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HomeMy WebLinkAbout0031 WESTMINSTER ROAD to�ttonmiaj F 0 rm 0 6 o � 0 Town of Barnstable Certificate of Zoning Compliance Certificate No, 2021-58 Map 1.68 Owner of Record Name as of 1/1121:. Parcel 076 PERRY, EVAN P Address 31 Westminster Road 9-11 SPENCER AVENUE Village Centerville SOMERVILLE, MA 02144 1 Zone RC Residential Overlay WP Water Protection Owner 01/29/2021 CHENG, ADRIAN Year Constructed 1971 Property'Use: Single-family Lot Size 0.34 Acres Cert of Occupancy Issued: NA Setbacks: Front Yard 20' Date Permit ;Side Yard 10' Rear 10' Open Permits: None on file Expired Permit: #163494 Remove window/new siding 5/18/2018 I Code Violations: No current violations on file. The Building Division does not receive or maintain information regarding municipal liens. Municipal Liens - Tax Office 508-862-4054 Refer to the Planning Dept.for information pertaining to the 'Zoning Board:of Appeals filings and decisions. Property Description: Map 168 Parcel 076 is a single family dwelling situated on 0.34 acre consisting of 3 bedrooms,two full baths with central air and gas fired-hot air heating system. Zoning Violations: No current violations on file. Reviewed by Title Date: Robin C. Anderson Code Compliance Manager 07/01/2021 I: f KIRK KESSLER(T1) 1 LBS OF 1 P 4692506530 SNAPTAX SEARCH,LLC DWT:12,9,1 411 WALNUT ST SUITE16496 FL32043 SHIP TO: BARNSTABLE TOWN BARNSTABLE TOWN 9 200 MAIN ST BARNSTABLE MA 02601 - �� tt MA 026 9-01 { ti. t�b•ti % !6 a}u;fit ••{?: ,i' }t?s} tt .a7.{.ti�ii t}�t.�}�•t{�i f UPSGROUND TRACKING#:1Z 585 F 1 A 03 3672 9666 r. BILLING:P/P Trx Ref No.:CR#8028,Parcel:168/076/,App p Trx Ref No.:CR#:8078 R.p o-24987 g as.on 06i2021+ TM Tax Search Technologies LLC dba Snap Tax&.Lien Search 35462 Barnstable.Town 6/15/2021 CR#8028, Parcel` 168/076/,App#249878, Property: 31 WESTMINSTER RD, $75.00 . CENTERVILLE, MA 02632. F Parcel: 168-076 Location: 31 WESTMINSTER ROAD, Centerville Owner: PERRY, EVAN P ...................._._........................_.__.................. Parcel Developer lot: Secondary road 1 07-6 LOT 18 ® - t Location Road type Road index 31 WESTMINSTER ROAD Town 1816 Village Fire district Interactive map ? Centerville C-O-MM y, 1 rs Town sewer account I No CWMP Sewer Expansion (subject to change with final engineering design) Phase 1 (0-10 years) i Asbuilt septic scan 168076 1 , 168076 2 , 168076 3 v Owner: PERRY, EVAN P ----- --- - (` Owner I y-------� Co-Owner Book page ! PERRY, EVAN-P %CHENG,.ADRIAN 23912/0303 Street1 Street2 . l 9-11 SPENCER AVENUE t City State Zip Country SOMERVILLE MA 02144 v_ Land Acres Use Single Fam M-01 I I Topography Street factor f Above Street Paved Utilities Location factor is Septic,Gas,Public Water I i Zoning Neighborhood RC 0106 f Town Zone of Contribution i, SPLIT (parcel is split between districts and should be looked up on the map) State Zone of Contribution SPLIT v_ Construction r_ Building 1 of 1 I, Year built y Roof structure Heat type 1971 Gable/Hip Hot Air ' Living area Roof cover Heat fuel 2122 Asph/F GIs/Cmp Gas a rf - 1 Gross area Exterior wall AC type E - 04 3880 Vinyl Siding,Wood Shingle Central � • Style----- Interior wall Bedrooms— Ranch— Drywall 3 Bedfrooms to Model Interior floor Bath rooms ` Residential Hardwood 2`Full-0 Half Grade Foundation Total rooms Average 7 i ` Stories r_ Permit History ---- __.-_ -- -- -- - _ ..._...... Issue Date Purpose Permit Number Amount InspectionDate Comments 04/25/1996 Addition 14723 $16,000 j __....... = ------- -- --- i 03/01/1989 Addition B32749 $25,900 01/15/1990 CE ADUN 1 V_ Sale History Line Sale Date Owner Book/Page Sale Price 1 01/29/2021 CHENG, ADRIAN 33740/345 $480,000 ... ....... . ..... .............. 2 07/23/2009 PERRY, EVAN P 23912/0303 $290,000 3 12/13/1999 GUERRIERO ANTHONY A & ROBIN D 12719/0248 $180 000 ---- -- -- ......-..- ...._.......... .. .............. ..._._.._....... -- 4 07/15/1995 GILMORE,JEROLD P & DAVIDA P 9777/0127 $135,000 I 5 03/15/1989 BODUCH, THOMAS L & KAREN 6664/0315 $1 ......._.._ - --- ___.._ .- ._..__...... -.......... ..... ...... E 6 03/15/1989 BODUCH,THOMAS L 6664/0313 $1 i 7 11/16/1973 BODUCH, THOMAS L&JEANNE ANN 1967/0044 $38,500 I' V- Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2021 $255,900 $29,900 $4,000 $122,800 $412,600 - .... _._ .___..--- _. ---- ---- --- ...... _.. t' 2 2020 $252,000 $27,400 $3,500 $122,800 $405,700 3 2019 $216,700 $27,700 $3,800 $122,800 $371,000 E f: # 4 2018 $170,300 $27,700 $3,900 $134,600 $336,500 i 5 2017 $157,900 $29,000 $3,800 $134,600 $325,300 f' 6 2016 $157,900 $29 000 $3,800 $135,600 $326 300 .......... .. ............ _ ._.... _ . _ T--- - _-._._. . 7 2015 $149,400 $27 800 $4,700 $131,300 $313,200 ......... - 8 2014 $149,400 $27,800 $4,900 $131,300 $313,400 9 2013 $149,400 $27,800 $5,000 $136,600 $318,800 _M . . . _... .,. -- -----...._�.._ _. _..... _ - ..... ._ 10 2012 $149,400 $27,500 $3,900 $105,100 $285,900 ( 11 2011 $182,200 $3,200 $500 $105,100 $291,000 12 2010 $182,100 $3,200 $500 $133,400 $319,200 E i t 13 2009 $177,700 $2,600 $300 $155,900 $336,500 14 2008 $210,200� _ $2,600 � $400 $166,900 ��^�$380,100 16 2007 $209,300 $2,600 $400 $166,900 $379,200 17 2006 $192,900 $2,600 $400 $169,400 $365,300 .._... __..._ i; 18 2005 $175,200 $2,500 $400 $135,100 $313,200 E P __.._..-------- _.. _._ _ - ..._. _ - ...........---._....._-_..--- ----- Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 19 2004 $142,500 $2,500 $400 $101,300 $246,700 - - - _----- __._..... ---- -------------- 20 2003 $127,500 $2,500 $400 $44,600 $175,000 ........... ._........._. . ........... .....__. _..._......... _...... _.-,..., ..__......... ......... .. ........_.. .. ._...__...___.. 21 2002 $127,500 $2,500 $400 $44,600 $175,000 22 2001 $127,500 $2,500 $400 $44,600 $175,000 _ _ _ _ 23 2000 $97,900 $2,300 $200 $33,500 $133,900 24 1999 $97,900 $2,300 $200 $33,500 $133,900 E 25 1998 $97,900 $2,300 $200 $33,500 $133,900 ' 26 1997 $97,100 $0 $0 $30,100 $127,200 27 1996 $97,100 $0 $0 $30,100 $127,200 � 28 1995 rt � $97,100 $0 $0 $30,100 �.�.- $127,200 ....... _ ......._ ...---- 29 1994 $86,200 $0 $0 $21,100 $107,300 -- --- ._ _ 30 1993 $86,200 $0 $0 $21,100 $107,300 31 1992 $98,300 $0 $0 $23,400 $121,700 32 1991 $104,100 $0 $0 $53,600 $157,700 is 33 1990 $88,200 $0 $0 $53,600 $141,800 f t: i 34 1989 $88,200 $0 $0 $53,600 $141,800 I 35 1988 $60,800 $0 $0 $23,700 $84,500 36 1987 $60,800 $0 $0 $23,700 $84,500 37 1986 $60,800 $0 $0 $23,700 $84,500 E_ Photos { - -- - - z4, - OF liff 111s s E_ fjj FF f 33 �i }t } f -_.-_.At Elio -17 � r� •"fir' .k 1 X w� t Y .t . , Y r 9 i {' h�jf dl d�r ✓ ;Y r' ,' 'g+�4 e/> +.ry" W �S,A � 's' I9 � t 1 S "Atvi' ♦'®44eNQi^�.3Wb �?!'�1 ��♦P•�♦ y` a. E a : -I &• 1�„�� > �.�;a.�����1�� 1�6�i#�$"�.����� ��,�•.: .� � �,�...— . i.. i Tr , id MR • � } ( �F }}}}pper � i 1 t 411 Walnut St.,Ste 16496 Green Cove Springs, FL 32043 Toll Free:855-767-9724 1 Office:469-250-6530 Fax:469-445-2407 info@snaptaxsearch.com I helpdesk@snaptaxsearch.com.I httr.s://snaptaxsearch.com June 15, 2021 Barnstable Town 200 MAIN ST, BARNSTABLE, MA 02601 Barnstable Town . i For the below referenced property, please provide a Municipal Lien Search to include any Open, Unrecorded, or Expired Special Assessments, Permits, and Code Violations. Attached is a check for the $75.00 fee. Address : 31 WESTMINSTER RD, CENTERVILLE, MA 02632 Parcel # 168/076/ Owner/Applicant: EVAN P PERRY t { Transaction Type: Foreclosure , Please Return via Email to Kgriffin@snaptazsearch.com LL Email : Kgriffin@snaptaxsearch.com y Fax: (469) 249-9371 Regards, Kaitlyn Griffin (T1) s CR#8028, Parcel: 168/076/,App#249878, Property:31 WESTMINSTER RD, CENTERVILLE, MA 02632 Tax Search Technologies, LLC. (DBA Snap Tax&Lien Search) "Timing.Accuracy. Consistency." 4E, 411 Walnut St.,Suite 16496 Green Cove Springs,FL 32043 #f$ _ Toll Free:855-767-9724 1 Office:469-775-9862 1 Fax:469-775-9862 info@snaptaxsearch.com helpdesk@snaptaxsearch.com r a https://snaptaxsearch.com Hello. We have a new client in your area. Some of your processes and requirements are somewhat new to us. Please find the enclosed request for property information and the payment for such information that is-required for our client's real estate closing. If we have prepared anything incorrectly, please contact me f directly so I can correct-the items going forward. We value your time and want all our requests to be prepared correctly for your team. Everyone in this process really appreciates your assistance. Thank you. Angela Chrisp Direct Phone: 469-775-9862 t Snap Tax & Lien Search achrisp@snaptaxsearch.com © Tax Search Technologies, .LLC. p _ 4 Tax Search Technologies, LLC.(DBA Snap Tax&Lien Search) "Timing. Accuracy. Consistency." fAssessor'3 office (1st floor): SEP=S MUST �iYNETO / '/, Assessor's map and lot number ....�G. ...d.��fn....��./T • INSTA=Ign �o Board of Health (3rd floor):' fO Sewage Permit number .... Z� 9TsnLE, . Engineering Department '(3rd floor): °o 2639• I ..3.......`�.......... � �s s, House.. number' ............................... . .. � Y CEO YPY d' Definitive Plan Approved by Planning Board _________________ '.-______--19-------- , APPLICATIONS PROCESSED 8:30 9:30 A.M. and 1:00-2:00=P.M. only, TOWN OF BARNSTABLE . BUILDING INSPECTOR . APPLICATION FOR PERMIT TO .............. . . 1 - TYPE OF• CONSTRUCTION .............W...4?l? ....S.........w..... �!-......... ..................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location '.........:�...'......�.��.��..Y!1!�STG.�! ..�CX......... .C.`^'K ✓`..Z1.4.�.�t.:..:�!'!...............................................:.. a Proposed Use t - Zoning District ......... .........................................:......... ..........Fire District ......P...... .... ........... . Name of Owner .�........................✓t......�O.CXi!?l:f'Y>�ddress .:3..�.:...�?..4.�....1:�'}.!`.:�5......'.�.....4.Q:�-Cci•.✓.��.!h Name of Builder ...............Address .14....Coy:{n.. 's.14 ......��'.'� ✓v-� l� Nameof Architect ..................................................................Address.........................................-. ..... i Number of Rooms ........:.........................................................Foundation ... .....:I.... Exterior ...V.. .t�.�.....S.�ZX6:�!��.......... Roofing .....CtiS, 4.A..`....................................................... T Floorst9.4. ..7 .��.t .............:...................................Interior .....�.. 7.5�...�. ................................................... , .. . Heating ....... . ..................................................... �a C Fireplace ......Approximate Cost ..,�� 5 / 0 . ......... .................................... Area .. ...e�. .....,...�............ Diagram' of Lot and Building with Dimensions Fee v a OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above , construction.' Name . . Construction Supervisor's License ...>��".`�.�i. .7...j.......:. r BODUCH, TOM & KAREN r 32749 permit for Build Addition ............... .................................... _ Sin le Famil Dwelling =5 . :...... g......................X..............a................... Location ....31...•Westministe. . . . . . . r....Road. . ........ ... .. .... .. . .. .... .... .. .. r Centerville . -� ................................................................. Owner ....Tom• &•••Karen Boduch ....... Type of Construction Frame _ .................. !.. ...................._...........r........... - Plot ...................... Lot ... #18................. Permit.Granted ......March.. 3.0 , .. 19 89 Date ofllnspection ..'........,p...ff..................19 Date Completed ....... ...............:...... 19 >r1 ,., ZV F _ Assessor's office (1st floor): oF T E Assessor's map and lot number .... A Board of Health (3rd floor): / - 5,7-, t-11-0 ?.:.ii��Sewage Permit number ....................I........ DAUSTABLE, Engineing Dep ' NAM& �� S; l 2639. Houseer numberartment (3rd floor):.................................. ..... 0 NPR Definitive Plan Approved by Planning Board ---------------------------------19-------- - APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING . INSPECTOR APPLICATION FOR PERMIT TO .. .... 4. ..... ....... ............ .... ................................... TYPE OF CONSTRUCTION ...........LJ.000..-��Ct V%-C_ ..... .......................................................................................................... /, .......--,A- --" . /.....?...............-....... .........�19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ) ..... .........C. �A. ...... ALocation . .................................................. ProposedUse ... ..........................................................................11.........I.................................................. I. 6/6 ZoningDistrict .......... . ........................................................Fire District ...........X................................................................. Name of Owner ... ...3A....Wg.:ST S�, .. ........................... Name of Builder .................Address ...... ...... Nameof Architect .................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ... ......................................................... Exlerior .... ...... ..........................................Roofing ...... .................................................... Floors ........W.0P....... . .....................Interior ..... .................................................. Heating .....�n.QA....0,--vJ.....................................................Plumbing ...... .. ........................................................... Fireplace .................................................................................Approximate Cost .....(/X..911 S.....j...........5 V 0........................................ Area ..... a2 v0. ............ Diagram of Lot and Building with Dimensions Fee c,= .................................. � � I sA OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree)to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........... LI Construction Supervisor's License .... 7,/......... BODUCH, TOM & KAREN A=168-076 �� - 76 No ..3.274.9.. Permit for .....Build Addition Single Family Dwelling Location ...,31 Westminister Road . ............................................. Centerville ............................................................................... Owner ......Karen & Tom Boduch . . ............................................... 'L Type of Construction ...........Frame . .......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .....March...3 0.f...........19 89 Date of Inspection ....................................19 Date Completed ......................................19 �ecaecnrc(�ffir P (1 � �j -Parcel Permit# Conservation Office(4th floor)(8:30-9:30/1:00-•2:00) Date Issued �� , 4 Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) $' p ,1 ° �,60 Engineering Dept.(3rd floor) House# i ���� ®.w e Planning Boar s 19 a Q. - TOWN OF BARNSTABLE Building Permit Application r J Project St et Addr Village h rJ Owner '° Address Telephone r � w Permit Request ApA/�!6 First Floor square feet Second Floor � (�" square feet Estimated Project Cost $ ��' 666, AO Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use A AA..44 Proposed Use Construction Type . 1&2a� Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths ,2 No. of Bedrooms Total Room Count(not including baths) 1p First Floor Heat Type and Fuel Central Air Ves Fireplaces Garage: Detached Ot er Detached Structures: Pool Attached Barn None Sheds Other- Builder Information Name AV Telephone Numbery� - 71p Address Oo1 License# 6/17 IA1 7 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 lie SIGNATURE DATE 1.,2 BUILDING PERM IED FO � E FOLLOWING REASON(S) f/ FOR OFFICIAL USE ONLY - PERMIT NO. # 1 a • r ' DATE ISSUED s` + 'I 1 MAP/PARCEL NJ. ADDRESS � VILLAGE OWNER t f ' DATE OF INSPECTION: FOUNDATION FRAME' . ; r ' INSULATION FIREPLACE ELECTRICAL: ROUGH _ FINAL PLUMBING: ROUGH FINAL t r GAS: ROUGH FINAL ' FINAL BUILDING ,DATE CLOSED OUT , ASSOCIATION PLAN NO. s — i + r. •s �"' The Coninionwealth of Massachusetts - - ucil � �_' Department of Industrial Accidents a t =:1 F Ofnceollm��sUgatlaas , tilt, =r•;�` 600 !f vhin,;ton Street Workers' Compensation Insurance ARdavit ___ -� .Aoolicaan nfot•rrtatio'ns Please PRINT t o jy �'' " location• citti• /�/ �f_/y%/ /il7✓� `� nhone# 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 1 am ati employer providing workers' compensation for my employees working on this job. m —r— insurnnce policy# I am a sole proprietor eneral contractor or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: compani,n nddress: ti •� nhone#s insuroncecn_ neiicv# •' 17c:_ «,-,�... _ rcn,✓ •a:..•.as fr,.'9�" -=1K -- "s�vE 7�••'�at;wr; a�ry"_'![�+" .e�4.3_ �""'� !' m �• C. city phone On insurance co. nolley# :Attach additidnal'sheet ittieeessary Vr Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of erimiaal penalties of a fine up to$1.500.00 and/or oneYears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I understand that s copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I'do hereht•ccrtif}}•under the ails a pc Ines of perjury that the information prosided above is vue copra Signature Print name tine# omcial use only do not write is this area to be completed by city or town official MY or town: permMieense It ritluilding Department pLieetan Board ` check if Immediate response is required OSeltxtmea's Office �Ilealth Department contact person: phone#; MOther Information and instructions Massachusctt General Laws chapter 152 section 25 requires all emplovees to provide workers' compensation for their employees. As"quoted from the "law", an emplmme is defined as every person in the service of another under any contract offiire, express or implied, oral or written. �4 An emplitrcr is defined as an individual, partnership, association. corporation or other :,-gal entity, or any two or more of tine foregoing engaged in a joint enterprise,and including the legal representatives of a deceased cmplover, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the o\vner 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 1.52 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 tine common wealth for any applicant who has not produced acceptable evidence of compliance with the in 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 insurance requirements of this chapter have been presented to the contracting authority. .... �. TWA 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 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 affida�•it. 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 co obtain a workers' compensation policy, please call the Department at the number listed below. •�*.7�.N..��Og1//'t.+@�R7ww..0'�•�! '. - _ :�v. �a,T1,.�. 6 .4'8. , �_ -�w�'�Tj� ♦ ._. �. . .� .. y� ...... •• - � .. •���.;••t:,•-�.ni:.<u'T:iw.•�•.'��,r ..«_�:. �Wyt..:.r'.:A3`[r�.�'.i�'� w.s t•:'r.`'. ,,.••- City or Towns 'lease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of .he affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please )e sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to he Department by mail or FAX unless other arrangements have been made. ?lie Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, )lease do not hesitate to give us a call. - .e..�,nor...... ..+q�e�ww:I1.w• —_ ��-.. u+•,++::• .. �r .w.-1'f:..�.::�R• •Y�..• •ylb:.wC ir•.•',uY�.isi. �iw+..w . - '..•,...Y,.,..: _ :,u��t�••:r`•:`. i'he Department's address, telephone and fax number. The Commonwealth Of Massachusetts �_.. Department of Industrial Accidents Office of Investigations �.. 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 • . ' ° The Town of Barnstable KAA& e$ Department of Health Safety and Environmental Services 16 Building Division 367 Main Strut,Hyannis MA 02601 Office: 508-790.6227 Ralph Fax 508-775-3344 Building Commis For office use only Permit no. Date AFFIDAVIT HOME DWROVEMENT CONTRACTOR LAW SUPPLEMENT TO PEpidiT APPLICATION MGL c. 142A requires that the-n=nstruaron,alterations,renovation,repair,modernization,conversion, improvement,.removal, demolition. or construction of an addition to any pm-wing owner oohed 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 exceptionst along with other requirements. Type of Work:sj!�, Est Cost4, W.DO Address of Work: za i O%mer.Name: Date of P cation: Al/,Vl I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S11000 Building not owner-0oxupied . Owner ping own permit Notice is hereby given that: OWNERS PULLING'I iEiR OWN PERMIT OR DEALING WITMDNItEGI3'iERED CONtTtACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO TIC ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL r- 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. 171 D e C tractor a Registration No. OR n,,A Owner's name THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) M /4 GLI 1 F DATA . .. .. THE COMMONWEALTH OF MASSACHUSEM ._ . Board of Building Regulations and Standards _ Transaction No. One Ashburton Place-Room 1301 r Boston, Massachusetts 02108 M Registration No. Application for Registration as a - r ' . .,; F.Efective Date Home Improvement Contractor or Subcontractor MGL Chapter 142A, CMR 780-6 Expiration Date FOR OFFICE USB ONLY Date L Name Print the name of the individual oVhwnew applying for the registration(not both) 2 Mailing Address gad, /!5' ( Area Code A Telephone Nu: 3. sty tTP.P� state ?3p OafoSS r 4. Street Address(if different) 7'J�(a Print street and Number(P. i.Box ao acceptable) Gty State 23p S. Applicant type: ❑ Individual ❑ DBA ❑ Partnership ❑Trust Private Corporation ❑ Public Corporation (See instructions on back regarding enclosing a city or town registration under the BA or"fictitious name"law-MGL c 110,ss S&6) 6. - � — (see instructions) 7. Number of Employes� 9. Title of individual responsible for Home Improvement Contracts 10. Does the applicant or responsible individual hold any other construction related state,city,town licenses or registrations? U yes,complete the table below. Use additional paper if necessary. Type license or registration hatted By Lleense or Expiration Name of L =w Holder registration number -Date VV •- —----—----- _ _ ,r , �.� _ / 11-41A '11� - + —'-. -� � - � � `' %;Z�-fir 1 � ,�'^'�`'^^ ;�� �—� �'.9:0,� ,?�� �(U �j f f 1� ��?Fj�� ,.I i Y j •' pi �.Sg 1 Ol .�� {� �/ ►�,�^��J�y��' - -, itqv -�--.�.__ 00 ff -ji wq a) r� tl k { 1 [ 4`� i no _ 1 7 I 1 _ _# j o � r , + I �-._ ._r.. }.'._f_-__..y__..�..1.-•1- �- -� --- - -"'----•i- pL �--� -.L. 1_-?- •--*--1- -{-_ _��-_f �t7-4 ---�--'+---'-r---r._.{.may-•- .- --�- I , N -r T�t --� -F��S►I �� --I- - T.—. 1 � i—T—f oe It I GO + i I , r r 1 A f '00��y V' f-I Aeld X l- vi- 1,d#4115 o?X /a 1ove ✓n �oo 77 O e T - 767 � � ��,�.Gca�C l�.�G� .£ . 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