit the BUYS BUYERtheir obligations are joint and several. If the cessors and assigns; and may be canceled, their or amended only y c If two or more persons are namedwhose representative executes this SELLER and the BUYER• -limited liability company or entity or BUYER is a trust, coreoration, the rincipal or the trust or estate represented shall be bound, The SELLER Capacity'acity,only p obligation,express or imp Agreement in a representative or fiduciary p shall be personally liable for any Agreement and neither the trustee,officer,shareholder or beneficiary considered Part of this e used only as a matter of convenience anatttter or practice which has not been addressed Massachusetts, captions and any notes ar arties. Any m the intent of the p overned by the are not to be used c determining a of performance shall be g subject of a Title Standard or Practice of the�EstP a Bar Association or agreement and which is the s ] formerly known as the Massachusetts Conveyancers Association, at e Standard of Practice h the Massachusetts Real Estate Bar for Massachusetts. 23. Additional Provisions. r UPON SIGNING,THIS DOCUMENT wII.L BECOME AGALLY BINDING AGREEMENT- ON NOT UNDERSTOOD,SEEK ADVICE FROM AN ATTORNEY. Date Date SELLER RUDOLPH V GIANNETTI BUYER erty quiSition LLC Moura Prop ate SELL R,or spouse 9/- LUCY. G IANNETTI IBUYE f c P{� oll JUG. Date S LER,or spouse Date NANCY A GIANNETTI BUYER , to. erform gent. in accordance with paragraph 4, but does not Escrow A By signing ning below, the escrow agent agrees P to this Agreement. otherwise become a party Date ESCROW AGENT or representative r� 'S Initial . SELLER'S Initials SELLER ' SELLER R'S Initials _— 'S Initials BUYE —- BUyER'S Initials BUYER SETTS ASSOCIATION OF REALTORS®ormNo.5 S 2010 2012 MASSACHU Sawbe Q �FoS. ©1999,2000,2002,2006,2007,2008, ziol.oaix.com R Produced with zipForm®bY zipLo9ix f 807o Fifteen Mile Road,Fraser,Michigan 48026 --- Parcel Detail Page 1 of 5 e' birk5& tea' � 3 Logged In As: Parcel Detail Friday,October 30 2015 Parcel Lookup Parcel Info Parcel ID�249-016 Developer Lot'.PARCEL II °. I Location g591 STRAWBERRY MIA Pri Frontage 1100 --l Sec Road I Sec Frontage village C N ERVILLE I Fire District C-O-MM l Town sewer exists at this address?NO _I Road Index 1546 Asbuilt Septic Scan: y � `r' 249016_1 Interactive Map ; 249016_2 tt�! Owner Info Owner zGIANNETTI, RUDOLPH I O Co :%MOURA PROPERTY f� �� wner, Streets s182 PITCHERS WAYl Streetz city�HYA . A_ p v,,,„ l state MAC. v."- .wl zip 02601 .,ri....�.�a,.,,,=Country .,, . I Land Info .................................... ... ........... ......... _ ...... Acres 0.23 use Single Fam MDL-01 I Zoning RD-1 Ngnbd 0104 Topography Level I Road[Paved Utilities Public Water,Gas,Septicl Location Construction Info Building 1 of 1 Year 1961 ��° �� sc uu Gable/Hip wM Wood Shingle Living 15576 Roof As h/F GIs/Cm nc Areas Cover z. p p Type li Style Ranch weu Drywall Rooms3 Bedrooms Model Residential Floor Hardwood R om2 Full-0 Half Grade Average Type�H�ot Water �l Rooms stories 1 Story Heat Oil Found- Typloa� Fuel anon - Gross 3170 ,,,,ynxrn Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 3/22/2004 Remodel 75478 $21,504 10/19/2004 RE GAR FIN, PAINT 12:00:00 AM KIT CAB http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17901 10/30/2015 Parcel Detail Page 2 of 5 Date Who Purpose 5/5/2014 12:00:00 AM Mike White Bldg Permit Completed 4/9/2014 12:00:00 AM Nancy Finch In Office Review 10/19/2004 12:00:00 AM Martin Flynn Bldg Permit Completed 11/21/2001 12:00:00 AM Paul Talbot Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 6/28/2002 GIANNETTI, RUDOLPH V.&'LUCY A& NANCY 15315/319 $100 2 7/15/1996 GIANNETTI, RUDOLPH V& LUCY _ 10291/91 $112,000 3 6/15/1982 SLOAN, JOSEPH J JR&TERESA 3507/141 $49,900 4 10/1/2015 MOURA PROPERTY ACQUISITION LLC 29176/181 $145,000 5 3/9/2015 GIANNETTI, LUCY A& NANCY 28727/74 $0 Assessment History ....... ......... ...... ......... ......... Save Building Total Parcel # Year Value XF Value OB Value Land Value Value 1 2015 $72,700 $22,300 $4,400 $65,600 $165,000 2 2014 $126,500 $31,700 $3,500 $65,600 $227,300 3 2013 $126,500 $31,700 $3,600 $65,600 $227,400 4 2012 $126,500 $31,000 . $2,800 $65,600 $225,900 5 2011 $153,600 $6,700 $0 $65,600 $225,900 6 2010 $153,500 $6,700 $0 $70,600 $230,800. 7 2009 $149,400 $6,100 $0 $151',200 $306,700 8 2008 .$174,100 $6,100 $0 $161,800 $342,000 10 2007 $173,300 $6,100 $0 $161,800 $341,200 11 2006 $159,700 $6,100 f $0 $162,000 $327,800 12 2005 $115,700 $5,600 $0 $128,100 $249,400 13 2004 $94,100 t $5,600 $0 $108,900 $208,600 14 2003 $92,500 $5,600 $0 $41,900 $140,000 15 2002 $89,000 $2,400 $0 $41,900 '$133,300 16 2001 $89,000 $2,400 $0 $41,900 $133,300 17 2000 $77,000 $2,600 $0 $31,100 $110,700 18 1999 $77,000 $2,200 $0 $31,100 $110,300 19 1998 $77,000 $2,200 $0 $31,100 $110,300 20 1997 $65,000 $0 $0 $24,800 $89,800 21 1996 $65,000 - $0 $0 ' $24,800 $89,800 22 1995 $65,000 , $0 $0 $24,800 $89,800 23 1994 $65,200 $0 $0 $27,900 $93,100 . 24 1993 $65,200 $0 $0 $27,900 $93,100 ' 25 1992 ` $74,300 $0 $0 $31,100 $105,400 26 - 1991 $80,000 , $0 $0 $49,700 $129,700 27 1990 $80,000 $0 $0 $49,700 $129,700 28 1989 $80,000 $0 $0 $49,700 $129,700 29 19818 $52,500 $0 $0 $20,000 $72,500 _ http://issgl2/intranet/pr'opdata/ParcelDetail.aspx?ID=17901 10/30/2015 4 r , .Town of Barnstable *Permit# Expires 6 months rom issue date Regulatory Services I w BARNSTA13 MAC Richard V.Scali,Director 16396 RFD MA'S A p . . 'BuildingDivision Per �. o Tom Perry,CBO,Building Commissioner 0 C 200 Main Street,Hyannis,MA 02601 /J/0 rO�1 vv� www.town.barnstable.ma.us Office: 508-862-403 8 F 790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address sko w ps ( � 1 w c6 kyw vim- Residential Value of Work$ � Minimum fee of�35.00 for work under$6000.00 Owner's Name&Address tq6yul OA )1 Contractor's Name Telephone Number-7 -, '&T Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable). ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance . Insurance Company Name Workman's Comp.Policy# , Copy of Insurance Compliance Certificate must accompany each permit. ` Permit Request(check box) ,n I f Re-roof(hurricane nailed)(stripping old shingles) All constructiondebriswill be taken to � S C�'l ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors:, ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Own r ust sign Property Owner Letter of Permission.' A copy of the a Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit form doc y`' Revised 040215 r x -� ne Comniorriveakh of-Massachusetts Departma t o,f Industrial AccideWs: - f1,farce of Investxkations 600 Washutgton Street r_ Boston,AAA 02111 ftavmv mass�govldia Workers' Compensation Insurance Affidavit-Bmlders/Contractnr&/Elect cians/Plumbers Applicant Inform atian Please Print Le gib Name(Bas®emnrgmh ationlln ivfdae): Address: City/State/Zip:.(� ( ��,� Cs3 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 employees(full and/or part-time)-* - have hired the sub-contractors 6. New constrmtion 2.❑ I am a sole proprietor or partner- -listed on the attached sheet, 7_ ❑Remodeling strip and have no employees. These sub-c=ractors have 8. Demolition working forme in any caps city employees and have wor3s' , [No worlmrs' camp.insurance comp-tasi rariml g. Q Building addition required-], 5. El We are a corporation and its 10.[1 Electrical repairs or additions of have exercised their I am.a h,ameo�c�er doing all v�arlt 11_Q Plumbingrepairs or additions mysel€[No workers'camp- fight of exemption per MGL 12.❑Roof repairs incarranre required.]F 3 c.152, §I(4).and we have no employees.[No workers' lOther camp-inswance required.] vv 'Any applicsmthat chetlts box#1 mnst also fill out than sectioabelow shoring their wo&eW compensationpelicy informatEan i Ho+neawnam who submit&s affidavit i.+&mt;ng tky are doing all W4A and then I&e aU=&contactors mast SUB=a new affidavit indicating mch- fCaattactms that check.This boat must attached an sde ilinad dwot shearing the name of the sub-coma zum and state whether or not those enfnties have -Voyees.I€themb-contactotshive empluee,they=utpruvide their workers'romp.policy nim bm I ane an enep1%vr d iat isprnr ding tirorkers'cocrrpe isaden imu'raucefor my earplayees..Below is the policy and job sae informrrliorE, Insumce Company Name: Policy-,At-or Self-ins,Lic. _ F-kpiration Date: Job Site Address: City/StaWZ. p: Attach a copy of the workers'coinpensationpolicy declaration page(showing the policy number and expiration date): Failure to secure coverage as req*edL under Section 25A of MGL c 1572 can lead to the imposition of criminal penalties of a fine up to$1,50D.OQ anctfor one-year imprisonment,as well as civil penalties.in the form of a STOP WORK ORDER and a tine of up to$250-00 a day against the violator. Be adcased that a copy of this statement maybe forwarded to the Office of Investigations.of-the IA for i9stmAmce coverage verification- I,�a hereby cerfif�a tt.d t e and pena)Xies of perjury that8�e informa€ia7rprmzrieda is and correct JQ 2 201 Sitmature: Date: Officid use only. Do not asrite in thb area;to be campieted by city artomn airciat City or Town: Permiff tense if y Issuing Authority(circle one): 1.Board of$ealth 2.Building Department 3.City{Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#- Information and Instructions ; M&ssar_husefls Geneaal Laws chapter 152 regoires all employers to provide wormers'compensation for their employees. pnrsaantto this stye,an.cupLJ'ee is defined as."_.every person in the service of another render any c:Dnt ct of hire, express or implied,oral or written.." An employer is defined as"an individual,parincrsla�,association,corporation or other legal entity,or any two or more of the foregoing engaged is a Joint entaprbe,aad including the legal representafives of a deceased employer,or the receiver or trmatee 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 occapaat 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 budding q pT r n alit thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local ficens ng agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings k the commonwealth for any applicant who has not produ,_ed acceptable evidence of complianm with the insurance.coverage regniz ed_" Additionally,M&L chapter 152, §25C(7)states'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work miff acceptable evidence of compliance with the has rranc4. req invert ents of this chapter have Been presented to the contacting aufhodty_" Applicants Please fill out the worlders'compensation a>�davit coin letel Y,by checking the boxes that apply to your situation and,if mp p, necessary,supply sub-contractor�s)name(s), address(es)and phone numbers) along with their certrticate(s)of IDm„-a„ce. Limited LiabEity Companies(LLC)or Limited Liabi-ity Partnerships(LLP)with no employees other than the members or partners,are not regrmed to taffy wonders'compensation insurance. If an LLC or LLP does have employees, a policy is squired Be advised that this affidavit maybe sobmiti--d to the Department of Industrial Accidents for confirmation of insurance coverage. Also he sure to sign and date the affidavit. The affidavit should be retrained to the city or town that the application for the permit or license is being requested,not the Department of Indutstrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Depariraent at the rxmber listed below. Self-insured companies should enter their self-incrrrance license number on the appropriate line. City or Town Officials . f _ Please be sni,that the affidavit is complete and printed legrIly. The Department has provided a space at the bottom of the affidavit for you to fill out in event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the pewit/ C Mse number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current p olicy hif6rmation.(if necessary)and under"Job Site Address"the applicant should write"all locations ia {city or bwn)_'A copy of the affidavit that has been officially s niped 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 affidavitmust 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 g e( i_e. a do licens or permit to bum leaves etc.)said pers on is NOT regrd red to complete this affidavit: The,Office of Invesfigaiions would like to thank you in advance for your cooperation and should you have any quiesiions, please do not hesitate to give us a call The Department's address,telephone and fax number T h Cz�=MmWujiij of Massachus-_tts IIeparinent of Iadnstzal AccWenta Bice of fl va tigatiau% 60-G,washivml t Bostan.,MA GI I I I TF L 4 617 727-4900 i�-xt 406 or 1-9 I SAFF Fax#617-727-7749 Revised4-24-D7 .ma5_gaVjdia . r �.�k1w AA7, v t sARNSfABLE. � MASS. 'Town of Barnstable FD MA't Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO " Building Commissioner + 200 Main Street, Hyannis,MA 02601 !` www.town.barnstable.ma.us Office: 508-862-4038 * x, Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 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: (Address of Job) Signature of Owner Date Print Name ; If Property Owner is applying for permit,please complete the Homeowners License Exemption F_or`m on the reverse side. Q:\WPFILES\FORMS\building permit forms\D2RESS.doc Revised 040215 Town of Barnstable Regulatory Services �opTME a Richard V.Scali,Director k Building Division * BARNSTAB ' Tom Perry,Building Commissioner Mass. 200 Main Street, Hyannis,MA 02601 pTED � www.town.barnstable.ma.us Office: 508-862-4038 Fax 508-790-6230 HOMEOWNER LICENSE EXEMPTION d Please Print DATE: 10/ / -. JOB LOCATION: I 's u )moo �"/ . VIC number street �Q ? 7 village HOMEOWNER": 1 ,;(''m' 'T'/��> �v �J(_ ��IS �am���r�1�� home ph ne# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land-on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersi4A"h�oner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures ats and that he/she will comply with said procedures and requirements. Signature o o Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that:. "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forrns\EXPRESS.doe Revised 040215 i =t \IASSACHUS1179 ASSOCIATION," RL%LTORS' STANDARD PURCHASE AND SALE AGREEMENT[#503] (With Contingences) The parties make this Agreement this 24th day of September , 2015 This Agreement supersedes and replaces all obligations made in any prior Contract To Purchase or agreement for sale entered into by the parties. 1. Parties: RUDOLPH V GIANNETTI, LUCY GIANNETTI, NANCY A GIANNETTI [insert name], the"SELLER,"agrees to sell and Moura Property Acquisition LLC [insert name], the "BUYER," agrees to buy, the premises described in paragraph 2 on the terms set forth below. BUYER may require the conveyance to be made to another person or entity ("Nominee") upon notification in writing to SELLER at least five business days prior to the date for performance set forth in paragraph 5. Designation of a Nominee'shall not discharge the BUYER from any obligation under,this Agreement and BUYER hereby agrees to guarantee performance by the Nominee. 2. Description Of Premises.The premises(the"Premises")consist of: (a)the land with any and'all buildings thereon known as 591 Strawberry Hill Road, Centerville MA 02632• as more specifically described in a deed recorded in the Barnstable Registry of Deeds at Book ,Page , [Certificate No. ],a copy of which❑ is❑.is not[choose one]attached;and (b)all structures, and improvements on the land and the fixtures,including,but not limited to: any and all storm windows and doors, screens, screen doors, awnings, shutters, window shades and blinds, curtain rods, furnaces, heaters, heating equipment, oil and gas burners-and fixtures, hot water heaters, plumbing and bathroom fixtures, towel racks, built-in dishwashers, garbage disposals and trash compactors, stoves, ranges, chandeliers, electric and other lighting fixtures, burglar and fire alarm systems, mantelpieces, wall-to-wall carpets, stair carpets, exterior television antennas and satellite dishes, fences, gates, landscaping including trees, shrubs, flowers; and the following built-in components, if any: air. conditioners,vacuums systems,cabinets,shelves,bookcases and stereo speakers, and but excluding [insert references to refrigerators,dishwashers,microwave ovens,washing machines, dryers or other items, where appropriate] 3. Purchase Price.The purchase price for the Premises is$14 7,000.00 dollars of which $ were paid as a deposit with Contract To Purchase;and $ 100.00 are paid with this Agreement; $ are to be paid ;and $ 146,900.00 are to be paid at the time for performance by bank's,cashier's,treasurer's or certified check or by wire transfer. $ 147,000.00 Total 4. Escrow. All funds deposited or paid by the BUYER shall be held in a non-interest bearing escrow account, by_ _ Jason Paul White Esq. ,as escrow agent, sub' t to the terms of this'Agreement and shall be paid or otherwise duly accounted for at the time for performance. If a I i, C, R G' BUYER'S Initials BUYER'S Initials BUYER'S Initials SELLER'S Initials SELLER'S Initials SELLER'S Initials MASSFORMS" ©1999,2000,2002,2006,2007,2008,2010,2012 MASSACHUSETTS ASSOCIATION OF REALTORS@ Q slale.idc.5lane.,dY..�n•eFam._ .d,. .,,,..., Keller William Realty,1600 Falmouth Road suite#2 Centerville,MA 02632 Form No.503 Phone:(508)934-6745 Fax: (508)771-1984 Juan Marichal Strawberry Produced with zipForme by zipLogix 18070 Fifteen Mile Road,Fraser,Michigan 48026 www.zipLogix.com f and is intended to benefit the BUYER,and SELLER and each of their respective heirs,devisees,executors, administrators, successors and assigns; and may be canceled, modified or amended only by a written agreement executed by both the SELLER and the BUYER. If two or more persons are named as BUYER their obligations are joint and several. If the SELLER or BUYER is a trust, corporation, limited liability company or entity whose representative executes this Agreement in a representative or fiduciary capacity, only the principal or the trust or estate represented shall be bound,and neither the trustee,officer, shareholder or beneficiary shall be personally liable for any obligation, express or implied.The captions and any notes are used only as a matter of convenience and are not to be considered a part of this Agreement and are not to be used in determining the intent of the parties. Any matter or practice which has not been addressed in this agreement and which is the subject of a Title Standard or Practice of the Real Estate Bar Association for Massachusetts, formerly known as the Massachusetts Conveyancers Association, at the time of performance shall be governed by the Standard of Practice of the Massachusetts Real Estate Bar for Massachusetts. 23. Additional Provisions. UPON SIGNING,THIS DOCUMENT WILL BECOME A LEGALLY BINDING AGREEMENT. IF NOT UNDERSTOOD,SEEK ADVICE FROM AN ATTORNEY. BUYER Date SELLER Mou'ra Property quisition LLC RUDOLPH V GIANNETTI Date Q BUYE c ittlei ate SELLER,or spouse Date r LUCY GIANNETTI 9/-q 01.r' BUYER c PO*4 k Date S LER,or spouse Date. NANCY A GIANNETTI Escrow Agent, By signing below, the escrow agent agrees to perform in accordance with paragraph 4, but does not otherwise become a party to this Agreement. ` ESCROW AGENT or representative Date 7 BUYER'S Initials BUYER'S (� '�Initials BUYER'S Initials SELLER'S Initials SELLER' Initials SELLER'S Initials MASSFORMS" ©1999,2000,2002,2006,2007,2008,2010,2012 MASSACHUSETTS ASSOCIATION OF REALTORS® Produced with zipForrn®by zipLogix 18070 Fifteen Mile Road,Fraser,Michigan 48026 www.zioLoaix.com Form No.503 Strawberry �INEr Town of Barnstable Regulatory Services * BARNSTASLE, 9 Mass. $ Thomas F. Geiler, Director 1 3q. �A 6 �0 TE9- i Building Division Thomas Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.tna.us Office: 508-862-4638 Fax: 508-790-6230 April 28,2 p 1 008 Mr. Rudolph Giannetti 591 Strawberry Hill Centerville,MA 02632 Re: 718 Strawberry Hill Rd. EXIT ORDER Dear Mr. Giannetti, Under the provisions or 780 CMR,the State Building Code,sections 3400.5.1 and 5310.1,you are hereby ordered to immediately,discontinue the use of the cellar/basement area for sleeping purposes: Your cooperation in this matter is appreciated. incerely, Paul Roma Local Inspector TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Q Map ' q ! Parcel I�I {, , Permit# f 5 g� Health Division U r �T UKT 0 Date Issued .�-° " Q�- Conservation Division �j III 6`. r Application F e L a S ' Tax Collector ✓ /G D G 2004 MAR 19 PH 4: 03 Permit Fee L'9Gv � Cn�m Treasurer 'SEPTIC SYSTEM MUST BE x Planning Dept. - DIVISION INSTALLED !N COMPLIANCE WITP rlTI..E 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL LODE q(dQ TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address SLt,�Jd��rr' i f �OaccJ Village C e n-f er'y ; I I e , M/I 6 913 a Owner J?V301 V h 6 ;CA n n e f' t Address S-V Sirawherr y di if f1'oaZ Telephone .5-4 SZ— -7TQ 36 IV 7 Permit Request c-r►.� 'Zjy � G'� C�� 1..___"l.7`' 3 �{�� "`�'.�'., v �� C!���C/•CA �.�C�:.C7�'�(f�n va..c U Wce��''1 ���(.(.G�le�'► a Q L Square feet: 1st floor: existing I L ' proposed I,9 '2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation LZ 15-0 L4 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family A Two Family ❑ Multi-Family(#units) Age of Existing Structure 3.5_yec r5 Historic House: ❑Yes )I No 'On Old King's Highway: ❑Yes No Basement Type: )d Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 3dg ,5T , Basement Unfinished Area(sq.ft) 106 Sg Number of Baths: Full: existing oZ new Half: existing new Number of Bedrooms: existing 3 new - " Total Room Count(not including baths): existing S new first Floor Room Count Heat Type and Fuel: ❑Gas )dOil ❑Electric ❑Other Central Air: ❑Yes )d No Fireplaces: Existing 1 New "" Existing wood/coal stove: ❑Yes J No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing O new size Attached garage: existing' ❑new size 3�.Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 0 No If yes,site plan review# Current Use_- GO,(CA Proposed Use Parr i ) V ROOM BUILDER INFORMATION Name- D I i h G i Telephone,Number - 6ff- 7 �7e— 3;::� V T Address -S-9/ 5741-ea whn-rr y Will lqoad License# C ev4eru i lJ e, OX Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 3 /3— t FOR OFFICIAL USE ONLY ti PERMIT NO. r DATE ISSUED -- MAP/PARCEL NO. ADDRESS VILLAGE OWNER - DATE OF INSPECTION: LA/ FOUNDATION FRAME ,'- INSULATION 0 rJ,5' 164 FIREPLACE- ! ELECTRICAL: ROUGH FINAL PLUMBING: ROU(W9 FINAL GAS: ROU 9� FINAL FINAL BUILDING 1 ^r � m _ �r D 00 r DATE'CLOSED OUT -' . AAS► ASSOCIATION PLAN NOS f1f p - t �veabth of Massachusetts The Common Department of IndustriatAccidents' 66a Washington Street t _ ~� I Boston,Mass. 02111 YS workers',.Coin ensation, risurance Affidavit-General Bugggg:sinesses address: .... � •. state, 14 A zi •end 63 a hone# work site location full address :.S,rI i i'a eub�i h!i it Road Cen�erU 4 III MN 6a6=�� ❑ I am'a sole proprietor and have no one; ' $psiness':rype; []Retail❑•Restaurant/Bar/EafingEstablishmeat ycrolJdng in any capacity. []Of(ice[� Sales(including Real Estate,Antos etc.)* I am Oib an en to er with ' %/////% %//G%/11111 /%/art/%% /%®%�/////% / ////%//%///%////%%%%�� ; Z an employer provi_ "g vY.orkers'compensation for my employees working on this job. , " » Yl t.t:j:' '•r; .:.T:•h• .I.�P •ri:; •i•r.t' ,:7'.,, lc' „l:.:l;i:`l:r� �ti', s,...• :li :.','.{ T ^t COm 8II^I19IIlet `T. ;L.: ,rt:iT:., a i ,�:Jw•i :i,• :I i,t:iri• `'y'!. T^i t ,., •�� :��. l.i• .� •;% :4.. :v. 1 s ;" •s'•:t;.' t':e�t��5'Mti..:.t:::' rT'.�yc..�'.r...•5='t:.e .. .1I` .•s.,::. '.;�(3:,� �5' .T,.;.�.:irr� .s{ii' ..r.j+'; ..3:::. R...•::i..5, .1� e. :. .. jidaregs: '• ;t.'s.7 ' " 'is J ti•T' ;, 9• :�•"'r'{''S�•`.'.°5 '�I:{i''•'_i •l: . .�, -1, ..�i;..:.1:•.3,:•' •, ,X :'tY5" �.l i•' •': .:�.. :;.i:i�• ,•.,' :•\' Y i .. ••s':'i. 'i••• :J.''` ti:• � .i'.•r l tt•t.,a One..#.::, Yet ''• Ci ; •:.�,,:�• :!�:, : •; ::.• .b.. it :;' .'•:5� :.�; .; •,;J}•"i?' ' ' •i!'i` "• •',• „ Jrte� `'• '�%:4."T.4 i.I•• "7:•.ti'1%w:?k;•,.. t)1C. .i�-• , Tama sole proprietor and'have hired the independent contractors listed below who have the following workers' coin ensation polices: '• tti ;' '' '.: t:: ' �•e.t, ,;,{.'�ii';.th}•.•�' ,�: rt�.,�.' ,., ,r;i{:.. f�.:•.• -< tl. :i:� g�..,�i:;a,E�:•*' '.r•+.,Y•� rt .� a: _ COIU'4 fiI17e:, .t. � .r.' ' T •.E * •,Y'',:;:..•-{ �•� ~ I •.r s',x�%,�'' Tit J {.ri f( .,,«. •r,•::t.T• tey,, , S r rT'i�T•S.• ::'. s :; i:rT y, :�•I• ♦,Z`1' , ,:r " •,t'`.^ 1,>.:d'•' �r,p t.i �t ,,a 6:,,: ,'�i',y u;.tie ''i I• ' ''.1:'. i�:: 0'.:y.J' .t•• '•• li address: :e; -'� :� j{ �•, • •, :: : ; J .;. `.:;•. •S• �• S 'T" 0...•i•'• ^'�'T'i• rl:y.e 41•• �' •I'•lal' .•J:i' �L;.'.+..�r.•r •rr�� —•l,.p „` y; I.'„'+ , .Y•i. �,r:;• .•n :ram,i i `�`` t' 'i.; `�idIle•�#:. t• / '•l'7•.�.. t. •' i .,' :i.'ii r,T„thyt i.::• ..... ,•.r.., .• .!«t Jy���• ,t r•'•,:y ••t1�,^iu �r:�:��;' t••,t, i, ., .'�: ,,:' •�,}•n r•'T'• eel:' 7�:t:t:•'T ,y, •l.,l«' �cr.,,°'j:a YT'• •'• •''�''�; ':.. 't;iY• .••.,••q•, 4:,,, s� 't:,f,:.i�:•• ,A t1•�•• '.,�;' •• ;�:'•' '• . �' ••r,.� ,µ aT.t.it'. ,�,'Y,"T t•' .Y •:J�. rt;t�:}'4a.:j}C;}.••r.;4 . .. �+ :alT••'a•;fLi• :•..l.•'.,`!•'zM1 H• 6"`.'i .3::•:.. "i• r0�1C -'#' i�������/.dl� insurance co.00 ' ,•:, ''••'{' '•f:.f:: ti' `7"' 1•':'+ir,• :t•� '•y<' • '''�,•:t.•' t+ .t.i'.::. Aag4 ry�:1,3+(.� „ coin!guy ic .Cl• R! .. '+ •.i. •s.•T: •l• •n.'•�,.• .{.•. .!.t': rs'•ar'. .•R:,��'i E'• .' ::�•' :1':!�; .it:f' .'!:''1• ^r T.l'•` 'i i r. '.•::. •'i '1''ti�:.Tfyel.!. :ti •';7• -'i: .. •rT r�' .r.:::l, .,. 'ii {•s•!'•'• ;:.';,Ss,S":la`•_l.{'. 'o'l1Cs•:#;•: :r•` — r..•, penalties of it Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imp si a fine of�100.00 day againstmme. I understand that Wr one years'imprisonment as well as ctvff penalties la the form of a STOP W ORDER copy of this statement maybe forwarded to the Office of Investigations of the DIAfor coverage verification ; I do hereby ce nde he p ins�and/pin t' of perjury that th inf`ormation provided above is true and correct b Date ) ' ✓ f�/ Phone# Print name - official use only do not write in this area to be completed by city or town official permit/ltcense# ❑Building Department city or town: ❑Licensing Board ❑Selectmen's Office Q•check if immediate response is required ❑Health Department , contact person: phone#; []Other q vied Sept 20A3) Information'and Instructions. Massachusetts General Laws'chgpter�152 section 25yequires all employers to provide workers' co Vens_atidn 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 intlied; oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, 6r any iwo or mgre of the foregoing engaged-in a�joint enferprise, 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. 'Howevei.the owner of a dwelling house having:not more than three aparhnents and-who resides therein, or the,omupant,bf the Aw* elling house of lb S ersoris to do maintenance, construction or repair work on such dwelling}io0e car on the grounds or ' another who.emp• y p PP bw7ding.a iutenant thereto shall not because of suchem be deemed•to beployment .:an�p to e'r y ,.: .. . . . . . . . • : •. •• MGL chapter 1•.52 section 25 also"states fhateve'ry state or lbcal licensing-agency sham withhold the issuance dr renewal of a license or permit to operate a business or to construct buildings in the.commonweaIth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required: Additionally;neither the' ' of its political subdivisions shall enter into any contract for the performance of public work until nwealth,nor.any P , coirnmo acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting eP ' authority: Applicants Please fM is 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 maybe submitted to the Departrnerit•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`Tndustrial AAccideuts. Should you have any questions regardiri�the"law"or if you are required to obtain a.workers'•carnpensationpolicy,please call the Department at the number listed•below. City or Tdwns . • Please be sure that the affidavit is.complete andprinted legibly. The Department has provided a space at the bottom of the affidavit for you to'fito ut in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill;in the permit/hcense.nee'which will be used as a reference number. The.affidavits may be returned to the D ep artment by,mail or F.AX unless othei'arrangements have been made. in advance for you co eration and should you have auy ' estions, ' ns ould lie to thank ou y op Y The Office of Investigations w Y . please do not hesitate to give us a call. The Department's address,telephone and fax number: . ' The Commonwealth Of Massachusetts Department of Industrial Aecidents BiPEcce of 11i"Sugmils 600 Washington Street ' Boston,Ma. 02111 fax#: (617)727-7749 r 1 Tp CM1.Xppm gx I CctttEIV4 will,gosxfl V114, Txbfe xg',1,1fl cd far dAc$A' p' 'R.�lL tw Hccildia�i gated ' p�sarip�'z PaeklS ' mmhl ,g glCcalingc}'' 1rYAXfM Flacr 13sscrz!cat S u{pmcrtc FJ�'taicn wal P=,w �iadn C}laxin R v Iu R•Yalcsc{ A Yxltsns ��i R �1 lsres ��.) t1 Y • pro 3-tai tc 6�aa x�tftt�t0� a�xn' � Narusal 19 Hart • 0.40 3$ l3 lg la I51sM1$ 1Z/, 0.52 30 13 19 to b NcrosaI O,S0 31 13 IVA �A Na�1 g I5T/. IS 3g t0 i5 AM 19 t5*!� 0• 3g 13 15 NIAA • 11 AFUE 0,44 3g 19 t9 to 141A 2{omsst Y t51�, 041 30 13 05 N1A Nuarml X 1g`!. 03Z 31 19 25 NIA N/A 40 AFUE 3 lg��, a42 13 lg la g0•AFUE Y 6 3g tgf, 0.42 S9 lg to x 0.30 30 +raca ,ob c cr H i 11 1� AD�RE55 OF PROPgR'l;'Y: C e n 4 erU ,� SQUARE FOOTAGE OF ALL EX'I'SR�OR WALLS. FOOTAGE OB ALL QLAZIGt 4• d/a GLAZING AREA(#3 I)IVMFD BY#2) ,p.•see chart aboYa}: 51 S�/LEC�'PAC�GE{Q RMORE UVOLYED METHODS OF DETE G ORGY REQtTIREN�ENTS TIM t�0 • Cp,RE AVAIL�LE' ASK U5 F0R'i' 5 UIFORMA e , BUQ,DVG INS PgC COR AppROV�L: YE5' 1 � 1 q•fa�,,•�ao3o3a • RESIDENTIAL BUILDING PERMIT FEES ' APPLICATION FEE New Buildings,Additions $50.00 O Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE woRKSHEET NEw JJWNG'SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) AI,T'RATIONS/RENOVATIONS OF FMSTING SPACE S3 0 square feet x$64/sq.foot= A 1 SaN x.0031= ' plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.1 t >120 sf-500 sf $35.00 ' >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: x.0031= square feet x$96/sq. foot= NE PERMITS STAND ALONE Open Porch (der)x$30.00 x$30.00= Deck (number) Fireplace/Chimney x$25.00= (number) Ing round Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moviug $150.00 (plus above if applicable) Permit Fee projcost Town of Barnstable -�E Regulatory Services Thomas F.Geiler,Director Era va s6 S& Building Division �pIFD Mp�k Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 , Fax: 508-790-6230 Of{ce: 508-862-4038 ' permit na. , AFMAVIT CTOR SUPP MNT TO PERMIT APPL ATIONw construction of an addition to any pre-existing ow]►er-occupied MGL c.142A requires that the,,reconstruction,O ctiioon,alterations,renovations repair,modernization,conver eon,° •improvemeIIt,removal,demolition, bg containing at one but not more than four dwelling units or to structures which are a tac n such residence or building be done by registered contractors,with certain exceptions,along with other requirements, d°-' r. Sb eefrocA 1 Pa%i�4 i y Estimated Cost 'type of Work:�f h�ocar5 0� ., Address of Work: � f Sfruc�6�QrrCen�erv'�IIe �A oab3� Owner's Name: 0 rji�+nne� i . hcation: 6 3 1 S— ®q Date of I hereby certify that: Registration is not required for the following reason($): []Work excluded by law ' ❑1ob Under$1,000 []Building not owner-occupied ]Owner pulling own permit Notice is hereby given that: EALING WITH OWM ES PULLING THEIR OWN 7?ERMIT MUROYEMENT WO EDO PLOT BkVZ CONTRACTORS FOR A ICAB.LE BOND A CCESS TO THE AItBITRA•TION PRO GRAMOR GUARANTY FUND UNDER MGL c.1�2A. SIGNED UNDER?ENALTIES OF PERJURY Thereby apply for&permit as the agent of the owner: Contractor Name Registrationldo. Date OR Owner's Name f - Town of Barnstable CF VE Regulatory Services - Thomas F.Geiler,Director `+ saxxsTaai.E. • � 94, SS b �.� Building Division ABED a Tom Perry,Building Commissioner 200 Main Street, Hyannis;MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 0 3 &—O y JOB LOCATION: nl SfraU. beru 1 1 ( Food. Ce_n+erg 1 (Iet T p 6a10Z number street village ,,ii "HOMEOWNER": R L A c5 I p)'1 L ►G n n e_4+% S®6— 1 0..p._3 p H 7 _ - name home phone# work phone# CURRENT MAILING ADDRESS: S9 f S-i-ret w b e r ry 14 i 11 Road Ce.n4ertr i ie MA 6a(.3a city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as _suvervism.- DEFE41TION OF HOMEOWNER Person(s)who owns a parcel of land onwhich he/she resides or intends toreside;-on which-there-is or-is intended°to :>..,. one�or-*twofamily=dwelling, attached or-detached:structures accessory_:to such usa and/o :fannstcuctures: A�:..._._T.., x_M -_ -.. . person who constructs more than one home in a two-year period shall not be considered a homeowner. Such - `,`homeowner"shall submit to the Building_Official on_a form acceptable to the Building_Offictal,ahat-he/she shall be _. - responsible for all such work performed under the building permit..-(Section 109A"A_) 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 _. minim hispection.procedures_an _requirements.and.that.he/she_will comply w#said procedures and - :...Yeg1nre' en _ r ----- - srgnature of Homeowner Approval of Building Official a Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section I27:0`Construction ControI: . , HOMEOWNER'S EXEMPTION - " work for which a building ermit is required shall be exempt from the provisions fates that. An homeowner performing w The Codes g g p mp Y P q of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is.fully aware of his/her responsibilities,many communities require,as part of the pemut application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. __- __ 0,fnrmschnmeexemnt 4 _ ' SQI STRAWBERRY H',LL RoQdl Cram4ervil►e, Aq 0.2&3 Re (qcC Cxis4-;Aj Poor alit Bedroom Bedroom NALI- Fami) Room Re lace Exis�',n W1n�aws Ki+then Bedroom Liyin Roori New wall 113ay W; ndow PT Sill wi+ti CaIKln9 ynder Vol ,�Xq"Corns�rryc�',on ya"coy For Ex+erlor wau w/Load Flashlr+q and Cedar $h,,ngle sidewcAil',nq. I fl � 0 � k 3 D � Ib _ m k' m rib ' g G 4i � p n i 3 w 3 °� . N 3 Q-1 + o n _ 1 u t H n £ S _r c N w gi O w x' rn l.ommonwealg o/Vaddachu6effi Official LDS I I 2e artment o D,}ire Jervicei Permit No. �'�I P l 'y` BOARD OF FIRE PREVENTION REGULATIONS ,Occupancy and Fee Checked . [Rev.,1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC,527 CMR 1 .00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: 1 City or Town of. ud.rn`5&,6 le To the Inspec r of wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. -Location(Street&Number) s� W�Ded'r _1401 r Owner or Tenant k0Ce- ZS' 10f:C� LQ i- F,_-.) Telephone No. Owner's Address :�7—e r—PI t"li1G' _0 a.) Is this permit in conju ction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Buildings ld�( Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity s Location and Nature of Proposed Electrical Work: Q�7 (.�-t�. (�i U, e e-4 F-�v k� -�. Completion of the rollowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No. of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA o No.of Luminaires Swimming Pool Above ❑ In- o.o mergency Lighting o a rnd. rnd. Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones zz $ In No.of Switches No.of Gas Burners No. Detection and itiating Devices 8 No.of Ranges No.of Air Cond. Total No.of Alerting Devices � Tons g Q LL No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ........................ Detection/Alertin Devices Municipal. 1 No.of Dishwashers Space/Area Heating KW Local❑it Connection ❑ Other ri No.of Dryers Heating Appliances KW Security Systems:* t2 B No.of Devices or Equivalent o No.of Water No.of No.of � Heaters KW Ballasts Data Wiring: t>b Si s No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent . OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: v (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. r CHECK ONE: INSURANCE BOND ElOTHER ❑ (Specify:) I certify,unde}t ains and pe}:alties ofper'ury,that the information on this application is true and complete. FIRM NATVIE: /-ec-�2'1 Cl CUn LIC.NO.: Licensee: Tom( ,--_ ��D Signature' / LIC.NO.: (If applicable, a er "ezemppt�� �in, th�gg�license number line.) Bus.Tel.No.: Get, Address: - wl�(/�d Y e to Alt.Tel.No.: *Per M.G.L. c. 147,s.57-61,securi work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑ owner ❑owner's agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. a ,