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0732 OAK STREET (CENT./W.BARN)
J3�Z 4 Ox�brdNO. 152 1/3 ORA ESSELTE 10% -- r o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �l Parcel 00 Application 3 a ` 1-71 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 3 Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address . 0 a Village ZW4-C1,—d_6fi0 Owner ,✓� dtio Address S Q°�'�P �S �Ve Telephone ,5�� Z vo /o3 Permit Request � isgA( A)q MiIi R (r Actoe O A` du Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new. Zoning District 14 Flood Plain Groundwater Overlay Project Valuation / 00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ml"' Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ©1 a Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use CZ)APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name "1*61,._,s1cey16jeS4 c� � Telephone Number/,�10� 37v , Address )c RUI'L4'L, �61 License # G 0,), J 1 `sa Home Improvement Contractor# 6 0 Email Worker's Compensation #TVG 33 S 5 W V ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ykt,//!'L(1� SIGNATURE DATE �1 ? FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. `C ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION F FRAME INSULATION FIREPLACE ELECTRICAL.` ROUGH FINAL PLUMBING:- ROUGH FINAL GAS: ROUGH FINAL t FINAL BUILDING C ' DATE CLOSED OUT 4.+ ASSOCIATION PLAN NO. r. i i Building Permit Authorization I, ::Robert Bono , as owner hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth,MA 02664 Office:508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 732 Oak St West Barnstable, MA 02668 Signed Date t r p N roan--- " nnc The Commonwealth of Massachusetts -- Department of Industrial Accidents Office of Investigations _ 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians Le bl Appticalnt Information Please Prbers v Name (Business/Organization/Individual): Cape Save,Inc. Address: 7D Huntington Avenue City/State/Zip: South Yarmouth, MA 02664 Phone#: 508-398-0398 Are you an employer?Check the appropriate box: r ype of project(required): 1.❑✓ I am a employer with 17 4. ❑ I am a general contractor and I ❑New construction employees(full and/or part-time).# have hired the sub-contractors listed on the attached sheet. . ❑ Remodeling 2.❑ I am a sole proprietor or partner- These sub-contractors have g. ❑ Demolition ship and have no employees working for me in any capacity. employees and have workers' 9. ❑ Building addition =insurance comp. . [No workers' comp. insurance c 10.❑ Electrical repairs or additions required.] 5. ❑ We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ 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 13.❑✓ Other Insulation employees. [No workers' comp. insurance required.] 11 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Technology Insurance Company TWC 3353968 Expiration Date: 04/09/2014 Policy#or Self-ins. Lic.#: p W,6, lob Site Address: Y�oC cS City/State/Zi : �S 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 im or s Be advised that ment�as well a copy of this civil tes in the stat statement ay be forwof a OardedOto�Offc oER f d a fine of up to$250.00 a day against the viola Investigations of the DIA for insurance coverage verification. I do hereby certify under the ains and enalties of erjury t at the information provided above is true and correct Date Si ature: - - - - - - - - - - - Phone#- 508-398-0398 Official use only. Do not write in this area,to be completed by city or town offciaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: ATE a�& CERTIFICATE OF LIABILITY INSURANCE D0/22IDD013 10/22/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. CIINT PRODUCER NAME:cT Colleen Crowley Risk Strategies Company PHONE E . (781)986-4400 FAX,�:(781)963-4420 15 Pacella Park Drive ADDRESS- Suite 240 INSURERS AFFORDING COVERAGE NAIC t Randolph NA 02368 INSURER A:Selective Ins. , of America INSURED INSURERB:Safet Insurance C an 3618 Cape Save, Inc iNsuRERc.Technology Insurance Company 7 D Huntington Ave INSURER D INSURER E: South Yarmouth MA 02664 1 INSURER F: COVERAGES CERTIFICATE NUMBER:CL13102268490 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. INSIR TYPE O POLICY EFF POLICY EXP LIMITS F INSURANCE POLICY NUMBER MMIDD MMIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY 100 000 PREMISES Ea occurrence) $ A CLAIMS40DE a OCCUR S1994480 0/16/2013 0/16/2014 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X jECT COMBINED SINGLE PRO- X LOC LIMI $ AUTOMOBILE LIABILITY Ea accident 1000000 BODILY INJURY(Per person) $ B ANY AUTO ALL OWNED X SCHEDULED 208200 1/6/2013 1/6/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED Per accident $ X HIRED AUTOS X AUTOS $ X UMBRELLA LIMB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESSLIAB 1-1 CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ ei 1994480 0/16/2013 0/16/2014 $ C WORKERS COMPENSATION Officers Included for X wCYS",TTAT OTH- AND EMPLOYERS'LIABILITY ANY pROpRiETORIPARTNERIEXECUTIVE YIN N overage E.L.EACH ACCIDENT $ 500 000 OFFICER/MEMBEREXCLUDED! NIA 3353968 /9/2013 /9/2014 E.L.DISEASE-EA EMPLOYE $ 500,000 (Mandatory In NH) If yes,describe under rC E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Weatherization Specialists GL: Blnkt AI, Blnkt PNC, Blnkt WOS, Per Proj Agg, Per Loc Agg / GL Exclusions: Snow & Ice Removal/OCIP/Wrap Ups CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE chael Christian/CLC ACORD 25(2010/05) ®1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005101 The ACORD name and logo are registered marks of ACORD . 1 MaSsachj_s _s -Je-dCt+Alen' o1 -ubiic C:liCt/Board of Buildinc eaaiai"onS and:Sandards ` Con%irurtion Supervisnr Speriak-, License: CSSL-102776 WILLIAM J MC CLUSICEY 37 NAUSET ROAD West Yarmouth NIA 02673 :. i-:;_for: J 06/28/2015 / e _.ra Office of Consumer Affairs andness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration: _ Registration: 171380 Type: Corporation Expiration: 3/14/2014 Tr# 222184 CAPE SAVE INC. -_ WILLIAM MCCLUSKEY 7-D HUNTINGTON AVENUE _ SOUTH YARMOUTH, MA 02664 " - Update Address and return card.Mark reason for change. OPS-CA1'0 501.Y04/04-G10121c i ; Address i; Renewal J Employment =i Lost Card -. �..: �!!6 tJ09$!)ZlYJ1GlEQt/f41• GwftQS.�C/L�dJ2� -' ----- .. ...__ _ - - Office of Consumer Affairs&Basiness Regulation License or registration valid for individul use only ' ,:r HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: , ...—:- Registration: -:-171380 Type: Office of Consumer Affairs and Business Regulation Ex 10 Park Plaza-Suite 5170_�g��• Expiration: 3/14/2014 Corporation ..> Boston,MA 02116 PE S CAAVE INC: WILLIAM McCLUSKEY .. . 7-D HUNTINGTON AVENUE'::.' SOUTH YARMOUTH:MkO2664 Undersecretary Not valid wit o signatw r Parcel Lookup Page 1 of 1 t 6T O A�FD lA�,�.A. 'e.^,' �.` _ L'(/.�!%I!/Fli�Cilf•.�����r/E/_ .�. fl:�iiw..v' Logged In As: Parcel Lookup Thursday, March 6 2014 Road Lookup Condo Lookup Multiple Address Lookup Reports Search Options , Search By Street Street# 732 Street OAK Name Village All Villages Ire Search <Prev Next> Page 1 of 1 in Rows/Page: 10 TF Parcel Location Owner Village Index Map 215-001-001 732 OAK STREET(CENT./W.BARN) BONO, ROBERT:FTR:] WB 1121 215001001 http://issgl2/intranet/propdata/lookup.aspx 3/6/2014 r March 25, 2014 Site Visit: 732 Oak Street, West Barnstable Map: 215 Parcel: 001001 A site visit was performed by me to establish the status of this property. There was some confusion as to whether or not it was a multi-family or had an apartment. The observed floor plan matched the one that was drawn for the Building Permit #201400669 and was a single family. There was only one kitchen and no evidence of any others. The basement/crawlspace has about 3' to 5' of headroom and is not habitable. The detached shed is a shed. Conclusion: This is a single family property. Robert McKechnie Local Inspector Building Department Town of Barnstable W i19 OF ! I� 'min F D �r ( � � Old 1 �3 �� J } C� �� IL � - 9 a 6 l �-� ��c�o�, ® : . cRM��„ Town of Barnstable *Permit'# Expires 6 months from issue date "7 Regulatory Services Fee °d 39.$ 2��a Richard V.Scali,Interim Director �Fp Mt►l& -I-OW�1 ®F�ARNS`� Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not alid without Red X-Press Imprint Map/parcel Number6 rA Ayj- C fir` ,i, 3.r- Property Address b (3- z� Residential Value of Work$ 06 .o Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address D _Sy' I /Z Contractor's Name /� � VI�/y��/J2I`� L L� Telephone Number j-6,r--71V— ?9 Home Improvement Contractor License#(if applicable) Email::P�/F��/aJJ� Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Re Vest(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to � �vv❑Re-roof(hurricane nailed)'(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. py th o provement Contractors License&Construction Supervisors License is re SIGNATURE: Q MPFUMTOR]AMbuilding permit for'SAXPRESS.doc Revised 061313 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor ' License: CS-087160 RICHARD T JOH$SON PO BOX 764 BUZZARDS BAYMA 02532 Expiration Commissioner 08/01/2015 ' ` Office of Consumer Affairs&Bt smess.Regulation ' VHOME IMPROVEMENT CONTRACTOR Registration: ?1.67244 Type: x Expiration: ig12312014 Individual ; RI RD T.JOHNS:ON '?%? jRICHARD•JOHNSON-- 61 WHITLEY TRAIL PLYMOUTH, MA 023(i0 .;; Undersecretary I Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supcn-isor License: CS-087166 RICHARD T JOH$SON PO BOX 764 {� BUZZARDS BA 02532 -,zr � �� ����� Expiration Commissioner 08/01/2015 License or registration valid for individul use only '. before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 A Not valid hout signature o The Coasmonnteahth of Mussaclkusetts Deparbnent of Industrial Accidents ©,ice of Investigations 600 Washington Street y Boston,MA 0111 wmv.mass gov/dia Workers' Compensation Insurance davit Brgders/Con " ns/Ph tubers Apphcant Information % please Print b. Name mudwsC1Y?rgm&atin l)_ A`4/ � Cy Address_ City/State/Zip: 4?41 Phone#_ f®rF `Z�, ' P-7,V Are you an employer"Check the appro, to bov. Type of project(required): 1.ElI am a employer with 4- ❑ I am a general contractor and I 6. ❑New consbtuction employees(full and/or part-time).* have hiredthe sub tractors 2.ElI am a sole proprietor orpartuer- listed on the attached sheet. 7- ❑Remodeling ship and have no employees Thy sub-contractors have g_ ❑Demolition working for me in any capacity. employees and.have workers' 9. ❑Building addition [No workers'comp.insurance comp-insurance_1 required-] VE d 5.` j We are a corporation and its 10_❑Electrical repairs or additions. 3.❑ I am a homeowner doing all work officers have exercised their 11_❑Plumbing repairs or additions myself[No workers'comp- right of exemption per MGL 1. oo c. 152, 1 4 and we have no P insurance required.]�' § ( � employees.[No workers' 13-❑Other camp.insurance required.] '?iny agplit�d that checks boa#1 must also fill out the section below showing their wo&ets'compensatiao policy inf roxtiob ffameawaets who submit this afi5dn it mdkztiag they see doing all wcA"then hue outsJ&contractors mast submit anew affidavit iadirstlmg such- rCont wwrs that check this bow must 2mched an additional sheet sbaming the nee of the sub-canftvAors and staff whethu or not those entities have employees. If the subrcantmaors have employees,they mustpmvide their workers'comp.policy number. lam an employer tharisprotiding.warlrers'congmisadon insurance for my empfoyees. Below is the policy and job.site information Insurance Company Name: Policy 9 or Self ins.Lie.#: ExpirationDate: Job Site Address: City/State zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL r 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 chril 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 ofthis statement may be forwarded to the Office of h vestigatiems of the DIA for insurance p7arage verification. I do hereby c r its nd nalties ofperjuty,that the information proud d a rg and correct Si Date: L Z Phone#: Official use only. Do not write in this area,it#be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 3.Budding Department 3.CiVrosrn Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: �'ME Town of Barnstable . Regulatory Services BMWS " $ NAM Richard V.Scali,Interim Director 'moo;i•�'�e� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 i Property Owner Must Complete.and Sign This Section If Using A Builder I, — ` " , as Owner of the subject property hereby authorizeA to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. SIpnatute of er �p �_. tote o Applicant Print Name Print Name 3 12 D(ate Town of Barnstable ,T Regulatory Services pFt Richard V.Scali,Interim Director Building.Division a43xcr4331 Tom Perry,Building Commissioner - BASS. 163Q. �� - 200 Main Street, Hyannis,MA 02601 �' �,�r► www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6250 . HOMEOWNER LICENSE°EXEMPTION Please Print DATE: . JOB.LOCATION: number street village • e "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does 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 Appi-oval 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. O:\WPFII.ES\FORMS\building permit forms\EXPRFSS.doc - — TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �\ Parcel v 1 Application #C�6 Health Division Date Issued A 1111 Conservation Division Application Fee Planning Dept. Permit Fee ;74 o26 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis '✓' 0� Project Street1 Address 1� �A iU6i 52AOUE t[ M Village U�?��tiidrlrJP / Owner Address —dw►`ci,)OoL 3 Telephone `1� A •� l g10 Permit Request* kj�-koy-& W b rLG Duty 3 6 Fr OF 'SILL Q_CP(,4C-G t.b PT DF CA-_'I K.JL ZekR • - �S tstM- .101st S 4 Alb JoL. -r t4"(%DES . J CIC- GlP s deST -?CS SjSLE Square feet: 1 st floor: existing proposed 2nd floor: existing _proposed 4JA Total new 0 Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size a kAKf Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, Cal Two Family ❑ l Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes M No On Old King's Highway: ❑Yes 5a No Basement Type: ❑ Full 5r Crawl ❑Walkout ❑ Other N —+ Basement Finished Area(sq.ft.) Basement Unfinished Area (sq ft). () r 9 0 Number of Baths: Full: existing_ new �� Half: existing '_ new d� Number of Bedrooms: existing new Total Room Count (not including baths): existing new C) First Floor Room Count _ Heat Type and Fuel: Al Gas ❑ Oil ❑ Electric ❑Other ro Central Air: ❑Yes If No Fireplaces: Existing O New �_ Existing wood/coal stove: ❑Yes M No Detached,garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes n- nNo If yes, site plan review# Current Use �.5i rtl�i� Proposed Use &CkAQ11 - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name W. Telephone Number Address d�' l-fr 6C�t.�S `Sr License # Home Improvement Contractor# !6 76 6 9 Email e U5t sUc a bmmr .fp(r. co m Worker's Compensation # --5�tr' C.�tem_g ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I.u14fTAARS 1AA cte'_ _1k - Nor SIGNATURE DATE I FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED r MAP/PARCEL NO. . ADDRESS �% : VILLAGE - 7.:1 OWNER •DATE OF INSPECTION: FOUNDATION FRAME INSULATION y FIREPLACE ELECTRICAL: ROUGH FINAL A PLUMBING: ROUGH FINAL ' . " GAS: ROUGH FINAL �( FINAL BUILDING DATE'.CLOSED OUT y- ASSOCIATION PLAN NO. ; I The Commompwa ofMassachusmvs ftarh ent qfT'aadfr 3&id-4cciderrts t ee of esfigafiam ' 690 WashingtoraSVreet $ostara,.l4gA 02111 immynasmgm/dia 'workers' CompensafionInmmuceAffidavit Builders/ContmcEorsl.Ei°ectricians/Rumbers plicant Infmrmatian Please hint Ee?_ibly Iel'a=ue(Pc�SmrssJOrga�tionl7ndividna[�: �Rk s�2uC*u � 12EP�t� Afress l0 6 -P 6►�(� St CnyfStat&lZip- L0 µrrM M`I, An 6038-k Phone,�- 771- 4'f7• `13 Are you an employer?Check the appropriate bo= T of o'ect Cr 4. I�a contractor and i 3'I.Se �• I t�e�= L❑ I am a employer with ❑ 6- ❑New eons n ioa employees{full andlorpatt4ime}* havtehiaedthe sub-eonfracfois 2.❑ I am a sole proptsetor or partner listed on the attached sheet y- X Rem,ode1'g slrip and have no employees These sub-contractors have g- ❑Demolition worlciag for mein any capacityi employees and have woyLkers' g_ El Building addition [No workers'camp.iumrranre comp_incnrar�l n- '1 5. ❑ We are a cotporatianand its 10-0 Electrical repairs or additions 3.❑ I am a homeowner doing all work ofbcers hn m exercised their 11 0 Plumbing repairs or additions myself[No wcrk='=nT- right of-mg tiorL per MGL 12-0 Roof c.152,§1(4),and we hnti e-no repairs �ncixanre required-]F emplayees-[No wodcem' 13-0 Other Comp_mcnrancerequired_1 *Amy spplibmtthat checks bos-9lmas'also Uomt the swduzLbeIowshowiug&e¢vmmkEn'compP*ggti pQTicpiafaEmxtiam.. t Homeowners who sabmft this jfffdxvxt m&cr mg they are doing sllttD�[a�&rear hire o-ntside con>zacma mnst snbmaL a neer.a�dacst in�rn. snrh tCom ctua tat check this b=mmt attached as additional sheet daYwiag the name of&e snb-c=ft*: n and st ztF-wh--&w ocmnt thane emines have emplayees. If the snb-cnatract—hx-employees,they must gmvi&their-rickets'comp.policy aumhez lam an emptnyer chaos pravidretg tt�orkers'competzsrrtian insurauca for rizy emp£nyeas Berate is thepoHq an.d,job site informa-twuL Insurance Company name: GoIJ-�ti�NYl4 �- ►u �CUaITy (�0}(,QiQ(V�i Policy a Cr self-ice Lic- : 760 c 4-4 469 4 136 '7D 103 - ExpirationDate: Job Site-Address. 73a Attach a wpy of the workers'compensation policy declaration page (showing the policy number and expiration date:}. Failure to secure caverage as retprired under Section 25A of MGL c.152 can lead to the imposition ofcriminal penalties of a fine up to$1,500.00 andlor one pear imprisaument as well as civil penalties in the form of a STOP WORK ORDEP,and a fine of up to$250.00 a day against the violator- Be advised that a copy of this sbdesn eut maybe forwarded to-the Office of Investigations of fhe DIA for insurance coverage vac ation- I da hereby Certify render thepains andpenaNes ofpedw y that the information prmddRd above fs hue and-correct tore: Date- Phone 9- 368 q5 Gist Qj}icia£use only. Da trot write in this area,to be completed by city or town officiaL City or Town: PerudVLicense# Issuing Anthoritg(drele one): 1.Board of Health 2.Buff-ding Department I CityJTown Clerk 4_Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone!#: r 6 information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute, au 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 tnistee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also slates 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 insttu ance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cerifncate{s)of insum ce. 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 i min nce_ Han 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 iamnanc6 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 pem3it 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 nnmber listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pmmitllicense 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 fur 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 (fie,a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address;telephone and fax number. The Commonwealth of Massachusett s D_egattmcnt of Industual Accidcmts Office ofkve,stigatiow 600 Washington Strcet $nsion.,1l4A 02111 Tel.#f 17-'27-49-GO W 406 or I-R77-MASSAFE Revised 4-24-07 Fax# 617-727-7749 wwwm=,gov/dia ACV 0 CERTIFICATE OF LIABILITY INSURANCE 1/282014°"Y'"' THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WANED,subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER NAME f Select Work ext.66807 Eastern Insurance Group LLC-Main PHONE F W,SOM51-7700 ac 233 West Central Street EaMAIL Natick MA 01760 INSURERM AFFORDING COVERAGE NAIL 0 WSURERA:Selactive Ins Co of Southeast INSURED INSURER B-.Continental Indemnity Company Beam And Structural Repair Co. INSURER C: 66 Pond Street INSURER D: Whitman MA 02382 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:605511296 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. LTLR CY EFF EXP TYPE OF INSURANCE POLICY NUMBER POLI POLICY TR LIMITS A GENERAL UABRRY Y Y S 1SZ7549 211/2013 211/2014 EACH OCCURRENCE $1000.000 X COM ADMERCIAL GENERAL LIABILITY I $1OO,XXm CLAIMSME X❑ (Any OCCUR MED EXP arePerson) $10 000 PERSONAL 3 ADV INJURY $1 000,000 GENERAL AGGREGATE 1$3 000 000 GENt AGGREGATE LIMIT APPLIES PER PRODUCTS-COWIOP AGG $3 000.000 X POLICY PRO-JECT LOC $ AUTOMOBILE LIABILITYCIA accidw) iAN AUTO BODILY RJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) t AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS S UMBRELLA LIAB OCCUR EACH OCCURRENCE 9 EKCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION S $ g WORKERS COMPENSATION N 13670103 242013 24I2014 X WC STATU OTH- AND EMPLOYERS LIABRM Y I N I Ry LIMITS ER. ANY PROPRIETORfPARTMER/EXECUTNE E.L.EACH ACCIDENT $100.000 N 1 A OFFICEUMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYW$100.000 rc yes,describe under DESCRIPTION OF OPERATIONS W- E.L.DISEASE-POLICY LIMIT 5500.000 DES'RIPnON OF OPERATIONS I LOCATIONS/VEHICLES 021a h ACORD 101,AddM wW Rernaft Schedule,Broom epees Is reWb" ARPENTRY,BEAM AND STRUCTURAL REPAIR. or information purposes only". I � . ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Beam and Structural Repair Co. ACCORDANCE WITH THE POLICY PROVISIONS. 66 Pond Street Whitman MA 02382 AuTMOR¢ED REPRESENTATIVE D 01988-2010 ACORD CORPORATION. All rights reserved. ,'ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD �VET Town of Barnstable o� ' Regulatory Services UM& .)Richard V.5cali,Interne Director 16;q. ♦0 ' ,r,�,t► 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 r Property Owner Must Complete.and Sign This Section If Usigg A Builder as Owner of the subject property hereby,authorize w hax EYI tXL sy to act on my behal� in all matters relative to work authorized by this building permit 21� r �nsl (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. Signatute of Owner Signature of Applicant Print Name Print Name Date Town of Barnstable - Regulatory Services - 0 Teti Richard V.Scali,Interim Director °-� Building.Division SiARNCPAnr.F : Tom Perry,Building Commissioner MASS 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6210 HOMEOWNER LICENSE EXEMPTION -_• c�� �� t lease Print DATE: a( ��AA�� JOB.LOCATIQI+I: K T AW number street village "HOMEOWNER": name homes phone# work phone# CURRENT MAILING ADDRESS: ` V .?'LT oL O�5 6"3 cityAown to zip code The current exemption for"homeowners"was extended to include o e occu ied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not posse a lice e,provided that the owner acts as supervisor. DEFINITIO OF HOME WNER Persons)who owns a parcel of land on which he/she resides r intends tore ide,on which there is, or is intended to be,a one or two_ family dwelling, attached or detached structures accessory o such use and/or structures. A person who constructs more than one home in a two-year period shall not be considered a ho owner. Such"home wrier"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall b r onsible for all such ork performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes r/nsibility for compliance with the Sta Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstab Building Department minimum inspection ores d e uirements and that he/she will comply with said procedures and re ements. Signature fHomeowner Approval of Bulding Ofcial 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. i Massachusetts 1?epartment of Public Safety $oard.of.B.pilding Regulations and Standards ' sfr .. s• CoAuction Supen-isor i 5 License: CS-039793 i WALTER W 275 xOLMES ST s HALIFAX'MA 02338 Expiration Commissioner 01/22/2015 �fce oF�essumev Affa�►rs& Si ess Itegu¢ation MFROVEMENTCONTRACTOR `ye ition 107609 `' i aatron: 81.512014 Pii�afeCorporat + o STRUCTUAL I EPAzR GO ter Murphy , r ?� HOt..NjES ST •: o [sA4;0h33 U dersectNeeary_. i @@IP DECLARATION OF TRUST ESTABLISHING 732 OAK STREET REALTY TRUST We,Robert F. Bono and Clotilde Bono, of Mashpee,Barnstable County, Massachusetts,(the"Trustees"),hereby declare that any and all property and interest in property,real and personal,that may r- w or hereafter be acquired hereunder(the"Trust Estate") shall be held in trust,for the ole t-ent fit of the individuals or entities listed in the Schedule of Beneficiaries in the proportions stated;n said Schedule,which Schedule has this day been executed by the Beneficiaries and filed with the Trustee("Schedule of Beneficiaries"). SECTION ONE Name, Purpose and Trust Address 1.1 This Trust shall be known as the 732 OAK STREET REALTY TRUST and is intended to hold the record legal title to property situated at 732 Oak Street, West Barnstable,MA 0266&and to carry out such functions as are necessarily incidental thereto. Trust mailing address is: 132 Situate Road,Mashpee,MA 02649 SECTION TWO Trustees 2.1 In the event there are two Trustees,ANY ONE TRUSTEE may execute any and all instruments and certificates necessary to carry out the provisions of the Trust. In the event that there are more than two Trustees,ANY TWO TRUSTEES, except as otherwise provided in paragraph 7.2,may execute such instruments and certificates necessary to carry out the provisions of the Trust. 2.2 No Trustee shall be required to-furnish bond. No Trustee hereunder shall,, be liable for any,action taken at the direction of the Beneficiaries,nor for an)-oror of judgment nor for any loss arising out of any act or'omission in the execution, the Trusty so long as acting in good faith,but shall be responsible only for his or her ownwillful breach of trust. No license of court shall be requisite to the validity of any transaction entered into by the Trustees. No purchaser,transferee,.pledgee,mortgagee or other _ lender shall be under any liability to see to the application of the purchase money or of T any money or property loaned or delivered to any Trustee or to see that the terms and conditions of this Trust have been complied with. Every agreement,lease, deed mortgage,note or other instrument or document executed or action taken by the person or persons appearing from the records of the Registry of Deeds to be Trustees, as required by Paragraph 2.1, shall be conclusive evidence in favor of every person relying thereon or claiming thereunder that at the time of the delivery thereof or of the taking of such action this Trust was in full force and effect,that the execution and delivery thereof or taking of r such action was duly authorized by the terms of the Trust. . 2.3 Any person dealing with the Trust Estate or the Trustees may always rely without further inquiry on a Certificate signed by a person or persons appearing from the records of the Registry of Deeds to be a Trustee, as required by Paragraph 2.1, as to who are the Trustees or the Beneficiaries hereunder or as to the authority of the Trustees to act or as to the existence or nonexistence of any fact or facts which constitute conditions precedent to action by the Trustees or which are in any other manner germane to the affairs of the Trust. Execution, delivery or recording of such certificate shall not be a condition precedent to the validity of any transaction of the Trust. SECTION THREE Beneficiaries 3.1 The term`.Beneficiaries"shall mean the persons and entities listed as Beneficiaries in the Schedule of Beneficiaries and in such revised Schedules of Beneficiaries,from time to.time hereafter executed and delivered as provided above and the respective interests of the Beneficiaries shall be as therein stated. Anything requiring an act of Beneficiaries in intended to only require an act of Beneficiaries with a present interest,not future interests. 3.2 Any Trustee may without impropriety become a Beneficiary hereunder and exercise all rights of a Beneficiary with the same effect as though he or she or it were not a Trustee. The parties hereunder recognize that if a sole Trustee and a sole Beneficiary are one and the same person,legal and equitable title hereunder shall merge as a matter of law. SECTION FOUR Powers of Trustees 4.1 The Trustees shall hold the principal of this Trust and receive the income therefrom.for the benefit of the Beneficiaries,and shall pay over the principal and income pursuant to the direction of all of the Beneficiaries and without such direction shall pay the income to the Beneficiaries in proportion of their respective interests. 4.2 The Trustees shall have broad powers to deal in or with the Trust Estate including without limitation the following powers: 4.2.1 to acquire,purchase,hold, own,manage,maintain, improve, develop, lease,mortgage,pledge, exchange,convey, and otherwise deal in and dispose of real and/or personal property or any interest and rights therein, chattels and chattels real, and all other kinds of property; to erect, construct, alter,maintain and improve buildings, structures,facilities, streets,roads, or work of any other description on any lands of the Trust, or upon'any other lands, and to rebuild,alter and improve existing buildings, structures, facilities or works thereon; and generally to deal with f and improve the trust property; 4.2.2 to let or license any part of the Trust property and to make.leases and grant licenses of any part thereof for a term beyond the possible termination of this Trust or for any lesser term and to dedicate or convey property for public purposes; 4.2.3 to make arrangements with adjoining owners and others respecting boundary lines,easements, and restrictions, and for these purposes to acquire adjoining land, or sell or exchange portions of the Trust property; and to grant easements or to acquire easements; 4.2.4 to exchange or sell all or part of the Trust property free and discharged of all Trusts at public or private sale,for such consideration as the . TRUSTEES may determine,including cash, credit notes with or without security, securities and other property and to abandon any interest in the Trust property; j 4.2.5 to mortgage with or without power of sale,for.a period beyond the date of the possible termination of this Trust or for a lesser period all or any part of the Trust property and to renew.or replace any mortgages existing from time to time on the Trust property; 4.2.6 to borrow money from time to time and to issue promissory notes, debentures, and/or bonds therefore binding the Trust property; 4.2.7 to insure the Trust property or any part thereof and the rents and annual income against loss or damage by fire or other casualty,to apply any moneys received upon any such insurance in rebuilding,repairing, restoring or replacing damaged Trust property or for such other purposes as the parties may deed proper,to insure the TRUSTEES against personal liability because of accidents, injuries or damage to others; 4.2.8 to acquire all or part of the property and assets of any person firm,Trust, corporation or business association in whatever form(thereinafter called the"Enterprise") carrying on any business similar or incidental to or capable of being carried on in connection with any business which this Trust is authorized to carry on,to assume any or all the liabilities of such Enterprise, and to take over and proceed to conduct or liquidate any business or property so acquired; 4.2.9 to purchase, acquire,hold for investment, invest,reinvest, or otherwise use, sell,assign,transfer or otherwise dispose of any shares of stock or beneficial interest,bonds, securities or other obligations of any Enterprise; to guarantee or otherwise become liable,with or without consideration,for any or all of the obligations of any Enterprise or of any Beneficiary who is r also a Trustee of this Trust and to secure such guarantee with Trust assets; 4.2.10 to carry securities and other Trust property in the name of the Trust or of the TRUSTEES or a nominee with or without designating the fact that the nominee holds for this Trust;to vote,exercise proxies with or without power of substitution, consents, elections, and other instruments with respect of rights pertaining to securities or other Trust property; 4.2.11 to hold Trust property uninvested or in non-income producing property; 4.2.12 to pay, compromise or otherwise settle all debts,obligations,taxes or other liabilities of whatever nature incurred by or imposed upon or against the TRUSTEES or the Trust property,to make any agreement for the payment of taxes to any State or the Federal Government, or any other taxing authority whether or not said taxes would otherwise be payable or assessable or permitted by any present or future law,and in connection with the foregoing to make such returns and do such other acts and things as the TRUSTEES may determine.; 4.2.13 to prosecute, defend, compromise, settle, abandon or adjust by arbitration or otherwise, all actions,suits,proceedings or controversies arising with respect to the Trust property or the TRUSTEES and to give releases in connection therewith; 4.2.14 to execute, seal,acknowledge, and deliver all written instruments, including but not limited to specific contracts,purchase and sale agreements, leases, deeds,mortgages, easements, covenants and conveyances for such consideration as shall be deemed proper; 4.2.15 to do whatever is desirable in promoting or carrying out the purposes of this Trust, including the transfer of property directly to the Beneficiaries, or to others for their benefit,with or without consideration, as fully as if they were the absolute owners of the Trust property; and to do all things legal or customary in connection with an understanding such as is hereby established; all without personal liability,however,as provided elsewhere herein. 4.3 Notwithstanding any provisions contained herein;no Trustee shall be required to take any action,which will,in the opinion of such Trustee,involve the Trustee in any personal liability unless first satisfactorily indemnified. 4.4 All persons extending credit to,.contracting with or having any claim against the Trustees.shall look only to the funds and property of this Trust for payment of any contract, or claim, or for the payment of any debt, damage,judgment,or decree, or for any money that may otherwise become due or payable to them from the Trustees, so that neither the Trustees nor the Beneficiaries shall be personally liable therefore except for such payments, claims or obligations of the Trust they may individually guarantee. If any Trustee shall at any time for any reason(other than for willful breach of trust)be held to be under any personal liability as such Trustee, then such Trustee shall be held harmless and indemnified by the Beneficiaries,jointly and severally, against all loss, costs, damage, or expense by reason of such liability. SECTION FIVE Termination 5.1 This Trust may be terminated at any time by grantor,provided that such termination shall be effective only when a certificate thereof signed by the Trustees, shall be recorded with the Registry of Deeds. Notwithstanding any other provision of this Declaration of Trust,this Trust shall terminate in any event TWENTY(20) YEARS from the date hereof, if not earlier-terminated by action of all Beneficiaries with a present interest. 5.2 . In the case of any termination of the Trust,the Trustees shall transfer and convey and otherwise distribute the specific assets constituting the Trust Estate subject to any leases,mortgages,contracts or other encumbrances on the Trust Estate or otherwise sell or liquidate said assets pursuant to the direction of the Lifetime Beneficiaries,to.the Beneficiaries in proportion to their respective present interests hereunder, or as otherwise directed by all of the Lifetime Beneficiaries,provided,however,the Trustees may retain such portion thereof as in their opinion necessary to discharge any expenses or liability; determined or contingent, of the Trust. SECTION SIX Amendments 6.1 This Declaration of Trust may be amended from time to time by an instrument in writing signed by grantor and delivered to the Trustees,provided in each case that the amendment shall not become effective until the instrument of amendment or a certificate setting forth the terms of such amendment,signed by the Trustees, is recorded with the Registry of Deeds. SECTION SEVEN Resignation and Successor Trustee 7.1 Any Trustee hereunder may resign at any time by an instrument in writing signed and acknowledged by such Trustee and delivered to all remaining Trustees and to each Beneficiary. Such resignation shall take effect on the later of the date specified therein or upon the date.of the recording of such instrument with the Registry of Deeds. 7.2 Succeeding or additional Trustees may be appointed or any Trustee may be removed by an instrument or instruments'in writing signed by all of the Lifetime Beneficiaries,provided in each case that a certificate signed by ANY TRUSTEE naming the Trustee or Trustees appointed or removed and,in the case of an appointment,the f acceptance in writing by the Trustee or Trustees appointed, shall be recorded in the Registry of Deeds. Upon the recording of such instrument,the legal title to the Trust Estate shall, without the necessity of any conveyance,be vested in said succeeding or additional Trustee or Trustees,with all the rights,powers, authority and privileges as if named as an original Trustee hereunder. In the event of the death,resignation or incapacity of all original Trustees without an appointment of.a Successor Trustee,then my daughter,Dawn Marie Bono, of Kingston,Massachusetts is designated as the Successor Trustee. 7.3 In the event that there is no Trustee,either through the death or resignation of a sole Trustee without prior appointment of a successor Trustee or for any other cause, a person purporting to be a successor Trustee hereunder may record in the Registry of Deeds an affidavit;under pains and penalties of perjury, stating he or she has been appointed by all of the Beneficiaries as a successor Trustee. Such affidavit,when recorded together with an attorney's affidavit who has knowledge of the trust affairs shall have the same force and effect as if the certificate of a Trustee or Trustees required or permitted hereunder had been recorded and persons.dealing with the Trust or Trust Estate may always rely without further inquiry upon such an affidavit executed and recorded as to the matters stated therein. SECTION EIGHT Governing Law . 8.1 This Declaration of Trust shall be construed in accordance with the laws of the Commonwealth of Massachusetts. SECTION NINE RegisLU of Deeds 9.1 The term"Registry of Deeds"shall mean the Registry of Deeds,Registry District of the Land Court for the district in which:any real estate included in the Trust Estate is located. SECTION TEN Other Provisions 10.1 Throughout this Trust the term"Trustee"shall include both.the singular and the plural whenever the context requires and refers to the Trustee or Trustees acting hereunder from time to time. In addition,the masculine gender shall be deemed to include the feminine and the singular the plural and vice versa where the context requires. i . y J EXECUTED as a sealed instrument this(±Lday of December, 2013. Clotilde Bono` Robe ' . B no, rustee ` COMMONWEALTH OF MASSACHUSETTS Plymouth, ss ``��,,``k On this Y, day of December,2013,before me,the undersigned notary public, personally appeared Robert F.Bono,Trustee,proved to me through satisfactory evidence of identity,which was an examination of a driver's license to be the person whose name is signed on the preceding or attached document, and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of his knowledge and belief. °""°""° " � PELLg"" fo - Cr tr8 :.2 o ) obert R.Pe grim, Jr.,Notary Public O :0 ��: k 0,�..lyRY PUg �O ;my Co fpires: 12-26-2019 4;-4S ONWEP'III lilt ��(5�� I i COMMONWEALTH OF MASSACHUSETTS Plymouth, ss On this l�day of December, 2013,before me,the undersigned notary public, personally appeared Clotilde Bono,Trustee,proved to me through satisfactory evidence of identity,which was an examination of a driver's license to be the person whose name is signed on the preceding or attached document, and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of his knowledge and belief. PM Exc'p� _Oc �;:,ti \o: Robe . Pellegrini, Jr.,Notary Public o l.1RY Pugs O y�o n�m.Expires: 12-26-2019 .• ,�gS ............ E 4,e,SACHUSE"`` , I e Sfruwu N _wg ; p A�tr C � d. 66 Pond Street,#5, Whitman, MA 02382 www.beamrepair.com 781-447-7324 or 800-732-8330 JA.NUARY 27,2014 ROBERT BONO 732 OAK STREET W BARNSTABLE,MA 508-479-7690 We propose to supply the expertise,equipment, license, insurance, liability and workman's compensation and guarantee to do your project in a workmanship like manner. JACK BRACE AND HOLD STRUCTURE SO AS TO BE ABLE TO: F/WtQ i — 1. TO REMOVE AND REPLACE 36 FT OF SILL WITH LAMINATED DOUBLE 2"x 8" :PRESSURE TREATED LUMBER AT FRONT AND RIGHT SIDE OF BUILDING. F2Gn)'- 2. TO REPLACE 10 FT OF 6"x 6"CENTER CARRYING:BEAM:WITH LAMINATED 2"x 8" PRESSURE TREATED:LUMBER GLUED AND TIM:BERLOCKED TOGETHER. r/ZUN i — 3. TO SISTER UP ALL 2"x 8" JOISTS WITH 2"x 8" PRESSURE TREATED GLUED AND TIMBER.LOCKED TOGETHER. CC-h1TE0 4. TO:REPLACE DAMAGED CENTER CARRYING BEAM ON LEFT SIDE OF HOUSE WITH LAMINATED(4)2"x 8" PRESSURE TREATED LUMBER.GLUED AND TIMBERLOCKED TOGETHER. 5. JACK UP AS BEST POSSIBLE. PRICE AND LABOR: $ 5,300,Qg O to Customer: Ca s Contractor: � Note(s): • if permit is required customer will have to coordinate with building inspector.for inspections and pay for permit. • No wiring,plumbing or painting. If any permits, engineer drmvings etc., are required; it will be an additional cost. • Also due to jacking: minor plaster cracks, door adjustments and ripples in wallpaper may appear. • Due to the nature of this type of structural remodeling, our work days may be interrupl.ed for various reasons. However, we will meet our agreed upon completion date. Lic. #039-793 Structural Repair is Our Specialty Reg. # 107-609 w V O l! � cr Q L (1) © o M dt � I J C 4� .tee 1.o S to3 s— / q l BEAM & STRUCTURAL ESTIMATE SHEETS mNs, REPAIR CO. INC. 66 Pond Street#5•Whitman,MA 02382 CUSTOMER NAME 1 L'�Jl.�l JOB LOCATION 73 i '�' DATE ADDRESS F-0:Zia C.11� 1Xa"STIA&C— /A41 SCt�nr�QaCYt �nR G%3 TELEPHONE �jC.� `�lb� TYPE: ❑ BARN 10HOUSE CRAWL SPACE 0 FULL CELLAR DAMAGED AREA QTY COMMENTSCOMMENTS PERIMETER SILLS 1/ FOUNDATION CARRYING BEAMS �� CORNER POST BOUNCE BEAMS HEIGHT FOOTING SIDING LALLEYS/PIERS CELLAR WINDOWS FLOOR JOISTS r'' �2 �d MISCELLANEOUS SUB FLOORING ELECTRICAL METAL HANGERS PLUMBING ACCESS TO WORK AREA REPLACE BEAM REPAIR BEAM SISTER JOINT SSSS REPLACE JOIST XXXXX INSTALL BOUNCING BEAM NEW,FOOTING & LALLY 0 JACKIrfG ✓✓✓ SKEWH OF B[J OING HANGERS -r-r �(// ICPj �SPG`tiL.lof�041I �G�iTi4PN� �--4 t 1 jLtj INSPECTOR F ONT OF BUILDENG ESTIMATOR i Parcel Detail Page 1 of 3 ---�-�,THE � ' -- Fin BAAti5[ABLE - ' MASS. Op L639. `ham -v ,ti• ./ {' - ^'`.-L" :sr.., ..,� t, Logged In As: Parcel Detail Tuesday,January 28 2014 Parcel Lookup Parcel Info Parcel ID 215-001-001 I DeveloLoot LOT 1 &2 Location 1732 OAK STREET(CENT./W.BARN) I Pri Frontage Sec Sec Road Frontage village IWEST BARNSTABLE I Fire District JW BARNSTABLE Town sewer exists at this address I NO I Road Index 11121 Asbuilt Septic Scan: P Interactive 215001001_1 Map Owner Info Owner IBONO, ROBERT F TR I Co-Owner 732 OAK STREET REALTY TRUST I Streets 1132 SCITUATE ROAD I Street2l City IMASHPEE I State MA I zip o2649 I Country I J Land Info Acres I 1.00 I use Single Fam MDL-01 I Zoning I RF I Nghbd 0105 Topography Level I Road Paved Utilities Ga;,Septic I Location Construction Info Building 1 of 1 Year 1948 I Roof Gable/Hip I Ext Wood Shingle Built Struct Wall Living Roof AC Area 2118 I Cover Asph/F GIs/Cmp I Type None I r: Int Bed C ; Z�r.,..,. .i • Style Ranch I Wall Drywall ( Rooms 4 Bedrooms Int Bath BAs Model Residential ( Floor Hardwood i Rooms 2 Full I ti 28 Average 1 9 I Heat I Total I Grade Type Elec Baseboard Rooms 9 Rooms 2e Stories 11 Story I Heat Electric I Found Typical Fuel ation Gross 2638 --I Area Permit History http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=15329 1/28/2014 Parcel Detail Page 2 of 3 Issue Date Purpose Permit# Amount Insp Date Comments j 5/1/1986 Wood Deck IB29367 1$1,400 1/15/1988 12:00:00 AM 1WB DECK 1W Visit History Date Who Purpose 11/10/2009 12:00:00 AM Paul Talbot Cyclical Inspection 10/11/2007 12:00:00 AM Jeff Rudziak In Office Review 8/15/2000 12:00:00 AM Paul Talbot Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 12/30/2013 BONO, ROBERT F TR 27910/175 $210,000 2 4/11/2006 ROSSIGNOL,JANE 20903/200 $1 3 12/5/1983 ROSSIGNOL, ROBERT R&JANE 3948/155 $79,900 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2014 $132,700 $3,200 $7,100 $124,000 $267'000 2 2013 $132,700 $3,200 $7,400 $124,000 $267,300 3 2012 $132,700 $3,000 $5,900 $124,000 $265,600 4 2011 $150,400 $3,000 $1,400 $124,000 $278,800 5 2010 $150,300 $3,000 $1,500 $124,000 $278,800 6 2009 $148,000 $2,400 $700 $132,000 $283,100 7 2008 $172,400 $2,400 $700 $132,400 $307,900 9 2007 $172,400 $2,400 $700 $132,400 $307,900 10 2006 $159,300 $2,400 $700 $136,000 $298,400 11 ' 2005 $141,300 $2,300 $800 $144,500 $288,900 12 2004 $114,700 $2,300 $800 $144,500 $262,300 13 2003 $98,600 $2,300 $800 $60,000 $161,700 14 2002 $98,600 $2,300 $800 $60,000 $161,700 15 2001 $98,600 $2,300 $800 $60,000 $161,700 16 2000 $86,900 $2,300 $400 $45,000 $134,600 17 1999 $86,900 $2,300 $400 $45,000 $134,600 18 1998 $86,900 $2,300 $400 $45,000 $134,600 19 1997 $96,800 $0 $0 $35,000 $132,800 20 1996 $96,800 $0 $0 $35,000 $132,800 21 1995 $96,800 $0 $0 $35,000 $132,800 22 1994 $83,700 $0 $0 $49,500 $134,200 23 1993 $83,700 $0 $0 $49,500 $134,200 24 1992 $95,300 $0 $0 $55,000 $151,500 25 1991 $101,800 $0 $0 $80,000 $183,100 26 1990 $101,800 $0 $0 $80,000 $183,100 27 1 1989 1 $101,800 $0 $0 $801000 1 $183,100 Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=15329 1/28/2014 Parcel O&6! Page 3of3 - : } � ¥ « ± » . : > . . • ht:%!mq 2in#a etp opd&a/Pac lDG6[a 2X9D=l5329 !%820l4 { Parcel Detail Page 1 of 3 h��o� wy \you 0C BAAI-ST,1IILP etnss. -! « - '60 M>.')d.. _ .. (. ._..�' /e riU•!%1GFl(iGU" Gam/ _•.�..,, /� ,.y�1 IL. Logged In As: Parcel Detail Thursday,August 16 2012 Parcel Lookup Parcel Info Parcel ID 215-001-001 I Developer LOT 1 &2 Lot Location 1732 OAK STREET(CENT./W.BARN) I Pri Frontage Sec Road I Sec Frontage Village IWEST BARNSTABLE I Fire District JW BARNSTABLE Town sewer exists at this address I No I Road Index 1121 Asbullt Septic Scan: Interactive 215001001_1 Map y Owner Info _ Owner FROSSIGNOL,JANE I Co-owner Streets 1712 OAK ST I Street2 City IWEST BARNSTABLE I State FMA I zip 02668 Country F J Land Info Acres 11.00 Use Single Fam MDL-01 I zoning IRF Nghbd 0105 Topography Level I Road FPaved Utilities I Gas,Septic I Location Construction Info Building 1 of 1 Year 1948 I Roof(Gable/Hip I Ext Wood Shingle Built Struct Wall Living 2118 I Roof Asph/F GIs/Cmp I AC oneArea Cover Type :7wDK Style Ranch I Int Drywall I Bed14 Bedrooms I ,; Wall Rooms - Int rBath Model Residential �I Floor I Hardwood ^I Rooms 12 Full I PAS 14 Grade Average I Type Elec Baseboard I Total Rooms.9 Rooms I F ,A stories 11 Story IHeat I Fuel Electric I Found- ation Typical I bs Gross 2638 Area Permit History http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=l 5329 8/16/2012 Parcel Detail Page 2 of 3 L � Issue Date Purpose Permit# Amount Insp Date Comments 5/1/1986 IB29367 $1,400 11/15/1988 12:00:00 AM WB DECK - Visit History Date Who Purpose 11/10/2009 12:00:00 AM Paul Talbot Cyclical Inspection 10/11/2007 12:00:00 AM Jeff Rudziak In Office Review 8/15/2000 12:00:00 AM Paul Talbot Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 4/11/2006 ROSSIGNOL,JANE 20903/200 $1 2 12/15/1983 ROSSIGNOL, ROBERT R&JANE 3948/155 $79,900 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2012 $132,700 $3,000 $5,900 $124,000 $265,600 2 2011 $150,400 $3,000 $1,400 $124,000 $278,800 3 2010 $150,300 $3,000 $1,500 $124,000 $278,800 4 2009 $148,000 $2,400 $700 $132,000 $283,100 5 2008 $172,400 $2,400 $700 $132,400 $307,900 7 2007 $172,400 $2,400 $700 $132,400 $307,900 8 2006 $159,300 $2,400 $700 $136,000 $298,400 9 2005 $141,300 $2,300 $800 $144,500 $288,900 10 2004 $114,700 $2,300 $800 $144,500 $262,300 11 2003 $98,600 $2,300 $800 $60,000 $161,700 12 2002 $98,600 $2,300 $800 $60,000 $161,700 13 2001 $98,600 $2,300 $800 $60,000 $161,700 14 2000 $86,900 $2,300 $400 $45,000 $134,600 15 1999 $86,900 $2,300 $400 $45,000 $134,600 16 1998 $86,900 $2,300 $400 $45,000 $134,600 17 1997 $96,800 $0 $0 $35,000 $132,800 18 1996 $96,800 $0 $0 $35,000 $132,800 19 1995 $96,800 $0 $0 $35,000 $132,800 20 1994 $83,700 $0 $0 $49,500 $134,200 21 1993 $83,700 $0 $0 $49,500 $134,200 22 1992 $95,300 $0 $0 $55,000 $151,500 23 1991 $101,800 $0 $0 $80,000 $183,100 24 1990 $101,800 $0 $0 $80,000 $183,100 25 1989 $101,800 $0 $0 $80,000 $183,100 Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=15329 8/16/2012 DetailParcel t, sr htt � s( � ?S��a� F�'gx � 4 °..�,��k._ `E,t'?6 !'�•. � '*tt,�„'x�.y 'r1'!i :Yu' ."•.L:°�57!' t ` ��r iH t.�" yA ra � Q1 �,+� �lr� S f 5` _ ,�*b� �p � �� �X�r' !��G •.�w. +'�1 'C' it S+�..��'� .ti +e. �+iN�,,_. :t���s tt 4 � '•1. ..�, � � � [ a.... 71ir, 't� t � f 4 �'•..z �. r f f.. .t' i�iortas'j���.. } Pt � �i~�;ae ���-a rr. i�" em.''. .,,,, •� ,t iviarzaos a'-�`Mt 1.l..!}14' Y,.'j IF�' r = T . :,.yy,,��Yx� '+*+�.t An•;�� � -i � -x S.,a,., A} r- �� ,aj r_� GI f , 4_ �� f f�. . . �ice^ yw,�i tr.,.Y,i y'�.j�� `�'i"'�".., '"��j.T�,� «y.��;±, ''�, 2 .>v.►•. .^t1.i'. ;*ref r�+r►� i i i • • • •••. / • • 8/16/2012 i Inspection Report --Building Department DateJ" Address S Referred By 411,4 Reported to Site with A Purpose of Inspection r Observations & Notes Message Page 1 of 1 Anderson, Robin From: Dabkowski, Cindy Sent: Friday, November 04, 2011 9:45 AM To: Anderson, Robin Subject: RE: 712 Oak St, WB Hello Robin Jane Rossignol declined to enter the Accessory Apartment Program 11/3/11. Cam✓ Cindy Original Message S From: Anderson, Robin Sent: Monday, June 06, 2011 9:47 AM To: Dabkowski, Cindy Cc: Perry, Tom �1 Subject: 712 Oak St, WB. Cindy, I The owner of this property is interested the Amnesty program. Please send her the information packet and call her to see the unit. She said her cell number is the best option to reach her and she would like a Weds. appointment as that is her day off. The unit is currently occupied by a woman and her three year child. I am not familiar with this unit so I have no idea what shape it is in. She claims the unit was created at the same time the house was built in 1987. I have no record or permits pertaining to this unit. A recent complaint brought this to my attention. Her information is as follows: Jane Rossignol , owner Cell: 508-776-5372 Work 508-478-4519 Please contact her directly.to see the unit with Tom Perry and keep me posted in case this becomes an enforcement issue. Thank you. W96in Robin C Anderson Zoning Enforcement Officer Town of BarnstabCe 200 Main Street 3Cyannis,'-%IA 026oi 5o8-862-4027 11/4/2011 S 1 _ � - .� �� � � -� � � c� � �`� � � � �� � cc� 'S � � � � � � � � r� � --� `'� � � � � � � o � � � � � TOWN OF BARNSTABLE 1639. BUILDING . INSPECTOR APPLICATION FOR PERMIT TO ... InA�,2—cl..... .......................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .. ../i .......................................................................................................................................... Name of Owner . .....Address ....42.-Ioll�......... /-R, Name of Builder 1.1.-2.1e: e I ecQ//-Address ............. Definitive Plan Approved by Planning Board ----------------------------- /' i-F Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH Al ' | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. mome ..x..|/ ..���^.v�����-- ---~' ' Nr Bragg, Raymond D. No ..150.35.... Permit for .....sto.ra&q...shed ...... .... ...... .. ................................................................................ Location Oak Street ........ ......... West-B. arr....1�i&41?jq.................... ......... ........ .... Owner ............�Y.Mq:n4.A...13;CA ............... Type of Construction .........................fram....... ................................................................................ Plot ............................ Lot ................................ it Permit Granted .........May 10 ........19 72 ....................... q. Date of Inspection .....................................19 Date Completed ..... .............19. PERMIT REFUSED ................................................................. 19 ............................................................................... ................................................................................ . ................................................................................ ............................................................................... Approved ................................................. 19 ............................................................................... ............................................................................... Coyle, Brenda From: Wadlington, Ellen Sent: Friday, December 23, 2011 8:53 AM To: Coyle, Brenda Subject: RE: Apt. not registered Not a registered rental. AXII WA§11#oir -----Original Message----- From: Coyle, Brenda Sent:- Tuesday, December 20,2011 2:16 PM To: Wadlington, Ellen Subject: Apt. not registered Hi Ellen, This is regarding address 732 Oak Street WB, need to know if this is a registered rental, if not we need to see if it is and find out how many rooms or apartments are being rented. Thank you, Brenda t 1 Application to R Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a ` CERTIFICATE OFAPPROPRIATENESS, Application"'ls hereby made, id.triplicate, for the issuance of.a Certificate of Appropr ateness under.Section &of Chapter 470, Acts and Resolves of Massachusetts, �1973, for proposed work 'af described below and on plans, drawings or photographs accompanying this application for: s r CHECK CATEGORIES THAT APPLY 1. Exterior Building ConstFu io New Ruilding'.: ,. ❑;Addition ;_❑ Alteration •,; �.. Indicate type of building: House ' ❑ Garage ❑ Commercial ❑:Other, 2. Exterior Painting: ❑ •- t 3. Signs or Billboards: ❑ New sign ~' ❑ Existing sign ❑ Redainting existing sign 4. Structure: ❑ Fence ❑ Wall. ❑ Flagpole ❑ Other' (Please,read other side for explanation and requirements►.;.;;,. , x s. - � :-: TYPE OR PRINT LEGIBLY °_t :DATE ' ADDRESS OF•PROPOSED WORK C' ► -�,� "` r ' u-�' = ASSESSORS MAP NOx OWNER' ASSESSORS LOT NO HOME ADDRESS FULL NAMES AND ADDRESSES OF ABUTTING OWNERS.. Include name.of adjacent property owners across any public street or way..,,f,At ch additional sheet if necessary)., , n. �A A IS :+ AGENT OR CONTRACTOR '�`�' ` `` """ '�t ADDRESS" DETAILED DESCRIPTION OF PROPOSED WORK * di ".all particulars of.work to be done lsee'NO 8,'otherside),including materials to be used, if specifications do not accompany plans:`In the case of signs,gid'e•Iocations'o�existing signi and proposed locations of new signs. (Attach additional sheet, if necessary)..; ol Signed tC: Owntr�Agent B` I'm r Co rp{ ee use. bY>Li m jqLL j �d ca The Certifite i}�ereby �'n�` �` Date r Date / . . 7 -7 4E AZ By , Approved tiZ IMPORTANT: If Certificate is approved;approval Is subject to the 10 day.appeal period. ' provided In the Act. Disapproved ❑ I Application to a Old Kings Highway Regional Historic District.-C-ortimittee to r in the Town of Barnstable for a S 4 'CERTIFICATE OF'APPROPRIATENESS , , Application-ls hereby made, id.triplicate, for the issuance of.a Certificate of.Appropriateness under Section 8 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as`described below and on plans, dra*ings dr"photographs accompanying this application for. r' r CHECK'CATEGORIES THAT APPLY:: 1. Exterfor-Building Constr i io X, I New Building.:_. j] Addition �_❑ Alteration F •„ ? ... Indicate type of building: House ' ❑ Garage -. s:°'❑ Commercial (];Other` 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ..❑ 'Redainting existingsign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please•'read other side for explanation and requirements) TYPE OR PRINT LEGIBLY • t% � �- , ,, .'DATE ADDRESS OF PROPOSED WORK r``' `mot, �` ` " ` "^ ASSESSORS MAP NO OWNER j��'�"" ASSESSORS LOT.NO HOME ADDRESS FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent per.: owners across any public ' street or way..,,(,At ch additional sheet if necessary).,: 1 AM 2 c( r. (!0 0 "-2,Vl .5 z AGENT OR¢CONTRACTOR ' ADDRESS �.[i►^ f I !/�`G�71 ,,..: ; :,;�`/(;� : tr i DETAILED DESCRIPTION OF PROPOSED WORK ' Give all particulars of work to be done(see'f�10 B,'otherside),including materials to be used, if specifications do not accompany plans: In the case of signs;give'•Ibcatiori, existing signi and proposed locations of new signs.. (Attach.additional sheet, if necessary).. AJA • . Signed Iwr` r Co rr'y ee uSe. ��iDate The Certificaereby � t' �`��Z�` Date 16-0 87; T By Approved [ IMPORTANT: If Certificate Is approved;approval Issubject to the 10 day.appeal period. ..: provided In the Act. >, Disapproved ❑ Application to f Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATION OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photo- graphs accompanying this application. TYPE OR PRINT LEGIBLY DATE C J 14 � ADDRESS OF PROPOSED WORK 932 QAk Sl y, 04 &JP—/V• ASSESSORS MAP NO. OLE ASSESSORS LOT,NO. OWNER n ems' n HOME ADDRESS /�Q OAK S ,�2A1 TEL. NO. �� 72 lya AGENT OR CONTRACTOR: ADDRESS TEL. NO. /D lJ[.� fS9Ti4f5-C K�CIr — This application is for exemption of.proposed exterior construction on the ground that: (1) It will not be visible from any way or public place. ❑ (2) It is within a category declared entitled to exemption by Old King's Highway,Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot, and, if an addition is involved, show- ing location of existing building. \l C_L 0_5 11l I �JJ / � �X I Sl l�Gi ;-7x 15T1nJC4 /6 x/�� .. ' I SIGNED , Owner-Contractor-Agent Space below line for Committee use. Received by H.D.C. The Certificate is hereby Date Time By Date Approved'- The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. EXTERIOR ARCHITECTURAL FEATURES SUITABLE FOR CERTIFICATES OF EXEMPTION FOR RESIDENTIAL USE ONLY FENCES: 1. Post and rail,split, half round or round; natural finish 2. Square rail;white or natural finish 3. Stockade;'natural or gray stain finish;not forward of face of main building 4. Picket;white only (Maximum height of all fences, 4 feet) HEDGES: natural, not to exceed four feet in height DECKS: constructed of wood,on single family dwellings, built after 1900, at first floor level, at the rear only, railings not to exceed 30 inches in height, not over 50%to be visible from a way; natural finish or color compatible with building involved BREEZEWAYS: enclosure of existing breezeways, consistent with style, material and color of house,excluding sliding glass doors facing street,way or public place FLAGPOLES: 'on residential property, not over 24 feet high, not less than 20 feet from way, constructed of wood, with'" natural finish or painted white, or of aluminum,or of fiberglas or metal painted white ARBORS AND TRELLISES: of lightweight,wooden construction, not over nine feet high ROOFS: natural cedar shingles,or asphalt shingles per approved color samples; not over five inches exposure to weather I _ j SIDING: natural cedar shingles, or wooden clapboards- natural or approved color;not over five inches exposure to weather STORM SASH,STORM DOORS,WINDOW SCREENS, SCREEN DOORS,GUTTERS AND LEADERS: permissible if consistent with style, material and color of building LIGHT POST: permissible if consistent with style,-material and color of building AIR CONDITIONERS: portable,window units at side or rear of building STONE WALLS: construction of field or split stone,`not exceeding 30 inches in height i . I I � LL NOTE 1. All prior bulletins hereby superseded. 2. Conditions contained in certificates of appropriateness shall be binding regardless of any exemptions contained herein. i Assessor's office (lst floor):' I �,. I of THE to Assessor's map" and lot number ........ ........... .......:.... Board Qf Health (3rd floor): _ QQ Sewage Permit number ...���� I....� + t BaEa9TADLE, .......... Engineering Department (3rd floor): e0� n �° M a House number ........................... .....�.3 �....�n..�r9/r:..., °°�0 M a. APPLICATIONS :PROCESSED '8:30-9:30 A.M. and 1:00-2:00 .P.M. only TOWN. OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..dack............ TYPEOF CONSTRUCTION ...u-)6.0. .....:....................................................................................................... .........Ap.(z.tL......t_'.1_....19z10 TO THE INSPECTOR OF BUILDINGS: } The undersigned hereby applies for a permit according to the following information: Location.OS,..�. � —... 5.1...... Pt1+.a��.�l.l..�.f.I..�...� ...Oaco.n." ProposedUse ............................ ........:....................................................................................................................................... Zoning District ........................................................................Fire District .. .4�.1. 1!GJ1..� . Name of Owner IC-?-4U.Q4rrn........Address'.I.�C�.. 1' 1►.,.,r�.�.. �. �..Ii;.Jir .J..t�10.� Name of Builder .s�. lE............... ....................:..........Address .............................ZS. '%.6................................ Name of Architect .............c`�f1Y1.�...............................Address ................................tom. 1. ............................... Numberof Rooms .............:...................:.......................'........Foundation ...10(oa ........................................................ Exterior .....�....... � ...Roofing ... ..... . ..................................... Floors .Interior Heating ...11 o r.'.. ......................................`....................Plumbing ...... V v.b. ..... ..................................................... s ,f Fireplace ... .U'r` .�-............................................:...........Approximate Cost ......�... .... 0..V��d `_ .................,�..f...... 4 Definitive Plan Approved by Planning Board ________________________________19________ . Area �£� ...�'.`.`.... .. . Diagram of Lot and Building with Dimensions Fee .........©............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH • -AXIS NG I� . l�Eel �Gx eo 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 ... ... ........................ Construct on Supervisor's License .. . .. . ............. ROSSINGNOL, ROBERT No ... Permit for Deck . ................... ............ Dwelling .... ....................... ................... Location ....Z32 Oak...Street.............................. ................... ........................... Robert Rossingnol Owner ...... Type of Construction .......)ft,!Rq......................... ................................................................................. Plot ....... ................. Lot ................................. Permit Granted ....................May 19,....................19 86 Date of Inspection ....................................19 Date Completed .......... ..............19 Assessor's office .(1st floor): ,tt i� THE Assessor's map and lot number . .:.'".....4. F to` Health (3rd floor): �Q o Board of Q tom' S Sewage' Permit number �J Engineering Department (3rd floor): °oo M639, m� House ny-mber Q . lU .... .,3.�....�.A�.J le:7 ... �a 0 YP�M1 APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR , APPLICATION FOR PERMIT TO �1 '/, C ..CC S 1.. ?.1./far-..�R, )`,Y,C'1)... r.���=/�............ TYPE OF CONSTRUCTION ...(J. 0.....:....................................................................................................... O(2..i.(:............1..Q.....,9A9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... A(?,. .) .1..(- , ..1.... ..�I�...nr�� ....:......... i ProposedUse ......................................................................................................................................:...................................... Zoning District .........................................................................Fire District ..a......-........................��...�.5.1....�`-1,��1..<;::.:............ Name of Owner �"�J�(n.n�...�.....�n.'S:.��.C�•:R.J��..............Address �.:.......,...........�.......:....T:.'.�......:...�................ ..�. J�..� Nameof Builder ..............` ..................................Address ............................. ................................ Name of Architect 7,5- eN r.F................................Address ................................slzv71c-:�.............................. . Numberof Rooms ............................................................:.....Foundation ... ...................................................... Exterior ...- .::..1.... '..... ..... .....Roofing ^:a:r.: ....r....11=� ` .S'.. .�-..................:....................... F Floors u( '.?� .Interior .................................................................................... Heating .........................' �.... .PI'umbirig ...... C:.. .......................................................... � n� � a Fireplace ..................................................................................Approximate Cost ....... 0 ............................................................. Definitive Plan Approved by Planning Board ________________________________19-------- . Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 4. . l� 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 ...1., .z-l�lslOQ�� >./ ...... Construction Supervisor's License Z��� ...... ROSSIGNOL, ROIrERT A=215-001/=215 -001 No .... Permit for .....Enclose D c�k' ................... ........... ........... ........................ . Dwellin..... ... ................ Location ..7.3.2...Oak.........Street..... ................................ .. . . ...... .. West Barnstable ............................................................................... Owner Robert Rossignol ............................................................... Type of Construction .....Frame........................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .....May 1....,............9 ........19 86 ........... Date of Inspection ................. 19 Date Completed ....... . ..................19 0-T T-0 0 �N o r C-r-0 IN6- Io a)