HomeMy WebLinkAbout0018 INDIAN TRAIL ..
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Town of BarnstableBuilding
�ASW� L(:
f Post This Card So That it is Visible From the Street.-Approved Plans Must be Retained on Job and this Card Must be Kept
�$ Posted Until.Final Inspection-,Has Been Made.% eY' 1
ctp Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made
Permit NO. B-19-1212 Applicant Name: Henry Cassidy Approvals
Date Issued: 04/12/2019 Current Use: Structure
Permit Type: Building-Insulation- Residential Expiration Date: 10/12/2019 Foundation:
Location: 18 INDIAN TRAIL,CENTERVILLE Map/Lot: 210-017 i Zoning District: RD-1 Sheathing:
Owner on Record: LAPINE,JOSHUA&.DENNIS, DANIELLE i
Contractor Name. „HENRY£CASSIDY Framing: 1
Address: 112 WORCESTER VIEW ROAD Contractor License.`CS=100988 2
I
WATERBURY CENTER,VT 05677 Est Project Cost: $ 5,070.00 Chimney:
Description: Insulation/Weatherization Permit Fee: $85.00
Insulation:
Fee Paid:c $85.00
Project Review Req: + Final:
Date =% 4/12/2019
Plumbing/Gas
{ Rough Plumbing:
—- �- - � ',,,Building Official
Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced with in`six months.after'issuance.
All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted.All
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.
Final Gas:
This permit shall be displayed in a location clearly visible from access street or,road and shall be maintained open forpublic inspection for the entire duration of the
work until the completion of the same. ' '
.n. ..� ,.� . Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. -
Service:
Minimum of Five Call Inspections Required for All Construction Work: .
1.Foundation or Footing ¢` Rough:
2.Sheathing Inspection -
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:
6.Insulation
7.Final Inspection before Occupancy Low.Voltage Final
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
Work shall not proceed until the Inspector has approved the various stages of construction.
Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).
Fire Department
Building plans are to be available on site n?" �/� Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ,cr'�
s
�t Town-of Barnstable *Permit#
mont
Regulatory Services gee 6hsrlm Issue date
• snatvsraste,
MAM
v 039. Thomas F.Geiler,Director
Building Division
Tom Perry,CBO, Building Commissioner
.200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax:508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number I
Property Address b I om.rj Ta A IL , CEA C(2(ALLE. IY 14 6 (1 3 JL_
[Residential Value of Work 1.3,OCR •oA Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address M P'i�4
!All, �0)u f, A44 61aC-��
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) I
❑Workman's Compensation Insurance SE P 9 2010
Check one: 7"®WN OF❑ F3ARNSTABLE
a sole proprietor`
I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box) ,
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping,, Going over existing layers of roof)
dRe-side
#of doors
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows
"Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: " Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License-&Construction Supervisors License is
required. nn
h'U�IJP� bt �TkJ<I'1(JG�
SIGNATURE>
C:\Users\decollik1AppData\Lo oft\Windows\Tempo temet Files\Content.Outlook\DDV87AAMXPRESS.doc
Revised 072110 "
The Conrrnonsvealth of Massachusetts
EMM Department of Industraal Accideras
- Ofte of Investigations
600 Washington Street
Boston,AM 02111
imi:nmas&gav/tlira
Wa rkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/pinmbers
Ap plicaut Information Please Print Legibly
Naive(Businessps/Organization&dividua1):
Address: l_Q �.fJ Di A n I L.
City/Sta&Zip: 2V I Ll C ame# 01 � �{cl�
Are you an employer?Check the appropriate
Type of project(requuvd): /
1.El am a employer with 4. a general contractor and I
employees(full tad/orpart:part-time)-* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet 7- F�Remodeling
ship and have no employees These sub-contractors have g- ❑Demolition
working for me in any capacity. employees and have workers' 4. ❑Building addition
[No workers'comp.insurance comp-insurance.
required-] 5. M We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions
myself[No workers'comp. right.of exemption per MGL 12.❑ oof repairs
insurance required.)1 c. 152,§1(4),and we have no
employees-(No workers' 13.L�S Uther R�� t
comp.insurance required.]
"Anyapplicam that chef ks box#1 mast also fill out the section below showing their workers'compensation policy infornotim
1 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors mw submit anew affidavit indicating such. .
=Contractors that check this box must attached an additional sheet showing the name of the sub-cuet=tors and state whew air not those entities have
employees. If the sob-contractors have employees,they must provide their workers'camp.policy number.
lam are employer tliat is prmdding workers'cot gwisadoit insurance for my employees. Below is fire policy and job site
in/brAeafi0e6
Insurance Company Name:
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: CityfState/Zip-
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure.coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 andlor one-year imprisonment,as well as civil penalties in the farm of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be.forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby eeW4 ander the pains an n Hies ofpedwy thatthe ie formation protriddeeddaboty is trite and correct
Si tune: Date: TI o�o/o
Phone#: SO
d f icial use only. Do not twrke in this area,to be mulpleted by r-ity or loran official.
City or Town: Pe.rmit/Ucense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other s
Contact Person: Phone#:
Sub-contractors for.18 Indian Trail, Centerville MA, September- October 2010
Charles Hulstien—no employees
Brian Bos—no employees
1
e
Town of Barnstable
Regulatory Services
MASS,' Thomas F.Geiler,Director
Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
//t�
Please Print
DATE: 9 Q010 1'
JOB LOCATION: I '(J o(A 1j TV-A)t_ &�j yr-�U I L_l_E
number
uumber � � street village
"HOMEOWNER": MaP' SoY 7/c6 IG
name home phone# work phone#
CURRENT MAILING ADDRESS: I OQ l kQ(ktj Tak I L
CbjT atfILCE
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow
homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-
family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one
home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form
acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section
109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,
bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection
pores and require is and that he/she will comply with said procedures and requirements.
!; P0g
Sign a of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code
Section 127.0 Construction Control
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall he exempt from the provisions of this section(Section
109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as
supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for
Licensing Construction Supervisors,Section 2.15) This lack 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 form/certification for use in your conkununity.
C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc .
Revised 072110
DURABLE POWER OF ATTORNEY
I, Mary R. Smedley of 18 Indian Trail, Centerville, Massachusetts,�hereby.appoint Kent
B. Smedley currently of South Yarmouth, Massachusetts to serve as my Attorney-in-Fact—
(hereinafter referred to as my "Attorney-in-Fact"), and to exercise the powers and discretions set
forth below. By this instrument I intend to create a Durable Power of Attorney under the laws of
the Commonwealth of Massachusetts.
I hereby make, constitute and appoint my Attorney-in-Fact to act under the following
provisions:
1. General Powers and Scope. To exercise or perform any act, power, duty, right
or obligation whatsoever that I now have or may hereafter acquire relating to any person,
matter, transaction or property, real or personal, tangible or intangible, present, contingent
or expectant, now possessed or hereafter acquired by me, including, but without
limitation, the specifically enumerated powers granted below. As an expression of my
intent hereunder, said Attorney-in-Fact shall have full power and authority to do
everything necessary in exercising any of the powers herein granted as fully as I might or
could do if personally present.
2. Powers of Collection, Payment and Enforcement. To demand, sue for,,collect
compromise, recover and receive all debts, moneys, property interests, claims and
demands whatsoever, which are now due or which may hereafter become due to me,
including the right to institute any legal or equitable proceedings; and to execute and
deliver on,my-behalf and in my name, any and all endorsements, elections, releases,
receipts, or discharges for the same.
3. Banking Powers. To make, execute, deliver and endorse notes, drafts, checks,
certificates of deposit and,orders for the payment of money or other property from or to
me or to my order; to-open accounts and to make deposits or withdrawals on any accounts
in banks or other financial institutions on my behalf. To borrow -money and execute
promissory notes,in my name, and as security to pledge, mortgage or hypothecate any,
securities or other property, real .or personal; to execute personal guaranties, guarantying
the debts of another person or entity.
If more than one Attorney-in-Fact shall be serving concurrently, then the signature of any
one of them shall be sufficient for the purpose of endorsing for deposit to, and drawing.
checks or drafts on, any bank account.of mine:
Prepared by the Law Office of Patricia J.Mello,,P.C.
766 Falmouth Road,Mashpee,MA 02649
508-477-0267
DPOAI
.4. Power to Acquire, Manage, Lease and Sell. To make, execute and deliver
deeds, releases, conveyances, leases, purchase and sale agreements, subleases, and
contracts of every nature in relation to both real property, including but not limited to 18
Indian Trail, Centerville, Massachusetts, and personal property, contracts of indemnity
and insurance, on such terms and conditions as my Attorney-in-Fact shall deem proper; to
manage or become involved in the management of any such real or personal property.
To carry on, manage or become involved in the management of any business in which I
have an interest, and to carry out any act of management which may be appropriate to
such involvement; to enter into and/or carry out the provisions of agreement for the sale
or transfer of any business interest or the stock therein, upon such terms and conditions,
including the making of such representations, warranties and indemnities, as my
Attorney-in-Fact shall deem consistent with my intentions and negotiations begun by me
or on my behalf prior to any disability.
5. Powers as to Securities. To purchase, sell, transfer or otherwise deal in any way
with all forms of securities,'specifically including, but not limited to all forms of
securities issued by the United States Government (or any other government) or any
division;branch or agency thereof, to act as my proxy with power of substitution; to vote
all stocks or other securities in my name relative to any individual or corporate action; to
deposit any stocks or other securities in connection with any plans of protective or
reorganization. committees; to purchase, accept or exercise rights to subscribe for
securities and to sell same; to endorse securities or any agreements relating thereto, on my
behalf; to create, utilize, terminate and otherwise deal with accounts (including margin
accounts) with securities brokers.
' 6. Powers over Safe Deposit Boxes. To have access to all my safe deposit boxes,
whether in my name alone, or held jointly with others:
7. Powers with Respect to Insurance Contracts. To have full authority to deal
with any policies of insurance on my life, or policies on the life or lives of others, but-
excluding any such policies on the life of my Attorney-in-Fact, in which I may have an
interest, including, but not limited to, the right to make irrevocable assignments thereof,
to surrender, borrow against, or convert any'such policies and to change the beneficiaries
thereof, to surrender, borrow against, or convert any such policies as my said Attorney-in-
Fact shall deem proper and consistent with my intentions or objectives; to receive
payments under any disability, income or other contract, to deal in every other respect
with such disability, income or other contracts.
8. Powers to Rent.Rent. To receive and give receipt of all rents and income to..which I
am or may become entitled, pay from.all necessary expenses for the maintenance, upkeep,
Prepared by the Law Office of Patricia J.Mello,P.C.
766 Falmouth Road,Mashpee,MA 02649
508-477-0267
2
DPOAI
care, improvement and protection of my property; to pay the net income therefrom from
time to time to me or in such manner as I shall direct, or in the absence of such payment
to me or such direction, to invest the same in my Attorney-in-Fact's best judgment.
9. Use of Funds for My Care. In the event of'my illness, incapacity or other
emergency, to incur, pay and satisfy such expenses and obligations for my comfort,
benefit and care, and obligations of a nature customarily incurred by me, as my Durable
Power of Attorney for Health Care or my Health Care Proxy may consider necessary or
desirable or consistent with my wishes.
10. . Power as to Taxes. To prepare,.execute and file federal or state income, gift, or
other tax returns and other real and personal property tax returns or statements and to pay
or compromise any or all taxes or apply for and collect any refunds due; to make any tax
elections on my behalf or which I am entitled to make; to appear for me and represent me
at any level before the US Tax Court or any state, federal district or federal appeals court
of proper jurisdiction, the US Treasury Department, the Internal Revenue Service, the
Massachusetts Department of Revenue, or any other taxing authority, in connection with
any matter involving taxes in which I am a party; to execute claims for refund, protests,
applications for abatement and consents to any waivers of determination and assessment
of taxes, agreeing to a later determination and assessment of taxes than provided by any
statute of limitations; to receive and endorse and collect any checks in,settlement of any
refund of taxes; to examine and to request,and receive copies of any tax returns, reports
and other information from the US Treasury Department or any other taxing authority in
connection with any of the foregoing matters.
11.` Power with Respect to Entities. or Forms of Ownership and Related
Transfers._ To create, amend or terminate one or, more trusts, partnerships, corporations,
co-tenancies or any other form of ownership or entity for the purpose of dealing with any
property or property interest of any nature that I may have or hereafter acquire, under such
terms and with such provisions as my Attorney-in-Fact deems in the best interests of
myself and my.family. In this regard, the fact that my said Attorney-in-Fact may be a
remainderman, partner, shareholder, co-tenant, or beneficiary of any such entity in
connection,with any such transfer hereunder shall not affect the validity,thereof, nor, by
itself, constitute a breach 'of-fiduciary duty hereunder; to transfer any or all property,
tangible, intangible or real, in which I may have an interest, into a trust or trusts, whether
revocable or irrevocable, and whether created by me or by my said Attorney-in-Fact on
my behalf, and whether or not such trusts were created"before or after the execution of
this durable power of attorney, or to any other form of entity or ownership,,including any
form of co-tenancy ,
Prepared by the Law Office of Patricia I Mello,P.C.
a 766 Falmouth Road,Mashpee,MA 02649
508-477-0267
' 3
DPOAI
f
12. Power to Make Gifts Exercise Powers of Appointment and to Disclaim. To
make gifts of my property either outright or in trust to or for the health, education,
maintenance or support of such persons as, in the opinion of my said Attorney-in-Fact,
would be the donees I might choose, including my attorney in fact, having in mind the
resources, both public and private, available.for my care after the making of such gifts,
and having in mind the objective of preserving the largest amount of my property for my
family, devisees or legatees as a whole. My said Attorney-in-Fact shall also have the
power to exercise any Powers of Appointment of which I may be the donee and which I
may execute through an inter vivos document, including but not limited to my power of
appointment in the property known as 18 Indian Trail, Centerville, Massachusetts. My
said Attorney-in-Fact shall also have the power to disclaim any bequests or other interests
to which I may become entitled from any source whatsoever, or to waive my spouse's
Last Will and Testament and to execute any documents. necessary to effect such
disclaimer(s), not withstanding the fact that my Attorney-in-Fact in fact may personally
benefit from such disclaimer.
13. Power to Employ Agents. To employ, compensate and discharge such agents on
such terms as my Attorney-in-Fact deems appropriate to carry out any acts authorized or
contemplated herein.
14. Powers with Respect to Retirement Plans. To establish and contribute to any
form of so called retirement plan for my benefit, including but not limited to Individual
Retirement Accounts, Keogh plans, and other form of pension or employee benefit plan;
to change beneficiaries of my account in any such plan, designating such beneficiaries as
my Attorney-in-Fact determines to be consistent with my wishes; to waive any spousal
rights I may have to benefits from any plan under which my spouse is a participant; to
borrow against or withdraw from my plan accounts on such terms as my Attorney-in-Fact
deems appropriate; to select any form of payment option or to modify options I may have
selected; to accept any.benefits or lump sum payments on my behalf and to "roll-over"
any such benefits on my behalf.
15. Third Party Reliance or Refusal. Any party dealing with my said Attorney-in-
Fact hereunder, may rely absolutely on the authority granted herein and need not look to
the application of any.proceeds nor the authority of my said Attorney-in-Fact as to any
action taken hereunder. In this regard, no person who may in good faith act in reliance
upon the representations*of my Attorneys-in-Factor the authority granted hereunder shall
incur any liability to me or my estate as a result of such act.
16. Successor Attorneys-in-Fact. If my Attorney-in-Fact for any reason ceases or is
unable to serve under this power, a written, acknowledged statement by the Attorney-in-
Fact or a certificate executed by a licensed physician,which opinion of such physician
Prepared by the Law Office of Patricia J.Mello,P.C.
.766 Falmouth Road,Mashpee,MA 02649
508477-0267
• 4
DPOAI
i
states that my Attorney-in-Fact is incapable of physically or mentally managing my
Attorney-in-Fact's own affairs. Such inability to serve shall be conclusive evidence of
such fact, and any third party may rely upon the same in dealing with my Successor
Attorney-in-Fact under this power if one is so named.
17. Guardianship. If a petition is filed in any court for the appointment of a guardian
or a conservator to care for me or my estate, then I nominate my Attorney-in-Fact as such
appointee. Nothing in this part shall be construed as a direction that such a petition be
filed or such appointment be made, and it is my express wish that such action be taken
only when and if absolutely necessary.
18. Reliance on Copies of this Power. A photostatic copy of this power.; as
executed, may be treated as an original power by any third party dealing with my
Attorney in fact.
19.' Effective Date. This power of attorney shall become effective as`of the date of
the signing hereof, and shall continue to be effective upon my disability or incapacity, as
defined by the Uniform Durable Power of Attorney Act, M.G.L. ch. 201B, section 1(b).
20. Ratification of Attorney's Acts. I hereby ratify, and confirm whatever my said
Attorney-in-Fact shall lawfully do under these presents.
21. ' Declarations Relevant to Execution of this Durable Power of Attorney. I have
employed my attorney at law to prepare this instrument according to my desires and
intention expressed to my attorney at law. The provisions that my attorney at law has
included in this instrument, including but not limited to those referred to in this article,
were discussed with me by my attorney at law. My attorney at law has advised me of the
benefits of and the risks involved in making gifts, including specifically the potential
impact on my future financial security and the possibilities of abuse of such power. I ,
have carefully considered the risks involved in creating a Durable Power of Attorney, and
the.alternatives to a Durable Power of Attorney, as explained by my attorney at law. I
have determined that accepting such risks offers benefits to me that I desire, and' I
therefore accept such risks.
Prepared by the Law Office of Patricia J.Mello,P.C. A
766 Falmouth Road,Mashpee,MA 02649
y' 508-477-0267
5
DPOAI
IN WITNESS WHEREOF, I have executed this Durable Power of Attorney this
day of fta 2006.
Mary. S "dley
COMMONWEALTH OF MASSACHUSETTS
Barnstable, ss
On this _day of 2006, before me, the undersigned.notary public,
personally appeared Mary R eTdley, proved to me through satisfactory evidence of
identification, which was personal knowledge of identity to be the,person whose name is signed
on the preceding or attached document, and acknowledged to me that Mary R. Smedley signed it
voluntarily for its stated purpose.
- y _ c PATRICIA J. MELLO
Notary Public.
Commonwealth of Massachusetts
My Commisssion Expires Feb 27,2t�9
4
4
Prepared by the Law Office of Patricia J.Mello,P.C.
766 Falmouth Road,Mashpee,MA 02649
508-477-0267
6 ,
DPOAI