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HomeMy WebLinkAbout0053 STARLIGHT DRIVE fl ��rl _D�' n ..y � l+-r _ - ...++w.�. .R �.,�a.�.:.erNiue.,-. ,�i.,.s•_..�c�.�.�d.y....�� .i..�a'da:.........,,n..—pie .�_r�.:b � -`+.�'--.w� ��L—.c..��.�n^'^"T I�"T'' _ ...-e ._, .. - ..�.. —__ _. 1-�..:,,,A Town of Barnstable .*Permit it Expires 6 months from issue date �7 Regulatory Services Fee II snsxsrABLF4 1639. ,,� Richard V.Scali,Director zlprtess Building Division Tom Perry,CBO,Building Commissioner SEP 1 200 Main Street,Hyannis,MA 02601 7 O www.town.barnstable.ma.us �f U OF BA J�(+,CT�� Office: 508-862-4038 Fax.USOts�/9�6�30 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY I O D _ fl 2 C� Not Valid without Red X-Press Imprint Map/parcel Number 63(� ",-Propert Address, S aja&v ❑Residential Value-of-Work$ 7. e:,as Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address -- 41CIC, Djcxrz4 L":5Z3 -SfQ-;1LU c.kAj bri ve nnaw&LLt4 M.Lftk M R 60l 6� s Contractor's Name Telephone Number .fib% y a b ,Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I 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. PermitRequest(check box)Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be�t�aken_to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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 co of the Home Improvement Contractors License&Construction Supervisors License is r quired. -SIGNATURE: w QAWPFILEMFORMS\building permit formsEXPRESS.doc Revised 040215 27ie CommonitveaIth of Vassadlrusetts Deparbnent o,fIndzutrid Accidents Offwe of bnw igadons 600 Washington,Street Boston,AM 02111 fvyin rnasmgovfdia Workers' Compensafim Insurance Affidavit:Builders/ContractarsJEIectricianslPlumbers Applicant Infarmaf Gn Please Print Legibly t-Name(BustnessganaationfF�dFvit]na1}: d��r�,ct ��rec c- c. cAddress: t_ea CA_T- b N v-.e r-City/Stahel Phone g-C ao- L&O S Are you an employer?Checkthe appropriate boz: Type of project(required): I.El am a employes with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full anaor part-time).* 'rave bred the sub-contractors 2.❑ I am a sale proprietor or partner- listed on the attached sheet. 7- ❑Remodeling strip and have no employees. . l'hese sub-conlractors have g- ❑Demolition wodking fax mein any capacity. employees aad have workers' 9. ❑Building addition [No a-mbecs'comp.insurance comp.insurance-1 required-] 5. ❑ We area corporation and its 10.❑Electrical repairs or additions G J]am.a homeoumoer doing all work officers have exercised their 1L❑Plumbing repairs or'additiems ='�f[No workers'gyp- right of exemption per MGL 1.2.[1 Roof repairs insurance required-]F c.152, §1(4X and we have do employees-[No workers' 13.❑Other comp-insurance required.) 'Any applicant diat checks box#l— also fill out the section below showing thenarorkenecarnpenmtion policy infntmsEioa. 1 Homeowners who submit This d5darg1 uuff:catiag they axe doing all waal end then}tire outside contractors aid submit a new affidavit indics=.-SiICIL fCan=ctors that check This bare must attached ou'additiaaat sit showing the xzine of the sub-contractors said state whether or not those entities ban emplvpees. Iftheaub-contactanshaveemployee%theymust provide their workeo'tnmp.policy numher. I am art eutpIoy�er Ebert is prauidirt�;rt�orkers'coerpertsrrtimt insuratrce f or ms'enrpIo3�ees. Mom is the policy and job site information. Insmamce Company Name: Policy 4a or Self-ins.Lic.;�: F-Viration Date: Job Site Address: . . City/State/2ap: Mach a copy of the workers'coccrpensation policy declaration page(shoving 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$1,50D 0o andlor 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 adi ised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for imsurmm coverage verification_ Ida IterBby under thept&is and penalties ofpedury that the irrfarmadon prm i&d above fs trace and correct (Simature: C Date_ S- 10 l S e Phone 47 :�D79� Ll aCD - ( &US" O,o"acial me only. Do not write in d ds area,to be cornpleted by diy or torn/of ciao City or-town: PermitlLuense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Citylrown Clerk 4.Electrical Inspector S.Plumbiug Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts Geheral Laws cbaptEir 152 requires all employers to provide workers'compensation for their employees. Pmsuantto this sfaftiE;aa.enplvyee is defined as."_.every person in the service of another Bader any contract of hire, express or implied,oral or " An ernpkye3-is defined as"air individnal,parhaersh�p,association,corporation or other legal entry,or any two or more of the foregoing engaged is 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 th=iin,or the occupant of the - dwelling house of another who employs pfssons to do maintenance,contraction or repair work on such dwelling house or on.the grounds or building appurtenantthereto shallnotbecanse of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also sues that"every state or Iocal 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 bi ra_n ce.cove)mge required_" Additionally,MCrL chapter 152, §25C(7)staters"Neither the commoavmalth nor any of its political subdivisions shall enter mto any contract for the performance ofpublic work until acceptable evidence of compliance with the ius rran ce._ requireniems of this chapter have been presented to the contracting authority." Applicants Please fill out the wozi-err'compensation affidavit completely,by chec1ci g the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone numbers)along with their certificates) of ffimarance. Limited Liability Compames(LLC)or Limited Liab>7ityPartnerships(LLP)With no employees other than the members or partners,are not regim-ed to casy workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affida-vit 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 ret=e:d to the city or town that the application fur the permit or license is being requested,not the Department of InrhT.ctrial Accidentr. Shouldyou have any questions regarding the law or ifyou am required to obtain a workers' compensation policy,please call thhe Department at the nnmber listed below. Self-iosLIIerl companies should enter their self-insurance license number on the appropriate line. City or Town Officials . f . 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 ourt in the event the Office of Investigations has to contact you regarding the applicant: Please be sure to fill in the pen�uit/licemse number which-will be used as a refe=ce number. In.addition, an applicant that must submit multiple.pennit(Ucense applications in any given year,need only submit one affidavit indicating current policy information Cif 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 fvtnre permit en 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 (Le. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit 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 Dej 7tnenfs address,telephone and fax number. The CO=1MWe&1tbE of Massachusetts ' Degartnent cif Iadustdal Accidents ��e of�.ve�gatio� �Q4-�ashin�tan S'i�t Bostau.,MA GI I If TeL 4 617'27-4900 Qxt 4€6 or 1-977-MASSAFE Fax#617-727 7M Revised 4-24--0 7 ..govldia Y Town of Barnstable Regulatory Services ` °FTt last, Richard V.Scali,Director .°� Building Division * szes� Tom Perry,Building Commissioner NABS. am39. �.�� 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: S— JOB LOCATION: ( number_ Utreet village "HOMEOWNER":�I(�l OL PQQ��Cc� SOS L1.10 — (80 ' 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 pr a ure uirements and that he/she will comply with said procedures and requirements. a, 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 do 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 form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 �VE Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO 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 I, r//11 A AAm (Way ,__ �Q.Ire.k rat , as Owner of the subject property hereby authorize m 000+L:p to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) I Signature of Owner j Date •Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit formsTMESS.doc Revised 040215 i f o la o q ?S oFnrq,,, Town of Barnstable ' *Permit# �0 Expires 6 months from issue date ' Regulatory Services Fee 3.S MASS 1 � Thomas F.Geiler,Director -PRESS PERMIT Building Divisio� Tom Perry, CBO, Building Commissioner Z0�2 200 Main Street,Hyannis,MA 02601 AN 2 s www.to wn.b amstab l e.m a.u s Office: 508-862-4038 N�' -790-6230 EXPRESS PERMIT APPLICATION - �IAL �5NLY Not Vafid without Red X-Press Imprint Map/parcel Number i Db —O ,�,R Property Address �.� C Q c-lic;U.'1 P [pr i.�t o c C-), ki U ED Residential Value of Work ?'cp n Minimum fee of$35.00 for work under$6000.00 Owner's Namd&Address '(,NA M ?o ce�r� Z3 Q 1K c_ Contractor's Name Telephone Number_ .§`p� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor © I am the Homeowner ❑ I have Worker's Compensation Insurance Insurarce Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑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 �pp required. IGNATURE: IWPMES1F0RMStbm7ding permit fnrmslEXPRESS.doc :wised 070110 The Commonwealth of Massachusetts Department of Industrial Accidents 9.3 Office of Investigations . 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): . J41 A m �Zc e\, c_ Address: S 1scn ---^� City/State/Zip: �:���t� . QLk Phone.#: JL�).u a_0 1 &0!�, 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. El New construction . 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an capacity. employees and have workers' Y P t1'• 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.9I am a homeowner doing all work officers have exercised their l l.❑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 C 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. 1contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.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 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 certify and ns•and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 60.,J 41.1 t� -- 1A c,S— - Official use only. Do not write in this area,tb be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): .'l.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 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-contiactor(s)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 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 io any business or commercial venture (i.e. a dog license or permit to bum 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:. Thte Commonwealth of Massachusetts Department of Industrial A.coidents Office of Investigafiens 600 Washington Street Boston,MA 02111 Tel. #61 7-727-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia THE Town of Barnstable Regulatory Services I SLAM ABM : Thomas F.Geiler,Director 94>,, 16.39. .•� Building Division lED IVIl►I� 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: ,S :DS � G=i olltt' number (� street village "HOMEOWNER": SOBS � O 111i name home phone# work phone# CURRENT MAILING ADDRESS:. 010 c &1 c� 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 Persons)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 req irements`�,_ ignature-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 do 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, I 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 form/certification for use in your community. Q:forms:homeexempt �IK Town of Barnstable }• Regulatory Services BAM Thomas F.Geiler,Director 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 Property Owner Must Complete and Sign This Section If Using A:Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM&O WNERPERMISSIONPOOLS J r��,-- ----- ----�-� ��3 s-�WI�� �� j I � �- ��� ��yr�J� ��f 2 r'r�� /t��� MGM r�� r ' F - • i \ + y f 40 J.e r 1, k* Aelk ,«� �yl i'""' i�!T �,. +s .�.. _ i° _ . •t\: �'. •'�,�'"' + 9 ems. ., - do 444 A�e� t� ^L r,� ;'p'� �. '.1•��r .Y'�t Y.�` �i. 'l} � � ,fir � •\ `�c�; `•,�; rr. � I ,"_ h ,+ j �•r. �'i4 - it 1�yfr �`�1'�► ' _ ` a Y y�r 4 r 00, 44 t All Woo or 10 Op Arm, jol r I );•'J�8" r i ' - R- y °*THE T TORN OF BARNSTABLE i i BARNS LE. "b 9 � ��� BUILDING INSPECTOR ' O0 YAY a 24 APPLICATION-FOR PERMIT TO ....................................... 1.�Y.s�7 ........................................... TYPEOF CONSTRUCTION ...., / /L1 f.. ............................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: r The undersigned hereby applies for permit according to the following information: Location .... �./'.........�.5 . . ..� .. �/G :S.. .... Proposed Use ..L.VAE...........( /��( 6' ..../1C RA .. //.T..il%' /G r ...... ........................................ .. ZoningDistrict ........................................................................Fire District .................................................... ....... ................ Name of Owner( .. .. ..... . �2s—Ze-Address(c'... (�/Sf/OG`sir � %z SC / i c.c Name of BuilderC/91VJV.4,1__ � �Address .... 5/ ........................................................... Address ,/,a/'!!!! ........................................................... Name of Architect .:................. ..... io Co C2��� Number of Rooms ../ � — el�..........................................................Foundation ...................................................,.................:'........ , Exterior .a�/�l//.. �r .r...vv.c�c�.d�.......................Roofing Floors ......................................... .....................Interior .... C . .��..�......�f'�.r,Efi�... ....C:�.............. Heating /..�a. ..u! ../ .....................................Plumbing ... .. /.4c. ...-..� tc.l....'......... ......... Fireplace .-.s.............. ......Approximate Cost �/ . .............................................. ........... ...................................................... Definitive Plan Approved by Planning Board _____________�_—___________19 Diagram of Lot and Building with Dimensions 3 /&cO / SUBJECT TO APPROVAL OF BOARD OF HEALTH Li w o � ¢ = w Lj Q Q z � WL� _1 ctw z 0 0 > < ¢ c� X < � Li LL mO y v. Oco 0 N� >_ Z �I �I9/ll9Ci= _ (L LLJZ 1 - J _j / o � � Q � �. f) Lu C`` V)LIJ can`., a ode Lz s8 ` ¢ U oQ z of r>, n ¢ 1 0 s z p _j ? < I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. I Name ... '..................................... Cammett Builders,, Inc. No ..... Permit for ..........one story .......................... J � in�le family dwelling ................... Location ..........Starlight Drive Starlight....................................... Marston Mills ......................... : ..................................I....... Owner .............Cammett Builders, ...... Type of Construction frame.............................. ......................V......................................................... Plot ............................ Lot ............. ............ June 19 72 Permit Granted .... ... .......................19 0 7 Date of Inspection I I .... ............... ....... . Date Completed ...... ....A4, 1p.;F!!...19 PERMIT REFUSED ................................................................ 19 ............................................................................... ��................................................................................ ............................................................................... ............................................................................... Approved ................................................. 19 ............................................................................... ...............................................................................