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HomeMy WebLinkAbout0035 BERKSHIRE TRAIL - - - UPC 12543 Now R `�srcorfi`�`' HAS?INGS, �N, Y��'L��im.lJiid�Jila_ -�......,_.. ...��_ . � _ _- - - - - .YUY'sG liuY...1Yw.�•� � ��Lu..� _� _ � �__ _ - � -_ - � �.��u..� i Town.of Barnstable *Permit# Expires 6 months from issuedate Regulatory Services Fee - snat+srnar.E, • r� Mass Richard V.Scali,Director i639- �0 QED MAt A Building Division , Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 0260.1 www.town.barnstable.ma us Office: 508-862-4038 Fax: 508-790-6230 n,. EXPRESS.PERAUT APPLICATION - RESIDENTIAL ONLY Map/parcel Number V ( Of Valid without Red.X-Press Imprint V l Pro Address 0 7Residential Value of Work$ 6 S G Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address A/a L S--I. J h Zc - rns Contractor's Name Telephone Number ' Home Improvement Contractor License#(if applicable)A,K5 M Email: SS 6 m M N4 ® C•c Construction Supervisor's License#(if applicable) S 9 -. ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor AUG 2 7 2014 ❑ the Homeowner I have Worker's Compensation Insurance Insurance Company Name �I„k�/ TOWN OFSARNSTABLE Workman's Comp.Policy# 14/c 3/ S 3/7 Z// O 94 Copy of Insurance Compliance Certificate must accompany each permit. Permit Rey st(check box) l Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ��, n.1 D Y ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A cop of the Home Improvement Contractors License&Construction Supervisors License is re red. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 771e Con2mo7meal&ofMassachusdts .➢gmrhn-ent raf 1axdrus&-hd Accidents Office-of luvesf%Yorrs 6OfO WaArington Street Boston,MA 0211E wmv.7nasmgov1dia Workers'orkers'Compensation Insu anca Affidavit:Buildei-sfContr-a;ctors/Me-cfriciansfPlvmbers Applicant Infmrm,ation Please Print,Lej�ibly Address- Ciiyf`tafr-IZip:C� �raY'7s o Z6o Phan G l you art ernploger?Cbeckthe apgrapriatebox: _._.._..._.____.—._.___-...---•--...-..... .... .... Typeu#grg9ect.(r q�redl=._.. .. ...__.. Ln lain a employer with , 4. ❑ I am a general contiractor and I 6- [:]New cnnmnr oa employees(Ra and/or gait-iime)* hi � tors 2_❑ 1 am a sole proprietor orpartaer- listed on the attached sheet 7. ❑Remodeling slap and have no employees These snb-eontmctors have g- ❑Demnlition wori ing for me in any czpacft employees and have workers' 9. ❑Ruildmg addition [go workers' cornp_iasa�e comp.mstran l• retired.] 5-❑ We area coiporationaad its 10-0 Electrical repairs or additions 3_❑ I am a homeowner doing all work officers hatim exercised their 11-0 Plumbing repairs or additions Mysef[No workers>camp. right of eammptionper MGL 12❑Roofrq,-Ia= ins7ranre required.]t 152,§1(4} and we have no 131❑Offier emp -INCY Wes' comp-insurance required-1 !Amy sap$xmnt that checks boat Rl vmst also 01 out the section below showing theirwodseaT compenssGonpolicy infhrmadacL t Erameowuers who subzoit this affidavit inEc ing they ace doing all wak sod theu hire otoside contractors mast sohmit a Herr sSd3rit mdr�v such =cont®ctoa ihsr check this box mot attached an additiawl sheet showing the nee of the soh--aaaktctoa and state whether ornnt thaw eotmes 5zve employees- Ifthe snlr-contciLctomhwe empIoyee-%they— provide their worker'comp.policy number I om art onplayer iliat is prmiditrg workers'co .qmn xrttan irrn4raitce for my empFaygm Belau is the punt}'anal job sits informa an_ f Insurance CompanyAFame: L.,6i./ !.t a Fo&cy;g or Self iris LiC #7 41C Z. Expiration Date: 6 Job Sife Address: 77 ( City/Staf 2l p: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure:coverage as reg6redunder Section 25A o€MGL c. 152 can lead to the imposition ofcrimiinaal penalties of a fine up to$1-500-06 and/or one-yearimprivonraent,as well as chit penalties in.the form of a STOP WORK ORDER-and a fine, ofup.to$250-00 a day against the violator- Be advised that a copy of this statem eat:maybe forwarded too the Office of IrnFegOgat ions of iJle DIA€or insurance coverage vecifrcation. I do hereby certify rt pm i id ponaities a,;�'perjury thatthe informidian prat�rI abave' true and corrsct Sieoa{ure: - Date` Z 7 / y Phone#- �a S'' 7 7 l_ Y 9 -7 9 E3WW.fft u'se aniy. Eta not twrita in Otis area,&be caamp&ad by diy or town offic&L City or Town- PermitUcense# T�Autharity(circle one): 1.Board of Health 2.Building Department I City-IT,own Clerk 4_Electrical Inspector S.Plumbing Eupector 6.Othex Contact Person: Phone#_ Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto tb.is statute,an employee is defined as"-..every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,-or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." i MGL chapter 152; §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC) or Limited.Liability Partnerships(LLP)with no employees other than the 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 mtirmed to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the penmit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications is 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 burn leaves etc.)said person is NOT required to complete this affidavZt The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number The Commanwmalth of Massachus6tts Department of Industrial Accidents 4f-ttce of lvestigatiaM ��fl�a,sbin<�an Streat Rasiozz MA G21 II Tel.A 61772 -,49OG exi:406 or I-� Revised 4-24-07 Fad#617-`27-`-74`9 viww-mas5�,gavddza w * anaxs•resr.K ,0� Town of Barnstable ArEn�y° Regulatory Services Richard V. Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I,_ Al Is�n �/-c ti � ► � j , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) o � ature o Date Ave Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPF=\FORMS\building permit formslEXPRBSS.doc Revised 061313 Town of Barnstable Regulator* Services P�opIHE TO1t,L Richard V.Scali,Director Building Division w satursraatE Tom Perry,Building Commissioner MASS 059. ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityhown 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&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor: The homeowner acting as Supervisor;is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFII.ES\FORMS\building permit forms\EXPRESS.doc Revised 061313 (MMIDD A4C"R"0 CERTIFICATE OF LIABILITY INSURANCE DATE aizs/zo,arn THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW: THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . CONTACT PRODUCER BRYDEN & SULLIVAN INS NAME: 88 FALMOUTH RD PHONE FAX HYANNIS, MA 02601 c o t A/c No: EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC A INSURERA: Liberty Mutual Fire Insurance 23035 INSURED INSURER B MASS BUILDING SYSTEMS LLC 24 ST FRANCIS CIRCLE INSURERC: HYANNIS MA 02601 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 21336796 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS INSD WVD POLICY NUMBER MM/DD MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR A ORE ED REMISES occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO- -❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION WC2-31 S-317211-044 6/7/2014 6/7/2015 ,/ SPER OTH_ TATUTE ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500000 OFFICER/MEMBER EXCLUDED? FN N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500000 If as,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 MAIN ST ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE -A-- Liberty Mutual Fire Insurance ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 21336396 CLIENT CODE: 1611184 Did! Dangas 8/26/2014 12:12:36 PH (EDT) Page 1 of 1 . Massachusetts Depa0[pent of PubIiQ Safefy ._ e�' �oand pflBujldlrfgfRe�u)atgns ant SfaBdards3 -.-ro..P !f�'A'aN ✓i' j-� � .? ^c i`9 2'. li. F-1>�A'...t._F.• . N{. Cbnstructloti',.Su�icrvr�br �. Li-cd...se CS4058987 • ' i7�i'i Ilt�i °ST EPHEN E B011911A 24 ST ERANCIS CIR HYANNIS MA 02601 I .�,.�.., JG .. Expiration Commissioner �02/04/2016 I �e tpo�nvnaaracuealC/e� /`aaaac/coreC�. : ------'._.:.•--___...�._.•-- -... _.__.`.._---..._.______.__._� - Office of Consumer Affairs&Busidess Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistretion: ;158588 Type: Office of Consumer Affairs and Business Regulation �.. expiration: __2F11?20]6-, Partnership 10 Park Plaza-Suite 5170 Boston,MA 02116 MASS UILDING SYSTEMS IS STEPHEN BOBOLA`=vr ?a 24 ST. FARNCIS CIRCLE =L HYANNIS,MA 02601 Undersecretary Not valid without signature Mass. Corporations, external master page Page 1 of 2 William Francis Galvin Secretary of the Commonwealth of Massachusetts G A O Corporations Division Business Entity Summary ID Number: 001118018 Request certificate New search Summary for: THE 7ENSETT CORPORATION The exact name of the Domestic Profit Corporation: THE JENSETT CORPORATION Entity type: Domestic Profit Corporation Identification Number: 001118018 Date of Organization in Massachusetts: 10-07-2013 Last date certain: Current Fiscal Month/Day: 12/31 The location of the Principal Office: Address: 504 MISTIC DR. City or town, State, Zip code, MARSTONS MILLS, MA 02648 USA Country: The name and address of the Registered Agent: Name: NELSON C. JENKINS Address: 504 MISTIC DR. City or town, State, Zip code, MARSTONS MILLS, MA 02648 USA Country: The Officers and Directors of the Corporation: Title Individual Name Address PRESIDENT NELSON C. JENKINS 504 MISTIC DR. MARSTONS MILLS, MA 02648 USA TREASURER NELSON C. JENKINS 504 MISTIC DR. MARSTONS MILLS, MA 02648 USA Y SECRETARY NELSON C. JENKINS 504 MISTIC DR. MARSTONS MILLS, MA 02648 USA DIRECTOR NELSON C. JENKINS 504 MISTIC DR. MARSTONS MILLS, MA 02648 USA Business entity stock is publicly traded: ❑ http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=001118018&... 8/27/2014 i Mass. Corporations, external master page Page 2 of 2 iThe total number of shares and the par value, if any, of each class of stock which this business entity is authorized to issue: Total Authorized Total issued and Class of Stock Par value per share outstanding No. of shares Total par No. of shares value CNP $ 0.00 175,000 $ 0.00 0 CNP $ 0.00 100,000 $ 0.00 0 ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Administrative Dissolution ^ Annual Report Application For Revival v Articles of Amendment View filings Comments or notes associated with this business entity: ^ v New search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=00I 118018&... 8/27/2014 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 6 %� I`� `'i ( l � Map Parcel (� pp ication Health Division Date Issued ' oZ- LLI Conservation Division Application Fee 1 ,l Planning Dept. Permit Fee LI V Date Definitive Plan Approved by Planning Board Historic - OKH _.Preservation / Hyannis .Project Street Addresses Village Owner C.:o,WD.eA77oA.." Address Telephone /s3/ Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District . Flood Plain Groundwater Overlay Project Valuatioroe o�Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family ((## units) Age of Existing Structure 195U Zalkout ric House: ❑Yes0'No On Old King's Highway: ❑Yes- ZO YP Basement Type: ❑ Full ❑ Crawl ❑ Other Basement Finished Area (sq.ft.) ,/�f/c Basement Unfinished Area (sq.ft) Number of Baths: Full: existing .3 new Half: existing new Number of Bedrooms: existing new Total Room Count (not inc '1 including baths): existing J new First Floor Rolm Count Heat Type and Fuel: ®'Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes No Fireplaces: Existing g New Existing wood/coal stove. ❑Yes ❑ No Detached garage: ❑ e�xi ting ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ 6 xisting :0 new 7 size_ Attached garage. Coexisting . ❑ new size _Shed. El existing ❑ new size _ Other: `' E to rn Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �/r�Ste"/� �,Q�I�o'J Telephone Number Address License # Z , //iz Home Improvement Contractor# ' ,Email A,1 /l�3/�r���� Worker's Compensation # ALL CONST UCTIONDDEEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE CG J FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED M MAP'/PARCEL NO ADDRESS ' VILLAGE . 1" OWNER s DATE OF INSPECTION: s i FOUNDATION FRAME INSULATION FIREPLACE p ELECTRICAL: ROUGH ' FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING f�®� �� �3 ���Ax DATE<CLOSED OUT ASSOCIATION PLAN NO. �s :I T 1fe Co;'a womwed&of Massachtmeffiv Ug7,7rlment of liulush al Accidents Office o,f Investigations 600 Workington Street Boston,M,4 02-HI wtov. nass.gov/dia Workers' Compensatian Insurance avit:Builtie � niractoisfElectriciansfKumbers ATI licant Infarmafiun ,E So v l Please Print L ih y Name(hsmesa 0Tani-,mfim t &idnat): Address-. 0 P G CityfStateMp: T17i1/.s' i AS Phone 4: 7 ' �'di�-1--3 / ___Am you_an-employer?Check the apprapriateabox.; ___T of paro]ect.(re-quired}: 1_ — ----r _ 4. I am a 6_contractor and 1 ❑ El am a employer with � New oonsfrrzcfion employees{full and/or part-time)* have hired the subcontractors 2-❑ I am a sole proprietor or partner- listed on the attached sheet 7_ ❑Remodeling ship mid have no employees These sub-oontractors have g. ❑Demolition wonting for me many capacitjr employees and have workers' 9 ❑Building addition [No workers'comp.irmn-ance comp-insuranoe l 5-❑ Vice are a corporation and its 10_❑Electrical repairs or additions 3. am a homsownt~r doing all work officers have exercised their 1 LE]Plumbing repairs or additions myself[No workers'comp right of ea�emption per MGL 12.0 hoof repairs insurance.repaired,]$ c-152,§1(4),and we have no employees-[No workers' 13.0 Other comp_insurance requir :] *Any appEout that checks boa 1r1 must also flout the section below showing rhea worsen'compensation policy udbrmx TM+ T eowners who submit is sff dwd in&czt g they ace doing fill nUA sad then hie outside conbmctms mm sobmat a near a83davit merrA snrh Hom th tCoutmctors that check this boot must attached an,mitionsl sheet showing the name of the sub-c=ftac hm and state Whether or not those entities hmm' mplayees.. If the sub-contnctars hire empIoyees,they must provide t eir workers'comp.policy number. .tam an employer thatis prmliding tt orkers'comperuntion itmarance for rtty emptoyeecr Beloty is the policy and,}ob site information. Insurance Company Name: Policy it or Self-ins-Lie-4- Expiration Date: Job Sire Address: City/State/Zrp: A##at h a copy of the workers'compensation policy dedaratiotn page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of It2GL c- 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprfs�as well as civil penalties in the fb m of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for inmwatnce coverage verification- I do hereby certify' rirrder the pains nerd penalties ofperjujy that the informationprmzrZedaba7Illzcorrec an tSignature: Date: T ©,f cial use only. Do not trine in this area,to be completed by city or town ofJiciaL City or Town:. PermitUcense it Issuing Authority(edrele one): 1.Board of Health 2.Building Department 3.City/rown Cleric 4.Electrical Inspector S.Plumbing Inspector 6.Other Cont2ct Person: Phone 9- 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto ties statute,an employee is defined as"_..every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the$rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shaII 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 perionnance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate-(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'workers' compensation insurance_ If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number oa the appropriate line. City or Town Officials Please be sure that:the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit'one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)_"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would hke to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts DepaAment of Industdal Accidents office of kvestigatiens &GO Washington Street Boston,MA 02111 Tel.A 617-727-4900 W 406 or 1-8 L AS E Revised 4-24-07 Fax# 617-727-7 749 www.massgov/dia i Town of Barnstable Regulatory Services �oFVi rOiyy Richard V.Scali,Director Building Division r ZARNST"M ` Tom Perry,Building Commissioner Mass. 16;g ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 I HOMEOWNER LICENSE EXEMPTION DATE: lorAIV Please Print ��. JOB LOCATION: number sheet �ilvillage ?^ ••HOMED R": t/FI� � �. lJ.e,i7��/t� T7`�/r.5�r'T" �A"�/�� _—�— home phone# work phone# CURRENT MAU-ING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINrrION 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 juirements and e/she will comply with said procedures and requirements. 724 ature of Ho gown Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFLLF-S\FORMS\building permit fomu\EXPRESS.doc Revised 061313 �TME lti Town of Barnstable Regulatory Services s a rBARNSTABMg Richard V.Scali,Director i639' ♦0 039 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: (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:FORM&O WNERPERMISSIONPOOLS I i i TO,NN of BAi'NS`iABLE 70111 .. IN "u Pli 3: 5 DIVISiN I� ZF7 L7 �� 7W -74 p 0 ��G G r c c ° 1 - tl MAIN OF BARN STAB!E 2�';�E JU 120 PI-, 3: ----------------- 11" � � A i ��+ �Via\\• � �.� Mass. Corporations, external master page Page 1 of 2 William Francis Galvin Secretary of • • of Corporations Division Business Entity Summary ID Number: 001118018 Request certificate I New search Summary for: THE 7ENSETT CORPORATION The exact name of the Domestic Profit Corporation: THE JENSETT CORPORATION Entity type: Domestic Profit Corporation Identification Number: 001118018 Date of Organization in Massachusetts: 10-07-2013 Last date certain: Current Fiscal Month/Day: 12/31 The location of the Principal Office: Address: 504 MISTIC DR. City or town, State, Zip code, MARSTONS MILLS, MA 02648 USA Country: The name and address of the Registered Agent: Name: NELSON C. JENKINS Address: 504 MISTIC DR. City or town, State, Zip code, MARSTONS MILLS, MA 02648 USA Country: The Officers and Directors of the Corporation: Title Individual Name Address PRESIDENT NELSON C. JENKINS 504 MISTIC DR. MARSTONS MILLS, MA 02648 USA TREASURER NELSON C. JENKINS 504 MISTIC DR. MARSTONS MILLS, MA 02648 USA SECRETARY NELSON C. JENKINS 504 MISTIC DR. MARSTONS MILLS, MA 02648 USA DIRECTOR NELSON C. JENKINS 504 MISTIC DR. MARSTONS MILLS, MA 02648 USA Business entity stock is publicly traded: 0 http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.... 6/20/2014 Mass. Corporations, external master page Page 2 of 2 The total number of shares and the par value, if any, of each class of stock which this business entity is authorized to issue: Total Authorized Total issued and Class of Stock Par value per share outstanding No. of shares Total par No. of shares value CNP $ 0.00 175,000 $ 0.00 0 CNP $ 0.00 100,000 $ 0.00 0 r OJ Confidential r Merger 0- Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Administrative Dissolution Annual Report "4 Application For Revival ; Articles of Amendment _I__ _L /•1__.1_.. / ..._..__J_._ View filings Comments or notes associated with this business entity: New search i http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.... 6/20/2014 Town of Barnstable *Permit# %L Fxpires 6nnmonths from issue dale Regulatory Services FeeMAM OS� v� z $ Thomas F.Geiler,Director E0N1°`� Building Division � Elbert C Ulshoeffer,Jr. Building Commissioner ��A� 367 Main Street, Hyannis,MA 02601w DEC+ 4 ,�/I T Fax c 5087 90-6 3038 TQWN op , Zr7�r EXPRESS PERMIT APPLICATION gR�STgeLF ! . + Not Valid without Red X-Press Imprint Map/parcel Number O 2 /—OZ5-/--OCR / Property Address A �r1�,�sh/�� �iQt2 i �1/ &,I-n Residential OR ❑Commercial Value of Work ��5,3�. Owner's Name&Address_j�: la i i-xt c &fir Mf=R 11e— �led•I / Contractor's Name Telephone Number L.J C2" rc?1515� Home Improvement Contractor License#(if applicable) L D O Z'y(�G Construction Supervisor's License#(if applicable) 5 Q 70 7 7 7 WWo kman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I the Homeowner have Worker's Compensation Insurance f Insurance Company Name ZU 4 l G .rl r 0_n Workman's Comp.Policy#_J�j C C 7 —f 0(� Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of r000 re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature V expmtrg • ' Application to 2 O,O 1 •�'2 2 4 ors. � Old Kings Highway Regional Historic District Committee 'in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS treuil SETS Application Is hereby made,iri•moise for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973. for proposed work *as described below and on plans. drawings or photographs accompanying this application for: CHECK CATEGORIESTHAT APPLY: 1_ Exterior Building Constriction: New Building ❑ Addition jir'Alteration Indicate type of building House ❑ Garage ❑ Commerciaf ❑ Other 2 Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4_ Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK S J�erk5b i cr., :;r4 a/ / ASSESSORS MAP No . ) OWNER 216- n�c't Pe ASSESSORS LOT NO. D O HOME ADDRESS /I.,�_J :�� l TEL NO_ �� U FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way_ (Attach additional sheet if necessary). AGENT OR CONTRACTOR Z T TEL NO. U '95 /y & M4ADDRESS G 35 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done including materials to be used, if specifications do not accompany plans_ In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet,if necessary). 0 A e n re. > n 05f0 47-1 nl C`v✓e Y�r e, fv I kll� {rvo Signed . C I� � Owner-Contractor-Agent Sparp!p"line Gfor�Committ� ��l 'I r ` P P, � D R.eceNed.by-tH.J. tro t lJ�����1�..✓ i��, atA U 12 20gl r e rtificate is hereby ate TOTiV OF BABNSTABLE L6&g� OLD KING'S HIGHWAY By -S 0 Town of Bar istable Old King's Highway Historic District Committee f; SPEC SHEET FOUNDATION SIDING TYPE j 1 COLOR C(n 5 M n of na m & h &-dae. CHIawr TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOWS COLOR SIZE TRIM COLOR DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS MATERIALS. GARAGE DOORS COLORS SKYLIGHTS F ZB1 .tt nr , COLORS rD nmF�gmWR_ nni COLORS 0 C-T 12 2001 UU I --------------- _ FENCE COLOR NOTES: Fill out completely. including measurements and materials/colors to be used. Pour copies of this f.,.,. owe .e.......a c..� ...w. i.. • _c '- --- '--' ,-, _ Assessor's office(I st Assessor's map and lot lnur �mber ` O d� � SEI�T��nT��fy " IN INSTAiLLED IN C ° Board of Health(3rd floor): WITH TI Sewage'Permit number �k A ENVIRONMENTA Engineering Department(3rd floor): � House number TOWN REGUL Definitive Plan'Approved by Planning Board /e P 91 DNA APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only, A41 i tz TOWN ., O F ' B A R N S TA B L E -tin Commission BUILDING IN-.S'FE _z _a APPLICATION FOR PERMIT TO T Date TYPE OF CONSTRUCTION �17+�/�' a���' h4wG7- 19 V, 9* TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 0 Proposed Use Zoning District t l r Fire District Name of Owner a !�/ Address Name of Builder I��L / � " "' Address i Name of Architect Address Number of Rooms Foundation y U/ / ( �' Exterior C�— Roofing ` Floors //Z C Interior S/{4�80C.t% II ' Heating Plumbing 21 Fireplace L- Approximate Cost Area Diagrr of Lot and Building with Dimensions Fee---- =� ' n� 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. Name Construction Supervisor's License No—' Permit For en Location to Owner Type 01 Constructions C, Plot - Lot 1,) ."+_ `•� , ,) /+ (. � i.•: J' �+ � fr'' ; ..J+ 3 fry .� Permlt;Granted� _19 Date of Inspection'- - ' t a� 19 Date Completed. .,-} ✓ ✓ 19 l� ! fly %� �'1 a i 1 f # f'• r r j e Aow �'04- Assessor's office(1st Floor): Assessor's map and lot number i �/��: �S -� � � �o�t" Board of Health(3rd'floor): Se �� l(Jc/� •_ SEP Sewage Permit number f INSTALLED�� �� ? �;�ws� DASlMUE i j '-Engineering Department(3rd floor): !'%House number -ar- ''; ". . ' '�'6 PO�fFo r�9 -;Definitive Plan�Approved by Planning Board 19 s T —i ;. APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only, TUV d, TOWN OF f BARNSTABL4 ApRpvED BUILDING INSPECTd stable can APPLICATION FOR PERMIT TO lu OF TYPE OF CONSTRUCTION IA; ) G TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location - 3 5— / Proposed Use J l Zoning District T Fire District Name of Owner ®yL yn 7:/9/, �i Address Name of Builder Address Name of Architect IC Address rk Number of Rooms Foundation S Exterior Roofing J Floors Interior I'Szaz Heating < .� 1, Plumbing 4(iLIA f Fireplace�! /G .--���Yc Approximate Cost �. Area Qm') ,-,� , rZ D S F. Diagram of Lot and Building with Dimensions Fee 0/1 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. Name Construction Supervisor's License L A'CALLAHAN, JOHN T. No 34773 Permit For 11 Story Single Family Dwelling Location Lot 08 , 39 Berkshi rP Trail West Barnstable Owner John T_ Callahan A Type of Construction Frame Plot Lot ; Permit Granted``.- January 3 , 19 92 ` Date of.lnspection 19 Mompleted• �J .19 ��/9li o ` �, ,>. ...:., ..y p �T -•a';.a 1.re. {;T":.sr,-1.1V'. b��^v-PY,'vT P;r'?0P°•„_ .•w,....:. OF BARNSTABLE, MASSACHUSETTS GUIDING PERM1u 1 I DATE A: 19 PERMIT NO. % - 34773 APPLICANT J..`( ' •• •r' ADDRESS ! , -f;0 Su (NO.) (STREET) •ICONTR'S LICENSE.! PERMIT TO --•�' ) •) .'-•I'' 'r NUMBER OF (_) STORY ti +-:,..i..:..: . ' DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) ZONING (NO,) J DISTRICT (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT I BLOCK SliE BUILDING IS TO BE FT. WIDE BY. FT, LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: 'AREA OR I ` VOLUME `'� - '•-•t' ESTIMATED COST `� liJ i't PERMIT .il) (CUBIC/SQUARE FEET) FEE OWNER ... . �.�;.: .-......_..�. I. ADDRESS .•..;.. _.:`:.. .. .._. ....... By THIS .��'': r�-- .��1Ly�/ '��•'�. t THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINS FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIOI OF ANY APPLICABLE.SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL F PERMITS ARE REQUIRED FOR INAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI 70 BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS All &4 1 Vt 4i��S4 HEATING INSPECTION APPRO.V INS N E ART T z BO HEALTH OTHER SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN CONSTRUCTION, PERMIT IS ISSUED AS NOTED ABOVE. ARRANGED FOR BY TELEPHONE OR WRITT; i NOTIFICATION. I 1 w ti..n,-"�.r-..i4.7���+nly,S`"'7i,:Y'�.,�T`�':+r.,.!'-•✓ti�,,,L,;',�n•"nr�/,���`1:.:tiaa.-[T�,���r�.�.}.,vr.`",y�it."1�:•�:,.-:.�.r+fr"'L-,�y'�I'�W.tir.,r,�"�r�•k..: I '✓.,F,...��':�-� TOWN OF BARNSTABLE Permit No. 34773 i� BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .M� N •era• • �tc�►r HYANNIS,MASS.02601 Bond X ................ • CERTIFICATE OF USE AND OCCUPANCY Issued to John T. Callahan Address Lot 08, 35 Berkshire Trail West Barnstable, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND,IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. s June 4 19 92 , .. .......................... ................. ........r- '" ........... Buildiw nspector I ..� °•. TOWN OF' BA.RNSTABLE •� '� BUILDING DEPA. 6 RTMENT f VA"s TOWN OFFICE BUILDING rut '679 HYANNIS, MASS: 02601 � B MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by Building Permit;#......_._. . /. _....._.............................. issuedto .. ..._.Y ( �... ....................._.........._................�..._._. _ �.. ».. . ._ Please release the performance bond. ti � � l;,ink.''-✓'tiv. „+,n'►'Yl�v*1�.`,o.t++'1J1Yjy.J 'l. yMi` 'Yi-'r •'� �Vtl+' i 'y.:�'e"�IiVJ� ��'` .r".'",+.ai'K(f7r 'w�y�/'►''F7"7C�� ""'- ,-M` .' (' ►�`eM'1"� ''� i T E M P O R A R Y T.r Permit No.. TOWN OF BARNSTABLE 34773 _ � BUILDING DEPARTMENT fi I ' I TOWN OFFICE BUILDING Cash ................ 7 .Yl 9 X .► HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to John T. Callahan Address Lot #8, 35 Berkshire Trail West Barnstable, MA. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. I April 2, 19 9 ................. .. ..................... Building Inspector c" � `"^i*0 - Y. a•-�:+a 'Y-s'C' r3"�.E'.?�''Y'yyYI'��`.� `5) f"1��'' ,.,BLEB^wy UJA} w�t� �M-1 . r „ t•prN vor�v�r V S) 1 iR7 .;r_. D� ,oq�a`,►�y�+,,wr Old Kings Highway Regional Histori {District"Commit;tee' Y � `2 tfl^ � •'y' in the Town of BaTn4i;ebte;fbr a CERTIFICATE OF-APPROPRIATENESS Application is hereby made, iri triplicate, for the issuar•:L, u: �,c catQ of Appropriateness under Section 6 of Chapter e-70., Acts and Resolves of Massachusetts. 1973. for "" ' proposed work as des crib "belpw and on plans, drawings or accompanying this aoofication for: "&: 't-iV'.',:� 4LO,' k :,•;, CHECK CATEGORIES THAT.APPLY:.,fir , 1. Exterior Building Construction: ❑ New Buildingk��io, ' ` type of building. ❑ Addition ❑ Alteration Indicate t H •� ' ' " . 9� � House - ® Garage ._ �❑ CommerC+al �t-��;•- ❑ Other 2. Exterior Painting: Q 3. Signs or Billboards: [] New sin �f 1 x 'r 9 [] Existing r'qn µaf 0'Repainting existing sign a. Structure: ❑ Fence CD Wall ❑ Flagpole [], Other. (Please read other side for expiinaxion and req'virements). ' TYPE OR PRINT LEGIBLY , `,` ";t 'R„t+ CATE Sept. 23, 1991 ADDRESS OF PROPOSED WORK Lot 8, Berkshire Trail' 1 ':R IASSESSORS MAP NO. - West Barnstable, MA John T. Callahan OWNER .�xe��.:-.�t•�� � — 4SSESSCRS LOT NO, HOME ADDRESS U Pleasant Street Randolph, `MA t{r' ' ' - -TEL. N0. �6 7-963-3618 FULL NAMES AND ADDRESSES OF ABUTTING ObvNERS, Include na e o adjacint property Owners ac-=:s any street or way. (Attach additional sheet if necessary). SPP attar hAd sheet } 114-441' Al AGENT OR CONTRACTOR HPri tape Realty & Develogme= Co, TEL. N0. �598) Z78-4700 ADDRESS 1600 Falm"th Road Centerville Bell Tower Mall, Unit 1 „ty DETAILED DESCRIPTION OF PROPOSED 'AICRK: G,:e all p;rticu;ars of work ;o be done '.see %t. 8, other r.ca! - materials to be used, if specificationsanv ,I.^do not accom an;. In .- _ ^ p r. c cssc of signs, give local ors of existing s,gns zr'd ^•-a�;:c Locations o' n^w sIsm. (Attach additional sheet, if necessary;. See attached plans and specifications - ' APPROVED ,. -fL Qwn�r•C tt3CtOr•Aoe E SOace pelow I+ne for Committee'lse. 0K:jRHDC '''• �`' Received by H.:D.CM ' -__ ; '.,.,;.J�q .. ',.s:,. . .-�• ��[[•- , The-Cer i e Date - �R. -• " c5 i5 h.rcby atE Time C/ By Ten)rv, IMA Approved IMPORTANT: If Certificate is aprr-•n-_:d. apPro•,al is subject to'the '0':ay appea: _ercd provided in the Ac:. Disanorcvec J Application to .DPP 5 OtpH t Pw Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, . Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: New Building ❑ Addition ❑ Alteration Indicate type of building: [[House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY � 8 G� %"'� ' //2 l 9 I ADDRESS OF PROPOSED WORK —T—� S N 1 RA5 7Q/4 �� ASSESSORS MAP NO. log R O 3 i-- R�' Lam-"- /��/N� L'' SSESSORS LOT N0. OWNER HOME ADDRESS ��-�J ii��o �' /y� .TEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet.if necessary). P �k �7.P Maw M/Cftt)9C ex/N C / /S — C 2 nuP-L c o,v S% AGENT OR CONTRACTOR k—LZL _ TEL. NO. �`� S3 9 ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans.' In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). OVEN S'g .{ . (A' €�F� - Owner ntractor-Agent Space below line for Committee o HDC V' Received by H.D.C. /' Date• /` I Rl E n The Cert' ' ate is hereb AAA a v2c,� J .o Date F Tirtlel D �y> seinn i tinl�tt.PA�t �`T �" LU WIVU i�t llvo v I Approved IMPORTANT: If Certificate is approved,approval is subject to the 10 day appeal period z provided in the Act. Disapproved ❑ I J I I _ COMMONWEALTH J OF t : i4TU C WPdON`W.'F.= "I AYE: i!•'STON, ✓.JS.02215 % y. . . :' MASSACHUSETTS j ENCLOSE CHECK OR MONEY ORDER L I C E N S E I FOR REQUIRED FEE, EXPIRATION DATE r'� p p ! .0 O N S T R. SUPERVISOR 04/ a2111 h MADE PAYABLE TO I RESTRICTIONS EFFECTIVE EFFECTIVE DATE OC-NO.- RESTRICTIONS � o ++� ' NONE �''o 06/30/1989� 03886.6.. � 1 :`COMMISSIONER OF PUBLIC SAFETY" i Kt5. Y ' (DO NOT SEND CASH). <" FRANK $�NEI:DPERICH- :� . JARf AA D `Mkl 1945;_,' PLEASE NOTE FEE INCREI4SE PHOTO teusrwG GPR oNLrI 'FEE: { 3 j �/e I/�/ e�4 v r r " 3 z t..`. 100.00 p , rm rAcj , OFECTIVE FEB. 1, 1989 t HEIGHT' - NOT VAUO UNTIL SIGNED BY 11EE' AND OFfiCULIIY ST'AMPE0.,OR SIGNATURE.0 TI COMM15�lQj�lEiS ' T.G4C Y chi, A s - THIS DOCUMENT MUST" l L �, t NgiUitE;QFllCENSEE SIGN NA Ft�t�AB.OLE SIGNATURE LINE y CARR ED oN THE PERSON t ti E J � p THE.HOLDER WHEN-ENGP ✓Q OTHERS RIGHT THUMB PRINT. ED W ;rH15 OCCUPgTLEp 4y 1�i20e M 2 87 81429 J e�' .s t ; n` t�✓S t�r Svtf f{i�ry r o e. 1 e``� i B.k 28103 Ps273 —17118 04-24-2014 a7 03 0 28ca MASSACHUSETTS(Quitclaim) revised 01/01/92 REO NO.: P130D6J "FANNIE MAE" A/K/A FEDERAL NATIONAL MORTGAGE ASSOCIATION, a corporation organized under an Act of Congress and existing pursuant to the Federal National Mortgage Association Charter Act, having its principal office in the City of (00 Washington,.District of Columbia, and an office for the conduct of business at P.O. Box N 650043,Dallas,Texas 75265-0043(hereinafter called the Grantor) 0 for consideration of Two Hundred Twenty-Six Thousand and 00/100 Dollars y ($226,000.00),paid /The cM grants to Jensett Corporation,a Massachusetts Corporation, now of 504 Mistic Drive, M Marstons Mills,MA 02648, with quitclaim covenants, i SEE EXHIBIT"A"ATTACHED HERETO AND MADE A PART HEREOF Grantee herein shall be prohibited from conveying captioned property to a bonafide j N purchaser for value for a sales price of greater than$271,200.00 for a period of 3 months from the date of the recording of this deed.Grantee shall also be prohibited from m encumbering subject property with a security interest in the principal amount of greater LO than$271,200.00 for a period of 3 months from the date of the recording of this deed. These restrictions shall run with the land and are not personal to the grantee The restriction shall terminate immediately upon conveyance at any foreclosure sale related to y a mortgage or deed of trust l70 For Title Reference, see Foreclosure Deed recorded in the Barnstable County.I Registry of Deeds, in Book 27959, Page 144 on January 29,2014. a o UNDER AND SUBJECT to any existing covenants, easements, L encroachments, conditions, restrictions,and agreements affecting the property. THIS DEED is given in the usual course of the Grantor's business and is not a conveyance of all or substantially all of the Grantor's assets in Massachusetts. The Grantor is exempt from paying the Massachusetts state excise stamp tax by virtue of 12 United States Code§1452,§1723a,or§1826. TOGETHER WITH all and singular the improvements,ways, streets, alleys, passages, water, watercourses, right, liberties, privileges, hereditaments, and appurtenances whatsoever hereto belonging or in anywise appertaining and the reversions and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever of the said Grantor in law, equity, or otherwise howsoever,of and to the same and every part thereof. 3 i Bk 28103 Pg274 #17118 Executed as.a sealed instrument this 8 Y da of 20--L11—. For Authority see Limited Power of "FANNIE MAE"A/WA FEDERAL Attorney recorded in the Suffolk County NATIONAL MORTGAGE ASSOCIATION Registry District of the Land Court at By: Orlans Moran PLLC Document 825990 and Delegation of Its Attorney-in-Fact Authority and Appointment recorded in said Registry of Deeds in Book 52849, Page 113. By: _ Sew �x_ andra D. Martin,Authorized Signatory, Real Property STATE OF MASSACHUSETTS 00 coo County of Middlesex,ss. N C> n /� 2 On this �� t day of �/"l •/ 20 / before me, the m undersigned notary public, personally appeared Sandra D. Martin, Esq., Employee, M Authorized Signatory, Real Property,of ORLANS MORAN PLLC,as Attorney-in-Fact for c "FANNIE MAE"A/K/A FEDERAL NATIONAL MORTGAGE ASSOCIATION who is either f° personally known to me, or proved to me through satisfactory evidence of identification, m N to be the person who signed the preceding or attached document, and acknowledged to me that he/she executed the same for its stated purpose as the free act and deed of "FANNIE MAE"A/K/A FEDERAL NATIONAL MORTGAGE ASSOCIATION. zzl B L to Noah J.Shi otary Public to My Commission Expires: 09/28/18 ch W N 0) o NOM J. Notary Ptuic col MONWEµTM OF MASSAOISUMM My Commission ExpIret y ufSeplember28.2018 rL 0 a Bk 28103 Pg275 #17118 EXHIBIT"A" All that certain lot,piece or parcel of land with the buildings and improvements thereon, situate, lying and being in West Barnstable, County of Barnstable,Commonwealth of Massachusetts,said parcel being known and designated as Lot 8 as shown on a certain plan of land entitled, 'Berkshire Trail,being a subdivision plan of land In Barnstable, Mass.,as surveyed and prepared for Cedar Street West Barnstable Realty Trust,Scale: 1 in= 100 ft.,June 12, 1989,Schofield Brothers Inc. Registered Professional Engineers, Land Surveyors and Landscape Architects Route 6A, Box 101, Orleans, Mass.0265Y which plan is recorded with the Barnstable District Registry of Deeds in Book 462 at Pages 30-34. This covenant is made subject to the Declaration of Protective Covenants, restrictions, rights and reservations of Cedar Street West Barnstable Realty Trust dated October 16, 1989 and recorded with the Barnstable District Registry of Deeds in Book 6950 at Page 97. 00 The Grantees,their heirs,successors and assigns shall have the right to use the ways N as shown on said plan for all purposes for which ways are used in the Town of 0 Barnstable. Said premises are subject to such a state of facts as an accurate survey might disclose and to any and all provisions or any ordinance, municipal regulation,executive order or 49 public or private law,easement,covenant, restriction, reservation,agreement,right of E way, building and building line restrictions as appearing of record and affecting the m subject premises. Property Address: 35 Berkshire Trail,West Barnstable,MA 02668 H :c m m LO M f/1 N N a ' 22 o_ MSTABLE REGISTRY OF DEEDS Parcel Detail Pagel of 3 P,',msTAiiLE MASS.. 6&04 <s ,�7 '� .� Z, 3" ray -•�a dry"' eT�D NAB Logged In As: Parcel Detail Monday, March 24 2014 Parcel Lookup Parcel Info Parcel ID 109-015-003 I Developer LOT 8 Lot Location 135 BERKSHIRE TRAIL I Pri Frontage —I Sec I Sec Road Frontage Village IWEST BARNSTABLE I Fire District W BARNSTABLE Town sewer exists at this address No I Road Index 2190 Asbuilt Septic Scan: Interactive ~' 7 109015003_1 Map ' - Owner Info Owner JKRAIVIER, ROBERT& ELAINA I Co-owner %FEDERAL NAT'L MTG ASSOC Streets PO BOX 650043 I Street2 City I DALLAS I State TX I zip 75265-004 Country Land Info Acres 11_00 Use ISingle Fam MDL-01 I zoning IRF Nghbd 0105 Topography Level I Road Paved Utilities lGas,Well,Septic I Location Construction Info Building 1 of 1 Year 1992 I Roof Gable/Hip I Ext Wood Shingle Built Struct Wall Living Roof AC :<•: Area 1360 I Cover Asph/F GIs/Cmp ( Type INone _ ze Bed Style Cape Cod I wali Drywall I Rooms 3 Bedrooms Model Residential I Int Hardwood Bath 2 Full Floor Rooms Grade jAverage Plus I Heat Hot Water I Total 6 Rooms I �e?` cAA "j .� T, 41 Type Rooms '-2Bx x4 Stories 1.3 I Fuel Gas I Heat Found- 1 Poured Conc. Gross 4236 Area Permit History -- — --- - -- -- . .- - .- http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6167 3/24/2014 i Pbrcel Detail Page 2 of 3 Issue Date Purpose Permit# Amount Insp Date Comments 12/4/2001 New Roof 57452 $4,539 2/12/2002 12:00:00 AM 1/1/1992 Dwelling B34773 $62,000 1/15/1993 12:00:00 AM WB 1 1/2S Visit History Date Who Purpose 7/25/2006 12:00:00 AM Paul Talbot Meas/Est 8/22/2003 12:00:00-AM Paul Talbot Meas/Est 3/2/2000 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 1/15/1993 12:00:00 AM IML I Meas/Listed-Interior Access - Sales History Line Sale Date Owner Book/Page Sale Price 1 7/19/2004 KRAMER, ROBERT&ELAINA 18838/117 $1 2 4/2/1992 KRAMER, ROBERT&ALEXANDER, ELAINA 7952/052 $127'000 3 9/20/1991 CALLAHAN,JOHN T III 7686/043 $35,000 4 11/13/1989 CROWELL CONSTRUCTION INC 6953/136 $1 5 18/6/1986 PRINCI, MICHAEL J&OCONNELL, PAUL R THI 5232/097 $50,000 6 1/29/2014 FEDERAL NAT'L MTG ASSOC 27959/144 1 $194,565 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2014 $130,000 $39,900 $5,600 $124,000 $299,500 2 2013 $130,000 $39,900 $5,800 $124,000 $299,700 3 2012 $132,900 $39,100 $4,500 $124,000 $300,500 4 2011 $172,000 $3,500 $0 $124,000 $299,500 5 2010 $171,400 $3,500 $0 $124,000 $298,900 6 2009 $185,800 $2,800 $0 $198,000 $386,600 7 2008 $199,000 $2,800 $0 $216,700 $418,500 9 2007 $198,000 $2,800 $0 $216,700 $417,500 10 2006 $211,500 $2,800 $0 $238,000 $452,300 11 2005 $196,200 $2,800 $0 $212,500 $411,500 12 2004 $174,500 $2,800 $0 $144,500 . $321°1800 13 2003 $142,400 $2,800 $0 $60,000 $205,200 14 2002 $142,400 $2,800 $0 $60,000 $205,200 15 2001 $142,400 $2,800 $0 $60,000 $205,200 16 2000 $97,700 $2,900 $0 $40,000 $140,600 17 1999 $97,700 $2,900 $0 $40,000 $140,600 18 1998 $97,700 $2,900 $0 $40,000 $140,600 19 1997 $88,800 $0 $0 $35,000 $123,800 20 1996 $88,800 $0 $0 $35,000 $123,800 21 1995 $88,800 $0 $0 $35,000 $123,800 22 1994 $106,400 $0 $0 $40,500 $146,900 23 1993 $0 $0 $0 $40,500 $48,800 24 1992 $0 $0 $0 $45,000 $45,000 25 1 1991 1 $0 $0 $0 $70,0001 $70,000 Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6167 3/24/2014 Parcel Detail Page 3 of 3 r http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6167 3/24/2014- ` ."� ia.?ii+ .'.: •yG_ .aL�, ^t`__ ,.x vyit S',�7Ya1L"S�`����� 2�;�C4j' ��<''.C.t �+. �ib��--�"i'ZC.. 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Tl� co O p W Z 4 P0. vC q q°I 6 0 y f A p qO oA �c• . i' 24p iv ' H R a as I ' I , • �orD ,r. ^ T-R rQ 1 Y PU.NT. 7•-• 1 Y'PLT.M. r do,m All SRI. 117E �F o c7 o I Oto 92 G o ] •E 1 ♦ A 1 4 m,^ \ • • f Vjr�/ y O O Cj . ,,C"♦' rN _-_JL, - ^t 1• 0 I 1 1 F q ell €� - 91n �•s�l' � � u� � LLE i jv i - r ♦:, m i i Nz� i. cc I X[i ' p p r G •' � 'a $ B Fy p R E W. e ' • I nG I I � I I - : 41 ICY p p �-� I I •_ 1 I o mo pu I L________ ______________1I ' T pp S•-0• ,j l of 'm T_ � ________ _ _ _� 1 O cZt� D 1 ' III I I I I I ------------- III COI 1 r 1 1 D ' I III 11 1 1 1 1/ , I I a ♦ . u 1 1 1 •/•DO 7'6'.3'5 1 I 8 z•.6' ct co 1 ♦ I . 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