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HomeMy WebLinkAboutBLD-23-001526 .01"-"R e �� Office Use Only lloc q I Iz 2 �Permit# 'Amount 5b MAT7A M ESEj� 4`"°""°. Permit expires 180 days from issue date EXPRESS BUILDING PERMIT APPLICA TILED Z O. �'�46 � TOWN OF YARMOUTH �/ Yarmouth Building Department ' 1146 Route 28 L SEP 2 2 2022 South Yarmouth, MA 02664 . (508) 398-2231 Ext. 1261 auiL C�By. T CONSTRUCTION ADDRESS: ( U is 4 L-. S- yrkoL. ,,A. Amt v ZQ,ki ASSESSOR'S INFORMATION: : ,�\ �� Map: �� Parcel: _ OWNER: CIV � " yP4i /-3 —�S J �0 ✓ � NAME PRESENT ADDRESS TEL. # CONTRACTOR: NAME MAILING ADDRESS TEL.# Residential ❑Commercial Est.Cost of Construction$ /� dda 00 Home Improvement Contractor Lic.# Construction Supervisor Lic.# Wor 's Compensation Insurance: (check one) am the homeowner ❑ I am the sole proprietor ❑ I have Worker's Compensation Insurance Insurance Company Name: Worker's Comp.Policy# WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares 19 Replacement windows: # Replacement doors: # Roofing: #of Squares ( )Remove existing* (max. 2 layers) Insulation Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing � r *The debris will be disposed of at: `,C Location of Facility I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief I understand that any false answer(s) will be just cause for denial or revocation of my license and for prosecution under M.G.L.Ch.268,Section 1. Applicant's Signature: Date:Owners Signature(or attalltment) �1 p� Date: /�2��2 Approved By: Date: 7.22- 2., Building Official(or d ee) EMAIL ADDRES . Zoning District: Historical District: ❑ Yes ❑ No Flood Plain Zone: ❑ Yes ❑ No Water Resource Protection District: Within 100 ft.of Wetlands: 0 Yes 0 No ❑ Yes ❑ No di._.. The Commonwealth of Massachusetts L Department of Industrial Accidents smm•aligi(._ /ll,y 1 Congress Street, Suite 100 _ali�_ ' Boston, MA 02114-2017• ,`s..-''y www.mass.gov/dia Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): \.--Z (,(S,,,\ Address: 3 yp,,,,,,uc,e,, City/State/Zip:Lam. YM,._.(vko$(l, `,.R1t O?(r Phone #: 77't- ..9 • CXa ( 7 Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑ New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 3t6-I am a homeowner doing all work myself. [No workers'comp. insurance required.]t 9. ❑ Demolition 10 El Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will . ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.El Roof repairs These sub-contractors have employees and have workers'comp. insurance.1 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees. [No workers'comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: v Date: 7/22/12_. v Phone#: 7Y 2 �`o-c(r 7 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#: 112.? Lex kjus,2_ f Cln> 9/ zatz *77tf—21 t-co> • • . , 14%) Doc: 1, 466, 948 09-09-2022 9: 12 Ctf#: 231008 NOT NOT AN AN OFFICIAL OFFICIAL COPY COPY NOT NOT AN AN OFFICIAL OFFICIAL COPY COPY Commitment Number: 200179969 Seller's Loan Number: 0015369424 After Recording Return To: ServiceLink,LLC 1325 Cherrington Parkway Coraopolis,PA 15108 PROPERTY APPRAISAL(TAXIAPN)PARCEL IDENTIFICATION NUMBER 059.215 QUITCLAIM DEED U.S. BANK NATIONAL ASSOCIATION, AS TRUSTEE, SUCCESSOR IN INTEREST • TO WACHOVIA BANK, NATIONAL ASSOCIATION, AS TRUSTEE, FOR J.P. • MORGAN ALTERNATIVE LOAN TRUST 2005-S1, whose mailing address is 3217 S. Decker Lake Dr., Salt Lake City, UT 84119, hereinafter grantor, for S202,000.00 (Two Hundred Two Thousand Dollars and Zero Cents) in consideration paid, grants and quitclaims 11) to TODD OLSON, hereinafter grantee, whose tax mailing address is O 3 Yeoman Drive. West Yarmouth, MA 02673 ,with Quitclaim Covenants: z THE LAND SITUATED IN YARMOUTH, (SOUTH) WITH THE BUILDINGS 9 THEREON, IN THE COUNTY OF BARNSTABLE AND COMMONWEALTH OF MASSACHUSETTS,BOUNDED AND DESCRIBED AS FOLLOWS: NORTHERLY BY PRIVATE WAY 4, EIGHTY-FIVE(85)FEET; EASTERLY BY LOT 32,ONE HUNDRED(100) FEET; SOUTHERLY BY LOT 36,EIGHTY-FIVE (85)FEET; Page l of 4 MASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY EXCISE TAX BARNSTABLE LAND COURT REGISTRY BARNSTABLE LAND COURT REGISTRY Date: 09-09-2022 @ 09:12am Date: 09-09-2022 @ 09:12am Ct1#: 87 Ct1#: 87 Fee: $690.84 Cons: $202,000.00 Fee: $618.12 Cons: $202,000.00 Doc: 1 , 466 , 948 09-09-2022 9 : 12 Page 2 of 4 N O T N O T A N A N WESTERLY BYcL Nf r oW IN6F4RMERL\0Olt eHA17ta 1iEiRY DAVIS, ONE HUNDRED (100) FEET- 0 P Y COPY ALL OF SAID BOUNDARIES ARE DETERMINED MIT THE COURT TO BE LOCATED AS SHOWN QNWLAN 21531-A (SHEET 2) RAVED SEPTEMBER 6, 1950, DRAWN BY NfifEk IB.0 S-rickWL ENGINFfIt gkNND cFliLkep LIN THE LAND REGISTRATION BOQK086p RAGE 81 WITH CERTCIFWI Tk OF TITLE NO. 12461 AND SAID LAND IS SHOWN THEREON AS LOT 31. THERE IS APPURTENANT TO SAID PLAN A RIGHT OF WAY OVER LYMAN LANE AND OTHER WAYS SHOWN ON SAID PLAN, IN COMMON WITH ALL OTHERS ENTITLED THERETO FOR ALL PURPOSES FOR WHICH RIGHTS OF WAYS ARE COMMONLY USED. SO MUCH OF SAID LAND AS IS INCLUDED WITHIN THE LIMITS OF THE PRIVATE WAY, IS SUBJECT TO THE RIGHTS OF ALL PERSONS LAWFULLY ENTITLED THERETO IN AND OVER THE SAME. SAID LAND IS SUBJECT RIGHTS GRANTED IN AN EASEMENT TO NEW ENGLAND TELEPHONE AND TELEGRAPH COMPANY ET AL DATED JANUARY 30, 1951 AS DOCUMENT NUMBER 29420. SAID LAND IS SUBJECT TO A TAKING OF WAY 4, TO BE CALLED VICTORY LANE BY THE TOWN OF YARMOUTH DATED APRIL 6, 1965 AS DOCUMENT NUMBER 95754, ENTERED UPON BY SAID TOWN DATED JANUARY 1, 1966 AS DOCUMENT NUMBER 102903. PROPERTY ADDRESS IS:9 VICTORY LN, SOUTH YARMOUTH,MA 02664 FOR TITLE SEE CERTFICATE OF TITLE NO. 230446. Seller makes no representations or warranties, of any kind or nature whatsoever, other than those set out above, whether expressed, implied, implied by law, or otherwise, concerning the condition of the title of the property prior to the date the seller acquired title. Page 2 of 4 Doc: 1,466, 948 09-09-2022 9 : 12 Page 3 of 4 NOT NOT AN AN The real itj disc bid bboie is conve dFsAjeJt aid tth the benefit of: All easements, covenants,cadfhiolis,nd restrictions ofrecord;gin ab i3.r Ks in force applicable. The real property !1s©rilbd above is conveyed subject tOthl following: All easements, covenants, conditions and rAst ptions of record; All legal higl v4s; Zoning, building and other laws, ordinances ttidFresulltiq s;IRit I jgstate taxes cnt aResnjntt IV Net due and payable; Rights of tenants in posstssisonp y COP Y TO HAVE AND TO HOLD the same together with all and singular the appurtenances thereunto belonging or in anywise appertaining, and all the estate, right, title interest, lien equity and claim whatsoever of the said grantor, either in law or equity, to the only proper use, benefit and behalf of the grantee forever. Page 3 of 4 Doc: 1, 466, 948 09-09-2022 9 : 12 Page 4 of 4 Executed as a sealed�Nlrument this ? ,• day of Oq;T ,20 2 OFFICIAL, U.S. BaRk Acssotiatiorf'as Trustee, """'"" successor in ietesiPtoWachovia Bank, FO�j,,,Q P Y @ o� p�j•• •�d National Association, as Trustee,for J.P. 101-• GO r Morgan Alterna the o Trust 2005S1 . f�Opt, Q` ; J, By Select Portf o eriricing,Inc.as w 19D c _ Attorney in Fact.A N ,, 9 u F I A I, O F I- C I A L, AUG 2 3 2022 r'r�lil Matthew Tell Its: Doc. Control Officer State of Utah For Authority see Document No. 1,462,842 County of Salt Lake The foregoing instrument was acknowledged before me on AUG 2 3 2022 Before me, LISA FISH ,a Notary Public of said State and County aforesaid, personally appeared(`A( pMreil Its Document Control Officer on behalf of Select Portfolio Servicing,Inc.,as Attorney-in-fact for U.S- Bank National Association,as Trustee,successor in interest to Wachovia Bank, National Association, as Trustee, for J.P. Morgan Alternative Loan Trust 2005-S1,with whom I am personally acquainted (or proved to me on the basis of satisfactory evidence), and who, upon oath,acknowledged himself or herself to be Document Control Officer of Select Portfolio Servicing, Inc. its Attorney In Fact,and that he or she executed the foregoing instrument voluntarily for the purposes contained herein by personally signing the above described instrument. *Personally Known [NOTARY SEAL] LISA FISH Notary Public Notary Public Slate of Ulah �' , } My Commission Exotics or): �.� , if! July 13, 2025 Comm Number- 718970 JOHN F. MEADE, ASSISTANT RECORDER BARNSTABLE REGISTRY LAND COURT DISTRICT RECEIVED & RECORDED ELECTRONICALLY