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0168 BARNSTABLE ROAD - (4)
Tj RULTIcFAMILY A m F * � t "• j;�.� `"'vim'"` t • � �QS.fi r .d f�f• �f - ♦ X / WENTZ r 3. MAR t3 �•E -pa_ 4� r .; ♦ •r'w++hY ♦ ♦s ? '1 as x y. w r • f Town of Barnstable Building Department �oFTHE TOtyy Brian Florence,CB0 Building Commissioner URNSr,mLE, : 200 Main Street,Hyannis,MA 02601 vvww.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION RAGISTRA.TION Date: °f 0' 1 (D 107. � Phone#: �a L4 .3(bg �g�5� Name: Address:�� 6��'" � 02 P1 Village: �-�-1 a ►-V V\- , Name of Business: ��(I's e of Business: ��C/ � Map/Lot: Type r {� INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation 1i Cn -� within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the > 0 activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual 0 alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal M-0 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 rn following conditions: The activity is carried on by the permanent resident of a single family residential dwelling unit,located _ry ;�.4 within that dwelling unit. Z Z O Such use occupies no more than 400 square feet of space. Z, M • There are no external alterations to the dwelling which are not customary in residential buildings,and there M is no outside evidence of such use. No traffic will be generated in excess of normal residential volumes. Q? • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular PM-0 .matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. ...p There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess ®5 of normal household quantities. Z • 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. Applicant: Date: )0-i(o Homeoc.doc Rev.10/17 _- I Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.bamstable.ma.us Pre-application for Business Certificate Date �10.1S J 9 Map Parcel Applicant Information Applicants Name ��� C'�`�^ ^-C 6�gs �oi'a M ya Applicants Address g �'�� � Email Address Telephone Number �`1 3�' g Listed ❑ Unlisted.❑ e Business Information New Business? Isr No Business is a registered corporation? ________________________. Yes ? If yes Name of Corporation Does business operate under the registered corporate name? Yes I Is the business a sole proprietorship or home occupation? _________ No If yes then a Home Occupation Registration is required-See Building Division Staff Name of:Businessh�- Business Address 06Z 'YV• rA_�'Ct elc 2 �_7 - ""y4t rI Type of Business "?'PLOO U 1AA vt/t- ` B ilding Commissioner O=.ce s Only Conditions S Building Commissioner Date Clerk Office Use Only �f ,' u� Wes`' u _T Shea, Sally From: Shea, Sally Sent: Wednesday, October 16, 2019 11:27 AM To: 'Tatiana Leal' Subject: RE: DBA Tati's Pet Care Hi Tati, We will need more information regarding the vehicle you are utilizing for this service. Please submit a picture and/or make and model of the vehicle used. Thank you Sally Shea Town. of Barnstable Assistant Zoning Adm_in/ Lead Permit Tech.. 508-862-4031 -----Original Message----- From: Tatiana Leal [mailto:leal.tatiggmail.com] Sent: Tuesday, October 15, 2019 3:38 PM To: Shea, Sally Subject: DBA Tati's Pet Care Good Afternoon Sally, how are you? Today I was in the office and I was asked to send you an email explaining my work. I need to open. a DBA to buy a work van. I am. Pet Grooming, today I work going to the client's house and attending to his Pet. I wonder if tomorrow I can come by to pick up the papers to take for registration. I already appreciate your help. Thanks. Tatiana Leal Costa 174-368.4952 CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email. address and know the content is safe! i ,� � �„.�. _ � }r}~— + F �� •pi�ty� 3` IVY �•�, i r Ml t� , x , a � f 1 + 4 � J T � .� .• n'. (§ �'"-� I lit �.,t. .�Yt t����,,•-#�R. •-s�,;,a�'F�„��.x�'w. �,r "f�ay.e� � $, 'k �a`ry`tt i � .Y R G:R IN ROOM A 11` F •y a y<+ �,r . {• y � .yam, � � .. ` ► `�,� n �„� +�{` �� ii.I !to i JtS., i � Y� s !•�1r"f A � , , v + r .. 4 , Town of Barnstable Building Department Brian Florence, CBO - Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.bamstable.ma.us Pre-application for Business Certificate Date CL5 � Map 3, AParcel, v, Applicant Information Applicants Name P1 A ki L DO 64 0 P A-10 Applicants Address J 63 15A"1u1JJ1"� YID Email dress Telephone Number 4�� !,q(A 36�00 Listed ❑ Unlisted ❑ "Business Information New Business? -----------------=-=-------------------- es No Business is a registered corporation? -------------------------- Yes No If yes Name of Corporation Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occu ation. -- es No P P P P � ------- . If yes then a Home Occupation•Registration is required-See Building Division Staff Name of Business LS (,,o IJ�S 7:2iJ G T Cd 0 Business Address- IZ 9 &ITLIJSIArB L6 ?D Sul WJA►VNiS O?roD) Type of Business (-,o A)--,TR,,j G I td 0 Build' g Coipinislioner Office Use Only Conditions V(,� d , � f t�Q a-1 6 i Building Commissionz-1ZAv,._4� ® � ! Date Clerk Office Use Only Town of Barnstable Building Department Op THE'Tp� Brian Florence,CB0 Building Commissioner BARNSTABLE, 200 Main Street,Hyannis,MA 02601 �Q brass. O 1639• $ www.town.barnstable.ma.us ATED��h Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Q Permit#: -- ROME OCCUPATION REGISTRATION N 'D 9 Date: �5 IZS laq Name: 5A Nl 1?41 0 Phone#: 4:4-q Li 36) Z Address: 163 BkZNf)TA-5-ri I M 14 ArtJ Jy 1 J Village: 1%Q►J,5tA&L'6 g � � I Name of Business: LS C.O,JS-rP-00-r1'0 0 H Type of Business: 00 06 7 2V C 7(O 0 Map/Lot: O 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 Q following conditions: Z 0 The activity is carried on by the permanent resident of a single family residential dwelling unit,located In O O within that dwelling unit. Q 0 Such use occupies no more than 400 square feet of space. a- L • There are no external alterations to the dwelling which are not customary in residential buildings, and there UCC CC is no outside evidence of such use. UO Q uj • No traffic will be generated in excess of normal residential volumes. U- Z • The use does not involve the production of offensive noise,vibration,smoke,dust or other particularLLJ Q M C/) M .matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. O Z Z 0 There is no storage or use of toxic or hazardous materials or flammable or explosive materials in excess _ J of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home :D w Occupation, and not within the required front yard. J W Cc • There is no exterior storage or display of materials or equipment. ,(� a cc Q • There are no commercial vehicles'related to the Customary Home Occupation, other than one van or one j. 0 Z 2 pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to Q } exceed 4 tires,parked on the same lot containing the Customary Home Occupation. H W a • No sign shall be displayed indicating the Customary Home Occupation. J If the Customary Home Occupation is listed or advertised as a business,the street address shall not be 1L 2 a C included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersigne v ead and agree with the above restrictions for my home occupation I am registering. Applicant, Date: S)e 8 1(9 Homeoc.doc Rev.10/17 Town of Barnstable Building Department Brian Florence, CB Building Commissioni N OF BAR 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma, 19 FEB I 9 `" ga Pre-application for Busines&Luj fi iWcate, Date Map Parcel Applicant Information Applicants Name 9W,_ Q-'' 1 /i 0Q V/C1.'�(3 i Applicants Address c-�Q ( Mo_t n S4 Email Address r rr r6 i'Y1 ro gddo'( 'Sph)12 r,i Z P r ,1 6 cO Telephone Number, Listed ❑ Unlisted ❑ Go NA f d,1 L Qor1 — nxr -F" 7 � Business Information NewB-�asiness? ----------------------------------------• Yes No BUSine3S is a registered corporation? ------------------------- Yes No If yes Name of Corporation S T'O a lj 7—e-0-r o Does business operate under the registered corporate name Yes No Is the Easiness a sole proprietorship or home occupation? -------- Yes No If yes then a Home Occupation Registration is required-See Building Division Staff Name of Business - Business Address Type of Business ( ) IA P `'" P fJ f f I Building Commissioner Office Use Only Conditions Building Commissioner Date Clerk Office Use Only i f -` Town of Barnstable Buildiog D6'J4i tme t pp IHE Tp� q, Brian Florence,CB Btl� �h®�6�i • inxNsrnBAE, t 200 Main:Stre.et,Hyannis;MA'026 � MASS. �p i639• �0 wWWnrit8blaS a Tpp�•(p Office: 508-862-4038 Fax: 508-790-6230 roved: blVI5I0N Fee: Permit#: HOME OCCUPATION REGISTRATION Date: +�, �} Name: I ' l C ( ��� V J�.1/ f Soo Phone#: Address: i Ilt 1"P.rU Village: l' n IS Name of Business: Type of Business:U,.6-(FfY-I>W, Rca�S In J?Jt� '4�ll�k'r , 1 d&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 activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single.family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or.use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed.4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my ho e occupation I am registering. Applicant: / Date: Homeoc.doc Rev. 10/17 n Town o Barn stable to le Building g Post This Card So That it.:is Visible From the Street}'Approved Plan_111S' t;be Retained on,Job and this`.Card Must betiKept x.w.; s� * :,i' p, ._,i,w '..'' $tee r7 r1yxe " : 3r@wsd �r «Y • til Finahlnspection Has Been�Made.:-Posted Un L. - µ.. . � d ` m.�i�t, tr`+�'""�';4'r ,�py.,,a., �.,�;� .^°<ti�:- .�4., a"r s� 19W"Yr,, ,�:#P' .o s, i;c.�. ....*r+,;� fi .1'Yys ,�, iiti _�S�m��n r« bpi �n:yak ;t� ,a t. ."x s .k�� ws Where a Certificate ofl0ccupancy is�Required,�suchBuildmgshall�Not beOccupied`until anal.lns ection4has�,beenrnade �er1t , --. '�revuNta� wa.;x• ,.. ..+L+.eaYY,Lwt4L.+;= -.• �-^ °'�•'.� �tt�B'di.+i.4..�awwAv=dr&:vi ."y 5�r,.: a- Permit No. B-16-3310 Applicant Name: hick Burke Approvals Date Issued: 01/03/2017 Current Use: Structure Permit Type: Building-Sign Expiration Date: 07/03/2017 Foundation: Location: 168 BARNSTABLE ROAD, HYANNIS Map/Lot 328 013 Zoning District: SF Sheathing: Owner on Record: CROMWELL COURT PRIES ASSOC LP Contractor Name: Framing: 1 Address: 3100 BROADWAY,SUITE 1234 Contractor License 2 KANSAS CITY, MO 64111 s Est Project Cost: $ 1,227.00 Chimney: Description: replace existing sign at entrance 12 sq ti Permit Fee:, $50.00 replace � ,Fee Paid $50.00 Insulation: Project Review Req. existing sign at entrance 12 sq 1/3/2017 Final: . Date h Plumbing/Gas . �'` .' r k A'"�* .fix �„�,. '•,�thiti,( -Gl,o iY�_ Rough Plumbing: - -_ Zoning Enforcement Officer Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authored by this permit is commenced within sii`months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and th&approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures sha11' in compliance with the local zoning by laws and codes: V - 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. i. " .r Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the'Building and Flre Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work €< 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 la-I �( - 1 � �� c�s�S � h c�C�.S: � � � � ��� a '��0— �i��x_/y_/ (/�, -�'� o �� i �� ��� ��� r�s �� �� _ r� i �� �� Town of Barnstable " �, " 200 Main Street, Hyannis MA 02601 50 038 s 6� Application for Buildi g Permit Application No: TB-16-3310 Date Rec'eved: 11/9/2016 Job Location: 8 _STABLE ROAD,HYANNIS Permit For: Building-Sign Contractor's Name: S ic. No: Address: Applicant Phone: (508) 830-0505 (Home)Owner's Name: CROMWELL COURT PRES ASSOC LP Phone: (508)771-4550 (Home)Owner's Address: 3100 BROADWAY,SUITE 1234, KANSAS CITY,MO 64111 Work Description: replace existing sign at entrance J� Total Value Of Work To Be Performed: $1,227.00 Zp� 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: Rick Burke 11/9/2016 (508)830-0505 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $1,227.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $50.00 ..... �. ........ ....... Total Permit Fee Paid: $0:00 E" �� SISNQ � �E I -No �jo n- - 1 PRODUCTION NOTES 3 k 1)2'X4'ALUMINUM TUBE WELDED FRAME 1 1 3)FACE 118•ALUMINUM WI PAINTED BKG/VINYL VBJYL•DICdTALPRBdTICONTOURCUT - GRAPHICS IST SURFACE CAPC•) Ey'd MATCH P2 8 UV PROTECTION FACE BONDED WITH VERSALOCK OR EQUIVALENT 4.11• 4)WINDOWS"ROUTED OUT TO SHOW CREATIVE -SEE SECTION 4•' LT BLUE ALUM.LAYER UNDERNEATH SIGN DESIGNS )DECORATION LAYER TO BEW TYPE I PVC BONDED TO ALUMINUM BKG.PAINTED SURFACE BKG. 2801 —difty A POAH OMMUNITY!�•� 3 .. 7 O i 580NOIECTO BKG ALL OPVC FCO LETTERS 0 OMAIN BE NAME iTPhwee813-81&7•100 _ DETAIL 1 Fland. 1626 XPAN COMP UTER CUT VINYL APPLIED TO IST SURFACE. Fex.81174&2311 S1 BY CSD_ 7)RETURNS-PAINTED LT.BLUE w.•,w.ueauvesigr�aeslsnsmm j tML -ftl S2 BY CSD : .: Przo¢cr: l: 7" RETURN DECORATION PAINT TO MATCH BY CSD 1 "BUILDING FROM FACE POAH 1 (NOTE:DIFFERENT HEIGHTS) .. 17 CROMWELL COURT Tq I'Ai }� q 5 STRUCTURE NOTES - APARTMENTS SIT 4'%4'X.250 WALL ALUMINUM TUBE SUPPORT slre,nRREss SI I„ 1 -BY CSD ON LEFT AND RIGHT TO SLIDE OVER 168 BARNSTABLE ROAD T•. �� .., •. BY CSD DIRECT BURIED 3'TUBE AND SECURED WITH HYANNIS,MA02601 '�. COUNTER SUNK SCREWS q ' w, � • i •• #S'� '� T -! -" S2)DIRECT BURIAL ALUMINUM TUBE 373'Xi8 8 WALL- � CRM/Quote: BYCSD W1TH.080 ALUMINUM SHIM APPLIED TO OUTSIDE EDGE EXTENDING UP TO RECEIVE ALUMINUM SIGN FRAME 16802-73035 SLID OVERTOP vmn N. S3)CONCRETE 3000 PSI @ 28 DAYS CONNELL MORRISSEY DETAIL 501E BEARING CAPACITY 2000 PSF(2 KSF) - Ralen Maa�a1P$C - PROVIDED BY LATERAL SOIL BEARING muu+PA=NA BYCSD INSTALLER CAPACITY=150 LBS I FT OF DEPTH omlPr o� .. - PAINT NOTES OPP 10,1— Re<bn: ALL PAINTED FLASHES TO BE SATIN -I— PI) MP41342SP BRUSHED ALUMINUM SILVER PAINT °"�°4p'-- PQ S3 PROVIDED BY P2)MATCH PMS WARM GREY 11U INSTALLER P3)MATCH PMS 5435U LT BLUE P41 MP 202SP WHITE - - - 0 p , VINYL NOTES ,4••T S2.3•X3X.188 ALUMINUM SQ.TUBESUPPLIED BY C,51) V1)3M 772S10 WHITE - -)' - --- -.- (21TWOSPPORT - V2)DIGRAL PRINT TO MATCH P2 GREYIIU WIW ' - (2)TWO SUPPORTS REQUIRED 9-PTYPICAL LENGTH wal: NOTE FIELD TRIM BY OTHERS - �.Apy.* TBO PER CODE REQ'0. 4 TO MATCH FOUNDATION _ MPwammea SI BY CSD REQUIREMENTS 1 'y W�• 1 extx250 WALLAlTOSUD . IP - IY NBESUPPORXLALUNET •m.+s_ _—. . 3' ISHOANuveuOWlrO suoE SIF NON ILLUM.MONUMENT. °�" x'• 6E SCALE:314'=V-0' 18.03 SO.FL S2 BYCSD =-k18AW-UNWUMTUs ISHOwNm.ueI OIHECreu�IAIWCOvtRETEw11H.0Bouu E— - " - v � SNNISHOMT'INREO)OPPl�0 d1dRLPE EDGE - rORECENE SWN FR/J�sIm OYERT0.P - Font-Gadugi(Bold) Tu6es4RE WsrnuEo ss oNCENTER soTHnra.wo- yq"-w ABCDEFGHIJKLMNOPQRSTUVWXYZ ,HERE B A 11•OAP ON THE LUTAND MGHr pt P2 P3 P4 slOss FOR WSTuuna+ abcdefghijklmnopgrsluvwxyz 1234567890 25" euE t1'a �•• sneer Font-Gadugi SECTION DETAIL 1 SIDE 'I 1 OF 1 ABCDEFGHUKLMNOPQRSTUVWXYZ " SCALE:318'=1'-0'. -vLEASEwrs:m.,vemen,' anitifmrm..x,Naw�NnPNm;M�«+x abcdefghijklmnopgrstu'Anxyz 1234567890 SCALE:Y=1'-T- 16802-73035 CC 10-12-16 » n { a �°9 rr�ie � Safi 6 4r�.*s G' , ?.� t' r�� ,.,.-.t� tk., `�' ,,� a""�"� +•,,,,�`'v�,���� •� prgFi pert'` y� r - . �5� ��,. 9 �� 7 �'� ''�xP •r`'r*�j�,�"� �'4. '». v',�. q�,.�'%. :. � ,w�•,. 1 fir&� -'�:y �a \ � 4 f!� 1. � i+.Njf `'. ,� {a .1f .. i: E� ✓lair a.;i++.,�\ tuw "�z••e.,h..+�, s �• ali4.-rYF�.'�t'F�`a,,��r'� f''tt j: �� � #t "� q. i +1M1G �:Of6+��0'�l i FAONPMENTSIGN � �E x:= '''�."� t t'. w`n"$� r..ar^..✓��l eEa ° ,._,.. _.. �� Q,�f�i `r� .. .. •S » w ,'n 4 may,}x Y 4_-�.,�-._ �. _. ... •.Z�.._. .+fir={-.T""_L'�� K� - . .•. ��ww�plYlart91. CURRENT MONUMENT SIGN LOCATIONS:, CCROMW:,EL COURT—'1 09G 14/2014. � ;" qL x AV t' w PRODUCTION NOTES' "" 1)2^X 4-ALUMINUM TUBE WELDED FRAME 3)FACE 11 ALUMINUM N PAINTED BKG IMNYL Gy GRAPHICS ISTSURFACE(AM l HIDDEN SEMI BELOW PVC LAYER "= FACE BONDED WITH VERSALOCK OR EDUIVALE v- _ 4'11' 1 a• _ a)LLT. UOEA,SiUM NDERNEOW �C`.RFATIVE ATTH SI N DE IGi�1S I, SEE SECTION - DETAIL I O. .... -S)OECORATION LAYER TO BE SS'TYPE'PVC-BONDED ,.. TOALUAtINUM BKG.PAINTEDBURFACE BKG. 2801 C ity Place '?' ..,=, �,,:- .n,.a•-�-'< "�,.,� o„tl ,.:` 7 tk'THICK EXPANCED FNC FCO LETTERS MAIN NAME. 1 Tsmpe.Florida 3. ?,,;�;. BONDED.TO BKOALLOTHER DECORATION TO BE .Phone:8IMIS-7100 COMPUTER CUT VINYLAPPUED TO tST SURFACE F�c 813 749 2sit St BY CSDP�A 9ndasignacan �' .z - , 7)RETURNS-PAINTED LT.BLUE wxvteree0vasi ... I S F ' •.r�F 9� RETURNS DECORATIONPAINTTOMATCH P ST j S2 BY CSO _ BUILDING FROM FACE - POAH BYCSD • (NOTE:.DIFF.ERENTHEIGHTS) a tn' in STRUCTURENOTES ilt- 5 St)4•X4•X.250 WALL ALUMINUM TUBE SUPPORT , Si BYCSD �ONL.EFTANDRtGHTTOSLKIEOVER MASTER.. . '® a BY CSID - DIRECT BURIED 3'.TUBE AND SECURED WITH - ;COUNTER SUNK SCREWS S2)DIRECT BURIALALUMWUM TUBE 3'X3'Xl$B WALL. CCIRM I Cuomo: ® BY CSD V EXTENODi�NQLIJP TO RECEIVE NUM SIGN FRAME C 8..322-6431;0 e• e • AUD OVmTOR .. AuwniMymxr --- R CONCRETE 3000 PSI 0 26 DAYS KFUS KAY DETAIL 1. SOIL BEARING CAPACITY 20M IF(2IfSF► ` S2 PROVItiFAeY�LATERAL S01LBEARtNG -- BY"CSD 1NSTALLEIi CAPACITY=150 LBS I FT OF DEPTH ORF 412UIG PAINT NOTES ALL PAINTED FINISHES TO BE SATIN uea oa+o oawou� L P2)MP 41 MATCH WARM GREY 1MI UM SILVER PAINT o S3 PROMDEDBY 1 1 111) P3)MATCH PMSS435ULT,BLUE w w� INSTALLER P4)MP 202SP WHITE w VINYL'NOTES w ) a,-p j Vt)3M 7T25.10 WHITE 0 �: •- -i • -L AppfVy l- El APO*,W TBD PER CODE REOD. - 4' ❑App--wat`4 61.BY CSD ❑.AaN:o we ra+timu 3500" 4'X4•zZ0VUAtUVA4UU TUBE SUPPORT RI CAOINT u.•�' 3• LSHOMASYELLOMTOSUDE� D/F NON ILLUM.MONUMENT' a e , xc SCALE 314'=1'-0' 82'BY CSD �t -`• :„ .. ., B8Uq�u c RUcTElil(i_o AwMan cli b SON t5H0W ALLA N WEtEO)A?Pll®ON OUTSIDE EDGE ... .n TOOECEI4E 61GH FRAME SU ARTOP }, :. •w�•de:,..0�• ..meoo�sw.. Font-Gadugi(Bold) TUBES ME INSTALlEO 56,OtI CENfIIt SO THAT ABCDEFGHIMNINOPQRSTUVWXY2 - , cEfTAvoraGkr ' P1 P2 P3 Pa y� � »e,•.oe "" abcdefghijklmnopgrstuvwxyz.1234567890 zs �' sheet -. u�+ PF6 YUAp PIB SII5IJ- .^OISP SVTI�,9 Font-Gadu L SIDE2:: "`•"' .r: 'ro ucaue xnrB u�mc Q SECTION DETAIL 1 scaLEsrs^=ram 9 ABCDEFGNUKLMNOPo RSTUVINXYZ t SC 7r EMS& abcdefghgklmriopgrstuvwxyz 1234567890 mcwwk cuvufn 0.d `e —; a 27-16 Me$sage Page 1 of 1 Anderson, Robin From: Anderson, Robin Sent: Monday, November 21, 2016 8:52 AM To: rick@aasplus.com' Cc: Anderson, Robin Subject: ViewPermit, Permit No: TB-16-3311 Please provide me with a photo & dimensions on the existing sign and a proposed graphic. I also need to see what the proposed graphic is on the new sign. �gbi.e Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis, MA 026oi 508-862-4027 11/21/2016 i� AB18 FND FALMOUTFI ROAD ROUTE 28 • (STATE HIGHWAY LAYOUT-SO-WIDE) UP PATH ..�.......------ __...584 45.40'E._—... ...... _...._ ....._._._ F ?32.56 Mte Frvo 780.00' jr I 'PLAN DK<aa PG._Dt +� I *t Z 1023 FALVAWTH.ROAD NIF ..JEdt' et+.C� JEG(, ttS iA _ 2S. W t •1 - HOUSING ASSISTANCE COPP aaz r 4,a, r" •' c r e. �t cwoe BIOLDMG'D' S } kk zas. BUI�.'rt ...."r i+ / 4 Q(L':3OC�� .n > I OUKPSTFR 4JC 0 i _ UP B55' try laa� TwSFa Ea nz - z+s<! P e .JDO -� m j: f`.A"' a, m r - 'i I) Q V rr ALILfloxes._ I C�lEllYMON praeK k )tom..: ..:L-, UP8551 i BL:AC BERRY LANE ) NI '� 14 G ,cT. vIAYGROUND. � r M \ ,Q r b . �, TRAN9FQilSFI; ` •, e .TT sR..+s q j r zzz s. t• MD ��a"�.1._ 'ha •bz ito 4.. m R+.ar°`•:�� ``l_!i � . :7.LAOAU -!�`qt...r z. - r N sPED9 Paz ,a� GRAPHIC SCALE z4?m �� �z a m,r•B�arN�,q, � ;r '^` 40 o m� ao eo 76 OLULBERA )I117..ROAD 1 � N„ -: aELYt 6 X - '�47ST. Jj DIXON Jam- cm(BBI) 2n9�i sok 1 INCH=40 FEET 82 DLW-MERRY IHLL ROAD 249/135 92;GLUEDZRRY HH.L ROAD a 249na - W ' I W ELU£BERRY HILL ROAD - RIF PAYINE i Owl _. - WA BOXY, ) - � 1.�3.1•i.t.,.°fr_,,I•`.'t.�._J,3`i lr,„i Ff'�f. �.,r.:�..:{• .•.*^'°""""r"nr._a•��nravr raur - `,,,�g.. 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FA .. - .. 1)7X4-ALUMINUM TUBE WELDED FRAME . 3)FACE 1R'ALUMINUM W/PAINTED BKG/VINYL GRAPHICS IST SURFACE('APO-) - - FACE BONDED V41TH VERSALOCK OR EQUIVALENT VINYL-DIGITAL PRINT I CONTOUR CUT 41 VINDOWS'ROUTED OUT TO SHOW CREATIVE MATCH P2 I UV PROTECTION LT.BLUE ALUM.LAYER UNDERNEATH SIGN DESIGNS - - 0 5)DECORATION LAYER TO BE Ah TYPE I PVC BONDED j 4'-0' TO ALUMINUM BKG.PAINTED SURFACE BKG. 12801 Commodity Plain i1 SEE SECTION I 4. - 1N'THICK EXPANDED PVC FCO LETTERS MAIN NAME Tampa da Flori 33626 OETARI I BONDED TO BKG ALL OTHER DECORATION TO BE P6one.81MI&]IN - COMPUTER CUT VINYL APPLIED TO 1ST SURFACE. Faz 81&74&2311 3.. 7 v..�w.«eaWesigndesgns.com _ _ _ _ ])RETURNS-PAINTED LT BLUE A POAH C MMUNIT :a RETURN DECORATION PAINT TO MATCH Si BY CSD qBUILDING FROM FACE S2 BY CSD \ - (NOTE'DIFFERENT HEIGHTS) POAH VT - FOUNDERS COURT STRUCTURE NOTES -- g2 -BY. +, •.. N 5 aTE St)4-X4-X.250 WALL ALUMINUM TUBE SUPPORT v BY CSD ON LEFT AND RIGHT TO SLIDE OVER 9]9FALMOUTHROAD"' 1P - DIRECT AND 3'TUBE AND SECURED WITH HYANNIS,MA 02601 - COUNTER SUNK SCREWS - S2)DIRECT BURIAL ALUMINUM TUBE 3'X3•X188 WALL-- CRM/Quae: r BY CSD,WTTH.080 ALUMINUM SHIM APPLIED TO OUTSIDE EDGE EXTENDING UP TO RECEIVE ALUMINUM SIGN FRAME 1718973078 SLID OVERTOP S3)CONCRETE 3000 PSI @ 28 DAYS coemE.0 uoBBDssEv BYCSD DETMLI SOIL BEARING CAPACITY 2000 PSF(2 KSF). Rd.au>..R.rRsc PROVIDED BY LATERAL SOIL BEARING - dl11AN PMgNA ;q INSTALLER CAPAGrFY=150 LBS/Fr OF DEPTH o°npr .. - PAINT NOTES IKEF f 1alvia ALL PAINTED FINISHES TO BE SATIN Be ah� PIMP 41342SP BRUSHED ALUMINUM SOLVER PAINT PROVIDED BY P2)MATCH PMS WARM GREY 11U w INSTALLER - P3)MATCH PMS 5435U LT BLUE i P4 MP 202SP WHITE —�-- o ' VINYL NOTES - 3.3. 123'XT1UMINUM SQ TUBE V7)3M 772S10 WHITE —i 777 SUPPLIED BYCS BYCSD V2)DIGITAL PRIM TO MATCH P2 GREYIIU W/LN -0 (2)TWO SUPPORTS REQUIRED .. i 8.8'TYPICALLENGTH Appm* NOTE FIELD TRIM BYOTHERS - TBD PEP.CODE REQ'D. 4- _ _ TO MATCH FOUNDATION St BY CSD REQUIREMENTS R..e _ 3,500' rxexzso—uwxuu � %mSVPPoRfNG u _ ISIIOwNA3YcL0.'4Tomm .. .�_..-T D/F NON ILLUM.MONUMENT ovEBrxr uaE Fiq 12 SF SCALE:3/4'=1'-0' S2 BY CSD APOAH<oMrauNmr-1.1 llE uuuwuu nsE lslmvx A3 W. - v OWECr611BPLWCONCRETE WIIlI.aBOP16MNDN HDIIN Ix REDIAPPL69 Cx OJTStpE EDG TORE E - TORE Sx�FRAVE SIDOYFHTOP - Font-Gadugi(Bold) - Tusssaawsrnu>:D>a'ax—xsorx4r ABCDEFGHIJKLMNOPQRSTUVWXYZ mEREaAw-D"'D"TMELETT^xowG,rtP STIES FOR MSTLLLAT abcdefghijklmnopgrstuvwxyz 1234567890 Font-Gadugi SECTION DETAIL 1 SIDE ABCDEFGHUKLMNOPQRSTUVWXYZ = SCALE:318'=P-0' SCALE:.3•=1'-0• xEAxERam:Tb,wnme,.w..,uamom.nv.ww�.airey.,.roam,a<ry -abcdefghijklmnopgrstuvwxyi 1234567890 - � - - - -17189-73078 FC 12-121fi . - .. .. .. PRODUCTION NOTESx^+k ' y. - 1)2'%4'ALUMINUM TUBE WELDEO FRAME 3)FACE 118-ALUMINUM WI PAINTED BKG I VINYL GRAPHICS IST SURFACE CAPC') `. - - FACE BONDED WITH VERSALOCK OR EQUIVALENT g' s .VINYL-DIGITAL PRINT/CONTOUR CUT .. 4)'WINDOWS'ROUTED OUT TO SHOW' CREATIVE - MATCH P28 UV PROTECTION "' LT.BLUE ALUM.LAYER UNDERNEATH - SIGN DESIGNS 0 5)DECORATION LAYER TO BE W TYPE I PVC BONDED --- 4W TO ALUMINUM BKG,PAINTED SURFACE BKG. 12801 Commodity Place SEE SECTION 4. 114'THICK EXPANDED PVC FCO LETTERS MAIN NAME Tampa,FWda 33626 DETAIL - v _ ) BONDED TO BKG ALL OTHER DECORATION TO BE - ftwo:813818-7100 -- COMPUTER CUT VINYL APPLIED TO ISTSURFACE. Far 813-74&2311 7)RETURNS-PAINTED LT.BLUE `w"�'. 9Pdeslgns.cgn A PbAH C IMMUNITY; RETURN DECORATION PAINT TO MATCH PawEOr 51 BY CSD BUILDING FROM FACE -- POAH 52 BY CSO- - 1rz• (NOTE:DIFFERENT HEIGHTS) CROMWELL COURT APARTMENTS STRUCTURE NOTES S1)4'X 4'X.250 WALL ALUMINUM TUBE SUPPORT iTSAnoPass BY CSD ON LEFT AND RIGHT TO SLIDE OVER 168 BARNS TABLE ROAD DIRECT BURIED 3'TUBE AND SECURED WITH - HYANNIS.MA 02601 COUNTER SUNK SCREWS S2)DIRECT BURIAL ALUMINUM TUBE 3'X3%188 WALL CRMIQuote: BY CSD WITH.080ALUMINUM SHIM APPLIED TO OUTSIDE EDGE EXTENDING UP TO RECEIVE ALUMINUM SIGN FRAME 16HO2'73035 SLID OVERTOP �� S2 - S3)CONCRETE 3000 PSI @ 28 DAYS cora+Eu NORRLSSEY BY CSD OETAILI _ SOIL BEARING CAPACITY 2000 PSF(2 KSF) wdaMo^ie<tPSL PRONGED BY LATERAL SOIL BEARING JILI.IAN PM A INSTALLER CAPACM=150 LBS I FT OF DEPTH - - 0RF t0nan8 - PAINT NOTES ReNs m: ALL PAINTED 4134 FWISHES TO HEDBESATIN • Pf)MP 41342SP BRUSHEDALUMINUM SILVER PAINT —"------ P I PROVIDED BY I 1 P2)MATCH PMS WARM GREY 11U w 53 INSTALLER - P3)MATCH PM 5435U LT BLUE -mT ----- wo I i PQMP202SPWHITE T $ VBIYLNOTES 3W*)L188ALUNLNUM SO.TUBE V1)3M5-10WHITE SU 772 PPLIED BY CSD -vI V2)DIGITAL PRINT TO MATCH P2 GREYIIU WIW - - (2)TWO SUPPORTSREQUIRED S4Y TYPICAL LENGTH - APFt NOTE FIELD TRIM BY OTHERS ❑ � TBD PER CODE-'D,. - 4• - TO MATCH FOUNDATION ❑Awo..ammma 81 BYCSO REQUIREMENTS 3 WBES 2g1W WC NINUM —REQUIRE ... _ ❑ - mN rnWX, TUPESUPFOWAU-INNU -- ET SIF NON ILLUM.MONUMENT °EP'ETRUE 4 SCALE:314'=1'-0' 12 SF- 1 2 BY CSD sw noxlmwAu,uuuwuuTueE lsHowxAsxuE1 . BRECT& JN ANLRETE WIIH.WON.UNRIUII u lsaxww PEREgASP1B0on auTaOE FDGE Font-Gadugi(Bold) ro BECBVE SK,x FRM4:%IDWFRTOP _ �o,m Tu8Es78E wsrAilr:n aaox�NTEx so THAT- o.a:�o.�r:�m.. ABCDEFGHUKLMNOPQRSTUVWXYZ THEREISA 1M•cAPONTHE-- Font- p1 P2- P3 P4 Vt SUES FOP NSTAWTKx1 I II abcdefghijklmnopgrstuvwxyz 1234567890 .25• _ _ '" u I I❑ `^M „� Si eec Font-Gadugi SECTION DETAIL 1 sloe2 ABCDEFGHIIKLMNOPQRSTUVWXYZ .,�;::, - SCALE:318'=l'-0' viuserrorE lrerw�e,wW,a�,wmom.n.rewwremren,euxam,arr,. 1 QF 1 abcdef hi'klmno rstu 1234567890 9 J. PQ v✓xY1 wv,ewA�aA uax�: 76802-73035 CC 12-12-16 Town of Barnstable oFWME rqy, Regulatory Services Richard V. Scali,Director Building Division BABNSTABIY4 M'U Paul Roma,Building Commissioner s6;q. ♦0 iOTF 3l a 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: — _ -Z(� HOME OCCUPATION REGISTRATION Date: 11 1 _� I f Name: ✓e� Phone#: N` n j9--h go- 4'7 t 5 Address: 6,4&A)S IL 7i d C� �F Village: v 14�ij I Name of Business: �A VIS SG2�if C c=-n L L C Type of Business: b - SE — Map/Lot: r 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 dwell'ungy unit. I,the undersigne av read and a ee with a above restrictions for my home occupation I am registering. 4 Applicant: C Date: Homeoc.doc4:,.06/20/16 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, 1st FI., 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required by law. 1 . DATE: f/ (� Fill in please: i APPLICANT'S YOUR NAME/S: (� BUSINESS YOUR HOME ADDRESS 1 h '�i• i'Fri'i.J li.''i s}f Jilo-` y'q��e / p (/�f ` �. _ �. =! ':11ii`Jv•f{i. .. i.y.�.•y .`J V O —IrJ AO —L 1 v �. ' TELEPHONE # Home Telephone Number p" �V i'r.''.:• .,•:�F;?.i.,:. v�•;ra ;+•::;� EIN #: E-MAIL: NAME OF CORPORATION: 11fA 4 P A L— L NAME OF-NEW BUSINESS TYPE OF BUSINESS rC ,i,J� Q IS THIS A HOME OCCUPATION? YES D41ADDRESS OF BUSINESS. . 9U —ti7� MAP/PARCEL NUMBER [Assessing) o 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' FI MUST COMPLY WITH This individual has been i rme f ermit r I em th -pe-main to this type of business., RULES AND REGU H HOSE OCCUPA11®N COMPLY MAY R _., CATIONS. FAILURE t S' n tu,e * ULT IN f fp ' T® CO EN S: �- 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 r'° 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 Parcel C 0 Application # Health Division BUIC®/ Date Issued. �1r��2�� Pp Conservation Division N�' %ption Fee Planning Dept. APR 12 2 rmit eFee Date Definitive Plan Approved by Planning Board 0wN0F8ARNST � I 1 tcv Historic- OKH _ Preservation / Hyannis ABLE Project Street Address i leg Village cn ns Owner �v�a�1 k.U.J\ COc1.< PCWT%ruc_ �w., NS dress L� u ° Lr+ Telephone r) 39 1 (:)qs�4 9�-s�,V, rNI'4 0-D-1 obi Permit Request QLk ; �-, w- 15 c s,p E3�,1 c,,cg* C - --re— 0-4 Qjwt�`S ry 1 c7�o�1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation`'443, 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 carage: ❑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 Telephone Number SoY G 3 b g D Address 17( Pi W I I " License # CS - ��� �S`I Wk-jTX,44 MA 9�793 Home Improvement Contractor# Email c Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY < APPLICATION # M DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER t f j DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL a w PLUMBING: ROUGH FINAL i,GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 10 I i Sit if 17 tllt *Ries ibYB ,! Inlyy �...tam Yk £� ° alil��;mtiy^b � £+. � �tir1a I r .. - � (92- �P�rvrrxa�uuecz� C%vGcrrlactc�tccaeCla Office of Consumer Affairs&Business Regulation \ OME IMPROVEMENT CONTRACTOR egistration: 177437 Type: Expiration:_€fiti91.30`1s7}. Corporation VILLAGE PLUMBING'INC'`!; ^ ,-; y- r:: WILLIAM BATTLES 171 PINE HILL RD '>= WESTPORT,MA 02790 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 I of valid without signature l i Taman af Ba .stable Re *afivxy Services oftrte Mchard,SeaIi,Director DuiltiinIg blCS'W.ox L sera-rnsu Tom Perry,Building Commissioner' XA SS .g :fig a`m 240 Main Street; Hyam ds,.MA:02601- w�vw tag*a.bstustabie.maus , OSice. 568-862-4438 Fax 508-790-6234 HOMEOWNER LICENSE m=nY'nON ��� PloasePc3nL - i - .roB rOcanox r n aba �Hai�owrt�.„ f .rb ;�re�1 �r* sl��io� S1�tztp6I7 3tj-� & f name ho=phoneai warlcphono CURRMC MAIWMADDRM . 40. Kk 5 �g . cityAom: atate. np codo The current exemption for"Homeowners"was;extendad to include owner-occttwied dwellitzas of six twits or less and to allow homeowners to engage:an individual for hirewho does riotpossess a.cense,pro�nded that the owner acts as supervisor; D r ON Og HOMOWrt Persons)who owns a parcel of Ind'on which helshe resides or intends to reside,on which there'Si 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"hrrmwwnee,shall subm tto the Buildmg Official on a form, acceptable to the Build�o.g Official,that he/she shall be responsible for a t sash work Rerformed under tine building pima {Section The undersigned"homeownee,assumes responsibility for compliance with the State Building Code and otiuer apphcabio codes, bylaws,.rules andregulatio= dersigned`•`iomeownee,testifies that he/she understands the Town ofBamstable Building Department minimum inspection d r and that he/she will comply with.said procedures and re quiir tsi Si o Homco Approval of V4ding Offioisl Note:; Three-family dwellings containing 35,1)0o cubic feet or.latger^will,be required to comply with the'State-Building Code: Section 127.4 Coistiucdon Control, . 3 HOMEOWNER*S TiON The Code states that "Anp Homeowner performing work for Which a building permit is required shall bel.eZeunpt from the provisions of this section(Section 109.11 Licensing of coustraction Sale visors) provided that ifthe homeowner engages a persons)for hire to do such wont,that such Homeowner shall act as supereisor" Many homeowners:who usethis exemption are unaware that they are assuming the responsubiIrtxes of a supervisor (see 4ppendix Qa Wes*Regulations for Licensing Construction Supervisors,Section 2.15) This Lack of awareness othen. results4u.serlousi.probldms, articutarlywhen the homeowner hires unficensed.:persons. Yn this case,our Board cannot', proceed against the unlicensed person as it would with a I1censed;Supervisor. The l omeo niter acting as Stzpervisor:ts ultimately responsible: To ensure that the homeowner b fully aware of his/her responsibilft3es,iuxany communities require,as part of the Perm it application,that the homeowner certify that he/she understands the responsibilitles of a Supervisor. On the last page_ of this'issue is a form currently used'by several towns. You may caret amend and adopt such a formtcertifiication for use,u, your community.. Q IWPFMEMRIvMuildkg permit b=%EXPRESS,doc Revised o613--13 27ie Coammompealth ujfMassacliusetls Department of Ind=& al Accidazis ' Offwe ofimerlligadons 690 Washington,street Boston,MA 0211 ` k v.mtu&gov1d>;a Workers' Compensation Insurance Affidavit:BuildersiContmctmrslEI ers �Ayp1tCaDt Informatinn Please Pant e1 y Address' c a rer MA Phow ik S 62r O L 9 aPZi Are you an employer?Check the appropriate b= Type of project(regnii eiT 1.A I am a employer veith 3 4. ❑I am a general contractor and I G. ❑New constcuofioa employees(full andfor part-time).* have hired the s -b-Comtractors 2.❑ I am a sole proprietor orpartuer- listed on the attached sheet 7. ❑Remodeling ship and ha-te no employees. These sob-contradors have ❑Demolition wod-ing forme in any capacity; employees andbmre workers' [No wodmw comp.ium ace Comp.imuran g- ❑Suildiag addition zeclosred-] ❑5. We area corporation.and its 10❑Electdcal repairs or additions officM have- v e exercised�etr 3. I am a hom 1L❑ ecru�mes datm.�all wont ❑Plvmbingrepaira or at3rFtiams myself[No worlmm'comp- rig1t of exemption per MGL L 7 imsumo a retp»ed.I i c-152,§IM and we have no ❑Roof repairs. employees.(No wod=- 13.N Other comp.jn=anm require&I '+my8ppbcmzt&ztchedmbos#1mastalsofMoutthesectioabgawshauinytwkwo&mecomp—t; npancyinom2ffaa ts,,,,,ommm wha submit this affida"inffcatiag they an doing all vat and the hhm outsidecont zctm—st submit anew affidarst mdiczdn sad- :Caatrac I rest chart this box test attached as additiamal meet dwemg the name of the sub-camt wAon and sdde whedw..or notfhase eafitks hose employees.Iftbesab-caahacmabmemplayees,theYmmstpunwktheh wurke&romp•paRFnumben ___I ant a>':eurptnyer thtrtrspratRtiirrg�t�arkers'caatperrs�raat irzsarmxce fay m}�empio3�e¢s: $eloov is tltspafiry and jab site '� Insurance Company Dame !. � t►1 t.� q Policy,or self-ins.uc.,P,- 3FF y 834- 61 FSpirstionDate: �- Job Site Address: i �'� ��n$��•�� Q-A City/StateE�.tp: �c-,cS� �S ('Y\A ate' Attach a copy of the warkere compensationpolicy declaration page(showing the poFicy number and expiration date). Failue to semen coverage as required under Section 25A of MGL c-1: 2 can lead to the imposition of criminal penalties of a fine up to S1,50D 00 andlor one-pearimprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a Ems of up to MO-0 l a day against the violator. Be ad ised that a copy of this statememt may be forwarded to the Office of Irrvestigatiaas ofthe DIPS for imsu ore coverage veafrcatian. Ida hereby c uitdgP a pdrns andpsaral es afperluF that Me th;{orwa€ianptmR'rW abate fs bw and correct D sit3tmute: ate: Phone g Off Fcial use only. Da not write in firs.area,to be cmmpLdmd by Laity or town official City or Town: PermitUcense# Issuing Authority(drde one): 1.Board of Health Z.Building Department 3.f5.ty1Tonm Clerk 4.Electrical Inspector 5.Phunhing Inspector 6.Other Contact Person: Phone#: Formation and.Instructions Massw me{ts Ge=zd Laws ebspbw 152 regn=all employers to Provide W05z='compensation for their eoaplayees- pmmant-fo this ,an CMPIop,!.-_is defined as.¢.every person in the service of another under any contmd ofhir express or implied,oral or vrhenf AIL er is defined as`an L i4iduA Partnership,associati on,c orpor�ion or other legal erlfhy,or any two or more �jOy . . er,or the of the;foregoing=Zinged in a joint=:tezprise,and inalndmg the legal re�seseaiaiiTes of a dcccas��I.y receiver or trast=of an individual,par r=nhip,association or other legal entity,emPloymg emPmY"- However the owIner of a dwe: ng house havingnot mere than Three apartneats anal who resides them,or the occupant of the air rk on such dweIlin house �on or wo g 'dwefinig house of mo5ier who employs Persons to do mamteBancc,c��fi rep or on the grounds orbm mgappmi=H0tffieretn shall nDtbecanse ofsach euuplcymedbe de=edto be an employer:" MGL chapter 152,§25C(Q also sues that"every state or local licensing agency shall withhold the swan ce or to construct bin cUm in the commonwealth for any business or gs a liceuzse or permit t:o o eratE a b renewal of P P applicant who has not produced acceptable evidence of cdmpfiance with the hsur"ance.covexage required." Additionally,MG_cbaPter 152, §25C(7)states aNeitherihe nor in ofhspolifical subdivisions Shan table evidence:of c Ii�nceTAffi the .. 'c umtl �P. forthe erL'o�auce of nblr wow �p meter min any corkud ? ? re rat a rents of this chaptEr have Been prmeniod b the contacting mzfhouty." AppIiratr�'c Please fill oi>t the worj=,compesation affidavit completely,by r�ecking e boxes that apply to your situation and,if necessary;supply snb-contr or(s)name(s), address(es)andphanemunber(s)alongW&IhMr C`Mtficate(s) of ro m-ance. Limilyd.Liability Companies(LLC)or Limited LiabRity par�ae:sbips(LIP)witT�no employees Dube✓than the eosafion insar-ance If an LLC or LLP does have: members or p are not requaed to cagy worke2s� cow Industrial be submit--d to the Department of emgIoyees,apoliey is regmred. Be advised that this a$day�may eP Accidents for confirmation of msurance coverage. Also be sure to sign and date ere afIIndavit. The affidavit should be retnmed to the city or town that the application for the pert or license is being requested,not the Depm me of h yh��q_ccir ,=tr Shouldyou have any questions regardmg the law or ifyou are required to obtain a workers' compensation policy,please call the Depmtna�at tile:namber Hst�d below. Self-rosined companies should enter their self-insor�ce license mm�ber on the appropriate Line. City or Town Officials Please be sure that the affidavit is complete andprktf dlc&y. The Deparimenthas provided a space at the bottan of the affidavit for your to fill out in the eves fhz Office oflnvesfigatiom has to contact youregm-ding the applicant Pleas a be sure to fill in the,pecLitflicease nwnber which will be wised as a reference nnmber. In addition,an applicant that mast submit multiple pmMitllicense applications in any given year,need only submit one•affidavit indicating current poke;✓mfonnation(if neccssarT)and-under"Job Sitz Address"the applicant should write"an locations in (may or . town)-"A copy of the•affidavit that has been officially stamped or marked by the city or t own maybe provided to the applicant as gmofthat a valid affidavit is on file fur finrrre pemuits or licenses. A nevi affidavitmust be,filled Olt each year.Where:a home owner or citizen.is obtaining a Iicrose or pern knotrelated to any busmcss or commercial veatrme (Le. a dog license or permit to brom leaves e3�.)said person is NOT req�ed to'complete the affidavit The Office of avesdgsdons would hke to thank you in advance for you¢,cooperation and should you have anygees-[ions. please do nothesliatn to grve us a call. The Department's address,tr4cphcne and fax TI e CGzMenwealft of Massachusaf . Depadmm±of IndutiA Accidents O$Ce Of J LVe9_`M_CL0= BaAonz MA 0 111 Tt,-1.4 617' -4905=t 4€6 Q.r I-9W-MASSAFE Fax 617 727 7749 lu_-vise 4-2a-o7 masg-ga r Town of Barnstable Regulatory Services ' 'nsra4. Richard Y SeaM Director Bui7tl09 Divislon,, Tom Ferry,Building Commissioner" 200 Main Street;Hyannis,MA 02601 :ww toWubarnstablematts s Office: 508-$62-4038 Fax: 508=190-6230' d I Property Omer Musti Cant. Iete and Si This Section P If Using A Bt der I CrDhvel1. kf pF-f3ervklib-) PACCfk as Owner of the subject,propercy .:hereby`aurhozize y i h G . to act on mp behalf, in all matters relative to work authorized by this::building permit..application for. i�g MA a:60: ' (Address of Job) t 1 Pool fences and alarms are the responsibility of the applicant. fools are not to be°filled or ut, � ed before fence is installed and all Ana] inspections are performed and accepted. OfOwne Signature of.Applicant Nat Narae -�' Print Name. 331i ate _ WoxMs owNWERI,uss or 001S' CROMWELL CT. SOLAR PANEL CONNECTION NARRAGANSETT ENGINEERING INC. SOLAR PANEL MAIN OFFICE: tit 3102 EAST MAIN ROAD, I o, PORTSMOUTH, RI 02871 �ys2 TEL (401) 683-6630 ATTACHMENT RAIL MOUNTING BRACKET WITH FLASHING AND LAG BOLT WOOD ROOF TRUSS ATTACHMENT RAILS SHALL BE"UNIRAC SOLARMOUNT MOUNTING RAILS". MOUNTING BRACKET SHALL BE"ECOFASTENER QUIK &6P�` FOOT" L TYPE. L FEET SHALL BE SPACED AT 4'-0"O.C. STAGGER 2-0" BETWEEN ROWS ATTACH TO ROOF WITH (1)-3/8" DIA LAG SCREW, 4" LONG PROVIDE PREDRILLED PILOT HOLE FOR LAG BOLTS AT CENTERLINE OF TRUSS MEMBER. APR/12/2016/TUE. 10; 31. AM Digestive Health FAX No, 9782216245 P. 005/009 1UN/18/2015/THU 09:55 AM FAX No, P, 003 'William Francis Galvin Secretary of tht Commonwealth One Ashburton Place,Boston,Massachwcm 02108-1512 Attachment Sheet Preservation of Affordable Housing,Inc,Officers&Directors Title: Name&Address! President Aaron Gornstein,40 Court Street,Suite 700,Boston,MA 02108 Treasurer Uura Vennard,40 Court Street,Suite 700,Boston,MA 02108 Secretary Andrew Spofford,40 Court Street,Suite 700,Boston,MA 02108 Managing Director W.Bart Lloyd,40 Court Street,Suite 700,Boston,MA 02108 Managing Director Rodger Brown,40 Court Street,Suite 700,Boston,MA 02108 Director Amy S.Anthony,40 Court Street,Suite 700,Boston,MA 02108 Director Aaron Gornstein,40 Court Street,Suite 700,Boston,MA 02108 Director William Apgar,40 Court Street,Suite 700, Boston,MA 02108 Director Jarrett Barrios'.40 Court Street,Suite 700,Boston,MA 02108 Director Reese Eayde,40 Court Street,Suite 700,Boston,MA 02108 Director Mark Goldhaber,40 Court Street,Suite 700,Boston,MA 02109 Director Tobin Levy,40 Court Street,Suit9 700,Boston, MA 02108 Director Herbert Morse,40 Court Street,Suite 700,Boston,MA 02108 Director Georgia'Murray,40 Court Street,Suite 700,Boston,MA 02108 Director Estelle Rlchman,40 Court Street,Suite 700,Boston,MA 02108 APR/12/2016/TUE 10: 32, AM Digestive Health FAX No, 9782216245 P, 006/009 1UN/`18/2015/TRU 09:55 AM FAX No, P, 004 'This cerdicaee is effmcive ar the rime and ors the dace approved by the AjvWon,udm a ld=.&ctt"date nor more than 90 days Crom die date of filing b spootficd: signed Aaron Gomstein a8fidf(O'!Of 47s�07EYa6 1/��itl7di(!9� ❑ Chui=m of the board of direcron, © Pseaidenr, ❑ Ocher officer, ❑ Couraappointed fidixemW. on this 19th day of June , 2015 APR/12/2016/TUE 10:32, AM Digestive Health FAX No, 9782216245 P, 007/009 MA SOC Filing Number: 201535281230 Date: 6/18/2015 10:50:00 AM THE COMMONWEALTH OF MASSACHUSETTS I hereby certify that, upon examination of this document, duly submitted to me,it appears that the provisions of the General Laws relative to corporations have been complied with, and I hereby approve said articles; and the filing fee having been paid, said articles are deemed to have been filed with me on: June 18, 2015 10:50 AM WILLIAM FRANCIS GALVIN Secretary of the Commonwealth APR/12/2016/TUE 10:3Z AM Digestive Health FAX No, 9782216245 P, 008/009 . i • i PRESERVATION OF AFFORDABLE HOUSING,INC. SE:C"TAR^Y''S CX-.RIMICATE' The undersigned.Secreiary-of Preservation of Affordal le.Houshig,Inc,, a 111inois non profit•corporation(the"Corporation'1y hereby ceftifibt thavattached Ureto asEAibft.A is a true;•complete and cprrect.copy of Ttetolutions of the Board of,,D.rectors,of the Corporation, adopted.on:nine 21,20.L1,,whith'resplutions]OW6'not been,fgdher ameAd.4, mo. ed,.ravo1Ced •or rescinded, end•which rernairi in MU-force and effect on-thy date•7aereof IN--WITNESS 'WIMREOF,.I have liereunta set my signature and'the-seal of the•Comp'any zszf the 30'da`y of September.ZOl•5. PRESERVATION OF AFFORDABLE ROUSING, INC.,:an,. W aois non-pr t;corpomt on I By: j Name;�dre offord nde: gedretaiy APR/12/2016/TUE 10: 32 AM Digestive Health FAX No, 9782216245 P, 009/009 i i 'ExhibitA Voted: That:tho folloWing.employees of the Corporation are elected to serve as Mataging Directors of the Corporatioh'. 1:) Patiiohi Beldea is herAy' Math Director amd' Chief Operating.0.ffiosr; 2,) Rodger L. Brown rr, Is hereby Managing Director — Roal Estate Development; .3.) W. Bart Lloyd is - °hereby _h4amging Director — ,A:cquisitipn�/General Cm.Ph and 4.) Laura 'Vennard is hereby Maoaging Director and Chief' Financial Officer; Voted: That any, Mmiag ig. Ditectof of the Corporation, on behalf of the Ciirpofatian in any:of.the following toles; acting singly,.be .=d hakeby is I allthorized, .and empowered to .exfeeute any certification, .agreement, application,,contract'for.architectural,services in atiy. Arno'ltnt, construction contract in arty amount, .and any other eontra.�ts in the amount of $50,000;9.0. .or.less which bad,laen.authot'iu l y the Bgard of Directors of.the Corporation:: Q. Creneral Partner of the ownership.entity of aily property; 2: Managing member of the Qwnehship entity of any, property" 3.,) f the ownership. entity of any prap®xty; R/12/2015/TUE 10: 31. AM Digestive Health FAX No. 9782216245 P. 001/009 PRi=SI=PVATICN OF AFFORDABLE HOUSING ... ........ ............. fax .. . . .. ........ TO: sly FRQM::C :.:::V; rOW�fld�flrl.::.' °Y ............." FAX: 7. PHONE. PHONE: DATE : RE: LdUrgent .1j.For.':Reyjew--`:.,.: !"P'I.":' 'CohI.m.. ... r)t:. n le..aseA.:'e p'.Iy Phea..sO'Re`c—Re cycle ............... J. POAH 40 Court Street,Suite 700 Boson,MA 02108 T 617-261-9898 F 617-261-6661 s infoOpoah.org www.poah.org APR/12/2016/TUE 10:31. AM Digestive Health FAX No. 9782216245 P. 002/009 4/12/16 Building Division Town of Barnstable 200 Main Street Hyannis, MA 02601 Lindsay, The following is an organizational chart which shows the ownership structure for Cromwell Court Preservation Associates, I.P. Included as well is documentation showing Aaron Gornstein as our new president, following Amy Anthony's retirement, as well as documents which list our Managing Directors, one of which,Is Rodger Brown. Thank you for your patience with me in understanding your process. Please let me know if you have any further questions. Bill Battles of Village Plumbing Inc.will be down to the office to follow up.Thank you for your assistance. Sincerely, Sam Bryson-erockmann Operations Analyst, POAHC Phone:617-391-9484 Email:sbrysonbrockmann@poahcommunities.com r a b x N N . O Cromwell Court—Ovaiership Organizational Chart c 0 ' - a Cromwell-Court -Preservation Associates LimitedCD Partnership- x POAH Cromwell Court,LLC- 7Unnamc�d (general partner)- . Unnamed Partner ar-bier 0 1%Interest 0 N Preservation of Affordable Housing, Inc. (sole managing member) 100%Interest in General Partner 0 0 W 0 0 C� f APR/12/2016/TU& 10:3L AM Digestive Health FAX No. 9782216245 P, 004/009 MA SOC Filing Number: 201535281230 Date: 6/18/2015 10:50:00 AM JUN/18/2015/THU 09:55 AM FAX No, P. 002 F The CommonturaYtb o �c ate tt Ott vIuig n Fame"CAdAift Secretary of the Commonwealth FPC One Ashburton Place,Boston,Massachusetts 02108.1512 F0RM MUST BE TYPED Cek"cau of Ameudm=t FORM MUST BE TY1350 (Geanetat laws Chapter 1561),Secdoe 15.04;950 CMR 113.49) (1) Ex=nano of corporation: Preservatlon of Affordtable Housing,[no, ex contained in theDtoudoa's records) (2) Rcgucrcd of,cc addcw: 10 Milk Street,Sulte 1055,Boston,MA 02108 (number,street,cky er town,lair,dp code) (3) This amendmentshaA ch=F: i (check appmprtwr bez(rr)) The coiporadon's'name to": ❑ the period of dac corporAdods duration to: ❑ the stare or countq of Its inwfpokadckL to*: r ❑ The street address of ics principal o'ilyce ro: ❑ the fiscal year end to: ❑ the aedv cirs conducted by The foreign corporatlom in the Commonweal& its officers end directors,See attached 118t [� 4. 7ht name watratisfy the requirement of G L Chapter 156D,Section 15.06 'If the amendmeret ina6 da a eh.¢nge of dn'corporam name,or the,rt ias or ca proy o�itr irsraorporation,attach a certificate evMexWx the changer duly authendcaud by the tecrerary of matt or orker of dad having cwM4 of the corporate records in tht state or cowwy under whore law it is ineorporatea p}the cent ficare 1r in a farrigw lartgmge;a trnrxrlaelon themf under aarh of the trarulamr shad[be acr,uhed. pG a�nsot>romnsros i 4 p ¢ / 4 All tta e ✓ i `` I i f 4 } Ufa '•S'R k�tl A.r~ �/Ip a_f�.p _ •._.1'.a* ��'1,NtL.�b� V�v!' p a'Ll�z.' '.�', pi AW ��� .r .y f �P" �. > T;,, M,l .�."sr�, t t r,� �'u�u � • �- k:tl ati' J r� `ti.'i' � i/ /• +ttf� .r,'� "� .:r,u�. �. 7 e ,. '1ex}• '�1. r/ ""a:yM.• .yLY a, jiwaa. '-� .aer.�r,',`_`w-r'-#i:,.i.""aax x}^j t" _. '. i •���I I 1 � 'Y.s�.eM.l...:..v'.i,'6'>, F,... '� l � .�, } � • � f �,t` I � �t {,I,Il �a r m 1� C Charles D.Baker Governor 7 7 7 ��� ThomasG. issionr P.E. Karyn E.Polito � !/ /�G (/ =-� ���' Com�i issioner Lieutenant Governor �1�, y yp q c%Qv ��/-/,G/-���� _Thomas P.Hopkins Daniel Bennett , -rector Secretary r f $`�Y TO: Local Building Inspector Docket Number V 15 100 Local Disability Commission I-idependent Living Center FROM: ARCHITECTURAL ACCESS BOARD RE: Cromwell Court Building 9 168 Barnstable Road Hyannis Date: 6/22/2015 Enclosed please find the following material regarding the above location: Application /Decision for Variance 'of the Board Notice of Hearing Correspondence Letter of Meeting The purpose of this memo is to advise you of action taken or to be taken by. this Board. If you have any information which may assist the Board in reaching a decision in this case, you may call this office or you may submit comments in + _, writing. _ d 91 ry 5�lb xyla Charles D.Bakery Governor c�i✓�/ Thomas G.Commissioner P.E. Karyn E.Polito e/ �LG�ILfi r/7 /.G Commissioner Lieutenant Governor 7 .G Thomas P.Hopkins Daniel Bennett Director Secre:ary / AMENDED NOTICE OF ACTION Docket Number V 15 100 RE:Cromwell Court Building 9 , 168 Barnstable Road Hyannis 1. A request for a variance was filed with the Board by Eric D. Chamberlin (Applicant) on April 17, 2015 The applicant has requested variances from the following sections of the 20 06 Rules and Regulations of the Board: Section: Description: 25.1 Accessible entrances 25.3 Vestibules 10. Public and Common Areas 10.8.1 Laundry Facilities 2. The application was heard by the Board as an incoming case on Monday, June 15,2015 3. After reviewing all materials submitted to the Board, the Board voted as follows: GRANT: the variance requests for Sections 25.1, 25.3, 10.1, and 10.8.1 for building#9~as proposed in the application' submitted, for the reason that impracticability (see definitions of impracticability in Section 5 of 521 CMR) has been proven in this case. (See AAB,case Docket#V10 - 140 and the "Notice of Action" September 13, 2010 requiring accessibility solutions or the complex.) Any person aggrieved by the above decision may request an adjudicatory hearing before the Board within 30 days of receipt of this decision by filing the attached request for an adjudicatory hearing. If after 30 days, a request for an adjudicatory hearing is not received, the above decision becomes a final decision and the appeal process is through Superior Court. ARCHITECTURAL ACCES/WSJ BOARD Date: June 22, 2015 Chairperson cc: Local Building Department, Independent Living Center, Local Disability Commission The Commonwealth of Massachusetts Department of Public Safety Docket Number Architectural Access Board One Ashburton Place, Room 1310 (office use Only) Boston Massachusetts 02108-1618 Phone: 617-727-0660 Fax: 617-727-0665 www.mass.gov/dps REQUEST FOR ADJUDICATORY HEARING RE: Name and address of building as appearing on application for variance do hereby request that the Architectural Access Board conduct an informal Adjudicatory Hearing in accordance with the provisions of 801 CMR Rule 1.02. et. seq. as I am aggrieved by the decision of the Board with respect to Section(s) of the Rules and Regulations of the Architectural Access Board, 521 CMR. I understand that I may request such a hearing within thirty (30) days of receipt of the Notice of Action. Date: Signature PLEASE PRINT: Name Address City/Town State Zip Code E-mail J Telephone PLEASE NOTE: This form must be received by the Board within thirty (30) days after receipt of the Notice of Action. Rev, 01/10 i yP d -s ti wv ' 1r » z k Steve O'Neill,left,and Kyle Griffith,carpenters with Whalen Restoration,board up Building gat Cromwell Court Apartments in Hyannis on Sunday.The building was damaged by fir On1 Saturda vening CHRISTINE HOCHKEPPEL,PHOTOS/CAPE COD TIMES ra r e use. _. so aage By Patrick CassidyRe ma pcassidy@capecodoriline.com y �� 5� � � . ...Lopes,.a resident of; HYANNIS-Alarge fire atanapart- A k Building 9' F& .g• {, I 3 Apartment ment complex on Barnstable Road aM° 0:,checks. Saturday caused about $750,000 * s ntin out the .fire worth of damage to.the building d g g an damage with.. . destroyed another$50,000 worth of i ± # her daughter, contents in the affected units,accord-. Nlalia Clark, , ing to afire Official. ba " i ' " 5,and son, Anrnawon The blaze displaced about a dozen families,some ofwhom were housed Weeden,'20, by.the Red Cross. ;. . `' on Sunday The fire alarm atthe Cromwell Court morning. t x, They are affordable housingex sounded $ x complex P kx��ON �4�50 A � P2 'M � S xr f ak x r x� aE?S � saying at, ' at 6:17 p.m. Hyannis fire Lt.Thomas f r t. /� Kenney said Sunday. 3b c z x ! the Comfort y Inn with the Thethree-alarm fire re uiredmutual q ws �ti � 7 ff help of the aid from nei hborin de artments _: q "�' 'r{ � Rid Cross. including Centerville-Osterville-, Marstons Mills,West Barnstable,. . ax " k" I �'1t tea Yarmouth and Dennis,Kenneysaid. The only injury was'a Barnstable ' ' police officer who was briefly hos- N pitalized after inhaling smoke while g Y f searching the building for residents who may have been trapped. The fire department is frequently. operate from inside;'he said. Other families were able to find nonprofit Preservation of Afford- called to the complex for alarms and The American Red Cross of Cape alternative housing,Potts said. able Housing,which-owns Cromwell medicals so firefighters know the Cod and,Islands responded with 12 Officials considered.opening a'shel-. Court,said that there are some units layout well but the building that caught volunteers who provided canteen assis- ter but when only seven ofthe families available at the complex where fire is probably the most inaccessible tance to about 80 people atthe fire,said requested lodging decided to use hotel affected residents maybe able to move . because of its location in the middle Rachel Potts,disaster program man- rooms,Potts said. but that the management company of the complex,Kenney said. ager for southeastern Massachusetts.. . Crews were expected to restore which runs the complex didn't have In addition, the fire had already. The organization assisted 12 fami- power and gas on Sunday to two build- more information about the fire and . made significant headway by the time. lies,including 30 individuals,including inns adjacent to the building which damage on Sunday, firefighters arrived and the style of con- distributing five stuffed animals to caught fire,she said. The last firefighter cleared the scene struction was conducive to it moving affected children,Potts said. In addition to the Red Cross assis- Just,after 1 a.m.and the cause remains . from the basement to the attic of the The Red Cross provided short-term tance, neighbors brought clothing under investigation,includingby arson building,he said,adding that damage housing for seven of those families con- and other donated items to a table in investigators from the department,the to the roof made it unsafe for firefight- . sisting of 20 individuals,said Hilary the apartment complex's community Barnstable Police Department and the ers to work. Greene,executive director of the local room,Greene said. office of the state fire marshal,Kenney . "We had to pull'off the roof'and' Red Cross chapter. Maria Plati,spokeswoman for the said. Tf OF BARNSTAW TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� Parcel Application # 2k�> \ Health Division Date Issued 3 Conservation Division Application Fee 4. C0 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board �p Historic - OKH Preservation/ Hyannis Project Street Address It 0EJR. -6 -Z Village Owner�fetp_f acm 0� t-r%cn&a L� Address Telephonek -'1l�• i� Permit Request �on� � �1.��u� nplu _0 cr Sea iPC, C`1rwtFly2e' �. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation . 0 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 f-a Central A.ir: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑;Yes ❑ No Detached garage: ❑'existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑`existing 70 new; size_ i Attached i garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: d 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 A6 0(1\a� U� o�ho,��7r� ,v�.�n� Telephone Number 1 oWl a31 V6LW Address 7� `6am:x , License # ssss Home Improvement Contractor# Worker's Compensation # 03\;LgNgLl ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CL y\ �� ---A. *�. �c�,Q a�x A. \MR SIGNATURE DATE _ FOR OFFICIAL USE ONLY APPLICATION# 1 . .t DATE ISSUED ` MAP/PARCEL NO.. .., S S , 1 f2 _. t ADDRESS VILLAGE OWNER DATE OF INSPECTION: 1 FOUNDATION: y FRAME F INSULATION, FIREPLACE �ff ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL GAS ROUGH S .,.. Q�r FINAL � tFINAL BUILDII�IG= o u �:: t1;_ A_ - - -— -� DATE CLOSED OUT ASSOCIATION PLAN NO. t r / pF THE Tp� O aARNSTABr;,, 16jq.MASS Town of Barnstable �lfD hlA'I a Regulatory Services Thomas F. Ceiler, Dircctor Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.to) n.bnrnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner must Complete and Sign.This Section ff Using A B udder - 1 as Owner of the,sub'ect Property hereby authorize K&O'CA a'� U. _c ��.,� \ru to act on my behalf, in all matters relative to work authorized by this btuldingpermit application for: 0 \ (Address ofJob) Signature of Owner Date L ham, Z Punt Name If property Owner is applying for'permit, please complete the Homeowners License Exemption Form on the reverse side. Q:1VIPFILESIFORMSftilding permit formslEXPRESS.doc Revised 6721.10 1 4' �plFHVE Town of Barnstable , Regulatory Services -ELAN(STABLE Thcrnas F, Geller, Director JAM. 46jg. `� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 wwiv.towh.barnstable.rrtn.us office.- 518-8627-403 8 Fax: 508-790-6230 _------------------ - HOMEOWNER LICENSE EXEMPTION Pleasc Print DATE: JOB LOCATION: number street village "HOMGOWNI R" (In me home phone N work phone N CURRENT MA[LNG ADDRFSS: city/town stale 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-yearperiod 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"F-ssumes responsibility for compliance with'the State Building Code and other applicable codes, bylaws, rt!les and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minirnum inspection procedures and requirements and that he/she will comply with said proceclures.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, }• IfOIvfE0Wrs'ER'SEXEInIPTd01W' '4 The Code states that: "Any homeowner performing work for which a building P Ljs{ qutred shall bye cxeiTapfrom the provisions of this section(Section 109.1.1 -Licensing ofconstruction Supervisors):provided that if the homeowner engages a person(s)for hire to do such work, that such Homeowner shall act as . supervisor." t Many homeowners who use this exemption are unaware that they are assuming the responsibilities ofa supervisor(see Appendix Q,Rules&Regulations for , Licensing Construction Supervisors,Section 2.15) This lack ofawareness often results in serious problems,particularly,when the Homeowner hires unlicensedfpersons., ti In this case,our Board cannotprocced against the unlicensed person as d would with a licensed Supervisor.afhe h'timeow�ner acting as Supervisor is ulumate7y responsible. 1. To ensure that the homeowner is fully aware ofhisAier responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she*ur,.derstands the responsibilities ofs Supervisor. On the last page of this issue is a form currently used by several towns. You may care I amend and adopt such a form/certiFiiation for use in your community. Q1 WPFILESIFORMS'b uilding permit forms1EXPRESS.doc Revised 072110 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street . Boston,MA 02111 www.mass.gov/dig Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): . Address: City/State/Zip: ; mot✓ Y��IS\. Phone.#: Are you an employer?Check the appropriate box: Type of project(required):. 4. I am a general contractor and I 1. I am employer with V ❑[�, a empl y van 6. ❑New construction employees(fu11 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 an capacity. employees and have workers'_._. .. g Y p �'' 9:"❑Building addition [No workers' comp.insurance comp,insurance.$ required.] 5. ❑ We are a corporation and its M❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l l.❑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' 13.0 Other comp.insurance required-.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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 isproviding workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name: \�� Policy#or Self-ins.Lic.#: \).-L wocc M Expiration Date: 1sz\ZG1 \\ Job Site Address: 2 .`City/State/Zip: � � Attach a copy of the workers'compensation policy declaration page owing the policy number a 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains•and penalties of erj that the information provided above is true and cornet!: Si ature: Date: c Phone#: \71 r Official use only. Do not write in th a ea,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#: e . ACORD. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDD/YYYI� 04/23/2010 PRODUCER (800)225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 41 Wellman Street. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Lowell,MA 0 185 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 800-225-1865 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Citation Insurance Company Advantage Weatherization,Inc. INSURER Bt National Union Fire Insurance Company of Pittsburgh Two Adams Place,Suite 100 Quincy,MA,02169 INSURER C Selective Insurance Company of America 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 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 ALDD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION O INSURANCE D D M - LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COM MERCIAL GENERAL LIABILITY DAMAGE O RENTED 100,000 PREMISES Eaoccurence $ CLAIMS MADE OCCUR MED EXP(Anyone person) $10,000 C S1928883 4/2/2010 4/2/2011 PERSONAL&ADV INJURY $.1,000,000 GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 POLICY JrCT PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $j 00Q000 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ A BBNT 98 4/2l20]0 4/2/2011 X HIREDAUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY g - EACH OCCURRENCE $ 15,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 15,000,000 B BE 1223010 6/20/2010 6/20/2011 $ DEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND X WC STAN- OTHFR - EMPLOYERS'LIABILITY 1,000,000 B ANY PROPRIETORIPARTNERIEXECUT VE WC001290194 6/20/2010 6/20/2011 E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate is issued as evidence of coverage, ff I CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN i NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR i REPRESENTATIVES. AUTHORIZED REPRESENTATIVE A I f I ACORD 25(2001108) Client# 17drI Mst# 2010 GL,Auto,WC,Umb Ccrt# ©ACORD CORPORATION 1988 I Ex vQ Two Adams Place a ADVANTAGE Suite 100 WEATHE.RIZAT.ION INCORPORATED QUII1C`', MA 021.69 ] Date: 2/18/2011 AGENCY: Action for Boston Community Development.. Inc. ABCD 178 Tremont St. Boston, MA 02111 OWNER: TOTAL Cromwell Court Apartments CONTRACT $16,808 168 Barnstable Rd, Hyannis, MA Date work performed: BUILDING # Work Order# DESCRIPTION QTY. UNIT JUNITPRICEI TOTAL PRICE DOORS Weatherstrip w/Q-Ion or equal 1 ea $43.00 $52 Fixed Sweep 3 1 ea 1 $15.00 $45 MISC.MEASURES Weatherstrip(Q-Ion or equal)& R-30 attic hatch 2 ea $32.00 $64 Attic/Basement sealing with two-part foam 44 man/hr $75.00 $3,330. Seal duct with mastic or butyl backed tape 33 hr $62.00 $2,034 Range Hoods:cut holes/install&connect transition duct 18 hrs $60.00 $1,080 A/C Cover-Interior 50 ea $85.00 $4,216 Labor only charge(properly layout attic insulation) 8 man/hr $60.00 $480 Labor only (remove duct tape on dryer vents/replace with high- temp tape) 12 man/hr $60.00 $744 Aerator 10 ea $10.50 $109 MISC.INSULATION Duct insulation R-5 1,165 sq.ft. $2.95 $3,436 ATTIC VENTILATION Propa Vent 325 ea $3.75 $1,218 Page 1 of 1 I�- .y NOTICE TO PROCEED Action for Boston Community Development(ABCD), administrator of the DOE Expiring Use energy efficiency program for low-income multifamily properties, is hereby authorized to have its contractors, employees, and other representatives access the property and perform the work contained in the attached Work Order, including final inspections. A copy of this document shall be carried by ABCD's contractors, employees, or representatives and presented upon request. By signing this Notice to Proceed, the applicant acknowledges that the benefits to the clients will be delivered as stated in the attached document. Application Information Site Name: Cromwell Court Apartments Street, City/Town, Zip: 168 Barnstable Road,Hyannis MA 02601 Contact Name &Ph ne at Site: Thac er Tiff an 617 449-0878 Signature: 6 Printed NamAmy S. ALthony ident. Title: __Qrganizaton_Preservation of Affordable Housing,-Inc.. wom Date: anip v Acknowledged by ABCD's representative: John Wells,Vice President for Real Estate and Energy Services, ABCD Please sign and date two originals. Retain one for your records and return the other to: Grace Park ABCD 178 Tremont Street Boston,MA 02111 Fax: 617-357-4661 park(@bostonabcd.org Attachment: "Massachusetts ARRA Weatherization Program: Application for Cromwell Court Apartments" l i 5 i I 1 P a gar pions and Stanelords `� Lecease_ � • , r�e � v, ` �a =`.3/17/2DI1 Try 98303 Ft�str��s�sst � 141 NEW.s rpm ... t 02745 �> omro iOiler ADVANTAGE WEATHERIZATION I NCO RP O RATED February 23, 2011 Town of Barnstable Regulatory Services Building Division 200 Main St, Hyannis, MA 02601 RE: 168 Barnstable Rd—Cromwell Court -REF: Jay Lambalot—project superintendent This letter is to confirm that Jay Lambalot is an employee of Advantage Weatherization, Inc, and is covered under our workers compensation insurance policy. Sincerely, John Kelly President Two Adams Place, Suite 100, Quincy, MA 021 69 Telephone 888.508.0886 Fax 61 7.237.1 851 www.advantageweatherization.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ZC, Parcel: l Application 6 11 j6 o cl 11 Health Division Date Issued J Conservation Division 'Application Fee Planning Dept. ...'Permit Fee _L �.5 Date Defin'tive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street.Address I. " Village 0,v-VyNu o Qq Qc), A Owner n. Address m oK Ana ,p 1<C Telephone Permit Request Wat*e?t Ne,KA11 P0, bya 5fA ii1 0 C irCBJ1`}}aner coyer.$� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation k , !?�0 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(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 A r: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detachec garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ hew Lie_ 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# M 'x Current Use Proposed Use _ � e APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ��c\ .te a ��o ����,�,,� ter, ��� Telephone Number W-) L�� \�sU� Address License# (Z) Home Improvement Contractor# Worker's Compensation # a'� Uc0i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO� SIGNATURE DATE a� \l� l FOR OFFICIAL USE ONLY 1 '• APPLICATION# DATE ISSUED MAP/PARCEL NO. f ? ADDRESS VILLAGE OWNER ' it DATE OF INSPECTION: . FRAME INSULATIONS FIREPLACE ELECTRICAL: ROUGH FINAL ` E PLUMBING: ROUGH FINAL M 1 i j GAS <u w ROUGH F. , FINAL s r } FINAL BUI_LDING-,kj I' I1 ...DATE CLOSED OUT s T ASSOCIATION PLAN NO. i j zTti Town of Barnstable Regulatory Services t uxxsresre. . v g Thomas F. Geiler,Director , E16'. 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 Owner Must Complete_ and Sign This Section If Using A Builder as Owner of the subject property hereby authorized � ��„�,;,. � \ to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) nature of Q6ef i'-e4, ate Prat Rairie Pi If Property_Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FO RMS:O WNERPERMISSIDN Town of Barnstable Regulatory Services H � rAtuasrwsL ; Thomas F. Geiler,Director 1 Building Division rEn►+tag" Tom Perry,Building Commissioner 200 Maio-Street, Hyannis,MA 026.01 www.town.b arnstabl e.ma.us Officer 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/t v,m 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 Superyiso . DEFINMON 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 constrgcts more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submi�"fo'the Building Official on a form acceptable to the Building Official, that be/she shall be responsible for all such work perforated under the building p='t. (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. fi HOMEOWNER'S EXENU`TION .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 pemson(s)for hire to do such work,that such Homeowner shall act.as supervisor." Many homeowners who use this exemption are unaware that they arc assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing.Construction Supervisors,Section 2.15) 'This rack 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 cun-ently used by several towns. You may care t amend and adopt such a form./certification for use in your community. Q:fornu:homccxcmpt Commonwealth of Massachusetts Department of Industrial Accidents . Office of Investigations ' 600 Washington Street . Boston,MA 02111 .y www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/Individual): .�'4\,rac�C"Ic\y Address: ,$, City/State/Zip: �� �c (`n�. \ Phone.#:_ Are you an employer?Check the appropriate box: Type of project(required):. 1.M I am a employer with 1y 4. [] 1 am a general contractor and I 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 g• E]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 ME]Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11. Plumbing❑ g repairs or additions myself. [No workers'comp, right of exemption per. their 12•❑Roof repairs insurance required.]t c, 152,§1(4),and we have no 13.❑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. $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 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 thepolicy and job site information. Insurance Company Name:- �� � ���u1 ��� ��, �� �,0 �� kbiNrAh Policy#or Self-ins.Lic.#: ��(�_ mock )\CA Expiration Date:- &Z\\ Job Site Address: 2 �� City/State/Zip: Attach a copy of the workers'compensation policy declaration page owing the policy number 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 Investisations of the DIA for insurance coverage verification Ido hereby certify under the pains•andpenalties�pof erj that the information provided above is true and correct Si ature: ` ` Date: Phone#: Official use only. Do not write in th a ea,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone.#: 1 ACORD�, CERTIFICATE OF LIABILITY INSURANCE DATDrYY9Y) 04/23/2023/2010 � PRODUCER (800)225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 41 Wellman Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Lowell,MA 01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 800-225-1865 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA Citation Insurance Company Advantage Weatherization,Inc. INSURER B: National Union Fire Insurance Company of Pittsburgh Two Adams Place,Suite]00 Selective Insumnce Company of America Quincy,MA 02169 INSURER C: p y 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 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 ADD'L POLICYEFFECTIVE POLICY EXPIRATION TYPE OF SU C POLICY NUMBER DATE f 4MIDDIYYILIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO PREMISES Ea occuren'a S 100,000 CLAIMS MADE OCCUR MED EXP(Anyone person) S 10,000 C S1928893 4/2/2010 4/2/2011 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE S 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 3,000,000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY A XSCHEDULED AUTOS 'BBNT98 4/2/2010 4/2/2011 (Per person) S HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ — RAUTO ONLY: AGG $ EXCESS/UMBRELLALIABILITY EACH OCCURRENCE S 15,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 15,000,000 B BE1223010 6/20/2010 6/20/2011 S DEDUCTIBLE S X RETENTION $10,000 S WORKERS COMPENSATION AND X WC STATU OTH- EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE W0001290194 0/20/2010 6/20/2011 E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S 11000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate Is Issued as evidence of coverage, 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 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,IT$AGENTS OR I j REPRESENTATIVES. AUTHORRED REPRESENTATIVE I i ACORD 25(2001/08) Client# e-tatit Mst.# 2010 GL,Auto,WC,Umb Ccrt# ©ACORD CORPORATION 1988 I Two Adams Place ADVANTAGE Suite 100 IZATION INCORPORATED NCOR P O R A'T E D Quincy, MA 02169 Date: 2/18/2011 AGENCY: Action for Boston Community Development, Inc. ABCD 178 Tremont St. Boston, MA 02111 OWNER: TOTAL Cromwell Court Apartments CONTRACT $16 808 168 Barnstable Rd, Hyannis, MA ' Date work performed: BUILDING # Work Order# DESCRIPTION ---7QTY. I UNIT JUNITPRICEI TOTAL PRICE DOORS Weatherstrip w/Q-Ion or equal 1 ea 1 $43.00 $52 Fixed Sweep 3 ea 1 $15.00 $45 MISC. MEASURES Weatherstrip(Q-Ion or equal) & R-30 attic hatch 2 ea $32.00 $64 Attic/Basement sealing with two-part foam 44 man/hr $75.00 $3,330. Seal duct with mastic or butyl backed tape 33 hr $62.00 $2,034 Range Hoods:cut holes/install&connect transition duct 18 hrs $60.00 $1,080 A/C Cover-Interior 50 ea $85.00 $4,216 Labor only charge(properly layout attic insulation) 8 man/hr $60.00 $480 Labor only (remove duct tape on dryer vents/replace with high- temp tape) 12 man/hr $60.00 $744 Aerator 10 ea 1 $10.50 $109 MISC.INSULATION Duct insulation R-5 1,165 sq.ft. $2.95 $3,436 ATTIC VENTILATION Propa Vent 325 ea $3.75 $1,218 Page 1 of 1 NOTICE TO PROCEED Action for Boston Community Development(ABCD), administrator of the DOE Expiring Use energy efficiency program for low-income multifamily properties, is hereby authorized to have its contractors, employees, and other representatives access the property and perform the work contained in the attached Work Order, including final inspections. A copy of this document shall be carried by ABCD's contractors, employees, or representatives and presented upon request. By signing this Notice to Proceed, the applicant acknowledges that the benefits to the clients will be delivered as stated in the attached document. Application Information Site Name: Cromwell Court Apartments Street, City/Town,Zip:_ 168 Barnstable Road,Hyannis,MA 02601 Contact Name &LPrhnnet Site: Thac er Tiff an 617 449-0878 Signature: Printed NamAMY S. Lthony"/ @n Title: Qrgan zat on_Preservation of Affordable Housing,-Inc,:- Date: anip v Acknowledged by ABCD's representative: John Wells,Vice President for Real Estate and Energy Services, ABCD Please sign and date two originals. Retain one for your records and return the other to: Grace Park ABCD 178 Tremont Street Boston,MA 02111 Fax: 617-357-4661 park ,bostonabcd.org Attachment: "Massachusetts ARRA Weatherization Program: Application for Cromwell Court Apartments" j r rse 521�rze® rz ar�BHis�a451 `"'��ta4fe�8a[nd'' grda 98303 �satcan .3/t7f�U11 "it#.983iD3 � 2W S A:02745 ss� aatiter I I �a GADVANTAGE COWEATHERIZATION IN CORP OR A.T E D - February 23, 2011 Town of Barnstable Regulatory Services Building Division 200 Main St, Hyannis, MA 02601 RE: 168 Barnstable Rd—Cromwell Court REF: Jay Lambalot—.project superintendent This letter is to...confirm that Jay Lambalot is an employee of Advantage Weatherization, Inc, and is covered under our workers compensation insurance policy. Sincerely, John Kelly President Two Adams Place, Suite 1 00., Quincy, MA 021 69 Telephone B88-50B.0886 Fax 61 7.237.1 B51 www.advantageweatherization.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel D Application # Health Division Date Issued << Conservation Division Application Fee C i 0481 Planning Dept. Permit Fee Date Defin'tive Plan Approved by Planning Board V Historic - OKH Preservation / Hyannis V Project Street Address . Village Nc-in 1\� ;� Owner Q *q Address V�) � Telephone ��5° Permit Request 1 V V IPRA?i-JAt kv ViAn C N D Vet -5�pcly 1 Il fi► P-6 r C A 0,►er ehf e � Square feet: 1st 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 Ex sting 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: Cj Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# �' ~+ �i Current Use Proposed Use `' 6 YJK r APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Numbers Address`�w License# Home Improvement Contractor# Worker's Compensation # W\�q Q)M ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CA_ 06\�rf_,n. SIGNATURE DATE FOR OFFICIAL USE ONLY f APPLICATION# DATE ISSUED '' f MAP/PARCEL—N0:__ ,r ; F -ADDRESS — VILLAGE OWNER DATE OF INSPECTION: s � 4`'FOUNDATION: := } FRAME 1 INSULATION:_ :'IQ r FIREPLACE f ELECTRICAL: ROUGH FINAL ; . PLUMBING: ROUGH FINAL GAS ! .°"x-: ROUGH FINAL __ FINAL BUILDING��O�"f==QY? NA:— E { ti --DATE CLOSED—OUT w t 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 Please Print Legibly Name(Business/Organization/Individual):_.'\\)c,\,f}(:,Sc\y C�) n Address: City/State/Zip: `(`c\% \ Phone.#: U0. Are you an employer?Check the appropriate box: Type of project(required):. 1.[A I am a employer with �O 4. El am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ 1 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 forme in any capacity, employees and have workers'_._ [No workers'comp,insurance comp,insurance.# 9:'❑Building addition required.] 5. ❑ We area corporation and its M❑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 c. 152 12.❑Roof repairs insurance required.]r ,§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 subnrit 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 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 thepolicy and job site information. Insurance Company Name:- Policy#or Self-ins.Lic.M \U_ �M\a,C\C)\C1a Expiration Date:_ la_\ZG, \\ Job Site Address: • 2 -4 City/State/Zip: Attach a copy of the workers'compensation policy declaration page owing the policy number a 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 foam 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 Ido hereby certify under thepains•andpenal des �pof erj that the information providedabove is true and correct Signature: ` Date: c_ _ Phone#: \�• a, 1 Ofj' atcial use only. Do not write in th ea,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone.#: 1 ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE CERTIFICATE 04/23/203/2010 PRODUCER (800)225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church,Inc, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 41 Wellman Street. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Lowell,MA 01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 800-225-1865 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. Citation Insurance Company Advantage Weatherization,Inc. INSURER B: National Union Fire Insurance Company of Pittsburgh Two Adams Place,,Suite 100 Selective Insuuance Company Quincy,MA 02169 INSURER c of Amcrica INSURER D: INSURER R 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 DD' POLICYEFFOCTIVE POLICY EXPIRATION,MLIMBS TYPE O INSURANCE POLICY NUMBER DATE GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY -PREMISES Ea occurence .$100,000 CLAIMS MADE M OCCUR MED EXP(Anyone person) S 10,000 C S1928883 4n/2010 4n/2011 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE S 3,000,000 GEN'L AGGREGATE LIMITAPPLIES PER PRODUCTS-COMPIOP AGG $3,000,000 POLICY PR0. LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accldenQ ALL OWNED AUTOS BODILY INJURY A X SCHEDULED AUTOS BBNT98 4nn010 annoll (Per person) $ X HIREDAUTOS BODILY INJURY X NON-OWNED AUTOS ('er accident) $ PROPERTYDAMAGE $ (Per accidenQ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANYAUTO OTHER THAN EAACC S AUTO ONLY: AGG S EXCESS/UMBRELLALIABILITY EACH OCCURRENCE S 15,000,000 X O=UR CLAIMS MADE AGGREGATE S 15,000,000 B BE 1223010 6/20/2010 6/20/2011 S HDEDUCTIBLE S x R=TENTION $10,000 S WORKERS COMPENSATION AND X WC STATU- OTH- EMPLOYERS'LIABILITYCR B ANY PROPRIETORIPARTNERIF_XECUTIVE WC001290194 6/20/2010 6/20/2011 E.L EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEREXCLUDED? - - E,L.DISEASE-EAEMPLO S 1,000,000 SPECIdescribe ALL PROVISIONS below ],D00 000 E.L DISEASE-POLICY LIMIT S + OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Certificate is Issued as evidence of coverage, I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION I ! DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLbER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL I IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR rA EPRESENTATIVES,THORREDREPRESENTATIVE J ACORD 25(2001/08) Client# z•?aFt Mst.# 2010 GL,Auto,WC,Umb Ccrt# ©ACORD CORPORATION 1988 • j i i Two Adams Place MO ADVANTAGE Suite 100 vv'E. I_.A1 IONQuincy, M A 02169 iticCRP O<� rt�: T.ft� Date: 2/18/2011 AGENCY: Action for Boston Community Development, Inc. ABCD 178 Tremont St. Boston, MA 02111 OWNER: TOTAL Cromwell Court Apartments CONTRACT 168 Barnstable Rd, Hyannis, MA $16,808 Date work performed: BUILDING # Work Order# DESCRIPTION CITY. UNIT UNIT PRICE TOTAL PRICE DOORS Weatherstrip w/Q-Ion or equal 1 ea $43.00 $52 Fixed Sweep 3 ea $15.00 $45 MISC. MEASURES Weatherstrip(Q-Ion or equal)& R-30 attic hatch 2 ea $32.00 $64 Attic/Basement sealing with two-part foam 44 man/hr $75.00 $3,330 Seal duct with mastic or butyl backed tape 33 hr $62.00 $2,034 Range Hoods: cut holes/install&connect transition duct 18 hrs $60.00 $1,080 A/C Cover- Interior 50 ea $85.00 $4,216 Labor only charge (properly layout attic insulation) 8 man/hr $60.00 $480 Labor only (remove duct tape on dryer vents/replace with high- 12 man/hr $60.00 $744 temp tape) Aerator 10 ea $10.50 $109 MISC.INSULATION Duct insulation R-5 1,165 sq.ft. $2.95 $3,436 ATTIC VENTILATION Propa Vent 325 ea $3.75 $1,218 Page 1 of 1 NOTICE TO PROCEED Action for Boston Community Development(ABCD), administrator of the DOE Expiring Use energy efficiency program for low-income multifamily-properties, is hereby authorized to have its contractors, employees, and other representatives access the property and perform the work contained in the attached Work Order, including final inspections. A copy of this document shall be carried by ABCD's contractors, employees, or representatives and presented upon request. By signing this Notice to Proceed, the applicant acknowledges that the benefits to the clients will be delivered as stated in the attached document. Application Information Site Name: Cromwell Court Apartments Street, City/Town,Zip: 168 Barnstable Road, Hyannis MA 02601 Contact Name &Ph ne at Site: Thac er Tiffan 617 449-0878 r Signature: _,,7 Printed Name' S. thong +fib eat Title: ____—_ Qrganzaton:_Preservation ofAffordable Housing Inc.,.-itswagg v Acknowledged by ABCD's representative: John Wells,Vice President for Real Estate and Energy Services, ABCD Please sign and date two originals. Retain one for your records and return the other to: Grace Park ABCD 178 Tremont Street Boston,MA 02111 Fax: 617-357-4661 j parkOabostonabcd.org Attachment: "Massachusetts ARRA Weatherization Program: Application for Cromwell Court Apartments" I i a i i ------— z_ x "'�q yLG '3✓g7Vftr7PSPr.S 7t(y� i�e,!��,r"�:#s'R f:�tlf.a�f{ y;�_ and ftuftrds Ucense 98303 rxoi Wi72611 Tr4 983iD3 Res�ire►n �- r PEDFOM... -:. MA 02745 £a��.€�iirxrer 5 I ADVANTAGE WEATHERIZATION 0@1 NCORPO RATED February 23, 2011 Town of Barnstable Regulatory Services Building Division 200 Main St, Hyannis, MA 02601 RE: 168 Barnstable Rd—Cromwell Court REF: Jay Lambalot-project superintendent This letter is to confirm that Jay Lambalot is an employee of Advantage Weatherization, Inc, and is covered under our workers compensation insurance policy. ' Sincerely, .i John Kelly President 1 Two Adams Place, Suite 100, Quincy, MA 02169 Telephone 888.508.0886 Fax 61 7.237.1 851 www.advantageweatherization.com Hof z�r�yy Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main-Street, Hyannis,MA.02601 www.town.barnstable.ma.us Officer 508-862-4038 Fax: 509-790-6230 HOA'IEOVNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/towo state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellinzs 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"fo 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 minimumm inspection procedures and requirements and that he/she will comply with said procedures and requirements. l Si afore of Homeowner s : . t����, .��� �"�°, �� � i • Approval of Building Official r t E Note: Three-family dwellings containing 35,000 cubic feet of larger will be required to comply with the State Building Code Section 127:0 Construction Control HOMEOVir ER'S EXEMPTION .The Code states that "Any homeowner performing work for which a building permit is requirsd shall be exempt from the provisions of this section.(Secban 1 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 assuming the responsibilities of a supervisor(see Appendix Q, - Rules&R.ggirladons 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 ticcnscd Supervisor. The homeowner acting as Supervisor is ultimately responsible. To cnaure 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 respmmbilities 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 fomr/certification for use in your community, ' Q:forms:homctxcmpt TKE Town of Barnstable Regulatory Services • lARN6TABLE, � MAss. $ 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 Owner Must - Complete and Sign This Section If Using A Builder I, as Owner of the subject property hereby authorize n(- to act on my behalf, M all matters relative to work authorized by this building permit application for: (Address of Job) A-111AC VA 1� ' nature of ' bate 4 L ,h L - J o PrintNanze If Property Owner is applying'for permit please complete.the Homeowners License Exemption Form on the reverse side. Q.FORMS:D WNERPERMISSION TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 01, Map 2�� Parcel Application # I" Health Division Date Issued l r Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address r Village Owner Address fl, :nY`CZ� Telephone Permit Request P V 1 N5(AAT QN , `UcT- seeiM hAT�C ( 1 ti p yeer caber, 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 Ex sting 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 cf Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Ai,: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn.,0 existing.; ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other 9 C-D Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use C,-i APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name V V�r� Q ����, tti �,. fin(, Telephone Number U V1 c���1 \SsV\.e +Address �� �'3\c.�_ S;.�e ��J License# N� q� 3 C�Z,\,k u\ Home Improvement Contractor# ll.. ub_V Worker's Compensation # ,cAft CQ\-4q G�c�-1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO CL r SIGNATURE DATE CaR r t FOR OFFICIAL USE ONLY APPLICATION# �r k DATE ISSUED , . -,,:L ,, ' �j 4 -MAP./PARCEL NO.: _. s ADDRESS VILLAGE OWNER DATE OF INSPECTION: -"."FOUNDATION-' FRAME -INSULATION' ?= FIREPLACE r ELECTRICAL: ROUGH FINAL ti F PLUMBING: ROUGH FINAL GAS:~ z` ROUGH 4 ;� ;l FINAL _,FINAL BUI'LD.INGld �E[?late 1� t '..DATE CLOSED OUT ASSOCIATION PLAN NO. i Me 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): . •Address: City/State/Zip: ?s, .mac `(`(M \ Phone.#: Are you an employer?Check the appropriate box: Type of project(required):, 1.[4 I am a employer with �t> 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. 0 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'_.__ .. _ [No workers'comp.insurance comp,insurance.#, 9: Building addition required.] 5. ❑ We area corporation and its 10.0-Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l l.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL c. 152, 12.❑Roof repairs insurance required.]t §1(4) and we have no 13.❑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. $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:- Policy#or Self-ins.Lic.#: ` (�_ C7)\ac�C)\G� Expiration Date:_ Job Site Address: 5 2 City/State/Zip: Attach a copy of the workers'compensation policy declaration page Vowing the policy number 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�Apof erj that the information provided above is true and correct Si ature: l Date c o`X1 Phone k \1' 3?5) Official use only. Do not write in th a ea,tb 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#: ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 23/20 04/ 3/20 0 10 PRODUCER (800)225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 41 Wellman Street. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Lowell,MA 01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 800-225-1865 INSURERS AFFORDING COVERAGE NA1C# INSURED INSURER A: Citation Insurance Company Advantage Weatherization,Inc. INSURER B: National Union Fire Insurance Company ofPittsburglt Two Adams Place,Suite 100 Selective Insurance Company Quincy,MA 02169 INSURER C- Selective of America INSURER D: INSURER I 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 DD' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION TYPE OINSURANCE- DD/YYI --QATF AMMIDDIM LIMBS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE To RENTEU-- X COMMERCIAL GENERAL UABILrrY PREMISES Ea or rence S 100,000 CLAIMS MADE .M OCCUR MED EXP(Anyone person) S 10,000 C 519Z8883 4/2/2010 4/2/2011 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE S 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $3,000,000 POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT y 1 000,000 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY (Per person) S A X SCHEDULED AUTOS BBNT98 4=010 412/201 I HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per ec)dent) $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN I EA ACC S AUTO ONLY: AGG $ EXCESS/UMBRELLALIABILITY EACH OCCURRENCE S 15,000,000 X OCCUR CLAIMS MADE AGGREGATE S 15,000,000 B BE 1223010 6/20/2010 6/20/2011 S DEDUCTIBLE S X RETENTION $10,000 S WORKERS COMPENSATION AND X fTNC SDRYTATU OTH- EMPLOYERS'LIABILITY - B ANY PROPRIETORWARTNERIEXECUTIVE WC001290194 6/20/2010 6/20/2011 E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOY $ 1,000,000 I(yes,describe under E.L DISEASE-POLICY LIMB S SPECIAL PROVISIONS below 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate is Issued as evidence of coverage. ' i 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 WRrfTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL I IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE I ACORD 25(2001/08) Client# 17AAI Mst.# 2010GL,Auto,WC,Umb Cart# ©ACORD CORPORATION 1988 I I i I i a i } 4, i } ji i t � z Saud ofB S�aadards ` Reg�iatx►as'and CS 98303: r Tr# 98303 AR�4 02745 €ar a i nea L J r Two Adams Place ADVANTAGE Suite 100 1INC0R OR ATE Quincy, MA 02169 tNCORPOAr�TED Date: 2/18/2011 AGENCY: Action for Boston Community Development, Inc. ABCD 178 Tremont St. Boston, MA 02111 OWNER: TOTAL Cromwell Court Apartments CONTRACT 168 Barnstable Rd, Hyannis, MA $16,808 Date work performed: BUILDING # Work Order# DESCRIPTION QTY. UNIT UNIT PRICE TOTAL PRICE DOORS Weatherstrip w/Q-Ion or equal 1 ea $43.00 $52 Fixed Sweep 3 ea $15.00 $45 MISC. MEASURES Weatherstrip(Q-Ion or equal)& R-30 attic hatch 2 ea $32.00 $64 Attic/Basement sealing with two-part foam 44 man/hr $75.00 $3,330. Seal duct with mastic or butyl backed tape 33 hr $62.00 $2,034 Range Hoods:cut holes/install &connect transition duct 18 hrs $60.00 $1,080 A/C Cover-Interior 50 ea $85.00 $4,216 Labor only charge(properly layout attic insulation) 8 man/hr $60.00 $480 Labor only (remove duct tape on dryer vents/replace with high- temp tape) 12 man/hr $60.00 $744 Aerator 10 ea $10.50 $109 MISC.INSULATION Duct insulation R-5 1,165 sq.ft. $2.95 $3,436 ATTIC VENTILATION Propa Vent 325 ea $3.75 $1,218 j Page 1 of 1 NOTICE TO PROCEED Action for Boston Community Development(ABCD), administrator of the DOE Expiring Use energy efficiency program for low -income income multifamily-properties, is hereby authorized to have its contractors, employees, and other representatives access the property and perform the work contained in the attached Work Order, including final inspections. A copy of this document shall be carried by ABCD's contractors, employees, or representatives and presented upon request. By signing this Notice to Proceed, the applicant acknowledges that the benefits to the clients will be delivered as stated in the attached document. Application Information Site Name: Cromwell Court Apartments Street, City/Town,Zip: 168 Barnstable Road, Hyannis MA 02601 Contact Name &Ph ne at Site: Thac er Tiffany 617 449-0878 Signature: Printed NamAmY S. Lhony'/" Title: Organization;_Preservation of Affordable Housing Inc Date: ��� v Acknowledged by ABCD's representative: John Wells,Vice President for Real Estate and Energy Services, ABCD Please sign and date two originals. Retain one for your records and return the other to: Grace Park ABCD 178 Tremont Street Boston,MA 02111 Fax: 617-3574661 park ftstonabcd.org Attachment: "Massachusetts ARRA Weatherization Program: Application for Cromwell Court Apartments" I THE Towns of Barnstable Regulatory Services s tarrsrABM Thomas F.Geiler,Director 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 Owner Must Complete and Sign This Section If Using A Builder 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 Job) %ignature of �?/V ate , Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Fo rm p on the reverse side. Q:FORMS:O WNEUERMISSION 1 1 �pF�Hte r�ti . Town of Barnstable Regulatory Services t � f Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Mairi•Street,_Hyannis,MA.02ti01 vt'wwAo wn.b arnstabl e.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER 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 constrgcts more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall subs: '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 n _ Approval of Building Official ° Note: Three-family dwellings containing 35,000 cubic feet or larger will be.required to comply with the State Binding Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that "Any homeowner perfomiing work for which a building permit is required shall be exempt from the provisions of this secton.(Sccdon 1 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 assuming the responsibilities of a supervisor(see Appendix Q. Rules&Rcgvlations 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:fonns:homcexempt ROM ADVANTAGE ®@WEATHERIZATION INCORPORATED February 23, 2011 Town of Barnstable Regulatory Services Building Division 2,00 Main St, Hyannis, MA 02601 RE: 168 Barnstable Rd—Cromwell Court REF: Jay Lambalot—project superintendent This letter is to confirm that Jay Lambalot is an employee of Advantage Weatherization, Inc, and is covered under our workers compensation insurance policy. Sincerely, John Kelly President Two Adams Place, Suite 100, Quincy, MA 02169 Telephone 888.508.0886 Fax 61 7.237.1 851 www.advantageweatherization.com • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application #W40 '0'1 Health Division Date IssuedConservation Division Application F / Planning Dept. Permit Fee Date Definitive Plan.Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Villagem��� Owner' a Address ��� ��� • Telephone !tSJ*6 s—l`1\• R—U Permit Request \ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation (Zd 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_ i Attached garage: ❑ existing 0 new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# 9 L..j Current Use Proposed Use 7.1 APPLICANT INFORMATION � 7 (BUILDER OR HOMEOWNER) -_ Name \m Telephone Number �Q�-1 a3`l W-4 Address` \\z�6 License# G Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C\A J)xwSncw� SIGNATURE DATE � 1�� ' S ` f FOR OFFICIAL USE ONLY APPLICATION# ' DATE ISSUED --U , MAP_/PARCEL N0. .- t r f ADDRESS VILLAGE - C t j OWNER DATE OF INSPECTION: a FOUNDATION. FRAME INSULATION," FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS.:--; _A-,-. ROUGH C'�' FINAL FINAL BUILDING i ' i DATE CLOSED OUT ASSOCIATION.PLAN NO. i i r. Ib y • HARNSrAHLE, MASS. Town of Barn table t6J9. �� .Regulatory Services Thomas F. Ceiler, Director .Building Division Thomas Per ry*, CBO Building Commissionet 200 Main Street, Hyannis, MA 02601 www.town.ba rnsfa ble.m a.its Office: 508462-4038 Fax: 508-790-6230 Property Owner .Must Complete and Sign This Section ff Using A B uildet I as Owner of the subject property 1-ereby authorize 3,-V- m �� o�ti.o, un�v�� to act on my behalf, in all matters relative to work authorized by this building permitappbcation for: .mil� �\.J •���• (Address ofrob) 4 AILIZ,- �3 Signature of Owner 5Pi1, Date Print Name Cf Prope'riy Owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. Q IWPFILESIFCRMSIbv0ding permit rormslEXPRESS.doc Reyiv,.d 0721 0 HErc�ti Town of Barnstable - ' Q. Regulatory Services " �Sn e,JASS, Thomas F. Ceiler, Director .� ass. � 6µ;R4 Ib Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town,ba rnsta ble.mn,us Office: 518-86274038 Fax: 508-790-6230 HOMEOWNER LICENSE FXEMPTION Please Print DATE: !OE LOCATION: number street village "I-lOMEO WN G R" name home phone N work phone N CURRENT MAILNG ADDRFSS: city/town state zip code The current exemption for."homeowners" was extended to include owner-occupied dwellings ofsix 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-yearperiod 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, ales and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimurri inspection procedures and requirements and that he/she will comply with said procedures.and requirements. . Signature of Homeown.cr 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, ; " fIOMfEOWNER IS EXEMPTION The Code states that: "Any homeowner performing work for which a building Permilis rcgarired slatall be exempt from the provisions of this section(Section 109.I.1 -Licensing ofconstruction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such'Homeowner shall act as su pervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of s supervisor(see Appendix°Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack ofawareness oven results in serious problems,particularly when the homcowncr hires unlicensedpc�sons.., In this case,our Board cannotprocced against the unlicensed person as if would with a licensed Supervisor. The homeowner acting as`Supe'rvisor is ultimately' responsible. To ensu a that the homeowner is fully aware ofhisAhcr responsibilities,many communities require,as purl of the permit application,that the homeowner certify that he/she understands the responsibilities ofa Supervisor. On the last page of this issue is a form currently used by several towns. You may care f amend and adopt such a form/certification for use in your community. Q:wPFILESIFORMSIbuilding permil rormslEXPRESS.doc Revised 072110 The Commonwealth of Massachusetts Department of Indtistrial Accidents Office of Investigations 600 Washington Street Boston,ALL 02111 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Naive(Business/Organization/Individual): f— aT f\ao-N r, Address:771 City/State/Zip: . �� Phone.#: U\1- (931.\� Are you an employer?Check the appropriate box: Type of project(required):. 1.[ I am a emlloyer with. 1l� 4. [] I am a general contractor and I employees(full and/or part-time).* have hired the-sub-contractors 6. 0 New construction 2.11 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'_._. .. [No workers'comp,insurance comp,insurance.t' 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 I.❑Plumbing repairs or additions myself• [No workers'comp. right of exemption per MGL 12.M Roof repairs insurance required.]t c. 152,§1(4),and we have no . employees. [No workers' 13.0 Other comp.insurance required:] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state 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 job site information. Insurance Company Policy#or Self-ins.Lic.#: ,�Y_ Expiration Date Job Site Address 2 pity/State/Zip: Attach a copy of the workers'compensation policy declaration page owing the policy number 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certify under the pains•and penaltiesEoKerjthat the information provided abovrve is true aKd correct: Signature: Phone#: Official use only. Do not write in th a ea,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'#: ACORD. CERTIFICATE OF LIABILITY INSURANCE 04/232010YIY) 04l23/2010 PRODUCER (800)225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 41 Wellman Street. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Lowell,MA 01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.. 800-225-1865 INSURERS AFFORDING COVERAGE NA1C# INSURED INSURER A. Citation Insurance Company Advantage Weatherization,Inc. INSURER a; National Union Fire Insurance Company of Pittsburgh Two Adams Place,Suite]00 Selective Histuance Company Quincy,MA 02169 INSURER a p y of America INSURER 13, INSURER IB 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 ADD'L POLICYEFFECTIVE POLICY EXPIRATION RL TYPEOFIN URANCE POLICY NUMBER DATE(MMIDDIYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY -PREMISES Ea occurence S 100,000 CLAIMS MADE M OCCUR '1 MED ECP(Anyone person) S 10,000 C S1928883 4/2/2010 4/2/2011 PERSONAL&ADV INJURY $1,000,000 GENERALAGGREGATE S 3,000,000 GEN'L AGGREGATE LIMITAPPLIESPER PRODUCTS-COMP/OPAGG S 3,000,000 POLICY F PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY S A X SCHEDULED AUTOS BBNT98 4/220]0 4/2/201 1 (Per person) HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY.EA ACCIDENT S ANY AUTO EA ACC $OTHERTHAN AUTO ONLY: AGG S EXCESSIUM13RELLALLABILTrY - EACH OCCURRENCE S 15,000,000 X OCCUR CLAIMS MADE AGGREGATE S 15,000,000 B BE 1223010 6/20/2010 6/20/2011 S DEDUCTIBLE S X RETENTION $10,000 s WORKERS COMPENSATION AND X I WC STATU- OTH- EMPLOYERS'LIABILITY - B ANY PROPRIETOWPARTNERIFXECUTIVE WC001290194 6/20/2010 6/20/2011 E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S 1,000,000 9PECIdAL PROVISIONS below 1,000,000 E.L DISEASE-POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate is issued as evidence of coverage. i 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 I i NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL I I IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. I 1 AUTHORIZED REPRESENTATIVE i I ACORD 25(2001/08) Client# 17AA] Mst# 2010 GL,Auto,WC,Umb Ccrt# ©ACORD CORPORATION 1988 Two Adams Place A Suite 100 DVANTAGE RIZA.TIO IN Quincy, MA 02169 CORPORA ATE D Date: 2/18/2011 AGENCY: Action for Boston Community Development, Inc. ABCD 178 Tremont St. Boston, MA 02111 OWNER: TOTAL Cromwell Court Apartments CONTRACT 168 Barnstable Rd, Hyannis, MA $16,808 Date work performed: BUILDING # Work Order# DESCRIPTION QTY. UNIT UNIT PRICE TOTAL PRICE DOORS Weatherstrip w/Q-Ion or equal 1 ea $43.00 $52 Fixed Sweep 3 ea $15.00 $45 MISC. MEASURES Weatherstrip(Q-Ion or equal) '& R-30 attic hatch 2 ea $32.00 $64 Attic/Basement sealing with two-part foam 44 man/hr $75.00 $3,330. Seal duct with mastic or butyl backed tape 33 hr $62.00 $2,034 Range Hoods:cut holes/install&connect transition duct 18 hrs $60.00 $1,080 A/C Cover-Interior 50 ea $85.00 1 $4,216 Labor only charge (properly layout attic insulation) 8 man/hr $60.00 $480 Labor only (remove duct tape on dryer vents/replace with high- temp tape) 12 man/hr $60.00 $744 Aerator 10 ea $10.50 $109 MISC.IN'SULATION Duct insulation R-5 1,165 I sq.ft. 1 $2.95 $3,436 ATTIC VENTILATION Propa vent 325 1 ea $3.75 1 $1,218 Page 1 of 1 NOTICE TO PROCEED Action for Boston Community Development(ABCD), administrator of the DOE Expiring Use energy efficiency program for low-income multifamily properties; is hereby authorized to have its contractors, employees, and other representatives access the property and perform the work contained in the attached Work Order, including final inspections. A copy of this document shall be carried by ABCD's contractors, employees, or representatives and presented upon request. By signing this Notice to Proceed, the applicant acknowledges that the benefits to the clients will be delivered as stated in the attached document. Application Information Site Name: Cromwell Court Apartments Street, City/Town,Zip: 168 Barnstable Road, Hyannis,MA 02601 Contact Name &Ph ne at Site: Thac er Tiffany 617 449-0878 1 Signature: / Printed NamAMY S. Ithony- Title: Qrganizaton:_Preservation of Affordable Housing Inc - ' Date: an-p v Acknowledged by ABCD's representative: John Wells,Vice President for Real Estate and Energy Services, ABCD Please sign and date two originals. Retain one for your records and return the other to: Grace Park ABCD 178 Tremont Street Boston,MA 02111 Fax: 61.7-3574661 park ,bostonabcd.org Attachment: "Massachusetts ARRA Weatherization Program: Application for Cromwell Court Apartments" 5 j t E a� 7-7 / ~ '>ze �r�ar�lte�a az esBedegutstaeansda€rda an Ss E f %ae U cense., CS gm �xt�rttran 171Z019 Tt 9&M n .00 JAY. gel MA 0274$ C�twcsisarer 7 e &wvm axweca� v�.1 61i_4a . e i Office of Consumer Affairs &Business Regulation HOME IMPROVEMENT CONTRACTOR Registration" 66075 Type: rc " k License or registration valid for.-individul use only Expiration: _ ; 012 Corporation before the expiration date, if found:return to: — Office of Consuij.ier Affairs and Business Regulation WDATAGE Wf _ - �FrINC. 10 Park Plaza-Suite5170 Boston,MA 02116 �^ JOHN KELLY � "' TWO ADAMS PLAA +TUd �✓Wes. �. ��.�.�a�r QUINCY, MA 02169'tip`. �s ,rj' Undersecretary �- N' valid without signature OGADVANTAGE COWEATNERIZATION IN C O RPO RATED February 23,2011 Town of Barnstable Regulatory Services Building Division 2C0 Main St, Hyannis, MA 02601 RE: 168 Barnstable Rd—Cromwell Court REF: Jay Lambalot-project superintendent This letter is to confirm that Jay Lambalot is an employee of Advantage Weatherization, Inc, and is cowered under our workers compensation insurance policy. Sincerely, . John Kelly President Two Adams Place, Suite 100, Quincy, MA 02169 Telephone 888.508.0886 Fax 61 7237.1 851 www.advantageweatherization.com 240A Elm Street Somerville, MA 02144 Tel: 617-628-5700 Fax: 617-62 8-1717 www.mostue.com M O S T U E' & ASSOCIATES Brooks A. Mostue,AIA Clifford J. Boehmer,AIA U Ross A. Speer,AIA Z Iric L. Rex, AIA vi U w TRANSMITTAL DATE: August 9, 2010 FROM: Laura Wolthuis TO: Al Melcher Chair of Barnstable Disability Commission PO Box 1520 Cotuit, MA 02635 CC: Tom Hopkins—MAAB Thacher Tiffany— POAH Cliff Boehmer—M&A RE: MAAB Variance Application PROJECT- Cromwell Court PROJECT.No.: i 0015.00 QTY. DESCRIPTION DATED Al: Attached please find: Cromwell Court, Hyannis MAAB Variance Application 08.09.10 (As issued to MA Architectural Access Board attn: Tom Hopkins) Thank you, Laura B. Wolthuis M MOSTUE & ASSOCIATES ARCHITECTS, INC. 240A Elm Street Somerville,MA 02144 www.mostue.com tel: 617.628.5700 ext. 108 cell:617.283.4204 fax:617.628.1717 Iwolthuis@mostue.com X US Mail (CERTIFIED) _ Overnight _ Picked up Fax Courier Fiand delivered E-mail As requested X For your use For review and comment G:\10\10015-Cromwell Court\CC-Code\CC-MAAB Variance Application\TRANSMITTALS\US-MAAB Transmittal—Variance App 20100810.doc 6 f x I i CC� � tt t 1 Preservation of Affordable Housing, Inc. Amy S.Anthony, President August 9, 2010 Tom Hopkins V Massachusetts Architectural Access Board One Ashburton Place, Room 1310 Boston, MA 02108 Dear Mr. Hopkins, Enclosed please find the MAAB Variance Application for Cromwell Court in Hyannis, MA. As discussed at your meeting with Cliff Boehmer,the project triggers compliance with 521 CMR 3.3.1.b because the property is scheduled to undergo rehabilitation work exceeding$100,000 per building. As such, we would be required to provide accessible ramps to all five of the buildings, none of which have units that can be reached from the entry via an accessible path, yet alone accessible units. As an alternative, we are proposing to create two reconfigured accessible units along with one fully compliant accessible ramp and entry. The details of the proposal are outlined in the enclosed variance application as prepared by Mostue and Associates. Thank you for your consideration. Do not hesitate to contact me at 617-449-8066 or Cliff Boehmer at 617-628-5700 x106 with any questions. Sincerely, Thacher Tiffa y Chicago Office - 77 West Washington, Suite 1005, Chicago, IL 60602, 312 283 0030, Fax 312 658 0666 Main Office - 40 Court Street, Suite 650, Boston, MA 02108, 617 261 9898, Fax 617 261 6661, www.poah.org The Commonwealth of Massachusetts Department of Public Safety Docket Number Architectural Access Board One Ashburton Place, Room 1310 (Office Use Only) r Boston Massachusetts 02108-1618 Phone: 617-727-0660 Fax: 617-727-0665 www.mass.gov/dps APPLICATION FOR VARIANCE In accordance with M.G.L., c.22, § 13A, I hereby apply for modification of or substitution for the rules and regulations of the Architectural Access Board as they apply to the building/facility described below on the grounds that literal compliance with the Board's regulations is impracticable in my case. PLEASE ENCLOSE: 1) A filing fee of$50.00 (Check/Money Order) made payable to the "Commonwealth of Massachusetts" and all supporting documentation (e.g. plans in 11" x 17" format, photographs, etc.). In addition, the complete package (including plans and photographs) must be submitted via one compact disc. 2) If you are a tenant seeking variance(s), a letter from the owner of the building authorizing you to apply on his or her behalf is required. 3) The completed "Service Notice" form provided at the end of this application certifying that a copy of your complete application has been received by the Local Building Inspector, Local Disability Commission (if applicable), and Local Independent Living Center for the city/town that the property in question resides in. A list of the local entities can be found by calling the Architectural Access Board Office or the Local City/Town Clerk. For a list of the Local Independent Living Centers you can either call the Architectural Access Board Office or visit the Massachusetts Statewide Independent Living Council website at http://www.masilc.org/membership/cils. 1. State the name and address of the owner of the building/facility: POAH Cromwell Court, LP (assuming acquisition) Email: ttiffany(@Poah.org Telephone: 617-449-8066 Page 1 of 7 Rev, 01/10 2. State the name and address of the building/facility: 168 Barnstable Road Hyannis, MA 3. Describe the facility (i.e. number of floors, type of functions, use, etc.): The property is a 124-unit multifamily garden apartment complex with entries at 5 residential buildings and an additional building which houses a community center, management office and maintenance facilities. The residential buildings are 2 and a half stories and the Vt floor units are half a story below ra ade. 4. Total square footage: 136,952 SF (total) a. total square footage of tenant space: 134,631 SF (5 residential buildings) b. total square footage of community space: 2,321 SF (community building) 5. Check the work performed or to beperformed: New Construction Addition X Reconstiruction/Remodeling/Alteration Change of Use 6. Briefly describe the extent and nature of the work performed or to be performed (use additional sheets if necessary): Site improvements include: paving repairs and new ramps for improved site access. Building exterior improvements include: reconfiguration of entries at the community building and building 4.7 to bring entrances into ADA and AAB compliance; upgrades to exterior stairs and stair railings; adjustment of existing entry doors for easier operation; and roof replacement. Interior improvements include: selective MEP ugrades at kitchens and baths; selective fixtures and finishes in common spaces and units, reconfiguration of public restrooms at the community building to meet ADA and AAB compliance; reconfiguration of units in building 4.7 to provide one accessible one-bedroom unit, and one accessible two- bedroom unit, and common stair railing upgrades. According to the following calculations, the scope of work does not tripper full compliance with MAAB, under 521 CMR 3.3.1, the work being performed amounts to less than 30% of the full and fair cash value of the building: 134,310 SF x $73.32/SF = $9,847,609 (replacement cost) $9,847,609 x (.30) = $2,954,283 Anticipated cost of construction: $2,500,000 (<$2,954,283) 7. State each section of the Architectural Access Board's Regulations for which a variance is being requested: 7a. Check appropriate regulations: 1996 Regulations 2002 Regulations X 2006 Regulations Page 2 of 7 Rev, 01/10 I I SECTION NUMBER LOCATION OR DESCRIPTION 3.3 EXISTING BUILDINGS 3.3.1.b. The project does not meet 521 CMR reauirement for an accessible public entrance at the building: existing building entries do not comply. 8. Is the building historically significant? _yes X no. If no, go to number 9. 8a. If yes, check one of the following and indicate date of listing: National Historic Landmark Listed individually on the National Register of Historic Places Located in registered historic district Listed in the State Register of Historic Places Eligible for listing 8b. If you checked any of the above and your variance request is based upon the historical significance of the building, you must provide a letter of determination from the Massachusetts Historical Commission, 220 Morrissey Boulevard, Boston, MA 02125. 9. For each variance requested, state in detail the reasons why compliance with the Board's regulations is impracticable (use additional sheets if necessary), including but not limited to: the necessary cost of the work required to achieve compliance with the regulations (i.e. written cost estimates); and plans justifying the cost of compliance. 3.3 EXISTING BUILDINGS 3.3.1.b. Existing building entries are typically accessed by exterior stairs to the front door. (Ref: photos) From the interior, units are accessed by a fliaht of stairs up or down from the entry vestibule. Existina construction makes reconfiguration at all buildings infeasible. However, the entrance at building 4.7 will be reconfigured to provide accessibility (via new ramp) to two fully accessible units. (Ref: SK-2 and SK-3) While not required, the Owner is doing a voluntary upgrade by providing two Group 2B accessible units. The Community building has an existing non-compliant ramp to the side door which will remain. A new fully-compliant ramp will be added to provide access to the front entrance. (Ref: SK-4) A further voluntary upgrade proposed by the owner is the accessible path between the accessible units and the common building (Ref: SK-1) 10. Has a building permit been applied for? No Has a building permit been issued? No 10a. If a building permit has been issued, what date was it issued? 10b. If work has been completed, state the date the building permit was issued for said work: Page 3 of 7 Rev, 01/10 11. State the estimated cost of construction as stated on the above building permit: N/A 11 a. If a building permit has not been issued, state the anticipated construction cost: $2,500,000 12. Have any other building permits been issued within the past 36 months? Yes 12a. If yes, state the dates that permits were issued and the estimated cost of construction for each permit: See attached Exhibit 1 13. Has a certificate of occupancy been issued for the facility? Currently occupied If yes, state the date: 14. To the best of your knowledge, has a complaint ever been filed on this building relative to accessibility? yes X no 15. State the actual assessed valuation of the BUILDING ONLY, as recorded in the Assessor's Office of the municipality in which the building is located: N/A - work being performed amounts to less than 30% of full and fair cash value of the building as defined by 521 CMR 3.3.1 (see #6 above) Is the assessment at 100%? N/A If not, what is the town's current assessment ratio? 16. State the phase of design or construction of the facility as of the date of this application: schematic design level 17. State the name and address of the architectural or engineering firm, including the name of the individual architect or engineer responsible for preparing drawings of the facility: Mostue and Associates Architects, Inc. 240 Elm Street Somerville MA 02144 attn: Cliff Boehmer E-mail: cboehmer(a)mostue.com Telephone: (617) 628-5700 x106 18. State the name and address of the building inspector responsible for overseeing this project: To be determined E-mail: Telephone: Page 4 of 7 Rev, 01/10 Page 5 of 7 Rev, 01/10 f Date: Signature of owner or authorized agent PLEASE PRINT: Name Address City/Town State Zip Code E-mail Telephone Page 6 of 7 Rev, 01/10 ARCHITECTURAL ACCESS BOARD VARIANCE APPLICATION SERVICE NOTICE as for the Petitioner submit a variance application filed with the Massachusetts Architectural Access Board on 20 HEREBY CERTIFY UNDER THE PAINS AND PENALTIES OF PERJURY THAT I SERVED OR CAUSED TO BE SERVED, A COPY OF THIS VARIANCE APPLICATION ON THE FOLLOWING PERSON(S) IN THE FOLLOWING MANNER: NAME AND ADDRESS OF PERSON OR AGENCY DATE OF SERVED METHOD OF SERVICE SERVICE Tom Perry, Building Commissioner Certified mail 08.10.10 1 Town of Barnstable/Building Division 367 Main Street Hyannis, MA 02601 -Arm ercher Certified mail 08.10.10 2---Chair of`Local`Disabifit 'Commission PO Box 1520 Cotuit, MA 02635 Coreen Brincknerhoff, Executive Director Certified mail 08.10.10 3 Cape Or anization for the Rights of the Disabled 106 Bassett Lane Hyannis, MA 02601 AND CERTIFY UNDER THE PAINS AND PENALTIES OF PERJURY THAT THE ABOVE STATEMENTS TO THE BEST OF MY KNOWLEDGE ARE TRUE AND ACCURATE. Signature: Appellant or Petitioner On the Day of 20 PERSONALLY APPEARED BEFORE ME THE ABOVE NAMED (Type or Print the Name of the Appellant) NOTARY PUBLIC MY COMMISSION EXPIRES Page 7 of 7 Rev, 01/10 Exhibit I. Building permits in last 36 months Issue date Work Cost 11/4/2008 vinyl siding bldgs 1 and 2 24,500 11/4/2008 vinyl siding bldgs 6 and 7 24,500 11/4/2008 vinyl siding bldgs 7 and 8 31,850 11/4/2008 vinyl siding bldgs 10 and 11 24,500 10/27/2008 rebuild 16 decks-bldg 1 and 2 65,000 10/27/2008 rebuild 14 decks-bldg 3 and 4 56,875 10/27/2008 rebuild 15 decks-bldg 5 and 6 60,937 10/27/2008 rebuild 11 decks-bldg 7 and 8 45,100 10/27/2008 rebuild 16 decks-bldg, 9, 10, 11 65,000 TOTAL 398,262 F ,.,■,r .�.:�__; tea. SM. ■_ — -- ` SM A ` i. f nil lee e e � � e e• e e e oF'THE rqk, Town of.Barnstable �y` o Regulatory Services xSTAs Thomas F. Geiler,Director , 059. ��� Building Division ArFD11'°�A . Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790- 6230 Nov. 18, 2010 Ellen W. Freyman Shatz, Schwartz and Fentin, P.C. 1441 Main Street, Ste. 1100 Springfield, MA 01103 Re: 168 Barnstable Rd Cromwell Court Zoning Dear Ms. Freyman; In response.to your recent inquiry, I hope you find the following information concerning Cromwell Court of assistance. The subject property located at 168 Barnstable Road,Hyannis was constructed with the benefit of zoning relief(Special Permits 1971-38 & 1972-25). Said project was first proposed on May 27, 1971 as 124 units in five buildings on Barnstable Road and completed accordingly. The zoning at the time of the aforementioned appeals was noted to be split involving both Business and Residence A-1 districts. The property has since been rezoned to Single Family and is therefore currently nonconforming under the governing provisions of the zoning code as identified in Chapter 240 Section 24.1.5. Please let me know if you require additional information. cerely, Robin C. Anderson Zoning enforcement Officer 22-1 y File "Edit Tools Help YearlType#Bill No. Customer account inforinatioti, l History - µ2�11 ! frE R l 5aa y, } CROM*ELLCOU.RTCO = 6 ail .. _ Prope j"snformaticsn 4,88CON1MON WEALTH AVE Orig B1l Parcel ID 328013 BCiSTN,.4h� Q221`5 ;M Pare: r Effective Date w l u'Prop lac 113 BaR1JSTiBLE ROAD r i en,/Sale % Special Cdhdifions/Notes a Y_ ly_ Scan Bill K. m Quick Entry Int'Dt Billed Aht/Add ,Prat✓ rd" 1r terest Unpaid bal 431.1 .00 iJtBity Acct 11 02il0 8,431.16 .00 , W 8."Cbsto - fi}? I ,{ } : - _ _ — Name s _ 0�. .d141 - t fees�PGn {lfY.. ,` Parcel Totals177 1 M 33�� �n � B 31 1� 8�31 1 B ` Pap Code i Die -NotesMe is r r2+ ' 1€l GT t4�B�luag Dates Per`Diem == JV4N 1 der C:Ri,��1'�u''ELLCOUTCO Bill AU dt I' lr>t laid,, Reprint w a pror rtparid bills s Preferences • Diagnostics �r Qisplay transaction history£urtl-i&WrrentbiN1,2 , Town of Barnstable Regulatory Services tp Thomas F.Geiler,Director ti Building Division BMtN8TABI.E. : Tom Perry,Building Commissioner 9 ," 200 Main Street,Hyannis,MA 02601 • RFD MA'S A Office: 508-862-4038 Fax: 508-790-6230 November 26, 2008 Sergio Desimone 601 Hope Rd. Cranston, RI 02831 RE: 168 Barnstable Rd., Hyannis, Ma., Map: 328 Parcel: 013 Dear Mr. Desimone: This letter is to inform you of a failed inspection at the above referenced address. This office performed an inspection of several decks and is was observed that the guards installed do not meet the requirements of 780 CMR 1021.3 which requires openings to be such that a four inch sphere cannot pass through. You are hereby ordered to correct the deficiencies and arrange for a reinspection. Thank you for your immediate attention in this matter. I may be reached at (508) 862-4034 with any questions. By Order, WrL .au Local Inspector Q:zoning5 � t TOWN OF BARNSTABLE BUILDING.PERMIT APPLICATION. Map 'Q Parcel �� ;� Application# �. Health Division Date Issued Conservation Division Application Fee Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Addressb1Pct Village Owner STATE STREET DEVELOPMENT Address Telephone 488 COMMONWEALTH AVE. Permit Request BOSTON, MA 02215 p a 17 r o� Square feet: 1 st floor:existing © proposed 2nd floor:existing (f;'/ proposed CD Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 00C) 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 J`No On Old King's Highway: ❑Yes `rNo Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other s� 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 F .el: Gas ❑Oil ❑Electric ❑Other °g Central Air: Yes ❑No Fireplaces: Existing _ New C Existing wood%coal stove: Yes a<o Detached garage:❑existing ❑new size _L ,,g g g � Pool:❑existing ❑new size�Barn:❑�xisting �,O new- size Attached garage:❑existing ❑new size � Shed:❑existing ❑new size Other: Z!_ Zoning Board-of.A�ppeals Authorization ❑ Appeal# Recorded❑ Commercial Yes ❑No If yes, site plan review# Current Use Proposed Use UILDER INFORMATION Name s dil 51uc f0 ® Telephone Number C,�e- _ 3-320 Address / Eckr � License# �� �o T_e)m< Home Improvement Contractor# /355g - Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE cv DATE / 7 4 °s FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED h MAP/PARCEL NO. ADDRESS VILLAGE OWNER K ,v DATE OF INSPECTION: FOUNDATION FRAMEz INSULATION �E FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING 1 u DATE CLOSED OUT ti ASSOCIATION PLAN NO. f ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street t Boston,AM 02111' wrdw.mass.gov/dia ' Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name(Business/Organization/Individual):. L ' C&AAr c G Address: r' / / a ✓�� � tAr f$-T©r7 City/State/Zip: Phone.#: 0/70 e 3 3?0 Are you an employer?Check the appropriate bog: :Type of project(required)-. 4. g I am a general contractor and I 1.[�I am a employer with / 6. ❑New construction . employees(full and/or part time).*• have hired the sub-contractors 2.❑ Tama'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling shipand have no employees These sub-contractors have g, ❑Demolition caemployee$and have workers' '�yorking for me in any capacity. $. 9, ❑Building addition [No workers' comp,m uranee comp.insurance. 10.❑Electrical repairs or additions required.] 5• ❑ We are a corporation and its '3.❑ I am a homeowner doing all-work . officers have exercised their 11.0 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 13.❑ 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 mutt 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 ornot those entities have employees. if the sub-contractors have employees,they must provide their workers'camp.policy number. I ant 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.Lie.A /-5�? ?O(b Expiration Date: Job Site Address: 3a iti 6 City/State/Zip: t 1 ' (6 D . Attach a copy of the workers' compensation policy declaration page'(showing the policy nun 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 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 maybe forwarded to the Office of Investigations of the WA for insurance coverage verification. I do hereby certify un et t e pains•and penalties of perjury that the information provi /d 'ed a ovg is true and correct. Si tore: /L �r r< Date• / //7',/ Phone k _ 53 Official use only. Do not write in ihis'area, tb be completed by.city or town off ciaL 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#: RightFax N3-3 10/3/2007 10:45:18 AM IJAUt OU;SiUUJ rax suz"vvi, ACORD. CERTIFICATE OF INSURANCE- DATE(MMIDDIYY) 10-03-07 PRODUCER 'THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE _ PAUL PETERS AGENCY INC HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 6 FALMOUNTH HEIGHTS ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.. PO BOX 669 COMPANIES AFFORDING COVERAGE FAL MOUTH,MA M54I COMPANY 25TSR A TRAVELERS 0112ECT A,%TGNMEINT INSURED COMPANY B M L CONSTRUCTION COMPANY INC COMPANY 651 RIVER ROAD C MARSTONS MILLS,MA 02648 COMPANY D r COVERAGES THIS IS TO CERrIPT THAT THZ POUCIES OF INSURANCE LISTED BELOW HAVE BEEN 1531JEO TOTH!INSURED NAMED ABOVE FOR TH8 POLICY PERIOO INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TCAM 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 113 SUBJECT TO ALL THE TERNIS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. CO POLICY EFF POUCY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM10D%YY) DATEi(MMIDDIYY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL PRODUCTS-COMPAOP AGO. S CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNER'S"CONTRACTOR'SPROT. EACH OCCURRENCE S FIRE DAMAGE(Any one fire) S MED,EXPENSE(Anyone Parton) -S AUTOMOBILE LIABILITY ANY AUTO COMBINED 31NGLE LIMIT S ALL OWNED AUTOS BODILY INJURY(Per Peron) SCHEDULE AUTOS BODILY INJURY(PerAccidanq S HIRED AUTOS PROPERTY DAMAGE S NON-OWNED AUTOS GARAGE LIARRM ANYAUTOS AUTO ONLY-EA ACCIDENT S OTHER THAN AUTO ONLY: EACH ACCIDENT S AGREGATE S EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE X WORKER'S COMPENSATION AND A EMPOLYCR'SLLACILMY UB-988X75E7-07 03-19-07 03-19-08 STATUTORYLIMITS X THE PROPRIETOR/ EACH ACCIDENT S 100,000 PARTNERS/EXECUTIVE X INCL DISEASE•POLICY LIMIT S 500,000 OFACER$ARE: EXCL DISEASE-EACH EMPLOYEE S 100,000 OTHER DE:CRIPTION OF OPCRATIONSILOCATIONSNENICLES)RESTRICTI=JSPECLAL ITEMS THIS REPLACES ANY PRIOR CUTIFICATE ISSUED TO THE CWIFICArE HOLDER AFFECT;NG WORKEM COMP COVERAGE, CERTIFICATE HOLDER CANCELLATION j SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL EED BEFORE THE EXPIRATION DATE TOWN OF BARNSTABLE,BUILDING INSPECTOR THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 19 DAYS WRITTENLNOTICE TO,THE CERTIFICATE MOLDER NAMED TO THE LEFT,BUT FAILURE TOtnnAL SUCH NCTICIE SHALL q' IMPOSE 367 MAIN ST. NO O&IGATION OR LLABILITY OF ANY KIND UPCN THE COMP Y IT$AGENTS GR REPRESENTATIVES. .£ _ HYANNIS,MA 02601 AUTHORIZED RCPRCSCNTATIVE s 6y Charles J Clark ACORD 25-5(3193) 0 Z00'd T7F960i9809 'Ib3 'SKI SHalad JfiVd L6:60 LOOZ-60-AOH OF1HE ro Town of Barnstable Regulatory Services * BARNSTASLE. 9 MASS. �,, Thomas F.Geiler,Director 16 ,39. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us ' I i Office: 508-862-4038 Fax: 508-79076230 I I Property Owner Must Complete and Sign This Section If Using A Builder I, L. , 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 Job) Signature of Own y ,t Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. I Q:FORMS:OWNERPERMISSION THE Town of Barnstable t)F 1p� Regulatory Services BARNSTABLE, Thomas F.Geiler,Director 9 MASS. g 1e39• ,0 a Building Division �ATEn H10� Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstA1e.ma.us Office: 508-862-4038 Fax: 508-790-6230 ------------ HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phon # work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to i lude owner-occupied'dwellings of six,urits or less and to allow homeowners to engage an individual for hire„who es not possess a license,provided that the owner acts as supervisor. . " DEFINITION O HOMEOWNER Person(s)who owns a parcel of land on which heishe rest es or intends to reside, on which there is, or is intended to be, a one or two-family dwelling,attached or detached s ctures accessory to such use and/or farm structures. A person who constructs more than one home in a tiwo-ye period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the bui in ermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibih for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/ e understands the Town of Barnstable Building Department minimum inspection procedures and requireme is and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dw lings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 1 .0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: " y homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1,1 - censing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shal act as supervisor." Many homeowners o use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licen ng Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires un]censed 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:foi- s:homeexempt t Construction Managers Transmittal Cover Sheet 80 First Street Bridgewater,MA 508-279-0012 Cromwell Court Project# 5293 Callahan, Inc. 168 Barnstable Road Tel: Fax: Hyannis, MA 02601 D. 1 , 11 , °Rom';^: m.�iy '" v" E` " '. ', R '�,,. •• >, 7 ransmlttedTO ��, f, 1?ranSmlttec! Thomas Perry Building Commissioner Rachel Aprea - To of Barnstable=Hyannis-Building wn Division Callahan, Inc. 200 Main Street 80 First Street Hyannis, MA 02601 Bridgewater, MA 02324 Tel: 508-279-0012 ext. 122 Fax: 508-279-0032 Package Tr nsmltted�For� �� '� � a F� �� ®Iive�,redVa�� �� ,�� Tracking Number�k;;�� UPS t.=-.^° a '� ..ate c �! M�t '"an Item#•,.�Qty, ItemY Reference Descrit�o w Notes x ;5#atus 'Cc Com an `N�me& 'M7 �f ` Contact Name C e0 1 8 'W NOte$ y ME- Original Final Affidavit from Davis Square Architects for Cromwell Court-Permit#620102595 for your records. Thank You! a. co NO u.. i Signature Signed Date Prolog Manager 0 Printed on: 11/7/2011 Page 1 FINAL AFFIDAVIT ARCHITECTURAL DESIGN Permit No. V> 20 T 25a 5 . To the Commissioner, Inspectional Services Department: Re: Building Division, Town of Barnstable-Hyannis Address 200 Plain Street, Hyannis, MA 02601 I certify that to the best of my knowledge, information, and belief, the work at Cromwell Court Apartments, 168 Barnstable Road, Hyannis, MA has been done in conformance with the permit and plans approved by the Building Division, Town of Barnstable-Hyannis and with the provisions of the Massachusetts State Building Code and other pertinent laws and ordinances known to me. Clifford J. Boehmer #10697 y — ,�V.E D AROy �� �T OrvlEe � Architect — Mass. Reg. No. �cR `cam ,":) ,max 1 o 6 Davis Square Architects, Inc. 4. GE. ® Company100 9A v 2� 5Pv 240A Elm Street, Somerville, MA 02144 ®�prH OF 0P��� Address a` 617-628-5700 Phone October 25 , 201 1 Then personally appeared the above-named Clifford J. Boehmer and made oath that the above statement by him is true. Before me, , Y KATRINA VOSGHANIAN Notary Public My Commission expires t CommonweaRh of Massachusetts My Commission Expires November 1,2013 t , 1�Tj 1,3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map _.aX Parcel , 013 Application # �� S f Health Division Date Issued Conservation Division Application Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ) Pf Historic - OKH Preservation/Hyannis Project Street Address $ r�(�ln'str,�b�e Y'r��} 10DAy5 mck Gab0 4 Village b a(i(lnfCd0ke T Owner tt St oimAbo Ylmt DYAD Address 4n ChMMMj.11QCLL*h GCL1on0 Q Telephone -01 R.A Permit Requestt� r" Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Totinewc) Zoning District Flood Plain Groundwater Overlay Project Valuation a Construction Type 'cam Lot Size' Grandfathered: ❑Yes ❑ No If yes, attach supporti g docu` ient�ti'on. 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 e 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 peals Authorization ❑ Appeal # Recorded ❑ Commercial es ❑ No If yes, site plan review# Current Use Proposed Use - - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name'lfin V 1 0 praffl MenT Telephone Number 69�-77 S= 17�Ff Address �Q_ G (ri 5iu-b ie- License # 10315 7 U�U an in 1 S Home Improvement Contractor# W Lf 3 Worker's Compensation # 700 Ll6t Lf 36 1Z-6 D R _ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN T04M(k Jh �( SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# ti= DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION } FRAME INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED,OUT ASSOCIATION PLAN NO. r 1 � The Commonwealth.of Massachusetts �\ Department of Industrial Accidents 42) office of Investigations 600 Washington Street Boston,MA 02111 www.mass-gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/P�Le ibl W. P Please Prj l!cant Information � -�- vame(Business/otganization/Individual): kddress: y p: Phone.#: iq)% 7l T_ Cn wit /St e/Zi re y an employer?Check the appropriate box: Type of project(required): I am a employer with 4. ❑ 1 am a general contractor and I 6 ❑New construction have hired the sub-contractors employees•(full and/or part-time)•* listed on the:attached sheet. 7. ❑Remodeling ❑ I am a sole proprietor or partner- These sub-contractors have g; ❑ Demolition ship,and have no employees employees and have workers' 9 ❑Building addition working.far me in any capacity. comp insurance.$ [No workers'comp,insurance 5 ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] exercised their 11. Plumbing repairsror additions ] exert q officers have ❑ ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers'comp. p p 12.[']Roof repairs c. 152, §1(4),and we have no 13.�Other insurance required.]t employees. [No workers' comp.insurance required.] ,y applicant that checks box#1 must also fill out the swoon below showing.their workers'compensation policy information. omeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new,affidavit indicating such. ntraetors that check this box must attached an additional sheet.showing the name of the sub-contractors and state whether or not those entities have loyees. If the sub-contractors have employees,they must provide their.workers'comp.policy number. m an employer that is providing workers'compensation in for my employees. Below is the policy and job site brmation. urance Company Name: Gl 1�1(1U 1- ` i icy.#or Self-.ins.Lic.M ��ua I��L�g Expiration Date: [•1 1 1 Site Address:h G` 6(�(� � City/Stale/Zip:AfiU :ach a copy pf the workers' compensation policy 4eclaration-page(showing the policy number and expiration date). lure,io secure coverage as required under Section 25A of MGL e. 152.can lead to the imposition of criminal penalties of a µp 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 r ip to$250.00 a day against,the violator. Be advised that a copy of this statemerit may be forwarded to the Office of esti ations of the WA for ins v a e verification Y hereby cerd u e aln nd penalties of perjury that the information provided above Is true and correct. ®8.. .-Date: °L-5° — ;nature: ne Jficlal use only. Do not write In thislete area, ib be compd by city or town offlclaL 'ity 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 i.O.ther �ontact Person: Phone#: v^:Y. - .ue.-a.aa.» .. �a�s:..�ti �3':t?�cS' EY;•3•N� sa?NF ._.�:V1• �rr n ,e ,;.:��:;s.: ,...... ..- .,,: . DATE(MM,OD/YYYY) ACORv CERTIFICATE OF LIABILITY INSURANCE OP SPRIN- 1 F05 09 O8 PRoolevR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden s Sullivan Ins Agency HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Fax: 508-790-1414 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Associated Industries of MA , INSURER S. Sprinkle Home Improvement Inc. INSURERc. 199 Barnstable Rd NsuRERO: Hyannis MA 02601 - 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 RNO CLAIMS. POUCYEFFE TIVE POLICY EXPIRATION - LTR NSRO TYPE OF INSURANCE POLICY NUMBER DATE MMlDD/TY DATE(MMiDD/Y LIMITS GENERAL LIABILITY EACH OCCURRENCE f r7COMMERCIAL 3ENERAL LIABILITY FREMISES(Eadtturence) 3 I CLAMS MADE OCCUR .. MEO EXP(Anyone person; 3 ' , PERSONAL E AOV INAXZY 3 ---_— GENERAL AGGREGATE S OEN'L AGOREOATE LNIT APPLIES PER: I PROOLCTS-COMPA7P AOG I f I POLICY 7IECo- Lac AUTOMOBILE UISSITY COMBINED SINGLE UNIT —AUTO I (Ea accident) IJ'f ALL OWNED AUL09 I BODILY INJURY I3 SCHEDULED AUTU9 (Per person) NIREC A7TOS • BODILY!NDJRY I NON-OWNED AUTOS i (Per accidanq 4f PROPERTY OMIACE 3 (Per accident) GARAGE LIAEILRY I AUTO ONLY•EA ACCIDENT 11 ANY AUTO 07FER THAN EAA.CC $ AUTO ONLY. AGO s E%CESR'VNBRELIAIUBIUTY EACH OCCURRENCE $ OCCUR �CLNMS MADE .AGOREGATE $ f 1 DEDUCTIBLE f REJIS TICN 3 _ ---��--- •- WORKERS CCMPINSATION AND - TORY LIMITS ER A EMPLOYERS LA"UTY AWC7 0 04 9 43 012 00 8 Ol Ol OB 01 01 09 L.EACHACCIDENT ;s 500000 ANY PROPRIETOR/PARTNEUXE(VTIVE _ OFFICERNEMVER EXCLUDED? E:.C/SEAS.E•EA EMPLOYEE If 500000 Ifyee,deecrai Inner F SPECIAL PROYLSIDHS ee!m E.L.d5EA9E•POLICY LIMIT Is 500000 OTHER OE SCRIP7ION'0►OPERATIONS/LOCATIONS%VEHICLE$I EXCUISIONC ADDED EY ENDORSEMENT/SPSCUL PROVISIONS - CERTIFICATE HOLDER CANCELLATION SPRNKHO INOULD ANY OF THE ASOVE OEBCRISED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL i0 DAYS WRITTEN Sprinkle Home Improvement, Ina NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00$0 SMALL Fax 8508-775-1350 Margo Mack IMPOSE NO OBLIOATION OR LIABILITY OF ANY KIND'UPON THE INSURER ITS AOENTS OR 199 Barnstable Rd. REPRESENTATIVES. Hyannis MA C2601 AUTHORIZED REPRESENTATIVE --cl-Kelley A.Sullivan ACORD 25(2001108) O ACORD CORPORATION 1988 f 13ou0`61 Bolding 12egul'a ions m StnnzGrctlti Eonstruc#ion Supervisor License Lrc:ense: CS 6643 t Expiration: 10/8/2009 Tr# 9427 Rd.sfel dion 00 BRA')K SPRINKLE 190 LOLHROPS LANE - W BARNSTAB'LE,MA 02668 comilli's:sio'irer I 00-35,000 cfienclosed^spae:e IA-1Vlasonry ori:l;y ' 1<G 1 2 Family Hon?'es Failure to-possess•a••ctrrrent ed°it�on of>t=he M'assachuseits State R.uildtng,Cgd'e i is cause for revocation of thtsaicenS:e: l Board-ofTuilding ltegulafi.ons anil:;Standards facia;. HOME IMPROVEMENT CONTRACTOR Lf `1,3 Ug- - Registration: 103757 Expiration 7/9/2010 Tr# 271:033 Type. Private Corporation SPRINKLE HOME IMPROVEMENT, INC. 136d :Spritikle Hyannis, MA-02601 AJmimsfr."a`•to� License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,.Ma.02108 Not valid wit out sig ture 1 1591 mmi TDD 1-800-232-0782 rATE STREET DEVELOPMENT FAX (617) 236-1809 MANAGEMENTCORD 488 COMMONWEALTH AVENUE, BOSTON, MASSACHUSETTS 02215 • (617) 262-9800 May 6, 2008 Mr. Brad Sprinkle Sprinkle Nome Improvement 199 Barnsr_able Road Hyannis, NIA 02601 RE: Cromwell Court Apartments—Installation of Vinyl Siding Dear Mr. Sprinkle: Enclosed is a signed Owner and Contractor Agreement for the work to be completed at the above referenced property. Sincerely, / Sam Marino Regional Manager SM/dv Enclosure pGQo pp 9cf�FNl ORGPaihPu ACCREDITED MANAGEMENT ORGANIZATION® *7�f'` 0' rF j t t— TOWN OF BARNSTABLE.BUILDING PERMIT APPLICATION Map � t Parcel` (�� Application #a?66 k6 603 9 Health..`Division Date Issued Conservation;Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Ca Project Street.Address I �� &ur f15+ab e- Kp qcA , 01.�C1.1 n t t) Ma oa(go l Village . ���(nS�LI���.. DcYsmr) OwnerSf(AL 5fi( 1 �UuMP_1'1T �GnniT Address Telephone_ - (�G -a3a ' a��a Permit Request _115nu l tdd tm f Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new, Zoning District Flood Plain Groundwater Overlay Project Valuation aL1,500 Construction Type cv �" Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supp ing 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: ❑1 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial t/Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) Nam4r►we_ Ww"e- �w►p(ay"Ent Telephone Number 50$-l1 S - 1`l18' Address (q9 RW(1)D W01e Pod License # 10512 4uG.nm w(A 6x01 Home Improvement Contractor#, Worker's Compensation # -100 LI q 4 30 I aw a' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO garnoc th I.F,VYI� -rit.1 SIGNATURE DATE W Z� f FOR OFFICIAL USE ONLY . - APPLICATION# DATE ISSUED _ MAP/PARCEL N0. ADDRESS VILLAGE OWNER- DATE OF INSPECTION: J FOUNDATION { FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH 'FINAL PLUMBING: ROUGH FINAL GAS: ROUGH - FINAL = FINAL BUILDING _ f DATE CLOSED OUT ASSOCIATION`PLAN NO. r The Commonwealth.of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia rs orkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians nt Le ibl �! P Please Pr � licant Information, � •-�- vame(Business/otganization/Individual): kddress: �qci ���� � oil ��, Y1tS (mOL Phone.#: L 71 S l`l7 amity/St e/Zip:��h re y an employer?Check the appropriate box: ff6. 6E:] f project(required): I am a employer with 4. E] I am a general contractor and I New construction have hired the sub-contractors employees(full and/or part-time).* listed on the:attached sheet. 7. ❑Remodeling ❑ I am a sole proprietor or partner- These sub-contractors have g: ❑Demolition ship and have no employees employees and have workers' . 9 ❑Building addition working.for me in any capacity. comp insurance.# [No workers'comp.insurance 5 ❑ We are a corporation and its 10•❑ Electrical repairs or additions required.] officers have exercised their 11.❑ Plumbing repairs or additions ❑ I am a homeowner doing all work right of exemption per MGL 12.• Roof repairs myself. [No workers'comp. �, 152, §1(4),and we have no insurance required.]t 13. Other V1 .employees. [No workers' comp, insurance required.] ty applicant that checks box#1 must also-fill out the section below showing their workers'compensation policy information. submit this affidavit indicating they are omeowners who doing all work and then hire outside contractors must submit a new,affidavit indicating such. Dmeo ors that check this box must attached an additional sheet.showing the name of the sub-contractors and state whether or not those entities have lloyecs. If the sub-contractors have employees,they must provide their.workers'comp.policy number. m an'employer that is providing workers'compensation insurance for my employees Below is the policy and job site brm ation. ►/l t�nr� trance Company Name: is . #:1�O�Q �I�l)�g Expiration Date: Y#or Self-ins,Lie. , Site Adciress:� t � P t City/State/Zip: , :ach a copy 9f the workers' compensation polkydeclarationpage(showing the policy number and expiration date). lure fo secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a :µp to$1,500.00 and/or one-year imprisonm f a STOP WORK ORDER and a ent,as well as civil penalties in the form o fine Y >p to$250.00 a day against.thF violator. Be advised that a copy of this statement may be forwarded to the Office of esti ations of the WA for ins v a e verification 7 hereby Gerd u e aln nd penalties of perjury that the information provided above is true and correct. oa mate:.. nat ue: ne .�t✓�- S— 1��� Tfficial use only. Do not write In this area, to be completed by city or town offlclat :�ity or Town: Permit/LIcense# Esstung Authority(circle one): L.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector i.Other' , Phone#: �ontact Person: ACORN 6801FICATE OF LIABILITY INSURANCE DATE,MMN°YYYY) OP ID DS SPRIN-1 05 09 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE $ryden & Sullivan Ins Agency HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Fax: 508-790-1414 INSURERS AFFORDING COVERAGE NAIC$1 INSURED HSORERK Associated Industries of MA NSURER B. Spprinkle Home Improvement Inc. tURSR R C. 199 Barnstable Rd D: Hyannis MA 02601 — I TEiURER 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. POUCYEFFECTIVE POLICY EXPIRATION LTR NERD TYPE OF INSURANCE POLICY NUMBSR DATF MNIlDO/YY DATE MM/DOIY LIMITS OENERALLIABILITY I EACHOCCURRENCE $ _- .I f.OMMERCUI GENERAL LIABILITY I FRFN'JSES(Eabaurence) $ I CLAMS MADE OCCUR. .. MEO Ew(Ary one person; PERSONAL RADV NJUIZY S GENEPAL AGGRECr\TE S GEN'L AGOREOATE UNIT APPLIES PER: I PRODUCTS•COMP'CP AGO Is POLICY �Ea LOC i AUTOMOBILE LIABILITY COMBINED SINGLE UNIT ANY S AUTO (Ea accuent) -- ALL OWNED A.UTO'a --- BOOIU'INJURY I S SCKEGULED AUTOS (Per persoA) HIRE.AUTOS BOOILY!NAJRY �S 14011-OWNED AUTOS i (Per accident) PROPERTY OMIAGE I S (Per accident) OARAOE LIABILITY I AUTO OILY-EA ACCIDENT f' MY AUTO I OTFOR THAN F.AACC I3 AUTO ONLY: AGO is EXCESC.'UNBRELA LIABILTY EACH OCCURRENCE Is OCCUR CLAIMS MADE .AGGREGATE 3 $ 1 DEDX:TIBLE f REJENTI',N WORKERS COMFUIDATION AND 11 TWCST'TU-ORYUMIIS ER EMPLOYERS'UA31UTY A AWPROPRIETOR/PARTFERIEXECUTNE AWC7004943012008 01/01 08 01/01/09 L.EACHACCIDENT s 500000 OFFICERNEMBER E000IDEDT EL.DISEASE-EA RdPLAVEE I3 500000 it Yes•describe War SPECWL PROYLSIONS below E.L.DISEASE-POLICY LIMIT IS 500000 OTHER DESCRIPTION-OF OPERATIONS I LOCATIONS/VENICUBB I EXCLUSIONS ADDED SY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SPRNKHO EHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUINO INSURER WILL ENDEAVOR TO MAIL 1O QAYSWRITT'EN Sprinkle Home Improvement, Inc NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL sax #508-77E-1350 Margo Mack IMPOSE NO OBLIOATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AOENTS OR 199 Barnstable Rd. REPRBBENTATNEE' Hyannis MA 02601 REPRESENTATIVE [AUTHORIZED Kelle A.Sullivan ACORD 25(2001/08) OACORD CORPORATION 1988 Boa 61 Building Regul.ii cans ird St�ndaI ds -,p Cori'§truction Supervisor Licen'Se . License:CS 6643 Expiration: 1:0-/8/2009 Tr# 94.27 Restriction: 00 BRA).K SPRINK E 190 LOrHRO.PS LANE W BARNSTABLE. MA 02668 C'onuri'ission'ci• 0.0-35;000 rf}enclos_ed'space' 1-A-Masonry:only I ''es i 1�G- 1 2 li am'�ly 1•Ioi : iia.ilure to:Possess a,c:urrent e0ition;of t-he Massachusetts State B.uildmg Cgd'e i is cause for r:e.vocation of.this.F�cense: rF lie r r-:eie' e ;a Board=oG:Building Regllations and Standards }J� k' t �ij,'• HOME IMPROVEMENT CONTRACTOR Registration: 103757 Expiration 7!9/2010 Tr# 27103.3 Type: Private Corporation .SPF2INKLE HOME IMPROVEMENT, INC. BYad:..855prinkle -. 19G Barnstable Rd. Hyannis, MA-O2601 A lministrator License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 Not valid wit out Sig ture I ME 11 El 1) . I . TDD 1-800-232-0782 699MM C 'E STREET DEVELOPMENT FAX (617) 236-1809 MANAGEMENTCOR2 488 COMMONWEALTH AVENUE, BOSTON, MASSACHUSETTS 02215 •(617) 262-9800 May 6 2008 Mr. Brad Sprinkle Sprinkle Home Improvement 199 Barnstable Road Hyannis, MA 02601 RE: Cromwell Court Apartments—Installation of Vinyl Siding Dear Mr. Sprinkle: Enclosed is a signed Owner and Contractor Agreement for the work to be completed at the above referenced property. Sincerely, Sam Marino Regional Manager SM/dv Enclosure G3GOp� + •�vsf�fNT OROPa+�po ACCREDITED MANAGEMENT ORGANIZATION® b i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 6 o Parcel' O L Application # Health<Division Date Issued 1 Lf Lez Conservation Division Application FJ 2 Planning Dept. Permit Fee Date Definitive Pian!Approved by Planning Board /,� Historic - OKH Preservation/Hyannis fi Project Street'Address . GL(w5twoke Pwa 4pon iS fflao (oo 0 Village d &UQ,�W� T- V- Owner �fi(.Q('� •m� Address u$$ I.QYYIPYICW11.UQCLA4) G UPyltX Telephone l J 00 -& A-0_1 g of Permit Request .Wiwi : dim CD __. 1 NJ 7 71..I Square feet: 1 st floor: existing proposed 2nd floor: existing proposed _Tcz al new; Zoning District Flood Plain Groundwater Overlay co Project Valuation r� O Construction Type o m Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Sing e 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 Apoeals Authorization ❑ Appeal # Recorded ❑ Commercial N,,Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION -- -- . _ (BUILDER OR-HOMEOWNER) -- Name �bCiAkLlk_ WOme_ T_M ,2r6Ya MT Telephone Number Address 09 -7'ba(r6abl - License# L0M Sr7 I�TUGIi�Y�1S �Gl lJa-l�G 1 Home Improvement Contractor# CQ Worker's Compensation # -100gQtL4 kjO I GIOQ'W _ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO I SIGNATURE DATE l Z�• yo FOR OFFICIAL USE ONLY APPLICATION# ` DATE ISSUED ' MAP/PARCEL N0. ADDRESS VILLAGE OWNER i l DATE OF INSPECTION: I FOUNDATION i FRAME INSULATION I FIREPLACE S ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r t y i The Commonwealth.of Massachusetts Department of Industrial Accidents Office of Investigations Street 600 Washington . Boston,MA 02111 www.mass.gov/dia VJ kers, Com ensation Insurance Affidavit: Builders/Contractors/Electricians/Plulribibl Wor P Please Print L Y kpp)!cant Infor nation vame(Business/Organizat'on/Individual): kddress: tqci VIUI(�j1i'1lS {�G� Phone.#: amity/St e/Zip:______v •re y an employer?Check the appropriate box: Type of project(required): 4. I am a general contractor and I I am a employer with 6. ❑New construction have hired the sub-contractors employees.(full and/oat-time)•* listed on the:attached sheet. 7. ❑Remodeling ❑ I am a sole proprietor or partner- These sub-contractors have g: ❑Demolition ship.and have no employees employees and have workers' 9• ❑Building addition working.for me in any capacity. comp insurance.t [No workers'comp,insurance 5 ❑ co are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 11.❑ Plumbing repairs or additions ❑ I am a homeowner doing all work right of exemption per MGL 12.❑Roof repairs myself. [No workers'comp. 152, §1(4),and we have no cs� insurance required.]t 13.( Qther � employees. [No workers' comp. insurance required.] ty applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. omeowners who submit this affida•�it indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ntractors that check this box must attached an additional sheet.showing the name of the sub-contractors and state whether or not those entities have rs'comp.policy number. rloyees. If the sub-contractors have employees,they must provide their.worke m an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site brmation. _ l - urance Company Name: t .[t►Y � U�CL �— � icy.#or Self-ins.Lie.#: Expiration Date: i Site Address: 1 k) QA City/State/Zip: VILiej M Ck--00-0 ' :ach a copy 9f the workers' compensation policy 4eclaration page(showing the policy number and expiration date). lure.to secure coverage as required under Section 25A of MGL•c. 152.can lead to the imposition of criminal penalties of a _4 lip to$1,500.00 and/or one-Year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine. ip to$250.00 a day against.thq violator. Be advised that a copy of this statement maybe forwarded to the Office of esti ations of the WA for ins v a e verification. i hereby certi u e ain n penalties of perJury that the information provided above is true and carrec� Date: nature: ine ��- 5 «�9 Yfcial use only. Do not wri.,e in this area, to be completed by city or town offlciaL 21ty or Town: PerwiMicense# issuing Authority(circle one): L.Board of Health 2.Building Department 3.Cityrrown Clerk 4.Electrical Inspector 5.Plumbing Inspector i.O.ther- �ontact Person: Phone#: ,� +aann. ,/n-.3Jh'i L.eilCn'�4iP&Ts4':9?&.�.?%w=� .., +:.&�F•F en1�YiS-:.5^.S�PR:x'?�aZ1..T�C1t�c"S2ln.'Z!.»Fi1-_.4=.S`.¢'h%P...;k�. , ACV-0 CERTIFICATE OF LIABILITY INSURANCE OP ID DS DATE(MMMOlYYYY) SPRIN-1 05 09 O8 P�oouceR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden s Sullivan Ins Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Fax: 508-790-1414 INSURERS AFFORDING COVERAGE NAIC# INSURED ------ IISURERA---Associated Industries of KA — --------.— INSURER B. Sprinkle Home Improvement Inc. t-u ERC. 199 Barnstable Rd ER0: Hyannis MA 02601 — MURER 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. POLICY EFFECTIVE POLICY EXPIRATION LTR NtRD TYPE OF INSURANCE POLICY NUMBER DATE MM(DOUTY DATE IMM/DDfYY LIMBS OENERALLULSILTY ( EACH OCCURRENCE $ COMMERCM GENERAL LIABILITY MN (Eao I IC NU Ge) S I CLAIMMADE GCCUR PR I - ! _ IIEO EXP(Ary we person; S _----- PERSONAL EADV NJURY S I GENERAL AGGREGATE f OEN'L AGGREGATE UNIT APPLIES PER: PRODUCTS-COMPA7P AGG 14 PRO POLICY JECT LOG AUTOMOBILE UAE UrY - COMBINED SINGLE UNIT iANYAUTO I (Ea"C""') I. ALLOWNEDAUTOS I . BOOILI'INJURY I S 9CHEQXLEO AUTOS per person) HIRED A'JTOS BOOILY!NDJRY I S NON-OWNED MOB i (Per a"iden!) 6 PROPERTY DMiAGE 14 (Per acddenl) OARAOE LIABILITY AUTO ONLY-EA ACCIDENT III- .WY AUTO I OTHER THAN F.AACC I f A.1TO ONLY: AGO f E%CESR'VNBRELIA LIABILITY EACH OCCURRENCE 4 OCCUR CLAWS MADE .AGGREGATE $ 4 1 UEDIJCTEILE -- f REJENTION $. -- WORKERS COMP (SATIONAND TORYUMITS 1 ER A EMPLOYER"ABILTr ANY PROPRIETOWPARTNER�EXECUTNE AWC7004943012008 01/Ol OB Ol/O1/O9 .I.EACH ACCIDENT s 500000 OFFICERMEMBER EXCLIZED7Ify.s E..DISEASE EA FIdPLOYEE IS S00.000 SK6L a PROYISraer E.L.dSEASE•POUCY UNIT is500000 SF£CIAL PRONSIONS below OTHER D6SCRIPTION'OF OPERATIONS/LOCATIC NE%VIHICL.S I I EXCLUSIONS ADDED EY ENDOR55MENT U SPECIAL/ROVI PONS CERTIFICATE HOLDER CANCELLATION S+lORNKHQ tNOVLOANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION GATE THEREOF,THE I5SVINO INSURER WILL ENDEAVOR TO MAIL 0 GAYS WRITTEN Sprinkle Home Improvement, Inc NOTIOE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Fax #508-775-1350 Vargo Mack IMPOSE NO OBUOATION OR LIABILITY CIF ANY HIND UPON THE INSURER,ITS AGENTS OR 199 Barnstable Rd. RE/RESENTAT Vi1. Hyannis MA C2601 AUTHORIZED REPRESENTATIVE ]-Kelley A.Sullivan ACORD 25(2001/08) OACORD CORPORATION 1988 L do If d.ot l3ufldint Rcgul;rh ons an'd . eml srrrtti Construction SupeeVISor Lice.nso sm , * C License. CS 6643 s . E-01ration: 10/8/2009 Tr# q'}`2:7 Restriction: 00 BRAD.K SPRINKLE 190 LOTH'ROPS LANE W BARNSTABL-E,MA 02668 Co Innti:'Wo rer i . I 0.0-35,000 cG=enclosed'spac:e' I A-M-490nry:on:l;y 1•.G-1 2 Fam!ily Homes ` Failure toapossess a•,current ed'.ition:o`f°the Massachusetts State-Buildtng:Cod'e l is c'a%use for revocation of.thls license: l -j ..............._... Board of'Building Regulationsan'd Standards It + I�" HOME IMPROVEMENT CONTRACTOR ti Registration: 103757 Expiration. 7/5/2010 TO 271-033 Type: Private Corporation SPRINKLE HOME IMPROVEMENT, INC. Brad:.Sp;rinkie 199:132irnstable Rd. Q Hyannis, MA 02601 Ailmimstrato'i License or registration valid for individul use only before the expiration date. If found return to: s' Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 'Not valid wit out sig ture , 5 nn nn"Enni I I�nn 1691mm cc TDD 1-800-232-0782 rATE STREET DEVELOPMENT FAX (617) 236-1809 MANAGEMENTCORP 488 COMMONWEALTH AVENUE, BOSTON, MASSACHUSETTS 02215 •(617) 262-9800 May 6, 2008 Mr. Brad Sprinkle Sprinkle Dome Improvement 199 Barnstable Road Hyannis, MA 02601 RE: Cromwell Court Apartments — Installation of Vinyl Siding Dear Mr. Sprinkle: Enclosed is a signed Owner and Contractor Agreement for the work to be completed at the above referenced property. Sincerely, Sam Marino Regional Manager SM/dv Enclosure ,4 0 �. ' 'A' 0R6P�+,'p° ACCREDITED MANAGEMENT ORGANIZATION® H i I Message Page 1 of 1 Barrows, Debi From: Buntich, JoAnne Sent: Thursday, October 30, 2008 12:11 PM To: Barrows, Debi Subject: Cromwell Court Debi, I have reviewed siding material samples for Cromwell Court as submitted by Sprinkle Home Improvements. Under the design & Infrastructure Plan provisions, I approve the Wolverine Millennium siding Sterling Gray (33) for the Cromwell Court buildings. IS will be getting me set up in MUNIS shortly. Thanks very much, Jo Anne Jo Anne Miller Buntich Assistant Director Growth Management Department Town of Barnstable 367 Main Street Hyannis, MA 02601 p 508 862 4735 f 508 862 4782 Joann.buntichaa.town.ba,rnstable.ma.us 10/30/2008 f Swiniarski, Ellen From: Daley, Patty Sent: Tuesday, October 28, 2008 1:18 PM To: Swiniarski, Ellen Cc: Buntich, JoAnle Subject: Cromwell Court vinyl siding Hi Ellen, Please have them send a sample of the siding they want to use to Jo Anne. We're not necessarily opposed, but want to see the quality of the materials they are proposing. Patty Daley .Interim Director Growth Management Department 508-862-4768 I 1 I�_ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map .3 r Parcel-0113 Application #0?06 0 663 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board o Historic - OKH Preservation/ Hyannis . Project Street Address 1e_ �iUQhV115 MCA 0aLaO1 Village larA ttkb1e_ - ,; k F Ownera[ke NIM-r 01�LWment Mat) Address U W CO•YY ODLML.-)&JAh C) D Telephone Permit Request 0 nut ilcu Q f ^y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay to Project Valuation 3 i 50 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$Highwaya ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other _ Basement Finished Area (sq.ft.) Basement Unfinished Area (sc Number of Baths: Full: existing new Half: existing new G` : Number of Bedrooms: existing —new r.' CD rn Total Room Count (iot including baths): existing new First Floor Rool 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 24es ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) Name Soryo ILLe Itfl-' Telephone Number 50 8'--P S — l�i`18 Address M 9 barn-stab le- &A•O License# 1031 S_"? 4nr\15 MCA 0-a'&01 Home Improvement Contractor# cto q5 ' Worker's Compensation #100 Li q u 3a( za 6 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO U- 4 SIGNATURE DATE ZY, OR l r. FOR OFFICIAL USE ONLY I y APPLICATION# ;z DATE ISSUED l F MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION:. FOUNDATION - FRAME i INSULATION e FIREPLACE t t ELECTRICAL: ROUGH - FINAL PLUMBING: ROUGH FINAL rf_ "GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION,PLAN NO. rY ") The Commonwealth.of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia idavit: Builders/Contractors/Electricians/Pluuibers Workers' Compensation Insurance Aff Please Print Legibly licant Information name(Business/Organization/Individual): �pf�n kddress: ;ity/S e/Zip: A�t1h15 �OL _ Phone.#: �$—� i TV? .re y an employer?Check the appropriate box: Type of project(required): I am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction have hired the sub-contractors employees(full and/or part-tim.e).* �7, ❑Remodeling ❑ I am a sole proprietor or partner- listed on the:attached sheet. These sub-contractors have g; ❑Demolition ship andhave no employees employees and have workers' 9 ❑Building addition working.for me in any capacity. comp insurance.t [No workers'comp.insuance 10.❑Electrical repairs or additions required.] 5• ❑ We are a corporation and its officers have exercised their 11.❑Plumbing repairs or additions ❑ I am a homeowner doing all work right of exemption per MGL 12.❑ Roof repairs myself. [No workers'comp. .c. 152,§1(4),and we have no insurance required.]t ees e to o workers' 13.Wther employees. [N comp.insurance required.] iy applicant that checks box#1 must also fill out the sectionbelow showing.their workers'compensation policy information. omeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new,affidavit indicating such. ntractors that check this box must attached an additional shect.showing the name of the sub-contractors and state whether or not those entities have 11oyew. If the sub-contractors have employees,they must provide their workers'comp.policy number. / man employer that is providing workers'compensation insurance for my employees. Below Is the policy and job site brmation. urance Company Name: icy.#or Self-ins.Lic.#: Expiration Date:AW Site Address: �9� � ���� � " City/State/Zip: 1 I :ach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). lure.to secure coverage as required under Section 25A of MGL c. 152.can lead to the imposition of criminal penalties of a op 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 r ip to$250.00 a day against,the violator. Be advised that a copy of this statement maybe forwarded to the Office of esti ations of the DIA for ins' v a e verification. Y hereby certi u e ain nd penalties of perjury that the information provided above is true and correct. .nature: Date: ,. ®� wne �� �ffacial use only. Do not write!n th area,tb be completed by city or town official :�ity or Town: Permit/License# issuing Authority(circle one): L.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector i.Other �ontact Person: Phone#: I rrtcx34sar; 4 ?fi'S 'a4?rRi7F,'E..A' a "r..L�a. � o CE'RTIFICA7E OF LIABILITY INSURANCE OP ID DS DAYE'5/0 /0 SPRIN-1 05 09 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden 5 Sullivan Ins Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Fax: 508-790-1414 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER Associated Industries OL MA INSURER B. Sprinkle Home Improvement Inc. INSURER C. 199 Barnstable Rd YJSURER D: Hyannis MA 02601 MURER 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 W TH 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. POLICY EFFECTIVE PCUOV EXPIRATION - LTR NERD TYPE OF INSURANCE POLICY NUMBER OATS(MMl00/YY DATE IMMrDD/Y LIMITS fL GENERAL LIABILITY EACH OCCURRENCE $ I COMMERCIAL GENERAL UASILITY I u FREMSES(Ea occurence) S I CLAMS MACE OCCUR I I hi E0 EM' _ (Arly one person; S PERSONAL&AOV INJURY S I GENERAL AGGREGATE S OEN'L AGGREGATE UNIT APPLIES PER: I PRODUCTS-COMP/OP AGG I S POLICY J COi LOC i AUTOMOBILE LIABILITY COMBINED SINGLE OMIT S -Y AUTO I (Ea accident) I} — ALLOWNEDAUTOS I--- ' BOOILI'IN,URY I S - i SCMECULEO AUTOS (Per person) MIRES AUTOS I Ber accidw,l) bS NON-OWNED AUTOS I i (Per accident) ' PROPERTY DMiAGE I S (Per accident) GARAGE LIABILITY I I AUTO 01ILY-EA ACCIDENT S — ANY AUTO OTHER THAJ4 F.AACC I S AUTO ONLY. AGO S E%CECCNNBRSAA LIABILITY EACH OCCURRENCE �s OCCVR El CLANS MADE .AGGREGATE S 3 1 DEDUCTEILE S REjBJT10N S Is_._ .. WORMERS COMPENSATION AND A EMPLOYERS'LLUILITY iORY UMiTS ER A ANY PROPRIETOR/PARTNERiEXECUTNE AWC7004943012008 01/01 OB 01/01/09 .L.EACH ACCIDENT I _ $500000 OFFICERJNEMBER E%CUAEU9 E.L.LTSEASE-EA EMPLOYEE j s 500000 I4 Yet,descnoe Infer SK61AL PROVISIONS below E.L.CISEASE-POUCYUMN Is 500000 OTHER DESCRIPTION'OF OPERATIONS/LOCATIONS%VEHICLES I EXCLUSIONS,ADOED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION . SPRNKHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION OATS THEREOF,THE 15SUING INSURER WILL ENDEAVOR TO MAIL ..0 DAYS WRITTEN _ Sprinkle Home improvement, Inc NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO EO SHALL Fax 0508-775-1350 Vargo Mack IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AOENTS OR 199 Barnstable Rd. REPRESENTATIVES. Hyannis MA 02 601 AUTHORIZED REPRESENTATIVE - [K.Iley A-Sullivan ACORD 25(2001108) 0 ACORD CORPORATION 1988 � 1io rrct of t3uilding R�g:ul.�hnns rn'd Stanilsrectti Construction Supervisor License License C, 6643 Expiration 1.0/8/2009 Tr# 91:7 t, R'esy"riction: 00 BRAD)K SPRINKLE 190 iLOTHRO.PS LANE W&:ARNSTABLE,MA 02668 C olami'ssio:ner 00-3S,000 cfenclosed space' ! p.A-Masonry only 1.G - 1 2 Fa4jMly Hv n'es . Failure to possess a-current editaon.oflth'e Nlassachus'etits State B.ulldtng;Code Is cause farr,:evoca'tion of thtVIree N-1.s:e: 1 t; t �lrr<-. l ,ra.t !ecr,/fib F•../�c..r'(.:c:rli icJR;Tta ,.. Board of:Building Regulations and Standards } T HOME IMPROVEMENT CONTRACTOR ar �� Registration: 103757 Expiration. 7/9/201'0 Tr# 27103.3 Type: Private Corporation SPF2INKL-E HO.M.E IMPROVEMENT, INC. Brad:.:S`pdnkle TY.9r Barnstable Rd. q..a � Hyannis, MA 02601 Ailm�msfrafor License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,.Ma.02108 r Not valid wit out sig ture 319iTDD 1-800-232-0782 STATE STREET DEVELOPMENT FAX (617) 236-1809 MANAGEMENTCORP 488 COMMONWEALTH AVENUE, BOSTON, MASSACHUSETTS 02215 •(617) 262-9800 May 6, 2008 Mr. Brad Sprinkle Sprinkle Home Improvement 199 Barnstable Road Hyannis, MA 02601 RE: Cromwell Court Apartments Installation of Vinyl Siding Dear Mr. Sprinkle: Enclosed is a signed Owner and Contractor Agreement for the work to be completed at the above referenced property. Sincerely., Sam Marino Regional Manager SM/dv Enclosure ,4 0 c9c°�ENf ORpa+''pu ACCREDITED MANAGEMENT ORGANIZATION® TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map J� Parcel 0 Application # 06 Health-Division Date Issued Conservation'Division Application F 2 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis D Project Street Address 1lp 3t(kb 1e 62&01 Village b ra)stc&(-e, s „MCC , Owners afiR_37. e bt_UR 60n3Cnt ryw Address 48a COYI'1f 01j(J_JQCd'h lill41 Telephone���OG Permit Request A)__(_nu -S id t q Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new;.',_ Zoning District Flood Plain Groundwater Overlay Project Valuation (1 4,'5'Dd Construction Type =* CA. ' Lot Size Grandfathered: ❑Yes ❑ No If yes, attach suppo ing documentation. 0 Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) N f 0 rt Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's High ay: ❑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�YesU ppeals Authorization ❑ Appeal # Recorded ❑Commercial No If yes, site plan review# Current Use Proposed Use APPLICANT-INFORMATION - (BUILDER OR HOMEOWNER) Name S irOn IL le 46Y"1-_ T_MjD 0 rn �1e_ t Telephone Number Address �� cu�n��r�1o(� K�AQ License # I(6751 ttLI6Y1V1 t5 Y1(A 6aLPD1 Home Improvement Contractor# 1&0 Worker's Compensation # WOCILMI"R, ALL CONSTRUCTION�DEBRISRESUG FROM THIS PROJECT WILL BE TAKEN TO U(J1r(YY)( SIGNATURE -DATE 2%-oQ� �� FOR OFFICIAL USE ONLY 4 APPLICATION# DATE ISSUED MAP/PARCEL NO. - 5 ADDRESS VILLAGE OWNER - DATE OF INSPECTION: FOUNDATION FRAME w INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 't PLUMBING: ROUGH FINAL 3 GAS: ROUGH FINAL N; FINAL BUILDING DATE CLOSED OUT ASSOCIATIONL PLAN NO. t f The Commonwealth.ofMassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/El Please Print Le ibl licant Information, -� dame(Business/otganization/Individual): kddress: �ity/S e/Zip: iUi'lY1iS {�r� Phone.#: ro rate box: Type of project(required): re y an employer?Check the app P 4 1 am a general contractor and I I am a employer with _ ❑ 6. ❑New construction have hired the sub-contractors Remodeling employees.(full and/or part-time).* listed on the attached sheet. 7. ❑ I am a sole proprietor or partner- These sub-contractors have g: ❑Demolition ship.andhave no employees employees and have workers' 9 ❑Building addition working.for me in any capacity. comp insurance.# [No workers'comp,insurance 5 ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 11.❑Plumbing repairs or additions ❑ I am a homeowner doing all work right 6f exemption per MGL 12.❑ Roof repairs myself. [No workers'comp. c. 152, §1(4),and we have no �lCL insurance required.]t 13.1 Other 1�1,�rj .employees. [No workers' Cf comp, insurance required.] ry applicant that checks box#1 must also.fili out the section below showing.their workers'compensation policy information. submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new•affidavit indicating such. omeowners who sub rgtractors that check this box must attached an additional sheet.showing the name of the sub-contractors and state whether or not those entities have lloyees. If the sub-contractors have employees,they must provide their.workers'comp.policy number, w an'employer that is providing workers compensation insurance for my employees Below Is the policy and job site ormation. 42. urance Company Name: a icy.#or Self ins.Lic.#• Expiration Date: L' Site Address: 1 �9� Le- ` City/State/Zip: t �� i ach a copy 9f the workers' compensation policy declaration•page(showing the policy number and expiration date), lure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a _Lm- .Op 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 r ip to$250.00 a day against.the violator. Be advised that a copy of this statement maybe forwarded to the Office of esti ations of the MA for in v a e verification. 7 hereby certi u e ain nd penalties of perjury that the information provided above is true and correct. Date: Z,,5 — nature. Tfficial use only. Do not write In th area, ib a comp eted by city or town offlciaL �ity or Town: Pernilt/License# issuing Authority(circle one): t.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector i.Other' bntact Person: Phone#: -•ryx�w .R4 P . 'd"0'�"uF.fr._�4RFPSk�SF?FRL t' .1Yt"C�.A;t,'-'Yt'Xv+.ii,..'i>+',ri.. �'+r+ . GATE IMM/DO/YYYYI QR-o CERTIFICATE OF LIABILITY INSURANCE OPIDDS SPRIN- 1 05 09 O8 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden b Sullivan Ins Agency HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Flax: 508-790-1.414 INSURERS AFFORDING COVERAGE NAIC# INSURED--- --------------------- .---------- NSURERA Associated Industries of MA WSURFR B. Sprinkle Home Improvement Inc. TGURER C. 199 Barnstable Rd NSURER0: Hyannis MA 0260.1 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. POLICY EFFECTIVE POLICY EXPIRATION LTR NERD TYPE OF INSURANCE POLICY NUMBER DATE MNVDD/YY DATE IMM/DOFYY LIMITS GENERAL LIABILITY FACHOCCURRENCE f COMMERCLIL GENERAL LIABILITY I PREMISES(Ea occorence) S I CLAMS MADE OCCUR ._ I MEG EXP(Anyone perscn; PERSONAL d ADV INJURY S I GENEPAL AGGREGATE $ GEN'L AGGREGATE UNIT APPLIES PER. I PRODUCTS-COMPIOP ADO IT I POLICY 0 IEDPROT LOP AUTOMOBILE LIABILITY COMBINED SINGLE UNIT S ANYAUTO (Es accuent) — ALL OWNED AUT09 BODIL\'INJURY I S 9CNFCVLFO AUTC9 (Per person) HIRED A'JTOS BOOILV!NAURY j S NOWOWNEDAVTOS i (Peraccident) 6 ' PROPERTYDMIAGE (Peracc!denl) f GARAGE LIABILITY I AUTOONLY-EA ACCIDENT f ANY AUTO I OTHER THAp F.AACC f AUTOOM-Y: AGO $ EXCEEBIUMBRELLA LIABILITY EACH OCCURRENCE I f OCCUR CWM3 MADE AGOREGATE f f 1 OEDUCTOL.E f REtBJTYDN f _ ' - —`�—� -•- WORKERS COMP`ENYATION AND TWC LIMITS ER A ANY PROPRIETORIPARTNER/EXECIJTNE ENO'LOYeRFLI AWC7004943012008 01/01 08 01/01/09 1 EACHACCIDENT ;S 500000 R/PART OFFICERINEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE If 500�000 If yet,tleeCnee sneer h- SECWLPROYLSIONSbeImY E.L.DISEASE-POLICY LIMIT I S 500060 OTHER DESCRIPTIO"F OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY INDORSEMENT/SPECIAL►ROVISIONE CERTIFICATE HOLDER CANCELLATION SPRNKHO iHOULD ANY OF THE ABOVE DEBCRISED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL i0 DAYS WRITTEN Sprinkle Home Improvement, Inc NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Fax N508-775-1350 Margo Mack IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR II 199 Barnstable Rd. RE►REIENTATIVES. fl Hyannis MA 026,01 AUTHORIZED REPRESENTATIVE —]-Kelley A.Sullivan ACORD 25(2001108) OACORD CORPORATION 1988 l ey s Board'tpl Building 12egulaaion5 audl'Sta ul.irds' :ffffks { Construction Supervisor License i- F F x Pry License; CS 6643 Exparatlon: 10/8/2009 Tr# 9427 R6striction: 00 BRAD.K SPRINKLE 190 LOTHROPS LANE W BARNSTAB E.MA 02668 couinti:ssioirer 0.0-35,000 cfenclosed space' 1A-)"sonry only 1G- 1 2 Family Homes I Failure to possess a current edition.o-fth'e Massachusetts State Building Ggde revocation of this liceis:e. is cause for � 4�1 . j; I - .. .,. ..._... ... ..ter Board-of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR ak Ott,` Registration: 103757 1 i Expiration.: 7/9/20T0 TO 271033 Type: Private Corpora#ion SPRINKLE HOME IMPROVEMENT, INC. Brad:.Sprinkle 1'99 Barnstable Rd. Hyannis, MA 02601 AtIminis'tratol- ------------ License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,.Ma.02108 F Not valid wit out sig tore q„ TDD 1-800-232-0782 %TE STREET DEVELOPMENT FAX (617) 236-1809 MANAGEMENTCORR 488 COMMONWEALTH AVENUE, BOSTON, MASSACHUSETTS 02215 • (617) 262-9800 May 6, 2008 Mr. Brad Sprnkle Sprinkle Horne Improvement 199 Barnstable Road Hyannis, MA 02601 RE: Cromwell Court Apartments -Installation of Vinyl Siding Dear Mr. Sprinkle: Enclosed is a signed Owner and Contractor Agreement for the work to be completed at the above referenced property. Sincerely, Sam Marino Regional Manager SM/dv Enclosure I pC�Qopp 9cF�FM ORGPa�1P, ACCREDITED MANAGEMENT ORGANIZATION® TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION Map / ?arcel Applicati on #QS?CZO Health Division S. 13 . Date Issued oZ� Conservation;Division Application F Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board loll d� LI/ Historic- OKH Preservation / Hyannis Project Street;Address /ePI 8 ,BAR N s Village Owner C'R O.-Of Wk C'oS,4 f �'. Address Telephone G12 ~ 2.6 :Z 860 Permit Request �F�����f� G �a,J s I �.1 Ls- "'k /,o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �p°� Construction Type Alf-W ,eA,- , Lot Size �7, 09 AcAkS Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ MUlti-Family(# units) 3Z� Age of Existing Structure ® X5 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: 0 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 I r`, Central Air: ❑Yes No Fireplaces: Existing New Existing wood/c°oal stove: ❑Yes No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑:existing O new`, size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: U), Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ L Commercial Yes (3 No If yes, site plan review# cn Current Use Proposed Use S�hF APPLICANT INFORMATION -(BUILDER OR HOMEOWNER) Name S���i� �� Ssa� a t Telephone Number Address !K41/ P� - License # Cs Home Improvement Contractor# Worker's Compensation # 60 d o ca Q B-2 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE -DATE 014z,Z i .M FOR OFFICIAL USE ONLY ~APPLICATION# + tl DATE ISSUED t - A MAP/PARCEL N0. .ADDRESS VILLAGE ' - 'OWNER r , DATE OF INSPECTION: F . w FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH ;FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. II ` � The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, ALL 02111 � www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Naive (Business/Organizat-iorJlndividual): A,"I t�Zw zitiv1-x._ e - _Zi c. Address: �� � SS•�Nf�-c��L 1�r2� City/.State/Zip: M94y✓i" /Y. 6"?Pg? Phone.#: yO/ 21�?/ — S911 _?Y Are you an employer? Check the appropriate box: Type of project(required): 1.�] 1 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. ❑ New construction 1[] I am a sole proprietor or partner- listed on the attached sheet. 7.XRemodeling ship and have no employees These sub-contractors have g• 0 Demolition workingfor me in an capacity. employees and have workers' - Y P t5'� [�$ 9. Building addition [No workers' comp.-insurance comp. insurance. required.] 5. We area corporation and its l0f]Electrical repairs or additions 3111 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 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.hirc outside contractors must submit an cw affidavit indicating such. lcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or.not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information.. Insurance Company Name: K€-,4ez,'r-5 IS4,f . Policy#or Self-ins, Lic. #: D 6 0® o 0 2 G Expiration Date: s- Job Site Address: /le"s �•Q.e�5, azA"- �� . City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains aril enaltie of perjury that the information provided above is true and correct Signature: 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): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector ], 6. Other Contact Person: Phone#: L 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 and including the legal representative's of a deceased employer, or the enterprise, g P ed ' a'omtg a m e foregoing.en J of the g g 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 ys persons to do maintenance,construction or repair work on such dwelling house' dwelling house of another who emplo 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), addresses) and phone number(s) along with their ccil ficate(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=egibly. The Department has provided a space-at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant•, Please be sure to fill in the permitllicense number which will be used as a reference number. In addition, an applicant that must submit multiple permitflicense 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 opener 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 persona is NOT required to complete this affidavit. TheOffice 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 lndust W Accidents Office of Investigaii411s 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 _evised 11-22-06 VAVW.Mas5.gov/dia ^K I} T^ ° Town of Barnstable 3ARNSTABLE, Regulatory Serviees pTFD �a 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 Propert-AT Owner Must Complete.and Sign This Section If Using A Builder as Owiler of the subject property hereby authorize to act on my behalf, in all matters relative to wcrk authorized by this building pem--ut application for: Ad (Address of Job) signature of Owner Date Seem 2i d ?rint'Name ):\WPFILES\FORMS\building permit=orms\EXPRESS.doc ;evise020108 Town of Barnstable FIHE rQw� Regulatory Services �. Thomas F. Geller,Director • ipFtNSTABLE.KA-Sa p�A Building Division Teo Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230. HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAI LING 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 homeo�vncrs to engage an individual for hue 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 pernnt. (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-farnily 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 Supertinsor 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 a towns. You may care t amend and adopt such a form/certification for use in your community. several Y Q:\WPFILES\FORMSUiomeexempt.DOC Page 1 of 1 � ' eacon . wtual Insurance 00 One Beacon Centre Warwick, Rhode Island 02886-1378 (401) 825-2667 Fax 825-2855 Certificate of Workers' Compensation&Employers' Liability Insurance CERTIFICATE HOLDER INSURED Town of Barnstable = Daniela Construction Co Inc 367 Main St. 10 Messenger Drive Hyannis, MA 02601 Warwick, RI 02888-1021 his certificate is issued as a matter of information only and confers no rights on the certificate holder. This certificate .oes not amend, extend, or alter the coverage afforded by the policy below. COVERAGES This is to certify that policy 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 is-siaed or may pertain,the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies. TYPE OF POLICY POLICY POLICY LIMITS OF INSURANCE NUMBER EFFECTIVE EXPIRATION LIABILITY DATE DATE Statutory benefits Required by the Rhode Workers' Island Workers Compensation Law(X) Compensation 0000002698 03-25-2008 03-25-2009 and Employers' $100,000 Each Accident Liability $500,000 Policy Limit by disease $100,000 Each Employee by disease DESCRIPTION OF OPEF.ATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CANCELLATION Should the above policy be canceled before expiration date thereof,The Beacon Mutual Insurance Company will mail 10 days written notice to the certificate owner'Aamed herein by regular mail. Authorized Representative: Date Issued.: 10/22/08 `t Broker of Record Successfully Submitted The Slocum Agency Inc PO Box 7910 Warwick, RI 02887-7910 'f . ACOR0 CERTIFICATE OF LIABILITY INSURANCE DATE -T---TM 1 PRODUCER 0122/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Slocum Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1229 Greenwich Ave. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Warwick RI 02886 INSURERS AFFORDING COVERAGE INSURED Daniela Construction Co.,Inc. INSURER A: PEERLESS INSURANCE COMPANY 10 Messenger Drive INSURER B: INSURER C: Warwick RI 02E 88 INSURER D: COVERAGES INSURER E: THEPOLICIESOF INSURAN:;E LISTEDBELOWHAVE BEEN ISSUEDTOTHE INSUREDNAMEDABOVEFORTHE POLICYPERIOD 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 INSURANCEAFFORDEDBYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHETERMS,EXCLUSIONS AND CONDITIONS OFSUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LIMITS POLICY NUMBER GENERAL LIABILITY EACH OCCURRENCE• $1 00O 000. A X COMMERCIAL GENERAL LIABILITY CBP9691778 0310812008 0310812009 FIRE DAMAGE(Any one fire $100 000. CLAIMS MADE a OCCUR MED.EXP(Any oneperson) $6 000. PERSONAL&ADV INJURY $1000 000. GENERAL AGGREGATE $2 000 000. hN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 2 00O 000. POLICY PROJgCT LOC AUTOMOBILE LIABILITY A ANY AUTO BA9690678 COMBINED ISINGLE LIMIT $1,000,000 0310812008 0310812009 ( ) ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY $(Per person) X HIRED AUTOS X NON-OWNED AUTOS BODILY INJURY $(Per.accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE 5 OTHER E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS SEE POLICY FOR CONDITIONS AND EXCLUSIONS THAT APPLY CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town Of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL'_10 DAYS WRITTEN 367 Main St. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE CD> ACORD 25-S(7/97) CORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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 6n lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. t? ACORD 25-S(7/97) , BU�i'9`of� 1�1QY6oi�s �`b`Stan i Construction Supervisor License it Liceuse: CS 56589 E p ratilon 1/20/2009 Tr# 7797 5 x SERGIO DESIMON 601 HOPE RD i CRANSTON,RI 02df --- r° Commissioner z ;. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1-3 Map- .. Map Parcel 3 g Application # D76S Health-Division G 13 Date Issued Conservation.Division Application Fee Planning Dept. Permit Fee S` Date Definitive Plan±Approved by Planning Board Historic- OKH Preservation/ Hyannis Project Street Address } Village Owner 67,�ta�►-A,1 241 y ou R 7� z'a Address 4/8W �'o�,ho.��✓���/� Q � Telephone a ec t --11191 e Permit Request /S" l�l i� i / W AoO' oe Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuationOo/97s Construction Type � J/> Lot Size, Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure .36',YIes Historic House: ❑Yes ❑ No On Old Kings Highway: ❑Yes ❑ No Basement Type: ❑ =ull ❑ 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: X Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes /'No Fireplaces: Existing New Existing wood/coal stove: ❑Yes J'No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ eAsting ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 1 cm f C:) A Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ nj w k Commercial Yes ❑ No If yes, site plan review# a. Current Use Proposed Use �� w cn r- cn M APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) Name S�/1��o Sim ti�" Telephone Number ya/ Address mod/ �o� .��. License # Home Improvement Contractor# Worker's Compensation # 00 co o a 2 � ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 1 _y FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED a � MAP PARCEL NO. ADDRESS VILLAGE t -OWNER DATE OF INSPECTION: It FOUNDATION FRAME INSULATION ,FIREPLACE 3 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH 'FINAL FINAL BUILDING 1 r DATE CLOSED OUT ASSOCIATION PLAN NO. J The Commonwealth of.Afassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, AAA .02111 w www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):��„/i E�� �o,� � _Z2 C� .Andress: Ae A)w,e to a City/State/Zip: Phone.#: /-'o/— 78f 3`" Are you an employer? Check the appropriate box: Type of project(required): 1. - �er with to 1 am a employer 4. ❑ I am a general contractor and I -- --- 6. ❑New construction have hired the sub-contractors �. employees(full and/or part-.time),* listed on the at 2.❑ 1 am a sole proprietor or partner- tached sheet 7. Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp.-insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 1.0.❑ 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 subrml 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 fur my employees. Below is the policy and job site information. Insurance Company Name: I(J 19Ge AJ ��JS Policy#or Self-ins. Lic. #: CDC GO O O X Expiration Date: Job Site Address: Xi44,•US`<9�1.0_/�Grc City/State/Zip:_� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). . Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250,00 a day against the violator. Be- advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un er thepains andpenaIt' of erjury that the information provided above is true and correct. Si ature: Date: Phone#: ��f Y4/1S Official use only. Do not:write in this area, to be completed by city or town gficiaL City or Town: Permit/License# ;issuing Authority (circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 11 6. Other Contact Person: Phone#: Information and 1,nst u.cti®ns 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 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 pro duced•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 fdl 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 ccdificate(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 havc 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 perriit/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 persop is NOT required to complete this affidavit. The Office of Investigations mould 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 Iadustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-490.0 ext 406 or 1-V7-MASSA.FB Fax# 617-727-7749 . .evised 11-22-06 - www.mass-govldia . i! IKE r, ` down of Barnstable Y i IARNSTABLE„ k Regulatory Services y� 16� 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-L038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using .A. Builder I, !j as Owner of the subject property hereby a" re U- �'!h�;r�E to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date 'Hint Name ):1WPHLESTORMS\building permit fbrms\EXPRESS.doc ,evise020108 Town of Barnstable �F IHtE o regulatory Services e Thomas F.Geiler,Director �rrsrnai Mnss. 9� �' Building Division Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.toven.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. 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 strictures. A person who constr-icts 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, riles and regulations. The undersigned"homeowner"certifies that he/she understands the.Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness oflen 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\vith a licensed Supervisor. The homeowner acting as Supenrisor 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/certificaftri for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC I Page 1 of 1 cteal lrl ter 2,Cap One Beacon Centre Warwick,Rhode Island 02886-1378 (401) 825-2667 Fax 825-2855 Certificate of Workers' Compensation&Employers' Liability Insurance CERTIFICATE HOLDER F INSURED Town of Barnstable - = Daniela Construction Co Inc 367 Main St. 10 Messenger Drive Hyannis, MA 02601 Warwick, R102888-1021 'his certificate is issued as a matter of information only and confers no rights on the certificate holder. This certificate oes not amend, extend, or alter the coverage afforded by thepolicy-below. COVERAGES This is to certify that policy 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. TYPE OF POLICY POLICY POLICY LIMITS OF INSURANCE NUMBER EFFECTIVE EXPIRATION LIABILITY DATE DATE Statutory benefits Required by the Rhode Workers' Island Workers Compensation Law(X) Compensation 0000002698 03-25-2008 03-25-2009 and Employers' $100,000 Each Accident Liability $500,000 Policy Limit by disease $100,000 Each Employee by disease DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CANCELLATION Should the above policy bL canceled before expiration date thereof,The Beacon Mutual Insurance Company will in 10 days written notice to the certificate owner`samed herein by regular mail. Authorized Representative Date Issued: 10/22/08 `+ r" Broker of Record Successfully Submitted The Slocum Agency Inc PO Box 7910 Warwick, RI 02887-7910` x #. io d m B o S WA an ar s Construction Supervisor License r + License: CS 56589 i Expiration: 1/20f2009 Ti# 7797 ' "� S Restnction� 00 SERGIO DESIAfiONF 601 HOPE RD CRANSTON,RI 02831 »='* Commissioner j TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION )2 Map �// Parcel '? 8— a/ 3 Application # eR i9egll, s Health`Division �-I I Date Issued -7 Conservation,Division Application Fee Planning Dept. Permit Fee 1635 Date Definitive Plan Approved by Planning Board Historic OKH Preservation/ Hyannis Project Street Address /d ��/1.t'57����<` ��• y�,,.,r,�j- �7��s-� Village Owner 4.e5.e®,,f Address Telephone Z!J Permit Request ����<� 1-5- Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 'e Project Valuation D -S Construction Type �/� Lot Size s Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) 3 Age of Existing Structure 3 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: W Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes/6 No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing 0 new size_ `= Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: = Zoning Board of Appeals Authorization ❑ ❑ u Appeal # Recorded <—,` Ri Commercial 4Yes ❑ No If yes, site plan review# ;. Current Use Proposed Use S�tiL `'' c..rk r Ln r APPLICANT INFORMATION (BUILDER OR-HOMEOWNER) _ - - Name s�2Gi' J�•T� ��� `%'oZ- Telephone Number Address L�®� /7ajJ License rdo o a7 �'3/ Home Improvement Contractor# Worker's Compensation # ©00 aA0 o e? ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /l o .F/1 cc rs r E SIGNATURE DATE 6 ,� o FOR OFFICIAL USE ONLY - APPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION i x FRAME INSULATION { FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL J FINAL BUILDING DATE CLOSED OUT A . j 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 Please Print Legibly Name (Business/Organization/Individual): &V F!4 z S Address: /o We3 5Se- )4— City/State/Zip: 1✓���/G� X1.2'- o;899Phoae.#: Are you an employer? Check the appropriate-box: Type of project(required): 1. 1 am a employer with- 4. ❑ I am a general contractor and I 6. El New construction employees(full and/or part-time). * have hiredX the sub-contractors hdh 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 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.] I c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp,insurance requited] *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 on 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 pro-vridt their workers'comp.policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A.) Policy#or Self-ins. Lic. #: Q 010 COOQ / y Expiration Date: . Job Site Address: �� .D�4.4�✓sf� �' l��+ City/State/Zip:z6sw N/� ,ez�S5 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 MG1 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 andpenalties ofperjury that the information provided above is true and correct Signature: 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 c ne): 1.Board of Health 2.Building Department 3. City/Tovrn Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: i, information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: r Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives,of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced•acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states `Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and if necessary, supply sub-contractors)name(s), address(es) and phone number(s) along with their ccatificate(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 returued'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 permittlicense 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 perruits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to coniplete 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 Qffi.ce.of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASS.AFE Fax# 617-72777749 revised 11-22-06 www.mass..gov/dia VE r, ` 'own of Barnstable i BMUiSfABLE. MASS.1639. Regulatory Services pTfD►rlP�A Thomas F. Geiler,Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 I'ropert, Owner Must Complete.and Sign This Section If Using A Builder er of the subject property hereby authorize ,S E� G-/6 ,f�r� /��Xj to act on my behalf, in all matters relative to work authorized by this building permit application for- (Address of Job) Signature of Owner Date ?rint Name ):\WPFILES`.FORMS\building permit forms\EXPRESS.doc ;evise0201.08 Town of Barnstable F Yxe TQk, �' o Regulatory Services « Thomas F. Geiler,Director « « « sAxxsrasr:E, �. HAS-& 1639. ,�� Building Division, °lEo ttAt" Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: _ i number street village "HOMEOWNER": MEOWNER": 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 hie who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of nand on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than-one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws, rules and regulations. The undersigned"homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that lie/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-farnily 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 personas 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:\WPFIL'ES\FORMS\homeexempt.DOC Page 1 of 1 .11 Seacon ' °` . M�t�al insuranoe Crab. One Beacon Centre Warwick, Rhode Island 02886-1378 (401) 825-2667 Fax 825-2855 Certificate o ' f Workers Compensation&Employers' Liability Insurance CERTIF'CATE HOLDER INSURED Town of Barnstable - -- = Daniels Construction Co Inc 367 Main St. 10 Messenger Drive Hyannis, MA 02601 Warwick RI 02888-1021 'his certificate is issued as a matter of information only and confers no rights on the certificate holder. This certificate oes not amend, extend, or alter the coverage afforded by the policy-below. COVERAGES This is to certify that policy 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 isaed or may pertain,the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies. TYPE OF POLICY POLICY POLICY LIMITS OF INSURANCE NUMBER EFFECTIVE EXPIRATION LIABILITY DATE DATE Statutory benefits Required by the Rhode Workers' Island Workers Compensation Law(X) Compensation 0000002698 03-25-2008 03-25-2009 and Employers' $100,000 Each Accident Liability $500,000 Policy Limit by disease $100,000 Each Employee by disease DESCRIPTION OF OPERATIONS/LOCATI.ONSNEHICLES/SPECIAL ITEMS CANCELLATION Should the above policy be canceled before expiration date thereof,The Beacon Mutual Insurance Company will mail 10 days written notice to the certificate owner'';iamed herein.by regular mail. Authorized Representative Date Issued: 10/22108 Broker of Record Successfully Submitted , The Slocum Agency Inc PO Box 7910 Warwick, RI 02887-7910 rINSUREODaniela T CERTIFICATE OF LIABILITY INSURANCE DATE OR 10/22/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ncy,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Ave. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 6 INSURERS AFFORDING COVERAGE aniela Construction Co.,Inc. INSURERA: PEERLESS INSURANCE COMPANY Messenger Drive INSURER 8; INSURER C: Warwick RI 02888 INSURER D: COVERAGES INSURER E: THEPOLICIES OF INSURANCE LISTEDBELOWHAVE BEEN ISSUEDTOTHE INSUREDNAMEDABOVEFORTHEPOLICYPERIOD 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 INSURANCEAFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER LIMITS GENERAL LIABILITY DATE IMMIDD=) EACH OCCURRENCE 1 00O 000. A x COMMERCIAL GENERAL LIABILITY CBP9691778 0310812008 0310812009 FIRE DAMAGE(Any one fire 100 000. CLAIMS MADE a OCCUR MED.EXP(Any oneperson) 5 000. PERSONAL&ADV INJURY 1 000 000. GENERAL AGGREGATE 2 000 000. GENT AGGREGATE LIMIT APPLIES PER:POLICY PRO- PRODUCTS-COMP/OP AGG 2 OOO OOO. i COC AUTOMOBILE LMIUTY A ANY AUTO BA9690678 Ea aBINEDiISINGLE LIMIT $1,000,000 0310812008 0310812009 ( ) ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY $(Per person) X HIRED AUTOS X NON BODILY INJURY $ NON-OWNED AUTOS (Per.accident) PROPERTY DAMAGE $ . (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGO $ EXCESS LIABWTY EACH OCCURRENCE $_ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY { E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE b OTHER E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS SEE POLICY FOR CONDITIONS AND EXCLUSIONS THAT APPLY CERTIFICATE HOLDER ADDITIONAL INSURED•INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town Of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL'_ DAYS WRITTEN 367 Main St. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR r REPRESENTATIVES. t AUTHORIZED REPRESENTATIVE <CD> I , ACORD 25-S(7197) CORD CORPORATION 1988 Bd&o Oio s W 4nh an ar s j ' Construction Supervisor License Licppse: CS 56589 3' M I k Ezprati�or} 1/20%2009 Tr# 7797 + SERGIO DESIMOhI i 601 HOPE RD I CRANSTON, RI 028M-j _ Commissioner III TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION Map Parcel- 3 00 Application # �� Health Division LA 3 Date Issued I Conservation Division Application Fee ®�- Planning Dept. Permit Fee �zo • Z� `- 4 Date Definitive Plan:Approved by Planning Board (D'Z74s� r Historic OKH Preservation/ Hyannis Project Street Address Village A�LGfi Owner evlte'afw �� �Ue Address � Telephone �'�J 1G -2 — 98e a Permit Request ��,d cti�� L/ �� /s X1 d 'J "e-/7 ,09,9, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay i Project Valuation a Construction Type Lot Size 91 -vs Am 45, Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi,Family(# units) Age of Existing Structure 3 6X4. 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: lGas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ,WNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes 9A0 Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Cn CD Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial Yes ❑ No If yes, site plan review# Tl Current Use ll�j/f -- �� c/ Proposed Use APPLICANT INFORMATION cn (BUILDER OR HOMEOWNER) Name S�-,e�i� �' S�� ©'�'''� Telephone Number Address fie% License# S S�6 -r's 1 ZZ Home Improvement Contractor# Worker's Compensation # 000 G a 0 .2 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .8 F/1 � ceh t 7�.FsQS SIGNATURE DATE s FOR OFFICIAL USE ONLY r f .i APPLICATION# DATtISSUED MAP/PARCEL NO. ' i ADDRESS VILLAGE OWNER DATE OF INSPECTION: .t I FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING DATE CLOSED OUT ASSOCIATION,PLAN NO. 'r i The Cornrnonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, M4 02111 •� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0bly.. Name (Business/Orgarization/Individual): Address: City/State/Zip: ®.Z89, Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer w ith- 8 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-tim.e).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. M Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' Y P �'• 9. [] Building addition o workers' co .insurance comp. insurance.$ 1.0. Electrical repairs or additions � 5. We are a cozporafian and its ❑ P . required.] ❑ officers have exercised their 11. Plumbing re airs or additions 3. I am a homeowner loin all work ❑ g P ❑ 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 Homeovmcrs who submit this affidavit indicating they are doing all work and then.hirc outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. 1f the sub-contr-actors have employees,they must providt 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: SIZ-4eo Policy#or Self-ins. Lic. #: ® D o 0 Expiration Date:_ e?r �/ Job Site Address: /11111 City/State/Zip: �y/S, ��5� 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un the pains and enalties o perjury that the information provided above is true and correct Signature: Dater Phone Official use only. Do not Prile in this area, to be completed by city or town offtciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Toyru Clerk 4.EIectrical 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 hue, 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.enterpnse, 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 ys persons to do maintenance, construction or repair work on such dwelling house dwelling house of another who emplo 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 perrnit 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�Zth 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 aud, if necessary, supply sub-contractors)name(s), addresses) and phone nurnber(s) along with their certificate(s) of than the insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other 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 Sile 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 t.o any business or commercial venture (i.e, a dog license or permit to bum 16aves 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 e6romonwv ,gth of Massachusetts. Department of Industrial Accidents Office of Investigatians 600 Washington Stmct Boston; MA 02111 Tel. # 617-727-4900 ext 406 or 1-V7-MASSAFB Fax# 617-727-7749 I-evised 11-22-06 www-.mass.gov/dia . �zrte;lam . Town of Barnstable y auaisTABLE, 'HAS Regulatory Services plfo �a '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 ,,as of the subject property � 0 hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner nate ?nnt Name >:\WPFILESTORMS\buiWing permit forms\EXPRESS.doc ,evise020108 Town of Barnstable "T Regulatory Service } Thomas F. Geiler,Director « BARNSTABLE 9$AKASS Building Division TEo�� Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 026.01 www.town.barnstable.ma.us Office: 508-862-4038 _ _ _ _ Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: street village number "HOMEOWNER": k phone name work home phone# P 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 hue who does not possess a license,Provided that the owner acts as supervisor. AEFINITION 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 But Official, that he/she shall be responsible for all such work performed under the building pernnt. (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 nmderstands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions , of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue.is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC Page 1 of 1 " '. i�tutu�al lns�a�amoe One Beacon Centre Warwick, Rhode Island 02886-1378 (401) 825-2667 Fax 825-2855 Certificate of Workers' Compensation&Employers' Liability Insurance CERTIFICATE HOLDER INSURED Town of Barnstable -- = Daniela Construction Co Inc 367 Main St. 10 Messenger Drive Hyannis, MA 02601 Warwick, RI 02888-1021 'his certificate is issued as a matter of information only and confers no rights on the certificate holder. This certificate oes not amend, extend, or alter the coverage afforded by the policy.below. COVERAGES _ This is to certify that policy 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 1&Qed or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies. TYPE OF POLICY POLICY POLICY LIMITS OF INSURANCE NUMBER EFFECTIVE EXPIRATION LIABILITY DATE DATE Statutory benefits Required by the Rhode Workers' Island Workers Compensation Law(X) Compensation 0000002698 03-25-2008 03-25-2009 and Employers' $100,000 Each Accident Liability $500,000 Policy Limit by disease $100,000 Each Employee by disease DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CANCELLATION Should the above policy be canceled before expiration date thereof,The Beacon Mutual Insurance Company will mail 10 days written notice to the certificate ownet'named herein by regular mail. Authorized Representative Date Issued: 10/22/08 `± Broker of Record Successfully Submitted , The Slocum Agency Inc PO Box 7910 Warwick, RI 02887-7910` CORD F1229 Tr CERTIFICATE OF LIABILITY INSURANCE DATE ER 10/22108 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ocum Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE reenwich Ave. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Warwick RI 02886 INSURERS AFFORDING COVERAGE INSURED Daniela Construction Co.,Inc. INSURER A: PEERLESS INSURANCE COMPANY 10 Messenger Driue INSURER B: INSURER C: Warwick RI 02888 INSURER D: COVERAGES INSURER E: THEPOLICIESOFINSURANCELISTEDBELOW HAVE BEEN ISSUEDTOTHE INSUREONAMEDABOVEFORTHEPOLICYPERIOD 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 INSURANCEAFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE 1 OOO 000. A x COMMERCIAL GENERAL LIABILITY CBP9691778 0310812008 0310812009 FIRE DAMAGE(Any one ere $100 000. CLAHAS MADE X❑OCCUR MED.EXP(Any one arson a 000. PERSONAL&ADV INJURY $1 000 000, GENERAL AGGREGATE 2 000 000. GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 2 000 000. POLICY J&m LOC AUTOMOBILE LIABILITY A ANY AUTO BA9690678 COMBINED accident) LIMIT $1,000,000 0310812008 0310812009 ( ) ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY $(Per person) X HIRED AUTOS X NON OWNED AUTOS BODILY INJURY $(Per.accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT It ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGO $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITYFR A E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE $ OTHER E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS SEE POLICY FOR CONDITIONS AND EXCLUSIONS THAT APPLY CERTIFICATE HOLDER ADDITIONAL INSURED•INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL'_ DAYS WRITTEN 367 Main St. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 1 > ACORD 25-5(7/97) CbRD CORPORATION 1988 O— w� ll,AMA "� Bd��o e io s an ar s p; s; Construction Supervisor License +`_ Y License: CS 56589 EMration 1/20l2009 Tr# 7797 J., Rest[ictior- 00 SERGIO DESiMO'NE-�,- 601 HOPE RD CRANSTON, RI 0283I Commissioner i t Y 4 j TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION e G� z Map ° l G� Parcel 3 ? _ I Application # wV � Health Division S a u 1 Date Issued �1 Conservation'Division Application Fee � Planning Dept. Permit Fee �?U�J•� Date Definitive Plan Approved by Planning Board 0 1 o4Zrz 10 Historic OKH Preservation/Hyannis Project Street Address Village Owner Address w"-A4 A r Telephone G"i7 — alb 27 66 Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation j GSA O U v Construction Type Lot Size of Grandfathered: ' ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) a %0e Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑1 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 /R No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Nd No Detached garage: ❑existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑nAew size_ C-2 Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ <1 w f� Commercial t)rYes ❑ No If yes, site plan review# ' Current Use Proposed Use crt u-r - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name S���� �� �� a Telephone Number Address License # Z-27- Home Improvement Contractor# Worker's Compensation # 6 G o-06-O a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO o e/1�t ar t E J SIGNATUII DATE 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED - MAP/PARCEL N0. ' iADDRESS VILLAGE t , OWNER DATE OF INSPECTION: ; 1 FOUNDATION FRAME t INSULATION ` FIREPLACE } F ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 4 GAS: ROUGH FINAL FINAL BUILDING 0-i . 7 F ' DATE CLOSED OUT ASSOCIATION PLAN NO. l v _ _ 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 Le-ibly Name (Business/Orkanizarion/Individual): Z •.-Sznl 11,z Ja Address: City/State/Zip: Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.[}�I am a em 10 er with- 4. ❑ I am a general contractor and I / P y —�— have hired the sub-contractors-contractors 6. ❑New corstrtietion employees (full and/or part-time).2.❑ listed on the attached sheet 7. � Remodeling I am a sole proprietor or partner- ship and have no employees These sub-contractors have g, [] Demolition worldu for me in an capacity. employees and have workers' g Y P ty• 9. E] Building addition [No workers' comp.-insurance comp. insurance.1 d.uire req ] 5. [] We are a corporation and its 10.❑ Electrical repairs or addition 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.hirc 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'compensationn insurance for my employees. Below is the policy and job site information. Insurance Company Name: �Fi�Co,rJ Policy#or Self-ins. Li c. #: 00,06450 ,2 e! h' 8 Expiration Date: Job Site Address: /,/,g �'4/1/r'S�i4�/t _/mil— City/State/Zip: �, t,�N/s 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 imprisorunent, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day again:the violator. Be.advised that a copy of this statement may be forwarded to the Office of Jnyestigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofp 'uty that the information provided above is true and correct Si ature: Date: 6 .Z U _ Phone#: ",0 �" 4�S— —Ca •� G13 Official use only. Do not write in this area, to be completed by city or town offlciaL 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 Insft uct-Ong 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 I 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 apartmrnts 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 vrith the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s),address(es) and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are.not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required_ Be advised that this affidavit may be submitted to the Department of Industrial Accidents.for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to.obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their Self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant- Please be sure to fill in the permitflicense 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" f-be applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to 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 IMassachus" Department of lndustz al Accidents Office of InVestigatlens 600 Washington: Street Boston, MA 02111 Tel. # 617-727-490.0 ext 40-6 or 1-877-MASSAFE Fax# 617-727-7743 .-evised 11-22-06 www.mass.._gov/dia . Town of Barnstable .. . ,, CIK TQ� " Regulatory Services y Thomas F.Geiler,Director MRNMBLE, "V KASS Building Divisiola 1639. Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 608-790-6230, 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 homeo`xmers 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 peinut. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws, niles 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-farnily 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 tl.e 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/certifica6on for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC Town of Barnstable + IARNSTABLE, " MASS. i63 9- Regulatory Services �S' plFo►N`�a Thomas F.Geiler,Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Properiy Owner Must Complete and Sign This Section If Using .A,Builder Z . er of the subject property 01 hereby authorize �,���'d/� ��S G�i Diu ' to act on my behalf, in all matters relative to work authorized by this building pernut application for. (Address of Job) Signature of Owne ? Date ?rint Name ):\WPFILESTORMS\building permit forms\EXPR.ESS.doc :evise020108 �t Page 1 of 1 'Beac '' MuWal Insurance Ooa One Beacon Centre Warwick, Rhode Island 02886-1378 (401) 825-2667 Fax 825-2855 Certificate of Workers' Compensation&Employers' Liability Insurance CERTIFICATE HOLDER F INSURED Town of Barnstable - Daniela Construction Co Inc 367 Main St. 10 Messenger Drive Hyannis, MA 02601 Warwick, RI 02888-1021 'his certificate is issued as a matter of information`only and confers no rights on the certificate holder. This certificate .oes not amend, extend, or alter the coverage afforded by thepolicy-below. COVERAGES This is to certify that policy 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 is50ed or may pertain,the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies. TYPE OF POLICY POLICY POLICY LIMITS OF INSURANCE NUMBER EFFECTIVE EXPIRATION LIABILITY DATE DATE Statutory benefits Required by the Rhode Workers' Island Workers Compensation Law(X) Compensation 0000002698 03-25-2008 03-25-2009 and Employers' $100,000 Each Accident Liability $500,000 Policy Limit by disease $100,000 Each Employee by disease DESCRIPTION OF OPEF.ATIONS/LOCATI.ONS/VEHICLES/SPECIAL ITEMS CANCELLATION Should the above policy be canceled before expiration date thereof,The Beacon Mutual Insurance Company will mail 10 days written notice to the certificate owner''named herein by regular mail. Authorized Representative Date Issued: 10/22/08 Broker of Record Successfully Submitted The Slocum Agency Inc PO Box 7910 Warwick, RI 02887-7910 L ACORD CERTIFICATE OF LIABILITY INSURANCE DATE PRODUCER 10/22/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Slocum Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1229 Greenwich Ave. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELO'dV. Warwick RI 02886 INSURERS AFFORDING COVERAGE INSURED Daniela Construction Co.,Inc. INSURER A: PEERLESS INSURANCE COMPANY 10 Messenger Drive INSURER B: Warwick RI 02888 INSURER C: , INSURER D: COVERAGES INSURER E: THE POLICIES OF INSURANCE LISTEDBELOW HAVESEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIODINDICATED.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 INSURANCEAFFORDED BYTHE POLICIES DESCRIBEDHEREIN IS SUBJECTTO ALLTHE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE 1 ODD 000. A X COMMERCIAL GENERAL LIABILITY CBP9691778 0310812008 0310812009 FIRE DAMAGE(Any one fre 100 000. CLAIMS MADE a OCCUR MED.EXP(Any oneperson) 5 000. PERSONAL&ADV INJURY $1 000 000. GENERAL AGGREGATE 2 000 000. GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 2 OOO OOO. POLICY PRO LJC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A ANY AUTO BA9690678 0310812008 0310812009 (Ea accident) $1,000,000 ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY $ (Per parson) X HIRED AUTOS X BODILY ODILY INJURY $(Peraccident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ _ OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY F 4 E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE OTHER E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS SEE POLICY FOR CONDITIONS AND EXCLUSIONS THAT APPLY CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town Of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL'_ DAYS WRITTEN 367 Main St. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR UASILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE NCD> ACORD 25-5(7/97) CORD CORPORATION 1988 R % / � & « Construction 3pery mr�mm . . . i \ 2 \ License: c m#g . - . ( \} / S Tm 7797 % t : . \ > - . . _ �� / . sRGIOoSIM61 K1HOPE RO CRANSToK m 98:Yl Umd&_r THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) A � F I m / � L DATA ,� I 168 Barnstable Rd., Hyannis 10/21/08 L rn ": 09 r' 168 Barnstable Rd., Hyannis 10/21/08 90 -►..� _ Ij la W jw '�\. -�' _ y,�`� ��•r"�GSA" f'" iM All Umffi 1�"y�y - v .� } .. � & - e praK Al 16. ... Ir zi �. r S hw r i t .�. t#• c � a7.S."1 ,�+ �'1N�.�,,°fi'a,°¢.'"f/t°''�rt-i+:����%�.��� .,r�r"�3`• :.f�.�o a1 lY ;'y, ,.� ({ ,y S A •'r i t_ 4'.t^ t.'At , '��' r�.�t«*.�•-`� 'k,�i.,�Sv+sta,,,'"`'E 9 "f.. � 7'y.��, _:r "' .+ (a. �- t�ti "., wtz 71 IT we a � � err✓ x. '�.• ! - r x ,. A y rn 0 v In v c (D n A -rolNN OF BARNSTABLE DFPARTMI NI OI II NLIII SNFPTN AND FNN It ONNILNI j SFRVICES 7 Bl ILUING UIV(SION t. S1'OP WORK i Illls blRlA 9TRh.,NNI)iOR PRFMISP1,IL15 BET INSI'1't'PI D NND(HI.FOI.1.01YIN(.VIOL ATiUNS - - O1 TH)DI'll DING CODE ANIYOR LOVING ORDINAN(1.11;1VF BLEN FOUND: 4 YOU ARE HEREBY NOTIFIED THAT NO ADDITIONAL WORK SHALL BE UNDERT.AKF:N UPON THESE PREMISES,OR THE PREMISES OCCUPIED UNTIL THE ABOVE VIOLATIONS ARE CORRECTED. AN)PERSON REMOVING THIS NOTICE R'ITHOLT PROPER At SHALL BE LLOLF TO A FINE OF NOT LESS TRAN FIFTY,NOR MORL THAN ONE HUNDRED DOLLARS. 4ddnss IA tr,j�blt /2ri - Date i vow Ing('ommi.cuoncr O N O `„�'" ' r � Y w w i i � ..iulF k4�t ...n..v. 5 L••�Y � �*,f:+ �':.+'•s.f. ... '+y`,f� aJ ..•..� I����..v+ �•'i'�x dti'i` r�'���^t�`'� V '7 �� � '�ltl�3 R v �' 4+'�.. F Y } � 4 �,�::a.c�;�.y�-�.,�"y•." ate._"'iF_ '.,.��- �`l TOWN OF BARNST�BUILDING PERMI=LICATION Map `�� Parcel 613 Permit# 29 V 71 Health Division Date Issued 9 ,9,- ei Conservation Division Application Fee Lam: Tax Collector' (3 _ Permit Fe Treasurer 02�V-3•S0 Planning.Dept. MN OW R ACCtlu f?7M Z,,A�4-L- Date Definitive Plan Approved by Planning Board .. Historic-OKH Preservation/Hyannis Project Street Address r 13���S��b� YJ cnm w , Village Ny aNvo 8 S Owner _ S 6-e..,j-e n e h&0JrA. C1/1AWAddress Telephone 60yl'1�q 1 _LI S S70 Permit Request -Cr,,w,r AWL) "54A a- /,q,e F.*s S AFfi'-a9 'a !® / c�<<1 i mid•�-� �.FC k/i �! Jlz- Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain ',I Groundwater Overlay Project Valuations o 00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) 2 Age of Existing Structure/dr Historic House: ❑Yes ;dNo 'On Old King's Highway: ❑Yes A 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 0 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: ❑exist ng ❑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❑ I _ Commercial ❑Yes ❑No If yes,site plan review# Current Use f f f —;Ir�vy;k_ Proposed Use nj BUILDER INFORMATION MIC Name Telephone Number Address ��hE3S,c�i(J4 F2 License# +A)Ah'LVY d.2 f Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE d D FOR OFFICIAL USE ONLY PERMIT NO. 1 "' DATE ISSUED MAP/PARCEUNO. ADDRESS , ' VILLAGE , OWNER r DATE OF INSPECTION: FOUNDATION FRAME - INSULATION - • FIREPLACE ELECTRICAL: ROUGH FINAL _J cl) �, f PLUMBING: ROUGH 0 _ FINAL ' { GAS: ROUGH - FINAL FINAL BUILDING - 4 DATE CLOSED-OUT, ASSOCIATION PLAN NO. J / S t I ,i The Commonwealth of Massachusetts — —_ Department of Industrial Accidents' 6k Washington Street - Boston,Mass. 02111'. of •- Workers'. Com ensation.Insurance Affidavit-General Businesses �/ .,� .>. ;vrai:a,. .y+:era'•F�L.r' .1..• •'''' �':i•: -� ^„�heitr]�: / name: IWO, address: �` a 9� hone ici —jao4 fullddress a �119 fi /1/✓ --t`site loc — —� ❑ I am•a sole proprietor and have no one Business Type: ❑Retail❑Re staurantBai/Bating Estoblishment working in• any capacity. ❑ Office❑ Sares Cmcluding.Real Estate,Autos etc.) ❑ Other ' I am an em to er with �,em'lo ees (full& arttime %/�%%lIN �%// %m%p %'ofo/ /r my%//////%lo%%%//%/s working on this job.. I am an evTloyer provld�ng vtorkers . ;,J• .,1,}j:3J il. r .'aY:•ti: T`s 'r Yls' ,♦v• lvt' 'G.HysM`%; ry.•L:r;. .ni,'Y a:*'''I:i=' .�t `':• l' Ji• re:`flTIIe' -i' ;A. ��+.Ii�— G-i✓/�y`w::J1 `:'-i. Jr:�.:i• •Yi '?•• COII] aII •I1 l 1. ;:y JI: J' !�y.'ti1•'�:: � 7 ?'4,11; ..i J'i` .�d l�:''r .I: •I ti h '�4). `r' J .r• ,ti' �'• '•''. ti r 'T ,ry•�• r'!a.i:.' Jr sa :�i:):: j..'•%�! J!•,�+>, •1.:. 17••-I'.:i F>,r,`',...'!t r , BdaTCSS'• ,1, ..;i.'Vi•,Y,•:J•. i•,:i' :tT,�,;.)•• 'i:I' i :' t '•j• ,+ .. '�•YY, ''i''t't'{:' y,il.;:r 'i'� ... :;1,;•, •,r .: s:l 1•t'- .�.•. ..t � ''.i.•'j,A� I��?e'i' 'I14i•'. � .::.', :;.:. _ .� �' '•1 •r 1 . CA:Littyl ♦ .I. '•J• • •'S i I C. -J r •J: O11 •#� y '"o s / •n e.c I am a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: ' •• •i 's' :•t;J.. �;�.�•.• •�'' }•fs •G:', .:,v .pig: :.�.ryatl' y..it,:ti�. :i: '::c t COI11raII xiamie• a y `. F^.•'rJ .}IfI s•.ti:sYa:'.y 'Yj• :$-1.]. i'' .. ' ;r. j.tl.a!F�t '.P ti.n fl tie;:, '1: 3 t. i3tj 't •;n i`a':'%. "„+';is •.:Y: :•• .p 1 •3 , t •,1;.• ',,...;.,ti(�, e�dress: ';�, ,.'N♦ ��' '�4.3.�:,.: .':��. �t r. ''r::. '+'= ,Yr `.:i `,.<,� :s, ,1 —.�•Iy„s• . • yr,•^,1�...:11.-.. •.,.••:i.,i j ..1�. •:Y:^'�;t•'rr rC:;`•��• '•t, r1•,.!'•'• Cl •Hs :''e - .•, ••ivf•y,J:•,1.�'J,d. 'r'1.;:� :I.1,.' �f r' f• ,'• ,t .P.• ;l !:• •'t'tI�I� '' r t: :!'•�a j„.'S: .}:••1, rt.'S •I't'„ .•' ''� '• �'.. �.', ,. t•/i: 7:y Y°.I,,.:Ti %.!'s,V.•:•F.�:,♦,'I,lii;i' ^s.• r0'IiC :ry•1'• )I :•1`•.k'• . .J1;•. .;r:+}� 'I:`{7.ti.'Y',' ... :s: .::,:.•r.!% fy.J:: �•v. t• 'i �' '•t..:i.• •:4,•('•^♦{:w•.�D';:•J•i' i•' 'i;I.•.. �.,Jl:s•'.! :`�• '/. ,•Ii}:'j•'t'•' i'..J',: 1':�'''�e��+art •�4'%y:��•..::: 'y' '! '" .. .i t., a il,' coin ari. IIg'�. t , r' • i'. ,' . ; AddTCSS: ,' 1 .. f': ;a., l.r.i, 'r,-•r:u• ''' ' ,, .. ^ •t•..� L. ., r8.� .ti,. .. •'`i'I.:t' 's?(! ;s.,tr y'4'� .f•' ;t . C1 ,- X,I; >� J:4 L. h .q^,i I'� j.' u'i;;a,; T:' %'i� .` :!'.;'�• :; •it•:),s' y_ :1•S i, -y;t•J ,f.• . J. 0 11CY .i�"• •�! ifs"�'�'s� '- is ' s• •1 'F' 'r'' "S •?'.:jr: .iri �s...•' J,. 'i�•;'..iu .s ' •i': :r •i�.t, rf.,d.., �:�.:y:;'•' insur-eace co;.ri .: i,';' / / J'., . .r ::s>••.,/ . 3 al ties of a Failure to secure caveentrag a well as civiled 1penalties in the fofm o a STOP WORK ORDER and a rive of$100 00 IL dayagainstt MP— I underastand that sL one years'imprisonment P copy of this statement maybe forwarded to the Office of Investigations of the DLAfor coverage verification I do hereby certify r the pains andiLenaities per ry that the ir-Armation provided above is Prue and correct Date 9,Z 3 /® Signature -- - --T. - C Phone# Print name � official use oDIY do not write in this area to be completed by city or town afTicial permit/hceme it ❑BtiUding Department city or town: ❑Licensing Board response is required (]selectmen's Of$se ❑•check ifimmediate P once ❑Health Department , ' contact person: phone R; ❑Other ' L - _ Inforniatiori and Instructions. ett$General Laws chapter 152 section 25 requires all employers to provide workers' compensatidn for*their. yiassacht erson in the service of another tinder any contract employees: As quoted from the 4`lavP, an employee is.defined as every p Of hire, express or implied; oral or written. em Toyer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of p ' oint enf rise, and including the legal-representatives of a deceased,employer, or the receiver or the foregoing engaged in a j �P to ees. 'However the owner of a trustee of an individual,F'�°ership,, association or other legal entity, employing emp y dwelling house ha`�g•not'inore than three apartments and•who resides therein, or fhe•occupant of the dwelling house bf other who loyspersons to do•mainfenance, construction or repair work on such dwelling house or on the grounds or an errant thereto shall not because of such:employment.bedeemed to be an employer. building appurt tates that eve state*or local licensing agency shall withhold the issuance or renewal lso's . section 25 a rS' 52 s , MGL chapter 1 operate a business or to construct buildings in the.cammonwealth for any applicant who has of a license or peewit to op not produced acceptable evidence of compliance with the insroae ctracgforethe performance of ublic work until P of its political subdivisions shall enter in y commonwealth nor.any• P ith the insurance requirements of this chapter have been presented to the contracting , acceptable,evidence of compliance w authority. / PP Applicants Please fill in .the workers' compensation affidavit completely,by checking of nsXu ace as alaffidavitslmay be submitted supply company name, address and phone numbers along with a certificate to the Department of bridustrial 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 youhave any questions regarding"the'"law"or if you are q orkers'•co ensation policy,please call the Depart*t at the number'listed below.. required to obtain a w mP- City or Towns . lete andprinted legibly. The Department has provided a space at the bottom.of the please be sure that the affidavit is ebmp _ affidavit for you to fill out in the event'the Office of Investigations b ference s to number,ct you rT]re affidavits may be.raturned to be sure to•ftllin the p errriitllicens.e number.which wM b e-used as a r . . the DepartrnentbY.rPail or FAX•unless other arrangements have been made. The Office of Investigations would lfice to thank y'ou in advance for you cooperation and should you have airy questions, please do not hesitate to give us a-call. ///� The Departa=t's address,telephone and-fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents gifEce of�s>i�iens 60o Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext:406 COMMERCIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $150.00_,_ Alterations/Renovations r'$10.0.00-' Building Permit Amendment $ 50.00 FEE VALUE WORKSHEET NEW BUILDINGS square feet x$140.00/sq.foot= x.0081= ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet X$96/sq.foot= 3 S X.0081= 02�•.�^ O STORAGE BUILDINGS ONLY square feet X$32.00/sq. foot= X .0081 Commprojcost Rev:063004 WO 'BOARD,. ,F UILDINd E„ .LA License: CONSTRUCTION SUPERVISOR i NUMOPOI,CS 056589 11, Expies.01%20�'2005 Tr.no: 6535 Restrite�d SER61O D ESIMONE j CRANSTON, pi 02831 Administrator t Friday, September 24,2004 1236 PM Karen Golden 508-778-4648 P.01 rCROMWELL COURT d� 168 Bamstable Road --� Hyannis, MA 02601 a P A R r N1 B N r S (508) 771-4550 Cromwell Court 168 B+Zrnstable Rotted (508)771-4550 Fax(S08)7T9-4 b98 'FAX TRANSMISSION COVER SKEET t3wtr: � T p: Fax.- Sender. YOr15H4(.W RECEIVE PAGE(S), INCI,UDI'NG THIS COVED SHEET. IF YOU DO NO CEIVE ALL THE PAGES, PLEASE CALL (508)773-4550, Friday, September 24, 200412:36 PM Karen Golden$08-778-4648 p.02 own of arn�tabXe �gcgatoryex^ ��s ,ihOM14 If C�ilax,pireetor y, rt tnUdiag sd�9 �uild3u�Gv�aaiouar 7Con,F err�►� g,),02601 . 1oa ear $ � "._. ' �a,ta�a.b arnat�b�emaua Jim 548-794-630 ®fflaot 508�862~4038 . petty iex 11 us _, --- •�. • . ,.�•�• �. � • ' - '�� �,ete and S�.g�'�1us Section ' if Us�ng A,��idex ch=r of the aub�ect prapsrty 'Lct oa snybahalf;' . - . . ;r•:;�� 0r Iota; jaercb�autbo buik tg pest sppucaJgn for, _- rnatrera relat'sve to work author bit amid O J� $i n tare o aptnCx TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �v a� Parcel D / 3 Permit# / 9 Health Division 5pvAr 1 Date Issued Conservation Division -571Tt �'�. Application Fee Tax Collector e Permit Fee Treasurer � 1 (511lu lm/) APPLICANT MUST OBTAIN A SEWER Planning Dept. AP'.00NNECTIO '�WC '.'RO'l :SHE ct.ENGINEERP.v� n'IsiC.: muoI INTO Date Definitive Plan Approved by Planning Board 1. coNSTRucTlo::a .. i..__,.. �o Historic-OKH - Preservation/Hyannis Project Street Address / 4 � b •� Village Owner S�,¢fc .ST�2 f.e�t ��• Address f �� �� �•F�/7�! U..F- Telephone _ O ? Permit Request 42 'f-s o✓�;�i� �m� � �,,,� ��� --�vx�`,,✓r � S���.� ��®.� � !,��'-�� �.ems — 1`�t/f�.�rt� �i �Y'�_ .�i✓d�.F/J,fs✓GY��!�lC /��v/r �o.�T3- J' ��fJ�m 2•ems /1�� .t 7`C� Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type 14JO Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) 41659 Age of Existing Structure S' 2s Historic House: ❑Yes �Nlo 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 (kNo Fireplaces: Existing New Existing wood/coal stover ❑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�ON Name �-1-24i v d��Si-y� ,✓r- Telephone Number o:0'4/ Address ib /�? S�J��r%' i�ir , License# _ CS' 1_1� ®s'�S"�s J[J 2ke42 i' /� 62?kd� Home Improvement Contractor# Worker's Compensation# 3/ ' �•`'�c6� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ����i y[ r 1 FOR OFFICIAL USE ONLY I PERMIT NO. T DATE ISSUED y MAP/PARCEL NO. P i ADDRESS _ VILLAGE , OWNER ' DATE OF INSPECTION: FOUNDATION FRAME '/ /l INSULATION FIREPLACE ; ELECTRICAL: ROUGH FINAL z PLUMBING: ROUGH FINAL 1 < Q a GAS: ROUGH---_- FINAL `M1 t 17 FINAL BUILDING [-!/ O k 9/ l b / d 6e, DATE CLOSED OUT ASSOCIATION PLAN NO. . t . F , f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map` - �.3 Parcel 0 / 3 Permit# a Health Division 3/l z'��� w�'� G y I Date Issued v Conservation Division Z kt4 Application Fee Tax Collector ,, r Permit Fee i Treasurer �Llcllll122 - Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ge Village 0 J Owner 5�,4 f� 57�2 Ff ,yls Address Y!?' �. -,� i✓�9/7�� !ice Telephone 6'/ ? - 2 9 as`o�/� Hfs' Permit Request �,�.0,9.2 ,p-s �✓�,�y 7� /�/oo� ©, r ems• ,% Yam' �i✓O�`'p,Fs✓C�.F'ir,°f o/`" /��ov,� �a.�fS � Q•E"SJ'�� /1.�' /1/J�/� .��`C. Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation/i�_U o 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 S- �-S Historic House: ❑Yes /4% 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: Jas ❑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:(3 existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial 0 Yes Q No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION�k,� L� - Name __.9i:WG/ C) ����-�.� .�� Telephone Number Address /d /`7�sS�cjrJG r`/1 �� , License# I /�s42 �/ ,�� d Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE -. - / � DATE FOR OFFICIAL USE ONLY PERMIT NO. 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' _ 600 Washington Street J Boston, Mass. 02111 Workers'.Co m ensation.•Insurance Affidavit-General Businesses -x` ''r:.3•. 'YC'�y• .. ..,.,t:-..F�,.."'fa. .� „•,ram:' � .8�v�1 IIame .LYf�/►��.L'/�'+` 3 !i/,�'7T/2•LE G./,f0 6 -.L i✓�—• .. ;�, _ ."" . city. J.✓i9'2�t1 i C state• zip• 0.p Fir am# ��l — 7 �� work site location full address I am a sole proprietor and have no one Business Type: E]Retail❑Restaurant/Baif/Eating Establishment worldng in any capacity. 0 Office❑ Sales(including Real Estate,Antos etc.) ❑I am an ism to er with ein to ees full 6 art time) ❑Other I am an employer providing vtprkers' compensation for my employees worlang on this job. e• L4. y. company n a m , as dr'essd' 41. i. N.: .insiirance.coC• d� I am a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: address:. Ile p ' insurance co. - MEME jjEj con an. name .:..•.•. .. _ address•. • • `} . :phone cl�v .•.:• .h �.t •..L:` �S: iiSsittaneV co. 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 cfvil penalties In the foim of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that i< copy of this statement maybe forwarded to the Office of Investigations of the DIAfor coverage verification. I do hereby Bert' u der the paities of perjury that the information provided above is true and correct Signs Date Print name W..✓ Av- Phone# official use only do not write in this area to be completed by city or town official city or town; permit/license# ❑Building Department : ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office []Health Department contact person: phone#; []Other - (revised Sept 2003) y Information and Instructions Massachusetts .General Laws chapter 152 section 25.requires all employers to provide,workers' compensation for their. employees.. As quoted from the Llaw", an employee is.defined as every.person in the service'of another under any contract of hire, express or implied, oral or.written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased:employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the.dwelling house of another who,employs.persons to do.maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer. MGL chapter 152 section 25 also'states that every state or local licensing agency shall wvithhold 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 fib is the workers' corapensaton 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 of Industrial Accidents. Should you have any questions regarding'"the"law"or if you are requested, not the Department 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 andprinted 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 perrrit/license number.which will b�e 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 . 8iftce of Investl�atlens 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-774.9 phone#: (617) 727-4900 ext.406 r COMMERCIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $100.00 Alterations/Renovations $50.00 Building Permit Amendment $50.00 FEE VALUE WORKSHEET NEW BUILDINGS square feet x$140.00/sq.foot= x.0061= ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet X$96/sq.foot= X.0061= STORAGE BUILDINGS ONLY square feet X$32.00/sq. foot= X .0061 s Commprojcost CC®RONWELL;COURT Karen Golden Office Manager A D A R T M F NET 5 Rental Office _.T. 168 Barnstable Rd. Hyannis,MA 02601 (508)7714550 Fax:(508)7784648 , Town of Barnstable h Regulatory Services 3 ]I Sri Thomas F,Gefler,Director �+ss. 9�pT163{���� Building Division FD MA` Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section. If Usitig A Builder __:: ....::.......:_.;as.,O�vnet..ofthe.subjectpropertp . .. .. hereby authorize .to:act on my..b.eh4. in all matters reIA&e to Work authorizetl•hy.this building,pe=ak-applicationtfot: (Address of Job) Signature of Owmet Date Print Name r /L6 TD I BOAR;O'F BUI� 4e EG�CATION License: CONSTRUCTION SUPERVISOR Number. 056589 1 X irl}©�IIbOrS Tr.no: 6535 Res'trr�te�g SERGIO DESI(tA(SGj.* r7 ( 601 HOPE RD CRANSTON, RI 0283 Aftinistrator j 2��r�%i4 � . = ; ,,nn . ActionAR kf { t Year T B1l No. Customer Account,In, o ftnatjon - i Htary 2 `R R f 177171 �000 CROMWELL ODURT CO' = Property Informatson r ,448 Gt?MMONWEALTH AUE a,m 1 t wg w e "Parcel ID 328-013 B(3STOPf,'MA 02215 ffecbve Date Ail Pare, , ,_. .( s _ . PrOp LOC 168 B RAISTABLE'ROAD.e+ w € d ' . " ' .'.' �� I� Lien jSate p �"� • - 400. pecta dt /H ttto F Ml Coed /Notes�� � `Quick Scan . k k? Wu 4 Sp�rfic Bst1 j� 17- Int Dt- Billed n Abf%Ad] Pmt/Crd= Interest Onpaid baI as �. 12/18/99 34571".51t °_ fl�, 4,571:51ik0 E a;. '00 05/02/0 34,571.49 00 . 345719 00 700 Customer I� Fees/Pen �0 00, Parcel Totals 69 143 00i + 00E t 69,I43.00+ 00 (h � -,a' =a• - ;� #' s x b��' �� d* R.;$7 �'�+"j x:. s. I y 9 ` r Name ° Notes Alerts £ � pue 09/06/2005, w Y Per Diem ' 00 . u 1 III 7ANC,1"ner::cROMWELLCOURTCO- 'Pk A' a �� s e �• Prefetences�;J x .; g � t o� 7 . awe .+.ae ,, �5: ~ �. r�4^" # 3�,� L } •�•f,�'`� `�. +. ,� F`€.-mot �� a rr",. �� t"� ,t,�. .� DBG BILL HDR .. ....... ,.'k/f£''U1►.. .P-t�{'t37gm,sl1np83dRBL.� tA ` 4 0. ors �` frtaY`, T77- tx .s a ✓� i,' ��r £ r� �. m 4 Disptay transaction history for the current bill t, AN�� I Town of Barnstable oFzx�>oi,, Regulatory Services Thomas F.Geiler,Director Building Division MMSTAaLE. btwss. Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Approved: 1z6— Fee: Do Permit#: St O 2, HOME OCCUPATION REGISTRATION D ate:�1Z"/ Name:. /> Phone#• J8 / � 9057 . Address: V-�Ilage: 4ya Name of Business: Greer) ' C/P�•,o F'aFi r 1 c &a/,0 2. Type of Business: Map/Lot: _ INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single famUy,dweRings,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 wirh 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. o There is no-storage-or.-use of toxic or-hazardou$materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be mei.on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials,or equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pickup-truek.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 include3. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit . I,the undersigned,hzve read and agree with the above restrictions for my home occupation I am registering. Applicant 1 Date 0� $ 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.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE:OQ10_516941 1 in please:21, APPLICANT'S YOUR NAME/S: of r 2/ A " ` BUSINESS YOUR HOME ADDRESS: /o%� TELEPHONE # Home Telephone Number NAME OF CORPORATION: NAME OF NEW BUSINESS Green Clec_r rb r i/' Enh P, TYPE OF BUSINESSSQ fP IS THIS A HOME OCCUPATION? t/ YES NO ADDRESS OF BUSINESS r o MAP/PARCEL NUMBER 307 3 (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 CON WSS NE R'S I ICE MUST COMPLY WITH HOME OCCUPATION This individu I h en ir�#s m of any p rmit requirements that pertain to this type of businessRULES AND REGULATIONS. FAILURE TO COMPLY MAY RESULT IN FINES. Author d igr�a re* COMMENT i 2. BOARD OF HEALTH ou 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: y J \f .Parcel it _ . (_dt}+ flnnr R Date Issued 3 1 96 Board of Health(3rd floor)(8:15 -9:30/1:00-4 45) " `- ���4ee � . - Engineering Dept. (3rd floor) House# NffrAB M 19 teARS s9. Leo Mr.+ TOWN OF BARNSTABLE i Building Permit Application TProjieFreetAddress //�.3,9 2 ivs 64114 �eOA o h LULIZ 7-' /%to f Village Owner S7`,�f,E- S% h 74 Address �o y yo.J sd.t-�/���� J�✓c Q'x fB,o Telephone l'lJ 1 G a? — ay _.Permit Request QE�,�i`� Qrg�, G Z ,G � A x �/y,�i�Tc h wit, �m .vi�o.� o / Gdo 'First Floor square feet f Second Floor square feet Estimated Project Cost $ �_60a r� Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use 7 �as/�/%yL' Proposed Use Construction Type y)V oc � ,g-�� Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air 'Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other `` Builder Information Name u C Telephone Number6/ Address License# G"S J6 '-9 24),411 poli 'if", 0? 1 D Home Improvement Contractor# Worker's Compensation# �,FS 4,0c� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ®X) Si �o SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. 1 l4TE'ISSUED MAP/PARCEL NO. + � r Yea ; - } r ` • i t j +— 1 - . DRESS VILLAGE 't Wl/NER DATE OF INSPECTION: FOUNDATION i t t t• ", c' I h FRAME INSULATION FIREPLACE ELECTRICAL: 1 ROUGH �'+ t FINAL UMBING ROUGH , FINAL + GAS: ROUGH ! FINAL FINAL BUILDINGS • •# f 1 1, - ": j 1 - � i + � 4 1 r t � L � - i fl� y i • ; 1 1' �� DATE CLOSED OUT 1 I r i o f ASSOCIATION PLAN NO. � � k t + ! 'p f , t 4 r 4 t r The Commoltll'eult/t of Alassucltusctts Department nj Industrial.9ccid,* Met 811HYMMMONS �If i 600 H•ashin11ton Street Boston.Mass. (12111 Workers' Compensation Insurance AMdavit Annlican nformatione - i'lease PRINT Ie tbl name: location: cite nhonc# ❑ I am a homeowner performing all work myself. ❑ 1 am a sole proprietor and have no one working in any capacity ® 1 am an employer providing workers' compensation for my employees working on this job. cotnnanv nntnc! �7.��✓/ //� ( 6 S �/�Gl C T!G irJ address• Do�k nhonc#: 2k1 insurance co. 94weo rolicy# J ❑ 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name, address: city: phone#: insurance co_ policy# �'_"`'._ -.., -.-r._-•- - .. .cn:/.-..Z..:�;.?-'?'�?",�►;ftt;`Ysr+si:s�-, - -- - t 'Sf.�"'% 7�LL.^^�+w".!!.!+.�4,"�aMsr!.•-.•-?sr comnam•name: address- citv- phone#: insurance co. nolicv# .Attach additi&A*sheet if rieeessary __ _ `�•' '� r=="� ,;,, ,=;a; Failure to secure coverage as required under Section:,SA of MGL 153 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one rears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. I understand that a cop)-of this statement may be forwarded to the Once of Investigations of the D1A for coverage verification. I do herebt•certi rler rlre pains and penalties of pedun•that the information provided above is true and correct. Signature Date Print name 2�e'c� �i o .r/G Phone# �O 'r ig 14112 official use only do not write in this area to be completed by city or town official � cite or town: permit/license# nlluilding D7iice OLicensing 0 check if immediate response is required CSclectmen'pliealtb Departent contact person: phone#; rlOther ,r Iwised 1-W PJA) . r.zavw.�i-N'i �%Ii�'"�f.$."'.R4.„t.:C?`:��V'..�s ri;e•.f''s'"!�."t.__a:.!lc+�!^s:kC'-.�>+Nwai.:_ r•..':�n,^n:Y M. .`'S.r.x...3.r _?; ."� s.., .. ... .,. .. .........�..,.3..<r+...._-.'. ... _'`'' ✓/ze V�am�moouaea o��/�aaaac6uaelt , RESTRICTIONS: 00 DEPARTMENT OF PUBLIC SAFETY license "-CONSTRUCTION SUPERVISOR Number Expires SERGIO ,DESINONE COMMissroNFA 691 HOPE RD CRANSTON, RI 02831 THE &C�ON MUTUAL INSURANCEWPANY WORKERS' COMPENBSRTION POLICY AND EMPLOYERS' LIABIL ITY POLICY INFORMATION PAGE Company:.R Voluntary/Residual Policy No.: 0000002698 Renewal of: 0000002698 1. Named Insured and Address Producer Name and Address 00632 DANIELLA CONSTRUCTION CO., ANDERTON INSURANCE AGENCY INC INC. .166 LAVAN ST 10 MESSENGER DRIVE WARWICK RI 02888-1059 WARWICK RI 02888 Named Insured is: CORPORATION Dec Type: RENEWAL Other workplaces P any shown in Extention of Information Page. 2. Policy period: From 03/25/96 To 03/25/97 12:01 A.M.standard at address of named insured 3. A. Workers' Compensation Insurance: Part one of the policy applies to the Workers' Compensation law of the State of Rhode Island B. Employers' Liability Insurance: Part two of the policy applies to work in Rhode Island. The limits of our liability under part two are, BODILY INJURY BY ACCIDENT $ 100,000 EACH ACCIDENT BODILY INJURY BY DISEASE $ 500,000 POLICY LIMIT BODILY INJURY BY DISEASE $ 100,000 EACH EMPLOYEE C. This policy includes these endorsements and schedules: OOP0101295 OOWC000311 P3601295 4. The premium for this policy will be determined by our manual of rules,classifications, rates and rating plans.All information required below is subject to verification and change by audit and premium surcharge as allowed by law. Premium Basis Rate Per Estimated Code Total Estimated $100 of Annual Classifications No. Annual Remuneration Remuneration Premium SEE ATTACHED Audit Period: ANNUAL Premium for increased limits part two, if applicable $ Total premium SL.bject to the experience modification $ 9,302.00 Premium modified to reflect experience mod of .7900 $ 7,349.00 Surcharge/Discou�t/Lossfree/Ded Reim $ 588.00- Total estimated standard premium $ 6,761.00 Premium discount,if applicable $ 167.00- Expense constant $ 100.00 Capital assessment $ Minimum premium 650.00 Total estimated $ Annual premium $ 6,694.00 2 Countersigned by C 03/07/96 horiz presentative Date Rev. P0061082 , GEORGE HOROWITZ ASSOCIATES JOB 69-0mWili 4_ nw20--r /' 6YZ=Ww, STRUCTURAL ENGIWRING SHEET NO. 6LMA72-90, t✓ {�JE�h.( G 224 Valentine SAW 1W West Newton, Massachusetts 02165 CALCULATED BY DATE ^18 (617) 244-4443 FAX (617) 244-2675 CHECKED BY DATE ,qL'1&A SCALE .. .. _... ..... ..._. .. _.... . .......... ........ .< :. .. ...... ....:.. .... ............ ..._..... ....... ............. ... '. r ..... ........... .. ....... .... ....... /ry` ... .... �C� N�rtt. G'Ps Zv t .........: ....... .. ... _ .... .... ... -Ova 'Bt*A,'' t yet �"`'D WAk t,� .... ........ .. PNOOUCT204-1(Sin0le Sheets)205-1(Padded) .lnc.,Groton,Mass.01471.To Order PHONE TOLLTNEE IM0225-00 .. . ._ ... ._.. .. ... .r _ „r r:• - ..w'--.r• y-e".M='ix�.p.K..... .�yx...:+.,ii''''-b.... .sw".` '.a .+ak,1.. . THE TOWN OF BAR TABLE r0� STAM m O� BABAM11"Ml Office of the Building Inspector i639• - + Date May 23, 1995 r Fee $50.00 Permit No. 97 PERMIT TO ERECT SIGN IS HEREBY GRANTED TO Cromwell Court Apts. D/B/A LOCATION 168 Barnstable Road Hyannis ANY VIOLATION OF THE SIGN LAW WILL CAUSE IMMEDIATE REVOCATION OF THIS PERMIT Building Inspector The Town of Barjetable permit no.-22— P . .�. De artment of Health, Safety and Environmental Services Building Division date �` 367 Main Street,Hyannis MA 02601 fee/,C—0 Application for Sign Permit Applicant: C m m u yA CayC 1 D. Assessor's no. �'�J7 a�� Doing Business As: ( Telephoned`L' 6 Sign Location 2d street/road: 6wot — a 0 Zoning District Old King's Highway District? yes no Property Owner Name: Mc- TelephoneTr Q 0 —a ML Address: � J D Cn M M On (,�Jg�� A�j Z Village fo4zn M a 6 a a(5 Sign Contractor Name: Telephone Address: J) kQ Yn i9jo �, Village M jd"Pk0 Description Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign to be drawn on the reverse side of this application. i' Is the sign to be electrified? yes no X (Note: if yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinances. Date Signature of Owner/Authorized Agent 5� Size (sq. ft.) Permit Fee P Sign Permit was approved: disapproved: — Date Signature of AUilding Official L N I a �✓�O�t IQ M O 5}�1 ........ ........ ........ ... LO LO erg 3cIWELL CGLT d f cr. i APARTMENTS S U it Gor»2Y SafhE � irwPn si ors aS fLX�s�r�„q S�'�n l �`�y RedaasZ 1 z '5,JQJ ,iA Posh � d�%��� - 3( J9 � E o C, � 1 L Ai rr / rs 3c RT APARTMENTS i Cornet ° s I r. rac K� $Ll Sar�� d ors Qn 5►a„s as rz.x��S�r�hq Sr'e�r )` l��z Red4ac • z S;Jad 41A POsh j, d�/',.�•y — 3t 9 l � K tx! ti e v „z. • w!v. F mi On t �5 3�,,. ,,. ,. '. �. .. ',� ,.,, • -3,. �?� � j��'$�s.�5�e�rs4 �W<h'�'r•�'A 3�^ k, °n,s'-$;c.. - 9: z -s •'�y y'i a3�, ,.t15., s"�F,. r :r..,�` x;.'�'SM`f,as ���� .-. ..Y.. IK A �r hx R r� w F; n•:. °F ,te a ¢ hYr'iy a a .v�AP, a as. '.. ..... � � � � r '. - .. I ,.- 't!:�'. 54 �.4'� .'1`- i S #t �' +„ t.. � �4,-jW�f � y'� Rs4{y'.• An si ��s ..Y tr. _ ..._. -.:.. � ?, li'` 1 •. "l yl�`a.�`��T� j�s,` � j��k oR k,��5rr .G11n.,� : .- s ...«..s_fir .,,�.:..t4 ,a�";��r ....-.,3x...�... _ ti..,a '`�'r;,#�,,�^ i.r !, S-ti.+„f „��.>N+� :,G•�tsa• �=1"� "..i.•�;` .. 4 yx karen golden office manager r cromwell court apartments rental office 168 barnstable rd.,hyannis,.ma,02601 - (508)77-1-4550'--,, Assessor's map and lot number 3 2�.......�,C�T" 13 lea Sewage Permit number A0 .J7—,....0 .....`�G ya*THE TOWN OF BAR.NSTABL • •BAHHSTdI1LE, i .69 OUILDI G INSPECTOR APPLICATION FOR PERMIT TO . o .. .T .VC' ...... ot. .... .... .�, 3pq. �+ C ee S�'d eV v APT RL,?G TYPE OF CONSTRUCTION .........LA.MM........ortw. .N�T�..... .........:........ .......................................... - ...... ...........,9.73 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .B.A.R.R.41-AZA.L... .1.b................................................................................................. �j R.tl il s Q r 1 ./4..H.I��G.T.M.. ,.``II ?".........6. .. ..� Proposed Use ...��(.�.�T./.fI..r.IF.�../T:�.C.I�w....�.... .. . . ,T... ... ...... Iry /iT rr cc �...............................Fire District .................. Zoning District ..�. . ..iw..7l.. .............T.............................................. Name of Owne�R .M. .E.�l�....�Q.v...JeT... 41dress � .......SrR..1:..F.......%5- 7.!...... DAT�r7 Name of Buildera)PR.-r,#.j.#*.-r..©0...... .......-47-h.l..s....S./..!....../&P.xra oy Name of Architect�.Q.M• ./Y,..`, /�.J4!kM,9.N� ....-.z eX*A,51.j.M04.....6.r• 0' •� Number of Rooms ..... ......'f"44-4—A.4..f..................Foundation 1..a2....... D... .L............rBos ?o.! ...... Exierior&Q 9.!�.v....0......3.a9.T-r.E.I..�.............Roofing ,�. ,/ / .......6#1#4.4LE. . Floors ..e,0*.eR-X.TE...........................................Interior .�� ..ji .. ...................................... Heating .r.� .�... I�.1.. ...................................Plumbing .......Rog../....►!r ^ ../....!.......... ar 6 Fireplace ......M.Q....................................................................Approximate Cost ..�. . ................................................... Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area d.......� ................... Diagram of Lot and Building with Dimensions Fee [ ! 6�........... .. ... ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �dd da Joe J a` I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable r garding the above construction. Nam �--T— --� � Crmmell Court Co. -~=�\ '� ' �� . ' No — ._Parmk for ------------� ' y� �� (�^ ^ � / �� /ii� recreation building ' �� 0 } --------------_=—,-------. , , ^ ~- ' .. ..3�w�%____---- ' ^�r7 � � .......................~'—'~=-------------'' ' ` Owner --' . ..{ _____. . �� - ---- --.. . , / Type of Construction .............SrPAQ................. ` > ` . ----.—.--------------------. � � . Plot ............................ Lot ................................ ^ | ' August 9 Permit Granted --.. .�----..lP ^~ � Dote of Inspection ------------lg -Date..Completed --- °r.��0;4�---.lg�V 4~�y � � i / ^ PERMIT REFUSED . / ' Li lV-------^-------'-----' ~~-------.-----.'---,------- � 'r---^--^^---------^--------' ....................................................... | ' � ' ~ �''��������,����������,�����, i Approved ................................................... lV ' �-- =. � =—' __ �����������������,�����,��� _ ' ` ^ i Tt., commC NWF-ALTH bF:mxA s cku sETTs:. TOWN OF BARNSTABLE BOARD OF APPEALS V, ....... ....... 72. ;NOTICE, O0 VARIAN.C8 Conditp6xial or Linifted Variance :or Special, Pernit (: eneral.Y.aws Chapter Sectioxt 18 ns amended): Notice is hereby given thaf a Conditional or Limited Variance or Special Nrmit:has,been granted; To ...aromweu._ cttEr __ s ... ...... ,:_:_ --- - Owner.or Petitioner Address ..1 2 Barnsta-40 Road (84 State Street, Boston, Mass, City or 'Town......#y�� . >. _...::_:.............. . 82 Barnstable Road ................................I.. _....,-., identify'Land Afidc". by the Town of Barnstable. Board of Appeals affecting the rights of the owner with ;respect to the use.of premises on.. ..1$2..Ba—=A`.able--Road $treob< CPty ox Town: the record titI6,standing ia'the name of ::...:. . . . . :. ::.....: amwell _Curt•.Ccr►P3Y.: ....... ..:::::....._ whoseaddress is............ ... ........ ................... ......... .................................................................... . street City or:Town state by a; deed duiv recorded in the ...... ,- ----_ -----..Cowity Registry of deeds in Book. --... Page..:: ........:.... .......: ..:..:... ...-- .:. ;._._ ...._;.:. Registry.District of the:Land court` ..Book Pa e.:-:: The decision of said toard is on file"with;the papers in Decision or Case No,:- .. in the office of the Clerk of. the. Town o: t Barnstable. Signed this:.. ...._..:day of .>....... ........ Board:of: A Is: C. . :�..._. . �-.. .� .. CI�¢xrmn:. _ _.. _.... ------. ----- ....__.Clerk IIoard of Ayprials ........... ....... ..........._.._ .....1.9........ at.............o'CNoek anti..._... ......_., ..--.---.....,minutes ...ate. N?ecezved an&entered with the Nieg'ster of Deeds:in the County of:::.. .::.......... ...... Book . . . . . Page: .... ..... .._ .Atnn . Register o f weeds Notice to be recorded by Petitioner' John Weida, Jr., Marjuej Amaral, XaPuel A. Amaral, Jr. M. G. Arvanitis9 R; Arenovski, T. Axvan tzs, D. 'Me Barbera,. :C. H. Bearse, F. Ba, ;Bearse, R: :H . Bearse, is , . Boese, I. Boreasa;; E.A6; Gaptainn9 '; Be Cash, D . Chawan, . I Clzapaiaa3, X. E. Chase : J. Ea Childs, E R. q;jjEL#I. Hanna . 'Clark, M. T. Garazzar , Rd-A. Crocker, Be. Damo.rafiville, C. Diniak, A. ,Dorbek David.:L. Ennis, A. Ediaa, Se 'Fagan, V. Fa Fisher, B.: I , -Fi.tzgerald Be H Francis, 'K, P _ G�:orgales, T. A. Georgantas, E. Golehski,,. Me E. Grogan, D,'Be Hwonett .: `Harno s, G. J. Hayes, E. Da Hennessey Je Re. Her , V` T. flodgidn.4, T :0a Holmes, C. a Hvoten, h�yat r Paint & 1 a13paper R, Oi son, L1I, D.. :Te Jones, Z. J. Karathansis, Ne P. Karukas, H. K ;erstaci, K. no'olauch, Caroline LeFauci, G ; A. Levis, J4dquist Realty'. We, Ha :Madden, A. MarPland, J. R. Mi ilin, .9 Naul t, G, Oliver E. (31i ►er, C A.. Pierce, Leslie Porter, R. L. poyant, John: W. Robertson, AI Rosenbaum.. E. A. scott, R , F. Sla*is3, SmaI3, Smith, R. Sprinkld, R. G. St arck 'W. . Strarageg G. �. Swansea, Eo TerPos, He C Terpos, Jahn J. Troccha, V . S HeRealty, Re He Wafters, Jr 9 S 6, D, Weeks, G. Unnoi los, Francis P. :and Carole. Anne. McAuliffe., Ruth Aranovski, Edwin task , Manuel A.. Amaral, Minton T. Sr., and Elizabeth Hodgkins, Sew to Jr, and Barbara ,Reid, Evergreens of Hyannis, Ine. Jenny A facturirg Do,, g Wand :Maxine E , Roberts, Milton H. and' ss a Howard, Laurie and Eva H Green, Coililam J.. and kizabeth M. Pear. TOWN OF BARNSTABLE' PETITION FOR x 1 X UNDER.:THE.ZONING BY-LAW AMENDMENT To SPECIAL.PERMIT R'a the:Board of:Appeals,. Hyanais,`Mass. Date Februaryrr.14,. 1972-- The undersigned petitionc:theBoard of ,Appeals:to vary, iiilhe'manner and.for the reasons: hereinafter set forth, the.'aPPlieation,of"the;.provisisns of the:,coning:by law,to the following.described premises.: Applicant CROMWELL COUR'P COMPANY - 84_State" Street. Boston Mass N109 tB'n11>'Tame) t'GVtaLer Addree8)- ONM" : 'SURF.MUSIC., INCORPORATED, 2.96 Nan:tasket.Avenue, Hull,:;Massachusetts _._ wintor'Aaareas)'(F�il1Name), { 'Tenant:(if any;:.Leonard Zimmerman, 124 Payson Road,,,"Belmont, Massachusetts ( '0 Name) (Wtut"Ad&ess)' 1. Location of Premises - $2 Brls �. Rrtd Hvann i tName'a street) (;What s— ecdol ni Town) I Dimensions of lot ......,,..U-5 21. » Area C't,1,Ara, t r more or (PYontsse3 tnevtt+) (squazo l oet) Tess 3. Zoning district.in which pzeuuses'are:)ocated : 5)X3 5 k3A 7 4: How long]:as owner ha.d title to the:.:.Above pzemiseSj.- S Hoed;many buildings are now on the Io9 . . 6: Give size of existin biial s:. 901 x. 160' (:to be demolished pprro a`sed b,nl ' s " 5_bu�ld3s, wYiieh, incluc es a.11l �Dings " 7. State present use o$"p emises O, C hAl T r. F n{t: rel a P_d thw+r_ rato 8. State:proposed use of prerniises Mu#3 &MYjy._dW.ejjjag- - 9. (dice extent of proposed eonstruction or ,iterations:C0nS±rli.C�iQn_Cf 12.;4.. 2 1t• units; in 5 bu +ding's. 2 ll o ?� _hit h_ lt) NUMber of:living units for.whxeh buildings to be.arranged 124 11. Have°yon:scbautted plans for above the Building Inspector€ YeS� I2. lla$rhe refused aperzait4 Not appicabie 13. What seetion.of zoning by-law do you. to be variedY see letter wit whi'pkt this ap lication is attached 14: State reasons for variance or special permit.: ..sl•-e y. io»- h'' h. t'lai --:=r---,�,.ttan is attached . Respeeifully;snb.intted,; (tiignatnre) Gl2OMWELL COURT., COMPANY Petition received by.- ;.( Address) HeartngAate set for -13 ,_ Walter R:. Winch': stem; eral Partner:-. °FBing:.fee of, O.Otf regni;ed with thas:petition: 84 State _Str 1.eet, Boston,MAssachu�et:ts. This form may also be used,for Appears_ SURF M I NCO ORATE By 7 William i.Spence,Presx ,29$7MbtaSjtet Ave. •Hull.:Massachusetts` The following are the n..,es ijid.miaffig addresses of'-the abuft, owners: of property and the nalne and address of the owner across: the. street, according to .the records in the Assessor 19.Office at the, date of:this a PIpliatioix: Please:type or print only. SEE LIST kftACHED.' HERETO There must be submitted With the within application at the;time of fig...a plan of;the land—in Auplieatq,,. (or two:,prints}.showmg:. 1. Ihe dim- ensio.n.s. of. tbe )Amd. The location of existing buildings on the laud. 3. The exact;location,,of .the improTements s.dughttm be placed on the land. Applieatious,filed without.sueh.,plans will be returned witbQut action by the. Board of Appeals. Verified by: .Assessor's Office ' F r "ap :ytree—' ,, t Vicar .�, i��$S._; r ✓"" ", .✓aTs a t=... GN c:�`r S c'�".J� 2 .tiCci.�., 1Ilil« S, NS U o:. a�>O Diu;? .1. A. , A 1 '. ,. 2 It Barmal t , 7aT1r. 5, :aSS`• G ,t 42 a`J yJ�. J J-i.Y'C Y�i .., �c Q.i,..i:<s , Mass. ... .. _ _ R. P ine 7 t "e :.i�, .e , warn: s, z la.ss r .� �,. .y.�„ ,�__,.y is�• �34: �o'L t�..'+ Street, wyani� f Mass,. ...:::.V'Ci...a. �. , . n� 3 ; u_c 17. ids. , j_- Duncan LaneG x rovin cetown, ,Sr SS'. ia.2G ;� 327 ?i T v S�:'.':"cL�z:., Cer c.ezv .: e., i c.55 B.,', 18- .Yisher Road, .iyannis., Ka 5s I '• �«� 'G1lils, Mass. _''.oc�C� 'y nil:s.cs :MASS:. 21r Bi00K:SC:iwe ,. X,j ri'CS 5. Way Hyann.'.S Pla:'s S':. A. 2$ S ring Str&e%r :hyanrS , isaSS'. IV,arr�V l�L';aG''., �`��:...>'�: ,.0 1iC�..i.. .ra'Ss. BCGok�i ire Roctdr fSy�r:li5, ass. ^J {� " ar"�. =�.1 , 5 �?pl:srl Si Cc?uy nVailr;;•;,5..�. .3'a ��• 1 . . ...a ". , 3rooshire Road, Hyannis, glass.. G`.a.0 C,a.�„ .. S t 1'la.a-ru' +- r.:• �r sc. C , j 33 v1TGOd 'i0 , (7tli'L}.,vG`LiuJU i:1 iuSS arir.a C, , o/o �o�e'�� �. Chase,. :'�:�, `S'ca oet, Hyannya,, Mass:.. .Co'e.Z a'�1, 2�. IT, Z$ 1 V Later S�. eei, lyann:+.S, Mass. 3. A , `135.8 l a_Lnb ..4 ?ZoaG1, Ce_s�ery 1 Ie, MaS'S �:.;:e aryl�e, ,. , 364r `�sreeAo ; y«rn sass. C, y 3 u 'i Sprllltre�L,. 'riyaiinis, MISS. aarnSRSys n<1S, cSS:.i87 3 e. s , DaV i i,;: r {81 }.Cry .'load, Hva. i S.:, masS f s] s,. , 5.0 Grove ;Scree:, x yann .�, ,�Jas .. 4 C-4n, S' , L07 Spicing S�. .ee L,. iYV'G3'i�'I.' S., Massa .. f lT. r../ iJ2 SCirej= S�r_eet ., ryas: sy Mans • 'r � ice=, . , 2 . P s, Mass`. r , , a:rC : "y �1.,., 112 Spring S Free. Hyarin2S, Mass'. I.,Coyyale X' ,.., 70 Sir ncF, S ree , Hyannis, Mass, Cti 0'r as, A. , 1 Bro.o,kshzire Rba:dl' Elyaa l'i .'s, YI&ss, 'Go1v..s c7. y ,. Redwood Lace E; l ass, a Cro,an, V. . '. , 12.7 Sp1�ng S ree'L , hvanro s, mass e.:t;y :. .B. , 29 Spig S txeet', rly ~�n .s, ,Mass:. :o 1. 4 £3aLriS�aaI ROac.r Hyannis: Mass. i � a.t72S y C. 5..., 24 B,wookS . V'c n nJ.Sy i�iaSS. _B. , +"79: Barnstable: Roady $ivannis;, 4as"s:�. qAy�..:., 1..3-� S'prinC•f.::SA10. c�..Vc.; ''Vd:72 33..�> , ._iYasS. - Hod klns, V . . , 289 Wi #'..e. '. SLr : �., yarn s, N!a'ss 29�A 3in' ec St eat Mass, y oo'cen., C. _j. , 2 Brookshil e Road, hyar i s,, Mass. ?ai.nc & Wallpax�e , 208 B rnstab�`e`Road, Hyanx s, Mass., ;i so , R. A. ii , 2 2a 3arnstab' Road, Hyannis,.. Nfass: . jo:is, :B. 1 . , 53 Spring Stree annis, Mass. ta'tc3..nc:rs!s,; Z J. , 4 Broo'. Sl J_' c Roata, 'yannis, mass" 22, is j.ns:.aye F.osriy�.�-.ras, ;- ayswu , . , 2ar�rard load, Derinisport, mass. �+ rn0.r aUf; -K , 133 Barns:abler IR6ad, H'Yannl is, 'K S:..:` r Caroline 37 Kir s Wa t3vannJ. mass a1G1,:G t+ i i.� J '� .: Y,J .. ✓' < La vor;.s, Gr A. , 3 Brookshire �oa,c, iraS s, .�'iaSca. Rea U_, , 5� p. Box 3:87 .Rock anc Mass. 1j, 1.C..1. � c, l i,.y, o r , 1 , �.aC%. i1.,. 'i^.. ,`^JS i,ouls S'treGL, Hyann, s , 1.v!as's. I J l j �Fc`w:Slazid�. A. , .7 ,rQo%:s .i c: {7aC1 I va23:1 I5., lti,aSS Barns table boa , :3yann .s, 1ass,; r , 0 S~: my t.T:. Ot s :.y3T3Tl.s ;+ :asS; v! Ib, rind greet., ILI a-m i S -K&ss. j- p .e.Yce„ :c s A, ) J,O: S� .� ^ig SrVrealw, Hyannis , a.s.s . "v i:2s De G, 50 ci2e%iton Roac.T Vol I as,..,- to ,J ^ cxS.S � o /' `:.,- -R. .:j..,. 279. Bar ns%al:l.t"'` G>ad., �yannIs Rog, r,-sor. John Tfd'. , 2:9 Sc oo1 Stre&t '�?'aun.4, ny ViaSw` Y' ose�Dak=1 A..,:p 11 ."vgash4 :1{�l0::. Ave. , Hyallll,..S,. 'l�c1S;Sa sc .t, E. A. Y 2.2 Brookshi%r0 Roaa, �1Yannis, IrasS. r av .'n,,-P, , 74 Gr6ve, 4 tr:eet, ,Hyani S, pass. E , C ?at''ham Mass. U_ 296 'Winter, Street'r �yann is, Mass. S•�� 7.]c1Fe,. R , BOX 22 ., eaz; Harv7.ich ,ass'. S c.ar C i,: R., G. B-1 6 }kS:r1'�r 2 IROad '�iyanni s, ,,ass. 25 GroV£' St'Ga'ai;p riy nn 5"paSS<a ' r Swa:nsea, 27C WinterStret, t nis., Mass. c:- P 4 3 w. � S %Lng: Street. cyan. is,, Iv. s. y'e�";oa, t.. C,,. , HC pkJ as Nock AoaCt, C,erit�rVille y Ma -:$_:.:: ✓' =L'iCcch,iy. uohi"i J.. 31 Bioo'',CShire. ,�Oc^i�, Hyannis, I�aSs . �r v. S.711, Reti a.lty 77.3 �s.3'ed a;.:: St e t, -"-tarX t-on,. 4M!aSs.._ ."` jr;F Lr t ats i R. yy.., 7^ ..ice: ' - . .::. 57 Sp_;'ng S� eSZI 3yaa.ri .s .Mass .S. D. ,.::95 S3r'.:1.Cy7 S- . y hyann s, ;�!aS.S. Lo.S G. , 1 9 C:iuY2 1'e l `Pt a -ve^ Tfi z s t Yarmoli t�2 y. .N..�S S°- T.;; fiy M :. and Carole Anne L` , �F _ .. �. _ . _, xa.4cz5 _ t� ;axles Street, yannis. Mass. .. ;•! A �.. i.{)Vc Ru'th 4.9 ml in. Street, Mass... t.[rJ'in:., 36 Charles sStreet, IAIyannis , Morass. _::,a_a� , Manue.I A-,. 250 Barnstable. .Roaa ; Hyanp- s, Mass., Od 1kins,, �?.i %o71 T. and .Y* lizabb.th:, SM'. , 2�9. Wln t2r '`J'tr@fit, Ii�yu3 �lS,.i aSS:, eid Seward :K. , Jr &' Barba a;, 333 Scudder Ave; , Hyannis, Mass. ✓` y�Tercre ._s of .I:yarn3s, Tnc. ifa:n St�zct, Hyannis, ,��iass. ✓`` ?s^.:ev Yla a"a:c 4uring. Cc . j Boni. 100,: Chasiru% Hi l.., Boston asS.: :toberts, E. MI ne E. , 5 C14,1- 1.es St>r:eety H a.yanns, Mass. '_101a4Za, ir1...ioX'. H. and Bess;ie, 7 Charles St:reat I Hyannis:,, Hass, o2i'i, .:.lau C]2 .and. :BVa :M. :, 24 �y�d.4�:1i21�t�.On Ave BXt. ,. :�':,yanT115 p :MaSS;.. vvill:"ian, J. and Elizabeth M. ; 19' ,Sprincg Stree"t, Hyannis, Mass.. ti T( � TA L Board, of Appeals CRf)P9SrE :,;, CQU1T Petitioner Appeal 19 7 FACTS and DECISION. Petitioner »�'�"�� AT �t � �l M . 1 ... _.._ ...,., ... .». ed petition on i _ 9 79 requesting a variance-permit for premises at` .�B ,st ..Fio :. #, in the village of. Y Hyam is ........I adjoining premises of _.. :,» »» .» _..... _ », .... for the purpose of --c�s�.� c� µ � r� .-Uzdt3:... _.. __� )....buildinga,�_ too--,. r ;:.��x .:. i12•�:_ a .lamsa:�._.� �::_ _....:.: _ .............._. sp ezoin � ;s_ 1:.Locus i res n Ity. ned Notice of this hearin g ,ryas given by mail, postage prepaid, to all person deemed af�eeted. and. by<:publislaiixzg in. Cape Cod Standard Ties, a daily newspaper published in Town of °,Barnstable a. copy of -which'is' attached to the;record, of these. proceedings filed with Town Clerk: A public hearing by the Board of :Appeals of the Town .of Barnstable was -held at the Town' Office Build Hyannus, Masfi, at : ..C34 1: P 11f :.: ..:xxj 19 7 . s: upon said petition wader zoning by-laws: Present at the gearing, were the following memben- c4ing rg Chairman e December, 1971 Board of Appeals Town 'of Barnstable Hyanais, Ma.ss.achusetts .G`entlemen; Can August 13, 1911, the Board of Appea s g�anted a�Sp'ecial. Permit in Case l o; 197]-38 on petition d`clted ;lone 2i, 1971 of C romwell C our l Company and Surf iVlusic„ Incorporated; aPp lieant and :.Qyj :r' respectively. A copy of that petition and your d�-cisxon is enclosed here.«ri h. The uncl4rsined C:rorn well Court �oxn_oany and-Surf N2use, xncorpov4ted, sti-i as appiicanti ana owner, rereby request :t eat the ec; zor� granting` said Special ermlt nati 'a amended fo inesuzle ;auclitional f ._findings as:zollow's s (a) That the third seatenct in, the first paragraph of the said ;.: decision. .,..of the B ea oard of ;ppls {Which sentences reads "Uri w`ij:aoi* said ;that the bu` ldir g.now located on the premises is and has s�een_a non-coao:^mng business use. f'3 'be deleted as�d that the;:re be :sui stst' tea ;in ;place thereof, a finding 'substanlz�isy as f.040W.s _ °IF rom testirmony pres.en'ted. at the hearing ;the Boarrd: have been OF f'rr°ds ;thaL noires-:td�rtsal .use rude s':r re 1941 of t}1e .r3Owt i:on of, the parcel presently zaned lZes i:�'.enCe' { Board of Appeals December 071. : .Page,2 (b): That the seventh paragraph of said _decisionvhich paragraph begins 9'T,his.parficular parcel, . ,, and ends with the words 't a business, use. } be deleted and that.. there be 'substituted 'in place:°therieof a finding substantially as.;follows "7:he Board of Appeals flnd's, that the rear part of this.. i ar.c.el :has been employed for'vario.us busrfi:s.s uses and: that the ;past and present e.mployrpent of the rear section which is presently zoned Reside J.A� constitutes a legal non:-conforming ujse under section G o the present Y- Zoning:B Lary.. The Board has 'examined the:.plans :for ` and,'has; heard testimony with respect to the proposed use of the premises for multi-family apartments and the Board is of the opinion :that the proposed apartment comple.� to be: : situated on the Residence 1 - port on f ehe parcel w;ou d .:....... ... .. .. . . . . F be a ix.se:;less detrimental to the. neighborhood than the: existing non�conforx#ing use. The Board, therefore; finds that. the petition falls within the requirement s'et -forth in, sub- paragraph 7 of paragraph A of section P of the ,Zoning �.f L Board of Appeals ' December 1971 .Page 3 (c) That there be added;at the end of the eighth paragraph of said decision {.which paragraph ends: with the words '„hon es. located on Spring Street a finding substantially as foll,oV"s:, "Based;on the evidence and testimony at the. hearing; it is the opinion: of the' Board that the proposed. apart-- ment oomplex, constituting a residntial use, <moxe nearly convlies with the spirit and intent of the Zoning y l,aw, particularly withi respect t. the section of the parcel which is zoned;for::residbence and that the. proposed use may be;:expeeted to be,of benefit. to the public :and the neighborhood rather than detriniental to either; " Inasmuch as, persons interested in this anatter. ma3- be entitled to noti.6e ;prior "to consider.at on thereof by your Board and in view of the change in section.l? of G. L, 40 .A,increasing the nui i of persons entitled to receive .notice of hearings, there Is .attachpd Hereto a list of the abutters aid the owners of l and -next. ad j o i n'i ng the 1 an,d of the abut- ters as. s own on; roost recent tax 1 ist.s avai table ,at the ToY:jn all . The undersigned further request that in the event that your Board determines: fol lowing a, be..aring to gr nt these requested ame► . mients, the. decision of the Beard incorporating swth amendments be: entered and filed vaith the Town C1';erk as the. deci:--lion of tt;e Board of Appeals in, the ;above case.No. :1971-38 and'; that; notice thereof`be given :as r'equ:i red by G'A. 40A, section 17. 8caard of Appeal sI pec.mber , 1g71 Pa'g`e :4 The Pet t,i oners herebv offer. to reir bur.se the t3oard; o.f Pippeal:s 'Tgwn of Barnstable far such ddi tiQnal costs; as may be ..Incurred $n Fec�nnect.ion w i:th pub'l i cat ikon., advert;i'.s i n <and ma i 1 i ng< Yours t.ruly:, STATE STREET DEVELOPMENT COMPANY 'OF' BOSTO.N 84=`STATE::$TRF= B©STOIC: ASASSA CHITS ETTS 0ji 617.742.4990 December Board of :Appeals °Town of Barnstable s Hyanni-s, MaSsachusetts- Gen tl'emenn;. tan August 1.3, 1971 , the. ,Board of Appeals granted a '.Special Permit; ir3 Case .Pfo. 1,971-38 an petrtlon dated June 21 1971 of Cromwell Court Company 'and surf Music,, Incorporated, appl icapt and owner respect velyo A copy of that petition and your decision 1s enclosed herewith, The undersigned Cromwell :Court Company -and Surf Music, Incor- posted, sti'11 as appl.i.cant and oalner� here request that the, ,ecrston, granting satd: Spec:ial Permit:: now be amended to. Include. additional findings. as foi Dais (a) That the th,i r.d. sentence i n the f i rs;t. pa;r graph of the said decision of the: Board of Appeals (which ...sentence I reads "Mr. W.11_sor sa i d that the bu i 1 di n..g now 1 ocat:ed. on the premises is and has been a non-conforming busipes-s use. be deleted and that there be :suhstltute:d (-n place thereof` a finding substantially ..as follows: ':':From' testimony::. p;re"sented at 'the hea r i rig: the Board. finds that non,,esidential uses have been made since 1941 of t:he portion .of� the parcel presently zoned. Residence Board of Appealss: Becember 29, 1971 Page 2 (b) That the seventh paragraph of said decision (which paragraph begins "`fhis particular parcei4<;0"' and ends with the words "....a business use.") ,be deleted and that there; be substituted in place thereof a finding substantially -as follows: "The Board of Appeals finds that the rear, part of this parcel has been employed for. various business uses and that` the past and. present employment of the, rear section which is presently zoned: Residence A-i constitutes a legal non-conforming use under, section of the present Zoning Bylaw, The Board has examined the.;plans for and has.. heard testimony with respect to the :proposed use of the premises; for muiti-family Iapartments anti the Board is of the opinion that, the proposed apartment complex to be situated on the Residence A 1.. portion of the parcel would be a use less detrimental to the neighborhood than the exis-ting, non-conforming use, The Board, therefore, finds that the.,, petition- falls within the requirement set forth. in subparagraph 7 of Paragraph. A: of ,sect ion., P of the Zoning By-Law," (c); That. there be added at the end of the eighth paragraph of said' ;decesion (which: paragraph. ends with the words "homes located on Spring Street"") a findil.ng substantially as follows;;; "Basted on the ;evidence and testimony at the hearing, Board of A peals December 29, 1971 Page 3 � proposed it is� the :oPlnlon of the goar4. that the peoPOd apart- - 0 ment, comp. ex., const Vtut ing a residential uszei. more : nearly complies with the: `spirit and intent of the Zoning. : By: Law, :pa'rticula.rl�y, with respect to the section of the parcel which is zone-ld for residence,:. ' an d that the proposed. use may: be expected, to be of benef it to :the :'pUbT Ic and. the: neighborhood ra ther than d6trimental. tazi:ther,oll .inasmuch persons interested.: in this matter ;may 6e entitled to 6 d Yn. :view of the change notice: p r for to: con't Werat ion thereof ;by yogr Board an in Sect ion 17 of G:.-:Ll. 4.0.-A. increasing the number of persons entitled to receive notice of hearings, there: IS. Hereto attached :h' to a IS li t of tho abutters and :the owners of land next adjoining the land of the: abutters as shoWn on most. recent :tax ll.s. ts available at. the: ToWn Ha I I The undersigned further request that in the: eve6t that your oijr Board �determTnes f ol I ow 1`ng a :he6il ng. to grant these requested amendments,, the decision .of the: Board Incorporatin e the Town g such: am ndments��. be:entered :and filed ed: with: on o Boar 6 f- Appeals the, Is o N and Clerk as th& declu I ea in above case 1, : 7'j�-3 decision .,P, that notice. thereof beie g I ven :as� requlre& by G.L 40A section. ITe The Petitioners hereby offer: to relhibur5e the "Board of Appeals ,oe ::the :Town :of Barnstable: for: suchadditil'o.nail.. costs -at may be in,c.urred. ln connection with publicatlon d t fi a ver ising. :awd ma l il,mg:'O Yours:: truly,::. CR. LL COU �e()11111111PANY B lag General Pa r jo n -R, Ga B wal ter Winchwen.er : er s General Partner :SURF MUS IC„ INCORPORATED 39a TOWN OF BA,RNSTABLE Board of Appeals _................GRQI ELL....GUm..._ 0101 ............ Petitioner Appeal No. .........1. 7.1.-3..8..........._........._....... .July.......3oa..........._............_. 19 71 FACTS and DECISION Petitioner,......cC'.onve.u.....o.Q.urt.....orv.mv. Y.............:.............. filed petition on ....... 7s.......... 197 Ms 2 1 requesting a- ar.�4@--permit. for premises at ........B:arA9:t.ab.]_A ...Road.................... -street, in the village. of N a86.:4g........................ . adjoining premises of_....................................3r— ...............................................:............. Domba�e ®vz- vV1,.� .0 Hdrs a r J e: �p> Ta d: � °. & jey a chaa-epcharae0 � be 12iia-k A .frTV.4 P,& ar a. Ddrbek, I��"iT3ld 010a 00 `enei & John K. a was, . ry * Gr oput DaVI BUZaboth 0. Hammett Oestrus oavlol tit th:01 * .,Ueuueoseyojolaephlua Ito & Xelnet Pain Al e `yo o a t0luoBy .s pp pe # Inc.u H�garet : 49" fo';. 11094o David T<m A Sheila, .. Jo eSt, Zatirls J4 4Y' ffie Vs rath asks0 x1oholas Pg & Jennie B® Xardkasp George Ao a r-le V# L-awis# Wmdquis. t fleAlty cap s 0 W-11 .1aa . o. Xa., Maddens A g t A., a h $ , bl, 00 U'la A 61'au 'verpo-s# Harry Co & 00bara J4 Terpos# 0obert 11# Jr* averly J. viattersi Silas 11% & Rveiyn B. WOeks.. A public hearing by the Board of Appeals of the Town of Barnstable was held at' the Town Office Building, Hyannis, Mass., at ..'.l 1.39.......................K'1CI. P.M. ..........Ju1y....21.1'.................................._....... 19 71, upon said petition under zoning by-laws. Present at the hearing were the following members: �e�n...�I,....�Bears�................. 8 3ex. ....G 1 ..................... ` .J.4. QP...... ....... ..W�,aliaans ...... ........... .. Acting Chairman _.................................................................................. ..........................:_....................................................... .................................................................................... At the conclusion of the hearing, the Board took said petition under advisement. A view of the locus was had by the Board. On .............................................................................................................................. 1.9 ............ the Board of Appeals found The Petitioner was represented by Kenneth B. Wilson, Jr. ,tsq, who stated that the Petitioner was seeking permission to construct five (5) separate buildings to contain a total of 124 apartment units, The parcel of land is located on Barnstable Toad, Hyannis, and is zoned partially for Business and partially for Residence use^r, Wilson said that the building now located / on the premises is and has been a non-conforming business use./ He stated that the Petitioner is seeking a Special Permit to change and extend the existing non-conforming use. Mr. Wilson said that this area had been chosen by the developer because of its centrak-location to the Village of- Hyannis, which was .necessary for any apartment use. It is within easy walking distance and would be of great convenience to the tenants. It is the intention ofthe Petitioner to connect the ap^ rtment buildings to existing tot�t}. sew-4' e. The laerrvice roads « 11 be approximately. 40f wide: and adequate offstreet parking will be provided within the apartment area, It is the Petitioner's. intention to have 34 one bedroom units, 7$ two bedroom units and twelve three bedroom units, The Attorney stated that, if permission is granted and the. apartment complex constructed, it will be managed and operated by the Petitioner. The Attorney said that he had had a meeting of some of. the abutters and as . a result of their reque-st, the Petitioner would provide a .ehain link fence on the northerly and easterly perimeter of the property, «l�t.�iet��r•���e�ec�- In .accordance with a req:uest . from the Pire Chief, provisions have been made to have water service from Spring Street as well as from Barnstable Road It was the opinion of the Attorney that the apartment use would not be detrimental. to the surrounding residential. property and will more closely conform to residential uses than to regular business uses. It was the opinion of the Board that the proposed apartment use would be in the best interests of the Town. The parcel of land on which Distribution:— Board of Appeals Town Clerk Town of Barnstable Applicant Persons interested ` Building Inspector Public Information Board of Appeals h• 'rman .� 2 .� At the conclusion of the hearing-, the Board took said petition under advisement. A view of the locus was had by the Board. On ............................................................................................................................... 19 ............. the Board of Appeals found he a to be locatec' is peculiar.t, Oart.ment complb# ts.� liar because it is divided into two differe t zoning district 'The zoning line I . . , h * - -a 1 . . 9 s cuts 't. rough the property 'at a sharp ahgXe And cuts off the residential portion from any access to existing streets. ,This. particular parcel haa been considered for other business uses but# in the opinion of the ,Boardi. the apartment complex Would most closely conform to the surrounding residential area and would be less detrimental than' a busine46 use. , The Petitioner has provided adequate access over the interior roadways and* ample offstreet parking* The fencing and shrubbd.'.ry , will effectively screen the area from the homes locatdd .on Spring Street-,:- The Board unanimously voted to grant a Special Perm it for the construction of the I apartment units in accordance with the plans presented to `the Board of Appeals. Restrictions imposed Distribution:— Board of Appeals Town Clerk Town of Barnstable Applicant Persons interested. Building Inspector Public Information Board of Appeals Actin Clirman Je MO earse .TO CHAPTER 40A, T81, ZONING 'EN_ABLING ,ACT Chap. 101$. AN ACT MAT:�CT'E TO FLING D4CISIONS OF BO RDS OF APP �,S �ITxI P-L,A1.�T1NG B�JAR.DS Se it enacted,, etc., as follo�x ;: Section 18 of cha ter . OA of the general Laws is her.eb amended b p � �" Y striking out .the sixth sentence, as amended by chapter .271. of the acts of 1974, and irsertibg 3n .place thereof the following two sentences The board.shall cause to,. be made a detailed record of its proceedings, showing the vote of each member upon each question, or; if absent or Palling to voter indicating such fact, and settir_g forth c1 rly th'e reason or reasons for its decisions;, and of its other official actions;: copies of all of:which shall be filed within: fourteen days in the. of- fice of the city ortown clerk and +in the office of the planning board. and shall be public 'records. Notice �o:f a decision of. the board- shall be mailed forth-oitY to parties i, interest,, as designated iri section' zevanteer , and to each person present at: the hearing who requests that notice .be sent to him acid states :the ad ress to which such notice is to: be sent. Approved November 9, lV . 1ONCO INC 84 STATE STREET BOSTON;.'NASSACHU E'i i'S 02109 Telephozie 617-742-4990 October 18,. 1973 Barnstable Board of: :AppeaV 397 Ma l n ,Street Hyannis, Massachusetts 02601: ATTENT I ON Mary S. F 1 s ke Gen t'1 emem,.: Re- Cromwell Court - Fence l.nsta:llation Per ;our recent. telephone conversat:i,on. , we are proceeding wi th the i nsta "1 at iron of a S'`foot cedar fence along. the :East:-� erly and :Northerly property lines of the Cromwell Court housing development at. 168 Barnstable ;Road. We are proceeding with this installation based on your �I review of the Board of Appeals letter which you., say. states, that the owners shall install a screening fence along the Northerly and E asterly property lhies with no distlnct order as :to the material: which the sald: fence shet1 be composed of:. We are, °tFierefore, .p:roceeding with the ihstall:a.tioh. of` a cedar fence, which ,is more in keeping with the architecture ofi the bu i'l dings and,after a su rvey: of many of the n,e i ghb:ors, 611 have expressed 3 di'sti.nct desire and preference to: have. the' cedar fence installed instead of a .chain l ink 'fence., Thank you very. much .for your attention and help in re.- se a.rch i n.g th is natter:. Very truly yours,.,. ORT,H:ING,TON C;ONSTRUCTI N Frank S. Scott, President 1 SS/:os We,, the :undersigned, wish to record: ourselves in favor of the application of Cromwell Court Company of. :said application pending before the Town. of Barrista:ble;. ;Board of Appeals to be heard by said Board on Wednesday; April 5 at 3100 p.m. .iri the ToWn Hall. hp A- r Ci r C� s,-/'� � .r'' ;� ✓ > y ;r_ fir / -c .._ �J A:-meeting of the. Barnstable ;Board of Appeal . was held Wednesday, April 5, 1972, at the Hearing Room of; the; Town Off ice Building, Main Street, 'fyanni:s Massachusetts9 at 3> F.M. Members in attendance C4Aix man.(Ac1;i;ng) ,Buf.ord Go ps� Joseph Wl Iams Ge:arge Gomes. Appeals Case No. 19 72 25;.. Cromwell Court Company for permission to construct five (5') separate buildings to contain 124 apart.ment.s. on premises located on Barnstable, Roa`d, -Iryannl s., and situated pa.rtl.y in` the Business`s Dis:triceAnd: partly, in the Resid'ence: A-l. District by making yaddition.al findings with respect to the existing and proposed use of the Res1"'denee A-1 portion of the premises. and with respect to: the applicability a.f` `Paragraph A- 7 -,of Section P: of the Zoning By-law dealing with specia:L exceptions. Kenneth E. Wilson, it. ,Esq appeared. in behalf of. the Petitioner .and stated that on June 22, 1971 the :Cr.omwel1 Court Company filed a petition bei`ore. 'the. :Board of Appe'al`s to allow canstroc;-; t .on of 124 apartment units, in 5 buildings, on Barnstable Road, the. premises are more co aoa l.y ]mown; as the Aaerican Legion. A hearing, was held on July 21,. 1971, requesting a Special Permzt'. On July 30 1971 the Board unanimously voted a favorable de- cision. The Petitioner waited for the appeal period to rain and then applied and obtained BidIding Pp.rmi is to go forward with the. construction.; Atty. Wilson:: stated, that; subsequently in the process; of the financing it was brought t,o the. Petitione:r° s attention that when the deci8irkon was filed :with the Town. Cl!erk,,I notice, was not sent to: those p.er son s interested (Abu'tters) <under Mass.. General Laws', Chapter 40A, Section 11 The Petitioner felt that it`wouZri be:: ne;cessary to request the 'Board to send this notice; ;out,.. Upon investigation it was deterr lne.d that the. Petitioner would come back before the Board to amend decision: to allow notice to be sent, t.o abutters.- Atty. Wilson. stated' that the° General Court furthe`.r amended Section 17, it is now .necessary to notify a;bu;tters to abutters:. Tha s necess'itated a iiew notice and notifying all :of the abutters:. In going over 'the decision the 'Petitioner felt they would like- to have the Board amplify three sections of the decision,.. Atty. WdiIson refers to letter whi ch, was filed with peel ib n dated February ? , 972: setting forth three sped fic ae Petitioner would like the Board to consider. The Petitioner is requesting that the amendments be, allowed-, and notice sent out after. :a decision. The Attorney said the Pet t,io'ner would like the B`o`ard to amplify its decision .f-o'r clarification pur-. pose:s-, in: accordancae with th;la 3.ett'er , :He said the original. pr'opos I to. this Board i:s, not being changed. Attorney Wilson:. stated that the 'axchitect; .O po a;ctox ov�x�er and. civil engibeer were present and 'they have all of the documents pr:esehted 'to' the Board in July, if the Board would like to go, into this fur-ther: He said the Pet�.t'a:oner had `the 'bu ld hg pe).,mits but because; counsel found lthi§ flav, they decided to come back to the l�oaar,€ , The Attorney said that if there were. any specific, -gtae,stons they would be hippy to answer them. Chairman Buford Goins, "you: ;are not changing; the sire: of the buildings,, inareasing the number of uxxits; strictly here fo.r a ch.' e ih.. the warding of the decis:itin?." Attorney Wilson, "We. have, to.. come batik before: you so , that we; can clarify the- fact that the abutters :were not no'tifie'd Of dec lion, that is, a techAical error which. could be: clarifi:ed. " In favor; Will i.wit R. MbAden:,. ab-atter Mrs.. L ews kanue.l Me.deir:os Oayanni::8 Paint A Walipa er Co. Fr,anc:is McAuliffe_, abutter Ethel Hennessey, abutter E. Seott,- abutter Kfs:., `Hen_ry, abutter Opposed Ethel Week`s, opposed to origina1 plan which had been approved. 2 Py�fTHEr��y TOWN OF BARNSTABLE • BARASTAU i "6 9 �•� BUILDING INSPECTOR �'E MPY Or• APPLICATION-FOR PERMIT TO Build* 19 71-38 ................. TYPE OF CONSTRUCTION ....New..Gonstructian....................................................................................... Bldg #1 OV7 .....................27....Qc.t...........19.71. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: /v 8' Location ......Ravls.tablq...RQ.a.d.................. ........................................................................................................... Proposed Use ....Multi-family..dwellin :........................................................................................................ Zoning District .........Fire District ....Hyannis ..................................................................... CROMWELL COURT COMPANY, 84 State Street Bosto , Ma�,ss, ll� Name of Owner . tl �,X IYii# Xi�� iH :aL� 4> �£ ••• Name of Builder .............................Address New...Ipswich......R.8........................................ Larkin, Glassman & Prager Name of Architect ..James.••Hail•Y'18...AS.SOC.w..............Address .234...Glar4andon—St...,....BoatJD.ay.-Mass.. Number of Rooms .3......... ...........................Foundation .,Concrete 3 .................................................................... Exterior Wood As halt Shin les ......................................................................Roofing ...........P.........................9... .................... Floors WOOd................................................................Interior ......Dry W Heating Gas fired warm air....... plumbing ,•• See plan .................................... ................................................................. Fireplace .......N411le................................................................Approximate Cost ..................../ ....../.. ..',.v.................... Difinitive Plan Approved by Planning Board ---------------____-----------19________. Diagram of Lot and Building with Dimensions / See attached. y -71 lo8d s . I hereby agree to conform to all the Rules and RegulatioAthwn of arnstabl egarding the above construction. N ........... ..... .... �r-mi I C--- - CO._ � � � . . No J�?.... Permit ......... Y . \ ' . ` / � 24 units . � ...................................................... / Barnstable Road Location --.---=............—.—^-----.--.- / � -------�Sy .......................................... Owner . Co�, ---------.—....---------. ' - f � Type of Construction ............. .................. —'----^--------.---------.--.- | � . . . ' Plot ............................ Lot ................................ ` ^ . ' ^ ~ nber �� Permit Granted --..Nove��.������'^----lg Date of Inspection .... ` . —..l9 Date Completed . . ' ( PERMIT REFUSED ----..----._--.---------.. l� �~- , . ,—.—~.---~.,.^---------.-----.--. � | ` ^ ' . ^ ^ ' .,.----...—,_-----------.----- . ' . � Approved ................................................. lV ' ^ � -------'—'----'--'^—'---'----`— / ' ----^---'------------^^^^^^'—^' | \ z { q 7 Aw 7(6 'll.. k pY ti r s �� l4i ^� te,. �v A d I �r Jj tf61 D� .,s k '. '• - ,.:r :w :_:. �•.;;�F",.'3sl r..y,.+d^�l� -1`J7' a �;.#s.,,�r c� ..;�v°'' syk u.��. of��'• Ir,�..?�.� ��,.� »r"��`"� x ;� �a""�,S„y rY ,r a #a �• �^ ,r.s�:pf "_ g w '' ,max '.rre -s �,z - �F-€d'J.. 4 �'a c !' k , �' '� hs... z . F .. t�',.�•,;.%•I� t3=...ts.'}r�'.`t,{?�':r'��JP���.-'���"��tx�M', .s:'��� xA'r,�::.. 'Ai=•e P :r� tt °ks � �€:: Y. .+,•� Jr.,�';�-.��,�yx.:y,..• z ,i a'� :'k <a r .sav,<:i:a't.�,.4.t"`�..r. -.s�v-.�i'..+3�aF -.r,rs.s.'. =YL2. L':...•�._ -r�+" i • TOWN OF BARNSTABLE 88HHSTADLS, i b 9 am BUILDING INSPECTOR ar a uild. 1971-38 APPLICATION FOR PERMIT TO B .................................................................................. ....................... TYPE OF CONSTRUCTION ......,, New Construction .................................................................................................................... _ Bldg #2 ......2..7...0C.t.A........................19.71.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 1 n .. Barns table Road J Location .........................................................../' .............................................................................................................. Proposed Use .Multi-family dwelling Zoning District ...B...&.. .- -S}te,cia ...Permit........Fire District ..Hyannis......................................................... 'CR EL 4 XEXji.;��4 XX State X�?..Street- osto�nd..XXas........ ................. Name of Owner ......................... ................... 1 * wfu Name of Builder ..,,Se pp..a1la W09-7'111AJ(jNew Ipswich N.H. ...................................................Address ..............................t..................................................... Larkin, Glasnan & Prager Name of Architect ..J.ame.s...Harr.iS...,AS.SQC,...............Address .234... are.ndoxi...�.�...¢...�RSG�.n, MaSS,. Number of Rooms ..9.3...........................................................Foundation ..Concrete...................................................... Exterior Wood ..................................Roofing ........A$.Pbalt...Shingles................................. Floors .........Wood....................................................................Interior Dry...Wall Heating GaS fired warm air..............................Plumbing .......See...Plan...................................................... ............................ Fireplace .....None....................................................................Approximate Cost /�, ........................................ Difinitive Plan Approved by Planning Board ________________________________19________. Diagram of Lot and Building with Dimensions See attached I hereby agree to conform to all the Rules and Regulations of t T wn of Ba stable re ding the above construction. Na ... .... .... .� _ p WironoaoJ_L Court Co* ^ / . ` � No - Permit for . ^p^^----~--~.--~---- | / building - 24 units -.------.--,-.-.-.-.-.~...-.-.--. ( . Barnstable Road Location_ .----..--,'—.,--..—.-----.—. Hds � / -.--.----���^���. -------.^----... ' g�000a�I�' �=n'�` Co Owner -... . -~^�~ -~ '' -^----'~^--.-^-^-----^ . - - - frType azu� of Construction -------------- { . ____,_.__.______________.___ ' Plot ............................ Lot ................................ ^ ' November �10 �� Permit Granted --..^�..���..�.----]V ' . | _ �Date of Inspection ____________]gDate Completed PERMIT REFUSED - ' ' ----.._-----..--------- lA - .-...--.--~.--..-..-----.--.---.--. , ^ - '-~...,................-..~....------.., . . | ^ ^`'—'-'^^^~^----'-------^''~^~^^-^^' --.-..-~.--............-~..-..--,.-,.. _ ^ � Approved l9 � ~ —'-------------- '------------~'-^^~^^^-^^^'^^^--' -.-------------.-------.--..., , . ' | . | �J. 7"Er°�� TOWN OF BARNSTABLE BBAUSTADLMASL E, i 39.1* 0 BUILDING INSPECTOR 1971 38 s� APPLICATION FOR PERMIT TO Blai.J,4�...►.....:...........'.......................................0`.........!; ............... TYPE OF CONSTRUCTION ........New..Cans.txua.>zim.................................................................................. Bldg #3 ���Y7 V .....................2.7....Oct ..........19.71. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information. /1�1? Barnstable Road Location ...........................................................................................� � .9................................................................................ Proposed Use ...Myl,tl-,familx..dwell...... .............................................................................................................. Zoning District Site.C14.1...P.e.1"4.it.........Fire District .............................................................................. CROMWELL COURT COMPANY, 84 State Street, Boston, Mass. Name of Owner X%1N#9 1N9FW.XM ....................... ewXX���X PP � / ( New Ipswicb, N.H. Nameof Builder .Se .. .all..... . ............... .. .. .. dress`.................................................................................... Larkin, Glassman & Prager Name of Architect ..james...Harris...Asso.0.................Address ......2334...C.Larp,ndQ.P.. ,......BoStOn, Mass . Numberof Rooms ..84...........................................................Foundation ..C.QnCX.e. e....................................................... Exierior ...................�'tWQR.d......................................................Roofing ........Afij?Malt„SYI1T1gleS.................................. Floors ......................WOOd......................................................Interior ........Dry...Wall....................................................... Heating .. Gas fired warm Copper ..................................air..............................Plumbing .................................................................................. Fireplace none...................................................................Approximate Cost � � ..............4 . .,......................................... Difinitive Plan Approved by Planning Board ---_----------------------------19________. Diagram of Lot and Building with Dimensions See attached /'y � fir 7do* A17 I hereby agree to conform to all the Rules and Regulations of the :Town of Barstable reg ding the above construction. Name .. . ........... .. ...... Cromwell Court Co. p No Permit for .........a....artment....................... building (24 urdt,$) ............................................................................... ........................................................Location ........Barns-table Road .......................Hyarmis.. .................................................... Cromwell Owner .......................................romwell Court..C..o..... ................ Type of Construction frame 0......................................................................... Plot ............................ Lot ................................ Permit Granted ..........................November ....10..........19 71 Date of Inspection ..................... ............ ...19 Date Completed .... 2— ......19 ..... ....... P PERMIT REFUSED ��Jf 19 .....jCWkPVW&,V...... ............................. . .................70....Z ...... ............................ Approved ................................................. I ............................................................................... ............................................................................... ��Q��F7HETO�♦o� TOWN OF BARNSTABLE i EAR ST"LE, i y 6 0 MPY 9 BUILDING INSPECTOR APPLICATION 'FOR PERMIT TO ....B.11ild...19.7 .7:3 .8................................................. ................................... TYPE OF CONSTRUCTION ............ ew Construction............................................................................... Bldg. 4 i G(47 T .....................2.7....Oct.t.........19....71 TO THE INSPECTOR. OF BUILDINGS: � _ __The undersigned hereby applies for a permit -according to the following information: Adr Barnstable Road Location .............................................................. ..... ... ............................................................................................................. ProposedUse .MUI.tinfaAa.7 ly..AW4':1.1;LT1.g.................................................................................................................... Zoning District ..B & RA-1-Special Permit ..Fire District .............................................................................. ...:........... ........................... CROMWE COURT COMPANY, 84 State' Street, Boston, Mass. Name of Name o�uilderSeppalla — !J/2irH� �Add New New Ipswich, N.H. Larkin] Glassman & Prager . 234 Clarendon St. Boston Mass .Name of Architect .Ja•fileG...liars'ls...AssGc..,...............Address ................................................�.............,......�............. Number of Rooms .93...........................................................Foundation Concrete......................................................... Exterior Mood........................................................Roofing .....ASPhal.t...Shingles.................................... Floors ...................Food........................................................Interior ......D...r..y....W..a...l...l........................................................... Heating ....GAS fire.d...warm air..............................Plumbing ...Q4P.Per............................................................... ........... ................... Fireplace .....N.....one........................................................................Approximate Cost .............., �, ..................... Difinitive Plan Approved by Planning Board ----------------------_---------19________. Diagram of Lot and Building with Dimensions �14e l . See attached. 1 l � 11 — j 0 8o s I hereby agree to conform to all the Rules and Regulations of th Town of Bar table reg rding the above construction. CozxnmxeJl Court Cw \ � No Permit for.-.���������---.. ` ) building — 24 units ` ........................._—,.^—.--------.---.. ^ � Location -- .I�»ad_____.r_.. _ _ _ —'---'--�7A)r1afs.......................................... Owner .......... . .Cmx—.---.- Type of Construction ............;UPAQ.................. . . ` ----.-----..---------------. .+ - . Plot ............................ Lot ................................ / 0cnresbwmr IW �� Permit' Granted --------_--..—.]P '— Date of Inspection ....................................lA v x ' -. . � . PERMIT REFUSED � lq---._---------------' ..—~.`..--~~.—.-------,—~—.—..—' ^- -- ...-,~.^.._.--.~—.---.—.------.--.—. y , . ---.—.—.—..-_—..--,.--.—'...~--.—.—.^ :7- - . _—.---.—.'.,..—..,.—..........~--~.�' - . . � ' Approved .................................................. 19 ' --------~.-----.—..--.--........— ' .................... ' � ` t y�FTMETO�� TOWN OF BARNSTABLE • BABBSTABLE, i 1639. am p„ ' BUILDING INSPECTOR APPLICATION FOR PERMIT TO .Bn.ild..19.71:nM......................................................................................... TYPE OF CONSTRUCTION .........Nw...0 ns I.mrai?n................................................................................. Bldg. 5 10,g371P TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Locati 16 Barnstable Road on ............................................... ........................................................................................................ ProposedUse ....... U It.i:-f.T.dIy....dwe, Uxig.............................................................................................................. Zoning District B & RA 1 Special...Permlt.........Fire District .............................................................................. .. CROMWELL COURT COMPANY, 84 State Street, Boston, Mass. Name of Owner .. i� /2 ' Y'ax=16X V 0414 A Aia-rQ� Name of Builder Seppa.11 .... ...........................................Address Ne.W...1p.STaLQb. ....X..H.,....................................... Larkin, Glassman & Prager Name of Architect Jame.s...Barr.i.s..Ass.oe...................Address .234...ClarendOA..St,,.,....BOs-to- y...Mass., Numberof Rooms .....3........n..............................................Foundation ...COncre•te....................................................... Exterior ........ Asphalt Shingles W04?4�...................................................................Roofing .................................................................................... Floors ........Wood...................................................................Interior ...... rx..Wa11......................................................... Heating has fired warm air Plumbing ....C4pper. ........... .... ......... ........... ...................... ....................................... Fireplace ....NAI1.e...................................................................Approximate Cost ........... ............... Difinitive Plan Approved by Planning Board ________________________________19________ . Diagram of Lot and Building with Dimensions See attached. ,! y 71 Ile I hereby agree to conform to all the Rules and Regulations of the n of Bar table regarding t e above construction. No ... ............, . /.. ... L - , � ^. b,d1di.. ......(24 )Crom4ell CO. _ . nstable Road Hyarmis frame Type of Construction ' ^ g . . , . ' . ' . ~ . . . `. ---------'------'-----------'^`` � - Plot ............................ Lot ................................ ' . 2��*mm�wa� I� Permit Granted 71 -----------.'—]V Dote of Inspection -------'... _—lg Date Completed | . - ` — . � PERMIT REFUSED .----_—.---..-------.--- lA . . . . ' . ...—~....---..~..—.—....~.......---,.—.. - ' ~ , ^--.—~--.—.—.-------....--..---,, . ' | ~ ' .—.........._.,.......'—.--..—.—.—..—. ` ~ ._^—...-----.~—...--.--.^---.--^.— ' - � l� ' Approved_.-_ _--------------. ^ .-------....-----,......-------- -------'-----------,.—...,....,.- \ ^ ~ ^ Y | � \ THE COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE BOARD OF APPEALS 1z{�ust 19 71 NOTICE OF VARIANCE Conditional or Limited Variance or Special Permit (General Laws Chapter 40A, Section 18 as amended) Notice is hereby given that a Conditional or Limited Variance or Special Permit has been granted Cromti,,ell Court Company To----•-•--------- -------•--------- Owner or Petitioner Address City c-r Town------------------------ ---=------------------------------------ .....................................................Barnstable. PYoad, Hyannis -- -------------------- ------------ -----•-------- Identify Land Affected by the Town of Barnstable. Board of Appeals affecting the rights of the owner with Barnstable Road Hyannis respect to the use of premises on------ -------------..................................................... --•-- Street City or Town the record title standing in the name of Surf Nisic, Inc. whose address is_..---296 -Haa.ntasket Aveme Bull Massachusetts ------- Street City or Town State by.a deed duly recorded in the---------- nst b_jo----------County Registry of Deeds in Book 13 Page 923- Barnstable - ----------------------------------------------------Registry District of the Land Court Certificate No...°'�.'2281--- ................Book ----- 33....Page...11-------- The decision of said Board is on file with the papers in Decision or Case No.-_-197--'3$__-_- in the office of-the Town Clerk of the Town of Barnstable. Signed this..-l Nay of......-- ..... ugust 71 Board of Appeals: ----------------------------------=-- Chairman Boaru of Appeais -------------------------------------------------------------------•- ..........Clerk Board of Appeals ------------------------------------------------19........ at..............o'clock and................................Minutes ---.M. Received and entered with the Register of Deeds in the County of............:............................. Book........................ Page....................... P-r ATTEST Register of Deeds Notice to be recorded by Petitioner } 1 At the conclusion of the hearing,, the Beard took said petition under advisement A view of the locus was had by the Board. on „„..,... ,»"19 the Board of Appeals. found The:; locus is presently situated partly in the Business District and partly in. the Residenee A!4 Distri:.ct4 Notice of a hearing°on July 21,4 19.71 wsa given. by psi l� postage pre�aids to ,all persons .deemed affected and by publishing in Cape Cod standard Ti,�$ a daily newspaper Published in the T of;BArnstable, a cc►py of #hiss vas at- tached to the ;record "of such proceedings filed with the.Totar% Clerk® A, public hearing by the Board of Appeals of the Toi of Barnstable was he7Lti at the Tom Office B ld ri'g, H axais, Aiassacchusetts at 300 p:® M- ,duly 21., 1971, upon petition under the honing Bye- Thee members of, the Board rde4ed the Pe" The: Board rendered its decision" on July 34,E 1.971, and a copy of its: decision was filed with the 'Town Clerk. on August 13, 19710 On tfiarch.:33, 147 ', the Pe#i.tioner filed ,an app3ic:ation v.ith the toard of Appeals, reques-ting' that:'.the Board amen& its decision of July �0.. 1971, by making additional findings Frith. respect ; o the a stinb; and proposed use of the Besi.dence`Asl portion of the premises and with respect- to the appli.ca- bid: ty of Paragraph.A,�w7; of °Section P .of the "Zoning By Law dealing'`with' special 0=9ptionsq, Notice of this 'hearing on "April: 5, 1972. At'..100 p:, so Was g .ven;by Mails p6stage prepaid,, to the, petitioner and to the MM-On of all •property .deem b ''the Board be :affected thex°eby, including the abutters axide rser of .Land next. adjoining the land of 'the abutters, a cope of which .is attached to the .r6cord.,.of these proceedings t t th the Town Clerk, At the. conclu .o o the ti ding the Board took said petition uudex' advisement.; es c ions Mp se Cln May 3S I!M, the Board t Appeals fowl, (and` amended its :decision iII appeal: 1400 1971 - 38)% as followst The. Peti»tioncr was represented by Kenneth t ;+;ikon, Jr4,, 11.6.q,U,re who statscl' that the Petitioner. wad seeking periiss on to construct five (�) separate buildings to ,contain a total of 1 aparrtment units® He stated that the Petitioner is: seeking, a Special Permit" to change :and extend the e-i.sting aeon- conforming- use. The parcel of land,e locate.on Barnstable Road, Lanni s, and is zoned pare tinily for Budin-ens and partially for Residence use* . he buildirt now lo- sated on the premises is and has .been a'non-conforming. business uses I.?itribut on -- Board of -Appeals 'own Clerk Town of Barnstable Applicant Persons interested. Bundling Inspector Public -Information By .. .. »... .» »»» ......,» ;.. ioard :of Appeals: Chairman At the eonehision of: the hearing; the Board .took said petition under advisement...:A. view;of the`koeus was had by the Board. ------ 19:......_...., he Board:o Appeals found` From testimony presented at the heat3 v '.he Beard finds, that n6nwresidential, uses have been made_ 'since 1941, of the portion of t':e Aercel presently zoned iresidence -1*; I I t is the intention. of the Petitioner to connect the apartment buiIdi.nga to existing-, town sewal.'rem The service roads wiii be approximately 40: wider and: adequate off-street parking,gill ;be provided within the .apartm-ent area. It is tie Fet tioner9 s intention :to ave 34 one-bedroom units. 78 twb-bedaraom units and 12 three-bedroom units* The .:attorney stated that if pernisS on is granted and tre apartment :complex. constructed it will be managed and.orer- a,ted by the .petitioner. The Attsarney said that he bad had a :r,deeting of some of the abutters* and as a result of their request the Petitioner would pros-ide. a chair link fence on the northerly and easterly perin.oter of the. Xop trty.. The #_,oard .hbr6bY requiros that in accordance vi.tn a reouest from the Fire CF ef9 provisions bn made to bate 'water service from Spring Street as we11. 'as. .from Barnstable Road, The Board hereby Inds :that the, apartment use would not be detrimental to the suz caund .g :residential. property and wi*l =ore closely conform to residential uses than to regular bts Tess uses, The Board finds that the proposed apart-Went a would tie ir►° the best interests of the fiown, Tice payee of ]a3d on w� eh t: a apartment cortex a tt�. be ,1 -- Cate is peeu]3ar because i.t : s� divided into two diI,ferent ;�oriin districts. The zoning 3 ne cuts through the property .at a. sharp angle and cuts off the Restrictions.unposed. residential portion from. any access to exi.st :ng streets® The Ward of Appeals finds that the rear part of tkIs parcel has. been employed for various:burin ess uses a.*id that the past and p resent. employment of the sear section_ w.bich is presently zoned Resi 6tice A-i constitutes a legal =iron-. con forrsin use under Section G of the present Zoning; ��l a The :Board has ex amined the Plwis far and has card, teatimpay s!i.th respect to the proposed use .of the premises for amiiti;-family apartments and the`. oard ;is of the opinion that the proposed Apartment complex to: be situated on the Residence Aa portion of the percel Voulci be a use :less detrimental: to the neightiorhofld than the. existing non-conforming use. They Board, therefore, finds thaat the petition falls within the requirement set ford 3n sub-paragraph7 of paragraph. A of seatiot P .of the 20n3.nF, aka bistribution Board. of Appeals; Town;:Clerk 'Town. of Barnstable Applieant Persons interested Lund ng Inspector Public 'Informa£ior. BY Board of .Appeals Chairman_ 3 . At the conclusion of the hearing; the Board took .said petition under advisement A.:view: of the locos was:had by the Board.: on Appeals. fouhcl the petitioner has provided adequate access over the interior roadmays and amp3.e off-street parking'SI :The I fencing and the shrubbery gill effectively screen the :area from the 'homes' located tin, Sprn:ng, Street. P'"ed on the evidence and testimony at the hearing, theord finds that the proposai apartment com lex, constituting a residential use, more nearly comet plies with the spir3.t, arid. intent of tho Zoning By;--Law., part cular?y �r�th re sped to the section of tYLe parcel �rhidh isoneci for r'esidenc , and that the: proposed use may be expected; to be of benefit to the piablic:.and ne ,} hbor hood rather t.;han detrimental to 'eitherp The Board us3y voted to grant a: Spec it F'ermi.t for the construction. of the. apartment units in accordance with the plans presented to the hoard of Appealsa Restrictions imposed Pistributio.n'- Board.of dppeals 'own Clerk Town of Barnstable Applicant - T'ersons: interested Stuldr Inspector Public Information ByefK ». .Board:of Appeals Chan NOTICE FOR PUBLICATION TOWN OF 1ARNSTABLE BOARD 'Q APPEALS NOTICE OF`PUBLIC REARING :MMER:ZONING BY--LAWS APPEAL 119.7141 JULY; .6'., 1971: (NAMES OF ABUTTERS AND OWNERS) Being: all persons deemed interested' or ;iffected. under sections .4 a ' 1:7 of Chapter 40A: of the General :Laws, of, the Commonwealth, of :Mas:sachusetts as'.amended, by a matter before:. the Board._°of Appeals. Notice. is hereby given that the: Board of Appeals will .hold a public :hearing, in. the> Town. Office Building on March 1 , 1972 at.. T.M. to determine whether` to aneud :ts decision of Tu1y 30; 19:71. in Case #1971738 grant' a�_ - . Special Permit: to Cromwell Court Company for cons:t.ruction of .five (5) separate buildings to contain :124 apartment units: on premises located on Barnstable Road, Hyannis, (located at 1.82 Barnstable .Road) and situated partly in ttte Business Aas-tict and partly an the Residence A.-1 District, by making additional, findings with respect. to the existing and proposed use of. the Residence A-4 :portion of the premises._ and with respect to the, applicability of paragraph A-7 of Section T of the Zoning. By-Law dealing w1 th special exception. r l r STA.TE STREET DE'V'EL€?PNMN.T :00AWANY OF. SCDST.0N e .:srAT s it 7BOii 'ON''"S&kCHUSWffS 02209 Feb rua ry 2+, 1972 Board of Appearl's: Town of Barns_tabl=e Hyannis, Massachusetts Gent`l emen On .August 13 1971 , the Board of Appeals granted a. Special Permit i'n Case No. 1.97I` 38 on.; p;etil i'on dated June 2:1 , 1971 of: 'Cromwel I Court Company and. Surf Music;. 6ncorpora;ted, ;applicant; .and owner respectively, A copy of that pet.i:tion and: your decision is enclosed herewith. The unde,rsign.ed Cromwell Court Company and Surf Muses, fncor:- porated,, st111 as ;appl avant and owner,. hereby request that: the decision ,grant i.n;g sa i=d Spec!ail Pe:rmi't n6w. b amended. 'to i n.cl ude add i:t i ona l' findings as follows. lj tF. third; ;sen-tence i n the fe rs.t pa'.ragra'ph of the saed: decisi on. of the Board of ;Appeals (whech sente,nce. reads "Mr. Wi l son said =that ;the,:building now- 1 ocated ;on the preme ses Is, and has been a non:-confo,rm'ing bps.i nes:s use-,.'!) be. deleted and that there be substituted in place' th.ereof a f i nd i ng; sub scant P.I: y as fa11 ows' "From' test'i'mony presented at. the hearing the Board 'finds-. that nonre'si.denti.aI uses ;have been, made since 19.41; :of the portion of: t.he .parceI presently zoned Residence; 'A: Board of Appeals. February 24, Page 2 That,. the seventh paragraph of said dpoics:ToP (which paragraph I 4eqfhs, "This particular pairte). an4. endis. with the.:.:word:s a business use.-.Yb6 deleted l and that there be substituted in :place. there I of a finding.. substantial ly as follows: l ,F 'The Board of Appeals finds that the rear part :of this: parcel has been employed for vaeio' us uses and. that the past and present employmen t of the rear sect[on i4h.i ch is presently z'Qned, Res,1den.qe ::A,!-:I constitutes a ;legal' non-conformifiq use undersection-6 of :the.,:pTesent Zoning; By-Laws:: The: Bo4rd 'examined the :01:ahs for and has healrid.. t.estimiriy vi:th, respect to the: proposed': :use of :the premises for: multi-fam'lly apartments and. the .Board, Is. of the 6p i n-Ton that the b :ed on': th-6 proposed: apa:rtment: complex to i ua t, e 'Residence A-.] port i on of the parcel wo. :1 : be a use 'I es.s Aetrimental to the, neighborhood 'than x 1 slg t)pn,-cqn.k formin.use. The, Board, :therefore finds. that the pet.1 tion f al Is within the..: requTreMent set forth In subpara,9.:.raph ] cif: paragraph �A: of section-I P: of the- Zoning ..Dy-Lpw..Il :that: there be :added at the end. of the eighth pa:ragrapfi of said deci s:i on (wh1ch1 ,pa.ragr phi ends with the words ''homes located on .Spring S, � treet.1 f tn dth. g substantially as :1,01lows: B ased on e ev on the Hence and testimony At.., :the 'hearing, Board of Appears February 14, 1972 Page 3: Itl Is I the op JP J;o.n of the Board that the Oroposed: apart..- men t, comp I ex, constituting :a resvdOntla.l use, more nearly compIT:.6s with. ,the spi I ri t .and. Intent of the Zoning By...Law, partTcuIa.rl:y. with respect to the section of the parse: . :which. is 7on6d, for residence, and . h6f the propbsed use, ma be eKpected. to be of benefit to the public and the y , neighborhood either.`."ghborhocid rather than detri.mental to etther. J.�rlasmuqh as: persons thtdrested in this matter .may be entitled to not.ice prior to consideration thereof by you I r Board and i n view ' ha the of he change Un Section IT:df G.L. 4ow-;A Increasing the n-piker :of pe,. :rsons entitled: to receive notice of .heari:ngs, there Is; attached hereto a I�ist, the abutters and the owner.s of l aril: :next adjoining the ']:and. of :the abutters. :as: shown on, most recent tax lists ,ayailabie at the Town. Hall V., The u ders:ignpd further request that in :event that your: Board: determines: following a heartng, to grant these requ.0'sted aimeridments., the decIsl:on, of the Board .incorporating such.. amendments be entered and filed with the Town Clerk ;as: the decision :.of the Board.. of Appeals in Xhe..above, case No:. 1971-38 and that potice thereof` be as required by. G.L. 40A;: Section 17, T e, .Oe boners hereby of to reimburse the Board of Appeats, or �qne r such additional cos :be .,,nc:urre the Town of .8 rnstabl for ts a s m6�' 'd' in: conned t.i tan with% :pub.II cat 16n:,. ;advert::isJn.g,, and. malling. Yours t rull y, SURF MUS,1 C:*: J.NGORPORATED CROMWiLL)COU", PANY B51�-�,� y By yr William j 6s John R. I I aq Partner her 11 As Gen.e:ra:l Aku:l: al ter: K,, 'Vr, :As G;;;ral Partner [ ] [R328 013 . � ] LOC] 0168 BARNSTABLE AD CTY] 07 TDS] 400 KEY] 243935 ----MAILING ADDRESS------- PCA] 1121 PCS] 00 YR] 00 PARENT] 0 CROMWELL COURT CO MAP] AREA] HY09 JV] MTG] 0000 ATTN MR REAGAN SP1] SP21 SP31 488 COMMONWEALTH AVE UT11 UT21 7 . 08 SQ FT] 1588 BOSTON MA 02215 AYB11973 EYB11973 OBS] CONST] 9342- 0000 LAND 1132600 IMP 2696600 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 3829200 REA CLASSIFIED #BLDG(S) -CARD-1 1 2, 696, 600 ASD LND 1132600 ASD IMP 2696600 ASD OTH #LAND 1 1, 132, 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL BARNSTABLE ROAD HY TAX EXEMPT #RR 0076 0400 RESIDENT' L 3829200 3829200 3829200 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE] 00/00 PRICE] ORB] 1672/111 AFD] LAST ACTIVITY] 01/06/93 PCR] Y R328 013 . •P P R A I S A L D A T Aq KEY 243935 CROMWELL COURT CO LA14D BLD/FEATURES BUILDINGS NUMBER ZN/FL=B 1, 132 , 600 69, 000 4, 121, 700 6 A-COST 5, 323 , 300 B-MKT BY 00/ BY RW /86 C-INCOME 3 , 829, 200 PCA=1121 PC`5=00 SIZE= 1588 C JUST-VAL 3 , 829, 200 LEV=400 CONST-D 9342 ----COMPARISON TO CONTROL AREA HY09 -- --MAY NOT BE COMPARABLE-- COMMERCIAL NBHD IN HYANNS HY09 PARCEL CONTROL AREA TREND STANDARD 101 30 LAND-TYPE 11326001 LAND-MEAN +0°s 53233001 IMPROVED-MEAN +0 500 4001 FRONT-FT 71 100 DEPTH/ACRES TABLE 02 100°s]; LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET ITC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R328 013 . P E R M I T [PMT] ACTIOR] CARD [000] KEY 243935 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT i O ..L oi F---------------------------------------------------- 1 I FFMI I I I ITT I \ a CD 9co CD - 1 I 5.10 5.11 ` \ U I • - Z 3.5 1.2 LL HC HC J O U -j a COMMUNITY .. - BUILDING W a�. Q : j N ---- ------- a t ,� �� /. O w HC I HC AOCESSIBLE 7BRUNIT - ACCESSIBLE . I 28R UNIT HC \ Y HC BLACKTOP PLAYGROUND /, - \ - O E ; •. ii ISK-2 �� ' M � a � � W F ACCESSIBLE SPACE o ACCESSIBLE ROUTE- a /' df '7NI'S1�3LH�bY ui / t 0 O O O Q 11 � oco a e— O t 6 _ C UNIT TYPE E UNIT TYPE C _ 1 Li e lyyA Gl U U r V' m m ILL AI ® 0 0 wo -_ Wo .L4 J - c o 1 II — � n f1 O cc I :flF \ 3 0 `� FF, I ,' BEDROOM 2 LL � I _ I . O L V FURN e I i FURPL I y C� I 4W I v > Z I -UP I m 0 BEDROOM 1 0 a 3$ m HC 1 BR UNIT HC 2 BR UNIT BEDROOM 1 § D { ❑ACCESSIBLE SPACE J �,�, _ - - j ❑ACCESSIBLE ROUTE � g� �� - 1—t BALCONY ABOVE .Hll-i-= Tj-)ll I ���u I I I i-tl- -n-I -n- • w u i op RAMP UP N ad �NI'Sl}]lIH�BV : W R SK-3 o • f _ Mr N . � r , O O 00 E=1 C N ai U U 00 _ Z LL C W a F- N F F11 LL I 1 Ell \�� W 0 0 z �' D GO $ RI / U ca r- o r 10 O_ 9 N N 3 H W fn Q j t as• � � � ' 0 0 0 of o c o MAINTENANCE EXISTING TO REMAIN STORAGE € z U aF1 ®® U ® mQ r-7— I Q t I I I z J COMMONROOM Z OFFICE • } g i II I I I I - IL —J I w o LOBBY Z O Q t U U g I . OFFICE " • g o ^ _ NEW RAMP , a V w i ao t° 15 ACCESSIBLE SPACE. € u °s RAMP UP 1:12C4 L! 0 to ACCESSIBLE ROUTE / y G" W i F•, 4 Q 24'-0" 5'-0" r v W GUSSETS B. C. D. E, F. G ARE 1/Y THICK PLYWOOD; TOP CHORD: SPLICE CONTINUOUS RIDGE VENT . LAP AT 2O'+12' r 15#.BUILDING PAPER-, • 5�8r CD SHIN RIDGE BOARD 8• . . - SHINGLES tOLMPHR ROOF 2x1 6' I X SHEATHING 30 YR. 0. DOUBLE ICE AND WATER SHIELD 4. 2' FOR FIRST 6' FROM EAVE + H2 5 HURRICANE AP 4 (TYP. OF 13 WEB MEMBERS) TIE (EACH RAFTER) BOTTOM CHORD: 2x8 54' SP 22, SPAN AN NOT TO SCALE NOT TO SCALE C•.^.8.. i R]. I •� y`m E GUSSETS _ GUSSETS.B. C. D. E ARE B. C, D; E ARE TOP CHORD: .SPLICE 1/2" THICK.PLYWOOD TOP CHORD: SPLICE I THICK.PLYWOOD LAP AT 20'+6•y . k LAp' AT . 1 >" } l6• 6' 4, ell t q 2' 10 lEr �. 2' _� w , . r w w . _ _ _ _ _ _ 50,_0w w x4 (TYP. OF 9 WEB;MEMBERS BOTTOM CHORD:2x6 . x4 TYP. OF 9 WEB MEMBERS : � • » OF , O N L. � ) ( ) UR H BOTTOM .CHORD: 2x8 CHILL �. CH CIVIL . _ N0.41807 50 SPAN 44' SPAN. �� c sT 1 NOT TO SCALE . NOT TO SCALE TEMPORARY ROOF SYSTEM PLAN FOR:. NOTES: THIS DRAWING SERVES AS AN AMENDMENT TO THE PREVIOUSLY SUBMITTED DRAWING A MINIMUM GUSSET SIZES (INCHES) FROM MARCH 11,2015. EBEN CONSTRUCTION 54 SPAN 50 SPAN 44 SPAN: _.. --,..._n._.:_..,...-_...,'.._.._....APPROVED BY:...._.......... . ......_..........._ : .._ ..._...._......_ORAWN.BY:... .,.......... .........._...._ ALL MEASUREMENTS.ARE TO.THE NEAREST HALF FOOT. _ _ = 1/8 =1 —0 K.R.R A 4x28 ' . A' 4x28 A 4x33 $=14x16 B=14x16 B=12x12` DATE: v• REVISED: ALL LUMBER 2x6.OR GREATER IS TO UTILIZE S-P-F(SS)OR DOUGLAS FIR#2. C 12x10 C=12x10' C=8x10 3/20/15 - D ........ .... .. ..... .... .. ....... .. .... =8x8 D,=8x6 D=8x8 PREPARED BY: ALL LUMBER 2X4 UTILIZED TO BE S-P-F#2. E=.10x10 E=10x8 E-8X8 J C ENGINEERING, INC. , TWO(2)FOOT SPLICES AS NECESSARY ON BOTTOM CHORD. Gn 28 0X 8x8y .. . ........- _ _-............_ ._ ....._....._.----..__.__.._....._._____.._ _.... ...._._.. - DRAWING NUM BER CROMWELL COURT, BLDG. 9 68 BOADHY:AN-N f_, M:AOF. 1BNE- R- • JCE#3023 i � Y f f t a i t �I 1p olo i lFXpo& Ap1 ° 8 P7 ol �x 0 14- All,vd t J Q ,, i , ►� vo A� 3 /r/ t . 1's° � �s 4 P f sq vi ; /.z0 12 it ✓oN _ l? SCALE:J I APPROVED BY DRAWN BY Ll ' Y y DATE:14 I DRAWING NUMBER --n __ II M ' I { �z I i � 1 1 r I L 1 .11-1 1 1 1 1 -1 l -, t,JA 1, I I 4/ V � x Cam- I r /° k AAA FA{ Rd..c • r � its pf C y f r is Ar CA j § _ lot { sq art APPROVED BY SCALE: DRAWN BY" _- ' Ll y 'f DATE: Q Z O � A�;�:•'' l(j � �/4-P�t/1�,�7'� .G9�t'� �° /i �i/#AFtdi DRAWING NUMBER S: NA/XMM Pal'7 NO.ISSA-IGX24 _ " I a s 14 j9y- ' v } E 4 its 10 f P �G s f egg M - 4 MM k Sq ly it G 1As Y + ! SCALE: APPROVEDBY DRAWN BY '3 K3 Y DATE: Q t9 / ►' Lill well g µ DRAWING NUMBER NAflONAL PAMPA 1 rw.ISSAaexza f j r i f i i 1 i � 1 , ax _ 40 its � Pto 1'^ ?7 I # � z 1 7 g ' 1 Coto Sq I Ll SCALE: APPROVED BY DRAWN BY �[ DATE: z O qx P � .0 „, . DRAWING NUMBER \ AlOn000/MEWMfT N0..fREA-1SX2a i } ' 1 k 6 s 4 s s` 1 a r It r4 '° 9 y e P 7` x JOV xqx G 1 d VV AI Y F f x r sq s Ov I JA f �' 77 f� SCALE: ° APPROVED BY DRAWN BY DATE: 14— 6 - DRAWING NUMBER � NAflOffiIIL/ROWlMff NO.10EA-00%24