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0045 LAKE ELIZABETH DRIVE
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Permit • Where,a Certifieate:of:O.ccu ant'as Re uire'd such-Bu ldm 'shall,Not;be.Occu ied until a Final'Ins ection hasfbeen made: ., ° Permit No. B-18-1081 Applicant Name: CROCKER CONSTRUCTION, LLC. Approvals Date Issued: 04/25/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 10/25/2018 Foundation: Residential Map/Lot: 226 154 Zoning District: CBDCV Sheathing: Location: 45 LAKE ELIZABETH DRIVE,CENTERVILLE I Contractor:Na &,, ; CROCKER CONSTRUCTION LLC. Framing: 1 Owner on Record: CROTEAU,DANIEL C&KATHRYN IFn•r cto rLicense: 180396 Co t a Address: 22 JARVIS AVENUE . - 14 r Est Project Cost: $ 18,000.00 Chimney: HINGHAM, MA 02043-1312 Permit Fee $ 141.80 Description: Remove Fixtures and Install new t ors he Showers and flom two Insulation: Fee Paid $ 141.80 Bathroom Install Durarock and Copper Pans � Date ,° 4/25/2018 Final Project Review Req: - - < r k .ter -f -G — 1 Plumbing/Gas Rough Plumbing: r .. _ . Building Official - _ y Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzedby this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved applicaUon'and the approved construction documents'for whicK�this permit has been granted. i : :,: Final Gas: All construction alterations and changes of use of an building and structures-shall-be in compliance with the local zonm b lavrs?and codes. g Y g P € Y ,,,F This i displayed in location clear) visible from access st�eet'or road and shall be maintained open for, blic ins a ion for the entire duration of the T s permit shall be d sp ayed a y p p p , work until the completion of the same. a Electrical kq- The Certificate of Occupancy will not be issued until all applicable signatures by the�Bwlding and Fire Officials are provided,on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1,3 , Rough: 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: � c� All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 1 - Application Lhimber..._.............. ....4.............. ..............._ u.Ru,�rar u_ s` Permit Fee ...... ........Othe[Fee ....... MASEL au Total Feu Paid. . .. .......... r APR 1 1018 4 y i TOWN OF BARNSTABLE)�iiy�`.DF PewA . ,.. .... ..on.... .... ........._ BUILDING PERMIT. Map.. ...Parcrl..... .. APPLICATION Section 1 Owner's Information and Project Location Project Addres ' s — , Owners Name ',�J 1` � /f l2}�/tJ C C ��9' Owners Legal Address �02 -� /4S A-ve-OM M City State zap j � 3 ,.�V� E-mail { /2L � /�'44 �'Yl Owners Cell# (O Section 2-Use of Structure Use Group_ [] .Commercial Shvchrre over 35,000 rabic feet ..Commercial Stwctvra.under. 35,000 cubic feet Single/Two Family Dwelling Section 3 Type of Permit .. New Construction El Move/Relocate >[� Accessory stwtaare 0 Change of use Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty Fire Alann Rebuild ElDeck Apartment D Sprinkler System 0 AdditionRetaining wall 0 Solar aRenovation 0 Pool ❑ Insulation Other—Specify Section 4 Work-Description '1`�ovt t { Application Number....................................................' 3 Section 5—Detail Cost of Proposed Construction 1 SScVV Square Footage of Project /ry-6)2jva2 ? ,r 75'' Age of Structure: Dig Safe Number N�4 # Of Bedrooms Existing Total#Of Bedrooms(proposed) AID C fi�vi, i 110 MPH Wind ZaneTCompliance Method F1 MA Checklist WFCM Checklist ❑ Design . I Section 6—Project Specifics ❑ Oil Tank Storage M ❑ Smoke Detector's ' - - —J� ; ['Plumbing r ✓L's ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply. Public ❑ Private Sewage Disposal ❑ Municipal "9On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: yAtm0 kk—V�A, I am using a crane ❑ Yes BNo Section 7—Flood Zone Flood Zone•Designation Within or adjaceiA to a wetland, coastal bank? Yes ❑ No ❑ Section S—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed { Rear Yard Required Proposed Side Yard Required ' Proposed ' Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No r asrtmdaft�R 2/9=18 The Commounwalth of Massachusetts De�acrrtaaentofIn irstr alAc€°� Enos Office o,f Investigatiom 600 Washington Sh t Boston,HA 02111 wn .inamgovld,ia Workers' Compensation Insurance Affidavit:Builders/ ontractorsJElectricians/Pllumbers Applicant Information Please Print Lezibly Name arsine rganizatio tEximd-al): ge-.7�Z C=,t �ly2,r,�..... Address: L City/State/Zip: {t it h � Are you an employer?Check the appropriate box:. I Tproject'am a general con tractor and }'�of (r� d): 1.El I am a employer with 4_ ❑ I 6. ❑New construction e (fall and/or past- )* have lire the sub-contractors [r listed on the attached meet. 7- ❑Remodeling �. I am a sole proprietor or partner- ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity. employees and have wodDeas' 9. ❑Budding 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 11.0 Plumbing repairi or additions myself [No workers'comp. right of exemption.per M_ GL 12.❑Roof repairs insurance required.) c. 152,§1(4),and we have no ] employees. o w-carlc ' 13_0 Other comp.insurance required] 'Any applicant that checks box#1 must also fill ow the section below showing heir workers'compenmti m policy i nfnrmaim i Homeownus who submit this afbdac a mdicating they me doing all work and then.bue outside contractors must submit a new affsdsm indicating finch_ =Contr wrs that check this boat mug attached an additsonst met showing the nine of the is and state wheffier or not those en=es have employees. If the sub-contractors have etWlo5 ees,they must pmaade their worken'comp.policy member., Taman erttpl er#hat as prrra rider workers'forsrj rrsadon insurance fmr my ensplvs wes. Below is the p lify turd job site informadon. Insurance Company Name: Policy#or Self-ins.Uc.#: Expiration Date: Job Site Address: City/Scat&Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and espiratilon date). Failure to secure coverage as required under Section.25As of MGL c_ 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or cane-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 lnvestigatoesvf Ae DIA for insurance coverage verification. I do D cer sand: t s and pen aIties of`pednt that`the info raaafaan prat ed a.bow is&no and correct Signature: S r" -C�2ac�L ra2llate: L Phone# , 8 2�o t?• ial aw only. Do not twrft in this area,to be completed by city or town official. City or Town: PerraitUcense 9 Issuing Authority 4ck r.Ie one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector d.Other Contact.Person: phone 9: 6 Application Number................. ........................... Section 9—.Construction Supervisor Name j'TC?Ay CZ0 Lug Telephone Number 5D'a 2>614 -1-02-0 Address ! 12>7 Z City N- � L,,44 State W1 ►4 Zip o-S-S��. License Number 05-�-Wq W 5 License Type U Expiration Date 08 l 2 19 Contractors Email '5TV1f04 dha QKCA0C-(L e 2r3aMAt L C�e�l�l# 5O"� 3G L � Zc> I understand my respousi llffies under the rales and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Bulling Code. I understand the construction inspec i m procedures,specific inspections and documentation780 and the Town of Barnstable.Attach a copy of your license. Signature A Date Q Section•10-Home Improvement Contractor. Name STEPNt-�? p -C Q OLICC-7Z Telephone Number 3G 07o 1 Address B X t3 7 2 City t4. �cry o,-c 0*State M.Af 'Zip 02,B-S-C Registration Number .L 2W 3c?( Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the MassaPbWetts State Building Code. I understand the construction inspection procedures,specific inspections and domnentafi by 78 the Town of Bamsstable.Attach a copy of your H.LC... Signature Date 0 l Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the roles and regulations for Licensed Coustracdon Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and docameufation required by 780 CMR and the Town of Barnstable. Sim Date APPLICANT SIGNATURE Signature �-� ,lam-C,�___ Date 4 Print Name '5-y& W61 Gae>c-At,3, Telephone Number 5Z 8 �,(,L( 3o Zo E-mail permit to: ATE?1+04 m 4-kx c z A L L LCYA r Section 12—Department Sign-Offs Health Department © Zoning Board Cif required) historic District ❑ Site Plan Review(if required) 0 Fire Department ❑ a Conservation } El For conunerdd work,please take your plans directly to the fire depoftmt for approval .Section 13—Owner's Authorization as Owner of the-subject property hereby authorize �,�L -�c�- .' 'Gcs o�.D �. to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner 2 date Print Name • f r" Last mdated:2/92018 1 CROCCON-01 RALLIETTA ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE / 03/303012018Y) 018 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 'CONTACT NAME: Almeida&Carlson Insurance Agency,Inc ;PHONE FAX PO Box 554 -(AIC,No,Ext):(508)540-6161 (ac,No:(508)457-7660 Falmouth,MA 02541 I AODRIES& INSURERS)AFFORDING COVERAGE I NAIC# INSURER A:Western World Insurance Company INSURED ,'INSURER B:Ace American Insurance Co III Crocker Construction LLC I INSURER C PO Box 1372 j INSURER D: N Falmouth 02556 INSURER E INSURER F: I 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 TYPE OF INSURANCE IADDLISUBRI POLICY NUMBER POLICY EFF I POLICY EXP I. LIMITS 7 S D M -MM A X COMMERCIAL GENERAL LIABILITY I - EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR I '.NPP8296569 05/07/2017 C 05/07/2018 DAMAGE GET Ea ocoU ence $ '00,—PREM000 MED EXP(Any oneperson) $ 5,000 _ I PERSONAL&ADV INJURY $ 1'000'000 1 I 2,000,060 . GEN'L AGGREGATE LIMIT APPLIES PER: i I. I GENERAL AGGREGATE $ POLICY PE� - _;LOC I PRODUCTS-COMP/OP AGG $ - 2,000,000 � I �I OTHER: I I $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT _ Ea accident) $ i ANY AUTO I BODILY INJURY(Per person) $ OWNED j SCHEDULED AUTOS ONLY AUTOS I BODILY INJURY(Per accident $ U UTONLY I I idetDAMAGEATOS ONLY (Per.cn $ i I$ UMBRELLA LIAB OCCUR I I EACH OCCURRENCE $ i I�EXCESS LIAB CLAIMS-MADE AGGREGATE $ i DED .RETENTION$ I I Is B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY l I I I STATUTE I ERH YLN I 15B97938 05/1012017 05/10/2018 I 100,000 ANY PROPRIETOR/PARTNERIEXECUTIVE i E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' NIA i 1 OO,000 (Mandatory in NH) ' E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below I t - I E.L.DISEASE-POLICY LIMIT I$ SOO,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF FALMOUTH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks oeACORD A. Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards `ti: pe Constr, t1tb rvisor , CS-079605 p - �" pires:081i 112019 ran STEPHEN M Gf2OifER e P.O.BOX#13� 2 NORTH FALMOUTHM dc' :t=a ALI Commissioner _ Cie.- Office of Consumer Affairs&Business Regulation 5 HOME IMPROVEMENT CONTRACTOR T°` LLC Registration valid for individual use only before the expiration date. ff found return to: �•----:k' gjstration it i Office of Consumer Affairs and Business Regulation y 11l1 t/2018 10 Park Plaza-Suite silo Crocker Consti'd ioti ,L1c -s- Stephen Crocker'•.__Y 1,V 21 Paddock Cire� East Falmouth,NIA.'f2536 Undersecretary t valid without signature i .Q Town of Barnstable Regulatory Services . g ry NAM Richard V.Scali,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 SigA this Section If Usi$ig A Builder as Owner of the subject prolterty hereby authorize CW&^I&LVA0PIN to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final "a are performed and accepted. WCL Signature of Own& ' Signatur of Applicant �i'rry�cat.. C. �� ��`��'� W1• �..,, a.�2 Print Name Print Name Date S: Section 12 o DepSrhnent S Heatth Dept la Zo=g Board(, re4=cd) Historic District ❑ Site pl.Review Cif mgte Fire Department Conservation For comm l*vr%pkm t ake yorr phM&CCOY 10 awfire dq f0r WMVd Seedon 13_tamer's AuftflUtiOu f e+N k l ,as Owner of the-subject propezty hereby �.. to act on my behalf in all matters relative to work suihori .by this building Permit application for. y (Address of job) 4. Siuro of Owner dam Print Name Town of BarnstableREC�E�PT 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-18-500 Date Recieved: 2/19/2018 Job Location: 45 LAKE ELIZABETH DRIVE,CENTERVILLE ;: . Co C:) Permit For: Building-Insulation-Residential N.) -' N cm Contractor's Name: MICHAEL T MCMAHON State Lic. No: CS-068111 UJ cn a Address: PLYMOUTH, MA 02360 Applicant Phone: (781) 831 234 W (Home)Owner's Name: CROTEAU,DANIEL C&KATHRYN F Phone: (781)831-1234 (Home)Owner's Address: 22 JARVIS AVENUE, HINGHAM,MA 02043-1312 Work Description: Insulation,weatherization,air sealing,blown cellulose cl a IoZd l tee-. Total Value Of Work To Be Performed: $2,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Mike McMahon 2/19/2018 (781)831-1234 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $2,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 2/19/2018 $35.00 XXXX-XXXX-o Credit card _ 1417 Total Permit Fee Paid: $85.00 2/19/2018 $50.00 X3CC{-3C{JO{?CC?Cz- Credit Card VW 1417 Elgineering Dept.(3rd floor) Map Parcel '" Permit# House# 4 e Wiz/ 1)f ' Date Issued Board of Health(3rd oor)(8:15-9:30/1:00-4:30 '; � r !_ Fee Conservation Office(4th floor)(8:30- 9.30/1:00--2:00)` - - ZMPUANCE Planning Dept.(1st floor/School Admin. Bldg.) INSTAL�E© w DE AND Definitive roved by Planning Board 19 - ENVIRON . '-f TOWN �� TOWN OF BARNSTABLE Building Permit Application ; Project Street Address Village �'/'��` —'� E�r✓ t Owner t.L-L Address .Telephone 77_S -Permit Request ReMollod: CX/STi 4r2*0,4-5 qi yD )2ed t l'i p %►-S Aieo /1voF 1 SXO f4v;-- Rea sic p ;:m mr cp&t-T) &�L o.✓ SAW<- A m oR#,l PoAc6 D-te-K First Floor 1-3 L/ square feet Second Floor C. s square feet Construction Type 'u � ` Estimated Project Cost $ y S O d-P �' o Zoning District F Flood Plain Water Protection Lot Size Grandfathered JNes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure IS M ° Historic House ❑,Yes J dWo On Old King's Highway ❑Yes �Wo Basement Type: ❑Full ❑Crawl CQValkout ❑Other Basement Finished Area(sq.ft.) Y e a Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 3 New Half: Existing 0 New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: 01tias ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) c` Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes W140 If yes, site plan review# Current Use l'S Proposed Use Builder Information Name Q Al64Ark— Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESUL O HIS PROJECT WILL BE TAKEN TO �1— SIGNATURE DATE BUILDING PERMIT DEINI-14E FOLLOWING REASON(S) ' 4 FOR OFFICIAL USE ONLY 4 PERMIT NO. �t � �^ .f • ' •- - �... �� • A '-� DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: d , FOUNDATION � ~' r • r. { •_• - ". `` •, ' • � .• FRAME o �{ . , ^^- t s• 'mil ` }. '_ • $ - d y _. � f ! , i�-�— / + r c INSULATIONf FIREPLACE t ELECTRICAL# ROUGH FINAL PLUMBING: ROiH + FINAL. ' F GAS: - •'9ROM FINAL a "' FINAL BUILDIi , F :;DATE.CLOSED'O J ,n t { t ASSOCIATION PLAN;NO't a • 23'11 ---------------------------------------------------------------- No -23-11... ---------------------------------- 37 11'7 O O 23'11- 118 J r a c C4 L--------j Ll 3 0 n I O I i i �(l s T/AI —UP A4 To S�fo��Ft� i 1'3*1'242 3'10 1'2* 1'5'I 7/A �o�c.�/�.�-s i>✓ ,C�+-D stiff.. o 13'5 N N r UP- UP 8'6 r 44'2 d� s 057 - � Al 0 o N 0 0 o , 1'3�1'2�1'2 3'10-- 1'2� 1'5'; - I - 23'11 - )3 A 12 = A W N O N N � O O t0 Fol FE) O O1 tLjd vl� V"/ OF- to A-3 0 24'3 all second floor 1. a K0o h 1� main floor Co 3'5 stairwell porch ground leve basement OD �no"^,� stairwell 6A-&Le- f24po tJ �. c z S►� u -NI IJ fi4lLVFI Sri n n i 0 q v � - QUITCLAIM DEED I, Philip L..Azoy, of Morristown, New Jersey, for consideration paid in the amount of Two Hundred Sixteen Thousand and'00/100($ 216,000.00)Dollars, hereby grant to Karen M. Kelley, of P.O. Box 144, Hyannis Port, MA 02647, with Quitclaim Covenants, the following property: A certain parcel or parcels of land situate in the Town.of Barnstable in the Village of Craigville, County of Barnstable, Commonwealth of Massachusetts, shown on a plan entitled "Plan of Land in Craigville,Barnstable, Mass. belonging to Edith G. Howe" which plan is recorded at Barnstable Registry of Deeds_ in Plan Book 75 Page 23 and is more particularly bounded and described as follows: Beginning at a Land Court bound set at the southeasterly corner of the premises at the Town Road;thence running south 77° 59' 40" W. 68.22 feet to another Land Court bound; thence continuing on a southwesterly course by a brook about 42 feet and thence continuing on a southwesterly course by said brook to the southeasterly corner of land now or formerly.of Edith G. Howe, all of said courses.running by land now or formerly of Oscar C. Lenk;.thence running north 45°3 5' 00" E. about 84.08 feet to a stake set on the southwesterly line of Bluff Avenue; thence continuing on the same course to a cement bound set on the northeasterly side of Bluff Avenue; thence running on the same course 108.83 feet to a cement bound set on the westerly sideline of Strawberry Hill Avenue, all of said.course running by land now or formerly of Edith G. Howe; thence running southerly on a curved he,by Strawberry Hill Avenue to the beginning of the Town Road; thence running southerly on the line of of said Town Road to its westerly sideline; and thence running south 190 01' 00 E. by the westerly sideline of said Town Road, 23.40 feet to the point of beginning. Said premises are conveyed.subject to and with the benefit of all rights, restrictions, easements, appurtenances, and rights of way of record, insofar as the same are still in force and applicable: - Property Address: 45 Lake Elizabeth Drive,.Barnstable For my title see deed of Margaret G. Sherman to me dated October 14, 1969, recorded at Barnstable County Registry of Deeds at Book 1452, Page 312 and Estate of Margaret G. Sherman, formerly Margaret G. Any, Barnstable Probate No. 51587. For title of Margaret G. Azoy, see deed at Book 655 Page.427; as well as deeds at Book 480 Page 587, Book 617 Page 151, and Book 652 Page 155: tti Witness my hand and seal this';_4 day of Tay►, , 1998. Philip L. Azoy STATE OF NEW JERSEY S.S. J o=— .10 ; 1998 Then personally appeared the above named Philip L. Azoy,'and acknowledged the foregoing instrument to be his free act and deed, before me, �0P EqQ {stamp} Notary Public My Commission E i s: CHRISTOPHER My Commission Expires March 27,2000 b'tkl-Yla-kilo 11 -JJ 1-'HUM-LAr:i'1bRN GUNVEYANG1NG 1D-6173318666 PAGE 2/2 MORTGAGE INSPECTION PLAN UNITED DATA SERVICES• INC 2013LANCHARD RD. • BURLINGTON, MA 01803 TEL (617) 272-9106 FAX (617) 27*2-6900 MORTGAGER: KAREN M, KELEY LOCATION: 45 LAKE ELIZABETH DRIVE DEED REF. 1452/312 CITY, STATE: BARNSTABLE (HYANNIS), MA PLAN REF. ASSESSORS DATE: 1/5/99 SCALE: 1" T 20' JOB #: 97/9150 A �J r �1 c%� N �G IA F LOT CONFIGURATION 15 BASE4 ON ASSESSOR'S INFORMATION AND MAY NOT BE EXACT iNSTRUWIENT SURUEY.f=oMMF.NDFA... .- _ CERTIFIED TO: FH13 FUNDING CORP ACCORDING TO FRDERAL RMERGENCY KkWAGEMENT AO%NCY MAPS.TIRE N A.IPR IMPROVEMVM ON THIS PROPERTS FALL IN'AN ARP,A OE§IGNM AS, `N COMMUNM PANEL No- T3�'/'� P- OF Fv"ICTIVEIUTE: O rAnEl,l VOTR:70NE It-aRFaMtSOF'M..N' ( uii Fa.vi;'vi:�GP1(T,HAVING). of ,M9 DESIGNATION IS NOT BASED ON AN ELEVATION CERTIF1eATE / a THIS MORTGAGE INSPE(-rIUN PLNN IS NOT INTENDED OR REMSSIP ISD Lro BE A LANb OR PROI F R7y UNE NO. 18467 p¢ SURV W.Kr FOR OT BE D[NC.PRFr aRINC DEED DpSCRIPITONF OR CONSTRUCTION.NOCORNERS �"F gnTf�cO J� SERE W.[T CANNOT BE USED FOR lZSFABUSHIr,C FENCE NED(�'OR EWILDLYC L1NE5 THF.1•LATTERS jj vQ SRO"EMRON ARE a,.=ON CUrW T FURNISHED INFORMATION AND:ILAY 8E SUBJECT TO FURTHER � PLR�FIp j OROTtE6RWCH'f�NOR65PONSIEALR'YISAS$uMFAH RETIN7pTHLt�.AN t�wM16ROR �N'�C LAHD OC PANT.TRL I'b'1tMANLNT STstUCFURFS ARF,APl'ROX{MAY.ELY LOC4T'EA ON THE CR N Local,zo:vlNc o ov n As sHowN.fiDL`IANCPS I 7 N 'ElEY EITH / lE1T'LC1'WHEN CONSTIW'C1'}.D wITH RESP ER CONFORMED 70 TH q ENFORCEMFIYI'ACIIONUNDPJgrI,GL.TFFU?viAC ECTTOHORYyAN-TpLD[A1F.NSIONAL UIREMENT�ON "���MF`'�UF'THE r . HAPTER<OA,SECPION T.t1Nt.rcc fYrr.v tt.OR 14'fRF b?(EMPTF v YtOCCpVRAI,A;r�TP�G1ntrCA�,JIANUAKUSKORMORTCAI.Et,UANiNSP M1 wtfuuOraOVnsN01v4(ticRZON.T�iyp�q,gy��;�.q�UfYA000RDAhrCETO LAND SURVEYOR,E,sA CMR ECT:ONS AS ADOrIED 6Y TM►:►IASSACNUSLIRS 80ARD OF'REGISTRATION OP PBOF655IONAC t:aC1NEER4 AND �AND USE.FOR ANY OTHLR PURPOSE 1S PRl1H)R�p. ` �`"' Tltc• C/1/1rlrrulrnfculr/t of:l tusrucllusctrs Deptirtrrrcfrt of Inclirsrriul.�ccidcfrts 08 !!•ashilrr tine Strea _ yr;• �•;�a•• ��' i Bu,tarrf.9liu�: U3111 . Worh-crs' Compensation Insurance A>>Tdavit •A tiPlic:,nt inftirmntinn /Iczse f'RTNT'le�iiiiy - nzirrt. L t✓ Inc inn /' ., ., 6 ,ii am a homeowner perrormin_ail work myself. I_am a sole proprietor and have no one working in an% capaeiry _r•�„•_,_.f._�__. I am an emplover providing workers compensation for my employees working on this job. r r cnn,nanr nnrnr� utrlrrcf r Clit.. , nfinnl'�' 1 in,mrnnrr rn. lict• _ l am .zOiC rrOTJrietOr. eencral contractor. or homeowner(circle oize; and have hired the :OlJtraGtOfs listed bG:Ow '+'r.c the :oilowing worker—. compensation polices: cnmr7mv nninr- atttlrrcc• Or nfinnC d• c 11r nllrt• _ _ cnnir.1nA �ntnr i and rrcc rir�•• finnc i�• Haile in�nr..nrr rn. _ r�tfacfl aU(lill0nal Shcc. ff neces_arr :% ��;•._, —•:•__�•.... __...•..... •...._..,:.. _.�...,..,._.�r.' Fa,iurr to xrurc cuvcraz:c as required Hoer=ecuon L°A of NG:. 152 can lead tU the tmpostuon of M ntnai penalties of a line up to S1f50U.UU at,uri;: unc•.card imprt%onment a. «ell ;,s civii penaiti wn the form of a STOP WORK ORDER and a fine ofS100.00 a day against me. I understand that cop• rf itu. aatentcnt ma% be fur„•ard to Cr of 1nV�estiCzt,ons of the DIA fur coveraec veriiicatlon. !do hercnt• ccrrrit-tut(,.sire (rt :allies of perjurt•that the information prorided above is true and correct. Date Prir,: am: Ov,el& �/'yL/L'� Phone 0 • olTivai u.c vet,• do not„•rite in tltis area to be completed by citti•or totrn otTicial `f I` lterntiz/llecnsr,3 �uuildina Department 61%.or tn„n: Ct.1cctisinc auard I L-piriectmcn'a Olrlur i — cneck irimmcuiate respunse is required allealth Department phone 9: r'Utticr cni,c: ccr.frn: ,v .y 4 AZW t h 1 .G NYC 44 40 • / , v y^•i 40 I4.Q/S a N ����. Pura Or L.•..+a Lr t c• cup CAAWWILtAE.AM40rr&4Mnsa. �. EOITH G. HOWL 3c.�,.c t ior•�0lE Jwa 7.�9lS. z ngineering Dept; (3rd floor) Map Parcel Permit# 3 � House# 'f t CL Date Is ued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30),� l L�-�� Fee �� THEnd ►ry;_ 19 , ' 4 BARNSTABLE. TOWN OF BARNSTABLEE° `'�� Building Permit Application Project et Address - r' !0e:- Village V C/L 6 4 LL �--- Ciu•.��Pl� Owner �L^�✓ . 6c-1 Address P V 3 P;C IV, /fy/WIVI S�a IV - P Tele hone Permit Request C /0/�✓ a t -First Floor / 3 square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain C Water Protection Lot Size Grandfathered FeWes ❑No Dwelling Type: Single Family�R Two Family ❑ Multi-Family(#units) Age of Existing Structure 'Historic House ❑Yes Po On Old King's Highway ❑Yes,,%42 No Basement Type: ❑Full ❑Crawl Walkout ❑Other 1 Basement Finished Area(sq.ft.) •1-/O e Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: . Existing (:� New Total Room Count(not including baths): Existing New First Floor Room Count 4 Heat Type and Fuel: XGas ❑Oil ❑Electric ❑Other Central Air ❑Yes `§JLNo Fireplaces: Existing New Existing wood/coal stove ❑Yes HNo Garage: ❑Detached(size) / Other Detached Structures: ❑Pool(size) �f Attached(size) X• /S ❑Barn(size) 11❑__ None ❑Shed(size) " ❑Other(size) Zoning Board of Appeals Authorization L3. Appeal# Recorded❑ Commercial ❑Yes Flo If yes, site plan review# Current Use D y?V7/ Proposed Use 12 PS jam'✓j��lZ Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 13 FJ 51 Tf— SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOL OWING REASON(S) I FOR OFFICIAL USE ONLY t.. PERMIT NO Z ✓ ( F _ ` DATE ISSUED. MAP/PARCEL NQ. -- . � .; G• ., t - '+w ems; ADDRESS - VILLAGE OWNER DATE OF INSPECTION: ► _ - r FOUNDATION v r ! ! t r FRAME - _ r•` INSULATION - FIREPLACE ELECTRICAL: ' ROUGH = ' FINAL PLUMBING: ROUGH FINAL GAS:.' ROUGH ! FINAL FINAL'BUILDING DATE CLOSED OUT. ° ASSOCIATION PLAN NO. ' } t The Town of Barnstable •• ,�.,�°� ents I Service s Department of SesIth Safety an d Envir onm Building Division 367 Main Sftni,Hyazmis MA 02601 r Ralph Crosser. Office: 508-,90-6227 Building Coma_ Fax: 508 90-6230 For office use only Permit no._ Date AFFIDAVIT, HOME INIPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION ` MGL a 147.A 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 dw con ra nits or to structures which are adjacent to such residence or building be done by registered th certain exceptions,along with other requirements ost L Type of Work: 7 /Address of Work: Owner's Name Date of Permit Application: [ hereby certify that: Registration is not required for the following renson(s): Work excluded by law _ _ ob under 51,000e Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT- OR DEALING WITS UNREGISTERED BLE HOME WORK Do NT HAVE CONTRACTORS FOR APPLIC--kIMPROVEMENT AM OR GUARANTYAND UNDER MGLO 14Za ACCESS TO THE A�ITIL''TION PRO SIGNED UNDER PENALTIES OF PERJURY /- I hereby apply for a permit as the ageat/of the o er-. �,(� ✓ t) R motion I TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. . DATE , '.. I'TOB LOCATION Number Street address Section of town "HOMEOWNER" Name Home phone Work phone - - 1 _ PRESENT MAILING ADDRESS City town State Zip ccd. 'i The current exemption for "homeowners" was extended to include owner-occur_ ' dwellings of six units or less and to allow such homeowners to engage an i dividual for hire who does not possess a license, provided that the owner acts as suervisor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to r side, on which there is, or is intended to be, a one or two family dwelliac attached or detached structures accessory to such use and/or farm structure person who constructs more than one home in a two-year period shall not h onsidered a homeowner. Such "homeowner" shall submit to the Building Off= n a form acceptable to the. Building Official, that he/she shall be resnon-s- or all such work performed under the building permit. (Section 109.1. 1) he undersigned "homeowner" assumes . respots . ty for compliance with the uilding Code and other applicable code y�laws, rules and regulations. he unde*-si-ned "homeowner" certi t he/she understands the Town of arnstable Building Depar"me inspection procedures and requiremen- nd that he/she will comply i "a . procedures and requirements. OMEOWNER'S SIGNATURE PROVAL OF BUILDING OFFIC A . ote: Three family dwellings 35 , 000 cubic feet, or larger, will be requi ed o comply with State Building Code Section 127. 0 , Construction Control. l The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Strut,Hyannis MA 02601 Ralph Crosse.,: Office: 508-790-6227 Building Cc=;—,-- Fax: 508 90-6230 For office use only ' Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUppLEMEINT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition,et one but�o t construction than fourn to any dwelling nm�oring to owner occupied building containing structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements L/ Type of Work: DF/ S/ �Address of Work: J_ L�97��' Owner's Name /J'y=�r0 Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law _Job under SI,000. ---/ 8 ilding not owner-occupied Owner pulling own permit Notice is hereby given that: _ OWNERS PULLING THEE HOME IIVIPROWN PERMIT OR �T WITH WORK DORNOT�I3AVE IM CONTRACTORS FOR APPLICABLE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c- 147.A SIGNED UNDER PENALTIES OF PERJURY , I hereby apply for a permit as the agent/of the a er: Registrat ion No. Date 4 • TOWN OF BARNSTABLE : BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION P ease print. . DATE • /.IOB LOCATION Number Street address Section of town "HOMEOWNER" i�'I, 7S- Name Home phone Work phone PRESENT MAILING ADDRESS � - City town State Zip codE The current exemption for "homeowners" was extended to include owner-occusr dwellings of six units or less and to allow such homeowners to engage an ir. dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to r side, on which there is, or is intended to be, a one or two family dwellinc attached or detached structures accessory to such use and/or farm structure A person who constructs more than one home in a two-year period shall not b. considered a homeowner. Such "homeowner" shall submit to the Building Off-4 . on a form acceptable to the Building Official, that he/she shall be respons: for all such work performed under the buildinc permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . respons ' ility for compliance with the ; Building Code and other applicable cc y-laws, rules and regulations. he undersigned "homeowner" certi t he/she understands the Town of arnstable Building Departme inspection procedures and requirement nd that he/she will comp y i a ' procedures and requirements. OMEOWNER'S SIGNATURE PROVAL OF BUILDING OF IC AL ate: Three family dwellings 35 , 000 cubic feet, or larger, will be require: 0 comply with State Building Code Section 127. 01 Construction Control. HOME OWNER'S EXEMPTION _.,• .,-= The code state that: "Any Home Owner performing work for which, &-buildinc permit is required shall be exempt from the provisions of this section (Section 109.1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a persons) for hire to do such work, that such Home Ow:. shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q. Rules and Regulations for . licensing Construction' Supervisors, Section 2. 15) . This lack of awaren; often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the 4nlicensed person as it would with licensed Supervisor. The Home "Owner act.: as supervisor is ultimately responsible. W. To ensure that the Home Owner is fully aware of his/her responsibilities, ma communities require, as part of the permit application, that the Home Owner -ertify that he/she understands the responsibilities of a supervisor. On t last page of, this issue is a form currently used by several towns. You may :are to amend and adopt such a form/certification for use in your community. r,. TIIL' ci/lrllrlUrrli'caltll of.1 fassuchuse-M pc�purtllielit of ludurtrial Accidents .r ONCZ.9/1nyeS&9.711onS :ZZ.` 6U0 lf'usltrtrhrutrSlrcer �i Btivem..1 fixs. 0111 %%Iorl:crs' Compensation insurnnce Affid:ii•it _ G AZI 1Qr inn �Z am a liomec A,ner performing all %work myself. I am a sole proprietor and have no one working in am• capaciry -... _..__-►-.___..___�,...��+-.ram.-�-•--.. _ - _ _. - I am an empiaver providing workers* compensation for my empiovees working on this job. cnmiumv n tmt 't[Irirr<c• cars•• nhnnc�• - in<nr^nrr rn. npiict d I am a soie rroorietor. ;cnerni contractor, or homeowner(circle ottej and have hired the contractors listed bciow whc the -biloNving %vorke.rs compensation polices: cmmrinnv nnmr- fie flitnnC d' . in<nr-nrr rn t►niicv d .-..._._ .._ _.�._....._. �.....���..�_.�.�..�_ �---.�_�r - -- _ _•yam rnmr.Inv "nine nchl rr— ri.11- nftnnc • in-mrnnrc rn, eiic•8 Tom__ AM'Ch Uidit10_1121 Sntet if necc:si1Y y•e - .�.i►ri �• •r...•..�I. 'r•• •-• �NL._.�v: -.air :_'••rv...�. F:(riurc to s'ccurc cnvcracc as required n he ucr�ectton "A of NIGL 152 can lead to t lmpostuon of cnmtnal Penalties o1 a line up to S1:OU.UU anurcr unc cars' imprisonment as %%ell as Civil penait. n the form of a STOP NVORK ORDER and a fine ofS100.00 a day against me. 1 understand that r. copy of this aaecmeut may be fur. and a ce of Investieations of the DIA for coveragc verification. 1 do herenr ccrrift•[ux'•r the s iri raltiu afperjun•that the information provided above is true u-itd/correct. Si.^azure Date for Prinz nxn ��/C i --�l�C— Phone 9 ' oRciai c unly do not write in dtis area to be compacted by tiny or town OJTiciai ' E gin or town: Permit/license ri r tluildine Department k �Liccnsina hoard — O seieermen's Mice check if im(nctiiatc respunse is required t.. — (_'Tlicaith Department . phone Uthcr :onca:t ncr.nn: ' Mass'L:hu.scn.s General Lows chapter 152 section 25 requires all employers to provide workers' ciallflens:i::.;111 :; emnlovees. As quoted 1rr�m the "ta��'".an Implorer is defined as every person in the sen'icc of :uiclthcr unc::,_ col:tr:.ct of hire. express or implied. oral or written. _ An en plover is dcf-mcd as all individual. partnership. association. corporation or other Icgal esttity. or an-,, tivo e- the fure�_oin�_ cn�_z=�•d in a joint ctnerprisc. and including the leigal representatives of a deceased employer. or recciVer or tnlstee of an indi%,idual . partnership. association or other le`ni entity. employing employees. Ho«C". OWT:cr of;t dwelling house having not more than three apartmenis and who resides therein. or the occupant of: :e dig eiling !rouse of another Nvilo employs persons to do maintenance ,construction or repair work on such or on the __rounds or ijuildinL appurtenant thereto shalt not because of such employment be deemed to be ::n er.-o MGL .banter ! section also states that ever- state or local licensing ngency sItnil withhuld the issuanc: of a license or hermit to operate a business or to construct buildings in the commonwealth for ury ic::nt Who has not produced acceptable evidence of compliance with the insurhnce coverabc require:i. ,ACL�.::onail\% neither the commonwealth nor any of its political subdivisions shall enter into any contract for:fie per:6rm:.::cc of public work until acceptable evidence of compliance with the insurance requirements of this c::cr: hcc:: presc:acc to the contracting authority. -kJ)piicants .'iil in the workers' compensation affidavit completely, by checking :he box that applies to your situaao;: ; succi� Inc company names. address and phone numbers as all affidavits may be submitted to the Departmc^t of nc,_'.Iriai .Accide::is for confirmation of insurance coverage. Also be sure to si gn and date ilre affidavit. Tire it J:ould be returned to the cin• or town that the application for the permit or license is being requested. :;te Jena:t;1:e::t of•I»dustriai accidents. Should you have an questions re_arding rite "fa�v" or if you are -ec compc:a:1tlon policy. please c-ll the Department at the number listed below. Cite or TwxIl.s P!e�I _ ^e -urc :hat :ire affidavit is complete and printed legibly. The Department has provided a space at the b0- th : :: -:aa%•it for ',•ou to fill out in the ez-ent the Office of Investigations has to contact you re_t-din` the appiic::n:. be _ : to fiil in the permi&jicense number which will be used as a reference number. The affidavits may be m:urn; -:ie by mail or FAX unless other arrangements have been made. Tit: Ifficc of Ilivesti_atioils would like :o thank you in advance for you cooperation and should you have any que_: piersc do riot hesitate m !;,,,e us a call. Z. Ti;e address. telephone and fax number: The CommomveaIth Of Mlassachusetts Department of Industrial Accidents Offica sf investigations ' 600 «'ashin-ton Street ` Boston. lMa. O2111 fax T: (GIB —IL'-;i49