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0006 LEXINGTON DRIVE
k I i Town of Barnstable Building BAPOWA t Post This Card So That rt is Uis�ble From the,,S-treat •Approved Plan Must be�Reta" on Jo and#his Card Must be Kept M"� Posted UntilFinal ln`spection Has Been Made � Y �= Permit Where a Certificate of Occupancy is Required,such Builclmg$hall Not be®ccup�ed unto a Final Inspection has been made Permit NO. B-18-2572 Applicant,Name: todd leduc Approvals. Date Issued: 08/24/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 02/24/2019 Foundation: Location: 6 LEXINGTON DRIVE, HYANNIS Map/Lot 270-101-021 Zoning District: . "RB Sheathing: Contractor Name TODD LEDUC Framing: 1 Owner on Record: BUDREAU,CHRISTOPHER J&JANE D �F g 41, Address: 6 LEXINGTON DRIVE �Contracctor license CSSL 106019 2 HYANNIS,MA 02601 .r �� EstProect Cost: $5 000.00 XT i J Chimney: Description: Air sealing and insulation of attic flat and common wall Permit Fee: $85.00: Insulation: $85.00 Project Review Req: , Date. 8/24/2018 Final: Plumbing/Gas F r ° Rough Plumbing: Building Official Final Plumbing: . g y , This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sixmonthsiter issuance. Rough Gas: All work authorized by this permit shall conform to the approved appl ation,'and the,approved construction documents for,which this permit has been granted. All construction,alterations and changes of use of any building and str>.uctures shall be in compliance with the local zomng'by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for publici nspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures byAf Building and Fire Officials aieaprovided mthis permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing � � a Rough: 2.Sheathing Inspection %' '" 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. - Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: 1 11 Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Z Ova Fa wt i 19 a 4 (o �QXv�dVl �I I - i q� CCAJ i Send Response to Requester Page 1 of 1 t rget tonts d .,ct My Dashboard Documents Report Manager Admin Help Welcome Brian Florence(Building Department Department,Department RA Role)My Profile(Logout] Satk Send Response to Requester Report an Issue Send Dail Cancel Date: 01102/2018 To: (kiambne@yahoo.com cc: Subject: Request#2017 0110:Response to your Request ........__1 Body: � � Font Name Size .._.._......_____._-___.. ...,,i Barnstable,MA iZ ublic Record Request Number:2017-0110 equester:Kimberly Lamb Request Date:Wednesday,December 27,2017 9:00:00 AM esponse Due Date:Wednesday,January 10,2018 Jai Dear Kimberly Lamb: e have completed the work in reference to your request as referenced above.The response is given below.In addition please refer to the attachments which includes the data and the description of response content,which we believe should suffice for your needs. �d Good Morning,the above request for a Zoning Compliance Certificate has the following fee of $75.00. Once the fee has been paid the request will e processed. Any questions please call 508-862-4038. hank you, Debi f you have any questions or comments,please do not hesitate to contact us at the following email address. Thank you. rian Florence,Department RAO Y Send Mail Crrncei ©Copyright 2009-2016 Stellar/Vistinv- All Rights Reserved. sncu TOP https://www.townforms.com/FOIADirect-BarnstableMA/Private/Intemal/Application/Email... 1/2/2018 Barrows, Debi From: Florence, Brian Sent: Thursday, December 28, 2017 4:47 PM To: Barrows, Debi Subject: FW: [ Probable SPAM ] Request# 2017-0110: New Request Received Hi Debi, Can you have this processed please? Thank you, -Brian From: admin=barnstable.foiadirect.gov@townforms.com [mailto:admin=barnstable.foiadirect.gov@townforms.com] On Behalf Of admin(@barnstable.foiadirect.gov Sent: Tuesday, December 26, 2017 8:53 PM To: Florence, Brian Cc: Quirk, Ann Subject: [ Probable SPAM ] Request# 2017-0110 : New Request Received Barnstable, MA Public Record Request Number:2017-0110 Requester: Kimberly Lamb Request Date:.Wednesday, December 27,2017 9:00:00 AM Response Due Date:Wednesday,January 10, 2018 Request Detail: I have an accepted offer for the property at 6 lexington Drive in Hyannis, MA and would like to request status of all permits that had been pulled for work on the property to confirm there are no open or missing permits for renovation or additions to the house or property. Hi Brian Florence We just have received a new Public Records Request. The request details are shown above. By design you are receiving this request first. Please evaluate and assign to the proper department and personnel in order to start working on the response. Please click the following link to arrive at your log in screen. https://www.townforms.com/FOIADirect-BamstableMA/ Thank you. Barnstable FOIADirect Administrator i Please be advised that the Massachusetts Secretary of State considers e-mail to be a public record, and therefore subject to public access under the Massachusetts Public Records Law,M.G.L. c. 66 § 10. "This electronic message and any files attached hereto could contain confidential or privileged information from the Barnstable Building Department Department. This information is intended to be for the use of the individuals or entities to whom it is addressed only. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is strictly prohibited. If you have received this transmission in error, please notify the sender by reply email and destroy all copies of this message." 2 � _ Iln , a� i�s� ���x �� ����I� 4� �� n � (50�) 3 �� - ally -� � ' �� ❑x REQUIRED: Attach 8h x I 1 inch map(e.g.USGS Quad sheet)showing location c Nearest Public-Use Aviation Facility: I'nnt'dr type,below,the name of person filing this request for review. Signature ****************DO NOT WRITE BELOW THIS LINT MAC's AIRSPACE ANALYSIS concludes the following: Closest Runway: Distance from RW end: ❑ Project violates MGL Ch.90, §3513 by ft. [Ri. ❑ Project violates MGL Ch.90, §3513 by ft. [R ❑ Project violates 702 CMR,§5.03(1)(a)by ft. [Ri. ❑ Project violates 702 CMR,§5.03(2)(a)by ft. [R ❑ Project does not violate MAC Airspace Laws or Regs. MAC hereby issues the following DETERMINATION: ❑ Permit is required*pursuant to MGL Ch.90, §3513,for: ❑ Sponsor must submit a separate written request for a MAC Counsel,Massachusetts Aeronautics Commission, 10 Park' ❑ Permit is not required pursuant to MGL Ch.90,§3513 ❑ ❑ MAC has the following additional concerns: ❑ FAA Standards ❑ Noise ❑ Traffic Pattern ❑ Wildlife ❑ VFR Route ❑ Other This determination is based on the foregoing description of the p provided by the Sponsor. Any change in the data provided to the null and void and will necessitate a new request for review. Mgr.of Airport Engineering,Massachusetts Aeronau MAC Form E-10 I i ItJ 1 1 �� (� Q I �_ � � op � Q . - o •' • .t, i . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION,,, Map Parcel: ?d� � . :Application # ' Health Division = Date Issued Conservation Division :;Application Fee Planning:Dept. I =3 I .,".Permit Fee; le Date Definitive Plan Approved by Planning Board Historic = OKH Preservation / Hyannis Project Street Address Village [ 'NJ no Owner(''/J,�ti►; �/�ce . Ue--lere W Address Telephone _ �mg 4/1 2!S L) Permit Request /a Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ,Z d a � Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family :Q/ Two Family ❑ Multi-Family(# units) Age of Existing Structure 8 0 Historic House: ❑Yes E(No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new i Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 114s ❑Oil ❑ Electric ❑Other , . Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood al stogy ❑)'es ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑e isting 1 newt; size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: o rr Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER O ffOMEOWNER - -- r 2 n ------- _ Name Telephone Number 2 '16 — 5/c3. Address _ •�P a,-) Le License # .J ��.� n, Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE �(.2j FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: / FOUNDATION `✓os FRAME 4 } INSULATION FIREPLACE - t' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH / f FINAL FINAL BUILDINGco DATE CLOSED OUT }} ASSOCIATION PLAN NO. t a ' t . J The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 v www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers APPUcant Information ` Please Print Legibly Name (Business/OrganizationAn"dual): Address: 6 Le aC n r, -v City/State/Zip: ,O N 0 02-.4-6 (Phone.#: Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. Vtlmodcling w construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the attached sheet 7. • ship and have no employees These sub-contractors have g, [:]Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp.insurance comp.insurance.# ,�,�equiracl.] S. ❑ We are a corporation and its 10.❑ Electrical repairs or additions' 3.L� I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp,insurance required.] ''Any applicant that checks box#1 must also fill out the section below sbovAng their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors trust submit a new affidavit indicating such. tcontractors that check this box must attached an additional sheet showing the name of the sub-contractm and state whether or not those entities have employers. If the sub-contractors have employees,they must provide their workers'comp.policy number. I tun an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: . Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy 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 fuse up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of _ Investigations of the bIA for insurance coverage verification. I do hereby ce under the pains penalties of perjury that the information provided above is true and correct Si m atur Date: _ Phone##: ` r offXymKise only. Do not write in this area, to be completed by city or town offeciaL City or Town: Perm.inicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Toym Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and his tuctions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance;construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL,chapter 152, §25C(6) also states that"every st-ateor local licensing agency`shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL ohapter 152, §25C(7) states `Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance RZth the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, i.f necessary, supply sub-contractor(s)name(s), addresses) and phone number(s) along with their certificates) of insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for.the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Towli Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permiVUcensc number which will be used as a reference number. In addition, an applicant that must submit multiple permit/licensc applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number: The C6mmozlwi,- t i of Massachusetts Dep.artmmt of Industrial Accidents Office of luvestigati.ons 600 Washington Street BQstan, MA 02111 Tel. # 617-727-49-0.0 ex t 4.05 Qr 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www-.mass.gov/dia THME Town of Barnstable Regulatory Services pKA �, Thomas F.Geiler,Director �jOTEDµIC�16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town-barnstable.ma.us Office: 508-862-403 8 Fax: 509-790-6230 Property Owner Must Complete and'Sign This Section If Using ABuilder 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 Form on the reverse side. O:FORMS:O WNERPERMISSION - Town of Barnstable tp�y4- Regulatory Services Thomas F. Geller,Director' • a A RNTSCAW.F_ MA3.S g �olfD 16 Building Division Tom Perry,Building Commissioner www.town.barnstable-ma.us Office: 50 9-962-403 8 Fax: 508-790-6230 HOTIEOWNER LICENSE EXEMPTION Please Print DATE: V— OB J LOCATION: nun cr street village "HOMEOWNER": l name home phone# work phone# c CURRENT MAILING ADDRESS: � �'e.X f> cityltawo 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. DEF NMON 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"asst es responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned.."homeowner"certifies thathe/she understands the Tpwn of Barpstable,Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requir nts. Signatzne of Homco Approval of Building Official Note: Throe-family dwcUings 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 bomeowmr 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 peson(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this cxenrptimn are unaware that they an assuming the responsibilities of a supervisor(see Appendix Q. Rules&Rcgulations'fm Licensing Construction Supervisors,Section 2.15) This lack of awareness often msuli;in serious problems,particularly when the homeowner hiirs unlicensed persons. In this case,our Board cannot proceed against the unlicensed person'as it would with a licensed Supevisw. The homeowner acting as Supervisor is ultimately nsponsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner c rtify drat�tlshe understeads the responsibilities of a Supervisor. On the last page of this issue is a form cun-mtly used by several towns You may tale t amend and adopt curb a fwnfeertifieation.for use in your community. Q:forms:homccxcmpt —)1-7 4 MO-H TG A G Z IIVSP-EC TIO lV PLA1V APPLICANT: BUDREAU TOWN: HY.ANNIS LOT 36 IO . Op �L DECK O � LOT 37 LOT 27 r FLOOD PANEL: 250001 0005 C FLOOD ZONE: "C" DATE MAP REVISED: 08/19/1985 := -. _ _ •- _ 'i _ __ _ = DATE: 07/08/08 SCALE: 1" = 26' CAPE :COD. FIVE 'CENTS SAMNGS BANK DEED REF: 19573-132 PLAN REF: 383-31. _ I Y n 'TELEPHONE: 508-428-0055 YANKEE LAND SURVEY COMPANY, INC FAX: 508:-420-5553 40 Industry Road, Marstons Mills, MA 02648 yonkeesurvey®comcost.net I www.yankeesurvey.com F 39827 SH 36"stairs (3) 2x8 p.t.rim and floor joists ` 1 I I I I I I 1 1 I I I I 16 I I 2x8 p.t. ledger' I I I I I I I I I I 8''x48'' cone piers (3) I 1 12, I 1 I 1 I c I I ® 6 Lexington Dr lead flashing e I Hyannis MA f, 1 I n I I Y II I I I I I - II I I 1 I I I 1 f-T _Inch 44 Assessor's map and lot number ...l %!� . . ���. �- THE ' �.�f Tpfr Sewage Permit number Z BARNSTABLE, i House number. ""Bq 'Ep MPy At' TOWNS :OF BARNSTABLE BUILDING INSPECTOR Construct; Single Family Dwelling ` APPLICATION FOR PERMIT TO ` Wood Frame TYPE OF CONSTRUCTION ................................................................................................... . September 26, 84 ................................................. ..........19........ I TO THE INSPECTOR OF BUILDINGS: j The undersigned hereby applies for a permit according to the following information: Location ...Lot...# 3.7. T:f?x�..?a.�f.r��l.. ??+';.�Tr?. TIN—•-rL-- n�0 .................... .................. . •y. s�•e:.d •y• �;u i ProposedUse ........................:....................................................................................................................................................... i Hyannis.. . Zoning District .Re..8.......................................................:..Fire District ............. ........... ...................... Capricorn Realtor Trust Address 765 Falmouth Road, Hyannis.? .Mass. Nameof Owner ........................................ ............................. ..... .............. Name of Builderranco Real Est.DeV.CO. ,InoAddress ..............5�� ........................................ .................... P Nameof Architect ....:.......................................................:.....Address .................................................................................... SAX Number of Rooms ...........Foundation ........P.C .................................................... ................. . ... Clapboard and/or Shingles As halt Shin les Exterior ......Roofing Floors Carpet Sheetrock Interior .. ......................•............•........ . ....... ............ ... !� Gas F.W.A. Heating .... ........ .....................Plumbing ...........TWO ..............CQj7PeY.... None 40,040.00 Fireplace ..................................................................................Approximate Cost ..... ...... .................... Definitive Plan Approved by .Planning :Board ---------------____-----------19________. Area 1��r6..•s�• f'�.......... L i Diagram of Lot and Building with Dimensions Fee ..:...:...................................... SUBJECT TO APPROVAL OF BOARD .OF HEALTH 1 v � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the T yn of Barnstable regarding.the above construction. ~A Name .. ...... rees. i Construction Supervisor's'License ...0.009.89............. . CAPRICQRN REALTY TRUST A=270-101 27511 Story No .................. Permit for ..........;�t9ry.............. ....................... ............. ......... Location ..Lot„...37,. 6 LexLqgt.Qxj..Driv .... ... .................. ........Hyannis........... ...........annis ............................................ Owner ..Capricorn Realt..............ry.. ............... Type of Construction ....FXaMe.......................... ................................................................................ Plot ............................ Lot ................................ .Permit Granted .....February.... .........19 85 Date of Inspection ....................................19 Date Completed ......................................19 Or eW I i �. l 'I �; SECTION 8 HOUSING INSPECTION CHECKLIST NAME OF FAMILY 4 PHONE NO. TENANT APPLICATION NO. 7 INSPECTOR PHONE N_O, DATE OF IN P CTI TYPE OF INSPECTION ❑ Audit ❑ Initial ❑ Special ❑ Reinspection ❑ Annual LAST INSPECTOR: INFORMATION STREET CITY Number of Children HOUSING TYPE UNIT r �'43 � t in family with (Check as appropriate) GRADE Elevated Blood Level STATE ZIP ❑ Manufactured Home FAMILY COMP MALE FEMALE ❑ Single Family Detached A ❑ t ADULTS ❑ Duplex or Two Family B ❑ NA EOFOWNERORAGENTAUTHORIZEDTOLEASEUNITINSPECTED PHONE NO. MINORS ❑ 3 Family House C ❑ _11%R(k i a ❑ Row House or Town House D ❑ ADDRESS OF OWNER OF AGENT CHILDREN ❑ Low Rise:3 or 4 Stories (UNDER 6) including Garden Apartment • • LBUILDING h Rise:5 or more stories FAMILY SUBSIDY SIZE: lti Family • No.of rooms used for sleeping ❑ YES.❑ NO ❑ Pass Fail ❑ Inconclusive Date Passed (or could be used if unit is vacant) PERMIT ❑ YES ❑ NO INSPECTION ITEM 1.LIVING ROOM YES No IN.• COMMENT PPRO NO. PASS FAIL CONIC �- .�;, INRIAUDATE 1.1 Living Room Present 1.2 Electricity 1.3 Electrical Hazards 1.4 Security 1.5 Window Condition,Screens } [} ,, 1.6 Ceiling Condition 1.7 Wall Condition F 1.8 Floor Condition ITEM 2.KITCHEN YES NO IN.- N0. PASS FAIL cONC COMMENT MALMv. INRIALfDATE 2.1 Kitchen Area Present 2.2 Electricity a 2.3 Electrical Hazards 2.4 Security 2.5 Window Condition,Screens (_/ 2.6 Ceiling Condition 2.7 Wall Condition 2.8 Floor Condition 2.9 Stove or range with oven (TT) (LL) 2.10 Refrigerator (TT) (LL) 2.11 Kitchen sink 2.12 Kitchen space for storage&prep 2.13 Ventilation ITEM 3.BATHROOM Pass NO coNc COMMENT INRUL DATE - FINAL NO. 3.1 Bathroom Present 3.2 Electricity 3.3 Electrical Hazards 3.4 Security 3.5 Window Condition,Screens 3.6 Ceiling Condition 3.7 Wall Condition 3.8 Floor Condition i" 3.9 Flush Toilet in enclosed room in unit 3.10 Fixed washbasin or lavatory in unit 3.11 Tub or Shower in unit 3.12 Bathroom ventilation ITEM 4.OTHER ROOMS USED YES NO IN.- FINAL COMMENT APPF01 NO. FOR LIVING&HALLS PASS FAIL CONIC INrtuuDATE 4.1 Room Code" = Room Location (Check One) ❑ Right/Center/Left (Check One) ❑ Front/Center/Rear_Floor Level 4.2 Electricity/Illumination 4.3 Electrical Hazards 4.4 Window Condition 4.5 Security ifLIJ P n 4.6 Ceiling Condition 4.7 Wall Condition 4.8 Floor Condition 4.9 Natural Light ROOM CODES: 1=Bedroom or any other room used for sleeping(regardless of type of room) 3=Second Living Room,Family Room,Den,Playroom,TV ROOM 5=Additional Bathroom 7=Garage 9=Other 2=Dining Room,or Dining Area 4=Entrance Halls,Corridors,Halls,Staircases 6=Attic 8=Laundry White Copy for Agency-Yellow Copy for Landlord-Pink Copy for Tenant- ITEM 4.OTHER ROOMS USED YES NO IN.- COMMENTnAPPROV. NO. FOR LIVING&HALLS PASS FAIL CONC 4.1 Room Code'0 Room Location Check One ❑ Right/Center/Left Check One ❑ Front/Center/Rear Floor Level 4.2 Electricity/illumination 4.3 Electrical Hazards 4.4 Security 4.5 Window Condition r.i L) 4.6 Ceiling Condition } t' 4.7 Wall Condition 4.8 Floor Condition n 4.9 Natural Light 4.1 Room Code"0 Room Location (Check One) ❑ Right/Center/Left (Check One) ❑ Front/Center/Rear=Floor Level 4.2 Electricity/Illumination 4.3 Electrical Hazards . V.k, ` 4.4 Security 4.5 Window Condition 4.6 Ceiling Condition 4.7 Wall Condition 4.8 Floor Condition 4.9 Natural Light 4.1 Room Code'= Room Location (Check One) ❑ Right/Center/Left (Check One)' ❑ Front/Center/Rear Floor Level 4.2 Electricity/Illumination 4.3 Electrical Hazards 4.4 Security 4.5 Window Condition 4.6 Ceiling Condition 4.7 Wall Condition 4.8 Floor Condition 'ROOM CODES t=Bedroom or any other room used for sleeping(regardless of type of room) 3=Second Living Room,Family Room,Den,Playroom,TV ROOM 5=Additional Bathroom 7=Garage 9=Other 2=Dining Room.or Dining Area 4=Entrance Halls,Corridors,Halls,Staircases 6=Attic 8=Laundry ITEM 5.ALL SECONDARY ROOMS YES NO IN.- COMMENT FINAL ' NO. Rooms not used for Living) "PASS FAIL CONIC Ixm PROV 5.1 NONE Go to Part 6 5.2 Security 5.3 Electrical Hazards Other Potentially Hazardous 5.4 Features in an of these Rooms ITEM FINAL 6.BUILDING EXTERIOR YES No IN.- COMMENT a OV. NO. PASS FAIL CONIC INmALIDATE 6.1 Condition of Foundation 6.2 Condition of Stairs,Rails,and Porches 6.3 Condition of Roof and Gutters 6.4 Condition of Exterior Surfaces 6.5 Condition of Chimney ( 6.7 Manufactured Homes:Tie Downs 6.8 Manufactured Homes:Smoke Detectors - ITEM HEATING&PLUMBING A S No IN. COMMENT APB• - FINAL N0. PASS FAIL CONIC INMAVMTE 7.1 Adequacy of Heating Equipment 7.2 Safety of Heating of Equipment 7.3 Ventilation/Cooling 7.4 Water Heater Gas/Elec/Oil 7.5 Approvable Water Supply 7.6 Plumbing 7.7 Sewer Connection ITEM S.GENERAL HEALTH YES NO IN.- FINAL APPaon. NO. AND SAFETY Pass FAIL CONIC COMMENT inmAwATE 8.1 Access to Unit 8.2 Lead Paint,LOC ❑ Not Applicable 8.3 Evidence of Infestation 8.4 Garbage and Debris 8.5 Refuse Disposal 8.6 Interior Stairs and Common Halls 8.7 Other Interior Hazards 8.8 Elevators ❑ Not Applicable 8.9 Interior Air Quality 8.10 Site and Neighborhood Conditions 8.11 Entry Door Security ❑ Not Applicable 9.1 Heating System Type ❑ Gas ❑ Oil ❑ Electric ❑ Other ITEM . , YES NO IN. N0: PASS -FAIL CtICm Comm .353 Asbestos Material -'- .482 1 Smoke Detectors This inspection has been performed to determine compliance under the HUD/DHCD Section 8 Programs.While some of the inspection requirements may be similar or identical to provisions of the(coal codes this inspection does not certify compliance with said codes.In all instances,it is the Owner's responsibility to maintain property to meet all applicable state and local codes and a tenant's right to request an inspection by the local code enforcement a enc . Party Present at Inspection - Inspector Signature Date Date Date a•. Al � p��1hC�1 270101021 8hF?' V �4 003194 c7t 7z� 0177472 y LOT 37 ��,•,•.. <r f.� 0 25 �� resv 'CIU DANA,CHARLES F&MARY C of Cam°ss 101 , � 00001056 ti 157 LONG HILL STREET r ea s. 85 EAST HARTFORD CT ` 06108 e, s tYGc,, \00 2552 000 100193 T '°" 8847 152 y \, j aKyrfsf DANA CHARLES F&MARY C Deeef `� 1093 ed Re: 8847/152 000039000 s 000085000 f epfu s< 0000000000 a Lo f 6 LEXINGTON DRIVE od d x 2034 tg:, 0000 ° '�� :tin�\`�F, -- ye• �,ry$. c? as o ro ovp Q.msW���-� ` C) I Z Gam" t . t Assessor's map and.-jot number C7K' T .2M/ir' E CF THE TO Sewage Permit number t. ,,MUST CONNECT TO TOWN SEWER a :1 ,/yy, r.. House number ... ���' '. . ........ ,{ =oo�"b 9 STABLE, 3 .TOWN; O . BA ON �1� liISTABLE - XRUIL 0 I NA INSPECTOR: r Construe Si tie Fa APPLICATION FOR PERMIT TO .... .....??';�- ..: ... TYPE .OF CONSTRUCTION W d F am 4¢.... . ....... ..... ....... ... ... ......... ......... ......... ......... ......... ............... r �, �`� _, . • Se tember 26 19$?�... �. rr.: TQ THE INSPECTOR OF BUILDINGS: ' The aundersi:gned hereby applies for„a permit according ito, the following information:' Location .:tot..A.3.7...: ........ 14%W',.1aLtOBI;..2r-i'V. . 4.Rrmj, Ida's5.,.................. ProposedUse ................ .. ... .................... Zoning Distract R.• B�............+ ..... ........................ Fire District. . .11 .!E J.1is......................... Name of,Ownei CapTloozu:.Rj3aJ.$y...'Ir.U..S t............Address. .'�.6,rj. �'8�11*.�1 •ROSG�r rH�i�Y�1�t��: Ma-s54 Name. of .BuildEFXWico...Real..E'B'1r,.Dex®.Go... ,Ina'Address ............ :S8,Ige: .. ..........., Name of Architect .............................................. ...... ..::..;..Addres's ......... .. ................ . � t Number of Rooms` .......5.1. :..:.:............ ....:.. . ... .. ..:. g .....:.foundation i. ... *'Q Exierior :...Cla., board.. .p andf�x'..Shizi�le8...: Roofing ,.Asphal-t Sh�:Mg�.e's Floors .....Carpet:........ Interior ��e;g-�Oe�.::c........ ............ ........id a WO pFeating G. S...... F.WA. ..... .Plumbing ..............T Y' « ? Fireplace. .N021@::. ......:... ....... :^...:..:.................................Approximate Cost ....... Q�.OQQ•«QQ. _ .... ...... 1 Definitive Plan Approved by Planning Board __ _:___ _____19 -______. Area �Q)r(.,. :�..:. t.�.,....... Diagram. of Lot and Bui'Id Fee ing'•with :Dimensions ✓ ; •x 7 = . SUBJECT'.TO APPROVAL OF BOARD OF HEALTH _ Y . 'OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to, all the Rules and Regulation's of the 14@wn of_Barnstable regarding the above< I construction. :Nam .... .. ...... „ Construction Supervisor's License ................ �oo�o9sg.. RICORN REALTY TRUST J; i E �. No 27511 Permit for One StorX.............. ... Single.F -?t><7 y...W.e11ing. .................... Location .. ?t..37.. 6..L,(�x1jlgtoa Drive.... Hyannis............................................... 1, -• ; Owner .Capricorn Rgalty...TZUS ....... Type of Construction' ...Trame... .......... , y. . < ............... ...... ......... , t Plot Lot. .............. Perrw�rt'•Granted .....ebrual.:T.-.. r... ......._19 85 ' .f Date of Inspection '....:. ...... ..19 w Date Complet'd,. �C ./\` .............19 ��. y C ^ rn i arm ,✓�. _ "� _ ' .. «. - �' < !.< o �w µ _ y' TOWN OF B .R1dSTABLE 27511 PermitNo. -------------------------------- L . Building Inspector cash ------— --- — - � x OCCUPANCY PERMIT Bond ----------�--L-- ----- Issued to Capricorn Realty Trust: Address Lot 37, 6^Lexington Drive, Hyannis Wiring Inspector :z 14 y Inspection date �/� ^ Plumbing Inspector . ti; Inspection date 7, Gas Inspector q R f AA--e, t}auJ sl Inspection date xEngineering Department /a ' Inspection date 7 OY Board of.Health Inspection-date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 4 ....I ............. 19.. ! /, �........ ..... . ....... V Building Inspector ': - -`A"' a4+ i e�P° °•mew TOWN OF BARNSTABLE BUILDING DEPARTMENT Z sasasr = TOWN OFFICE BUILDING rqa HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: /Z An Occupancy Permit has ibeen issued for the building authorized by Building Permit ... . ._ issued .to ............ .�'/CDC �t/.._ ."-.� ` ............ 5. � ... .. ..... �. ..� Please release the performance bond. .-.•..,., �2..:t.... .c'.eFko-a.�a.�„t-:Y+,r t-x...exx�.-:. -.4. .>.se xz.-..r>_-�.;:.s..",5�.. .c'k:::c.,.4. ,,.:�t.,.k..-�z-,..�:i:,.. .. s:,:f„h.. ':.. e� .:., ...a�..a;,,. .: _. ;.._ ........ .. .. .. .... ... .... .... .... _. D Z Sv ' rn�'.� rn o-o -pi Z D v 4 C v ,n� a. D n to z 467 Z - y to z xJtvGTot✓ fL,tl� �F c r 0 .� z 40, < D tar tt• 3 4 �5 E 8 lir 0OZ=— p 34 ' IS zmfq-� Z o..i to to Z I� -*� -40 � r z == v r- v a. Ic -i r ° O o z zozZn d v Z v 0 - ._ n .A!_ 0. f Z 00 -� Z3 . a v - ON Z = -4 O Lt rr3z-p-l p p X),,167 ���2 to r � m N ��' 34� qo CS �s" E= ' _ a ati -I. C •y0s :a c ci i p Cc)06o I`� � �►O_ov b f" �b D�0 Z z is 0-4 zxx D o �' �y, y v �" v "� DDN�r= 10 CIO, ' Z a y L p (^ 44 Town of Barnstable �pF THE rp� Regulatory Services xsragLe Thomas F. Geiler,Director ' P � MAS& Building Division 2�'39 AP s63q. �m R14�r��►�`� Tom Perry,Building Commissioner PMj 3:58 200 Main Street, Hyannis,MA 012601 www,town.barnstable,ma.us " uI'�I S10N Office: 508-862-403 8 Fax: 508-790-623( PERMIT# 'S FEE: : U C� SHED REGISTRATION 120 square feet or less Z �' 6 �l l/ Ct Gt v1 S .7tf Location of shed (address) Vi lage 0 7 Property owner's narfie Telephone number Size of Shed Map/Parcel# V13A-0 0 Signature Date Hyannis Main Street Waterfront Historic.District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30 &3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR.DETAILS, THIS FORM. MUST BE ACCOMPANIED BY A PLOT PLANT r i Q-forms-shedreg REV:042506 MORTGAGE' INSPE'CTIOIN PLAN APPLICANT: DUDREAi i TOWN: HY:ANNIS LOT 36 .� 1 . QQ, O � 0 DECK LOT o. LOT 27 7 � � x - , 00, ST FLOOD PANEL: 25000.1 0005 .0 FLOOD ZONE: "C" DATE MAP REVISED: 08/19/1985 - -- DATE: 07/08/08 SCALE: '1'" 20' CAPE COD FIVE CENTS SAVINGS BANK DEED REF„ 19573-132 PLAN REF: M3-31 _ c TELEPHONE: 508-428-0055 YANKEE LAND S'UR VEY COMPANY, INC FAX: 508-420-5553 40 Industry Road, Morstons Mills, MA 0.2648 yonkeesurvey@comcast.net Iwww.yankeesurvey.com 39827 SH YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). 'A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hail) DATE: a t O6 Fill in please: APPLICANT'S YOUR NAME: E //0N 5C 69y6-T�� M. BUSINESS YOUR HOME ADDRESS: 6 n d"I le t s a Sob% -3670217(t Nya-,n i S ► A 6a60) TELEPHONE # Home Telephone Number 5'06- 7753g, 17 NAME OF NEW BUSINESS Besf k ecre TYPE OF BUSINESS ear) %r4 SerV/I�Ps IS THIS A HOME OCCUPATION? ,� YES -NO: Have you been.given approval from the building ivision? YES NO ADDRESS OF BUSINESS 1-eXl ri fb� . ve, i5 PA# oAto AP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. -(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.. 1. BUILDING COM SI ER'S OFFICE. This individu 1 has b mfSrm o permit requirements that pertain to this type of business. Author' d Sig re** COMMENTS( f 2. B ARD OF HEALTH This individual s 9bein in Xm of p t quirements that pertain to this type of business. orized Signature** COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHOR TY) This individual h en inf d o the " s6gey2ments that pertain to this type of business. Authorized Signature** COMMENTS: Town of Barnstable THE Ins Regulatory Services P Thomas F.Geiler,Director • Building Division snxxsTaen.E. � - �� .1KAM1�$ Tom Perry,Building Commissioner rfD Mp'l s 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: �s Permit#: / �S HOME OCCUPATION REGISTRATION Date: �4I CI66 Name:_ t 1- w SLN-NC I LCiC Phone#: Sok -36 7 22-1 7� Address: 6 Le,�l n a 4-cn � I r/Q. Village: farr1 S 4-rC Ue- Name of Business: ge-s ��" Secret Type of Business: 61 e 4.t1 r n g Se r U1 C c l Map/Lot / ) V l IN'I'EN'T: It is the intent of.this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there 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,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: fll Date: 6 B� r Homeoc.doc Rev.5130103 �a Town of Barnstable *Permitf� D � Expires 6 months from issue date Regulatory Services Fee Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address 1, Ue x I ng tor-, �q i ye, 11 ay,✓1/ S M H r).,�_b 01 C9 Residential Value of Work 1000 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address G I t®N S C H N T L C2 6. Le.;<il�.� 'bl-. r�fl✓C fT�QMht�S M� 6;2-601 Contractor's Name Telephone Number i Home Improvement Contractor License#(if applicable) 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 be.on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side (� Replacement Windows/doors/sliders. U-Value . 4`i (maximum.44) *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.is required. SIGNATURE: t9 Q:Forms:expmtrg Revise061306 ' 4'• - The Commonwealth of Massachusetts Department.of Industrial Accidents Office of Investigations d 600 Washington Street Boston,MA 02111 , ' ;<vww.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):. 6,- NtN S G..6AlE 'f LC C, •Address: (11 L e.'T l r.el+o V of 1 L-4-9. City/State/Zip: Ya,- r,1 S ML02-60 Phone A S o d 36 7 21 +7(t 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 construction . 2.❑ I am a•sole proprietor or partner- listed on the'attached sheet, 7. ❑Remodeling ship and have no employees - These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance,$, required.] 5• ❑ We are a corporation and its ME]Electrical repairs or additions 3. I am ahomeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance,required.] t c, 152, §1(4),and we have no employees. [No workers' . •13.❑ Other comp. insurance required.] , '`Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet sbowing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must providb their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below isthe policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date), Failure,to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereby certify:ender the pains•and penalties of perjury that the information provided above is true andcorrect: Sienature• Date: az OCT A00? Phone#: _SO 1 367 .2/ Official use only. Do not write in this area,'tb be completed by city or town ofj7clal City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: ..Phone#: t oF1HE Town of Barnstable Regulatory Services r sM IN3TABt.B. : Thomas F.Geiler,Director MASS. i639• a.�� Building Division lE0 µpal 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: L II r JOB LOCATION: l� L2x J ✓1�1 1C)� �r [isx le- numbier street village l"HOMEOWNER": -64 SC-44 NtrLC - 50k 367�174 soy 771 36 3? name home phone# work phone# CURRENT MAILING ADDRESS: (� Len I✓15 f vA 0(4" ,tV-- 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 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 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. Town of Barnstable Regulatory Services t BAMSPABU& ' Thomas F.Geiler,Director MASS. 1639 Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 May 22,2001 Charles Dana 157 Long Hill Street East Hartford,CT 06108 Re: 6 Lexington Drive,Hyannis(Map 270 Parcel 101021) Dear Property Owner: A review of our records,including the permitting history of 6 Lexington Drive as well as the Zoning Board of Appeals records indicates that the use of that address as anything other than a single- family home is illegal. You are hereby ordered to discontinue the use of the above referenced property as it is now being used and restore it to a single-family home. You are to accomplish this work and notify this office to inspect within 14 days of your receipt of this letter. A building permit must be applied for to redesign the layout to accommodate the conversion. You ' must do this before you make any changes. You have the right to appeal this decision. If you so choose,we will be more than happy to help you. If we do not hear from you within the 14 days,we will be forced to seek criminal action against you. Very truly yours, Gloria M.Urenas Zoning Enforcement Officer /lb q-forms-g980218a �'THE r', Town of Barnstable *Permit# ago a Expires 6 months from isssu date Regulatory Services Fee BARMASLE, • r 059� ,m� : Thomas F.Geiler,Director rEDMP't� Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma:us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X--Press Imprint. Map/parcel Number Property_Address .x• s? KResidential Value of Work 166, Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address C/I/S f4-i,1A /3 0 P Ile -r' L X 5C. Contractor's Name Telepho R 'e� a Home Improvement Contractor License#(if applicable) X-pR Construction Supervisor's License#(if applicable) 16 2�12 ❑Workman's Compensation Insurance STABLE Check one: .-TOWN OF-BARN ❑ :I am.a sole proprietor (� I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name ' Workman's Comp.Policy# . Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roofl. [L/�'—Re-side ". . #of doors. ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windowsEJ _ ' Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate.Electrical&Fire Permits required. *Where required:_Issuance of thus permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. iIGNATURE: k\WPFlLES\FORMS\building permit forms\EXPRESS.doC I .evised 053012 t_ i 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 U9 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lef!ibly Name (Business/Organization/Individual): KC 44 c) C-* Vl'J —e Cr, iJ Address: L Z__ qr 4 I'll- City/State/Zip: Y_f�GnnJ--_$ 0.7-6 0 Phone#: 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 construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.i.l.am a homeowner doing all work officers have exercised their I LEI Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. t Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under t epains andpenalties ofperjury that the information provided above is true and correct. Si ature: �,l!� -z. i' Date: 7 - `_;2-tJ / if Phone#: S—J 1V Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i oFt"E - • HARMAB14 • Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division a Thomas Perry,CBO Building Commissioner_ 200 Main Street, Hyannis,MA 02601 www.town.6arnstable.ina.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder h , 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 Form on the reverse side. I . Q:\WPFMES\FORMS\building permit formsTEXPRESS.doc . Revised 051811 f . Ali THE 'own of Barnstable Regulatory Services 9 $' Thomas F. Geiler,Director Ep;p.,A`� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax, 508-790-6230 HOMEOWNER LICENSE EXEMPTION i —7 Please Print DATE: / ` 1 G �2,=f y—� tt11. JOB LOCATION: ('!; L��I-?G,1 6-il9 number street village xorowNER":rA VI sfj F.>��0D/tea�� �a�S3Y-l y name . home phone# work phone# CURRENT MAILING ADDRESS: & cityflown 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) I 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 require ents and that he/she will comply with said procedures and requirements. SignatureofHomeo er 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 ag-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\ENPRESS.doc Revised_051811 Property Location: 6 LEXINGTON DRIVE MAP ID: 270/101/021// Vision ID: 20093 Other ID: Bldg#: 1 Card 1 of 1 Print Date:05/22/2001 �� . escription Coae lAppraisea value Assessed value %FURBAN,MARIA A LEXINGTON DR ' ' 801 YANNIS,MA 02601 SIDNTL 1010 85,000 85,000 IVE DATA-Barn.,MA ccoun an e Tax Dist. 400 Land Ct# UP er.Prop. UP FY03 #SR I S I ON Life Estate DL 1 LOT 37 Notes: DL2 CIS ID 7.0t.11 , U IN- go .WANEJ� ..s --.. mom, ,z :... r. ;': % r' auk .:. �,.`•� ;- ; , r. Code Assessed Value -Y r. Code� ssesse �value Yr. Code ssesseValueV NIDER,ROBERT&CAROL T 4621/226 07/15/1985 Q I 75,300 RANCO,NICHOLAS D TR 4204/266 08/15/1984 U V 0 A 2001 1010 859000 2000 1010 67,0001999 1010 67,000 Total: To-tar- 92, Total: 92,10 41 R_. is signature ac now a ges a visit by a Data Co ector or ssessor Year lypelDescription Amount (-ode Description Number Amount Comm.Int. � r , Appraised Bldg.Value(Card) 82,300 Appraised XF(B)Value(Bldg) 2,700 ota: Appraised OB(L)Value(Bldg) 0 s , Appraised n a (Bldg) 39,00 t .. •> - .. -�,. pedal Land Value VaWWI N% lue e 0 Total Appraised Card Value 124,000 Total Appraised Parcel Value 124,000 Valuation Method: Cost/Market Valuation et TotalAppraised Parcel Value 124,000 a , ,.:,.. r �c,: M„ .�. "q.., .,.„. :.o-. ..r...• ,- .:, '.0 ,. ,...>.: '.> -.r.�-�. s-fir a .. ' eYmZtIssue Date lype Description Amount Insp.Date o Comp. Date Comp. Comments " ate ID CA PurposelKesult p g p �. pecia ruing �. nit rice an a ue I Wit)se o e escn hon one ronta e e t n:ts rat rice actor actor otes- ing a k am o es: Total Card�and unitsiarce ota an rea: 6.25 �'otal LandValue , Property Location: 6 LEXINGTON DRIVE MAP ID: 270/101/021// Vision ID:20093 Other ID: Bldg#: 1 Card 1 of 1 Print Date: 05/22/2001 . ..G _._.u'._.Zs. .... MIL ?.z -: T ,—�`„ ... _.'��dC .3.k„3%`�e-_-�' �< .'.. ..� _, >:.., � ,-...-. - i, .�,� �';R ..a ,.i,. .. .," �.d,_::.. X.. ,"�4. .,.�PdL•..n. )� Ek,," Element Description Commercial Data Dements Style/Type H RanchElement Ca. I Ch. Description ode] 1 Residential ea ade C Average Grade Frame Type Baths/Plumbing tones 1 Story ccupancy 0Ceiling/Wail ooms/Prtns 10 1 Exterior Wall 1 14 Wood Shingle /o Common Wall 2 11 Clapboard Wall Height Roof Structure 03 able/Hip 12 Roof Cover 03 sph/F GIs/Cmp 44 Interior Wall 1 05 Drywall . .,. 2 Element o e Description ractor Interior Floor 1 14 Carpet omp ex 2 Floor Adj Unit Location eating Fuel 03 Gas Heating Type 04 Hot Air Number of Units BAS C Type 01 None Number of Levels 4 BMT 2 /o Ownership Bedrooms 3 Bedrooms Bathrooms 2 2 Bathrooms I ^ 0 Full �. �� , na j. ase Kate Total Rooms 5 5 Rooms Size Adj.Factor 1.18002 ath Type Grade(Q)Index .01 YP Adj.Base Rate 71.51 Kitchen Style Bldg.Value New 91,461 44 Year Built 1985 ff.Year Built A)1990 rml Physcl Dep 10 uncnl Obslnc con Obslnc � pecl.Cond.Code .; pecl Cond% Go de Description Percentage Overall%Cond. 0 mge amlUU eprec.Bldg Value 2,300 + ', h,.' ,.r#' + - '>. z. _ °s Vie` .., .' ,i`.. ��• t, P"a V0, Code Description LIB units Unit Price Yr. Dp t %C;nd Apr. Value Fireplace �.,ar ;<.. "., ., -• �. 4::� ': % -tea.', = ,..A? Code Description LivingArea ross Area .Area Unit Cost undeprec. Value First Floor , , BMT Basement Area 0 1,056 211 14.29 15,089 WDK Wood Deck' 0 120 12 7.15 858 xItt. Groi LivlLease Area g a: 91,461 i v a qgd�! ° ,. s asp 6 Lexington Dr., Hyannis 9/12/07 77 Ply 1,4 vl Y y= p r yr. < Y 'd 'i •�- 4 31, 6 Lexington Dr., Hyannis 9/ 2/07 ro t .p d010 O NW, 3 d � k � I t t =sue i R s� i Tkry G�' a THE FOLLOWING IS/ARE THE BEST i IMAGES FROM POOR QUALITY ORIGWAL(S) m -A. Pill DATA } o' 1 � • 1 1 1 � 1' :• �1 1: '1 . 1 low LOIN �. `}✓. 1r � •• � � i � i 1 . ,i ����', �' �� � '�,�� ,i° � as t'�� +�.� t >i +�� 'rr{ �^ .�. MAY A 2 v Yr},_+" r r s § 3;t F T . :L r\Sr; t'r"�` "' 4 rh•-„,r��5, a a;. - r 3" er s. s 4V a r } � i��r'25�� +-C�T'��;i..�4�,.s�z� f Ix f _ I� E SL rbn[r� .1 Y -9 9 1� a ( � S✓A. � r[�\; • � � � � . � � � •� i 3 � u. y t is t� s F .'�� r�iti a ���t�' �4�?��'b' r7 r �t k.xr• �_- it t� w 3. ;1��'- sh.s � r f d1�i� ,�° � ���Crev��r »� ""�• ip" rtss a��'+•�.�'r al4 s' 11yjYt1fK .r't r}}-5�•.,,+ d.'4.3°..f o �1 r'.s # � F � �^'� 4� rw ��',.. x� t' -i . ; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i W Map Parcel l QV-OV- 0 Permit# Health Division / Date Issued Conservation Division 0 Application Fee Tax Collector n Permit Fee Treasurer E7/Z APPLICANT MUST OBTAIN A SEWER CONNECTION PERMIT FROM THE Planning Dept. ENGINEERING DIVISION PRIOR TO Date Definitive Plan Approved by Planning Board CONSTRUCTION. Historic-OKH Preservation/Hyannis Project Street Address ' e P✓ o Village I � n� Owner R L A Address � o Telephone Permit Reque �� '_ !�' Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation '� Off 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 Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Basement Type: Gull Ll Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing D new Half: existing new Number of Bedrooms: existing io`3 new Total Room Count(not including baths):existing n new First Floor Room Count Heat Type and Fuel: &-6as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing -n New Existing wood/coal stove: Q Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yesf ❑No If yes, site plan review# Current Use Proposed Use ,� BUILDER INFORMATION ( 'N'm-e- J!/ // �i 2 Telephone Number - Address L�'�i L�'Gkc�k_ b Ic License# r1 �{ d,41V 66i Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO '' SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIZ NO. x DATE ISSU`j�D MAP/PARCEL NO. ADDRESS VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING . m ''. DATE CLOSED OUT ' ASSOCIATION PLAN NO. ., X� oFIKE to Town of Barnstable Regulatory Services BARNSTABLE. ` Thomas F.Geiler,Director KAM 9`bprf p``� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. I !ti Type of Work: �( /� —�i/� Estimated Cost Address of Work: O t' Owner's Name: _na i (A 'A-J Date of Application: f Z �/ ® `� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law ❑Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date- Contractor Name Registration No. OR L —i U. Pk I-A n Date Owner's Name, Q:forms:homeaffidav The Comn�onwealth ofMassachusetts - — Department of Industrial Accidents' 600 Washington Street Boston,Mass. 02111 . Workers', Com ensation.Insurance Affidavit-General Businesses SAM MN �•'y5P :'c4:•�+ toq:.. ,'�°'S.a.. .. :.rp:r.-,4}yr••/•yt,,,.. .r. •y^•'. �'.c_ . •.S ,d§3 name t�f1 R \ r U '�3�`Ni` -- —- ;•'" address..�2 L /V64 /" a state: 1lJ hone work site location(full address)• R3'1 am.a sole proprietor and have no one Business Type: 0 Retail❑RestaurantBar/Eating Establishment working in any capacity. ❑Once❑ Sales(i lcluding.Real Estate,Autos etc.) ❑I am an em to er with etn to es(full& art time: ❑Other %/////%/%////%%/%/%//%%/%%//��Gi�. ////%/ /////////%//////�//�%//%/%//%%//////%%%%%//// } I am an'employer providing vtorkers' compensation for my employees working on this job. coikif)figm me: .::y':x' ;S`.: '� ..•fit: :i •;.,,,.:•,�,:i• .?' `.� ;. - r. )•,' .Z -f. :.mil..�'•• i i}::• su I a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: am ' �ry .t ,l; "Y f .�•.i •'•t:.�..17:'' •.S'r•r-•,`t'+^.il.:i l�ii+ �l:!:.2' phone ;,:;`t•': :r': a•a'. F'"` ..c,.' �..v�,':i 'O.11C :.#�: :.)i�Y+.:}Y•. :t:• �+' �`•;. ,,; PEA insurance co. - ��/��/ yv.,,y.,;t. '(.. _ � :-t. 'i` •.4 �Q:i .4,•. •Ytl i. 'j y.t:. a�dIC'S57 i :4 i.,r '.:Lit I.• i•T;'11� •+ ID '".4•. %�•Ri.: :.t;t t F.•...• .:R.1'•:..1�:'4�. li. +� i+..•.4. ti.•..-S.v.. .i.. •:.T��•• '.1:;•.�:.. .:f tom,' •}•�• '•�' •'Y.: :9• •`i.1< 1 ,{j '.r'` i•i'0ir.;f.iF.b''.•• • irisiireace�co: - Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties In the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that copy of this statement maybe forwarded to the Office of Investigations of the DU for coverage verification. I do hereby certify under thepat ana penalties ofperjury that the information provided above is Prue and correct c� Signature Date o _ 7 Print name '�' ���✓Ll� Phase# 7 �J .�0 official use only do not write in this area to be completed by city or town official city or town: permit/ilcense# DBuilding Department . _ 0Licensing Board ❑check if immediate response is required ❑selectmen's Office []Health Department , contact person phone#; Other (revised Sept 2003) Information and Instructions. �152 section 25.requires all employers to provide workers' compensation for their. Massachusetts General Laws chapter ' employees.. As quoted from the"law", an employee is.defined as every person m the service of another finder any contract of hire, express or implied; oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or mgre of the foregoing engaged in a joint enfeiprise, and including the legal representatives of a deceased,employer, or the receiver or artnership, association or other legal entity, employing employees. 'However the owner of a trustee of an individual,P dwelling house having'not'more than three apartments and who resides therein, or the.occupant.of the dwelling house bf- another who employs persbris to do.maintenance, construction or repair work on such dwelling house 6r on the grounds or building appurtenant thereto shall not because of such.employment.be deemed to be an employer. MGL chapter 152 section 25 also'staies that every state*or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.cOmmonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements,of this chapter have been presented to the contracting . authority Applicants Please fill mi fhe workers' compensation affidavit completely,by checking the box that applies to your situation..Please supply companynarne, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the`law"or if you are required to obtain&•workers.'zompensation policy,please call the Department at the number listed below. City or Towns . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to Olin the pernut/hcense number.which wM be used as a reference number. The.affidavits may.be.returned to the D epar(ment by mail of FAX.unless other arrangements have been made. " The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a calL- The Department's address,telephone and fax number: , The Commonwealth Of Massachusetts- Department of Industrial Accidents eftice of Wmsugaugns 600 Washington Street ' Boston,Ma. 02111 fax#: (617)727-7749 phone#: (61.7) 7274900 ext:406 oFt►,E,�w. Town of Barnstable "0„ regulatory Services sasTnB Thomas F.Geiler,Director 9 b9. .0� Building Division �'ArFcr s 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: � �V JOB LOCATION: 06 Z� ��✓ e �[9 �. - pt number street g^ village "HOMEOWNER": P1 ` TO '2'_A S D ! — �° i4 ° name home phone# work phone# CURRENT MAILING ADDRESS: TO .9 V A1,1V _S w 0./✓ ant'6z"l i) t20--L 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 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 requirem gnature eowner i Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt i 1 • LET 3 G \Q w • w l ' d cl 0 'i 0'�• in . ti L or 27 It ? a L07 io,aGGsF j S'•00 �� . .� N �£� ZS' `a•S W 20AmlE R B �N OR.GESTc_ e_ L. q NE I 10 0-o sF 1�7N (40' PAIVA. v..,) /t70 1`J•v �✓/DTfI Z O/10/10 P9nv B CERTIFIED PLOT PLAN h�;�of ra.�;•J.� RaBERT '' r`= LoT 37 Lax/�cTmv,/ �e 1/y/9v� S NEW CONSTRUCTION ONLY = �I�i E �..TOP OF FOUNDATION IS FEE INT ABOVE LOW POINT OF ADJACENT A 7 z ;� SAAA SIAS.L I ,W,, S$q s� ROAD. 44'o suk` � SCALES D ATE t F&s GE ENGI EE INO CO.INC ,�,,.,�� I CERTIFY THAT THE CLIENT SHO�IN 03� Ttils PLAN 13 LilC.�T�D E CIVIL ED RE LAND ED JOS NO. ,__ ON THE GROUND AS INDICATED A10 CIVIL LAND CONFORMS TO THE Z0,41,40 LX13 ENGINEER SURVEYOR CR.BY .7)4) OF SARNSTASL M. 3 71 A NYA N►4 P; M A S S. -WiF?rT r OF I ;CEO. LAND 3U lk/ EYC.2 G--T 4 S j' t C7 HT a7 ,aa. i-' st9 ,� -0s.;a.,'� Y t e �"`s 3 „y j.r a-c ifc�� �'aY^.h;Fv.. ky-�• Y ~� �r `'- � 1 tk Y 4, mot w +� ��..�5 �_�..,,.sa`eca w�ma-. n»�g.isae 1___. _d,.1�,c.ea. ._>..•_.—.,+...,�...,,,.,,,,. _. af; g g Alp ni"Tr, u $ 4 , 1 j s - �p d I r i4 lob -N it 1 3 ; ;' 1 j Town of Barnstable °^ Regulatory Services BMW9rABM " Thomas F.Geiler,Director 9 MASS. g 165;.t•`e Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 May 22,2001 Charles Dana 157 Long Hill Street East Hartford,CT 06108 Re: 6 Lexington Drive,Hyannis(Map 270 Parcel 101021) Dear Property Owner: A review of our records,including the permitting history of 6 Lexington Drive as well as the Zoning Board of Appeals records indicates that the use of that address as anything other than a single- family home is illegal. You are hereby ordered to discontinue the use of the above referenced property as it is now being used and restore it to a single-family home. You are to accomplish this work and notify this office to inspect within 14 days of your receipt of this letter. A building permit must be applied for to redesign the layout to accommodate the conversion. You must do this before you make any changes. You have the right to appeal this decision. If you so choose,we will be more than happy to help you. If we do not hear from you within the 14 days,we will be forced to seek criminal action against you. Very truly yours, Gloria M.Urenas Zoning Enforcement Officer /lb N q-forms-g980218a } r 100-0.11 � aw _C 1_ cl c1 1 in LOT L7 2 G• r?.2- 4y ,�Ar oN�•.:� 9rt n ?� u J3 W oil, C�o,eGGsF 5-00 %4 �NO2CEST:- Q_ LANE I 10 000 SF J`�N 040 PRivAr"G Dior, /J� 1`J•v �✓/DTfI 201101 io M,N 4B CERTIFIED PLOT PLAN '= RaBER7 v,4 Lor 37 Ljex,iyGT�r NEW CONSTRUCTION ONLY , E � TOP OF FOUNDATION IS dR FEET`"' IN ABOVE LOW POINT OF ADJACENT , 7�� �:` .B AJ1,N BIAS L.14N A-S$. t� ROAD. SCALE, / "- 4o' DATE Fsa sq' Bs GE ENGINEERING CO. �,,,,�� 1 CERTIi�Y THAT THE Fou,DA-r.oO --� CLIENT SMOWN ON THIS PLAN 13 LOCATE E8ISTERED REQiSTERED J03 N0. ,__ ON THE GROUND A3 INDICATZD A-1C CIVIL LAND CONFORMS' TO THE Z4?�1Y0 LX33 ENGINEER SURVEYOR C .SY� ..�.r:� OF 3Aitt�3TA'aL .�3 j, T t 2- MAIN STREET C,%3y, --�-�'- 8� / ( f HYANRIS, MASS. VEET,�O7_!_. O TE REG. LAND 3U",1V .'fn TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map—?o 17 d Parcel 01 1 • Permit# J�� ii&4@41 ` 7 /Z O/ Date Issued r xzoo Conservation Division 7. l� ® Fee — ---- ,1-Taz Eolleetor— 0PUCANT MUST OBTAIN A SEWER `yam CON:.ECTION PERMIT FROM Th =T--reasur i:NUINZERINCI DIVISi X PRIOR T. .Planning-D.epL — �� Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address t0 � �` Y4 4 r�0J Villagea Owner I Ui? fA W Address Oro U—_ C 1 A1CAV uV 012t�— Teleph_one= CAD oG d PQ Permit Request ` Y` — �✓ x / Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation ®� " 00 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: O Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I:a Historic Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: _Xull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new ' Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil Electric ❑Other Central Air: ❑Yes *No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn: ❑existing ❑new size Attached garage: ❑existing ❑new size Shed: ❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use C>W X) P4—, BUILDER INFORMATION K Name� �?/�:��f� �-'U � Telephone Number Address OG 1)a a I /V 6-kQjd DJPLAL License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS SULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE /ter DATE /� �/ FOR OFFICIAL USE ONLY PERMIT NO. 'y DATE ISSUED r . ' MAP/PARCEL NO. t N. Y t i ADDRESS f - Iis ^^r VILLAGE OWNER DATE OF INSPECTION: t FOUNDATION j FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ` GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO.,.r t t . The Commonwealth of Massachusetts N— Department of Industrial Accidents OlfiCe 0///IYBSdg8U0/1S _ 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit �/ name: location: hone# city • I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one working in any ca acity ❑ I am an employer providing workers' compensation for my employees working on thls Iob. MEMO' M - Address.. . c� X. ;: hone ❑ I am a sole proprietor, general contractor,or homeowner(etrcle one)and have hired the contractors listed below who have the following workers n compensa polices: coin anv name. ss. :>. stints ................. :... ..:::::::..... .::............ .............. hone ::»::»•::::,::::........... '> o %r in�nranceca;i / /c anv:namec adiiress. _ . ::::::.::::.:;::<:>:::<::>:::<:>:::: 0 insurance . �. atni a fine to Failure to secure coverage as required under Section arm of as STOP WORK ORDER and a fine of$10�0 0 152 can lead to the imposition of a day ptiesagfainst m�I mtdentand that ar one years'imprisonment as well a' copy of this statement may rwarded to the ° Investigations of the DIA for coverage verification I do hereby certify th p en es of perjury that the information provided above is truo and sorted Date — �--Signature Phone# Print name official 1L9E only do not write in this area to be completed by city or town official permit/license# ❑Building Department city or town: ❑Licensing Board ❑Selectmen's Office ❑check if immediate response is required :]Health Department contact person - phone#; -- ❑Other (revised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. xxxx Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be cidents for confirmation of insurance coverage. Also be sure to sign and submitted to the Department of Industrial Ac date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please to be sure to fill in the pe i��rmit/license number which will be used as a reference number. The affidavits may be reamed the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lavestigatloas 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 F THE The Town of Barnstable . N � BARNSrABIM N 9 Regulatory Services �ArE&6 p. 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 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. , (�)o 3l� Type of Work: Estimated Cost � Address of Work: YJn 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 caner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav:rev-070601 s QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 05/22/01 PARCEL ID 270 101 021 GEO ID 31941 LOT/BLOCK 37 DBA PROPERTY ADDRESS OWNER DANA 6 LEXINGTON DRIVE CHARLES F & MARY C HYANNIS 157 LONG HILL STREET EAST HARTFORD CT 06108 PHONE DISTRICT HY DEVELOPMENT STATUS C ASSESSOR' S CODE CAPACITY(NOTES) ZONING DIST/ZOC RB SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? # BEDROOMS ZBA DECISION FAMILY APT LOT SIZE 10890 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST WP (N) EXT / (P) REVIOUS / NO (T) ES / PER(M) ITS / (V) IOLATIONS / (G) EOBASE / (E)XIT NO MATCHING RECORDS FOUND f I The Town of Barnstable + BARNSTABLE, Regulatory Services TEow►a't° 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: JOB LOC �7/ 1 RIO ATION: number street village � "HOMEOWNER": 1 r rn`_CA� 6t, 1 0— name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersign I"homeowner"certifies that he/she understands the Town of Barnstable Building Department n spection procedures and requirements and that he/she will comply with said procedure a requir nt Si ag tture Ho owner 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