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0015 OAK NECK ROAD
i I �i r�A Assessor's map and lot number .40.......... ..... 2- T Sewage Permit number ............t1l......... �.Gvr. v�-LUJ �= ��UG�/Gy�Lc6 F11IETp�O TOWN OF BARNSTABLE I BAWSTOBLI, i 6 9 �•� r BUILDING INSPECTOR O•Ea M Ar. � �C,tLb SWIM rNC �00 APPLICATIONFOR PERMIT TO ............. ... ....................................... ......•.�...... ............!-......................... n�rc f..b q u TYPEOF CONSTRUCTION ......................�.®.........1..4�.....`�.............�.. ..........................:.................... A.... ..........:...............,973.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 5 ....�XA 1?j + -VA1 h..4 iS Proposed Use ............ (!�?..l.l'1l.1!'!.�...• ...... .nQ.. ....A!; SoQ ...�'�.....A.PA.R.i o�FAT ................... .I .................. ZoningDistrict ........................................................................Fire District .............................................................................. sEArCoN� coR� ? hy Nameof Owner ..... ... ... ... ... ... .. .. .. .. ...r........................Address . .... ..... .�.. .. f �OQIS ..........Address 0!4�J a.u.. �Ss......................... Name of Builder ......�. .............. .................. ........ .......... ...... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior .....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. 4fT o vo Fireplace ..................................................................................Approximate Cost .................................................................... M- Diagram Definitive Plan Approved by Planning Board ______________________-________19_______. Area ....S .....of Lot and Building with Dimensions Fee ...........ro..xvio......... SUBJECT TO APPROVAL OF BOARD OF HEALTH JID I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. e Name .... ..... �L� f :.... ......................... Q Sea-Cone Corp. 16u1& No —.����.— Pmrmi�for -- .��mI � ` ......Location — --- --------.------ � " ---''r---'-�����..'------------' \ ' Corp Owner ----.��������..�z����-------.. } � Type of Construction -------------- � ---`----------------------'' ! � . � . / / | Permit Granted .. 22 lg �� \ ' \ ------------'' ( . � Date of |n ------------lgDate _ > / Completed /........ .........19 . r , V � PERMIT REFUSED ----...---.------------- 19 - ' [ ------r-------------------' | --'----------~--~—~^'-------'' � ~.----./----------.—~..—..---- | ----------.-------.-------~. Approved ................................................ 19 [ ' ^ ----------------------~---' . , ------------------------.—.. Shea, Sally From: Bill Rex <wrex@hyannisfire.org> Sent: Wednesday, February 21, 2018 5:07 PM To: Shea, Sally; Sumner, Matthew; Melanson, Dean; O'Neil, Edward Cc: Lauzon,Jeffrey;Anderson, Robin Subject: RE: 15 Oak Neck Hyannis Hello, First level units are marked 11-15. Second level units are marked 21-26. Third level units are marked 31-36 17 units total. Captain Bill Rex Hyannis Fire Department 95 High School Road Ext. Hyannis, MA 02601 508-775-1300 From:Shea, Sally [ma iIto:Sally.Shea@town.barnstable.ma.us] Sent:Wednesday, February 21, 2018 4:26 PM To:Sumner, Matthew<Matthew.Sumner _town.barnstable.ma.us>; Bill Rex<wrex@hyannisfire.org>; Deputy Dean Melanson <dmelanson@hyannisfire.or >; O'Neil, Edward<Edward.O'Neil@.town.barnstable.ma.us> Cc: Lauzon,Jeffrey<Jeffrey.Lauzon@town.barnstable.ma.us>;Anderson, Robin <Robin.Anderson@town.barnstable.ma.us> Subject: 15 Oak Neck Hyannis Hi Everyone, Someone came in today to register her home occupation for unit#25 at the above address. There is no reference to #25.Our Town of Barnstable records (parcel lookup) shows we only go to #17. Per Hyannis Fire Dept. they do have records that reflect units in the 20's. Hyannis Fire shows 17 units total so the number of units look correct however it looks like the building lost some of the lower numbers. This building appears to have gone from apartments to condominiums. Captain Rex from Hyannis Fire will be making a visit there to see how it is numbered. Our records do not appear to match the Fire Dept. numbering. Sally Shea Town of Barnstable Assistant Zoning-Admin/Lead Permit Tech. 508-862-4031 1 1308-176-f A 15 OAK NECK ROAD UNIT 1 OOTT, ANTHONYT & JOSEPH-SCOT, NICJNA, H, .n 308-176-OOC 15 OAK NECK ROAD UNIT 3 FIEDLER, LYNN & ERI'C J & AMY H' 338-17I�-flE 1'S OAK NECK ROAD UNIT 5 LAROSE, DONNA L H' 65 3 8-17 15 OAK NECK ROAD UNIT 7 WALKER WILLIAM J H' OOG ' �., maim 1308-176-Mi 15 OAK NECK ROAD UNIT 9 MANGALO, MI'CHEL :H' o y 3fl8175-OOK 1,5 OAK NECK ROAD UNIT SANFILI'PPO KATHRYN H' 1'1' F 398-176- 15 OAK NECK ROAD UNIT OBRIEN, TIMOTHY J H' i99M 1'3 s- =308-178- 15 OAK NECK ROAD UNIT BONAZZO, GARY & SOP'HIE A TRS H' oloo 1'5 38-176- 15 OAK NECK ROAD UNIT CUNHA. KLAUS V& MARIA D H` (.....,. 2 ..r_�;;:,..'_..:..._.::c'..::�;_s^:..vu.i.r_:;,.r.:.w.rsu::,enr.�-•.;rvar:.,,r.,�_„a.ycxwu�,:.�.<._=�aa,u;,c,n.c.,.b;.:::urea..✓.x.-.v9u..s.xr,.w.ausu:>x..:.uv.a.,v_.:.w,rs,v:,.acru+:.mnv;.o-a,.,e. .,.a:,c-.w...ae�...n,.w.ow..u.w��uxnn...m..u_s,�.n.,..cev,u.,rm—nye,+^c,."u,......�,.vroe,...m.mnw.w..�o.c....nu.,�..,.n,......�.-. YOU WIS14 TO OPEN A BUSINESS? For Your Information: Business certificates(cost40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town [which you must do.by M.G.L.-tt dogs.riot give you.permissionto operate.) You mustfirst obtain the necessary signatures on this form at200 Main St., Hyannis. Take the completed.form to.the Town Clerk's Office,.1st FI_, 367 Main St., Hyannis, MA 026.01 (Town Hall) and get the Business Certificate that is required by law. DATE: ��'"�'r -� Fill in please: ][>Z'F L�+ 1 APPLICANT'S YOUR NAME/S: - U S�/V F' ! h *�- )� �h:�� USIN 55 YOUR HOME ADDRESS- A/0 (' 'Ok1.7- �►" ae!� i' d LEPf-IONE # Home Telephone Number E-MAIL NAME OF CORPORATION: NAME bp-NEW BUSINESS L I VD5 w' l Alf lv TYPE OF BUSINESS V4 11V_r ,M C- IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS. 6C G Mr5•MA AP/PARCEL NUMBED�(t'1_ � (� 'Assessing) When starting a now 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 intend'od 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 CO ISSID dER'S OFFI E MUST COMPLY WITH HOME OCCUPATION. This individ al h ee in or o any e m aqu' emerits thet pertain to this type of business. RULES AND REGULATIONS. FAILURE TO COMPLY MAY RE8ULT'IN DINES. Aut on ed Signature OM NT 2. BOARD OF UTH This individual has been informed of the permit requirements,that pertain to this.type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS [LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: I i uma ui narnstavie ZHE I Building Department Services F 1p� •� �, Brian Florence,CBO Building Commissioner ' RARNS'ABLE. 200 Main Street,Hyannis,MA 02601 Mass. 9 1639. � www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Name: /r y SO/ ) Phone#: 7 Lf)"Z3 6. D 6/.Z. Address: 1 5�Or,/ BOG It 2,5 z-ro o I Village:_ r Name of Business: A/-U yS cg/V,5 Pw 11V771V G— Type of Business:'!PU?7/1M G_ Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the.dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is tamed 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 are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing-the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall by employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,hav read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: -Z I Homeoc.doc Rev.06&0116 r Town of Barnstable Regulatory Services o Richard V. Scali,Director t.�. Building Division BAaivsrns M^CQLQ $ Paul Roma,Building Commissioner s63q. �0 200 Main Street,Hyannis,MA 02601 www.town.barnstable.dia.us Office: 508-862-4038 4 Fax: 508-790-6230 Approved: Fee: Permit#: ' HOME OCCUPATION REGISTRATION Date: at) 10 Qs ) K2 Name: rM1 � � Phone#: Address: 15 OW I e&Q� JI Village: KI-1 y Name of Business: U l Type of Business: Map/Lot�(1 INTENT: It is the intent of this section t 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 are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersigne ,have read and agree with the aboverestrictions for my home occupation I am registering. Applicant: (D, u`hon—) Date: Homeoc.doc Rev.06/20/16 YOU WISW TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required by law. _ DATE: 0ONW i t Fill in please: YDUR NAME S: I Yx�2j �I Acau APPLICANT'S )I7 1 r'�! -;,+ BUSINESS YOUR HOME ADDRESS: ►S OprI ......` 'Wr=;�r TELEPHONE # Home Telephone Number ol19 605 _�, t'O 2A-y��. UICe, �1o" I a .: ,r.:.rm ' .rr;.a�;i�•r=;;� E I N #: E—MAIL: NAME OF CORPORATION: NAME OF-NEW BUSINESS( K1w U► ' TYPE OF BUSINESS YL�, IS THIS A HOME OCCUPATION? . U YES NO �YV I g) ADDRESS OF BUSINESS. . MAP/PARCEL NUMBER VV UYI!I (Assessing) When starting a new business there are several things you m'bUirmation o In order to be in compliance with the rules and regufations of the Town of Barnstable. This form is intended to assist you in obtaining tha you may need. You MUST GO TO 200 Main St. (corner of Yarmouth ' B Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 'I. BUILDING COMM ISSIONE 5 FFICE MUST COMPLY WITH HO�E�' OCCUPATION . This individual has be f ed of a r1'er re is that pertain to this type of business. RULES AND REGULATION C( II I_Y MAY RESULT IN FINES. Authorized Si n urn** COMM TS: / Al 2. BOARD OF HEALTH C individual has been informed of the permit requirements that pertain to this type of business. This +n P q Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: . TOWN, OF BA,.RNSTABLE BUILDING PERMIT APPLICATION Map Parcel / Ii Mr',!N OF BARNSTASIEApplication # Health Division Date Issued <Cl�f f Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ' `'t.` ' Historic - OKH _ Preservation/ Hyannis w/ Project Street Address /S' 06L /Ve_c-t Village Owner C'�Q^�"�� CO40 Address O�-� //ec L Telephone 50 4 -• 9 2-0 - U Permit Request ce_ ('av1p. PVC.- V-,Q_v L r c n Q -713 Square feet: 1 st floor: existing proposed 2nd floor: existing?3°U proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ±1°k Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes O16 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 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 7peals Authorization ❑ Appeal # Recorded ❑Commercial Yes ❑ No If yes, site plan review# Current Use co-jov-\,k �-� Proposed Use APPLICANT INFORMATION -- -- �- (BUILDER OR HOMEOWNER) Name )) /��Oo r� "`' �`� - L- i� ( fi� Telephone Number Address "Z rilL_ License # C 5 ' U t °- W) o( a7- Home Improvement Contractor# C 3 6 o6 3 Email Worker's Compensation # W C v'71 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `"t' _l b FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. RE-ROOFING/RESIDING/WINDOWS (COMMERCIAL) ❑ If located in OKH or Hyannis Historic District- Certificate of Appropriateness required unless same color/same materials specified on application ❑ Map/parcel number Approval Sign-offs from: ❑ Tax Collector ❑ Treasurer ❑ # of squares of shingles or square footage of roof or sidewall to be shingled/sided ❑ Specify stripping old shingles or going over old roof. If going over ❑how many roof layers existing now ❑what size are rafters? What is span? ❑ Owner's name & address ❑ Project valuation must be entered ❑ Builders Information ❑ Signature ❑ Workman's Compensation Insurance Affidavit State form must be completed and.a copy of Insurance Compliance Certificate must be submitted. ❑ A copy of the Construction Supervisor license is required. Effective March 1, 2009 ❑ Check expiration date,no restrictions ❑ Permit fee$160.00 ❑ Property Owner must sign Property Owner Letter of Permission. Projects requiring the use of a crane must complete the forms issued by the Aeronautics Commission e q-forms/bldgpermits/permitchecklists rev.070610 . ..... . -- axe Carom peam Of-musachuseft Deparmzmt afladusftidAccidents - - OjTwe Of brRfs at«arrs 6170 Was gtbw meet Bastar%.MA 02 - rvK�w.rx�us�gr�dint ' Workers' Compensation Insurance Affidavit:EziiIdersfContra:ctors/MectricmnslPlumbers A-PpEcalnt Information. Please Print Lef�ibly Dame(&esig� ail vidmo: j<jdl-t!vvLLc, t'iddrt s Z3 /Vor`� Sf C ity/StatxI�: Wa ice S t!^ I - C,%O�— Phoney: Am you an employer?Check dLe appropriate box: Type of rct. �s. c ��e ����� L L9'1 am a employer with ZZ 4 ❑ I contractor and I 6_ Neer,„nd uc-fi employees{fall andlorgacf=time}* havehiaeatbe s at ors 2_❑ I am a sore propiietctr or partner- listed on the attached sheet; y- ❑Re,- der, shsp and ba-ve no employees These wab-contractors have g- ❑Demolitibrx working for me in any capacity employees and have.workers' 9- ❑Building addition U96 workus' conlp_in arrange comp-insaranr reT:,ire,i-] 5_❑ '%Te are a corporatimand its 10_0 Electrical repairs or additions 3.❑ I am a hommev%mer doing all work officers have exercised d�ek ILO Plumbing repairs or additions myself [No workers'cam: fight.of exerr ption per n+fGL I2,.[�j-g f c 15Z §Ire a �s br��xangc -11 (�'and weh %ma 13_0 Othei employees [Nn WDAMM, comp insurance retluired.1 *Airy saps that checks bars#1— also f1 or4 the sec6oabeIaw chaw*c dL&vuleni'corn mnsa6na pricy mffmxmticm T aDmeawaes vrbo sabmrt this afEdxvd iniWicstiug they am d0mg aII Uwk Md dim I&E ou=&contt=ars nmst submit a iL-w afdsrit mdir�mr-h rCMjtrnctnrs that check ihEs bmc nest XMr7 ierl art additimisI s3xeet shirceh¢g the nsone off>hP:�¢oml �mdsiste Ahether ocnzti these�ifies fi� employees_ If the mTa-<ont mctars ha;,e employs,they must piuvide their workers°corny pohry n unbeT Iam arc employ"that is prmi workers'congmmafinn armwarcca for rimy ewplayem Helow is the pafic,}and}ob saLc i formahia- Insarmce CornpanyName: Policy#or sd ins_Ur vAl C-a ? I 6 30 l ExpiE fi=Date: 2c� f Job Site Address: is Qe-L Ale��'67�. � Cit0stawZip: `�y r A&Uch at copy of the:Nw-orkers'compensation policy declaration page(showing the policy number cad expiration date). Failure to secare coverage as reTuiredunder Section SA o€MGL c. 152 can lead to the imposition ofcriminal penalties of a fine up to$I,500.00 and/or one-yearin3prisonment,as well as civil penaffies in the foam of a STOP WORK ORDER and a fine ofup to$250.00 a day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Investigations of fbe DIET for ineir=e coverage verification— Ida hereby eerh r . gains and'penaIties ofpedw y that the infornztfian prati&d above Is b-ua and correct SiEnature: Date_ Phow#: e, - ti s'J D l vzd-a£rue ouTy. Do not mite in t{rig area,to be compered by c4 or town of, C&L City or Town- PermitUcense# fssning Authority(drde one): 1.Board of Health 2.Budding Dep2a meat I CitFFawn Clerk 4_EIectrical lnspector S.Plumbing Inspector .6.Other Contact Person: Phoine;k 6 Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statate,an anployee 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 o a dwelling house having not more than three apartments and ide therein, e occupant e own f g vmg ap who rest s th r m,or the o upon of th 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 state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance,coverage required." Additionally,MGL chapter 152, §25C(7)slates"Neither the commonwv alth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance)Nzth the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checldag the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),addresses)and phone numbers)along with their cerri_ncate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)vi ith no employees other than the members or partners,are not required to carry workers' compensation insurance_ U an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Depa-unent of ladustrial Accidents for confirmation of in urance coverage. Also be sure to sign and date the a:M2,vgt The affidavit should be retlzrned 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 stlf-insuraace license number on the appropriate line. City or Town Officials Please be are that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant_ Please be sure to fill in the permit/license number which-,,U be used as a reference number. In addition. an applicant that must submit multiple permit/license applitations in any given.year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Addmss"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 fulled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (ire,a dog license or permit to bum leaves etc.)said person is NOT required to complete this allidwFit 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: Teo CommanwitaJ&of Massachusetts Degattment of Industdal Accidents Q-ffzce Qf VIv Sgotiom (500 wa,3ynaton Stet Boston,MA 02111 Tel.A 6I7 727-49OU Qxt 406 or I-& MASSAFE Revised 4-24 07 Fax# 617-727-7149 7iww_mas�gcvldia E i � F 9$��a Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Mam' Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, \JQ �' �``` � ,as Owner of the subject property hereby authorize' �-s- o Cd�a rC h. 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 A Print.Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:1WPFn ES\FORMS\building permit focros\EXPRESS.doc Revised 061313 I F r s t P ro p e r t M p, N A G E M E hl T 1046 Main Street Suite 11 Telephone 508.420,0299 Osterville, Ma. 02655 Facsimile 508.420.0789 www.fpmcapecod.com April 4, 2016 To Whom It May.Concern, My name is Devin Witter and my company First.Property Management has been contracted by Oakview Condominiums to serve as their Property Manager. ,I am authorized'by our contract and the Master Documents of Oakview Condominiums to act as the Agent of the Board of Trustees and as such hereby authorize Kidd tukko Construction to pull any and all necessary permits to replace the roof at Oakview Condominiums located at 15 Oak Neck Road, Hyannis MA. If you have any questions feel free to reach out to me.by phone at the office or by email. Thank V you for our y time. Sincerely, Devin A. Witter CMCA,AMS Property Manager First Property Management Devin@fpmcapecod.com 1 l® Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-081045 Construction Supervisor i SEAN G KIDD `' K k` ' 233 EIGHT LOTS ROADS*r' SUTTON MA 01590 Expiration: Commissioner 11M312017 pJWee o _.- Gansu �acU COME AMP mer 4. �r ` $` s�e � aclz e egistrat7o ROV EMEINT CO ° ss Re 4� �atl� IKl- xPrradon:_� �, CONTI�q.CTOR gala ioa DD.LUVKK. O Co P TYPes SEAM KID ..' r�wate CorPorati! 23 D �U �DRT H STREET y. RCESTE R•A44 -__ U�tlersecrefai�, , AC40 o' CtRTIFICATE OF LIABILITY INSURANCE FDATE 6 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND 'OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Denise Thomas, CISR AAI NAME: R.S. Gilmore Insurance Agency, Inc. PHONE (508)699-7511 AC, IC No:(508)696-3957 27 Elm St. E-MAIL ADDRESS: P. O. BOX 12 6 INSURERS AFFORDING COVERAGE NAIC# N. Attleboro MA 02761 INSURERA:Gemini Insurance 10833 INSURED INSURERB:Safety Insurance Company 39454 Kidd-Luukko Corporation INSURERC:Scottsdale Insurance Company 23 North Street INSURERD:Star Insurance Company INSURER E: Worcester MA 01605 INSURER F: COVERAGES CERTIFICATE NUMBER:CL164553411 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSrnR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/DDY EFF MMIDD� LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE �OCCUR DAMAGE ( RENTED 300,000 PREMISES Ea occurrence $ VIGPO16323 10/1/2015 10/1/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Blanket Primary& $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,0700 Ea accident ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AUTOS Ix AUTOS 6219509 9/1/2015 9/1/2016 BODILY INJURY(Peraccdent) $ NON-OWNED PROPERTY DAMAGE% HIRED AUTOS AUTOS Per accident $ Medical payments $ UMBRELLA LIAB R OCCUR EACH OCCURRENCE $ 5,000,000 C % EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ XLS0098012 10/1/2015 10/1/2016 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA A E.L.EACH ACCIDENT $ 1 000,000 OFFICER/MEMBER EXCLUDED? y❑D - j (Mandatory in NH) wc071916301 4/2/2016 4/2/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Roofing work at Oak View Condo. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Hyannis THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Tim Gilmore/AMKAHA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025rnnaml N9800 Fredericksburg Road San Antonio,TX 78288 1111. USAW 04664 .23P2Z.JSS1138993079. 01 . 01 . 3096 CITY OF BARNSTABLE October 29, 2015 367 MAIN STREET HYANNIS,MA 02601-3917 Reference: Massachusetts General Laws, Chapter 139, Section 3B Attention Building Commissioner, I am writing regarding the claim referenced below. = . Policyholder: Anthony T Scott Reference #: 012786035-10 Date of loss: October 21, 2015 Location of loss: Hyannis, Massachusetts Address: 15 Oak Neck Rd Apt 11 Hyannis, Barnstable, MA, 02601-4584 A claim has been made involving loss, damage or destruction of the property referenced above, which may either exceed $1000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to my attention and include the reference #. You may submit correspondence or questions to me. My contact information is: Address: P.O. BOX 659468 SAN ANTONIO, TEXAS 78265 Fax: 1-800-531-8669 Phone: 1-800-531-8722 x77961 Sincerely, Celeste M Sanchez USAA Southeast Regional Office United Services Automobile Association PO Box 33490 San Antonio, TX 78265 Phone: 1-800-531-8722 x77961 Fax: 1-800-531-8669 REM/CMS 012786035 - DM-04664- 10 - 6764- 12 54577-0715 Page 1 of 1 r, S.023 P 2Z.003096.0001.0001.1.000000.Z. Town ®f.Barnslable. TMV a OF BARNSTABLE F T�9E T � Regulatory Services ,, Richard V.Scali,Director BAW�STA� SS. $� Building Division 16.39. Tom Perry Building Commissioner .200 Main Street,Hyannis,MA 02601 D I I I M41 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 COMPLAINVIN UIRY REPORT g Date: D � Rec'd.by7. Complaint Dame: //�- � �Q Map/Pai eel l'D/v Location Address: Originator . Dame: iU��• -/}/�� �/ Street: Vil l7 lage• W./ � State: Zip: D Telephone: �D '3�� ' 1 vZ n Complaint Description: t RI FOR OFFICE USE ONLY �� Inspector's Action/Comments .Date: ,5' I �.S Inspector: LG��ci�T G,G �Y�3� D/oa- Q/'(5iJ✓l0 /tom 7"il/r� U? c{7SCl�:` Additional Info.Attached Q:forms:complaint. Revised 040414 Bk 24.003 P2Y4.6 -504.09 1-2009 Q 03_ 18P • �Comrnoub�ea�Cttj of�'a�gg�c�ju�l'tt� BARNSTt4BL)f;*ss: SUPERIOR COURT , a` No.BACV2009-00520 The„Ca a Cod„Five„Cents„Sapin plaintiff P. gs Bank ?. A TRUE COPY ATTEST. VS. 4 Ty Agthrya... anfilippo .,Defendant WRIT OF ATTACHMENT To the sheriffs of our several counties or their deputies: WE COMMAND YOU to attach the goods or estate of defendant , .ICathrpn„Sanf ilippo.............. ......................................................................................... of 8 Cazenove St..�...Bostont...Massachusetts ..., to the value of **50,000.00** ..........................I.....................(the amount authorized),as prayed for by plaintiff, The Cape Cod Five Cents Savings Bank Orleans, Massachusetts ........................I......I.............. .........................'Of................... ...........................................................:; whose attorney is..Bradley„J.,, !4il Y.p... sd........................of 100„W. Main St., Hyannis MA 02601 in an action brought by said plaintiff The Cape Cod Five Cents„Savings.Bank .against said defendant „Kathryn Sanf ilippo .....................................................................in the Superior Court for Barnstable County,and make due return of this writ with your doings thereon. The complaint in this case was filed on .July,,,29? 20Q9.... I � This attachment was approved on .August. 27,,,,2009 .........I .....................................,fib ,by Robert....C..Rufo......................................................... ..J.,in the amount of$**50 000.00**......... r. Witness, ....................... W. .4,.R0. .....................................:............................ ...,Esquire,at Barnstable, 27th ..dayof...Aupust.t...2009............. ,W the........................:.................. ............................. .................................. Clerk PROOF OF ATTACHMENT Barnstable ss. August 31,2009 t By virtue of this writ, I this day at 2:10pm attached all the right,We and interest that the within named defendant Kathryn Sanfilippo'now has not exempt by law from levy or attachment, in and to any and all real estate situate within the County of Barnstable. The within is a true copy of this writ, and the above so much of my return as relates to the attachment of this real.estate on this writ. Bradley J.Bailey, Esquire 100 West Main Street Hyannis, MA 02601 Attorney for Plaintiff a Ke nedy-Murp y BARNSIABLE REGISTRY OF DEEDS Deputy Sheriff 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 1_7 Application # G Health Division Date Issued 1 Conservation Division Application Fee n Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project-Street-Address 15 00-IL. �LeCAL qc5AA Village Ld1hLS •' 75 old 1�►�s6_d D �Owner I�►!Yl '� N�V�C� �.�,� Address ��V� .Telephone's=7Z5b'b " �3 a- 31 3-3 Permit Request u E u p� Square feet: 1 at-floor existing proposed 2nd floor: existing proposed Total new Zoning District, Flood Plain Groundwater Overlay PT ect,G_1uation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ 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) CNa e� nK.��P EJDrerv�e.� rTelephoneaNumber J�� ^ ?r7s 7 7 + '� Are ddress 1f1'1 �a�oc stub L,icense°# C 4`(3 k.. �.-- - dMAAiS < A �Ja�(ociJ Home Improvement Contractor# 16 3`75-7 Worker's Compensation # 7W �'f/q Uj(U/o?b ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �U1YF1Ct�tY�r� �i� to SIGNATURE DATE , �" FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED 3 - MAP/PARCEL NO. ADDRESS VILLAGE f � OWNER E DATE OF INSPECTION: 3 FOUNDATION FRAME 5 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING C i - DATE CLOSED OUT ASSOCIATION PLAN NO. 3 Oct 31,•11 .09:36a Factoryuser 508-432-4971 p.2 OAKVIEW CONDOMINIUM TRUST PO BOX 1204 HYANNIS., MA 02601 October 31, 2012 Building Department Town of Barnstable Re: Oakview Condominiums 1S Oak Neck Rd. Hyannis, MA 02601 To whom it may concern: The Sprinkle Home Improvement Company is authorized the repair the soffits on the Oakview Condominium building located at 15 Oak Neck Rd:, Hyannis, MA 02601. For original signature see town approved Authorization Form attached. Sincerely, Thomas H. Benton Business Manager/Chairman Oakview Condominium Trust 5 , The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 02111 www massgov/dia Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/lndividuai): Sprinkle Home Improvement Address: 199 Barnstable Road City/StatelZlp:Hyannis, MA 02601 Phone#. 508 775-1778 Are you an employer?Check the appropriate box: Type of project(required): 1. 1)X I am an employer with 9 4. 0 1 am a general contractor and I 6. 0 New construction employees(hill and/or part time).• have hired the sub-contractors 7. 0 Remodeling 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' g ❑ Building addition (No workers'comp. insurance comp. insurance. t required) 5.0 We are a corporation and its 10. 0 Electrical repairs or additions 3. 0 1 am a homeowner doing all work officers have exercised their 11. 0 Plumbing repairs or additions myself [No workers'comp. right of exemption perm MGL insurance required)t c. 152,§ 1(4),and we have no 12. 0 Roof repairs employees.[no workers' comp. insurance required.) 131.4ther *A"apptlaat that cbmb box 01 mast alw an oat the seetbn blow showing thdr workers'compensation pocky information. tHomaowoers who submit this amdsvit indkating they are doing all work and then hire ontdde contrwtors must tobmtt a new affl"vit indicating weh. XOGIU ton that ebaek thb box must atteeb an addMbnal sheet showing the name of the sub-contractors and state whether or not thaw entitkt have employee. if tbw subt+ontraetors have emabvw o,they must Provide their workers'eom&policy number. 1 ant an ampkyer dw is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:Associated industries of MA Policy#or Self-ins.Lic.#: AW C 7004943012011 Expiration Date: 01-01-2012 Job Site Address:J,� (J L Q City/State/Zip: t'ti[c.,A VX 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 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S250.00 a day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. 1 do herby certify lit# ties ofPmlury that the mforrmation provided above is true and correct Si Date: PKWAame. Brad Sprinkle Phone#: 508 775-1778 Ext.10 i Official use only Do not write in this area to be completed by city or town official City or Town: Permit/license#• Inning Authority(circle one): 1-Board of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other" Contact person: Phone#: Town of Barnstable Regulatory Services . Thomas F.Celter,Wrerbur Building Division Thomas Perry,C130 Ba HI"Commisdoner 200 Man►Street, Hyannis,MA 02601 www.town.barnsMbk=a.as Ofoe: 5084W 4038 Fax: 508-790.6230 Property Owner Must Complete and Sign This Section If Using A Builder L ( 6n'1 41 ,as Owner of the subject property ` k hereby authorize Sprinkle Home Improvement to act on my behalf in all matters relative to work authorized by this building permit application for. (Address of Job) 'C�60xew 'Ir I - lo��►-7 1/ Signature of Owner Date Print Name U PrGPWq Owner 4 8PPW fOr PwM%PINu complete the Homeowners License Exemption Form on the MOM ski& c o9►wmdv"T=Vomy moaner F,OWA.Leoc xBss aoo Ravised 072110 W1111 t {t DW}! ll1t i -fit tit 113111itti vIv kirrard of , . . . • a�kr,srt.C/ ine/s�s Kc'ru.°ra�t fzovnrr h (� ti y 4 HOME IMPROVEMENT CONTRACTOR 4Ql�si(ll4 it fn ill(3c'.?V ICQF t.iCi:r?;±$ � I.. 1 t Registration: 103757 Type: c.tcene CS 6643 "'� a\ , Expiration: 7J9t2012 Private Corporatic x � SPRINKLE HOME IMPROVEMENT,INC. BRAD K SPRINKLE 190 LOTHROPS LANE farad Sprinkle .W BARNSTABLE, MA 02668 '� 199 Barnstable Rd. Hyannis,MA 02601 13udrrsecrctary Exlrtrmion, 1.018r2013 License till registration valid for individul use unly Failure to possess a currant edition cot'th bel'01-C the eN flil:uion date.. If found return to: Massachusetts State Building Code ORick ofConsumer Affairs and Business Regulation is cause for revocation of this license. 111 P:u•k Plain-Suite 5170 116ston,MA 02116 Refer to: WWW.Mass.Gov/DPS Sol alid without sign ture ti e t ' CERTIFICATE OF LIABILITY INSURANCE DATE 11 4�010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE i CERTIFICATE HOLDER. nG`ORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(iss) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the,policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsament(s) aWatNM(sm CONT„T Bryden 6 Sullivan Ins Agency vNarsc Mti TrAA Inc IA/C. Mu.. I-t): (A/C. Mo), I-101L 88 Falmouth Road AWRA Hyannis, MA 02601 CUSTOM& 10/. INBURW(/) Arra"INO C0VwU OI wIC M INSURED IN/VAE, A: A.I.M. Mutual Insurance Co Sprinkle Home Improvement Inc msumm Rt 199 Barnstable Road TN/UPRR c. __ Hyannis, MA 02601 tN/URRR D! IRA/UARA it TN/UAi11 fe ! COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIRn2HT,-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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFF POLICY EXP t our TYPE OF INSURANCE POLICY NUMBER e,riooitYtn ,r.imfntt) LIMITS GENERAL LIABILITY LACK OCCURANCi a aCOpICNCIAL GENERAL LIABILITY DAle,Oi TO REMliD / i OQGIAIN7 NAI1G ❑OCCVP PR MMSzS4LS.PDOUri-) _ ElECP (AAy—P.....) a _ a ' PZMCNAL a AVv INJVRY a OtoOtRA1 AOOAROATR + 7 GLN'L AG£PEWTL LI NIT APPLIES CN.P ❑POLICY MPPOS LCT DIAC PRODUCT/ - COI®/ov Am a AUTOMOBILE LIABILITY I avm2NID s2NDIJt LZMaT ❑ANY-AUTO RODSLY 1NJVRS (par Pr�.nl 'a �uL OWNED Autes QSCNEDVI.Cb AUTOS DMILY INJURY(pt.otuo.nt) PROPERTY DAMAM aHi RCD AVt05 tP.r.mi0.ut) - a Q.YDN-OWNLD AVTO7 i a �I a RUNRLLIA LIAB OCCUP ! iACM OCCURAINCi a QIXCGS Lt AD CLAI N9 MADL ! A CM"TT ' S D.-.t BLC ORETPNTION S a WORKERS C06O7ENSATION AND ZbUWYEES LIABILITY ia.t u.ir. to THE PROPRIETOR/PARTNERS/ i.L, rACH AecrDErT a 500,000 EXECUTIVE OFFICERS ARE A ® 1ncl ❑ exci 7004943012011 01/01/2011. 01/01/2012 i.L. D1/iA/R -POLICY LIMIT a 500,000 K.L. DI/CASs - a=&LOY«i s 500,000 ovRmerff DLOI►TIOU Or OPEtATION/OR LOCATIONS: WORMRS' COMPENSATION COVERAGE APPLIES TO MASSACHUSETTS EMPLOYEES ) ( - CERTIFICATE HOLDER CANCELLATION PROOF OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE r POLICY PROVISIONS. f AVTMO/J till RtrRilEriATlvt/�'^-•� �[//� /� �sessor's Office(1st floor) Map L? Lot Permit# q&17 onservation Office(4th floor)--;re;& -gam Date Issued oard of Health(3rd floor)(8:30-9:30/1:00- 2:00) Fee 05-4 ' - ^ C' PERMI M THS Engineering Dept. (3rd floor) House#1 /, CONNECT', ENGII1TE hNI C Planning Dept.(1st floor/School Admin. Bldg.) CONSTRIXTION. BARNSTABLE. Definitive Plan Approved by.Planning Board 19 MASS. �. 039. � fp�� TOWN OF BARNSTABLE Building Permit Applicatio Project Street Address Village 4 Owner ///+e40 Z2A Address ,Telephone - .Permit Request JcQo 1_ i?�It�.(lz �"- Cn Total 1 Story Area(include 1 story garages&decks) square feet 010.Z'" Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ S Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces. Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name 71;L2e) Telephone Number �� Address 7l _ �'%/'2 License# r (Q2-cc�-f' 0i',z: Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURk� ! j�� DATE\,14 /Z BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY 4- PERMIT NO. 9678 DATE ISSUED 8/14/9 5 ' ; MAP/PARCEL NO. 308 176 OOA - r ADDRESS 15 Oak Neck Road VILLAGE Hyannis OWNER Bessie Hinds _ DATE OF INSPE( I'ION: + 5 r r FOUNDATION ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING:�,-o ROUGH FINAL GAS: HOUGH FINAL - FINAL BUILDING'' t tv DATE CLOSED.O:UT { ASSOCIATION PLAN NO. t.:. a..res"r5evs'-nR-• z y-e: �.� �-777,,,-^'.!-.s'^ ...,r.,rt '�'�.e .' ".}R;' i�a'"'r-.'�.....,-:._.r,^h,.-- - `"�..`.•. c �-A r J..4 d'^ - %.? �..-."` i ��.,- /■//�/)/.� `.� $ 1ra�„TIC',' fir-- L «C.,•i3`u�y�. zx$myyh j iY`l8�"S> Y 51 rr 3 s f- ,�'�Si wi s �u F in '-z` .` 9 r/ �'drfs.'t' ra�'' .._Y. ;,•�",.',�i >.c ^aCOME-, r•7. ��'„c�i a,�:r ,: h �S r t ;trr*'('�•' iJ '�y 4P k r -;�` y. Y k��� �g';qi ^+ t �� �` ' t 'HOME iIMPROVt ME✓N ,CbNTRACTOR ;REGIS RA -ION ;� '4 4 ,vwyd+rt ..'R xs ,F '-,M,. '£ r...r d`S�b a1. \.4 �"�:" -saP k, ;� 9 D ��6 V yBd..ard of ;BUii d ng FZegul'atic ns --ar7d tandard� 4 y, a s µ4 .$ f t;r .._.Y s �. w� a�s 4/r i�c}r#5 t ° "� ` '�xr ,One �Ashk UronY P�ace� Roo0 : *y u !'uiAm \ tom, 4 t t� , L/ Bo for =Massachusetts \tO21O8 � �, . Me: ' °` cv � HOME �i�PROVEME1vT C0� RACTOR '� .:.nF - xs,r�= Syr �, 't ..f.'s, vf,.�';�p..t. :��•� �� a � ' >� H�sr�p�$a-%� 'rReraton 11�2536 WE.xPiration O4/O /97t �S wq , jjj};rho st��-„,�,E 1 ✓A8 TO6AN![07�! UR LJBQ6 TYPe..' DBA } : �urr �� t t tii i r 4 i}"" .;' :� e��,kyx 3'�';. ::} e..�r� Y�� t wf• '�,t,, a x -^i-b, _ YNQME IMPROVEMENT,CONTRACTOR r vS tiF� } ,. *� •Jw.; S• �y >t r ��a3y�k A. pb 'rY - � # � -. � J��' �� +.�� v ;, I�hr.t�r � r � t n •a ����,.�k'y. ��^�S,'¢s .RegiSEration ` EAN `C ERASERS �{ R' F$�_ r. �� " w� iype UBA� y �t •,}' axq.�"11x ERASER �Explratlon 04/O6/97: ,�. y. t w; F#. ' ���f' ail rat, r Y¢t " �cc 71 TARRAGON 'CIF � , x \if :� � �$ ' } g.�a`. t COTUIT . MA 0.2635 `� ,�t . +�tx' «".n:�aR }"z T" } ,\ "' - AN C ERASER , b �-'r , d'h � ON ,'4 \ r r try � r axceM�o '�eLe.71 TRRRA CI ;h ADMINI > COTUIT NA 02635 '` ' .w_ ...._�,_.,e._„ -.� _ J F ....,w. _ s �'rY.". �' S;wL,. =S' ..e'4f 2}�f��y, r^, ,_ t• 3` .r. ..."�:a.>u::ln .y+�-` _...Y�..A.'.r..`._ 'f�..u-a��.Js:+�imti-!�M°RJ'`o�"' ... .. .J'T. .':�lA-'.\�'�!!�•t"^� � .- The Town of Barnstable .� WMIL ,F Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 ftfph C.msse Fas- 508 775 3344 Budding Cot For office use only Permit no. Date AI+TtIDAV1T HOME I PROVEMENTCONTRACTORLAW SUPPLEMENT TO PERM1[T APPLICATION MGL c. I42A requires that the-reconstruction,alterations,MOVation,=P2k modam �,mason, tzmmal, demolition, or construction of an addition to any pie-adsdng owner oomptee building containing at least one but not more than four dwelling units or to s which am adpu= to welt residence or building be done by registered eoatr =Zs,with oatain cmcpdons,along with other tequiraaeats Type of Work: S'tGQL Est.Cost � "� Address of Work: o/9 K d/.&j a �� O%mer.Name: L V<,,2 Dam of Permit Application: _ -g/,///5-4� I hereby certify that: Registration is not required for the following reason(s): Work cxdnded by lxw Job under S1,000 _Bnilding not oama6occopied tailing own permit Notice is hereby guru that: OWNERS PULLING THEIR OWN PERMIT OR DEALING V=1JNItEGISTF3IED CONTRAC't�R: FOR APPI.ICABLE HOME IMPROVEMENT WORK DO NOT PROGRAM OR GUARANTY FM UNDER MGL c 142A� ACCESS 'I'O TIU ARBI1' -nON SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the Owner: RM i 15r Da a Contractor name Registration No. OR ' _— use Owners name $817 i 27 i 122 Conunonwaaa 0 Ma46ac1x"deffj-. •v ta�L�' 600 1/1/adzixf oa.Shwd James a t:dnpbEq ?7?a wJ&u & 02f f 1 commissioner Workers' Compemtion ItMn=Ce Affidavit (Ifoeofedpamaael with a principal place of business at: tens . (�risrs�zty� do hereby certify under the pains and penalties of pe*ry, tb= t am an employer providing workers' o=p law it I an Coverage for acy employees we this job. LL4L4L)�� Insurance Company Policy Number () I am a sale proprietor and have no one working for the is any capacity. �) general conu=wr or homeowner (circle one) and have fir I am a sole proprietor,concr c tors &zed below who have the following workers' oompensattca Po�Cdes: � FICY Contractor lossaanoe panylPa Contractor [ostuaace CemlaUy/PoficY Contractor hu mance CompanylPoiicy () I am a homeowner performing air the work myself. .I undmand dat a co7f of Ltis srt em w�l be fa�uded q d� Hof t(e of a do twies:Ee:s nG:-ed under secdion ZSA of MGL 1:2 tan IWd YQ=, InIp .-.7-tim u weil as dYH panaides to cite fam:of a STO P WORK ORDER aid a tine of S TCM00 a dal►2Pb=mc. Sign this day of , t9 , LicenseelPermitte Building 0epazmtent Lim Board L�_ Setecuaeas Ol�ce 4� A46ve 4-TOWN OF BARNSTABLE BUILDING PERMIT AP LI A IO Map Parcel Applicationi Health Division 3 � � Date Issued Conservation Division Application Fee 60 Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board %NfYF {f�c or,? t4NT Historic-OKH Preservation/Hyannis ` ,a^�° ati�'�t, 4- EYI Project Street Address oft- Village Owner k) i� Address k 5 Q0q-1< OUCC-(<— W Telephone 97 -�;q q q J%o Permit Request aeFL&!��C 7RK4�C w I� �-✓s , G Y-D N(r'� -to "-t-f- �'p I-tt4+6/'J n)C C813rOter- C0L//LTGi�-;' -5 IA5TPr_., ,v�" �� �2� e 5 `t Iry 1�u ;�A/l w Le cvv Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 0 0 Construction Type J00 Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing i net Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Roor-Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other 77 C Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coalstove: 4:Yes )='❑No c, Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑exic ting ❑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# G Current Use= -- - Proposed Use BUILDER INFORMATION wo,77. fie. N a m e7j�2 y Al,y t t,67N r Telephone Number 60E-737-3—Z-Y!7 Address i��� 12,7 License# q l q.15 M f t, L,�5 OV�4 0 Home Improvement Contractor# 13 F3 Worker's Compensation# V:?� �1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO S�"Aj rl PAPy' a r9 SIGNATURE AQ r DATE 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL-NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME. J INSULATION FIREPLACE `:K ELECTRICAL: ROUGH FINAL y PLUMBING: ROUGH i FINAL GAS: ROUGH } FINAL FINAL BUILDING `te DATE CLOSED OUT f ASSOCIATION PLAN NO. tF" a The Commonwealth.ofMassachusetts l \ artment of DeP findustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia - Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �/� V!� Address: ,n City/State/Zip:4A/ 2 ON�, /O )G� 5 Phone.#: 7- A;Zai' an employer?Check the appropriate box: Type of project(required): 1. a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ ew 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 workingfor me in an capacity. employees and have workers' Y P tY• # 9. ❑Building addition [No workers'comp. insurance comp. insurance. 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its 3.❑ I am a homeowner doing all workf 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. 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 insurance for my employees. Below is the policy and job site information. _ Insurance Company Name: A �T �. Policy#or Self-ins.Lic.#: � � "I Expiration Date: Job Site Address:15 DPK_ City/State/Zip: ►,l / ��'1 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 certi nder the ins and penalties of perjury that the information provide 1above 's true and correct Si ature: Date: /U 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#: j s T Information and Instructions �. Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. s 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 state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced_acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)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 with 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, if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s)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 Town 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-72774900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia EC-12-2007 03 :55 PM OCEANSIDE INSURANCE 5087907955 P. 00EM PRODUCER THIS CERTIFICAW 191SSUED AS A MA1TFR Off' INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Ocaanelde InsuninoeAg4noy lno HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR !S2 Weltt Main 8t ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Hyamis,MA 02601 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Doug Mullen ,Po Say,1274 NkMtows Mills,MA 02640-M THIS 18 TO CERTIFY THAT THE POLICIES OR INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH REBP jCT TO WHICH THIS CERTIMQATE°MAY BE ISSUED OR MAY PERTAIN,THE INSURANCES AFFORDED THE POLICIES DESCRIBED HERE?IN18 SUBJECT TO ALL THE TE MA$,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. S OP WA NU a P erP� uu�oN oR TA PLOYERS'LKBLrrY LIMITS R17MCUTM AItE NC 0LrXE7 6388843 11/21/2007 11/21/2008 ATUTORYLNIIra ER ERAPON10MAOWdcnm0*. ACCOENT 6 100100 WAR POUCYLMR � 500,00 � ECU1L W"004. EMPLME 100 00 THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR DOW MULLEN. CERTIFICATE HOLDER............_...._..:CANCELLATION Town of Barnstable GHOULOAMYOFTNQAROVeORWREEDPOLICESBECANCELLED BEFORE THE EXPRAT ION DATE THEREOF.THE OWN 000MPAHY WLL ENDFAVOR To ML V 200 Main St., OAYawRIITE9NNOTIATO THE OERTFICATHHOLDIRNAMEDTO THE LEFT,BUT PAI.U"TO hW.SUCH NOTICH VMLL HOSE No OOLIOATM OR LNBLrtr OF Hyannis,.MA ANY KIND UPON THE COMPANY,If8 A0EWM OR REPRESENTATIVE& AUTHORIZED REPRESENTATIVE i r BZeorBaila g ewgulatioefs and tandar Construction Supervisor License � . License: CS 81995 Expiration 1/23/2010 Tr# 15516 r ,Rest ctio 0Qf i DOUGLAS W Ml1LLN � rs 59 NOBBY LN W YARMOUTH,MA 026-b5 Commissioner l • r I Massachusetts Department of Environmental Protection Bureau of Waste Prevention . Air Quality BW P A 06 Q Notification Prior to Construction or Demolition Instructions and Supporting Materials Table of Contents • Introduction Permit fact sheet Introduction MassDEP encourages filing Construction/Demolition Notification Form AQ-06 online via eDEP! If you have not already done so, please register online with eDEP at https://edep.dep.mass.gov/DEPHome.aspx. Select"New User"and complete the required steps. It should take no more than five minutes to complete the registration process, and you can begin online filing of your notifications right away. For paper filers, the Construction/Demolition Notification Form AQ-06 on MassDEP's web site should be used. Construction/Demolition Notification Forms and Instructions are available for download from MassDEP's Web site at www.mass.gov/dep in two file formats: Microsoft Word TM and Adobe Acrobat PDFTM. Either format allows documents to be printed. A MassDEP Permit Transmittal Form is not required when submitting a Construction/Demolition Notification Form. Instructions in Microsoft Word TM format contain a series of documents that provide guidance on how to prepare a Construction/Demolition Notification Form(which is considered a permit application). Although we recommend that you print out the entire package, you may choose to print_specific documents by selecting the appropriate page numbers for printing. Notification Forms in Microsoft WordT""format must be downloaded separately. Users with Microsoft Word TM 97 or later may complete these forms electronically. Instructions and Forms in Adobe Acrobat PDFTM format combine Instructions and Notification Forms in a single document. Adobe Acrobat PDFTM files may only be viewed and printed without alteration. Notification Forms in this format may not be completed electronically. ag06ins.doc•rev.7/07 BWP AQ 06 Instructions•Page 1 of 4 Department of Environmental Protection� Massachusetts ep Bureau of Waste Prevention • Air Quality BWPAQ 06 Notification Prior to Construction or Demolition Instructions and Supporting Materials 1. What are the Department of Environmental Protection's(MassDEP's) notification requirements for construction or demolition of a building? In accordance with 310 CMR 7.09, MassDEP requires notification 10 working days prior to the construction or demolition of a building. The purpose of the notification requirement is to protect public-health and the environment by preventing the release of dust or other potentially hazardous air pollutants to the ambient air. Under the federal National Emission Standards for Hazardous Air Pollutants(NESHAP), the U.S. Environmental Protection Agency also requires notification of demolition of a building. 2. Who must notify? Any owner or operator responsible for construction or demolition of a building, excluding residential buildings with less than 20 units, must notify MassDEP. 3. Is there a specific notification form? Yes. Notification must be made using MassDEP's"BWP AQ 06 Notification Prior to Construction or Demolition." The Construction/Demolition Notification Form and Instructions are available on MassDEP's website at www.mass.gov/dep. 4. How do I submit the Construction/Demolition Notification Form? To submit a Construction/Demolition Notification AQ-06 Form, do one of the following: 1. File the AQ-06 online via MassDEP's website. If you have not done so registeronline with Q Y Y � eDEP at https:Hedep.dep.mass.4ov/DEP Home.aspx. Select"New User"and complete the required steps. It should take no more than five minutes to complete the registration process, and you can begin online filing of your notifications right away. 2. For paper filers, when the AQ-.06 is completely filled out, and the appropriate decal is affixed to the form (see Question#6 below), use regular, certified or U.S. Postal Service Express mail to send the form to: Commonwealth of Massachusetts Asbestos Program .P.O. Box 120087 Boston, MA 02112-0087 3. Use a private delivery or overnight service and send the AQ-06 to the following address: Asbestos Notification, 8th Floor, Massachusetts DER One Winter Street, Boston, MA 02108. 5. What is the notification fee for construction or demolition projects? The notification fee required-by MassDEP regulations(310 CMR 4.00,Timely Action and Fee Provisions)for construction or demolition projects is$85.00 per notification. However, owner-occupied residential properties with four or fewer units, cities, towns, counties, districts of the Commonwealth, municipal housing authorities, and other state agencies are not subject to construction or demolition notification fees. ag06ins.doc•rev.7/07 BWP AQ 06 Instructions•Page 2 of 4 Massachusetts Department of Environmental Protection Bureau of Waste Prevention .Air Quality BWP AQ 06 Notification Prior to Construction or Demolition Instructions and Supporting Materials 6. How and when do I pay the notification fee? When filing online via eDEP, you will pay the fee online using a credit card. For paper filers, in order to pay the fee, a notification fee decal must be purchased from MassDEP and affixed to the Construction/Demolition Notification Form prior to submitting the notification form. For jobs that are exempt from the notification fee an EXEMPT decal must be obtained from MassDEP and affixed to the notification form. Fee decals may only be purchased in person at the reception area on the second floor of MassDEP's One Winter Street Boston Office. For fee-exempt construction/demolition jobs, EXEMPT notification decals may be picked up(free of charge) at the reception area of MassDEP's One Winter Street Boston Office or at any regional MassDEP office. For decals requiring a payment, payment must be in the form of a check or money order made payable to "Commonwealth of Massachusetts." Cash and credit cards cannot be accepted. Each notification decal contains a unique number that is used to track the notification. Forms without decals will not be accepted. 7. Is the notification fee decal refundable? No. In the event that a construction/demolition notification is withdrawn, the notification fee will not be refunded. For paper filers, decal fees may be refunded if the original purchaser returns the unused and intact decals. Contact MassDEP's Revenue Office at-the MassDEP Boston Office to find out how to obtain a refund. Lost decals are not eligible for a refund. 8. What is the timeline for notification review? After the AQ-06 is received it will be reviewed by MassDEP. The notifier will be contacted only in case of deficiencies in the submitted notification form, in which case the construction/demolition operation may not start. Where MassDEP informs the notifier of deficiencies in the notification form; the notifier will have 30 calendar days from the date of being informed of the deficiencies in which to respond. Where the notifier responds to the deficiencies in the original notification form within the 30-day period, MassDEP may review the updated notification within the 10 working day notification period. If MassDEP does not issue a denial letter within the 10 working day, the job may begin: MassDEP will deny a notification only in writing. If deficiencies are found during MassDEP's second review, MassDEP will reject the notification, and the notifier may not proceed with the job. If the notifier wishes to proceed with the construction/demolition operation after MassDEP has rejected the notification,.the notifier must submit a new notification and fee to MassDEP for consideration. 9. Can I revise my construction or demolition notification form? Yes. Revisions to the original notification form may be made by doing either of the following: 1. File the notification revision online via eDEP (you can do this even if the original notification was a paper copy). 2. For paper filers, on a copy of the original notification form, write"REVISION" under the notification fee decal, and on the form indicate the revisions being made to the original notification. Mail a copy of the revised form to Commonwealth of Massachusetts, Asbestos Program, P.O. Box 120087, Boston, MA 02112-0087. ag06ins.doc•rev.7/07 BWP AQ 06 Instructions•Page 3 of 4 Massachusetts Department of Environmental Protection Bureau of Waste Prevention a Air Quality BWPAQ 06 Notification Prior to Construction or Demolition Instructions and Supporting Materials 10. What if I need an emergency waiver from the 10 working day notification requirement? Contact the appropriate MassDEP regional office to determine if an emergency is warranted, and to receive an emergency waiver number. If MassDEP issues an emergency waiver, the construction/demolition operation may proceed. A Construction/Demolition Form and fee must still be submitted to MassDEP as described in Question#4. The Form should be submitted within one working day of the beginning of the construction or demolition operation that received the emergency waiver. 11. What can I-do in avoiding the most common mistakes in submitting this notification? a. Fill in all information required on the Construction/Demolition AQ-06 Form. Filing the AQ-06 online via eDEP helps avoid common mistakes. b. For paper filers, make sure you attach the appropriate fee decal in the upper right hand corner of the Construction/Demolition Form. c. Make sure you print out a copy of the Construction/Demolition Form you file online. For paper filers, make sure you make a copy of the Form with the notification fee decal affixed to retain for your records or for use in the event that a revision must be submitted to MassDEP. d. If you have any questions about the Construction/Demolition Form, call the appropriate MassDEP Regional Office. Find your region: http://mass.gov/dep/about/region/findvour.htm 12. Where can I get copies of the regulations that apply to air quality and construction or demolition of structures? MassDEP's regulations include, but are not limited to: • Dust, Odor, Construction and Demolition Regulations, 310 CMR 7.09. •Timely Action and Fee Provisions, 310 CMR 4.00. •Administrative Penalty Regulations, 310 CMR 5.00. MassDEP's regulations are available on MassDEP's website at www.mass.gov/dep. Official copies of MassDEP's and DOS's regulations may be purchased at: State House Bookstore' State House West Bookstore Room 116 436 Dwight Street Boston, MA 02133 Springfield, MA 011.03 (617)727-2834 (413)784-1376 ag06ins.doc•rev.7/07 BWP AQ 06 Instructions•Page 4 of 4 i ` 'ME r Town of Barn-stable Regulatory Services vI'E$ Thomas F.Geiler,Director Fn.19. 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, Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize" /��✓� J r��/�/��� to act on my behalf, IJ in all matters relative to work authorized by this building permit application for. (Address of Job) Signature o Owner a Print Name if Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FO RM S:0 W N E RP ERM IS S ION THE Town of Barnstable �pF Tp�� Regulatory Services BAIMM ST" Thomas F.Geiler,Director Mass Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 vt'ww.town.b arnstable.ma.us Office: 508-862-4038, Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as 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 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 � Im �r -- -- b r v N c� a . _. Sw TOWN OF BARNSTABLE_BUILDING PERMIT APPLICATION �� p Map 1 Parcel Application # Cy =QI I �� Health-Division Date Issued Conservation Division C_ Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Prod ect-Street A d ss S ��k /tIE Village- 1��A �r✓ � f -S O "4 �� �o e✓�v /�ssoe i Address TelephorT Permit Request—, 96 •k v /, r/o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Lk<o On Old King's Highway: ❑Yes Qlo 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 Total Room Count (not including baths): existing new First Floor Room Count P 2 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:40 xisting news size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: s Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOME � R) �" U ,s��f e lit; ,//`� elephoneDNumtjer Address / _.13o3 Y el) k cj� License # 7 l' �,g6✓Ac/, 'Z' d'9,4 OAS 3 7 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Cs;pB hod �SS� az �� r s' ��Y �.v .•+�S q SiGNATURE�' ` ' o rlI1ATEV'_.n y'. p FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE -' OWNER DATE OF INSPECTION: r.. x`• FOUNDATION ' ` FRAME ,r `4 INSULATION' t # FIREPLACE - ELECTRICAL: ROUGH FINAL 'r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r P FINAL BUILDING'S '.: DATE CLOSED-OUT ASSOCIATION PLAN NO. ` y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): /7 114 A../ �2 e oy 1 rz4 Scz,09 ?- Address: U e,� �o City/State/Zip: Fa-rr Phone #: Are you an employer?Check the appropriate box: 4. I am a general contractor and I Type of project(required):. 1.❑ I am a employer with ❑ g ployees(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. ❑R modeling ship and have no employees These sub-contractors have g• �molition working for me in any capacity. employees and have workers' 9. Building o workers comp. # addition [N comp.insurance p.msurance. ❑ g 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 11.❑Plumbing repairs or additions myself. [No workers'comp, right of exemption per MGL insurance required.]t c. 152, §1(4),and we have no 12.❑Roof repairs 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 ob site information. P cJ'and job 1 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 under thep 'ns an enalties of perjury that the information provided above is true and correct Signature Date: l� Phone#- 7 ��3 `ON��' 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#: , 1 tssachuSOts•- ci►a�tnunt.ut Put)lic $ii'ct Board (4 Building Re-ttlatims and St u1dali ds:` Constru i-1 q uperylsor cease.,I, License: C 91672 . 8 ALAN ARCHAMBEAULT •16,.8AY VIEW•RD E SANDWICH, MA 02537 Expiration: .1 2/2012 ('innmicsi�:incc Trt#: 2517 . , ,. . .; . '' I -d— :,�--�':��.—�Ri:':. I . .. I :: --.:. � �— - I —1 '� . i I I .. . ' ' "I :'�. . — ' — — 11 I.,,- 1-1 . " � — �, :—'�: : " ��:- '�' . — . . � � � . — 1 -1 . 11I .— � ., I — . I . . .— — I — . . I . . I 1. — ,. . 4 .I � . � � e % . 1, I I . — I , 7 � . . 1 � .. � . — I .1 ; � r � 11,. I. I� I11 — : . ,-- I �� , — ". .�' . . I . I I :� . 1. I � I— I r. , — � '�' — ,% 1. bl—. �'::': '� I . :': � .L, �'—' � , :' '. �..'�-- ."". : �� '_�:� ---:� �. :' ' "':'� .- - . � , '.l.- I - 1—:' ' . . ':' �.�' . Z- ..�. — �� � .. I . I - � 1 : 1 . — . : - , I I . , — � — I . ,� , September 13 2011 i ; . �. � . , .. .F I' , - I - �--,. 1. . . � I I � . � . An Thom I Bintorl IIi Ti Vale mar� vfia�� , bra�d�# an re is n as bs6 .' Oak a �nr�t i r-m 4.. -' .' t. t 10ia a-E,Camara o ��Qdd- ` er.Gas: Cam 1 un�: 78fi-907.2927 761752Z4056'ax 4 '9V. O Y63P7 YQA/6.iW' L 3 - Wa ham.9 ,a,.fl2451 I 1 t ..., ,:.. :., -F t 1 - 3. s -3 i e. f -t i _ i h y t INS Department of Public YVorks ,F: ""a ' Water.;Suppiy Division �, Hyannis UVater System aperatsons ! September 7 201 I; y Town of Barnstable .., Ru l.ding Inspector Town Hall ! Hyannis,MA 02601 F ! ' RE: #7= 15 Oak Neck..,Roadl Hyannis 1V1A. .Q2G()1 ! Ace{# 6f)5072 e : d l�earSiT. wised that the abouc:watcr service to the eondornitziusn building (meter# 2fi072778). Please bead There is no wate�service to the pool. The owner has informed us of plans to demolish the pool on the I property. , If you have ariy questions,please call the office. f: F ! 1 Sincerely,. aA -�h ' aTcta=rc1k H Ennis ater System 1 Y i OAKVIEW CONDOMINIUM TRUST P. O. BOX 1204 HYANNIS.) MA 02601 August 26, 2011 Mr Alan Archambeault Arch Construction Co. PO Box 914 Hyannis, MA 02601 Dear Mr. Archambeault; Thank you for meeting me this morning to review your proposal of May 2, 2011 to demolish and fill in our swimming pool at 15 Oak Neck Road, Hyannis,MA, located next to the Oakview Condominiums. At our annual owners meeting held on June 26, 2011, it was voted that your company, Arch Construction Company be awarded the bit and authorized to demolish our swimming pool, fill it in, and landscaped with loam and seed. Please let me know if you need anything further. Sincerely, Thomas H. Benton Chairman/Business Manager Oakview Condominium Trust S WhitePages.com - Online Directory Assistance Page 1 of 1 GABRIEL COIMBRA 15 Oak Neck Rd Hyannis, MA 02601-4584 (508) 771-7635 http://www.whitepages.com/10001/search/ReversePhone?phone=508-771-763 5&localtime... 3/6/2006 I Building Department ComplafiWInquiry Report " Daw / -/z -- G e ' Rec'd by: 9 Assessor's No. Complaint Name.• Location Address: / WP _ Originator Name: Street: r Vim: 7 7/- -7 7� State: Zip:__ Telephone:D/G Complaint Desaiption: r -- °�✓i2-Q�P Inquiry a , 7,72 , Desaipdon: ' For Office Use Only Inspector's Action/Comments Date: 7 3 Inspector. Follow-up Action Additional Info.Attaclied Cap y Dtsari&don. Mji&--Depamaent He Yellow-Inspector pink-Inspector(Return to Olfce:lfanager) �, rp Town of Barnstable *Permit# S ro �7 p Expires 6 months front issue date Regulatory Services Fee :;�,r 9 1 Thomas F.Geiler,Director ��FO MA't a• Building Division pp Elbert C Ulshoeffer,Jr. Building Commissioner X-PRESS PERMIT 367 Main Street, Hyannis,MA 02601w Office: 508-862-403 8 O C T 2 2 0 01 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION TOWN OF BARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number -OC Property Addres64 aai(e / l f_ 1i71 Y 2 3 0 Residential OR ❑Commercial Value of Work 90, 'm Owner's Name&Address / rr) G AJ Un .23 Contractor's Name (mi Telephone Number `�,S j Home Improvement Contractor License#(if applicable)_! ,(�07''60 Construction Supervisor's License#(if applicable) V a y—Z2 jyj Oa/worlamn's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner Ave Worker's Compensation Insurance Insurance Company Name Eu/ ,{-�( n Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roofl ❑ Re-side [ teplacement Windows. U-Value : kV (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature V )6A CL expmtrg e o � • k V!� Y' t i� TOWN OF BARNSTABLE 12 BUILDING PERMIT PAkEL ID 308 176 OOA {3EOBASE ID .. 22140 ADDRESS 15 OAK NECK ROAD PHONE Hyannis- , ZIP' - LOT UNIT1 BLOCK' LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 9678 DESCRIPTION REMOVE & REPLACE PERMIT TYPE ASIDE TITLE BUILDING PERMIT EDEFAtitment of Health, Safety CONTRACTORS: FRASER, DEAN C. and Environmental Services ARCHITECTS: TOTAL FEES: $50.00 BOND $.00 CONSTRUCTION COSTS. $5,000.06 750 ROOFING AND SIDING 1 PRIVATE P:t P S X $TABLE. ; MASS. 165 10� OWNER HINDS, BESSIE E p A ADDRESS 15 OAK NECK RD APT 11, HYANN I S MA , BUILDIN i S f N DATE ISSUED 08/14/1995 EXPIRATION DATE BY .rr� DIVISION APPROVALS FOR CERTIFICATE OF OCCUPANCY t TO BE SIGNED BY EACH DIVISION HEAD UPON COMPLETION BUILDING: ' f DATE: fA COMMENTS:�- PLUMBING: DATE: COMMENTS: ELECTRICAL: DATE: COMMENTS: GAS: DATE: COMMENTS: y CONSERVATION: DATE: - COMMENTS: OKH: DATE: COMMENTS: HISTORIC: DATE: COMMENTS: FIRE DEPT.: DATE: COMMENTS: OTHER: DATE: COMMENTS: '! i TURN THIS IN TO THE BUILDING COMMISSIONER AFTER ALL SIGWOF�8 ARE COMPLETED.A CERTIFICATE OF OCCUPANCY WILL BE ISSUED AT THAT TIME. TOWN OF BARN9TABLE BUILDING PERMIT PA-CELF ID .308 178 OOA GFOBASE IU 22140 -ADDRESS 15. OAK NECK ROAD : PHONE Hyannis rtH Z I P LOT UNIT::. BLOCK LOT' SIZE DBA : DEVELOPMENT. DISTRICT 11Y PERMIT 9678 DESCRIPTION REMOVE & REPLACE �' PERMIT TYPE: BSIDE TITLE -BUILDING PERMIT UeVfftment of flealth,i Safety i CONTRACTORS: FRASER., DEAN C and Environmental Services. ARCHITECTS: TOTAL PEES $50-00 O� BOND. $.00 CONSTRUCTION COSTS $5,000.-00 Q^ 750 ROOFING AND. SIDING .1: PRIVATE :P'M STABLE, , . MA$$: OWNER HINDS, BESSIE EFp � ADDRESS 16 OAK `NECK: RD APT 11 HYANNI A S M BUILG I IS O DATE ISSUED 08/14/1.996 EXPIRATION :DATE BY f - i THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE,SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND M FOR (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THis CARD SO IT IS FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 508-790-6227 I II I I I I Ij I I I I I I I . I I I I I � + I . I I I I I . I I I I I I I j I I I j I I i r 1 Town of Barnstable of Regulatory Services .:3' T11E'r Thomas F.Geller,Director�ry Building Division MAR _6 € - v M Tom Perry,Building Commissioner sbgq. �0 �fp Mpl 200 Main Street, Hyannis,MA'02601_. www.town.barnstable.ma.us DJV/S7(___''- --� J Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: LIOG� '� HOME OCCUPATION REGISTRATION a--- Date: 03-66-06 Name: GQAr I(',' Phone Address: l S OG l e ApC e Re) Ad. *3_5 Village: Name of Business: rIrA/til h 9t yr�p Type of Business: I eA ZHoudC + o`T - Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4.1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in 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 pickup 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 undersign ve read d ee with above restrictions for my home occupation I am registering. Applicant r / PP Date:n 0 Homeoc.doc Rev.5/30/03 YOU WISH TO OPEN A BUSINESS? Ji 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 Hall) and 200 Main Street Offices at the Licensing counter. DATE:43- a.-06 Fill in please: APPLICANT'S YOUR NAME: G x6rie,I 6N,WL►vc. BUSINESS YOUR HOME ADDRESS: 1 S On to Moe Rd da 435 TELEPHONE # Home Telephone Number: NAME OF NEW BUSINESS Kr� - ►�� Ne-r TYPE QF BUSINESS �eAti.� 15 THIS A HOME OGCUPATION� YES NO Have au laeen yaw.approa[ from the budding d1Y�sion YES NO Y g ADDRESS OF BUSINESS MAP/PARCEL NUMBS �- 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 CO 1honzed NER'S OFFICE This indivi ual haery in m of any pernfi4 requirements that pertain to this type of business. CW Au ature** C MMENT i 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature" COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual een inf rmed of li si re uirements that pertain to this type of business. � _fig q p YP Authorized Signature" COMMENTS: PERMIL.PAYMEMT RMSS-,T,_.� TO0H OF BAROSYAELE BU-fLOIMG DEPARUM 200 MAIM STftET � HYAHMIS, NA 0,2601 :DATE: 05/10/06 ',TIMC-- .15:13 -- -� T---------101ALS - P. RW1($1100 � n AMT. TENDERER:_ 2� 0a., Al APPLIEV '25.(10". CHANGE,; .60, RPPLICATIO'! PIl�1ER: PA'IMEM-T 'MEt,H. CHECK. PAYMENT REF: 789 r. Town of Barnstable Regulatory Services OF 1HE�� Thomas F.Geiler,Director • Building Division + 13AMSTA11M i v MASS& $ Tom Perry,Building Commissioner 1 p 9. a 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: OS l I o I &'00� Name:TEQE Ti 14 A (Zt/} Address: Village: Name of Business: \zw S CLC-et P N S e�w C cc—S Type of Business: Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. Afte: "'stration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the folloll.,conditions: • The activityis carried on b the permanent resident of a single family residential dwelling unit located within Y P g Y g 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 son shall be employed in the Customary Home Occupation who is not a permanent resident of the dw unit. I,the undersign ve read and agree th e above restrictions for my home occupation I am registering. [� Applicant: `�v — Date: 0 d I Q Homeoc.doc 4'.5/30/03 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$3 .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 t operate.) Business Certificates are available at the.Town Clerk's Office, 1"FL., 367 Main Street, Hyannis,MA 02601 (Town Hall) DATE:0 N10 Fill in please: (LC"tip ��(? Y2✓ APPLICANT'S YOUR NAME: BUS NESS YOUR HQME ADDRESS: K.�IaN�� 0��0 1 S0 blo s- It-c rat - b ��- ;� ..._ TELEPHONE # Home Telephone Number '50 $ clO G1y.SFS NAME OF NEW BUSINESS CCZ 'i(L✓- ,4DU�.3 F2Vi - YPE OF BUSINESS r9A)J. 1AO V S.e IS THIS A HOME OCGUPATiON? YES N Have oval If n. S NO ADDRESS OF BUSINESS 1(� We _ NYVIS- 0.204 MAP/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 obtainin the information you may need. You MUST GO TO 200 MMaiin St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate yo-'r b-usiness in this town. 1. BUILDING COMA NER'S OFFICE his individ al h s enaaafo e f ny permit re uirePrients that pertain to this type of business. Au prized ture** COMMEN S a r ' 041 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: . 3. CONSUMER AFFAIRS ( EN NG AUTHORI This individual has b e forme f the li mg r u' ements that pertain to this type of business. tho ¢ed Signature** COMMENTS: ��ayr�c �Nk��i �c�� -{a Sir e �'^j.GC ptC.lL� CCd�itE.O-S� `��i �'1�N� �� I Town of Barnstable �t Regulatory Services Thomas F.Geiler,Director Building Division * IARNSTABI.& s v Mass g Tom Perry,Building Commissioner Q) 1639. ♦0 'OPF �A 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 x• 5 8 90-6230 Approved: �. Fee: — Permit#: HOME OCCUPATION REGISTRATION Date: 0/- a5-�0 / en Name:�Ol�r I C'') C—'o I'm 0CA Phone#: Address: I '5 94 l' lV e"--lz Village: 7 t1✓,7V��S / Name of Business: t�)P a "Type of Business: 1()r mu1 l ON er—h hole 6V Map/Lot: VE INTENT': It is the intent of this section to allow the residents of the Toxvii of Barnstable to operate a home occupation ivitlnin single f<lmnily 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 Arith 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 xai'thin that dwelling unit. • Such use occupies no more than 400 squaree 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,ul 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. r • There is no exterior storage or display of materials or equipment. • llnere are no commercial vehicles related to the Customary Home Occupation,other than one vane or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet un length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign sliall 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 pernnalnent resident of the dwelling unit. I,the undersi e nave read ee-with the above restrictions for my home.occupation I am registering. Applicant: Date.: 0 - QS- ©$ Homeoc.doc Rev.01/3/08 5„ YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR7AEtown (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at Clerk's Office, 15tFL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and 200 Main Street Offices at the Licensing co z DATE: r Fill in please: APPLICANT'S YOUR NAME: ed co) �' � BUSINESS YOUR HOME ADDRESS: \< (\je oa.G n t RAC — TELEPHONE # . Home Telephone Number: _SOBS- StS-?:jgnq NAME OF NEW BUSINESS ' r. - eclh TYPE OF BUSINESS _ c�Y c�c� ic3t� �fec���1�6 IS THIS A HOME OCCUPATION? Z EYES NO . y Have you been given approval from the building division? YES NO ADDRESS OF-BUSINESS f MAP/PARCEL NUMBER 32Y 76 CEO P 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 This individual has been i �rmit any permit requ�r�ements that pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION Authorize ig ature** RULES AND REGULATIONS. FAILURE TO COM MENT&L ICOMPLY MAY 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to.this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This in dividual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: w r T � :y � $+_.,.� i- _ '!.aw � 4y - f #� 4 y �._'� •v��/`+ i i1 -�Ylfl 1 •�`ti3• ce - ,.,f - I •' of: _ FEE TOWN`' OF _BARNSTABLE, MASS 19 ' � �m p'9 .THIS IS TO CERTIFY THAT A PERMIT,IS HEREBY GRANTED TO O�•:'i0' .dl�',��af �ti�� - _ ��!`;S��.L�`.:.:2.g d'•%i.a. 4 ._................:...................... IPROPERTY OWNER) _ ___.—__.— ^•••— _•' (ADDRESS) - h ISUILD•I� IALTERI (REPAIR)', ' �i. - �,p.•`3!'D' ..3„��:3=rA. ray_,.-'xT s;7 cr,.s .�;m- t ,� a - - ITYPE.OF BUILDING)- Y M1 •.•• )APPROXIMATE SIZE). ' .. � P p� 1 ,;My LOCATION -- — — f (STREET AND NUM_BERI (VILLAGEI' s s sir 1'h3•A.�, i: t�,!'.7:t:.� NAME.OF`BUILDER.OR CONTRACTOR — o APPROXIMATE COST _ I .HEREBY AGREE TO CONFORM TO ALL.THE R f e ULES A G WN.; AND RE ULAT1 S OF THE TO go r OF: BARNSTABLE,.,.-REGARDING .THE ;ABOVE. CONSTRUCTION k o -Z ti } 3f -`(OWNER) - - )CONTRACTOR)+_ f - r BUILDING ANSIPECTOR Subled-to Approval of Board of Health ., - .-. .r., :_-._ ! t,s_,rt:i '-.;.t.-i .,n„- _' -_- �l-->>r?� z ,n:..f. t�,..�.fir, w.,._-.e,Ft.�..._5�-* ��e:, 1 ..,_ .1.�._�:.f?t ,r., .. 1 t k<,•igl- .:zzi. ; �. � ' s , �_y. 5 �� - �!. / Assessor's map and lot number ..................... . .. ............ SewagePermit number .......................................................... y f7HETp�i TOWN O "DARNST 1-1�LE Z BARNSTABLE, i �j 90 M6 9 ��pp �0�� 1]�1ffipL® pWU INS rECT® U1 'ED MPY a' r r APPLICATIONFOR PERMIT TO ....... .. .................. ..................... ......... ............... .....`..................................... TYPEOF CONSTRUCTION ..................................................................................................................................... l. .. ..................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the f lowing information: Location .............d-. �7 �.....................C//......................................................................................................................... ........................ ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner . . ............. ........ ................. ... ..Address .................................................................................... 77 77 l� ........... .........Address .................................................................................... Name of Builder ...,/9�........ .... . ................. . Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH t f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ..... ..... ............. .......... � Bacon, Henry ' "" ` ^ ��r�� demolishNo ------ Permit for ------------ dwelling ----'-----'::-------'--------' 27 [akl�e�k I�"al v� Location --.--.---.---���-------'' annis ------..��............--------------.. ' Henry Bacon ' Owner ---.---------_--------'' ' ' frame Type of Construction .......................................... . ' -----^---..---..------------- � Plot ............................ Lot ................................. ' $ ' | Permit Granted .....DQ.Q.#a%r..l8..........lV 73 Date of Inspection Dote Completed .. .n�\ --.lA �� / ^ � l' PERMIT REFUSED � � \ � l�--------^-----~------- ...............................................................................' � ^-------..----------..-------.. � ''-----^----~-------.v'—^---''`'' � > --------....~.—.--...—...—.—.--.-.. � . Approved ................................................. lV ' --------------'~^—'-----^'---' ` -----------'---------'---~^'- � | [ .