HomeMy WebLinkAbout0007 TIFFANY ROSE LANE ' (� o�
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Town of Barnstable *Permit#0?0Q7o6021�
Expires 6 months from issue date
X®p �SS PERMIT Regulatory Services Fee
JAN 16 2007 Thomas F.Geiler,Director
Building Division .
TOWN OF BARNSTABLETom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.townbarn table.ma.us
Office: 508-862-4038 Fax: 508-790-6230i�
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red.Y Press Imprint Y
p/parcel Number o 3 / o o Yo t 3
,perry Address 7 r o
� po
Residential value of Work Y// Minimum fee of$25.00 for work under$6000.00
rner's Name&Address l� (,`C 0 S 0-/j
intractor's Name OWLP—dJ�Bd � I Telephone Number
)me Improvement Contractor License#(if applicable) t
It Aa-appfimbic)
orktnan's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I AM the Homeowner
have Worker's Compensation Insurance
surance CompanyName e,bO 9am �`�u�
orkman's Comp.Policy# l0 to Oct
opy of Insurance Compliance Certificate must be on file.
;rmit Request(check box)
, /Re-roof(stripping old shingles) All construction debris will be taken to elomr s Z �SpoSQ( S �c
❑Re-roof(not stripping. Going over existing-layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders. U-Value (maximum.44)
'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 opy f the Hom r e ent Contractors License is required.
',IGNATURE,
rForms:expmtrg
xvise061306
The CominorifvWd _of Massachusetts
Department of Industrial Accidents
Office of Investigations
600,Wiishington Street
Boston, MA 02111
°'� SV•'. www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
..Applicant Information L Please Print Legibly
Name (Business/Organization/Individual): o-,lnz
Address: . S Lt,d�S j '�
City/State/Zip:
j( - - fT : .3�3�q Phone #:
Are ou 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.❑ is 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 tY• 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.t
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions
myself [No workers' comp. right of exemption per MGL 12. R of 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.
*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.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: yr /1`e- /JS. co
Policy#or Self-ins. Expiration Date:
Job Site Address: I+ �O C City/State/Zip:
Attach a copy of the workers' compensa ion 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/tereby certi and the a' s nd a alties.of perjury that the information provided above is true,and correct.. . .
Sijznature. Date:
Phone#: J p
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#:
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: r
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-contractor(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 periruts 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 gyve 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 eat 406 or 1-877-MASSAFE
Fax 4 617-727-7749
Revised 11-22-06
www.mass.gov/dia
Town•Of Barnstable
Regulatory Services
Thomas F. Geller,Director .
XAS& N1� Building Division
TomPerry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-403 8
Fax: 508-790-6230
Property Owner Must
Complete arid*Sigh This Section
if.Using A Builder
(� SIM , ,as.owner of the subject property
I,
hereby aori
uthze
o to act on my behalf,
matters relative to work authorized by this building permit application for:
in L (Address ob)
7
Signature of Owner Date
print Name
Q:FORMS:0V NMZ 2 ERMIS SI0N
L
Q 310 0 g013
HOME 110111PROVZMENT CONTaAcr
Branch Name s �✓ Dale: I U r7 Sold Furnished and h mued by:
THD At-Home Services,Inc.
d/Wa The Home neltot A"ome 9QYie6
145A Otecawood Street,Worcester.MA 01607
Branch dYmbtr._ 3/ _ Job 0-—'IiS L o son - Pwc:548-756-28510
Pademfl'li' tits 02e)a fllCoecLice1642T
CT Lis a s6S722: MA Kam lmpto etomt CaealatOr atE•atzaar�
Installation Address: 1`7 ^1,' �,.i I�os S .LA A'ir 'd
City State Zip
rbeWre farts 0 b of Driver's Lla a&Ct Malve Went pane or.
Gut a Hr 0 71 ( )
Rome Addreas:
(If diffemtt from Installation Address) City State Zip
E-mail Address(to mocive updates and promotions from The Home Depot).
Prolttt Information: UWGIYou("Pumbasa'y,the Owns Of the property located u the above installation addrt:ss,offer to
conaatt with Home Depot U.S.A.,Inc, ' omc NA)to fy rang mish,deliver and are for the Installation of all materials as
described on the attached Spce Sheet 0 :14,ioeotporattd herein by reference and made a putt hereof.
Hone Depot reserves the right to cancel tbb contras+ H.upon t.-1113Protlon of the job.Home Depot determines that it
cannot perform Its Obligations due to t,strnetural problem with the bomt,pricing errors or became worts regnlmd to
complete the job vas not Included in the Spot Sheet or Contract,
DEPOSIT PAYMENT OPTIONS
4&tvj 10"vadliaaionrndlorCrodboppeoWlJ
CONTRACT AMOUNT S t7 t tone
nett ar a Para.srrelw Kwuy Order )VF 7Nt�rrd
(Meat payawtc a 7we Nmae Deaoq. �Iw
r"LESS DEPOSIT S O � 2. credit Cud•and/orot6e.peyrmroopt.ont-Circle floe Below N
VW MMUCard Olreo"r Ar bAcan JtateY
BALANCEDUB
ON COMPLETION S M C¢9 7.0 D Thc Namplot Haft rmprovemnet Lora 'two qzov&Z Credit Card
IAe.r Amdut r,elisuaa Aeeegat (NIL RDCC ONL
'Mialntnm 2S%of Contnict Amotmt due upon
execution of two Contract. Avaau"k CC Rddn�S;_ 0IIL Q KoCC pNLV)
AC W.A ' �P-Date: .._
Nmcukappsanoau W J J&AP? k S'MaSe N
Indicate Payovent Method For By my/our sigmture below.I/We agree to a11ow Home Depot to
BALANCE DUE ON COMPLETION*•: charge t1fEr end credit card far the deposit indicated
6a3S-3 92---a'73 —
ttoWer s siaastute ur
'•May be suDJect to Credit Approval,fund HIL or HDCC Authorimtan Codes
Verification and/or Credit Card Authorization aa(t FIQ Payment
� egos � ao
Purchaser agreea that,immediately upon tompled0b of the work.Purchoaer will ezecuto a Complotlon Cerificate and P nn
balance due. Purehaaer 81SO agees to be jointly and severally Obligated and liable herpmder. A y
Ev Astrcement:This 40temerrt and ill attzchmtnm,including any financitig agreement.contain the complete agreement
between the parties and can net be amended or modified unless in writing in a separate agreement Signed by both pattim
NOTICE TO PURCHASER
Do not sign ibis contract before you read It. You arc ttrtltiod to a completely Riled-in copy of the contract at the time
YOU sign Keep It to protect your tlgllta. Do pot sign r CampletIon CertHltate before tbfa project is eompkto. Law
Prohibits bone, puir cuntractors from rag11165"or accepting a Completl0a Certificate signed by the o'wuer prior to
the actual eomplettoq Of the work to be performed under the contract.
You may canal tbls trouaaettan any time prior to midnight of the third business day after the date of this eoatract See
Notice of Cancellation for an ezplar211108 of this right. There curl[be A 1"Ce cIl& a equal to 10%of the contract
amoglt U job is cancelled by Pumbaser AFCER the third business day,but BEFORE Inattritsh are OrdoretL'There relU
Da a service charge equal to 25Sre of the contract amount if Job is Cancelled by Purchaur AlF'j ER materials are ordered.
BY MY/OUR SIGNATURE BELOW, VWS AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. I/WR
ACKNOWLEDGE RECEIPT OP A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE
OF CANCELLATION.
BY MY/OUR SIGNATUAE BELOW.I/WE UNDFJLSTAt&THAT THE AGREEMENT IS SUBIECT TO REVIEW Ol'
MY/OUR CREDIT HISTORY AND VWE AUTHORIZE ROME DEPOT TO VERIFY AND RE MY/OUR CRBpIT
RECORD WITH AN IND ENDINT CREDIT REPORTING AGENCY AND RELEASE THEM FROM All LIABILITY
INCURRED FROM INA VERTENT OMISSIONS OR ERRORS.
SUBMITTED BY:
Da cc!_,64z—e' --
ACCEPTED BY: •
Hem net Dme' O
Name WRq Date:
NOTICE:ADDITIONAL TERMS AND CONDITIONS ARE STATED ON THE REVERM SIDE
AND ARE PART OF THIS CONTRACT
10-24•06 C-SC Whltc-8ranchFb Ydbw—Cwtartts "_Solo,COrtcultaN
50 39Vd 609LbL889 TS'bT /itR7/Qp/ra
119-1 100/100'd 096-1 6006991909+ S301AUS 310H 1V Oft-A011 PdVE:20 100E-9l-or
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Re Board of Building Regulations and Standards
g istrati o n;;;:-126893
,� Expiration__873/,2008 One Ashburton Place Rm 1301
t� 'r - .f� Boston, Ma. 02108
J �� hype Supplement Card
THE Home Depot`,AtlHome=Serve
WCHAEL BEDARD - ,_ %t1
3200 COBB GALLERIA-r*-WY#20
AVANTA, GA 30339 J
Administrator Not valid ithout signature
t i- ✓ y �
Assessor's offioe (1st floor):
Assessor's map and lot number ..;.... .........��.:��....d�� THE TOE`
Board of Health Ord floor):
Sewage Permit number �... 1.....`....... = EAMSTGDLE,
Engineering Department (3rd floor): moo BI o
.House number 3
AR
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 ........ . .........
TYPEOF CONSTRUCTION ................fN�D....................................:..................................................................
........................:......1...�.......19......
�
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ....... fi... .3 .. . G6 ... 1 A' �a /l) �...... l►�..I,�.�.5
— -
ProposedUse ....................y... ........... .............................................................................................................
�J .......................................................
� C ,, ` rn / C
Zoning District .......!!�-::�.....................................................Fire District ...�j!��QQS........(/..{.!.�.�.5.........
Name of Owner .. K.. ...� IL...... P:..Address .. % -�.'" c. �:.V,�L.4c
Name of Builderfl/.!1. .............................................Address ..: .,), ............................................!..............
Nameof Architect .......//...........................................................Address ....................................................................................
(l/
Number of Rooms .............Foundation .... l!.�!��E% fJ <
k7)/o
Exterior t!V/C. � . )..( .. ..... �:: ......Roofing ................. .......�. ...................
\A c.� L /�'..�....fj.. 97 � �6Cr ...................................
Floors ;.f ...../ .... ', 1` .................... I.................Interior .................J�"1:.... ;......
Heating , ...... .q...... ................................Plumbing _ �A7.T► J
Fireplace ..................................................................................Approximate Cost .............. ..�T.:?:..a
............................
Definitive Plan Approved by Planning Board _ �11�:_ �;_____19 jU . Area ..........................................
Diagram of Lot and Building with Dimensions ?
Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
X/10,
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 !?. .. L .. ...�
.�,. . .
Construction Supervi'sor's License ......� .......
GREENBRIER CORP. A=031-004-006
031-005-012 ,
No 30862 Permit f r ....1 z....Story...........
Single7amily Dwelli 9.........................................................
Location .....Lot #30, 7 Tiffany..Rose Lane
.....................................:..........
Marstons Mills
...............................................................................
Owner .....Greenbrier...Cpr.P.!.....................
.. .... .. .... .. . .. ..
Type of Construction ....Frame
................................
...............................................................................
Plot ............................ Lot ................................
Permit Granted .........June. 15.f..........19 87
Date of Inspection ....................................19
Date Completed ...................19
L "
ofEre TOWN OF BARNSTABLE Permit No. . 30$6.2
BUILDING DEPARTMENT
D°8;a I TOWN OFFICE BUILDING Cash
....
�rcuvR HYANNIS,MASS.02601 Bond
CERTIFICATE OF USE AND OCCUPANCY
Issued to Greenbrier Corp.
Address Lot #3 0, 7 Tiffany Rage Lane
iarstons Mills, Mass.
1 USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
.......... July..�8....., 19....87............ ..........
G1i1
Building Inspector
1
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
_ 2 ST =ru a tOWN OFFICE BUILDING
t
�679' HYANNIS, MASS. 02601
f '�o rnr►•
MEMO TO: Town Clerk
FROM: Building Department
DATE:
An Occupancy Permit has been issued for the building authorized by
BuildingPermit ............................................................................».»..._......».........
»». .......»»
II issued to !....». .... .% _.1..................._..........._..._............._
Please release the performance 'bond.
i
i
' I
r V': ,r. •• 'fit - � tr �,yJ
•q' ,\.•-.:i'.':.-.�,a. .:.•�:�:i.fit• `•• `, I•i'�� I'.. • �.1 1 B U'�,,D PE�`����.• ,
TOWN OF BARNSTABLE, MASSACHUSETTS
A=031-004-006-031-005--OPE J'und 15, 19 87 PERMIT NN
APPLICANT Greenbrier tooip. •' ADDRESS p. O.' 130;f 510, Centnrui],•_•I s> nn�3c
7 (NO.) (STREET) (CONTS LICE NSEI
Build Dwel'lin 1`) STORY .Sin1g to 1?ami•ly nweI Li n DWELLR OF
PERMIT T0. ING UNITS
(
' (TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) Lot. #30, 7Lot. 7 Tiffan� kCI�F t '�rII-•'_iy� •f�.• en _i l 1 DISTRICT kF'
IN0.) (STREET) •
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
U �I tT (TYPE) ,
--REMARKS:- _ SewagG_ ,$,I-149
Bond
AREA OR 1076- sq. it+. ESTIMATED COST $• 45, 000..00 FEE
$ 86..00
VOLUME
(CUBIC/SOUARE FEET) �.1
OWNER Gr6enbrier Corp.
• O t.�a erVl J L BUILDING DEPT.
ADDRESS BY
5
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER 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.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED' FOR
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MINAL INSPECTION
TI TO LATHE FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE _
OCCUPANCY. '
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 1 �OdG�(/ D G�•� 1 �
7
3 HEATING INSP TION APPROVALS ENGI EERING DEPARTMENT
1
OTHER 2 �•�•'y� CC.C�.�,1� �'� B
WORK SHALL NOT PROCEED UNTIL THE INSPEC• PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED JIT144 SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
,PONSTRUCTION. PERMIT IS ISSUED AS NOTED.ABOVE. NOTIFICATION.
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EXISTING SPOT ELEVATION 0 j
PROPOSED SPOT ELEVATION �
OF
EXISTING CONTOUR ---0--- ��P�(NOF44ss
PROPOSED CONTOUR 0 o `�N ass
NOTE: THE LOCATION OF ANY UNDERGROUND ao P A A.
L' �� ��,'cp 4c
SEWERAGE,WELLS, OR OTHER UTILITIES SHOWN ON LEVY y IN
THIS PLAN IS APPROXIMATE ONLY AS DETERMINED llo.10050 O X H
FROM RECORDS AND/OR VERBAL INFORMATION. A PF tv o.31341
THE CONTRACTOR IS RESPONSIBLE FOR THE ��,� �f T ��``
THE FIELpON OF THE EXISTING LOCATIONS IN Fsi L�No �ss�NQ`�SLA�pcoQa
I N IN R A
EVY aELOREDGE ASSOCIATESy INC. CLIENT ROPOSED PLOT PLAN
ENGINEERS — LANDSCAPE ARCHITECTS JOB NO./D ZV�.
.PLANNERS — LAND SURVEYORS DR. BY_
IN
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4-DIA GRADE, 24"O/AM ETER CoNGRETF COVE
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LEACH//VG PIT SCALE : %s" _ /=0" 0/ME/V.S/ON A 37 FT.
DEGN SI CRITERIA 101AMNs/O N a FT.
NUMBER OF BEDROOMS 3 D/HENS/ON C 4—FT.
GA AMA GEDISPOSrSL(IN I7r SOIL LOG SOIL TEST
TOTAL E3T/MATED FLOC-V�� t� GAL.1DAY SOIL TEST A/ SOIL TEST�it2
NUMBER OF L,LYACNlNZ P/T,S f`E[EYa 7Ora 3 1'�-E[!rK ,DATE aF SO/L TEST IS�
SIDE LEACHING PER PIT 51Q IW7 01-21 -mT f RESULTS WITNESSED dY T M CKC
60T70M LF,ACN/NG PEIt P/T // $Q. PT. 5 J�� L' PER COAT/ON RATE / y 1y/N1I NCH
TOT^L LEACN/NG AREA SO. FT. � _,�, F�,�� F ERCOL�471a V RATE/k 2 M/N./INCH
RESERYELE.4CNlNGAREA SQ. FT. ,S/LTy SA-AJO
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A ,p No.10050�0 - LEVY & ELDREDGE ASSOCIATES. INC.
9ccErG0 ` 889 WEST MAIN STREET CENTERVILLE.MASSACHUSETTS 02632
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ZON F R F I CERTIFY THAT THE
_FOUNDATION
_A ,43,5(o.0 S F, -- '-- SHOWN ON THIS PLAN IS
_ _ ► 5.0 F R O N TA G C LOCATED ON THE GROUND o a
f! _--SETBACKS AS INDICATED
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,�•A.S;�VME LO7 13 1 r
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DATE REGISTERED LANDSURVEYOR•
�EVY 81 ELDREDGE ASSOCIATES,INC. CLIENT�REE R CERTIFIED PLOT -PLAN '
ENGINEERS - LANDSCAPE ARCHITECTS JOB NO l_...3? 30
rI
PLANNERS— LAND SURVEYORS p G r !�oT .-:?.IfFANY RoS G SANE
DR. 8Y= I N =
:'.
889 WEST MAIN STREET CHKD. 8Y=______...
CENTER I LLE, MA. 02632 SHEET OF-L.,, SCALE= 1 _ = q O DATE, I0 3 `
Assessor's offioe, (1st floor):-' /� - '
Assessor's map and lot number �........D? �,�, .,D/o�. TIO SYS-rEM MUST ' FTHETo``
Board of Health Ord floor): ,,.y-qTALLED IN CiOMPLI V
. '
Sewage Permit number .......... .......� .... .. •.•..•••• i BaHa9TODLE. !
Engineering Department (3rd floor):
- r �. WITH TITLE 5 NAGS
House number i NVIRONMENTAL CODE 6,9. •�
APPLICATIONS PROCESSED 8:30-9:30 A.NpandC1:00-2:00 P.M. only, TOWN REGULATIONS
TOWN OF , BARNSTABLE
BUILDING . INSPECTOR
APPLICATION FOR PERMIT TO ...... .C/ `�� f!l. .)........ t.C:r.�r�-.(. ...................................
TYPE OF CONSTRUCTION ................!!V 10)........r[ - .................................................................
........................... C ......19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for as permit according to the following information:
Location .......1- .50....:.Y��r � !)� `� ����....{�.�7���Q�.�.�..... . t"a.
ProposedUse .... 1. .C. .....::1.••f!!•!•'..I. .............................................................................................................
Zoning District ......�'i..........................................................Fire District ...l..'..1/ TJQ& 0.1445
Name of Owner .. �iNs/..K,.1I ...... vr..Address .. •:jCG ::: � � �d�,.�� � V.` C.C�
Nameof Builder .............................................Address ..: ......................:....................................
Nameof Architect ....................................................................Address .......................•.........�...................................................
Number of Rooms ......'!�........................................................Foundation ..... t .f!�-1 ,.U....... Q �./ ...
.. 4� ........... O-!✓/.IJ......Roofing ...........��g•• . .1.t�f...... .. ...................
`Exterior u. ..A.� ..
• yam 1
Floors ............ J.. .. .!�.!��.................Interior ..........
HeatingW l../........ ..�J....... ................................Plumbing ........... ,........3-6-7 .. ...................................
Fireplace ...................................................................................Approximate Cost ......................
p ..�.D..l .../,..................
Definitive Plan Approved b Planning Board 4 fro ..... .� .74 i0/
PP Y 9 -" ---�J?/-----19- ----- • . Area ...... ........... .... .....
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
i
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 .G �/ - />�..:.. �.......
Construction Supervisor's License ...... � .......
GREENBRIER CORP.
30,.862 ...St r
No ....
.......................Permit for ......A ..... ............
Single ............
............ ..... .....
Location ..Lot #30, 7 T4fc� v Rose
n Re Larie
.................................. ..... ................
Marstons Mills
...............................................................................
Owner ....Greenbrier....Cori?......................
.... .. . .. .... .. .... .... ..
Type of Construction .......F.raAl�......................
..................................... .........................................
Plot ..................... ....... Lot .^...............................
Permit Granted ......June 15,..................................19 87
Date of Inspection 4 51e:79,'7............19
�Date Compl ted --:7cR-7 6� ....19
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