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0124 CLIFTON LANE
of N C{ - ate L 0 o u 0 0 0 r ��� 1 �= 12�f oz, 99�� w�� 40- 0 e kk 44 4 411 tow, IS 11/14/14 Thomas Perry, CBO Town of Barnstable Building Division 200 Main St Hyannis, MA 02601 RE: Insulation Permits Dear Mr.Perry, This affidavit is to certify that all work completed for insulation work at 124 Clifton Lane ,(application#201401049) has been inspected by a certified Building Performance Institute(BPI) Inspector. All work performed meets-or exceeds Federal and State requirements. Sincerely, Conor McInerney ConserVision Energy CD tier kxi r" 376 ROUTE 130,SUITE C SANDWICH,MA 02563 508-833-8384 WWW.CONSERVTODAY.COM 1uST CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT ( DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES 1875 Route 28•Centerville, MA 02632-3117 1926 508-790-2375 x1 • FAX: 508-790-2385 John M.Farrington,Chief Martin O'L. MacNeely, Fire Prevention Officer Craig E.Whiteley,Deputy Chief Francis M. Pulsifer, Fire Prevention Officer September 19,2008 Mr. Thomas Perry- Building Cornmissioner4 Town of Barnstable t 200 Main Street Hyannis, MA 02601 Dear Commissioner Perry: Pursuant to MGL Chapter 148 Section 28A, I am making you aware and request your interpretation of construction of an apartment without pennits at: 124 Clifton Lame . Centerville, MA zf ,Vhile'on'alsale and transfer inspection at this address, I observed an apartment in the basement of the structure. The apartment has separate entry, full kitchen, bath and J one room suspected as a bedroom. No permits are on file for this address to construct an apartment and no upgrade to the fire alarm system has been done. We are holding the certificate pending your interpretation. Please contact me with any questions you have relative to this situation at 508= 790-2375 Ext.l. Thank you for.your attention,to this issue. - .Sincerely, Francis M. Pulsifer Fire Prevention Officer +.)( T lam. 1..lt'rE Cc: Robin Aiidei•bn :,j>c ri .,�:.,. ;. ? "Commitment to Our Community" Bk 23207 Ps204 4W-52743 10-10-2008 c1i 01 = 17cf QUITCLAIM DEED KNOW ALL MEN BY THESE PRESENTS that we, JANKEL CYKER and SIMA CYKER, husband and wife, as tenants by the entirety, of 124 Clifton Lane, Centerville;MA 02632, for the consideration paid in the sum of$255,000.00, grant to RICHARD M. PAIGE AND JOAN M. BERGLUND, husband and wife, as tenants by the entirety, of 6 Nichols Street, Salem, MA 01970, with QUITCLAIM COVENANTS, the land,together with the buildings thereon, situated at 124 Clifton Lane, Centerville,Barnstable County, Massachusetts, more particularly bounded and described as follows: SOUTHERLY by Clifton Lane Seventy-five and 04/100 (75.04) feet, more or less; and EASTERLY by Lot 30A, One Hundred and 00/100 (100.00)feet, more or less, as shown on the plan of land hereinafter referred to; and NORTHERLY by Lots 27A and 28A,a total of Seventy-five and 00/100 (75.00) feet, more or less, as shown on said plan; and WES 1'ERLY by Lot 26A One Hundred and One and 82/100 (101.82) feet, more or less, as shown on said plan. Said parcel contains 7,570 square feet more or less, and is shown as LOT 29A on a plan of land entitled "Re-subdivision of a Portion of Block `i;'' (comprising Lots 1131 through H-49 inclusive) at `Craigville Beach Estates', West Hyannis Port—Barnstable-Massa Property of Alfonso Cannata"; dated May 26, 1953, Bearse & Kellogg, Civil Engineers, which plan is recorded with the Barnstable County Registry of Deeds in Plan Book 118, Page 123. Said premises are conveyed subject to and with the benefit of all rights, easements, appurtenances and restrictions of record, insofar as the.same are now in force and applicable. For Grantor's title see deed from Doris A.Marotta recorded with Barnstable County Deeds in Book 3563, Page 9.4. Bk 23207 Pg 205 #52743 `.4 WITNESS our hand and seal this day of September, 2008. JANKEL CYKER �� 00`000ISS6$ :SU03 OT718$ ;aaj `� MM :*3a0 ESL :4143 �� �/ T C� WaLMO e BOOZ-0I-OT :84Da ---- S0330 30 A`ISI93H A1NO03 319VISHSVU SIMA CYKER XVI 3SIOX3 MVIS Sl13SnH3VSSVW COMMONWEALTH OF MASSACHUSETTS S.S On this a �day of ,2008, before me, the undersigned notary public, personally appeare JA KEI,CYKER, proved to me through satisfactory evidence of identification, which was a driver's license, to be the person whose name is signed on the preceding or attached document, and acknowledged to me a he signed it v tarily for its stated purpose. ' Notary Public My commission expires: BEVERLY""MAN MY COMMISSION#DID 516436 �;. EXPIRES:Apri130,2010 BondedThmNotaryPublkk7ndemMtors COMMONWEALTH OF MASSACHUSETTS SS On this_ _day o 4CK!?tR, 2008, before me, the undersigned notary public, A personally appeared SI proved to me through satisfactory evidence of identification, which was a driver's license, to be the person whose name is si 7 ed on the preceding or attached document, and acknowledged tome t. she signed ' voluntarily for its stated purpose. F � e�,FAL Notary Public '= '/1'f CO Y = ' �1MISSIO Qm sion expires: E�XPlRES.-AA+-302010 , 6 `----.-�_�nrruNc�aypuWtc �Rderw+Ye� BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 10 10-2008 0 01:17pm Ct1P: 754 Doc'v: 52743 Fee: $581.40 Cons: $255r000.00 2 BARNSTABLE REGISTRY OF DEEDS J APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 00MA U-) 3 60 Telephone Number Address 319 641yr-GS L/V License # Oq q-S� 6A&NjT0 Home Improvement Contractor# 62(3 4 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO w(w- M V1"C rc SIGNATUR DATE 101011A TOWN OF BARN�TABLE BUILDING PERMIT,APPLICATION.. t e T Map arcen Application Health Divisi61 on - `1 / Date Issued Conservation Division Application/fee Planning Dept. Permit F Date Definitive Plan Approved by Planning Board Historic OKH Preservation/Hyannis J L Project Street Address / Cl� Village Owner �G��' A re 7 Telephone 2_(�ro ",PScf>.5 � ( rcdopd_ �r,Permit Request 0 Square feet: 1 st floor: existing : proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ( '.. Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ 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 Number of Bedrooms: 3 existing _new v Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ n8W size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 1K?` Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ `-0 ~'s Commercial ❑Yes ❑ No If yes, site plan review# - urrent Use Proposed Use © a, APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telepho e Number 3 Address b Lice se # 2� me Imp oveme CoV 2v y Z y orker's C mpe sationG J ALL CONS T UCTIO DEBRIS R JNG FROM HIS ROJECT WI TAKE 1 ��Jd✓ e SIGNATURE DATE v y FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED } MAP/PARCEL N0: ADDRESS VILLAGE • t OWNER > DATE OF INSPECTION: FOUNDATION I FRAME INSULATION i -� FIREPLACE ELECTRICAL: ROUGH FINAL I PLUMBING: ROUGH FINAL 1 GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT R ASSOCIATION PLAN NO. ,i - NMIZN IZL - -� ----�x �-- 17 �_._ M w p cao Y If , k_ Y I _ I , t i f n I C -Ec cd - 5- !Massachusetts- Department,of Public.Safet) Board of Buildinl-Regulations and Stxnda►-ds Construction Supervisor License 4 Licenser cs 44383 Restricted to: 00 DONALD J PIRES 379 BRAGGS LN BARNSTABLE, MA 02630 - Expiration: 2/26MI01, C unuuisiuncr Tr#: 77 a I DATE(MMIOOrYYYY) ACORD CERTIFICATE OF LIABILITY INSIURANCE 1010200e THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Cowan Insurance Agency,Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 359 Main Street ALTER THE COVERAGE AFFORDED BY THE! POLICIES BELOW. Haverhill MA 01830 INSURERS AFFORDING COVERAGE —_ NAIC# INSUReD PIres Construction Corp. INSURER A InSUranae Company of the State Of Pa. 379 Eiraggs Lane INSURER B: INSURER C: — Barnstable MA 02630 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANC5 LISTED BELOW HAVE BEEN ISSUI 0 TO THE INSURE D' NAMED WI ABOVE FOR CT THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERT1FlCA'TE MAY BE 155VED 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. INSRT. OD' POLICYEFFECTIVE POLICY EXPIRATION' LIMITS POLICY NUMBER DCTELD EACH OCCURRENCE $, GENERAL LIABILITY DAMAGE TO RENTED COMMERCIAL GENERAL LIABiuTY r MI,SE�(Ea�ccl+reocell— S CLAIMS MADE ❑OCCUR MED EXP(Any one Par%?n $ PERSONAL&ADV1N�URY S GENERAL AGGREGATE, S GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCT$•COMPIOP AGG $ POLICY PRO- LOC — AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY -- (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY 8 (Per'Accident) NON-OWNED AUTOS PROPERTY DAMAGE — — — (Per seddeni) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN .EA ACC $ AUTO ONLY: AGO $ i;XCESSIUMBRELLA LIABILITY EACH OCCURP,.ENCE — 8 D OCCUR ❑ CLAIMS MADE AGGREGATE — $ $ DEDUCTIBLE RETENTION b X wC STATU- oTH- WORKERS COMPENSATION AND T,DBr I IMITS_— I PR A EMPLOYERS•LIABILITY WC5877222 08124ID8 08124109 E;L.EACH ACCIDENT 9500,0)0 ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER F,XCLUDED7 Yes E.L.DISEASE;EA EMPLOYEE 3500,000 It dea6riDe under IG tAL PROVISIONS a E.L.DISEASE-POLICY LIMIT S SOO,ODO OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEM ENT I SPECIAL PROVISION$ 508 362 9001 Carpentry contractor. Donald Fires is excluded from coverage. CERTIFICATE HOLDER CANCELLATION SHOULD An'Y OPTHE ABOVE DESCRIBED POLICIES BECANCIELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 PAYS WRITTEN 367 Main St NOTICE TO THE CERTIFICATE HOLDER EP TO TH LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIr�ATION OR LlABI� OF ANY KIN; PO THE INSURER,ITS A®ENT9 OR Hyannis,MA 02601 REPRESENTATIVE$, AUTHORIZED REPRESENTATIVE ACORD 25(2001f08) @ ACORD CORPORATION 1988 �.JVVG/VVJ 10/07/2008 10:57 FAX 508 362. 9001 K1NL1N GROVER BARN 'Taws-of Barnsta Re ato Services g fl ry _ BAN246TARM Tfiomas P.Gettrr,.Ur&tor MAM Tom it' Buffdink Cottiti stoner 200 Mai-&rer,%Hyannis;MAt 02601 www.town.b arnstable.ma.us A Office: 508-8624038 Pax: 508-790-6230 Property OvnerMust Complete and, Sign This Section If using--A Builder holder of Power of Attorney for the Z, Natasha C Lisman, Esquire ,' erf 4subject property, 'Jankel and Siena Cyker, hereby authorize Donald Pires to act on my behalf, in all mattett-telati�ve to'Work authorized by this btulding,perrriit apPlt r.cation fo 124 Clifton Lane, Centerville, MA (Address_of Job) Copies of their Powers of Attorney are attached IO 7 o r Date. Natasha C. Lisman Prise Name i-f Pmp¢rty Owner is.,.applying-for pernut-please cornplete the H me*awwners Leese Exempt onvDorm on tl�e:1 verse side. O:FORMS-OWNERPERM ISSION 10/06/2008 09:24 6175234001 SUGARMAN ROGERS PAGE 02/10 q TO: Donald Pires FROM: Natasha C. Lisman, Esq., as holder of Power of Attorimy fur Jankel Cyker and Sima Cyker(copies attached) RE: Work at 124 Clifton Lane, Centerville, MA DATE: October 6, 2008 This is to authorize you to do the agreed upon work on,the lower level of the above- referenced property ("the Property"), at the cost of$1,000.00 or less. Please be advised that the holders of title to the Property, Jankel Cyker and Sima Cyker, no longer use it as their primary resideue;C as.they have permanently moved to, and established legal residence in, Deerfield Beach, Florida. is is 10/07/2008 10:57 FAX 508 362. 9001 RINLIN GROVER. BARN WJ uuziuua R. ' Town-of Barnstable °• Regulatory Services n.,„S,.. Tbesna9 '.Gxilet' Director µlCt �YlI3 �i31g'Divisiaa ' Tom Perry,$uildiagCottmissioner 200 MaiafStree%Hyannis . A.02601 www.tow n.b arras tab I e.ma,us Office: M8-8624-038 " Fax: 508-790-6230 Property Owner Must Complete and, Sign This Section If Uri A Builder,, holder of Power of Attorney for the ), .,Natasha C,. Lisman, Esquire ,asrbvmer of the subject pt perty, "J nkel and Sima Cyker, hereby authorize Donald Pires to act on my behalf, In alI marten iela&e to work authorized by this;bading:perra.applteation fora .124 Clifton' Lane; Centerville,' Mk' (Address;of Job) Copies of their Powers of Attorney ire attached ; a rt Date. printNairle "Natasha C. Lisman --If Pm Rz pwner-is-applying for-perr t-p�lease c-c'pje.teAhe— Homeowners LiEM. se-Exempti4an-Form or1 #-e re verse s"ide. Q:F0RMS_0WNERPER:MISST0N DURABLE POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS that I,Jankel Cyker, of Centerville, Massachusetts, do hereby constitute and appoint Natasha Lisman, of Watertown, Massachusetts, to be my true, sufficient and lawful attorney, for me and in my name and for my use to perform the actions hereinafter set forth from time to time. 1. This durable power of attorney shall become effective immediately and shall survive my subsequent disability or incapacity. 2. I hereby authorize my attorney to sell, convey or lease any real property I may own, or any part thereof, for such price and on such terms as to my attorney shall deem meet and proper,to negotiate and bargain with respect to such real property,and to sign,seal, execute, and deliver any and all instruments,and to do and perform every act and thing whatsoever requisite and necessary therefor;to sell,transfer, and deliver any and all of my personal property, including stocks, bonds, or other muniments of title, and to sign,seal, execute;and deliver any and all papers or instruments necessary,proper,or convenient therefor,and in my name and for my use to make subscriptions for stocks,bonds, or other securities, or to purchase the same,and to collect dividends,profits, or any income whatsoever belonging to me;to vote stock owned by, me and to appoint proxies;to make,execute and deliver any checks,notes, drafts, leases, assignments,and agreements which my attorney may deem necessary or appropriate to protect my interests; to endorse any checks,notes, or drafts payable to my order, and in my name and stead to collect any and all claims and demands of every nature and description which I may now or hereafter have against any person, persons, or corporations whatsoever, and on my behalf to sue for any and all sums of money now or hereafter due me or for any right that I may now or hereafter have in any court of law or equity, and in my name and for my behalf to appear and answer and defend any action or actions or suits,either in law or in equity, which may be brought against me in any court or courts, onto which I may be a party. I hereby also authorize my attorney: a. to submit any matter in dispute to arbitration,to settle, adjust,or compromise all claims and demands in which I am or may in the future become interested;to have access to all safe-deposit boxes in my name or with respect to which I am an authorized signatory,and to add to or remove from the contents of said safe-deposit boxes; " b. to make gifts which are excluded from gift tax under Sections 2503(b) and 2503(e) of the Internal Revenue Code to such members or member of my family(including my attorney)as my attorney may select;to make gifts to such charitable organizations exempt from tax under Section 501(c)(3) of the Internal Revenue Code as my attorney may select provided that the total amount of such gifts in any one year do not exceed twenty percent(201/6) of my federal adjusted gross income in such year;to execute gift tax returns with my (husband/wife)electing to split gifts as provided in Section 2513 of the Internal Revenue Code; e to disclaim any gift,devise or bequest given to me, or any interest in any trust established for my benefit; c. to appoint one or more substitutes to exercise any power contained herein, and to revoke any such appointment at any time; to employ such legal counsel as my attorney may deem advisable in connection with any matters or proceedings; d. to apply for,pay premiums on and maintain any policies of insurance on my life;to apply dividends on any such insurance to pay premiums thereon;to exercise all rights of ownership over any such insurance, including, without limitation,rights to assign, borrow upon,pledge or surrender such insurance,to change beneficiaries or to convert it into paid-up insurance; e. to apply for,pay premiums on,and maintain any policies of insurance which my attorney may deem advisable, including, without limitation, accident, health, hospitalization and medical coverage,and insurance against loss of or damage to any property, real or personal, at any time belonging to me; in the event of any loss, damage or expense thus insured against,to apply for recovery or reimbursement under any such insurance policies and to agree to the determination of the amount of such loss, damage or expense as my at may deem advisable; f. to execute and file,on my behalf,any applications, certificates or other instruments which may be required by law to obtain medical,hospitalization, convalescent or nursing care or any other benefits or public assistance provided by any governmental agency, including,without limitation, any benefits under the Federal Social Security program; and to execute and file on my behalf any applications,certificates or other instruments which may be necessary or appropriate to obtain my admission to any institutions,public or.private, for medical treatment,hospitalization, and convalescent or nursing care or otherwise for my health and welfare; g. to pay any obligations or liabilities incurred by me or incurred by my attorney in the exercise of the powers conferred hereunder,including,without limitation, such expenses as to provide for my comfortable care, maintenance or support and any medical treatment,hospitalization, and convalescent or nursing care which I may require, in a private room, or otherwise; 1 h. to borrow money from any lenders but without my attomey's individual liability therefor, and as security for such borrowing to mortgage or pledge all or any part of my estate,real or personal,upon such terms as my attorney shall deem advisable, and no lender shall be responsible for the application of the proceeds;to guarantee the repayment of the notes of any, person or entity; i. to execute and file any tax returns, including, without limitation,any income tax or information return required by the laws of the United States or any State or the 2 f District of Columbia;to execute and file such protests, affidavits,claims for abatement,refund or credit,bonds,powers of attorney,petitions,appeals to a District Director of the Internal Revenue Service,to the United States Tax Court or otherwise,compromises and agreements, including closing agreements, as my attorney may deem advisable;to execute and deliver receipts and discharges for any sums refunded and waivers and agreements extending the time within which any taxes may be assessed against me,waiving any restriction, consenting to any taxes or any assessments or collections,or for any other purpose in my interests;to employ such legal counsel as my attorney may deem advisable in connection with any matters or proceedings relating to any such taxes and to execute such powers of attorney to any such counsel as may be required; and j. generally,to do all acts and take all steps which in the judgment of my attorney are necessary, convenient,or expedient in the management of my property and affairs, whether or not the power to take such steps is specifically granted herein, it being my intention to give my said attorney full power and authority to act for me in relation to my affairs, business, and property as fully and with like effect as I could act"if personally present. 3. In the event of my disability or incapacity,my attorney may transfer any of my property or properties to fund any inter vivos trust which I have created and which is still in effect, including any trust of which my attorney may be a beneficiary. 4. The power of attorney granted herein shall continue in effect until it is expressly revoked, either by myself or,in the event of my disability or incapacity,by my duly appointed conservator or guardian in accordance with the provisions of Chapter 201 B, section 3(a), of the Massachusetts General Laws. 5. If for any reason(Attorney) should fail or cease to serve as my attorney,then (Successor Attorney),of(City/County/2)County,Massachusetts, shall become the successor attorney hereunder. 6. In the event that protective proceedings are instituted at any time in any court of the Commonwealth of Massachusetts to appoint a conservator, guardian of the estate,or 3 guardian of the person forme, I hereby nominate(Attorney),of(City/County/1) County, Massachusetts, for consideration by the court for appointment as such conservator, guardian of the estate,or guardian of the person,as provided by Chapter 201B, section 3(b), of the Massachusetts General Laws. t 7. All references in this durable power of attorney to the Internal Revenue Code shall be deemed to refer to the Internal Revenue Code of 1986, as amended, and as it may be amended from time to time after the execution hereof. All references in this durable power of attorney to particular sections of the Internal Revenue Code shall be deemed to refer to and include any successor provisions thereto. Where the provisions of any section of the Internal Revenue Code are to be applied by my attorney pursuant to the terms of this durable power of attorney,my attorney shall apply the provisions of such section as are in force on the date of their application. 8. I hereby reserve the right to amend this instrument in any particular and to revoke it in its entirety at any time that I am not disabled or incapacitated. WITNE S WHEREOF, I have hereunto set my hand and seal this day of , 2006. y Jankel Cyker COMMONWEALTH OF MASSACHUSETTS --Q- ss• k5v--5�1 2006 nlC�.( .jkp' Personally appeared before me the above-named,personally known to me to be the person who executed the above instrument, and(he/she)acknowledged the same to be (her/his) free act and deed. Aoo' bli My commission expires: To rw- 94 s 4 DURABLE POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS that 1, Sima Cyker,of Centerville, Massachusetts,do hereby constitute and appoint Natasha Lisman, of Watertown, Massachusetts, to be my true, sufficient and lawful attorney, for me and in my name and for my use to perform r the actions hereinafter set forth from time to time. 1. This durable power of attorney shall become effective immediately and shall survive my subsequent disability or incapacity. 2. I hereby authorize my attorney to sell, convey or lease any real property I may own, or any part thereof, for such price and on such terms as to my attorney shall deem meet and proper,to negotiate and bargain with respect to such real property,and to sign, seal,execute, and deliver any and all instruments,and to do and perform every act and thing whatsoever requisite and necessary therefor;to sell,transfer, and deliver any and all of my personal property, including stocks,bonds,or other muniments of title,and to sign, seal, execute, and deliver any and all papers or instruments necessary,proper;or convenient therefor, and in my name and for my use to make subscriptions for stocks, bonds, or other securities, or to purchase the same, and to collect dividends,profits,or any income whatsoever belonging to me;to vote stock owned by me and to appoint proxies;to make,execute and deliver any checks,notes, drafts,leases, assignments,and agreements which my attorney may deem necessary or appropriate to protect my interests; to endorse any checks,notes,or drafts payable to my order,and in my name and stead to collect any and all claims and demands of every nature and description which I may now or hereafter have against any person,persons,or corporations whatsoever, and on my behalf to sue for any and all sums of money now or hereafter due me or for any right that I may now or hereafter have in any court of law or equity,and in my name and for my behalf to appear and answer and defend any action or actions or suits, either in law or in equity,which may be brought against me in any court or courts,or to which I may be a parry. I hereby also authorize my attorney: a. to submit any matter in dispute to arbitration,to settle, adjust, or compromise all claims and demands in which I am or may in the future become interested;to have access to all safe-deposit boxes in my name or with respect to which I am an authorized signatory,and to add to or remove from the contents of said safe-deposit boxes; b. to make gifts which are excluded from gift tax under Sections 2503(b) and 2503(e) of the Internal Revenue Code to such members or member of my family(including my attorney)as my attorney may select;to make gifts to such charitable organizations exempt from tax under Section 501(c)(3)of the Internal Revenue Code as my attorney may select . provided that the total amount of such gifts in any one year do not exceed twenty percent(20%) of my federal adjusted gross income in such year;to execute gift tax returns with my (husband/wife)electing to split gifts as provided in Section 2513 of the Internal Revenue Code; to disclaim any gift,devise or bequest given to me,or any interest in any trust established for my benefit; c. to appoint one or more substitutes to exercise any power contained herein, and to revoke any such appointment at any time; to employ such legal counsel as my attorney may deem advisable in connection with any matters or proceedings; d. to apply for,pay premiums on and maintain any policies of insurance on my life; to apply dividends on any such insurance to pay premiums thereon; to exercise all rights of ownership over any such insurance, including, without limitation, rights to assign, borrow upon, pledge or surrender such insurance,to change.beneficiaries or to convert it into paid-up insurance; e. to apply for,pay premiums on, and maintain any policies of insurance which my attorney may deem advisable, including, without limitation, accident,health, hospitalization and medical coverage, and insurance against loss of or damage to any property, real or personal, at any time belonging to me; in the event of any loss, damage or expense thus insured against,to apply for recovery or reimbursement under any such insurance policies and to agree to the determination of the amount of such loss,damage or expense as my attorney may deem advisable; f. to execute and file, on my behalf, any applications,certificates or other instruments which may be required by law to obtain medical,hospitalization, convalescent or nursing care or any other benefits or public assistance provided by any governmental agency, including,without limitation,any benefits under the Federal Social Security program; and to execute and file on my behalf any applications, certificates or other instruments which may be necessary or appropriate to obtain my admission to any institutions,public or private, for medical treatment,hospitalization, and convalescent or nursing care or otherwise for my health and welfare; g. to pay any obligations or liabilities incurred by me or incurred by my attorney in the exercise of the powers conferred hereunder, including,without limitation,such expenses as to provide for my comfortable care,maintenance or support and any.medical treatment, hospitalization, and convalescent or nursing care which I may require,in a private room,or otherwise; h. to borrow money from any lenders but without my attorney's individual liability therefor, and as security for such borrowing to mortgage or pledge all or any part of my. estate,real or personal,upon such terms as my attorney shall deem advisable,and no lender shall be,responsible for the application of the proceeds;to guarantee the repayment of the notes of any person or entity; i. to execute and file any tax returns,including,without limitation,any income tax or information return required by the laws of the United States or any State or the 2 . u District of Columbia;to execute and file such protests, affidavits, claims for abatement,refund or cred it, bonds, powers of attorney, petitions, appeals to a District Director of the Internal Revenue Service,to the United States Tax Court or otherwise, compromises and agreements, including closing agreements, as my attorney may deem advisable; to execute and deliver receipts and discharges for any sums refunded and waivers and agreements extending the time within which any taxes may be assessed against me, waiving any restriction, consenting to any taxes or any assessments or collections,or for any other purpose in my interests; to employ such legal counsel as my attorney may deem advisable in connection with any matters or proceedings relating to any such taxes and to execute such powers of attorney to any such counsel as may be required;and j. generally, to do all acts and take all steps which in the judgment of my attorney are necessary, convenient, or expedient in the management of my property and affairs, whether or not the power to take such steps is specifically granted herein, it being my intention to give my said attorney full,power and authority to act for me in relation to my affairs, business, and property as fully and with like effect as I could act if personally present. 3. In the event of my disability or incapacity, my attorney may transfer any of my property or properties to fund any inter vivos trust which I have created and which is still in effect, including any trust of which my attorney may be a beneficiary. 4. The power of attorney granted herein shall continue in effect until it is expressly revoked, either by myself or, in the event of my disability or incapacity,by my duly appointed conservator or guardian in accordance with the provisions of Chapter 201 B, section 3(a), of the Massachusetts General Laws. 5. If for any reason(Attorney) should fail.or cease to serve as my attorney,then (Successor Attorney), of(City/County/2) County, Massachusetts, shall become the successor attorney hereunder. 6. In the event that protective proceedings are instituted at any time in any court of the Commonwealth of Massachusetts to appoint a conservator, guardian of the estate, or guardian of the person for me,I hereby nominate(Attorney), of(City/County/1)County, Massachusetts, for consideration by the court for appointment as such conservator,guardian of the estate,or guardian of the person,as provided by Chapter 201 B, section 3(b), of the Massachusetts General Laws. 7. All references in this.durable power of attorney to the Internal Revenue Code shall be deemed to refer to the Internal Revenue Code of 1986, as amended, and as it may be amended from time to time after the execution hereof. All references in this durable power of attorney to particular sections of the Internal Revenue Code shall be deemed to refer to and include any successor provisions thereto. Where the.provisions of any section of the Internal Revenue Code are to be applied by my attorney pursuant to the terms of this durable power.of attorney,my attorney shall apply the provisions of such section as are in force on the date of their application. 3 8. I hereby reserve the right to amend this instrument in any particular and to revoke it in its entirety at any time that I am not disabled or incapacitated. IN WITNE WHEREOF, I have hereunto set my hand and seal this day of V ,2006. 17 Sima Cyker COMMONWEALTH OF MASSAC1 USETTS lf , ss. 1 , 2006 Personally appeared before me the above-named Personally known to me to be the person who executed the above instrument, and(he/she)acknowledged the same to be (her/his) free act and deed. No blic 'My commission expires: j()n c c l) Q 007 F 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers -Applicant Information Q Please Print Legibly Naine (Busi.ness/Organization/Individual): Addiess: � City/State/Zip: Al(.,N TO(3C6-- � Phone-#: J 7� Ran Are you an employer? Check the propriiaoe box: Type of project(required): 1.[��-Tam a employer with 4. ❑ I am a general contractor and I . employees(full and/or part-time). * have hired the sub-contractors 6. ❑New construction. 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 workingfor me in an capacity. employees and have workers' Y P tY• 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or addition's officers have exercised their Plumbin re-pairs.or additions 11. ahomeownerd � all ork ❑ g 3. Iam doing w ❑ 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.❑ 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. tContraetors 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 is providing workers' compensation insurance for my employees. Below is the policy and job site inform ation. �r1 Insurance Company Name: Policy#or Self:ins. Lic. #: �9.�G> 7 7 xpiration Date: Job Site Address: 2 City/State/Zip: C_�%/y��I�CGC,z d� I� O-Z �2 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 Investi ations the DIA for insurance coverage verification. I do hereb certi y under the p . sand penalties of perjury that the information provided above is true and correct Sizuatur '!i'+i Date: f e - S Phone#: J 0 Official.use only. Do.not virile in this area, to be completed by city or town official City or Town: Peru-dULicense# Issuing Authority(circle one): 1.Board of Health 2.Building DepaFtment 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: THE COMMONWEALTH OF MASSACHUSETTS For DPS Use Only. ' Board of Building Regulations and Standards One,Ashburton Place,Room 1301 Registration No: Boston,MA 02108 Application for Registration as a Effective Date: Home Improvement Contractor Expiration Date: ter- (MGL c. 142A; 780 CMR 110116) 1. LEGAL NAME OF APPLICANT: lJ/NS72uc p wi C� (MUST BE EITHER AN INDIVIDUAL,CORPORATION,LLC,LLP,TRUST,OR OTHER LEGALLY FORMED ENTITY) 2. APPLICANT TYPE: _INDIVIDUAL _ CORPORATION X LLC—PARTNERSHIP _LLP _TRUST (CHECK ONE-MUST BE SAME AS IDENTIFIED IN#1) 3. . IF APPLICANT IS DOING BUSINESS UNDER ANY NAME OTHER THAN THAT LISTED IN 41 ABOVE,PLEASE - IDENTIFY THE NAME(DBA): - ---- - - (SEE INSTRUCTIONS REGARDING THE ENCLOSURE OF A CITY OR TOWN REGISTRATION GER-TIFICATE:IF DBA IS LISTED)---- 4. MAILING ADDRESS: Lw g �qcc, M.A 3 STREET . CITY STATE ZIP 5. PERMANENT ADDRESS: (y\r (IF DIFFERENT FROM#3) STREET CITY STATE ZIR (PLEASE NOTE THAT A.P.O.BOX IS NOT ACCEPTABLE FOR PERMANENT ADDRESS) w APPLICANT EMAIL ADDRESS: 1✓�1 l 6. APPLICANT PHONE#:J�d� 1 0 UV 7. OR FEDERAL TAX I.D.OF APPLICANT LISTED IN#1 ABOVE: (1 3 t QSZ� 8. NUMBER OF EMPLOYEES: 9. A) HAVE YOU REGISTERED PREVIOUSLY UNDER THIS LAW? -Y YES _NO B) IF YES,PLEASE PROVIDE THE NAME AND REGISTRATION NUMBER UNDER WHICH YOU WERE PREVIOUSLY F REGISTERED: of o cva-r gets w �. NAME: L K. I HIC REGISTRATION#: d O6 (yrr 10. A) ARE YOU CURRENTLY OR HAVE YOU EVER BEEN AN OFFICER,PARTNER,OR CO-VENTURER OF AN APPLICANT WHO PREVIOUSLY APPLIED FOR OR HELD A REGISTRATION UNDER THIS LAW(G.L. C. 142A)? _YES No IF YES, PLEASE PROVIDE THE NAME OF.THE APPLICANT AND NAME OF THE BUSINESS (IF DIFFERENT)AND REGISTRATION NUMBER: HIC REGISTRATION #: ?YOU CURRENTLY OR HAVE YOU PREVIOUSLY BEEN EMPLOYED BY A REGISTRANT OR APPLICANT `EGISTRATION AGAINST WHICH DISCIPLINARY ACTION WAS TAKEN BY THIS DEPARTMENT? a No PLEASE PROVIDE THE NAME OF THE INDIVIDUAL AND BUSINESS(IF DIFFERENT)AND REGISTRATION HIC REGISTRATION#: c. 12. A) HAVE THERE EVER BEEN ANY COURT JUDGMENTS OR ARBITRATION AWARDS ISSUED AGAINST YOU? _YES D�,No B) DO YOU OWE MONEY TO THE GUARANTY FUND? YES Y,,VO C) IF YES TO EITHER, PLEASE IDENTIFY THE COURT,THE DATE,CASE NUMBER,AND/OR DOCKET NUMBER: 13. PLEASE PROVIDE THE NAME,SOCIAL SECURITY#AND TITLE OF THE INDIVIDUAL IN THE CURRENT BUSINESS THAT ISAESPOSNSIBLE FOR THE OVERSIGHT OF HOME IMPROVEMENT CONTRACTS: "Z ZT bA18LO J � TITLE 14. A) DOES THE APPLICANT-OR RESPONSIBLE INDIVIDUAL--HOLD ANY OTHER CONSTRUCT ION=RELATED STATEI CITY OR TOWN LICENSES OR REGISTRATIONS? YES _ NO B) IF YES,PLEASE FILL IN INFORMATION BELOW. ATTACH ADDITIONAL SHEETS IF NECESSARY. LICENSE TYPE IMA SSUED BY LICENSE/REG. # EXP.DATE LICENSEE NAME C S qq-3B o2 aG- to tDl p��F 15. LIST ALL PARTNERS,TRUSTEES,OFFICERS,DIRECTORS,AND MAJOR OWNERS(10% OR GREATER OF OWNERSHIP) OF AN APPLICANT PARTNERSHIP OR CORPORATION,BELOW. USE ADDITIONAL PAPER IF NECESSARY AND INCLUDE NEEDED PAPERWORK(SEE INSTRUCTIONS). PLEASE INDICATE BY AN "X" IN THE LAST COLUMN THOSE INDIVIDUALS WHO REQUIRE AN APPLICATION FOR ADDITIONAL REGISTRATION I.D. CARDS. USE ADDITIONAL SHEETS IF NECESSARY. FULL NAME TITLE % OWNER ADDRESS a 4 � S 61V 16. IS THE APPLICANT CLAIMING AN EXEMPTION FROM THE REGISTRATION FEE AS A CSL HOLDER? DQYES. NO . 17. REGISTRATION FEE ENCLOSED: $ GUARANTY FUND FEE ENCLOSED: PLEASE INCLUDE TWO(2)SEPARATE CERTIFIED CHECKS OR MONEY ORDERS,ONE MARKED "REGISTRATION FEE" AND ONE MARKED "GUARANTY FUND." MAKE CHECKS PAYABLE TO "COMMONWEALTH OF MASSACHUSETTS." PERSONAL/BUSINESS CHECKS WILL BE PROCESSED BUT WILL TAKE AN ADDITIONAL TEN (10) DAYS. I hereby swear, under the pains and penalties of perjury, that all information set forth on this application and .submitted in support hereof is true and accurate to the best of my knowledge. Further, I certify under G.L. C. 6 7CUigLlnaure �49A that I am in compliance with all laws of the Commonwealth relating to taxes, reporting of n ontractors, and withholding and remitting of child support. Applicant Position held in company Date INS(►RUCTIONS FOR COMPLETION OF APPLICATION FOR REGISTRATION AS A HOME IMPROVEMENT CONTRACTOR OR SUBCONTRACTOR - Please refer to the following instructions for assistance in completing the Application for Registration as a Home Improvement Contractor or Subcontractor. ITEM #: Name: I he name on the application.must be the legal name under which you are operating. if you are renewing a previous registration,the name cannot be a different name than used for the previous registration.. If you wish to register using a different name you must pay the initial registration fee as well as pay the required Guaranty Fund amount. 3. Applicant type: If applicant is not a corporation and the surname of the principal or one of the partners is not included in the company name or D/B/A,a copy of the fictitious name certificate filed with the city or town clerk must be included with your application. , 7. Applicant partnerships and corporations must submit a Federal Tax I.D. number. Even if the applicant is applying as an individual he or she must submit a Federal Tax I.D. number if they have employees in addition to the owner. 8. The number of employees must include all construction-related employees who worked 20+hours or more on the payroll --.in the weekly pay period prior-to..the filing.of.this renewal.form..Businesses that-.are renewing a.registration and have. increased the number of employees since the previous registration may need to pay an additional amount into the Guaranty Fund pursuant to M.G.L. c. 142A, §1 1. 10. Applicants must provide the name(s)of any businesses registered pursuant to M.G.L.chapter 142A and 180 CMR R6 in which the applicant was an officer, partner,or co-venturer. Attach additional sheets as necessary. IL. Applicants must provide the name(s)of any businesses against which disciplinary action was taken by the Department of Public Safety that the applicant is currently or was once employed by. Attach additional sheets as necessary. 13. Responsible individual: If the name in Question 1 is other than an individual(i.e. a corporation, partnership,etc.)the name of the individual person responsible for ensuring the performance of home improvement contracting work of the entity must be entered here. If the person named holds a construction supervisor license and owns 10%or more of the applicant entity,the applicant entity is exempt from the registration fee. Please enter license and ownership data in Questions 10 and 1 1 and claim the exemption in Question 13. 15, Corporations or partnerships listing partners,owners,etc. must include an official document listing the information in addition to including it on the application. The document may be any one of the following: pertinent sections of the Articles of Organization, a current annual report;or registration with the Secretary of State as a foreign corporation. Organizations other than corporations must submit copies of a business certificate filed in the city or town where the business is located, pursuant to M.G.L. c. 110, §5. 16. If the applicant holds a construction supervisor license("CSL") in accordance with M.G.L. c. 143, §94(i)or is a registered motor vehicle repair shop operator and is claiming an exemption from the renewal-fee;pplease indicate by checking yes. Include a copy of the current license or registration certificate with this application. 17. Enclose a certified check or money order for the Registration Fee(if the applicant is not exempt)and a separate certified check or money order for the Guaranty Fund as indicated below. Make checks and money orders payable to the Commonwealth of Massachusetts. All applicants must pay the Guaranty Fund even if exempt from the Registration Fee! Registration Fee: a. First time registrants: $150.00 Valid for three(3)years from date of issuance. b. Renewals $100.00 Valid for two(2)years from date of issuance. Guranty Fund: Applicants must pay the amount that corresponds with the number of employees in accordance with M.G.L. c. 142A, §11. Zero to three(3)employees $100.00 Four(4)to ten(10)employees $200.00 Eleven(11)to thirty(30)employees $300.00 More than thirty,(30)employees $500.00 Completed applications, Registration Fees, and Guaranty Fund payments should be mailed to: BBRS--Home Improvement Program One Ashburton Place,Room 1301 Boston,MA 02108 Parcel Detail Page 1 of 3 any Logged In As: _> Monday, Septemb. JParcel Detail Parcel Lookup Parcellnfo Parcel ID 247-012 I Developer LOT 29A Lot Location r124 CLIFTON LANE ( Pri Frontage 175 Sec Road I Sec Frontage village'CENTERVILLE I Fire District C-O-MM Sewer Acct I Road Index 6323 Interactive Map ' , Owner Info Owner JCYKER, JANKEL& SIMA I _ Co-Owner Streets 1124 CLIFTON LN I Street2 City ICENTERVILLE I State MA Zip -02632 Country US Land Info Acres 0.17 Use SingleFam MDL-01 ( Zoning RB J Nghbd 0106 Topography Level I Road Paved Utilities Public Water,Gas,Septic I Location Construction Info Building 1 of 1 y Year 1969 Roof Gable/Hip I Ext Wood Shingle J Built Struct Wall Effect Roof AC Area 1456 I Cover Asph/F GIs/Cmp I Type None Bed Style Raised Ranch I walt Drywall I Rooms 3 Bedrooms Model Residential ( Int Bath Floor I Rooms 2 Full + 1 H Grade jAverage Minus I eat Typical Total I6 Rooms Type Rooms http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17330 9/29/2008 Parcel Detail Page 2 of 3 Heat Found- stories 11 Story `Fuel Gas . ation Poured Conc. 7) HI ff Y Permit History Issue Date Purpose Permit# Amount Insp Date Comme 12/01/1994 B37339 $18,250 01/15/1996 00:00:00 HP ADC Visit History Date Who Purpose 12/10/2001 00:00:00 Paul Talbot Meas/Listed-Interior Access 10/15/1991 00:00:00 ME Sales History Line Sale Date Owner Book/Page Sale P 1 09/15/1982 CYKER, JANKEL&SIMA 3563/94 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcc 1 2008 $126,100 $28,800 $800 $157,600 3 2007 $125,500 $28,800 $800 $157,600 4 2006 $117,000 $28,800 $800 $160,500 5 2005 $109,900 $28,400 $800 $155,400 6 . 2004 $89,100 $28,400 $800 $105,700 ; 7 2003 $80,100 $28,400 $900 $40,700 8 2002 $80,100 $28,400 $0 $40,700 9 2001 $80,100 $28,400 $0 $40,700 10 2000. $60,400 $24,700 $0 $26,500 ; 11 1999 $60,400 $24,700 $0 $26,500 12 1998 .$60,400 $24,700 $0 $26,500 ; 13 1997 $82,600 $0 .$0 $20,600 14 1996 $69,400 $0 $0 $20,600 15 1995 $69,400 $0 $0 $20,600 16 1994 $66,800 $0 $0 $26,500 17 1993 $66,800 $0 $0 $26,500 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17330 9/29/2008 Parcel Detail Page 3 of 3 18 1992 $85,500 $.0 r $0 $29,500 19 1991 $91,400 $0 $0 $53,100 20 1990 $91,400 $0 $0 $63,100 21 1989 $107,300 $0 $0 $53,100 22 1988 $60,400 $0 $0 $17,600 23 1987 $60,400 '; $0 $0 $17,600 24 1986 $60,400 $0 $0 $17,600 Photos r http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17330 9/29/2008 Message Page 1 of 1 Anderson, Robin To: Frank Pulsifer(fpulsifer@commfiredistrict.com) Subject:_124 Clifton 3-!i Frank, I just wanted to memorialize our discussion this morning concerning the Ctifton Lane property. I emailed the seller's agent this morning as a result of a conversation with the buyer's agent, Pam Wood yesterday. During that conversation, NS'Wood expressed that the buyers wouCd like to maintain the Cower CeveCas is minus the kitchen sink as this is a nice storage space. Because the seller's agent stressed and re-stressed the fact that the buyers were not interested in using the Cower CeveCfor anything but storage and that they hadno problem removing the kitchen I had originally agreed to allow the sale to go through unhindered andl gave them 2 weeks to obtain the necessary buiCding permit. Now, with interest expressed in . keeping the kitchen intact I am no Conger comfortable with changing our normaCprocess and allowing the sates to go through first. I have emailed the seller's agent andnotified him accordingly. I also left a voice madfor him. I'CCbe unavaiCable for most the day today but I shouldbe in tomorrow morning. you also have my cellnumber if you needit. 'hanks. Robin Robin C. -Anderson Zoning Enforcement Officer 'own of Barnstable 200 Nain Street Hyannis, NA 026oi 508-862-4027 9/25/2008 i 1aST CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES 1875 Route 28•Centerville, MA 02632-3117 1926 508-790-2375 x1 - FAX: 508-790-2385 John M.Farrington,Chief Martin O'L.MacNeely, Fire Prevention Officer Craig E.Whiteley,Deputy Chief Francis M. Pulsifer, Fire Prevention Officer September 19, 2008 Mr. Thomas Perry- Building Commissioner , Town of Barnstable 200.Main Street Hyannis, MA 02601 Dear Commissioner Perry: - Pursuant to ter 148 Section 28A, I am making you aware and request your interpret ' n o onstructi of an apartment without permits at: j 124 Clifton Lane Centerville, MA While on,a s d transfer inspection at this address, I observed an apartment in ''the basemen of the structure. The apartment has separate entry, full kitchen, bath and one room suspected as a bedroom. No permits are on file for this address to construct an apartment and no upgrade to the fire alarm system has been done. We are holding the certificate pending your interpretation. Please contact me with an questions have relative to this situation at 508- 0 y you q y 790-2375 Ext.l. Thank you for your attention to this issue. Sincerely, Francis M. Pulsifer Fire Prevention Officer Cc. Robin Anderson} "Commitment to Our Community" C Asscssor''s Office Ost floor Ma bat- Permit# V `1� Cgnservation Office 4th floor Date Issued - Board of Health Ord floor e Engineering Dept. 3rd floor House# z Planning Dept. (1st floor/School Admin.Bldg.): i KUMSTABMi �. � 1639. Definitive Plan Approved by Planning Board � 19 e� A (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) t TOWN OF BARNSTABLE ' r Building Permit Application 1Z-q NZPro-ect Street Address ( F7- O ��z d7 Z�f/'� Villa e , Fire District (hvncr Address Telephone Permit Request: 600 SU1v9-cx3rn, I tit--r� l ¢Ft/i✓(��L y Zoning District Flood Plain 4/1 Water Protection Lot Size - ` 7S'70 Grandfathered (� Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Tvpe RAM Fr Eaistina Information Dwellin 7T e: Sin le�FqnfflvTwo family Multi-family Age of structure Basement Nm i URCQ�( C'�N('2�`7 (74,4 wL Historic House Finished iC-a'S Old Kin 's Highway Unfinished Number of Baths 2•e-%C.S'79�- AI)o No of Bedrooms Total Room Count(not including baths) (D First Floor 6— Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds ?l Other Builder Information Name !1-(V f�t eX I-"tc -Ey Telephone number 7 L-� /3-0 Address�Z,\ k v 0 k/y�T le License# Home Improvement Contractor# 16�-7 t(l Worker's Com usation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ProieetPrOlect COSL��2J—c—c� Fee SIGNATURE , DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T ✓' �, � .39 FOR OFFICE USE ONLY ADDRESS I Z4/ VILLAGE OWNER DATE OF INSPECTION: , FOUNDATION- FRAME -INSULATIONS s FIREPLACE ELECTRICAL: ROUGH FINAL f T f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL v FINAL BUILDING: �J DATE CLOSED OUT: r ASSOCIATE PL AN NO. . , , g i n. n 1 • 1 s .Cat 27 A .C'o-t 28 A 75.00 r -_ —'o.t26R At29A Pot 30A 7570 S9 �yl 4 o � E I . �w� j 2 0 e4jw,7q i ' A=s9•SQ I ,5.z4- cti,404 .&ne 40 slown .0 o. �4 ghe bum ahown on awl. plan ti -Located i on the mound aa. 41town h.e&wn, and ► aet4. the, aetback o? .the Jown o? ga&n6tabde. Jate- 7-1-94 Site /%-Lan o wand is ,Ued t 1Vgcauvi, pott 90a C eL Cyk-et 1. i o� 29 A ad. ahown on a p.Lan "cecoIUd i . { an book 118 pace 123. ' Date 7-1 -94 Sca& I"-30 � tqu Cape Z"oa�d �" �9 /da�cbo�c _ byaqni.,,, M,9 02604 a -AMAk _ —,DFPARTMFNT OF PUBLIC SAFE- OF . COMMONWEALTH >r _ s ONE ASHBORTON PLACE � � �' ' �• .r.r< ,;..; , MASSACHUSETTS BOSTON,MA 02108 I of(hiax 1105rraa. L ,EN ar. EXPIRATION DATE C"I r 'S T l I J p E i y I S 0 R CAUTION r; 0 2/2 6/1 9 9 r EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS �,a=; ►may THEFT, PUT RIGHT THUMB 3' NONE "`` ` G � P�6 31 /1993 044383 PRINT IN APPROPRIATE BOX ON LICENSE. f)tiALD J PI RES 192 S K U N K N E T R D BLASTING OPERATORS CENTERVI .LE MA C2632 TQ .i; PHOTO(BLASTING OPR ONLY) FE r"r i"1 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER � 4 THIS DOCUMENT MUST BI SIGN NATJfIMrl?[L-ABOVE SIGNATURE LINE _ 5 CARRIEDON THE PERSON Oi NATURE OF LICENSEE I- THE HOLDER WHEN EN OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATION TONER < h t HOME IMPROVEMENT CONTRACTOR 105741 Registrations w ,.DBA 3 • „x>y prat10n07l20l96 Y ` � Building& Ref t Donald`J:'Pires w ' Centerville MA 02b32 gpMINISTI3ATICR e The -TI Of ~``'�\•I• lii!li•. iti'' lli\ i�i Ili 36 i Mam Stroci,Hyannis MA 02601 Office: 508 790-6227 Fax 508775 3344 P21phCmssm Building Commissioner For office use only Permit no. _... _.. Date AFFIDAVIT HOME I&iPROVEMENTCONTRACWRLAW SUPPLEMENTTO PM&TAPPUCA-n0N MGT. I42A esquires that the"recorutructioq alterations,renovation,=pail;modaniratioq coma; 'mprmvement, mrnrnal, demolition, or construction of an addition to any pre-cki! g OWE= building containing at least one but not more than four darning units or to sirup which arse adjacent to such residence or building be done by registered contractors,-v ith catain exceptions,along with other requirements- Tjpe of Work: Q i/a a Est.cost 2 Address of Work: ( ��df✓ N� (171 Owner Name::i94469 �t-J t:�� Date of Permit Application: I hereby catifv that: Rcgisu-ation is not required for the following m2son(s): Work cxcludod bv-I2w Job undo S1,000 Building not ewncr-occupicd Owncr pulling own pernvt Notice is hereby gi,.cn th2t: 0V-rN'EP.S PULLING TIfflP,owN PERMTTOR DEALPT G VM-il U:•'REGISTERED CO�'IRACTORS FOR APPLICABLE HO. 11✓TFIO\L!.mil\i 'OPt; DO NOT HAVE ACCESS TO T1 E ARBFIRATION PROGRf,1,1 OR GUARA-M'FUND L'ZDEP M(;L c. 1<2A I SIGNED UNDER PENALTIES OF PERJI PY I hcrcbN'2ppl%-for 2 permil 2s the 2�cnt c'i.:c• .c; Date Contr2cor n2mc Regisuation No. OR Date Owncr's name 11/0 2/9 4 17:02 Z'6177277122 DEPT INT ACCID Z 001 L.O/i7aii,Ull.i<%F.'G�tli1. G� %l'/CZJ�cZC/Ll.t�('-LL�'S 20partnteni o��ndu�tria[,_/Hcccde itd n 600 Wa�hin�fon James J.Campbell ��o1Eon., 02 f f 1 5 - - Commissioner Workers' Compensation Insurance Affidavit 2)0 A/ �ao k\7 (aoCucdperm}ttee) with a principal place of business at: 2 ��✓ ��r r' /cC (csrise�z�a) - do hereby certify under the pains and penalties of perjury, that: 0 1 am an employer providhig workers' compensation coverage for my employees working on this job. nsurance Company Policy )Number 0 1 am a sole proprietor and have no one working for me in any capacity. () l am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor insurance Company/Policy Number Contractor Insurance Company/Policy Number O I am a homeowner performing all the work myself. l =e-s�1nc:•`at 3 cc;�y of&;is s_te rent will De fo-:arded is d:e Of icc of of C:e DIA for coverage verification and that failure to secure cC 2gt`<rEc' ec c"oer Seaton 25A of MGL 152 car,leac to LkC imposition ci criminal pecalues consistne of a fine of up to S 1,500.00 ane.Jer cc- Ye3:s'imrrLCt'nen; µ•Fit as&-,if;.enalties in the fcn-:cf a STOP WORK ORDER and a fine of S 100.00 a day against me_ Si - d this day of 19 Licensee/ ermittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING PERMIT ;f i �St1cv�L i i 1 910, c!'Svrr ' a ,k cr Tili Z/ez" En�rcT SCALEX/'_/' APPROVED BY - - . DATE: DRAWN BV ' I7^/-�]LI v Al �/0"/3ELov Pv�:6AAGc I 4 j.. • i ' ; i �Y (' ,J �o�yK rlHRwa�o riooR- TOWN OF BARNSTABLE ' �' �tHE � Builji ding Application Ref: 200805416 m it BARNSTABLE, Issue Date: 10/08/08 Peel 1 . 9 MASS �p 1639• Applicant: SCHULZE WILLIAM rFG Mpl A Permit Number: B 20082222 Proposed Use: SINGLE FAMILY HOME Expiration Dater 04/07/09 Location. 124 CLIFTON LANE Zoning District RB Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 247012 Permit Fee$ 25.00 Contractor PIRES,DONALD J. Village CENTERVILLE App Fee$ 50.00 License Num 044383 Est Construction Cost$ 1,800 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND REMOVE CABINETS,COUNTERS AND SINK IN BASEMENT AND RE OYijjIS CARD MUST BE KEPT POSTED UNTIL FINAL 2 BEDROOMS IN BASEMENT BY CREATING CASED OPEN -INT ONLY!INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: CYKER,JANKEL 8I SIMA BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL.. . Address: 124 CLIFTON LN INSPECTION HAS BEEN MADE. CENTERVILLE, MA 02632 Application Entered by: JL Building Permit Issued By: U" 44=-- THIS PERMIT CONVEYS NO RIGHT TObCCUPYANY STREET;ALLY OR SIDEWALK ORANfjARTTHEAD%MTHIYR TEMPORARILY ORPERMANENTLY ENCROACHEMENTS.ON'PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED.UNDER THE BUILDING.CODE,MUST BE APPROVED BY THE-JURISDICTION. STREET ORALLY GRADES AS WELL AS DEPTH AND LOCATION OF;PUBLIC'SEWERS MAY, OBTAINED FR0141,THE DEPARTMENT OF'PUBLIC,WORKS'`-- THE ISSUANCE OF.THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANYAPP,LICABLE'SUBDIVISION RESTRICTIONS. ; MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). ., u, BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS d7 (/ 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health / v yOFV0 IHEt, Town. of Barnstable C0 1 ~' Regulatory Services cxraes '�; Thomas F. Geiler,Director 16;9..�a Bung Division Tom Pei-ry, Building Commissioner, 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ,Property Owner Must Complete and Sign This Section tf Using A� Builder 6 as Owner of the subject property hereb authorize `/'�►� / to act on my behalf, y in all.matters relative to work authorized by this building permit application for: 21 (Addres of job) Q -2 - 08 S a e of ner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. } Town of Barnstable Regulatory Services f awxxsTwsre, Thomas F.Geiler,Director y MASS 16.19. Building Division Tom Perry,Building Commissioner . 200 Main Street, Hyannis, NfA 02601 www.town.barnstable.ma*.us Office: 508-862-4038 Fax: 5.08-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current.exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1,1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations, The undersigned homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. k Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner perfomung work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1,1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption sic unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2,15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons__In this case,our Board cannot proceed against the unlicensed person as it would Kith a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by iseveral towns. You may care t amend and adopt such a form/certification for use in your community. THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA 75190-0000 WC 641-30-37 13889 -------------—------------------ 013-82-0508-00" P O CHULZEBOOX BUILDING COMPANY LLC 288 Member Companies of CENTERVI LLE, MA 02632-0000 01M American International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.Y. 10270 SEE NAME AND ADDRESS SCHEDULE - WC990610 I.D# MA U I •• 1 1 PMC INSURANCE AGENCY INC.. WORKERS COMPENSATION AND EMPLOYERS 50 CABOT STREET LIABILITY POLICY INFORMATION PAGE PO BOX 920179 NEEDHAM A 024 2-0002 INSURED IS PREVIOUS POLICY NUMB R LIMITED LIABILITY COMPANY RENEWAL 0OV8 8 0 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE WC990610 ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the Insured's mailing address FROM 05/11/08 05/11/09 ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Worke Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed In Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident Bodily Injury by Disease $ SOO,000 policy limit Bodily Injury by Disease $ 500.000 •each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: . AK AL AR AZ CO CT DC DE FL GA HI IA ID IL IN KS KY LA MD ME MI MN MO MS MT NC NE NH NJ NM NV NY OK OR PA RI SC SO TN TX UT VA VT WI ITEM a The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated oassifications Code Number l-muneration $100 OF Re- Premium 0 Annual❑3 Year muneratlon 0 Annual 3 Year SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES $550 t EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $ 1 8 MA MINIMUM PREMIUM $ 00 MA TOTAL ESTIMATED PREMIUM $1 0 7 8 If Indicated below,Interim adjustments of premium shall be made: Semi-Annually El Quarterly Monthly DEPOSIT PREMIUM - ENDORSEMENTS(FORM NUMBER) SEE ATTACHED FORM SCHEDULE - WC990612 03/24/08 PARSIPPANY 82 Issue Date Issuing Office Authorized Representillve WC W 00 01 39967 be fore or re �\.. 1 t gist fi °nrd of e expl.,ratfutiOn va// �! Bo toAshb, pgR gu/�e.^ rfs. foun dividu/ • . . Mn• 02�08ace llm I30l.an�sta turn toe ony ndards• _ Cf ; Not l/id c Wit ✓ �1, h 0 u t gn re `� •f� S - '� z ✓'Gt U/CVI➢7/197A9ZL({PpLLfL O�✓!/(, ( yP,t- ' oJ2� 'C/>O�II7/riE0921�/CCLGLIL O�✓vU.uwA�Zl66P.1f6 +.' Board of Building Regulations and Standards i Board of Building Regulations an'd.Standards s Construction Supervisor.License e HOME IMPROVEMENT CONTRACTOR s" Regiystration 112049 i Lie e!CS 56340 Expiration' 2/19/2009 Tr# 127259` 1f J xsi ¢ p`ias o x n =OO2Ir�w9Exra 0ype (Restrlcti IG,CQ. LC /2008 SCHULZE BUILD WILLIAM L SCHULZE X- , i PO BOX•288 WILLIAM SCHULZE G— ,y y%„a Commissioner Pb•BOX 288/65 C.ROCKER ST ?, CENTERVILLE,MA'Q2632 JJJ #.. CENTERVILLE MA 02632 Administrator v k The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, ,AIA 02I�1. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Informtation Please Print Leuibly Name (Bus iness/Organizationllndividua]): Address: `' aC (� i City/State/Zip: 4%`/ a�% .L9?i Phone Are you an employer? Check the appropriate box: Type of pi oject(required): 1.X I apt a employer with �� 4. �.I am a general contractor and I rt t7 * have hired the sub-contractors 6. ❑ New construction employees(full and/or pa - me). 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 worlds for me in an capacity. employees and have workers' g Y P h'• � 9. ❑ Building addition [No workers' comp. insurance comp. insurance:required] 5. ❑ We are a corporation and its 10.0.Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l l.❑ 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.� 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 thcahire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. X am an employer that is providing workers' compensation insurance for my employees_ Below is the policy and job site inform ation. a l Insurance Company Name:_ Policy#or Self-ins. Lic. #: �I e G xpiration Datte� fob Site Address: z City/State/Zip: C9-411� ,e, 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 Inve.stigations of the DIA for insurance coverage verification: 1-do,hereby certify under the ins andpenalties ofperjury that the information provided above is true and correct Si afore: Date: Phone#: Official.use only. Do not ivrile in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#: