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HomeMy WebLinkAbout0207 CLAMSHELL COVE ROAD �O 7C © low y RIP 0 r J i '. i I' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# Health Division �` — �6 �' ,��_ Date Issued Conservation Division Fee yP yl O 0 Tax Collector � �����- � 444 KIWISEPTIC SYSTEM MUST B Treasurer INSTALLED IN C®f�'�PI-IANCE C1 WITH TITLES E=I�IVI�C���E6�9`�d` L P,�1 ��v� Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address -2 0 7 CLA►"!J n LLL 01,0VE Village Owner �--IA iJ L 6!OI d wmi Address 207 C 1Ab4S f1tLLCove 4A C o7u,T Telephone Permit Request �f( OVL i7�vu0 L1A-i(aA Gkio ell -i- r rzes L& bu.0_VJ _ amoualTWIZ00AI 3, Akw fieifrl(e u e.A6t9J-k_1C 5' Cou_tP1e_-zJyS q ilk-WA a a A-f 7—" AO-01Z F MV &p4M, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new _� _Estimated Project Co$ OZoning District Flood Plain Groundwater Overlay Construction Type 4600 f0-rfiC i'U 04 60 0&(4_ Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family Q-"'Two Family Cl Multi-Family(#units) Age of Existing Structured C) ogS Historic House: O Yes 9416 On Old King's Highway: ❑Yes Oid� Basement Type: ©mull lrCfria�wl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 7 new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count 5 Heat Type and Fuel: ❑Gas ❑Oil & lectric ❑Other Central Air: ❑Yes ❑Q No Fireplaces: Existing VAS New Existing wood/coal stove: ❑Yes O Detached garage:Ca existing O new size Pool:0'existing 0 new size Barn:0 existing ❑new size Attached garage:0 existing ❑new size Shed:f3'existing 0 new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded 0 . Commercial ❑Yes 211'o If yes,site plan review# Current Use V15CA_1_10"4J tISL: Proposed Use BUILDER INFORMATION p Name Telephone Number Address License# ASU&L MA. 02,6LIq Home Improvement Contractor# 0593W 108701 Worker's Compensation# d y,3O77ZT f ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ;Cu -fasov?C l i-JC, SIGNATUREL DATE r ^-a - FOR OFFICIAL USE ONLY PERMIT NO. � � Z DATE ISSUED ; MAP/PARCEL NO. � I ' ADDRESS, 'VILLAGE OWNER DATE OF INSPECTION- FOUNDATION FRAME - INSULATION FIREPLACE ri ELECTRICAL: ROUrG�fs' FINAL PLUMBING: ROUGH FINAL r �y GAS: RQi<J0 c,-., FINAL FINAL BUILDING DATE CLOSED OUT- ASSOCIATION,PLAN NO. , The Town of Barnstable s�aHer,►s�. • Department of Health Safety and Environmental Services ' . Fo►�a't' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that,the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. ( i Type of Work: J P ibZl0g, Ctywox 1,J ujagx Estimated Cost ®� Address of Work: Q-7 lA s , _OtJ-&02") Owner's Name: /�i��Q—l 9 G WAO Date of Application: qrb—qq 1% I hereby certify that: Registration is not required for the following reason(s): ork excluded by law Job Under$1,000 Building not owner-occupied ' Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. L14W 05-eD� Date Contractor Name Registration No. OR Date Owner's Name q:fbr ms:Affidav - '� The Commonwealth of Massachusetts -. . _ -- _ Department of Industrial Accidents • ••� `__ � .�� OlTica nfln�estigatioos I 600 Washington Street Boston Mass. 02111 Workers' Compensation Insurance Affidavit OEM name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proDrictor and have no one workin in amr capacity ❑ I am an employer providing workers' compensation for my employees working on this job. comannv name: address: city: phone#: insurance cn. pnlicv# a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follo«ing~corkers' compensation polices: comyanv name: \C 10(L)S -�- - ;..... .;.. address-- c9 cav (() t phone#-...�� rnsarnnce ca. oiiev#• ::::: . :..� •.: .: . camnanv name: :.. ..: ... ::.. .:... :•.::.:... address- citf: ... phone#? ::;.....::::;:;;. ::::::•::. ....... ::.:: insurance co. ::...;::::,..... .:.... .:::.... oiicv# Fallure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one vears'ltnptisownent as well as civil penalties in the form of a STOP WORK ORDER and a Me of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verincation. 1 do hereby certi 'under the nsin aldes of perjury that the information provided above is trapand correct Signature Date �[ - •� I _ 0 n ,gyp /1 Print name I U l Phme# - 0^ � official use only do not write in this area to be completed by city or town ofllcial city or town: permitNcense# QBuilding Department ❑Licensing BL ❑check if hn0nediate response is required ❑Selectmen'sce❑Health Depent cont$ct person: phone#; ❑Other (Bytes 9i95 P1A1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contra- of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or.the receive: trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartrnents and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renews: of a license 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 insurance coverage required. Additionally,neither the . commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have bees presented to the contractiae authority. J/�./ Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and -supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and -date the 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 Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to caaitact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retuned io the Department by mail or FAX unless other arrangements have beets made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts ' Department of Industrial Accidents Office of imlesduatlons 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 N 0NEsIMPROVY PENT,C0NTRAC 0 PMlVATEICORPDRAT " � xpi�atlo F "'�� 0_NzI ~ x 081211.0 i-t�� 'r EVFSIDN � C 4, t �� Sha�tan �� mo�� Y n r %AD MIIS NIAIURASHP> fCIRv p tN �.e 7. .I I . DEPARTMENT OF PUBLIC SAFETY CONSTRUGT_T.ON.S.UP.ERVISOrtfttHSE 1fu�er.s- EMpires: - -- Res.tr-�c�7 00 DAVIDa.P,SNAS,TMY POBX 1830..: MARSTONS HILLS, HA 02648 t 1 Engineering Dept.(3rd floor) Map 005- Parcel Permit# 3 � House# ate Issued $oard of Health(3rd floor)(8:15 - 9:30/1:00-4:30) ^' e ' Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) / Planning Dept.(1st floor/School Admin. Bldg.) SEPTIC SYS �wE ` �� BE Definitive Plan Approved by Planning Board 19 INSTALLED NCE WIT 0 S TOWN OF BARNSTABL �JfOWN RE"' IONS ONS N® D Build�in"g��Permit Applicati n Project Street Address C, Village ® To C a/ Gf Owner �(1 ¢— tGhefti° P(`ef1/7e l� Address �R�y►^-� Telephone 2 j 3 Permit equest x 12� /� CiG W fTFI $ffED �e0 r First Floor square feet Second Floor square feet Construction Type % GcJO-7r� Estimated Project Cost $ `f, OOL Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family (8; Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes 1-$TNo On Old King's Highway ❑Yes GtNo Basement Type: N Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 1 2-0 0 ` Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 1�t' New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing /0 New First Floor Room Count Heat Type and Fuel: Gas ❑Oil JTlectric ❑Other Central Air ❑Yes 'KNo Fireplaces: Existing ( New Existing wood/coal stove ❑Yes WNo Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) /Y,'T_36 ❑Attached(size) 2 CffA, ❑Barn(size) A10"r ❑None ❑Shed(size) 8 12 ❑Other(size) POOL S?fEb 9 f Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use A Builder Information Name �"�-+� Telephone Number , Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Idhd SIGNATURE DATE — /1,1 —9'7 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) I` FOR OFFICIAL USE ONLY , r' PERMIT NO. 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 S:422,97 7 DATE CLOSED OUT ' 9 n ASSOCIATION PLAN NO. �n+e r The Town .of Barnstable • ELAMSrna= • ,1 `0�' Department of Health Safety and Environmental Services �fDrr1A'�� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-700-6230 Building Commissioner For office use only Permit no. I Date , AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: 02 X o2 / Est.Cost Address of Work: old Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. -Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A r SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR -16 - 17 bl�2 Date Owner's Name The Connttonit'cafth of Massachusetts �:► -._. �;_.,- Dcpartnunt of Iudustrial.4cciflerits Office 8110 V921fons 600 !t'ashingivit Street Alas. (12111 Workers' Compensation Insurance Afridavit. � li :in irif errs �' locitio o20 sin• ��(,r�� nhonc# j0 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity ' .. -.s_ �.7 n,vau- +�tr[T�„Hr!r:�/T�.w!+w..�,��,�.�ww.wr."•.raw-..�w�...�w..�..H�w,.--....-_.....:. .... r �.^ ..-... .�� .tfl "f: ...-..�-••-�.-Lam..-�y ..Y. - 1..�. ` - �_ [i I am an entplover providing workers' compensation for my employees working on this job. enntnanv name: aticlress• city [!hone!- insurance co. nnlicy# a-..-. -r• _*y -�• w...�r,...�.!.-w-I•^��—�. r..r- .r. w-•w.Mr•r..r..aY•.1�• . .•�...— ...+-. .. [) I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers compensation polices: company natne• address• i city: 11hone k: insurance rn policy 0 -..._._ ... .._ ...�.-....... _I.♦ ram. .- ir•�.+•Jr''- -_ - _ -_- -- .-a. r` ._ -.L--� cmmr)nn%• n•tmc• addresc- rite nhonc 0- insurance co nolicy# .Attach additional sheet if neccssary��r -- •• - -,_ �•� s:t�•,"ram �sti�•- - -•.aie•� :�ws.:r...o. Failure to secure coverage as required under Section:5A of 111GL 153 can iced to the imposition of criminal penalties ol'a lineup to 51.500.00 andiur unc years' imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. I understand that n cope of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification. I rlo hereby cerri.r id the pr ills an p realties of rjun•that the information prorided above is true uu**--��orrect. Signature Date ✓a4,4 # Print name Phone# nRcial use only du not write in this area to be completed by city or town official e� cin•or town: permitilicense if r tlluilding Department C3Liccnsing hoard check if immediate response is required selectmen's Ofr C311caith Department contact person: phone#: nOther „ .v Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the employees. As quoted from the "1a��'". an ely'Plot•ec is defined as every person in the service of : liuthcr under any contract of hire. express or implied. oral or written. An enyph rer is defined as an individual, partnership, association. corporation or other legal entity, or anv two or mo the forcuoitia•enuage&in a oin , t,enter rise`and including the legal representatives of a deceased emplover. or the receiver or inistce of an indlividual , partnership. association or other legal entity, employing employees. However tl owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the d%\clIin- house of another who employs persons to do maintenance , construction or repair work on such dwelling he or on the ;,_rounds or building appurtenant thereto shall not because of such employment be deemed to be an empio\e MGL Ilia'pier 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commomi•eaith for any applicant who has not produced acceptable evidence of compliance with the in coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the 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 Industrial Accidents. Should you have any questions regarding the "law"or if youare require. to obtain a workers' compensation policy. please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom c the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. PIE be sure to fill in the permit license number which will be used as a reference number. The affdavits may be returned the Department by mail or FAX unless other arrangements have been made. Tile Office of Investi_ations would like to thank you in advance for you cooperation and should you have any questio please do not hesitate to uive us a call. The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations.. 600 «'ashington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone P,: (617) 727-4900 ext. 406, 409 or 375 I TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. . DATE •• „�� JOB LOCATION Number Street address Section of town "HOMEOWNER" •_ Name Home ph ne Work phone . PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occuvi dwellings of six units or less and to allow such homeowners to engage an it dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to r side, 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 structure A person who constructs more than one home in a two-year period shall not b. considered a homeowner. Such "homeowner" shall submit to the Building Offi on a form acceptable to the Building Official, that he/she shall be resnons for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum -inspection procedures and requirement. and that he/she will comp w' h aid r cedures nd requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35 , 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. ��:. _ j .�� _� 1 ry' L ,:� _ .-� , .,�- ,. I,5 � a 41/` � � �� �' � :� �, �� � � ���. � � - .� �� �' �.=� � -•. O C 0�0 . /) _/J � I- 1 .� I jam. �1 T f y _ Y y` I� / _'�"�• ,n= i . //� .4 ... �4 1 -,' yr'ap'./.. '� r.>1 'ii :� I w f e_./ L. �_ /if I �' y�,�,3 1 �r( / � //; �� / �� f, ;f�/" ;- „ . .� - ;� !; �. _ ,: } r-1 N I r.. r,. y ' 207 Clamshell Cove Road, Cotuit, MA 02635 LOT 62 150.00, o 4 !Dec(( :4� SLED S674210.:p, 150.00• Robert E.Kennedy 207 Clamshell Cove Rd. Cotuit,MA 02635 LOT- 64 RCS. ZONE.• "RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Annk Use Only TOWN: _QQYVM __ ._ REGISTRY OWNER: 13��?[�.�/�/�� GQQNZI_SA1NES DEED REF: _4B35,ZL4___ BUYER: _ROBE8T_ff XEd'NF.DY____________ DATE: _ 1.2/� ____________ PLAN REF: _ZIG/39 SCALE:1"= 30'___FT. I HEREBY CERTIFY 'I'0 ul nr . _SA V/A'CS_DANK _______ 'THAT THE BUILDING ��� Ass SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS PAUL YANI<EC SURVEY SHOWN AND THAT ITS POSITION DOES _—__ CONFORM CONSULTANTS Ir1F.RIrlIE TO THE ZONING LAW SETBACK REQUIREMENTS OF THE = 40B (SUITE 5) ,., No. azos8 z TOWN OF ___8,A9&SL4&,Z________ AND THAT C9• i' ---- T. INDUSTRY ROAD IT DOES-1VQT' LIE WITHIN THE SPECIAL FLOOD HAZARD �rr �CISTE+�Z T��� �`•1;p g�� MARSTONS MILLS, MA. 02646 AREA AS SHOWN ON THE H.U.D. MAP DATED_Z/1Z/JZ__ �4;u tnNa TEL 428-0055 Co unit —Panel # 250001 0022 D '°*'�r'� FAX 420-5553 � _ ___ THIS PLAN NOT D1AOE FROM AN INSTRUMENT pA0 A. MEMTR p -- SURVEY, NOT TO BE USED FOR FENCES. ETC. 12000 DPC zvi %..iamsnett Cove tCoaci, k otuit, iviA VLbob. • L.0 T 6,2 S67.4,-�> J p 150 p0 0 r / / / / / / / / V "N SI1 ED 15p op.* 1 . 1 . Nor 1 I 2 Car Game i • 1 I I I - _ �.-•r-- .. /Irt Studlo� Touf Nargers 2x 8 Rake O.0 RaF- C. ktovse $ ��.� p. P Pwd Columns 0 7-5 (SEC PMoro) 1 ( .�:.. I• i •o - ,• =~ — 29.3 ` "c� oc� oll OO 9"cDncreie Pat r 9'oeep � 20 (arnshe(f Cc)v4� i -�YC�-f�• .QM6n �rr.cX�sue� St6�Lr>NS Ss:; A&rJ_s :A7'.1VALCs -RIDGE VFNr i I s i 12 10 � r 3..:Zx/8L'lNT6L -=r.r LAN 77 / 'L7NrEL 3 �/0 LINTELCO Z'Y lb O'c 1 � ,.tea A73E0 1. AA7N^SfE/pLnw �a - . = l�lli _y -CE,N�a«o , y'DEfP 8""Concrete r: pil in0)r • .ALSO._..::SEE..-::r�RS���T�VE GAF f�OVS�- ���'�F�G�, CPD..;ED: /-104Z5E CARAGam" ..: .ON-.. CLANS E L L. CGY1 RD._ . A C9.TZ.1/7' �+< Cv Ll r ,�Eu�tEu ARC �_ O�,a�1.-./�!'r_.._�cr�F , �''A aE �'• ��� RYAAW/5,. A-M, BAR1 IASLE. AVIM __l✓ '7._. ALMS"i H, AA a � i� r5 111OV SIF IT K L/ TUDIO V//yGAPo ,► - - ' S f ► E f � � sis, x 6° P r. �e�l�n9 over Floor. a'o/sTS FRAMING PLAN FOR. DEcfc .+ 207 C/b M sh.t.// Cmr 1.. Cofv�t { f LAWRENCE POOL CO. Sales Service Supplies Inground Pools Installed&Repaired / Concrete Decks Fencing 477-5550 s hssessor's Office(1st floor) Map 0 d, Parcel ' Permit# j a Conservation Office(4th floor)(8:30-9:30/1:00--2:00) Date Issued ,,// Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) �• !J—r� &4,z Engineering Dept.(3rd floor) House# C2 Planning Dept.(1st floor/School Admin. Bldg.) ' TI� ST BE AI.L.E® 1p►IVCE CefvePlan Approved by Planning Board 19 {�iIT ENVIlE�®IVIVIE ®E��® TOWN OF BARNSTABLETOWN REGul_��r"Building Permit Application t Address 2 Q '7 �/�rh -sA e- Owner P)c-3 K C n n e- Address Telephone Permit Request in „ S�a.llrlx en L .First Floor square feet Second Floor square feet Estimated Project Cost $ Zoning District R Flood Plain _:Onh p �� Water Protection � /LJ34 Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use q V,7 L 1 Proposed Use 11 r Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces �. Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name 6LO Telephone Number Address_p.�. X 'al) License# c.> i e­k .S 6 ., Home Improvement Contractor# 1113 - Worker's Compensation# NEW CONSTRUCTION OR.ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �kP� DATE c!�P /�zm BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. � DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER rR , DATE OF INSPECTION: FOUNDATION FRAME " INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH" FINAL t FINAL BUILDING DATE CLOSED OUT? r �� ASSOCIATION PLAN,NO.- L ` I� x 3tv Cft'N LDCf Tfc>1v Q gx ( 01 s PETM(T a 1710 LOT 62 S674210'� 150. 00' tio) 1 . �lY s g CDo ,. " 26l O DEC1f ►' SHED c j 150. i Op' LOT 64 ' RCS. ZONE. RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" i Bnnk Use Only TOWN: _4QVL7.' -- --____-- REGISTRY OWNER: RCB1f$-H sQl1NZY_���N�S ' DEED REF -4835ZL4 _________BUYER: JZDBE8Z�XEAINED-Y_________ DATE: _B/1.21-0____________ PLAN REF: _ 16/39 I HEREBY CERTIFY -1-0 L?Ly?E,�dU� E2 _____ SAV/h'GS_9ANX ____ __ THAT THE BUILDING ;�' a�JO^ SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS 1 PAUL y� YANI<EE SURVEY SHOWN AND THAT ITS POSITION DOES ---- CONFORM ' A = CONSULTANTS TO TIME ZONING LAW SETBACK REQUIREMENTS OF THE MF.RITrI[W � 406 (SUITE 5) � z TOWN OF $A8NjSLjd4 '—___-- Plu. 12098 —AND THAT \'', T 0 ,k, INDUSTRY ROAD IT DOES_1VP—T ' LIE WITHIN THE SPECIAL FLOOD HAZARD F°f�c!sn' MARSTONs MILLS, bta ozsae AREA AS SHOWN ON THE H.U.D. MAP DATED—V-,�Z5LZ 4"11 LAaos TEL: 428-0055 Co unit —Panel # 250001 0022 D � FAX 420-5553 _ ____ THIS PLAN NOT MADE FROM AN INSTRUMENT pA0 A. E fifl ES — SURVEY, NOT TO DE USED FOR FENCES, ETC. 12200 DFC RG GPM M 6" -rttE 5+4 5D I Art Vv I L IN6 - I WOULD a KE- rb ' C4PO GIB LocA--'/PJ As IN -nif , ABDVE Now COVER J-ft e PtfMp AND { DDL M0 IPME�T � My PeRM I 'r ND. c- �07 06Le ice, gl.,,f. . The Town of Barnstable • •ces ILUMMM � S Department of Health Safety and Environmen�l Serve Building Division ' 367 Main Street,11yaanis MA 02601 Ralph Crosses Office: 508-790-6227 Building F= 508-775-3344 For office use OdY Permit no. Date AFFIDAVIT HOME McROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERM APPLICATION aeon,alterations;renovation,rem modernization,Conversion, MGL a 142A requires that the"reconsuu ed imprvvemcs�,rcmc'%- , demolition. or ,construction of an addition wM&are adjacent building Ong at least one but not more than �or to certain�Qo� bong with other to such residence or building be done by nest requirements ' ,w� @� Est. 'CODType of Work h' ®e'►'' Address of Work. Oa-ner.Namct 9e5 Date ofpermit Application: y� I herzb�y certify that: Registration is not required for the following rc son(s): Work=ciuded by law ob tn:der#L000 Building not owner-oompicd Ownerptvn ,pallu'g,ca Pc=it Notice is hereby gh=that: CONTRACTORS OWNERS PULLING MiER OWN PERMIT OR DEALING DSO NOT HAVECESS TO ME APPLICABLE HOME IIVPROVIIv�'1� �MGL c 142A ARBITRATION PROGRAM OR GUARANTY FUND SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. �7 Registration No. D to Contractor name OR ' f +"=• rite Cunrmonll•Calllt ujllfassachusctts ,00^; Department of Industrial Accidents lip -:d� . . OIIICP�//OYCSD�DaSS iiF - . � 600 Wasliing7on Street Bos-ron.Afars 02111 Workers' Compensation Insurance Ai d2vit iL'me* �, r !^ ��✓ Iles an t• y city, r) ❑ 1 am a homeowner performing all work myself. am a sole proprietor and have no one worl:in_.in any capacity ❑ I am an employer providins workers' compensation for my employees working on this Job. CRmnIna nnme Si�,V)00t � addrets s'tiy SA n tJ1'W Yl D 25 G 2 nhene4 �,•1`• r �ur,nc r� nniin• _ tI am a sole proprietor,general contractor, or homeowner(curie one)and have hired the contractors listed below the following workers' compensation polices: na•n n dress! nhone f/- noiic�•� surnnee Co. r+�+rer4+r" s'�► " " r""`=— �-. '-•c -.-• -—� „snran�aa•w-nwr►'r1+'T'^r"�s - - m env na c• addresi, JIM 'n • ao Co- .Attach addiBdiini sheei if niewir 're +••- "� "•"' ••r•••�--' �- Failure to secure coverage as required under Stxtioa.SA of 111GL 152 can lead to the imposition otertmtaal ptmalties of a tine n Pto 51.500.0 une±eau'imprisonment as well as cis ii penalties in the form of a SMP WORK ORDER and a nag ofSI00.00 a day against me. I nade:stss copy of this statement may be forwarded to the OMcc of Investigations of the D1A for co*enge veriQeatioa. 1 do Iterebr certifj•unrlcr the pains an penalties of perjury that the infornmtion prorided abow is V99 and cvrtrrt Sicnatttre ate _r_ Print name !.C� y(� L� ,d '•� w �v & Phone# / -/--5 � 5 0 7oMcial-useair do notaarite is this area to be completed by eltlr orttrwa officialNGs ase# s"i8tuidi�Department : (3LieensiVg heard 0ydectmeas Omce mmediate response is required Olinith Department Information and Instructions . . 1 Massachusetts General Laws chapter 152 section 25 requites 211 employers to provide workers' compensation employees. As quoted from the "law an empinree is defined as every person in the service of another under contract of mire. express or implied. oral or written. An eynpl( trcr is defined as an individual. partnership, association. corporation or other legal entity. or any two the fore�soinL; enaaged in a joint enterprise, and including the legal representatives of a deceased employer. or receiver or trustee of an,individual , partnership, association or other legal entity, employing employees. Howe owner of a dweilina House having not more than three apartments and who resides therein, or the occupant of t dwelling house of another who employs persons to do maintenance, construction or repair work: on such dwell or on.the grounds or building appurtenant thereto shall not because of such employment be deemed to be an en MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuanct renewal of a license or permit to operate a business or to construct buildings in the commonwealth for ar. applicant who has not produced acceptable evidence of compliance with the insurance coverage required Additionally. neither the commonwealth nor any of its political subdivisions shall enter into anv contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this ch: been presented to•the contracting authority. . •�..•�..��. _ - :�:.. .. . -a.: .. ».. .-„�;:.fir. •.� .. .. :t':.. .N. �^7 70.7:•.tip. Applicants Please `,.1 in the workers' compensation affidavit completely, by checking the box that applies to your situatior. supplying company names. address and phone numbers as all affidavits may be submitted to the Department of industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tltt affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are re: to obtain a workers' compensation policy, please call the Department at the number listed below. City- of r0«'n5 Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bolt the affidavit for you to fill out in the event the Office of investigations has to contact you regarding the applicant. be sure to fill in the permit/Iicense number which will be used as a reference number. The affidavits may be retu! the Department by mail or FAX unless other arrangements have been made. Tlie Office of Investigations would like to thank you in advance for you cooperation and should you have any qut please do not hesitate to �anve us a call. The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents r Office of investigations 600 Washington Street Boston,Ma. 02111 r fstY •i- (61'n 77'7_17dU i E • ! I.I.as II.a 11•a • I • •�a � ' i r •.as : , ► •?Y ,r � K i I• ••V b f n.a eta• Zoe � :•.� „J;, q . .. �� av`-- CLAMSALL COPE Im. .I as •• s [� 1 • , oA :... •M y �� � Nj 1.1 r..1•,M• I O�I[91 QM 1•K �� •.I.If 1.•l • -pr.,It S { nw ni Mnr nIC. • TM ,°t stapmcleap I I 10 CARTRIDGE FILTERS Hayward Star-Clear II cartridge filters provide crystal clear water and have extra cleaning capacity to :hP accommodate pools and spas of alltia types and sizes. " ~ Star-Clear II filters feature a heavy- - duty cartridge element engineered of high-quality reinforced polyester MAIN for maximum OWN $�N�� THE RMN efficiency, easier = HSYSTERM°MTAL o�m cleaning and _ PUMP HEATER FlE�' longer life. - A single locking knob provides easy access to the cartridge , W element and securely fastens the ✓ filter head to the filter tank— -- _® eliminating clamps or bolts. J Injection molded of attractive, high-strength DuralonTM, these corrosion-proof filters set the stand- and for value and convenience. G - Y. • .It t . ■Star-Clear 11 cartridge filters are available in 75, 100 and 150 square foot models to accommodate p pools and spas of all types and sizes. , HAYWARDO Hydrogen,Oxygen and Hayward. The"elements of clear waterTM yy At 1Fi•.�. Star-Clear I I'm Cartridge F i l t e r s - " Single Locking Knob securely fastens filter head to tank,eliminating clamps or bolts. Filter Head provides easy access to cartridge element.Attractive and durable,the head may be rotated to conveniently.position pressure gauge and manual air relief valve. Heavy-Duty Filter Tank injection molded of high strength Duralon", for dependable,corrosion-free performance. I. Automatic Air Relief purges any trapped air during filter operation. Cartridge Element is engineered of high-quality reinforced polyester with gasketed molded end caps for maximum efficiency,easier cleaning and longer life. Molded Center Core incorporating unique"Waffle-Pattern Design" allows for maximum flow and provides extra strength. L Elevated Filtered Water Collector and Debris Sump prevents accidental by-pass of heavy debris to pool or spa when cartridge is e removed for cleaning. R; V/2"or 2"FIP,or 2"Socket Connections for plumbing versatility. 1/2"FIP Filter Drain Valve provides fast draining for elevated spas and tubs.Also accepts standard spigot valve. FILTER TYPE: Cartridge element:75,100 and 150 sq.ft. FILTER TANK: Injection molded Duralon'" Vr� FILTER ELEMENTS: Reinforced Polyester j PERFORMANCE RANGE: '/2 TO 3 HP(75 to 150 GPM) DIMENSIONS: C-800-29'/2" H x 13" W(749 mm x 330 mm) C-1100-35'/2" H x 13"W(902 mm x 330 mm) C-1500-47" H x 13" W(1194 mm x 330 mm) f MODEL EFFECTIVE DESIGN TURNOVER(GALS.) NUMBER FILTRATION AREA FLOW RATE 8 Hr. 10 Hr. EASY TO CLEAN CARTRIDGE ELEMENTS. Hayward cartridges have extra dirt-holding C-800 75 sq.ft. 75 GPM 36,000 45,000 capacity and are engineered of durable,high- quality materials to last for years with only q minimal care.Simply remove the cartridge element and hose off with Hayward's EC-2024 C 1500 150 sq.ft. 150 GPM* 72,000 90,000 Jet-Action Cleaning Wand to restore to clean operating condition. "Determined by pump size and piping system hydraulics. 2"piping is recommended for flow rates of 90 GPM or more. Flow rates above 120 GPM are not usually required for residential pools. HAYWARD POOL PRODUCTS INC. Hayward Pool Products,Inc. ' Hayward Pool Products,Inc. Hayward Pool Products Canada Hayward S.A. 900 Fairmount Avenue 2875 Pomona Boulevard 2880 Plymouth Drive Zoning de Jumet Elizabeth,NJ 07207 Pomona,CA 91768 Oakville,Ontario L6H 5R4 B6040 Jumet,Belgium 1gg.g2 ©1992 Hayward Printed in U.S.A. LO 'm ax- o 0 - HIGH - PERFORMANCE PUMP .SERIES - 1 - I S 4 • ■ Max-Flo.high performance and value with quiet operation. Te new`Max-FIoTM is a series of high a heavy-duty high-performance motor; and technology pumps that combine performance exclusive "service-ease" design'for'extra and value with durable corrosion-proof convenience and easier operation. construction. The Max-Flo pump series sets a new higher Designed for pools of all types and sizes, standard for and as an ideal replacement pump, Max-Flo performance, has an upgraded design which incorporates durabitlity, and swing-aside knobs for easy value. The efeatures .access to the strainer com- new Max-Flo— partment and a debris basket the best just . that's 50% larger. Max-Flo also got better. a "see-thru" cover, i 0 HAYWARD Hydrogen;Oxygen and Hayward. The elements of clear waterTM ©1996 Hayward Printed in U.S.A. Max-F10- High - Performance Pump Series ; Exclusive,Swing- Lexan®See-Thru All Components Heavy-Duty,High- • Aside Hand Knobs Strainer Cover lets you Molded of Corrosion- Performance Motor make strainer cover see when basket needs Proof PermaGlassTm with air-flow ventilation for removal easy.No tools cleaning. Heavy-duty cover for extra durability and quieter,cooler operation. required...no loose gasket assures positive long life. parts...no clamps. seating for dependable Heat Resistant,Industrial Service-Ease Design gives simple sealing. Size Ceramic Seal. access to all internal parts.Motor Long wearing,and 100% and entire drive group assembly drip proof.For fresh or salt can be removed,without disturbing _ water use. pipe or mounting connections,by disengaging just four bolts. Rugged,One-Piece Housing with full-flow ports,assures rapid +c= priming and continuous pi operation. Totally Balanced, Corrosion-Proof Noryl® Impeller has smooth,wide Mounting Base provides openings to prevent fouling or stable,stress-free support,plus clogging.Energy-efficient versatility for any installation design produces more flow at requirement.Adapts 48 and 56 equivalent horsepower. frame motors. Model HP Pipe Dimension Overall Dimensions SP-2800X5 1/2 11/2" 101, / • SP-2805X7 3/4 11/2" 105/8" SP-2807X10 1 1'/2" 11" SP-281OX15 1'/2 1'/2" 12'/8" SP-2815X20 2 1'/z" 13'/e" Max-Flo Pumps are also available with dual speed motors. 100 90 F 80 UJ W 70 `_ EXTRA LARGE 60 CUBIC INCH BASKET is 50% z 60 larger than before for extra leaf-holding capacity a 50 and longer time between cleanings. Rigid = 40 construction with load-extender ribbing assures a 30 SN 815X20 free flowing operation for heavy debris loads. 0 20 sP-2 10x15 Max-Flo Series Pumps are listed by: 1 0 SP- 800X5 P-2807X 0 1' HP) 0 HP ('/, P) 1 HP U NSF® CIP 0 10 20 30 40 50 60 70 80 90 100 110 120 ® OR GALLONS PER MINUTE HAYWARD POOL PRODUCTS, INC. r7 Hayward Pool Products,Inc. Hayward Pool Products,Inc. Hayward Pool Products Canada Hayward S.A. 900 Fairmount Avenue 2875 Pomona Boulevard 2880 Plymouth Drive Zone Industrielle de Jumet Elizabeth,NJ 07207 Pomona,CA 91768 Oakville,Ontario L6H 5R4 B-6040 Charleroi,Belgium 20-95 ©1996 Hayward Printed in U.S.A. i� IN 1 I, 6s I � TON I •`aa �'�� '.. a OHRNANGNtLY At� �-- _-� r'S}r P✓tf+Y ui � ��iSe I ap t:y _ I I.i'.�/.NG I66EIf0LY a a r..,.c.stm�4 <2?e��✓.L 9t•oNN Mtr w►+�r.ks R•I p'�O� .�d l r _ � rI. ,IZc OMOY3N SO.4L!' '1/c..1i S.:CP.k2FA a i!'" f M4 S.P.7JIu'.•ALEk. !ak-Jy- - KIDNEY ROMAN END-RECTANGLE. • .sawn:famaa,m txutt WnCITI[S stoo XV uwmnPAR.M AK MM a MM K"M 90n nth aatn L S.F.uo rs SUAM.If aKmat STIRS NQ Itttl/Jal). - v, J CL o �.LU — ------s-- (n." • � yseee� 76- p �.o"'` .w�.+a FEC tiAL A INSTALLATION OF DIVING BOARDS t ttA.Pq ' a . r iu:Prw t� ►JOTL 2.-s I I . _ .'Nq�kf. :D"t.4. l6..i..Y.../...Lr.1aYe w...i. I I• �WAL*wot� i I ' ROMAN END LAZY EL - ►* T.n, -`Pr,�'.'.,`�.O��a►a.IT w...�PP.. ` yam... yn.•..... n�.a�.ta~r�.wr°i'.....a:w�o�:�aorw�. :. ..a..r..P..t.., R2 ,s ' SECTION _M.' a.w'f D _ _ 7 '4"r� , Apr } rr+sa! Umae -Lr ,v?h����`\�1ir s sty .:q��•.}; • NOW,_ TT^^ ME:IMPROVEMEITONTR `C10R ' �Ezp�r �mSANDIdICH�P.001a st � t b 'Engineering Dept. (3rd floor) Map Parcel 0� it# 7 cJ House# Date Issued ' `� — !(v Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) h o7�'S1 Fee 4,,R5 d-2) ® _ Conservation Office(4th floor)(8:30- 9:30/1:00-2:00)'s (, ti6 �sVS;7"11 ^ BN , 19 I'© A� ' �6rycae s�/pBitRNST R1MA§5� TOWN OF BARNSTABLE Building Permit A plication j P ect ee ddress o2 ( !� Village Owner Address Telephone Permit Request cf X /O First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ O'W • d?) Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#u ) Age of Existing Struct S Historic House ❑Yes o On Old King's Highway ❑Yes U o Basement Type: Full ❑ rawl ❑Walkout ❑Other P / Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing. VNew Total Room Count(not including baths): Exist in New First Floor Room Count Heat Type and Fuel: Gas ❑Oil lectric ❑Other Central Air ❑Yes L o Fireplaces: Existing I New Existing wood/coal stove ❑Yes p-N—o Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 4 BUILDING PER IT DENIED FOR THE FOLLOW G REASON(S) A �"E t ' The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: Est.Cost Address of Work: o�6 Owner's Name Date of Permit Application: ' 7 I hereby certify that: Registration is not required for the following renson(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME E"ROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR.G �O v 0 D to Owner's Name. . . . ti _• The COMMMINIC01111 O AMUMIUSCUS Dc partinent of IndusYrialAcddenly 011lcrolla aW&Mda ff10 . 6110 !f uslunl,ton Street Buxton.Mass O2111 Workers' Compensation Insurance.ARdavit �Rnlicant reformation• - -• Please PRiN'T`,m�v• - ,�;, • -------------- c�3 1 am a homeowner performing all work myself. I am a sole proprietor and have no one workins in any capacity ❑ I am an empiover providing workers' compensation for my employees working on this job. ewemnant•name- . aeidress• -- e�h•• nhone#• inaer•ence co nolier# ❑ 1 am a sole proprietor,general contractor,or homeowner(curie one)and have hired the contractors listed below who the following workers' compensation polices• H comn•mv name* .ddres . eih.. phone#! insurnner co npiieril m �• nddresr eit%-: phone 09 -.--rn"c co- .. poiiev# Attach addid6iisi'sheet if a'eee• r+►• .•+ -+•:�'�„-'i"`""'e"""" ' "'"''"'� t`• Faiiurr to secure coverage as required under Section 25A of 1NGL 152 an Ind to the imposition oteriminai pennitin of a tine up to d1.50D.0D aad. one gears'imprisonment as wen as civil pe asides in the forte of a STOP AVORK ORDER and a lice ofS100.00 a day against me. 1 undeastand tdai i coin.,of this statement maybe forwarded to the 0M c of tnvestigatiom of the DIA for coverage veritiation. 1 do hePebr exrdj d he p ' and tla ojpaj that the injormadan prorided aborc is erne and aoretim sinnat= ate Prim name eme# Fdtyor only do not write in this area to be cmupicted by city or tovra oMc ial : ptxmitlUexase# nl3undiogDepartment Ol.texaig!bard mmediate response is required Oselectmens Offie e(311=1tb Department phone etc nGibe r__on• r � _ • Information and Instructions ' requires all em lovers to provide workers' compensation for Massachusetts Grncral Laws chapter 153 section..5 req p emplovees: As quoted from the"law".an empinvee is defined as every person in the scn►ice of another under.an} contract of hire.express or implied oral or written- An employer is defined as an individual, partnership.association.corporation or other :--gal entity. or any two or i the foregoing engaged in a joint enterprise.and including the legal representatives of a deceased em el Sye.or the e receiver or trustee of an individual , partnership.association or other legal entity, employing employees. owner of a dwelling 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 maintenance, construction or repair wort:on such dweiJint or on the grounds or buiiding appurtenant thereto shall not because of such employment be deemed to be an empl, MGL chapter 1'52 section 25 also states that every.state.or local licensing agency shall withhold the issuance o renewal of a license or permit to operate a husinCSs or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally.neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public wort: until acceptable evidence of compliance with the insurance requirements of this chap: been presented to the contracting authority. is ...: :rrf.•F �:::�...� ►';;'•$i.1�•16.'.t3;�'�a'.:rt'•�.•.•,~,r �y+ M•: �!^Jt:.u. ti+.i !.i:'..•„4:`•-='.'1w�•..rr »'....'t.—•'" _ Applicants _ Please fill in the workers' compensation affidavit completely, by checking the box that applies to Your situation a: bers as all affidavits may be submitted to the Department of supplying•company names.address and phone num Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are rcqu to obtain a workers' compensation policy,please call the Department at the number listed below. 'L 3. _ ._ O�-- '� ii•%1C•. �.a•"�.:r:.i. .Ian .••+'. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at th1i�L I the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the app be sure to till in the permitAicense number which will be used as a reference number. The affidavits may be returr: the Department by mail or FAX.unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any ques please do not hesitate to give us a call. The Deparmient's address telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of luesdgadons �.,•=.. • �t » 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 1-4 414 -- ��: , , _ ,, . , Zy7 CLA1�I SHEL.L C YE PLD Ai" 1 I t i �.F„�y•�`'� �`'$� '�YF Kenn ;fr, Ws-�-aae shed 90- .,S �..�„o'•�`S� it-. i � 1`�Fr a f'+. t�4� i. ' !�iY6'2'Ll♦� bt bye e5 Zf/1a I! 7/ ���• P A ' y.�t?� C.-4 ,L,k. j=,'y +3yK. .`ey'+•5:'P+e.-.� / /D `t3T2 Y e �'1'�Pl" f M/ O 8 O •'`�, `ti O 1. 2 x 6 Pressure-Treated Floor Joists, 16" on Center i tea` 2. 5/8" Top-Quality Flooring 3. 2 x 4 16" on Center Framing g O 4. Tongue & Groove Siding an 5. Heavy-Duty Roof Trusses, 16" on Center �. 6. Roof Sheathed with 1/2" Exterior Grade Plywood " 7. Aluminum Drip Edge 3. Asphalt Roof Shingles with 20 Year Limited Warranty `' 13 9. Aluminum Louvres with Screens 10. Three Light Window Hinged to Open ~ _ 11. Window Box & Shutters O12 12. Solid Pine Doors Diagonally Braced with 2 x 4's 2 O and three 6" Heavy Duty Zinc-Plated Black Hinges 13. Black Bugle Head Screws +. LOT 62 S67' 150.00 �0 LOT T63 � �A,� s s•; ��. DECK SHED I.. J-1. S67 4.9 0 L, 150. 00' LOT 64 RES. ZONE.- 'RF This MORTGAGE INSPECTION Plan is For FLOOD ZONE. "C" Bnnk Use Only TOWN: _CQl'1JU___ ________ REGISTRY OWNER: 13E�?({SHIRE�Q�ILV�Y ,��1�VES B�N�lL___ DEED REF: _i_3,5ZC _________BUYER: J?OBEQZE XEAYSED-'-------------------- DATE: _$/1.9✓-3------------- PLAN RER _216/39 . s...4 _SCALE:1"= 30'---FT. I HEREBY CERTIFY 70 I�EL�LfSUU�l�E2UJ1'�L______—_—_ `1N ��• Mq�. _S_A_V_1N_GSI_3A_N_1_C_ _____ ___THAT T14E BUILDING :�``"� Jq!y, YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS _ I qUL CONSULTANTS SHOWN AND THAT ITS POSITION DOES __ CONFORM MF.FZITHEW 40B SUITE 5 TO THE ZONING LAN' SETBACK REQUIREMENTS OF THEMo. 320so z TOWN OF ---$AWHA.$.wl'-------------AND THAT INDUSTRY ROAD IT DOES__N_OJ'' LIE WITHIN THE SPECIAL FLOOD HAZARD ��rJO�iSTE�ZS��Q°(` MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED_V_Z!/9Z__ �4',11 t�N°� TEL: 428-0055 Co Unit —Panel 250001 0022 D `*T'r' FAX 420-5553 � _____ THIS PLAN NOT MADE FROM AN INSTRUMENT 12200 DPG T'AD A. 6{ER�IFFI W. ? S SURVEY, NOT TO BE USED FOR FENCES. ETC. I-- (0 F . • . TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. • DATE •- JOB• iocATloN • 'Number Street address Section of 'town "HOMEOWNER" -L::�_ "jW Name Home phone Work phone- PRESENT MAILING ADDRESS City town State Zip cc The current exemption for "homeowners" was extended to include owner-occt dwellings of six units or less and to allow such homeowners to engage an dividual for hire Who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNERS Person(sj who owns a parcel of land on which he/she resides or intends tc side, on which there is, or is intended to be, a one to six family dwelli attached or detached structures accessory to such use and/or farm structu. A person who constructs more than one home in a two-year period shall not considered a homeowner. Such "homeowner". shall submit to the Building Of on a form acceptable to the Building Official, that he/she shall be respo for all such work performed under the building permit. . (Section 109.1.1) The undersigned "homeowner" assumes .responsi.bility for compliance with the Building Code -and other applicable codesJ. , by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requireme and that he/she will WNER'S SIGNAT comply=1jpro edures requirements. HOMEOURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be requir to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which;xa. bu 3 permit is required shall be exempt from the provisions of this section. (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided tl Home Owner engages a persons) for hire to do such work, that such Hon shall act as supervisor. " Many Home Owners. who use this exemption are unaware that they are assu the responsibilities of a supervisor,,.(see Appendix 0, Rules and Regula for .licensing Construction Supervisors, -Section' '2.15) . This lack of a often results in serious problems, particularly when the Home Owner hi unlicensed persons. In this case our Board cannot proceed against the inlicensed person -as\it would, with .licensed- Supervisor. The Home Owne as. supervisor is ultimately`iesponsibl:e. :•_. •�• To ensure that the Home Owner is fully aware of his/her responsibiliti i communities require, as part of the permit application, that the Rome + certify that he/she understands the responsibilities of a supervisor. last page of this issue is a form currently used by several towns. Yci care to amend and adopt such a form/certification for use in your comet; • d Engineering Dept.(3rd floor) Map Parcel a Permit# 16-119 House# SEX D e Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Conservation Office(4th floor)(8:30-9:30/1:00-2:00) a -�;_�-� '/STE PAUST BE ,+ 6 ALLED IN PLIANCE P c ) l:NVIRON110 WIT Def• • ' e ed Board 19 E AND TOWS! seep. �e TOWN OF BARNSTABLE Building Permit Application Proj treet ess Zb 7 CLq SN9 - tl (�•�/ �'(o Village C 0 T V (1 - , Owner Robe--cc—, Address Telephone OLS) Permit R,e/quest /D KZ9� 9 aA S First Floor �Wb 2ae square feet Second Floor 140b square feet Uonstruction Type W tTrX Estimated Project Cost $ — /,z 2� Zoning District Flood Plain Water Protection Lot Size / ?X'/ v ( Grandfathered ❑Yes ❑No Dwelling Type: Single Family 1Y Two Family ❑ Multi-Family(#units) Age of Existing Structure f? Historic House ❑Yes ?E�No On Old King's Highway ❑Yes two Basement Type: Uf Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) J P D Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing Z New Half: Existing New No. of Bedrooms: Existing New r r Total Room Count(not including baths): Existing New First Floor Room Count J Heat Type and Fuel: ' Gas ❑Oil 2MIectric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) Attached(size) 2O n DL2-�—m) ❑Barn(size)tiZ f+ ❑None ❑Shed(size) r,'X-J' &D SA of ❑Other(size) NA Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes b;:90 If yes, site plan review# Current Use RC31AA" Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Lev �l SIGNATURE �4'� DATE 6426.144 BUILDING PERMIT DENIED FOR THE FOLLOWING ASON(S) " �a • I .J r t' LOT 62 150 O0 4 f LOT 63 s 5 N 0� DECK SHED 1 N S67 4,2:10':C 150•. DO' � LOT 64 RES. ZONE- 'RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE- "C" Bnnk Use Only TOWN: -00jVU.___ ________ REGISTRY OWNER: 13CRdSHL?E_-C L/(V�Y ,FA1LVC, DEED REF: _4B35,ZL4_________BUYER: _1?0TEQZE XEd�NED_'-------------------- DATE: -8-11.2/�3____________ PLAN REF: _.216/39 . s.•• _SCALE:1"= 30'___FT. I HEREBY CERTIFY TO L1L,:6ff 'LLUff,E2UlYZL'__________ ��� u'. _S_A_V_/N_CSD_A_N_K ____ ___THAT THE BUILDING :�`��� AJJ9�. ____ A. � CONSULTANTS SHOWN AND THAT ITS POSITION DOES CONFORM MF.RITIIEW TO THE ZONING LAW SETBACK REQUIREMENTS OF THE ,, Me,. 32096 z 40B (SUITE 5) TOWN OF ---$A$ M&Z-------- L----AND THAT \' T. >' INDUSTRY ROAD IT DOES_N0_T_ LIE WITHIN THE SPECIAL FLOOD HAZARD �F�r '"Olm�z �Q.t` MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED_z/_- /�z__ At LA"D TEL: 428-0055 Co unit -Panel # 250001 0022 D FAX 420-5553 THIS PLAN NOT MADE FROM AN INSTRUMENT T'AD A. �E'1'FA SURVEY. NOT TO BE USED FOR FENCES. ETC. 12200 DPG F/?,qn'1lN6 P4f Al APR �VFI�t/�/��f'��E7tiFN1')d�'C�c 207 CLO0t/??.rff& C Cd V5- RV. 2 X$ 7015T DANGERS DOVSVF 2x8, ovEe *'comour PIERS Al DEEP y i I Z�a 3/ yL Rolf s c vt)ecl`�h� n/ew 'IX g o ex�rtr�� Sill ' 8 � 7alsTlt�IG�S ort �ef�i en�(s a-� 3 ' l I � 207 C4AM.SHELL COVE R D. , COTUi7� OWA/tR Metro ect' �f2B-3g31 . L..wOvL D LIKE ro L3t//Lb A- IVEp✓ . DECK OVE? THE R-XAT/NG DFC1� To 13Rinle. iT LIP-TO 7#F 'LE.VEL REAR WA LL.D F HM15 of 4*e. Ll vllv6. m.o DM -FL o o R- 'fil7en enclose it wIT14 S PD Roo F AND WA LLS ro CREAT E- A 'FLoRIPA RooM' !D'x 29� RAFTERS -16"O.0 . �qi,. - 2 1 tiYA_LLS I.I, ...0..C, INTER1v �'Xg* l b O-C erp pgsed NEW DEC4C FLOOR LEYE1- C 6KISTiNG DECK '° (R4tS,C ' bLerel wil* Lt✓infro0�) v. Q Fx�s7//YG •9 g" Concn.ele P .4 feet.40 ' 4 _ r , 4 The Commonwealth of Massachusetts _ f2p 'Department of IndustrialAccidents '� -- -�-� � OA�ceollneesbgeliens 600 Washington Street Boston,Mass. 02111 Workers'Compensation Insurance Affidavit Pill / Cation z/ K�� CoVcr / l�Ier pelf- ing all work myself.ietor and have no one working in any capacity ❑ I am an employer providing workers'compensation for.my employees working on this job. dSl¢reaa: _city: hon ts- . . olio .� •� ; .. ❑ I am a sole proprietor,general contractor,or homeowner(elute one)and have hired the cor►tractots listed below who have the foliowind workers' compensation polices: llttur9eice co. . . . 'policy tptn tan . . t'silure to secure coverage as rcgoired ouder Section 15A of i✓fGl.152 tau lead tO the inpOtitioa otcritpinal peaaluct of a fiat up to It,500A0 aad�or ooe years'impriSonmeat as well as dvil penatda is the form of a STOP VCORK ORJ)HZ sad a 1me of S100A0 a day agaiatt tne. !aoderttand that a cony or this statcmeat stay be ton►arded fo the UtTia of JavcstiAatina�Of the DU far eovernge verit3cstion. I d, 4f ereby cc Jy, der 9he pains a d penalties of pery'yry that the utrami ation providrd cis true and cornea. 1 Q aturc ate �� Z �� 9 li�• Prin[nutnc r h hctic arrIcial uec Only iJo not wntt In this area to be completed by city or tows otficitrt dty Or tov' permitAiccmie# Building Department plieentiog Bard Q check if immedlale renpoOac i9 requited 0Seleettteen's Ofiiec contact OHcalth Department person• pboat p; _ Z Other (isvicee IM r7A1 i WE r� . : . The Town of Barnstable • aARxsrnBU �0� Department of Health Safety and Environmental Services 16!19- Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL-c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. /Type of Work: Est.Cost /Address of Work: C g -' ?lot— Owner's Name IZO&4x—c ` Date of Permit Application: J W�� 3��� -I 1 6 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's9Name i • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. ATE JOB. LOCATION 20 -7 C.(a*yl S AeM ,' �- Number Street address Section of town "HOMEOWNER" w�7�C!—f E' 2h Neat- Name Home phone Work phone PRESENT MAILING ADDRESS S ZO I CA M 2-(v ity town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and Co allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as su ervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 sponsible re for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Depart ent minimum inspection procedures and requirements and that he/she will com y i sa ' d r ce ures d requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. I •m a HOME OWNER' S EXEMPTION The code state that: "Any Home Owner 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 a Home Owner engages a person (s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a�,s`upervisor`(seejAppendix Q, Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires , unlicensed persons. In this case our Board cannot proceed =against the inlicensed person as 'it .would; with licensed] Supervisor-. The Home ' Owner- actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man• communities "require; as' part 'of the permit"application, that the Home Owner 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•-to' amend and adopt such a form/certification for use in your community. Assessor's Office(1st floor) Map c7 Lot Q �. ermit# p Q • Conservation Office(4th floor) \1�--� �-' ^' S��vS Date Issued 7 / Board of Health 3rd floor (8:30-9:30/1:00-2:00) 1007 le � 0� Engineering Dept. 3rd floo House 7 evs Planning Dept.(1st floor/School Admin.Bldg.) ®e ��v � /� • RNSTABIE. Definitive P Apg ove Planning Board 19 °� °� 9. NST TOWN OF BARNSTABLE Building Permit A plkation Project Str ess Village COT-v17 Owner v Ke4h e Address Telephone 0 -3 1 � r Permit Request I61 dA L. .yam. 537 Total 1 Story Area(include 1 story garages&decks) 0 square feet Total 2 Story Area(total of 1st& 2nd stories) square feet Estimated Project Cost $ �j,00 a ` Zoning District Flood Plain Water Protection Lot Size 1 S &_C/)� Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial h-O Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Iw Number of Baths 2—' No.of Bedrooms Total Room Count(not includin•,g baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached t Barn None Sheds Other 'I Builder Information Name/ Telephone Number y, ev e3 I Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUREU DATE BUILDING PERMIT DENIED FOR THE FOLLO NG REASON(S) i • FOR OFFICIAL USE ONLY PERMIT NO. #8808 DATE ISSUED July 12,, 1.995 MAP/PARCEL NO. 005.023 ADDRESS 207 Clamshell Cove Road VILLAGE Cotuit, MA 02635 ' OWNER Robert E. Kennedy ' Z DATE OF INSPECTION: FOUNDATION FRAME INSULATION ' Y . FIREPLACE v , i ELECTRICAL: ' ROUGH FINAL - PLUMBING: ROUGH' FINAL.. e GAS: ROUGH `> FINAL 44 FINAL BUILDING :N - ' DATE CLOSED OUT - ASSOCIATION PLAN NO. k' t 11;0=;'Ad 17:02 IC6177277122 DEPT IND ACCID Z o CojnunoncUeahli of �Waajac�i.usetb ' ..UaParfine�cl o�.�ndu�rr�,�fcc 600 walnffoA„ 1, at James J.Campbell &ton, "Iamadu&u& 02 f f f Commissioner Workers' Compensation Insurance Affidavit - eaoe�permi�«, with a principal place of business at: �-o Ups C (c�►is�zly, do hereby certify under the pains and penalties of perjury, that: () 1 am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Number () I am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Humber Contractor Insurance Company/Policy Number I am a homeowner performing all the work myself. 1 under<_tand t,.t s copy of L`is s ate rent will be fo�earded to cite Office of Investigations of the 01A for coverage verification and that failure to sect ccVerage:s ree ired under Section ZSA of MGL 152 can lead to the Imposition of criminal penalties eonsisdu of a fine of up to s i,500.00 and/or r yea:s' imprLorr..ent zm well as civil penalties in the fora:of a STOP WORK ORDER -nd a fine of S 100.00 a day against me. Signed this n *11 day of , 1 qz" ze� 0 ------- Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 m TOWN OF BARNSTABLE o BUILDING DEPT. (JUL I 11996 M 1 $" Cot<gET15 P1 M 1 15VAI& 39i5T 65 3j aq bol5 COtT!'iez-f(A N6u1 zX iZ M pi CV d � 1 C3 i Me 1 I i 1 , ( _ eoP_ OVE G _ _ _ - - y — - - - - - --g U1 � �udf3t-E 2x 8�a� 8�` catICKE`rE P167. Foi- A/EL/\/ DECK Y 'c.o % � b'P.7= �FcX/-,y 6 C 01eR CT�d S WIL* 3 hF 91/ covcRem Pa€ i Rd RT • K�NN�I�� (OWNER) 2 8 co�srF _ AMP F Z a7-~CLAMV IEl-L COVE R� Co T�Jr T M A-• LL- - 28.383/ T - *iv air. �E w i t TS �Ry�✓s:c. - 1rB-76•dc i j l�'AfYropf DBCAl f� E !! a x�sr. .✓case f ,ev_sroa vsass. - qua nr,,,,v fc. � I 1�� 6�� � `:o• f�c`" I t r� _x»WQecI (SjelsCCVas- o SILL QBmu OVERIMS (Ftdu ✓�exsr/Zr3t .) 4 �'c• i=or ;o I Y 11 -G.�6k I 'aar.�a.w.s�y�• � • • 4AO .a d.34f7 A RLMWAI. 6 iAt n(OIIs. I I - -�� --- - - - - - - - --- 51DE V~ ?Amzm6 PIA l • :7dLY e /og 9S 2S �f //v C7iQoUltl� T HEO 3C �2�C 3 Oaf • ;r ? MR. �` MRS. K&W"Eo y - R 207 G A?- J--. s co rvtT T x At RSs'rep of you w-< Co�v vt�s 7'0 [ WIMPMEA rtuE tZOUNI> CDI-D ri1P �$ox��t v1�tDE� P01eF 1 -------- 2x S r 41OVE7 . G of 5 i f I3.4TE0 `EKED ARC,y�! J s� r )RE- R . SLAM N ALN�o uT N, MA. �: � C./��.:/ r G h r /I U u.�L• lJG J(!IY L - :SG6 PLAN r. w Gi/. w „ eu.r►R a Lt�s�ac. lb DRrwett. ,IDE fLA".IA f 4 Sion rPAT)e WOO f.GBCAf yw4odT. 1450 @xidr. NoOSG I@NJ10N YdR/ice, AS MAIN 4L,III.IN �FWSN W P __.jV&W OCCA i-vdeS • .x►SppNG � )AV Ortf LAN OiIq. fi GI�o6R I �cvucpr..przi+i�^ O ac C/dvicer 1 C,aO� WALL.Nl. !_o'r •'d I I __�r .a R`xor.dSMT. 1v RLMA/N. 4N e/or&s. IND .CA rCO 6192166 Wv opE B, e SLAM N _°Nm4307 z ^AS'T' �ALMoL.:1'�'N, MA , -I- • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB. LOCATION `'wt CO�U f '. . :.. Number Street address Section of town "HOMEOWNER" l �1it� 3 3 / �jjrt.,,r•.e..: :::.... Name Home phone Work phone . PRESENT 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the Stat Building Code -aad other applicable codes, by-laws, 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 comp w' s id procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which -abuilding `permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that,.if Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this, exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for •licensing 'Cons-truction' Supervisors, Section 2. 15) . This lack of iwarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed .person as` it' would `with licensed. Supervisor." The Home"Owiier-*-`*actin as supervisor is ultimately responsible. To ensure that the Home ;Owner is . fully aware' of his/her responsibilities,. man communities require, as"part of"fhe permit application, that the Home *Owner 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 to amend and adopt such a form/certification for use in your community. r � Q �; . . °: The Town of Barnstable z 9. Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790.6227 Ralph Crosses Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement, removal, demolition, or construction of an addition to afi► pre-existing owner opted building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: ��� Est Cost 3 -0 Address of Work: Owner.Name: \ 1 Date of Permit Application: e I hereby certify that: Registration is not required for the follo%%ing rcason(s): Work excluded by law _Job under SI,000 Building not owner-occupied ::�O«ner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hcrcby apply for a permit as the agent of the owner: Date Contractor name Registration No. OR (0 1-4 1 k" Date Owner's name P �\ YL c- - b z7o _� t ` A Ow Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 7 Ralph Crossen Fax: 508-790-6230 Building Commissioner Procedures for a Demolition Permit Note: Old King's Highway Historic District Commission approval required prior to issuance of permit for any property located in the Historic District (north of the Mid Cape Highway) 1. The following departments must sign off on the permit application: Assessors Office - 1 st floor Town Hall Engineering Department -3rd floor Town Hall Historic Preservation-4th floor School Administration Building 2. Specify on permit where demolition debris is to be disposed of. 3. Certification that all utilities are shut off is required. 4. Workers Compensation Insurance Affidavit form must be submitted if more than one person will be involved in the work. 5. Fee to be paid. II R' -2 720 � 2- 9 � PERMIT Assessor's office(1st Floor): Assessor's map and lot nu ; poi'furSEPT to` Conservation(4th Floor): S`A INSTq IC.a��f$1'E Board of Health(3r`d floor): l 7 ] - �' 11V C • Sewage Permit number W" r Engineering Department(3rd floor):.? rJS ✓�N ONAMAr ff��i L oe3o. House number i - _� 0 7 T� Definitive Plan Approved by Planning Board 19 �N REGULATIONS APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only x i TOWN OF BARNSTABLE BUILDIHGINSPCTOR APPLICATION FOR PERMIT To TYPE OF CONSTRUCTION 19�3 _ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 2-07^ gn I/I"lJi—U, COVE Rb ' CDT(// r �r— Proposed Use Zoning District ' 1 Fire District Name of Owner iP,Q13 67 2 I KiIJ Y Address Name of Builder 5�L Address Name of Architect J Address Number of Rooms ! Foundation �SD lye) Exterior S ff/NG'C L Roofing ��'►�/�9 Floors 09 Interior U/yr1,4li R qFD Heating Plumbing Fireplace ND��= Approximate Cost�/0 a 17 Area �o v 4P Diagram of Lot and Building with Dimensions Fee 1�0�- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Si ipervisor's License KENNEDY, ROBERT j. No 36164 Permit For BUILD ADDITION Single Family Dwelling 207 Clamshell Cove Road ` � y Location 9 Cotuit OWner .- Robert Kennedy Type of Construction Frame Plot- Lot Permit Granted ., September 14 ,1.9 3 Date of Inspection: „Frame �91 ;a Insulation 19 Fireplace 19 - Date Completed �� f 19 tan All y ^ LO T 62 ,• S67 4,210 150, 00, tl,-ro Rear of Odra e LOT 63 5. 41 •N �0 ' DECK SHED S67 4,210'�p 150. 00' LOT 64 RES. ZONE.• "RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE- T" Bnnk Use Only TOWN: _CQ VJY -- ---- -- REGISTRY OWNER: DEED REF: _483,5,ZL4__________BUYER: J?0BE8ZE 10E 6T.0_'-------------------- DATE: _8A.,91_9 ------------ PLAN RI✓F: _zrs/3s __ . �,..�, __ __ SCALE:1"= 3o"_ FT. 1. HEREBY CERTIFY TO VL,!?,U51(14Y,,_'EQUJ✓Z1_____------ �\It u`. 4%a 2 _S_A_V_!N_GSB_A_N_K __________THAT THE BUILDING `r qy YANKEE SURVEY � I�AUI_ SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS ? ; CONSULTANTS SHOWN AND THAT ITS POSITION DOES ---- CONFORM kill ' rAFRITHIE 40B (SUITE 5) TO THE ZONING LAW SETBACK REQUIREMENTS OF THE , I.iu. 32098 T TOWN OF $A�'N,� F' � AND THAT �;, s- �'' INDUSTRY ROAD IT DOES__N_OT—_ LIE WITHIN THE SPECIAL FLOOD HAZARD i <`,rr�,lSTE�� MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED_2'/_V_9_�__ �*�n f<! �� TEL: 428-0055 Co unit —Panel 250001 0022 D °4r' FAX 420-5553 ���� _____ THIS PLAN NOT MADE FROM AN INSTRUMENT 1,2200 DPG 'PA DL A. ME VTR W. P SURVEY, NOT TO BE USED FOR FENCES, ETC. cI� �c.csrN� oust• ti• �` ?b AM TCN i/TGN �l •• ,` tc -. `'._ .,j,.-1". —��: ,ate '�'C.. �..,.� `-•a,;.'a-..� .i1�:..,.�.`M,..�y..t.. iWe • `S Y ;.., .. � _ sr�crsner aa+�R• I. 11 N - :.�. ,.,. \ ,• T�v.. . . . � SEC• � /rL. K b/Mt`A/JH'INt. -• -•� _ro sulT f J. . IYg/v,�ov/7roiv '` :' . '� (fZtisfl fx/STinrG ,2~• L. i j' s• b '.I Z w r� /G'I•c 4-II.a Gr JxTcIl,IIT•.sica'A5 Q wAtr�.p►roof O&CAe fuK. 3ELECT£�d101NVElt /01 - 40 US.�" R 'ac J9ur L _.. . .. ..f/dlaG.L�Y .4voi/KG, sie AL%O l.w Fi.j-CAA/. —- �>r/tfs �✓oasG M -_ S2C AMIN AL.)ZAN NEW- 20-O� p/MCNJ/ON rAgl . / ��?/N L ODR _L�VEL (now N�trrs��►C � Z"d-fa' •.0 SA euNo,�7roH�L�++oKq /m/wx i r� . , r „ i __ _ I _3*}IAUY e4C- �eextr tf t • ' �'. � �� � // '•, we��xco sus;aN Gti�oie. �fintfL) �� � ' s coNC. fI4• COMM ONWEALTH OF MASSACHUSETTS L DEI'AI�'MENI' OF INDUSTRIAL ACCIDENT'S ' 600 WASHINGTON STREET BOSTON, MASSACHUSETTS 02111 fames.: Camooei �o-'m:ss'°ne, WORKERS' COMPENSATION INSURANCE AFFIDAVIT e Ke oo R (lice nscc/permi ttcc) with a principal place of business/residence at: C'd yf— o C/L (City/State/Zip) do hereby certify, under the pains and penalties of perjury, that: ( ) ] am an employer providing the following workers' compensation coverage for my employees working on this job. Insurance Company Policy Number ( ) I am a sole proprietor and have no one working for me. ( ) or homeowner (circle one) and have hired the contractors listed below 1 am a sole proprietor, genera] contractor who have the following workers' compensation insurance policies: ]dame of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number I am a homeowner performing all the work myself. DOTE: Plcasc be aware that while homeowners who employ persons to do maintenance,construction or repair work on a dwelling of not more tban three units in which the homeowner also resides or on the grounds appurtenant thereto are not generally considered to be employers under the Workers' Coropensation Act(GL C. 152,sect. 1(5)), application by a homeowner for a IICCDSe or permit may evidence the 1cg21 status of an employer under the Workers' Compensation Act 1 understand that a copy of this statement will be forwaidcd to the Department of Industrial Accidents' Office of Insurance for.eoveragc verification and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of-ictiminal penalcics consisgng of a fine of up to 51500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fine of S100.00 a day against me. f�— SiS ned this day of ' ` , 19 Licensee/Permirtee Licensor/Permittor (' l `Assessor's offioe .(1st floor): •. U ��E� SYSTEM MUST BE FTNfr Assessor's mao and, lot number .......................................:.... SC Qom° Board of Health (3rd floor): ® LE Board IN C+©MPL'A�8�� Sewage,:.P,e�m.it dumber ..... ... ......./A .. .............. l�, ITL@ 5 y'1 `!... ( o/� ICE P BAS39TSDLE. i �VIZH T i Enginee�iT` .:.. F;tmnt (3rd:floor): §eMENTAL CO!�� ��' 'ocr63o \0� House nm ' 01......................F-�_9YROOqq��6��N A gq M Y y. APPLICATION'S'•''P�&ESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..e605TO-Me% S�r2� TYPE OF CONSTRUCTION .....Na4D ....r7?5 ?.V,,5;�....................................................................................... .uLy...... .........19.Zl, TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...C!V.?.......('ref./LI.511 4-1 (70.ve�...... .`.'(,!v,,)...........<!v.Z.7�—. ...... ... .......... Proposed Use ../` S/ / ................................ .............................. Zoning District ........... '..r......!..................................................Fire District ..... .. ..5/... 14/ �Q Nameof Owner C.7:.Fd.RO.,it .......... %J/.5.....................Address .................................................................................... Name'of Builder .!} tF.> ...CdDv^,7j G(CT<�lJ Address OF / ,. x?A...... Name of Architect 7e.�.......6."t/�v............................Address /CA u � ...... .. ... ...... Number of Rooms ....L.rabM...............................................Foundation ... ..Q�!���Q.....�ON�-orl—e .?CAI COT/N6S Exterior .. P !4/21�...? Roofing .....1�J�lj�......� D.42.....siY//✓CC0.S.............. Floors ......................................................................................Interior /..G..4S.T.. ..... ... /:tl .................................. Heating �GF �IG....................................................Plumbing ...C!S?li' ,Q,ey,....�i� ! ....zi& ........................... Fireplace ....... i...................................................................Approximate Cost ................................ Definitive Plan Approved by Planning Board __ _----------------_----------19________ . Area /.."....... .!. ..�.... Diagram of Lot and Building with Dimensions Fee L� ......................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH D�b�b D J �C I S7-/A)6 Ci,4fA L L C'cl jer4j) OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. • Name ... . . . .. .. ...... .. .....���'!. .............. Construction Supervisor's License ..00g0.,3.7........... KORDIS, GEORGE No ...3.1.0.1.7. Permit for ...Build Addition ........................... Single Family Dwelling ......................................................................... location Cove Road . ..........................G.otu ....................................... Owner .Q.r.ge...Kordis ........................................... Type f Construction ..F.KAMP.................... ............................................................................... Plot ............................ Lot ................................. Permit Granted........July...2.4..............19 87 Date of Inspection ...........19 Date Completed .......... ...........19 IA• d -- :1.� - _ _ K .fi1�- .)_ __}�_ \ lea .sT ��I-,f^_' -•"4 i. S�Assessor's offioe .(1st floor): �THETo i D. oa 3 j1A Assessor's map -.and, lot number ................... ................ o.. �♦ Board of 1-16Ith (3rd floor): e� Sews e .P'e m.it umber ..... . ...'.......................... - .. 07 g �;,�, ...� �.,; � ... 1; BJB.il9Tl�DLE. Engineeh' '�, tm nt (3rd floor �< 1�� vo teas �vK.", : � ,b, � House n "R1E e'r�l............................................. �. ....... � r �e APPLICATIONS''�Ft'OCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ••••••G••••57`0/L\�... TYPE OF CONSTRUCTION .....WO..�� ..... `� Y� ......................j....'............................................................. .......... 19. � TO THE INSPECTOR OF BUILDINGS: / The undersigned hereby applies for a permit according to the following information: Location ....1.! .......�/- 1. ! 4.........(7U".(�o.....(0.e.4.1 '�0?7"T............ Zrj,...eM �r S/i�,>.�T/n�G Proposed Use ............................................................................................................ �0 Zoning District ........... ..,...!...'..................................................Fire District ......7.. . .......!.Y -Inl .........._...................... Nameof Owner a0F4)06A.!7 .....................Address .............,.................................,.................................... Name of Builder .) � �N eT�a� •S�a' C�/t s/ ���,�,� .........--n--.-.15770(/ .......... ...........Address ........ j. ...Al:....-"..............�........................."`.. .;A Name of Architect t'.E.D••••,SL•'4(//�••••••••••••.•.•-•.••.•••••.Address .. //`� Number of _Rooms. ..................................................................Foundation ... ..D.!!/���Q.... ! .... O�tl.l. 00T//✓lS- •„ram - _ Y W � Exterior ...&,4R4VA/2D...P`'....Sid//. 6.��1..� ..Roofing .....1����jJ.....!'F0,471Z ...si111VCe0S Flodrs ............... ...............................................................Interior ./..1A..5..7. ��..... ..V..!`y!.t/T ... ........................................... e HeatingGf=C'iT�'�G 'i Plumbing ... .5�!/ 0,��/ �i�..................................................... ... �� .....................:... Fireplace .......A.11-4...............................................................Approximate Cost ........��4.0.4..:.e U ...................................... Definitive Plan Approved by Planning Board ________________________________19________ : Area � �ol\. ."................ rA Diagram of Lot and Building with Dimensions �, 1w,` Fee �..�.. .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH _�- - 4,r J \ a ��f9T�� pRj • • �x r STliJ6 �-.,� { �+ W�F /o V Ss — � �. (fC,4M,4 15, a't)Ca OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS . I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .... . . ..< .. ....... .... ........... . ....."""....................... ` ' Construction Supervisor's License ..DO• �J43••.7.""••••••••• KORDIS, GEORGE A=005-023 3 No ...31,017, Permit for ...Bui,ld•.Additon Location ......2 Q.7....C.].umsk��.J, :.CO�.�..Road ..........................C.Qtu i,-...................................... ¢ a a 1 Owner .............Qe9x'.q KQrdi.s................... Type of Construction ..........Frame................... ...................................................................... e Plot ............................ Lot ................................ -� Permit Granted .............. Jul 24 87. =� ....... '.........�...............19 , - Date of Inspection ................................../:•19 �. Date Completed ,.•19 `...........................�v Sod fYBF f: 332 Co A n. 1 f TOWN OF BARNSTABLE Permit No_ ______________ } VA"ST,u Building Inspector cash ■3 ' - - - - "' OCCUPANCY PERMIT Bond _ S Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. - Building Inspector FROM TOWN OF BARNSTABLE Mr. Francis Lahteine T w IroY 1P•1►RNY9.V>R��h+ BUILDING DEPARTMENT Tawn Clerk 367 MAIN STREET HYANNIS, MA 02WI !l Aw.aiiw».+.F4 is+'`*'wr�ea i►v ��w.•ryr ya.=.f. Phone: 775-1120 SUBJECT: FOLD HERE DATE F MESSAGE - .. Work has been oatpleted under Permit' #25906 (Clamishell Cove bev i!k MU{wra•c.'jyR�y►,±�+»v. +rY vq+s:vs...crsrrTor..:rr..xir" wi.vas'tra B+ r e.+►ar. Corp). Please-rem-Bend. • • Rt2q+,�wt:fMf•iyih.rtr'a.•.•1�W.1?SM'tt+i�Ysie.y. - SIGNED F ltz)-1 DATE REPLY ' .. SIGNED N87•RMI r RECIPIENT;RETAIN WHITE COPY,RETURN PINK COPY' PRINTED IN U.S.A. ^SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES-WITH CARBON INTACT. /llglL �AssessV's map and lot number ..............�......... FTNET v wage Permit number ....� ..............7..... .. . SEPTIC SvSi",m 4� „�• Z 96$a3TABLE, i 0..� INSTALLED IN COM OV ", House number GO 1639 \� WITH TM_"' MA TOWN OF BAR �; A ��L�E` BUILDING INSPECTOR 0 APPLICATION FOR PERMIT TO :�// .. . TYPE OF CONSTRUCTION ..........A..�' :. ........C/`.. .P. !.�1. Q..P...t ......[..J4.`ZF{"L�-... lG. .....9........19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies f?or a permit according to the following information: 1 �- Location ......4I..CJ.7....... ....U 3...E...�.l.u./t?.:�.�1 C'�/...�Q..(��....��/:... Ll d...7.lIJ..�..)..� G.S F................... Proposed Use ..S, .5?xzAe...66.itt..1../.......!/�. .. ti. ........ .......�....�—��'.5......� ....................... Zoning District ........ Fire District CU7li/T ....�.......... ......................... . ................................................. . .. ... .... Name of Owner "'°!1 Address ...s..f ........ .....n. ... � G[.��./s./1•IGs nn • Name of Builder .1:. �/I`..U.y. Pk v............................Address �'"'... iP ���/i".IUn...�!!a SS... i$a3 Name of Architect h.Q.G..�/..1�.�. ..R:. s�l f/!.`1..........Address �i✓l a r/ !?......................................... Number of Rooms .............xl ....... ...................................Foundation ........ ........... .................... Exlerior �� h /f ...Roofing .... Pu` �0' S �'h /P ...�.�. �................./... .................................. ..................................,ill................................... Floors ).......................:...............................................Interior ....�/....�...�Y ..................................................... Heating (J/ Plumbing :. �L ...................4........................... ................. :`..&..... !.,...:................................. Fireplace .I�S ................................Approximate. Cost �t... ..........W Definitive Plan Approved by Planning Board ------------ _______-----------19_______. Area ......e 44 ...... Diagram of Lot and Building with Dimensions Fee r......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 Il.'20 1-1641 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... ............... .... .................................... Construction Supervisor's License .a (Ol a 3 r _ _ I q4.AMSHELL COVE;L-YEVE�LOP-IrE-N--i:--,-JORP. Mo a 25906 Permit for .......... ......Sincfle, Family..Dwelling,,,,,,,,,,,,,,, ......Single. ..... Location ,Lot. 6.3... ...2.0.7...C.la.m.sjjg.j.j...Qgve Rd- Cotuit ............................................................................... ;tiOwner .... Clamshe1 1 Cove Developpent CorP............................. I Type of Construction ..XDaDg.......................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .......Dec......2a .............19 83 Date of Inspection ...........19 Date;'Completed ..... .............19 .5.r. Irla A4 o9N OF LA/MO -40 EXAV Tom$'•.gNO .7 4✓i 7 7- 7-0 2dN/NQ .�PE'GVGfs7T/ONS. > Ci4pE /SL.9i�/OS Su�✓EY/NG rEs!T/G%rFT 4 Assessor's ma and lot number .....................�x ...... i_ ✓p / _ �FTHEtO rf 'kSSewage Permit number ��- ,y J BARNSTAB E, i ,. Y House number .............. .... /1.�/...:..........: N................. 9ao�°b a \eke 39- � TOWN OF BARNSTABLE ` BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......:..?.....! ` � TYPE OF CONSTRUCTION ....... :....:. ....... .��f ... ��'�.<'�...............� ................. f t.... .•.....1111..........�....:.....19. .. . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......�i.r. ......... ....�� .?...... f?'?... . .� .. �. / .... �/..:. ui, A �,S ................. .�••.. Proposed Use ... .r!!.��... 1..!al...'.��...... � �'.. �"g'..... :L... p�.....�.?��C......(..9...��.1��.�........................ 1; CG7 / � . Zoning District ........!!I........�....................................��:..........Fire District ..........................1, .. Name of Owner �..`.��M.5. ./?;�� / a✓P..!��!�� . "110'7:A dress ...S. -�l�.l.y,.t�. k .u.. ?..... ........... .. . i n / Name of Builder /: !i� U�?.h P� Address ..... ... M. ! S S a(Sra ..../� . .... j n <- f/�l. �l /t. S�i/�'.'!..�..Address li Name of Architect .......................................� ...................................................................:.................. Number of Rooms ..............: ........ f.....................................Foundation ........`...C.G'...1 .. ..tP................................ Exterior ... °..: ..;`.��. .....a /hC, �t v H ........7../..............................S.Roof(ng ...........! ............?.. '....�bPC"................................. Floors ............:?....................................................:...................Interior .... /........................................................................ Heating g /.... ..................................P.lumbin 7.. �, �./ Fireplace ............ ..............Approximate. Cost /s , C1�1/ .Definitive Plan Approved by Planning Board _________________-----------19_______ . Area .....f... ..d............... ._t Diagram of Lot and Building with Dimensions Fee ,y9 SUBJECT TO APPROVAL OF BOARD OF HEALTH k� T j s OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 0�/ Name .......................................... ........................... ' 'Construction Supervisor's License ................................� �S CLAMSHELL COVE DEVELOPMENT :C Rl A=5-23 No Two Story.... Permit for ............................... Sing.le Family Dwelling .............. .............................................................. Location Lot 6 3 207 C14mshdll Cove Rd, ................................................................ Cotuit ............................................................................... Owner ....Q.1AM-5h@.l 1...Cov.e...D.evelopmeni. Type of ConstructiorfKAMP.................................. ................................................................................ Plot ............................ Lot ................................. 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