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2040 MAIN ST./RTE 6A(W.BARN.)
S M E A D No. 53LOR UPC 12543 smead.com • Made in USA �CYC.(� 2 CO2� m Nl9tUS®NTiSORODUCT!!E SFI � E Res ERRRED C ISOURCJNG WWWSFPROGRAMORG ,. .. / �/� �r�,`,� c __ .:. - - _ ... _ .:. . . :�.1.:�..�.... - r.. - - _ -_�,�� - - -- - . � . r a-e � iv/7/9 7 o q ef o�C' ,� i �� �9 � p a� i � i Town of Barnstable Building Post This Card So That it is Visible From the Street Approved Plans Must be Retained on Job and this Card Must be Kept' BAMSTABLE M14M Posted Until Final Inspection Has Been Made. Permit Mn+' Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until'a Final Inspection has been made. Permit NO. B-20-1832 Applicant Name: Scott Doughman Approvals Date Issued: 07/15/2020 Current Use: Structure Permit Type: Building-Sid ing/Windows/Roof/Doors Expiration Date: 01/15/2021 Foundation: Location: 2040 MAIN ST./RTE 6A(W.BARN.),WEST Map/Lot: 217-019-W00 Zoning District: RF Sheathing: Owner on Record: BETTENCOURT,STEPHEN B&MORSE, Contractor Name: HOME DEPOT USA INC Framing: 1 Address: 2040 MAIN STREET Contractor License: 112785 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $4,859.00 Chimney: Description: Remove and replace 5 windows, like with like, no structural Permit Fee: : $35.00 Insulation: changes. Fee Paid.. $35.00 Project Review Req: Date: 7/15/2020 Final: Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is cos menced-within six months after i,gri . icia Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: j This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ) Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by the Building-and-Fire-Officials-are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Service: . 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Final: 6.insulation 7.Final Inspection before Occupancy Low Voltage Rough: Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department i� All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: A - Application numbe ....... ....................... Date Issued........... HARNSTABLF- MASS. Building Inspectors Initials...........�0................. Map/Parcel-------ALT:...0�-6i....... ............. TOOT OF BA STABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDINGIWINDOWS/DOORS/TENTS/STOVES/WF,ATHF-RIZATION PROPERTY INFORMATION Address of Project: --2-c) q(D -11a,;1 V/ NUMBER STREET VILLAGE Owner's Name: &rL,ro- t1p,r5e- Phone Number - 77( -Z90 o �� Email Address: Cell Phone Number Project cost 7& I Check one Residential ✓ Commercial OWN EWS AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CNM Owner Signature: See- A4c,, eQ Date: TYPE OF WORK ❑ Windows (no e change).,�iding InsulationfWeatherization Doors (no header change) I Commercial Doors require an inspector's review pne C'Roof(not applying more 1 er of shingles) Construction Debris will be going to AIA CONTRACTOR'S INFORMATION Contractor's narneA/i.�se� / /P� owe l US — Home Improvement Contractors Registration(if applicable):9 112--7 F S (attach copy) Construction Supervisor's License# 2— L-1 7- (attach copy) I -3`�9 Email of Contractor _Phone number -,!,/o/- 71V- 6 ALL PROPERTIES THAT HAVE STRUCTURE OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY Is IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. A "• APPLICATION NUMBER............................................................ *For Vents Only* I Date Tent(s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a:for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approvaaL *WOOD/C®ALJPELILET STOVES Y Manufacturer# Model/I.D. i Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXLWTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date AP LI CATT'S SIGNATURE Signature Date All permit applicatio are subject to a building official's approval prior to issuance. i i i i t SPECIAL SERVICES CUSTOMER INVOICE Page 1 of 12 NO. H2612-100897 - - - - - -- - - -- - -- - -- - 0. Store 2612 HYANNIS Phone: (508) 778-8948 65 INDEPENDENCE DRIVE Salesperson: JXL0928 HYANNIS, MA 02601 Reviewer: VXG1123 Name Phone 1 (617) 799-6487 REPRINT MORSE BARBARA Address 2040 MAIN ST Phone (508) 776-8805 Company Name City W BARNSTBLE Job Description exterioor door instal 2019-02-0411:30 State MA Zip 02668 County BARNSTABLE ' CUSTOMER PICKUP #1 MERCHANDISE AND SERVICE SUMMARY ssooldrtoc stomershttolimitthequantitiesofinerchandise REF# W17 SKU# 0000-515-664 Customer Pickup/Will Call S.O. MERCHANDISE TO BE PICKED UP: JELD-WEN S/O REF# S15 ESTIMATED ARRIVAL DATE: 03/03/2019 1935754 REF# SKU QTY UM I DESCRIPTION PI TAX PRIC EXTENSION S1515 0000-577-270 1.00 EA NA/ INTERIOR MOLDED DOORS SLAB ONLY LEFT 30/ INTERIOR A Y p $163.60 $163:60 MOLDED DOORS SLAB ONLY LEFT 30 X 78.5 COLONIST 6-PANEL #1 S1516 0000-577-270 1.00 EA NA/INTERIOR MOLDED DOORS SLAB ONLY RIGHT 30/ INTERIOR p $163.60 $16360 MOLDED DOORS SLAB ONLY RIGHT 30 X 78.5 COLONIST 6-PANEL #2 SCHEDULED PICKUP DATE: Will be scheduled upon arrival of all S/O Merchandise • $327.20 OF CUSTOMER PICKUP -REF#W17 INSTALLER DELIVERY #1 0 REF# 101 STOCK MERCHANDISE TO BE DELIVERED: REF# SKU QTY UM CRIPTION PI TAX PRICE EACH EXTENSION R04 0000-254-294 3.00 EA 3/4"X5-1/2"X8' PYMINW A Y $23.48 $70.44 R05 0000 625-464 3.00 PC 1X5-8FT E BOARD/ A Y $14.62 $43.86 R06 1002-961-477 1.00 EA 6" & DOOR SEALING TAPE/ A Y $17.97 $17.97 R07 0000-715-499 1.00 _RLft PURP 16"X48" ROLL INSUL 5.3SF/ A Y $5.481 $5.48 R14 0000-933-616 J.qQ, X80 LH PREM 9 LT FG IS BM / A Y $254.001 $254.00 ***CONTINUED ON NEXT PAGE*** WILL-CALL MERCHA UP R FOR WILL CALL Will-Call items in the store for 7 days only. MERCHANDISE PICK-UP Check your current order status online at PROCEED TO WILL CALL OR ! C wtV www.homedepot.com/orderstatus I SERVICE DESK AREA I �_ _(Pro Customers, Proceed To The Pro Desk) _ J SPECIAL SERVICES CUSTOMER INVOICE - Continued Name: MORSE Page 7 of 12 ®_ H267 2®1®0897 4 TOTAL CHARGES OF ALL MERCHANDISE & SERVICES - - , •® m® ® 1 769.83 Policy Id (PI): SALES TAX . $59.49 a A: 90 DAYS DEFAULT POLICY; TOTAL $1 829.32 BALANCE DUE $1 239.44 PAYMENT TERMS : Refer to the Home Improvement Agreement for payment terms 'The Home Depot reserves the right to limit/deny returns. Please seethe return policy sign in stores for details.' END OF ORDER No. H2612-100897 Customer's signature,a, 11. Date a / _ i ^-- - _r ... 1►1� �!`��'� �_� AAA®°7 -�- - ^- i t trrt e. CS-074247 :Xonitructlan Satperivis*r . :PAUL M DOWNING � A00 KESWICK ROAD r� BROCKTON AAA 02$02 f r, . - Commissioner tot .�� 77'e Commonwealth of Massachusetts Department of Industrial Accidents i Office of Investigations Q.r,' I Congress Street,Suite 100 Bosto�e,1VIA 02114 2017 www.mass gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): l,L .. Address: City/State/Zip: ;,;n l s - Phone#: "Z� Are you an employer?Check the appropriate box: Type of project(required): - 1.❑ I tun a employer with 4- ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2_ am a sole proprietor or partnar- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have, g. ❑Demolition Working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance.* 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10-❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I Ln Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. (No workers' 13.❑ Other comp. insurance required.] Any applicant that cliecls box rl must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all.work and then hire outside contractors must submit a new affidavit indicating such_ #Contractors that cheat this box must attached an additional sheet shoeing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees:they must provide their workers'comp.policy number. I am an employer that is providi►zg workers'compensation insurance for my employees Below is thepolicy and job site information. _. Insurance Company Name: Policy#or Self-ins.Lie.-#: Expiration Date: Job Site Address: City/Sthte/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of.MGL c. 152 can lead to.the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ' I do hereby certt under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: _-........._�..___.__ - Phone#:- - use only. Do not write in this area,to be completed by city or town.officiaL City or To, Permit/License# Issuing Authority(circle one): - 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f The Commonwealth of?Massachusetts Department of Industrial Accidents �►�° Office of Investigations J 1 Congress Street,Suite 100 .- Boston,314 02114-2017 Ilk- w►vw.mass.g ov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl•v Name (Busincs/Crgu=tiowTndividual): Ho �ei -Address: /B 9 6 Citv'State/zi : Si/'swt6 /10 . of yr Phone#: 7 �L�� 7S - C2-ASS Are you an employer?Check the oropriate b � Type of project(required): ]. i am a empiover with , 4. 9mn a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors il i r' I am a sole proprietor or partner- listed on the attached sheet 7. ]Remodeling ship and have no employees These sub-contractors have g, E Demolition for in any caps employees and have workers' wor�o �'• 9. ❑Building addition o workers' comp.insurance comp.basuramce.*- 5. 71 We are a corporation and its 10.❑Electrical repairs or additions 1 ;.r I am as homeowner doing all wort officers have exercised their j 1 L[3 Pltmmbing repairs or additons myself. :,No workers' comp. right of exemption per MGL 1=.❑ oof rep:.irs instance re aired t c-152,§1(4),and we have no q ] employee. [tio workers' i 13-i.vi Other Pn.�'Y A,� comp. insurance required.] •—Y appi=E that_hccL—box if'_must also fill out the section below showing their work='compensation policy utformation. riomcomms who mbmitthis affidavit indicating they art doing al]work and then hue outside comracmas must submit a new afi;davu indicating such. :Corm-tors that check this box must attached an additional sbeet showing the name of the sub-comments Had stare wbetber or not those entitics have =ployees. 1 the nrb-cnn=ct=have employees,they must provide their workers'comp.policy number. I inn an employer that is providing workers'compensation insurance for my employees. Below is the policy and job sire information. L-is,rance Company dame: r/Z>✓ Q oitle�� VN�on/ /Pt� ,�.t/S . �� _ Policv#or Self-ins.Lic.#: W (ti 1 S I I Expiration Date: Job Site Address: 1 rn qc) M.2,n S-/. City/S1nte/Zip-. 1•-t3aC4c- /e_ . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Faihire to secure coverage as required under Section 25_4,of_VIGL c. 152 can lead to the imposition of criminal penalties of a fine un to$1,500.00 and/or oue-yg imprisonment, as well as civil penalties in the farm of a STOP WORK ORDER and a fuse of up to S250.00 a day ' qt a lctor. Be advised that a copy of this statement may be forwarded to the Office of I>;vesti;ations of the DL9 ce coverage verification. I do hereby certify un the information provided above is true and correct S aurae: Date: Z — 52 Phone T: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit'l icense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CityiTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 4 f',ie t• J.6Y L 2. Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Supplement Card Registration: 112785 HOME DEPOT USA INC Expiration: 04/22/2019 2455 PACES FERRY RD C-1 1 HSC ATLAN'TA, GA 30339 Update Address and return card. Mark reason for change. 10 Address C1 Renewa! 0 Employment Ell Lost Card 7 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE.Suodement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 112785 04i22/201 9 10 Park Plaza.-Suite 5170 HOME DEPOT USA INC Bostori,MA 02116 ANDREW SWEET 2455 PACES FERRY RD C-11 HSC • A7L-ANT A,GA 30339 *6�2!!04houl signature Undersecretary DATE(MMIDDr1YYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 022220% THIS RTIR ATE 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME MARSH USA,INC. PHONE FAX TWO ALLIANCE CENTER ac No 3560 LENOX ROAD.SUITE 2400 E-MAIL ADDRESS: ATLANTA.GA 30326 INSURERS AFFORDING COVERAGE NAIC d THE HOME DEPOT,INC CN101642o69-HOmeD-GAW-1B-19 INSURER A:Old R ublicinsuranceCo i 14147 INSURED INSURER 9:New Ha shire Ins Co 23841 HOME DEPOT U.S.A.,INC INSURER C:HomeRisk Capilve Insurance Company 2455 PACES FERRY ROAD INSURER D: BUILDING C-20 ATLANTA.GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL•004353439-16 REVISION NUMBER: 3 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 AOOL SUER POLICY NUMBER MMIDO EFF MMIro EXP LIMITS LTR A X COMMERCIALGENERALLIABILITY MWZY312717 03N12018 03/012019 EACH OCCURRENCE S 9.000.000 . -YA-M-AGE TO RENTED j CLAIMS-MADE a OCCUR j PREMISES Ea occurrence I 1.000.000 i I I LIMITS OF POLICY XS ! EXCLUDED MED EXP IAn one person) +s j I I i OF SIR:Sim PER OCC i PERSONAL 8 AOV INJURY S 9.0Cd1,G00 1 GEN'L AGGREGATE LIMIT APPLIES PER: I I GENERAL AGGREGATE S 300C'100 l x 1 POLICY❑PRCT 1 LOC O- i I PRODUCTS.COMPIOP AGG � S 9,OOC.000 ' JE I OTHER: S A AUTOMOBILE UASILITY MWTB312718 03l012018 03/012019 1 COMBINED SINGLE LIMIT ! s i.000.00C i Ea a¢tdenl X I ANY AUTO ! I I BODILY INJURY(Per person) 1 S OWNED 1^�!SCHEDULED I SELF INSURED AUTO PHY DMG I BODILY INJURY(Per accrdenll S f AUTOS ONLY I�AUTOS HIREC i NON-OWNED I PROPERTY DAMAGE s AUTOS ONLY AUTOS ONLY I I I Per acadenl I I IS I UMBRELLA LIAB OCCUR i I EACH OCCURRENCE S WACCIOENT , EJCCESS LU18 CLAIMS-MADE 1 'sDED RETENTIONs SB wORNERS COMPENSATION WC 0141225Ti (AK,NH,NJ,VT) 031012018 031012019 OTH-ERBAND EMPLOYERS'LIABILITY YIN iI WC 014122578(WI) 031012018 03/01/20195,000.00C ANYPROPRIETORIPARTNERIEXECUTIVE ❑ IIJ $OFFICERIMEMBEREXCLUDED' NIA 5(Mandatory in NH) PLOYE s d yes,describe under Continued on Additional Page ; EL.DISEASE-POLICY LIMIT s 5,0WOM DESCRIPTION OF OPERATIONS below C Excess Aulo 297-1-10011-00-2018 031012018 031012019 Until: 4.000.000 I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA.GIN 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi MukherjeeaKov'� ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD r AGENCY CUSTOMER 10: CN101642069 LOC 9: Atlanta ,a►— ®' ADDITIONAL REMARKS SCHED ULE EDd1LE Page 2 of AGENCY s - i MARSH USA.INC. l NAMED INSURED THE HOME DEPOT.INC j POLICY NUh19ER HOME DEPOT U.S.A..INC. 2455 PACES FERRY ROAD SU!LOING G20 i caa�t=e ATL,4N A.GA 30339 NAIC CODE ) ADDITIONAL REMARKS EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, +FORM NUMBER: 25 FORM TITLE: Certificate of Liabili Insurance Workers Compensation Conanued Carrier.Indemnify Insurance Company of North.America ?dicyfJumbarV'LRC647o^319i(AL,AR•P ID•IA• S;(Y.W,;,ij,AiU.PiEFIE.i;ND,gk,SC.SO.Tr!'NV,SVY Effective Date:03/012018 Expiration Date:0 310 12 0 1 9 (EL)Unit 3 i.000.000 Iearner Nev:Hampshire Insurance Compar,/ I ?dicy Number WC Old122576 (OC,OE.HI.IN.MO.MN.MT NY,RI) _ffectiva Date:01012018 I xpuation Date 03/01/2019 ;EL)Liml:s1.00D.0oD i artier ACE American Insurance Oompany ?chcy Number.WCU C64783221(QSI)(AZ CA•IL.AIC.OR.VA.'NA i ! Effective Date:03/012018 E<mralion Date 03/01/2019 I (EL;Limit:S,.000.000 SIP.S 1.000.000 SIR for the states of Ac.CA,IL,NC.•0R,VA•'NA 1 Camer.National Union Fire Insurance Camp-any Pdicy Number XWC 4595580(QSI)fCO,C i•GAAI E,111,W,OH,?Fl.UT) Eifectve Date 03/012078 ecuation Date:0310112019 i IS; Umil:3 i 000,000 51.000.000 SIR for the statas of CO.,AF NV,,AI,OH.PA.UT S7 0.000 SIR.ar tha stale of GA S350.000 SIR.cr the state of CT Camer.National Union Fire insurance Company °dice Number.XWC 459MB i(OSI)(,Y1A) Eflf G Oa'e:0 310 12018 Expiration Oate:03/0t2019 (EL)Umir Sl 000,000 SIP, S500,OCO Tx Empioyers XS Indemnity. ICamer71mios UNon Insurance Company Pdicy Number.TNS C4916693A(T.() Elective Dale:03/012018 E.cpirallon Date.03/01/7019 I (EL)Limb SIO.000.000 SIR.3 i.000.000 ACORD 101 (2008/01) CORD CORPORATION. All rights The ACORD name and logo are registered marks of CORp reserved. s -' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 1 , 130�7 :r t�j ,V� 0 - ` Permit# 3 Z Health Division 3 `3:v SEP Date Issued �_1 0� Conservation Division 14r4, ot,4i tL :/NST,gILEp 8r WUS Fee Tax Collector �y�l�® wl�/1�1���/IPLIA�E /� r� E 5 Treasurer/.Cffl ' f l •q� T ®i°�9 J ��� C� Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 0 Y0 40,A Village Owner 7 A/1- 7_ VL ild i_e_� Address Telephone 3(�,,2_ I otbS_' i Permit Request 'Cz t,L d 2_C�J(-11' Square feet: 1 st floor: existing 'proposed 2nd floor: existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size (,,._S G1LAZ� Grandfathered: 0 Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family �1 Two Family 0 Multi-Family(#units) Age of Existing Structure Historic House; O Yes ❑No On Old King's Highway: '�tles ❑No Basement Type: XFull ❑Crawl 0 Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing % ; new _ Half: existing new Number of Bedrooms: existing_ new Total Room Count,(not including baths):existing new First Floor Room Count Heat Type and Fuel: C Gas 0 Oil 0 Electric ❑Other Central Air: ❑Yes jV0 Fireplaces: Existing New Existing wood/coal stove: ❑Yes o Detached garage:f existing ❑new size Pool:0 existing Elnew size Barn:0 existing 0 new size Attached garage:❑existing ❑new size Shed:❑existing 0 new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial 0 Yes O No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name UiC� /, Cj Telephone Number 412 03 l7 Address License# D5 7SV n M GA_J S M,,La 0,Z 6 V J, Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE } FOR OFFICIAL USE ONLY y PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION:io FOUNDATIONT� Z , FRAME `,% INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: R&GH FINAL GAS: ROUGH FINAL _ FINAL BUILDING - DATE CLOSED OUT ASSOCIATION PLAN NO. , l 09/84/1992 09:48 FROM YANKEE SURVEY TO 7751952 P.01 - 190.00' BY PLAN RZ5 BY DEED 1 N8870'25"S 41, o +b q w 4 co „ o PARCEL .2 � G,3tu�"-°� aJl •Q O 645'1 NOTE• PRE-EXISTING PARCEL 1 NONCONWO,RXING- = ' o I o IngAfAl 5'IS t 7$ l TREEr RES. ZONE- "RF" This MORTGAGE INSPECTION Plan is Use OnI°r 1rLOOD ZONE. "C" TOWN: _FFgSZVARA'5 L4&W- — — _ REGISTRY OWNER: -JQYY-G . &RUTH D�'L91? _, _ DEED REF: 4�7 181— — — — —BUYER. DI NF _ & HEgay Ar_ DATE: PLAN REF: 182 -0- -SCALE:1,'_ 50�--FT. I I RELY CERTIFY TO ,C !E—COD L�T_�LL_�c �'A S SIICCES50RS .41VD THAT THE BUILDING SHOWN ON THIS PLAN is LOCATED ON THE GROUND As o PAUL YANKEE SURVEY SHOWN AND THAT ITS POSITION DOES --_- CONFORM CONSULTANTS TO THE ZONING LAW SETBACK REQUIREMENTS .OF THE 4 A9�RITHEW H TOWN OF ---B_R�,9�'�BIT DOES NOT LE' !y roo. 32098 143 ROUTE 149 _____AND THAT i3 QfGI$il��e MARSTON'S MILLS, MA 02648 IJE AREA AS SHO'YN ON HE H.U.D. M DATE FLOOD as�OM�i IANd°� TEL 428-0055 - e �250001 0003 D FAX 420-5553 _ __ THtS FLAN NOT MADE 1 ROM AN MTRUMENT �A EW, SURVEY NOT TO BE USED FOR FENCES ETC. 9351 DPG E TOTAL P.01 Application to 1..9 9 us3 Old Kin is's Highway Regional Historic.District Committee g g .�; in the Town of Barnstable for a CERTIFICATE.OF APPROPRIATENESS Application is hereby made, id 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: ❑ Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (.e-L L �'n C (Please read other side for explanation and re uirements). v-5 TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK ��ICJ /'lam��- I� /1�I1 �4�C5SESSORS MAP NO. al -7 OWNER l/e_u/►1Cl_ ?da re-eldl'e ASSESSORS LOT NO. HOME ADDRESS 010(tV /nlLVA C51' 'A)405al&Z" � �-�- TEL. NO. 3" FULL.NAMES AND ADDRESSES OF ABUTTMG OWNERS. Include name of adjacent property owners Toss an public street or way. (Attach additional sheet if necessary). zM CD W"� o a(d &L, S+ , !� = ;0L jJ Lk v - hh d C 7 AGENT OR CONTRACTOR V' !Z_C1C_4 TEL. NO. (' ADDRESS J 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). Ict If APPROVE1 Owner-Contractor-Agent Space below line for Committee use. ..:...�.... Q Ke Certificate is hereby / / da,,4 R 3 I IQQQ mA '/` i Approved y ❑ IM RTANT: If Certificate is app ed,app oval is subject to the 10 day appeal period provided In the Act. p . Town of Barnstable ` Old King's Highway Historic District Committee SPEC SHEET FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOWS COLOR SIZE TRIM COLOR DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS r'Z � "(j�e-p�CcCP� /2,`XZ2)MATERIALS �it-2y3Gt�Q, GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS SIGNS COLORS FENCE COLOR r NOTES: Fill out completely, including measurements and material a/colors to be used. Pour copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SP$CSHT Revised 11/98 - i c� vE " t It Arr- .................d- mv 6 Z 4. - l � ... _.. .:�-.. .!.•.�y,+,��_ ,. � ..,.. .. 1. 'ME The Town of Barnstable ®F '�o Department of Health Safety and Environmental Services r • Building Division • BAMSTABLE, 367 Main Street,Hyannis MA 02601 y 1639. �ArFD MA't A Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: oZ 0`/& 9Y lCi c V\ number street village c "HOMEOWNER": �) f72. f�a,re- name c1 home phone# work phone# CURRENT MAILING ADDRESS: °2 b i. 0 y0a UA —� ml lea 6 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&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 to amend and adopt such a form/certification for use in your community. `i Q:FORM&EXEMPT The Town of Barnstable 9�A 059. I�' Department of Health Safety and Environmental Services rFo may" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: J6 1,21Ck�� Q Estimated Cost ���� • Address of Work: o_0`�0 M 0--c-4 ,S4 Owner's Name: M. BA4-e_r7d�-e- Date of Application: ELF! 9 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law o1ob Under$1,000 uilding not owner-occupied �Svwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY 1 hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. _ OR Date Owner's Name q:fbr ms:Affidav r _ Tile Commonwealth: of Massachusetts �j __ Department of Industrial Accidents .. •L '__ ONCe ollnyestfUnfans < 600 Washington Street Boston,Mass 02111 Workers' Compensation Insurance Affidavit name: 1 J i G\\-Q 1' ' • a r e Ad J location: 40 q VV\ %city GJy s phone ii ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in anv ca acity ❑ I am an employer providing workers compensation for my employees working on this job. comonnv name: address: :.;:.. :.,. . . ... ..... city: phone#• insurance co. niicV //////////////%///////////%////////%/////////////////////////%/////////%//////////////////%//////%// ///////%//////////// ////%/%/%/%///////////// %///i. I am a sole proprietor, general contractor, o homeowner( !e one)and have hired the contractors listed below who ve , the following workers' compensation polices: company name: C' Ck C,.u address: Ms. f����f city: hone#. nsarttnce co. a/00/i aaiai//�aii���/iai�a�i ////i// /��iia/� camnanv name: ;,....,:.,:...:.. ............,..... address- city- phone ::::..:....:. :...::::.:;:»:: ............ insurance co. oiiev ME Failure to secure coverage as required under Section 15A of MGL 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Me of 3100.00 a day against me. I understand that a copy of this statement may be forwarded to the Ofnce of Investigations of the DIA for coverage vertneation. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct signature D t,&,vtR.- -73a/z�, Date c�/�7�Q - Print name !J I LIA V1 -P, Fhtme fl 'Z 1cZ0 Echeck nly do not write in this area to be completed by city or town oRicial perrnifAfcense# QBullding Department ClLicensing Board mmediate response is required QSelectmen's OMce ❑Health Department on: phone#; QOther VCVLMa 9i95 PIA) Information and Instructions - Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contra= 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 receiN e:,: 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renews of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither.the . commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. , Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of inn=ce as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and .date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the'law"or if you i are-required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete 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. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to.thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of imlestfoaucas _ 600 Washington Street Boston'Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext 406, 409 or 375 F ate Time �— W�ILE YOU WERE OUT M ofw� Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTSTO SEEYOU URGENT RETURNED YOUR CALL essage ozo�o � -f1 Operator AMPAD 23-021 -200 SETS EFFICIENCY® 23-421.400SETS CARBONLESS Assessor's map and- lot •number �i /. :...- ...... .. Q � *THE Sewage Permit number. O_...� �13 ..0..:...... d�Qyo �4� ouse `number �: v s m H ......................................................... � ....0.:...... 00 aaa 9TODL MAB9 i' i639• 9 TN ►OAF rBARNSTABLE y =' BUI-:LDIHG - INSPECTOR APPLICATION FOR 'PERMIT TO .. ... .............al CJ . 1� G Tv r TYPE OF: CONSTRUCTION ..:.:..� .........OIJG ..4 .d'�iL'dsLG............................... i .... .....� .................................198 5 TO::,THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... ........�(.!��/l'�......... .........�..... i !l�.................................. ................................... ProposedUse ...... d ........... l/G .........4.... ... GG-r.......................................................... Zoning District ....... ... .../ Fire District .................• % Y.�T.f.Ir. <<. .................................... C!L �/ T ot� Address 70 C-..... . Name of Owner .. ..'.`. ........................................... ................................... ........ ..... Name of Builder l.. 0 2� �✓ � ( 54.. �� Address �^ 5 �......................... SS............ .............S........�: Nameof Architect .................................:................................Address ....................................:............................................... o e4T= 3Cv. Number of Rooms ............l�.�!}��..........................................Foundation .../C.........��.........G.......1...........G�..... Exterior ........6G`'.�'�1L...... �T��� ���.G.�-S ...Roofing .YTS G ......... ................. Floors ..........................................................Interior ........ �/� Tr/ ................................................ Heating ........� = ............................................Plumbing .......�. F1............ i .............. Fireplace ..................................................................................Approximate Cost Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area 1...�.' ..... 1� �..c � Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH V ° �b CV CqX 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 ........... .. . NORTON, ROBERT 25692 for-.REPAIR"FIRE Da age Permit - _ .. .. r Dwelling Over Gara e 2040 Pain Street - _ocation ................................... . .. ........ - West Barnstable Jwners.:Robert Norton....... .. . " - - Frame 1; ryPe f Construction: ..... `a ........ - "�; 'lot ....................... Lot= _ ..... ................. r = 'ermiJt'Granied COctober 26 r {19 83 )ate of Inspection ................ . .. .19 )af Completed R",7 ... `.'1:9 1 •. �3 _ Assessor's Office(1st floor) Map /�-2/ 7 Parcel 0/Y. WXPermit# 02 Conservation Office(4th floor)(8:30-9:30/ 1:00-2:00) JhOL1016 Date Issued Board of Health(3rd floor)(8:15 -9:30/ 1:00-4:45) F3 - 30 T ewlLl?-4 a. i/l�et yo© Yea Engineering Dept. (3rd floor) House# "&4 �� Pl @11 ) SERTbC SYST� L INSTALLE® N WITH �C D oard 19 � TOWN OF BARNSTA fr"111MENTAL CODE AND Building Permit Application Project Str et A dres I p Q MAJ� I W�S/ IS4&�-243� �. Village IJ ,/Owner-1,.L/'T�v� �r ��9� + Address Telephone ` : (0 Z 7/ V 0 : � �Z 2-6 S_ (J J 4-94y6 0 ,P€rmit Request -1 f- �-C`� &J S First Floor 0 0 square feet ,,,�Second Floor ,S (0 Y square feet fi 1'�fsstimated Project Cost $ r 60 Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type WU(sQ PWkE, Commercial Residential L,-� sl/Q (s i.E i`,4wk LAf Dwelling Type: Single Family I/ Two Family Multi-Family Age of Existing Structure Basement Type: Finished H' toric House fini nshed Old King's Highway 'S�A WPIUVAC — Number of Baths 3 No. of Bedrooms 7 Total Room Count(not including baths) First Floor Heat Type and Fuel F tf UJ Central Air A/ l} Fireplaces 0 N& Garage: ✓Danetached Other Detached Structures: Pool A) /�- Attached Barn IV f* None Sheds N '/- Other to I A-- Builder Information ✓Name KX-S j g�S�( VL_ 4V 1 _YG S Telephone Number / ` 0 oo -S-y a — (o L 3 3 Address U7 0 &I License# 0 Z� 2-1 ?-- CA&IL- 2A49 Lf- ,,—Home Improvement Contractor# / C7 Q O )'7 W, 6 MIJ S LE, ,/ -. 0 2b� rker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO d/U" 5 f Ir d aw S-J-Y2 S 06 SIGNATURE,�, DATE BUILDING PERMIT DENIE OR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. T, DATE ISSUED - L MAP/PARCEL NO. ADDRESS - VILLAGE - OWNER . 1 DATE OF INSPEfTION: _ J) F , FOUNDATION FRAME= ' INSULATION ' FIREPLACE "r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i CIO .y GAS: ROUGj-I'. `' ' ' -- FINAL A FINAL BUILDING • ! �' DATE CLOSED OUT R ASSOCIATION PLAN,NO. 1 + `SINE Tq, O� The Town of Barnstable aA Department of Health Safety and Environmental Services MASS. t6y9 �0 � ' Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection, Sli 1!�\7 Location /2—ci L- k( �A Permit Number Owner Builder , One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: �P CS' kL(NU t11S:�u1 i c of t Please call: 508-790-6227 'for reeinspection. Inspected by f Date -�' `�t• i . . _ The Town of Barnstable KIM& 1�P Department of Health Safety, and Environmental Services Building Division 367 Main Strut,Hyamis MA 0=1 F Ralph C== O> SOS-790.E-W Hag F= 508 775-33" For office use only • - Permit no. Date AFFIDAVIT , HOME MOROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c I42A requires that the"t+econstruaran,alterations,•renovation,mpais;modernization,wavers M improvemeent,temenal, demolition. or eonstf ion of an addition to any pre,-ccisting owner o=upied building containing at least one but not more than four dwelling units or to saudures which ate adla = to such residence or building be done by registered oonttact M With Certain exugdons along with other Type of Work: � EsL Cost f L �ddrtss of work: Date of Permit Application: I hereby certify that: Registration is not requited for the following r ason(s): Work emcluded by law Job under SI,000 Building not owincriiiiied Owner ping own persuit, Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WtIIit7NIZEGISTERED CONIRACPORS FOR APPLICABLE HOME IMPROVEMENT ENi' WORK DO NOT HAVE .ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c•I42A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the ag t of the owner. Date nuac for name OR The Commonwealth of Atassachusetty ---= sNl: Department of Industrial Accidents ,.a Met ol/oi S119211oos »` .;P..__r t5llll 11'ashirrltun Street • Burton.Altus. 02111 Workers' Compensation Insurance Affidavit i1C�=rat ntnrmatin`n� - rleflSe PR1N'1''leI�►'' name! ti(I KE XlnJ 6 S:TVJ Z (/L 5 t r4-/S q location• 11-7V city , +V v� nhone# < ' U L�' S��)' (0 l'S I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity e •^?�-.r•-tea-u, r, """�a.,,o� lam an emplover providing workers' compensation for my employees working on this job. ...- /om�nnx nnmc: �Idress• - i nhone#• Insurance co. Zola# ' lam a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comonny n•tme• 64US6 , W rJ4, Ah, S'U�VvvZ. addresse City: Sf✓",✓ VAT r " / ,.. nhone#• U insurnnceco (2wi7 Policy C l 6776 Y �- -,�c: :«,,-:,T.r .- - , ,rcri!r:...Q:,,:ars.-s-�-`r?'-�.et;Ms;-'!.S�*�r_', .- i�avrns�r�•±�?��%"+',•_T+ �^*�+^•�se�+ms.+r-....vt -- � - - -•-..V r' - "- - rifi3iiiii7111�•_" _ -- _ =_ ��_' _ - - _ y name: address: ��' V t �V / 0 - W /F, �r� 3z - 0 yjj•• J nhone#: �— U utfDoi (Jlr� :Attach additional'sheet if tieeessa =_w Wit' traa:—` ?•� " Failure to secure coverage as required under Section 25A of A1GL 152 can lead to the imposition of criminal penalties of a fine up to '1.500.00 and/or une rears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certlj' !cr the p • and penalties ojpeduq•that the lnjonmadon provided above is true and correct Sicnature / —✓ 5 , ;/Print name At ( C4-(,� Lt/J 6 �' —phone# [on nly do not write in this area to be completed by city or town official permit/license# nBuilding Department Licensing Board ` mmediate response is required QSeleetmen•s Office C3I�ealth Department on: phone#;, nOther -•...� .s.oar+..-�!.'.''� IMISed 3:95 PJA) a,r w J -Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees: As quoted from the"law", an emplovee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An empinver is defined as an individual, partnership, association, corporation or other ;cgal entity, or an%,two or more of the fords=oing enga=ed 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 dwc1lin�; 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 1'52 section 25 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 in coverage required,. Additionaliv. 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. 1`+:�-r.. - .+'....��w :�:•a. . 1•n. �.�a. ty:.. tr.. �„ .i•,d y_•-•r^ S.:.CK:�.w.¢`ya".9,�`•.ar • . t. • •°v},t: S'i;.'.1:+ tip_, .O?^•: �.'•: A c. :). Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying-company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date tl�e affidavit. Tl�e 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. r--s-•,....�...rw�n�.s....Q..c.... ,.�.—.e.., _ ::�w.:�.:_ .,i. ::..:a'ta:r.;:c•;•... sb:Kw- =.f= j:_.: "!�i•'�'' z;" :•s.: _ _.. �. ,- .-0r• •. _ —• "y,> :••:.:«.,=:; _ .:.5's7i�!!.�:1`. tE:-` ' : -•yes , �:; Cite or Towns 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/iicense number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. Tlie Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 190. 00' BY PLAN 225' BY DEED i N8810'25"E \ r� I � zv � wq W I 3 CAR GENT ABOVE \ N ppPAR7 21.0' o I4.0 PARCEL 2 I � 2 � o 813E D I 16' IO _._040__N W65 f . ==-321 -__ ES. Proposed I ISide addition 16' x 241 Rear addition I NOTE. PRE—EXISTING PARCEL 1 I 281 x 81 NONCONFORMING. o � N79.55'13"E I S83' ,E AfAIN S TREE - RES. ZONE.- "RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Bank Use Only TOWN: _WKST_RAf�US_T_98_LE_ _ _ _ REGISTRY OWNER: — QH-,Y G_ & RUTH D CURKT _ DEED REF: 457?,�1 _ _ _ _ _BUYER: DIAYZ_AL_ &H',�&.L9—R_J80WSK DATE: 914192_ _ _ _ _ _ _ PLAN REF: 18Z/ 5_ - -SCALE:1"= 50___FT. I HEREBY CERTIFY TO C PE_CQQ Nf & TRUSS'C0._ jet\ of as,; _I_TS S_UC_C_E_S_S_O_R_SD_0_RA_S_S_IG_NS_THAT THE BUILDING �` ss�o' YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS PnUL yG� SHOWN AND THAT ITS POSITION DOES _ _ CONFORM '` h CONSULTANTS THEW TO THE ZONING LAW SETBACK REQUIREMENTS OF THE ME. 32098 N `.o No. s2o9�1 Q 143 ROUTE 149 TOWN OF _ BARNSTABLE-------------AND THAT i� >� IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD ��°s GISIER%Q�' MARSTEL: 428 MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED 7 2 92 r� cO FAX 428—5553 --_...---•� FAX: 420-5553 C munit —Panel 250001 0003 D �`'°��' _ _ _______ THIS PLAN NOT MADE FROM AN INSTRUMENT 9351 DPG PAUL A. ERI EW PLS SURVEY NOT TO BE USED FOR FENCES ETC. Ell q� 5�^Y; :✓/b W/1JrAOR�Gtl6�Gf��tM:dMOYeYN 1��;� , - rp f* (� W.'�s.•'�'e aY�Yaideitt lw", :@ "� N�IE IKPR4VEKEKt'WkTRACTOR T Re rat'Lop i00017� ° ' - s Type eP,RIoT 'ctI�PORai olF .Y Ezfxiration� l08/9 {(, r Ae wit oofflata letcwaarfn rl` tea= 6a Ri'Of 'S16 % COMMONWEALTHa1 Bafllata9 V, ► 01668 1 DEPARTMENT OF PUBLIC SAFETY Failure toPossess¤t ,�.. OF ONE ASHBORTON PLACE MassacAasotts5taw"Idip9 MASSACHUSETTS BOSTON,MA 02108 Code locause for revOtdtbR� ' LICENSE of this llcesso. ' •�A+, SUPERVISORCAUTION : EXPIRATION DATE C O N S T R. � C 04/1 2/19 96 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB NONE 06/30/1993 023212 PRINT IN APPROPRIATE K. BOX ON LICENSE. MICHAEL L KING.STON ? � FORESTO,ALE MA.�02644 USTI INCLUDE MUST INCLUDE PHOTO. ff s` PHOTO(BLASTING OPR ONLY) FE� '� 1"_� /� \ �� :•' ' l U 0.G 0 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: AM D-OR-SIG TORE OF THE COMMISSIONER I• ti THIS DOCUMENT MUST BE AL ♦ SIGN NAmE'IN FULL ABOVE SIGNATURE LINE CARRIEDON7HE PERSON OF! wpormw SEEj I J J a u�_� THE HOLDER WHEN EN4 OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATION{ COMMISSIONER .� t MEMORANDUM TO: Building Commissioner FROM: Gwendolyn Brown, OKH Secretary DATE SU13J: Modification to Prior Approved Plan A minor modification has been approved by the OKH Committee to a prior approved plan for the applicant (s) named below. The modification is briefly summarized and. I have attached backup material for, your records . . Applicant (s) �t an-�►� a re--h C`i`S �. Address of proposed Work Meeting Date Approved by OKH . r Minor Modification czS 4- X.� e)LA_ Chairman I:f�you- should have any questions; please do not hesitate to contact me at ext . 285 . MMOBc ) M r Application to Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a 9 A 9 0 e� CERTIFICATE OF APPROPRIATENESS Application is hereby made, id 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 0 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 DATE /D—ID ADDRESS OF PROPOSED WORK Ma un 6&. ""' r ASSESSORS MAP NO. OWNER D t 0..✓( @ I ` —6a I''ert cfS� ASSESSORS LOT NO. HOME ADDRESS TEL. NO. FULL NAMES-AND ADDRESSES OF ABUTTING OWNERS.- Include name of adacent property owners across any public street or way: (Attach additional sheet if necessary). AGENT OR CONTRACTOR TEL. NO. 0 L J ADDRESS ILLnzA .>'. 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). kit" ,.,__ Signed Owner-Contractor-Agent S.. o J be.f_:g,_.._.mmttee use. Ricirefybd by H.D.C. 4L �,4 s .1 d OCT 1 2 i9q,11 �,v L-e J 19 Die The Certifi to is hereby a Date 9J Taime TCI^IN OF 6) ;'. S � By Approved ❑ IMPORTANT: Certificate i ppro7ed, pproval Is subject to the 10 day appeal period ___ provided in the Act. Town of Barnstable gW's Old King's Highway Historic District Committee SPEC SHEET FOUNDATION �Q 1w_lac) l (5 Q(, SIDING TYPE 2= 4j-k) COLOR CHIMNEY TYPE COLOR ROOF MATERIAL_ 012LIN,' ' Gj �� COLOR PITCH ` O N11,TC J4 WINDOW DOIJ SIZE TRIM COLOR o � DOORS . (� �,) `b �. ��,,T_COLOR�p - SHUTTERS �), ( . GUTTERS DECK GARAGE DOORS COLOR NOTES: .Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, along with throe copies each of the plot plan, r` D landscape plan : and elevation plans, when applicable. Plot plan need not be "Certified",. � but should show all structures on the lot to scale. SPECSHT MEMORANDUM TO: Building Commissioner FROM: Gwendolyn Brown, OKH Secretary DATE : /-// lam- SUBJ: Modification to Prior Approved Plan A minor modification has been approved by the OKH Committee to a prior approved plan for the applicant (s) named below. The modification is briefly summarized and I have attached w backup material for your records . Applicant (s) �toW,►� e, �Q re.•� c`,`S Address of proposed Work ;20\4 0 `VV\ S� = Meeting Date Approved by OKH Minor .Modif.ication wj oo"� l �6f vim. r' p—u.�" �►1� �� o o <- c 1l II Zr - © r S e)L-A- T Chairman If you - should have any questions,. please do not hesitate to contact me at- ext . 285 . bEMOBC Assessor's map and lot number Z,12................. THE Sewage Permit number .. : ....f.l... .✓....... .. ..,... .. ( -, House number Z� 7 �� LB Y039. a �0 TOWN OF BARNSTABLE -BUILDING INSPECTOR ' APPLICATION FOR PERMIT TO ......./L7G............ � /l2.... . ...... .�.....................`:............. TYPEOF CONSTRUCTION ..................................................................................................................................... � t .... ��-T.......Z TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according too the following information: Location ..... ../.. ........ .. .....s.. .......... ..... _S.s�,�i✓:...................:............. Proposed Use ................................................... Zoning ,District ........... .... / ...........................Fire District C� Nameof Owner 2�?e......................................................./ Address ........................................... ........................................2i-�r Name of Builder'A ✓:: Q'v ' !?!J..Address ..v�....C� ���.:'�(..............:t� Name of Architect ....:.............................................................Address Number of Rooms ............� :r.�.......................................Foundation .. .�?�h��;/� ................c...G ............ Exterior ........ F: t'/?.......5/i�6? �:.5..................Roofing ........,A�.As��'��C./.........5/�l!XiGI..... ......... �. a'� .Interior . Cs��� Floors ...............�................................................................... ............ .................................................................. Heating (G:G./I�/C.................. .....................Plumbing ......�./� ?�.......... ��'�/TCIi�C7�.............. .... .. .. Fireplace �S^ OOC> 4******** :c p ..................................................................................Approximate. Cost ........ �..............Definitive Plan Approved by Planning Board ________________—___________19______. Area ... n GO .J i Diagram of Lot and Building with Dimensions • ' Fee � •} SUBJECT TO APPROVAL OF BOARD OF HEALTH CU cl V \� C9\� 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'...!:..' .....`..`..........^...��.G�l/ ............... Construction.Supervisor's License ................ of s�.3.y..... , NORTON, ROBERT 25692 - REPAIR FIRE DAMAGE No ................. Permit for .................................... Dwelling Over Garage .......... .................................................................... 2040 Main Street Location ................................................................ West Barnstable , ............................................................................... Owner .....Robes t..Norton............................ Type of Frame Construction .......................................... ................................................................................ Plot .........................*.. Lot ...............................? Permit Granted ...... .....19 83 Date of Inspection ....................................19 Date Completed ......................................19 Assessors map and lot number Z1.. ..........{........................ pi THE to Q � Sewage Permit number ..!�..: f..................... :.. House number � BABd9T�DLE, MM6 ...................................................... 00,0,t659. `00� 'Ep M a' , TOWN OF BARNSTABLE BUILDING -"INSPECTOR G P �,� l i��s . �� APPLICATIONFOR PERMIT TO .................................... ...` ......................................................................:.......:.. .AR �G T OIJGR. �J li¢,ed¢G G— TYPE OF CONSTRUCTION ......... . ........... . ..................................................... .................................................... ....42c__ .......z . .............�983 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... .....................................................�'4 ...............! !4�:........................................................................ Proposed Use ......f..:!.1.. let j _., ..........G?!/G„— ......... `GGf`.......................................................... Zoning District /2 ......................Fire District ...5�✓ 'l ,rTf1�/.� L...... . .. 1............................. f�. � . . . .. .... .......................... Name of Owner ..,1 od4R 2r ................Address GC/ lyl f' Name of Builder Address ......................................... :lsy�2oii Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ............ .......................................Foundation ... ............ Exterior 'f ..Roofin S ................. Floors ..........................................................Interior ....:...Pl- 1'n ................................................ -Heating ....... ............................................Plumbing ...... ......... .............. Fireplace ..................................................................................Approximate Cost .......5.^ IJCJ �.. ........ .. . Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area A 6 (f .... ........... .... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH o �b C. 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 .....V` ............... ........................... Construction Supervisor's License �.5... .3.`f..... NORTON, ROBERT No .25........692... Permit for ,REPAIR FIRE Damage ..... ....4.............................. Dwelling Over Garage ............................................................................... Location ......2.04.0...Ma.i.n Street................ .. .... .. ..... . ....... .. .... .. .. West Barnstable .................................;.............................................. Owner ...Robert.....N........ort.on .... ............................... ... .. .... Type of Construction Frame.............................. ............ ................................................................... Plot ...-......................... Lot ................................ O Permit Granted .......ctober 26,.................................19 83 Date of Inspection ................. ..................19 Dqte Completed .......... ...........19 PROPERTY ADDRESS I I ZONING (DISTRICT CODE SP-DISTS.I DATE PRINTED(CSTATE LASS I PCS I NBHD �118L_FLjQENIIEICATION N KEY NO. 2040 ROUTE 6—A. 05 RF 5 1)0 05'wB 07/09/95 1il1'I tJJ 6 jAd a 17 ::19.w.90 13.3901 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS Y UNIT ADJ'D.UNIT Lawn ByrDate Sin:D:::o,n.:nn P ACRES/UNITS VALUE Dascnpbon [S;� {[pl;) _, H E N R Y D i A N t MAP- CD. FP.Du uvncres LOC.IYR.SPEC.CLASS ADJ. COND. PRICE PRICE !i L A'i i! 1 45,700 CARDS IN ACCOUNT - L 10 1aLJG.SIT 1 x 1 I =10t 100 39999.9 39999.99 1 .00 4JL)U! J:1Li�..;(;)-CAitD-1 1 53,600 01 pp 02 q 11 1RESIDUAL 1 x _61 =10: 122 8000.0 9760.U0 .50 57UJ AL:):�(S)-CARD-2 1 62,300 ILUb 1 1316= N BATHS 1 .0 U K I = , FtrIN '040 MARKET 148000 C 100 3500.E:C 150C. J 1 .(l1 i7J S i i. ... jf ARNSTAciL� iJvl D PAPPRAISED VALUE D JI 1 161 ,600 A U PARCEL SUMMARY T S AND 45700 q T LDGS 1 T5 900 —IMPS M OTAL 161600 F E CNST E N DEED REFERENCE Ty,> DATE A—d.J R I O R YEAR VALUE q T Bap. Page Inst. Mo. vr.Dl S.I.!Pdc. A N D 4 5 7 0 C T ;S 31`-i 1/307: E I:J9, , 165000 -1L D%S 115900 U 4572/191: ib6/35 N 145000 TOTAL 161600 R 3572/129: Ib9/32 N 6.5000 E BUILDING PERMIT S Numppr Date Type Amount LAND LAND—ADJ INC ME SE SP—ELDS FEATURES SLJ—ADJS U N i T 45700 3500 Class Const. Total Base Rat Atll R.I. r B II Age Norm. Obsv. CND Loc Ab R G Fepl GOst New Atll Repl Value $to::e= He: t Room! Rm! Blln! •Fi><. Pvt U.- L:-Is A u 1 Oepr. Contl. on �etl ywlll Feo. O1C+ 0,90 100 100 65.00 65.00 00 75 19 80 100 80 67024 i3cJu 1 _0 5 2 1.0 4.0 Descnpuon Rate $boaro Feet Repl.Cosl MKT.INDEX: 1'00 IMP.BY/DATE: / SCALE: 1/00.7 5 ELEMENTS CODE CONSTRJCTION DETAIL S SAS 1U0 65.U0 944 61360 t Nb NS � :. — fEP 65 42_25 12 507 *4-*---12---* STYLE 03RANCH 0.0 T ------------------�=-r FE4P 55 S.SU 45 248 FEP* *-----16----* SESCGS -aOJ�tT 00 ;;.,. R FOP 35 22.75 45 1024 ! I _X .-'Al:A-CC3 -JT;1 0-F-R-bME--------i:O U FMP 55 5.50 70 385 ! i"-r/A -TYPc -J40-CC---------------7T=0 IkT� ;i:r TKT3H -`JC ------------------ L'T.-0/; T ! ! ItN T'cR LaYOO T- -JT ----------------- -U.O U ! ! 1NT717: 1ifsCTY- -Li2 ,C4E-AS ERTTIT - TT.0 R 28 BASE 28 FLUOR iTiQ CT O,J ------------------ZT.E1 q W ! ! EFLilTTR Cill';R-- -J0 ------------------U L D reas 172 Bale. 944 ! ! ROJr-TY?F---- -JC; ------------------IT.0 E Tolat A ! ------------------U.0 BUILDING DIMENSIONS . L L L T R.I�N L JU S N23 EJ4 N04 E12 SO4 E1.h S28 ! -OT!"7ATT-g!G - -JO------------------9V_-9 2 AS .. FEP N28 E04 NO3 W04 ! I -------------- - --- ---------------------- �' 3 SZc _. fE4P S05 E09 NOS W09 3-8-A&-;d-EST_lTXRNSTX t L FOP EU9 S05 E09 N05 W09 W09 X--9---18---32*---------* LAND TOTAL MARKET FMP E18 S05 E14 N05 W14 W18 5 FMP FOP FMP5 5 PARCEL 45700 161600 .. *--9---*--9---*----14---* AR A 13900 VARIANCE +0 +1063 STANDARD 25 c PROPERTY ADDRESS -0 DATE PRINT-EDT ZONING lt)ISIRICTCO(:)E- sp is rs.I CLASS I PCs NEIHO PARTEIC6TION NUMBER KEY NO. J 40 ROUTE :,-AR F 500 0 S w lj 071U9195 lo')l jL) -j Ad ;ll 2 1% :)19_t.UU 133901 t7—NU/5-fHiEn FEATURES DESCRIPTION AOJUS rMENT FACTORS Ty UNIT ADJ'D.UNIT ACRES/UNITS -LOC./Y R.JSPEC.CLASS ADJ. CON PRICE PRICE VALUE J A-Z t:N H N R Y D.1 A Mo A P BATHS 1 .0 / ':�1) .1 Pr — — CARDS IN ACCOUNT - L U x C= 100 3 5 GO C 3 5 LI 0.0 0 1 .0 13 3i0 d 02 OF 02 A NO 6S i'l T S X D= 100 7.2 ' 5.61 706 4-.3 J U J COST 161600 N MARKET 148000 A D IP P:l A f 3 E D VALUE D i A 161,600 A u PARCEL SUMMARY T S LAND 4 5 7 0 C, A T ;3 L D G 3 115900 m O_lmlpS E TOTAL 161600 N N CNIST DEED REFERENCEYP LDATE C 10;11 P.� YEAR VALUE A T Pa 1.0 0 S.ISal„P';_ L A N D 4 5 700 T S I PL DGS 115900 u R TOTAL 161600 E OU ILDING PERMIT LAND LAND-ADJ INC ME SE 3 P-8 L b S FEATURES B L 0-A 0 J Sl UNITS d 1 500- Class Consl. TOIJI Base Rale Atll.Rate Year Buill Ago Norm. Obsv. CNO L C I N - I%RG I R1 _T A.. R.d. Value $ He,ghl Rooms , Fi.. I P..,.Il F 0 1 C 000 100 100 61.00 61.00 30 75 19 80 130 100 104 59946 6 2 3 0 D 1 .'.) 2 1 1 .0 4.0 Raie Sq.—F RepL Csl MKT.INDEX: 1-00 IMP.BY/GATE. i SCALE. 1/01 .00 —ELEMENTS CODE CONSTRUCTION DETAIL S SAS 100 61 .00 708 43188 IGROSS AREA 1108 SINGLE FAMILY DWELLING CAST VP:00 T USF 60 36.oO 400 14640 N ------14-----* S T YL E 133ARAGE & QTRS 0.0 R U , -- : A� __6j___ -6b----------------------- W D 35 3.50 308 2618 --------- UWD 0 L sfi T 0.0 u x r- ij.4 - -------------------- c Y _E: -'.-A S 0.0 - - ----------------------6 6 u 114 T R.LAY 0 U T A 1 0.0 R 22 SASE 22 1 f.., r i-f A C T-y' 0.2 -.45q E i`cR IT.-ol 20 20 0? STWIJ --------------------cf_6 A w IS - ---0.0 0 D • F L Z)_J tz t R -�9[:::::::":---------- L E [T.1 Al- JA 3D?, I,_ 708 R 0 7)_F_-T -PI-C---- -- BUILDING ------------------ DIMENSIONS c L--;:-c r P -C-kc G.0 T*AS W34 N20 E20 USF S20 W2-3 N20 --------------------�V.9 -0 SAS NO2 E14 S22 UWD N22 USF --------------- - --- 1 --------------- ------ 14 S22 E14 SAS ------ ---------20-----34—------14-----X L LAND TOTAL MARKET PARCEL AR E A VAqlAN',_-E +0 +0 S T A?4 D A R D [ ] [R21'7__019 .W.00.. 0 LOC] 2040 ROUTE 6-A CTY] 05 TDS] 500 WB KEY] 133901 ----MAILING ADDRESS------- PCA] 1091 PCS] 00 YR] 00 PARENT] 0 3ARENDSE, DIANE M MAP] AREA] 88AB JV] 427988 MTG] 9201 2040 MAIN ST SP1] SP21 SP31 UT11 UT21 1 . 58 SQ FT] 944 W BARNSTABLE MA 02668 AYB] 1900 EYB] 1975 OBS] CONST] 0000 LAND 45700 IMP 115900 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 161600 REA CLASSIFIED #LAND 1 45, 700 ASD LND 45700 ASD IMP 115900 ASD OTH #BLDG(S) -CARD-1 1 53 , 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #BLDG (S) -CARD-2 1 62, 300 TAX EXEMPT #HN 2040 RESIDENT'L 161600 161600 161600 #SN MAIN ST W BARNSTABLE OPEN SPACE #RR 1387 0169 COMMERCIAL INDUSTRIAL EXEMPTIONS SALE] 09/95 PRICE] 1 ORB] 9855/271 AFD] I A LAST ACTIVITY] 09/04/96 PCR] Y R217 019 .W00 • P P R A I S A L D A T � KEY 133901 BARENDSE, DIANE M LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RF 45, 700 115, 900 2 A-COST 161, 600 B-MKT 148, 000 BY 00/ BY /00 C-INCOME PCA=1091 PCS=00 SIZE= 944 JUST-VAL 161, 600 LEV=500 CONST-C 0 ----COMPARISON TO CONTROL AREA 88AB -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 88AB WEST BARNSTABLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 457001 LAND-MEAN +0* 1616001 97303 IMPROVED-MEAN +1901 250 ] FRONT-FT 11 100 DEPTH/ACRES TABLE 02 1001 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R217 019 .W00 • P E R M I T [PMT] ACT* [R] CARD [000] KEY 133901 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT i G� mar n {- d� ,� ,o hs z a", .,M.v,. r r t i ,, ,,. , h.... 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