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0085 JAMES OTIS ROAD
�c -ems 0f7 �oc�cl , I. 4 �Application numberg.......6...... .................... Date Issued... a.............. ................ . s �,' ` AUK 222�q Building Inspectors Initials...............� .. ................. Map/Parcel..... .. . TOWN OF- BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: CI, -M05 DIr S IZow NUMBER STREET VILLAGE Owner's Name: P?rvLuooM AL'i 5 - Phone Number -3,9') .Email Address: tQz V CtAA 0LYQ1_—. Q W^ ) _C 07XCell Phone Number 1 Project cost $ 411 q7 Z °'° Check one r Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize A s e_,c. A*,Acv dl *-0,A— to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK Siding 0 Windows (no header change)# 0 `Insulation/Weatherization ED Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of.shingles) Construction Debris will be going to -rrwiy - or- Vadfmd,,,� rvy CONTRACTOR'S INFORMATION Contractor's name J(t. i`�'� i D,I�e_ �iwl- 'din'�`ses CIL Home Improvement Contractors Registration(if applicable) # 13 yyq 3 (attach copy) Construction Supervisor's License# 0 S Q gJ30 y-1 (attach copy) Email of Contractor wI 0 rt. of �Qtsrca SfiPhone number SO 36 L •�(� B (e ALL PROPERTIES THAf HAVE STRUCTUR S OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER F` X *For Tents Only* Date Tent(s) will be erected Removed on number of tents total t Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a:for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# y Model/I.D.' Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I.understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date zz All permit applications are subject to a building official's approval prior to issuance. I �4 T S J The Commonwealth of Massachusetts Department of Industrial Accidents {� Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electrician's/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Clam"t-"Vrc ��N {�12r`seS LL Address: City/State/Zip: C live%`✓h)f Z AA- O 2G 3 ZPhone#: S-i�8 36 z ,06 0 4, Are you an employer?Check the appropriate box: Type of project(required): 1.�] I am a employer with_3 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employeesThese sub-contractors have g• Demolition workingfor me in an capacity. employees and have workers' Y P h'• # 9. ❑Building addition [No workers' comp.insurance comp.insurance. - required.] I 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.ElI 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.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A10 ( vet✓`�/ tr�,�s Policy#or Self-ins,Lic.#: JfE WC ! -7Z _I 0 Expiration Date: Job Site Address: O f'i f 9 _ City/State/Zip:1!l tit, VI-L�6 Q 2�p Z Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify unde�the ains and penalties of perjury that the information provided above is true and correct. Signature: Date: FATI he? Phone w 40 Official use only. Do not write in this area;to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions ,Y Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. i Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another wlio employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in`the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability,Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may'be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number; - - The Commonwealth of Massachusetts Department of Industrial Accident Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#61.7-727-7749 Revised 4-24-07 www.mass.gov/dia I Propo!5al Keith C. Gilmore Enterprises, LLC HIC#134443 _ P.O. Box 17, Centerville, MA 02632 MA CSL#98047 _ Phone: 508-420-9934 Fax: 508-420-9935 Date: 7-21-18 Project#EVA01 Client Name: Paul Evangelista& Max Siu Phone#781-656-3891 Billing Address: 85 James Otis Road,Centerville,MA 02632 Alt.# Fax# Project Address: Same as billing. Email : pevan0001@gmail.com Project Description: See below. Project Task Items: Remove and replace all of the siding on the home using Certainteed 5" Cedar Impressions in client selected solid color. Prep wall surfaces with Typar vapor barrier and Vycor window and door flashing. Prep chimney wall area with ice and water barrier underlayment. Install lead flashing along chimney,bulkhead and steps. Install white pvc trim board stock behind electrical meter socket. Install color matched vinyl protrusion blocks as needed for all utilites existing the home. Replace the fascia board using white pvc trim stock and install all new white seamless aluminum gutters and downspouts. Install white vinyl soffit vent system with white pvc bed molding trim and frese board. Remove and re-install existing shutters, lighting and window well covers. Install two roof exhaust kits for two bath vent fans in the attic. Permitting, labor,materials and waste total. $ 27,560.00 Remove and replace all trim boards on the shed using white pvc trim. Replace bottom V of shed plywood with pressure treated plywood stock. Fabricate a new shed door set up with white pvc trim stock and stainless steel hardware. Install new Certainteed 5" Cedar Impressions in client selected solid color. Install a new Certainteed asphalt roof system. Permitting, labor,materials and waste total. $ 9,303.00 Remove and replace the existing outdoor shower with a new custom pvc outdoor shower built using pressure treated sub frame,white pvc frame trim, shelves,and bead board walls. Install new stainless steel _ door hardware. Install new plumbing valve enclosed in wall. Install Azek Slate Gray deck surface for shower floor. Inspect existing drain for any modification if needed.. Permitting, labor, materials and waste total. $ 5,109.00 Total $ 41,972.00 Initials ,. X, .. V PAYMENT TERMS The amount or estimated amount of said contract is $41,972.00. Customer agrees to pay / the Contractor according to the following terms: ! $ 4,000.00 Due at scheduling t. $35,972.00 Due as invoiced in weekly installments during production $ 2,000.00 Due at.completion Description of payment terms All work will cease under this contract if payments are not made pursuant to the terms described herein. Workmanship issues must be documented by the Customer,in writing,to the Contractor within fourteen(14)days that Homeowner knew or should have known. x There will be no refund for special-order materials and/or any other non-stocked items after three days from approved proposal.Any other refunds shall be calculated and/or determined by Keith Gilmore Enterprises. The Contractor retains all legal remedies available if the Customer fails to pay including the recording of a mechanic's lien on the property pursuant to M.G.L.254,§5 to secure the payment of all labor, including construction management and general contractor services and materials,including those furnished by Keith Gilmore Enterprises. Customer guaranties the payment of all sums owed to the Contractor. Customer understands that any debt to Contractor over 30 days past due is subject to a 1'/z%finance charge per month(APR 18%). Customer agrees to pay all legal fees and costs incurred in the collection of any money owed to Contractor. Customer acknowledges that Keith Gilmore Enterprises has a reasonable expectation of payment from the Customer for any materials furnished by Keith Gilmore Enterprises as part of this project between the Customer and Contractor notwithstanding any payments to or disputes with the Contractor. This Notice of Contract is to be construed and interpreted_ according to the laws of the Commonwealth of Massachusetts. The undersigned acknowledge that they have read and understood all of the enclosed terms and that their signatures appear freely and voluntarily below: Authorized Agent* Date - , Contractor Date I Page 2 of 2 Initials f CERTIFICATE OF LIABILITY INSURANCE o° /02/20;°°""YY' 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT „Paychex Insurance Agency Inc PAYCHEX INSURANCE AGENCY,INC. PHONE 877.266-6850 IAX F 585-389 7426 150 SAWGRASS DRIVE ROCHESTER,NY 14620 EMAIL Certs@paychex.com INSURER(S)AFFORDING COVERAGE NAIC# NSURED INSURER A: NorGUARD Insurance Company 31470 KEITH C GILMORE ENTERPRISES LLC INSURER B:- PO BOX 17 CENTERVILLE,MA 02632 INSURER C: INSURER D: INSURER E: INSURER F: :OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ISR TYPE OF INSURANCE A DDL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS rR NSR D MWOONYYY) (MM/D GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL UABILITY DAMAGE TO RENTED $ fre CLAIMS-MADEI__OCCUR ~ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY =PROJECT=LOC _ $ A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY $ ALL OWNED SCHEDULED (Per person) AUTOS AUUpT�,,,��OS BODILY INJURY HIRED AUTOS AUTOTNED (Per accident) $ PROPERTY DAMAGE $ (Per accident) I,' EACH OCCURRENCE $ UMBRELUI UAB a OCCUR - .. ��----�� AGGREGATE $ EXCESS LIAR CLAIMS-MADE DED RETENTIONS ' - X WC STATU• OTH- WORKERS COMPENSATION AND KEWC972498 02/04/2018 02/04/2019 ' EMPLOYERS'LIABILITY E.L EACH ACCIDENT $ 500,000.00 ANY PROPRIETORIPARrNERIEXECUTIVE E.L.DISEASE.EA EMPLOYEE $ 500,0D0.00 OFFICER/MEMBER EXCLUDED? (MeMetory In NN) N N/A E.L.DISEASE-POLICY LIMIT $ 500,000.00 II yes,describe untler oESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more apace Is required) 'WERTIFICATE HOLDER CANCELLATION BIII Flfl Pryor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 40 Pryor DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY 40 WiltonW ltone,M Drive 02632 PROVISIONS'BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE kCORD 25(2010/05) 1988-2010 ACORD CORPORATION. All rights reserve The ACORD name and logo are registered marks of ACORD e ® Commonwealth of Massachusetts Division of Professional Licensure Board of Budding Regulations and Standards ' . onstruction Supervisor CS-098047 Expires: 07/15/2019 KEITH C GILMORE a; PO BOX 17 CENTERVILLE MA 02632 Commissioner a Office of Consumer Affairs and Business Regulation . One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Type: LLC Registration: 134443 KEITH C.GILMORE ENTERPRISES,LLC. Expiration: 10/28/2019 PO BOX 17 CENTERVILLE,MA 02632 Update Address and Return Card. SC 7 ea 201,1-05117 "•��r�r ururrvrnvri�/�r/ �lrr..,ur•�ri.:r•// Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. ff found return to: Reaistration Expiration Office of Consumer Affairs and Business Regulation 134443 10/28/2019 10 Park Plaza-Suite 5170 KEITH C.GILMORE ENTERPRISES,LLC. Boston,MA 02116 KEITH C.GILMORE 28 HIDDEN VALLEY RD. MARSTONS MILLS,MA 02648 Undersecretary !' Not valid without signature TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map / d Parcel / O ":'Application Health Division ` Date Issued 3 Conservation Division Application FeO.. Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation / Hyannis V Project Street Address 2:5 SAAAC,S oT O *DK Village CEw°TC-K✓ 46- 4Aoq Owner /W to 5OV7,-A Address 9R L N 76 %10t Telephone Permit Request gr>=g n* A10 At- &0^1) : IW 4) w 0-L k�G�CC, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District 11Flood Plain Groundwater Overlay Project Valuation ,500,4,onstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, atta supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Ba ment Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing ew C Number of Bedrooms: existing _ w On otal Room Count (not including baths): existin new First Floor Room Couf? 9 Heat Type and Fuel: ❑ Gas ❑Oil lectric ❑ Other 3 N Central Air: ❑Yes ❑ No Fire p ces: Existing New Existing wood/coal sty: 4,Yes ❑:No Detached garage: ❑ existing ❑ w size_Pool: ❑ existing ❑ new size _ Barn: ❑existing cjW n6 size= Attached garage: ❑ existing . new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appe s Authorization ❑ Appeal # Recorded ❑ Commercial ❑Y s ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name I>O✓h A4V;-kE&� Telephone Number Address _?.0,?OX 1171 N License# v f STUB A4,11," AAA GZ,& 1-/1' Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TON% <TRf\1Q/7F6A v Z op SIGNATURE DATE 0 /,�v� 0 : S FOR OFFICIAL USE ONLY { t APPLICATION# L r DATE ISSUED MAP/PARCEL N0. ' ADDRESS t VILLAGE OWNER 1 . 1 DATE OF INSPECTION: FOUNDATIOM t ) FRAME r 'y INSULATION FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:-i :_ ROUGH FINAL ,,tw'�FINAL BUILDING, ,f �' # .F DATE CLOSED OUT ASSOCIATION PLAN NO. E e Tlxe Commonwealth ofMassachusetts Y Department oflndustriralAccidents,. , Office of Xtiv.estigafions w 1600 Washington Street t� :Boston, MA 0jX11 • .�yy www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/,Contractors/Electricians/Plumbers Applicant Information Please Print LejZibly Name (Business/Organization/Individual): ,, �"►� �yV� Address: City/State/Zip: 104 MIWS N .Phone Are you an employer? Check the appropriate box: Iype of project(required): 1.❑ I am a employer with 4• ❑�T am a general contractor and T 6. ❑ Ne construction - * have'hired the sub-contractors.. . yees (full and/ part=time) - -- - -- - , 2. I am a sole proprietor.or partner- listed on the attached sheet. 7. Remodeling. ship and have no employees These sub-contractors have g. Demolition workingfor me in an ca aci employees and have workers' Y P tY• 9. E] Building addition [No workers' comp. insurance comp.Msurmce.l t ' required.] S'. We are acorporation and its 10:❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 'I l.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t. c. 152, §1(4), and we have no employees. [No workers' 1.3.0 Other comp.insurance required.) *Any applicant that checks box 41 must also fill outthe 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 most attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employers,they must provide their workcrs'comp.policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: Policy# or Self-ins.Lic. #: `Expiration Date:_ Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. 'Be advised that a copy,of this statement may be forwarded to the Office of Investigations of the DIA for'insurance coverage verification. I do hereby certify u er the p i .. nd penalties ofperjury that the information p`ovided above is true and correct. Si nature; 7, 2 Phone# Official use only. Do not write•in this area, to be completed by city or town officiaL. " City or Town: `" . Permit/License# Issuing Authority (circle one): 1. Board of Health Z. Building Department 3, City/Town Clerk 4. Electrical Inspector 5, Plumbing Inspector 6. Other Contact Person: Phone#: Information and fnstructzons Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees, Pursuant to this statute, an emplo),ee is defined as ".,.every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,-parinership, 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 the dwelling house of another who employs persons to do main tenance,•constniclion or repair work on such dwelling house or on the grounds or building appurtenant thereto sha11 not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing'agencyshall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant lvho has not produced acceptable evidence of compliance with the insurance coverage required." ical subdivisions shall Additionally,MGL chapter 152, §25C(7) stales "Neither the conunonwealth nor any of its polit enter into any contract for theperfofthance ofpublic-work until acceptable evidence of compliance with the rns�>rance requirements of this ehaplerhave beenpresented to the contracting authority." Applicants Please fill out.tbe workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s) name(s), addresses)and phone number(s)along with their certrficate(s) Of insurance, Limited Liability Companies,(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of lodustrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or [own Lhat•ihe 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 e.workers' compensation policy,please call the Depariment at the number listed below, Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly, The Department has provided a space al the bottom of the affidavit for you to fill out in the event the Cffice of Investigations has to contact you regarding the applicant. Please be sure to fill in the,permitllicense number which will be used as a.reference number. In,?ddition an applrc�i that must submit multiple permit/license applications in any given year, need only subrnil one affidavit.indica tin current policy information(if necessary)amd under"Job Site Address" the applicant should write I'd locations in __(city or town),"A copy of the affidavit that has been officially stamped or marked by the city Or town y be provid e d to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new sffidavi l--',Mu be filled olt 1 each year. Where a home owner or citizen is obtaining a license or permit not related to any businesaorconunerciaJ venture (ix. a dog license of permit to burn leaves etc.) said person is NOT required to complete this aff'davtt. cor�peratino and shou➢d p-0 baye any questions, The Office of Investigations wou IrTo l inn « please do not hesitate to give us a call. { s° The Department's'add-css, telephone and fax number: t j The Commonwealth of Massachusetts Department of industrial Accidents Office of In-yestigations 600 Washington Street Boston, MA 02111. Te). # 617-727-4900 ext 406'or 1-877-MASSAFE Fax 9 617427-7749 Revised 4-24-07 www.mass.gov/dia i o , �`" ..� - ✓�ie "C�oz�zoncnsueatC� c� �j/lcz,2.lar�iuQeld•�� T Board ofBuild,n�Ile for indn nu reigns end fii ai �r` L�cc rise or i eg�stratton.�atic! t else orl i HOME IMP ROVEMENTfCONTlZACTGR 1�ztorL the expiration d d _•lf foyer cl return_to r r ';oar.l of>tntdmg`Reguh*tons na�I,St ndards Rbgistra+ion 138308 "Y Oi c lshlim ton Pl.a a r,nixl'301 i Expi�at�on 3/�7� 011 Tru ;1{ 9`i Bas an,11I'a 021;03 r i GQF1 *JII;LLEN BUILDINCy&REMODEL!Nr'. , .. j i y E QQ LAS MULL EN ' "x UBBY LN C � �• - — .n d i,d,l d tn lui�ig n�tu j�z s��v� YARtr1Gl ri h"�F v2673 Minn iisti y 1�.��9..._...�..--.��-.��..:_ - _._ _:.._._._.�. �. fit. � �.v;` � � '•E c>. s.aR.lam__ .exte. ..3:, Ili.S's u _ .- Massachusetts- Department of Public S rtcti , f. Board of Buil(lin��-Regulations aril! St mdutd, . Consttuction Supervisor License f: License:.Cs;: 81995 wi ww�.. -' Restricted.to;. 00 DOUGLAS W MULLEN ' 87 VICKORY HILL CIR �a OSTERVILLE, MA 02655 Expiration: 1/23/2012 Tr##: 16801 s i �3 THEr Town. of Barnstable `. o� Regulatory Services p uAa9 Thomas F. Geiler,Director 165 ArEo � Building Division Tom Perry, Building Commissioner " r 200 Main Street, Hyannis, MA 02601 www.towri.barnstable.ma.us Office: 508-862-4038 Fax: S08-790-6230 Property Owner Must Complete and. Sign This Section A If Using A Builder as Owner of the subject property J hereby authorize 1, V-6 /K kCAl, to act on m_ y behalf, in all matters reiative;to`work authorized by this Suildiiig permit application for. (Addzess of Job) a c� ;7-6(-U Signature of Owner Date Print N If Property Owmr is applying for permit please complete the. y Homeowners License Exemption Form on the reverse side. Q:FORMS:OVWNERFERMISStON tl y ��of Y�ray Town of Barnstable r Regulatory Services ( ; Thomas F, Geiler, Director l,��r EQ All Building Division P µay Tom Perry, g Building Commissioner 200 Main Street, Hyannis, MA.02601. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Plefse Print DATE: t JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The currant 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 Persoa(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 constrgcts more than one home in a two-year period shall not be considered a homeowner. Such "bomeowner"shall submit to the Building Ofbcial on a form acceptable to the Building Official, that he/she shall be responsib)e 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;ie/sbe will comply with said procedures and i r requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings.conta 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shall be cxcmpt from the provisions of this scc6on.(Section ID9.).1 -Licensing of construction Supervisors);provided that if ncc homoovyner engages a pc sons)for hire to do such work that such Homeowner shall act as supervisor." Ivi'any 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. Thew homeowner acting as Supervisor is u)timate)y responsible. To ensure that the homeowner is fully aware of his/her responnbilitics,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 forrn/certification for use in your convnunity. Q:for rns:homccxcmpt I t Pl OMB No.2502-0265 „4 B. TYPE OF LOAN . A SETTLErNIENT S1'ATE-IEb`T.(HUI)-J) L C] FHA 2. ❑ FLHS 3, FXi Cow.UNTNS. 4_ \A S f j CONY INS, 47 4.FILE\Lt\BER 7 LOAN\UrtBER. - -C-XILL.I DEvirlie.. 0 1444 0073576811 MORTGAGE NS_CASE N s. C.NOTE TAis form is Run istr:d to givel&i."e ststetami of ecutal sealcment costs.Amrrurs Irld to and b)the sculelnenr xgem arc4to.n.Items i iaelmd'(p.o c.)'were paid ontsida the closirgp they are shaven here farinformauonal purposes and are nit it duded.in the iatals:.. D.NAME&ADDRESS Marie M Sotrre OF BORROWER: 175 Sunset Lane.Bamstable,lvlA 02630 E. NAME&ADDRESS Paul J MCBrien Jr and Jacqueline E McBrien. OF SELLER: 28 Stonev Cliff Road Ccnfcrville,NLA 02632, F.NAME&ADDRESS (v7etLifeHoine Lrxns OF LEER: P.O.Box 7481.Sarinelield.OH 45501 1 G.PROPERTY LOCATION: 85 J=es Otis Road Cent_tmllt,,MA 02632 } H.SETTLEMENT AGENT: Gilt Devine P C � PLACE OF SETTLeJENT:Gill Dcvine P.C.776 Maim Street,Hyannis.DLA.02601( 08)775-9300 1. SETTLEMEW DATE: 8/10/2010 DISBURSEMENT DATE: 8/10/2010 J: Summary of Barrawer's Transaction It. Summary of Seller'.T'mnsaction ; 100.Gross Amount Due:From Borrower;_ 400.Gross Amount Due To Seller:, a 101.Contracrssles Price 245.000.00 401.Contract sales prict _ 45.000.00 103.Personal Pm Mi, - 402.Personal propefty - - 103.Ser7emenicliarbrstottaam�:er:11'mt tie). S 713,70 - - 104;Aug Taxes to-Tawnd'Barnstable. - 473.99 404. .: .. -. ... .: .: . . - 10S.Water Cw"C'sto C-0-NSI Water. _ 35.001 5.. Seprc Haleberi 10 9io.00 Adjustments For Items Paid By Seiler In Advnnce:. adjustments For Items Paid By Seller In Advance:. ; 106,Cityftowtt rases to 406.City/town ta,xcs to 107.County taxes' - to - - - '407,County taxes - to - 1 108.Assesuneacs to 409.Asscsiments to ' 109. 409. 11 o. _ 14. II t. 411. 411. 114, 414:. 120,Gross Amount Due From Borrower. 262,171.69 420.Grass Amount true To Seller. 245,000,.00 i tf 200 'mount,Paid Rx Or In Reh&Of Barrower. 500 Rgdogion3 In AMountDue.Ta II ) MI.Deposit or carnes mancy 10.000.00 SOL Excess deposit(seoin�Mdoas) 202,Prinap+t atount of new loan($) ..:IS3750:00 i02,Sstlerners charges to ut!s tliae 140'3j 1.786.44 i 203.Exisrae10aa(5)takenPtieetto• _ - - 503.Editing loat(5)takcnsubjectrio.. �204: $04,Payo:r tsi Mtg.La.PNC Dtatrgage 240 721.60 [. ZOS..Lender Credit - 415.00-505;Paya$3nd Mtg.La. :os. 306,Deposit Tet Seller 10 000.00 �t 307, 507. . 208. 308.Aaartey Fet to Joseph J Beri rdi; 2,500.60, 3D9. 509.Water Chip to G4)-:1ihi.Water 49"79 r )f i Adjustments For Items Unppid By Seller: adjustments For,Items Unpaid By Seller. 21o;Cityhowataxes 07101110 0 08/10110 206:40.510.Cityitowntaxes 07/01/10 to 08110110. 206:90 1i . 21 1,eaunry.times. W - 51 L County taxes to 212.P.Ssessmrmti - .ro:- :- :512.Atsessnints - :m 213.. _. 513. . . - - - 515. , 216. 516_ ZEB. _. 518. •.,,,,., 219, Sig. 210.Total Paid B/Fdc 520. uetad Total'Redns y 194,37L9 -55' 63469 Borrower. to AmountBue:sellor. 30Cash At Settlement F- a tv r: 6(10 as tt nn Fromfra Set 39t_Gross ovardatiratlttirrouxrpinel?0} _ 262t7;69 601.Gmssamcuntduntostuer(lie420) 245000.)0 302,'Less amount paid by for borowee(line 220) 194,371.0 602-Less reductions in amount due stile(line520) 255.263>69 i 303.Cash('t )FROINI),DrO) Borrower. 67.799.79 603.Cash jJr0),OFROXI),Seller-. 10,263.69 i t The Public R2po' Burd-a for this cdlxim of informt:iGn is estimated at 35 mut-i:t per response for ealletaitr3 revieain&and reporng the data This agency _ •may no collect ddi inia:�iauaa,im1 you ors tua tegtrira�m eompltte il»s item,tmlcss it displays a crras;j}+2lnd 0\iB rabtmt cutabtr \o cmnfitlartrdCory is:s3�..a',' - ihisrriin6rucismandamry.77dsittlisieatdi6prrnadtthe ES'pattiestoa.RPA.wvctedtYattuctionwitbinfatttatioadwingthestatematprtxgs. Previous editions a e obsolesa . Paee t of 4 HUD4. 1 1 T MEMEN CRARGES Escrow, 0-1494 ^* 700.Total Real Estate Broker Fees Paid From Paid From ;. _ Borrowet's . Seller's Follows: Funds Funds 701 'It At .at 701 S Settlement Settlement 70 704. RO 802.Your credit or charge ipcqnis) 903 Your ad'ugted griginatinn charges (from GEE A) 903 ais fee n Nicholas A 805 Credit ro2ri to Total Credit S- (fromGFE,k 806 Tax service o (from-QFE fill_ 907 Flood certification ffrom GFF.93 . 8 915 917, .814 819. TWAA—.- 901 Dailv' 0 %, 902. (from k 903. <' ¢ ') - 04 V< to 906. Initial -escrow - acentint 002 <' 0601 00.3 M 0 n ntonth� 37. 293) . 00i County DLgn==eq 0 00 per mwth 10% Annual i 0 . 0 0 0 1010. 1101,Title smices and lender's title insurance (from GFF tW) 1,519, I 101, Settlement or cloqOng fee to 1103, O%vneeq (from051 649- 1104, <dtle insurance MA first Amenican Title Insur2nce Company S506.00 06 Chi )41000 00 1107. Agenf s portion of the total title insurance premium S808.50 Gill Devine P.G F 1108. Undenvriter's portion of the total title insurance premium S346.50 MA First American Tide Itts ranee Company. 09 - 0 ` S25,)DO 1113. Courier Fee to S 4 Plot PlanI.Survey to YankeeSurvey Constihiigts $160.00 369.00 1207 Deed S 126.00 Morteage S 176.00 Releases S 76.DO 76.00 @8 1204, Citv'Countv06 49 Obtaino Raidsm n.Deetis M 00 . 1301 Required smi ce,that M can*shop for FE 06) 0 Survey. 1303, Peg inspscrian to 1304 12ascharee Tracking Fee to Gill Devine PC 10000 C .Tax SeMce Fee to Tntal Mortmac Solution 07 FLOOd Certification to Federal Flood26 C. n it 7 71-796.4 Pre%ious editions are obsolete Page?of4 HM) . Comparison �. ChuMn That Cannot I-- HUMI Lone Number Your crediz or charge(ligiinti)for The=ific interest rate chosen s 801 Your iWjusted origination chame. B 801 Transfer r 703 Charves'nut in increase More Ilan o/ enol 375.a) ;6g Tax Service Fee AH306 goo() 94100 FLOOd Certification 91307 . 1600 16.00 500.00 - 375.00 01103 60;<7 64900 a1101 1-045 0 y Tatsit e g S .. _ - e., 0 QuIX interest charges 9901 S 11 4350 60357 60357 1 ) 1 t Loan Terms Your initial loan amount is S 183,750.00 Your loan tern is 30 years , Your initial interest rate is 5.375000 Your initial monthly amount owed for principal.interest,and S- 1,029.95.includes and any mortgage insarance is © principal ❑ Morgagelnsureoce Can your interest rate rise? Q No.]Yes,it can rise to a maximum of S.The fits change will be on - and can change again every:after Every change date.your interest rate can increase or decrease ' by %."Over'the life of the loan,your interest rate is guaranteed to never be. lower than %or higher than %. Even if you make payments on time,can your loan balance rise? Q No.❑Yes,it can rise to a maximum of S Even if you make payments an time.can your monthly Q No.❑Yes,the fast increase can be oo and the monthly amount amount owed for principal,interest,and mortgage insurance rise owed can rise to S The maximum it can ever rise to is S Does your loan have a prepayment penalty? Q No.❑Yes,yocr maximum prepayment penalty is S. Does your loan have a balloon payment? Q No.❑Yes you have a balloon payment of S due in : . _ Yvon •_ Total monthly amount owed including escrow account payments ❑ You do not have a monthly esaaw payment for items,such as property taxes and homeowner's insurance..You must pay these items directly yourself.. ❑X You have an additional monthly escrow payment of S . - 263.34 that'results in a total initial monthly amount owed of S 1,292.29 . This includes principal,interest,any mongage mSu aooe and nay items checked below- ©.property taxes Q Htimeownds msurmoe ❑ Flood Insurance Note:. If you have any questions about the Settlement Charges and Loan Terms lived on this form.please contact your leader. Previous editions are obsolete Page 3 of< HUDI Ju i .l d eU 1 U r: 4dHM BERLHNU I 5083750023 P. 2 FT i0M FAX N0. ;15087904005 • Jul- 08 2010 02:32PM P2 r INOMMEM STANDARD FORM PURCHASE & SALE AG''REEIIAN7` From the Offto of: COpa Cod R*ah.iatita ainrle", 1867 Pallmok Rd.,soft 1 1r PARTIES.AND Centarvilk MA.02e3z MJULINO ADIES$ES This „: day of (RNJn) Paul J.MaBrIM Jr Qi JgegUellrllr'E Menriek a6� ,/11m Otis`Rasd,C�nterrlfh,MA`02a3Z hereinafter caned th SeLLQIi;-agresa to MIL arid,. MiarltM Seuaa, 171i 8urkskLvirv.Barnstable,MA,Qb6s0. 2, PESCRIPTION hereinafter celled 0,a BUYER or PURCHABFR;agreao to BU .'Upon th6 to fM In and ifidudo the fdbwing daeCril;ad promises: nns heratnsher set fo lh, llffe Latnd and the bufte(Inys thecort located at . E0 Jarriea Otia.'Ro",:Centarvq�,MA o263x Arid farther desorOied at the Elarnetable County Re91Ptry o1 Deeds 9k1400a` Papa 174. 3. ' BUILDINGS, InCluded In the sale es a s1 RUCTUREg thereon,and the Tixl jrss bsk�tO n9 0 1phe�EL� R a^d i d ilnaconna dw*@,and iMPRt>VWENTS, atl wall-lawail Car ii!!n di �mOma n� FIXTURES, shege8. larsens, eiircen door&norm Windows(an d 0 aownl Orewlth rn0lyding,if any, (Nil iln O►dalate) ha I ,sh venetlan hdnde, Mrlrliiow at rM equipment, ;fovea, ranges, oil end pas bumere nptT,.shutlefe: fumaos, heaters, heaters. Pkimbing arnd bathroom hxturee, parbaos di arse Fktures rote, hof:weter appurtenant th. h,antals, outside telitvislen ant9nna$, fences, ego. . elaearit; and other Il ota; trxturos, Oat so, freer:, shrubs, phirda and; 7 Is IF t3UI W-IN;. redlQoralOra,sir am litionir> eq�llpment,Ventiletpre;diahw�Ifere,waaMng machinsaand drYetB;emd but excluding 4. TITLE bBf;D 8eid Promisee We i.: be rnva ad (AN In) li by a 900 end suftldwnt quhds�m dsetl rutlrrin0 to:the BUYt:Ft,. `rnc idd hem by k or to the n01t7iAae deslpnated by the BUYER by wditen n olio& to the gELLER at +east stale@A +aG anyrestrlet�na, ehetl cbnve ra days before the deed je to be delivered a4 ttereln oase'trailfe,- a� y two Ind clear rftord and Inorketablrl ship il4reto'1r96 from n-*'Wds ,ardi Mid d6W ►d2 M prriy welts a. Provisions rd exist building and toning laws; aulcept rrolMah�Iltt:(b),leaasa SUcb. hing rig da and ehllgattono In party wail*which'are AOhtha subplot of wrNten a' munlc"and ofherporta, Such tames for the t►wrrCurrent Year as are not rue a 9reti!mm l; oflrer+P M such deE��; and Peyatib on fha dpte of the dsllvaiy ne-Wt►bntrrcbs,mrrJ d. Any liens is munkipel bottortnenta as8ebaed`after the dale of pile gorpbment ilralra R viticn l p>9vep a. Easantei:ts,restrictions and reseNdllona Of record,if anti aO lon�_ae the sent;do n Sr!?LL�ft eMlnaf BUYr;as br�h of SEUE010 prohibit or n isterially Interfere with the currant use of told premteee; tit' covollems AI kebea where na�cmaiaty, , 6' PLANS If Bald devo refers to s plan necessary to be recorded:therewlth the SELLER s with the deed In form adequate for recording or registeatl0n, hurl db rer such den 6. In)(N PRICE (11rY The agreed purchaon Price for said promise, is$ In)space Is stlbMoetl to TWO HUNDREb AN FORTY-FIVE THOUSAND ,000.00 spell out Me amounis N desired $ doNat�;Of►Yhlch 1Q,000.011 haVe been paid es a d610"it lhIm day`and S 238,000.0t1 ar4 110 be Pahl at the tune OtdolivajyL Of,the cashier's, :dQed In taaeh,or by eertlf11a; phedc(oj t5 r I s ,411,000.01'TOTAL 1eo0e aIA1p taaeTolt Rt:.0 Bet�iTt!BOARD Ali np m re A �" Perm 10:RAM ft.mroe Pape 1 era rorw;��w,Tnie!•orna'" www.tweFerme,aom eoa.�ao.;n1� , t Jul 13 2010 7: 43RM SfRLANDI 5083750023 P. Frei tom. :150S790g0( Jul. 09 201Q 8z:32Ph1 P3 T, REGISTERED TITLE Jn addition to the lorsaoinp; 0 the Tee to said,promiset# is tiufficl•M tb sMltle fhe_ftt1YER10 8 Certtficacp of Tea of ►eglsfered, with sold deed all mild... ,deed shay h0 n form Title. Inetrurr�enIs;If any, necessary to srteble, thPe 6rnist ,j-b o n�L I deliver a, TIME FOR _ Certmeate Of PERFORMANCE. such doacr is to ba dolivored at ON VERY OF 06ED �I t �Q..1A_, at the 9 t COCCIl y am pQ Pm on the etM� day of Otherwise pgreea 6 bon In wril ftQ It 4 4gradd that bnte I:of lho Qs Regvatry of .Ceedi.'ur ae 6, P013 t g�ON and ;Cn or before t atahis CONDITION Of PREMISE bar ppseoeslon Of laid p►ernibos free of all ternnto end �ft►nettt (eh•cp p flal or be:deflVered at tho tlroe. of Ih• dgllvrry of the d oCr6Wnte"=ex cogdilian his they n'-Iw hue. reason ueo and !FOPt os..hereJn prbvfded`sls to excepGC+ts,I/any) aed, sold premrsag to 'than (a}..vn the eanb builpinQ and=nnint; taws, slid{c}In compli.nowsaq�teri9of Rucoe �buae 4 heroof. Thar$uY ib).not In Vfoleaon of.said the d R Shall be entitled Parsohdfly to ontorlsald� y;instrument:referred.,la m 9Yd to order to determine whnlh or the condil106 thoreof ifea.. P►vmrsea.prlor,b fie debvary of ntP with the tnttg of this d•ue6,10; Fxi"EN$ION Tp If the SELLER shal be un�gbb'to iYe tills PERFECT TITLE p►emir,ee, all as he�ain itl 9 or.to ntakA�rry4y Imp:01 fo lkV. OR MAKE PREMISES Pultited, or if ql the lima pf. ds Poi i;abn the CONFORM CDC with the prcvtalons hecebf,then sn a fnA de>llvery of the deeaahe refunded and all ell'er obligatlone of Md rt parties, Under this'=a0namant shell be far�iwitlt I'Cl+ertQp perr�rot r'lma y without►aCourea to the parties; parties hereto shall aaase,and this hanito, unless the SELLER el"to use reesoaft ntent;�hsh Id any detect In fide,crto deliver pos"6110,Ae k eBerla,to rs r oire to the plpvisi0ns.h6'eof, as the; p�'ovWed herein, or to make firs sold Y gAfe caryk m cage Ina bs, In whloh evdrtl the ULLER shah; ive wrltfan'noliQe thereof s�tits BUYER st or before the time for Perhbrmenoe hers PAr"anes hereof +hall be Nlended for period of thirty under,7artd thereupon the lima`Mr 111. FAILURE TO PERFECT If at the eXpiretbn Of the Wended Ilme thq SELLER s TITLE OR MAKE title,dellvsr poseebaron, hall halls'fy sc to remove an da PREMISES CONFORM,olo. f<et an tt or msk01t1e premitles Conform,as the rase may bo,a.11 as hereF�, his In Y "w during Iho period of this agmemaht or any.&Mensior,theOr* agtbeetC or on sold`aremiees shad1 refuse to pc+rrtlit the Insurance ►col, the holder at a mort then sny peymentY nods under this agreement shsNtb a40t1, If>any,to be used.f A+Be of such purposes, Of the parties herato shall Cease and this Sareament ohs a hold wlthaut r id"all a ��Oetlons hereto. 12; suYER's Rerrgas ELECTION TO The BUYER ahbtl rtErve the elactlO at<61ther the'erlgfnal or any esfanded dyne for r{o ACCEPT TITLE accept such title as tyb t4ELLf;tR can tlNivr t0 the sold'I fh0 purchaurr rmence,;490 fmtseo:tn their than Condition end to price without deducllon, In which�000i the SELLER shall oonv Pay except that ill the evitrJt of such CortVeyariw In aecafd with promfess Shoji have been dvvvma the Islone ey`suoh>Ffh, Oed � hrw ar cdsually {neurnd ai of this:clelrse, if the estd unf�s ftSELLER h aprjWOw! � nilr::thYn ttli SELL SR"ah�l, y re8tbtad he promises.to�etf fOrmsr condition,alfhor a. say over or assign to the BUYER an dellrr reaeverabte do s000unt of such Insurance, ia'amo<Ints 011sb racov�ed:or SELLER for kny pa+dil reeterretlon;or Y Y' xpend d`bythe . b, R a holder o a mortQe00 an sold '—`— Ihersbf to &1 a Premisee.ah+IlNresl p IMF[the Inlurance sad to restore the er4ld rerhlsee to their forvlrer p steeds or a pMy over or Anil:n®d,give 10 the BUYER o credit oohdltlon or to he eo.PWd coed,equoI :o sitid amounts aid ret:over�i agek►ef iha pumhomij prroe,.cxi dollve sold rhortgalN less any mounts row b lersble and raialned.b the h ry of the jhq restoration. Y °fdir'Of the IY pended by the BELL ER Ibr'any,partial •13• ACCEPTANCtc Tho acne ante of a coed b •OF bEED a full Y the BUYER or his nomirlse, rAr the cseo m•Y , eheq be tleenbd to ba pe once an,l discharge of every pgfeement and obllgatlb�°.herein c except each as Ow Fr, the tonne hereof,to be parionned aRer ttre O11tltrnod ar.etprsseeel 14. U$!*.OF_MONEYTo TO t3nrittih► the SELL i to vn•kra deMvaryofsaid desld. CLEAl�TITLE delMery of,the dead w Conveyance as harain Provided, ttNA 3ELkt:R IdBy; at the Cilia of lib free purchase mar+oy or any portion therept to cfear the tb of @ With the olive or Inte��adt8, pravkletl lhal'all Instruments ;d �Y Oral!with the dellyery of Hal f daed. ArocUrQd tee.reeerded'olmultn or,si l "002afAj lr,. r'e+++eiNtY►,��rnleForMu" wwW,TtwFenpi,gse, lICO•Mo•0+!�Z Tv v � r �� h Jul Id eul u. /: 143HM BERLAND I . SQ'83750023 4 M FAX NO. :151 7904 July 08 2840 02:32W P4': 16, INSURANCEme 4lnaerf OM LW Until the dellVery 011he deed,the seLLEA rYAo OPbrBurFnlcy mein shell unl(N� fain one moure ar said prpml89s ea fotklws: ed�r�fons!lypee d/ a, Flro d Exl,;nded Coverage Amount c7C�virrq Mavr�nae and aaaawrte as y 8 AS PRaeEMTLY iNSUR!'D' alaep� C W3 1e. ADJOSTMENTB "t8 'le•hthL"lh� tbl0!! rotor bNd•:r�eyYi1� uaq `G�10 Ra any.aaMaohdeo) rg Year. eheH to app,,ttiCned and fuel value Mall be adJueted,�ns 4t 1aXe9 far_' ihen't:u a9rdis r ent and the net amount Sh4repf�jefl.b�added't4�tled , cif.,tfacsi WOWS price pay;,b� hr day of per�ormaru:e of thi$. by the BuvER at t lime cf derlvery of mte dsd as the cae.e mat►be,the 17, AdJIJl3YMENTOF If the 8mnUnt Ot s;ed tWleo is not k110wn of=f UNASSEt38ED AND ABATEb TAXES aPPanioned on the faalr;of the taxes.aai69 ' h6 tins of iha deuveR of rho deed f as seon Ae the 8sed Ibr ther re hW �tl be net r tax rate and vaWMIllon can. be.a P cetlirp flaoel Par,-4 with®respgortlannteni apPonioned shell 1 1ereefter be roduc4d KOerfeinttd, and,:it the taxes which rodaonarble Co6t of obtaining the aarna, shflabbesment, the amount of such ehelamanl bis IM nehher party Shan bo obil pportionW,betwa+erl the otherwise herein to Melllutb or pree�We P►ogeedl PaRke, provbad`;that aD'ar�d, ns� for an ebalem�t.un 11111 Give", }! `BROK 9 ..)1MARRANTY The 8rdker (!t�!►nnarrle) (ef rtem,,td herein. warrant(s)that the Bi*Dr(s)Ja(ore)duly liconelad ae such by the G 24, bEP01>IT �nlonweakh.p oeChue (►Yl1 to"a, t as aRcrowM mods.ha reu rider,$hall be:held in Qeorow by ant eabieet to the ft of this a8r�menl end eh4N be dui parnpnoe of thid !for In the event of an died r4 YounoRti/or at tho time Tor A11enl May retain al d4Aoalls ma.t� under this e�reertl9 Yt °d ne�'M+een the pdrelee;a escrowWrRi , ►C by the BELLE Arta the 8L1Yt R, p 0 Nrudbne mtnueitty'f ri lit 21, DAMA31 pSFAULT, If the BUYER$hall f ill to fuhW the BUYl:p1p a DAMAt3ES BUYER shall be ratti'n6d Imements herein,'all li 1 +eMeq b)+ the SELLER"as IiClUdaied deirlsgae. ar a made hareunderay th'e n i thle$half be the Sellers 81) remedy at-law and in utt 22. RILEAGE_BY The SEI,LEIR'e s Y HU8gAN0 OR WIFE I�utl horeby agree+o to-IOin in s+Icl d sod ono to tales tither rights and lntorr Ste in said"Misers. ee slid Convey all at tut 23. BROKER AS PARTY wY and Tro Broitor(e) niMMhcl herein 1niM4)in this agreement and,becorne(6) a art llerdlo Ina provitdorur of this a 3reenteni expresslyp .Y afar. modiNcahvne pf each xoyilbons to whlCh the 8rok6r(s)pree(a)�nrt+vvriftng, 10 any amenaiiiergaao 24. LIABILITY OF COO Cod Rra1 Bob.*8ervlqos TRUSTEE, if the SELLER or t3U ,ER utewtes this a principal Or lhs seteti�rep►eeertt lil►alM+ent In tt SHARSJiOLD R, ed$hot bd bo iameontatfue cr fiduaery.ppad! on th nor eharehgltlor i:ir b4MSfl a t arid,llrtd npifhar the 19�LLER or r�UYER eo s BENEFICIARY,ebC, ar impibd, hereunder rY o ally trust 4hall`be r►llonehy`e*ble for'a alai adon n0 ny grew: 28, REPR ANTI TAtldD T BUYER acknowlr dgea that the BUYER has not REPA"gal, rATIONt3 has he relied been tnAuel tl o artier°into Chit)trarfeaetbn �Mli7rwne,atrty none',H � UAoA ar�y wlrrrontleo er reAn�Matione not set'lorfh Ol inapt nor Ibbd�.kldlwtosywlna p►eYitlyely made it wrlllrtp,except (or the f�Nawinp.edd(tiolael watrrprtti and rs s m Y�hre"W"Mumwoo any,Made by ellheir the SELLER the Orbke (e); NQNC, e4, �++ent pentetlona;1f. Form;pst,q� y NOQO 9 ar A i bJ►TIUARar� www.T►u@Forma.a d0�at,0-Nirr;r Ted J u l 14 eU 1 U '1 t 4JHM HERLIFI D I 5083750023 P. 5 ARM. Fes! hld c 150Bt�ea005 lull @8.2@i0 012:3h1 p5 x6. CaNTINGENCY CLAUSE in order to IaMtllhp�DllDvidadlhrin help Arl,bltCd the apqu1911ion of sold prem►sea, the 9UYER`°shall QIl'iV to these) bank or other Jnbtllutlorle, m° Qe►osn Of. condltfons. if dsapir,g tna 1311YE ft dillgent effect rnrrtltrni ht far pp>y fora �rwehtlortal Or before IxevedNnv rhea,tarns and ncUOe to the SECT.Rlan 21R tlke aj�red- BUYt;R Atetot euoh toart�nnOR:Oe obtained an Y termineta this agreement by written such time,whereu port'arty agent(a) for'the 8Et,LER, p►ior to the e,rpl►atlon of Other obllgetlolS a!the pawn t�t!lr p made under that aereelneht $halFbe to ihs parties hsretu. in no avert will the if 00 e n dt�Ogre v,Ont ehallb aid wrid ar►d all such oominttment unlema the roe BUYER submits a com feta�d to howl:.used dl5genl etlbrts the fompoing pmvis 0r15 ort Or before p aAe Itktn i 27. CONeTRUDt*N 1L#s♦ 4 si_�_ ka'tlon canfatn;sq:� O AGREEMENT Thie lnsteumQnt, sxclouled in multi roarts is to take etfgtt ae a !,ealad instrun>QntpIQ efoMh the Qr>bre construed ad:it- solo MaseechusMfi Corttnsct,le upon and cmLif"let the bensljt Of-the conirract batwpen t! psrti edminletrator®, sua;eas s pert)°s hereto amd thw t bindlog and asslprts. and may be onneal1 e�Dectnre helre, dovlsses,eiteautore,written tn6IMArwn,l e1,8cuted by bath the VLLER �� madlftetl or amengeO onl ybys her+eih as 6uYEit Weir ot�igatbne hereunderahil s 130Yt R If tWo 4r marq Pam Mg are need not6e arp ltaed an r es a nlbttvr of conVanlsnrs erltl erojOinla�nafetoet Ttte.captiOne`artd me. I"agreement Or to by I,aed In determining the Intent of thQ ps e$to tl.. Gonsi rotl a.. r6 ) 28. �EADp HINT LAW part of this T'he part la4 46know cedar: that :Under years of BOB reskia o III an Mssaechueetta lajv wtlarwYef a `chUd or:chlMfgn un malaria! conlsins de igaraue levels of sel dr the ,in wl ch any, der;:alK ntir:.ot seJd y pBt►nt, plgeter or dher eccapeibla palrtt. Prater at oth�7'ntatsNml ao as to make It lnaocesabi-tO c nei 'dMustar eIX yams of e 28: SMOltEJCO t3taECTORt3 4r coverItl The 8E#!fW shell. al the Ilene of the deavey oi.tf►+ dead ctiPeRrhent of the 0 y Or lawn In Whidh avid premtaei`+are looeiled at�tl., t , �IiYer ,a.,CeRlflcete 'irate tMs fire been e4uIPPe with tpproy ernoke and carmen nti hat 6eid pramreas Frays law, In the event the premlesa axe I rrtiDrtOxlde definelen Jn conformity wIW. 1he shsN prcvldo aatisfeet ►np ad from the statute Governing Irsttailptlpn of co lee�j 4� 3a: AD01TiONAL cry evldenOQ of sLreh exemptlorl, PROVISIONS the initialed riders,it any,attad W hereto,are Irtcr rporsted herelR.py y rence pay Ip beln0�s1►1d In"as Is"Condition.Tits V Septie has V IrnbMsQaftor afa closfnn, at auyet's sole a T1liled.Brayer wile hsys new TitN aertiTtoation as►equlred by AAA.Law.Subjecf t Bu Ors Martialpt be reaPonslble:,for Jill*V eerrow buyOm fund,at closing ft7!r.Tltts V iregtaltlliltton'd.eertllioatien. she Is a fYIA.'Li om d Broken afNllatftl with C C ' psny agnrNnp_ diaol6sed'OwlAgermy,.7hfe agresrnar/tlew � od:Rlel"Ea �°f horebydlaolo�,. 1Ah.QeMGIa.Thee h a bJedl to t3e11 tnxler approval. fOR`RSllolli LAL PROPERTY GONSTRUCTEI:I PA10R YEA MUS "PROPERTY TRAN:iiFt?tR kOY p CATIOAI C RTIF CATIOp NAB SIQNaO LEAD PAINT NOTIC s legstdooumentthat creates bl lnp oblljldBons.if not understood.con t1Ull an attars SELL" Print`Nrune; .ram BUYERc �''�� print Natt�a; Taxpsy�lr 1D18adal ISOMPAy No._ _ , .._...`�.. Taxpayer iD/8odal security,No, 3EEa.��for 8pocieb):- prMt(dune: BUYER: Tipsyarll)/800lel98curl PnrltlVarl>e; kpdyer ID/^aoclel aoauiity:No.-.�.... 9ROKER{6) 6ROKERI ) —••�- .,a . Papa of 4 ('arn�b�nlirlbdby;'ty11lFarm[r'" �,TruO�amaAOnr �1D.490�af9) � 4 N La 'Wb s 4 7 f ®�'i'Il of al�°ffit . ' *Permit#. —: �G 3 +? Expires 6 months,;out issue date Regulatory Servrices Fee . OD Thomas F.Geiler,Director 5Jzs/s� J� Building Divisi®n (vim Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 vm w.town.barnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ff __ Not Valid without Red X-Press Imprint Map/parcel Number Property Address Residential Value of Work ���� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address VC 1,J V 10 ,� " 1 G �Telephone NumbeT_h5 3L�- Contra ame Home Imp rovement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance X-PRESS PERMIT Check ne: MAY 2 4 2007 Pt a sole proprietor ❑ I am the Homeowner TOWN OF E3ARNSTAE;LE ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) construction debris will be taken tV Was s) All[ e-roof(stripping old shingle ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. J-Value _(maximum.44) *Where required: issuance of this permit does not exempt compliance with other town departmenitr�g+a^ s .e•H�stow nc Conservation,etc. ***Not operry er must sign-Property Owner Letter of Permission. co y e ome Improvement Contractors License is required. SIGNATURE: fi Q:Forms:expmtrg Revise061306 The Commonwealth ofMassachusetts a TO .Department oflndustrial Accidents Office of Investigations !� d 600 Washington Street Boston,M4 02111' www.mass.govldia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ARRucant Information .Please Print Legibl Name(Business/Organization/laditiidual): . •Address:_ � `� r �'"�`'�- • City/State/Zip: Phone.#: Are you an.empioyer? Check the appropriate box: :Type of pioject(required):. 4. I am a general contractor and I 1;❑ a employer with 6. []New construction . employees(full and/or part-time),* • have hired the sub contractors 2, I am a sole proprietor or partner- listed.on the'attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, (]Demolition �vorkin for me in an ca act employees and have workers' g y p ti'• 9• Building addition [No workers' comp,insurance comp,insurance.#' 5, [] We ate a corporation and its 10,❑Electrical rep airs or additions -required.] officers have exercised their 11. Plumbin re pans or additions 3,❑ I am a homeowner doing ill-work . right of exemption per MGL ❑ g p myself,[No workers comp. 12,❑Roof repairs insurance.required.]t c. 152, §1(4),and we have no employees, [No workers' i3.❑ Other comp,insurance required,] 'Any applicant that checks boz#1 must also fill aut the section below showing their workers'compensation policy information, f Homeowners•who submit this affidavit indicating they are doing all work and then hire outside contractors must subrrit anew affidavit indicating such, =Contractors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether drnotthose entities have employees. Ifthe sub-contractors have employees,they must provide their workers'comp,polity number. I am an employer that is providing workers'compensation insurance for my employees. Below is-the policy and jab site information. Insurance Company Name: Policy#or Self-ins,Lic, Expiration Date: Job Site Address: City/State/Zip: A,taeci a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Fai:ture•to secure coverage as required under Section 25 A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of'Ls'statement maybe forwarded to the.Office of IoXes'ff e DIA for insura=2 cover€se verification, 1 do hereby certify u r th nd penalties of perjury that fhe inforn�aton provided above is true and cc-rect. Si atu?e: Date: 2-�I G' Phone#: a OfTrcial use only. Do not write in ibis area, to,be campleted by.city or town ajTzzcial, City or Town: ' Permit/L•icense r Issuing Authority(circle one): :1,Board of Health 2•Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I Town of Barnstable. h Regulatory Services 9$ ss Thomas F.Geller,Director wilding Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 "'w.town.barnstable.ma.us Office: 508-862-403 8 Fax: 50.8-790-6230 Property Owner Must Complete and Sign This Section If Using A wilder I, as Owner of the subject property hereby authorize. oc uOCLA— to act on my behalf, 'in all matters relative to work authorized bythis building permit application for: . (Address of Job) �y �7 Sign e of Owner Date ft %A-� Print Name Q FO RM S:OwNERP ERM IS S ION t, • -- Elie �oa�7irnOlzuca/�/,..O�•-/U(.!,/iJd1C�JPS . 1 Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date: If found return to: lug Board of Building Regulations.and Standards Registration:_ .147273 One Ashburton Place Rm 1301 Expiration: 6/23/2007 Boston,Ma.02108 _: Type DBA . .:. .tom. V.HADAWAR&SO,NS 4 VICTOR HADAWAR 86 WATERSHED Not valid without signaturi MARSTONSMILL,MA 02648 Administrator TOWN OF BARNSTABLE Permit No. ___ __.- . Building Inspector cash OCCUPANCY PERMIT Bond Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .................................................... . 19............ ....................._..........................................................._.............................. Building Inspector JOSEPH 10. DAL!UZ - 4TEIEPHONF, 775-1120 Rnileing,1= miuiontr _ _ EXT. 107 N TOWN OF BARNSTABLE BUILDING INSPECTOR p � TOWN OFFICE BUILDING HYANNIS, MASS. 02601 MEMO TO: Town Clerk , FROM: Building Department U DATE: � � r An Occupancy Permit has been issued for the building authorized by 16, :• �% Building Permit # 1 � issued to Please release the performance bond. /mod l/ `. ` �•rr9y •r>EPT1G :T�►�K-°s '334><15�'/. =A9 EX 0'1'�� Q�7^� wi" 41 c t§ r a ISAS. • I+ I 3 J,L FFld aM O `11► �►. . . �P.o ' t3 _ � �•o G.P o• -ZSq fur.- � X� ff� � � -raTA *^�42 S G•P TL O t ! a ! yy -Xa `v c '.S o G PR � ", �5t �,•.. .r.r rr•� v,r � n /,� '* 1�',._�• � ��'mt .c ��SY. OYFiv FLoa! k �: PE2GQ�,ATiaN P.4'fE: .:1''IN '2MtN o>`Y�C 55 /�I•/�i//� ! 9> li 3' �' 1 6/ f// r j M 1.411 MXIU '. P1 OR u �:,�� , . ✓ ` s ', 'fit c'� in , t• i T0P SND� ti . [� TZ'1_1` hq5 r ��J�y/����'! ♦ J 4 k" y -,t S �.".}-' r ^lx .� yQ��=)z�� f�y�= � }_ �'G• �'�, 4 ,,,,,� vfi' i 4 =, �� SSA �.��,:�G'.,� ��� v• r} xs4e e.tY LpoANI � .;� �`" _ � >•' '. ' ;Q. D15T. J. GAS 5F►$_ . n� �,-, >�� ��, Y. !N r.�j� Yz - •/ P'flf.,� ,, x x �000 �N� 54�G T�N►� - G se. A 4- AT ra z< �7 i. ... 2T1 F GC p1.oTs� P�,.Akl � _( � G6 I ! PRO -LO4A-T low No Mr A. sfN '�' TNTou►J�laTtO�, SK4vYN k ' �„ S YJITN HE 5►1 o1L�N Fs ' �[.p.t3 vW., u , 3 {. 14GRiiG.ttlr C ' Y oF'tNE n �4 # �•, ` A'1JG� S6RT Gk R6QV��LEMEN't> 4 A �', , '.S NM'; �•�*►,� T �OWN- O -, 7T� $ AWD ILi r:q . " s '.! . q' t TN6 FLoo� P4.�►�N (� T 3 40F LQCATE D W ITN► q t� BAXTEiZ! NdYE#1NC. F F - R.EG 1'SZ E.R64'�l►►W D Su I.Yi'sY�11 I�1CrT Qyl��jFiU Id AN OSTEQ.V�1.{.E • Tu1SrQPpu 6;1,4r dSV VC:Y -rNE AHF�ETS 6uQu',A ` �•r pp ? IN5 M tJ �.oT �INE.S APP I P. ;�/U�GL' �R1G rf r .�tGnTA DE'TER.I^I `G -- As 'Asor% snap and cif number 1. �/ p`} Q . , *'THE TO Sewage ,Permit number .r......�. TI y i�,� A -" UfoBAHBSTdDLE i House number r ............ ... ... i w s�:AA O° 1639. `0 a: ,4 L_ <Fp ypY a i TOWN OF BARNSrAt Pls • . BUILDING IN,SPEGT0RCoe F��• 4 a� S f . t APPLICATION FOR PERMIT TO ................................., TYPE, OF CONSTRUCTION -' ' ... • e TO TH;.t INSPECTOR'OF BUILDINGS The .unders'igned hereby applies for rmit according' to the f Ilowir g information.- Location .. . ....................................� :� ...: Proposed,,Use, . ............... ....... ... ........................................... ... .......... . Zoning Distract ........................ ......... ....... .. .........Fire Distract ........................................ 7. .... y Name: of Owner .:..... .. Address J.. .. ........ .. �............ Na'rn6 of:.Builder .. .........Address ......................................... ........ Name of Architect ........ Address �j ( -� . Number of Rooms,, .....Foundation .... ....... k Exterior .. . .... .Roofing Floors ... ....... ........ ........ ....... ........ . .. .:Interior ... .. Heating :.. ��`�:. .. cam!.. Plumbing .................................................... Fireplace .... . .. ....................... pp A roximate Cost ... l .. . tDefinitive Plan Approved by Planning Board __ ___________________________19--------. AreoL•• ............:.......:.. Diagram of 'Lot and Building with Dimensions Fee � ... • SUBJECT ,TO APPROVAL OF BOARD OF HEALTH OCCUPANCY'PERMITS REQUIRED FOR NEW DWELLINGS- , N . • I 7- f hereby agree.to conform10 all the Rules and Regulations of,theTown of Barnstable re • ding the above ` construction. Name ....... .................... Construction Supervisor's Licens �: ...;„ ...7............ SMALL, ALAN E. ` 2 t420, 'One Sto ,•� � } - No, . ,t:..... , Permit for . Y..... d ;, inc�le Family Dwelling. ............. ^ - Locatiori ..I,ot••260• 35••James• Otis•;Read, � - "Centerville � '' � � _ � - R ��. ;^�. '- ;' Y • OwnerT..Alan E. Small:.. ........4 :..... �� n Type'of: Construction r .............................. y . ..... .' ............ ......s" ............ x. . Plot ............................ Lot' ................................ ,, - January;;11, 85 Y . Permit Granted ...:.......... ......19 i Date of Inspection ....1.9 Date Completed . ...� :............19 - ' 0 -_ ®' 4 K. Assessor's.map and Iota number ................. �,7 Z 6..0 'Sewage Permit' number ...... ........... 4 1 13AWS ABLE, Housenumber ..........0�.:......................................... ........... MAG& t639- VAj A,. TOWN OF BARNSTABLE - BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... ............................................................................................ TYPE OF CONSTRUCTION ........... ............................................................................................. ................. 19 .5 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a,-permit according to the following information: 1 140 Location .... ........ .............. ......................................................................... Proposed Use -(1 ..... ... k ......................................................................................................................................... i . .............. / ZoningDistrict ........................................................................Fire District ........ ........ f........................................................... 1 17 Z� l ...........Address .... Name of Owner ........ ............ ........................................................................ V, Nameof Builder ......11................................... ..........................Address ..........................................................................0......... Nameof Architect .................o................................................Address .................................................................................... Numberof Rooms ......61 .........................................................Foundation ... ............................................... Exlerior ...o.. .................................................................Roofing ............ .................................................................. Floors ...... ..................................................................Interior ................?...............0................................................... G . Heating ........!�7..... 1/-0 -2- ....................................................Plumbing .................................................................................. Fireplace ....... ...........................................Approximate. Cost ......F// ,-0 ...(,.............................................. Definitive Plan Approved by Planning Board -------------------------------19--------- Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS f hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name X ......................................................... .......... Construction Supervisor's License/,-; . ............ SMALL, �ZLAN E. A=170-160 No ..27.420.... Permit for ..Cne..,SWry............. , ........Single..F�jy..Dwelling...................... Location J, t--260.......85..,T. s 49t--is...Road Centerville ............................................................................... Owner Alan E.. .. Small + ............... ............................................. Type of Construction ,,.Frame F r Plot .............:.............. Lot ...:............................. ° Permit Granted ....�Pua?-Y...11r..............19 85 Date of Inspection .....19 Date Completed ...................... '7b t d - II T L