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0204 TIMBER LANE
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", � u � � ..: �a - .. �� � ,. �� �,. 5 _ - „ - r ,. .` �, „� 6 - � � - u �n ,� , ,� 4 - � � 0 �, ,� ,..� - o,. ,. .. _ .. -- � � - � ',� :. ,� -. � � �, T .r-.^f :,�.--�+,p.��v...... .Y�w -�rr+r..w C; _ -- n..� �9,� ...h� ..v..cw....+. r°n,.� wmwe., r..�:�++�.n. r�ti.�1h. -fk�^ _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel: Application #62 60 sUcs Health Division Date Issued Conservation Division Application Fe ' ^� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - 0KH Preservation/Hyannis Project Street Address `f 7 7 M 6 eR �-�X>c- Village �'1• rp��S % Owner J-o k 0 Address 1� 76"I e e 0A y m� Telephone 509 4 20 a 5-L 5. ,p � Permit Request 1 t Z MOVE ekoiw-evs�� �l �.r ¢rye i Ok ��`rC.ks 4 N Renjek.0 s' 4-r-`Z Red- bee WiEsc. r;�e -c4_�4 ��. .�y/e_r dd4vb Alck6 - Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District d Flood Plain Groundwater Overlay a� Pr44ezt\a_on • 4/9'd0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl -❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count � ra Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other fir} s Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stov6-Ll Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing O-new size_ Attached garage: 0 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: I -y C.;] C:) Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 0 No If yes, site plan review# Current Use Proposed Use — - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name; .S'/,Bud su vtJOigri� �� Telephone Number Address / Z License # CY SSG 5- Home Improvement Contractor# 7W° Worker's Compensation # f(e ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Au A(a .4-If SIGNATURE DATE °7 ' -2 ' k o h FOR=OFFICIAL USE ONLY APPLICATION# DATE_ ISSUED e :MAP./PARCEL NO., s ADDRESS VILLAGE OWNER z1 1 ' DATE OF INSPECTION: FOUNDATIONS" y' FRAME INSULATION . 1 FIREPLACE ' ELECTRICAL: ROUGH FINAL s PLUMBING: ROUGH FINAL GAS:_ kiW-'_4 ROUGH : , .. FINAL S _r FINAL BUILDING: D. _ ' It 4 t . r ._ DATE CLOSED OUT ` ASSOCIATION PLAN NO: �;t ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 �- www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians[Plumbers Applicant Information �1,� Please Print Legibly Naive (Business/Organization/Individual): c.5p reye e—Agp /JCC" l�Ll¢SOIV &n�—IP22� Address: /Z roi'aoey 4-9•tie_ p2G7SPhone #: JQ� City/State/Zip: �!i/'/hd�yl�l o.e��� Are you an employer?-Check the appropriate box: Type of project(required): 4. [] I am a general contractor and I ] . ❑New construction einployees'(full and/or"patt-tune).* have'hired the sub-contractors.. 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 employees and have workers' working for me in any capacity. 9. ❑ Building addition [No workers' comp. insurance, comp. insurance. 5. � We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 1 1.❑ Pltmbing repairs or additions 3.❑ I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152,employees. [ and or have no 13.❑ Other IQe r9 wiR 0 1� employees. [No workers' LL --) / t / comp.insurance required.] � TtR/62 *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 arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tContraetors 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 my employees. Below is the policy and job site information. Insurance Company Name: Ja✓��i e�J rt'P� Z.�s'� 9.e>Gf scvc. PC2 Y990 Policy# or Self-ins.Lic. #: C! G 2 T Expiration Date: i2 /n. 01'J./ 4 0074' Job Site Address: -74V 7;70ft 6 C 4Ay� a2Gyp 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. 1 do hereby certify tinder the pains andpenalfies of perittry that the information provided above is trice and correct. Signature: Phone#: 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#: J Information and fnstructiODS Massachusetts General Laws chapter 152 requires a)lemployers to.prn in lhe�servioceker ' lh P Dsatior Linder any contra I otheir f n forlhire, Pursuant to this statute, an employee is defined as ... y p 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 (he legal representatives of a deceased emp)oyer, or the iatiob or other legal entity, employing employees. However the receiver or trustee of an'individual, partnership, assoc owner of a dwelling house having not more than three apartments and who resides therein,.or the occupant of the air work se dwelling house of another who employs persons to do maintenanc of such employment be deemen SUch d to beaaneempl employer." or on the grounds or building appurtenant thereto shall not becauseemployment L MGL chapter 152, §25C(6) also stales 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 cant ptable evidence or compliance with the insurance coverage required," appli who has not produced acce Additionally,MGL chapter 152, §25C(7) states "Neither the con unonwealth 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-contraclor(s)name(s), addresses)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies (L.LC)or Limited Liability Partnerships(LLP)with no employees other than the comp insurance. if an LLC or LLP does have members or partners,are not required to carry workers' of employees, a policy is required. Be advised that this affidaviturge to siay be snbanudled to the date the aaffrdavit Department iThe affidavit should Accidents for confirmation of insurance coverage. Also be s l; be returned to the city or (own Lhat-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 beloy�.,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 for you to fill out in l. space.al the bottom davit he event the Office.of Investigations has to contact you regarding the applicant. of the affi Please be sure to fill in the,permit/license,umber which will be used as a.reference number. In addition, an applicant that must submit multiple permit/license applications in any given yea (r, need only submit one affidavit indicating cCu Y o policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in ity or town may be provided to the town)."-A copy of the affidavit that has been officially stamped or rriaiked by the c applicant as proof that a valid affidavit is on file for future permrts or licenses. A.new affidavit must filled put each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (ix. a dog license of permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations Would like 10 �� dam_" GOeperatinn and should you have any questions, please do not besilate to give us a call. The Department's address, telephone and fax number: The.Cornmonwealth 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.mass.gov/dia r y� ° 'THEr, �. Town of Barnstable ` BAHTf6TABLE, Regulatory Services • • v MAB& $ Thomas F. Geiler,Director �'°rEoµ ►.�m Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Dffice: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign.This Section If Using A Builder I, /1/ �(/.�/✓c� , as owner of the subject property hereby authorize �� �e1�PP�GLyCC/ to act on my behalf, in all matters relative to work authorized by this building permit application for- (Address of Job) ture of OwKer Date d,61,r A 61vmg- Pnint Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form,on the reverse side. Q:FORM5:0 WNERPERMISSION Town of Barnstable 0p7HE rp�y Regulatory Services Thomas F. Geiler, Director MAS& . � 1639. ,�� Building Division PrEn►+tA'�� . Tom Perry,Building Commissioner 200 Main.Street,_Hyanais, MA.02601. www.town.barnstable.ma.us Office: 509-862-403 8 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 constrgcts 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 minirnum 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 sha11 be exempt from the provisions of this sccbon.(Sccdcrn 1 D9.1.1 -Licensing of construction Supervisors);provided that if thc homeowner engages a pc son(s)for hire to do such work,that such Homeowner shall act as supervisor:" Many homeowners who use this rxe option are unaware that they an 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 ultimatc)y responsible. To ensure that the homeowner is fully aware of his/her responnbihtics,many communities ttquirc,as part of the permil application,, that the homeowner certify that hdshe 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/ccrtification for use in your community. Q:forrns:homccxcmpt .�• �la..arhu.ctt� - lh•It:u•Intrnt nt I'ul!lir �alrt� . 9 B{�:utl nl' t3uiltfin_ 1:�•�ulatinn. :ui�l �t:uitl:tnl� License: CS 74635 STEVEN D CAPPELLUCCI t ; 12 GORDON LN YARMOUTHPORT, MA 02675 Expiration: 7/16/2012 Tr=: 31477 .,` .J//N '1!.'O Il1.Ylt(It!/.rvll�llt' L'ff�.•7�QJJrI!'l/UJP.I�J Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 132610 Expiration: 3/8/2011 Trll 281035 Type: Individual STEVEN D.CAPPELLUCCI STEVEN CAPPELLUCCI 12 GORDON LN YARMOUTHPORT,MA 02675 Administrator License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 r Not valid without signature 1/2 MDA-rM ALV' KUT 2010 %ockTIFICATE OF LIABILITY INSURANCE 820o P. /23/2010 n, 07/23/2010 PRODUCER 508.997.6061 FAX 508.990.2731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Seutheastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 439 State Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 79398 North Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC# INSURED Steven Cappelucci INSURERA: Central Insurance Companies 20230 12 Gordon Lane INSURER B: Yarmouthport, MA 02675 INSURERC: INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICVEFFEE OLICY EXPIRATIONLIMBS LTR NS DATE MMIDDCTIV DATE MMIDD GENERAL LIABILITY CLP7944623 11/30/2009 11/30/2010 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY PREMISESUj Ea occurrence $ 100.00 CLAIMS MADE M OCCUR MED EXP(Any one person) $ 5,00 A PERSONAL 6 ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000.001 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 POLICY JJEEC r7 LOC AUTOMOBILE LIABILITY BAP84S8349 10/28/2009 10/28/2010 COMBINED SINGLE LIMIT ANY AUTO (Ee accident) $ 1,000,000 ALL OWNED ALTOS BODILY INJURY A X SCI-IEDULEO AUTOS (Per Person) $ X HIREDAUTOS BODILY INJURY $ X NON.OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY ALTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS 1 UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC8624990 12/08/2009 12/08/2010 X I ToRYLIMIT,I ER AND EMPLOYERS'LIABILITY A ANY PRW�MEMI�BOERPARCER ULUL DE0�7 CLTIVE YIN ER E.L.EACH ACCIDENT $ 1,000,OO OFF(Mandatory In NH) N E.L.DISEASE-EA EMPLOYEd$ 1,000,000 SPECIAL PROVISIONS STEVEN CAPPELUCCI INCL E.L.DISEASE-POLICY LIMIT 1$ 1,000,00 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAID 10 DAYS WRRTEN Town of Barnstable NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Attn: Building Dept IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main Street REPRESENTATIVES. Hyannis, MA 02601 ['Joanne UTHORIZED REPRESENTATIVE Bretton ACORD 25(2009l01) FAX: 509.362.1681 O 1998-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �p THE TO�, Town of Barnstable e�b��g r1 Expires 6 months from issue rin(e awRNStAC3[E Regulatory Services Fee A L10, MASS. Thomas F. Geiler, Director �OrfornA�a Building Division Tom Perry, CBO, Building Commissioner —f 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Pax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number r) (,S Property Address dd ig��$1 S 0�/445 Residential Value of Work ;aUU,r a) Minimum fee of$25.00 for work under$6000.00 Owner's Name& Address -'I'l)X"✓ Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance �P RE "S PERMIT Check one: �� ❑ I am a sole proprietor JUL _ Z009 I am the Homeowner ❑ T have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp. Policy It Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to Re-roof(not stripping. Going over�_existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum .44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e. Historic,Conseivalion,etc. 'Note: Property Ow er must sign Property Owner Letter-of Permission. Iome�Jmp ement Con actors License& Construct Supervisors License is required. SIGNATURE: `� ✓°tom Q:\WPFIL:EST=OR xpress\EXPRESSPL"RMI"C.DOC Revise060409 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 _�•`• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):s; Address: o2D V %i Mb6/L IV Ci• /State/Zi t0� /�/LLS / /4 `1 ���City/State/zip:p: �'g/�' hone.#: J`r0 F, av--�(st,�16' Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6, ❑New construction employees(full and/or part-tirne).* have hired the stab-contractors ..2.❑ I am a sole proprietor or'partner- listed on the'attached sheet. T. ❑Remodeling ship and have no employees These sub-contractors have g. "❑Demolition working 'for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.-insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.)� I am a homeowner doing all work officers have exercised their HE 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 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. xContractors 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. #: 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 fo secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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=ir:fyderr tt he ns and p alties of perjury that the information provided above is true and correct. Si ature: /� Date: Q Phone#• 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#: ro 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 tru 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 of 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 worst 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 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 permittlicense 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 roof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each p year.Where a home owner or citizen is obtaining a license or permit not related fo any business of 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: The Commonwealth of Massachusetts }department of industti.al Accidents Office of Investigations. 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-72777749 Revised 11-22-06 www.mass.gov/dia Town of Barnstable Regulatory Services Thomas F. Geiler,Director .16.5¢ �� Building Division PrED Tom Per ry,Building Commissioner '200 Maiii:Street;Hyannis;MA-02601 www.town.barnstable.ma.us Office: S08-862-4038 Fax: S08-790-6230 HOMEOV NER LICENSE EXEMPTION Please Print DATE JOB LOCATION: number s�trcct village "HOMEOWNER': -V1 A) �d �U/�N� '0'7- yad 'S'63-5- name home phone 9 work phone# CURRENT MAILING ADDRESS: S� � 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"bomeowner"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 Tpwn of Bar.ustable.Buildipg Department rni, i.mum inspection procedures and requirements and that he/she will comply with said procedures and e ements. awrc of Homco . 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 pmrnit 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 arc assuming the responsibilities of a supervisor(sce Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hirrs 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 oflris/hrr msponnbilitics,many communities require,as part of the permit application, that the homeowner certify thkt he/she understands the msponstbilitics of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a fonn/ccrtifi cation.for use in your community. IKME Town of Barnstable Regulatory Services f F 9xsAB $ Thomas F. Geiler,Director 16 L aim ]Building Division e 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 ABuilder 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 job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable Accessory Affordable Apartment Program Notice of Public Hearing under the Zoning Ordinance 6:00 P.M. —October 29, 2008 To all persons interested in or affected by the Zoning Board of Appeals under Section 11, of Chapter 40A of the General Laws of the Commonwealth of Massachusetts, and all amendments there to you are hereby notified that: Appeal 2008-046 Blaisdell Chapter 40B Comprehensive Permit Stephanie A. Blaisdell, John Blaisdell and Amanda A. Blaisdell have applied to the Zoning Board of Appeals for a Comprehensive Permit under Chapter 40B of the General Laws of the Commonwealth of Massachusetts and in accordance with Section 9-14 of the Code of the Town of Barnstable, more commonly termed the "Affordable Accessory Apartment Program." The applicants are seeking to convert an existing one bedroom apartment located in the lower level of the principal residence into an affordable accessory apartment. The property is shown on Assessor's Map 191 as Parcel 075, addressed 63 Knotty Pine Lane, Centerville, MA in a Residential C Zoning District. Appeal 2008-048 Cardiges Chapter 40B Comprehensive Permit Judith A. Cardiges has applied to the Zoning Board of Appeals for a Comprehensive Permit under Chapter 40B of the General Laws of the Commonwealth of Massachusetts and in accordance with Section 9-14 of the Code of the Town of Barnstable, more commonly termed the "Affordable Accessory Apartment Program." The applicant is seeking to convert an existing one bedroom apartment located in the second story of the principal residence into an affordable accessory apartment. The property is shown on Assessor's Map 308 as Parcel 187, addressed 51 Chase St, Hyannis, MA in a Residential B Zoning District Appeal 2008-050 Perry Chapter 40B Comprehensive Permit Timothy T. Perry has applied to the Zoning Board of Appeals for a Comprehensive Permit under Chapter 40B of the General Laws of the Commonwealth of Massachusetts and in accordance with Section 9-15 of the Code of the Town of Barnstable more commonly termed the "Affordable Accessory Apartment Program." The applicant is seeking to create a one bedroom affordable accessory apartment in the lower level of the principal residence. The property is shown on Assessor's Map 169 as Parcel 015-002, addressed 526 Skunknet Road, Centerville, MA in a residential C Zoning District. Appeal 2008-051 Gady Chapter 40B Comprehensive Permit David Gady and Amy L. Gady have applied to the Zoning Board of Appeals for a Comprehensive Permit under Chapter 40B of the General Laws of the Commonwealth of Massachusetts and in accordance with Section 9-14 of the Code of the Town of Barnstable, more commonly termed the "Affordable Accessory Apartment Program." The applicants are seeking to convert an existing one bedroom apartment located in the first floor level of the principal residence.into an affordable accessory apartment. The property is shown on Assessor's Map 149 as Parcel 045, add ressed217_Timber Lane Marstuns_ �ills1 MA in a . Residential F Zoning District. Hearing to Revoke/Rescind Comprehensive Permit At the request of the Monitoring Agent for the Affordable Accessory Housing Program and in accordance with Section 9-14 of the Code of the Town of Barnstable, more commonly termed the "Affordable Accessory Apartment Program", and the comprehensive permits issued, the Hearing Officer of the Zoning Board of Appeals will hold a public hearing to show cause why the following_ comprehensive permits shall not be revoked: • Comprehensive Permit 2005-050 issued June 9, 2005 to Stephen Duff for 1586 Hyannis Road, Barnstable, MA(Map 298 Parcel 018/001) • Comprehensive Permit 2007-027 issued March 29, 2007 to Mary Jo Seguin for 6 Cedar Street, Cotuit, MA(Map 018 Parcel 055/001) These Public Hearings will be held at 6:00 P.M. in the Barnstable Town Hall, 367 Main Street, Hyannis, MA, Hearing Room, 2"d Floor, on Wednesday, October 29, 2008. The Comprehensive Permit files may be reviewed at the Growth Management Department, 367 Main Street, 3rd Floor, Hyannis, MA. Please contact Program Coordinator Cindy Dabkowski at (508) 862-4743 for more information. Barnstable Patriot Laura Shufelt, Hearing Officer 10/3/08 & 10/10/08 Zoning Board of Appeals �! 1/ TOWN OF BARNSTABLE F CERTIFICATE OF OCCUPANCY PARCEL ID 149 065 GEOBASE ID 8565 ADDRESS V 204 TIMBER LANE' PHONE Marstons Mills ZIP - LOT 42 BLOCK LOT SIZE I DBA t DEVELOPMENT DISTRICT CO i PERMIT 22155 DESCRIPTION SINGLE FAMILY DWELLING (PMT.#32088) PERMIT TYPE BC00 TITLE CERTIFICATE .OF OCCUPANCCYY l CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 Ox CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY * HARNSfABLE. MASS. \ J OWNER RUAN.E, JOHN F & NANCY A i639. A� ADDRESS 988 PLEASANT ST E� CANTON MA BUILDkN� I �I'�ON BY DATE ISSUED 04/02/1997 EXPIRATION DATE Y THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) Im ^��J C DATA * OWaLJiw?F 3A� ►$T-ABt; 45. H Sf1T , I }��� ' ■— � .iui 45—ub�) DATE rut !' 19 uv PERMIT NO. A.FLICANT Fhr;,*� 6 r.ems ADDRESS :p,.r V (NO.) (STREET) (CONTR'S LICENSE) r.?4z,..�C:. Vrw `�`:" .r<<i _ ,:I'd.j tllti+' NUMBER OF NG UNITS PERMIT TO - a. (` ) STORY -• `-lo (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) .l�Ls -.,).tiw$ c3t_'w ,s,.,T '� . ei.. .+.,�<:� DISTRICT I`' (NO.) (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 (TYPE) i REMARKS: r AREA OR aF:, aS' + ,e �•a�� "3r�b1eid PERMIT .•» _®vfoe VOLUME ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) OWNER ADDRESS BUILDING DEPT. f� A BY 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- ROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED OM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS ANY APPLICABLE SUBDIVISION RESTRICTIONS. C -NIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE PECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FORS'~ / L CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND•' FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. ?RIOR TO COVERING STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL M EMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. INAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS E E TRICAL INSPECTION APPROVALS z z ' 4" 3 ^ HEATING IN?PECTIqN APPROVALS ENGINEERING DEPARTMENT OTHER J J7 N BOARD OF HEALTH SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'N!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE iAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN N, UCTION. / PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. e , r BUILDI. .NG PE :RMIT v _ d a 4 J /6-5�-Assessoi's offioe• (1st floor): 1.41..... ,,// !� pFTHE TC Assessor's mop and lot number ....a.`�.�........ ................... Board of Health (�rd floor):3�'Sewa a Permit' numberr 3.�.... �� d� o� BAHDST&BLL, i (/ Engineering Department Ord floor): rasa . . 00 t639. ♦� `,.�_ ..� aHouse number ............. /J. ..................;............................ DMA APPLICATIONS PROCESSED 8:30-9:30 A.M. .and 1:00-2:00 P.M. only- TOWN OF BARNSTABLE BUILDING _ NSPECTTOR APPLICATION FOR PERMIT TO ... Ll �7Q� .... - 302o6k( .9!Y��f ' TYPE OF CONSTRUCTION ....�-1��d �"��E.................................................................................................................. nn � ...................., .-.± `.119......19�.p�?. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......4,�T.....Via.....%M 6�2, Zw ............:. 9e5TOrY_5....eK4;-5. ........' 9s5 ...................................... / ryT 2E$� ... ................................................................................... _ Proposed Use .....................12.�.........:........................................ ''�� ,,. ft �' � /Zoning District �" ..........Fire District ............................... ' Name of Owner ....V.gh/V..; :! UA .,,• 2 9 /L�����-T' .5r 6. ,'W—OV f�f ems, Address ............................................... ............................................................ 9... 4 Name of Builder ............S�}M ....................................Address S9.vi Name of Architect ,t,'T... 419T/..........................Address /D l'y�y�EGQ/... !?-..... ,9�;�y Number of Rooms / � 02 .4?47! S 74�!/��.?�....�<. �.P.�7 ........................... ..................................Foundation .............. Exterior .. !J.//Y . t4.�J�09.. ....................Roofing .... ................ Floors/ CG�IQ�/;,.. �...0 ?% e r...........Interior .. UG°rc ra�!�1 .-- iJS7�".C'. Heating ..... 11111,,.,.........:...................... .................Plumbing .......... ..n..................................................... Fireplace .....1.11V .......;C�/1/.................................................Approximate Cost ................�.r....................................... ........... Definitive Plan Approved by Planning Board ________________________________19________ . Area ..... ....... ®................ Diagram of Lot and Building with Dimensions Fee ©O SUBJECT TO APPROVAL OF BOARD OF HEALTH 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 < �.�.1/ ?�G�� ..................... Construction Supervisor's License ................ . RUANE, JOHN F. JR. 149-065 32088 One Story No ................. Permit for .................................... Single Family Dwelling .......................................................................... Location Lot #42, 204 Timber Lane ................................................................ Marstons Mills ............................................................................... Owner ....John F. .Ruane, Jr. .................... ....................................... Type of Construction ......Frame ......................... .... .... ............................................................................... Plot ................... Lot ................................ Permit Granted ......July 20...............19 88 ........ ........ . Date of Inspection ....................................19 Date Completed ......................................19 5WA PERMIT COMPLETED 11/1/21.._ I) , r � J AcT N Z - EX�s'riNG 1 H r' LAN 00, OLEO lor LoT'�/6 �. Our, Stec ELEV• P FJ S . Q• � (ioV .� rAN it FouNo � � 1 . � .. r RESERVE 84 S,� "tiA �� ESE w•vs �11�A4a .F.P� OF MA s HENRY G � o HENRY 0. o.21173 ' 1ST D1gAL EN , i REYISED 511E PLAN /,or -Yz T/m6E2 LANE • MAQSToN M/�S SCA�� /'= yo' /,79R, Z.y /986 /SFENi2 Y 4,muN501d P,E." P-4's, /yOTC: /-�UUSE SILE��CoCAT/oN lZcVi5E0. 6 PtiEf}SANT GFtRf�EN O, R A41, oTNEK =NF0,2/"147WN /S T'o L'ANTDl1I� /y'1A. OtoL/ 2EM4114 AS S N 0 w N ON 4 PLAN ay. EDv,/A2DE,k CAGEY, P,,L,S. DArEZ 9-3 -BS /ATTACNED YEREW�7N. Z Kz AfX/Ss1n/G I . sl • v b , 1 49$703 � S sxjSnwa I •y� Y- Le>iCll ,;,VP of id o 7' zb.¢69 .sQ3y 1 k -�Pp/7ox.) "J'sn v G ' sb7VAGCs ' (APP►eo-<J • /Va7vr'- EZ6�/A77oNS BAS�a oN Assu.�se•b a��s. • LOCATION ,e�MFsn;vs - mow SCALE : .��ii•.¢o�. . DATE Of `1 PLAN REFERENCE ..BtV vG,. �7-w4z EDWA �� J , ,-siyd t�y�v • ,o.V• PL�}�. . Boo�!G . CD CD Y, t.EY r�• • • . . . . . . ' o tGUip c . ss�o f"tilt"g�, . . . . . . . . . . . . . . . . . . . ... . . . . . . . CERTIFY THAT THE ,,,,,,,,,, SHOWN ON THIS PLAN IS LOCATED ON THE OROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE _ SETBACK REQUIREMENTS OF THE TOWN OF . . .. . ... . . . .. . . . . .. ... . . . WHEN CONSTRUCTED. DATE � . . . . . . . . . .. . ToN�►/ STA,►/G�'y - �G•rTi noN�-Tz _--•------ - -- - - t i TOWN 011 13ARNSI'ABLL; j 'BUILDING 'DEPARTMENT HOMEOWNER -LICENSE EXEMPTION Please print. DATE � p_ r., JOB. LOCATION.• um er Street a ress f� ection OT town "HOMEOWNER" 2Rr ome ph one Work p one PRESENT MAILING ADDRESS g �� 7 lty town tate . ::: .:..:.�l�D .�.. The current exemption for "homeowners" was extended 1p co e dweIlings. of six units or ess' an to allow suchdhomeo include owner-occupied Zvi ua for hire. who does not possess a license homeowners to engage. an in- . acts as su ervisor. provided that the owner P (State Building Code Section j......••.: :DEFINITION OF HOMEOWNER: Pid2 (s') .who owns a parcel of land on which he/she resides 'side, on -which there is, or is intended to be, a one to six family-attached or detached structures accessor to s fa intends, 1inol re- A person who constructs more than one home in uch use and/or farm ysLructures. considered a homeowner. Such "homeowner" shall submitar period shall not be on,a.. form. acceptable to the Building Official , that he/she shall for all such work performed under the buildin Building Official be respons.ibie g permit. ection :The undersigned "homeowner" assumes responsibility for compliance Building Code and other applicable codes b " y-laws, rules and regulations. State , 'The undersigned "homeowner ;ertifies that he/she Barnstable Building Department. minimum inspection procedures the. Town of :and that he/she will comply 'with said procedures and requirements.,. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING ING OFF ICIAL Note: ' Three family dwellings 35,000 cubic feet ` d r .to comply with State Building Code Section 127 . . larger . ConstructionlCo btrolQuired HOME OWNER'S EXEMPTION The Code state that : Permit Ig "Any Home Owner performing work for which a building . required shall be exempt from (omction 109. 1 . 1 the provlsl.ons of this section Home.Owner Licensing of Constr�rctlon Supervisors) ; shall act engages a persons) for hire to do such work, provided that If a- as supervisor . that such. Home Owner . Many Home Owners who use this exemption ar the responsibilities a Unaware that for. Llcensln of- a supervisor (see A they are assuming often Licensing Construction Supervisors, Appendix 0, Rules and Re results In Section 2. 15 9ulatlons. Unlicensed personsrloUs" problems, particularly when This.aack of awareness . Unlicensed In this case the Home 'Owner hires our Board' cannot - : .as. sU person as It would with our Supervisor.. RerVlsor Is Ultimate► proceed against. the y responsible. The Home Owner acting To ensure that the Home Owner is full CommUnities require, Y aware of hls/her responslbllitles , man certify that he/she as part of the permit application, y 'last understands the responsibllltles, of that the Home Owrier page of .this Issue IS ,a form current ► care to amend a supervisor . • On the and adopt such a form/certlflcUted by Several. towns. f or 'YOU may Use In your community. ' 1 r i r . :. 00,t"8 3zt d T y� SS��.• RY GAR, :. :..0� p.'oF .Foat \ fo i _ Ti I.DI:N •.o-Nr>-ors 'p�.Ar� Is:�,oc�T'E D•�.N "TH'E .GR'av:�-r� .� -.: � ' .. .� . . - - . . /1'S Srlo\,j14 14crzeLoN "A:'N-D. TNS.7.IT. CON.FO--fZNLS. .. To r1�.E.. sc rr3r�cl� REquIQ.EiylEnlrs .o .:T:�a TOWN OF f3i9.RN5rA31'E • /�'N'0:',TH ?. .TH.E LOCvS IJcie: .Nt T Lid �./tTH7N A".SOECIp'� f�dov,. . .. HAZ.r;kD 'ZvN� /�S O,N. "TNE .. FLVO� .Zn/SU��h'C�"" KF3TE N]A F S AR=TEQ. s:. /� R� .Qvi�7 FvuNrJ�9Tlo Pc N AN p2or'�SSio y l./r/ao scizvcl':o2' LQT y2 T/�'tB�-R �A'N� /`'7ffKSTo,v /Y/1IUs .. o� HENRY yGn�, 'SC 44 E.../ T U�y.. :. �• .. UNCOLN• :. �. y' HFNR Y ,MU NSo/`� MUNSON.:- � � •� . IVo;2d173 G". RE EAS/�/KT Cr✓1 R pE/�: 20.,.. AN.T. E[:LVAT�.pN SNlyw/y /S iCiRSL�' . UPON A-N A.SS U.M E b DNTO M �. _Oa.oa 'We OSOO, 94b/on,P.762-6627' April 7, 1988 John F• Ruane 988 Pleasant' ''St. Canton, MA 02021 RE: Lot 42 Timber Lane, Barnstable Dear Jack, Listed below are the last 3 previous owners of the above lot which was purchased by you on February 17, 1988. 1. James .Groom ' Dec. 30, 1986 to Feb. 17,. 1988 2, Forrest A. Parmenter, trustee of H.P. Realty Trust Nova 19, 1985 to. Dec. 30, .1986 .. 3. John S Stanley, trustee of USA Realty Trust . June 30, :1985 :to Nov. . 19, . 1985 . Very truly yours, ;. A. David Webster . ,` ADW/em i�ssessor's offioe (1st floor): .... Assessor's map and lot number `y�. .`�. � . TNE . .... ......1102B ..�.` REF Qom° ...... . . oard of Health ,(3rd floor): ` Sewage Permit number ¢ W 1.J g ..... .........., t Z 13ARNSTODLE i /� Engineering Department (3rd floor): E4 VO-''UaNtii49Em4 TAL CODE AND 'moo rb 9. a�House number .............a64e................................................ `t't"MN REGULATia ' e0Va*qW* 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 ... !!! ! ...... ... r�! ......"..3.. 2OG .....�� ?���T TYPE OF CONSTRUCTION .... 40140! Iq�... �� ........................................... .................. .. ........ ........�9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the. following information: Location ......h4T y° ..... !.Me�/L.. q�✓E.............. 9��5To/JS..../�L,Z4 �9s� ................. ....................,.................................. Proposed Use �/ ✓2�! 1!T .................................................................................... ................... ................ Fire District .................Zoning District /. .> ...................... .C/..... ................................ . ................. el ,%x v..F../.cr�ft ...�2........ �' f . ...... Name of Owner ..... ..a... � ....... Address ... .................. Name of Builder ............Sg!✓a....................................Address ............. ..................................................... Name of Architect ..........................Address ......�iYld/d1 i/.ilS //�� -/ /r ................ Number of Rooms � //'Z `.7J�.S ... Uf Q.....C!�!!?�� rF............................... ..................................Foundation . ............................... Exterior .. !I.//J���'�F ./ !! a19.. ....................Roofing ....!9-Sf�/f'�•�L .. !��/Yas ............................... Floors ..... ✓..�f .C!/�0C1 ..��.. —'`�!I?�� I `'...........Interior .. �p¢2Q�— �.rTEs.......................... y I / Heating /CDT /✓4/ ................................................Plumbing v Fireplace ..... ...... p Q/1!�.......•�2/1�,�......................................Approximate Cost ..�_���(� ...................... Definitive Plan Approved by Planning Board _______________________________19________ . Area .....p� ... ................ Diagram of Lot and Building with Dimensions � g 9 Fee ...... .. .. ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 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. oe Name . ........................... 1 Construction Supervisor's License .... ............. -7 RUANE, JOHN F. JR. ;No .�k�P... Permit for .4n.e...S.t-o-ry........... Sing ............. .......... . ..... ..... Location ...Lgt...#A2........20,4...Timb.qr_W.iAne Marstons Mills ............................................................. ......I.......... Owner ..John F. Ruan6'....q�:K.,................. ............................. Type of Construction ..Frame............................. .. ....... ............. ................................................................. Plot ............................ Lot .................... ............ G Permif, ranted .......q:u1.Y...�.Q...............19 88 Date onnspecti6n ....................................19 Rate Completed .......... .... .......... ........... ....199 t 14