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L�_ I,,� ��tkw.-`! 4 I 71, a , } f , TOWN OF BARNSTABLE REGISTRATION AND CERTIFICATION FOg _6 AN 9� 2 3 FOR FORECLOSING/FORECLOSED PROPS Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each prop (section 224-3) or already foreclosed for which possession has been a' jtion 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property,is located. If you claim you are exempt from registering under Massachusetts law,please state.the reason(s) and complete section 1 (property information) and the first paragraph of section.2 (foreclosing party, court, etc. and foreclosing party representative,but not other representatives and attorney)so that the Town can review the exemption and update its records: Section 1 —Property Information Property Address: 296 Buckskin Path `" Town of Barnstable, MA Assessors Map#: arcel#: 191 124, M 294911_82 Land area and description Building(s) description and contents r Occupied: x Occupant(s)(if borrowers so state and include name(s)) Andrius Pabedinskas Phone: email: other: Vacant: No Date: Anticipated Length of Vacancy: Last occupant(s))(if borrowers so state and include name(s)) Phone email: other: " Has possession been taken If so,please explain and complete and file the maintenance and security plan form(unless exempt as stated above) Section 2—Foreclosing Party Information Foreclosing Party(full name/title) Foreclosure Case Court: Docket# Date filed: 9/21/2016 Current Status: Public NOD Foreclosing Party's representative(s) for property(entry,management,repair, etc.)(name,title,): Code Compliance Company,(if different from foreclosing party): MCS Address: 350 Highland Dr.Ste. 100Lewisvil1e_TX.75067 codecomplianceOmcs360.com Phone: 813-3,97-1100 email: other: If an exemption is claimed, please do not complete the remainder. Other representative(s)(if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information(i. e. "none"or"see above")). Name, title, other: Eric Moore Company(if different from foreclosing party): Shellaoint Mortgage Servicing " Address: 41951`Remington Ave. Suite 150, Temecula, CA 92590 877-338-3791 rp opertyre istrations broninc.com Phone(s): email(sl: other: �• Name,title, other: Company(if different from foreclosing party): Address: Phone: email: other: " Attorney representing foreclosing party Firm name (if different from attorney's name): Address: Phone(s): email(s): other: I acknowledge that the information provided"is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. - Date Name: Eric Moore Title: COO I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner,Town of Barnstable Mckechnie, Robert From: Mckechnie, Robert Sent: Thursday, January 25, 2018 10:22 AM To: 'property registrations' Subject: RE: Compliance Verification The subject property 296 Buckskin Path, Centerville, MA, in the Town of Barnstable, has not been registered.There are no fees due on the property. No fees are required to register the property. Thank you Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 From: property registrations [ma i Ito:aropertyregistrations@broninc.com] Sent: Tuesday, January 16, 2018 7:40 PM To: Mckechnie, Robert Subject: Compliance Verification Attention Compliance Department: I am writing on behalf of Bron Inc.We are a P party vendor who specializes in property compliance as it regards to Municipal Registration Ordinances. In the attempt to research every property in our client's portfolio we have found the below property is governed by your municipality and may be subject to registration. Our goal is to ensure that all properties stay in compliance and would appreciate you help by answering a few questions. Subject Property: 296 Buckskin Path,Town of Barnstable, MA 2632 Is property currently Registered? What date was property last Registered? What Fees are currently owed if any? i I apologize if this email has reached you in error. If you know of the best person(s)to answer the above, it would be greatly appreciated if you could provide us that contact information. Thank you and have a great day. Sincerely Bron Inc. Registration Compliance Dept. 877-338-3791 propertyregistrations@broninc.com #578180536 https://na46.salesforce,com/0060H000OOkRWM3 2 Town of Barnstable •pw-mit 0'720 L, - � �iw ri wwe�sJPwe 4e�f�Me Regulatory Services �`57 dII-1 Team F.04w,Director Snag Division 2om 00Al.mseas. lly�aoe:s. of X®PRE*m� Wriac: 508.962.4038 Fsx. $08.790-6230 NOV 1 3 2003 a r Not Maw*00*WA0rX-JOi�elmepui _TOWN OF BARNSTj,_ !Lisp:parcel i✓wab�r L v PMpesty Ac*tw l:124— U z • :deatiel Valor of Work 40 Owaer'a yarns is Ilddtoas L(r Ccatraowr'e QCl7C+�' a > ^et ,�_'Icirpt►o�at Nuatbsr ( � �r�-� ��� Borne lroprvvartxru Contrtectur Liceart a(+1 Cattswomou 4uperrvtsoJ o Uorew of(if �]Wurknpsn°t Compeosatwn Jw,4reace. Luck oas: l Wo a salt proprfewr i as the)dwaeowaa bave Worka's Comptnsatior..stints :wtwreL.e Company � trZZi" 5_f _ 1Vaiktt"'f Comp.Poltcy o_� Pettrsit 3lagssat(ebsck box) � - a 1Rc•re�t stripping old shmihs) 1 Re•ttsof*4►Qippiad. Qow4 ova tristng la)vrs of rwh Q !le-aide �� 1 D-%�plectmmot Wits OWS. L--Valoea S (toaxar-wn.r4) (Q OWMM ro4,wet, bo"W®pL'IiC pen+at 4M aot eattmt corny% W*I:h other fo.a+4ep4ratsn;tiif"?Atvw,i a.t UNWia°C400wates,ax..1.a,4 o 24e-Z C-Pon%#e4paws 061►NAi1?I!0'. ' d 063-A-047 wm 40-45 DH NFRC 6100 Renovations Double Hung - Vinyl Argon/Low E SC Netlof�el Feneekeron SS PA"OMM 1 •Fwr or war Wbd ,o„o t 0 . 3 0 . 2 ,, 0 . 4 CmdWed -------07 --------- ------- Q: U:4 MUdWrardPJ tee as bee mb,pe oft., t4 a wilt wooedoraatod1w1m r p ►t*MW ae W padam=m tC MMP are Mngned bra Wd eat of w*nnmdtl oondrdona end�ao�c oiodua epee w ' A C I ND: lei w t 01GLA55 ;S/"S— L a c.i o t a:. av .r w Order 0:3367129010001 40199 $3 ftwdof W ftmbnk _ 's2*M A/3III�104 t V*w Supownwocew ►ions.DgxA A644wm$.*Am COWAo JOHW oN 3200 cove AALL.EWA PKWY OU UTANTA,GA 30339 ` HOME IMPROVEMENTJ INSTALLATION CONTRACT Branch Name: U Date: V /�(�3 Sold,Furnished&Installed by r The Home Depot Installed Sales Branch Number: _ Job#: 6 3 ll Ire I 345A Greenwood Street,Worcester,MA 01607 Toll Free(800)657-5182; (508)756-6686; Fax:.508-756-2859 Federal ID#75-2698460 ME Lic#C 02439 RI Cont.Lic#16427 CT Lick 565522 MA Home Improvement Contractor Reg.#126893 Installation Address: C is .��4Utl✓I �it. L6111 VI�'lQ j 12�1I _Lyf . 77 City State Zip urchaser(s): Home Address: _Sealvv. (if different from Installation Address) State Zip Proiect Information I/We("Purchaser"),the owners of the property located at the above installation address,offer to contract with The Home Depot("Home Depot")to furnish,deliver and arrange for the installation of all materials as described on the attached Spec Sheet#I b i 3 LZ. ,incorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if,upon re-inspection of the job,Home Depot determines that it cannot perform its obligations due to a structural problem with the home or because work required to complete the job was not included in the contract. DEPOSIT PAYMENT OPTIONS (Subject to fund verification and/or credit approval.) CONTRACT AMOUNT $q 1. Check,Cashiers Check or US Postal Service Money Order (made payable to The Home Depot). Z*LESS DEPOSIT $ / J�. 2• Credit Cards and/or other payment options-Circle One Below BALANCE DUE V' ercard Discover American Express 2 1 /_ � - ON COMPLETION $ Home Improvement Loan Home Depot Credit Card *25%of Contract Amount due upon execution of this Available Credit:$ UUL). (HIL&HDCC ONLY) contract.One-third(1/3rd)of Contract Amount is required Acct#:I A for MASSACHUSETTS RESIDENTS ONLY. Name as it appears on card: fi d r l bl c L. Indicate Payment Method For *By my/our signature below,VWe agree to allow The Home Depot to charge the BALANCE DUE ON COMPLETION ve referenced credi c it for he deposit indicated. / Cardholders Si nature P e rnti��� v — -4 If this is a finance transaction,the agreement for financi g i ontained in a separate document,which is incorp led erein Hy.a Reference,and made a part hereof. At-Home Services redit/Loan Application Ref.# All Purchaser agrees that,immediately upon satisfactory completion of the work,Purchaser will execute a Completion Certificate and pay any balance due(unless the job is financed,in which case,upon submission of the executed Completion Certificate,Home Depot will be paid in full by the lender). Purchaser also agrees to be jointly and severally obligated and liable hereunder. For Mass.Residents Only: Contractor,at owners expense,shall procure all permits required by law as follows: Owners who secure their own permits will be excluded from the guaranty fund provisions of MSL Chapter 142A. Unless otherwise noted within this document,this contract shall not imply that any lien or other security interest has been placed on the residence. Entire Aereement: This agreement and its attachments,including any financing agreement,contain the complete agreement between the parties and can not be amended or modified unless in writing in a separate agreement signed by both parties. NOTICE TO PURCHASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign any Completion Certificate or agreement stating that you are satisfied with the entire project before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under the contract. You may cancel this transaction at any time prior to midnight of the third business day after the date of this contract. See Notice of Cancellation for an explanation of this right. There will be a service charge equal to 25% of the contract amount if the job is cancelled by Purchaser AFTER the third business day. BY MY/OUR SIGNATURE BELOW,YWE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. UWE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW, UWE UNDERSTAND THAT THE AGREEMENT IS SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND I/WE AUTHORIZE HOME DEPOT AND RMA HOME SERVICES,INC.,A HOME DEPOT AUTHORIZED CONTRACTOR, TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDENT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FROM INADVERTENT OMISSIONS OR ERRORS. j SUBMITTED BY: _ •�? i 1'I Date: l U Sales onsul t ACCEPTED / ,�,L�r—" ' Z 6 Date: v ,r(J / F �r Homeowner ��q I.tl- Date: Homeowner NOTICE:ADDITIONAL TERMS,CONDITIONS AND WARRANTIES ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT , White-Branch File Yellow-Customer Pink-Sales Consultant 9-I9-02 C-SC Town of Barnstable `approved Regulatory Services Uq �3 tl Fee 61215- DD Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Home Occupation Registration p �� Date: I I /0� Name: ���11t, L'J ZeI Phone#: 7W 7/y6 Address: 96 is Sl �Q f`h Village: Name of Business: D KS n Type of Business: -1—{1 �� +J�C�a h Map/Lot: 1 2 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. 9� • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration, smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • . There�is no storage or use of toxic or hazardous materials,or flammable or explosive materials, in excess r" of normal household quantities. L- • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with-thee above restrictions for my home occupation I am registering. Applicant: L uk_QLn Date: �B�C Homeoc.doc 3 P TO ALL NEW BUSINESS OWNERS DATE: `� -1 -7 -0c;)- �- Fill in please: r APPLICANT'S er' `'' YOUR NAME: /4C�// LJ(F-o ZC BUSINESS / YOUR HOME ADDRES c�9F, l�� C CfG;F1 gf� TELEPHONE Telephone Number Home -7 - —71Yf NAME OF NEW BUSINESS uv<f-, 1 I (l TYPE OF BUSINESS_r�fer')ar' 0ec�QfjnI IS THIS A HOME OCCUPATION? YES NO Have you been given approval fro the buildig g division? YES=NO ADDRESS OF BUSINESS c�`�6 L�KSKn qf h Cecl rv��.� frR a, MAP/PARCEL NUMBER l`y I /a When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, Listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor- Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. —(corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING C SSION �ed S OFFIC This individual as b en in of requ rements that pertain to this type of business. t ed SA atur COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: Business certificates (cost $20.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you`must .. do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various- departments involved. `A"SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. INEiq, The Town of Barnstable SAE. = Department of Health Safety and Environmental Services MASS. i639• �e QED 9,a Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-796-6230 Building Commissioner Inspection Correction Notice Type of Inspection ;� (,`�L {,J Location 2 ,.� t X' (Lc�� 6,4(permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. e following items need correcting: a ` �. Y'<�v"—c k d-E a -1�n- V- l `� A 'A r e � Please call: 508-790-6227 for re-inspection. Inspected by q k-e�ry�— ��' Date 'Z-- '� Engineering Dept. (3rd floor) Map Parcel Permit# i House#' Date Issued Aew Board of Health 3rd floor 8:15 -9:30/1:00-4:30 ' Fee Conservation Office(4th floor)(8:30-9:30/1:00-2:00) &_"CAIV� �tME Tp;_ e im 19 SEA,=SYSTEM . A �.. ED 6N E TOWN OF BARNSTA�B�: A i r1TL Building Permit ApplicationnSgs `�i�� Project Street Address a 9 L Ala r k s1C i A plik+(n ° - Village 2V Owner �j b n n clni cU A) Address Telephone Permit Request �} 1 �.ti ` ho i TAB r�` �- �e .A e'iC� � 1 fi� W1� ,.-��2 'YI f ��h7 s First Floor ;R square feet Second Floor square feet Construction Type kiiox-)d rPexn1t_ Estimated Project Cost $ Z`7 000,00 Zoning District L- Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family [ Two Family ❑ Multi-Family(#units) Age of Existing Structure a c�a5 Historic House ❑Yes ®'lqo On Old King's Highway ❑Yes pro Basement Type: LI/Full ❑Crawl ElWalkout ❑Other Basement Finished Area(sq.ft.) rVQ 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 J First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing INew Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) i C d�1L ❑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 i S T_ Cn�b x+k Telephone Number b-5 S 3 Address ®d fJ`a �\ RcA License# () (414 Home Improvement Contractor# 1 12 a.a 3 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 DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE // DATE Ao- BUILDING PERMIT DE IED OR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. L �' DATE ISSUED MAP/PARCE ADDRESS VILLAGE OWNER ' DATE OF INSP ION: FOUNDATION FRAMEh INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN NO. 1� he Town of Barnstable •_ : T Services K � Department of Health Safety and Environmental Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Building Commissioner Office: 508-790-6227 Fax: 508-790-6230 For office use only i t _a ' Permit no._ Date AFFIDAVIT _ HOME UVIpROVE ETMTNR CCATIONW SUPPLEMENT requires that the "reconstruction, alterations, renovation, repair, modernization, MGL c. 142A req y re-existin conversion, improvement, removal, demolition, or but construction than four dwelling units or to owner occupied building containing at least on registered contractors, with structures which are adjacent to such residence or building be done by certain exceptions,along with other requirements. Type of Work: ,� Est.Cost '3�0 o o <� Address of Work: GLWACS�S�►� Owner's Name Date of Permit Application:--��ra I hereby certify that: Registration is not requi*ed for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby U given O PERMIT OR DEALING WITH UNREGISTERED OWNERS WN SOME IIViPROVEIVIENT WORK DO NOT HAVE CONTRACTORS FOR APPLICABLE FUND UNDER MGL c.142A ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY SIGNED UNDER PENALTY OF PERJURY I hereby apply fora permit as the agent of the owner. f 2� Contractor Name Registration No. Date OR. Owner's Name nntp The Contmonit•calth of ifassachusetty !` ;__.-#•� Department of Industrial Accidents ^ �= 1_ :� -•!� Ol1/ceo!/nvest/gat/ons 60(11i'asltingtnnStreet Busto»,Mass. (1 111 Workers' Compensation Insurance Affidavit 0,p"lic�n: ,!'ormation� -• - ^ - -. .� . _. Please PRiNTI��lY a,� :"'�..'.'.•',..,,e`:•..._,.._..._..r_.� �--- loci ion, City' nhonc it 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity . ._.ra.:...,.,..Yr� ....r+ae�-,.dry.....=..�.eRrc :.s•�1+�..myJAav?!�•_ .. . _. .••.. ..._W "'^`!�"""•"'.�-r.'"Y""" � 1 am an employer providing workers' compensation for my employees working on this job. , comp•tm•name: asl d peer may nhonc#: . insurance co policy 0 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: comp9ny name: address: cirv- nhone#• insurance co nelicv# ... _... „err.- -r��yti-=��..y" :'T�t-e.Fs'+_ ._ -nay+++s���Tssr.R�+w!!.�,'..,�.::ii`�.; s�SS7�va.r•-ia+..»�,;.�,.eva-�-•;-•--z� emmniev name• - address- pin•• phone#• insurance co nolicy# +�.MM��......... Attach additional shctE if tiecessary, w-r---:,�:'-s�'r:'�;.•;f ::•��--�-:•{r �. .••,` n`•��•�r".� Q.-oil: •�':�yyer.."'A"'�.IwSc:.zi+� Failure iu secure coverage as required under Section 25A of A1GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 andior one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the D1A for coverage verification. ' 1 do hereht ccrtij tinder Ntc itrs and penalties of etjun•drat the information provided above is true and correct Sienatum n Q, Date 3'- 2L Print name (. ' s dt- Phone# �LIY .7 ofricial use univ do not write in this area to be completed by city or town official city or town: permit/license# rikluilding Department Licensing Board check if immediate response is required 13Sclectmen's Older Lj C311calth Department contact person• phone#• MOther ; PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers'-coniouns,atiol I for the employees. As quoted tom the "law", an empooeee is defined as every person in the service of another under an contract of hire, express or implied, oral or written. An cmpl►fiver is defined as an individual. partnership, association. corporation or other legal entity, or any two or mor the foregoing enLa`_ed in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However th owner of a dwellina, house having not more than three apartments and who resides therein, or the occupant of the dwcllin'�, house of another who employs persons to do maintenance , construction or repair work on such dwelling he or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employe MGL cha.pier 152 section '_5 also states that even,state or local licensing ngenc,% shall withhold the issuance or rencival of a license or permit to operate a business or to construct buiidin;s in the commonwealth for any applicant who leas not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into anv contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter i 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 ydit have any questions regarding the "law"or if you are require-, to obtain a workers* compensation policy, please call the Department at the number listed below. Cin• or ,romms Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pie: be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned 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 question please do not hesitate to give us a call. The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 __ _-nhone #: (617) 727-4900 ext. 406, 409 or 375 UNREGISTERED LAND FILE NUMBER: 63722 DEED BOOK: 190t PAGE:28 ATTORNEY: HAYES k HAYES FLAN BOOK:Z44. PACE:67 LOT(S)` 43 LENDER: NEWORLD BANK PLAN NUMBER: OF OWNER: ROBERT k ARLENE E. ST. JOHN REGISTERED LAND APPLICANT: KRISTIN A. CONWAY ik JOHN P. MELCHIONO REGISTRATION BOOK: PACE: DATE: 06/14/93 SCALE: 1"=40' CERTIFICATE OF TITLE: FLOOD HAZARD INFORMATION PLAN NUMBER: LOT(S): FLOOD MAP COMMUNITY NO.: 250001 ZONE: C ASSESSORS MAP PANEL: 0015C DATED: 08/09/85 MAP: 191 BLOCK: 124 PARCEL: 43 MORTGAGE INSPECTION PLAN IN BARNSTABLE, MA N� N/F Crosby 100.OII' _ Lot 43 15,591 S.F. Shed rn L Deck ,4. Lot 44 Lot 42 1 Story Owe I1 n � \ z cc No.296 100.00' - B U C K S K I N PITH THIS IS THE RESULT OF TAPE MEASUREMENT, NOT THE RESULT BANK US ONLY OF AN INSTRUMENT SURVEY AND IS CERTIFIED TO THE TITLE INSURANCE COMPANY AND ABOVE LISTED-ATTORNEY AND LENDER. DES LAURIERS & ASSOCIATES INC. THERE ARE NO DEEDED EASEMENTS OR ENCROACHMENTS WITH 130 WEST STREET WALPOLE, MA 02081 RESPECT TO BUILDINGS S!Tt1ATED ON THIS LOT EXCEPT.AS SHOWN. TEL.:(800)287-8800 (508)668-5010 FAX.:(508)668-4512 THE LOCATION OF THE DWELLING SHOWN DOES NOT FALL WITHIN. A SPECIAL FLOOD HAZARD ZONE. THE LOCATION OF THE DWELLING AS SHOWN HEREON EITHER o�� STEPNEN WAS IN COMPLIANCE WITH THE LOCAL ZONING BY—LAWS IN 9 P' '^ EFFECT WHEN CONSTRUCTED (WITH RESPECT TO STRUCTURAL AW.336M CA REQUIREMENTS ONLY), OR IS EXEMPT FROM VIOLATION 9 � Ss�°aoQ ENFORCEMENT ACTION UNDER MASS. G.L. TITLE VII. CHAPTER 40A, SECTION 7. GENERAL NOTES: (1) The declarations mode above are on the basis of my knowledge, information, and belief as the result of a mortgage inspection tape survey made to the normal standard of core of registered land surveyors practicing in Massachusetts. (2) Declarations ore made to the above named client only as of this date. (3).This plan was not made for recording purposes, for use in preparing deed descriptions or for constructions. (4) Verifications of property line dimensions, building offsets, fences, or lot configuration may be accomplished only by on accurate instrument survey. ,":s�.f`. �=<`t(�v-r''• �,acA� .�.�r+arca��x��.`,�y r�;�r �r.:.�:,'�`�r.?' 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"'a•.��.�t�' -yh► J.nfc `x stt•: �a,•<�fn i i�{...�F?`+/*.�+,.• 1_j1` . 1te 66wt,m"L(l, a/Mt oll &IJ,I or,e ,uJe 41,1 HOME IMPROVEMENT CON FRAC;TORS REGT.STRA`I" I()N `Board of Building Regulations and Standard One Ashburton Place — Roofn 1301 � r; t.i-Is 02108 1E IMPROVEMENT CONTRACTOR )ist.ration 117293 Expiration O9/18/96 e — INDIVIDUAL a� G;,,,,.,,,<,.,,,,w•„�i/, ,`:.//.,�..,�,, air HOME IMPROVEMENT CONTRACTOR d Registration 117293 DENIS J COLBATH �- n_ o Type - INDIVIDUAL DENIS J . COLBATH; Expiration 09/18/96 282 OLD MILL RD bSTERVILLE MA O2�55 DENIS J COLBATH DENIS J. COLBATH 6ac- .282'OLD MILL RD - M 'II ADMINISTRATOR OSTERVILLE MA 02655 I , r Restricted To, 00 t DEPARTMENT OF PUBLIC SAFETY t CONSTRUCTION SUPERVISOR LICENSE 00 None !I Number: Expires: 1G - 1 & 2 Family H Restricted To, 00 t �muurxe�.r:�;:g_>anaon..®nr t DENIS J COLBATH ��• �:��; :NA97^teen,,. .�•n•v ..tenor 282 OLLD MILL RD t OSTERVILLS, NA 02655 t