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07-15-2008 16:20 From-WYNN ii WIYNN 508-775-1244 T-517 P.004 F-Z83 <br /> Da No,( Trial Court of Massachusetts <br /> CIVIL.ACTION Superior Court Department R <br /> COVER SHEET" County. BalmstableEFEND <br /> ) IF'F'(S) pOAraci( )�as o �o a�+m'p1ri tepee <br /> Auordalble Housing Association of Now England <br /> TTORNE , IRM NAME,ADDRESS ANd T6LEPHe�NE A ) <br /> Robert F, Mills, Esq,,Wynn&Wynn, P.C. <br /> 300 Barnstable Road, Hyannis, MA 02601 <br /> hoard of Bar Overseers number. 542732 (508)775-3666 _ <br /> Orlgln code and track designation <br /> Place an x in one box only: C 4, F04 District Court Appeal c.231,s,0*7&104(After <br /> 0 1. F01 Original Complaint trial) (X) <br /> 2. F02 Removal to Sup.Ct. C.231,s.104 5. F05 Reactivated after rescript;relief from <br /> (Before trial) (F) judgment/Order (Mass.R.Civ.P.60) (X) <br /> 3. F03 Retransfer to Sup.Ct. C.231,s. 102C QX Q 0, F-10 Summary Process Appeal (X) <br /> TYPE OF ACTION AND TRACK DESIGNATION (See revere side) <br /> CODE NO, TYPE OF ACTION (specify) TRACK IS THIS A JURY CASE? <br /> _ CO2 Zoning_Apxpaal c. Q.A ( F ) ( )Yes (X )No <br /> The fallowing is a full,itemlzed and detailed statement of the facts on which plaintiff relies to determine <br /> money damages. For this form,disregard double or treble damage claims; indicate single damages o"_ <br /> TORT CLAIMS <br /> (Attach additional sheets as necessary) <br /> A. Documented medical expenses to date: <br /> 1, Total hospital expenses...................................................................................................................... $ <br /> 2. Total Doctor expenses........................................................................................................................ <br /> 3. Total chiropractic expenses...........................•...............,.,........,.........,............................................... $ <br /> Total physical therapy expenses.......... ............................................................................................ $ <br /> Totalother expenses (describe)........................................................................................................ $ <br /> Subtotal $ 0100 <br /> B, Documented lost wages and compensation to date_................................................. ............................. $ <br /> C. Documented property damages to date.................................................................................................... $ <br /> D. Reasonably anticipated future medical and hospital expenses.............. .................................................. $ <br /> E. Reasonably anticipated lost wages........................................................................................................... $ <br /> F, Other documented items of damages (describe) <br /> G. Brief description of plaintiffs injury,including nature and extent of injury (describe) <br /> $ <br /> TOTAL $ 0.00 <br /> CONTRACT CLAIMS <br /> (Attach additional sheets as necessary) <br /> Provide a detailed description of cialm(s): <br /> `].'his is an appeal pursuaftti to M.G.L. c.40A, Section 17, fran � <br /> the decisicon of the Town of Mashpee Zoning Board of Appeals <br /> decision upholding the Building Commissioner's cease and TOTAL $ ,. ,_._ J <br /> PLEASE IDENTIFY, BY CASE NUMBER, NAME AND COUNTY,ANY RELATED ACTION PENDING IN THE$UPERItOR <br /> COURT DEPARTMENT <br /> "1 hereby certify that I have complied with the requirements of Rule 5 of the Supreme Judicial Court Uniform Rules on <br /> Dispute Resolution (SJC Rule 1,18) requiring that I provide my clients with Information about court-connected disputo <br /> resolution services and discuss with tlArn the advantages and disadvantages of the various methods." <br /> jure of Attorney of Record DATE:July 14,2008 <br /> A.0.8.0 1-2000 <br /> v WYNN <br />