Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0129 SCHOOL STREET
Quo --o��. __ _ __ . _ _ ,� � ��:.:� f �� ��+ ` !� �L 1 � I v � r A �I .. r ] [R02a 072`. # ] LOC10129 SCHOOL STREET TDS 01 CTY ] ] 200 CT KEY] 8422 ----MAILING ADDRESS------- PCA11091 PCS100 YR100 PARENT] 0 PERLMUTTER, CARL J& LINDA R MAP] AREA] 03AB JV] 271280 MTG] 000'0 49 DAMIEN RD SP1] SP21 SP31 UT11 UT21 . 17 SQ FT] 510 WELLESLEY MA 02181 AYB11940 EYB11960 OBS] CONST] 0000 LAND 35400 IMP 84700 OTHER -- —LEGAL DESCRIPTION---- TRUE MKT 120100 REA CLASSIFIED #LAND 1 35, 400 ASD LND 35400 ASD IMP 84700 ASD OTH #BLDG (S) —CARD-1 1 15, 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #BLDG(S) —CARD-2 1 69, 100 TAX EXEMPT #PL 129 SCHOOL ST COT RESIDENT'L 120100 120100 120100 #RR 1433 0083 1272 0170 OPEN SPACE #SR PINEY ROAD COMMERCIAL INDUSTRIAL EXEMPTIONS SALE] 08/95 PRICE] 252000 ORB] 9785/049 AFD] I TE LAST ACTIVITY] 08/28/96 PCR] Y R020 072 . 0 P P R A I S A L D A T KEY 8422 PERLMUTTER, CARL J& LINDA R LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RF 35, 400 84, 700 2 A-COST 120, 100 B-MKT 114, 800 BY 00/ BY ML 1/91 C-INCOME PCA=1091 PCS=00 SIZE= 510 JUST-VAL 120, 100 LEV=200 CONST-C 0 ----COMPARISON TO CONTROL AREA 03AB -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 03AB COTUIT PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 354001 LAND-MEAN +0% 1201001 97665 IMPROVED-MEAN -130-o 250-o ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1000] LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] S R020. 072 . • P E R M I T [PMT] ACT* [R] CARD [000] KEY 8422 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT [B33470] [01] [90] [AD] 100001 [GB] [01] [91] [100] [NEW ] [CO ADD'N ] I SP UPC SM, No. �* NASTIN08, NN �-- - r 7r►./a�d r olc-, a � l a .Y k' R�,���r .7 '4r. fi�•".� s �,iadii'-� .,al:1 UI J114axU Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: FT am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each p Permit.Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All c ❑Re-roof(hurricane nailed)(not stripping. Going over :Re=side, ❑ Replacement Windows/doors/shders U-Value k. { Smoka/Caibon Monoxide rd 0 or„plans marked _ e detecfors 4 flo Separate El ctrici lATir"e^Permits re`q'uired. *.Where iequued:.,Issuance of this permit does not exempt compliance with o --`�-7 ._ Property Owner must sign`Property Owne •anti x ' p "oHome, Imgrom veent,Cn ,re q,�•'��` ta 7,d4.1. .��`a .. )^ .... .w s• .+, ems' C,St�s t.�%...ta' ,syy,L. �`¢Y�"". +vI• X Assessor's office Ust floor): Assessor's map and lot number �n oFtNEtc i v Board of Health (3rd floor): Sewage Permit number ....../ ...-./, ...... �:.: .:........:.... Z BAMSTADLE. i Engineering Department (3rd floor): ��S , oo 039 House number , �0 Definitive Plan Approved by Planning Board _-------------------------------19________ . APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO `—' "' .�. ...... d�l....................................... ........................................................... TYPE OF CONSTRUCTION UU O o..................................................................................................................................... 42. . ...................19... 7n TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location l So— ... O Ca ` .� �.........�=... l .v.... �.....t..° /l.f�...:....................................... ............ ................................................................... ProposedUse .......v..... _......... ................................................................................... f f � v..`.� . . ZoningDistrict ..................................................2........................Fire District ......C�........ ......................................... Name of Owner ., ...... ... ..............1.................... ....5�. Address ....� .../.....5 ... 1 ,ter /3 e Co 1. e. v,�r s lac ......r/V\ ' Name of Builder .... .......`}................................../.................Address ... ......................................... .... .o 7v Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms !............. ....................................................Foundation .............A./.O.......................................................... cd t JrC Exterior .........a._. .......iti!...�".��:............................................Roofing ......... ..g.. .......� .. �.�.n.l r�'� .3.................... Floors .! . :p.'a......................................................Interior SA. .e I �. G /�.`. .................................................... Heating .....................................Plumbing ........................A/.6.................................................. Fireplace ..............Approximate Cost ........ C' O Area .......1..4..G..... .7. ..... Diagram of Lot and Building with Dimensions Fee � Q. o i 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 ..; ,...../.:. ....:., 4".................................. Construction Supervisor's License BURGESS, ROBERT W. A=020-072 � ao�o-ova No .334.70... Permit for .. Build Addition ......Single Family..Dwellinc Location ...12.9...School...Street. .. .. ..................... Cot .................................u...i...t ........................................ Owner .....Robert..W....Burge.ss......... .. Type of Construction ..Frame........................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ....January 19 , 19 90 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT COMPLETED 1/11q L A Z, W TTF_K,,� T 41 m If N, W 0s: N .� h. VV" 41 Ax L Ei,; �jll 7 t4 Fo, 12. 1 qe, ��,A As3es"s6r's office (1st floor): LI F �,7 I S qq t�� C iY �71 P aP F TN E T Assessor's ma and .lot number ..6�-0 ,.QG'C.. P �....... INS'ALLED IN Conn� WQ�� �`o Board.of Health (3rd floor): WTM'I'TLI `O Sewage Permit number ...... .. ........ � ENVIRONMENT �.y:. . pp �e ..••.� �/� ACa'6� -'. ,r._._ : BASa9T4DLE, i Engineering Department (3rd floor): j �' J �a r 'a H ?�q .......`r.:.,�.:.:.... ' TOWN REGi1JWi��.�_ �DMA y ouse number` ......................... ,Definitive Plan Approved by Planning Board ___--------_____________________19-------- . APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00.-2:00 P.M. ^only TOWN �OV . BAR•NSTABLER BUILDING '- INSPECTOR y APPLICATION FOR PERMIT TO ..... .:....La `?........ TYPE OF CONSTRUCTION ......,......VU� �..................................... i ------------------ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to' the following information: Location .............I.�..`2......... .........h a...a. —........5..:�.,...:..,. .1..U l ( �1 .............................................. Proposed Use . 'e tom{ O O/Vi\. .... .. ........ ...... .... ..,.. ..... .. Zoning •District ...............Fire District ......C r".�. ..�. ....;../., �`� ......:.. 1. ..... .......................... a b...�. :� `l.��..........v9�'-$S.:Address ....�.��Z t....!�l- ...o..O. ........ .....................V./_/ Name of Owner - .. . .. Name of Builder .... ... .`}..ti' ', A E-1 Address / �� �n�t5 .I�d �� �� !................... �........ ....... ice Name of Architect ...... ........ ...Address Number of Rooms .............t........:......,....................................Foundation .... . ...... .......................... Exterior ..�l.f.l..Z.A!.. ��.s........ ...................Roofing ......... ..5:. ..... .. .�./�.!... .l.` . J� ..................... Floors .........LA.�. P'.!...................................................Interior �'.........� C`. Heating 1 .G f c%: ..Plumbing A/ 6 :... .................................. :......................:............................... .... Fireplace 11 ....:......Approximate Cost �4 d G' Area ......./4.9... 5. ... Diagram of Lot and Building. with Dimensions Fee' ......... � ................. r, Sc, 6C, 0l S k � i • 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 .. ,� �l..�l..... ... ................... , Construction Supervisor's License .. 1.. 1.1....1.....'......... BURGESS, ROBERT W. Nq .�.�470 ........ �Permit for ....P:�.i.1 d...Addition. . ..... .... .. .... .. -Sing .............. l.d...F.ami.1v. w .-..De.1.1.inq........ .. .. ....... ... ....... . .. ..... % Location .-...1°.2.9....School...Street. .. . .... .. .... .. .. .... 4 ...................... "Co-Euit ................................................................. ............. -A Owner ...Robert -W...Burcfess....................... ......... Type qfkonstru�ction .....F.r a.m.e...................... .. .... .. .. Z' IN- ............. .............................. ............:.................. = �� ,� `• Plot ...................... Cot``._...'........:.................. j Permit Granted ....... anuary..19.,....19 90 ............I....... •..... .. Date. of lrjspection'..7__>_��............:.1.9........... Date -Completed ........ �I-9 r ?OPERTY ADDRESS ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CSTATE LASS I PCS I NH D KEY No. 0129 SCHOOL STREET 01 RF 200 01CT 07/09/95 1011 OD 03A8 R02U 072. _ 8422 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS Y UNIT ADJ'D.UNIT Land By/Date SFte DIW_Asn P ACRES/UNITS VALUE D �ipti J d J TURNER ASSOC INC MAP— LOC./YR.SPEC.CLASS ADJ. COND. PRICE PRICE #LgNp 1 35,400 / CD. FFDe.Ih/Acres E CARDS IN ACCOUNT — 10 19LUG.SIT 1 x .1I =10c 347 59999.9S 208199.97 .17- 3i400 #9LDG(S)—CARD-1 1 15,600 01 OF 02 #9LDG(S)—CARD-2 1 69,100 O S T12(3100 BATHS 1 ,0 U X D= 100 2700.0 2700.00 1.00 2700 U #1PL 129 SCHOOL ST COT MARKET 114800 — NO 8SMT S X . D= 100 7.85 6.12 510 3100—:`3 1 #!RR 1433 0083 1272 0170 INCOME A #SR PINEY. ROAD �SE p pp RAISED VALUE J P OG U � ARCEL SUMMARY AND 35400 S IBLDGS 84700 M I �—IMPS E (TOTAL 120100 N CNST N I DEED REFERENCE TYPa DATE Reco/C.. R I O R YEAR VALUE T Bool, Page Ins" MO Yr.D S.I.s P'" AND 3 5 4 0 C S 3304/082, I111 /92 229000 LDGS 84700 1488/353: 00/00 TOTAL 120100 BUILDING PERMIT S T I M A T E D-8.3 Number Dale Type I Amount LAND LAND—ADJ INCOME USE SP-8LDS FEATURES BLD—ADJS UNITS I 35400 1 1 1 1 400— B33470 1190 AD 10000 Class Consl. Total r B -11 Norm. Obsv. 1 Units L'ni15 Base Rate Atll.Rate A u I Age Depr. Contl. CND L. ^m R.G Fep1 Goal Naw Atll Rapt Value Slorie� Heigh) Rooms Rms.Baths •Fii. P—,.11 F.c 010+ 000 100 100 53.45 53.45 40 60 34 56 100 56 27796 15600 1.0 3 1 1.0 4.0 ph on Rate Square Feel Repl.Cost MITT.INDEX: 1.DD IMP.BY/DATE. ML 1/91 SCALE'. 1/0 1.53 ELEMENTS CODE CONSTRJCTION DEl'AIL 160 53.45 51D 27260 _ F 35 18.71 50 936 N STYLE 09COTTAGE 0.0 *--------------------28-------------------* ESI-GN-A—JMT- -90 ------------ - =XTFR.-WAILS- -01 il a06-fvkME--------(j-=0 EAT/AC-TYPE- -03 E L�CTRI-C --------70-.-0 NTFR.-FITIISH- -00-------------------- NTE-R:LAYQOT- -GT ------------------D-.O NTE-R:OUALTY- -J2 SAXE-AT"EXTFR---7.-0 15 F LDUR ST-WUCT- -00 -------------------0.0 D W ! ! E -L0u-R COVER -00----------- --------- D_0 ------------------ E mlal Area: Au, _ BaSe. .510 ! _T Y PF-... -- U G D-.0 -LET-TRICAL"-" JG ---------__-._ BUILDING DIMENSIONS 2 O BASE -----Ty. D T 8AS N20 E28 S15 W10 S0.5 W13 OU-N-DAT7-0-N- -UO ---------------- - -=9 A FOP E18 NUS E10 SUS W28 � -------- - ___ _________________-- ___ L i - - --NElG 3ORH OD ff37AB-r-QTUIT-------- ------10------* LAND 'TOTAL MARKET ! ! ! PARCEL 35400 120100 5 5 AREA 4439 FOP ! ! VARIANCE +0 +2605 ------ STANDARD 25 zOPERTV ADDRESS I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I STATE Ke CLASS I PCS NBHD y>ro 0129 SCHOOL STREET 01 RF 200 01CT 07/09/95 loll 00 03AB RD2U 072. 8422 LAND/OTHER FEATURES DE SC RIP 710N ADJUSTMENT FACTORS T Land ay/Dale Sze D,mens�on v UNIT ADJ'D.UNIT ACRES/UNITS VALUE Description J S J TURNER ASSOC I N C M AP- / CD. FFDe m/Acres LOC./Y R.SPEC.CLASS ADJ. COND. PE PRICE PRICE BATHS 2.0 U x C= 100 7000.0 7000.00 1_00 7JOU a CARDS IN ACCOUNT — 0 2 OF 0 2 FIREPLACE U x C= 100 3100.0 3100.00 1.00 3100 a i ARKET' 114800 NCOME A SE D , PPRAISED VALUE Ji I 120,100 UI I PARCEL SUMMARY S � AND 35400 TI LDGS 84700 M i 0-IMPS Ei I OTAL 120100 N CNST T I s DEED REFERENCE TYPe DATE R I O R YEAR VALUE S Boots Paq� Incl. MO. Yr IDI S.I..Pnc. A N D 35400 LDGS 84700 OTAL 120100 BUILDING PERMIT S T I M A T E D-8 3 ber Date ' I LAND LAND-ADJ INCO�9E i�SE I SP-SLDS FEATURES OLD-ADJS UNITS Num i ype Amount 10100 C.- Consl. Total Base Rale Atl Rale Year Buill A Norm. Obsv. U nns Unrls I �ALri/r�-� I qe Depr. Contl. CND Loc 4b R G Repl Gosl New A01 Repi Vaiue $tones Heigbl Rpoms Rms.Balba M Fi.. P.rlyw.Il Fx. 01C+ U00 105 105 65.85 69.14 20 70 24 74 100 74 93425 69100.2.0 8 5 2.0 7.0 'rrplion Rale Squ .Feel Repi Cost MKT.INDEX: 1.UO IMP.BY/DATE. ML 1/91 SCALE. 1/UO_79 ELEMENTS CODE CONSTRUCTION DETAIL 100 09.14 727 50265 R REA SINGLE FAMILY DWELLING CNST GP-.00 F 35 24.20 120 2904 .-----15----*---12---* STYLE 10 OLD STYLE 0.0 820 60 41.48 727 30156 ! ! ------- - ------------------------ FOP D_ES_IGN ADJM_T_ UIDESIGN AOJ_U_S_T____ 5.0 10 10 kTER.WALL S _01 060 FRAME 0.a- ! ------------ --------- EATIAC TYPE 04 IL *---12---* 0_0 0.0 23 ! INTR.LAYOUT- -Oi ------------------ 0.0 ! IINTER.QUALTY 02"AME ASEXTER� 0.0 U ___ ! ! FLOOR STR CT DU 0.0 D BASE EYLouR COVER JG ------- O.OI Total aI Areas Au. - Base o 7 i � I - - -------- BUILDING E dOUF TYPE 00 T BUILDING DIMENSIONS .4—* 25 E L E C T R I C A L 00 1 SAS W21 N12 W04 N23 E15 FOP E12 I ------------ 0.0 OUNDAT[ON UO - ---- - A S10 W12 N10 .. SAS S10 E10 S25 � � 99_9 L12 - -- ---------- - - ------ ------------ LAND TOTAL MARKET ! PARCEL *-------21-------X* AREA VARIANCE +0 +0 STANDARD o?6f y3,S �l oFTME ,� Town of Barnstable *Permit#/ �^ Re tics Expires 6 mon from issue date • gulatory Services aw FeeMASS ���s, • atvsrwst,.E, ' ��eg Thomas F. Geiler,Director 1 / Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstabid.ma.us Office: 508-862-403 8 EXPRESS PERT APPLICATION - RESIDENTIAL.ONLY 508-790-6230 MI Not Valid without Red X-Press Imprint Map/parcel Number OCR b d 7cZ— Property Address Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address l/1Il/7/S27 Contractor's Name ` Telephone Nutitber,' Home Improvement Contractor License#(if applicable) / Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: -PRESS PERMIT ❑ I am a sole proprietor ❑ I am the Homeowner AUG 0 have Worker's Compensation Insurance 11 risurance Company Name TOWN OF BARNSTABLE. ✓orkman's Comp. Policy# (/� �IaX y �J opy of Insurance Compliance Certificate must accompany each permit. -rmit Request(check box) pr'Re-roof(stripping old shingles) All construction debris will be taken . ❑Re-roof(not stripping. Going over existing layers of r000 ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value #of doors (maximum.44)#of windows *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. t A copy of the Home Improvement Contractors License& Co r quired. license Supervisors is 'NATURE: i PFILESTORMSIbuilding permit formslEXPRESS.doc ised 070110 i The Commonwealth of- Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 - www.mass gov/dia Workers' Compensation Insurance Affidavit:,Build ers/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/IndividhW): Address: /_q Z�4�i�1�/�1J City/State/Zip: A/(' �2 Phone #: v , [E] i an employer?Check the appropriate box: Type of project(required): a employer with-_ 4. ❑ I am a general contractor and I 6. ❑New construction loyees(full and/or part-time).* have hired the"sub-contractors a sole proprietor or partner- listed on the attached sheet t ?•. ❑Remodeling and have no employees These sub-contractors have 8. ❑-Demolition ing for me in any capacity. workers' comp. insurance. 9. ❑ Building addition workers' comp. insurance 5. ❑ We are a corporation and its red.] officers have exercised their` 10.❑ Electrical repairs or additions a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions lf. [No workers' comp. c. 152, §](4),and we have no12.VRoofrepairsance required] t employees.[No workers' 13.0 Other comp, insurance required.] *Any applicant that cheeks box 11 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this atbdavit 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my erployees Below is the policy and jab site information. Insurance Company Name: // V//1 I z Z -� .Policy#or Self-ins.Lic.#: U '� /�i�, �� Expiration Date: Job Site Address:_ City/State/Zip: ter/ 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 un er the pains and genaltles of perjury that the information provided above is true and correct: Si ature: Date: Phone#: �y Ofcial use only. Do not write in this area;to be completed by city or tmvn official City or Town: - Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5:Plumbing Inspector 6.Other 0 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 Iegal 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 bean 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 wbo 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 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 Tequired. 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 Iaw 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 ur 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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hke 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 'l _ Fax# 617-727-7749 I of T y Town of Barnstable w�,�.�.� Regulatory Services v' MABI Thomas F. Geller,Director ` Building Division Tom Perry,Building Com -dssioner 200 Main Street,Hyamm ,MA 02501 www-town.barnstab le.ma.us- Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Mus t _ Complete and Sign This Section If Using A Builder r' Ci�•�� /��•� // , as Owner of the subject property here by authorize_� to act on my beha]f, in all matters relative to wQIk authorized by this building permit application for. �z9 . '&/vooz. z (Address of Job) .;S g:Gt of Owner ate- Print Name If.Property Owneris applying for permit please complete. the Homeowners License Exemption Form on :the reverse side. Towu of Barnstable ���txa ray - ,,� Regulatory Services i AlA�ucr1R�, . Thnmas F. Geller,Director - *g Building Division Ufa { Tom Perry,Building Commissioner 200 Mam-Street; Ayannis,MA 02601 R".town-barnstable.ma.us Offiac: 508-862-4038 Fax.- 508-790-6230 HOMEOWNER L.ICEl\'SE EXEMPTION Please Print DATE JOB LOCATION: number street village "HOMEOWNER": name borne phone# woric phone# C JRRENT MAILNG:ADDRESS: ety/tawn state ap Cod. The current cxrmption 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 droner acts as supervisor. DEFINMON OF EOMMOWN'ER Persons)who owns a parcel of land on which helshe resides or intends to reside, an which.thcre is, or is intended to- bc, a one or two-fatly dwmll.ing, attached or detaphed structures accessory to such use and/or fans structures. A person who constrgcts more than bne home in a two-year period shzn not be considered a hotneow=. Such "horneowner"shall submit to the Building Official on a form acceptable to 6r-Building Official, that he/she shall be resoogsible for aIl such work performed umdcr the building penait_ (Section I 09.1.1) 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,hclshc understands the Town of Barnstable Building Dcpn-tunent miTirnnm inspoction procedures and rMnir=cnts and that he/she will comply with said procedures and . requirements. Signat&=of Homeawncr Approval of Building•Official Note: Three-family dwellings containing 3 5,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. iimmowmm,9 Exlzm=bN .The Code states rbat Any bomcawncr peforrrang worn for which a building perrnit is required span be excanpt$am the psoyisigns of this secd=.(Scctidn 109.1.1-Licansiiag or wnstvction Supervison);provided that if the homoownrr=gag=a persaff(s)for hire to do such wont that such Hmneti"cr sban act itssupa•visor.- lraay homeowners who use this,czrrsnjption are unaware that they arc assuming the rrspons b ities of a supervisor(sea Appcmdix Q, Rules&Regulations for.Lic=Tint Construction Supc yisoa,Section 2.15) This lack of awa=c=btjan tr subs in serious problems,particularly A=the homeowner hires unlirsased p—^^&' In this cue,our Board cannot proceed against the unlicensed person as it would with In licensed :u'pc visor. The ham;=woa acting as Supervisor is ukt mtely responsible To euura that the bomcawncr is fully'¢ww7p ofhislhrrir-sponsbilitics,many eonumnities requfre as part of the permit application, mat the homcuwncr catify that bclshe undastamds the responsnbiltict of a Supervisor. On the]art page of this issue is a,form currently used by •ecral towns. You may Care t mT=d and adopt such a forni/catificadoo for us.in Your eonmwnity. , t Massachusetts- Department of Puhlic Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 63537 Restricted to: 00 11pl" DAVID R COX PO BOX 401 S YARM:OUTH, AAA 02664 Expira ' n:D58 � Commissioner T ✓0 TOoor�im ,,� o on Office sumer irs i�igess egu ahon License or registration valid for indlvldul use HOME IMPROVEMENT COCTOR Registration- t// before the expiration date. If found return to., dly I . Expiration: 3/2. -- Tie Uftice of Consumer Affairs and Business Regulation Private Corporation 10 Park Plaza-Suite 5170 I ucox. JNCa:, Boston,MA 02116 David Cox I 19 LAVENDER LN'� f W.YARMOUTH, Undersecretary !. Not valid without signatu �.� DAVID-2 OP ID: KG ACUR® CERTIFICATE OF LIABILITY INSURANCE DATE(MMtDD1YYYY) �.,.r 06/29111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements). CNTACT PRODUCER 608-771-1632 NAME: Northwood ins.Agency,Inc, PHONE SO Main Street,Suite 9 508-393-2965 A/C No �> Nod:—..... — --- Hyannis,MA 02601 ADDRESS: _ INSURER(S)AFFORDING COVERAGE INSURER A:Travelers Insurance Comp_!�g INSURED David Cox, Inc. INSURER B_ _...._____..._�.........__...............i -_..._.__ P.O. Box 401 INSURER C: S Yarmouth, MA 02664 - —_ _.___.._._..........— ---- ._...�....__ .....____ 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. _ `- .. .......—_—. _ .._ ..-- —O --T----._._.._._. .__. _...---..... ....................__...----- " """-"�-"--"' ADD $U� i POII Fib PO LICY TEX EXP i INSR( TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY IYYYY LIMITS TR II GENERAL LIABILITY EACH OCCURRENCE $ 1 r0��A0 —I A)viAGE Y25 R'ET1YE0....._.____...� ..____.._........-----...—.__..._ A i COMMERCIAL GENERAL LIABILITY 6801481M796 03114111 I 03114H2 pREMISEsI�aocwrrenea�_ s__.,. _..,., 300,000 -- 1 CLAIMS-MADE X j OCCUR I I MED EXP(Any one person) 8 51000 X Business Owners I PERSONAL 8 ADV INJURY S 1,000,00 GENERAL AGGREGATE I$ 2,000,00 . - ------ i PRODUCTS-COMPIOP AGG $. 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: —_ PRO. _ I I COMBINED SINGLE LIMIT POLICY I LOC S AUTOMOBILE LIABILITY Ea accident + UBODILY INJRY(Per person) E- -----.^ — I ANY AUTO I _PR a aade_n_iDAMAGE --� I — ALL OWNED AUTOSr�� SCHEDULED BODILY INJRY(Per accident) AUTOS NON OWNED I S HIRED AUTOS AUTOS i S UMBRELLA LAB ;OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ DE- D RETENTIONS I $ WORKERS COMPENSATION WC STATU• OTH•, j AND EMPLOYERS'LIABILITY YIN I TQR�,LI $ A ANY PROPRIETOR/PARTNERIXECUTIVE �-} NIA GKUB91OX742211 07/15/11 I 07/15/12 fl L EACH AGCfoENT -- s 100,0001 OFFICERIMEMSER EXCLUDED? �..j ......__. _—_. (nandatory in NH) i DISEASE-EA EMPLOYEE$ 100,006 If yyea,tlesalbe undw E.L.DISEASE-POUCY LIMIT I S 500,000 !,DESCRIPTION OF OPERATIONS below I t 1 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,i/more space is required) CERTIFICATE HOLDER CANCELLATION TOWNBAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS, 230 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE 1 /' �•�,, ��,,yy-� ,�J� I ©1988-2010 ACORD CORPORATION. All rights reserved, ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD R ; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � � Map 010 Parcel o t?Z Permit# iC 6 ! 0 6 Health DivisionA 2 L74 b._J -,tW STRgge&sued a a � G :2- Conservation Division G ° a o� � C ���, 1 Application Fee Tax Collector j �< /o�2 yz/ g Permit Fe Treasurer — µ::, .._ SEPTIC SYSTEM MUST BE �;�'(S;M IN COMPLIANCrr Planning Dept. VM TITLE 5 ENVIRONMENTAL CODE AK Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address I&R S Ct4 oo L Cs T , Village C_crr L7�T' Owner CAQL it Lt► oa PEK.LMt9TmX, Address qo scAvF.tz sT Telephone 6 l? • 23S•• 3►O 1 Permit Request F.Ew%oflr-�,_ -nj o rant o sTi N T3 E mi t _001 vns I r lln o K E- V-1/-IST-92 .S19°TL_ . REPI-RCL Z &MSTIN46 l.c��NDowS Wl plc? Square feet: 1st floor: existing "IL? proposed_0 2nd floor: existing 7&7 proposed n Total new o Zoning District fzF Flood Plain N1A- Groundwater Overlay AP Project Valuation t9,591. � Construction Type woofl FeAimE_ Lot Size . l'2 AC_ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ffi Two Family ❑ Multi-Family(#units) Age of Existing Structure 6o+ Historic House: ❑Yes 29 No On Old King's Highway: ❑Yes Flo Basement Type: Gull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) M' O Basement Unfinished Area(sq.ft) 72-? Number of Baths: Full: existing Z new i Half:existing new 0 Number of Bedrooms: existing_ new Total Room Count(not including baths):existing new S First Floor Room Count Z Heat Type and Fuel: 29 Gas ❑Oil ❑ Electric ❑Other •Central Air: 4 Yes ❑No Fireplaces: Existing I. Newer_ Existing wood/coal stove: ❑Yes 29 No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:Cl existing ❑new size `—' Other: Zoning Board of Appeals Authorization ❑ Appeal# V./& Recorded❑ Commercial ❑Yes Q4 No If yes,site plan review# Current Use st N&k t= C=Nvw i L Proposed Use S/41M BUILDER INFORMATION Name PoGEQs A w%A z, �c =Nc. . Telephone Number -Co V • 42- g • 6106 Address tx3 t o License# L"r+ 15 2 6 zc— Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN 8Y 1MF�G�Wlf3E,2 S _�, SIGNATURE DATE <Z- ' ` FOR OFFICIAL,USE ONLY f r is 1 r —PERMIT NO. r .DATE ISSUED y , I MAP/PARCEL NO. - J ADDRESS ', VILLAGE . OWNER r DATE OF INSPECTION: , FOUNDATION ' FRAME INSULATION ,f FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH 'S " FINAL GAS: ROUGH ',. FINAL , irav iE f i FINAL BUILDING n _ DATE CLOSED OUT ASSOCIATION PLAN NO. = _ The Commonwealth of Massachusetts Department of Industrial Accidents _ Mce 011mestlg2UvQs 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: location: city 4 hene# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. company name. ROGERS & MARNEY. 'INC: .: address: P.O. BOX 310 city.. OSTERVILLE. MA .02655 phone#: (508) 428-6106 insurance co. AMERICAN INTERNATIONAL policy# wt fi751 dFs� I am a sole proprietor, General contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: SEE ATTACHED SHEETS address: phone 9- insurance co. 1701icv comnany name: address: city: phone insurance co. policy ii Yttta - .. ch additionai shet if,ne:essan_ :1• _ - - _ _ _ ;-_ �_: _. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as v.ell as civil penalties in the form of a STOP WORT:ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forts arded to the Orrice or Investigations of the DIA for coverage verifiearion. 1 do hereby eerrify under the pains and pen ies of perjury that the information provided above is true and correct. Sienatur: e4 RQ6FAZS A Its Date /Z• 23 -0 2• Print name lac GOOL. Phonc official use only do not rice in this area to be completed by city or town official ein or town: permit license ti OBuilding Department Licensing Board check ifimmediate response is required Selectmen's Office Health Department contact person: phone At; nOther i Ire,un:;n<PIAI CERT I F' I LATE OF' 2 NSL7RANCE Issue date: 12/16/02 ------------------------------------------------------------------------------------------------------------------------------------ Producer: I This certificate is issued as a matter of information only and confers I no ri ghts upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies below. SOUTHEASTERN INS AGCY � I---------------------------------------------------------------------.---- 641 NIS ST (----------- COMPANIES-AFFORDING-COVERAGE ----------------------- -- HYANNIS MA 02601 ------- Code: Sub-code: I Co Ltr A: CENTRAL MUTUAL INS ------------------------------------------------------------------------------------------------------------------------------------ Insured: I Co Ltr B: ARBELLA PROTECTION HOLCOMB PLMB 8 HTNG F76 Co Ltr C: DAVIDHOLCOMB I------------------------------------------------------------------------- P 0 BOX 170 I Co Ltr D: CENTRAL MUTUAL INS OSTERVILLE MA 02655 I---------------------------------------------------------=--------------- I Co Ltr E: WESTERN SURETY CO ------------------------------------------------------------------------------------------------------------------------------------ COVERAGES This is to certify that 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. -------------------------------------------------------------------------- ------------------------------------------------ -- Co I I I PoI icy I Po icy I Ltrl Type of Insurance I Policy number Ieffictive date (expiration datel All limits in tha ns�ds ---------------------------------------------------------------=----------------------------------------------------- -------------- A I ENERAL LIABILITY I ORDERED I 12/18/02 12/18/03 (General aggregate: Z,000 Commercial general liability General aggregate: gre ( ] Claims made [X) Occur I I I Personalgadvert• ng in9: Owner s 8 contractors Prot I I I (Each occurren ; 11000 I (Fire damag ' 100 I (Medical pense: 5 -------------------------------------------------------------------------------------------------- -------------------------------- B (AUTOMOBILE LIABILITY ► 80035400001 1 12/18/02 1 12/18/03 ICom 'ned I I An pp auto I I I IS' gle limit: I I All owned autos I I I odily injury I I Scheduled autos I I I IilPer person); 100 I I Hired autos I 1 I I odily injury I 1 Non-owned autos I I I I(Per accident): 300 I Garage liability I I I I I I I I ►Property damage: 250 I (EXCESS LIABILITY I I I ! I Each I I I Occurrence A re ate I Other than umbrella form d l I I -------------------------------------- ------------------------ ---------------------------------------------------------- D I WORKER'S COMPENSATIONED 12/18/02 I 12/18/03 IStatutorp I---------------------------- AND 100 (Each accident) EMPLOYERS' LIABILITY I I 1 500 (Disease-policy limit) I I 1 100 (Disease-each employee) E I OTHER 790 1 12 7/02 1 12/27/03 1 L 110 DISHONESTYBOND i I------- ---------- ----------- ----------------------------------------------------------------------- Description of operations/locations/ striction /special items:ANY BING HEATING OPERATIONS ------------------------------------------------------- ---------------------------------------------------------------------------- CERTIFICATE HOLDER CANCELLATION I Should any of the above described policies be cancelled before the I expiration date thereof, the issuingy company will endeavor to I mail 10 days written notice to the certificate holder named to the ROGERS 9 MARNEY INC I left, but failure to mail such notice shall impose no obligation or P 0 BOX 310 1 liability of any kind upon the company, its agents or representatives, OSTERVILLEMA 02655 I------------------------------------------------------------------------- IAuthorized representative; JOAN M MARTIN JA 4/89 Drfy AcvR� CERTIFICATE OF LIABILITY INSURANCE'° s 04/09/02 THIS CERTIFIC TE IS ISSUED AS A MATTER QF INFORMATION PRODUCER ONLY AND CONFERS NO R UHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 11orthwood Ishbaugh Ins. Agency ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. wA05 West Main Street HyarLnis MA 02601 INSURERS AFFORDING COVERAGE Phona1: 508-771-1632 Fax:508-778-1789 wsuRERA: MA3SMST INSU MIXICE INSURES INSURER B: M�C:ARp In INSURER C: Harmon O nP C�c�86ing INSURER D: O>itervillo MA 0265 INSURERE: COVERAGESpERIOD INDICATED THE REQIUIREMENT9TERRMM OR CONDITION OF ANYONTRW HAVI!DEEM ACT OR OTHER WED TO THE INSURED NAMED WITH RESPECT TO NMiCCHTHIS CERTIFICATE MAY BE 18SUrAD OR DING MAY PERTAIN,THE INSURANCE AFFORDED fly THE POLICIES DESCRIBED HEREIN IS SUBJECT TD ALL THE TERMS,EXCLUSION8 AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHO"MAY HAVE BEEN REDUCED BY PAID CLAIMS. WAITS TYPE OF INSURANCE POLICY NUMBER TE M DOlIY DA EACH OCCURRENCE I!lOQOOOO GENERAL LIABILITY , FIRE DAMAGE(Any one fire) I S 50000 A COMMERCIAL CiENERALLIAsltltt ART0360573 D2 i I MED ExP(Any one pere0ni s 5000 CLAIMS MADE 1 OCCUR. X Huaineea Owners 04/01/02 ', 04/01/03 PERSDNAL6ADVINJURY s GENERAL AGGREGATE 2000000 j PRODUCTS•COMPoP GO $ GEN'L AGGREGATE LIMIT APPLIES PER I j O' Loc I CSL 1000000 POLICY ecT AUTOMOBILE LIABILITY COMBIIILD j RVOLE LIMIT s A ANY AUTO CA0082603 04/01/02 04/C1/03 IF" deal f✓ i ALL OWNED AUT09 I BODILY INJURY (Per Pang~) SCHEDULED AUTOS I E HIRED AUTOS { I [BODILY INJURY s NON-OWNED AUTOS I e eaWer PROPERTY DAMAGE I(Per gccK S N i I` -� AUTO ONLY-EA ACCIDENT 3 w►RAOEl1AmLm I _ -- ANY AUTO I j OTHER THAN EA ACC $ AUTO ONLY: ACIG S EXCESS LIABIUtt EACH OCCURRENCE b OCCUR 7 CLAIMS MADE \ I AGGREGATE S - s DEDUCTI9L6 I $ RETENTION S — $ WORKER6 COIYIPENSAT1pN AND TY TORY LIMIT3 ER . EMPLOYERS'LIABILI I ' 822X567-4-02 01/04/02 01/04/03 E.L.EAC H ACCIDENT 14500000 E.L.DISEASE•EA EMPLOYED 5.500000 j E.L.DISEASE-POLICY LIMIT 1 $ 500000 OTHER _ A � Commercial Applica JART036057102 04/01/02i 04/01/03I PROPERTY 25000 A Property Section AART036057102 04 01/02c 04/01/03 , DESCRIPTION OF OPERATIONS/LOCATIOMSNENN;LE&EACL.USICNO ADDED BY ENDORSEMENT78PECIAL PROY1810M9 CERTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER: CANCELLATION R=RS SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE uPIRAr DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL -2.0_DAYS VIRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 80 SHALL Rogers 6 Marney,r IBC. IMPOSE NO OBLIGATION OR L1AVILM OF ANY KIND UPON THE INSURER,ITS AGENTS ON P. 0. Box 310 Outerville MA 02655 RSPREtQNTATIVE9. AUTHORIZED REPR1VMLTYE ACORD 25-6(7197) OACORD CORPORATION 1988 ACo , CERTIFICATE OF LIABILITY INSURANCE izio3jiooz PRODU_cR (518)994-9688 FAX (508)991-5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RUTKOWSKI & KESTENBAUM ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR .414 COUNTY STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I. i )W BEDFORD, MA 02740 INSURERS AFFORDING COVERAGE INSURED Randall C Agnew Electrical Contractors Inc INSURER A: OneBeacon 381 Old Falmouth Rd INSURERB: American Home Assurance Co Unit 32 / INSURER C: Marstons Mills, MA 02648 �/ INSURERD: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION IMITS LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDIYY DATE MM/DDNY GENERAL LIABILITY LW59141 11/16/2002 11/16/2003 EACH OCCURREN $ 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAG ny one fire) $ 300,000 CLAIMS MADE M OCCUR MED EXP ny one person) $ 5,000 A PER NAL&ADV INJURY $ 1,000,000 NERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY ZBXE04239 11/16/2002 11/16 003 COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY $ (Per person) X SCHEDULED AUTOS A X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ h (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR ED CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ -WC STATU WORKERS COMPENSATION AND C568-21-85 06/23/2002 06/23/2003 TORYLIMITS ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,000 B _ E.L.DISEASE-EA EMPLOYEE $ 500,000 E.L.DISEASE-POLICY LIMIT $ 500,000. OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER:' CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL j 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Rogers & Marney Inc General l 1 dl ng Contractors BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Ge BU Ge Box 3Bu OF ANY K 'THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Osterville, MA 02655 AUTHORIZED REgRE4NTATIVE� iACD CORPORATION 1988 ACORD 25-S(7/97) FAX: (508)428-6106 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations S25.00 2S. Building Permit Amendment 325.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x S96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONSIRENOVATIONS OF EXISTING SPACE 3 0& square feet x W/sq.foot'= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.f� , >120 sf-500 sf S 35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building pert:, square feet x S96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x S30.00= (number) Deck x S30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool S60.00 Above Ground Swimming Pool $25.00 Relocation/Moving S150.00 (plus above if applicable) Permit Fee projcosc I r Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 F Home Improvement Contractor Registration Registration: 100134 Type: Private Corporation Expiration: 6/9/2004 ROGERS & MARNEY, INC. Charles Rogers P.O. BOX 310 Osterville, MA 02655 Update Address and return card.Mark reason for change. Address ❑ Renewal ❑ Employment ❑ Lost Card ✓`ce T�anvnzan.�uea�i a�✓�aaaczc�euaelta • Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 100134 Board of Building Regulations and Standards Expiration: 6/9/2004 One Ashburton Place Rm 1301. Boston,Ma.02108 Type: Private Corporation ROGERS&MARNEY,,INC. Charles Rogers 445 WEST BARNSTABLE ROAD ,,� C " Oww _ Osterville,MA 02655 Administrator Not valid without si ature 'F °Tk >°. alt� �✓l / BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 016174 Birthdate: 05/07/1939 { Expires;.05/07/2004 Tr.no: 24057 Restricted: 00 CHARLES D ROGERS' _ ?. PO BOX 310 OSTERVILLE, MA 02655 Administrator r AKE T Town of Barnstable Regulatory Services * saxKsTne . ' Thomas F.Geiler,Director MASS. 9`b 039. �`� g Buildin Division plfD MA'S A 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: Q2 til c%zA- t o Estimated Cost t Q, b 00. • Address of Work: 1 oo" Sr IXECT7 Owner's Name: CA9.1— A L 1140 11 lP£IZ•L.M t7TT`F VZ Date of Application: t 2-Z 3 . 0 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 ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 17 2.a 02.. MAQt XLq, rlG• 10013�1 Date Contractor Name Registration No. • OR Date Owner's Name Q:forms:homeaffidav SCf>'00L_ STREET ` 99.75 CD _. r7-T.'W.r r� 1cl Us ? 9. r�- 70.3 lST•W,f L O- A fr NIC) o� 3z.90 PLAN OF LAND i,"'t'. 5� I N a �371 Bid 4 2i' {� l � f I SCALE : I I NCH= 30 DATE :,TUL/ /9� 199S �H OF MASS SAY SURVEY INC. { ` PAULJ NEWTON MASS. SAWTELLE ' j Nn-470 �� - - RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET cotu�t 73 LAND School 8t, — 20 72 C BLDGS. OWNER TOTAL — LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. rn NickerSon ..,"Robert-F;"SE"DOmtb -P.-r. •,..,--•-- tl6—--ro-41 TOTAL LAND Zieliaski;i�erroi--�: _._._.__.___._ ...._r. b/24/-78— -147b _469. ..�-..., BLDGS. Bur , Robert W. .& Nanny N. 10/23/70 ' 1488 353 TOTAL mw LAND BLDGS. TOTAL LAND 01 BLDGS. TOTAL LAND Ot BLDGS. TOTAL LAND BLDGS. TOTAL 'LAND INTERIOR INSPECTED: /. BLDGS. 1 1� � � lJ_.G�-•t TOTAL -DATE: �_ 6 -- �.� \Y ✓ �J LAND ACREAGE OMPUTATIONS O BLDGS. ND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE LOT LAND CLEARED FRONT O BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND 01 BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL Rn, TOTAL LOW DIRT RD. LAND FOUNUAIIUN tibM1. tk A11-IL PLUMBING PRICING — . - LAND COST nc.Walla Fin. Bsmt.Area 0 Bath Room O Base //�.7 U BLOG. COST one.Blk.Walls Bsmt.Rec. Room St. Shower Bat Bsmt. 20t PURCH. DATE onc. Slab Bsmt.Garage St. Shower Ext. .- _ Walls PURCH. PRICE. rick Walls Attic Fl. &Stairs Toilet Room Roof RENT tone Wells Fin.Attic /Vo Two Fixt. Bath Floors Q isrs INTERIOR FINISH Lavatory Extra smt. 1 2 3 Sink s� Attic 1/2 r/ Plaster Water Cie. Extra EXTERIOR WALLS Knotty Pine Water Only Double Siding Plywood No Plumbing Bsmt. Fin. Ingle Siding Plasterboard Int. Fin. /o p Shingles It _ D. TILING onr c. Blk. G F P Bath Fl. Heat , Face Brk.On Int.Layout114 Bath Fl.&Wains. Auto Ht.Unit 29 Veneer Int.Cond. I JA Bath Fl.&Walls Fireplace ,ZO J!/ {S Com.Brk.On HEATING Toilet Rm. Fl. Plumbing /a Tiling �s' "o) olid Com.Brk. Hot Air Toilet Rm.Fl.&Wains. S Steam Toilet Rm.Fl.b Walls /g 5 /o lanlns. Hot Water St. Shower ket Roof Ins. Air Cond. Tub Area Total , Floor Furn. ROOFING COMPUTATIONS ° sph.Shingle Pipeless Furn. S/ S.F. /0.f U ood Shingle No Heat Q S.F. G .3 O 3/ sbs.Shingle Oil Burner S.F. ° Slate Coal Stoker S.F. Ile Gas S F OUTBUILDINGS ROOF TYPE Electric Gable Flat S.F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED Hip Mansard FIREPLACES S•F• Pier Found. Floor 7,0 Gambrel Fireplace Stack Wall Found. 0.H.Door LISTED FLO RS Fireplace Sgle.Sdg. Roll Roofing onc. LIGHTING Dble.Sdg. Shingle Roof Earth No Elect. DATE r Shingle Walls Plumbing me 7 Hardwood ROOMS Cement 81k. Electric Asph.Tile Bsmt. 102-0-,5'l-/i TOTAL O S Z 3 Brick Int.Finish PRICED Single 2nd 3rd FACTOR REPLACEMENT a' .Pc•s:�c OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. DWLG. 'Alf ,S° Nd / 0 .� S� S y D MCAt 2 3 4 5 6 7 B —9 � can �i aS 6t CCARTHY y R € +esrd t[ial and Commercial Builder r t } 4 :: YI2ATIOlY SPECIALIST ci A 01 October 21,2014 Town of Barnstable Thomas Perry CBO 1<1 .2 Building Commissioner � . -^-a .4:31 r 200 Main Stret Hyannis, MA 02601 _ a RE: Insulation Permits cy: g ' I Dear Mr. Perry, This affidavit is to certify that all work completed for permit application#201404021 at 129 SCHOOL STREET has been inspected by a certified Building Performance Institute(BPI) inspector.All work ~' performed meets or exceed Federal and State requirements Sincerely, Michael McCarthy McCarthy Construction TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map D 20 Parcel 072- Application # Health Division Date Issued 7 Conservation Division Application Fee Planning Dept. Permit Fee Vi Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village 6a A Owner Cyx;� rc rh`r�►- Address �� Telephone Ql -31L>-?13C Permit Request 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 U"" Two Family 0 Multi-Family(# units) Age of Existing Structure V Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.-ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Numkser of�edrooms: existing _new TotaIP-oonF-Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: p❑ Gas ❑ Oil ❑ Electric ❑Other a': c Central Air-L3 Yes 0 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No DetC0hed garage: ❑¥'existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attag-ed garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION - - - _ (BUILDER OR HOMEOWNER) Name Telephone Number Mike McCarthy Construction p Address PO Box 52 License# West Dennis, MA 02670 Cell(508) 280-6964 Home Improvement Contractor# CSL-58633 HIC-169393 Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /V.r SIGNATURE DATE'- �'//B��Y s ., FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE r f• 4ya '"' OWNER _ ' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSSDGIATION PLAN NO. The Commonwealth ofMassachusettr ,,, Department oflndmirid Accidents Office Of bryestigations 600 Washington Street Boston,MA 02111 www.n=s gov/din. Workers' Compensation Insurance Affidavit;Builders/Contractors/Electricians/Plumbers Applicant Information I Please Print Le gib IVT!We- McCarth. Name(ansiness/organizafimgndividlal): P.O Box 52 West Dennis, MA.02670 Address: Cell (�08).280-6964 CSL-58633 IC-169393 City/StatdZip: Phone#- Ar eemployer? Check the appropriate bow Type of project(required: 1. employer with 4. I am a general contractor and I employees(full and/or part-te). * have hired the sub-contractors 6. ❑New construction time).* 2.❑ I am a sole proprietor or partner- listed an the attached sheet 7. ❑Remodeling These sub-cofactors have ship and have no employees 8. []Demolition working for me in any capacity, employees and have workers' [No workers'comp. insurance comp.insurance 9. ❑Building addition # re4mTed] 5. We are a corporation and its 10,❑Electrical repairs or additions officers have'exercised their 3.❑ I am a homeowner doing all work � 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees..[No workers' 13 ther comp.insurance"required..] *Any applicant that ebecks 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 him outside contractors roust submit a new affidavit indicating such, tContractois 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 mast provide their workers'comp.policy number. lam an employer that is providing workers.'compensation insurance for my employees. Below is the policy and job site information.M Insurance Company Name.- Policy#or Self-ins.Lic.#: rf j�lL —fd,-�ol,�'�6G' I Expiration Date: ,7/I'7�ir Job Site Address: low 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$1,50-0.00 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 time Office of Investigations of the DIA r insurance coverage verification I do hereby certify t p and penalties of perjury that the information provided ab is tree and correct Si atnn-e: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town ofjiciaL City or Town: Permit/License# Lo uing Authority(circle one): Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector Cther ntact Person: Phone#: Massachusetts Department of-Public Safety Board of Building Regulations and Standards Construction Supervisor Lice nse: e. C -058633 w S MICHAEL J MCC , R PO BOX 52 x: W DENNis MA 626'7Q, ( y F �e51 Expiration Commissioner 04/10/2016 n / Office of Consumer Affairs and Business Regulation 10 Park Plaza - u S ite 517 0 Bosto n, Ma ssachusetts us efts 0211 b Home Improvement Contractor Registration Registration: 169393 r Type: Individual Expiration: 6/16/2015 Tr# 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY P.O. BOX 52 WEST DENNI A 0267 Update Address and return card.Mark reason for change. scA i r, zone-osn i [� Address Renewal Employment Lost Card R acoRo� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°DmrYY) ��. 10/16/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 01962-001 NOoNNTACT i AME: Bryden&Sullivan Ins Agcy of Dennis Inc (508)398-6060 �a`C.No.: (508)394-2267 PO Box 1497 ;EMAIL . ...._ .._ ... ----' -"-- .. So Dennis,MA 02660 DORESS: __._ •_.. __...... __..._._ __ A.I.M.Mutual Insurance Company 33758 INSURED SIIREfi B __- Michael McCarthy Construction Inc P 0 Box 52 West Dennis,MA 02670 IN_&8E8,L_INSURER F I 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 CONDIT!CNS OF SUCH POL!C;ES.LIMITS SHO'A'N MAY HAVE BEEN REDUCED BY PAID CLAMS. IN R -._. ... . AD L�UBR r POLI ---T-- — -- - - - ----._.... g p g Cy gp� AID y��p ---- LTR - TYPE OF INSURANCE INSpR I WVDi_ _ POLICY NUMBER (MM/D0/YY1"!) MLI°NID�/YWY) LIMITS - ._ I _..- GENERAL LIABILITY ! I EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY I I DAMAGE TO RENTED I CLAIMS-MADE I OCCUR 1 I !MED EXP(Any one person) S i"PERSONAL�ADV INJURY' $ I GENERAL AGGREGATE i $ GENT AGGREGATE LIMIT APPLIES PER: ! I rPRODUCTS-COMP/OP AGG '$ - PRO- i POLICY J_E.CT LOC I..._ ^- AUTOMOBILE LIABILITY I I COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJU )INJURYDILY (Per person $ - -- ---- - ALL OWNED !SCHEDULED ~ i !AUTOS AUTOS BO RY(Per accident) $ — HIRED AUTOS 'NON-OWNED I PROPERTY DAMAGE !AUTOS UMBRELLA LIAB I :OCCUR ! LEACH OCCURRENCE $ - —--- -- EXCESS LIAB CLAIMS MADE i :AGGREGATE 1 $ I DED RETENTION $ ! S WOoRKERgCory�P�NSg7�oN j --- - -- I X LTORYLArdITS .._. '0 (— AND EMPLOYERS LIABILITY ------- A PROPRIEIQR/PARTNE R�E ECUTIVEr I'NI' I I E L.EACH ACCIDENT $ $QQ,000•QQ A o� Ic M M R X LUDED Y'LIN/A! VWC-100 6017656-2013A 17/17/2013 7/17/2014 r - - -- — "---- -- " (Mandator,,in NH) -- j E.L.DISEASE_EA EMPLOYEE S 500,000.00 Ye dd sY��bb �1det I --�---------- ..... ;.OtSsCRIf�t10N VnF OPERATIONS below I F E.L.DISEASE POLICY LIMIT 500,000.00 �. .. _.. DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION TOWN OF SANDWICH Attention: BLDG DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN HALL ANNEX THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sandwich;MA 02563 ACCORDANCE WITH THE POLICY PROVISIONS. . AUTHORIZED REPRESENTATIVE _�� -3Ica 33�� 157485 OWNER AUTHORIZATION FORM M (Owner's Name) owner of the property located of 12� .act-+00` (Property Address)- (Property Address) �hereby authorize _ L/ C, , (Subcontractor) i an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building , permit and to perform work on my property: Owner' Si ature 7 " Date A Y '2,0 2014 - �! :.,;; '~ RESIDENTIAL PROPERTY l MAP NO. LOT NO. t FIRE DISTRICT SUMMARY 1 STREET School St. Cotuit 73 LAND 20 72 C BLDGS. OWNER TOTAL J,3 LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. Bickersall r."Robert._F -:'b°Dorot :F..-�,._.,,-.F.�,.,:� .,. ,a.._2 23 -h6---441 -422— TOTAL 3 p� LAND Zielinski"F`Berol-Bi "" _ 6 24 70- •14 -"46 rn BLDGS. AV ss, Robert W. & Nancy N. 10 23/70 1 353 � - a 0 0 0 TOTAL ? -4 0 0 LAND d .O CG�Sw 6 So 0 al BLDGS. TOTAL 4 4LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND O1 BLDGS. TOTAL LAND INTERIOR INSPECTED: 1 { "Fr 1q;i �./,' I ^' BLDGS. TOTAL DATE: �j 7--�" LAND ACREA E COMPUTATIONS BLDGS. ND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE 'LOT Y,2°10 0 0 0 6 -7 o o LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR a) BLDGS. WASTE FRONT TOTAL REAR LAND OI BLDGS. TOTAL LAND BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND �3 5 ROUGH TOWN WATER BLDGS. S HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND FOUNDA I III UN H!bM 1. & A I I IC HLUMBING PRICING ' Conc.Walls Fin. Bsmt.Area %0,, Bath Room LAND COST Base • Conc.Blk.Walls Bsmt. Rec. Room St. Shower BathM aO 7 r-{S BLDG. COST Bsmt. . PURCH. DATE Conc. Slab Bsmt.Garage St. Shower Ext. Walls , PURCH. PRICE . Brick Walls Attic Fl. 8 Stairs Toilet Room Roof • RENT Stone Walls Fin. Attic I Two Fizt. Bath Floors 3 U Piers INTERIOR FINISH Lavatory Extra ' Bsmt. F 1 2 3 Sink I sf�! OT 1 /• s/4 1/2 '/4 Plaster Water Clo. Extra Attie / EXTERIOR WALLS Knotty Pine Water Only Double Siding Plywood No Plumbing Bsmt. Fin. NNNN Single Siding Plasterboard Int. Fin. W&py,Shingles TILING C � - Conc. Blk. G F P Bath Fl. Heat 2d/O Face Brk.On Int.Layout Bath Fl.&Wains. Auto Ht.Unit ohs Veneer Int.Cond. Bath Fl. &Walls Com. Brk.On HEATING Toilet Rm.Fl. Fireplace + �/(�p t/3 t•Plumbing f— �'tf t7 J 77I Solid Com. Bra. Hot Air Toilet Rm.Fl. &Wains. — s _ Steam eAA.,* Toilet Rm.Fl.&Walls Tiling ��j' Blanket Ins. Hot Water St. Shower �Z Roof Ins. Air Cond. Tub Area Total . Floor Furn. ROOFING COMPUTATIONS Asph. Shingle Pipeless Furn. - 577 S. F. Wood Shingle No Heat r7 S.F. / 9,U 0 .2 k U Asbs. Shingle Oil BurnerCo A-J . .z J S. F. 7.00 Slate Coal Stoker S. F. Ti le Gas ROOF TYPE Electric S. F. OUTBUILDINGS Gable Flat S. F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED Hip Mansard FIREPLACES S. F. Pier Found. Floor �j Gambrel Fireplace Stack ASdg. 0. H. Door LISTED FLOORS Fireplace Roll Roofing - Conc._ LIGHTING -44 Shingle Roof No Elect. DATE Pine Plumbing Hardwood ROOMS ElectricAsph.Tile Bsmt. 1st {/Z TOTAL 7 O Int. Finish ED Single 2nd 3rd FACTOR -+-RF1 REPLACEMENT -- OCCUPANCY �JCONSTRUCTION SIZE AREA AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. ,2 0 03 1 ao 900 2 3 4 5 6 7 B 9 It _ 10 TOTAL -3OPERTY ADDRESS ^------------ r o------ 01 29 $C H OO L STREET ZONING I DISTRICT CODE. SP-DISTS.I DATE PRINTED I STATE pCS I NBHD 01 R F 200 D 1 C T CLASS KEY NO. LAND:OTHER FEATURES DESCRIP 710N ADJUSTME NT FAC TORS T 07/09/95 1D11 JU J3AB RD20 072. 8422 Lantl 9yr0ale siee D�men.�on UNIT ADJ'D.UNIT / cD Ff_De /A-c es BLOC./YR.SPEC.CLASS ADJ- COND. pe PRICE PRICE ACRES/UNITS VALUE Description J J T U R N E R'ASSOC -I N C MAP— BATHS 2-0 U X C= 100 7000.0 7000.00 00 7J00 a CARDS INAC66UNT — FIREPLACE u 1. C= 100 3100.D 3100.00 . 1.00 3100 a 02 OF 02 ARKET . 114800 A NCOME D USE JI APPRAISED VALUE UI I I I PARCEL SUMMARY a T AND 35400 LDGS 84700 M ' O—IMPS NOTAL 120100' -r 9N C N S T T I I t DEED REFERENCyE Ty DATE M ReCpfQhy —� R I OR YEAR VALUE .S I - Boot, Page l Inst. AID.y,iDl smea Pt:co r A N D - 35400 �BLDGS 84700 OTAL 120100 I ' I BUILDING PERMIT S T I M A T E 0-8 3 I LAND LAND—ADJ INC ONE "probe, Dela o Amoont WSE SP—SLDS FEATURES! BLD—ADDS U.41TS 10100 .Class Uonss Untas Base Rale Atli Rale Yer era,-Built No,m Obsv. "'juy I Age D¢P� ,'COntl CND Loc %R G I RePI Cpsl New Atll RePI Value $t�i,es Meigbt Rpp.ns Rms 0albs •Fig. Pert O1C+ GJO 105 105 65.85 69.14 20 70 24 74 100 74 93425 691.30 2.0 8 5 2.0 7.0 'option Rate S4ua,e Feel Repl Cpsl MKT:INDEX: 1.J C - IMP.BY/DATE. ML 1/91 SCALE. 1/0 D.7 9 100 0 9.1 4 7 2 7 5'D 2 6 5 R $ A R E j ELEMENTS CODE CONSTRUCTION DETAIL F-Ur' 35 24.20 120 SINGLE FAMILY DWELLING CNST GP:00 29J4 +-----15----*---12---* _ 100LD STYLE 820 30156 1 STYLE 60 41 _48 727 ! FOP ! - -------------------------- DES IGN ADJMT 01DESIGN ADJUST 5.0 10 10 XTER.W Al:LS J1 OOD fRAkE----- Q 0 EAT/AC TYPE J4 IL 0.0 12---* I7VT�R.FINISH 00 ---- -- - -- 23 1 0.0 _cE lll - p_0 ILNTER_QU_ALTY 02�AME AS EXTER_. 0_0I FLO ---- D IW 6>�5E U 2 a7RJCT JO� D.QI E TQIaIA,aas 120 Bese 727 rrLJO_ CJVER__ JO - 0_0I BVILDING DIMENSIONS _ R 0O F T Y?E oo - 0-0i T SAS 'd21 N12 W.04 N23 E15 FOo *4 * 25 tLECTRICAL _u0 - -----_ 0.01 q E25 ! OUYOATION O0 S10 W12 N10 BAS'S10 E17 S25 _ --- 9q_9 ----- --------------------------- LAND TOTAL MARKET PARCEL *-- 21-------X* AREA VARIANCE +0 +0 STANDARD ?OPERT\'ADDRESS .j - ZONING I DISTRICT CODE "SP-DISTS.j DATE PRINTED(STATE pCS j NBHD IDENTIFI ATION Nl 0129 SCHOOL STREET 01 RF 200 01CT CLASS KEY NO. LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T a 7/O /95 1 01 1 00- 03 A 8 R 02 0. 072. 8422 Lana BylDale sloe D�men.on v E UNIT ADJ'D:UNIT ACRES/UNITS VALUE Descr;Puon _J $ .J 'TURNER ASSOC INC M A P— / eD. FF De InrAcres LOC./VR.SPEC.CLASS ADJ. CONE). P PRICE PRICE [3ATHS 0 1BLDG.SIT 1 x .17 =10 347 #LAND 1 35P400 _ CARDS IN ACCOUNT 59999.9 Z08199.97 .17 35400 #BLD,G(S)-CARD-1 1 15,600 01 02 1 _0 U X #3LDG(S)-CARD-2 .1 69.100 SLO T 0 00— D 100 2700.0 2700.00 .1.00 2700 3 NPL 1.29 SCHOOL ST COT1ARKET 114800. �- NO BSMT. S X o 100i 7.85 6.12 510 3100-3 L 11RR 1433 0083 1272 0170 IINtOME A i kSR P -INcY . ROAD 0 i APPRAISED "VALUE ' J. A 120,100 SI ARCEL SUMMARY T AND 35400 b ' LDGS 84700 M , i' —IMPS N I I I (TOTAL 120100 11 .CNST RE FERENCE D EF T DEED E ENCE - DATE T RIOR YEAR EAR VALUE Book Page fin W. MO. vr.D Sales Price S AND I 354 OG 4/83 0 .08 2- -I1 1 /9 2 229000 LDGS 84700 . 1488/353: b0./00 TOTAL 120100 I BUILDING PERMIT ESTIMATED-331 j• - Number Dale Ty,- I meunl� LAND LAND=A DJ INCOI+IE 35400 1�5E j ' SP—BLDS FEATURES 9LD—ADJS UNITS l CIa55 Is s . 400-Atl- l RePI Velue ES3lor3ee4 H7e0p nr Roo1rr/rs90 . AD ia. 10000 Unn5 TP tlIae A A9e R CPtl U1D+ 00G 100 100 53:45 DqP RG I ow F.c. 56l 100` 56 27796 156a0 . 1_0 3 1 1.0' 4.0 :Plion A... Souare Feel Repl Cosl MITT.INDEX: 1.0 V IMP.BY/DATE. ML 1/91 1/o 1.53 �SS SCALE: ELEMENTS CUDE CONSTRJCTION DETAIL 100 53.45 510 2 7260 J J fvY 35 18.71 50 936 N STYLEESTG 09 OTTA-- 0.0 3 *--------------------28-------------------* ESTGN-AtiJ;9T- -J0 ----- ! =X7FR-,;J WLCS- _0 114 00-D-fVXME------- U=0 ! ! EAT/AC-TYPE- -03 LE_CTRI-C`---- --- � U.- 0 INT-ER.FIWrSH- -00' ---- ---------- NTcR-LAYGOT- UT --------------- ! I(GTE-R:17UAL-TY- -J2 SAXE AS--EXTFR'_ TT=O ! 15 L00R STYUCT Qa w I -U.0 cF L0-J"R COVER-.. -00 E Tnlnl Arens Aua . ! U�a SO Hn,e . SIC OOT--TYP-E---- I)C ---- --- ------ ---- T BUILDING DIMENSIONS 20 BASE -L`cTTRI-CA-L- JG ------------- 8AS N2' E28 S 1 5 ' _16-S05 w13 U:0 0U7V'D ATlON- - --U0 - ---------A FOP E18 NOS E1O SU5 w28 - -- -9--.-9 L ! -----NEI-THSORH OD ff3AB-T-QTUIT-------- *------10------* LAND TOTAL MARKET ! PARCEL 35400 120100 5 5 AREA 4439 ! FOP ! ! VARIANCE + ! 0 +2.605 , I -----"-- ------------ STANDARD------------- 25 1 7 a RESIDENTIAL PROPERTY MAP NO. LOT NO. STREET FIRE DISTRICT School St. SUMMARY 20' Cotuit ,T2 OWNER C 73, LAND _ BLDGS. TOTAL RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: LAND Ot BLDGS. Nickerson; �tober -F; $e' OTOt}ly-P:=---�_- 2 ty5 -641--422— TOTAL � _ - - b/24/7,0 -147b -"g- --- LAND Burg a,, Robert W. b Nanny N. 10/23/70 ' 1488 353 OlBLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. TOTAL .INTERIOR INSPECTED: ' LAND ` - .DATE: 7— / _ �J�✓ V � t`�.l BLDGS. 6 TOTAL ACREAGE OMPUTATIONS LAND L;ND TYPE # OF ACRES PRICE BLDGS. TOTAL DEPR. VALUE Ol HOUSE LOT TOTAL CLEARED FRONT LAND REAR a BLDGS. WOODS&SPROUT FRONT TOTAL REAR LAND WASTE FRONT BLDGS. REAR TOTAL LAND BLDGS. TOTAL LAND BLDGS. ' LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH gb FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH BLDGS. TOWN WATER 1 Parcel Detail Page 1 of 4 THE t �.:*t-_•u_ 0 ++ a NtA55. c634. gi yd Logged in As: Parcel Detail Tuesday,May 14 2013 Parcel Lookup Parcel Info Developer Parcel IDLot 020-072 Location F15 SCHOOL STREET I' Pri Frontage JK Sec Road JPINEY ROAD I Sec 7 Frontage 170 Village COTUIT -� I` Fire District —TUIT I Town sewer exists at this address NO .._�«. . . .I Road Index 1433 Y I Asbuilt Septic Scan: Interactive 020072_1 Map $� f Owner Info Owner!PERLMUTTER,CARL J& LINDA'R I Co-Owner'; I' Streetl 140 SEAVER ST#7 I Streetz City IWELLESEEYO ) state EAJ zip 02481 Country!_J f I,w Land Info Acres 10.17 I Use jZti Hses MDL-01 I zoning RF ". I lghbd'0110 Topography I Level I Road ,Paved Utilities IPublic Water,Gas,Septic I Location Construction Info Building 1 of 2 Year Rooff Ext. WooBuilt 1940 struct(Gable/ Walll d hin le J�12 — Living r454 I Roof As h/F GIs/Gm ac Central _ � 1 � Area Cover p Type L Be style lColonial I wall Drywall ( Rooms'3 Bedrooms sMi Model I Residential DTI nt Floor Hardwood Bath Rooms 3 Full J Grade jAverage Plus Heat Hot Air Total 6 Rooms I 2 Type Roomseaund _ - Stories 12 Stories ( Fuel GasI F ation' PouredConc. Gross 2301 Area " Building 2 of 2 Year�1920 Roof Salt Box Ext Wood Shingle, Built Struct Wall http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=900 5/14/2013 . Parcel Detail Page 2 of 4 �. Living Roof s{`� -'-` AC Area 560 Cover°^"ph/F GIs/Cmp I Type None Style(C� e I Drywall ottag `� wau Dll I Bed .1 Bedroom I I Rooms20 1 Model Residential I tnt Carpet I Batn 1 Full _I • Floor Rooms PTO; Grade AveTotal 2C rage I Type Elec Baseboard I Rooms 3 Rooms I. a Heat Found- S_ 12 Stories�1 Story I Fuel Electric I ation.Conc. Slab r Gross l864 I Area Permit History.. .__.._ Issue Date Purpose Permit# Amount Insp Date Comments 12/27/2002 Remodel 66106 $19,584 10/19/2003 12:00:00 AM 1/1/1990 Addition B33470 $10,000 1/15/1991 12:00:00 AM CO ADD'N Visit History Date Who Purpose 6/15/2012 12:00:00 AM Jeff Rudziak In Office Review 3/30/2005 12:00:00 AM Paul Talbot Meas/Est 10/9/2003 12:00:00 AM Martin Flynn Bldg Permit Completed 9/5/2003 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 11/9/1999 12:00:00 AM Paul.Talbot Meas/Listed-Interior Access 1/15/1991 12:00:00 AM ML Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 8/15/1995 , PERLMUTTER, CARL J&LINDA R 9785/049 $252,000 2 11/15/1992 J&J TURNER ASSOC INC . 8304/082 $229,000 3 10/23/1970 BURGESS, ROBERT W&NANCY N 1488/353 $0 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2013 $195,400 $20,500 $1,100 $262,600 $479,600 2 2012 $185,700 $20,600 $800 $320,906 $528,000 3 2011 $211,200 $0 $0 $320,900 $532,100 4 2010 $214,600 $0 $0 $320,900 $535,500 5 2009 $220,600 $0 $0 $1.87,500 $408,100 6 2008 $222,900 $0 $0 $209,200 $432,100 8 2007 $222,300 $0 $0 $209,200 $431,500 9 2006 $214,700 $0 $0 $192,600 $407,300 10 2005' $188,900 $2,300 $0 $124,300 $315,500 y 11 2004 $138,200 $2,300 $0 $124,300 $264,800 12 2003 $115,200 $2,300 $0 $62,000 $179,500 13 2002 $115,200 $2,300 $0 $62,000 $179,500 14 2001 $115,200 $2,400 $0 $62,000 $179,600 15 2000 $94,800 $2,300 $0 $35,500 $132,600 http://issgl2/intranet/prbpdata/ParcelDetail.aspx?ID=900 5/14/2013 •• ee .e '.e -ee a ee • ••. ee '.e '.e -ee a ee e •• :� ee '.e '.e gee a ee ••, ' •e eee '.e '.e • :ee • :ee •• ' •e eee '.e '.e • :ee • :ee •• a .ee '.e '.e ee �. :ee •• e ee '.e '.e ee ee ••e a ee '.e '.e '.� ee � ee •:• a ee '.e '.e ee ee • ee e e ee :ee •• ' • ee '.e '.e e � :ee • •:. ' • ee '.e .e a :ee t P, „♦+ r .F-r ///1!t r <@Ic-•,•...v., Wt> ,�` *'�` Af .+'•1;p , "",.r�+�` "�"' _" „ Spa r+ �� !;. Ew+ �"t., �.I12�.�t]I � Y ,rS. _„�^1 YY''.^'•�r��r��m�-d. �.- ..r.«« � i �}r'r.' ' -,''"" ��i yam. � ': -• , :.n�yY �,��`,o�"�. ��.` ':.�"p�`^�,` ��. ham.' '.(j A.r "A`''#•s ••Tw.+y �:�,1 ��''i'!!� � �«k$` rK �S '� ►�) r �!y�rw+� ���. '� .+• ° AW Rp ......,.ram.,,...-. '-` _ 'rr..�...w'rayc.._. _S� ' I 1 • e ` =�A1LJIflIwLa�lJs,wJYYFJId6a..+�.iia�i�iN J..ali'IaLu.r.r P v.� •�yY� T��� �iW�!'.Yua. W' \YiL�tf��lyggYars��ia: ��� rl rt� � ..:.,�C- S .-. '.Fi'.,S��i}�1 r r ry7�•.�- �'�,r'�,v`}. a�„� t� -,f 2.�p,Ys,[5 �Y �� •,} "`_.....--" *`��'i����`iy�(MA-_r+•t �� i4'�,"�'°` RESIDENTIAL PROPERTY MAP NO. LOT NO. ` FIRE DISTRICT SUMMARY STREET School t S • Cotuit 73 LAND N C 20 72 OWNER C 01 BLDGS. oj' L S TOTAL 33 LAND RECORD OF TRANSFER DATE sK Pc I.R.s. REMARKS: O BLDGS. Nickerson Robert F. & Dorot T. ^ TOTAL .,.. 2 23 �6__ �6�,1- -422-_ 6 24 70 - 1.47 69 3 °i LAND Zielinski Karol B: - BLDGS. rn BU•--Pss, Robert W. & Nancy N. 10 23/70 14.0 353 a o Fo o ^ TOTAL / S G 0 4 LAND O CGvS6v SO U BLDGS. I� TOTAL LAND O1 BLDGS. TOTAL LAND BLDGS. ^ TOTAL FLAND O INTERIOR INSPECTED: 1 l al DATE: + � ACREA E COMPUTATIONS 1--AND TYPE #C OF ACRES PRICE TOTAL DEPR. VALUE ^ TOTAL HOUSE LOT 5/,z"10 0 0 0 6 7� o (o 7 0 o LAND CLEARED FRONT BLDGS. REAR ^ TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL err LAND zs/ a`tj BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH qb FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND 03 5 ROUGH TOWN WATER rn BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT,RD. LAND DUNUA I K.) tibM l. tk A I I IL NLUMUING , PRICING alb LAND COST Fin. Bsmt.Area Q Bath Room O Base /� ,—� 0 • . COST k.Walls BLDG Bsmt. Rec. Room St. Shower Bat Bsmt. cj PURCH. DATE Ib Bsmt.Garage SC. Shower Ext. Walls illsPURCH. PRICE Attic.Ff. &Stairs Toilet Room RoofRENT , � � .• ' Ills Fin.Attic ^/6 Two Fixt. Bath - loors U - INTERIOR FINISH Lavatory Extra F Sink r Plaster Water Clo. Extra - Attic ERIOR WALLS Knotty Pine Water Only. tiding Plywood No Plumbing Bsmt.Fin. iding - Plasterboard - Int. Fin. O ' Shingles t;Nlt iz TILING /t/d S t• G F P Bath Fl. Heat On Int.Layout Bath Ff.&Wains. Auto Ht.Unit ag Veneer Int.Cond. Bath Ff.&Walls Fireplace k.On HEATING Toilet Rm.Ff. 2D Plumbing m.Brk. e Hot Air Toilet Rm.Ff. &Wains. � ` Tiling 0 !S 1 Steam Toilet Rm.Fl.&Walls 'g ✓r io S 1 / p' Ins• Hot Water St. Shower dz/ Air Cond. Tub Area Total Floor Furn. ROOFING COMPUTATIONS single Pipeless Furn. ' S/O S.F. single - No Heat 0 S. F. G single Oil Burner S.F. Coal Stoker ' S.F. Gas 'OOF TYPE Electric S.F. OUTBUILDINGS Flat S. F. 1 2 3 4 5 6 7 B. 9 10 1 2131 4 5 1 6 7 8 9110 MEASURED Mansard FIREPLACES S. F. Pier Found. Floor Fireplace Stack Wall F01! ound.' , /1 FLOORS eplace � �� 0.H.Doer LISTED Fir Sgle.Sdg. Roll Roofing LIGHTING No Elect. Dbl..Sdg. Shingle Roof yl ' Shingle Walls Plumbing DATE 'd ROOMS Cement Bik - ———. Bsmt. 1st Electric 7• t ile TOTAL .2-Jssi�� Brick Int.Finish PRICED 2nd 3rd FACTOR REPLACEMENT - OCCUPANCY .CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.De .S p• ACTUAL VAL. - /Ud S zs SG 0 a FOUNUATIUIV t35M'1. tk ATTIC PLUMBING PRICING LAND COST , Walls Fin. Bsmt.Area O Bath Room Base a0 ctC� BLDG. COST Blk.Walls Bsmt. Rec. Room St. Shower BathM Bsmt. Slab Bsmt.Garage St. Shower Ext. PURCH. DATEWalls PURCH. PRICE Walls Attic Fl. &Stairs Toilet Room Roof - Walls Fin.Attic / Two Fixt. Bath RENT _ Floors 3 CJ INTERIOR FINISH Lavatory Extra j F 1 2 3 Sink �5 �! O.4 PI, Plaster Water Clo. Extra Attic TERIOR WALLS. Knotty Pine Water Only e Siding Plywood No Plumbing Bsmt. Fin. MMM Siding Plasterboard Int. in. pp.Shingles TILINGCJC&- yd L_. Blk. G F P Bath Fl. Heat ark.On Int,Layout Bath Fl.&Wains. Auto Ht.Unit Veneer Int.Cond. Bath Fl.&Walls Brk.On Fireplace } //i7 0 43 .. .._1 HEATING Toilet Rm. Fl. t Plumbing i- �cfp rf .7 77) —� Com. Brk. Hot Air Toilet Rm.Fl. &Wains. - Steam 60A..,Ji Toilet Rni.Fl.&Walls Tiling at Ins. Hot Water St. Shower �� •�' ' Ins. Air Cond. Tub Area Total Floor Furn. ROOFING COMPUTATIONS Shingle _ Pipeless Furn: 577 S•F. Shingle No Heat s/J S. F. I /•U 0 .2 Y 5 U Shingle Oil Burner Co c2 J S.F. ;o p �' u Coal Stoker S.F. Gas ROOF TYPE Electric S. F. OUTBUILDINGS Flat S. F. 1 2 3 4 5 1 6 7 8 9 10 1 2 3 4 5 6 7 8 9110 MEASURED Mansard FIREPLACES S. F. Pier Found. Floor )Tel AV- Fireplace Stack Wall Found.' 0.H.Door LISTED FLOORS Fireplace - Sgle.Sd I _� LIGHTING g' Roll Roofing \ Dble.Sdg. Shingle Roof No Elect. I DATE Shingle Walls Plumbing Nood ROOMS Cement Blk. Electric -7- ^17K .Tile Bsmt. 1st y{/� TOTAL A 7 b p Brick Int. Finish Fr.ICED le 2nd 3rd FACTOR REPLACEME ' OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dap. PHYS. VALUE Funct.DeD• ACTUAL VAL. LG. i. 07"'��I Ste— ? -2 ,k 7 TOTAL NEW SMOKE DETECTOR REQUIREMENTS ARE NOW Lz\W. EVEN THE ADDITION OF A u NEW BEDROOM WIL L TRIGGER AN . UPGRADE OF THE SMOKE DETECTORS FOR THE WHOLE HOUSE. YOU MUST PLAN ACCORDINGLY AND HAVE YOUR. ELECTI ICIAN TAKE OUT THE APPROPRIAT' ' + PERMIT AT THE FIRE DEPARTMENT. 6 SMOKE DETECTORS O.K. ' �� - _I _ ,cam•,.,,.r= ; � �� BARNSTABLE BUIL.plNCy DEP " "A,N'(,/%L TI31H,VAIJIT'l� t 1• l •� O M fj+p'T-O VL''4?'r01 L -"'v-- i •PA.In�e AcL. LVOs',t�.-•1C�K i(, r�C'CE1411.a -Jt,,, •11JS�'<•L.1_ ' EYaO.�C A:=—4. � i C'EFL l'C=--•---• __ TILES "PIEPLAZC- W j 1,2' - - - 't ;ataPu�D Cs rr-2:Icr..z FrE :$Ital>=e1oP Gn_Jtt r✓,R�•r Vi(Au.tuSr/-e••.J..t_ 0 'i Pco Y1MR t'f?.�a Qg r nl j �,':FKh3�! c La TVs Cp P L LLar• AL'L:G••/EGA 6i Je,T. � � % C1i8T" " 1-I<f'r• � , n i �Irc+� �a. • ' •7AIl.IT:l1•�T-1rL:lOL� G ��( � j'�^(--n-Ii,1� i�i.:•r;•n:' �•AnlD6P�E� 'YW344�. l _I_�. .� -EizTC�IrJ� K1Tc'la'_4-,' ' I ._• I j •Pnl:•a rin�l-c clFr l Aj' 71;.v. F�.V::,>�1.� :• Q !1 I Exls j- "�EDa'ao ► I'.przovJr+� I,�°cry'P.' >?i 11�1'p-LP..Ior GicicL._. .�,-_.J•,o..c_ I11�-l=i.)Oc� I 1 I .6vrI�LL 'O ,"Ayl�r U ' i Wln.[�'JH'S1-Iv►T.L•rL�, .. . !- '--•--r - . GL,O,.:G._sra �%,.� .: � �' - .FIt<,L'I?LYl_..SI-LJWc'f,_' 4%?J'';3G•'• % { �:.ti'-{-.' ,.I'•• sU•v� �.. SHGY+L:.k: W/5E4'1• Qn�',•1_7G . • 2' 3 3 of..^TJ 2-�_ t-yL� (� C�fLA,:, 77c, �!1 _ _71 t� �!�'fE�'--H�T+i—,I�---p :+I _ �__y. �I ,Y m3� � � .e• v L .E-5S 1s F'Ot2�t-t I �' .J+c.<o1-IaLro•C 'PL rZ)r-)Fi I 2ti3"F-IGT. D2E•:<�u.:;•-_.___-_ 1. ,/'.: F r �- MAS r-z i3ti i^n.•a ,I �•� C°ISd '. ..I H� , NATI-71 i460VLTn1M i., A� V __ (,rYJINI � ' + ' � `47-^C W�FO F�•1! c__..... t 27 PGA cs" --- _i__ II n 1�1IDE''y% Tom` 4 . � ��.�• IJ�j.1l .r1.o. � � - - ...... .. _ St_cbNt�-. r _ � 'Pl��t`t. a v --- -_._ .. I. .T'F{CtV l vf:.61' '•.12t_C.E�5c� I:Iv- ur2I=S FLY 11G•rn-c�u t3 t?. I oo3.tZl.ioos.wl 1 ��3 f�F.�?'•'•: -50 GA{- .Pl�1?C.1 Ill-ICi-1{'Gi.:: OLI' fr.-...1� r•.l /�:�! r FL.;,? j 1=1XTLJeI?ice J!('SIJI'i'=1)iiS AT ALL NE(,J GLf�ar•(�� 3r 72U•/1DC.'Nu7�>!_iL-i. T-Ia1J/L-I C..I-!Tj4-4EAj- L4i-lw /�T PA71-.lr:'.7,-'Irl. .. . eF". P1=4•i r�L S".�ti". i'i Ca- (:j i jl i�Li:COr2 .j:IG r' LGo'� (:jr(:.J 't=i�( 1.1 rl i"(vLlo-_I•? 1 oG' SI-bWE=G? 5.. G ft••1:a•lL.� ri:V r.::_ uiN, r.l.a—e. h('tL>l:'r•4r I,.i.. T(FI` •c5,: '.J1:-J1"T:.I-IG •C 1!'tA j 7 cr•l+�:. '�`! 6..Peo,1}�L: 5pi1.!!L 1.. ATSI S«r�l� 1. L' PI;O VJ���.N:_L.:.Pas%F�•: 'Q�•,bfr-1L::J 1!.�L^LJL-,^...P.P.Ov1.Dc tl-'�PA1�lEL boors. �,•r'• ��?sco . .. - �-ALiYJ roCE: :=,Mo-t'f7-1.:..•4 �;vr�.4• Ar`i.11_1:T�F-r. 1�.3". THIL/:_:.or_ ' P11 E. Th- IoS•3 SWh.FGr A5 el\ • '1. �C-L .�i`•il=.c�.:' TI'.. 1:1.1:-.�:". .'r .a•y516LC= ... .' . . - � l- V KJ�>IOPI•�,.WIn/L•0li•1' .`_' �•?4?.•..5.1Zi:''� .. . . -