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Home My WebLink About0319 MARINER CIRCLE maw-Iner Town of Barnstable Building ' �PostTh�s Card So:T,hat�rt;s Visible From-theStreet Approved Plans'Mustbe Retained on;9ob and this Card,Must�b`�e Kept SA�13T['AESLE, • e;�� .'xiTx '� � r ,°�,.,•. � 3 �..� 4 w � ��'� v �; ¢ z ..� x � � ,,. � 9 163 `� )Posted Until Final Inspection Has Been Made 4 y ��Where a Certificate of Occupancy is Regwred,such Buildmgrshall N t be Occupied until a.Final Inspection has been made Permit .w...=w,,,.�.."�.�,-�•rw ..,1 q,K• ..�.. I-a_<.�-, �A.......;,,..,e._K. ,ar�....._..,s;.•4-, ...-n..:,.,... .-.,:.,a3e.,� .,c.�¢5:...:.,.,x.>. <:., ...._.,. .�.,< �,. ,_, _�Cc�.....e�.. ,.�.�. .«,....aa»,.,+»-x,., ..sdF';x.,...,,:w,.`.+. Permit No. B-18-1687 Applicant Name: AU REALTY CORP Approvals Date Issued: 05/24/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/24/2018 Foundation: Location: 319 MARINER CIRCLE,COTUIT Map/Lot 039 013 Zoning District: RF Sheathing:, Owner on Record: AU REALTY CORP Contractor Name Framing: 1 Address: 128 MAIN STREET' Contractor License 2' HYANNIS, MA 02601 s R ,; ,Est Project Cost: $4,500.00 Chimney: Description: Siding and (2)Windows , Permit Fee: $120.00 Insulation: k F.ee Paid:' $120.00 Project Review Req: g Final: Date 5/24/2018 Plumbing/Gas Rough Plumbing: s Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sixmonths after.ssuance• Rough Gas: All work authorized by this permit shall conform to the approved appl tion andtheapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures-`shall be in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access strget�or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical -J � ;_ The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required forAll Construction Work: , � , 1.Foundation or Footing � ' Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application number............ /......... ..... Date Issued........�. .f ... .................. PRE XAM „ MAY 2A 2010 Building,lnspectors Initials .......... ......................... r��.E TOWN ��- BNt�N Map/Parcel v .• ••••••.•• ...... ............... TOWN OF BARNSTABLE ✓� EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: °i �✓1e/ Ci J C }" �` NUMBER STREET VILLAGE Owner's Name: L�-L —Phone Number (4�&� q 5 ��,L.Coo Email Address: �a ( a Cell Phone Number vti e Project cost$ S0 a� v 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: Date: r TYPE OF WORK Siding Windows(no header change)# 2 ED Insulation/Weatherization Q Doors (no header change)# , Commercial Doors require an.inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to �n CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER.75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN. --. A..I .#,rTr%n1- Aoovnve► RAMRF a PFRMIT CAN BE ISSUED. 4 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-4.30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION ` 1 Homeowner's Name: ` )y 0,- G Telephone Number ,5 07-- '9 S�( ') VC Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CM_R the Massachusetts State Building Code. I understand ro the construction inspection pcedures,sp ific inspections and documentation required by 780 "a CMR and the To o ' stable. Signature Date "PLIC S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. T - .. The Commonwealth of Massachusetts Department of IndustrialAccidents efface of Investigations 600 Washington-Street Boston,MA 02111 wwH.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electri ians��umb bs Please Applicant Information Nance(Business/0rganizatiowbdividual)' � )JOP ✓� ��/ v"`v 1 Address: ` ,S �Z�,OPhone#: i "C1� �7 C4 S� City/State/Zip: _ � Type of project(required): A re, an employer?Chec the appropriate box:m a general oonlractor and I ❑ 6. ❑New construction. ❑ I am a employer with have hired the sub-contractorsemployees(full and/or part time).* listed on the attached sheet7. ❑Remodeling I am a sole proprietor or partner- These sub-contractors have . 8. ❑Demolition ship and have no employees employees and have workers' 9. ❑Building addition working forme in any capacity. ;.,s,ranre 1 o workers°comp.insurance' 10.❑Electrical repairs or additions [N 5, nee a corporation and its Vqwed.] officers have exercised their 11.[]Plumbing repairs or additions 3, I am a homeowner doing all work right of exemption per MC 12of repairs myself[No workers'comp. e.152,§1(4),and have no insurance requrred.]t 13.❑Other employees.[No workers' COMP.insurance requiired.] 1 must also fill out the section below showing their workers'compensation policy information. *p=ry applicant that checks box# indicating they are doing aII work and then hire outside contractors must submit a new affidavit indicating such. t Homeowners who submit this 1 mush i[;outractors that check this box must attached an additional provide their workers'comp pot cry number�d states not those entities have employees. If the sub-contractors have employees.they P and'ob site I am an employer that is pr oviding workers'comperrs ' n insurance for my employees. Below is the policy 1 information. Insur.mce company Name: Expiration Date: Policy#or Self-ins.Lic.#: City/State/Zip: Job Site Address: the policy number and expiration date). Attach a copy of.the workers'compensation policy declaration page(showing , e �' penalties of a Failure to secure coverage as required under Section 25A of MGL 0.152 can lead to the imposition of criminal fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form be forwarded to ththe a STOP WORK Coffic of d a fine the violator. Be advised that a copy of this statement may of up to$250.00 a day against ce coverage verification. Investigations of the DIA under the and penalties of perjury that the information provided above is true and correct I do hereb fy ,�� r ' Date: Si Phone#: official use only. Do not write in this area,to be completed by city or town offrciat Permit(License# City or Town' -------------- issuing Authority(circle one): ector 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Insp 6.Other Phone#: Contact Person: y� 4 y , Information and' Instructions Massachusetts General Laws chapter 152.requires all employers to provide workers'compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person iil the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more. of 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, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate_a business or to constrict buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance covera.ge*required." Additionally,MOL chapter 152,§25C(7)states"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." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the.Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town rout 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant: PIease be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided,to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i,e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The COMM Mealth of Massachusetts Department of Industrial Accideuts Office of IAvesti flow 600 Washington Street Boson,MA 02111 Tel.#617 727-440 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617 727 7749 www.namgov/dia Mass. Corporations, external master page Page 1 of 2 i �y r J Corporations Division Business Entity Summary ID Number: 463663321 F R quest certificate New search Summary for: ALJ REALTY CORPORATION The exact name of the Domestic Profit Corporation: ALJ REALTY CORPORATION Entity type: Domestic Profit Corporation Identification Number: 463663321 Date of Organization in Massachusetts: 09-18-2013 Last date certain: Current Fiscal Month/Day: 12/31 The location of the Principal Office: Address: 182 PITCHERS WAY City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The name and address of the Registered Agent: Name: JUAN MARICHAL Address: 128 MAIN STREET City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The Officers and Directors of the Corporation: Title Individual Name Address PRESIDENT JUAN MARICHAL 182 PITCHERS WAY HYANNIS, MA 02601 USA TREASURER JUAN MARICHAL 182 PITCHERS WAY HYANNIS, MA 02601 USA SECRETARY SVETLANA KOLESNIKOVA 182 PITCHERS WAY HYANNIS, MA 02601 USA DIRECTOR SVETLANA KOLESNIKOVA 182 PITCHERS WAY HYANNIS, MA 02601 USA Business entity stock is publicly traded: ❑ http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=463663321&... 5/24/2018 Mass. Corporations, external master page Page 2 of 2 IThe total number of shares and the par value, if any, of each class of stock which I this business entity is authorized to issue: Total Authorized Total issued and Class of Stock Par value per share outstanding No.of shares Total par No.of shares value CNP $ 0.00 100,000 $ 0.00 100,000 ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Administrative DissolutionE Annual Report Application For Revival » Articles of Amendment _ I View filings Comments or notes associated with this business entity: f I N New search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=463663321&... 5/24/2018 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION - - Map Parcel " Permit'# v V Health Division '- -7 Z Date Issued 67 3 Conservation Division 5 O Application Fee Tax Collector G 7 0 Permit Fee c�a Treasurer Planning Dept. r Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address J Village J'fi y Owner4m-NWAddress Telephone L_ 1 ! a —3 9 � Permit Request R I��4 C!AL 21Gcana,4- Uvrl, � Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes IKo On Old King's Highway: ❑Yes B_90 Basement Type: ❑Full ❑Crawl �alkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: O Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes. Oslo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:Cam!existing ❑new size Shed:❑existing ❑new size Other: 3...P Me- A, Y,3 0 Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use UILDER INFORMATION Name �� / G� Telephone Number Address /" (d,1Z1y/t° /V ,l-P License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �^�� FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE r OWNER l ` DATE OF INSPECTION: FOUNDATION s $)g103 '7S7� FRAME INSULATION r ? FIREPLACE ELECTRICAL: ROUGH FINAL- ' PLUMBING: ROUGH FINAL` GAS: ROUGH - FINAL FINAL BUILDING J DATE CLOSED OUT - ,ASSOCIATION PLAN NO. z The Commonwealth of Massachusetts Department of Industrial Accidents OfficeVUHNsti 8019s _ — 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name Nl f�!`hC- �® L19 location hone# -2 ci _ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worldn 'many capacity an em to rovidin workers'compensation for my employees working on this job. I am g .......................... -..... ❑ P Y .P.................:.:::.. .......................:::.:::.::.:.::::::::::.......:.::::.::::..::::::...:......................:.::::..:::.::.::::.. :com an n }•: ......:....:. .;•:::::. ..:..�.:::................. .... .........;....... y;:;y: :?:r5 ):ii: )riA^: n....., ? elalE'e .............. -} "i};;:;>:?:•�}is4'::.`•:`ice?:::Y:�:;:;:;:::: ?'i:.......: ri :.. ..:::•:::::::::.:.�::::::::::::::.�::::::.::.�.�::-:.:::.::.:�:.:::::.:::::.::.�:::::.::.::::•::::::.::.. bane:# ei ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have t ollowin workers' co ensation polices: the g mP................................::::::.::.........................:::. . ........................:::::::•::::::.:.::::::.}:;o:•}:.}:}:•}}:•:•};:•}:;;•::::•}:{•}}:•:�::}•}:::::'<<::i:r ::;:;i ::2:::::<:::: : ;i:;:; is2`Yi?55:::; :::;:;:`5:::::<::':::?:: :::::::'i�::8:i;}: :com sn •:name: :<:>�<:�>::<:::>::>: -:. ........................:......... >. ...Si''ri:vS;4:i�:�ii::i::iiiii:Yi:;i:}:::sin:�:}>isi::;:;:j;:;{:;:;:L::::;:::};i:jj:t?� :ii:':'v:<}:i S<:i:::i:;?:<{�i':Si: iYiii��ji:{:j};L:i:;::::i::>::::i:i:i�<::v:C�i:{{:..}::.}:•:•:•{^:{:i}}ii:3}i}:}:{:?4:•:G}}}}}i}i}:•}}::v}}:?:•}i:{�}}:;^::h:^:tidh�:{ti•:v:: .;•h .. ....... ......... ............ ..........:............r.....} ..............L.:v:•:::::.:.•}i::;P}iv:{6:{?•}i}Y?O}.....,..:,'ti•::.,v,.}w¢:a]�-W-.B}.J\ .rii}C{?v:ii: r.. ............ ................... ...r.............. ................-.....................:w:::::::•.�::::::::�:';}{{{{:•}}::•.},: :.#.?ii^:;i:•ii:i•:�:.:.:;{.:i::•i}i:•i:•i}•?:•}:{{::}:<+{;+;;•i::::•::.{•::•:::w::::•:::::.:;:•}}:::x::::•::::: . ....:..:........................................................................................ :::........:.::..:::.. . an .aatn ��.11DII 'sunrarice �� Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tbte up to$1,500.00 and/or one yes,imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S10o.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury than the information provided above is true.and correct I n -�,-C� Date sipature / r_ name /1 L 'lylt°l�1 Phone#( �� Print official use only do not write in this area to be completed by city or town official city or town: puadttlicense# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selechnen'a Office ❑Health Department contact person: phone#; - ❑Other Unuad 9/95 PJla Y f 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. 'An employer is defined as an individual,partnership, association, corporation or other 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 employs ersons to do maintenance, construction or repair work on such dwelling house or on the grounds or another whoP deemed to be an employer. se of such to ent be building appurtenant thereto shall not because emp ym 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 insurance requirements of this chapter have been presented to the contracting authority. Applicants ;a please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and company naives, address and phone numbers along with a certificate of insurance as all affidavits maybe supplying <, P Y 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 Permitllicense number which will be used as a reference number. The affidavits maybe retarhR 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 WHO of I13V831192tloas 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 �optNe roe Town of Barnstable Regulatory Services * Thomas F.Geiler,Director - NAM 9� i6 a 19. Building Division .eTFD MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type.of Work: Estimated Cost � � a" Address of Work:y Owner's Name: Date of Application; ��- �' �2 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 &?5wner 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. Date Owner's Name 1 1 The Town of Barnstable .Regulatory services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION / ```` Please Print DATES ' to— ( 1 13 y�� /� JOB LOCATION:_ 3 r I 1"L �YC�LVL'P r C l �G Biq number sttrreeett village ��- name home phone# work phone# CURRENT MAILING ADDRESS:_ 3/f At tl`tags &YP city/town state zip code The current exemption for"homeowners"was extended to include owner-occUied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building-permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedules and requirements. Signature of Ho owner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed•Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. jt / 6 ®• C, H s?qk� � �c► G /C? Focs-�►V.�C..s 5AUNP.- eugFS A i L ha r, �q :;L'� i --- -- -------- { ' �__�! I j s � ,� ;= I ' �_ _ !� i I� � � [�, !�, f I ! � 3 S 4 ;t` f S ' t i E � �I � _ f t� f /� � i { I � r i i I I ' Charles I I-11rennan BUYER: 125, C) c' I i I 8 ' 0 �_ wood -2 o cow TO Advantage MortrraFe Corp. AANTHE S nnE INSURERS. MORTGAGE INSPECTION PLAN LpCATm IN I CERTIFY THAT THE BUILDINGS 6HOIhM DO ( FORM TO SETBACK REQUIREMENTS.I.E. (FRONT. SIDE. 4 REAR SMACK ONLY) OF COtAL -� LA T MEN CONSTRUOTED, OR ARE EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS. G.L TITLE MI, CHAPTER 40A. SEOTION 7, UNLESS OTHERMASE NOTED. MASSACHUSETTS I FURTHER CERTIFY THAT THIS PROPERTY Is Not .LOCATED IN THE ESTABLISHED FLOOD HAZARD AREA.OOMMUNITY PANEL NO.: 250001 00210 DATE: 8-19-85 DEED '2-46O THIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT TO THE RECORDED BOOK DATE OF THE LATEST DEED OF RECORD. PAGE Z 1 WHENEVER BUILDINGS ARE SHOMM LESS THAN ONE FOOT FROM THE PROP ' &'') /}(j�VISED CERT. NO. THAT A MORE PRECISE SURVEY BE MADE TO VERIFY THESE MEASUREMEt �.' �i: •� v e c ROIL 1 CERwr-ATION IS BASED ON THE LOCATION OF SURVEY M �D 1ERS, ANU"Dp�S`N PLAN OK: PAGE - R�SENT A PROPERTY SURVEY. VERIFICATION OF SURVEY MARK o7lND iN TOM. ui)e #167 DATED- — MAY Be ACOAO�M.PUSHED ONLY BY AN ACCURATE, INSTRUMENT SUR A E NOT 6'JCTED PLAN 'ML CERWICATION TO BE USED FOR MORTGAGE �� ; T)u-C OFFSETS AS SHOWN ARE NOT TO B' .�5 SCALE: I USED FOR THE ESTABLISHMENT OF PROPER�'f�t`: A D F O R D NGINEERING CO. ...�� eP.O. BOX 1244 ` HAVERHILL MA. 01831 ...,. %u nniinin4av,o n� unirnn Town of Barnstable �OF 7HE r�ti o Regulatory Services Thomas F.Geller,Director aARNSTABLE. MASS ,� Building Division prFD �a Tom Perry,Building Comnussioner 200 Main Street, Hyannis,NIA 02601 a-ww.town.b arnsiabl e.ma:us Office: 508-862-4038 Fax: 5.08-790-6230 II0MEOWNER LICENSE EXEMPTION Please Print DATE:- � JOB'LOCATION: �l /o d'A�� rnuppmbcr f /. street village/ ..HOMEOWNER": JL C C/ P�r 6472,&0 A) 00 ' c�27�f_ 0j name I '�home phone# work phone# CURRENT MAILING ADDRESS: /t� k ��C C e ('0 % OZ ,b, city/town state rip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF ROMEOWNER Persons) who owns a parcel of land on'which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to.the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for al]such work performed under the building permit. (Section 109.1,1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws, rules and regulations: The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and require nts. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner perfomung work for which a building permit is required shall be exempt from the provisions of this section(Section 1 o9.1,l-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supevisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the rnponsibilitics of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a form/certification for use in your community. Y °pTHETo�y Town of Barnstable Regulatory Services !�BARNSTABLE, Thomas F. Geiler,Director rFOMa�a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in affmatters relative to work authorized by this building permit application for: (Address of rob) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. •'1 / r( C OF r PERMIT `Town of Bax nstable . *Permit �= j Erpires 6 months from issue date 008 Regulatory Services T Thomas F. Geiler, Director 9 � 1639. ST,�13L-€ Building Division PrFb MP't a Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www:town.b arnstab l e.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number —s' J Property Address ❑ Residential Value of Work ��Q ,dU Minimum fee of$25.00 for work under $6000.00 Owner's Name&Address ��(�� '((�12-( e CIA 1 SD Contractor's Name cv Telephone Number Home Improvement Contractor License# (if applicable) ❑Workman's Compensation Insurance Check one: ❑ [,am a sole proprietor [C]/f am the Homeowner ❑ [have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy.of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side -placement Windows/doors/sliders. U-Valu,.,ZU (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e. Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner better of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: . �Wze:6a \ mwpFrr FC\F(nRuS\hiiil iino n _i, fn \FXPR F_CS rnr. The Commonwealth of Massachusetts Department of Industrial Accidents Office'of Investigations 600 Washington Street Boston, AM 02111 - www_rnass.gov/dia Workers' Compensation Xnsnrancc Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print Legibly IrTame(BusinesslOrganizstion/individual): pr► C-�A�2��oc1 City/State/Zip: c .t�lfi d�� (.Q'�` Phone.#: Are you an employer? Check the appropriate box: 'Type of project(required): 1.❑ I am a employer with 4= [] 1 am a general contractor and 1 6 ❑New constrmtion employees (full and/or part-time).* have lured the sbb-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling These sub contractors have g" 73emolition ship and have.no employees employees and have workerS' working for me in any capacity. 9. ❑Building [No wark addition ers' camp.•in�rranr_c imp-insurance"t S. We arc a corporation and its� 1011-Electrical repairs or additior 3. am a homeowner doing all work officers have exercised their 1l.[]Plumbing repairs or addition myself [No workers' comp. ngbt of exemption per MGL 12 ❑Roof repairs inerrrance t c. 152, §1(4), and we have no r egmred_] employees. [No workers' 13.❑Othcr camp,inciirainCe required] *Any applicant that thcskr box#1 maat also fill out the erection below showing their wm+=s'cnmpcas4on policy inform-ation_ t Homcownas who submit this affidavit indicating ffiey an:doing all work and thrn hire outside contrector6 must submit enew affidavitindicating sucb h--=b actats that ehmI this box must attached an additimul sheet showing the name of the sub-conbactnrs and s�whether or not thosC entities have employers" If the sub-contractms have employees,.they must pruvi&their workrrs'cutup-Policy number" I am an employer that L provid ng workers'compensation insurance for my employees. Selow is the policy and job site information. inmu-ancc Couipany Name_ - Policy#or Self-ins:Lic.,#: Expiration Date: rob Site Address: City/sbfclzip: Attach a copy of the workers' compensation polity declaration page(showing the policy number and expiration date; Failure.to scmwc coverage as regvircdunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of: fine rip to$1,500.00 and/or one-year imprisonment, as we as civt-1penalties in the form of a STOP WORK ORDER and a t of up to$250.00 a day against the violator. Be advised that a copy of this statLmcrit may be forwarded to the Office of Investigations of the DIA for insurer-nce caves e verification. I do hereby certi under the pains• enalties of perjury that the information provided above is true and correct �R T Si c: Phone# O j7dal use only. Do not write in this area, Ib be completed by c'or town offx aL City or Town: Permit/Licewe# Issrung Authority(circle one): 1.Board of Health 2.Building Department 3. CityfTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other 5-30- 17 oF� Town of Barnstable *Permit Regulatory Services F re. 6 anwNsrnsiA y MASS. Richard V.Scali,Director i63;;9'p10 Se Building Division V Paul Roma,Building Commissioner •-, 200 Main Street,Hyannis,MA 02601 MAY 2 6 1017 www.town.bamstable.ma.us Office: 508-862-4038 /�&(!t�90 'TABLE � EXPRESS PERMIT APPLICATION - RESIDENT I Not Valid without Red X-Press Imprint Map/parcel Number Property Address ck ,-v��.-`��n C r C_u r" �d y '" f� Z(v I Lei Residential Value of Work$ 7r�b® Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address &Ce_Iv=t 5 0� Contractor's Name 6 r LjA r T+ Telephone Number S� S�"!s' c7y Home Improvement Contractor License#(if applicable) 17&2- 7 Email: L 1 r`Wat,_i m ryweM ,, Construction Supervisor's License#(if applicable) PWorkman's Compensation Insurance r Check one: ❑ I am a sole proprietor - ❑ I am the Homeowner", .. � • _ ❑ I have Worker's Compensation Insurance 6C �� ;� Insurance Company Name ''7� . 1 .. Workman's Comp.Policy# �E b4k3 1 r 6a•/ Copy of Insurance Compliance Certificate must accompany each permit. ; Permit Request(check box) .Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to - ❑Re-roof(hurricane nailed)(not stripping. Going over, existing layers of roof) y ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value - . (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. 4 ' py of the Hope Improvement Contractors License&Construction Supervisors License is e SIGNATURE: , C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 .. -7 t.9 •�I f. Q � INE iABNSfABI�, 1639. Town of Barnstable Ec Ma+" Regulatory Services Richard V.Scali,Director a Building Division Paul Roma Building Commissioner - 200 Main Street, Hyannis,MA 02601 www:town.barnsta ble.m a.us Office: 508-862-4038 .. .. ,Fax: 508-790-6230 Property Owner Must Complete and Sign This Section ` If Using A Builder 1 as Owner of the subject property hereby authorize TT LaV to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) k fry ?e z S.' re of caner Date s Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 t ' The. Commonwealth of,�Iassachttsetts -' 13ep7tfv'ttfient.=of Industrial Accideniv , 4" Office of Invesfigattons ' 600 Rashington Street" Boston,M-4 02I11 Pvrvtr..mass gouldia Workeis' Compensation Insurance Affidavit:BuddersiConfractat•s/Electricians/Plumbers Applicant Information - , tr° • , - , I Please Print Legibb° Naf21e(Business?Orgmiza-.iouiladividual): 1-03 k V A� Address: Z �r <-k. �a City/State/Zip: ^ ,rcS'A -g 0 0. 0 2 o 4 Phone 141: Sv Sr $(o fv Q'i 7 ' Are you an employer?Check the appropriate box: Type of project(required):- 1. I am a employer with _ 4. ❑I ant a general contractor and I enrpioyees(full andtorpnrt-time.}_* have hired the sub-contractors b. EINew construction i 2.❑ I am a sole proprietor or partner listed on the attached iaheet. 7. ❑Remodeling shipand have,no employees These.sub-couiractor,r have. mp $_ ❑Demolition n orking forme is any capacity- employees and have,workers:- 4 El Building addition jNo tiorkers'comp_insurance- comp.insurance. .t required.]t • 5. ❑ Ve are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeonmer doin-all work officers have exercised their I LFJ Plumbing repau:s or additions ' myself[No icorkers'comp. ri�eht:of exemption per NIGL insurance required.].i - . _c. 152,g1(4)_,and nee.have no 12 °of repairs employees.[No workers' I3.❑Other comp.insurance.required_] 'Any applicant that check;im=1 muse also fill out the.section below showing the r workers°comper;ation pohc tT infOtmaaou. 1 Fatneottmers Who subuill ms afridn it indicating They are doing all Work and then Ure outside contracto,s wan submit a new,affidavit indicating such. =Ccntracto*.s that check this box must attached an ad -dtnonat,heft shotcsnz the came of the• -�tb-coLtracrozs and sure Whethe.or not those eotBre_:hare employees. L`the sins contrecto_ has a employees, .•t6ttSi pm:ide Their wo ks'cusp.poLct number. I attr arc entpki-er tliat is protadisg ii,orkers'cottipetrs'atioir iiis'tiraiice for tilt'e+rrplvt=ees. Below is tite policy mud job cite information. Insurance Company Name: Policy r or Self-ins. 2Lic�j Expiration Date: Job Site Addres.s: J I \ V- �L3.v-t �� `—• " City+state/Zip:_�r�,�b t wl� �7& Attach a cope of the workers,compensation policy declaration page(showing the policy number and expiration date). Failure:to secure coverage:as required under Section 2.5 A of MGL.c. 152 can lead to the imposition of criminal penalties of a. fine up to S1,500.00 and/or one tear imprisonment,as well aT;civil penalties in the:form,of a STOP WORK ORDER and a.ftrie of up to$250.00 a day against the violator_ Be advised that.a copy of this statement may be:fonvarded to the Office of Investigations of the.DLL for imurance coverage verification.' I do Jreraby cerfift Illip,tit ins ale a ties of peijnrt that the information prowled abor.Is trite an correct. Si Date: ture: c ' S'r s Phone r So �7 t Official use onlu Do not write hi this area,to be cotupleted bv,cilti or faith official ' 2 ft't City or Ton► ` " 'PermitlLicense Lssuing Authority(circle.one)- I.Board of Realth 2.Building Department 3.Citvrrdnm Clerk 4.Electrical Inspector 6.Other 5.Plumbing Inspector Contact Person: Phone M 6 Town of Barnstable Regulatory Services pQ Richard V.Scali,Director Building Division &UMSTnsM Paul Roma,Building Commissioner `0$ 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ` JOB LOCATION: - - number street village "HOMEOWNER": name `"' "home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFE'fMON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures..A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 A<X>RID0® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/14/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER WNIAGI NAME: Erica.H.O'Connor HART INSURANCE AGENCY,INC. PHONE Fax 243 MAIN STREET ac No): PO BOX 700 ADDRESS- eoconnor@hartinsuranceagency.com BUZZARDS BAY MA 025320700 INSURERS AFFORDING COVERAGE NAIC B INSURER A: SAFETY INSURANCE COMPANY 39454 INSURED Scott Lohr dba Lohr Home Improvement INSURER I.. ACADIA INSURANCE COMPANY 31325 23 Grand Oak Rd INSURER C: Forestdale,MA 02644 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER LIMITS A COMMERCIAL GENERALLIABILITY BMA0024755 01/08/2017 1/08/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE O RENTED CLAIMS MADE OCCUR PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JT PRODUCTS-COMP/OPAGG $POLICY❑E 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ac' e ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Par accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION B WORKERS COMPENSATION ASSIGN201704131240119687 04H3/2017 04/13/20t8 PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ SOO,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Proof of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AtmtORQFD REPRESENTATIVE //{A 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ,,r Massachusetts of Public Safety ' Department Bcatd of Building Reg.uiations and:Standards Cn»ctruetitr;�Su!►enoaot z K .; License: CS-053961 SCOTT A LOHR 23 GRAND.OAK ItD y Forestdale MA OU44 yy ` �J. � ar7tii�� Expiration i. 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Mckechnie, Robert From: s4e.b@cyprexx.com Sent: Wednesday, September 27, 2017 10:53 AM To: Mckechnie, Robert;stie.b@cyprexx.com Subject: DE-REGISTRATION REQUIRED-SHMA1390071-319 MARINER CIR, COTUIT, MA 02635 .Y9 00.ill >. �#$$$ 41l+kSElf3u8SrfitJt��RCiS; Wednesday, September 27,2017 To: Town of Barnstable- Building Department Vacant/Foreclosed Property De-Registration Parcel 039/013/1010 Our Client, Shellpoint Mortgage Servicing, LLC has advised us that the property located at 319 MARINER CIR, COTUIT, MA 02635 needs to be de-registered from your Vacant/Foreclosed Property Registration Program. Property is no longer in Bank's or Cyprexx's inventory,please remove both, as well as our local Agent(if applicable), from any future responsibility. Please send confirmation to sue.b@cyprexx.com that this property has been de-registered. Property sold to: JUAN MARCHAND, 128 MAIN STREET,HYANNIS, MA 02601 508-934-6745 on 9/25/2017. Note: It is the responsibility of the new,owner to submit or update anew registration if required. Thanks, Sue Busk Cyprexx Services, LLC Vacant Property Registration Coordinator Direct Phone: 813-387-5873 1 Toll Free: 866-516-6348 Ext. 5873 Fax: 813-661-7489 sue.b@cyprexx.com www.cyprexx.com Statement of Confidentiality. The contents of this e-mail triessage and its attachmitnits are intended solely for the addressee(s)hereof in addition,this email transmission may be confidential and/or privileged communications protected from disclosure tinder applicable law.if you are not the named addressee,or if this message has been addressed to you in error,you are directed not to read,disclose,rel�roduc;.,distribute disseminate or otherwise use this transmission Delivery of this message to any person other than the intended recipient(s)is not intended in any way to waive privilege or confidentiality.if you have received this transmission in error,please alert the sander by reply e-mail;WC also retgiest that you immediately and pci-nianentfy delete this message and its attachments,ifany.Furthermore;any attachments contained in-this email transmission should be virus checked by the recipient and shall be opened at your own risk. 1 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 7/10/17 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601z. . � RE: Building Permit#B-17-1989UID TO: Building Inspector(s), c`n This affidavit is to certify that all work completed for 319 Mariner Circle,Cotuit has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey P" Ie� ' Town of Barnstable U - SA ` 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-1989 Date Recieved: 6/23/2017 Job Location: 319 MARINER CIRCLE,COTUIT Permit For: Building-Insulation-Residential Contractor's Name: WILLIAM J MCCLUSKEY State Lie. No: CSSL-102776 Address: West Yarmouth, MA 02673 Applicant Phone: .(508)398-0398 (Home)Owner's Name: GARRISON,JEFFREY S Phone: (508)274-4636-�r y>, -� (Home)Owner's Address: 319 MARINER CIRCLE, COTUIT,MA 02635 1 ZZ Work Description: Add R-11 cellulose and R-19 fiberglass to the attic.Air seal the attic plane with expanding M. -' Uj r— Total Value Of Work To Be Performed: $5,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: William McCluskey 6/23/2017 (508)398-0398 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $5,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 6/23/2017 $85.00 XXXX-XXXX_XXXX-, Credit Card 0299 i ....................................._............__..................-:.....................................................,..........................................................._................._..........................._..................._........................................:_............... . Total Permit Fee Paid: $85.00 E'll" ��` 7. Off, of�onsulner Affairs and business Regulation Park Plaza Suite 5170 '_; v • � r ,x a '$oston,'11t1assaChuse✓tts 02116 i:�r:� Home Improvement,Co�i�raCtor'Registration �':= ' �; s r �,.,,., � .IRegistration �17T380 , ' _ �r � �� "•""'""� t `, " T.Ype ,Corporation r< irxi i it #h i& • Expiration 3/14/2018 Tr# 419391' , CAFE SAVE ING ° ' q :. �d � k�w4 } •WIL'LIAM McCL:USKEY '. < i 7 Q:,HUN INGTON AVE�NU.E� ti �• _SOUTH MRMQUTH'.�:MA 02664 r , - s ' i 4 a ` ?`� . ' �; 1lpdate Address and return card,Mark reason fcir''change.`,M +, - - r ` t: ( Addr.'ess p'Renewal;(� Employment LC ost ard1 scd i',ri zbM•osl�i. z77 >-Offce ofCanii a`fme crr:xl; ci�e&:Bq soi/ Rt�tu6 ef 2 License onlY.pao ~ HOME IMPROI/EMENT CONTRACTOR�.' before the,exp�rat�On date Tf found return ab L Registration 171380 Typ® Office of Consumer Affa►rs,and Business Regulation:x t Expiratio $ 4'I2Q18 Corporation 4r 10 Park Plaza 'Suite 570 'r, v i , $.ostoa,MA 02116 <4 .� GAPE SAVE'INC is #"V11fLLfAM 'A+ICCLUSKEY` ��A r 1 f _ 7-0 HUNTINGTON AV<rNE SOUTH YARMOUTH MAy02664 Undersecretary -Not valid;; ,t signature" Commonwealth of Massachusetts uDivision of Professional Licensure• Construction Supervisor Specialty Board of Building Regulations and Standards Restricted to: CSSL-IC-Insulation Contractor Constructq� kip3kr Specialty CSS L-102776 41P i res:06/28/2019 ; i S ` WILLIAM J MCC 37 NAUSET Rt3 - ` WEST YARMO A; 2fh'k3 �ISt T_l� Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner DIPS Licensing information visit:WWW.MASS.GOVIDPS r: 7/i } �)e uc- .faj yO-f t. DG�Her urarki� .N �t/CtT_ WI►1�o Gu3-a'�i�k f�'►1r 4 . vu- 3 .Parcel Detail Page 1 of 3 n r kv 1 C`r r°:.T` ..�... Logged In As: Parcel Detail Tuesday, Ju Parcel Lookup Parcel Info Parcel ID 039-013 Developot BLOT 61' Location 319 MARINER CIRCLE Pri Frontage;;125, Sec Road Sec Frontage Village COTUIT Fire District COTUIT Sewer Acct Road Index 0978 Asbuilt Septic Scan: Interactive 039013, 1 - Map Owner Info owner GARRISON, JEFFREY S &VALERIE Co-Owner: streets 319 MARINER CIRCLE street2 City COTUIT State MA zip :02635 Country Land Info Acres 0.46 � Use!Sing le Fam MDL-01 I zoning RF Nghbd 0105 Topography Above Street Road ;,Paved utilities Public Water,Gas,Septic Location Construction Info Building 1 of 1 Year Roof Ext _ Built 1981 Struct Gable/Hip Wall Wood Shingle Effect 1481 Roo p p f AS h/F Gls/Cm ' AC None Area I Cover I Type Style Ranch In l Dry , Wall Rooms Drywall Y Bed ,3 Bedrooms„ . Bath " Model Residential- Int --' - —I Rooms 2 Full~+ 1 H — _ Floor Grade Average Heat Hot Water Total 8 Rooms I Type Rooms http://issgl2/Intranet/propdata/ParcelDetail.aspx?ID=2464 .7/29/2008 :Parcel Detail Page 2 of 3 to t h YNA`,YS L4i.� g Heat �� Found-, stories 1 Story l Gas Poured Conc. Fuel ation � b Permit History Issue Date Purpose Permit# Amount Insp Date Comments 7/1/1981 B23321 $0 CO 1 STOR Visit History Date Who Purpose 7/9/2008 12:00:00 AM Karen Perry In Office Review 6/23/2005 12:00:00 AM Paul Talbot Meas/Listed 6/16/2003 12:00:00 AM Martin Flynn Mea./List Bldg Permit Only 3/3/1999 12:00:00 AM Frederick Stepanis Meas/Listed Sales History Line Sale Date Owner Book/Page Sale 1 10/11/2007 GARRISON, JEFFREY S &VALERIE 22398/274 2 4/18/2003 AMENDOLA, CHERYL A& BRENNAN, CHARLES A 16774/53 3 8/6/1999 AMENDOLA, CHERYL A 12460/298 4 11/15/1990 DICARLO, ELLA C 7364/256 5 5/15/1990 DICARLO, ELLA C 7153/114 6 12/15/1982 DICARLO, EMILIO & ELLA C 3622/310 . Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2008 $142,500 $10,500 $0 $152,100 3 2007 $141,800 $10,500 $0 $152,100 4 2006 $134,000 $10,500 $0 $157,200 .5 2005 $125,500 $10,300 $0 $142,800 6 .2004 $100,600 $10,300 $0 $142,800 7 2003 $90,900 $10,300 $0 $47,700 8 2002 $90,900 $10,300 $0 $47,700 9 2001 $90,900 $10,300 $0 $47,700 10 2000 $71,900 $10,300 $0 $29,100 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=2464 7/29/2008 I - -Parcel Detail Page 3 of 3 11 1999 $68,900 $6,200 $0 $29,100 12 1998 $68,900 $6,200 $0 $29,100 13 1997 $82,000 $0 $0 $25,400 14 1996 $82,000 $0 $0 $25,400 15 1995 $82,000 $0 $0 $25,400 16 1994 $78,700 $0 $0 $26,200 17 1993 $78,700 $0 $0 $26,200 18 1992 $89,400 $0 $0 $29,100 19 1991 $87,100 $0 $0 $54,500 20 1990 $87,100 $0 $0 $54,500 21 1989 $111,700 $0 $0 $54,500 22 1988 $69,800 $0 $0 $16,800 23 1987 $69,800 $0 $0 $16,800 24 1986 $69,800 $0 $0 $16,800 Photos http://issg12/intranet/propdata/ParcelDetail.aspx?ID=2464 .7/29/2008 Family Movers 319 Mariner Cir Cotuit, MA (508) 420-0611 14,, 0/1 us1 W 65 acrIle Scocr s w�KPrS is r��I� s , 4 — �� w YIA",Il YO(-) AVO e157-`3l/ SuperPages.com: Yellow Pages Page 1 of 1 Family Movers LLC " `` pho"ne: (508)420-0611 «1, email:familymoversllp@mxn.cc j 11 • 06 �Lws Rate It Let Our Family Move Yours. Service is Our#1 Goal. ON Areas Served: Products 8:Services: Cotuit,and Barnstable&Falmouth • Antique Moving * Moving Trucks&Vans Cod&Yarmouth • Apartment Moving • Next Day Service • Appliance Moving * On-Site Inventory Services Residential • Assembly&Installation Online Reservations • Boxes • Organizing Licensed,Insured • Bubble Wrap * Packing&Unpacking • Car Moving • Packing Supplies Appears in the Categories: • Clergy Discounts * Padding Materials Household Goods Moving&Storm • Competitive Rates Padlocks ' Services, Office Movers&Relocate • Custom Packaging&Shipping • Pallets Storage, Moving Companies Services • Phone Orders • Dismantling • Piano Moving • Dollies • Pick-Up&Delivery Services • Door To Door Services * Professional Packing • Door-To-Door Services * Quality Service • Drop Shipping * References • Estimates • Referrals • Extra Large Items * Reservations • Family Owned • Ropes * Free Estimates • Screened Employees • Free Quotes • Shrink Wrap • Furniture Delivery&Set-Up • Skid&Track Loaders * Ground Service • Tape * Hoisting • Trailers • Keys&Locks * Vans • Liability Coverage * Vehicle Transportation • Loading&Unloading Services • Wardrobe Boxes • Local&Long Distance Moves • Water Beds • Mini Storage Specialties: * Guaranteed Pricing Available Certifications 8:Affiliations: • DOT 1347082 • Vanguard Gold Status • ICC-MC51831 Additional Information: Barnstable-(508)420-0611 Falmouth-(508)548-6683 Data provided by one or more of the following:Verizon Directories Corp.,Acxiom,Amacai,or'lawyers_com. http://www.superpages.com/egi-bin/print.cgi 5/15/2006 I Page 1 of 1 i r - �t f r Y=.r Family M.c rs R 1 http://65.54.168.250/cgi-bin/getmsg/100_0757%2ejpg?&msg=7D8086B6-B81 C-4316-A2... 5/20/2006 Page I of I htt y � ��R1 It r n :ry'r 1 / / • • 1 • I I 1• • • 1 • 1 / • / / r ..i _.} - , �.�- - '�r j ••fir _ lei, All- • _ f too off ' 1 , M ♦) s 0 R 1 1 1 Page 1 of 1 17 w ME INEW r. �.: acsu•, http://65.54.168.250/cgi-bin/getmsg/100 0755%2ejpg?&msg=7D8086B6-B81C-4316-A2... 5/20/2006 Page Farr LLl Y- • a • L � r � °FTHE ram, Town of Barnstable Regulatory Services BMWSTABLE. MA� Thomas F.Geiler,Director Building Division • Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 May 31, 2005 Cheryl Amendola 319 Mariner Circle Cotuit, MA 02635 RE: 319 Mariner Circle, Cotuit,Map : 039 Parcel : 013 Dear Ms. Amendola: This letter shall serve as notice that upon inspection of work done under permit#68610; several violations of 780 CMR exist. It is imperative that you contact this office as soon as possible in order to address the problems and discuss your options. The number I may be reached at is 508-862-4034 or you may come to the office at 200 Main Street in Hyannis. Thank you for your attention in this matter; I look forward to working with you to resolve this issue. Respectfully, • a Jeffrey Lauzon Local Inspector . � 231os Q:zoning5 ��' • TOWN OF BARNSTABLE Permit No. '3321 Building Inspector Cash ------------ A�Yl OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to .(-,Oar Acres l iea!Ly `l.I Ub is Address Wiring Inspector Inspection date Plumbing Inspector . ~"�4 Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................................................., 19..._._ ............... ��». ........:... . _.....:..........:..» _ ��:: _ _._ Building Inspector ,.FROM, .. - TOWN OF BARNSTABLE BUILDING DEPARTMENT Ell D �3 rlo 8 367 MAIN STREET HYANNIS, MA 026M Ella 13z�ar�+ . 319 Mariner Circle Phone: 775- 120 Col uits s MA €32635 SUBJECT: _ FOLD HERE DATE - - Jun-e 2-6, 1964 MESSAGE This office Yeas no record of a permit for an addit t rta luring ur a t . _ 119 Mariner Circle, Cotui t. Please cbntbLot this office and arrange for .an inspection of the property. - - • - JSIGNE .• E. arlin, Assistant Build n .DATE :R E P'l Y inspector SIGNED - ne7•Rnn RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY • ' - -, PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. ' 7— numb Assessor's map and I a t b ..........., . THE SEPTIC SYSTEM MU TOE Sewage Permit number ........ ............................... INSTALLED IN COMP Wff BA" TABLE,N TITLE,5 BARN Housenumber ............................................................................. a' Fb ENVIRONMENTAL COD, 09. Ar' TOWN RTULATION away TOWN OF BXRNSTAI BUILDING I-N SP E.0 T 0 R APPLICATIONFOR PERMIT TO ........................... ............................................................................................ TYPE OF CONSTRUCTION ..... �-(*"U—... ............... ... ...................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 12 Location ..... ..... . ... ....................('444�� ..... .............................................................................................................. ProposedUse .............. .. .................... .......................................I............................................... ZoningDistrict ................... .................................................Fire District .................7.......................................................... X.... .../.�'.-......AddressName of Owner ... 7 ............ .......... ..................... ....... Name of Builder ...... ... ........................Address .................................................................................... ........ .... ---------- .Name of Architect ..................................................................Address .................................................................................... . ... .. . . . .........i...................Foundation ...Number of Rooms ...................... �..�.............................................. Exterior ........................ ........... ......................Roofing ...... .... . ......................... .... ... .. ............................... Floors .......... ............. . ..................... .... .. ... Interior ....... .... . ... .................... .................................... Heating .... ........ ..........................Plumbing ...... .... .. .. ......................................................... ..........................................................Approximate Cost ........Fireplace .................... ................................. Definitive Plan Approved by Planning Board 19 Area .... Diagram of Lot' and Building with Dimensio Fee ........9,4.,A-5......... SUBJECT TO APPROVAL OF BOARD OF HEALTH Ll I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ... ..................... ...... ........ ................ ... ...... ... -,- CEDAR ACRES REALTY TRU T VRU 23321 Permit for One....S t ..ry............. �X*-,No ........ .. .... ..... .... Sin Dwell ' g ..... ........................ .. ..................... Location Lot #61 319 Mariner Circle ................................................................ ..................cot.ui.t......a........................................ Owner .,:,Cedar. Acres Realty Trust ...................................... ................. Type of Construction Frame ............................... .... .. .. ................................................................................. Plot .......................... Lot ................................. July 28 , 81 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed '/./, ..........19 PERMIT REFUSED ...... ........................ 19 M tr r- ................................................ r .................................................... Z) Cr 0 Approved , ........ 19 .................................. .......................... ....................................................... Assessor's map and lot numb�era}.::................... ................ (" Q�ofINETo�y Sewage Permit number .-.............. -0............................. d� K Z BABBSTABLE, i House number .................. 90 Mae& 0� p 1639 00 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............................�...;c c;` ........................................................................ TYPE OF CONSTRUCTION .....161! � IVJ.�- �GL�c° j.......................................................... �........... / . .,..'..................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...../�.!...... ////.1�! :......t:. � C..................................................:........:........ .... .. .. .... ProposedUse `:W. 01e. ...................................................................................... .......................................... ZoningDistrict .....................................,..................................Fire District ............................................................................. Name of Owner ................. .......................� ........... .....Address ...........' .. .......... ..... l ?`f............... Name of Builder 7:: &O....., .-Ua. c9.,IG :J.........Address ............ ...................................................................... f Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .......................n...... .............................Foundation ......... ..... ................. ... ... Exierior ..��... ...t off ,, Roofing ...........................................�'' ....... .,.......................:.... .. ........... ... Floors �� -! �'z t Interior / /. %<�..�!..�. ..... ✓l,..... Heatingf .. .:.':; ..........................Plumbing ..........., :.:......................................................... Fireplace .....................:............................................../..... ......Approximate Cost ......... ..� .................................................. r Definitive Plan Approved by Planning Board _____4!,X-qJ- ' 19_% Area Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .: r.............................................................. CEDAR ACRES REALTY TRUST No 3 3 21 Permit for .,One Story ...... ingle...FamilX .Dwelling Location ,Lot #61 319 Mariner Circle. ............................................... Cotuf t ............................................................. Owner ..Cedar Acres Realty Trust ............................................................... Type of Construction .Frame ......................................... ................................................................................ Plot ............................./Iot ................................ Permit Granted .... JuL. ._28................19 81 Date of Inspection ......... ..........................19 Date Completed ........ ..........................19 PEtMIT REFUSED ... . ............................... 19 ........1..'.. . ............................ ............................................................................... ............................................................................... a Approved ................................................ 19 ............................................................................... ............................................................................... r Z 4 7 b b v 1 a N , 1 r N ^i ti 1 Him A N �:S L 7 r FOUNDATION LOCATION Ln � T -1 . G O TUI Ti, MASSACHUSE T T S 9 OWNED BY • ��•� f} '` Ifi c ^� { n O 4- SCALE : '�z •Sd DATE, 7-v Ve In u MORNAm CROSSAMN------ REGISTERED LAND SURVEYOR C f �u i HEREBY CERTIFY TMAr THIS FOUNDATION IS .LOCATED ON T►!!E LOT AS SHOWN'AND CONFORMS T0. THE TOWN -i OF BARN STABL E ZONING REGd LA T I OHS REGARDING � � � q`� ➢ � r '• '` L rl T (1► T I1 SEtBAGKS FROM STREET LINES AND LOT LINES . .� �'�- , ,:•..;s� a�� -- (' }�, MORON GROSSMAN R. L. S. RATE ::::::::.:..:......:.:.:::.:. :::' ' :b.:..::.>:Karen Ioura lRichard Stevens.Cotuit :::::: Insect�••.. or.�� . . :::::::.::::::.::::::::.::::::.:::::.::::::::::.::::::::::::::::::::::::::::::::::::::::::.:::::::::::::::::.::: :... «««:>31'9 :#ei Mariner::>:::<: ircle ' .......:::..:.... ...... C .::. :T::::IT mo anon us •a:•::•:•>::•:• suspect o alterations occurringwithout a P Buildin Pe nn E ewitnesse 2x4 ..............:::::::::.: g Y d son site an d consi e d rable o :»>:«:::>::»»:::>:>;<::;«:::: "construction e ris .db AA A -lea 1M1�1. J o �hj S 1�-Jb� ti i.� o.1. l S 1�1,® L C ............. .:::::::................. ::::::::....:; ...............................................................:..::::.