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Home My WebLink About0549 STRAWBERRY HILL ROAD M nmyj lot e r,. _ ...� I'T..• .. �... 't sX e' �� *".+fie?*. ♦Y h c. ,A 5 step SAW 4 ` r r x ni f rANN ' 4 a r l -ji 10 ads - r t � o- 5 � t r A .,... ..-...,; ..,.. .,.mac. -,.. � � :-:, ,,.,. .., .. ,:. .. ..,,.�:Z.so ,�e�. ..,. .,. ..... ,.� ... ... .�......,�..e....a. s. ..cw.a... _ .m�...d�,o,v... h.w.,_.�v�...+e.,n�.wstu��a�aza.u-.k�..yus.aeiw.ranne✓ t � a► �,Irz1,z 36 o� r Town of Barnstable *Permit# . . p� Expiiesj months from issue date Regulatory Services Feqle CD HAarrsresrt M 16 Thomas F. Geiler,Director prfDMA�a X-PRESS PERMIT' Building Division Tom Perry,CBO, Building Commissioner 2012 200 Main Street,Hyannis,MA 02601 SEP www.town:barnstable.ma.us Office: 508-862-403 8 E EXPRESS PERMIT APPLICATION - RESIDEIV'1'O . 'lG Not Valid without Red X-Press Imprint Map/parcel Number 0 1 / 4 f _ Property.Address �J c�✓�w�etl^� l Il0 (i' tl�V�LI`�' c V ' esidential -Value of Work �0, LAv �- Minimum fee of$35.00 for work.under$6000.00 Owner's Name&Address Vl '@ ' t 53 O1-1z5—Z/Z}l3P U ! Xiv- 0 Contractor's Name `e -e.� d iJ Telephone Number Sy �� 3 ��- 0,6 b Home Improvement Contractor License#(if applicable) La 3> ! Construction Supervisor's License# if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I e Homeowner ave Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit Permit Request(eheck box) e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ✓a��'76 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) e-side . #of doors �• Replacement Windows/doors/sliders.U-Value . maximum 35 #of windows ( ) Li ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Prope' er must sign Property Owner Letter of Permission. py of th Home Improvement Contractors License&Construction Supervisors License is' required: SIGNATURE: - Q:\wPF1LES\F0RMS1bui mpermit forms\02RESS.doc Revised 053012 TVHE t° ti Town of Barnstable Regulatory Services «. BMWgrABLE, " v MASS. g, Thomas F.Geiler,Director Qj i639 �0 'OrFc N,p�" Building Division Tom Perry,Building Commissioner. 200 Main Street,Hyannis,-MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: .508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subjectproperty l . . hereby,authorize / / , � �� P0/�/S7`''l//°i�i dL.. to act.on my behalf, . in all matters relative to work authorized by this building permit: (Address of Job) **Pool fences and alarms are,the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signo6re of Owner Signature of Applicant' µ r Print Name Print Name Date WORM&OWNERPERMISSIONPOOLS 6/2012. t r Town of Barnstable Regulatory Services r swxxsrABM Thomas F.Geiler,Director MASS. �p 1639. 0. Building Division tED MA't Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street" village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be res onsible for all such work Performed under the building permit. (Section.109.1.1) - The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the a unlicensed personas it would with a licensed Supervisor.,The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt Bk 24611 Ps215 �28924 06--1 1-2010 02 2 22P DEED I,ELIZABETH L.PERRY-MARSHALL aka ELIZABETH P. MARSHALL of 549 Strawberry Hill Road, Centerville, MA,for nominal consideration,hereby grant to Elizabeth P.Marshall for life,then to ELIZABETH D.TRAYNER of 67 SPRUCE STREET, HYANNIS, MA,02601,PAMELA J.SISSON of 1701 VOGT ROAD, RAYMOORE, MO,64083 and EMMA MARSHALL of SOUTH MADISON STREET, RAYMOORE, MO, 64083 as tenants in common,with QUITCLAIM COVENANTS: The land in Centerville,Barnstable County, Massachusetts,together with the buildings thereon, consisting of two contiguous parcels, bounded and described as follows: 0 First Parcel: On the North by land of Roland W. Perry, 100 feet; On the East by Strawberry Hill Road, 150 feet; 3 On the South by land of Osmo A.Willman et ux., 100 feet; and 41 On the West by land of Roland W. Perry, 150 feet. N "t r Second Parcel: North by other land of Roland W. Perry, 27 feet, more or less; N o East by other land of Amanda J. Perry, 150 feet, more or less; a, a South by other land of Roland W. Perry, 27 feet, more or less; a West by other land of Roland W. Perry,150 feet,more or less. a //o+e o01 The remaindermen grantees hereof are beneficiaries under my will.and A( my descendants. A- U This above-described premises are conveyed subject to and with the benefit of all rights,restrictions, reservations,easements,appurtenances and rights of way of record,insofar as the same are still in force , and applicable. For Title see Book 1403 Page 453. . J The Commonwealth o,f ussacl nsdts Depaphnent o•f Industrial Accidents Office oflnvoestigations 600 Waskington Street Boston,MA 02111 tt mimgovldia. Workers' Compensatkin Insurance Affidavit. Bailers/Contraeturs/Fledricians/Phumhers A,pplicant Information Please Print Lei bIy Name 0Eusiue oull fmiduau:�� Cott i)we,-)� l` O k�) Address: 3 -7 _CsAl f City/Statizip: kfn ,.,l U.. Phone it— ^3 6 y'— Are ggu�dn employer?Checlsthe a►pprapriate boa: T of project r 4. I am a. cxmtaactor and Type p ,1 (required): 1_ I atn a etngl with ❑ .. �— 6_ ❑I'+Ieu*tonsfiauctiotz employees��: rpart-time)* have hired the sub-canhwtors 2..❑ I am a sale or partuec- listed on the attached sheet_ 7- ( 4deling ship and have no employees Zhese sub-contractors have S- ❑Demolition wudring for mein any capacity_ employees and have woikms' g_ Budding addition. [No worlCtraS'Comp.in ncesurance comp-insura Y rye.-]. ❑ fie ate a r✓cxpoiation and its 1t}_❑Electrical repairs cr additions 3.0 I alma homeowner doing all:worle. officers have exercised their l I.0 Plumbing repairs.or.additiew myself [No workers'comp_ sight of exemption per MGL 12.EWof repairs insurance &]T c. 152, §1{4h and we have no employees_[No v odors' , 13.0 Other � &P w comp_insnxerei*ed-] J •Awry mat checks ltoa#1 most also fill out'tL a,section below sLawing iLeir waaiiess' Po y"fnrmatiaei Homeoat>aers oho satanic this affid-ir-bcating'they use doing all work and t m hire outside raert=wrs amst submit a new affidavit M&Cat 4 such. lC-=ctars IL d cheek tWs btu[must attached an ad&&nal sheet showing the name of the Sub-coIItrwwn and:state whetf armt these entities ham . . empimes..If the sub-con=dUrs hate employee.%they mmur pmvidie dwir wwken'romp.poling number. lam an empLayer that isprottidir workers'corrapr€aasadon.imuraxce for my emplojwes. .Bdow is tha policy and job:s&ff information, Idsu ace Company Name: Policy#or Self-ins_Tic_#: 7 �J / f t 0 " `I>_Fxpuation Date: 31143, Job'Site Address::. J '� ��itaw��.�y .r�..lt (L® City/statel :C.e�r.,,•U,- Wh- oXS�_> Attach a copy of the workers°compensation polio declaration page(showing the policy number.and eapu-ation date). . Failure to secure coverage as required under Section 25A ofMGL c- 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprizannumt,as wen as civil penalties in the form of a STOP WORK ORDER and a Erne of up to$250.00 a day against the tvzolatot. Be.advised that a copy of this statement may £aywrarded to the Office of hwestsgations of the DIA far ,,ciUMnCe coverage verifi+catisau_ I aIo k erabp cRrYa.ft,a •ns and allies trfp�rjur}�diattite information.prrrvir�d above is and correct Date: . Phone#::' `7 l/ t,►fji' ital arse only: Do not wfrfte in Mis area,to be completed by city or town officiat City or Town: PermitUcense# Issuing Authority{circle one}: 1.Board of Health I Building Department 3.City/Town Clerk d.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 NOTICE N NOTICE TO a TO EMPLOYEES EMPLOYEES OqM Sve The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 — http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152, Sections 21,22&30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO MA 02344-1450 ADDRESS OF INSURANCE COMPANY (IHUB-2B991 1 0-3-1 2) 03-1 G-i 2 TO 03-i G-i 3 POLICY NUMBER EFFECTIVE DATES MALCOLM & PARSONS INS P 0 BOX 527 STOUGHTON MA 020720527 m- NAME OF INSURANCE AGENT ADDRESS PHONE# APPLETON, PETER 37 BAIRD WAY APPLETON CONSTRUCTION °_— CENTERVILLE MA 02G32 EMPLOYER ADDRESS o.= EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE N- MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with.the provisions of,the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 000340 WzoP,Goz TO BE POSTED BY EMPLOYER Massachusetts - Department of Public Safety Board of Building Regulations and Standards - i Supervisor . . , ConstructionSup, License: CS-005414 PETER J APPLETON 37 BAIRD WAY CENTERVILLE MA 0�2632 Expiration I . Commissioner 06/08/2014 • �1e�par�un2o�ruuea��o�C /�czaaav�cv�eCta- -- Office of Consumer Affairs&Busibess Regulation License or registration valid for individul use only OME IMPROVEMENTTCONTRACTOR before the expiration date. If found return to: egistration: ,b3218 Type: Office of Consumer Affairs and Business Regulation xpiration: DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 APPLETON CONSTRUGTIONE =' i Peter Appleton .y x 37 Baird Way ix l �a2 —� /2, Centerville,MA 02632 ' c— f` ✓L�— Undersecretary of valid without re Bk 24611 Pg 216 #28924 f Witness my hand and seal this /O day of June, 2010. �y4er Elizab th L. Perry-Marshall aka Elizabeth P. Marshall by her Attorney in Fact Elizabeth D.Trayner STATE OF MASSACHUSETTS. County of Barnstable On this W day of June, 2oio, before me,the undersigned notary public,personally appeared Elizabeth L. Perry-Marshall aka Elizabeth P.Marshall,through her attorney its fact,Elizabeth D.Trayner;as aforesaid,proved to me through satisfactory evidence of identification,which were L4,e,-- ,and acknowledged to me that she signed it voluntarily for its stated purpose, Witness y hand and official seal. O0 o�OE 8 , ", & � IV IM .....• My Commission Expires: 4-- a-f 1p •G �,a 3 I Bk 24611 Pg 217 #28924 I . ATTORNEY'S AFFIDAVIT I, Elizabeth D. Trayner, hereby certify that I am the Attorney-in Fact named in a certain Power of Attorney for Elizabeth L. Perry-Marshall aka Elizabeth P. Marshall Dated December 15, 2006 and at the time of the execution of the attached deed' said Elizabeth L. Perry-Marshall aka Elizabeth P. Marshall was still alive and,to my knowledge, the Power of Attorney was in force and effect and had not been revoked. t Signed under the penalties of perjury this V day of June, 2010. Atto ey-in-Fact COMMONWEALTH OF MASSACHUSETTS County of Barnstable On this _(0 day of June;2010 before me, the undersigned notary public, personally appeared Elizabeth D. Trayner proved to me through satisfactory evidence of identification, which were 'pM.,.. to be the person whose name is signed on the preceding or attached document, and acknowledged to me that she signed it voluntarily for its stated purpose, as attorney in fact for Elizabeth Perry-Marshall aka Elizabeth P. Marshall, the principal. Witne d d official se goo °' Ean J A s =Z � My Commission Expires: (�.. —_,�— -- (,! B BARNSTABLE REGISTRY Of DEEDS