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0007 HITCHING POST LANE
I r y ° y u �y tl' r a r b It i,o rt w b ,�b PM• a 4', '�, �. � a r 4 Q' w( 9 tl PNPNPNPNPNPN t� 4 rr 0 " a i.. p a ° . ° e d Town of Barnstable _ Building., �U c asp'; .ate w« •:�Y �a extt &.°" .a•. C' s iPost'This Card So That it isVis�ble.:Froni.the Street ApprovedPlans Must be Retained on Job and:this Card Muat be Kept q BAIWxJCABLE, : ' r a' .. MASS er ;; x y.. ,c r , erm• :asa A,m� Pasted Until Final tnspection�Has Been Made a , raa+ Where a Certificate of Occu anc -is Re uired,such Buildm sF all Not be Occu iied'until a Final Ins ection has been made JL _p� . Y q. ns g s..�., P� �P c o .... . Permit NO. B-20-67 Applicant Name: MICHAEL S MEAGHER,JR Approvals Date Issued: 01/10/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 07/10/2020 Foundation: Location: 7 HITCHING POST LANE,CENTERVILLE Map/Lot: 173-030 Zoning District: RC Sheathing: Owner on Record: THATCHER, DANA M -Contra ctor'Na me: MICHAEL S MEAGHER,JR Framing: 1 Address: 7 HITCHING POST LANE Contractcir License:' CS-102260 2 CENTERVILLE, MA 02632 Est Project Cost: $ 18,000.00 Chimney: Description: replacement siding and 11 windows PermitFee: $91.80 Insulation: Project Review Req: Fee Paid:: $91.80 Date 1/10/2020 Final: �nJls�sCrn Plumbing/Gas a � . s 4 Rough Plumbing: F Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after,issuance. All work authorized by this permit shall conform to the approved application;and th'e approved construction documentsfor which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws and codes. This permit shall be displayed in a location clearly visible from access street or',ro0 Final Gas: ,6nd shall be maintained open for public inspection for the entire duration of the work until the completion of the same. s 7 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building aril Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:l Service: 1.Foundation or Footing Rou 2.Sheathing Inspection _ g h: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final' 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation r 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to.the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final Application number d...... ...... ................rf... Fee q-1 , ..................................... ................................... . 3 .Bull � KAK 9 10 Building Inspectors Initials. ...... ...... .......... �-.��:��.�����,� ,,, .�•� Date Issued;; ...... 10 Map/Parcel......... ..`:.L!............................. TOWN OY BARNSTABLK ... ..EXPEDITED...PERMIT.APPLICATION: ROOF/SIDING/WINDOWSIDOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION ,.Address of Project: 7 i NUMBER T VILLAGE er's Name. .�, CGL`�Ce.Z Phone Number ��" �I C �' E mail Address Cell Phone Number Project cost$ On® �/ � ► Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize make application for a building permit in.accordance with 780 CMR Owner Signature: Date:. TYPE OF WORK 014'Siding Windows(no.header change)#_j 0 Insulation/Weatherization Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than l layer of shingles) , onstruction Debri will be going to CONTRACTOR'S INFORMATION C ntractor's name G. tC . I me Improvement Contractors Registration(if applicable)#--L� )Q3 (attach copy) C nstruction.Supervisor's License#.. L S p 10 a c-��O (attach copy) E nail of Contractor �� !Yl �.i!iC• C'CA— Phone number "�(4 -W) A L PROPERTIES THAT HAVE STRUCTURE VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL RFFORF A PFRM►T rAM RR 1cc111M f " w The Commonwealth of Massachusetts Department of li duslrial Accidents Office of Investigations _ 600 Washington Street Boston,MA 02111 www.mass.gov/dia W rkers' Compensation InsuranceAradav4: Builders/Contractors/Electricians/Plumbers Applf ant Information Please Print`Le 'b Name(Business/Organ 7ation&divid1)aI)J �C� �.(� c_(� 0- Addre s: } ` U �" City/State/Zip: `�"�� �� " " Phone#:" J �a y u • Ayuan employer?Check the appropriate:box: . " Type of project(required): 1. a employer with 4: 0 I am.a:general contractor and I loyees(full"and/or"part-tune): * have hired the>stib-contractors 6: 0 New.construction 2.❑ I a sole proprietor or partner- listed an the attached sheet 7. (Q Remodeling These sub-contractors have. _ and have no employees 8. ❑Demolition. w king for mein any"cap acity. -employeEs.and_have workers' • cam insurance. 9. 0 Building addition workers comp.insurance P• rec ed] 5. F1 We are a corporation and its 10:0 Electrical repairs or additions 3.El I a homeowner doing all work officers have exercised their IL0 Plumbing repairs or additions m sel£[No workers' comp, right of exemption per MGL 12..0 Roof repairs ce required:]t c:152 §1(4),and we have no y employees. [No workers' 13.a0ther !j't comp":insurance required] *Arryapplicmt that checks box#1 must also fill out the section below showing"dieir wo6cers'compensation policy information. R.O . t Homee who submit this affidavit indicating they are doing all work and then hire outside oontractors.must submit a new affidavit indicating such. n� $--ontractoq that check this'box must attached an additional sheet showing-the name of:the sub-contractors and state Whetherr or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. lam an e mplayer that is providing workers'comp ens insurance for my employees Below is the olicy and Jotii site inform n. suran Company Name: ✓•(Cuti In �'-�• Policy# r Self-ins:l;ic.#: C-)Q :6L�5(4 3/4-ExpirationDate: Job Site i Lddress: t't r 4 (Q� _ City/State/Zip: Attach a copy of the.workers'compensat-14 policy declaration page(showing the policp.number and expiration date). Failure tc.secure coverage.as required under Section 25A of MGL c.152"can lead to the imposition of criminal penalties of a fine up $1,500.00 and/or.one-year.nn ,.-onment,as well as civil.penalties'm the form of a STOP WORK ORDER and a fine of up to 3 250.00 a day against the violator. Be advised tbk a copy of this statement may be,forwarded to the Office of: Investig ons of the DIA,folinsurance coverage.verification. I do her y.certify. nd pains and pen. of p 'ury that,the information provided abov b true and correct 4 Z©?O Si ate Date: f ' Phone#: Offs ' 1 use only. Do not write in this area,to be completed by city or town official City r Town: PermitUcense# Issuing Authority(circle one): 1.Bog rd of Health 2.Building Department 3.Ctty/Towq Clerk 4.Electrical Inspector 5.Plumbing Inspector. 6.Ot er contct Person: Phone#• I Town of Barnstable Regulatory Services " • Nam Richard'.Scats,Director Building Di�ision Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA.02601 x www.town.barnstable.maus Offs 508-862-403 8 ?, Fax: 50&190-6230 , Property Owner Must ' f Complete and. Sign This Section = If Using A Builder I ( a.- { A C .i b2 ,as Owner of the subject propetty ' hereby authorize 1 GL a� act on my behalf. , in all matters tektiveto�vo authorized by this 1m" permit appiicat a fon • j � sl-o1fA.JO ' "Pool fences and alaims ate the responsibility of the applicant Pools are not to be filled or utilized before fence is installed And all final inspections are performed and accepted. 4 , 3 _Ev e of Owner ..' . s4aamxe dApplicant Print Name Print Naive Oi z�2� Date y r i 0 �ngMea heflncncom commonwealth of Massachusetts Division of Professional;Licensure Board of Building Regulations and Standards Con st to r l iap ,rVlsor 5.t CS-102260 r L��plres 11/0572020 MICHAEL S MEAGHER,. �� 0 EMERALD'r1NE t MARSTONS Mi" S MA 02648`* Commissioner • .�� �i�zazoiuoeoli/'%/�la�sar�oiclli . w office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Corporation Registration. Exairation ' 182338�-�'`, 04/26/2021 MEAGHER CONSTRUCTION iINC. O MICHAELMEAG4RJR`., fir. �(� • 776 MAIN STREET=;-` ' OSTERVILLE,MA U655" Undersecretary Client#: 16665 2MEAGHERCO A-CORDTM CERTIFICATE-OF LIABILITY INSURANCE- DATE NW 10/30/2019 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: The Hilb Group of N.E.dba PHONE 508 775-1620 FAX 5087781218 Dowling&O'Neil Insurance Agy E-MAIL o Ext: aC No ADDRESS: P.O.BOX 1990 INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A:Penn-America Insurance Company 32859 INSURED Meagher Construction Inc. INSURER B:Associated Employers Insurance Company 11104 Timothy Meagher INSURERC: 776 Main Street INSURER D: QSterville, MA 026W INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MWDDNYYY A X COMMERCIAL GENERAL LIABILITY PAV0232762 10/16/2019 10/16/202C EACCH�OCCURRENCE $1 000 000 CLAIMS-MADE �X OCCUR PREMISES EaoceTu ence . $50,000 X BI/PD Ded:500 MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ECOT- LOC PRODUCTS•COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS- HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WCC50050064422019A /23/2019 06/23I202 X PER E oTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $100 000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town Of Barnstable THE ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 200_Main Street. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016I03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S246109/M245856 LS1 r PEPE t 7 wn of Barnstable *Permit# �(Q ices 6 monthsfr om issue date Z015 Regulatory Services Fee t �nnr+srns •MAM �s d TA& rd V.Scali,Interim Director Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number i 1 3 tt Property Address ��t �G 1,N c P®'s r rb Residential Value of Work$ *7t Voo UO Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address (p Q� Contractor's Name kA e v Cl �L�K1tXl Telephone Number Home Improvement Contractor License#(if applicable) A��� Email: Construction Supervisor's License#(if applicable) l7n ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name I Workman's Comp.Policy Copy of Insurance Compliance Certificate must accompany each permit. Permit Rrste-roof (check b ox(hurricane nailed)(stripping old shingles) All construction debris will be taken to❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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. A copy of the Home Improvement Contractors License&Construction Supervisors License is requi SIGNATURE: TAKEVIN_D\Building Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 i SARNST•,BLI& 63 Town of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 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 ' 3 to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 10. ignature of Owner ate Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. TAKEVIN Muilding ChangeslEXPRESS PERMITIEXPRESS.doc Revised 061313 The Commomvealtit tz•f M;assadjnsetts D4paFtweut afrud=ftid Accidents face o,f1 gadem 6VO WaslrhWoFt,reet _ Bastanr M 02.H1 mniz rwasmgovldia Workers' CunTensaf an Insurance Affidavit-13-nilderslCuntractursMecfr ciansiTlumbers Applicant Iufw-m,af gn (per' Please Print Led Namo - Address: `7?(o Cfty/Stag 5�c/V dle- Phan-- e; . u an employer?Gheclsthe apprapriaft.ba=: ' Type of project(required).-- I. I erg a erato �,cith. P 4 I am a geneaal.confwctor and I 6- ❑New cons muti� ❑ employees(fW1 anAlorp ine * hay*ehiredthe sub,-contractors 2.El I am a role proprietor arpartnrr listed oathe attached sheet: 7+- ❑RemodeNng shin and have no employees. These sub-•comae#ors have g_ Demolition w a forte in any �-cl c. � employees andhave vro9cers' AI I _ g_ ❑B.IIi1dtng addiflosf [No.ors' comp_insurance: comp_mEnr�an�$ 1 EleeEaral r oraddittans ' rerprired] 5. ❑ We are a-corporation and its 0 epaim 3_❑ I am.a homemamer doing alb work officers have e=cised their 1L0 Plumbingrepairs ar ad8 tiaras o v keEs' right of eM=p6,orr Per MGL ❑ repa • � � �F- l.�? Roof - in nxanre required-]i C.M. ,§l(l} andwe hime sea employees-[No vMIers' I3_❑other comp.rnsurance regtltrefl_l '.mayappEicmtthatcherlcshoxrlrmst also ffioulth_sedioabefowshor 6ekwarkeeeompersa&npolieyiofrma`aoa IHameawasxwhosubmithisaxTda«i lair- try and�naelf-raniau-d Chen hire astrider,,,,tvvuzamst submit anew sfad2i&mdicaha smrT7 ZCaasractarsAe a"I'this bmi mast aitached saxadditiaasl skeet dwwingthen2meof ffis sob-ccntc�m=4 stafevrhethec or mat time o2ideshave! ®3nyeas.7fibesn5-c—'have empky�theymusrgmFide&eir wmke&gyp.parky en I arrr arm errtpl�r$arrt is prauidurg 11�arkers'aotrrp,ertsaftara insrira�sa,for m}s enipta}�ees $eroov is ri'ce�paficy arrd ja&vita irz,�ormrrltan, 1_ It ceCompanyName: Job Rte Mdress l t G• rt>C I��'S 1�/ City/StwW27v: l:er-1 le�4 v- Attach a copy of the workers conqpensatiotrppoIicy-decYa,ratiou page-(showing the policy nurahes and espi a�aa date). Fails to secure.coverage as requiredunder Section 25A of MGL c-157—can lead to the impositim of c-rimiral penalties of a fine up to,$U.OD OG and`or me ye arimprisonment:,as w6a as civil penalties ism tfie form of a STOP WORK ORDERand a Ene of up to -@Yti a dap a��a.ust the vic Ldar. Be advised that a copy of thig s•Eatemml maybe forwarded to the Office of lmvesEga&=.oftp DI A for insurance coverage verEffca#iaa Ida hawby and paudga afperjcry thattfie it fornuc6uaprm-w* a w i s twm and correct - a(/ ;3 Phone g OJItial asp an£y. ,Do not awke in fFds ama,&be cerittp£eta by city artown affieirt£ City or•Favi m - Fermiff-kense;g Bsn6mg xdharity(ca cle one): L Board.of M21th 1 Ruffdug Department 3.City1rown Clerk 4.Electrical Inspector S.Pkmbi ng Inspe dMr 6.Other contact Pe rson: Phone#: r - Client#:16665 2MEAGHERC0 ACORD. CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDIYYYY) 6129/2015 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((es)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 NAME: Dowling&O'Neil aCNE E t:508 775-1620 AID No): 5087781218 Insurance Agency E-MAIL 9731yannough Rd., PO Box 1990 ADDRESS: Hyannis,MA 02601 INSURERS)AFFORDING COVERAGE NAIL ffi INSURER A:National Grange Mutual Insuranc INSURED Meagher Construction Inc. INSURER a:Associated Employers Insurance Timothy Meagher INSURERC: 776 Main Street INSURER°: Osterville,MA 02655 INSURER E` INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LTR TYPE OF INSURANCE D SUB POLICY EFF POLICY EXP INSR WVD POLICY NUMBER (MMIODIYYM LIMITS A GENERAL LIABILITY MPT125OG 0/16/2014 1011612015 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE bjOENTED PRREEMI3SES ochanrenc�e $500 OOO CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $1 O 000 PERSONAL&ADV INJURY $1 000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $2,000,000 POLICY I I PRO El LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I,accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS AUTOSULED BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B AND EMPs COMPENSATION WCC505005"22015A 6/23/2015 06/23/201 X WC$IL, oTH AND EMPLOYERS'LIABILITY OFFICERIMEMBER EXCLUDED?ECtIT1VE® NIA E.L EACH ACCIDENT $100 000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEEI$100 000 If yes,descnbe under IPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $500,000 DESCR DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,AddMonal Remarks Schedule,B more space Is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR12:D REPRESENTATIVE 01988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S153340/M153339 CBD 9 Massachusetts -Department of Public Safety voara or Buc1ai,ng R-gu1at;ons and St,and ar; Construction supen-isor License: CS-102260alx MICHAEL S MEAGHER JR 97 EMERALD ~; Marstons Mills NFA 026, . Expiration Commissioner 11/05/2016 ��e`�aiiir�aa�ccoceclf�o�Glla�:;ccc�rc�e(!• Office of Consumer Affairs&Business Regulation � 1IOME IMPROVEMENT CONTRACTOR b `Ri egistration 162938 Type: ='Expiration:= 4/27/2017 DBA MEAGHER BROTHERS.-CO ' ZPjCTION MICHAEL MEAGHERJR 97 EMERALD LN MARSTONSMILL,MA 02648 Undersecretary Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Cade is cause for revocation of this license. For DPS Licensing information visit. www.Mass.Gov/DPS �k dRliffiv. .........-, .... .. License or registration before valid for i the exp vidul use onl iri aton date. md Office of Consurti If found return to: Y 10 Park Plaza_ Affairs and Business Regulation MA 02 Boston S e 5170 . 6 " i F `N4/ ot v d'wi hout signature l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 Parcel Application Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 'J J c Historic = OKH Preservation/ Hyannis Project Street Address 7 l+�teh L, As 1 Lh Village Cenller4_11ffe Owner Da via. �"f'Q`��L ter' Address: -k h Ali A711.7 Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ,0 Two Family ❑ Multi-Family (# units) Age of Existing Structure 3 7 Historic House: ❑Yes A No On Old King's Highway: ❑Yes ID No Basement Type: ❑ Full ❑ Crawl ®Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing Z- new Half: existing new ,AO' Number of Bedrooms: existing 0' new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: A Gas ❑ Oil ❑ Electric ❑Other Central Air: Q9 Yes ❑ No Fireplaces: Existing .' New Existing wood/coal stove: ❑Yes ;W No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: n6RECU'D Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name l2 � C Telephone Number 3-Ok P2 Rye Address pa License# %0V v a 60-7A-2- Home Improvement Contractor# /`/y`//2- Worker's Compensation # wG 003 7.5 6 f L-9 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO a.0 - p(S aswL lYlcw g-ulFrnc� SIGNATURE. DATE FOR OFFICIAL USE ONLY ' APPtICATION# -JiSD TE ISSUED .,MAP_/PARCEL:NO._�k 4: ;ADDRESS VILLAGE OWNER t 5 � r DATE OF INSPECTION: r c: !"FOUNDATION _C ',, , ' Ai,, AJ.'( t` FRAME FIREPLACE l ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS::- FI--;ROUGH h2'4_ FINAL FINAL BUIEDING4 G4- *- r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts " Department of Industrial A ccidents Office of Investigations 600 Washington Street . t Boston, MA 02II1 L�yy WWW.Mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeEibly Name (Business/Organization/Individual): Address10`// City/State/Zip: r-#,fi All-rer Mu- Phone M 5Vf- �37 Are you an employer?•Check the appropriate box: Type of project(required) 1. I am a employer with 4. I am a generalcontractor and I - * have'.hired the sub-contractors 6. ❑ New construction employees (full and/or part time). -- - - — -:. 2.Elm I a a sole proprietor-or partner- .. listed on the attached sheet. 7. Remodehng ship and have no employees These sub-contractors have g, 0 Demolition workingfor me in an ca act employees and have workers' Y P h 9. [] Building addition [No workers' comp. insurance comp. insurance.$ required.) 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a bomeowner doing all,work officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers' comp, right of exemption per MGL 12.[] Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Otber comp. insurance required.) *Any applicant that checks box#1 must also fill out the section below showing their workcrs'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing[hc 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 information Insurance Company Name: C �S Policy# or Self-ins. Lic. #: RUC U©3`7SG V4 Expiration Date: Job.Site Address: 7 f f-e4 iwf Qa f 4n City/State/Zip: (�w��vv/�Ie 41-& o Attach a copy of the workers' compensation policy declaration page (showing the pglicy 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 31,500.60 and/or one-year imprisonment, as well as civil penalties in the forr{rof a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be. advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify trnde pains and penalties ofperjury that the information provided above is true and correct. Si1?n attire: Phone#' `J?7Y ff 3 7 Official use only. Do not write in this area, to be completed.by city or town official City or Town: PermiULicense# . 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#: hformation and b.structzons Massachusetts General Laws chapter 152 requires a)) employers to provide workers' compc-nsation for thei71�nP1oyees,, Pursuant to this statule, an elnployee is defined as ".,.every person in the service of another under any contract of hire, express or implied, Ora) or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any tw o o meore of the foregoing engaged in a joinL enterprise, and including Lhe legal representatives of a deceased employer, receiver or trustee of a❑ 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, conslniclion or repair work on such dwelling house or on Lbe grounds or building appurtenaot thereto shall not because of such employment be deemed to be an employer.' MGL chapter 152, §25C(6) also slates 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 ivho has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) stales "Neither the commonwealth nor any of'IS political subdivisions shall enter,into any contract for the performance ofpublic-.Work until acceptable evidence ofcompliance with the insuUancc requirements of this chapter have beenpresented to the contracting authority." Applicants Please fill out.tbe workers' compensation affidavit completely, by checking the boxes that apply to your sitLiation and, if necessary,supply sub-conLractor(s)name(s), addresses)and phone numbers)along with their cerlificate(s) of imited Liability Partnerships(LLP)with no employees other insurance, Limited Liability Companies (LLC)or L than the members or partners, are not required to carry workers' compensation insurance_ if an LLC or LLP does have employees, e policy is required. Be advised that this affidavil may be submitted to the Department of IndustriaJ Accidents for confirmation ofinsurance coverage, Also be sure to sign and date th-e affidavit, The affidavit should be returned to the city or town Lhat•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 belojv. 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 afdavit for you to fill out in the event the Office of InYestigations has to contact you regarding the applicant. Pease be sure to fill in the permit/license number which will be used as a.reference number. Inaddition 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"a11 ]ocaiions in _(city or town)."'A copy of the affidavit that has been officially stamped�or marked by the city or town �y be provided Lo the applicanf as proof that a valid affidavit is on file for future permits or licenses. A new affid-Yi ljnust be filled ot�t each year, Where a home owner or citizen is obtaining a license or permit not related to any bLlSinesSibr commerci al venture (i,e. a dog license of permit to burn leaves etc,) said person is NOT required to complete this afidavi(. Tbc Office of Investigations wo ^"Pral,nn and show➢d shave any questions, please do not besit.ate to give us a call. t's'address telephone and fax number: The Deparlmcn p The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02 11 l Te). 4 617-727-4900 ext 406 or 1-877-MASSAFE Fax 9 617427-7749 Revised 4-24-07 www:mass.gov/dia HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED Y THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN HE ISSUING INSURERS 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 and endorsement A statement n this certificate does not confer rights to the certificate holder in lieu of such endorsement PRODUCER Vlvelros Ins Agcy Inc 375 Airport Rd Fell River, MA 2720 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Michael St Rock Dba Rock Solid Construction Po Box 1®a1 Fell River, MA 02722-0000 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING 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 THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ao LTA ME Or INaURANCE POLICY NUMBER PCLICYEPFECTIVE DATE POLICY EXPIRATION DATE A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY LIMITS ME PROPRIETOR/ PARTNERSIEXECUTIVE OFFICERS ARE: 'Iwlill�g9111+� �1�� 1, 'I�'tlP''''1' � INCL❑EXCL❑ 3756929 1/28/2010 1/28/2011 aTATUTORYLIMITS OTHER Coverage Applies to MA Operelone Ordy. EACH ACCIDENT . $ 500,00 DISEASE POLICY LIMIT $ 500,00 DISEASE-EACH EMPLOYEE 500,00( DESCRIPTION OF OPERATIONMEHICLESISPECIAL ITEMS RE:THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR MICHAEL ST ROCK CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF TMEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE 200 MAIN ST WIMTE THE POL ICY PROVISIONS. HYANNIS, MA 02701, AUTHORIZED REPRESENTATIVE 'Massachusetts- Department of Public g BOard of Building a: „Regulations and St:tntlards Construction Supervisor S ecial P Lice '. tY .. ,nse License: CS SL 100412 #' Restricted to..W5 IC,•., a MICHAEL ST ROCK; 207 FLINT STREET' FALL RIVER 'MA 02723 Ex piration: 9/11/2012 ;;, • ('onuni�siener ; Tr#: 100412 --- -- — g . �� � �1ze-Uoorinxaizyrea�i ../, ft,W � n _ Boa*M of Building Regulations and Staudard$6 j. e +"_-".yew• c. . HOME IMPROVEMENT CONTRACTQRr Registrattott 144412y fi l x 3 rti.¢ 1-0/4/2010 Trll:' 275694 , }4�� `License or registPation vand'�for in ivi(ul use only, ; < 4 n aMT}rpe D'B 1 , before the exp►ration date If found ret.irn to i h OL r i Board of Building Regulations and Standards ' CC v r ROCK SOLID CQN& - One Ashburton'P1aceRm 13:01 :it` "} 3 Lf MI ° CHAEL ST.ROCI- , Boston,Ma:02t 8 -` 207 FLINT ST#3 � FALL RIVER,MA 02Rt 723 21dmm�strlfo; ,4 t o is � '� Not valid without s�ignature'��` �� k' '* Piz 4 h �f ��Ytv Teti Town of Barnstable Regulatory Services ` B.LRTl6TABi.� t Thomas F. Geiler,Director s639 �� '` BaiIding Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www,town.barnstab le.ma.us office: 508-862-4038 Fax: 508-790-6230 Property OwYier Must Complete and Sign This Section If Using A Builder T, )no— aC1 , as Owner of the'subject.property hereby authorize to act on my bebaY, in all matters relative to work authorized by this building permit application for. Address of Job Signature of Owner Date - Pnnt Name If Property Owner is .applying for permit please-complete the , Homeowners License Exemption Form on the e p rev rse side, Q:FORMS:O WNERPERM1SS10:1 Town of Barnstable r ; Hof T�ray - o Regulatory Services Thomas F. Geiler,Director Building Division � PrEo>.�'t" Tom Perry, Building Commissioner 200 Main.Street, Hyannis,MA.02601 vt�v.town.b arnstable_ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOKEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCAMN: number s trcet vi l l age "HOMEOWNER": name home phone# work phone# CURRENT MASLING 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_ DEFTItMON OF EOMEOwNER 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 const-gces 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, Hiles 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. Signature of Homcowna Approval of Building 0$-icial Note: Three-family dwellings containing 35,000 cubic feet or-larger%U be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION .The Code states that "Any bomcownrr performing work for which a building permit is required shall be exempt from the provisions of this section.(Sccdon 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner argages a person(s)for hire to do such work, that such BDr c6,Ar c:r shall act as supervisor." Many homcm;mas who use this rzcmption arc unaware that they ar:assuming the responsibilities of a supervisor(sec Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bftcn results in serious problems,particularly when the homeowner hires unlicensed parsons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. T hr homcowncr acting as Supervisor is ultimatc)y responsrb)e. To cnsur:that the homeowner is fully aware of his/her risponsibilitirs, many communities rcquirc,.as part of the permit application., that the homcowncr citify that hc/she understffirds the mspons�bili6cs of a Supervisor. On the last page of this issue is a form cun=nt)y used by scvcral towns. You may care t amend and adopt such a fom/ccrtification for use in your community. Q:forrns:homccxcmpt TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # a2� Health Division Date Issued 15 0 Conservation Division A lcation Fee Planning'Dept: i"Permit Fee Date Definitive`Plan Approved by Planning Board �9J�slo " Historic = OKH Preservation/ Hyannis Project Street Address 14 1�xoS-�- LA Aed,ILl' 64 �LOQL Village_(2,--a S � Owner,. ' ( Address Telephone 7 Ll— � 31�D Permit Request r`e SI C-0-mWy iAa—k k b0.&e.n.Q,�` - I s creo4... -StCVA 116 v) �s-�a,�c S r Ch!Lm-k. c., L-A Square feet: 1 st floor: existing that proposed S)LMe- 2nd floor: existing �Ik proposed Total new Zoning District. Flood Plain Groundwater Overlay Project Valuation Construction T 3 � Type Lot Size Grandfathered: ❑Yes' ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family I Two Family ❑ Multi-Family (# units) Age of Existing Structure . , Historic House: ❑Yes No On Old King's Highway: ❑Yes No Ile Basement Type: kFull ❑ Crawl Walkout ❑ Other Basement Finished Area(sq.ft.) V06 Basement Unfinished Area(sq.ft) I Z-10 Number of Baths: Full: existing new Z- Half: existing new Number of Bedrooms: existing 3 new Total Room Count (not including baths): existing new 77 First Floor Room Count Heat Type and Fuel: 2�has ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: ❑Yes YNo i Detached garage: ❑existing ❑ new size Pool: ❑existing ❑ new size _ Barn: ❑ existing gneve size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: N p Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ CD Commercial ❑Yes /I(No If yes, site plan review# x w 3' Current Use Proposed Use Fn APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number -77 Address 71 LGA L4 License# C 0_,ARr-\'t`0S— Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� '� I FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. r ADDRESS VILLAGE OWNER i DATE OF INSPECTION: FOUNDATION i FRAME -.INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ` ASSOCIATION PLAN NO. i 'TIhe Commonwealth of Massach.usotts - Deparfmolr t of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compex>sationinsuranceA.f icavit: Builders/ContractorslElectxi�cians/Plnmbers A_ licant Information ^ Please PrintLe�zbly Name (Business/Organization/Lndividual): Address•_'_? pal R's LA City/State/Zip: Og ` LIF tAlTL(c32 Phone.#: ��1 — - 0166 Are you an employer? Check the appropriate box: 'Type of project(required): 1.❑ I am a employer with 4• ❑ I am a general contractor and I 6 ❑Hew construction employees (fail and/or part-time).* have hired the stub-contractors 2.❑ I am a sole proprietor or par ar-r- listed on the attached shzrt 7. ❑ Remodeling These sub contractozs have g, Demolition ship and have pfl employees employees and have workers' working for me in any capacity. $ 9. []Building addition • . [No workers' c0•fn�].-iUParancc comp.insurance. 5. [� We arc a corporation and its 10_❑Electrical repairs or additions rtgwrcd] officers bavc exercised their I1.R Plumbing repairs or additions 3. I am a homeowner doing all work myscl£ [No workers' comp. right of exemption per MGL 12.❑Roof repairs P. 152, §1(4), and we havt no ins=cr-rcquirPa] t employees. [No workers, '-13.❑ Other comp.insurance rcquu-ai] *Any applicant that ebeela box#1 roust also fill out the section below showing thcu workers'eon4—L Jion policy infom-;ation_ t Homeowners who submit Chia affidavit indicating tbey arc doing all work and then brit outside mntrac�rs must submit anew affidavit indicating such_ tcuntractoat ebeck6is box must attached an additional sbcct showing the name of the sub-contractors ands whether or not thosd cntitits have n th employees. If the sub-contractors have anployccs,they must prrrvi dC their workers'comp.pob cy nurnbcr. ,f am an employer that is providing workers' compensation insurance for my employees. RuLow is the poLicy and job site information. lnsurancc Company Name: ` Policy#or Self-ins. Lie. #: Expiration Date: Job Sitc Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration da-te). Failure to sccurc coverage as required tmdcr Section 25A of MGL c. 152 can Icad to the imposition of r-rirrcirial penalties of EL 5ne up to $1,500,00 and/or one-year impnsonm nt, m.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. Bc advised that a copy of this statemcrit may be forwarded to the;Office of InYesti atians of the DIA for;nrrrraJice coverts e verification. I do hereby certify under the pains-and penalties of perjury that the information provided above is true and correct. Simattue Date:—t Phone C16 Offuinl use only. Do not write in this area, ib be completed by city or town offtciaL City or Town: Permit/L,icen9D# Issuing Authority (circle cue); " 1. Board of Health 2.Euildi.ng Department 3, City/Tow'a CIerk 4,Electrical Inspector S. Plumbing Inspector 6, Other Contact Person: Phone#: - lI _vfassaehusetts Gcnnral Laws chapter 152 requires ail employers to provide workers' compensation for their crr_rployecs: t° 'ursuant to this statute, an amptayee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is dzfmrd as "an individual, partnership, association corporation or other legal entity, or any two or more Of the foregoing engaged in a joint cnirrprise, and including the legal representatives of a dcccasctl employer, or the receiver or trust=of anindividual,partnership, association or other legal entity, employing employees. FIowevcr the c,wner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the _welling house of another who employs persons to do maintenance, construction or repair viork an such dwelling house :r on the grounds or building appurtenant thereto shall not becaust of such employment be deemed to be an employer." �SGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or -enewal of a license or permit to operate a business or to construct buildings in the commonwealth for amy rppUcant who has not producedlacceptable evidence of compliance with the insurance coverage required." �dditionally,MGL ohapter 152, §25C(7) states `Neither the commonwealth nor any of its poligizal subdivisions shall :ester into any contract for the performance of public work until acceptable cvidcace of compliance With the in-surance equiremcnt-s of this chapter have been presented to the contracting authority. applicants _case fill out the workers' compensation affidavit completely, by chsckorg the boxes that apply to.your situation and, it rcessary, supply Ob-contractors)name(s), addrnss(cs) and phone number(s) along with their eertificate(s)of uurance. Limited Liability Companies(LLC) or Limited Liability Partnerships (LLP)with no employees other than the ambers or partmai-s, are not required to carry workers' compmsation tngurancc. If an LLC or LLP does have mmployees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial }:�cidcnts for confirmation of insurance coverage. Also be sure to sign and date time affidavit The affidavit should returned to the city or town that the application for the permit or license is being mqucstrA not the Department of idustri.al Aecidenls. Should you have any questions regarding the law or if you arc required to obtain a workers' ,mpensa.tion policy,please call the Department at the nurgber listed below. Sc ur 1f-insed companies should enter thczr :If inr,rranrro license number on the appropriate,line. ity or Towii Officials case be sure that the affidavit is complete and printed Icgibly. The Department has provided a space at the bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant case be sure to MI in the permit/licensc number which will be used as a rcfcrcncc number. In adtlition, an applicant Lt must submit multiple permitlliecnse applications is any given year, nccd only submit onp affidavit indicating euacnt liey information(if necessary) and under"Job SiLe Address" the applicant should write"all locations i a (city or vn)."A copy of the a$davit that has been officially st uDpcd or marked by the city or town may be provided to the Aicant as proof that a valid affidavit is on file for faf:arc permits or licenses. A new affidavit,must be filled out each sr.Wharc a home owner or citizen is obtainiag a license or permit not related fo any business or eormercial venture ermit to btrm leaves etc. said person is NOT required to conmplctz this affidavit Clog license or ) . a g . P c Office of Investigations would lOce to thank you in advance for your cooperation and should you have any questions, asc do not hcsitatc to give us a calL Depa�tmcnt's address, telephone and fax number. The C6mmonwealth of Ma.ssaGhu.si_ Department of Industrial Accid=ts atflc�e of IVesnglatiOns 600 Washingtan Stet Boston, MA 02111 Tei. # 617-727---490.0 ext 4.06 or 1-M-MAS.SAFB Fax# (517-727-7749 11-22-06 www.ma.s.-,.gov/dia ........... 17--M OIL, File 'Edit Tools Help x a RON:�86�ctp �Q Action—, Year/Type/Bill ill No. Customer Account Information History 76331 274368, 20 LF ASH Detail DELAZARI,CARLA S CA H CHECK Information 7 HITCHING POST LN i Property Info 'c U In 2rig Bill 0 0 Parcel ID CE N T E RVI LLE,MA 02632 173-030 _2 -SEP-1-�-Z008 Alt Pare Effective Date ........ Prop Loc 7 HITC41 LNj' Lien/Sale i Special Conditions/Notes _Quick Sea Specific Bill Int Dt Billed Abt/Adj Pmt/Crd Interest' Unpaid bal IL81 L2/01 5 .00f 755 Utility Acct — L .00, i 11L/�2/0 513-0 0! 001 .001 .00' Customer �5102AL6 z I---- . .0011- 7�77 . : .".-i... 2/06 9 .4Parcel . ---7 2.11 lf Lf——8�94e 0Y-11. l-,-"- Fees/Pen: .00 5.00i 00 5.00 Name 1 Totals: 39 104.101 2—F 11i Billing D tes Notes/Alerts Due 09/12/2008 422.86�' Preferences JAN 1 Owner: D E LAZAR 1,CAR LA S Per Diem .121 Int Paid .00i Display transaction history for the current bill. 7HE Town of Barnstable �pP rp�� Regulatory Services , Thomas F: Geiler,Director BARNSrABLE Y MASS. Building Division PlfD �n Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: S08-862-4038 Fax: 508-790-6230 _ -- HOMEOWNER LICENSE EXEMPTION ---- --- - Please Print DATE: JOB LOCATION: � "E '� Q Q6s.�ZA Ce4t4"Wl k number street•+�7[tj'3 /v-Pllage ,HOMEOWNER":-s' SLR �.��LZ�`ft� / 91--6 60 eats -775"78/� name home phone# - work phone# CURRENT MAILING ADDRESS: 46 C city/town state np code The current exemption for"homeowners"was extended to in 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 1 person who constructs more than one home in a iwo-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 requizeme -, Signature of Homeowner Approval of Building Official - . t Note: Three-family dwellings containing 35,000 cubic feet or larger will be required'to comply with the ' State Building Code Section 127.0 Constriction 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 1o9.1,1-Licensing of construction Supervisors);provided that if the homeowner engages a parson(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 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 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 fonn/certification for use in your community. HE oFz r Town of Barnstable Regulatory Services BAxxsres ' ' Mass Thomas F. Geiler, Director y 3 prFp �a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 tY Prop er Owner Must . . Complete and Sign This Section \� If Using A Builder r, GneL as Owner of the subject property hereby authorize �� to act on my behalf, Jr in all.matters relative to work authorized by this building permit application for: 'Y (Address of Job) %f f f 1 Signature of Owner' Date 1 j! f Print Name -� If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. 09/07/2008 23:46 FAX 5083628815 UPSIDE ' 16002 ,a� ASCipa., A al h„rA $ sL Av If!Ilya r.Oe,Fa AN DUAL LIEN REVISED Date:09/08/2008 BorrowerNamc; DEIWSON TP BATISTA/CARLA S DELAZARi ASC Loan Number: 1115:037215/1115037218 Prop Address, 7 HITCHING POST L CEN ERVILLF MA 02632 Dear Mr.8atistL and Ms.Delmari: In response to your request for a sale of the above referenced property,for less than the total payoff of the property,America's Servicing Company hereby agrees to the short sale between Dciwson TP Batista and Carla S. Delazari,the scller(s),and Dana M.Thatcher,the buyer(s),and will release its lien,contingent upon the following terms: ice of 190 000.00 in which the required minimum net proceeds for ASC loan number '11.15037215 With a purchase price $ , P P should be no less than$168,419.00 and for ASC loan number 1115037218 should be no less than$1,000.00_ The Settlement/Closing is scheduled on or before 09/16/2008. 1. Any extension of the closing date requires the written approval of America's Servicing Co. A copy of the HUD 1 Settlement Statement(preliminary)must be faxed to America's Servicing Company. This fax should be sent to Eliza Melendez'attention at 966,493.8767 or emailcd to eliza melendcz(c+�wcllsfargo.com 2 IN NO EVENT SHALL THE BORROWER RECEIVE ANY Ft1NDS FROM THE SALE OF THIS PROPERTY. Any surplus funds above the agreed upon Short Sale purchase price at the time of closings is the cxclusivc property of America's Servicing Company and shall be mode payable to America's Servicing Company. The mortgagor(s)also waive their rights to any escrowed fiends or refunds from prepaid expenses. Upon satisfaction of all terms of this approval,the mortgage will be discharged and a release document will be forwarded for recording. If a foreclosure action was commenced against this property,then upon satisfaction of at I terms of this approval,the pending foreclosure action will be dismissed and appropriate instruments recorded. ALL REMITTANCES MUST.BE MADE BY CAS11IERS CHECK or CERTIFIED FUNDS,PAYABLE TO ASC:. ASC 11200 W.Parkland Avenue Milwaukee,W 153224 MAC 4 X9400-02M Attn:Eliza Melendez ASC is required by Fair Debt Collections Practices Act to inform you that if your loan is currently delinquent or in default.as your loan serviccr,we will be attempting to collect a debt and any information obtained will be used for that purpose. However,if you have received a bankruptcy discharge,and the loan was not reaffirmed in the bankruptcy case,ASC will only exercise its right against the property and is not attempting any act to collect the discharged debt from you personally. Feel tine to call Eliza for closing in She can be reached at 414.214.4964 fax 866.493.97671 or eliza.melendcz@wellsfargo-corn Sincerely. Eliza Melendez Mortgage Loan Adjuster ASC-Loss Mitigation Note: Check should be made out to America's Servicing Co in the amount of$168,419.00 and$1000.00. Please fax or email a copy of the final HUD-1 48 hours before closing for review. i • S T • STANDARD FORM PURCHASE & SALE AGREEMENT. From the Office of: anma Source Realty Group 525 South St Unit C2' Hyannis NA 02601 phone: 508-77a-1982 Fax: 508-778-1981 This i day of August , 2008 I. PARTIES CARLA DELAZARI AND DEIWSON TP BATISTA AND MAILING 7 HITCHING POST ADDRESSES hereinafterJ'called the SELLER, agrees to SELL and CENT ERVILLE MA 02632 (fill in) Dana M Thatcher 9 Alden Circle Kash pee hereinafterIcalled the BUYER or PURCHASER,agrees to BUY,upon the terms hereinafter 2. DESCRIPTION er set forth, following described premises: (till in and include 7 HITCHING POST title reference) I CENTERVILLE MA 02632 FURTHER DESCRIBED IN THE BARNSTABLE COUNTY REGISTRY OF DEEDS, iBOOK/PAGE C166099 3. BUILDINGS, Included in jthe sale as a part of said premises are the buildings,structures,and improvements now STRUCTURES, thereon,and the fixtures belonging to the SELLER and used in connection therewith including,if any, IMPROVEMENTS, all wall-to-wall carpeting, drapery rods, automatic garage door openers, venetian blinds, window FIXTURES shades, screens, screen doors, storm windows and doors, awnings, shutters, furnaces, heaters, (fill in or delete) heating eqereto, hot water uipment, stoves, ranges, oil and gas bumers and fixtures appurtenant heaters, plumbing and bathroom fixtures, garbage disposers, electricc and other hlighting fixtures, mantels, outside television antennas, fences, gates, trees, shrubs, plants and, ONLY IF BUILT IN, and but excluding NONE 4. TITLE DEED Said premisl s are to be conveyed by a good and sufficient quitclaim deed running to the BUYER,or (fill in) to the nominee designated by the BUYER by written notice to the SELLER at least seven *Include here by specific days before the deed is to be delivered as herein provided, and said deed reference any restrictions, shall convey,a good and clear record and marketable title thereto,free from encumbrances,except easements, rights and a. Provisions of existing building and zoning laws; obligations in party walls not b. Existing rights and obligations in party walls which are not the subject of written agreement; included in(b), leases, c. Such taxes for the then current year as are not due and payable on the date of the municipal and other liens, delivery of such deed; other encumbrances, and d. Any liens for municipal betterments assessed after the date of this agreement make provision to protect e. Easements, restrictions and reservations of record, if any, so long as the same do not SELLER against BUYER's prohibit or materially interfere with the current use of said premises; breach of SELLER's covenants in leases, where necessary. ' 5. PLANS If said deed refers to a plan necessary to be recorded therewith the SELLER shall deliver such plan with the dee in form adequate for recording or registration. 6. PURCHASE PRICE The agreed purchase price for said premises is$19o,o00.00 (fill in)space is allowed to One Hundred Ninety Thousand spell out the amounts if desired $ 1,000.00 have been paid as a deposit this day and dollars,of which $ 1,000-00paid with offer dated August 10, 2008 $ 188,000.00 are to be paid at the time of delivery of the deed in cash,or by certified, cash ier's,check(s). $ 19.0,000.00 TOTAL ©1979-2005 GREATER BOSTON REAL ESTATE BOARD All rights reserved. Form ID:RA700 PD:03/06 j This form was created by Criatina Junqueira icing e-pORH3'. 8-FORMS is copyright protected sad my ® „a not be used by any other party. pPPpa,Ua1TY •7. REGISTERED TITLE In addition to the foregoing, if the title to said premises is registered, said deed shall be in form sufficient to entitle the BUYER to a Certificate of Title of said premises,and the SELLER shall deliver with said deed all instruments, if any, necessary to enable the BUYER to obtain such Certificate of Title. ` 8. TIME FOR Such deed is to be delivered at 12 o'clock p M.on the day of August PERFORMANCE; 2008 ,at the BARNSTABLE COUNTY DELIVERY OF DEED OR BANK 11S ATTY OFFICE (fill in) Registry of Deeds, unless otherwise agreed upon in writing. It is agreed that time is of the essence of this agreement. 9. POSSESSION and Full possession of said premises1ree CONDITION of PREMISE be delivered at the time of the delivery of the deed, said premises op be then r ein(a) in the esameo (attach a list of condition as they now are, reasonable use and wear thereof excepted, and (b) not in violation of exceptions, if any) said building and zoning laws,and(c)in compliance with the provisions of any instrument referred to in clause 4 hereof. The BUYER shall be entitled personally to enter said premises prior to the delivery of the deed in order to determine whether the condition thereof complies with the terms of this clause! 10. EXTENSION TO If the SELLER shall be unable to give title or to make conveyance, or to deliver possession of the PERFECT TITLE premises, all as herein stipulated, or if at the time of the delivery of the deed the premises do not OR MAKE PREMISES conform with the provisions hereof,then any payments made under this agreement shall be fortent shall be hwith CONFORM refunded and all other obligations of the parties hereto shall cease, and this agreem (Change period of time if void without recourse to the parties hereto, unless the SELLER:iects Ouse reasonable efforts to desired). remove anyI defects in title,or to deliver possession as provided herein,or to make the said premises conform to the provisions hereof,as the case may be,in which event the SELLER shall give written notice thereof to the BUYER at or before the time for performance hereunder, and thereupon the time for pe formance hereof shall be extended for a period of thirty CALENDAR days. 11. FAILURE TO PERFECT If at the exp ration of the extended time the SELLER shall have failed so to remove any defects i TITLE OR MAKE title,deliver[Possession,or make the premises conform,as the case may be,all as herein agreed PERMISES CONFORM,etc. or if at anytime during the period of this agreement or any extension thereof, the holder of a mortgage on said premises shall refuse to permit the insurance proceeds, if any, to be used for such purposes,then any payments made under this agreement shall be forthwith refunded and all other obligations of the parties hereto shall cease and this agreement shall be void without recourse to the parties hereto. 12. BUYER's The BUYER;shall have the election,at either the original or any extended time for performance,to ELECTION TO accept such!title as the SELLER can deliver to the said premises in their then condition and to pay ACCEPT TITLE therefore the purchase price without deduction, in which case the SELLER shall convey such title, except that in the event of such conveyance in accord with the provisions of this clause, if the said premises shall have been damaged by fire or casualty insured against, then the SELLER shall, unless the SELLER has previously restored the premises to their former condition, either a. payl over or assign to the BUYER, on delivery of the deed, all amounts recovered or recoverable on account of such insurance,less any amounts reasonably expended by the SELLER for any partial restoration,or b. if a holder of a mortgage on said premises shall not permit the insurance proceeds or i a part thereof to be used to restore the said premises to their former condition or to be so paid over or assigned,give to the BUYER a credit against the purchase price,on delive ry of the deed, equal to said amounts so recovered or recoverable and retained by the holder of the said mortgage less any amounts reasonably expended by the SELLER for any partial restoration. 13. ACCEPTANCE The acceptance of a deed by the BUYER or his nominee,as the case may be,shall be deemed to OF DEED be a full performance and discharge of every agreement and obligation herein contained or expressed,except such as are,by the terms hereof,to be performed after the delivery of said deed. 14. USE OF MONEY TO To enable the deliver SELLER to make conveyance as herein provided, the SELLER may, at the time of CLEAR TITLE y of the deed, use the purchase money or any portion thereof to clear the title of any or all encumbrances or interests, provided that all.instruments so procured are recorded simultaneously with the delivery of said deed. This form was created by Cristiha Junqueira using e-FORKS.4e-FORMS is copyright protected and may not be used by any other party. •15. INSURANCE Until the delivery of the deed,the SELLER shall maintain insurance on said premises as follows: *Insert amount(list additional Type of Insurance Amount of Coverage types of insurance and amounts a f Fire&Extended Coverage *$AS PRESENTLY INSURED as agreed) b.1 *$ C. *$ 16. ADJUSTMENTS C�lleeted_Fer�te, mortgage interest, water affa~®eweF use charges, (list operating expenses, if according to the schedule attached hereto or set forth below, and taxes for thethennccuurrrentf is al any, or attach schedule) year, shall fbe apportioned and fuel value shall be adjusted, as of the day of performance of this .agreement and the net amount thereof shall be added to or deducted from,as the case may be,the purchase price payable by the BUYER at the time of delivery of the deed.Up"kwtee•cera ec4pe GWFF@;44*4 ied.skaatLb®-aPPoai©ae�ifacid-wk seAested-�}.eEtpeci�art . 17.ADJUSTMENT OF If the amount of said taxes is not known at the time of the delivery of the deed the UNASSESSED AN shall be D apportioned on the basis of the taxes assessed for the preceding fiscal year,with a reapportionment ABATED TAXES as soon as the new tax rate and valuation can be ascertained; and, if the taxes which are to be apportioned shall thereafter be reduced by abatement, the amount of such abatement, less the reasonable)cost of obtaining the same, shall be apportioned between the parties, provided that neither parity shall be obligated to institute or prosecute proceedings for an abatement unless otherwise Flerein agreed. 18.BROKER's FEE A Broker's flee for professional services of 5% OR $9500 OR AS APPROVED BY LENDER (fill in fee with dollar amount or is due from the SELLER t HOME SOU RCE URCE REALTY GROUP TO BE EQUALLY SPLITTED percentage;also name of WITH REALTY EXECUTIVES MARIE SOUZA AT CLOSING Brokerage firm(s)) the Broker(i)herein,but if the SELLER pursuant to the terms of clause 21 hereof retains the deposits made hereunder by the BUYER, said Broker(s) shall be entitled to receive from the SELLER an amount equal to one-half the amount so retained or an amount equal to the Broker's fee for professional services according to this contract,whichever is the lesser. 19. BROKER(S)WARRANTY The Broker(s)named.herein HOME SOURCE REALTY GROUP AND REALTY EXECU (fill in name) warrant(s)that the Broker(s)is(are)duly licensed as such by the Commonwealth of Massachusetts. k 20. DEPOSIT All deposits made hereunder shall be held in escrow by HOME SOURCE REALTY GROUP (fill in name) as escrow agent subject to the terms of this agreement and shall be duly accounted for at the time for performance of this agreement. In the event of any disagreement between the parties, the escrow agent may retain all deposits made under this agreement pending instructions mutually given in writing by the SELLER and the BUYER. 21. BUYER's DEFAULT; If the BUYER shall fail to fulfill the BUYER's agreements herein,all deposits made hereunder by the DAMAGES BUYER sha'11 be retained by the SELLER as liquidated damages unless within thirty days after the time for performance of this agreement or any extension hereof,the SELLER otherwise notifies the BUYER in writing. 22. RELEASE BY The SELLER's spouse hereby agrees to join in said deed and to release and convey all statutory HUSBAND OR WIFE and other rights and interests in said premises. 23. BROKER AS PARTY F The Broker(I)named herein join(s)in this agreement and become(s)a party hereto,insofar as any provisions Of this agreement expressly apply to the Broker(s), and to any amendments or modifications of such provisions to which the Broker(s)agree(s)in writing. 24. LIABILITY OF If the SELLER or BUYER executes this agreement in a representative or fiduciary capacity,only the TRUSTEE, principal or the estate represented shall be bound,and neither the SELLER or BUYER so executing, SHAREHOLDER, nor any shareholder or beneficiary of any trust,shall be personally liable for any obligation,express BENEFICIARY,etc. or implied, hereunder. 25. WARRANTIES AND The BUYERj acknowledges that the BUYER has not been influenced to enter into this transaction REPRESENTATIONS nor has he 'relied upon any warranties or representations not set forth or incorporated in this (fill in)if none,state"none";if any agreement or previously made in writing, except for the following additional warranties and listed,indicate by whom each representations, if any, made by either the SELLER or the Broker(s): warranty or representation was .made NONE BY SELLERS/NONE BY BROKER. SALE SUBJECT TO LENDER'S FINAL APPROVAL OF SHORT SALE. This form was created by Cristina Junqueira using e-PORxL:i a-FORKS is copyright protected and my not be used by any other party. Ulf/1(f/LucaL2:v2 me avoavcooi� UlJlt/L ,�,��� FROM FAX NO. :15087904005 Rug. 14 20013 02:S2PM V 26:CONTINGENCYCLAUSE in orderm help tnance the acqulsltion of said premises.the BUYER shall apply for a conventional (onNt9not prodded for bank or othher Imo llild-net mortgage loan of$ 974 at prt:vallI ng in OAerto PWL*Sw) rpl & terns and conditions. if despite the BUYER's diligent efforts a commitment for sLth loan cannot be obtained an or before Augumt 20 . 2002 , the BUYER may Wminato this agreement by written notice to the SELLER and/or fire Broker(e).as agents)for the SELLER,prior ib Vie axpirehon of such time,whereupon anY paymentli mode ur%W this og-noment sftl be tblthwlt refunded and an other obligations of Vie parties hereto shati osase and this ag-Lemont shall be void vAWR recourse to the perd"hereto. In no event will the BUYER be deameo'o have used 6111pr t to obtain such commitment unless the BUYER submits a complete mt trtgage loan applicatioi conforming to Ow foregoing provisions on or before ALRF►Dx A"& E m 2000 27.CONSTRUCTION This Instrument;executed In multiple counterpaft is to be construed as a Massachusetts oor tract.is OFAGREEMENT to tam affect W a sealed Instrument.sole forth the entire cothact between the parties.it binding upon and enures to the benefit of the portion hereto and their respective melts,devisees.d>.ttoutors, adminblratt7fe,�wjCooes m and assigns, and may be CanOetied, modified or amended arty by a written irhstrharherd eoceautsd by both the SELLER and the BUYER.If twD or more parsons ar3 named heroin as BUYER their obligations hereunder shalt be Writ and several. The oaptions and I isralnal notes are used only me a matter of convenience and we not 10 be considered a part of this af-r Bement to 40 treed bi deterrhdning tthe intent of the psrdae to it. 28.LEAD PAINT LAW The parties a0iinowledge that. under Massachusetts law, whenever a child or chilftP under six years of age resides in any reol kmW pren6ses in witch atN pairs,plauW or oll ow aooesalble notarial ow talno dartgrm tevele of Mad,the owner of said premises must remove or cover srdi paint, plaster or other material so as to make it kiaccm9lble to children under sic years at age. 29.SMOKE DETECTORS The SELLER shall,atom time otiho del"of the deed,deliver a certificate from the fire dep artmatnt of the city or lawn In which sald promises are located stating that said premises have been to a►dpped with appnwred smoke datmWiTs In corttom►Ry with applicable low. 30.CARBON MONOXIDE For properties old or oonvayed after March 30,2W6,the Soler shay ptwide a cwtiftate t rom the DETECTORS fire QepoMheM of the city or town in which the promos are basted,eNhar In addition to or lace paroled Into the certifcata described stave. staling that the premises have been equipped w0i carbon rnonoodde detaclors In compliance with M.G.L.c. 148$26F1/2 or do*a Premises we(oherwlse exempted the Statute. 31.ADDITIONAL The initiated riders.M am,adachad hereto,are Incorporated herein by reference. PROVISIONS susiz= To FZnL APPROVAL rOA A IMP SALX PAYOFF. BVIMR ACCMMS PROPSATY = OAS 18' CONDITXOK OTB=A TIM DZZR19 UM R8$1t2DGERAYOR TO SA ROOM rM= 8OV89 AND YAitD. SUBjgCT To T=TLz v szpT%c gy8T= CXXTIVICATE OF COMPLIM-= ON OR ssFOR* c>rn 8=0 8$Lt,NAB A48E3 TO PAY UP TO S8000 OP SUM68 PREPAMB AM CL0033M .�0870 As C?ASI=. FOR 1At481OVIT IAL PROPERTY CONSTRUCTED PRIOR To 1070.9WFR MUST A1.80 HAVE SONEO LEAD PAINT "PR4Pttam I AM ER NOTIFIVATiON CERYU4CATMO NOTICE: Is Anz og that creates binding obligations. If not understood.oonau/llf an a'tmey. SELLER: _ Print N Print NBmems" N 1"taber ^_ Taxpft E TWoyer SWARR(or 8pousex BUYER: Print Na nwrizz a I Print Nome: Taxpayer ID/ Taxpayer l �,,, ~ Pants aovm= RsastT GROUP eROICLR(a)rosin =wtrrrvaa r . s7W oies V" bi tru�&moms=oAq tVum. —rum*s+."gasa to 9oteatae=a MW t.ee hr 0"s b/aw a"Mi pwtr• l e 3( - i CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE&EMERGENCY$ERVICtBRNS''ABLE 1875 Route 28•Centerville, MA 02632-3117 1926 508-790-2375 x1 • FAX: 508-790-MM A.LI"' 28 �� John M.Farrington,Chief Martin O'L. MacNeely, Fire Prevention Officer Craig E.Whiteley,Deputy Chief Prevention Officer August 26, 2008 Mr. Thomas Perry- Building Commissioner Town of Barnstable 200 Main Street I Iy arms, NIA 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 permits at: ' kZRtohing Post LanYe Ca enter�vi'll 01MV While on a sale 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 / two rooms suspected.as bedrooms. 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 S- i. Cc: Robin Giagregorio , A. y" "Commitment to Our Community" -J� {�s n 1�C•-�Q�s���� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUM6111G CityRown:[t1 T MA: Date:I Building Loca a «!,f�iu� _ _T� �y .w ei' Name: Type of Occupancy: Commercial' Educational El Industrial Lj Institutional Residential New: Alteration < Renovation: Replacement: Plans Submitted: Yes FIXTURES w co a, O ti cn cn a Cl) w a U �, Q � m w a a- w N Y 9 U Y cn ° X z W z W to O V o- u_ 5 l rJ 0 a In W a w � O p w � w J z � o a xitl'- 0 0 !— .x z ~ u_ � a- Y a x W W w o w I- cxn v�i O cn F- U > O O O z z cn I- t— _ Q m o o s Cal Y w vzi ai 3: O SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 4 FLOOR 5 FLOOR 6 FLOOR 7 FLOOR 8 FLOOR Check One Only Certificate# Installing Company Name:{ �-y�j iV1 n• ' z -- orpora ion ^—. Address r10— l r i (—AJ !. 4�E��.�, �F CityJTown (�C C State: �y' - -.n- Partnership Business Tel: Fax: Firm/Company -- Name of Licensed Plumber: INSURANCE COVERAGE: . I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 142 Yes i No�� If you have checked Yes, please indicate the type of coverage by'checking the appropriate box below. A liability' policy ; d Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner Agent Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my . Knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By r----�-—w-------- -- — Type of License: Title!� ✓ plumber Signature of Licensed Plumber Master City/Towni� I License Number: ! � APPROVED OFFICE USE ONLY—) Journeyman �i __ � hSE&A Barnstable Assessing Search Results Page 1 of 2 '[ [ ' a> tt- �<- ?+ tab '� "'?• >° a "� as R J, r • �. V � Home: Departments:Assessors Division: Property Assessment Search Results ' New Search 4 Iv New Interactive Maps >> Owner: 2008 Assessed Values: ° DELAZARI, CARLA S & 7 HITCHING POST LANE" Appraised Value Assessed Value Map/Parcel/Parcel Extension ,Building Value: $ 139,600 $ 139,600 173 /030/ Extra Features: $27,100 $27,100 Outbuildings: $ 1,100 $ 1,100 Mailing Address Land Value: $ 149,200 $ 149,200 DELAZARI, CARLA S& BATISTA, DEIWSON TP Totals $317,000 $317,000 7 HITCHING POST LN Residential-Exemption Received=$105,082 CENTERVILLE, MA. 02632 2008 REAL ESTATE Tax Information: Tax Rates: (per$1,000'of valuation) Community Preservation Act Tax $41.83 Fire District Rates Town Barnstable FD-All Classes $2.04 . .$6.58 C.O.M.M'-AII•Classes $1.03 Commercial C.O.M.M. FD Tax(Residential) $326.51 Cotuit FD-All Classes $1.33 $5.80 Hyannis-Residential $1 e53 Personal Proper Town Tax(Residential) $ 1,304.42 Hyannis-Commercial $2.35 ' $5:.80 ; Hyannis-Personal $2.35 Other Rates • W Barnstable-Residential $1.86 Community PresE W Barnstable-Commercial $1.86 • W Barnstable-Personal $1.8,6, Total: $ 1,762.76 • Construction Details • Building Property Sketch & ASBUILT,Car h Building value $ 139,600 Interior Floors Hardwood Property Sketch Legend• Style Raised Ranch Interior Walls Drywall Model Residential Heat'Fuel Gas , Grade Average Plus Heat Type Hot Water Stories 1:Story AC Type None Exterior Walls Wood Shingle Bedrooms - 3 Bedrooms • Roof Structure Gable/Hip Bathrooms 2 Full http://www.town.bamstable.ma.us/assessing/assess/displayparcel08map.asp?inappar=`173030 9/2/2008 Barnstable Assessing Search Results Page.2 of 2 Roof Cover Asph/F GIs/Cmp living area 1080 Replacement Cost $162353 Year Built 1973 a@?n^M+°xPS kp�wmd iul ,ma+3ya91'��aw, ,p�. Depreciation 14 Total Rooms 6 Rooms IN Land CODE 1010 Lot Size(Acres) 0.38 f - Appraised Value $ 149,200 Assessed Value $ 149,200 AsBuilt Card N/A �� �,����View Interactive Maps » Sales History: Owner: Sale Date Book/Page: Sale Price. DELAZARI, CARLA S & Dec 16 2005:12:OOAM C178816 $ 10 DELAZARI, CARLA S Jul 31 2002 12:OOAM C166099 $263,000 PEREIRA, JAIR C JR Oct 152001 12:OOAM C163101 $229000 KENNEY, RICHARD M &DEBORAH J Jan 30 1998. 12:OOAM C147363 $ 108,000 MAYNE, HELEN T C83487 $0 Extra Building Features Code Description rUnits/SQ ft Appraised Value Assessed Value SHED Shed 160 $ 1,100 $1,100 BLA1 Bsmt Liv-Good 1000 $27,100 $27,100 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT 'Attic Area(Unfinished)' BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS 'Second Story Living Area(Finished) UST 'Utility Area(Unfinished). FAT Attic Area(Finished) GAR Garage UTQ Three Quarters.Story(Unfinished) FCP Carport, GRN Greenhouse UUA Unfinished Utility Attic *` FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished), http://www.town.bamstable.ma.us/assessing/assess/displayparcel08map.asp?mappar=173030 9/2/2008 I Town of Barnstable Regulatory Services OF SHE rOw Thomas F.Geiler,Director STABLE, Building Division i SARN + v MASS.. Tom Perry,Building Commissioner �0lent° 200 Main.Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: �s °o _ Permit#: HOME OCCUPATION REGISTRATIO Date: Name: (2 is A4 S V{ev-cy ley Phone#:_(5cs)(i'85-- 'A t--+9 Address: �k'4t° h i,A a 1�oS-F Lan Village: �eYl L'Y V i I e 11�l z� Ua.6� Name of Business: JA2r e y Les 4aw,e -l-wn ?ro ve v►3 e!2 + Type of Business: Ee)v-e Map/Lot: /--'' I- U 3 O 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,tho�vQa'd'dress shall not be included. • No person shall be employed in the Customary Home Occupy on�is,,tpermane t0ent of the dwelling unit. �� I,the undersigned, a read and agree with the above restri tions for my home o%fa-oh&m, gistering. Applicant: Dat y 3�/ —C2-T LV Homeoc.doc Rev.5/30/03 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) ,:. DATE: 'al-off Fill in please: APPLICANT'S YOUR NAME: BUSINESS YOUR HOME ADDRESS: -1 "Po '\- Lane TELEPHONE # Home Telephone Number GtSVV71-1 -a53-t ' ..,, �,. .,.,". v.h. ...., :I:r us.,.,e..#y��.-»;.:,e..._►r...►r.r '�tt;, c^s ST_Y"Y;p E.O..,rFrd B '"."' - r '�:2.' .NAME FN WBUSINE ay%aXou USINESSyr e&" r . „ ,. ... . r.. Nl+c ,. z:1:.,_ < .u,: pP, 4 .� , .;. n YE <. NO,_.3 � ;� ��.. .� .,-�� `�•�.;M > When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFIC This individual has b informe of ny permit requirements that pertain to this type of business. thorized Si ture , COMMENTS: L(J 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: Barnstable Assessing Search Results Page 1 of 3 �� crs , � � 0 +i i • �' ti Home: Departments:Assessors Division: Property Assessment Search Results New Search , New In Ma_ps 2007 Owner: Assessed Values: DELAZARI, CARLA S 7 HITCHING POST LANE Appraised Value Assessed Value Map/Parcel/Parcel Building Value: $ 138,900 $ 138,900 Extension 173 /030/ Extra Features: $27,100 $27,100 Outbuildings: $ 1,100 $ 1,100 Mailing Address Land Value: $ 149,200 $ 149,200 DELAZARI, CARLA S %DELAZARI, CARLA S& Totals $316,300 $316,300 BATISTA, DEIWSON TP 7 HITCHING POST LN CENTERVILLE, MA. 02632 2007 REAL ESTATE Tax Information: Tax Rates: (per $1 ,000 of ve Community Preservation Act Tax $39.98 Fire District Rates Barnstable-All Classes C.O.M.M.-All Classes C.O.M.M. FD Tax(Residential) $325.79 Cotuit FD-All Classes Hyannis-Residential Town Tax(Residential) $ 1,332.71 Hyannis-Commercial Hyannis-Personal W Barnstable-Resident W Barnstable-Commer W Barnstable-Personal Total: $ 1,698.48 Construction Details Property sketch Legend Building Property Sketch & Building value $ 138,900 Interior Floors Hardwood http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO7map.asp?mappar=17... 5/30/2007 r Barnstable Assessing Search Results Page 2 of 3 Style Raised Ranch Interior Walls Drywall Model Residential Heat Fuel Gas01 Grade Average Plus Heat Type Hot Water a ; Stories 1 Story AC Type None _ " � � Exterior Walls Wood Shingle Bedrooms 3 Bedrooms ° Roof Structure Gable/Hip Bathrooms 2 Full +,° Roof Cover Asph/F GIs/Cmp living area 1080 Replacement Cost $161472 Year Built 1973 Depreciation 14 Total Rooms 6 Rooms Land CODE 1010 Lot Size(Acres) 0.38 AsBuilt Card N/A Appraised Value $ 149,200 _ µ View Interac Assessed Value $ 149,200 ` Sales History: Owner: Sale Date Book/Page: Sale Price: DELAZARI, CARLA S Jul 31 2002 12:OOAM C166099 $263,000 PEREIRA,JAIR C JR Oct 15 2001 12:OOAM C163101 $229,000 KENNEY, RICHARD M & DEBORAH J Jan 30 1998 12:OOAM C147363 $ 108,000 MAYNE, HELEN T C83487 $0 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value SHED Shed 160 $ 1,100 $ 1,100 BLA1 Bsmt Liv-Good 1000 $27,100 $27,100 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area (Unfinished) FTS Third Story Living Area U HS Half Story(Unfinished) (Finished) CAN Canopy FUS Second Story Living Area UST Utility Area (Unfinished) (Finished) FAT Attic Area (Finished) GAR Garage UTQ Three Quarters Story (Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic Enclosed Porch Patio Full Upper 2nd Story http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO7map.asp?mappar=l 7... 5/30/2007 Barnstable Assessing Search Results Page 3 of 3 FEP PTO UUS (Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story t (Finished) http://www.town.bamstable.ma.us/assessing/assess06/`displayparcelO7map.asp?mappar=l 7... 5/30/2001 buildln,, e Complaint/Inquiry Report ///7 , Date. Ree'd by: Assessor's No: a�— Complaint Name: _ Location Address: M/P Originator Nane• Street: VULIge: State Tlp: Telephone:D/E Complaint Description: Inquiry ❑ Description: For 09ce Use Only Inspector's 1 Z -�� I Inspector. s Action/Comments Date: LD Tollow up O — L G-V-1- Action R ®fig CA C3 C Addidonal Info. Attaclied Cop3•D=boson: Mite.Depamnent Fdc Yellow-Inspector Pink-Inspector(Ret=to Office Mana3er) sy9mm MIST Assessor's office(1st Floor)* a Assessor's map and lot number JC, /!Z�3 Q 30 INSTALM IN C� o �` Board of Health(3rd floor): ° Sewage Permit number Em Bg�LL i Engineering Department(3rd floor): TOYMM 4 House number o +b3o9- of, Definitive Plan Approved by Planning Board 19 ��ePY APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN , , OF ' BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO S 49 ic xg TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location y z.' &- # /SU po f i: )% A Proposed Use � Q� 97 Zoning.District . Fire District ���L ®� �1y0� ®�✓� � Name of Owners pry �I-/ e�L r Address 7 .#zh J;4C, �'asJ k E CNi�2w/Is� Name of Builder Xto gig f L,!>T�7�� Address ! n, ,N Name of Architect Address Number of Rooms Foundation t'P 1 S' �aVP2� Exterior C2KI),119.. X)DLat" Hoofing Floors PLY 0 D" � Interior 6 PgAj x7jw Heating Plumbing Fireplace of Approximate Cost� 20a Area Diagram of,Lot and Building with Dimensions r Fe6 to l �o �] Au-3 E )is , OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS `!j l7'r_j.1+4G foS7' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License MAYNE, JOSEPH & HELEN No 33247 permit For BUILD SHED Accessory to Dwelling i :r Location 7 Hitchi nci Pn-t- Lam- Centerville ' .r Owner 'Joseph & Helen Mayne , •. Construction Frame ` t Type of z _ „.�. Plot Lot Permit Granted September 27, 19 8.9 Date of Inspection 19 Date Completed 1 7�''f Q'> 19 t i R • • S e S _ f, -. tea low Assessor's office(1st Floor): # ` 'Assessor's map and lot number � /�� tJ�O Q�oF 7 11 M,E To`` Board of Health(3rd floor): /� d� w Sewage Permit number /jbt� A i?Zl�, E • Be Engineering Department(3rd floor): 0 a Lt House number °° i630' ®� Definitive Plan Approved by Planning Board 19 �a MAY d• APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only v, TOWN. OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ,5'� �J(� -� Z7 TYPE OF CONSTRUCTIONa) 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:. Location 2 )Y /77' j Al C; P0,F ,. At 4' tProposed Use Zoning District Fire District(� 1J7;~ //! ��'., - an--,,�y /1 lie- Name of Owner erPP 4- /1e-1 I14V14 Address 7 (FO.f> 1AR kNTt,? /;A, Name of Builder.�' ,. .1 V / Address Name of Architect Address. Number of Rooms t Foundation Exterior Roofing Floors e0I-V I,,o rn n Interior P%'A) _('ru f Heating 1; f=" Plumbing �t N Fireplace 14 n .fit �' Approximate Cost Y'_J` n Area Diagram of Lot and Building with Dimensions Fee ,l 0 I i sn �l i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS, ' iN G 13o !- O},` I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Ile Name Const ur ction Supervisor's License MAYNE, JOSEPH & HELEN A=173-030 7.3 No 33247 permit For Build Shed Accessory to Dwelling Location 7 Hitching Post Lane Centerville Owner Joseph & Helen Mayne Type of Construction Frame Plot Lot Permit Granted September 27, 19 89 Date of Inspection 19 Date Completed 19 yo�TIN FTo�° TOWN OF IBARNSTABLE BAUSTA13LB, i NAM ,•� -� r BUILDING INSPECTOR ��o yav a• _ APPLICATION FOR PERMIT TO F�f ... ... x �...j .... TYPE OF CONSTRUCTION_ r� .....1'.......... •�..... ...... a ,err. -sc .. .V/ ......... ......,9........ TO .THE INSPECTOR OF BUILDINGS: The undersigned hereby a` , for a ermit according the following information: 61 .......Location ..Jj ......:................... ............J.............. ... ..... ............ ....................................................................... Proposed Use . ... ....:... ..._:.. ....... • ....�: = PaE` s, _i..................................... V O Zoning District .....i...... .. .... .........'.. ....Fire District .. .... .. Name of Owner .. ... Address ....... ................. .... Nameof Builder .................................. ............. ....... .. .....Address ...( .....: .............. ..... ... Name of Architect ..- Y�._....................Address ....................(./././..v.......................................................... �©Y VIA Numberof Rooms .......... ........ ......................... .....Foundation................. ............................... Exterior .... ......... ... . ..... ...... . ...........................Roofing ............ .. ................ .........................-......................... Floors ..... . ........................... .....................................Interior /4 Heating .. .. .......... .................................. � . ...........................................Plumbing ...........`....(....... ............................................... •.• • . Fireplace ....... .....Approximate Cost -� Definitive Plan Approved by Planning Board --------------_---------------- /Od ' Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH 117-5 SEPTIC SYSTEM MUST BE 3i. INSTALLED IN COMPLIANCE WITH ARTICLE SANITARYCODE AND TOWN — 30 REGULATIONS. r? - M I hereby agree to conform to all the Rules and Regulations of the wn of Ba nstable gardi thejaboveconstruction. Name . .............................. ... `�� Mahoney, John J. one story No —���...... Permit for .................................... ' ' single family dwelling . . -- —...............................—..................-----.. �� Pmst--Iazma Location .*---. ------.-------- i . Centerville --------.—=,`=.`=..=,----------. ' ' \ Owner ..............John'�... _____.. ' \ ` � Type of Construction -----�rape.'---_ . ' . . _-----'-.------------------ \ . Plot ............................. Lot ...........#35.......... — J�oriI 27 �� Permit Granted --�����.-----.'—.lA '~ � - � � \ Date of |nopec tion lA 7' = \ Date Completed �� 24 | ' _ - �PERM0TREFUS00 l� � -----`—_----'r--------' / ` '---'----'----'r------------- ^ ^'-----'~^------~^----------' .-----.--._---.—.----`—.---.—.. � � ^ ( —'--'------------'—~—^~^----- Y \ � ~ \ � | �prove6 _-------------^.. lg � � . -------'---------------^--~' ! ' | ----------------------.—..-- ' ) � ~ ` I vi Au!' IPA } ii _ r, i i. 11 I ° - D I� N SMOKE 15ETECTORS REVIEWED A A _BUILDING DEPT. DATE FIRE DEPARTMENT . DATE I ��1 BOTH SIGNATURES ARE REQUIRED FOR PERMITTING. A-s 0, a), o Q 4s, C IMPORTANT -- UPGRADE REQUIRED STATE BUILDING CODE REQUIRES THE UPGRADING OF SMOKE DETECTORS FOR THE ENTIRE DWELUNG WHEN v __ ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. - .-. : A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL PE MIT DOES NOT SATISFY THIS REQUIREMENT. CARBON MONOXIDE ALARMS k MUST BE INSTALLED PER MASSACHUSETTS BUILDING CODE — . ..-• ��� r,, �� - .. geMove,l( v o �- Uj UJ r