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0045 PINE GROVE AVENUE
/�/ k f ��i t �` I I I t ��, r s i - Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 8/14/18 Brian Florence CBO T P)ItVG Town of Barnstable Building Division 200 Main St. 7 2p18 Hyannis,MA 02601 RE: Insulation Permit B-18-2179 Dear Mr. Florence: This affidavit is to certify that all work completed for 45"' P e Grove Ave,Hyannis?has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey vW Town of Barnstable Building +Po"st�This Caird So That'itis"Vis�ble>From°theSt"ceet -A '`roved Plans.Nlust be Reta�ried on Job and this Card Must=be Ke t � '. & d`te Until'F�nal 1' ad' PP ,$ \ E p 36s� i'ors,., nspection Has Been M e a � Permit Where aCeyrt�ficate,of Occ�upancyisRequired,such Butldmg�shall Not^be Occupied unt 1 aFnal Inspection has been made ) Permit No. B-18-2179 Applicant Name: William McCluskey Approvals Date Issued: 08/06/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 02/06/2019 Foundation: Location: 45 PINE GROVE AVENUE, HYANNIS Map/Lot: 290-034 Zoning District: RB Sheathing: Owner on Record: TAVARES,THOMAS Contractor Name,WILLIAM J MCCLUSKEY Framing: 1 Address: 45 PINE GROVE AVE Contractor'License CSSL-102776 2 HYANNIS, MA 02601 i Est Project Cost: $ 1,900.00 Chimney: Description: Add R-10 rigid insulation to the basement. Dense pack the walls Permit F $85.00 with R-13 cellulose.Air seal the basement with expa:nding-foam. Insulation: General weatherization. Fee Paid $85.00 Final: 8/6/2018 Project Review Req: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: Rough Gas: �F This permit shall be deemed abandoned and invalid unless the work authorized by tips permit is commenced within siz`rr onths-after"issuance. Final Gas: All work authorized by this permit shall conform to the approved application and the;approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zo rig by laws and codes. Electrical This permit shall be displayed in a location clearly visible from access street, and shali,be maintained open for publlc,inspecfion for the entire duration of the � a work until the completion of the same. Service: The Certificate of Occupancy will not be issued until all applicable signatures by�the Building and Fire Officials ar`e provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons con ith unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Town of Barnstable e�a6r,l,rR °' . An is�Ctaiarl..�r,t dF�f iniScaoas ltw T eIrh:iosafpt eOrtc�c t:ic2si,o�V n.i.�sH.i balse'B�''::Feroe,5'..nm:.,;z�M.thaed eS tre:''��e t Apprro ved;�PR la n.s�M$-u,.s t b.�e.;';:`.�R etameY dy o�n Jo�b�a.n,.d:t�h�is C.a..r.'�d M3su�.s.t.'�v b v e,`K�e\. k }s s Building <Tahost?P HAMMKAWweu Permit te noseu` Wh a Ce �a pancy isRequ�red;such Bu�ldingall N ttlbe Occupied until a Final Inspection has,been made - �� �» Building plans are to be available on site , All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT It I ° Ot THE J ®`�'Il of Bc`I1"�1tSta�7le �er 4{ Expires 6 inciahs jroin issue dale Regulatory Services Fee cd = sARNSrABLE, � . Thomas F. Geiler, Director �PJf�Mp�A Building ]Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number rtt Property Address l� `C 41t r�� C � _i 1,:;, residential Value of Work VA cl�1 U c) Minimum fee of$25.00 for work under$6000.00 Owner's Name&.Address-�A?) r Contractor's Name VV\.KY1= �1F� G✓ Telephone Number y Z1 �c3 Home Improvement Contractor License#(if applicable) L( 1 Construction Supervisor's License#(if applicable)_ + ❑Workman's Compensation Insurance -PRESS PERMIT Check one: ❑ I am a sole proprietor SAP .m Z��q ❑ I am the Homeowner TOWN OF BARNSTAE3L T�I have Worker's Compensation Insurance` Insurance Company Name �I 'A Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Il t1 Er`ke-roof(stripping old shingles). All construction debris will be taken to cp�`d C 11 f7 ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum .44) *Where required: Issuance of this permit does t exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Proper Owner List sYna perty Owner Letter of Permission. H pr ve s License& Construct Supervisors License is required. SIGNATURE: Alt Q:\W PFILES\FORMS\Express\EXPRESSPERMIT.DOC Revise06O4O9 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations + d 600 Washington Street Boston, MA 02111 _�•� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Name(Business/Organization/Individual): l�rt;— Address: City/State/Zip: Phone.#: ;M o?I to Are you an employer? Check the appropriate box: Type of project(required): 1. ✓ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner-' listed on the attached sheet. T. ❑Remodeling ship and have no employees These sub-contractors have g. -❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp. insurance comp. insurance" required.] 5. ❑ We are a corporation and its '101]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 LE]Plumbing repairs or additions. myself. [No workers' comp. right of exemption per MGL 121 Hoof 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. XContractors 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. ,n Insurance Company Name: �T yy f Policy#or Self-ins.Lic.#: ( , e - �� �'�.�s� Expiration Date: (b Job Site Address: C1u�e �r�s _ 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 crrtinal penalties of a fine tip to$1,500.00 and/or one-year imprisonr-nent, 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 ' urance ;overa erification. h do hereby certify u r th pa a open tie f perjury that the information provided above is true and correct Date: `t` Si afore: ,,t — Phone#: , ® (06t l Official use only. Do not write in this area, to be completed by city or town official i "City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other t , Information a nd 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 be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or business or to construct buildings too crate a busin s in the commonwealth for any g renewal of a license or permit p P 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 . mance of public work until.acceptable evidence of compliance with the insurance enter into any contract for,the perfor 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 numbers) along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or 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 permitllicense 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 aecessarv) 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 maybe provided to the applicant as proof that a valid affidavit is on file for. iturc 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 burn leaves etc.)said person is NOT required to complete this affidavit. ,me^ffice 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 e6mmonwealth of Massachusetts Department of lndustri,al. Accidents Office of fnvestigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-WSSAFE Fax# 617-72777749 Revised 11-22-06 www.mass.gov/dia - <'.y nt+✓='ir ,f :. 3.t7 Rk p,fit :�yn/�,�}'r[r's�cs Y'i - 4 M,AR.K I IGR���z to -Fy' ` Ss t ( p .... Nr 35 ElE CENTERVILLE MA 03632 Z w t>; 508`420=6216/774-238=2938 «nT www.markherbst.com r' a f '.w PROPOSAL SUBMITTED TO: WORK PERFORMED AT: : t Thomas Tavares 4 y 1 R, �A ,k" 45 Pine Grove Ave. SAME Hyannis MA 02601 n � ' 508-775-9441 � We herby propose to furnish the materials and perform the labor necessary for the completion of: r = New Roof Remove 1 laver of existing shingles r r�L is j Install 8"drip edge r� ti L Install ice&water shield at edge&in valley areas ' Install Certain Teed XT 25vr.algae resistant 3 TAB shingles N` Color=Moire Black , Cut ridge&install cobra vent I Y,s Replace plumbing boots,24 Storm nail all shingles t 5 ` Nt f Install rubber roof to flat roof area Replace 1x12 rake trim by rubber roof area x , , ,,r r All debris cleaned daily Price includes material,labor&dump fees 3 € � All material is guaranteed to be as specified. The above work will be performed in accordance with the specifications submitted and completed in a substantial workman-like manner for the sum of Four-Thousand Two-Hundred&Twenty Dollars($4,220.00)with payments as follows: full amount due upon completion `Any alterations from above proposal involving extra costs will be added under a separate written agreement and become an extra-. Exj charge over and above said proposal, r RESPECTFUL. SUB It ' ` - 07118109 Mark Herbst rr ' ACCEPTANCE OF PROPOSAL . 4 r= The above price,-specifications and conditions,are satisfactory.I herby accept this proposal. You are authorized to do;.tNe work am payments will be as specified above. k ' SIGNATURES Proposal Y y p Y iaccepteddays. LL '4 a � � within 30 days : f This ro osal may be withdrawn b said company,if not wit t. N l�'.�kt a�d `?a•45*� �s .��C r z+.� ���kk517�,�'�d<{a -"�!�,( 's»�.;<`-7^�v'.� J'¢ - S '') E x:",. '+' - .. .a.'• j u Ys`` a,'+F°r a ar ;1: i 'lf'F €4`i , 4 ,s. .*� 15 s °� °a S x' r v :; r it „'�� w .��ji�i�,rl � xt0 � �.u,�p&�f rr tk�t��uE r 1����'�+ �.`I r r3 cS.ro {;a d•'.-'� � rf FF., 7 ,. i _ - � �: ,, ie✓ } � ifx`s } t d it, f � ".a �3a�dt:`,19 „ra:. w ": .4 = i 4 ,ti ., } - Y - x.�;..� NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you. notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED INDUSTRIES OF MASSACHUSETTS MUTUAL INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY AWC 7016215012009 01/10/2009 - 01/10/2010 POLICY NUMBER EFFECTIVE DATES P O Box 494 Leonard Insurance Agency Inc Ostenrille, MA 02655 (508)428-6921 NAME OF INSURANCE AGENT ADDRESS PHONE Mark Herbst 35 Peep Toad Road Centerville, MA 02632 EMPLOYER ADDRESS 12/23/2008 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYED _ Board of Building Regulations.and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: in Regulations and Standards i Board of Build g - g Registration`:: 126480 One Ashburton Place Rm 1301 Expirattgn 6/8/2010 Tr# 267766 I Boston,Ma.02108 1 R`{ JTYpe: Individual If MARK HERBST ELM '`+ .' MARK HERBST kT = J . 35 PEEP TOAD RD <J `� �I Not valid without signature CENTERVILLE,MA 02632 Administrator i {, e ` Construction Supervisor License : it 1 N, ' License: CS 48546 f ( a - Tr# 14362 �.l Expiration 1/27/2010 S ', "' IrlRet n 0 Pi ;S _ t s MARK D HERBS _' ` 35 P�ET ? CENTERVILLE,MA12632 w°f Commissioner i I MASSACHUSc"'i TS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) 9MA(5T4,04E Mass. Date hag, 9, o Permit # I Building Location yam_ 9" Amxe AVE Owner's Name_70MAS / 11dA�PES 11(N15" Type of Occupancy New ❑ Renovation [3� Re acement ❑ ; Plans Submitted: Yes❑ :No .Cl l' FIXTURE., LU Y 1� 8g N = N a Cr. a • ~ z C Q Oya H ¢ = a , : `W E' 3 ¢ N a= = W N a O Q y N Cr a < a3QFxW. Cr. O d ¢ Q W ° ¢ a L6 iL LU = 1< W 3 c c 3 -+ �' 0 a a Y _ = Y a 0 iu W Y W 3 X J m N G O J = t. N ti C� = II d 3 C: III O SUB—B-WT. I �k BASEMENT AST FLOOR I I # e I I 2ND FLOOR j F SRD FLOOR I 1 I 4 4TN FLOOR I a,•, I I I STH'FL.00R I -= i. 6TH FLOOR 1 7TH FLOOR I I I 8TH FLOOR I ,,'1 stalling Company Name E. F- w+N S Ly r.J pw w+r3 I tiw- -�- �n w(r Check one: Certificate f� Address g E A-P-Do N C► A-L t_E Corporation 04-Z 846 93 So • Yr-2nA o 0-rlf M A- O 2 6 6 4 ❑ Partnership Business Telephone(Sa.E) 394 - '77 7 A ❑ Frm/co. Name of Licensed Plumber Lc W INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes W No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)in above"application are true and accurate to th best of my knowledge and that all plumbing work and installations performed under the permit issued for this apphcati It compliance 'th all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General taws. • Signature of Licensed Plumber Title Type of License: Master / Journeyman❑ Giy/To�n 9 l �6��C � A�RDV£v(Di-r/c� Vsz ONiy License Number 7 q 088850 ❑ File Letter Name Address �-5 PIHe Gave Date:` i city AIA'/1-/12 State—,&A-- Zip d'26o/ j Phone 50F 2 2 S F"W 1 Date ` to In Time In Time Promised i GMm F, OPAPER . • zyr, - a Prints Made: El �� ❑ o. . - (� a r� ❑ oVJN -- Special Instructions: Pric . ' F N2'088850N2 °rt eaYt^iM�" )J lC7if 3 a`. 6 ax I,3r.`u .tom d rL. - e��� ,' ?y't• I(u.tt�Y •-i.V9° , ,t #¥ READ THIS NOTICE Submitting film print slide.or negati eto this film for processing,printing or other handling constitutes an AGREEMENT by you that any damage o�loss by;ouP,company,sub- sidiary oragents even thotlgh,due to negl'igenci3 o'r oth'ef fatllf of odr company subsidiary or agents will onlyerfrt Ldl yb toreplacerriWillialikeamountofunexposedfilm:Exceptforsuchreplacement, the acceptance by our company,subsidiary and/or agents of the film,print,slide or negative is with- out other warranty or liability and recovery for any incidental or consequential damage is excluded. NOT RESPONSIBLE FOR FILM LEFT OVER 30 DAYS. xv i O T _ o H P �:A:A:�LILII] L�IJLI 0 0 1JlJoo @EiJ 8389 MINN01 r u4 ��`� �, � t. �` �µa � ?fir,; ► � #� 1 i� �� ..r � � � ��� ���� Q � J ' � ,a '`,�(/� � i �r v '.J .r y � � � i �Y!'�.�° _ � Y A V� �` L r - � E. � �L 'Kf'' � ''� 1' P Y Q r i _37� s to •`�i.e+ - ? 1 � ` �- P� � � .r • v.. �� a�*�so'+!I fti,,., ♦d e`*r s� t*�: ��.tom y �•� �Jz�^._ r,'Fr1?!f 9� f 1 µ,di .'; �- f'�'.� `L ,..�.`� t 1 �, �� ��'�n�� �.. P �' �, v, .��;-R ,� t. ` � p,jCQ4 �1 �} \_ \ _ �} _ Y 11 �! -� �� � � j po ARM--, lot. JAN 12 Not " r W• Admit. � R fR �' e \ _ . r �! �, �' �'' �i . ` `:c �y�� � '�. � ,, �, e V' e `, � �, t -_�- �� Y' SO w . ,..� � � �"i, P1,.t� _ P ,' V' .,'..� R ,. " �'� P► V `i .�`,> v1t.��(�Q t - `"`� �'''' �1 V' p! � e � _ w r "I'X 1i f, 1t .r P P Y f• � •-a;�� J- D3 �+ - .� s•. .ice.. �. 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Village HYANNIS Fire District;HYANNIS Sewer Acct 2794 Road Index 1249 Owner Info owner'TAVARES, THOMAS Co-Owner Streets 45 PINE GROVE AVE Street2 City HYANNIS State MA zip,02601 Country.US Land Info ..� 9 m Acres;0.16 use=Sin Ie Fa MDL-01 zoning RB Nghbd 0105 ......... __.__... _...... .. _. Topography'Level,, Road ;Paved _ ........... .... ...... utilities lSeptic,Gas,Public Water Location E t � Construction Info Building of I _.. Roof .... _. _, ...�.. � Ext Built 11945 Gable/Hip Struct Wall Wood—Shingle " — . -.---. - Effect Roof AC Area.- Cover 832 Asph/F GIs/Cmp Type None ' " Style: Ranch 9 wall-Drywall J Rooms 3 Bedrooms .... .... .__. a ;' . ........... ....... ........ ...... 1.Res,id,eontial Floor Rooms 1 Full r Grade Below Average Heat Hot Air Total 5 Rooms Type. Rooms . Stories; Heat � �' � '�' Found- Stories 1 Story Ll Fuel Gas ation iPoured Conc. Q http://issql/intranet/propdata/ParcelDetail.aspx?ID=22236 5/25/2006 Parcel Detail Page 2 of 2 7 Permit History __.._. Issue Date Purpose Permit# Amount Isp Date Comm 4/21/2005 Addition 83532 $800 DORMI 5/12/1998 Out Building 30837 $18,000 6/3/1999 12:00:00 AM 28 X 2; Visit History .... __......__ ............... ........ . ......... .... ..... ....__ .. Date Who Purpose 2/26/2001 12:00:00 AM SM Meas/Listed 11/15/1987 12:00:00 AM ML µ� Sales History Line Sale Date Owner Book/Page Sale P 1 8/15/1991 TAVARES, THOMAS 7643/323 2 9/15/1990 TAVARES, THOMAS &JENNIE 7298/308 3 5/15/1984 TAVARES, JENNIE 4111/321 4 6/15/1983 TAVARES, JENNIE P65347 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcf 1 2006 $67,800 $2,400 $22,800 $141,000 2 2005 $62,900 $2,300 $23,200 $123,700 3 2004 $51,400 $2,300 $23,500 $105,200 ; 4 2003 $46,000 $2,300 $24,000 $28,000 5 2002 $46,000 $2,300 $24,000 $28,000 6 2001 $46,000 $2,300 $24,000 $28,000 7 2000 $35,400 $2,200 $24,500 $17,400 8 1999 $35,400 $2,200 $4,500 $17,400 9 1998 $35,400 $2,200 $4,500 $17,400 10 1997 $28,400 $0 $0 $17,400 11 1996 $28,400 $0 $0 $17,400 12 1995 $28,400 $0 $0 $17,400 13 1994 $29,500 $0 $0 $20,900 14 1993 $29,500 $0 $0 $20,900 15 1992 $33,600 $0 $0 $23,200 16 1991 $40,300 $0 $0 $37,800 17 1990 $40,300 $0 $0 $37,800 18 1989 $40,300 $0 $0 $37,800 19 1988 $42,100 $0 $0 $15,100 20 1987 $42,100 $0 $0 $15,100 21 1986 $42,100 $0 $0 $15,100 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=22236 5/25/2006 c Edson, Linda From: Taylor, Madeline Sent: Tuesday, May 30, 2006 10:51 AM To: Edson, Linda_ Subject: RE.45,PAQe Grove Ave It makes sense, especially with our large population of seniors. It may increase our numbers if we can include them. On another issue, I went out to see 110 Longfellow Drive last week. The only issue I have with it is that now that Mr. Gonzalez has converted the garage into a living room (with a five foot opening) it exceeds the square footage requirement. Was that included in the Family Apartment decision? I have a copy of the agreement but it does not state the size of the apartment. I was under the impression that the size requirement was the same for a family apartment but maybe I'm wrong. If you include the new living room the main house is not much larger than the apartment. My main concern about this is the fact that there has been so much neighborhood opposition to this application. Mr. Gonzalez said that Paul Roma had been out there on a number of occassions and was ok with everything. What is your availability these days? I was going to have the Five Corners people come in, possibly on Friday or else next Monday. I think it would be good to have an interpreter present to make sure they understand exactly what they need to do. Do you think Christine should be at the meeting? I'll catch up with you later. -----Original Message----- From: Edson, Linda Sent: Tuesday, May 30, 2006 10:36 AM To: Taylor, Madeline Subject: RE: 45 Pine Grove Ave. I agree. Older folks who want to keep their homes only need a smaller space. They just might want to move into the smaller space and rent out the larger space. See what you can do. -----Original Message----- From: Taylor, Madeline Sent: Thursday, May 25, 2006 4:00 PM To: Edson, Linda Subject: RE: 45 Pine Grove Ave. Hi Linda I'm going to raise this issue with John. I think we are going to see more and more cases like this pop up and I think we should try and find a way to allow it. Although it doesn't fit the square footage requirement it would at least satisfy the owner occupied provision. Do you have any thoughts on this from your perspecctive? Thanks Maddie -----Original Message----- From: Edson, Linda Sent: Thursday, May 25, 2006 3 :48 PM To: Taylor, Madeline Subject: 45 Pine Grove Ave. Tom Tavares who lives at this address says he is applying to amnesty to make an apt over 1 y � his garage and put his 3 bedroom house in the Amnesty. I told him to talk to you because I didn't think he could do that. He has a 3 bedroom house and he wants to rent it and live over the garage in a studio. Linda 2 i Parcel Detail Page 1 of 2 ,a '� •y "•�:. p9,"'4, eras✓ ✓ 'poi y "" F e " 3i• t '."3 '��•g' i N ._^" iy ✓ Y ........ . w 3 rs�z ^s d ry Logged In As: Parceli l Tuesday, M7 Parcel Lookup Parcel Info .. ............... ___.. Developer Parcel ID 290-034 Lot Location '45 PINE GROVE AVENUE Pri Frontage;75 Sec Road Sec Frontage Village HYANNIS Fire District;HYANNIS Sewer Acct;2794 Road Index 1249 Owner Info ownerTAVARES, THOMAS Co-Owner Streetl 45 PINE GROVE AVE Street2 ........ ,City;HYANNIS State MA zip 02601 Country I US Land Info m_ _... ..._ _.. . _._,._ Acres 10.16 use'Single Fam MDL-01 zoning RB Nghbd .0105 .. __... ......... ......... .............. ............. TopographyLevel Road Paved ........... ......... _ Utilities Septic,Gas,Public Water Location Construction Info _......... . .................................................__ . _................. _ . .........__... ... _ .... . _....... ....__.._.... ....... ................ BuildingI of Year Roof Ext ,. Built 1 1945 Struct(Gable/Hip wall `Wood Shingle Effect j. Roof AC, Area =832 Cover'Asph/F GIs/Cm Type;None n 2:. Int- ..... ....Bed Style(Ranch Drywall 3 Bedrooms Wall# Rooms ...................................... Int Bath i BM 33 3 3' Model Residential 1 Full I Floor Rooms' HeatHotAir Total i5 Rooms Grade(Below Average Type Rooms, Stories 1 Story Heat 1Gas Found Poured Conc. Fuel ation . http://issgl/intranet/propdata/ParcelDetail.aspx?ID=22236 5/23/2006 IParcelDetail Page 2 of 2 Permit History Issue Date Purpose Permit# Amount Insp Date Comm 4/21/2005 Addition 83532 $800 DORMI 5/12/1998 Out Building 30837 $18,000 6/3/1999 12:00:00 AM 28 X Z Visit History ............ Date Who Purpose 2/26/2001 12:00:00 AM SM Meas/Listed 11/15/1987 12:00:00 AM ML Sales Line Sale Date Owner Book/Page Sale P 1 8/15/1991 TAVARES, THOMAS 7643/323 2 9/15/1990 TAVARES, THOMAS &JENNIE 7298/308 3 5/15/1984 TAVARES, JENNIE 4111/321 4 6/15/1983 TAVARES, JENNIE P65347 Assessment History „ Save# Year Building Value XE Value OB Value Land Value Total Pare( 1 2006 $67,800 $2,400 $22,800 $141,000 2 2005 $62,900 $2,300 $23,200 $123,700 3 2004 $51,400 $2,300 $23,500 $105,200 4 2003 $46,000 $2,300 $24,000 $28,000 5 2002 $46,000 $2,300 $24,000 $28,000 6 2001 $46,000 $2,300 $24,000 $28,000 7 2000 $35,400 $2,200 $24,500 $17,400 8 1999 $35,400 $2,200 $4,500 $17,400 9 1998 $35,400 $2,200 $4,500 $17,400 10 1997 $28,400 $0 $0 $17,400 11 1996 $28,400 $0 $0 $17,400 12 1995 $28,400 $0 $0 $17,400 13 1994 $29,500 $0 $0 $20,900 14 1993 $29,500 $0 $0 $20,900 15 1992 $33,600 $0 $0 $23,200 16 1991 $40,300 $0 $0 $37,800 17 1990 $40,300 $0 $0 $37,800 18 1989 $40,300 $0 $0 $37,800 19 1988 $42,100 $0 $0 $15,100 20 1987 $42,100 $0 $0 $15,100 21 1986 $42,100 $0 $0 $15,100 Photos http://issql/Intranet/propdata/ParcelDetail.aspx?ID=22236 5/23/2006 OpTME loy, Town of Barnstable Regulatory Services * an ASS.�'M " Thomas F.Geiler,Director v nss. g Qpe i63g. ♦0 rF1639. s Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 May 23, 2006 Mr. Thomas Tavares 45 Pine Grove Avenue Hyannis, Ma. 02601 Re: Illegal Apartment: 45 Pine Grove Avenue Hyannis, Ma. 02601 Map 290 Parcel 034 Dear Property Owner: Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincerely, da Edson Amnesty Program Zoning Officer Building Department gforms:zoning3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION -9 0 Parcel 0 3 4 Map l � � �r�}„+t;,� fPermit# �3 s Health Divisiort V 191>' A W^Je r r Date Issued �� S �— I005144 Rc 20 Ptl 12• 50 Conservation Division Application Fee Tax Collector - -,: Permit Fee 7 y 4 Gt!lfSiOf Treasurer Planning Dept. CONNECTED SEWER ACCOUNT Date Definitive Plan Approved by Planning Board # �7 1 Historic-OKH Preservation/Hyannis Project Street Address P4/C &P_,0VC Ay. &f°�4AJVI,Y Z/,g, 02 6p/ Village 1 1)y vt t ✓ Owner joF,— 774119RC.S Address F Telephone 7-7S'— 9�Ul/ Permit Request , is it Aver Z)®eeie Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation � ��G Construction Type �� 40.< 2O v e Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. s ? Dwelling Type: Single Family C4' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes L j No J' 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 !Y,Heat Type and Fuel: ❑Gas ❑Oil ❑Electric Cl Other iCentral Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No ; Detached garage:Zeting Cl new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: l Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ i Commercial ❑Yes ❑No If yes,site plan review# Current Use 1263- Proposed Use BUILDER INFORMATION Name %f�O�''��1 %�,4i/gYZ�f Telephone Number �� �� 7-- Address 41S 6 vlaae License# �A +�-i" S /��} O 26 / Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE F FOR OFFICIAL USE ONLY a PERMIT NO. v ' DATE ISSUED MAP/PARCEL'NO. - r .c ADDRESS VILLAGE OWNER l { DATE OF INSPECTION: FOUNDATION FRAME INSULATION ® (� S 6(7' FIREPLACE ELECTRICAL: ROUGH FINAL n PLUMBING: ROUGH t? FINAL"%I ni GAS: ROUGH 0 FINAL u _ a FINAL BUILDING ti m m DATE CLOSED OUT ' i r j' ASSOCIATION PLAN NO. { v 1 r .F t r 4; The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations -- 600 Washington Street, a Floor %r Boston,Mass. 02111 Workers'ComiDensation Insurance Affidavit:Buildin lumbin /Electrical:Contractors name: —7WOHAS 47� address: 45 city state: zie:®Z60( phone work site location(full address): V I am a homeowner performing all work myself. Project Type ❑New Construction❑Remodel ❑ lamas ole rorietor and have no one working in any capacity ❑Building Addition f.' .�-i�;"F' ❑ I am an employer providing workers' compensation for my employees working on this job. company name, address: city 0 one insurance co. D01iM# 1 ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers'compensation polices: company name: address: city phone#' insurance co. volig# company name: address: city: phone#• insurance co. 01M# .,, ., .,. .a 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 S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a' copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permittlicense# ❑BuildDDepartment❑Licen❑check if immediate response is required ❑Select❑Healt contact person: phone#; ❑Other (revised Sept.2003) e i r Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract of hire,express or implied,oral or written. An'employer is defined as an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or!trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or;building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. I Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned.to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns i 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone #: (617) 727-4900 ext.406 OFTM9 r Town of Barnstable Regulatory Services . F.Geiler,Director . � saxNsraBr Thomas�, T . �b 1659. •�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508462-4038 permitno. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,wc u red ion, emen removal,demolition,or construction of an addition to any pie-existing ch 'acent to imp rov t, structures wbi ] bolding containing at least one but not more than four dwelling units or to s c such residence or building be done by registered contractors,with certain exceptions,along with other requirements. C-_41,' p A, {rL Estimated Cost Type of Work:_ oi Address of Work:_ &ner's Namd: 'Date-of Application: I hereby certify that: j Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied Ong ownpermit that; 's hereby given D Notice i Y g GISTERE OwnRS PULLING THEIR OWN PERMIT OR DEALING WITH o]kK DO NOT OVEMENT CONTRACTORS FOR APPLICABLE ROHO M oRGUARANTY F R h,IG HAVE'142A. ACCESS TO THE ARBITRATION -SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Contractor Name Registration No. DateOR Date Owner's Name Q,focroshomeaffidav Reguiatory Services Y�RNSTAKE; —'J#A s-F;::C�eiler,•Directoc -. ...�_...-- �_Y.M. _.. 9�pr MASS. �� : . . . '.'Building Division �. . _. . M.. . . . Tom Perry,-jkrildi:ngCommissi'oner - '. 200 Main Street, Hyannis,MA 02601 ' www.town.barnstable.ma.us - Office: 508-862-4038 = Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION:_ �S rY/x-L;G o r'1dv� Ale— e4&��k---f 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 be,a one 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 strictures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall pot be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building*Official,thathe/she shall be res onsible for all u p such work performed under the buildin 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 T ovyA of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and ' requirements. ' Signature of Homeo ' 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.. TI HOMEOWNER'S EXEMPON The Code states that "Any homeowner performing work for which a building permit is required shall be exempt firm the provisions of this sectioa(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)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; up r On the last page of this issue is a form currentlyused b several towns. You may care t amend and adopt such a form/certification for use in your community. y Q:forms:homeexempt RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE ,.., :. New Buildings >_ $100-00, _ - Residential Addition $ 50.00 -- - Alterations/Renovations. $50.00D,d "-'Building Pefhiit Amendment.. $ FEE'VALUE WORKSHEET _ NEW LIVING SPACE / �l square feet x$96/sq.foot= lel 7 S x.0041= Y plus from below(if applicable) ALTERATTONS/RENOVATIONS OF EXISTING SPACE - square feet x$64/sq.foot= x.004,1= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY-STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf • 50.00 >750 sf-1000 sf. 75.00 >1000 sf=1500 sf • 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck.... ... .. :_ x$30.00= (number) Fireplace/Chimney . x$25.0.0= (number) Ingrodnd Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) 4or Permit Fee 7 Projcost Rev:063004 I i —._.a v4 `° Kl� 7"`-- ? f _ f f! J I • • t� m id floor) Map Parcel 1� � Permit# ti 36 O " House# '��j` ` Date Issued �- rLIU�T OBTAIN A SEWER �3bar-&UfEeahth(3rd floor)(8:15 -9:30/1:00- ) :EONNECTION'PM, PDOU =P. r Conservation Office(4th floor)(8:30- 9:30/1:00=2:00) 1 U;XING DIVISION PRIOR TO "^ Planning Dept. (1st floor/School Admin. Bldg.) THE ; _- q)e Plan Approved by Planning Board ( 19 �- MASS.TOWN OYBARNSTABLEBuilding Permit Application treet Address Village Owner Addresses r`{ Telephone - Permit Request First Floor square feet Second Floor square feet Construction Type ���0.0•• + Estimated Project Cost $ / �, a a a + Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No.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 Garage: ❑Detached(size) 2 P L Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number .3 L 2 // 7 V Address"/ 9 ,� License# 001/el Z l ,fly Home Improvement Contractor#/O 9 Worker's Compensation# W C /00 p / 2 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 SIGNATURE DATE ��/// a BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 'hR '- FOR OFFICIAL USE ONLY PERMIT N(-). _ DATE ISSiJED 4 MAP/PARCEL NO. ADDRESS VILLAGE.; ` OWNER .: � j � _' - '� r � _✓ - - TM�, DATE OFJNSPECTION. ' - - FOUNDATION FRAME 12 INSULATION, FIREPLACE ` �-e> y t ' ELECTRICAL: ROUGH 4 FINAL` PLUMBING ROUGH f' FINAL GAS: ��a ROUGH FINAL, FINAL EFUILDING 1 DATE CLOSED OUT ASSOCIATION PLAN NO. OfZME t01f� - : . The Town of Barnstable MAM • ,�arrsrnar� • �0� Department of Health Safety and Environmental Services rEo '' Building Division' 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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: emot, Est. Cost Address of Work:/d,*" Owner's Name —/-W-7 o Date of Permit Application: g I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Of / g Dati Contractor Name Registration No. OR Date Owner's Name The Commonwealth of Massachusetts ==_ Department of Industrial Accidents �a Office of/nsestigatioes ^ t 600 Washington Street Boston,Mass. 02111 Workers' Co/m�ensation Insurance Affidavit name• !�t y/" L Do��a�f location: city M/. /7.4�`'/?J //T� /l- a phone# ❑ I am a homeowner performing al work myself. ❑ I am a sole ro rietor and have no one workin in any ca acity 90/00/0,%//%%%% %%%%%%%%��%%//%%/%%%%%%%%%%%%/%/%%%%%%%%I%%%%%/%%/%��%%%%%%%%%/%//%/�/�/�/%/%%/�%%%�%%�/��%%%%/// I am an employer providing workers' compensation for my employees working on this job. company name address. �r " dty / l f t r tifsi Ra%`t'.G phone#: insurance co. olicv# @ 1 FREE ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: companv name- address. , city phone olu #insurance co ;: cotnoanv name. address. ciW shone#: ............... insurance co::; ::::.; oli #; i Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is truo and correct Signature Date Print name .*- d6r1c:Q�'l C Phone#. 'ZG official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other UevzW 9195 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation,ot otlTer-legal`entity, or any two or bore 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 douse of another who employs persons to do maintenance , construction or repair work on such'dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this,chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be 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. j City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: , The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Invesilgaffons 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 y - .. �, it rira r�-��Kr✓�T ?ii.•.�.p's.Lim":�".,s /�.' .:i.,.•as . .i;.r � ' A g �• ✓ U/69�7/In09L1!/Pl/L •f{�/�I�G!sk1GGG�tU.s1Pt OEPpR-TAENT OF PUBLIC SAFETY k. CONSTRUCT-ON.-SUPERVISOR LICENSE Ntt�er ;EzDires; Birtndate CS 9 2 6 -1211.111999 1211111941 -_---- Re d-Q AkT:NURU OQihff Gg 14 MCCORMICK OR W BARNSTABLE, MA ?2668 > dew t AHOME IMPROVEMENT,CONTRACTOR - Registration a104499 ; 6TYPe ,.,,,'-,PRIVATE CORPORATION . 4 ExPirationM407/14/98 �R s� ART DOL60FF3UILDIN6/REMODELI � ; KAr.thur L:-Dolgoffrmid Or ADMINISTRATORu .Barnstable MA 02668 h s + 3c Y '7 PIC qx7 9x7 j A04 �� o�T FRAMING SECTION ALL DIMENSION LUMBER SHALL BE KID SPF NO.2 OR BETTER. x COLLAR.TIE @ ` b O.G. 2 x ?RAFTER @ O.G. 1. SHINGLE i 2 x CEILING JOIST @ "" O.G. W/IS LB. FELT i Ix PINE FACIA R-30 KRAFT FACED FG S R- UNFACED FG BATTS —! SOFFIT VENT W/6-MIL POLY VAPOR BARRIER PINE SOFFIT (1 sT E 2Nu FLOUR) I \ 240 FLOOR JOIST o.c. (isr 2m FLOOR) y. i �, nn A - V � u SILL I c > SILL SEAL ' O ANCNDR BOLT @ 6'-0" O.G. CONCRETE ". o FOUNDATION WALL 2 nA !1/lI M M n � t 0 t f • � I WALL S rC V`/7 S�ct 4�41 t v !fit DID! �,tli4LL. V SLR T The, own of Barnstable cr�.�-E -sgZ:r/a r�l L_ 4 yrill X X Ln a m , c i i� `n VN 1 o o b _}.-.-1 ......,...r^k•R'r-'�`*'°o,-t+..:�.sw+_-�=J'rr.,,-^r•�-.r...�t-emu.,r.:.-"f'? �...:.i�-r'•r""` '..'-c..acs-^w.'�"�.. - .+a�"yr,�"'^"`w`.v��-�+r�C.++'?Ott,;.'gin';,";-^,-Jcri.-c-',�•Tv c. ..r,�.�.-- wr .r,. The Town of Barnstable BARNSTABLE.MASS. Department Department of Health Safetyand Environmental Services � Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspections Location e_ .e• Permit Number �6- 3 Owner Builder , One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: (A.) ��i� �c_.s.l "�P ) J �� A'G� _..�' :�'Jrr�cv,�--► if.1-PP��S Sv 7- 13�c,r S a P�.� I �- W 0 e•J C'O jZ� �.. Please call: 508-790-6227�for re-inspection. s Inspected by I / r /Date THE TOWN OF BARNSTABLE DA"ST'"M 1639- go?MOR BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... ....... . .... . . .. ............................................................................. ......... .. . . . . .. .. ........ .......... TYPE OF CONSTRUCTION .......... ......... . ...... . ........./......................I .....19.9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ap, ylls for a permit accordin to the folloyfng information: Location ........... ...... .... .. ..... ........... ............... ProposedUse .................. . ...... .. ..... ........................................................................................................... Zoning District ............................ Fire District ..........I Nameof Owner .......... ..... ... ... . ..................Address ..... ... .. . ... .. . .. . . .................................................. Nameof Builder ....... .... .......................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....................... ................... .......................Foundation ................. ....... . ........ . .... .. . . . ... ............ Exterior ..... ...... .. .......... ..................................Roofing ....................... . ....... .... ........................................... ...... ...... ......... ........... . ...... ... . .................. Floors .....................................................................Interior .......................... ......... Heating ..................................................................................Plumbing .................................................................................. 00 Fireplace ............................... CID 6-0 ...................................................Approximatt- Cost .................................................................... Difinitive Plan Approved by Planning Board --------------------------------19--------- /3 x Diagram of Lot and Building with Dimensions v'/ 7E6 _IhlL PROPOSED METHOf) OF PROVIDING FUR SANITARY WATER SUPPLY, SEPGE DISPOSAL AND DRAINAGE IS HE . - R� ROVED N/OF BARNSTABLEI, ' OARD OF HEALTH HE /0' LGrI hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above -construction. Name ................. Tovarea^ Eugene _ . } ^� *��� - � �:nv « � � ��a`bo oloo8�» No ....�.�.���.. Pernn� for --.-----.—.���. � dwelling . Location .........45_�ioe..Grov*_J�rern�a..u°�+�4v� . .~.--.—.—...�Z�����-------.------ . � . Owner ...........�ane�e_Tavareu........................ ' ! Type of Construction ----- me ---'-----.. —^~~—^^—'-----'--------'~—~'—'- \ / � pkn ��/ --'---^~--' ----------'' ' Permit Granted .— ..14.............l9 71 n / . .^ Date of Inspection - ------.]g Dote Completed —. ------..lg . � | ' PERMIT REFUSED ' \ ' .—._—..~—,--.—..—.------- 19 '----^---^^^—^~--^~^--'—'---''`—' | / ~.~.—...~—.......----.......-----... ` � -~--'—^''---------~^'~'~~^^'---'—^' � --------------.-----.—~.---.— Approved ................................................ lg _______._______._________.__. | . ----'------.---------.—......,, b_ r" V I j C r, v rb 66 e�A J = ; ,72 \ 1 b � x Jr-. �- LAI