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Town of Barnstable �� �lIl
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: Post This Card So That it is Visible"From tfie Street ,Approved Plans Must be Retained on Job and t is Card Must be Kept ,
+,BAR1V'SPABt$ .4., x.., :� k .�� � „�... W +� �+ .,,�•�..: � ,��e-- O
"�" Posted Until Final Inspection Has`Been Made
pud• WFiere,a Certificate of Occupancy.:is ReciT.," ,,su.ch Buildmgshall N,ot be Occupied until a Final Inspection has been made ;•., Permit
Permit No. B-20-1592 Applicant Name: Jonathan Whipple Approvals
Date Issued: 07/02/2020 Current Use: Structure
Permit Type: Building-Insulation- Residential Expiration Date: 01/02/2021 Foundation:
Location: 72 SKUNKNET ROAD,CENTERVILLE Map/Lot: 191-113 �e Zoning District: RC Sheathing:.
Owner on Record: FEDERAL NATIONAL MORTGAGE Contractor Name: �,JONATHAN N WHIPPLE Framing: 1
Address: PO BOX 650043 Contractor License: CS'0�78683 2
DALLAS,TX 75265-0043 Est. Projet Cost: $5,053.00 Chimney:
Description: Insulate attic,vent existing bathroom fan,install home air sealing, Permit Fee: $85.00
ventilation chutes,4"x16"soffit vents,8" rod vent and home air I Insulation:
- Fee Paid./ $85.00
sealing. Perform combustion safety test and t Iower:door test.
Date: { 7/2/2020 Final:
Project Review Req: Plumbing/Gas
Rough Plumbing:
\Building Official Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by th s permit is commenced within,six monthsafterissuance.
All work authorized by this permit shall conform to the approved application and the.approved construction documents for which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures ructures shall be in compliance with the local zo�ing by-laws and.codes.
This permit shall be displayed in a location clearly visible from access street or road arrd shall be maintained open for public inspection for the entire duration of the Final Gas:
work until the completion of the same.
-1.
Electrical
The Certificate of occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
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Minimum of Five Call Inspections Required for All Construction Work: Service:
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
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
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Bk 25540 PS297 =33612
06-30-2011 a 02=51p
FORECLOSURE DEED
BAC Home Loans Servicing,LP,having its usual place of business at 400 Countrywide
Way,Mail Stop:SV-35,Simi Valley,CA,93065
- the present holder of a mortgage
from Vera L.Godoi to Mortgage Electronic Registration Systems,Inc.dated April 14,
i 2005
recorded with the Barnstable County Registry of Deeds at Book 19723,Page 43,by the
M power conferred by said mortgage and by every other power,for THREE HUNDRED
nt NINETEEN THOUSAND SEVEN HUNDRED FORTY DOLLARS AND 43/100
($319,740.43)paid,grants to Federal National Mortgage Association, P.O Box 650043,
a
Dallas,TX 75265-0043 the premises conveyed by said mortgage.
Fh- This conveyance is exempt from the Massachusetts Deed Excise,M,G.L.C.64D Section
O1,pursuant to Massachusetts Department of Revenue Directive 91-2(Sept. 19, 1991),and
pursuant to 12 United States Code Sections 1452, 1723a,or 1835.
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oExecuted as a sealed instrument this 22nd day of June,2011.
a? See Power of Attorney recorded in BAC Home Loans Servicing,LP
Suffolk County Registry District of the By Orlans Moran,PLLC
Land Court as Document#782245. Its Attorney-in-fact
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n" For signatory authority,see Delegation of By:
Authority and Appointment registered Caleb J.S eb,
with the Suffolk County Registry of Deeds Employ ,Authorized Signatory,Real Property
as Document Number 776825,
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Affidavit
Orlans Moran PLLC,under the pains and penalties of perjury on oath deposes and says
that it does not have knowledge of revocation or termination of the Power of Attorney by
the principal or by termination of the existence of the principal.
�/�'�ZAZ�
By:
Ca eb T.Shgqb,
Authorize8 Signatory,Real Property
Return to:
Orlans Moran PLLC
P.O.Box 5041
Troy,MI 48007-5041
File Number:617.6101
1
Bk 25540 Pg 298 #33612
STATE OF MICHIGAN
OAKLAND,SS JUNE 22,2011
On this 22nd day of June,2011,before me,the undersigned notary public,personally
appeared Caleb J.Shureb,Employee,Authorized Signatory,Real Property,of Orlans
Moran PLLC,as attorney-in-fact for BAC Home Loans Servicing,LP,proved to me
through satisfactory evidence of identification,which was personal knowledge,to be the
person whose name is signed on the preceding or attached document,and acknowledged
Q to me that he/she signed it voluntarily for its stated urpos
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M Nicholas A.Kasperek,Notary Pu lic
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My Commission Expires:5/2/2016
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W(TfA"Y!:1!'RUC-ST W£OFN11CURCAN
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Return to:
Orlans Moran PLLC
P.O.Box 5041
Troy,MI 48007-5041
File Number:617.6101
Bk 25540 Pg 299 #33612
Affidavit of Sale
I,Caleb J.Shureb,Employee,Authorized Signatory,Real Property of Orlans Moran
PLLC under Power of Attorney for BAC Home Loans Servicing,LP,("Lender")named
in the foregoing deed,make oath and say that the principal,interest and other obligations
mentioned in mortgage from above referrred to were not paid or tendered or performed
when due or prior to the sale,and that I caused to be published on the 29th day of April,
2011,on the 6th day of May,2011 and on the 13th day of May,2011,in the Barnstable
Patriot a newspaper published or by its title page purporting to be published in Hyannis
Q and circulated in Centerville,a copy of which is attached hereto as Exhibit A.
I also have complied with Chapter 244,Section 14 of Massachusetts General Laws,as
amended,by mailing the required notices by certified mail,return receipt requested,
(if checked)I also gave the Internal Revenue Service notice by mailing Notice of Sale
pursuant to Section 7425(c)of the Internal Revenue Code.
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OPursuant to said notice at the time and place therein appointed,the sale was postponed by
public proclamation upon the mortgaged premises to June 21,2011 at 10:00 AM,and
thereupon
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The Lender sold the mortgaged premises at public auction by Jerald Tache,a licensed
auctioneer,of Tache Auctions&Sales Inc,to the successful purchaser BAC Home Loans
Servicing,LP,400 Countrywide Way,Mail Stop:SV-35,Simi Valley,CA,93065,for
the sum of THREE HUNDRED NINETEEN THOUSAND SEVEN HUNDRED FORTY
DOLLARS AND 43/100($319,740.43).
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ti Said bid was then assigned to Federal National Mortgage Association as evidenced by
Assignment of Bid recorded herewith as Exhibit B.
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Caleb J. •e , .�
Employed,Authorized Signatory,Real
Property of Orlans Moran,PLLC,attorney-
in-fact for BAC Home Loans Servicing,LP
STATE OF MICHIGAN +
OAKLAND,SS JUNE 22,2011
On this 22nd day of June,2011,before me,the undersigned notary public,personally
appeared Caleb J.Shureb,Employee,Authorized Signatory,Real Property,of Orlans
Moran PLLC,as attorney-in-fact for BAC Home Loans Servicing,LP,proved to me
through satisfactory evidence of identification,which was personal knowledge,to be the
person(s)whose name(s)is on the preceding or attached document,and who swore or
affirmed to me that the contents of the document are truthful and accurate to the best of
their knowledge and belief.
Nicholas A.Kasperek,Notary Public
My Commission Expires:5/2/2016
Return to: 1 WOM-1I'r":!6Lii;-b'l -C JF Ill!Cx!41
Orlans Moran PLLC ^Ui;"iY 0`=i;'A:(
P.O.Box 5041 Ex 1 r' ?,4ay
Troy,MI48007-5041 !:�cfin�i;�!!i..'•out;vutc�(l �M! .
File Number:617.6101
Bk 25540 Fig 300 #33612
EXHIBIT"A"
ATTACHED TO AND FORMING A PART OF FORECLOSURE DEED AND
AFFIDAVIT IN LAND COURT CASE NO.437021 FOR PROPERTY LOCATED AT
72 SKUNKNET ROAD,CENTERVILLE,MA 02632
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M BY Vktw MORTGAGEE'S NOTICE OF SALE OF>REAI.ESTATE and in exeaton d'Ihe Rower of Sale can
certain '
f]. Registration F age given by Vera L.Godol to Mortgage Etectraik
the leC"tc,dated anddwilh
Of wh�bry the MC°a^ty Registry of Deeds14'at B000kk I lirp,page 43
F assignment for"tWo the undersigned ld the present holder by
O the P�pose of foreclosing
sale wWlll be saoM�at Mo
a and for
a '"'AM on May 20,2011 at 72 Skunknet Road,,CananteA ct,�.
N ailA certaiand n parceular l ofland�described fn said MWaage b wit. .
r+1 afhiafad b BemsraWe �11-with the buildings'"..n,
ON Massachusetts s ftm,fle), Ba.,t,.C.
- Pyn �M9 Lat 7 as ahoarn on.t.and�uR
hL Sa M(S eat1�dated October 11,1967,drawn byChades
Bamsta,County1 Surveyorsgis 'and said plan Is also gled C the
�g the same premLses veyedW o 22�q, 8P 127.
nsfin rained
e Deeds Mortgagor(s bhanaiy�deed recorded witi Samsbble County
The R
premises are tobe sold subject b and with the benefd
of all
[ b'sonor waterres�am�Dal��and zoning
unpaid taxes,
o) tenants and argils N esemenw•rghts of
U TERMS OF SALE:Possession.
.
A deposit of FIVE THOUSAND DOLLARS AND 00 CENTS
ro 05,000.001 In the form of a check tattled chedt or!rank heasarer'8
04 � red. TIrere aud to be de0vered el or before the tme the y.
rearrio
a Foreclosure-Sa'e �W bidderwill be required toexearte
61dding. The balanceof the nt immadlately after the dose of the
thirty(30)days from the sale purchase price d form�0 be�ed
7 bank treasurer's check or Dow dredc ee a
.�C attomey, The Magee reserves the a10 M
reject any and at bids,to trgtne bid to Mre sale,to
conttnue five sale erid.b amend the
lama of five sale.by writ tan or oral annau
nownent or during Me foreclosure sale. If Vie sal@ is set l"deafor artery^� •Ble Pufchasar et.the sale shag be entitled only b a realm
of the deposit pald.The WmJtesar dl have no further ra return
against be at>octeMofba9eeor the Morigagee'sattorney.
control In tlleon of of en"eiror Inontained in said mor(g898 shag
OF THE ESSENCE. this p TIME WILL BE
Other terms tarty•b be amouncedat the sale.
SAC Home Loans SgMck ,Lp
Resent Noiderdf eed Mortgage, .
BY J115
P.O.Box 962169
609L MAM96
The Barnstable paM Rims:(617)502d1t0
April 29,May 6 and May 13 2011
Return to:
Orlans Moran PLLC
P.O.Box 5041
Troy,MI 48007-5041
File Number:617.6101
x
Bk 25540 Pg 301 #33612
1
EXHIBIT B
ASSIGNMENT OF BID
Whereas,BAC Home Loans Servicing,LP,400 Countrywide Way,Mail Stop:SV-
35,Simi Valley,CA,93065("Assignor"),was the successful purchaser at the public sale
of property located at 72 Skunknet Road,Centerville,MA,02632,which sale was made
on the premises hereinabove described on June 21,2011 at 10:00 AM by BAC Home
Loans Servicing,LP,400 Countrywide Way,Mail Stop:SV-35,Simi Valley,CA,93065,
dated April 14,2005 and recorded with the Barnstable County Registry of Deeds at Book
19723,Page 43,of which Mortgage the undersigned is the present holder by Assignment.
For THREE HUNDRED NINETEEN THOUSAND SEVEN HUNDRED
FORTY DOLLARS AND 43/100($319,740.43),the undersigned Assignor
unconditionally sells,assigns,and sets over unto Federal National Mortgage Association,
P.O Box 650043,Dallas,TX 75265-0043,its successors and assigns,("Assignee"),all of
the Assignor's right,title and interest in and to said bid for the said property with the
right to said Assignee to take and receive title thereto by conveyance directly from said
Mortgagee pursuant to its power and authority under and by virtue of the aforesaid
Mortgage.
Executed as a sealed instrument this 22nd day of June,2011.
See Power of Attorney recorded in BAC Home Loans Servicing,LP
Suffolk County Registry District of the By Orlans Moran,PLLC
Land Court as Document#782245. Its Attorne -in-fact
j
Caleb J.S eb,
Employ ,Authorized Signatory,Real
Property
STATE OF MICHIGAN
OAKLAND,SS JUNE 22,2011
On this 22nd day of June,2011,before me,the undersigned notary public,personally
appeared Caleb J.Shureb,Employee,Authorized Signatory,Real Property of Orlans
Moran PLLC,as Attorney-in-Fact for BAC Home Loans Servicing,LP,proved to me
through satisfactory evidence of identification,which was personal knowledge,to be the
person whose name is signed on the preceding or attached document,and acknowledged
to me that he/she signed it voluntarily for its stated urpos .
Ni olas A.Kasperek,Notary Public
My Commission Expires:5/2/2016
L. •�'I.;;i.Dili?']�,./v';SI'�'F:tiK
;�Ir7:`',L:,ntl(';•�"ICf;:U AW
xyises .'ay/1,, 16
Return to: t ''..C.J . ! :� 1
Orlans Moran PLLC
P.O.Box 4 50 1
Troy,MI 48007-5041 File Number:617.6101 BARNSTABLE REGISTRY OF DEEDS
oF1NE r Town of Barnstable
*
Regulatory Services
* BARNSTABLE,
y MASS. �► Thomas F. Geiler,Director
Building Division
Tom Perry, Building Commissioner
200 Main Street,Hyannis, MA 02601
Office: 508-86274038 Fax: 508-790-6230
E,
February 3, 2011
Vera L: Godoi
72 Skunknet Rd.
Centerville, MA 02632
RE: EXIT ORDER '72 Skunknet Rd., Centerville Map: 191 Parcel: 113
Dear Property Owner:
This letter shall serve as notice that the building department has-become aware of
building code violations at the above address. In accordance with 780 CMR 9304.7 you
are notified that the basement bedroom(s) are declared dangerous and unsafe and
their use must cease immediately.
You are hereby.ordered to bring the property into compliance or be subject to criminal
prosecution as.provided for by 78b CMR 5118.4. Compliance may be achieved by:
1) Obtaining a building permit to correct the.violations (and subsequent inspections)
or;
2) Dismantling all construction for which no building permit,was issued.
Please contact this office at (508) 862-4034 by February 173 2011 with any questions to
avoid further action. Thank you for your anticipated cooperation in this matter.
By Order,
Jeffrey L. Lauzon
Local Inspector
(508) 862-4034
Qzoning5
Engineering Dept.(3rd floor) Map y` Parcel 11c " /Permit# 0 0 2, /
r House# % Date Issued
Fee
114E►p;_
BARNSTABLE,
fEn
TOWN OF BARNSTABLE l
Building Permit Application
Project Street Address 7 i -�` ! .
Village �` � JLA
Owner u-11-�eia—Q y Address -
Telephone
Permit Request
First Floor square eet Second Floor square feet
Construction Type
Estimated Project Cost $ C)0
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No. of Bedrooms: Existing , New
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
Builder Information
Name t94J A � Telephone Number
Address -7 ( ��/?l,� o'Y� ��/� License#
Home Improvement Contractor# Z/9
Worker's Compensation#(
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CC
SIGNATURE DATE
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
,
FOR OFFICIAL USE ONLY
}� '5
PERMIT NO. � A
DATE ISSUED 0.
MAP T?A#CEd NO
2
SOt `
ADDRSS VILLAGE .
�M
OWNER
DATEIFLsAcTibN: z r
FOUNDAON ,
th
FRAME
} INSULATION
Y C.'F ' • • .
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS:,; ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
The CommonN'ealtlt of Alassachusetts
Dt.partniew of Industrial Accidents
1 office Of111F tfgatlons
•���' ''�'�_-':•�' 600 Washing-ton Street
Boston. Aluss. 02111
`-' Workers' Compensation Insurance Affidavit =="
�nitcant tnformatton: 4_ y_Please PRINT;Ie�ibly,._s,�_ _...__ _._.. ..
location �l If4i7 '�Ci✓� /��
city .0 phone#
I am a homeowner performing all work myself.
1 am a sole proprietor and have no one working in any capacity
1....7{,uz. :. '�w�ar' + P¢^.;^'??' '"f .'•'•r }lx�rav�r<'.u.w•'�"�7°,4' -!• 4"` #"�N �x"'�r::•�'•.ias...'.,. 'Y7^:. �wr+.r**a.w+y..+....^a�r Drr.t+-.;+..a►t?+" -^•n,-m-.a,4�
m an employer providing workers'compensation for my employees working on this job.
company name:
address:
city: 11hone#•
insurance co, W-�V lie # 3 .:) 36 e 0/
I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have
the following workers' compensation polices:
company name:
address
city: Ilhone#•
insurance co. policy
.. ,`5-.;:,, c.: :' ._...-• «e:a[z:::... .n..m.-..,.,..�..y.. '^•rrY < '9 yy,,._.,e....•ar wm"'9ti4` '-'-. `f,►F?+!^'fig• �.Zr,•.v.,al p.;r•••rn-.. �P.. •Mc- ....
- .:... _ tom,
�.::w__a•� .�s�. ..:..:.. ._ :.:�:a• n_'."....w.:...:a:..3ay:..:i.:Ion.w �i:t �inita _ .}—.�_'.._ _.....-�..- •''°�' - ' �4 SS$r3ixx."1.r".cc."laf►r"rii�t��ia.iixuic
company name:
address:
city phone#-
insurance co. policy#
:Attach adds
_honal sheet if necessary,�•�� '-fr��ti i•'+�JY'a';�.il�� •<.tyl,,:;a� e.:. a� ry �� ___ _ +�•re*.�h a-•
Failure to secure coverage as required under Section 25A of DtGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. 1 understand that a
cope of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do herebt•cerli render tlr pains n penal! s of perjury that the information provided above is true and correct.
Signature Date 2 6
Print name '(✓ ��t 7 Phone#
rofficial use only do not write in this area to be completed by cityor town official +
city or town: permit/license# Building Department
OLicensing Board'
O check if immediate response is required OSelcetmen's Office_
`•_ Oliealth Department '
contact person: phone#; r JOthcr -
•Y�.�' _'..'!;Y:T!'�`'Y?.n'Ml,c•.nP'l,^'`n _ _ - •."sv'e�a.¢"R.'
.. s. . .. ... 'mt_v: . __ .sue....JS _}..-»J._.h...._- _..'.._._... i __.�..,ew+......e ._. '- .� '�.;'�!'iT•FT:!�'•�• Y��' ._
_ r
Im ised 3;95 P1A)
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted lro n the "law", an emploree is defined as every person in the service of another under any
contract of hire, express or implied, oral or written.
An enypl(�ver 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 emplover, or the
receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling, house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an emplover.
MGL chapter 152 section 25 also states that even,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 commonivealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally, 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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and
supplying company names. address and phone numbers as all affidavits 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.
._..tY .nx m.r.+ +7.......,.5-.. -.,- '.c►•-,;: .vr-.«+•'T '.t•".�°n+sre ••vl.-e-
77
777
t
Citv or Towns
Please be sure that the affidavit is complete and printed legibly. Tile 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. The affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made.
Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any questions,
please do not hesitate to give us a call.
t�sau..-+....•. _,-�.....ta..r-r.s.. .r-:-cer.- .,...^.:n..+yg+7.•�a_��..r�.my!e�...:'4S'�wa..'w"""a".'m�.. .+.•- ►+vwsar�a-gars.eye•+^'.;-n-...v�•.,+iw....ra.-.+a..i+e.
.. noF.
Tile Department's address, telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 «Vashington Street
Boston,Ma. 02111
fax #: (617) 727-7749
phone#: (617) 727-4900 ext. 406, 409 or 375
.�� The Town of Bar
,, , Barnstable
STABLE.
�0�' Department of Health Safety and Environmental Services
° Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
For office use only
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units or to
structures which are adjacent to such residence or building be done by registered contractors, with
certain exceptions,along with other requirements.
Type of Work: Est.Cost_
Address of Work: 2 a
Owner's Name lu
Date of Permit Application: /
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under$1,000.
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
/ems
Dat Contractor Name ` Registration No.
OR
Date Owner's Name
f c
Engineering Dept. (3rd floor) Map22Z Parcel ' Git# 1 /
House# ' : _ Date Issued 1 -41
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) ' Fee C�7/
Conservation Office(4th floor)(8:30- 9:30/1:00-2:00)
Planning Dept. 1st floor/School Admin. Bldg.) DIME Tp;_
DX*ve pproved by Planning Board 19RARN"ARLE,
59.
TOWN OF BARNSTABLEE°Building Permit Applicatioon
dress "I a
Village C&hA&A /i/14 /Yli4
Owner L-eA i (3 1U Address
Telephone y�
Permit Request !CQ
a� P7
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No.of Bedrooms: Existing New
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
Builder Information c
Name D,A-pi d'✓L6,Qg," Telephone Number
Address / 7�j-�j. �"//� License#
�D� ifs Home Improvement Contract Sa-3 3 01Y
Worker's Compensation# �S
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO YO-401OZA
SIGNATURE DATE llzl -k
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
~ FOR OFFICIAL USE ONLY
t
PERMIT NO.
DATE ISSUED
F
MAP/PARCEL NO.
s
ADDRESS VILLAGE
OWNER a r
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION ,
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT ,
ASSOCIATION PLAN NO.
s
°FTMe r
The Town of Barnstable
MAM
• a�axsres�, •
! ,0�' Department of Health Safety and Environmental Services
rFo Mop" Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 5087790-6230 Building Commissioner
For office use only
Permit no.M
Date 1 I !5 >
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL,c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units or to
structures which are adjacent to such residence or building be done by registered contractors, with
certain exceptions,along with other requirements.
Type of Work: Est.Cost
Address of Work:
Owner's Name
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under$1,000.
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
<< FAA, st/2
Datd Contractor Name Registration No.
OR
Date Owner's Name
The Cotntttontrealth of.4fassachusctts
k•l` -�'`:=_-�� Department of Industrial Accidents
' '�' Office ollnvest/gotivns
'; j 6011 11 ashinrlun Street
�.x Boston, Alas& 02111
Workers' Compensation Insurance Affidavit
�pplic tnt tnformahon• Please PRINTFZ-Q,�
name '
location -71
nhonc 1r
1 am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity 4
I am an employer providing workers' compensation for my employees working on this job.
cnmp•tnv name: �✓lG� �R�1 wG'"��"
s -
itdd Tess• S
city: phnne#•
insurance Co. �/ ///" U//y licv# .,;
I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who hay
the following workers' compensation polices:
comranv n•tmc•
address:
cih phone#•
insur•Jnce co nnlicv#
t. .. .re rl'..- y 11R`:� � '.1'.:t...-_ -_ _- ��r•"'I�L�.��.lt-5.7!•'� .:..5'.�f...:. ..._�.._,- ..�-_ .i.rw!_-.�i�.�-��.
Cmmpnnv n•Jmc•
•tddress-
cih phone#•
insur�ncc co policy# 7
.Attach additia_nal sheet if necessa' +.
+•: #p--�` s�r� f" ""'•': •" ' '7"�s'" "'?�='`'' ��
� :�� r �..�. 3 "'£ yLYe�.rile•r�:c;.z.a
Ka to secure coverage as required: under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a fine up to 51500.00 and/or
one years' imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and it fine of 5100.00 a day against me. 1 understand that a
copy of tlJis statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
1110 1,ere hr c• undo h nr as ar cnaltie ojperjun•that the injortnation prorided above is true and correct.
Sianature Date
Print name �� ��/ � Phone#
.:�•oRciat use only do not twrite in this area to be completed by cih•or town olricial `�
cih•or town: permit license# riBuilding Department
Licensing hoard
check if immediate response is required OScicctmen•s Office
011calth Department
contact person: phone#: []Other
tmised 3,nc PJAt
µ
information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers` c()mpcnsation for thei
employees. As quoted from the "law an emplimee is defined as every person in the service of another under anv
contract of hire, express or implied, oral or written.
An etnpinver is defined as an individual, partnership. association, corporation or other legal entity", or any two or more
the foregoing enuaged in a_joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the
owner of a dwelling_ house having not more than three apartments and who resides therein, or the occupant of the
dwelling, house of another who employs persons to do maintenance , construction or repair work on such dwelling hoi
or on the `_rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer
MGL chapter 152 sed1ion 25 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 N-s•ho has not produced acceptable evidence of compliance with the insurance coverage required.
Additionaliv. 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 h
been presented to tine contracting authority.
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to ;your situation and
supplying company names. address and phone numbers as all affidavits 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 cite 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 requires
:o obtain a workers compensation policy, please call the Department at the number listed below.
7.
City or,towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pie,
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questioi
please do not hesitate to give us a call.
The Department's address. telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents '
Office of Investigations
600 Washington Street _
Boston,Ma. 02111
fax #: (617) 727-7749
nhnne 4: (6I 1) 7" -'`00 ext. 406,,409 or 375
��ti ry�'�i'""�iL'J�xs�"�'+�.L'u;� ,iy2.;�� ,ti'�+:>e:....+a:...��s..•e.Lis.rrrbrv'S�'ya�•"1a'.r-'Gv=:-' ' a.:�- �-.__._ i�:e->T<i:'.»s. ^-
J+ �
V ,
• HOME IMPROVE':1.1ENT LOl'J-FRACTOR -i REGISTRA:FIOh,�,
• Board of Burld.ing Regulations acid Stalid8 ds 0 5-766o?-
One Asl7k'urton Place Room 1301
(;ostv;' Mass -iusetts 0210. ' c0�L�s I
HOME IMPROVEMENT CON;I RACTOR
Y+
r R.egil�tration 112536 ; Exv)iratiorr 0irl 06/97
? Type — D E3 A �oosxs,•ouaeald4 o�✓�aaaa✓e..aeQ3
?� HOME IMPROVEMENT CONTRACTOR
Registration 112536
_,. 'DEAN C FRASER Type - DBA
DEAN C . FRASFF( r u Expiration 04/06/97
71 TARRAGON CIF..
Y
COTUIT MA 02631;. DEAN C FRASER
DEAN C.
tm7I TARRAGONSER CIR
iY -- ADMINISTRATOR %uiUIT NA 02635
i
•
y IS #
S� .
TOWN OF BARNSTABLE
BAWSTADLE,
VASIL
9-163
ON BUILDING INSPECTOR
--'eve 4IM-Z 4L IAJ
APPLICATION FOR,PERMIT TO ..............eaw's............--1............j.........I.................................... 'V.
. . ............. . ..... ..... ......
TYPE OF CONSTRUCTION ................. ..................................................................
.............................. ...... ......19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ..............04 ..... .............................................
.......
................................. .......................................................................................
Proposed Use ......... ....... F&N*2-
............ ..... ...... .. ... .... . ..........................................................................................
......................v
ZoningDistrict ........ .......................................................Fire District ......... ......................................
Name of Owner .41......i"9e---NV,0e
............................ ..........Address
Nameof Builder A ............................................ .........Address ........................................................................
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms ....................7..........................................Foundation ......
Exierior 4XV'7'Co4i- ... Roofing ..................
............................. ........
Floors .........IN.....I-.r........ . ..................Interior ..............J�Yjq��
Heating ............
.. .............. ....
.......................................Plumbing ...............
y�5 �9
.......................................................
Fireplace .... .................................................Approximate Cost .................... ................I ............
Definitive Plan Approved by Planning Board --------------------------------19---------- -40 7-f74
Diagram of Lot and Building with Dimensions a
SUBJECT TO APPROVAL OF BOARD OF HEALTH
PC4—L A, 2
SE 4
PTIC SYSTEM M/ST B� 7-3'
INSTALLED IN COMPLIANCE
WITH ARTICLE 11 STATE
SANITARY CODE AND TOWN:.
REGULATIONS;
0 0_9:
321
Zk-
t4
-2
Ulu
1 hereb agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the c ove
co struction.
Name ...40. ....... .... ...................................................
. ..
Ward W. Arthur
No ...159 .. Permit for ..... story
.................. ...
..........single,..f am4y..dwe13.1.2.15..... ... .........
......... .......... ..
Location ...2........a....W...&...n..e...t....R..o...a...d.........................
.......................... .............................
Owner .............W,* Ar'.Ithw..Waxd.......................
Type of Construction ...................X rame...........
................................................................. ..............
#7
Plot ................ ........... Lot ................................
February 26.......19 73
Permit Granted ............. ...................
Date of Inspection .............. .......... ..........19
Date Completed ...71.....19
-3
PERMIT REFUSED
................................................................. 19
................................................................................
................................................................................
...............................................................................
...............................................................................
Approved ................................................ 19
...............................................................................
....................................................... ........"..........
Town of Barnstable
Regulatory Services
„ Thomas F.Geller,Director
9�. KASS. Building Division
039.
0 MA'1 Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
PE RMIT# 2 Lv FEE: $
SHED REGISTRATION
120 square feet or less
Location of shed(address) Village.
Property owner's name Telephone number
Size of Shed Map/Parcel#
Z Date
r'
Hyannis Main Street Waterfront Historic strict?
Old King's Highway Historic District Commission jurisdiction?
Conservation.Commission(signature required) es, 1(,413 6�
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
Q-forms-shedreg
REV:121901
LOCATION OF F" RTY L E Y NOT BE CCU RA E STANDARD LEGEND ,
NOTE:not all symbols will appear on a map
/ GOLF COURSE FAIRWAY
v J EDGE OF DECIDUOUS TREES
EDGE OF BRUSH
ORCHARD OR NURSERY
1 _
/ f " EDGE OF CONIFEROUS TREES
MARSH AREA
ap 192
- EDGE OF WATER
DIRT ROAD
- 62 Ma 91 DRIVEWAY
p IE=PARKING LOT
62 PAVED ROAD
1 O DRAINAGE DITCH
1 PATH/TRAIL
PARCEL LINE**
r MAP 110 MAP#
!Ij 21 E PARCEL NUMBER
#1860 E HOUSE NUMBER
1
-..............--- 2 FOOT CONTOUR LINE
—!0 10 FOOT CONTOUR LINE
Elevation based on NGVD29
1j Ma 191 ��4.9 SPOT ELEVATION
- - 1 3 STONE WALL
-X--X- FENCE
----------
72 Map 1 RETAINING WALL
1 1 �� RA STONEIL DTRACK
JETTY
.................__... .._. SWIMMING POOL
1
38
voo i
1 ,- PORCH/DECK
0 BUILDING STRUCTURE
DOCK/PIER
1` \. HYDRANT
J e VALVE OO MANHOLE
1 91 /j o POST OF" FLAG POLE
T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N 1 T .a SIGN ® STORM DRAIN
M PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimefia(man-made features)were interpreted from 1995 aerial photographs by The James ❑ TOWER
1"=100'scole map and may NOT meet of property boundaries.They are not hue locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD ¢ UTILITY POLE
" e 0 20 40 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimehics,topography,and vegetation were mapped to meet National Map Accuracy Standards LIGHT POLE O ELECTRIC BOX
1 INCH=40 FEET* enlarged scale. on the map. _ at a scale of 1"=100'. Parcel lines were digifaed from FY2003 Town of Barnstable Assessors tax maps.