HomeMy WebLinkAbout925 PITCHER'S WAY � ,
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Assessor's office (1st floor): 4 �' O�TNETO
Assessor's map and lot number .. - ...-./.. .......... �f
Board of Health (3rd floor): _ ,�-� �P o
Sewage hermit number ( Q 7(-K l . — i
......................... ............. ..��^• r Z B9H.89TADLE, i
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Engineering Department (3rd floor): 900 �e a•
House number ................................... .........'...................
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APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only'
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ... . l.!% ?, l..(�.. ........ ........................
TYPE OF CONSTRUCTION .........................Y. O�L........4�.A -4.£....,. ;��l C1............! :............
.......................:...... .................19.....
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according tothe following information:
Location ............. . ?. ../.. .......J..... ...... .f.7?,.?h ..... .1✓1 Y.
..r... .`1&�,5 .......
Proposed Use ..........1 �r ....... 11��. !..�- .............--.y..�5�/Y0 D �
�. ....... �l�' •....... ..........................................................................
Zoning District ........................ .r'./.................................Fire District ................hIV4�'(/
Name of Owner . ��' ' �r1� ..... .!1.! '... .............Address `1` /G�iY .(�(/ "� //��. ......
�y.......�.j... p. ......>.v......
�..�:.• � f� red Address �X.,. 1 / -�C U f!L
' Name of Builder .... ..r-... .. ....... . ...�.............. .....,..... ... ......................................�
t/ r/
Nameof Architect ....................................................................Address ....................................................................................
Number of Rooms ................ ?C.............................................Foundation ......................................
Exierior i!f ,r �...e . !1...............................Roofing ............ I h , .......................................
Floors ...........� .y��(/..(� ... f f!.� ..................Interior .............1/�, ................
�A�G :�'�- �=G Plumbing /='UGC........13 Heating .... ......Plumbin ........... . .......................................
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
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
N` I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
IIII f
Name .. ..��� � l.!..... . ./�/',Y�/. ...............
;��
Construction Supervisor's License ...:....... ........................
V/-1MacKAY, LORRAINE A=272-141
No .2913 permit for construct
dormer on single family dwell.
................+.............................................................
Location .Lot #13 .925 Pitchers Way,
I
.............................................
Hyannis....................
Owner .........Lorraine,,.MacKay
Type of Construction .........frame
.. ..............................
................................................................................
Plot ............................ Lot ................................
r
Permit Granted .. .........ApKi.l.. 2.........19 86 i
Date of Inspection ................................:...19
Date Completed ....................:.................19
1
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Assessor's office (1st floor):
FTNET �
Assessor's map-and lot number ..�� ..........
Board of Heplth (3rd floor): no SySTEi BUST BE
Sewage Permit number' .......:..:.......:...�5.(..-Q...: No ED Its COR�PLIA�iC = EAWSTABLE,
Engineering Department (3rd floor). i t LWITH TITLE 5 - ®9'` 1639• `00�
House number ................... ..� ................... DE AN o Y a
APPLICATIONS PROCESSED .8:30-9:30 A.M. and, 1:00-'2:00 P.M. only;�'���I�D� EaC L�eO
TOWN-_ ,OF BARNSTABLE
BLUILDIHG INSPECTOR
APPLICATION FOR `PERMIT TO .. ......L. <.�. 'U ...................
C!..f -!X................................
TYPE OF CONSTRUCTION ....... /--A8i.4.4........� �C
.. ,l..... .............
............................
............... ......./...... ..........19.....w
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Zz.>.2.1_1 .... ........�_-4. �11115....Location ............. ........... .......... ...s'...... ... .....
Proposed Use ......'.. �1!'.��....... L:�7i!�..t�. ........... .1"S yv�l........ .. .. ...........................................
Zoning District ....................lev ..7.1................................Fire District ................ /
Name of Owner ..L�.b!t" .��1� .... fl C�/EfjF... .............Address ...�G% .. 4f�` �f/ .. ..... .........
Name of Builder .... .........Address
�..� 1 � �. �V �?1.:...... !C„V�L� ..........Name of Architect ..................................................................Address ....................................................................................
Number of Rooms ............Foundation ..............................................................................
Exterior ...........�/U�,�. G�....CrZW-lL...............................Roofing ............ `l7X.
fT ......:......................................
Floors ..........��. !/t/�t!!/..,1. / � .� ..................Interior ............p1r. vi! ..........................................
Heating .............. f?.� `�F� �.�. � 4�......Plumbing .......r ...... ...................................
Fireplace ..................................................................................Approximate Cost Z �
Definitive Plan Approved by Planning Board --------------------
------19-------- . Area ..�......... .
00
Diagram of Lot and Building with Dimensions Fee ...
....... . ..............................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .. .. :......
{ Construction Supervisor's License ... . .... ......................
> MacKAY, LORRAINE A=272-141 -
No29131•: permit forconstruct dormer
................... ,
r on sin le famil dw li
J ...................Y........ ......1��1............ - -
Location
Lot #13 925 Pitchers` Wa
....HY.anni s..........:.............................:....... , ..... ,
Owner
Lorraine MacKay
...................................y............................ '
Type ofConstruction frame.............. , f
ti
Plot ...................._......... Lot,................................
r
F ' r
Permit Granted .. 4..... .AP.r?1 .2........19 86.
r
...
Date of Inspection ............:........................19` ,
.
e Date Completed '
in`t
$ E1'
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M Et T
a- r -
4 fi
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TOWN OF BARNSTABLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print.
DATE
JOB. LOCATION Z5 CC C'r1 t R� S A1v tJS '
Number Street address Section of town
"HOMEOWNER" ��V D 'C� \ Z�� _ . . --
7�8�-0�-1� S `77��� �oz-�~
Name Home phone Work phone -
PRESENT 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 such homeowners to engage an in-
dividual for hire who does not possess a license, provided that the owner
acts as supervisor.
DEFINITION OF HOMEOWNER:
Persons) who owns a parcel of land on which he/she resides or intends to re-
side, 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 Officia_
on a form acceptable to the Building Official, that he/she shall be responsibl4
for all such work performed under the building permit. (Section 109. 1. 1)
The undersigned "homeowner" assumes . responsibility for compliance with the Sta4
Building Code and other applicable codes, by-laws, 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 co with id oc res and requirements.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings 35, 000 cubic feet, or larger, will be required
to comply with State Building Code Section 127. 0, Construction Control.
HOME OWNER'S EXEMPTION r
The code state that: "Any Home Owner 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
Home Owner engages a person(s) for hire to do such work, that such Home Owne:
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the
responsibilities of. a supervisor (see Appendix Q, Rules and Regulations
for . licensin Construction Su ervis g p ors, Section 2. 15) . This lack of awarene;
often result
s in serious problems, particularly when the Home Owner hires
unlicensed persons. In this case our Board cannot proceed .against the
inlicensed person as it would with licensed Supervisor. The Home ' Owner actir.
as supervisor is ultimately responsible. ,
To ensure that the Home Owner is fully 'aware of his/tier responsibilitidst man
communities require, as part of the permit application, that the Home Owner
certify that he/she understands the responsibilities of a supervisor. On the
last a P
page of this issue is a form currently used by several towns. You may
car
e to amend and adopt such a form ce
P / rtification for use in your community.
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February 16, 1998
David H Preston
AVAVAVAVAVAVA&®
P.O.Box 322•Centerville,MA 02632-0322•Telephone(508)778-0495
Dear Gloria Urenas,
In response to my current situation at 925 Pitcher's Way, Hyannis I
would like to submit the following.
First, I bought the property in 1988 with the understanding that it was
allowed to have three lodgers in a single family home. I have done nothing
to the property since I bought it from Edmund Flynn. Currently I have three
lodgers with no kitchens in lodging areas. As per our discussion on what a
kitchen might be considered; I will remove any cabinets and or counter top
that might present a kitchen atmosphere.
Second, I am planning to renovate the property. At the end of the
renovations I will only have room for two lodgers instead of three, since our
immediate family require more room.
Third, as to the health violation that started the complaint, which was a
flea infestation. Before the lodger that occupied the infected unit, there was
a problem left by the last lodger. I took all proper measures to correct this.
After the new lodger moved in the problem reoccurred. The situation was
then corrected within two weeks. After the lodger left in December of 1997
the problem has not been repeated.
Lastly I would like to-say that the health inspection by my knowledge
was never done. No appointment was made and I never met with an
inspector. I reside at this property and will cooperate in any way I can with
the town. If there are any further questions please call me at the above
phone number or mail any inquires to the above address.
Sincerely,
UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fees Paid
USPS
Permit No.G-10
I a Print your name, address, and ZIP Code in this box 9
I r
TOM of Barnstabia
Widing Division
367 Main St.
Hyannis, MA 02601
N
ai SENDER: I also wish to receive the
v ■Complete items T'and/or 2 for additional services.
■Complete items 3,4a,and 4b. following services(for an
■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you.
■Aeramcfahis form to the front of the mailpiece,or on the bads if space does not 1. ❑ Addressee's Address
` ■Write'Retum Receipt Re nested'on the mail piece below the article number. d
d p 4 a 2. ❑ Restricted Delivery N
$ ■The Return Receipt will show to whom the article was delivered and the date
C delivered. Consult postmaster for fee. a
3.Article Addressed to: 4a.Article Number
11
d � `
E 4b.Service Type
u 9� ❑ Registered ❑ Certified M
c U ❑ Express Mail Insure
d
y ❑ COD4
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7.D to o Deivery w
p 5.Received By:(Print Name) M:' J'f Ad res ee's d ress Only if requested
z 3 and fee Vs paid) Cd
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6.Signat e:(Addres a or Agent) n
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PS Form 3811, December 1994 yS t62595-97-13-0179 Domestic Return Receipt
Z 203 495--41J5
us Postal Service
Receipt for Certified Mail
No Insurance Coverage Provided.
Do not use for International Mail See reverse
Sent to
St a7"*tFl�
P s1 qffice,State,&ZIP Code
i
P e $
Certified Fee
Special Delivery Fee
Restricted Delivery Fee
rn Return Receipt Showing to
Whom&Date Delivered
n Return Receipt Showing to Whom,
Q Date,&Addressee's Address
0 TOTAL Postage&Fees $ a, 77
Postmark or Date
E
0
LL
rn
a
Stick postage stamps to article to cover First-Class postage,certified mail fee,and
I
charges for any selected optional services(See front).
1.If you want this receipt postmarked,stick the gummed stub to the right of the return
address leaving the receipt attached, and present the article at a post office service y
window or hand it to your rural carrier(no extra charge).
2. If you do not want this receipt postmarked,stick the gummed stub to the right of the
return address of the article,date,detach,and retain the receipt,and mail the article. t
LO
3. It you want a return receipt,write the certified mail number and your name and address
on a return receipt card,Form 3811,and attach it to the front of the article by means of the
gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article a
RETURN RECEIPT REQUESTED adjacent to the number. Q
4. If you want delivery restricted to the addressee, or to an authorized agent of the
addressee,endorse RESTRICTED DELIVERY on the front of the article. ccoo
C'!
5. Enter fees for the services requested in the appropriate spaces on the front of this E
receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. li
6. Save this receipt and present it if you make an inquiry. 102595-97-6-0145 a
.k. . .. �.. ,. ..__ ,. .....-.�,... ,,,.. .. .. ..,fit ... a .-, .. � .. .. .. ._ .. .. ...
10
: . f. : he Town of Barnstable
NAM
• ■narrsrnsi.E, • .
Department of Health Safety and Environmental Services
o " Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
January 6, 1998
David Preston
925 Pitchers Way
Hyannis,MA 02601
RE: M-272/P-141
Dear Property Owner:
Our records indicate that your house at,925 Pitchers Way,Hyannis,MA is currently being used as a four-
family home contrary to Barnstable Zoning Ordinances. You must contact this office as soon as possible to
either:
1) apply for a building permit to restore the property to a single family home.
2) apply to the Zoning Board of Appeals for a variance
3) prove that these are legal four-family.
You must contact this office immediately to tell us what direction you wish to take.
Sincerely,
Gloria M.Urenas
Zoning Enforcement Officer
GMU:lb
CERTIFIED MAIL Z-203 495 465
f9703IIa
RESIDENTIAL PROPERTY
MAP NO. LOT NO. FIRE DISTRICT SUMMARY
+14 STREET pitchers Way Hyannis '
7
272 141 S LAND -�G
H SLOGS.
,/ OWNER
y. TOTAL C
LAND
RECORD OF TRANSFER DATE BK PG I.R.S. REMAEiKS:
D L BLDGS.
V'3 TOTA'.
Sac LAND
Carpsntex�— eph-P•, T�•�____._-- ____. -_._ _(-8-73 1875 03 Blocs.
1- — o
't Bank _ - _-...-=— -_.._..__...-__ ._ 9-3=76393- 27 tg.-F c'1:'49—tG'ts 250�00(7 TOTAL
"> -- LAND
`lark, Wi 11 i amH _ 12-8-80 320 92 55 0 lots SLOGS.
TOTAL
LAND
BLDGS.
— at
TOTAL
LAND
BLDGS.
OI
TOTAL
-- LAND
BLDGS.
TOTAL
LAND
INTERIOR INSPECTED: BLDGS.
TOTAL
DATE: LAND
ACREAGE COMPUTATIONS /,/gC BLDGS.
LAND TYPE OF ACRES PRICE TOTAL DEPR. VALUE TOTAL
HOUSE-LOT /S- s�Q-,rJ LAND
CLEARED FRONT - BLDCS.
REAR TOTAL
WOODS&SPROUT FRONT LAND
REAR BLDGS.
WASTE FRONT TOTAL
REAR LAND
m BLDGS.
TOTAL
LAND
/G O BLDGS.
LOT COMPUTATIONS LAND FACTORS TOTAL
FRONT DEPTH STREET PRICE DEPTH FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND
ROUGH TOWN WATER BLOCS.
HIGH GRAVEL RD. TOTAL
LOW DIRT RD. LAND
SWAMPY NO RD. BLDGS.
' TOTAL
TOWN OF BARNSTABLE, MASS. UNITED APPRAISAL CO..EAST HARTFORD•CONN.
Cont.g
Conc.
Bsmt Rec.Room !.Shower Bath Bsmt. PURCH.DATE
Conc. Bifrlt.Garage St.Shower Ext. Walls PURCH.PRICE.
{ Attic FI.&Stairs Toilet Room Roof RENT
t Brick Stone Fin.Attic Two Fixt.Bath Floors
Pier!.
INTERIOR FINISH Lavatory Extra w`•
BsmL F 1 2 3 Sink ._ Attic
Plaster Water Clo.Extra ----- -- '
EXTERIOR WALLS Knotty Pine Water Only h�.
8smt.Fin.
Double Siding Plywood No Plumbing
Int.Fin.
Single Siding Plasterboard _ -
TILING
Shingles
Conc.Blk.
G F P Bath FI. Meat .
Face Brix.On Int.Layout Bath FI.&Wains. Auto Ht.Unit ,
Veneer Int.Cond. Bath FI.&Walls Fireplace
Co..BA.On HEATING Toilet Rm.F1. Plumbing
Solid Com.BA. Hot Air Toilet Rm_FI.8 Wains. Tiling .
Blanket Ins. H
Steam Toilet Rm.Ft'8 Walls
ot Water St.Shower
Total __
Roof Ins. Air
Floor Furn
ROOFING COMPUTATIONS
Pipeless Furn. S.F.
A,Dh.Shingle ,
S.F.
No Heat
Wood Shingle '
Asbs.Shingle Oil Burner S.F.
Slate Coal Stoker _ S.F. OUTBUILDINGS
Tile Gas S.F. 1 2 3 4 5 6 7 JE. 9 ID MEAS
1 2 3 4 5 6 7 8 9 30
ROOF TYPE Electric S.F. Floor
Gable Flat Pier Found.S S.F.
Hip Mansard FIREPLACES Well Found. 0.H.Door LIS
Gambrel Fireplace Stack — Sgle.Sdg. Roll Roofing
F LO IRS Fireplace Shingle Root DO
LIGHTING Dble.Sdg.
Conc. Plumbing
Earth No Elect. Shingle Walls
Cement Bilk. Electric
Pine _— PRI
Hardwood
ROOMS Brick Int.Finish
ASDh.Tile
Bsml. 1st TOTAL
Single 2nd 3rd FACTOR
REPLACEMENT
AREA CLASS AGE REMOD. CON D. REPL. VAL. Phy.DeD. PHVS. VALUE Funcl.Dep. ACTUAL VAL.
OCCUPANCY CONSTRUCTION SIZE
DWLG.
I
2
3
4'
5
6
_7
B
9
TOTAL
10
PROPERTY ADDRESS STATE PAR
I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CLASS I PCS I NBHD KEY No.
0925 PITCHERS WAY 07 RC-1 400 07HY 07/09/95 lull OO -5JAC R272 141 . 182689
LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T
Y UNIT ADJD.UNIT Y it j T'7 N I D A V I D H a—
wntlBy/Dale s.ee D.mens�on LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE ACRES/UNITS VALUE Description MA.
I CD. FFDe m/ngres 4 L AND 1 2 7,5 O O CARDS IN ACCOUNT —
L 10 1dLUG.SIT 1 x .45 =10C L= 95 161 39999.99 61199.99 -45 2750U #3LDG(S)-CARD-1 1 91,000 O1 OF 01
7PL 925 PITCHERS WAY HY
A N BATHS 4.0 U X C= 100 14000.00 14000.00 1.00 14O00 J #DL LOT 13 IARKET 92600
p '1.tR 1276 0125 INCOME
SE
A
D APPRAISED VALUE
'
D i A 118,50C
A U ARCEL SUMMARY
T S ANC 2750C
A T sLDGS 91000
-.IMPS
M rOTAL 11A50C
F Eq CNST
E N DEED REFERENCEI Type DATE q�ord� .R I O R YEAR VALUE
Ins.. Sales Pric. ) t 0(�
A Book Page MO V r.D A tr 7 (.7 5 Lt 1:
S D+D�/17'l ilJv/8 1S50t�ii 3LDGS 91000
T 4391 /146: IJ3/86 925n0 OTAL 11850E
U
R 3!.34126 IJ5182 4560+0
E DJ LAND - ACRCS '
BUILDING PERMIT
S Nom , Date Type A.nouAt S STREET FROM
LAND LAND-ADJ INCOME ISE SP-ELDS FEATURES 6LD-ADJS UNITS SEWER TREATMENT.
27500 14000 217995 lu/66 AD 8500 ..............
Const. Total r B ilt Norm. Obsv.
Class Units L."" Base Rate Atll.Ra.e A I I Age Ne Contl. CND Loc %R.G Rep. Cost New Adl Rapt Valee Stones Height P— Rma Baths a Fia. Partywai:Fac.
02C 000 10D 100 61.60 61.60 81 31 13 88 90 73 116618 910JJ 1 .5 6 3 4.0, 14.0
Desc.iplon Rale Sgea.e Feel Repi.Cost MKT.INDEX: 1 a IMP.BY/DATE: ML D/91 SCALE: 1 /U U-7 7 ELEMENTS CODE CONSTRUCTION DETAIL
c3AS 100 til-6O 768 47309 w wL
S FWD 85 8.50 144 1224 *-----16----* N 'TYLE 04 APE COD 0.0
T 15S 132 81 .31 384 31223 ! 15S *------15-----* -__, r 1-
R FSF 90 55.44 54 2994 ! ! FWD ! =kT:-,'f,,4Atl '3-- -1T d0'J-0-SFI-PTGCIS---U-.t3
U 815 42 25..37 7,58 1 9868 11TrF Fl d--'- jk tYW?iCL---_____--
C _
T 24 20---*---12---*--32----------* NT -F:CAYJJT- TZ I VEF I74ZSFT1AL----- .-J
U ! !FSF ! 815 ! ENT=sF.:37�.-Li9 li AiTc-AS-'cRTEI`�-- �.
R ! 9 9 ! -CDD-R, ST -:ICT UZ.T�-J013T/3EAY---D-CF
A ! ! ! r tbuf! COY R-- -1-4 IL,rRUwiCPRT--D._7
L D Total Areas A— 144 Baaa 120:5 ! *-6--* ! ?u 0`r TYPL---- -IT,A6rt E=A-SF9-SIi---T-L,
E BUILDING DIMENSIONS *-----16----* 24 BASE 24 LcCT+t IT A-L J 1VFRZ AISE D.V
T BAS W32 N24 FWD E 2 N 8 w18 15s ! ! 0 UTNITATIti.S-_._ +J-7. DTn:D-_ 9i9C-----99.77
A N04 W16 S24 F-16 N20 .. FWD SOS ! i -------------- - --- ----------------------
I E06 . . FSF W06 S09 E06 N09 .. ! ----N'Ei�?.3t7FFi:):J-u jiI9"-HYA fly NZR-------
L BAS E32 S24 .. 815 N24 W32 S24 ! ! LAND TOTAL MARKET -
E32 .. ! ! PARCEL 27500 113500
*-----------32----------X AREA 102000 657
VARIAi`dCE -73 +17934
STANDARD 25
PROPERTY ADDRESS I ZONING I DISTRICT CODE SIP-DISTS.I DATE PRINTED I CSTATE
LASS I PCs I NBHD PARCEL IDENTIFICATION NUMBER KEY NO.
092.5 PITCHERS WAY 07 RC-1 4t0 07HY 07/! 9/95 1011 0J 5JAc t271 141 . 182689
LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T f n J T Jy !) V I H A P—
Land By/Dale s ze D�menson LOC.IVR.SPEC.CLASS ADJ. COND. vP UNIT AD 'D.UNIT
ACRES/UNITS VALUE D ac'pli
1 CD. FF D INAc E I/L A N J 1 27,1500 CARDS IN ACCOUNT —
L 10 13LDG.SlT 1 x _4 =100 L= 95 161 39999.99 61199.99 .45 275uJ jl L11G S -CARC-1 1 91.000 OF 01
A '25, TC'HERS WAY HY
N BATHS 4.0 U x C= 100 14006.00 14000.00 1.00 14JJU d 4DL LOT 13 iaPiCE'T 92600
D ar:F, 'J 276 1
A S'
D
APPRAISED VALUE
D J 118.500
A AGCEL SUMMARY
T S MIND 27.50C,
A S ;LOGS 91000
T ?-IFrPS
F
E 0 T A L 118 0 50 E
' C�;ST
E N DEED REFERENCE Type DATE Recorded R'`O f? YEAR VALUE ,
nar. S.._Pric. 2 7.5 00
A Book P.ge MO. Yr.D ;�
T S 6452/179, 51 9/818 185070 3LDu5 91000
U 4391 /146: IJ.3/r.5 925^0 OTAL 118500
34,81 /26 1u5/87; 45600
BUILDING PERMIT D J L. ND - A C R O S
J N-1— D.te Type Am t , S T R E E T FROM
LAND LAND-ADJ INCOME t SE SP-ELDS FEATURES BLD-ADJS UNIT;; SEWER TREATMENT.
27500 14000 329'?95 1i)/ i6 AD 8500
Class DOnal. TOlal r B ilt Norm. Ob—
Units L'nils Base Rale Adj.Rate A I r I Age De , j Cond. CND Loc %R.G RePI Cost New Adl Repl Value Stories H69.1 R-- Rma.B.t�a I Fi><. I Panyw.il Fu.
02C 000 100 100 61.60 61 .60 81 ?i1 13 88 90 73 116618 910J0 1.5 6 5 4.0 14.0
Description Rate Square Feet Repl Cpst MKT.INDEX: 1-O0 IMP_BY/DATE: ML 6/91 SCALE: 1100.77 ELEMENTS CODE CONSTRUCTION DETAIL
aAS 100 61.50 768 47309 >. c
FWD 8.5 8.50 144 1224 *-----16----* N iTYL 04 -APE COD 0.0
T 15S 132 81.31 334 31223 ! 15S 5 E1I-I:;N-t1UJ T- ,iU ------------------0=r,
H FSF 90 .55.44 54 2994 ! ! FWD ± =AT'-.+7 LS - -1T-—[ -Sf II4,CtS---�J---
D 815 42 2.5.87 768 1 9868 ! 3 8 EA,T-FAsS TY'c J Lt CfRi ---------�-�r
! I PaTc!:FIAiiSFi- -04)'?Y'qA ------�:G
F 24 20---*---12---*--32----------* NTf?F=CAY-7U T- _r Vc_ 7NT_T;T 1A.L-----
L {T
J ± !FSF ± 815 ± [fly= EXTEh=--
1 ± 9 9 ! LD07T 5T ?JCT- J2 ?D"-JOIS-T-f:lE
D 144 1206
! ± ! ! f L 0-kPi OV C 7 -1-4 .IL-F/R t��dD/CPFi_T '0.T7
! *-6--* ! iL7F -TY�------ --J7JAs`LE=ASPN-Sl{---r.-G
E TOlal Areas Au.n Base=
BUILDING DIMENSIONS *�----16----* 24 BASE 24 LE_C_rRI C-A-U yJT tVtf'AGt D.-a
T HAS W 2 NZ FWD E N W18 S ± I 0UN-D-ATIV-N- T,LrRED C_OT?gi,-----99.-T
A N04 W16 S24 E16 N20 ._ FWD S08 ± -------------- - rr _-_-__----------____--
E06 _. FSF W06 S09 E06 N09 .. ! -----WEIJTc7'v'RFIU 1 5-UrkC-NYts!AN_I_S -------
L El E32 S24 ._ B15 N24 W32 S24 ! ! LAND TOTAL MARKET
c32 " ' -' ! PARCEL 27500 118500
*-----------32----------x AREA I
1J2000 65
VARIANCE -73 +17934
STANDARD 25
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February 16, 1998
David H Preston
P.O.Box 322•Centerville,MA 02632-0322•Telephone(508)778-0495
Dear Gloria Urenas,
In response to my current situation at 925 Pitcher's Way, Hyannis I
would like to submit the following.
First, I bought the property in 1988 with the understanding that it was
allowed to have three lodgers in a single family home. I have done nothing
to the property since I bought it from Edmund Flynn. Currently I have three
lodgers with no kitchens in lodging areas. As per our discussion on what a
kitchen might be considered;-I will remove any cabinets and or counter top
that might present a kitchen atmosphere.
Second, I am planning to renovate the property. At the end of the
renovations I will only have room for two lodgers instead of three, since our
immediate family require more room.
Third, as to the health violation that started the complaint, which was a
flea infestation. Before the lodger that occupied the infected unit, there was
a problem left by the last lodger. I took all proper measures to correct this.
After the new lodger moved in the problem reoccurred. The situation was
then corrected within two weeks. After the lodger left in December of 1997
the problem has not been repeated.
LastlyI would like to say that the health inspection b m knowledge
Y p Y Y 9
was never done. No appointment was made and I never met with an
inspector. I reside at this property and will cooperate in any way I can with
the town. If there are any further questions please call me at the above
phone number or mail any inquires to the above address.
Sincerely,
C
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Assessor's offioe (1st floor): o2 7,-)- / c�THE to
AsseAsor's map and lot number ............................................ Q� �♦
Board of Health (3rd floor):
Sewage Permit number � ......!.............�.�
Z BAW9TADLE,
Engineering Department (3rd floor): � U �o rasa
House number O t63q `00
............. 'EO YA d
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ............. D!y.. 1..../)..�!.. ./...............
TYPE OF CONSTRUCTION ............................(!.`::.......D.................��/�.!.:.!...................................................
.........._T......V.._�` ......0.-.......19......
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ,......... ..........���..................... ....�................. ... .........�.....................................................
Proposed Use ..................C (T ......�......................................................................................................................
........
Zoning District ........................ .....l..............................Fire District ..............�.��.���,�
....... ......................................
Name of Owner ........1.t..Cal'!tl✓ ...... v.........Address ..�./.. � !t!�, Vi/i /� ��b✓Z-
...... .................................
Name of Builder .....C�.........Address
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms �..... .........................................Foundation ........... / ..D�1/2 .�
Exterior .........(!1�!7/./ ......i r, ..Jf�I� l��Soofing .............eff� 1�/ ..................................
Floors ..................... �._. ,! i(.G- ........................Interior ✓1/
.....................................................................
g Plumbing .................../V Heating ....................................... ..............................................................
Fireplace /'� � �....................................Approximate Cost = � 0................................... .............................................................:.....
Definitive Plan Approved by Planning Board ____________________________19_______ . Area � �...41..r..�...n
Diagram of Lot and Building with Dimensions Fee Jv�
SUBJECT TO APPROVAL OF BOARD OF HEALTH
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ......... ........ .. ...........
4
Construction Supervisor's License ���/
FLYNN, EDMUND A=272-141
Ncr� ...2.9 96 Permit for .,.BUILD GARAGE
Single family Dwelling
.........................................................................
Location 925 Pitchers Way
..............................................................
Hyannis
...............................................................................
Owner Edmund Flynn
..................................................................
Type of Construction Frame '
...............................................................................
Plot ............................ Lot ...................:.............
Permit Granted October 2, 19 86
.......................... .
Date of Inspection ....................................19 r
Date Completed ......................................19
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Assessor's offioe (lnt floor): ; �k,y. 7�= � � t ��� US �STHE-F
Assessor's map_a d lot number .......... • COMUA��
Board of Health (3rd floor): _ W�TALLE 5 fO� lot
Sewage Permit. number ..... a.......:.....:.....!....:............ �� r vy1THTITLE i
AK
BaaasTnnte
Engineering Department.(3rd'floor): ��S a�L��lvl�®HMENTAL CODE '�0 NAM
.�
House number ......::.........................�.�.....- .......... . ......... I,psTl®�� a.
TOWN FIEGUO YP
APPLICATIONS PROCESSED 8:30-'9:30 A.M: and 1:00-2:00.P.M. onlyt '
` a _
-TOWN ;OF- B- STABLE '-STABLE
. . r 4
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ........4r.(/'!V., .!!..: "1......::....... „/.J.. ......................................
....
TYPE OF CONSTRUCTION ..........f............................
` .3. .... .............. ... ............................................
��. . ...----� 9 -
d
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following 'information:
Location ....................... r..............Pt�/ ..��1�� ...... :.. :�J: S...................
Proposed Use ( �
Zoning District / .........................Fire District �l..,� ':.!V! �5.....
... ... ... .......... ....... ..............
Name of Owner'.... .......Address ... �A•��.. ......
....
v ,
Name of Builder Address
Name- of. Architect ..............................Address ............ :.....
' % Lam- ' .� Ic�oeL� ...
Numberof Rooms ...............................................:..................Foundation ............. ........ .......;.
Exterior .......!/Ufl ....�/.. .6,4-- ... /!, 1/(TI�G 'Roa ng . ................ .. � 1��
Floors ..................... � ...::...................Interior ............t.........
/!!... ..............
I�
Heating
'. ........................�.�.!.(/�.......:..........................Plumbing ...................... �..................................................
Fireplace .........................W.CI ................... ..........Approximate Cost ................ — �.
.... ....................
Definitive Plan Approved by Planning Board --------------- c=J �! r 7`-
t 9------- • Area .... ................�...
,t Diagram of Lot and Building with Dimensions
Fee ..............!....................
SUBJECT TO APPROVAL OF BOARD OF HEALTH >
t
t OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
,I hereby agree to conform to all-the Rules and Regulations of the Town Iof Barnstable regarding the above
construction.
Name .... � J?d �.
�6 /_
se
Construction Supervisor's Licen ....... . . ..........
i -� �. - -
1
FLYNN, EDMUND
F
' 2096' ` BUILD GARAGE
R3'.� .............. . Permit, for ..................................... < -
f#W Single Family..Dwelling................
t Location'....,925 Pitchers Way
Hyannis... :..................:.....
^ Owner .......Edmund Flynn............ ........I..........
Type of:Construction Frame................. ...........
....................,I. ......................................
Plot .... . .........` Lot ......................
.� ;. Ir .... r ;; �• ter •t � � . ,, • x: -' .. - ,
October 2 86
Permit Granted ......... '....... 19 i
1 Date of Inspection ................ ... ' :19 r• , c ,
'Date Completed .........................: ..........19
ell
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-Assessor's map and lot number.... THE c
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Sewage Permit number ........................................................
y , 7• ^ , S IIA"STLBLE, i
,r^
House number ,,................ ...f ................. 1..: yoo�Mb a
3 9. \0�MAY a•
i TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ..... /1/II�� �1 ......... /!!/` .......................:..
TYPE OF CONSTRUCTION I/ /!'�,h!�..! ............... sal?T� ,.......................................
.................... !.....................19....`
TO THE INSPECTOR OF BUILDINGS:'
The undersigned hereby applies four as permit according, to the following information:
Location ................. .�. .�..ff.... ....`................ !! ... / !y......................:............
I`/ .�/- .... �r- �� �.. id '...............................Proposed Use .................
Zoning District fir� . � . ... .....................
Name of Owner ... %' 7 ?.,u ...................Address ................Z!5�':?5.....-.�-�. .✓.......... / r !1�1f„
Nameof Builder .........................:> .Gs%;,'•'-`C;;..................Address ....................................................................................
.Name of Architect .................... .................Address ....................................................................................
......
......................•
Number of Rooms ............... ..........4...................................Foundation � �1�fp�'(�
Exterior /E/ •/f// �1?� `� �1��1•%. ••..Roofing ......................a./..... �'/„r�/
V; < f - �.............. .
Floors A... J ........................Interior ........:...............
Heating .���-�-- /-�Ca' ........Plumbing .....................�... .............................
Fireplace ..:......................�...�... --.............................Approximate Cost ............ ... ............... ................................
.t-
Definitive Plan Approved by Planning Board ____________,%_________________19________. Area ... �,a .. .......r:.
Diagram of Lot and Building with Dimensions Fee ................ '........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
t �
/ 1
Name
-
C & F BUILDERSA=272-14,1
No :„23401. permit for One 1/2 Story
Single Family Dwelling
...............................................................................
LpLocation ... t #13 925 Pitchers Way.............................................................
kyannis
...............................................................................
Owner C & F Builders
...................................................
Type of Construction ..,,Frame
................................
................................................................................
Plot ............................ Lot ................................
Permit Granted ......August 21, 19 81
Date of Inspection 19
Date Completed ......................................19
PERMIT REFUSED
/......... 19
................................. ............................
........................... ...................................................
Cow ...,........�..:. -may.....................
Approved ................................................ 19
...............................................................................
...............................................................................
TOWN OF BARNSTABLE 2 � L
�.� Permit No. ___
Building Inspector - - ---
� Cash _ / •�
OCCUPANCY PERMIT Bond
No building nor structure shall be erected, and no land, building or structure shall be
used for a new, different, changed, or enlarged use without a Building Permit therefor
first having been obtained from the Building'Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
Issued to C & F IBuild�. r° Address Sox 37, . Ce.-Itexville
I-ot #13. . 925 Pinchers Way_ l'zyanni s
Wiring Inspector ,t� * Inspection date
Plumbing Inspector f Inspection date
Gas Inspector j ` Inspection date
Engineering Department,of +/+C F _ /s Gffs�•. Inspection date/,/—,2 -� f
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
................. ...... .., ....... f, .....Building�Inspeetor .._._......_.....___
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soes map and lot num . '�..
SEPTIC SYSTEM MUST BE yoF THE tOi�
Sewage Permit number .. ....:�....... INSTALLED IN COMPLIANC
a WITH TITLE 5 2 MUMBLE, S
House number ..'.:'.............. .. /••�►� ••• ENVIRONMENTAL CODE ��� "'tea
° �e •�
TOWN REGULATIONSyav a`_
TOWN OF ,-.BARNSTABLE -
BUILDING" INSPECTOR
APPLICATION FOR PERMIT TO ......G✓ /...�1�. /........... �(.�� 0. �'�...................:......
TYPE OF CONSTRUCTION ................. ..42.4D.............., ��JL�!
.. ............................................
.................... .. .... .. .....19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to
the following information:
Location .... ..o.�../..�. 7 :�1 .... , �............................. .... .............. ........................................................
Proposed Use t� ���
5....................
Zoning District .......Fire District...........1........................... ........ .� �.. .... . .........
Name of Owner .... fi .�� ..................Address "�
................. ..... . .•. ... .✓.............. ............... ...........
Nameof Builder ...................... ..................Address ....................................................................................
.Name of Architect ..................... . ............. .................Address ....................................................................................
Number of Rooms ........ ..........✓.................f.................Foundation ............ C�f�I ... &.......
Exierior ........... . Roofing .�s .��................ .. ...
Floors ...................el/..�! ....... .......................Interior .................................................... ..............................
Heating :............... .:..G�e ... ...Plumbing'.::....... < .. ..........::..:..........:.:...:...........
Fireplace ......................... ..(✓.�U�..............................Approximate Cost ............�z/ (/
..................................
Definitive Plan Approved by Planning Board ------------�r2?---------19 Area .`.�••• 40�
Diagram of Lot and Building with Dimensions Fee �-
SUBJECT TO APPROVAL OF BOARD OF HEALTH �/�
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ..... ....... . .. ... . .. ..... ..... .. .. . .....:✓. ,...
'
' )t
3401 One 1/2 Story
-----'' Permit,for -----^------' !
Single Family Dwelling �
-------------------.-------
Location uot #I3 925 Pitchers Wa�
---------------------. ^
- Hyannis '
--------'------------------
,
C & }� BoiIdezo '
Owner -----_--------------�—. �
� . .
' ' I'�anze '
Type-of Conmru'�ion --------------
,
'----_---------------------
Plot ---------. �t —'---------
^ '
' -
Permit G,onx,6 .....AUQ.0 5.t...2,]-........... P 81
. ^ '
. � .
Dohs of Inspection ....................................lg
/4 1:1v'
~ ^
. ' . .
. . .
REFUSED
�
—...----.. lV ^
.� /'..------------------.
--------------'
. `
----..—^----------'—'—^--''
nr �
� ^
--.�/------------.. l� ' ^
Approved
. `
-----------------~.----.---..
,
'
-------------------------^''
'
�
U' '
t 3rd floor Off,/ / D
P • ) Map P ���� Parcel ' /,- [f1 - Permit#� �
House _ Date Issued
Board bf Health(3rd floor)(8:15'--9:30/1:00-4:30) /��
963044.
ld a tMe
Ay,B
oard i9 C
' - BARNSTABLE.
MASS.
ED"''I
TOWN OF BARNSTABLE
t Building Permit Application
Project Street Address
ddress Q
Village �1 kto N L�GC + {
'
Owner b Ft V t D N ' �(Z E a- Address %`vk A E
Telephone 8) -7 g ®Lk Ct 5 f
Permit Request E woo%sk L. p F aAr9LA G E 'b oo iL A Icc r en i L y
First Floor CO square feet Second Floor 1 5 square feet
Construction Type
Estimated Project Cost $ 3 Ste•t�)O
Zoning District Flood Plain Water Protection
Lot Size • w 5 Rot-Qs Grandfathered ❑Yes ❑No
Dwelling Type: Single Family fs Two Family ❑ Multi-Family(#units)
Age of Existing Structure 13 4 RS, Historic House ❑Yes (�No On Old King's Highway ❑Yes LH/N o
Basement Type: M/Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 7 4,e G
Number of Baths: Full: Existing�_ New Half: Existing New
No.of Bedrooms: Existing New r
Total Room Count(not including baths): Existing_ New First Floor Room Count 4
Heat Type and Fuel: ❑Gas ❑Oil M lectric ❑Other
Central Air ❑Yes Tf No Fireplaces: Existing New Existing wood/coal stove ❑Yes Ud/No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
M/Attached(size) Co x ZL4 Ll Barn(size)
❑None Shed(size) 9C 8
❑Other(size)
Zoning Board of AppealVN
thorization El Appeal# Recorded❑
Commercial ❑Yes o If
,es site plan review# -
Y
Current Use -Proposed Use
Builder Information Q
X-Name (*1v �f> � ��,.7J Telephone Number -7 Z�! C7'q
Address �0 License#
l� y LL F Mk 02AD 'j`L 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 RE ULTING FROM THIS PROJECT WILL BE TAKEN TO
L
SIGNATURE DATE
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
'�
;T .: 4 � A,
�+ FOR OFFICIAL USE ONLY
PERMIT NO.
21
DATE ISSUED 4
MAP/PARCEL NO.
ADDRESS { VILL^AGE
OWNER
DATE OF INSPECTION:
FOUNDATION'
FRAME
INSULATION
FIREPLACE f '• +
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL, 6 i _ t• _ ,
GAS: ROUGH FINAL:
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
r
OFTHEry�_O `
The Town of Barnstah-le
'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.
i
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.
r
Type of Work: - lh Est. Cost 1
Address of Work:
Owner's Name
Date of Permit Application:
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
V Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date Contractor'Name Registration No.
OR
3�q"-(T.0
Date Owner's Name
Tile Currrrrru»11\Caltlr of fanarlwTellx
1 ��• ' • f�
Dt, artmarl o IJrdiarrral Acridemrs
• :y'11r1. -I �flfc9ZYIQYCSll�dllodS
;:�,,�::�+ �:► 611!J if irslriu�tun Srrcrr
Smarm.Afa= 92111
workers/ Compensation Insurance Affidavit
A6niic`tdt•matirin .� Plc•tsr itRI1VTTeriiiiv _
`)KV
In�tinn 2 e-vx e 7- IS W tef
�. Pc A'YJ A.) l S
1 am a homeowner performing all wort:myself.
❑ 1 am a soft proprietor and have no one working in any capacity
QI am an employer providing workers' compensation for my empiovees working on this job.
Cmm�•Inv onto;
+\ttlrccc• •
tin nfinne 0*
nniirw•d
inalrtnre cn - _ —
•❑ I ant a soft proprietor. general contractor.or homeowner(circle one)and have hired the cantractors listed beiow who r•
the following wori:ers' compensation polices•
m �nr name•
r Ilrt•cr
t nfinne t+•
inwtlnt+rr en nniirrf! _ i.__
fttfllR\• n!Imr• .
ritw nfinne 0-
ii tl
' evnn �•
Attach additionai sheer ifneeesiir• ��':•^..•• - .•• _�• . •• •." :�. _.�......_,., .:....:---•.•_.. ..�:..�
rail UW ia;;Lure'oycrace as regatretl under hecnon 3A of 111GL 1si can tend to ute imposition of cetratnat penalties of a tine nit toS1.500.Ua andre
one years'imprisonment as%well as civil penalties in the form of a SM?WORK ORDER and a fine ufSiSOUD a day aping tar u
in l adetsnad that
Coln•'If this statement mad be forwarded to the()Mce of lnwestications of the OlA for t:oyet:pe yerifieatioa.
1110 lure r and t nitrs a.d Pena ojperjnrr that the infonwrion prot ided above is true oad correct
Date
3-25-F
ic_.^.aturt:
Prim name
raMciat use unh• do not wriite in this area to be completed by city or too. ofilciai
dtv or town- pertoitilieense d r'tltuildlaq Department
• OLireasro�Board
(?Check if immediate response is required QSdectmen's OMCC F
. �tleattb Department
phone itt r'1Vther��
contact persnn•
information and Instructions
MassachuNem General Laws chapter 152 section '_5 requires all employers to provide workers' coilipellsatloil far
employees. As quoted firom the "lacy".an elnpinree is defined as every person in the service of another under ally
contract of hire. express or implied. oral or wrinen.
An emplrn•er is defined as an individual. partnership, association. corporation or other legal entity. or an}• two or ,r
the forcuoin__cnunued in a joint enterprise,and including the legal representatives of a deceased employer. or the
receiver or trustee of an individual . parttlerslhip. association or other legal entit}•. employing employees. Howe:cr
owner of a dwelling_ house haying not more than three apartments and who resides.tlherein. or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwc1lin__
or oil the__rounds or building appurtenant thereto shall not because of such employment be deemed to be an em .c-
MGL chapter 152 section 25 also states that every state or local licensing agency shall withiluld the issuance or-
reneival of a license or permit to operate a business or to construct buildings in the commonwealth for uny
applicant who leas not produced acceptable evidence of compliance�vitlh 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 tills cJlap:c:
been presented to the colltractille authority.
APlllica..ts
` Please fill in the :vorkers' compensation affidavit completely, by checking the boa that applies to your situa:iotl an:
supplying_ company names. address and phone numbers as all affidavits may be submitted to the Deparnncnt of
Industrial Accidents for cont of insurance coverage. Also be sure to sign and date the afGda�•it. TZIe
of" -wit should be returned to the city or town that the application for the permit or license is being requested.
nuc a Department of Industrial Accidents. Should you have any questions regarding the "law"or if.you are
to e--ain a workers' compensation polic}•• please call the Department at the number listed below.
City or Towns
Piewse be sure that the aff7dayit is complete and printed legibly. T1he Department has provided a space at:he bottom.
the affidati•it for you to fill out in the event the Office of Investigations has to contact you regarding 'Ire cpplicant. P'.
be sure to f::i in the permit/iicense number which will be used as a reference number. T1he affidavits may be rett:rne=
the Department by mail or FAX unless other arrangements have been made.
Tile Office of Irlyestiantiolls would like to thank ou in advance for you cooperation and should you havean.•questi:
:ease do not hesitate to give us a c:.11.
:. .. -... .. .Wit'•
•The Department's address. teiepihone and fax number.
TIhe Commonwealth Of Massachusetts
Department of Industrial Accidents .•.
r�x
Office of Investigations
600 NVasihington Street
Boston,Ma. 02111
fax ": (617) 7 Z7-7749
MCMR Appends:i
Table J32Jb(couthm l)
pmaiptive Paekaga for One and Two-Family Residential fluddingi Heated with Fad Fuels
MAXIMUM MINIMUM
Glazing Glazing Ceiling Wall Floor Batemeat Slab Heating/Cooling
Am'(%) U.values R value' R•value' R valmmm;� Wall Paimaa Equipment EffldencY'
IP=kap R value` R value'
5701 to 6500 Heating Degree Days'
Q 12% 0.40 38 13 19 10 6 Normal
R —ANormal
S 12% 0.50 38 13 19 10 6 85 AFUE
T 15% 0.36 38 13 25 WA N/A Normal
U 159A 0.46 38 19 19 10 6 Normal
V 136/0 0.44 1 38 13 25 N/A N/A 85 AFUE
W 13% 0.52 30 19 19 10 6 85 AFUE
X 18% 032 38 13 25 WA WA Normal
Y I BOA 0.42 38 19 2S WA WA Normal
Z 12% 0.42 38 13 1 19 10 6 90 AFUE
AA 18% 0.50 1 30 19 1 19--T 10 6 90 AFUE
1. ADDRESS OF PROPERTY: 9 2
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS.
3. SQUARE FOOTAGE OF ALL GLAZING:
4. %GLAZING AREA(#3 DIVIDED BY#2): O so
5. SELECT PACKAGE(Q—AA-see chart above):
NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL:
YES: NO:
00mms4980303a
780 CMR Appendix J
I
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Footnotes to Table J5.2.1b:
Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors,`skylights, and
basement windows if located in walls Shat enclose conditioned space, but excluding opaque doors)to the gross wall
area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area.
z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for
whole units:center-of-glass U-values cannot be used. I
' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full
insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38
insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity
insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between
the conditioned space and the ventilated portion of the roof.
•Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include
exterior siding, structural sheathing,and interior drywall. For example, an R-19 requirement could be met EITHER
by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to
wood-flame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction.
The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements,
or garages).Floors over outside air must meet the ceiling requirements. ''
The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must
meet the same R-value,requirement as above-grade walls. Windows and sliding glass doors of conditioned
basements must be included with the other glazing. Basement doors must meet the door U-value requirement
described in Note b.
'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs.
' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more
than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest
efficiency must meet or exceed the efficiency required by the selected package.
'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a
NOTES: '
a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels.
R-value requirements are for insulation only and do not include structural components.
b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested
and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value
in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
glass area of the door with your windows and use the opaque door U-value to determine compliance of the door.
One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35).
c) If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with
different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors).
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