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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
T-11141IN or,
Map Parcel Application #U o 1 U n
Health Division )� rrp ?a Q'I y: `Date Issued iCY I Ila
Conservation Division Application Fee
Planning Dept. , .Permit Fee ('15
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address A43 A oS
Village GU TU t T A)14
Owner,�,�3t3�16'� T� /U AIAL4-E ,eds%Address /�jf&&-X.1fj6_ /Ply 607-01
Telephone 7 7,2 3.7 3 ff l:� 6
Permit Request BE A P_o b M � 3 6 ��rC c �P/�C�' A.#v 4D
® Pag/h/T TE b A.),b f'io S'/ `7.-4 .
Square feet: 1 st floor: existing f0proposed 6W 2nd floor: existing proposed Total new
Zoning District ?L Flood Plain Groundwater Overlay cloweja L-46 LJ
Project Valuation 0,pevb Construction Type ZooaD r'oe-IME'
Lot Size 'elLB Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing Structure -30 Historic House: ❑Yes/,(No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl Walkout ❑ Other
Basement Finished Area (sq.ft.) 6--d>o Basement Unfinished Area (sq.ft) �2 6y
Number of Baths: Full: existing 3 new Half: existing new
Number of Bedrooms: =I_ existing / new
Total Room Count (not including baths): existing 7 new First Floor Room Count
Heat Type and Fuel: ❑ Gas XOil ❑ Electric ❑ Other
Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes XNo
Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage:Xexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes XNo If yes, site plan review #
Current Use RE5 f DEM r"/ Ah Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name 0 4,4_5 Telephone Number 7 70q 3 / 3 A W
Address ��g94 License #
0 Tf//T , IT D Z 6 3 Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE / DATE
o i
I
f
FOR OFFICIAL USE ONLY
APPLICATION#
DATEISSUED_
MAP/PARCEL NO.
ADDRESS VILLAGE
J OWNER
a
DATE OF INSPECTION:
t
:14FQUI-DA—I W►
FRAME
FIREPLACE
- ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
s
FINAL BUILDINGr1 I' 11- v " Y
DATE CLOSED OUT
ASSOCIATION PLAN NO.
77te C'ommonnwid h gfMassachusets
Depariarent ofludusftwd 4ccidents
Office of invesagadions
600 Washuegton,SYreet
Boston,MA 02111
wit mynassgov/dia
Workers' Compensation Insurance Affidavit:Builders/C,aatractors/ElectriciansfNumbers
Applicant Infarmation Please Print Legibly
Name(Bus►nesslOrganizafionlln&Unaq_ AL56EYGfi7C �D/I�N�C i�r/.S-
City/StatrJap: (f!J 7-411 7- M . 4 431'Phon;e47
Are you an employer?Check the appropriate box: T . of o'ect r nire _
4_ I am a contractor and I � � 7 �� � �-
1.❑ I am a employer with ❑ 6. D<New won
employees(full andlorpa t-time)* have hired the sub-contractors.
2.❑ I am a sole propaetor or partner- listed on the attached sheet 7- ❑Rrrodelmg
ship and have no employees These sub-contractors have g. ❑Demolition
woding for mein any capacity employees and have workers' y_ ❑Building addition
[No.workers' comp.insurance comp.insu l
required] 5_❑ We are a corporation and its MCI Electrical repairs or additions
3_ I am a homeowner doing all work offters have exercised their 1I_❑Plumbing repairs or additions
f [No workers'cxrmp- right of eiemptioa per MGL 12_❑Roof
-insurance required.]$ c.152,§1(4),and we have no
repairs
employees_[Na 13-❑Other
comp.insurance required:]
*Aay sapti thzt checks boa-#1 must also fill out the section below showing�wari'cers'mnapeasatioar policy infumution-
Hnmeaaners who submit this sfdzvia in&csbxrg they are doing al'1 VUI and then hag outside contnrctnrs ra=submit a URW afd.mit i1 di fn such_
lContrsctors that check this boat mmt attached awadditional sheet d o wmb the nme of the sub-mars znd state whether ornot Sense enhfes Gave
eplayees- If the sub-contnctars hate employees,they must provide their markers'comp.policy number.
-Taman employer ihatisprovidi►rg it�orkers'conWerLs r l n irzmirarece for r ty enTloyegs. Below is the parity and,}ob site
information.
Insurance Company-Name-
Policy;9 or Self-ins_Lic-4: Expiration Date:
Job Sites Address: city/State P:
Attach a copy of the workers'compensation policy declaration page(showing the policy number• and expiration date).
Failure to secare coverage as mquired 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-yearimprisonment,as well as civil penalties in the form of a STOP WORE:ORDERand 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
hn-estigations of the DIA for insurance coverage-verification-
I do hereby certify render the pains and penalties ofperjury�the informafion protdded abinw is hue and correct
�
Sizoature- s� , 1. // Date:
Phone 9: 3, / 3 Cl- /—�C�
(IJf%c1�=97wilj--Dowo is Derr,-ta bs compte#ed by-city or town afcia
City or Town:. PermitUcense#
Issuing Authority(dr-cle one):
1.Board of Health 2.Building Department 3.CitVFown Clerk 4.Electrical Inspector 5.Plumbiug Inspector
6.Other
Contact Person: Phone#:
6
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire,
i' 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 sus that"every state or Iocal licensing agency shall with the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for ally
applicant who has not produced acceptable evidence of compliance with the insurance.coverage required."
Additionally,MGL chapter'152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s) of
insurance. Limited Liability Companies-(LLC) or Limited Liability Partnerships(LLP)with Do 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 ins rancz coverage. Also be sure to sign and date the affidavit 'I1ie of adavit should
be retumed 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. Sells insured companies should enter their
self-insurance license number on the appropriate lime.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
tom
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 ill (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 hike 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:
ne Comiaonwealth of Massachusetts
Department of Industrial Accidents
Office of kyestigatxons
600 Washington Street
Boston,MA G2111
Tel A 617-72 r-4900 W 4-06 or 1-a77-MASWE
Revised 4-24-07 Fax# 617-727-7749
w .mas,3 govldia
Town of Barnstable
Regulatory Services
��oFttce roiyy Richard V.Scali,Director
° Building bivision
r • -
t 4
$ARNS'ABM ' Tom Perry,Building Commissioner
16 ��� 200 Main Street, Hyannis,MA 02601
TES MAC a
www.town.barnstable,ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
^ Pease Print
DATE: vS_ ZO I JOB LOCATION: J /4-8 E Sf ATE �014 C Q'7 LI/T 1111/d
- O Z 6 5j )
number steet village/
"HOMEOWNER': Al3B � F d/a/iii.I�e-cam �.ey5 7' /r/i e-A 1-,4-'!5 iG Cv 77ae 3a
name C home phone# work phone# ,384 6
CURRENT MAILING ADDRESS: A-,e, ti 6. e CIE
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 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 &ReguIations 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 last page
of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in
your community.
Q:\WPFILES\FORMS\building permit fonns\EXPRFSS.doc
Revised 061313
�TME rti Town of Barnstable
Regulatory Services
B"Ny MASS.�E�` Richard V.Scali,Director
p 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
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.
1
(Address of Job)
" 'Pool fences and alarms are the responsibility of the applicant. Pools `
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner Signature of Applicant
Print Name Print Name
Date ,
Q:FORMS:O WNTERPERMISSIONPOOLS
DECLARATION OF TRUST
ESTABLISHING
THE ABBEY GATE NOMINEE TRUST
Wendy Franco of 5155 N Highway A1A#311, Fort Pierce, Florida and Nicholas D Franco of 5155 N
Highway A1A#311, Fort Pierce, Florida (the"Trustees".), hereby declares that Ten (10) Dollars is held in
trust hereunder and any and all additional property and interest in property, real and personal,that may
be acquired hereunder(the "Trust Estate")shall be held in trust,solely as nominee,for the sole benefit
of the individuals or entities listed in.the Schedule of Beneficiaries in the proportions stated in said
Schedule,which Schedule has this day been executed by the Beneficiaries and filed with the Trustees
with receipt acknowledged by at least one Trustee (hereafter, as it may be amended, "Schedule of
Beneficiaries').
SECTION ONE
Name and Purpose
1.1 This Trust shall be known as THE ABBEY GATE NOMINEE TRUST and is intended to be a
nominee trust, so-called,for federal and state income tax purposes and to hold the
record legal title to the Trust Estate and perform such functions as are necessarily
incidental thereto.
SECTION TWO
Trustees
2.1 In the event that there are two Trustees,ANY ONE TRUSTEE may execute any and all
instruments and certificates necessary to carry out the provisions of the Trust. In the event there are
more than two Trustees,ANY TWO TRUSTEES,except as otherwise provided in Paragraph 6.2, may
execute such instruments and certificates necessary to carry out the provisions of the Trust.
2.2 No Trustee shall be required to furnish bond. No Trustee hereunder shall be liable for
any action taken at the direction of the Beneficiaries,nor for any error of judgment nor for any loss
arising out of any act or omission in the execution of the Trust so long as acting in good faith, but shall
be responsible only for his or her own willful breach of trust. No license of court shall be requisite to the
validity of any transaction entered into by the Trustees. No purchaser,transferee, pledge, mortgagee or
hall der any liability to See to the application of the purchase money or of any money
other lender sndu be u��u�� any ,
or property loaned or delivered to any Trustee or to see that the terms and conditions of this Trust have
been complied with. Every agreement,lease,deed,mortgage,note or other instrument or document
executed or action taken by the person or persons appearing from the records of the Registry of Deeds
to be Trustees,as required by Paragraph 2.1,shall be conclusive evidence in favor of every person
relying thereon or claiming thereunder that at the time of delivery thereof or of the taking of such
action this Trust was in full force and effect,that the execution and delivery thereof or taking of such
action was duly authorized, empowered and directed by the Beneficiaries.
I
SECTION THREE
Beneficiaries
3.1 The term "Beneficiaries" shall mean the persons and entities listed as Beneficiaries in
i the Schedule of Beneficiaries and in such revised Schedules of Beneficiaries,from time to time hereafter
executed and delivered as provided above and the respective interests of the Beneficiaries shall be as
therein stated.
3.2 Decisions made and actions taken hereunder(including without limitation, amendment
of this Trust; appointment and removal of Trustees; directions and notices to Trustees; and execution of
documents)shall be made or taken, as the case may be, by all of the Beneficiaries.
3.3 Any Trustee may without impropriety become a Beneficiary hereunder and exercise all
rights of a Beneficiary with the same effect as though he or she or it were not a Trustee. The parties
hereunder recognize that if a sole Trustee and a sole Beneficiary are one and the same person, legal and
equitable title hereunder shall merge as a matter of law.
i
SECTION FOUR
Powers of Trustees
4.1 The Trustees shall hold the principal of this Trust and receive the income therefrom for
the benefit of the Beneficiaries,and shall pay over the principal and income pursuant to the direction of
all of the Beneficiaries and without such direction shall pay the income to the Beneficiaries in proportion
to their respective interests.
4.2 Except as hereinafter provided in case of the termination of this Trust,the Trustees shall
have no power to deal in or with the Trust Estate except as directed by all of the Beneficiaries. When,
as, if and to the extent specifically directed by all of the Beneficiaries,the Trustees shall have the
following powers:
4.2.1 to buy, sell, convey, assign, mortgage or otherwise dispose of all or any part of the Trust
Estate and as landlord or tenant execute and deliver leases and subleases;
4.2.2 to execute and deliver notes for borrowing for the Beneficiar1es;
4.2.3 to grant easements or acquire rights or easements and enter into agreements and
Arrangements with respect to the Trust Estate;
4.2.4 to endorse and deposit checks in an account for the benefit of the Beneficiaries;
4.2.5 but the Trustees shall have no authority to maintain bank accounts in the name of the
trust or trustees but they may maintain bank accounts in the name of Beneficiaries. In
the event of a violation of this subparagraph, the Trustees shall indemnify and save
harmless the Beneficiaries from any liability resulting therefrom, including taxes and
accounting expenses.
Any and all instruments executed pursuant to such direction may create obligations extending over any
periods f time, including periods extending beyond the date of any possible termination of the Trust. A
direction of the Trustees by the Beneficiaries may be by a Durable Power of Attorney.
4.3 Notwithstanding any provisions contained herein, no Trustee shall be required to take
any action which will, in the opinion of such Trustee, involve the Trustee in any personal liability unless
first satisfactorily indemnified.
I
4.4 All persons extending credit to,contracting with or having any claim against the
Trustees shall look only to the funds and property of the Trust for payment of any contract,or claim, or
for payment of any debt,damage,judgment,or decree, or for any money that may otherwise become
due or payable to them from the Trustees,so that neither the Trustees nor the Beneficiaries shall be
personally liable therefor. if any Trustee shall at anytime for any reason(other than for willful breach of
trust) be held to be under any personal liability as such Trustee,then such Trustee shall be held
harmless and indemnified b the Beneficiaries,jointly and severally, against all loss, costs, damage, or
expense by reason of such liability.
SECTION FIVE
Termination
5.1 This Trust may be terminated at any time by notice in writing from any Beneficiary,
provided that such termination shall be effective only when a certificate thereof signed by the Trustees,
shall be recorded with the Registry of Deeds. Notwithstanding any other provision of the Declaration of
i Trust,this Trust shall terminate in any event NINETY(90)years from the date thereof, if not earlier
terminated by action of a 'Beneficiary
5.2 In the case of any termination of the Trust,the Trustees shall transfer and convey the
specific assets constituting the Trust Estate,subject to any leases, mortgages,contracts or other
encumbrances on the Trust Estate,to the Beneficiaries as tenants in common in proportion to their
respective interests hereunder,or as otherwise directed by all of the Beneficiaries, provided, however,
the Trustees may retain such portion thereof as is in their opinion necessary to discharge any expense or
liability,determined or contingent,of the Trust.
SECTION SIX
Amendments
6.1 This Declaration of Trust may be amended from time to time by an instrument in writing
signed by all of the Beneficiaries and delivered to the Trustees, provided in each case that the
amendment shall not become effective until the instrument of amendment or a certificate setting forth
the terms of such amendment,signed by the Trustees, is recorded with the Registry of Deeds.
i
I
SECTION SEVEN
Resignation and Successor Trustee
7.1 Any Trustee hereunder may resign at any time by an instrument in writing signed and
acknowledged by such Trustee and delivered to all remaining Trustees and to each Beneficiary. Such
resignation shall take effect on the later of the date specified therein or the date of the recording of
such instrument with the Registry of Deeds.
7.2 Succeeding or additional Trustees may be appointed or any Trustee may be removed by
r •.�Ic �., c�rh race th?t�
an instrument or instruments in writing signed by aii of the Beineiiciar ies, provided in ..nrin rn--�
certificate signed by ANY TRUSTEE naming the Trustee or Trustees appointed or removed, and in the
case of an appointment,the acceptance in writing by the Trustee or Trustees appointed,shall be
recorded in the Registry of Deeds. Upon the recordation without the necessity of any conveyance, be
vested in said succeeding or additional Trustee or Trustees,with all the rights, powers,authority and
privileges as if named as an original Trustee hereunder.
7.3 In the event that there is no Trustee,either through the death or resignation of both
Trustees without prior appointment of a successor Trustee or for any other cause, Richard Thomas
Franco and Christian William Brackett shall be successor Trustees hereunder and may record in the
Registry of Deeds an affidavit, under pains and penalties of perjury,stating that they have been
appointed as successor Trustees. such affidavit when recorded together with an attorney's certificate
under M.G.L.c.183 Section SB, stating that such attorney has knowledge of the affairs of the Trust and
that the person signing the affidavit has been appointed a Trustee,shall have the same force and effect
as if the certificate of a Trustee or Trustees required or permitted hereunder had been recorded and
persons dealing with the Trust or Trust Estate may always rely without further inquiry upon such an
affidavit as so executed and recorded as to the matter stated herein.
SECTION EIGHT
Governing Law
8.1 This Declaration of Trust shall be construed in accordance with the laws of the
Commonwealth of Massachusetts.
SECTION NINE
Registry of Deeds
9.1 The Term "Registry of Deeds" shall mean the Registry of Deeds or Registry District of the
Land Court for the district in the Commonwealth of Massachusetts and.in which the real estate which is
the subject of this Trust is located, and in which this Declaration of Trust is recorded or registered.
1
i
Executed as a sealed instrument this day of ,2013. 1
Wendy Franco
Aicholas Franco
i
r Address
Witness ¢
COMMONWEALTH OF MASSACHUSETTS
.A /a& ,SS ?/`li , 2013
Then personally appeared the above-named Wendy Franco and Nicholas D Franco and
acknowledged the foregoing instrument to be their free act and deed,before me;
i 41)
Notary lic
My commission expires;
I
MAT-THEW R.Rult=m 1 a
Notary Public
COMMONWEALTH OF MASSACHUSETTS
My Commission Expires
December 16.2016
....._......_._.-
NOMINEE TRUST
SCHEDULE OF BENEFICIARY
The undersigned hereby certifies that Wendy Franco and Nicholas D Franco are the sole
Beneficiaries of THE ABBEY GATE NOMINEE TRUST established under the Declaration of Trust dated
under that the following is their beneficial interest thereunder:
Beneficiary Percentage of Beneficial Interest
Wendy Franco 50%
Nicholas D Franco 50%
Held as husband and wife,tenants by the entirety.
I
Successor Beneficiaries Percentage of Beneficial Interest
Nicholas C Franco 25%
28 Seaboard Lane
Hyannis, MA 02601
Mark Franco 25%
c/o Nicholas Franco
28 Seaboard Lane
Hyannis, MA 02601
Keith*B Franco 25%
c/o Nicholas Franco
28 Seaboard Lane
Hyannis, MA 02601
Jacqueline A Dugan 25%
355 Beacon St
Tequesta, FL. 33469
The terms of said Trust are hereby approved and the undersigned Beneficiary agrees with the
Trustees of said Trust(a)to be bound by said Trust,and (b)to save the Trustees harmless from any
personal liability for any action taken at the direction of the Beneficiary,or for any error of judgment, or
for any loss arising out of any act or omission in the execution of the Trust so long as the Trustees act in
good faith,and (c)that the Trustees may withhold from any distribution,transfer or conveyance such
amounts as they from time to time reasonably deem necessary to protect themselves from such liability,
and (d) that each Trustee shall be responsible only for such Trustee's own willful breach of trust and (e)
to reimburse the Trustees for any expenses incurred in the performance of their duties.
Executed as a sealed instrument this day of , 2-013
Wendy Franc Nicholas D Franco
RECEIPT OF SCHEDULE OF BENEFICIARIES
I
1,the undersigned, hereby certify that I am one of the Trustees under said Declaration of Trust
and that the attached Schedule of Beneficiaries has been filed with me this day of
2013.
-Z"Va- r-Irl
Wendy Franco
i
THE ABBEY GATE NOMINEE TRUST
TRUSTEES' CERTIFICATE
I, Wendy Franco, Trustee(s) of the The Abbey Gate Nominee Trust, u/d/t dated Apri122, 2013,
(hereinafter the "Trust") do hereby certify and swear under oath and under the pains and penalties of ,.
pedury,.that:
I
1. I am a Trustee of the Trust;
2. That there are no unrecorded amendments to or alterations or modifications to the Trust and that
the Trust has not been revoked or terminated and remains binding and in full force and effect; i
3. That none of the Beneficiaries of the Trust is: (i) a minor or legally incarrei+a or under any I
guardianship, ii an estate subject to estate tax liens, ui a corporation transferring all or
substantially all of its Massachusetts assets,or(iv) a foreign citizen or entity;
I
4. That the Trust is the sole owner of the property presently known and numbered as of 143 Abbey j
Gate, CotW4 MA 02635 (hereinafter the "Trust Property") and that I/We, as Trustee(s) of the I
Trust, have been fully authorized, empowered and directed by all of the beneficiaries of the
Trust,to sign, seal,execute,acknowledge and deliver, on behalf of the Trust, a deed and any and
all other documents, instruments and agreements incidental to and which I/We, am/are the
Trustee(s) of the Trust, deem necessary in order to effectuate the refinance of the said Trust j
Property. i
I �
5. That the execution,acknowledgment and delivery by me/us as Trustee(s)of the Trust of any and
,a c_1�_.._a .t—J"..to+oh,1,;.,rl t—he Trngt as
all of the aforementioned documents and agreements wur li.uiy auu vvu�,ia.�i.,y .,...� .....
to the covenants and agreements therein contained.
I
Trustee Certificate 13-0739
Executed as a SEALED instrument, under the pains and penalties of perjury this 22nd day of April,
2013
The Abbey Gate Nominee Trust
BY:
Wendy Franco
Trustee
COMMONWEALTH OF MASSACHUSETTS
/lfI ss.
On this Z-�&y of April,2013 before me,the undersigned notary public,personally
appeared Wendy Franco,Trustee(s) of the The Abbey Gate Nominee Trust, proved to me through
satisfactory evidence of identification,'which were to be theffi
person who signed the preceding or attached document in my presence, and who swore or armed to
me that the contents of the document are truthful and accurate to a best of(his) (her)knowledge and
belief.
(official signature and seal of notary)
My commission expires:
MAMEW R.ROBERTSUT
Notary Public
COYAIONWEALTH OF MASgAC}1USET73
MY Commission Expires
December 16.2016
Trustee CertMcate 13-0739
Executed as a sealed instrument this day of 2013.
Wendy Franco
Nicholas D Franco
----------------------------------------
Witness Address
I.OM VIGNVVCALTHN Vf IVIAINALIito- 1�
,SS 02013
Then personally appeared the above-named Wendy Franco and Nicholas D Franco and
acknowledged the foregoing instrument to be their free act and deed, before me;
i
Notary Public
My commission expires;
i
i
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TOWN OF BARMTABLE BUILDING PERMIT APPLICATION .}
t
Map Parcel a, S _ Application # Z n VU&
Health Division Date Issued 07 /O1/-15
Conservation Division Application F e d
Planning Dept. Permit Fee b
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address L' 3 A B 8 E y (SATE
Village C d T U IV T , M ft
vvt'-N-0 'i= 12A /SG(� , TRcJs r�� �4-3 /F13f3G4 C_ttTE
Owner A b�k"y rAT-CE No M iNGar T#2057-Address_moo -ry I JN A . 0A�3�
Telephone 7 7 a — *A a 5
Permit Request (a 0 k a al 4 4o Sc - r-r Mer-,e -pEa s e b Roo
�-
DDL rION '"o EXIST- / N 6- 0Sog-
Square feet: 1 st floor: existing proposed ` LiD 2nd floor: existing proposed Total new *40
Zoning District R F Flood Plain Groundwater Overlay
Project Valuation $501.000 Construction Type Woo b F12#QmE
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 ;KNo On Old King's Highway: 0 Yes XlNo
Basement Type: ❑ Full 0 Crawl Walkout ❑ Other
Basement Finished Area (sq.ft.) l0 Basement Unfinished Area (sq.ft)_ .f/dr
Number of Baths: Full:.existing A new Half: existing / new
Number of Bedrooms: existing /new
Total Room Count (not including baths): existing _7 new First Floor Room Count �-
'Heat Type and Fuel: ❑ Gas XOil ❑ Electric 0 Other
(}Central Air: ❑Yes )(No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ exisjing ❑ new sie_
Attached garage:Xexisting 0 new size _Shed: ❑ existing ❑ new size _ Other: c..
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ,
Commercial ❑Yes XNo If yes, site plan review #
Current Use ri z— Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name /Uo e-#0 LA-6 ��' #A/e o Telephone Number 77a- 3a/- 3 1?6.6
Address License #
1002 6 _`�� Home Improvement Contractor#
10,
Email PJ ri?,+A1r0 err& &STATE 61 G&#ij °�Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE C%�/ a`7�-��DATE /�
FOR OFFICIAL USE:.ONLY
APPLICATION# - -
DATE ISSUED
I
f
MAP/PARCEL NO.
ADDRESS — VILLAGE -
OWNER
DATE OF INSPECTION:
a -' FOUNDATION 8�3e1� J
FRAME �2 t3
INSULATION
'} FIREPLACE
ELECTRICAL: ROUGH FINAL J
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
Department afFz IAcdden,&
. O,ffice oflm�ertrgations .
600 Washington.Street
Bostor4 RA 92M -
Wts►Wmd=gav/bra .
Workers' Compensation Iusm ante AffdaviL-BmldaWCont acfnrsMecbnicLuLVPltmbers
plicau.t Information Please Print Legibly'
Name(hSia s/Organuafioa/lndnvidnan:
77-23-21
Ate you an employer?Check&e appropriate box: ' Type ofproject(reqr&ed):
1.❑ I am a employer WI& 4. Q I am a general ca dmc tm and I
mnpL peas(fall and/or partthm).s have hand the sob-ca*acEon; 6 ❑New conshmc
2.[[ I am a sole pivprietnr or partner- listed cu the aftchod sheet 7. ❑Rcmndclmg
ship and have no cmployoes 7h= have 8. []Dmn nI;4 m
wor3dng forme in'aay capacity employees m dhave wa kers, 9[Na wo ' mpm mcrtrnnr t • ❑p�,Id,,
S��on
rar
5. We are a corpmahmi and rts 10.[]Bloctxicalrepairs or ukHdms
3 I am a homcowne r doing aII work officers have mmidsed them• I L❑plmmbingrcpaks or additions
myself[No wow'cxnmp. . right of wremptionper m(m I2-El Roof rcpaas
fi manco requizr41 t c.152,§I(4),and we have no
employees.[No warkers' 13.[]Otter
cam,insurance ce recluicd-1
*Any appU=atIhmf ehcr m biz#1 mast alm M o'utIm r=f=bcbw shawing t cir w M=pmsaticm Ply
t Hameownca wha sal�rt�is affidavit mdicah'ag Buy ato daiag aII wodc nud�m bae onlsdn uashactna nmst mbn m=WZMdzmtmff=rfmgyc
tCortm cfm rs tbatrh=ktbis boxmmstait Acd as addibainl shcctAm igtho a—afthe sah-=3hm:tos curd sb&v hr#hanrnottb=cmff=have
cmploycm Ifthe saber ban
I am am mpkyer flue is provitritg workers'corrryenaatfan bum nce for M=FLVeM Belary it the po&y and job site
. iirforrnarion, .
Insurance Company Name:
Policy#or Self-ins.Lie.# Exp atiamDafm
Job Site Address: SET:
Attach a copy of the work='mmpeusatiou policy declaration page(showing the policy comber and c4drAiion data).
Fa&=to secure cavemage as regahrd ander Section25A ofMOL,err M cm leadto the imposition of m mma:al penalties of a
fimn'Up to$1,500.00 and/or ana-year aapi sommec4 as VrZ as civil peaalties im the hun of a STOP WORK ORDER and a fine
of no to$250.00 a day against the violator. Be advised that a copy of this statcmeatmay be finwardad to the Office of
Investigations of the DIA f or hmmm a coverage ymificatiem.
I do hrreby crWjy=der the pains and penalties afperjMy that fhC VIforauAan prOMded above is&vz and carr=4
Phone .
O,�udal=e anly. Do not write in this err n�to be conrpkfied by cky or tmm q�rrlaL .
My or Town: Pexmiflf CC=�
—I=d g Authority(circle one):
L Board of Health 2 BtuldmgDepattment 3.CRiffmm C.erk 4.Mmfticallmpector 5.Phambiuglnspector
&Offer
Contact Person: phone : '
' Information and Instractions
e:tfs Gc=zal Laws chapter l52 req=w all employers to provide W Caj='CoMp ration fi3rr bate eMPIoyees.
Pmz=ttD this statatr,an m ployee is darned as.every person is fhe service of another under any ofhir ,r,
express or iazplied,oraI orwathen."
Am ezgp oye-is defned as"an.inciivi A pmtm=bip associaticm,c mporatiom or adier legal a ft or EM two or mm-D
of the ffiregoing=gaged in a joint MfEEI wise,and mcbzdmgf Iegal=pros of a deceased employer,or ffio
receiver or trast=of an kdiividnat partnmzhip,associpfion or'offizde gal enii%employing employers. However the
owner of a dwelling house havingnot mare than fire Hpaztrneofs and who icsi there=,cr ffie occq=t of ffie .
dwailing house of anade:rr who employs prmams to do mevnteoance,caushudion or repair wmk an.sash dwcI mg house
or an tle grounds or b ildmg appurtenant fmm o sbaH not because of sunh emplaymmt be deemed to be a a employer."
MGL raspier 152,§25g6)also stems that'every stab:or local liir•rng ageucyshaII Wit hold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
appli=twho has nut produced acceptable evidence of cdmpM mce With tan nnsuranceq coverage required."
Atidhionaly,MG'L chapter 152,§25C(7)sW='Tefther the commonwealth nor any ofits political subdivisions shall
enter m10 any contrad firtheperformanco ofpoblio wmkmntzl acceptable evidence of compliance with the rosa¢ancd..
reg irenj is of this chapterhave lien presented to toe CMAMCffig aaffi01Y-" -
Applicants
Please fill out fine wozio:[s'compensation affidavit completnbY by rhecJcing Iho boxes fast apply to your situation and,if
necessary,amply sob-contrachor(s)mmne(s), address(es)and phone noxnber(s)along with.taes cerbficate(s)of
insurance. Lmmrtrd Imbfirty Companies(LLQ or LimutrdLiabz7ity Pips(LLP)wiffino employ=oil=ihm the
members or pmt=c%are not rid to carry wmkme cazzzpomfia a fim= nee. If an LLC or LLP does have
employees,&policy is regained. Be advised tbatthis affidayhmaybe suhmi ttmd to the Depattnm t of Industo.al
Accidents for armfamaffin ofiosarance coverage. Also be sure to sign and date the affidavit The affidavit should
be re5mned to the city or town flat the applicatim for the pemit or license is being requested,not the Depaztme It of
Indust dal Accident& Shouldyon have say grusfioms regarding the hrw or ifyou are repaired to obtain a worlarrs'
_campeusationpolicy,Please call the Department at toe mnober listed below Self-insured campanies should enter their
self insurance license nnaber on the appmpii er line.City or Town Officials
Please be sore that the affidavit is complete and printed legzbIy. The Department has provided a space at the bottom
of the affidavit for you to fill not in the event the Office of_mestigatans has to contact you regarding the applicant.
Please be sure to ML is the peanit/liceose mzmbe r which will be used as a refhre nce number. In addition,an applicant
that must sabmit multiple pemnitlLic=se gThtziams in any given.year,need only m3hank one affidavit indicafmg cuurnt
policy fi fonmation.(if necessary)and under`Job Site Addzcss"the applicant should write"all locations in (may or
town)."A copy of the affidavit that has be=officially stamped or mmimd bythe city or town may be provided 10 the '
applicant as proof that a valid affidavit is on file fior fire permits or licenses. A new af3adav�must be fiIled out each
year.Whmro a home owner or cruets&is obtaining a license or prmrt notr@Bt edto any business or ca®.mmmal Vdn.f .
(i.e.a dog licmose or pm3nak to bum leaves dc.)said person is NOT required to complete this affidavit
The Office of Investigations vudd lflm to fl okyoain advance faryour coopedinn and shouldyoa have say questions,
please do not hcsitsin to give us a call-
TEm DeRart 's address,telephone and faxnumber: - • "
Tba fire of M.�� P�. -
Depadmmt of l�&zfdel Aci:eat%
OMCC of jWeSt!&ti=,3
600Wt
Bostoao,MA 02111
'Tel.#617?27-49Q4 eit 4€6 or 1-477 MASS
Fax#617 727 774
Revised42447 MaS5 gldia
- --•--•---- --- --- --=---------- - -7---
' fw • .
AfVC Guide to )Mood Construcdau in High Hrznd Areas: 110.mph )Find Zone
Massachusetts Checklist for Compliance (7s0 CiNiR53ol.7-I.i)r
Loadtiearing Wall Connections
Lateral(no.of 16d common nails)......._..._._...:......_(Tables 7)........
___................__...._.....__..
Non-Wadbearing Wag Connections
Lateral(no.of 16d common nails)-.._.......__.._.-.....(Table 8).-.....__..._.__..
Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9)
Header Spans ....._.......__...____......_:.........._.(Table 9)__...:...___...._..._....—a in.511'
Sig Plate Spans ___._........._._..---.,..-.(Table 9)_........._.._...._.._......_it_in.911'
Fug Height Studs (no.of studs)._..__._-..._....:.:......(Table ..........
Non L oad Bearing Wag Openings(record largest opening but check ail openings for compliance to Table 9)
HeaderSpans......_.._....._.._...___.....:..__.._..__...(Table 9).._...._.....-..__._........_ft_in.512'
Sig Plate Spans.... _._._.._. able 9
Fug Height Studs(no.of studs)..._....._...._...r...._....(fable 9)._............._.._..__.:.__.___..._...._
Exterior Wag Sheathing to Resist Uplift and Shear Slmultaneousiy4.
Minimum Building Dimension,W
Nominal Height of Tallest Openine -.....................
SheathingType...._._...__......_.._._.- ._...!(note 4):e,......._..................__._....-.-.-......
Edge Nail Spacing............: ........-'..,._"(Table 10 or note 4 if less).__........__....:. in.
Feld Nail Spacing .... able 10 in.
a
Shear Connection(no.of 15d common nails)(Table 1 D)...• ,.....__..._..__... ..M.__...-
Percent Full-Rei ht Shea thin able 10 °
MAdditional Sheathing for Wag with Opening>WB'(Design Concepts)_.__._._...
Maximum Building Dimension,L
Nominal Height of Tallest Opening2.....-_....................................................0.0---------
Sheathing Type...... .(note 4)...._...._._....__-..._.._....__..._...
Edge Nail_Spacing...___.__._... ....(Table i 1 or note 4 if less)....._................ in. .
Feld Nag Spacing._.._....__....__._....._-,(Table 11).._...._.....,----..._..__.....,_..._ in.
Shear Connection(no.of 16d common nags)(fable 11)............._._......
..._.:...,_;._.._.._
Percent Full-Height Sheathing..._.;_�..�._(fable 11).......
5%Additional Sheathing for Wall with'Opening>6'8'(Design Concepts)_-._._....._:..
Wall Cladding
Ratedfor Wind Speed?......_...........................__........_..............__........._._-__.__...._...__._.--......._ -
5.1 f ZOOFS '
Roof framing member spans checked?._...._..:..___...(For Ratters use AWC Span Tool,see MRS Website)
Roof Overhang ......................___....................(Figure 19).............—ft 5 smaller of 2'-or U3
Truss or Rafter Connections at L oadbearing Wags
Proprietary Connectors
..:..U= pif
Uplift........._._........_._._._-r:._..(Table 12)_...._....................__..._. -
Lateral...._.__.........._..._....._.......(Table 12)_..__._..___...___..__....._..L= pif
5hear.�.__.._...._........�._.�...._-.(Table 12)...........-...._.----------._...S= '.Pif.
Ridge Strap Connections,if collar ties not fised per page 21... (fable 13)..__._......._.....__._T= pif
Gable Rake Outlooker........._......:_...._........_.._.(Figure 20)..........__ft s smaller of 2'or L2
Truss or Rafter Connections at Non-Loadbearing Walls'
Proprietary Connectors
Uplift._.._-_.:...._._..:..._.__.._. (Table 14)_....._._.__._...._.�...:....�U= Ib.
Lateral(no.of 16d common nags)_.(Fable 14)......................................L= . lb.
Roof Sheathing Type____.__.:.._.._...__...._...._..(per 7B0 CMR Chapters 5B and 59)............
In.>_TI16'WSP
Roof Sheathing Thickness_........... .:.....:....._.....____...........__._..:__ � .
Roof Sheathing Fastening._._.....-.__...-_---.-'(Table 2)_.............__%....._..._-.._._._..._._.._
Notes:'
-1. . This checklist shag be met In its entirety,excluding the spedfic exception noted In 2,to comply with the requirements of
7B0 CMRS30121.1 Item 1.If the checidlst is met In Its entirety then the following metal straps and hold downs are not
required per the WFCM 110 mph Guide: • .
a. Steel Straps per Figure 5
b. 2b Gdge Straps per Figure 11
m Uplift Straps per Figure 14 '
d. Ali Straps per Figure IT
e. Comer Shed Hold Downs per Figure 16a and Figure 1Bb
2. Exmpb=Opening heights of up to 8 fL shall be permitted when 5%Is added to the percent fuMeight sheathing
'requirements shown In Tables 10 and 11.
3. The bottom stg plate in extiMor wags shag be a mh nium 2 in.nominal Uckness pressure treated#2-gra4e. '
A FYC'Guide to Wood Construction ul High Wind Areas:110 tnph irad Zone
Massachusetts Checklist for Compliance(78o m rR s3o i•7.u)'
m= .
' compliaz=
1.1 SCOPE r
WindSpeed(3-sem gust)»._....:»._......_........_...__.._.. ......_........._...»__.........._ _ .110 mph
Wind Exposure Category..»:..._:...__._..._..:...._...�..._.».__.
-Wind Exposure Category................Engineering,Required For Entire Project........................»_.............0
12 APPWCASILITY .
Number of Stories(a roof which exceeds 8 In 12 slope shall be considered a story) stories 5 2 stories
Roof Pitch. _.._..:._..._..»....._.»»-.-.....__..... , ...(Fig 2) ._.._. ..»...».._.......... 512:12
Mean'Roof Height-_.__._...___._._»__...._._......_......_(Fg2)___..,..._.............._........_._._ ft 5'33'
Building Width,W_.»._....._._..._.__».....__._.._....__,-(Fig 3)-.-----.._..:._.....:........».�._._ft s BO'
Building Length,L' .:...._..___._..___...._.__.....:._�_.._:.»(Fig 3).._..._.....».._..........».»...__.:___ft 5 80'
Buldlr g Aspect Ratio F 4 s 3:1
Nominal Height of Tallest OpeningZ .�.._..�....(Fig 4) ._............. SSW
• 1.3 FRAMING CONNECTIONS - ,i • •
General compliance with framing connections»....._.....__.(Table 2)...».._..........................
__._...._.._._.
Z1 FOUNDATION
Foundation Walls meeting requirements of 780 CMR 5404.1
Concrete...........................:.......................:.........................................................................
ConcreteMasonry....... »....._..... ........:.......---..__:»......_.....
22 ANCHORAGE TO FOUNDATIOW-3
5/8'Anchor Solts•imbedded or 518'Proprietary Mechanical Anchors as an alternative in concrete only
Soft Spacing-general..................................»_..:.(1'able - In.
Bolt Spacng from endTointof plate ..»...................... in.5 6'-12'.
Bolt Embedment-concrete_—.__.w.. ..._.......(Fig 5)..»..»___....»_.._..:»..;.._..._.._in.i 7-
Bolt Embedment-masonry._._....._.»»:.....»._._......_(Fig 5)_..-._.r....................___». in.a 15'
Plate Washer..: 5)..__.__ is 3'x 3'x%'
3.1 FLOORS
Floorframing member spans checked ...__.....»»..__._._.(per 780 CMR Chapter 55)_...-.._.._.._..
Maximum Floor Opening Dimension (Fig 6)....._..... _._...__.»......._._.........._ft512,
Full f elght Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)..:....................................
Mh)dmiim Floor Joist Setbacks
Suppoiting Loadbearing Walrs or Shearwall...._.._...._(Fig 7)......................__._.._.._...»_.._.. ft s d
Maximum Cantilevered Floor Joists T
Supporting Loadbearing Walls'or 5heaiwall».._...-.__(Fig 8)-_._.__»....-- ..»_ft s d
FlooFBracing at Endwals__.._.._........_»._._...»._.._....__(Fig 9)-._.._...._.._..._.__.....
Floor Sheathing Type ....__.».._.._.......:____.._.»._.......(per 780 CMR Chapter 55) .......
Floor.Sheathing Thldmess_......._.»._..._»..»..._...._:..._(per 780 CMR Chapter 55)..........._..:..:.». - In.
'Floor Sheathing F-Istening__»........_......._..__»._..__..:..(ratite 2)_—d nails at In edge/_in field
4.1 WALLS "
Wall Height '
• Loadbearing walls._._._..-_....__»....__..»......_......_(Flg 10 and Table 5)_........�.............—ft 510'
...:.».._..». F 10 and Table 5 ft's 20'
.. Non-Loadbearing walls_»..._».:._.._...._.._. (Fig )..._.».........._._....—
Wall Stud Spacing .....__.._..._...._..:...._»___.».........._(Fig 10 and Table 5)..__.......»_—In.s 24'o.c.
Wall Story Offsets (Figs 7!L 8)_».._...»......_......_....» —ft s d
42 OcTmoR•WALL.S� .
Wood Studs
Loadbearing wails...._._»._...........__......_._.r...._(1'able5)..»._._.........__»»_.�c_- ft in.
Non-Loadbearing walls ...».».__» able 5 --ft—In.- -
(T )............:..........._»..2x .
' Gable End Wall Bracing'
.__.__._......_._.._-. —
Full Helg'ht Endwall Scuds...________ ...__..._ .(Fig 10)- _ _....._.....»......_ ...:».�
WSP•AttiaFloorLength__»_._.»_... .._...._..._.(Fig 11)__..._..._»...»......._»..»_. ftZW/3 _
'Gypsum Carling Lengthy(If WSP not used) (Fig 11)_.._.._..._._ ....»........_. _ft;-.
and 2 x 4 Continuous Lateral Brace @ 6 ft.o.m-Fig 11)...............................
_._.......__.......,....
or 1 x 3 celling furring strips @ 16'spacing min.with 2 x 4 blocidng @ 4 ft.spacing in end Joist or truss bays
Double Top Plate
Splice Length ....»_....._:___....._.._.» _......(Fig 13 and Table 6)..._..-..._...»_..._..... —ft
Splice Connection(no.of 15d common nai'Ls)..»..__»..(Table 6)._.._......»......»._........�._._._».... .
tlWC Guide to Wood Construction ia►High ja�inrli{reas: I10 ntpl► fr7rrd Zone
Massachusetts Cheddist for. Compliance(790 CIAR s-3Ot.zJ:l)'
4. "
a From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height
Sheathing and Nap Spacing requirements
b. Wood Structural Panels shall be minimum thickness of 7116"and be installed as fonows:
. L Panels shall be installed With strength axis parallel to studs,
t Ali horizontal joints shall occur over and be nailed to framing.
pL On single story construction,panels shall be attached to bottom plates and top member of the double
top plate.
Iv. On two story construction,upper panels shall be attached to the tap•member of the upper double top
plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band Joist
and lower attachment made to lowest plate at first floor framing.
v. Horizontal nall spacing at double top plates,band Joists,and girders shall be a double row of ad
staggered at 3 inches on center per figures below:Vertical and Horimntal Nailing for Panel Attachment
5. Glazing protection:a)new house or horizontal addition—required if project Is 1 mile or closer to shore(generally,south of
Rte.28 or north of Rta.6)
b)vertical addition—not required unless there is extensive renovation to the first'tioor
c)replacement ivtridows—needs energy conservation compliance only(chap 93)_
6.Wood Frame Construction Manual(WFCM)for 110 MPH,Exposure B may be obtained from the American Wood Council
(AWC)website.
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See Detail on Next Page -
Dahill
Vertical and Horizontal Nailing Vertfaal and Horizontal Nailing
. 1or Panel Attachment for Panel Attachment "
.t.
• :�
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.. .. ..
i
_ ,�
Town of Barnstable
Regulatory Services
'AMISTANX g Richard V.ScaI4 Director
ibsp. �e
Building Division
Tom Perry,Biking Commissioner -
200 Main St cet,Hymns,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 .Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
herebyauthorize to act on mybehA
in all matters relative to work authorized bythis building pe=it application for.
(Address of Job)
''-Pool fences and alarms are the responsl ity of the applicant. Pools
are not to be filled or utilized before fence is installed and all final
inspections are perform d and accepted.
Signature of Owner Signature of Applicant
Print Name Pont Name
Date
WORMS:OWNMERNESSMIeWIS
1
Town 01•15arnstable
Regalatorp Services
`of f roYyy Richard V.Sca%Director
Building NVWOU
_ XUMTA M ` Tom Perry,Building Commissioner
BEAM
.�� 200 Main Stiff Hyannis,MA 02601 .
www town.barnstablema_ns
Office: 508-862-4038 Fax 508-790-6230
HOMEMU R LICENSE IIEPION
DATE: '
JDB i OCATIM 3 i�T� I�e s¢�' Cd fill 7-1 Aid • 0-2 6 3s—
number shot' vMW
-aohMOWNSR':A11Mo/C -5 AMYCO 772 3 a l 31F46
name - QQ home phono f ,/� worts phone
y __ CURRM4T MAILING ADDRESS: H 3 �+ �t�/�T� ( ( ,O Ty/ T �A-
CsUTU/T' .^49L
citYAMM shag zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of sic units or less and to allow
homeowners to engage an individual far hire who does notpossess a license,provided that the owner acts as supervisor_
DE INUION 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 faum 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 build: 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. _
I
The undersigned`homeowner"certifies that he/she understands the Town ofBamstabIa Building Department mmimmn inspection
procedures and requirements and that he/she will comply with said procedures and=IL*ccments.
Signature ofHomcowncr
Approval ofBuuldingOfcial
Note: Three family dwellings containing 35,000 cubic feet or huger will be required to comply with the State Building Coda
•Section 127.0 Construction Control.
HOM}tOWNER'S EXXhgTION
The Code states that: "Any homeowner performing work for which a building permit is required shill,be exempt
from the provisions of this section(Section 109.Ll-Licensing of constrmction Supervisors);provided that if the homeowner
engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor
(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often
results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot
proceed against the unlicensed person as it would with a licensed.Supervisor. The homeowner acting as Supervisor is
ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the
permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page
of this issue is a form currently used by several towns. You may can t amend and adopt such a form/certification for use in
your community.
Q.XVPFII.ESIFORMSIbmldmgpermitfn=AE PPM&doc
Revised 061313
r
DECLARATION OF TRUST
ESTABLISHING
THE ABBEY GATE NOMINEE TRUST
Wendy Franco of 5155 N Highway AlA#311, Fort Pierce,Florida and Nicholas D Franco of 5155 N
Highway AlA#311, Fort Pierce, Florida(the"Trustees"),hereby declares that Ten(10) Dollars is held in
trust hereunder and any and all additional property and interest in property, real and personal,that may
be acquired hereunder(the"Trust Estate")shall be held in trust,solely as nominee,for the sole benefit
of the individuals or entities listed in the Schedule of Beneficiaries in the proportions stated in said
Schedule,which Schedule has this day been executed by the Beneficiaries and filed with the Trustees
with receipt acknowledged by atleast one Trustee (hereafter, as it may be amended, "Schedule of
Beneficiaries").
SECTION ONE
Name and Purpose
1.1 This Trust shall be known as THE ABBEY GATE NOMINEE TRUST and is intended to be a
nominee trust,so-called,for federal and state income tax purposes and to hold the
record legal titleto the Trust Estate and perform such functions as are necessarily
incidental thereto.
SECTION TWO
Trustees
2.1 In the event that there are two Trustees,ANY ONE TRUSTEE may execute any-and all
instruments and certificates necessary to carry out the provisions of the Trust. In the event there are
more than two Trustees,ANY TWO TRUSTEES,except as otherwise provided in Paragraph 6.2,may
execute such instruments and certificates necessary to carry out the provisions of the Trust.
2.2 No Trustee shallbe required to furnish bond. No Trustee hereunder shall be liable for
any action taken at the direction:of the Beneficiaries, nor for any error of judgment nor for any loss
arising out of any act or omission in the execution of the Trust so long as acting in good faith, but shall
be responsible only for his or her own willful breach of trust. No license of court shall be requisite to the
validity'of any transaction entered-into by the Trustees. No purchaser,transferee, pledge, mortgagee or ,
other lender shall be under any liability to see to the application of the purchase money or of any money
or property loaned or delivered to any Trustee or to see that the terms and conditions of this Trust have
been complied with. Every agreement, lease,deed,mortgage,note or other instrument or document
executed or action taken by the'person or persons appearing from the records of the Registry of Deeds
to be Trustees,as required by Paragraph 2.1,shall be conclusive evidence in favor of every person
relying thereon or claiming thereunder that at the time of delivery thereof or of the taking of such
action this Trust was in full force and effect,that the execution and delivery thereof or taking of such
action was duly authorized,empowered and directed by the Beneficiaries.
SECTION THREE
Beneficiaries
3.1 The term "Beneficiaries"shall mean the persons and entities listed as Beneficiaries in
the Schedule of Beneficiaries and in such revised Schedules of Beneficiaries,from time to time hereafter
executed and delivered as provided above and the respective interests of the Beneficiaries shall be as
U ICI ciII stated. '
3.2 Decisions made and actions taken hereunder(including without limitation, amendment
of this Trust;appointment and removal of Trustees;directions and notices to Trustees; and execution of
documents)shaii be made or taken,as the case may be, by all,of the ne,neficiaries.
3.3 Any Trustee may without impropriety become a Beneficiary hereunder and exercise all
rights of a Beneficiary with the same effect as though he or she or it were not a Trustee. The parties
hereunder recognize that if a solve Trustee and a sole Beneficiary are one and the same person, legal and
equitable title hereunder shall merge as a matter of law.
SECTION FOUR
Powers of Trustees
4.1 The Trustees shall hold the principal of this Trust and receive the income therefrom for
the benefit of the Beneficiaries,and shall pay over the principal and income pursuant to the direction of
all of the Beneficiaries and without such direction shall pay the income to the Beneficiaries in proportion
to their respective interests.
4.2 Except as hereinafter provided in case of the termination of this Trust,the Trustees shall
have no power to deal in or with the Trust Estate except as directed by all of the Beneficiaries. When,
as, if and to the extent specifically directed by all of the Beneficiaries,the Trustees shall have the
following powers:
4.2.1 to buy,sell,convey,assign,mortgage or otherwise dispose of all or any part of the Trust
Estate and as landlord or tenant execute and deliver leases and subleases;
4.2.2 to execute and deliver notes for borrowing for the Beneficiaries;
4.2.3 to grant easements or acquire rights or easements and enter into agreements and
Arrangements with respect to the Trust Estate;
4.2.4 to endorse and deposit checks in an account for the benefit of the Beneficiaries;
4.2.5 but the Trustees shall have no authority to maintain bank accounts in the name of the
trust or trustees:but they may maintain bank accounts in the name of Beneficiaries. In
the event of a violation of this subparagraph,the Trustees shall indemnify and save
harmless the Beneficiaries from any liability resulting therefrom,including taxes and
accounting expenses.
I
Any and all instruments executed.pursuant to such direction may create obligations extending over any
periods f time, including periods extending beyond the date of any possible termination of the Trust. A
direction of the Trustees by the Beneficiaries may be by a Durable Power of Attorney.
4.3 Notwithstandingany provisions contained herein, no Trustee shall be required to take
any action which will, in the opinion of such Trustee, involve the Trustee in any personal liability unless
first satisfactorily indemnified.
4.4 All persons extending credit to,contracting with or having any claim against the
Trustees shall look only to the funds and property of the Trust for payment of any contract,or claim,or
for payment of any debt, damage,judgment,or decree,or for any money that may otherwise become
due or payable to them from the-Trustees,so that neither the Trustees nor the Beneficiaries shall be
personally liable therefor. If any Trustee snail at anytime for any reason(other than for willful breach of
trust) be held to be under any personal liability as such Trustee,then such Trustee shall be held
harmless and indemnified b the Beneficiaries,jointly and severally,against all loss, costs,damage,or
expense by reason of such liability.
SECTION FIVE
Termination
5,1 This Trust may be terminated at any time by notice in writing from any Beneficiary,
provided that such termination shall be effective only when a certificate thereof signed by the Trustees,
shall be recorded with the Registry of Deeds. Notwithstanding any other provision of the Declaration of
Trust,this Trust shall terminate in any event NINETY(90)years from the date thereof, if not earlier
terrininated by action of as BenefiiJary.
5.2 In the case of any termination of the Trust,the Trustees shall transfer and convey the
specific assets constituting the T>ust Estate,subject to any leases,mortgages,contracts or other
encumbrances on the Trust Estate,to the Beneficiaries as tenants in common in proportion to their
respective interests hereunder,or as otherwise directed by all of the Beneficiaries, provided, however,
the Trustees may retain such pottion thereof as is in their opinion necessary to discharge any expense or
liability, determined or contingent,of the Trust.
SECTION SIX
Amendments
6.1 This Declarationof Trust may be amended from time to time by an instrument in writing
signed by all of the Beneficiariesand delivered to the Trustees, provided in each case that the
amendment shall not become effective until the instrument of amendment or a certificate setting forth
the terms of such amendment,signed by the Trustees,is recorded with the Registry of Deeds.
SECTION SEVEN
Resignation and Successor Trustee
7.1 Any Trustee hereunder may resign at any urne by aan iitstr umem t it,;-1-1a..D.. land
a�•o•
acknowledged by such Trustee and delivered to all remaining Trustees and to each Beneficiary. Such
resignation shall take effect on the later of the date specified therein or the date of the recording of
such instrument with the Registry.of Deeds.
7.2 Succeeding or additional Trustees may be appointed or any Trustee may be removed by
an instrument or instruments in writing signed by all of the Beneficiaries, provided in each case that a
certificate signed by ANY TRUSTEE naming the Trustee or Trustees appointed or removed, and in the
case of an appointment,the acceptance in writing by the Trustee or Trustees appointed,shall be
recorded in the Registry of Deeds. Upon the recordation without the necessity of any conveyance, be
vested in said succeeding or additional Trustee or Trustees,with all the rights, powers,authority and
privileges as if named as an original Trustee hereunder.
7.3 In the event that there is no Trustee, either through the death or resignation of both
Trustees without prior appointment of a successor Trustee or for any other cause, Richard Thomas
Franco and Christian William Brackett shall be successor Trustees hereunder and may record in the
Registry of Deeds an affidavit,unifier pains and penalties of perjury,stating that they have been
_r�r_.: ...L............►A-A rnanthcr with an attorneys certificate
appointed as successor Trusiees Such ofnudvi�w��c, ,cwIuc�
under M.G.L.c.183 Section 5B,stating that such attorney has knowledge of the affairs of the Trust and
that the person signing the affidavit has been appointed a Trustee,shall have the same force and effect
as if the certificate of a Trustee oT Trustees required or permitted hereunder had been recorded and
persons dealing with the Trust or Trust Estate may always rely without further inquiry upon such an
affidavit as so executed and retarded as to the matter stated herein.
SECTION EIGHT
Governing Law
8.1 This Declarationiof Trust shall be construed in accordance with the laws of the
Commonwealth of Massachusetts.
SECTION NINE
Registry of Deeds
9.1 The Term Registry of Deeds shall mean the Registry of Deeds or Registry District of the
Land Court for the district in the:Commonwealth of Massachusetts and in which the real estate which is
the subject of this Trust is located,and in which this Declaration of Trust is recorded or registered.
Executed as a sealed instrument this P-day of 12013.
Wendy Franco
17
,:� IVIl,11lJ1OJ Vn f C
rdlll.V
'�'
Wetness Address ���� � a&-ee� Fe—
COMMONWEALTH OF MASSACHUSETTS
E"
,SS 2013
Then personally appeared the above-named Wendy Franco and Nicholas D Franco and
acknowledged the foregoing instrument to be their free act and deed, before me;
' Notary lic
My commission expires;
MATTHEW R. ROBERTS
�I R1 I Nolary Public
fl
COMMONWEALTH-OF
F ti"ASSAGHUSETTS
My Commission Expires
December 16.2016
I
i NOMINEE TRUST
i SCHEDULE OF BENEFICIARY
The undersigned hereby certifies that Wendy Franco and Nicholas D Franco are the sole
Beneficiaries of THE ABBEY GATE NOMINEE TRUST established under the Declaration of Trust dated
under that the following is their beneficial interest thereunder:
Beneficiary Percentage of Beneficial Interest
Wendy Franco 50%
Nicholas D Franco 50%
Held as husband and wife,tenants by the entirety.
Successor Beneficiariesi Percentage of Beneficial Interest
Nicholas C Franco 1 25%
28 Seaboard Lane
Hyannis, MA 02601 i
Mark Franco ' 25%
C/o Nicholas Franco
28 Seaboard Lane '
Hyannis, MA 02601 ;
KeithB Franco 125%
C/o Nicholas Franco
28 Seaboard Lane
Hyannis, MA 02601
Jacqueline A Dugan i 25%
355 Beacon St I
Tequesta, FL.33469
The terms of said Trust bre hereby approved and the undersigned Beneficiary agrees with the
Trustees of said Trust(a)to be Ijound by said Trust,and (b)to save the Trustees harmless from any
personalliability for any action taken at the direction of the Beneficiary, or for any error of judgment, or
for any loss arising out of any act or omission in the execution of the Trust so long as the Trustees act in
good faith,and (c)that the Trustees may withhold from any distribution,transfer or conveyance such
amounts as they from time to time reasonably deem necessary to protect themselves from such liability,
and (d)that each Trustee shall Ile responsible only for such Trustee's own willful breach of trust and (e)
to reimburse the Trustees for any expenses incurred in the performance of their duties.
Executed as a sealed instrument this day of ,2013
Wendy Franco Nicholas D Franco
li
RECEIPT OF SCHEDULE OF BENEFICIARIES
I, the undersigned, hereby certify that I am one of the Trustees under said Declaration of Trust
and that the attached Schedule of Beneficiaries has been filed with me this day of 419- -(
2013.
J�
Wendy Franco
Town of Barnstable
Regulatory Services
OFF Richard V.Scali,Interim Director
Building Division
• aAexsl'ABM ` Tom Perry,Building Commissioner
nMass.
039. 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: ��'� A ifo�U 7
�n/umber �'—T-- street village
••HOMEOWNER": A/MP Vfi IfO/AS FRAble-0 7/y,1 — A
name T home phone# work phone#
CURRENT MAILING ADDRESS: 14-5 A64 A-V
6-67-01 7- a�� 3s-
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 buildingpermit. (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.
ilzoiWa4me
Signature of Home-owner G� T✓c e.�/ /2 Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required
shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);
provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act
as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of
a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15)
This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed
persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,
as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a
Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend
and adopt such a form/certification for use in your community.
TOWN OF BARNSTABLE BUILDING PERMIT� � .ICATION
�'-(( g"��, - �c
Map Parcel ��.�� , 35Application o
Health Division Date Issued ll 2S
Conservation Division , Application Fee
Planning Dept. dv Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation / Hyannis`
Project Street Address
Village
Owner Address
Telephone
Permit Request 7'i4*. S7�4ru2 p—
6AA-4 w)7W
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed o a new /l 7
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl XWalkout ❑ Other
Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing 0 new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER) CAIt,
Name /j94W6A7Tf 6� &�'�Iephone7tSE5Feb Number 77a'3-/-381,(0 0p— 2I �
AddresPRfZ;YAA/ tu. 7kl- WY-20-icense # CS o s57 4
0�58 A41N 67 Home Improvement Contractor#
�'(,iA7GrS 1a/✓ A* oa3(,y Worker's Compensation # /y/I+
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNAT Ir-A� DATE
FOR OFFICIAL USE ONLY
.—APPLICATION#
DATE ISSUED
r MAP/PARC,EL NU.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION: '
FOUNDATION2�
FRAME
INSULATION
FIREPLACE ~
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
o
GAS: ROUGH FINAL i
4
FINAL$UILDING 3 I5
DATE.CLOSED OUT
ASSOCIATION PLAN NO.
Vie Conmomvealth ofAfmach=dtY
Depotnent aflxdw&WA
offce ffbrPaWgations
600 Warhmgton S&ed
Boshon,MA DzM
mmanamgov✓dia
Workers' Compensation Insurance Affidavit:Builders/ContraCtorsAgzctiiciansffl m abets _
Applicant 7�oformaiion Please Print
Name
Address_k-2 -A�iiV 5T
Gig/S`tabelT.zp: Nt -zsr� Phone. -- '4,-t'g
Are you an employer'!Check the approprh a bocc Type of Project(required):
i.❑ I am a e apIayea with 4 ❑I am a gwcal and"I 6. ❑New camst uefi n
fnU and/or e * have baed�sub-a�ac�s
�P�Y ( l �mm �- BAed raf ft shed 7. ❑IL=oc��
2- I am a sole proprietu or pat= nese have
ship and have no employees S. ❑DemoTfian
wodit fay me in any capacity. �r�and bane wor>�s' s ❑Bmldmg addrfon
ENo w03CCIS'�.msmmiae 10-❑Electrical repairs or additions
reqakv&1 5❑ We are a ca qm r2iaa andifs
3.❑-I an a homeow=doing aH work officegs have exmised$lays ME]❑Plambmg repairs or additions
Myself[No ,CMMp- - rlglrtofezmmPtIamperMGL Iz❑Roafrepaizs
msaumcerequired.]t" G 152,§I(4),and we have no 13-❑Odes
emPlayees.END wodOM?
cmmp. xeqnhed-1
*Any ap{tHmmtt6zt b=-V l mm3tzbD fM uu hcsxtiar
tHnmeowaaswhosubmlithe m�g&eyamdomgaII�md&mbi eabide anffisabmitanewaffidavitmpgsazh
xCaalxadns tfn rher]c�s has amst ai�ehed an addi l sh x2 Leo— s� urnatt h=gibes have
=p]ayecs...If&csub-ca mI���ftY�P�
I am an employer drat it protyidiNg workers'compeuon nr=M=efor my emplaveec Below is thepo&cp and�obstte
Wonnadon-
Insmmuce company IQam
Policy#or self-ins.Lic. Date'
Job Sitc;Addres. (ity/stftPlsp.
Attach a copy of the workers' p poficyded.,:,U-P�( tke P�cY�ber and CXph Son irate}.
as under sec flm 25A of MGL a;152 can Ieadtn%e i Wosdia�n of�mal penalties of a
Fadare to secare Coverage re4
fine lap to Sl.=.00 amd/ar onerye izodsamnet,as wedl as caviil pena�s m me taffi of a STOP WORK ORDER and a hire
of up to$250.00 a day agai 3A the vWdOr- Be advised alai a copy of$bis may be��to the Office of
Investigatioms of&e DIA fat msoaa=GOYMP vam-
I do hereby cffAYY- under Pains ndcc pp�emalfes ofPE&DY tka the u¢ormadon proved above is lute and.col .
-;Z 3 r Zyl i¢
Pltoane� ���
p�aat use army_ Do not wri&is thu wm%fa be completcd by city or fawn alai
City
iowi�=
Zug�`'ath°ray(�r]e one): 3.(5dp)TaWn(9erg 4. rical Isspec or 5.PIumbiag IasPednr
L Board of Heap 2 BDepartDuent -
6.ptber
1 Massachusetts -Department of Public Safety
Unrestricted -Buildings of any use group which Board of Building Regulations'and Standards t,
contain less than 35,000 cubic feet 991M3 of
Construction Supervisor
enclosed space. License: CS-055714
♦ • i. t tk �r i:fi
CHIUSTIAN W BY ACKEfT�T.
258 MAIN ST
IQNGSTON MA -02344
IFailure to possess a current edition of the Massachusetts ,
State Building Code is cause for revocation of this license. i �J..9-., �J " " Ex pi ration
For DPS Licensing information visit: www.Mass.Gov/DPS Commissioner 11/20/2014 E,
is
n ie�cruniro•riiuca///1 1/16—AK"Jnc/<ur-//'
Office of Consumer Affairs& Business Regulation License or registration valid for in'dividul use only
-( before the expiration date. If found return to:
OME IMPROVEMENT CONTRACTOR
j — — egistration: 180053 Type: Office of Consumer Affairs and Business Regulation
Expiration: 10(6/2016 DBA
10 Park Plaza-Suite 5170
Boston,MA 02116
C.W. BRACKETT CARPENTRY
CHRISTIAN BRACKETT
258 MAIN ST
KINGSTON, MA 02364 Undersecretary Not valid without signature
I
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I
�VIE Town of Bamtable
. . ReguIatorytServices
Thomas F.C:ea'ier,Direcfnr
Bmlding Division
Tom Perry,Bmld ng Commasinaer
200 Baia Sheet
.El ,s MA 02601
wwvwrtuv barnsfable ma.us
Office: 508-8624038 Fa= 50"0-6730
Property Owner Must
Complete and Sign This Section
IEUgjgW A Builder
w— Z —.as owner of the sablea PmPetty
hereby=ffixd e G Lsl. u�i' to act oa my behalf
in all TM relative to work2uffiadzed by this binding petout:
(Address of Job)
**Pool fences and glnrms are the responsibility of the applicant. Pools
are not to be filled or uOxed before fence is installed and Alt final
inspections are performed and accepted. .
siesta of l x.�!�4-�� ggatare of gPPIiraut
Print N Print Name
Dgta
QYORMOWNWERMEMNMIS M012
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Doll Parcel Application g-MA3�J6630
Health Division Date Issued 1
Conservation Division Application Fee* A
Planning Dept. Permit Fee ff? Ca 0
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address A1.3 66�
Village 6O71Jt`7—
Owner Cv - riAE►vacr. 77Z Nis.Ats 77C Address
Telephone�lo?- 36 �3�6ro
' �NI,Z'12s,oN iyP foul c (/�-9Gsvr2 .o'L9 /
Permit Request kv:�?LM'4F)►7 f�J N��,yS����I� cFt�»=i✓T�.�f�'Nt tS- R�Pc�+ rri�yi
l�-APm. o. R=�c,geur,�hr; .�EGc,•�✓�. %g x i_f'QJ_ds /axis 5 smw'v onl
1324
i0 :A5 .S,�vN%dB . aA .�snaLtd�
JA/W .�� R/��i�✓6 s If aWrIoAX-6 ,
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type Ewl
o � o
Lot Size 0,4/9 Grandfathered: ❑Yes ❑ No If yes, attach s, orting ddcums`5tation.
rrl
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
`'_)I N vo
Age of Existing Structure %Cl A2 Historic House: ❑Yes )�No On Old King's 4ighway:`a YeEOf No
Basement Type: ❑ Full ❑ Crawl lWalkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) r`
Number of Baths: Full: existing— new Half: existing / new
Number of Bedrooms: 1.14 existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas 14 Oil ❑ Electric ❑ Other
Central Air: ❑Yes 14 No Fireplaces: Existing / New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: U4 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes 0 No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
41Voy �v — 7%'?-
Name uJ. Br�Ar.��►�Ca �En/i�2y1 Telephone Number 7P- !VA41 - 966
Address o?5�) I#Aini 57— License # O S< 7/4
Al"/VlrSTyn/ /tO Om2G 3 Home Improvement Contractor# 10_5'34 S
1��1f� �2i4eI<EfaS S �� Corneas:. 1yEl-Worker's Compensation # n/A
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE ���-- !7�& , DATE / 7 ' 1_3
FOR OFFICIAL USE ONLY
APPLICATION# }
s DATE ISSUED_ _- `•
MAP/PARCEL NO. ,
ADDRESS VILLAGE
OWNER
�4 DATE OF INSPECTION:
;,FOUND AT,10NIDAR&M1)AFVOi+itAR&
FRAME
LONSULATION.
FIREPLACE ,
T ELECTRICAL:-,ROUGH FINAL
w
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
` FINAL BUILDINGI341r
}}
I? DATE CLOSED OUT .
ASSOCIATION,PLAN NO. -
The Commonwealth of Massachusetts
Depotnent of fitduv&WAccidents
Office ofbrvestigations
. � 600 Wash�cgton Street
Boston,MA 02III
www.mass gov/dia
Workers' Compensation Insurance Affidavit:Buffders/Contractors/Electricians/Plunabers _
Applicant Information PIease Print Legibly
Name(B»,sincsdOrganizatio-Individwo:
Address: .2r2 •/4IltiAl 5T.
City/State/Zip:�G /V Phone#: W1
Are you an employer?Check the appropriate bow Type of project
1.❑ I am a employer with 4. I am a general contractor and I P I (required)
employees(fall and/or part-time).
* have hired the sub-contractors 6. Q New construction
2. I am a sole proprietor or partner- listed a the ate het she& ?.
ship and have no employees , ,1� These sub-contractors have 8. ❑Demolition
working for me in any capacity.)`1 IN employees and have workers'
t 9. [:]Building addition
[No workers'comp!'insurance comp'insurance' 10.El repairs or additions
required.] s 5.'E] We are a corporation and its
3.0 I am ahomeowner doing all worm . s officers have exercised their 11.❑Plumbing repairs or additions
myself[No workers'comp. ~ right of exemption per MGL
12.❑Roof repai rss
• insurance ]t` �..� c.152,§I(41 and we have no
employees.[No workers' 13.❑Offer
f^,k camp.msaianee rimed.]
*Any applirimt that checks box#1 ums?aso f L out The sxtian bc-1oBvshow ng the vro s'won L�yy i� icn
t Homeowners who submit this affidavit indicating they an:doing all work and then hue outside connactm must submit a new amdavit indicating such
tContractors that check this box most 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 mmV.t provide their woslm&comp.policy nmbet:
I con an employer that is providing workers'eompewadon buu rance for my employees: Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-has.Lic.# Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisomnent,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 stairment may be forwarded to time Office of
Investigations of time DIA for insurance coverage verification_
I do hereby�cat_Vy under thepains andpenaliies ofperjwy that the information provided above is true and correct .
Date: ���3
Phone
Q-fjYrid use only. Do not write in this area,to be completed by oily or town ofjidd
C�ivy or 1 otvn: eel-mil CBJe#
Issuing Authority(circle one):
1.Board of Health L Building Department 3.City/Town Clerk 4.Electrical Inspector 5.PIumbing Inspector
6.Other
J
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Ptasuantto 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,cooporation 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,parineaship,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 appmteuant 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
Plcasc fill out the workers'compensation affidavit completely,by checldng the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),addres (es)and phone number(s)along with their certificates)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(I.LP)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 amber listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town MciaLs
Please be sure that the affidavit is complete and printed legbly. 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 pennrt/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 etn.)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 amber:
The CommonwT4&of Massachusetts
DepaTlrnenl:of 16i&stdal Accidents
Office of ktvestigatians
640 Washington St ceet
Boston,MA 02111
i
TeL#617 727-4900 W 406 or 1-877 MASSAFE
Fax#617-727-7749
Revised 4-24-04
w ►.ma.ssgo a
oFT Town of Barnstable
0
Regulatory Services
! F
Thomas F.Geiler,Director
163g �$
Building Division
Tom Perry,Building Commissioner
200 Main Street;Hyamiis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Ownet of the subject property
hereby authorize C•td. to act on my behaI�
in all matters relative to work auffiozized by this bmlding permit
(Address of Job)
Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
/�i,L�,G'►�y�'�✓�x�,�eQ.!C ate' -
signature of et—,2"�� Signature of Applicant
Gt'.rr�V��1 ��.Ar✓Ct�� C�'s�'�-� u/- �2��=ate
Print Name Print Name
'7 /3
Date
Q:FORMS:OWNERPERMI=NPOOLS 62012
I
J
Town of Barnstable
Regulatory Services
. RA,..,&MAEMr Thomas F.Geiler,Director
.�19- Building Division
Tom Perry,Budding Commissioner
200 Main Street Hyannis,MA 02601
www.towiLbarnstable-ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE E7CEAnMON
Please Print
DATE:
JOB LOCATIOx:
nrmzber street village
-ROMEOWBiElt^:
name home phone W work phone#
CURRENT MAILII IG ADDRESS:
cityhown state up 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,aSiached 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 fur all such work performed under the building hermit (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 Budding Department minimum inspection
procedures and requirements and that he/she will comply with said procedures and requirements.
Signature of Homeowner
'Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code
Section 127.0 Construction Control
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt
from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner
engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor
(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often
results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot
proceed against the unlicensed personas it would with a licensed Supervisor. The homeowner acting as Supervisor is _
ultimately responsfle.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the
permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page
of this issue is a form currently used by several towns. You may caret amend and adopt such a form/certification for use in
your community.
C:\Users\deconk\AppDaffi\Local\ crosoft\Wmdows\T=Porary Internet Files\ContmtoutlooMQRF,6ZUBx\E XTRESS-doc
09/20/2013 16:07 7815850534 KINGSTON SELECTMEN PAGE 02/02
OfticC Of Cooeomer Affairs'!Sc' tisi cvs Rehuindon License or registra4ion'valid for individul.ikse only
OME IMPROVEMENT CONTRACTOR.. before the expiration dnte. if foand rl tWfn'tn:
egistration: 1b6365 Type. Office of Consumer Affstirs and Bus inese,ReEulation
plration:•. 7117Y2014; Indlvldual 1.0 Park Plaza-Suite 5170
Boston,MA 0211.6
CHRISTIAN W,
Christian.Brackett
258;Main Street -••
Kingston, MX 02364
VndcrsArctnry Not valid without slgnnturc
JIM Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Comtruction Sapen'bor
License: CS-055714
CHRISTIAN w
258 MAIN ST
laNGSTON MA;023Gj-*
Expiration
commissioner 11/20/2014
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• Parcel Detail Page 1 of 3
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Logged In As: Parcel Detail Friday,September 13 2013
Parcel Lookup
Par o ,-
P I Ib 021-025 Developer LOT 11A
roc I EY GATE I Pri Frontage 1125
Sec Road I Sec
Frontage
Village 1COTUIT r I Fire District I COTUIT
Town sewer exists at this address I No I Road Index 10001
Asbuilt Septic Scan: Interactive
021025 1 Map
Owner Info
Owner JMCNAMARA, DAVID I Co-Owner /.FRANCO,WENDY TR I
Streets JABBEY GATE NOMINEE TRUST I Street2 143 ABBEY GATE
City I COTUIT I State MA I zip 02635 I Country
Land Info
Acres 0.48 use Single Fam MDL-01 I ing��R�FNghbd 10107
Topography Level I Ro ed i
Utilities I Public Water,Gas,Septic I Location Imarginai View
Construction Info
Buil of 1
Yxt
uilt 1982 S r�ct Salt Box I wall Wood Shingle
A a I1770 Roof AC
Asph/F GIs/Cmp I Type
None
Area Cover Type
�Bed 2:, WDK I
style Saltbox I wall Drywall I Rooms 3 Bedrooms I a�
Model Residential Floor Hardwood Bath
Rooms.2 Full+ 1 H I
Grade Average I Heat Hot Water I Total 18 Rooms I siLR �' '
Type Rooms r , !
Stories 2 Stories I Fuel OIl I Heat F ation(Poured Conc. I 18
is 1 .20
Gross 3387
Area
Permit History — --- -- - -
http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=1002 9/13/2013
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`pFIR ra Town of Barnstable *Permit#
p: Expires 6 months fsom issue date
Regulatory Services Fee� U C/
v "9. Thomas F.Geiler,Director
�p s639• F�0 �
Building Division ®PRESS PERMIT
Tom Perry, Building Commissioner D t G 2 9 2003:Qk
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 TOWN OF BARNSTABLE
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number L�
Property Address
esident!al Value of Work 9( � �� C�
wner's Name&Address 1 / !�- J�f/l
Contractor's Name V ll'— C0/LS'""-e''tCl�(Telephone Number 9Dd q —C a T
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
ha Worker's Compensation Insurance
'/
Insurance Company Name —
Workmen's Comp.Policy# l���1 C, ( J At
Permit Request(check box) A c�
e-roof(stripping old shingles) All construction debris will be taken to
(FE]Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side'.
❑ Replacement Windows. U-Value (maximum'44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
Home Improvement Contractors License is required.
Signature
Q:Forms:expmtrg
J� o .
Board of Building Regula 'ons. and Standards
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement Contractor Registration
Registration: 134313
Type: DBA
Expiration: 10/24/2005
DAVID SAWYER CONSTRUCTION
DAVID SAWYER
318 MEIGGS BACKUS RD.
SANDWICH, MA 02563
Update Address and return card.Mark reason for change.
Address Renewal Employment Lost Card
Tk C�omvnxonure¢ o�./�Laaaac�iu4ek` -
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 134313 Board of Building Regulations and Standards
Expiration: 10/24/2005 One Ashburton Place Rm 1301
Type: DBA Boston,Ma.02108
DAVID SAWYER CONSTRUCTION
DAVID SAWYER
318 MEIGGS BACKUS RD.
SANDWICH,MA 02563 Administrator Not v i wi out signature
David Sawyer Construction
318 Meiggs Backus Road
Sandwich, MA 02563
(508)-539-1992
Proposal Submitted To: Work Place: Date
-cG
WHau
�- -7 '�'y
Strip, .Remove, y all old roof shingles.
...f car rPPLY&INSTAT:I.::
�
-- CLEAN&REMOVE ALL DEBRIS FROM WORK PLACE AFTER
JOB IS COMPLETED. ALL DEBRIS TO LANDFILL.
C-TOTAL INVESTMENT FOR MATERIAL&LABOR$
All material is guaranteed to be as specified, and the above work to be performed in
accordance with the specifications submitted for the above work and completed in a
substantial workmanlike manner. Payments to be made as follows ` ` t
Any alteration or deviation from the work specifications involving extra costs will be executed.only upon
written order, and will become an extra charge over and above the estimate. All agreements contingent
upon strikes,accidents or delays beyond our control.
IOYEAR LABOR WARRANTY/PLUS MANUFACTURES SBINGLE WARRANTY.
NOTE-This proposal may be withdrawn by us if not accepted with 3 days.
Respectfully submitted
ACCEPTANCIMF PROP. AL
The above prices, specifications and conditions are satisfactory and are hereby
accepted. You are authorized to do the work as specified. Payments will be made as
outlined above.
Dat Signature 122ell�
• . TOWN OF BARNSTABLE -2452-2- --_Permit No. ___ -. -. _
�x Building Inspector
Cash - - -- --
'RF• ' OCCUPANCY PERMIT Bond _ _________________��/_� '
Issued to -;Fohn AIcSbane Address DemiS y 1``r.A
lot #11A 143 Abby Gate, Cott t
Wiring Inspector /A' Inspection date
Plumbing Inspectors t _ Inspection date
Gas Inspector Inspection date
✓Engineering Department ;' Inspection date
✓Board of Health t. '� Inspection date
THIS PERMIT WILL/NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.Aw �3 ���V�
_..., 19_ . ................................................. _.__......._...._..
�Buil g Inspector
i "' !
" t AssAor's map and lot`number J
,........: AA
THE T��
�7 r Qy
Sewage:��Permif number' .'6>�� .......... L. o� /
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<` Z BAMSTeBLB i
House number ............................ .o4.3................:................. SEPTIC
�. l��flVEklN SY�TEi� • m� C0E+ PLiA CE
TOWN OF BARNS AI TITLE 5
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BUILDING INSPECTORfiKi�S C0MM,SSl1",1y"x
APPLICATION FOR PERMIT TO . ........ ...
TYPEOF CONSTRUCTION .........5!W. ........ ... .................................................................................
3/�. .......................19 ..�
TO THE INSPECTOR OF BUILDINGS: t
r
The undersigned hereby( applies for a permit according/-to the following information:
Location .........6 .Q-.Fl.I..!:C........... j ...... .................4... ..............................................
Proposed Use ..... f....
!V. ..L.. ..:........ .:...........................................................................................................
ZoningDistrict .....................................................:....................Fire District ...............—...................................................................
^3$� Name of Owner .. �. ....Y.....C..C?..!!l./ hJ ......Address ....�.5..._1.... :.... :.............................. ..
�1L 'C ( ( ` t. .. y
Nameof Builder. ....................................................................Address ....................................................................................
Nameof Architect .............................................................:....Address ....................................................................................
Number of Rooms ...........�s ................................:..........Foundation ........C.................... . ... .. ... ... . ...............
Exterior ........4....... .... ......... .......................Roofing .......... .. ....................................
Floors ........�./.. ..................................................Interior ......::...:�.."�?c��...................
Heating ................................................Plumbing ........ . ................. ....................... .... . ..
Fireplace ............. . .G ..................................................Approximate Cost ..............�.. `. ......
Definitive Plan Approved by Planning Board ---------_________-----------19_______. Area 1 ...... �... ..
Diagram of Lot and Building with Dimensions Fee. .......'� �
SUBJECT TO APPROVAL OF BOARD OF HEALTH
- 170
I yj
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OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
/y 016 060
Name .... . . ....
. ..w.... . ... .............................
7
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� MoSBANE, JOBN
242� l� Story
' 2y6 --�}---.. Permit for ------___---
`
Family Dwelling
---.=--..---...------.—.----~.
Lot #llA 143 Gate
Location ---.—.------_..�����___-- '
vL
Cotoit ' .
—...—~------.-----~.--------. '
Owner --
Jmb� 88cShane '
----___,______.______
Frame ^
Type of Conohoctkon -------------- , !
'
---'----------'------------'
— `
Pk .............................Plot Lot ................................
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November 8, 83 -
Permit Granted .......................................... g
Date of Inspection ....................................lA
Date Completed
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Assessor's map and lot number °'�.�..`����./4'
�SeOt6e Permit number d� y�
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Z 33ASd9TLBLE, i
House number .................'`..... d....�.3........................._........ +� NAGIL9
c �0 wil a�
TOWN OF BARNSTABLE
B-UILDING INSPECTOR
APPLICATION FOR PERMIT TO ............. .�.����........ ::?�:..�..... ....... ... ... . .. ....... . . ..
TYPE OF CONSTRUCTION ........�� 7 ..
....`....................................... ..................
......... .............. ............I9 ..
TO THE INSPECTOR OF BUILDINGS:
The undersigned
hereb/y' applies for a permit
according to the
th,�e�following information.:
Location ... ? .,(y....1../�. ......... ; r�.f�,/al.l?���:.t r?!Y-�1 :`.`....... ..4...? ...... � ..... .............:...:.....................
Proposed Use ..... .?...�U' ..cs .:....... '�-°:' ................................
.. .. .......... .........................
I Zoning District ... ..... ............... .... ....................Fire District ` r:...........
Name of Owner .`. .c ..... (� e ..y!�1,!r dl ........Address ....�'.S
Name of Builder' ...................................................................�l. ..' Address ' ........ � ....•..-F'c.-� '.....`.... .......... .... .c.;
a Name of Architect ........... ................................................Address ....................................................................................
Number of Rooms Foundation ....... :`... .............................
Exterior ....... �.........................Roofing .........C.A� �� .....:f..........:.........................................
Floors f ..! Z R' -.. ... . ..................w,....................Interior - � rfr 'C ...................
i
' 4
Heating . . .. .:.. ......................................................Plumbing ........ ; .!-tc.' ......................................................
' d � C
Fireplace ............... .P ...................Approximate Cost .....................J� :...
�.
Definitive Plan Approved by;Planring+Board ______________ 19 . Area ..........................................
'I J
Diagram of Lot and Building with Dimensions Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
a
la,
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OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. �,�,� r
NameC / "J Al ��-..... .(L `..rt -
MIANE, -JOHN A=21-25
No 2t.1-4-5 2 2, p for ... ...�t6ry
........... Permit
.......................
......15.1n.92-e...FAMI-Ly...DW
..............
Lot #11A 143 Abbey Gate
Locatitn ................................................................
cotuit,
.......................A. ............;................................
Owner
John McShane
..................................................................
Type of Construction ....KKaMe......................
..................................................I..............................
Plot ............................. Lot ................................
Permit Granted ...November 8.........19 82
-Date of Inspection ....................................19
Date Completed .....................I
19
December 23, 1980
Mr. and Mrs. Norman W. Kalat
Box 850
,y Cotuit, Ma. 02635
Re: Lots 11A and 13A, Abbey Gate
Dear Mr. and Mrs. Kalat,
In reply to your letter dated December 20, 1980, the Zoning
Board of Appeals advises that the 7 year acre lot zoning protec-
tion expired 'in June of 1980. It will be necessary for the
builder on Lots 11A and 13A to obtain a variance from the Board
of Appeals before a Building Permit can be issued.
The lots in question were visited by Ted Panitz (Chairman
of the Commission) , Chris Kuhn (member) and myself on December 18
prior to the hearing. Enclosed is a copy of the site visit
report. The engineer' s plansfor Lot 11A were approved by the
Commission (proposed building and septic system conformed to the
minimum distance from the edge of the salt marsh according to
Wetlands regulations) , with the condition that the six-foot
contour be maintained as the limit of work area. The plansfor
the neighboring Lot 10A were also approved, with the condition
that the eight-foot contour be maintained as. the limit of work
area. The proposal for Lot 13A was taken under advisement, and '
the engineer (R. J. O'Hearn) will be- requested to submit revised
plans for consideration. Another hearing for this property has
been scheduled for Thursday, January 8 , at 8 : 15 in the Selectman' s
Conference Room.
We regret that you were' not informed in- time to appear at '
the December 18 hearing. Feel free to contact us if you have
any further questions.
Sincerely yours,
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bey Gate Road a.p
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