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HomeMy WebLinkAbout0209 RALYN ROAD aa� ��i� � ��� t f iii I t Bk 31045 Pg38 #4072 01-25-2018 @ 01:26p QUITCLAIM DEED We, Janice L. Johnson,being unmarried of 21 Wood Path Ashburnham, MA 01430, W. Bruce Johnson being married to Linda M. Johnson, of 2025 S. Davis Circle, Mesa, AZ 85210 and Richard W. Johnson,'being married to Louise B. Johnson, of 551 Washington Avenue, South Amboy,NJ 08879 For consideration paid of Three Hundred Fourteen Thousand and 00/100 ($314,000.00)Dollars M Cq 0 Grant to Daniele G. Cutrona and Amy E. Cutrona, Husband and Wife as Tenants by the Entirety,of 209 Ralyn Road,Cotuit;MA 0263.5 U With Quitclaim Covenants 0 The land together with any buildings and improvements thereon situated in A Barnstable(Cotuit),Barnstable County Massachusetts being shown as 0 rn LOT 17 on a plan of land entitled "Plan of Land in Santuit, Mass., Cotuit Country N Estates,Raymond D. and Gwendolyn W. Crawford. Scale: l"=40' Nov. 14, 1968 Robert G. McGlone, Surveyor & Engineer, Main Street, West Barnstable, Mass." duly recorded with the3arnstable Registry of Deeds in Plan Book 229;:Pages 51 and 53.and to which plan reference is hereby made for a more particular description. Together with a right of way over the Ways as shown on said plan in common with o all others lawfully entitled thereto for all purposes for which public ways are used in the a. Town of Barnstable. Subject to, and.with the benefit of, all rights restrictions, reservations, easements, appurtenances and rights of way of record, insofar as the same are still in force and applicable. MASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 01-25-2018 @ 01:26pm Date: 01-25-2018 @ 01:26pm Ctl#: 678 Doc#: 4072 Ctl#: 678 Doc#: 4072 Fee: $1,073.88 Cons: $314,000.00 Fee: $960.84 Cons: $314,000.00 f Bk 31045 Pg39 #4072 Meaning and intending to convey the same premises conveyed to the Grantor's by Deed dated March 18, 2014, and recorded on March 24,2014 and recorded,in Book 28047, Page 126. Grantors hereby release any and all homestead rights to the within premises,whether created by declaration or operation of law,and further state,under the pains and penalties of perjury,that there are no other persons entitled to any homestead rights to the property being conveyed herein. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK J 1 ' A� Bk 31045 Pg40 #4072 Executed this q day of January 2018 under the pains and penalties of perjury. ice L.Johnson COMMONWEALTH OF MASSACHUSETTS County of Wo-'-C e Stt. On this ,!� day of January 2018 before me, the undersigned notary public, personally appeared Janice L. Johnson, proved to me thr.6ugh satisfactory evidence of identification which was [ ] personally known to me [ ] Other: to be the person Whose name is signed on the preceding or attached document and acknowledged to me that she signed it voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are WAhfiil and accurate to the best of her knowledge and belief. Notary Public My commission expires: LI--) - o (SEAL) � C 1 i i �n I �N u• - CNJw,.. Bk 31045 Pg41 #4072 Executed this ! day of January 2018 under the pains and penalties of perjury. W nson 1, Linda M. Johnson, wife of W. Bruce Johnson hereby release any and all homestead rights with regard to the above-referenced property and swear and acknowledge under the pains and penalties of perjury that no other persons are entitled to any benefits of an existing estate ofhomestead as set forth in M.G.L. , haptcr 188. Wife AC Johnson STATE OF ARIZONA County of on this 10 clay of January 2018 before me, the undersigned notary public, personally appeared W. Bruce Johnson and Linda K Jo proved to me through satisfactory evidence of identification which was [ ] [ ] personally known to me[ j Other: to be the persons whose names are signed on the preceding or attached document and acknowledged to me that they signed it voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are tiuthfui and accurate to the best of their knowledge and belief. Notary Public My commission expires: (SEAL) NOTARY PUBLIC ATE OF MO A County Arloops SCHWARZ02KAREN pUee February 2B,2019 Bk 31045 Pg42 #4072 Executed this,a day of January 2018 under the pains and penalties of perjury. Richard W.1ohnj I, Louise B. Johnson, wife of Richard W. Johnson heresy release any and all homestead rights with regard to the above-referenced property and swear and acknowledge under the pains and penalties of perjury that no other persons are entitled to any benefits of an existing estate of homestead as set forth'in M.f�L.Chapter 199. uise.B.1#91,J STATE OF NEW JERSEY County of On this day of January 2018 before me, the undersigned notary public, personally appeared Richard W. Johnson and Louise B. Johnson, proved to me through satisfactory evidence of identification which was [ ] ` [ ] personally' known to me [ ] Other. . to be the persons whose names are signed on the preceding or attached document and acknowledged to me that they signed it voluntarily for its stated purpose and who swore or.affirmed to me that the contents of this document are truthful and accurate to the best of their knowledge and belief. otary Public My commission expires: (SEAL) , „a�uvngyy� Q`0 g P E wy1 , �„�.`oaµ Exp•.Z� PUB 7aC.H 4p1A a� " Huuaa`'a JOHN E. MADE, REGISTER BARNSTABLE COUNTY REGISTRY OF DEEDS RECEIVED 6 RECORDED ELECTRONICALLY YOU WISH TO OPEN A BUSINESS? For Your Information_ Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary:signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town.Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 Clown Hall) and get the Business Certificate that is required by law: DATE: 31 0 194 1 o f� Fill in please: Al ��Wst� l' .LN APPLICANT'S YOUR NAME/S. AV BUSINESS YOUR HOME ADDRESS: '9J� it,i TELEPHONE # Home Telephone Number K rzvi�aiLvi�t.t — - S vF;a.w t.+n.nt 3 ElN #: y%� E-h1AIL: On U ra h UC7, SUM NAME OF CORPORATION: O&A {ro c o NAME OF-NEW BUSINESS TYPE OF BUSINESS 5(2r 0' Doc a,p IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS.. a O c C> 0 MAP/PARCEL NUMBER � �_ t1 SJ (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you,may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO ISSJON R's oFl=lC MUST COMPLY WITH HOME OCCUPATION This individ I h' b n . o any e ie r it-ments that in to this type of business. RULES AND REGULATIONS. FAILURE TO C0k4PI.Y MAY RESULT IN FINES. Auth riz i ature* 11 COMMEN4 n �n l r, ab , 2. BOARD OF HEA TH rU V This individual has been informed of the permit requirements that pertain to this type of business, Authorized Signature COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature' COMMENTS: - k town ul Darnstame Building Department Services � h ppTHE rp� ' Brian Florence,CBO o* Building Commissioner . ' 200 Main Street,Hyannis,MA 02601 7 MA3& 16.59• �m - www.town.barnstable.ma.us �prf k Office: 508-8624038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: a, Name: tiC'l Cyhlana Phone 9X".5 Address: a 0 I po ly"n 0r Village:_ Name of Business: pan (ft-krona Rai. ,I f'Ll ra HJ TypeofBusiness: I ofogm,Dhv Sfrvies Map/Lot ���—VSS INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the.dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carved on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing-the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included • No person shall bg employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and a e the above re lions for my home occupation I am registerii . Applican• ` Date: Homeoc,doc Rev.06&0116 . * Town of Barnstable Building h_�Us;n,r�Cta..�'lr tlF nsS iao:,l Tlnhsapt eitc trsio Vn��i s Hki'.ba lse-,,B Fereonrn M't`'"haetl eSt,trj;,,e,y et ,,Ak ppro�edPlans Mjuk s`t be Reta;m ed,ona:JFdo DAMMMA PostT 163 Posed in ba al.nInds this Card Must be.Kt e".pt , F; Permit ectio�n has been made Permit No. B-18-387 Applicant Name: CUTRONA,M DANIELE&AMY Approvals Date Issued: 02/21/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 08/21/2018 Foundation: Residential Map/Lot 022 055 Zoning District: RF Sheathing: Location: 209 RALYN ROAD,COTUIT � t Contractor Narne: Framing: 1 Owner on Record: CUTRONA,G. DANIELE&AMY E. Contractor License t 2 Address: 209 RALYN ROAD � Est Project Cost: $1,000.00 COTUIT, MA 02635 Chimney: Perrn�t Fe'e: $85.00 11 Description: install closets to existing room:to create a bedroom dn6hidoacl ,_Fee Paid S 85.00 Insulation: bearing interior partitions(2x4@16.06) up date smokeOdetectors Date 2/21/2018 Final: Project Review Req: fix, Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work aiaYhoriied by this permit is commenced within six o iths after issuance. i� 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 hall be in compliance with the local zonmg'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,,pub"p.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 bythe Building andFire Officials are provided onxthls permit. Service: Minimum of Five Call Inspections Required for All Construction Work:, 1.Foundation or Footing , - Rough: 2.Sheathing Inspection '' ' ' `" � `Nf IN" 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 �p 1HE T Q pApplication Number......e.5.. y..... ......:.......... * sARNSMLF, MASS.. , g, Permit Fee......... ..................Other Fee......................... 9� 1659. Total Fee Paid........................... ............... ...... TOWN OF BARNSTABLE Permit A Approval An... ... .1...�U.... PPy... ........... BUILDING PERMIT Map..............................:.........Parcel............................................. APPLICATION Section I — Owner's Information and Project Location Project Address ;;to IPW. Village Owners Name aA 1 P 1,e T LZ�Ard r1 oc Owners Legal Address a07 r City State Zip OQ S 1 r Owners Cell# Z9 5OZ-257 E-mail Q yyt Section 2 z Structural Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3 —Type of Permit ' ❑ New Construction ❑ Move%Relocate ❑ Accessory Structure ❑ Change bf use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ arm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar FEB 08 2018 Renovation. ❑ Pool. ❑ Insulation . TOWN OF BARNSTABLE . Other—Specify Section 4 - Work Description �� P G, AeQ61d ill X ,C T oci nnria4Pr1. 17/7R/7n17 Application Number.........................:............................ Section 5 —Detail Cost of Proposed Construction Square Footage of Project �q l S�� Age of Structure J q 72 Dig Safe Number ` # Of.Bedrooms Existing __'.% Y Total# Of Bedrooms (proposed) e? 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Designs j Section 6 —Project Specifics i ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑.Masonry Chimney Add/relocate bedroom Water Supply LJ Public - ❑ Private Sewage Disposal ❑ Municipal FLrOn Site Historic District /U//} ❑ Hyannis Historic District ❑ Old Kings Highway ❑ Debris am using Disposal Facility: �� g a crane Yes No Section 7--Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use ho-) .//�P Lot Area Sq. Ft. f o 76- Total Frontage _Percentage of Lot Coverage _# of Dwelling Units (on site) _ Setbacks Front Yard Required -Proposed Rear Yard Required Proposed Side Yard Required Proposed ,e 1 Has this property had relief from the Zoning Board in the past? ❑ Yes No L _ , I _ _ SIOKETECTO,'�S�REVIEWED { I BARNSTABL�E BUILDING DEPT.' DATE k Rc:14 two t '� DATE FIRE DEPARTMENT � ® � 1 —! - —-- - --�- - --- - BOTH SIGNAT�IRES ARE RrOUIRED FOR"PERMITTIIUG t /Jv IN I ...:w. , N KrTctl� - c�oy�� 17 \ , f i 4 12 �31�i00/ .I.VIR/.G- t • Yoo y i f - Ny - .. .4.. � � ♦ 1. 1 ... - --rt- , , , , Co 70 Imo. I E ��•� Jam' `,1� � �3p�7H � r n TDfj f'flr� i 6 i. I t . SMOKE ! __ . KE DETECTO��Sf RSV' IEIhIED BARNSTABLiE BUILDING DEPT..{ �.:UATE i I # // -aW I�oRG t ! �`.: EPARTPUIENT I i 30TH SIG,NA�JR �L DATE �F.QuIR — NGES ARE R PERMITTI �mA Cr EN _ 4 t KfTcry 3f}-T�{ C/U60, c al , " .. ...._ ...... ........-:... _i....... • ... }.. � � 1. . ... .. y .. t _ / I :i .. .i . - ... , 3 , Fn . a s ; cL nn ; t ._.._....., 12 ?#� !_1,.VI/�l ; CL 4(06K N1 Z, � H - , , f i 1 ; �- I co!� �� ; . � !27 j ' 779 f - i 12 L ul i � S� •Q �zr 00, 20 1 / _ f r } K 4 Bk 31045 Pg38 #4072 01-25-2018 @ 01:26p QUITCLAIM DEED We,Janice L. Johnson, being unmarried of 21 Wood Path Ashburnham, MA 01430, W. Bruce Johnson being married to Linda M. Johnson, of 2025 S. Davis Circle, Mesa, AZ 85210 and Richard W. Johnson, being married to Louise B. Johnson, of 551 Washington Avenue,South Amboy,NJ 08879 For consideration paid of Three Hundred Fourteen Thousand and 00/100 ($314,000,00)Dollars Cn N Grant to G Q Daniele G. Cutrona and Amy E. Cutrona, Husband 'and Wife as Tenants by the Entirety,of 209 Ralyn Road,Cotuit,MA 02635 V With Quitclaim Covenants 0 The land together with any buildings and improvements thereon situated in 0 Barnstable(Cotuit),Barnstable County Massachusetts being shown as ON plan of land entitled "Plan of Land in Santuit Mass., Cotuit ON LOT 17 on a P � Country ,0., Estates,Raymond D. and Gwendolyn W.Crawford. Scale: i"=40' Nov. 14, 1968 Robert G. McGlone, Surveyor & Engineer, Main Street, West Barnstable, Mass." duly recorded with the Barnstable Registry of Deeds in Plan Book 229,Pages 51 and 53 and to which plan reference is hereby made for a more particular description. Together with a right of way over the Ways as shown on said plan in common with o all others lawfully.entitled thereto for all purposes for which public ways are used in the w Town of Barnstable. Subject to, and with the benefit of, all rights restrictions, reservations, easements, appurtenances and rights of �vay of record, insofar as the same are still in force and applicable. MASSACHUSETTS STATE EXCISE TAX BARNSTA13LE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 01-25-2016 r.• 01:26pm Date: 01-25-2018 01:26pm Ctl#: 678 Doc*: 4072 Ctl#: 678 Doc#: 4012 Fee: $1,073.88 Cons: $314,000.00 Fee: $960.84 Cons: $314,000.00 f Bk 31045 Pg 39 #4072 Meaning and intending to convey the same premises conveyed to the Grantor's by Deed dated March 18, 2014,and recorded on March 24,2014 and recorded in Boots 28047, Page 126. Grantors hereby release any and all homestead rights to the within premises,whether created by declaration or operation of taw,and further state,under the pains and penalties of perjury,that there are no other persons entitled to any homestead rights to the property being conveyed herein. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK Bk 31045 Pg40 #4072 Executed this q day of January 2018 under the pains and penalties of perjury. I.Johnson COMMONWEALTH OF MASSACHUSETTS County of On thrs day, of January 2018 before m the urzdersrgued notary pubires p Y ppeared Jtce t: Johns" s rou bn prayed. to meg6; afisfactorr :evtdcttce o ersanaJ( `a tdettttt�Catt n MIX", xvas Dr►yer's L ccnse [ ]personali kaowa tp me j ] Other:: to the person asc rtamc:is sigricd:on the prece ng:osr a c cltcd,46tu is 1 I& acknowledged to that she signed it voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are hufli ui and accurate to the best of her knowledge and belief. It _w Notary:tOlic. My commission expires: ' (SEAL) t yrriai rR ,+,► �1 T'r �•L5. i Bk 31045 Pg41 #4072 Executed this I o day of January 2018 under the pains and penalties of perjury. 1; Linda X Johnson, wife of W. Bruce Jobnson hereby release any and all homestead rights with regard to the above-relemped property and swear and acknowledge under the pains and penalties of perjury that no other persons are entitled to any benefits of an existing estate of homestead as set forth in M.Gi ter 188. a �44 M:JohtnSozr STATE OF ARIZONA County of .c {sc. On this 1 o day of January 2018 before me, the undersigned notary public, personally appesreci: W Bnue Johnson and Lwd 2vZ John n, proven to me tlunugb' satisfactory cvidi+nee of rdentificatxop::wltich W;Ls [ ] veers LYcciyse known to me Other: to be the C ] personally: [ a persons whose names are signed on the preceding or attached document and acknowledged to me that they signed it voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are truthful and accurate to the best of their knowledge and belief. Notary Public My commission expires: J-;6 l'l (SEAL) NOT* F'l Af1C STATE OF ItRtZON = Wlaifoopa C4irr►kV KAR�N S6HIM�4R IuSy<Gomr . . EIrea feMatetY 280.1,9 Bk 31045 Pg42 #4072 Executed this-a day of January 2018 under the pains and penalties of perjury. Richard W Jo . _ . I, Louise B. Johnson, wife of Richard W. Johnson hereby release any and all homestead rights with regard to the above-referenced property and swear and acknowledge under the pains and penalties of perjury that no other persons are entitled to any benefits of an existing estate of homestead as set forth m l r;:.Chapte; Esc l3.Ja p,` STATE OF NEW JERSEY County of On this 111 day of January 2018 before me, the undersigned notary public, personally appeared Richard W. Johnson and Louise B. Johnson, proved to me through satisfactory evidence of identification which was [ ] personally known to me[ ]Other: to be the persons whose names are signed on the preceding or attached document and acknowledged to me that they signed it voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are truthful and accurate to the best of their knowledge and belief. �'�13ubltc, My commission expires: (SEAL) , r _ JOHN F. MADE, REGISTER BARNSTABLE COUNTY REGISTRY OF DEEDS RECEIVED 6 RECORDED ELECTRONICALLY 3- I2; Off ro!.Kr&�s 0 pew"Y ��DPDy mil) � i\ M1 EV5Tii' 3 ST?�rp, - ., `6= 70 - � 3 Nft -..... z N 017K. � F t { ll!! �i 1� �r� A h�J•�.,. 5.f/D - r�T 011� z17118 cif I - 23 r� 7-7 - �# oAc/r/rltG -J DPI�I> - st 4L=x%S7'/N !yvatr. - - FtR��G,4-cam ct- - I fff f t r► ©ff wl.KAP.JS `fib�.?�.,,3 �.Dom/ • __.Y_�.-.:.. 3 Y j I � � NOOK. - FiR�PL,,�c� t L s '-t 1C/5-7,'Ar6- t_,., r Vw 2./71/9 CaT'f 4 ,* 1Z Dtf w!n��tr.JS �XjST"iiu� .. O G Pie EK1571 ' _ STii;rgS, To t t z/7119 D Nr The Commonwealth of Massachusetts Department of Industrial Accidents — 3 . Office of Investigations ' 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganizatiordIndividual):_ a I;1>110 ( j� �jj—tenth Address: ;::�!j City/State/Zip: Phone 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New constriction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ,,Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' comp.insurance$ 9. ❑Building addition [No workers'comp.insurance P• ,�prequired.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.L� I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers' 13.[:1 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees, if the sub-contractors have employees,they must provide their workers'comp,policy number. . I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob 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(showing 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 a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250,00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and the ains nd penalties of perjury that the information provided above is true and correct. Signafore: Date: Phone#: 5D2 ' �-- Official use only. Do not write in this area,to be completed by city or town of City or Town: Perinit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 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,MGL 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-contractors)name(s),address(es)and phone number(s)along with their certificates)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 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. 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 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 Commonwealth of Massachusetts Department of Tndustual A=dents Office of Investigations 600 Washington Street Rostan,MA 02111 Tel,#617-7274900 ext 406 or 1-977-MASSAFE Fax##617-727-7749 Revised 4-24-07 wwwmm.gov/din Application Number............................................. Section 9= Construction Supervisor Name Telephone Number Address City State Zip License Number License Type' Expiration Date Contractors Email Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section 10 -Home-Improvement Contractor Name Telephone Number Address City State Zip " Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Lang;a.1 e a ka Telephone Number 2 Z6 15o2—!JSI2_ Cell or Work Number 5c—) I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Buildin derstand the construction inspection procedures,specific inspections and documentation required by C and the To of Barnstable. Sign - Date 2 Z7 APPL T SIGNATURE Signature VDate q j Print Name a,�� e- Telephone Number ,7g 50 Z--qT/I E-mail permit to: ct m iq P p ort'e_o n Ca ja e Co , Cc Last undated: 12/28/2017 Section 12 -Department Sign-Offs Health Department ❑ Zoning Board (if required) ❑ Historic District Site Plan Review(if required) ❑ . Fire Department ❑ y"'°' Conservation For commercial work,please take your plans directly to the fire department for approval. Section 13 — Owner's Authorization l t� ,jam , as Owner of the subject property hereby authorize ar i,+Q! to act on my behalf, in all matters relative to w k authorized by this building permit application for: (Address of job) lee �l T i e o Owner date L)'r,o nc_ Print Name t i F I Town of Barnstable B1ldlllg - " Re arced on Job antlahis Card MusAe Ke° -' PostTh�s CardSo That it�s Uisible4From the Street Approved Plans tie, apt M, Posted Until FiiiaF=lns ection HasBeen ade •; � i6�4 u 3 p\ ram' ,° F s 1lllhere a Cert�ficateo#Occu an, is Requred,�suchEBuilding shall No#be Occupied until a FinalAnspect�onhas°been made Permit Permit NO. B-18-387 Applicant Name: CUTRONA,M DANIELE&AMY Approvals Date Issued: 02/21/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 08/21/2018 Foundation: Residential Map/Lot 022-055 Zoning District: RF Sheathing: �1 Location: 209 RALYN ROAD,COTUIT � _ k��Contractor Narne Framing: 1 Owner on Record: CUTRONA,G.DANIELE&AMY E. Contractor Licen e" xs � 2 Address: 209 RALYN ROAD �� z •- Est Project Cost: $ 1,000.00 Chimney: COTUIT, MA 02635 R Permit Fee: $85.00 Description: install closets to existing room to create a bedroom.non load Fee PA II, 85.00 Insulation: bearing interior partitions(2x4@16.06) up date smoke detectors Date „ 2/21/2018 Final: Project Review Req: CSCJV\ Plumbing/Gas N y Rough Plumbing: 5 M Building Official o r ?` y u Final Plumbing: This permit shall be deemed abandoned and invalid unless the work a6, ho�hied�%ythks permit is commenced within six monthsilaft ssuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents fo rwh' this permit has been granted. All construction,alterations and changes of use of any building and str ctuf�es shall be in compliance with the local zornng by laws;and codes. Final Gas: This permit shall be displayed in a location clearly visible from access Lreet orroa and shall be maintained open for public mspect1on 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 bythe Building'an Jr Officials are�provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work 4 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 S.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 1 Assessor's map and lot number .................... ......... ......y. .,,. �... THE P�pf tp�y Sewage Permit number .. r .O Z BARNSTADLE, i Housenumber ........................................................................ 9�Cs�MA \0� 1639. TOWN OF BARNSTABLE BUILDING INSPECTOR - � c APPLICATION FOR PERMIT TO f' �. TYPE OF CONSTRUCTION - .......19........ � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to�the �Ifollowing �information: Location ...... ,O /✓„ 1;,.�`J�l � .......`. t! ?�... 0 '�. .............:............ ProposedUse ...Y!! !� ........ ......................................................................................................................................... Zoning District ..........�. ...... ...............:..........................Fire District �`/ Name of Owne,.;<f�N .............. `c:%G�/ wt:.....Address ..... :, �-�� i Nameof Builder .......... /.T............................a.................Address .................................................................................... .Name of Architect ..................Address T Numberof Rooms ..................................................................Foundation ........................................................... Exlerior � :h.'�.:�' ��' ... s7r z� r.........................Roofing ' ,✓� !`� ............................ . ...................: Floors ....................................................................Interior .................................................................................... Heating ..................................................................................Plumbing ....... ......,.;a. ........................................................... Fireplace ..................................................................................Approximate Cost ........ �a ........................................ Definitive.`Plan Approved by Planning Board _________-_ ____-__19--------. Area �'� .........................�................... 0 G Diagram of Lot and Building with Dimensions Fee "...................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH of I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name. .................... .....-..,.... 'r_ ..:-x .....tom_.... �x._-.-...n. �.. .:... ......:a.-. � .._.�...,.u':�.....�..1.. .. _ _.. ..- ... -.. .. 32-55 JOBNSONv \�I0��{ROP.B �\x� ` n ' No2.22,2.0-. Permit for nniId'���g��.-- _ ' Garage . -'--------'-------------'---' ` ^ Location ........2 0.9_8alxoz...Road'------' ' � - c�»tuit � Owner .......YiJltlax�ov J3 . ' 'vp= of Construction` -F � . ' � � (--2ia AIT REFUSED ' __. . .................. 1p ----'r---'' � ------ '`-------~------- ,~^_-~. ---------------^'-----'-'---'' � ------------.----.-.---~---.- � / Approved ---------------- lQ ---------------.------~---. . ---------------------'--^'-^' | Assessor's map and lot number ............................................ THE Sewage Permit number SEM SYSTIM House number ........................................................................ INSTALLED W 66M WMMOITL 6 1?M TAL CODE TOWN OF BARNSTWA G ULATIONS BUKWNGr�l 'ASPEPITOR APPLICATION FOR PERMIT TO .... ........................................................... . ................................. .......................................... TYPE OF CONSTRUCTION .............. ... ... .... ..... ........ ........ ............................................. .............. ........... ?......19.A0 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby aWlies for a permit according to the following information: .. ...... Location ....... ........ ........(.�................ . .....I...... ........ ............................................................ ProposedUse ..�792an ................................................... .......................... Zoning District ........................ .... . ..................Fire District ....C.O.7........................ 42 Name of Own�e ......... .................... ............. .... ......................I...Address .... .................................................. 7 ...... ......... Nameof Builder ........... . ............................0 .................Address ............... ...........................i......................I................. .-Name of Architect ..............Cc............................rr..................Address ................. ............................................................. Numberof Rooms ..................................................................Foundation ............................................................................... Exierior Z... . . ..... .............................Roofing . ....... ................ ....................................................... ............. ... -;< Floors ........................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing ............... Fireplace .. .............................................................................Approximate Cost ........ .......................... Definitiv Plan Approved by Planning Board ------j—-------------------19--------- -277 .2—..Z-- Area ....... ...... ..... 00 Diagr,M Of Lot and Building with Dimensions Fee ... ....................... ............ SUB ECT TO APPROVAL OF BOARD OF HEALTHJ I hereby agree to conform to all the Rules and Regulations of the wn of Barnstable reg�3cling the above construction. ........... ........................................... ....... ......... ... ... 7 JOHNSON, WINTHROP B. No 22220 Permit for ..Build..................... Frame Garage ............................................................................... Location .....2...0.9......R.A...1.yajRqzjd....................... Cotuit ............................................................................... Owner. ...Winthxotp... ............ Type of Construction ...Frame........................... .......... .................................................................... Plot ............................ Lot. .................... Permit Granted May 27 . ...........19 80 .............................. `-Date'oflnspection ....................................19 ,.,Date Completed ................... S. 9 E 5 PERMIT REFUSED .............. .... ....... ............................... 19.. ............ .....................................I............. 6. ................. .................................................. 41 4 i ............ ................................................ .................................................. ............ ApproAe ?4 ................................ 19 40 17 .................14........ ................................................ ............................................................. Assessor's map and lot number .......................................... SewagePermit number .......................................................... �QF?NEt��♦ TOWN OF BARNSTABLE i • i HAMSTAHL i o 9. BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................................................................................................................. tTYPE OF CONSTRUCTION ..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....................................................................................................................................................................................... ProposedUse ............................................................................................................................................................................. * Zoning District ........................................................................Fire District .............................................................................. Nameof Owner ......................................................................Address .................................................................................... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board -----------_______-----------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 .................................................................................. Capewide Development �p `' 1, � � � 19499 mne atory � No ................. Permit for .................................... single family dwelling .............................. . 1164 Location --.���.�..��..�.....�..'...............----. ........................ --.---.--.��:�^,��^.a.=�—. Owner Cammwide Development frame Type orConstruction Plot ............................/Lot ............ ................. Permit Granted 'Au,gus.t...15............19 77 uo,e or Inspection . ' uo,e Completed PERMIT~ . � - lg - � --.------_—.. ~—.—.----.,. � ���������' �................. ....................................... '----'---`--'—^^~^^^^'``—'^^~^''^'—^^~^' Approved ................................................ 19 ' '---------------''-'^`—^^^~-^^^—'` � —'---'-----~^-----^'^---^^^'-^'`^- �& ���