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0225 OST.-W.BARN. RD - Amnesty & MULTI-FAMILY
o o AMNESTYFILE o 00 0 0 � o a 1"ET°�'' Town of Barnstable &ARNSTABM Building Department-200 Main Street 9MAS& m Hyannis, MA 02601 M Tel. (508) 862-4038 . Certificate Of Occupancy Permit Number: B-17-4319 CO Issue Date: 5/7/2018 Parcel ID: 121-002 Zoning Classification: RC Location: 225 OST.-W.BARN. RD, OSTERVILLE Proposed Use: Name of Tenant: Sprinklers Provided: Gen Contractor: Permit Type: Residential-Single Family Type of Construction: Design Occupant Load: 0 Comments: ONE BEDROOM ACCESSORY AFFORDABLE APARTMENT ABOVE DETACHED GARAGE. FINAL INSPECTION ON 3/21/18 BY KEN MURPHY. Building Official Date: A Certificate of Occupancy is Required Prior to Occupying Space Building Code: 780 CMR 8th Edition 4 Town of Barnstable Building oAaiverABt B Postx Ths is.Card Soas::T'..a,hat'.i-.t.0,=vz .r.wbT d Plat'.i MuNANO 4¢nbsVleF xromth Sr s,c,J ob-v and t'h.is..zrCsla!"'r,cdf M"'r utxs t'++f°bse�i K,e+ +at Pr os5twre;rd ' pP e z v p lis - ,� r� c ,. , . a.,.t , , -. �+ �, •Until F ,}y ��� � °`� �;g� qg � _'`` '3'""fir";..i'�.K :k'ey."ss*g'tn?>; e-� .`. ,s.,�7'."- s ' ?'tsr ';,r'�1: ', "'a °�°`Y�,`, .4`-.s�mr � 5� a.�� 'IWherehBuildm ,shall Not;be Occu iedAuntiha Finallris action hasbeenriade Permit �g�.. A�� ��.. �tr,, Permit No. B-17-4319 Applicant Name: COUET,KATE E Approvals Datelssued: 02/20/2018 Current Use: Structure Permit Type: Building-Amnesty with Construction Expiration Date: 08/20/2018 Foundation: Location: 225 OST.-W.BARN.RD,OSTERVILLE Map/Lot: 121-002 Zoning District: RC Sheathing: Owner on Record: COVET,KATE E ,�� s Contractor Name 3 Framing: 1 } ` Contractor License " Address: 225 OSTERVILLE-W BARNSTABLE RDhx`t 2 ect Cost: $60,000.00 OSTERVILLE, MA 02655 % Chimney: ,�F ' �A Permit�Fee: Description: Accessory Affordable Apartment with Construction fora Kitchen ��1:;. x � $381.00 installtion an existingdetached garage. - Insulation: g g - Jq 24 Fee�Paid $381.00 x� Date a 2/20/2018 Final: Reconstruction of one bedroom apartment on the=second floor t , above the detached garage for Accessory Affo d nie Apartment ` 1 R Plumbing/Gas Project Review Req: Permitted as a dwelling unit or apartment,contmgenE'upon Rough Plumbing: compliance w/Comprehensive Permit No 2017062 Couet = a ` �r Building Official y Final Plumbing: - Al This permit shall be deemed abandoned and invalid unless the work authorized bywthis permit is commenced within six months'after issuance. Rough Gas:' All work authorized b this permit shall conform to the a ` in' s `' y p approved appl�cat�on and the approved construction documents forkwhich`this permit has been granted. nZ. All construction,alterations and changes of use of any building and structures shualll'be in compliance with the local zoning by law4siand codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public mspectlon for the entire duration of = r r K. the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fie6;Officials are'provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work ; r 1.Foundation or Footing ' - , 3 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 Low Voltage Rough: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy 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: 3 LZ "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable Building u ��� PostThis Card So:That it is Visible From the Street Approved Plans Must be'Retained on'Job a nd this Card Must be Kept x MAS& ` Posted,Until Final lr�spection,Ha's Been(Made r" {:` r „.E � <t a;. . • a iWhere Certificate of Oc�cupancys Required such Bur dmgshall Nottie Occupied until aFinal Inspection has beemmade �� �t Permit No. B-17-4319 Applicant Name: COUET, KATE E Approvals Date Issued: 02/20/2018 Current Use: Structure Permit Type: Building-Amnesty with Construction Expiration Date: 08/20/2018 Foundation: Location: 225 OST.-W.BARN. RD,OSTERVILLE Map/Lot 121-002 Zoning District: RC Sheathing: Owner on Record: COVET,KATE E t Contractor Name: Framing: 1 Address: 225 OSTERVILLE-W BARNSTABLE RD Contractor License: 2 OSTERVILLE, MA 02655 `` � Est Project Cost: $60,000.00 Chimney: Description: Accessory Affordable Apartment with Construction for a-Kitchen Permit Fee: $381.00 installtion an existing detached garage. ,€ ) $381.00 Insulation: Fee Paid Reconstruction of one bedroom apartment on the second floorr - Date..` 2/20/2018 Final: above the detached garage for Accessory Affordable�Apartment _ � Plumbing/Gas Project Review Req: Permitted as a dwelling unit or apartm nt;`contingent upon'-- Rough Plumbing: compliance w/Comprehensive Permit iNo 2017 062`z-Gouet`v � , � s-� � fi Building Official 3. Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months'after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the''approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street orroad and shall be maintained open for.public inspection for the entire duration of the work until the completion of the same. r ` Afr Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the BuPilding and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing r r' t 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 S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy g 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 r� 13111L®IN Applicadconx ...... .."..... ................................ XAMJ�N �Q1� rmit .Pe Fee....... .... ...... ..........other Fee........................ - ���► TOWN OF SARYSTAB Total Fee Paid 432t.&D............. TOWN OF BARNSTABLE PmmitApFovalby.....Cl. ? .` .........OIL......'&A ...... BUILDING PERMIT APPLICATION ......./, .�..............I......parca.... ..................... Section 1 — Owners Information and Project Location Project Address �i �j d 1 I �;5 I Village 5 1�1 I k Owners Name KA t Owners Legal Address AK Mflkyi l l�, st em( tOf U GtK— ,U 1 I I?, State O A Zip 0a U S'S- Owners Cell# J V& "-n U" Q Frmail 46 U Section Z—Structural Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3—Type of Permit ❑ New Construction ❑ . Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ hsulation ,--- Other-Specify Section 4-Detail Cost of Proposed Construction� lQ (��V Square Footage of project I �3 Age of Stricture �, -7 9gs 0 d Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Lastupdat&linrz017 Section 5 -Work Description ►2 waVCt cr) di Ot Yhd OM a0dk�tnt rho \�h�, cues o(a I cue s �z Section 6—Project Specifics ❑ Wining D Oil Tank Storage . Smoke Detectors Plumbing ❑ Gas [Fire Suppression .Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply IJ Public ❑ Private Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: L l4 I an using a crane C Yes `f'' No Section 7—Flood.done Flood Zone Designation J Within or adjacent to a wetland,coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District �`G Proposed Use�NU (� Lot Area Sq. Ft. Total Frontage tag d Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed AU Rear Yard Required Proposed y � !' 1 Side Yard Required Proposed G _1pj Has this properly had relief from the Zoning Board in the past? ❑ Yes No Last updated:11nn12017 Section 9—Construction Supervisor . Name Telephone Number G Address City State Zip k License Number License Type Expiration Date Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and docummentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section 10—Home Improvement Contractor Name Telephone Number I; t Address City State Zip I ' Registration Number Expiration Date I understand,my responsri ffides under the rules and regulations for Hone Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and doc nientation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentatim 780 the of Barnstable. ,., Signature Date j APPLICANT SIGNATURE . E 'mature LaWri I -, (_1 �_/rw�CJIJ Date I I ame ko i D i Telephone Number U 1 permit to: K Cc e+ a U Gft o, am Last updated.I Inr2017 5 Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation Lam' For commercial work,please take your plans directly to the f re department for approval Section 13— Owner's Authorization I 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) 02 � 1 Signature o er to aft Print Name I Last updated 1 v7/2017 Town of Barnstable Building Department Services Brian Florence,CBO ' Building Commissioner 200 Main Street, Hyannis,MA 02601 �er,►e[s, > www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 11 l I I l �/ Please Print DATE:LO /� A JQB CATION: 051• d . ' (ll V S��{�V��I-?- number street village -HOMEOWNER^: 1�a �� 77 U lQ 3C y name ,,/home phone# 'n �( work phone# �CURRENTMAIIINGADDRESS: A� )I yV os+. agog - l{U mli- crtyhown state rap•code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildingRermit (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 procedure mad requirements that he/she will comply with said procedures and requirements. Si of Hom 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPF]IM\FORMS\building permit forms\EXPRESS.doc 09/16/17 'ME Town of Barnstable Building Department Services ` MAO& Brian Florence,CBO 56 Building Commissioner 200 Main Street,Hyannis;MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section - If UsWg 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) **Pool fences and alarms are the responsibility o e f thPPlicant. Pools a are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMSIONPOOLS Rev:0&116117 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 Address: 1 ,� �U ti I�� 111y�S� to I t goad City/State/Zip: GS �y`��Q, i 0'�U S 'Phone#: -7—) U V'Zb Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 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 ge-❑Demolition workingfor me in an capacity. employees and have workers' Y P tY• x 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions yself.'[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and 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 the pai and p na ' of perjury that the information provided above is true and correct Signature: Date: Phone#: q� ` _7W `U�0 1 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other 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 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 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 cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents.for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in__(city or " f e affidavit that has been official] stamped or marked b the city or town may be provided to the town). A copy o the y p Y tY 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 (Le.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#61.7-727-7749 Revised 4-24-07 www.mass.govCdia I Search by Permi[ mdsd�ProJect Rev7ewyacons',C C O Stignoff GIS Personnel <FeportsPWeb� ScheduFe $ 'r e Permit#. (4 Character minimum) v Workflow/Project Review f i TB-17-4319.. z ........ ........ Yf t '? Barnstable Historic Adrillnl�Euilding-lnspectvr Censer Uztion Health-inspector a f C;�rrtmerrt 1 � C�mrnents:3 L ', 3` L Reviewing Department: Review For:TB-17-4319 Review Date 1111 f2o1 B �+ save Review �ss Building-Admire Dept. Review,Status -__----- CondRionally Approved [t,C' Required f Requested C None f �Emad Project Reviewers Email Applicant r Staff Assignment 1 Protect Management Show Project Review History 3 Notify Reviewers of Plans Resubmittal Last Reviewed B ` Pr©feet omments&Requlrem erats Permit SelectiA eux InsartR4u i Text �� L (— PnvateCamment _._..... _ t r s q a, ✓ a s Ad d Show All Types b Type your comment here or select from the list T, .. id- CommunityDev. + ................. .... �u,. 6arrowsd i[I Building + January applicant will return with existing smoke/carbon locations on plan and consult with building inspector for any additional devices needed Inspection Certificate _ 2018ti DPW I + s Haalth + .4 . �3 .. � � �.� �_ ,N ._ k.x a� a. ...£ .. .a t-y Town of Barnstable F) $ Zoning Board of Appeals n'. r_'_i •� Comprehensive Permit Decision and Notice _. iY Accessory.Affordable Apartment Progra f Comprehensive Permit No.2.017-.062 Couet Summary: Granted with Conditions Applicant: Kate E.Couet Property Address: 225 Osterville West Barnstable Road,Osterville, MA Map/Parcel: 121/002$ Zoning: RC—Residence C Zoning District Summary: Allow the conversion of 433 square feet to a one-bedroom accessory affordable apartment, located on the second floor within the detached garage pursuant to the Code of the Town of Barnstable,Chapter 9,Article Il. Deed Reference: Book.28622,Page 308 Applicant/Site Control The Applicant is Kate E. Couet, the owner and occupant of property addressed as 225 Osterville West Barnstable Road, Osterville, MA. The Applicant has been the owner of the property since January, 2015, as evidenced by a deed recorded at the Barnstable County Registry of Deeds on.Book 28622 Page 30.8 recorded January 9, 2015. A signed Affidavit dated June 23, 2017, declares that 225 Osterville West Barnstable Road, Osterville, is the primary residence of Kate E.Couet. Locus The.subject,property is a .78 acre lot and fronts onto-Osterville West Barnstable Road between Bumps River Road and Falmouth Road. The property is improved with.a .2,473 ,gross square foot three-bedroom single family dwelling (1,253 living area) constructed-in 1932. It is served by public water and an on-site septic system. Also located on the property is a. detached garage constructed in 1980, Background Kate E. Couet seeks to. convert 433 square feet of area on the second floor of the detached garage to a one- bedroom Accessory Affordable Apartment by a Comprehensive Permit pursuant to Chapter 40B of the General Laws of the Commonwealth of Massachusetts,; and .in accordance with §. 9-15 of the Code of the Town of Barnstable, more commonly termed the "Accessory Affordable Apartment Program". Procedural&Hearing Summary Kate: E. Couet submitted an application for a Site Approval Letter as prescribed in the Code of Massachusetts Regulations;760 Section 56.00 and provided for within the Accessory Affordable.Apartment.Program of the Town of Barnstable. The application was submitted asa local initiated Chapter 4M Notification of the application was submitted to the Department of Housing and Community Development. A Site Approval Letter was.issued to the .Applicant for the subject property by Town Manager, Mark Ells, on August 23, 2017. Notice of the Site Approval Letter was sent to the Department of Housing and.Com'munity Development in accordance with the:requirements of CMR 760 56.00. An application for a Comprehensive Permit was filed at the Town Clerk's Office on September 12,2017. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the Barnstable Patriot on October 6 and October 13, 2017 and notices were sent to all abutters in accordance .with Section 11 of MGL Chapter.40A. . I Town of Barnstable Zoning Board of Appeals Decision&Notice-Com pre hensive.Permit:No.201M62-Couet Findings of Fact At the hearing on October.25, 2017,the Hearing Officer made the following findings of fact; Concerning standing, the right of the applicant to seek a comprehensive permit,the Hearing Officer found: 1. The Applicant, Kate E. Couet, is the owner and occupant of the property located at 225 Osterville West Barnstable Road, Osterville, NIA,as evidenced bydeed recorded at the Barnstable County Registry of Deeds on Book28622 Page 308 recorded January 9, 2015. A signed Affidavit dated June 23, 2017.declares that 2.25 Osterville.West Barnstable Road,Osterville, is the primary residence of Kate E.Couet. 2. The application for a comprehensive permit was made in accordance with the Town of Barnstable's Accessory Affordable Apartment Program, Chapter Article:I.I-of the Code of the Town of Barnstable.. That program is structured:as a self,regulating;income-limiting local initiated housing program, a qualified funding program accepted under the Code. of Massachusetts Regulations 760 Section .56.00 that governs grant of comprehensive permits. 3. In accordance with 'MGL Chapter 40B and 760 CMR 56.04 (4), a Site Approval Letter was issued to the Applicant for the subject property by Town Manager, Mark Ells on August 23, 2017, Notice of the Site Approval Letter was sent to the Department of Housing and Community Development, in accordance with the. requirements of 760 CMR 56.04 (2), and no issuers were communicated from the Department on this application. Regarding consistency with local needs, the Hearing Officer found: 4. The Applicant is proposing to convert and area within the .detached garage to an Accessory Affordable Apartment. The apartment is 433 square feet, one bedroom and located in the upper level of the existing detached garage at 225 Osterville West Barnstable Road, Osterville.To permit the apartment as an accessory affordable unit under Chapter 9 Article II of the. Code would represent no perceivable change in the neighborhood.. 5. The Building.Commissioner performed an initial review of the property and determined that an accessory apartment unit can be created in conformance with applicable state building codes. Prior to occupancy,a building permit shall be required and'hardwired smoke detectors and carbon monoxide detectors shall be upgraded/installed and the unit.shall meet all requirements of the Building Code. 6. The property is served by an on-site septic system adequate to accommodate the addition of a one-bedroom unit on the property with a restriction from the Health Department if required. 7. The Applicant has-been informed that buildingand occupancy permits shall be obtained prior to,occupancy of the accessory apartment. This step is required to assure final approval that the apartment unit conforms fully to all applicable building,fire, and health codes and this decision. 8. The Applicant has been informed that upon certification of:this:Comprehensive Permit by the Town ClerkVa 4 Regulatory Agreement and Declaration of Restrictive Covenants, restricting the accessory apartment unit in perpetuity as an affordable rental unit shall be executed. Thereafter both the Comprehensive Permit.and the Agreement shall be recoded at the Registry of Deeds as binding covenants on the property. The documents limit the apartment to that of an affordable unit rented to a person or family whose income.is 80%or less of the Area Median Income(AMI) of the Barnstable Metropolitan Statistical Area (MSA) and cap the monthly rental income.(including utilities)to not exceed 30%of the monthly household income.of'a household earning 80%of the median income,<adjusted by househo Id."size. In the event that utilities are separately metered., the utility allowance established.:by,the Town of Barnstable shall be deducted from rent level:so calculated. 9. According to the Massachusetts Department of Housing.and Community:Developme:nt, Subsidized Housing Inventory, the Town of Barnstable has 7.14%of its year round housing stock qualified as affordable housing 2 Town of Barnstable Zoning Board of Appeals Decision&Notice-Comprehensive Permit No.2017-062-Couet units. The town has not reached the 10%'sta`tutory minimum affordable housing required in.MGL Chapter 40B or met any of the Statutory Minima provided for in 760 CMR 56.03(3). 10. The Town of Barnstable.'s Comprehensive.P.Ian encourages the ad.aptive'use;of existing housing stock to create affordable units and the dispersal of these units throughout Barnstable. This application and the location of the unit conform to that objective. Based upon the findings,the Hearing Officer ruled that the application of Kate E. Couet is deemed consistent with I ocal needs because it adequately promotes. the objective of providing affordable housing for the Town of Barnstable without jeopardizing;the health and.safety of the occupants provided'certain conditions are imposed. Decision&Conditions: The Hearing Officer "ruled to grant Comprehensive Permit No. 2017-062 to.Kate E.Couet for 225 Ostervi.11e West Barnstable Road,Osterville to allow the conversion of the area on the second floor of the detached garage to a: one-bedroom affordable apartment unit at 225 Osterville West Barnstable. Road, Ostervill.ea as provided for in Chapter 9,.Article li of the Code of the Town of Barnstable and in conformity to the following conditions and restrictions:. 1. Occupancy of the affordable unit shall not exceed-two(2)persons. 2. The number of bedrooms in the.AccessoryAffordable Apartment shall be-limited.to one(1). 3. Family members of the applicants/owne.rsshall not,at anytime occupy the.accessory unit. 4. All leases shall.have a minimum term of one year and have provisions that require the tenant to provide any and all information necessary to verify eligibility with the Accessory Affordable Apartment Program including income.information of the tenant and rent and utility payments. 5. All parking for the accessory apartment and the 'principal dwelling shall be on-site. Overnight on-street parking is expressly prohibited. 6. Accessory lodging or renting of rooms is prohibited for the duration of this.Comprehensive Permit. 7. The applicants.shall, aftercertification of this Comprehensive Peffnit by the Town Clerk: a. execute a Regulatory Agreement and Declaration ofRestrictive Covenants, as approved by the Town Attorney's Office, and b. make application for a building permit with the Building Division for the accessory apartment..Work required to bring the unit into compliance with present day code standards shall be.completed prior to issuance of a Certificate of Occupancy for the accessory apartment. S. It is the explicit intent that the applicant:secure an occupancy permit and the. unit be occupied by qualified tenant(s) as restricted.by this comprehensive permit within one-year of the certification of the permit. The Building Commissioner:and/or monitoring agent may extend this time for good cause. 9. To meet affordability requirements the rent charged:(including.util.ities) shall not exceed 30%of 80%of the median income*for the Barnstable MSA., adjusted for fain ly size, as calculated and published annually by the Town of Barnstable: In the event that utilities are separately metered,the utility allowance established by the town of Barnstable shall be deducted from rent level so calculated. 10. The applicant shall engage in open.and fair marketing of the.unit and provide documentation of the activity to the Housing Coordinator/Monitoring Agent. 11. Information regarding the income level.of any prospective tenant shall first be submitted to and approved by the Housing Coordinator/Monitoring Agent before any lease is signed. 3 Town of Barnstable Zoning Board of Appeals Decision&Notice—Comprehensive.Permit No.2011-062—Couet 12..Annualiy, the applicant shall work with the Housing Coordinator/Monitoring Agent to provide necessary information and documentation of tenant income eligibility and conformance with the Accessory Affordable Apartment Program. 13. The Applicant must register the unit with the Regulatory Services Department at 200 Main Street, Hyannis.. 14: Whenever a vacancy occurs; notice shall be given to the Housing, Coordinator/Monitoring Agent- before reengaging the tenant selection process previously cited. 15. Annual-income,to determine program eligibility,will be calculated per 24 CFR Part 5. 16. The Housing Coordinator of the Planning and Development Department shall be the monitoring.agent for the accessory apartment. Annual monitoring shall include verification of tenancy, affordability, and compliance With Comprehensive Permit. The homeowner.shall be responsible for the fee for Housing Quality Standards (HQS)inspections. 17. Every twelve months the applicant shall review the income eligibility of the tenant of the Accessory Affordable Apartment unit. No later than a year from the date of issuance of this Comprehensive Permit,the applicant shall file with the Housing Coordinator/Monitoring Agent an annual affidavit stating the rent, charged and income of the unit tenant along with all required supporting documentation. The property owners and/or tenant shall:provide any additional information deemed necessary to verify the information provided in the affidavit and:.annual monitoring documents; 18. Upon'any report from the Housing Coordinator/Monitoring.Agent that the terms andconditions-of this permit are not being upheld, the Hearing Officer of the Zoning Board of Appeals may hold a hearing;to revoke this. permit or cause enforcement action to. be.taken for compliance. 19. This Decision, the Regulatory Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be recorded at the Barnstable County Registry of Deeds prior to application for a building permit. 20. Should ownership of the subject property tratisfer,'the permit holder identified herein shah notify the Housing Coordinator/Monitoring Agent and,;provide, within 60 days of the date of transfer, the name and current contact information forthe new owner ofthe.subject.propeety, 21. This Comprehensive Permit shall be exercised,as:conditioned herein or it shall expire. Ordered Comprehensive Permit No. 2017-062 is granted with conditions to Kate E. Couet for property addressed as 22.5 .Osterville West Barnstable Road, Osterville;MA. This permit is not transferable without prior permission of the Hearing Officer.The zoning reiief.issued.in this Comprehensive Permit is that of a.variance to Section 240-13(A) Principal permitted uses in the RC.Zoning Districts to.:permit atone-bedroom accessory affordable:apartment unit Within the detached.'garage.. A written copy of thin decision will be forwarded to the Zoning Board of Appeals as required by the Town of Barnstable Administrative.Code .Chapter 241, Section 11. If after fourteen (14) days from ;that transmittal and provided that the members of the:Zoning Board of,Appeals take no action to reverse the:decision, this decision shall be filed with the Town Clerk's Office. It shall then become final only after 20 days has expired and certified by the Town Clerk that.no appeal was filed on the decision, Appeals of this decision, if any, shall be made to .the Barnstable Superior Court pursuant to MGL.Chapter 40A, Section 17, within twenty (2.0) days after the date of the,filing of this decision in the office of the Town Clerk. The applicant has"the right.to appeal this decision as outlined in MGL Chapter 40B Section.22. 4 r Town of Barnstable Zoning Board of Appeals Decision&Notice-Comprehensive Permit No.2017-062-Couet "Ilex ffodolakis, Hearing Officer Date Signed I,Ann:Quirk,.Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty(20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this�day of N y� under the:pains and penalties of perjury. Ann Quirk,Town Clerk h d� { tt;�� • M 0 `stltqro � �� U3 f.�D Fz�i"tl {�i,� �i';�5 S.1t;.'.ii 4�IV.71> ":4 5. i ' 3 1 12 REGULATORY AGREEMENT AND DECLARATION OF RESTRICTIVE COVENANTS THIS REGULATORY AGREEMENT:and DECLARATION OF RESTRICTIVE COVENANTS,is made: this-a-5- -7- day of OG�L �P ,20 1 ,by and between Kate E. Couct of 225 Osterville West Barnstable Rd,Osterville,MA and its successors and assigns:(hereinafter the"Owner"),and the TOWN OF BARNSTABLE(the"Municipality"),a:political subdivision of the Commonwealth,; WHEREAS the-Owner:has been granted.a Comprehensive Permit under.Massachusetts General Law Chapter 4.OB and:local regulations by the Zoning.Board of Appeals to.permit.the creation of an accessory apartment in an owner occupied dwelling which will be rented to a Low or Moderate Income Person/.Family(hereinafter "Designated tffordable Unit") and NOW THEREFORE,in mutual consideration of the agreements and covenants contained Herein,and other good and valuable consideration,the.receipt acid sufficiency of which is;Hereby acknowledged, the patties_agree as follows: I. PROJECT SCOPE AND DESIGN: A. The terms of this Agreement and Covenant regulate the property located at 225 Osteiville West Barnstable Road,Osterville,:MA,as further described in a deed recorded herewith as Barnstable County Registry of Deeds Book 28622:Page 308. B. The Project located at:225 Osterville West Barnstable Road;Osterville,MA will consist of one accessory apartment unit which will be rented to an eligible low or moderate income individual or family(the j "Designated Affordable Unit"or.the"Unlit"). C. The Owner agrees:to construct the Project in accordance with the terms of comprehensive permit Appeal No. 2017-062 and any plans submitted therewith and all applicablc.statc,federal and municipal laws and regulations. Said permit is recorded herewith as Barnstable County. Registry of Deeds.Book&17 Page 7 Y D. The Owner agrees to occupy the principal.dwelling unit located on the property as their principal residence in accordance with.the terms of the comprehensive II. THE OWNER'S COVENANTS AND RESPONSIBILITIES: A.. THE.O`'VNER HEREBYREPRESENI'S,COVENANTS AND WARRANTS AS FOLLOW: l 1 In receiving the.comprehensive permit to create the Designated Affordable unit,the Owner agreed that the Designated Affordable Unit shall be set aside in perpetuity for the public purpose of providing safe and decent housing to persons earning at or.belo v 80%of the area median income:of Barnstable Metropolitan t Statistical Area(MSA).and that the Designated Affordable Unit shall be deenned to be impressed with a public trust. 2. The Designated Affordable Unit;shall:be rented in perpetuity to a household with a maximum income Of 80%q of:the Area Median Income (AMI)of Barnstable MSA.and that rent(including utilities) shall not exceed an.amount that is affordable to a household whose income is 80%of the median income of Barnstable MSA. In the event that utilities are:separately metered,a utility allowance.estabhshed by the Barnstable.Flousing Authority. shall be deducted from the.rent level. 1 i l i l 3. The Designated.Affordable-Unit will be retained'as;a permanent,year round rental dwelling unit with at least a one-year lease. 4. The Owner has the full.,legal right,.power,and authority to execute and deliver this Agreement. 5. The execution and performance of this Agreement by the Owner will not violate or,as applicable,has not violated any provision of law,rule or regulation,or.any order of any court or other agency.or.governmental body,and will not violate or,as applicable,has not violated any provision of any indenture,agreement,mortgage; mortgage note,or other instrument to which the Owner,is a party or by which it or the Owner is bound,will.noi: result in the creation or imposition of any prohibited encumbrance of any nature. 6. The Owner,at the time of execution and delivery of this Agreement,has good,clear marketable'title to the prenvses. 7. There is no action;suit or proceeding.at law or in equity or.by or before any governmental instrumentality or other agency now pending,or,to.the.knowledge of the Owner, threatened against or affecting it,or any of its properties or.rights,which,if adversely detcrir fined,would materially impair its light to carry oil business substantially as now conducted,;(and as now contemplated by this Agreement) or would materially adversely affect:its financial condition. B. COMPLIANCE The Owner hereby agrees that any and all requirements of the laws of the Commonwealth of .Massachusetts to be satisfied in order for the provisions of this.Agreement to constitute restrictions and covenants running with the land shall be deemed to be satisfied in frill:and that any requirements of privileges of estate are also deemed to be satisfied in full. i C. LIMITATION ON PROFITS 1. The Owner agrees to limit his/tier profit by renting the Designated Affordable-Unit-in perpetuity to.a household with.a;maximum income of 80%or,less of theArea Me&.n.Incorne(AMI)of Barnstable Metropolitan Statistical Area(1W5A) and that rent(including utilities)shall not exceed an amount thaHs affordable to a household.whose.income is 80%of the median income of Barnstable MSA. In.the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. 2. The Owner shall annually deliver to the Municipality and to the Monitoring Agent,as designated by the Town Manager,proof that the Designated Affordable Unit is rented;the tenant's income verification,a copy of the lease agreement.andthe rent'charged for the unit or units. Such information shall also be forwarded to the Monitoring Agent within 30 days of the occupation.of the dwelling,unit or units by anew tenant.. The Owner shall notify the Monitoring Agent,as'designated.by'the Town Manager,within thirty(30) days of,the date that tenant has:vacated the Designated Affordable Unit. III. MUNICIPALITY COVENANTS AND RESPONSIBII..I'IJES 1. The MUNICIPALITY,through the monitoring agent designated by the Town Manager agrees to perform the duties of verifying that the Designated Affordable Unit is being rented in perpetuity to a household with a maximum income of 80%or less of the Area Median Income(AMI)of Barnstable MSA and that rent (including utilities) shall novcxceed an amount.that is affordable to a.household whose income is:80%o of the median income of Barnstable MSA. In'the cvent.that utilities are separately metered,a utility allowance established by'the'Barnstable'Housing Authority shall be deducted from the rent,. 2 IV. RECORDING OF AGREEMENT: Upon execution,the OWNER shall.immediatelycause this Agreement and any amendments hereto to be recorded with the Registry of Deeds.for Barnstable County or;if the Project consists in whole or iii part of registered land, file this Agreement and any amendments hereto with the Registry District of the Barnstable Land Court(collectively hereinafter the."Registry of Deeds"),and the Owner shall pay all fees and charges incurred in connection therewith. Upon recording or filling,as.applicable,the.Owner,shall immediately transmit to the Municipality evidence of such recording or filingincluding the date and uistrument,book and page or ] registration number of the:Agccment. II V: GOVERNING OF AGREEIVMNT This Agreement shall.be governed by the laws of the Commonwealth of Massachusetts. Any amendments to-this Agreement must be in writing and executed by all of the.parties hereto. The invalidity of 1 any clause,part or provision of this.Agreement shall not affect the validity of the remaining portions hereof. VL NOTICE: All notices to be given pursuant to:this Agreement shall be.in writing'and shall be deemed.given when delivered by hand or when mailed by certified or registered mail,postage prepaid,return receipt requested,to the parties hereto at the addresses set forth below,or to such other place as a party may:from time to nine designate by written notice: VIL HOLD HARMLESS:, The Owner hereby agrees to indemnify and hold harmless the'Munrcipality and/or its delegate.from any and all actions.or inactions by the Owner,its agents,.servants or employees-,vhich result in claims made against Municipalityand/'or its delegate,including but not hinted to awards,judgments,out-of-pocket expense's and attorney's fees necessitated by such actions.. VIII. ENTIRE UNDERSTANDING A. This Agreement shall constitute the entire understanding between the parties and any amendments or changes hereto must be in writing,.executed by the parties,and appended to this document. B. This Agreement and all of.the covenants,agreements and restrictions contained herein shall be deemed to be for the public purpose of providing safe affordable.housing and shall be deemed to be, and by these presents are,granted by the Owner to run in perpetuity in faNtor of and be held by the Municipality as any other permanent restriction held by:a,governmental body as that term is used in MGL Ch,184,Section 26 which shall run with the land described.in a deed recorded.herewith as Bathstable;County Registry of Deeds Book 28622 Page.308.and shall be binding upon the,Owner and all successors in title. This Agreement is:made for.the benefit of the:Municipality and the.Municipality shall be. deemed to be the Bolder of the.restriction created by this Agreement. The Municipality-has determined that the acquiring of such.a restriction is in the,public interest. The Municipality shall not be subject to the defense of lack of.privity of estate. The covenants and restrictions contained in this 1greemcrnt shall be deemed to affect the title to the property described in a deed recorded, herewith-as Barnstable:County Registry of Deeds Book 28622 Page 308: IX. TEMA OF AGREEMENT The teen of this Agreement.shall be perpetual;provided,however,that the Owner,of a Designated 3 i Affordable Unit or Units may voluntarily cancel the granted Comprehensive Permit and the terms acid restrictions imposed herein. Such.cancellation shall only take effect after: 1)expiration of the lease terms entered into between the Owner and Tenant occupying said unit and 2)notification by the Owner o:fsaid dwelling to the Coning Board of Appeals of his/her desire to cancel the:Comprehensive permit upon a date certain and the recording of said notice-at the Barnstable County Registry of Deeds or Barnstable County Registry`of.the Land Court as the case nay be, thus rendering said Comprehensive Pertnit void. Upon the cancellation of the comprehensive permit,the property which is.the subject matter of this restrictive covenant shall revert to the..use permitted under zoning and the restrictive.covenant shall be rendered void. X. SUCCESSORS AND ASSIGNS: A. The Parties to this Agreement intend,declare,and covenant on behalf of themselves and any successors arid assigns their rights and duties as defined in this Regulatory Agreement and theattached.comprehensive perttiit. B. The Owner intends,declares,and covenants on behalf of itself andits successors and assigns,,(i) that this Agieenient and the covenants,agreements and restrictions contained herein shall be and are covenants running with the.land,encumbering the Project for the term of this Agreement,and are binding upon the Owner's successors in title,(ii) are not.merely personal covetianis.lof,the:Qwner,.and shall bind the Owner,'its successors and,assigns'and inure to the benefit of the Municipality and its successors and assigns for the term of the Agreement. X1. DEFAULT: If any default,violation.or breach by the Owier,oF,this tlgreement is not cured to the satisfaction of the Monitoring Agentwithin thirty (30) days after notice to the Owner thereof, then the Monitoring.Agent may send notification to the Municipality'that the Owner is in violation of the terms and conditions hereof. The Municipality may exercise:any remedy available to it. The Owner will pay all costs and expenses,including legal fees,incurred by the Monitoring.Agent in enforcing this Agreement acid the Owner hereby agrees that the Municipality and the Monitoring Agent.will have a lien on the Project to secure;payment of such costs and expenses: The Monitoring Agent may perfect stich a lien on g the Project by recording certificate setting forth the amount of the costs and expense dine and owing in the Registry of Deeds or the Registry of the District Land C:ourt'for Barnstable County,. A purchaser of the Project or any portion thereof will be liable for the payment of any unpaid costs and expenses that vvere'the subject of a,perfected lien prior to the purchaser's acquisition of the Project or portion thereof. XII. MORTGAGEE CONSENT: he Owner represents and warrants that'it has obtained the consent of.all existing mortgagees:of the Project to ;the execution and recording of this Agreement.and to the terms acid conditions,hereof and that all such mortgagees have executed consent to thus Agreement. IN WITNESS WHEREOF,we hereunto set ou,r hands and seals this , day of OWNER BY:. Sign is Printed Name: { ,U 4 A l COMMONWEALTH OF 1AASSACHUSE`ITS County of Barnstable,ss: On this 25 day of October , 2017, before me,the undersigned notary public, personally appeared Kate E. Couet the Owner(s),proved to me. through satisfactory evidence of 4dentification,which were Personal Knowledge „to be the person(s) whose name(s)is signed on the.preceding or attached document and acknowledged to be that. he/she signed it voluntarily for the stated purposes'.. ""t;ti„uunnto��r l Mgg''r, Notary P - Lxwr�� A� � 3 Printed: cL C �v► i es: AV Z Z07D_ -s NbWy Public OF WA06RUM �, G •� My Cdr�H us 2� ®s ��,.� �i,�rr! o 0 �A HtrrnnaFj° t ,::' 1.1�4fi z� I TOWN OF BARNSTABLE. BY: 1 i SUN fANAGER 3 COMMONWEALTH OF MASSACHUSHITS County of-Barristable,,ss; On this. J3 day of/1�aV(-/-r- 20r=I before me;the undersigned notary public,personally appeared Z'At ,the Town Manager.for the Town of'Barnstable,proved to me through satisfactory evidence of identification,which were r�r >«:yI4 I ,.� to be the person whose name is signed on the preceding or attached document and acknowledged� to be that he/she signed it voluntarily for the stated 1 purposes-. Notary Public r/ Printed: 'PC w.xu He. My:Commission Expires: z,r� 7,2 42.E t i It JOYCE A. PERSUiTTE ufNotary Public Public OF ASSA HUSEfTS My Commission Expires January 27, 2023. 5 BA NSTA LE REGISTRY OF DEEDS 1 )(11111 K Meade, Register l SMOKE DET TORS REVIEWED 2 (s B T L D G DEPT. ATE FIRE EP TMEN VDPkE BOTH z.GNATURES ARE REQUIRED FOR PERMI TING co LNING F i c i I _ o 6 = _ f I Y � g, a E�ciS�►�� � � �� ----1�.___.-._.._ .----------- �. 11' ion, IT � �� I i �� - - I � � i __ - b . � � . {-- -, U t -- --_ .__ _-- _' 6 - Ip �- �. .I I�___..____... �_ � _ J j._--___._-__ __ . O T -�--- 't, .O t - i� ll���'s' ' I o v i ci i i - Lolil e 1 6 � w r .1 1 1 e ; �� i i e �� j G �o� � <®� 2�� ��� �® 2�A � '�� �� Town of Barnstable RECEYIPT; BAW4erAft& KAM 200 Main Street, Hyannis MA 02601 508-862-4038 awe° Application for Building Permit Application No: TB-17-4253 Date Recieved: 12/7/2017 Job Location: 225 OST.-W.BARN. RD,OSTERVILLE Permit For: Building-Addition/Alteration-Residential Contractor's Name: BRUIN CORPORATION OF ATTLEBORO State Lic. No: 104439 Address: 479 Mount Hope Street, N. Attleboro, MA Applicant Phone: (508) 695-8222 02760 (Home)Owner's Name: COUET, KATE E Phone: (508)776-6301 (Home)Owner's Address: 225 OSTERVILLE-W BARNSTABLE RD, OSTERVILLE, MA 02655 Work Description: 8 hrs of air sealing,3 door weatherstrips, 492 sgft of attic space, install two roof vents z � O £V —n 70 Total Value Of Work To Be Performed: $2,336.00 ts� 0o a in Structure Size: 0.00 0.00 410 r— Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by tiling a waiver with th.-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: Brian Olsen 12/7/2017 (508)695-8222 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $2,336.00 Date Paid Amount Paid } Check#or CC# i Pay Type Total Permit Fee: $85.00 12/7/2017 $35.00 °X)M-XXXX-XXXX Credit Card 3637 i Total Permit Fee Paid: $85.00 .... P,_,. 12/7/2017 $50.00 XXXX-XXXX-XXXX-i Credit Card 3637 I ,r . .,. . r• ... n >.. .., a. .f s x,c. _.. .n .,+.**ie.... no. ,.,..x ,v.a.+.N «a .. ....._»k.3`3'.d- - < � � 4_ I -7 � y �� � _ � �� � _ � � � � . . - � � � � -� -....r ..... P ' _..�. ,. J - ,�. a, . _ , 2 J i (508)862-4025 d'w'o,�4 * n FAX(508)790-6230 a .: PAU L ROMA "'" m� BUILDING COMMISSIONER �Ecr'"An�' TOWN OF BARNSTABLE REGULATORY SERVICES BUILDING DIVISION TOWN OFFICE BUILDING 200 MAIN STREET,HYANNIS,MA 02601 email:paul.roma@town:barnstable.ma.us ,q IME 1 Town of Barnstable O� BAR`ISTABLE , Regulatory Services 7 MASS. s659. Building Division piFO MA'S� 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection V-f Location s /� K Permit Number Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: M r L "o-- I J�f S U t-A TC- 0 C G- A � G-� h Please call: 508-862-4038 for re-inspection. Inspected by Date — /� Page 1 of 1 Coyle, Brenda From: Barrows, Debi Sent: Wednesday, April 19, 2017 9:49 AM To: Coyle, Brenda Subject: FW: accessory apartment inspection From: Cadrin, Arden Sent: Wednesday, April 19, 2017 9:46 AM To: Roma, Paul Cc: Barrows, Debi; Jenkins, Elizabeth Subject: accessory apartment inspection Hi Paul, 1 understand you are scheduling a site inspection or Kate Couet at 22 Ost West Barn Y g p f 5 Road as part of the AAAP process. I just want you to know 1 am in communication with them regarding this application; she did not understand it would have been best for me to make the introduction. Also, for your information,you will see a kitchen in the apartment. The homeowner some how received a building permit in 2015 to create that space. This AAAP process hopefully will rectify this situation. Arden Arden R. Cadrin Housing Coordinator Gt�C3W7H MAld�►C��MEIbYT Town of Barnstable 367 Main Street Hyannis,MA.02601, arden..cad.rin.@town.barnstable.ma.us (508)862-4683 4/19/2017 r Town of Barnstable Regulatory Services anBNSTABM # ,Knss. Richard V. Scali,Director 'OtE1639. p Building Division Paul Roma,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 January 30, 2017 t Kate E. Couet 225 Ost. West Barnstable Road Osterville, MA 02630 . Dear Ms. Couet, Re:Illegal Apartment This letter is to inform you that you may currently be in violation of Barnstable Zoning Ordinance §240-13; any use other than a Single-Family home is prohibited. You must contact this office by Date to arrange to bring the above address into compliance or be subject to fines of$100.00 per violation,per day. Sincerely, Robin C. Anderson Zoning Enforcement Officer /blc TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . Map Parcel Application # l�J 7(3 Health Division Date Issued Conservation Division Application fee I Planning Dept. Permit Fee }' �Pl- C, Date Definitive Plan Approved by Planning Board t Historic - OKH _'Preservation/ Hyannis ® � A L Project Street Address �2-� ()0C(yN\k Wes ey&W-f . Village Owner Z C��e Address Telephone 1� 2-0 1 � R Permit Request c CW tar 001 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ��� 00o Construction Type p Lot Size 0 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ® Two Family ❑ Multi-Family (# units) Age of Existing Structure All Historic House: ❑Yes 41,No On Old King's Highway: ❑Yes �l 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: 1 existing _new _w Total Room Count (not including baths): existing new First Floor R000m Count: ,D Heat Type and Fuel: ❑ Gas ❑ Oil Electric ❑Other Central Air: ❑Yes a No Fireplaces: Existing New Existing wood%coal stove: 10 No � �- Detached garage:W existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new?'size_ r" Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 1 Name ` �� t�� Telephone Number L,UO P u G Address U J"\� �t��C �< y��� - License # C� �� -1 0 l W. t� � �A D7 G13 Home Improvement Contractor# Email W(��\"\ (�\`ACC nV6 - C0K\ Worker's Compensation # ALL CONSTRUCTION'DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO _s¢ SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. - ADDRESS VILLAGE OWNER DATE OF INSPECTION: ` FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL R PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT rk ASSOCIATION PLAN NO. 4 �r The Camrra �ea�ri c�jfitsdts �,e�r,�drtre�'�jfgu�l'r�sb�iat�ict� ts office af600 , r W rkecs' affipensa as Ius a Af&vit B de AnnUczaInfarmatianers Please P E,ety Nye AddF !3 0 A K UK)I -Z QW u o �3 Phasi _ wog- �loo r.�3 8 Are you an employer?.Checkthe appropriate bay L❑ I am a er npl 4 E1112M Type of Proptom= employees(fg11 audfor part-fiime).* have l brie sett-coaftwt ss p�ief�ar Hsted onIhe attached shm� I Remo ❑ I am a sole partner_- ® debug slip and hm no employees These snub--confractap bate g (�Dgmalifrort; Wodir6- formeiaaogcapaaty_ employePsaaclhave�orkers'` ■ 9: Bud atTziiti �Ta comp_inmmuce ccmap.,MSM 1 � ❑ � rec�ized] i.❑.We are a u pa;afion aacf 14.❑Elechicd repairs,or acicEh—o 3.❑ i am a homeowner doiMA wa& a�ce�s lsave�cisecl'� 1L[]Fiuml'm�rePai�az a�tigms msett:[N°warlas'gyp- of exemFfi°g get lQ.. 12❑Rcaaf repam M,§1(4k an$s�re bavezeo employam[Mo b.E1 Other coffip_msoran,e requited-1 'fir�s��t # 5Q'bM*eTvs ' dmY��ai�sg�c¢Tc ead ff�a�uam�c�misamst snhmi�tanem a� � fCa�trsctvaS�t�Tri�baa masa�aau�suaaa;nrma2 sit�a�gtbeaa�of,�e s�- .aeia srmEe�rhe��not�nse�ti�hss�. .�r3esi�-caLs�ee�pl��Y�'r�vsiaet�esr saa�'ca�.;A�F��c " I am an eatpiny sr Seat is prauidirtg workers' a peresa�ivn;vtsuraa�eor my e 2S,itlee iTH. arm oFi site rifornudro a. 3. . insmncecamparTl Poficy4crSelf-im]Uc�4- r)A)e-�/c�-7Dr5SPI-3-20r�A Firaar /-./- 20 Jobe Address C�p �ap: At ch a csrPF'afthetisorkers'ea peusat ea palkydechwationpage(shag theeP'o Yaumlaerand cxpiratiox,date).. Faihna;to see=caVerage as repued=der Sergi 25A a€MQ,c LFZ c as lead to the imposifi=o£crimiaal peuabi of a fine up to$L,5OU 00 aadtar one smpr some,as u e1I as peaalties:m a faaa of®SEQP W0R&0]?DERand a fine of Bp Id$25M 3.day a„�amst The ciolatur:.Be advised*at a copy of this statemed=ay,bs forwarded to tine Office of 7aveshans ofthe DI A€or ice coverage Urfa keraby carf ,rrtrdsr&epainsand p91 ' afFeduq is bars and eamct 0f�iciad rrss grc£y. Do net trt tlds aMa,$x'bc arnpp�Feted b 'cafp�artoirtt a,�ra'aL - CW�Toga: PerndffLcesse Ewrdng,Au&oritp(dreIeone): L 1 oard of$eaIth :l.; T Deyr t 3;`{ivrown Qsrl; A E ettriical I�, 6.Other spectu€ .I' bbiag InsPecEor Contact PaToa: 6 Town. of Barnstable F of Re to Services - r i NAM � IY E $► Richard V.S=4 D =tor RuUdi g MyWon . `romPetrp,B��Cam�amer ' 200 Mam St=i;Hy=i*MA 02601 �rwW fio�ea.�araa'EablamaU Office: 508-862-4038 508-790.6230 PropeAy Owner Must ' Complete and Sign This Section If Using ABuilder As.Qwner of the subject ProPuY her�by�os� n m act Qn mpbeha in an m2tb, m1aiiya to work=fimlreri bpt3iis bmlding pew aPPE=inn.for. (Address of job) ''Toolfences and alarms am the responsibmq of tie applicant Pools are not to be filled or .d before fence is installed and all final ' inspections_are perfomaed and accepted- Si accepted- sigaai=a Sigaabae of UVp-LEA- -Name Q � oars ' Town.of Bamstable Regala-tory Services - Billiard V.Sc A Director d - 13MIIHM9 DividQn t • TomPrM=T Em7dmgCammissancr 2D0 Mafia Stox.t, Hymaik MA QZ60I l 7P TV W t1SYII.�2]3rfaf,T�ma Office: 569-962-4039 Fa= 509-790-6230 TT C0F N=LRM=ErmnIW • •PirssePtimt JOB rnra•rr sis - affi,ber• . mcdcpa=4 . T CQBRF�]T MAJLU4GADDRESS- _ • �9` ZIP Coda Ibe current exemp'&oa for"homeowners"was in incI�a ownrs�ccunied dwaIImEs of sirs Iess and aIIa� homC;ownas tD.=gagm m fiunvida l for hirewho does notpossess a Iicrosq pivvidad thatthe owner ants as supctyisoL DXIDN ORHOMEUW ER P mmn(s)who owns a parcel of Land on which hd es she resid or it t ds in reside.,do which theta is,or is htmded to baa on, e or two- fmniily dwe i�attar.hcd or detached st mziz=accessory in such use and/or farm strnctnmr, A person who constucts mp m thm one brans m a two-yem-pedod shzU notbe co d&miiahameowarm Such =a wince ,sbaII sabm>tto the BmZdmg Official on a t= azccptable to the Bm7�Of aural,fatbdsha shall be res�ans�bIa for an such worker �derthe boz73mg Hermit (Sc ion 1Q9.LI) ' The nndeaaig=d`bomeovmce asses rmpmmffiZtC-y for c:=phm=wiSitbe Stain Bm7d n Coda and o$=apphcablc codes, bylaws,rales andr g-ukda= - The Bnd=nv ell-hommware-des timtbelsbe mid=tmds$ie Tow.dBmmsbhje Bm ldmg Depattmznt wATm=filsp=:Em procr aasMdrMqah==CLt8 and.thathdshewMcomplywifisaidprgc &a=andraprac =dF' • si�sazafH®eo�ens - • ApFrr4 ofBm7d"mgOfcial • Note_ Tbrao-family dwcUh3gs contammg 35,000 c:abk feet or larger wMbo rmla edto comply wish the St&-Bmldmg Cods gocdon 1:27.0 Cm;.Et�CanimL • �&MOWNEXIs EXENYMN Tb.e Code stairs that allay homeowner performing work fnr Mich a b pert is ruldred shall be emmpt from the provisions of this section(Secfion I09_U-Licensing of consffrurfion Supervisors);provided fiat if fie homeowner engages a persons)5or bare to do such,work,that such Homeowner shall a±as s¢pety ;=-r A ,n;,,Q the respoasibrTities of a supesrvsar Mang homeowners who nse�e�napfnn are t¢naw-drefcatfu�are ---zt C=e Appendiz. g nT�Bc u F= for I.icrnsiag Cansbr ac�n SapctVisors,Serbian Z.15) This lark of aWareaess ofirn results in semus problems;pardmL rlywhen fie home�awncr hires persons. Ia this case our Board cannot prO=a d.against the umHc:=se3 person as it would widL a licensed Supervisor. The homeowner acting as Supertrkar is ulf=tay responsible com'ma�fes requirt,as Part of the To emsu. t k2±ff=homeowner is SsIIp mare of his/fier respaasffim ,many Pmmdt appIucadnn,f:at the homeowner certffy tbzthe/she m de a tine respansMTffm of a Supervisor. On fur Las-tpage of tL s issue is a form m rea$y mtvd by seYetal towns- You may ca=t amend and adopt such a formleertHicaflon for um in gym'tamsamziig. - Revised D6U 13 ' Caa�aasiapan a =€L9Z0,b'W`H1f10W2idA"M ZA�Q8 3S3NVIIVW 09 a r +-€br NVNN389 2GiIVM TO-RA . �IVt/NtV3219'0 2i3 M lenpinlpui 9L0Z-1V11V; :uol;ejldx3 :adA1 £StiLZ I==J:u0.1eaasl6ab NO10VH1N001N3W3A021dWi 3WOH aoquIn23g ssaa►s g 2p u!vjjd jamnsao3 jol a3►wo q�ap�yrJypppme/' v �naarzcnuvtuoC]i. ��. ` Massachusetts Department of Public Safety Board of Building Regulations.and Standards License: CS-004389 Construction Supervisor ntz"' — WALTER C BRENNAN 80 MATTAKESE RD UNITE 2 W YARMOUTH MA 02673: I Expiration: Commissioner 01/21I2018 I i 6/2/2016 11 : 41 : 34 AM 8790 CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD/YYYY) 0 610 2/2 01 6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 04507-001 CRWCT Branch 4507-1 pX Minuteman Insurance Agency PNC.No.Ext: (781)229-1555 FAIL.No.: (781)273-6644 1 Burlington Woods Dr Ste 203 a�°s ss: Burlington,MA 01803 INSURE AFFORDIN9 COVERAGE NAIC# INSURERA: A.I.M.Mutual Insurance Company 33758 INSURED INSURER B Genesis HR Solutions Inc INSURERC: One Burlington Woods Drive I Suite 203 NSURERD: Burlington, MA 01803-0000 INSURERS: 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE I SR VND POLICY NUMBER P(IMPOLISN%Y (MPPAADIy1XYY) LIMBS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE SET Ea oNTEDence $ CLAIMS-MADE ❑OCCUR PREMMED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ OLICY RCO� OC AUTOMOBILE LIABILnY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMSMADE AGGREGATE $ DED I RETENTION $ $ WOR�EERS COMPgNSATION C gTATU- OTH- AND EhAPLOYERS LIABILITY T RY LIMITS X T AVyyPRppPRIETORIPARTNER/ CUTIVEYIN A OFFICERlMEMBER EXCLUDED? FN] NIA AWC-400-7015863-2016A 1/1/2016 1/1/2017 E.L.EACH ACCIDENT $ 1 000 000. 0 (Mandatory in NH) Y d S E.L.DISEASE-EA EMPLOYEE $ 1000000.00 DESC RY I ON OF OPERATIONS frelow E.L.DISEASE-POLICY LIMIT $ 000 00.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Ath-ch ACORD 101,Additional Remarks Schedule,if more space is required) Job:Couet Residence,255 Osterville-West Barnstable Road.Oasterville,MA.Projected Timefram-6 weeks,1,100 manhours.Coverage is restricted to employees leased to Brennick Building Systems,LLC.Client:Brennick Building Systems LLC CERTIFICATE HOLDER CANCELLATION Town Of Barnstable Attention:Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis,MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ®1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The.ACORD name and logo are registered marks of ACORD 8662 06/02/2016 10:43AM (GMT-05 :00) s — I '77— bitc i -I ICI_"j -T T 1-I-- I 'T I I 77. - t- 1� t� ItB JFm mod`I I — � ! - Lill , I I .I ► ! 11 I ! i I II i I - I a� t� %CUa okst _ V- H4 - _ ��TK a� 0 50 �INE TOWN OF BARNSTABLE 201500050 Building BARNSTABLE, Issue Date: 01/16/15 Permit MASS. prF6 39. A Applicant: MONROE,WILLIAM A&ANN E Permit Number: B 20150081 Proposed Use: SINGLE FAMILY HOME Expiration Date: 07/16/15 Location 225 OST.-W.BARN. RD Zoning District RC Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 121002 Permit Fee$ 102.00 Contractor PROPERTY OWNER Village OSTERVILLE App Fee$ 50.00 License Num OWNER Est Construction Cost$ 20,000 � Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND CONVERT COLD STORAGE TO HABITABLE SPACE INCLUDING A B TffV4UWRD MUST BE KEPT POSTED UNTIL FINAL &KITCHEN.AMNESTY TO BE APPROVED IN MAIN HOSE REMV B DRMSWCTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: MONROE,WILLIAM A&ANN E BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 225 W BARNSTABLE RD INSPECTION HAS BEEN MADE. OSTERVILLE,MA 02655 Application Entered by: PR Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY.STREET,ALLEY OR SIDEWALK OR ANY PAR T.THEREOF,EITHER TEMPORARILY OR PERMANENTLY; ENCROACHMENTS ON+PUBLIC PROPERTY,NO „. SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST.BE APPROVED BY THE JURISDICTION: STREET:OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF.THISTERMIT.DDES NOT RELEASE THE APPLICANTFROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION: . RESTRICTIONS. l MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1 " .1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). s p, BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health ' ; I II.4�+ y►l 9�� I t�?�5� v �{; a (2; 00 Cn I-- 1I ; -- I , - I ! I rIiIIII !i.� 1iiIIIjI jjl ; I !� I ; -. I __ I 1 I L , I I I i � .I � f i j� ► i j , I � , I I I I i I I 9� � �I I(���`�---- ' I i I II II ! iiiLll ' iil i I i I I I j :i � III II , � I IIi i I I I Ijj i _I ' a� co : CUB PITC VV\ t.--r H L, �� - i i (-,/ A � ALL vt ( iL SSA TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel v Application # 6 �� Health Division Date Issued C [c� Conservation Division Application Fee �0 Planning Dept. Permit Fee �® Date Definitive Plan Approved by Planning Board PPI Historic - OKH _ Preservation/ Hyannis Project Street Address 0 ST EX Vt<<a wAr:;r 8U gST-41&L " Village; bS aVi I != Owner B"itzmrJ Address P.12 l rj � /1 Telephoner —��►� �s / �" Permit,Request Co N ytA. ( Co i ck 'S Ta xA crtF- 'rz f'�ac 61 Trc 16 Spt a e- rj Cl ,.ra 4047WAd wt ICg gAl !� AAlAIC6 tD b e ✓ ! N d wto✓t _ owi /��wta✓c✓f Wr a I a 2 trw tK vnv► � v w4nGa kJ� Square feet: 1st floor: existing proposed 2nd floor*xi !proposed Total new Zoning District Flood Plain Groundwater Overlay CProject Valuation4-- d-P, �00- 00Construction 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: — Y existing _new oN PP..a��wry 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,,:C}existing .'❑ no-)$ size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Others Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ . � Commercial ❑Yes ❑ No If yes, site plan review # - Current Use Proposed Usey, ' 7a'., tom+ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Names C � �.5 Telephone Number i Address License # Home Improvement Contractor# Email �v✓totiGSClc�2Iz- J�a��O-Cdv►� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE f /y FOR OFFICIAL USE ONLY APPLICATION# x ~DATL ISSUED r_ MAP./PARCEL NO. ' ADDRESS VILLAGE OWNER t Y. a 4 DATE OF INSPECTION: FOUNDATION R FRAME INSULATION - FIREPLACE w - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , l y' GAS: ROUGH FINAL FINAL BUILDING ' 1 , DATE CLOSED OUT ASSOCIATION PLAN NO. t Ctr =wmdj*o -Min5ac h ' r 6a##WmhhWo'x xReet wec*tu.r��.grr�"ux . WGrkers' Canpe=GmIu&arauce davit Borders/ ttaact-Grs/Mech-ician&Oumbers Pteas-&P Tr zbFy v ire}iFn an eurploy er?Check the apprupriafe ba= T a ec-t L I a 4 ❑ I=a ger�Rl contractor and I Type of Pam. � � = employer w �_ �ItNewfm employees(full mdforgait-tune)* have hiredfhe moors ❑ I arm a sole progaetar orpartner- Irste-d on the attached shy y- ❑Rexwdtl_ing ship and have no employees These mb-contractou have g- ❑Demolition forme is ar: emplayees and have workers' '�`'v°� Y��- I 9_ ��uilnmg addition L`7'6w• a7 ffi� camp-Ms rranc:6 comp-ksyrarcr� . 1 5_ ❑ We area corporatianand ifs IO.O Electrical repais m addi ions a himnwwner doing all work others ha.:ve emccised their 11..0 Plumbing repairs or addition myself [NO Wiorb 8'comp_ right of em=pEaa per MGL 12-0 Pmof repairs- ;sxcr I ncereTl;md_I.F a 15Z§I(4),and we lava ac> employee .[No rxs work ' -❑Qihef 's comp_ms=ce requ rt&j � y�g�nmtfiat cbedksbactlbmctalsnffiovtt�sec(ionbcIvAchi*�RFhetrwo3�es'comne�ariouperTi�}Sgf ��w�,,,,es R�di�bn:-Y�a`xis s�tl�:u;,-n r<+T,•���rllzing.lI:e^�—+�t�hTMe a>�a�coutracturs ems#sabffiit a aec�s�dsrit m33r,�suclL �i `CE..�LS ThSrt rh kt�Zs tl�F�mssI StTSC1xP{l ffiSr3riiti rrnui 5�g�terra-i�a�jbeIxSIDE6fI�e��'�T�13 a01i 5S8tE Alxet'�S❑c'rintfiY35e pmTfpSFx3P.2 . `rnpluJ.es. Ifthe svb{GIftmC=hx;e employees,$xl-Y—st 171U41L1E t TY�b-�'tOIIxp.paIi�IIIIII1bPL �trm ffrt arrigInyes rhrr#isgrrx�tn lu7iag tr�or&e-rs'cotrgxt�rrzrdiurt insztFrcgce far rtz��etscgFpyecs. Be�ots is fftep�&c}curd}ob srie u�f¢rxtmtzare Inter-ance GompanyName: RNficy 9 or Self-ins Lic k E-pfmfion-Date: zfl-9-ifa.�ada 5- as Td" I If. w;49ZN W-d 067U- Y 14. M CGt 6 -g ' Attach a Copy(If the Tmrkers'conrpensation po&E-decoration pzge(showing the policy number and erpuation ste3: Failure to secure coverage as mToired under Secfioa SA ofMGL c. 152 can lead to the iuipo5it1I3Il of criminal penalties of a Ran up to as v ell as civil perratlies in the furor,of a STOP WORK BORDER-and a fine of up to V-50-00 a day against the violatac. Be advised fiat a c4Ty of tbig ctaternei t maybe farwarded to the Office of Inrestigatiom of the DIk far i*,saranre wwiage vedfica#ion- I too hereby _ s s er of atfhe uxfvrzrtafiexa grm�d etbax�e` - d crxrr¢ct EcizI use anly, Do-not wri&in fibs arer4 to bg carurgieted by city or firm a icia£ City ar Town: /I;cease 9 lssnia AafhGrity(tack aney- . . LRoadofHealth2.BuckingDepartmentICif)dFaRaO=k 4.Electrical hmpectorS..Plrrmbmgh,spmtor S.CWher Ceaf act P=na: Fho-ne . - 6 Massachmsdts General Laws chapt-r 152 ri-,cp s RI,employers to provide workers'compensation far their emplayem ,a to fats sL tie,an.errrp£oyee Is defined as"__every person intge scram m of another no any cantrac� rf ofhhe, ' express or in>pHNe oral or written.." . An anprzye-is&Eaed as`-du iadivi±mL parfneashrp,association,corporation ar other legal enfrty, or any two or more of the foreggmg engaged in a joi ut enterprise,and in dmgthe legal representatives of a deceased employer,-or the receiver or trustee of an individng partnaxhip,association or other legal entity, employing employees. However the owner of a d:welliag'house having not mare than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to da maiaten u%cons rncdon.or repair work on such dwelling house or an the grounds or building appu tenint'thereto shall not because of such employment be deemed to bean employer." MCTL chapter 152,�§25C(6)also suits thk aeveiy State or Iocal kensiorg agency shaII withhold the rss-uance or renewal of a license or permit to operate a business or to comtract buildings is the common r-alth for arsy applicant who has not produced acceptable evidence,of compliance with the hisnrance.coverage required."' . Additionally, MGL chapter 152, §25C(7)states`Ne ffim the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance vaith the i`e�ce requirements of this chapter have been presented to the contra.etmg authority.' A-pplicants Please fill out the workers' compensation affidavit completely,by checkiag the boxes that apply to your siturtiDn and,if necessary,supply sub--contractDr(s)name(s), address(es)and phone nrnnber(s)along with their cer Scale:(s) of insurance. Limittd Liability Companies(LLC)or LiE i Liability Partnerships(I U)withno 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 requirert Be,advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of in urance Coverage. Also be snlre to sign and date the affidavit The affidavit should be mt need 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 regardiag th e law or If you are required to obtain a workers, compensation policy,please ca the Depardent at the mmnber listed below. Self-i3:=ed companies should enter their self-m mince license number on the appropriate line. City or Town.Officials . Please be sure flut the affidavit is complete and prirrt..ed 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 f E in the pemitllieense number which will be used as a reference number. In addition- an applicant that must submit multiple ptr it/limnse applications m any given year,need only submit one affidavit indicating current M policy infomiaiion(if necessary) and undef."Job Site Addiess'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 an file for future permits or licenses A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i_e. a dog license or permit to bum leaves etc.)said person is NOT re;c d 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 ris a caII. ` The Department's address,telephone and faxnumbel. k. a1 Com-mastw(_I3Ith of Massachns�,tts` D--pazimc�at c&Ia&mtaaI AQaldmt ofcvtFan 600 wasbiI9 an t MA G21 I 1 TeL.f4 617` 7-45a�0 at 4-€6 4r 1-977-hLA.-S E . . FAX A 617-727-774.c� Revised 4-24-07 Town of Barnstable Regulatory Services ' 'HE ri Richard V_Scali,Director ` Building Division rt E RA2NgFA rt � MASS.r � Tom ferry,Building Commissioner 200 Main Street; Hyannis,MA 02601 www.town.barnstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION y Please Print DATE: sJ� JOB LOCATION OS�GK��/I�� —Ax.4e,G a A*j ✓,1 /4' number �j street a village -• name home phone# work phone —•—_`CURRENT MAIL I1dG ADD_RESS'r cityltown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The dersigned"homeo er"certifies that e/she understands the Town of Barnstable Building Department minimum inspection p ure eq ' en and that he/she 'll comply with said procedures and requirements. Sign ,o.__omen= 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 persou(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 2.1S) 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 Iicensed 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 Iast 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. QAV,TFILES\FORMS\building permit forms\EXPRBSS.doc Revised 0 613 13 �t►+E T Town of Barnstable Regulatory Services q'nxr'TAsI'E' Richard V.Scali,Director �'prEo;9..�a Building Division _- --- ------- Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must `Complete and Sign This-Section If,Using ABuild:er ,, as Owner of the subject property hereby authorize o act on my behalf, in all matters relative to work authorized by this building> t application for: (Address of Jo Pool fences and alarms are the re onsibItyof the'applic ' . Pools y are not to be filled or utilized before fence is installed and all al inspections are performed and accepted. Signature of Owner Signature o Applicant Print Name Print Name Date Q:FORMS:O WNERP ERMISSI0NPOOLS From the Office of. Cape Cod Title and Escrow,P.C. 3261 Main Street Suite 6 Barnstable,MA 02630 PURCHASE AND SALE AGREEMENT This 1"day of December,2014 1. PARTIES AND William A.Monroe and Ann E.Monroe of 1379 Bumps River Road,Centerville,MA 02632 MAILING ADDRESS hereinafter called the SELLER,agrees to SELL and Burton B. Morris,Jr. of 605 Main Street, Hyannis, MA 02601 hereinafter called the BUYER or PURCHASER, agrees to BUY, upon the terms hereinafter set forth, the following described premises: 2. DESCRIPTION The land with buildings and improvements thereon, located at 225 Osterville-West Barnstable Road, Osterville, Barnstable, Massachusetts, and further described deed recorded with the Barnstable County Registry of Deeds in Book 9693,Page 14. 3. BUILDINGS, Included in the sale as a part of said premises are the buildings,structures,and improvements now STRUCTURES, thereon,and the fixtures used in connection therewith including, if any,all wall-to-wall carpeting, IMPROVEMENTS drapery rods, automatic garage door openers, Venetian blinds, window shades, screens, screen AND FIXTURES doors, storm windows and doors, awnings, shutters, furnaces, heaters, heating equipment, refrigerator,stoves, ranges,oil and gas burners and fixtures appurtenant thereto, hot water heaters, plumbing and bathroom fixtures, garbage disposers, electric and other lighting fixtures, mantels, and all appliances and fixtures seen by Buyer when Offer was made. 4. TITLE DEED Said premises are to be conveyed by a good and sufficient quitclaim deed,running to the BUYER, or to the nominee designated by the BUYER by written notice to the SELLER at least seven (7) days before the deed is to be delivered as herein provided,and said deed shall convey a good and clear record and marketable title thereto, free from encumbrances,except (a) Provisions of existing building and zoning laws: (b) Such taxes for the then current years as are not due and payable on the date of the delivery of such deed; (c) Any liens for municipal betterments assessed after the date of this agreement; (d) Easements, restrictions and reservations of record, if any, so long as the same do not interfere with the current use of said premises as a three bedroom single family home; 5. PLANS If said deed refers to a plan necessary to be recorded therewith the SELLER shall deliver such plan with the deed in form adequate for recording or registration. 6. REGISTERED TITLE In addition to the foregoing, if the title to said premises is registered, said deed shall be in form sufficient to entitle the BUYER to a Certificate of Title of said premises, and the SELLER shall deliver with said deed all instruments, if any, necessary to enable the BUYER to obtain such Certificate of Title. 7. PURCHASE PRICE The agreed purchase price of Two Hundred Sixty-Five Thousand Dollars($265,000.00),of which: $ 1,000.00 Have been paid at the time of the Offer to Purchase and $ 5,000.00 To be paid at signing of this Agreement $ $259,000.00 Are to be paid at the delivery of the deed by certified, cashier's,treasurer's or bank check(s)or MA Attorney's IOLTA check $ $265,000.00 TOTAL 8. TIME FOR Such deed is to be delivered at 1:00 P.M. on the 16'h day of January, 2015, at the Barnstable PERFORMANCE; County Registry of Deeds. It is agreed that time is of the essence of this agreement. DELIVERY OF DEED 9. POSSESSION AND Full possession of said premises free of all tenants and occupants,except as herein provided, is to CONDITION OF be delivered at the time of the delivery of the deed, said premises to be then (a) in the same PREMISES condition as they now are, reasonable use and wear thereof excepted, and (b) not in violation of said building and zoning laws, and in compliance with the provisions of any instrument referred to in clause 4 hereof. The BUYER shall be entitled personally to enter said premises prior to delivery of the deed in order to determine whether the condition thereof complies with the terms of this clause. 10. EXTENSION TO If the SELLER shall be unable to give title or to make conveyance,or to deliver possession of the PERFECT TITLE OR premises, all as herein stipulated,or if at the time of the delivery of the deed the premises do not MAKE PREMISES conform with the provisions hereof,then the SELLER shall use reasonable efforts to remove any CONFORM defects in title, or to deliver possession as provided herein, or to make the said premises conform to the provisions hereof, as the case may be, in which event the time for performance hereof shall be extended for a period of thirty(30) days. Reasonable efforts shall not require the SELLER to incur costs in excess of$1,000.00 to make the premises conform as herein stipulated exclusive of voluntary liens. 11. FAILURE TO If at the expiration of the extended time the SELLER shall have failed so to remove any defects in PERFECT TITLE OR title,deliver possession,or make the premises conform,as the case may be,all as herein agreed,or MAKE PREMISES if at any time during the period of this agreement or any extension thereof, the holder of a CONFORM mortgage on said premises shall refuse to permit the insurance proceeds,if any,to be used for such purposes, then any payments made under this agreement shall be forthwith refunded and all other obligations of the parties hereto shall cease and this agreement shall be void without recourse to the parties hereto. 12. BUYER'S ELECTION The BUYER shall have the elections, at either the original or any extended time for performance, TO ACCEPT TITLE to accept such title as the SELLER can deliver to the said premises in their then condition and to pay therefore the purchase price without deduction, in which case the SELLER shall convey such title,except that in the event of such conveyance in accord with the provisions of this clause, if the said premise shall have been damaged by fire or casualty insured against, the SELLER shall, unless the SELLER has previously restored the premises to their former condition,either (a) pay over or assign to the BUYER, on delivery of the deed, all amounts recovered or recoverable on account of such insurance, less any amounts reasonably expended by the SELLER for any partial restorations,or (b) if a holder of a mortgage on said premises shall not permit the insurance proceeds or a part thereof to be used to restore the said premises to their former condition or to be so paid over or assigned, give to the BUYER a credit against the purchase price, on delivery of the deed,equal to said amounts so received or recoverable and retained by the holder of the said mortgage less any amounts reasonably expended by the SELLER for any partial restoration. 13. ACCEPTANCE OF The acceptance and recording of a deed by the BUYER or his nominee as the case may be, shall DEED be deemed to be a full performance and discharge of every agreement and obligation herein contained or expressed,except such as are, by the terms hereof,to be performed after the delivery of said deed. 14. USE OF MONEY TO To enable the SELLER to make conveyance as herein provided, the SELLER may,at the time of CLEAR TITLE delivery of the deed,use the purchase money or any portion thereof to clear the title of any or all encumbrances or interests, provided that all instruments so procured are recorded simultaneously with the delivery of said deed,or as is customary in local real estate practice. 15. INSURANCE Until the delivery of the deed,the SELLER shall maintain insurance on said premises as follows: Type of Insurance Amount of Coverage (a)Fire and Extended Coverage $ as presently insured 16. ADJUSTMENTS Water use charges and taxes for the then current fiscal year, shall be apportioned and fuel value shall be adjusted,as of the day of performance of this agreement and the net amount thereof shall be added to or deducted from,as the case may be,the purchase price payable by the BUYER at the time of delivery of the deed. 17. ADJUSTMENT OF if the amount of said taxes is not known at the time of the delivery of the deed, they shall be UNASSESSED AND apportioned on the basis of the taxes assessed for the preceding fiscal year,with a reapportionment ABATED TAXES as soon as the new tax rate and valuation can be ascertained; and, if the taxes which are to be apportioned shall thereafter be reduced by abatement, the amount of such abatement, less the r reasonable cost of obtaining the same, shall be apportioned between the parties, provided that neither party shall be obligated to institute or prosecute proceeding for an abatement unless herein otherwise agreed. 18. BROKER'S FEE A Broker's fee for professional services of$15,900.00(6.00%of purchase price) is due from the SELLER to William Raveis, who shall then pay a fee of$7,950.00 to RE/MAX Spectrum. Said fees shall be due and payable only in the event a deed is recorded from the SELLER to the BUYER,consistent with the terms of this Agreement,and not otherwise. 19. BROKER'S) The Broker(s) named herein warrant(s) that the Broker(s) is (are) duly license as such by the WARRANTY Commonwealth of Massachusetts. 20. DEPOSIT All deposits made hereunder shall be held in escrow by William Raveis Real Estate as escrow agent subject to the terms of this agreement and shall be duly accounted for at the time for performance of this agreement. In the event of any disagreement between the parties, the escrow agent shall retain all deposits made under this agreement pending instructions mutually given in writing by the SELLER or BUYER,or a court of competent jurisdiction. 21. BUYER'S DEFAULT; if the BUYER shall fail to fulfill the BUYER'S agreements herein,all deposits made hereunder by DAMAGES the BUYER may be retained by the SELLER as liquidated damages and this shall be SELLER'S sole and exclusive remedy at law and equity for any breach of this Agreement by BUYER. The Parties acknowledge and agree that Seller has no adequate remedy in the event of BUYER'S default under this Agreement because it is impossible to compute exactly the damages which would accrue to SELLER in such event. Therefore,the Parties-have taken these facts into account in setting the amount of the deposit hereunder and hereby agree that: (i) the deposit hereunder is the best estimate of such damages which would accrue to SELLER in the event of BUYER's default hereunder,(ii)said deposit represents damages and not a penalty against BUYER,and(iii) the Parties have had the benefit of counsel with regard to the provisions of this paragraph. 22. RELEASE BY The SELLER's spouse hereby agrees to join in said deed and to release and convey all statutory HUSBAND OR WIFE and other rights and interests in said premises. 23. BROKER AS PARTY The Broker(s)named herein join(s)in this agreement and become(s)a party hereto, insofar as any provisions of this agreement expressly apply to the Broker(s), and to any amendments or modifications of such provisions to which the Broker(s)agree(s)in writing. 24. LIABILITY OF If the SELLER or BUYER executes this agreement in a representative or fiduciary capacity,only TRUSTEE, the principal or the estate represented shall be bound, and neither the SELLER or BUYER so SHAREHOLDER executing, nor any shareholder or beneficiary of any trust, shall be personally liable for any BENEFICIARY obligation,express or implied,hereunder.. 25. WARRANTIES AND The Buyer acknowledges that the BUYER has not been influenced to enter into this transaction REPRESENTATIONS nor has he relied upon any warranties or representations not set forth or incorporated in this agreement or previously made in writing, except for the following additional warranties and representations, if any,made by either the SELLER or the Broker(s): NONE 26. MORTGAGE In order to help finance the acquisition of said premises, the BUYER shall apply for a CONTINGENCY conventional bank or other institutional mortgage loan of$257,050.00 at prevailing rates, terms CLAUSE i and conditions. if despite the BUYER's diligent efforts a commitment for such loan cannot be r obtained on or befor the BUYER may terminate this agreement by written notice �f @ to the SELLER and/or Broker(s),as agent(s) for the SELLER,prior to the expiration of such time, whereupon any payments made under this agreement shall be forthwith refunded and all other obligations of the parties hereto shall cease and this agreement shall be void without recourse to the parties hereto. In no event will the BUYER be deemed to have used diligent efforts to obtain such commitment unless the BUYER submits a complete mortgage application conforming to the foregoing provisions three days after the Buyer and Seller fully sign this Agreement.. 27. CONSTRUCTION OF This instrument,executed in multiple counterparts, is to be construed as a Massachusetts contract, AGREEMENT is to take effect as a sealed instrument,sets forth the entire contract between the parties, is binding upon and ensures to the benefit of the parties hereto and their respective heirs,devisees,executors, administrators, successors and assigns, and may be cancelled, modified or amended only by a written instrument executed by both the SELLER and the BUYER. If two or more persons are named herein as BUYER their obligations hereunder shall be joint and several. The captions and marginal notes are used only as a matter of convenience and are not to be considered a part of this agreement or to be used in determining the intent of the parties to it. 28. LEAD PAINT LAW The parties acknowledge that, under Massachusetts law, whenever a child or children under six years of age resides in any residential premises in which any paint, plaster or other accessible material contains dangerous levels of lead, the owner of said premises must remove or cover said paint„plaster or other materials so as to make it inaccessible to children under six years of age. 29. SMOKE DETECTORS The SELLER shall, at the time of the delivery of the deed, deliver a certificate from the fire and CARBON department of the city or town in which said premises are located stating that said premises have MONOXIDE been equipped with approved smoke detectors and carbon monoxide detectors in conformity with DETECTORS applicable law. 30. SEWAGE DISPOSAL This agreement is contingent upon the Seller providing the Buyer a copy of an inspection report, SYSTEM including a Certification Statement signed by an approved system inspector of the on-site CONTINGENCY subsurface disposal system in accordance with the requirements of Title V of Massachusetts Environmental Code and municipal board of health regulations, if applicable. If the Certification states that the on-site subsurface sewage disposal system does not pass as described in 310 CMR 15.303 as amended, or municipal certification, if applicable, is denied, the Buyer shall have the option to revoke this Agreement by providing written notice to the Seller at which time all deposits made by the Buyer to the Seller shall be refunded forthwith, and this agreement shall terminate without further recourse; unless within two (2) business days of receipt of said written notice from the Buyer by the Seller and/or Broker, the Seller agrees in writing with the Buyer to repair, upgrade or replace said subsurface sewage disposal system in a manner sufficient to obtain an issuing Title V certification and municipal certification prior to the date set for closing. 31. ADDITIONAL The initialed riders, if any,attached hereto,are incorporated herein by reference. PROVISIONS See Riders A and B attached hereto. FAXED,SCANNED AND/OR ELECTRONIC SIGNATURES ON THIS DOCUMENT SHALL HAVE THE SAME EFFECT AS DELIVERY OF A SIGNED ORIGINAL. THE PARTY FAXING OR EMAILING THIS DOCUMENT AGREES TO MAIL OR DELIVER THE ORIGINAL FORTHWITH. FOR RESIDENTIAL PROPERTY CONSTRUCTED PRIOR TO 1978,BUYER MUST ALSO HAVE SIGNED A LEAD PAINT "PROPERTY TRANSFER NOTIFICATION CERTIFICATION" NOTICE: This is a legal document that creates binding obligations. If not understood,consult an attorney. William A.Monroe Bu n B. [Glory ,J C �'t. Its-• ;- /�c..; ,,t.,�:.G , Ann E. Monroe SELLER RIDER A To Purchase and Sale Agreement 1. This rider shall be incorporated by reference as part of the Purchase and Sale Agreement. In the event that this Rider is in conflict with any provision of the Agreement,this Rider shall control and prevail. 2. Notices. All notices required to be given hereunder shall be in writing and deemed duly given when: hand delivered,or sent via recognized express/overnight carrier, or placed in the US Mail postage prepaid or by registered or certified mail, return receipt requested, postage and registration or certification charges prepaid with proof of receipt, or sent via facsimile with proof of delivery and transmission,or sent via e-mail with proof of delivery and transmission,addressed as follows: If to Seller: Stacey A.Curley,Esq. Cape Cod Title and Escrow, P.C. 3261 Main Street Suite 6 Barnstable, MA 02630 (508)744-7539-ph (508)744-7219-fax Stacey@capecodtitleandescrow.com And If to Buyer: Bryan Reardon, Esq. Dubin& Reardon 1645 Route 28 Centerville,MA 02632 (508)771-0330-ph (508)778-7624-fax breardon@dubinreardon.com Or to such other address or addresses as may from time to time be designated by either party by written notice to the other. Buyer and Seller hereby authorize their respective attorneys named above to execute on their behalf extensions, modifications, notices and other documents affecting this Agreement or in connection with the conveyance and financing of the Premises contemplated hereby. Facsimiles of signatures shall be deemed originals for purposes of the execution of this Agreement and any modification. 3. Buyer-Seller Broker Representation, The Buyer and Seller represent and warrant to each other that neither party has contacted any real estate broker, other than those BROKERS named in this Purchase and Sale Agreement("BROKERS"), in connection with this transaction and were not directed to each other as a result of any services or facilities of any real estate broker other than BROKERS. Buyer agrees to indemnify Seller against and hold Seller harmless from any claim, loss, damage, cost or liability for any brokerage commission or fee which may be asserted against Seller as a result of Buyer contacting any broker, other than BROKERS, in connection with this transaction. Likewise, Seller agrees to indemnify Buyer against and to hold Buyer harmless from any claim, loss,damage,cost or liability for any brokerage commission or fee which may be asserted against Buyer as a result of Seller contacting any broker, other than BROKERS, in connection with this transaction. The provisions of this paragraph shall survive delivery of the deed. 4. Seller shall not be liable or bound in any way for any verbal or written statements, representations,or information pertaining to the premises furnished by any real estate broker or agent or any agent or employee of Seller, or any other person. It is understood and agreed that all prior and contemporaneous representations, statements, understandings and agreements, oral or written, between the parties are merged in this Agreement, which alone fully and completely expresses their agreement, and that the same is entered into after full investigation, neither party relying on any statement or representation not embodied in this Agreement made by the other. 5. The acceptance and recording of the deed by Buyer on the Closing Date shall be deemed full performance and discharge or each and every agreement and obligation on the part of the Seller hereunder to be performed. Any and all representations and warranties of Seller contained in this Agreement shall not survive the Closing Date except for Paragraph Three (3) above relating to the warranty regarding the real estate broker(s)to whom a real estate brokerage commission is owed. 6. All offers, agreements, and any other understanding made prior to this Agreement, including without limitation, the memorandum executed by the Parties hereto, entitled"Contract to Purchase Real Estate" ("Offer"), are hereby superseded, rendered null and void and shall have no further force san effect, it being the intent of the Parties that all obligations of the Parties are contained only in this Agreement and this Agreement represents the complete and full agreement of the parties hereto. 7. Buyer warrants, represents and acknowledges to Seller and agrees that Seller is relying upon the following: By execution of this Agreement, Buyer acknowledges that Buyer has been provided ample opportunity to conduct any and all inspections of the premises(either independently or through agents of the Buyer's choice), including all improvements thereon, and any and all component parts thereof, desired by Buyer(and that the Seller has no responsibility for any failure by the Buyer to fully exercise such inspection rights), including, without limitation, mechanical, structural, groundwater tables, utility systems,all appliances and personal property being conveyed with the premises as provided in this Agreement, pest,termite, lead paint, asbestos, radon, mold, and any hazardous chemicals, materials or substances, dimensions and area of the premises, and that Buyer is fully satisfied with the results of same,and accepts the premises"AS IS",reasonable use and wear thereof excepted, and is not relying upon any representations of the Seller or Seller's agents in connection with same and in connection with Buyer's decision to purchase the premises (other than those specifically set forth in this Agreement), including, without limitation,as to the character,quality, use,value,quantity,or condition of the premises 8. Any title or practice matter arising under or relating to this Agreement which is the subject of a title or practice standard of the Real Estate Bar Association("REBA")shall be governed by said title or practice standard to the extent applicable and to the extent such title or practice standard does not contradict any expressed term or condition of this Agreement. 9. This Agreement may not be assigned or recorded by the Buyer without the prior written consent of the Seller and any recordation by Buyer(including a recording of notice hereof)or purported assignment by Buyer in violation of this paragraph shall be considered a default by Buyer under this Agreement, whereupon all deposits hereunder shall be paid to the Seller with interest thereon and shall become the Seller's property and this Agreement shall terminate without further recourse to the Parties hereto. 10. All of Seller's representations under this Agreement are to the Seller's. actual knowledge, and without conducting any independent investigation or inquiry and are not intended to imply or create any obligation for the Seller to take additional actions or more further inquiry with regard to any topics contained within this Agreement or elsewhere, including but not limited to, documents, to be executed in conjunction with the Closing; furthermore, it is acknowledged and agreed by the Parties that any such representations shall not constitute a representation or warranty against the existence of such conditions about which Seller has no knowledge, nor a representation or warranty against the discovery or occurrence of such conditions. The provisions of this paragraph shall survive the Closing and the delivery of the Deed hereunder. 11. The parties acknowledge and agree.that this Agreement may be signed in counterparts, and for purposes of this Agreement, facsimile or electronically scanned signatures shall be construed as original, provided however that no party shall avoid any obligation hereunder by failing to provide such original signature. 12. If this Agreement or any other provision by way of reference incorporated herein shall contain any term or provision which shall be invalid,then the remainder of the Agreement or other instrument by way of reference incorporated herein,as the case may be,shall not be affected thereby and shall remain valid and in full force and effect to the fullest extent permitted by law. 13. By executing this Agreement, the,Buyer and Seller hereby grant to their attorneys the actual authority to bind them for the sole limited purpose of allowing them to cancel,grant extensions, modify or amend this Agreement in writing,and the Buyer and Seller shalt be able to rely upon the signatures of said attorneys as binding unless they have actual knowledge that the principals have disclaimed the authority granted herein to bind them. Further, for purposes of this Agreement, email transmissions and/or facsimile signatures on such written instruments shall be binding, provided however that no party shall avoid any obligation hereunder by failing to provide such original signature. 14. Both Buyer and Seller hereby acknowledge that they have been offered the opportunity to seek and confer with qualified legal counsel of their choice prior to signing this Agreement.. //1110 � William A.Monroe Burtq B. Ann B.Monroe RIDER"B" PROPERTY: 225 OSTERVILLE-WEST BARNSTABLE ROAD, OSTERVILLE, MA I. TAXPAYER CERTIFICATION NUMBER: At the time of the delivery of the Seller's deed,the Seller shall execute and deliver to the Buyer and any title insurance company insuring title to the premises (for the Buyer or for any lender granting mortgage financing to the Buyer with respect to the premises) either(i) affidavits setting forth that the Seller is not a foreign person or foreign corporation and providing the Seller's United States Taxpayer Identification Number, or(ii) such other documentation as is required by Section 1445 of the Internal Revenue Code and any regulations promulgated thereunder that would exempt the Seller and/or exempt the sale of the premises from the provisions of said Section 1445. The Seller agrees to execute and deliver to the Buyer's attorney a certification, signed under the penalties of perjury, of the Seller's taxpayer identification number and of the Seller's present and/or future mailing address. 2. TITLE REQUIREMENTS: Notwithstanding anything herein contained, the premises shall not be considered to be in compliance with the provisions of this Agreement with respect to the title unless: a. no building,structure, improvement, property, way, or prescriptive rights or easements, belonging to any other person or entity, encroaches upon or under the premises from other premises, unless provided for by a recorded easement; b. all structures and improvements on the premises and all means of access to said premises shall be wholly within the lot lines of said premises and shall not encroach upon or under any property not within said lot lines, unless provided for by a recorded easement; c. title to the premises is insurable for the benefit of the Buyer, by a title insurance company, in a fee owner's policy of title insurance at normal premium rates, using the American Land Title Association form currently in use, subject only to the printed exceptions to title normally included on the"jacket"to such form or policy and such other exceptions permitted under Paragraph 4 hereof; d. the premises shall abut and have legal access to a public way or way or ways over which the Seller shall have an expressly granted right of way to a public way, which right shall be transferable to the Buyer and included in the deed to be delivered hereunder. 1 3. TITLE INSURANCE: At the time of the delivery of the Seller's deed, the Seller shall execute and deliver affidavits and indemnification forms regarding the following: mechanic's liens, materialman's liens, and parties in possession sufficient to eliminate any title insurance exceptions for these matters. The Seller will execute a survey affidavit as is commonly accepted by any title insurance company providing title insurance with respect to the premises and any affidavits and certificates as are customarily required by a lender granting mortgage financing to the Buyer with respect to mortgage loans for transactions of this type. The Buyer or the Buyer's lender will provide said affidavits, indemnifications and certificates. 4. DELIVERY OF THE PREMISES:At the time of closing SELLER shall deliver the premises to BUYER in broom clean condition with all rubbish, debris, or other items of personal property not otherwise conveyed or remaining at the I Premises, removed by SELLER. SELLER shall also deliver to BUYER all keys to the premises and any warranties for appliances, fixtures or improvements. BUYER shall be allowed to inspect the premises immediately prior to the closing to confirm that the premises comply with this paragraph and Paragraph 9 of this Agreement. 5. ACCESS TO PREMISES: Upon reasonable notice to SELLER or the broker (which need not be in writing) and in the presence of Seller or Seller's representative, the BUYER and/or the BUYER's designees, agents and representatives, shall have the right to enter upon the Premises from time to time and make such investigations, surveys,tests, examinations and the like as the BUYER deems necessary or appropriate in connection with the performance of this Agreement. BUYER shall indemnify and hold SELLER harmless for all liability arising out of such entry upon the Premises. 6. If, pursuant to paragraph 10 of the Purchase and Sale Agreement, the Seller extends the time for performing and the terms of Buyer's mortgage commitment expire during the extended period and cannot be extended at the same terms, Buyer shall have the option of voiding this Agreement and receiving their deposit funds immediately in full, whereupon the Purchase and Sale Agreement shall terminate, without recourse to either party unless the Seller elects to cover the cost, if any, to maintain the Buyer's commitment and terms. In any event, the date for closing cannot, without the Buyer's written consent to be determined in the Buyer's sole discretion, be extended beyond thirty days from the original closing date set forth in this Agreement. 7. REPRESENTATIONS OF SELLER: SELLER represents to BUYER that,to the best of SELLER's knowledge, information and belief, and without undertaking an actual investigation; (a) there are no underground fuel storage tanks on the Premises; (b) there is no asbestos present on the Premises; (c) there is no litigation or proceedings, pending or threatened, against or relating to the 2 Premises d there are not now, and will not be an outstanding agreements with > ( ) Y g g any party pursuant to which any parties have or could acquire an interest in the Premises (other than outstanding mortgages), including any tenancy and occupancy agreements which affect the Premises and which will survive the closing; and (e)the Premises and the present uses on the Premises are not in violation of applicable zoning, building and subdivision laws and regulations. Seller further represents that Seller is not the petitioner in any bankruptcy proceeding, presently or in the past. 8. Buyer's obligation to perform is subject to the bank appraising coming in equal to or higher than the purchase price noted herein. This contingency shall expire on the same day as the mortgage contingency expires, including any extension, if applicable, noted in paragraph 26 of the main Agreement. 9. Seller agrees to close out open building permit prior to closing and provide written evidence of same. 10. Seller hereby authorizes conveyancing attorney to obtain payoff information from Seller's mortgage(s) or other security holder(s) listed below and in connection therewith hereby authorizes any equity mortgage lender(revolving line of credit) to freeze the equity account. The Seller hereby authorizes the mortgagee(s), upon receipt of the payoff funds, to close the account and forward a discharge of the mortgage in accordance with the instructions provided with the payoff check. MORTGAGE(S) 1ST MORTGAGE 2ND MORTGAGE Name of Institution: �, ,z �v� 1 �"'►�'�'f"UN�ti Lrn•e., �f cad�� Address: Account Number: Telephone Number: r , ;• Seller Seller A / . 7Buer , Buyer 3 ■ ■■ !■ ■ ■■■ ■■■■■!■■ No ■■■! No ■ NE ■■■ MEMEMOMMEMIZI OMEN■ ■MMMMMMMMMMMMM�V■MMMEEM ■ ■■■ mommommosoM o!mommoma■MM M MEN MO■MEMOOMME■■ ■■ MEME■■ MEN■■ MNo NONE■■ ■■■ mom MMOME EMOMMOMMOMME ME ME 0 mom MOMMEMEMOMMEMEMI ONO ■ MMEME■EM■E■M■ME■■O ■■■ ON M"EMEME0 MEM■E N■■Mn■O N i-MM ONOO MOM■■■■ is ` ■N MEN■■■ MINESIMM01iME WNE ..o �� ■ ■N■■ ! ®NM fir■■ lm ■M��■■■ MEM■ �i�ME MEN■ ■ a . 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IiI `' CID - v C31- I IIIII -IjII � L. I � I � I ' I ! i�� I i I I I i ; I I ' i I I , T l ate' abT�✓c�ll� W��" ��,NSi�'$l� 03 Uri . N a� I ` ,.t 45 ys/ �oEz Towti Town of Barnstable *Permit# ¢ O Erpires 6 monthsfroni issue date ♦ a Regulatory Services Fee 5-2 . y BABNSTABLE. r MASS. Thomas F. Geiler,Director / l / �A i63q• A1� 7f�/l�V TFD i PERMIT Building Division APR 5 2010 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 .�.��A, �� ����S-�-���� www.town.barnstable.ma.us Office: 508-862-40 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address e��J J l — w f IJ����►� � �• o s'lC,21ffCLC residential Value of Work 47CV Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address / "t 6AJjZ06 6,u 11,L44M A f 4uN ZS QSi 1 W, /,342AJS !-P 0STc21-V/Lt& l del4 Contractor's Name -1('4oM,4.s 4 Lti/J 6 Telephone.Number Home Improvement Contractor License#(if applicable) 1¢a23 U Construction Supervisor's License#(if applicable) CS o� � ❑Workman'ss Compensation Insurance Check one: I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will betaken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Qiows oors/sliders. U-Value ' (maximum .44)#of windows _ I *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.'Historic,Conservation,etc. ***Note: Property.Owner must sign Property Owner Letter of Permission. copy of the e Impr ement Contractors License&Construction Supervisors License is quired. SIGNATURE: QAWPFILESWORMS\building permit forms\EXPRESS.doc Revised 090909 f The Commonwealth of Allassachusetts Department of Industrial Accidents Office of Investigations c� 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): -1-14 OM 4 t4 LfJtJG Address: LUG KNo-y Q 1Nc- Lvr City/State/Zip: M 2vtLL6 M 02(,32. Phone #: -7-7. 3(o &0 Are you an employer? Check the appropriate box: Type of project(required): L❑ I am a employer with 4. I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New.constntction 2.4 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 mein any capacity. employees and have workers' Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. We are a corporation and its l0.❑ Electrical repairs or additions 3.0 1 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 41 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. 3Contradlors 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 andjob site information. Insurance Company Name: Policy# or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MOL 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 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 o the DIA for insurance coverage verification. I do hereby e ify under the pai s nd alties ofperjury that the information provided above is true and correct. Signature: Date: �0 Phone;V 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 S. Plumbing Inspector 6. Other r'.,,,f rPArcnn• Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, constriction 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"Neither the commonwealth y o compliance with the insurance coverage required." Additional)Y,MGL chapter 152, §25C(7)states ealth nor an f 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 f111 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 certificates) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(UP) 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 pen-nit 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.frll out in the event the Office of Investigations has to contact you regarding the applicant: Please be sure to fill in the permit/license number which will.be used as a.reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i,e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia �1HEro� Town of ]Barnstable Regulatory Services ' BARNSTABLE, " Thomas F. Geiler,Director Mna9. p D;c 141 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, WU4AM ' AoNy w , as Owner of the subject property hereby authorize !�naMA . LON 4 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 Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable FVE r � 1 Regulatory Services J Thomas F.Geiler,Director y IARNSTABLE, 69. ,mb Building Division PlED1�'�a 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#i work phone fl CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and 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 dQ 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 supervrsor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often.resu]ts 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 per mrt application, that the homeowner certify that heJshe 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:\WPFI LES\FO RM S\ho meex empt.DOC I, Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Y': Office of Consumer Affairs and Business Regulation Registration —142393 10 Park Plaza-Suite.5170 Expiration` 4/1/2012 Tr# 294837 lug Boston MA 02116 Type."i,',"Indwr�uat= ' THOMAS A LONG i T ` THOMAS LONG 166 KNOTTY PINE`LANE -� '�_— CENTERVILLE, MA Undersecretary U 'Ili Not valid without signature +� Massachusetts- Department of Public Safe" Board of Building Reaulations and Standards Construction Supervisor License License: CS 86040 �•}. Restricted to: 00 THOMAS A LONG 166 KNOTTY PINE LANE CENTERVILLE, MA 02632 F @` Expiration: 8/29/2011 ('unuuissiuner Tr#: 19457 ) 1 it TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma I Parcel Application # p v� Health Division Date Issued t 1 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH — Preservation/Hyannis r5 37 Project Street Address oZ�� tOy esl ���'�s �1 e �466 V4L 05-�rvrlk 1•'!//eSt rn��5/�2 Village Owner �� '�`'� A ®hr Address S Ct Zx_ Telephone D '+a-O Permit Request -o re_p(4 r e cX r °° J eCK r5 an born, corn rng l &,,4s ZA es4rv7ej. cx)�ect/ J�ee I h S rM, C� d PCV Gv�S S ' Square feet: 1 st floor: existing proposed ° 2nd floor: existing [00 proposed r� Total new Zoning District Flood Plain 20n-e C Groundwater Overlay Project Valuation Sa °• 0'6 Construction Type k/0 �izt Lot Size ,78 ger-S Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Ul o On Old King's Highway: ❑Yes UKo Basement Type: C+�'Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) .900 Number of Baths: Full: existing_ new Half: existing new.'-=l Number of Bedrooms: 3 existing —new Total Room Count (not including baths): existing new First Floor Room Count 31 Heat Type and Fuel: as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑-<o Fireplaces: Existing 0 New Existing woo oal stoves ❑l 4 p_P4o �� Detached garage: existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: � isting Egnevvosize_ Attached garage: ❑ existing U new size _Shed: ❑ existing ❑ new size _ Other:2! 00 °O cn Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ .o 59 Commercial ❑Yes P11<0 If yes, site plan review # Current Use ,nq m, ,_4 om,'e __ Proposed Use S of n-e - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name K�'N�I �kU `'� Telephone Number Address Fl- License# 6 5C101 'nI� 2� �-.J I Home Improvement Contractor# 12 S S ��- Worker's Compensation # 6 K U f3"`f' I-74 P2 l—_7 1.o ALL CONSTRUCTIO EBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO o� o 'DE."JN as —D PAD SIGNATURE DATE 1 y -28— 10 > FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ` MAPJ PARCEL NO. s ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION i - ,t FRAME ' INSULATION FIREPLACE S ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL *GAS:" 3- : ROUGH FINAL _A _ r F,INAL,BUILDINGl-. — %4 u DATE CLOSED OUT ASSOCIATION PLAN NO. T"fte C�rrcrnonwedl(Ic ofCccssdchusetts Deparfrnertt of lrtdustricrl.4cetder>Is Office of.l)npesdgalzons 600 glash ngfon Str'eee Boston, AL4 02111 wrvw•rnass.gov/dia Workers' Compensation Insurance davit; Builders/Contractors/EIecfricians(Plurnber Please print Lef?ib) A Ilcant Znformatiori a�1e (SusincsslOrgani�tionlLndividual): �� '� Address: + As"KP45 �2 City/State/Zip: c5J;-I-H l7L'x��t� /Vl � Phone.#: 5 B 3 Are YotL an employcr7 Check the appropriate box: Type of project(required): �c 4. [] I'am a general contractor and I 6 Q NGW construction 1•`t�' 1 am a employer with ployccs (full andlor part,timc),* hay.c hired the sub-contractors 7. 1Zcmoricling 2.0T am a'sole proprietor or partner- listed on the attachcd sheet ❑ i ship and 1 avc no cmployces Thcsc sub-contractors have g. Demolition working for me in any capacity. cmployccs and bavc workers' 9 ddition Building a camp. insurancc.t {No WorkcLs' GoIDP.-M' E lraIlCe IO.C] Electrical repairs or addi T r11rCd ] S. [� We arc a corporation and its ^i officers bavc exercised their 11_E] P7Lmobing repairs or add_ 3, I am a bomcowncr doing all Work ri gb t of excm tion p er MGL mys rIE [No workers' corm. 12.[] Roof rep airs and we bavC no inc„rance Tcqu red]t 13.0 Other crr�]oyccs. [No workers' comp. insurance required.] r lLiy applicant that chcckz'box ul must also fill out the section bdoW showing their workers' com a�ptnson policy inforrpa.don. t HomcowntrY rvno rubnn t this s$idavit indicating tbcy art doing all workmnd thm hire outside cant Ecior5 mtrsl submit anew�diY tindirai�ng FticF h'-ontraclors fiat check this box must ztiachcd an additional rhect showing the name of t}1c sub eonh�ctrns and state ahcthcr oT not fhose tntitirshave erYplo� lfthe sub-ionh-actorrhavDm'nploycd,theymuripruvidb their workers'comp. poEcynumber. lam an eraployer Lhal is prcvidLngg Porkers'compertsazwri insurame for my employees: $elolp 15 the policy artdjob sit inf ormallor. Z Los uran0G Corop2IIyltZIl]G: Policy# or SIcif--ins, Lic.#: KJ 3— �F+ - ''�'L°I "�- — ® Expiration Date' DZ5 ' 1 Job Sitc A-ddress: . 5 VCST Zt612N 0tC3Lc- Rp Ciiy/Statc/Zip; Cs,zfWro-� Attach a copy of the�Yorkers' compensation policy daOaration.page (EbOWingtbe�olscynumber and-cxp Lratzon da ' c Failure to secure covcragc as rc*; i cd under Smction 25A of MGL G. 152 can Icad to-the imposition of rrim;n a1 penalties Eno tip to 51,500.DO iLDd DT ono-ycar imprisonment, as well as civil penalties in fbc form ofa STOP WORK ORDI?K and of up to 5250,D0 a day against the violator, 13 e adYis rd that a copy of this statement may be forwarded to fhe Office of Investigations of the bIA for inn raucc mvera e veri cation. I'do kereby cc fy under the pains•artd penalizes bfperjury ehal the irrform-ation prapided ahuva is true and correct Datt; �V" 20 ' 10 ' Si aturc: Phone3 23�' VIA �— Official use only, Do not write in this area, (b be completed by city or town offlciaL City or ToYa; Pernvt/License # Zssuiog Authority (circ)e one): Y. Board of Health 2, Building Department 3, City/Town Clerk 4. Electrical Inspector S, Plumbing Inspec{or 6. O th e r cncral Laws chapter 152 requires all employers to provide worker o p tbcr ndctrroa"ny Contract Of hirccs: y Mass achusctts G crson in the scrVicc of pursuant to this statute, an employee is dcfincd as "...cYcry P express or implied, oral or written- co oration or other legal entity, or any two or more An crrepl�yer i.s dLfrocd as "an individual partnership, association rp of the fore ping engaged in ajoiat cntLrprisc, and including the legal 1GPrenti taomploy ng cmpl YccPs.1HOWcvcrhthc g artncrshi association or other Icgal ty, roccivcr or trusteo.of an individual, P p+ owncz of a dWclling hDuso having II0t more than three apaztmcnts and who zesidcs therein, or the occupant rI o dwcJLin house of another who craploys persons to do znaintcnancc cons h m°�o°L cnt be dcemod to bcn SUChL dan c PI D c g P Ym or on the grounds or building appurt cant thereto shall not because of MGL cbaptcr 152, §25C 6) also states that"eYerystnte or local licensing agency shall)fithhold the issuance or in the rerzePs a 1 of a license or Permit to operate a busincss Or to COnstruc'a of com li nce psi thdtheslnswan COMM enragn reguir d•" applicant who has not produeed•acceptable eYideac P of its olitical subdivisions shall AdditionaIly, MGL o�ptGr 152, §25C(7)states 'Neither the commonwealth nor any P entcr•into any contract for,nc�porforznanGo of public work until a�Pta to evidcncc of eompliencc v2th the j�ura�cc requirements of this cbaptcr bavc bccn presented to the contracting tY Applicants d` Please fill out the workers' compensation affidavit completely, by chcclang the boxes that apply to your situation and, ncccss s ply sub-contractoz js) address(cs) and pbono numbc;Ks) along with their ccrtificatc(s) of �Y, lip inslIrdllce, Limited Liability azopanics(LLC) or Limited Liability Partnerships If an f LC o LLPPdoeecbavccez than the rnombcrs orps lDors, azc notrequired to carry workers' compcosatioa insuzan of Cc- c loyccs, a policy is required l3�advised that this affidavit may be sub it date the Drpartmc t c fEdzy tlshould P ;Lnd Accidents for confirmattron.Of'nsurancc coverage. Also be sure to sign bo returned to the city Or town that the application for.the permit or Jiccnsc is bo magro rgcqu iGd to obtain acworkkcrs t of Industrial Ac6dcnts. Should you have any questions regarding the Iaw or if y co cnsation obey,pX o d enter thcii call the]DepUlmcnt attbe number listed below. ScLf insured companies skDul P P sc1#-jusuranGo lircasc number on the a ropzJatc lino. Clty or To-ffR Offlclals Please be sure that e bOttDra the a.ffidayit is,eomplctc and printed legibly. Tho DcPat�oat b Pt o oudzeg ding OaPPh mt o f tho affl& i.t for you to fill out in the cvcnt the Off c° of Investigations has Y car,nccd. only submit onp affidavit indicating current Pleaso be suzc to fill in the Permiy/ ccwo number which will be used as a reference number. In addzhon, aPP cant that must submit multlplc permiVllccaso applications in any given y DhCy information(if pcecssazy) and undcr'7ob Sit,-Address" �D ap kcd by should cay orttown limy b provided to y of P ed or mar Y towzi)."A cbpy of tlic affidavit that has bccn officially stamp a licanat as proof that a Yalid afSid.avit is on file foi future pczrnits or o�latcd/to any incss or c-ObDm al pP a keens c or cllnit n yeaz.'Wharo a home owner or citizen is obtaining P. (i e, .- dog Jo a ho ox'permit to bum leaves etc.) said persoia is NOT required to eonrplcte this a$davit Oc of Investiga-dons would bke to thank you in advance for your cooperation and you bate �} Questions, should Tho ffic plcaso do not hcsitato to give us a call. Thd Department's address, tcicphoac-and fax number. Thb Commonwt,4th of Massachusats D,�paztmut of hdust al AAcidc�nts Office of 7Itve4tigations 600 `Neshinlgton Suet $�ston, MA 02111 TGL # 617-727-4900 ext 406 pr 1-877-NiASSAFE Fax# 617-727-7749 Revised 11-22-06 www—mas,9..gov/dia it • r OFTH5r Town of Barnstable Regul2tory Services a ILNx-r )3 Thomas F" Geiler, Director `659• - Building Division g Tom Perry,,BuildingCOMM4ESiDner 200 Main Street, 14yannis, MA 02601 wtvw.town"ba rnsta ble.m e.us office: 508-862-403 8 Fax: 508-790-1 Property Owner must Complete and. Sign. This Section I TJsi gA Buildei T j I�(pi✓1 / Oi1 r�J� , as OW er of the subject ptoperty hereby authorize t7 -hang ulo by to act on my behalf, in all matters relative to work authorized by this building permit application for, (Add.tess of Job) Aly" lvavv-� Signature of Owner Date W,11 �awl. 6� t^Oe Print Name 11 property owner is applying for permit please complete the Homeowners Licerise Exemptiofl Form on th'r, reverse side. Town, of Barns t a b Z e �'�•. of 7HE ro�y� Regulator Services . Thomas F. Geiler, Director - .B,taxsTAa[�, , Mtiu .Building Division ",� Tom Per,.ry,Building Comrrussionel, 200.Main Street, Hyannis, MA 02601 K Wjy.town.b2Tnstable.m-a.us Fax; 509-790-6230, Office; S08-862-4038 HohTEOWNUR LICENSE EXENIPTION Plcasc Prinl DATE: J 013'LOCATION s4 cct Pillage number ".HOMEOWNER work phone# -home phone N name CURRENT MAILLNG ADDRESS: stale zip c°de city/town tion for"homeOWIICIS"was extended to include owner-occupied d a d a thelowz ez acts a jcss s The current excmr _----- to allow homeowners to engage an individual for hire who does not possess a teats , Sup�erY?sor. bFk7NITIOI`N OF HOhTEOWNER € . sons Who owns a parcel of land on'Whieh`her/she resides or intendssoto z to dueh us hand/o efarm tinctures re or is dA to 1'cr ( ) �' bc, a one or two-farruly dwelling, attached or detached structures acees uch ll not bo parson Who constructs more than one home in a fwo year nnla d ehtablc to the Buildding Offtc fll0 t has ho shall be "homeowner" shall submit.to the Building Oflzcial on.a o p . res onsib]e for all such Work crformc.d under tho buildingm ciif, (Section 109.1,1) L• The undersigned "homeowner" assurmcs responsibility for compliance with the`State Building Code and other applicable codes, bylaws, rules.and regulations, abIc Th'a undcrsig red "17oII100Y�ilcr" certifies that he/she understands the Town of Bar said pruccduges ardent minimum inspection procedures and rcquircmcnts and that he/she till comp y requirements, Signature of Homcowncr a APP"oval of Building OfEcial I , Note; Three-family dwellings containing 35 000 cubic fret or.larger,will be required.to comply with the Statc Building Codc Section 127.0 Constru HOMEOWNER'S) XEMFI ION omit is required Shall be exempt from the proYtsions a ason s for hire to do such The Codc slates lhaC "AnyhomcoxncrPcrf°rmingaryis for which a building p of this section(Section 1 o9.1,1 -Licensing of construction 5uperYisors);provided Thal if the homeowner enragesp son see Appendix Q, work, that such H°men�Yf7R shall net a,s supervisor. the res onsibl"tics of a supem ( brtiwlarly Many.hom�owncrs who use Ibis exemption `ofnsection 2,15)wprc tyThis Assuming lack of awarenes often results in serious problems,p Rues &Rcgulalions for Licensing Construction Supem when the'Rcgucown�r hires unlicensed persons, In Ibis cuc,ourcB RFd c: nnoi proceed against the unlicensed person as it wohe Lld Hash slu non d Supervisor. The homeo`n'x e.cting es Superviso�is ultimet0yr p To ensure That the homeown n is dcrslalnds Lhc ro ponsnbil'tiLT cB of a Su'pcm or.yOn the lsl�pagc of`this aispuc izrt B ac. lform u'rre P Y used by Lna-t,thc homcowncr ccrlif7 that he/she r r r ;„✓r,rtifica(ion for use to your community. { _ Orlice or('ustimer Arr;tirs& Busin A�� ess ulatiuu n � tl HOME IMPROVEMENT CONTRACTOR Registration: 125537 Expiration: 1/15/2012 Tr# 293009 Type: Individual ' ANTHONY SEAMUS(QUINN °: ANTHONY QUINN ��l, 17 ASHKINS DR SOUTH DENNIS, Mrl- 02660 Unticrsccretan I)clrarunrnt nl Pu)ilic :rfct� r' ' ? Bnardl of B11iIdin R ulatirnt, ont1 �tnntl:rnl, i - Construction S�_i,�ervisor License =•'t" License: CS 68599 Restncted to: 00 ANTHONY S QUINN 17 ASHKINS DR SOUTH DENNIS, AAA 026h-0 ---__—_-- ---- l� E x p i r a ho n 4/6/2012 Tr... 24309 ..i 60EyZ :r:�l lOZJ9/ti :1101leardx3 ___ ram"t'.I�""... 1 099Z0 Vw 'SINN30 Hinos 210 SNINHRV L l NNino S AN OH1Nb 00 'ol pd7aLttsaM 66S89 SC :asua:7i� asu��,r� aoslnladnS uollona;suo0 Ii.trlrur'1� Ilur. ,uurlr.In�;•�?� ur r ur it.�Ir:� .�ilynd.lrr lu•�tul.n:(I,a .11. F� .Iu (r.tt:utl atnleu�ts;not t,aplleAaoti 911ioVK`"isog _ 1 , o09 apris-ezLld�Ln;,{ o f uo1ltlnSa2{ssaulsnu put;s.11gJV.1awnsuo;)•lo aa})O :01 u-1R11a punojjj •alup u013tuulw ayl aaojaq ,Ohio asn InpiArpat.tot prleA u013e.gsl�3-j.r0 asuaa±'1 } :;r I certify that this property is located in Flood Hazard Zone C (outside the 500 year flood) as identified by the 'Department of Housing and Urban Development (HUD) . Q i Date Reg. Pik' ,+�,` ? � yor 4° f lid I certify to Bank of America, FSB. and o its title insurance company that there no visible encroachments or easements except as shown and that this plan was Zv prepared under my immediate supervisionl�P�� � k d p � 1 � � v SMAIL&L ,—rrm+ �k CERTIFIED PLOT PLAN- / LOCATION �9�N 'ABLE LosTVeGG�, SCALE .. .�.' ?.. .... DATE PLAN REFERENCE ,sue L3oo� 68�! j L3 /livz> . .. I CERTIFY THAT THE !SJ"/�VG DGt/ELLf/lG . f SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF ,dff7T.t/5Ti9¢,G WHEN CONSTRUCTED. DATEG 1,c//(�f6? /�a�✓/zoG �j�%a'�i J REGISTERED LAND SURVE R tZ� U S I it i 2 ` X12 PiYI / Pcw-5de - i 10 of SAVNP- -IRRAO � s �✓� i �X��STi�1Cr 48 i I K i 4 i � 1 2`x 1 `FaAm744G- �� I Barnstable *Permit (� 62z � � Town. of Expires ti months from issue date Regulatory Services Fee r Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number r Zl Z 6 0 1�' •Property Add ress 15 ©'S 1 _- W j3rJ9JJS-1AW P-b Residential Value of Work P ;5-op .0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address � 'r of Contractor's Name I b � Telephone Number 77 1 �"(e'6�'� Home Improvement Contractor License#(if applicable)_---!—' q3 Construction Supervisor's License.#(if applicable) c S 9(o o 4-0. ZWorkman's Compensation Insurance Check one: 7 L 1 am a sole proprietor -PRESS PERMIT ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance MAY 2 6 Z009 Insurance Company Name @ U F BARNSTAaLF- Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side [Replacement Windows doors liders. U-Value J _(maximum.44) I *Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A.dbpy of the Hom Improvement Contractors License is required. SIGNATURE: %0"kA_ S� Q:Fonns:expmtrg Revise061306 . The Commonwealth of Massachusetts .f Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ' www.mass.gov/dia Workers" Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Lesribly Name(Business/Organization/Individual):. A, L.W4 -Address:— i ?zje Ly. City/StateiZip:_ C-6JT&M 1-L !`I 4- 0743 L Phone.#: •774-S 3 6 d&6'q,r Are you an employer? Check the appropriate box: Type of project(required):, 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6• ❑New construction . 2. I am a•sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' co insurance.$' 9• ❑Building addition [No workers' comp.insurance comp. required.] 5• ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself [No workers' comp_ right of exemption per MGL 12•❑Roof repairs insurance required.]t C. 152, §1(4),and we have no employees. [No workers' . .13.& Other- comp,insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. xContractors 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 providb their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below isihe'policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date), Failure,to secure coverage as required under Section 25A of MGL e. 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 V%ft:ender the pains,and enalties of perjury that the information provided above is true and correct: Sit?nature; Date: �� _ Phone#: -7 7 4�--t7 G -W 4 r Official use only. Do not write in this area,Yb 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 CIerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: - ��ofz►,e, you . Town of Barnstable Regulatory Services t s srns Thomas F.Geller,Director nsnss. 16 P. , Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 wvvW-town.barnstable.ma.us Office: 508-862-403 S Fax: 508=790-6230 Property Owner Must Complete and Sign Tl-i-is Section If Using ABuilder L WcLtA to Mum , as Owner of the subject J property hereby authorize 1146M/}S A, LW C- to act on my behalf, in all matters relative to.work authorized bythis building permit application for: , S OST LJ.64axJ i Y-A Lec i2�, (Address of Job) GG 57 ignature of Owner ate Print Name FORMS:OwNE Q RPERMISSION /ae �ammwmusea�� o� �/faaaactucaeCa License or_registration valid for individul use only Board of Building Regulations and Standards before the expiration date. if found return to: HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards Registration:-.;142393 One Ashburton Place Rm 1301 Expiration 4L:1/2010 Tr# 264734 i Boston,Ma:02108 1,C Ty Individual t , IL THOMAS A LONG THOMAS LONG 166 KNOTTY PINE LANE _ % Not valid without signature J CENTERVILLE,MA 02632- Administrator r - �-, --x - -- ,— Board of Building Regulations and Standards , ' Construction Supervisor License z' •; License: CS 86040 � : 3 Birthdaate--8/29/1960 � , Ex ii ton ,a E p 4a n 8[29l2009 Tr# 811 Restriction�:00 i THOMAS A LONG,, I' 166 KNOTTY PINE CENTERVILLE,MA 02632Yj Commissioner 3 � Ok 81 pleb � Town of Barnstable *Permit#an X-PRESS PERMIT Expires 6monthsfrom issue date Regulatory Services Fee OV JUL 2 8 2006 Thomas F.Geiler,Director A* TOWN OF BARNBTABLE Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL, ONLY Not Valid without Red X-Press Imprint Map/parcel Number f ®0 Property Address ;L.�L5 1 j�� ps71- 8err,7S'/9�4 /-�Zd D& residential Value of Work 4 a&00,ate Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Will 1 /lIt 4V4- /�CPO 1-09— Contractor's Name t "Ir J Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor gam the Homeowner ❑ I have Worker's Compensation Insurance ezz- Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ®'Re-roof(stripping old shingles) All construction debris will be taken to- Cr ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: lssuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. om 141provement ontractors License is required. SIGNATURE: Q:Forms:expmtrg Revise071405 --.......-_...... .._.._. . .. i ne c,ommunweairn uJ lrlussavn"Ellaf Department oflndustrial Accidents Office of Investigations Y 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/]Electricians/Pluilibers Applicant Information Please Print Legibly Name (Business/Organization/Individual): w �QN` 14, Address: �L? 04 vt��ry�t 5'orr�ls City/State/Zip: 0,,S17`re-,lle 110 01 sNe�,_ Phone#; 4dr2 Z,74 _(oOr®-Y Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hued the sub-contracto$ 7. 0 Remodeling 2.ElI am a sole proprietor or partner- listed on the attached sheet ship and have no employees These sub-contractors.have 8. ❑ Demolition working for mein any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its . required.] officers have exercised their 10.❑ Electrical repairs or additions 3. I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.(No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.' t Homeowners wbo submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their worker'comp.policy information. I am an employer that is providing workers'compensation Insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,50Q.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250,00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature /'t�V� /// "�— Date: Phone#: 8 �40 limo® Official use only. Do not write in this area,to be completed by city or town official: 1 City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk e.Electrical Inspector 5.Plumbing Inspector I 6. Other , Contact Person: Phone#�: Information and. Instructions r 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 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 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 permittlicense number which will be used as a reference number. In addition,an applicant that mast 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 maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE T ax# 617-727-7749 Revised 5-26-05 wy,mass.govIola 1 Asse, 'Ior's map and lot number ../...�d.�...- .����.:........... �/` !/. C� L �1 7' " o%THE TO Sewage Permit number !.? ............................... SEPTIC SYSTEM Z BAUSTABLE, House number ...... .D�...................................................... �NSTA� Q IN UST g goo rb 9 e�w WITH TITLL M5 LIANC CHIN TOWN OF BAR" E DE AND ULATIONS RULDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ... .5:1.Z4aSr`l���r. ...................................................................................... ........... 17...........19.3e) TO THE INSPECTOR OF BUILDINGS: A The undersigned hereby applies for a permit according to the following information: Location .. �'�?.-... 'U;'l���.t`e .. .......... � .1114.7 .m. ,........:... ProposedUse ...................................................................................................................................... ZoningDistrict ...........................................................:............Fire District .. .................................................,............ Name of Owner .. . ....Address ........./.................................................... ............. Nameof Builder ,. .. ....... .L ..Address .................................................................................... Name of Architect " ........Address Number of Rooms .... ......................................................Foundation .............................................................................. Exterior ... ...�.. .. .. ...........................................................Roofing .........................................:.........................:................ Floors4y.,.r:.............................................Interior .................................................................................... T Heating .. ........................................................Plumbing .............. ..... ..M........ . ................................ Fireplace ......lklk ......................................................Approximate Cost CJ �/.. .......::........................................... el Definitive Plan Approved by Planning Board --------------------------------19________. Area ...............p- --r. .. �0 .. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH a �a 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........ .. ..... .. .. . . ....................................... GIFFORD, HAROLD E. z too 22 15 ... Permit for ...]3gil4�.. QS?a,...Sk1ed ` ........AC.GQS.SOX'.Y...to...DWQ1.1.7 ag............... Location 2.25...West...Baxn.9tabLe...Road.. � ..............Ostexv-lle....................................... w Owner ...lia Qld...Z....Glffoxd................. Type of Construction `....Frame. ............................................. .................. .......... Plot ............................ Lot ................ .......... Permit Granted . Sept9 eX.— ..:19 80 Date of Inspection . ............................. ,19 , � ti � _ _ ..� �• ; . - Date Completed ':19 p ................... Ma ` PERMIT REFUSED -- • r .............I .. . . .. ;.......................................... J. fT: .;,. . .. ............... .. .................... .................. W:.... .................................... • i Cr '...............(.�...::?........... ....................................,... Approved'................................................ 19 �X ............................................................................... `` JJ Assessor's map,. and lot number `... ... '.... �. sEgYS l� r BE I. a � ,� � ;PLIANCE IR!STALLEJ { C. �. Sewage Permit _number STATE .� I ....... WITH A TtCL II y TY COI�s AIyIa. OVVN P�OFTNE ropy TOWN OF, B AR N� TF� _ Z 11 TAXE • �� r; 1639'. IL .1HG INSPECTOR\ D D tl t. I V .... ........... .............` AP.`PLICATIOIJ�FORr�PERMIT TO ...�U�GQ.....Y•�.�.�:'.'L��.......:................: TYPE OF CONSTRUCTION ...W"R.. !( .4�................... .. ...................... . ....................................... In� 9.� .....- ... ................. . .�.......1 S. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: n Location >?�5..... !GS�... �� ! .�51 �1fL ...... .'./.( ........... ..5/.. .................:......................... ProposedUse ..........................................................................................................................................:.................................. ZoningDistrict .............................................................:..........Fire District ...................................................................:.......... Name of Owner ��LD....... !......V.// ............Address ....5. ''?.` .............................................................. Nameof Builder ..........f/'!7 F.........................................Address .................................................................................... Nameof Architect ............ .......... ......................................Address .................................................................................... o Number of Rooms ��` ..Foundation ............... Exterior ..:......... ......................................................................Roofing .................................................................................... --- .Interior .............. Floors ..................................................................................... ...................................................................... Heating ..................................................................................Plumbing ....I........................................................................... Fireplace ..................................................................................Approximate Cost A� ......................................I.................. Definitive Plan Approved by Planning Board ________________________________19________. Area If ��1................................ Diagram of Lot and Building with Dimensions Fee pG SUBJECT. TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... .... ..... ............... Gifford, Harold E. 18105 dormer No ...... ..... Permit for ..................................... .................. i { ...........:.................... Location..........2.2 ...5..W.e.s.t..Barnstable...Road..... . . .. . . .. .. . ...... . ........ ........ Osterville .............. ................................................... Owner ......Harold E. Gifford V ......................................................... Type of Construction ..........frame ................................. ................................................................................. ti o ................................. 'Plot ........................... L t. .. �� � n. � fir. ` December 16 75 Permit Granted ....................................... 19 Date of<Inspection,--?-.. 9 ....r- 19..................... ...Date 6'rinpleted PERMIT REFUSED 17- ................................................................ 19 IJ • .......................................... .................... .................. . • ......................... ............................. .......... ...... �Cq iP ..................... .............................. .................. Approved ................................................ 19 ............................................................................... V .......................................................................... � I i 1 I I I I _�' 1 i ) 11 _ , i � � � �.-. � I _j � ; G�5 v t► I l�T. ���5 �12u{ ; i : I , I : I I �i"U'J 11!"1' i I�•j j�1 i—I� II I�I►L__ I►�i �I�I jiIjj -II r�IILI� III,, jig? -00 :1IIi1 WAN. I Y JOIN OL k. <eo B RN TABL BU LDi G E T. DATEiv UIV MUT OIDE q FIRE NDATE AC US` n IA F � e� P�`�V FFS IF b 1iIIIiiI Tf �-jLIIIII1 iiiijIII 1 jIiIiIr _--_.I I I I I i r , : �I t 11 i v ►I r cr I I 1 7LE r OWN I rl r .FL� i I I j I I. , r i _ - Y L I L /61 ,75t y I L41t � -Pry- � _ I I - _ I I - — � JA `I - I i I A I T AE II I R A F EQ 'lR D OR E Ml IN AR ON U rB INS,AMLAI --- S L!(t IN6 - I I 41 _ ?�rP I t qq y i1. J , y T.I a•+- .. , '. .... :.. r , I ..,. 1. .: ,:.'.... ','. ,..... ':.. :, ft.,