Loading...
HomeMy WebLinkAbout0040 OLD STAGE ROAD �� � :u �, y � �� � a � � _ . . , ., �_, a t . y ti - +; .. . . � o- .. - .. y c �: .... .. ....k I I �� � � i .. �, v -. - - � - _ i �. o Z �, l 71 .K �y � .. v '.. � _ .� � i. _ ..< � ,.. a .� a � �. u ' �� s ' >� „y �. � . .� � .. - ew .. r .., �+.. - _ « ! .: k a e .. e.. .� � - _ _� _ � � ., � s� 0 A F' � _ ,. , - ' r. ,_ �. .� .�. r -. ... -.. - ,:- c � .. .. .. .`, �, .� i � �¢ �5 0? "Sr -.. .�] r q i �� � t n:.. 9 a e .- i ' d e �., ,. ,, � , .. ,. y � - _ - 71{ � � � S �� a .f _ w'�" a `' i x � .v •q �� t ����.a �A � �,, ., � .. .. n i. _ - �. n ,. r ,. .� i�. .. ., �.- +v ..' � � � f. .. v - � .. .. ... o .. . .6. - v Town of Barnstable .k'l Building Post;ThlsCard So That rtls 1/ISIble:From�theStreelt�Approved,Plang's, Must,bepRetalned on J,ob and,atfils Ga„yrd Must be Kept i 1MAM 6 Posted ilnt I Flnallns ectlon Has Been Made f _ �y ebMxt° Wher, aCertlficate of Occupancy;s Reyu red;such Building shall,N,otbe©ccupled until a Final Inspection has been made er 1 ... ... ...«.,,�z� P.,, ,>+. -:,.:.x..�« :-F,. <,,. ..�"�>' -.tea:. S +.: •, x.:;: „ ." t�s,«.... k',..;"�.m.. «.aw.a.. ..«¢.«.,,:,f. ..,,h., ,_.�,..�,.3,..: t«.k ,.�.,.«.,, '- Permit No. B-20-513 Applicant Name: Henry Cassidy Approvals Date Issued: 02/21/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 08/21/2020 Foundation: Location: 40 OLD STAGE ROAD,CENTERVILLE Map/Lot: 208-041 Zoning District: SPLIT Sheathing: Owner on Record: MCKEEN, MICHAEL F&TRACEY A y� � Contractor Name CAPE COD INSULATION.INC Framing: 1 Address: 40 OLD STAGE ROAD Rk Contractor License 153567 2 CENTERVILLE, MA 02632 I'mProiectCost: $4,600.00 Chimney: Permit Fee: $85.00 Description: Weatherization � � s� , Insulation: Fee Paid.: 1 $85.00 Project Review Req: �` � Final 4- P Date 2/21/2020 Plumbing/Gas 1 a5 Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by h this.permit is commenced within sixJ' hs after issuance. All-work authorized by this permit shall conform to the approved application and t approved construction documents for which,this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zonmg::;by laws and codes. n This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. ' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Bu ding,d re Off als are provided on- is permit. Service: Minimum of Five Call Inspections Required for All Construction Work ' 1.Foundation or Footing z Rough: 2.Sheathing Inspection '" g F_. ': .. �,. �',R>- �•,° .« Via.^ �....� 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 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: 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: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT IMF Town of Barnsta l *Permit �� � - 6 month om issue date Building Department BARNSTABM Brian Florence;CBO Oct 9e� MASS, 1639• Building Commissioftft 3 �®,l ♦ 200 Main Street,Hyannis,M www.town.bamstable.ma.us 19k,84t 1p Office: 508-862-4038 �/ �5,08-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY enr\ �/it( ( Not Valid without Red X-Press Imprint Map/parcel Number " LJ-C 1 Property Address Yy D1,b $T*G4 2-1) CC-NTS7e✓/1iLC residential Value of Work$ 14 d 00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address /(l MAN6 le M44465 Contractor's Name Dou(aLor::S M V LLeA.) Telephone Number 7 7Y-Y87-6 77 5 Home Improvement Contractor License#(if applicable) ! 7 5 31 7 Email: l jUti mu-ILAiJ ak&Ld-�I&A,[aM Construction Supervisor's License#(if applicable) L 5 O� 5 orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ m the Homeowner I have Worker's Compensation Insurance Insurance Company Nam G 15oo 15 bt 3 30 A Workman's Comp.Policy A-al L Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ (check box) 0 Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ' ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *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 required. SIGNATURE: v — C:\Users\decollikWppData\Local\Microsoft\Windows\INetCache\Content.Outlook\9NNOKXYW\RESIDENTILONLYEXPRESS.doc 09/26/17 i T monweakh OfMassach setts 1J►s, rrr�raetr oflrrda strlal:Aeddeitf E�rce:af Itru�stigis 60,0�f'as�utgtoxr Street ' B�ston, U2�11 V rttas . ay/dia Workers' Compensation Ir susa davrh'Borders!Costa-actor lecta cians/Plumbers Aplicaitf:Infaematian 1 Please Print Teel* Name(Bus�inr hot nds�rdr lj N1 U &� .1ZU) W_k, '�C JQ L►� ` ��� G�� rPo Gcy/ rarep- TONS : iPone1 737 3?Ycl A►rr yro employer"Clerk the appropriate boa T of ert r . ,�, 4 I am a eaters! tractar and I y I p .1 ). 1 LSd'i am a employer vcith ❑ 8 6: ❑.Nevi .....baa .. employees{full andtor gait ome}' t��e: ued tt : b-c��ctais 2:❑:;I errs a sole pmpi e#ar pr partrret > listed on the aftached:sit Rem adelrag T1 a sub-csisttracton fra�xe and have no 8: I7emaPatioa:' '.�P Isi sad hac�e�ia�mrs, ❑ wodktng for we in arty tvwity 7 4: addition [into vuns s'coaup msa awe : camp:snsuranre x ❑B�i�ng I ❑ We are a coiporatron acid its 14:❑�ectrscai rega ar:asldrtro . reclurred-f �have exercised tl etr 11. Pleiinbtn errs ar.sdds#eons 3 ❑;I amp a hazer dour&;all vorl< ❑ f oWorkers rightofexe:";mperMOL myael [N crimp 12(� of retr i. mstuunce regrured c. 15.2.42(4),and use tie uo 2 ¢worker 13,C}the�r r1 comp;insurance required.) +Any apples diiti"b6z#1 MILSt llso SMow the secteccbAvwsbawiagr4eam es'c4mpenisadoupo cy afa €aL �Homeoatners w��bmit finis affidevu:tadicstmg itfie}ate doing aU��aiur 56en hne oae coattectats ttausc subatte a sea"attxracrn Sadtzatuig such. Coos wa ffimt:dE tkt box maul&=died=addifie [shm she the nme of the -ca amcwn and states.wlaethee Knox those'etmtie�_]ia�e -vlayees. iftheswb-contsav—ha e.e loy?es:du *Lt gmuide ter she€,"romp.polies a teuber I Qin B F #hl t isirov dues nror ers t Co eirsal oer it st�c for:may`e?u�p a .,MOO is th�Pvtloy turd' b sit inorrtiahort ;: �^� is Iastuansce Coany blame POhcy or Self ms IA G:# NJ J1/�/�/V / r[ I.., iratiall�8ti. Job Site Aar �U t 4.5 6- A� City/StatdZi0(�'Nt y/L1�T �ZG Attach a ropy Qf the.workers'compensa ti4oiL police deebration page.(showing:the pokey number and expiration date) Failure to.secure covserage as required under germs 25A of Br&c 1 S2:cam lead to the i�o�ttticm of criaiisaI pen�9t es of a. fine,up tc>$i; i?U.tKk andr`or one-Year imprisoninent,as vest as civil penalties inthiform of a.STDP.W.ORK ORDER And a fine, of np to$254:f Be advised-dia a rttpyr o. emeat,may behmarded to lire©f6ce of Investigations tareD.IA for itstmance:coverage verifiron 1 do hereby cer6fj ralr er tree pt#iias and pen alties ojJaerj ti that the an orrrrrr#iorr p rtrr�ded above is:i�r and;rarer. S Dam. ]?howr to c t arse;arrty arot aveite rvr tliis area,tv be co np ded crty me tmnn o croI City or 1'oircr. Pe.rrmt#tlieense#. - A.athonty{cuxle ose) 1.:Board ofHealth:2.Bing 1?epartmen#. 3,Cit}€Ease Clerk :Eleetricai Inspector S.:PIr€rabigg Insptc#or 6.:OOther::. Contact Person Phone#..: ` ,6 ACVRO® DATE(MNUDD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 5/15/2017 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 Ileu of such endorsement(s). PRODUCER CONTACT Ashley Paiva Southeastern Insurance Agency, Inc. PHONE (508)997-6061 A/C No:(508)990-2731 439 State Rd. E-MAIL ADDRESS: P a aiva@southeasternins.com P.O. Box 79398 INSURERS AFFORDING COVERAGE NAIC# North Dartmouth MA 02747 INSURER A Arbella Protection Insurance 41360 INSURED INSURER B AEIC Mullen Building & Remodeling LLC INSURER c PO BOX 1274 INSURER D: INSURER E: Marstons Mills MA 02648 INSURERF: COVERAGES CERTIFICATE NUMBER:2016 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 ADD S BR POLICY NUMBER MOM/LDI D/YPCY EFF MM/DI D/YYXP LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE OCCUR PREMISES Ea occurrenceDAMAGE TO RENTED $ 100,000 9520043214 9/8/2016 9/8/2017 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 R POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY CEOMB� BD SINGLE LIMIT $ 1,000,000 n A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED R 'SCHEDULED 1020024224 11/12/2016 11/12/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS R AUTOS Per accident $ Uninsured motorist BI split limit $ 250,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATt17E ER. ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A B (Mandatory in NH) WCC50050133082017A 4/30/2017 4/30/2018 E.L.DISEASE-EA EMPLOYE $ 1 000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/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 Display Purposes Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Ashley Paiva/AMP % ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 rgrrt4nit ��e�{Jcae,�tanmLcvett���a�UUGaJda�u.Je�J 1' Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR .. TYPE:LL I R Expiration xpiration a1�76317� 05/02/2019 MULLEN BUILDING:&;RiEMO5ELING,LLC.. r t„: JO - DOUGLAS MULL�N,. 87 HICKORY HILL CIR OSTERVILLE,MA 02655 Undersecretary ' t. Massachusetts Department of Public Safety ' ' � f Board of-Building Regulations and Standards r License: CS-081995sa Construction Supervisor I DOUGLAS W MULLEN ` 87 HICKORY HILL CIRCLE s 'OSTERVILLE MA 02666 / Expiration.: �Commissioher l Registration valid for individual use only before the expiration date. if found return to: Office of Consumer Affairs and Business Regulation _ 10 Park Plaza-Suite 5170 Boston,MA 02116 —R) 7 N t lid without signature r Massachusetts Department of Public Safety Board of Building Regulations and Standards .. License: CS-081995 :. , Construction Supervisor a DOUGLAS W MULLEN z s. 87 HICKORY HILL CIRCLE OSTERVILLE MA 0266li d1 F n+ , Expiration: // 01123/2018 Commissioher w �*�� :"47 to gY q J( r ,'y `�r���' " '^ Y 'Jyr �i' �''}a i'�y�,a�`• n•x'�.: k?t „ t, v`bf �a." a E4�t � r?''. -.,t w ,!��� u w t x _ r �a � �� ��. P.�,�.�rn,.•�rc�a. .�,5c � ��� s a "a. s �"!,. .� �ay � .:,�x ,�; � ' r SHE, Town of Barnstable Regulatory Services • BARNNST&E, ` Richard V.Scali,Director �Q M 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 Michael McKeen I, ,as Owner of the subject property hereby authorize Doug Mullen to act on my behalf, in all matters relative to work authorized by this building permit application for: 40 Ud Stage Road Gentesys44e,MA (Address of Job) F **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 inspections are performed and accepted. _ a Signature of caner Signatur of Applicant Michael McKeen Imo' LIb AQi Ce/^J Print Name Print Name October 21, 2017 Date e s�. Town, of Barnstable r Permit# Expires 6 mo s f om issue e yT Regulatory Services Fee * •AMSTABLE039. ass. Richard V.Scali,Interim Director ED k, 1 Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA'02601 , www.towii.bamstable.ma.us Office: 508-8624038, Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Q D Not Valid without Red X-Press Imprint Map/parcel Number Property Address c) I D S G s esidential Value of Work$ 1 Z?0 Minimum fee of$35.00 for work under$6000.00 r ' Owner's Name&Address I vl ( Q. Contractor's Name Telephone Number Home Improvement Contractor License#,(if applicable) Email: _ Construction Supervisor's License#(if applicable) - `- ❑Workman's Compensation Insurance Check one: ❑yam a sole proprietor IVQ V Q'I am the Homeowner 2.2 2��3 ❑ I have Worker's Compensation Insurance TO VVIV®FE Insurance Company Name ARAIe . TABLE . Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed).(stripping old shingles) All construction debris will be taken.to ❑Re-roof(hurricane nailed)(not stripping. Going over,._ existing layers of roof) RepIde lacement Wiridows/doors/sliders.U-Value ,4.AS:;+J (maximum.35)#'of windows _ r #of doors: ❑ Smoke/Carbon Monoxide detectors.4 floor plans'marked with red S and inspections required. , Separate Electrical&Fire Permits required. *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 SIGNATURE: TAKEVIN UBuilding Changes\EXPRES �RMITXPRESS.doc Revised 061313 The comrrto-Tavealth of Vassachusetts Depar'tnr ent ofhidustrial Accidents Offwe offwfffigafians 600 Washington.S?'eet Boston,Mai 02111 wnnv rnasmgoWdia Werkeis C:am nce Affidavit:Bindders/C;ontractorsMectriciansMumbers pensa.t�an Insures Applicant Infarmatiun Please Print LezibTy Name gkdwssl0rganizafiowIndividual): 1/*CA63z Ad&ess: °/a 060 ! :-7- f fin. City/State/Zip: ✓t ll6r- I-P241 Phone 47 4 '7- Aire you an employer?Check the appropriate box: Type of project(required): 1._❑ I am a employer with 4. ❑ I am a general contractor and I 6_ ❑New comsfruchoa employees(full and/or part4ime)* have hired the sub-contractors. 2.❑ I am a sole proprietor or partner- listed on the attached sheet +. ❑Remodeling strip and have no employees These sub-contractors have g_ ❑Demolition w for me in an capacity. employees and have workers' Diking y1 9_ ❑Building addition [No workers' comp.insura c nce e - comp.insura 5. ❑ We are a corporation and its 10..0 Electrical repairs or additions required]ho officers have exercised their 11-. Plumbing repairs or additions 3. I am a homeowner doing all work. ❑ g right.of exemption per MGL myself [No workers'comp- 12.❑Roo repairs insurance requited.]F c.152,§1(4),and we haim no employees_[No wotiCers' 13.❑Other comp.insurance required.] *Airy applicmt that dhedcs boa#1 amst also fill out the section below showing their worriers''compensation policy infocmatiam- T Homeowners wbo submit this affidavit indicating they are doing all work and then hire Outside contractors mnst subumit anew affidavit and csting scull tractors that check this box maul attached an additional sheet showing the name of&e sub-cogs and state whether ornot those entities have employees. If the sub-contactors have employees,they must provide their workers'comp.policy number. I am an empLuyer that is pros idirrg workers'comgeruafion insurauce for my empinyam Below is die policy and job site information. Insurance Company Name: Policy,;#or Self-ins-Lie 9- Expiration Date: Job Site Address: City/Stat&Zip: Attach acopy of the workers'compensation policy declaration page(shoving the policy number and e3 ration date). Failure to secure coverage as required.under Section.25A of MGL c. 152 can lead to the imposition of rim nil penalties of a fine up to S 1,500.Oa and/or one-year itnpri'sonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine.. of up to$250-00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do[tore by 'rtd�theprnns an doles ofgetjury thatthe information prntzded ab~is true and correct Si lure: Date: Phone#: official use only. Do not write in fills area,to be completed by city or town official. City or Town: PerimtUcense# Issuing Authority(circle one): 1.Board of Health 2.Butid ng Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing.Inspector 6.Other Contact Person: Phone#: 6 Regulatory Services Richard V.Scali;Interim Director tFIE Building-Division • t Tom Perry,Building Commissioner B" MASS.. Hyannis,MA 02601 �$ 260 Main Street, 679` www.town.bamstable.ma.us' . Fax: 508-790-6230 Office: 508-862-4038 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ^ dUD✓rsr,:n.�l . . n ✓ l�r a L� �J r de� ( village TOB.LOCATION: c. street number c�i1 - 2c "HOMEOWNER": 2 home phone# work phone# name CURRENT MAILING ADDRESS; br�1�12✓s l l Lr state ZIP coae cityltown g�s of six ts or less and to Th e current exemption for"home�ers was extended to include ssess Owner-ense,cu provided that theowner acts as supervisor. ow homeowners to engage an individual for hire who does not OF HOMEOWNER r two- e and/or farm structures. A person who constructs more than one 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 o form Person(s) family dwelling, attached or detached structures accessory to such all such work performed under the building-2ermit. (Section in a two-year period shall not d considered a homeowner. e for"homeowner"shall submit to the Building Official on a home y acceptable to the Building Official,that he/she shall be res onsib 109.1.1) e caner"assumes responsibility for compliance with the State Building Code and other applicable codes, The undersigned"hom o bylaws,rules and regulations. The undersigne d"homeowner"certifies that he/she understands the Town o dur Ba d regluirementsg Department minimum inspection proced emen and that he will comply with said procedures Signature of Hom can Appjoyal of Building Official p Code _ dwellings ill be required to comply with the State Building Note. Three-family s containing 35,000 cubic feet or larger w d g Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION shall be exenipt • "An homeowner performing work for which a buildingof construction opsrm provided that is t if the homeowner The Code states that. y from the provisions of this section(Section Se ti work that such Homeowner shall act as supervisor."p : engages a person(s)for hire to do r This lack of awareness often Many homeowners who use this exemption are Construction Supervisors,Section 2t15) Thisie lack of a suBoard pervisor (see Appendix Q,Rules&Regulations for Licensing Con er results in serious problems,p artices 6licensed persons. in this ease,our ularly when the homeown nsed person as it would with a rSupervisor. The home owner acting as Supervisor is proceed.against the unlicensed he ultimately responsible. .ensure that the homeowner is fully aware of his/her respndsithe"bilitresponsibil tie of re as part of the a Supervisor. On the last page To permit application,that the homeowner certify that he/she understa . of this is sue is a form currently used by several towns. you may care t amend and adopt such a form/certifieation for use in. your community.. <. Q.\wpFILES\FORMS\building permit forms\E}CpRESS.doc y i y _ Revised 061313. 1 oETME Town of Barnstable .. Regulatory Services - , 114,10MAsU, MAM Richard V.Scali,Interim Director ram" 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 OwnY st Complete and Sign Section If Usin A Bf as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to wo authorized by s building permit: (A dress <f job) Pool fences and alarms are the responsibility of the applicant. ,Pools are not to be filled or utilized e ore fence is installed and all final inspections are performed a 'd ac epted. / Signature of Owner ( S' a e of Applicant Print Name ' Print Name Date Q:FORM&OWNERPERMISSIONPOOLS 10/13 ::i::jiY;iiiY^i'i::;:;}i:;i.;:iivi}i::i:'viv$YM1::.:: :•: '�•:Y(Lttttiii:: .................:.:... ............. .. ; 1..... : il '1111 ME :... � ... Q..STAG....�..E RD.<:>:: n R LLE 03. MMR w� € :�< > > x v.,. ..:. ` AT IS LEGAL. Milli MEET WITH OWNER V AT OOP.M. is NOR i ISO 7 a G d� C RE iiiii! i 9 > ` M1 ................�..::........:.................................�<.:::.;:::.:::.::::::.�:::::.�:y:...................................................... .............:.:.:... ..... ..::::.:::........... L X�� Mt�.•.R........ . . fix:.. S G RD.4 iiiiiijCE NTERVILLy E Lid Jtgk . > „ S GL FAMILY.. ..�........... G USED S MULTIPLE.U LE. ;;. ..,:.:::t. :. :.:.:......,.:v.... ..... ems. ........,.v...,....::: ...:::.:::::.:.::..:::..... l 1� d on J G 5 Z � o a v �. o `s VAX T �3 r a �e� 0 rc! i .:•::.::::::::::::::i:4::tttLt4:t.,;..,:'v:•i:4.,:�:t:.:.. ::.:i:G:ti•:t i::v:'::' '•i:•i:•:•i:^:::::::::....::::.....w.v.�:::::vittv:w::.v:4:8:Gi};::::i:... �p•.�Yiiii}ii +:::::::::::• ttit:.t:L..y::::::.�::::: 2sessor's Office Ost floor) Map Lot O'V/ C-2_ Permit# r 'Conservation Office Oth floor Date Issued 6 J' ABoard of Health(aid floor) 7 ��z ,,� r QPTM ny,_ En gin eering Dept. Ord floor) House# �� /d/� ""'►� Planning Dept. Ost floor/School Admin.Bldg.): f M .. Definitive Plan Approved by Planning Board 19 SEP71C S .6 4. UST BE A lications roc sed 8:3 - :30 a.m.& 1:00-2:00 .m. INSTALLED IN C®NIPLIANCE W"TITLE 5 ENVIRONMENTAL CODE AND TOWN OF BARNSTABLET`'"""l r-"-1 r.1P Building Permit Application Project Street Address LI r Village /�,('a., .v.� l e_ Fire District Owner Addresses Su p r.� S{� �.to�-a,. .e.� Mt.„ , Telephone b 7- Ca Permit Request �a n•.t��.2�\ �o �a �.�w ,les1z 4— wt �v R Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Appeals Authorization Recorded Current Use 7,5.. Proposed Use ca Construction TyM Existine InfaLion Dwelling T �Single Family Multi-familyr Age of structure Basement Historic House Finished Old Kings Highway Unfinished Number of Baths No.of Bedrooms i Total Room Count not including baths 7 First Floor Heat Type and Fuel Ll r 14z \.. (,vim 4�e„r Central'&r Firet>lade's Garage: Detached Other Detached Structures: Pool Attached Barn Other Builder Information N,3me 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 Project Cost t ,S''cxX�,. ` Fee ©• SIGNATURE DATE le f gs BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) oa-h—, T�. BPERM T // 7 7 FOR OFFICE USE ONLY .A,/26/95 -r 7-8_z_, _ 208.041 -.,. 40 Old Stage Road Centerville ADDRESS I VILLAGE Richard Sher OWNER DATE OF INSPECTION: i FOUNDATION r �fG FRAME a ` W SULAJION ' _ ! ! t , FIREPLACE E r ELECTRICAL: ;ROUGH FINAL ` PLUMBING- ROUGH FINAL 7 GAS: W`` ROUGH b FINAL FINAL BUILDING: pj DATE CLOSED OUT: I ASSOCIATE PLAN NO. k { I in f r i UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS SENDER INSTRUCTIONS Print your name,address and ZIP Code J in the space below. • Complete items 1,2,3,and 4 on the reverse. U.S.MAIL • Attach to front of article if space ®� permits, otherwise affix to back of article. PENALTY FOR PRIVATE • Endorse article "Return Receipt USE, $300 Requested"adjacent to number. RETURN Print Sender's name, address, and ZIP Code in the space below. TO X Mr. Joseph D. DALuz, Building Commissioner TOWN OF BARNSTABLE 367 Main Street Hyannis, MA �©� ® SENDER: Complete items 1 and 2 when additional services a e-de-siied, and complete items 3 and 4. -Z-:- Put your address in the"RETURN TO" Space on the reverse side. Failure to do this will-prevent this-16ard from being returned to you.The return recei t fee will provide you the name of the person delivere�ty and the date of delivery, For additional fees the following services are available. Consult postmaster for ees an check box(es)for additional service(s) requested. 1. ❑ Show to whom delivered, date, and addressee's address. 2. ❑ Restricted Delivery (Extra charge) (Extra charge) 3. Article,Addressed to: 4. Article Number P 650 798 524 Mr. Michael Carr Type of Service: Economy,Cash Register of C.C. ❑ Registered ❑ Insured 40 Old Stage Road Centerville, , MA 02632 ❑ Certified ElRODrn Receipt ❑ Express Mail ❑ for Merchandise Always obtain signature of addressee or agent and DATE DELIVERED. j 5. Signature ddr s , 8. Addressee's Address (ONLY if requested and fee paid) 6. Sigliature — Ag :t X 7. Date o Delivery k PS Form 3811, Apr. 1989 •u.s.G.P.o.198e-238-e15 DOMESTIC RETURN RECEIPT P` 650" 795 524 V Certifi?. cf Hver Receipt No Insurance Coverage Provided Do not use for International Mail um ' (See Reverse) POSTAL SEINICE Sentto Mr. Michael Carr Economy Cash Register f Street&No. C C 40 Old Stage Road P.O.,State&ZIP Code Centerville, MA 0263 Postage Certified Fee Special Delivery Fee Restricted Delivery Fee C Return Receipt Showing rn to Whom&Date Delivered Q) Return Receipt Showing to Whom, Date,&Address of Delivery 7 TOTAL Postage C &Fees 0 Postmark or Date M lL (D a STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS.POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). 1.If you want this receipt postmarked,stick the gummed stub to the right of the return address J leaving the receipt attached and present the article at a past office service window or hand it to m your rural carder(no extra charge). y m 2.If you do not want this receipt postmarked,stick the gummed stub to the right of the return' address of the article,date,detach and retain the receipt,and mail the article. I . o 3.If you want a return receipt,write the certified mail number and your name and address on a},' rn return receipt card;Form 3811,and attach it to the front of the article by means of the gummed' T ends if space permits.Otherwise,affix to the back of article.Endorse front of article RETURN c RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, p I[ endorse RESTRICTED DELIVERY on the front of the article. M 5.Enter fees for the services requested in the appropriate spaces on the front of this receipt. If E return receipt is requested,check the applicable blocks in item 1 of Form 3811. i 6.Save this receipt and present it if you make inquiry. *U.S.G.P.O.1990-270.153 a i i _ � r ' JOSF,PH D. 'I ALUZ (508)790-6227 P Building Comnriuioner TELBPHONEt 87,p== 7;»4SXO�C . TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS. MASS. 02601 August 15, 1991 Mr. Michael Carr Economy Cash Register of Cape Cod 40. O1d Stage Road Centerville, MA 02632 RE: A=208=041 40 Old Stage Road, Centerville Dear Mr. Carr: This office is in receipt of your request for a two (2) month ex- tension of time to relocate your business. Please be advised that I cannot grant your request and further that the sign must be removed and the business use of the property must be terminated immediately. Your failure to comply will cause me to seek a complaint in the First District Court. Peace, 4 \ sep D. DaLuz ' Building Commissioner +� JDD/gr Certified mail: P 650 798 524 R.R.R. v ;4 9 Ik 1. t Fa ECONOMY CASH REGISTER 40 OLD STAGE ROAD CENTERVILLE, MA 02632 August 8, 1991 Dear Mr. DaLuz, This is in response to my accidently operating an office in a residential zoned area. Again,my landlord telling me he had to take the utilities out of commercial rating when he purchased the property, the rear shed having a formal burglar alarm, and then-e being a bakery and coffee shop a few doors down, and the buss_iness license being issued for this address, (Florida is computerized �irld- clieck's for proper zonning when license is taken out ) . These were the the things which mislead me to thinking an 'office" without retail "walk-in" traffic would be no problem here, my apologies. With regaurds to the time it will take to move the office, I respectfully request two -rented"months to facilitate this move. This would- allow me to locate a suitable local, and gear up financially the estimated 2000.-3000. ( First and last's months rent, damage and security dei. osit, electric deposit (now included in my rent) , phone installation, ect. ) In addition this, by chance, will allo�,,T :pie to keep my word to T�,1u current landox:d and fullfill my lease. This needed time will be much apprieciated, and be certain we' ll do everything in our control to deep a low profile in. route to our move. Thanks again for your cooporation. Respec fully ours, Michael Carr .Economy Cash Register i` UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS SENDER INSTRUCTIONS Print your name,address and ZIP Code in the space below. • Complete items 1,2,3,and 4 on the reverse. V�O • Attach to front of article if space permits, otherwise affix to back of article. PENALTY FOR PRIVATE • Endorse article "Return Receipt USE, $300 Requested"adjacent to number. RETURN Print Sender's name, address, and ZIP Code in the space below. TO Mr. Joseph D. DaLuz, Building Commissioned- TOWN OF BARNSTABLE 367 Main Street Hyannis, MA 02601 • SENDER: Complete items 1 and 2 when additional services are desired, and complete items 3 and 4. Put your address in the"RETURN TO"Space on the reverse side. Failure to do this will prevent this card from being returned to you.The return recei t fee will rovide ou the name of the person delivered to and the date of deliver . For additional ees t e ollowing services are available. Consult postmaster for fees and check oxles or additional service(s)requested. 1. ❑ Show to whom delivered, date, and addressee's address. 2. ❑ Restricted Delivery (Extra charge) (Extra charge) 3. Article Addressed to: 4. Article Number i P 650 798 513 Economy Cash Register of Type of Service: Cape Cod ❑ Registered ❑ Insured 40 Old Stage Road ❑ Certified ❑ COD ❑ Express Mail ❑ Return Race-pt Centerville, MA 02632 for Merchandise Alway§gbbtain signature of addressee h, a or aber,t aqd DATE DELIVERED. '5. S'gnatu e — Addresse I 8. Addressee's Address (ONLY if X ati> requested and fee paid) ,4. Si ure — Agen X 7. ate eliv y� PS Form 3811, Apr. 1989 *U.S.G.P.O.1989-238-815 DOMESTIC RETURN RECEIPT Certified Mail Receipt No Insurance Coverage Provided o Do not use for International Mail 11RfrE0 ST1RES (See Reverse) POSTAL SERVICE Sent onomy-Casri Register o Cape Cod Street&No. 40 Old Stage Road P.O.,State&ZIP Code Centerville, MA 02632 Postage Certified Fee Special Delivery Fee Restricted Delivery Fee O Return Receipt Showing to Whom&Date Delivered Return Receipt Showing to Whom, Date,&Address of Delivery TOTAL Postage p &Fees Postmark or Date M E 11 co d STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, M CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). i 1.If you want this receipt postmarked,stick the gummed stub to the right of the return address i leaving the receipt attached and present the article at a post office service window or hand it to f your rural carrier(no extra charge). 2.If you do not want this receipt postmarked,stick the gummed stub to the right of the return aa;, pI address of the article,date,detach and retain the receipt,and mail the article. I I O 3.If you want a return receipt,write the certified mail number and your name and address on a rn return receipt card,Form 3811,and attach it to the front of the article by means of the gummed i ends if space permits.Otherwise,affix to the back of article.Endorse front of article RETURN e RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, j endorse RESTRICTED DELIVERY on the front of the article. A i 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If i return receipt is requested,check the applicable blocks in item 1 of Form 3811. i i 6.Save this receipt and present it if you make inquiry. *U.S.G.Ro.1990-270-153 a i s JOSEPH D. DALUZ Building Conimirtiontr - XXXRMXkW TELEPHONE 508-790-6227 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 July 22, 1991 Economy Cash Register of Cape Cod 40 Old Stage Road Centerville, MA 02632 RE: A=208-041 40 Old Stage Road, Centerville Gentlemen: This office is in receipt of a written complaint re the use of the residential property located at 40 Old Stage Road, Centerville, for business purposes. Please contact this office immediately re the above matter. Peace, ?Jse' D. DaL zing Commissioner JDD/gr Certified mail: P 650 798 513 R.R.R. 4 r�S L r P 650 794 503 Certified ;Mail Receipt No Inpranea+�overage Provided o Do not use for International Mail �ntoAL STATES (See Reverse) POSTAL SERVICE Sent to Mr. William A. Allen Street&No. 2729 F Ridgewood Avenue P.O.,State&ZIP Code Elkhart, IN 46517 Postage Certified Fee Special Delivery Fee Restricted Delivery Fee O Return Receipt Showing pt to Whom&Date Delivered O) r Return Receipt Showing to Whom, Date,&Address of Delivery 7 71 TOTAL Postage p &Fees co Postmark or Date M E LL tL STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). 1.if you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to Y your rural carrier(no extra charge). i, 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date,detach and retain the receipt,and mail the article. C [[ o I 3.If you want a return receipt,write the certified mail number and your name and address d a rn return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to the back of article.Endorse front of article RETU.ON !, RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, O ° endorse RESTRICTED DELIVERY on the front of the article. co 1 5.Enter fees for the services requested in the appropriate spaces on the front of this receipt.If E return receipt is requested,check the applicable blocks in item 1 of Form 3811. ti 07 6.Save this receipt and present it if you make inquiry. *U.S.c.ao.19s0-z70-fs3 a r J03F,PH D. DaLuz xR�+[lti kill lx�xlAEkx Building,Commissioner EXT. 107 XXXRXXxxxx . xs:sra°Ns soa-iso-ezi7 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 June 19, 1991 rk Mr. William A. Allen 2729 :F.Ridgewood AVenue Elkhart, IN 46517 r i RE: A=208-041 40 Old Stage Road, Centerville Dear Mr. -Allen: *' ;�. This office is in receipt of a written complaint re the use, of your property located at 40 Old Stage Road, Centerville, -for business purposes. Please contact this office immediately re the above matter. Peace, ' z Y JsphD. D uilding Co issioner, k + JDD/gr Certified mail: P 650 798 503 R.R.R. cc: Town Manager ' . L .mot 62 Old Stage Road Centerville , MA 02632-3177 June 19 , 1991 Mr . Joseph D . DaLuz Zoning Enforcer Town of Barnstable Town Office Building 367 Main St . Hyannis , MA 02601 Dear Mr . DaLuz : I wish to bring to your attention and action a zoning violation in the Village of Centerville . There is at present a company doing business as Economy Cash Register of Cape Cod at 40 Old Stage Road . Both the NYNEX white pages and classified pages of the directory carry a listing of the company without a street address ,. only the Village . This morning , Wednesday , a delivery truck was present at that address over an hour with a negative impact on the commuter traffic . This and the presence of automobiles at the address during the day provides certain evidence of a business establishment . Will you please provide me with the results of your investigation of this zoning violation . Very truly yours , William H . Crowley �D�J ° qs ][R20S 041 . LOC10040 OLD STAGE ROAD CTY110 TOSI 300 CO KEY] 126697 ----MAILING ADDRESS------- FCA11041 FCSj00 YR100 FARENTj 0 ALLEN, WILLIAM A a SANDRA L MAFj AREA154AA aV140321S MT011004 2729 P RIDGEWOOD AVE SFI] SP2j SF3.j-3 Uri] UT2] .50 A FT] 1664 ELKHART IN 46517 AYS]1900 EYB11975 OBSI CONSTj 0000 LAND 112500 IMF 123700 OTHER 4100 -----.LEGAL DESCRIPTION---- TRUE MKT 240800 REA CLASSIFIED &AND 1 112,500 ASV LND 112500 ASD IMF 123700 ASV OTH 4600 #SLDO(S)-CARD-1 1 123,700 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 4f600 TAX EXEMPT #PL 40 OLD STAGE RD CENT RESIDENT'L 240800 240800 240800 W LOT PAR I OPEN SPACE #RR 1174 0123 COMMERCIAL INDUSTRIAL EXEMPTIONS SA101SS PRICE 147500 RB]6234213 AFVj I TE4 O 1 LAST ACTT VITY10410SI91 PCRjY yob twc ro` 4' = The Town of Barnstable '" NAI ` Inspection Department 1e1o. 367 Main Street, Hyannis, MA 02601 50.8-790-6227 Joseph D.DaLuz Building Commissioner S September`10, 1991 Mr. William H. Crowley 62 Old Stage Road Centerville, MA 02632 RE: A=208-041 40 Old Stage Road, Centerville Dear Mr. Crowley: Please be advised that this office has made unsuccessful attempts to contact the owner of the property located :at 40 Old Stage Road in Centerville. However, I have been in contact with the resident of the dwelling and informed him that his business operation is in violation of the Town of Barnstable Zoning Ordinance. Enclosed please find a copy of my latest letter to the resident. The sign has been removed and apparently the business use has been terminated. If I may be of any further assistance please contact this office. •P lace, !JoseD. DaLuz Building Commissioner r = JDD/gr ► cc: Town Manager Enc. $< RESIDENTIAL PROPERTY, r;MAP.NO.' FIRE DISTRICT SUMMARY LOT. NO. 40 Old Stage Rd. f. STREET. EeAteY'Vill 73 LAND N' 2O8 41' C-�0 � BLDGS: � 7. a OWNER TOTAL LAND ;,.•,,.-. RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: PS,T'Cel. l BLDGS. TOTAL t% LAND s �x a) BLDGS. TOTAL L - --- LAND ai ��- _ f.. � � BLDGS. TOTAL i Bel l.a • Andree U.` _ /_ ' LAND /Pf Z oX / o r95T/IIfI p / rn WE� BLDGS. TOTAL LAND � BLDGS. TOTAL r e 1 LAND BLDGS.` a f - 0) TOTAL LAND j BLDGS. INTERIOR INSPECTED: 7 TOTAL DiATE. /� 7/ ��G�l/ ji Gj/ ��'��/t� %�/L.C�_� LAND ACREAGE COMPUTATIONS BLDGS. y µ> f.LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE ^ TOTAL °HOUSE LOT U �L �� 2� Zaa LAND BLDGS. {';CLEARED FRONT - TOTAL REAR LAND j�'WOODS&SPROUT FRONT -- � BLDGS. - ",`t•„ . REAR TOTAL.. .WASTE FRONT. LAND' REAR � BLDGS. TOTAL LAND BLDGS. ,.; LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT. PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ' ROUGH TOWN WATER BLDGS. �,. •. . HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. rn TOTAL C AA ACG - UNITED APPRAISAL CO., EAST HARTFORD.CONN. Conc'Blk.Walls Bsmt.Rec.Room St. Shower Bath Bsmt. d $ O PURCH. DATE Coec::Slab ,.' Bsmt.Garage St. Shower Ext. Walls _ PURCH. PRICE Brick-Walls" Attic Fl. &Stairs Toilet Room Roof RENT [/!9J'"• Stone Walls Fin.Attic I= Two Fixt. Bath Floors PierE• INTERIOR FINISH Lavatory Extra Bsmt. F 4 2 3 Sink 1/2 ycy Plaster j Water Clo. Extra Attic EXTERIOR WALLS Knotty Pine Water Only i Double Siding Plywood No Plumbing Bsmt. Fin. —�� 7 � t Single Siding Plasterboard Int. Fin. /.yO(Shingles TILING :onc. Blk. G F P Bath Fl. Heat6, Face Brk.On Int. Layout Bath Fl.&Wains. Auto Ht.Unit Veneer Int. Cond. Bath Fl. &Walls Fireplace Com. Brk.On HEATING Toilet Rm. Fl. Plumbing Solid Com.Brk. Hot Air Toilet Rm.Fl. &Wains. --- -- Tiling Steam Toilet Rm.FL&Walls Blanket ins. Hot Water St. Shower Roof Ins. Air Cond. Tub Area Total Floor Furn. a ROOFING COMPUTATIONS Asph. Shingle Pipeless Furn. O S.F. 3 3 U , Wood,,Shingle. No Heat S.F- Asbs. Shingle Oil Burner ;( S.F. Slate' ' Coal Stoker S. F. Tile Gas' S. F. = OUTBUILDINGS ROOF TYPE Electric Gable Flat S.F. 1 2 3 '4 5 6 7 8 9 10 1 2 3 4 5 6 71819110 MEASURED Hip Mansard FIREPLACES S.F. Pier Found. Floor 4 i✓ Cj/ G Gambrel Fireplace Stack Wall Found. 0. H. Door LISTED . FLOORS Fireplace Sgle.Sdg. Roll Roofing �y Conc. + LIGHTING Dble.Sdg. Shingle Roof Earth No Elect. ^ DATE Pine Shingle,Walls Plumbing ,Hardwood ROOMS Cement Blk. Electric PRICE D 'Asph.Tile Bsmt. Ist�f TOTAL �� Brick Int. Finish Single.` 2nd oZ 3rd FACTOR �O a� UD _ REPLACEMENT ta: .00CUPANCY CONSTRUCTION SIZE .AREA CLASS AGE REMOD. CONE). REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. ADVVLG. -'a1n, S"f" /t� S \ /��* S cZ x•) J O IS-1 5/7 S o o 75 a 3 a 4 - - 5 - - 6 8. t.-9 .. - 14 . . TOTAL. r c F