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0118 HIGH SCHOOL ROAD -
i �l 0 O �nn �1 i i -fif�o A44,AIL i► r� The Commonwea[tb of 0aaacbm5em DEPARTMENT OF HOUSING& COMMUNITY DEVELOPMENT Sean Keating Construction Advisor (617)573-1173 100 Cambridge Street,Suite 300 Call:(857)294-1698 Boston,MA 02114 ® Fax:(617)573-1335 www.mass.gov/dhcd sean.keating@state.ma.us 1 COMPLETESENDER: COMPLETE THIS SECTION • ON DELIVERY ■ Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse ..X 13 Agent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mallpiece, B. Rec ived (Printed Name) C. Date of Delivery or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item 17 13 Yes f, If YES,enter delivery address below: ❑No &ram/ 3. Service Type ❑Priority Mail Expresse II I'lll'I IIII I'I I II II II I I I IIIII I III II I I I I III ❑Adult Signature ❑Registered Mail R r ❑Adult Signature Restricted Delivery ❑R istered Mall Restricted t 9590 9402 1933 6123 1427 99 0 Certified Mail Restricted Delivery p Return eceipt ror t ❑Collect on Delivery Merchandise sfer from serviC_e label - ❑Collect on Delivery Restricted Delivery ❑Signature Confirnationn" _2..Arti�ls NlrmhellrM0s -- - ----� • c' a —1 Mail t i ❑Signature Confirmation 7 015 1730 0001 4990 3585 6 )I Restricted!Dellvery ? ,Restricted Delivery PS Form 3811,July 2015 PSN17530 02-000 9053: Domestic Return Receipt PostalTI a RECEIPT -DomesticOnly Ln rnTWA o Er Certned Mail Fee Er A Extra Services&Fees(check box,add fee asappropriate). o�L ❑Return Receipt(hardcopy) $ 0 ❑Retum Receipt(electronic) $ f Post rk 1-3 ❑certified Mail Restricted Delivery $ i .. .�� Here �� 1--3 ❑Adult Signature Required $i { ❑Adult Signature Restricted Delivery$ Postage w r%- $ V a r-1 Total Postage and Fees Lr) Sent To M1 siieet z o. %7w d� :.r r r r rr •r 1 USPS TRACKING#' First-Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 1933 6123 1427 99 United States •Sender:Please print your name,address,and ZIP+4®in this box* Postal Service .11 . '1VN ( 8ARNSTABLE OUILDING DIVISION 200 MAIN ST. YANNIS, MA 02601 11 fi1 f i f'1 3�i � _if} y 1111i�lli'l f .31 JIFii�� il.ilf�ttf� 1 x i Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Cor ified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides e for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. Important Reminders: Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified ■Insurance coverage is not available for purchase by name,or to the addressee's autborrzed agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is Insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Retum Receipt attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. Ps Form 3800,April 2015(Reverse)PSN 7530-02-000.9047 1 1 Anderson, Robin To: Gallant, Therese (gallantt@barnstablepolice.com) Subject: 118 High School Rd, Hyannis HI, am sending this strictly as an FYI. This property consists of 23 apartments owned and operated by the BHA. I received a call from an adult male who seemed a little off. He wasn't sure he intended to call me or if he was trying to get to another agency. He did not identify himself..He provided an address(118 High School Rd) and the name of the owner(BHA) but not his unit number. He didn't know or remember it he said because he was calling from somewhere else. He claimed people keep breaking into his unit and trashing it and defecating in his room and Leaving the place a mess. I offered to put him in touch with the BPD Community Impact group but he refused. I offered to ask the HFD to stop by as well but he refused that, too. He stated he would check with the on-site manager about resolving his issues. I provided him with my name and direct line and told him to call me back if he is unable to work this out. Without more specific information I am unable to officially refer this matter to anyone. I did contact Dean Melanson to see if there was any recent medical activity there. He stated there has been nothing he is aware of lately. He will alert me if something happens. O�Phln Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis,MA 026oi 5o8-862-4027 1 Town of Barnstable u Building 1P,ost This n It So That rt is$VisibleFrom the Street Approved Plans Mustbe:Retained on Job andahis Ca„rd Must be Kept 1MAW 639+ iPosted Util Final.ln�spect�on Has Been Made , '',' s� ,;, ru ° Where a Certificate of Occupancy Is Required such Bu�ldmg shall Not beOccupied until a Final Inspection has been3de Permit .,,,.7.. m.,,.. �,....� .m... .� _.,._. . > Permit No. B-19-875 Applicant Name: Edward Zaniboni Approvals Date Issued: 03/20/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 09/20/2019 Foundation: Location: 118 HIGH SCHOOL ROAD,HYANNIS Map/Lot 326-012 Zoning District: SPLIT Sheathing: Owner on Record: BARNSTABLE HOUSING AUTHORITY �A C6ntrktbr�Narne: . ZANDER CORPORATION Framing: 1 Address: 146 SOUTH STREET Contractor, icense`. 148948 2 HYANNIS, MA 02601 Est Project Cost: $37,950.00 Chimney: Description: Remove and replace(4)exterior doors and (1)slider Permit Fee: $ 193.55 Insulation: Fee Pai;d: $ 193.55 Project Review Req: is Final: E Date: 3/20/2019 ` �; / �� Plumbing/Gas Rough Plumbing: _ Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authoniedby this permit is commenced within six months afterissuance. All work authorized by this permit shall conform to the approved applicati n and the approved construction documents for which this permit has been granted. Rough Gas: � K All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by,laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: ° Y work until the completion of the same. s y Electrical The Certificate of Occupancy will not be issued until all applicable signatures bythe Buiid�g and:Fire Officals are provided on this;permit. A Service: Minimum of Five Call Inspections Required for All Construction Work z 1.Foundation or Footing Rough: 2.Sheathing Inspection g 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 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: "Perso c acting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). -t�` Fire Department Building plans are to be available on site c- Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT °FWEt�y The Commonwealth of Massachusetts Town of. Barnstable Kw 2024 Certificate of Inspection Issued to BHA-Dorothy Bearse Apartments Certificate No. Type: Building -Certificate of Inspection DBA BHA-Dorothy Bearse Apartments IC-17-311 Identify property address including street number, name, city or town and country Certificate Expiration Located at r 4/30/2024 Map/Lot 26-012 in the Town of Barnstable 118 HIGH SCHOOL ROAD, HYANNIS Location Use Group Classification(s) Allowable Occupant Load 1st R-2: Apartment houses, dormitories 20 Restrictions 20 One-Bedroom Units This Certificate of inspection is hereby issued by the undersigned to certify that the premise, structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall be framed behind clear glass and\or laminated and posted in a conspicious place within the space as directed by the undersigned, Failure to post or tampering with the contents of the certificate is strictly prohibited. Name of Municipal Building Official Robert McKechnie Date of Inspection 9/24/2019 Signature of Municipal Building Official /I Date of Issuance .-- 4/13/2014 I The State of Massachusetts — - ° M ;$ Town of Barnstable New and Renewal Certificate of Inspection Application Date go(q � Fee Required 0.00 In accordance with the provisions of the Massachusetts State Building Code,Section 110.7,hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: 118 HIGH SCHOOL ROAD,HYANNIS Name of Premises: BHA-Dorothy Bearse Apartments DBA: BHA-Dorothy Bearse Apartments Purpose for which premises is used: License(s)or Permit(s)required for the premises by other governmental agencies: Certificate to be Issued to: BHA-Dorothy Bearse Apartments (Corp,LLC,or name of Business) Address: 118 HIGH SCHOOL ROAD,HYANNIS Telephone: (508)862-0308 .e ,.,. Owner of Record of Business or Barnstable HousingAuth. :d• Establishment: Address: 146 South Street Hyannis, MA 02601 Manager or Persons responsible for Lorri Finton daily c eration: E- Lorri—Finton@bha.barnstable.ma.us w ,O S A RE OF PERSON TO WHOM CERTIFICATE IS IS D OR AUTHORIZED AGENT pp l.oR.a� Fi+rvrotn PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE#i EXPIRATION DATE c Town of BarnstableHE " ti Building Division 200 Main Street Y ♦ Y * BARNSTABLE. L Hyannis,MA 02601 BARNSTABE u Hs a,c -Wn CU"U1T itt (508) 862-40385o 5713 .. NInspection Report A ❑ Notice of Violation" Business: Date of Inspection: Contact: '0 ''?*fw'Fr' oi'�g4"e `/ Info: Address: �� y���A )W �7� Info: Phone: d��z " ( 30� /// Info: Email: �`" Info: . �55 Ya i 1 f During the annual occupancy inspection of your premises,performed in accordance with Section 110.7 of 780 CMR, Massachusetts State Building Code,as amended the following deficiencies and/or violation(s)were noted: ®' 4erf.' jv cA46AW7 '" Section(s): Location: e&y,, � AaP y�F4ka'7eS4 0 Section(s): Location: �k Y 0 Section(s): Location: z P4 i 0 Section(s): Location: 0 Section(s): Location: L 0 Section(s): Location: 0 a Section(s): Location: w *, 0 Section(s): Location: ` 0 Section(s): Location: Action required to abate the above violation(s)you must: 0 None:no violations were observed at the time of inspection t 0 Make corrections immediately and contact this office for a follow-up inspection 4 Re-inspection fee of$ is required and a re-inspection to be requested by business within days. " � VMake corrections prior to your next annual or semi-annual inspection. y 0 Property/business owner or owners a prove agent contact inspector for consultation .r !� Official/Ins ector: ! � Telephone: 508 862-4038 Received By: . �•� /" Date: Print Name: r Section 102.6 existing structures-The owner as defined in 780'CMR 2,shall be responsible for compliance with provisions of 780 CMR 102.E And,if aggrieved by this notice and order,to show cause as to why you should not be required abate the violation in this notice,you)nay file a Notice of Appeal(specifying the grounds thereof)with the State Building Code Appeals Board within (45)days of the receipt of this order and in accordance with MGL e. 143§100. 9 - ° I t The State of Massachusetts Town of Barnstable w .. New and Renewal Certificate of Inspection pp A Iication Date - liq Fee Required 0.00 In accordance with the provisions of the Massachusetts State Building Code,Section 110.7,hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: 118 HIGH SCHOOL ROAD,HYANNIS Name of Premises: BHA-Dorothy Bearse Apartments DBA: BHA-Dorothy Bearse Apartments Purpose for which premises is used: License(s)or Permit(s)required for the premises by other governmental agencies: Certificate to be Issued to: BHA-Dorothy Bearse Apartments (Corp,LLC,or name of Business) Address: 118 HIGH SCHOOL ROAD,HYANNIS Telephone: (508)862-0308 a p Owner of Record of Business or Barnstable Housing Auth. ? 2f Establishment: - Address: 146 South Street Hyannis, MA 02601 Manager or Persons responsible for Lord Finton daily eration: E- Lorri_Finton@bha.barnstable.ma.us ,p S A RE OF PERSON TO WHOM CERTIFICATE IS IS D OR AUTHORIZED AGENT ya PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# EXPIRATION DATE ✓� �� Zfl� Roma, Paul From: Sherman, David Sent: Monday,July 3, 2017 8:58 AM To: Roma, Paul Cc: Sherman, David Regarding visit to 118 High School Rd. Hyannis to survey boiler and equipment installations. Found all mechanical areas to be congested and difficult to maintain and service with some code and safety violations. The is fairly new and workable so that when properly installed will be able to perform satisfactorily and safely. Equipment installed could be described as a "Blivot" or ten pounds of something in a five pound bag. Recommend a complete survey by an engineer in order to establish a functional and accessible fully operating installation. Respectfu lly'su bm itted, David G.Sherman, Plumbing Inspector The Commonwealth of Massachusetts TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to FELLOWSHIP HEALTH RESOURCES, INC Certify that I have inspected the premises known as: DOROTHY BEARSE APARTMENTS located at 118 HIGH SCHOOL ROAD in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): R2 The means of egress are sufficient for the following number ofpersons: Location Capacity Location Capacity ONE-BEDROOM UNITS 20 Certificate Nu r: Date Certificate Issued: Date Certificate Expire Map Parcel 20 .401422 4/13/2014 4/13/201 3 6 012 e budding official shall be notified within(10) days of any changes in the above information. Building Off cial .pF:1HE p The State of Massachusetts Town of Barnstable ,} FDMA�s New and Renewal Certificate of Inspection Application Date 8/31/2017 Fee Required 0.00 In accordance with the provisions of the Massachusetts State Building Code,Section 110.7,hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: 118 HIGH SCHOOL ROAD,HYANNIS Name of Premises: BHA-Dorothy Bearse Apartments Purpose for which premises is used: License(s)or Permits)required for the premises by other governmental agencies: Certificate to be Issued to: BHA-Dorothy Bearse Apartments Address: 118 HIGH SCHOOL ROAD,HYANNIS Telephone: (508)862-0308 Owner of Record of Building: Barnstable Housing Auth. Address: 146 South Street Hyannis, MA 02601 Name of Present Holder of Certificate: Margaret Crane Owner of Business: Margaret Crane p -7 E-Mail: Woo oo , " a�7/ 80j48ING SIGNATURE OF PERSON TO WHOM CERTIFICA D& IS ISSUED OR AUTHORIZED AGENT 4PI?1 2� p rOWN or 19 O-A toe, 6md �RNsTq� PLEASE PRINT NAME �E INSTRUCTIONS: 1) Make check payable to: TOWN OF BARNSTABLE 2) Return this application with your check to: BUILDING COMMISSIONER, 200 MAIN STREET, HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. , 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# TIC-17-311 EXPIRATION DATE 4/13/2019 The Commonwealth of Massachusetts TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code,Section 106.5, this CERTIFICATE OF INSPECTION is issued to FELLOWSHIP HEALTH RESOURCES, INC Certify that 1 have inspected the premises known as: DOROTHY BEARSE APARTMENTS located at 118 HIGH SCHOOL ROAD in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): R2 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity ONE-BEDROOM UNITS 20 Certificate Number: Date Certificate Issued: Date Certificate.Expired: Map Parcel 201401422 4/13/2014 4/13/2019 3 012 The building official shall be notified within(10) days of any changes in the above information. Building Official Ok lax The Commonwealth of Massachusetts TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to FELLOWSHIP HEALTH RESOURCES, INC Certlf / that I have inspected the premises known as: DOROTHY BEARSE APARTMENTS located at 118 HIGH SCHOOL ROAD in the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type:, Use Group(s): R2 The means of egress are suff cient for the following number of persons: Location Capacity Location Capacity ONE-BEDROOM UNITS 20 Certificate Number: Date Certificate Issued: Date Certificate.Expired: Map Parcel 201401422 4/13/2014 4/13/2019 3 6 012 The building official shall be notified within(10) days of any changes in the above information. Building Official CommbNV%S LTI-I OF MASSACHUSETTS`. TOVdN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date _pw Iq ( ) Fee Required$ ( X ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named-,premisep located at the following address: Street and Number; n l Name of Premises: a e Purpose for which premises is used: s)�n+t�, ! rCm GY 1 l ` l License(s)or Permit(s) required for the premises by other governmental agencies: License or Permit A enc l ](' Certificate to be Issued to: n+hu Rea nch r4meit --F-C I 10A ksh r) Lko I th Address: Poll ^C' x d 4 TelepliRne: Owner of Record of Building; ap�ftc Addrd is. --a Name of Present Holder of Certificate: -0th " ` � "` ` " ' Name of Agent, if any: GNA F PERSON TO WHOM CERTIFICATE IS ISSUED AUTHORIZED AGENT W?d . dmJ >•r+ �, co LEASE -. T NAME - — INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET, HYANNIS,MA 02601, PLEASE NOTE: 1)Application.form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10) days of any change in the above information. FOR OFFICE USE ONLY: r CERTIFICATE# EXPIRATION DATE: J020115c TOWN OF BARNSTABLE INSPECTION WORKSHEET Glos9' CERTIFICATE NO: 201401422 CANCELLED: MAP: 326 DBA: IDOROTHY BEARSE APARTMENTS I PARCEL: 012 NAME/MANAGER: FELLOWSHIP HEALTH RESOURCES, INC STREET: 1118 HIGH SCHOOL ROAD VILLAGE: JHYANNIS STATE: FKA ZIP: 02601- SEQ NO: 1❑ BUSINESS TYPE: MULTI-FAMILY CONSTRUCTION TYPE: STORYI: CAPACITY: USE1: R2 Capacity Under 50: ❑ STORY2: CAPACITY: USE2: Outside Seating: ❑ STORY3: CAPACITY: USE3: BY PLACE OF ASSEMBY OR STRUCTURE _ CAP1: 20 LOC1: ONE-BEDROOM UNITS CAPS: LOC8: CAP2: LOC2: CAP9:- LOC9: CAP3: LOC3: CAP10: LOC10: CAP4: LOC4: CAP11: LOC11: CAPS: L005: CAP12: LOC12: CAPE: LOC6: CAP13: LOC13: CAP7: LOCI: CAP14: LOC14: INSPECTI N: DATE ISSUED: EXPIRATION: i 04/ 009 04/13/2014 104/13/2019 I Prin�Certifi to 4 COMMENTS: be Commoubnealtb of JRaq.5arbu!6dt5 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to FELLOWSHIP HEALTH RESOURCES, INC Q�ertlfp that I have inspected the premises known as: DOROTHY BEARSE APARTMENTS located at 118 HIGH SCHOOL ROAD in,the Village of HYANNIS County of Barnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): R2 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity ONE-BEDROOM UNITS 20 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 200901770 4/13/2009 4/13/2014 326 012 The building official shall be notified within (10) days of any changes in the above information. _ Building Official C� COMMONWEALTH OF MASSACHUSETTS s .� � TOWN OF BARNSTABLE,, � E tiff APPLICATION FOR CERTIFICATE OF INSPECTION 5 - �,�t�9 �,PR 24 � 12.• Date 12J0q ( ) Fee Required.S, gMoPee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5, 1 hereby apply for a Certificate_ of Inspection for the below-named premises located at the following address: Street and Number: C�H ��� set 6041 RwC 4 , "q ml tst(n A Q Z,(p d 1 Name of Premises: — A Da1('-R"I/Ae VN—�'� Purpose for which premises is used: rGS1AP—n-a4 License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit enc ' f JD' Certificate to be Issued to: ( �, , � I 11�V"I�Gl,k�Y1 12SoyreeJ -Address: i g �4,Q ,Sekooi emj ,44wannus ,MA-ate 1 Telephone: -� R 3'!02.03OR Owner of Record of-Building: r lW Ass CL-h 0 h Address: (4ts SoU44q S+reed 44uajjnL<,. lrY1 A 021o0� Name of Present Holder of Certificate: )B ' Fi-,Rnu_ 1%o t'Lfa[" Rr SavezrS Name of Agent, if any: SIGNAITURE OF PERS TO WHOM CERTIFICATE IS ISSUED OR AUORIZED AGENT �L �1► Lar(�S PLEASE PRINT-NAM-0 - 1 INSTRUCTIONS. 1),Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET, HYANNIS, MA 02601 PLEASE NOTE: 1)Application form with accompanying.fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE-ONLY: p CERTIFICATE# rJ 67l 770 EXPIRATION DATE: J020115c TOWN OF BARNSTABLE INSPECTION WORKSHEETc"dos CERTIFICATE NO: I 200901770—] CANCELLED: MAP: 326 DBA: IDOROTHY BEARSE APARTMENTS IPARCEL: 012 NAME/MANAGER: FELLOWSHIP HEALTH RESOURCES, INC STREET: 1118 HIGH SCHOOL ROAD VILLAGE: HYANNIS STATE: MA ZIP: 02601- SEQ NO: 1❑ BUSINESS TYPE: MULTI-FAMILY I CONSTRUCTION TYPE: STORY1: CAPACITY: USE1: R2 Capacity Under 50: r STORY2: CAPACITY: USE2: STORY3: CAPACITY: USES: Outside Seating: . BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 20 LOC1: ONE-BEDROOM UNITS CAPS: L005: CAP2: LOC2: CAP6: LOC6: CAP3: LOC3: CAPT LOCI: CAP4: LOC4: CAPS: LOC8: INSPECTION: DATE ISSUED: EXPIRATION: UJ ` Pnnt This'Screen ® 04/13/20091 04/13/2014 c K a' p�Prim., t�wCert�ficate ofrilnspe�tionf 6v/so/a9 COMMENTS: TOWN OF BARNSTABLE INSPECTION WORKSHEET s"cos . CERTIFICATE NO: 75951 CANCELLED: MAP: 326 DBA: IDOROTHY BEARSE APARTMENTS I PARCEL: 012 NAME/MANAGER: JK MAIBAUM, PROGRAM DIRECTOR STREET: 1118 HIGH SCHOOL ROAD VILLAGE: JHYANNIS STATE: FWA ZIP: 02601- SEQ NO: 1❑ BUSINESS TYPE: MULTI-FAMILY CONSTRUCTION TYPE: STORYI: CAPACITY: USE1: R2 Capacity Under 50: STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: r BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 20 LOC1: ONE-BEDROOM UNITS CAPS: L005: CAP2: LOC2: (, t t, . CAPE: LOC6: CAP3: LOC3: CAP7:" LOC7: CAP4: LOC4: CAPS: LOC8: INSPECTION: DATE ISSUED: EXPI ATIO $ t This'e j,, Pr1nt,Certiflcate of Ins El pection COMMENTS: 1n(`Q.�t, °�• v1 CdvY\V.V)ah AA 9 Cr �- � e eommonweattb of '41a!6.5aC U!6dt!6 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to FELLOWSHIP HEALTH RESOURCES, INC 3J Ctrtifp that I have inspected the premises known as: DOROTHY BEARSE APARTMENTS located at 118 HIGH SCHOOL ROAD in the Village of HYANNIS County ofBarnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): R2 The means of egress are suff cient for the following number of persons: Location Capacity Location Capacity ONE-BEDROOM UNITS 20 Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 75951 4/13/2004 4/13/2009 326 012 The building official shall be notified within(10) days of any changes in the above information. Building Official F D ``A APR 08,2004 11:19 Dorothy Bearse Apartment 508-862-6340 Page 2 1"17- A I J COMNIONWrWTH 01�MASSACM.I.SE17S TOWN OF BARNSTABLE A PPY JCATION MR CERTIFICATE Or INSPL,CTION hate Per,RC44un C4 S---, x ) Nu free Rcquirw In accordam;c with the Provisions of the M75sac.hasatts Swv-.Suilditj Code,Sektioll I hereby APJ)lv for C,Certificate of fyjspCetion ftg Ate below named pTemJsrs 10CAed at the followina 3ddre.q: Name of Premises: V)jrpoic for which pie4nises it used: bk;ewse(s)or Pcrniit(s)wquiTed foy Tht pitnities by oUicr Bove mmeritAl a?ej16vK. Liwat-91 Ponwt Auacy L-ov tv be Issued to: Address: AL'Si Tc1cp hops.- Ownu of Re�;cwd of HUding: --"Address, Sc—, Name.eft Prww Holder of Certificate: Naw of Agrnl it wxy! SIGNATURE OF PERSON TO WHOM CrMTIFIC,y'J'E IS T$SVED OR A UTHORIZFJ)A GF.NT U L) C %1L PLEASE PRINT NAME PISIMUCTIMS: ])Make check p&,Yahlr to, TOWNOFBARNSTARCI.. 2)Renim this applicativii with yciur check to, 4LJ1j.j)TN( (..C)NM. SS10Nr--'R,WO MAIN SINFFY,KYANNIS,MA 0.2-601 &LANE NUTE: 1)Applicatim furor wiLb accompan)nng Nw.writim be 6ubmiucd for each budcling,'-w%to"umire 01 pw I thelcof to be Critirled. 2)Applicatign and fee must he rtwaivftl tnikite the%;crtificate will be. 1)The building officiai KhK4 he notified within leu(10)days:tifmiy vjj4jqg4-in d1c,above h1forwation CERTIkiCATR 0 -7 M'lRATION DAIT: APR I')0 8 i�-'0(2, U APR 08,2004 11:18 Dorothy Bearse Apartment 508-862-6340 Page 1 DOROTHY REARSE Fvflms �1 i APARTMENTS j� 1)B Iliyh Scltcxil Ro9G 9rH annis M tl�eGl � y � nources, Inc. 1clephone 50RIf;62-03(1F, Fax 501/862.6340 ww%vAllowsh ipllr,orS. Creative Solutions for Rebuilding Lives and Restoring Hope Menial healNn and aMctitnr services FAX COVER SHEET for New England rind the Mid-Atlantic DATE: , TIME: OTHER LOCAL PROGRAMS TO: Q LacC'-s " �2A �* .5.�— Bayherry Home } _ Residential Program � AGENCY: 1.3 ..\d.;,; L�,.t ; rr, Falowulh,MA I FAX NUMBER. r16' rip'-7)^ 1 Cape Cod Supported Ilovsing Apartments FROM: Sandwich,MA ' J ti per Lane TOTAL NUMBER OF PACES: (including cover street) ResiJenrinl Program r . Fknni.sport,MA ❑Urgent © FOT I CAM ❑ Reply Requested C] Confirm Rcucipt Depot Road Residential Program ADDITIONAL INFORMATION OR COMMENTS: west Harwich,MA Emmaus Ilousa Supported Hnasing Orleans,MA FairHinds ' <aubhuxse xwxxrxtxkAk"rWwwrw* tslkklrkkkyrktA,4kwxvr�k{r*F1xYkk*a**"rkWWAwwr>gxk7rk Fa11110Uth,MA Lagoon Ileighls IF FAXING CONFIDENTIAL Ci.TENT IINFOI01ATION,COMPLETE TIiF, Residenlial Program FOLLOWING: Ook Bluffs,MA, Client initials Program name— Oceanside. Brief description of faxed informntinn Residemial Progrnm Centerville,MA Pal+ncr Avrnuc Re.cidenrial Program Recipient Name(confirmed) Falmouth,MA Plyrnnush Ray CONFIDLINTIALITV NOTICE Clubhouse The information in this transmission may contain PRIVILEGED ANU CONTIDr.NTI AL Plymouth,MA itla^ormation intended for use only by the above named recipient. li-you have recr.ived this transmission by error,please notify us immediately by calling the person noted�l,ove. Rrgianol Qfticc m Any disclosure,dissemination,distribution,or copyin,of this information 0r its contelits Sandwich,MA is strictly prohibited under the law. eVv .ArrmMlad ny MVpyQ4 VERIFICATION OF RECF,IPT: Please call the person retciving the inromiation listed above ! s►t4+r—� to Verify receipt of this;transnussiou. L.rN 1140.09 Attuhn+m+A i �✓F F�a CmM eflM I+du !�r Assenlvo Gnmmurny Realment, Comm�,ntry knt�clnp, ' �.a+nrsldontfet r/OAMIM? i TOWN OF BARNSTABLE INSPECTION WORKSHEETC�os CERTIFICATE NO: 75951 CANCELLED: MAP: 326 DBA: IDOROTHY BEARSE APARTMENTS PARCEL: 012 NAME/MANAGER: IFELLOWSHIP HEALTH RESOURCES, INC STREET: 1 118 HIGH SCHOOL ROAD VILLAGE: IHYANNIS STATE: MA ZIP: 02601 SEQ NO: 1❑ BUSINESS TYPE: MULTI-FAMILY CONSTRUCTION TYPE: I STORYI: CAPACITY: USE1: R2 Capacity Under 50: 17 STORY2: CAPACITY: Ij USE2: STORY3: CAPACITY: USE3: Outside Seating: r. BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 20 LOC1: ONE-BEDROOM UNITS CAPS: L005: CAP2: LOC2: CAPE: LOC6: CAP3: LOC3: CAP7: LOC7: CAP4: LOC4: CAPS: LOC8: INSPECTION: DATE ISSUED: EXPIRATION: Print T1s ScHE ffo reen; loy/q�`' 04/13/2004 04/13/20N 7 Print Certificate of Inspection, COMMENTS: Ftrc�, Town of Barnstable a BARNMBLE. Regulatory Services 1639.MASS. ,0$ Thomas F. Geiler, Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLEASE FORWARD THE ATTACHED PAGE(S) TO: TO: Dorothy Bearse Apartments ATTN: Kelly FAX NO: 508 862 6340 FROM: Lois Barry DATE: 4/8/04 PAGE(S): (INCLUDING COVER SHEET) 1 Ft Town of Barnstable do Regulatory Services • BMWSrABLE, v MASS. Thomas F. Geiler, Director �p s6gq ♦� rE1639n. Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 8, 2004 Dorothy Bearse Apartments 118 High School Road Hyannis, MA 02601 By Fax 508 862 6340 Attention: Kelly Re: Certificate of Inspection Attached you will find an application for a Certificate of Inspection as required by Section 106.5 of the Massachusetts State Building Code, Sixth Edition. Please complete the application and return to the Building Commissioner's Office with the required fee (amount as set on the top right-hand corner). The fee has been established by the Massachusetts State Building Code (Table 106), and amended by the Barnstable Town Council effective 8/6/01, and must be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5.2 of the State Code. Sincerely, Tom Perry Building Commissioner Enclosure jcoilet COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION Date ( ) Fee Required$ ( X ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: Name of Premises: Purpose for which premises is used: License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be Issued to: Address: Telephone: Owner of Record of Building: Address: Name of Present Holder of Certificate: Name of Agent,if any: SIGNATURE OF PERSON TO WHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER,200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# EXPIRATION DATE: J020115c �� �� � � �� �- 15� `� OpIME r Town of Barnstable tia ,ARNAB . Regulatory Services 9 MASS. ArE0 39. A Thomas F. Geiler, Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM TO: Tom Perry FROM: Lois Barry DATE: 3/30/04 RE: Dorothy Bearse Apartments 118 High School Road,Hyannis 326 012 and 4 Unit Multi-Family 69 South Main Street, Centerville Kelly Maibaum, Program Director for Dorothy Bearse Apartments, called. This property is owned by the Housing Authority and leased to the Department of Mental Health. She said there are 20 one-bedroom apartments (2 story, motel style) connected by a community building. All residents have individual apartments. Staff is there 12 hours a day (no overnight staffing). They have a copy of the CO, but called to see if they need other inspections. We do not have a COI on this property. It is not on my multi-family data base. We do have a CO for Dorothy Bearse Apartments (attached). Do we need a multi-family COI? In 1997 this property was in the DMH Apartment Program and listed in a letter from Ralph Crossen(see attached). Since that date we have issued multi-family COIs for 9 of the properties listed in that letter. Ralph Crossen's determination was that the individual apartments didn't need inspections but the property should have a COI even though it was part of the DMH program. If we do need a COI, is it fee exempt? We have COIs for the following housing properties owned by the Housing Authority, all fee exempt. Ralph Crossen did not charge a fee for buildings owned by BHA (see 1997 notes). COI J040325a 21475 500 Old Colony Rd. Colony House 68 units 21476 200 Stevens Street Adams Court 64 units 21477 32 Sea Street Ext. Hyannis House 36 units 21478 54 Sea Street Ext. Barnstable House 35 units 21479 30 Pine Street Captain Eldridge House 20 units 61152 93 Pleasant Street Aunt Sarah's Harbor View House 12 units I have reviewed the other properties on the list and it appears that we may need a COI for 69 South Main Street, Centerville. The CO (attached) is for a 4 unit multi-family, and is owned by Callahan/Hostetter. Do you want me to request the COI fee for this property? J040325a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r Map Parcel Application Health Division Date Issued �J l `'� 6V' Conservation Division Application F Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address 4 Pi 1r�IM�'t� � 1 1 k �00 NW�iS �b01 Village Owner r It Wowinor1wTh0H,b4 Address Telephone 508—? 7/— _7r�Z 2 D_ Permit Request 10 D S q roor;,g pro� (d o0ro tAy QP&I-Se Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District II Flood Plain Groundwater Overlay Project Valuation PI/C 60Q DO 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. Number of Baths: Full: existing new Half: existing newa C1 Number of Bedrooms: existing _new -- ' w Total Room Count (not including bath,;): existing new First Floor Roo Count: Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other w 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 ofAppeals Authorization ❑ Appeal # Recorded ❑ Commercial I/Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number f�(o _.? Address /Z" �'� License # Home Improvement Contractor# ��coO s Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 03--13 —,,2,0/ S c FOR OFFICIAL USE ONLY ca s i ti APPLICATION# S w� DATE ISSUED MAP/PARCEL NO. g ADDRESS VILLAGE c. OWNER ! r � , t DATE OF INSPECTION: FOUNDATION FRAME ' r INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i P FINAL BUILDING r ,Y DATE CLOSED OUT r_ ASSOCIATION PLAN NO. J . �` j7 The Commomvedtfh ofMassachusetts sa •ri hi 1 U �t�f 5�f�1�(Yl1(i 4llLGlLG1- t a t _ i. r Ql'tJnBTlt O fliwrww 1.�.c" ' ce oflavestigatwns 600 Wraskington Street _ Bostan,.MA 02111 www.masLgov1d4a Workers' Compensation Insurance Affidavit: Bmlders/Contractors/Electricfans/Plumbers A.Pplicant Iriforni,ation Please Print Le eh Name(Business/ 5`r' G7"7ON �1 City/Siate/Zip: I ; S NA 0)� Phone.# �`j�- 20— V t6 —�� Are you an employer?Check the appropriate box: Type ofectre ro. mu a mal contract d Ior an p 1 ( � 1. ' I am a employer with 4 _ ❑ I. 6. ❑New construction . employees(fall and/or part time).* have hired the=b-cont actors 2.❑ I am a'sole proprietor or partner- listed on the-atta.ched sheet': 7. ❑Remodeling ship and have no employees These sub-confracfnrs have' 8. ❑Demolrtinn working for many capacity: erployees and have workers' [No worImp' comp.insurance CdII�.ms molce $• -9. ❑Budding addition reqaimi] 5. F] We are a corporation and its 10.0 Electrical�epaiis or additions officers have exercised their 11. PI airs or additions 3.❑ 1 am a homeowner doing alLwork ❑Plumbing repairs . myself_ [No workers' camp. - rigbt of exemption per MGL. 12.�of repay insurance required]t c. 152, §1(4),and we have no insuranceemployees.[No workers' . 13.❑Other cep,insorance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'coinpeasafion policy information. t Homeowners who subidt this affidavit indicating they are doing all work and ffien hire outside contractors must a bffit a new affidavit indicating such. $Conhactms&at check this box must attached an additional sheet showing the name of the sub-cantactors and state whether or not&ore entitirs have employees. If ibe sub•conhactors have empiuyees,they mustprovidb their worla:rs'camp.policy number. 'I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information r Insurance Company Name: Policy#or Self-ins.Lic.#: V PPO Q7l{job 7 Expiration Date: 193— 7—d 01.3' Job Site Address: ®� Rd City/State/Zip:4 /V Attach a copy of the workers compensation policy declaration page'(showiag the policy number and expiration dafe). Failure•to secm'e coverage as required under Section 25A of MGL c. 152 can lead to the imposition of caiminal penalties of a fine up to$1,500.00 and/or one-year imprisonenf as-well as civil penalties in the foul 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 ctaternm t may be forwarded to the Office pf Investigations of the DIA for ir=ranCe coverage verification. I do•herebyycerdjf under the pains-curd penalties of perjury that the information provided above is true and correct Sienatae�/�Q PGI�G ���ar r DatE: -3 1- " cW1_5. Phone# (��^ (D/o2 qS617- official use only. Do not write in this.area.6 be completed by city or town official. City or Town: Permitucense# Issuing Authority(circle one): A,.Board of Health 2,Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone# . r� J&DCO-1 OP ID:KA 7`031113113 CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO.RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIKMATIVIELY OK NhUATIVImL.Y AMhND, hAIhNLU UK ALIEK IHI_ WVhKAUL AI;+OKDEU MY lHE FFULlEakiS BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SN AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. it tho eezrtifleato hVldnf iS an ADDITIONAL INSURED,tlro puGay(ltm) Inwt tra andumad. If SUBROGATION 15 WAIVED,subject to Ow forms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRooucCR T. O'Connor&Co.Ins.Agenc Inc PHONE 16 Village St. P.O.Box 146t N AM ac Ne_ udley,MA 01671 ADDRESS: - O'Connor&Co.Inaurance A INSUR S AFfdRCINGCOVERAbE NAIC>s INSURER A:Western World Ina.Co. INSURED JD&D Construction Inc. INSOMR 2:Travelers Indem WCAR Dariusz Ochocki 114 Upper Gore Road INt;uReR c; Webster, MA 01570 INSURER D INGURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 POI ICIFS LIMITS SHOWN MAY HAVE.BF.FN RFDLICFO By PAID CLAIMS. LTRA-W TYPE OF INSURANCE POLICY NUMBER POLICY EFF MYO� .. LIMITS GENETALLIABILITY EACH OCCURRENCE $ 2,000,90 A X COMMERCIAL GENERAL LABILITY NMh't/U74liti7 QW17112 U3/17113 PREM E7 a NTED nee i 50,00 CLAIMS-MADE �OCCUR MED ECP(Any cnd perypn) $ 5.00 „P S N4 ADV INJURY S 2.000.00 GENERAL AGGREGATE li 2,000,00 GEWL AGGREGATE LIMIT APPLIES PER PRODUCYS-COMPIOP AGG $ 2,000,00 1-1 POUCY PRO- 1-1 LOG I I 3 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 6n ecci eN ANY AUTO BODILY INJURY(Perperaon) S AU T03 ED AUfOSULZD BODILY INJURY(Per eocklent) 6 PROPERTY AIMAGEy. 6 HIREDAUTOS AUTOS �5�� S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCEL LJA13 I CLAIMS-MADE AGGREGATE $ U:U HEII-Nnomt5 z •~• � WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY I 1131 - B ANY PROPRETOR/PARTNERrEIfECUTIVE YINN/A 6KUBUSUN87612 0&31112 06131113 EL EACH ACCIDENT 100,0 FPI OCOMWEMOrR C%CLUOm4 (NWwatury In NN) E.L.DISEASE-EA EMPLOYEE1 s 100,0 If yea,detlratibe under DE CRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500100 DCBCMPTGN QF 0PEFt^V*140/UKC^71o"/V9K00Wa SAINN,ACO1tD lel,AJJIIMwI ltaua,ns B�I,wlrly,If uw,v Mwnv I�rvyWrW) Roofing,replacement windows and vinyl siding, CERTIFICATE HOLDER CANCELLATION BARNSTA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE MT7 POLICY PROVURONS. 200-Main Street Hyannis,MA 02601 AWDIORIZED. T O'Conn no a 0 'Age ® 598 0 Addgkf CORPORATION. All rights reserved. TO 29Vd 00 210NN000 LSZCEP6809 LS:80 ETOZ/ET/EO i f C s tv d jt -� t _ tL�, ,�i r,tt �t f }p ,,,q j.� .5 �� i s kv�trY '4 4 .,.,t :.,f ;' a7`'4 :- S j l �f �R'"L {'lJj ye. T r. TovPn`0 Barnstable Regulatory Semees BARMUBM n� Thomas F.Geiler,Director i6gq. �y� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www:towmbarnstable.ma.us. Office: 508-862403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This .Section If Using A Builder �)(r ,as Owner of the subject property hereby authorize to act on my behalf, in 0 matters relative to work authorized by this building pettnit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of 04. et Signature of Applicant Print Name Print Name Date BARNSTABLE HOUSING AUTHORITY 146 SOUTH STREET QTORMS:OWNERPERMISSIONPOOLS 6/20I2 HYANNIS,MA 02601 y 1} ttitd � �TME To. of Barnstable } ' Re ato Services . + _. rY • s�atvsresr; • Thomas F.Geller,Director n�►ss. . s6S� •0� Building Division . Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 62601 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 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 no`possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersignsd"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 inspec ' pro es and requirements and that he/she will comply with said procedures and requirem ts. NSTABLE HOUSING AUTHORITY BAR r ture o Homeown 146 SOUTH STREET HYANNI6,MA 02601 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 f, 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 helshe 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 fonn/certification for use in your community. Q:forms:homeexempt " lr tSroaj'S4 of tStiaUiur-1 Kel—IlllaU0au :1111 M:tnUaril-. ��,n--zYlructicn Supervisor license License: CS 1.02347 Restricted to: 00 LUKAS JAGIELLO 43 GRANITE ST WEBSTER, MA 01570 Expiration: 4/18/2013 Tr#: 102347 ..I 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. i Refer to: WWW.Mass.Gov/DPS II The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts �i f J William Francis Galvin f Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor a ` Boston,MA 02108-1512 Telephone: (617)727-9640 JDBD CONSTRUCTION, INC. Summary Screen Help with this form ,Request a Certifit ate �4} The exact name of the Domestic Profit Corporation: JD&D CONSTRUCTION,INC. Entity Type: Domestic Profit Corporation Identification Number: 204643134 Date of Organization in Massachusetts: 04/06/2006 Current Fiscal Month/Day: 12/31 The location of its principal office: No. and Street: 114 UPPER GORE ROAD City or Town: WEBSTER State:MA Zip: 01570 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: DARIUSZ J.OCHOCKI No. and Street: 114 UPPER GORE ROAD City or Town: WEBSTER State: MA Zip: 01570 Country: USA The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT DARIUSZ J.OCHOCKI 114 UPPER GORE ROAD WEBSTER,MA 01570 USA TREASURER DARIUSZ J.OCHOCKI 114 UPPER GORE ROAD WEBSTER,MA 01570 USA SECRETARY DARIUSZ J.OCHOCKI 114 UPPER GORE ROAD WEBSTER,MA 01570 USA DIRECTOR DARIUSZ J.OCHOCKI 114 UPPER GORE ROAD WEBSTER,MA 01570 USA business entity stock is publicly traded: _ http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 3/13/2013 i The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 2 of 2 The total number of shares and par value, if any,of each class of stock which the business entity is authorized to issue: Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares CNP $0.00000 275,000 $0.00 25,000 Consent _ Manufacturer _ Confidential Data _ Does Not Require Annual Report Partnership _ Resident Agent _ For Profit _ Merger Allowed Select a type of filing from below to view this business entity filings: ALL FILINGS 11TU Administrative Dissolution Annual Report Application For Revival Articles of Amendment -LL View Fllings�� tr,New Search . ..� �taa,. ��.�..�..,:��.�:�� Comments O 2001-2013 Commonwealth of Massachusetts All Rights Reserved Help http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 3/13/2013 { t #xr;v52 C9c,kocl % C) pfi o cons�ruc�"qkn) 1 a� E l y V 1 1 r 6D/ \ 1 ` aS W` bs l er 1,'lj i , Ilo 6L4 Ql Gr,a/i �k �1 Goer o-I f-c+ CJ -8, Qorfl+ti p, Qeat^I-� I IB (4:0 Sc`-ssl Roo, �ann i S /1714, t 1 i k i I t 4 t . . �= The Town of Barnstable • a►ruvar�. _ NAM Department of Health, Safety and Environmental Services °.19. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner March 27, 1997 Ms.Lee Canto Kelsey Commonwealth of Massachusetts Department of Mental Health 259 North Street Hyannis,MA 02601 Dear Ms.Kelsey: Pursuant to Emergency Amendments to the Fifth Edition of the State Building Code//Sections 631,636 and 638 dated December 24, 1996(copy attached),the following properties do not require any inspections from our office until further notice. Properties: 1493 Newton Road,Hyannis 357 Main Street,Hyannis 201 Hinckley Road,Hyannis 209 Main Street,Hyannis 148 Sea Street,Hyannis 32 Sea Street,Hyannis 69 South Main Street,Hyannis 800 Bearses Way,Hyannis 225 Main Street,Hyannis 182 Main Street,Hyannis 59 School Street,Hyannis 148 Cedar Street,Hyannis 12.WI igh School Road,Hyannis 59 School Street,Hyannis 15 Sterling Road 270 North Street,Hyannis 270 North Street,Hyannis 209 Old Yarmouth Road 209 Main Street,Hyannis Founder Court Apt. 720 Main Street,Hyannis 241 Village Market,Hyannis On the other hand,it appears that the following properties are group residences or limited group residences and must be inspected as required by the Mass.Building Code. Would you please make arrangements to complete and return the enclosed applications along,with the required fee of$15 for each group residence. Upon receipt we will send a building inspector to make the inspections. 336 Sea Street,Hyannis -Angel Road Residence(Group Residence) 47 Cedar Street,Hyannis-Sea Winds(Limited Group Residence) 78 Pleasant Street,Hyannis-Kit Anderson House(Limited Group Residence) 50 Bent Tree Road, Centerville-Oceanside(Limited Group Residence) Sincerely, i Ralph M. Crossen Building Commissioner Enclosure Memorandum DATE: January 30, 1997 TO: Lois Barry FROM: Lee Canto Kelsey" RE: Housing List Enclosed is the housing list for Barnstable County, Please note that houses with the* symbol are group homes all the rest are apartments. 357 Main St Hyannis 15 Sterling Rd 209 Main St.Hyannis 78 Pleasent St 32 Sea.St Hyannis 270 North St 800 Bearses Way 209 Main St 182 Main St Hyannis 720 Main St 148 Cedar St Hyannis 50 Bent Tree Rd Centerville 59 School St Hyannis 270 North St Hyannis 209 Old Yarmouth Rd Founders Court Apt E2 336 Sea St �Iro t 148 Cedar St 241 Village Market Hyannis 1493 NeAlon Rd 201 Hincley Rd 148 Sea St 69 South Main St 225 Main St 59 School St Hyannis I 120 1 High School Rd Hyannis �G�� �rG %��� l 47 Cedar St Hyannis I 2/20/97 Ralph, Attached is a list of the Barnstable Housing Authority's multi-family housing. Some of them are DMH or DMR and we have dealt with them. Do we need COI for the following: 500 Old Colony Blvd. nc load 75 in occupancy Elderly Housing, p Y . file-R-2 Eld y g CO m , There are 68 units, all 1 bedrooms but may sometimes have marred couples. Do we need COI? Do we charge fee or is BHA exempt? If fee- chart,R-2 multi-family, 5 year certificate, note f- $211 Correct? Would whatever decisions you make on 500 Old Colony Blvd. also apply to 200 Stevens Street 32/54 Sea Street Ext. az 30 Pine Street or do you need any ore information on thes . Any letters we send on these properties should go to: Thomas K. Lynch,Executive Director ll , Barnstable Housing Authority G � 146 South Street,Hyannis 771-7222 Gc� II t3C1101A ems-/q� av r MEMORANDUM To: BBRS Members From: Susan Motika, Assistant Attorney General / y Re: Sargent v. O'Toole proposed regulatory .changes Date: March 12, 1996 The following proposed code change, developed with technical assistance from BBRS staff, is submitted in compliance with the HUD conciliation agreement in Sargent v. O'Toole. Proposed Change to the State Building Code 638 .1 General : A Group Dwelling Unit is a dwelling unit licensed by or operated by the Department of Mental Retardation or the Department of Mental Health as special residence for up to four (4) persons who mayor may not be capable of self preservation from fire or other related hazards. The provisions of this section shall apply to both new and existing. Group Dwelling Units. Exception: Apartment programs as defined in_ 104 CMR 17 13 (2) (c) in which residents residing therein are also capable of self preservation (unimpaired) shall be exempt from all requirements of Section 638 Such apartment programs shall be classified as R-1 R-2 R-3 or R-4 as applicable. f NOTE: Below are amendments to DMH regulations, already promulgated as emergency regulations, which address the same population of "unimpaired" clients who are capable of self-preservation. This regulation was reviewed by BBRS staff, and the Attorney General' s Office before its promulgation. Change to DMK Regulations 17.13 (4) (k) . Provision of or arrangement for a program of training in self-preservation, including knowledge of fire safety. Except for those clients defined in 17 . 13 (2) (c) as residing in--an -arartment program -and also capable of ti of TOWN OF BARNSTABLE In accordance with-the Massachusetts state Building Code, section 120.0, this CERTIFICATE OF USE AND OCCUPANCY Dorothy Bearse Apartments is issued to Dorothy Bearse Apart.mer s structure known as c�J a¢rtif that 1 have inspected the villa e Hyannis located at 118 High School Rd. in the g of Barnstable Commonwealth of Massachusetts. The building is hereby certified to be in compliance County of with the Basic Code and for the purpose stated below. R-2 - USE GROUP ---- OCCUPANCY LOAD FIRE GRADING November 10, 1994 i1Ji„xUtfic�t Date Certificate Issued The building official shall be notified of any changes in the above information. 5 UPDATE PERMIT RECORDS : ADD CHANGE DELETE PRINT FEES HELP END CHANGE' RECORDS IN PERMIT TABLE PENTAMATION----------------------------------------------------------- 03/25/04 PERMIT NO. 3660 PARCEL ID 326 012 118 HIGH SCHOOL ROAD PERMIT TYPE BUILD NEW RESIDENTIAL BLDG PMT DESCRIPTION 32663 CONSTRUCT A NEW RES . BUILDING STATUS C COMPLETED APPLICATION DATE 02/24/1989 DATE ISSUED 02/27/1989 EXPIRATION DATE DATE COMPLETED 11/01/1990 MASTER PERMIT VARIANCE VALUATION 1400000 . 00 BOND 0 . 00 CONSTRUCTION TYPE 101 GROUP TYPE 1 CONTRACTORS 050037 STANDEN CONTRACTING ARCHITECTS/ ENGINEERS/OTHERS ENTER Y IF ALL ARE CORRECT OR N TO REENTER LEAVE BLANK FOR NON-PROPERTY RELATED PERMIT. CTRL-I FOR HELP. PDATE PERMIT RECORDS: ADD CHANGE DELETE PRINT FEES HELP END HANGE RECORDS IN PERMIT TABLE ENTAMATION----------------------------------------------------------- 03/25/04 PERMIT NO. 3660 PARCEL ID 326 012 118 HIGH SCHOOL ROAD PERMIT TYPE BUILD NEW RESIDENTIAL BLDG PMT DESCRIPTION 32663 CONSTRUCT A NEW RES . BUILDING STATUS C COMPLETED APPLICATION DATE 02/24/1989 DATE ISSUED 02/27/1989 EXPIRATION DATE DATE COMPLETED 11/01/1990 MASTER PERMIT VARIANCE VALUATION 140.0000 . 00 BOND 0 . 00 CONSTRUCTION TYPE 101 GROUP TYPE 1 CONTRACTORS 050037 STANDEN CONTRACTING ARCHITECTS/ ENGINEERS/OTHERS ENTER Y IF ALL ARE CORRECT OR N TO REENTER EAVE BLANK FOR NON-PROPERTY RELATED PERMIT. CTRL-I FOR HELP. TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 120.0, this CERTIFICATE OF USE AND OCCUPANCY Dorothy Bearse Apartments is issued to Dorothy Bearse Apar*.mei s structure known as �1 (gErtif that!have inspected the H annis 118 High School Rd. in the village of located at of Barnstable Commonwealth of Massachusetts. The building is.hereby certified to be in compliance County with the Basic Code and for the purpose stated below. R-2 USE GROUP OCCUPANCY LOAD FIRE GRADING November 10, 1994 juing official Dote Certificate Issued tified of any changes in the above infornurtivn. The building official shall be no Assessor's offioe (1st floor): Assessor's map and lot number ....Map.,326,...Lot,• 12 .k ..���"ET��` b�Q ow Board of Health (3rd floor): Sewage Permit number ........................................................ 2 DaDaszsDtL Engineering Department (3rd floor): oo NABIL House number ........................................................................ 'EO YPY a' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN_ OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO '.�.—....Demolish ts ................................... ...................................... TYPE OF CONSTRUCTION .. Wood frame ................................................................................................................................... ..............•---•I...February....-.,1988. TO THE INSPECTOR�OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .:�120..High School...Blood,...HyanniS............................................................................................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict .............................. .........................................Fire District .............................................................................. Name of Owner Barnstable Housing Authority Address J1 6 South Street, Hyannis ................................................................... Name of Builder .....Donovan Crane Service ,,.,Address .,178 No. Dennis Road, So. Yarmouth ................................... ...... ............................................ Nameof Architect ..................................................................Address ........................................................................ Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ....................................................................................Roofing .................................................................................... Floors .....................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .................................................... ................. . , : _ - -. . _ . . - Definitive Plan Approved by Planning Board --------------------------------19-------- . Area ......../.................................. Diagram of Lot and Building with Dimensions Fee 1 V SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 d %' r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. s / Name . ` .... ..................................:"............. Construction Supervisor's License .................................... BARNSTABLE HOUSING AUTHORITY A=326-12 W - 3.z � - ��• �. �. No 31588 permit for ..Demolish Dw.....ling.......................... Location ....I&9—H.igh. School RQ.ad........ ..H.Yanni s..................................................... ..... Owner ..Barnstable,,,Housi?�g...Aut,hori�`_y Type of Construction .....j r.aMe........................ ..............................................................I................ Plot ............................ Lot ................................ Permit Granted F.ebruary. . 4, 19 88 .. .... .. ....... Date of Inspection ....................................19 Date Completed. ......................................19