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0169 GOSNOLD STREET
/69 Cos��o�� sr ACTIVE 1 o � ` lZ" ,,� w \\,,� \Y FF�` `�\ �n� , �� �,� �`�� �r� � � °i.�,.�a ��, 0 �� � �� `�� �� � 1 �® � .- I #' r r � 1 � ,. I �� �� e � ,` '1 ` �� �� \� �► �"� �t f 4 s,_y: Yam' � . 1 I. . .. ,R 4 Px' j. f .. h � 7 " 1 r �1 vtl6 "i^ F 1Y � a 'f T 5 ` � � �� � � E i ����` � ��� � �G� �� �, I � /��� �� � �� � : o Town of Barnstabie Building Division 367 Main St. Hyannis,MA 02601 � '`� , (� Cry sv ct S� _� • l A-e_- h.oy ti w ,� �.. � ;7 '� _i y *, , � 9 �' �� �¢ Building Department ComplainVInquiry Report Date; Rec'd by: O h r(s N n r Assessor's No.LLL-- `� Complaint Name: QS e Location Address: Q l\ C1 L n(� I C� y I ►. —�/�� - M/P Originator Name- • Street: verge; State: Zip:__ Telephone:D/C Complaint , 10 Description: o `ELo Z Ck C fv Inquiry 5 Desaiption: For Office Use Only Inspector's Action/Comments Date: Inspector. / 3 Tollow up _ Action ;�Oa Additional Info.Attaclied Copy Dizibidon. W dw-DepamnentHe Yellow-Inspector (? Pink-Inspector(Return to Office Manager) 7 /�'— 00. f yorrM� o. The Town of Barnstable ..,T►s,,Y.. .a Inspection Department `�. 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLuz Building Commissioner May 5, 1993 Ms. Mary Nguyen 13 Sunset Road Wayland, MA 01778 RE: A=306 125 169 Gosnold Street, Hyannis Dear Ms. Nguyen: Enclosed please find the information you requested via telephone. If I may be of any further assistance please contact the office. Ver truly yours, Richard Bearse Building Inspector RRB/gr enc. i I 13 5 - � 1` 40 of 6, 4-f 3 ` L t l Vr,..e.- r�. f3WL U ra YW- zj� VvLay w tL f II E �- ,� \,` �� `�\ \ �:, �� � �" r/ � \ '� �� � �f �� J y -_ � ��� \ i ,��� ,, ,�� ,, i y ��� �� �� I r ��� -_ LEASE FOR: 169 GOSNOLD STREET HYANNIS,MA DATE z) Landlord (owner) Minh and Kim Nguyen I Tel: (508)-653-1323 and (508)-553-2363. TENANTS r TENANT(S) agrees to pay-as follows: Deposit and first week- rental. pay in full amount. Payment to be made in Traveler`s check,Money Order, Or Cash. Cancellation Policy: Subject to Owner's approval,the deposit less 15%handling fee will be y returned Provided The Owner is able to re-rent the property. A SECURITY DEPOSIT of_950_is due at time of occupancy.This deposit shall be held by the Owner and returned with 30 days after the tenant vacates the property PROVIED that there is no damage and clean. RENT: $ _950—a week in June through Sept. r . SECURITY DEPOSIT: $ 950 f+ BALANCE DUE $ A telephone is provided.Local calls out and all incoming calls are free.All other calls can be charged to the TENANT' s calling card. Cable TV, Water and Electricity shall be paid by Owner. The Owner is responsible for the care and maintenance of the property and repair of the premises, and he shall be notified immediately of any damage to the leased Premises. Plumbing and Electrical problems should be reported for timely repair. . The Tenant shall provide towels and linen for-: 4 twin,3 double, TV and several small radios are available. The parties,Tenant and Landlord agree to the following: The Landlord shall prepare the property for occupancy,and The Tenant shall maintain and leave the property in GOOD CONDITION for next occupant. There will be no Subletting of the property without the express permission of the Landlord. All property of the Tenants will be at the sole risk of the Tenant. Should the property be destroyed by fire or other casualty,so as to be come unfit for habitation,all monies shall be refunded for the term unused. Rubbish pick up is done early on Wednesday morning;Please,place the barrels at the front end of driveway on Tuesday night. THANK YOU AND HAVE A GREAT SUMMER!!!. LAND LA/ )l DATE TENANTS) �o C,e- -0- _ i 13 SECTION 3 DISTRICT REGULATIONS 3-1 Residential Districts 3-1.1 RB, RD-1 and RF-2 Residential Districts 1) Principal Permitted Uses: The following uses are permitted in the RB, RD-.1 and RF-2 Districts: A) Single-family residential dwelling (detached) . 2) AccessoryUses: The following g uses are permitted as accessory uses in the RB; RD-1 and RF-2 Districts: A Rentingof- rooms". for not more than--�three'..(3) . non- am t fily `-�, -members by the family residing in a-'single-family_.---\ i dwelling':$�_ B) _Keeping, stabling and maintenance of horses subject to the following: - a) Horses are not kept for economic gain. b) A minimum of twenty-one thousand, seven hundred eighty (21, 780) sq.ft. of lot area is provided, except that an additional ten thousand, eight hundred ninety (10, 890) sq.-ft. of lot area for each horse in excess of two (2) shall be provided. c) All State and local health regulations are complied witfi:.�---:::- d) Adequate fencing is installed and maintained to contain the horses within the property, except that the use of barbed wire is prohibited. e) All structures, including riding rings and fences to contain horses, conform to fifty percent (50%) of the setback requirements of the district in which located.`. f) No temporary buildings, tents, trailers or packing crates are used. g) The area is: landscaped to harmonize with the character of the neighborhood. h) - The. land is maintained so as not to create a nuisance. i) No outside- artificial lighting is used beyond that normally used in residential districts. /�S'' SEPTIC SYSTEM Assessor's map and lot number3 ..••.... INSTALLED '� DUST k�$IrH ' COMPLIANCE SANITARY 11 STATE ARY coD 1 ��Sewage Permit number ���.4..y<'� ......,�C����--� � $��'�`IC�iS. TOM �QyQF7NEt��o TOWN OF BARNSTABLE • mum .e� BUILDING INSPECTOR r � APPLICATION FOR PERMIT TO ... ............... .............. ... ...... .... ...................... TYPEOF CONSTRUCTION ..................................................................................................................................... .. . -""....5;�. .v..........19.�a"1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereebb applies/for a permit according to the following information: Location 1404,. ..... . � fy! ./..........................................I... ................................... ProposedUse 4./..U.,l../?. ....�..�..�..Y�........................................................................^ ............................................... Zoning District .Fire District S T Name of Owner /.,� gx. . �'e, e......................Address Name of Builder ,9�. e�1t^.(' .h•l�/J�l'Ct..............................Address/./.4..!!/? Nameof Architect ..................................................................Address ......./.�......................................................................... Numberof Rooms ..................................................................Foundation C..G..n. .:............................................................. Exterior ..... . C �!':.........................................Roofing ....."" C... Y................................................... Floors ... .. . . ..................................................Interior ....................................:.............................................. HeatingGl .......................................Plumbing .....................:............................................................ Fireplace ..................................................................................Approximate Cost .....sP..�J .o........I.................... Definitive Plan Approved by Planning Board ---------------____-----------19_______. Area ��v--...�. .....'....... Diagram of Lot and Building with Dimensions Fee .....� ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I� 0 'fl - F ♦ •. O 7- i i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name :�..! .s� .................................... Kehoe, Theodore 16693 Permit for addNo ... .... .......... ........ dwelling & remodel .................... .......................................j...... ......... Location .............1,§9 Gosnold StItt ................................... ............................. ................................... ± 1 Owner Theodore Kehoe Type of Construction ..........frame ................................ t P .....................................................;........................... Plot ............................ Lot ................................. t Permit Granted .........Qctober..'30.........19 73 Date of Inspection ..... . ..... ............. 19 r-e Date Completed 19 PERMIT REFUSED ................................................................ 19 ...........................................................7.................... ................................................................................. . ....................................................... ............... ............................................................................... Approved .............................................. 19 ....................................................................... ............................................................................ --- 14 3)�lconditional uses in tn _efollowing uses are permitted as RB, RD-land RF-2 Districts, provided a,Special Permit-is=f-rrs =obtarie'd-fromythe=Zo ng_Boardof Appeals_ subject _to the provisions-of�-Section- 5-..3::3-herein and �tle specific standards "for such conditional uses as required A) Renting of rooms -to no more than six 6) lodgers in one (1) multiple-unit dwelling. B) Public or private, regulation golf courses subject to the following: a) A minimum length of one thousand (1, 000) yards is provided for a nine (9) hole course and two thousand (2,000) yards for an eighteen (18) hole course. b) No accessory buildings are located on the premises f . - except: those for' storage of golf course maintenance equipment and materials, golf carts, a pro shop for the sale of golf related articles, rest rooms, shower facilities and locker rooms. i C) Keeping, stabling and maintenance of horses in excess of the density provisions of Section 3-1.1 (2) (B) (b) herein,- - either on the same or adjacent lot as the principal • building to ,,which such .use is accessory. . D) Family Apartment- subject to the .following: a). Not more. than one (1) family apartment is provided. b) The. family apartment is within or attached to an existing residential structure or within an existing building located on the same lot as said residential structure. ' c) The residential character of the area is retained as nearly as possible d) The .familyapartment contains not more than fifty percent (50%) of the square footage of the existing residential structure if being proposed as an addition thereto.. e) All setback requirements of the zoning district within which the family apartment is being located are complied with.. f) The property owner resides on the same lot as the _ family apartment.- Property Location: 169 GOSNOLD STREET MAP ID: 306/125/ Vision ID: 24336 Other ID: Bldg#: 1 Card 1 of 1 Print Date:07/18/2000 vv� A f "7 Descrrption ode Appraised Value Assessed Value NGUYEN, N H ft&IVIAK 1 1), RIES LAND 50,00— 50,100 13 SUNSET RD RESIDNTL 1010 95,800 95,800 801 WAYLAND,MA 01778 RESIDNTL 1010 3,800 3,800 E DATA-Barnstable, ax Dist. 400 Land Ct# Per.Prop. #SR Life Estate #DL I LOT 19 W Notes: VISION #DL 2 /PT 20 CIS ID: jotall 149,700i 149,7011 �OK;Vy G-L, UNASSEXYMEAlloi('Vjslmp' NUU YEN,MENH7 K&MAKI D UJ7 11/15/1991 Yr. Code Assessed Value Yr. Code- Assesse a e r. 0 Assessed Value ALBANO,ROCCO A&DIANNE M 4051/057 03/15/1984 Q 1 73,000 -2un TOPF 1998 1010 KEHOE,THEODORE R 1476/501 Q 0 2000 1010 95,8001999 1010 95,8001998 1010 95,800 2000 1010 3,8001999 1010 3,0001998 1010 3,000 —Tatak, 149,700::::::?70ja.' 148,900— oa: 148,900 L IRR attire aCT --F 4 ,R Iftissign nowTe ges a visit y r or A ssessar A�' Data Co U Year lypelDescription Amount (,ode Description Number Amount Comm.Int. Y Appraised Bldg.Value(Card) 93,500 Appraised XF(B)Value(Bldg) 2,300 Appraised OB(L)Value(Bldg) 3,800 otal. Appraised Land Value(Bldg) 50,100 ",Ix�71'_L] Special Land Value Total Appraised Card Value 149,700 Total Appraised Parcel Value 149,700 Valuation Method: Cost/Market Valuation et Total Appraised Parcel Value 149, ; 700 JkDA�fV Pk q GL #L Permit ID Issue Date lype Descripiton Amount Insp.Date '16 Go nip. Date Comp. Comments Date ID ca. PurposelResult -V4ALV_AT1bN3M1 B# Use coae uescription one L)jProntagel Depth Units unit Price I.Pactor S.L C.Eactor Nbhd. Adj. Notes-AdjlSpecial Pricing A df. nit Price an value T- 1010 Singletam KB 4 U.1 AU 347,0(JO.00-----FN--5-----T.UU-7UA-C---U.95SPCL(.17,UIU)No-fe-s-.-rffTBEDG---I94,IJ50.W 50,101) ..I.... �and Area: L7 AC 0 Total Card Land units U.17 AU I tat an value UU1 Property Location: 169 GOSNOLD STREET MAP ID: 306/125/// Vision ID:24336 Other ID: Bldg#: 1 Card 1 of 1 Print Date: 07/18/2000 Element Cd. Ch. Description Commercial Data Elements Style/ type 6 uonventionalElement Cd. Ch. Description Model 1 Residential Heat AC-- Grade + Average Grade Frame Type bAb BM Baths/Plumbing Stories .4 2 Sty w/FAT ccupancy 0 eiling/Wall 10 1 10 10 ooms/Prtns Exterior Wall 1 14 Wood Shingle /o Common Wall 13 10 2 Wall Height Roof Structure 03 able/Hip FUS Roof Cover 03 sph/F GIs/Cmp AS , BM Interior Wall 1 08 Typical 2 Element Code Description bdctor nterior Floor 1 20 Typical Complex 2 Floor Adj Unit Location 26 2 Heating Fuel 2 it Heating Type 9 Typical Number of Units C Type 1 None Number of Levels /o Ownership Bedrooms 5 5 Bedrooms Bathrooms 1.5 2 1/2 Bathrms 1 2 Full+1H Unadj.Base Kate 48.00 26 Total Rooms 7 7 Rooms Size Adj.Factor 0.99543 �us 26 Grade(Q)Index 1.12 ZOP Bath Type dj.Base Rate 53.51 Kitchen Style Bldg.Value New 119,916 Year Built 1920 26 ff.Year Built 1970 rml Physcl Dep 7 uncnl Obslnc con Obslnc pecl.Cond.Code a pecl Cond Code Description Percentage Overall%Cond. 78 single fam luu eprec.Bldg Value 3,500 U LEADLNGI& r Y ao Code Description nzis Unit Price Y r. Lp Rt o n pr. V Value irep- , FGR2Garage-Avg L 504 25.00 1920 1 100 39800 ":'..� "MA Code Description LivingArea Uross Area Ey.Area Unit Cost Undeprec. Value F—irsTFIoor43,129 FAT Attic,Finished 338 676 338 26.76 18,086 FOP Porch,Open,Finished 0 208 42 10.80 2,247 FUS Upper Story,Finished 884 884 884 53.51 47,303 UBM Basemcnt,Unfinished 0 806 161 10.69 8,615 WDK Wood Deck 0 100 10 5.35 535 t. ross LivlLease Area g a119,9161 12; �r'�-� o%i� �w =tee 7/, -06' Cl.'« 14. 141- Z� � r RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET 169 Gosnold St. Hyannis 366 125 - H 73 LAND G OWNER BLDGS. —)2 3 v TOTAL 9 RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: LAND c BLDGS. A.?s TOTAL a:�a.69" .]J.��6 ��77-. SS 1 a LAND. Kehoe, Theodore R. & Mary .J. 6/24/70 1476 501 t:� .y BLDGS. TOTAL v/ LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND 0) BLDGS. TOTAL LAND BLDGS. TOTAL LAND f�.•� { E: , 7�u`'^a, ;�+!i G�/�� .v"'",3';'4.', , (/s` I , .Te.;fI�.�'S z - I `�},..t f+a ,f,l};;,.r?�' 1, ;j,I•� }?i k-iI''tllft�!l' S; t �, e �I - }" p•—Irl BLDGS.INSPECTED: TO DAT LAND q!NTEF10R TAL K P ! 1 ACREAGE COMPUTATIONS BLDGS. LAND TYPE # of ACRES PRICE ch TOTAL DEPR. VALUE TOTAL HOUSE LOT Z �'c. p c i 6 7 7 LAND ICLEARED FRONT BLDGS. REAR TOTAL 4.VKOODS&SPROUT FRONT FLAND ! REAR OI WASTE FRONT REAR BLDGS. rBLDGS. LOT COMPUTATIONS LAND FACTORS FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER ROUGH TOWN WATER 01 BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. TOTAL TOWN CIF RARNSTAP+ F Pn _. tlLUG GUST Conc. Blk.Walls Bsmt. Rec. Room v St. Shower Bath Bsmt. Conc. Slab Bsmt.Garage St. Shower Ext. .PORCH. DATE _ Walls PORCH. PRICE Brick Walls Attic Fl.&Stairs Toilet Room Roof RENT •-� Stone Walls Fin.Attic Two Fixt. Bath Floors Piers INTERIOR FINISH, Lavatory Extra Bsmt. 1' 2 3 Sink s/ 1/2 'A Plaster Water Clo. Extra Attic 10 /U EXTERIOR WALLS Knotty Pine Water Only Double Siding Plywood No Plumbing Bsmt.Fin. Single Siding Plasterboard 000, Int.Fin. O Shingles TILING Conc. Blk. G Fj P Bath Fl. Heat Face Brk.On Int.Layout Bath Fl.&Wains. Auto Ht.Unit �- �_•� �J �� Veneer Int.Cond. Bath Fl.&Walls Fireplace Com. Brk.On HEATING Toilet Rm.Fl. Plumbing Solid Com. Brk. Hot Air Toilet Rm.Fl.&Wains. Steam Toilet Rm.Fl.&Walls Tiling Blanket Ins. v Hot Water St. Shower Roof Ins. Air Cond. Tub Area Total Floor Furn: ��� Q ?S S ROOFING COMPUTATIONS — Asph:Shingle Pipeless Furn. G S.F. Wood Shingle No Heat S.F. A ba.Shingle Oil Burner r 0 Aj L, ✓ S.F. Slate Coal Stoker S.F. Tile Gas ROOFTYPE Electric; /3 O S.F. D AS OUTBUILDINGS Gable Flat i VD S.F. n�,s0 as0 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 8 7 8 9 10 MEASU Hip l? y E Mansard':-;, FIREPLACES i S.F. Pier Found. Floor C Gembref""' `4' Fireplace Stack ; Well Found. 0.'H.Door LISTE `1 "FLOORS Fireplace Sgle.Sdg. Roll Roofing' Cone" LIGHTING Dble.Sdg. Shingle Roof' ` i ,rth ! No Elect, Shingle Walls PlumbingDATI Pins , a,k r, :S g r: Hardwood '° + " I ROOMS r 3, p Cement Blk. Electric " 1p Asph Tile" Bsmt.`' 'j, 1st TOTAL` Brlek' Int.Finish PRICE Single ;(;s' 2nd j 3rd FACTOR „ ` i. , , r REPLACEMENT J/0 .7 6 0?IV'D. OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep.•- PHYS. VALUE Funct.Dep. ACTUAL VAL. p r. , 3 - - '4' .. .5 - , 6 7 8 9 — r 10 �: J TOTAL t. )O 1/66- 3 � �] Town of Barnstable *Permit# -- Expires 6 months from Issue date Regulatory Services Fee 13S t eAxtvsrABI *' IMAM a`�' - Thomas F.Geiler,Director&639. j.��' - � b � Building Division � d Tom Perry,CBO, Building Commissioner AA% 2 200 Main Street,Hyannis,MA 02601 1 TA www.town.barnstable.ma.us M /A] OFBAR�a1�-�- Office: 508-862-4038 Fax: 508-790-6h3tL,S EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address /l f�es elol �� I� ,x Yi Blesidential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address /�lam°. �i t� J Contractor's Name p g 6 .46Nz-I R l'^ "• Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) E[Vrorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner M-Kave Worker's Compensation Insurance � Insurance Company Name 1' ^'+ / �Sv / %� '�. ^ce C.C Workman's Comp.Policy# V i l,A P Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) e-roof(stripping old shingles) All construction debris will betaken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders U-Value (maximum.44)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ' ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\decollik1AppDataU-ocal\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc . Revised 090809 I T`ke Ca ain- eaft : st ims-,etts Depai*ne ` ad t&EA fknts Ufftce-°qf , W &ba v 600 WaY t r i2n3 Sk eeti Boston>, 0211,11 wit-immamVedfu Workers' Compensation Insurance A dam ddieWC tractors/El'ectr cians/Plumbers Applicant Information Please Print Legibly NaMe(Business/Organization/Individual): Address: Z)o, goy- 149 City/State/Zip: dlt�t/j/ f4/1 062UZPhono A: Are employer?Check the appropriate box: , Type of project(required): 1. am a employer with ? 4. E] I am alonemlicontbactoirandl I employees(full,and/or part-time).* have tifredltht~aLLil comma,b I 6 0 New construction 2.0 I am.a sole proprietor or partner- listedlonithe;aiRacbedlsfiee#, T. �,lternodeling ship and have no employees These siil centractbhg,ha«; 8. F1 Demolition working for me in any capacity. emplb eesandlbave Nvc&ers? [No workers'comp.insurance comp insurance q. Building addition required.] 5.. Q' We-are,wemporat onianddil�; ME]Electrical repairs or: additions 3.El I am.a homeowner doing all work officers fiamCwTM&dtfieiir 1 t.0 Plumbing repairs or additions self.m ' ri:ghtt fem gfiiam a per,m. �L, y �o workers comp. � 12. of repairs I, insurance required.]'t c. 15,1, and ty&,fiavenov emptci ,. t3. ;Other comp).;insurance:regrii ]l *Any applicant that checks box 91 must also fill out the section lion policy infonnatiou- i-tomeoitivers who submit this affidavit indicating they are doing all must submit a new affidavit indicating such. *`Contractors that died:this box must attached an additional sheet shouiiiwrtfiuiyamoafftlie;aaT%conitwit)rs and state whether or not those entities have employees. If the sub-contractors have employees,they must provide th-eir ner. lam an employer that is providing workers'compensation insrirancce�ar,inyvennp doyees Below is the policy and job site information. �' Insurance Company Name: rX1?-, 1 -11KI'` C 8a�,,, Q,i, Policy#or Self-ins.Lie. a--piration Date: Job Site.Address:�` ��NB�cf �T ;y/State/Zip: ,✓��i /� ����/ Attach a copy of the workers'compensation policy decl'aeatiom pa�e(kfowjhg the policy number and expiration date). Failure to secure coverage as required under Section 25At,QR°l�'UM,c� lil52earril'ead9 to the imposition of criininat penalties of fine up to b 1,500.00 and/or one-year imprisonment,as well as,eivif penalties initbe-, form of STOP WORK ORDER andl a fine of up to$250.00 a day against the violator. Be advised thattaa copy ofrthi;stattrnea it may be forwarded to the Office of Investigations of the DIA for insurance coverage verificatonni. I do hereby certify r the pains and penalties of perjur,Jyliiatitlieli fomnat ani j rrovided above is true and correct. Signature: Mite: 161 1:1w-la Phone#: Official use only. Do not write in this area,to be conzpfel,ed1hr1C,7t$V&r,thwelafficiat City or Town: Permit/License.#' Issuing Authority(circle one): 1.Board of Health 2.Building Department. 3.City/j1%wn)06& 41,Elect'riical Inspector 5. Plumbing Inspector 6.Other Contact Person: Plioz►e#:; ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATEtm°... 09/01/2010 PRODUCER (508)428-0440 THIS CERTIFICATE IS.ISSUED AS A MATTER OF INFORMATION Mark Sylvia Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 771 Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville MA 02655 INSURERS AFFORDING COVERAGE NAIC# INSURED Doyle& Thomas Construction,Inc. INSURERK. Farm Family Casualty Insurance PO BOX 168 INSURER B: Centerville,MA 02632-0168 INSURER C: INSURER D: i INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR EFFECTIVE T DD' E I POLICY POLICY EXPIRATION POLICY NUMBER D M/DDNY) DATE MM/DD/YY LIMITS A .GENERAL LIABILITY ' EACH OCCURRENCE $ 1-,000,000- X 20OIX0485 7/21/2010 7/21/2011 DAMAGE TO RENTED 50,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence $ _ CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP qGG $ 2A00,000 X POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) . PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO - OTHER THAN EA ACC. $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WCSTATU X OTH- A EMPLOYERS'LIABILITY. 2001W6390 7/1/2010 7/1/2011 ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 SPECIAL PROVISIONS below Yes E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION.OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMEIyT/SPECIAL PROVISIONS Carpentry Troy A Thomas, President; Shawn Doyle, V President are not covered by the workers compensation policy. CERTIFICATE HOLDER CANCELLATION (508)896-8089 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Brewster DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN 2198 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Brewster,MA 02631 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/0r3) ©ACORD CORPORATION 1988 I 506®328-1635 SPECIALIZING IN ALL FORMS OF ROOFING & SIDING doyleandthomasconstruction:com j P.O. BOX 168 _ BBB CENTERVILLE, MA 02632 Fully Licensed & Insured Construction Supervisor Lic# 99913 Doyle and Thomas Inc. Proposes to perform the following work: Location of proposed work: Mr. Walter Dykeman 169 Gosnold Street Hyannis, MA 02601 Date on which construction should begin: Fall 2010 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired, creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the.duration of the work and the schedule date of completion may differ,and that such variation is not to be considered a violation of this contract. The total cost for labor and materials under this contract: 30 yr., AF/Elk Timberline Architectural shingle r STD.1-7) $5,421.53 30r.GAF/ELK Lifetime Timberline Architectural shingles(roof over) $3,477.88 .25 yr. Royal Sovereign 3-tab shingles $5,421.53 25 yr. Royal Sovereign 3-Tab(roof over) $3,477.88 Thank Yni i Fnr (,ivinn 1 Ic Tho ()nnnrh inity Tn I-InIn Vni i Imnrnvc In the event that while stripping the roof we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$45.00 for a carpenter and$30.00 fora carpenters laborer, plus the cost of materials. y -Roof to be stripped and cleaned.of all old shingles and debris -Roof to be papered with weather watch leak barrier,Synthetic underlayment,and installed with Timberline architectural shingles using galvanized nails. (Storm nailed) -All new 8 inch drip edge and pipe flanges to be installed -Cobra ridge vent to be installed on all ridges - Timberetex premium ridge cap to,be installed` - -10 yard dump trailer will be needed on site; and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE-REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 ofthe estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in'full upon completion of work described in this contract. .Payment as agreed upon shall.be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5% per month. The contractor warranties the work.completed under this contract for a period often year from the date of completion: During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but.the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse,and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties,for the'materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may;be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any,responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the ; discretion of the contractor:: The homeowner acknowledges that the form,content, and notices contained_in this contract.are intended to comply with the applicable portions of the Mass. General Law Chapter 142A, " and regulations promulgated there under. In the event of any instance of non-compliance,only such portion shall.be invalid and the remainder of this contract shall be in full force effect. In addition, any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. IJd Signed as a seated instrument on this date: Date: Homeowner- Contrac or. ,> ✓ram �� �r'✓�:� � --- _ ---- - - II Board of Building Regulat�ofis and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: -- Registration: 145954 Board of Building Regulations and Standards Expiration: 3/15/2011 Tr1t 282668 One Ashburton Place Rm 1301 Boston,Ma.02108 Type: Private Corporation DOYLE+THOMAS CONST INC TROY THOMAS 499 NOTTINGHAM DR.; --- --= ---- CENTERVILLE,MA 02632 Administrator Not valid wit out signature _ Massachusetts- Department of Public Safety Board of Buildin-g Regul ►tions and Standards Construction Supervisor Specieft,y-Iicense License: CS SL 999t3 Restricted to:. RF,WS TROY THOMAS 499 NOTTINGHAM DRIVEf CENTERVI,Li_E, MA 02632 --=ranExpiration: 4/13/2012 nnmisi mc�- Tr##: 99913 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . i Map Parcel d Permit# Health Division awl Gl4- df Date Issued 10 s Conservation Divisions Fee Tax Collector �/Z e Treasurer 2-0O3 Planning Dept. CON'�' r_C MUST OBTAIN A �t'ER ECTION PERMIT FROM ^!P i�NGINZERING DIYJSION 8R10a 1', Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis e, D u 1 001 Project Street Address / C,00,rr U JU Village By Owner 0,tc lja4 ( Address 9 4-as��� S Telephone RS 775_!� 76- Permit Request r✓h,zr o ToE 6 % �s v �O 1 Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation �- Z b Zoning District Flood Plain Groundwater Overlay Construction Type 1,&4vy,c' k Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Z/ Two Family ❑ Multi-Family(#units) Age of Existing Structure I at Historic House: ❑Yes p4o On Old King's Highway: ❑Yes ❑ No Basement Type: P�'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) S �s d, Basement Unfinished Area(sq.ft) Number of Baths: Full: existing _�new Half: existing _ new Number of Bedrooms: existing new `1!5r— otal Room Count(not including baths): existing new v First Floor Room Count _ Heat Type and Fuel: �as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Plo Fireplaces: Existing New Existing wood/coal stove: 0"(Ybs ❑No Detached garage:4existing ❑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 Cl No If yes, site plan review# Current Use - - Proposed Use BUILDER INFORMATION Name Mylt,e ( c, 0/( Telephone Number Address l Gq 6 Syd)J !�-n License# #4wylI" dia C),u 6/1 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AAinA- SIGNATURE DATE .E FOR OFFICIAL USE ONLY" cA ^3 PERMIT.NO. DATE ISSUED :. r MAP/PARCEL NO: r ADDRESS f. :. VILLAGE J OWNER' DATE OF INSPECTION:- , Y 1 v FOUNDATION x FRAME ' INSULATION FIREPLACE ` Y ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING r DATE CLOSED OUT d ASSOCIATION PLAN,N_O. 5 - i k 3 I SCREE-� �e.FN�• G4SNDo gq 92' 1, NI s eR9 FRS. , 26•32 2p 5 — W,E�-NN 9.6 IOEO� to- , Ag9 NSEa 9 35 2p.5� N FOONOP ON � • --------------------:x 8 ce a�sx l0 Z °L 0 `j10 V FNO �I "1 certify that the foundation shown on PLOT PLAN OF LAND this plan is as it actually exist LOCATED I N ground. This plan was m -irq, HYANN IS,MASS. actual instrument survey PREPARED FOR Al DAVin r MICHAEL BECAL date:,luly 20,2001 \^�F::, _ !� i DATE:J U LY 20,2001 flood zone c(non-hazardf SCALE:1 "=20' i �., �.�, gosnaldst169 " r e ^'° CAPE & ISLANDS ENGINEERING MASHPEE,MASS. RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEWT6,G6SPACE r square feet x$96/sq.foot= , Z: x.0031= o� G ._. �' plus 6o-hi below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= .J plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft, >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: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee (/ —�7 projcost F IHE The Town of Barnstable UMSrABLL 1� Regulatory Services 039. `b'°TEp �►�0 Thomas F. Geiler, Director, . Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 , 4 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. Type of Work: {����'"�-e]s G A Estimated Cost eQ4 Address of Work: / r q ( .C.) , Owner's-Name: I �� Date of Application: U 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 CTOHE ARBITRPLICABLE HOME ATION PROGRAM GUARANTYMENT WORK DO NOT c. FUND UNDER MGL c ACCESSCONTRACTORS TO .142A. ACCESS SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Al:��� �/ � OR L. ` � rScc Date r s Name q:forms:Affidav:rev-070601 �_ The Commonwealth of Massachusetts- Department of Industrial Accidents � ^ --..s Olflce onfivestiffst/nos 600 Washington Street Boston,Mass. 02111 - - :Workers' Com ensation Insurance Affidavit name location city hone# am a homeowner ptformmg all work myself: � l � %%��'wridn anv= i'- 1 workin on this I� %/////////,�/'�'�////��D%' %�%////%// 1 workers' compensation for my emp a •:::::::::;:.:.;;:g.;;. ...... >:.b>:.;:.<;;:;:<:::><:<:;:;::::»>;»::;::.;: I am an Dyer P .......................:.::::::::::::.:::.:.:::::.:::::.::.:.}:.}::::;:>::.;:;::.:;;:.::::.:::.;;;::.::.:.:::::::::::.:::::::: : ::::::::.>::::::::. ❑ �P.......:..:.::::::,:::.......:,..::.::,::.:::::.:.:::::... .,..:...:.::.::.:::....,::,:::..:...:.::::.::.:::::..:.:.::::,::..........:::::::.:..:::.:::,:.::::::..:::........::::::::...,:.:::::.....::..:::.:::::..,...::::::. cam anv nam ::.::::. .:.. ........ ::...:.. aatranc oiicv /.• ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have 'compensation polices: workers win ..................:::::::.:.: :::::..,....:.................:.:PROEM,... olio mP ..............:..........................,,.........:...-.-..:.:........:..:.....: f ::::::..:::.:::::..:.:' the g :: am .con: anon .:........ ......::.. ......:.:... .- . . .................::::::.::.,•-::::::::.v::::::•:::;•::•.v:.Y.}:{•};:v.;:a•:2;;i::�:i;rFr"::'ary-'i;:;:'\::�:rv::::;. r:-3:O•--.v�:•v:�w.3:ti•}is4:v:4::Jiiiii}i??ii:�`:>:i}i:x:{}ii Y;•}:?v:•i:?{t?n;{.•r.::::::::?•i::•:r•?, ti>nL:^i:;:jn:-iit�?:�iiii`ii'l.+i:t•:is is+::. ::::...:,^;r.}i:•A:i;?;.}}}:{�'::.... ...........:•:,v::.v::.:v::::w:::,:•,vv}':.•:{{:i.ii.::w..f.x:-.n.v..nv.. .:..n. } . .. . ... ......... ....... . w> .vi•}:•}:•}:•}Yj;:v.;;.....'{S;}i.:::ii:iji:'v.;i:;:j•:ii.:ii�ii:�:i:Ji��= ........... ............. ............ .........:............ ......................,..... .... ..:•..........w.n..�......%v:}::}:ii$:�:}iiri�:ij;:ti i}:i:>�i::::.-...-.. v.....{.: ..:•::...............�:•.:.............::w...........•• .-..................•••••:•::v:;, Y.4:•}:.....3......;.. � .r..::x:r.v::ry:.v•, ... ............ ........... .....-...... ........................... ..............-.-...q.{M.f.. ,•::.�.vn:•}:-0;8)C•Y•...,.....-.. ..-,:r':•...3'{''}}Y: ....... Q.,w:•::.. ...... ............. .,.. ......r:.., ..... ............ ............. ......... --......................... ..:.m-v v.....:;..C•',vrf.ww,.ryn; .......:•.:................. }.. •.vW:::::.....v:v:.......:.••;v•n..vv:}:::::v......-...-�;,-,vr.: }.:::::::::•.. �u`�'itp....::::ii:b: i}}::!!i.}.i:;::.::..:..:.:..... ... ........... nam ................. : ........:..:..::::•::::. ...... ... ......................... ...........:..:.........:•.:.s... .. addre3S.`' yy 77.77, I.::::.X.:.......}::..::.................. ::::::::::::.:::::::::;:::.:.:::::::: bn e i► . ................................... .... .................... Failure to seems coverage as required order Section 25A o[MGL 152 can lead to the imposition of crteduai penald of a Sne nP to SI.S00.00 and/or one years,imprisonment as well as dvfi penalties in the form of a STOP WORK ORDER and a fine of 3100.00 a day against me. I understand that s copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage veriffatioa I do hereby certify under the pains and penalties of perjury that the information provided above`is trrt.and coned Date J; ,g( G Signature Phone# PrintAV . official use only do not write in this area to be completed by city or town official pe�yIIcense# ❑Building Department city or town: ❑Licensing Board (3Selectnm's Oflue ❑checkuimmediate response is required ❑Health Department __ ❑Other contact person• phone#; Urmw 9/95 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their ees. As quoted from the"law", an employee is defined as every person in the service of another under any coma:: employ of hire, express or implied. oral or written. An employer is defined as an individual, partnershiassociation,the le ornoration or other al , or any trusteethe receiver the foregoing.engaged in a joint enterprise. and including gal r representatives of a deceased ememplo lo• employees. However the owner of a trustee of an individual,partnership, association or other legal entity, employing emp Y 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 an such dwelling house or on the grounds shall not because of such employment be deemed to be an employer. building appurtenant thereto MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or rene� for of a license or permit to operate a business or to construct buildings in the commonwealth diti�y,nneeithheerthheho h not produced acceptable evidence of compliance with the insurance coverage requiredr fo rce of public work urine the P commonwealth nor anyof its political subdivisions shall enter into any contract r performance to the coatzacting insuranCe have been p acceptable evidence of compliance with the • authority. , Applicants completely,by checking the box that applies to your situation and Please fill in the workers' compensation affidat comp with a of insurance as all affidavits may be supply company names,address and phone mimbers along a Also be sure to sign and submitted to the Department of Industrial Accidents for canfizmati°n of insurance coverage. or town that the application for the date the affidavit. .The permit or license is affidavit should Industrial.Accidents Should you have anY returned to the . questions regarding the"law"or if y being requested,not the Department of Indust are required to obtain a workers' compensation policy,please call the Department at the member listed below. City or Towns tinted legibly. The Department has provided a space at the bottom of Please be sure that the affidavit is complete and p ons has to contact you regarding the applicant. Please fill affidavit for you to out in the event the Office of Investigate be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retmmed to the DepartasY ent b mask or FAX unless other arrangements have been made. like to thank you in advance for you cooperation and should you have any questions. The Office of Investigations would please do not hesitate to give us a call. ffl MEN / The.Department s address,telephone and fax The Commonwealth Of Massachusetts Department of Industrial Accide nts Olnce of Imiestloadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 °F ZHE The Town of Barnstable = BAMSTABt.r, - 9� MAS& �0� Regulatory Services '°rEc 39. A Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: � 8 f JOB LOCATION: number street village p ,7 "HOMEOWNER": K0 i C A, .' � �e- c, 4 � �J X �� 7 , O�C S �� �� 7 J ,C name n home phone# work phone# CURRENT MAILING ADDRESS: y 'a U 6d6c city/tow 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 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. ure o Homeowner ,,,,,* Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN i a t t .i .. f i - i i w. " qd 6 Ye i � 4 ' � 3 4 � 1 3 I 9 Za- I 1 r6 Tau f i i z E f * � . a6t s : 1 + t 3 _ 4 a ,i r ; i S t 1 F i I a6� X34, x d� } { j r ZY 9 a 6J 3 � C 4 q>d, .- -- _ d�6 ' -: "x. _. _<s r�a_n`>_,?:..�,z,,.... ..v..._,.._, L::.zx-ei,..v.,.,.,, IN,z:,•y:�' wk�u,.>,w:....�ua;'�,d. ..a. m,.,-?�.� ,U,?,:, ,.1.:- - \ui'c.,-9�ta ��r;' 4::, A�X_114 . ,'�: ,fig,. .. ,%' � a. - �`.¢:a:1 :.:;. ;..;,::n..��� 1 ,�., -,° a _.wa:rz •�f s,�: .�"�; rod... <:' .,__]..."1>aLx �,�,x-i .'';,, .»; ',, Y ems" ;n ::.: �,:ra.,. "f �°,,� :.. �/�r,.� .....l 'r;'<5T�. ..w' !h� •�,. -•' �"' ,� r,p..,� ,. .:'_A OWN f,�.;� x47J t wk1. �` s ,k .,r.•. z .. ,4,, ,v,,. '�..:, :W .,. `.,���, ....:„�2..1 .: 1. .:...R+Y .. ...-. . ;. ,fir ,. ,�,::..•a'.,'� � ,....'.....o ,:,, .....� ..1: Z,Flo y .:..Q. , �.<:,:: k." �i ��"r j .n'� -, ,.,fit:n� .,.. .�! Yt :} , �:�• �9GT+W1`.r., a rf# , xrv'v :. 3"c.�� �.u�.{ � .'�,�w �• 1 'a �; s:. ��i.. la ,. ��>~�ZFx �7 'ta :�`�' a .. ,, .vro:e S, -� F ff1 t x ,,:."",i t, _ +, ;"ti n rt ,-e >a•�"t' x ia�:a. )®�+:�: g�f fER'; \ S`� ( .,e, a A:. -I^;ar t ,,� fi •W4, �..,.�', R'. Y:> }�:.^ a'i VON �� r �n������ "'' .:.t� S ,� .y{ 'i�t�p�, � 1 'isr l,,flYSd�_ y�:, 0�.: '>•-�, � ":h z �� C'. i c@� K � 'r�� Y� �'d. �r a *.� •� :�y=.'� } a :::fin, M�-;� �,��' �O � -�""";� •'«.' 'r x s'.�''; -.,,5 � �+Yid re' j: �g � a � I, + t .:''' `J ,� -� ➢ `.� A', x# t;,3 a p t},- , i. i>,-: ,c +,•7, t z ;\ 4 :'t r t.. h 7 ..A;. 3>5 �.�s 6 2� sit' .r,� e +i i\:::�4Yu ,s...a 5 i 5>s .:� 5,i; �S "�•' •:`�•� xn,� �:l ..� �'�i'... ` '_�s;i � •�2' .�I� `��' a >• n ,sa i 4 -.t�..ra �,>r �6 ,_Y�` ..;n i ,� i 1: ,y. i�nt�v, I"J"� t 'i t r �" � 4 +r �/ z✓ -;.* a,�-h '� x r .,.: ..� '�' ^xra;a ': .,..�: ,.: 1 A: _F,• a :i P kkn '�+'+ d'�`„vw �i ><,i..,« J :k+�, +. •i-'} {{ , <; •:.� ,+,,, ...,:. ..n.> _. .._,s f.. .. ., .�- `rt�,• ,. -�� , �t ��'",�.tiaC � �s,tsa d s:,� y a.'g r .. .. , .� • ^e �kf.. .-c;:}. ; � r1�n`r ,. z ..�:: ,.a` jj�� 4, ,iJ.: rr �y1 :. i .::. � �.'�... .-^s--_. .::._. ..: :_:, ., w,� Ai ;,...- :5� � .:(, aa(� ,.'z•} 'v^ � .x ,.K� r �i� '%,F..r 1 ._; �`.. `� d, , '.•� :. ..c- .�;': ��, � .,. :., ." �# ,at fi t i><,. ,:�(� �'� ,wz` -rat, t z I 1 ':., .....,. ...�. fix.:K; a.:'�•i .::: �`.'. 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L: :t�.n` �2 � � � ,.�'r..-.a.._� �- �.. ,v�sue,•,.; 1,.;�ti t 1 �� S t.' -� � ��3(s sx 2 ;.� "�i#• `Y 1 � st ,ti t c t SM 1 1 �»sK gag; I 777 Ks. ;3- ,'.- t'6, z'7 ya G ,a, .. , tie { :�l /J,p��/(�J��c �� - ,, h`` 'u�°'L .: a,„'1•,SS � , ; `" ::�# a :`" ram' is an a r x a 4 3 7 3, rg r _L,.}'.,-:.., '�,`� �£ �• �,�aY t, '�`��:a-a,.� � 7'L •. n 4 � ! as � x- rra tt S ,,yy `2 t a +. 3 PA Too � F TOWN OF BARNSTABII RUILDING'PER�VhITjAPPL`ICATION o� "JUN 11. .2001, , Map Parcel l O.:v -0 ~Permit# J Health Division �/C' �` 'ENO�O�------ - - Date Issued a-I Conservation Division � Fee Tax Collector AN rrxo-u— (olos4lo( 0�- a Treasurer Planning Dept. ter/ Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis ` Project Street Address b� 6�6 S no Village_may s Owner -Address Telephone G -7 Sid G Permit Request e .bu.J �propose Square feet: 1st floor: existing d 2nd floor: existing proposed �/� Total new f �Xi sic Valuation Zoning Dis rict Flood Plain Groundwater Overlay Construction Type--Wq(),(JA Lot Size / Grandfathered: ❑Yes O No If yes, attach supporting documentation. Wwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure O Historic House: ❑Yes ❑ No' On Old King's Highway: ❑Yes ❑No Basement Type: Full .Crawl ❑Walkout ❑Other Basemenf Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new 177715 q, Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count a Heat Type and Fuel: (dGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ,Z No Fireplaces: Existin New Existing wood/coal stove: Yes ❑ No ,Sqm e ?Mt,.A- Set of (4&% Detached garageZ6existing O new size d Pool: O existing ❑new size Barn:O existing ❑new size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use #1l 04oh&-BUILDER INFORMATION Name A/c, ��' telephone Number S y 7 7 rll ?Y Address 3 4/ Cr►�c4�� /9-ac, License# %ZG 0h i S ��f. Gd6ci Home Improvement Contractor# Worker's Compensation#n ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ke AeA SIGNATURE DATE 3 FOR OFFICIAL'USE ONLY. PERMIT NO. , DATE ISSUED MAP/PARCEL NO. ' ADDRESS :0 VILLAGE. OWNER DATE OF INSPECTION= a FOUNDATION FRAME - r INSULATION ;- FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ~ GAS: ROUGH FINAL r y FINAL BUILDING DATE CLOSED OUT - M ASSOCIATION PLAN NO. t p ' 1 • r s • f p JI r GGSNGV N\ 1 f BR6.Ft�D 26.32, I I I I I I I I \jA \DECK r? 1? 51 I o 161 Na.A69 a,123 SF. N FDDNDA DxA � oK "!certify that the foundation shown on PLOT PLAN OF LAND this plan is as it actually exist LOCATED I N grounactuaa'nstrume This lan was nl�ntsurvey ��' Mgsfgl HYANNIS,MASS. �o DAVID ti� PREPARED FOR TILES MICHAEL BECAL r -._ _ - _KI 28085 date:July20,2001 90� 9� �o oQ DATE:JULY 20,2001 Al flood zone c[non-hazard Fs�,o L LAND N�s� c� SCALE:1 "=20' gosnoldst169 CAPE & ISLANDS ENGINEERING MASHPEE,MASS. GOSNO 2B 32 96 10EOK N 1T 5 N SOT 19 N N NI certify that the buildings shown on PLOT PLAN OF LAND this plan are as they actually exist on the LOCATED I N ground and that they conform to the town of HYAN N IS,MASS. Bamstable zoning regulations regardiQoa: Ate, PREPARED FOR yard setbacks at the time of con n.'�. MICHAEL BECAL ATE:JUNE 8,2001 SCALE:1 "=20, date:June 8,2001 2��s�4 1 jCAPE & ISLANDS. ENGINEERING flood zone cfnon-hazard] MASHPEE,MASS. gosnoldst969 s,��q( 1 "D��;;�� i ne i own oii i5arnstame t�►sr►srnet.� 94, r59.. ,e� Regulatory Services Thomas F. Geiler, Director Building Division Elbert UIshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862--1038 Fax: 508-7 90-6=: HOMEOWNER LICENSE E7CEUMON Please Print DATE: G JOB LOCATION: �l �c s�l a �� S T IV 17 1 e, At, :,-,)6 C� number street llage "HOMEOWNER": l G a G C' C ct !)X 7 2 5—f 7 Sl 7 S �� • ° ,� ^' /� home phone# work phone.a • •• CURRENT MAILING ADDRESS: , G-I llM 'A Y a state zip code The current exemption for"homeowners'was extended to include owner-Occuoied 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 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. rgnature 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 EMOTION 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. ensure To that the homeowner is fully aware of his/her responsibilities.many communities require,as pan of the permit application.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:E.YE.MPTN The Town of Barnstable Y 9iA8l eg Regulatory Services �1es� . EDPAP��' Thomas F. Geiler,Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street.Hyannis MA 02601 Of{ce: 508-862-4038 Fax: 508-790-6230 n iA Permit no. Date —&-�eZ 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 registered contractors,with certain exceptions,along with other x ' ence or budding be done by residence g requirements. Type of Work: �o/'�� Estimated Cost 3 G, e, o U d Address of Work: Owner's Name: ` 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 [DOwner pulling own permit • Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERID CONTRACTORS FOR APPLICABLEION PROGRAM O GUARANTY WORK DO NOT AD�D�M�142A. ACCESS TO THE ARBITRATION SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Contractor Name Registration No. Date / R Date Owner's Name g1ornu:Affidav �b M � � 'y p "h � O FEE VALUE WORKSHEET LIVING SPACE (2000 sq ft or greater) square feet x$115/sq.foot= (less than 2000 sq ft) square feet x$96/sq.foot= (affordable housing) square feet x$57/sq.foot= (40B or low income) GARAGE(UNFINISHED) Wa Z square feet x$25/sq.foot=. ,Z4 3 PORCH '05;, square feet x$20/sq.foot= DECK square feet x$15/sq.foot= ALTERATIONS/RENOVATIONS OF EXISTING SPACE . .. .. .. cost=.. .. .. .. . ... .. .. Total Project Fee Value Office Use Only Permit Fed 5N 3 3 projcost 7 Town of Barnstable *Permit Expires 6 months from issue dat/ O N . FeeR&R 555 ,�,�LL Regulatory Services v��r 9 Building F.Geiler,Director Eo,r,pt '�• ilding Division I®jQ Elbert C Ulshoeffer,Jr. Building Commissione r 367 Main Street, Hyannis,MA 02601w � - Tp Office: 508 862-1038 �IiN OPe Fax: 508-790-6230 EXPRESS�PEJRMII dxPPLrCp�TION �RNST,gei Not Map/parcel Number /� J Property Address / ,� C� Residential OR ❑Commercial� Value of Work Owner's Name&Address / / l c y(k>? e Contractor's Name : ,yy� ��� Telephone Number - T Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: .a ❑�., I �a sole proprietor . I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) e-roof(not stripping. Going over existing layers of roof) Re-side �eplacement Windows. U-Value ' 3 3 (maximum A4) ❑ Other(specify) Alew /,v[h S`�-^ *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic.Conservation.etc. f I Sisnature. txpmtrg r The Commonwealth of Massachusens __ =r Department of Industrial Accidents Meto/lapestlgatloos _' 600 Washington Street 43 Boston,Mass. 02111 Workers' Co m ensation Insurance Affidavit name 3 6 7�a city `Ih, � dot�CJ I phone it � ,S 77 1 )JI .0—I am a homeowner peaorming all work mysdL �❑ I am a sole azoarietor and have no one in aav caaidty ❑ I am an employer providing workers.' compmsauea for my employees working on this job. x,. ..:...::.:....::::...::•:...:.:.:. :.:.. w.w:..... •:iiii;}i;:�:..:......nw.v:?:::..:.......:::•....:::::::.v:::::::::::n�::::.yw:{3}:i}:v}'J:•+:{4ti{ .::•• ..... .vifiin�v r:::::?;h ................................................ ::::::.�::.iiiii:}:iii ii:{i:i:i:�iii::':::: ::i;i{i::•i} :i 'i:!•:::i:: '::.::. ............ ;.:v:.:................................t:w:.v::.v::.:v:•:::w.x•.:::{::{•:r.+:. 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