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0064 THREAD NEEDLE LANE
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' .. r , Q0�0 I -T lot t I , }4- f i ii If ee& tj z 4et t O PatrN A d G� ement/S pi the . jte- 11 S ) of to ?QW D - - - ' '. p : I I t.. . -t-- .t--. a- ,-i J t•,- - _. _,..J-t.,.{ ..F r{_.i...� t - ' ; fr i i •- �C'ur� v-r:E.le i 9o� ��cftwG�e;� o. as an o a zeco.,o t l i n J I at t i at rNa,- 0. 601. { -�_. .a � • _ r }..i J t :'..':. t_ I=:; ( ,..i.j i 1 V' I r _... ...j ':..._a... .. .� _.j_� .� 1 :i�� �a -�{ � �f .--"� I , _ _ :-_J_'_ _- 'i__ _..-•'�'� -..1._1. �l- _y._ '� r ... _ � j 71 . - - -- - , 17 t. -- NO�� y � Application numbe ...a. �.. ...... Date Issued,............�.lZ�,�,��,,, .�srnsie. .. ...................... � x639. ,AyFa ��� Building Inspectors Initials.......... Z.., MAR 262019 ' 20�9 TOI�,�� Map/Parcel... R....O�..�................................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: . ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/VVEATHER IZATION PROPERTY INFORMATION Address of Project: e NUMBER STREET VILLAGE Owner's Name:!,.L� r a zx—ta-phone Number °�ZS= S��_ � /a o Email Address: q ensa,eO12_7Cell Phone Number Project cost$ 5 Z p p - Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Sep -1cA,JwV 061,4`14 Date: TEE OF wORK �idg Windows (no header change)#, El Insulation/Weatherizatio n Doors (no header change)# Jo Commercial Doors require an inspector's review ❑ Roof(not applying more than I layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractors name I;cal, `7Qn.�,sor, - �„(-1.��� a�jp� �r (<v4 kfi'n Jaw Home Improvement Contractors Registration(if applicable)# 17 3 Z.q.5 (attach copy) Construction Supervisor's License# O-I S—7 07 (attach copy) Email of Contractor $L,)ee�9 55d ; (• C M Phone number qol- Z 2 R -I R ALL PROPERTIES THAT HAVE STRUCTURES as YEARS OLD OR IF THE SUBjE r pRopERTy►s e,V A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a:for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pnr. Commercial events may require Fire Department approvap *WOOD/C®A.JPELLPT STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab r Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number . Cell or Work number I understand any responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures;specific inspections and documentation required by 780 CMR and the'Town of Barnstable. Signature Date PLICANT'S SIGNATURE Date -Z O- 19 .Signature , AM permit applications are subject to a building of vial's approval prior to issuance. f Renewal Agreement Document and Payment Terms b Andersen• dba:Renewal By Andersen of Southern New England Tomas&Barbara Isaksson Legal Name:Southern New England Windows,LLC 64 Thread Needle Lane RI#36079,MA#173.245,CT#06345551 Lead Firm#1237 Centerville,MA 02532 ...... pE .ncee,ent 10 Reservoir Rd I Smithfield,RI 02917 - - - - H:(925)586-3400- Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com' Buyer(s)Name: Tomas & Barbara Isaksson Contract Date: 03/08/19 Buyer(s)Street Address: 64 Thread Needle Lane, Centerville, MA 02632, - Primary Telephone Number: (925)586-3400 Secondary Telephone Number Primary Email: TOm6slsaksson9@msn.com Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Con tractor'),in accordance with the terms and conditions described in this Agreement . Document and Payment Terms;any documents listed in the Table of Contents,and any other document attached to this Agreement Document, the terms of which are all agreed to by the parties and incorporated herein by_reference,(collectively, this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $15,200 By signing this"Agreement,you acknowledge that;the:Balance Due,and the Amount Financed must be made by personal check;bank check,credit card,or cash. Deposit Received: $5,066 Balance Due: $10,134 Estimated Start: Estimated Completion: Amount Financed: 8 to 10 weeks $0 8 to 10 weeks Method of Payment: Cash/Check : We schedule installations based on the date:of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that - we are providing at this time is only an estimate.,We will communicate an official date and time at a later date..Rain and a%Creme weather are the most common causes for delay: Notes: Deposit paid via check; (To be mailed); ;Taxes paid in Barnstable MA s i Buyer(s)agrees and understands that this Agreement constitutes.the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without.the signed,written consent of both the Buyer(s) and Contractor. Buyer(s)hereby acknowledges that Buyer(s) 1).has read this Agreement; understands'the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement: NOTICE TO BUYER:,Do:not sign this contract if blank:.You are entitled to a copy'of the:coniract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 03/12/2019.OR THE THIRD BUSINESS.DAY AFTER THE DATE OF THIS TRANSACTION,' WHICHEVER.DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dkia:Rene�Bynderseiof So�Newnd Buyers) —",+ Signature of Sales Person Signature Signature Josh Ocharsky Tomas Isaksson Barbara Isaksson Print Name of Sales Person. - Print Name Print Name- { UPDATED:'03/08/19 Page 2 / 11 F I. Office Of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home improvement Contractor Registration Type: Supplement Card Registration: 173245 SOUTHERN NEW ENGLAND WINDOWS, LLC Expiration: 09/18/2020 10 RESERVOIR ROAD SMITHFIELD, RI 02917 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Reouiation 173245 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW ENGLAND WINDOWS.LLC. Boston,MA 0211�8-tee` BRIAN DENNISON 10 RESERVOIR ROAD SMITHFIELD.RI 02917 Undersecretary va n. without Signature C.-3mmon`t eail:s of i!Massachuls;e Board of Building Reg"'jilati;oris and S3andat ds 1(y(�3py ®C Ey9g5q��i,/�gJ L (gyp CHARLTON MA..01507Commissioner s �� 1 The Comntottwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 a Boston M4 02114-7017 www mms.. Idia «-orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMf1TLNG AUTHORITY. Applicant Information Please Print Legibly Name(Business/Oraanization/Individual): G her Q IA.� Address: City/State/Zip:S t t-�j e�c( ��! 4z9 17 Phone#:_ 40l—Z2 R-- ? �y Me y as employer'Check the appropriate box: Type of project(required): I. 1 am a employer with 20- employees(full and/or part-time).* 7. New construction 2.M I am a sole proprietor or partnership and have no employees working for me in 8: Remodeling any capacity.[No workers'comp.insurance required.] 3.01 am a homeowner doing all work myself.[No workers'comp.insurance required.]' 9. ❑Demolition 4.®I am a homeowner and will be hiring contractors to conduct all work an my property. [will 10 ❑Building addition ensure that all contractors either have workers'compensation insurance or are sole I I.[]Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.01 am a general contractor and I have hired the subcontractors listed on the attached sheet. 13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance.* __ff __ 6.®We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Cher /ram�/ [�'Q�.� 152,§1(4).and we have no employees.[No workers'camp.insurance required.] *Any applicant that checks box Al 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. ;Contractors 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 subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for ray employees Below is the policy and job site information. Insurance Company Name:- !ceAe 5 as of a A °- (o . Off- a Policy#or Self-ins.Lic.C yV C a .3 15 g-7 2.c'1 2- Expiration Date: Job Site Address: Lla V �h/'end 4[eecl% 4a4e_ City/State/Zip: eei)�wy dle_ ti'IA Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pal d penalties of perjury that the information provided above is true and correct SiQrtature: ' Date: Phone#: (ZI 7 2� (� Official use only. Do not write in this area, to be completed by city or town offrciaL 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!#: DATE(MMIDDIYYYY) AC� `�. CERTIFICATE OF LIABILITY INSURANCE 12/26/20 18 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 O A CoBiz Insurance, Inc.-CO NAME: 1401 Lawrence St., Ste. 1200 PHCNo Ext: 303-988-0446 we No:303-988-0804 IL Denver CO 80202 ADDRESS: COMail@cobizinsurance.com INSURERS AFFORDING COVERAGE NAIC is INSURER A:Acadia Insurance Company 31325 INSURED ESLERC"l INSURERB: Flremens Insurance Company of WA,D.C. 21784 Southern New England Windows, LLC. dba Renewal by Andersen of Southern New England INSURER C: Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:787175890 REVISION NUMBER: A 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. I�TRR TYPE OF INSURANCE ADDL SUBR . POLICY NUMBER MMIDDIYCY YYY MMIDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $1.000,000 A AGE ToCLAIMS-MADE a OCCUR PREMISES Ea occurrence $300,000,,; MED EXP(Any one person) $10,000 PERSONAL 8 ADV INJURY $.1,000,000 GEN'L AGGREGATE.LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY❑PRO- ��LOC PRODUCTS-COMP/OP AGG $2,000,000 X JECT I_1 Y OTHER: $ A AUTOMOBILE LIABILITY CPA3158728 1/1/2019 1/112020 COMBINED SINGLE LIMIT I$ Ea accident 1 000000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ ,A X UMBRELLA LAB X OCCUR CPA3158728 1/l/2019 1/1/2020 EACH OCCURRENCE $15,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000;000 DED X I RETENTION$II $ B WORKERS COMPENSATION INCA315872924 1/1/2019 11112020 X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECLITIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,000,000 N yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Pollution Liability 7930073340000 1/1/2019 1/1/2020 Each Occurrence $2,000,000 Claims-Made Policy Aggregate $2,000,000 Retroactive Date 06120/2 01 3 Deductible $25,000 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR INFORMATIONAL PURPOSES ONLY AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01), _ The ACORD name and logo are registered marks of ACORD Town of Barnstable j"E' Regulatory Services TOWN OF BARNSTABL Thomas F.Geiler,Director. M AM g Building Division 417t1 AUG -5 PH �; �� o�►`� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us - .x. Office: 508-862-4038 Fax: 508-790-6230 0 PERMIT# �b I U`f f �. FEE: $ , SHED REGISTRATION 200 square feet or less Location of shed(address) Village �e Property owner's name Telep one number Size of Shed Map/Parcel# jipgn"atureo"� Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:004:30&3 3r 0 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE `> COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A �- -PLOT PLAN -forms-shedre L/ Q 8 REV: 2 OS Ol l NNEt — .a _.—,- •— - -1-, L..+—T"T';' 't-;—.`.--a--'-'�,--I—Ir-I -�.'- - --�—F 1 i. � . G t - - 5-1 RUSS _ 1 L .. _ _. --- - - - - I . .. ,: . I i - 44 y -, - - t 1 j 1 . r F Ff�7 ITT Till —1 I ipill1 � 1 - nseetis. xii.e a.e.� 0 Point tk... �' .,. back g Mice . y LSt no t . E E .- r } � 1 0, r LS:oa I , /� I n:_ ' e�u�.Ge, u�,lcG,ui Co, 9o� �cJIu.C�e l3 I . ehown o a zero 1 lid ABC p c1910115 off 9 ►twat o1 ca /dya.wu,e.,-, In4 026 � s .f-.� t I ( { -'.. t i I } { � I •_.� �._ 1 a 1- i 1. � � �..1 � 1 r.; -1 i- � ;- { �-� � ���.�. -i -� - —�---~ •i t - 1. - - M` 1 TWIT 1 TO { j A ! AT '-} — - Y }— t F _ rtrt I ALLYFAL 1004.,: .. t.. -ryy- ; ,-t-�+-H-i--r ---�- ! -. 1 —r _ _I.�y....f•1- --i--{ -f_�_., { t - F ,..t TOWN OF BA.RNSTABLE ' -CETIFICATE OF OCCUPANCY PARCEL ID 210 081 OEOBASE ID 13008 ADDRESS . 64 THREAD NEEDLE LANE PHONE � CENTERVILLE ZIP - LOT. 4 BLOCR - LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 40729' DESCRIPTION CERTIFICATE OF OCCUPANCY PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY . I CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: THE 1r�. BOND $.00 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P * " STABLE, +' MASS. s6g9. A�� I EO MAl BUILD � VISIO � "B DATE ISSUED .08/27/1999 EXPIRATION DATE, PARCEL ID 210 081 GEOBA.SE ID 13008 ADDRESS 64 THREAD NEEDLE LANE PHONE s CENTERVILLE L -��� ZIP - If LOT 4 BLOCK LOT SIZE' DBA DEVELOPMENT DISTRICT CO PERMIT 30207 DESCRIPTION SINGLE FAMILY DWELLING (SEW_#98/97 PERMIT TYPE BU.ILLD- -T-TITLE- -�- - -NEWS-RE8IDENTIA'L, BLDG PMT y CONTRACTORS: SCHULZE, WILLIAM Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $291.90 Ox BOND $.00 � k CONSTRUCTION COSTS $94, 160.00 101 SINGLE FAM HOME DETACHED 1 PRIVATE P ' a. 'd°°kAB ' BA'iRLE, MASS. 0.19. BUILDING DIVISION y BY DATE ISSUED 04/16/1998 EXPIRATION DATE �l . - WILDING VtMMI.T PARCEL ID 2J-6 U81 GEO—BASS III: 13008 ��DDRES� , 84 ` I�?EAD NEEDLE LAN PRONE � ITER�'I�� E � �� zip DI LOT a BLOC ;` LOT SIZE. DB FVELOPMENT, DISTRICT CO .. PERMIT r 30207 DESCRIPTION SINGLE FAMILY' Dy4E'llINC (S W- 98/97 PERMIT e�YPR' ` BUILD TITLE NEW RESIDENTIAL BLDG Wt CONTRA'CCTOR,fj• 89kUL E� WIMIA Department of Health, Safety, ?RCTIITECTS __and Environmental Services TOTyA'�L FEES: v }� $2911 9U CONSTRLId'TT:0N $94,160 r DD "` ' � Qi► 10 1 SINGLE FA HOE DETACHED 1 PRJ WM ram. '; * HARNSTABM . MASS. ti i639. BUILDINGDIVISION BY `:. A - - i...,.- _^• .. _ .f err - -. ,..++ DATH 'ISSUED 04/16/1998 PI RAT IO'R DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN= CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED.FROM THE DEPARTMENT OF PUBLIC W_ ORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE.APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND M FOR (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. CH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION-HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. - ® - o • - em m 0- BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 ( � QILG'r'19 2 � Yr�jC ovN" 2 3 1 HEATING INSPECTION APPROVALS ENGINEERI D PARTMENT . 2e Q, BOARD OF HE L p IIIJJJ � �ttQij %�c„ � �Z� 9/ OT ER: .4t"ASITE PLAN REVIEW APPROVAL r WORK SHALL NOT PROCEED UNTIL PE IT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE.ARRANGED FOR BY VARIOUS STAGES-OF CONSTRUC- MONTHS,OF)DATE YHE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. - '?' �'� � • saA t � 1 I �jj► . �� � �� - _ _ . F �.x-_ __ -. _ .... ` i . ,,� . p �+ / �'� HENRY L. MURPHY, JR. J. DOUGLAS MURPHY MURPHY AND MURPHY TELEPHONE Y COUNSELLORS AT LAW (508) 775-3116 4 G. ARTHUR HYLAND. JR. 243 SOUTH STREET - F A X SUSAN MERRITT-GLENNY (508) 775-3720 LOCK DRAWER M '� ALSO ADMITTED IN CONNECTICUT HYANNIS, MASSACHUSETTS 02601-1 4 1 2 NOTARY PUBLIC REPLY OUR FILE No. 8378—A November 27, 1992 Joseph DaLuz, Building Commissioner Town of Barnstable Town Hall Main Street Hyannis, MA 02601 Re: Lot 6, P1an1Book 191, Page 47', Threadneedle Lane, Centerville) MA. Being also Town cf Barnstable Assessors Map 210, Parcel 83 (the 10Locusto Dear Mr. DaLuz: This office has been asked to review certain materials submitted to us b T Walter r Wannie and Meredith S. Wannie relating to the Locus. The materials submitted include the followin g- 1. Deed from James J. Taylor and Pauline N. Taylor to T. Walter Wannie, , Jr. and Meredith S. Wannie, dated 9/10/65, recorded with the Barnstable County Registry of Deeds 9/15/65 in Book 1311, Page 406. This deed conveyed the Locus. r 2 . Deed from T. Walter Wannie, Jr. and Meredith S. Wannie to T. Walter Wannie dated and recorded 10/23/89 in Book 6930, Page 226. This deed conveyed the Locus. 3 . Deed from T. Walter Wannie, Jr. to T. Walter Wannie, Trustee T. Walter Wannie Revocable Trust u/d/t 6/29/90 dated 2/3/92, recorded with said Registry in Book 7863, Page 15. The Locus is located within an RD-1 Zoning District of the Town which permits single family residence dwellings. Prior toi February 28, 1985 the Locus conformed to the requirements of the " then existing zoning by-law relating to area, fron and depth. tage, width, yardr At a Special Town Meeting on February 28, 1985 the Town voted ) to increase the area requirements for most of the single family residence districts within the Town to one (1) acre. The Locus, lying as it does within an RD-1 Zoning District, was affected by the increased area requirements. Prior to the adoption of one (1) acre zoning the minimum lot area requirement in the RD-1 Zoning District was 20, 000 square feet. As a result of the above zoning amendment, said minimum lot area was increased to one (1) acre. i The effective date of the zoning change was the date of its adoption by Town Meeting February 28, 1985. I Massachusetts General Law Chapter 40A, Section 6, as amended, provides in pertinent part " . . . Any increase in area; footage, width, yard or depth requirements of a zoning . . . by-law, . shall' not apply to a lot for single or two family residential use which at the time of recording . . . was not held in common ownership with any adjoining land, conforms to the then existing requirements and' had less than the proposed requirement but at least five thousand, square feet of area and fifty feet of frontage. " . In Abamowic..z v Tow; of TarT�switch ( 9851 481 N.E. 2d 1368 395 Mass 757, the Court noted that " . . . the most recent instrument of record prior to the effective date of the zoning change . . . " , is the document to which the Court should look in determining the . . .Status of the lot immediately prior to (a) zoning change . . . . On February 28, 1985, the time of the adoption of the zoning amendment changing the area requirements for Locus from 20, 000 square feet to one (1) acre, the Locus was owned by T. Walter Wannie and Meredith S. Wannie pursuant to the most recent instrument of record prior to the zoning change, being the deed recorded in Book 1311, Page 406 supra. At that time neither T! Walter Wannie or Meredith S. Wannie owned any land adjoining the Locus. Accordingly, it would appear, based on the facts herein recited, that Locus is grandfathered from' the increase in the lot area requirements of the zoning by-law (20, 000 square feet to one (1) acre) pursuant to Massachusetts General Law Chapter 40Ai Section 6 and the corresponding provisions of the Town of Barnstable Zoning By-laws Septipn 4-4.5 (1) . Sincerely., envy L. phy, J HLM:bb t l I I � STATUTE FORM I JAMS J. TAYIAR etIC ux' r w® T. IdALTER 'F-, et ox- 11 1 Dated, 19 '19 Y 4 at o'clock and_--n;}nutes____-=� Received and entered With Deeds ' Book___--Page_--=-- Attest: TUTSLANX "O'S"R&O va.vwT.oFr'ea ^�.:. W.Pnjm Publishe-Rb1/19120' - ' FORNt 292 PLAN T. HUNT AyyORWSY.AT u►w s • talAAN fDTR�Y I MASS- sot)" HARWIC , H F, ' �. f ... •rn nr. �. •. sR v,>i3S'Ci.p.yll:...':dG:"—....:,. I .rwv w- rr...... «. ..ra�n.r-.. Y "'!tx•�..i...orn+^n"�"'...ea Y ' t I I f ' JAMES J. TAYLOR and PAULINE N. TAYLOR, husband and wife as tenants by the entirety,, of Centerville, Barnstable County, Massachusetts, being mmiarried, for consideration paid, grant to T. Walter and Meredith S. Wannie, husband and wife as tenants by the entirety, r of Centerville, Massachusetts, `M with QWIrlalm COV9 Unt.6 I the land in Barnstable, that part called Centerville, Barnstable County, Massachusetts, bounded and described as follows: PARCEL 1 ON THE SOUTHWEST by Thread Needle Lane'as shown on a plan hereinafter described a>� one hundred twenty-five (125) feet; ON THE NORTHWEST by Lot #3' as shown on said plan, one hundred sixty (160) cP i J feet; 1, ON THE NORTHEAST by land now or formerly of Girard G. and Audrey W. Cottle and,land now or formerly of Hilda E. Wannie as shown on t. said plan, one hundred twenty-five (125) feet; and ON THE SOUTHEAST by Lot #5 as shown on said plan, one hundred sixty and 01/100 (160.01) feet. BEING LOT #4 as shown on a plan entitled, "Quail Hollow in Centerville. Plan of Land in Centerville, Barnstable, Mass; as Surveyed for James J. Taylor, Scale 1 in. _ 40 ft. Jan. 29, 1965. Nelson Bearse - Richard Law, Surveyors, Centerville, Mass.102 and recorded in Barnstable County Registry of Deeds in Plan Book 191, Page 47. PARCEL 11 ON THE SOUTHWEST by Thread Needle Lane as shown on a plan hereinafter described, eighty-three and 95/100 (81,95) feet; ON THE NORTHWEST by Lot #5 as shown on said plan, one hundred sixty and 01/100 (160.01) feet; ON THE NORTHEAST by land now or formerly of Hilda E. Wannie and a reserved area as shown on said plan, one hundred thirty-eight and 55/100 (138.55) feet; Old THE. SOUTIL:AST by a 101-Foot Path and Drainage Easement as shoran on said plan, eighty-six and 93/lo0 (86.93) feet; and ON THE SOUTH by said 101_Foot Path and Drainage Easement as shown on said i plan, an arc distance of ninety-six and 78/100 (96.78) feet, and fourteen and 13/100 (14.13) feet, respectively. BEING LOT #6 as shown on ,a plan entitled, "Quail Hollow in Centerville. Plan of Land in Centerville, Barnstable, Mass. as Surveyed for James.J. Taylor, Scale 1 in. 40 ft. Jan. 29, 1965. Nelson_Bearse _ Richard Law, Surveyors, 'Centerville, Mass.", + and recorded in Barnstable County Registry of Deeds in Plan Book 191, Page 47. Together with the right to use Willow Run Drive and Thread Needle Lane for all pur- poses for which roads or ways are commonly used in the Town of Barnstable, and the F ! l�I:f ! ..J `t� •F' ,t+a �.k;. t ,. �, •, -•, ,'�'�-Ar.- °,,;,mow,o f Kit0041 # � � 1: ? l a. P., x', I � .. •,�:..-' ...Vie. f ¢1'. P .C j ai.� �5 - t 1 j �14 4>f *3-�--i LP i I �s=�•� 1 t I. ' { , - OWN, �' > tSYS IRA. .,...' '} �r';� _: ..-L..t ��-�- :.. S- .:.� - __ .I __ - - r Jr y I,. rr:. rs• �s `}�91 sd r a .1� ��;: t'. vy .k��, r .j e a j - �� � ,---�.r:•'_' ate" F a,.__� ,.,.' i'. s t tt ., ry• t I - Iy :,,. it - Y I #: i ,,(: .. r I 1T i it ink , {'�T ,' ',, 1! ;y.t t. '; e ,a ''• '9- '� i A: 1. 'ti 1.. x rj y 1 g ' i - `al.�. ''' >•Y"6 .,.i L�r_ ��_ .c..:y: a I tit 211 t 1}, .l. `(`}l'.y), q �,. .. 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A7./ 3 41111 4� S ., Definiti 1 Approved by Planning Board 19 ® Ip� � rE0 MAr's a���gp TOWN OF BARNSTABLE Building Permit Application Projec Street Address �' e ��. � Villaget1I Owner - d� f� (•� ��L L`-' - Address ' �'- O a2 .Telephone `-Permit Request 'C, 0/7<Z . 1?1 0d_r_ ✓'�JG _ � a t First Floor /AZ/® squ e f 4t loor 5 / 2— square feet Construction Type Estimated Project Cost $ 9 / Zoning District Flood Plain Water Protection Lot Size �� 0, C7 G /'- Grandfathered ❑Yes ❑No 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) r Number of Baths: Full: Existing New 2— Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New ( First Floor Room Count �7 Heat Type and Fuel: )9Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes JyNo Fireplaces: Existing New Existing wood/coal stove ❑Yes 12 No - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) 'None ❑Shed(size) - ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use > Builder Information Name,A///.1,1A M C /7 .�,r Telephone Number 77 J — q 60 Address �j �''�' � ,��' �'" License# 0-5 3/-/J 7 .erF✓1/rE- A Ul t L - Home Improvement Contractor# Worker's Compensation# G-G 00 Z 3 T 0- NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,.AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FORT F..FOLLOW NG REASON(S)lip �\ r ' tAN� _ FOR OFFICIAL USE ONLY y PERMIT NO. DATE ISSUED_ _ MAP/PARCEL NO. - • ', - _ t -_ _r _ •_ ADDRESS VILLAGE OWNER 1 y .. •1, DATE OF INSPECTION: FOUNDATION �l FRAME INSULATION FIREPLACE ' F , ELECTRICAL: ROUGH FINAL . PLUMBING: 4- ROUGH FINAL , ' M GAS: _ ROUGH FINAL s FINAL BUILDING; r? ` DATE CLOSED OUT �- ASSOCIATION PLAN NO. '= • f l fti N SMOKE DETECTORS O.K. _ ac 4,0. , G Z Z43 p /... 4•IY4 H l ' - 2.6Ye.w -Iti • i oY+:ro`18 BARNSTABLE BUILDING DEPT. _ 24 310 7'5' 10 3b" to 6'1144.1.G;wH CW25 P5610R- N.Wt1Nw.L14310 4'V w 5 YL w' 2442 uz o� 41Y4`H T� LoF1 ¢8 - / WK� O /57Npy ao- DEN //linn y ae` fias F�P /Qoo na. s 171•': -per - - 18'0.' fua�wv 21 0.. - C12 y T1 ._ 42•"5 cwl;s a"4.0, W ___ - Gifi. l/�l�s357lL,1�,31 '47/ -F 0 loa 3.5. _2y42 -T - O b. 2442 0" - I;YU� p 9" 12 2Yi-1 _ .. 4 .0 " 7\ 1,-14'i-- 4� cNI.? z s i 2421oycrNz 32- S'S — 2'S Y04V'W CN27S 5,51ve N 5"4" ;'S Y4'w 2.1.H[aDGR F,esT Fiore PLAY Z,uf oin C,4oq _ LrAcw� f GbnnR-_ SGNNLLE b4 TvscAo✓czo�t. Gv CAAj7wWuzC a i .o,41� oIrmAV If q •9,F--I ,2Tw'3 c!c tb- - ,4, •, ry+\Q'" .-.�c\o Ib"QG• 1 I, I,• 2• I i I: I - - r - _- 2.10 Id...nC......_._._ --_.- 1I - O. I I T-13 ' q• r 4 p 0• p 5 61 b , �� 7'4'*-o ,aN Ib'O' - - — — 6- A - - - - - - - - - -� - 8 o Caoss Serb,!/ 3 _ 4 .rv.'U0NEfo L f LM�8, (�i✓�Qut1`�.%+/�� a e .. 'ROPERTY ADDRESS I ZONING I DISTRICT CODE 'SP-DISTS.I DATE PRINTED I CSTATE LASS I PCS I NBHD KEY NO. 0064 THREAD NEEDLE LANE 10 -1 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T,, UNIT ADJD.UNIT Lantl By/Date S¢e Dimenswn ACRES/UNITS VALUE Desoriwien HU88ELL. ANN- S. _ MAP- LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE cD. FF.Datn/Ao,e: E #LAND 1 49.100 CARDSINACCOUNT - L 13 1VAC. SIT 1 X .46 =10C 8=150 158 44999.9S 106649.9 .46 49100 #DL LOT 4. 01 OF 01 A #PL 64 THREAD NEEDLE LN COST N #RR 1715 0125 MARKET 22800 D INCOME A USE D APPRAISED`VALUE D A 49.100 A PARCEL SUMMARY U LAND 49100 A S T i BLDGS TOTALS E 49100 N CNST N DEED REFERENCE Type DATE Rec-cletl PRIOR YEAR VALUE T Book Page Ina. MO. vr.D sate,Poc. LAND 49100 T S 131A/1041 t00/00 BLDGS TOTAL 49100 3 BUILDING PERMIT LAND ADJUST.FOR j Number Dete TyPe Amount VIEW;........... LAND LAND-ADJ INCOME SE SP-EILDS FEATURES BLD-ADJS UNITS 49100 ............... Const. Total Vear Built Norm. Obsv. Class Unils Unils Base Rale Atlj.Rate gctual Eft. Ago De pr. Contl. CND. Loc. 4b R.G. Repl.Cosi New Adj.Repl.Value Stories Heignt Rooms Rms.Betbs I •Fix. I Pertywell Fx. 0 Do crept n Rate Square Feel Repl.Cost MKT.INDEX: IMP.BY/DATE: / SCALE: ELEMENTS CODE CONSTRUCTION DETAIL 3 r -------------- --- ---------------------- ---------------- -------------------------- J --------------- --- ------------------ --- r --------------- --- ---------------------- ------ --- --------------------- J ----- -- --- ---------------------- 'i ----- --- ---------------------- D --------------- --- ---------------------- E Total Areas Aua= ease= --------------- --- ---------------------- BUILDING DIMENSIONS ---------------- -------------------------- T ----------------- --------------------------- A -------------- --- --------------------- L NEIGHBORHOOD 4ZAC CENTERVILLE LAND TOTAL MARKET PARCEL 49100 49100 AREA 3297 VARIANCE +0 +0 STANDARD 20 ROPERTY ADDRESS I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CSTATE LASS I PCS NBHD KEY NO. 0052 THREAD NEEDLE LANE 10 RD-1 300 loco 01/04/96 1011 00 42AC R21U 082. 130094, LAND/OTHER FEATURES DESCRIPTION I ADJUSTMENT FACTORS TY UNIT ADJ'..UNIT L AMA S TR 0 A S SU NT A M MAP— Lana By/Date ane Dimens;o n LOC./YR.SPEC.CLASS ADJ. CON.. P PRICE PRICE ACRES/UNITS VALUE Description co. FF-oe th/Aces E #LAND 1 49,100 CARDS IN ACCOUNT 10 18LDG.SIT 1 X .46 =10C 8=150 158 44999.95 106649.9 .46 49100 #BLDG(S)—CARD-1 1 102.400 01 OF 01 #PL 52 THREAD NEEDLE LN BATHS 1 .1 U X C= 100 6000.0 6000.00 1.00 6000 3 #DL LOT 5 MARKET 109300 FIREPLACE U X C= 100 3100.00 3100.00 1.00 3100 3 #RR 1715 0125 INCOME USE A APPRAISED VALUE 151o500 > PARCEL SUMMARY l AND 49100 a T LDGS 102400 0—IMPS M TOTAL 151500 E N CNST _ N DEED REFERENCE T,.pe 1 D.ATE" Reo,eeo PRIOR YEAR VALUE T eBook D Seles Price AND 49100 S 9191/018!" 1,05/94 145000 BLDGS 10240C 91791217: IA5/94 A 1 TOTAL 151500 7735/272,YEI:10/91 134000 BUILDING PERMIT LAND ADJUST.FOR j Number Date Typo Amount VIEW. ....... LAND LAND—ADJ INC ME SE SP—BLDS FEATURES BLD-ADJS UNITS 49100 9100 835056 5/92 AD 200 *1/93 FMP EST . censl. Tetal Year e„m Nprm. oba�. G E'DOGS.Class Unils Unils Base Rate Adj.Rate A I Age Depr. Contl. CND. Loc. %R.G. Repl.Cosl New Atlj.Repl.Value Stories, Heignl Rooms Rms.Balns a fia. Penywall Fee. ....... 01C+ 000 110 110 61.55 67.71 73 75 19 80 105 100 84 121933 102400 1.0 5 2 1.1 6.0 Description Rate Square Feel Reps,Cost MKT.INDEX: 1•DD IMP.BY/DATE: / SCALE: 1/00•62 ELEMENTS CODE CONSTRUCTION DETAIL BAS 100 67.71 1496 101294 GR S AREA 6 SINGLE FAMILY DWELLING CNST GP:00 ' FFG 30 20a3l 334 7799 *-------------------68-------------------* STYLE 03RANCH 0. FMP 55 5.50 680 3740 10 FMP 10 D ESTGN-ADJ MT -02 �SILN-A0JUS-T'-1-U:0 EXTE74 S ALLS 01W005 FRAME 0. *----------------57----_---_------*----16*--* H EAT/AC TYPE 04 IL---------------0.0 FFG NT R E . .T9 FISH OD _ -------- INTER.LAYOUT 01 ------------------{J.0 1 ! 1N- ER. IUALTY 02SAME AS EXTER. 0.0 24 24 FLOOR STRUCT 00 ------------------ 11.0 W28 BASE ! EFLOUR COVER-- -00 -------------------B.0 E Total Areas Auz- 1 064 a_e e 1496 ! ' ! ! k 00 TYPE---- -_00 ------------------6.0 --------------- ---------------- 0.0 BUILDING DIMENSIONS ! : ! E L E C T R I C A L D O j T SAS W09 SO4 W23 S02 W25 N28 E57 FOUNDATION- - -00 --------------- SFq FFG E16 S24 W16 N24 .. FMP Ell N10 W68 SID E57 .. SAS S22 .. *------25------*=-----2.3-----* -----NE-1-G OR 60D 4ZAZ CENTIRVYLLE L LAND TOTAL MARKET PARCEL 49100 151500 AREA 3297 VARIANCE +0 +4494 STANDARD 20 IROPERTV ADDRESS I I ZONING i.DISTRICT CODE SP-DISTS.I DATE PRINTED I STATE I PCS I NBHD CLASS KEY NO. 0076 THREAD NEEDLE LANE 10 RD-1 300 loco. 01/04/96 1011 . 00 42AC R210 161. 130931 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS TY UNIT ADJ'D.UNIT Lana By/Dale Sze D�mensron P ACRES/UNITS VALUE oa:c,iprgn COHEN. ROBERT & MYRNA D MAP- DD. FFDe In/Acres-BLOC./VR.SPEC.CLASS ADJ. COND. E- PRICE PRICE ,LAND 1 _ 49.80D CARDS IN ACCOUNT - 10 18LDG.SIT 1 X' .47 =10 a=150 157 .44999.9 105974.9 .47 493UU 4BLDG{S)-CARD-1 1 173,400 r 01 OF 01 A #OTHER FEATURE 1 3.500 IL 226ji N BATHS 2.1 U X I B= 100 12000.0 12000.00 1.00 12000 3 4PL 76 THREAD NEEDLE LN ARKET 186300 D FIREPLACE U X ( C= 100 3100.010 3100.00. 1.00 3100 8 #DL LOT 3 INCOME BMT GARAGE U X 2 S= 100 3900.0 .5070.00 , 1.00 5100 8 #RR 1715 0133 1847 0140 SE DRP2 POOL PF S 16 X 32i 196 C= 40 17.15 6.86' •512 3.500 F #SR WILLOW RUN DRIVE APPRAISED VALUE D J A 226,700 A U PARCEL SUMMARY' T AND 49800 ' A S T SLOGS 173400 M -IMPS 3500 E , TOTAL 226700 r N CNST DEED REFERENCE T,� DATE Regq,aea PRIOR YEAR VALUE � A T Book Page Insl. MO. Yr.D S.1-PH- LAND 49800 T S 7866/1081E1102/92 A 1 SLOGS 176900 J 7498/226: I!04/91 A 1 TOTAL 226700 6486/068YEI:10/88 205000 BUILDING PERMIT - *LAND ADJUST.FOR Number Dale ... LAND LAND-ADJ INC ME SE SP-BLOS FEATURES BLD-AOJS UNITS Type Amount VIEW......... 49800 3500 ................ 20200 COnsl. TOI aI Vear Built Class Base Rate Atlj.Rate q e Norm. Obsv. CND. I-- 4y R.G. Repl.Cosl New Adj.Repl.Value Stories, Hei hl Rooms Rms Baths /Fix. PertywWl Ft U oils Units A r t q Depr. Contl. 9 018- 000 105 105 65.55 68.83 71 75 19 80 105 100 84 206383 173400 2.0 6 4 2.1 9.0 De' cnpli- Rate Square Feel Repl.Cost MKT.INDEX: 1�DO IMP.BY/DATE: / SCALE: 1100.52 ELEMENTS CODE CONSTRUCTION DETAIL BAS 100 68.83 1656 113982 L WE L N CNST GP: 820 60 41630 1656 68393 *----------44---------* . STYLE 08CONTEMPORARY 0.0 3 UWD 85 8.50 . 448 3808 ! UW0 ! ETSTGN-716JMT- -01 FSIGV-ADJUST---3_0 J *--------36--_--'-* + ERTER:aALLS-- -01W0a6-FRAME--------G- ! + 20 -EA'fiiYYPit- -0 2 G AS ---------------6.0 + _ 12 NTFR:f-lWf SFI- -00 ------------------(f.0 INTER:LAYOUT- -01 ----- -------(.0 IWTER.OUALTy- 02 AIMe-AS EXTER. 6=0 + + FLaOR-ST-fFUCT- -00 ------------------Q.0 D W' 54 ! EFLaOR R-- -00 ------------------6.0 448 ea�eo 1656 ----------- ------------------- - E TplalAreas Au== 46. BASE 46. ROOF TYPE---- -OU (f.0 r t - T BUILDING DIMENSIONS ! ! EL�C 1 pIC(L DO ---------------- --6�D SAS N46 E36 S46 W36 .. UWD N46 ! ' + - -- - - ----------------- - F- - DATION 00 .-----------------q--- A E36 S 12 E08 N20 W44 S08 S46 UWD + i -------------- - -- ! + NEIGN307tH066 42AC CENTERVILLE L ! ! LAND TOTAL MARKET ! ! PARCEL 49800 226700 X-_---_--36-------* AREA 3297 VARIANCE +0 +677.5 STANDARD 20 RESIDENTIAL PROPERTY. r MAP NO. LOT NO. FIRE DISTRICT. SUMMARY p STREET -': 2 Thread Needle Lane Centerville I. 210 82 - C-0..., 73 LAND 9/0 tD f / � BLDGS: OWNER / ., -F G� f u o�c�i11 TOTAL I o d ..- _ LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: „} LOt 5 BLDGS. '�s'43 SL _ TOTAL Koskin.�en, Sigrid A. 9.28.65 131 . 103 LAND rn BLDGS. � TOTAL LAND BLDGS. TOTAL i LAND / BLDGS. _ TOTAL LAND BLDGS. m TOTAL LAND BLDGS. TOTAL LAND P INTERIOR INSPECTED: BLDGS. m TOTAL DATE. LAND ACR. ,AGE COMPUTA IONS �, BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. NYALUE TOTAL HOUSE LOT 6 7,7, b 7.2 U " �2 LAND CLEARED FRONT /d 7Od BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. m WASTE FRONT TOTAL REAR LAND - BLDGS. TOTAL LAND x& J / 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. TOTAL MAMNICTn AI C AAACC - Irr.I.rrn +naon.e+r .-.. r.•cr r.r+o�cnnn rn ` FOUNDATION BSMT. & ATTIC PLUMBING PRICING LAND COST j Cone.Walls Fin. Bsmt.Area Bath Room Base %�� BLDG. COST ��7 + Conc. Blk.Walls Bsmt. Rec. Room St. Shower Bath Bsmt. _ PURCH. DATE ' Conc. Slab Bsmt.Garage St. Shower Ext.� Walls PURCH. PRICE. Brick Walls Attic&Stairs 17 Toilet Room Roof RENT i Stone Walls Fin.Attic Two Fixt. Bath Floors ' Piers INTERIOR FINISH Lavatory Extra _ Bsmt. F 1' 2 3 Sink f a ' ' Plaster Water Clo. Extra Attic /x h /4 EXTERIOR WALLS Knotty Pine Water Only 5 7 Double Siding Plywood No Plumbing Bsmt. Fin. Single Siding Plasterboard Int. in. ,C�. A 4 hingles TILING Z / . GZ .Z4 i Conc. Blk. G F P Bath FI. Heat Face Brk.On Int. Layout Bath &Wains. Auto Ht. Unit f Veneer Int.Cond. Bath Fl. &Walls Z 4 . Fireplace D Cf Z`� Com. Brk.On HEATING Toilet Rm. FI. 2 Plumbing -}- Zp® �• ". . Solid Com. Brk. Hot Air Toilet Rm.FI. &Wains. Tiling� Steam Toilet Rm. FI. &Walls -y� �l/ Blanket Ins. Hot Wate St. Shower / Roof Ins. Air Cond. Tub Area Total Floor Furn. ROOFING ✓ COMPUTATIONS Asph. Shingle_ Pipelets Furn. S.F. �•. 'Wood Shingle No Heat. Asbs. Shingle Oil Burner S.F. 1Slate Coal Stoker S. F. / /_"i.G L/.vf'..' �y_ 23- 2 -Z < -Z•3 7-F L/- (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 7 8 9 10 MEASURED !, S. F. Pier Found. Floor Hip Mansard FIREPLACES Gambrel. Fireplace Stack Wall Found. 0. H.Door LISTED ! FLOORS Fireplace Sgle. Sdg. Roll.Roofing 1 Conc. LIGHTING Dble.Sdg. Shingle Roof -'"40 Earth No Elect. Shingle Walls Plumbing DATE Pine' Hardwoodl✓CJ ROOMS Cement Blk. Electric 74 PRICED i Asph.Tile Bsmt. 1st 6 TOTAL - '7 !� Brick Int. Finish li Single 2nd 3rd FACTOR REPLACEMENT G�b OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. CONE). RE�PL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. DWLG. t - 2 I 3 4 5 . 6 7 i t3 { 9 tO TOTAL I RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET .76 Thread Needle Lane Centerville - CEO 7j LAND` - /1// U " . 210 , .161 BLDGS. OWNER TOTAL _ LAND RECORD OF TRANSFER DATE BK PC I.R.S. REMARKS: Lot 3 707 BLDGS. �T�90d 70 cod $'ornsteii'; ° tort = 20 6 102 TOTAL f/BATR� 77 LAND Bornstein, Stuart Tr. 1111171 14 381 BLDGS. �l p ®, :3 ?�'�' Ia7./��� �E. e a f' /v,i�, , ?,' I.' , -2 -75 2174 224 Wet L TOTAL s'pa 10 n 79 LAND / O d / BLDGS. TOTAL : (o O 6 SC LAND C� m BLDGS. I} YII IU C> ` +l Yx1i I C- L S / �l 1,7(,a TOTAL e.c tZ15, f.cS<4j.,�Nt-' -rze VO f L> LAND G R 1?D a• l U - /(p( O) BLDGS.. TOTALS " I-Vbt 11174 " S d 6 F fq'S LAND of CH D gppty BLDGS. TOTAL j L dS �� LAND INTERIOR INSPECTED: BLDGS. ~! TOTAL DATE: AND ACREAGrE'COMPUTATIONS BLDGS: LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE LOT 14106 LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND BLDGS. ' LOT COMPUTATIONS LAND FACTORS 7 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. TOTAL Conc. Walls Fin. Bsmt.Area Bath Room Base LAND COST 6 f'•i BLDG. CO'.. Conc. Blk.Walls Bsmt. Rec. Room3(oo Q ✓ St. Shower Bath Bsmt. G J �O 2 ��.r, ` L C. / St. Shower Ext. ✓ Walls PURCH. C, -E Conc. Slab Bsmt.Garage J Brick Walls Attic FI. &Stairs r Toilet Room �_ t/ ` PURCH. PRICE . Roof .�.- C• RENT Stone Walls Fin.Attic 77 Two Fixt. Bath = 'A7 Piers INTERIOR FINISH Lavatory Extra Floors /; yly I Bsmt. LF- j 1' 2 3 Sink a/� r/z I/ Plaster Water Clo. Extra Attic i EXTERIOR WALLS Knotty Pine Water Only a� �z Double Siding j-_:;"�� ..:.'•` Plywood No Plumbing, Bsmt. Fin. Single Siding Plasterboard Int. Fin. d" ' Shingles TILING, Y /g:, _ J/� ✓�� /Z !Conc. Blk. G F P Bath FI. Heat 1 L- Face Brk.On Int. Layout / Bath Fl.&Wains. G Auto Ht. Unit -I-- Veneer L 9(✓ I / ` I Int. Cond. Bath Fl. &Walls J Fireplace i Com. Brk.On HEATING Toilet Rm. FI. - ' / Plumbing Solid Com. Brk. Hot Air /�(jyEw�. v Toilet Rm.FI. &Wainst V' Tiling Steam Toilet Rm. FI. &Walls Blanket Ins. Hot Water/2-7 Roof Ins. St. Shower Total ! ICI Air Cond. 1/ Tub Area Co Floor Furn. I ROOFING COMPUTATIONS f/ Asph. Shingle _ Pipeless Furn. J(a S. F. Wood Shingle No Heat 4 1}- S. F. `---- Asbs. Shingle Oil Burner �I '74� aL✓t L r� 25 f�1fj�yw' wH(f Slate Coal Stoker S. F. //t:,� -�:r 1sG'!y ti y 5 1(5&1 Tile Gas ROOF TYPE Electric S. F. OUTBUILDINGS Gable Flat S. F- 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED Hip Mansard FIREPLACES S. F. Pier Found. Floor _ Gambrel Fireplace Slack `' .!/ Wall Found. 0. H. Door FLOORS Fireplace ` L/'" Sgle. Sdg. Roll RoofingLISTED Conc._ LIGHTING Z. Earth No Elect. Oble.Sdg. Shingle Roof Pine Shingle Walls Plumbing DATE Hardwood"-r: % ROOMSQ � Cement Blk. Electric "-. Asph. Tile Bsmt. 1st TOTAL n f •l-' ^._ Brick 7 C Int. Finish PRICED I Single 2nd 3rd FACTORIle'" " �^" '-• REPLACEMENT :V-'`_• � /- 'a © �� . /l Fad�lI�lo o OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. �. DWLG. itlr z 5/ 1?72 J jOZ .5- J 1 7 3 E3vff !� s dGRe .,-0 s. w 15 C,?#Cks a s.. iw ,Y o 64, C C fg d 6 7 B 9 10 . S�Co 7�5y TOTAL RESIDENTIAL, PROPERTY, MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET 64 Thread Needle Lane Centerville LAND 210 81 C-0 79 BLDGS. o 0 OWNER L E"/'l..ri^t: .-'N, 3X, .. e/ lCr TOTAL ' 9�o D LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: Lot 4 BLDGS: Ot. ^Hubbell, Ann S. 11 23 65 131-8 l.Ol_j2 TOTAL BLDGS. TOTAL LAND BLDGS. ! TOTAL LAN D BLDGS. TOTAL LAND 0). BLDGS. E ^ TOTAL LAND , BLDGS: at TOTAL LAND INTERIOR INSPECTED: BLDGS. TOTAL DATE: LAND ACREAGE COMPUTATIONS BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE ^ TOTAL, HOUSE LOT 7a v c / 6 O LAND CLEARED FRONT BLDGS. REAR ^ TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. rn WASTE FRONT ^ TOTAL REAR LAND 0)- BLDGS. - ^ TOTAL LAND 00 0 0) BLDGS. LOT COMPUTATIONS / LAND FACTORS ^ TOTAL FRONT DEPTH STREET PRICE DEPTH rya FRONT FT. PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL' LOW DIRT RD. LANDSWAMPY NO RD. LDGS.OTAL :onc. Wk. Walls tismi. Kuc. nuum awnci uo.o b ml. PURCH. DATE onc. Slab Bsmt.Garage St. Shower Ext. Walls PURCH. PRICE trick Walls Attic FI. &Stairs Toilet Room _ . Roof RENT :tone Walls Fin.Attic Two Fixt. Bath --- — , Floors ' iers INTERIOR FINISH Lavatory Extra smt. F '1 2 3 Sink ' 4 r/2 r/4 Plaster Water Clo. Extra Attic . . . . . . . . . . . . . . . . . . . . . EXTERIOR WALLS Knotty Pine Water Only _ ouble Siding Plywood No Plumbing Bsmt. Fin. ingle Siding Plasterboard Int. Fin. Shingles TILING )nc. Blk. G F P Bath FI. Heat ace Brk.On Int.Layout Bath FI. &Wains. Auto Ht. Unit Veneer Int.Cond. Bath FI. &Walls Fireplace om. Brk.On HEATING Toilet Rm. FI. Plumbing olid Com. Brk. Hot Air Toilet Rm.FI. &Wains. -- --- --- Tiling Steam Toilet Rm. Fl. &Walls Blanket Ins. Hot Water St. Shower oof Ins. Air Cond. Tub Area Total Floor Furn. ROOFING COMPUTATIONS :sph Shingle _ Pipeless Furn. S. F. Vood Shingle No Heat_ S.F. ,sbs. Shingle Oil Burner S. F. late Coal Stoker S. F. ile Gas S F OUTBUILDINGS ROOF TYPE Electric able Flat S. F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED lip Mansard FIREPLACES S. F. Pier Found. Floor gambrel Fireplace Stack Wall Found. 0. H. Door LISTED ' FLO RS Fireplace Sgle. Sdg. Roll Roofing :onc. LIGHTING Dble.Sdg. Shingle Roof .arth No Elect. DATE 'ine Shingle Walls Plumbing lardwood ROOMS Cement Bik. Electric \sDh.Tile Bsmt. 1st TOTAL Brick Int. Finish PRICED Tingle 2nd 3rd FACTOR +1 1 REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. :)WLG. 2 3 5 -- -- t3 10 TOTAL T. Walter Wannie 129 Willow Run Drive Centerville, Massachusetts 02632 Jan.27,1992 Mr.Joseph Da Luz, Building Inspector Town of Barnstable Main Street Hyannis,MA 02601 RE: Hubbell Lot -' 64 -Thread Needle Lane, Centerville,MA Deed Book 104 Assessor's Map 210/81 Dear Mr. DaLuz, This letter is to certify that the above described lot was acquired through me,by Ann S. Hubbell of 22 Forest Rd. Utica,NY as an approved building lot on a plan dated Jan.29,1965 as .recorded in the Barnstable County Registry of Deeds , Plan Book 191, Page 47. I further certify that her title was acquired in September 1965 in a deed recorded on Book 1318 Page 104 at said Registry of Deeds. This lot has been continuously possessed by her since then, with taxes assessed and paid on this building lot. This lot has met percolation tests and zoning laws, and Mrs. Hubbell has found a buyer. A building permit should be issued, so the sale can be finalized. Mrs. Hubbell has asked me to represent her in this matter,as a former owner and an abutter. If there are any further questions, please let me know: Sincerely yours , T.Walter Wannie - - y : I v - -- - Ir • � I I i 4 0 Lj _ _— --- -Eil Lim t t F I h rl&A-Tt-r-Op-Al a-Ae Ce.CIOP&Al H4681.E .4POGAACE 6,4 CftO yaue0 r� - --_ - r'-�- --_ LeFr rya EccvAli�oA/ ...o Ore.MA ....m 1 I -� - 1 7- -- i- - - 1 I .. .P��HT S�oE E'cBugl�av Nueacs ResioE,cr.F OBc 19971 ! 64 -rwdeoo A/EEPcE 4+vE CfWc✓)Lic �i 14 1 � I (/o^cFEjf I 1 I WAS � I 1 I 1 GPNw1r. - - �7E ' I 22' I i - 14' I a.��� vcK - 4ce�u O YEE,pout 3.10' \ocgM / �N/vN r , ✓fir L � S'6�� Dmo K /oaK j poN:rto /2L2a1'nnct 8'Nibu - / 1 Cow—PaoS S6• Q•fNRf i S•I rl I - ��REO I 'r P 1 6 I I � 1 - .. 26 - -� 34 a I � �28•1 /6•wOL• � r 7 1 /0•rM[d/�Lfp 1 1 r'ti B L ' I I I 1 - i Co^`R�r'oT uy 3'4' ?r/0 3lassf�� 34` 1 accssun+�c' I l s ju+u f I 14 i»f+•Q6 ?�i^ys CWWI.j�SrE Cat�Cff wwcc � 3'6' 0f — — -- ---_-— — — — -- — t—4' S'3 g'io• - — la'e• 22' Nueacc ,��rivutt :. -..------- PLAN .a..a . I ....... I 3 C.4 ?�t4tE�I0 �EtO�cc L�olv6, C'C.vIEx�!•cr , 14' ----- 7 3 3" 46 m FT I � N M II' 120° /•�ASjER' Fj&ORpOM O 12x 22 PT DECK 22" 4p• L•t; 0 ® 0 3V 4 6' g,µ�o 74 , 8 4• 4'BiO-0 39" I POWO O Kaj[MEN 5 bxbLV ... 1 © //Rcp liJFlL G� w1�010C CAP RoeM 96" , 26 G ' I I Q .Z;L I� 40• O• DI F apjlDinw,Room . 718" i I two 7I 5.3.. Io' 14' I I 2 Z' -— 22' OnUO.,rOOR.�gnL:._. F,Rsj AMR A*") �wwm wurmmw I I� I it — I 3I7' 'T li roRlk i I SEcavv `cnt`.P.9iyli,vy ' NusaLB IQFSiOE,ccE i by Ti1�E�0(iEFOcE Grol fE, .CaA�7WLII"E_. a n • gUw,Fa>N I Tiloc ILYIRO • �•F1r / 1 ram. 1 Wpm, .Q�,o,c A 2 i 2.Iz R.oyc � - 1a r - IZ/ ` Z410 R.O 6 12 L I(.- C. IkSL. - - - 12 Q5 L`�Twic i .R.30 924' �s C 2 10 I6"OC i3Rssb 77/61 t.4.ee" `a i2TOF/lo5 9r,. 2.¢.88' Cot R•II unc. e, Ib" oc R-/9 4� PewRfo Ca Ucnfr E . 0 . ON ll"R to•Ab fflso Citcow GRAA6 4 ,O�X C.Wa rr '(�// 4"hull.94ory CKtt C<ceeq f2-.2.rr..,-KPo Stc foN. A-a Sc�Tiow 4 B _ �v6/3LC PEVDIAIIG f s44 Th"44D IW'101E .U.VEr C4rA.ree0lir 1 .......woos e j - r II. .. M-131 Eiji , i �I I - - .......... ._— 7 IILFUI _ U fO��LGVAT,nA1 _ BAR£c6liA�-ioN ---- .. _ i _ _ N486C£ nE5i06AKE e ,.: nv 7 m 64 rllxroo A/ccocE LgNE cfa /Zdcc6 A Y I LEFT �Of Ec cvAlioN t t .r..,e i 'o• s i �f�Rwoo�i€�ocE�L,ouE_, Cra:Tctur�c� { s � � i .. .. - 1 ' .Pi�„yT S�oE�cEugliav . ' - NUBBLE -RES/OE,tCE _ ._ o. ......�... 64 THaE,vo NEEPce Lp vE,C6n 4 v� 16 I WAL I i ' t I 1 '5Paw1 L l 22 14 REj<�Urny 1 � t 4 �d_Oa.v - t � . I 2',2"I'7NKI, 8'Ni 1.0 p .� Gout..PODS S•6' Q'f1/.rR 1 I I C,oncasTc � I P9' i 1-4 ,�'w1DEX t i (0 34 Zx/o Am"Is 34` AE 14 JE4� /1`p Q'O(fp P 4NPovRfo i 136„ 22, to �OtINDAjION PLA,f/ _ �`�, /997 ••••` .w '•••"•• 64.T.v.READ 4/Eaoae Gaffe, CeAfLm& i-s _ I 3'3": b'e m N N O 12'0` MASJER SBOQpOM O I 12 z 22 PT C) K 22' o� 40" I; f� 34" 4' 6' g,Fxo 74" Is'i" d'6 O $,O 46" -C I I S4• I ! �oFf`Of`/CS I`- l j933 Rw K p Ofi 24 3R" H a I 40 " 1.Z*N -. /D/rtray Room O .I � 34" pr-7014.Zr 4'C9 14' I t' 22' -- �._. 22' ----- Fi,vsj.�ooa Pcan/. ' 64 Tmt000 /re ri1 laai Ca n%e�e.v�r cs s u,a , 3T !I 37 — 1 �. oRW . ,PST FicnR ��Arniv4 - . o•64 Tif�EAo�iEF�ocE Ga,tiE_�Ceu��vicc�_.. i — I i 1 2 ni 2.r IL"oc w—r \��a I<.Yc Ro gv,M FwsN } 4.4 �/to a.rs�a I I.w s i F,T ti?r.P.r SNP fyrAJV t i y X.cunwct - / W. _ 1 G-q,t q Otr..,t c T 22.1E R,oae 1 12 12� V I .2a10 R,o e I I Nit. 12 IL �S Dk- ril,t R-3o A - -4 ¢S 9sr,' ,•�t�Ta,c 8 ------` ----- --r- 2. xI�i4ja�s DT41L .. /3,RSEy 77/8` Px4x88' - 2+4xse" yt" 4os n�a l2 rW409 9 A coR sr4o,. SRC P.y a R•41 Just_ I/Z lir . 16" oc X-H — 8"TNKK I 4� P.-ac C.Wl AErE St ON /r"R/o,A} R60 l36las,,v ClIm's A—r,,V4S M1+ I I ,-41TN.cx co"tefE 6"twee`1$r,aeo Cw,cRt CFceva ' i CZx2`.1'fN.tKP0 Stc f,oN. A-A ScoTioiv D B — 32 _ '• Oat/991 i e(�l THa�O (/EEOLE -CANE, CtfdrBAN/LL6 s me rq�, . y The Town of Barnstable • �►aivsrnaM • 9�A 'M 1��' Department of Health Safety and Environmental Services rEDMA'��' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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: Est.Cost74s Address of Work: Owner's Name Date of Permit Application: y// I hereby certify that:, Registration is not required for the following reason(s): Work excluded by law Job 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: Date Contractor Name Registration No. OR Date Owner's Name • � - • ,. ---- - �✓lie �aavinaiuuea�C o�.:2u:fel�t 1 l01 DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPER 4 SOR LICENSE Nuaber: kpires: 'Birthdate: CS 056340 01!"sll1998 f1012911954 Restricted To: 00 " WILLIAM L SCHULZE PO BOX 288 CENTERVILLE, MA 02632 6 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. k An employer is defined as an individual,partnership; association, corporation or othei legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However 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, construction 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 section 25 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 who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the inmirance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the'law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns 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 permit/license number which will be used as a reference number. The affidavits may be retmmod to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any 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 Me of ImiestlgauOns - 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 The Commonwealth of Massachusetts Department of Industrial Accidents -- office 9111/yesl%g8U0/Is 600 Washington Street r Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit go I name: �7 location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole r netor and have no one workin in an ca acity %% %���%%%���%%%%%%/l��%%%%%%%%%/��%%%%/%%%%%%%/��%O%/%/�/G/%%/%%/%%%%%%%%%%%%%%%/ I am an employer providing workers' compensation for my employees working on this job company name:. -: address: j '9 i city:: hone insurance co.:: olicy# t ..✓ ': ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: _. company name: Address: city _. phone#:.. insurance ca <: 'oluv# camaanv name: address: cites- phone#::: insurance co. / olicv#' Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains penalties ojperjury that the information provided above is true and J�orre Date Signature d �i ` �a /G _ Print name �'c�'""` Phone# 771 7 official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (imud 9/95 PJA) 780 CMR Appendix J Footnotes to Table J5.2.1 b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the,gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area. =After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-b insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions, but do not apply to metal-frame construction. `The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. e "Me R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. `If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and U-values•are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope,must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in'accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 M CUR Appedts Table JS.2-lb(continued) Fran ptive Packages for One and Two•Fan*Residential l3nildingi gated With Fad Foals MAXIMUM MINIMUM Glad (Ilaang Ceiling Well Floor g, glab Heaang/Cooling �!ng (K) U-value R value' R value' R value' WaU h== I Package awelue' R value' $701 to 6500 Hating Degree Days' Q 1 12%. 1 0.40 38 1 j§$/A 10 6 Normal R 12% 0.52 30 10 6 Normal S 12% 0.30 3E 10 6 83 AFUE T 15% 0.36 38 WA WA Norma! U 15-A 0.46 38 1O 6 Normal V IS-/. 0 44 3E WA WA 83 AFUE W 13'/. 032 30 16X19% 0.32 38 WA WA Norma!Y I8% 0.42 3E WA WA Normal Z 18% 0.42 38 10 6 90AFUE AA Ir/. O.SO 30 10 6 90AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 2— �70 4. %GLAZING AREA(#3 DIVIDED BY#2): o 0 S. SELECT PACKAGE(Q—AA-see chart above): G— NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a . Do 0/ Western Surpty ,Compan POWER OF ATTORNEY KNOWAL''L'MEN'BY THESE-PRESENTS:` .That WESTERN SURETY COMPANY,ta•corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, 'Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine,Maryland,Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana,Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee; Texas, Utah, Vermont, Virginia,.Washington, West Virginia, Wisconsin,Wyoming,and the United States of America,does hereby make,constitute and appoint Stephen T. Fate of Sioux Falls State of South Dakota ,its regularly elected President as Attorn%JO=Fts�with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and�� . �Itep ety and as its act and deed,all of the following classes of documents to-wit: lit aniertaldngs that may be desired by contract,or may be given in any action or proceeding in any court of law or e ;p nt�rfyimployers against loss or damage caused by the misconduct of their employees;official, bail,and surety and fir•= ds. Inderrl�r rl,cases where indemnity may be lawfully given; and with full power and authority to execute consents and V&KWO� o modify or char g-&extend any bond or document executed for this Company,and to compromiss'and settle any and all claims o�d ion made r exiptingigainst sakd,Company.i., : `Votgs r urety �,y further'oertifies that'the following is a true and exact copy of Section 7 of the by-laws of Western Surety Comprty Ed now in force,to-wit. Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary,any Assistant Secretary, Treasurer,or any Vice President,or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary,any Assistant Secretary,or the Treasurer may appoint Attorneys-in-Fact or agents who shall have authority to issue bonds, policies, or undertaldngs in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertaldngs, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its President with the corporate seal affixed this 20 day of January , 1999 ATTEST W E S T E S7R.ETY COMP (Z)y zdajz�i� By T. Assistant Secretary Stephen T. Pate,President STATE OF SOUTH DAKOTA ss COUNTY OF MINNEHAHA On this 20 day of January , 1999 ,before me;a Notary Public, personally appeared Stephen T. Pate and L. Nelson who,being by me duly sworn, acknowledged that they signed-the above Power of Attorney as President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. s B. THOMAS 8 s SEA NOTARY PUBLIC SE — SOUTH DAKOTA S Notary Public S My Con=ission Expires 6.2.2003 S .Form F1975 ��� F � J �lU R r , ( J G y F J R F 7 F � Wes'tem -Surety G G 9 F CONTINUATION CERTIFICATE , R Y R M1 ll u d p 9 Western Surety Company hereby continues in force Bond No. 42882196 , ° 9 briefly described as Street Permit Town of Centerville for William Schulze dba Schulze Building Company as Principal, in the sum of$FIVE THOUSAND AND NO/100 Dollars, for the term beginning May 13 1999 , and ending May 13 2000 , subject.to all the covenants and conditions of the original bond referred to above. This continuation is issued upon .the express condition that the liability of Western Surety Company under said Bond and this and all continuations thereof shall not be cumulative and shall in no event exceed . the total sum above written. Dated this 20 day of January 1999 WESTERN SURETY COMPANY tP JAM ` B y Stephen T. Pate, President IN , R F !I F f r• n rt THIS "Continuation Certificate"MUST BE FILED WITH THE ABOVE BOND. G , G p 9 G , F Four SO-A-'0-95 Finish grade above system shall slops of 2% or greater ,• { �` � diam, cast ii o or schedule 40 PVC pipe t L US 20 min. distance (building to edge of leaching system 10 min. dirt. T hread NPFOle �- t CPO Marsh cbql •: - c �f19i RT ~` ?8 First e1 R F1 =4 O (Vwoised) / Locsa Mop t1SGS Nya :iad 47+5 i EDGE OF WE t LAV `S �� I } .-`� T Removable 12 t -------,__,---- ,,• 12" cT°-ver�T� I min. Cover 2" 0fI/8t0 WAY —'-77 Li�n14_level-- ,�level �-- ' n bod�ftll 112: washed stone 12' WtuF AVECNL tAVEI_ED - _ _ --- /� --- 4 - -� 4 --' -- --� --� SEPTIC TANK - ° ' ' —EL=42*0 ...... ,. ,.� BSM, T `.' 1�43+,`L 6 S Buse 4 L - 16' _ 4' 125.E i 40+5 -1- GAL. -'T-` M Inv e1=44 0 l+° a2 Intel.=43+75 4 of 3✓4 to I Vz stone Inv. e1=4 0 washed store all around sides of flow diffusors. PROFI LE_ LOT 3 ' t LOT 4 LOT 5 Not to scale 20,000 S.R / / DESIGN CRITERIA NUMBER OF BEDROOMS 2 (equiv to220 gals/day) `) I GARBAGE DISPOSAL UNIT NONE GENERAL NOTE 7 w i rf Q n _ LEACHING CAPACITY REQUIRED -220 GALS/DAY. I-NO CHANGE TO THIS SYSTEM SHALT 13E MADE' WETL,t ,,, � f``:PAYEE. o Da SIDE AREA PROPOSED _Q�Q sf. UNLESS APPROVED IN WRITING. . '_ } ✓ ( tp / BOTTOM AREA PROPOSED_294 sf. 2-FLOOO ZONE: - r TOTAL AREA_ 294 T LEACHING CAP. 3-ZONING: Appvx loco of 'out setbac> 4-THE CONTRACTOR SHALL REFER TO THE standirr- water �f WATER SUPPLY TOWN FOUNDATION PLAN FOR DIMENSIONS OF PRECAST CONCRETE UNITS H-20 LOADING. THE FOUNDATION. BENCHMARK SEE PLAN 5-NORTH ARROW SHALL NOT BE USED FOR _---—.._._ -_, SOLAR OBSERVATION PURPOSES, SOIL LOG 6-THE SEWERAGE SYSTEM SHALL BE BUILT If ACCORDING TO TITLE V. o 0 8.2 / `s r r �, _N - 11 N- 2 e CAPACITY = BOTTOM AREA x Q 75 GAL./SF =220 De th Soils .EL th Solls Eh. err ENCROACHMt 'J f SEPTIC TANKS Dbcac TO BE RELOCATED WHEN *es _ 0 Loam 45 I 0 t oam ar+ci 48 7 _-. _Subsoil RESERVE AREA IS INSTALLED, HOUSE IX 3 � 22 / 1.5 2.Q Subsoil l - 6,7 v �C�' k-' 44.5 Coarse NY / ( F L AWN �,oerse TO BF AS`-IGNEn Of ,� ( Sand �J tULL hy,, TITLE REFERENCE A� wf / !' PATE OF SOIL TEST- 7/3QL9I-3/1L/ 2 Tp.#2) /BHSEMEtd r / and Sand TEST TAKEN BY: JACK LANDERS-CAULEY 3,74 �� Ike F F 49+0 � -- - RESULTS WITNESSED BY: O {►nIn) 11.0 ravel _ ED BARRY/ DONNA MIORANDI (tp.#2) P , o / NO -— Gravel 34.1 -- - — �� o / /, '45EMENT FROST WALL PERCOLATION RATE _ 2 rein./in. Q 13.0 35.7 z, __ 4 5 a� -- - - -u- GROUNOWWTM NONE ENCOUNTERED ASSESSORS N! 210-81 r� inotp RESERVE `tr 0'm �,,..r.•� 1 / �.✓' AREA �. /' ' par�,r 2 FLOW L1IFFUSUF2S ',h --�} _ - ' --- . �_ �,' �#� IU may 4� OF STONE ALL o ,.,. SEPTIC T,'�,. t H-20) � UTILITY f.tE 1 i -- HIT SWALE ________- _ 3/24/92 MOVE SEWERAGE SYSTEM J.D.R. _ _,_____-, HEAD I ' 4T.7 3 /18/92 ADD TEST PIT * 2 J.D.R. L AE 1 � ' Vrivats; (4U wide- 3 /12/92 MOVE SEWERAGE SYSTEM WATER SERVICE J D.R. 46.3 THREAD NEEDLL _ 2/28/92 MOVE GAR./DRIVEWAY/ADD DECK/PARKING J.D.R. ---------------------- DATF DESCRIPTION DRAWN Br ICHECKED BM• SPIKE IN O --K SITE PLAN =50.00 of LOT 4, THREAD NEEDLE LANE PREPARED FOR Rt r>�r" " , FFE TO BE REPLICATED L r �� AFtE� C ION O► r W` ----- -- * 1►V� t� '7 c ` -- , ER NA11', WITH '"s'NOIJS PLANTS. ANN S. NUBBLE CENTERVILLE BARNSTABLE , MA. JOB NO_91008 A-219 SCALE: I"= 2d - DATE: 1/31/92 DWG NO 91008 DRAWN BY : J.D.R. CHECKED BY : . JACK LANDERS- CAULEY , PE . PO Box 36,1 West Falmouth , Ma. 02574 ( 508) 540 - 2035 CIVIL ENVIRONMENTAL ENGINEERING