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0053 SHERYLES WAY
J3 J zl s ..,1•. ^--• .�..�... _e,.. ,.._ r��.,,.r,,,,,,,.+�-;..... --"-'^"..-^'t-`�.::.eG.;:.�_ ,i,u."."�''......�...,....,.�._�......�:.�•+.�+y�`+-�-� - - --�--++.- xr+-. ,�..•./"R.✓+ic..�., - __..�..� ..__.�....+�d.:--."d.�.� - - �.SHE T Complaint Call Report Printed On: 122/13/2019 B"W i679•6 53 SHERYLE'S WAY, MARSTONS MILLS `00 Case# C-19-502 Case#: C-19-502 Address: 53 SHERYLE'S WAY, Date: 6/13/2019 MARSTONS MILLS Owner Info: Property Info: LIMA, MICHAEL L& RUGGIERO, MBL: AMANDAL 53 SHERYLE'S WAY 045-050 MARSTONS MA 02648 MILLS Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Building Code, Medium Priority Phone Complaint Summary: Caller states owner cut down all the trees on his property, now runoff(mud) going into storm drains. Action History: Action Taken Date Description Fee Inspector Close Case 12/13/2019 No violation present $0.00 bowerse landscaping is completed Inspector Assigned to Complaint: bowerse Filed by: barrowsd Comments Comment Date Commenter Comment 6/14/2019 andersor Dispatched inspector to check for evidence of run-off after recent rains. Date: 12/13/2019 Town of Barnstable f A LT ER'N'•.`•T I.V'E W fAT KE R;I:ZA�;I:Q:N:: ON .� Date:' Town of Barnstable • ' ,�,d•., � .. • .200'Main St •`:'�:� r' ,..>:s,. . . • , • .ic is �,�: •{:x..:Y; .. :wv ;Hyannis,MA 02601 •:�::i:':`� •:��s;=%,���"�z�. �:�,:::%'•;i:z •. ' ' M.• i �t1� •'���•"r.)=y�".xfr�T:.,'.,.�rry.�+`,M�YE��':, Re:Pesmit# " �'� r fiy::, "�" ''' ,/�_(•s/ G�' . �;sue:��:. 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'�i!.;f'i:.t• SyaF .,:'v .F`•>?�i:�:r i�e"�`••Y'�'�"' •. , ;�a�yr„h�'?l'c`J2%•;:• .yid•.'_•.Co�tf r�'ly�:r' ;.?,�%1•':.'yrY``�.A`1�+'ti.,,-�'r�, ^�cj�':?".r•ar> •:•rLc•.' n{C•L"'u'�,'•-�''`'• 1. :;`:,:•..c:•>�-;- •.' �.=-��..<,r-• , . i,:"r,rlr " y ��.7;f� k.; '�'• •Go" ;,,e,.F:r.' :..:.w 41�J:'�"<,Y•:.'�. • 1v :�. '.. >:::• Dom':.... Tiinothy Cabral, President CSL-105454 58 DICKINSON:SrREET FAIL RFvC-R�Mn o272'1. 1 15o8J'S8�-4240. 1.,ALI'ERNATIVEv.EA3.TIERIinT(ONOdMAILOOM,;•:: • Off" Application number..... �..1..'. .<..... DateIssued...............`r...........A. ............................ -. •SEP 04 2019' - s Building Inspectors Initials.. ;11....:................... OWN OF BARNSTABLE ... .• -Ma ?arcei........iQ.Z..S - Qs-d ._ p/ ... .............. TOWN OF BARNSTABLE EXPEDITED-PERMrr APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 53 NUMBER' �:` S, T•, VILLAGEQ Owner's Name:Qom, - y j'Q Phone Number CV Email Address: OLMae&tee I i n CL @ el'1 y,!A(.c41m Cell Phone Number Project cost,$ 1 U3 J ' Check one Residential Commercial OWNER'S_AUTHORIZATION As owner of the above property I hereby authorize � •� to make application for a building permit in accordance with 78 MR Owner Signature: Date: TYPE OF WORK Siding ❑`Windows(no,header change).#__ rs i Inswation/Weatherization..- ❑ Doors (no header change)# Commercial Doors-require-an insp `ctor's'.Tevie'w ❑ Roof(not applying more than 1•layer of shingles) , Construction Debris will be going to V CONTRACTOR'S INFORMATION s • Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) 71 Construction Supervisor's License# (attach copy) Email of Contractor Ct.�f'er'rZaliye_U&9"gf2W � Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR/F THE SUBJECT PROPERTY IS/N A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only ' Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPAICAn9S SIGNATURE Signature Date 9 All permit applications are subject to a building official's approval prior to issuance. i DocuSign Envelope ID:59D75D3F-3DB24BB4-81D6-C961964720A7 Town of Barnstable n R AB E, Building Department Services �e MASS, m0 Brian Florence,CBO p Yd39. ♦0 iOlFa Apr"' Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1, Amanda Ruggiero , as Owner of the subject property hereby authorize A, n e 11/ Ay f act on my behalf, in all matters relative to work authorized by this building permit application for: 53 Sheryles Way Marstons Mills (Address of Job) OocuSigned by: ..l r ! .. r SYA,`r..c. >gna ure o Dwner S,1 a of A phc n Amanda Ruggiero /`- Print Name Print Name 8/28/2019 1 8:10 AM EDT Date t - '\ The Commonwealth of Massachusetts = Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):ALTERNATIVE WEATHERIZATION, INC.' Address:2 LARK STREET City/State/Zip:FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): l.❑✓ I am a employer with 16 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself[No workers'comp.insurance required.]t 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑ Building addition ensure that all contractors either have workers'compensation insurance or are sole I L❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance. ❑✓ Other INSULATION 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. ' 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for lily employees. Below is the policy and job site information. Insurance Company Name:LIBERTY MUTUAL INSURANCE Policy#or Self-ins.Lic.#:XW058867158 Expiration Date:06/07/2020 Job Site Address:5 City/State/Zip' Attach a copy of the workers' co ensation policy claration page(showing the policy humber and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. In . I do hereby certify under e s and alti s of a ury that the information provided above is true and correct. Si nature: Date: / Phone#:508-567-4240 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: e' DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE l O5/24/19 .THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED.BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Anthony F.Cordeiro Insurance Agency PA/CONNo Ex II: 508-677-0407 FA� No): 508-677-0409 171 Pleasant Street E-MAIL Fall River,MA 02721 ADDRESS: HSouza@Cordeiroinsurance.com INSURER(S)AFFORDING COVERAGE -NAIC# INSURER A: Liberty Mutual INSURED INSURER B: Ohio Security Alternative Weatherization INSURER C: Ohio Casualty 2 Lark St INSURER D: Fall River,MA 02721 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR FkUUL jUtSK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Ful OCCUR PREMISES Ea occurrence) $ 300,000 MED EXP(Any one person) S 15,000 A Y Y BKS58867158 06/07/19 06/07/20 PERSONAL a ADV INJURY $ 1,000,000 MOTHER: L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY❑ PRO- ❑JECT LOC PRODUCTS-COMP/OPAGG S 2,000,000 S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) S B AU OWNED M SCHEDULED Y BAS58867158 06/07/19 06/07/20 BODILY INJURY(Per accident) S TOS ONLYAUTOS X HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLYAUTOS ONLY iper accident) S X UMBRELLA LIAR X1 OCCUR EACH OCCURRENCE S 1,000,000 A EXCESSLIAB CLAIMS-MADE Y Y US058867158 06/07/19 06/07/20 AGGREGATE $ 1,000,000 DED I I RETENTION$ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 500,000 C OFFICERIMEMBER EXCLUDED? Fn—] N 1 A XW058867158 06/07/19 06/07/20 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA,its direct and indirect parents,subsidiaries and affiliatesshall be named as Additional Insured on commercial General Liability and Automobile Liability polcies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NGRID USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENT ¢ l ©191#°-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD a Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constrodtibn tSdpervisor CS-105454 `' JE*pires: 05/08/2021 TIMOTHY CABRAL r- 58 DICKINSON ST4ET;,_, v FALL RIVER MA 02721' Y` Commissioner �l�P CCU«2/�2C�`IC�G•C000 z�G� ��-l'GCl,�1:1-CGC�C.%P��.� Office of Consumer'Affairs and Bus.i.ness Regulation 1 000 Washington Street = Suite 710 Boston; Massachusetts 02118 Home Improvement Contractor Registration I qpe: Corporation Registretion: 175-683 ALTERNATIVE WEATHERIZATION. INC:2 LARK ST Expl Q;ion: _ 05;28/2021 FALL RIVER,i\r;A 02721 Update Address and Return Card. SCA 1 is 2oM•05117 Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corooration before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 175683 051ZW021 1000 Washington Strut -Suite 710 _ AT!ON.iNC.ALTERNATIVE WEATHERIZ . . . �iB osj jto,n;MA 02118 I / TIMOTHY CABRAL T 2 LARK ST: FALL:RIVER,MA 02721 lot vatiid without signature Undersecretary i IME A Complaint Call Report Printed On:6/14/2019 ;'"° 0a 53 SHERYLE'S WAY, MARSTONS MILLS rE°MP'� Case# C-19-502 Case#: C-19-502 Address: 53 SHERYLE'S WAY, Date: 6/13/2019 MARSTONS MILLS Owner Info: Property Info: LIMA, MICHAEL L& RUGGIERO, MBL: AMANDAL 53 SHERYLE'S WAY 045-050 MARSTONS MA 02648 MILLS Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Building Code, Medium Priority Phone Complaint Summary: Caller states owner cut down all the trees on his property, now runoff(mud)going into storm drains. Action History: Action Taken Date Description Fee Inspector Inspector Assigned to Complaint: bowerse Filed by: barrowsd Comments: Comment Date Commenter Comment 6/14/2019 andersor Dispatched inspector to check for evidence of run-off after recent rains. Date: 6/14/2019 Town of Barnstable Town of Barnstable Building Post This'CardSo That it is Visible From the Street Approved Plans Must be Retained on Job and this Card Must be Kept .iusnr�r,�, • - MAS& Posted,Until'Final Inspection Has Been Made. Pt 36S¢ �� Permit +'' Where a Certificate of Occupancy is Required,such Building shall Not be.Occupied until a Final Inspection has been made. Permit No. B-19-1676 Applicant Name: LIMA, MICHAEL L& RUGGIERO,AMANDA L Approvals Date Issued: 05/29/2019 Current Use: Structure Permit Type: Building-Deck Expiration Date: 11/29/2019 Foundation: Location: 53 SHERYLE'S WAY, MARSTONS MILLS Map/Lot: 045-050 Zoning District: RF Sheathing: I Owner on Record: LIMA,MICHAEL L&RUGGIERO,AMANDA! L a Contractor Nam Framing: 1 Address: 53 SHERYLE'S WAY Contractor License: �`�t 2 MARSTONS MILLS, MA 02648 - Est. Project Cost: $4,000.00 Chimney: Description: Installing composite decking replacing existing PT Permit Fee: $ 110.00 Wood rails and adding stairs and landing Fee Paid:` $ 110.00 Insulation: Project Review Req: Date: r' 5/29/2019 Final: Plumbing/Gas Rough Plumbing: 1 This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. { Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by the Building-and..Fire Officials are"provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: r' 1.Foundation or Footing Service: 2.Sheathing Inspection f 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed ____ _ Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: I ------------- �'WE �C Application Number........................ ................... ............ s ` snRr�srns�, •' MAS& g, Permit Fee :..I........0 .............Other Fee........................ a639• �0 TotalFee Paid.....................`o�.....�..Y...�...................... ...... TOWN OF BARNSTABLE Permit Approval by..� ..........,.'..........On...'!/�..`.-`..1... BUILDING PERNUT rvV........................................Parcel..........D..Jr............................ APPLICATION Section 1 —,Owner's-Infor-oration-and'Project Location Project Addres J 6�vP C Y l L s l,J`�1'� Village f\/\ac6A0rvn MA5 Owners-Name P lM C,, — e r d Owners Legal:Address 1 State Zip Owners Cell# E-mail Section 2 —Use of Structure Use Group Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3-=Type-of_Perinit� ' J ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) Finish Basement ❑ Family/Amnesty El Fire Alarm Rebuild IvJ -Decker Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ . Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify ' Section-4=Work�Description---�� ex 3i-k n vc�Q 2c�:1 ��S a i Application Number.................................................... i Section 5—Detail Cost-of Proposed.Constracti_ - - �, Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing IJ Total# Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ + ; Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No r act-—-a+P�• i i n cnm Q . ........... Application Number........................................... Section 9- Construction Supervisor f f Name Telephone Number I Address City State Zip License Number License Type Expiration Date Contractors Email Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section 10—Home Improvement Contractor I Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date ,Section 11 —Home Owners License Exemption Home Owners Name: (° Y 1C'P( L-mck Telephone Number 1 y-SZ I-,SS q Q Cell or Work Number ��O m Q I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the wn of Barnstable. CSignatu`r Date APPLICANT SIGNATURE Signature Date Print Name ln> C``j,w epl L,',.,na Telephone Number E-mail permit_to: J�� lY1 i �!j-P ��d CIM 6d, An4 Section 12—Department Sign-Offs i Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval z Section 13 — Owner's Authorization I I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of j ob) Signature of Owner date Print Name The Commonwealth of Massachusetts Department of IndustddAcciden& Office of Invadgadons 600 Washington Street Boston,MA 02111 www.mass.govh a Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information n / Please Print Legibly Name(Business/Organization/individual): Address: L2 cShaKt/ le City/State/Zip: A 4 s/ Phone#: .) y'S Z Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. modeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp-insurance comp. '_ 9. El Building addition. 5. We are a corporation and its 10.❑Electrical repass or additions 3.ET I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fin out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractor;have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy.#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c�qneppe f perjury that the information provided above is fate and correctS' ��� Date: G — �Pfione#: Of,j` kd use only. Do not write in this area,to be completed by city or town o ftial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person iu the service of another under any contract 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 join enterprise,and'including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the 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,§25C(6)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 commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"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 been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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 contact you regarding the applicant. Please be sure to fill in the permit(license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigatiow 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www:mass.gav/dia . s= Legend � d � 4 Parcels - own Boundary a450t6002.� n ` 0460/5003 Railroad Tracks .045019 t, #32 _��-#•1a9 Buildings #`2.8 046015002 r' 0 Approx.Building *�i►"��� 1� p�. l` , rJJ Buildings t #23 f,--' z t . Painted Lines �` ��' � Parking Lots �a 1} Paved Unpaved 045004 �,,.r'`r~ Q45054 -Driveways 045049 #4s I S � Paved ; 51 Unpaved #` #35 7t ?` Roads t 13 Paved Road Unpaved Road Bridge � ��,,.:�-^ •�� `� :. ��, i _ y,,,�.1-_-_,_._ •_� � Paved Median ` --Streams -Morky t� - t _� Marsh \, t Water Bodies 045065 �l '$ 045053 #54 t'1 #6 , . � 04 5a bw �� 8 tv d 045020 `* #66 ti . � - `� •�.�"�, - �'� 0,30016 045051 t r #65 t, � A•3 Y.i(t S 045021 #72 tit 045Q23 N.•:;.045a t 1, t1, / 045011 ; '' �' •#74 �'ti ` 1;84 , �'� #94@ *g Map printed on: 5/28/2019 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026ot 0 83 167 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch= 83 feet Q cartographic errors or omissions. gis@town.barnstable.ma.us i �oF1H ,, Town of Barnstable *Permit# M Expires 6 months front issue date A O• �. Regulatory Services Fee y ➢ARNSrABLE, r� h6 9 `t ;C e � Thomas F. Geiler,Director 'Dr a 4 2049 ®F Building Division egR�sT�� Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barns table.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red,Y Press Imprint Map/parcel Number Property Address _ h2.e - ` 'FI [c]Residential Value of Work (d SU u Minimum fee of$25.00 for work under$6000.00 r fff Owner's Name &Address Cj Ct I 1 \ l A wt _ S t� Contractor's Name C Telephone Number Home Improvement Contractor License#(if applicable) IS-6 O 5 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: L�51 1 am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) I t� Q Re-roof(stripping old shingles) All construction debris will be taken to ?A-jq jC 'S IkUI, ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is required. SIGNATURE: i Q;\WPFILESTORMS\building permit forms\EXPRESS.doc Revised 090809 BO of dui mg)�eguCalion�nd an ards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: 156038 One Ashburton Place Rm 1301 Expirat _5/29/2011 Tr# 283569 ; Boston,Ma.02108 _ T, =Individual _ CHRIS COLBATH'--� CHRIS COLBATH\ - �f- 383 OLD MILL ROAD. �Q a' Not valid without signature OSTERVILLE,MA 02655C_ '= Administrator I Board of Building Regulations and Standards Construction Supervisor License License.Z CS 49696 Er Expiration_5/25/, 010 Tr# 23478 M T s Restrict�,on .1 1.. CHRISTOPHER W C` �,.�._ iy iJ 383 OLD MILL RD Commissioner � OSTERVILLE,MA 02655 r 1 1 ' The Commonwealth of Nlassachttsetts Department oflndustrialAccidents !�? r2 Office of Investigations 600 Washington Street c �A;r Boston, MA 02111 y� wfvw•mass.go v/di a Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / i Q Please Print Legibly Name (Business/Organization/Individu �al): ut s C.� Address: City/State/Zip: J A 0 Phone M - 7 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ I am a general contractor and I have fired the sub-contractors 6. ❑ New construction employees(full and/or part-time).*" 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These stlb-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.) required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or addition 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or addition myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.) t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContraclors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. ff the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: Policy# or Self-ins. Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK.ORDER and a fin of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cent' under the pain and Penalties ofperjury that the information provided above is trice and correct. Si nature: Date: / - d Phone#• 5 08 - '71-7 0-77 b Official cese only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.'Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector d 6. Other Contact Person: Phone#: r Information and Instructions Massachusetts General Laws chapter 152.requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract 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 receiver or trustee of an individual, partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the 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, §25C(6)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 commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states"Neither the conunonwealth 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 been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractors) name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit 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 pen-nit or license is being requested,not the Department of Industrial Accidents. Shouldyou 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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 contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a.reference number. In addition,an applicant that must submit multiple permiUlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to'butrn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should your 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 Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.tnass.gov/dia opIHiEro� Town of Barnstable do Regulatory Services 9hc ss� � Thomas F. Geiler,Director Eo � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Prop e rty Owne r Mus t Complete and Sign This Section If Using A Builder as Owner of the sub' Ject Pro e P rt5' hereby authorize s L 16 ,,A to act on my behalf, in all matters relative to work authorized by this building permit application for. (Ad r�ss of Job) Signature okOvner Date Print Name i If Prop rtY, Owner is applying for permit please complete the Homeowners License Exemption.Form on the. reverse side. Town of Barnstable Regulatory Services • Thomas F. Geiler,Director snatasr"LE, h''3 1639• Building Division . �� PIE0 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 . HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT 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 homeowners to engage an individual for hire who does not possess a license,provided that the owner,acts as Supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, 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 State Building Code and other applicable codes,bylaws,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 comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner 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 the homeowner engages a person(s)for hire to dQ such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section-2.15).This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible:- To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner 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 t amend and adopt such a fomJcertification for use in your community. Q:\WPF.ILF-S\FOR.MS\homeexempt.DOC yo�Tesr°° TOWN OF BARNSTABLE Permit No. ..Aq6M..... ° BUILDING DEPARTMENT ; TOWN OFFICE BUILDING I-'Cash �onr HYANNIS,MASS.02601 Bond ...... .. . CERTIFICATE OF USE AND OCCUPANCY Issued to Paul, Pnzx1,.amn(%an Address :Lot 04s, 53 Kialoa Drive IIArstons Nills, UA. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY,COMPLIANCEWITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. AuaU a.... 19.....f... ....... ....;.... ............... 4 Building Inspector • 1 ��..° °•.w TOWN OF BARNSTABLE _ BUILDING DEPARTMENT TOWN OFFICE BUILDING rua HYANNIS, MASS. 02601 �o r�,r�• MEMO TO: Town Clerk FROM: Building Department DATE: /e2J An Occupancy -Permit has been L issued for the building authorized by BuildingPerm�t—#. ....�0� ��.......................... .............._.........................».......__....................___ issuedto ..... /. /f!L .... .. ...........,Q........................................... . Please release the performance bond. { a TOWN OF BARNSTABLE, MASSACHUSETTS, "'BUILDING PERMIT t A=46-15 DATE�LrLj� �a�y 19 ell PERMIT APPLICANT Nort{1 .alki, P nt ADDRESS (Y • > n h I ( it L-/ l.C) ti zo, LICENSE) y- PERMIT TO R11? 11-1 f)o is y r•� , NUMBER OF 1 7 4 7 ( ) STORY :".J a ! '- 1(PR;P'hl.E f)1y''� � li DWELLING UNITS (TYPE OT IMPROVEMENT) •� N0. (PROPOSED'USE) ' 1 S �72y[r3 Li/ ZONING AT (LOCATION) LC)ti~" 14 'i� ' DISTRICT (N0.) +. (STREET)�� jcj- `7T�j iTT� ' BETWEEN AND - (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: .('iErwac;o #86--715 OR VOLUME 1696 �i'7- FS ESTIMATED COST $ JL/ UU0• Va FEEMIT $ 1'1(1 (CUB C/SOUARE FEET) ` J OWNER Pcatli Pc?7i!'ea;nj:)r c:1t- BUILDING DEPT. , 'J; A ADDRESS 24 CC)tuit 13a L)r1Vi,� C;C1i':I11 7 BY j THIS PERMIT CONVEYS NO RIGHT T_O OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. E1T'HER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,,-MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS-MAY BE OBTAINED '• FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS } OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. a MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHEREAPPLICABLE-SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING :AND { I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL ' i MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE - ' OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUI 1 INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS r, z z rto z 3 HEATING INSPECTION APPROVALS ENGINEE DEPARTMENT OTHER Z � BOARD 0 HEALTH Co PiucPs7 �1.987 ldn a WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT.W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK, IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN ! CONSTRUCTIOP. I PERMIT IS ISSUED Al' d-$D ABOVE.. NOTIFICATION. (� .o3.yrr, ' N Lor 3 Old r , 11z.s 00 M Lo s "AS BUILT" PLOT PLAN TO THE BEST OF MY INFORMATION,' MASS. KNOWLEDGE, . AND THE Lor y Ki0tOA b2IIyE k0No is ,� f � 'SON THIS /� J. D%�CARN /NC. PLAN HAS BEE �� LKDJ. N THE SWAN RIVER PLAYA GROUND AS IN (6 T e AFIN 35 ROUTE 134, UNIT 2 Pao. 278 0 �� SOUTH DENNIS, MASS. 02660 DATE : q16187 SCALE: l�= yo G o7 JOB NO. 3100-OY CLIENT- Noe7litAee' ENT. DATE REGIS TWED. LAND SURVEYOR DR. BY - C.A.V. SHEET —I OF I 13PS 17/.�I/Z K as Assessors offioe (1st floor): /_ Assessor's map and lot number .......` .(0 1.V................ : SEf.`Rdp' i "S��'' CC ` � . flFTHETO` Board of Health (3rd floor): _ INSTALLED �N C®E 5 e� ♦'' Sewage Permit number ........e.b !S ��.>..... WITH'TITLE... ........................... ... ... 9TADLE. i Engineering Department (3rd floor): - , n / ENVIRONMENTAL COD raea House number ......................... ......r.3. .. ..d.9. TOWN REGUL.ATIOB� °„�i63q'd�e�'' 0 ypV APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF -BARNSTABLE BUILDING INSPECTOR APPLICATION FOR 'PERMIT TO �. �. 1�.�.... 1�.. �......'.... TYPE OF CONSTRUCTION ......... � .. .S./.... �:.lU... .!.r4...� J...(:U..� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: a / n •J� L.o - `� . .. ...(Q.`f:......10Tr Iue. 0.fk.....sC �00 �T r ....... Location ................. ...................... ........... . .... 2 ........ ............. .. �( I / 1 >� Proposed Use ........'.\.e-S.�..C.„e/1...�.!..Q....I............`.....�..M...�........................................................................... Zoning District .... ..er. .S , j � � �. ...�................Fire District............... ..............�.a Name of Owner ...A.o..I..... .....Addressa.Y..CO�Cd. �..��.S�t...... �................. Name of Builder /Varl.k...L.a.t......0—AJ_ ..............Address lV.t. 4.. ;.I�.....L�-r. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ............LP................................................Foundation ..........a.4.... ...c.0.......................................... Exterior ..� !G.r..... �}.� .�.IG ..... ...CC...4`!..C.XQ.(.5Raafing .....�../... �1.. 1. ..... .....�. J 1C.�...... ... .�.. .. . Floors �C rnt..`} ./... .d.�.. .............................Interior ... .pC.T. . 'rL�e.. ..../.�`� !../�✓(�.C'. ..... Heating ....1.....d.r. ..... C�..I........W.Q.44.! .........Plumbing .... .�.`rG��¢ n� 5�......... ........... Fireplace � r... �, 0o0 p ...................... ..................................................... Approximate Cost ...................... ..................... .. . Definitive Plan Approved by Planning Board �ae__�!_-__�'_____19_--- Area ............. :..................... Diagram of Lot and Building with Dimensions (r� Fee ...... .. .... ............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH G 7 f 119, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Bornst b regarding the above construction. Name j ........... Construction Supervisor's License ... ........ W-NAMPEDE PAUL 30685 ' 2 Story o ................. Permit or .. ................................. Single F ily .Dwelling .......................................... Location ...L.ot....#.4.........5..3...........................ive Marstons Mills . ............................................................................... Owner .....P.au.1...P.e.nn.amp.ede........................ .... .. .. .. .... ....... ....... Type of Construction .....F...ra.....me............................. ............................................................................... Plot ............................. Lot ................................ Permit Granted .......Apxil...Z9............119 87 Date of Inspection ...........19 Date C mplet d ...19 /70 Assessor's,'offioe Ost floor): F - -� Assessor's map and lot number—,:•:.:.. .. .... . ........ ......... Q . Board of Health (3rd floor): Sewage Permit number ........ b 7 1 S ......•... Z BAH35T1►DLE, i Engineering Department (3rd floor): °o YA°a m� House number �}- / / o i639 �0 APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P,M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........ 1� e. . .....................................'....... . .... TYPE OF CONSTRUCTION !.:'.C1►.. ..A .... .! r-f.../............,.,1.. ,U, � �.1., .. ................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location L.o T q D u o f SC O..(......�..S....�....r ProposedUse ' . .e-S r L L' n� .! Q..../...................®..........................,................................................................ f� , Zoning District .... 5..:..�!..e...AJ..��,a...�................Fire District 02.0Name of Owner ... ../...... .! . Address � ...... i' ...,...,........ ,�/ 1 Name of Builder lvtl. L ...�:.G,..��c........�- .................Address .. ...��-...l ,.�)...!!�.%.�......L�J. .e Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....................................................................Foundation ..........�� ... ..0...................:. EXIe iOr ..t.... .r.!!'.....: .......... ....�!.....r.�G. S.Roofing ..... ..(... ?.�d.......�.T......s. ..,.'�. ..f.e .,.r...... Floors C..e. �..'.`.......I... .G6.G`�.............................Interior ..C��.P...� . . i..1..(.� . / r � i . Plumbing ..... D . . C.� f.tf•/ .f.n.d....,...........Heating „ ..... ........................................ . t Fireplace �.. ..��.............................................Approximate Cost a�, Q O i .......... ................................................. Definitive Plan Approved by Planning Board aa -------19_ 4. Area ...../. �....�J..... ............ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i d OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstab a regarding the above construction. • I Name .. ........ ........................... ...................................... Construction Supervisor's .License .. ..� / �. PENNAMPEDE, PAUL -A---4, 5 30685 lj Story No ..............:.. Permit for .................................... Single Family. Dwelling . ................................. ------ ---- Lot #4, 5 3�KdirpaA-lf64a�—D rl-ji*.v.e Location ................. .......... ................................. Marstons Mills. .. ............................................................................ Owner Paul Pennampede .................................................................. Type of Construction Frame .......................................... ............................................................................... Plot ............................ Lot ................................ April 29 , 87 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed .......................................19