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HomeMy WebLinkAbout0019 GUILDFORD ROAD z ' Wellse s Fargo a o Bank N.A. g I Home Campus MAC: N0012-O I G F * Des Moines,IA 50328-0001. Ph:877-617-5274 July 20, 2018 ` Town of Barnstable Attn: Robert McKechnie Building Department 200 Main Street Hyannis, MA'02601 - Regarding Property Registration at: n 19 GUILDFORD RD CENTERVILLE MA 02632 Tax ID/Parcel#: 172-083 Dear Sir/Madam: The property above has been paid in full and the lien released; therefore,Wells Fargo no longer has interest in the property and is no longer the responsible party. Please update your registration records. Thank you for your assistance in this matter. Sincerely, 's w t.. ZE s i r— Z Amy Rogers,Wells Fargo Bank, N.A., Research/Remediation Associate. Cot Wells Fargo Bank, N.A. amy.l.rogers@wellsfargo.com 4n M, o. r _ tXf;�?" v 0 Town of Barnstable , 367 Main Street, Hyannis, MA 02601 REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure. (section 224-3)or already foreclosed for which possession has been taken (section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property,is located. If you claim you are exempt from registering under Massachusetts law,please state the j reason(s) and complete section 1 (property information)and the first paragraph of section.2 (foreclosing party, court, etc. and foreclosing party representative, but not other representatives and attorney) so that the Town can review the exemption and update its records: N/A Section 1 —Property Information .Property Address: 19 GUILDFORD RD CENTERVILLE MA 02632-2026 Assessors Map#: Unknown Parcel#: 172-083 Land area and description 14,810 sqft (0.34 acres), Building(s)description and contents Single Family Dwelling, 1 Unit; 1485 sqft Occupied: X Occu ants if borrowers so p O( state and include name(s)) Unknown (877) 617-5274 codeviolations@wellsfargo.com Fax:(866)512-0757 Phone: email: other: Vacant: N/A Date: N/A Anticipated Length of Vacancy. N/A Last occupant(s))(if borrowers so state and include name(s)) NIA N/A Phone: (877) 6:17-5274 email: codeviolations@wellsfargo.com other: Fax:(866)512-0757 Has possession been taken No If so,please explain and complete and file the maintenance and security plan form(unless exempt as stated above). - N/A Section 2—Foreclosing PaM Information Foreclosing Party (full name/title) Orlans PC Foreclosure Case Court: Unknown Docket# Unknown / / Date filed: 06/13/18 Current Status: Active Foreclosing Part 's representative(s) for property (entry, management,repair, etc.)(name,title,): Wells Fargo Bank, N.A. Company(if different from foreclosing party): Wells Fargo Bank, N.A.- Address: 1 Home Campus, MAC F0012-01 G, Des Moines, IA 50328 Phone: ;(877) 617-5274 email: codeviolations@wellsfargo.com other: Fax:(866)512-0757 If an exemption is claimed,please do not complete the remainder. Other representative(s) (if foregoing representative is'primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so'state and do not complete f contact information(i. e. "none"or"see above")). Name, title, other: Wells Fargo Bank, N.A. ' Company(if different from foreclosing party): Wells Fargo Bank, N.A. Address: 1 Home Campus, MAC F0012-01 G, Des Moines, IA 50328 Phone(s): (877)617-5274 email(s): codeviolations@wellsfargo.com other: Fax:(866)'512-0757 Name, title, other: N/A Company(if different from foreclosing party): N/A ' Address: N/A Phone: N/A email: N/A other: N/A Attorney representing foreclosing party N/A Firm name (if different from attorney's name): N/A Address: N/A Phone(s)- N/A email(s): N/A other: N/A I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. Angela Pryor,VP Loan Documentation),Digitally signed by Angela Pryor,VP Loan Wells Fargo Bank,N.A. .%�''baie:2018.06Pocumentation�08:18 177-05'00'N.A. Date: 06/21/18 Name:Angela Pryor Title: VP Loan Documentation,Wells Fargo Bank,N.A. I t I t I hereby certify that the above-named foreclosing party is in compliance with the . provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town.of Barnstable .J . � 21174 ACORO� CERTIFICATE OF LIABILITY INSURANCE P ATE(MM/DDIYYYY) �...� 3/25/2015 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 CONT NAM EACT Wells Fargo Certificate Service Center Wells Fargo Insurance Services USA,Inc. PHONE 404-923-3719 FAX 1-877-362 9069 3475 Piedmont Rd a/c t AIC No EMAIL wfis.certificatere uest wellsfar ADDRESS: o.com Q @ 9 Suite 800 INSURERS AFFORDING COVERAGE NAIC# Atlanta,GA 30305 INSURERA: Old Republic Insurance Company 24147 INSURED - - Wells Fargo Home Mortgage INSURER B: INSURER C: a division of Wells Fargo Bank,N.A. -INSURER D 90 South 7th Street, 14th Floor - Minneapolis,MN 55402 INSURER E:INSURERF: COVERAGES CERTIFICATE NUMBER: 8901677 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR - yl LTR TYPE OF INSURANCEINS POLICY NUMBER MM IC YYYY MM DDIYYYY LIMITS ' X COMMERCIAL GENERAL LIABILITY 04/01/2015 04/01/2020 A MWZY 304056 EACH OCCURRENCE $ 10,000,000 CLAIMS-MADE Pil OCCUR - - DAMAGE TO RENTED PREMISES(Ea occurrence) $ 10,000,000 MED EXP(Any one person) $ ' PERSONAL&ADV INJURY $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE $ 10,000,000 X POLICY❑PRO- JECT LOC ❑ PRODUCTS-COMP/OP AGG $ 10,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT r $ Ea accident - ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ a HIRED AUTOS AUTOSNON-OWNED PROPERTY DAMAGE Per accident $ UMBRELLA LIAB HOCCUR - - EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION MWC 302638 04/01/2015 04/01/2020 X AND EMPLOYERS'LIABILITY - Y/N. STAT H UTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑N N/A - (Mandatory in NH) 1 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Insurance CERTIFICATE HOLDER CANCELLATION Wells Fargo Home Mortgage, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE a division of Wells Fargo Bank,N.A. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 90 South 7th Street, 14th Floor Minneapolis,MN 55402 AUTHORIZED REPRESENTATIVE 9� . The ACORD name and logo are registered marks of ACORD ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) F f WELLS FARGO BANK, N.A. CONTACT INFORMATION For questions or concerns regarding a property registration issue please contact the Property Registration Department. Property Registration Department Registrations wellsfareo.com For other inquiries please route applicable requests to• Building and Code Compliance Department CodeViolations@wellsfargo.com Utility Bills ConvUtilitvPmt(a)wellsfargo.com HOA or Condominium Dues or Fees HOAPmtRequestFH@wellsfargo.com Tax Related Requests: TaxG'atekeeper@wellsfargo.com REO property inquiries PASAPinguiries@wellsfsargo.com Insurance Claims HazardClaims@wellsfareo.com General Property Preservation Property.Preservation@wellsfargo.com For questions regarding purchasing a Wells Fargo property'please contact 1-877-617- 5274. You may also contact our dedicated property preservation call center at 1-877-617-5274 Monday— Friday from 8:00 AM —9:00 PM EST. Please note all legal documents should be sent to our legal mailing address below: Wells Fargo Bank, N.A. 1 Home Campus MAC F0012-01G Des Moines, IA 50328 t , Wells Fargo Bank NA MAC Fo012-oiG One Home Campus Des Moines,IA 50328 Ph:877-617-5274 06/21/18 Z Town of Barnstable v Attn: Robert McKechnie =� Cn Building Department W 200 Main St. r Hyannis,MA 026o1 " °' -,..h: ',y«-n•.'�,ww.:..,w'•,t'.w�^,w`s,'�Wa:w�:f'.,,.+a,^a-.�':<-•� -R - .,...,- - _.,t" _._ ... .. - "' nn.- -..f - _, .. .. Completed Property Registration for: IN GUILI)FORDRD CENTERVILLE NTA o2632 2a26 r TAX ID: z7 83 v a �� y 2 x.....;.„ _.....,fix .. .. .. Dear Sir/Madam: - Please see the attached property registration form and' se the below contacts to expedite any future requests. Code Violations: y �A Co&Violations@WellsFacgo.com . Property.Registrations: Registrations@WellsFargo.com General Property Preservation: Property.Preservation@WellsFargo.com Call Toll Free: 1-877-617-5274 For questions regarding purchasing a Wells Fargo property please contact 1-877-617-5274• Sincerely, Wells•Fargo-Home.Mortgage o, ;-. MAC Foo12-01G One Home Campus Des Moines,IA 50328 "tgela L'`Pryor@ ellsfaigo com >. ✓" TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel O X3 Application #J0 do oc)6"' Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee l y Date Definitive Plan Approved by Planning Board t FSI I�/n Historic - OKH _ Preservation / Hyannis Project Street Address Iq 61AIld��d V/Dd j� e Villa9 Owner Address Telephone L4 o Permit Request ol Coal 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/r ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ull ❑ Crawl ❑Walkout OtherA )( Basement Finished Area (sq.ft) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing a new Half: existing new Number of Bedrooms: existing —new Total Room Count (noZG Type ding baths): existing new First Floor Room Count Heat T e and Fuel: s ❑ Oil ❑ Electric • ❑ Other Central Air: R es ❑ No Fireplaces: Existing New Existing w%&coal stove: des ❑ No c ' E Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn:x existing ❑ neR size-10 Attached garage: 2 existing ❑ new size _Shed: existing ❑ new size _ Other: Zoning Board of AppealVN thorization ❑ Appeal # Recorded ❑ rn Commercial ❑Yes o If yes, site plan review# co • Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR OMEOWNE Name Telephone Number Add`dlress1s A rnu[14�,&d License # M( �V Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE 4� FOR OFFICIAL USE ONLY APPLICATION# e DATE ISSUED MAP/PARCEL N0. : ADDRESS t VILLAGE OWNER DATE OF INSPECTION: , FOUNDATION 5&oft5C6A 961ohl tak FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING f DATE CLOSEDi OUT ASSOCIATION PLAN NO. The Commonwealth o Massachusetts ,per f Department of Industrial Accidents W Office of Investigations ' d 600 Washington Street -- Boston,M- 02111' M s• wrdw.mass.gov/dia Workers" Compensation Insurance Affidavit: Builders/Contractors/Electriciaus/Plumbers Applicant Information A Please Print Le ibl . Name(Business/Organization/Individual): . Address: Ca City/State/Zip: Phone.#: �— 40 Are,you an employer? Check the appropriate box: :Type of project(required):. 1.❑ I am a employer ' 4. ❑ I am a general contractor and I mP Yer with 6• ❑New construction . employees(fall and/or part-time)•* have hired the sub-contractors` 2.El I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractor's have g. Demolition Workingfor me in an capacity., employees and have workers' Y 9• ❑Building addition [No workers comp.insurance. comp.'insurance_$, required.] '5. We are a corporation and its 10.❑•Blectrical repairs or additions officers have exercised their 11. Flumbin repairs or additions 3. I am a homeowner doing all work . ❑ g p self• o workers'`comp. right of exemption per MGL 12. •- Roof repairs insurance required]t c. 152, §.1(4), and we have no •' P employees.. [No workers' 13.❑ Other_ comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'c6mpensation 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. xContractors that cbeck this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot 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 information.. Insurance Company Name: Policy#or Self,ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: ... Attach a copy of the workers' compensation policy declaration page•(showing the policy number and expiration date). Failure,to secure coverage as required under Section 25A of MGL a. 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 insuran era e verification, I do hereby erti under the ains and per Ides of perjury that the information provided bav is true arid correct Si mature: Date: . Phone#: s Official use only. Do not write to this area, to be completed by,city or town official City or Town:` Termit/Licease# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town_Clerk 4.Electrical Inspector, 5.Plumbing Inspector 6. Other. E Contact Person: Phone#: 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 hiie, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee-of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any Applicant who has not produced,acceptable evidence of compliance with the insurance coverage required." Additionally,MGL ehapter.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 required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information-(if necessary) and under"Job Site Address"the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen.is obtaining a license or permit not related fo any business or commercial venture (i.e.a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The CoznMODWeaith of Massachusetts ` Department of Industrial A.caidemts Office of Investigations 604 Washingt6 Street Boston,.MA 0.2111 TO. ##617-727-4900 exti 406 or 1-$77-N.aSSAFE Fax# 617-721-7749 Revised 11-22-06 www.m=-gov/dia F Town. of Barnstable - y�. o Regulatory Services ,�xxsr�aLE Thomas F. Geiler,Director BaUding Division Tom Perry,Building Commissioner 200 Main-Street,_Fyannis,MA,02601 www.to wn.b arnstab l e-ma-us Office: 508-962-403 8 Fax: 50g-790-6230 HMMOGNNER LICENSE EXEMPTION qPlease Print DATE JOB LOCATION: ILAU q fit u bar street villa e g "HOMEOWNER.': 1tA &�j LM L D-3 Y&,L3,2q name home phone# work phone# CURRENT MAILING ADDRESS: �y�� �� citY/town state zip code T r- 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. DEFIXMON of HonRowNER Persons)who owns a parcel of.land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constrgcts more than one home in a twD-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 responstb]e for all such work performed under the building permit (Section I09.1.1) The undersigned`homeowner"assi tsaresponsibility for compliance with the State Balding Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies thathe/she understands the Town of Barnstable Building Department rnn„imam inspr:cti . Dccdures and requirements and that he/she will comply with said procedures and e ements. ignatiirc of Ho 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. HOMEOWI�'ER'S EXEMPTION .The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section.(Sceticiii 1D9.1:1-Licensing of canstruction Supenvsms);provided that if the hom=wner cngages a persons)for bin to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they arc assuming the responsibilities of a superyisor(see Appendix Q. Ru)cs&Regulations for Licmssing C®struction Supervisors,Section 2.15) This lack of awareness bfirn results in serious problems,particularly when the homeowner hires unlicensed persons. In.this case,our Board cannot proceed against the unlicensed person as it A Duld with a licensed Supervisar. The homeowner acting as Supervisor is ultimate)y responsrb)n. To ensure that the bomeovener is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that lit/she understands the responsibilities of a Superrisor. On the last page of this issue is it farm cun=t)y used by several towns. You may care t amend and adopt such a fomoicertificati.on for use in your community. Q:forms:h om crx cmp t Fey zr � Town of.Barnstable F Regulatory Services sAxxsrAst uAsa g Thomas F. Geiler,Director Building Division Tom perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstab l e.ma,us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder , I'. as Owner of the subject.property hereby authorize to act on my behalf, in all matters relative to work authorized by this building pemut application for. (Address of Job) Signature of Owner Dite Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on 'the reverse side. Q:F0RM5:0 WNERPERMISSIDN rt ;eON i I y, cE e Ti�iEo odor y,�,cf ZOCAT/0/,/ C��/`T,Ci2Vi/� ' Ti c y T,UA7- / s�/owit/h�E,QEO.(/COMGL yS WI-22V sCA Z-� � '_ OA 7'E 7zS /O,6: %c/ - A 7 6A A. .CEQI�/.2FitilE.t/r-S O/c-, 7-/-1E Towit/aF 4 o cA Two //A 7 L l.4/,i! 0,4 7,(5 . 7 F Z3A XTE,2� .VYE /NC. TiV/S P/,.4.v/S .t/aT BASE-O .4it/ .2E6/STE.2F1� L1gc�0 SU.e{�6}27t� /NST,2U ti/,E�c/T sve'✓EY E T.�,�� QSTE.21�/,C.��a M,4ss. O.c,�s'E7 S .sf,/o y✓,j/.Si�,C�UCI� it/OT 8� ,g Oi�,L/C 7. � S �l� . D,4VIj:�> Y — e _ z r J� T�N a N xn .•� s � JAIa �. 7. _ fit i v �- re; , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION- Map Parcel , . Application# G7c"!> �Health Division °2nD 5_.517 Date Issued (77— Conservation Division n� Application fee Tax Collector Permit Fee Treasurer Planning Dept. �712641 Date Definitive Plan Approved by Planning Board - Historic-OKH Preservation/Hyannis " Project Street Address A 6 o I oe6ap tE-Uf-tD Village Owner Address Telephone -� Permit Request — q�K Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation W b Construction Type Lot Size 15k f L�F PLAO Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 1% 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: existing new Total Room Count(not including baths):existing new First Floor Room Count F� � -- cw Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other COO Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coalstove: Ell-Yes ❑No Esl Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑A sting Qhnew size Attached garage:❑existing ❑new size Shed:❑existing Xnew size Other: / c-1) r-- Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Gommercial-'❑Yes -O`No____Ifyes,site-plan-review* ►--_ _ --__ Current U Proposed Use BUILDER INFORMATION Name e�`(1�. s:. Telephone Number �i5"a y d - c- ail cs -Address J 1/ s� License# 2_ CC o o� � . Home Improvement Contractor# CG� Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 8 FOR OFFICIAL USE ONLY 'fPPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ((D) 00,,'9 (off MAI� FRAME T INSULATION SR} w FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ti GAS: ROUGH FINAL FINAL BUILDING q 1 01 v DATE CLOSED OUT i,L y • ASSOCIATION PLAN'NO. t+ �t• L ft The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a' d 600 Washington Street Boston,MA 02111 wtvw.mass.gov/dia ' Workers,-Compensation Insurance davit: Builders/Contractors/Electridans/Plumbers Applicant Information .Please Print Le gib �j raln- a(mousiness/Organization/Individual): City/Sgy te~I p� L� '�J j� Y�'� Phone w: �p ' �� �'�,� ta we Are-yo au n employer?Check the appropriate box: :Type of project(required):. 1,El I am a employer with 4• ❑ I am a general contractor and I 6 []New construction . employees(full and/or part time).* • have hired the sub-contractors listed on the-attached sheet. 7. ❑Remodeling 2:❑ I am a'sole proprietor or partner- These sub-contractors have ' ship and have no employees 8. ❑Demolition employeeg and h working for me in any capacity. have workers' 9 Building addition comp.in surance.$ [No workers comp.insurance 10.❑•Blectrical repairs or additions � } .required.] y.�• 5. � We are a corporation.and its =�Iaam a-homeowner-doingrall•work . officers have exercised their 11.[]Plumbing repairs or additions ' �,- y right of exemption per MGL myself.[No-worke s:..comp, 12.❑Roof repairs �inE Zance rued]-tom c. 152, §1(4),and we have no 13. Other employees. [No workers' comp.insurance required,] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. . $Contractors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. ram an employer that is providing workers compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic•#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page'(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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby,certify nder the pains a etia ties of perdu that the information provided above is true and correct. Phone#: Official use only. Do not write in this area, tb be completed by.city or town official. City or Town: ' Permit/License# Issuing Authority(circle one): "I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Town-of Barnstable Regulatory.Services ST'AZU, _ Thomas F.Geller,Director Mess. ��prEn � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax; 508-790-6230 Permit no. Date . AFFIDAVIT HOME IM PROVEM.ENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL e. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, ovement,removal,demolition,or construction of an addition to any pre-existing owner-occupied ied i '� �P 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. Zf Woik;� -.x i,P CEstimated Cost=`J Owner's Name: . ate f A.ppb,cation• _ . I hereby certify that: Registration is not required for the following real on(s): []Work excluded by law []Job Under$1,000 E113uildiag not owner-occupied' - --... Owner.pulling own perffit 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: D ate l Contractor Name Registration No. OR 6Lc!2- Date er's Name_. i oFTHE, Town of Barnstable Regulatory Services BAMSresr.E, Thomas F. Geiler,Director MAs& �pr�t639. � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ----—----—----------------_— —____—=_------- -__----- - HOMEOWNER LICENSE EXEMPTION Please Print ��'''''' I�Z Sty �� r•+��. JOB LOCATION: num er street village "HOMEOWNER'�'�U home phone# work phone# CURRENT MAILING ADD- ESSE 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. mini j um inspection and requirements and that he/she will comply with said procedures and requi ements. Si nature of Homeowner - Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack ofawareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. � I _ o I \ I i i . i - - i '��`'_`� CE,2 T/.c/E4 .SLOT p„L•4,c/ / CE-e racy THAT T/,�� L.0C,4 T W/V yE,QEO.(��OM,�L YS Gr//ry C C Ci2(/i��� T'4� S��E.0/ic/� ,q,c/O SETBA Ck Coc,4 rEv G�iTy/N 7-.�/E FLoar��G4/.ii / � �Z �L-✓ Z V7 A5. 8 ct OA Tom: 7 F'. • BA XT,E,e� ,VYE /NC. Tiy/S �.CA.v/S .(/o�- BASSO a ,4�f/ �.2EG/STE�2E1� L.4�/O SU.e{i6yb.c�//t/ST,eU-y,�,vr SU.2liEY E Th�E asTE,21�/.C,C:�'a l/SEU 7 G� OE T .� /.t/E .LIST /it/ES 14 Ic \° t Y _ Cr >q4 � � The Town of Barnstable Department of Health , Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: / Yo� Name: N CD Phone#: �y� qa Q r Village:C'er��Z Address:_ ��(1 Name of Business: Q-eM. Type of Business: V e Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity shall not be discernible from outside,the-dwelling: there shall be no increase in noise or odor; no visual alteration to the premises which would suggest anything other than a residential use; no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. • Such use occupies no more than 400 square feet of space. There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise, vibration, smoke, dust or other particular matter, odors, electrical disturbance, heat, glare, humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials, or flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed 4 tires, parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business, the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I, the undersigned, have read and agree with the above restrictions for my home occupation I am registering. Applicant: j ' Date: Homeoc.doc �Q TO ALL NEW BUSINESS OWNERS Fill in please: APPLICANT'S ® ® ® %Ak YOUR NAME: BUSINESS YOUR HOME ADDRESS: G v e-Zo i TELEPHONE t, Telephone Number (Home) 0� ciao a (o NAME OF NEW BUSINESS TYPE OF BUSINESS C AT IS THIS A HOME OCCUPATION? ADDRE SS OF BUSINESS m MAP/PARCEL NUMBER / 02 When starting a new business there are several things you must do in order to be in compliance with the rules and.regulations of the Town of Barnstable. This form Is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall). 'S 1. GO TO BUILDING INSPECTOR'S OFFICE (4TH FLOOR TOWN HALL) This individual ha . o 2! c� �pe requirements that pertain to this type of business. X Authorized i ature COMMENTS: _ 617 GO TO BOARD OF HEALTH, 3RD FLOOR TOWN HALL) 2. ( This individual has been informed of the permit requirements that pertain to this type of business. • Authorized Signature COMMENTS: 3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY) - (3RD FLOOR SCHOOL ADMI . ISTRATION BUILDING) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: After,obtaining the required signatures you must return to the Town Clerk's Office to obtain your business certificate (cost $20.00 a .,,......1 A hisainncc raroarop nNl.Y REGISTERS Yni iR M A e4F in the town (which you must do by M.G.L. - It does not give you { 7 1 A TOWN. OF BARNSTABLE ; Permit No. --;,'Z66$3-- ---__ Building-Inspector s,.sn Cash OCCUPANCY PERMIT Bond Issued to-'° David t4o1 onlg - Address t L@t 92, M-Gf uilford Road,-eenterville Wiring Inspector -` y Inspection date Plumbing Inspector / f Inspection date Gas Inspector { � ,� f Inspection date ' .*Engineering Departm nt r , , j� Inspection date , L Board of Health �/3G°7f`S �(j«L�'i` Inspection date �- �y� �`� /� THIS PERMIT WILIINOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY `,COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF JHE MASSACHUSETTS STATE BUILDING CODE. Building Inspector f °�Q..°`T °•.w TOWN OF BARNS TABLE BUILDING DEPARTMENT sA%L • TOWN OFFICE BUILDING raj► *639. `� HYANNIS, MASS. 02601 , MEMO TO: Town Clerk FROM: Building Department ` DATE: U . 9Sr An Oeeupaney Permit has -been issued for the building authorized by Building Permit #... ...��' ��.. 3 ..... issued to �r�v`C 4t)0 L,0 S '............................# / oz C I Please release the performance bond. V � lI:P Z " " �✓!%'`E � !L f Assessor's map and lot number ..e�.�(.. ..... ,.. - THE . Q�L .. ropy . /i4 .M �/.�1 . Sewage Permit number .....................<...�.... ..,........... . 1; BARESTABLE, i House' number ................. q �/� mum f........:............:.[�. .................... 90� i639 r Aj�G MON a� TOWN OF BARNSTAB\LE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �// .l?�. .,�.......:�� -'� '�/:;'� TYPE OF CONSTRUCTION .......�ad� ...�....<. ram•✓ �y .�............................................................ y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... XQ?. . .....?��i//��� �f'i•, ....5.-.!z r�%r r......... .....� ............................ ................................... Proposed Use ......XZ ......... ,���/.,/•... l! .r '/................................................... .................. ......................... i Zoning District ....t �V� ...rr.,�04 UAJS.... Fire District Name of Owner ......�l�i /%!/. �f�.. %:.l`."^�?i/..Address ..... .. ..ifir�Gc�G X/...x ;••� `:-�.. Name of Builder ... � �./.?/./...........................Address ....................... ." �j </ Name of Architect . '......Address '............. �� C.s�.<t✓/ Number of Rooms ....................:G?.................................:......Foundation ........................1......................... ......... .............. Exterior ................. .........:........l..... ..... . ....:...:..... ..... ...Roofing .......... �.. .... ..... ... .......................... Floors ..... .:�. .....Interfor ...... ✓. !t H (7eating <:.. ......... .............................. .,,..... .. ....... .............r�..;.".........��l Fireplace ...................../1�l/................................................Approximate Cost ...... Amoo' Definitive Plan Approved by Planning Board ______________________________`_19________. Area .... ..'/ Diagram of Lot and Building with Dimensions Fee T SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re arddi.gg the above construction. Name ...... �. .......... ..................................... C✓��<Q�_ Construction,Supervisor's License ..............................f..... r WOLONS, DAVID A=172-83 2-83 26683 to Y No ................. Permit for ... ....... .. ..... Single Family Dwelling ...................................... ..................................... Location .,Lot 9 2, 19 Guilford Road ......................................................... Centerville ............................................................................... Owner ....David Wolons ............................................................. Type of Construction ....Frame.....,,.... ................................................................................ Plot ............................ Lot ................................ Permit Granted ..........J.U....ly.......'..'...............19 84 Date of Inspection ....................................19 Date Completed ......................................19 Assc sor's map and lot numbe4r ....� ..... ...... - �Taer Vr S Tel •Sewage Permif number !................l ..... ..... 1 � ; �, �� pe�Q ♦� 5 `1 9. f BABH"M3 aaJlH � j 0 ouse number ................. ... „ LE, i t TOWN , OF BARN STAB ,4 i _r :y BUILLDI G IH ECTOR APPLICATION FOR PERMIT TO �Sl���... /.�4!....!+'...lr�'! .. f�...............:....... TYPE OF CONSTRUCTION . ..... X�mr"l4` l'v 1���✓/................................................................. ...... ......... .........19...... . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......4 .4..7... .... /./ � <:.. ....Ci �✓�rc�. !.` ............................ . .... ...... .... .............. ProposedUse `�.11 !. 1/1.... ..l !�Z��y.. ./✓�.. "�................................... .. .................................................... Zo ning District �i�}!.i :...�d vl - ...t . .....Fire, District ................ :...... ...... . .... .......... ... . ...... e Norne of Owner ... ........ ;/ . % .p:�..i/Address ..... ............... . ... . ..................... Name of Builder ,.. ...r/l.................................Address ✓ ✓.. ..... e .;............r.C.. .. ....C:?...... ` Nameof Architect ......................../........................................Address ..................................................................................... �? ...............Foundation ....... . ......f� G��� �/ Number of Rooms' .................... ..... ................... ..... ......f....!�.. ............. .............. Exle-ior KYv�< ....�✓... ......:............:..........:Roofing ..........�.✓..�!�.. ........ . le . . .................. ............ ...... C_.� ,�✓ v�-- �,�d .Interior �4 ..1r�a Floors ..........::..X�..:............... . .......... ....................... ............ � ..... ................................ ....... .... . .... Heating .....C�i ✓../��'� ...�'......... !T..:...:........Plumbing ............ ............................................... .. ..£.... . Fireplace �/� .Approximate Cost 5,���Io%.................... .... y.. ......... . ,. ...... Definitive Plan Approved by Planning Board ---------__19 _______. Area .. ............. .. Diagram of Lot and Building: with Dimensions Fee .�/... .. -SUBJECT TO APPROVAL OF .BOARD OF HEALTH zj OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1,hereby agree to conform to all the Rules and,Regulations of the Town Bar , to e e r the above,. construction. Name . .. . ................................ ......... �` Construction Supervisor's License ����� fi 19OLONS, DAVID '14o 26.68.3... Permit for ........... ......Sing.IQ...FirmaJ.y....D.We-1.] ".4.............. Location Lot...9.2......19....Guzlf.ord..Road Gen.tex.vi lle - ' `Owner .......D.q..vi.d.;.W.Q loll s........ .... r A . TyPe r� Con`struction' .F.r.ame........., r 3.......... .. .... }................. ............... ........ ... . ........ r, Notj ....................... Lot . ....... ................ r-. Perm Granted ....R11Y....l l........ '... ..19 84 Date�of•,Inspection ...................................19 D e�.Comple ed .........19 F ' { r iszv� L� N ay . i &71 TNAT T.U,�E- I COMGL YS fir//Th' SCE L / '_ c1 4ATE 71V9V 7",�/E- s'/OE.0/.vim �q NO SETB.4 Ck ,2EQlii.2FiyE.t/Ys of THE '�'-ow�V aF 0,4 TE= 7 ti 6?!4 XTE,2 A/o7' B-aSE�O O .4�t/ .2EG/STE2Ep L.�/O SU•eli6y�r� O.�.SSE7 z . s/,�az✓�V Ss-�U�� �c%T B.� (xA1,, �S O*IHE� Town of Barnstable *Permit# 2I 0 B _:-. Expires 6 monthsftom issue . . . .ntnss. .. _ . ._ ... Regulatory Services _,Thomas F.-Geiler,Director "^ --. ...._.. :.. ....._..:.:::_m;..;:..._::.-_Building Division" - - --Tom Perry, Building Commissioner 200 Main Street,- Hyannis,MA 02601 ' ' E E �1T - Office: 508-862-40382005 L Fax: 508-790-6236 :.; _ o EXPRE' ' 1ERSM OPI:YCA'TI.ON BARNSTAELE Not Valid without Red X-Press Imprint ?/parcel Number I �� QF� perty Address Residential Value of Work o Minimum fee of$25.00 for work under$6000.00 ner's Name&Address 2 �5 atractor's Name -e Telephone Number <D © 1 me Improvement Contractor License#(if applicable) astruction Supervisor's License#(if applicable) Workman's Compensation Insurance Check one: ki am a sole proprietor am the Homeownerhave Worker's Compensation Insurance .urance Company Name orkman's Comp.Policy# ipy of Insurance Compliance Certificate must be on file. mut Request(check box) 1l _ _ `` Re-roof(stripping old shingles) All construction debris will be taken to �v�6a C, ��� ❑Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improveme ontr s License is required. .gnature ' .Forms:expmtrg -vise063004 '''f-ate 2'`m..y�'�F�y,4�p + •t. M1 �+F rsk .yy5, .. '' "`�". ,fir• wm ' "'�,� " '? ',tea : �+.; �,� > z Y NO der n m 4 ura:' 6 Sub 4 r t .z Ash 1 '" and �BFltldrn �2Qgu�lat,b�s a nk�Uwr g �.� +" r. 3 � aKe.15t �'228v2 e fi vk.; �I'flG n Y�y C,e et%•t'd arb` ) fi k.. . s'. Centerville,MA 02632 Administrator Mile c r d E,O�'ti 'down of Barnstable Regulatory Services s Thomas F.Geller,Director bit Building Division Tom Perry, Building Commissioner 200 Main Street, Iiyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 I . Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize: to act on mybehalf; in all matters relative to work authorized by this building permit application for; 04 6� cep, (Address of Job) ignature of VaLte Print Name . _�...,�rn.nZTn.TCaOL'�l..fTQ CTf1TT