HomeMy WebLinkAbout0130 CRAIGVILLE BEACH ROAD _ _ �
i
Y
�.,/ z/A 7
i Z
� •�.��97 1���-�� �`�c%�:��' �� '� �-mot'-�-�- j
9� z
7
t
�e �r/` Q��
ZAf7lL� 25
-ld,6v, �
674-
r .
t
S
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 267 Parcel S RJS Permit# 55 t0 q
Health Division -74v,1—J_f_Z ��d,6/_(f� Date Issued _
Conservation Division U Fe ,
Tax Collectora -
Treasurer 1 �'� SEPT`iC SY3T M MUST BE
INSTALLED IN COMPLIANCE
Planning Dept. oIle "0".. „"% o e?oK'`L ENVIwM'I�®
Date Definitive a proved by Planning Board � : MWkdOOEAND
�, TOWN REGULATIONS
Historic-OKH Preservation/Hyannis
Project Street Address 11,30 Cr}-W] 3 ..� ��-• C o vro Co-a f;S-6 S m c Sr.
Village �, P. ,i P.
Owner T 0 ,R. , Address
Telephone
Permit Request - -, 't wa F =+, �5 Z S f t :a; 4�,2-Q a +
Square feet:1 st floor: existing proposed 2nd floor: existing proposed Total new
Valuation Zoning District Flood Plain Groundwater Overlay
Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes 6d 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 Cl new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial Cl Yes ❑ No If yes, site plan review#
Current Use - - - Proposed Use
BUILDER INFORMATION
m e4 Telephone Number
Na �Q p c
Address aQ Cr License#
yeA'.7171/, Home Improvement Contractor#
T i
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
c f Vr_.
SIGNATURE DATE - �i
FOR OFFICIAL USE ONLY
•
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.'
f
ADDRESS '. VILLAGE '
OWNER t - • _.. `' _ � ,
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH' FINAL
PLUMBING: ROUGH- FINAL
GAS: -~ ROUGH ,�, FINAL
FINAL BUILDING .. m
vy
DATE CLOSED OUT
ASSOCIATION PLAN NO.
i
I
Aua-02-2001 02:52pm From-NSTAR ELECTRIC 5082951294 T-093 P.001/001 F-225
I�ffl/Ms-riqH N4la►x l tecu,c
2421 Crsnb�rry Highway,Warcrtym,Ma&,;u;Auxi[s 1kS71-1091
EL ECTHI C
GA S
• F
J
August 2, 2001
Town of Barnstable
George Rackliffe
Barnstable DPW
367 Main St.
Hyannis, Ma. 02601
FAX: 1-508-790-6318
Dear Mr Rackliffe:
Please be advised that Nstar Electric has no electric service wire going to the two buildings
located at 130 Craigville Beach Rd. Centerville. It is my understanding that these buildings
are to be demolished.
Yours truly,
Claudette M Moses
Mid Account Executive
Account Management/Sales
Y
AUG-03-2001 FRI 11 : 15 AM KEYSPAN ENERGY DELIVERY FAX NO. 5087607611 P. 02
I;crw�1
� 1(eySy2n Energy Delivery
Energy Delivery 201 Rivermoor street
Wcst Roxbury,MaSSachusolls 0222
TO 617 74-5512
August 3, 2001
George Ratcliff
re: 142-156 Craigville Beach Road, Centerville, MA Smith Street (possibly also
known as #130)
To Whom It May Concern:
This letter is to confirm that the natural gas services to the above referenced
property have been cut and capped at the main.
If you have any questions, I can be contacted directly at 508-760-7503.
Sincerely,
Sally Sinclair
Distribution Department
08/02/01 THU 14:53 FAX 8346025 BROOKLYN UNION GAS U 002
■/lam �� One Center
��■vrArY Brooklynklyn,,Now New York 11201-3850
Diergy Delivery
KeySpan Energy Delivery
201 RiveLmoor St
West Roxbury, MA 02132-9987
Thursdav August 2, 2001
Ref: 130 Craigville Beach Rd
Hyannis MA
To Whoin It May Concern:
Our records show that there is no active gas service at this address.
Thank you for choosing KeySpan Energy Delivery.
AUG-03-2001 07:43 BARNSTABLE WATER COMPANY 508 790 1313 P.02i02
Barnstable
47 Old Yarmouth Road
P.O.Box 826
WAL�R
N Y Hyannis,MassaChusetts 02601.0326 508M5-0063
AUGUST 3 , 2001
TOWN OF BARNSTABLE
BUILDING INSPECTOR
TOWN HALL
HYANNIS MA . 02601
RE: water service #6545 and water service #5050, Craigville
Beach Road and Smith Street
Dear Six:
Please be advised that the above water services have been
abandoned; the water was - shut off at the main and the meters
removed several years ago.
It is our understanding that the buildings thereon are to
be torn down and demolished. Plesse contact us if you have
any questions.
Sincerely,
nneorse, Clerk
Barnstable Water Co.
I
TOTAL P.02
1
f
-� `_ The Commonwealth of Massachusetts
n� .�- Department of Industrial Accidents
Office offnVo$mgzdons
600 Washington Street
Boston,Mass. 02111
WorkersIC om ensation Insurance Affidavit
name:
location: t `e '^ 2
170
ci
phone# �
❑ I am a ho eowner performing all work myself.
❑ I am a sole rcTrietor and have no one working in any ca achy
/%,VONNO//O/%%////%%%
employer rovidin workers' compensation for my employees working on this job. :: : : .: .
❑ I am ang
�--^ '
r
comnanv et�'li�1
nam i � � %(►� � a�
�ddre_ ssi_ � � .
one#
O//insurance co. :.
ohcv#'
❑ I am a sole proprietor, ene al contracto ,or homeowner(circle one)Mndhave hiredMhecon=ractors listed b elow who
have
the owm workers' compensation polices:
com 'anv name::.
address
by
... ....::....:..... .
;Imuranceco.> ..
...:
:address: _.
xx
one#:
aIISilanCC CO..:':
Faibue to aecore coverage s,required under Section 25A of MGL 152 can lead to the impositlon of criminal penalties of a tine up to 31,500.00 and/or
one years'imprisonment a,weII a+dvII penalties in the form of a STOP WORK ORDER and a fine o[5100.00 a day against me. I understand that a
copy of this statement may be forwarded to the O}Hce of Investigations of the DIA for coverage veriScation
1 do hereby certify under the pains and penalties of pedury that the information provided above is truo.and coned
Signature Date ---
Print name Phone#
official'use only do not write in this area to be completed by city or town official
'�j 57wbLF permit/license ❑BulldingDepartment
city or town ❑Licensing Board
❑checkifimmediate ponseisrequired ❑Selectmen'a0ffice
MM
Q �' ❑Health De artment
contact person: phone#; e/�� _.���� eT—�� o
O vaed 9/95 PIA)
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law", an employee is defined as every person in the service of another under any 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 representatzves,of adeceased employer, or the receiver or
.trustee of an individual, partnership, association or other legal entity, employing employees.-However the owner of a
dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of
another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal
of a license or permit to operate a business or to construct buildings in'the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage;required. Additionally,neither the
commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the firm ance requirements'of this chapter have been presented to the contracting
authority.
Applicants
Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and
supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is
being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you
are required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retuned io
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Me of Ipuesduatlons
600 Washington Street
Boston,Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 ext. 406, 409 or 375
I 8-09-2001 12. 14PM FROM HYANNIS FIRE/RESCUE BOB 778 6448 P_ 1
The Commonwealth of Massachusetts
DEPARTMENT OF FIRE SERVICES
P.O. Box 1025 - State Road - Stow, MA 01.775
Hyannis, Ma 08/09/01
DUMPSTER>6YDS PERMIT
�j � �rTrr, PERMIT# 'OOi791
PERMIT TYPE 1 RM 1 1
In accordance with the provisions of. -section: 10-to wit:52ZCMR39.
This permit is granted to: STRUCTURES&GROUNDS for permission to:Vs.�the following:
DUMPSTER at the following property:
PropertyName TOWN OF BARNSTABLE
PHONE
No.&Street 130 CRAIGVILLE BEACH ROAD FAX
USE GROUP MAP I PARCEL CONTACT GEORGE RADCLIFFE
DESCRIBE USE(2)40 YD.ROI LOFF CONTAINERS-DEMO TWO BUILDINGS AND PLACE DEMO IN DUMPSTERS PERMIT REF.#
PROJECT -8/18/01 OR 8/25/01
RESTRICTIONS:
REQUIREMENTS:
CALL DISPATCHER PRIOR TO AND FOLLOWING 'WORK AND GIVE THE ABOVE PERMIT NO.
NOTE
** CALL WHEN COMPLETED FOR FINAL INSPECTION '*
APPLICANT INFO
STRUCTURES & GROUNDS
800 Pitcher's Way Hyannis,Ma 02601 508-790-6320
LICENSE TYPE LIC.# EXPIRES APP.PHONE
APP. FAX
zry 508-790-6318
EORGE A. RADCLI,�O%
PRINT NAME 'E,N �%tNl SIGNATURE
PAID $0 1%A E��fr tW ON 08/09/01 Will expire on Aug 01,1999
�S g o 1
al LOGGED BY DHC
GRANTING FIR
INSPECTION INFO '
Hyannis YFire Department - #01922
508-775-1300 Fax 508-778-6448
Maloney,Kathy
From: Schlegel Frank
To: Maloney Kathy
Subject: Map 267 Parcel 098
Date: Monday, December 06, 1999 8:31AM
Hi Kathy, I just reviewed this parcel and found a bad address attached to it. I changed it from#156 Smith Street to
#130 Craigville Beach.Road, Hyannis. I believe you have a demo permit on it. THANX.
. .GCS► �/ �.
3 qoio �
r
.r
6t
Page 1
- �I
? TOWN,OF BARNSTABLE BUILDING PERMIT APPLICATION
n
Map o2 6 Parcel L-7 Permit# c3 v
Health Division Date_ Issued 9 L
Conservation Division Fee o'er
Tax Collecto
/Treasurer( '
Planning Dept. '
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address
Village
Owner �-� e Address 3 C ip. Ynt
(1 —
Telep one
Permit Request e—
Square feet: 1 st floor:existing proposed 2nd floor: existing proposed Total new
. Estimated Project Cost Zoning District Flood Plain Groundwater Overlav
Construction TYp e `'��
Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family V Multi-Family(#units)
Age of Existing Structure --.Historic House: ❑Yes. ❑No On Old King's Highway: ❑Yes ❑No
Basement Type: ❑Full ❑Crawl J alkout ❑Other
Basement Finished Area(sq.ft.) -Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half:existing new
Number of Bedrooms: existing 13 new
Total Room Count(not including baths): existing 7 new First Floor Room Count
Heat Type and Fuel: WGas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes U4W/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:
Zoning Board of Appeals'Authori ation ❑ Appeal# Recorded❑
Commercial ❑Yes 2160 If P
,es site Ian review#
Y
Current Use Proposed Use
BUILDER INFORMATION
Name D uJ It/e I Telephone Number
Address ,S� s /� S License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY ,
s
PERMIT NO.
..DATE ISSUED ' �� � _' _ 1 — - •
MAP/PARCEL NO:
ADDRESS VILLAGE
' OWNER. I&F
DATE OF INSPECTION:,
FOUNDATION {
FRAME
INSULATION' • - '' 4 — y ^ ~i t n�
FIREPLACE
ELECTRICAL: ROUGH . FINAL
PLUMBING: ROUGH FINAL
GAS: .f ROUGH FINAL-
FINAL BUILDING `
DATE CLOSED,OUT t
ASSOCIATION PLAN NO.
TFIE e own o Barnstable
�OF r
°r'�o Department of Health Safety and Environmental Services'
Building Division
MAM 367 Main Street,Hyannis MA 02601
9A i639'
'GprFD MA't A
F �
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
HOMEOWNER LICENSE EXEMPTION
Q �J Please Print
DATE: 0/ � / p
JOB LOCATION: l S_��
number strOet village
"HOMEOWNER': 'Q �� ✓ .01folJ-j
name home hone# work phone#
CURRENT MAILING ADDRESS: JV YL {�• ' O f�
021A.
city/town state zip code
The current exemption for"homeowners"was extended to include per-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.submitto the,Building-Official,on_a-form_acceptable=to-the Building Official,that he/she shall be
- - -responsible for all such work performedunder=the-build'ng p rmit (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.
l
Signature f Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the
provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for
hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,
particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would
with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used
by several towns. You may care to amend and adopt such a form/certification for use in your community.
Q:FORM&EXEMPT
w
WE
-'Y The Town of Barnstable
snxivsTns[.E.
���' Department of Health Safety and Environmental Services
1°rED 59. Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.Type of Work: 2e,�OLH� ) ��
./ /�1 14Cw, Estimated CoA`— U`n
Address of Work: /J ,7
Owner's Name:
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job Under$1,000
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date Contractor Name Registration No.
OR
Date Owner's Name
q:forms:Affidav
`�" The Commonwealth o Massachusetts
_�-- = f
a Department of Industrial Accidents
—
600 Washington Street
c,: ' Boston,Mass. 02111
Workers' Co m ensation Insurance Affidavit
name: :2�;e-=e�, ` 4 /LI& .
location: �� ��� 10/L �"
ci i�l G7. �'� d'� hone#
am a homeowner performing all work myself
iiiiiiiii i i iii iii an iiiii i iiii i iii i iiiiiiiiiiiiiiiiiiiiiiiiiiii//////iiiiiiiaiiiiiiioiiiii�iiiiiiiii
❑ I am an employer providing workers' compensation for my employees working,on this job.
:::
comaanv:name.: ... ;;.
_.
address:.. ;;
. :;::;.::::.;......::::.: .;:.::.::;:.;:..;:::.:.::.;:.;................................. .. .........::: ::::.:::.:::..:::::::::.::..:.::::.::.::.::.::.::.;;;:.:::.:::.;:.;;;;:.;;;::::::.,..'."'
phone#: ..
:::.:...::: ........
city. ...::.:......;:<:>::: »::;;»>::;:::;::
oiicv#
insurance co. :::
/%
❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who
have .
the following workers' compensation polices:
company name..
.... .. ....
ad
dress. ,.:;.:.:::. ::::.;
...;:.:;.;..:....;:::::..:..
.......... .:.: >; ......... ..::::....:::.::.;:.;:..;:::;:.;;:.:. ..::.::.
.::::::.:".:x ::.:.:.....:.......................:............::.......:.:::.:..::................................................................:::.::...
.....:...........................:..............:...:::::::::::::::.............
. .........................................................................................................................:.............:....,..:..:......::::::.............................:.::::::::::::::::::::::::.................
............................... :;:•;:;::::
>::;.:::::::::::::::.
.........................................................::.:.::::.::.:::::::::.::::::::::::::::::::::.::::::.::::::::::::::::::::.:.::::::.:::>!::::: >:::::::.:::::::.::>::><:
city:. pone :::
....
:..:::............. :..:..:::::.::::..:..:..:::.
... . ...: .............................. .......... ..............
::::....:...:::.:::::::::..:..:::.:::.:::.
:..... .................:.::.::.;;:.>:.;:.......
:.;;;;::.;:.
tnenrance;ca:. olicv#,
.. . . :M:.X.:.:.....�
campany name
...:::. ....
..
....... ....:.
address.
..:.......:.:.
....
:...
. phone#.
city:
:: .:: .:..
:..:........................................................... ..;:.;:.;;:•.:
....:.:::..........::::...... :: :»::.:'::
.::::..."::...::*--: ::.;:.::...::.::.:....:...:.::.:.:...;:.;.;:.;:..,. ...
;murance.co.:.
:::>><:::::>::>:;>:>::>::> »:>::::>::::;:::.......... .......:;::;: ::.... ..........<::::::::.::.::......:::::;::
.
lead to the imposition of criminal Failure to secure coverage as required under Section 25A of MGL 152 can al penalties of a fine up to$1,500.00 and/or
one years'tmprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby certify under the p ' and penalties of perjury that the information provided above is truo and correct.
signs --- -
Date L/ — v / ' 7 z
_ -
Print name C `� C' Phone# `6fQb - O . ' )
—
official use only do not write in this area to be completed by city or town official
city or town: permit/license# ❑Building Department
❑Licensing Board
❑checkif immediate response is required ❑Selectmen's Office
• ❑Health Department
contact person: phone#; ❑Other
(revised 9/95 PIA)
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract
of hire, express or implied, oral or written.
An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or
trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a
dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of
another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal
of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the
commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting
authority.
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situatiowand
supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is
being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you
are required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be reburied to
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investlgallons
600 Washington Street
Boston, Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 ext. 406, 409 or 375
A�ISRESS a STATE
I I ZONING DISTRICT CODE SP-DISTS.I DATE PRINTED I CLASS I PCS I NBHD KEY NO.
'6 SMITH STREET 09 RB - 400 09HY., 07/09/95 ,1011 Ou 55CC R267 098. 16921Z
It D/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS - Y ' UNIT ADJ'D.UNIT
Date S"D'mens on LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE ACRES/UNITS .VALUE Description CONEYi BETTYE L 8 �gAp-,.
CD. FF-De ih/Acres
CARDS IN ACCOUNT —
S 2.0 U X , C= 10D 7000.0 7000.00 1.00 7000 i3 04 °:04#
ARKET 175700
INCOME
SE
PPRAISED `VALUE
ARCEL SUMMARY'
AN 38000
LDSS 45500
—IMPS
OTAL_ 83500
d CNST
<• DEED REFERENC Ty,�y' DATE RecordaC R I O R YEAR VALUE
. Book Peg, Inst. MO. Yr.DI Sales Pricy is ND 38000
," nrS 45500
a3500
'dFc I
BUILDING PERMIT
m Nuber Dale T mou ype Ant
II
LAND LAND—ADJ INCO�E iSE SP—BLDS •I FEATURES SLD—ADDS UNITS I I I I
70,30
' Consf i Oral 1 e'-6c i Age Norm OEsv uo
Base Rale Atli.Rat Ct'D. _
Hcrca to I non __.- I . I%R G.r repl.[:nst N,w ....� .._..:
_
�, Uu. Tu =10. 61 00 65 90 4S 49 21 83944. ii i O
` .:. . —`- — -
'"; F�:11 Nt r A i l7 a rX J1 I /^'t n L-' m?.o DATE: :Sf:A1 E 1
v v _ L. TTtv'- 1 CCTAiL w
- i e..... ... ........ I,T K.,. a. �:-j ix. d ..� i� .a v ua�a.i.i1q9�
JJ.I ISIi I zyjyA76--ee--- :,TT 1..a I -rr ___________ ' .. ..
-/ * -
0 Li - it --f
ricer.w»'L L.) I J:-A J'dL ----- F'
v�
- - A 7N- --- --- -- - 'r
iiy.e-: -�rI- ------------------0_
clwv o �`.._. '---- 1 1 1. --------------- -I
r _ -.__-___.__ _.____
I I m tr-a. .
F:roi -t dVHL•T� YJGIi A!';= -AL. 7-�T�qm i^. fj'I
BASE
-- I -------- ---
--- n-
, -
. 'Au,-... _... Base= til 0,r—I Tr`
- iJ$iONS I __ _ ___ ____.__- "I
N U FZ6 530, '26... FWD NI$ � !8 �tEL9KiLRI - ly��r - - - - ����
ri1.2 EDS S.i2 518 .. I c {P vv_uS„'---- I IJil1--- ------- ---------�
i l
cc i— ------ --- ..l — ---- `
- LAND TOTAL PIAR SET
h , I r-AK'_t L
y, X---,ever°-.----26----------* AREA
V Ie..INC,E +U t0
5TAVDARD
r
t
STATE
l7ORESS I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CLASS I PCS I- NBHD PARCEL IDENJIFICABON NUMBESKEY NO.
fr
6 SMITH STREET 09 RB 400. 09HY, 07/09/95 1011 ' 00 55CC R267 . 098
l/VD/OTHER FEATURES DESCRIPTION 1 ADJUSTMENT FACTORS TY UNITADJ'D.UNIT CONEYi BET7YE L & - _
/Data size Dimans�on ACRES/UNITS VALUE oeacriplion MAP
Co. FFDe m/Acres LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE #LAND 1 3$i O D D CARDS IN ACCOUNT -
�1BLDG.SIT.1 X, .52I =100 146 49999.9 72999.99 .52 33000 #8LDG(S)-CARD-1 1 20.500 01 of 04.'3'
#9LDG(S)-CARD-2 1 3r100 GIST
S_1.0 U X, C 100 3500.0 3500.00 . 1.00 3500 B #BLDG(S)-CARD-3 1 4.300 FRKET 175700,
.BSNT_ S X ' C= 100 7.2 . 7.20 840 6000-a #BLDG(S)-CARD-4 1 17,,600 COME
u: #PL 156 SMITH ST JSE
#RR 1498 0122 0369 016DIF
PPRAISED VALUE
� #SR CRAIGVILLE BEACH RD 83i500
ARCEL ' SUMMARY
AND 38000
LDGS 45500
-IMPS
' OTAL 83500
CNST
DEED REFERENC Ty
pa DATE R�� R I O R YEAR VALUE
.. Book Page Insl. MO. Vr.f, Si—Pl100 A N D 38000
P1178-E1 d0I 8/90 A ILDGS 45500
2451/325: i70/OD l�CTAL 83500.•
8348/203: 12/92 A 1
BUILDING PERMIT ALL BUILDINGS
Namber Date Type Amoum N FAIR OR POOR
LAND .LAND-ADJ , INCOME SE SP-BLDS FEATURES BLD-ADJS UNITS rnN;nTT7C%%I
�,.
2500-I 38000 ! ! I �
i I j
ar em NOrcn. Obsv. '
Consf. To:at r - ,
i--- I`— a Rale Adj.Hale t—=(-1?- ,. Age _ CND Loc ^.S R.0 - 1 - -
� Units Units i oae vp� •_ 1 ✓e r. COntl. �a�� Cosl New AO� f/0o1 vwarw I$10'�es I Het:.^.: RC.^ .., �.,:I :F:., ,„t�__ - - - •
_ v u yl
10U:100_ 56- 0 56.50 62 63 34 .8 90 416 44624.
20500 1.0 5 2 1_0 4 0 �
1.LrM1. pLon Refe r Square Faer R. Co l T I t=00 _e :0.0 9 7
w11t1� I��v3fl i Wi.i 4L1G$ �r4.e.. noa_n ".BY/DA 6 4 � 1:�� .nfr�.u.• SCALE: `i� uc I aces=,.re
74kI i I I -- - — ----------- 4_A----- --.--- ==�;z n n� i 0:yf2T T AG,c i
' I 2 a nu,)j•1 t UI
I i e r TnLLST i ucF+JicS3U� --------+I fiI
I. t aTlAC TYPE I U AO r i^ii
i
;PUSH � ---� ---- -1.C'I
I I I I BASE �� lt;: o L'iit?tJT } .11a - -------- ---- -
I ---U.ul
I µi9T aJH<7i i ) �iAi t d� FY7F-u n n!
--- ---- - - - -- -
r' ;• �; '
.ACT JGr �r,
-_ ----- f - -----------------u- V tLv;i:i C�tizk f !�!I t3 wf'rl
m base v4..� � n -- --------
-----------------
IA— � 1 �_ I
44 —� i-> T I Jt3 DN16 E46S20 W26 N04 W0 ----------- rs * - --------- - -
_
99.91
� -- --- --- L_- ---- -------I
--- �E�Gne`6Fcrt>Sti -1, HY.' l Is `
LAND TOTAL MARKET
PARCEL 38000 83500
AREA 4027
3F JARiAINcE tU
� STA:y;;ARD �5
hz,
x
f
CI,
i L�DRESS I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I STATE CLASS I PCS I NBHD ON NUMB ICEy NO.
5. SMITN;STREET, 09 R1I 400 09HY, 07/09/95 1011 00 55CC R2b7 . 098. 169212
LAi•J/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS Y UNIT ADJ'D.UNIT F
Dato Sze D:mens:on LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE ACRES/UNITS VALUE Description C 0 N E Y� B_T T Y E L & M A p—
� / CD. FF-De ih/Acres '-
CARDS IN ACCOUNT —
HS 1.0 U X. N 100 1.00 1.00 1.00 8 02 OF 04
SSMT S X; C= 100 7.85 7.85 , 440 3500-8
ARKET 175700
INCOME
SE
PPRAISED 'VALUE
830-500
ARCEL' SUMMARY
AND 38000
LDGS 45500
—IMPS
OTAL 83500
CNST
DEED REFERENCE Typo DATE Reo ri d R I O R- YEAR VALUE
Rook Page Inst. I MO. Yr.n Swtee rrlce *A N D_ 38000
L D G S 45500
I
"TAL 83500
I
BUILDING PERMIT
Number Date Typo Arrount
LAND LAND—ADJ . INCOME dSE SP-BLDS FEATURES BLD—ADDS UNITS I
3500-1
,i4S Gonst. Total Base Rate Atli.Rate �a-i n Norm. 'Un^v. _I p Yolu^ Stxics kei ft:an�s 1
1 I , .. -^'` lour .. o, I CND. Lac I Cb R.3 Ra I c—New I Ant R n I I gy.
a 0u0, 1 CIO.`_`_?0 57.85- 57a85 40 40 54 24 90 14 21954 31 1 i
p 0 4 2 "l.0 a t7 i
Grs nt�e--T—RA�� S •�•e c^ Re^I C�-'^-1 K .-o U ,� i -c n
n`r,LII� �7eti ba!«e c�5'.1Y-v BY/DATE .. SCALE: t -�� _ -.w
s L 7 J `I ST
--------------
s}Rs...,.. ,..W._._..�-gym.�..,.2i Qt ITE5 - nl a e ee t i _ --------------
1 L=7T S--t - -- ----- - ._i
; � •,•_ I Ji L>JUv �K`1i'iE ilaUi
e
+ ttuTe FIfY'YCA- -z- a -- --- - 42
---- -,-i
---- ----
3
1.' I ,
------------------
--------------
as
Aux= Base= i 4 7{'��oO Ty P- -_t u�------------------
a
SUiLDING DIMENSIONS BASE J(l LI r^E -r�Kt Ef _{ L OU __ _____ ✓t_ -
u R1U L SC4l �1 -{I --- ---- ---- L�
.�..'
----------------------
�` i -------
I -----------I
! -----
LAND TOTAL MARKET
! ° AREA
ynniANICE
ST_ A11D +RD
$z
s .-
Da
"DRESS I I ZONING I DISTRICT CODE SP•DISTS.I DATE PRINTED I STASS I PCS NBHD Y�-.._....PARCEL IDENTIFICATION_ . ...a _•_..•`" - KEY NO.
:,5b SMITH STREET 09 R8 400 09HY. 07/09/95 1011 00 55CC R2o7 098. 169217
LAN-MOTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS V UNIT 'ADJ D.UNIT
ey/pale S,:e Dimens,on ACRES/UNITS VALUE Description CONEY, 9ETTYE L 8t MAP—
.p;c. / CD. FF De Ih/Acres LOC,'YR.SPEC.CLASS ADJ. COND. P PRICE PRICE
CARDS IN ACCOUNT -
kHS 1.0 U X• C= 100 3500.00 3500.00 1.00 3500 8 03 OF 04
r"NO MT S x C= 100 7.85 7.85 512 4000-3 CST IARKET 175700
INCOME
SE
PPRAISED VALUE
14 83.500
ARCEL SUMMARY
AND 38000
LDGS 4550C
I, —IMPS
OTAL 83500
CNST
DEED REFERENC Type DATE Recorded [Lf)CS
RIOR YEAR VALUE
saesPrlpoANID 38000
Book PageD 45500
i
.OTitL 83500
f
1 1
.J_ BUILDING PERMIT
'��t Number Data Type Amount i
�I{t't_ LAND LAND-ADJ I INCO E SE SP-BLDS FEATURESI SLD-ADJS UNITS j
1� wn51. iolnl ease Rate Atli.Rate t-;Tr-yr'ru'i:.� l Aae l Narm. �bev. CND Lec %R.0 p:Ccs: :a'x Ad Re 1 Vxlue l Stories Hwiohr R I --
I llnn� Oo l I. l r. •+eur. l ond. I l P aoms R •J Be!.^._
# 090 .100 100 57.85 57,85 ^4U r^ 5� 24 90 t� 30623 430C 1.0 4 2F�1.0 4.0
Des:iPlion �- Ra:e � Sr7uare F RePI.__ 1• � -_-- nr. r SCALE: - -'—' -- _-
'�y �0 1�I!? i�•Y_ C I 2t I -�r h-� _`, '...BY/DATE: �- •�W I---� ELEMENTS lC cf _ t
,.�fir.• 1519 I _',:�'= �x ...... ........ rx� oD_. cer:STa�:i�:D '
F0u I LL 7iiS4 i _--va- L- ---_-__ i.•r I � '__ '
n ; i.M- i It `:
1 r � ?. !.. J I Lb
1 1 �cY._w _ - _ ------
n__-t
fri'\t^C
:F-f a-T i
1�¢H � .`�'� i r I✓W.
v
JH � Ju
aLi 7_ 0 A C C LI fY- - -
# TGA=IEAS EXTEei_ `1
_
1 cur 1=r
ritirr,.o l;F------------------T,- =i
I LQ 55 r .I -.... ....._.. ..LI lfaJ
V�Ao ease 2 I ==Y-~ a ISOn - �or�------ - -r------------------ --�i
" rea .- 1 1 UI 1_t:t
---- - E--- - - --------------------
IJUILOIt�G vlrviENSIGiJS I = � IvL L L T r•i�A � .7 U [1 i
a.N22 E24 S20 W08 S02 tdlb 7 a
N07 . WG4 N10 E04 S10 S07 .. - - -------p:--T-- 1Ts --------------------- l
-------------1---L------------------- -i
" __-_ I�
LAND
W:TOTAL Ar STET
n
.�,..t
t PARCEL
Y
AREA
.. VA UI h?;CE r0
Y V
3TANDARD
z... -
I•
i
3
G
� 17-
.1 C•1267 098. :! TAX ACCOUNTING E 3 4 .1 1_..C 1692121
RECEIPT NO. PAYMENT TAX YEAR/B.G. AMOUNT DATE TYPE PID ;
1 3
------CERTIFIED OWNER------ TAX DUE 1 , 270.88 1 OUl..SiAf'dLil:NG „ 00
CONEY, E E=.TT YE L.. & :I TAX CODE 400 1 CI••I••Y 091 DIS..i.RIC^...i.'S !...!Y
-.-----dANUARY 1 OWNE::R..__........---.. ,'-`tt::TIC:N 3 MORTGAGE C::OI-.)E ;'00001
CONEY, BE`!....i.tE i & - - ::I _....--CER'l"IF:EEIT:t VALUES----
-------CURRENT OWNER------- TAX EXEMPT .00 :!
COMET,— T^..i..TY•E: L & � "I T AXABI.,_E. . 00 0 :l
COAL, '
!v!(••'RI L..Y",!==C'•�1�G-R 3 !=�ESIDEt�l..!..;i .-,:
"��t1-°OR—Pica I TAXABLE S3, 500. 00 ']
M I L.TON MA 021863 PEN SPACE . 00 a 1
00003 TAXABLE . 00
-----LEGAL DESCRIPTION-._..--_. COMMERCIAL. o o 1
#L..ANEi 1 30, 0003 TAXABLE . 00 :1
#BLOG(S) •-C'ARL't-1 1 20, 5003 INDUSTRIAL.TRIAL. , tit-;
.I
i BL_I:G(S ) -CARD-1:: 1 3, 1003 TAXABLE ., lilt 1
#BL DG(S) -C("iRD- 1 4, 3001 1
#BLDG(S ) -C::ARC:t-4 1 17, 6001
1 :1
LEGAL DE:SC CON"f'`I:t XM..i.. E?l
i....00::1t,a156 pSMITH STREET CTY309 TDS3 400 HY E:::EY3 169212
FCA3101. 1. PCs.�z� 0 YE��1c:0 E'AE��!�t+i'i 3
_.___.I'�iA l:!.-I!.a GADDRESS------- , - ..
CC:NEY, BE:TTYE L & MAP] AREA150C".C:: uiV32:'8671 MTG30000
HILL, MARILYN TAYLOE SE'1. 1 SP23 SE=':.1
,.''" AMOR RC UT 1. 1 U"f'2 3 55._ SO F"i..:! 840
MILTON MA 02186 AYB7196: ' EY011960 "—USS3 CO!`!ST1
......---LEGAL. DESC1RI!'-TION-._._.- TRUE MKT 83500 REA CLASSIFIED
#L-(-iND 1 30, 000 PSD L_NO 38000 ASD IMP 4::5500 ASD OTH
#ILfi+iG(S) --C:A!D--1 1 20, 500 DESCRIPTION TAX YR CURRENT EXEMPT T'AXABL.!::::
fl BL DG(S) --CARD-2 1. 3, 100 TAX EXEMP..i..
:F _; tG(S) __At,D-:I; 1. 4, 300 RES:E3:tE:fi'•.i"f'''!_.. 83500 8350t_a 83500
'D--4 1 17, 600 CAI}E::N SPACE
QL.. 15� rM I TH- 5-1- COMMERCIAL
-""Qo
�i RR 1498 0122. j 0:1:69 0160 :NCiUSTR I A!_
:I* I A"4GwV G["t=EEE:AfG'H RlE
EXEMPTIONS '
SAL..E308/ t_i PRICE] ORX BPI 17 -E:!.. AFD1 1 90 A Y..
LAST ACTI.VITY306/29/93 PC::R7Y
- -.,yri - .. .. . . � '_� ,.,.�,e•+ems-r�+�er,•+� QS"��'� .3�Y Fri
ot •�
*.t
eU X1
e,-.- ...r..'�..# r -,., .. H < .,.x-..+. ... .. .. .M• ..R 3. .. ... -.. 1. ,. «..i. }:.. -.,„d, �,.L � d S.fi:.
.. 1..::.E^ .. ..d,�Y! •+'�,.fir. .,. .... e. ,b.....S'�...,. ,.�'�-....,.z.., .,•,f:H. h. r: ,. � .c_�.ri•�F. .� a. t...i u. Sir rs .v.• - ":xa iAt;#.�
.,1,- .,:, .} x ...At-:. t_... :-:....*Y 4 _.. ,..';d,•� ..- -.«, .y.'2 *4.<. ;•.a'z. r- 1Ts;.:. .�., .vl:. '"S`:! 9 .i _.+
...,��,•.r�"...i,• $Ya. :......� S .. .. .. ..� _..� ��.-:' ,::-. .'•'-M .,.,•z.,v �;�.a• ,.. .�'?s sa,.�- .tS� .,rs� tt �wr;� r Y n � r,. y�j '� ,.
.., r.�a - .Rn .-..'.w`-f c. ..-�_i1 �- • - .� .. =�� _i .� '�ti' -�Sa.;3 � Y� Fv �� .,�.�• 3, aYaP y'.
`o•'••'.'. `-,.-` ,.-. .:.' - ,,�� ,.,"-� ��.,.:;: ��Y-e�,t.. :~'.3'�`-�'2, ',� - .Y..%":s�, 3a`�F� i74§�.i��;� 71y �x�' 71� .. �'•�.-..='�.. ..,�.�
Or
DISTRICT SUMMARY-'-
r
s�•F, mac] STREET 156 5mit�h Ste �• Hy'a'xlnspor•�; ' , � r�
78 , - — ---- -- H �3 ;^LAND �: S
y�v•g^g �"� 1� x b'•r..r i ;ski $ :,1 .. '� BLDGS. 6,>-3 9
TOTAL
RECORD OF TRANSFER ;'' DATE BK PG I.R.S. REMARKS LAND...
�p 5 cn-' BLDGS: -
34AA
53 sf, j� �j — TOTAL r. s
LAND
*{ (Tones Benin EA 1=5-77 2451 •325 ---'-=--= " -- „
----- - — BLDGS.' a
,TOTAL. e
-
�1-.. Gib-rrJ•-a-2.i d � --#�4-----��G-�_�'�
rs u �� q�;x Ys y �S✓ , -- -- J'� LAND s
"BLDGS;
�, - - ---- J -�—� Q; t x i
F s h r t £ v � aL"e TOTAL'
t �'�75
- - ., '.3 ..tr .LAND.,
�7`,l .t�. 31•�rT i ,*� tir.t. t .4' y.t" f
BLDGS.�.
�. yv+ a,.a'�-q�'a z�`3 tl.,, f r., r• _ t. -- .TOTAL
IR
rx " Ep,'CT#;•x: f r•µ ,# 6 -.t.. ,b -- -' _ ND
t `#.;•::.s+`Y.�� ti?-a. ,:er� t ,y r a S .•1 - "BLDGS.,r
M emrd•eda�'b"�Ji•�%','.a x >'•-;:6^t :n,..,y¢a ulr .tr.•, ,. .- fi• .. - .. - , - i
*� LAND.
0) ..BLDGS 9 x x
OTAL1' - ,s
-- LAND
e INTERIOR INSPECTED:" j - - -f - .:BLDGS is :?
TOTAL
LAND -�lp
DATE
r;
�,, ::...• ACREAGE COMPUTATIONS
s BLDGS.` , Y
1 " '�'T'LANDIT;YPE 'y^ # OF ACRES +., -PRICE - TOTALlo z` DEPR. "• VALUE - '�t .TOTAL'.t } ' ~" �•
.�.,•...
`HOUSE LOT SD — LAND
6
CLEARED FRONT -----
_ c BLDGS:' u .
TOTAL
WOODS&SPROUT FRONT --- ---- -- ------------ LAND i
REAR ------------------------•---- _ _ BLDGS.
WASTE FRONT.. --------------- ^ . TOTAL , k
y REAR - -- ------- ---- ------ LAND
�y x> y -- —_-- - ---------- — --- BLDGS.
_ `TOTAL
LAND
BLDGS.: r
LOT COMPUTATIONS '
LAND FACTORS TOTAL `
g� F FRONT r ; ,LDEPTH„ STREET.PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR, COR.,,INF.= —VA IJE --IiiLLY LANDS- '
r * c c• ,� i s. - -- --- _ TOWN SEWER t
--- 4O'UGIi� TOWN WATER BLDGS.
u4 — —
i, - HIGH t GRAVEL RD. `,TOTAL.tt
f; _ i r ., :: t r = z I O 1V 3h n DIRT RD.' n',e LAND t
T :B. __.-_...
S cWAA�IfY NO RD± .BLDGS
Y 3—.
c Bath„o Ls.' 7 4 {
s r �
e P i room St.Shower Sa'.h - -- ---- r 'Js k
Slcc• U fr St. ShoviWExt Na_Iis: « 1, — —L i L'N i e
.n„ ..-,. . _ _ PU 2C H. PRICE •°
k Wall Attic FI x Stair's Toilet Room 1/ }„ f „�
RocF w c RENT
le Wells-Walls j.` Fn.Attic _ Two Fixt`Bath — . ?
Floors �'•f
;`'-'£.� •"I.NTERFO:R.„FINISHr 'Lavatory Extra
^ '`_`_
t. •'r',s T,.`;w f."' :.s1" ..1' 2 ..3 Sink + •"` -././1... .&>', _ _Y �_ �-., .T�w �'�.1
i
r; _� ,} / Attic ec. } 'hay t: t` s } s* s q a
i• /2-- .4 �,.,...-Vz" Plastet.. .,K`r,i::»:; ... .Water Clo.Extra #.-5..'',y,. °.' >.. 'e�s� - +,
s ' Knot PineWator Only
a -_§ �' - .# ; �" - -•?•• � s'a+'+ ..XTERIOR WALLS'' tY y
• .s Bsmt.Fin`. a f •^ . 's v ._ -'. ..s ^t
,
�leSiding:,: may. � _._•, Plywood a.'�,tsdi ..R _•'•.. NoPlumbingx, � - �„`",,,, ;-� „�. ..,. .,-..,...,.-,:;r `,�. _ �'--.-.:�•--f-3-•�a,:,.�-'
le Sidin , w W Pasteboard 'aY 8 ^- -.x>,•. Int. Fin. r
g "£ C
x. Shinglos:r .r :.TILING .r':J
g < _ � t
`•-�- -- Y 3t Y ^•S
G F P Bath Fl.,.s Next '..0 n?
t /
Ark.On �v' r Int.tayoutt.;.'= Bath :&Wam3 !. t y0 eP ::a
_V.'
Auto Ht.Umt
y r:^ y 4
,M Veneer z;r , W .x
a r".y, _..e. Int.Cond.'? y/ Bath FI: &Wells �'.w —p t,�b � •.•; i � /�, �•- ;.2�`a `; �'^•: ,�.�� ',!r-f
;, Fire Iace
-Brk.On"', HEATING Toilet.Rm.FI.
Plumbing
of AirI`Oorn.Brk. `. H Toilet Rm.FI:&Vdains.
i Steam Thin
t
T s, Toilot Rm.'FI,&Walls
y
;�' - a-°-s ,�rxi'ee .F � -.�:.� ,.y �e .S *+,11'g z'•„*;
'cf. err :^3. .3 .v(") ky 4 a „ :t. _..'ij,yp; p ,'C l 3."oe,'f'Sis {.Y„..e '&k;3 •i-F 3 ri ;,h q.}'' A•_ .
ket Ins Hot Water / St.Shower :#, _ T w 1 �C
::Y *' �... .•. .',-::, jts .:0., ..:... .. :.x --
r ,tt
.-...-. - a 1:.-" i. a-a^ s. .;t . : ... z"'..:{.^: ' s tY'.•t?"'t ryy�:s.;. s-8.�:`F}fr J. :$- ,.°l.t;e F;�.
:,:... .. -.:k.: rd::. -.,.•. Total. s s.. a.. ,Y+. x _a`-»y 5-i.ls•,'a., :qa .^.u. Y:-{ < -x «T• #,„t
Ins. .,. r, -, A d: = Tub Area -,. r:: # t: 3 µ k.s. * C,
�..� it Con si. p T t. c .�{
...,..: a. .- ..� :...- .,., Y..,. 'u .,F y>. ,,• „ a•T ft� ,P•,)t ,�i fit+. g1z�:Yt I. Fy,io: };. r ti 'y,' ,�> `gt i'" 1„#•-k.- if:. ._}_
6,. l r. -.. .T St.
.,., ....o:. .- ,:r.... Floor Furn:,.,.:r, ,.f.f. i ',,. : t+_.. .....:.M...., ,r,s,.. ,.[. s^.e•• c- .i+• t^ta' [ :..«-t
... 5,._.. .,�. -:. _� � a a L�; �y 'k fl:7-'7 S. �•" e� .�aayK,:s,`�a ,�_-..t
.y.....t
�•..« s.f-:;-. ,,..r r „�'. ,,,ei, uT,. . r. :,e1. •,.d,. o- :7•:...t >f..: e s,-.- 3r r 'c.. .is
k^a a;f* 5�, :"<:^:,-. r....Yc= i...,: .x"t.,.-,.-` ° s-' - :ti• n t :.''�,.' i a 're x ,t,. r :.-.Sa:.F200FING ,. ,=�%,o _,�;� � _' ;».. _.•..st.< „s_:.f �-,CQ.MPUTA;fIC?IVS.. :,�: �: -�'^ r,. •:e„ } :a,`x �..„.... •+>`. .. .. ..
.. -.. ...y,- s,. ,,.a ..r .>..- , r .,_ .. .«.. ,.:H. a'.:'rr;. ....ii"• _'.:,y. rt�_ •n,,.-,. -k}`-` ±`..'�s
Shi +ire..aw+,_, �.. ,.:, .a. �,. :,+ ?".y.. a:Y ,+:, J /- ^ .� - „ s., ^aa+,..r.•_9.,.., ..s.F. ...-e .. -. «,}- nt t _ � q .er s �":r��..• `w:- 1": '9tai ..:.'z:,
i. n le -,.- n.x y Pi el¢ss Furn.,, ,itc.,�... ,� � �:,br c -� S:F:,. y.u� •e ,.,. 1 �..:,w, ..r -... ..+; t. ,�K q _ ..g..,ca* ..:�,st%'N••�-
. 8 f--, .. .^t�, ..:..-�• p-.-. _ .. ,.-A.. •� .-. _ .... ,.s9;•�.-+ .,,.*. =r :i n S.i...,'k a _ q..c ".S .,,.+». _ ..'I.". tY'� h{# •r=1'�
— _ ...�.•> . . > , S- F,$hing¢ _ s i,__ ; `•� t q{lx- ♦x F3.;^.1:.
#
Shingle a s+ Oil Burner •o',':.., r.'
S 'F. is� + f
La`
Coal Stoker, „ „t � }1
I, . . ';r a
i' 1 S. F.
Gas_ s _ _ _ 7 - '-- x "
ROOF TYPE Electric ` S• F, ,. OUTBUILDINGS
e �/ Flat
S. F. 1 2 3 4 5 6 7 1 8 9 10 1 2 3 4 5 6 J 8 .9.1 10 'MEASURED
* tit Mansard FIREPLACES " S. F. Pier Found. Floor
brel.,,.° .r . Wall Found., a 0.H.Door
"LISTED`.
44�>:. F Lob RS > replace y` ••_ _ • �'r=a ' ., Sgle, Sdg:_ Roll Roofing
LIGHTING' -
h to Elect -r D .. g.
Shingle x- `hingko V,! lls Plumbing
Roof
DATE "+a
Iwood-,> h'.r ROOMS S.=' Cement Blk. Electric
Tile Bsmt' 'W lsi'S� to ',TOTAL K ice:P C�" Brick lot.Finish y. PRICED'..
Ie" 2nd 3rd a a �� t/• �r rt f
FACTOR
,rt :REPLACEMENT 4 .j.'.6/ 7 -
Y,.00CUPANCY %11,CONSTRUCTION '�•SIZE- ` ,-'AREA CLASS AGE REMOD. COND. REPL, VAL.: Phy.Dep. PHYS. VALUE- Funct:Dep: ACTUAL VAL. r ;e
:. •�"r ,�' Ste. sry.i.�. h- ,..,:' .S .`:� •.'�[ � /, _ ->�.•�� 7 �• ° p.
•�'Y - -,
j t.
i � e
,
R
--'4 r�•,,` ,t`a,..z�e �#. e ,V
_ -� " y�1a ,..chi.+ .`�•.. .4t.
Y
�W.�
..
Wig.. .•, %,,s,3• ,;.�A. �w,. r'^� x3^',�,>+',.. • _ _ s i' i j� C -- r t s" d: , ,p• ♦i
i�?�..'�ra�c. :e•�6 � � � `u f ;s '+, ,u.. P � `"�:e s. TOTAL �x: � P.
�.
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
I M ^ACC
DATA
ice--• 'r` ".s, '."Y�; �'yr°" "'y"" +.:., Y•,*... ,a�?'.iv"�'� µ,.,, ".f �wr * !'"ti', ""„tft 'r sry r+• rylwp{, a..
1'1."
,•,�f^qw.,.:;�v #!` p i�Y'.� :""a,`•". %,c;r " .s.rtw .. "" ! a + �".y ^"!
,f'�i's*,: 1. �a �?-'!ar 4._.wr _ '+r" :.r"* '' gyp. .•�e`:+�.. -��_ -+�; C' ''.G•�n - �:F� A�1(�f5. -
";., l•-+g=.
L F.'
1� q�. rn:_ .a. 't ,.,.. .,, "S•.s._„5,. ,":.... aa..:..ss,ar :_+F:'a :.,`„4;,-, ry. e gl• '-Y�.'3 ..s�f- h,
.,,,.,...y q k.; {w.-,Y :� .rr .*:.,- a .•., :�:.. #'. t. a.is-r, t. +� ;. +. ,.fit•, y. f3' -__�{?':r3 .".,;,i •a.:a ... ': �s` S•, i,,:
�'� �.�� � � ,.,. �, I�ES I D�[�'1•I AL.-�, PRO
�.,,;,•s.•.4+7 *"" �!y :k^.t`a�i "4%�, ruN r�.i ! { �€ a r;, a - .::v{;1 jt..1.�.. 'e x 4{. 'f'*:- _.�*+�+�t �, 'r`;a;.�««:,t - ,�t,r r +.•
MAQ,,+rNO {{ L xLO�T�;NO .,.yk C .a � ...®. •�� �~" _ ._:', T .. t -��- �'�' .
77
k{va:�gi t? •V4 '++'� t K. �+•SW+�'^YM'iy 1'��'T� JT R.��T .J t �1 !- - "A �.� ..� -
s..A,y ST. �' 'i. ,:T ��F�!S: •7f �r,�� '+�.I-}�^� � . .... .< _. .. ..,. .. ._._. .. ._ ,,..:.. .......Jl t:_.�, _ .._ _.�... ... .- a. .... {
<F . � .'i fx� ...r .,,.,-_. ,.. ..-. _ .-._-� ,.. __ .:_. .� .. __.p ...:. t a.. •... �..., .,,.�r_.�,.r: ,,, , � i�1�-#j tiI,�" r *tr"
r
4
" `• _ _ r+±e_`Y,. ..,.a may.. .i �. �' t •-t r �. r... * -'-.. _ q - ..,._ .- __.,:.._ _c .«_. .� t
n
y
3., d
- , }, :'t} 3•:iz. ift'.+. rat c.t;�i� ���(..�' tjtF._ tt�z •.z' .. r .J ir, -�('* - --i - '�r'. - 't ti. 1tiF` i,
-
yF i• t !1
No' ..*i •,'„T 4s,. "4•k '*+°*" #t'} ^z• .Y w ' , !___,. _f - _mot-. _.-._. _ _. - t�z , :.F§£ tf'� t�ti�
L •"
,
,
Fr.{, tr P s�#2111�}x-.j`
(tq .
I + r _ .+• .. ., .. ..�.r-'. F r,
>_ -
•. -=:x. .,. ! •.11 kr }!',-. iFj` A a11 .itlty�ll f r.i• ... } _ _... 4 -
.! �;.��'`��ia}' �:�}��s i '"• xz{f �!l��
t ._s-.. o c:,ftrf d ;�it •, � F". - � ,�. .,r.�.- -1. __, .._;•. ._...._.ra_....... ._., -..... _ - s} �;F.-...F > �irf t.. r •f.� .Nits qit 3ii
�r •t;,ka _. z ,.,tgc, il�, t FP 9,+: t FF
-
Fti�, '1�it
jiff Fttrf
J ,
, a
,
s'4 q`r. nx� r°�c 4 .� �.,. +. '••�» —71
X + ` a, �. 'r .t F2 ,« •.o. ,w�, :.
--- ----- - -
r.
onc:BIk..Walls'. , i r
.Bsmt#Rec�Raem p'���" �, .St:bShower.8ath 1:-'s�;r. ' x3smt, .,�. .r 'r. ! +�,,�. _ � �,:�,��. y T + kx _ .t•:
_ _.. «•'.�.. ..-:"k .. ,... -�. ♦e • ... .r ____—_���_ __—__�__—._---�_ '~ 4i ..4;:• Sa.:',, , ^ir '•i -41..,. ..€T.S, ,:ii'^ Y.•
Conc :Slab. . PUPCH DATE g
x_. y. ,x a. ,Bsmt.,Garage'.„ pt# St.,,Shower Ext.r�:x-'� , '�:.$•- �:, �: I b'll.,:y *u :. ., �, t ._;. �:-,::, „s_
;. ."_ r Wrll ,.� tF�lr IL 't PURCN:..FRICE.# z
Prick Walisr.., f - x .s Attic F.&Stairs Toilet`Room. aY, .. fed; __,yp a�
/.. e„ Rc of r Y.z 1 r"! rr ` as 3, dtyk
--- RENT
- .c .,ti. s
,.. *.< r .-: ._,-..: --• }.-r- 'r :.5.'.;t ____--- •ri:^`� ,.+5., 3 r:c ,ay-iiCrw'ii.:�
Story:; ,tls, '_ ;_ _. Frn.`Atbc•. .. .. Two Ftxt.Bath vtY`.- ;,.,;., tS' air,S x:.k,,' eG s.sr y Fz. "s; a x v. c.yw -z st
-- .. r .. �- _--- Fleets_ ':. `"� - �+ r:' { ? i - .r: :1 _ �, -"+y'is. w
7 1, .
Pt .o, kh
INTERIOR"'FINISH Lavatory:Extra }. - -- �;--c y, 1 }. rd „ :
Bsmt F :. a t 4,a 1 2' 3 Sink c` M✓•y �1 , -to - -- - _— z M1 ,o a, x + 3,:
. . !ct?Go. F,.. s-Y 'K•"t - a:='. w,..� .":ta::... 1°' ..•k_�..ex -*.e tc k.:75'i�.A,k.y�2i�,
a r u,+-.,...e-:_1 1... .y ..r,... ..:°4M -..:e,.. ':•�.- 'M.,.. .. .�.,...... '.';1G f pN.2+3f .. Z x: �Mid.� , „jy�3✓.��r.,- T•ylY•°V� %
/s /2 /a+ Plaster x Water Cie.*Extra tt - -- - - t Y R > . r, rat ` t t x7
'_`EXTERIOR WALLS Knotty Pin Water bnly
Double Srdtng - "..; Plywood S-, No Plumbing I Bsmt. Fin. r °q ,,; = y erx
. _ I_;_.Fin.l Siding lasterboard t . _ s,. ra..,:.�_^Y-r-,s, .di&�_-.firr.•^+
a: Shin lest`x -
g , . `i. TILING C
~
one Blk a L = Y : G4 - - t
Face 0rk On Irit' Layout; Bath�+l!&Watns.:.J. Auto Ht. Unit
V ^ "max
,r• a�F L --r-.°'✓i-1r r `� +.:3s'.3 r. # �� w +3
-- o
y. Veneer :; Int.'Cond. . Bath FI.&Walls -_ ,
Com:,Brk On «u' ;`•. - HEATING Toilet Rm.Fl 77 iAi
I'nepl:ca
-- Plurnoing w- r ;tax a
Solid Com Brk Hot'Air Toilet Rm.FI. &1Va;ns.
t: Steam Toilet Rm.Fi. &Wzl;s --- - ------ 7 it,
�. � a } g? M v
Blankef lns r ;, v % Hot Water St. Shower
Roof Ins. Air Cond : Tub Area, { 1 lo:al--- ; ¢ ,
_ =
Floor Furn +...., L t +:,r3• #.r. fir' , ! x E k.+. .-, !'- 4s" - e n i _
G, ,.v rt, .# s g•, :,;r: *c. i_ t_ 4.:,, «to ,t C,e. iLll U r,a:1.IC).J:S
t ROOFIN t, .,.1 # G .. . ..1 r. c...T,1, C, t 3 ,...:. . .1 >
-- ---
.: .. ,. .. ,.,. .,,r ice.^;
a t .: c. T i . 1.AsPh:ShI g1631 t: .i':. P.ipeless Furn.:.. ,t�J,,r. r g F� g - :i S.t. «I. 1. s r E.+ .3
Wood Shrn le 33yy»yx. t,. bet. No.Heatr•.,T t2 t.i r {t..x2. 'r:S_ uti } � J• _ V '�.�..
8 ��r'C_ t ,E.r c,•I.: . s�Fl,:#. .w I $.F.
Asbs.Shingle - a:f.: 011:Burner£ S.F.
Siate�''+ �':�!' �- '� '+ C6a1-Stoker
...w.. . �. ..,. ,. s.,.-,
r,n ssr. .�- t,•., .. - ..:... r as m+< -!� -_ _ .�: r ^:i• �'...'r. M��
*� f s• Gases'-,. *.;,: c: Y ; -- - - -- -- —
,.r S•F - e r Nt r^R t � Fit v _3 - Ya .t Ste"
'tt .a .r::r^?r...f.x4_�« .r..cro! .,t t:: s f,+.., , ..c:
r t t. '., r S.F. OUTBUILDINGS y ,q g4 w rWs
"'ROOF' .PE_ii;,J=', Electric r+ t x: 11
�3.,rt r st+ .k --f- - ry rr.,ry
S f, sr- t " j "'"'t' t+� s 1 2 3 4 5 6 7 8 9 10 t Y�, 1 2 3 4 5 6 7 8 9 10 PyIEASUREC
k
Gable ` ' ;Flat i, :t , I-r jri r f v Y -
Ht n: Mansard :` �r �� + ..` t z +« S.F. i r� fits Fend.'. Floor t
PCdT $ FIREPLACES 3 Lt, r. .£t Ma _ -- = --- * >
Gambrel. :: r Fireplace Stack r c ` ' ° ', t : k •. 11zII Found:, O.H.Door LISTED,
fire'lace a> tt s ^s x - - - ,s x a _
• ,,,,. c P �:x �. ,.f,N #�"t ace+^ r -r �J e?r1 v-+•tF wr Sglc dg `� Roll Roofing r-7
Conc "' LIGHTING'%' ,, ;c /<-7
a ` r t4 t } P`T•.9,,. y1 �,.s.,�s y` :fir Utle odg k _ Shingle Root tea'
Earth ; 3rrr tit :: No;Elect,� r a]a —. DATE
w
4 fg >yc4- ` t ''Rr. ;t '•+ ,tfi .,4fr ,e
Pine n e, aka:I § :xs 't "`eta _. g-. Shingle Walls Plumbing`
a _
t {
Hardwood :"' ` "• {'ROOMS .tW'; r 'z'fi P r !tt .� t -'rL+ ttsf" s s°: Cement Blk.; Electric 7/.:
r _.
As ph.Tile £'t .L �' ' 1" s Brick
Int.Finish PRICED;.'
P 'I- Bsmt 1st f TOTAL ' i3.;{ + a;_tlJ, + y /. f
<
Sirigle,, .� . , . . .+c CY A 3rd T OR� j} .p
,5 _4, �••r! h_
+ 1. ^+s'?^", � ':,r ,:,. �.. „ t f.. „5�. ••_`'4 - <a.3..• c,„r.:,'#', v;'z... 1 srfp3R -'"v aas s .i
..tREPLACEMEI�lT, :. _• ':",. x �.., a. } tl�Kaif3g.,- �+:. .. r L. _ »k,s- - °'� x 3. xa,
,,.00CUPANCY ;a»,.-c .� xr'.:CONSTRUCTICIt ;; •SIZE- ..�` AREA " CLA55 '�ACE`� REMOD. OND., REPL.`'Vf L:"w' Phy.Dep. PHYS, VALUE Fwtct.Dep• ACTUAL VAL.
�.Y" L •.y.-
s
r :•�.. � �� � •'t ��,6 _,. s�. �3,n: ;
—
_
i.•, ''3 e...-� ,s., :.4•s� n A1111,'4-, .,. ., p e ;..•:. dx £ y h r • .h` aF ;1" a
.,:�: `:L„rrSe ""•:`'S�n ;�"%y-•.+�' x rr,�3. .a.`�': ..,,. -�., =.t-., .ra. �i .S� 'L _ -.1 f. _ ,_.t a y� _ ,?..r'.. :� fro•- .».art.; 'iiL�;
:nip�..,.. r ,,. -�, 2 :.�— }* ____- --s _ - e' -_••_ -r.. y:a- t :iia+s
a
a
•s. ..._ .n. nX?.S-ja. 5tl .,:. .4. .. , r!k.iFr ..5 . v. 'a t # r '} l p.. ;'•`.. j�. f'( 4 Gx' ,h.,y..y' `,d
a:9-
x t. - :=%i' .'4"". .;,;. ..;r,•::w a^.;,':`'- r..,i+i•:. .,.,;;;..- ,.r.,�,itexJ=`F's' ;w_.
. .,
g
- ----=-----
5 -� ...- «' :. °«�,".:. � ...:± .. •k �. + `+.+ .-t: :." -: ----- _- -_ _-_—_ _"_ - - 'a' '-;'v+v ley i:��,r%•4`c's'Ki�r
a,
_ T -_
_ _ 3,r
4 {�
B �'•_ - -
g C�c r �' = _ - — --,--------- -- -- ------ -- --- r-3 •a"0 ,r-.
tO
,
TOTAL s.
r �§_i.'tt'•v�.,fw' y..y 1 G.�Y ., .--. .-r --. o-v ...�,., F , ,
#Yt �1 J s r•' .,a;¢.v^ radar. ems':+ g n x . b i
�` A+v s��Y.: `v � ¢ µ�� it. ti'k� r :-�:+s °tR '•:-? r t
,x•�t.siw s x•? Rr• a# � +t 1;.�+- .r• '( x+ }• `>e v� i,gym i •t(,*•�a+» e w-.r: ,.»'.'w A+ ..•,,e^ r..:..,- �+ •.r<.: is :, ,
,r
.4... .: s. a r- .> mt b:., r:_,s,,, , .,..:, 1 ..,. -. .. 1 ,X 5r �1'. `4 n•^ x"• +,.':j:} ,S_"--� F�
�:
�:
,�i .�'.�S'i a .... �.,,�.- � vwrs'+�. a; , Yc:... .......... �,,.z�+,:'. .�- .� t.. t •a ro-� {r ^r .e +'_ r.�;..
- '+a
.. �•:.x.a•'. '..: 3�. .:'i2"+., t .fi..:.,.: -+'. y,. r._3� .,.: .r$ ,.•..,. ♦L�:. ":: �k:. �` yx pp��[pp,�r 8 pp4�'pp`�,pA gyp p.^V p.^� p��/p^ V6 .tM +u -
': y__ ^{#::, • •�T..L .. 1-:::�' R(F�6•,._, .. L.. :%. 0... �. - ij',":" 7 .t S gyp• R � �.a. .!'. S:t�■1\.s�II®Yw`LL Y��Jr\� ■R,, 6 Y®-��..i�.�.� 11.E L k^I 5.:;`,�"`k.''�,I`y",.
t-,.:.>-: a x a .�„ +"?t>.:•T• 4 y.;. rii;. a..:: ,a�.,..- :... r. d # , a: .,.s - `ti. .t. ,-{
.. r �:.i.,- 'rs..w•:, ,_'...Zv$
x ..c
.AAP NQ 3 �LOT,NO
FIRE DISTRICT
Y
.. ,-.,v..., , t,.�r .:a,d t+.� � 'R' f3.; :# �'� * e.rt. "•.a.::SUMMARYY,sia,.�.rx{,>"�
ST REET ;, ...::^
1�j6r'Sm.ith St Zi , nniS• ort r, LANDS : Y
267° H BLDGS. Q.
OWNER T 7 TOTAL ,4�1
•� s f.s xyr> �,.•,•. x, - �: .. ' 7
j Y ti s LAND
RECORD OF TRANSFER DATE eK PG I.R.S. REMARKS:
z •.p,,; - - — .. _ ' CW BLDGS.
=x < °' ;w�mw4* •+.pig. > :.2 , CttY E:. ;y.l��7i�, n �.a1 +i , _. . . .TOTALi
yJones:; cBettenia. r Lm8 1-5•-77 2451 325 LAND
s. s, w
TOTAL
LAN qr +.
BLDGS.
TOTAL a "t`r,: .{5
LAND41
,Y tkt
BLDGS.
a
TOTA
,
_ .. LAN Da
.. BLDGS. :
,{ , ryes• yvli C"ti 'cp �{T>R•'T3arFt rl'¢?,Ftb' : . . - »+'� TOTALry' -..
LAND r q
�1 INTERIORJIN�S{PELTEDIad ) _11,
BLDGS. .sa •$
fik yr w� ".z Rti41«' �rkr}rit Nzi [ /J• TOTAL
•',,+ ,r. is � zf.:*' Q gyp.-��„ ,.
LAND
dns N:ust� p3` ,., ACREAGE. c ` r r
COMPUT ftiONa s BLDGS.
w,..'., r het s.=.• _ .."„-. .. ,.,� t z t.e .. r,.�.,:
L"AND,TIYPE,i f }}
.; I,xy•,; ka{ :#C:OF ACRES PRICE TOTAL• DFPR-. VALUE r r TOTAL• Ct
,.
?HOUSE LOT 2 . . �, ; i a, LAND
Ms. hksirt...f . i,,*•.,. .,..,a. 1 ,....,,:z- , —
3 :,.. r, r::r- ,...:Lif eic+aw ,.•x,
�'„•.•;CLEARED,' {` �`� 'r_'Fj�,.z�?"tt°f..1 BLDGS.
,FRONT � r:, .- •: .; .. •„.: �. t, .M� + ,� _
_
SiE-A ,.»,-v.< .i ._.,•S. . .c... 9 'x«';L fi*h'rir'd n
; .5,. •o}3*i is _.'' x - TOTAL,'
PROUTFRONT LAND
BLDGS'
�: .
� * s7+'.31,"r..:""="�•?z-h":w,
a•x.4A.
.°�
s�.ut:s
�T01AL
WASTE.FRONT : r{t. r;K t T „t,s x
LAND,-!,t��` g s .,,,x, .fi:: m. r- "t„s•= r33 ">4.
4
>' REARr;*.A. B�DGS:. -&..c-...;,TR#r? '.�:•., .rr' f k ,3;:" .!f. .f,:a _...,. `k sz
�E 5 h' „'f9 Jam•} -+� �'�•I''.,�
..,*� ... r,.,,,x -' -fi .}..;.`k���,.�.,k 7b �i,e.r •,- � 1 r. _ .r:'�,. - ,e' .:�.
.y._'.' .e+.., .a- .*r4-.'..�. ,....:, ... .v,-,.::.. ..:, ♦: _ _— - +y,r.:.4• t'." - .F«.:%54:. 7p"r. `.;' :rs•<.-
r .,7r:..4...a, a•:,,.. ,. , .> :..,..t .,�..p .:.T.,- :, `y:" .� c: TOTAL"•
-:La 'f.=fix ••*.�*+.;.,.. 8 .:: ., .g ,.;.�.:; .. r: ,, r ,. .: :..:': : -,.' a 4 „fi. -
'�F.:... .r -tag +•r -_.v,.•ro' aa:;. F. c. .�k ...:. :s' -- �— — x 'k rtx
jr.t' Y• �.� p ,k.�«„ k :; s,, .,•. .. :. ..,5,:. f'- °s., p a..- LAND
..t..;.: 4 .. .T;r pT03 ,�?,�. c u, ,e .:.:.y,:: ,,s .. ix. c• ,..j .. s.
w
. u '
fi"`?': *' •a•..w, t. .-:7''f ar$�' r;,_., sa 4 .. .,<,-;:� - - .m :a.-� >s< ;vi <c. 1: a. rA •.a�
—
p,...,._,,,:,.a�` ,-.x„v„„,,..�*:...�(-� ,,._.,�'dt5d .. .R.;-.< ..�,P:':.. ti :;:rs..._ >,n..:_.._.w a :'. �•- ''i� ,^R .,M: .ai-r ,1` °r+. ,,ie:,. f. -,�':
BLDGS. �
f "
COMPUTATIONS •.�>.: .•::;:_ s+ .,xe; c :�3.- LAND i=ACTORS vs>:_ " TOTAL..
t *FRONTrsr F 'DEPTH ,STREET;.P,RICE DEPTH.% FRDNT:FT.PRICE 1"GYAI DEPR. CO+�. INF. —V4 dALL'E -- HILLY TOWN SEWER LAND
ROUGH TOWN V}tATER ' r BLDGS.4 _
GRAVEL RD. TOTAL H v
Dial RD.
LAN D
4
NO RD. O BLL �1
s, : NTitl + "it1rd�"
...-.,._. .,.....u.w�'.,.,s+.+i.,,.,.6:J. ,_ _. .-:: , r R :..._°.._......._.,.�_��..-- ,. .. ._.-... .,.,s .. ...,.,,m ,£-.n s,e....+..r...•.._s�fiC:Rt.v.,.:;'Sy
t l rr T ial G
v+�
>)C0.3TtL
. t _': "' -.`a^ r c. ty 'd' ,• t 1"cl•
s t.. r rtt Area : ,_LDG.COST' si
one.Blk.Walls ;►*� .Bs wt. ..r..-;com ' St.'Showe, Lath tr
p,mt• C'^ e
PURCH. DATE �t r
Conc.;Slab t Fry:: ' Bsmt.Garage ` St:Shower Ext. ,y ells `!: PURCH. PRICE: `` :r x, r �} a fi.�
%Brick Walls`- t ` :Attic FLI&Stairs Toilet Room ." Roof'`" RENT, • "'
w�
Stone Wells a:3:fi�z Y �.• Fin.Attie. ,. Two Fixt:Bath _ 7
Floors ° *#
Pieit"_ gyp' 'a INTERIOR :.FINISH`s- Lavatory Extre 1
z
�'Bsmtt s">;F;'�f'�:.- �..� � �1• 2 3 Sink � .; ->�- ...•...� -- '�as�`•
t
Attic:::• s',
s/s :.h r/: ;� t/�..;. s Plaster Water Clo.Extra
EXTERIOR WALLS,,. Knotty Plne. ,,�. - > Water Only _ - _ •„�
w -
n :-;. . < . Plywood
... �. No Plumbing i�srntFln' "« ry- C^R. x T+
Dooble Sldl B-- xr M> :«. Yvr _ z _ r+L� � —
Single Sidrn4.
6>- :Plastorboard:.w.,.� -- - - - ._..:�%:- '�'."a'�•-- _ '? } _ ` n �.�.•.•- } " _# u a
-'-. rShtngtes ". '•. . . -�..^r"asc�`•;:, ea` c$:_ _ _....;....-•;•--"•'.�'`' s'.'zt TILING [ ...�-- f
p Bik >=r t r : _Bath FI.� ?*'F"" °a'��, Heat � -.I--
Cone' I' � i •. . :�_ - �" � a
Layout - Bath .&Wains.:: / Auto Ht'Unit F
y
eVeneer).,., �+" lot.Cond. Bath"Fl, &Walls Fireplace
r t` 3t
Com:,Brk s.r`HEATING ToiletRm. FI 3"° >> r r s t v"
T Plumbing
. .
,.x+' Toilet Rm.FI.&Wains. ;.ry t.-a ,-
Solid Com.Brk r t
. HotAir>r* t# �4 Tiling �it
r «: Toilet Rm'.Fi.'&Walls a Y 2 I t, 1 Lr• t.':Epr tl I ` ,r tt:,, t' .f h.:�,-
'Steam.•
e •r a t.' pi.g tr t t` t t9'w ji y I r t
r
at r St Shower t�`t ": 1.. t x „t'rt c i t 4 1 f y ;
Blanket Ins.p, .r r q.xt :Hot.W e +, t t.,
:r.Roof•Ins x t. _ t: ;pir Cond.:b`k s Tub Area`> ,k_aq fps ! z.r1.
*. - ,..•.,.1.:z>. .#- r t �r
a
•1 -'}TYv. '-p._.I:u r.•t .i.r ,iti yF -:A.. y-�n'`%:. 'K:. i.' 1 e y.7
I urn:'..:. :„ _,:}.,_+...-+. .at. rl. ... ..,.>. -' -.}. .•s.,,:x.. `$+s�t -E,,;.,g.., ?:. yy :t.:,a* a:;`.. i-.
Floor,
t a
6 •t7 s: - COMPUTATIONS •xf.-#e
•;: Sx;ROOFING:v,.l,.. r ;+ e $ t•#�#�{":+ } �s �Y� K _ ��..,l.ir: *�# s' '��.
1 k,.r dr qb $ x. ... at a ,it• a }
-.SAs h:Shin le s Papeless-Furn ;c, #
Y_ r f
P g � a. N a / '.r� .it f a� p. ;r,.r A:.• �: j E ifi. �a'2 tr st
Sg T �+:•'.s ( �k ',i' et>4. ( t, TM4's +tl''•
w.
I NO Heat � r 5,>r,r.' - >rt,r, f -s. #� r` °awe-•
-.cWood.Shing ems.:- '.t'.z• ^.,�•. t�:r.::..-'_a`3. t:. .,./�' t. ,€
..:• �r { -e ' f At x ]- t. - S to Yr .x. •41
.� -),. >.:. 7..r;.:(s.6•s �.. s. . .. a:. .,•.y,. x•. u �� s,s .t t a i dr x, r Y. -•.Ji.
+,Asbs.Shm le _ Oit.Burner tI g to r-
g .4_.5 $. ` S'F r; s a i a^ ;t -i.-.. M r 1�.. •..r•::
' - .n •s:t e c - r _� .., r>`f •'s• r - •�._ �r .l: !>'.t� :,�
'Coal Stoker•2C S.F.
r
.Tile wrr r tttt, Gas +,
' "? to
+ S F. OUTBUILDINGS
ROOF TYPE Electric
�• ` S.F. , �tw �'� �` „ ` 1 2*3 4 5 6 7 8 s l0 1 2 8'4�5 6 7 8 *9 10 MEASURE[
= `.
Gable„ Flat
S.F. t� Pier Found. ` •Floor
� Hfpr Mansard FIREPLACES ; ,-•"
�t, x
4
a' , i Wall cued. 0.'H.-Door
r' mbrel t ,,z"+, Fireplace Stack ti #( t r i D
F,. :?`?RS •. •Fireplace:-•:, x* Sgle.Sdg. t RaIlRoofing'-
a
tt
� Conc. :`".LIGHTING Dble Sd Shin IeRoof xe "�
— t f�DATE
o Earth' �")`f'+ °° No Elect, �' ,. -- �,a{'
e Shingle P:'alls Plumbing t i Pine
- - Cement Blk. Electric *. _
Hardwood ROOMS
! Asph rile fi`"` Bsmt. - 1st �� TOTAL j� .-!� Brick Int.Finish PRICED
k`-.Singts ' :" .•. ._ 2nd 3rd , - FACTOR
REPLACEMENT S �n ,s
OCCUPANCY CONSTRUCTION• SIZE - AREA CLASS - AGE 'REMOD. CA`ND. -REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. 7`•'..>}
2 a �4f!�r'•.a a�
•5
z 5'r a t ••�
�6.�?'..•���. �a�°r'Sa - .x� - 'S� yi' � - - - it;T�'"'tr'S
.��8?«.ES Id.�;*�'.`-�:t.••,�r-�t�,s:r.,� ..�' �a _ x :tl _ :i• ��� r @ `;s,i
l
�- r�{r' `,.�•�,.ia # .E .'> `-•� ',a E:' �r >ti.; t �, .,y� t:. ;..}. Gs'
�-;y.: .;;xE��� 9.�•.-e..t r! y.. �:�.. 't .:N,. i Y � t l�, ] - �r - ^'! �,F�y:;.�'.
tp'-�,.ya".� a~�r't`.iy #� -;,'r r,;t�'Y• r�;". ..�. ?�, _a fi.. ,f ^f _ t r �t�. _
�,�xi� :r.5*, v,�€o�.-'':t> ''.-: a. .Y _ �` •t. ,f,.,,.- r ..y' Y:jz `' '<..^ a- ;TOTAL"
s
tx .i.. -', , ny.� - sr.�q- "'»`. L` `.`." _ ,. - t .. -cEa M..ar,'t a_..r RP:.is�;- - t'�. !$. s ...�•¢ ;r'` a .. w. ,':x"
r$
-•.,,,�: . ,.,mow.
..... .?�+.�,�.r "';. -.."'"'.."` ,"';"„ ,.. r .t_�;"v ••-r• � _�5, R ;, ..._-. � ..'_".•,, ..,'•. - t �'v- r�'t .:�i'".:;itb, ..-+7's',.^*3•„ a.�',„?4<2 3'
- .0 +r1; ,� �.. 6. q'.:�".: I f `�,. ./ ;•Fr. y !. ,M;:., :5;• :.0 ..Yr x::. <:i`,+. Ys
.+ :"M"t ,�._ .,.,...i .. .";!3- > .,. •!Y'1. ..-.. >• .. z--« 1'1 ,.n,.C .i. a, l ,r:y t/` Yj,, �.`+;:', Qr S'I f '�'K i
a :
..a+.n,.. ,v:, ,,. ,4--"..,.. ,�r.,. ...a 7 .r- ::,'k:Y ''i... r i f ,:.7 i-- �..4 ly :�. ",,5,..a .,<•S .-.e .5.. .�' ,. �','
�'. 3 .. T ,,s ..`Rr �,...., .:.,.,..... o, .,,. P f': .•:<.r. s ::t, .s. ".,r:. „S` : .n ti .w .�-:
.,_ ,,+s- ..eY .,e -,_,.._ .. .,.::_..., :, ' �:t,',.b SDI" .a.. .. . ..:d ,...,. r ,. ,.-,: u r..s"' x4,.. ,:nr- en:,. ,ws'. €�f� ~A •F.,�i' �k.1`
,. .�. _$. .a ... ..3.e: ._x>,.. .' ,:, .£r� ,.- ,. .> .,� w..✓"�. _.,. .,a,, -:.6': .,..,. fi: ��5,,. r. ra" 't Ly. '+a:,> �..�:�+t ,n
z,iTTjY;; .y :k,,..,., e -i M. ...- x ,.:.... .:. .:`*� .. ,...y�, i' iv,. .y.,,��.r.., .,.F,-r'.., :.' '.+ +t•, � �'1,: � 1 W:, y �. ik.. }y$
.a�:,,.yF; <`}..,...- ..a. '-�FV.-r �........, ...,..,-+... ..�.,'�",m t. Y.:9 +ST•.''�" ..,. S 59,i1�.:• � !, �e;X"1!`�.
r&.. a. .. .r .r,..y.,;,,.s :a.<�•:.< J :;.:.,- .� ,£fi:_.ti......,y,., +"-3:, 77 qqyy
:F�ESflDEflil'TflAlr fl':ROPEfl�TsIC
,.: 3a._ "F :. ".. 4,�ai:_.,.,., .,.:.. .d-. Y3 .:. ... 4 S ::+Ir ., rj ....1. .r.:? •.s.:x:. ;.e I iy. +4 .�n,.
v,N1. +t�F�...r.„q m::. 3 r. .... �€a .:a J. r N..1 : Yr. ., . -..,. .a. , � t.•.:�:,� ..d9. , n. -.,.i.., .-..r_ ;._�' x;r,.q�tp.
th4ss .^r.- a' .:t,.. ..+ ...e.., ,c. .,. a ,. ., -,a'fi ':4 ,r•'
+.k4. .,c..„=-., �i,.,F,;,r„ .a'N. r F•.+:. :7„ 4 ,ri ;>'r. .d .t -Pr.^.ttri FIRE STRICYn' N"iTX: ,•. +' ...,,5},IV
MAP.";NO .-.{_LOT,NO..,, ; _..r ?. . �,«.. Z, .,. ;. r, ,:.- it 3•:. �'.�.. DI .x
�,... C ..h ,-. ,., .-,.: r.: { r til �� "". r+ ; i-T�,:Pr •�" SUMMARY
;f
"
r c "Y.e r ✓r, `z r, STT REETS ;, ✓ :
.d`r'vtr"rt,Mw4+4�A
LL.
1 "l7 STrii•fYl. St
LANDS
,, <.. j �. :.,.w .-.i•,. �_—_—
� Y
,n'.r.., •1+y.v �3.. s,'yY.{x,
'-H BLDGS, --s
OW
N i ✓., f t S, L s ', «�u.,:..,.. r. l° ..a_ .-,.. .s .n� t '-r ":� � w.e:...l• +.
:, :�+' >w' 'n .,;::. _ _:.. :�. ":'ts: ] ;--�.: ;<--..': 3 :..a: a.. s.. -�,*�.' •TOTAL; 1. •'70. .a
K` ;.`-':�'� .. }'a:.'-•�`s ;x_ ax,'�. t�1,,,' �.,,re. ::7�, x x• 1 r :,Ya,:„ .f.- ,;y r.a,cs. _T v :y«' _r.. t ,r:.-: # .�1 3•.u;
,
• ,t
LAN Dr
RECORD.;OF%TRANSFER. c DATE EiK . PG I.R.s, REMARKS ?
.i�".,.. #.,...,' '.4 >- ry..•. Y,:.:: , 6..r:., - _ x. :'`;k. Y" •-# c, .ryk";�, #'<+ t :,,t a..x �. {.
.,..,' - ,kp BLDGS:
�L pl��
^,>xrx a- wg .✓. s, .°F"F.. 1 v r rY. n'r. -v..i 'a > ^at s: h- ..a
' E
" , , .,,. :-r- �•,<,. t:� r,` >Y, TOTAL,:.
'Qettarii G � t
s �fcr' SA'�s1SR21ii:•f� M1rr�.'A'�4Er�."!.2 T�A�Y��.:<'-pg.".�f�'.G�.uJ 3
.,� .,r'• zv. b ..- . �, . n....�- �, .. cr t.".:�. ,.'><,':.. ,," :.' — .. a. s°i-',^' •+.:-:��" a .aw;'Y ,a.', ,.,,«... .,LAND: m�.s+.�-� �,., ..fh,
•X •[ �..: '.",�,''::• X. i. r+ a ., y< i Gf - -�. a� i, '�* r':,,
AeS' y8. }}.to a, 7 . 5.yr r1' �a�� �. 1 1_. ^G�F'.S L 3 L�1 a :BLDGS.*.
�• oL�., x,. .r,tea. .,s "v�3 § G^
k� !!/y -t'F" fiz'-' i•?-,.,.. ?a �r�,r a;£ f w - ... c ,t4 -s+ w.;y. ,;T a �TOTAL� l :X:A'���'�'.G
01 ;BLDGS.'
TOTAL
�Y m<I� a ..� � a•r c /fit:, :( �!'� e .. ..
' t i•S �" '` a; "" k��. r ::: - 6 "�f. - ---- — - ti *r LAND
s
a" BLDGS.q
,
-
r
Dril_�. at'r y u;, e•g y.k, j
;:TOTAL 4, r_ TIr x S'
a 'S'*<",.:. kX v:y , .r t- ,., _ ,•� a 'LAN D - Fcx�fti 'G
BLDGS:'
INTERIOR INSPECTE
T
,+ +$ «r •&` S n F"' L. [ "R t iC ;;•;. n f a � +., _ TOTAL*;i„
rDATE., q rr
:LAND" .K
ACREAGE.COMPQ ATIONd. BLDGS:
sus .• r #LAND T.Y,PE 4 �. 'OF ACRES !`'":'PRICE .`
+� „k TOTAL` DEPR. _ VALUE TOTAL a
5
:Y•� r '.`_r. 'z-.. a"' `p'e•` e .,.'!:. :x '_ - LAND
..wousE,:LOTw
C'CLEARED:FRON7 BLDGS..
REAR•+ s.r "' :`'.�1, Sg s r ;ra i s i e: TOTAL
WOODS&.SPROUT FRONT : ' i +�� . : r .. r., ar a"" D ,°5
,.
w LAND
w.+:R#:':.. <.,. ,,.:c 'a k 3 k'ts '>- „;.M}., + .R'.+ .�y 'pkr _ �'•.
asc„ •:ki.:,.K.Mry�REAR �; r •BLDGS.v
.W ra•:.. ce: s .xu tG ,,cr xy. y +Y Y z s..:r„ ,E r �5. e y a, t ".TOTAL
r ASTE;FRONT -
��.xu"y> LAN C
,REARS;. •� ,. s ,._, _-., — � D
Ol vY BLDGS.
+1„�X';,-..l:S..+',,. rl�'p `t £ --.''.•y, r,s .,x .. ,,} f �----t h`," a r z„ "TOTAL
y k' r{7 z r t a roq `• x: 'LAND.
r
BLDGS.
Y
LOT"COMPUTATION."a tr _": ', � 4t ' LAND `FACTORS " TOTAL,
4 ": FRONT-:_i: ,"DEPTH '.STREET PRICE '.DEPTH,% FRONT-FT.,PRICE TOTAL Df_PR. COR. Mr. vA.LIIE HILLY •a TOWN SEWER-- """ LAND,• at`J�F,V
ROUGH BLDGS. * !w
a 4s t
—_�_— TOWN WATER
i . ilGli s '`i GRAVEL RD. TOTAL
:...
_.:,.
A - !-�� . — ---- - .. ---- _.t.,"•4: ,r: DIRT RD." - LAND 'r ,�"• .:q„
.:< - —---,- N RD. '� c ",-41 tb
~ LOW
„
O y
�FOUNDATION:��- ;BSMT.<':&'ATTIC `� PLU`�i:� sT+ _ , � ,=•1? y + /- �: ry
Cono;.WalbtF ,f-- ,; Fin.Osmt.Area _. ' Br,th Room �. Base a F`r3+
' ', r;LDG.,COSI
u4
t Cond.,f31k Walls; : Bsmt.Rec. Room St. Shower Bath,_rATF
FILRC C3smt.
.
'r Conc:Slab Bsmt.Garage St.Shower.Ext PR a h wj
#,. `°.* ''t.Fs. B Walls
Brick Walls' ;� `, ,;;,'� Attic FL&Stairs- �- Toilet Room. F l RC `
H DAI j
Roof ;. RENT ,�t '--s •# t?.y a`n< .r
Stone Walls * f ' Fin.Attic`. Two Fixt.Bath t. ,Floors r ; ? &
__
iPiorsa �" s INTERIOR FINISH'4 Lavatory .Extra - '
- $. T2 •F.� p7'I .f! S•
1' 2 3 Sink
ar L�41�
Attic• ,ir 7L.t/�, r�:. PlasterWater Cio.ExtraX fERiOR WALL S, Knotty Pine w Water Only-Doublo Sidm ywoNo'PlumbingBsmt.FinSinBlp Siding+p rasa: Plasferboerd --y�is Int..... ' w �t;
an es` Y _:_ '^'-TILING.C<_ wst : sa _-a, r _--
a B__ t.�,w"&�- .s. �........,,.a- `�-- --sr: _- _ '`f' at-
.�, .-.""-r-* _ .G. .F ,P Bath Fl _ ----�-�-'Heat` ,!_.. /'' t.:�.> I " f I ,� y}. >,=tt'�'e Yii
i Conc ,t31k ,� ,�.aaig- ; .��s-•�'. .�:`-�' _ _ � _ -!-`---=--�'/e�i_�
aceBrk On- r` " _' =1nt.-layout"r ain Aaito'Htr,Unf4 -
:_ .-.. Bach '.&K s., Jt{��
'�"�"' *^"f" .,. / r• /."T {'t��/./ �p/.5r l� �'�'�+k� yr'1�3' ee�,4: i�"•t�f Y'�.•� �,1i
3U ,2
:. :+ Fl- Wells . .-,. _.,-,. �:�.,,
zVeneer,.,, Int.Cond.,a - 3 :Bath Fireplaze
f 4 3'' }`.^ r' Fad : La t6ri:.r,•::
-,;"- '. :Toilet Rm.Fl...�,- ;,�..•&:_ r. �• : .� :s _ ,• a� e.. -. ,v ,.AM., s fi.
a�Com#Brk.Oni;..<,•;�-+ta ,t�_.�. EATING r„�c- 1t/,U,v
! . P Bc ,:.:a.: ,.rr . :.- a '- �.- t-. a;.F I`: Y,a,.;ar. F � .+•,r
Q
I &Wains ttAji�• �=- 'i y:i F" �^• t: z r,..t,;a p y a r,•. -r �i--:.`f .I� _,My. 4: •:�'.
_Solid Com Brk . Hot Air �`:' rt. Toilet RE F. t 3 .E. ,
'r{ .:...t ,: -,••g39;t, r_.--., �. - .Tllm Yi•,,. n- - 4 L
j.1' ';�
': aw. �._. .a { I .. k-.. . . . •,..I< s. t} tr,:.,
f-: Steam 4, _. .,.. 3 .bToalet Rm.tl.&.Wal s _r. : . _ �{ ^3. ,- .4
i$r.,,'e4i'i7:r�• .:c^. '?'i. .:.�a»,. ...... ...,,.. w.. .'Yas`zi. ., ...x ..r..;,rs.F� ;t�t ,t S. -.3i .1:, +.al t,i5• .r.� .:7- i. �'1 it"� .+:
,.. a, a:_ Yid • :.'
,s x r c. p :_.t t:,.,,._ T:r. t. l .� . l t: ,4 s ?t t e e -ax .F t t rtv. .�.fazi 6!S
;.�ti7'z o Water $t. :.ower, t•-_ .- •,fk _ t f 1. - E,, j.'p .I - :. .,. ,i .. o':k. r r,I3£c a �,., "•;
,Blanket ins? .., rit H t• S ic. ; i i., tY ",t ,t-; y,:. t k?c i 3, t
a�
$. „
._.. .:. .., ._ n a, F +7s a# ':� ei ', „ $t� ,4'
•-s,-,,v.:.-:r.u: .. .,' ,....:., ,„.. »atgS ,...,.tx. ,..yy ,_z :. C�.. ..:,I.i:6z.tc ,asr .3'.'ttY .�k.}} r•
N+ ,.mF ,Yr. ,...cifb ,..._• .,,r.. a ..3 .':" t. }. 5.-;.. •,..,. b. .4y TI.• .-:b p..: f 3.Aar Cond y:t"ifit�ia ,TuL?fit
_... .._.. ..:.'
.1'
, w .a,. ., y ., t P-q} 3 if:t t 'w 3• a r u'r
Floor x
x .-.. ... .... -' - , �.t`,�. an k � yy SZ$? iz.{;"
,.:r .. .a..,.x.,t:i.♦1 >}':kYr: ,�„ ee+• ,a .b F v„, ra,#>.. {� , 'SFx..• _.z`f- •"a9 .'k'+" { -r.'•w It
O IN 1` a ;yr; �.x:'d•3,e..COMPUTATIONS. Y r !r> r 1 5
F ., ,O, F =-- a#"r};sr;� .,_ :.�- i•� 'itv:+�L£ sri'F°k{ ��x} i
r 3
z r` rK
,.w. .a.. ::t•, 7'
�A• s h. Shan 19,. Pi eless Fiirn. �) .,> S..F.., { :, r
P B..a'rxv�ax,. •. . P .we' r..... t�
�e-.., '.I''.>a#' j ,i ','� -t 9x• >'Y'. qq [{ ,!: �.z,• S v ��4, •a
,, , s, i t.,. `I' I-':• .F }. .# �r�`"• y,: ,s -lr.l ,i,.[. is ,. t # .+�. + . (,S;'.
No He r z S:'F.. m.+f a t;I re Fr,t ;. t• ,bs. rj
:., s^�i• �s} i•.� +,_ 6/ +b i3 �� n. +e 1'
J' ^I
>. :
,.t z.. ,-i. nx Y•- -r : , 1� ) Y., t t :t"�.
an le•:�t�5"., ;`. ..-; 0il Burner.>�':, r i , ; •.=, ,� >.` .4 •ei Y €tt•.
s�Sh 8 �, E,� ,3 ,a Y S.F: ,�.,��1,F{ � .aa �i a y ,f L T. -r. "s ^"" -�• s �;
„y
y
;:4a ! ,. ,.,..t.kiF 4.,:..}Y..;.- t ._•.:4. „
rfoaP:StokF
'2Slate t:.� C :c, r`t :z .t. ::5. �1
,
Gas_,x� .,.:, . .; _.. •.;.... :, ., . ,.r,.+>*•.«sz-.4 t'" - Y +
S::F: r t OUTBUILDINGS.
A
t�jR00 ,tTYPE::e�MA� Electric
..St
4..:; ..
irGabla ^Flat ------
S F`' , 8* t^" "' '1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 ,MEASURED
J-.•a
u wyctl" 3` S.F 4' r` L.: Pier Faund.' Floor
Ilia :_ : . 'Mansard i- , L7-..FIREPLACES f
,: tit
a gGambrelM +4 Fireplace Stack *" °s _ ..+ + t.„ a F i -_ Wall found:: 0.H.Door t
a TY; — i '4 LISTED
F Lob
RS __" Fireplace - 't' - Sgle.Sdg. Roll Roofing
Conc ? six "•s-'LIGHTING _ D61e.$dg. Shingle Roof v+ c }
Earth,.{ No Elect.'x"
Shingle Wails Plumbing
Pine •':' x , '•`` 'r .
y.
Y
Hardwood r.•e n«W ROOMS _ --s�
Cement Bik Electric: t
Asph.Tiler} 'k. esmt 1st ' TOTAL Brick Int.Finish hx?.RILED`"
Single`, sb taw' 2nd:�v_ 3rd. .. FACTOR
st-r
r
y '�, ,.y,ri'..r„_a„ ;1• ,:a '+. sn;>:�7,,. ,...'. .. .. ..;,..; REPLACEMENT
_tOCCUPANCY:4'1•<•�' "CONSTRUCTION' :SIZE r` - AREA I CLASS ,.AGE REMOD' ,OND. �REPL. VAL.- Phy..Dep. � PHYS. VALUE Funct.Del). ACTUAL,VAL:. - i •,•}-,.. ?
r, n {
DWEc''t' .� ;:-}M",t ". _ _ .S t/ ,�,.; i /v�Ta_`/ S� =T! Y'.�1. sf� t /'Y 7 00 F� ; a
+.1�tr,��luki�`3 ,Ui,r'�. +"ts�•� �K ,,c -/�
ke
sr' t2 -ice s.��.m•••<+'�c�r 'ems a k _i'..,. r - .., .. - _ _— �,n- ____ - -_ - - -. — ,. .. .�, ..
fi q ;aio. :�' ar.S',' ."ri:`!f.F '� Y A
5EpY }-�i »zKi; caz,-.z rd-. -.,•.' - - _ -- -- ----- - --- _ t #r.
� 7,.-,* �,,,�:ra.. '�'Ii' .� !e+-:a� .:Y-, ��, 1. �•t .A— v ;�- � '9.r.F a�� Y i 9.F:�,.,�v1
ns 84`•��'1 .wls. a •t.ix$"s x'�", a - e, - ,(t•.. _ .. 1 - .:.t r r�.y. ,.41
z 9`a`;.`+cZri'"j'•'>„`�^a- YA. a` .r =-5 F - ;z.—
_
fr'+" 41
.f.•e', F+'.v.r' w:i£s+.•- 5r�*$ a•.�, {h�- F. '.r-^ �;y,,i . .3r ^}r. - TOTAL
- - rs,'F�er`...�'ta�,.,>�,z,�-+�s'.0 ., .,._ .. .rt y..,: } '`} ; +' crtut {�P x .�•e..,.
� �. �
A
/��
i7
%��Z�Z�
- ,
s
i
� _ —
.._ --.-. �_ _ _._.�-�- � _ ... A,. �-�- f
To: Ralph Crasser From: Lt. D-na1-3 Chase Fri 12 Feb IC199 18:44:5 8 Page: I
HYAONNIS FIRE DEPARTMENT
9.5 HIGH SCHOOL RD. EXT. HYANNIS, MA, 02601
HEV,KAL
HAROLD S. BRUNELLE, CHIEF
8T; N A*FFGA33 CF FIRE IOUCATWA
FIRE PREVENTION BUREAU
BUSINESS PHONE: (508)775-1300 FACSIMILE PHONE:(508)778-6448
L.T.-DO.N- 1-ALD K CHASE,JR.,CFI LT.ERIC F.KLMLEPI,CFI
FIRETREVENTION OFFICER FIRE PREAENTION OFFICER
Feb 12, 1999
Ralph Crossen
Building Dept.
Re: 156 Smith Street, Hyannisport
Dear Ralph,.
After having viewed the property mentioned above and discussing the matter with the Chief,
we feel that the safest remedy for the building is to have it torn down. Our past dealings with
abandoned properties have led to finding street people living in them and building fires in them to
keep warm.
4
The only entrance to these dwellings is through plywood barriers which are then fastened to
maintain the appearance of a "tight" building. Often, the fire started inside becomes uncontrollable
and therefore traps the person inside resulting in injury or death.
Our personnel responding to fires in abandoned buildings are at greater risk due to the
subsequent damage created inside when the interiors are vandalized. We have to always assume
that any building is occupied and are therefore forced to mount an interior attack at greater than
normal risk to responding firefighters.
!t is our opinion the building should be razed.
Sincerely,
494k��'A45eo'
Lt. Donald H. Chase, Jr., CH
Fire Prevention Officer
HYFD
Facsimile Cover Sheet
Recipient Ralph. Crossen
Organization Barnstable Building
Fax Number 790-6230
From
Sender Lt. Donald Chase.
Organization Hyannis Fire Department
Phone Number 508-775-1301
®ate Fri 12 Feb 1999 18:44:58
Pages 1 excludin
g ng cover sheet.
This facsimile was transmitted from an Apple LaserWriter 1.6/600 PS prime p(�S'fSCRIPT
utilizingthe Adobe PostScript interpreter and Adobe Po r'� �'siSc i t FA,.ca abilit .`
p p - � P - Y
--„�...
D +' � `
�l/ � � i
' L�v� 1X i. - ��
i =�-
� - �, --_
�tN
Town of Barnstable
1STAB 1 Department of Public Works
vMAS&
,e� Engineering Division
367 Main Street, Hyannis MA 02601
Office: 508-862-4088 Thomas J. Mullen
Fax: 508-790-6400 Superintendent
(Z
January 29, 1999 r f
TO: Ralph Crossen, Building Commissioner
FROM: Robert A. Burgmann, P.E., Town Engineer kft�.
SUBJECT: 156 Smith Street, Hyannis, Map 267 Parcel 098
As per your request I have inspected the above referenced property along with Jim
Stewart of my staff. We both feel that if both of the buildings can be completely boarded up and
the closures made tamper proof there is no need to raze the buildings at this time.
V
' oF�
. The Town of Barnstable .
1639. $ Department of Health Safety and Environmental Services
sec 's" Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-90-6230 Building Commissioner
MEMORANDUM
DATE: January 21,1999
TO: Robert Burgmann,Town Engineer
Chief Brunnelle,Hyannis Fire Department
Paul Coleman,Supervisor,Structures&Grounds
FROM: Ralph M.Crossen,Building Commissione
RE: 156 Smith Street,West Hyannisport
Article 1 of the Massachusetts State Building Code requires that,if I move forward in an effort to order the
razing of a building,I have to form a"survey team". This team is to be comprised of the Town Engineer,
the Fire Chief(or representative)and one disinterested party. All are to independently look at the subject
property and render a written opinion if it should be razed or merely boarded up.
I would like to ask each of you,at your leisure,to examine the buildings at 156 Smith Street in West
Hyannisport under this authority. Thank you for your assistance.
g990128a
6
•
i
M-
nom /
MI, / i
/. ...
L - I ► i
it
Bettye Coney
38 Amor Road
Milton,MA 02186
December 9, 1998
Town of Barnstable Building Department
Attention: Gloria Urenas
367 Main Street
Hyannis,MA 02601
Dear Ms. Uranas:
Enclosed please find a certified letter regarding the properties in Hyannis. I would appreciate it if you
would keep me informed as to what action will take place.
I can be reached at(617)696-2822.
Thank you for your patience and help in handling this matter.
Sincerely,
Bettye L. Coney
r •
r � �4f S• r( }},.'1'�". �..,. .r'r�_• "•}�1. sP .'i' }`T.rrt'e.
i
i
I
r,
� r r f
+' i
j l�'
r
Town of Barnstable Building Department
Attention: Ms. Gloria E. Urenas
367 Main Street
Hyannis, MA 02601
Dear Ms. Urenas:
This request is being made because of financial hardship. The cost associated with tearing
down the buildings is not obtainable at this time. You have indicated the properties must
be torn down because of the numerous complaints you have received about the condition
of the properties and the unauthorized squatters that have taken residence on the property.
We have complied with the requests you have asked of us in the past, in having the 2
cottages torn down and the 2 buildings boarded up but have been unsuccessful in our
attempt to keep people from trespassing.
I, Bettye L. Coney and Marilyn E. Taylor-Hill being joint owners of this property give our
permission to have the buildings located at 156 Smith Street and 142 Craigville Beach
Road demolished by the Town of Barnstable. It is understood that a lien will be placed
against the title to the property until such time payment is received for the cost of the
demolition and removal of the 2 buildings.
Sincerely,
Marilyn E. Ta for-Hill
Y
Date: .7 � R /S'1i'9�re i i✓ �- �'�
Bettye L. Coney
Date:
Subscribed and S orn to bef 90_
tli ' ay_Of cw�19 `1 Q'
Notary Puk)lig
TOWN OF BARNSTABLE
BUILDING DEPT.
®December 4, 1998 ;DEC 4 1998
Commissioner Ralph Crossen
Town of Barnstable Bldg. Department
367 Main Street
Hyannis, Ma 02601
Dear Commissioner Crossen,
I'm writing to bring to your attention two abandoned properties at the end of Smith Street
and Cragiville Beach Road. I have verbally complained about these properties over the
years and I believe that my last complaint brought about the boarding up these buildings.
My complaints were heard and acted upon by Gloria Uranus. It served the purpose for a
period of time.
These buildings are now being used for various activities by street people, and the young.
It is also becoming another dumping ground in our town.A couch and a chair were.
dump, and I placed them in the back of the larger building. This morning I saw that they
are now in the.smaller building indicating the type of activity I described. This.is also a
bus route to Hyannisport, and it a view I would prefer that they not carry away about our
town.
These properties are causing our neighborhood to deteriorate. It is being used to dump
tree limb and leaves. I respectfully request that action take place.to remedy this.situation,.
and I be notified of any action instituted. If any further action is necessary or my part,
that I be notified forthwith.
Sin rely,
Lu en P. Poyant
56 est Hyannisport Circle
Hyannis,.Ma 02601
Telephone: 775-2371
11AI-7
�,yj / —6 7
=r3�' � tM
I
' �
� � 1
•.ram:..
I
/�V � ►� • i
/ ,
1
� Awl-L _ I1J•. �i�� .� � � �
u..J.• � -` - �
I
', � 4 �► �
�. '
1
ii� � , .
� �,� 1� '-
���
r
PAR ] Real Estate System - General Property Inquiry] Help [ ]
Parcel Id: 267 098- - Account No: 169212 Parent :
Location: 156 SMITH ST Neighborhood: 55CC Fire Dist : HY
Devel Lot : Lot Size : . 52 Acres
Current Own: CONEY, BETTYE L & State Class : 10
l' HILL, MARILYN TAYLOR No. Bldgs : Area: 840
38 AMOR RD Year Added:
MILTON MA 2186
Deed Date : 080190 Reference: P1178-El
January 1st : CONEY, BETTYE L & Deed MMDD: 0890 Deed Ref : P1178-El
Comments :
Values : T1 ,
d38000 BuilAi gs .- ---- 500 Extra Features
Road System: 6 Index: 14982SMITH ST ) Frntg: 122
Index: 369 (CRAIGVILLE BEACH ROAD ) Frntg: 160
Control Info: Last Auto Upd: 050695 Status : C Last TACS Update : 062993
Land Reviewed By: Date': 0000 Bldgs Reviewed By: Date : 0000
Tax Title : Account : Taken: Account Status : Hold Status :
Cancel [ ]
Press XMT or more data
Nex sc n [ ] Action
Ow ers me ]
a In [ ad Name [ ]
Par el Number [267] 0991 [ ] ]
. .. �OFSFIE Tp��
The Town of Barnstable
BAMSTABM
9� '� `0�' Department of Health Safety and Environmental Services
prEo r��" Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
November 6, 1997
Warren Miranda
476 Main Street
Harwich,MA 02647
RE: 156 Smith Street,Hyannis,MA
M-267/P-098
Dear Mr. Miranda:
The two buildings are now down and all debris has been removed. Also,the lot is graded.
Sincerely,
Gloria M.Urenas
Zoning Enforcement Officer
GMU:lb
g971106a
FROM
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
367 MAIN STREET HYANNIS, MA 02601
v'7L�7 Phone:ff� 7yo-L.72 7
I J
SUBJECT:
FOLD HERE -
DATE
MESSAGE � /•�w ��
GNEO
'r J
DATE
REPLY
SIGNED
N07-RMI RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY
-11 ineering Dept. (3rd floor) Map „Z Parcel- G�� `w' �it# • 1
House# o0 Date Issued �-
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee Z�e
Conservation Office(4th floor)(8:30-9:30/1:00--2:00)
Planning Dept.(1st floor/School Admin. Bldg.) THE rq
Defi -tive Plan Appr ed lanning Board 19 1MR
MASS
TOWN OF BARNSTABLE
Building Permit Application
dress l
Village s472
L Owner G� ��c✓ Address ��' G >� ell
Telephone — - 'G/ -02 --/796
Permit Request G±::�z �.a�
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No. 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
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
/� Builder Information
Name (�(/ --J Telephone Number .3 Y CS Q
Add e s License#
��a S Home Improvement Contractor#
i
Worker's Compensation#
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEB IS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -
SIGNATURE DATE1-1
BUILDING PERMIT NIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY
PERMIT NO. ?
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
Barnstable
ATE R 47 Old Yarmouth Road
P.O.Box 326
C O M P A N Y Hyannis,Massachusetts 02601-0326 775-0063
2/25-/97
TOWN OF BARNSTABLE
BUILDING INSPECTOR
TOWN HALL
HYANNIS MA 02601
REGARDING: Water Service #5050 156 Smith Street
Dear Sir,
The above water service to the main house and two rear
cottages was turned off at the street on 3/23/93 .
Sincerely,
arnstable Water Co pan
DATE 25 FEB 97 15 :17 :25 REPORT GENERATION IHW
BILL: 5415779007 156 SMITH ST HYAN B2 STCD=REM SDTE=06/13/94
NAME: VACANT TEL:508 SIC= BL=00 . 001 DD=0 . 0001
MAIL: 156 SMITH ST HYANNIS MA 026014356 B2 CC= RATE=R3
2ND : LAST GASM UPDATE DATE = 03/13/92 MC CCF= 0
MISC: BC=O DW=1 READ= 5779 EX= TY= NM= 0 FA= MB= TP=
INFO: O/T= 3RD P= SEQ=123920
BUDG: DATE= AMOUNT= 0. 00 OWED: . 0 .00 DRP:
METR: NO= 0 SZ=240 TEST=03/12/99 SET=03/12/92 TYP= ORD= I=
READ:LST ACT RD= 5779 DATE=920417 SRC=MR TAX= DTE= WK TEL:
OWNR: BETTINIA JON 508-849-4573
SRM1:O/S REAR; COTTAGE 2
SCOD: LANDLORD /WINT $ OWN/
SCOD:
ORDS-13JUN94-5_4.9_06_7.COMP 0-15.0--REMO-V-E_INACTIVE
ORDS: 29MAY92 463033 COMP 0121 TURN OFF-OFF LINE
ORDS: 12MAR92 452393 COMP 0167 CHANGE-LEGAL CHANGE
ORDS: MC STAT PRV: 2616 OUT: 2616 MC CCF: 0 SET: 5779 OLD NO: 2720309
ORDS: 06DEC90 398526 COMP 0112 READ IN-PRIOR CUST
ORDS: 06DEC90 398525 COMP 0141 READ OUT-OFF LINE MV
BAL CURRENT 30 DAY 60 DAY 90 DAY SUBTTL TOTAL
GAS 0 .00 0. 00 0. 00 0 .00 0. 00 0 .00
. . . . . END REPORT . . . . .
r
.DATE 25 FEB 97 15: 17: 02 REPORT GENERATION IHW
r BILL: 5415778959 156 SMITH ST HYAN Bl STCD=REM SDTE=06/13/94
NAME: VACANT TEL:508 SIC= BL= 4 . 818 DD=0 . 0998
MAIL: 156 SMITH ST HYANNIS MA 026014356 B1 CC= RATE=R3
2ND : LAST GASM UPDATE DATE = 05/15/92 MC CCF= 0
MISC: BC=O DW=1 READ= 3792 EX= TY= NM= 0 FA= MB= TP=
INFO: O/T= 3RD P= SEQ=123960
BUDG: DATE= AMOUNT= 0 .00 OWED: 0 .00 DRP:
METR: NO= 0 SZ=240 TEST= / / SET=04/15/87 TYP= ORD= I=
READ:LST ACT RD= 3723 DATE=920417 SRC=MR TAX= DTE= WK TEL:
OWNR: BETTINIA M J 508-775-6509
SRM1:0/S REAR; COTTAGE 1..
SRM2 :NO HW 5-27-87MN *HWH 3-29-88 TAG
SCOD: LANDLORD /DONT T/OFF/
SCOD:
ORDS: 13JUN94 549065 COMP 0150 REMOVE-INACTIVE
ORDS: 29MAY92 463032 COMP 0121 TURN OFF-OFF LINE
ORDS: 27MAR92 454139 COMP 0112 READ IN-PRIOR CUST
ORDS: 27MAR92 454138 COMP 0141 READ OUT-OFF LINE MV
ORDS: 24MAR92 454116 CANC 0141 READ OUT-OFF LINE MV
BAL CURRENT 30 DAY 60 DAY . 90 DAY SUBTTL TOTAL
GAS 0 . 00 0 . 00 0. 00 0 . 00 0 . 00 0 . 00
********************************************************************************
. . . . . END REPORT . . . . .
.DATE 25 FEB 97 15 :16 :38 REPORT GENERATION IHW
" BILL: 5415778884 156 SMITH ST HYAN STCD=REM SDTE=09/21/92
NAME: VACANT TEL:508 SIC= BL= 0 . 680 DD=0 .2069
MAIL: 156 SMITH ST HYANNIS MA 026014356 CC= RATE=R3
2ND LAST GASM UPDATE DATE = 05/07/90 MC CCF= 0
MISC: BC=O DW=1 READ= 2287 EX= TY= , NM= 0 FA= MB= TP=
INFO: O/T= 3RD P= SEQ=124000
BUDG: DATE= AMOUNT= 0 .00 OWED: 0. 00 DRP:
METR: NO= 0 SZ=240 TEST= / / SET=08/23/86 TYP= ORD= I=
READ:LST ACT RD= 2270 DATE=900419 SRC=MR TAX= DTE= WK TEL:
OWNR: BETTINIA M J - -
SRM1:0/S REAR; MAIN HSE';NUMBER. ON MAILBOX;ONE METER FOR 2 APARTMENTS **
SRM2 :I/SODOR890.105MLP;ODOR RNG890421DJB;NOHT891225CMS;
SCOD: LANDLORD
SCOD:
ORDS: 21SEP92 474666 COMP 01.5_0_REMO_V_E-INACTIVE
ORDS: 14MAY90 373056 COMP 0126 TURN OFF-S.O.N.P.
ORDS: 15NOV88 309883 COMP 0112 READ IN-PRIOR CUST
ORDS: 15NOV88 309882 COMP 0141 READ OUT-OFF LINE MV
ORDS: 29JUL88 298031 COMP 0110 READ IN-NEW CUSTOMER
BAL CURRENT 30 DAY 60 DAY 90 DAY SUBTTL TOTAL
GAS 0 . 00 0 .00 0 . 00 0 .00 0. 00 0.00
********************************************************************************
. . . . . END REPORT . . . . .
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
m ^�c� C
DATA
FOLD AT ARROWS(• •)TO FIT WINDOW ENVELOPES
1
Message%=R'071,
Urgent
1.
_ -= z 3 :3 ❑ Please Respond By
,„ f�.._..�_„-ry `� ,';•Ic' ❑ No reply Necessary
1.
I
i
Date: `'b. 7, 1997 i
t
Subject: t
i
Message. ,lid ��r �-__=c�: er rlc:� 'ind m.e`er.s for 156 Smith St. Cottage 1 & 2
FOLD FOLD
~ 1V1 nn ,);jrr ,.er,l �^r,r(1�s:�G� " ' 12 r_n.1995. Till was :o- .: .. t loll.'"- quef-if:. ~ i.
- I
i
i
• I
I
I
i
I
i
Si9 ned:
Barbe-_ra Trocchi
Cu-1-oiler ^•Pr-,,4ce Dep. {
SIan ed. Date. _
MF 46 E
WE
.�� The Town of Barnstable
• enxxsrns�, •
039. Department of Health Safety and Environmental Services
ArED .�A Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
February 26, 1997
TO WHOM IT MAY CONCERN:
RE: 156 Smith Street,West Hyannisport,MA
M-267/P-098
This office is in receipt of confirmation letters acknowledging the shut-off of the following utilitiy
companies that were advised by Mr.Warren Miranda,476 Main Street,Harwich,MA 02645,who is in
charge of doing the demolition work on the above referenced property.
ComElectric Company
Colonial Gas Company
Barnstable Water Company
This allows the demolition of 2 cottages,after the permit is processed.
Sincerely,
Louise Bain
Clerk
lb
g970226a
1 The Commonivealth of Afassachusetts
Department of Industrial Accidents
I Y l
t /
�_ ;;,; � • � Office ol/nvestigat/ons
600 Id ashinr ton Street
Boston. A1uss. 02111
Workers' Compensation Insurance Affidavit �;.-
i It an int rm i n: PI P
loc t' n•
C i�
I am a homeowner performing all work myself.
1 am a sole proprietor and have no one working in any capacity —
_ 7 .r��- .....
-.. n�.-�• fee v>r+ .s'!n�rxr^.+.�n•+.�.rs;,.%�*t.r•...�•+!"`+w!+;1...f++.. ,w•.*..s... .+..•w.•+•wn e...�,�..-......_.....:.
........ _r..:...L: --- ................c.....:.:.:r....«.u..+.r,.._ .Lsi..�.•..r.- +,s;� ...... ..,t'�.:_� .�..•^'tic:�' .�.c.:�b" c� �_r.-�—.�_
I am an emplover providing workers' compensation for my employees working on this job.
conmanv name:
address:
city: Phone#•
insurance co, Policy#
1 am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have
the following workers' compensation.polices:
company name:
address:
cirv: phone#•
insurance co. nnlicN.#
� .• _ .f..' '�: n"c^.-' - '�';Y•^._ ••,._•-.-- rr"---••:w-�-.>n�ix`•'yc.w�s,:.,.• —Trrv-.:; ---•- •.c•-•.-:-t_.•-._....--r' ,
__..__-_...... __.�^.._._...__ .I_r:.....�J,:......_..........•__.:.r+::►r.�w...�.:..at.w...w '-i1• - _..��a'..�i:o+�ii-__. .a.�_..:3
comnanv name:
address:
cin•: phone#:
insurance co. policy#
Attach additional sheet if nec essary
=f�'.rr.:I.•.Sf_Y�'JA _ _ .'.'.j.^_ f!. `f. oy.Wr...i\,T"fr+�yNi`..�4•+»,.r�,r�-"� 4 M
- ---».. ...._---•- ._.._ .:a`,.::_ --- -- ;emu ..•�'+s• -y:�`�__-- ia'i�r�.t.�:�..:w�r..:n.
Failure uJ secure covernae as required under Section 25A of N1GL 152 can lead to the imposition of criminal penalties of a line up to 51.500.00 andiur
one y cars' imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. I understand that a
cope of this statement may be fo Larded to the Officc of Investigations of the DIA for coverage verification. �
1 do hereht cer"i , r rlr aims and cs njper' rr that th�iinffor Lion prorided above is True and correct. '7
Sienature Date �5 /
Print name Phone#
warcrr
official use only do not write in this area to be completed by cih or town official
city or town: permit/license# rIBuilding Departmi dt
Licensing Board
check if immedime response is required Selectmen's Office__
011calth Department
contact person: phone#: nOther s
i.
r
Ireslsea i. ;P1A1
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted front the "la++ an emplitme is defined as every person in the service of another under anv
contract of hire, express or implied. oral or written.
An emplut•er is defined as an individual, partnership, association, corporation or other legal entity, or anv two or more
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
d+wellin- house of another who employs persons to do maintenance , construction or repair work on such dwelling, hour
or oil tite `_rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapicr 152 section 25 also states that every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the
performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha
been presented to the contracting authority.
Applicants
Please fill in the workers" compensation affidavit completely, by checking the box that applies to your situation and
supplying company names. address and phone numbers as all affidavits may be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The
affidavit should be returned to the city or town that the application for the permit or license is being requested.
not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required
to obtain a workers' compensation policy, please call the Department at the number listed below.
City or ro+wns
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. Pleas
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call.
,-..y,v.-r+. ....-..�..v...... .-��++.w.-r.r..:-.►.��...•.v..-+s'Zr.-.«....++q+.rt+.r++'.�R�+aw-+wqT w--.....v+Ift..:+An-r'yo.oNL•I!'1r.�
-!�.vn�99viwd.
Tile Department's address. telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,Ma. 02111
fax #: (617) 727-7749
phone #: (617) 727-4900 eat. 406, 409 or 375
'ACORD DATE
(MM/DDIYY)
2/5/97
PRODUCER 508-790-1030 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
MCSHEA INSURANCE AGENCY, INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
320 WEST MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
HYANNIS, MA 02601 COMPANIES AFFORDING COVERAGE
COMPANY A NATIONAL GRANGE MUTUAL
INSURED COMPANY
WARREN MIRANDA DBA B
MIRANDA'S BACKHOE SERVICE COMPANY
476 MAIN STREET C
HARWICH, MA 02645
COMPANY
D
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 B Y 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:
CO POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DDNY) LIMITS
GENERAL LIABILITY GENERAL AGGREGATE $ 600,000
A X COMMERCIAL GENERAL LIABILITY PENDING 2/5/97 2/5/98
PRODUCTS-COMP/OPAGG $ 600,000
CLAIMS MADE [X]OCCUR PERSONAL&ADV INJURY $ 300,000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 300,000
FIRE DAMAGE (Anyone fire) $ 500,000
MED EXP (Anyone person) $ 10,000
AUTOMOBILE LIABILITY
A M9J42071 9/25/96 9/25/97 COMBINED SINGLE LIMIT $
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY $ 100,000
X SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $ 300,000
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $ 100,000
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE S
OTHER THAN UMBRELLA FORM I $
WC STATU- OTH-
WORKER'S COMPENSATION AND TORY LIMITS ER
EMPLOYERS'LIABILITY EL EACH ACCIDENT $
THE PROPRIETOR/ H INCL EL DISEASE-POLICY LIMIT $
PARTNER,' ECUTIVE
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
TOWN OF BARNSTABLE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
BUILDING DEPT. 10 DAYS WRITTEN NOTICETO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BARNSTABLE, MA BUT FAIL E TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF AWIKIND UPON THE ANY ITS AGENTS OR REPRESENTATIVES.
AUTH RI REPRESEN TI
i
i���-�
. � _ �
Town ofBarnstable
Building Department
ComplainKnquiry Report
Assessor's N :Wz � -�9
Date: - - 9 Rec'd by: o.
Complaint Name:
Location
Address: � �`��
, ,,-?
Nur
Originator Name-
Street:
Village: Swc: G% Zip:
Telephone: D/E
Complaint
Description:
Inquiry
Description:
For Office Use Only
Inspector's
Action/Coinments Date: Inspector.
Follow-up
Action
Additional Info. Attached
('nnv 17imibudon: Mike-Department File
,t ] [R267 098 . ]
LOC10156 SMITH STREET CTY109 TDS] 400 HY KEY] 169212
----MAILING ADDRESS------- PCA] 1011 PCS] 00 YR] 00 PARENT] 0
CONEY, BETTYE L & MAP] AREA] 55CC JV] 298671 MTG] 0000
HILL, MARILYN TAYLOR SP1] SP21 SP31
38 AMOR RD UT11 UT21 . 52 SQ FT] 840
MILTON MA 02186 AYB11962 EYB11960 OBS] CONST]
0000 LAND 38000 IMP 45500 OTHER
----LEGAL DESCRIPTION---- TRUE MKT 83500 REA CLASSIFIED
#LAND 1 38, 000 ASD LND 38000 ASD IMP 45500 ASD OTH
#BLDG (S) -CARD-1 1 20, 500 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE
#BLDG(S) -CARD-2 1 3, 100 TAX EXEMPT
#BLDG (S) -CARD-3 1 4, 300 RESIDENT'L 83500 83500 83500
#BLDG (S) -CARD-4 1 17, 600 OPEN SPACE
#PL 156 SMITH ST COMMERCIAL
#RR 1498 0122 0369 0160 INDUSTRIAL
#SR CRAIGVILLE BEACH RD
EXEMPTIONS
SALE] 08/90 PRICE] ORB] P1178-El AFD] I 90 A
LAST ACTIVITY] 06/29/93 PCR] Y
1F267 098 . A P P R A I S A L D A T A KEY 169212
CONEY, BETTYE L &
LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB
38, 000 45, 500 4 A-COST 83, 500
B-MKT 175, 700
BY 00/ BY /00 C-INCOME
PCA=1011 PCS=00 SIZE= 840 JUST-VAL 83 , 500
LEV=400 CONST-C 0
----COMPARISON TO CONTROL AREA 55CC -- --MAY NOT BE COMPARABLE--
NEIGHBORHOOD 55CC HYANNIS
PARCEL CONTROL AREA TREND STANDARD
101 10 LAND-TYPE
380001 LAND-MEAN +0%
835001 78256 IMPROVED-MEAN -420-. 2501
] FRONT-FT
] 100 DEPTH/ACRES TABLE 02
100%] 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 [?]
'"'R267 098 . P E R M I T [PMT] ACTION[R] CARD [000] KEY 169212
000000001
PERMIT-NO MO YR TYPE VALUE CK-BY MO YR oCMP NEW/DEMO COMMENT
i
•
,� ice. .�• .
� r �
' � i