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0384 WAKEBY ROAD
AkLk ��/ v ' n n , o , n , , �'r n „ � n !I 0 0 v , y m- o , TOWN OF BARN$T"LE Permit No. - 28240- • —- ----- Bang pector 1 UMMU s BAIL hls ti r Cash _------___--- -/ NOCCUPANCY PERMIT- " Bond Issued to Rilmurray / Brunswick Address { Lots S & 6, 384 Wakeby Road, Marstons Mills Wiring Inspector �� Inspection date Plumbing Inspector Inspection date Gas Inspector �, Inspection date / xEngineering Department Inspection date i-A Board of Health �r''i , Inspection date �� 2 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. .....ET- 9 *e �/a..vB Inspector ......._...._._._._ i /A4-A ssessor's map. and lot number-....r.� . . .......................... QC o SEPTIC SYSTEM MU a ropy �Sewa ` ermit=number ..........<•F•✓. �O �.��..��..............8 L T�TINSTALLED IN COMP WITH TITLE t BABBSTSBLE. House. number `s Q , d „� �,` .............. . ....... ... ........:.;,... -.::..... .. . ENVIRONMENTAL CO .0 .. rav TOWN REGULATIO a a TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO Uc9/ � S�/� ... n?.�� ...n� .e.........1°L.....S.�BR.. .. ........... ............. .. c Q TYPE OF CONSTRUCTION .........i OS T �/t 0 9?t.W n.. ! ...9?t.W.n......................................................................... pp .�Lf...... .............................. 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location y....)off .....H!9�s.7o17s /�F(LLs 40 F f d ProposedUse ....SnLe �ftirt�L ......................................................................................... Zoning DistrictL.!IA...... .................Fire .District e.......0......I �............... ........................................ Name of Owner f.`.'.!' ��R�./.. .......................���.Address .�0./�l C T /C, ..... e /..9 ........ / ... ........................... Nameof Builder .......................... ... ....................................Address .................................................... ...................... .... Name of Architect PerMer� 60Pr�� 11017P tVo./. I C�j r/P/'/rid/? ............................. .. ................... ddress .................................................................................... Number of Rooms .......S�.U.�O..........................................Foundation /.... d/1C/�L°....!................................................ Exterior ...s. . .n. .LS.......................................................Roofing .... !.5 !.! L�..................................................... ....P.t .�T SPrctC e..............................Interior .....P../1 C° Floors ...........� .......................... ......................................................................... Heating e./e�j 7- �(1<YlP Plumbing g S /tq/7 J�r J a ........................................................................... .......... ................................... Fireplace ...... O� ........................................... ............A Approximate. Cost ` OD6 ........... ................. Definitive Plan Approved by Planning Board -----------_______-----------19 . Area ........',3 ....................... Diagram of Lot and Building with Dimensions Fee .......J�.. :a� .. ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH j#5 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. Nam42r .:�11/�hl° ... Construction Supervisor's License '-77'KILMURRAYP BRUNSWICK I r No .... Permit for ...TYP�J�9�!Y............. .. .........J_ .................... Location .... Marstons Mills ............... ..................... Owner .......Kilmurray.�..��n�j�ick . ................. . ...................... Type of Construction .......Frame................................... ................................................................. ............ Plot ........ ............. Lot ....................................... July 23, 85 Permit Granted .........................................19 Date of Inspection ..................19 Date. Comply d' .........19 Co M ca > 0 A. 0 co M a>. P M c: tv — z r, 3c cr :�- - -.-' i 'V TOWN OF BARNSTABLE BUILDING DEPARTMENT = seslST = TOWN OFFICE BUILDING J � raa 9�413 9 HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by Building Permit # .........�R zj�. ................................... issued toy!/�� �2�!/YL. ..............c. ._ .....................__. Please release the performance bond. • t pp`QFtHE Town of Barnstable BAR AS,%. E. Regulatory Services tSMASS. t639. Building Division prFD MA't a 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice 1 Type of Inspection Location 3 P y /.�A AA Permit Number Z O 13 a 2 0 5' Owner Builder S'j4R/aKLL One notice to remain on job site, one notice on file in Building Department. i The following items need correcting: OoX149�C-:--IC7vs �c- e--A C . /> hie U t/S1'C-�Tra Re erJ Q l iv6 IA-1�rz u P EA7WG ea .D C2) r ���R of ✓�l��a�� Gvic� b�� �tr ��� . 444 D C, I�3 boF P 117— ( /4/p7� EV V i 0 Please call: 508-862- for re-inspection. Inspected by, Date izz TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Z b� � 35( Map Parcel Application # Health Division Date Issued 4 Conservation Division Application Fee v" Planning Dept. Permit Fee ' l Date Definitive Plan Approved by Planning Board r�rA� Historic - OKH Preservation/ Hyannis ilk Project Street Address Village Mo_S6 M�O S rAA Owner `.tJavTc,J YCLr3e&c;,- Address Telephone O Permit Request Code, Gti a✓Gh /V'y r, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Totatgiew Q r Zoning District Flood Plain Grouhdwater Overlay I— CD Project Valuation 11144qConstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family A(' Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Vfull ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 9 39- Number of Baths: Full: existing_ new SZ Half: existing fd new Number of Bedrooms: , 9 existing ig new Total Room Count (not including baths): existing :7 new OC First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil XlElectric ❑ Other Central Air: ` Yes ❑ No. Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No allrDetached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ N/p� Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name f4ri n10-e- 16Yne lvnnwe_(e vK -eoJ Telephone Number 90�_ 7-75 (7l�— Address d l I_A,�+A S4*3DI 2 Yam. License # eIS T 66 tc-&q 3 &_aA6 S. PA CTo_U0t Home Improvement Contractor# 1637S'7 Worker's Compensation # 100qg1 lc �(of 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 6_f M oUA\ Tru�S SIGNATURE DATE j FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ? e -' FOUNDATION Saes a 5 k: r • -FRAME s oK S �� s � — :y ?} INSULATION " - r: FIREPLACE 4 ELECTRICAL: ROUGH ' FINAL '.— PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r°> FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. � Z f ,tom 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): Sprinkle Home Improvement Address: 199 Barnstable Road City/State/Zip: Hyannis, MA 02601 Phone#: 508 775-1778 Ext.10 Are you an employer?Check the appropriate box: Type of project(required): 1.[XI am a employer with 10-12 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. f0 lbw 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 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 I I.[] 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' 13.0 Other comp. insurance required.] 'Any applicant that checks box ill 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. tContractors 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: A.I.M Mutual Insurance Co. Policy#or Self-ins.Lic.#: 7004943012013 Expiration Date: 1/01/2014 Job Site Address: JO q Wak f'(cL City/State/Zip: &_#'5 t AS MC 1 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 un e s nalties of perjury that the information provided above is true and correct. Si nature: Date: Phone#: 508 775-1778 Ext. 10 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#: 2/21 /2012 11 : 39 : 11 AM 8740 02 /02 CERTIFICATE OF LIABILITY INSURANCE DATE 12/21/2012 i THIS CERTI[ICATE IS ISSUED AS A X&TTER Or INrORN=XON ONLY AND CONrERS NO RIGHTS UPON TEE CERTIrICATE NOLDER. lNIS CERTIIICATE DOES NOT ArrIRYATIVELY OR NEGATIVELY AM=, EXTEND OR ALTER THE COVERAGE ArrORDED BY THE POLICIES EELOV- THIS CERTIlICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT HHTVEEN TEE ISSUING INSURER(S) , AUTHORIZED REPRESENTATIVE OR PRODUCER, AND TEE CERTIrICATE HOLDER. , IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate doe: no' eohfer rights to the certificate !older in lieu of such endorsement(s). vNmu4i �*r* Bryden 6 Sullivan Ins Agency . = rAi ----'— Inc Wc. r.. att — Wc. r.l. E can i 88 Falmouth Road ---- I'IlODV4N Hyannis, 1;"g, 02601 NSTOD H 1D{ -- __..- -- INEURED(il APFCADDID coveaaac ---_T Ham` •__ ±BSODAD INSBNER A: A.I I.M. Mutual Insurance Co Sprinkle H— IMprCVeM0nt Inc 199 Barnstable Road INSURER t•: Hyannis, M, 02601 INSUS" c: ' rAsu m r. -- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THZS Is To CERVWY THAT TM POLICDiS or =XURhW=T4== SE&M NAVE ON= ISSU=SO THE ISSUE= ■AIELD MOVE r0= TQ POLICY VZR=o >EDDCA=. - zVwrxRSTA1DIfG MY NEQDDIfwe", 2s OE CONa3TDoN or ANY Ooe'AAcr OR O'Ixxx Docamu ET V18 Ri"wr TO MM= IRIS C=213 QSE may AS ISSVEa OR tlx: ! P=R'A=. M DISURAN=Areo"Noi By I= POLICIES DESC233M Rsi=D IS SOEJZCT TO ALL THE TERNS, NZCLUSIO=s AM CONDITIDE& Or SUCK ROZ,=XCS. Ln TI SHOWN may HAVE =m saaOCZE) By eAm CLA=- --._.. ... .._ t'•• POLICY 10101N3I POLICY Err POLICY Sze LDaTS ua TYPE or INSURANCEG301110 ! IIDUAArrYn, �•t*^YI " LIANIIQTY rant MCUBJXCE ❑CCtMEAC UAL GCi/DAL LIABILITT ❑❑a.Atro NADe ❑occuv I NrD ccr IANr —.•E..AI i e ElPERSONAL c ADv ISFOXI c B[NEaAL "GRZOLIC OWL AaOAlGATr LIMIT APPLIES EP: ' - 1 ❑POLICT �Pw ECT M. PRODUCTS- cuts/as aBD 1 s 1 cao=D Scuts Lair , Aoaaiaaas LIABILITY � L. tYDtl ` ❑ADY Avro j BODILY LNTINY (D•r V—) DAI._ CaACD AlJT00 i 1 BODILY lN7tXY(..E.mtYat) { � � 1 rRDt QfY.AOQ ❑tl1DED A— ( I DBOY-"eD AUT03 1 ! { '— ❑UNID CLLA LLLD ❑ aC[UF I ^— CACN Oc C1OY04 I ❑EXCESS LIAR ❑ CLt Ile NAME I 1 AGS&Z"TE { •--_-_--_, -.. -. I oRETERIOY s 1 a< Ill.• Dib I .. ..• �— WORNaE OOIOaSATIDe ..�. ._ �Ttva taaYa� 1 THE PROPRIETOR/PARTNERS: I r..L. EACH ACCIDER I c 500,OCf. A Ex rrm OFFICERS ARE E I Q tnc' ❑ escl 17004943012013 1 o T E.L. D:uaa -vDLLCY LOU? I -` �OC.00- Ol/Ol/�O13 O1/0_/2014 ' i E.L. DISEASE - CA EamiOYCE i c SOC.'JO% caslntrS DiicnirrlaN or wrA►nc�s w t.ocnLau: CERTIFICATE HOLDER -- CANCELLATION -_- CERTAINTEED 5 STAR CONTRACTOR seooLD ANY or THE ABOVE DERtstzaeo eoLxas ss cANCILJ,sa BQORI: THE EXPIRATION DATE THMZOT, EOTZCE WILL S= DEI.ZVOED IS ACCORDANCE WITH •,^.L, P.O.B OX 20126 POLICY PROVISIONS. I AUTNOAI XrS BLPAE L[tITATIK/"""� i BETHEHE4, PA 18002-0126 / 9351 A 'y Town of Barnstable Regulatory Services Thomas F.Geller,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street. Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-740-6230 Property Owner Must Complete and Sign This Section If Using A Builder tr w o.rr I[J tAlC 1/,5/d Uitl Slits//1r ,as Owner of the subject property hereby authorize Sprinkle Home Improvement to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of J �� � Si ature f Owner Date L d cww,rd [VAIVCV .&AVIVIW & Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Usets\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 r Unrestricted -Buildings of any use group which COntain less than 35.000 cubic feet (991m3)of Massachusetts - Department of Guoiic saret• enclosed space. . Boara at Building Regulations and Sta^aares ( ••n.trurti,in Supcni%.�r .-;cense' CS4XWA43 n� 4 BRAD K SPRINK� failure to 190 LA37HROPS[:AN'E�, Possess a current edition of the Massachusetts W BARNSTABLE MA j State Building Code is cause for revocation of this license. tl' ror BPS Licensing information visit: www.Mass.Gov/DPS :oo nrmsswner 10/08/2013 Ofllee of COwwwer Affairs&Business Regulation License or registration valid for individul use only �kt�OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: F 1`�uon 103757 Type: Once of Consumer Affairs and Business Regulation ' cxpitatlon: 7/9/2014 Private Co 10 Park Plaza-Suite 5170 _ rporatior• SPRINKLE HOME IMPROVEMENT.INC. Boston,MA 02116 Brad Sprinkle 199 Barnstable Rd. i Hyannis,MA 02601 � Undersecretary Not valid witho signature I I • w Aviv ukxA 16E & o U E. i f O yGs c Is y No. 29874 0 a s �TISTEA���Q s��NAL t.AH�S4 IA v3 j &V _ Vic.•'•. 'L74.9s ..�� . 19e� (jl 1�J/F I� I�1L7 . N , s <= PT1 f=1 e b P Lj=r-r p L A►-1 l a-Ps S • IrJ 1�a4�n/ I,JST �3L1✓/ , MPnric1S%✓'1 I(15 �KUIsSW IGK�ILI L.J�U�k/j�,o•NUEQ-> r3D� �su�cK = NEP�F3�( ( =a7rrF( 7t4A'T 'n4r--' f✓L L 15 � 'TN U LI�J tl-J G. ' F�.Jr�DA-nou oI.t-f)-1 1 S .1c$rah 8S-�oR.. 4-7ei 1E �A nn __ fir' IS Lr�cA•TED IW QaY-J c:)" To GR 6 l: -1 PE T-1E t=jCIS"Pub uUMEu75 --st4�iJ E•ASr SA,JDvjte-t-4, MA .,-= s37 GN a•,/: Ncr 5N�'r 1 of , a Town of Barnstable $ Regulatory Services 6 »<�`e 3 �,'i �' Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: -508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not VaUd without Red X-Press Imprint Map/parcel Number 0 d O ► b Property Address_3164 Oo-Ke j CY) a r S S mills InA inau 4- Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address J U20A Q a N.(Arx0v Er � cX Contractor's Name Sprinkle Home Improvement Telephone Number 508 775-1778 Ext. 10 Home Improvement Contractor License#(if applicable) 103757 Construction Supervisor's License#(if applicable) CS 6643 XWorkman's Compensation Insurance MAR - 6 2013 Check one: ❑ I am a sole proprietor I am the Homeowner TOWN OF BARNSTABLE I have Worker's Compensation Insurance Insurance Company Name Associated Industries of MA/ AA.M Mutual Insurance Co. Workman's comp.Policy# AWC 7004943012012 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) I ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders.U-Value . _(maximum.35)#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. me Improvement Contractors License&Construction Supervisors License is SIGNATURE: C:\UsersWecollik\AppData\Local\M crmft\Windows\T tary Internet Files\ContentOutlook\DDV87AAZ\EXPRESS.doc Revised 072110 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): Sprinkle Home Improvement Address: 199 Barnstable Road City/State/Zip: . Hyannis, MA 02601 Phone#: 508 775-1778 Ext.10 Are you an employer?Check the appropriate box: Type of project(required): 1.(XI am a employer with 10-12 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P h'• 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 I I.❑ 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,Fki Other g 3,'AAoJ comp, insurance required.] *Any applicant that checks box#I 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: A.I.M Mutual Insurance Co. Policy#or Self-ins.Lic.#: 7004943012013 Expiration Date: 1/01/2014 Job Site Address: Skq 43o,4bV � City/State/Zip: /Mrj,_o1mSlYl�(�s 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 her r ' to7pa,ins and penalties of perjury tit at the information provided above is true and correct. J Signature: Date: Phone#: 508 775-177 Ext. 0 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#: 12/21 /2012 11 : 39 : 11 AM 8740 ® 02/02 CERTIFICATE OF LIABILITY INSURANCE DA-rE12/�D/Yyy) ,HIS CERTITICATZ IS ISSUED AS A MATTER Of INFORMATION ONLY AND COHreRB NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AWED, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND T8E CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poliey(ies) must be endorsed. If SUBROGATIO■ IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRDDUMA CONTACT I Bryden 6 Sullivan Ins Agency "m' Mum vas Inc. (A/c. ■D. Ext): (a/c. ■P): E- AXL 88 Falmouth Road ADDREsi: PR=uczo ; Hyannis, Lei 02601 eunoloR IM' MuR®(s) AFFGRDDNG covERaGE WAIc A IMAED usumm a: A.I.M. Mutual Insurance Co 33758 Sprinkle Rome Improvement Inc -4 199 Barnstable Road rus,=R t: Hyannis, MA 02601 INSURER D: IRmRER E: INSRRm r: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIN IS TO C3WMZY THAT THE FOLICIEE OF INSURANCE LISTED BELOW HAVE NINE ISSUED TO THE IaSUREa ■AMRM ABOVE volt THE POLICY v22I00 IZDICAT=. NoTwm3TAND1t0 ANY REQUIREMENT, wesm OR CONDITION or ANY CONTENT OR OTC DOCOIUXT WITH RESPECT TO WHICH THIS CERTIFICATE HAY BE ISSUED OR MAY PERTAIN, THE XESURANCX AFFORDED BY THE POLDCIES DESCRZam SNUMN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. Lffi15 SHOWN � MAY HAVE BEET REDUCED BY PAID MAZES. Lar+ TYPE OF INSURANCE POLICY NUMBER POLICY Err POLICY ESP LffiTS unlaa/rrw (In/AA/rrrr/ GOERAL LIABILITY 6ACN OCCURANee ❑COIMSRCLAL GENEPAL LI•BD.ITT DANAGE TO ROTED PUMISEsMA.oreo a—) s OOCLAIMS MAD! ❑OCCOP =D Ea (Any me peen) i ) ❑ rms on"L ADv IOUNT G!❑s'L AGGREGATE LIMIT APPLIES ER: CENLRAL AGGREGATa i ) []POLICT F]I—CT aLOC PRODUCTS- Cmw/OP AGG i 1 i AUTOMBIId LIABILITY corm lNED sums LIMIT ART AUTO (ee .cold..) i 1 ALL OWNED AUT03 BODILY lXnW (Oer Perm) S ❑.MDULED AUTOS NDDILY t$URY(,.,—I&—t) S FtlIRlD AUT05 PP mT) t6E s DROP-OWEED AUTOS Oi ❑UNBRQ.LA LIAR OCC OP EACH occuRREJR i 1:1—.1 LIAR CLA De MAD! AGGREGATE i ❑DSDUCTt DLE i ❑FETE ATIOR i i WORMS COMSENSATION ® AND EMPLOYEES LIABILIW Tosr LLQri ER THE PROPRIETOR/PARTHERS/ E.L. EACH ACCIDENT i 500,000 A EXECUTIVE OFFICERS ARE ® inci ❑ exci 7004943012013 01/01/2013 01/01/2014 L.L. E.L. DISEA -POLICY LD31 S 500,000 E.L. DISEASE -EA ENFLoaE i 500,000 CMAZIFTS DESCRIPTION Or UPmATIONS GR LOCATIONS: i f f CERTIFICATE HOLDER CANCELLATION CERTAINTEED 5 STAR CONTRACTOR SHOULD ANY OF THE ABOVE DESCRZBm POLICIES BE CANCQSED BaORE T88 EXPIRATION DATE T88EOF, NOTICE wn.L BE vzmx IED IN ACCORDANCE wrre THE P.O.B OS 20126 POLICY PROVISIONS. BETHEHEM, PA 18002-0126 ANTMORISED PEPRESZNT►TIVE 9351 Unrestricted-Buildings of any use group which contain less than 35.000 cubic feet(991M )of Massachusetts - Department of Public Safety enclosed space. Board of Building Regulations and Standards Con.trucrnon Supcni%,ir License: CS- MG43 BRAD K SPRINn--E v 1"LOTHROPS " • Failure to possess a current edition of the Massachusetts W BARNSTABLE MA _ State Building Code is cause for revocation of this license. For DPS Licensing information visit: ww*,.Mass.Gov/DPS _J Commissioner 10/08/2013 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only 4"` 4 ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: .; eglsttation. 103757 Type: Office of Consumer Affairs and Business Regulation x xpitation: 7/9/2014 Private Corporation 10 Park Plaza-Suite 5170 ' Boston.MA 02116 SPRINKLE HOME IMPROVEMENT.INC. Brad Sprinkle 199 Barnstable Rd. � ` Hyannis,MA 02601 Undersecretary N — ot validqwitho* ignature MAW Town of Barnstable Regulatory Services Thomas F.Geller,Director Building Division Thomas Perry,CBO 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 e'Qu , as Owner of the subject property hereby authorize Sprinkle Home Improvement to act on my behalf, in all matters relative to work authorized by this building permit application for: 31 �► mo kS 6z, mk 11S (Address o Job) , %% ♦ 6 Signature of Owner 0 l5ate Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppDataU-4Dml\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 FEIRM TOWN OF BARNSTABLE, MASSACHUSETTS i A=028-014-003 DATE August 26 N4 36989 19 94 PERMIT NO. APPLICANT Owner ADDRESS 384 Wakeby Road, M. Mills Owner (N0.) (STREET) (CONTR'S LICENSE) NUMBER QF PERMIT TO build Horse Shelter ) STORY Axcessory Dwelling DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 384 Wakeb Road Marstons A ZONING AT (LOCATION) Y • Mills,, DISTR'ICT- (N0.) (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) REMARKS: Sewage #86-211 AREA OR . VOLUME 240 sq. it. ESTIMATED COST S 600.00 FEE PERMIT 50 QQ (CUBIC/SO DARE FEET) -7 OWNER Nancy Brunswick 384 Wakeby Road, -Marstons Mills BU" Y ADDRESS B k� TOWN OF BARNSTABLE, MASSACHUSETTS. PERMIT A=028-014-003 DATE August 16, ,9 94 'N9 96989. PERMIT NO. APPLIICANT- Owner - ADDRESS 384 Wakeby Road,, M. Milts-, Owner (NO.) (STREET) (CONTR'S LICENSEK `^+q PERMIT TO wild Horse Shelter ) STORY Ancessory Dwelling OWEBEL UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATJ,ON) 384 Wakeby Road, Mars tons Mills, M NGA ZONI (N0.) � � (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'-- W ' TO TYPE , USE GROUP BASEMENT WALLS OR FOUNDATION sewage #86-211 ( (TYPE) REMARKS: AREA OR $VOLUME 240 sq. ft., ESTIMATED COST $ 600.00 ,` (� FEEMIT 50 QQ (CUBIC/SQUARE FEET)' OWNER Nancy Brunswick ADDRESS 3$4 Wakeby Road, Marstons Mills B U I L Iro 5/81P lrl�2' BY 7A e, t�T • l THI.S;.PERMIT CONVEYS NO RIGHT T:O OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EIT HER TEMPORARILY OR i 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. tk MINIMUM OF THREE CALL -A PPROVED. PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARDi KE PT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK,:` ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS: MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO'COVERING-STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI N BEFORE FINAL 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 1 2 2 2 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 1 2 BOARD OF HEALTH OTHER SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. 1 BUILDING . PERMIT pf O yG� o IS N No. 29874 as ' \fv ss/ l lA i Ov IN 3 ' 4.95 'Z t. 4 . u/F d - - 1-91 CE�.TIFIta� ALOT ALAS l�Ts 5 Ca WA L/-E • T TAi-,La, MAI-szc+ S/ 1),a5 I3Ku►.r5w Ic.K�1LI LN��k 11�(,avuc�-> ..ALA. I Z. 1� DATA: -7•22.85 fsucL 2 N EP�f3`� ?7-I AT GLIB-1T: Kic�PFkP - E�(IS'T'l11S C LL I S e� TF-IU LIrJ li-1 G. Jc�rs`-' : bnn�S OIL fir. IS L�A7�D II-� QCIJ�CfIo►-J T<n 4'76 �xJ'TE �A pQ F5-!% J Lt 'Tt-I� �cIS"P►-tb rJVMEuiS �r b�N►J )=AST SAt1�/!Gr-!, MA .,02537 Gt1 0-(: bcr �-�.-�-�- ;I a y TOWN OF BARNSTABL£ BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE _ �GAg C JOB LOCATION •3 � L(/i�i���� . � �,�.�T�J'C0 �/YJGC.G� Number Street Address Section Of Town "HOMEOWNER" 4 r¢AJ Name Home Phone Work Phone PRESENT MAILING ADDRESS City/Town State Zip Code The current exemption for "homeowners" was extended to include owner- occupied dwellings of six units or less and to allow such homeowners to engage an 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 to six family dwelling, attached or detached structures accessory to such use and/or farm structures. ' A person who constructs more than one home in a two-year period shall not be considered a .homeowner. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such cork performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Coda and other app:licab'e codes, by-laws, rules and regulations. . The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements HOMEOWNER'S. SIGNATURE 0 ' APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. HISCS v HOM� OWNER'; EXEYIPTION The code states t11at: U Permit is required shallAbe exmpOwner pthe pMingsiork for (Section 109. 1. 1 ns of thisch a building Home - Licensing of Construction Supervisors) section Owner engages a persons) for hire to do such w % Provided that if Owner shall act as supervisor. " work that such Home Many Home Owners who use this exemption are unaware the responsibilities of a supervisor see g that the for Licensing Construction Supervisors, Appendix Q 1' are assuming awareness often results in serious problems, pa 2.15' Rules and Regulations .Owner hires unlicensed persons. � ' This lack of P In this case pOurlBoardrlcannot when the Home ay`ainst the unlicensed person as it would with lice Home Owner acting as supervisor is ultimately res proceed onsi used supervisor. The To ensure that the Home many comm ,. P ble. Owner is fully aware of his/her responsibilities unities require, as part of the e Owner certify that he/she understands he permit application, that the Home On the last page of this issue is a form currently used of a You may care to amend and adopt such a form/certification supervisor. community. f sti by several towns. tion for use in your I f The 'Town of Barnstable • BA&NSfABU- MASS. �0l Department of Health Safety and Environmental Services ram' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crosson Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW ' SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair, modernization,conversion, improvement, removal, demolition, or construction of an addition to any preexisting owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. /Type of Work:�Ud� ry-a o e— 3 Sl�Ste, Est. Cost (� o-o Address of Work: 3 a Y Owner Name:D79/1OC�� r� (J/USC•U'lC�( Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law —Job under S 1,000 Building not owner-occupied O%%Mer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor name Registration No. OR D e wner's name CO MMONTWF A T TH OF MA.SSACHUSETTS DE^„ TNfF—NrT OF TN'DUSTRIALACCIDENTS James Zip)\i Q?�, ',`._ ,L i l S I I ti 02111 m l.c r'::�c WOItKa-RS' COINOENSATI0N INSURANCE AFFIDAVIT (licensee/permincc) with a principal place of business/residence at: t37�y L Q r4(<661-/ 111 YAP S nu s A ►e c. cis (City/State/Zip) do hereby certify, under the pains and pena]ties of perjury, that: [ ] l am an employer providing the following workcrs' compcnsation coverage for my employees working on this job. ]nsurancc Company Policy Numbcr O I am 2 sole proprictor and havc no onc working for mc. ( ) l 2m 2 sole proprictor, general contractor or homeowner (circle one) and havc hired the contractors listed bclo,,%• who have the following workcrs' compcnsation insuranec polieirs: Namc of Contractor ]nsurancc Company/Policy Numbcr 1\2mc of Contractor ]nsurancc Company/Policy Numbcr N2me of Contractor Insurance Company/Policy Numbcr 91 Cm 2 homeov•ncr performing all the work myself. NOTE: P1c:sc be :--+•:.sc th:t wbilc borncowncrs v.•bo employ persons to do maintcnancc,construction or repair work on dwelling of not more th:.a tbrcc uniu in wbicb the bornco�zcr also resides or on the grounds appurtcaant thereto arc not FcncrJl)- considcrcd to be employer u s ndcr the Woriccrs' Compcns:uon Act(GL C. 152,sca. 1(5)). application by a bomcowncr for a liccnsc or permit r :y evIdcccc the 1cFJ sur s of:- er-.sploycr undcr the Workers'Compensation Act I understand that a copy of this st:tcmcnr will be forwarded to the Departrnent of Industrial Aeadenu'Ofisee of]nsurancc for eovera=c �criftcaio.^. ��d tb:; fi!u:c to secure caller-gc :s rceuircd undcr Scetion 25A of MGL 152 e.:n ]cad to the imposition o(uimina]pcnJtics eor.siscnp or; fmc of up to S l 500.00:.nd/or imprionmcnt of up to onc yc.:: :nd&-:.' pcnJtics in the form of: Stop Work Ordcr and fine of S 100.00 a day ag:ir.s; Mc. Signed thi dayof. 19 Licensee/Pcrmirtcc Licensor/Purnirtor 2e A7��,R"e- Assessor's office(1st Floor): - a. Assessor's map and lot numb �� ''Ol�' ��3 a SEPT#C$yq y E 5 � r c�YMc to ' WS BALLED 8P9 COMPL@d"ACE �`Q�'�`•,, Conservation(ath Floor):.- �f6TB�TOTLE Board of;Health(3rd flo ! ' n { D�Ii17T�DLE Sewage PermiCnumbe - ENVQRONVJENTAL C®E 039• d° Engineering Department(3rd floor): , 'Tolp"N House number Definitive Plan'Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2-W P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO { TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location / Proposed Use`1-f{� Zoning District Fire District Name of Owner Ili A-"t�`( i.1 NSci s/f,lC Address ? �� 1 A-<156`/ Name of Builder Address—,t d]3 S Tt 6J5 L.tr S Name of Architect Address Number of Rooms Foundation �o to Exterior ` Roofing Floors A i f Interior Heating Plumbing Fireplace Approximate Cost 4-6 Area Diagram of Lot and Building with Dimensions Fee U 3 s tAd s 1�-e_d C� x I il a_{ls r �r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Siipervisor's License �. BRUNSWICK, NANCY No Permit For BUILD "HORSE SHELTER > AccPgsnr�z to DwP1 1 i nq Location 3 8 4 Wakeby Road I Z� Mar-stons Mills i Owner' Nancy Brunswick Type of Construction Frame � I `tea t _ Plot ` Lot f Permit Granted August 26 , 19 94 =ti` Date of Inspection: ! Frame 19 } 1 , Insulation 19 Fireplace n 19 ' g Date>bomi leted Q. Z/� 19 i t �Q wlnonmri��. �r) Map Qc2g Parcel 01 11n Permit# 3o 7 Q 0 House# Date Issued rIm /Board of Health(3rd floor)(8:15 -9:30/1:00-_,�,�n'1 Fee Conservation Office(4th floor)(8:30-9:30/1:000-�21:00) �- J Planning Dept.(1st floor/School Admin. Bldg.) BE SYSTEM MU Definitive Plan Approved by Planning Board 19 INSTALLED 1N GOMP , WITH TITLE BARNSTABLE. TOWN OF BARN NTAL CO ,� ECULAMA TIO Building Permit Application Project Street Address VVAKC a�1- Al2' Village MPR64X;P1S MA"U.S '. Owner NJ L (Zvv4s c Address CZ,� Telephone Permit Request �OJ4Iw 0r 1'L x\2 �O`k Sect lS o�► First Floor square feet Second Floor square feet Construction Type \-Ck70 Estimated Project Cost $ 1,�Qo Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure S A2. Historic House ❑Yes -6-#o On Old King's Highway ❑Yes C4 o Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other_ (V �.. Basement Finished Area(sq.ft.) Aj _ Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 4Zd New /V� Half: Existing A/4 New No.of Bedrooms: Existing (? Alf)— .New 2 e5l j)� Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric El Other &4 Central Air ❑Yes 9No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE B I GP EN ED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. ./ U DATE ISSUED MAP/PARCEL NO. 1y 0 ADDRESS VILLAGE ' OWNER _. DATE OF°INSPECTION: FOUNDATION r - FRAME INSULATION - FIREPLACE ... ' ELECTRICAL: ROUGH FINAL' PLUMBING: G FINAL, Aj GAS: ' !10-UGli FINAL:r - �.;� m - K FINAL BUILDING tia 4 .d u - DATE CLOSED OUT i ASSOCIATION PLAN NO. t r AWEBy IRO Hcsec :s+-Au, PpDtt,o Aj en Cl\ BOA C4 C S o_ , i �r -P6'5T" COASTAL CONSTRUCTION CORPORATION ., DAILY FIELD REPORT Date: PROJECT NAME: QUINCY RETAIL BUILDING WEATHER: GENERAL REPORT OF WORK: c-, MANPOWER REPORT- Subcontractor Subcontractor Trade # ofinen Description of work r. COASTAL EMPLOYEES. Name Description ofwork Hours worked: DELIVERIES, REMARKS& VISITORS JOB SUPERINTENDENT i 8� W A\<CBY 'RD HCR5 C- SIAU, A4-1 BoA QV 7 OD � 1 i la lo� 3 �� y f •1 The Commonwealth of Massachusetts =_ Department of Industrial Accidents exce ofinlrestigations = t 600 Washington Street Boston, Mass. 02111 Workers' Com ensation Insurance Affidavit �ocation: one ci # am - a ho:�mepowner performing all work myselfg. I am a sole ❑ I am an employer providing workers' compensation for my employees working on this job. company name: address city phone#: insurance co. V0IicV# FRI ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name- address: IX city. phone#: :., insurance co olicv# company name address: city-, phone#: Insurance co. - : ,<:_ olic # Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date :/'S L— _ Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised 9/95 PJA) ti Information and Instructions t Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any 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 ihan three apartments and who resides therein, or`the occupant ofthe'dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or 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,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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be ret<rned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. WOMMEVEMN The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Invesugadona 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 - ' phone#: (617) 727-4900 ext. 406, 409 or 375 • ii, • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. `.'DATE �.- ..... , ./JOB. LOCATION c�� � � ,�„�,.�,`�,� • -• Number S eet address Section of town 11 HOMEOWNER" Name I Home phone Work phone . 1 f PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEPINITION OF HOMEOWNER: Person(s)' who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one 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 Officia. on a form aceeptAble 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 Sta- Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands . the Town of Barnstable Building - Department minimum inspection procedures and requirements and that he/she will compl with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. I ' HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a 'building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do such work, that such Home Owne: shall act as supervisor. " 4 Many Home Owners who use this exemption are unaware that they are assuming the responsibilities' of a supervisor' (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This lack of iwarene; often results in serious problems, particularly when the Home Owner hires unlicensed persons. ' In this case our ,Board. cannot proceed against the inlicensed person as it would with licensed Supervisor.: The Home ' Owner actir. as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/Ater responsibilities, mar. communities require, as part of the "permit application, that the Home Owner certify that he/she understands the responsibilities of a `supervisor.- On- the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. CF THE T� . � The Town of Barnstable • �txsTnst,E, • 9e�A 0519 Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 I Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only , Permit no. Date ' AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW t SUPPLEMENT TO PERMIT APPLICATION c MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work• ),, aZeo Est. Cost Address of Work: - 11--cwner's Name *JAWU� G ate of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY [hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date O ner's Na e FRAM I NG SECT ION ALL DIMENSION LUMBER SHALL i BE KD SPF NO.2 OR BETFER. x COLLAR.TIE i, 2 x RAFTER @ O.G. i. SHINGLE 2 x ' CEILING JOIST " O.C. W/IS LB. FELT � I Ix PINE FACIA R-30 KRAFT FACED FG BATFS R- UNFACED FG BATTS —f SOFFIT VENT W/6•MIL POLY VAPOR BARRIER PINE SOFFIT (1 st 2ND FLOUR) I1 1 I I 17-7-71 I 1 L2x FLOOR JOIST @ O.G. (isr 4 2Nn FLOOR) i I 1 1 SILL , e SILL SEAL yp- ANCHOR BOLT _ @ 6"-0` O.G. CONCRETE ", c FOUNDATION WALL • � �1�rl;t'C2 St��E 2" i�A /1A/ll1 AVM n n . 4 ZifIE-LIA16 �ar.sf G, WALL S .. iC i r v of t) A-T-I D Al WALL i ' ►� g��cl�� �taa� SC•l4f� T(�I[!1 oil The • own ®f Barnstable , \��'i,v a F_ S o UE/� -- FELT yam. o P� • '�>�- � \� � /�/AFTER 5 @��©, C, � . CI-G JOIS7S (TIL O.0 i C X(S T/N G C G.G , SD!S -r >. . Dv c,u xlSTlA) G I jf)L(- ro 6E 9E1novEP- F4-vw 00 D FL o o F 7=- F. 77 slc.L T V m/n4 seSsor_'s_man,..«.-4—L+. __ OFTMETG - . G�CSewage Permit number .... �, oaNEcT � o ........... .. ........... House number ............. .... '. :. ... -3 v y 90 Asa s .n , .. v� 9T/1DL MASM 1639. [ TOWN OF �'BARNSTABLE BUILDING -,j,IHSPEC:T01 APPLICATION FOR PERMIT TO . rrl/G�j...:s�.!i.Jrle... i9..i7�L ....f/orrr.e......................................... TYPE OF CONSTRUCTION ......... OS.7... /7.�J......�P ........................................................................ u.'...��.....a....................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: I-Mr s /�(LGs C .Location W e Q KC/`1�.................S /0�1 .........r.......:......... Proposed Use s. �9Le r �Pn� _................................................................ ......................... Zoning District .. �- .� !�. �.!Y.L...............................Fire District. ........................................................................... . Name of Owner 4 iMvrroq f /QrunSW1���.Address .�O7uI T /C/) Hl�j�?PPe .... ........................................................................l6rul7s*wy., .. ...r!rnurro� C �qic rT // (117S/7,0eName of Builder .......................... ... ....................... ....Address .................................................... ............................... Name of Architect rDr Pry ?`off H0177 NO�W(C/j UP/'/y7e/7 ..........................................i ...................:Address ..................................................................................:. F Number of Rooms .......:5....V.�n........................................Foundation ......0!!C ... .......�................................................ Exterior ShlrryL�S .........................Roofing .... sPti�L . ' ................ ........ Floorsa � sPru� ..............................Interior ..... .P....�..�....�.................................................................... ` Heating ElP� T Al�+'1/� .......................Plumbing S //9/� �fI.. Jk:...�.... 7� .................................... ' Fireplace ..Approximate. Cost �Ob n ..17 L�.................. ................................................... Definitive Plan Approved by Planning Board --------------------------------19________. Area .......p 3 ................. Diagram of Lot and Building with Dimensions FeeC'.7 . SUBJECT TO APPROVAL OF BOARD OF HEALTH A 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. NamemkU , _ . Construction Supervisor's License KILMURRAY/BRUNSWICK A=28-14 --�_3 28240 Two Story N( ................. Permit for .................................... Single Family Dwelling ............................................................... .............. Lots 5 & 6 384 Wakeby Road Lcation ................................................................ Marstons Mills . ........................................................................... Civner Kilmurray/Brunswick ................................................................ • T e of Construction ....Fame.:..................................... .................................... ......................................... PbtLot ................................................ mit Granted ........b4lv..23..................19 85 te of Inspection ....................................19 Dte Completed .................................... 19 r. A /Y7 r c July 23, 1985 Dwelling will not be occupied until oil burner permit is issued by Centerville-Osterville Fire Department. Michael Silva M.M. Construction .t1lJ t G T )A ,. 27466 W-N TO f OF BARNST;ABU Permit No. - --------------..------ • . Building Inspector a►nn f v ►i}6 i Cash fyb OCICUPAN.CY �PER IT Bond -------------------- p r l.cJ & Issued to Frederick Rojee } Address lot #7 /-) 4Q4 Waleeby Road, Mar,�tons Mills_ �%� Inspection date Wiring Inspector �. ,` � f Plumbing Inspector Inspection date Gas Inspector �s r Inspection date i n -"Engineering Department Inspection date J Board of Health C Inspection date 6 THIS PERMIT WILVI 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 BUIL DING CODE. J!",Zq....2-3 �r Building Inspector WQ'' •o TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BU,,ILDING ab '639• `� HYANNIS, MASS''02601 I d , MEMO TO: Town Clerk FROM: Building Department DATE rJ /�s An, �-O'ceup'ancy .Permit, has //been issued .for the building..authorized by., Building Permit #._ l . L ... /2...................................................__. ._.... .._...r.........._........ . w issued t r ................._...... ... _ .Please release the performance bond. ,y ' �`i � �` � 'y '�...�"p �, Off- .• . _ Ao , 1 O T Ir - - E` Nl� "I CERTIFY THA T THE FOUNDA TION SHOi✓N ON THIS PLAN TS AS IT ACTUALLY EXISTS AND THAT PLOT PLAN OF. LAND. i I T CONFORMS TO THE TOWN OF SARNSTAB �oZ _01VING LOCH TED IN REGULA TIONS BARNSTABLE -- MASS. DA TE:-.%-/ ..,v e& 1985 � _` � • PREPARED FOR 4t)K;� DATE'✓•v�v .c'3� 19BSw� SCALE. 1 BO FT. "^^ � CAPE C ISLANDS SURVEYING FL O,OD ZONE _ TEA TICKS,T - MASS. ',/3 P1-- 0/1/17/ Aisessor's map and lot number .40+71 -19- oo& THE ro OK. )J '35 - D- Sewagg Permit number .............................. ...................... INS"IALLED IN WiTH TITLL 11ARNSTAILE, ouse number ......................... MAO& . ................................................. 1639. L ENVIRONMENTAL CC,�� NO TOWN .,OF BARNSTABLE ' BUILDING INSPECTOR � ^y LA-t APPLICATION FOR PERMIT TO ..........Qn..e........0 .. ,;;,.. . aa.s --. �:................ .. ...... e ti TYPE OF CONSTRUCTION .........ff.... ....C-t......... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ...........1.�� -. .... ..A i;g Location ............. ,CAP .... ..Y.E.J.., ........................................................ I.v kl�k A.........W"' ProposedUse ..................... ..... ..... .................................... ............................................................ ZoningDistrict .................... ................................ . .........Fire District ....b........................................................... 14-C 27 WS rV-- ame of Qew�er ........4......... ................ ..........Address ........ .......................................... ............. .......... ..z of '..Address ...t4a.4.y.....caf.v ame JQVr�...................................................... ..4..............L... Name of Architect ........ ............Address ...../.U.7....... ...... Number of Rooms ............1�7-4(9.L.4--S...........................Foundation ......... 1%........................................ Exterior ......... ........................Roofing .......... ............................................................. Floors ................... ...................................................Interior .... ........................................................ ................. /- 404 46AZ 6 AAi s Heating .................A........................................�.?!g.......Plumbing /�.a.......&.1........................................... Fireplace ..................................................................................Approximate Cost .......... 000 ;/................................................ Definitive Plan Approved by Planning Board --------------------------------19-------- - Area ...... ............ ......... . ......... C�7,5 Diagram of Lot and Building with Dimensions Fee ...... / :z ..................... ........ 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 ............................ .. . . ......... ........ Construction Supervisor's License -71 - , -FREDERICK 4 IN. .... Permit for .one—Stoxy. ............... • �Sa ngle Family..Wellin r Lot 7, Wakeby Road = � Location .......................................... ................... Marston Mills ............................................................................... Frederick Rojee Owner ........................ �,- .. ............................ Frame Type of Construction .......................................... t ............................................ .. ................................ �: r Plot ............................ Lot ................................ - Jai?...... 2 4 ..........: 85 Permit Granted ........ ..��'.... , 19 Date of Inspection ............................ .......19 Date-,Completed /� .' 3 5. .19 of ��� 0� ,) Assessor's map and lot number ...... 'ti. L ... (> 07 R -K *THE �4,,. ro 3b�c, � �,. Sewage Permit number .......... Z BA439TADLE, i House number .................... ..�1 ........�.......................... *oho,1b 9• r L CFO MAI ale TOWN OF BARNSTABLE _ 'BULDIN•G JNSPECTOR �� �y APPLICATION FOR PERMIT TOE ©h F .OW L �......./ c2A,.) $ _ _ 4TYPE OF CONSTRUCTION .. . .�....!Y....2.(:�........�!:�:.� 'C. ....... G ............................�� Fcv�+ y ......./..a. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit 1 according to the lfollowing information: Location ............. o. �d� �....... K� �� I/ Yj r `. f4.��..5. .S ! �..�':S......... .�....... . ..................................... .... ProposedUse ........................... ............ , If.... ..................................... ...... ................................. ZoningDistrict . ......Fire District ....... ..........................................................\ ( Name of Owner .................. ..e.......................................Address ..................:......................................... ......... ............. Tr. fig"c" c2 C P77 ffP 1 t Z. .. F �? � c?�� � Nameof BoildQr ...............................!......................... E ' Address ........................................ . � .�... ........ Name of Architect . ! , ...........Address i : r � t . o wt. Number of Rooms � S .:............Foundation d � h .........` Exterior :........ 0 �`1 ...:`�.,<,.,�.!`!�r�.i/.0 ..r (_...Roofing ........ ,i ........... 1...............................:.........:...... t. .. Floors ...................Interior ........ ........................v.. .S........................... /../.................. Heating ,(� [�!4 �E- ... :�........Plumbin ...............................................................111 .�'............... .. ..... ....�.................................... g Fireplace ..................................................................................Approximate. Cost .......... ?..�i....QdU............................... Definitive Plan Approved by Planning Board ---------------_----------------19________ . Area ���/ /* f J Diagram of Lot and Building with Dimensions Fee ' ..<........ SUBJECT TO APPROVAL OF BOARD OF HEALTH41 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform t9 all the Rules and Regulations of the Town of Barnstable regarding the above Name ..............................-,t .......1. �.. ��'..... r - Construction Supervisor's License �j 2 S'�Z— " ROJEE, FREDERICK A7-28-14 No ..274.6.6..... Permit for One Story ...................... . . .. .... .... ...... Single Family Dwelling ..................................... Location . -3X Wa .......... kebY Road ................... ................Mars ns Mills................................ Owner ......Frederick Rojee ........................ .............................. Type of Construction, ....Frame...................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ... .............19 85 Date of Inspection .....................................19 Date Completed ......................................19 -2- 3-1 Assessor's offioe (1st floor) TNfaQ . :Assess TnaP:an��lo�nume� ........ ..� .� /l K o Board4of Health Ord floor): Sewage Permit number .............................. ..... .. . ......... t DAUST&BU, S NAB Engineering BEn ineering Department (3d floo 16 House number .ry ff.. 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 .......................?..'`� �................................................................................... TYPE OF. CONSTRUCTION C/U U.C�.. .4Y.. Q.rn ........................../............................ .... c! �.................19... � TO THE INSPECTOR OF BUILDINGS: / The undersigned hereby applies for a permit according to the following information: Location .. .•1......... /= ..l....... . /C/ ......... . .L........ � 5 ProposedUse .C .......5 .v ...................................................................................................... ..................... .................... Zoning District ...... ...........................................................Fire District ....................... .: �• Nameof Owner ......................................... :........................................ sC - Name of Builder r..................................Address . Name of Architect ........................ .........Address ..............:. N U...... ...................... .................................................................... Number of Rooms ..................................................................Foundation ...........5011 O TCJ P S Exlerior ................. ...........al.............r........................................Roofing /�'S�/�/� L;% ......................... ... .. .................................................. Floors ..............................(1�,1...o(Q..f..................................Interior ................U.n. :�n I S ................................................... Heating ..........................N..o.(�J..�..................................Plumbing .............. /1! d q Fireplace Ad..0.N e.. !...............................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board ________________________________19-------- . Area ......... T ZO ..... .. ................... C90 Diagram of Lot and Building with Dimensions Fee v�� .................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH- ,h • 3 �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 !� 0 -1..... .......... ....... ......... Construction Supervisor's License ... ........ KILMURRAY, MARK -& NANCY , A-287014-003 31261 Build Shed No ................. Permit for .................................... Accessory to Dwelling ......................................................................... Location .........3.8.4...Wa.ke.b.y. ...Road. ... .....(.Lot...#5) ..... .... .. .. .. .... .... .. Marstons Mills ............................................................................. Owner ........Mark....&....N.an.cy,...K.i.lmu.r.r.ax. ..... .... . .. .... .... .. . ....... .. . .. .. Type of Construction ' Frame ................. ............. .. .. .... ............................................................................... Plot ............................ Lot ................................ Permit Granted ............19 87 Date of Inspection ....................................19 Date Completed ......................................19 M Assessor's off ioe (1st floor): TEE A -nap or lot��r umbei ...a.% ssessor's ...Q.�. ..`..� � l `•Of ?OHO . 7 Board�Health (3rd floor): SYSTEM M MU�� Sewage Permit number ............. .. .... ........ . ......... Engineering Department (3�floor); [Cb-LED IN �'®�� A;atL, ° tln� �I���House number . . ........ gatAPPLICATIONS PROCE SED 9:30 A.M, and 1: 0 2:0. P.M. only i1`'�"�� � �����EGUL ®�� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..................... !`'C i.................................................................................... TYPE OF CONSTRUCTION ........................ ...c1.C�.. .. . ...G4.�Y�Q I , . ... ....`,�.................19- ... TO THE INSPECTOR OF BUILDINGS: The undersignedd hereby applies for a permit according to/thhe following information: 64:7r:$) Location .. .U.. ......Wh4icl ..Y.....�1.� �l/. ,5......... L.L..��.... ProposedUse f7`. .V.................................................................................................................................................... Zoning District ...........................................................Fire District ......................... Name of Owner //lMIQ7001 (./1�4 !..UM/1-lAddress .................................................................................... Nameof Builder ............................:.......................................Address ....:............................................................................... Nameof Architect ............... ..U. ..e..............................Address .................................................................................... t 1 Number of Rooms ...................I..............................................Foundation ..........., ....U. .e. ............................. Exterior ............................ ......................................Roofing ................... ................................ Floors ..............................(..U.nl..C..................I.................Interior Heating ..0(\1.. ..................................Plumbing .............. ...../...`.f�/U..E-....... �p 6-6l/� 0-6/..1 Fireplace ........................ j..Cf.1 ...................................Approximate Cost .................. ;".,",v..'......................... Definitive Plan Approved by Planning Board ________________________________19-------- . Area .........1-TZ.o.` .............. Diagram of Lot and Building with Dimensions Fee �� OO ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH -- 3 i6 75 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �. Name ...../. .. .. ..................... ......... Construction Supervisor's License ... ul". .- ............ I - KJLLMURRAY; MARK & NANCY 31261 Build Shed No .................. Permit for .................................... Accessory to Dwelling �g............. Location .....3.8.4....W.a.k.eb.Y...R.oad....(Lq.t....#-5) Marstons Mills ............................................................................... Owner ......Mark....&...Nancy..!�i.lmurray.. .. .... .. . ........... .. ............... Type of Construction .........F.r........ame..................... . .. .................. .......................................................... Ploi ............................ Lot ................. October 5, Permit Granted ........................................19 87 Date of Inspection ..... ..............................19 4 or ,117 Date Completed r pF SAS o yG� O IS y No. 29874 0 P A �tv ssi�cis.T NoSJQ,� W �: v e3• �; W o � IA 6 0- . 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