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0872 CRAIGVILLE BEACH ROAD
THE FOLLOWING . IS/ARE THE BEST IMAGES. FROM POOR QUALITY ORIGINALS) I m DATA fA z i� �,(EOIA Lei -i oi - .. t f t ro 'ROPERTY ADDRESS I ZONING DISTRICT CODE SP-DISTS.I DATE PRINTED STATE PCS I NBHD CLASS KEY NO. 0872 CRAIGVILLE BEACH R 12 RC 300 12CO 01/04/96 1041 JO 46AD R226 169. 136828 I LANDIOTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T j La na Byroate Size D�mensron vP UNIT ADJ'D.UNIT ACRES/UNITS VALUE Descripron PERKINS, CONSTANCE J & MAP- 'IOC./VR.SPEC.CLASS ADJ. COND. PRICE PRICE t1 L A N D 1 53,000 cD. FF-De , r2,A S E CARDS IN ACCOUNT - 110 1BLDG.SIT 1 x .13 =10c A=155 438 59999.91 407339.95 .13 53000 #9LDG(S)-CARD-1 1 69,400 01 OF 01 j -lPL 374 CRAIGVILLE BCH RD LUST lf24UU J IBATHS 2.0 U x i C= 100 7000.0 7000.00 1.00 7000 B #DL LOT 13 MARKET 85600 D EIS MT S x C= 100 6.1C 6.10 1350 8200-a #RR 0369 0036 192.3 0059 INCOME I 0 PLACE U x C= 100 3100.0 3100.0 1.00 3100 B #SR SOUTH WIND CIRCLE USE A ' FIREPL U x C= 100 1300.0 1300.0 1.00 1300 a APPRAISED VALUE Di J A 122,400 U f PARCEL SUMMARY LAND 53000 Ti BLDGS 69400 f { 0-IMPS El TOTAL 122400 - N GNST NI PRIOR YEAR VALUE DEED REFERENCE Type DATE Raco•Oee 'n�' 53000 Sale,P•Ka S I 839741222JTIl2/93 D 128500 BLDGS 69400 J 4542/332: I:05/85 110000 TOTAL 122400 j 2933/161: II00/00 BUILDING PERMIT *LAND A D J U S T.F C R � j I Number Date Type Amount LOCATION.....LAND LAND LAND-ADJ INCOME SE I SP-BLDS FEATURES BLD-ADDS UNITS 53000 j 3200 Consl, Total Year Buill NOr m. Obsv.Class Units Units Base Rale Atll.Rale A t 79e Dep Contl- CND. loc. 4b R.G. Repl.Cosl New Atlj.Repl.Value Stories Haig nt Rppms e0 Rms.Balns I-F ia. Pertywall Fec, 02C 000 100 100 60.80 60.80 50 75 19 80 100 80 86703 69400 1 .0 6 4 2.0 8.0 "10'C)0 Square Feel Few Co MKT.INDEX: 1.JJ IMP.By/DATE: / SCALE: 1/00.90 ELEMENTS CODE CONSTRUCTION DETAIL R.I.60.80 1350 82080 GROSS AREA TWO FAMILY DWELLING CNST_ GF: FEP' 65 39.52 36 1423 *---------------------50--------------------* STYLE 170UPLEX 0.0 --------------- --- - i � ! DESIGN ADJMT -OU ___________________0 0 J - ! EXTER.WALLS O1wO0D FRAME 6A ----- ----- - - ----------------. HEATIAC TYPE 02GAS 0. I N -- ---I--- -------------- TER.fINSH 00 O.D - ----- - 1 � ! Ili-T�p.LAYOUI` 72 VEk.INORMAI 6. ' t z,7 ! INTtR.t7iJALfiY 02SAME -As EXTER. -Cl BASE 27 FLOOR ST u2fi OG _ _ ---6- D W! ! EFCi)6R-ZO-1iER-- -70 -------------------6: Baee. 1 3.50 - ---- Q.0 E Tot al Al- 36 ilea-F-TY-PE---- -OD --- EC CTRICAL- -00--------------------0:0 �- BUILDING DIMENSIONS ! . BAS W29 FEP SO4 E09 N04 w09 A .. ! ! F0UTi0AT1-6N- - -00 -----------------TT9:9 BAS W21 N27 E50 S27 .. ! -------------- - --- ---------------------- L - -FJ t 1-1;14 ig O-A-H 666 746AD--CENt-Cf VILLE *--------21-------*---9---*----29-----------x LAND TOTAL MARKET 4 FEP 4 PARCEL 53000 122400 *---9---* AREA 14614 VARIANCE +0 +738 STANDARD 20 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ' Parcel 0%� ��T Application #c�) 0icI6 7 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board r Historic.- OKH _ Preservation/ Hyannis Project Street Address 7 a- C a ✓a- t CG V l Village Owner 'Tp IV k67 A4 �t t Address Telephone 6 I? 9a -a- -7-7 c f So ffZ?S—a $4 3 Permit Request ��. n.s fie K C trot pieG p —04-ck e.x 8 5- X17 Square feet: 1 st floor: existing 4LJ9pr0p0sed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1,90a Construction Type Lot Size 2�405'r Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 2r Multi-Family (# units) Age of Existing Structure 6o?qIL4 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes 211 o Basement Type: ❑ Full O'rawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing o2 new Half: existing new Number of Bedrooms: Al existing _new 5 Total Room Count (not including baths): existing Tr new First Floor Room Count Heat Type and Fuel: 2116as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing A 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: 2�existing ❑ new size _ Other: Q Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ NJ Commercial ❑Yes ❑ No If yes, site plan review# LO . , Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 6 Y6 g �� Name "O ,/l oee1ei- Telephone Number Address I FN (f w)Af A 1 M 6 AD cJ License # C S' b qO �}6 Home Improvement Contractor# t°0 Q0 9 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY 3 4 z APPLICATION# F DATE ISSUED F MAP/PARCEL NO. z 'F ADDRESS VILLAGE - s OWNER.= Q DATE OF INSPECTION: n_FOUNDATION- + . FRAME INSULATION E FIREPLACE 4 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH J FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. d r. w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Name (Businessiorg iization/Individual):_ 1/ D la �o[.lam/�2 Cyr RA14`4.4 Z-(,I5 �t2 14 C4 11VP r+U C_ Address: +,A Y'l L ,o J u s �'� City/State/Zip: o w 2NL_ Y� oa s3a Phone#: gOg 7S'1 F you an employer?Check the appropriate box: r Type of project(required); I wn a employer with 4. I amageneral contractor andI mployees(full and/or part-time),* have hired the sub-contractors 6. 0 New construction . I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have P8, []Demolition working for me in any capacity. employees and have workers comp. insurance.$ 9• Building addition [No workers'comp.insurance P•. required.] 5. 0 We area corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E]Roof repairs insurance required.] t. C. 152, §1(4), and we have no employees.[No workers' 13.Z&her 4 4 h/CI tG,} comp. insurance required:] 14,M.P *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. lam an employer that is providing workers'compensation insurance for my employees.- Below is the policy and job site information Insurance Company Name: �'� V V 4 Policy#or Self-ins.Lic.#: We L Expiration Date: 40 'p�tC Job Site Address: 97a A 6&A 1 Vl`��E' .�� G� City/State/Zip: Z tiV Attach a copy of the workers' compensation.policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year impnsonment,..as well as civil penalties in the form of a STOP WORK ORDER and a fine of up.to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information.provided above is true and correct. Signature: Date: Phone#: 7:S-Y oL ' [E6th only. Do not write in this area, to be completed by city or town official -City n:. Permit/License# hority.(circle one): ealth 2.Building Department 3. City/Town Clerk 4,Electrical Inspector. 5.'Plumbing Inspector son: Phone#: I, i o�j"E,ati Town of Barnstable Regulatory Services y Mnss g Thomas F.Geiler,Director 16gq �0 �En►v+ar" Building Division . Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8627403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section ,If UsinLr A Builder — as Owner of.the subject property J) here y authorize to act on nay behalf,. in mattersrelative,to work authorized by this building permit �7oL CA64 I1r(i/ (Address-of Job) Pool fences:'and alarms are the responsibility of the applicant. Pools are not to be.filled'or utilized before fence is installed and all final nspections are performed nd.accepted. 60 .Owner Signa of Applicant i A-VN� '�J�✓� � I OC��ctt) Print Name Print Naive Date QTORMS:OWNERPERMISSIONPOOLS 6/2012 �'THE Town of Barnstable Regulatory Services * snaxsrnsrs,9 ` Thomas F.Geiler,Director Building Division rEb MA'16 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town:barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: . JOB LOCATION: number street village "HOMEOWNER"; name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. ` DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner .ti 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 t amend and adopt such a form/certification.for use in your community. Q:forms:homeexempt Map Page 1 of 1 Town of Barnstable Geographic Information System New Search Home Help, Parcel Viewer Custom Map Abutters Map'Slze ® Zoom 0u1 1.1 A;MAMA®In Ful-- ,',� JPG Map: 226 Parcel: 169 Property e:.._ p rty. ' 1 Location: 870 CRAIGVILLE BEACH ROAD Info 220159 +1 + 0 9 if Owner: PERKINS,CONSTANCE J& J i2 Location Information t i 220953. Map&Parcel 226169 Location 872 CRAIGVILLE BEACH ROAD 220157 b Acreage 0.13 acres 0834 + ill Current Owner -Mailing Address PERKINS,CONSTANCE J&' E+ BURK,.JOANNE M -- �B18o 872 CRAIGVILLE BCH RD =_. 8572 - CENTERVILLE,MA 02632 - rl 229n9 Appraised Value(FY 2012) '-. Ra04 Extra Features $7,000 - Out Buildings $0 .. Land - $256,000 Buildings $86,600 " Total Appraised $349,600 - 225001 �Rq �ACfI .v Assessed Value FY 201 2 N 915 o ( ) e°4{ 39 Feet Extra Features $7,000 ��Y225031 CND Out Buildings $0 ;_;., Land $256,000 - ' - Buildings $86,600 Set Scale 1" = 39 ; I Aerial Pho[os. I MAP DISCLAIMER Total Assessed $349,600 Copyright 2005-2010.Town of Bamstable,MA All rights reserved.Send questions or comments to GIS - BdmstableMA vi.2.4672(Production) r http://66.203.95.236/ar6ims/`appgeoapp/map.aspx?propertyID=226169 11/20/2012` Town of Barnstable Geographic Information System November 20,2012 226157 #884 226167 ' #12 226168 f r m ' � w g Ilk r . 226169 _ #872 �0" 1 1 F' � a �^r _ 6 '�, ' �* k Y 'R 'M. 01 3 x �0 226170 :. . #864 g 0 0 8 Feet y�o DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:226 Parcel:169 boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:PERKINS,CONSTANCE J 8 Total Assessed Value:$349600 Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map E are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner:BURK,JOANNE M Acreage:0.13 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:870 CRAIGVILLE BEACH ROAD / such as building locations. Buffer / r 6 t x • .. .�./lL.0�O�J71//9L0�/ZLCClC�1L 0����1:JfCC�LCJ2� � _ . Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR egistration: 160909 Type: ;< xpiration -9/10/2014 Private.Corporatio DAVID A BOEGLERiGSENERA-CONTRACTING ' ` VA . � DAVID BOEGLER 184 CAPTAINS ROW BOURNE,.MA 02532 Undersecretary - Y Massachusetts-'Department of Public Safety ti Board of.Building Regulations and Standards . Construction Supervisor License i�`�7 CS-0429fi0 - DAVID A BOEi UR 184 CAPTAID S BOURNE ii 02532 Expiration Commissioner 04/20/2014 . K L L r a a _ Y i z Y (J r ,0� - � . � • . � l� aol�a v6l II. C 1 -�. -. J�.' ••. • ,.. ... ., •. ",ems _. 4 00A , s�-qtic-, C (�,R r C�� IGV1 ��c' w ` . Y�yA 1 y . r 3% T 5 x 6 ro E car 7>7 �s C Go r� Ef-c u yg r� Dot FOUNDATION BSMT. & ATTIC PLUMBING PRICING . LAND COST conc.Wells Fin. Bsmt.Area Bath Room Base BLDG. COST Conc. Blk.Walls Bsmt.Rec. Room St. Shower Bath Bsmt. — PURCH. DATE Conc. Slab Bsmt.Garage St. Shower Ext. Walls PURCH. PRICE . Brick Walls Attic FI. &Stairs Toilet Room Roof RENT Stone Walls Fin.Attic Two Fixt. Bath Floors Pier! INTERIOR FINISH Lavatory Extra Bsmt, F 1 2 3 Sink oZ Attic s/ r/i r/ Plaster Water Clo. Extra . EXTERIOR WALLS Knotty Pine Water Only Double Siding Plywood No Plumbing Bsmt.Fin. Ingle Siding Plasterboard Int.Fin. �f Shingles TILING o(IL S onc.Blk. G F P Bath Fl. Heat Face Brk.On Int. Layout Bath .&Wains. Auto Ht.Unit �7 `3 �0 Veneer Int.Cond. Bath Fl. &Walls .Fireplace d Com. Brk.On HEATING Toilet Rm. Fl. Plumbing , Solid Com.Brk. Hot Air Toilet Rm.Fl. &Wains. • _-- Tiling Steam Toilet Rm. Fl. &Wales Blanket Ins. Hot Water St. Shower y Roof Ins. Air Cond. Tub Area Total , Floor Furn. ROOFING COMPUTATIONS A ph. Shingle Pipeless Furn. S. F. Wood Shingle No Heat S.F. Asbs. Shingle Oil Burner S.F. Slate Coal Stoker S. F. Tile Gas S F OUTBUILDINGS ROOF TYPE Electric Gable Flat S.P. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED Hip Mansard FIREPLACES S.F. Pier Found. Floor 7 Gambrel Fireplace Stack Wall Found. 0. H. Door LISTED onc. FLOORS Fireplace , Sgle.Sdg. Roll Roofing � C LIGHTING _ _ _ Dble.Sdg. Shingle Roof Earth No Elect. DATE _ Shingle Walls Plumbing Pine u,lr✓ _ Hardwood ROOMS Cement Blk. Electric AsDh.Tile Bsmt. 1st 6 + > TOTAL a Brick Int. Finish F ED Single 2nd 3rd FACTOR (� 'a REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. DWI-G. 44 00L f _ S, J9 .� .3 3 /6 9 so 1 2 3 4 5 6 7 8 9 10 TOTAL RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET 87h Craigville Beach Road W. Hyannisport LAND / 226 4 C-0 73 BLDGS. /6 C/.S 169 OWNER TOTAL 7 RECORD OF TRANSFER DATE BK PG I R.S. REMARKS: Lot 13 LAND "� BLDGS. Denni rb-Famity"`ESo:'- -1p,-I 40 B TOTAL LAND �> >p•''% � oT5 . 3 ( G � BLDGS. u� TOTAL WItf LAND BLDGS. '- TOTAL LAND 6-13-79 2933 161 1 .00 BLDGS. ! 3 V F• �{ TOTAL f� 017,30 ABLDGS. LAND BLDGS. m TOTAL LAN D INTERIOR INSPECTED: / BLDGS. TOTAL DATE: Gy //_� J �� LAND ACREAGE COMPUTATIONS BLDGS. JD TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE LOT o. yp p� / LAND CLEARED FRONT - BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR rn BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAN D BLDGS. 01 LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH % FRONT FT. PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND ------ r Town ®f Barnstable ermi Evpires 6 months fie date Regulatory Services Fee MA`"s' ,�.` Thomas F. Geiler,Director �g f�� Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 W'A'W.town.barnstablc.ma.us Office: 508-862-4038 Fax.: 508-790-6230 . EXPIIESS PERMIT APPLICATION = RESIDENTIAL ONLY Nid Valid wilhoul Red 1-Press Imprint Mapplparcel Number Prope Address Residential .Value of Work ' o Minimum fee o"f S25.00 for work under$6000.00 Owner'sName&Address. u C+, n C /J Contiaetor's Naine (;C ro W z%S Telephone Number IIome Improvement Contractor License#-(if applicable) I G/ Construction Supervisor's License#"(if applicable) ❑Workman's Compensation Insurance Clr one; I.am.a.so:le proprietor I am the Homeowner X-PREIT Q.T have Worker's Compensation Tnsurance Insurance Company.Natne E.0 18 2008. Workman's Comp.Policy# :"o\A/N OF BARNSTABLE Cop}of Insurance Compliance Certificate must be on file. Pennit Request(check box:) '[ Re-roof(stripping old shingles) All construction debris grill be taken to []Re-roof(not stripping. Going over_ existing layers of roof ❑`Re-side replacement Windows/doors/sliders.IT-Value (in ximtun .44j "NAere required: Issuance of this.penrit dries n()t exempt crnnpliance with M)er town.depattment.regulations,le,Histirlia f nnvervatinn etc "*�lvote: Property,Owner must'sign Property Owner Letter of Permission. �,; e„ A copy of the II rre Improvement Contractors License is required: . SIGNAT€TRT: i C:lUsenkdLcollik�4ppD 1Iocal+MicrosolilWinduws\Temporan}lnternetPiles!Content.nutloa!:4T�•iY7IvB=4II\E 'R)SS:du Revised`10060S t The Commonwealth of Massachusetts Department of Industrial Accidents -:011Office of Investigaddj s 600 Washington Street Boston MA 02111 .. www.mass.gov/dia Workers' Compensation-Insurance Affidavit: Builders/Contraef©rs/E.tectricians/Plumbers A . licant Information Please Pn*nt Leeibly `e PVa5 4uMe 2 a� VCri.,n 3 Name (Business/Urganization/Individ tal`): ` D Address: 3 CJ F� City/State/Zip: �,�,c<,,; r� t'f A - U G Phone #: � Are you an employer?+Check the appropriate box:. Type of project(required): 1.0 I am a employer with 4._E] T am:a gene ral. .and r ployees(full and/or part-time):* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on tlic-attached sheet. �. 0 Remodeling These sub-contractorshave ship and have,no,employees 8. n- Demolition workin forme in.any capacity. employees and have workers' g Y p ty 9. O]Building-addition [No workers'comp: insurance comp. insurance:+ recuired.] -5. 0 We are a corporation and its. 10:0 Electrical repairs,or additions officers have.exercised.their 1l_. Plurnbin repairs or additions 3. :I am a homeowner doing all � g p " myself. o workers' right of exemption per MGL y � comP. 12_[]Roof repairs insurance required:]t c. 152,§1(44),and we have no employees. [No workers' 13.M.Other W t comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. . t Homeowners who submit this affidavit indicating they are dining all-work.and then fine outside contmetors must submit a new affidavit indicating,such. lContractors that. check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sib-c ontrac ors have employees,-they must provide their.workers'comp.policy number. lam an employer that is-providing workers'compensation insuranceformyemployees. Below:is the policy rind.job site information- Insurance Company Name- Policy 4 or Self=ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing-the-policy number and expiration-date). Failure to secure coverage as required under-Section 25A of MGL c. 152 can,lead to the imposition of criminal penalties�of a. fine up io$1,500.00 and/or one-year imprisonnienL,.as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. lido hereby certify .rider a pain dpena ties of perjury that the infomta ion:provided above is:true and correct Si ry✓ to afore. Da Phone W: Official use only. Do not write in this area,'to be completed by city:.o_r town official "City.or Town: Permit/License## Issuing Authority(circle one): 1,Dowd of health 1.guilding Department 1 City/I owo.Clerk 4.-electrical Insp€ for Plumbing!inspector b.Other Contact.Person:- Phone:9- t. �A8�TA11jj. s , 'down.of Barnstable Regulatory Services Thomas F.teiier,Director Building Division. Thomas Perry,CBO' Building Commissioner 200'[Main Street, Hyannis,MA 02601 www:tow.n.barnstable.m a.us (Afire: 508-862-4038 Fax: 508-790-6230 -Property Owner I ust Conmplete and:.Sign This Section, IfU's ngA'Builder !1 Av NI/ ,as Owner of the property suliject . hereby authorize to act on my behalf, in all.matters relative.to work.authorized.bv_this:builcl'ing.peff it application for. :(Address ofJob) Si e of Caw. Date Print time 'It Property owner Is applying for permit,please complete the flomeowners.LieensetExemption Form on'the reverse side. C:I,,LSmW=oUild.AppDatall.QuillMicrosofilWindows\Temporaq lntemat Files\Content:0ut1ookWY7NB41L%XPRESS:doe. Revised IOOfa08 M i e h{ L✓fie (oorryrno�� �w _ 1 '�g�r R�. i �✓aCczJ/aucfzetde/a` I .i 1 . ,+ oard-of Building Regulations and Standards G I ; = Construction Supervisor License 1 License: .CS 80579 ( w r fiaton 72009 Tr# 1:5236 f 9 "aRestnction 00 y { 'JOSEPH W POW,ERS7 t E elf 9 . , 130 FULLER RD p CENTERVILLE;MA 02. Commissioner * ✓fie �.,�mu�u �,.� - . .'` Board of Building Regulations and Standards Licens•�or registration valid-for individul use only HOME IMPROVEMENT CONTRACTOR .'before the expiration date. If found return to: l Board ff Building Regulations and Standards j Registratic i' 139619 . One Ashburton Place Rm 1301 l Expiration Tl28/2009 Tr# 131937 Bostoe,Ala.02108 rType DBA JOE POWERS HOP�tE RENOVATIONS JOSEPH POWERS, ', f 130 FULLER RD ' Not valid without signature C`_NTERVILLE,MA 02632 Administrator. g \ II a Town of Barnstable *Permit# /y®C X-PREVS PE^�p.�Tgul Expires o rom issue "� atory Services Fee U APR X 0 2006 Thomas F. Geiler,Director Building Division TOWN OF BARNSf .y,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 wavw.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid.without Red X-Press Imprint Map/parcel Number Property Address $7 �- eoa i V r/,[. flt4c,4 G Residential Value of Work Minimum fee of$25.00 for work under 6000.00 f$ / J Owner's Name&Address.--�0 4t l ��i'( � , L Il G l J C to c � �p/ L c >7 r✓��/�/t�4i ContrZ4r's Name G iC �� S Telephone Number S G 7 —1 U/ Home Improvement Contractor License#(if applicable) 3 1 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance C_hSpk one: ,. LY I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance hsurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Dermit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re roof(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows, U-Value (maxim».44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. ome prove t Contractors License is required. ;IGNATI U: !:Forms:expmtrg .evise071405 1 6 - r ✓lie �ommeaizusea�l o�✓�aaaacLi+.raP,G` Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 1 Board of Bidding Regulations and Standards_ Registration, 139619 One Ashburton Place Rm 1301 Expiration 7/2 /2007 Boston,Ma.02108 t ;c' Type f JOE POWERS HOMERENOVAIONS JOSEPH POWE'ftS < -3�w; 4 130 FULLER RD CENTERVILLE,MA 02632 Administrator Not tvalidwithout signature I Town of Barnstable y` Regulatory Services 9saxt I'E$; Thomas F.Geller,Director �639. �0 Apia►��° Building]Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A wilder I, -sue_ . ,as Owner of the subject property �e!reby autho to act on my behalf, in all rr{tters relvE to work authorized by this building permit application for: (Addre s of Job) T4naeOwner ate -1 Print'Name { Q:FORMS:OwNERPERMMSION of Town of Barnstable *Permit# (902 f �.* Fxpbes 6 months from issue date Regulatory Services FeeMAW D �E A�0 Thomas F.Geiler,Director Building Division CS S PE Tom Perry, Building Commissioner Office: 508-862-4038 200 Main Street, Hyannis,MA 02601 T SEp 1 © 2a04 Fax: 508-790-6230 OwN op BARS EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY STAR Not Valid without Red X-Press Imprint Map/parcel Number pKP�J Property Address ❑Residential Value of Work s: 'I JQ Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address JJ LL Q /)Q JIC P;17 Contractor's Name o�G(� "��� Telephone Number��0 Ff, 7 Home Improvement Contractor License#(if applicable)_ ,�ff:41 q 17 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance .: Ch k one: [ am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Con*.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) �Re-roof(stripping old shingles) All construction debris will be taken to ea 1-r t ]fan 56c/ 1 4 jn3 j-.% ❑Re-roof(not stripping. Going over existing layers of roof) , ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance.with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature O:Formwexnmtra I � f ' 1 Board fBE ,,,� Board of Building Regulatidus�Sut----/d dd, lot HOME.IMPROVEMENT CONTRACTOR Registrajidn: 139619 �. Exp+capon -28/2005 FYPe I:�{+uidual JOE.POWERS Ff©IV1E RE�I`ppTIONS JOSEPH POWERS'r 130 FULLER RD _ i CENTERVILLE,MA 6z Administrator Town. of Barnstable , 4KHrt 1pk, Regdatory S eryim Thomas V.Geller,Director romperry, Suildfng Con missioner 200 Alain Street, symmis:MA 02601 • , •. _ q�t,ta�n.barnstable.tna.us --- " 608-790-6230 pffice: 608:862-403 8 .. ,. - proper Sr Ovmer Must - --- Complete a,-,aSignTl .s Section -- xf Using A Builder as Oyyner of the subject property c - to act on mybealf; _.. • '. . hereby authorize�— � .. • . e to work autborized by this building permit application f or, - -- matters relative _._._.. � L f (A dxess of Job - of Owner ate. S•ignature e �xint Name =ti - [ ] [R226 169 . ] LOC] 0872 CRAIGVILL BEACH R CTY] 12 TDS] 300 CO KEY] 136828 ----MAILING ADDRESS------- PCA] 1041 PCS] 00 YR] 00 PARENT] 0 PERKINS, CONSTANCE J & MAP] AREA146AD JV1291071 MTG12001 BURK, JOANNE M SP1] SP21 SP31 15 WHITTEN STREET UT11 UT21 . 13 SQ FT] 1350 DORCHESTER MA 02122 AYB11950 EYB11975 OBS] CONST] 0000 LAND 53000 IMP 69400 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 122400 REA CLASSIFIED #LAND 1 53 , 000 ASD LND 53000 ASD IMP 69400 ASD OTH #BLDG (S) -CARD-1 1 69, 400 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 874 CRAIGVILLE BCH RD TAX EXEMPT #DL LOT 13 RESIDENT.'L 122400 122400 122400 #RR 0369 0086 1923 0059 OPEN SPACE #SR SOUTH WIND CIRCLE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE112/93 PRICE] 128500 ORB18974/222 AFD] I JT LAST ACTIVITY] 11/17/94 PCR] Y R226 169 . • P P R A I S A L D A T S KEY 136828 PERKINS, CONSTANCE J & LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RC 53 , 000 69, 400 1 A-COST 122, 400 B-MKT 85, 600 BY 00/ BY /00 C-INCOME PCA=1041 PCS=00 SIZE= 1350 JUST-VAL 122, 400 LEV=300 CONST-C 0 ----COMPARISON TO CONTROL AREA 46AD -- TREND EXCEEDS STANDARD NEIGHBORHOOD 46AD CENTERVILLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 530001 LAND-MEAN +Oo 1224001 91427 IMPROVED-MEAN -240-. 200 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1000] 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 [?] n�"C TOWN OF BBHNST88LE a NTARY CONTINUA REPORT aG REPORT S LEWE / . NAME (LAST, FIRST, MIDDLE) DIVISION /02" NOTE DETAILS i OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL IS ETC- -_,2-65 PAGE 0 SUBMITTED BY �/