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HomeMy WebLinkAbout0720 PITCHER'S WAY / � � �� � �� �, • 1 w „h �vl^ � �\ ��\ O ' I i - - . � � �f �� E �' � � ,�� ..a �+ ��i' ^� �� �. .I NI mop, ` � \ . — - - -- ---- - P ) . \ �± � . � � f#\ J �do .22 \ . .� � f � ( 'r r� t ' � o Town of Barnstable Building A !Post This Card So That it is Visible From the Street-Approved Plans Must'be Retained on Job and this Card Must be Kept MARK iPosted Until Final Inspection Has,Been Made. n1 1�er1t m Where a Certificate of Occupancy`is Required,such Building shall Not be Occupied until a Final Inspection has been made Permit No. B-19-807 Applicant Name: Marc Schaefer Approvals Date Issued: 04/01/2019 - Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/01/2019 Foundation: Location: 720 COMMON AREA PITCHER'S WAY, HYANNIS . w Map/Lot. 271-041-OOA Zoning District: Sheathing: Owner on Record: Patricia Lake Contractor Name: Marc Schaefer Framing: 1 Address: 720 PITCHER"S WAY-COMMON Contractor License: ,169163 2 t HYANNIS, MA 02601 Est. Project Cost: $ 142,000.00 Chimney: Description: Remove and replace all siding,windows and doors at Building D. Permit Fee: $ 160.00 i Insulation: Fee Paid,' $ 160.00 Project Review Req: NO STRUCTURAL WORK. i Date: `> 4/1/2019 Final: , Plumbing/Gas Rough Plumbing: §Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for,public inspection for the entire duration of the Final Gas: work until the completion of the same. ' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials areprovided on thispermit. Minimum of Five Call Inspections Required for All Construction Work: t' Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 6ad Town of Barnstable Regulatory Services BAMSrABLE, MA Thomas F. Geiler,Director reo ' Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 March 13, 2012 To Whom It May Concern: This letter is in regards to Building I Unit 4F at the Sea Meadow Village Condominium r 9 located at 720-Pitcher_'s--W_ay--in-Hyannis. On March 12, 2012, we received a report prepared by Michele Cudilo P.E. regarding structural changes that appear to have taken place according to the cover letter. This Department has no record of a Building Permit issued to authorize this project. Please rectify this matter immediately. :Respectfully rnas Perry, CBO Building Commissioner Cc: Lys Terkelsen, Manager Sandee Perry, BHA Paul Carlson, Chairman , Michele Cudilo, P.E. I , 03/12/2012 09:49 FAX 5088277061 SEA-MEADOW VILLAGE CONDO Z00 1/005 TOWN 4F BA N TAB E V i_l�;p 13 A 9: 59 SEA MEADOW VILLAGE' - "` CONDOMINIUM ASSOCIATION 720 Pitchers Way Hyannis MA 02601 FAXFAXFAXFAX FAX FAX FAX FAX FAX FAX TO: BHA ATT: Sandee Perry FROM: Lys Terkelsen DATE: March 12,2012 RE: Bldg F- Unit 41F Fax: (508) 778-9312 Enclosed drawings for repair done into Bldg F(structure). Michele Cudilo, the engineer we hired, proposed the changes. The project was finished and inspected by her on March 9, 2012.. If you have any questions, please feel free to contact Paul Carlson or Ms Cudilo. Lys Terkelen Manager Paul Carlson, Chairman (508) (862)-2329 Lys Terkelsen Resident Manager (508)771-2063 fax(508)827-7061 lysiet 17(acomcast.net 03 12/2012 09:51 FAX 5008277061 SEA-MEADOW VILLAGE CONDO 16001/005 SEA MEADOW VILLAGE CONDOMINIUM ASSOCIATION 720 Pitchers Way Hyannis MA 02601 FAXFAXFAXFAX FAX FAX FAX FAX FAX FAX TO: BHA ATT: Sandee Perry FROM: Lys Terkelsen u MICHELE CUDILO, P.E. Consulting Structural Engineer 123 Cottonwood Lane•Centerville,Massachusetts 02632-1979•(508) 771-7601 • Fax(508) 771-7163 mcudilo@comcast.net Sea Meadow Village DATE: February 15. 2012 720 Pitchers Way Hyannis, MA 02601 Attention: Ms. Lys Terkelsen Manager , RE: STRUCTURAL REPAIRS to Condominium Unit 41F SEA MEADOW VILLAGE 720 PITCHERS WAY,HYANNIS,MA Dear Ms.Terkelsen, At your prior request, I went to the above captioned project on January 31 and February 16,2012. for the purpose of addressing the structural integrity of the labove Residential condominium structure, in particular as related to observed I"floor sags and wall intersecTion ceiling drywall cracks,during current renovation work. The purpose of this report is to list the structural issues of concern with regard to the observed conditions. Other issues are not covered herein. Hidden conditions remain the responsibility of original parties. Background The site is located on a relatively flat lotin a residential inland neighborhood. It is understood that the building was constructed around 1988 as a two story wood framed condominium residence over a partially crawl and full unfinished basement. The 1984 building construction plans by`Winslow Design Associates,Cambridge, MA and C/BI Chaloff! Barnes Inc. (structural engineers), Boston, MA were available at the time of our review. We observed the existing main footprint foundation carrying a two-story with attic and stick-framed compound gable-roof building,all wood frame construction on poured concrete full and crawl space foundation. Foundation and IS`Floor Framing The First floor framing requires reinforcement with a continuous bearing wall constructed with properly fastened connections as shown on SK=1;to assure;continuous support. Attempting to jack the area to level is recommended. Note that the number of deviations from the construction plans is sufficient to warrant the supplemental support of these continuous foundation supports. There are two sides of the foundation as shown on SK-2,unfinished foundation and crawl space. The area to be underpinned is in the crawl space. Continued a STRUCTURAL REPAIRS to Condominium Unit 41F SEA MEADOW VILLAGE 720 PITCHERS WAY,HYANNIS,MA Page 2 We discussed the following items: 1. There are wall to ceiling cracks in the architectural finish(drywall)at either the first and/or second floor. 2. The floors are somewhat out of level,as discussed due to inadequate framing of the 1"floor span. Conclusions and Recommendations The above information provides you with the minimum requirements for maintenance of the structural integrity of the above captioned residential structure,namely reinforcement of the existing wood fram inc,and foundation support below walls above. I trust the contents of this report meet your needs at this time. Should you have any questions, please call. Sincerely, i Michele Cudilo, P.E. /2012-13 sy��A OF M4s�, 0 HIICHELE \G� 0 No.34774 1•''n` ' U 1 STRUCTURiAt. RFG:S'TE�/�� "c�iC3NAL 03/09/2012 12:09 Michele Cudilo, PE NO.846 02 UN 41 , O O �0— I p o 0 ►Jo I i 4l fvLlll- o _ a OF MICFIELE CUOILO No.34774 y $TMCTUAAL t PROPOSED REPAIRS MICHELE CUDILO, P.E. SEA MEADOW VILLAGE cartsuwood Structural Erlgineer 123 Cottonwood Lane, Centervilfs, MoasocAuaetta 02832 Drown B : MC Date: 2/13/12 D r awi n g 720 PITCHERS WAY sale: 'As Nbr Ray. 0 ; . HTANNIS, MA S K— 2 File Name:SEAMEADOW Project No.:2012-13 03/09/2012 12:09 Michele Cudilo, PE N0.846 01 7 Z At, �i ,IA-Me-I��` I A -fo>✓r-�rLefl '� N I ri?�tA OF MICMEL CUDILD No.34714 STRUCTURAL • � AFfi:STfi�` Zyc l.2 pw+lbr�lc� Gv'Its- - ks-8c/l �-T 3�R11 a. PROPOSED REPAIRS MICHELE CUDILO, P.E. Consulting• Structural Engineer SEA MEADOW VILLAGE 123 Cottonwood Lone, Centerville, Maeeachusetts 02632 Drawn By: MC Date: 2/13/12 Drawing 720 PITCHERS WAY state: >z As o Rev. 0 S — 1 HYANNIS, MA Fite Name:SEJIMEADOW Project No.:2012-13 Town of Barnstable Building Department MUST COMPLY WITH HOME OCCUP J �� Brian Florence CBO ' 'ULES AND REGULATIONS. FAILURE TOOK Building Commissioner COMPLY MAY RESULT IN FINES. 200 Main Street,.Hyannis, MA 02601 www.to wa.b arns tab l e.ma.as Pre-application for Business Certificate Date / Map a9_1_L Parcel OLI l -66 Applicant Information Applicants Name �<l Applicants Address - G - ✓f�� � v !>r Email Address ;S — ��/d d0 Telephone Number Listed ❑ Unliste Business Information New Business? Y No ---------------------------------------- Business is a registered corporation? ________________________. Yes If yes Name of Corporation Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? _________ Yes No If yes then a Home Occupation Registration is required—1 See Building Division Staff Name of Business Business Address wA, /101J `I'll 62-6 o Type of Business �L Building Commissioner Office Use Only Conditi ` l W 61 C 2_ r1 Building Commissioner Date Clerk Office Use Only _ Town of Barnstable Building Department �pF SHE Tp� o Brian Florence,CB0 Building Commissioner IARNSTASLE, + 200 Main Street,Hyannis,MA 02601 MASS. 1639 �0 www.town.barnstable.ma.us ,oTED pM'�A Office: 508-862-4038 Fax' 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: N. Phone Address: d &Jlage: Name of Business: Type of Business: 1 Map/Lot: c2f J V INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within,single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other.than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • . There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. The use does not involve the production of offensive noise,vibration,smoke,dust or other.particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities: - • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment.. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • , No sign,shall be.displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling upit. 1,the undersigned,h' read and ee th t a s 'ctions for y home occupation I am registering. Applicant: Homeoi.doc Rev, 10/17 MUST COMPLY WITH HOME OCCUPATION RULES AND REGULATIONS. FAILURE TO COMPI.Y MAY RESULT IN FINES. V i J l i. I Town of Barnstable Certificate of Zoning Compliance Certificate 2018-63 Record Owner: Map 271 Parcel 041-OAB Jeffrey L Pimental & Jodi Ann Audet Address 720 Pitcher's Way 728 Pitcher's Way—Unit 28 Village Hyannis Hyannis, MA 02601 Zone RB Residential- Single family Overlay WP Water Protection Year Constructed— 1988 Property Use: Single Family/Condo Complex Lot Size 0.00 Setbacks: Cert of Occupancy Issued: Yes Front Yard 20 Side Yard 10 Date April 15, 1988 Permit#30535 Rear Yard 10 Open Permits: None Permits: Building Permit#5664 Building C—Unit 28/ Condo Gas Permit Building C—Unit 28 Gas fired furnace G-2010-00463 2/22/2010 Code Violations: Zoning Code None Building Code None Zoning Violations: NONE Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 12/11/2018 TOWN N OF BARNSTABLE BUILDING DIVIS13a� r , 200 MAIN Sr'° n�9au I Town of Barnstable Certificate of Zoning Compliance Certificate 2018-63 Record Owner: Map 271 Parcel 041-OAB Jeffrey L Pimental & Jodi Ann Audet Address 720 Pitcher's Way 728 Pitcher's Way—Unit 28 Village Hyannis Hyannis, MA 02601 Zone RB Residential- Single family Overlay WP Water Protection Year Constructed— 1988 Property Use: Single Family/Condo Complex Lot Size 0.00 Setbacks: Cert of Occupancy Issued: Yes Front Yard 20 Side Yard 10 Date April 15, 1988 Permit#30535 Rear Yard 10 Open Permits: None Permits: Building Permit#5664 Building C—Unit 28/ Condo Gas Permit Building C—Unit 28 Gas fired furnace G-2010-00463 2/22/2010 Code Violations: Zoning Code None Building Code None Zoning Violations: NONE Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 12/11/2018 TOWN OF BARNSTABLE BUILDING DIVISION' . 200 MAiN ,�'-),,..s nl' a PEMCO LIMITED 31226 DATE INVOICE NO COMMENT AMOUNT DISCOUNT NET AMOUNTti 12/3/2018 1699997519 720 Pitchers Wav Unit C28 75.00 0.00 75.00;: Check: 031226 12/3/2018 Town of Barnstable r 75.00 I PEMCO L I M I T E D PEMCO-Limited 4600 South Ulster Street, Suite 530 Denver, CO 80237 —� 11/29/18 0. p Z. I 'n RE: Code Violations Search Town of Barnstable Attn: Robin Anderson N 200 Main St 0' a es� Hyannis, MA 02601 Dear Code Enforcement Pemco-limited represents Fannie Mae,the owner of record of the property located at: Property Address:720 PITCHERS WAY UNIT C28 We would like to request copies of the following: 1) Copies of open code violations and summons (if applicable) attached to the property. 2) If there are open invoices pertaining to the code violation or past due lien, please send copies along with the fee breakdown. Thank you for your time! Barbara Haynes Property Specialist Direct: (720) 509-3249 Fax: (303) 284-8026 Barbara.Haynes@PEMCO-Limited.com PEMCO-Limited,4600 S.ULSTER ST,STE 530,DENVER,CO 80237 Town of Barnstable Building BARNSTABM Post This Card So That it i5 Visible From the Street-Approved Plans Must-be Retained on.Job and-this Card Must be Kept Posted Until Final InspectionHas Been Made. .� Permit 1 111 1 a Where a-Certificate`of.Occupancyis Required;such Building shall Not be Occupied until a Final Inspection has been made Permit No. B-18-4049 Applicant Name: Marc Schaefer Approvals Date Issued: 12/12/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 06/12/2019 Foundation: Location: 720 COMMON PITCHER"S WAY,HYANNIS Map/Lot. 271-041700A Zoning District: Sheathing: Owner on Record: Sea Meadows Village Condominium Trust w Contractor Name:'-,Marc Schaefer Framing: 1 i Address: 720 PITCHER"S WAY-COMMON Contractor: License: "169163 2 HYANNIS, MA 02601 €,,,_ Est'-Project Cost: $90,000.00 Chimney: I Description: Replace and replace windows at Building C. Permit Fee: $160.00 Insulation: Fee Paid: $ 160.00 Project Review Req: WINDOW REPLACEMENT IN EXISTING OPENINGS 'it r Final: Date: 12/12/2018 Plumbing/Gas Rough Plumbing: �. �• s,Buildina Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorised by this permit is commenced within six monthsafter'issuance. Rough Gas: All work authorized by this permit shall conform to the approved applicationand the`:approved construction documents for-which'thi•s permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-liwskand codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. -•#, Electrical The Certificate of Occupancy will not be issued until all applicable signatures,by the Building and Fire Officials are provided on th�is'permit. Service: Minimum of Five Call Inspections Required for All Construction Work:l ` 1.Foundation or footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0 wi.�,-'E 15MAXL- SCE l REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3)or already foreclosed for which possession has been taken(section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law,please state the reason(s)and complete section 1 (property information)and the first paragraph of section 2(foreclosing party,court, etc. and foreclosing party representative,but not other representatives and attorney) so that the Town can review the exemption and update its records: Section 1 —Property Information Property Address:720 PITCHERS WAY UNIT C28. HYANNIS, MA 02601 Assessors Map#: 271-041-OAB Parcel#: 271-041-OAB Land area and description Condo Building(s)description and contents Vacant Occupied: Occupant(s)(if borrowers so state and include name(s)) Phone: email: other: Vacant: X Date: 11/15/2018 Anticipated Length of Vacancy: Unknown Last occupant(s))(if borrowers so state and include name(s)) Unknown E O Phone: email: other: Has possession been taken Yes If so,please explain and complete an a the o maintenance and security plan form(unless exempt as stated above) See attac d a a.. z av_ Section 2—Foreclosing Paqy Information Foreclosing Party(full name/title) Foreclosure Case Court: Docket# DPP l�� A ur Date filed: Current Status: Complete Foreclosing Party's:representative(s) for property (entry,management,repair,, etc.)(name,title.): W Company(if different from foreclosing party): Address: _ Phone: email: other: If an exemption.is claimed,, please do not complete the remainder. Other representative(s)(if foregoing representative is primarily responsible for property and/or foreclosure and .is most.likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information(i. e. `'none" or"see above")). Name,title, other: TaNisha Tankard, REO Compliance.Specialist Company if different from for closing Federal National Mortgage Association(Fannie Mae) P y ( g: Address: c/o PEMCO Ltd, 4600 S Ulster St; Ste 530, Denver, CO 80237 720-509-3246 tanMa.tankard@pemco-limited.corn Fax:303-284-8026` Phone(s): email(s): _ other: Name,title,other: Company(if different from.foreclosing party): Address: Phone: email: other: Attorney representing foreclosing party Firm name(if different from a.ttorney's name) Address: Phone(s): emaii(s): other: I acknowledge that the information provided,is accurate and correct. I also understand that any.inaccurate information.will result in non-compliance with section 224 3,of chapterp of the Code of the Tow f-Barnstable. ' Date.. ...W _ ariie: a ishaTankard ... Title: REO Compliance Specialist PEMCO L I M I T E D Vacant Ongoing Maintenance Plan My name is TaNisha Tankard and I am registering this property as vacant or in default with your municipality. This property 720 PITCHERS WAY UNIT C28 is a post foreclosure REO property owned by Fannie Mae (Federal National Mortgage Association.) The property is currently vacant due to foreclosure and is either listed or will be listed for sale. The property will be inspected weekly by the local listing agent and every two weeks regular maintenance items will be performed by our local field services contractor. If the agent notices any issues during the weekly inspection,field services will be contacted to go out and address these issues in a timely manner. All properties are to be winterized and have active utilities. Fannie Mae has blanket coverage insurance on all properties. We have no timeline for the duration of vacancy. Please contact me directly for any assistance including notification of code violations and warnings issued on the property. Fannie Mae has many local contacts for different issues as the arise. Property Address: 720 PITCHERS WAY UNIT C28. HYANNIS, MA 02601 Parcel—Block/Lot: 271-041-OAB Date of Vacancy: 11/15/2018 Date of Foreclosure: 10/05/2018 You may contact me directly. Phone: 720-509-3246 Fax: 303-284-8026 E-Mail: TaNisha.Tankard@PEMCO-Limited.com ThaaJn�k"you, TaNisha Tankard 4600 S Ulster St Ste 530,Denver,CO 80237 Anderson, Robin From: Gallant, Therese <gallantt@barnstablepolice.com> Sent: Friday, December 07, 2018 9:24 AM To: Anderson, Robin Subject: 120 Suomi Road FYI, patrol has been out to this house on three occasions. There is one registered motor vehicle and one vehicle covered by a tarp. No other vehicles have been observed there to substantiate the complaint. Therese M. Gallant Barnstable Police Department Consumer Affairs Officer Office: 508-862-4667 Confidentiality Notice I This email message,including any attachments,is for the sole use of the intended recipient(s)and may contain confidential, proprietary, legally privileged and/or CORI information.Any unauthorized review,use,disclosure or distribution is prohibited. If you are not the intended recipient or have received this email in error,immediately contact the sender by reply a-mail and destroy all copies of the original message.This email message may be monitored by the Barnstable Police Department. 1 Date: Oct. 4, 2018 To: Building File RE: Work without Permit/Windows Address: 98 Chase St, Hyannis Originator: Laura Wentzel cape33@verizon.net Complaint: Work without permits/installing windows. Enforcement Process Steps ® 1. Initiate local investigation: RA ® 2. Document/enter into system Yes 13 3. Contact ® 4. Property Owner Homeless Not Helpless, Inc 5. Seek access to subject property 6. Seek administrative warrant (if necessary) NA 7. Notify state authorities of findings NA 8. Document conclusion OPEN ® 9. Referred Bldg/Bob Property—307-134 Property is developed with a 2 story dwelling (1915)containing 4 bedrooms and 1 Y: baths on 0.2 acres located in the RB zoning district. 10/04/2018 Email inquiry received concerning work without a permit. Confirmed that there is no permit pending or issued. Dispatched Bob immediately. YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.&L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1 FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) } DATE: Fill in please: APPLICANT'S YOUR NAME/S: k ' x s` x " BUSI ES r YOUR HOME ADDRESS: f e� 0 TELEPHONE # Home Telephone Numbers 7 F•� d 5,11 NAME OF CORPORATION: n NAME OF NEW BUSINESS - TYPE OF BUSINESS nfcn�9 IS THIS A HOME OCCUPATION? _e ES NO 0 ADDRESS OF BUSINESS _ MAP/PARCEL NUMBER `'C Iv � C_2�(Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street] to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S C This individual has ed f a y permit requirements that pertain tot ' of business. E COMPLY WITH HOME OCCUP Autho ized Signature** RULES AND REGULATIONS. FAILURE TO N COMMENTS: COMPLY MAV PXSi ,. 2. BOARD OF HEALTH This individual as)beninorrn d of he per irequirements that pertain to this type of business. `A thorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has, een infor ed of the licensing requirements that pertain to this type of business. Authoriz d Signature* COMMENTS: Town of Barnstable Regulatory Services o Thomas F.Geiler,Director Building Division n�xxsrAar.E. v iMA_qs �g Tom Perry,Building Commissioner �'DrEp 5.9- no Main Street, Hyannis,MA 02601 Office: 509-862-4039 Fax: 508-790-6230 Approved: Fee: Permit#: �/ Z HOME OCCUPATION REGISTRATION Date: I iD Name: Phone# �, Address: r l �✓ — Villager c /� Name of Business: Type of Business: /G Map/Lot: IlN'I E1�F: It is the intent of this sectio 4o allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the- premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does trot involve the production of offensive noise,vibration,smoke,dust or other particular matter,' odors,electrical disturbance,heat,glare,humidity or other objectionable effects. There is no-storage-or use of toxic-or-hazardous materials, or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be me'Lbn the same lot containing the Customary Home Occupation,,and not within the required front yard. • There is no exterior storage or display of materials or equipment • .There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pickup-truek—not-to•exceed•one torr:capacity,and one trailer not to exceed 20 feet in length and-not to — ex=d 4 tires,parked.on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit . I,the undersigned, ve read and a ee with the ove restrictions for my home occupation I am registering. 451 Applicant,' Date: Jul 09 09 12: 40p Michael Bedard 1 -401 -246-2868 p. 2 f, ; 07-09-'09 13,12 FROM-THD PRODUCTION 5087569009 T-963 P001/001 F-997 Sea Meadow Village Condominium Assodafion 710 Pitchers Way ,l(mmis MA 02601 June 24, 2009 Home Depot . Attn_ Laor+e Dow By fax sw 6 Re: Janet Hastings,720 Pitchers Way, Unit A-9.Hyannis.NU To Whom It May Concern: You are hereby given permission to ir: W1 new windows and slider door for Unit Owner Janet Hastings. She will be directly responsible for payment to Home Depot fbr this. Sincerely, Deborah Zielins i TrusteeBoa6d of Directors Sea Meadowtondominium Association . f ;.S;tl, 13oard of Building Regulations and tandards } HOME IMPROVEMENT CONTRACTOR Registration: 153140 Expiration: 0/31/2010 Tr# 278191 Type: DBA NU-VISION INSTALLATIONS STEPHEN RESTAINO 32 OVAL DRIVE milt— µcQ� WEST YARMOUTH, MA 02673 Adminish•ator License or registration valid for individul use only before the expiration date. If found return to: Board of P.;uilding Regulations and Standards One Ashburton Place Rm 1301 ! Boston, iota.02108 Not valid without signature It, aa Licenser CS &L 99560 : f , , Restricted to:. WS £= � �h<,F� x, � m iog STEPHEN RESTAINO 32 OVAL DRIVE WEST YARMOUTH, MA`02673 �- . - - �� -'� expiration: 1 /22/2012 T ram; 99560 � Y�-ll41�ioK The Commonwealth of Massachusetts Department of Industrial Accidents Of,ce of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A Ucant Informadon Please Print Ledbiv UT Name(Business/OrpnizatiorOndividual): S e5 i 0�9'© Address: VAl- Z6 City/State/Zip: �' 'yu� M ®�Phone Are you an employer?Check the appropriate box: Type of project(required): 1.El am a employer with 4. ❑ 1 am a general contractor and I employees(full and/or part-tip). • have hired the sub-contractors 6. ❑New construction 2. JI am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity. employees and have workers' insurance.t 9• ❑Building addition co [No workers'comp. insurance mP• required.] 5. Q We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL insurance required.]t c. 152,§1(4),and we have no 12.❑Roof repairs employees.[No workers' 13Other �Gk� comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy inforffation. t Homeowners who subntit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached m additional sheet showing the name of the sub-contractors and smile whether or not those entities have employees. If the subcontractors 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 fob site information. Insurance Company Name: Policy q or Self-ins. Lic.M Expiration Date: Job Site Address: (�® [ (`I�-`L'L7 l yU-c( �c� A- / CirygvaW4�t_sr/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy numbe and expiration date)°a`� Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a tine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify-surd r the pains and penalties of perjmry that the information provided above is tsar and correct l � Si curer �� �S Da _ Phone F only. Do not write in t area,to a comp eted y ciyor town ofJ7claln: Permit/License N hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employees 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 apartmentsmaintenance,and onstruction or.repair work on suchwho resides therein,or the occupant dwelling.house dwelling house of another who employs persons or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the Issuance or, renewal of a license or permit to operate a business or to construct buildings In the commonwealth for any applicant who has not produced acceptable evidence of compliance with the Insurance coverage required." Additionally,MGL chapter 152,§25C( )states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicant Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other then 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 Accident. 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 annopriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your,cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Of tce of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-7274900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 11-224)6 www.mass.gov/dia HOME SERVICES June 12, 2009 200 Main Street Hyannis, MA. 02501 The following is a list of approved installers for The Home Depot: R+R,Delivery Service Timothy Thomas CS # 51899 HIC # 152121 Nu-Vision Installations ---� Stephen Restaino CS # 99560 HIC # 153140 Casablanca Ericsson Torres CS # 100546 HIC # 147289 Michael Viola CS # 99403 HIC # 140993 Robert Reposa CS # 60526 HIC # 147080 J+J Remolding Joseph Duarte CS # 70077 H1C # 132349 Bradley Paddock CS # 48086 HIC # 121967 Soundview Construction Wayne Keith CS # 94607 HIC # 157610 Timothy Hanscom CS # 99162 HIC # 149128 THD At-Home Services,Inc. 345 A Greenwood Street•Worcester,MA 01067 508-756-6686•Fax 508-756-8823•Toll Free 800-657-5182 r If you have any questions please contact Mike Bedard our permit coordinator at 508-962-6942 or myself at 617-438-9017. Sincerely, ussell J nstone Install 'on Manager New gland Region JUN-12-2009 13:06 HOME DEPOT HYANNIS P.001 . HOME IMPROVEMENT CONTRACT "PL.EAWREAD•TIHS Sold.t1t mj*cd=d1nsPalled by: :nW ArH omelS , e,Inc' Wjancb Name:.}�n The Iomc_7eporAt-£otne,Servicesa ' n r Branch Numbe 45A•Gieenwood Street,:Zinit:2,.Wox cescer>M!�•01607 a?P :rxe4 _ ax 5p8 6- 823 __.. []North'33: >outlr31 _ Fedeis(IIl,#75-269t14G0;ME L6a#C 024 TtI G�ntT icu id427. CI Lie#565522'MA Homo Imp cmefit Contiactoirlt- e&#Z26893 Installation Address: _ Stfic _ .. ehaw�(�: 1 Work Phone $oinePhooc G:II Phone: a t-E ak -Home Address:_i... State Zip : (IE different rom Imti dilation Address). Cm E-maii kildress=(to r xelve project inmimications and FThct.•`Lome updates): Ej I'DO NOT wish t!i Temve'any noarketing'CntMls'from The Home Depot �, Proicct Tiifdrmatio�:"Undessisn'ed'("Customer•'},�e-owners of the property located ai the`abovb installiitioa addreI sire es to and etl)At-Home;ccvicesr Inc ("The Home Depot' abgrees�to•f>mzish':devverand ivrange for'tlie'insmllatioa'(;instxUation")of . all matcriah:desrnb d on the:below:and.on the referenc0-5pce.Sheet(s),•.al of-.whioh arc:incorporated.into this;Contract-by.this reference,along.wid any gPPiicableStete.Supplement.aad:Payment.Summary.attacbed heretoaad:any Cbange`,Oicters(collectively, "Contrncf); . ' lob# ;Naee.iiier �' Profluefs: s Shetit Amount oofing Siding.. Windows insulafion �, If e QGaite�f Cgvers• nay.00rs ❑ 69SnS Siding- :Wwdotv3:. 'lnstilxtion $ 6' - j .QGuttets/Covers D< rY Doors:0 - . pig Siding Windows: insulation: : `1,3r, i -t Covers.0ttiti'y Doors - :.� RoofiP6 Siding Wutdows.. .htsulatiou $ pexutteis`rCo�ers OEnuy ooT$.a` Wwliauyri25%D41iskofCunttnctAmountdueaponcxcentionOf ta.eontra&.:'. 'Total ContractAmouitt S Maine pure rs nay not depoidt more than one-third of the Contract Amount• Customer agrees,rh iy itniricdiatety;upon coaiplgtion.of t}xe work.for eachkroduct'CustomcC-wi .ezccute.:a:Completion Ceitifionte (orie:for each,Pxach ct as defined by an A divfduW Spec:Sheet)and.paf''any balance due-,As-aPAliet►ble,each Customer under this Contmet agrees to 1 loiaW.;xd severally obligated and liable hereunder .:. .' s>ry:rztdivsdaili'roduct{s)Imclude�herein,•at The Ilbme Depot rl siWcs.:. te.tighoto issue a Changv Order-or7ematnate this Congact ar its discretion,if Tbi Home Dcpot or its anthor•'ved<service;provtder detetntines that'>�. pcdorm,its obligations dnc to a.sbuctutal problem with.the h rate,envizonwental harazds such,as mold,asbestos or lead-".other safety,concerns,.pnciag,errors or because work required o ec nplcte the job was notncluded in the Contract. s ;- Pa a tSuinmsl Tlte`Payment:Srunmary ts- d ; ,•included awparto£this Cortttslct;'rels.forth.the total � uired'fortlfedepositsand•finalpaymenisbyPWuct'(asapplica ble). ContracEamount=ar dpaymentsTcq ;.. .;..., �• .. . . . - " NOTICE TO CUSTOMER .,I ....�...;.. Yon are entitled tw•a completely EClled-in'copy o'£ihe-Cotit•Eaix at the timc,you sign:.Do.00t sipni sr omplctitin CerRfrcate:(note: there is one.Coral letion Certificate for each listed Product ii 'dcrwed'by:individuai SperSheci4)before•work on that Product is complete. Depot the costs.of materialls,tabor,expenses the.event of tel mination of this Contract,Customer agrees.to pay The home and services prof ided by Tbe.,llome Depot.or Authorized Service Provider through the dam of termination,plus any other amounts set.foldla this Asrecment or allowed under applicab TIIEIt PAYMENTS MADE, WITHOUT le taw. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO'TH) HOME DEPOT FROM THE DEPOSIT'PAYMENT OR O LIMITING THE!HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF'SUCH AMOUNTS. Acce tanee and ,uthorns+tion: Customer agrees and,uDdeistands that this Agreement is the entire agreement;between Customer and The e tome DK tot with regard to the Products and Installation services and supersede all prior discussions and agreements,either oral or-written,re)rting to said Products and Installation.This;Ag ent cannot be assigned or amendLd except'by a writing signed oral tstomeeand''he Home Depot.Ct stn d actrnowiedges and agrees tbat Customer has read,understands;voluntarily accepts the -- -,,-terms of and bas n ceived a copy of this Aareemc t. rAc Sales Cons t s Signature Cult ignal use X Tel Customer's Signs ure Date - Salsa Consultant Lionise No. (as apCditsble) C&NCELL'ATIG N:.:-CUSTOMER MAY`CANCEL: THIS AGitEEMENT j VTI ROUT PENALTY UR ObLiGATION BY DTLIVERIT'G WRITTEN NOTICE TO THE HOME•. Dy,POT BY,.b1 UN1GHT.ON THE.TF)<RD BUSINESS DAY. AFTER.1 iIGNING TW ACREEMENT. ..Tl E STATE SUF PI,EMENT A YTACk1ED. HERETO i CONTAINS!- FORM` TO USE IF UNE IS SPECIIHICALLI-' PRESCRIBED BY LAW IN. r CUSTOMER'S13TAT& -- �SCONTRACI NOTICE:d ADPPIOIVAL TERt S ANTI'CONDITIONS ARE STATED ON 7..jW REVERSE.b'iDE AND ARE PART OF THI �_ . lalo8rov White-$r8r><hFile Tea _CUsWoier Pink-sales Consuttar+t _ 11 �t:Sc Town of Barnstable Building _a x^ '�"`"` C3"'" ,*"'+C��.,, rrv, ^n""w'°'�e�'" � � `„�`"'"""�'"">" '"`�"'"`"" ,r>.�%. " ` Post,This Card So That rt is Visible From' he Street=Approved Plans:Must be Retained on Job and this.Card Must be Kept F ABLB F ss • 'g y Posted Until Final Inspection Has Been Matle g �`' f63p ,$' ra s, cX Ek r Permit Where a;Certificate of Occupanc. is Re uiretl'such36uildm- shallRNot be Occu ied'unti1 1 Final,Inspection has, een:made�3 ~� c Permit No. B-18-2212 Applicant Name: Marc Schaefer Approvals Date Issued: 07/18/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 01/18/2019 Foundation: Location: 720 COMMON AREA PITCHER"S WAY, HYANNIS Map/Lot: 271-041-OOA Zoning District: Sheathing: Owner on Record: LAKE, PATRICIA ,a Contractor Name* ,Marc Schaefer Framing: 1 Co License 169163 ntractor Address: 720 PITCHERS WAY-UNIT 1A 2 HYANNIS, MA 02601Est. Project Cost: $75,000.00 Chimney: Description: Remove and replace existing siding with rigid PVC siding on Building ",,,Permit Fee: $382.50 Insulation: F. Remove and replace windows,sliders on Building F 4t Fee Paid:: $382.50 Project Review Req: Date 7/18/2018 Final: Plumbing/Gas Rough Plumbing: ._ - r.x" --- Building Official Final Plumbing: 4 , �.o t Rough Gas: This permit shall be deemed abandoned and invalid unless the work auth6 ed by this permit is commenced within six mnths after issuance. All work authorized by this permit shall conform to the approved application'and the approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws-ano codes. This permit shall be displayed in a location clearly visible from access street o.r`road and shall be maintained open for public inspects n for the entire duration of the Electrical 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 Officals are provided on•this permit. Minimum of Five Call Inspections Required for All Construction Work �_ .: � e`` �- � ,` '°' �� � M_.�= Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection)6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable RECEIPT SAPIW„ " 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit PP g Application No: TB-18-2212 Date Recieved: 7/10/2018 Job Location: 720 COMMON AREA PITCHER"S WAY,HYANNIS Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: Marc Schaefer State Lic. No: 169163 Address: 195 OAK LEAF ROAD, Eastham, MA 02642 Applicant Phone: (508) 237-2005 (Home)Owner's Name: LAKE,PATRICIA Phone: (508)237-2005 (Home)Owner's Address: 720 PITCHER"S WAY-UNIT IA, HYANNIS,MA 02601 Work Description: Remove and replace existing siding with rigid PVC siding on Building F. Remove and regllace v�dows, sliders on Building F. _, , CD -n Total Value Of Work To Be Performed: $75,000.00 e � r C:) rn Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Marc Schaefer 7/10/2018 (508)237-2005 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $75,000.00 Date Paid # Amouut Paid Check#or CC# Pay Type Total Permit Fee: $382.50 7/10/2018 $382.50 XXXX-XXXX-XXXX- Credit Card 1653 ......... Total Permit Fee Paid: $382.50 1 ........ , I �� THI�SIS N T A �PERMIT� 1 REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3) or already foreclosed for which possession has been taken(section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law,please state the reason(s)and complete section 1 (property information)and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party representative, but not other representatives and attorney) so that the Town can review the exemption and update its records: Section 1 —Property Information Property Address: 720 PITCHER'S WAY, UNIT C28, HYANNIS,MA 02601 Assessors Map #: Parcel #: Land area and description RESIDENTIAL Building(s)description and contents USE CODE 1020 SNy i Occupied: X Occupant(s)(if borrowers so state and include name(s)) 0- UNKNOWN . Phone: email: other: y. ., c� Vacant: Date: Anticipated Length of Vacancy: sv rn Last occupant(s))(if borrowers so state and include name(s)) Phone: email: other: Has possession been taken If so,please explain and complete and file the ' maintenance and security plan form (unless exempt as stated above) Section 2—Foreclosing Paqy Information Foreclosing Party (full name/title) MR.COOPER Foreclosure Case Court: Docket# v►� 9 � Date filed: 1/11/2018 Current Status: Foreclosing Party's representative(s) for property (entry,management, repair, etc.)(name,title,): Company (if different from foreclosing party): MR.COOPER Address: 8950 CYPRESS WATERS BLVD., Dallas,TX 75063 Phone: 888-456-0714 email:CODEVIOLATIONS@MRCOOPERtbeN If an exemption is claimed,please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information(i. e. "none"or"see above")). Name,title, other: Company (if different from foreclosing party): CYPREXX SERVICES, LLC Address: 525 GRAND REGENCY BLVD,BRANDON,FL 33510 Phone(s): 877-339-8202 email(s): VPR@CYPREXX.COM other: Name,title, other: Company (if different from foreclosing party): ° Address: • Phone: email: other: Attorney representing foreclosing party Firm name(if different from attorney's name): Address: Phone(s): email(s): other: I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. _ Date: 7/10/2018 Name JAMIE RAY'•/O CYPREXX SERVICES, LLC FOR MR.COOPER Title: VPR COORDINATOR r I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town of Barnstable i r Town of Barnstable BU11Cllilg w i T r_ A f. r ... • Post This Card So That�t is Visible From the;Streetf Approved Plans Must be Retained oBAIUMABM n Jobd this Card Must be Kept "'" & Posted Until Final Ins section Has 6'e211'Made. y i `to • p . . _zx`- .::: �_ �,� "''.,.�''&^a�`.fi•..�'fi '".`. ;;:�i"�, Where,a.Certificate,of Occupancy.,is RequYysired, uch Bulldmghall NotPbe Occupied until aFiynal5lnspectonhas,been;made Permit Permit No. B-18-2213 Applicant Name: Marc Schaefer Approvals Date issued: 07/27/2018 Current Use: Structure Permit Type: Building-Deck Expiration Date: 01/27/2019 Foundation: Location: 720 COMMON AREA PITCHER"S WAY, HYANNIS Map/Lot: 271-041-OOA Zoning District: Sheathing: Owner on Record: LAKE,PATRICIA Contractor Name: ,,,,Marc Schaefer Framing: 1 :.- . Address: 720 PITCHER"S WAY-UNIT 1A Contractor License 169,163 2 HYANNIS, MA 02601 ; Est Pro ect Cost: $ 100,000.00 r y, j Chimney: Description: Remove and replace existing decks on Building F Permit`Fee: $ 150.00 Insulation: ': k " Fee Paid:` $ 150.00 Project Review Req: T� Date 7/27/2018 Final: Plumbing/Gas wilding Official Rough Plumbing: ML, u.. Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed by this permit is commenced within six'months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which'th s permit has been granted. All construction,alterations and changes of use of any building and structures;shall be in with the local zoning by-lawstand codes. Final Gas: This permit shall be displayed in a location clearly visible from access street oi`.road4and shall be maintained open for public inspecti n for the entire duration of the work until the completion of the same. 1 r =` — - � / Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this'permit. Service: Minimum of Five Call Inspections Required for All Construction Work: _ g 1.Foundation or Footing Rou h: 2.Sheathing Inspection �. k .•. .- 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. OR �J"� Health Work shall not proceed until the Inspector has approved the various stages of construction. �f`t} Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT d YOU WISH TO OPEN A BUSINESS? w For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you . must do by M.G.I,,.-it does not.give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the.cornpleted form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE 0,5'D�:�"l Fill in please: APPLICANT'S YOUR NAME/S: �10 al,L rN U INS YOUR HOME ADDRESS: TELEPHONE # 5. C_ Home Telephone Number OUR ,: i,6,L i sl . � t ' EIN OR SS : T7 E-MAIL: �` _ Q © 0d, NAME OF CORPORATION: f NAME OF NEW BUSINESS TTh in K TYPE OF BUSINESS i IS THIS A HOME OCCUPATION? L,,'1`YEP NO ( /� ADDRESS OF BUSINESS 2a 17; �OZwl MAP/PARCEL NUMBER L —a ssessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONE�OF MUST COMPLY WIThis individual has be any equirements that pertain to this type of business. WITH HOME OCCUPATION RULES AND REGULATIONS. FAILURE TO Aut iobd S' n e . COMP Y MAY RESULT I INES. CO MENTS: BOARD OF' This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: r town oz xsarnsiapie 'I Building Department Services FTHE Tp� -�•(, Brian Florence,CBO o� Building Commissioner EARNST'AZLE. = 200 Main Street,Hyannis,MA 02601. . Muss. v 1639. � www.town.barnstable.ma us �,r fONO Office: 508-8624038 Fax: 508-790-6230 Approved: Fee: Permit#: O HOME OCCUPATION REGISTRATION Name: d G�! Phone#: Address: ��v Village: M . Name of Business:4 J ' Type ofBusiness:Un UK-AL Map/Lot: Gq 1 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,'subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside tbe.dwelling. there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • -The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • ' Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing-the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No perso shall bg employed in the Customary Home Occupation who is not a permanent resident of the dwe t I,the undersign ve re and a e Vffi;eaerictions for my home occupation I am registeri Applic Date:l(/ � /S/ i Homeoc.doc Rev.06/20/16 �- _ s Imo/ e� i � �� , � � I�1,,,,..� ,ice_ •I � �� - � -- � f .�,. ,, I � � i"'/ i ' � , � � �. ,�-.I � �ia/ � i �i� , �'/ � �. �- %, III I � _ A � . � � �' � �/�1 � � � I ,_ �I �,� I ' � , � I I I I I I I I I I I I I I I cam= -- _ r if f f � � f\ ( � r r ' *- ,- :- �%, .- t ��.. � c..i �1, � �'' � � ��., �' � �_, t J f/ L _ � ': _ �, � .' f � u �., � _ . �� � � F ��� W i -, l� � r r �'1 ,�'" ,� . �- r �, f / � ., r .. / - ,; t � �- ,,. r � ,/ i' ! �.. � _ y,, � ,� 1 A � k '� h � ,, / ,✓ f . 7 f � Lr 1 1 / � f `7 � f y/t r :, �., � � i' � J � � .j 3. ` � ` p + ' / � � �,w � f, / �' / ' 1J / / _ � ` J 7/ � � r; I �, _�` Town of Barnstable 1 Post This Card So That�t>is`:Visible Fromahe Street Ap;provedyPlans Must be_RetaI on J'ob and this Card;Must be Kept + tARIJ3['ABLC, .. r ei M' Posted UnFinal�lns ect�on HasBeen Matle � kr Permit 38s9 1v to,ps y ,y , <, a -..; a u �a3,n Where a Certificate of Occupancy�s Required,<u h;Buildmg st all Not be Occupied unt�l'a Final Inspection hasybeen made Permit NO. B-18-680 Applicant Name: Marc Schaefer Approvals Date Issued: 03/23/2018 Current Use: Structure Permit Type: Building-Deck Expiration Date: 09/23/2018 Foundation: Location: 720 COMMON AREA PITCHER"S WAY, HYANNIS Map/Lot 271-041 OOA - Zoning District: Sheathing: Owner on Record: LAKE, PATRICIA ` Ns Contractor=Name Marc Schaefer Framing: 1 Address: 720.PITCHER"S WAY-UNIT 1AContractor License 169163 > 2 HYANNIS, MA 02601 � Est Project Cost: $ 120,000.00 Chimney: Description: Remove and replace all decks on Building A Permit Fete: $ 100.00 ` Insulation: Project Review Req: .y Fee Paid $100.00 Date 3/23/2018 Final: tlaly «, r ttcy Plumbing/Gas u v�� Rough Plumbing: 77 Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work aithorzed byths permit is commenced within six m'oriths after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents fowh'ch this permit has been granted. All construction,alterations and changes of use of any building and structures shall be incompliance with the local zornng bylaws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street�or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. •" � �-- �. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Bwldmg and FireOffcials are$providedn this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing • Rough: . 2.Sheathing Inspection Final' 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �Mvst.. S Ems'"r .°� Town of Barnstable Building BLB. W7's h:t.:4e.d Un,..tMai l.dF in,Sao�l Tlnh«,'3s,a..p t he,.tc.t.s,o Uns_H"iba•ls,a�e BFereosnm'M,t_.haed..eS t_,.;„,' ,. �,, Bt Posrceet163 Pos :se eprovge,:rd,r:Plans,-:M.u�F s t;be% 'R"p Ee ta,nesd on;p J,o.ke•b.au n'd- pth s•+�,fi aairtlr=a Ms.us.,.s'e te'b�nem£Ke p te:„x ) ei ' Permit No. B-18-795 Applicant Name: Marc Schaefer Approvals Date Issued: 03/23/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 09/23/2018 Foundation: Location: 720 COMMON AREA PITCHER"S WAY, HYANNIS Map/Lot 271-041 OOA Zoning District: Sheathing: Owner on Record: LAKE PATRICIA x Contractor Nam Marc Schaefer Framing: 1 Address: 720 PITCHER"S WAY-UNIT 1A Contractor.License 169163 2 HYANNIS, MA 02601 Est Project Cost: $90,000.00 Chimney: Description: Remove and replace all windows and doors at'Bu,ld,ng 6 Perm,t Fee: $459.00 h Insulation:, Project Review Req: Fee Pa,d:" $459.00 Date. 3/23/2018 Final: Plumbing/Gas Rough Plumbing: t Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized bey this permit is commenced within six months after issuance. Rough Gas: All work authorized b this permit shall conform to the a i 'k �' y p approved appljcation and the approved construction documentsfo�rtwhic�h than permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures'shall be in compliance with the local.zoning by laws acid codes. This permit shall be displayed in a location clearly visible from access street o road and shall be maintained open for public�nspect,on for the entire duration of the work until the completion of the same. Electrical S . 2" Service: The Certificate of Occupancy will not be issued until all applicable signatures by thea Building and Fire Officals are provided ont s permit. Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing ., 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health, Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the �yuL�'C property of the APPLICANT-ISSUED RECIPIENT - ' . Town of BarnstableBuilding POSt ThIS Card So T at�t,isU�s�bleFrom.,theStreet;,Approved;.PlansMust be Retained on,Jgb and.this Card Must beKe' t • DAMMABLE. 6 � ' Post ed Un tIlFinal InspectionHas Been iVlade F£ :r fi m � Permit p x Whete a Certificate of�Occupancy isRequired,such Building shallNot be Occupied until a.Fnaln�spection has,€been made Permit No. B-17-4449 Applicant Name: Marc Schaefer Approvals Date Issued: 03/05/2018 Current Use: Structure Permit Type: Building-Deck Expiration Date: 09/05/2018 Foundation: Location: 720 COMMON AREA PITCHER"S WAY, HYANNIS Map/Lot: 271-041-OOA Zoning District: Sheathing: X Owner on Record: LAKE, PATRICIA Contr i` "N"i ,M rc Schaefer Framing: 1 Address: 720 PITCHER"S WAY-UNIT lA t 'Ontracto�,•Ocense 169163 2 HYANNIS, MA 02651 Est"Project Cost: $50,000.00 A Chimney: Description: Remove and replace second level decks on BuildingS r Permit Fee: $150.00 Insulation: Fee Paitl $ 150.00 Project Review Req: BLDG E SECOND LEVEL DECKS ONLY. Final: ��Oate 3/5/2018 4£ .. <>f Plumbing/Gas 414 Y Rough Plumbing: . s Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. g All work authorized by this permit shall conform to the approved application:an4 the approved construction documents for which'Ahis permit has been granted. All construction,alterations and changes of use of any building and st uctures shall be in compliance with the local zonng by ilaws and codes. Final Gas:. This permit shall be displayed in a location clearly visible from access street or�roadland shall be maintained open for public inspection fo.r the entire duration of the work until the completion of the same. p Electrical The Certificate of Occupancy will not be issued until all applicable signatures by'the Bwlding antl Fire Off cialsare provided ontAii his permit. Service: Minimum of Five Call Inspections Required for All Construction Work. 1.Foundation or Footing Rough: x w ` �. � 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �ry►grz� S�� Town of Barnstable Building PostThis C.ard�So.,That ituis Visible From`the:Streety,A roved>Plans:Must:be Retained on Job and this,Card Must 6e.Ke t :,;,. NAM e x3;. al`a.'�3.x �+ ''s8.& 4 a x.�s i Permit i639. hosted Until Final Inspection Has Been\Made s a �� , t+' a Wre�aCertificateofOccupancysRequi„ d,such Bwldingshall Notbe Occupied untila Final Inspection has been made he µ Permit No. B-17-4448 Applicant Name: Marc Schaefer Approvals Date Issued: 01/31/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 07/31/2018 Foundation: Location: 720 COMMON AREA PITCHERS WAY, HYANNIS Map/Lot. 271-041 OOA Zoning District: Sheathing: Owner on Record: LAKE, PATRICIA Contractor Name Marc Schaefer Framing: 1 Address: 720 PITCHER"S WAY- UNIT lA Contractor�License 169163 2 HYANNIS, MA 02601 Est Project Cost: $75,000:00 Chimney: e; Description: Remove and replace existing siding with newlrigid PVC siding on Permit Fee: $160.00 Building E. Insulation: Fee Paid $160.00 Project Review Req: t Date 1/31/2018 Final: _ Plumbing/Gas s Rough Plumbing: - Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorzed by this permit is commenced within six nionths�afterissuance. All work authorized by this permit shall conform to the approved applicaUon and the approved construction documentsfioWwhich this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws;and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for publ�cinspection for the entire duration of the Final Gas: work until the completion of the same. P Electrical 1 The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officals are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service:„ 1.Foundation or Footing 2.Sheathing Inspection Rough'. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do.not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable11 RECEiP-r t3arnBt.ty. = �,.,.. 200 Main Street, Hyannis NIA 02601 508-862-4038 Application for Building Permit o Application No: TB-17-4448 Date Recieved: 12/31/2017 Job Location: 720 COMMON AREA PITCHERS WAY,HYANNIS Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: Marc Schaefer State Lic. No: 169163 Address: 195 OAK LEAF ROAD, Eastham, MA 02642 Applicant Phone: (508) 2 7-5002 00 r.. (Home)Owner's Name: LAKE, PATRICIA Phone: (508)237-5002 (Home)Owner's Address: 720 PITCHER"S WAY-UNIT IA, HYANNIS, MA 02601 Work Description: Remove and replace existing siding with new rigid PVC siding on Building E. Total Value Of Work To Be Performed: $75,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute, regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Marc Schaefer 12/31/2017 (508)237-5002 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $75,000.00 Date Paid Amount Paid Cheek#or CC# Pay Type Total Permit Fee: $160.00 1/5/2018 $160.00 i Visa:}0M-XXXX- i Credit Card XXXX-2305 .......... ......... ..... .... .......... ....... ._.........._ Total Permit Fee Paid: $160.00 `THIS IS NC�T�A PE IAg u.,...,. . ., .. . . , ,_ , u.- a , r SyP ��� (�� �Cyois i t -jJJ III r Town of Barnstable RECEiPr, 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit pepyteA '(31 < 4 (? Application No: TB-17-4449 Date Recieved: 12/31/2017 Job Location: 720 COMMON AREA PITCHER"S WAY,HYANNIS Permit For: Building-Deck Contractor's Name: Marc Schaefer State Lic. No: 169163 a o 9 _ Address: 195 OAK LEAF ROAD, Eastham, MA 02642 Applicant Phone: (5017-5002 ;--. _.._ t•-A L y.' (Home)Owner's Name: LAKE, PATRICIA Phone: (508)237-50Q, (Home)Owner's Address: 720 PITCHER"S WAY-UNIT IA, HYANNIS, MA 02651 a 3 En Work Description: Remove and replace second level decks on Building E. co cn 0 rn Total Value Of Work To Be Performed: $50,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Marc Schaefer 12/31/2017 (508)237-5002 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $50,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $150.00 1/5/2018 $100.00 Visa:XXXX-XXXX- Credit Card a.._.,.: ....._...._ XXXX-2305� __. _... ..w_.w_..:.._... Total Permit Fee Paid: $150.00 1/5/2018 w $50.00 Visa:XXXX-XXXX- £ Credit Card XXXX-2305 V THIS IS NOT'A PERMIT: Florence, Brian To: billing@mareschaeferc tr=o�n.com Subject: Perm it/AppIicati n:TB-17-4447 at 720 COMMON AREA PITCHER"S WAY, HYANNIS for Building - Siding/Windows/Roof/Doors Mr. Marc Schaefer, Building permit application fee of$382.50 is due in order for us to issue your building permit. Regards, Brian Florence, Building Commissioner Building Department I Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4038 Brian.florencePtown.barnstable.ma.us 1 Town of Barnstable RECEIPTa s" " 200 Main Street, Hyannis MA 02601 508-862-4038 a Application for Building Permit . ZE Application No: TB-17-4447 Date Recieved: 12/29/2017 in Q Job Location: 720 COMMON AREA PITCHER"S WAY, HYANNIS Permit For: Building- Siding/Windows/Roof/Doors Contractor's Name: Marc Schaefer State Lic. No: 169163 .. 63 <n rs+ Address: 195 OAK LEAF ROAD, Eastham, MA 02642 Applicant Phone: (508) 23 -5002 Q (Home)Owner's Name: LAKE, PATRICIA Phone: (508)237-2005 (Home)Owner's Address: 720 PITCHER"S WAY-UNIT IA, HYANNIS,MA 02601 Work Description: Remove and replace existing siding with rigid PVC siding on Building A. Total Value Of Work To Be Performed: $75,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area 1 hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation.Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with.the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Marc Schaefer 12/29/2017 (508)237-5002 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $75,000.00 Date Paid I Amount Paid Check#or CC# Pay Type Total Permit Fee: $382.50 I I ........_....... __... Total Permit Fee Paid: $0.00 THIS IS NOT A PERMIT / 4 Town of BarnstableRrECEiP-r NAM 200 Main Street, Hyamis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-4447 Date Recieved: 12/29/2017 Job Location: 720 COMMON AREA PITCHER"S WAY,HYANNIS Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: Marc Schaefer State Lic. No: 169163 Address: 195 OAK LEAF ROAD, Eastham, MA 02642 Applicant Phone: (508) 237-5002 (Home)Owner's Name: LAKE, PATRICIA Phone: (508)237-2005 (Home)Owner's Address: 720 PITCHER"S WAY-UNIT IA, HYANNIS,MA 02601 _ q� q Work Description: Remove and replace existing siding with rigid PVC siding on Building A. CPO 0 o a cn :V n av � r— Total Value Of Work To Be Performed: $75,000.00 rv + Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Marc Schaefer 12/29/2017 (508)237-5002 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $75,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $382.50 ......... ......... r ... ......... Total Permit Fee Paid: $0.00 T'IIIS IS NOTsA F'EI�1dII'T�F 4 f ' d...e.._ T TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION =f Map Parcel `I Application # . Health Division Date Issued `3 Conservation Division Application Fee W Planning Dept. Permit Fee /00 Date Definitive Plan Approved by Planning Board Pic Z— I Historic - OKH _Preservation / Hyannis Project Street Address a V i 4-G h Q r� Lo.n-� �� a �- C. o� 7 Village R y C`q Owner ���� < C, Address �a� �i+hers Telephone Permit Requesth� �1� 1�►�1� �� P j�CJ�✓h�,n �- �i ��� QU ru V-C\ 1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including bathe): existing new First Floor Room Count , Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other x rn Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove:*❑Yes,;❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑new maize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 1 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ rn Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION y (BUILDER OR HOMEOWNER) Name J 4T �� �� '� Telephone Number �J� ! ✓o 6 07 Addresses l S License # V b V1�otr2 r `o`er V"► Home Improvement Contractor# 5 Worker's Compensation # O C� _ 3 S_ S y` 00-61 L ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 't FOR OFFICIAL USE ONLY m, APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: 2--FOUNDATION . k FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL '• PLUMBING: ROUGH FINAL t, GAS: ROUGH FINAL F FINAL BUILDING :Y DATE CLOSED OUT ASSOCIATION PLAN NO. Departrrient of Industrial Accidents Office of Investigations 600 Waskington Street Boston,AM 02111• w :4, www:mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciaus/Plumbers Applicant Information Please.Print Lezibly Name(Businesslorgmdzadon/Individual): . 1 b M 1.n Address: �.. V� S0r\- City/State/Zip:. f OZ Phone.#: Are you an employer? Check the approp iate box: .Type of project(required):. 1.❑ I am a emP to er with' 4. 0 I am a general contractor and I ,Y _ 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 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me.in an aci employees and have workers' Y capacity.t3'• t• 9. ❑Building addition [No workers' comp.insurance comp. insurance. re ed 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions _. 3.❑ I am a homeowner doing all work• officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance re ed t c. 152, §1(4),and we have no ] employees. [No workers' 13.M Other `eP blP�l �dt� 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 Insurance Company Name: Policy#or Self-ins.Lic.#: W C�``�f S ".� 1 DO Expiration Date: Job Site Address: �.2 b f c �S (� . t C City/State/Zip: ITS f Oo/\ Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1'1500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby ceT under the pains-and enalties of perjury that the information provided above is true and correct Si afore: [[�� Date: Phone �UU l 6 2 — lQ"1 Official use only. Do not write in this area, to be completed by.city.or town official, City or Town: Permit/License# Issuing Authority(circle one): A.Board of Health. 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Inforato and Instructions Massachusetts General Laws chapter 152 requires.all employers to,provide workers'.compensationffor.their employees. t Pursuant to.this state ''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 otherlegal entity,employing employees. owever e . - owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the 'dwelling house of another'who employs'persons to do maintenance;construction or.repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant'who has not prodnced,acceptable:evidence of compliance with the insurance coverage required." AdditionaIly,MGL chapter 152, §25C(/)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract form the performance of public work until-acceptable evidence of compliance with the insurance requirements of this chapter have been presented-to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call.the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials: Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to.contactyou regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pemmit/license applications_in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or, town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related io 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 The-Office,of Investigations would like to thank you in advance for your cooperation and should you have.anyquestions, please do not hesitate to give us a call. The Department's address,telephone-and fax-number: Yhi� CQmm9,u wealth of Massacbusetts DQpazt wat of.kdUsixial Moidents Office Of,luvestagat on s 600 ashi gbg Street &astan, MA€1-111 Tel.# 617-727-14900 ext 406 aF 1-87 IMASSAFE Fax#CO-727.774 ' Revised 11-22-06 WWW.MaSS,goV4a '/26/20 .2 6.30: '41 AM 37' (&MT-8) FROM: 1,00005-TO: 15Cf73020,6E Page: 2 of 2 ACC>RV CERTIFICATE OF LIABILITY INSURANCE `1%� .L THIS CERTIFICATE IS ISSUED AS A MATTER OF MFORMATIO14 ONLY AND CODERS NO RIGHTS UPON THE CERTIFFICATE BOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR 14EGATNEt.Y AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 13ETWEEN THE ISSUING ROURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AMID THE CERTIFICATE HOLDER. ?i IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(les)nwat be endorsed. it SU11ROGATION IS WAIVED,subject to the tome and conditions of the policy,certain policies may requiov an endorsement. A statement on this Certificate does not senferrights bt the certificate holder in Neu of such endorseme e. PRooucEK PAUL B,SULLIVAN INS AGCY INC r 1467 S MAIN ST PHONE FALL RIVER, MA 02724 roNStIR AFFOfdww coviWAGE NAIG m INSURER A: ' u"R a 1 JOSEPH DUARTE&JOHN DALIEY «suRER o, DSA J&J REMODELING 15 WILSON WAY nsu o: MIDDLEBOROUGHMA 02346 Ws~E: Rf• COVERAGES CERTIFICATE NUMBER: REVISION NUM"R. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE UNSUITED NAMED ABOVE FOR THE POLICY PERIOD ` INDICATED. NOTWITHSTANDING ANY REQUIREMENT:TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 13E ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED fY THE POLICES DESCRIBED HEREIN IS SlB)EC?TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN,MA`1 HAVE BEEN REDUCED BY PAID CLAIMS. LearTS LTR t TYPE OF rNBVRANCE PotICY Nu~ LTa EACNtOCCtIRiwme i GENERAL UABILITY IS S a acarcenLa E COMMERCtAL GENCRAL LIABILITY MED E XP(Any ene person) 5 CLANS-LADE OCCUR i PER.SOWIL a,ADV INIURY S GENERAL AOMOATE t 4 PROOt1CTS-CtX4�/�AGG S GEN L AGGREGATE LIMIT APPLIES PER: S POLICY PRO LOC e actow ; AU MOB"UABLITY I BODILY two(Per person) ANY AUTO I BODILY INJURY(Few aced4d) $ PLL�WMEO SCHE4ULED AUTOS NNOONAwNEO e"I Y VIREO AUTOS AUTOS _ i EACHOCCLIPMNM S UMBRELLA LOB .OGCUR f - E1tCESSL IAB CLAMSANADE I AGGREGATE S {I{ f pE0 RETENTION S g S waRNtlEtts ConNPENSArIaN WCS-31 S384800-012 2l2J2012 212Q013 RY l G N• A AND N9ailOYERS uAeLLrrr VIM E.L.EACH ACCIDENT s 10000 ANY pgppR>E�OppAgTNEAIExECttTNE N t A E.L.DISEASE.EA EMPLOYEE S 1 0 OFFICERILIEMBER EXCLUDEO? tMen4alory in NMI E.L.DISEASE•POLH;Y LINT f 50000 tl et,des under p T(ONON OF ired) OPERATWNS bebw DESCRIPTION OF OPE.ATtONB r LOCATIONS r VE/8CLE9(AL1uh AC0g0161,Add tiDrrel RemeAre BnbaduM,H note epece b rNqu Workers compensation instxanCe coverage applies only to the workers Compensationtaws of the stale of MA. NO PARTNERS ARE COVERED BY THE WORKERS'COMPENSATION POLICY. \ CAN E C(?ITT AT N SHOULD ANY OF THE ABOVE OEtxRiBED ppLNMS r3£CANE�LI-ED AFORE TOWN OF BARNSTABLE nc oaaAlewl'It+IRATWN nt�po�ilcywnslNOTICE wlu Be nEL *' 200 MAIN STREET HYANNIS MA 02601 AUMA *9MV ESEWATNE Jeff Ekkidas 0198t14010 ACORD CORPARATION. All rights resented. ACORD 24(201 WS) Tlw ACORD name and logo am tegtstered martts of ACORO US LTas I,artiSicataT?anCCLUNT ele and r supeseedesr ALL p tYlOv91%sion ii94ed=Cl LLLSLLdCleg• peyt 1 Of L ?!Lo = x tr f a ��5;;u 1 <"Y.:�t« '.gyp - ''�: � t fi:- ;"y ,~ a ��eF! Ai^° +� i'.r '..7'a^v � �.�ti a ik•�' '�S;'A'v - Yi� -�I' ,i lyp ­t a R Q r e¢ sN f i. ��Ys �.v'� -✓"��,-���ER �t}w,i 1',,�r �' f .1 ..,.r �:;...ev« stnF,,,. r° r rt;!:. 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Simonton Windows 6500 VantagePointe ivFAC Double-Hung Vinyl 1f8"Glass Argon Loy;a-E No Laminated Glass La With Grids Parova Ventana de doble guillotina-Vini!o 3.18 mm Vidrio Argon Love-E Sin -w` `rcar video laminado Con rejillas WINE CPD:SBP-A-44-21042-00002 07-75 DH ENERGY PERFORMANCE RATINGS EVALUACION DE RENDIMIENTO ENERGETICO U-Factor i Solar Heat Gain Coefficient acicr-G Coefn:ien" Ganancia ae Fnergis So!a. t 0.29 1 .65 a 0.24 ADDITIONAL PERFORMANCE RATINGS a EVALUACION SUPLEMENTARIA DE RENDIMIENTO Visible Transmittance rarcmisicnde..;zVisbla I i I 0.45 �Marva' ture;stip��ales tr.at t~ese ratings conform tc applicable NFSC r 6Y pmradu for daterm ring whole product pelormance.NFRC ratings are detar.l.-ed fora fixed set cf errrironrrental conditions and a specfc product siza.i•!FRC(ices not recorr:mend any produc'end does not vaaranl the suitaoi:!y of am,groduct`r arysp,&.c use.Cc..ms it maufactura's literature icr otne prodLlct pe forrnence informaEon.w .aSc.ag E-se fab^:;ante estioula oue valores cumpien con ios proced:rmentos ap!gal>s de NFRC pa d terminor e rendirr,onto Mai dei producto Los valors usads3 per NFP.0 son daterminados por urn coniun?o fi o ce condicicr:as 2m,bleniales y ur tarcaro de pr odac espec:ficc.NFRC norecorr�ienda ,;ng.ln pr..duct y no garcnl¢a we ei Product sea adecuaco Para un use esceclfix Consoe,con at fo§eto lei fabnzante Para el use apropiado de esle product wvrrv.r�frc.crg �.;• r,,I ,� ,�� _ Unit qualifies for ENERGY r * STARSregion(s):Northern, • � � � � North Central,South Central Southern. , ,� STC:29 "f• �ueFv€iir DR+25/-25 IND:Rein OO/Glass ProSolar/H-LC25 Tested Size:48"x 80" Florida Product Approval.- FL5167 Applicable Test Standard(s): ANSI/AAMA/NWWDA 101/I.S.2-97,AAMANVDMA/CSA 101/I.S.2/A440-05,AAMA/VVDMAICSA 101iI.S.2/A440-08, r , A440S1-09 Canadian Suppl P 8858790/01 g0333 HS Howard 6400094A Keep icis iabei for possible ENERGY STA,RO-ebais To.'earr:more visit w+x w.energystar.gov.' Gua?de esia etlCuele xsbles reemoosos ENERG. STAR.Para cone e;ro9s ace�a de evo,visi;e+a^,v+w.energystar.gov. t HOME IMPROVENIENT CONTRACT / a PLEASE READ THiS Sold,Famished and installed by: . Branch Name: Boston Date: a ' -1 3` T13D At-Home Services,.Inc d/b/a The Ilome Depot At-Home Services 908 Boston Turnpike,Unit 1,Shrewsbury,MA 01545 111 Toll Free(800)657-51$2;Fax(508)845-6017 Branch'Number.31 Federal Ili h 75-2698460;ME Lie V C 02439;'Ri Cont:i.ic 4 16427 CT Lie#111C.0565522;MA.1i.6mc Improvcmcut Contractor Reg.4"12>699.i Installation Address: O TG C( k+~. /Jim/!� e c7 �ra11R15 �, 6 (a,6 1 City State LIP....,,:;,.,;;:.,;rir::-:a:; Purehaser(N): Work.Phone: Home Phone: Cell Phune: . a ' Q G l Home Address: (if different from Installation Address) Ovy State Zip &mail.Address(to receive project communications and Home Depot updates): ❑I DO.NOT wish to receive any marketing emails from The Home Depot Proiect Information: Undersigned("Customer"),the owners of the property located at the above installation address,agrees to buy, and THD At-Home Services,Inc-("The Home Depot")agrees to furnish,deliver and arrange for the.installation("installation")of all materials described on the below and on the referenced Spec,Sheet(s),all of which are incorporated into this Contract by this ieference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract"): Job#: (rnwmmac&rcnw) P oducts: _ S Sheet(s)#: Project Amount. ¢ Roofing Siding Windows Insulation j $ 6 aL f 3 ❑Gut—/C.overs ❑Entry T)co1 ElQ! �4 L ©Roofing ❑Siding ❑Windows ❑Insulation $ ❑Gutters/Covers ❑Entry Doors ❑ ❑Roofing ❑Siding ❑Windows Ll Insulation $ ❑Guuers/Covers []Entry Doors❑_-.,_. Rooting ❑Siding ❑Windows ❑insulation $ ❑Guuers/Covers ❑retry Doors ❑ Minimum 25%Deposit of Contract Amount due upon execution or this contract Total Contract Amount $ Maine Purchasers may not deposit more than ooe4hird ofthe Contract Amount �0?r S" Customer agrees that, immediately upon completion of the work for each Product,Customer will execute a Completion Certificate (one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Horne Depot reserves the right to issue a Change Order or terminate this Contract or any individual Prgduct(s).included herein,at its discretion,if The Home Depot or its authorized service provider detemtines that it cannot.perform its obligations due to a Su'octural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safely concerns,pricing errors or because work required to complete the job was not included in the Contract. Payment Summary: 'the Payment Summary#_ o included as part of this Contr cl,.set, forth the total Contract amount and payments r quired for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You are entitled to.a'eompletely filled-in copy of the Contract at the time.you sign- Do not sign.a Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. Inthe event of termination of this Contract,Customer agrees to pay The Ilome Depot the costs of materials, labor,expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus any other amounts set forth All this Agreement or allowed under applicable law. THE H0IN11: DEPOT MAY WITHHOLD AM0UN.TS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENT'S MADE, Wl.'1'I401IT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrees and understands that this Agreement is the entire agreement between Customer and The IIome Depot with regard to the Products and installation services and supersedes all prior discussions and agreements,either oral or written,relating to said Products and installation.This Agreement cannot be assigned or amended except by a writing signed by Customer and The Home Depot.Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the teens of and hag received a copy ofthis Agreement. 4Lepted y:, Sub�nul.n, Signature Dal Sale 's SNq attire Date X Telephone No. Ib �— Customer's Signature Date Sales Consultant License No. _. (as trpplitOblc) . CANCELLATION: CUSTOMER MAY CANCEL THiS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE 1S SPECIFICALLY PRESCRIBED BY LAW IN. CUSTOMER'S STATE. NO'fICE:ADDITIONAL.TERMS AND oONDTrtAN5 ARE:S'CATED ON THE KCVERtiE SIDE ANU ARE PART OF THIS Coh'TRA6r 05-10-12 White-Branch File Yellow-Customer Td WUZT:OT 600E ET 'Inf T2_ZZZ9290S: 'ON XUA p26w2 : WONA 7 Z I 11 f 1— WINDOW SP WFICATION SHE Spec.Sheet%: 6 O 6 4 ' �H /rg v sheer j o f • 1obp. � Cf�' Consultant Date- Neer W i ow Hinge Locations tabor ExisttnglYndow Measurerments Grids Product Options p tlons Frcrnoutside, Cl- p Leh to Right Etsys,Bow-, � Cdor RouO Opening 0 of bars 41 of bars [runts,I Pnl, Locationwet,R or$ Glass�a m Fill- Oj Hardware FdisCode ItemsFor door use Screens '5'=sG[Ionaryor O1 1 't I Sp 3 yd hlvlE x'=oatln9 0 g Style Wraps c F i > x 3 f t= Room Floor Code YIN St IeCode Series Code �. L on ao �} qq 3 a 5 r.f E t11 lv _ CV lD rn e CO m In O 1c Z CE n LL 12 13 r SPECI ONSIDERA r S: AIN wrap color � � txabr Casing T7pe Bay or Bow ldndow: -10 kal6oard Nseledar:ldnyl ony�Blyd1 ar aaW Bx�?rcjerYm Arse 130°cr a5°? _ . Oa�Flanker Type;pN,SH«CsmnU Tap of Mrdwr to soffit Und*sr E.. ffitmaterial Iha�re ie wed andagree Kith a'I!hepbspedfitallons acae ant&a ) I Spedol Te"sandCond'IBcn3onitebark of Bss yE m Kulto•n?ri copy. Garden Window: _ Q1 ccly-11tire PionitC.Bicha Oali ' -�A ro fib 'a.. - Custamu astwe �!s' Wall Thltknr>ti l7nrtesl •. .4dditro,01 She€ffes cr NO - D I.lrl�+l�roga✓3riGF?7+1�!�f1.}[ja'n-1 fulJ,tv i4FVOtY. LL; V4NN.--rhc Ffasle papa Yefvry•C.LS"r h Im � � �.a•+wssr-v+ ll 4 ::r' •'✓4 AT-HOME .lob# To wham it may concern, ire:address: Concerning the above location,We give the Home Depot approval to install Number of windows Z/ Style (Double Hung/ ment,name Color &) t �` Manufacturer �/�L�?��� i4g Exterior finish as agreed to be PVC(wrap trim)? color , We agree to the grid or lack of grid corfguration�J r! Are grids between the panes of glass? As stated these proposed-windows do meet vwth the Condo-Management approval. Si ned Print name S, ZC . ' Trt1e Phone# .,.,.�► Date: 1'_,,,�,1'?-��� � — Id WULT:8 600Z 6T 'I nZ UZZZ9£$0S: 'ON Xdd pie6w*e[ : Wodd January 10, 2013 1, Faith Cavanaugh, residing at 720 Pitchers Way, Unit C27, Hyannis, Ma. 02601 authorize The Home Depot and contractor J &J Constructihn to replace the window at this address. Signature,_ Date / 1 4/4 d 9992 9 ? �0'i' 4 << %LtZ56905 3NOHd'NladXUM t5:14 IL-40-£402 FROM jam gad Ft=s 10. 508362 y2 r 1 Jul. 25 2009 2:39PN P2 Sea Meadow Village Condominium Association • 720 ditcher' Wray Hyannis M4 02601 Qecember_22,-2Q 12 Re: Replacement Wndows - [Unit C27 located at the above address Approval given for dome Depot to install.new windows in Unit C27 located at Sea Meadow Village Condominiums. If you have any questions or concerns,please do not hesitate to contact me. Lys Terkelsen Resident Manager Tqh (508)77.1-206 i Fax: (508) 827-7061 / L lvsiet17(a�Galxtcm.net �r,u 5�cc Ile-,— l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 0 IS plication # Health Division Date Issued to ( Z, Z, Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 0 Q-r F 4 GJ Village H AnA(s ,_ mR �i- Owner Bacns�6�e tteu�Sin� f`i r'f'�_Address lq 6 5 o vA �1 aft Zs Telephone_ _ 508- 3-71 - '��4� Permit Request �td� �9 GellAose, +o 4e, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation $ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure il q g 8 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other `7� a Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new.:, Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil X1 Electric ❑Other Central Air: ❑Yes X No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ® No If yes, site plan review# Current Use Proposed Use r APPLICANT INFORMATION Y r (BUILDER OR HOMEOWNER) - Name W1,11M G /CxL�050M/ J'r. Telephone Number Address knTi n1 4tn,. License # _ZC 5 6wA �0.f(Yl6V��Tl' 6 �L 64 Home Improvement Contractor# Worker's Compensation # TU1 C 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE a 1 r FOR OFFICIAL USE ONLY APPLICATION# _ DATE ISSUED MAP/PARCEL NO. ! ADDRESS VILLAGE OWNER_. F DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH - FINAL - PLUMBING: ROUGH FINAL L.3 GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. F The Commonwealth o Massachusetts Department of Industrial Accidents Office of Investig ations 600 ff,asizington Street Boston,M 0-7111. )vwiv.nms.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Ledbly Name(Business/Organization/Individual):_ C n t-Ye- S n C. Address: - D Hti iiaej-i-an Nvenwe City/State/Zip:501A-4 YarMOPA MR OA6 4 Phone#: 508- 3 4 $ - 0 3 4 $ Are you an employer?Check the appropriate box: general contractor and I Type of project(required): 1.� I am a employer with 1� 4. ❑ I am a g " employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in-any capacity. ' employees and have workers' 9 ❑Building addition [No workers'comp.insurance comp•insurance.= required.] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. -. right of exemption per MGL insurance required.]t c. 152,§1(4)„ 12.❑Roof repairs and we have no a employees.[No workers' 13.50 Other 7'n g a,,o 1 on comp.insurance required.] *Any applicant that checks box RI must also fill out the section below showing their workers'compensation policy information. r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affida-6t indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. _Teo n 01 0 -1n 5 w,r'an oC G M n Policy#or Self-ins.Lie.r: �W C 3 3 Expiration Date: y � ' 1 3 p I�Gh R F Job Site,Address: �j 1 ' fl 3 W a C IS City/State/Zip: MA Attach a copy of the workers'compensation policy declaration page(showing the policy numb r and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised,that a copy of this statement may be forwarded to the Office of lnvestisations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjun'that the information provided ab ve is r(ue and correct Sianature: Date: Phone:": Official use only. Do not wrile in.this area,to be completed by cin,or town official City or Town: Permit/License . Issuing Authority(circle onel: 1. Board of Health ?. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone-: =yT ® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/10/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement..A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NA EACT Risk Strategies Company Risk Strategies Company PHONE (781)986-4400 C No:.(?81)963-4420 15 Pacella Park Drive ADDRE S: ' Suite 240 INSURERS AFFORDING COVERAGE NAIC# Randolph NIA. 02368 INSURERA:Selective Insurance INSURED INSURER B:Safe Insurance Co an 3618 Cape Save, Inc INSURER c-TechnologyInsurance Co ari 7 D Huntington Ave INSURER D:. INSURER E South Yarmouth MA 02 644 INSURER F: COVERAGES CERTIFICATE NUMBERCL125948081 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR,MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I TYPE OF INSURANCE L B POLICY NUMBER M�pY EFF MMIDD EXP LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMA TO RENTEDS 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence A CLAIMS-MADE a OCCUR PPS1994480 0/16/2011 0/16/2012 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY PIFCT RO LOC S AUTOMOBILE LIABILITY ea accident)COMBINED SINGLE LIMIT S 1,000,600 B ANY AUTO BODILY INJURY(Per person) .S ALL OWNED N SCHEDULED 6209200 1/6/2011 1/6/2012 BODILYINJURY(Peraccident) S AUTOS AUTOS EED ra�dDAMAGE X HRED AUTOSAUTOS Pe accident) S X I Underinsured motorist el split S 100,000 X UMBRELLA LIAS OCCUR EACH OCCURRENCE S 2,000,000 AXCESS LIAR CLAIMS-MADE AGGREGATE S 2,000,000 EXCESS I I RETENTIONS RPS1994480 0/16/2011 O/16/2012 C WORKERS COMPENSATION B ITC WC STATU OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE YIN N E.L.EACH ACCIDENT S 500,000 OFFICERIMEMBER EXCLUDED? NIA C33181007 /9/2012 /9/2013 (Mandatory in NH) E L DISEASE-EA EMPLOYE s 500,000 If yes,descn-be under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Issued as evidence of insurance. Issued as evidence of insurance. Thielsch Engineering, Inc. is listed as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION msong@capelightcompact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cape Light Compact Attn: Margaret Song AUTHORIZED REPRESENTATIVE PO Box 427/SCH 3195 Main Street Barnstable bik 02630 Michael Christian/BAM ACORD 25(2010/o5) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn2A r7ninnsini Tho Annpn name and Innn or*ronla4crnrl marlec of annia l alas achusctt - Departmrnt of Public SafelN Board oi•Buildin�L Re!_ulatiun` and Standards - t+�.+ Construction Supervisor Specialty License License: CS SL 102776 Restricted to: IC WILLIAM MC CLUSKY ' ~ it 37 NAUSET ROAD - WEST YARMOUTH, MA 02673 Expiration: 6128/2013 T r4-: 102776 Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 b / Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation Expiration: 3l1412014 Tr# 222184 CAPE SAVE INC. _ - WILLIAM MCCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. - 17 Address. 7 Renewal 71 Employment Lost Card _ PS-CA1 0 50M-04l04-G101216 J/W-60111"emiweaNt. 11 Ilasac/uaeti✓ License or registration valid for individul use only _ Office of Consumer Affairs&Business Regulation � before the expiration date If found return to: HOME IMPROVEMENT CONTRACTOR _ = Office of Consumer Affairs and Business Regulation H Registration: :171380 Type: �i 10 Park Plaza-Suite 5170 Expiration: 3114/2014 Corporation <, . Boston,MA 02116 CAPE-SAVE INC... :.....=_-._._........ :_ WILLIAM McCLUSKEY_;; _= 7-D HUNTINGTON AVENUE- SOUTH YARMOUTH.MkV664`' Undersecretary Not valid with o signa ` 460 West Main Street i4o. r Hyannis,MA 02601-3698 r F T (508) 771-5400 F (508)775-7434) Housing r , =on all lines Assistance � unvuf.haconcapecod.rtrg Corporation Cape Cod . .Fret,-::%� Weco-Aheriz t i Ul IC1 Your tenant has requested and is eligible for weatherization,of your rental home through government funding. This will be provided at no cost to you. Program regulations permit us to spend around $4,000- $10,000 in materials and labor per dwelling unit. Program regulations require us to weather-strip and caulk doors and windows; insulate attics, sidewalls and floors. All work is professionally done by established private contractors. We will conduct a final inspection to make sure that all work is completed to specifications. If you request, you will be informed of the estimated measures before they are done and provided with a list of the actual measures and costs following the completion of the work. We also need proof that you own the property. A copy of a CURRENT TAX BILL OR DEED listing you as the owner will satisfy this requirement. Please fill'in all blank areas of the enclosed agreement and return with the proof of ownership as soon as possible. If we do not receive the enclosed form within two weeks, we will do a basic energy audit of the home, but no weatherization work can be recommended or done. ` q If you have any questions please call Ca n at 508-771-5400, ext. +99- 't�i� LANDLORD TENANT 45hefo, PHONE PHONE 77�1 " �' 70e,- '�. TENANT/PROPERTY OWNER/AGENCY WEATHERIZATION AGREEMENT 1. The Parties to this Agrg- meat are the following: e) V IiUi Jl"C (hereafter known as Tenant), (print your tenant's name) (hereafter known as Property Owner) (print your name) nuuS141!. fiS_-i1S Q11CZ -vWf/tifabuil ificircdtlCt ru iowfl aS'Ryieficy J. In consideration of the mutual promises hereafter stated, the Parties agree as follows: 2. The date of Agency's signature will be the effective date of this Agreement_ 3_ Property Owner and Tenant consent and agree that the Agency may do the following with respect to the property located at(street, town) '/IWO / ' unit#�� , and currently leased or rented tot e Tenant: a) Enter the premises for the purpose of performing a Weatherization inspection. b) Enter the premises to perform Weatherization work which the Agency determines in its discretion is necessary and appropriate as a result of the Agency's inspection of the property and in accordance with the appropriate priority list for the type of dwelling_ The Agency and the Agency's contractors may also enter the appropriate common areas of the building for the purpose of accomplishing the Weatherization work. The Agency and representatives of the Commonwealth of Massachusetts, Department of Housing &Community Development(DHCD) may further enter the property to inspect any and all work hereunder. The Agency will provide reasonable notice of the timing of.the Weatherization work and inspections. The Weatherization work will be performed in accordance with the Property Owner's consent as further specified below. ' INITIAL ONLY ONE OF THE FOLt_OW NG*'* I consent to performance by the Agency and its contractors of any Weatherization work determined necessary and appropriate by the Agency as a result of its inspection of the property. i understand that the Agency will provide a detailed statement of the actual work performed and the associated value at the completion of work. i will provide a separate consent to performance by the Agency and its contractors of Weatherization work following my receipt of the Agency s inspection report and a statement of the estimated work and associated value. This additional consent will be sent under separate cover as Attachment A. I understand that the Agency will provide a detailed statement of the actual work performed and the associated value at the completion of the work. 4. The Property Owner understands and agrees that any and all work, including related repairs for which the Property may also be eligible,will be performed at the Agency's discretion. The Agency estimated completion of the Weatherization work by the end of 2012. 5. If the Property Owner is required to make repairs to the property prior to the commencement of Weatherization work by the Agency, the Property Owner will be notified by the Agency and will be required to make the repairs as soon as possible. Except where the Property Owner receives a written extension from the Agency, time is of the essence in the performance of repairs by the Property Owner. 11. For breach of this Agreement by the Property Owner, the Property Owner shall reimburse the Agency in an amount equal to the cost, as certified by the Agency, of the Weatherizabon materials installed and labor performed on the premises, as well as attomey's fee and court costs. The Property Owner may also be liable for damages to the Tenant in accordance with applicable law; in such instance, the Property Owner shall reimburse the Tenant for attorney's fees and court costs. Without limiting the foregoing, the Agency may at its option terminate this Agreement, by providing written notice to the Property Owner and Tenant, in the event of breach by the Property Owner or Tenant. 12. Performance of the Weatherization work hereunder by the Agency is contingent upon the availability of funds to the Agency from the commonwealth of Massachusetts and the federal government, as well as the eligibility of the Tenant under WAP program requirements. The Agency may terminate this Agreement, by providing written notice to the Property Owner and Tenant, if the Agency determines that the unavailability of funds or ineligibility of the Tenant warrants termination_ 13. The Parties acknowledge that this Agreement is under seal. It is intended by the Parties that the Tenant or any successor Tenant is the intended beneficiary of the Agreement and shall have a right of enforcement. _Property Owher"s = ,, ::Signature: Date Phone-- Address: '� BARNSTABI.E HOUSINGAt1fF1O ( Owl Tenant Signature Date Agency Approved Weatherization Company C5 6 ((e, All Ca e Energy Caliber Building & Remodeling Cape Cod Insulation ape Save Frontier Energy Solutions Lohr&Sons Resolution Energy Agency Signature Date I t MI HELE CUDILO, P.E. Consulting Structural Engineer 123 Cottonwood Lane • Centerville, Massachusetts 02632-1979• (508)771-7601 • Fax (508)771-7163 mcudilo@comcast.net i Sea Meadow Village 1 DATE: February 15,2012 720 Pitchers Way i Hyannis, MA 02601 Attention: Ms. Lys Terkelsen � Manager RE: STRUCTURAL REPAIRS to Condominium Unit 41F SEA MEADOW VILLAGE 720 PITCHERS WAY,HYANNIS,MAC i Dear Ms. Terkelsen, i At your prior request, I went to the above captioned project on January 31 and February 10,2012, for the purpose of addressing the structural integrity of the above Residential condominium structure, in particular as related to observed I"floor sags and wall inter5ec,ion ceiling drywall cracks,during current renovation work. The purpose of this report is to list the structural issues of concern with regard to the observed conditions. Other issues are not covered herein. Hidden conditions remain the responsibility of original parties. i Background j The site is located on a relatively flat lotlin a residential inland neighborhood. It is understood that the building was constructed around 1988 as a two story wood framed condominium residence over a partially crawl and full unfinished basement. i h The 1984 building construction plans byVinslow Design Associates,Cambridge, MA and C/BI Chaloff/Barnes Inc. (structural engineers), Boston, MA kere available at the time of our review. We observed the existing main footprint Ifoundation carrying a two-story with attic and stick-framed compound gable-roof building,all wood frame consitruction on poured concrete full and crawl space foundation. Foundation and I"Floor Framing The First floor framing requires reinforcement with a continuous bearing wall constructed with properly fastened connections as shown on SK-1.,4o assure continuous support. Attempting to jack the area to level is recommended. Note that the number of deviations from the construction plans is sufficient to warrant the supplemental support of these continuous foundation supports. 1 There are two sides of the foundation as shown on SIC-2,unfinished foundation and crawl space. The area to be underpinned is in the crawl space. , I " i Continued i i i \_ice' �� i l 'a I i I STRUCTURAL REPAIRS to Condominium Unit 41F SEA MEADOW VILLAGE I 720 PITCHERS WAY, HYANNIS, MA Page 2 I I We discussed the following items: 1. There are wall to ceiling cracks in the architectural finish(drywall)at either the first and/or second floor. 2. The floors are somewhat out of level,as discussed due to inadequate framing of the I"floor span. Conclusions and Recommendations { The above information provides you with1the minimum requirements for maintenance of the structural integrity of the above captioned residential structure,namely reinforcement of the existing wood framing and foundation support below walls above. i i I trust the contents of this report meet yo4 needs at this time. Should you have any y questions, please call. Sincerel Michele Cudilo, P.E. /2012-13 -�N OF MA CUDILO o� MICHELE No.34774 ! STRUCTURAL 9FG:s-Tt �S10N ALA i I I I I I I I I { i f 03/09/2012 12:03 Michele Cudilo, PE N0.846 02 UN IT 4107-0 f :4 -1 f i ►. p _ I ' 0 tN GF� MICNEL CUO&O NO.34774 H STRUCTURAL -�V I C. 3 1 (1464 r/ 1mv i s� PROPOSED REPAIRS MICHELE CUDILO, P.E. Consulting_ Structural Engineer SEA MEADOW VILLAGE W Cottonwood Lane, Centerville. Mcssothuastts 022632 Drawn B : MC Date: 2/13/12 Drawing 720 PITCHERS WAY sco1e: 7AS`N6T Rev. 0 ; HTANNIS, MA 'S K— 2 File Nome:SEAMEADOW Project No.:2012-13 03/09/2012 12:09`r Michele Cudiloy PE NO.846 01 "r0 Z AI fi.•/AIVG/XOOF 4-4 47 A 1%4 OF A1A NtICMELE CUD11.0 No.34"4 S?RUCTURAL PROPOSED REPAIRS MICHELE CUDILO, P.E. eer SEA MEADOW VILLAGE 23°CCottttonwtodd�L.ane,Structural :�Ntl: Massachusetts i n 2 32 Drawn By: MC Date: . 2/t 3/1 2 Drawing 720 PITCHERS WAY Scale; f As Rev. o S�� 1 HYANNIS, MA File Name:SEAMEADOW Project No.:20 t 2—1 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �Wation # r� Health Division ` ( Ca ssued l Conservation Division Application Fe Q� Planning Dept. }r {` ..T.,..ty: Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis f --3 1 /a Project Street Address - _ G�t'"f ADCy -9 *--Own era ra _ .Address-0 �d`��r � U rl lie'phi ne -�---� e sir Sic Flo �i ��r-•� t Sv f �PermifRequest Gi Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay (P_roject_Valuatio-n_55' 7 ) ,6OConstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: _ existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal #_ Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use = Proposed:Use - APPLICANT INFORMATION � ` (BUILDER OR HOMEOWNER) Name r` Z f�U l '" Telephone°Number Address`I k riot 6r4 r, r I&I M . c:Lic # CS - /0 o 3 V Al`� G�(I 3 ,' Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE -,DATE /A 4 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH _ FINAL -FINAL BUILDING s g DATE CLOSED OUT ASSOCIATION PLAN NO. 77te Contndomvealth of Massachusetts Deparhnent of Industrial Accidents Office of Investigations ir 600 Washington Street Boston,ALA 02111 1rivinntass gov/dla Workers' Compensation Insurance.Affidavit: Builders/Conh•actors/Electricians/Plumbers Applicant Information , / / Please Print Legibly Naive(Business/Orgmizetion/Individual): 1/4 a lie+ (A 2 e-k U J.�I JA- a✓bf 6t Z e c u l'�A-d Address: Z 5I / y r Ci��'r► Y/,f /J Cc, 'sL-,4 AC, �- ClWstaWLp: Phone#- 0 f-Y t7-0 ✓-Z%e- Are you an employer?Check the appropriate box: 4. I Type of project.(required): [Ti 1_ am a employer with 6am a general contractor and I 6. Neu,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_ 7_ ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity. employees and have workers' . [No workers'comp_insurance cones_insurance.l 9_ ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3_❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12_❑Roof repairs ur insance required.]i c.152,§1(4),and we have no t employees_[No workers' 13.[Other Y'5r1Q1' comp_insurance required.] *Any applicant that chedks boa#1 tmrst 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 mast submit a new affidavit indicating sudL 'Contractors that check this boot must attached an additional sheet showing the name of the sub-contractors and state whew 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 protdding workers'compensation insurance for my employees. Below is tile.policy and job site information. ]� h Insurance Company Name: '!� �r '�. Policy#or Self-ins.Lic.#: W L - t-"-V — a-0 — 0 6 �� — potion Date: Z ). y i)—d 12 / 2—o c TL, �,,r-S WIC\ 1 Job Site Address: 7 ® /' / City/StatelZip:� vu / Attach a copy of the workers'compensation policy declaration page(showing the policy num er and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under die pains and penalties of perjury Mat tie information protdded above is true a d co rest Si tore: Date: "C / Phone#: Official nse only. Do not write in this area,to be completed by city or town official City or Town: PermidUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityaown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Massachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality 1100144628 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition ImporMen filling out A. Applicability forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not DEP , Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of use the return ( ) tY 9 key. Construction or Demolition operations is required under 310 CMR 7.09(2)ten (10)days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. B. General Project Description 1. a. Is this facility fee exempt-city, town, district, municipal housing authority, owner-occupied Instructions residence of four units or less?❑✓ Yes ❑ No 1.All sections of b. Provide blanket decal number if applicable:this form must be Blanket Decal Number completed in order to comply with the 2. Facility Information: Department of BARNSTABLE HOUSING AUTHORITY Environmental Protection a.Name notification 1720 PITCHER'S WAY BUILDING F-UNIT 1 requirements of b.Address 310 CMR 7.09 H annis MA 02601 c.Citvrrown d.State e.Zip Code 5084205482 f.Tele hone Number area code and extension .E-mail Address(optional) 1020 h.Size of Facility in Square Feet i.Number of Floors j. Was the facility built prior to 1980? ❑ Yes ❑✓ No k. Describe the current or prior use of the facility: HOUSING _ I. Is the facility a residential facility? ❑✓ Yes ❑ No m. If yes, how many units? 1 �o Number of Units �0 3. Facility Owner: -1N BARNSTABLE HOUSING AUTHORITY �o a.Name -0 1146 SOUTH STREET b.Address HYANNIS IMA 102601 �co c.Ci /Town d.State e.Zip Cod 0 15087717222 f.Tele hone Number area code and extension .E-mail Address(ontional a DAVID HEART �Q h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06•Page 1 of 3 f Massachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality 1100144628 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General Statement:If B. General Project Description cont. asbestos is found during a 4. General Contractor: Construction or Demolition JCAZEAULT ROOFING AND REPAIRS operation,all responsible parties a.Name must comply with 1198 FIVE CORNERS ROAD 310 CMR 7.00, b.Address 7.09,7.15,and CENTERVILLE MA 02632 Chapter 21 E of the General Laws of c.Cityaown d.State e.ZiD Code the Commonwealth. 15084205482 This would include, f.Tele hone Number area code and extension .E-mail Address o bonal but would not be limited to,filing an IRICHARD P. CAZEAULT,JR asbestos removal h.On-site Manager Name notification with the Department and/or a notice of release/threat of C. General Construction or Demolition Description release of a hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. . RICHARD P.CAZEAULT,JR. a.Name 198 FIVE CORNERS ROAD b.Address CENTERVILLE MA F02632 c.Ci /Town d.State e.Zip Code f.Telephone Number(area code and extension) g.E-mail Address(optional) RICHARD P. CAZEAULT,JR. h.On-site Manager Name 2. On-Site Supervisor: RICHARD P. CAZEAULT,JR. On-Site Supervisor Name 3. Is the entire facility to be demolished? ® Yes ✓® No �N �0 4. Describe the area(s)to be demolished: �o NONE �O �0 5. If this is a construction project, describe the building(s)or addition(s)to be constructed: RAISE SAGGING FLOOR WITH PERMANENT SUPPORT WALL co a-o �a �Q agO6.doc•10/02 BWP AQ 06•Page 2 of 3- Massachusetts Department of Environmental Protection ■ Bureau of Waste Prevention • Air Quality 1100144628 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project, were the structure(s)surveyed for the presence of asbestos containing material (ACM)? ❑ Yes ❑✓ No If yes, who conducted the survey? b.Survevor Name c.Division of Occupational Safety Certification Number 3/20/2012 3/20/2012 7. Construction Or Demolition: a.Start Date(mmldd/yyyy) b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving❑ wetting ❑ shrouding b. If other, please specify: ❑ covering ❑✓ other NONE USED AS NO DEMOLITION TOOK PLACE 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? N/A a.Name of DEP Official N/A b.Title 3/1912012 c.Date(mm/dd of Authorization N/A d.DEP Waiver Number D. Certification I certify that I have examined the IRICHARD P.CAZEAULT,JR. 0o above and that to the best of my a.Print Name �o knowledge it is true and complete. lRichard P.Cazeault,Jr. The signature below subjects the b.Authorized Signature N signer to the general statutes OWNER �o regarding a false and misleading c.Position/Title �0 statement(s). IBARNSTABLE HOUSING AUTHORITY d.Representing 3/19/2012 (D e.Date(mm/dd/yyyy) �o �d �Q ■ ag06.doc 10/02 BWP AQ 06•Page 3 of 3■ IM Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supers isor ' License: CS-100393 P f TTs �� a RICHARD P CA'LEAIJL-T JR 198 FIVE COPM-- RD CENTERVII3LE 1VIA 02632 •i, a`-. a Expiration Commissioner .02/0312014 » BnnxsTnaIX MAW �, Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property'Owner Must Complete and Sign This Section If Using A Builder 1, U, 14 1,l fb �Y� ' ,as Owner of the subject property hereby authorize 0�`iC4arc` �4 7 t 1 11 ,J to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) J Signature of Owner Date Print ame If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 L] Barnstable Telephone 508.771.7222 HousingAuthorityFAX: 508.778.9312 TDD/TTY: 508-778-5333 146 South Street•Hyannis,MA 02601 March 19, 2012 Mr. Thomas Perry, Building Commissioner Town of Barnstable 200 Main Street Hyannis,MA 02601 Dear Mr. Perry: Barnstable Housing Authorizing(BHA)hereby authorizes Cazeault Roofmg&Repairs to complete floor repair work on the BHA owned unit 41F which is located at Sea Meadow Village, 720 Pitcher's Way, Hyannis, MA 02601. Sincerely, Sandra Perry Executive Director MICHELE CUDILO, P.E. Consiulting Structural Engineer 123 Cottonw ood Lane• Centerville,Massachusetts 02632-1979•(508) 771-7601 Fax (508) 771-7163 mcudilo@comcast.net DATE: February 15. 2012 Sea Meadow Village 720 Pitchers Way Hyannis. MA 02601 Attention: Ms. Lys Terkelsen Manager ` RE: STRUCTURAL REPAIRS to Condominium Unit 41F SEA MEADOW VILLAGE 720 PITCHERS WAY,HYANNIS,MA Dear Ms.Terkelsen, At your prior request, I went to the above captioned project on January 31 and February 10, 2012. for the purpose of addressing the structural integrity of the above Residential condominium structure, in particular as related to observed I"floor sags and wall intersection ceiling drywall cracks,during current renovation work. The purpose of this report is to list the structural issues of concern with regard to the observed conditions. Other issues are not covered herein. Hidden conditions remain the responsibility of original parties. Background The site is located on a relatively flat lot in a residential inland neighborhood. It is understood that the building was constructed around 1988 as a two story wood framed condominium residence over a partially crawl and full unfinished basement. The 1984 building construction plans by Winslow Design Associates,Cambridge, MA and C/BI Chaioff/ Barnes Inc.(structural engineers), Boston, MA Were available at the time of our review. We observed the existing main foatprinf;foundation carrying a two-story with attic and stick-framed compound gable-roof building,all wood frame construction on poured concrete full and crawl space foundation. cl Foundation and 0 Floor Framing continuous bearing The First floor framing requires remr rc ent w th support. Attempting toljack the area toale el is recomsmended. connections as shown on SK , to Note that the number of deviations from the construction plans is sufficient to warrant the supplemental support o these continuous foundation supports. unfinished foundation and crawl space. The area to be There are two sides of the foundation as shown on SK-2, underpinned is in the crawl space. Continued 'a i i STRUCTURAL REPAIRS to Condominium Unit 41F SEA MEADOW VILLAGE 720 PITCHERS WAY,HYANNIS,MA Page 2 We discussed the following items: 1. There are wall to ceiling cracks in the architectural finish(drywall)at either the first and/or secogd floor. 2. The floors are somewhat out of bevel,as discussed due to inadequate framing of the 1"floor span. Conclusions and Recommendations The above information provides you withlthe minimum requirements for maintenance of the structural integrity of the above captioned residential structure,'namely reinforcement of the existing wood framing and foundation support below walls above. i I trust the contents of this report meet you needs at this time. Should you have any questions, please call. Sincerel , Michele Cudilo, P.E. /2012-13 JNOFA-141, S MICHELE ° No.3477 I: U 11 STRUCTURAL. , ��10NAL F i I j i i ! f I i 7o �L �14---C u T!�)W�l I i • ����H O F M,a SS9 O I MiICH LE tiG� CUDILO ° N0.34774 u STRUCTURAL �Q a° I 'FWMbWCj C;V. 7 .S..-rr it . .. t�(s-)A,5 gel`'D, PROPOSED REPAIRS MICHELE CUDILO, P.E. Consulting Structural Engineer SEA MEADOW VILLAGE 123 Cottonwood Lane, Centerville, Massachusetts 02632 Drawn By: MC Date: 2/13/12 Drawing, "720 PITCHERS ,\ (/D n Scale: 2 AS NOftD` Rev. 0 HYANNIS, MA U-' S K- 1 File Name:SEAMEADOW Project No.:2012-13 i i UN IT 41 RIK I , ' rl, 3 -.10 to k_ q I I i i � . .� .� ° OF MgSS cy S MICHELE CUDILO a 00 N0. 34774 u i STRUCTURAL Inl c�tnl �Y 19a / v' $ PROPOSED REPAIRS MICHELE CUDILO, P.E. Consulting Structural Engineer SEA MEADOW VILLAGE 123 -Cottonwood Lane, Centerville, Massachusetts 02632 Drown By: MC Date: 2/13/12 Drawing 720 PITCHERS WAXY (o scale: 'AS N o Rev. 0 �J - HtANNI'S, MA S K 2 File Name:SEAMEADOW :Project No.:2012-13 E� 7C-VMr,1 W r�-cr._-�'�T�� /i Vd- - x ^lro� .rl l � -- ._�7�_`_i'�_�-�p NbF L..V-..�''�.�_CX _OTn.�.���•1 �VjN OF SS o`er MICHELE y�N CUDILO a U No.34774 i STRUCTURAL AL I � 2x (,2. @ Fc Hb.IhJ.q :Gv... . �. s-6v1 7" ��1/� l PROPOSED REPAIRS- MICHELE CUDILO, P.E. Consulting Structural Engineer SEA MEADOW VILLAGE 123 Cottonwood Lane, Centerville, Massachusetts 02632 Drawn By: MC Date: 2/13/12 Drawing 720 PITCHERS WAY Scale:V2 A NO D Rev. 0 HYANNIS, MA S K- 1 ' File Nome:SEAMEADOW Project No.:2012-13 UN If 4 i ° °Ln z:;t 1441 3-2x10 (S .I 0 I 0 0 SN OF^4S6 a� MICHELE yGN CUDtLO a O No,34774 en U STRUCTURAL Q. LAA-s -r�'V I 9FGlS'i��FO l PROPOSED REPAIRS MICHELE CUDILO, P.E. Consulting Structural Engineer SEA MEADOW VILLAGE 123 Cottonwood Lane, Centerville,Massachusetts 02632 Drawn By: MC Date: 2/13/12 Drawing 720 PITCHERS WAY Scale: 3 AS N6TED Rev. 0 HI'ANNIS, MA S K- File Name:SEAMEADOW Project No.:2012-13 MIjCHELE CUDILO, P.E. Consiulting Structural Engineer 123 Cottonwood Lane• Centerville, Massachusetts 02632-1979•(508)771-7601 • Fax (508) 771-7163 mcudilo@comcast.net DATE: February 15, 2012 Sea Meadow Village 720 Pitchers Way Hyannis, MA 02601 Attention: Ms. Lys Terkelsen Manager RE: STRUCTURAL REPAIRS to Condominium Unit 41F SEA MEADOW VILLAGE 720 PITCHERS WAY,HYANNIS,MA Dear Ms.Terkelsen, At your prior request, I went to the above captioned project on January 31 and February 10,2012.for the purpose of addressing the structural integrity of the above Residential condominium structure, in particular as related to observed I"floor sags and wall intersbction ceiling drywall cracks,during current renovation work. The purpose of this report is to list the structural issues of concern with regard to the observed conditions. Other issues are not covered herein. Hidden conditions remain the responsibility of original parties. Background The site is located on a relatively flat lotIn a residential inland neighborhood. It is understood that the building was constructed around 1988 as a two story wood framed condominium residence over a partially crawl and full unfinished basement. The 1984 building construction plans byWinslow Design Associates,Cambridge,MA and C/BI Chaloff./Barnes Inc.(structural engineers), Boston, MA were available at the tirYie of our review. We observed the existing main footprintfoundation carrying a two-story with attic and stick-framed compound gable-roof building,all wood frame construction on poured concrete full and crawl space foundation. Foundation and 0 Floor Framing The First floor framing requires reinforcement with a continuous bearing wall constructed with properly fastened connections as shown on SK-1,to assure,,continuous support. Attempting to jack the area to level is recommended. Note that the number of deviations from the construction plans is sufficient to warrant the supplemental support of these continuous foundation supports. There are two sides of the foundation as shown on SK-2,unfinished foundation and crawl space. The area to be underpinned is in the crawl space. Continued STRUCTURAL REPAIRS to Condo"inium Unit 41F SEA MEADOW VILLAGE 720 PITCHERS WAY,HYANNIS,MA Page 2 We discussed the following items: 1. There are wall to ceiling cracks in the architectural finish(drywall)at either the first and/or second floor. 2. The floors are somewhat out of+evel,as discussed due to inadequate framing of the I"floor span. Conclusions and Recommendations The above information provides you with!the minimum requirements for maintenance of the structural integrity of the above captioned residential structure,namely reinforcement of the existing wood framing and foundation support below walls above. 1 trust the contents of this report meet yout needs at this time. Should you have any questions, please call. Sincerel Michele Cudilo, P.E. /2012-13 SN OF Mq o� MICHELE y6 `T CUDILO i 'Ti " PIo.34774 U STRUCTUR�L. ' �T v ONA �. I ' i i i f 03/09/2012 12:09 Michele Cudilo, PE N0.846 02 UN iT 41 F, , ° 0 � I r•. i t p — o Io I I I g � �— •.I i(1 2e.10 _ ' f - ti � • � t l• � I f \ I-- IL__ o ��,►of MLCNEL11 CUoA No.SM4 STRUCTURAL. *S-,bV14T � 1st �Y 19s4 w 1v s 1 PROPOSED ]REPAIRS MICHELE CUDILO, P.E. SEA MEADOW VILLAGE Consmwoo Structural Engineer 123 cottonwood Lane, Centervin.. Maeeocnusetta 02832 Drawn : MC Dote: 2/13/12 Drawing 720 PITCHERS WAY saole; 'As`N6 Rev. 0 ; . S K- 2 HTANNIS, MA File Nome:SEAMI;J►OOW Project No.:2012-13 03/09/2012 12: 09 Nichele Cudilo, PE NO. 846 01 -To Z Ato f:�, `AIVC/(LDOF t a a �tN OF A61 MICHELE CUDILO No.34714 $tAUCTURAL �'FcirST�ir' As AD - -aut 1-T PROPOSED REPAIRS MICHELE CUDIL09 P.E. Consulting Structural Enqineer SEA MEADOW VILLAGE 123 Cottonwood Lone, Centerville, Maeeachusetts 02632 Drawn By: MC Date: . 2/13/12 Drawing 720 PITCHERS WAY Scale: f- As AAD Rev. 0 S _ 1 HYANNIS, MA File Nome:SEAMEADOW Project No.:2012-13 Town of Barnstable Geographic Information System March 19, 2012 271030 m 271109 �#440 271118) s 271025 :#183 f �� #176 #1171 , #433 271031 271036 434 #1911 #186 y 293001 _ 4 #382 271160 271032003 271116 271108 #805 �� 4426 #199 aV #,194 A AZV Q1 C� 271237 271032002 #205 #2oz TH Ra 1 RTC #416 271114 271159 FAL O U 271148 292092 #213Y 271106 #791 �x #4r #445 #210 271 040 00 1 271147 JJ #9292091 #2213� 27�1105 2711�9 #46 040002 271032001 #220 271#6 271146 #�#398 271112 271044 2#22 #766 271040004 �#22 . #16' 271145Y 292209 271049001: 271133 #7614 + ` #29�/ Q R #71'� #4 #619 271043 qg 292210 271104 j #577 271040006 26 Airi 271151 #63 271064 #9 ,271049002 ` # 271144 34 292090 292089 #2191 #362 #12 271186 271185 1 1CND #41 $#7 #63 271103Y pR '#201 (k8l 720 271040008 2 2r922216 #19 E7 271187 ^^# v �:4 292212 271152 2710651 27106� 2#202� #22 WV1ES pJVC1R 27711#040009 #50 ja 292217 Q weo # #360 #27 271184 '" 271143 #17 922 6 5 -192 214 ew 27111- - •. #571 g #16 292213 271051 2#25 "� 27118 #11_ #731► 27#040 all d'� #39 271061 #34 #17 t1, #37A3 •• n 271183 271040012 271142 271153 �. y4N 271192 271191 #721 #56 #49 v# 292218 era._ 292222 ♦ 271193 #20� -�— #691 4 #46 � 0" .•— - � m #39- '292288 29219 4 271052 271194 #40 271060 0 #50- #46 WAYLAND Rn ' 27#t?44 0 4' Y p 271154 ' #17- 292220 #55 Q 271141 *#74 292297 #7 292087 • 271 182 #7W #128 #56 271215 #71� S 271053 • 27121�6c, #4 271445 271155 292298 ... 271124 #56 t 2771195 �# 1 #31 V #702® 271040015 AF#82 #122 292002 2920030J0�1 t #63 f� v' _ #78 271140 #129 #67 292003022 4 271054 O 271214 271181 271040016 �I # zj #7� #68 271217 701 �-..#80.. ® 271156 2#71�� +�O 271196 271230 #13 C 271175 92 271102 #62] #59 �� �9% 292003002 #72 � 271218 �- 271173 271139 #77 271213 A 271176 #684 #101 292296. # 2 #2611 #681 $',J 4 271157 #107 • 292003020 271058 271101 271197 229 #102 292299 y #46 #77 �, 27677 #108 292295 292003003 #78 #7 �#69 ro #678Q 2#373 271212 � 271138 41, #101 #8g v 1 e e t71198 271228 #. 271177 34 #1W13 #m 6 292294 QW 27W057 e v$1 p 27122D #�9 271172 #116 292003004 292003005 4.,�.../ # 9 #45 #670 m #95 #101 #45 "`- DISCLAIMERS:This map is for planning purposes only. tt is not adequate for legal Map:271 Parcel'04100A a boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel 1"=100'may not meet established ma accuracy standards. The Owner:LAKE,HOWARD&PATRICIA Total Assessed Value:$138300 y p y parcel lines on this map I(� are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:0 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:720 PITCHER'S WAY l such as building locations. Buffer PROJECT C�o S NAME: � '� ADDRESS: --72c� Cl, PERMIT# PERMIT DATE: M/P LARGE ROLLED PLANS ARE IN: BOX C SLOT .Data entered in MAPS program on: -a a � BY: I I ,f Sea Meadow Village Condominium Association 720 Pitchers Way Hyannis MA 02601 TO: Town of Barnstable Regulatory Services ATT: Thomas Perry DATE: February 7,2012 RE: Unit 41F.@ 720 Pitchers Way,Hyannis MA With regards to your letter dated 1/25/12,we have contracted the services of Michele Cudilo, P.E., a consulting structural engineer.- We have met twice with her identifying the area of concern and have in our hands the original architectRral/structural drawings for Building F. Our next step is to take this i information an&,once again look at the issues of the floor system and other factors which might be contributing to the problem. Hopefully,we will have some definitive answers and an acceptable way to correct the problem some time next week. We will be in touch as soon as Michelle has given us her evaluation. Regards, ^ i0t, / Lys Terkelsen Manager = ' cc: Michelle Cudilo, P.f. Paul Carlson, Chairman Sandee Perry, BHA i 'a CASE Document 1-1996 An Agreement for the Provision of Limited Professional Services Prepared by.the Council of American Structural Engineers , Structural Engineer(SE): �� f Michele Cudilo;P:E Y { �- ;. 23 Cottonwood Lane �4 Dom: w 1 .. `, 3 f'.. Centerville MA 02632-1979 .=.(508)771-7601 voice voice: , (508)771-7163 fax fax: mcudilo@comcast.net email: I Project No.: Date: 1 Project Name: Verify Existing Conditions Location: b Li /A v F (0,0 T— Scope of Services: A site observation and/or drawing review of existing conditions will be performed to determine the adequacy of the existing structural components. Structural modifications'will be proposed,with a letter to approval authorities and engineering working drawing(s)as documentation,as required. Fee Arrangement:.Time charges.as-listed. ;. [Minimum charge=$640] Principals $_160_/Hr. Sr. AutoCAD $ 80 /Hr., Engineers $ /Hr. Clerical "`'$ /Hr. Retainer Amount: / Special Conditions:The Client will supply all background site and/or building drawings available at the start of project review. Offered by(SE): Accepted by(Client): (signature) 1 (signature) (date) 7ichjele Cudilo,PE,Principal (printed name/title) (printed name/title) - r The'terms and conditions on the reverse of this �' _. s;• Form are part.of this Agreement. s 2y,. .'c' ti' _, ;CASE Council of American Structural Engineers 1015 Fifteenth Street,N.W., Suite 802,Washington, D.C. 20005 202-347-7474 p • a Terms and Conditions , Structural.Engine er,(SE)shall perform the.services outlined in this agreement for the stated fee arrangement. Fee .� ,::' >. � t: .. . :."' • .:, t ;; , ThCtotal fee,except stated lump sum,shall be understood to be an estimate,based upon Scope of Services,and shall not`be'exceeded=by:more than ten percent,without-written approval of the'Chent. "ere the fee'arrangement is to be on'air hourly basis.;the rates shall be those that prevail at the time services are,reridered o s ^� +• ' Ile Billings/Payments ` Invoices will be submitted monthly for services and reimbursable expenses-and.are due when rendered. Invoice PAST DUE if not aid within 30 days after the invoice date and the SE may,without waiving considered P shall be co any claim or right against Client,and without liability whatsoever to the Client,terminate the performance of the service. Retainers shall be.credited on the final invoice. A service charge will be charged at 1.5%(or the legal rate) per month on the unpaid balance. In the event any portion of an account remains unpaid 90 days after billing, the Client shall pay cost of collection,including reasonable attorneys'fees. Access To Site Unless otherwise stated,the SE will have access to the site for activities necessary for the performance of the services. The SE will take precautions to minimize damage due to these activities,but has not included in the fee the cost of restoration of any resulting damage. Hidden Conditions and Hazardous Materials A structural condition is hidden if concealed by existing finishes or if it cannot be investigated by reasonable visual observation. If the SE has reason to believe that such a condition may exist,the SE shall notify the Client who shall authorize and pay for all costs associated with the investigation of such a condition and, if necessary, all costs necessary to correct said condition. If(1)the Client fails to authorize such investigation or correction after due notification,or(2)the SE has no reason to believe that such a condition exists,the Client is responsible for all risks associated with this condition,and the SE shall not be responsible for the existing condition nor any resulting damages to persons or property. SE shall have,no.responsibility for the discovery,presence,handling, removal, disposal or exposure of persons to hazardous materials of any form. Indemnifications The Client shall indemnify and hold harmless the SE and all of its personnel from and against any and all claims, damages,losses and expenses(including reasonable attorneys fees)arising out of or resulting from the performance damage,loss or expense is caused in whole or in part by the negligent such claims of the services,provided that any g act or omission and/or strict liability of the Client,anyone directly or indirectly employed by the Client(except the SE)or anyone for whose acts any of them may be liable. This indeminfication shall include any claim, damage or losses due to the presence of hazardous materials. Risk Allocation In recognition of the relative risks. rewards and benefits of the project to both the Client and the SE,the risks have been allocated so that the Client agrees that,to the fullest extent permitted by law,the SE's total liability to the Client,for any and all injuries,claims,losses,expenses,damages or claim expenses arising out of this agreement, from any cause or causes. shall not exceed the total amount of$50,000, the amount of the SE's fee(whichever is greater)or other amount agreed upon when added under Special Conditions. Such causes include,but are not limited to,the SE's negligence,errors, omissions, strict liability,breach of contract or breach of warranty. zTermination of Services, .� This agreement may be terminated upon 10 days written notice by either party should the other fail to perform Yus obligations hereunder. In the event of termination,the Client shall pay the SE for all services rendered to the date of termination,all reimbursable expenses,and reasonable termination expenses. Ownership Documents All documents produced by the SE under this agreement shall remain the property of the SE and may not be used by the Client for any other endeavor without the written consent of the SE. Dispute Resolution Any claim or dispute between the Client and the SE shall be submitted to non-binding mediation, subject to the parties agreeing to a mediator(s). This agreement shall be governed by the laws of the principal place.of business of the SE. CASE Council of American Structural Engineers 1015 Fifteenth Street,N.W., Suite 802,Washington,D.C. 20005 202-347-7474 Town of Barnstable Regulatory Services Mass. Thomas F. Geil er,Director. 1e39. Building Division FD MA'S Thomas Perry, CBO 1 Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us i Office: 508-862,4038 Fax: 508-790-6230 January 25,2012 t Barnstable Housing Authority 146 South Street Hyannis, MA 02601 To Whom It May Concern: Recently I was requested to view a problem located below unit 41 F in the.Sea Meadow Condominium Complex 720 Pitchers Way,Hyannis. There appears to be an issue with the supports of the floor system causing a sag to develop in this area. In order for this to be resolved a structural engineer must be contacted to design an acceptable way to correct this situation. This must be resolved by February 15,2012. Respectfully omas Perry, CBO Building Commissioner M1 j TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION I Application # OQ A lb— CC Map Parcel pp Health Division Date Issued A � Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address a akem Village 1^S Owner /�� ' Address o e!"S Telephone O a 30,�' Permit Request 21A, 1l7 /V Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type_ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's,--Highway: Q Ye!❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ OtherCM > Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft�' v Number of Baths: Full: existing new Half: existing n Number of Bedrooms: existing _new rn Total Room Count (not including baths): existing new First Floor Rooms Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION f 01142p/ (BUILDER OR HOMEOWNER)Name �'S� Telephone Number Address W J 4A OV✓ ( �'/ License # 7001?7 c) d r Home Improvement Contractor# Worker's Compensation # IJ Uor), 015)'o ALL CONSTR CTION DEBRIS RESULTING OM THIS PROJECT WIJETAKENTO JAI � SIGNATURE DATE w ti FOR OFFICIAL USE ONLY APPLICATION# f k f. DATE ISSUED MAP/PARCEL NO. . ADDRESS VILLAGE OWNER t _ DATE OF INSPECTION: s , R FOUNDATION' FRAME _ INSULATION' r '� FIREPLACE r t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH,-,- - FINAL ;aFINAL BUILDING 4_ 'z DATE CLOSED OUT ASSOCIATION PLAN NO. r The Common-iroalth of Massachuseft Ri rie aflurust 'Aert deef� i fie of Iff twitwfions , 600 washb on Street Boslona MA 02111 rr:mass-goWdia Porkers' Compensation Insurance Affidavit: Bu-ilderdCoutractors[Elec-tridawfflbuiibers A Kcant Information. Please Print Lq&ly QtYlStatelz,iPAj,%dJj,c o cl 3 Pholle fie— CI O 01-1 Are:Y'n ennpiny�er?Check the ap riate box: ype ofX -eat � _ 1. I a l �4. ❑ I am a mil.cortlactar and.I � ��9 ❑ 'gip 1o�es(fuH mi&w pat-dme)-� have homed ssub-C taact s di_ ❑ ctt�n 2.9 I am a robe pruoeior or listed an the attached sheet- 7- F3"R"w"efimg ft an hagre no empltyees These sub-noaftsci re S. ❑Demafition. employees and have woders' �rood<irg for env in any capacity. 9._ ❑B, g adffltiten [Novaodws' cep.iommmme 'GOi P.inm manro,t H1 ] 5. ❑ We are a cwponutim and its 11,0'.❑Ptes&al repairs or,addihow 3.❑ I an a homeowner daft all work 'Qfkms have exerrased tbeir 11_❑Plmnbing Mp ffi s or.addhimm myseX[No weders' cep- rightof exemption Per IM GL 1:I.❑Roof repaiQs rtnmunnca,regnimd-]t iL 15,2,.§lQtX and we have no ,ems- o.warkerV 1.I_❑'Mer ,comp,inmmsnre required.] •tom agpPirraat flm dboas boa Al�zha£iD autdha u g.t � °z=pm= an pdi� n6 t �snbadt tin a t g:tbay.a,®ddmg&Uwad md1&umhim auhkb cuataalm mEst mbsme a.=wafr hWkatmS sue. $Cmumam d at absl lbs box—st awrhad an a&ff eng sbsat s='mg ianamc of tha nuts-off and -w aw*vw boa hra wWbyQ9&ntha hmn amplop a tt4Qyn tpmvUa66m uw&w'cosap.Polar c=ahiU -- -- --- -- - ------- — --------- - ---- ---- -- ---- -- ------- I am are amp r t hr pro awlm'co My a B',alo"a&ff.pv&y nerd job spa Insurance � Nam- �� �U �` p� C ✓� Pot #w Sell:-ins.Lac.#: 1, 0 ® Hq D&T2: fob Site Ad&ess: �,o 1 ��S .V V f} C hY..P.St"elzip: �/1/'✓V s ,�/J-'�' Attach a cap3 of the pOcy d , fhwn age(slhuerh g the po&y n= r and k6mfim abate`)_ F-sihue to secure coverage as requEmdrundher Sedan 25A of MG c- 152 can lead to Ike imposition of penaltaes of a. Sae up to$1,50Q00.andfor one-year imprisomment,as we V as civil penalmes.ha the form of a STOP WORK ORDER and a fme of up to$250-00 a dap sgaiw the violator_ Be advised that a icopy*of thin nau mat may be forwarded to The Office of of the DIA for insurance cosrEmp vedfwzda& I do Jit►. eky &a pmw ed.above.is tto Si tartae: Date: � 7w' Rhone N Q#Wd nstr .Do Beatwke in Ak area,to be completed',by efry or.t'om.qpdd City or Town: Permit'r c mse il Issuing.Authority(three one): I L:Board ofHeaft Z.Building Department 3_Cdv ftv Cterk 4.1leckkil InspKtor S.Plumtrieg Iuve+cter � er Contact Persian: Phone p: 08/05/2011 10:25 FAX 5087714417 SEA-MEADOW VILLAGE CONDO IA002/002 F ` Sea Meadow Village Condominium Association August 5, 2011 Re: Replacement Windows - Unit A7 located at the above address Approval given for Samir Mossaa to contract Mr.Joseph Duarte for the installation of 6100 Series vinyl windows in Unit A 7 located at Sea Meadow Village Condominiums. If you should have any concerns or questions, please do to hesitate to call me. Lys Terkelsen Resident Manager Tel: (508)771-2063 Fax: (508)771-4417 siet I N—Overizon.net "� DI.TE tMM1DOlYtiM'1 CORD" CERTIFICATE OF LIABILITY INSURANCE 03/'23/20 a �,•PYtODUCER 508.295.4440 FAX 508.295.5864 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Paul B. Sullivan Insurance Agency Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2$70 Cranberry Highway HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Y 9 Y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 551 East Wareham, MA OZ538 INSURERS AFFORDING COVERAGE NAIC# INSURED l $I 7 Remodeling INSURERA: Vermont Mutual Insurance Co. 26018 15 Wilson Way INSURER B: Middleborough, MA 02346 INSURERC: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH. POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR rTYPE OF INSURANCE POLICY NUMBER DATE MhVDDIYYYY ION DATE MM.IDD!YYYY LIMITS GENERAL LIABILITY BP11020520 03/22/2011 03/22/2012 EACH OCCURRENCE S 1,000,00 X COMMERCIAL GENERAL LIABILITY PREMISES Ee occurrence $ 501 00 CLAIMS MADE OCCUR MED EXP(Any one person) $ S,00 A PERSONAL$AOV INJURY S .1,006,000 GENERAL AGGREGATE $ 2-,000,00 GEN'L AGGREGATE LIMIT APPLIESPER: PRODUCTS-COMP/OPAGG $ 2,000,000 PDLICY Ea LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANC AUTO (Ea acddenti ALL OWNED AUTOS BODILY INJURY $ S:;HEDULEDAUTOS (Per Person HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Pei,acddem) $ PROPERTY DAMAGE (Peracdden:) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ AN"AUTO OTHERTFIAN EA ACC S. AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAINS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATIONIAIU AND EMPLOYERS'LIABILITY YIN TORV LIMITS ER ANY PROPRIETORIPARTNERIEXECUTIVE� E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L_DISEASE-EA EMPLOYE $ H yyes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT '$ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS HD At Home Services, Inc and the Home Depot are included as additional insureds ith respects to general liability linsurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN THD At Home Services, Inc. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE T00080SHALL 3200 Cobb Gal l eri a Parkway IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Suite 200 REPRESENTATIVES. Atlanta, GA 30339 AUTHORIZED REPRESENTATIVE ,o Edward Sullivan/MARIE ACORD 25(2009101) FAX: 508.7S6.8823 ©1988.2009 ACORD CORPORATION. All.rights reserved. The.ACORD name and logo are registered marks of ACORD �i office of Consumer Affairs and usiness Regulation '31 10 Park Plan - Suite 5170 Boston, Massachusetts 02116 Nome Improvement C!�x,tfactor Registratiotl. Registration: 132349 '-: .: ;, Type: Partnership .,Jr Expiration: 1/1112013 Tr# 207392 J & J Remodeling ...�m_- Joseph Duarte 15 Fall St. ------ Wareham, ma 02571 card.Mark reason for change- Update Address and return Address M Renewal ❑ Employment )Lost Card )PS•CAi A 60M-04I04-Qt01216 —T �„ License or registration valid for individul use only Ot6ce o oasum s rs sores egu a on before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Offlee of Consumer Affairs and Business Regulation Registration: •132349 TYpe' Partnership 10 park Plaza-Suite 5170 vjqrmrodeling�: Expiration: :�1t1/2013 p Boston,MA 02116 Joseph Duarte 15 Fall St. ?:. '.:..• ���s.�x,��_s� _ d__. - Wareham,rna 02571 Undersecretary of v d without signature %la.:achusett•- Dep.trtmcnt of Puh"C N:tfcq ! Board of Buildimu' Rr"Iul:ttiuns:tad titandurd� Construction Supervisor License incense: CS 70077 JOSEPH C DUARTE 15 FALL ST WAREHAM,MA 02571 • �; _ Expiration: 12130/2012 Tr#: 7048 (�annd.�io�ul' TO 39dd Z9L696Z ES:ZZ ZZOZ/ZO/ZO TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map c I Parcel Application : mo 7� Health'Division Date Issued Conservation Division Application Fee2;��t Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 7 0'0 Village Alq/v-/V,� MA, 01 Ca Owner I A AIA �Q i 1Y1 Address Telephone So l r Permit Request No �N P Square feet: 1 st floor: existing proposed 2nd floor: existing - proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Rep Line44 w;W'0aw. Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: . Zoning Board of Appeals Aut orization ❑ Appeal # Recorded ❑ � Commercial ❑Yes No If yes, site plan review# - i Current Use Proposed Use T APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name #n Z e✓V i rW0 Telephone Number Address Vs cre-elv C oew s� . License# C) �1 ,Ir _ 7 Home Improvement Contractor# 1�j-5 �j Worker's Compensation # P1� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS OJECT WILL BE TAKEN TO IGNATUR DATE �� d r rr s FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ,w MAP/PARCEL NO. ADDRESS VILLAGE OWNER'- DATE OFINSPECTION: FOUNDATION ,1 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r l PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r s FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information � Please Print Legibly Name (Business/Organization/Individual): _ c T)ry v7lw-- Address: v La . tl_)cu. /� f 3 5 3 , Phone #: " 6:J l ' �� 2- City/State/Zip: �I. G/ �, k�dT ' �� A ou an employer?Check the appropriate b Type of project(required): 1. I am a employer with _ 4. . I am a general contractor and I employees(full and/or part-time) have hired the sub-contractors .* 6. ❑N construction 2.❑ 1 am a sole proprietor or partner- ship and haveno listed on the attached sheet. 7. Remodeling -- ..employees--- -- - These sub--contractors have- g..Q Demolition working for me in any capacity. employees and have workers' 9 Q Building addition [No workers' comp. insurance comp. insurance.t required.] 5. Q We are a corporation and its 10.❑Electrical repairs or additions 3.Q I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12.Q Roof repairs, insurance required.]t c. 152, §1(4),and we have no 13.R Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit.indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet 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 thepolicy and job site information. Insurance Company Name: ZZ U,6 eW3 S ` Policy#or Self-ins.Lic.#: J_ 1� 6 l l Expiration Date: -3�� 1 7 l Job Site Address:< s Vv City/State/Zip: Attach a copy of the workers' compensation olicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coves e verification. I do hereby certi he pains and penalties of perjury that the information provided above is true and c rect. 'L Date: Signature: Phone# i �p � - /V r0fJficialuseonly. Do not write in this area, to be completed by city or town officialn: Permit/License# Issuing Athority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#: Contact Person: I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �' e /� 'e�El NO Address: UVW1 15 , City/State/Zip: W, Y_!n2f) /�/I Q2(2?Phone.#: �50�- Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑N construction 6ployees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions . myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the subcontractors 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. �w. Insurance Company Name: W . Policy#or Self-ins.Lic.#: 0 c 3 Expiration Date: Job Site Address: d�o 04e ' ' (r�fT City/State/Zip: ti•�4 /64. Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify er the ains and pe ald s o perjury that the information provided above is true and correct. Signature: Date: _ Phone#:ff 0 Off use only. Do not write in this area,to be completed by city or town official / City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a.deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwellinghouse of another who employs ersons to do maintenance construction or repair work on such dwelling house P � P or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related 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. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 0.2111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax##617-727-7749 Revised 11-22-06 vAm.mass.gov/dia _. l;o.ii d of Iiuil� ng R gul ltians rnd Standards HOME IPAPRO'JENIEY\l'f CONTRACTOR Registration: 1�,3140 Expiration: '.0/31/2010 Tr# 278191 Type: DSA NU-VISIO,•i INSTALL A T IONS STEPHEN RESTAINO 32 OVAL DRIVE WEST YARMOUTH, MA 02673 Administrator License or r•e&,tration valid for-individui use only b-,fore the expiration date. If found return to: Board of Pailding Regulations and Standards One Ashburton Place Rm 1301 Boston, Nla. 02108 Not valid without signature . Boa,i-d {)t uJ di��� t�,jida 10111 t o 1 ?„ Lf v�:� . r. ✓al ..�. pe Sd ':c.3�� � ,It i �f License: ' -CS SL .. 995. 60 r Restricted to:_ W5 x' car�rafiw�, zr� STEPHEN ' RESTAINO x� r 32 OVAL DRIVE WEST YARMOUTH M.A 0 3 Expiration 1 /2212012 li Tr X 99560 v; i&6 . o `� � O `� � �� � M �' '� �� F ACORD,M CERTIFICATE OF LIABILITY INSURANCE D2/20ATE IDDlYYYY, 02/20/09 PRODUCER 1-409-995-3000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR homedepot.certrequest@marsh.com ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3475 Piedmont Rd NE, Suite 1200 Atlanta, GA 30305 iNSURERSAFFORDINGCOVERAGE NAIC# Fax (212) 948-0902 INSURED INSURERA:Ste3dfa9t Ins Cc '226387 THD At-Home Services, Inc. 16535 wSURERO:Zurich American Ins Co 2690 Cumberland Parkway INSURERC:NATIONAL UNION FIRE INS CO OF PITTS 19445 Suite 300 23841 Atlanta GA 30339 INSURERD:New Hampshire Ins Co INSURER E:Illinois Natl Ins Co 23817 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR OD' POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR N RD POLICY NUMBER DATE(MMIDOffYI DATE MMIDD A GENERALLIABILITY IPR 3757 608-02 03/01/09 03/01/10 EACH OCCURRENCE $4,000,000 DAMAGE OR N 0 $1,000,000 X COMMERCIAL GENERAL LIABILITY LIMITS OF POLICY ARE EXC SS PREMISES Eaoccurence CLAIMS MADE aOCCUR "OF SIR: $1,000,000 PER CC" MEOEXP(Any one person) $EXCLUDED PERSONALBADVINJURY $4,000,000 GENERAL AGGREGATE $4,000,000 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $4,000,000 X POLICY PE t T LOC B AUTOMOBILE LIABILITY BAP 2938863-06 03/01/09 03/O1/10 COMBINED SINGLE LIMIT $1,000,000 GEN (Ea accident) ' X ANY AUTO ALLOWNEOAUTOS BODILYINJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS _ BODILYINJURY $ (Peraccident) NON-OWNED AUTOS X SELF INSURED AUTO PROPERTYOAMAGE $ (Per accident) PHYSICAL DAMAGE AUTO ONLY-EAACc16ENT $ GARAGE LIABILITY ANY AUTO OTHERTHAN EA ACC $ AUTO ONLY: AGG $ A EXCESSIUMBRELLAUABIUTY IPR 3757 608-02- 03/01/09 03/01/10 EACH OCCURRENCE $5,000,000 X OCCUR CLAIMSMADE AGGREGATE $5,000,000 DEDUCTIBLE - $ RETENTION $ WC STATU- OTH- C WORKERS COMPENSATION AND 3566916 (CA) 03/01/09 03/01/10 X ORYLIMIT ER D EMPLOYE RS'LIABILITY 3566915(AOS) 03/01/09 03/01/10 E.L.EACH ACCIDENT $1,000,000 ANY PROPRIETORIPARTNERJEXECUTIVE E OFFICERIMEMBEREXCLUDED? 35,66917 (FL) 03/01/09 03/01/10 E.L.DISEASE•EAEMPLOYEE $1,000,00 If yes,describe under E.L.DISEASE.POLICY LIMIT $1,000,000 SPECIAL PROVISIONS below - OTHER D Workers Compensation 3566918 (KY, MO, NY, WI, ) 03/01/09 03/01/10 F. TX Employers Excess. TNSC45694422 (TX) 03/01/09 03/01/10 ccurrence/SIR.' 25M/2M C Workers Compensation 4801323(QSI) 03/01/09 03/01/10' DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS RE: EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN THD AT-HOME SERVICES, INC. _ NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 2690 CU14BERLAND PARKWAY SUITE 300 REPRESENTATIVES. ATLANTA, GA 30339 - AUTHORIZED REPRESENTATIVE USA ACORD 25(2001/08)ckomraus_hd ©ACORD CORPORATION 1988 11172180 r 79-23-2009 10:3�„ FROWTHD AT HOME SERVICES +508 T56 8823 T-535 P.001/004 F-651 PLEASE READ THIS / Sold,Furnished and Installed by: q � O T11D At, Services,Inc. Date: t-��l dJl,/a The Home Depot At-Home Services Branch Name: Boston ;45A Greenwoad Street,Unit 2.Worcester,MA 0 i 607 Toll Free(S00)657-51$2; Fax(508)756-5323 Branch'Number:31 FCderal ID#75-2699460:ME Lie#C 02439;RI Cont.Lic#16427 1 q CT Lic#565522;VIA Homc Improvement Contractor Reg. ,1� / Installation Address: Z City State "Lip t E. Work Phone: Home Phone: Ceti Phone: Purchaser(s): Home Address: City State zip ,If different from Installation Address) ,� E-mail Address(to receive project communications and home Depot updates): V" 8 ' i , /` 4 El I DO NOT wish to receive any marketing etnails from The Home Depot located at arse above in address,agrees to buy, Pro'ect Information: Undersigned("Customer'),the owners of the property for the installation("Instullation")of and THD At-Home Services,Cnc.("The Home Depot")agrees to furnish,deliver and arrange 9 a1i nacetials described on thclionble State 5upplcmenand PPape ntec ltSummary ttached h of which e eto and any incorporated Change Orders(collective y / t -eference,along with any app DDLrr- "Contract"): job r,: ,l ,rn.,aer,•cn�e, Products- Roofing- cc Shert(s)#f• Project Amount Roofing Sidin _ Windows ❑Insulation 06 t/ $ �jry ❑ Doors / 4t Gutters i Covers []Entry ❑ Roofing Siding ❑Windows Insulation ❑Gutters I Covers []Entry Doors LJ ❑Roo fin g Siding Windows insulation ❑Gutter.,/Covers rIFntry Doors❑, Roormg ❑Siding Windows Insulation S QGutters 1 Coven QEntry Dcwrs ❑ 1 Minimwu 25%Deposit of Contract Amount due upon execution of this contract Torsi Contract Anwunt $ a Yam' Maine Purchasers may not deposit more than one-tiurd of the ContmetArnoont Customer agrees that,inunediately upon completion of the work for each Product,Customer will execute a.Completion Certificate tone for each Product as defined by an individual Spec Sheet) and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and Severally oblisated and liable hereunder. Th.Home Depot reserves the right to issue a Change,Order or terminate this CO U cl or any individual Product(s)included herein,at its discretion,if The Home Depot or its authorized service provider determines teat it cannot perform its obii Aiondue to a structural Cot problem with the home.environmental hazards such as mold,asbestos or lead dint,other safety concerns, ricin.errors or because work required to cornpletc the job was not included in the C�yo/ntracctt�// Pavment Summary: The payment Summary #F_ 7�J 0 (C/ included as pan of this Contract, sets forth the total Contract amount and payments required for the deposits and final payments by Product(as applicahks). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before worst on that Product is complete. omer agrees to pay The Home Depict the costs of materials,labor,sany Other In the event of termination of this Contract,Cust and services provided by The Home Depot or Authorized Service licable lawrovider through the date THL'II011IE DEPOT MAY termin IT3FIHOLA AMOUNTS awounts set forth in this agreement nr allowed under aPP OWED TO THE HOME DEPOT FROi�1 THE DEPOSIT P:1I'AIE\"f OR OTHER PAYMENTS MADE, WITHOUT Ll',v1ITLNG T1iE HOME DEPOT'S OTkIER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. acceptance attd .4 ithorization: Customer agrees and understands that this Agreement is the entire agreement between Customer nd"Che Hine Depot wills regard to ttte Products and Installation sel-vices and supersedes all prior discussions and agreements.either Coal or writ e reiatiri_to said Products and Installation.This Agreement cannot be assigned or amended except by a writing signed b)•Custunier and The ficime Depot.Customer acknowledges and agrees that Customer has read,understands,v'olunlarily accepts the terms of and has received a copy of this Agreement. Zibmi d hy:Ace,.p.ed bv' _ Date X I les Co ultani S Si^nature Customer '-na Date — TcIeplicit No. Customer's Signature Date Sales Consultant License No. (as;tpplicuble) CAT_NCTLLATION: CC STONIER MAY CANCEL THIS AGREEMENT WITH0 VT PE'.NALTY OR OBLIGATIOE BY DELIVERING WRITTEN '.NOTICE TO THE Hi DEPOT BY MIDNIGHT ON THE THIRD BUSINESS D_lY At:TER SIGNING THIS AGREEMENT. TffE STATE SUPPLEMENT ATTACHED I.1 RET0 CONTAINS A FORM TO USF IF ONE IS ,SPEMICULY . PRESCRIBED BY LA•t'V LV CUSTOMPR'S STATE. (NOTICE.ADD1T1O.%AL TFRiIS,1L,\D I:O�ITIO.NS ARE STATED ON TIIE RC�UtSE SIDL AN ARF PARTO I S CO- ,aha4-Rranch File YeVow-Customer Pink-Sales Consultant ' Sea Meadow Village Condominium Associadon �t 13 l December 3, 2009 Re: Replacement Windows - Unit A 16 located at the above address Approval given for M/M.Geraldo Amorim to contract Home Depot for the installation of Arni6rican Craft windows in Unit A16 located at Sea Meadow Village Condominiums. If you should have any concerns or questions, please do to hesitate to call me. Lys Terkelsen Resident Manager Tel: (508) 771-2063 Fax: (508) 771-4417 lysietl7(&.verizon net Td WdTT:90 60az.60' '�aQ S9TT&Z 80S: 'ON XUA er ; WO�A r: �'` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� ( � Parcel b LJ I A licatian PP / Health'Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/Hyannis Project Stre4 Address K Ic 6=t U VillageA'1411VVV)'AU deco fl Owner CL.1,C, I!1N �r (Afk Address S�✓YI� Telephone G-PI9 Permit Request C f/7? f/A/ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation29ai.--Construction Type 0,PYDZ/"f,/W i,IJ,1*&ks Lot Size A Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family aOO7 Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count -a Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other CD Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woddcoal stoves ❑Yes ❑ No Detached garage: ❑ existing 0 new size_Pool: ❑ existing ❑ new size _ Barn: 0 existing ©-new 'size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Q0 co Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ rn Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 11100AI Telephone Number C21` Cgc)U Address ' 3 / P4 k 0License #Ay a A)s x,k e/�, E c� Home Improvement Contractor# �� Worker's Compensation # 0 V ALL CONSTRUCTION DEBRIS RESULTIN P FROM THIS PROJECT WILL BE TAKEN TO ajoolvSoc pj--- IGNATURE DATE ✓ �� FOR OFFICIAL USE ONLY APPLICATION# "DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents _ Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information A^ /J) Please Print Le ibl Name(Business/Organizati Indiv &00 dual): V s OCN� Address: � /� City/State/Zip: P�/OOA7 0 �� Phone #: Are u an employer?Che th�appropriate box: Type of project(required): l. I am a employer with I— 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑N construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees . These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' insurance.: 9. ❑Building addition [No workers' comp. insurance comp. required.] 5. ❑ We are a corporation and its 10:❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.El Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.7 Other comp. insurance required.] *Any applicant that checks box#I 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 insura ce for ily employees. Below is the policy and job site information. AInsurance Company Name: ��C�%r/l/ /l Policy#or Self-ins.Lic.#: IpA Expiration Date: / ✓ Job Site Address: t/V City/State/lip: f C/;& Attach a copy of the workers' compensation policy declara ion page(showing the policy nu ber and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and cor ct. Signature: . Date: l �J Phone#: r l 1— 9 y't/l/ Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): t 1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: i 0 G ur Co� C[ts[nrnrr NKfne hCcar Ptt'sl[: _......— Ikentwal by Andrnen crf Rhocic Idarld& '�IE.' W Saps Agreement Addnw5:�Zlt / J t:ustonrer[1yx: (;ai r('tid Y� C 'ism —_ City,state.Zip: /r�1S_�tg• ntsbe/ Otdtr Ncfmhrr: 1137 V4&F +sc Drive �11 i(;.le s �«�)'I , Pifnnc-i(xnr: `�r— Woonsocket,ILi 0�8')5 WINDOW REpiAOfitq EMT as Arsl+.'zeeret:zxnepnY ^^� :} '?^7y[ ✓ i�3aotae-l4nrk ��td�ST ref e hart of_ Date: _ licc[isc#RI-.308:39 RI- 1225q&I X- Email: 1 195 55(:"1'-5C_725 UNITS Technicalwa g Dimensions GRILLES ZO S Room P, a-6 0 '" m rn C `« $fi �.$ �� y Ail F� �r sLfsT rXi SPRICES ! s go Dcssr lion N; o � z Gif Wp 1 j _ tAA tJK i _ T) s 6 wg t _ A o R wfii Y5 Ys ! 2 ®a tt PRI Y5 Inz7 to K x3 x I Sir um A.Y S XS1 I I K R X P[vpefsrl 17 f 1 t aMYn.vwh, a e>I k n.to I o f tt hit x atu una}am, nr zmre cn et.%'he �i3(eii lt}Mtl7 (e(Fiig Qr Mt1CnSCs Sub total I"(t �— rvulslmi�dl x e pf enlni au bi,?D raf In anb= m a�<prm,r try M1niH f osu,nro rewnl iy ixnh.nrn Dfnraa�rr as (Staining,IX nia,Mat.JteC.eir,.l'rontottoe,rtS,i Payment Method E arfcic ari,wi Sub Total fbaa.,pw Dcwiptiou!Notes $.Cris¢$ Check Sub Iota)ae r.a.t - Customt Ac�Lntonr c 1 i p 1 vi t n t a cur h eL whui ms !h q a rd n pk r H Misc Crodlts or Expenses Credit Card wtt,rrp,rm t wheelr itw+auM++ mt t y !v r -uami d ,y,rne,tn r.I acc+s ink{c,the lr.rr 1.t.naof —�y�— Sre CVer&l Side fQr TCrtns and >n[lttlpnsiaf i1c,Xc+u,t$c buyer,may r cancel / Total �f�r d nnancing e ii this transaction at any time prior w midad•1t of the third business day afte the class rtf thin transit In lease cc lecl notice of caucetiatinn fear an sales tax (,( emee wtalt-ty ex l anxt n this Ti to AOdhWW Draw Urm Anedrod / — Tu..l;c9iu,ellaneo+.+(naWaorFai,cnsri ------ �trcat+t<�J p p txxsry purr anal en nutt. :Ajt'cxprnK<oiwun..1 ti�litl Work Permit Cost /{,'(� .Tut r,.;,mt�pernnuf Sfmaeure (Weise cirete ati that agWY{ :\<rcq,rrxt SpenlAl Ch,h•r Acotea _ ... Total Amount of Agreement raoo over Stmm poor v eurmew rmn tool Deposit Required v' 5pxppiry varidow ao pn't+Naae.[ceoiatga Renpaat brnateraen rawoca and reNsiau.ppa wrne occe m+s+..mermae to bk9 an tyuwrcy Balance Due on Completion•� aw�bas+BaHa9 wHUE nvY etcex rpat +ante:Mro oho <nwAagr Aa uliy unseeta ds+ws+.wownauf my unuen etaauge r_ta¢welre k not ItwlUkxl ut as tasa'lY(ice«�'�'f N is dNrepr¢tEd drAtro EpaolWtl�xw esiL ttarplNe ..—_.. _.�. in etzs dd��Oenernt uNxt r �1ascot nn':unto [HeuMpnxx rtAlass and< euym+Ea tEe re-o is in Rico is u4h ,�,_,,.,a.,,,,„_,,,,,,,,_.•�___. [ its lei{:hc lrs laLvr,e+,atrrials.naatrll�aAo.: �p�yjRµdtj rte0d 3dnave. MN�. Ongrwi30 na141, x1 Ilse efad ed li+e ptia dE(arcxfn+Ctiar'aeipiA a1{k HO reneww+ana,n'eruf<fean yap�Na,damaw YA,h- Rfinewal tr Anlhaseo"*0ow.IM A4stun Pon,,,fiw,,w xl8r rent,>W:il,atddial*xs.al of pmduccs rcPlared. Custom er er Custom Customer tAe lnttauacum area. D �wvtinh; Ini41als: Initlah: •ww.e o-..�:,�„,,;'.,.a IM r..,,.,.e..v.L,...eK,:M,.w-aotr.x,wa.,..:r..:.n..K,;r•A p:Iwr:a,,.t.:,m�'.,•1.«e<.n.„ar,ap+a�^t.:..m M*n,.u,,a,:�i r Sea Meadow Village Condominium Association 720 Pitchers Way Hyannis MA 02601 TO: Renewal by Andersen DATE: November 23, 2009 RE: Supply/Replace Window Units Unit F44- Sea Meadow Village Renewal by Andersen is authorized to supply/replace Andersen window(s) for the owner of Unit F44 located at Sea Meadow Village Condominiums. If you have any questions or concerns, please contact me. Lys Terkelsen Resident Manager Tel: (508)771-2063 Fax: (508)771-4417 lysietl7@verizon.net Lys Terkelsen Resident Manager Sea Meadow Condominiums ' 720 Pitchers Way Hyannis,MA 02601 (508)771-2063 From:Shaunna Robinson,Hunter Insurance At:Hunter Insurance,Inc. FaxID: To:Denise Glode Date:9/23/09 09:45 AM Page:2 of ACOR® CERTIFICATE OF LIABILITY INSURANCE OP ID" 8 DATE(MMIDD/YYYY) PRODUCER MOONA-1 0 9/2 3/0 9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON-THE CERTIFICATE Hunter Insurance, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 389 Old River Road, P.O. Box 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Manville RI 02838-0001 Phone: 401-769-9500 Fax:401-769-9502. INSURERS AFFORDING COVERAGE NA(C# INSURED Moon Associates Inc. DBA Gutter Helmet INSURER A: National Grange Insurance co 14788 DBA Renewal by Andersen of RI INSURER B: season rntual insurance co'' DBA Gutter Helmet Roofing DBA Moon Works INSURER C: 1137 :Park East Drive,Woonsocket,RI 02895 INsuRERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT",WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - DATE LTR NSR DAT TYPE OF INSURANCE - POLICY NUMBER M/DD/YY) DATE(MM/DD/YY) LIMITS ` GENERAL LIABILITY EACH OCCURRENCE $ 1.0 0 0 0 0 0 AX COMMERCIAL GENERAL LIABILITY. MPS26619 09/16/09 09/16/10 PREMISES(Eaoccurence). $500000 , - CLAIMS MADE FX OCCUR MED EXP(Any one person) $.1 O O O O - PERSONAL&ADV INJURY $ 10 0 0 0 0 0 . .. GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 0 0 0 0 0 O" POLICY JJECaT LOC AUTOMOBILE LIABILITY - - COMBINEDSINGLE LIMIT A. X. ANY AUTO B1S26619':.., r 09/16/09 09/16/10 (Eaacoidenq $ 1000000 ALL OWNED AUTOS SCHEDULED AUTOS, BODILY INJURY(Per (Per person) HIRED AUTOS NON-OWNEDAUTOS - _ - - BODILY INJURY - $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - - " AUTO ONLY-EA ACCIDENT $ ANY AUTO . . . . - . _ .. OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLALlABILITY EACH OCCURRENCE $ 1000000 A X OCCUR ❑ CLAIMS MADE 'CU526,619 09/16/09 , 0.9/.16/10 AGGREGATE - $ - DEDUCTIBLE - $ X RETENTION $10 0 0 0 $ WORKERS COMPENSATION AND - b - EMPLOYERS'LIABILITY - - X TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE 28586 - 10/01/09 10/01/10 EL EACHACCIDENT $500000 OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE $500000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS - - CERTIFICATE HOLDER. CANCELLATION BUILDIN. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Building Cont. Reg. Board NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE"-EFT,BUT FAILURE TO DO SO SHALL Dept, of Administration R " One Capitol Hill IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Providence RI 02908 REPRESENTATIVES. AU 2 D REPRESENTATIVE ACORD 25(2001/08) OACORD CORPORATION 1988 T I , - t mo wo had AM hil ;. yp MOON A6900 iJg' - Y tat 1107 99mi lam WOONSOCKET, R 14RV5 �e Uudersecrex y rt -p-� �:�€ eta M= ts PA NE ROAD �# Vim.. 4 f j TOWN Of BARNSTABLE BUILDING PERMIT APPLICATION Parcel 3- 27S Map-4-70-"_` ., ,Applicati(5h # 0 Health Division Issued Conservation Division A I pp.ication /1----n 6 `.,`Per Fee, Planning Dept; Date Definitive',Plan Approved by Planning Board I Historic OKH Preservation Hyannis P, r7,) ti Project Street Address o Wvj V/Vt fD Village -S Owner a16 Address-:7,P10 P('�Lcs : &/�w 0AI (J Telephone 17) Permit Request (O,Ce4 u,J A) S47-1) Square feet: 1 st floor: existing—proposed 2nd floor: existing—provosed Total new a Zohing District Flood Plain Groundwater*Overlay Project Valuation on Construction Type Lot Size Grandfathered: Ll Yes LJ No If yes, attach supporting documentation. Dwelling Type: Single Family '0 Two Family U Multi-Family(# units) C) Age of Existing Structure Historic House: LJ Yes Ll No On Old King"­Highway:;�JU YeF Q No C) Basement Type: Q Full LJ Crawl LJ Walkout LJ Other Basement Finished Area(sqft), Basement Unfinished Area (sq.ft)1.11 Number of Baths: Full: existing. new Half: existing ne Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: L3 Gas L3 Oil LJ Electric U Other Central Air: LJ Yes Ll No Fireplaces: Existing New Existing wood/coal stove: LJ Yes LJ No Detached garage: LJ existing J new size—Pool: J existing L3 new size Barn: LJ existing L3 new size Attached garage: L3 existing L1 new size —Shed: LJ existing Q new size Other: Zoning Board of Appeals Authorization Ll Appeal # Recorded L] Commercial -LI Yes Ll No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 5419�� Telephone Number Address 3 a ova License#_c, Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO DATE SIGNATURE or- FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. 4 j ADDRESS VILLAGE OWNER F DATE OF INSPECTION: FOUNDATION .FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ,f DATE CLOSED OUT ASSOCIATION PLAN NO. 't 403/3 j'2009 14:34 00000000000 PAGE 01 j"Vi" CIF BORN-3 ABL& MAR F 2009 APR - I AM 8: 35 'r.�• us now= Di ISION FACSIMILE TRANSMITTAL TO FROM 1044) FACSIMILE: (508) 778-0770 �^ DATE a 3— DISTRIBUTE COPIES TO i COMMENTS TRANSMITTING 0_ PAQES, INCLUDING TRANSMITTAL SHEET. IF THERE ARE ANY PRORI-EMS, PLEASE CALL. (508) 77B-0734. THANE; YOU. 110 Breed's Hill Road, Unit 10 • Hyannis, MA 02601 508-778-0734 • Fax: 508-778-0770 • E-mail: info@markwood.net �� t i ^� 1.�. � '. '`� '� � v o .a ° o � 4 _ ___ �....r_.� 03/31�(2009 14:34 0000000.0000 PAGE 02 MEMORANDUM TO ; Tom Perry — Barnstable Building Commissioner FROM Tim Pearson . DATE 3-31-09 RE Permit Sea Meadow Condo Unit C-23 720 Pitchers Way Hyannis, Ma. We reformed the demo of the water ater damage and were Instructed to stop as the property manager was dealing with insurance company on who was paying the cost to repair. It has just come to my attention owner and or property manager subbed out the work themselves with the insulation done and possible the drywall. I am requesting our name removed from the permit. Thank you for your attention to this matter and If there are any questions please call me at 508-509-3971. - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Parcel, `Application Map- P '' # Health Division Date Issue ex) Conservation Division L:Appilicatbh Fee Planning Dept. ?errhit Fee Date Definitive Plan App roved by Planning Board Historic - OKH Preservation Hyannis re' Vh Project Street Address A Village //Yet n" elf Owner Z VA 7-ra n 1'e y, Address 6 w of�6 W V 4 00 0 Telephone Permit Reques;t nn Square feet: 1 st floor: existing proposed 2nd floor: exiding r3-J proposed Total new Zoning District Flood Plain Groundwater'.Overlay Project Valuation 3f4o d 0 Construction Type Lot Size Grandfathered: Q Yes Ll No If yes, attach stMborting�cu entation. Dwelling Type: Single Family L1 Two Family J Multi-Family (# units) o Age of Existing Structure �tyll Historic House: J Yes A No On Old King's ighwap,, J Yes ;h No Basement Type: AFull Ll Crawl LJ Walkout U Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sj JQ Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing —r- new First Floor Room Count Heat Type and Fuel: 0 Gas LI Oil #Electric LI Other Central Air: LJ Yes ANo Fireplaces: Existing New Existing wood/coal stove: LI Yes No Detached garage: Ll existing LJ new size—Pool: Q existing J new size Barn: L11 existing LJ new size Attached garage: Q existing U new size —Shed: Ll existing LJ new size Other: Zoning Board of Appeals Authorization LI Appeal # Recorded LJ Commercial Ll Yes L11 No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 14'C 4 ri 2e.,11 " — Telephone Number Address t License# Cc vt"'( if A—a ad- Home Improvement Contractor# Worker's Compensation # 4fo 31) L ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C was e SIGNATURE DATE eyr-1/ 6) V I r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: a FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ,_GAS: ROUGH � � FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. a , t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 sY www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): c1r, 2 c-ar V Address: /z c/ City/State/Zip: 6e,�,-� V71C-e >h� �d� Phone.#: Are you an employer? Check the appropriat bo%: Type of project(required): L❑ I am a employer with . 4.Pam a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. ❑New construction listed on the attached sheet. 7.. ❑Remodeling El I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp. insurance.t required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other C f� comp.insurance required.] F`IO d *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the MA for insurance coverage verification. I do hereby certify u der t e pains nd penalties of perjury that the information provided above is true and correct r/ Signature: Date: ��r Phone#: � Official use only. Do not write in this area,to be completed by city or town official .City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation'for their.employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states`Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contiactor(s)name(s),addresses)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit(license number which will be used as a reference number. In addition,an applicant that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial'venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations, 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 61 77- 2 7-7749 Revised 11-22-06 www.mass-gov/dia N'Iassuchusetts- Department of Pul lic Safety Bo tr(I oUROldin�- Re-uiations and'St tndards ` . Co6struction Sdpervisor Licensee License: CS 100393 Restricted to: .00 RICHARD a CAZEAULT,JR 198 FIVE~CORNERS_ RD CENTERVILLE, MA 02632 ('piiunissiincr Tr#: 100393j f, \ i -Zio ,7� f� r �y w i ply' �� . �' a 1 � . . , r DATE ACORDTR, CERTIFICATE OF LIABILITY INSURANCE t�0n ► 03/16/2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Insurance Agency Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 341 Court Street P.o. Box 3700 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Plymouth, MA 02360 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_ INSURERS AFFORDING COVERAGE NAIC# NSURED INSURER A. F Company Savers Property&Casualty Insurance Com 31771 Richard P. Cazeault Jr INSURER B: 198 Five Corners Road INSURERC: Centerville, MA 02632 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING-ANY— REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DQCUMENT.WqH-RESPECT-T0 WHiCH'rHiS CERTIFICATE M/VY GE ISSUED OR MAY PERTAIN, THE,INSURANCE-AFFORDEDBY THE-POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCHPOLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER PATE EFFECTIVE POLICY EXPIRATION LIMITS LTR INS ATE(lWAIDONY) DATE IW&MDIYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES(Each Cccurence} CLAIMS MADE❑OCCUR MED EXP(Any one person)- $ PERSONA.BADV INJURY $ .. - GENERALAGGWGATE - GEN'L AGGREGATE LIMIT APPUE S PER: PRODUCTS-COMPIOP AGC- $ _ ... POLICY -JECT Loc- AUTOMOBILE LIABILITY COMBINED SINGLE UNIT $ (Each accident)... _ ANY AUTO— .._ .... ._ .. _..._.. ... ., .. ALL OWNED AUTOS 'BODILY INJURY' - $ - (PM person).- SCHEDULED AUTOS ' HIRED AUTOS BODILY INJURY $ (Per accident) MON47N NED AUTOS PRCPERTY DA.1AGE $ (Per accidonl) GARAGE LIABILITY - AUTO ONLY-EAACCIDENT $ ANYAUTO EAACC $ TFi RTHAN AUTO ONLY: - AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION S $ WORKERS COMPENSATION AND WC STATUTORY OTHER EMPLOYERS LIABILITY U CTS ANY PROPRIETORPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER+MEMBER EXCLUDED? If yes,descroeunder AR0392714 `02/01/2009 02/01/201 0 EL DISEASE=EA EMPLOYEE $ 500 000 .SPECIAL PRCVISIONS.Be.Fi E.L DISEASE—POLICY.LIMIT.:..,.., $-100,000: OTHER DESCRIPTION OF PERATKINSIL.00ATIONS/YENCLESIEXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS -- - , CERTIFICATt HOLDER ' r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1Q DAYS EN N KX:To ICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TN A SO SHALL IMPOSE NO 0 R LL461 KIND UPON THE INSURER, TrVESL ITS AGENTS OR REPRESE p AUTHORIZED REPRESENTATIVE ACORD 25(20 1l08)®ACORD CORPORATTON 1988 (OMD/YYW) ;dc `�©� CERTIFICATE OF LIABILITY INSURANCE Pages I of 2 ATE 041M 3/M2009 PRODUCER 877-945-7378 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willie or Tennessee, Inc. HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 century Blvd, ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW P. O. Box 306191 N;Obville, TN 37230-5191 INSURERS AFFORDING COVERAGE NAIC# .......................I.............. ..................I.............11.1............................................................... ................................... ........................................................................... ............I....................... ......................I..................................I.............. ................. MAP lnot4alad Building Producto IN:.`+URFRA: Zurioh A"rlzmm 1,Ajourancep comp4ny .005 195 state Rd ....... . .................. *5''3'5 INSURERS: Cincinnati Insurance tvan 10 -99A B.O. Box 130; .. ......... ......... ................. Co y................................................. sagamore Beach, MA 02562-1309 INSURERC: Steadfast Insurance Co 387- ............. ..................................................... ..;.q........... ............................................ ..............I...........—..........I...... ....I Iqs ER D: ...................... ... .............. INSURER E- COVERAGES THE POUCIES OF INSURANCE,LISTED BELOW HAVE,BEEN ISSUED TO J'HE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE[),NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES OESCRIBet)HEREIN 1.5 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ................. ..................... ......... ................. .......... ........................... ... .... ........................... .. .............. ..............I ............ ICY CTI E LTR I TYPOOP IN$UFtANCj! FK�IkICY WMBVR LIMITS A G.ENCRAL LIABILITY GLO913952702 10/1/2008 10/1/2009 EACH OCCURRENCE S_2.,00.0. 00.0 A&A r4F X. COMMERCIAL GENERAL LIA21LITY J C-LAIK5 MADE OCCUR E ........... PERSONAL&ADy . I INJURY : GENERAL AGGREGATE C,EN't,AGGREGATE LIMIT APPLIC&'PrufZ- PRO(,X,IC;T8•(;QMP1OP AGG 9 2 POLICY] Xj rX LOC, B AUTOMOBILE LIABILITY CALASS78127 10/1/2008 10/1/2009 COMBINED SINGLE LIMIT 1,000,000 ANY AUTO 1 0/1/2008 ...... .......I..................... ........ ................................... CAA587B131(NX) 1 3,0/3,/2009 Att,OWNED AIJTOS ........... BA6000545(TX) 10/1/2008 10/1/2009 RODILYINJURY W HVIDLILED AUTO$ (Per Deraoli) ........... ....... ........... ................. X HIRED AUTOS BODILY INJURY X NON OWNED AUTOS (Per dcddent) .................I.......... ................ ................................................................. ........ .... ............. ..... ........... PROPERTY DAMAGE (PCs avddelf) $ !RARAOELIASILITY AI.rT' ONLY-t"A A(;CIDENT ................................ ............................................... ANY AUTO EA ACC S OTHERTHAN ................................................................ AUTOONLY: AGG S C EXCESS)UMBRELLA LIABILITY AuC913958002 10/1/2008 10/1/2009 X]oc'QtJR GLAWSMADE A(4<4RE02ATE .................................................... ........... ............. .. ................ DEDUCTIBLE RETENTION S WORKERS COMPENSATION A WC913952602 10/1/2008 10/1/2009 !X AND EMPLOYERS'LIABILITY YJ 9 E,L.EACH ACCIDENT A ANY WC9139528012(WI) 10/1/2008 10/1/200 OFFICER/MEMBER EXCLUDGD? (mi-inclatory in NH) E.L.a8EA$E-EA Em- .................. ........ xuder enaif PF'b"AL P ROV 1Z I0 NS b0g, j,E.L DISEASE-POLICYLINT_j S B OTHER X81154851(AOS,NT, 10/1/2069 10/1/M5 Rxcops Auto ,$4,000.000. Limit DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUMONSAD015D BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0— DAYS WRITTEN NOTICE'To THIS CRRTIFiCATe mOLOFA r4AM90 TO TH9 LC PT,IBUTFAiLvRe To DO$0 smAlt. IMPOSE NO OBLiOATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Sea Meadow Condos R%EPRESFiNTATIVES. Liz Torkelson A .A 702 Pitchers Way, unit 217 ALRKWE FRESENTA D REFF Hyannis, MA 02601 ACORD 25(2009101) Co11i2662563 Tp1:825002 CartzI216 9 2 Q 1988-2009/,�IbORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD J IHE Town of Barnstable ' Regulatory Services . HARNST"v iEB, Thomas F.Geiler,Director f1619- Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder property bj as Owner of the subject ro e iv l P riY heieb authorize r C a r J y �� � � f ?tad �i to act on my behalf, in all matters relative to work authorized by this building permit application for: S WAY . (Address of Job) S tore of Owner Date IPA P ' t Name If Property Owner is.applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION trte 'Town of Barnstable P�oF r , Regulatory Services BARNLF- Sr,m Thomas F.Geiler,Director hUm Building Division rED Tom Perry,Building Commissioner 200 Mairi.Street, Hyannis,MA_02601 vrww.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. " DEFINPTION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to- be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/she understands the Town of Barnstable Building Departtnent minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section I D9.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assurning the responsibilities of a supervisor(see Appendix Q, Rules 8,Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awarcness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a,form currently used by several towns. You may care t amend and adopt such a fon✓certification for use in your community. :fonns:homeexem t Q P TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 69 / bo6i LApplicati6h Health Division Date Issued Conservation Divisio n r,,Applicatidn, Fee Planning:Dept: Permi Fee,' Date Definitive:Plan Approved by Planning Board Historic - OKH Preservation Hyannis 22D P1—/o4tw 1,)A/Project Street Address S Village A-A41U i Owner Address Telephone Permit Request ni i^JOYL 60,!5 664 zvv,/t Z�4 Mail t Square feet: 1 st floor: existing /&VO proposed 2nd floor: existing 6-v proposed Total new Zc'ning District Flood Plain Groundwater Overlay Project Valuationo Construction Type Lot Size Grandfathered: LJ Yes LJ No If yes, attach supporting documentation. Dwelling Type: Single Family � Two Family Ll Multi-Family (# units) Age of Existing Structure P7 Historic House: L]Yes LKNo On Old King's Highway: LJYes Sko Basement Type: LaTull Ll Crawl Q Walkout LJ Other Basement Finished Area(sq.ft.) -ty-p,� Basement Unfinished Area(sq.ft) /c7z,,n Number of Baths: Full: existing new Half: existing —new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: LJ Gas 0 Oil SrElectric LJ Other C=) Central Air: NIYes LJ No Fireplaces: Existing New Existing wood/co I stove?Y(;s Ll No Detached garage: Ll existing LJ new size—Pool: Ll existing LJ new size Barn: LJ Ming view=Oize_ Attached garage: Ll existing Q new size —Shed: LJ existing U new size Other: > Zoning Board of Appeals Authorization LJ Appeal # Recorded U Commercial LJ Yes U No If yes, site plan review # M T Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER), Name -7/-; a.-,, Telephone Number 711 1­1 ' Address 0 d��J6 ' 10 License# Home Improvement Contractor# Jcn�?/ Worker's Compensation # UX,2- ALL CONSTRUCTIC)N DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE— r r FOR OFFICIAL USE ONLY APPLICATION# s DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , I GAS: ROUGH FINAL 'r FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r The CommonwecrLth of Massachusetts toDepartment of lndustriaf 4c cider,ts Office of Investigations 600 Washington Street Boston, ALA 02111 www.mass.gov/dia Workers' Compensation Xnsarance Affidavit: Builders/Coutractors./EIectric' print Le "bl .Inmbers A Licant Information Please Pz i Name (Bus iness/Org-mizaEbn/IndividuaI): Address: 7- City/StEctc/zip: 144 — Phone.#: Are you an employer? Check the appropriate box. 'Type of p"oject(required): 1. ' am a employer with 4. ❑ I am a general contractor and I 6 ❑Ncw construction employees(full and/or part-time).* bavc hired the sbb--contractors 2_El I am a sole proprietor or partam- listed on the attached shad. 7. ❑ Remodeling These sub contractors havo g, Demolition ship and havc no employees employees and have workers working for MC in any capacity. 9. ❑ Building addition [No workers' c mp..inyl=c e �mP incuiance.t 5. ❑ We arc a corporation and its 10_❑Electrical repairs or additions r�gtnr�j officers have exercised their I l.❑Blnmbing repairs or additions 3.❑ I am a homeowner doing all work myself LNo workers' comp. right of exemption per MGL 12 ❑Roof repairs c. 152, §1(4), and we bavt no inc[trance required_] t - employees. [No workers, 13.❑ Other comp.rns raIlCC rcquixcd.] *!wy applicant 6W ehccla box#1 roust also fM out the section below showing their workers'eoroparsahon poficy infonriatiorL t Iiorocowncn who submit thin affidavit in6catmg they arc doing all work and then hire outside contractors must submit anrw aifda-vitindicating such. XContzaetors that cbeck this box mast adacbEd an additional sbmt tbowing the name of the =d state wbethcr or not thosd MtN is have anployecs. lftbr sub-.c-ontraators have rsrployces,theymustprovidr tbLir wDTkCT_5'comp.pob%ntnmber. f am an employer that is providing workers' compensation insurance for ray employees. Below is the poUcy and jab site informadm ( D Innuancc Ca any Name: Policy#orSclf-ins. Lic. #: WL�'� '� �/��7�1' Expiration Date: /�� Job Sitc Address: L d3 City/State/Zip: 1 C,l11r%� Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to scctrrc coverage as required.tmdcr Section 25A of NIGL c. 152 can lead to the imposition of criminal penalties of a 5ne tip to S 1,5DUO and/or one-year imprisonment, as well as ei`it penalties in the form of a STOP WORK ORDER and a fmc of trp to$250_DO a day against the violator. Bc advised that a copy of this statLmerit may be forwarded to the Office of JnVogtigatiOUS of the MA for inner ancc covGra e verification. r do here r fp-rrirder e pairrs-and penalties of perjury that the information provided above is true mm cQrrert Signatiue: Datr: Phone Ofj-clal use only. Do not write to this area, fb be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6, Other Contact Person: _ Phone#: I Massachusetts Gcneral Laws chapter 152 requires all cmployers to provide workcrs' compensation for their employees: Pursuant to this stato-te, an employee is defined as "._.every person in the service of another under any contract of birc, s cypress or imphcd, oral or written_" JII� An employer is defined;s"an rRdrvidual,partnership, association, corporation or other legal entity, or any two or rare of the foregoing engaged in a joint catcrprisc, and including the Icgal represcntativcs of a dcecascd employer, or the receiver or trusted of anindividual.,partnership, association or other legal entity, employing employees. HOwcYcr the owner of a dwelling house having not more than thr-c apartments and who resides therein, or the occupant of the iwclling house of another who employs persons to do maintenance, construction or repair work on such dwelling house )r on thr grounds or building appurtenant thereto shall not because of such employment be deemed-to be an employer." vfGL chapter 152, §25C(6) also states that"every state or Iocal licensing agency shall withhold the issuance or -enew2l of a license or permit to operate a business or to construct buildings in the commonwealth for any ra ippIint Who has not produced-acceptable evidence of compliance with the insurance coverage required." Vdditionan),MGL ohapter 152, §25C(7) states `Neither the commonwealth nor any of its poli#ical subdivisions shall rater into any eontract for•the pciformance of public work until acceptable evidence of complfzncd adth the mice cquircmenfs of this chapter have bccn presented to the contracting authority. ,_pplicants lcasc fill out the workers' conOpensation affidavit completely, by checking the boxes that apply to.your situation and, if of �sary, supply sub-cantractor(s)name(s), address(cs) and phone numbers) along with their eerEfic e- t Muancc. Limited.Liability Companies(LLC) or Limited Liability Par(ncrsbips (LLP)with no-cmployccs other than the icmbers or partners, arc not required to carry workerx' compensation inurar ee. If an LLC or LL.P does have mployecs, a policy is required-. $e advised that this affidavit may be submitted to the Dqu-tracat of Industrial ccidcats for confrmation of insurance coverage. Also be sure to sign and date the affidavit The a5davit should returned to the city or town that the application for the permit or license is being requested, not the Department of idustrial Accidents. Should you have any questions regarding the law or if you arc required to obtain a workers' ,nopr,mation policy,please call the Dopadmcnf at the nur.qbcr listed below. Self-insured companies should cntcr tbeir If-ins ranrro liccnse number on the appropriate line. ity or Towii Officials ease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom du affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant case be sure to fill in the permit/liccnsc number which will be used-as a rcfercncc number. In addition, an applicant it must submit multiple permitAiccnsc applications in any given year, need only submit onp affidavit indicating current licy information(ifneccssary) and under`Job Site Address" the applicant should write"all locations in (city or Nn)."A copy of the of 5davit that has bccn officially stamped or marked by the city or town may be provided to the plicant as proof that a valid affidavit is on file for fiitarc permits or licenses. A new affidavit,must be filled out each ar.Whcrc a home owner or citizen is obtaining a license or permit not related fo any business or conomcrcial venture a dog license or permit to burn.Icavcs etc.) said person is NOT required to eompictc this affidavit e Office oflnvestigations would like to thank you in advance for your cooperation and should you have any questions, asc do not hcsiiatt,to give us a call Department's address, tcicphone•and fax number. The Commonwealth of Massacbus(-,tts Dg)a.rhment of Tadustrial Accidents Office of Invesngatiuns 600 Wa_Z gtGn street Boston, MA 02111 Tel. # 617-727-49-0.0 ext 4-06 ar 1-M-MASSAFB Fax # 617-727-7749 11-22-06 www.mas3.gov/dia Liberty Mutual Group Liberty P.O.Box 9090 10�Mutu al® Dover,NH 03821-9090 Telephone(800)653-7893 Fax(603)-245-5330 February 12,2008 TOWN OF BARNSTABLE ATTN:BLDG DEPT 200 MAIN STREET HYANNIS, MA 02601- RE: Certificate of Workers Compensation Insurance Insured: MARKWOOD CORPORATION 110 BREEDS HILL RD UNIT 10 HYANNIS, MA 02601 Policy Number: WC2-31S-319674-038 Effective: 2/1 /2008 Expiration: 2/1 /2009 Coverage afforded under Workers Compensation Law of the following state(s): MA Employers Liability(Limits: Sole Proprietor/Partner Coverage Election: Bodily Injury By Accident: $ 100,000 Each Accident Bodily Injury by Disease: $ 100,000 Each Person Bodily Injury by Disease: $ 500,000 Policy Limits As of this date,the above-referenced policyholder is insured by Liberty Mutual Fire Insurance Co under the policy listed above. The insurance afforded by the listed policy is subject to all the terms, exclusions and conditions,and is not altered by any requirement,term or condition of any or other documents with respect to which this certificate may be issued. This certificate is issued as a matter of information only and confers no right upon you,the certificate holder. This certificate is not an insurance policy and does not amend,extend,or alter the coverage afforded by the policy listed above. If this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such cancellation. AUTHORIZED REPRESENTATIVE LIBERTY MUTUAL INSURANCE GROUP This Certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those companies. cc: Insured: Producer of Record: MARKWOOD CORPORATION FREDERICKS INSURANCE AGENCY INC 110 BREEDS HILL RD UNIT 10 P O BOX 427 .HYANNIS, MA 02601 OSTERVILLE, MA 02655 ,per 71m tir anvmanuiea o�.�aeouc�euoek2 �\ 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: Registratiotl:. 100671 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Ezpirafloh &24/2010 Tr# .267906 Boston,Ma.02108 Type _PBvate Corporation MARKWOOD TIMOTHY PE OIV, 110 BREED'S HILL ROAD UN)T 10 HYANNIS,MA 02601 Administrator Not valid without signature j n In C m B � . v m Tawn of Barnstable Regulatory Services `v=" 'STABM $ Thomas F_Geiler,Director i639 166 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02661 www.town.b arnstable"Ra.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete, and Sign This Section If Using ABuilder -/ .i',�-,1,�� � , as Owner of the subject property hereby authorize._ to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of rob) S'I nature o Owner Date i1"� Prid Name • If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:F0RMS:0 WNERPERMISS10N Town of Barnstable ��pp THE Tp�� Regulatory Services t &kRNS.,BLF_ ; Thomas F. Geiler,Director MASS.�b Building Division �rEo�y n Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 vsww.town.b arnstable.ma.us - _ Office: 508 862-4038 Fax: S08 790-6230 ErOM EOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village name home phone# work..pbane# CURRENT MAILING ADDRESS: city/town state, zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and {" to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)-who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to" be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeownee?-shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/she understands the Town of Barnstable Building Department. minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family.dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this scction.(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 an unaware that they are assurrring the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require;as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a.Torm currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. , Q:forms:homeexempt J'4 7.. 2009 1 : 2`1-PM. MA DEP N01 027.5 P. 2 Collnmonwealth of Massachusetts > PI®ase Enter Decal# --r-- --- Asbestos. Notification Farm ANi=-001 Affix-Asbestos Nottfication Decal Here A. Asbestos Abatement;Description Important: When filling out ill Facility Location. .forms on the n� _ ii computer;use �� .444 A ou Val i� O,�i CSC} () `f.�TLL�23 S •c.�da�/`, V T'�';a--� only,the tab key Name of.Facility Street.Address to move.your t—�-%. ti i� VhA "` 3 �I t'3 cursor-do-not" Use the return City/Town State Zip,Code Telephone key... Worksite.Location: Sew' :VAL1` �y P.-r t�i 6&cv-r Building narire;#,wing,floor,room Is the facility occupied? s;❑.No Asbestos Contractor Name Address INSTRUCTIONS WM 1.All sections of . City/Town- Zip Code- Telephone ' this form muse be Contract Type: ❑Written ❑Verbal completed in order DOS License to comply with DEP notiftatements on i acih y Contact Person Contact pe on's title . requirements of 110CMR7.15 L "',.and the.Divlslon Name of On-Site Supervisor/Foreman DOS Certification# —of Occupational Safety(DO$) ' SWc lclwt •°S'le�^'r�r } Name of Pro ect Monitor. DOS Certification,# notification j. requirements of 453 CMR 6.12 Name of Asbestos AnalyticalrLab -DOS Certification# 2.'Sabmit'Original Form to: Commonwealth of </ 'Massa chusetts ;Asbestos Program Project Start Date End Date, PO Box 120087 .. a Boston MA ' 021124087 . Work hours Mon-Fri..- Work hours'Sat-Sun. 8. What type.of project Is this? �emolitiorl ©-Renovation ' Repair ❑ Other;�please specify `rye �j Check abatement procedures 1 t _ ❑ Glove bag ❑ EncapsulaUon ' a ❑ riclosure O'Disposal only' [j Cleanup ❑-Other;specify: -UIV s ❑ Full containment `10 Is the job being conducted. , Indoors:? -❑-Outdoors? anf609 ap•6/04 ':Asbestos Notificatlon Form-Page_1 of 3 J'AN. 7 2009 1 : 21 PM MA DEP NO, 0215 P. -3 Commonwealth of Massachusetts 010 Pl ease Decal# Asbestos Notification Form ANF-001 .A. Asbestos Abatement Description (cont.)- - �11. Total amount of each type of Asbestos Contairnng Materials (ACM)to beJremoved, enclosed, or encapsulated: pipes•orducts(linear ft) oiher.surFaces(square,ft) Bole[ breaching;duct,tank surface tnsulating cement / coatings:. Im.ft sq.,ft lin ft sq h Corrugated or.layered paper pipe v "Trowel/Sprayer coatings insulation fin.ft.. sq,, lin.ft. , sq.ft Spray-on fire roofin p 9 tin.ft !sq.ft' Transite`board, tl boa lin.ft sq Cloths,woven fabrics . Im ft, sq.ft `Other,please sp®Cify: ' Thermal solid core pipe insulation / Ilni ft sq-ft lin ft sq-ft = 12. Descr be the decontamination system(s)to be used:. / Lv^`tJ 3 Describe the containerization/disposal methods to comply with 310 CMR 7:15 and 453.CMR 6.14(2) (9) w-RA;,�0L p For Emergency Asbestos:'Operations, the DEP:and DOS officials who evaluated the emergency: .. Name of DEP officialilia Date of Authorization + Waiver.# -Name of DOS offiGal° ' Title_ Date ofAuthorization Waiver# �C 15. Do prevailing wage rates as peg M G L_.C.�149,,§ 2t3, 27 or 27A—F apply to this,project?. Yes; No'` facility Description Current or prior use of facility- Z. S�c. e 2 Is the:faclllty owner-occupied residential,with 4 units or less .❑ No r R Ltd _ Facility Owner:Name• Addr ess .C tyR wn. Zip Code Telephone. 4. Name of Facility Owner's On-Site Manager Address C.ityli own Zip:Code' Telephone enf!)Otap 76/04 Asbestos..Notification Form Page 2 of 3 J'AN, 7: .2009 1 ,.21 PM MA.. DEP. NO. 0275 P. 4 Commonwealth of Massachusetts Please Enter Decal# Asbestos Notification Form ANF-001 B. Facility Description {cont:) 5' Name of General Contractor Address: {{ I City/rows Zip Code Telephone .. E Contractor's Worker's Comp, Insurer Policy#: Exp.Date - 6. : What Is.the size of this faclllty� Square Feet #of floors- C: Asbestos"Transportation'�an,d Disposal: Transporter of asbestos-containing material from site to temporary storage site(f necessary)to final disposal site Note.Transfer Name of transporter, Address' Stations must W Get:.,y (o� S 7 3� comply with the City(rown Zip Code Telephone Solid Waste egulattsio ions 310'Regulations 2; Transporter of asbestos.containing waste material from removal/temporary site to final disposal site: CMR 19.000. Name of transporter... - Address, Citylrown Zip Code Telephone 3. 'Refuse transfer station and owner ".Address Cityrl"own . Zip Code, Tel®phone FinahDisposalgite location name Owneft.Name, Address Cltyrrown State Zip.Code Telephone I. D. Certification'` The undersigned hereby states 'underthe : 5lltj_j�>w r��J2r penalties of perjury,that he/she has`read ;Name Authorized Signature the;Commonwealth of Massachusetts regulations for the Removal �Contairiment Note:,Contractor or Encapsulation of Asbestos,453,CMR Position/Title__ Date must.sign this form 6.00 and 310.`CMR 715,.and that the -� �' b ^b0 for Dos notcation information contained in this. is- information Telephones Representing pur poses true and correct to the best of his -$ ,. Pb f(}, ?. _ knowledge and.belief. Address 'City/Town .:ZipCode Fee exempt(city,Town district,municipal housing,authority,owner-occupied'residential of four units'or less?) ❑Yes ❑ No anf001 ap r 6104 -Asbestos Notification Form Page 3 of 3 . 1H OF&" •• NOTICE of New Federal Pool Requirements uV Vva4 9VJ The Virginia Graeme Baker Pool & Spa Safety Acty r oc aV The provisions of the new law are designed to prevent serious injuries and fatalities associated with suction entrapment in pools and spas. By December 19, 2008, in accordance with the new federal law • ALL public, semi-public and special purpose swimming pool drain/grate covers MUST conform to the American National Standard ASME Al 12.19.8 2007 Suction Fittings for Use in Swimming Pools, Wading Pools, Spas, and Hot Tubs, or any successor standard, published by the American Society of Mechanical Engineers (ASME); • EVERY public, semi-public and special purpose swimming pool with a single main drain, other than an unblockable drain (interpreted by the Consumer Product Safety Commission to have minimum dimensions of 18 inches by 23 inches or have a diagonal measurement of 29 inches or more),. MUST be equipped with one or more additional systems or devices designed to prevent suction entrapment. As outlined in the law these additional systems or devices may include a safety vacuum release system (SVRS), suction limiting vent system, gravity drainage system, automatic pump shut-off, or any other system determined by the CPSC to be equally effective in preventing suction entrapment; • If a public, semi-public or special purpose pool can not comply by December 19, 2008, the CPSG requires that the pool or special purpose pool shut down until the proper covers are installed and, when applicable, an additional suction entrapment prevention device or system is installed as outlined in the law; and • Non-compliance with these federal provisions may result in the imposition of civil or criminal penalties under sections 20 or 21 of the Consumer Product'Safety Act. By December 19, 2008, in accordance with regulation 105 CMR 435.00 • Anti-vortex drain covers must be replaced if they do not meet ASME Al 12.19.8 — 2007; • Gravity drainage systems are NOT exempt from the drain/grate cover provisions; • Drain disablement is NOT an acceptable suction entrapment prevention option, pursuant to 105 CMR 435.00 Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V;, • An operating permit, pursuant to 105 CMR 435.21, should NOT be issued to any public, semi- public or special purpose pool that does not comply with the requirements; Variances pursuant to 105 CMR 435.46 shall NOT be granted since the federal law implies preemption of state requirements; • Public, semi-public and special purpose swimming pools that are not open on December 19, 2008 -are not required to be in compliance until the day that they re-open; and • It is the pool operators' RESPONSIBILITY to provide written confirmation that pool drain/grate covers conform to the American National Standard ASME Al 12.19.8 —2007. For more information please visit the MDPH —Community Sanitation Program website www.mass.gov/dph/dcs or contact the Massachusetts Department of Public Health, Bureau of Environmental Health at 617-624-5757._ JAN-. 7. 2009 1 : 21 PM MA DEP J�y� �OR NO. 0275 P. 2 3eco3S D Commonwealth of Massachusetts Please Enter Decal# -- -- ----------------------- i Asbestos Notification Form. ANF-001 Affix As bestos ' Notification Decal Here i I A. Asbestos Abatement Description Important: " When filling out. V►: Facility Location:forms on ii computorthse ��"�C,}"�J �AII�� �_ � �. (j �►iTc [ 6 l�i^�`/ V�•T �'ot�. only the tab key Name of Facility Street Address to.moveyour � �iFE�l til vv�A d 3 t " S�3 .- 9� cursor-do not City/Town state Zip Code Telephoneuse the return key. Worksite Location: !' 5C lM� c�� V✓A1.� + ( c» �r�' �, �:Tc Nei' w� ljl�'l L-^� / Building name,#,wing,floor,room, � Is the facility occupied? El"res ❑ No . V Asbestos Contractor: Name., Address INSTRUCTIONS C +-aT�°`V��� W� U �, 5`Z�`[� 3�a SG7-D3 Cityf-rown Zip Code Telephone 1.All sections of this form must be Contract Type-- ❑Written ❑,Verbal completed in order- DOS License# s 'e f DEP notification 1ry Uy41Srt requirements of. Facili y Contact Person Contact pe on s title 310 CMR 7.15 ri�c�cA \c and the DfVlslon �' Name of On=Site Supervisor/Foreman DOS Certification# of Occupational Slddacm 'A- t Safety(DOS) notification Name of Project.Monitor DOS Certification'# requirements of 453 CMR 6.12 Name of Asbestos Analytical Lab DOS Certification# 2.Submit Original . Form to Commonwealth of J:67 0 ( _ (� Massachusetts Asbestos Program Project Start.Date End:Date PO Box 120057 Boston MA 02112-0037 Work hours Mon-Fri...: . Work hours Sat-Sun: What type.:of project is this? Eg"6emoiition, ❑.Rehovation. - [�kepair ❑ Other,please specify: Check abatement procedures: Glove flag ❑ Encapsulation ❑ Enclosure E9 Disposal only [Cleanup ❑ Other,specify: Full Containment 0 is the job being conducted: indoors? ❑ Outdoors? ; anf001 ap..g/04 A c Asbestos NoGfi atlon Form•Page d of 3 JAN. '7`1 2009 1 ; 21 PM MA DEP - NO. 0275 P, 3 Commonwealth.of Massachusetts D Please Enter Decal# Asbestos Notification Form ANF-001 A. Asbestos Abatement Description (cont.) v11: Total amount of each type of Asbestos Containing.Materials (ACM)to be removed, enclosed, or encapsulated: Pipes or ducts.(linear ft) other surfaces(square ft) . Boiler,breaching;duct,tank surface coatings in.ft s ,ft- Insulating cement g q lin.ft sq.It Corrugated or layered paper pipe / Trowel/Sprayer coatings / insulation lin,ft. sq;ft lin.ft sq.ft Spray-on fireproofing / Transite board, II boa[d lin.ft sq,ft lin.ft -sq,ft. Cloths,woven fabrics lin.ft sq.ftOther,please specify: Thermal,solid core pipe insulation Iln:ft sq.ft lln.ft sq_ft . 3 Descr"be the decontamination systems) to be used: C-ir L) � 3. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR pY 6.14(2) (g): w Sites_ w sup 17— P.4. For Emergency Asbestos Operations, the DEP and DOS officials who evaluated the emergency: Name of DER official - Titlo Date of Authorization salver# - Name of DOS official Title' Date of Authorization ' Waivers 15. Do prevailing wage rates as per M.G.L c. 149, § 26, 27 or 27A-F apply to this project?❑Yes, No B. Facility.Description Current or prior use of facility_ 'Ge` ls-the facility owner-occupied-residential with 4 units or less? L9*1'es ❑ No ti Tfl Facility Owner Name I Address City own Zip.Code Telephone 4. Name of Facility Owner's On-Site Manager Address CitylTown Zip Code Telephone anf00Iap•.6/04 Asbestos Notification Form•Page-2 of 3 f JAN. 7. KQ.9 .1 : 21 PM: MA DIP N0, 0275 P; 4 Commonwealth of Massachusetts G> ^ Please Enter Decal# Asbestos Notification Form ANF-001 B. Facility Description (cont.) 5' Name of General Contractor Address City/Town Zip Code Telephone Contractor's Worker's Comp, Insurer Policy# Fxp.Date 6. What is the size of this facility?. Square Feet #of floors C. Asbestos Transportation and Maposal Transporter of asbestos-containin material from site to temporary storage site if necessary)to final P 9 p rY 5 � ry) disposal site: Tb Note:Transfer Name of transporter r; f� Address Stations must 1i�1 G`S[ 1✓ t1 l (� / b`j ? U � .comply with the City/Town Zip Code Telephone Solid Waste Di vision 2. Transporter of asbestos-containing Waste material.from removal/temporary site to final disposal site: Regulations 310 CMR 19.000 Name of transporter Address City/Town Zip Code, Telephone 3. Refuse transfer station and owner Address . City/Town Zip Code Telephone MA Final Disposal 5 to location name Owner's Name ILD Address Clty/Town oL State Zip Code Telephone D.:Certification The undersigned hereby states, under the, r"2T penalties of perjury,that:he/she has read Name Authorized.Signature- the.Commonwealth of Massachusetts - regulations for the Removal, Containment positionLTitle Date Note:Contractor or Encapsulation of Asbestos,453 CMR..: must sign this form .:. 3,6 g 6.00 and 310'CMR 7:15,and that the for DOS.notification.: Information contained In this notification is Telephone Representing purposes true-a nd, correct to the best of his/her knowledge and.belief. Address Cityrrown Zip Coda Fee exempt(city,Town,district,municipal housing authority,.owner-occupied residential of four units or less2) .0 Yes:❑No anf001 ap vl 6104 Asbestos Notification Form•Page 3 of 3 Town of Barnstable u11d1I1 U�s� I .Fromm =eet-;rA ve PIanS�M s#b Retame"d on.Job andth�s Card Must be;Ke t `rnx�vsr��sra P011 ast, hCax S �# b e , #,_ r Ppiro x SIB u P ate. 'I F n 1 I", ection.Has-� een�Made � N, ���. �,,�,� P 3 � � ,� �� Posted Urlti � nsp � � � ,� "'I�m �slt`all`Not�be Occu i d un#�Ipa Final Ins eci�on has3been made .: 1 el 1111t Where a C,ert�ficate;,of OcCOpan n �s Required,such f w d g" � p e � � p � _ Permit No B-174618 Applicant Name: BRIAN D DENNISON Ap provals Date Issued:` 06/05/2017 Current Use::: Structure Permit Type: Building-Siding/Windows/Roof/Doors-- ,f Expiration Date: 12/05/2017 Foundation: Location: 720 UNIT 48 PITCHER'S WAY,HYANNIS Map/Lot 271-041 OAV Zoning District: RB Sheathing: Owner on Record: PLANTE,THERESA � 4 , Contractor Name BRIAN D DENNISON Framing: 1 Address: 720 PITCHER'S WAY UNIT 48F Contractor Ucense CS-095707 2 HYANNIS,MA 02601 Est Project Cost: $4,066.00 Chimney: Description: install (1) replacement patio door Permit Fee: $ 160.00 Insulation: Project Review Req: install (1) replacement patio door FeePa�id $160.00 x R Date 6/5/2017 mal: d at.G., v Plumbing/Gas Rough Plumbing M Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved appl'cationand t6,'approved construction documents for�which this permit has been granted. All construction,alterations and changes of use of any building and strpcturesshall"be in compliance with the local zoning by laws;and codes. Final Gas: This permit shall be displayed in a location clear) visible from access street or roa dG nd shall be maintained open forypub inspection for the entire duration of the pY work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable sign ures by the Build g,and ire Officials are provided on this"permit. Service: Minimum of Five Call Inspections Required for All Construction Worka s g 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not.proceed until the Inspector has approved the various stages of construction. Final: Persons contras ing.With unregistered contractors do.not have access to the guaranty fund" (as set forth+in MGL c.142A). Fire Department _ Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel y 1/ G� OAV 9Q�kb Application Health Division �� � �: Date Issued S 17C�17 Conservation Division 71 y�gO"r Zo�l ApplicationRe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address 7v?y Pr-if i C6 wl9�( Village S Wf Owne S LAWIe- Address 720 MIeA- s W-4 OZloo �T Telephone 7 ~Gv 7 Permit Request a Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District 1 Flood Plain Groundwater Overlay Project Valuatio o64 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family. ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use -+ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name(5rm*) Telephone Number 7(-' Address 2,i / License # 0?r x7 © Z"S Home Improvement Contractor# r73z�s Email q5 w&�94 Worker's Compensation # OrA 31c360 ALL CO TRUCTION DEBRIS RESULTING FROM THIS PROJFCT WILL BE TAKEN TO SIGNATURE DATE 6 , FOR OFFICIAL USE ONLY `APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION .. FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING f DATE CLOSED OUT ASSOCIATION PLAN NO. r 2 < Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal B Andersen of Southern New England_ Y g Theresa Plante Legal Name:Southern New England Windows,LLC 720 Pitchers way RI #36079, MA#173245, CT#0634555, Lead Firm #1237 Hyannis,Ma 02601 WINDOW RE LACEMENT 26 Albion Rd I Lincoln,RI 02865 H:(774)487-6474 Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com Buyer(s)Name: Theresa Plante Contract Date: 05/03/17 Buyer(s)Street Address: 720 Pitchers way, Hyannis, Ma 02601 Primary Telephone Number: (774)487-6474 Secondary Telephone Number: Primary Email: tip2447@gmail.com Secondary Email: Buyer(s) hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms, any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein b reference(collectively,this"Agreement"). Buyer(s) hereby agrees to sign a completion certificate after Contractor has completed all g work under this Agreement. Total Job Amount: $4,280 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $2,140 Balance Due: $2,140 Estimated Start: Estimated Completion: Amount Financed: $4,280 7-9 weeks 7-9 weeks ' Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: 50%deposit by bank,balance on completion by bank Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s) and Contractor. Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 05/06/2017 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New EnglandWindows,LLC dba:Ren&al y Andersen of Southern New England Buyer(s) Signature of Sales Person Signature Signature Paul Sandrey Theresa Plante Print Name of Sales Person Print Name Print Name UPDATED: 05/03/17 Page 2 / 11 Massachusetts Department of Public Safet/ Board of Building Regulations and Standards License: CS-095707 __ .- _ •r so! _ BRIAN D DENNISON 7 LAMBS POND CIRCLE - CHARLTON MA 0 1507 , (�„M Expir3tion: Commissioner 09/0812018 f5' of Consumer:�aLirs and Business Regulation 10 2 k Plaza- Sui_e 5'170 Boston,1;assacn>rsetts i;, 16 Nome Improvement(-'o.tractor Regisndon _ ---- - Registation: 1-,3245 Type: Supplement Card Expiration: 9I19YL018 SOUTHERN NEW ENGLAND WlldDONFS LL BRIAN DENNISON p 26 ALBION RD =_- LINCOLI\I,RI Q2866 = _ Undaw.kati' s and retn,-n vird.&Iar:.reason For ranee. address :_Rene-211 _:EaQlovmeut Lost :ntl _�Rec of Gmnmer:Vfays 1 Basins RezablIoa Registration rafid far individml use only before the r = es Aretion date.If found return to: t-W OME IMPROVEMENT CONTRACTOR omc2 of-ansmer.x f:drn and Basins R rlaene R istrauon;11.73245. Type: 10 Part:Pl=-suite 51T0 E--pIrad an:'gV.lW2(j18 Supplement Card Benton.NLA 91116 SOUTHERN NEW ENGLAND WINDOWS U C. RENEWAL BY ANDERSONi-� aRIAAl DENNISON UVCOLN.RI 02865 '-Undersecretary No[�aGd withna[si�tamre ` The Commonwealth of Massachusetts Department of Industrial Accidents o I Congress Street,Suite 100 Boston,MA 02114-2017 -, www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers- TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Q Please Print Leeibly Name (Business/Organization/Individual): Jp��.�n �� E'nr,lan J I&)l'o d zn,,,J Address: c2(0 v-x City/State/Zip: 1_;1lc /1) I Phone#: 4o) Z 29 _ 9 8 C)O Are you an employer?Check the appropriate box: "Type of project(required): l.laam a employer with �O employees(full and/or part-time).* 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.FJ I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.FJ I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.�ther do d r 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees: If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. / Insurance Company Name: t��- fine•-3�A Wes fir In 5• Co Policy#or Self-ins..LLic.#: WC A 313 (aloe I Expiration Date: Job Site Address: 7,2 I"1 c) 4eCS tJa y QD4 F-(k City/State/Zip: ,l-,lw all,s Attach a copy of the workers' compensation poli y declar tion page(showing the policy number and etxpiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1. I do hereby certify under the i s andpenalties ofperjury that the information provided above is true and correct. r _ Si ature: Date: j —/ — / Phone#: (Ll O 1 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Cou tact Person: Phone#: ., SOUTNEW-01 CZOLLINGER CERTIFICATE OF LIABILITY INSURANCE DATE w2912WYYYI� 29�zo1s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CON S.TITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL.INSURED,.the policy(ies)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: CoBiz Insurance,Inc.-CO a� Ert (303)988,0446 a No.(303)988-0804 8211 Tth St `MALDenver,CO 80202 ADDR SS:CoBizlnsuran obainsurance.com INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:Continental Westem Insurance Company 110804 INSURED INSURER B Southern New England Windows LLC INSURERC: DB1A Renewal by Andersen INSURERD: 26 Albion Road 1 Lincoln,RI 02865 INsuRER.E: INSURERT: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED-ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, IXCLUSIONS AND CONDITIONS OF SUCH POLICIES:tUMITS SHOWN MAY HAVE BEEN REDUCEDBY PAID CLAIMS. POLICY EFF POWCY EXP LTR TYPE OF INSURANCE INSD W VD POLICY NUMBER IJS I. A X COMMERCIAL GENERAL LIABILITY I I i EACH OCCURRENCE I S 1,000,00 ^ I I ICPA3136080 ; 07101120JS J 07/0112017 j p s CLAIMS MADE OCCUR 100,0 MED EXP(Any one Person) i S 10,00 1,000,000 PERSONALS ADV INJURY I 2,000;000 GEN'L AGGREGATE LIMIT APPLIES PER: !GENERAL AGGREGATE is PRO- i i i I PRODUCTS-COMP/OP AGG i s 2,000,00 I_LOC i `— ; i EMPLOYEE BENEFI :s Z,ODO,000 X I POLICY OTHER: i COMBINED SINGLE LIMIT i S 1,000,000 AUTOMOB11E LIABILITY I I ' BCdde� A F ANY AUTO i iCPA3136080 '07101120161,0710112017.1 BODILY INJURY(P errso pen). S. ALL OWNED SCHEDULED ! i I BODILY INJURY(Per axideM)i S I AUTOS i,�AUTOS I i PROPERTY DAMAGE ;5 NON-OWNED i ; j raaiderri HIRED AUTOS AUTOS I i I i i I I I X UMBRELLA L LIA9 i�OCCUR EACH OCCURRENCE 15 5,000,000 A EXCESS LIABI J. CLAMS-MADE] ! CPA3136080 107101/2016 i 0T/01/2017F-- REGATE s DID X REIENIIONS Oi ' 1 S 000,000 WOPER RIQ?RSCOMPENSATION j i t STATUTE I ERA I AND E111PIOYERSLIABILITY YINI I 1,000,0 A ANY PROPRIETORIPARTNERIEXECUTIVE L_JI IWCA3136081 07/0112016 OTIO I12017 E L EACH.ACCIDEPIT s oFFICER/MeurBER EXCLUDED? N!A I ; 1,000,000 OFRCERIM(Mandataly M HERNH) I I ' ! I EL DISEASE-EA EMPLOY s If yes desrnbe turder EL DISEASE-POLICY UMrr s 1,000,00 . DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 107,Addtllolml Ramerls Schedura,maybe atlaclled R mo>e°page is re9tdred) CERTIFICATE HOLDER CANCELLATION SHOEI-LED BEFORE THELD ANY OF THE EXPIRATION DATE�THEEREOF,�NCTICE VALL BECIES BE CD D N ACCORDANCE Vn7H THE POLICY PROVISIONS- AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I MERCANTILE PROPERTY MANAGEMENT CORP. P.O. Box 790 Buzzards Bay,Massachusetts 02532 (508)759-5555 email: jeffb@metcantileproperty.com May 1 G,2017 To: Renewal by Andersen Re:Approval of new patio door install. To whom it may concern: This letter seines to confirm that Renewal by Andersen has received permission fiom Mercantile Property Management acting as Sea Meadow Village representative to install one new patio door at unit F48 located at Sea Meadow Village 720 Pitchers way in Hyannis.The door conforms to the association requirements for style and color. Sincerely, effrey Byers,CNICA Property Manager for Sea Meadow Village Condominium Assurant Use Only PID# 1712506 ASSURANT® November 30,2016 Attention: Building Division Assurant Field Services(AFS)is working on behalf of our clients to ensure compliance with ordinances requiring vacant/foreclosure property registration. Client's Name: NationStar Mortgage LLC AFS previously registered a property located at: Street Address City IState I Zip Folio Number 720 Pitchers Way Unit 28C Hyannis IMA 102601-6706 000271-000000-000041 -S000000 This letter is to serve as notice that the property has either been sold to a new owner,the property is now occupied,foreclosure has been rescinded and/or borrower is no longer in default.AFS does not represent the new owner and has not been provided any further information or documents. Please de-register this property and send confirmation of de-registration to the email address listed below or by mail. Assurant Field Services Attn:Property Registration 101 W.Louis Henna Blvd.,Ste.400 Austin,TX 78728 vpr®fieldassets.com Thank you for your time and attention to this matter. OM ASSURANT' -- Field Services 101 West Louis Henna Boulevard,Suite 400 M Austin,TX 78728 A!!'4 zac Town of Barnstable Attn:Building Division 200 Main Street Hyannis,MA 02601 PID: 1712506 REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3)or already foreclosed for which possession has been taken(section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law,please state the reason(s) and complete section 1 (property information) and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party.representative,but not other representatives and attorney) so that the Town can review the exemption and update its records: Section 1 —Pmpertv Information Property Address: 720 Pitchers Way Unit 28C, Hyannis, MA 02601 Assessors Map#: Parcel#: 000271-000000 000041 S600006 Land area and description single family home- condo Building(s) description and contents , Occupied: _x Occupant(s)(if borrowers so state and include name(s)) unknown Phone: email: other: Vacant: Date: Anticipated Length of Vacancy: Last occupant(s))(if borrowers so state and include name(s)) unknown Phone: email: other: Has possession been taken NO If so,please explain and complete and file,the maintenance and security plan form(unless exempt as stated above) Section 2—Foreclosing Party Information Foreclosing Party(full name/title) Nationstar Mortgage Foreclosure Case Court: Docket# I Date filed: Current Status: Post-Filing Foreclosing Party's representative(s) for property(entry,management,repair, etc.)(name,title,): Company(if different from foreclosing party): Address: Phone: email: other: If an exemption is claimed,please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information(i. e. "none"or"see above")). Name,title, other: Assurant Field Services c/o Christopher Sideman Company(if different from foreclosing party): Christopher Sideman Address: 268 Mammoth Rd, Lowell,MA 01854 Phone(s): 800-468-1743 email(s): vprkfieldassets.com other: 800-468-1743 Name,title, other: Company(if different from foreclosing party): Address: Phone: email: other: Attorney representing foreclosing party Firm name(if different from attorney's name): Address: Phone(s)`. email(s): other: I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapt 224 o Code of the Town of Barnstable. Jca J AA� Date: 11/10/2016 WLa trickland. te AFS Authorized Agent Property Manager: Assurant Field Services 101 W Louis Henna Blvd, Ste 400 Austin, TX 78728 P: 800-468-1743 E: vpr@fieldassets.com I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable.. Date: Building Commissioner, Town of Barnstable a ASSURANT BUILDING PLAN: 720 Pitchers Way Unit 28C Hyannis,MA 02601 AS OF: 11/10/2016 PROPERTY WILL REMAIN SECURED AND MAINTAINED. PROPERTY WILL BE INSPECTED PER ORDINANCE. PROPERTY WILL NOT BE DEMOLISHED. PROPERTY WILL BE LISTED FOR SALE. OWNER CONTACT IS: Nationstar Mortgage 350 Highland Dr .Lewisville,TX 75067 PH: (800)468-1743 EM: vpr@fieldassets.com AGENT CONTACT IS: ASSURANT FIELD SERVICES 101 WEST LOUIS HENNA BLVD. STE. 400 AUSTIN,TX 78728 T: 800-468-1743 E: vpr@fieldassets.com STANDARD GUARANTY INSURANCE COMPANY Blanket Real Estate Owned PO BOX 50355, ATLANTA, GA 30302 Policy -Declarations ITEM 1. NAMED INSURED: POLICY NUMBER: BRE-0004 CENTEX HOME EQUITY COMPANY, LLC LENDER NUMBER: 0729,0732 3250 Briarpark Drive, Suite 400 Houston,Texas 77042 PRODUCERIMAJOR NUMBER: 5992 ITEM 2. POLICY PERIOD June 1,2004 12:01 a.m. standard time at the address of the named insured and continuing until cancelled. ITEM 3. MAXIMUM LIMIT OF LIABILITY: $ 1,000,000.00 ITEM 4. COVERAGES: DIRECT PHYSICAL LOSS subject to all terms of this policy. ITEM 5. RATE PER$100 PER MONTH: Property: $0.08 Liability: $0.0125 ITEM 6. DEDUCTIBLE: $500 ITEM 6. ENDORSEMENTS attached to policy at issue:SG-BREO-POLICY (1198); NOT-TX-1; NOT-TX-2; DP 00 03 07 88, BREO-MOLD-END(11/02), BREO-LIAR-END (10/99) `THIS INSURANCE CONTRACT IS WITH AN INSURER NOT LICENSED TO TRANSACT INSURANCE IN THIS STATE AND IS ISSUED AND DELIVERED AS A SURPLUS LINE COVERAGE PURSUANT TO THE TEXAS INSURANCE STATUTES. THE STATE BOARD OF INSURANCE DOES NOT AUDIT THE FINANCES OR REVIEW THE SOLVENCY OF THE SURPLUS LINES INSURER PROVIDING THIS COVERAGE AND THIS INSURER IS NOT A MEMBER OF THE PROPERTY AND CASUALTY INSURANCE GUARANTY ASSOCIATION CREATED UNDER ARTICLE 21.28-C, INSURANCE CODE. ARTICLE 1.14.2, INSURANCE CODE, REQUIRES PAYMENT OF 4.85 PERCENT TAX ON GROSS PREMIUM! IN ADDITION,A STAMPING FEE OF.10 PERCENT IS REQUIRED ON GROSS PREMIUM. Surplus Lines Agent Agent Name and Address: Charles D.Helton Longhorn General Agency P.O.Box 1010 Euless,Texas 76039 (800)888-3008 SG-BREO-DEC(1198)-TX oFtHE r Regulatory Services Richard V. Scali;Director � uaxsresr.E, Building Division KAM v� 163 � Tom Perry,Building Commissioner Ar foY a 200 Main Street,Hyannis,MA 02601 www.town.b arnsta ble.ma.us Office: 508-862-4038 Fax 5,08- 0-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date.: o 6 ' J ro Name: M o-(% n fl l Ma 's C 101 Jd n Phdne M 0 ° &J Address: �n i chess' Village: •Name of Business: d iY)aJ.1-s—tic 71 ,U 6o Type of Business: Lw1woC .�CY�ICCd Y0Vis'a(i0�f'Map/Lot 7 / D y/ Q/� L �Y�12J�(E l it IlV=.- It is the intent of this section to allow the residenrof the Town of Barnstable to operate a home occupation• within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling, there shall be no increase in noise or odor,no visual.alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such'use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lotcontaining the Customary Home Occupation. • . No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,-the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I,the undersigned,have read d agree with the above restrictions for my home occupation I am registering. Applicant Date. ���✓����/6 Homeoc.doc Rev.103113 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 6/16/2016 Fill in please: > pt APPLICANT'S YOUR NAME/S: Marineti. Matos BUSINESS YOUR HOME ADDRESS: 720 Pitchers' Way# Unit 38-E, .(774) 8363656 Nv2nnic AAA n�601 TELEPHONE # Home Telephone Number (774) 836-3656 -FAX: 508-5349182 AMEQ tiCORPORgT10N=� : ::.:; -c.�.,:.r r. ., $,, - ►1:�.�.> c�c...r-�. ����.,,;,Y4� *,��� w�,.�_' �_. f .: ,T :slat 5/I.nte ra In /Lan .' NAME OF:NEW�BUSIN `;S m, In .wstie_.C.o_.. ....unication..Seruic�s� C TYPEOFxBIJSINESS__• —n Ion r t q QuageFS� ::,>< •t t.. s" r-:k;.., �-.; .,..:.: v ..x.,, a: .. .. ,. ..„ .' :.. • ,.*...:�,. ,an� •k:.+a ._ .. c, ,... , �:xy � r a-+„> a -'.- ..,..,w:ie<,r...•Y.��+�x:.w„aaa.r,`�u...g�.r a..-1' ..rr,:�:� a + ,.-�};a:g.„ �.,.w,h; : ' - .aa.%s.. k „ >-':Y' "` ' }} � .. ;:F } .-<' ..n,.a; C;.-,{,:#.£d:'3,w: :•4' .'. f ,r !`� y '1'.^.,tn...to :^h i,.. k .r ..Y.. ..k• .1. � :!!;A•„�..w.....�t.H`.1.. i.. ,iT�. !-i.. �ih'k1fi=:...... � .�,� n .{ 3> 3 y�... iYb �F ..T.Wr in(."Vn..." "4 f ;IS•THIS,A OME OCGUPL!►TI011� .• , E ;,, N „ ,„;; �Y IIn ulstS1cornrnunicatlo.n aia com}z ,:.a r a;'"i..r... .. .,y•., ..: _ wu,is.> .➢J_';, i. ,.tE,:k;GY:..l s w`:e w ',"".. f ,.,,..:>y�:a,.�i�c-«�'..";N i ^,,tJc'_-.3} �� +r."o - t, <� - �"• K x e;- 5".. r When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. MUST COMPLY WITH HOME OCCUPATION 1. BUILDING COMMISSIONER'S OFFICE RULES AND REGULATIONS. FAILURE TO This individual has be nforme f anv permit requirements that pertain to this type of business. COMPLY MAY RESULT IN FINES. Auth P' a Signature*,* r ri COMMENT ' r W NJ 2. BOARD OF HEALTH This individual has been informe *,F.1.,, er i r qu' ements that pertain to this'type of business. v Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LIC SING AUTolri� n This individual has informed of tng quirements that pertain to this type of business. A o zed Sign ure* COMMENTS: Parcel Detail Page 1 of 2 �) ^ �,` i ;3Alslh57KBLE a Logged In As: Parcel Detail Tuesday,January 5 2016 Parcel Lookup Parcel Info Parcel ID 1271-041-OOU ( Condo U iit FuN,T 21 1 Condo Complex SEA MEADOW VILLAGE I Building'BLDG B�v Location 1720 PITCHER'S WAY I Pri Frontage E Sec Road FALMOUTH ROAD/RTE 28 Sec Frontage Village HYANNIS I Fire District HYANNIS ---^-- `— Town sewer exists at this address Yesv I Road Index 1276 �v Asbuilt Septic Scan: ` P Interactive 271041000 1 Map I m_ Owner Info owner IDASINA, MARCELO B&SUZANA C B I Co Owner! %HSBC BANK USA, NATIONAL ASSN TR r streets C/O OCWEN LOAN SVCG LLC I Street23 1661 WORTHINGTON RD STE 100 City IWEST PALM BEACHI State jFL zip 33409 Country I Land Info Acres 10 _J Use Condominiu MDL-05 I Zoning I RB Nghbd 0001__� Topography F7 Road Utilities �I Location I Construction Info Building 1 of 1 Year 1988 I Roof(` I ExtI Built Struct# wall Living(�1236� Roof AC One Area Cover L Type I Style Condominium nt Bed I wall Drywall ( Rooms 12 Bedrooms _ {; Bath Model Res Condo I FloorCarpet I Rooms 1 Full-1Int Half I w Grade — I Heat Elec Baseboard I Total 4 Rooms Type Rooms < Heat Found-ip rt stories 2 Stories Fuel Electric ation I'"oured Conc. Gross 2028 Area http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=20395 1/5/2016 Parcel Detail Page 2 of 2 Permit History Issue Date Purpose Permit# Amount Insp Date Comments r Visit History Date Who Purpose 9/16/2013 12:00:00 AM Tony Podlesney In Office Review 8/4/2004 12:00:00 AM Paul Talbot Meas/Est v, Sales History Line Sale Date Owner Book/Page Sale Price 1 4/26/2004 DASILVA,MARCELO B&SUZANA C B 18497/114 $225,000 2 12/31/2001 TEMKIN, ROBERT H&ELLEN P 14646/334 $138,000 3 6/15/1988 THOMASINO,WILLIAM L&LINDA 6314/50 $100,000 4 4/15/1988 SEA MEADOW VILLAGE ASSOC 6232/3 $1 5 111/2/2015 1 HSBC BANK USA, NATIONAL ASSN TR 29245/85 1 $130,000 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2016 $124,500 $22,700 $1,300 $0 $148,500 2 2015 $137,100 $19,800 $1,600 $0 $158,500 3 2014 $137,100 $19,800 $1,700 $0 $158,600 4 2013. $161,900 $15,800 $0 $0 $177,700 5 2012 $157,800 $15,800 $0 $0 $173,600 6 2011 $176,100 $0 $0 $0 $176,100 7 2010 $179,700 $0 $0 $0 $179,700 8 2009 $228,600 $0 $0 $0 $228,600 9 2008 $228,600 $0 $0 $0 $228,600 11 2007 $228,600 $0 $0 $0 $228,600 12 2006 $218,300 $0 $0 $0 $218,300 13 2005 $207,300 $0 $0 $0 $207,300 14 2004 $167,900 $0 $0 $0 $167,900 15 2003 $74,400 $0 $0 $0 $74,400 16 2002 $76,800 $0 $0 $0 $76,800 17 2001 $76,800 $0 $0 $0 $76,800 18 2000 $63,600 $0 $0 $0 $63,600 19 1999 $63,600 $0 $0 $0 $63,600 20 1998 $63,600 $0 $0 $0 $63,600 21 1997 $61,400 $0 $0 $0 $61,400 22 1996 $61,400 $0 $0 $0 $61,400 23 1995 $61,400 $0 $0 $0 $61,400 24 1994 $62,100 $0 $0 $0 $62,100 25 1993 $62,100 $0 $0 $0 $62,100 26 1992 $70,800 $0 $0 $0 $70,800 27 1991 $102,000 $0 $0 $0 $102,000 28 1 1990 1 $102,000 $0 $0 $0 $102,000 Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=20395 1/5/2016 L Sep,5. 2G12 11 : 24AM No. 2443 P. 1 t: Christina Wells (C) To: Brenda at the Building Divison 200 Main Street, Hyannis MA 02601 Subject; 720 Pitchers Way Unit B 21, Hyannis MA 02601 -- Marcelo B Dasilva To: Brenda at wilding Commission for the county of Barnstable-- Massachusetts VIA; Facsimile: 508-790-6230 Thank you for speaking with me Brenda. My company is the 3rd party property preservation servicer for the mortgagors' bank. We are checking to see if there are currently any outstanding liens, code violations, and or fines, etc on this address/property. If indeed there are, please return those notices in a paper format? I will then submit that paperwork to the client, i.e. Bank for evaluation. Their legal department has the final call as to What if any amounts will be paid during.this pre-foreclosure time period. I thank you in advance for your time and attention to this matter at hand, Tina Wells On-Site - Pre e atlo Specialist National-Field Representatives 16675 Addison Road Addison TX 75001 Tel: 469-645-3000 ext 50116 christina.wellss c,power-reo,corn It is our mission to provide excellent customer service to our clients. Please contact my supervisor direclty if l hove not met your expectations. Korrie maybe reached via email:kgoodspeed@nfronline.com or by phone at 800-639-2151 ext 2254. 1 ., LISA GARDN FR lNV[STIGATOR LO O LO N O \ 1' o Coyle, Brenda From: Coyle, Brenda Sent: Thursday, September 06, 2012 8:42 AM To: 'christina.wells@power-reo.com' Subject: 720 Pitchers Way Unit B 21, Hyannis To: Christina From Brenda Coyle T-h in'response to your facsimile;regarding 720 Pitchers Way Unit-B-21, Hyannis,_MA_,�We currently do not have any code violations, or open building permits that pertain to mentionedproperty. We cannot tell you if there are an liens on the Y Y property, you will need to contact the Barnstable Registry of Deeds phone number 508-362-7733, our Tax Department phone number is 508-862-4054. Thank you, Brenda Coyle Building Dept. Admin Assistant 1 !1 ` Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 9/4/15 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 ; RE: Building Permit#201505280 r ' TO: Building Inspector(s), This affidavit is to certify that all work completed for 720 Pitchers Way,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 . . YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates.(cyst$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you. must ao by M.G.L. it does not give you permission to operate.) You rnust first obtain the necessary signatures on this form'at 200 Main St:, Hyannis, Take the completed form to the Town Clerk's Office;.1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get'the Business Certificate that is required by law. QQ DATE:.1 .6 15 Fill in'please:• ffi��"" '�r`� � �" xi APPLICANT'S YOUR NAME/S: s1LU 6ESt SiLIJA a;�� rlb.3 .rii u,,y, BUSINESS YOUR HOME A DRE S: O e r 3 3 6 A{yJNI AAA 1 baA O� TELEPHONE # Home Telephone Number ID�P N ME�OF C OR R T N ;:. ��=TYI?6..OF'BUSINESS:. O BUSINESS, a>. NAME F'NEW :. ..t ,. P TI N YES. •.:•' :O E w I T I A H A ' IS:A s A[]DRESS'.O.:B1�51NES5...._,.. ., i. .,,.: > vet.`} >. -0 ..MAP/PARCEL.N,UiViBRI> ; When starting anew business there are several things you must do in order to be in compliance with the rules and regulations of the Town'of Barnstable. This form is intended to assist you in obtaining the information you.may need. You MUST GO TO 200 Main St. -(corner of Yarmouth ..Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM SSION R'S OFFI This individu I ha en inrarm d fa y p " mit e uirements that pertain to this type of business: . MUST COMPLY.WI.TH HOME OCCUPATION RULES AND REGULATIONS' ,FAILURE.TO - uth 'z d.Slgnatt7re COMPLY MAY RESULT'IN FINES.. COMMENT r1 1 - ' 2. BOARD OF EALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** ; COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** ' COMMENTS: Town of Barnstable 'THE Regulatory Services, o Richard V. Scali.Director Building Division # snxNSUBr E x v mass Tom Perry,Building Commissioner s639. '°lE ►dra't° 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us. Office: 508-862-4038aX: 508-790-6230 Approved: Ile/ Fee; J73 S Termit#: a 4,/-S HOME OCCUPATION-REGISTRATION Date: a K? A5 Name: 06 5t Cf ey y/L V Phone#: Address: 1?0 C ke rs � ClI�/s A� i( ,llage: r Name of Business: ��/y 0/t 4 Type of Business: Map/Lot / - D ' 6./ R%TI=: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation. within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning"ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in'traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be pennitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit • Such use occupies no more than 400 square feet of space. There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, . odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. . There is no exterior storage or display of.materials or equipment • There are no commercial vehicles related-to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. No sign shall be displayed indicating the Customary,Home Occupation. , • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be . -included: - • No person shall be employed in the Customary Home Occupation who is not a,permanent resident of the dwelling unit I,'the_undersigned,have"read d wi e abo,. restrictions for my home occupation I am registering. Z Applicant Dater Homeoc doc Rev.103113' own of Barnstable Regulatory Services Richard V. Scalii,Interim Director Building Division 1639. `e� Tom Perry,Building Commissioner fp 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: LIM Permit#: HOME OCCUPATION REGISTRATION Date: 14 Il'Y\ llY-.-) Phone#• J( � Address: T Will _ J �: ann s Name of Business.7S-Y,� XJ Type of Business: '� r �� — l� I :. �� Map/Lot: ` INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation - within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activi shall not be discernible from outside the dwelling- there shall be no inc. ty increase in noise or odor;no 'visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes and no 'increase in air or groun dwater water pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit •. Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. There is no exterior storage or display of materials or equipment • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked.on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Q1Applicant. /�..[� v Date: l `y Homeoc.doc Rev.103113 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$4000 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you . must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200.Main St., Hyannis. Take the completed form to the Town Clerk's Office,.I st.FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 7= v - Fill in please: cct=tip+s ia�,a " jujyn APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS:'�'cr7 -- 1 h 64 r'y'$i4rS.�n /dAof 6 TELEPHONE # Home Telephone Number (5 0!21 27 Z - / Q 6- NAME OF CORPORATION NAME OF,NEW BUSINESS: 1 . - TYPE OF BUSINESS IS THIS ANOME OCCUPATIONS YES . NO J iVIAP PARCEL.NUMBER 1 (Assessin9) ADDRESS OFBUSINESS .,v<r ..nJ� Q When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. -(corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONERS OFFICE This individual has been informed of n permit requirements that pertain to this type of buV89YCOMPLY WITH HOME OCCUPATION AuthorG ed Signature* RULES AND REGULATIONS, FAILURE TO COMMENTS: n r t ,2 iy�� 'T-� '� ; C,0 fl.Y MAY RESI 1I T IN FINIFC 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: i ar Dorothy S Schrumpf DBA Common Threads Alterations Et Tailorshop Mashpee Commons Mashpee, MA 02649 (508)477-7103 June 26, 2014 To whom it might concern, This letter is in to explain the tailoring process that Tania Amorim performs for Common Threads, Alterations Et Tailoring at Mashpee Commons. Tania makes alterations on articles for our customers by coming twice a week to our facility to pickup and drop off any article that needs to be altered. The articles are already marked and ready for her to work on them, so she has no need to be in contact with the public. We are extremely satisfied with the high level of quality that she offers. Please do not,hesitate to contact me if you have any further questions, call at 508-477-7103, Sincerely, tv Dorothy Schr pf Owner June 18, 2014 Cape Cloth Care, INC. d/b/a Centerville Cleaners 1663 Falmouth Rd. Suite 2 Centerville, MA 02632 ,a- To Whom It May Concern: . This letter is in regards to Tania Amorim. Mrs.Amorim performs ur alterations for fr Centerville Cleaners, and on a daily basis, she picks up any article�of clothing that needs to be altered. When she completes the alterations�vlrs Amroim drops the clothing off at our Hyannis location. She roughly w&'.ks of t fifteen hours a week, and does a tremendous job. If you are to have axfy of questions,please do not hesitate to call at 508-778-0288. Sincerely, 141 Emilios Rigas President M .. r• YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town.Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required bylaw. s M T DATE: 17 Fill in please: APPLICANT'S YOUR NAME/S: S LVA- x =C�1 BUSINESS YOUR HOME ADpRESS: � S 3 TELEPHONE # Home Telephone Number NAME OF CORPORATION NAME_OF NEW BUSINESS TYPE OF.BUSINESS T' IS THIS,A HOME OCCUP:ATION9 YES J ADDRESS OF,BUSINESS . MAP/PARCEL.NUMBER � Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO ISSI NER'S O FICE This individ al h en�rlf o any ermit requi ements that pertain to this type of business. A on Sig ure** - `+ COMME T �— 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS LICENSING AUTHORITY) ) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: Town of Barnstable Regulatory Services P Thomas F.Geiler,Director Building Division MUMSTANX v� tMASS. Tom Perry,Building Commissioner prFn MAc" 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:�0-6230 Approved• Fee: s -O Permit#: o20/c>2 D5 3D.3 HOME OCCUPATION REGISTRATION Date: lag I IQ Name:�I lU a� l Va Phone#:�� pZgO Address:7a Q P17`-r—h(KS(JQu ArP34, Village: Name of Business: �s P�'� / Type of Business: ��z � Map/Lot: INTENT: It is the intent of this section to allow the residents of die Tome of Barnstable to operate a home occupation F«dnin single family dwellings,subject to die provisions of Section 4-1.4 of the Zoning ordinance,provided fiat die activity shall not be discernible from outside die dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use; no increase in traffic above normal residential volumes; and no uncrease in air or groundHater pollution. After registration with die Builduig Inspector,a customary home occupation shall be permitted as of right subject to the folloHang conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located«athii that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve die production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hamrdous materals,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one win or one pick-up trick not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on die same lot containing tie Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If tie Customary Home Occupation is listed or advertised as a business, die street address shall not be included. • No person shall be employed uh die Customary Home Occupation who is not a permanent resident of the dwelling unit. I, die undersigned,have read and above r trictions for my home occupation I am registering. Applicant: st Date: (/ 9 Homeoc.doc Rev.01/3/08 t �T TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a Parcel s r* SWRI-� A.` I � _��1� �ST �F Application #C Health Division Date Issued Conservation Division Application FW d Planning Dept. ,. ,, Permit Fee_ 1 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 4g.n 1 1\4aerS W a, y Village 'C et r�aAn IS Owner S km i r �1 OSSG�al,d Address fn (' Telephone_ 5 n R 3 0 rr Permit Request Add ���� ce � R -� t 6 +o ' �e I , e I.G �aSe4 CCAJ �i i C At It Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 310 b Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑ Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ANo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION / _ -.-- - - - -(BUILDER OR HOMEOWNER) - Name �A G LU�ShB r�f tr cJ�i� ����Telephone Number ( 9D 98 � 1 Address _T�� +06,1 ,%IAn A-Ye License # ZC S• � Home Improvement Contractor Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Ya�mpK�� SIGNATURE DATE' A I /� s FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER 4 'i DATE OF INSPECTION: F FOUNDATION t FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL 4 FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite.100 < Boston,MA 02114-201.7 www massgov/dia - «'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electrielans/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Busi nesslorganization/.Individual):Cape Save Inc Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 0266.4 Phone=#:508-398-0398 Are you an employer?Check the appropriate bog: Type Of project(required): 1.R I am a employer with. employees(full and/orpart-time):* ]" blew COriS1T11GtiOn 27 lam a sole proprietor or partnership and have no employees working:for me in: capacity. 8: any Remodeling p ty.[No workers'comp.insurance.required:] 3.r-1 I am a homeowner doing all workmyself.IIVo workers'comp.insurance:required.]:t 9. ❑Demolition 10 Building addition 4❑1 am a homeowner and will be hiring contractors to conduct all work on my property: I will ensure that all contractors either have.workers'compensation,insuruice.or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.n Plumbing repairs or additions 5:❑I am a general contractor and I have hired the sub-contractors'listed on the attached sheet. 13.❑Roof.repairs These sub-contractors have employees and'.have workers'comp..insurance.- 14.(�✓ OtherInsulation 6.❑We area corporation and its officers have exercised(their right of exemption per MGL c; - 152,§1(4),and we have no employees.tNo workers'comp.insurance required:] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy,information: f Homeowners who submit this affidavit indicating they are doing all:work and then hire outside contractors must submit a new-affidavit indicating;such. *Contractors that check this box must attached an additional sheet showing the name.of the sub-contractors and state whether or.not those entities have employees. If the sub-contractors have employees,they must provide their workers':comp.policy number.. I am an employer that is providing workers'compensation insurance for my employees. Below.is the policy and job site information. Insurance Company Name:Wesco Insurance Company Policy#or Self-ins.Lic.#:WWC3136274 Expiration Date:04/09/2016 Job Site Address:, 720 Pitcher's Way City/State/Zip; Hyannis Attach a copy of the workers'compensation policydeclaration page(showing the policy number and expiration:date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to$l„500.00 and/or one-year imprisonment,as well'as civilpenalties in the.:form of a STOP WORK ORDER and a fine of up.to$250.00:a day against the violator:A copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. I"do hereby certify under th pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 8/11/2015 Phone#:508-398-0398 Official use only. Do-not write:in this area,to be completed by city or town official 4 , City or Town; Permifticense;# Issuing Authority(circle.one): 1.Board of Health 2.Building Department 3 City/Town Clerk 4.Electrical Inspector S..Plumbiniz Inspector 6.Other Contact Person: Phone#: AC CERTIFICATE�c� / �i— �'J'i ' �. -- BILITY IiVSURA�ICE DATE(MMJDDr^TY) �,24�zDss THIS CERTIFICATE IS ISSUED iAS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE H04DER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND; EXTEND OR ALTER THE COVERAGE AFFORDED.BY`THE POLICIES: BELOW. THIS CERTIFICATE OF INSURANCE DOES>NOT CONSTITUTE A'CONTRACT BETWEEN THE ISSUING INSURER(S)AUTHORIZED RERRESENTATNE QR PRODUCER,AND THE;CERTIFICATE HOLDER: I PO.RTANT: If Ills Cectitlsate holder Is an ADDITIONAL INSURED,then potieylles)must be endnrserl. If SUBROS3ATiOFI is tiyAi fED;,srxbject to the terms and conditions(it.the Policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER NAME: Colleen Crowley Risk Strategies' Comipany <. PHotE {781)98fi.=4400 Fa 4. /C o:(781)963=4A20 15 Paeella Park Drive ecrowle @risk-stategies.com Suite 240 .,. INSURER S AFFORDING COVERAGE NAIC P,aadcslp2t M 0236I3 INSURERA:Se'3ective Tns.. 6F America AmUREDMuRERs Al3aafexica. Finaacia2 A�liagce: : 0212 Cape Saire., Inc INSURERC-Pesco Insurance. an - 7 D Hunt3ugton. Ave. - INSURERE Mth Yanatith 019" . INSURERF•• COVERAGES CERTiFtCATE NUMBER.CL1532491503_ REVISIQN NUMBER: .T#•FiS'IS TE?CE4Z'nFY T1 AT THE PGLICIESflF"INSURANCE 11STED i3ELOW HAVE BEEN ISSUED TO THEINSURED"NATGIED ABOVE YOR-KET'OLICY`PERTOtI INDICATED. NOTWiTFl3TANDING ANY REQUIREMENT T'ERiUi OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT UUITi1 RESPECT`.TO tNFIIGH THI5 CERTIFICATE MAY BE:ISSUED OR MAY:P.ERTAIN,THE INSURANCE:.AFFORDED BY THE POLICIES DESCRIBED HERElN-1$SUBJECT TO ALL THE TERMS,: EXCLUSIONS AND CONDITIONS OF SUCH,POLICIES.'LIMrrS,SKOWN'MAY HAVE BEEN REDUCED,BY PAID CLAIMS. ,NTRR TYPE OF INSURANCE,„ II=AM S POLIC.Y NJMBER COL ICY.EFF MPO M!ICY EXP LIMITS GENERALLIA8ILITY EACH OCCURRENCE $` � ,000,000 X. COMMERCIAL GENERALLIABILITY DAMAGETO PREMISE Ee ocurrenc $ 100,000 A CLAIMS rotADE �X OCCt1R ' ' 1994480 0/16/2014 O/1,6/2015 MED EXP(Any one person) g 10,OQO PEtSONAL,:$ADV NJjPY s ` 1;Q001Q00 GENERAL AGGREGATE $' 2,-000;000 GEN'L AGGREGATE LIMIT APPLIES PER, ' PR ODUCTS Comp/Op 2 000 00,0 POLICY- X. PRO-. $ r , _X IOC. $ AUTOposie-liniury Ee accident 1,000,000 ANY M0 BODILY INJURY(Per perron) $ ; AIT LLOWtdED SCHEDULED 6.796600, 1/.6/2014 1f6f2015 AUTOS AUTOS BODILY INJURY(Per accident) $ t. X :HIRED AUTOS x AUTOSV4Plt� RROFERTY DAME It 5.. X:. P 0ni X. UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 1,.000,.000 EXCES9 LIAB GLAidtS tvLADE AGGREGATE DED REfENIION oil 01994400 9/16/2014 0/16/2015 WORKERSGPI►9PZN§ATIQN $..: AND EMPLOY ERS'I fAB�ITv fEiebrs Included. for X TOPY `vac STAT T TH ANY PROPRIETORIPAITNER/EXECUTIVE Y 1 N average I OFFICEP,JMEIvg3EREXCLUpED? N, NIA. E.L.EACH ACCIDENT' $ 500 000 (Mandafory in NHI 1352 T4 jr9/201'S 19/2i71`6 . IP yyees•descr'be under E.L.DISEASE=EA.DAPLOY 17ESCRIPTION OF OPERATIONS befow __. . E L.DISEASE.-POLICY.LIMIT $ 506 0O0 DESCON OF OPERATIONS/LOCATIONS(VEHICLES(Attach WORD 101,Addlttenal Remark PoPTi s Schedule,If more space is required► Issued as evidence of:: nsurance. Thielsch Engineering, Ina is listed as additional insured.;as respects General Writ Liabilitlr`as xequired ,bjr te aontragt... CERTIFICATE BOLDER CANCELLATION .. ' r oa<Jt:Oape] ghtconpac ar S#10tiLti AlYif OF'THl:ABOVE DESCRIBED'Pbj ICIES BE.CAfJCE1,LED EEFORE 7tiE EXPIRAfiON DATE.'THEREOF, NOTICE WILL 6E DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS.: Attu. Margaret Sgag; ... .. :.. .. . RO BqX 427/501 AUTHORIZED REPRESENT TIME 3195 Main t-r t Sarastable ; 1�' -02630; ahael ACaR�'2 (�TD/05� Q E999-2D'10 ACOR:t3 Ct1RRd�ltAT{OPJ A##Aqg reservsd. IN8025(zows).a1 The ACORD name and::Io o are registered marks of A.CQRD Office of Consumer Affairs and Business Regulation r 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation M 1 Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. WILLIAM McCLUSKEY ,--� 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 ---- — - -- ----- " i' Update Address and return card.Mark reason for change. Address E. Renewal 0 Employment Lost Card SCA 1 % 20M-05/11 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only qOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 171380 Type: Office of Consumer Affairs and Business Regulation gk Expiration� 3/14 2/016 Corporation 10 Park Plaza-Suite 5170 t Boston,MA 02116 CAPE SAVE INC. . M k N WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE°p SOUTH YARMOUTH, MA 02664 Undersecretary Not vali rthout signature Massachusetts -Department of Public SAfety Board of Building Regulations and Standards Col-rit7iittif-in siifiriti"fir Snecialiv, - :License: CSSL402776 WILLIAM J MC '�- 37 NAUSET ROAid West Yarmouth I%A `` Expiration Commissioner 06/28/2017 f 4,ug. 11. 2015 2; 31PM HOUSING ASSISTANCE CORP — ENERGY No. 5231 P. 2 Sea Meadow Village Condos August 16,2015 Energy Source Attn: Suzanne Smith Re: Weatherization of Unit A7 This letter authorizes%Energy Source contra to perform their weatherization program in Unit AVr ned by Samir A. Mossaad located at 720 Pitchers Way, Hyannis, Ma. 02601 f Paul C. Carlson Resident Manager 720 Pitchers Way 19B Hyannis , Ma. 02601 Ph-508-862-2329 e/m paulretired@comcast.net HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. I hereby consent to and agree that weatherization work may be done by the Wea erization Program of Housing Assistance Corporation on the property located at: The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping; air sealing; attic & basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement and give my consent. Home Owner(si9nature •v Home Owner email: Date: Agent:(Signature) Date: j"� +, Weatherization Contractors. Adam T Inc ape Sav�nergyy All Cape Energy Solutions Alternative Weatherization Lohr Home Improvement Building Science Construction Resolution Energy -Cape Cod Insulation Tupper Construction TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' Map t?,7 Parcel 6 Ll I 60 sV N O rl�--11STAB E Application # Health Division Date Issued Conservation Division Application Fee / /6 Planning Dept. S�Permit Fee ��10 • Date Definitive Plan Approved by Planning Board, Historic - OKH _ Preservation / Hyannis Project Street Address 0 ETC ' IT- Village 146ank�5 Owner L I B-T H u Y N H Address Telephone SO _ 9!0(0 Qc? tj C Q,LL �[� e G 7, 1 Permit Request r fi s . S Square feet: 1 st floor: existin� O proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuationAl 000 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family `� �2 Two Family ❑ Multi-Family (# units) Age of Existing Structure l\g��7 Historic House: ❑Yes XNo On Old King's Highway: ❑Yes XNo Basement Type: ❑ Full ❑ Crawl ❑Walkout Ather JOnOC Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) JA Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: � existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil Electric ❑ Other Central Air: ❑Yes <No Fireplaces: Existing MNew Existing wood/coal stove: ❑Yes)<No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name A'F5 e sc ��q�! ►2 15�rA.5 Telephone Number bc�;.(03 ,. `V Address 5 MCtAT-0r5H ] l 4 License # i(16 " [ -� L ` I -7- -A UkmO IPA Home Improvement Contractor# 0(o (4 zS R Email Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO gm_sm is LX ow,,.i IdAd<�3W, 5,rA­-r('C�A�N �o G SIGNATURE ��n�ATC FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. y, ADDRESS VILLAGE " OWNER 7 DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL c FINAL BUILDING DATE CLOSED OUT x ASSOCIATION PLAN NO. r - •� �e�arf '�ru�sl�ird�lEcidett�s tree e��uYQ�ts WO W=*hWvw&reet Aostwae MA.92 wnm.rna=ga f4dza Camapensafiau lnsua-ance Affidavit:Rpfld-rsfCagfra Grs/BecbcicianMumbers Applicant Iufurmafian Please Print i Name _ BEST ' LAT erV l QC4S 61�JC, citylsta CLJ-rO Q4jgA Plwno Are ytn an employer?Check fire appropriafr.bu= Type of project �= L❑ I am a employer wia 4'[ I s confzaetor acid I 6_ [:]New man employees(2311 aaWorpa>t-fine)_* havehiredthe 2.❑ I am a sole proprietor orparEner- listed on the attached sheet y- ❑Remodeling ship and have no employees These sib-contractors have g_ ❑Demr&ion . working for me is any capadty. employees and have wozkess' prosvorleis`camp:insure cep.insma�Y �_ ❑Building addition 1 5_El wi a are a earporatian d its I ❑Electrical repairs additions 3.❑ I am a homeowner doing all work officers have egrrcised their I L❑Plumbing repairs or additions. myself[No woriors'camp- rigbt of em=ptionper MGL I?❑Roafrepaus i umnance reqMir ]I c.152,§I(4},and we have no employem[No worms' I Other.L A I GJr-, comp-insvrarim required. QA M IAay wFliot=t3ssrcIm&s box al=scalsa M evrthe sec�b9vwdowimg menva&ee oompensK loin lEEmwwneisvrbasubrmit$usaTulavyff5d) theyamd=3gwg-vadcsadH�mbireDu=dec�astm==—s`abmmt�ya�mwafidaukmnJY-inch_ mS thit APAIbh WR ,�}j�xa2Aeitl AR9t,iLQet IL w_nstw Ui�•flLrll3W`l�lWi.\ 'tzbt rhEdke �=tiasE iWLMc mnployees Ifthe sa�r coa�akush.�e�Ioy�s,the3*�xst pQavide their—1-e{clap.poRicp MM b- Irun atz emptGow that isprmiding u arkers cougma ndiarn t m=rmca jor my emp7ayem Helots is ffte pa cX and job site " i�t,fnrmrrhart_ Insurance CompanyNa ne: Folicy I,-or Self inr-Lie. FxpfrationDate. Iob Site Anidress. Colstat yzip_ Attach a copy of the vrorkers'compensation policy-ere Lwation page(showing the polky=mber and expiration date). Failure to secam coverage as regtriredunder Section 25A of MGL c. 152 can lead to the imposition of criminal pwalties of a fine np to$LSOD.Oa and/or ana year- - I as well as civil geaalfi es in die fcr=of it STOP WORK O1ZDEiand a oi`up to$250-00 a. gainst the r. a advised that a copyr of this t may be ffirtuarded its the Office of Investigations 9fte D�A for coverageffnoexc I do hereby fy r ' s urp� ur atiari prods£abase a/h7w and correct Si mature: i ate` J Phone i#_ b r 3 s• 1 9 Oukild use only, D&scat Write ill fhis area"to bg crrrrtpleted by Gdy at tmn oficiaL City or Towa: Perm tiI.,cemse 9 F`�Aathordy(circle one L Board of Health 2.$uiF�;Department Cifyfrdw a Clerk 4.Electrical Inspector S.Piumbmg Iaspmtar 6.Other CaUIRet Person: Pherne=#: 6 TME flown of Barnstable .A ,� o Regulatory Services r r ' * A1A11 SAT s suss. Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Omer Must Complete and Sign This Section If Using A Builder na HA as Owner of the subject property hereby,authorize AQ S 1 n c, to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Fools are not to be filled or utilized before fence is installed and aMnal inspections are performed and accepted. ignature of of ppli t , �QJ le) N - 1A y 4 S Print Name Tint Name Da e , QFORM&OWNERPERMSSIONPo0LS 62012 Office of Consumer .Affairs and Business Regulation y= .. 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration ................ Registration: 106438 _ Type:_ Supplement Card A R S SERVICES INC Expiration: 7/23/2016 _ - WILLIAM REIS ........... ..--- .. - i i 38 CRAFTS ST _.... .. . . NEWTON, MA 02458 Update Address and return card. Mark reason for change. scar 0 20ts1-05111 _i Address I, Renewal Employment ! Lost Card ,r r.uriur.irrrrn /�r n:�.;rrc rrr:tr/L; `' Office of t:onsumcr rlfl'airs�&Business Re uintion g License or registration valid for individttl use only before the expiration date. If found return to, t• it- Office of Consumer Affairs and Business Regulation Registration: 106438 Type: 10 Park Plaza-Suite 5170 Expiration: 7/23/2016 Supplement:''ard PP Boston,MA 02116 A R S SERVICES INC ' WILLIAM REIS i 38 CRAFT ST NEWTON,MA 02458 . -...... _. ._. .... - ----- --- Undersecretary valid without signature SEA MEADOW VILLAGE CONDOMINIUMS 720 Pitchers Way Hyannis Ma. 02601 April 20,2015 Barnstable Building Department Hyannis, Mass.02601 This letter authorizes ARS to act as GC in unit A8 at Sea Meadow Village Condominiums. Paul C. Carlson Resident Manager/Trustee 720 Pitchers Way 19B Hyannis Mass .02601 Ph 508-862-2329 C 508-566-2329 E/M paulretied@comcast.net I r' O Bedroom 12 x 12 Lin (1002 In 1 Untt1 0!1 Living/dlnlnp Bedroom 1Bx1t1 12x15 V � UNIT - 982 S.F. K UNIT �+ T '- 1.012 S.F. Sea Meadow Village - Nyannls, Mass- Do Unit Nos. 6, 16, 43 & 53 (1 Unit) Unit Ar000 Aro AppWoxtnat. AM 4 Mot 012345 10 8, 14, 45 & 51 (K Unit) • IneWl. eaw�.nf, CsrrNao AM MIe.nN. •> �Aassach.usetts - Department of Public Safety Board of<Building Regulations and.Standards Construction Supenfisor License: CS-103111 JASON R FRMTA,!� v `�; .-:j.. 5 MC INTOSH DI+tIVE", Taunton MA 027$0 . �� ` Expiration 05/1312016 Commissioner l t Client#:235036 ARSSERVICE ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 4/06/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: HUB International New England PHONE Fax 600 Longwater Drive (IC L°.E"t: A/C,No): 978-988-0038 ADDRESS: Norwell,MA 02061 INSURER(S)AFFORDING COVERAGE NAIC# 781 792-3200 INSURER A:Nautilus Ins Co 17370 INSURED INSURER B:Hartford Fire Insurance Co 19682 A.R.S.Services,Inc.A.R.S.Services,Inc.dba A.R.S INSURERC:Commerce Insurance Co 34754 Restoration Specialists INSURER D: 38 Crafts St.Newton,MA 02458 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS INSR WVD POLICY NUMBER MM/DD MM/DD A GENERAL LIABILITY X X ECP0153788714 9/24/2014 09/24/2015 EACH OCCURRENCE $2 000,000 X COMMERCIAL GENERAL LIABILITY PREMISES RENTED $100,000 CLAIMS-MADE I OCCUR MED EXP(Any one person) $5,000 X BI/PDDed:10000 PERSONAL&ADV INJURY $2,000,000 X Pollution Liab CPL X X GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PEOT LOC X $ C AUTOMOBILE LIABILITY X X 13MMCBGBJWM D912412014 09/24/201 COMBaacci INE SINGLE LIMIT 1,00O,000 EdenDt $ X ANY AUTO BODILY INJURY(Per person) $ X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accdent $ A UMBRELLA LIAB X OCCUR X X FFX153788814 9/24/2014 09/2412015 EACH OCCURRENCE $5 000 000 X EXCESS LIMB CLAIMS-MADE AGGREGATE $5 000 000 DIED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under . DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ (. B Property 08UUMR06539 9/24/2014 09/24/201 $950,000 Blanket Business Personal Prop incl Prop of Others DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) - a i CERTIFICATE HOLDER CANCELLATION Seameadow Village Condominiums SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 720 Pitchers Way 19B ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE } c ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1355460/M1222934 CW001 i �11 . 1. 1. ARSSE-1 OP ID:SH' • .4C"MLY , DATE(MMIDOMYYY) l� CERTIFICATE' OF ;LIABILITY INSURANCE; 0410612015 THIS CERTIFICATE IS ISSUED'AS A MATTER-OF INFORMATION ONLY AND CONFERS NO RIGHTS.UPON THE CERTIFIC1.ATE HOLDER.THIS CERTIFICATE DOES`NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLII.CIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE"ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 'IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGAT10N IS WAIVED;subject to the terms and conditions of thepollcy,certain policies may require J.an endorsement 9.A statement'on this to does not confer rights to the certificate holder in lieu of such,'endorsements PRODUCER COMACT NAME: Rodman Insurance Agency,Inc. r. pHOHE 145 Rosemary St.,Bldg.A c No, E A/c No:" Needham,.MA 02494-3238 EMAIL Evan TObaSI(yADDRESS:-: INSURERS)AFFORDING COVERAGE NAIC t 1NSURERA':BeaCOn Mutual Insurance INSURED' A.R.S.S,enriCes, Inc. INSURER s':/4.LM:-'Mutual dbaA.R.$ Restoration NsuRERt Specialists-Newton 38 Crafts.St INSURER D.: Newton,MA624666 1NSURERE INSURER F't COVERAGES CERTIFICATE NUMBER- REVISION NUMBER: THIS IS TO CERTIFY THAT THE'POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED':NAMED ABOVE FOR THE,POLICY PERIOD INDICATED. NOTWITHSTANDING ANr .Y REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT-OR.OTHER DOCUMENT VI'ITH RESPECT TO WHICH,THIS CERTIFICATE MAY BE ISSUED OR MAY'PERTAIN,THE INSURANCE AFFORDED BY THE C E POLICIES DESCRIBED HEREIN IS'SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES .,LIMrrS SHOWN MAY HAVEB REEEN, DUCED BY PAID LAIMS. ILTR TYPE OF INSURANCE INSR POLICY NUMBER MMIDD MMIDDIYYYY LIMITS GENERAL LIABILITY r. EACH OCCURRENCE $ ' COMMERCIAL GENERAL LIABILITY, DAMAGE T D jitPREMISES Ea occurrence - $ CLAIMSMADE..a OCCUR MEDEXP(Anyoneperson) $ - PERSONAL&ADV INJURY $ GENERAL AGGREGATE $' GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMPIOP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO= BODILY INJURY(Per person) .$ ALL OWNED SCHEDULED % Ir. BODILY INJURY(Per accident) $ AUTOS AUTOS: NON-OWNED PROPERTY DAM 46E HIRED AUTOS AUTOS' 9. PER ACCIDENT $ . �:� . ::r I �� . . 9 1 . �. � : �9:-:%a 9 ..I: � .;� : I 9. ,, :��,�:.1 :9 _. ,,. .9 , . ��.. , 9�� �'r%- : �..�_:�r�. UMBRELLA OCCUR EACHOCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION$ $ WORKERSCOMPENSATION _r. WCSTATU- OTH AND EMPLOYERS'LIABILITY X Y LI 5 E A ANY PROPRIETORIPARTNERIEXECUTIVE Y/N 0000064630(RI) r. 09/24/2014 09/24/2015 E L.EACH ACCIDENT $ 1,000,00 % OFFICERIMEMBER EXCLUDED? N!A B (Mandatory in NH) % MZBO080062932014A MAINH 09/24/2014 09/24/2015 Ea.DISEASE=EA.EMPLOYEE $ 1 000,00. If yes,describe under - DESCRIPTION OF OPERATIONS below: E L DISEASE>POLICY LIMIT $ 1;000,D0 I . r . . ��r::.�iffi I w .. ,�.� ,.. r '.. . .�r,:I r� .. : I � � ,. 1�. �� . DESCRIPTION OF OPERATIONS LLOCATION31 VEH]CLES (Attach ACORD 101,`Additional Remarks Schedule,if more space is required)' CT Work Comp-w/The Hartford #,6S60UB9972M31013; 9/24/14-15. 1m1/lmil/lmi1- r : , . :: .��.I , . I� .:"I 9 , .. i -9 9 � -,:7�1.:. I .: �I . .,� CERTIFICATE HOLDER ,'• CANCELLATION S EA-- s HOULD ANY'OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Seameadow Villa a Condos _ THE ExPIRAnoN DATE THEREOF, NOTICE WILL , DELIVERED IN g. ACCORDANCE WITH THE POLICY.PROVISIONS 72C Pitchers IMay 1`9B Hyannis,MA Q2601;_ `AUTHORIZEDREPRESEMAI 1 ©1988-2010 ACORD CORPORATION.'All rights res®rw.�.� . .. I �.., - - � �,,� ued ACORD'35(2010f05) = The ACORD name anti logo are registered marks of ACORD Oil iCAcT e A 4LI CAFE- I N, irnt� T�,ST n T- ,, _y - - ' - �. `� �1 Y � i ��� �� �' y , Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-102341 ITSt, WHIAW R REI% /r rut 251 OLD CRAIG HYANNIS MA 0 601 Expiration Commissioner 09/17/2016 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �- Parcel r' 00d Application # O 58 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee !!r>l00.0 Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address 1 C KC FZS t(/4/y 0 tf' /-�- Village Owner ; It c-Al� (Out ,Cp Address �� �(C�IrRS � 01 Telephone 50�K �z !/ 2 Permit Request O w .' +LA-C- i✓ �t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation .v' Construction Type W n-6�- Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new .4 Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# u� Current Use Proposed Use APPLICANT INFORMATION f (BUILDER OR HOMEOWNER) Name -(�s ' `� Telephone Number sd�` a 3 �l �' r Address �.✓ 144 License # _C S_ rQ 14 f� Home Improvement Contractor# i S3 7�� Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE A DATE r FOR OFFICIAL USE ONLY i� t APPLICATION# DATE ISSUED r MAP/PARCEL NO. •4 ADDRESS VILLAGE 9 OWNER t '9 DATE OF INSPECTION: FOUNDATION FRAME t INSULATION K FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT t ASSOCIATION PLAN NO. r r 5• THE r, Town,of Barnstable . Regulatory Semees * saFuvsrwste, � . v MASS. �, Thomas F.Geiler,Director 1639• jDrED MAC A Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Ovmer Must Complete and Sign This Section If Using A Builder I, Ile t-L , as Owner of the subject property hereby authorize i2CDS ( 0 C—1 kc)Y+ to act on my behalf, in all matters relative to work authorized by this building permit. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. L- Signature of ne Si ture of Applicant Print Name Print Name ® Date Q:FORMS:OWNERPERMSSIONPOOLS 62012 The CommonnteaM of Vassachusetts Deparhnmt of htdmsl id Accidents - f3Twe-of rnvesAkafions 600 Washirjgton Street Boston,MA 02LIJ wn'w.ina-mgmMica Workers' CompensationInsaranraeAffidavit:BuildersiContractvrs/FAectricianslPlumbers A. ydicant Infarmation Please Priut Legibly Name(13ttsie�lOrganization(fndivittnal7: � f���G' %� . Address---?" /�-►n U" � (� - City/State-/Zip: Phone Are you an employer?CheVk the appropriate box: Type of ect r 4_ Ia�txs contractor and 3'1� �� {���_ 1_❑ I am a employer with © f� 6- ❑New construction employees(fall andlorpart-time).* havehired-the sub-contractors. 2-❑ I am a sole proprietor or partner- listed on the attached sheet: y- ❑Rtrnodeling sb3p and have:no employees These�-contractors have 8_ Demolition w for mein y employees and have wormers' ❑ or�ng Y capacity- I 4_ ❑Building addition[No�workers' comp_insurance comp_insurance_ regmred-., 5..❑ We are a corporation and its 10_[l Electrical repairs or additions 3_❑ 1 am a homeoumer doing all wad officers have exercised their 11_.❑Plumbing repairs or additions myself [No workers'comp- right of exemption per MGL 12_.❑Roof repairs insurance required_]1 c_152,§1(4),and we have no employees [No wormers' 13-0 Other comp-insuranm required-1: *Amy appliamt that checks boa W 1 must also fill out the section below showing iheir wa lers'compensation policy iuf rontima- Homeowners orho submit this affidavit miirv&g tbay are doing all trod[and area hire outside contractors= submit a near affidwit md'acs n such 40Dntcactors that check this boa must attached an additioosl sheet showing the nmme of the SDI)-oorrft3cboss and state Whether tsnot those emities Lave employees_ If the sob-cotlttactots here employees,they must pmvide their-workers'tamp_policy number_ I am an employer that is prm idirag it�orkers'compensation insurance for my employees Belau is the policy anal job sita informahan. Insurance Company Name: Policy;ff or Self-ins-Lic-;`: Expiration.Date: Job Site Address: CityMate/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requireduuder Section 25A of MGL c_ 152 can lead to the imposition ofcriminal penalties of a fine up to$1,500.00 and/or one-year-imprisonment,as well as dirii penalties in the fog 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 maybe forwarded to the Office of im estigations of the DIA for i surance:coverage vetification- I do hereby ciertafy cinder paints saaadp8nallies o_perur}�that the inforrraafion prm�id8d above is Eros and correct SiEmture: Bate: 41 b- Phone#: Ojiciul use only. Do not write in this area,to be completed by city or town official al City or Town: PertmtUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CityfFawu Clerk% 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 Information and Instructions � Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance-coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their cer%ificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'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 Indusirial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 'I1e affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Depar-mient of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly- The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant- Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would Ile to thank you in advance for your cooperation and should you have any questions, please do not hesitate,to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Tndustaal Accidents Office Of kvestigatfons 600 Washmgton Size Bostou2 MA 02111 TeI.A 617 727-4g40 W 406 or 1-9 MA.SSAYE Revised 4-24-07 Fax A 617-727-7149 W .roass-govIdia J -r ' � C, ;..7r `r.�� � cC r �� ItC.t.yCi lf ,k e •'.; t ?+�.trt ,"t 9.7.'? � � .y r'< C'f ,<_" ,f,`� ,f•t'„p, t t ;�."e �,..ram L Vfl.F3i ry/92'YJ'LdYi CllG6l;���L Q��JI�G.GQ9CGC17�/.G1f:� Office of Consumer Affairs&Busidess Regulation -- ME IMPROVEMENT CONTRACTOR ,egistration: .193792 Type: xpiration: 1iiryib __ DBA. C & F REMODELINGq"_ _ �$ CARLOS FIGUEIR—.% _ 20 CAPTAIN NOYES R S. YARMOUTH, MA 02604 Undersecretary Mazzschusc", Dep.- 4ment of Public Saftty f Board of Bu !zwq RSqut.,._,vns end Stzndr-rd C,m,,truction !:aperi hur License: CS-104107 %N,.t 1 I\ lj f CA WS H FIGUEIROa 20 CAPTAIN'N'O)'ES RD '1 SOUTH YARMOUTH MA 0244 6 11 13i CW, ,TM isSFespar 081251201 cop o 0 ,��t.�r`x�,y �n..y5 `� .��:�'�.,,,'z,.r��•,w. �,�;� ��.#�',r4 ss'�'� �`���.� �a � �'za"�� ,"�'T � a; a re.a..:,�.�mo- ,�y x-��F.,4 a''� a+"� '?.� �•�y a�r�$'�+"� 7 '�'4 f ,�-xb N`rTy`} t'� 3�� �i�F�'�4`. • !�'•i`2.4'kxi:+b.�a�i�.�."�. d�4.a..'�.a-.s H�.wrf4..��'`r .w:��'xd,.F3,«x�.+.x�",w�s. ...�ttn.�`�.r.�.'^'+ �(e±$' °�iCdr.ra99��ggly(s��r�y �q'�yy�z�♦sp����r�x�ca •i't�,r+h�fA} POY✓�'�.PI 00..�' ��d` 3 Mf Z.VO5lnf;�E[ U'f b a iitg r Ne;. r'=�l�J rP+�C�ft15 .c4il2'iai�:: 00 ems✓ �..+ Aso' HR GV`r'.A Y - f 0 TMY+. X ♦f� • x cy SEA MEADOW VILLAGE CONDOMINIUMS 720 Pitchers Way Hyannis Ma. 02601 April 2,2015 r Barnstable Building Department Hyannis, Mass.02601 This letter authorizes Carlos H. Figueroa to act as GC in unit A4 at Sea Meadow Village Condominiums. Lic . CS 104107 Paul C. Carlson Resident Manager/Trustee 720 Pitchers Way 19B Hyannis Mass .02601 Ph 508-862-2329 C 508-566-2329 E/M paulretied@comcast.net The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 To whom it may concern, _Y am sending-a copy of the original_affidavit that the client, and or insurance agent sent to us a while back. I just want you to know that the original affidavit is good forever and that you must keep a copy on file at all times. Also know it is the client's obligation to give a copy to his or her agent and or insurance carrier each year. Unless the agent is the one that received the original approval then it would be up to the agent to keep the copy on file. So please keep a copy on file at all times. Thank You, Department of Industrial Accidents Office of, Investigations The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations i4 I Congress Street, Suite 100 Boston, MA 02114-2017 May 12,2014 G Tile,Inc. 593 Old Strawberry Hill Road Centerville, MA 02632 Notice of Decision Regarding Affidavit of Exemption for Certain Corporate Officers or Directors Pursuant to the provisions of MGL 152, Section 1 (4)as the amended-by Ch. 169 of the Acts of 2002 your affidavit has been reviewed and the Office of Investigations has determined the following: NOTE: It is your obligation to submit an approved affidavit to your insurance carrier in order to complete this process. X The affidavit was approved on 5/12/2014 . Attached please find your approved affidavit. The affidavit was rejected on . Your affidavit was rejected for the following reason(s): Related SWO Case ID#: Affidavit ID#: 171540 f. FORM 153 The Commonwealth of Massachose . Department of Industrial Accidents Aw Office of Investigations- Dept 153 i Congress Street,:Suite100,Boston,Massachusetts 021:14-201 http://www.mass.gov/dia ' 7 AFFIDAVIT OF EXEMPTION FOR CERTAIN CORINot?,stal�r<�`4ctrraTs::- OFFICERS OR DIRECTORS Chapter 169 of the Acts of 2002 amended M.G.L. c. 152, §1(4) by adding the following paragraph.- "This chapter shall be elective for an officer or director of a corporation who owns at.least 25 percent of the issued and outstanding stock of the corporation.Notwithstanding section 46,-these provisions shall apply only if the corporate officer provides,the commissioner of industrial accidents with a written waiver of his rights under this chapter. Said commissioner shall promulgate regulations,to carry out the purpose:of this paragraph.Violations of this paragraph shall subject the corporation to.the penalties set forth in section 25C Pursuant to M.G.L. c. 152, §1(4)as amended,I/We the undersigned officers of: (Name of Corporation and Address) each holding at least 25%of the issued and outstanding,stock in said corporation,do hereby invoke the right to be exempt from the provisions.of M.G.L.-c. .152, §25A and therefore,are not required to carry a workers' compensation policy covering the undersigned corporate officer(s) or director(s). I/We the undersigned do also waive any and all rights to make claims for benefits as defined in M.G.L. c. 152 for any injuries that may be sustained while in the employ of the above-named corporation. Further, I/we the undersigned do understand that,.should the above-named corporation hire or have in its employ any employee(s)in addition to the undersigned corporate officers) or director(s), said corporation is required to obtain workers' compensation coverage for the employee(s)as prescribed by M.G.L. c. 152, §25A:. I/We the undersigned have read and understand the statements and obligations as delineated above and I/we have checked the appropriate.box below'my/our name(s) indicating my/our desire to be exempt or not to be exempt from the provisions of M.G.L. c. 152. Si ned der a pains and penalties of perjury:ciagLa Si re Print Name.& Y g P ❑ Y g p ( �YYyy Sign to exercise m right of exemption tion or rwish NOT to exe le,e m ri ht.of exemption Date mm/d Signature Print Name&Title Date(mm/dd/yyyy) ❑ I wish to exercise my right of exemption or ❑ t wish NOT to exercise my right of exemption Signature Print Name,&Title Date(mm/dd/yyy Y) ❑ i wish to exercise my right of exemption or ❑ 1 wish NOT to exercise my right of.exemption. Signature Print Name&Title Date(mm/dd/yyyy) ❑ 1 wish to exercise my right of exemption or ❑ I wish NOT to exercise my right.of exemption Note:ALL ELIGIBLE CORPORATE OFFICERS MUST SIGN. THERE CAN BE NO MORE THAN 4'SIGNATURES. InStrUctionS on back Form 153—712010 _ 1 i Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 6/5/13 Town of Barnstable Thomas Perry CBO _ Building Commissioner 200 Main St. Hyannis,MA 02601 = 4 RE: Building Permits d„ Dear Mr. Perry, This affidavit is to certify that all work completed for 720 Pitcher's Way APT F45,Hyannis has been inspected by a certified Building Performance Institute(BPI)Inspector. Ceiling: R-19 cellulose w/air chutes All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey �� � `� � � � � � � ',, i1 � � � � YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. Fill in please:__ .-- - - - - _ DATE APPLICANT'S YOUR NAME/CORPORATE NAME. BUSINESS TYPE: BUSINESS YOUR HOME ADDRESS: �jMA N1 TELEPHONE # Home Telephone Number, o R '-;-,J NAME OF NEW BUSINESS`-'— � ' OR EIN: Have you been given approval from the uilding divisio ? YES `�, NO ADDRESS OF BUSINESS - ` MAP , CEL NUMBER U-rl 5 When starting a new business there are several things you must do h,00rder to be in compfi nce with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the inform tion you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. / f f,. 1. BUILDING COMMISSIONER'S OFF IC This individual has .een informe o any permit requirements that-pertain to this a of business. Authorize Signatu ** COMMENTS: 0 r2, �o e 2. BOARD OF HEALTH This individual has bee orme f thep re mit requirements that pertain to this type of busines L � Authorized Signature** COMMENTS: Z,. 3. CONSUMER AFFAIRS ( ICE SING AUTHORI ) This individual has e n 'nf r f the 1' ements that pertain to this type of business. Authorized Sign a** COMMENTS: � ' 1 'J✓t � I y* vS�s�I OFTHETpt�, Town of Barnstable *Permit Expires 6 h o e Regulatory Services Fee * aARuvsTnsis, 9� nMas.� Richard V.Scali,Director 16;q. Building Division Tom Perry,CBO,Building Comm '% r 200 Main Street,Hyannis,MA It I If www.town.bamstable.ma.us MAR 27 2015 Office: 508-862-4038 F p�AaTO8,_f9O-6230 EXPRESS PERMIT APPLICATION - RESMmf1! L' `8 Not Valid without Red X--Press Imprint Map/parcel Number 2 7 19 Yl 00 Property Address 7 0 fitc le-r_s �✓`� l ❑ Residential Value of Work$ / Minimum fee of$35.00 for work under$6000.00 //Owner's Name&Address 0 U G e— Contractor's Name M e-rr ee,lee (1 G1 # Telephone Number t%lecf riC/qn t C tractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance r f Check one: ❑ I am a sole proprietor ❑ I anlike Homeowner ave Worker's Compensation Insurance Insurance Company Name /n e. h�lgc t f-19 4 Workman's Comp.Policy# '0 O e c/7 31 a Copy of Insurance Compliance Certificato4nust accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Wind6ws/doors/sliders.U-Value (maximum.35)#of windows #of doors: Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. J SIGNATURE: l Q:\WPFILES\FORMS\building permit forms\EXPRESS. c Revised 061313 ` fr'-= 4. r The Commonwealth o,f Massachusetts Department of Industrial Accidents q Office of Inivstigations, 600 Washington Street fi wmv,.mas&gav1ilia '"Forkess' Compensafian Imur a ce Affidavit,Builder sl n-h-actorsrtEl nslP"lumbers Applicant Information Please Pint Legibl Naive(Bush orgauizationrIndixidualy e�/7?e-rr ' leep-IC Q' Address: e_C t4-b e_ I City[Stata/Z p_ c✓, Leg t'►'101- M 0 d ' Phone 47- W -2,4 3J S— Are yyjefin employer:'- eck the appropilate box: Type of project r uire 4. I am a general contractor and I }7� p 1 1. l am a employer with 1 ❑ 6- ❑New construction. emTloyees(M andlarpart-time).* have hired the sub-contractors 2-❑ I am a sole proprietor or partner- listed on the attached sheet. 7_ ❑Remodeling slip and have no employees These sub-contractors have g_ ❑Demolition working for mein any capacity. employees and have workers' 9_ D Bu ty addition [No worla-ss'comp_insurance comp._insurance.1 required-] 5- ❑ We:are a corporation and its 1t1_ ectrical repairs or additions 3.❑ I am a homeoumer doing all work officers.have exercised their I L❑Plumbing repairs or additions myself [No workers'comp. right ofexemption per MGL 12.❑Roof repairs insurance required.]7 c-152, §1(4),and we have no employees_[No workers' 13.❑Other comp.insurance required.] •Any applicant that checks box#1 most also fill out the section below shoacing their wuAe a coffipenwtion policy inform3don_ Homeowners who submit this:affdmit mi&caung they are doing all worts and then hire subuut anew affidavit ind catng,sack- Conuacmfs that check ibis box must attached an addivonal sheet showing the ring ofthe sale-contractors and state whether or not those enrif es have errrpin}rees.If the sub contractors have employees,dieymust provide their a orkers'comp.policy number. lain an empLa er tliat is proiridirrg workers'conrpertsaliorr itrsrrrarrce for ury ettipIoy=ees. Below it the polic}'cued job site iraforrrrcrliora. insurance Company Name: %//e /7�1��/-0 r -- Policy 4f'or Mf-ins_Lim 0 i7 W e C+ ,7 d Fa piration Datef Job Site Address: Do f e.( u A i t City/statelzip: 6"I' h i t Attach a copy of the workers'compensa.' n.policy declaration page(showing the policy ber and expiration date). Failure to secure.coverage as required un Section 25A of MGL r 152 can lead to the imposition of criminal penalties of a. fine up to$1,500.00 and.ror one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDERand a fine of up to$250-0.0 a day against the violator. Be advised that a copy of this statement may be fxsmwded to the Office of luvestigataons of the DIA for insurance coverage verification_ Ida lrereb�),certi ,tender tlrepairrs alyd peralt es df p. :i+.rt dratflee irrforrrrntiore ptardcted dbos is trrr-e arrd correct Signature: ! Date: '2 b/ / Phone 9: Official rise onlj. Do not ivrite-in this area,to be completed by city or totvrt ofciaL City or Tom : PermitUcense# Issuing Aathwity(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone f#: a _ -. .. .. . . --------- -------- rl � C., �FTHE Tp� f * BARNSTABLE, 9$ "�: ,�� Town of Barnstable 'OTEn Ma,�a Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, O `� , as Owner of the subject property hereby authorize 6-d M @ Cr V to act on my behalf, in all matters relative to work a/thorized by this building permit application for: P f t C Xtri lvew (Address of J ) AK� 3 7_ o>S Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILESTORMSIbuilding permit formsEXPRESS.doc Revised 061313 t. Town of Barnstable Regulatory Services �oFsr+e roty,� Richard V. Scali,Director Building Division BARNSTPABLE, � Tom Perry,Building Commissioner MASS. 1639• 200 Main Street, Hyannis,MA 02601 ATFD MAt t` www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 1 `� o�� Please Print DATE: A —,2 ( j� JOB LOCATION: / �� C �✓ ,,- ,41 tA A I nu ber s eet village "HOMEOWNER": Q M- 7,5 name ho e phone work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requiremen s d th t he/she will comply with said procedures and requirements. Signature of H eo r Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doe Revised 061313 gj(o olm � I CARBON MONOXIDE ALARMS ` MUST BE INSTALLED PER _.- MASSACHUSETTS BUILDING CODE ✓ S KE DETECTORSREVIEWED 3-Zo—1� I BAR TA13LEBUILDING EPT. ATE - FIRE DEPARTMENT DATE i BOTH SIGNATURES ARE REQUIRE0 pop p6HMITING r J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map..'Iq Parcel 0A Application Health Division Date Issued/1 7` _1 q P� Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address �OAO �l i C I�E�S (�l/�`� — u N T- Village LU Owner 6ei'5 i 7'AfJ_& 15�4',U4 Fi'i Z.&7&Z4&'6 Address Telephone cc� Permit Requests Square feet: 1 st floor: existing proposed 2nd floor: existin proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 0 No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area..s .ft) _ Number of Baths: Full: existingJ new Half: existing ;newer_ Number of Bedrooms: existing _newCn --_ --s Total Room Count (not including baths): existing new First Floor loom Count C'" Heat Type and Fuel: ❑ Gas ❑ Oil IN Electric ❑ Other Central Air: ❑Yes 22 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ® No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION I (BUILDER OR HOMEOWNER) Name %J&P O '�b;1 '1 'V6 `�.(,/wo�C-z,;!� Telephone Number S 0sc,27 3 Address `� S 9,a i Tom/ S -r' #Y,4V✓✓I S AOLicense # 5 - I 0 Home.Improvement Contractor# lT . Worker's Compensation # 1 10Q1 14 0,3 5011 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AIZAw Es Po 4Q,� SIGNATURE V DATE FOR OFFICIAL USE ONLY APRLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER '�. DATE OF INSPECTION: FRAME --INSULATION : . FIREPLACE ELECTRICAL: ROUGH FINAL ; PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING l _DATE CLOSED OUT ASSOCIATION PLAN NO. J � Hie Corr monywa th ofMassachaseffs Depa f uent of firt lutrid Accidents 600 Was-ldnglonStreet Bast aay MA 02HI www.rn ass.gor-ldia 'workers' Compensation Insurance A fidavib BuilderslContr-actorsMerfriciansMumbers Applicant Information Please Print LePibly Name Co 61?A)0 i&D,'Al 6,, cf, P,,(,/L40 b66,�'U 61 CitylStatrJZip: ,AM— d 5 —M4 O ® Phone 47 508 c�7q 3 q Y Are you an employer?Check the app:rapriate box: Type of ect o. �r ITT 1 eqnired)_ 1_❑ I am a employer with 4_ �^i I at�t a ge�al cxmfractor and I employees(full andlorpart�me). * have hired the soli-contmdors. 6_ New o�z listed on the attached sheet, 7- ®Remodeling I am a sole proprietor or partner-sinp and have no,employees These s�cc4tractors have 8. ❑Demolition w for me in an Capacity empla��and have wodcers' Working y cape. t5 1 9_ ❑Building addition [No workexs comp.me�iranre COMP.incitrance_ 5_ We are a corporationand regair ifs 14:0 Electrical repairs or additions ed._3 3_❑ I am a homewAmer doing all work right ht of bona r their 11_.Q Plumbing repairs or additions right:of e�mption per IvfGL nryrsel€ [No workr�'comp- 12..0 Roof repairs inntrsanrcLt:quired_]I C_152, §1��,a4dwelnHL�eua emplo--yees_[No workers' 131-1 Other comp-insurance required-J. *tiny saps that checks boa f l mast also fM out the section belaw showmg their woakeisT coir�pensatioxi gaii�in�imafioo_ t Homeowners who submit ibis attidxvif m r Uw they afe doing&H troth.m3 then bee outside contractors— submit a new afdavk mH"irstm &ar'h =Goatraciors thst chrff--k this box most attached an additional sheet sbawi,-the name of the sub-omk3cton and stet$whetker ocnat those mntities have ampinyees- If the ni -contmctois have employees,the}zmi-st ptmride th-ir rwkess'comp.policy number I am arE helots is thepaHry an.d}ob site iri�OYri;Ct[tf1Zf6 . Insarance Company Name: O a r� /� ` /�L p — Policy 4 or Self ins_Lim o�� 0 p >? 0 1 0 Expiration Date: Jab Site Address:7k �i�f{�2S WAY y.5/ �9N�S AO cit���staterzip: ��;'�-v�✓�� � O�G D� Attach a copy of the wGrkers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure cry ge as required under Section 25 A of MGL c 152 can lead to the imposition of climiinal penalties of a fine up to$1,50G_00 andlor one-yearimptiso ty as well as civil penalties in fhe 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 maybe forwarded to the Office of fimestigations of ihe DIA fUr insurancz coverage verification I de hereby., f& tkepca"hs arutpenatlies o.p,edjury that the information prmi&dabm a is Eros and correct Phone#- �Q 0 � 7 q 3 Y ' E3zcPa[use ant} Zkr not fvrit�in flits area,#v bs caaapteted by t�F fovea-afciaL — — — -- — City or Town: PernfitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.£ityffown Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 onthe grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also statts that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealh for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)series "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 vith the insurance requirements of this chapter have been presented to the contracting auth�onty." Applicants — Please fill out the workers' compensation;.,davit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)=a .(s),address(es)and phone number(s)along with their c:ertaficate(s)of insu;�nce. Limited Liability Companies(LLC) or Limited Liability Parineish_-ps(LL P)with no emp!oy�,s other than the members or partners, are not required to ca11y 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 Depardment of industrial Accidents for confirmation ofinslrance coverage. Also be sure to sign and date the a,$da-,rit 'nit 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 zny questions regarding the law or if you are required to obt:_i.-i a workers' compensation policy,please call he Depa:-�ment at the number listed below. Sell insured companies should enter their self-insurance license number on he an,Dropriate line. City or Town Officials PIease 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 Tnvestigations'has to contact you regarding the applicant Please be sure to fill in the permitllicense number which will be used as a reference number. Tn addition,an applicant that must submit multiple penaiVEcense applications in any given year,need only submit one affidavit indicarng current poLcy information(if necessary) and under"Job Site Address"the applicant should write"all locations ilz (city or town).-A copy of the affidavit that has bin officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on idle for future permits or licenses. A new affidavit muurst be tilled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.c. a dog license or permit to burn leaves etc.)said person is NOT required to complete this aiiidw it. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. Th1 Commonwealth of Ma.ssachus,-�tts Dt ar>zatDI ofIndnstdalAocidents Q��fI4'e Qi�.�e�tigdlFUxi& 600 Wasbingtaa Sftc,et Boston,IAA 02111 Ttl. 617-72 -49-00 W 406 or I fASSAFE Kevinetl 4 2 d7 FaX# 617-` 27-�49 ------- - - ----- ---- -- Town of Barnstable Regulatory Services MASS. Thomas F.Geiler,Director �Eoca Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Ov►rner Must Complete and Sign This Section If Using A Builder I, C/V617 4d C' �UA A i Z&7&12®-C'D , as Owner of the subject property hereby authorize tf,&/,o y'ly E Z to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. L 0� / r- Signature of Ow�ep Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS 6/2012 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction SuPer"isor License: CS-103617 PABLO C MART 49 SMITH STZ HYANNIS.MA 02601 y Commissioner Expiration 11/17/2015 Office Of Consumer Affairs&Bus] ess Regulation e�°" OME IMPROVEMENT CONTRACTORLicense or registration valid for individul use only egistration: before the expiration date. If found return to: / 142802 xpiration 5/20/2016 DBAType' Office of Consumer Affairs and Business CUERVO BUILDING+ 10 Park Plaza-Suite 5170 Regulation REMODELING` Boston,MA 02116 t, PABLO MARTINEZ i 49 SMITH ST - HYANNIS, MA 02601 Undersecretary - . Not valid witho t signature SEA MEADOW VILLAGE CONDIMINIUM ASSOCIATION November 15,2014 Ms. Cristiane M. Fitzgerald 11 Sierra Way West Yarmouth, Ma.02673-2622 Sea Meadow Village Condominium Association authorizes Ms. Fitzgerald owner g g of unit 43C at 720 Pitchers Way, Hyannis to replace the windows that have selected to be done with Harvey white vinyl windows. Thank you for taking this measure to update your unit. Paul Paul C. Carlson Resident Manager 720 Pitchers Way 19B Hyannis, Ma. 02601 Fax: 508=827-7061 Ph; 508-862-2329 E/M paulretired@comcast.net .. .. ,G•W'ti! `ai-.. .j.y'�: .l s:�L,,:ki�.."�.„'.rw,:�i+'S.d -;.{.N.,�{.r.; (Y-s.'.{.,sR"" .c.v. ,. ++. ... +.�'" .s:*�r_4i4 fw;..r:`-u t,..R; i .. Town of.Barnstable oFt"e Regulatory Services do Thomas F. Geiler, Director r * * BARNSTABLE, MASS. $ Building Division i63q. ,0 Thomas Perry, CBO, Building:Commissioner 200 Main Street, Hyaniiis,,MA 02601 www.town.barnstable.ma.us ,Officer 508-862-4038 Fax: 508-790-6230 EXIT ORDER DATE: 7 / LOCATION: 6 - cze UNDER THE PROVISIONS OF 780 CMR, THE STATE BUILDING CODE, SECTION 3400.5.1, YOU ARE HEREBY ORDERED TO IMMEDIATELY DISCONTINUE THE USE OF THE CELLARBASEMENT AREA FOR SLEEPING PURPOSES. C_ LOCAL INSPECTOR SIGNATU-RE� RECIPIENT ODEM DE SAIDA DATA: LOCALIDADE: DE ACORDO COM 0 PROVISORIO 780 CMR, CODIGO DE CONSTRUCAO DO ESTADO, PARAGRAFO 3400.5.1, VOCE ESTA OROENADO DE DEIXAR DE USAR,IMEDIATAMENTE, A AREA DO PORAOBASEMENT PARA 0 PROPOSITO DE DORMIR. INSPETOR LOCAL ASSINATURA DO RECIPIENTE � �\ yy,,, � . Rv � � � � � � � � � �, , � � � � � � � �� -� OF THE Tp Town of Barnstable BARNSTABLE. Regulatory Services 9 MASS. °639. Building Division �prED Mp'1 p. 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 J�----�"nspection Correction Notice Type of Inspection Location C 2 3 5-ec, I y,Nl�c Gl�c�r�s Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: IN Ci,,4 e y ei o u - cL--5 s 1�c�.�-._-i r� a—c"L s Z /c` 7 �.'V t Nii�L 1.C' 4 �a I' ✓�G/ ���"Z��i/'l // Please call: 508-862-4038 for re-inspection. Inspected by Date E sY ..r' `'/ -Sty§'�'�'�+�-r�!^'� t� 1. :.v� � l.ev,. �. r+ .._ -,'�'�s"s• '�.. T".:+ ,��s�h-.�..::ylr`'�-ta`3t"'�"'r.-Y�.:.pr.. ���-'"��t •y,�};,ti ,tti�N" OF `oFTHE. ti Town of Barnstable BARN5fABLE. = Regulatory Services MASS. .. _ 1 O3 9. �a`0 ¢" Building Division 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 / Fax: 508-790-6230 Z ,O Inspection Correction Notice +r�� /} s Type of Inspection , Location C Z 3 Se4 APc-do u/s Permit Number at)a1,r Owner. Builder One notice-to remain on job site, one notice on file in Building Department. The following items need correcting: Cb \ l.�ci.-�P r 1� w• li 5 t N'b A a-r/t s `N; j s r t w • ��k4e� sow �:�_f �.� , 'Y w s 1 , . Please call: 508-862-4038 for re-inspection. Inspected by Date a PIrcel Detail Page 1 of 3 j ill , ».% 's 170 Logged In As: Parcel Detail Monday, Decemb Parcel Lookup Parcel Info - Parcel ID 271-041-00W I Condo Unit'UNIT 23 Condo(SEA MEADOW VILLAGE 9 Building BLD C J, Complex Location 720 PITCHER'S WAY Pri Frontage Sec RoadFALMOUTH ROAD/RTE 28 , sec Frontage Village IHYANNIS ..._..w�_.�.._._..___.._.._.�. .....�_.._..._...I Fire District HYANNIS Sewer Acct Road Index 11276 �y w J yp�axilS d. .•^ � Interactive ' Map _ Owner Info owner 1TROMBLEY, LYNN A �� Co-owner Streetl ;196 NEW LUDLOW RD Street2 -� � -.___ City CH Cl OPEE State jMA zip 01020� Country - Land Info Acres 0 use Condominiu MDL-05 p zoning ;RB Nghbd 0001 Topography( I Road Utilities Location Construction Info Building 1 of 1 Year'_._.___. Roof ..._ r_ Ext, Built 11988 Struct! wall I Effect 11426 Roof __.___ _ ---._._ Ac None Area i i Cover? Type Int.___._..�.__.._..._. Bed _'__._. ._.___ __.._._.. Style!,Condominium I Wall Drywall � Room, Bedrooms Bedrooms Int{ Bath Model I Res Condo Floor'Typical i Rooms 12 Full / tll3/ O� — ,aul:lT 91C-6 1'cts /,V RM ak http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=20397 12/15/2008 Parcel Detail Page 2 of 3 Grade I Heat{Elec Baseboard Total�5 Rooms ustSST� Type Rooms S 853t: #IT[836] Found- Stories 2 Stories Heat;Electric Found :Typical 4- Fuel ation Permit History Issue Date Purpose Permit# Amount Insp Date Comments _Visit History.... Date Who Purpose 11/05/1999 00:00:00 John Greene Cycl Insp Completed-Update Sales History __ _ - Line Sale Date Owner Book/Page Sale P 1 03/26/1999 TROMBLEY, LYNN A 12151/169 2 12/01/1998 WASHEK, ROBERT J TR 1 1 878/2 7 2 3 09/03/1998 PNC BANK, NEW ENGLAND 11677/325 4 05/15/1988 LEACH, WILLIAM C 6244/060 5 04/15/1988 SEA MEADOW VILLAGE ASSOC 6232/003 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2009 $252,600 $0 $0 $0 2 2008 $252,600 $0 $0 $0 4 2007 $252,600 $0 $0 $0 ; 5 2006 $246,400 $0 $0 $0 6 2005 $234,200 $0 $0 $0 7 2004 $221,500 $0 $0 $0 8 2003 $84,500 $0 $0 $0 9 2002 $84,500 $0 $0 $0 10 2001 $84,500 $0 $0 $0 11 2000 $73,100 $0 $0 $0 12 1999 $73,100 $0 $0 $0 13 1998 $73,100 $0 $0 $0 14 1997 $66,900 $0 $0 $0 15 1996 $66,900 $0 $0 $0 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=20397 12/15/2008 r Parcel Detail Page 3 of 3 16 1995 $66,900 $0 $0 $0 17 1994 $64,900 $0 $0 $0 18 1993 $64,900 $0 $0 $0 19 1992 $74,100 $0 $0 $0 20 1991 $110,500 $0 $0 $0 21 1990 $110,500 $0 $0 $0 Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=20397 12/15/2008 .720 Pitcher's Way, .Unit C23 12/13/08 _ t r y � ''C!'� ��, di'� �. 1 w��_-,i ems"^•..- . f ra x II I f p i •i / f JF j � ti - ail v5G t • �r s�WD , a,M ww I i I A �u x 'f x �.,,,� r l � �., � � �•� � � � � �"" � Jos „* WAX raw ;�. 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'n'ra, f� ^ �:x •,,; a 4, ,��.y,�,�sf �; ������4a: �s ? �,�ti ;•�ry�,�"k ,n a �` +�` ,+� ct�' d P�+ ti 1 �i•a h• F .�,��1 �'ti: , I 720 Pitcher's Way, UnifC23 12/13/08 Py [ yJ 7 k 4 W. e t �n �r 3 4 4 tlp` +r &A CI ♦i .;... • - _ i Far� '..:� k .?.•irr� �s „ s i "0 h1` " 1 f ^ e, o.. .• ..�,.,.. .. 1. r Town of Barnstable Regulatory Services ,Yo Thomas F.Geiler,Director Building Division 1AMSTABLE, y MASS. $ Tom Perry,Building Commissioner �i0lfo Mpg aim 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 x• 508-790-6230 Approved: Fee: 4 Permit#: c> Dp '70,(o--3c/f HOME OCCUPATION REGISTRATION—�- Date: oc-r_ D Z - Name: t"�?��S'U�lJ s l v� Phone#: 15 0�3) 4q o- _�1 9 B q Address: :�20 fi 7Ch2-�ae S w.q y C - z6 Village: A�� Name of Business: PFS PZTeC5,04V ,E=A_,zG-7--L, Cis V /yC i (� Type of Business: v` C z�:--.5 Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke, dust or other particular matter, odors, electrical disturbance,heat, glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires, parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned, have read and agree N ith the above restrictions for my home occupation I am registering. xApplicant: Date: 10- Oa Homeoc.doc R€,r.5/30/03 f� C/ YOU WISH TO OPEN A BUSINESS? . y For Your Information: Business certificates (cost$30.00 for 4.years). A business certificate ONLY REGISTERS YOUR NAME in town [which you must do by M.G.L.-it does not give you permission to ope.rate.] Business Certificates are available at the Town Clerk's Office, 1°` FL., 367 Main Street, Hyannis, MA.02G01 [Town Hall] yn :Lt Gill9'. '.�`••_ """ GATE•�V " ' Fill in 4,.or.{... , cc ,i 1 ocffi OEM �a.._ YOUR NAME: •a��,s�s� APPLICANT'S it ,�„y." ^�:• �, aid,;A• •. ..4 13USIIVESS YOUR HOME ADDRESS:- _ TELEPHONE # Home Telephone Number alp - ---9 8 q NAME OF NEW E3uslNEss' P)`S L8C' 2iC/•aw .! G TYPE QF BUSINESS:IS THIS A HOME OCCUPATION? YES NO .: ­14a ou been ..ividh a ro ADDRESS.OFBUSINESS S 027/ 06 . MAP/PARCEL NUMBER When starting a new business there are several things you must do in order.to be in compliance with the rules and regulations of the Town o Barnstable. This form is intended to assist you in obtaining the information you Rd. & Main Street). to make sure you have the appropriate permits and ce ses.reed'. You MUST GO TO�0___0 Main St. - [corner of Yarmouth quired to legally operate your business in this town. 1. BUILDING COM NER'S OFFIC This individu I his errinfoprr ed y permit requirements that pertain to MUST COMPLY WITH HOME OCCUPATION J ��; P type of business.RULES AND REGULATIONS. FAILURE TO Authpriz Si n ure * COMPLY MAY RESULTN.FINES. �CafA�MM NT u • 2..BOARD OF HEALTH This individual has been informed.of the permit requirements that q pertain to this e of business. mess. Authorized Signature** COMMENTS: . 3 CONSUMER'AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature.* COMMENTS: N&PERM.1 PAVgENT RECEIPT TOWN-OF BARNSTABLE BUILDING DEPARTMENT wHYYANNIS, STREET DATE; 10/02/07 TIME: 12:16 -----------------TOTALS----------------- PERMIT $ PAID 25.00 AMT TENDERED: 25.00 AMT CHANGE: 25.000 APPLICATION NUMBER: 200706246 PAYMENT METH: CHECK PAYMENT REF: 837 Town of Barnstable *Permit# S9009 Expires 6 months from issue date Regulatory Services Xe Thomas F.Geiler,Director S PERMIT Building Division DEC. 1 2 2005 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE 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 Q2 7/ d Yl 6 Property Address 77,77 Residential Value of Work Minimum Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Z�� � � — ���� r� `�' ���T 1-4� Contractor's Name Telephone Number� � C Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) (t% orkman's Compensation Insurance Che ,ck one: Kr I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name 11�2_t /7j4 Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Reques (check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. dome Impro ent Contractors License is required. SIGNATURE: Q:FMTM:expmtrg Revise071405 Department of Industrial Accidents " Office.of Investigations- ' . 600 Washington Street y` Boston,MA 02111 Sy www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name (Business/Organizationa&vidual): L./-7—. aA. . Address: /q City/State/Zip: )4Vc.,ori 15 a M D,4M&Phone#: S-6 S 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 I 6 ❑New construction employees (full'and/or part-time).* have hired the sub-contractors 7. Remodeling 2.❑ I am a sole proprietor or pa4aer- listed on the attached sheet:I ❑ g ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. g, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required,] officers have exercised their 10.❑ Electrical repairs or.additions 3. I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself:[No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.]t _ employees. [No workers 13.❑ Other ' camp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: �• t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. - Insurance.Company Name: Policy#or Self-ins.Lic.#: Expiration Date:• Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$.1,500,.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and aline of up to$250.00 a day against the violator. Be advised that a copy of this statemenf maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the p ws-a d enalties of perjury that the information provided ab ve is true and correct Si a - Date:'. Phone#: Official use only. Do not write in this area,to be completed by city.or town official. City or Town: Permit/License# ` Issuing Authority(circle one): I I.Board of Health 2.Building Department 3.City/Town Clerk 4..Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employec�d:, 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 iudivi4ual,.:Parinersbt association,porporation'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. Howev..er.-i4e 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 woiYnn 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, §25 C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence-of compliance with the insurance coverage required." 152, 25C states"Neither the commonwealth nor any of its-political subdivisions shall Additionally,MGL chapter . . § (� enter into any contract for the performance of public work unto acceptable evidence of compliance with the insurance requirements of-this chapter have been presented to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), addresses)and phone number(s)along with their certificates) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the arry workers' compensation insurance. If an LLC or LLP does have members or partners' are not required to c 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 botm of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit(license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is-on file for;fixture permits or licenses..Anew affidavit must be filled out each year.Where a home owner or citizen is obfaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and.fax number:The Commonwealth of Massachusetts . :. Department of Industrial.Accidents . . .. .. �. ..Office 9ff Investigations 600•Washingfon Street. . Boston,MA 02111. Tel.#617-727-4900 ext 406 or•1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 wwwmass.gov/clia i Town of Barnstable F ZHE Regulatory Services � �p� Thomas F.Geiler,Director Building Division I `+ sARNSPABM i v MASS. , Tom Perry,Building Commissioner $iOTfot 1,44 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us i Office: 508-862-4038 Fax: 508-7pM230 Approved: gow Fee: c 'dy Permit#: HOME OCCUPATION REGISTRATION Date: �'� C� - O Name: t7 IJ t `/ Phone#: Address: 7-2 n Pt fG h C= r?S ti �, 3&pyillage: H \ �S Name of Business: � x � 4 V A Peo Type of Business: � ��v1 Map/Lot: c, (Iz i INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that,the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual' alteration to the premises which would suggest anything other than a residential use;no increase in traffic above'normal residential volumes;and no increase in air or groundwater pollution. l� After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that.dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. p • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. { • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in'excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident'of the dwelling unit. j I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. o Applicant:. Date: 4� Z �71 / - I Homeoc.doc .5/ 03 - •. TO ALL�NEW US_1NESS OWNERS DATE: - Os p Fill in please: APPLICANT'S YOUR NAME: ,r BUSINESS YOUR HOME AD RESS: 9 TELEPHONE Tele h ne Nu ber Home o S S NAME OF NEW BUSINESS x to S Z C��rZ�. TYPE OF BUSINESS o 7I i clyl a IS THIS A HOME OCCUPATION? YES NO Have you been given approval from th building division? YES=NO ADDRESS OF BUSINESS 0 a anis MAP/PARCEL NUMBER g�7� �7� D&� When starting a new business there are several things yo must do in order to be incompliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St.— (corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S OFFICE This individual has een info ed of any permit requirements that pertain to this type of business. r I t onzed ignatu COMMENTS: TKO(y KaA—� �C,c� rI r4 rr� i Q1 V� 2. BOARD OF HEALTH This individual has bpen informed of theM__1 equi ents that pertain to this type of business. uthnnzed Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: -- Business certificates (cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. ?' **SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. ................................................................................................................................................................... .:::::::::. ..:.: �........ ........ .::. :.�::: Ills!....::::.: %:�::}iiii::;ii%iiii: is%C�Y.%ii:%i:%iii:�.•.:%iiii:%iiiii:%iii:%iiiiii mills!:.... :...:::......:.........................:n..............:n�-:vv.v.�ii.r.%i5i}:6:......:,�}:.i�':vi:i:.+}`}i:v.v.4:•}:•}:•} ........ ............::.�::v::::... :}::::::.�.�:::;. :} :%i:.. 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". - , ., , , W.M � �td.. . u ., � r, •r - ro �,. � � � F-mow _..d�,.� ... ,,.' .�. ., .. i a `'a e a o- x 720 Pitchers WayD33 , Hyannis 12/ 16/05 s e A 1 i a ` 4 y 1 o" ea ' w yy - •., �".�= - y,.. - ,��. � ar ��� ���'� III III A �, w„�,. -� 720 Pitchers WayD33 , Hyannis 12/ 16/05 fx Tr * y � y5 k yyk _ r n . e +5 a tea: am t # l f ' � F L f ` j � � a w "� r r r,E`i Vat i, 2 `.,�' .s-?Wr Ott wkfyh �.- ShFa•mm'b�n i�-,�'T,0�� �1�+�sk"� �,e'en���rir v"'� � �� ��'�'� S "� 'ry S' - -• - �"�.F Rib n,,/, sty 720 Pitchers Way D33 , y H a n n i s 12/16/05 !� I -14-o5 pF Town of Barnstable *Permit# Id ' p* Expires 6 nfonAsfrqx Issue date 41-100 gul ry Re ato Services Fee *63 Thomas F.Geilert Director Building Division Tom Perry, Building Commissioner PERVIT 200 Main Street,.Hyannis,MA 02601 J U L 1 8 2005 Office: 508-8624038 Fax: 508-790-6230 TQw� OF:BARNS TALE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ry t� Not Valid without Red X-Press Imprint Map/parcel Number Prop Address Addre Residential Value of Work ,,d tO D Minimum fee of•$25.00 foo or der$6000.00 Owner's Name&Address Contractor_s_N O—R-0--149f— ��Telephone Number 1 g� Home Improvement Contractor License#(if applicable) Constructi upervisor's License#(if applicable) orktnan's Compensation Insurance Check one: I am a le proprietor the Homeowner R I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# SPW Copy of Insurance Compliance Certificate'must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-Si Replacement Windows. U-Value r (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other tows department regulations,i.e.Historic,Conservation,etc. ***Note: - Property a must sign Property Owner Letter of Permission. H v t Contra a is required. Signature QForms:expmtrg Revise063004 j r • °F'WE goy, Town of Barnstable Regulatory Services ' B" MUM . Thomas F.Geiler,Director i639 ,�� i0rec3�A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder IgK]O~ C14�15 as Owner of the subject property hereby autho to act on my behalf, in all matters relative to work authorized by this building permit application for. -57 (Address of Job) Z,3�e� Signature of Owner Date Print Name Q:FORMS:OWNERPERMISSION v 063-A-0 38 -A3 DH m6100 Renovations`ns91c Double Hung - inyl ��1"C�'C3 n Ul ow E sc SS NApFWFWmWm Rfto wd No Grids I-800-746-6686 N PC 2001 ENERGY PERFORMANCE RATINGS U-Factor(U.SA-P) Solar Heat Gain Coefficient 0 - s 4 0 . 29 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 49 mm atamrdpw*stwtheseralingsconfbrmtoapplicableMCproceduresfbrdetenniningwhole Pmdad perbinance.WRC ratings are determined for a tbmd set of environmental conditions and a s wMaproductsize.COMMmanufacWmfs Ibmtum toratherpmduct performance information. wwwjft org Unit qualifies for Energy Star Regions): Northern, North Central, South Central, Southern . fl DP : 30 DID: REIN 0o1G_ASS SS/a-x30 'fast Size: 44 x 60 - Order 4c383087303000l 3 c � m t 4 t Xf 2-1 -/l A7 I I I _��•,� - _. � f`. � .1 1. h r r, �• t .. 1 \.. f 1 � 4• � �# ..:5 � � `+ � ` �4 i• .. 'L• ' f peINErp� wk BARN ELF, y MASS. ���// pp ! �0 039. \gym G :�. vfGAdJ�rc/si�dc�ll 02601 RFD MA`1 k' (617) 775-1120 hxf. 123 COMMISSIONERS: - ROBERT L. O'BRIEN KEVIN O'NEIL. CHAIRMAN SUPERINTENDENT JOHN J. ROSARIO, VICE CHAIRMAN THOMAS J. MULLEN PHILIP C. MCCARTIN F Sheldon Buckingham September 8, 1986 Mr Lewis S Gordon 319 Sesuit Neck Road East Dennis, MA 02641 Re: Sea Meadow Village Sewering Dear Mr Gordon: On July 19, 1985, this department issued a letter approving a request made by Louis Teutonico to extend the sewer system in Pitchers Way, Wayland Road and Sudbury Lane, with conditions. Since then studies by this, department now indicate that there may be serious flow capacity .problems in the existing sewerage system through which that approval was predicated. Please be advised that" the prefer-red route is now from the front of the property on Route 28 easterly along Route 28 by gravity to the ten-inch force'main in Bearses Way. There are two possibilities in entering the force main. The first is to investigate entry via "Christy's" existing wet well and pumping station. This would require permission from Peter Mihos, owner, and an evaluation of the pumping system for adequacy. The second possibility is the installation of pumping station with a force main connected directly to the existing ten-inch force main. When your engineer develops a preliminary design you may present it to us. At that time we can make an evaluation of the design, with recommendations and conditions, in order to develop a final design that is mutually acceptable. Should you have any questions please feel free to call. Sincerely, R ER O RIEN Superintendent WNM/RLO/bw . cc: Mr Robert 1 W' Sea Meadow Village _11 As5e4&11 ,f r eµOst floor): ` S y Assessor's map-and lot number ...... �� /. �a�: r �........ 080ard.of Health (3rd floor): / 91 Pc� Sewage Permit xnumber ........................... ... Engineering"Depa'rtment (3rd.floor): - ao r ` House ;umber ..... e,1 APPLICATIONS PROCESSED: 8 30;9 30 •A.M. and 1:00-2.00-P.M. only: "• .. TOWN "1OF BARN:STABLE G IHS-PE,CTOR APPLICATION FOR 'PERMIT TO. .. � ... .,/,. Jf' ... ...... ............... ......... ..... TYPE OF CONSTRUCTION .....:XU..II ....... �°. + ..... .............. :........ TO THE 'INSPECTOR OF BUILDINGS:; "" The undersigned hereby applies for a permit according to the following information: Location ........................... ....... .... . . .. . . ..... ..... ...... ICG'V/, ....�'.� .................................... . ................ Proposed Use / . / l/ i....1.. .1 I�..:..:.1.1�1i1./'I. ..... . . ... Zoning District ........ ..B................... ....:...........................Fire isTrict ........::.. .... �/j � ....... ............................... Name of Owner e Jf l....4dall,- JP :<0,0 �dr ss ....1�. .. ..1 if ..... i Name of .Builder °1 ' , .............................:.....................,................Address ....:. Name of Architect �'1.. ?��4..L`.....Address .l.11�- /'a�O. ..: P..........!!� �/ .AW— _<S r r Number of Rooms ��j..:�.�..... .�..�......." ....::........ .Foundation ,.. �1/e C' ......Q .f�,�'.. 5-...................... Exterior ...!� �.tG.L� e 7.0i leJ.. .G.�. .:&4)Roo�ing S. /� :! !!1/� f .� ..................�� iy Floors (" .... . .5. ���.. !!i. . .... . ................Interior ......... � 1. ... .... ............•......... Heating ... .�...�..(.a`l'G':.:�Q.�:.�1 � .... ........Plumbing ..... `.�.��.L�� :� T.�.L--.........:......:.. M r „_ Fireplace ......... .. Q. .. .............,...:.....................................Approximate Cost .....`..o`. �.vQv................... Definitive Plan Approved b d ____________________'___-:______19.________ . Area y q�do�AP�AIs :.:. ..� Diagram of Lot and Building with Dimensions Fee .:....- — �:.................. SUBJECT TO APPROVAL OF ABOARD OF HEALTH , AWE se, -77T ,l 2- Ct q ll,r(r7p - ,`fl ^ f., - 1. - -.--. • .< - 7 OCCUPANCY PERMITS 'REQUIRED.FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of. Ba stabl rega ing the above construction, Name ............................. .. .. ................. R Construction Supervisor' License f �D*014, LEWIS (SEA MEADOW ASSO(:. ) + " 30535 TOWN HOUSE: .................. Permit for ...........................:........ - - a Multi-Family Dweiiinc; ..... ...'..:-Route...2a.'....7.20...Pitc�zer.s...Way- Location ......................................... .... _ L ............................................................ ..................... "+ t ! `} r. Y_ ��' >/ ��^' + _ • •` .. Own .................Lewis, Gordon ( Sea Meadow Assoc )- i �✓ - `" _ .�. . -,.- �r r, _ Owner ...... ................................... )'�. 1. r Type of'Construction ....Frarn:..... t .. ...................................... . .. ~ . r �=' mil.• �,��,,,...._..-..� ✓,y� �' - -� � v� � i'_ � � r, Plot ............................. 'Lot ................................ = '. ! =' - 1 -'•' ; . rmitranted .I March. �....:° .. 19 Date of ,Inspection ....................... 19. Date Completed ............................ � .19 r sr ell fi .�;t,.. A s f- .+r� fi' 1 �'� r �. �%'M'',•. /.. Ltd G' Zd' 14 '�t( / f /</ '�GI,�� '..Si+�' of�..C=�,}fY�' Spy,F)<a y.�•�' . n +n }rr 71.7s �K "1y�a� d "5 lys i . J�..,Jk'.. � ,N�a tf P�? }.. •� i.��'.,fi�tc rah`?5.*_. 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M�...i>..c, - _ .�s5,• ...., r ems. .m. ..-.��. ,._,... r _._.... . .;�-� �a :_��:'sti�:'�r.�� ..f,� Irh.><.:..i! ��4�.,..2� '+w..� ` 7 z2, 1f it I b '7 i i 11 ,y `.._.... ._:..�,: _ -,N„►,.+.t..itlM1-.+ry�:....,.a ,. �.. ���� �„'P -�y<„�._ ..._.. �.»-�..,... n,..�.�.. .. ,,.»<. �...w... � �. � .� ,.n.�r.«-.-� --� �,,yir•v i tl TOWN OF BARNSTABLE 30535 a Permit No. ................ ` r BUILDING DEPARTMENT aeai a I TOWN OFFICE BUILDING639. Cash u HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to �ewis Gordon (Sea Meadow ;Assoc. ) Address Bldg. E, Unit #38, 720 Ditchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. �f April..15!...., 19....$........... . ............ ......... ............. Building Inspector 4 J FF �,fTHETo ° TOWN OF BARNSTABLE\ 30535 • Permit No. ................ BUILDING DEPARTMENT $ { I HAS TOWN OFFICE BUILDING Cash t639• `h9r�r► HYANNIS,MASS.02601 Bond .............:.. CERTIFICATE OF USE AND OCCUPANCY f� Issued to Lewis Gordon- (Sea Meddow Assoc. ) Address B1dq. F, Unit `#39,`-,720\`P tckhe : Way Hyannis, 14assachusetts�� USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. f AI7r i.i 1. !. 19 $$ !' Building Inspector 11 y "'>7f ..�Cr'..r,l*wa...yTy.J.{gx„Otr :•.411i�. ...:fY' `a" Y t ,e6 .�-: �;r(...+aa+w .._ _ .. i '�.r.x. w. wyR!4:w."+,,."M"+.+�^h�M..>.�s.e.- _yt-fa r 1 . } 0 THE) e - TOWN OF BARNSTABLE Permit No. 3a53,5... BUILDING DEPARTMENT F near i I TOWN OFFICE BUILDING Cash ,679 HYANNIS,MASS.02601 Bond ................ 4 s s` ` CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg. F, Unit #40, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, 88 , 19................. . --.... Building Inspector FFF p4yo o a ___TOWN OF BARNSTABLE Permit No. .�Q535....... . BUIL'DING'DEPARTMENT ne■nn TOWN OFFICE BUILDING Cash ,639 �Q■�+" HYANNIS,MASS.02601 Bond ............. CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc; ) Address Bldg. F, Unit #41, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING -OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ,4 April 15! , 19.... ................... ...... . X�213 �u"A.din�'..,.` ! .� Inspector i • i `r..`-•.y-r»_1,..t 1��•�,e4n�M-�..e.+�J�t..ic+a...,..ry,:V�ma+ ..,:. r,�F!t�'l;r;�r7� F'�L"q"/!yoipgi$f.._'°'— .a-«.«-..-+vr'r�F -�-„ .-� v .,... k .. ..-,-,.., �..-.� -�., - m �,�y _.S. �a. yof*ME TOWN OF BARNSTABLE P 30535 ` Permit No. ................ BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING i679 °hor►xk� HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY r Issued to Lewis Gordon (Sea meadOW ASSOC. ) Address Bldg. F, Unit #42, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. f , ...........A .........'.., 19....... ....... ' Y Building Inspector ` R •`"'..--:a: Fi+, '1 ', . .,_,-_.,f,-.:. ,y.,,.,,.s,,.•.,,.v�r:i.� _ r is a[Fl. ..•,,-. .,. , •-' -wV, k�5,#aC;.e.' t o�tNET, r TOWN OF BARNSTABLE �30 Permit No. ...• BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ................ 7 ■Ya +639• HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldq. F, Unit #43, 720 Pitchers Way Hyannis, !Massachusetts ,USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ........Apr 1 l..�-�!....., 19......`g.8....... . . •..J��=.�:�, ���........ ... • Building Inspector '+"`_'`plan-,.eta+^Nmc.'7irs...^m'7�'�"ts.'yirfr=n.FbY-,.••'1+.,..... ��+,."ti.:3�«b"�F.�Ywy,b, r.3'. -.-. .,.,,,..._�;. -. ,R, .,... - ., ` x ...... .,....,-...a.. .at - - - ,y�.:-, .. *�E�o TOWN OF BARNSTABLE P 30535 � Permit No. ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ................ .wa ' 0 MR HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea MeadOW ASSOC. ) + Address Bldg. F, Unit #44, 720 Pitchers Way Hyannis, llassaohussetbs USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15. 88 ......... .......... ....... 19..... Fr'n, .� .•. ;... .,.y.... .......... Building Inspector t }�•"t1F1.r��� �"rt"ih.rar�rl.7-,t«.. _. E..e ram•. --ad'sa.";.Y+�:-��'�s�*-htL..�`e.- -.ro., _ .,... :vyr. �.. •, .�. .,,_a... l.'J 'a • t'�ti +r5v�� ofTxsre . TOWN OF BARNSTABLE Permlt nlo.3. • BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) FF ' Address Bldg. P, Unit #45, 720 Pitchers Way F ! Hyannis, Massachusetts i USE GROUP FIRE GRADING OCCUPANCY LOAD a. 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. - April 15, 88 Cam- si / {'! ............. 19................. ..... �............. .�7 Building Inspector r -• of TMfi>o TOWN OF BARNSTABLE Permit No. ..3Q535 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash FF t639• HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordan (Sea Meadow ASSOC. ) Address Bldg, F, Unit #46, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ........... ....1. ........, 19... .......... . ......o ................................. 15, r ............ Building Inspector -"""""�' 'in.' +i.�f�`.�viG..—.}..s`&*,:.�•: .'7.. :• .I;�E.^e�?le..r,7,,,w :_. Rs ��, � r .::. ,+.;,,,„, .� ,. � �l�:c '� FF o��ar� TOWN OF BARNSTABLE Permit No. .......30535 ......... OJT . ! BUILDING DEPARTMENT aeaaNn� I f 1 d1 TOWN OFFICE BUILDING Cash ............. rytouvR� `t HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) J Address Bldg. F, Unit #47, 720 Pitchers Way Hvann s, l4assachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD\ THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN f REQUIREMENTS AND IN ACCORDANCE WITH SECTION`119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .........April 15, -188 /� c �.. '.., '• rr '!. , ..., 19................. Bui ng Inspector LL `^'r.,,Ev"m`:a ?�`�++✓�„;-Ht :4•�iT;'-tS."�'G'�'�t�T'i=3�;.�"�h::�...i �n'�r. 5. r..,v, ..,,, :��.. ..,sn..w"'�*;, ,_,,,�5�3"'�'+.:.� ofTwe ro TOWN OF BARNSTABLE 30535 `J a Permit No. ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .�.. HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldq. F, Unit #48, 720 Pitchers Wav Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. t� April 15, 88 y� ........... ............... 19................. ...... .�.� Building Inspector - V6 t you � TOWN OF BARNSTABLE Permit No. ...'9535.... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ,639 .a. HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg. F, Unit #49, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. r. 7 ! r \ ...... April 15s......, 19.... g......... ........................... ' Building Inspector P �� f Ate. a Try lK.F- tt.:,' + �' c,lyklN�.Cyf .. x.JL•rtwa`+ ".�FY ..,t SKr, }- Y 2 y TOWN OF BARNSTABLE Permit No. .3053... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash � t6jq' HYANNIS,MASS.02601 Bond ................ 't CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Z-ieadow A SOC. ) Address IIlda. F, Unit i'50, 720 Pi' c.h-Y� :i��anni� ,iu►d:i'�c.1CilU:c+ctw FF USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL I SIGNED BY-THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. R - .............Apri.l..15."' 19.......�8...... ........................................ ... Building inspector 1'.', 1t-.+-�.. +.�'.i i .4'.� ,.. t ,w v�.^.�,/, s.n.�r�r; s�.-�..�• ic...: ;.:e »ram.'.,. .. ..., to _ .. -...s ._ ,r s ` J r 4, HE- a TOWN OF BARNSTABLE Permit No. .30.5.35..... BUILDING DEPARTMENT nea1M /i! { I TOWN OFFICE BUILDING Cash .a. s6}q. "�orrvk HYANNIS,MASS.02601 Bond ................ R CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow ASSOC. ) Address Bldg. F, Unit #50, 720 Pitchers Wa.•,' Hyannis, 14assachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April.. 15.r..., I9..... 8....... %� ........ ....... r ......... Building Inspector ,„�,..�-�b•rd+.�i. "=ham or+�`,- yr�,,,_,.,..:;d°'+'���-�-+txw.t:a•�.r,,?►�n:�aestgt�x`a'it''!:"Mxw4rn.��r_^�^* ,..._r>-•a,.r�, ,.� .-�.... x r„'��,,:xvf ... O TOWN OF BARNSTABLE P 30535 Permit No.................. • BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING 'zeuv► HYANNIS,MASS.02601 Bond s CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea MeadOW Assoc. ) Y. Address Bldg. F, Unit #51, 720 Pitchers Way Hyannis, ,Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD r 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. r Aril 15,..., I9...$8......... . y Building Inspector _ f 2.�r�..�.NII]O�'3-:.._ .. :.�i�t::'s1 R. o ...-a- ..+rJ.�.•.... ... ... -... ' ,,.,;,.;ry ::...: � ., j. .mow,;.+:.�.�.�...,....:s'•R-ss ;.a,•�r ..- _ _ ,...,.-,- .. ,y,-,,,; .+r-'- � t.:....s •v « a ofTxe ro TOWN OF"BARNSTABLE Permit No. ®535 + ........ v BUILDING DEPARTMENT warn Cash TOWN OFFICE BUILDING aara f6}9• Of HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordan (Sea Meadow Assoc. ) -,,e,. Address Bldg. F, Unit #52, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15 ..........�....., 19.....88....... ' �'.... '' Building Inspector ,,.. f�i-.:....r.:.::_y.v .art ., _ < r �. �ii�,��...r.: ,,.¢ a��_.�.�f�r✓�I�f�,fi4s__..,.,�. ....,r. r -.. .. ,,.,.-� M.�,,;.,.,�.��r.��, r �„-..`.. }TNE> TOWN OF BARNSTABLE Permit No. . 5 a...... BUILDING DEPARTMENT-- a,aan, TOWN OFFICE BUILDING Cash �8er�r HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg. A, Unit'Ir1, 720 Pitchers ,Vlay "Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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'AND,J ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, - 88 ............................ :19................. .`........ ........,.•.,. R _ Building Inspector I �'.. .��.-,.+'!�"''�q.�:I'k..7.^:^^.. .. ..r..r:-,. ..?y.�Cs'''s..r:.;:.�r,�r...+vr++..,...w.......- ,..'w r. :w ryr�+xs� , -..•.S—•Y'��--t.�it••N-r �.. ...- ...mow^,.. - a �w w.r ... _. 3qy is �i -i' y TOWN OF BARNSTABLE Permit No. ....... 'BUILDING DEPARTMENT TOWN:OFFICE BUILDING "Cash 7 .N\ t679• � HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg, A, Unit #(2, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .J J April 15, 88 f ...... ...................... 19................. ... Budding Inspector ' :;• t7.ta-..n...,.,t..r i �MTT.�F1�vd;.'o-'l'•.4Actrc4"7"k". �9,��„'A"w"�,^,:.��'1Nf.''„. +-�*r��:`r'lF+IM"e.�- ..r�'..r --.r •-dyhir�r-.. _ ..��...�.,...y- �-. ... T-r---stri.r•-, .-,, ` a � q 1, 4 TOWN OF BARNSTABLE Permit No. ..3,0535..... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash Yl ryteur► HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Seat Meadow Assoc. ) Address ' Bldg. A, Unit 03, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, 88 Building Inspector ...��'h,d'"'4.eh!''�-Qa�-•fit;.,-�Y=?..�y,f�:f�.P%-���F^.�t.`y`zir.tk,..�y�,�Jfw'i'�-a�er+�eo;}1 .'���,{y±r�:��,�t�'��''r'r�i��'�"!�''�p,... :.,-..,, .,,,.,�-.,,,--•-,,,,..;•.-.�,.-r ,.. _4 , l T-- (� TOWN OF BARNSTABLE 3053.5 � Permit No. ....... ........ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .659• '�ternr' HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea—Meadow ASSOC. ) Address Bldg. A, Unit #4, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND,IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. l r .� !A 3] 1 5►, 19.....g.8....... ..f -'..............I....... '�_ Building Inspector �;rY�•rrr��....;..;�.. ':�+;,cx...=F`F`•,,`• .��'�"'" 4r ai.:: Ks,�A�-:>.r ''n'�?j�in;reef'�"!*.'��-`�-x«tr.:�.,..�..,..,.+t.�'---�n��.,.-,•ty--,.:,w,.-,.�-..,_._..r TOWN OF BARNSTABLE permit No. 3©53_': BUILDING DEPARTMENT a�aan 4yt' .Nl TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond ................ s` CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg. A, Unit##5; 720 Pitchers Way Hyannis, Massachusetts ' USE-GROUP FIRE GRADING OCCUPANCY LOAD 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 AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .............. 19................. Building Inspector r �y .-i,;ya-'6^f.J'...:..t,t..t;..;�'-� �l�r'#ins/^�3��.1�`s'1r;',1'`t^�'°.{��`R+`X`� �.as'"'�'"�.+�;?M,�'`:�,m.:�c'�.Cv';s'w�t�+'�!:"t:�^.F*rtL"?°4.t. • _ c� '$r ,",� v 4 TOWN OF BARNSTABLE - Permit No. .3 .�5...... • BUILDING DEPARTMENT 4 DaaDR f TOWN OFFICE BUILDING Cash 7 .Ml t679• �'�o.►+` HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg. A, Unit #6, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL 1 SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. A r i l 15 8 8 ter, ✓r ' � n Building Inspector 4 n-�-�.s,..h,'L+�9�' fit'°'*#'``�"+''f'•��ii$.;:fi�Y'��"7:'k,';�'Eu'R?�i•'�t.'1.:�'"t„�+`'Fyw„„�>n'''�.k%�� r�elSv "`rt✓rl'►ir'^a*r "? , .. 5.. '���+tJ � '�{-, L3 ,�rNE TOWN OF BARNSTABLE Permit No. 3P53! ,...... BUILDING DEPARTMENT TOWN OFFICE BUILDING" Cash HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg. A, . .Unit #7-, 720 Pitcheru, Kay Hyarinis, MaSsachusefts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, IL Building Inspector FF O�YM[:Tp♦ TOWN OF BARNSTABLE Permit No. 345 ....... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .639• HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg, A, Unit #8, 720 Pitchers way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. avRw' Apr?i..�5l....., I9...$8.......... ...:. �.. '.. ' �` Building Inspector ��•r'rr.w*.rt+^.,,;�;,e„�,n .#r ;.;.e�'3r_-v�1�i.�Yqr'!',ar.� `YPX'y�ts'��::fx`4 •.-. '�'A��'1�!.M" ,N�iX�'�' " '—....,.a,�.m�,,.�,'+Y'"M'. ....."g'."'"�;;+,T7";^. ..-r ,FINE TOWN OF BARNSTABLE Permit No. .395;.5...... f BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash _........... r.ra '�crry HYANNIS,MASS.02601 Bond .............. CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow ASSOC. ) ,- Address Bldg. A, Unit #9, 720 .Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 ANWIN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April ......... ....!:..., 19....$ ........ �. f � i /✓ Building Inspector .,... . .. 1 �: �,�,�,e.�,,,�..�,.M�.._"fw4'ti"f'�^�'4�dmMrr+°�p"•',S*`�'�""." �6 r.. ' _.�,. �,�.,�iltPr.% ,�F•r-+�';{�'*�.��'Pi„i� �Y!`�"i�,+#;a'1N�•'��+�C'!'L�Rt},�>ray,�.�Ld,la'' "fE,".•'r�'p :�*d�c"'� �r7"" �'�li'r -1`i / M ,�TMEro� TOWN OF BARNSTABLE Permit No. .3 .35...... BUILDING DEPARTMENT A"77 Cash." I TOWN OFFICE BUILDING 7 \Nl �raur► HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issuedto Lewis Gordon (Sea HeadOW Assoc. ) Address Bldg. A, Unit. #10, 720 Pitchers- Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND,IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ...... .................... 19.................. Building Inspector --1.-,if""'�-�""",,y',o ..: ..y, 1�: ...,:<,. ��,u.-•'+x+..y�'tid-�.,�rii'-•..'4"--.+f*+r„gv..r*�*�wm�"�tc�+,� ua�w-"•- .�_ _�.. ., �. _ ,;y�...,,, � r ,�•ME TOWN OF BARNSTABLE 30535 • Permit No. ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash 7 .Nl s679• HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued toI Lewis Gordon (Sea Meadow Assoc. ) i Address Bldg. A, Unit #11, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD b- 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 AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. >................. 19...PS.............. ,...... j................. Building Inspector d . .._ .�:—c .-.: _ ... � _..... i�hb�`t +r�4riR�Y�ka�,nr+i•= 7dt+4i^io`.: �,w!��a6^'i�""r'1��''itiPtr' � a ;� _ �,:;.:<. ,y,.r+,v:rr,, v a,1'i: ti'�'�t"w+.....�f'`ri�^,�"h.�:u'��.. �3i'�'t�y�'�e�iY`.�C''�H�r�.�»}r �. �:.• , S � _2 Er F BARNSTABL 9855 ,� ,� TOWN O E Permit No. ................ BUILDING DEPARTMENT "°"` I t TOWN OFFICE BUILDING Cash �NL �►�ouYR HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to j,eWis Gordon (Sea Meadow AS:oc. ) Address Bldg. A, Unit #12, 720 Pitchers Way Hvannis. Mas sachuset+ts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. // �, A ri1 15 8$ ,ram ...... ... .P. � , ..., 19................. r•_.•fir.-:..'.�� Bw ldi g�,x` �^'"�.�,,��»�;.- :+�,.;..,;�..,,�.,. Inspector -......�..-+i.r«.w.w-•a.:*,,,,.....^�-r,.v�aMa. ,f-�4�'�•d'a-:�.N :1+'•v,Rf.�t.i„�iii$V:n�T'.V'N"".'l.'r`rir�-�+y+�.`"�.yr'X':r.,,M....,wv....�.t„ �..w..,..�,.r.. . ... t .....-.- -....�.-. s.t. ., .i� � TOWN OF BARNSTABLE Permit No. .�.0535: BUILDING DEPARTMENT x�n Cash ................ TOWN OFFICE BUILDING �Ml ` HYANNIS.MASS.02601 Bond . ................... CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordan (Sea Meadow Assoc. ) Address Bldg. A, Unit #13, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, $8 c: . � --,. .... ...... ................... 19................. � .. .�,... .............. Building Inspector „,.,,1._.: ,._. _ ._, _..._...,,,. , ' p.- .., ., ,..; .�..-.--.. _... _ + .,,r'Y;� »^i'^.✓.-.t'E'1..,✓„ rr. _.,.�,:.,.. --or'^r:b; 3 R �.rl ss y.4 oFTMEro E TOWN OF BARNSTABLE 30535 � f Permit No. ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash 7 Yl F HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY 00 Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldq. A, Unit #24, 720 Pitchers Way Hyamnis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .............Apr .... .�!, 19......$........ ... `, x✓"+r” - . ;_ Building Inspector . i . �....;-__..,—: ,. :...�..,._.K�;.,,- .., .r..._:.:.`y,�,� ./p'_. ._.__......�,y ..,y.•..,,wx.r""`yG:,- .:E'rV'R„f*1'�°.x�','�ee w.a:.y •a°.t .�� ,,. ,..,.,....,.re� .�: .;} ..4 a .i,.r, _A k1 FFt L0 5 pF ETp TOWN OF BARNST,ABLE Permit No. .�9U BUILDING DEPARTMENT D�DDb! n { TOWN OFFICE BUILDING Cash rrra +639• �or6r i HYANNIS,MASS.02601 " Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. )' Address Bldg. A, Unit #15, 720 Pitchers Way Hyannis, Massachusetts i USE GROUP FIRE GRADING OCCUPANCY LOAD i THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL. _J" SIGNED BY-THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN.""' REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15 Building Inspector r —a. } r OftNETp TOWN OF BARNSTABLE _ 30535 Permit No. ................ 4 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ................ HYANNIS',MASS.02601 :r Bond ................ , w CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) , Address Bldg-. A. Unit #16, 720 Pitcher_s wav - tvannis, Massachusetts , USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, 19................. '. ................................ Building Inspector fa- ----------- I p- `J � pitNEro` TOWN OF.BARNSTABLE Permit No. .3.0.55.15......Fm BUILDING DEPARTMENT F aeaan TOWN,OFFICE.BUILDING Cash ,639 BASK �t9W,r HYANNIS,MASS.02601 Bond ................ r ti f CERTIFICATE OF USE AND OCCUPANCY g, Issued-to Lewis Gordon (Sea Meadow Assoc. ) s • r. Address �, Bldg. B, Unit #17, 720 Pitchers Way � Hyannis.,, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN -ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. C April 15, { , r/'.f. '` .................: 19................-I ...��.. .. '.... d Y Building Inspector .�. . "10 a.+ - " w.tir..ste.`k,��--v.�«f�:,- .s..., .. .. ,,. _ re.,er... .;;_ ;fin.+' .:., •� Y x, oiTxere TOWN OF BARNSTABLE P -3 r35 � Permit No. ................ BUILDING DEPARTMENT F D°81� TOWN OFFICE BUILDING Cash ................ � Baia - ��OU� HYANNIS,MASS.02601 Bond ................ e CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis .Gordon (Sea Meadow Assoc. ) Address Bldg. B, Unit #18, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD ti THIS PERMIT WILL NOTL BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. . � April 15! 8 8 . r X ---- ! ..... Buildi g Inspctor r.- _ "... ...- .�..�... _ ..� r,_.�:�v-.—.M—�s.",4_ N. ...�.�. .r'mm� ...—• �t}^p[q� .,;..rt.IT'�.•. r _.. y --�, ,Y,_ _ *..� �y �e - L_� ., .tor7t7'Nh��3.�rn.,a.^F^4e•..�`' ..,,_ .�,.-.... } TOWN OF BARNSTABLE Permit No. . q05 5 .J BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash �$ i639-39 HYANNIS,MASS.02601 Bond ................ .CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow ASSOC. ) Address Bldg. B, Unit #19, 720 Pitchers W&y Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE: .. f .r April 15, N 88 ....................... . 19................. •, . rr ' y �-••;r �� t"Building Inspector T+A,., T�.�. r, yO�THE, TOWN OF BARNSTABLE 30535 � t Permit No. ................ v BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING.a. s6}q. MAX - _ HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc.) . Address Bldg. B, Unit #20, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. r A zil 15 88 ...... ..........+ . 19................. '::....... •.. .... ....... " -- .� . � �_ Building Inspector .� :-..,5}y_ .. r{_ .�-,,,� *-€;'t.+'�rj;Ft ..� . .,.._-, "`r°+�' a„^;`�"mi�,yt+v: ;s�.�;Fr3r'<x�:.s+s^ r ..y.., w�.. .,,,�,.,,._... . .-_..-„'�: +".,.-.f- •- �� a-+-s t i INCTOWN OF BARNSTABLE Permit No. ..3P535...... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash �OpY HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ). Address Bldg. B, Unit #21 , 720 Pitchers Way Hyannis; Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, 19 B8 ... Budding Inspector TOWN OF BARNSTABLE 3 .35 yoFT"er°+ ` Permit No. ................ •'� BUILDING DEPARTMENT TOWN OFFICE BUILDING i Cash •63q. HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordan (Sea Meadow Assoc. ) Q Address Bldg. B, Unit #22, 720 Pitchers Wdy, Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, 88 ........ ................... i9................. .�.. �'' Building Inspector ,,.., � _ :.rye„-., �Y ,. -w r� m .. -,-_•-ajt�..� f"q��7'rwu,-�-�;r a��xero .t TOWN OF BARNSTABLE Permit No. ...3FF9., ♦e 4 BUILDING-DEPARTMENT F D°s"T TOWN OFFICE BUILDING Cash .wa HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY _Issued to Lewis Gordon , (Sea Meadow Assoc. ) Address Bldg. C, Unit##23, 720 Pitchers lgay Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ;A . .......APB. ..? r......, 19...... ........ . )!'1 ..:............. Building Inspector r TOWN OF BARNSTABLE Permit wo. �� �.:..... BUILDING DEPARTMENT > TOWN OFFICE BUILDING Cash 'l.�our► HYANNIS,MASS.02601 Bond ..............�. CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address B1dq. C, Unit #24, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15 19 88 ...... ..........!...... Building Inspector TOWN OF BARNSTABLE Permit No. .3fl535,..... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash '�orrr .HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Asso . ) Address Bldg. C, Unit #25, 720 Pitchers Wav Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, . . 88 r 19............... .. r ..;............f. Building Inspector s ��;..,-,.... �_ +... ,.......,:.ky.�,+wl.#,s...�y:., _ � -„�,.;,-y,fi-',p,.,.. e.«..e..�d.as:h+�-ac�a••r..,wa'�.,,,e,,,, .. .. „ .�,,,,• _ _ T ��,. �.,,d,yt•E Vo.r ._. �*« "_ 5Ur�o -- TNE>, TOWN OF BARNSTABLE Permit n1o. ..39535,.... °F BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ................ �Quv� HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg. C, Unit #26, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .......... Apri1..15,.., I9.....8$........ :'.....: ... Buildinglnspector �' 4 ,F TOWN OF BARNSTABLE Permit No. ..�03.5.._... o�. BUILDING DEPARTMENT { D°81S 1 TOWN OFFICE BUILDING Cash r...... t639' HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc.:} Address Bldg, C, Unit #27, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 1 April 88 ....... ....��...... 19....... ...... . . v, ;........... Building Inspector � � r 11_504 WEr, =r TOWN OF BARNSTABLE Permit No.3Q535......, BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .N.a t.39• z HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to �ljl; Jw.S Gordon (Sea MeadOW ASSOC. X Address Bldq. C, Unit 228,, 720 Pitchers Way UVanni.S, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Buildi g Inspector t M mJyOf TNEt e-.�., TOWN OF_BARNSTABLE 305K.. Permit No. . BUILDING DEPARTMENT -4.,,,, ,, TOWN:OFFICE BUILDING ,Cash :.......... 1639 HYANNIS,MASS.02601 Bond ................. a CERTIFICATE OF USE AND OCCUPANCY Issued to LeWi.s Gordon (Sea Meadow ASSOC. ) Address Bldg. D, Unit #29, 720 Pitchers Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD z THIS PERMIT WILONOT BE VALID, AND THE BUILDING!SHALL NOT BE OCCUPIED UNTIL SIGNED BY-THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .... A ... ..............., 19................. . .......j!l"; ,... r .. Building Inspe�or�r yT`i --s rJ c oFTME>, TOWN OF BARNSTABLE 3�535 . f Permit No. ................1 BUILDING DEPARTMENT .................. TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc.) Address J3idg. D, Unit #30 f 720 Pitchers .Way' ay Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 1, r/ April 15, 88 _ ✓ � r Building Inspector •:v ° ,...-_..� ..�.,y.y-. t�.T,.,,� ���t::`on� �_ .,, ... __.. _ .� ...,r+a.�`n.^..efrrtwww3Ew+i.'wla'=,,,.^^r ,� ... ._..._. w v •a .' � *M'i'tr_. .e i.. .{ Ys �Of TXE)0 TOWN OF BARNSTABLE Permit No. .39.5 5...... - --a- BUILDING DEPARTMENT } D°8:: I TOWN OFFICE BUILDING Cash s639 HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. Address Bldg. D, Unit #31, 720 Pitchers 1�ay Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .' ........April ` $$............, 19. . , Building Inspector t (D(c)� jo a TOWN OF BARNSTABLE Permit No.�.�5....... . BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash `�eUV► HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF,USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) Address Bldg, D, Unit #32, 720 Pitchers Way Hyannis, Massachusetts 4 USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND LN ACCORDANCE WITH SECTION 119.0 OF.-THE MASSACHUSETTS STATE BUILDING CODE. ; April 15. 88 .: 19................. � ./,e_ ;. Building Inspector ..•....y.,� 'b.I Y '.�• , , , I _A•. t,��.f.,—.4f�,..,�-�-.�...-.,..�,�,�,...,.a�.,,,�;.s-...,..�„�. -„ ,.,.,^y.,^.+w.w�rt., .. iv T. 91; TOWN OF BARNSTABLE 30535 . � Permit No. ................ • BUILDING DEPARTMENT D°r"s TOWN OFFICE BUILDING Cash .a. 6 r HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to JLeWiS Gordon (Sea Meadow Assoc. ) Address Bldg. D', Unit #33, 720 Pitchers Wav Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, 19 $� � ! � Building Inspector ..+...,-.=.^4+,'.:.....�`� "M,#�s.3fiFaM'rt* ., _.. c�fanj'_.�'. � .-�..,.,Yc4+dn.,.ea..•.�;.xv�«.. ...,�..., .-..,o ,....�, .. ;..n:,, '" .. .r�+•— •.,d.T°.'^-s-ri:r+^ TOWN OF BARNSTABLE 30535 • Permit No. ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash Ito u�M HYANNIS,MASS.02601 p Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) ; Address Bldg. E, Unit #34, 720 Pitchers"Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ...........A��l..... �.., 19................ .!% L-......` ! f✓'t'�'�- -�— Building Inspector y . f. T5 1Lb )Z *ME> TOWN OF BARNSTABLE 30535 Permit No. ................ of BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ...I............ °�roWr► HYANNIS,MASS.02601 Bond ................ FF CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow Assoc. ) .',,,*, , ,' Address Bldg. E, Unit #35, 720 Pitchers 14ay Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Apr i 1 2 5.!..:...., 19....$$........ . ' _ i p ............. f Building Inspector 4 +� (o7 2, oFtNE>0 TOWN OF BARNSTABLE q` a Permit No. .A Q5.35.... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .w. owr t HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Lewis Gordan (Sea Meadow AssOC. ) Address Bldg. E, Unit #36, 720 Pitchers way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, 19. 8 .t.!! .�G ............................ ................ L_ ti • Building Inspector ofTrer°• TOWN OF BARNSTABLE Permit No. .. P5.35...... ° BUILDINGDEPARTMENT TOWN OFFICE BUILDING Cash ................ .wa 7 i679. , �"�towrk HYANNIS,MASS.02601 Bond ................ :i CERTIFICATE OF 11 USE AND OCCUPANCY Issued to Lewis Gordon (Sea Meadow ASSOC. ) Address Bldg. E, Unit #37, 720 Pitchers .Way t Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD r THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE.00CUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. � .. April 15,...., I9.8$........... ..:... Building Inspector" p 4 .`"r�'_-^l;iat;r-�n.Ml. '�i:.,r.+sef:�'�rz ...:?'�;7�:.�ej►«r.'v.,;s!sz��.�„�'}�t,�;�*; ,�.. ., ..•r.,r,�x'�.r'i,�rt�.-w..�.„ � :. -.-.....-.,,....,,.-_ .�, , - ,,�:� s a� .. } 4 of o TOWN OF,BARNSTABLE Permit No. ..3053,5..... BUILDING DEPARTMENT TOWN OFFICE BUILDING I Cash HYANNIS,MASS.02601 Bond' ................ CERTIFICATE OF USE AND OCCUPANCY Issuedto Lewis Gordon (Sea Meadow Assoc. ) Address Bldg. F, Unit #5.3, 720 Pitchers tray Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. April 15, 19 88 , ................ .. . ........... ................ '� Building Inspector TOWN OF4B4RNSTABLE Permit No. ..:3.05. -S-- mJ '� BUILDING DEPARTMENT /' ........ j {D68:a I TO4WN OFFICE BUILDING.t Cash 1639• ♦ u "! ff �~HYANNIS,MASS.02601 Bond ............ CERTIFICATE OF USE AND OCCUPANCY. Issued to ! Lewis Gordon (Sea; Meadovi ASSOC, ) Address Bldg, F, Unit #54 J,, 720 Pitchers way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD r 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. r Building Inspector z [ ] [R2 71 041 . ] *****ACCOUNT DELlw- LO,C] 0549 DANVERS WA� CTY] 07 TDS] 400 HY KEY] 179979 ----MAILING ADDRESS------- PCA11121 PCS100 YR100 PARENT] 0 SEA MEADOW VILLAGE ASSOC MAP] AREA] 62AC JV] 333552 MTG] 2001 %MARY WHITNEY SP1] SP21 SP31 P 0 BOX 314 UT11 UT21 4 . 61 SQ FT] 18370 S DENNIS MA 02660 AYB] 1988 EYB] 1988 OBS] CONST] 0000 LAND 208100 IMP 3790400 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 3998500 REA CLASSIFIED #LAND 1 208, 100 ASD LND 208100 ASD IMP 3790400 ASD OTH #BLDG (S) -CARD-1 1 1, 020, 000 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #BLDG(S) -CARD-2 1 1, 019, 600 TAX EXEMPT #BLDG(S) -CARD-3 1 404, 200 RESIDENT' L 4034500 3998500 3998500 #BLDG(S) -CARD-4 1 404, 200 OPEN SPACE #BLDG (S) -CARD-5 1 471, 200 COMMERCIAL #BLDG (S) -CARD-6 1 471, 200 INDUSTRIAL #PL 720 PITCHERS WAY HY #RR 0425 0162 SPLIT091189 EXEMPTIONS SALE104/88 PRICE] 1 ORB16232/003 AFD] I B LAST ACTIVITY] 03/04/92 PCR] Y r n -fie .t R271 041 . OPPRAISAL D A T KEY. 179979 SEA MEADOW VILLAGE ASSOC LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB PARCEL DELETED 208, 100 3 , 790, 400 6 A-COST 3 , 998, 500 B-MKT 111,400 BY 00/ BY /00 C-INCOME PCA=1121 PCS=00 SIZE= 18370 JUST-VAL 3, 998, 500 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 62AC -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 62AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 2081001 LAND-MEAN +Oo 39985001 66410 IMPROVED-MEAN +56080 250 ] FRONT-FT 41 100 DEPTH/ACRES TABLE 02 100%] LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R271 041 . • P E R M I T [PMT] ACTO[R] CARD [000] KEY 179979 000000001 PERMIT—NO MO YR TYPE VALUE CK—BY MO YR °sCMP NEW/DEMO COMMENT [B29684] [07] [86] [D ] A ] [ ] [00] [00] [000] [DEMO] [HY DWELL. ] [B30535] [03] [87] [NM] A 38000001 [ ] [00] [00] [000] [NEW ] [HY 54 UNIT] [B30778] [05] [87] [ ] A ] [ ] [00] [00] [000] [NEW ] [HY INFO. ] [B31201] [09] [87] [ ] A ] [ ] [00] [00] [000] [NEW ] [HY INFO. ] I N FROPERT FYKE,� Al,v, D E N T I•A"U,`�'Sl IRE 'A 'FIRE DISTRICT gg, A LOT.N��. P NO .LOT. V, ,5, STREET 559.Falmouth Rd j, Hyannis', yarinis� V., .3 H"' ;: AMR41"! `v° R -I,' BLDG33 �Ltq�,j�illld;111610_ kt - '4 'TOTAU OWNER WJ�7 R: SFER.RDt-OF R TAN DATE BK PG I.R.S.- REMARK BLOdt- ZwTAL!•W- 4 hn /rIn 'B To 7 -61a - - AAND!a$, ;-p lbb 7.7 BLDdS'3-1-77 2474 1.4W a, fi TO TAL �25,jOOO)- - 3�4-77 2474 0 M 1_9 tij­.Pamela,.:Nw LAND 77 BLI)GS.1 or '777 TO 4F-757 1-5 -:5 -A Z- �Z, "x Vk 4'1 13, 4 r F U v " l4JrVr T ot f In f "N ',tot -zz CkA J7 T, J­ INTERIOR INSPECTED..-�,' 77777� -7 ­7, -:�_ Z.- ,;f 577,7� Z 777�., Xr, 15 7, M17 & CRE t6mPUTATIPN�P'�.-" ',:l" LAND YPRICi TOTALS 1! D Ef-,R., -- .. Of IH66ii Lr[ V LEAEjiQNT A BL G S;F,:-TOTALL Zlr `i,l SPROu"T'44ow"'.`� BLDGS.' 3/ 6 .41, '014 TOTAL T'i WASTE FiC* re C37 44RFR ! WN�" k", A MNT , m -z'i75 04. JdTAC�i X i A, 'jOl "V.� ..... Sq JoO, ItZ K. .4- -TOTAL- LOT COMPUTATIONS' " 1,., �,.­ . - . L ­:, , il"4� Vw '�.LA ND-:FACTORS FRONT STREET ICE- TOTAL DEPR. LAND ON R FRONT Fr.PRICE ',COR.:I NF.t-I T­ IJIEL`..�$ T J N SEWER Ar;r77-1 �,2 �:i�, r TOWN WATER L MD BLDG TOTAI D'P LAN D 01� -,A(,-Jq' IV, J_ nct . 'l,�Z_�� — _LOW_!-A MR 'Dlifil) , �l Avv, r sw 47 Ai_,40T W, 34,i-�! ,g nx 0 7"li.5 _-,TOWN:`,OF�BARNS _ UHITED_AP.PRA ISAL,m IXASTMAZT� One Blk:'Walli ub; Bgmt.Rec Room f (-U St.Shower Bath Bsmt. — 6 �� ` F PURCH. DATE v. la.:,SIa6 Bsmt:Garage St:Shower Ext. Wells .PURCH.PRICE nck Walls _ E Attic FI.;&Stair,'' y Toilet Room Roof_ RENT . ; �k y_ r t y tonetWalls Fin.Attic Two Fixt.Bath Floors J ers ;INTERIOR' FINISH ' Lavatory Extra imt wi. F 1 2 3 Sink J'� Attic " r r/= r/ 2 Plaster Water Clo. Extra r 7 EXTERIOR'WALLS,'. Knotty Pine , Water Only �3 { 4 ;5 Oeble Skiing Plywood, No Plumbing Bsmt.Fin. L0 Iegle sill g '' Plasterboard: Int.Fin. h Shinglea TILING /u,5 3G t• 'r r j me Blk1, G 'F P Bath FI. „ . 'o r, y` Heat 770 ice Brk'On Int Layout Bath F.&Wains. Auto Ht.Unit 3 02 / razz` r 7.Venear Int.Cond. Bath FI.&Wells Plumbing ?� r r , r Fireplace tmrtBrk::On HEATING Toilet Rm.Fl. C/ilhl `r slid Com:Brk Hot Air ' &-1 Toilet Rm.FI.&Wains. Tiling z Steam Toilet Rm.Fl.&Walls /U lankat'Ina f - Hot Water St.Shower 2 y oot Iii Air Cond. Tub Area Total v y' ti• Floor Furn: - - ! ^.•ROOFING a COMPUTATIONS ' ph Sfilhgle Pipeleu,Furn ` 2 S.F. rj loud S6ingle No Heat. S.F. atia Shingle Jtj Oil Burner g F • '� •/vy ` /R�• I�2♦•/j u ; r late--:' Coal Stoker S.F. Ilex Gas S.F. i OUTBUILDINGS f ROOF '.TYPE Electric able -Flat S.F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED,,; Mansard FIREPLACES S.F. Pier Found. Floor !J lemtiret'.'. ',' Fireplace Stack Wall Found. 0.H.Door LISTED' 1 h, a -!FLO ORS Fireplace - Sgle.Sdg:: Roll Roofing one LIGHTING Dble.$dgr. Shingle Roof arth° No Elect.. DATE Shingle Walla Plumbing lardwood ROOM S Cement Blk Electric 7 Isph ..Tile Bsmt. 1st j � TOTAL �,7.2 Brick Int.Finish PRICED ,,ogler; - 2nd 3rd FACTOR Otc. t.. -REPLACEMENT 'IS��.\' ;•,-.a � - SNEd O,✓-'�)/ �/� f% . R ,•PANCY CONSTRUCTION SIZE AREA' CLASS AGE' REMOD.. COND. REPL..VAL:' Phy..De0. RHYS.'VALUE Funct.Dep. ACTUAL VAL. }A S YQ . p �r /�i C65�1'': �.NL•� i� 3 O F ` _ ,�, , ' 5.... 3, Garc zX` c �yff 3 _ a fh - sc 50 . l d n too /: �X 90 a 3 . 8Al 111� r SO' `{ �� I. �': •� ... - - = TOTAL. tt;. wLl`'r) }' { ,(;'^' - - t { Ihy I• .. A I 4:- :. s r I • _` — { ,-`tl . .r - ' - - - .,. __ ✓u•v _ems, BARNSTABLE ..7 �_ . �/ • •+. } HOUSING AUTRITY • LEASED HOUSING DEPARTmETT TELEPHONE(508)771-7292 146 SOUTH STREET-HYANNIS MA 02601 ZONING VERIFICATION TO: Barnstable Building Inspector FROM: Leila R. Bruce, PHM, Leased Housing Coordinator RE: Uerifying legal rental unit Date: j,2 DRAFT Address: Village: v Unit type: o-'.70/0' Bedroom size: The owner of the above listed property is entering into a contract with us for the rental of the property as listed aboue. Please uerify by signing below that the unit is legal and meets all zoning requirements for a rental- in the town of Barnstable. If it does .not, please list reason here: ank o-u fo our assistance in this matter. / i, nature Print name Date MRVP Section 8 Assessor's offioe (1st floor):. ". L , Assessor's map`�and lot nGmber �� , " ,•, k:"" �, TNETo�o ................................. Board of Health (3rd floor): • - t fO Sewage Permit number ......... 's........................... ............... r p BABD9TABLE. i "House Engineering Department (3rd floor): i 9 number .................. ............................... `........r..... o6}Y•a`0� APPLICATIONS PROCESSED 8:30' 9:30 ,"A.M. .and- 1:00'--;2:00-P.M. only] _ '.TOWN. OF BARNSTABLE BUILDING INSPECTOR . / I APPLICATION :FOR .PERMIT TO o�r�.. ..r TYPE OF CONSTRUCTION q. .. r r, 1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a,permit according to the followi' g inform tion: Location ...............................f.. ......Y4 .. / .��.�Z�J!/. /1....../ ......1........•.. ! ........ . ......................... Proposed Use . ........... ..... ........... Zoning District l .../41.. ' Fire District' I1 S > .S Gee ...................... ...�(.t........ ............................. . Name of Owner ........K.�9... ... Q. h...........................Address .... .�. .. mow/ ..... .................... Name of Builder ...........1/`/�5:. .V� �11 .......................Address .. ..: Sl�i•• •'LC! .�!...1/C.�!.!l.r.3 .All- Nameof Architect ............................................................. Address ...:................................................................................ Numberof Rooms,..:...,......... .. ..Foundation........................................... . ®�.............. ............................................ Exterior ...............'/.l..n.(yr..(�..�......................................'.....Roofing ........ .f�� / ..........................................,. ... Floors / f7 �,�r�(J�.G/� .............. . ................................................................................::....Interior ......: ... Heating .......ei-tl..............:................................................Plumbing ......./.��} .......... .. Fireplace ......... .. �.�. ....Approximate,Cost ........................ .................................. Definitive Plan Approved by Planning Board ------------------------_-------19___ ____ . Area Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH , F r: OCCUPANCY PERMITS REQUIRED FOR*NEW DWELLINGS I hereby agree to conform"to all the Rules and Regulations of the Town ofble re rding the above construction. t.. Name ............. f Construction Super isor's Licerise .... � ® ............ + GORDON, LEWIS Permit for Location" Route 28, .. ... .. r T.............................................. . °. .� Hyannis .... ..................................... a... ....... •, :�, /S�-. f�= '`' ' -r;' - ` - .... . Owner ......Lewis Go-rdon . ' r r Frame Type of Construction ................... .. .. .................................... .. ........ .... .. ......... tPlot.............................. 'Lot .......... ...... ...... f a _ Permit Granted'... ...July 22, L.. 9-9 86 r Date of Inspection'...... ........ 9 .04 Date Completed ....... ....... .........o ... 194 � �,A a.} tat�Sc.• .��' /'.r. - - - �' s � . Assessor's offioe Ust floor): I „ 9 o�THE�11to` Assessor's map and lot number ............................................ Q�� t Board of Health (3rd floor): Sewage Permit number 2 B6H39TAXLE, ................ . Engineering Department (3rd floor): roc MAOIL '°rFo YpY House number .......... �e 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 .......1 N'., .al. .�1...:.. �.{<,!J`!//dl.(T.......... !••'.T•• 1� ........................... TYPE OF CONSTRUCTION Vv adVP / ...........19�?. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... !... .! CLI../.. f!...... ......... i6;, .. ..�. .i ..................................... ProposedUse ............................................................................................................................................................................. Zoning District ................. .1..f.lAn..7t.I............................Fire District .......... ....... /7. ^.G.S.......................................... Name of Owner ........K.�t/I r�. 0..............................Address ....7.....`�..��wl..�.......... . Z� �P/r^..S .............................. ... Name of Builder .........,.'!�(5... .I!� 4.l�.........................Address ... �r S�SL/„ C�C`�...Y,• hr,, S ' Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ................�.............I...............................Foundation ...... /Q�.� ....................................................... Exterior ......... h,;i n ..tl............................................. ........4.;.( �.. ..: .............( .............................. Floors ......................................................................................Interior ......./.. ............. .......................................... Heating ......././.. .../...............................................................Plumbing .......I.jj �../ ....................................... Fireplace .......,...,.;�1;`1,...�J.................... Approximate Cost .................................................................... Definitive Plan Approved by Planning Board ------------------------_-------19________ . Area ........I.:................................ Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. QQ Name ..................:.......... .... .................................. 90� j Construction Supervisor's License .... ��t/ ............ ..� . GORDON, LEWIS A=271-41 No ...2MM.., Permit for ....Dem:olish.............. ...........??W.P.11 i ng.A..Gar.age.......................... Location .....RQuze...28......................................... Hyannis ............................................................................... Owner Lewis Gordon ................................................................. Type of Construction Frame . c ...............:............................................................... Plot ............................ Lot ................................ Permit Granted ....,...July .22.................19 86 Date of Inspection ....................................19 Date Completed .............................:........19 �� ` � e 7 95 High School Rd. Ext, Hyannis, MA 02601 Hyannis Fire and Phone: 508-775-1300 _ Fax' 508-778-6448 rr Fax To: oi4tJ /�[ �S F►orrea �� 1�,� ,� �.�s>' � Fax: Phoneh: ,. Pages: 'Y /+mac�u c�.:✓g Chu�Q Rer /C Y' PQS �AJ CC: i 0 Urgent �For Review C Please Comment 0 Please Reply 0 Plesse Recycle *Comments: I TO SJad SbId SINNVAH 8btr98LL809 TZ:9T 900Z/£0/E0 A I o Delete 1 ' 01922 MA 3/3/2005 I 001 I A250251_. 0 p Change L_........ �... l—_._._ L�....—_1 ,-- NFIRS----�-- O No activity Basic Sbtte ncid�nt Date station Incdart Number Exposure I I Cnecx this box to indrkAto that the address for this incident is provided on the VAldfend Fire Cenaue Tract 30 B Location ModUle in Section D"Altamative Location spadfiostion".Use only for wiMland flees. ® Street Address L I 720 PITCI-ER"S WAY 278 760_. I WJ `Y —...... ❑ Intersection �..__............ ..J L�— _—..__. l,� f NumberMlllepoat � -Street 1Y6e Suffix L ❑ Prefix Street or Highway In front of I ❑ Rear Of AS I Hyannis —�.. J MA J �_02601 __......� ❑Adjacent to ApOSuitatRoorn 7Jp Code © Directions West main st Cross street of dkackons,as applicable 2- stese C Incident Type E1 Dates 8 Times knidnamle0000 E2 Shiftspio alarms LV 740 Unintentional transmission —•••-I Check boxes ir Month Day Year Hour Min � � Incident Type Of 8 .4theT --- ---- datesaethe L j tL11 L___.�__.._ ALARM always required Aid Given_ReCelYed same as Alarm Shia or No Of Afarmtlliuriat p Date. Alarm LL3-1 103 11 2GGS 10:52 I p+owa^ 1 ❑ Mutual aid received II ARRIVAL required,unleo*orioalador did ootart$ve -- 2 ❑ t a i aid recv. l -- - Special Studies Theu FOib Their Arrival I 03 03 �QQS I 10:57 �3 Local Option 5 ❑ Mutual er acid given state Controlled CONTROLLED Q Qi;lonsl,arcaptrorlwildiendf ee 4 4 ❑ Automatic aid give t_.J L— , U N ® Nona g Their 1nCT0611i Num> ® Last Unit LAST UNIT G4Ef+REO,resat ed szaepl wnouno ire Spaoal 5psaa Cleared 03 03 2G05 l 1139 StudylDk studvvaiue Actions Taken G, ResiourceliT G2 Estimated Dollar Losses&Values Check this box and skip this section It an ores N known. Optional for non Area. L1 Apparatus of Personnel form is used. 86 4 Investi ate__ P Non Required for all , yA Apparatus Personnel primaryActlonTaken(1) Property ................ .....� pp L-0_� L.. --] i PRE-INCIDENT VALUE.�_ — �_p�_.... Suppression 1 3 J$4 � Refer to ro er authority _..� �- �• �__ Additlw�atAetbn7aken(2) EfiA$ � 0 I �: optional L.,..—.._� I � Other L()�� L_�........I Proper I � L Additional Action Taken(3) Crygck box A reeq ro counts include aid ❑ received resources. Contents ❑ Casualties None �3 Hazardous Materials Release Mixed Use Property Completed Modules Hi [I Fire-2 Fire Deaths Injuries N® None NN Not mixed I ❑Structure-3 service I n ) L 0 J 1 © Natural gos'.slow leek,noevaCumyonat Helmer Acilone 10 Assembly Use [)Civilian Fire Cas.-4 2 ® Propane gas: K41 lb.tank(as In nomo Hsp grill) Z) Education use 3 Gasoline:vehicle fuel tank or ponsioa container 33, ❑ Medical use ❑Fire Serv, Casualty-Civilian 0 U ❑ ao Residential use ❑$MS-6 4 Kerosene: 51 Row of stores ... �•••° 5 Diesel fuellftrel oil:vehicle fuel tank or parable storog 53 ❑ Enclosed mall ❑HazM -Date at-7 6 Household solvents:Homarolnceap!n,cleanup only 58 ❑ Business&residential ❑Wildland Fire-8 H2 Required for conflrmedOres. T Motor OII:from engine er p 59 ❑ Office use iortable oontalner ❑Apparatus-9 ❑ 60 ❑ Industrial use 1® Detector alerted occupants B ❑ Paint:from pint cone totaling<55 gallons 63 ❑ Military use ❑Personnel-14 fy 2❑;Detector did not alert them 00 Other:Special Ha:Mat actions required or spill>5ri gat, 66 Q Farm use U❑i Unknown Piesee complete the HaxMat form 00 Q other mixed use j Property Use Structures 341 ❑ Clinic,clinic Type Infirmary 1338 ❑ Household goods,sales,repalrs 131 Church,place of worship 342 0 Doctorldentist office 99 ❑ Motor vahiclelboat sat"lrepairs ❑ 361 ❑ Prison or jail,not juvenile 671 ❑ Gas or service station 161 ❑ Restaurant or cafetarla 419 ❑ 1•or 2-family dwelling 999 0 Business office 162 /t Baravern or nightclub ❑ 428 ❑ Multi-family dwelling 615 ❑ Electric generating plant 213 ❑ Elementary school or klndergart" 439 ❑ Rooming/boarding house W 0 Laboratoryleclence lab 215 ❑ High school or junior high 449 O Commercial hotel or motal 700 ❑ Manufacturing plant 241 O College,adult ad_ 459 ❑ Resldentlal,board and taro 619 ❑ LlveatocK(poultry storage{barn} 311 Care facility for the aged O 464 ❑ Dormitory/barracks 882 ❑ Non-residential parking garage 331 ❑ Mospltal Sig 13 Food and beverage sales 891 ❑ Warehouse Outside on ❑ Vacant lot 981 ❑ Construction site 124 ❑ Playground or park W ❑ Gradedlcared for plot of land 264 ❑ Industrial plant yard Ill ❑ Crops or orchard 948 ❑ Lake,river,stream 669 Forest(thnberland) ❑ 961 ❑ Railroad right Dewey W? Outdoor storage area ❑ gA0 ❑ Other street Look up aUM enter a Property g181429 Dump o sanitary landfill se rode enly it Cl❑ D r it 961 ❑ Highwayldlvlded highway Props you have NOT chocked a 931 ❑ Open land or Held 962 O ew Residential strest/drivay properly Use box: IMultifamity dwellings nnnbt nw'Mon(ri'r.?B A250251 - EXP 0, 31312005 PAGE 1 OF 2 HYANNIS FIRE DEPARTMENT - MFIRS REPORT Z0 39Vd 36I3 SIN'NVAH 8Vb98LL809 TZ:9T 900Z/£0/80 K, Person/Entlty Involved ` 508-778-6990 ` Bueireaa name(if aDGucebw) Phone Number ®check this box it Mirian Oliveira �... ...� acme addreas as L.�».,�-.__ �..�--. .-. -_... Mi Last Name .. ... 3u111Y Then Skipt the three Mr.,Ma.,Mfa firer Neme —. - ThaneklDlhsthme I WAY WA`4Y tluGlicate address 720 I ` PITCHER'S 278-76Q L ...... . kinea. �_..... .. . ..,—.... &raef Type Suffix , NumberlMitepost Prefix Strael or Highway I As ...J [Hyannis POOR Ofnca Sox Apt.lSultelHoom city L_ MR .-.� �. 02601.....� Stele Ilp code ❑More people Involved7 Check this box and attach Supplemental Forms(NFIR848)as necessary, ownerciii'box 90 K2 Local Option ®t enreast a 1H S Section d skip M 1r1 name a G� Phone Number 6(� ® Check this box it Mirian J Oliveira some addreee as s.._. - ....... Incident location. Mr.,Me.,Mrs. First Name MI last Name Suffix 'hen exit the three WAY WAY dupreateadAres► IER'S 278-760 Iktea. 72a I �---..—�I Prmcl- .., ... I . NumberlWaNst Prefix &traef or Hphwey Street Type Sulfx L .— AS ' Hyannis Post Office Box Apt.rSuke7Room City L_m L-026U1� State Zip code L Remarks: t.ncsl Option ITEMS WITH A I MUST ALWAYS BE COMPLE`f1501 ® More remarks?Check this box and attaoh Supplemental Forms (NFIRS-1 S)as necessary. M Authorization 18203 lRichard A Knowlton _ Lieutenant / P �uppressionj 0033 i 03 2005� .. position or rank Assignment Month a LY................. Officer In chefg9l[7 Signature g � �` Mr Check box if same as Officer in roe.41918203 � !Richard A Knowlton � Lieutenant / � Su ressioni 03 03 � 20U5 Membef making report ID Signature Position or rsnk Assignment Month Aar Ysaf a250251 - Exp 0, 31312005 page 2 of 2 HYANNIS FIRE DEPARTMENT - MFIRS REPORT CO 3CVd 2aId SINNVAH 8VV98LL809 TZ:9T 900Z/E0/S'0 i L1 O Delet® NFIR5 -1S 01922 MA 3I5� 99 1 .._ _.. . ..•-,� �..A250251 0�� p Change ISupplernentall Slate -I IrvcAent 08te 3tAtl9� InC1Aom Num6ni ' Ezpoauro K2 Remarks We received alarm #6, the automatic fire alarm for 720 Pitcher's "Way, Building A. I responded on 826 with FF P_ Cabral and .FF Alger driving. We arrived on location side alpha of building A with nothing showing. The audible alarm was sounding throughout building A. There was a pile of construction material on the sidewalk in front of building A "right". We were met by the property manager, Dave Dalton, who was ,notified of the alarm. The fire alarm panel indicated Zone 8 "Building A - Might - Attic and Loft" as the area of alarm origin. We investigated the area of the alarm origin and found a heat detector disconnected/removed in the attic/lof of apartment 5. There was construction being done in this attic/loft and the owner, Mirian Oliveira, did not know if a permit was issued for this work. It was obvious that electrical work was also being done. The owner stated that the contractor had left just prior to our arrival and he had gone to a local hardware store to pick up some items_ She did state that he was going to return today. FF Cabral noted that one of the electrical wires was out and there were exposed wires showing. We could not determine if the wires were; live. Ms, Oliveira stated that she did not expect the electrician to be there anytime soon. She said that he will not return until the contractor has completed his finish work. We were able to gain access to the other attic,rloft areas from apartments 6 & 8 and they checked O.K. We could not get into apartment 7 so we could not check this space. We could see from apartment 6 into the attic area over apartment 7 and there was no sign of smoke or fire. .1 called the contractor, Mr. Edmilson (774-353-6955), and spoke with him on the phone. At first he denied working at this property but then he did admit that he has. He stated he was in Hyannis and could meet me at this location at 12 noon. I called fire alarm and requested they contact the building inspector, wiring inspector, and a fire prevention officer and ask them to meet me at noon at this property. The wiring inspector was unavailable but the building inspector and Fire Prevention Lieutenant Hubler would be there. I I asked Ms. Oliveira if we could return at noon to inspect this area again and she yes and stated that someone would be there. I attempted reset of the alarm system and the "Fire" condition reset but the system then went into a "Trouble" condition for zone 8_ 826 secured the scene at 1139 hours and arrived back in quarters at 1143 hours. NOTE: 1 returned to this location at 1155 hours and met with Lieutenant Hubler. The building inspector, Dave Mattos, arrived on scene. The property manager, Dave Dalton, was also present. We proceeded to the attic/loft area. Mr. Edmilson did not show and I left a message on his answering machine. There was an employee of his on scene but he did not speak English. Mr. Mattos ordered a work stoppage for this property and explained to Ms, Oliveira that before any work could continue, the proper permits would have . to be applied for and the work approved. He instructed her to obtain a qualified electrician and contractor to have this work completed. He asked that Ms. Oliveira translate this information to the employee and to Mr. Emilson and she stated she would, Mr. Dalton was advised to contact the alarm company to have them replace the heat detector in this attiOlo11. Richard A. Knowlton, Lieutenant A250251 - EXP 0, 31312005 HYANNIS FIRE DEPARTMENT MFIR5 REPORT PAGE I b0 39Vd S�JI� SINNt1AH 8OP98LL809 TZ:9T 900Z/60/60 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 Parcel �t7 Permit# Health DivisionP 0: �13'nan k"o e^, Date Issued Conservation Division Application Fee Tax Collector Permit Fee S.0 0 Treasurer CONNECTED SEWER ACCC1U-,,1T Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 7 Z -, f�/ -S 6w_41 &IA117- S Village y� lylyl,5 Owner ✓!' Z4ead Al a/l rVJ;ft2.9' Address 7,w 1 c,1c—A-1S 461;1l Telephone Svc 7 7, — C 9 9,0 Permit Request .4&hd o do-t 1Js 'to S y d Secv y d _l0 a r ;1 r" /0 4 � k /G 3 C/Gk S. yew r.' vSe 5 a TV l'lea.i 1 Square feet: 1 st floor: existing proposed ✓ 2nd floor: existing (i proposed y Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 rc'00.0o Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Cl Two Family ❑ Multi-Family(#units) Age of Existing Structure , o JHistoric House: ❑Yes )qNo On Old King's Higl ay: ❑YR JNo Basement Type: lull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 7-- new Half: existing new r_a _ Number of Bedrooms: existing 7- new 2 Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil W4lectric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing /-/0 New Existing wood/coal stove: ❑Yes )(No Detached garage:❑existing ❑new size ----Pool:❑existing ❑new size = Barn:❑existing ❑new size ~—' Attached garage:❑existing ❑new size ^ Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION I Name r(EG In 1 y-21 Telephone Number S-O 3 (f t _Address i �¢%s ' Ja)� License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO )(W ukA j er 5 'SIGNATURE jk-� �- .: �- sue. DATE o�Lae l4 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED � I. MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH' FINAL PLUMBING: ROUGE FINAL t\3 GAS: ROUGRI FINAL m FINAL BUILDING Q ` DATE CLOSED OUT ASSOCIATION PLAN NO. f RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $ 50.00 Alterations/Renovations $ 50.00 Change of Contractor/Builder $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq. foot= x.0041= • O® 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$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee G'0 tw7 l� Projcost ` Rev:063004 l a Town of Barest ble CF THE tp� ' "o Regulatory Services Thomas F.Geller,Director 1KAM 6 9. Building Division 9� ><bz9. �� g Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION:. number ff street village "HOMEOWNER": (f 't"� I l Vc>fC, SC7 2�' 6 ' name home phone# work phone# CURRENT MAILING ADDRESS: zc �,�/ S �yG�t�►i� Mfl oz�o� city/ wn 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 Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that'he/she shall be responsible for all such work performed under•the building uermit.__(Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with.the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger,will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This ladk 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 ultimatelyresponsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, ilities of a Supervisor. On the last page of this issue is a form currently used by that the homeowner certify that he/she understands the responsib several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms-.bomeexempt The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations -_J}y = 600 Washington Street, 7`h Floor ?� Boston,Mass. 02111 ti— Workers'C sation Insurance Affidavit Building/Plumbin /Elec�ttrical Contractors NEW., K.. name: /�`/2/� / (/Ll 0ACo! � address: 7 7--D city /TY/�"��/S state: zip:®L6 0/ phone# work site location(full address): ® I am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel ❑ I am a sole pr?p5rietor and have no one working in any capactry ❑Building Addition '�"1-`k� `s•""�. ?!". --G:�;. r�.P_,...�_.. ':J'�•..3n��.F q� J ,f;' �c 3'.P l .�� �rc:4.A•.au. .us.' '�Yi ...,_+ ... .. ....2..-.r.... .. r ..r .. .. .,.....,. ,.... .�.)° ... ...Cam... ❑ I am an employer providing workers' compensation for my employees working on this job. company name: address- city: phone#: insurance co. IDOUCY# ❑ 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 M insurance co. oyllii�c # F.. ...��' ;.-, .�.M'6iP-47+4- ., :•r :. 'fVn3TliA'�i'N"ifl'�.��.Kll.��•..�.y'Yi�a"'.P",3�a''41^"Mu�tT:+�.+., �s�;�A.a�a 4'�.A��Y..:�_ 'a-6`.��g• ,�� ���.YA4?Pe company name: address: city phone M insurance co. policy# 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 fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Sy-;-, Date ( , f l�5 05 Printname nA e- -N<-q Phone# (Soz) 71g6990 Eperson: nly do not write in this area to be completed by city or town official - : permit/license# ❑Building Department []Licensing Board immediate response is required ❑Selectmen's Office ❑Health Department Y on: phone#; ❑Other .t 03) 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. 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 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 oFt roe Town of Barnstable VI Regulatory Services SARNSTAB Thomas F.Geiler,Director 9�a 16j a1�� Building Division rED NIP' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 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 adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. __ Zvd0 Type of Work: fIAV t-S 1 ��f�i-le Estimated Cost � Address of Work: G4 S O•,vner,s Name:_ 'a 7 ![/!�'�49 Date of Application: ,L ���L �, ?p o I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMP G U�� FUND F�DER MGLc.142A. ACCESS TO THE ARBITRATION PROGRAM OR SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: • Date Contractor Name Registration No. OR r 0�1 Date Owner's Name Q:fotms;homeaffidav i To: Building Department Town of Barnstable This is to inform you that the interior construction details of an added TV room at 720 Pitchers Way,unit 5A will be completed as follows: 1. Floor .... Two layers of 1/2"plywood with staggered joints in both directions. The edges that span the joists will be secured with screws. 2. Walls .... 1/2 "sheet rock 3. Ceiling ... 3/4"tongue& groove boards 4. Exhaust Fan... Installed on the right side wall exhausting to the outside through soffit vents Joseph Sangiolo ,L i a