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0036 BODFISH PLACE
n LA Town of Barnstable Building ,,J- i6" PostedUntll''Final Inspection Has'BeenyMade v � �o>� Where:a Cert�ficateof Occu anc �is,Re aired such Bu�ldm shall Not be Occu` ,ied�until a�Ftnal Ins section%has been?made � Pe • Permit No. B-18-3110 Applicant Name: Ubaldo C Miller Approvals Date Issued: 09/26/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 03/26/2019 Foundation: Location: 36 BODFISH PLACE, HYANNIS Map/Lot 306 100 Zoning District: RB Sheathing: Owner on Record: PIERRE,AUGUSTIN A&EXANIE A Contractor Name ,h HOME DEPOT USA INC Framing: 1 Address: 175 MAIN ST � ontractoe Licenses 112785 2 Mr HARWICH, MA 02645 .,. Este Project Cost: $12,493.00 Chimney: Description: re-roof Permit Fee: $63.71 . k � Insulation: Project Review Req: , F Fee Paid,' $63.71 Date 9/26/2018 Plumbing/Gas . .. Rough Plumbing: .- ,, .1 Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after.issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents1,for which this permit has been granted. •� All construction,alterations and changes of use of any building and structuress shall be in compliance with the local zoning by�law�s and codes. Final Gas: A4 Y EWAN 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. Electrical 30 6 The Certificate of Occupancy will not be issued until all applicable signaY res by therBuildmg�end Fire Officals ale royided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: ' A 1.Foundation or Footing a _ F Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ;y 1 ` Application number... . ... .. .....'.,,��.�,�, Date Issued.............. EMMSUBM9,a6 .,l ........................... Building Inspectors Initials...... ' -„ 84P 9 ?® Ma 3 j� p/Parcel....... - .....1.4 ............................... TOWN BARN STABLE . EXPEDITED PERMIT APPLICATION: ROOF/SID1NG/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: (4Y4nni S NUMBER STREET VILLAGE Owner's Name:/- ►,Gu c- -, �;�r�� Phone Number Email Address: elan e.o.A��e @�/� for, Cell Phone Number; Project cost$ (2 y -S Check one Residential ✓ Commercial. O dER'S AUTHORIZATION HOR]IZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR w Owner Signature: See Loa k e2 T r��--- Date: TYPE OF WORK ❑ Siding ❑ Windows (no header change)# ❑ Insulation/Weatherization ❑ oors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to e. o� CON RACTOR'S INFORMATION Contractor's name_-86z? i V� Home Improvement Contractors Registration(if applicable)# 1/2—7$S (attach copy) Construction Supervisor's License it /h 9 Z O (attach copy) Email of Contractor fie"4 91 S - r ,� .C.or-- Phone number 4lo/- 7 G 3 S 9 ALL PROPERTIES THAT HAVE STRUCTURE OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS I191 A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* 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-4:30pni. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOMEOWNEWS LICENSE EXEMPTION 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 APPLICANT'S SIGNATURE Signature Date ( — / — � All permit applicatio are subject to a building official's approval prior to issuance. Home Improvement Agreement: Page 1 Home Depot License Number(s): Visit www.homedepot.com/c/SV_HS_Contractor_License_Numbers for latest license info MA: 107774, 112785 Salesperson Name: Christopher Read Registration No. (if applicable): Home Depot U.S.A., Inc. ("Home Depot") or service provider named below ("Service Provider") will furnish, install or service the equipment listed below at the price, terms and conditions as outlined on this form. PIERRE AUGUSTINE New England South 17C3XZR Customer Last Name Customer First Name Store #/ Branch Name Lead/Customer Order# Bodfish Place Hyannis 102601 Customer Address City State Zip (774) 209-39 1 1 lexaniepierre@yahoo.com Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT HOME DEPOT USA INC., 2455 PACES FERRY ROAD, BLDG. B-3, ATLANTA, GEORGIA 30339 or EMAIL The Home Depot I @ customercancellationnortheast@homedepot.com BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENTS WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN B LO 0 ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF Y RI T TO A E . Acknowledged by: 09/05/2018 Customer's Signature Date Contract Price and Payment Schedule : Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: 12493.32 Includes all applicable taxes. Excludes finance charges.* Sales Tax: 10.00 (If applicable) *Maximum deposit ONLY applicable in MD, MA, ME(33%), NJ, Wl(999ol) Dep. 125.0 % Deposit Amount 13123.33 Remaining Contract Balance 19369.99 The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 Customer Agreement(C,E,1)(31 Jan.18) v 50.1.2 ti. nttstt�ttint'rilllsiac�s Re�elatioa ®ff6et of Consumer Af mirs�c -HOME IMPROVEMENT C NTRACTOf Type, • - ��, kr•-.—'..�y_ 159788RegisMatlorr Expiration- 529120 individual . UBALDO MILLER UBALDO MILLER 28 LESLIE LANE OAK BLUFFS, MA 02557 Undcmtretzry !� iVl-SSachUsCZtS Gepar me ^ it of rubiiC SaTeE+j !!- BGard Of Building Raguh-a-ions and Standard's /^. License': -i092fl5 U13ALDO C MILLED f: P.O. BOX 3238 28 LESLIE LANE OAK BLUFFS MA 02657 t . 0712412019 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a I Congress Street, Suite 100 Boston,MA 02114-2017 5� www.mass.gov/dia Workers'.Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information e Please Print Legibly Name (Business/Organization/Individual): l)A L b o 1 '�(( i u E R Address: I.e.s I i e-, L q rtN— Zy'S7 _. City/State/Zip: Oct K 3 I u tp a I MA , Phone#: Are you an employer?Check the appropriate box: 4. I am a general contractor and I Type of project(required): 1.❑ I am a employer with ❑ t employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.E�I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp.insurance comp.insurance.1 required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1.am a homeowner doing'all work officers have exercised their I LE]Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.[D Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $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 ant an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: 9 Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy-declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby`celMyuir the pains and penalties of perjury that the information provided above is true and correct. Si-anature: V• Date: Phon #- Official use only.Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4:Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: I The Commonwealth of?Massachusetts Department of Industrial Accidents Office of Investigations J 1 Congress Street,Suite 100 191 Boston,M4 02114-2017 `y www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ApOcant Information H `� Please Print Le 'blv -Name Mminessl rganiratiocvTndividual): 0 Pi 1/ D — A.ddress: Citv'State/zi : S11I t6 N • dAr-M- Phone : 7 V " o2 lS - S�5_ an employer?Check the_4Drb Type of project(required): ' ram a empiover with;• ��a eneral contractor and I 6. [7 New construction v ed the sub-contractors employees(full and/ti,lr�t-timed on the attached sheet. 7. ❑Remodeling _ _ I am a sole proprietor or partne ship and have no employeesThese sub-contractors have 8. LIi Demolition woiia cr for me in anv capacit / o!ovees and have workers' P ❑Building addition _oworkers' comp. instaance come 'r's'*a*+ce.* i n o We are a corporation and its 1 D.,�Electrical repairs or additions 3.[ re e&] ❑ officers have exercised their j 11. P bin repairs or adci ons I am a homeowner doing all work ❑ g myself. ZIo workers' comp. right of exemption per 1vIGL 1_. Roof repairs insurance required)+ C.152,§1(4),and we have no emplovee4. [No workers' j 13.1 Other comp.insurance required_] I , •.•u:;•apphcant that checks box+r'_must also fill out the section below showing their workers'compensation policy information. +Homeowncs who submitthis affidavit indicating they are doing aU work and then hire outside contractors must submit a new aft davit indicatimgsuch =Cont*actots that check this box must attached an additional sb=showing the name of the sub-cofactors and state whether or not those entities have zmpioyees. s the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer chat is providing workers'compensation insurance for my employees. Below is the policy and job site information /l j / L-isurance Company dame: r/tr Police or Self-ors.Lic.#: X we, 7 7 o % ' Expiration Date: Job Site Address: �� �O�—F "C ?u ce City/STatelzip: H Vd4,1r 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'_VIGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-yeK imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to M50.00 a day a st 4lator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DLS r' e coverage verification. I do hereby certlfv un he tiP�of n ��,. ha the infnnnation provided above is true and carrert Si atue: Date: 9 Phone#: — Official use only. Do not write in this area,to be completed by city or town official. Cite or Town: PermitlLicense n Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 0.Other Cuutsct Person: Phone#: lo. 3,. �7 Fifty f'Ct� C.( Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Supplement Card HOME DEPOT USA INC Registration: 112785 2455 PACES FERRY RE)C-11 HSC Expiration: 04/22/2019 ATLANTA,GA 30339 Update Address and return card. Mark reason for change. ❑ Address ❑Renews! D Employment C Lost Card Office of Consumer Affairs&Business Regulation _-- — HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:SuDDlement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 12785 04i22/2019 10 Park Plaza-Suite 5170 14OME DEPOT USA INC Boston,MA 02116 ANDREW SWEET `,� Ca J/1- 2455 PACES FERRY RD C-11 HSC ATLAN'TA,GA 30339 Undersecretary d ithou signature • 1 DATE(MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02122QDIB 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: ff 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 CONT AC MARSH USA,INC. PHONE FAX TWO ALLIANCE CENTER Arc No: 3560 LENOX ROAD.SUITE 2400 E-MAIL ADDRESS: ATLANTA.GA 3W26 INSURERS AFFORDING COVERAGE NAIL>< CN101642069-HomeD-GAW-18-19 INSURER A:Old Republic IsuranceCo 24147 INSURED THE HOME DEPOT,INC. INSURER B:New Ha hire Ins Co 23B41 HOME DEPOT U.S.A.,INC. INSURER e:HomeRisk Capfwe Insurance Company 2455 PACES FERRY ROAD INSURER D: BUILDING C-20 ATLANTA.GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-DD435343946 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 REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMfDD)EFF MWD EXP LIMBS LTR A X COMMERCIAL GENERAL LIABILITY MWZY312717 OY0112018 103101rWIS EACH OCCURRENCE S 9.000.0a CLAIMS-MADE I OCCUR DAMA E NTED 1.00D.00D PREMISES Ea occurrence S LIMITS OF POLICY XS ^ D � MED EXP(Any one person} �S EXCLUDED OF SIR:$1M PER OCC PERSONAL&ADV INJURY S 9•000•50 0 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 9,006,.100 POLICY❑PRO LDC PRODUCTS•COMPIOP AGG S 9=0.000 X JECT OTHER: s A. I AUTOMOBILE LIABILITY MWTB312718 031012018 0310112019 EOa aBIINN eD1SINGLE LIMIT S 1.000.000 X ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) S AUTOS ONLY AUTOS ) HIRED NON-OWNED I PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY i Per accident � S I , UMBRELLA LIAB OCCUR - EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S -' DED RETENTION S s B WORKERS COMPENSATION WC 014172577 (AN,NH,NJ VT) 03107rz018 03101rz019 X STATUTE ER B AND EMPLOYERS'LIABILITY YIN WC 014122578(WI 03I01P201e 0310112019 5,C00,COC ANWROPRIETORIPARTNERIEXECUTNE E.L.EACH ACCIDENT s OFFICERIMEMBEREXCLUDED'? N I A E.L.DISEASE-EA EMPLOY s 5•�•0w (Mandatory In NH) U yes.describe antler Continued on Addi Tonal Page E.L.DISEASE-POLICY LIMIT S 5,000.000 DESCRIPTION OF OPERATIONS below - C Excess Auto 297-1-10011-00-201e 03ro1rz016 o3ro1n019 Urtul: 4.00D000 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 CANCEL 1 BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA.GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukhegee _Mau�o'r I ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN 101642069 LOC#: Atlanta ADDITIONAL REMARKS S AGENCY CHEDULE Page 2 of 3 MARSH USA,INC. NAMED INSURED THE HOME DEPOT,INC POLICY NUMBER HOME DEPOT U.SA.,INC. 2455 PACES FERRY ROAD BUILDING C-20 caRRi=_R NAIC CODE ATLANTA.GA 30338 1 ADDITIONAL REMARKS EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Uattilit Insurance Workers Compensation Continued Carrier:Indemnity Insurance Company of North America Policy Number WLn^C64783151(AL,AP,FL,ID,IA,KS,KY.LA,;,iS,MO.NE•Na,ND,OK.SC,SD,TPJ;WV;NY) Effective Date:03f012018 Expiration Date:03MI12019 (EL)Linnil:S 1,000,000 Canner New Hampshire Insurance Company Policy Number.WC014122576(DC.DE.H,)N.LID,MN.MT,NY,RI) Effective Date:031012018 Exoiralion Date:03/0112019 (EL)Lim il:S1.000.000 Carrier ACE American Insurance Company Policy Number.WCU C64783221(OS-1)(AZ.CA,IL,NC.OR,VA•WA) Effective Date:03/012018 Expiration Date:03/012019 (EL)Limit:S1,000,000 SIR S7 000,000 SIR for the states of Ai'.CA,IL,NC,OR VA,WA Cornier:Nation Union Fire Insurance Company Policy Number.XWC 4595580(QSI)(CO.CT.GA,ME,MI,NV,OH,PA.UT) Effective Date 03101201E Expiration Date:0310112019 (EL)Limit:S1,000,000 51.000,000 SIR for the states of CO,hfE NV,;d1,OH PA,UT S750,000 SIR for the state of GA S350,000 SIR for the state of CT Carrier:National Union Fire Insurance Company Pdicy Number.XWC 4595581(QSI)(MA) Effective Date:031D12018 R Exp ration Date:031012019 n1Y (EL)Limit:SI.000,000 Y� SIP,:S500,000 TX Employers XS Indemnity. i Canier:tilinios Urooh Insurance Compam; Policy Number.TNS C4916693A(TX) Effective Dale:03101018 Expiration Date:03/01019 (EL)Lint:SIO.ODD:000 SIR:S 1.000 COD iORD 101 (2008/01) The ACORD name and logo are registered marks off A 008 CORD CORPORATION: All rights reserved_ CCIRD I f �HE Town of Barnstable ti Q, Expires 6 m nth om iss date Regulatory-Services Feed BARNSTABLE, A � Thomas F. Geiler,Director - Building.Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.bamstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number061 Prop rty Address 16 'S l Ce -7 ®� Residential. Value of Work / Minimum fee of$35.00 for work under$6000:00 Owner's Name&Address f¢�f�US ��✓I�e d "/'� 73 QU�zN � e &�W)^c ✓ol. O Contractor's Name' Q N "�e 0 & S Telephone Number Home Improvement Contractor License#(if applicable) , (� Q Cons ion Supervisor's License#(if applicable) Ig/>� Q Workman's Compensation Insurance X-PRESS PERMIT Check one: ❑ I am a sole proprietor12 )01 el m the Homeowner ave Worker's Compensation Insurance TowN OF BARNSTABLE Insurance Company Name Ae w Workman's Comp.Policy# i Copy of Insurance Compliance Certi i ate must ac pany—each—permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roo not stripping. Going over existing layers of roof) ❑ -side #of doors Replacement Windows/doors/sliders. U-Value f - (maximum .44)#of window *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission.' A copy of the Home Improvement Contractors.License& Construction Supervisors License is required. SIGNATURE: I Q:IWPFILES\FORMSIbuilding permit forms\EXPRESS.doc Revised 070110 The Commonwealth of m assaaihuseas Department of Industrial Accidents Office of Investigations SOQ Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl "I C, D ..NaTne Business/organizat oonflndividuaII.:;FE7:7�7 Address: c� j Pa.6116 relP— . �� f�L City/State/Zip: (2 )q' 3' 3y Phone#: 'E7 Are you an employer? Check the appropr' to b Type of project(required): la a general contractor and I 6 ew construction 1.[� I am a employer with �� ve hired the sub-contractors employees(full and/or part-time).* 7. Remodeling 2.El am a sole proprietor or.partner- listed on the attached sheet. These sub-contractors have g. (] Demolition _ ship and have no employees ` employees and have workers 9. � Building addition working for me in any capacity. comp. insurance.# No workers' comp, insurance , 10. E pairs re airs or additions [ 5. We are a corporation and its required.} officers have exercised their 11.0 Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12.[] Roof repairs c. 152, §1(4),and we have no insurance required.]t employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation polity 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. tContractors 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. . sation insurance for my employee s. Below is the policy and job site I am an employer that is providing workers'compen information. // �� Insurance Company Name: Expiration Date: 3 ! Policy#or Self-ins.-Lic. C' City/State/Zip: Job Site Address: Attach a copy.of the workers'compensation policy declaration page (showing the policy number a 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th ins and penalties of perjury that the information provided ve is true and correct. Date: 'e c� Signature: Phone M Jib Official use only. Do not write in this area, to be completed by city or town 0.011ciaL 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 Phone#• I ." -,/ 'f%l-' cc<�± Office of Consumer Affairs usiness Regulation {. ;HOME IMPRflVEM1E�iT GOi`dTRAGT{�R _ Registration :126893 Type. Expiration 8/3/2012,. Supplement C The Home Depot At Home Services DARREN DEMER.S __. _ 2690 CUMBEAN RLD PARKWAYS ;4cAN , GA 30339 Undersecretary ]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 'ard Boston,MA 02116 Not valid without signature a , CERTIFICATE F LIABILITY INSURANCE �DDfYYY�;3 12128120112010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Vieira Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT%AMEND, EXTEND OR 65 Alden Road ALTER THE COVERAGE AFFORDED BY-THE POLICIES BELOW. Fairhaven MA 02719 INSURERS AFFORDING COVERAGE l NAIC# INSURED Douglas Szynal dba Szynal Property Services INSURER A: Essex Insurance Com n 24 Logan Unit N504 INSURER B: Granite State Ins CO INSURER C: New Bedford MA 02740 INSURER D: INSURER E-. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE 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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ITR GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A COMMERCIAL GENERAL LIABILITY 3DE9446 11/22110 11122/11 DPRA'ISES Me TO RENTED e S100,000 CLAIMS MADE �OCCUR MED EXP An one erson 5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 1,000,000 POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ` (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per acciderd) $ ,. NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY E- L -EA ACCIDENT $ ANY AUTO EA ACC $AGG $EXCESS/UMBRELLA LIABILITYRRENCE $OCCUR CLAIMS MADE $$$DEDUCTIBLE $RETENTION $WORKERS COMPENSATIONATU- x OTH- AND EMPLOYERS'LIABILITYB ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WC 002-25-3582 1112312010 11/2312011 CCIDENT $1 OOOOO OFFICER/MEMBER EXCLUDED? ® E.L.DISEASE-EA EMPLOYEE$100000 (Mandatory In NH) II yes,descnb.under E.L.DISEASE-POLICY LIMIT S 500000 SPECIAL PROVISIONS below —" OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS additional insured:THD At Home Services Inc and the Home Depot are included as Additional Insured with respects to General Liability Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THD At-Home Services Inc DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN dba The Home Depot at Home Services NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 2690 Cumberland Parkway IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Suite 300 REPRESENTATIVES. Atlanta GA 30339 AUTHORIZED REPRESENTATIVE ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and hgG are registered marks of ACORD !, e (a„r.arorr..xc��/f c�.,•'l�lux�fr�� !!' License or registration v31id for indiviclul use unly ` office of Coosumrr Affairs&Baisiuess Regulation before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR ()ffice of Consumer Affairs and Business IieMulatieft .' Registration: 146142 type 10 Park plaza-Suite 5170 Expiration 3129/2013 aBA ITosttm,NIA 02116 Sir( AL PROPERTY SERVICE DOUGLAS SZYNAL ~ 24 LOGQN ST UNIT 802 i NEW BEDFORD Mf��d274t}; �!ndersecreh:r? AV42,. lid wit ut signatugl ..•!*.. ;k�rr e �.,7.1 t� 1 F�,y.i+�;..3.11t �a ::41.,.1'lSIIIIL '" liat, C)C?l,,('t As:StYA AL NEW k3EilFc7i�D M.AU?7,m �S'.....«../ � .�'t77r:,•.f.i...um,?r�l,..m•e• ., tc"739.5G Sep 11 11 04: 23p Michael Bedard 1-401-246-2868 p. 3 F$OM :jamgad FAX NO. :50836=I Mar. 23 2098 5:39A19 Pl HOME AIPROVEMENT CONTRACT PLEASE READ TMSU. l Sold.Fwnishcd and Installed by: Branch Name: $piton Date: - L THD At-Home-Services,Inc.. �J d/b/a The Home Depot At-Home Services 345A Greenwood Stmet,Unit 2,Worcester,MA 01607 Toll Fmc(300)657-5182;Fax(508)756-8823 Branch Number:31 Federal TA d 75-2699460;W;.IA-;ft C 02439:Rl Cont;[jc#I6427 C T T.ic 9 MC.0565533 M; A Horne lnPrnvamerrt Contractor Reg,9 126893 Installation Address 3 �'` ��cL't t J� �la e City I tate 7vp Purehaser(s): Work Phone: Home I°hone: CCU Phone: Home Address: (Ef different froi Installation Address) City Sure Zip E-mail Address(to.receive project communications and Home Depot updates): _ _— ❑1 DO NOT wish to recta ve any marketing.emails from The Home Depot Project[ntormation: Undersigned("Customec 7,the owners of the property located at the above installation address,agrees to buy, and THTM At-Home Services,inc.("Thc Hoare Depot")agrees to furnish,deliver and arrange for the installation("Installation")of all inoterials described on the below and on the relerLaccd Spec Shcct(s),all of which are incorporated into this Contract by this reforence,along with any applicable State Supplement and Payment Summary attached hereto bid any Change Orders,(collectively, "Contrat:t'7; Job#: (---k—Mere ) P netti; S Slieet s 9, Project Amount `�) I- --- �JJ ❑RnoCm� $idin� indo%as Insulation _ .. QCnaters/Covers Loo n on ❑ '[7,Cj�i 1 ❑Rnoting...0S dmg Windrnvs insulation $ r-1Gutrcn/Coverts ❑lzatry Doors 0 ❑Rooting[]Siding Windows ❑insulation $ ❑Gutters/Coven ❑11rtry Doors❑ ❑Roofm-. LJSicung❑WIw— O lnsalatiou $ [](;utters/Covets [JEnuy Doors © t M1iininrum 75%Depr>tiit uE('untnul Amtwnt due upon exerittiun of fhn contract Total Contract Amount $i Maine pitrrbasers may not deposit more than one-third erthe C nntract ArnMniL V Customer aRmes that,immediatt�ly upon completion of ttir;work for each Product,Customer will execute a Completion Certificate (one fur each product as dufmcd by an individual $pec Sheet)and pay any balance due. As applicable,eacfi Customer under this Contract.sprees to be jointly and severally obligated and liable hereunder. The Home DepnT reserves rile right to issue a Change Order or terminate this Contract or;my individual Product(q)included herein,at its discretion,if The Tdome Depot or its authorized service provider determines that it cannot perform its obligations due to a srructural prnblem with the home,environmeniat hazards such as mold,asbesius or load paint,other safety concerns,pricing errors or because work required to complete the job was not Included in the Contract. Payment Sumwarv- The Payment Suuunttry#-_-..CyC Lam•included as part of this Contract. sets forth the total Conirset amount and payments required fur the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You ure entitled to a completely filled-in copy of the Contract at the time you sign. Do not signs Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)berore work an that Product is complete. In the event of termination of this Contrac4 Customer ageCS to pay The Home Depot the costs of ntaterials,labor,expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus any other amounts,,at forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAY WiTHHOLD AMOUNTS ()WF.D TO THE HOME DEPOT FROM TII1G I)EYOSl'I YAYr1dFAT t)R UTHER PAYMENTS MADE. WITHO[iT i.1NITTTNG THE.HOME DEPOT'S OTHER REMEI)IrS FOR RECOVERY OF SUCH AMOUNTS. Atxetrtaitce nrrd.4uthorivatipn; Cus(oute[natter and tmderstands that this A�greetnent is the emir:agreement between Customer and'The Home Depot with regard to the Products and tnstallation services and supersedes all prior discussions and ugrcernencs,either oral car written,relating to said Products and Ins(allalioa Ilus Agreement cannot be assigned or amended except by a writing signed by O)stouter acid"l• t!H te Depot.Customer acknowledges and agrees that Customer has:read,widerstands,.voluntarily arccpts the terms of and has recci copy of this Agreement. Ace tea hy: Subunit by: X . \.- x 1 Customer' Tare Saks Cons nut's Sianatur.0 /�} Date y��f X Telephone No_ �>�� t5 v 7S O _Customer's Sisntaram Date Sales Consultant Incense No. CANCELLATION: CiTSTOMCR MAY CANCEL THIS, (as applrwble) ACREEM18N71'WITHOUT PENALTY OR OBLIGATION RF DELIVERING wRiTrE'N NOTICE TO THE HOME DEPOT BY MiDNICJHT ON '1'HR THIRD BLISiNFm bAy AFTER SIGNINC ifl3LiS AGREEMENT. TXW- S"rATIt St1VRI bMEIV')' ATI'ACHCO HERETO RM T CTRF, Tr 'ONE LS -CONTAINS A FiQ O SPECIFICALLY.•._,pRGRIBED BY LAW IN - CUSTO OTICE:ADDIT10PlAL_T&Ruts A`7»CONT41-IONS AI2I{STATED ON TM RE t'E+RSr SW A�T�AxE PaitT tit tstiS CON716 ACr .:._..._ 'w�. Town of Barnstable *Permit# R q9 t72 Expires 6 mond/ts front issue date -� .�tvsrnar cgul r3'Re ato Services Fee . r MASSThomas F.Geller,Director i639 ED 1AP� Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street. Hyannis,MA 02601wX-PRESS PERMIT Office: 508-862-4038 Fax: 508-790-6230 w r EXPRESS PERMIT APPLICATION ' 1p/mot 5 Not Valid without Red X-Press Imprint TOWN OF BARNSTABLE Map/parcel Number ,2 Property Addr residential OR ❑Commercial Value of Works 300, Owner's Name&Address 4z C�v t"'fig 4s 44flItE ' Contractor's Name � -irk ---,-- Telephone Number Home Improvement Contractor License#(if applicable) a 95 57 — Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: •'�' ❑ I am a sole proprietor 1 4," ❑ the Homeowner I have Worker's Compensation Insurance ' Insurance Company Name �` ' "" Workman's Comp.Policy# G2 3 1 $ 33 8iS O14 ©2-q Permit Request(check box) tj dRe-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) . ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) ;Where required: Issuance of this permit does not exempt compliance with other town department regulations.i.e.Historic.Conservation.etc. Signature' O J.eo...m 0/1//�� Board of Building Regulations and Standards License or registration valid for Individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registtat[on; 128957 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration 6/14/2007 Boston,Ma.02108 Type Individual Oliver Kelly I, r Oliver Kelly l 9 Peregrine lane � ,,� South Yarmouth,MA 02664 Administrator Not valid without signature KELLY ROOFING 9 PEREGPjM LANE PH/FAX 508 775 4498 SOUTH YARMOUTH INSURED MA 02664 MA. REG. #128957 May 9, 2005 Proposal submitted to Augustin Pierre of 175 a Main Street Harwich MA. We propose to supply all materials and labor necessary existing mansard roofs only at 36/3813odfish Lane Hyannis and replace the All debris to be removed to town transfer. 8"Aluminum drip edge to be installed on all eaves. Remainder of deck to be covered with#30 felt paper. 25 year limited warranty 3 tab style shingle to be installed(Similar to existing). Protect an walls,windows, decks, plants and shrubs etc. during roof strip. Obtaining of town permit. At a total cost of$5350 For use of 30 year architect style shingle add $320 Payment Schedule;30%with signed contract, balance upon completion. Respectfully submitted, Oliver Kelly. Proposal accepted by, Date 5 / / 5 This Proposal is void 45 days fr om om Date above. �� NOU-15-1999 12:45 BARNSTABLE HOUSING 15087739312 P.01 1 Barnstable Telepho nc'(50,S) 771-7222 t Fax (50,I) 775.931'? W 3 IDLeased Housing Dept. (508)771-7292 s ;•. Housing Authority South StrLet •Hyannis. Mass.02601 ZONING VERIFICATION TO: Gloria Urenas FROM: Robert Hooper, Leased Housing Coordinator RE: Legal Rental Unit Verification Date: �._-.�---- ----- �_....e.r.e-�-� Address: b' 3p . Village: N Unit Type: 'VNgf_ex Bedroom Size: 0Z Map & Parcel 1No.: 3 o(o - o a The owner of the above listed property is entering into a contract with us for the rental of the property as listed above. Please verify by signing below that the unit is legal and meets all zoning requirements for a rental in the town of Barnstable. If it does not, please list reason here: — -------------e.............._e.__--..,.—_....—,. ---------- Thank you fior our assistance in this ma i nature ' rint name Date VIA FAX: 790-6230 MRVP Section B Rev. 9/98 F.aual Hou.in-Opportunity Agency TOTAL R.01 7 - 07-22-1937 12:51PM FROM BARN HOUSIN5 AUTHORITr TO 97906230 P.10 BARNSTABLB OUSIING AUTHORITY LEASED I'I011SIIEPAF�TIbIENT EPHONO* {508j 771-7292 146 SOUTH STREET IS FAX (508) 77$-9312 HYANNIs MA 02601 TO: Gloria Urenas FROM: Leila Botsford, PHM, Leased Housing Coordinator RE Verifying legal rental unit DATE: July 22, 1997 ADDRESS: 36 Bocifish Place VILLAGE: Hyannis Unit type: BEDROOM SIZE: 2 Map & Parcel Number: R306100 The owner of the above listed property is entering into a contract with us for the rental of the property as listed above. Please verify by signing below that the unit is legal and meets all zoning requirements for a rental in the town of Barnstable. If it does not, please list reason here: ---------------------------------------------------------- u for your assistance in this matter. 4�n-ture � 2 rint name / ?j -97 ---------------------- Date VIA FAX: 790-6400 SEC.8 lnPas Rev 1;97 [ ] [R3.9.6 100 . • ] LOC�.0036 BODFISH PLACE CTY107 TDS] 400 HY KEY] 214235 ----MAILING ADDRESS------- PCA] 1041 PCS] 00 YR] 00 PARENT] 0 YOUNG, JENNIFER L MAP] AREA161AC JV1308054 MTG10000 8 VILLAGE BROOK LANE SP1] SP21 SP31 UT11 UT21 . 26 SQ FT] 2128 NATICK MA 01760 AYB] 1974 EYB] 1974 OBS] CONST] 0000 LAND 33000 IMP 78100 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 111100 REA CLASSIFIED #LAND 1 33 , 000 ASD LND 33000 ASD IMP 78100 ASD OTH #BLDG (S) -CARD-1 1 78, 100 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 36 BODFISH PLACE HY TAX EXEMPT #RR 0149 0120 RESIDENT'L 111100 111100 111100 #DL LOT 5 OPEN SPACE #UP FY99 COMMERCIAL INDUSTRIAL I EXEMPTIONS SALE103/97 PRICE] 103900 ORB110653167 AFD] I LAST ACTIVITY] 06/09/97 PCR] Y L ]' [R-306 100 . ] LOC] W036 BODFISH PLA CTY] 07 TDS] _ 400 HP KEY] 21423 --MAILING ADDRESS------- PCA] 1041 PCS] 00 YR] 00 PARENT] 0 BERTINI, CLAIRE D MAP] AREA1 61AC JV] 308054 MTG] 0000 -.YOUNG, JENNIFER L SP1] SP21 SP31 8 VILLAGE BROOK LANE UT11 UT21 . 26 SQ FT] 2128 NATICK MA 01760 AYB] 1974 EYB] 1974 OBS] CONST] 0000 LAND 33000 IMP 78100 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 111100 REA CLASSIFIED #LAND 1 33 , 000 ASD LND 33000 ASD IMP 78100 ASD OTH #BLDG (S) -CARD-1 1 78, 100 DESCRIPTION TAX YR. CURRENT EXEMPT TAXABLE #PL 36 BODFISH PLACE HY TAX EXEMPT #RR 0149 0120 RESIDENT'L 111100, 111100 111100 #DL LOT 5 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE110/94 PRICE] 80000 ORB19411/224 AFD] I LAST ACTIVITY] 03/18/97 PCR] Y R306 100 . op P R A I S A L D A T A• KEY 214235 BERTIP�TI, CLAIRE D LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 33 , 000 78, 100 1 A-COST 111, 100 B-MKT 108, 300 BY 00/ BY /00 C-INCOME PCA=1041 PCS=00 SIZE= 2128 JUST-VAL 111, 100 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 61AC ----------------------------- NEIGHBORHOOD 61AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 330001 LAND-MEAN +0 1111001 74880 IMPROVED-MEAN +4*1 2501 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 15001 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 [?] R306 100 . P E R M I T [PMT] ACTI ] CARD [000] KEY 214235 'j 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR .CMP NEW/DEMO COMMENT [ J [ J [ ) [ J J [ J [ J [ J [ J [ ] [ J i �IIIIn n �RgCYCLFOC 116 UPC 68021 " No. SF11 SA ��posr•cow5°`D�� HASTINGS, MN RESIDENTIAL PROPERTY MAP NO. LOT NO. *� T Hyannis FIRE DISTRICT SUMMARY STREET \l✓•!![-'LQCCZr'�Ll.�•36-38 Bodfish Place - 1 6 100 _ H -73 LAND BLDGS. OWNER TOTAL L'7 7S LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: rn` BLDGS. 3 TOTAL ,3 " 0 LAND L7 v I�s .'148.r' -5 ,:r,•,�,.,., � BLDGS. - TOTAL Siciliano Nicholas Jerome 10- 1-78 2810 288 � 4250C LAND 17S —_. 1 Q P. Ll7 00 BLDGS. sT N e W To /V a- U' c1�6 S_ TOTAL. LAND BLDGS. _ TOTAL LAND BLDGS. Of TOTAL LAND BLDGS. TOTAL LAND BLDGS. INTERIOR INSPECTED: 1 ;_. —q���{r f f TOTAL DATE: (� 1 LAND ACREAGE COMPUTATIONS _ � BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUS LAND CLEARS RONT Q d BLDGS. REAR TOTAL WOODS 8 SPROUT FRONT LAND REAR 0) BLDGS. WASTE FRONT TOTAL REAR LAND O1 BLDGS. TOTAL LAND � � BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH % FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND Ilan i r;• I ROUGH TOWN WATER BLDGS. / HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. Cone.Walls `' Fin.Bsmt.Area Bath Room t/ Base ct7 / 00 BLDG. COST Cone.Blk.Walla Bsmt. Rec. Room; St. Shower Bath Bsmt. r,` f- y Q� PURCH. DATE Cone. slab - Bsmt.Garage ✓ St. Shower Ext. Walls PURCH. PRICE. Brick Walls Attic FI.&Stairs Toilet Room Z ✓ Roof RENT Stone Wells Fin.Attic Two Fixt. Bath Floors iers I INTERIOR FINISH lavatory Extra smt. F1 V 1 2 1 3 Sink Z. 3 _ y= y, Plaster Water Clo.Extra Attic 2- EXTERIOR EXTERIOR.WALLS Knotty Pine Water Only �9Z ouble Siding Plywood No Plumbing Bsmt. Fin. Z x 3 D N Ingle Siding Plasterboard Int.Fin. 3 Z (o I. Shingles 4NEB. TILING onc.Blk. G F P Bath FI. Heat a ace Brk.On Int.Layout Bath FI.&Wains. Auto Ht.Unit //-- Veneer. Int.Cond. Bath FI.&Walls Fireplace om.Brk.On HEATING Toilet Rm. FI. Plumbing 7 Z Q L,C 32 Off lid Com.Bilk. Hot Air. Toilet Rm.Fl.&Wains. Tiling • Steam Toilet Rm.FI.&Walls lanket Ins. Hot Water 133 C//1 ✓ St.Shower (p y 3 cof Ins. Air Cond. Tub Area Total Floor Furn. / ROOFING q Z O yz ✓ COMPUTATIONS 3 ' p 2 ,c vH ph.Shingle Pipeless Furn. �Q�p S. F. 3� p 9� 3P. ood Shingle No Heat ,Z S. F. C�t� 6 sbs.Shingle Oil Burner 7(� S.F. /S S 7 b / 3 ' late Coal Stoker / S.F. /S 7 0 Q Qs Ile, Gas UNrts ✓ (O ROOF TYPE Electric .]� S'F. �S, 7 0 �� 93 OUTBUILDINGS Pablo I Flat S.F. /S•70 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED ip Mansard FIREPLACES S.F. Pier Found. Floor /"+ - 'Tq Gambrel Fireplace Stack Wall Found. 0.H.Door LISTED FLOORS Fireplace Sgle.Sdg. Roll Roofing Conc. LIGHTING Dble.Sdg. Shingle Roof Earth No Elect. DATE Shingle Walls Plumbing Pine W Hardwood ROOMS CementBlk. Electric / �/ Y Asph.Tile Bsmt. 1st I./ TOTAL 3 7N i0 Brick Int.Finish PaLCED Single 2nd 3rd FACTOR — REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. DW LG. t)L, J,I; - •;<-!3 F= S ., IG 3 7 7 to(o -36633 1 2 3 4 Y 5 . 6 7 B 9 10 TOTAL OCT-13-1999 12:12 BRR-JSTABLE HOUSING 15097799312 P.01 r�\ Barnstable Tc1cphone(508)771-7 low F Fax(508)778-9312 Leased Huusing Dept.1508)771-7292 yi Housing Authority e.� 146 South Street•Hyannis,Mass.0260 f ZONING VERIFICATION TO: Gloria Urenas FROM: Robert Hooper, Leased Housing Coordinator RE: . Legal Rental Unit Verification Date: -------- Address; �✓ Village- Unit Type: -Dw:pl Lr Bedroom Size: 'A Map & Parcel No.: _3e is � i® o The owner of the above listed property Is entering Into a contract with us for the rental of the property as listed above. Please verity by signing below that the unit is legal and meets all Zoning requirements for a rental in the town of Barnstable. if it does not, please list reason here: ------�------- ..--- .�..r ------,®_------ Thank ou qbrourassistance in this matte $l nature rint name Date.---®---------------- VIA FAX: 790-6230 MRVP section e Rev.9/95 Equal Housing Opportunity Agency TOTRL P.01 oROPERTV ADDRESS ZONING j DISTRICT CODE SP-DISTS.j DATE PRINTED j CSTATE LASS j PCS j NBHD KEY NO 0036 BODFISH PLACE 07 RB 4D0 O7 Y 7 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T`, UNIT ADJ'D.UNIT ~ Land By/Dale Saxe D�men.�on LOC./VR.SPEC-CLASS ADJ. COND. P PRICE PRICE ACRES/UNITS VALUE oeeonption B E RT I N.I. C LAIR E D M AP— CD. FF De In/Ac,es E #LAN D 1 33,000 CARDS IN ACCOUNT — L 10 18LDG.SIT 1 X .21A=15C 242 34999.9S 127049.9 .26 33000 #3LDG(S)—CARD-1 1 78,1"00 01 OF 01 A IPL .36 BODFISH PLACE HY COST 111100 N t S 2.2 U X C= 100 1200D.0 12D00.0 1.00 12000 ?3 #RR 0149 0120 MARKET '108300 D V #DL LOT 5 INCOME A 4UP FY96 USE D APPRAISED VALUE D J - A 111,100 A u PARCEL SUMMARY T AND 33000 S LDGS 78100 A T B i I O—IMPS E ! TOTAL 111100 i I FF NI I Bpp. Page N C N ST (DEEDREFERENCEt�pe DATE ���° RIOR YEAR VALUE A T gMo. Y, D � AND 33000 T S a 9411/224: I:10/94 80000 BLDGS 78100 5548/050�TEI,04/87 142500 TOTAL 111100 5488/263; 1;12/86 125000 BUILDING PERMIT S Number Oete Type Ameunl 3LAND LAND—ADJ INC ME SE SP—BLDS FEATURESI BLD—ADJS UNITS 12000 Const. Total Vear Buill Norm, Obsv. Class Vmts Unils Base Rate Aej,Rate A I Age Depr Cond. CND Lee %R C Repl Cost Naw AOI Rep, Value Stones Height Rooms Rme 8alha I Fi>,. PutyW.11 Fet. i D00 loo 100 58.50 58..50 74 74 20 79 90 69 113222 78100 2.0 8 4 2.2 13.0 '-sc,iption Rale Square Feet Repl,Cost MKT.INDEX: .1.00 IMP.BY/DATE. / SCALE: 1/00.82 ELEMENTS CODE CONSTRUCTION DETAIL SAS 100 58.SD 1064 62244 G OSS AREA —TWO fAMILY. OWELLiNG CNST GP:00 FWD 85 8.50 192 1632 *------------32------------* STYLE 170 PLEX----------------- 0_0 1 820 60 35.10 1064 37346 6 FWD 6 bES.I£;N ADJIMT DO 0.0 ------------S - i ---------------------- - ! tX ------ --- OI WOOD FRAM£_------ 0.0 *—*--____'— 32-----------*—* EAT/AC TYPE 02 AS B2U -- ------------------ D.0 T IN TER.FINISH DG ------------------ 0.0 NTtR.LAYOUT J1 3 ! 1NTER.Q ALTY 62 S AME AS _EXTER.- 0.0 LOJR STRUCT 00 - - __ 0.0 ------ ------�.0 D - ! E LOOK COVE-- 00----------------------- BUILDING- E rptalaeas Aua. 192 Base_ 1D64 28 BASE 28 OOF TYPE I)U 0.0 --------------- ------------------- T DIMENSIONS ' E L E C T R I-CAC L J 0 D.D A SAS W38 N28 £03 FWD NO6 E32 SO6 -OuvoA7:I-ou--- -Uu ----------------q9.9 W32 .. BAS E35 S28 .. 320 N28 ! -- - -- - ---------------- t W38 S23 E38 .. ! --- NEIvN90kiI0JU 61 AC HYANNIS L ! ! LAND TOTAL MARKET PARCEL 33000 111100 *--------------38-------------x AREA 2848 VARIANCE +0 +3800 STANDARD 25 116 S,�lll,lnry� J��ECYClf0�0 ,O R ° ? UPC 68021 NOSF11 SA post-coos�`'�� i HASTINGS, MN -73 ' Sewage Permit number .�/1.!-�------'--------' � - r���-���77l�T �-&�� � �� l�T�3 «�� � �� l� �� �� � � �� |� � �j� �� /� �� |� �� �� �� N��� �� � EARISTOLL | MAM BUILDING � 0� �� INSPECTOR - am | 039, ��00 0 @ 0� � ���� ' �= �� ����� � wm�� � J _�, �� / i �~ '�PPLUCATU���@ FOR P��8&X� �� ..�l&1 -..-7�^^-.��./���^�--..�!�/�././l��\�.��-------,-- ^ . > ^ ----4��1�.���!�—'---..^�-------.. .................................... ���� ~ �� / . ----+����-����----l��.^<- * * TO THE INSPECTOR. Of BUILDINGS: The undersigned hevu6v applies for o permit according to the following information: Location ........k?-e-��� 5---'�\ .L-..��/ ~�t�.'-.. �/���.��------.----_-----------.. � , - . - )� v ' ~ Proposed' Use -..��7\y���/�e`----_---------..--^.-.---.-..--...,.-..-...-----,--------. �" b( ' ZoningDistrict --/����.........................................................Fire District ........................................................ Nome of Owner -- ..... '`�p ---------..A66,eo ..�,pre ... ���~"i� - ................................. / Nome of 8vi|6e, - -�6/l �~�° ----------A66re» ./Q-.�\^^"�\.�.�"--.. --_------ ' � Nome of Architect ~----' . Address' -'------'------------' -� ............ -----.............. ��------------'' . ,�~` Number of Room, --..��---.--------------.Foun6oiion .�������!�����------.-------.--- Exi*erior .........:������1--------------------Roofing -��������-����.K���-------'-------... . . . °^. F|oon| ---�/��du�]l--------------------|nn��r ----------------_-__.,_______ � - Heoh � � � = ' . '����[^ � . Plumbing !�. �p���� = �''-�---_� -- -.' .----.. ------- � ------. --.. , -.----.----~-.. ' | Finep|o8e -- ---------------..App,oximoheCos -.~��� 000 � � . DefinitivetP ' n' 6v P�nning Boond lQ��-'. Area ........ , Diagram of-Lot and Building with Dimensions Fee ....... =~�.......................... 'SUBJECT TO APPROVAL OF BOARD OFF HEALTH . 4+ LU co oe of 7.2,71 13 ' � y' | / | - -- - -----' ' , . � ~ ^ ` . -- * | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above � construction. ^ Nome -���.../ -..-�......�-�----------... � J m �N�7 �~� -White, Hugh �, ~ � � f ' No _ _. Permit for ._..tn*n_ntcb�'___ ! | / ! duplex dwelling .----...~------~..._----..-----. ` � ��e ~ --- n__ ---—---,--I�-----------.. � --------.xQr������------------. � Owner ____I�ip� �������������t�__________. lit Type of Construction ---.'�����------.. \ '^----'^--------------------'' . '' ` ' . �� ^ Plot -----..^--_ Lot ----°.^----- ' � ' | ~ / Ncnreobmar 20 �� ' Permit Granted —. lA '~ . Date of Inspection , ° ` ^ Date Completed PERMIT REFUSED -----.-----..---------.. 19 \ --------------------------' . ` � ^—.-.—~--.--.--------~-------- � —''----^------~--^^^—~--~----' ' ' '---------''------'~~^'------- � Approved ................................................. lg ^ � | ^ -------.-------..—.-----~.--- —r---- ............ U ' - fir° TOWN OF SARNSTASL31 REPORTS DMDNTARY/CONTINIIATI ZgI3P08T NAME (LAST, FIRST, MIDDLE) DIVISION /DEFT�L l �/- NOTE DETAILS i OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL IS ETC' U � _ PAGE ! � Y SUBMITTED BY r_.es� i K i s �o�tENT by:, p :r O u U ya o W�NIW•�� N!n O r rri co, O LL z UN �C a �Z x P, `i Y� j sc �1 i