Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
1292 CRAIGVILLE BEACH ROAD
i J �s m r 411 is �m- G►.�aks 1 kt �s S, r - 3 I { S i •A S t. � 4 _ ' � 1 � � � _ I 1 -� -� .� _� - � � w;. � _ --- t- � ; ��. ��' : � . . � . � 3 .. ::� � � �.= d ,�� - - F "?-J�;t �. �, i / � � � t 1 � ce� v � � �� M lJ � � � � � � `� �- � � � � q � `� � C� � � � � � � � � � � � 2 � � - �. � v Date: February 9, 2018 To: Kevin O'Neil & Building Dept. File RE: Former Family Apartment Address: 1292 Craigville Beach Road, Centerville Record Owner Patricia O'Neil Contact: Kevin O'Neil After discussion with Building Dept. staff the following facts and conditions were identified and agreed to on this date: The aforementioned property was the residence of my late mother. A family apartment was created in order to accommodate a related live-in care giver. Since my mother's passing,the family member residing in the apartment has remained in residence in accordance with her desire and my approval. I recognize the governing ordnance now currently requires the kitchen to be removed from the accessory unit and I have reviewed the forms my mother signed and submitted over the past few years concerning the use of the apartment. The primary unit previously occupied by my mother is vacant. I have no intention to rent this space and it shall remain unoccupied. In the event that circumstances change and I decide to sell or rent or my family member vacates,or is evicted from said unit, I will immediately contact the Building Department to determine what course of action shall be necessary. Kevin O'Neil Feb. 9, 2018 Bk 28424 P'9312 �4 41L 10-02--2414 a 11 = 11 a Total pages: 3 QUITCLAIM DEED I,KEVIN M.O'NEIL of Centerville,Barnstable County,Massachusetts, for consideration paid, and in full consideration of ONE DOLLAR($1.00); grant to a� KEVIN M.O'NEIL and NANCY P.O'NEIL, Trustees under a Declaration of Trust entitled O'NEIL REALTY TRUST,dated October 18,2013 U (see Trustee's Certificate pursuant to M.G.L. ch. 184§35 to be recorded herewith), having an address of. x° 45 Strawberry Hill Road,Centerville,MA 02632 a� with QUITCLAIM COVENANTS t� all of my right, title and interest in two certain parcels of land located on Craigville Beach Road, ,boo Barnstable(Centerville),Barnstable County,Massachusetts bounded and described as follows: co 0Vo PARCEL 1: 1292 Craigville Beach Road N NORTHERLY by a Way, as shown on the plan hereinafter mentioned,two hundred fourteen and 13/100(214.13)feet,more or less; N O� EASTERLY by said Way seventy-one and 24/100(71.24)feet,more or less, a SOUTHERLY by LOT C and by cranberry bog now or formerly of William Wirtanen 'd eighty-two and 48/100(82.48)feet,more or less; b EASTERLY by cranberry bog now or formerly of William Wirtanen eighty and 52/100 (80.52)feet,more or less; 0 SOUTHERLY by land now or formerly of Beatrice White one hundred thirteen and 98/100(113.98)feet,more or less; and WESTERLY by Craigville Beach Road,one hundred nine and 30/100(109.30)feet, more or less. Return to. JFF21553 Fedele and Murray,P.C. 17 Walpole Street File No.13-0157 Norwood,MA 02062-3318 Bk 28420 Pg313 #45018 Being shown as LOTS A and B on the Subdivision Plan of Land in Centerville,Mass,as surveyed for Lloyd W.Miller,Dec. 3, 1947 Bearse&Kellogg, C.E. which said plan is filed with the Barnstable County Registry of Deeds in Plan Book 83,Page 39(F2). Together with an easement in all of said Way in common with all other persons now or hereafter lawfully entitled to use the same. PARCEL 2: 1278 Cralgvdle Beach Road Beginning at a cement bound on the easterly side of Craigville Beach Road, a public way,at the, intersection of Horseshoe Lane,a public way;thence running NORTHEASTERLY 135.47 feet to the land of William R. O'Neil and Patricia O'Neil; thence running SOUTHEASTERLY 113.98 feet by the land of said O'Neils;thence running NORTHEASTERLY 80.52 feet by the land of said O'Neils:thence running SOUTHEASTERLY 173.73 feet by the land of said O'Neils and the land now or formerly of Lloyd W.Miller;thence running in a general NORTHERLY direction 247.61 feet by land of said Miller; thence running SOUTHEASTERLY, northeasterly and northwesterly 30 feet by the land of said Miller; thence running in a general NORTHERLY direction 70.97 feet,more or less,by land of said Miller;thence running SOUTHEASTERLY 45 feet,more or less,by the land now or formerly of William Wirtanen;thence running in a general SOUTHERLY direction 450 feet,more or less,by the center line of a creek bordering the land now or formerly of Mosher; thence running SOUTHEASTERLY 80 feet,more or less,by land now or formerly of Mosher; thence running SOUTHWESTERLY 99 feet by land now or formerly of Mosher;thence running SOUTHWESTERLY 48 feet by land now or formerly of Mosher; thence running NORTHEASTERLY 54 feet more or less by land now or formerly of Mosher;thence running in a general -2- Bk 28420 Pg314 #45018 '1 SOUTHERLY direction 170 feet,more or less,by the center line of the creek bordering the land now or formerly of Mosher to Horseshoe Lane, a public way;thence running in a general NORTHWESTERLY direction 409.37 feet,more or less,by Horseshoe Lane, a public way,to a cement bound; and thence running in a NORTHERLY arc 30.51 feet to a cement bound and the point of beginning. Said parcel is shown as containing 3.37 acres of land,more or less,on a entitled"Plan of Land in Centerville,Barnstable,Mass.,belonging to William Wirtanen, Scale 1"=40 feet,dated April 6, 1961,Nelson Bearse&Richard Law,Land Surveyors, Centerville,Mass.".and recorded at the Barnstable County Registry of Deeds in Plan Book 161,page 95. Said conveyance is subject to a life estate reserved in a deed to the grantor herein recorded with Barnstable County Registry of Deeds in Book 24926,Page 155. The premises are conveyed subject to and with the benefit of all easements,restrictions,rights of way,takings,reservations,exceptions and covenants contained in the deed to the grantor herein and in all other instruments of record,to the extent now in force and applicable,but not intending hereby to recreate or extend restrictions,reservations,exceptions and covenants previously terminated or expired. Meaning and intending to convey all the grantor's right,title,and interest in and to all the same premises conveyed to the grantor hereof by deed of Patricia A. O'Neil,dated October 20,2010, recorded with the Barnstable County Registry of Deeds,in Book 24926,Page 155. WITNESS our hands and seals this o day of 'aA,— ,201Y (L.S.) IAEVN M.O'NEIL COMMONWEALTH OF MASSACHUSETTS County of ya� ,ss: On this 3 Iday of qc,v` ,20If,before me,the undersigned notary public,personally appeared KEVIN M.O'NEIL, ❑^/ personally known to me,or rd proved to me through satisfactory evidence of identification,which was ©' ❑ (other:) to be the persons whose name is signed on the preceding or attached document,and acknowledged to me that he signed it voluntarily for its stated purpose. ROBERT C. CROCKER, JR. N taryP �blic Notary Public My Commission Expires; COMMONWEALTHOF MASSACHUSEUS My Commission Expires November 28, 2019 -3- BARNSTABLE REGISTRY OF DEEDS Bk 28420 Ps312 00-45018 10-02-2014 a 1 1 2 11 a. Total pages: 3 QUITCLAIM DEED I,KEVIN M.O'NEIL of Centerville,Barnstable County,Massachusetts, for consideration paid,and in full consideration of ONE DOLLAR($1.00), grant to KEVIN M.O'NEIL and NANCY P.O'NEIL, Trustees under a Declaration of Trust entitled O'NEIL REALTY TRUST,dated October 18,2013 U (see Trustee's Certificate pursuant to M.G.L. ch. 184§35 to be recorded herewith), having an address of: 45 Strawberry Hill Road,Centerville,MA 02632 with QUITCLAIM COVENANTS all of my right, title and interest in two certain parcels of land located on Craigville Beach Road, Barnstable(Centerville),Barnstable County,Massachusetts bounded and described as follows: PARCEL 1: .1292 Craigville Beach Road N b NORTHERLY by a Way,as shown on the plan hereinafter mentioned,two hundred fourteen and 13/100(214.13)feet,more or less; N O� EASTERLY by said Way seventy-one and 24/100(71.24)feet,more or less; SOUTHERLY by LOT C and by cranberry bog now or formerly of William Wirtanen b eighty-two and 48/100(82,48)feet,more or less; EASTERLY by cranberry bog now or formerly of William Wirtanen eighty and 52/100 (80.52)feet, more or less; 0 SOUTHERLY by land now or formerly of Beatrice White one hundred thirteen and 98/100 (113.98)feet,more or less; and WESTERLY by Craigville Beach Road,one hundred nine and 30/100(109.30)feet, more or less. Return to: JEF21553 Fedele and Murray,P.C. 17 Walpole Street File No.13-0157 Norwood,MA 02062-3318 Bk 28420 Pg313 #45018 Being shown as LOTS A and B on the Subdivision Plan of Land in Centerville,Mass,as surveyed for Lloyd W. Miller,Dec. 3, 1947 Bearse&Kellogg, C.E. which said plan is filed with the Barnstable County Registry of Deeds in Plan Book 83,Page 39(F2). Together with an easement in all of said Way in common with all other persons now or hereafter lawfully entitled to use the same. PARCEL 2: 1278 Craigville Beach Road Beginning at a cement bound on the easterly side of Craigville Beach Road, a public way,at the intersection of Horseshoe Lane,a public way;thence running NORTHEASTERLY 135.47 feet to the land of William R. O'Neil and Patricia O'Neil; thence running SOUTHEASTERLY 113.98 feet by the land of said O'Neils;thence running NORTHEASTERLY 80.52 feet by the land of said O'Neils: thence running SOUTHEASTERLY 173.73 feet by the land of said O'Neils and the land now or formerly of Lloyd W.Miller;thence running in a general NORTHERLY direction 247.61 feet by land of said Miller; thence running SOUTHEASTERLY, northeasterly and northwesterly 30 feet by the land of said Miller; thence running in a general NORTHERLY direction 70.97 feet,more or less,by land of said Miller;thence running SOUTHEASTERLY 45 feet,more or less, by the land now or formerly of William Wirtanen;thence running in a general SOUTHERLY direction 450 feet,more or less,by the center line of a creek bordering the land now or formerly of Mosher;thence running SOUTHEASTERLY 80 feet,more or less,by land now or formerly of Mosher; thence running SOUTHWESTERLY 99 feet by land now or formerly of Mosher;thence running SOUTHWESTERLY 48 feet by land now or formerly of Mosher; thence running NORTHEASTERLY 54 feet more or less by land now or formerly of Mosher;thence running in a general -2- Bk 28420 Pg314 #45018 SOUTHERLY direction 170 feet,more or less,by the center line of the creek bordering the land now or formerly of Mosher to Horseshoe Lane, a public way;thence running in a general NORTHWESTERLY direction 409.37 feet,more or less,by Horseshoe Lane,a public way,to a cement bound; and thence running in a NORTHERLY are 30.51 feet to a cement bound and the point of beginning. Said parcel is shown as containing 3.37 acres of land,more or less,on a entitled"Plan of Land in Centerville,Barnstable,Mass.,belonging to William Wirtanen, Scale 1"=40 feet,dated April 6, 1961,Nelson Bearse &Richard Law,Land Surveyors, Centerville,Mass."and recorded at the Barnstable County Registry of Deeds in Plan Book 161,page 95. Said conveyance is subject to a life estate reserved in a deed to the grantor herein recorded with Barnstable County Registry of Deeds in Book 24926,Page 155. The premises are conveyed subject to and with the benefit of all easements,restrictions,rights of way,takings,reservations, exceptions and covenants contained in the deed to the grantor herein and in all other instruments of record,to the extent now in force and applicable,but not intending hereby to recreate or extend restrictions,reservations,exceptions and covenants previously terminated or expired. Meaning and intending to convey all the grantor's right,title,and interest in and to all the same premises conveyed to the grantor hereof by deed of Patricia A. O'Neil,dated October 20,2010, recorded with the Barnstable County Registry of Deeds,in Book 24926,Page 155. WITNESS our hands and seals this ol3 L day of QO,, ,201Y (L.S.) E M.O'NEIL COMMONWEALTH OF MASSACHUSETTS County of ,ss; On this a 3 oklay of ICc v ,20If,before me,the undersigned notary public,personally I appeared KEVIN M.O'NEIL, Q/ personally known to me,or rg' proved to me through satisfactory evidence of identification,which was ©' ❑ (other:) to be the persons whose name is signed on the preceding or attached document,and acknowledged to me that he signed it voluntarily for its stated purpose. ROBERT C. CROCKER,JR. N taryr tic ITO Notary Public My Commission Expires;COMMONWEALTHOF MASSACHUSETTS My Commission Expires November 28, 2019 -3- BARNSTABLE REGISTRY OF DEEDS Town of Barnstable 4 Regulatory Services oF�"E'gy. Richard V. Scali,Director Building Division " �& Thomas Perry, CBO,Building Commissioner �0r i6�9' � 200 Main Street Hyannis, MA 02601 Ec Mor � Y wwwaown.b a r n s to b l e.m a.u s J Office: 508-862-4038 Fax: 508-790-6230 " Town of Barnstable Family Apartment Affidavit' . a i I, being on oath, epose and state as follows: My name is, (fit 1Z,2z" I am the owner/resident of the pronertv located:fit• r �o i The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Name &relationship to owner:' l �'UuJotl/ The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,I will immediately } note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. '- I understand that I am required to file an Affidavit annually with the Building - , Commissioner listing the names and relationship of occupants in said Family ApiFfient. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit ' and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Aparlwients.- I agree PC)- to note the Building Commissioner immediately in the event of the sale of this pro,erty. If there is no longer a Family Apartment at this location,please explain: rn i uc CCpart ilralt ll been dismantled. 4— The apartment has been transferred to the Amnesty,Program(Appeal No. ) Other Sworn under the pains and penalties of perjury this day of1042016. Signs a Phone Number z _ Print Name s ' r� q"forms/famaffid.doc rev 11/08/12 � # � N a as a p* �� �s �� " g b iC f �e . e�ath aye � ����., �� �R ��� � �� � � � ��� +�� t "; a''il �WA January 19, 2016 To Whom It May Concern : Patricia O'Neil, DOB 03/29/1941, has been a patient of mine for many years. She has complex medical issues and requires live in assistance to remain independent •in her home. Please contact me if you need any additional information. Sincerely, UL Mark E. Collins, MD Osterville HealthCare, PC e f rt. i Customer Statement Pg 3 of 3 OEastern Bank Statement Period: Oct 23,2015 thru Nov 23,2015 Account Number: 00405927633 Number of Items Enclosed: 9 I PATRICIA A ONEIL PATRICIAA JetnVm 134 KEVL�I VEIL wINMONEII 139 1242C 1,1E BM RD. �, 1MCRAIGVILLEBCHRD. y� ,Gl, C VRIE,MA 02632 1 t-N� I CBN7TRV=MA 02632 au EAy I$' PAYTO r 11 I.lll', A Ff.iCf/a.i r!. I `S ' �W. 1 RLt/ , DotuR a 4✓e DDLFAaS ®EastemBdllk ..rwwmus I ®Eastern Bank aYtmEmMmo - Meo �mr.,,FM 10000007 5001 I i1:0iL30i79 �31 +1:01L30L79an 040 59 2 76 3 3a 0L39 ` i CK#13 /2 $50.00 CK#139 PD 11/06/2015 $75.00 5rPATRICIAAONEIL ernv,u �3� PATRICIA A ONEIL - - -- 202 - KEVINMONEIL KEVINMO' 1292 CIWGVRIE BCF7 RD. w. ,_ -- ,1-n _ / -_ -_ - CENT G MA07b32 - �/ �..^ 12TC" LLE OCH kv. . •`•��~ LE, I M1R: e /�7A C VRXE,MA M632 @ l�.-•/'I� PAs o¢0u W.4Y`s MfC_l' a $1'V C F 6 0 t',O J (`V�`�W ' _�`V /L /AM, LiMzkd MAN'1 D[1tlAR9' DEastpm�Batlk d ws,W ®Eastern Bank i MrvD I 4: 3017916, 040 59 2 76 3 3[' OL35 1:O11301?981: 01.059276330 0202 I ' I CK#13 $100.00 CK#202 PD 11/12/2015 $ I I PA AONER yr,xnn ~' 136 PATRICIAA ONEI Rr,wnq VINMONEIL - - KEVINM 3 1242CRA]GVILLEBCHRD. ..I�/ /� 12T.0 R.LEBCHRD. ,. 1 CENTERVn.LLMA 02M - D Te .w Ls-L vntE,MA omn / IFAYM ' I • i s 75,C7d rnrm C Can-K1CD.eV`. I •� a � DpUAA,e I ,MfiORDLROI II e ®Eastern Bank f E.Ye..9anic ,1'01L30L OL36 +I= +40&L30L7981: 06059276330 0203 I CK#136 PD 11/03/2015 $75.00 203 PD 11/16/2015 $1 ------------------------ I PATRICIA A ONEIL o-a 3 137 PATRICIA A O KEVINcvn ONEIL D. KEVI EiL 204 IMCRMCENTERVRL�MA N61E `DArn GVILLEBCH R0. - � I �/�'[(��[{� CCNTER LIMA 016RI �'.'x))I THE oF¢ - f- ..t � � 1I.. ~� PAY 70 B�.l^' 1MAA L�Q�1/' I. ' -�.++,' -•. r` ,.. .�.. ®Eastpm Bank OEaslpm Bank MF2w I�/uD\'_I� .1 fl.Ff• • i L.. laewmw `,1/,(� � \ //1 K.(% r - I ,N,01L3017981: .04059276330 0137 ,1:0113017 9276330 0204 CK#137 PD 11/09/2015 $288.41 CK#204 PD 11/19/2015 • $50.00 .. I I I PAMUCIA A ONEIL sa,Fviu 136 Y KEVIN M ONEIL L081EB40003/R ZA Mastemsank 98a: 0405927633r OL38138 PD 11/09/2015 $80.60 CNS.D.S.081EAST001.26550292.%875_2357/005381/008237/ib2 s a :2-D C _ r r to i, 'Zis iifl U g18v15N�V2 40 to v,,Oi , � _ J � , ��5 � � �� " � �V �� � . 3iAl fAj 9 Town of Barnstable Building Department - 200 Main Street sAMSTABLE. MASS �, Hyannis, MA 02601 1639. . (508) 862-4038 Argo�s Certificate of Occupancy Application Number: 201005475 CO Number: 20140114 Parcel ID: 207074 CO Issue Date: 08/20114 Location: 1292 CRAIGVILLE BEACH ROAD Zoning Classification: SPLIT ZONING Proposed Use: SINGLE FAMILY HOME Village: CENTERVILLE Gen Contractor: PEACOCK, (SCOTT) JAMES S. Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: f Am BYidAe4a'nment Signature Date Signed I TOWN OF BARNSTABLE -Building., �t� 201005475 PermitBARNSTABLE. Issue Date: 11/23/10 y MASS �pr1 639. A Applicant: PEACOCK,"(SCOTT)JAMES S. Permit Number: B 20102542 D MA Proposed Use: SINGLE FAMILY HOME Expiration Date: 05/23/11 Location 1292 CRAIGVILLE BEACH ROADbning District SPLTPermit Type: FAMILY APT W/CONSTRUCTION Map Parcel 207074 Permit Fee$ 255.29 Contractor PEACOCK,(SCOTT)JAMES S. Village CENTERVILLE App Fee$ 50.00 License Num 94500 Est Construction Cost$ 50,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND CREATE A 1 BEDROOM FAMILY APT FOR MARK O'NEIL(SON TO THIS CARD MUST BE KEPT POSTED UNTIL FINAL PATRICIA)IN BASEMENT WITH KITCHEN AND BATH INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: ONEIL,PATRICIA BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1292 CRAIGVILLE BEACH ROAD INSPECTION HAS BEEN MADE. CENTERVILLE,MA.02632 Application Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS;NO RIGHT TO OCCUPY ANY STREET L ALEY'OR SIDEWALK OR ANY PART THEREOF EITHER TVbRARfLVdVJRtWN LY ENCROACHMENTS ON PUBLIC PROPERTY NO SPECIFICALLY PERMITTED UNDERTHE BUIIAING CODE;MUST BE APPROVED$Y THE JURISDICTION. STREET:OR ALLEY GRADES AS.WELL AS'DEPTH AND LOCATION OF PUBLIC SEWERS 1a1AY BE OBTAINED FROM THE,DEPARTMENT:OF PUBLIC WORKS THE ISSUANCE OF THIS PERMIT,DOES NOT•RELEASE THE•APPLICANT FROM>THE CONDITIONS•OF ANY APPLICABLE SUBDNISION '+ RESTRICTIONS " MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION" 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE;SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). OM lulii, BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 (3mn J g 1 2 2 1 v I 1 . . 3 1 Heating Inspection Approvals .Engineering Dept Fir Dep 2 Board of Health d �d " ,' �� f i {�{ t 1 � �_ - --- �. . �. E _.. � �� - �. _. � .. � Town of Barnstable FTME lqy, Regulatory Services Richard V. Sca1i,*'i'r_kkt6F BAR 'STABLE 1 eax►vsras[E. : Building Division y� Mass t3 is pr 1639. A.0 Thomas Perry,CBO, Building"Comm siAer- ?• fD MAC 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 DIVISION Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, pose and state as follows: My name is Z IIJ O I am the owner/resident of the property located at: Z Z G64. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: 2 a ��- Name &relationship to owner: & z ✓L, The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately-in the event of the sale of this property. r If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled'. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this S day of 2015. _6',0g -7`16 C85� Sign ture Phone Number Print Name' q:forms/famaffid.doc rev 11/08/11 ; -5 P:9 288 :6t7337 oF'THE Town of Barnstable Regulatory Services r r BARNSTABLE. Thomas F. Geiler, Director 9 MA99. �p 039. �.�s Building Division. rFn�� _ Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 1292 CRAIGVILLE BEACH ROAD, CENTERVILLE, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds or Barnstable County District Registry of the Land Court in Books a6, Page I—s , or as Document No. , being shown on. Assessors' Map 207 as Parcel 074, hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment,which contains living quarters, is intended for use as a family apartment, for year-round occupancy. The intended and authorized use is for MARK O'NkIL, SON OF OWNER, PATRICIA O'NEIL, associated with the residential use on the same premises. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit shall not be rented as an apartment or as a single room, or in any fashion,which rental would be a violation ` of the Town of Barnstable's rules, regulations,.and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants.are to be recorded with the building department. This agreement shall be,updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property,of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the'issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this 19 . day of_A6ern 201C) . TOWN OF BARNSTABLE OWNERS) By: ; { uilding Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY,SS Date Then personally appeared the above-named (owner), 0.4; and made oath as to the truth of the foregoing instrumenVtary bf e. BARNSTABLE COUNTY PublicREGISTRY OF DEEDS °" ""' mmission Ex ires: A TRUE_COPY,ATTEST p LFDA HENNESSEY JbHN F.MEADE,hEG1STER c�1� ?�� 9�s'. * Notary Public o. -' Commonwealth of Massachusetts My Commission Expires October 20, 2017 01dFalmouthRd80 % �ft11N nFAeS� ;� } III,.; REGISTRY OF DEEDS f Town of Barnstable Regulatory Services �1NE Thomas F.Geiler,Director Building Division BMWSTABM « Tom Perry,Building Commissioner v� ,MASS.. �� 200 Main Street,Hyannis,MA 02601 prFD MA'S A Office: 508-862-4038 Fax: 508-790-6230 February 4, 2014 James S Peacock PO BOX 171 Osterville, Ma. 02632 RE: 1292 Craigville Beach Rd., Centerville, Map: 207 Parcel: 074 Dear Mr. Peacock: This letter is to follow up on a letter dated February 11, 2013 sent by this office regarding two open building permits. Application number 201005475 was issued on or about November 23, 2010 for a family apartment and application number 201005993 was issued to construct a deck and install two sliders. To date, successful final building inspections have not been completed. To avoid further action please contact this office and arrange to bring the property into compliance. Thank you for your immediate attention in this matter. Respectfully, OWL La zon Local Inspector jeffrey.lauzon@town.bamstable.ma.us (508) 862-4034 Town of Barnstable Regulatory Services THE Thomas F.Geiler,Director Building Division sARNSTABLE, « Tom Perry,Building Commissioner. 1 � 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 _ Fax: 508-79076230 February 11, 2013 James S Peacock PO BOX 171 Osterville, Ma. 02632 RE: 1292 Craigville Beach Rd., Centerville, Map: 207 Parcel: 074 Dear Mr. Peacock: A review of our records, including the permitting history of the property, indicates that the above referenced address has open building permits without successful completion of final inspections. Application number 201005475 was issued on or about November 23, 2010 for a family apartment and application number'20.1005993 was issued to construct a deck.and install two sliders. Please contact this office by February 25, 2013 to arrange for final inspections or explain why the worlds not progressing to satisfactory completion.. Thank you for your immediate attention in this matter. Respectfully, Lauzon Local Inspector j effrey.Lauzon(a�town.barnstable.ma.us (508) 862-4034 } • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION - Map- pp Parcel 1 A`iication # Health Division Date Issued O Conservation Division "_D)<_, Application Fee U Planning Dept. .:Permit Fee , 2� Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address I Z ft( y(if 4W d Village AA tt Owner---;p/ ��� Iy�� AddressL J, Telephone rJ` Permit Request / -� ✓ ''" ma r L fir- U lv�L n _t Square feet: 1 st floor: existing pose 2nd floor: existing_proposed _Total new 0 Zoning District Flood Plain Groundwater Overlay Project Valuation I =� (� Construction Type hU � � Lot Size (J f &rk-' _. Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. 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: Ofull ❑ Crawl ❑Walkout ❑Other p� Basement Finished Area(sq.ft.) IIwo Basement Unfinished Area(sq.ft) s, v Number of Baths: Full: existing ,,;"r,,: new . Q Half: existing t o w L7 Number of Bedrooms: existing a new o o. 0 Total Room Count (not including baths): existing new y First Floor Room ComIt o Heat Type and Fuel: XGas; ❑Oil ❑ Electric ❑ Other ca Central Air: ❑Yes ANo Fireplaces: Existing New Existing wood/coal s@e: Yes ❑No Detached garage: ❑existing 0 new size—Pool: ❑existing ❑ new size _ Barn: ❑ existin ❑ 0ew sizeco Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: o m Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes A No If yes, site plan review# Current Use , ' Tft(�� Me- Proposed Use l W APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 4 c Name I1 `t�.�- Telephone Number Address �,IJ; trdG�� �� License# S -1q oc) Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �"��~' DATE ffl -- / ""I 42 7 1 FOR OFFICIAL USE ONLY f[S APPLICATION# x _DATE ISSUED .,MAP/PARCEL ADDRESS,. VILLAGE OWNER 4 DATE OF INSPECTION: - FRAME l I T I '.l INSULATION ' w 7IL'jl+. t FIREPLACE } ELECTRICAL: ROUGH _ FINAL ti t - PLUMBING: ROUGH FINAL- . ROUGH l'FL-; �,IA FINAL - i _ (!FINAL MDATE CLOSED OUTn -.�k < ASSOCIATION PLAN NO. 4 i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111UT . www.mass.gov/dia' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information lease Print Legibly Name(Business/Organization/Individual) 7 • Address: 3 U010P I, City/State/Zip:0*f lil{_ M A WPT Phone.#: %8-V BGP7 00 Are you an employer? Check the appropriate bog: Type of project(required): 1 I am a employer with_i 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. 0 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y P tY• # 9. Building addition . [No workers' comp.insurance comp.insurance. •10. Electrical re airs or"additions required] 5. ❑ We are a corporation and its P 3.❑ I am a homeowner doing all work 'officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof,repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers' 13.❑ Other comp.insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation 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. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. f Insurance Company Name: Policy#or Self-ins.Lic.#: � - Expiration Date: , Job Site Address: City/State/Zip: ' "4 A 020 Z Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine ` of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage.verification I do hereb erti der the pai nd pen lties of perjury that the information provided above is true and correct Si attire: Date: C Phone#: Offccial use,only. Do not write in this area,to be completed by city or town official ` City or Town: '` ; Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.,City/Town Clerk 4.Electrical Inspector. 5.Plumbing Inspector 6.Other Contact Person: Phone#: r � ACt1�RE` CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) 07/19/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER CONTACT I Germani Insurance Agency NAME: PHONE x 908 Main Street c No E :(508)428-9194 FA Alc Ne:(508)428-3068 E-MAIL ADDRESS, Osterville,MA 02655 PRODUCER CUSTOMER IO M INSURER(S)AFFORDING COVERAGE NAIC t INSURED - INSURER A: SAFETY INS CO Scott Peacock Building 1L Remodelling,Inc. INSURERS: P.O.Box 171 Osterville,MA 02655 INSURER C: INSURER D: National Union Fire Ins.Comp. INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDL SUBR POLICY EFF POLICY EX LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMID MwooryYYY LIMITS A GENERAL LIABILITY CP00001152 7/52010 7/5/2011 EACH OCCURRENCE . $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEG__ PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY n P O El LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS SCHEOULEDAUTOS 80DILY PIJURY(Per accident) $ - - � - PROPERTYDAMAGE $ HIRED AUTOS (Per accident) NON-ON ABED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ O WORKERS COMPENSATION WC 5815464 6222010 622/2011 wC STATU- 0 K AND EMPLOYERS'LIABILITY - LR AM!PROPRIETORIPARTNER/E.XECUTIVE Y 1 N E.L.EACH ACCIDENT $- 100,000 OFFICERIMEMBER EXCLUDED? N 1 A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100,000 If yes•describe under r DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES(Attach ACORD 101,Additional Remarks Schedule,Amore space is required) CERTIFICATE HOLDER CANCELLATION Scott Peacock Building 8 Remodeling,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FaX#"508-428-7625 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE v ■ ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Nlassachusetts- Department of Public Safeh Board of Building Regulations and Standards Construction Supervisor License License: CS 94500 .y.,;,., JAMES S PEACOCK - PO BOX 171 � OSTEVILLE MA 02632 Expiration: 7/22/2012 ('uumissiunci Tr#: 29233 ' � rt 1 . r Consumer aAffairrs& �,�actu�oe License or registration valid for individul use only 71. Office of Consumer Affairs&B siness Regulation I; y HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: :1;51853 Type: Office of Consumer Affairs and Business Regulation Expiration: _7/712012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 SC TT PEACOCK BU ddk- &REMODELING INC JAMES PEACOCKL F 1046 MAIN STREET\SUITE 7 OSTERVILLE,MA 02655 -y v Undersecretary Not valid without signature IKEr Town,of earn-stable 4 , ` Regulatory Services - t RARNs'rABLE, v KAS& Thomas F. Geiler,Director n Building ]division Tom Perry,Building Commissioner. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 s ' Fax: 508-790-6230 Property Owner Must.." Complete and Sign This Section If Using A Builder as Owner of the subject property" hereby authorize S�,6111 Pf a(&' ",L, to act on my behalf, i in all matters relative to work authorized by this building permit application for- IM2, C�� V Ile -6h (Adc6ss of Job) . . „ U-13 -1 Signature of Owner Date ., 1. ' • - 'I Print Name , If Property Owner is applying for permit please complete.the ; Homeowners License Exemption Form onthe reverse.side. Q:FORMS:O WNERPERMISSION r t it 0 0 L BLOKE DETECTORS REVIEWED Ri I BL B ILDING D PT. DATE DowFIRE DEPARTMENT DA F V "TN SUAryURES ARE REWIRED FOR PERklIT7yNG : 1� I k , e � i f 7t IT if o-ya W — f TN L r: 10 03: 07p SCOTT PERC 508 428 7625 p. 2 i`0v,'v A i �IAl LF 36 SCOOT PTA,CO( Building & Rernodel,iti.g; :Inc. a - P.O. Box 1.71 • 104.6 Main Street, #l OstervillC2 MA 02655 plu>i)c 509-428.7600 0 508.428-7625 -Igrx rcuit pca«►ck(aWerizon.net .FACS.IMULE TRANS Mir.RTALI SHEET j_ lA t COMIPA.NV: 'I ' DATE: -� I?Ax No4T� A 30 OF 'PA G.E.s INCLU.UIN(y COV.LJt .FAGS CI URGENT ❑ FOR REVIEW ' ❑ PLEASE REPLY ❑ FOR YOUR USE N0"I'E,S COM..MEN7'S: 14 10 03: 07p SCOTT PEAC 508 428 7625 p. 1 BARISTf-.2 LE TII, [J36 Scott Peacock Building.& Rcmodcling, Inca 1046 Main Strcct, Unit.3 1 1 I I K ►> Post Officc Box .171 Oster dle, MA 02655 508.428.7600 December 14, 2010 Town of Barnstable building Department Attn_ Jeff Lauzon 508.790.6230 Sent By Facsimile Re: Trailer Permit 1292 Craigville_Beach .Road, Centerville r Patricia O'Neil, .owner. " Dear.Jeff, Further to our conversation today, I am requesting for a two (2) month extension of time in-connection with the above-identified trailer permit. We had a set back with the gas piping and there is no heat in the house. Therefore, more time is needed for the use of the trailer: As soon as the heat is resolved we will call the building department with this information. Please call me with any questions. Thank yo Scott Peacock TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �6 P rcel C.Q A licaation# o`er! 93 a ,- pp 4f Health Division °'Date Issued Z 1 a~ (c7 Conservation Division ���— Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Boardk'l ` Historic - OKH -Preservation/ Hyannis Project Street Address .� Village - N — Owner f�(Xfi u r NP�I L Address CaL i l'e6ea(h !r-EJ Telephone .9 b 71�_5 (47 04*wd f le_ w 0 Z&32 Permit Request C Y smlal bin a-AC SA"�� Square feet: 1 st floor: existing (, proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio 8500 Construction Type Lot Size 6 &I Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. 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: 0 Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 44 Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new O Half: existing new Number of Bedrooms: existing _new 3 a 32, Total Room Count (not including baths): existing ;�/�� new First Floor,{Room Co6,6t Heat Type and Fuel: g Gas ❑ Oil ❑ Electric ❑ Other rx3 Central Air: ❑ oo Yes l No Fireplaces: Existing New Existing w t/coal stb_-"a e: �Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: existing''❑ n w size_ rn Attached garage: ❑ existing U new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes X No If yes, site plan review# Current Use �- P TProposed.Use;. _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name w - Telephone Number M �Q r�' AddressP-W License # ��,3 "1 Home Improvement Contractor# Worker's Compensation # (A) ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT W LL BE TAKEN TO SIGNATURE DATE ` ` r d FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED i MAP/PARCEL NO. ADDRESS VILLAGE OWNER, - DATE OF INSPECTION: FOUNDATION 4 5 owu 569 1 zj v e FRAMEOR) - I INSULATION ► FIREPLACE ELECTRICAL: ROUGH - FINAL PLUMBING: ROUGH FINAL s - ;GAS ROUGH FINAL s�FINAL BUILDING� jrc:•t' r _ y h 1 r -1 J DATE CLOSED OUT r `> ASSOCIATION PLAN NO. - The Commonwealth of Massachusetts Department of Industrial Accidents, Office of Investigations,:. 600 Washington Street Boston,MA 02111 www.mass.gov%dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information lease Print Legibly Name(Business/Organization/Individual)' 7 • KM Address: wn 5" 3 Uo . (J Q City/State/Zip:05k���• WiffPhone.#: 5bS' 12 V�I&00 Are you an employer?Check the appropriate bog: Type of project(required): a employer with 4. ❑ I am'a general contractor and I 6. ❑New construction Alrr .__employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P f5'• # 9. ❑ Building addition ' [No workers'comp.insurance comp'insurance'required.] 5. ❑ 10.We are a corporation and its ❑ 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.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers' 13. Other comp.insurance required] 1.1 S *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. 1Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: I V I �� City/State/Zip� ?1CF/I Attach a copy of the workers' conYpensation 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 tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of - Investigations-of the DIA for insurance coverage verification. I do hereby rtify under the p and penalties of perjury that the information provided above is true and correct Date: --/ Phone#: Z 1(POD Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one). 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - ' Contact Person: Phone#: F , i-r..rr_u i� ._y uuu-._v-�uuu ,�uuvnc wuu ruyc u� DATE(MMIDDIYYYY) '� F'' CERTIFICATE OF LIABILITY INSURANCE 07/19/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT Germani Insurance Agency PHONE FAX 908 Main Street c No E :(508)428-9194 cNo:(508)428-3068 E-MAIL ADDRESS, Osterville,MA 02655 PRODUCER CUSTOMER IO A: INSURER(S)AFFORDING COVERAGE NAIC S INSURED INSURERA: SAFETY INS CO Scott Peacock Building&Remodelling, Inc. INSURERS: P.O.Box 171 Osterville,MA 02655 INSURER C: INSURER D: National Union Fire Ins.Comp. INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EX LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMlDDrYYYY) (MWDDATM LIMITS A GENERAL LIABILITY CP00001152 7/5/2010 7/5/2011 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LABILITY DAMAGE TO RENTEG— PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY JE LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO - (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULEDAUTOS PROPERTYDAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESSUAB Ed CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ p WORKERS COMPENSATION WC 5815464 622201 O 6222011 WC STATU- OTFF AND EMPLOYERS'LIABILITY Y/N I FIR ANY PROPRIETORIPARTNERIEXECUTIVE - E.L EACH ACCIDENT $ 100,000 OFFICERIMEMBEREXCLUDED? NIA (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEd$ 100,000 r DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(Attach ACORD 161,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Scott Peacock Building&Remodeling,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Faxft'508-428-7625 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Massachusetts- Department of Public Safch Board of Building Regulations and St<indilyds Construction Supervisor License Licenser CS 94500 JAMES S PEACOCK e J PO BOX 171 ;,,� OSTEVILLE, MA 02632 Expiration: 7/22/2012 ('anuuissiuncr Tr#: 29233 t fie 7oar,znzaiaruea�z o�✓�laQaacfu�arlla Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date.. If found return to: Registration: -1,51853 Type: Office of Consumer Affairs and Business Regulation Expiration 7/7/2012 Private Corporation 10 Park Plaza-Suite 5170 - w„ z _ Boston,MA 02116 SC TT PEACOCK BUILDING&REMODELING INC , V 1 - JAMES PEACOCK 1046 MAIN STREETSSUITEy7 tea, 4 OSTERVILLE,MA 02655 Undersecretary Not valid without signature r T+ rti Town of Barn-stable Regulatory Services k s�RtrsTas[.E. - . Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 au. www.town.b arnstable.ma.us,• Office: 508-862--403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subjectproperty T ` _ l hereby authorize � `�`� . S ' _ f to act on my behalf, in all matters relative to work authorized',by this building permit application for. j (Ad ' ss of Job) Signature of er Date z. Print Name ' If Property Owner is applying"for permit please complete.the Homeowners License Exemption Form on the reverse side. W, . +. 0708 Q:F0RMS:0WNERPERMIS9]0N - :" I O I T o m I o -- � m I o I m <o w I I -- I � I mmrn I I w X o I I I I N 9E mzm x O w m 1 I m WOc, I I O o I I m g a • �o I I N C7 . 1 S* •E- C�"-- w a 1 x m A AliG2 3 -n I oo I rt � �� V I 1 I �_ � I I I I I I 1 � o I I I a I I N mm zco -T1a t,ps.J' w I I p o N I SMOKE OPTCCTO S REVIEWED i 1 m I I N - Q R L B LLOINO D P7. DATE n I I 1 [n�,.�b, NE4 o I 1 Off. C ^ __..._...�E 4EFARTMENT DA,6 o I O I OWN MAME3 AN AEyUREE POP PERWMM& V I I iE � I I I I # I I I I � I I I I 1 I o ¢+ I I m - I I CJ7 1 I m 1 I I I I d _ I"E TOE Town of Barnstable *Permit# Expires 6 months isue rs date Regulatory Services Fee � 9cb PERMIT SS L63 �� Thomas F.Geiler,Director ''reontn.�" OCT 5 l010 Building Division TOWN OF BARNSTARr'fPerry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY nof Valid without Red X-Press Imprint Map/parcel Number Prope Address- Residential Value of W G Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Z 8atemlle &(" Pd (!M-1Wd(C . n&3 Contractor's Name 7 dlephone Number '5)8-q2 ,J'' Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) l. � Workman's Compensation Insurance Check one: ❑ 1 am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance /nnTi�t Insurance Company Name � a;h Wt� Rm uy t Insuanu Workman's Comp.Policy Copy of Insurance Compliance Certificate must accompany each permit. Permit 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 / - #of doors Replacement Windows/doors/sliders.U-ValueZd _(maximum.44)#of windows /*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is requir .SIGNATURE: C:\Users\decolIik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\QK I H7J6E\EXPRESS.doe Revised 070110 I • Massachusetts- Department'of Public SafctN Board of Building Regulations and Standards - Construction Supervisor License License: CS 94500 JAMES S PEACOCK PO BOX 171 s 4 T OSTEVILLE, MA 02632 µ'n 'Expiration: 7/22/2012 ('unuu'isiuncr Tr#: 29233 z , w ya, ��Z6 1JM??llG(YJ2CI.62LCiL O•�'✓(��.JdfU Office of Consumer Affairs&BJsincss Regulation License or registration valid for individul use only , 6 HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 1 Registration 151853 Type: Office of Consumer Affairs and Business Regulation - k/ Expiration 7/7/2012 Private Corporation 10 Park Plaza-Suite 5170 p Boston,MA 02116 Sc TT PEACOCK;BUILDING&REMODELING INC JAMES PEACOCK :t F 1046 MAIN STREET''SUITE 7:. OSTERVILLE, MA 02655 Undersecretary Not valid without signature a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers Applicant Information lease Print Legibly Name(Business/Organization/Individual)' 7 • Address: City/State/Zip:0*f t i j{_ MA p&r Phone.#: Are you an employer?Check the appropriate box: Type of project(required): 1x I am a employer with_ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P t5'• # 9. ❑Building addition [No workers'comp.insurance comp' insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation 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. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. -ohm (As. 600 Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: W%p Job Site Address: City/State/Zip Attach a copy of the workers' co ensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine 1 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 hereb ertify u r e ains and penalties of perjury that the information provided abo a is true and correct Signature: Date: ��Phone#: T Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: rayc ui AiC40 DATE(MMIODIYYYY) CERTIFICATE OF LIABILITY INSURANCE07/19/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER CONTACT Germani Insurance Agency NAME:PHONE FAx 908 Main Street C No E :(508)428-9194 AIc No:(508)428-3068 EMAIL ADD SS: Osterville, MA 02655 PRODUCER CUSTOMERID/: INSURERS)AFFORDING COVERAGE NAIC S INSURED INSURER A: SAFETY INS CO Scott Peacock Building&Remodelling,Inc. INSURERS: P.O.Box 171 Osterville,MA 02655 INSURER C: INSURER D: National Union Fire Ins.Comp. INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITSSHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLISUBR POLICY EFF POLICY EX LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMI MMID LIMITS A GENERAL LIABILITY CP00001152 7/512010 76/2011 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RERT170- PREMISES Ea occurrence) $ _ CLAIMS-MADE OCCUR MEO EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY n PPERCOT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accdent) ALL OWNED AUTOS BODILY INJURY(Per person) $ SCHEOULEDAUTOS BODILY INJURY(Per accident) $ PROPERTYDAMAGE $ HIRED AUTOS (Per acadent) NON-OWNED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESSUAB CLAJMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ D WORKERS COMPENSATION WC 5815464 6/2W010 6/22/2011 vic srnru- oTK AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? NIA E.L-EACH ACCIDENT $ 100,000 . (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 It yes,describe under r DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(AttachACORD 101,Additional Remarks Schedute,if more space is required) CERTIFICATE HOLDER CANCELLATION Scott Peacock Building&Remodeling,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FaW'508-428-7625 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009l09) The ACORD name and logo are registered marks of ACORD T+ r ti Town of Barn-stable ` Regulatory Services • iARNSTASLE, v MAE& $ Thomas F. Geiler,Director 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 Builder I, a�n�oL c , as Owner of the subject J property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: vtilfQ &A Ed , ObJ4*V11tf (Address of fob) . o 10 o Signature of er Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. qi 070h Q:FORMS:O WNERPERMISSION TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map U"] �' Parcel `,0r 7 44 Permit# _ 6 Health Division&VZ,4Z �' �. Date Issued 7 d 1 Conservation Division 9/�f1D] } Fee n 7b Tax Collector Tq- d�/ �' SEPTIC SYSTEM MUST BE, Treasurer INSTALLED INCS�MI�Lpq WITH TITLE 5 - s Planning Dept. ENVIRONMENTAL CC,Lso . Date Definitive Plan Approved by Planning Board TOWN REGUL ; C ', Historic-OKH Preservation/Hyannis Project Street Address Tff R& Village ifSZC) V 1 Owner �cc-TK tua- Address SGc i'Yl:� -Telephone -775 SJ�/ Permit Request 'I C)1,5 t1 O I ,)( f G'kA CL- 16 Ic n C/ OSQi� & d Lkb/E On Tk— f Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation J �Jf• 60 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathiered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 6--' Two Family ❑ Multi-Family(#units) F ,Age of Existing Structure Historic House: ❑Yes P-14o , On Old King's Highway: ❑Yes ❑ No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other 2 = Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) J p Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new -�2 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 0 new size Attached garage:O existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization Cl Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name— ,�0; 0-c Yl e �Ynn l���e e^N( Telephone Number Address /G L/5 /y-Q w-&L ai License# (.,5 W7 4/7 Cb t UdJ�3Y Home Improvement Contractor# 00 74/0 Worker's Compensation # tjQ 0?/7- 9,96 - (� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO CX SIGNATURE ��I�DCP/u �(i(/ /��.�-�-�1 �� DATE • t FOR OFFICIAL USE ONLY J *RMIT NO. r DATE ISSUED: _. MAP/PARCEL NO. ADDRESS : f VILLAGE OWNER' . . t DATE OF INSPECTION: FOUNDATIONir 1 . �,//r•r r FRAME INSULATION -' 4 s FIREPLACE »>> '? .~'`' • ; ELECTRICAL: ROUGH._ FINAL PLUMBING: ROUGH`: :- •' FINAL �. } rk GAS: ROUGH FINAL + 1-1FINAL BUILDING 2&io r • r DATE CLOSED OUT ; ASSOCIATION PLAN NO. r ,s R r • The Town of Barnstable Regulatory Services 1Fo;or•�e Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-79.0-6230, 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: i gaza l.4j�u Estimated Cost Address of Work: 0 9 R C1-41-q11l /LQ_ ALL`r"h P Owner's Name: Date of Application: f I hereby certify that: Registration is norrequired for the following reason(s): []Work excluded by law FlJob 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 ate r Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav ESTIMA TED PROJECT COST WORKSHEET LIVING SPACE -Value (high end construction) 3 square feet X$115/sq. foot= 7a?Nam, V (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X.$25/sq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Value 7 h e Common wealth of Massachusetts Department of Industrial Accidents h° - -- Office 01 18yesUgaU00s 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit narneo location: city I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity t [-ram an employer providing workers' compensation for my employees working on this job. company nam Z-2- �/Al Aq 0 V f_� address. city; OQ f5 phone#• (_56 V insurance co: ' Z A-ti4r_�' / CA-Al policy# Ll1 L' i -� a 7-996 '00 I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who hi-- the following workers'compensation polices: comllany name: address• may: phone#: insarancv:co: polio.# company name: address. _ :_.. city: phone#: iarancrco. policy# Failure to secure coverage as required under Section 25A of h1GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 andiu- 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 Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties of perjut y`that the information provided above is true and correct Signature--�tJQii f� ` - � � _i,L, Date l �v� Printname 4?EDLtOirr_ V. R.fi-Seld 1/1 D� l: :�f• L• Phone#(e d ���`qs-le o fficially do not write in this area to be completed by city or town official permittlicense tt r'lBuilding Department oLiccnsing Board mediate response is required Selectmen's Office 0He2lth Department . phone q; nOther ; (raised 3M PIA) - T/te [�om�nancuea ! a��/ aaaan/u BOARD OF BUILDING REGUtsAT04 IONS i License. CONSTRUCTION SUPERVISOR e fo.n.n6xwealU.a�:l�a N/.,eta, I Number CS 057032 HOME IMPROVEMENT CONTRACTOR Registration: Fri Exp es:A9/26/2001 Tr.no: 5742 Expiration: 6/23/02 es r c ed,'To: 00 Type: Privy oratio THOMAS X CAPIZZI JR 280 PERCIVAL DR - CAPIZZI HOME IMPROVEMENT, : . W BARNSTABL:E. MA 02068 Administrator Thoias -Capizzi, Sr: 1645 Newton Rd. ADMINISTRATOR Cotuit MA 02635 UILDIN ✓/ie l�no�Unwnu G REGULATIONS BOARD OFB : nv�no�uueal(�. n ���avva 4 License: CONSTRUCTION SUPERVISOR DEPARTMENT Of PUBLIC SAFETY I L . Number: CS 007454 I f CONSTRUCTION SUPERVISOR LICENSE -- f r • ! Numbers. Ex i } :9 p � _RestrlCtPd To P �, I Restricted To: 00 THOMAS CAPIZZI r-� r FREDERICK V RASCH I11 1645 NEWTOWN RD `• �. *a«7S i;ram,✓' 3U, Cq-^SK%LL : i COTUIT, MA 02635 Administrator OdS3.� t3ct�A-was Q✓�-Y�/1�t/Q ( � l ^�- iLU,N a tYYuER - NEwD.H.w�.+OOw aYe/ya vD�y 4♦—% NGw ^wN�Yb W/Y Dow � �1 'L WIlf "el Neu OATH . wwut SH c�-rno ue w+u.f ub. . YEW CIRCT /VFW TDIIfT HOr 6VI�bAT6D Foc cN.Y 9V 4T. ' .. MPMemeM��ry�ISE o1CaY��H°me trnPm�eme� . . ' and wbCo/ItrecOom.pnyune ey - . a - ��ahould fieM verAy ell enb6rlg caltlftlo/n�,� . - OCtlBE end Um conk.Jty b bcel en.,state bulldin0 _O N E i -7D 6 �n➢/eVe/INM CIUNtme eny recponyarir�CapDy Hama —. . > � �»�erW(nNn llre uSB of mBee wy�p� 'i-O" mom• CWtrlHwro Mpnnemere• 6B4Ec°"°ea°r°°t �'Y 1.f-a�/ ' n� SNAtoY /u w./e—J'DNNyu.J >f1 66T/ Foc GAPro i. No.ItE INP�ad"9S/B 7;7 oFtKKE r Town of Barnstable Regulatory Services ` n BARNSTABLE, MASS. $ Thomas F. Geiler,Director 1639. n Building Division 5 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office:,508-862-4038 Fax 508-790-6230 August 12, 2010 Patricia O'Neil 'rµ 1292 Craigville Beach Rd. Centerville, Ma. 02632 RE: 1292 Craigville Beach Rd., Centerville Map:207`Parcel: 074 > - Dear Ms. O'Neil: _ This letter is to remind you of a continuing violation at.the above referenced property. As you may recall, you were notified in February of 2007 that the'prop erty was in violation of the Town of Barnstable Zoning Ordinance Chapter 240 Section 11.To date, our records do not show that the problem has been resolved. Be-advised that the building permit recently issued by this office is for the removal of fire damaged materials only, to expedite the process of getting you back into your home. A separate building"permit will be needed to reconstruct the building and the application must contain resolution to the zoning violation. Thank you for your immediate attention in this matter. , Sincerely, We auzon Local Inspector (508) 862-4034 j Q:zoning5 ± TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- Applicationw � ZZ h-7 I , r, Health Division Date Issued o Conservation Division =Application Fee j. Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis V Project Street Address C'FA tQ V L LZ e- njcl�( Village lie/)T e 12-V L (e, Owner C I I Address Telephone SO f3 7 5- S-54 YZ Permit Request /tee o Vi_- ILe l��r-,,,��, � ° C�-�/'�� ,, .,S'O,»e Wilk J Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation &a-TV& 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 ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# f .e Current Use . _ __ .,T.T, Proposed.Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) (Name Zo't lC r c c c° Telephone Number Address ly Co L e-7'T`S 1w License# L°S r 4 dt2 141 /fit c 4 0 Z6 Y g Home Improvement Contractor# ` a R ®3 i Q Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7-2-7- 1 a FOR OFFICIAL USE ONLY APPLICATION# 'DATE ISSUED MAP%PARCEL NO. - Y ' _ r ADDRESS VILLAGE OWNER DATE OF INSPECTION: 7 FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL 14 FINAL BUILDING .l DATE CLOSED OUT f ASSOCIATION PLAN NO r The Commonwealth of Massachusetts Department of Industrial Accidents , . Office of Investigations Y 600 Washington,Street c ` •Boston, MA 02111. . y www.mass.govIt uz ,t Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information - Please Print Legibly Name (Business/Organization/Individual): �'�,U_LT1 Address:� La,/D t ^ ��' u o T,Id Ai4S,4 ,Dee G S�} City/State/Zip: Phone #: � �'12 Are you an employer? Check the appropriate box: . Type of project(required): IOU I am a employer with 4. []'I°am a general contractor and I .: have hired the sub-contractors ` 6 ;❑New constructton_ . ' employees(full and/or part-time).* Remodelin, 2. I am a sole proprietor.or partner- listed on the attached sheet. 7• ❑ g ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition s or additions [No workers' comp. insurance comp.insurance.#. 5. Q We are a corporation and its 10.❑°Electrical repair required.] ' 3.❑ I a homeowner doing all'work. officers have exercised their l l.E] Plumbing repairs or additions myself. [No workers' comp: right of exemptionper MGL ~l2.❑ Roof repairs required.]insurance re t c.152, §1(4), and'we have no . ' q ] employees. [No workers' 13:0 Other_ comp.insurance required.] *Any applicant that checks box 41 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. lContractors that check this box must attached an additional sheet sho�virig the name of the sub-contractors and state whether of not those entities have employees. If the sub-contractors have employees,they must_provide their workers'comp,policy number.. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. ' • Insurance Company Name: Policy#or Self-ins.Lic.#. ,.' Expiration Date: h- �+ Job Site Address: X elm au, itC &� � 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 MOL e. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-yearimprisonment, as'`well as civil penalties in the form of a STOPWORK ORDER and a fine of up to$250.00 a day against the violator: Be'advised that a copy'ofthis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. , I do hereby cer ' tinder the pains andpenalties ofperjury that the information provided above ts true and correct. Si ature: p" 1.:. , Date: � � -7 •Phone# � �6 Official use only. Do not write in this area, to be completed by city or town officidL City or Town: Permit/License# Issuing Authority (circle one):: \ <_ 1.Board of Health 2. Building Department 3 City/Town Clerk 14.Electrical Inspector S:Plumbing Inspector 6.Other Contact Person: Phone#: i information and. lustructi'ons ' Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, 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 tie foregoing engaged in a joint enterprise, and including the legal.representa,tives 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, constniction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also slates that"every state or 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,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of pubJic--work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies (LLC)of Limited,Liability Partnerships(LLP)with no employees other than the members orpartners, are not required to carry workers' compensation insurance. if an LLC or LLP does have employees, apolicy is required. Be advised that this affidavit 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 refurned 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 wo rkers' ber listed below, Self-insured companies should enter their compensation policy,please call the Department at the num self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permiAcense number which will be used as a.reference number. In addition,an applicant that must submit multiple permiUlieense applications in any given year, need only submit one affidavit indicating current under"Job Site Address" the applicant should write"al] locations in (city or policy information(if necessary)and town). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or coFnmercial venture (i,e,a dog license or permit to bum leaves etc,)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, Please,do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-87.7-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia oFtKE ro Town of Barnstable Regulatory Service_s BARNMULE, Thomas F..Geiler,Director , Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 t www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using.A Buildev .v f as Owner of the subjectproperty hereby authorize a uL-n SyL rr— , RIf 57-Va-/W o,✓ to`act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) C/� Signature of Owner. - t Date 7/-?W e L µ ' Print Name N If Property40wner is applying„for`permit please complete the ` Homeowners License Exemption Form on the reverse side. { Q:FORMS:OWNERPERMISSION E Town of Barnstable , pF THE Tp� - Regulatory Services " Thomas F. Geiler,Director * " + LARNSI'AHI.E, MASS. 1639. ��� Building Division oTfpa Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.t own.b am s t a b 1 e.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION . Please Print DATE: JOB LOCATION: number street village "HOMEOVA'NER": - 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 s ' 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 Offcial,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 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 sweral towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\bomeexempt.DDC o From: 07%27/2010 14:5B #571 P. 001/001 r Client#:34309 MULTtSTA ACORD. CERTIFICATE OF LIABILITY INSURANCE F OATE(MMlO°"YY"' 7/27/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ICONTA cT Marla BarnowskT Starkweather Shepley N"i"E:--.-_.-- HON :401 435.3600 'k PO Box 549 E E -.L___-- _._-- c,Nor_401 431 9326 FAX Providence,RI 02901-0549 ADDRESS: mbarnowskl@starshep.com -....._...._. 401435-3600 cusro�tERIDp;• MULTISTA - _-.-__-.____ _._..---_-------.._._._._:__._._._..__..-_.-............._........_...... ..................._: . ...............__._._.______.___.-•_--_.._._._...._.._----_.._._._---_-.—.-_._._.---.—._._.._..�_._..._._-----.--._.._._._._-___._..--.__-.-�INSURER(S)AFFORDING COVERAGE INSURED -...---...___.._._.___.__.._.._............_._...___.........._._._L.NAICti__..........---. - Multi-State Restoration Cape Cod I wsuRERA:Employers Mutual Ins Division, Inc. INSURER B:Beacon Mutual.Ins Co I 1135 Charles Street weuRERc: North Providence,RI 02904 INSURER D: C7� 7a%/-9/✓/ P/JDL� IINSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1NSR! ADOL eR ' LTR1 TYPE OF INSURANCE SR POLICY NUMBER POUCY EFF iPOLICY P •-• MW 0 1 MWDQIYYYY 1 LIMITS q GENERAL LIABILITY I 3D6630911 1/201001/Q1Y2011 EACH OCCURRENCE )s1 000000 X I MERCIAL GENERAL LIABILITY CO"" PREMISES Ea occurrence I s300 000 ' �AADE X OCCUR CLAIMS f i 1 MED E!(P(Any one person) ' I I PERSONAL&ADV INJURY : $1 000 000 I _ GENERAL AGGREGATE 1 S2 ..._.._ 000,000 GEN L AGGREGATE OMIT APPLIES PER: ( FPOC ,COMP/OP AGG I$2 000 Q_- _ _.POLICY PRO- LOC OO A AUTOMOBILE LIABILITY I 3E6630911 01101/2010'01/01/20111 COMBINED SINGLE LIMIT 1 XJ ANY AUTO ? j • (Ea accident) I s _._.—__._..--_._.-._.___._-..._ 1 OOO OOO ALL OWNED AUTOS i I BODILY INJURY(Per person) s _ I —.._.--- --- --- ...--- I I ' i y.__..___..__.--------------._-_.........__._ ' i SCHEDULED BODILYINJURY(Peraccident)18 - -XJ HIRED AUTOS ? I i PROPERTY DAMAGE - (Per accident) $ XI NON-OWNED AUTOS X; is Drive Other Car $ j UMBRELLA LIAR A9 I I - OC ' EACH OCCURRENCE EXCESS LIAR 'CLAIMS-MADE I - j F---•----- --.._.$ -------------- -----.---- ---- ----� I AGGREGATE ' DEDUCTIBLE i--._.._.._.__...._...._.-__......_._._._..._._I$_.... --.._._..:. .._....__......_...._ RETENTION I - - {. _._._..-•----._._.__ S._._.._..__......_._._.._._..._....._.:. 'tt WORKERS COMPENSATION - 508� ' ' I$ B ,,ANDEMPLOYERS'UA81Lny YIN I 1 2/0 1/2 0 0 9 1 1 2/01/2 01d WCSTATU- I .OTH- . ANY PROPPJETORIPARTNERIEXECUTIVE I !I ITORY1IMli& OFFICERIMEMBER EXCLUDED? I NIA s - - i E.L.EACH ACCIDENT $$QQ,000 (Mandatory In NH) I I ........................_..,.._---.-.-....___._....._._......._....._.. HyS describe under I ) 1 E L DISEASE-EA EMPLOYEE$500,000 DESCRIPTION OF OPERATIONS below I 1 E.L.DISEASE-POLICY LIMIT I$500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) - RE: Patricia O'Neil,1292 Craigvllie Beach Blvd.,Centerville,MA CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE 01988.2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009109) 1 O f 1 The ACORD name and logo are registered marks of ACORD 4S276446/M274190 . . MBB MULTISTATE RESTORATION INC, Fire o Flood o Wind P.O. Box 2210 • Mashpee, MA 02649 • Tel: (508) 477-3333 • Toll Free: (866) 921-9111 • Fax: (401) 723-8294 CAPE COD DIVISION • roy@multi-staterestoration.com 07/27/10 To Whom It May Concern; Richard Lauria is employed by Multi-State Restoration. He heads up my demolition & construction division. If I can be of any further assistance I can be reached at (508)-922-8965 Thank You Roy M Ricci (Owner Multi-State Restoration) Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 w Boston, Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 140427 Type: Corporation Expiration: 10/15/2011 Tr#: 290319 MULTI-STATE RESTORATION, INC :CARE a ROY RICCI P. O. Box 2210 --- MASPHEE, MA 02649 ; Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card DPS-CA1 is 50M-04/04-G101216 ✓fie �arrhnaruaeczllt a��aaacfivaelta - Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registratioki .R140427 10 Park Plaza-Suite 5170 w Expiration ,,1:Q/F5/2Oil Tr# 290319 Boston,MA 02116 Type;,a�-sCorpoiafion;-'- MULTI-STATE RESTORATION INC.CAPE COD ROY RICCI 21 PEQ0OT RD. MASPHEE,MA 0264'9` Undersecretary vali without signature ttitiucliuutts- D(p,t►tnicnt of Public Sufch Bo�u-d of Buildin(y Rc2ulations :ind Standurd5 Construction Supervisor_License License:-cs 51784 Restricted to;'1 G J RICHARD, D LAURIA I 1 LEAH DR ROCKLAND, MA 02370 I Expiration: 4/1/2011 ('pnuni,lirmer. t Tr#: 14552 " P I - Map Page I of 2 Town of Barnstable Geographic Information System New Search I H, Parcel Viewer -Custom Map Map Size [3 Zoom Outj g I I I I N j MIn F JIJU Map: 207 Parcel: 074 207069 ZY I Location: 1292 CRAIGVILLE BEACH ROAD j�o 07057 207012 349 207062 %V Zp Owner: ONEIL MARK & KEVIN TRS - it 614 #6 207118 3.29 46, k , 20 7116 L#357 - . ......................... ...... .................. .............. ............ ... .... 2079Af 207070 #SO Location Information #638 #169 Map & Parcel 207074 20.7081- -447 Location 1292 CRAIGVILLE BEACH ROAD W7000 1�8 1- #1312 Acreage 0.61 acres 406 207071 #39 V 1324, 1..,., 1 . , .1 .e207072001 ................... 31 ["Current Owner 07 A Mailing Address ONEIL, MARK & KEVIN TRS 1314. C/O ONEIL, ERIN 2 COY BROOK LN 207073 HARWICHPORT, MA 02646 #:1300 N 76 2070 207065 Ais Braised Value (FY 2006) It i31ll rl # #419 207064�- 40 Extra Features $16,800 ", R, 7142 20,714 Out Buildings $23,300 207066 k ii2§2 94 i 439 Land $228f300 Buildings $136,400 207075 127.6 Total Appraised $404,800 Assessed Value (FY 2006) 207077 2070 5.idb L,'-�............... # Extra Features $16,800 206,081003 20601,9�� Out Buildings $23,300 . . ... 55 206081001 Land $228,300 7,CT 1250 2 5 El Buildings $136,400 Set Scale 1" i Aerial Photos Total Assessed 1404.800 Copyright 2006 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS - BarnstableMA v0.2,7 [Production.) http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=207073&mapparback=address 12/11/2006 Barnstable Assessing Search Results Page 1 of 3 Home: Departments:Assessors Division: Property Assessment Search Results New Search '; K. 0 'New Interactive Maps >> Owner: 2006 Assessed Values: ONEIL, MARK& KEVIN TRS 1292 CRAIGVILLE BEACH ROAD Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $ 136,400 $ 136,400 207 /074/ Extra Features: $ 16,800 $ 16,800 Outbuildings: $23,300 $23,300 Mailing Address Land Value: $228,300 $228,300 ONEIL, MARK& KEVIN TRS C/O ONEIL, ERIN Totals $404,800 $404,800 2 COY BROOK LN HARWICHPORT, MA. 02646 2006 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $76.63 Fire District Rates Town Barnstable-Residential $1.90 $6.31 Barnstable-Commercial $2.51 Commercial C.O.M.M. FD Tax(Residential) $429.09 C.O.M.M.-All Classes $1.06 $6.54 Cotuit FD-All Classes $1.33 Personal Property Town Tax(Residential) $2,554.29 Hyannis-Residential $1.61 $6.49 Hyannis-Commercial $2.50 Other Rates W Barnstable-Residential $1.60 Community Preservation Act 3%of Town Tax W Barnstable-Commercial $2.46 Total: $3,060.01 Construction Details http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO6map.asp?mapparback=parcel&mappar=207074 12/11/2006 r Barnstable Assessing Search Results Page 2 of 3 Building Building value $ 136,400 Interior Floors Carpet Property Sketch Legend Style Ranch Interior Walls Drywall Model Residential Heat Fuel Gas Grade Average Heat Type Hot Air r T _ Stories 1 Story AC Type None Exterior.Walls Vinyl Siding Bedrooms 4 Bedrooms Roof Structure Gable/Hip Bathrooms 4 Full Roof Cover Asph/F GIs/Cmp living area 1286 Replacement Cost $170487 Year Built 1950 � t Depreciation 20 Total Rooms 8 Rooms Land CODE 1010 Lot Size(Acres) 0.61 Appraised Value $228,300 =View Interactive Maps >> Assessed Value $228,300 Sales History: Owner: Sale Date Book/Page: Sale Price: ONEIL, MARK& KEVIN TRS Aug 30 2001 12:OOAM 14187/201 $ 100 ONEIL, PATRICIA Jun 15 1987 12:OOAM 5802/295 $ 1 ONEIL,WILLIAM R 1282/658 $0 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FGR2 Garage-Avg 656 $ 11,600 $ 11,600 BFA Bsmt Fin-Aver 1200 $ 14,400 $ 14,400 SHED Shed 360 $ 1,700 $ 1,700 http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO6map.asp?mapparback=parcel&mappar=207074 12/11/2006 Barnstable Assessing Search Results Page 3 of 3 GRN2 COMM GLASS 756 $4,300 $4,300 GRN2 COMM GLASS 1040 $4,400 $4,400 GRN2 COMM GLASS 160 $800 $800 FPL1 Fireplace 1 $2,400 $2,400 SHED Shed 128 $500 $500 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO6map.asp?mapparback=parcel&mappar=207074 12/11/2006 d. Parcel Detail Page 1 of 3 al ? p at io - 3 us v Logged In As: Parcel e i I Thursday, Febru Marcel Lookup Parcellnfo Developer Parcel ID.207-074 Lot,LOTS A& B _. ...._. _ . _ .. _. .. ....... Location 1292 CRAIGVILLE BEACH ROAD Pri Frontage 109 Sec Road Sec Frontage ........ ........ ......... ........... village CENTERVILLE Fire District,C-O-MM ......... ................... ................... ... _......... ............ Sewer Acct Road Index 0369 jq "'' Interactive Maps Owner Info ... ........ _ ...... ........ Owner ONEIL, MARK& KEVIN TRS Co-Owner; _._......._ __ ......... ....... ...... Streetl '1292 CRAIGVILLE BEACH RD Street2 I City'CENTERVILLE State MA zip',02632 Country Land Info ......... _ __... ......... ...................... _.... ..__. Single = _1 Acres 10.61 Use Sin le Fam MDL-01 zoning °RD1 Nghbd 0108 Topography€ Road Utilities Location Construction Info Building1of1 Year' Roof Ext 1950 ,Gable/Hip Wall:Vinyl Sldrng Built` Struct Effect Roof I __ AC Area 1568 Cover lAsph/F GIs/Cmp Type None Style Ranch Wa11 Drywall Rooms 4 Bedrooms _._ lalh Model =Residential Floor -.. R oms E4 Full _.............._.._.,_.,..n, ". Heat Total ._..,, „ ......_ Grade:Average Type 1 Hot Air Rooms,8 Rooms http://issgl/intranet/propdata/ParcelDetail.aspx?ID=14558 2/1/2007 Parcel Detail Page 2 of 3 t � r ... __..... ......... FE ........... 3 i L. Heat Found- Stories i 1 Story Fuel 'Gas ation!Typical }F Permit History Issue Date Purpose Permit# Amount Insp Date Comrr 1/14/2004 New Roof 74178 $5,800 7/26/2004 12:00:00 AM 7/2/2001 Remodel/Renov 54267 $7,200 4/8/2002 12:00:00 AM - Visit History Date Who Purpose 7/26/2004 12:00:00 AM Martin Flynn Drive by inspection only 4/8/2002 12:00:00 AM Martin Flynn Meas/Listed Sales History „ ...:._ Line Sale Date Owner Book/Page Sale P 1 8/30/2001 ONEIL, MARK& KEVIN TRS 14187/201 2 6/15/1987 ONEIL, PATRICIA 5802/295 3 ONEIL, WILLIAM R 1282/658 Assessment History ......... ............................... .................. ......... ............ . Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2006 $136,400 $16,800 $23,300 $228,300 2 2005 $124,100 $16,200 $24,100 $210,100 3 2004 $101,100 $16,200 $24,500 $210,100 4 ` 2003 $93,300 $16,200 $25,100 $136,800 5 2002 $87,200 $6,900 $15,300 $136,800 6 2001 $87,200 $6,900 $15,300 $136,800 7 2000 $61,600 $6,100 $13,900 $73,000 8 1999 $61,600 . $6,100 $13,900 $73,000 9 1998 $61,600 $6,100 $13,900 $73,000 10 1997 $68,600 $0 $0 $73,000 11 1996 $68,600 $0 $0 $73,000 12- - 1995 $68,600 $0 $0 $73,000 13 1994 $65,100 $0 $0 $73,000 http://issql/intranet/propdata/ParcelDetail.aspx?ID=14558 2/1/2007 Parcel Detail Page 3 of 3 14 1993 $65,100 $0 $0 $73,000 15 1992 $74,100 $0 $0 $81,100 16 1991 $83,300 $0 $0 $97,400 17 1990 $83,300 $0 $0 $97,400 18 1989 $83,300 $0 $0 $97,400 19 1988 $69,600 $0 $0 $46,800 20 1987 $69,600 $0 $0 $46,800 21 1986 $69,600 $0 $0 $46,800 Photos I http://issql/intranet/propdata/ParcelDetail.aspx?ID=14558 2/1/2007 .,��THe,Ot�ti Town of Barnstable *Permit# Expires 6 months from issue date r7 ,AR,,, Regulatory ServicesSUBL Fee �7 = v MASS. � Thomas F.Geller,Director. ® __ lEt,ram'` Building Division Tom Perry, Building Commissioner , u 200 Main Street, Hyannis,MA 02601 )-® 4.ZQln4 �61 `' Office: 508-862-4038 Fax: 508-790 6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY � Not Valid without Red%Press Imprint Map/parcel Number_ Olr 0 r G -ovl, Property Address ',Residential 7 Value of Work Owner's Name&Address Contractor's Name Telephone Numb er ��a� j Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: 104am a sole proprietor u I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken ❑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,Le.Historic,Conservation;etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature Q:Forms:expmtrg Revise053003 V ' A. TDarr�rrzoouuea o�✓ltaaaaclucaeda Board of Building Regulations and Standards HOME IMP OVEMENT CONTRACTOR m I. stern:_ t j r 1 T, �212005 r =a, 'f 74 7ev vidual __-. MICHAEL S.TUC MICHAEL TUCKED 19 CAPTAINS _- HARWICK MA 02645 °' Administrator Poi row�o Town of Barnstable h Regulatory Services 1 B L ' Thomas F.Geiler,Director 9`bpT'16 r+- 61 Building Division _ Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 508-8624039 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Usirig A Builder - ;.as.0uinet..of the. property- .... ........._.. .. hereby authorize in all matters relative to work authoized•by this building.pe=oit-application for: (Address of Job) ; — 04 o S' ke Owner Date Print Name , Town of Barnstable Regulatory Services * * snxNSTABLE, v MASS. g Thomas F.Geiler,Director 039. & Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4024 Fax: 508-790-6230 February 14, 2007 Mrs. Patricia O'Neil 1292 Craigville Beach Road Centerville, MA 02632 RE: Illegal Apartment: 1292 Craigville Beach Road Centerville, MA 02632 Map : 207 Parcel : 074 Dear Property Owner, This letter is to inform you that you currently are in violation of Barnstable Zoning Ordinance 240-11 You must contact this office by February 28, 2007 to arrange to bring the above address into compliance or be subject to fines of no more than $300.00 per day of non-compliance. Thank you for your attention in this matter. By Order, n a Edson Amnesty Zoning Enforcement Officer Building Department Q:zoning5 ... ,.v,r � g z r x �::` � � ���: k << _,.. � i {-j ....�a.,,,.. I, Ali x'�a mUS 3R� �, � m ffi d F gB w. x < �kgsOi t x $z � € ll r Rows IN LANG s /�-i�-o/ �� Ir o. p y P� ,i 1W, a 13t, �,.u�vibe �c4 ah �. �,�` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 11A Application # -7, 1_7 ) Health Division Date Issued Conservation Division _,Application Fee Planning Dept. ° Permit Fee' Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 12 g Z CI[nL; ✓i l Ca— lBeaLl, ! . Village Le".c ✓i, Owner ?aJ-f i C['0_ ' AJ e L( Address IZ9 Z Cr"Li s Ville Ee2`� . Telephone s-y Permit Request Lam - L Z )C 3 t, 41 V �O L( 0 huyc_ �v 0.5e- Q. i. ✓t T�c.4 II S 2 t LJ Le r1AAAa Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑`No If yes, attach supporting documentation. Dwelling Type: Single Family: 6a" 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) c , Number of Baths: Full: existing / new Half: existing new Number of Bedrooms: existing _new ! Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 2 , : 2 CD Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ $_r_�J yrD Commercial ❑Yes ❑ No If_yes, site plan,review# Current Use Proposed Use t r APPLICANT INFORMATION CO (BUILDER OR HOMEOWNER) Name &,,ea�� & i&' Z&wc ITac_ Telephone Number 32 Address '5-t V OZt /►W _ 9)4t,04mi�4 _146Q License # �I`Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7 7 l b FOR OFFICIAL USE ONLY i APPLICATION# DATE ISSUED_ " PARCEL.NO:_. ADDRESS... VILLAGE OWNER DATE OF INSPECTION: I a,-fFOUNDA_T_ION FRAME _.. 1 Y iINSULATION`t -` ,4 �1 FIREPLACE r ELECTRICAL: ROUGH ' FINAL PLUMBING: ROUGH FINAL � 'ii GAS 4 57V 4- ROUGH .' K 5 FINAL &-i FINAL}BUILDING .a.QrG';J•. : DATE CLOS.EDAOUT _= _ } ASSOCIATION PLAN NO. if ,i The:Commonwealth of Massachusetts y Department.Of Industrial Accidents Office of Investigations 600 Washington Street c Boston, MA 02111 yy www.mass.gov/dia Workers' Compensation Insu ran ce.Affidavit:.Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �M 2 r!('Gd•�� Yy�Ur/J� �3 ��� Address: City/State/Zip: Phone #: ��/ 3 �� 6333 Are you an employer? Check the appropriate box: Type of project(required): am a employer with 1� 4. ❑ I am a general contractor and I New.construction employees(fiiil and/orpaIt-time).* have hired the sub-contractors., 2.❑ I am a sole proprietor.or partner- listed on the attached sheet. 7. ❑ Remodeling These sub-contractors,have g, ❑ Demolition ship and have no employees working for me in any capacity.' employees and have workers' 9 ; ❑ Building addition [No workers' comp. insurance comp.insurance. required.] 5. ❑ We.are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 1.❑ 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.❑ Other comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below.showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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. I am an employer that.is providing workers',compensation insurance for my employees. Below is the policy and job site information. ,/ Insurance Company Name: �✓t A -S 4P ZA',— Policy#or Self-ins.Lic.#: �!�� 37� Expiration Date: / Z. Job Site Address: 2 Z C I/ - City/State/Zip:_ �,.�t--r�� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the pains�pen !ties of perjury that the information provided above is true and correct. ��" Date: �/-7/) S i nature; r Phone# Official use only. Do not write in,'this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector. 6. Other Contact Person: Phone#: Information and Xnstruc ions Massachusetts General La4vs chapter 152 requires all employers to provide sderviworkers' of another Compensation oplh e, PursLiant to this statute, an employee is defined as "..,every person in the express or implied, oral or written." fined as "an individual, partnership, association, corporation or other legal entity, or any two or more An employer is de of tl.c foregoing engaged in ajoint enterprise, and including the legal representatives of a deceased employer, or the vidual, partnership, association or other legal entity, employing employees. However the receiver or trustee of an indi owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of an who employs persons to do maintenance, constn�ciion or repair work on such dwelling house or,on the grounds or building appurtenant thereto"shall,not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also 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 tvho has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall m enter into any contract for the performance of publicwork until acceeptable evidence.of compliance with the insLvance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out.the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if supply sub-contractors)n necessary, ame(s), address(es)and phone numbers)along with their certificaie(s) of insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the_ members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees"e policy is required. Be advised that this affidavit may be submitted to the Department of Indust a] 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 obtain a work Industrial Accidents. Should you have any questions'regarding the law or if you.are required to Workers' please call the Department at the number listed below..Self-insured companies should enter the compensation policy, ir self-insurance license number on the.appropriate line. City Or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. J Please be sure to fill in the.permiojicense number which will be used as a,reference number. In addition, is applicant that must submit multiple permit/license applications in any'given year,need only submit one affidavit indicating current �ity or policy.information(if necessary)and under"Job Site Address" the applicant sbould write"all locations in town). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the town) a valid affidavit is on file for future permits or licenses. A.new affidavit must be filled out each applicant as proof that year. Where a home owner or citizen is obtaining a license or permit not related to itiz any business or commercial venture (i,e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. ould like to thank you in advance for your cooperation and should you have any questions, The Office of Investigations"w 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 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 . Revised 4-24-07 www.mass.gov/dia Jul 07 10 09: 38a american mobile homes 781 -335-0707 P. 1 ACC>R& CERTIFICATE OF LIABILITY INSURANCE "A,y22,2009' PRODUCER - THIS CERTIFICATION IS ISSUED AS MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Duncan e Ins,Agcyl., Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 835 Broadd Street. Weymouth,MA.02189 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. E. ' INSURERS AFFORDING COVERAGE NAIC N INSURED- •--•-- - INSURER A: Scottsdale Ins.Co, American Mobile Homes,Ina INSURERS: Insurance Company of State of PA. " 51 Moore Road INSURER C: "Arbella Protection E.Weymouth. MA.02189 _.,.. - ------ INSURER D: " INSURER E: COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID_CLAIMS., IN5 ADU' POLICY NUMBER -T POLICY EFFECI'1VE`•VOLICY EXPIRATION LIMITS LTR INSR TYPE OF IN9URANCE DATE MMV D(YYI DATE.MM/DD/YY GENERAL LIABILITY - - 02/04/2009 02/04/2010- EACH OCCURRENCE - E $1,000,000 A X BCS0018023 COMMERCIAL GENERAL LIABILITY PREMI ES Ee occurence 9 CLAIMS MADE u OCCUR ' MED EXP(Any one perem) PERSONAL&ADV INJURY I ------- GENERAL AGGREGATE I $1,000,000 GEN•L AGGREGATE LIMIT APPLIES PER' PRODUCTS-COMPIOP AGG' S --�POLICY PRO--JECT LOC _IO - --S•--- - aurOMoBILE uAeluTr :23DO4400DOO -- 02/25/2009 - 02/26/2010- COMBINED BINr.LF I IMIT t -$1,000,000 C ANY AUTO - - (Ea acrJdeni) , ALLOWNEDAVTO& - - - .BODILY INJURY -, B X SCHEOULEDAUTOS (Perperedn) _ HIREDAUTOS -- -- BODILY,INJURY -I. NONdVuNEO AUTOS (Per ecadent) PROPERTY DAMAGE I . - (Perecddent) GARAGE LIABILITY 01/01/2009 01101/201.0 AUTO -ONLY EA ACCIDENT .I - $1.000,000 361744000g0(' I ANY AUTO OTHER THAN EA ACC s _—......._..:�—_ X Scheduled Autos AUTO ONLY, AGG S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE f , --,,OCCUR CLAIMS MADE .' AGGREGATE•,, •-•--- f y DEDUCTIBLE a` . RETENTION i $ WORKERS COMPENSATION AND - '08112/2009 '.,-•, O8M 2/2016 x TGRY LIMITS ER I t3 EMPLOYERa'LIABILITY WC 987 3731 - I ANY PROPRIETORIPARTNERlEXECUTIVE E.L.EACH ACCIDENT .S 100,000 OFFICER/MEMBER EXCLUDED? E,L.DISEASE-FA EMPLOYE 'I If Van,daarnbe under _SPECIAL PROVISIONS below E.L;DISEASE-POLICY LIMIT I $00,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS l vLHrCLES I EXCLU610N5 ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Rental of Mobile Homes •� . CERTIFICATE HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE11E0 BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTIC!TO THE CERTIFICATE HOLDER NAMED-TO THE LIFT,BUT FAILURE TO DO$0 5HALL� F IMPOSE NO OBLIGATION OR LIABILITY OF ANY XiND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, .. - AUTHORIZED RE E -ACORD 25(2001108) (D ACORfaRPORATION 1988 AMEMCAN MORE HOMES INC. 51 Moore Road AMH Weymouth, .MA.02189 (781)331-0333 1-800-232-9991. PROPOSAL Fax'(781)335-0707 w Date 7 0 Name { C Ck_ .� /u-4e-6, � Est. delivery date. , Address lL S Z Cr�c s►�/��� C�- l� �s Zvi , � American Mobile Homes,Inc.hereby propose to furnish the materials and perform the labor necessary for the completion of installing ram— 1.Z 3 leased mobile home containing: Refrigerator,stove,dining set, living room set,curtains,bedding Ist_f1A4A_,2ud__ 3rd— ,washer and dryer,/air conditioning. porary Plumbing installation to mobile home . Applying for building permit for mobile home 1-Temporary Electric installation to mobile home A3 Remove necessary trees,tree limbs or shrubbery ❑ Temporary LP gas installation to mobile home ❑ Remove any necessary fencing ❑ Other: Any resulting damage to said property as a result of the installation,removal and existence,of mobile home and its its utility connections shall not be the responsibility of American Mobile Homes,Inc.,specifically driveway,fence, stonewall,:septic system,trees, lawn.or any other type of landscape items and/or: American Mobile Homes,Inc:;is not responsible for the re-installation of any of these items. Costs: The monthly rental of the mobile home mos. The'delivery and pick up charge of Air conditioning 'Pet fees , 361D. other Theremill be additional charges for utility connections,permits,fees,site preparation: F There will be a profit and overhead charge of 10& 10 for all sub contractors and fees paid out. ' Any applicable sales tax.A 50/6:carrying cost will be billed and payable on all invoices not paid within 45days of billing. A$1,000.00 security deposit is due on delivery of mobile home:Uwe agree to sign a lease for the mobile hom rental at delivery. , Projected job cost: l l�. !/UZ� Z� �f(� i'N Payment Method : Billed directly to insurance company with a signed assignment of payment. ❑ Other: Any alteration or deviation from above specifications involving extra costs, will become an extra charge over and above the estimate. All agreements Respectfully submitted contingent upon strikes,accidents or delays beyond our.control. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. If insurance company is not willing to honor assignment of payment;I/we understand Uwe will be responsible.for.full payment of all services. NOTICE OF RIGHTS TO CANCELLATION You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the Seller,which may be his main office or branch thereof,provided you notify the Seller in writing at his main office or branch by ordinary`mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signi Bement. See attached notice of cancellation form for an explanation of this ignature Date. Signature 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: Registratio r�n' 106386 Board of Building Regulations and Standards ? Expiration 7>/2312010 Tr# 271199 One Ashburton Place Rm 1301 Boston,Ma.02108 TYpe7EPrivate Corporation •AMERICAN MOBILE .: FRANCIS WARD�II _ 51 MOORE RDE.W EYMOUTH,'M 021.89 Administrator Not valid without signature - = - IVlassuclIUS.C. ts..- Department of Public Safety Board of Buiididg Regulations and Standards .,Construction•-Supervisor License License: CS 57291 a, a Restricted to 00 � — }t � �`�94c r4 far s• FRANCIS V=WARD III ,51 MOOREIRD WEYMOUTH MA�0 2189 ` • • ` .Expiration: 9/17/2011 C:ommissi6ner Tr#: 2211 y s a t � n rF. �P � Ile `�� 7 y�Yyr i Appeal ors Permit tVa Apelf" j Statu s Pending � Last First E Applicant,..,O'Neil IPatricia .1292 Craigville Beach Road � wvkw � � zz" 1%illa a Centerville MA 02632 � " z Aff Received Map par.' 207074 Zonmgr 4 r ,. BRAW MINA . Note bldg per app 200700901 for Patricia O'Neil,mother,to live in ,; I main house,son,owner to live in apt, not submitted, not n, ?approved by BOH,needs title 5&floor plans. LE letters 2006 2007 on� v Closers b ,AO 0141M _ :`i�rt s ,axi7a2� �-V t � m �d d 4 v 2 Y Naemd w t a FIME T Town of Barnstable Regulatory Services x x x x * BARNSTABLE, x MASS. g Thomas F.Geiler,Director IE1639. & Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4024 Fax: 508-790-6230 February 14, 2007 Mrs. Patricia O'Neil 1292 Craigville Beach Road Centerville, MA 02632 RE: Illegal Apartment: 1292 Craigville Beach Road Centerville, MA 02632 Map : 207 Parcel : 074 Dear Property Owner, This letter is to inform you that you currently are in violation of Barnstable Zoning Ordinance 240-11 You must contact this office by February 28, 2007 to arrange to bring the above address into compliance or be subject to fines of no more than $300.00 per day of non-compliance. Thank you for your attention in this matter. By Or , nda Edson Amnesty Zoning Enforcement Officer Building Department Q:zoning5 cFTHE ram, Town of Barnstable Regulatory Services BMtNSTAB ASS.�' MASS. " Thomas F.Geiler,Director 9 �p i63y. ♦� rE039.,A Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 Decemberl2, 2006 Kevin &Mark Oneil Trs. C/O Erin Oneil 2 Coy Brook Lane Harwichport , MA 02646 Re: Illegal Apartment: 1292 Craigville Beach Road Centerville, MA 02632 Map: 207 Parcel: 074 Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincerely, L--inch Edson Amnesty Zoning Enforcement Officer Building Department gforms:zoning3 1 u i=1i2..:Edlt Ttrls �i �Y a ., x di .a c: ty� tadN w ,2L� NayP .t cH(r a s#d!"6aA 4 �1( 1 � � }1 r,. ;'' � "ilk''" N icrh t. Status '* T1 i?trae> 5 2 } ., DepartmantP a B 11Li�N a i EP TENT' ., ONE i_, tf41� `8 �1asel errgr ectlActiv £}1 PAMI,L- AP'T W�Na tbNST rx t +` n '' l0, ow Descnptioi�l Fr 1 1LY P Th9 NT S�T£t "u'E�IIU APi Tht NT0�15 3US Business escxa titt� a1C�T sw T � i 1Nti �USIPRTICB"Nii� a s isc R a. Fees effective";d} AMM.1 Sd7 _ �4s�gned to N Propefty/ tse t+9ori-uOrifonTling Clates li'sc Perms Business last - vr 4 sra ti. rtion :1 � rsi` " ,, linrE Existing use i'. 1Q14k# S Reactivate Street CRf i Li EBE Ct1 ROA x t �r aor ng SPLT SPLIT Hai �y,� wro' tom. u A ,te am I Mlil�`h b. '"w,P � •� 'P0�e1 i -RJnicipality CENT CENT !iLtE y Fscro J�'ui3dlY4xg slor OS3 ZUf1E E # - » 4 tisc gs Pro ased'use 1418 " Si LotdSedlon Phew z ty R . G m,w,xw f an.N tq,NYi't sarS d� "2 s r "aa 5 ''i,e " r 4 , Ir , xacwl , °��eg�y e., � �i ,�,O':= err; 7 x i Pa rd°Histoiy Betrseen zoning SPAT-aSPLIT 4._ r =;.w,..w .d+:a4Y_ 'r ,�s� a• na. F .:�`,�6=. .s`Ya. ,�pkw .yam ''^ "# » r - nw .. .., �i•.. x ;�,�h .. N :-:. ��ywwk"iN m,�N4�"'q , *�„�$u °"'nu"ar:��amniw"an.w'�!;�Yi ° veation desc WT A� i a � <,� N " :7i Id1T. e17T1(t w " a Y J ak p y N #"' q'N'n i[T3�3t�£N3f7e PP7Wmmt`` t EoRS �p w; ," ..,, 't.r m�;.� •- 's'prr."",...� '",.;x'a`.«s �;.y '"�„" "r €N'x'""'" "i, e„ " ter " P.reregyi,,es :i ( Ha rd C esti. ( . f es Br ads i[ Sub 4ddrs ,Text [ P i evietr� Pei ff"Hi Aerts y ., A `^v , °?` (f3P or3 lstdn{ a°[ li spe iot7s`t, (�.Iiolatioris. ( Fieu�e�n+s [ •Cper�fEer�s �.�4A�arriin S 5. e. a b',t -a`�r'e•� a :' �w � i9 �FISps ,w, � '.a;r. .. '.'e'. `- .�v x. �n'"m�P°°�5� "�m4� v�•";f".U: ,r��¢' .,gig"a�u .�y«'� 5 "�• � 1, S'� �. 'i��"i zahhs' .a ua u'.d IA 1 i81r�t +fo ec etp .detail r'tise{Llffetlt li[ati ra ` y t f �� '''n+Ekrw""'�fr,x54 "�ia�fi .N'naw •"t +k "'a '# ,'.ua,@y afvi"y a»aaaukakaa'�ruuHr ;q 77777 My Fite -:Edit Tools t 61p dam, Schsrlue Tyae. ieq�esYed `a Schedules . Tai , ; a h �nspec#er ' F`edca�medstlts Fjeld s=- 4, K Y 10 ` �ikbiS 7777771 3 Ip ' k ?ld.�iCfledLies r i'a,.,rr a F C-i r.,JJ.!" R'�1JRy.';i!"' 7a.r. $ -x.'+t' 'f�..i!; tt rii .• e a ti a t e 9; r . .;, .:t t.,.:7 _ T TOWN .OF BARNSTABLE BA R-W °. Ordinance or Regulation WARNING NOTICE, Name of. Offender/Manager �; G c c E -�--» s Address.,,.o.f Offender MV/MB Reg.# Village/State/Z,i,p . G, G . Business Name a /pm, on� 19 Business Address Sign ture +of Enforcing Officer . Village/State/Zip Location ofi Offense LffAw'� Enforcing ept/Division � k t Offenses Facts Thi's ,w, .lsl- erve only as a/-warning. At this time no legal action has been taken. It is the ,agoal of Town agencies to achiev volun -ary compli ce of Town Ordinances,, Rules and Regulations. Education' ffoits and warnin notices are attempts to gain voluntary compliance. Subsequent 71olations will, result in appr0 riate. legal action by the Town. ,� RESIDENTIAL P ERTY MAP NO. LOT NO. FIRE DISTRICT STREET 1292 Cragville Rd. Centerville SUMMARY 207 74 - -.. C-0 73 LAND /3 b 0� BLDGS. a U O O OWNER `/,c..l�.�l.. _ 6!T] i tl-L TOTAL �D LAND w�(o 00 RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS:/,,-�- dq_ �J, + /,�7' :G_ BLDGS. O 40 O illiam R & Patricia 11/30/64 128 658 TOTAL a d LAND (3) BLDGS. TOTAL o LAND (3) BLDGS. TOTAL LAND BLDGS. TOTAL LAND 0) BLDGS. TOTAL LAND BLDGS. at '" TOTAL LAND INTERIOR INSPECTED: BLDGS. 0) TOTAL DATE: LAND ACREAGE COMPUTATIONS _ BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE rJ ` / r` ' TOTAL iOUSE LOT -, LAND_ ' =LEARED FRONT Oo00 /iSCoOO ���0 a / SO �eaYn L �n �/ M1[LE� Flux � BLDGS. REAR TOTAL MOODS&SPROUT FRONT LAND REAR BLDGS. MASTE FRONT TOTAL REAR LAND BLDGS. TOTAL JL LAND y� O BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER �BLDGS. ND /G v ROUGH TOWN WATER HIGH. GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. T BLDGS. FOUNDATION BSMT. & ATTIC PLUMBING PRICING �^ �" %'i� •�" '' LAND COST nc.Walls Fin.Bsmt.Area Bath Room Base _�(0 1-1 BLDG. COST _ onc.Blk.Walls Bsmt.Rec. Room St. Shower Bath;, Bsmt. PURCH. DATE nc.Slab Bsmt.Garage St. Shower Ext. Walls PURCH. PRICE. rick Walls Attic Fl. &Stairs Toilet Room Roof RENT 7 tone Walls Fin.Attic Two Fixt. Bath Floors iers INTERIOR FINISH Lavatory Extra $mt. F 1' 2 3 Sink ijv Plaster Water Clo. Extra Attic _ EXTERIOR WALLS Knotty Pine Water Only J Fin. ouble Siding Plywood No Plumbing Bsmt. •� 200 Ingle Siding Plasterboard Int. Fin. S %- .`,Shingles TILING(, onc^Blk. G F P Bath Fl. Heat 097 —arm L ace Brk.On Int.Layout I'llBathA&Wains. Auto Ht.Unit 3� Veneer Int.Cond. Bath Fl. &Walls Fireplace 4- C /S om.Brk.On HEATING Toilet Rm. Fl. plumbing olid Com.Brk. Hot Air Toilet Rm.Fl. &Wains. f S' Tiling 2 /Z 8 Steam Toilet Rm. Fl. &Walls lanket Ins. Hot Water St. Shower / ✓. toof Ins. Air Cond. Tub Area Total . Floor Furn. ROOFING COMPUTATIONS ph.Shingle Pipeless Furn. 7S.F. 3 L. , nod Shingle No Heat 19 0.0 S.F. ` ksbs.Shingle Oil Burner S.F. Slate Coal Stoker S.F. F�� �/ .J J<<Z ��' �..- tile Gas S.F. OUTBUILDINGS ROOF TYPE Electric S.F. 1 2 3 4 5 6 7 8 9 101 1 2 3 4 5 6 7 8 9 10 MEASURED able Flat Nip Mansard FIREPLACES S.F. Pier Found. Floor �/ /-''/ Gambrel Fireplace Stack Well Found. 0.H. Door LISTED FLOORS Fireplace f Sgle.Sdg.,, Roll Roofing onc. LIGHTING Dble.Sdg. Shingle Roof r.• arth No Elect. DATE Shingle Walls Plumbing ine ardwood ''Cv ROOMS Cement Bik. Electric sph.Tile Bsmt. lst� t2•� TOTAL '- Brick Int.Finish PRICED Single 2nd 3rd FACTOR I I U" /%✓ ij— REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. ' t . 2 3 4 5 6 7 B 9 10 "ILOTAL RESIDENTIAL PR RTY AP NO. LOT NO. FIRE DISTRICT SUMMARY STREET 1292 Craigville Beach Rd. Centerville 207 75 C—o 7.3 LAND 0) BLDGS.OWNER i' TOTAL RECORD OF TRANSFER DATE SK PG I.R.S. REMARKS: % LAND Q` BLDGS. Z G d O Mail, R. Patricia 10 16 6 IJ452 569 I .55 TOTAL O O LAND .2 o� BLDGS. 0I TOTAL LAND BLDGS. TOTAL LAND Of BLDGS. TOTAL LAND d A/ BLDGS. TOTAL �a alp -VY-1 o A-) LAnO ���/ �� BLDGS. • LS To l�J(iiV% Of TOTAL LAND TERIOR INSPECTED: BLDGS. TOTAL TE: LAND ACREAGE COMPUTATIONS rn BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DE PR. VALUE TOTAL SE LOT o 0 0 0 S ISO c LAND RED FRONT ' 01 BLDGS. REAR TOTAL DS 8 SPROUT FRONT LAND REAR BLDGS. TE FRONT TOTAL REAR ''•-_" O J 3 G 0 o LAND BLDGS. TOTAL w� 95 LAND 5" /00 BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL IONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER 01 BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. m BLDGS. UNDATION BSMT. & ATTIC PLUMBING PRICING LAND COST Its Fin.Bsmt.Area Bath Room Base BLDG.COST k.Walls Bsmt.Rec. Room St. Shower Bath Bsmt. _ PURCH. DATE b Bsmt.Garage St. Shower Ext. Walls PURCH. PRICE. .. Its Attic FI.&Stairs Toilet Room Roof RENT 11s Fin.Attic Two Fixt. Bath ' Floors INTERIOR FINISH Lavatory Extra . 1 F `1 2 3 Sink . Attie r/x y4 Plaster Water Cie. Extra RIOR WALLS Knotty Pine .Water Only iding Plywood No Plumbing Bsmt. Fin. , ding Plasterboard Int. Fin. Shingles TILING G F P Bath FI. Heat , On Int.Layout Bath FI.&Wains. Auto Ht.Unit Veneer Int.Cond. I I Bath FI. &Walls Fireplace I.On HEATING Toilet Rm.FI. Plumbing Brk. Hot Air Toilet Rm.Fl.&Wains. Tiling Steam Toilet Rm.FI.&Walls ns. Hot Water St. Shower Air Cond. Tub Area Total , Floor Furn. ROOFING COMPUTATIONS ngle Pipeless Furn. S.F. ngle No Heat S.F. ogle Oil Burner S.F. Coal Stoker S.F. Gas S F OUTBUILDINGS OF TYPE Electric S.F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED Flat Mansard FIREPLACES S.F• Pier Found. Floor Fireplace Stack Wall Found. 0.H. Door LISTED FLO RS Fireplace Sgle.Sdg. Roll Roofing LIGHTING Dble.Sdg. Shingle Roof No Elect. DATE Shingle Walls Plumbing ROOMS Cement Blk. Electric Bsmt. lst TOTAL Brick Int. Finish PRICED 2nd 3rd FACTOR REPLACEMENT a�-lir•: -y.r .t_ CUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD, COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dap. ACTUAL VAL. ;�Gr✓a 3. ra L Property Location: 1292 CRAIGVILLE RD MAP 1D: 207/ 074/ Other 1D Bldg# 1 Card 1 of 1 Print Date:09/24/1998 SIDNeTseLn pnon 1292 CR WIL1E RD ENTEK'I LLE,MA 02632 SIDNTL 10o1 0e ppr-als...,..6,c7a,7.u0.e 801 70 ccoun ,1010 13,90 13,90 BARNSTABLE,MA anRef ax Dist. 300 Land Ct#A k ' er.Prop. #SR Life Estate ISION DL I LOT A,B Notes: DL2 &2 i q u v a r ss. k " ..a •,M^:.ta':ma's„ ...: ..•,. ....k:: o, ._., �,ak ,,. - .t ., ;�..... " r. o e ssess a ue r. o e 'ssess n ue..vim r. �<o e ssess m a ue NEIL,WILLIAM R 1282/658 Q Ota. e Ot yp escnptlon mouni � is signature ac now a ges a visit y a ata o ector or ssessor ear O e z_ _ 3 �.: escnptlon um er mount omm. nt. sum Appraised Bldg.Value(Card) 619600 Appraised XF(B)Value(Bldg) 6100 of Appraised OB(L)Value(Bldg) �c Appraised Land Value Bl g) 13,900 73,000 �. Special Land Value 0 Total Appraised Card Value Total Appraised Parcel Value 154,600 Valuation Method: CosdMarket Valuation Neto pprais arce a ue . ermlt ssue Ole ,. ,..�, ,. .. a.YPe escrlpt:on mount nsp. ate o m ate om ° '� �" �`"° °•,_�'� ,;•�.;� P• p. omments ate rpos esu t Se O e esCrl llOn "` ..._. .. � ,.,-.?�,• ,' .s�,.< c., ..Q:� ,_ �:<..-: ._fix, a$< :: ,,.::.m ��"' b °` r,.,r i ,g I", z c� �W, I. ales- . � , � � x ..��:P nets nit rice actor actor"-mg a am _ . •,/ pecla ncing �. nit rice a ue ota n n of an u , 'roperty Location: 1292 CRAIGVILLE RD MAP ID: 207/ 074/ Other ID: Bldg M 1 Card 1 of 1 Print Date:09/24/1998 �:.z.. � :.'�-.. � ';: ��� ,.�, .. - � �""� � � 1. � _. .. ... ; ..,... �..:.: ..... .. ,....,_. �.'� ,Z.r., a�a �� �-� g, ,._' £ ��. aE ,__ ,,�:v.. y Element escnption Commercial Da—t—aErem— ,Ty- ents e ype anch Element Cd. Ch. Descnption _ '4odel 1 Residential Heat Trade C C Frame Type Baths/Plumbing�;tories Story GRN 0 PTO 0 ')ccupancy 0 Ceiling/Wall ooms/Prtns ixterior Wall I 14 ood Shingle %Common Wall 2 Wall Height goof Structure 3 able/Hip I:oof Cover 3 sph/F GlstCmp iterior Wall 1 8 Typical . 2 ement Code escnptton Mactor Ihterior Floor I 10 Typical �oplex 8 Adj 2 nit Location BAS eating Fuel 4 Electric UBM eating Type 9 Typical Number of Units C Type 1 None Number of Levels 32 /o Ownership ;edrooms 4 4 Bedrooms Bathrooms Bathrooms 0 Full .. a. �. j 8.1,111 otal Rooms Rooms rear . asa e dj.Factor .08972 (Q)Index .07 12 Bath Type ase Rate 5.97 :itchen Style Value New 10,615 Built 950 ear Built 965 r nl Physcl Dep 2 uncnl Obslnc on Obslnc i, pecl.Cond.Code .:� �, •. ._ peclCond% Code Description ercenta a verall%Cond. 8 single Fam 1110 eprec.Bldg Value 1,600 Fu Ui1 .ate. .. Code escription nits nu nce r. p t Yocna Apr. ,Value JSKK smt Kec Room , FPL1 ireplace 1Sty B 1 3,000.01 65 1 100 2,00 SHED hed L 28 4.0 81 1 100 90 'SHED hed L 121 4.0 50 1 100 30 GRN2 OMM GLASS L 16 8.0 71 1 100 90 iGRN2 OMM GLASS L 88 8.04 76 1 100 5,60 SHED 3hed L 36 4.0 63 1 100 1,00 rGRN2 2OMM GLASS L 1,06 8.0 58 1 100 5,20 gt = r o e escnption LIVIngArea ross rea rea nit Cast n eprec. value ors oor , , GRN Greenhouse 12 6 27.9 3,58 PTO Patio 12 1 5.6 67 UBM Basement,Unfinished 1,28 25 11.1 14,38 It ross tv ease Area i 1,281 Z,Szq 1,611g Vak 90,611 Property Location: CRAIGVILLE BCH RD MAP ID: 207/ 075/// Other ID: Bldg#: 1 Card 1 of 1 Print Date:09/24/1998 F ; ,.. : .. escnption Code AppraisedValue ssess Value 292 CRAIGVILLE RD ' 801 ENTERVILLE,MA 02632 BARNSTABLE,MA ccounVA an e Tax Dist. 300 Land Ct# er.l'rop. #SR VISION Life Estate DL 1 LOTS A& Notes: DL 2 B Iota ov'lu , <# Y Q F r. a ssessed Value r. o e ssess a ue r• e . ssess a ue NEIL,WILLIAM R 1452/569 Q o u s k. ota , o , is signature acknowledges a visit ala eetor or Assasor ear l ypO esenption' Amount Code Description Number Amount Comm.Inc Appraised Bldg.Value(Card) 0 Appraised XF(B)Value(Bldg) 0 Appraised OB(L)Value(Bldg) 0 TO Appraised Land Value(Bldg) 69,100 Special Land Value o Total Appraised Card Value Total Appraised Parcel Value 69,100 Valuation Method: Cost/Market Valuation Net'lotal AppraisedParcel a ue : r ..•;§»t ., ..c . .�.. k,..^. ,aL., a. �d i. z w ,.fff." 9, •;1R a?} :'i+k Permit ID Issue Date Jype Descriplion Amount Insp.Date o Comp. ate Gomp. Comments ateID Gd. PurposelKesult a.5�,..:, Use Code ese ��., x,...�.k. 8 P s nit Description one ronta a Depth nil u Price L Pactor actor Nbhd. Adj. otes-Ad/lbPeCial Pricing Adj.unit Price Land value 1 1300 RESACLNDV RC 3 2 2.31 AC 500.00 1.00 5 1.00 35AA 0.9Q 161WETLAND 450.00 1,10 Total n ntil J.J-JAq Total Lanaau 69, roperty Location: CRAIGVILLE BCH RD MAP ID: 207/ 075/l l Other ID: Bldg M 1 Card 1 of 1 Print Date:09/24/1998 , > �. .. ,5.._.. ... 7 ,.:.;.. .. .. . .,. r.. ..;..,:. ... r.,. r:x�_.. s �. A: c. S."�' w �l*x?w���.,�.�d`.a •�'k. Maw >.;� »�.��. ,$� ,y , ement escnption Commercial Data Elements �tyle ype 99 acan Landement escnp ion odel 0 acant Heat rade Frame Type Baths/Plumbing tones ccupancyCeiling/Wall ooms/Prtns xterior Wall 1 %Common Wall 2 Wall Height oof Structure oof Cover nmo tenor Wall 1 2 ement o e escription actor terior Floor 1 2omplex 2 loor Adj nit Location eating Fuel umber of Units eating Type C Type Number of Levels /o Ownership edrooms 5 s athrooms i m na j. ase K otal Rooms ize Adj.Factor rade(Q)Index ath Type dj.Base Rate 'tchen Style ldg.Value New ear Built ff.Year Built rml Physcl Dep uncnl Obslnc con Obslnc • pecl.Cond.Code pecl Cond% Code I Des!Fnetion ercenta a Overall%Cond. eprec.Bldg Value .,, Code Description L.IB Units Unit Price Yr. LipMt ouna Apr. value MET Code Deschplion LiVingArea CirossArea rea Unit Cost undeprec. value IYL luro-sLsLivILease Area Bldg a: 07(JUIa/2010/WED 10: 06 C-0—MM FIRE DEPT FAX No, 5087902385 P, 002 M MM DP YY^Y^Y' ❑Delete NFIR9 -1 01�20 IMA : 07 I u2-1 I 910 11 J 110-0001797 000 Change Basic FDID * state* 1ncldenL Date * station Incident Member * expoaufe �f No Activity Check this box,to Tndy-•t. ch•t the address for thie 16c14•nc is p—ided on the w1141and Tix• L'1 Location* ❑xed.l•1n$cation a -Altern•tav tet•tien 8peelfiaetion". Uae oa}y E..wildland fires, census Tract —I t✓ ®street addrasa 1292 t : ICRAIC.VILLE BEACH RA ❑IfiCereeation Number/Milepoat prefix street,or xighway. street Type Suffix ❑Tn,front of I CENTERVILLE 'I� 02 632 -1 . Q Rear of Apt./suite/Room City state Zip Code QAdjacent to ❑Directions - Cross street or dix tions as applicable - - - Midnight is 0000 Incident Type * E1 'Date & Times E2 Shift & Alarms . 11 `Building fir e I Check boxes li Month Day Year' Hr Min Sea Local option i i dates are the dant T f � � same as Alarm ulx ALLAM always reqe4 11 L-��)- COM12 Aid Given or Receiv®d* Date, Alarm L�07 LO2 2010 20:52:43 Shift or Alarms District Platoon QMutual aid received 101922 I ARRIVAL required, unless canceled or did riot arrive L__1 ® A=rival ilr .07 02 2010 20:57:18 �,3 ❑Automatic aid reCv. Their FDSD 'their ❑Mutual aid given State CONTROLLED Optional, except for wildland tires Special Studies ❑Automatic aid given I I ❑ 1 Controlled J L J 11 'J Local option Other aid given Their LAST UNIT CLEARED, required eXCept for wildland firea Incident Number bast Unit � p7� p�� Special Special ❑None ) - ) L --i 2010 07:37:28 study IDN study value ❑ Cleared Actions Taken* G1 Resources * G2 Estimated Dollar Losses & Values X Check this box and skip this❑ paretue or section if an A LOSSES: ReVired for all, tires if known. optional 11 IExtingyishment by fire' personnel form pis used. for non fires.. None Apparatus Personnel property $L�1 /1 020 1 000 ❑ Primary :Action Taken (1) Suppression �� 0014 Contents $1 r d 000 El12 ISalvage & overhaul ' 005 Additional Action Taken (2) EMS I J BRE—TNCIDENT,VATUE: Optional 51 (Ventilate Other, I 0008 1 0003 Property 136 J 000 ❑ Additional Action Taken (3) ❑ CheCk box if resource Counts include aid received resources. Contents tiQI—_J r D30 , Q00. -❑ )mpleted Modules Hl*Casualties®None H3 Hazardous Materials Release I Mixed Use Property (Fire-2 Deaths Injurias N ❑None NN Not Mixed 10 Assembly use 19tructuce-3 Fire 1 Natural Gas: .lor]tek, no w.e.u.n.:..:rt.ationa service I h1 20 Education use ICivil Fire Cas.-4 2 ❑Propane gas: en lb. t.,,k (.• is home earl gcyyll 33 Medical use IFire Serv.'Cas.-5 L_J 3 ❑Gasoline: chink fuel tank or pas-_k,.ce.t.i.e: 4 0 Residential use C1 vilian IE -6 Q ❑Keroaen®: Coal b.—L.;.gdipscnt 05 PUI-k Q■udr.Q. 51 Row of mall L�•7�n�j Detector 53 Enclosed mall IHASMat-7 Required for Confined Fires. 5 ❑Diesel fuel/fuel Oil:,,,,h;e7,• feel tank ov p.xt.nx. 59 Bus. & Residential IWIldland Fire-8 ❑ 6 I]Hous®hold solvents a /oppt..•po •.ei, .1 p only 59 Office use 1 Detector alerte ema .. JApparatus-9 d ocaupanes 7 ❑Motor oil: xxo,a..y1.... ?..t.hl.aonoesner 60 lndustXiai use personnel-10 2E]natector did not alert them 63 Military use 8 ❑Paint: fr�.oi.t cane towers<ss q.i1e., 65 Warm use I Arson-11 U❑Unknown 0 []Other-.: ap•y1.p.st.etie el or-pill,>aaQ.l QQ Other mixed use ple . •e•en•xsa.t.frn• Property User Struotures 3410Clinio,alinic type infirmary 539 ❑Household goods,sales,repairs 342❑Doctor/dentist Office 579 []Motor vehicle/boat sales/repair 31[]Church, place of worship 3610Prison or jail, ,not juvenile 571 ❑Gas or service station 51 QRestaueant or cafeteria 419N 1-or 2-family( dwelling 599 ❑Business office i2,❑Bar/Tavern or nightclub 429 EI ldulti-family dwelling 615 ❑Electric generating plant L3 ❑Elementary•school or kindergarten 439❑Rooming/boarding house 629 ❑Laboratory/soiQhOe lab L5 ❑High school or junior high 449❑Commercial hotel or motel 700 []Manufacturing plant 11 ❑College, adult aduoation 459❑Residential, board and care 819 E]Lives took/poultry storage(barn) A ❑Case facility for the aged 464❑Dormitory/barracks 882 ❑Non-zesidential parking garage jJ, QBoapital 539❑Wood and beverage sales 891 Warehouse outside r 936 ❑Vacant lot 981 F]Construction site 24,❑Playground or park '938 ❑Graded/pare for plot of land 984,❑ industrial plant yard: 55;❑Crops",ox orchard,. --a". 94.6 QLake, rit r, stream, Lookup and erateP a property Use coda only if 59 ❑Forest (timberland) 951 []Railroad right of way you have NOT checked a Property.Use Lox: )7 ❑Outdoor storage area 960 []Other street property Ube 419 L9 ❑Dump or sanitarY landfill 961 ❑Highway/divided highway 31 ❑open land or field 962 []Ros.:deiltial atreet/driveway 1 or 2 family dwell' ME Am NFIRS-1 Rev on 03 11 99 1M Fire 01920 07/02/2010 1 ^0001797 07/JUL/2010/WED 10: 06 C-0—MM FIRE DEPT FAX No, 5087902385 P, 003 Person/Entity Involved I I 1508 1 - 827 - 1138 '+ Local Option B1lsinesa name (if applicable Area Code Phone Number IMark _� �� IOneil I �J check This Box if Mr_,Ila.,Mrs. First Name MI Last Name suffix same address as - Thin entski location. 1292 I I ICRAIGVILLE BEACH I RD TAep skip the three I�.� duplicate address Number Prefix Street ox Highway street Type suffix lines. P.O. Box 309 . ICENTERVILLF, i Post Office Box Apt../Suite/Room city �� 02632 _I state zip Code More,people involved? check this box end attach Supplemental Forme (NFIRS71S) .as necessary Owner ❑ Same as person involved?. Then ekeck this box and skip The reic of this section. .cal option - Business name (if Applicable) Area Code Phone Number J JPatricia Oneil Check this box if MK.,Ms., Mrs, First Name MI "Last Name Suffix some address as I incident location. I1292 ICRAIGVILLE ,BEACH II RD Then skip the throe duplicate address Number - prefix street or Highway - Street Type 3ut1GSx roes. I I IJ I'CENTERVILLE Post office Box Apt./Suite/Room City - �, 102632 state Zip code Remarks Local option sponded in 321 (1) with Sta. 1,2,3 and HYFD LIne Box -to a reported structure fire at 1292 aigville Beach Rd. , Cent. -on arrival, l st wf, fine showing from the D side of :the structure from a basement window. ,D on location reporting everyone out of the building. :terior check. of the building reveals a 301x40' , l story structure `with a walk-out .sement. Fire showing on the exterior of side D near the A side corner. Five visible .rough the window of the basement in the interior. A walk around of the building reveals :avy smoke visible from all windows and doors in the basement and first floor. ,on arrival of 307 at side A, an 13/41 handline was stretched to .the basement, D side and try was made through the greenhouse addition for an interior attack. Heavy heat and smoke s encountered by' 307Is crew and the line was advanced into the fire, room and the main fire .s knocked down. -on arrival of 306, they were ordered to establish a water supply'into 307 . 306 took up a ,sition at the closest hydrant whichn was just beyond the fire building and hand stretched 4" supply line back to 307, a 200' lay. 306 tied into the hydrant and pumped the line ..into 17. The pump operator stayed with the engine and the remainder of the- crew reported to side and were assigned to assist 307 crew with the interior attack. ion arrival of 305, they were ordered to force entry through the front door on the first oor and perform a primary search of the first floor and to open up. the windows for !ntilation. ion .arrival of 802, Deputy Chief Melanson was. assigned to sector ,C. ion arrival of 823, they were assigned to take a.back-up line`off 30:7 to side.0 and assist 17 crew with the fire attack. (1; 301 arrived pin scene and took accountability and spoke' with the occupants. -ews extinguished the fire and checked for extension, 305 found some extension into the Authorization 18260 I IELDRIDGE, BYRON L. IICAPT I IShift Comm .I 07 03 . 2010 Officer In charge IP aiQnaturs Position or'zank Assignment Month Day Year z® 18260. 1 J ELDRIDGE; .BYRON L. I ICAPT _� I Shift Comm I 1 071 U 2010 officer Member making report ID signature - position or rank A881gnmep[ Month pay Year :barge. . Fite 01920 07/02/2010 10-0001797 07/JUL/2010/WED 10:06 C-0-MM FIRE DEPT FAX No, 5087902385 P, 004 MM DD YYYY _._.__.. f 01920 U 1 � 2010 1 10-0001797 000 complete FDID State Incident Date station Incident Number Narrative * * * * exposure arrative: �sponded in 321(1) with Sta. 1, 2,3 and HYFD LIne Box to a reported structure fire at 1292 caigville Beach Rd. , Cent. , ?on arrival, 1 st wf,. fire showing from the D side of the structure from a basement window. . ?D on location reporting everyone out of the building. �texior check of the building reveals a 301x90' l .story structure with a walk-out. . isement. Fire showing on the exterior of side D near the A side corner. Fire visible through -ie window of the basement in the interior. A walk around of the building.reveals heavy-smoke Lsible from all windows and doors in the basement and first .fioor. ?on arrival of, 307'at side A an 13/4" handline was stretched to the basement-, D side and itry was made through the greenhouse addition for an interior attack. Heavy heat and smoke is encountered by 307's crew and the line was advanced into the fire room and the main fire as knocked down. )on arrival of 306, they were ordered to establish a water supply into 307. 306 took up a )sition at the closest hydrant whichn was just -beyond the fire building and hand stretched a supply line back to 307, a 200' lay. 306 tied-into the hydrant and pumped the. line into )7. The pump operator stayed with the engine. .and the remainder of the crew reported to side and were assigned to assist 307 crew with the interior attack. )on arrival of 305, they were ordered to force entry through the front door on the first Loor and perform a primary search of the first floor ,and to open up the windows for :ntilation. )on•arrival of 802, Deputy Chief Melanson was assigned to sector C. )on arrival of 823, they were assigned to take a back-up line .off 307 to side' C and assist )7 crew with the fire attack: i1r 301 arrived on scene and took accountability and spoke with the occupants. -ews extinguished the fire and checked for extension. 305 found some extension, into the zseboard area of the first floor at the A/D corner and opened up the wall and floor and itinguished the visible fire, ie structure was.ventilated using a PPV fan. ie utilities were secured by the interior crews and upon arrival of NStar and National Grid xe power and gas meters were removed and the water was shut-off at the meter. :ews rehabbed and went back in service. lief Farrington spoke to the homeowner, Patricia A. Oneil and her son Mark W. Oneil, who ,re. at the structure when the fire occurred. Mark W. Oneil stated that his mother had reset circut ,breaker for a window air conditioner in the livingroom and approx, 5 minutes later began to smell smoke. Mr Oneil checked the first floor and,'found nothing, he then went )wn the cellar stairs and .when he opened the'door he, was met with a large amount of black Ioke and heat. Mr Oneil then went back upstairs and removed his two-young children to the a erior where his mother, Patricia was. Mr Oneil, gave his youngest daughter to his mother id took the other daughter to his vehicle that was parked in the side yard'. :He then drove to ie next door neighbors house to call FD but no one was home. He then returned to the scene id removed some items from the first floor. itri.cia A. Oneil stated that shortly before the fire started she had noticed that neither ie lamp or the air conditioner in the living room were working so. she went downstairs to set the breaker, when she got to the panel the breaker would not reset, so she told her' son irk Co unplug the air conditioner. After the 'air, conditioner was unplugged she was able to aset the_break r she aid- the.lamp .then came back on. `Mrs oneiil then *went upstairs .and went it side and worked in her front yard until her son came out with her granddaughter and told :r there was a fire. ie dispatcher received a cell phone call from a passerby reporting the fire. ?D Fire Investigator, Det. John York was requested to the scene' to assist, with the fire ivestigation. Fire c1920 07/02/2010 10-0001797 I •07/JUL/2010/WED 10:06 C-0-MM FIRE DEPT FAX No, 5087902385 P, 005 01920 U I 71, L2] 1 2010 1 10-0001797 1 000 complete 1 FDID * State* Incident Date * Station Incident Number * Exposure * Narrative larrative: fire watch, was established with FF C. Riley and FF M. Judge in 317. upon arrival of-Det York; an origin and cause' investigation 'was done. Iamage; .Fire damage' to the .struoture, heavy fire damage to the basement bedroom in the A/D' !orner and the hallway leading .to the bedroom. The bedroom directly above on the first floor . ' Iso .sustained some damage from the fire. The basement sustained heavy to.moderate heat and ,ater damage.The entire basement and first floor sustained heavy to moderate smoke damage. he fire room also sustain a total loss of all contents: he State Fire Marshalls Office was notified and I advised Tpr. Mile Fagan of the ircumstances of the fire @0013 hrs. Tpr. Fagan was tied up at another fire and due :to this ire appearing to be accidental, he would not 'be' responding to the scene and I. will follow up -ith him in the am. oss: Toss to the contents of the structure is $5,000.00 and loss to the' property is 25,000.00. he TOB Wiring Inspector was requested to the scene 00630 hrs and arrived on location @ 0701. he firewatch was maintained until 0700 on 7/3/10, no furth6r problems were found by.the irewatch. The property was turned over to the homeowner, Patricia Oneil and her son Kevin neil. - 7/05/2010 07:52:01 beldridge a � . I Fire 01920 07/02/2010 10=0001797 - 07/JUL/2-010/WED 10: 06 C-0—MM FIRE DEPT FAX No, 5087902385 P, 006 MM DD YYXY Delete 01`920 U 07 02 2010 1 1 110-0001797 ' 1 000 ChangeIRa -2 State Incident Number H-No- FDID p, e * *; Ineideot Dace * Stetson * Ergo auze * Activity Property Details C On-Site'Materials[]None Complete SC tops° were any BignTficdnC amountB of coxnercSal,i❑ ustrial., energy or or. Products agricultural prodvcta ox metarials on the Proparty, whether of not they became involved Enter.up to three codes, ,Chozk one Not ReaidAntial or more boxes for each code entered- OOOl 0 � 11 Bulk storage,or warehousing. Estimated Rvmber of residential living-units in I' 2 Processing or manufacturing building.of origin whether or not all units on-site material (1) 3 Packaged goods fox Salo became involved 4 Repair or service 1 Bulk storage or warehousing 2 001 FIBuildings not. involved I � 2s Processing or manufacturing Number of buildings involved on-alte roater as (2) 3 Packaged goods for sale .� Repair or service r 'r l Bulk storage or warehousing 3 I None �` I I '2 Processing or manufacturing Acres burned - (outside fires) ❑Less than on®.acre on-site material (3) 3 Packaged goods for sale 4 Repair or service Ignition El Cause of Ignition .,14%u an Factors - check box 1r this is an exposure report. _ Contributing To 2gnition ekiy to aechion G Check all applicable boxaa 1 121 (Bedroom - < 5 persons; 1 ®sxitentional 1 �Aaleep ®None Area o)t Lire origin * 2Unintentional' 2 Poaai.bly impaired by 3 Orailuro of equipment or neat source sloohol or drugs 4 ❑Act of nature 3 [:]Una.tteanded person Z 110 (Heat from Powered 4'�Poaaibiy mental disabled Neat source, * 5 gCavee under investigation U CaUBo undotnrmined after investigation 5 �Phyaicaily Disabled Factors Contributing To Ignition 6 ❑Multiple persons involved 3131 Mattress, pillow � �2 . k Box it rice spray None 7 Age was a factor Item first ignited Cbec * 1 ❑was confined to ob3gct 334 1 IUnspecifieci I of origin Estimated ago of Factor Contributing To.Ignition (S) 4 171 (Fabric, fiber, Cotton, person envolved Typo or material Required only if item drat .( first 1gDIted ignited code is 00 or<70 Factor Contributing To Ienition 121 1 ❑Xale 2 E]F*Zale 1 Equipment Involved In Ignition lit Equipment Power G. Fire Suppression Factors None If Equipment was not involved,Skip to - SQotion G - I I Enter up to t1r06 COdeB:. ®None - L I Equipment power SoUroo Equipment Involved Equipment Portability INN7u INone -I �3 Fire aupgreeaion factor (W and I lPortable del L - I, 2 pStationary UJ Fire suppression factor (2) rial 8I I portable equipment normally can be moved by one person, is designed t I I be use in multiple locations, and � J ar requires no tools to install. �xre suppression factor (3) Mobile Property Involved H2 Mobile Property Type & Make Local Use Pre-Fir® Plan Available Nona - _ 4� Bomeof:the information presented,in II, this report may be based Upon reports- Not involved in ignition, but burned Mobile progeny type from othar Agancios Involved in ignition, but did not burn E]Rreon report attached Involved in ignition and burned �,� []Polica report attached . Mobil& property make Coroner report attached E]OthAr reports attached l— L r Mop11e proparty_.model— - Year License elate Number state vIN Number NFIRS-2 Revision 01/19/99 M Fire 01920 07/02/2010 10-0001797 77 -- —•- - r '07/JUL/2010/WED 10:06 C-0—MM FIRE DEPT FAX No, 5087902385 P, 007 • p NFIRS�3 . 41 structure Xn Type 12 Building Status * I3 Building tic �d Main Floor Size S.1 SSFe sae Ln enclosed building ore Height Structure ' (nxte�bie/mobile structure complete the rest of this form Count the ROOF as part Fire ®Enclosed Building 1 ❑Under construction of the highest story ❑Portable/mobil® structure 2 ®Occxwied & operating { El open structure 3 ❑Idle, not routinely used 001 U 1 001 596 d ❑Uhdar major renovation sow.�._.c .eooe. Totals are feet Air supported structure ��� � i ❑Tent 5 ❑vacant and secured OR en platform - i ❑0 orm 6 vacant and unsecured p P (e,g, piste) 001 ❑Uhderground st_ruCtur®(work areas) 7 ❑)3aang demolished x.t.i nw�.r er etoriao I Connectve structure O El Other °oION QraB° 036 BY. , 042 ❑ i 1e.g. Lanese) iaoht in foot Width in feet i ❑Other type of structure U❑Unddtormined L g Number of Stories Material Contributing Most �1 Fire Origin * �3 K g Damaged By Flame To Flame Spread Count as Ski To 001 ®Below Grade Ct the ROOF part o£ the 6igTw9b Story Check if no flame spread p Story of fire origin ❑ OR same as material first Ignited Section L I N�ssnber of stories v/ minor daaaya OR unable.to determina J (1 to 24%fL mo damaga) r2 Fire Spread* K1 15 llnterior wall covering - OO1 Number Of stories.w/-eignifiaant damage ❑Confined to object of origin (25 to 496 flame damage) Ite7(I COUCrIbUtlnq mOBt Ce flame a reed ❑eonfined to room of origin ) Number of etori.ee w/ heavy damage K2 ®Confined to floor of origin u (50 W 74B flame damage) 6�� (Sawn wood, ineluding Type of materiel q contributing, Required Only SL itea Confined to building OE origin most of flame spread contributing number of BtoFiba N/ extrem¢damage - ❑eeyood building of origin 175 to 1008 flame damage) code is 00 or<70 1 Presence of Detectors * L3 Detector Power Supply L5 Detector Effectiveness (In area of the fire) Required if .detector Operated N ®None Present Skip to l ❑Battery Only 1 section M 2 Hardwire only 1 ❑RXmttAd Occupants, occupants responded 1 ❑Present 3 ❑Plug in 2 []Occupants failed to respond t TJ ❑Undetermined 4 ❑Hardwire with battery 3 [-]There were no occupants 5 ❑Plug in with battery B ❑Failed to alert occupants 6 ❑machanical '; U []undetermined 2 Detector Type 7 ❑Multple detectors & power supplies L6 Detector Failure Reason ❑Smoke 0 ❑Other Regu.ired i£.detector failed to operate - ❑Heat iJ❑Undetermined 1 ❑Power failure, shutoff or disconnect' Q Combination smoke - heat La Detector OpeTatioA 2 ❑Improper installation or placement ❑Sprinkler, water flow detection 1 ❑Fire too small 3 []Defective, to activate 4 q Lack of maintenance, includes cleaning []More than 1 type present 2 ❑Operated . 5 ❑Battery missing or disconnected (Complete Suction L5) I Qother 6-❑Battery discharged or dead. 3 ❑Failed to. Operate 0 Other ❑❑ f❑Uhdetera(ined (Complete Suction 1,61 U Undetermined U �Undetermined 1 Presence of Automatic Extinguishment System- * M9 Automatic Extinguishment Nf j Automatic Extinguishment N ®None Present, System Operation System Failure Reason Complete rest Required if fira vas withiq deskined range y X fired if system failed 1 Present of section X 1 ❑Operated & effective (Go to U4 Type of Automiatie Extinguishment System * 2 ❑Opexatod G not effective NO 1 ❑3yatem shut off 3 ❑Fire too small to activate 2 ❑Not dough agent discharged Required if £era was within designed rangmof AE9 . i. 1 ❑wet pipe sprinkler 4 ❑Failed to operate (Go to U5) 3 ❑Agent discharged but did 2 ❑ pr er[]Dry pipe sprinkler 0 []Other not reach fire 4 ❑Wrong type of system . 3 []Other sprinkler system ❑viidetermined 5 ❑Fire not in area protected 4 ❑Dry chemical system 5 n Foam system Number of Sprinkler 6 ❑System components damaged - Heads Operating 7 Lack of maintenance 3 Xp y _ " . - . 6�❑Halo en t ®-s�`9tAm - - g`❑Manual Intervention - 7 ❑Carbon dioxide (CO 2) system Raquired if system operated. 0 ❑Others 0 ❑Other special hazard system I U[]Undetermined tJ 0 Undetermined Number of sprinkler heads operating NFIRS-3 Revision 01/19/99 1 Fire: 01920 07/02/2010 IO-0001797 Lk 25015 P's 288 --,6033 11-19--2010 a 02 : 3dv �TMe Town of Barnstable Regulatory Services BARNSTABLE, : Thomas F.Geiler, Director 94, MASS. ,� Building Division QED MAr� Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 1292 CRAIGVILLE BEACH ROAD, CENTERVILLE, MA, holding title under a•deed recorded with the Barnstable County Registry of Deeds or Barnstable County District Registry of the Land Court in Book ab, Page IS- , or as Document No. , being shown on Assessors' Map 207 as Parcel 074, hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment,which contains living quarters, is intended .for use as a family apartment, for year-round occupancy. 3 The intended and authorized use is for MARK O'NEIL, SON OF OWNER, PATRICIA O'NEIL, associated with the residential use on the same premises. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit shall not be rented as an apartment or as a single;room,or in any fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with'the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or riled at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance,of a building permit and/or'certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this 1 day of vem 20Q. TOWN OF BARNSTABLE OWNER(S) By: hl'44 A, ny, uilding Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date // I Then personally appeared the above-named (owner), icic and made oath as to the truth of the foregoing instrument, befor e. rXA1C_X BARNSTABLE COUNTY tary Public REGISTRY OF DEEDS ""' ""� y Commission Expires: A TRUE COPY,ATTEST 1�E1(Af ESs '. ��c� P�9� LEDA HENNESSEY JOHN F.MEADE,REGISTER �� `�' _ * Notary Public —'` N ( ► Commonwealth of Massachusoft c �Il My Commission Expires ti October 20, 2017 �o 1 A` OlffalmouthRd8041 SARNgTAg1E REGISTRY OF DEEDS r - 1 TINVAJ OF R SUABLE " 22 - I I 7 E' YII' �i u � e e 4 4 . a r JOS ' _;t, it t AM 40.0 • -� °c rce/?.: ."•//F �%y c ✓�✓. �Yl�/err ,. v � \ �� y ? LOCL15 PLAN i° C.P. � nrain n � `" II � p ;%/� • —= _ l 1 •� f L f� ` Greenhouse /' •r 140R5,9No�r Bi od Nouse ' ``'• v T 1 i r 7 1� I 1 , 4 H rP Z 3o•F ti Lawn I O I , q '� (/ 3:r r.'r•eci �' !� - � i .•i � 9d•r1���• ,` a�c;/' ��Iil � II niTCh �WQtJ s Flay Pore I jdr."P•o n V ---- -- - _"__ R 1� ) r,._��?r�'•'•t fir.- ;� � �i G"7 Y � i• ` i 1 rYd�-1 t �r/ , . '� , p 6 .". , / / - �J�� .. .I.• �°>ns ram. 9a•�j -„ ...._...... . `C p� C ROSERTR Shed u R" 19 ' \ c�,1 i�,�/J/CX�•.:dE �iiYJi�T"5 0iINP�%^fir/ S .r� 1 ✓ •i,` `/� :7`.� A\ i / .�i f � y C65P ,i� ran � ." � • .. _ 1)4 `U�a V 1 Ares i.q ;y( `r/` fe i �' ( F 1 l,L E 5 E 3 -449 rA5 f3 U I L T P L A NJ f \ ;I (! �. Fop- The - ' S�f2 t %l [3><1 R IJ S T�B I..E i01a VAT 10 t�.l CO •1 t S�i D s. �AfG ILL BE. 11R AD nuI :ORSE5HOE LAMF 1 MAP 2.Q�. PARCELS 711'and 7.�' S,E r/DPP l. _ _ --- - MOTES ✓� _ 1 _ PATt�1C"l ` 1 L R` _. 129 2 R f-s �.__. I :7_ne_.ro��QQ�rf ./ine _.�howcr_'.an_�s _a�._►uerr_esfafi/ished.._frar».:decn's"-:r_ccatd�cr! /ans."-a!sd�ssesso�s.ma s.aid�"s_no�.as� - aresu/T.o i Id.,Surye P !� OAD CC.: _y .fc y FI�fTFI�.�fLC,.�, IvtA 02�32' �71ie.eXis>:�9deaf shown.cn.71�irs_p/ar�.rydS../.oc f�a� iar�:'d�:�/d.. u�de..:ar�..7�s�99:a�drey�esP ..ean�.fa ,r;� o6sPrr°d, _ 1... . " y Pr1: c_ . .1 n7,'-.o - .ra �d l= wa c/ c e _!, c�.To..co_ T �0� ! S .T��i) J r7.f' c/ +� - P re pare,r r Y P 31?I 77 ..�ere���f..r�.�om.�xi . �� �la'sr�,ey �i..�at�'t�d- d,.�'....r'��_ _ - /an d / P�a. , e _5._. an 8 r7 Ms . `$ .1'17 fi an b WV. u � .. , .. d. _ ._: . . D ca1�-r5;T99g : �Zate 4 :a .e ...: . , ?e 7u g. �� .�Qe v� d kt�2G�l9 ,i V ✓,._--___ � - �s'vi-asp, Al r-. w,nc .I y I. 2 - -- I T."- _ _ ._'St�IP."AKl'.;6ElC-- - -— • :. • ._—may; :--r-t�Rc�-r:Rzr���-+� , - y t I � a i - __f_-:�.». � � � � _G[=�7�R-��T6'7S�1d�, �_:..-.,_ � � -�p'T--Fr��ovA•Slph,� f� 9MP. e i _ �o f � :--re -, . I II ' P ,3 CENT��^�-ire �l.c `' 'pPLvvn- / jZc�h f II + gMai too ALAN • � 4