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0022 OAK NECK ROAD
&v P a,. h y Commonwealth of Massachusetts Sheet-Metal Permit Map Parcel Date: i;L o2.f 0_01 5 ° Permit# Estimated Job Cost: $ - "rj0,4 '°°3 P R O u Permit Fee: $ ;rs,orj Plans Submitted: YES (1l NO r. C 22 2015 Plans Reviewed: YES NO Business License# j� TOVI�fv 111= RAR�pp icit icense#_ J Business Information: Property Owner/Job Location Information: Name:, 6rr- BWi . n c Name: Street: l o Street: City/Town: TA ��'t /144 City/Town: I�YQ k7h :f Telephone: 344- 4 e�- 01 q 9 Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES l,1 NO _ Staff Initial estricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family V Multi-family Condo /Townhouses Other Commercial: Office Retail Industrial Educational Fire Dept. Approval Institutional_ Other Square Footage: under 10,000 sq. ft. L.111 over 10,000•sq. ft. Number of Stories: Sheet metal work to be completed: New Work- Renovation: HVAC 4/ Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: Svc}/ Q i^ i`►l S T� lit ' Li ?K �'r'� V jr-el A Ct T'V—P, ✓A. W4W/1.t kcayR W` C?Kt .^�(QYa goo, SURANCE COVERAGE: ave a current liability insurance policy or its equivalentwhich meets the requirements of M.G.L.Ch. 112 Yeso ❑ ,ou have checked Yes, indicate the type of coverage by checking the appropriate box below: mbility insurance policy (K Other type of indemnity ❑ Bond ❑ MER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the ssachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent j checking this boxE], I hereby certify that all of the details.and information I have submitted(or entered)regarding this application are true and urate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be ompliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: M/Master ❑ Master-Restricted Town ❑Journeyperson Signature of Licensee lit ❑Joumeyperson-Restricted / $ - License Number. . t0 Check at www,mass,govldpl ector Signature of Permit Approval �IKETown of Barnstable Regulatorg� services AIRNCr'Afi�Y E �aq i639. Thomas F. Geiler,Director ,Q,� Eo rvta� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject ptoperty heteby authorize to act on mY e b hal� M 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.before fence is'installed and pools are not to be utilized until all final inspections ate erformed an p d accept, A. Suture of Owner Siguatute of Applicant -Alzx � Pi'n.t Name / Print Name Date 5 QXORMS:OWNERPERMSSIONPOOLS Me Commonwealth of Massachusetts Department of Industrial Accidents Office pf Investigations 600 Washington Street Boston,MA 02111 www.mass.gov1dia Workers' Compensation hisu-ance Affidavit. Buf[ders/Contra.°tors/Electricians/Plumbers AyRlicant Information Please Print Lezibly Name(Business/organization/individual): P-a- V_WS � I e Address: 1S r_e-ab . L t f City/State/Zip:_ M&O( PhoneA: Are ou an employer?Check the appropriate box: 1.WI am a employer with .4. ❑ I am a general contractor and I Type of pao]ect(required);: 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 employees 'These sub-contractors have g. ❑Demolition working for me in any capacity, employees and have workers' [No workers' comp.insurance comp.Moir nce.+ 9. ❑Building addition required.] 5. ❑ We area corporation and its 10.❑Electrical repairs or additions -3. officers have exercised their❑ I am a homeowner doing all work 11.®Plumbing repairs or additions myself. [No workers'coma. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no � V employees. [ o workers' 13. Other L comp.insurance regiured] *Any applicant that checks box#1 mast also fit 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: �: d�C r 1- Mu v cal . Policy#or Self--ins.Lic.#: A P 03^f 3 9 T Expiration Date: lob Site Address: >uCIL Vd- City/State/Zip:_ y.1ta»n r7 i✓f,¢ 0.1 btu/ 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.tip 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 staterawit maybe forwarded to the Office of Investigations of the DLA-fo-fjusuraiice coverage verification. I do hereby certi t a and penalties of perjury that the information provided above is true and correct. Signature: Date: . f 4i ly Phone#: T43 G iO- -o l 47 Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitlLicense# -Issuing Authority(circle one): J.Bbard of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Page 1 Residential Heat Loss and Heat Gain Calculation 12/21/2015 In accordance with ACCA Manual J Report Prepared By: Braga Bros. Plumbing & Heating Air Conditioning For: Cezar Martini 22 Oakneck rd Hyannis, MA 02601 Design Conditions: Cape Cod Indoor: Outdoor: Summer temperature: 68 Summer temperature: 100 Winter temperature: 74 Winter temperature: 0 Relative humidity: 55 Summer grains of moisture: 100 Daily temperature range: High Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) Whole House 600.3 sq.ft. 9,336 1,958 11,294 28,612 ( 1 tons ) Main Floor 9,336 1,958 11,294 28,612 All Rooms 600 sq.ft. 9,336 1,958 11,294 28,612 Infiltration 2,253 1,958 4,211 13,023 -Tightness: Poor; WinterACH: 2 ; Summer ACH: .8 Duct 445 0 445 2,601 -Supply above 120; Exposed to outdoor ambient; R-8 Floor 600.3 sq.ft. 0 0 0 5,994 -Concrete slab on grade; Concrete; No edge insulation W Wall - 128 sq.ft. 235 0 235 568 -Wood frame, with sheathing, siding or brick; R-19 5 1/2 in.; none Window 15 sq.ft. 1,152 0 1,152 612 - Double pane; Wood frame; Clear glass - No inside shading; Coating: None (clear glass); No outside shading. Window(2) 15 sq.ft. 1,152 0 1,152 612 - Double pane; Wood frame; Clear glass - No inside shading; Coating: None (clear glass); No outside shading. Window(3) 20 sq.ft. 1,536 0 1,536 815 - Double pane; Wood frame; Clear glass - No inside shading; Coating: None(clear glass); No outside shading. Door 18 sq.ft. 226 0 226 546 -Wood; Panel; Metal storm S Wall 181 sq.ft. 332 0 332 804 -Wood frame, with sheathing, siding or brick; R-19 5 1/2 in.; none Window 15 sq.ft. 642 0 642 612 i Page 2 Cezar Martini 12/21/2015 Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) - Double pane; Wood frame; Clear glass - No inside shading; Coating: None (clear glass); No outside shading. E Wall 190 sq.ft. 349 0 349 844 -Wood frame, with sheathing, siding or brick; R-19 5 1/2 in.; none Window 6 sq.ft. 461 0 461 245 - Double pane; Wood frame; Clear glass - No inside shading; Coating: None (clear glass); No outside shading. N Wall 178 sq.ft. 327 0 327 790 -Wood frame, with sheathing, siding or brick; R-19 5 1/2 in.; none Door 18 sq.ft. 226 0 226 546 -Wood; Panel; Metal storm Whole House 600.3 sq.ft. 9,336 1,958 11,294 28,612 ( 1 tons ) HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101 Load calculations are estimates only,actual loads may vary due to weather and construction differences. �C CYa I yu GlL 14" 5 l2" 5 i Please visit our web site at http://www.mass. Please visit our web site at http://www.mass.gov. ALEX"B BRAGA ALEX B BRAGA BRAGA BROS INC (SM) 2 MOUNTWOOD RD .2 MOUNTWOOD RD MARSTONS MILLS,MA 02648 MARSTONS MILLS MA 02648-2111 Fold Then Detach Along All Perforations Fold Then Detach Along All Perforations COMMONWEALTH OF MASSAMUS�TTS M �A,eI 4rY'4 rP `� ,`. a: `�a v- .<.aq.�. 'r+`"' r ',:• '�y"" �' ={ SHEE i'IETAL WO'RKEI S �� z SHEE1'�UETALINORFEERS � IS 'U EIS THE F0 LLVOW�I: `r N :;L.I.CENSEy ,,yV � ISSUES THOLL'OWINGLICI=IVS•EASA� r 1S ��' t'k" T`'f ,,, }. t E'� 1;�_7 �r TL• - W q. ^a r � + +`y^., f,'-ea `1` r^, %Z Ak.�X,�B �,,�.. 5� NJ,"' `�' q ,<�^a`'" 'ewe a` t 2 MOUNTWOODRD � `• W2 MOUAITWUOD ROgp y' Z ate£ f4tt1 >>� Jj' ? �.. .al sF �4� W 9 � . } MARSTONS MILLS,MA 02648 �'�� W a "f J .y �1ARST�01VS # v3 r o I MI�Li S � 02648 21 l�l`t 14 ,u.z a # y z � k k : u 6121>1E/07/2017 6425 i ,.W iillllplll z �aGia� ; ,'- 3 J' u� �t. 6 i CERTIFICATE! OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 04/02/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF. INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE � DOES NOT AFFIRMATIVELY OR NEGATIVELY; AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed: If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain y q p y policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu Of such endorsement(s). PRODUCER UUNIAQU NAME: JAMES R HINDMAN SCHLEGEL INSURANCE BROKERS INC PHONE FAX i (AIC,No,Ext), 508-771-8381 (AIC,No).508-771-0663 34 MAIN STREET i E-MAIL ADDRESS:_ 8CHLEGELINSURANCE@GMAIL.COM WEST YARMOUTH, MA 02673 INSURERS)AFFORDING COVERAGE NAICU INSURERA:NGM INSURANCE CMOMPANY 14788 INSURED INSURER B:LIBERTY MUTUAL - Braga Bros Inc INSURER C: 110 BREEDS HILL ROAD INSURER D: UNIT 5 INSURER E: HYANNIS MA 02061 INSURERF: COVERAGES CERTIFICATE NUMBER: f 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 'I 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. INSR WSK LTR TYPE OF INSURANCE I POLICY EFF POLICY EXP INSR WVD POLICY NUMBER POLICY (MWDDIYYYY) LIMITS A GENERAL LIABILITY MP03439i ' 02/17/201502/17/2016 EACH OCCURRENCE S 2,000,000 X COMMERCIAL GENERAL LIABILITY ! DAMAGE TO RENTEU PREMISES(Ea occurrence) S 500,000 CLAIMS-MADE OCCUR MED EXP(Any one person) S 10,000 _ PERSONALS ADV INJURY $ 2,000,000 GENERAL AGGREGATE S 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 4,000,000 POLICY PRO- i JECT LOC S AUTOMOBILE LIABILITY _C0MuINED SINGLE LIMIT j (Ea accident) S ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) S NON-OWNED !HIRED AUTOS AUTOS PROPERTY DAMAGE $ (Per accident) $ UMBRELLA LIAB I EACH OCCURRENCE S OCCUR EXCESS LIAB CLAIMS-MADE AGGREGATE - 5. i DED RETENTION S -S B WORKERS COMPENSATION WC5-315,-376462-024 06/14/201406/14/2015 WCS AT - O H- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.I.EACH ACCIDENT S ZOO OFFICER/MEMBER EXCLUDED? NIA ,000 I (Mandatory in NH)If yes,describe under E.L.DISEASE-EA EMPLOYEE S 100,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 107,Additional Remarks Schedule,if more space Is required) ALEX BRAGA HAS ELECTED NOT TO BE COVERED UNDER HIS CURRENT WORKERS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601 AUTHORIZED REPRESENTATIV EMAILED i i i 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD 1111 arne and logo are registered marks A RD ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION dZlMap Parcel Application #� D Health Division Date Issued I—?A 6 Conservation Division BU11 �1P Planning Dept. J0nit Fee Date Definitive Plan Approved by Planning Board �-��IV®F 8,��20i ' Historic OKH _ Preservation/ Hyannis �1&L, Project Street Address AA OAK NECK 406k 1��J 14y Village f sN N S Owner CEO b Alv-kK-Ti Ni Address 3 a S TU K,115Rd DgG Dr Telephone '1`1 LA 3(o a 1 d (O Permit Request F100 6- I4 WfS ff)- 5� W N9 LAM W p;; L Psi PiTi N — i J<�N eP Chi X-T'� Square feet: 1 st floor: existing _proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 16.000 Construction TypeUSM6 C RE NoV iO fJ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach 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.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number 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 Q No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) t Name IA-VAA- NV"Z6 NI Telephone Number 8'3( 4 Address 3 aV CZ Z5 R 1 D!�6 1 License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i j FOR OFFICIAL USE ONLY PPLICATION # .DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING xrk DATE CLOSED OUT ASSOCIATION PLAN NO. ?lie Copnorrfrealth of-Vassachusetts Department.t eflfndzrstrial Accidews - _- Of- ce o,f fm.-wtigations # 600 Wash higton Street Boston,?IAA 02111 wivii:niasmgovIdui Workers' Campens3t GnIusurance Affidavit:BuilderslContracturs,EIech cians/Plu nbers Applicant Infhrmat an Please Print Legibly Name(BusiwstOrgan tionffi dividml) Address: "f . , City/Stat&Zip: '�h�(J�U i I I 'Y 1�'1' 1J7,�00 Phone 02/)024 Are you an employer?Check the appropriate box: Type of project(required).: I. I ant a general contractor and I ❑ I am a employer urith. ❑ 6. New construction employees(full andlor part-time)-* have hired.the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7_ ❑Remodeling slop and have no employees. These sub-contractors have g_ ❑Demolition wodring for mein in any capaci43: employees and have workers' YLV9. Building addition iv-orkers�' comp.insuzanct; comp-msuraszce.I � g required_] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. F am a homeo-mier doing all work officers have exercised their i l_❑Plumbing repairs or additions myself[No workeers'comp_ right of exemption per MGL ins+ nce retuired j i c.I52 §1(4k and we have no 12.❑Roofrepaiits � employees.[No workers' 13.0 Other comp.insurance required-] #AnyappBc gntchedrsbox91rmst also filloutthe section below shor ingtheirworkerecompensatwapoTrginfomtauom F omeoavne m who submit dais af5davu iuTxzdng they axe doing all waxk and t5ea l*e omside contractors atnst snbmit an EW AMdaVit iodlcatMv staclL fCbniractots t$aY check ih is bane mast attached m additional sheet shoumg the name of the sub-ca ntrwAm.and state whether.or not tbose entities have employees Ifthesnh- ontactneshave employers,they=Lst provide their workers'romp.poricg ntaobm. I am aril elrtpinyYrr that is pra�ading�vurkers'canrpertsah'art insrirance,�vr rri}*encplaf�ees Setv�v is Etta policy aftd jab�trr it formation. Insurance Company Namre: Policy-4 or Self-ins..Lic.;ff Elpization Date: Job Site Address City/Statet7.tp: Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and respiration date). Failure to secure coverage as requued.under Section 25A of MGL c� 152 can lead to the imposition of criminal penalties of a fine up to$1,500,00 and,'ar one-yearimpriso—I-A,as well as civil penalties,in the form of a STOP WORK ORDERand a fine of up to$250-DO a day against the violator_ Be ad,,ised that a copy of this statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. I do heraby ce&ft,under tha prrbis andpena ' ofpe.;yuty 17iatifle infonuatioispronirled abmv fs hire and carrect Signature: Date: I �/ phone A �11 � �✓ � a1 � � Offidal use only. Da oat write in tlifs.area,ter be cainpteted by city artea-n offl" City or Toff a: PermitUcense# Essuing.A.thorny(circle one): 1.Boated of Health 2.BuMing Department 3.CityLTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.other Contact Person: Phone#: lafarmatzan and last rncfions Massachusetts C ehaaI Laws chapter 152 requires all employers to provide WOrkers'compensation for their employees. . Pmmmatto this fie,an empIoyze is defined as."—every person in the service of another under any conra.ct of hire, express or implied,oral or " An 7npTzyer is defined as"air individual,partnership,association,corporation or ether legal entity,or any two or more of the foregoing engaged is a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trostee of an iadividnml,par am-ship,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - - Ouse o such dwelling h use of another who Io Persons to do maintenance,construction or repay wor3c n g dwelling ho �p YS or on the grounds or building apptuteuaat$ieretu shall notbecanse of such employment be deemedto be.an employer." -es that"every state or local licensing agency shall withhold the issuance or MGL chapter 152,§25C(6)also sta renewal of a license or permit to operate a baseness or to construct buuTcTings in the comm ouwealth for any applicant who has not produced acceptable evidence of compliance with time hisura ce.coverage required." Additionally,MCrL chapter 152,§25C(2)states"Neither the comm®.Wealth nor my of its political subdivisions shall enter into any contract for the performance ofpublic woric until acceptable evidence of compliance with the amlrancc6 requirements of this chapter have been presented to the contracting aDihOdty." Applicants Please fill out the worker'compensation affidavit completely,by checking idle boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), addresses)and phone numbers) along with their certificata(s)of ir=ance. Limited Liability Companies(LLC)or Limited Liability Partnerbips(LLP)withno employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have e]n.ployees, apolicyisrequired. Be advised that this affidayitmaybe submitted to the Deparfraentof In.dustial Accidents for confnmafion of insurance coverage. Also he sure to sign and date+hffi e affidavit The affidavit should be retnmmed to$e city or town that the application for tine permit or license is being requested,not the Department of n , A_ccide Shouldyou have any questions regarding the law or ifyou are regoired to obtain a workers' compensation policy;please call the Depa tnent at the number listed beIow. Self fi sLa companies should enter their self-fi sarance license number on the appropriate lime. City or Town Oifidals Please be sure that the affidavit is complete and pried IegilbIy. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Of of Investigations has to contact you regarding the applicant Please be sure to fill in the pelmitllicense number which will be used as a reference nuunber. In addition,an applicant that must subn3 t mutiple peimitllicense applications in any given year,need only submit one affidavit indices• *�g current access and under"lob Site Address"the applicant should wute"all locations m (may or p ohcy Lfbj=.ation(if ary) the - town)_"A copy of-the•affdavitthathas been officially stamped or marked bythe city or tows maybe provided to applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled oiit each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venfrse (ie. a dog license or permit to b=Ieaves eta.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you ja 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 TJ e CO.MM W-e aRj ire of Mass chmttks ' Department cuff Iadusfdal Accidents ffii=of Boston„MA 02111 T,!-,1.4 617-727-4}RG Cxt 40f Or 1,?77-MA-S AFF Fax 9 617-727 7749 Revised 424-07 mar -gavIdia yob , � ►� off ' ' 04 a 6 00 W O , IC1 fDpo En 00 Oh 10 PS &' y G Er Er Pd ►B .x � H In O � � R' � � p �' � V lip, x KPI - o �. rt rod ►Li _ R, ,� o o . H '" Cl ' aru w DO , . p 6 �1. �"di o tin bd i° �• �',. a e u , TiEr° y Town of Barnstable Regulatory Services . ' E HlS7'1NCPlFCr4 F 4 neat� R,iAard V.SmlI Dkedor Buldmg Division Tomrerry,BmIrHM Canunissioner 200 Maim Street Hyam*MA 02601 wWW tWularnsf2ble_Ln us office: 508-862-038 Fag: 508-790-6230 Properly Owner Must Complete and Sign This'Section If Using A Builder L ,as Omer of the subject property- to act on mybebalf in all mattes relative to work authorized bytbis budding permit application for. . (Address of Job) '-Pool fences and alarms are the responsibik7of tie applicant Pools are not to be filled or teed before fence is installed and all final " inspections_are pedo=d and accepted., sign of Owner Skaatuxe of Applicant Pri=Name Priut Name Dam . r r QFaRnrss�wr����oors ' i c CC-ZAR MA'RT�N l a o1 QPsVC IJ&CK �➢ $ �' ?AV\A- M PrtQ,Tr N KA h11 S M P` 1?D�212 BAS 8: y G fAc �� 16 Ch _ T P4 - l� co s m&T1 C5 — btrn�,n q� Q _ VO � New NOi� �pT STAUCTURIt" C H�G� � JAN�1 r ?n�6 i C �,e MAR.T 6 ('N 1 f� �6 00 f � 0 ` yl� cosm�TiCS & ylqc _ NeUdi\� — oJeW ��` a�i T ✓ qN —p /v'0 VTR UGTU C HNW ' ' * TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map v Parcel _ Application 4Q,_IQ Health Division Date Issued Z C. Conservation Division a&plication Fee G Planning Dept. P r Date Definitive Plan Approved by Planning Board *j 1 Historic - OKH _ Preservation/ Hyannis 102V 0,c: ?ft CProject-Street Address _ Ok 0QCK R 0 --b),a ' Dl' �Viliag N N 3� COwner"` � b MTi o1 (Address�a S l�lA .M Telephone- `1`14 $�6 A 1 16 Fe Req P` � r 0 CE EAM°L SSquare�feet: 1 st floor: existing ._proposed 2nd floor:"existing proposed Total new Zoning District Flood Plain Groundwater Overlay (Project Valuation Construction;Type OS m6 `t RR.tv0 J M w^y Lot Size Grandfathered: ❑Yes ❑ No If yes, attach 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.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number 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 Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C, CW`� r`TelephonerNumber Address 3a � �G D'�. License # , . . __ Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i•�G,�--- FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. the ConirnorriveaiFth of- assachusetts Departrnerrt ofrndrrstriat Acciderds - - - O,j7ce oflnivstigations 600 Washington,S reet Boston,MA 02111 it-mmunassgovIdia Mrarkers' Camp ensat an Insurance Affidavit:Bnildei-s/Cuntrac urs/EIectricians/Plumbers Applicant Infal-matan Please.Print Legibly IRa ul A. ►'l�ccn a1., Aaare�s: 3a S�{,wty� .. �� • Are you an employer?C ee the appropriate box: Type of project(requirtd)c I.❑ I am a employer with. 4 ❑I am a general contracture and I G_ New constructionemployees(full andlor part-time)* have hired.the sub-contractors 2.❑ I am a sole proprietor orpartner- listed on,the attached sheet 7_ ❑Remodeling ship and h-we no employees. These sub-contractors have 9. ❑Demolition worlring for sue in any capaci yS employees and have workers' [No nmd mrs'comp.insurance comp.insuranmi 9. ❑Building addition. --/e F&ed] 5. ❑ We.are a corporation and its 10.❑Electrical repairs,or additions 3._ -I.am.a homeoumer doing all work officers have exercised their 11_❑Plumbingrepairs or additions uq ml-f,[No workers' right of exemption per MGL 12.❑Roof repairs insu cerequited]i c.152,§1(4k and we have no employees.[No workers' 13.❑Other comp.insurance required-] #Any apptfcaut that checks box 91 most also fill outthe section below showing their vioikeie*compensation policy information_ Hameosaraers who submit dtis af5davii indicating they are doing all wcd aa3 then wn outside contractors most snbmit a new affid,&vk indicating sstrR ZCantractorsthat check this bout must attached an additional street showing the na>ne of the sub-contrwAms sod state whether ornatihose entitieshive employees.Ifthesnbtaatactorshave employees,theymustpmvide their workers'comp.policy number. I am art ersplo}�trr tltat is pratzrlterg workers'canrlrerrsafiale irrsrirarrce f br tri}*enrplat�ees Helom is the parity and job site reformation Insurance Company Name: Policy or Self-ins..Lic.k EipirationDate: Job Site Address. City/State/Z.p: Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and respiration date). Failure to secure coverage as required.uuder 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 Rue of up to$250-00 a day abainst the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations ofthe DIA for•insurance coverage verification. I do herabycerfef y,rutdar the pacers a penalties ofpetjuey thatths informa€ion.pt mRded abow�is.bare and carreat -Date- 1 61 1 � Phone Offisial use a:nly. Do scat write in this area,ter be completed by city artbirn of j�reiaL City or Town: PermitUcense# Issuing Authority(circle One): 1.Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Otherr Contact Person: Phone#: Information and Instru'-lions Massachusetts Ge'nf-zg Laws chapter 152 rues all employers to provide workers'compensation for their employees. Pnrsuautto this sty,an employee is defined as."-.every person in the service of another under any contract of hire, express or implied,oral or " An employe is defined as"an individual,pa�rinershzp,associati&A corporation or other Iegal entity,or any two or more of-the foregoing engaged is a Joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of as individual,partnership,association or other legal entity,employing employees. However the owner of a dwc inag 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 mamtmao ce,construction or repair work on such dwelling house or on the grounds or building appurten.a tAhcmto shallnotbecanse of sack 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 Incense 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 a saran ce.coverage required" Additionally,MGL chapter 152, §25C(7)states Neither the commonwealth nor auy ofits political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of complianceTp itii the thin-dacc.. req rire ents of this chapter have been presented to the contracting aulhozity.': Applicants Please fill out fe workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone numbers) along with their certificates)of innu nce. Limited Liability Companies(LLC)or LimitedLiabrlityPartnerships(LLP)withno employees other than the members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is requited. Be advised that this affidavit maybe submitted to the Depa1-iment of Industrial Accidents for conformation of iamaz ce coverage. Also he sure to sign and date it-he 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 Iudt strial Accidents. Should you have any questions regarding the Iaw or if are required to obtain a workers' compensation policy,please call the Department at the number listEd below Self-insured companies should enter their self-m surance license nummber an the appropriate line. City or Town Officials t Please be sm-e that the affidavit is complete and printed legs-bly. The Department has provided a space at the bottom of tame 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 peffiit(licewa number which will be used as a reference number. In addition,an applicant enD.itllicense li-cations in any given year,need only submit one affidavit indicating current that mast submit multiple p aPP policy information(if necessary)and under"lob Site Address"the applicant should write"all locations in 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 proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.There a home owner or citizen is obtaining a license or permit not related to any business or commercial ventLire (i_e_ a dog license or permit to bum leaves etc.)said person is NOT required to complete thu 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. Thft COMM Wean-of Massachns-t-tts ' Dagartia eat of Iudustdd Aoc dent% Of of l vewntio---W ��4�a'shin�tan t - BostO33,M&G I I I Tf,-1.4 617-727-4900 cxt 406 Or 1-3-77- SAS F Fax 617-727 7M Revised424-07 w vi .maz-gavfdia Town of Bamstable • Regulatory Services psrT�r � Eidiard V.Scar,Director °* BrdIding WvMon. t E i Tom Perry,Biding com-iccioner :tom tea$ 200 haia Sfteet Hya[Mis,MA 02601 �En WWWt"Mb%rM 5bbje m_us Office: 508-862-4038 Fa: 508-790-6230 HOIMWNM LICEMEXIIa-MIf Ge D K JOBLOCAnM,L- ORQO 0"N)6Ck Jkb l'rV ter N� AIZTJ N i `'114 3(e d d �►-•-'na.., _ •-- "' - �,,.b®cphonc#.a.:..�. - �.r.tWoi3Cphanc#r`...,•,,.,.,-•a CURRENT kiAIT WCIADDAESS: _ ---- a4tmr Ile M4- '2=c^� The cusent exemption for"homeowners"was extendedto include owner-occ�ied dweIImes of sic Zmits or Less and to allow homeowners to engage an individual for hirewho does notpossess a license,provided that the,owner acts as supervisor_ DTFu4rrLON OF HOMEOWNER P eson(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,aitacbtd or detached stmdarm accessory to such use and/or farm sftuct ncs. A person who constrncts more than one home is a two-year peaiod shall mtbe consider* d•ahomeowner. Such°homeawnee'.shag snbmitto the Building Official on a Ran acceptable to the BOrin Official,thathelshL shaII be mmonsible for aIl sash work peafoffied imder�e bmZdmg permit (Section `109.L1) The undersigned`homeowner"==s rmpmmliI y for compliance withthe State Bu7ldmg Code and other applicable codes, bylaws,roles and regulations. - f • The tmdersigned`•`homSowne�'certifies thathelshe imdends tha Town ofBazIIstab�e Biu7ding Department inspection procedures and requirements andthathelsha wM comply with said procedures andreqiremcnis. " fSigaatrsr�ofHomcowncr` �'%*j;a;- .N - . Approval ofBm7dmgOfficial • Note: Three_ miry dwellings containing 35,000 Lvbic feet or larger wMbe required to comply with the States Budding Code Section 3227.0 Cori.stru.clion ContmL Hon�owru�s,�s pox The Code states that: `Any homeowner performing work for which a buiZdiag permit is required shaII be exempt from the provisions of this section(Section 109-U-T I=nsm- g 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(fiat they are assuming g the responsibrTrtz'es of a supervisor (set Appendix Q,Roles&Regulations for llmnskg Constriction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly whey ffie homeowner hires mTir_ensed persons. In this case,our Board cannot Proceed against the mdicensed person as it would with a Hcensed Supervisor_ The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeownrr is fully aware of his/her responsibr es,many communities require,as.part of ffie permit appHcafron,that the homeowner certify t3lat helshe understands the responsrbzTrh'es of a Supervisor. On the last page of this issue is a form currently used by.seierel towns. You may care t amend and adopt such a formle=tiffcat*na for use in your cammm:dty, �q�p��ct�g�,�re�F,.,���pr�itfrirmsl�B,F55.doc Revised 061313 . � To„yy Town of Barnstable Regulatory Services 4�$ Richu d V.Sc4 I&ecbr BIIRding Division `TomPerry,Buaciimg Comn*doner 200 Maim Stree4 Hya�,MA 02601 ww w townlarnstable ma.IIs Office: 508-862-4038 Fag: 508-790-62M Propeify.Owner Mist Complete and Sign This Section if Using AB der I, I/asner of tie Subject property . hereby a thorize to act on my behalf, in all matters idative to work antboazed bptbis bmIding pa=k application for. (Addiess of job} I'oolfences and Al s are the responsl"iL7Of the applicant Pools are not to be filled or v• Lxd before fence is installed and all finial mspectmns•are p4ormed and accepted. S.a=of Owner Signature of Applicant Print Named Print Name Date : �Fo�ts:owz��slmr�oors . �o CEZ� MAITi N i .u, PA-0Ir MAxTi r-i i 16 PTO 16 18 1s' 8 BAS 22 6 - 16 -- -18 - mo IF'�` 3 4 A6ey s b c,D ro o rn AEN A ��`�Nf►e�t•1.Ci � 1 �v i�� "eOM Yz,00 in I 3 5 i� fyzo �� _D ON LY 1awti FIoo r ®lNG G�nn� Dw JANI1 ?o D �ej TD�NOr -� NevJ S ko w e-f, egR�����`F VcT� R� G Ikoj�►� 0 0GCV, � �� ,,= CE?� MPr Ti N i • PA-0 VA- Mk.Ti ►� i rTo a Y�Oo In --t g— _D oN Ly a6ina-7i GS �P►NC� Flvo r D w G -ff,� c- DFP �.D fj TP,01 IJT1tJ� JAN11 N 2W S ko vi ek �� G �� Building Department ComplainVInquiry Report r I Date: Rec'd by: Assessor's No.: Complaint Location Address: � 1 1 WP Originator Narne• GLa- Street: Village: State �p •6 ` Telephone:D/R Complaint esaiption: S��S SiV 33a� ! Chi %d' ��%t �S ��e.(. -)' s c p n S?� T OYC�s� Lour �r,ar,ee i e-)is' e- S4 id So-- t-el . Me% o 'r;�-N For 0 ce Use Only �!t Inspector's Inspeor Action/Comments Dace: J Tollow up Action I Additional Info. Attached Copy Distribution: White-Depattrnent File I'CBOW-Inspector pink-Inspector(Return to Office Manager) Building Department Complain.VInquiry Report Date: Rec'd by: rt� Assessor's No O Complaint Name' I Location Address: M/P Narne• Onginator Gx� Street: Village: �� State: Zip Telephone:D/E Complaint Description: , i Inquiry 4 Description: — For Office Use Only Inspector's o? - c' / Inspector.-- Action/Comments Date: Follow-up Action ----------------- Addidonal Info. Attaclied Cop},Distribution: White.Department File Yellow-Inspector Pink-Inspector(Rem=to Office Manager) \ 1 \ . /• • , ice.. � r'� ► i . l:e.i. •� � _'•1.. r • it , I � ` ► ' � � � ' `� J 1 • ,MEW 1 _ i • "Nalaw 1 �t rqk Town of Barnstable *Permit# Expires 6 months from issue date .Regulatory Services Fee��� rinMsrasrc. • vim—`_' 039. Thomas F.Geiler,Director � fDMptA Building Division Tom Perry,CBO, Building Commissiomer 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESMENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address p2� oA IC�a�it Q � ].Residential Value of Work p� / Minimum fee f$35.00 r-work under$6000.00 Owner's Name&Address �/L QA k M JZa1 4/4 Contractor's Name OH lQ �t A S -Cl*�b �,� Telephone Number O V g /1,?j_. Home Improvement Contractor License#(if applicable) $ Construction Supervisor's License#(if applicable) 9/3 QW;orkman's Compensation Insurance M PRESS PERMIT Check one: ❑ I am a sole proprietor .l 1 ❑ lam the Homeowner F []4-have Worker's Compensation Insurance ��� C l �-• �• TOWN OF BARNSTABLE Insurance Company Name Spa J.h Workman's Comp.Policy# IJ63 o Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Pj"Re-roof(hurricane nailed)(stripping old shingles) All construction debriis will be taken to�w�J ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximunn.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town departmem,t regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\decollik\AppData\Local\Microso \Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 The Comunonwealth ofMassachus,etts Deparhnent of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.inassgov/dia Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leaibly Name(Business/Organization/Individual): O E Or+�4S 7/Lv >a Address: City/State/Zip: / /1W a2=Phone#: SUo° Are an employer?Check the appropriate box: Type of project(required): 1. I am a employer with s2 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 employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.Elloof 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'compensalion policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contraclors 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: 6�'►�l ve ..is. Policy#or Self-ins.Lic.#: / G✓�j�'O Expiration Date: Job Site Address: a�� �j0k �' Qcd` City/State/Zip: "" Attach a copy of the workers'compensation policy declaration page(showing the policy num er and eipiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead ta>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 Norm 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 statemenit may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pat s andpenalties ofperjury that the information provided above is true and correct Signature: t�►?""� Date: ID Phone#: 7"d 3,2 163� 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#: ACORDTM CERTIFICATE OF LIABILITY INSURANCE DA0(MM/D2010) PRODUCER (508)428-0440 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mark Sylvia Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 771 Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville MA 02655 INSURERS AFFORDING COVERAGE NAIC# INSURED Doyle& Thomas Construction,Inc. INSURERA: Farm Family Casualty Insurance PO BOX 168 INSURER B: Centerville,MA 02632-0168 INSURER C: INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X 2001 XO485 7/21/2010 7/21/2011 DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY 50,000 PREMISES Ea occurence $ CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICYJECT PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ ' NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- X OTH- A EMPLOYERS'LIABILITY 200IW6390 7/1/2010 7/1/2011 1 TORY-LIMITS 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED?. 500,000 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below Yes E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry Troy A Thomas, President; Shawn Doyle, V President are not covered by the workers compensation policy. CERTIFICATE HOLDER CANCELLATION (508)790-6230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable Building Department DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL { Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE rye ACORD 25(2001/08) ©ACORD CORPORATION 1988 . rl £1,666 :gal ' ZIOZ/£Nb �r.oiteaidx3 Z£9Z0 VW '311tA631N30 3AI8G MHONI110N 66t, SVWOHl A06I SM'�21 :ol paioutsa6 £3666 IS-So :asuaail asuanll ftl:-taact5 aos�f,aadnS uo(1ona;suob Ttnr1S* Pur. suuUr(n,.ta ,uip(!nB.1�� p.rrir8 +�.�J►'� .�i(ynd &n tu.�url.rr.rl,�Q - :u.�.ny.�rrc.r.l.�. �. /fie {a»orcf�useu e[[. l�utrartu Board ofBui ding fteguintiofis and Standards vVP License or registration valid 1w indi`hrdul'use only HOME IMPROVEMENT CONT CTOR beforethe expiration date, if found return to: Registration: 145954 Board of Building Regulations and Standards Expiration: 3/15/2011 Tr# 282668 One Ashburton.Place Rm 1301 Type: DBA Boston,Ma.02108 DOYLE+THOMAS CONST TROY THOMAS — F 499 NOTTINGHAM DRY•+ -` �� CENTERVILLE,MA 02632 — _. ' _ ' �-- ' --------- ' Administrator Not dal' without signature SPECIALIZING IN ALL FORMS OF RW ING & SIDING doyleandthomasconstruction.com P.O. BOX 168 0 BBB. CENTERVILLE, MA 02632 Fully Licensed & Insured Construction Supervisor Lic# 99913 Doyle and Thomas Inc. Proposes to perform the following work: Location of proposed work: Mr. White 22 Oak Neck Road Hyannis, MA 02601 Date on which construction should begin: September 2010 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall naot be considered as a violation of this contract. The contractor agrees that when such delays become known 9:o the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired,creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the. duration of the work and the schedule d;.ate of completion may differ,and that such variation is not to be considered a violation of this contract. The total cost for labor and materials under this contract: $2,910.62 30 yr.GAF/Elk Timberline Architectural shingle In the event that while stripping the roof we find rot t hat needs to be replaced,the homeowner then has to agree and authorize any replacement or res'..oration. Then in addition to the above contract price,the homeowner agrees to compensate the cant ractor for any repairs or restoration at the hourly rate of$45.00 for a carpenter and$30.00 fov a carpenters laborer, plus the cost of materials. Thank You For Givina Us The Onnortunity To Haln Ynu lmnrnvp r -Roof to be stripped and cleaned of a((old shingles and debris pP g -Roof to be papered with weather watch leak barrier and #30 felt paper, and installed with Timberline architectural shingles using galvanized nails. (Stornm nailed) -All new 8 inch drip edge and pipe flanges to be installed -Timberetex premium ridge cap to be installed -10 yard container will be needed on site; and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start; and remaindler due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when dlue. Any payments which are delayed shall be subject to a finance charge of 1.5%per month. The contractor warranties the work completed under this contract for a period of ten year from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsi ble 4for the normal maintenance, repair due to abuse, misuse, and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or ma51 in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form,cortent,and notices contained in this contract are intended to comply with the applicable portions of the Mass.General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance,only such portion shall be invalid and the remainder of this contract shall be in Ball force effect. In addition,any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument o,n this date: Date: Homl�iW r� Contract Barnstable Assessing Search Results Page 1 of 2 a el; ; n+ s x Home: Departments:Assessors Division: Property Assessment Search Results 22 OAK NECK ROAD Owner: Property Sketch Legend LIPPMAN, ROBERT D&TERRI B This property contains multiple Please use the navigation below the sketch to br< Map/Parcel/Parcel Extension 308 /201/ Mailing Address LIPPMAN, ROBERT D&TERRI B 65 WILANN RD MASHPEE, MA.02649 2004 Assessed Values: Appraised Value Assessed Value Building Value: $ 109,600 $ 109,600 Additional Sketches 1 12 Extra Features: $0 $0 Click Here for print version that displays all sk( Outbuildings: $500 $500 Land Value: $ 104,600 $ 104,600 Interactive Property Map: ap requires Plug in Totals:$214,700 $214,700 1 have visited the maps before s Show Me The Map - _ 7 April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: PERKINS, RICHARD P JR 12/15/1988 6568/116 $ 150,000 PERKINS, RICHARD 11/15/1982 3611/50 $45,000 LIPPMAN, ROBERT D&TERRI B 2/28/2001 13600/074 $ 158,000 http://www.town.barnstable.ma..../displayparce103.asp?mappar=308201&SearchBy--Addres 1/14/2004 Barnstable Assessing Search Results Page 2 of 2 2004 Tax Information: Tax Rates: (per$1,000 of valuation) Town Tax $ 1,419.17 Town Fire District Rates Other Rates 6.61 Barnstable 2.01 Land Bank 3%of Town Tax Hyannis FD Tax $435.84 C.O.M.M. 1.10 Cotuit 1.52 Land Bank Tax $42.58 Hyannis 2.03 West Barnstable 1.36 Total: $ 1,897.59 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.15 Year Built 1946 Appraised Value $ 104,600 Living Area 584 Assessed Value $ 104,600 Replacement Cost $64,568 Depreciation 24 Building Value 109,600 Construction Details Style Cottage Interior Floors Carpet Model Residential Interior Walls Knotty Pine Grade Average Minus Heat Fuel Gas Stories 1 Story Heat Type Hot Air Exterior Walls Wood ShingleClapboard AC Type None Roof Structure Gable/Hip Bedrooms 2 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 Bathroom Total Rooms 3 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area (Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area (Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area (Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma..../displayparce103.asp?mappar=308201&SearchBy--Addres 1/14/2004 Barnstable Assessing Search Results Page 1 of 3 ., 22 OAK NECK ROAD Owner: Assessed Values: LIPPMAN,ROBERT D&TERRI B Appraised Value Assessed Value Map/Parcel/Parcel Extension 308 /201/ Building Value: $75,200 $75,200 Mailing Address Extra Features: $0 $0 LIPPMAN,ROBERT D&TERRI B Outbuilding: $500 $500 Land Value: $27,900 $27,900 65 WILANN RD MASHPEE,MA.02649 Totals: $ 103,600 $ 103,600 Sales History: Owner: Sale Date Book/Page: Sale Price: PERKINS,RICHARD P JR 12/15/1988 6568/116 $ 150,000 PERKINS,RICHARD 11/15/1982 3611/50 $45,000` LIPPMAN,ROBERT D&TERRI B 2/28/2001 13600/074 1$ 158,000 Tax Information: Tax Rates: (per$1,000 of valuation) Town Tax $973.84 Town Fire District Rates 9.40 Barnstable 2.88 Hyannis FD Tax $299.40 C.O.M.M. 1.54 Cotuit 1.88 Land Bank Tax $29.22 Hyannis 2.89 West Barnstable 11.96 Total: $ 1,302.46 Other Rates Land Bank 3%of Town Tax Due to rounding differences these values may vary Land and Building Information Construction Details Land Style Cottage Lot Size(Acres) 0.15 Model Residential Appraised Value $27,900 Grade Average Grade Assessed Value $27,900 Stories 1 Story Exterior Walls Wood ShingleClapboard Building Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp Year Built 1946 Interior Floors Carpet Living Area 584 Interior Walls Knotty Pine Replacement Cost $44,301 Heat Fuel Gas Depreciation 24 Heat Type Hot Air http://www.town.barnstable.ma.us/tob02/Depts/Admini.../displayprint03.asp?mappar=3 0820 1/14/2004 Barnstable Assessing Search Results Page 2 of 3 ouuuuiy value 'D IU,LVu Ali Iype IVVI lu Bedrooms 2 Bedrooms Bathrooms 1 Bathroom Total Rooms 3 Rooms Extra Building Features Code Code Units/SQ ft Appraised Value Assessed Value Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area (Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area (Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) 41 fi p r � X € y n http://www.town.bamstable.ma.us/tob02/Depts/Admini.../displayprint03.asp?mappar=30820 1/14/2004 [ ] [R308 201., ] LOC] 0022 OLD NECK R09 CTY] 0#7 TDS] 400 H KEY] 221799 ----MAILING ADDRESS------- PCA] 1091 PCS] 00 YR] 00 PARENT] 0 PERKINS, RICHARD P JR MAP] AREA] 61AC JV] 310522 MTG] 0000 PO BOX 14 SP1] SP21 SP31 UT11 UT21 . 15 SQ FT] 584 ACCORD MA 02018 AYB11946 EYB11980 OBS] CONST] 0000 LAND 20300 IMP 62600 OTHER 700 ----LEGAL DESCRIPTION---- TRUE MKT 83600 REA CLASSIFIED #LAND 1 20, 300 ASD LND 20300 ASD IMP 62600 ASD OTH 700 #BLDG (S) -CARD-1 1 25, 800 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #BLDG(S) -CARD-2 1 36, 800 TAX EXEMPT #OTHER FEATURE 1 700 RESIDENT'L 83600 83600 83600 #PL 22 OAK NECK RD HYANNIS OPEN SPACE #DL LOT C COMMERCIAL #RR 1118 0080 INDUSTRIAL EXEMPTIONS SALE] 12/88 PRICE] 150000 ORB] 6568/116 AFD] I A LAST ACTIVITY] 08/21/95 PCR] Y 1! YI 1^ R308 201 . op P R A I S A L D A T A` KEY 221799 PERKINS, RICHARD P JR LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 2.0, 300 700 62, 600 2 A-COST 83 , 600 B-MKT 86, 700 BY 00/ BY ML 5/88 C-INCOME PCA=1091 PCS=00 SIZE= 584 JUST-VAL 83 , 600 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 61AC -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 61AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE .203001 LAND-MEAN +0% 836001 74880 IMPROVED-MEAN -160 250 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1000] LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R308 201 . • P E R M I T [PMT] ACTIOR] CARD [000] KEY 221799 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR oCMP NEW/DEMO COMMENT I AovclfD`° M UPC 68021 ias Now SA MASTBNGS.BAN ' I i •• rffi .• �. xd•�:.rmn..�.�•'oa+YfiyOu•liF� :.�u1/:n�: :..�p'ti.'!G..a_ eb:. .,.,..� :o..�ib-JClVWf: ,c... i.., w:`Fri .� -till RESIDENTIAL PROPERTY MAP NO .. LOT NO. FIRE DISTRICT STREET 20 Oak Neck Rd. Hyannis SUMMARY 308' 201 H '73 LAND s ^ BLDGS. OWNER TOTAL •� n - /0. - LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. L ns John P & Cathetine V. 11 18 69 1455 740 TOTAL LAND BLDGS. of TOTAL /� LAND &C L�� Rh O KNIT & AcR 0 0) BLDGS. e �o I 4- TOTAL O LAND I J �IZG U BLDGS. — } �►Z G SO TOTAL LAND O) BLDGS. TOTAL LAND JAL i BLDGS. TOTAL c ti _/ _ ZY LAND INTERIOR INSPECTED: J BLDGS. TOTAL DATE: '� O� ll✓ LAND ACR GE COMPUTATIONS BLDGS. O ND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUS LAND CLEARED FRONT BLDGS, REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND O /j BLDGS. OI _ LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT,PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND 60 ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL !2! LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. Gone.Walla Fin.Bsmt.Area — LAND COST Bath Room Q Bess G Q Cone.Blk,Walla Bsmt.Rec.Room BLDG.COST St. Shower Bath � Bsmt. Cone.Slab Bsmt.Garage St. Shower Ext. PURCH. DATE Brick Walls Walls PURCH. PRICE. Attic Ff. &Stairs Toilet Room Roof RENT Stone Walls Fin.Attic Two Fixt. Bath ' iers INTERIOR FINISH lavatory Extra Floors G 1 $mt. F 1' 2 3 Sink 1 �"�`� 02 y 0 u h r/2 r/ Plaster Water Clo. Extra Attie ny N EXTERIOR WALLS Knotty Pine Water Only �j 16 ouble Siding Plywood No Plumbing Bsmt. Fin. ingle Siding Plasterboard Int.Fin. Shingles TILING ace Brk.On ne. r G F P Bath Fl. Heat O l�0 �G k. Int.Layout Bath Fl.&Wains. Auto Ht.Unit Veneer Int.Cond. Bath Fl. &Walls Fireplace 9• om.Brk.On HEATING Toilet Rm. Fl. Plumbing olid Com.Brk. Hot Air . Toilet Rm.Fl. &Wains. Tiling Steam Toilet Rm. Fl.&Walls lanket Ins. Hot Water St. Shower oof Ins. Air Cond. Tub Area Total Floor Furn.G ROOFING COMPUTATIONS sph,Shingle Pipeless Furn. 400 S. F. /e7 SS"D Lsb.. Shingle No Heat S. F. / O /� �Shingle Oil Burner late S.F. Coal Stoker S.F. 'le Gas OUTBUILDINGS ROOF YPE Electric S. F. able V1 Flat S.F. 1 2 3 4 5,16 7 8 9 110 1 2 1 3 1 4 1 5 6 7 8 9 10 MEASURED iP Mansard FIREPLACES S.F. Pier Found. Floor ambrel Fireplace Stack Wall Found. 0.H.Door LISTED FLO RS Fireplace Sgle.Sdg. J' Roll Rooting ✓ onc._ LIGHTING girth No Elect. Dble.Sdg. Shingle Roof ins Shingle Wells Plumbing DATE ardwood' ROOMS Cement Bik. Electric ii sph.Tile VBsmt. 1st TOTAL Brick Int.Finish D in Is ,-� B !N I 2nd /0471 3rd FACTOR REPLACEMENT OCCUPANCY _ CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.DeP• PHYS. VALUE Funct.DeP. ACTUAL VAL. 'WLG. �I7 — R K �� 7/ zo S 3 u 0 z Z v !J Z c7 4 5 6 7 --- 10 TOTAL F a � RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET 0& Neck Road H i 3 LAND 308 20I H Blocs. OWNER TOTAL LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: � BLDGS. Lyons, John P. & Catherine V. g TOTAL LAND // BLDGS. / TOTAL 6 LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND INTERIOR INSPECTED: i/�yv ��(�!. '��^--�7 BLDGS. U TOTAL DATE: . LAND ACREAGE COMPUTATIONS BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE ^ TOTAL HLWLOT LAND - CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND q BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER rn BLDGS. HIGH GRAVEL RD. TOTAL ^ LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. LHIJU VV'1 . ' ♦ ' . Cone.Walls Fin. Bsmt.Area Bath Room Base J `r BLDG. COST Cone.Blk.Wails Bsmt. Rec. Room St. Shower Bath _ 4 Bsmt. // PURCH. DATE Cone.Slab Bsmt.Garage St. Shower Ext. 20 oNG /°yTo Walls PURCH. PRICE Brick Walls Attic Fl.&Stairs Toilet Room Roof RENT Stone Wells Fin.Attic Two Fixt. Bath /G,O 4 Floors ' Piers INTERIOR FINISH Lavatory Extra �Zc c f Bsmt. F 3'G /v t. 'f 2 3 Sink u - s/s Attic r/2 r/4 Plaster Water Clo. Extra 1 EXTERIOR WALLS Knotty Pine Water Only Double Siding Plywood No Plumbing Bsmt.Fin. .23 Single Siding Plasterboard Int.Fin. Wow.hingles TILING STi 16 ' Cone.Blk. G F P Bath Fl. Heat �— Face Brk.On Int.Layout Bath 10&Wains. 7� O Auto Ht.Unit + / { Veneer Int.Cond. Bath Fl. &Walls Fireplace Cam.Brk.On HEATING Toilet Rm.Fl. Plumbing aQ Solid Com.Brk. Hot Air Toilet Rm.Fl.&Wains. Tiling Steam i Toilet Rm.Fl. &Walls Blanket Ins. Hot Water j Il/ St. Shower Roof Ins. Air Cond. Tub Area Total Floor Furn. ROOFING COMPUTATIONS Asph. Shingle Pipeless Furn. S 7A S.F. 13 b'3 Wood Shingle No Heat S- F, Asbs.Shingle Oil Burner a c/ S.F. 3 7 ' Slate Coal Stoker S.F. Tile Gas S F OUTBUILDINGS ROOF TYPE Electric Gable Flat S. F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURI Hip Mansard FIREPLACES S.F. Pier Found. Floor Ly' Gambrel Fireplace Stack Wall Found. 0.H.Door LISTED FLOORS Fireplace Sgle.Sdg. Roll Roofing l Cone. LIGHTING Dble.Sdg. Shingle Roof DATE Earth No Elect. Shingle Walls Plumbing Pine ROOMS Cement Wk. Electric _. Hardwood -R Asph.Tile Bsmt. 1st TOTAL /�j.'3j r' Brick Int. Finish ICE L' Single 2nd 3rd FACTOR J / REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. DWLG. L f IS t7 5 3 Im2 J d U f 1Shcd. / s fit' B g 6` .3•66 /9?/ C- Z� 2 3 4 5 6 7 6 9 10 TOTAL UPC 68021 1 OG E�O�SA HASTINGS,M; i b .VSP DIST V- EDI CLASSIC .. ZONING I DISTRICT CODE S.I DATE PRINT S I NBND KEY NO. 0022 OLD NECK ROAD 07 RB 400 07HY 07109/95.1.091 00 61AC R LAND/OTNERFEATURES DESCRIPTION ADJUSTMENT FACTORS UNIT ADJ•D.UNIT PERKINSi RI CHARD P'JR MAP- LaM eymal. S."D�meneem LOC/YR_ PEG.CLASS.ADJ. C P� PRICE PRICE ACRES/UNITS �`'—VALUE D.anrollen - cD. oF. NA�,e, _ D -1 20 P 300 CARDS IN ACCOUNT F,SATHSLI.0 1B0G.SIT 1 X' ,a1 •=10 387 34999.9 135449.9 AS -20300 6(S)—CARD-1 1 25PBOO 01 OP 02 _DG(S)—CARD-2 1 36.800 T U X C= 100 3500.0 3500.0 1.00 3500 8 ROTHER FEATURE 1 700 ARKET 86700 O SS MT. S X' C= 100 .7.8 i 7.85 584 4600-8 OPL 22 OAK.NECK RD HYANNIS INCOME RDL LOT C SE ORR 1118 0080 PPRAISED. VALUE 83.60C ARCAND EL SUMMARY 2030[ LDGS 62601 —IMPS 70C OTAL 8360( CNST DEED REFERENC Typa DATE Rsp PRIOR YEAR VAL[ 8... Paps 1nt1 MD. Y,. S_°"ea AND 20 3 0 C 6568/116 I12/88 A 150000 LDGS 63301 3611/50 I:11/82 45000 OTAL 83601 BUILDING PERMIT Nu— I Dale Tyga AyneVIX LAND LAND-ADJ INC ME SE SP-OLDS FEATURE OLD-ADJS UNITS 20300 .1100 Clara Unna Un'i�e Bea.R.e -Rpe NO Age =P Co= CND — m R G Rap Coal Ns. A.l Rml V4 Slaw NspN RP— Rme Bama /FL. P.IywaY Fs. '01C— 000 100 100 57.85 57.85 46 80 14 87 90 77 33500 25800 1.0 3 2 1.0 4.0 Des.np n Rete 1-11 Feel R C.el MKT.INDEX: 1"oo IMP.BY/DATE- ML - 5/88 SCALE: 1/00.86 ELEMENTS J?o CONSTRUCTION DETAIL BAS 100 57.85 584 3784 FWD 85 8.50 96 816 N *-----16----*--8--� TYLE OTTAGE 0.0 *--8—*------20------* ! ESTGN-'A JMT ------------------IY O ! 9 XTER;WALLS tif8D7Sl!IRStE --V:0 ! ! ! EAT/AC-TYPE AS=WAYS-Alit -_'U.0 12 12 BASE +--8---X RTER.FINISN WTTY--FINE------II:O !FWD 1 ! INTER:LATOOT VER:7NORMAI----V.0 ! 6 INTER;9UALTY ANE"AT-EXTER: U:0 +--8--*----12----+ ! LOT<R"STRUCT ti"JOISTI8E-AN---II:O W +--__---_-24--------+ E LOVII COVER- AAPET------------Ir:0 T.,Aram AV.. 96 Bafe_ 584 DOF-TTF'E"-" A8CE=71SPN"3H---U.-O BUILDING DIMENSIONS LETTRIr'KL VERAGE V.0 SAS Y 8 S 6 Y 4 NO2 W1 FWD W08 OU"ATIIFN-- ONCRETE-BLVCK-➢V".-9 N12 E08 S12 .. SAS N12 E20 NO2 ------------- ---------------------- E16 S01 E08 S09 .. -----REIbNBOR %TXC"NTARNTS--__--- LAND TOTAL MARKET PARCEL 20300 83600 AREA 2848 VARIANCE +0 +2835 STANDARD 25 rL IDENTIFICATION Y ADDRESS I ZONING I DISTRICT CODE -SP-DISTS.I DATE PRINTED I STATE I PCS I NBND LEY NO 0022 OLD NECK ROAD 07 RIB 400 07HY. 07/091V5 1091 D LANDIOTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS Y UNIT 'ADXD.UNIT LA.Br/Dale sae D�mane�EE v PRICE PRICE ACRES/UNITS VALUE DncrroraR PERKINS. RICHARD P JR MAP— CD. FF=AmE CC./YR.SPEC.CLASS ADJ. CO CARDS IN ACCOUNT BATHS 1.0 U X' C= 100 .3500.0 3500.00 1..00 3500 B 02 OF 02 NO BSMT S X C= 100 7.2 7.2 872 6300-8 DST 8360C 'SHED S 8 X- 8 198 C= 90 ."11.7 10.5 64 700 F ARKET 8670C 1 NCOME SE PPRAISED" VALUE 'y 83.6OC ARCEL SUMMARY AND 20301 ' LDGS 62601 —IMPS •70( OTAL 8360( CNST DEED REFER ENC Type DATE RemeeE RIOR YEAR VALI AND 2030( LDGS 6330( OTAL 8360( BUILDING PERMIT N-- 1 O_ Type Amaral LAND LAND—ADJ ' INC ME SE SP—BLOS FEATURES BLD—ADDS UNITS j 700 2800— Clans Canal. Tpol gays Rale A41 Reta Year Buill Age Norm OaaY. CND La: AO R O RW Cml New AEI RW— St— HeipM RI-iI Rmd Beae a R- Perrywea Fec. Unea unny A9'9 fln Door. Ga.E. '01C— 000 100 100 56.10 56.10 46 80 14 87 90 77 47747 36800 1.0 4" 2 1.0 4.0 DexrOlan Rua Sauna van Rap.Con MKT.INDEX: 1.00 IMP.BYIDATE. ML 5/88 SCALE. 1/00.63 ELEMENTS DEJ CONSTRUCTION DETAIL BAS 100 56.10 872 48919 GROSS AREA 872 SINGLE FAMILY DWELLING CNST GP:00 FMP 55 5.50 296 1628 *------20----* TILE--------- 09 OTTAGE------------0�0 FMP 10 ESIGN_ADJMT_ OD _OtQ XTER.YAILS 11 OOD SHINGLES 0.0 EAT/AC TYPE 07 AS—HOT PATER 0.0 -------- --- _11156------ --------6 NiER.FINISH 09 NUTTY PINE 0.0 -------- --- --- --------- ! ! NiER.LAYOUT 12 VER./NORMAL 0.0 -------------- *----18----*----16---* NiER.1UALTY 02 AME AS--EXTER- . 0.0 --- --- --- ---- ---- -------- ! LOOR STRUCT 02 D JOIST/BEAM 0.0 W ! ! E LOOK COVER_ 04 ARPET _ 0.6 'T.,A,eu Aa=_ 296 Bays. 872 ! ! OOf TYPE D1 ABLE—ASPH SH 0.0 -------- --- ------- --------------- BUILDING DIMENSIONS !" 23 LECTRICAI O1 VERAGE _ _ 0.0 BAS W16 S05 W18 N28 E18 FMP N06 28 BASE ! 0_U_N_D_A_T_I_0_N_ _0.2_ _614_CR_ETE_BLOCK_99.9 E04 N10 W20 S16 E16 .. BAS E16 ! ! --------------- --- ---------------------- S23 ! *----16---X LAND TOTAL MARKET !' 5 PARCEL *----18----* AREA VARIANCE ♦0 +0 STANDARD UPC 68021 1Q6 No. 11S HASTINGS,MN d �.. TOWN OF BAILNBTA 3LZ REPORT SU MENTARY/CONTINUATI PORT �1 DIVISION /OR" NAME (LAST, FIRST, MIDDLE) G NOTE DETAIX.S i OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL 15 ETC- Doi-a" 01. 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