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HomeMy WebLinkAbout0003 LYNXHOLM COURT L� � � ����� �� Town of Barnstable ►�,, Regulatory Services Thomas F.Gefier,Director sAarsrnsza, • llailding Division g Tom Perry,Building Commissioner t 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: r� Pee: 0­0 Permit#: E2013 6 2 3`f� HOME OCCUPATION REGISTRATION Date:(6/ Name: 605100 �e,ffew_ V�2 Phone#: Got go g�9 7. Address: LA t4,)o1.N. G1'. Village: L4 A N/u,S Name of Business: Coo P i�i w-g: 1E Z�. D nt>Ei�.. a�►1" Type of Business � Le INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the actnaty shill 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 d4Fellmg 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 wiR be generated m 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 flamniible 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 die Customary Home Occupation,and not within the required front yard. • There is no extenor storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. i • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,die street address shall not be included, • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the I dwelling unit. r 1, die undersigned,lain , `d with the above restrictions for my home occupation I am registering. r' Applicant Date: Homeoc.doc Ree.01/3/08 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office,.1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. ...r , { ,e, ; DATE: Id/1 I/ 13 Fill in please: y� -vukj� , APPLICANT'S YOUR NAME/S:_ C2ys I�V0 98{+e�-52 Pwat'*I'll r �-11 BUSINESS YOUR HOME ADDRESS: 3 ct u1 ,N C ,M A cn kal TELEPHONE # Home Telephone Number Sc-R -Va9 3 NAME OF'CORPORATION - NAME OF:NEW BUSINESS ( A - iv-- i �,e�-�%;T .'TYPE.OF BUSINESS. . i4.L--,0. Ste-cno T IS THIS A HOME`OCCUPATION YES NO 1 ADDRESS.OFBUSINESS L oi;+ I yANr�°5 A:-..Oa6C MAP/PARCEL NUMBER �`� [ 5 (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE MUST COMPLY WITH HOME OCCUPATION This individual has ete/forme any permit requirements that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO —� horize� d Signa re COMPLY MAY RESULT IN FINES. COMMENTS: �� - 2. BOARD OF HEALTH This individual has een or d of the permit requirements that pertain to this MUSfi,4M PLY WITH ALL �b �ir�FV r� p q p type of business. '>;:�MAP�ar<iirS MATERIAL SRFCU!_ATi�,,n Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS[ E SING AUTHORI This individual b e i li r q i ents th pertain to this type of business. Authorized Sign r COMMENTS: CAPECOD TOWN OF BARNSTABLE INSULATION 1[t13JAIN30 PiN 12: 51 v IIYIR O.Aii ........ SPp AT IOAl1 SUSPS110YR Wf$ WfiRi 111iYtAIION CNUMOS =. .yt, _ 1-800-696-6611 OIVISD)q or 'I'own of Barnstable Regulatory Services Building Division 200 Main St Hyannis, A 02601 Of Date: 111 -4113 Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit .application, All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed.meets or exeeeds Federal & State Requirements. Property Owner Property Address Villa e Eoga & fla- d4a- 3 L yn1A01AA lrc% 4aAPL/s Insulation Installed: -Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( Jc) ( SL) ( ) (X ) Slopes ( ) ( ) ( ) ( ) ( ) Floors Walls ) ( ) ( ) ( ) ( ) At,- Sincerely He y E C' sidy J , President Cape Cod nsulation, Inc. �.; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION c, Map Parcel App ical' tion # —( Health Division Date Issued Conservation Division Application Fee A Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Addrss 3 Village k�vl_ k1le�, Owner 'y dWU �.�ii��0 Address Telephone ' �/ 6 �Q Permit Request (/l�lla D� `w a D 4 all/ �IaA e -fiPer lme. g ° 6ep,em� m r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 000�A Construction Type hI v- Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Familyp/ Two Family ❑ Multi-Family (# units) C�y Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's ghway: 0-)Ves a No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other e�. w 100 Ze Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) i Number of Baths: Full: existing new Half: existing new. rn 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name l4;:C 2 Zd� Telephone Number Address /6;ZIM��� License # ,r d LZ"& 4 Home Improvement Contractor# L��✓,'G� Worker's Compensation # e�� eDL ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO v v SIGNATURE DATE ` S 201 Z_ is I � � - FOR OFFICIAL USE ONLY is F . j APPLICATION# It DATE ISSUED MAP/PARCEL NO. y ADDRESS VILLAGE i ; r OWNER 1 DATE OF INSPECTION: .; FOUNDATION j : FRAME .; INSULATION i FIREPLACE w ELECTRICAL: ROUGH FINAL ? PLUMBING: ROUGH FINAL rj GAS: ROUGH FINAL FINAL BUILDING �z ' f DATE CLOSED OUT ++�• "- - ` ` jay r-rt- ASSOCIATION PLAN NO. n" ` 4• The Commonwealth of Massachusetts Rnnt Forrn Department of Industrial Accidents Office of Investigations ' 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individuaal): ej Ix Q Address: &VA& lilVU City/State/Zip: V IM A- Phone #: Are you an employer?Check We appropriate box: Type of project(required): 1. I am a employer with 26) 4. ❑ I am a general contractor and I ❑ employees (full an�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 g, ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions myself. o workers' com right of exemption per MGL y LI`I p• 12.❑ Roof repairs �,,I,. insurance required.] t c. 152, §1(4), and we have no j Waif Lf� /fl employees. [No workers' 13.� Other W Tl 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. 1 f the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site inf•ormation, f,, Insurance Company Name: avl 11L �VT I�I�y�AI�GLf/l Policy#or Self-ins. Lic. #: WGA ODD 2'� �D f' Expiration Date: Job Site Address: N City/State/Zip: ��� 7 M 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 tip to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer 'y, n er the ains nd penalties o er'ury that the in ormation provided above is true and correct. i Si nature: Date: Ul, z�I ko 7/ Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: No, I /+�y�j Client#:4597 CCINBUL /�C V!Z IJL, ------- CERT•IFICATE OF LABILITY INSURANCE DATE(IIM10VYYYY) THIS CERTIFICAI E IS ISSUEO AS A MATTER OF INFORMA17UN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLQEIR`IZQSZ CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY ANII ND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONS-1I'I UlE A CONTRACT BETWEEN 7'HE v,$UING INS URER(S),AU-1-1IOR(4LU REP RESL:NTATIVE OR PRODUCER,AND THE CERTIFICATE IIQLL)c IMPORTANT:If tho carllflcate huldar Ifi an AbDITIDNAL INSUki:O,inr IJollcy(lea)must be encloised.It SUBROGATION 1S WAIVED,sub)uci 10 — M4:icrIII's at Gal anx of the policy,Ce1t51r1 p011cles IIIAy"-iuli-Sit undorfianwint.A BlatelliVni On this cartilicatd docu Ila(Gplllel'riullt'tU(TIC ctrrtlFlc�ltr huldL.r in IieU Elf Such dndaraement(s). PkUWJt6it-- ' RaOL:r 1&Gray 1118. -SO. Dennis NAME: Margaret YOUI> _ 434 Haute 134 PHONE Arc No Ell: 08 7604602 L�_N�1:_ !j 01G•2156 E-MAIL -- - - ------- :otjlh Duti ic, MA 02660-16(yI SOb 398-7980 INVURI RIO)AF-FORDINIII COVENA(;C NAIL s INSURERA;Peerless insurance -- --- ..IN5uRku•......_-----------•---'--'- - '16333 Crape Cod Insulatlon Inc — wsuRERa:Evanston Insurance Cornpany �' — --- 4'S5 Yarmouth, Road INSURERC:Atlantic Charterinsurance I-Iyruuli3, MA 0260-1 INJURfRD, Qrnlnerce Insurance Company 34754 INSURER E: --- I'ovL:ICAt,Is GERTIFIGATE NUMBER; __ - _ REVISION NUIv(BL--.R; TI-IIB IS 10 CERTIFY THAT THE I3OL-ICIES OF INSURgNC L E ISTFo IkU 1VV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDIGAILD. I`I0IWITHSTANDINC ANY REQUIREMENT, TERM OR CONDiTIONOF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO Wtile I IRIS CER'IIFIC:ATL MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFOr�DED 9Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL. THE TE+2MS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. tTR rVPk OF INSURANCEAQOL POLICY EFF pOLICV EIrP ---'-R FoycY Nun,a�ly WMIDD/YYYYI IMMJDDJYYYYI LIMIYF: A (aENI'W1L uawlLn r 7IC2'M P821i3063 -410112012 04/01/201` EACH OCCURRENCE s 1 UUU UOU X GOMMERC CAL GENERAL LIABILITY erttr�i< l ��-y��� I?P�k�l� DlDU 0D1) CLAIMS-MADE l ^I OCCUR .MEP FxP IAl1Y OOd POrdOB) $S,ODp ---- ^— — PER60NA4 S ADV INJURY _ 11 000 000 QENFRALA013REQAW $2 000,O_00 GLN'L AGGHEUAI E LIMIT APPLICB PER T PRODUCTS•GOMI'IUP ALiG 2,000 pUp u AUTOMUNILLLIA1aILIrY --- .-MBCKVNIK 4101/2012 04101f201• COMOIIVEf)SINGLEIIMIT Ea accdenl __ ,'I,OUO,000 -- AI.1Y AU'fU BODILY INJURY(P..Peronl :p AU,OWNFD X ScmEI-)UI.cD _ ------------_._...------.._-. AUICS _— AUT03 BODILY INJURY(Po,-AA Aienl) S No PROPERTY DAMALl X I11HEU AUI'U'o X AUTOS y —....._._......... - H X UMtlF1k LLA UAB _ occur, XONJ453512 41010012 04/01/201 EACH OCCURRENCE= Q pp pOO � eMCttiG Y1 LIA13 — 00 0o ACCRecATE ocu X +eleNnar1�100UO WUNKetta rPhIPENUAI'ION -�- ANUEMNLOYEN.S'uAQaITv WCA0U525Ji12 6/3012012 U(;13U/201 �( WGSTA"I'u, OT_H, ANYPROPRIC�OWp y}'a}'rI L /"'(;UU'rlVf;YIN QFFICEWM�M R 6.G_UO �� NIA C.L.EACH ACCIOIkNT [�ODU,000 (Mnndulory m Nil) M _ 'F"I QUO UOO T it Yuy,Ueul;nu.wider E.L.DISEASC..GA C PLOYEC ___ UESCRIPTIUN OF OPLPiA'I'IONS tJnluw ___ C.L.DISEASC"POLICY LIMIT $'t Opp1ppU-- I F ION OF OPEI<Al(ONSI.LOCA'11ONS!VEHICLES(AUach ACORD 101,Addldu,ul,¢„nm,ks fil:h0aul0,It mwe swo to rdglllrtiu) ers Curnp 111f01-ITIU00l'1(I Officers or Proprietors ate Mulder i3 111Cluded as an additional insured unLlur GonQral Liaoility when roqulretl lay written t or agreemel)t, CERTIFICATE HOLDER A_-- CANCELLATION Cape Gad I1lhulafIUn,IrIC SHOULD ANY OF THEA13OVE OESCItII3EO POLICIIE$WE 4ANCkI120 D FORE THE EXPIRATION DATE THEREOF, NOTICE WILL 13E DELIVEkEQ IN ACCORDANCE WITH THE POLICY PROV1310N3, AU DWR12E0 REPRESENTATIVE ^- 19B -2010 ACORD CORPORATION,All rlyh15 re�arveti. ACuRU 23(2p Iplpg) 1 of') The ACORN name and logo aru roolstored marks of ACORD 1fS83d4U1Mti384t1 MAY 1 Massachusetts.- Department of Public Safety Board`of BuilUing Regulations and Standards; `. Q.onstruption Supervisor License Licen CS 100988 , HENRY CASSIDY 8 SHED ROW: WESIT,IARMOUTH;, MA 02673 ; Expiration: 11/11/2013 <'ununissiuner Tr#: 7620 = Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration = Registration: 153567 '1 Type: Private Corporation Expiration: 12/15/2b14 Tr# 233831 u - CAPE COD INSULATION, INC HENRY CASSIDY ". 18 R EAR DO N CIRCLE ------ ---- -- — -- .; t 7 SO. YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. Address Renewal 0 Employment Lost Card SCA 1 .70 20M-05/11 d � Office of Consumer Affairs& Business Regulation License or registration valid for individul use only _ OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 153567 Type: Office of Consumer Affairs and Business Regulation xpiration: 121f512014 Private Corporation 10 Park Plaza-..Suite 5170 Boston,MA 02116 CAPE COD INSULATION,,,,JN HENRY CASSIDY 18 REARDON CIRCLE SO.YARMOUTH, MA 02664 Undersecretar y of val witho t ' nat re i i OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at 3 L-ynXk & LoL) r (Property Address) H. ,5;1nn ,rs (Property Address) hereby authorize �—cCc) d .- Y a (Subcontract) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. ` r \) \ Ow er's SignAre Date EOE0v[ ' D NOV 1 9 2012 Town of Barnstable Regulatory Services insxsrABM Thomas F.Geiler,Director 1639. .�`� Building Division rFD MA'S A Thomas Perry. Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 September 20,2005 CERTIFIED MAIL#70022410000384253720 Ms. Soraya Prada 3 Lynxholm Court Hyannis, Ma 02601 RE: Illegal Finish Basement Map/Parcel 327/185 Dear Ms Prada: Since our last conversation in regards to your basement,we discussed some options if you choose to decide on keeping finished room(s)below. Please call my office to set up an appointment to go over all details on the process within (14) fourteen days. cerely, k Russell Wheeler Local Inspector of Buildings 022202f oFY r Town of Barnstable *Permit# . Fxpires 6 monthsfrom issue date Regulatory Services Fee saxNsresre, 9 MASS. g' Thomas F.Geiler,Director s639 plF° RSS PERMIT g Buildin Division FEB 161 Tom Perry,CBO, Building Commissioner 2010 200 Main Street,Hyannis,MA 02601 TOWN OF 13ARNS I ABLE www.town.barmtable.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 (V 1��. �✓� ►nS �,✓' d�'�� EI/Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 1 ( y M � Contractor's Name 1 1 f= 0 '6 S &k __7 elephone Number Home Improvement Contractor License#(if applicable) � tJ rWor ction Supervisor's License#(if applicable) 0 s /6 kman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ Yam the Homeowner have Worker's Compensation urance Insurance Company Name (VOW) Workman's Comp.Policy# 3 5 r /Z Copy of Insurance Compliance Certificate must accompany each permit. 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- ide �'1' (maximum.44 #of doors Replacement Windows/doors/sliders.U-Value V )#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 requ, SIGNATURE: ---- Q:\WPHLESTORMS\building permit forms\EXPRESS.doc Revised 090809 • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street s Boston,MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): E ' G C, so me Address: City P:/State/Zi p one Are you an employer. heck the appropriate box: Type of project(required): 1.❑ I a employer with 4. ❑ I am a general contractor and I ployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. -I am a sole proprietor or partner- fisted on the attached sheet. 7. modeling 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 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]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. lContractors 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 insuranc fo my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 1� 8 Expiration Date: Job Site Address: v City/State/Zip: IV Attach a copy of the workers'compensation policy declaration page(showing the policy num er 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 certi nder the pains gadpenah'ies of perjury_that the information provided above is true and correct Sianafore: Date: d /0 Phone#: 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#: Jul. 2J. 2009 9 2UAM lharle5 ase Jr. 1u0. 411 ! r, j �0/&fig"Mbnsumerndd 4siness e . ,g �ion • 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 163528 Type: DBA Expiration: 7/7/2011 Tr# 285903 F ERICSSON HOME IMPROVEMENT ERICSSON TORRES 16 HOOVER RD ---- --- — WEST YARMOUTH, MA 02673 Update Address and return card.Marts reason for change, Address E1 Renowal n )Employment (] Lost Card 'JP5•CA1 0 a0M•008.088LIFORMCA108212008 1 <L Ada I.tcense or rogistratlon valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation f Reglstra�lon: 163528 10 Park Plaza-Suito 5170 Expiration: .7/7/2011 Tr# 285903 Boston,MA 02116 'type: 08A. . ERICSSON HO.MEIMPROVEMENT ERICSSON TORKS -.,Z � 16 HOOVER RD' WEST YARMOUTH;MA•02673 Undersecretary Not valid without signature Jul. 23. 2009 9: 20AM Charles C. Case Jr.. No. 4717 P. 6 t Restricted to:,gyro- :>Insx,ichu�ctts= 1)cp;�rtmcnr ut'f'uhlic,5:�1'et� IA- Masonry only 80.1rd of Buildin-, Regulations and St.indords RF- RoofCovcfing Construction Supervisor Specially License VS-Windo4s Anil Siding License: CS SL 100546 SF- Solid Fuel Burning:Devices Restricted to:. W.S DM-Demolltlon only ERICSSON; TORRES Failure to possess a current edition of the Massachusetts State Building Code 16 HOOV�1�ROAQ is cause ror revocation of this license. WEST YARMOUTH, MA 02673 Refer to: WWW.Mass,Gov/DPS Expiration: !Ylk012 f (' nuutsxluur Trn: 100546 AZiORD CERTIFICATE OF .LIABILITY INSURANCE OP ID DS DATE(MM/OD/YYYY) TORRE-1 11/02/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden & Sullivan Ins Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88. Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Fax: 508-790-1414 INSURERS AFFORDING COVERAGE NAIC 4 INSURED INSURER A: Western World I' INSURER.B: Ericsson Torres INSURER CC. 16 Hoover Rd INSURER D. West Yarmouth MA 02673 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 DD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSIRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A }{ COMMERCIAL GENERAL LIABILITY BINDER 11/02/09 11/02/10 PREMISES(Ea occurence) $ 50000 CLAIMS MADE a OCCUR - MED EXP(Any one person) $ 5000 PERSONAL B ADV INJURY $ 1000.000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 1000000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Perpersorq - HIRED AUTOS BODILY IN,IUP.Y $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGO $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WC STHTU- H- WORKERSCOMPENSATIONAND. TORY LIMITS OT ER EMPLOYERS'LIABILITY ' E.L.EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? - E.L.DISEASE-EA EMPLOYEE S It yes.describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry/Painting/Drywall-*Certificate Holder is included as an additional insured with respect to general liability if required by a written contract. CERTIFICATE HOLDER CANCELLATION THDATHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL THD AT-HOME SERVICES INC IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR and The Home Depot 2690 Cumberland PkwyrSte 300 REPRESENTATIVES. Atlanta GA 30339 [Hyannis ORIZED REPRESENTATIVE Office The Commonwealth of 1fassachusett5 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, 1V4 0111 www.mass.gov/dia bers Workers' Compensation Insurance Affidavit: Builders/Contractors/El arisePleas Print m ibly A licant Information V ALL SenzlcL�5 Name(Business/Organization/Individual): Address: - 3C'City/State/Zip: _3 3 Phone #: � G� j you an employer?Check the appropriate box: r pe of project(required):4. [] I am a general contractor and I N construction[A�re . I am a employer with._* have hired the sub-contractors employees(full and/or part time). listed on the attached sheet. Remodeling 2.❑ I am a sole proprietor or partner- These sub-contractors have g. Demolition - ship and have no employees employees and have workers' working forme in any capacity. 9. Building addition comp. insurance.1 [No workers' comp. insurance 10.[]Electrical repairs or additions . 5, � We are a corporation and its required.] officers have exercised their 1 I.❑Plumbing repairs or additions 3.0 I am a homeowner doing all work right of exemption per MGL 12.[]Roof repairs myself.[No workers' comp. c. 152,§1(4),and we have no insurance required.]t 13.❑Other . employees. [No workers' comp.insurance required.] fill pensation policy *Any applicant that checks box 1 must alndicatingtthey the are doiction nglall work and then hirow showing their oe outside clontractors must submitt aanew affidavit indicating sucli. t Homeowners who submit this (Contractors that check this abox ctors attached an mustheet provide theuthe name worke s'eo the mpspoli y numberand state whether or not those entities have employees. If the sub-con r P I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. "ns s S Insurance Company Name 3 Expiration Date:Policy#or Self-ins.Lic.#: 'City/State/Zip:Job Site Address: JAttach acopyofthe wry declaration page(showing the policy nu m er and expiration date). *mposition of criminal penalties of a Failure to secure coverage as required under Section 25A ofaMc civil152can lead to the I the form of a STOP WORK ORDER and a fine fine up to$1,500.00 and/or one-year imprisonment,as well penalties 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 Investi,ations of the DIA for insurance coverage verification. n provided above is true and correct. I do hereby certify under the pains and penalties of perjury that the informatio Signature: Phone#: 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 Phone#: Contact Person: l Board of Building Reeuiatiops and Standards~ HOME IMPROVEMENT CONTRACTOR Registration: 126893 Expiration: W3i2010 Type: Supplement Card The Home Depot At-Home SeNice DARREN DEMERS 3200 COBB GALLERIA PKWY#20 r`— ATLANTA. GA 30339 Administrator License or registration valid for individul use only l before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Nia.02108 A t Not valid without signature a AC®R® 02/20/0m CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY). 0/09 PRODUCER 1-404-995-3000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR . homedepot.certrequest@mmarsh.com ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3475 Piedmont Rd NE, Suite 1200 Atlanta, GA 30305 Fax (212) 948-0902 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:steadfast Ins Co 26387 THD At-Home Services, Inc. INSURERB:Zurich American Ins Cc 16535 2690 Cumberland Parkway INSURER C:NATIONAL UNION FIRE INS CO OF PITTS 19445 Suite 300 Atlanta , GA 30339 INSURERD:New Hampshire Ins Co 23841 INSURER E:Illinois Nat1 Ins Co 123617 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 PC'LICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . IN SR DD' POLICY EFFECTIVE POLICY EXPIRATION LTR N R POLICYNUMBER DAT MMDD DATE MM/DD LIMITS A GENERAL LIABILITY IPR 3757 508-02 03/01/09 03/01/10 EACH OCCURRENCE $4,000,000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY LIMITS OF POLICY ARE EXCESS PREMISES Eaoccurence $1,000,000 CLAIMS MADE OCCUR "OF SIR: $1,000,000 PER CC" MED EXP(Any one person) $EXCLUDED PERSONAL&ADV INJURY $4,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMPIOPAGG $4,000,000 X POLICY PRO- E T LOC H AUTOMOBILE LIABILITY BAP 2938863-06 03/01/09 03/01/10 X - (Ea accident) SINGLE LIMIT 0,000,000 ANY AUTO ---- ALL OWNED AUTOS BODILY INJURY $ SCHEDULEDAUTOS (Per person) HIRED AUTOS BODILY INJURY $ - - NON-OWNED AUTOS (Per accident) X SELF INSURED AUTO PROPERTY DAMAGE $ PHYSICAL DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ A EXCESSIUMBRELLALIABILITY IPR 3757 608-02 03/01/09 03/01/10 EACH OCCURRENCE $5,000,000 X OCCUR ❑CLAIMS MADE - AGGREGATE $5,000,000 $ DEDUCTIBLE - $ RETENTION $ $ C WORKERS COMPENSATION AND 3566916 (CA) 03/01/09 03/01/10 X TH- OR Y IMIT STMIT ER_ D EMPLOYERS'LIABILITY 3566915(kos) 03/01/09 03/01/10 E.L.EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E OFFICE R/MEMBEREXCLUDED? 3566917 (FL) 03/01/09 03/01/10 E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under - - - SPECIALPROVISIONSbelow E.L.DISEASE-POLICY LIMIT $1,000,000 OTHER D Workers Compensation 3566918 (KY, MO, NY, WI, ) 03/01/09 03/01/10 F TX Employers Excess TNSC4569�422 (TX) 03/01/09 03/01/10Occurrence/SIR 25M/2M C Workers Compensation 4801323(QSI) 03/01/09 03/01/10 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THD AT-HO14E SERVICES, INC. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 2690 CUMBERLAND PARKWAY IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR SUITE 300 - REPRESENTATIVES. ATLANTA, GA 30339 AUTHORIZED REPRESENTATIVE USA ACORD 25(2001/08)ckomraus_hd ACORD CORPORATION 1988 11172180 FROM iam4ad FAX NO. :5083622271 Aug. 21 2006 4:31PM P1 � .t, "rt MROVEMENT CON ROMF. PLEA E READ TIIIS�ACT Sold,Furnished and Installed by:.... t� 0 THD At-Home Services,.fnc- Branch Name: Boston pate: V d/b/a The Home Depot.At-Home Services 345A Greenwotxl Street,Unit.2,Worcester,MA 01607 Toll Free(p))657-51$2; Fax(50$)7.56 8823 Branch Number:31 Federal ID#752699460;ME.Llc#C 02439:RI Cant,Lic#16427 CT Lac#$655Z2;MA Homy nprovelumt Coutrwlor Reg.#126893 'Im Installation Address: Ci State: Zip Home Phone: Cell Phone.,C�Q Work Phone: 1 l•l .. d'urchaserlsl_ r ' � ,�j ry ----------- home Address=_ City State Zip (If diffeltnt from Installation Address) E mail Address(to receive project communications and Nome Depot updates): Home Depot ❑.1.UO NOT wish to receive any marketing emails from The Yroicct Information: Undersigned("Customer"),the owners of The property located at the above installation address,agrees to buy, arxl THD At:Home Services.Tnc.("The Home Depot")agrees to furnish,deliver and arrange for the installation("Inontaatioy t of all materials described on the below and on the referenced Spec Sheet(s),all of which are incorporated into this Contract. ti this refetcrrcc,along.with any applicable Stttc Supplement and Payment Surmnary.attached hereto and any Change Orders(collectively, "Contract"): ,lob#: finerndBararecc> 1' ucts: S Sheet(s)#: 1'ro act Amount ❑Roofing Siding Windows ❑insulation /yS. $ D `J _ []Gutters/Covers []Entry Mxnx ❑- QRoofing Siding ❑Windows insulation $ ❑Guuenrs/Covers ❑Entity Nolen; ❑ Roofing Siding ❑'Windows Insulation $ ❑Gutters/Covers []Entry Doors❑ - offing Siding ❑Windows ❑Lisulalioit $ [:]Cutters/Covers ❑Entry Doors ❑ �-r Minimum 36 To.1)epoait of Contract Ammer due upon execution of this contract Total Contmet Amount $. � 1 Maine flux baser 4 may not deposit mole than one-third of the ContractAmotwt -7 (`ustnmer agrees that,immediately upon completion of the work for each Product,Customer'will li execute a h Completion ustome under this ('tine for each Product as defined by an individual Spec Sheet.)and pay any balance due. As App Contract agrees to he jointly and severally obligated and liable hereunder. The Hume Depot reserves the right to issue a Change Orier or terminate this Contract or any individual Products)included herein,at its discretion,if The}Tome Depot or its authorized service Provider determines that,it cannot perform its obligations due to a struchtral problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerts,pricing errors or because work required to complete the job was not included in the CO t, wavm t Summary: The Payment Summary# J ` included as part of this Contract, sets forth the total en � -.�- Contract atmuunt and,payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER tled to a wmpletely filled-In copy of the Contract at the time you sign. Do not sign a Completion Certificate<notc: You are enti here is pile.tled to ton Certificate for each.listed Product as defined by individual Spec Sheets)before work-on that.Vroduet is complete. in the event of termination of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses anil services provided by The klome Depot or Authorized Service Ptvrvider through the date.of termination,plies any other amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAY WITH14O.LD AMOUNTS OWLI.) TO THE HON1r. DEPOT FROM MY DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LiMMNG THE IIOME DEpOT'S OTHER IteMEDTFS FOR RECOVERY OF SUCH AMOUNTS. Acce tance and Authorxzatlon: Customer agrees and understands that this Agreement is the entire agreement between Customer -.ainkrrhe i-Tome Depot with regard to the products and instal.l.ation services and supersedes all prior discussions and agreernents,either oral uz writt0n,relating to said Products vrd Tnstallation.This Agreement cannot be assigned or amendcd except by a writing signed by 1:'ugtnrner and T Home Depot.Customer acknowledges:old agrees that Customer has read.understands,voluntarily accepts pts the terms of and has re ved a copy of this Agreement. �cce red h Suhn' red by: Customer Si,nature Date Sales onsultant's Signature ate Telephone No. t� X - Customer's Signature Date Sales Consultant Licence No. (as appli<31ato) CANCELLATiON: CUSTOMER MAY CANCEL THIS ACRF.FMENT WITHOUT PENALTY OR OBLIGATION BV DELIVF,RING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNTGHT ON THE .rffJRJ) BUSINESS DAY AFTER .SIGNING THIS AGREEMENT, THE, STATE SUPPLEMENT ATTACTTrD HERETO i CONTAINS A FORM TO USE IF ONE IS SPECIIICALLY PRESCRIBED BY LAW iN CUSTOMER'S STATE. NOTICE:ADDITIONAL TERMS AND CONDITIONS ARE STAfiM ON Tear RgVFP-SF.SIDF.AND ARE:PART'OF TWS CONTRACT veitnw-Cintomer Pink-Sales Consultant . U.S. Postal ServiceTM CERTIFIED MAILTM RECEIPT (Domestic Mai110nty;Ni o_In°surance Coverage Provided) JF,o�,delivery,information vvisit our,website:at www.usps.com� r PS_Foim 38June 2002 See Feverse for Inslfuctions Certified Mail Provides: ZM-w-zo-565301 o A mailing receipt (esianedi)ZOOZ aunr`ooae WIDj Sd f•A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®' o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. e For an additional fee,a Return Receipt maybe requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information Is not available on mail addressed to APOs and FPOs. SENDER;::C'OMPLETE THIS SECTION ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X - ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mallpiece, or on the front if space permits. . D. Is delivery address different from item 1 T Yes 1 Article Addressed to:Article y� If YES,enter delivery address below: ❑No i ®a�Q 3. Service Type� Cam► / *-Certified INa�/ ❑ Ex s M ❑Registered\ R etfrQi,R cel•t for Merchandise ❑Insured Mail �II CA.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7002 2410 0003 8425 3720 (Transfer.from service label) PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 1 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • I I I I TOWN OF BARNSTABLE BUILDING DBTISION 200 MAIN ST. HyANNIS,MA 02601 I I I I I I I _ I oFtr Town of Barnstable Regulatory Services snxxsraBr.E. : Thomas F.Geller,Director 1 p•0� Building Division Thomas Perry. Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862. 4038 Fax: 508-790-6230 September 20,2005 CERTIFIED MAIL#70022410000384253720 Ms. Soraya Prada 3 Lynxholm Court Hyannis,Ma 02601 RE: Illegal Finish Basement Map/Parcel 327/185 Dear Ms Prada: Since our last conversation in regards to your basement,we discussed some options if you choose to decide on keeping finished room(s)below. Please call my office to set up an appointment to go over all details on the process within (14) fourteen days. cerely, Russell Wheeler Local Inspector of Buildings 022202f 07/19,12005 15:01 5087736448 HYAMIS FIRE PAGE 01 tF" lad HYAWNIS FIRE DEPARTMENT 95 HIGH SCHOOL RD. EXr. HYANNIS.MA.02WI Ad eA� HAROLD S. BRUNELL,E, CHIEF • FIRE PREVENTION BUREAU BUSINESS PHONE:(&*)775-1300 FACSIPALE PHONE:(SM Y -SW LT.DONALD IR.CSIMIF.,I..CR Z.T.ERIC F.HUNLASt.C AGENCY NOTIFICATION Building Heam G � Consumer Affalra Pursijaint to.Il ss ,General Law, Cht Ater 146:28A:and 5V CMR 1.00, the above agency is hefty notified:#W a hazard or violation is Weved to oft tiWating to ft above agency's Jurisdiction. r The or vbWbn noted Is not within ft inspecM code cftdora msr t or judsdic0on. The follawkV Has.been reported in parso Of lay eon. :date: for the prqxoly located at: ._.: in Hyannis: 2) --- Owner Of recordy phone: 50Q" it37-q 13 30 Fire Pr notion Office cc:street file rev. 1 rxw0 07/19/2005 15:01 5087786448 HYANNIS FIRE PAGE 02 A , � I 1 I C3 Delete ��� I 01922 ' 'L y�l 7/10/2005 1 i�o0l A250670 i o © Chan- - N�1RS-1 State .JL ImIcanl Date Station Incident Number xpoaure ® No AN00ty �dSjt: ® W�rr''99 Ctreek this box to Indicate that Ale eddress for thle!ncident is provided or fha Vutldlend Fire Census'Rsct i® Location LJ Modido in gotten a"P.Itametive t.,ocatfon Speolicatlon"use only tar wndiandflroe. 40 ❑ Street Address E] intersection 3 L [I YNX1-IOI M COURT J l CT J 9 In front of Numtnermtllspost Prefix Street or Highway -�MF&17 y-Fd* Sirlix- ❑ Rear of �� I Hyannis - MA 02601 ❑ Adjacent to Apt/$ukayrioan y -, _- 2 Code 8(a�a__—._.. ® Directions CAMP S'TRTEET Cross strati ur diredXlne,fie 9ppilsbla C Incident Type �1 Dates&Times Mld%ros000O G2 Shifts& Alarms 710 lIMalicious, mischievotts Local Option lneldaroTyps lfalse C•alt. other i II Cnackbaxeslf Menth Day Year Hour Min � 1� � same are fha ALARM always required L=J I Still Aid GIVen_Re681Ved same as Alarm Date. Alarm * 07 l0 2005 03:25 Shift No0 Alanm0tatra 1 ® Mutual aid received ARRIVAL eaquir6d,unlosd oanceled or did not anlre 2 ❑tAutomatic.aid recv. U Arrival * �J t(1J 20U5 03:32 E3 $peciel Studies 3 Their FDID They ® al aid given stare LaxlDpaon CONTROLLED national,excart wr w�k11Wm nroe 4 matic old Ivan 5 © r a givenControlled 107 10N ® it na Number Lost Unit LAST'UNIT CLEARED,required" ,•roileland Ire 5p"I Specal Cleared Study IPa Study Value i I o7 t o (Zoos I �1�3:41 � F Actions Taken Gli Resources s G2 Estimated Dollar Losses&Values CMerkUlis box and eKlpthie section Won LOSSES: Re udndforanflr9arknown. Oplionolfornonfires. 86 i Inyest1F.,ate Apparatus Of Pbraollhal form is used. q Non Prlmary Action Taken(1) Apparatus Personnel i Property ff I L Suppression 1 w L 3 Contents L w... — .I' Additional Action Taken t2) EMS 0 j _.,......JL._.,•��0 !� � PRE-INCILIENT VALUE: optional Other j 0 Property Additional Aa;idn Taken(3) r-r Chaco.box if reliouroe ixurts include aid 1 received rasourcaa. Contents ❑ Completed Modules H1 Casualties None H3 Hazardous Materials Release Mixed Use Property Qeathe Injuries N® None 1'lIC-^.. Firs NN❑ Nt?tmix9tl vies. 0 1 Natural gas: blow leak,no avacuatan or HezMat actlone 10 Assembly Use [] Civilian vi l i a Fire �w• ^� �__ a ® Propane gas: <21 It,.tank(as In home BBO grill) 20 Education U68 ®Civilian } ire C'b3.-41 I I 33 ❑ Medical use Y.l Civilian , 0 0 3 Gasoline:vahiClb fuel tank or pxtabie umlemer ®Fire 5erv. Casualty, I I � ❑ ao ® F�esidential use .__j — 4 ® Kerosene:fuoibLmingaqulpntonlorpmabiestorage 51 []EMS-6 ® Row of stores 5 Diesel fuellfuel oil:vetlidefual lank orp6 Awe a:crag 53 Enclosed mall ®HazMat-. Detector ® ❑ ®W'ildland Fire-8 H2 RagUirad for mnf rtned fires. 6 Household solvents: HomatuAce spill,deanup only 59 ❑ Business&residential 7 Motor oil:from engine ar portable container � ❑ Office use ®Apparatus-9 60 ❑ Industrial use ®PG rsd n ae l-10 10 Detector alerled Occupants 6 Paint:from point cans totaling 55 gallons 53 ❑ Military use 2❑l Delac for did not alert them 0 C3 Other:Special H.Masl adiona requred or spO r66 gal. 65 H Farm use u❑1 Unknown ?lease complete the HarMat form 00 Other mixod Use J Property Use `L Structures 341 ❑ Clinic,Clinic Type infirmary 539 ❑ Household goods,sales,repairs 131 Church,place of worship 342 0 Doctcrldentist office 679 E3 Motor vehiclalboat sales/repairs 151 © Rostaumnt or raf0aria 361 1: Prison or jail,not juvenile 671 ClGas or service station ®182 bar/tavern or nightclub419 ❑ 1-or 2•family dwelling BN ❑ Business office 213 ® Elementary school or kinder+gart, 429 ❑ Multi-family dwelling 615 ❑ Electric generating plant ® 430 ❑ Rooming/boarding house 629 ❑ Laboralorylscienoo lab 216 41 [3 High school or junior high 449 ❑ Commercial hotel or motel 700 ❑ Manufacturing plant ® C 4� [0Residential,board and care 819 ❑ Livsstocklpoulkry Storage(barn) 311 ❑ Caarres f faa adult ad.cility for the aged 464 ❑ Dormitory/barracks 882 [3 Non-residential parking garage 331 ® Hospital — —„ — Me ❑ Food and beverage sales 891 ❑ Warehouse - Outside an ❑ Vacant lot 961 ❑ Construction alto 1Z4 ® Playground or pant 9S8 ❑ Gradtad/catrod for plot of land aM ❑ IndustrIal plant yard 60 Crops or orchard ® 9>96 ❑ Lake,river,stream GN Forest(timber land)[3F tti 9b1 p Railroad right of way W7 Outdoor storage area ® 9611 ❑ Qthor street Look up era enter a prgpany sae �,l q gig Dumpor landfill PropertvuseWJeonly r Q ry 861 ❑ HlghwayldiYidgti highway nu havo NOT ohtcked a L- 931 Open land or held Y ® 982 ❑ Residential Propem•usebox: 1 or 2 family NCIAylibrebn eS'llxa A250670 - EXP 0, 711012005 PAGE 1 OF 2 HYANNIS FIRE DEPARTMENT - MFIRS REPORT' 07/19/2005 15:01 5087786448 HY44,IIS FIRE PAGE 03 K1 PersonJEntity Involved —� Local Option Bus Hess,amapW(tetcaWe) Phons NurrW II I �. Cheat this box H I I aBrne pddrass All ,Me tW., a. Fir`!NBmB MI 6.ast Name Y 3u1�JK inoloom i4 on. Then 61�p the three I I I lines. Nwn Rdllepuat L__...... v L_._.. --—�,, Type 1. affix dupksfle=11.1 I 1 . Nratix 3veBl or HlQhway Street Typa §u(flx Part Mom Box ity �Steta zip Code,_.., —..I 0 More people Involved? Check this boa and attach Supplemental Forms(NFIRS-1 S)as necessary. O wneracne as t>�t —MJ Then d6 D this hqx and strip n the real of altb saMion. mass nano Ya pYgl�Numbor — epil'A-6 C H —�sss —__ �--_- --1rl. Mr,.Ms.,Mrs. First NomQ �Iylt Lasl Ndme SusM><Tasp ?it" NurnktortMil"M Prefix StlaettxHighway 5lrttal Type 3uf� IPoet 08iCe Box Ili,. �—,Iulia. c+ty stale zoC�OB Lliemarks: Local Option ITEMS WITH A ; MUST ALWAYS RE COMPLETEDI ® More remarks?Check this box and attach Supplemental Forms (NFIRS-1S)as necessary. M Authorltation 7281 Kraig E Farre.ukopf C._ -� Ca rain /EMT I I Suppression Q7 l I 0 j 20gs Otlloerincheroeto signsture Position or rank Aaegnment K"h C* Yow L'neCk Doe li same a9 OHinat in - 720] Crai E Farrenko f C. _`µ w ^ C.a.ptain h#T [Suppressiot! 147 I Q It 2005 j Mamma a skins tea it io S ..-.._ I---position or/E.............. ..--�:. ,„..., !h' rep; aeacrmiarn nroin!n t7ay veer A250670 - Exp o, 71101200.5, page 2 of 2 HYANNIS FIRE DEPAR MENT - MFIR5 REPORT 07/19/2005 15: 01 5087786448 HYr' t IIS FIRE PAGE 04 L1 01922 MA i 7/10/200.5 � OO I_ __�1250670 _' �_` n� Q delete NFIRu-1S L._._ m� ske IncldoM oats . IrcdenlNufflW Ez�olui9 ❑ Change Supplemental i�N Remarks BRINKS HOME SECURITY DALLAS TEXAS [1-800-574-0881) OPERATOR # S2 CALLED � REPORTING." .A FIRE ALARM SOUNDING AT# 3 L:YNXHOLM CJ'QUR"r. WHILE ARRIVING ON LOCATION FIRE CALLED REPORTING THEY RECEIVED A CALL FROM THE HOME OWNER CANCELING US. ARRIVING ON LOCATION, ONE STORY, SINGLE FAMILY, WOOLLEN .FRAME,NOTHING SHOWING, A GROUT' OF YOUNTG ADULTS STANDING OUTSIDE. .INVESTIGATING ONE FEMALE [TEtiTANT] APPROACHED US REPORTING THEY ACCIDENTALLY i TRIPPED IT BUT THE LANDLORD MS. PROCTOR [W!140 LIVES IN THE BASEMENT] CAME UP AND RESET IT. CHECKING THIS DEVICE THEY TRIPPED IT TURNED OUT TO BE A KEY PAD CONTROL PANEL NOT A TDETECTOR7`? ?????'??7???? OCCUPANT STATED THEY WERE FOOLING AROUND AND HIT IT. SPOKE WITH THE LANDLORD WHO WOULD NOT LET US IN'T'O THE FINISHED OFF BASEMENT. SHE STATED SHE CANCELED OUR RESPONSE. I ASKED WHETHER O.R.NOT SHE HAD A SMOKE DETECTOR. IN THE BASEMENT. MS, PROCTOR WENT ! DOWN CHECK: AND CAME BACK UP STATING YES????? INVESTIGATING; FURTHER I SPOKE WITH BRINK'S [DALLAS] AND CONFIRMED A CLEAR BOARD. CAUSE: MALICIOUS FF, FUSCO, FF. MURPHY. WEATHER CONDITION: CLEAR, WARM, WIND OUT OF THE SOUTHWEST ABOUT 6 MPH, T 69° F. FARRENKOPF C. CAPT. o7/laios. A250670 - EXP 0. 711 012 00 5 HYANNIS FIRE DEPARTMENT MFIRS REPORT PAGE 1 � ,. +� � � �` r �_ r, Barnstable Assessing Search Results Page 1 of 2 ®fro "'^.--.~-.,:_• , �R �,Oc� RR C Do Q TAI .MI rep Ql1S? Ektl'.'�A' Jj m,. a � - Cfr/�IG/.✓G/al�� 'r .r �.`_ "` _ Home: Departments:Assessors Division: Property Assessment Search Results a 3 ILYNXHO LM COURT Owner: PRADA,JAMES J JR&SORAYA Property Sketch Legend Map/Parcel/Parcel Extension 327 /185/ Mailing Address - ---. -24-- ---- - PRADA,JAMES J JR&SORAYA 3 LYNXHOLM CT ' HYANNIS, MA.02601 2005 Assessed Values: Appraised Value Assessed Value Building Value: $82,700 $82,700 Extra Features: $2,400 $2,400 Outbuildings: $1,800 $ 1,800 Land Value: $124,300 $124,300 Interactive Property Map: ap requires Plug in: licl�;For Totals:$211,200 $211,200 I have visited the maps before , Y Show Me The Mann -"--- April2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: PRADA,JAMES J JR&SORAYA 4/24/2002 15082/093 $ 148,000 GALVIN, MARY J 9/15/1982 3562/346 $45,000 MURPHY, 5/15/1982 $38,000 2005 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $38.33 Town Fire District Rates Other 1 $6.05 Barnstable- Residential $2.12 Land B. Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $321.02 C.O.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $1,277.76 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 W Barnstable- Residential $1.44 W Barnstable-Commercial $2.10 Total: $ 1,637.11 Due to rounding differences these values may vary http://www.town.bamstable.ma.us/tob02/Depts/Administrati veServices/Finance/Assessing... 7/27/2005 f. Barnstable Assessing Search Results Page 2 of 2 Land and Building Information Land Building Lot Size(Acres) 0.17 Year Built 1960 Appraised Value$ 124,300 Living Area 816 Assessed Value $ 124,300 Replacement Cost$ 102,067 Depreciation 19 Building Value 82,700 Construction Details Style Ranch Interior Floors Carpet Model Residential Interior Walls Drywall Grade Average Heat Fuel Oil Stories 1 Story Heat Type Hot Water Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 2 Bedrooms Roof Cover Asph/F Gls/Cmp Bathrooms 1 Bathroom Total Rooms 4 Rooms Extra Building Features Code Description Units/SO ft Appraised Value Assessed Value FPL1 Fireplace 1 $2,400 $2,400 SHED Shed 112 $800 $800 FCP Carport 180 $ 1,000 $1,000 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bam stable.ma.us/tob02/Depts/Adrnini strati veServices/Finance/Assessing... 7/27/2005