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Home My WebLink AboutBLDTR-22-007272 TOWN OF YARMOUTH Y '° -iR4o BUILDING DEPARTMENT Permit Number C 1146 Route 28,South Yarmouth, NIA 02664 OI H kA ."7 M .'S 508-398-2231 ext. 1261 Fax 508-398-0836 Date Issued be) ld- 17a— Expiration Date eik. - a—1 t45 $50.00 TRENCH PERMIT Pursuant to G.L.c. 82A §1 and 520 CMR 7.00 et seq.(as amended) rms PEILMIT MUST BE FULLY COMPLETED PRIOR TO CONSIDERATION Nairn of Appikant S ? 4t(Ms LXcAV47)/Vc Phone Cei1 j Street Address �o 2 cf 3 2 SSG 3 2 3 J�,� E —r c�EJ7El7�v Z i� City/Town MA ZIP OC/WI Nana*of Excavator lit different from applicant) Phone Cell E Street Address 5/4 M City/Town MA ZIP Name of Owners')of Property Phone Cell /A, I(--F4 c1 iLt7C Street Address Ciy/Town MA It ZIP Other Contact I Permit Fee Received No o Yes( Description,location and purpose of proposed trench: Please describe the exact location of the proposed trench and its purpose(Include a description of what is for is intended)to be laid in proposed trench tea;pipes/table lines etc..)Please use reverse side if additional space Is needed. SEPT,c /VS 4t-1, e )74— L►tis Lou ,311 ;7-0 [RECEIVED JUN 16 2022 Insurarnce Certiikate#): VV, C /bo - 6ocCZ2vi —ZOzZ4 Vane sod Contact lntorrnstion of Insurer: - /1-/M /'1U'1 vm Policy Expiration!?a / / ^ r Z Dig Sett N: 2 021Z4 ! 022-2_ Nusne of Competent Person tat defined by 5211 C'MIt 7.112): 1 of 2 • Nfasenchusetts Hoisting License N � - f.')66 0 License Grade: 2 _Expiration Date: I t)2) )23 By SIGNING THIS FORM, THE APPLICANT, OWNER, AND EXCAVATOR ALL ACKNOWLEDGE AND CERTIFY THAT THEY ARE FAMILIAR WITH,OR,BEFORE COMMENCEMENT OF THE WORE,WILL BECOME FAMILIAR WITH,ALL LAWS AND REGULATIONS APPLICABLE TO WORK PROPOSED,INCLUDING OSHA REGULATIONS. G.L. e. S2A, 521 CMR 7.IM et seq., AND ANY APPLICABLE MUNICIPAL ORDINANCES, BY-LAWS AND REGULATIONS AND THEY COVENANT AND AGREE THAT ALL WORK DONE UNDER THE PERMIT ISSUED FOR SUCH WORK WILL COMPLY THEREWITH IN ALL RESPECTS AND WITH THE CONDITIONS SET FORTH BELOW. THE UNDERSIGNED OWNER AUTHORIZES THE APPLICANT TO APPLY FOR THE PERMIT AND THE EXCAVATOR TO UNDERTAKE SUCH WORK ON THE PROPERTY OF THE OWNER. AND ALSO, FOR THE DURATION OF CONSTRUCTION, AUTHORIZES PERSONS DULY APPOINTED BY THE MUNICIPALITY TO ENTER UPON THE PROPERTY TO MONITOR AND INSPECT THE WORK FOR CONFORMITY WITH THE CONDITIONS ATTACHED HERETO AND THE LAWS AND REGULATIONS COVERING SUCH WORK. THE UNDERSIGNED APPLICANT,OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO REIMBURSE THE MUNICIPALITY FOR ANY AND ALL COSTS AND EXPENSES INCURRED BY THE MUNICIPALITY IN CONNECTION WITH THIS PERMIT AND THE WORK CONDUCTED THEREUNDER. INCLUDING BUT NOT LIMITED TO ENFORCING THE REQUIREMENTS OF STATE LAW AND CONDITIONS OF THIS PERMIT,INSPECTIONS MADE TO ASSURE COMPLIANCE THEREWITH,AND MEASURES TAKEN BY THE MUNICIPALITY TO PROTECT THE PUBLIC WHERE THE APPLICANT OWNER OR EXCAVATOR HAS FAILED TO COMPLY THEREWITH INCLUDING POLICE DETAILS AND OTHER REMEDIAL MEASURES DEEMED NECESSARY BY THE MUNICIPALITY. THE UNDERSIGNED APPLICANT,OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO DEFEND, INDEMNIFY, AND HOLD HARMI•Kccl THE MUNICIPALITY AND ALL OF ITS AGENTS AND EMPLOYEES FROM ANY AND ALL LIABILITY, CAUSES OR ACTION, COSTS, AND EXPENSES RESULTING FROM OR ARISING OUT OF ANY INJURY, DEATH, LOSS, OR DAMAGE TO ANY PERSON OR PROPERTY DURING THE WORK CONDUCTED UNDER THIS PERMIT. APPLICANT SIGNATURE rilr,e(----______ --- DATE 6 1 ii{ 122 7.,,,p EXCAVATOR SIGNATURE(IF DIFFERENT) DATE OWNER'S SIGNATURE 1IF DIFFERENT) (_._ .i. _.___ _ DATE: DATE: Far(.b'Tvar ma-De nut writs it tat lectial s Application re* . E r7 1 Dile I t 1 • . =hi . 2 of 2 Bk 35001 Pg267 #15748 03-25-2022 @ 02 : 31p NOT NOT AN AN OFFICIAL OFFICIAL COPY COPY QUITCLAIM DEED NOT NOT AN AN OFFICIAL OFFICIAL WE, MICHAE '1°. ( EIYLER and KATHLEEIN Ii . &EYLER, being married to each other,of 30 Everett Road,Bourne,MA 02532,for consideration paid of TWO HUNDRED EIGHTY-FIVE THOUSAND DOLLARS AND NO/100 ($285,000.00) grant to Fabricio Painting Inc., a corporation established under the laws of the Commonwealth of Massachusetts with a mailing address of35 Washington Ave.,West Yarmouth,MA 02673 WITH QUITCLAIM COVENANTS, The land together with the buildings thereon, situated in Yarmouth (West), Barnstable County,Massachusetts,described as follows: 15 Containing an area of 4,470 square feet,more or less,and being shown as LOT D on plan entitled"Plan of Subdivision of Lots 12,13,and 14 in Swan Lake Shores as surveyed for George F. Cobb, May 1941. Scale: 40' 1". Newell B. Snow, Engr. Buzzards Bay, Mass." o E which said plan is duly filed in the Barnstable County Registry of Deeds in Plan Book 74, H Page 33. 44 v The above-described lot is subject to an easement in favor of the Cape&Vineyard Electric Co.,et al,recorded in said Registry of Deeds in Book 1059 Page 359. U, Said premises are conveyed subject to and together with the benefit of all easements, restrictions, reservations and rights of record insofar as they remain in force and applicable. 6:: Grantors hereby release any and all homestead rights to the within premises, whether created by declaration or operation of law,and further state under the pains and penalties of perjury that there are no other individuals entitled to homestead rights to the property being conveyed herein. For Grantors' title see deed recorded in the Barnstable Registry of Deeds at Book 22999, Page 45 Property Address:174 Winslow Gray Road,West Yarmouth,MA 02673. MASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 03-25-2022 @ 02:31pm Date: 03-25-2022 @ 02:31pm Ct1#: 657 Doc#: 15748 Ct1#: 657 Doc#: 15748 Fee: $974.70 Cons: $285,000.00 Fee: $872.10 Cons: $285,000.00 Bk 35001 Pg268 #15748 NOT NOT AN AN WITNESS my d p"Y seat this 1 �d y �L ,2022. NOT NOT i_ _ AN %is �"`� f OFFICIAL OF "' IA COPY MIIHitt. f. GEI ER COMMONWEALTH OF MASSACHUSETTS County of S)-a-bt On this i1141 day of VeLiGh , 2022, before me, the undersigned notary public,personally appeared MICHAEL T.GEILER ❑ personally known to me,or Z proved to me through satisfactory evidence of identification,which was i driver's license 0 (other:) to be the person whose name is signed on the preceding or attached document,and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of his knowledge and belief, and acknowledged the foregoing to be his free act and deed and signed it voluntarily for its stated purpose. ��` �R10GET�R ,.,, , 1-5-exey z_ 7.../.-t. ..,�` .-.04,-.°. Notary Public AR �c - My Commission Expires: 3 110(2O?- S =c10 r.. :` tip = [SEAL] •�y�<<� .YExplf&S • -..- ',,,,,H OF�MASS r''` + Bk 35001 Pg269 #15748 WITNESS my hand andAse this 11th day of MarchN O T AN 2022 OFFICIAL OFFICIAL COPY COPY NOT 1i AN OFFICIAL O FE C I , COPY COPY COMMONWEALTH OF MASSACHUSETTS County of Bristol On this 11th day of March 2022,before me, the undersigned notary public, personally appeared,KATHLEEN M.GEILER Cl personally known to me,or ❑ proved to me through satisfactory evidence of identification,which was ❑ driver's license ❑ (other:) to be the person(s) whose names) are signed on the preceding or attached document, and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of her knowledge and belief, and acknowledged the foregoing to be her free act and deed for its stated purpose. Kathleen M.MacKay 4649,S4,-r") 41Q 1. Notary Public My Commission Expires: 02/10/28 `£. ,,. JOHN F. MEADE, REGISTER BARNSTABLE COUNTY REGISTRY OF DEEDS RECEIVED & RECORDED ELECTRONICALLY