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Town of Barnstable
Regulatory Services
4,P O
Thomas F.Geiler,Director ii���, e.l�
MASS. �;k 9- (4 J
'" Building Division
9 MASS' 0a
039.
peen MA.�s Tom Perry Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4638 Fax: 508-790-6230
COMPLAINVINQUIRY REPORT
Date: Reeld by:
Complaint Name: &4dzE. Map/Parcel
Location
Address:
Originator Name: -
Street:
Village: State: Zip:
Telephone:
Complaint Description:
d
c-,/
IL z Cd �S
OR//OFFICE USE ONLY
-T 'Inspector's Action/Comments Date: 2�/0� Inspector:
035.7 SZTC MASPF-C-T76rJ 'IbLILU) J00T G; .T' ;E�A7, d�Ji= CAC
Additional Info.Attached
n-forms:complaint
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oFIHKE Town of Barnstable
Regulatory Services
+ BARNSTABLE,
v MASS. Th om as F. Ge i1 er, D it ect or
3q.
�A s6
�ED Building Division
Thomas Perry, Building Commissioner
200 Main Street, Hyannis, MA 02601
ww w.to wn.b a rns tab l e.ma.0 s
Office: 508-8.62-4038 Fax: 508-790-6230
November 9,2007
Ms.Jennifer Byers
438 Old Town Rd.
Hyannis,MA 02601
Re:438 Old Town Rd. EXIT ORDER
Dear Ms.Byers,
Under the provisions or 780 CMR,the State Building Code,section 3400.5.1,you are hereby ordered to immediately
discontinue the use of the cellar/basement area for sleeping purposes.
Your cooperation in this matter is appreciated.
Sincerely,
W
Paul Roma.
Local Inspectorff
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- � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION:
Map Parcel ` Application
Health Division " Date Issued
Conservation Division Applicationl,Fee
Tax Collector Permit Fees'
Treasurer pll
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address
Village H �/�N/u
Owner C s. .Aju I 00 Address
Telephone
Permit Request
Square feet�:_-'lst floor:existi g proposed 2nd floor:existing proposed Total new/0
Zoning District Flood Plain Groundwater Overlay
4y r t
Project 40ation`i 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 4,Wd" On Old King's Highway: ❑Yes Ck6__'
Basement Type: II ❑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: as ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes
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 If yes,site plan review#
's Current Use / Proposed Use1
BUILDER INFORMATION Jn
Name40- ( \ Telephone Number
Addres. , /0 License#
I4 Y �Llyk Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY
APPLICATION# _
J DATE ISSUED
MAP PARCEL NO.
ADDRESS VILLAGE
OWNER
k DATE OF INSPECTION: x
FOUNDATION
FRAME - -� 7 /
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT 4
i
ASSOCIATION PLAN NO.
Town of Barnstable
�^ Regulatory Services
qTABLiE, Thomas F.Geiler,Director
° '6'� ►,�� Building Division
rED My,.
Thomas Perry, CBO,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fa„: 508-790-6230
PLAN REVIEW
Owner: �O—# y� Map/Parcel: ~�
Project Address 0 -Lb TC)kJff Builder:_ 6- C-,4vLc—y
The following items were noted on reviewing:
Lv S cc� y S7
v PP -1 Eb pR-r 7) dZ 7-0 Flp-
Reviewed by: II �� --
Date: 9 ^ 11 ` 07 ,
Q:Forms:Plnrvw
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/Electridans/Plumbers
Applicant Information Please Print Lezibly
Name(Business/Organization/Individual): '�9y� �/G w ;zf
Address:
City/State/Zip: Phone.#: r`� 92
Are you an employer? Check the appropriate boa: Type of project(required):.
1.❑�am
loyer with 4. ❑ I am a general contractor and I 6. ❑New construction(full and/orpart-time).* have hired the sub-contractors2. proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g: ❑Demolition
wor for in an capacity. employees and have workers'
king y p ty 9. ❑Building addition
[No workers' comp.insurance comp.insurance.
5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
required.]
ffi ocers have exercised their 11. Plumbing'3.❑ I am a homeowner doing all work ❑ lbig r. epairs 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 .13.0 Other
employees. [No workers'
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.
TContractors that check this box must attached an additional sheet sbowing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
Iam an employer that is providing workers'cornpensation insurance for my employees Below isthepolicy and job site
information. �,�•,
Insurance Company Name:
Policy#or Self-ins.Lic.#: � �1' Expiration Date: -2
Job Site Address: � City/State/Zip-
Job �'Ll
lea Q �
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 lip 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 MA for insurance covera ca ' n.
I do hereby certify tinder the pains-and nalties of ZYuthat the information provided above is true and correct:
Sigmature: Date:
Phone#:
Official use only. Do not write in this dfea,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#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee-of an individual,partnership, association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the'
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean 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, §25g7)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 in.�nce
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-cont=actor(s)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 fo 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 Investigation
600 Washington Street
Boston,MA 02111
Tel. #617-727-4900 ext 406 or 1-877-MASSAFE
Revised 11-22-06 Fax#617-727-7749
Aww.mass.gov/dia
Town-of Barnstable
yP °� Regulatory Services
'* ssrABiE, Thomas F.Geiler,Director
'
Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyara s,MA 02601
Office: 509-862-4038 Fax: 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion,
-improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: 0 N Estimated Cost ��"(�/�✓
,kddress of Work:
Owner's Name: �
Date of Application: °
I hereby certify that:
Registration is not required for the following reasou(s):
" Work excluded by law
❑Job Under,$1,000
QBuilding not owner-occupied
❑Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.,142A..
SIGNED UNDER TIES.OF PERJURY
I hereby apply for a permit as the agent of
6
Date Contrac ame Registration No.
OR
Date Owner's Name
Q:fm=:hcmeaffidsv
Tame as.7-IV tcunuRUNQ
pmcriptirs packsgd far dire and Txo-F'aias' 'AuldaatW BaiIilIaga,Ante$t '��°�
• A4AXfhSU11'Y ' • �
GIaMing Glaring Coiling Wail Floor AiLsa Zzd Slab ' =Czt/Caolirsg
C/a) U-vatnc= A-vslneT ' Jt value, It•Ysluc3 Wsll •Feslrade�r F.qulPnseat EtSdeac .
Par'.msc R valtte� &•s�A
470I to 8500 F ting Regret DR� j
IZ°/a• 0.40 38 I3 I9 10 $ N0
12% 0s2 30 19 13 10. 6 0
13 19 10 Norasai'
•� IN 038 38 I3 ?.3 WA NIA.
LJ IS'/. 0,46 38 19 19 10 S• No mal
15Ya 0.4j1 38 13 ZS NIA' 1SUA U AF1JE
U AM
30 19 19 10 38 Norl
Ill% 032 • l3 2. NIA tsia
N/�► Norma
ml
T 4aY. Q4Z 38 19 23 WA NIA
2 I3'lo 0,41 33. 13 l9 i $ 94 A
FUEjAA IoY. t130 30 19 19 10 6 SCAM
FV$
I, ADDRESS OF PROPERTY: /d
Azu1MA4-f
VARE FOOTAGE OF ALL EXTERIOR WALLS:
SQ .
g, SQUARE FOOTAGE OFALL GLAZING: �
4, °Ia BLAZING AREA 03 DIVIDED B'Y'42): f
S. SELECT PACKAGE AA sea chart above); ;
O'IB: QTTiEA MORE IgIOLVFsD NMTHODS OF DE iG Ei-ERGy REQUIREIY=' s
ARE AVAILABLE, ASK US FOR THIS ItUt P&Lk
I
Bq�1,DI�iTG L tSPECTOR AMOYAL:
YES:. NO:
Q Irv-f�cQ303x
ryoF,�, y Town of Barnstable
Regulatory Services
qULMABI'E'$ Thomas F.Geiler,Director
`b'°TFca1` Building Division
Tom Ferry, Building Commissioner
200 Main Street, Hyannis,MA 02601
www.towu.b arnstable.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
he authorize to act on mY behalf,
in all matters relative to work authorized by this Molding permit application for. ,
(Address of Job)
Sign of Owner D Re
Pnn ame
QFOPMS:O WNF-RPERMMSI0N
p Standards
Bu Building
R�s and CTOR .
Board Ot VEMENT CONTRA
HO
MEIMPR0
�106395 `'
Registration 312008
Expir?t� :_ �'dial
•� ��R"1ndNidt
_pye xt
n'S� 4
GREGORY
M•CAU�E
Cauley � `�'' �`'t ►
�> % ►n►strator
Gregory er Avenue -' peputy pdm
33 p,Baxt -
W;.Y armoath,MA 02601
j ---—_--;`-- ✓!ze �o�.vrrw�.uuec �i a�/�a°°acfauaa
BOARD OF BUILDINGREGULATIONS
License: CONSTRUCTIO-SUPERVISOR
Number: CSys� 009013
�
Expires,�05111/2008 Tr. no: 25325
—— Restricted 00
GREGORY M CAUt EY: c,
3.3A BAXTER AV
-W YARMOUTH, MA
Commissioner /`
PPP-
.
SMOKE DETECTORS REVIEWED •VM a
�}S CARBON MONOXIDE ALARMS
—r� 0 J � c f9 MUST BE INSTALLED PER
r BARNSTABLE BUILDING DEPT. DATE At MASSACHUSETTS BUILDING CODE
FIRE DEPARTMENT DATE
BOTH SIGNATURES ARE REQUIRED FOR PERMITTING
IMPORTANT- UPGRADE REQUIRED
STATE BUILDING CODE REQUIRES THE UPGRADING OF.
I SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN
ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. �. .
V.. �.._..._...._._ �.�A... _ _.
NOTE` A SEPAf3ATE PERMIT IS -REQUIRED FOR THE .
.....:......._._..:.........
INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL
- PERMIT 2a N-
XSATISFY THIS REQUIREMENT.
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