HomeMy WebLinkAbout0051 PRUDENCE LANE J07
L
,l
1
ram'
N4,
master bed;man cave -
1100 sgift
am upgrade fire&security Electric Smoke 12/27/2017 PASS Rough alarm
passed
TRIO WIRING FOR Electric Final3. 8/3/2006 P_ass'•r`, = WAMA:
GENERATOR
Iger (6)Fixture Gas Final 11/29/2018 PASS
ger '(6)Fixture Gas Final 11/29/20;18 PASS ?;gas fireplaces
er (6)Fixture Gas Rough 11/15/2017 PASS
er (6)Fixture Gas_ Rough 11/15/2017 'PA$S Yellowmefer'
'band number
0064081
er (6)Fixture Gas Rough 12/28/2017 FAIL No line test on
fireplaces and
cookstove
branch.
er (6)Fixture Gas Rough; . 32/28/2017' .' PASS
RIC GAS GENERATORS& Gas Final 7/28/2006 Pass RBUR:
TEST
3 of 4
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map — Parcel ��� Application # 9
Health Division Date IssuedLb
a
Conservation Division Application Fee
Planning Dept. Permit Fee Z =80
Date Definitive Plan Approved by Planning Board C�
Historic - OKH Preservation / Hyannis
Project Street Address
Village ,
Owner/��i i/�'�!� �/�/21 /W�/%�f�i3 sJ.� Address Z Z3 /^D,S'�r��-� /
-fix � J� L��[�l/f�C A�,
ol�S�
Telephone 191AU rWhe)3,g6& iFj�;a7 a12 e',17—V1T-6!'6 92_
Permit Request 41,w/L ev-- a" 1% fi
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation ( � 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 A No On Old King's Highway: ❑Yes ❑ No
Basement Type: L"Full ❑ Crawl ❑Walkout ❑ 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: ❑ Gas ❑Oil ❑ Electric ❑ Other
o Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woodYboal stove;'':33 Yes>❑ No
Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑exi ting ❑mew Sze_
Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ w s
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name LC9 Z J�C a Telephone Number_
Address � 7.3 1"i ��i � .� License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE d
FOR OFFICIAL USE ONLY w -
4APPLICATION#
DATE ISSUED
,-y
MAP/PARCELNO.
r _ .
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
� FOUNDATION � D 'D�"3 311ale6XWV,—� -
FRAME "
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL =¢
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL , .
FINAL BUILDING Io' ��'� y Zi o
DATE CLOSED OUT
J
ASSOCIATION PLAN NO.
F
'�.. The Commonwealth of Massachusetts
.Department of rndttstrial Accidents
Office of Investigations.,
600 Washington Street
c� f Boston, MA 02111
lvww.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): ��rT C. • 1.��iQ/�ST/.ViG 0"'/�/ i��C
Address:_/�
Ci ty/State/Zi Phone##: �17� /3- O6'z
p: Z o LL
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor'and I 6. ❑ New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner-'
listed on the attached sheet. 7. ❑ Remodeling
ship and have no employeesThese sub-contractors have g, ❑ Demolition
working for me in any capacity, employees and have workers' 9 ❑ Building addition
[No workers' comp. insurance comp. insurance..
required.]
5. [] We are a corporation and its 10.❑ Electrical repairs or additi
3. I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs.or additi
myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs
insurance required..] t c. 152,§1(4), and we have no
q employees.[No workers' 13.❑ Other
comp.insurance required]
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work ind then hire outside contractors must submit.a new affidavit in
such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp,policy number.
1 am an employer that is providing workers'compensation insurance for lily employees. Below is the policy and job site
information.
Insurance Company Name:
Policy# or Self-ins, Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(shoveling the policy,number and expiration date
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a
of up to $250.00_a day against the violator. Be advised that,a copy of this statement:may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
1 do hereby ce tin r the pains and penalties of perjury that:the information provided above is trite and correct.
Si nature: Date:
P
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License #
Issuing Authority(circle one):
1. Board of health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S.Plumbing Inspector
6. Other
Phone#:
Contact Person:
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 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 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
d'
renewal of a license or permit to.operate a business or to construct bull mg s in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally,MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
contract for the performance of public work until.acceptable evidence of compliance with the insurance
enter into any on p
requirements of this chapter have been presented to the contracting authority."
Applicants
e workers' compensation affidavit completely, b checking the boxes that apply to your situation and, if
Please fill out the woY
P
address es number with their certificate(s) of
necessary, supply sub contractors)name(s), )and hone( p (s) along
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 that the application for the pen-nit 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.
Please 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 o'r citizen is obtaining a license or permit not related to any business or commercial venture
(i.e, a dog license or permit to burn 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 Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax # 617-727-7749
Revised 4-24-07
www.mass.gov/dia ,.
• .
`�`owr. ofBarnstable
• of Yrte r� '
'6 Regulatory Services
- s.�xxsrAar_e,
Thomas F. Geiler, Director
s63p. �a
Building Division
PrEO '�h Tom Perry;.Building Commissioner.
200 Maid•Str.c • _Hy annis,MA 026.01
P ww town.barnstoble.ma.us
Office: 509-862-4038 Fax: 509-790-6230
ETM,9_DWNER LICFNSE EXEMPTION
Plcasp Print
.DATE:
Jos IACATION: I
number street villa c
"HOMEOWNER": /
name �7 home phone fF workpbone#ef 7:L�l?(J�Z
CURRENT MAUNG ADDRESS: / / 3_,/"
city/town state ap coat
The current cxcmption for"homeowners" was extended to include owner-occupied dwc ngs of six units or less and
to allow hQincowners to engage an individual for hire who.docs not possess a license,providcd that the owner acts as
superyiso
DEFINrrION OF HOMEO'SYT�'ER
Persons) who awns a parcel of land on which he/she resides or intends to reside,tin which there is, or is intended to
be, a one or two-family dwelling, attached or detacbed structures accessory to such use and/or farm structures, A
person who constructs more than one Dome in a two-year pcnod,shall not be considered a homeosmcr, Such
"homeowner"shall submit to the BmIding Official on a,form acccptablc 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 Codc and other .
applicable codes,bylaws;rules and regulations.
The undcrsigned'`homeowncr"ccrdfi,s that.he/sbc understands the Town of Barnstable Building Dcpartrpcnt
minimum inspection procedures and requirements and that he/sbc will comply with said procedures and
A
mof Ifomcowna
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic fcct or larger will be required to comply with the
State Building Code Section 127.0,Construction Control.
.HOMEOWNER'S EXEKP'TION
The Codc stairs that "My homeowner performing work for which a building permit is require
shall be exempt from the provisions
of this sceGon•(Section 109.I,1 -Licensing of construction Superyisors);providcd that if the homeowner engages a pason(s)for biro to do such
work, that such Homeowner shall act as avpuvisor. `.
Many homeowners who use this rxemption arc unaware that they arc assuning the responsibi)itics of a supervisor(sce Appendix Q,
Rides&Regulations for Liccnsing Consbvetion Supervisors,Scction 2.1.) This lack of awareness'often reSUltS in serious problems,particularly
when the homeowner hires unlieenscd persons. In this cast,our Board cannot proceed against the unlicensed person as it N ould with a licensed
Supovisar. The homeowner acting as supayisor is ultimatclyresponstblc.
To ensure that the homcownct is fully awtm of his/her responnbilitics,many communities require,m part of the permit application,
that the homeowner ecr ify that hclshe understands the responsibilities of a Supers sor. On the last page of this issue is A.form cumcntly used by
scverzl towns. 'You may caret amend and adopt such a fom><ertvfication for use in your community.
�TREr� ` `awn of B arnstahle
o
Regulatory Services
` t
$"'u'nMg Thomas'F_ Geiler, Director
�o; �'� Building Division
Toni Ptrry, Building Commissioner
200 Main Strcet, Hyannis, MA 02601
)vww.town.bamstable.ma.us
Office: S08-862-4038. Fax: S08--7
Property Dwter1V Must.
Complete and Sign This Section
If Using A Builder
as Owner of the subject.property
hereby authorize to act oa my behalf,
is all matters relative to work authorized by this building permit application for.
(Address of job)
sipattire of Owner. Date
Print Name
if Property'Owner is,applying for pein-.Lit please complete the
Homeowners License Exemption Form on the reverse side.
Assessor's mop and lot number ............................................
S&Woge Permit number ........................................................
BAMST&BLE,
House number ........................................................ ............... 90 N&M
1639-
0 MAI&
T0W. VV N . . OF BARNSTABLE
BU ATOR IL DING I N S 5P Et";
APPLICATIONFOR PERMIT TO ................................................ t6................................ t ........... ...............I. llue,
TYPE OF CONSTRUCTION ...........1 ........7... .......................................................
.................HAV...�:a.......19v.�
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies'for a permit according to the following information:
Location ..... ........... ............................................................. . ..... .... .
ProposedUse ............ .5. ..........................................................................................................................
..Fire District ..............................................................................
Zoning District .............R............................................
....Address
Name of Owner ` .... ....\ L)..... e4
................................................... ...........
Name of Builder AN�XAddress .................
7
Nameof_A+EhUeat• R ...... ......Address ............................. .......................................................
Numberof' Rooms ............G..................................................Foundation ........... ...............................................................
Exterior . .... .............
A,�A,::�� t ......
...........Interior ............ ......................................
Floors ............U0.A>.7?;� ............................................ . ...... .. ... ....
� C- -,g7.xs�.........................................Plumbing ...........
Heating .......... ..........I.. ..............................
Fi repta-Te .................. ............ Approximate Cost ....................................................................
Definitive Plan Approved,3by Planning Board -------—--—--———----------- Area ..........................................
Diagram of Lot and Builclip.g with. Dimen§.ions,., , Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
11
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 ....................................
FAIRBANKr RICHARD R. 11
/� �`� '. • �� £' ors PSV-''T'
No 2F607 '.. Permit for One Story...............
'(' _
Sa.rtgl6 ..k'c�A17.J. ..Ii�J.�axlg. ". G • r- At
t 7t °�. a! i,. r r,f t r �.� f., •it' tg l�'.
Location ..Lot• 69�.....51,Prudence Lane„ � '
.X'
cotuit
................. ............................... ...
Owner „R.ichard R. Fairbank f............4 M
- ',� c2 ray rs' -f:�
Type of Construction Frame ....... y�
' # '
* ..
................ ...... ..... .....�.�.... .......... r �� '�`v i',::+ .�, ' � •ter �r, �'3 �`
•
Plot Lots',! ............................
•
�,�,�,� r• e.., . � .6 � `e - _ a ��#y5, e a�i. ,.+,,,;wa.� wt"
Permit Granted June 21c,.. : . 19 84
Date of Inspection ........................
. ..19 c: h
z{ ;.uAA .x i tt, ,;•;� _. •y t4• ;�: , fib'• y v4r t ,� �"' .;.>
Date Completed ,.. .19 f ;r a �: t ` * :%-K
• C�� i �#�� •� y + t '� ,
IL ,
12
i r
.., w
Town of Barnstable_
Building
a Post This,:CaIrd So That it is.Visible From theStreet-Approved Plans Must be Retained on Job and this Card Must be Kept
BA"BrAOLK
M" Posted Until Final Inspection'Has�Been Made. ;i Permit
039, 1 l�Jl JIiJIJ1I a.
Where a Certificate of Occupancy is Required,such Building shall Not be Occupied;until a Final inspection has been made
Permit No. B-19-76 Applicant Name: Carl Rebello .
Approvals
Date Issued: 01/11/2019 Current Use: Structure
Permit Type: Building- Insulation-Residential Expiration Date: 07/11/2019 Foundation:
Location:. 51 PRUDENCE LANE,COTUIT Map/Lot: 040-056 Zoning District: RF Sheathing:
Owner on Record: PAGLIUCA,JOSEPH-&THERESA M -Contractor.Name:` Carl J'Rebello Framing: 1
Address: 117 DAMON ROAD _ Contractor License CS=084358 2
MEDFORD, MA 02155 r `� Est. Project Cost: $5,132.00 Chimney:
Description: Insulation&Air Sealing. + . Permit Fee: $85.00
j Insulation:
Project Review Re J Fee Paid: S 85.00
J G Final:
Date. 1/11/2019
Plumbing/Gas
I? Rough Plumbing:
- `\Building Official Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months;aftereissuance. Rough Gas:
All work authorized by this permit shall conform to the approved application and the:approved 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 street or road and shall be maintained open for public inspection for the entire duration of the
work until the completion of the same. Electrical
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 for All Construction Work:
1.Foundation or Footing i > ; 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
0
Town of Barnstable *Permit#
P�OFVE Tp Expires 6 usontGs from issue date
N�
Regulatory Services Fee
• 1AftNStABLE. �
ss. Thomas F.Geiler,Director
ntA � Thou IT
��jOlEoMa Building vivisloll
Tom ferry, Building Comutissioner OCT 12 2004
200 Main Street, Hyannis,MA 02601
TOWN OF BARNSTABLE
Office: 508-862-4038
Fax: 508-790-6230
PERMIT MIT APPLICATION - 13LSIDE N'lIA.L ONLY
Not Valid without Red.Y-Press IMP"int
Map/parcel Number D
Pro erty Address
Value of Work �JV
Residential
Owner's Name&Address
,t
` n " Telephone Number
Contractor's Name 'i
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
CSD S-?032
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
M,kh'aive Worker's Compensation Insurance
Insurance Company Name
vt z.P/c� w s
Workman's Comp.Policy#_ _
Permit Reques (check box)
Re-roof(stripping old shingles)
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value (
maximum.44) �.
i °
❑ Other(specify)
*Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
Signature
Q:Forms:expmtrg
Reviscd 121901
CAPIZZI HOME IMPROVEMENT INC .
SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6
STATE OF MASSACHUSETTS
LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT
OWN THE PROPERLY LOCATED AT I �j VllhV1, I' 1
IN , l MASSACHUSETTS.
I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT
TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,
THE MASSACHUSETTS STATE BUILDING CODE.
I GIVE MY PERMISSION TO
LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE
MASSACHUSETTS STATE BUILDING CODE.
SIGNATURE OF OWNER:
OWNER'S ADDRESS:
OWNER'S TELEPHONE:
LESSEE'S SIGNATURE:
LESSEE'S ADDRESS:
LESSEE'S TELEPHONE:
APLLICANT'S SIGNATURE:
APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUIT, MA 02635
APPLICANT'S TELEPHONE: 508/428-9518
RESPONSIBLE OFFICER:
RESPONSIBLE OFFICER ADDRESS:
RESPONSIBLE OFFICER TELEPHONE:
ACCEPTED BY DATE
THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL #
ohs andzan--cis Y
- ' One AsHb=tom Place- Room 1301
Boston.Massz.chuSetts 02208 . - -
} zlome' rovemen �Can `actor Relation
t i r'tepisL2tion: '100740
'Type. Private Corporation
: iration: 5,212005
C�PiT.11 IDIJIE1J[EN�T, INC. .::
i nomas Capi=i, ir. _.
'i 545 Newton ?d. ,
Cotuti, JVIA M35
s Update Address ant re=urr, card.Mark reason for ztaaOe
''. Address Renewal imploymeat _ Los.Gard
i
✓nc'`�iammwnu� cl✓�i,aaoctci:.uoP,lli � .
s
Boars o.Building Reguiatiors ant Stzadares Lizense or valid for individu) use Drill-
-before.the expiration date. If fount ed rn to:
Board of Buiiding Recruiations and Standards
��. iceai5:7z:ior 1Dr'4C -
- One kshburtor.�.place Fim _301
Boszoz:,Wit. 0_208
Private �,orp=mibn
�otut,IJr.G2835 Not valid without signature
,=inarrarcr
• I
I
C.::t^-✓r^-....:....a�n.c�-n�.Y!`,�^' ...:.;�.+ ..� - .. r-f' '^a.�'� � f'yy"l 34""fi�y�T; a� ;n t i r ',.1gµz.�� �^c-+..ar 4_, .� .ra-s----c' :
• ° .TOWN OF B ARNSTABLE Permit ,No _ 26667
• ,
Building Inspector
saasa ` Cash —
a7�
��r xG� ' �
OCCUPANCY ;PERMI{ _
T Bond -_-- _
�y -: —
issued to Richard R.. .Pairbank Address
Lot 69, 51 Prudence .Lgne, Cotuit '
Wiring Inspector � � �" Inspection date
Plumbing.Inspector`, n \ ' �M F Inspection date ��� �
Gras Inspector '07 Inspection date
hEngineering Department �r- Inspection date } {�
Board of Health Inspection date
v v
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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE. t
......... .�....-�.....�3 i9..$s" .�...........................r......_........._._._........-
Building Inspector
- r
��` °•°e TOWN OF BARNSTABLE
BUILDING DEPARTMENT
seH IT
"Aaa : TOWN OFFICE BUILDING
ru
i639' �� HYANNIS, MASS. 02601
�o r�r►'
MEMO TO: Town Clerk
FROM: Building Department
DATE:
An Occupancy Permit has been ,"issued for the building authorized by
Building Per »»_494�O12 7 » .... ................»......._. .......... .. .�_. . ..«
issued .to ...».»...... .........._. ....»�' ....»»�._....�..._...._..._.»...»....................r.............................»».»...».....»..........»..»».».._..................._....»»
` Please release the performance bond.
Y
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7 •� ~• / ^��� �. jlitia.77.t'� Ig Fr+ Yid ?s'=�s^ .l. '.;
Sewage Permit number . ...................... ..1J7 . . . .. ........... ,p
prt� W1111-1 TITLE ) i BaaasTenLE,
MAOHouse number ...................... ......o.t................................. - `' 00p, 16 9
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TOWN OF BARNSTABLE
L. .
i� LR � INSPECTOR
APPLICATION FOR PERMIT TO ••••• ••.•••••. ••••••
TYPEOF CONSTRUCTION ............ ......... .! .�._.,........................................................
• o
..................C'!. 'f.... ......19�_.
i TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby opplies`for a permit according to the following information:
Location ...... . .... ( v. e.Fa..,....A.o.!t..........0 Tt?.A.T. ............................................................................ ..
i
ProProposed Use ..i..�. .:.1`�. .........................................................................................................................
p ............
Fire District ................
Zoning District ............�i�!..1.,0..................... �.LJ�............... ...............................
Name of'Owner �.el� T�. ...?. .. " ?.1.)��. P ....Address .."—��.��. s .1--1.t �: 7"... IN 5Al.JX?.U..?.P.r.�N
Nameof Builder J... .. S.A ..Address ......................................................................1.............
Name of-A&t4 oo-RD. .. . .. 1".�1.�'�. ►J.. ...Address t
Number of Rooms ...........(2>.................................................Foundation ...............
v o n
Exierior .b;�C7t.. .11 ..�i.. �. .�.�aa� .�.....Roofing ....... .ej..1���s?:a... .� ..'I.......................
t �,�� .
Floors ...........�.c`r:>">..�.......................................................Interior . w
..
Heating .................................... Plumbing �. I.
Fi o �.v p:��:.`7-�a:. �, Approximate Cost �fJz?-t?..................
I ............... v.:.. :.. .._...._.
Definitive Plan A&roved by Planning Board ---------------____-----------19_______. Area ....., .�®
Diagram of Lot and Building-with,Dimensions:. Fee. -::........
./... ..."..—..............
SUBJECT TO APPROVAL OF BOARD OF HEALTH
1
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to-oll the Rules and Regulations of 4Toof rAaeI the ove
construction.
Name . .......... ...................................
n
Construction Supervisor's License Dwne/ '.................................
FAIR PM, RICHARD R. r_ t „1 s;: r: #• r, t'
N� 2607...::. Permit for .SAxy...........
za t, is s} 3
Single Famil�'..? l�. g.
Location ....... ;' } +°
/'+may !•^ r. $ + - ! ti. .. y'� � ,�„':
uit
.... .. . ........
Zichard rbancOwner . { � !
+ {
Type of Construction r 4 . ........
Fd - 4f ..tom. ..I. .' •• :r+
.............................. .................................
Plot ... Lot-k� "p y
Permit Granted ..:.June 2'], :19 $4
Date of Inspectio 1+ w, ,+
• 9
;x .';E e
Date Completed ..........
�,� rP .. _r
riatS �• :'? i• 5 .w7 Y :;1 r S..r six , _ u4t.oil
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.- C
F COMMONWEALTH OF MASSACHUSETTS
THE TRIAL COURT
PROBATE AND FAMILY COURT DEPARTMENT
MIDDLESEX DNISION DOCKET NO.
TEMPORARY DECREE OF EXECUTOR/EXECUTRIX
At a Probate Court held at Cambridge in and for said Courity of Middlesex,on the y�h
day of in the year of our Lord two thousand and
.. r On the motion of of 4
in the County of representing that
the irlstrument herewith presented purporting to be the L s ill and Testament aa4Co+eil(s) of
,7
late of in the County of Middlesex, deceased; and
praying that,
be appointed temporary execut- tempetary adini�rat with--the-Wi}l annexed
with the powers set forth in Massachusetts General Laws, Chapter 192, section 13-16, first giving
bond w•44t suffrctent/without sureties. And it appearing that all persons interested having
assented and/or been notified. The Court finds that said petitioner is/ar-g competent and suitable
person to be appointed to said trust.
IT IS DECREED that said petitioner"
� �.
be appointed temporary execut ten%garary adr trat wtth the Will
arcked thereof, first giving bond w4h--suffieiertt/without sureties for the due performance of
said trust with the powers set,forth in'Massachusetts General Laws,,Chapter 192, section 13-16,'
the authority of the temporary execut iry'" ; teerary;adrninistrat with t W-i1l
annexed named herein is limited to a period which.shall expire on 2,.
ti j S y
Date: JUSTICE OF PROBATE AND FAMILY COURT
DATED FEB 0 9 2019
I,the undersigned HEREBY CERTIFY that I am the Register of Probate and Family Court in the County of
Middlesex,that such as I have Custody of the records of said Court, and I further Certify that the foregoing is a
photographic copy of the decree of appointment of the fiduciary,that said fiduciary has given bond as required by
the law and that said appointment remains in full force.
Witness,by my hand and seal of Probate Court of the Commonwealth of Massachusetts,in Cambridge.
Register of Pro e
4 ,
t LAST .WILL "AND TESTAMENT
` OF
HRISTINE FAIRBANK
I, L. CHRISTINE FAIRBANK, of 51 Prudence Lane, Cotuit, in th
County of Barnstable and Commonwealth of Massachusetts, do .make,
publish and declare this to be my Last `Will .and' Testament, hereby
revoking all wills and codicils heretofore made by me.
After the payment of mv ,just debts , funer_.al expenses , and
expenses of administration ,- I give, devise and bequeath as fol -
lows :.
FIRST:: I give and bequeath to. mv husband, RICHARD - R.
FAIRBANK, if he survives me, all my household furniture and
furnishings ,' personal effects,`., books, works of- art , jewelry,
silver, . automobiles, and all other articles . of tangible, personal
property of whatever name ,or nature owned by me , but not
including `under this bequest any `bank books,' securitfies, cash, or
other intangible personal property.
If my sai'_d husband, ,does not. survive me . I give and bequea
said tangible personal property in. equal shares to. my children,
if they survive me. If any of .mv* children does `not survive
me , their issue surviving me shall t'a.ke by rcfht ' of
representation the bequest'_ which my children would have taken had
DITO.SWEENEY. they survived me. If at, my, death any .one of my children's issue
SSE.ROBERTSON'.
QOUPUY.P.C. is then a minor, my Executor may in his discretion distribute. 'the
TORNEVS AT LAW
T YARMOUTH,MASS.
02673
Page No . 1 of will of L. CHRISTINE:iFAIRBANK
1.(508)775-3433
share of such minor to such minor, or to his or her legal
guardian; or to a relative, or my Executor may in hi-s di.scretion
sell such minor's share and in his <discreti.on
pay over the
proceeds of. such sale to such minor or add the same to the
residue of my estate; and the receipt of such minor or such other
Person shall be sufficient evidence that the obligations of my
Executor hereunder.,`have been fulfilled.
In making any, distributi on , or `sale 0f . aid tangible
property, I request that my Executor consider any written memo-
randum or oral, instructions which I may give him as an expression
of my wishes. I :have every confidence that .my wishes will be
carried out , but . I do not intend to impose any legally
enforceable obligation with respect to this request.
The decisions of my �Executor as to• what is tangible personal
property and, other decisions . made and. actions _ taken by my
Executor . in carrying out the provisions of this article shall be
final and binding on ill parties.
SECOND: I. give and devise to my said husband, RICHARD 1R..
FAIRBANK, if he. survives me, any interest which I own at the
time of my death 'in the real property which I occupy' as my
principal residence at the time of my death. I also direct that
during th.e period of administration of my estate, without expense
to my said husband, the expenses . of maintenance and repair of sa •
real estate, including taxes insurance, and all such items,
D1T0.SWEENEY• shall be
Paid out of my_ creneral estate as part of the costs of
;SE.ROBERTSON.
&DUPUY• P.C. administration thereof.
TORNEYS AT LAW
r YARMOUTH.MASS.
02673
Page No, 2 ,6f Will of L. CHRISTINE FAIRBANK
L.(508)775-3433
If my said husband does not survive me, I give and devise
said real property or interests therein to my-Executor to conve
all or any portion -thereof in equal shares to my children, if
they survive me, otherwise their: share to their issue equally by-
right of, representation and if no issue,, , then to the survivors. of
them., If my Executor is of 'the opinion that such a conveyance of
all -or any portion of such real property or interests therein is
not then expedient , he may sell all, or any portion of such real
property or interests therein at public or private sale, in his
discretion, without the license ofany, Court, to such purchasers
and upon such ' terms, as. my Executor in his sole discretion mav_
deem advisable, the net proceeds of any such sale to be added to
the residue of my estate; provided, however, that if in the
opinion of • my Executor it shall appear practicable and advisable,
he may retain all or any portion of such real property or
interests therein and rent the same until such time as a sa.lel, or
a conveyance to my children shall seem to him expedient, the `net
proceeds of anv . such rental to be added to the residue of my
estate. Any decision with respect to any such conveyance, sale
or rental made in good faith by my Executor shall be final and
conclusive.
THIRD: All the rest, residue and remainder of my property,
real and Personal and wherever situated, ' but not including any
property over which I may have any power-, of appointment, I ggive,
DITO.SWEENEY. devise and bequeath to my� said husband,. RICHARD R. FAIRBANK, if
SSE,ROBERTSON.
&OUPUY,P.C. he survives me, otherwise to my children in equal shares , if
-TORNEYS AT LAW
T YARMOUTH.MASS.
0203
Page No . 3 of Will of• L. CHRISTINE FAIRBANK
L. (508) 775-3433
. 1
they survive me... If any of my children does riot survive me, then
their share shall go to their issue, if any there be, in equal
shares, by right of representation, and if no issue, then to the
survivors of them.
FOURTH : I nominate and appoint my said husband , RICHARD R.
FAIRBANK, to be Executor" of this Will. If -he shall for any
reason fail to qualify or cease to serve, I nominate.-and appoint
my son, JOHN FAIRBANK of Lexington, Massachusetts to serve as
Executor in his stead.
In accordance with Mas"sachus.etts- General Laws, Chapter 192,
Section 13 , I request that the -above-named and any other person
..appointed to serve as �Executo.r. also be appointed as temporary
Executor '. with all of the' powers and duties specified in
Massachusetts General -Laws., Chapter 192., Section 14.
No bond .shal1 be required of any Executor, Executrix or
Administrator at any time acting under this Will , or if* a•bond is
required' by law, no .surety shall be required on -s -
uch bond.
References in this Will to "Executor and "temporary
Executor" shall include any person or corporation administering
my estate under this Will.
FIFTH : My Executor in addition to and not in limitation
of his common law and statutory powers, •shall have and" mav exer-
cise the following powers without the necessity of court license
or approval , and any decision made. by him pursuant -to any
VTO,SWEENEY. discretionary power hereunder shall' be final and binding on all
SSE,ROBERTSON,
&DUPUY.P.C. persons interested:
fTORNEYS AT LAW
iT YARMOUTH,MASS.
02673 - _ -
Page No . 4 of Will of L. CHRISTINE FAIRBANK
_L.(508) 775-3433
( 1 ) To lease, to sell, or to grant options to purchase
all or any part of °my estate, both real and personal ,
at any time, at, ,public or private sale, ' for such
cohsideration and upon such terms, including credit,
as he shall deem advisable, and to: ,execute., acknow-
ledge, and deliver ..deeds or other instruments. - No
purchaser shall beheld to see to the application of
the purchase money.
(2 ) To retain for whatever period he deems advisable
any property, including property held - by- me at my
death, and to invest and reinvest in any property ,
both real , and personal , which shall- seem - to him
advisable without reqard to whether,- any particular
investment would be proper for an Executor or whether
the aggregate amount of anv investment would b`e large
i"n proportion to other investments' or to the entire
estate. My Executor shall be exempt from any
liability by "reason of any' loss occurring from any
investment made or retained by, him 'unless such loss
shall be caused by his own willful default.
(3) To pay, compromise,Isettle or otherwise adjust any
claims and anv taxes which may asserted in favor of .
or against me or my estate, .including, without limita
tion, any taxes which may become due and payable by
reason, of my death or by reason of any devises '•and
bequests in this my will.
( 4 ) -Except as mav- otherwise be .provided . hereunder ,
upon distribution or separation into shares., to make
such. distribution or separation in whole. or in part. in
kind at values, ,determined by him, with -or without
regard to tax basis ," and to allocate different kinds
and disproportionate amounts, :of property and ,undivided
interests in property among the beneficiaries.
( 5 ) In ' connection with the preparation of any tax
return for me or my estate, to determine whether to
include or exclude any item of property, to determine-
within permitted limits the date of valuation-. of my
estate, to determine whether, certain deductions shall
be taken as income 'tax deductions or .estate tax
deductions, . and to determine whether to adjust between
principal and income.
(6) To employ counsel , brokers, accountants and other
agents and pay them reasonable .compensation from my
OITO.SWEENEY, estate .
SSE.ROBERTSON.,
RQUPUY.P.c. (7) To make any payment or distribution due hereunder
ITORNEYSATLAW to a minor directly to such ,.minor or to a. parent of
;T YARMOUTH..MASS.,
02673
Page No . 5 of Will of . L. CHRISTINE FAIRBANK
L:(508)775-3433
d
such minor for the benefit of SU41 minor..
(8) To make any elections permitted as. a result of .my
death ' under any . pension, ' profit sharing, employee
stock ,owhership,.or other benefit plan.
( 9 ) To join with my said husband or my husband's
Executor or Administrator in filing .joint state or
federal income tax returns for any ,pe.riod for .which
such a return may be permitted, and to. determine as
between my estate and my said husband or my husband's
estate how the viability for any such taxes shall be
borne and who shall be entitled to anv refunds or
credits for any amounts paid on account .o:f any such
taxes regardless of whether such taxes , refunds or
credits are applicable to periods before or after my
death.,
( 10 ) To consent for. federal and state "gift tax pur-
poses to gifts made by my said husband' as having -been
made in part by me and in part by "my husband.
SIXTH: I direct that the representation by guardian ad litem
of the interests of persons unborn, unascertained or legally
incompetent to act .in. proceedings for the all of accounts
hereunder be dispensed with to _the extent permitted by law.
, SEVENTH : For all purposes of this my Will , the terms
"child," "children,'" and "issue" shall include those who trace
their relationshin' throudh adoption as well .as through birth:
EIGHTH : Masculine, feminine, and neuter pronouns and the
words , " Executor , " " Executrix , " " Executors , " and/Or
"Administrator," shall' each include all genders and the singular
shall include the plural , and vice versa, where the facts or
context so admit.,,,
NINTH: Except to the extent to which I have included them in
IDfTO.SWEENEY, the provisions of this Will ,* I have intentionally and not as the
)SSE.ROBERTSON.
aDUPUY, P.C. result of any accident, mistake or inadvertence omitted in this
TTORNEYS AT LAW
ST YARMOVTH,MASS.
02673
_ Page No . 6 of Will ° of L. CHRI'STINE FAIRBANK
EL.(508)775-3433
�•o
Will- to
Provide for any °of' my issue, or. 'issue of my issue,
whether now living or hereafter born or adopted. '
TENTH: Any Administrator or succeeding Executor -of. my Wil
shall have' all the powers and discreti.ons herein given , to my
Executor, and the word "Executor" or "Executrix" where herein
used shall be construed to include 'any . Administrator of t his .Will.
No Executor, Executrix, or . Administrator shall be liable for any
error in judgment or for anything other than• his:; .her or its1own
willful default.
ELEVENTH : . I direct that all' taxes payable by .reason of my
-
death, other than taxes attributable to gene ration=skipping
transfers :of which I am the deemed transferor, whether or not with
respect to property. being under this will , shall be paid out of
the residue *of my estate ' as administration expense and shall not
be apportioned.- I authorize my Executor t'o pay, adjust; or
compromise 'any taxes, on future 'interests payable- by reason of my
death. when 'or before the. same become due or, if he determines it
advisable, •to refrain from so doing.
TWELFTH : This Will shall be governed by the laws of the
Commonwealth„of Massachusetts in all. respects; including without
limiting - the foregoin4 `
g, itsY.val .dity,. construction, effect and
administration.
IN .WITNESS WHEREOF, 'I , the undersigned Testatrix,. do hereby
declare that I sign and execute this instr'ument, typewritten on .
3SE.RBERTSO eight pages- in .the attestation clause, signatures of ,
�SE.ROBERTSON,
&DUPUSATC. witnesses , and 's elf-proving affidaviTORNEYt , as my, last Will , that I
T YARMOUTH.MASS.
02673 - -
Page No . 7 . of Will o-fyL. 'CHRISTINE FAIRBANKj
L. (508)775-3433
•
sign it willingly in the presence ,of each, of the undersigned
witnesses, and that- I execute it as my free and voluntary act for
the purposes herein expressed, this day- of
1991 .
L.-.CHRISTINE FAIRBANK, Testatrix
We, the undersigned witnesses, each do hereby declare in the
presence of the aforesaid Testatrix .that the Testatrix signed an
executed this instrument as her last Will in the presence of each
of us, that she signed it willingly, that each .of us hereby signs
this Will as witness in the•presence of the Testatrix, and that to
the best of our knowledge the Testatrix is eighteen (18) years of
age or over , of sound mind, and under no constraint or undue .
influence.
' f
'residing at aj
A
7ZL� residing .2
THE COMMONWEALTH OF MASSACHUSETTS
Barnstable, ss .
Subscribed, sworn to, and acknowledged before me by the said
Testatrix and witnesses this Kday of _
1991
wy Notary Public
H .
My commission expires:!/
t
DITO.SWEENEY.
3SE.ROBERTSON,
4 OUPUY,P.C.
TORNEYSATLAW ..
T YARMOUTH,MASS: A
02673
Page No. 8 of Will of L. CHRISTINE FAIRBANK
1.(508)775-3433
SECTION -'SEWAGE
I CD -SEPTIC TANK - - "D" BOX - - LEACH �'T
TOP OF FON
(MSL)a "2"OF yieTO 42" c
WASHED STONE
yr ixow
10,
I N• OUT+ I N»
OUT» IN+
t 5 d_C7 G
SEPTIC
'C�1(o8 TANK col n
ELEV. ELEV. ELEV. ELEV.
ELEV. ELEV. 4 V4
I
5cl.0, yam,, ( �� b�9 � � � 4'
�l.�zV. .LT_� OFF/a"•1�/z" f ,t+. ICU 4QI�. �,1 \ -'1,0� ,
WASHED STONE
PQ.o e is
TEST HOLE LOG ' 1 �'O p �p4>rs�a.Tl Ol11 A
TEST BY�.-��.1 R:.4 A!_jL t �. ,v.c p L
WITN
TEST DATE $�25/153 �''�,�.,ESS�',,- DESIGN �- BEDROOM HOUSE
T.H. * 1 T.H. # 2 r !
//�� , 'T4
ELEV.�eS•�./ ELEV. � NO � Y'f , O •�
PERC RATE L MIN/IN. DISPOSER DISPOSER :' l
( 4 .
+� U�
CleaH FLOW RATE �"�-C�(GAL./DAY)
(on-sit SEPTIC TANK A(1c
HcAv REO'D SEPTIC TANK SIZE
LEACH FACILITY
SIDE WALL 18S'so( Z,S) 41 l G/D.
lrar BOTTOM 5,L •1T l9.sti I ) = 18 G/D. LC�j �o`/ 7�(0
Sl.a TOTAL 21o1•oa' = `y4 cj c�jt' `' 23�5 ZZ . .5,F
' . USE: Q.F- LEACHING
1JC� WATER ENCOUNTERED
NOTES: (UNLESS OTHERWISE NOTED) - '
+ Go v � 4�> OF
1:DATUM(MSL)—TAKEN FROM .............-T..._.-.I.......___...QUADRANGLE MAP n� _
2.MUNICIPAL WATER................. ---------•---------AVAILABLE f�. `.• .. •\ 11��II11
3.PIPE PITCH:1A"PER FOOT .� Itw►(ARD CPS
4. DESIGN LOADING FOR ALL PRE UNITS: AASHO E + �b .44 .� 'R
,; :` --Q--
5. MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1)'FT. -41 DISTANCE AS CERTIFIED / �l
6.PIPE JOINTS SHALL BE MADE WATER TIGHT V. F 1.RLANM, f v
7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. f�i0- cG303 '�. I HEREBY CERTIFY THAT THE BUILDING --�^^— SITE PLAN `
STATE ENVIRONMENTAL CODE TITLE 5
SHOWN ON THIS PLAN IS LOCATED ON THEr�` � �LOCUS: � _ i
GROUND AS SHOWN HEREON &THAT IT
CONFORM TO THE ZONING BY LAWS OF THE
—# — TOWN OF
EG.PROFESSIO AL ENGINEER WHEN CONSTRUCTED. DATE r
� I .. REF ..L";G•�+ , Z�^�� '
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down cape engineering t PREPARED FOR: 3 A'1> e�R+.�Il4 .
CIVIL ENGINEERS ` ` "zL 5��►cro-se
y° LAND SURVEYORS ----- Y a
CO n BOARD OF HEALTH AEG.LAN[ SURVEYOR y 1
(EXISTING)•• �. J1
DATE
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