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HomeMy WebLinkAbout0083 WHEELER ROAD �� � � � �2 � � � �� .__, c ,. � ,. . � - _..r. ..�.. .. �_:v..,... �._�.—_ V Town of Barnstable *Permit# Zt1E o Expires 6 monift from issue date Regulatory Services Fee 1 [ �W q a-BARNSTABI:E:. 059 -�- $ Thomas F.Geiler,Director s63q �0 Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma us Lo Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY n Not Valid without Red X-Press Imprint Map/parcel Number / 0/3) Property.Address Y'A 0J_4 `Y g- [Residential Value of Work q,�5 Uz) Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address • �3 �R�� fop Contractor's Name Mal-h— -7� Telephone Number 5o�j'lj� -41 I$ Home Improvement Contractor License#(if applicable) lZ �C5 Construction Supervisor's License#(if applicable) 6 i�t5 5 ct 4, no-rm C F RM ff ❑Workman's Compensation Insurance 4 2013 Check one: JAN ❑ I am a sole proprietor Pam the Homeowner have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name "Y' Workman's Comp.Policy# -7 O L .41 C 5 6110 -Z Copy of Insurance Compliance Certificate must accompany each permit. Permit Req st(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to SG ❑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. ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required.• +Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner t sign Property Owner Letter of Permission. A A�, V, Iprovement Contractors License&Construction Supervisors License is r SIGNATURE: QAWPFILESTORMS\building permit fomrsT)TRESS.doc Revised 053012. A i The Commonwealth of Massachuseth $eparbnent--of-Industriall�cEidenis Ogre of Investigations `"4 600 Washington Street Boston,l4 02111 . "n mmass.gov/dia Workers' Compensation Insurance Affidavit Builders/Contractors/ElectricianslPbnabers Applicant Information Please Print Legibly Nagle(Budnew/oiganizationftdividual): City/StatelZip: r 6 Phone# Are n 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 consb=ion employees(full and/orpait-timre)-* have hired the sub-conbachm 2.0 I am a sole proprietor or partirer- listed on the attached sheet 7. ❑Remodeling strip.and have no employees These sob-contractors have g_ ❑Demolition::-- working for me in any capacity. employees and have workers' g ❑Building addition [No workers' comp.insurance comp.insurance-1 5. ❑ We are a corporation and its M❑Electrical repairs or additions required]3.❑ I am a homeowner doing all work officers have exercised their 1 l_❑Plumbing repairs or additions right of exemption per MGL myself [No workers'comp. 12.❑Roof repairs insurance required.]T C.152,.§l(4),and we have no employees.[No workers' 13. 03herC.b camp.insurance required.] 'Any applicant that checks box#1 mast also fill out the section below showing their wotiters'compensation policy information. i Homeowners who submit this affidavit indicating they are doing aII tract and then hire outside contractors must submit anew affidavit indicating such. FCmtract ors that check this box most attached an additional sheet showing the tame of the mob-contractor and stale whether at not those entities bare employees. Ifthe sub-contractors have emplo3ves,they must.Provide their workers,comp.policy number. I a-in an employer that is ptvviding workers comgnsation:insurance for my ampioyee& Balom is thepaU(y snd,joh site information. Insurance Company Name: �l�"' Policy it or.Self-i ins.lie.0- 7d 5 f?b a'nDate: Job Site Address: �!r City/StaWZip:�G r S/e,10 S l/JJS 0�b y'U 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 tine 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 maybe forwarded to the Office of Imestlgatitms of the DIA for insurance coverage verification I do hereby caW y under the pain an aloes ofpeditry that the information provided abo v is true and correct S #ure:. Date: Phone#: 0joicial Use only. Do not write in this area,.ta be completed by city'or tow,offiicia! m -ram: Permmit./License If Issuing Authority(circle one): L.Board.of ffialth 2.Building Department 3.Cityff-own Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other . Contact Person: Phone#: of ems. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02661 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 I,Tc— A, Y",,rt44(- LJ,.'k-IS w ; as Owner of the subject-property hereby authorize llkllo 20e)+ to act on my-behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner 0 Date --:(A/VC. A, Y►-LA 2SN4L1-- LL)YL i 641 iY il,A t✓ Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on,the reverse side. QAWPFILESTORMSIbuilding permit fonns\EXPRESS.doc vo 4—A A-Ml 1n °FIHErO Town of Barnstable Regulatory Services M Thomas F.Geiler, Director e�s � Building Division Tom Perry;Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office:. 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned "homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and,requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 15,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing-of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot,proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 6 .3 a assac users-1epai ci-nent A"r'ub6c Sc etui Bawd of 8Li4iding Regulations and Standards _icene e: CS-048546 MARK D BMO T I 35 PEET TO1Kb CENTERVIFLEMA0263Z ratjcrl :•om.miss:ane 01/27/2014 8 /.6/2012 1 : 18 : 40 PM 8935 0 02/02 CERTIFICATE OF .LIABILITY INSURANCE FDaTEos o 20 "'. THIS C1RTZPICE IS ISSUED AS A MATTER OF INFORNATION.ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE AYS I . DOES;ROT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER".TNE COVERAGE AFFORDED BY THU.POLICIES BELOW. THIS CERTIFICATE OEt INSURANCE DOES NOT CONSTITUTE A.CONTRACT BETWEEN. THE ISSUING INSURER(S)', AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ' IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the po'licy(iss) must be 'endorsed'. If SUBROGATION IS WAIVED, subject to .the terms and conditions of the policy, certain policies may require an endursement. A statement on this certificate does not i ;..confer rights to the certificate holder in_lieu.of sueh•endorsement(s). _ -----_— _� PRODUCCR CONTACT Leonard Insurance Agency Ina AM: eNJRe r(A: 683 Main Street Suite B e-xAI 17.i (A/C. Ro,: L osterville, MA. 02655 —_— —T— INSURED(S) AFFORDIRO COVERAGE RAIC N :NsnRED ( INSURER—A: A—.I.M. Mutual Insurance Cc J Mark Herbst I--- 3�50 —? I{�•INSURER B: _ 35 Peep Toad Road SH6'Ul �C' Centerville, MA 02632 INSURER D: . r, IirsuRER e: I INSURER T: - -- I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: T8I5 ZS 1G CERTIFY THAT THE POLICIES OP INSURANCE-LIS'1ED BELOW HAVE BEEN ISSUED 7rD THE INSURED NAMED ABOVE FOR TBE.POLICY PERIOD INDICATED. iNOTWITHSTANDING ANY MUIRQSRT, TERN OR CONDITION or ANY CONTRACT OR.OTKER DOCUMENT WITH RESPECT TO WHICH-THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, .EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN LMAY HAVE BEEN REDUCED BY PAID CLAIMS. Iwar LII4IT5 POLICY NUMBER� POLICY Err POLICY Eh? ' I j L:r TYPE OF INSURANCE -- � IADNn/TTT'r) � ,AVlonnrrn I GENERAL LIABILITY 1 ' EACH OCCURAHCL 6 , �.C'"ERCIAL GEVERAL LIABILITY I I DAMAGE TO RER`TED e ; ' PREMISES(Sa. 4a ..') j I I l I �❑CLAIMS NWE []OCCUR ' , RED L707 (Any one PDxaon) I 8 I 1 I I I I PERSONAL G ADV IIFTURY ! I F] ..RAf. AGGREGATE i I :TO'L AGGPECATE LIMIT APPLIES CR: I L_ ' i ❑ ❑ ❑ ) : PRODUCTS - CDxP/OP POLICY PRCJE[T LOC I AUTOMOBILE LIABILITY I --� �- CnFE�SrBGu LDIIr .6 i I I I (ea accident) ' ❑ARY AUTO • .I., � I I BgDILY INJURY (per_p�•.r�ml—i.8'. - I ` ALL QiI ED ADTb9 - SCHEDULED AUTOS I .� �'aODILY INJURY(Pr[aooidCrt, I G .) PROPERTY DAIAUE - a O HIRED AUTOS I I (Per...id-t) I [boll-CURED AUKS I P.L.LI.1B O OCCUR � T � I EACH OC CURRCRCE � 8 J I I OEXCESS L!AB O CLAIMS MADE) - ( ! AGOR?FATE DEDUCT:TLE I RerENrloR r -�—rlr sTeQ=WORKERS COMPENSATION on ; AND EMPLOYEES LIABILITY LIAIr Th'E 7RCPRIE'POR/PARTNERS% ( ' I I E.L. EACH ACCIDENT 8 100,000 EXE6TIVE OFFICERS ARE , A I ❑ Intl ® exc_ 701621501201� E.L. DISEASE -POLICY LIMIT 6 500,000 ! I � I o1/l0/2012 � c1/lo/2013 =—y fe.I. DISEASE -EA ENeLOYEE I 6 100,000 I rCONKLNTS DESCRIPTION OF OPERATIONS 09.LOCATIOUS: j i MARK HERBST IS NOT COVERED BY THE WORKERS'COMPENSATION POLICY. i CERTIFICATE HOLDER CANCELLATION WHITCOMB REMODELING INC T —, SHOULD ANY OF THE ABOVE DESCRZOED.POLICIES BE CANCELLED BEFORE THE ERPIRATION DATE TBLREOr, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE 707 MAIN STREET POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE —..-•. HYANNIS, MA 02601 . 8LOZ I Office of Consumer Affairs & Business Regulation- Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business Regulation = Home Consumer Home Improvement Contracting HIC Registration Complaints Registration# 126480 Home Improvement Contractor Registrant Registration Home Page Name MARK HERBST Address 35 PEEP TOAD RD. City, State Zip CENTERVILLE, MA 02632 Expiration Date 06/08/2014 Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search http://services.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=26443 1/4/2013 F^assaettuses-Denar eraent c;?ui{i-Safety Board of BUPdirg Pegulations acid SYandar-4s CunsftuLiion Suprn•isor License.: CS-048546 e`�� 35 PEET16 RD3 sx i CENTERVII3LE 1VIA0263 Commissio, 2.f }X,°..' � irFtib 01/27/2014 r,r ✓sae 'L�aninHireuie2�C/' ✓l�aaeacLa.�aelta.�':?: Office of Consumer Affairs&B siness Rcgulation' = HOME IMPROVEMENT CONTRACTOR istration: Re . 9� .=,126480 Type; Expiration__6XB12012 Individual •V-,KMKRBST _ _ :r 1 MARK .HERBST.' — _- . :35 PEEP'TOAD RD `✓ K.. CENTERVILLE,MA 02632 � x - Undersecretary. 3. OFIK Town of Barnstable Regulatory Services ' M �' ` Thomas F.Geiler,Director 039.iO�Fc3,r& Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 December 27, 2012 Mr. Mark Herbst Mark Herbst and Sons Roofing 35 Peep Toad Road Centerville, MA 02632 Mr. Herbst, This letter is to inform you that you are in violation of the Massachusetts State Building Code 780 CMR Sections R105 Permits and R113 Violations. Our observations indicate that your company has performed work at the following locations without a permit: 82 Wheeler Road, Marstons Mills, MA—The Walker Residence 83 Wheeler Road,Marstons Mills,MA The Wrightsman Residence A Stop Work has been applied to these properties effective today. Each location is considered to be a separate violation with potential action and fines as described in the Massachusetts State Building Code 780 CMR. as well as the Massachusetts General Laws where applicable. Your immediate attention is required to address these issues to eliminate the possibility of additional penalties and fines. .A simple solution is to fill out the appropriate paperwork and come into this office and apply for the appropriate permit for each location. Sincerely, Robert McKechnie Local Inspector Town of Barnstable 508-862-4033 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION - A Map 0 Parcel O a O Permit# Health Division ��o .� r ��' Date Iss a - Conservation Division I Fee Tax Collector SEPTIC SYSTEM MUST BE Treasurer (- INSTALLED IN COMPLIANCE WITH TITLE 5 Planning Dept. , ENVOONMENTAL Date Definitive Plan Approved by Planning Board "���g,•�-, '' "' Historic-OKH Preservation/Hyannis Project Street Address P 3 0 ff-XA1;4-gam Village NW&70yf' 11i`l�S Owner 5T'eW 6(J e/!a4- f 'WW-r/ � Address r i Telephone Permit Request Square feet: 1st floor:a 'sting proposed 5-b0 2nd floor: existing proposed y 37 Total new Estimated Project Costlf� Zoning District Flood Plain Groundwater Overlay Construction Type tAl0OT 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: El �Yes o On Old King's Highway: ❑Yes Basement Type: ClFull ❑Crawl ElWalkout @'Other_ e/ Basement Finished Area(sq.ft.) 11/114 Basement Unfinished Area(sq.ft) y:4 Number of Baths: Full: existing / new Half:existing 1 new Number of Bedrooms: existing 3 new _ Total Room Count(not including baths):existing new First Floor Room Count 5� Heat Type and Fuel: 0 Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes E(No Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes O'No Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:©'existing 2ew size a";� lr Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name //C, Z-- �dc[ � --,"'Telephone Number ;7 Of Address �'� ���� sq. cense# 0-or 9 j 4 ome Improvement Contractor# Ow //0 �0 r ✓W6rker's Compensation# �✓ 3 " �'.��5' 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE £ 4 (� �� - DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED . MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTIO . u FOUNDATION FRAME . 3 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH- FINAL GAS: ROUGH :� FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. . . The Town o ''' 'Barnstable aAsrierAss.& - 9 �. �' Department of Health Safety and Environmental Services cc► '' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner 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 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: /JVD o2 U� o,?relce I c'/l d7fN4 k1� Estimated Cost 3-,//7/. Address of Work: 4J hPo lPf^ TOyf Ad l6 Owner's Name: 4-/J nl,4.) Date of Application: t �✓?/goo 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 I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav . MAScheck COMPLIANCE REPORT. Massachusetts Energy Code Permit. # MAScheck Software Version 2 . 0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE : Other (Non-Electric Resistance) DATE: 11-23-1998 DATE OF PLANS : 11/23/98 TITLE: Wrightsman garage addition with office above COMPLIANCE : PASSES Required UA = 141 Your Home = 118 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 437 38 . 0 0 . 0 13 WALLS : Wood Frame, 16" O.C. 768 15 . 0 3 . 0 51 •GLAZING: Windows or Doors 65 0 .400 26 DOORS 21 0 .350 7 FLOORS : Over Unconditioned Space 437 19 . 0 21 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code . The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 1250 of the design load as specified in sections 780CMR 1310 and J4 .4 . / Builder/Designer GU �� - �c�� ��lP� Date -- , The Commonwealth of Massacftusetts -�— Department of Industrial Accidents . . �� :_-_ __?�� Office af/nyestigations 600 Washington Street � S Boston Mass. 02111 Workers' Compensation Insurance Affidavit •'/�'�,"n�"�nE"•t�`�r�'�" !%��/'/�%/,%%/%%//�%%//!/////%%`�t�""�ei�,��1'i�'"C�..'."f6'Y�'////�%////%%%%%�%%%�%�%%%//O�%�/��/����///�%%''%'`"" name: A�- t yAitlyLS'-) location: ..C�(o �/J� k )d- LL// city STY 4, lvt.S` 1 ✓144, ohone# ❑ I am d homeowner performing all work mvself.. �am an employer providing workers' compensation for my employees working on this job. comnnnv name: address: city: 9"4"v(S // phone Gey/ insurance co. l'-r-910,d f/Uf. nolicv PrP 7 ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follo«ing workers' compensation polices: company name: address city ohone#: ......:.. Jnsarnnce co. ....:.. o tt:v#.. . ...: ., ;..:.:.. ......:............. /L./'////%%/E company name. address: city. ... phone#' Insurance co. :•:.... .:..o If.v 3k#t444D8%%%%%�%//%%%%//%�///��%%%% Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a line of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage vetiflcation. I do hereby terrify'under the pains d penaities of perjury that the information provided above is true and correct Sitmamre 57 G�2G,�Z C Date G11�311g11p- Print name l "(!F, �. lJ-1 "5-,t/ Phone# G O�y/ o(flcial use only do not write in this area to be completed by city or town oMcial city or town: permit/lacense# 70Building Department ❑Llcetuing Board ❑check if immediate response is required ❑Selectmen's Offlce ❑Health Department contact person: phone#; ❑Other (rnvea 9,95 P1A) Information and Instructions 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 co=- . 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 receive. trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa: 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 returned io 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. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents DInce o11n11asugadons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 ✓/e i�anvrreoruuec�C�i a ac�zrcde ; DEPARTMENT OF PUBLIC SAFETY. i CONSTRUCTAMINSUPERV I SOP. LICENSE L.• Expires: ' •• Aestr<i;ct'ed�T=o;�Y - 00 �- - fit. a Bllll =RAUTHEN 86 HYANNIS, CIA 02601 .CONTRACT9R< ram, .�.. �:;.� .,�,• rat`�onnta�A.b6O: s3rka riffif UA t1fANNI�SaL`i 1126O1. - J AssQssor's map and lot number, y.. ..:...f� ..."....a SEPTIC SYSTEM MUST BE INSTALLED INCOMPLIANCE Sewage Permit number .......................................................... WITH ARTICLE II STATE SANITAgY CODE AND TOWN �Q�OFTMEtO�o :; TOWN OF BARNS AABLE Z 89BBSTODLE "b BUILDING INSPECTOR . �'E YPY a' _•� L. / �1 t.L APPLICATIONFOR PERMIT-TO ......... ��.................................................................................. ........:........................ TYPE OF CONSTRUCTION `j ...........5:.l.4�j—...../............1�74 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to #IIie following information: Location ....... .//. W ......L 7� / ".. ..................................................................... ProposedUse �' P� •...................... .................. ....................................................................................................................... Zoning District ...................Fire District ..............0 '��� v................ .........�........................... ff-4 S� 1'Y[1_1'VA1 AAS.S Nameof Owner .....f...J................. .....................Address ..... ........................................................................ Name of Builder vV' � ..........Address ��� � ... �.f�1lfil .C= iffs@,; .....Address ............... Name of Architect ............................................../T.......... ................................,................... �55.. Number of Rooms ........................ C ,e ..................................... ........................................[..-�.....—�.......................... Exterior .................1..,.4... 7 ®���.�.......................Roofing /. 6 / ........................ ........ ........ Floors �/ J�1 1�.... ... /Woo . ,Interior J e5/G� .C.L �-!c/FL.. ........ ........ ....................... .. ....................................... Heating . , el., ..............................Plumbing ....................P s ..................................... ... 9......................................... ` o•• swr- Fireplace ,.ES. ...........................................Approximate Cost .............................. :•••••t0 i ........................ . Definitive Plan Approved by Planning Board _________ `_ -----------19/_q__. Area /.!�8.....-'.... . X.$.d.... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH / r- or L IL ry 3 �. _ QV -Mo � W � s� I hereby agree to conform to all the Rules and .Regulations of the Town of Barnstable regarding the above construction. • Name ....:.:.6�.f%.::. ..... . ........ ........................... .... .......' Larson, Mr. & Mrs. Roy 18754 1 1/2 story N.o.................. Permit for •.................................... single family dwelling ...............................................:............................... Wheeler Road Location ................................................................ Marstons Mills . Owner Mr. & Mrs. Roy Larson .................................................................. Type of Construction frame .................................................................:.............. Plot ............................ Lot ........... ................... Permit Granted ....... ..Oct..o.ber 21 19 76 ��h a Date of Inspection ............................19 Date Completed ..• f1....� ..............19 "PERMIT REFUSED ....................................................... ... 19 ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... IMF,✓ _ � !..... _. _:-1' _.<., -,.. -_. ':1� _,.c .: _ _ ..,�JRTY_ �,../.i.�J .. .�.... .. _ _...., J � __.... — .�,.. "t._ _f� . _ _ Assessor's office (1st floor):; _ r �oFTNETo` Assessor's map and lot number .....(-�. ....D...... f..... _ Board of Health Ord floor): . fO�Q Sewage Permit number .......... �'.r,� ..�� Ti.... ,..`1._.J................ Z 13AHd9?ADLE, i Engineering Department (3rd• floor): o raea House number ................................ ._ ................I.. �O YPY d' Definitive Plan Approved by Planning Board .____�- � 19______=_ . APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 Cp�M, only _ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO � �.. ../cT/O /•..................................................................... TYPE OF CONSTRUCTION ............/.........O .................................................................................... � T � , ............ .....19.-...... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: /' Location ......lJ.,.. �... f .E � ! .. . i�. ../../f�'<c�So�/s .. ��/// ..�/.��5.:(............... Proposed Use ....... ..... Zoning District ............� :. ..............................................Fire District ...✓..�..'....... .l... Name of Owner/" ... dress t10c. .L.L. ../,.,�f�9�(' �iUf/�'/�%!S Name of Builder✓ S�J4nJA�y�' . y ✓�q ST ro. L)C7- rJ E+!/.:..........................................................Address ... '.............................................................................. Name of Architect �1..(J./�/IV...Zlo�,!�/f✓/I.!�6.............Address ....................:...y!1..�.......................:........................ Number of Rooms ...................�....:. ..Foundation 3 Exterior .. .1J.. .. ...........................................................Roofing ... /...5i`..i9.L.. ...................................:.......... F C��2 �cr Floors .....................................................................................Interior ..........................................................:. Heating �...../ ............ '............................Plumbing ...............,/, " ........................................................ Fireplace ..................... 0..................................................Approximate Cos .../..../.U......`......�................................. /6 ,rzv Area ......:................................... Diagram of Lot and Building with Dimensions Fee ......�!.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 Supervisor's Licensw�.�....3'............... LARSON, ROY D. A=082-020 No .•..32.2.85.. Permit for ..Build Addition ....................... Single Family Dwelling Location .....83 Wheeler Road . ............................................... Marstons Mills ............................................................................... Owner ....Roy D.. Larson . ....................................... Type of Construction Frame ............................................................................... Plot ............................ Lot ................................ Permit Granted ......September 21 1.19 88 Date of Inspection ....................................19 Date Completed ......................................19 Assessor's map and lot; number/....!............. .. . Sewage:Permit number .......................................................... +, ,O`T"ET°�° TOWN' OF 'BARNSTABLE 1 BASBSTADLE, • p�"6 9 MAX �: BU 'LDING , INSPECTOR O'EOa' + I APPLICATIONFOR PERMIT TO ........................................................................... ...................:.............................. n TYPEOF'CONSTRUCTION .......................................................................:.......:.................................................... .. ` TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for�a permit according to;the follow/wing information: Location +. Y ... .,L�S!•h�� ".Ltd......�/`.....1 !...��i�...................................................................... ProposedUse .............................................................................: ZoriirigDistrict ....................... ...............................................Fire District .............................................................................. • /y2IIoe llk-T �V /` ..IK'S©dAe .�.l.ACNameof Owner ............................................. ......................... ddrss k �..... J........ �.........c.....�b.....,.t..J... ....1..�.9..s.. S GV• �iG�i`JS�I/� �V..... ..........Address -Eit//���/�L �� 5•..a Nameof Builder .......................................................... .............................................................................^..... Name of Architect " � ^' ��'���� 4Address '`s i�-7e .t��....................................... //..ii.... f....... ................................... Number of Rooms ........................t0.....................................Foundation ...O/�G'.f� .............................................................................. Exterior ...Roofing .��... ..�5....d...eL . •� /GJ Ate . �' /EZ. Floors ....................Interior � Heating ...............................Plumbing =. �4♦ g '9...."...�JL '�/a 3.............................. Fireplace ..I...........................................Approximate Cost t. ,. ....... Definitive Plan Approved by Planning Board _________ _/7____19?d__ . Area LZ?$....................ga..... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH r � A I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �� Name .......1 �.'. .............................................................. --777- Larson, Mr. & Mrs. Roy A=82-2.O No .....18754 Permit for ....1...1/2...story, shgle family dwelling ............................................................................... Wheeler Road Location .................................................................. ...........................Ma.r.s.tRPs...k1 ills..................... Owner Mr. & Mrs. oy Larson ........................... . .... .............................. Type of Construction ....... .....frame..................... ........................................ ........................................ • Plot .................. ....... . Lot ...........B ..................... ....... ........ ........ Lot/L Octob 21 76 Permit Granted .................... .......19 Date of Inspection ....................................19 ...................... Date Completed ......................................19 PERMIT REFUSED .... ..I.................................. ...... 19 CU, ............. J��Ie- ...... V ......11 .......... ... ................ ... ............................. ............................................................................... ............................................................................... Approved ................................................. 19 ............................................................................... ............................................................................... C . e Assessor's map and:lot number Sewage Permit number .... %�'✓' ...: �!'h. .� �?.!�: QV0FTNEt0�0 TOWN OF BARNSTABLE Z EARNSTODLE, i 1639. Op,0 YaY Or . BUILDING - INSPECTOR k ' � APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ................................................................................................................: .................... .......................0 1 19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location � w1- t�. '1 1 Y�,�C c!?� C l l is S 3 ................... !:.:.......... $.............. a Proposed Use ... .......................................r7— P L& �l �...�..?� ..g L ......................... ..................................................................................... ZoningDistrict ....�..................................................................Fire District h...........:9._........../........................................................� ' Name of Owner ° ` U \l SCi')1 '1 :.................................Address .......,..................................................... ..:..........:.......1 Name of Builder W..A+1' �. ' ! ! n 1? �................. ..........................................Address ....................:�:� ..............................................:.... Name of Architect .. 1....�...17�'� '� c1'1...............................................Address C L '�'L,t�! Ly'....:.A7A S S ........ ............. { r y Number of Rooms .Foundation ......................................................4.. `.+ .. T L ?�' ................................................................. ............ Exierior � w �^.....b G e1 1 ti.......!?. V WO U C..........Roofing .... !... .. . f. ....................................................... Floors ......................................................................................Interior ..................................................................................... Heating .......................................................................:..........Plumbing ............ .�....�... ............................................ ............. : Fireplace Approximate Cost ........ ................................................... ...... Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ........ ............ `. ............ Diagram of Lot and Building with Dimensions ! Fee ................ ..r"�' .... ........ SUBJECT TO APPROVAL OF BOARD OF HEALTH 1p ( 0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .�C.; .;/ .......y.... . � i Larson, Roy D. A=,k,? _e No ........20.0.9�ermit for .......... ........................................ 83 Wheeler Location ......................................P,Qg.d............... ........................Mars. ...M11.1.$.................. ..... .... ....... R� D LarsoOwner ................ . .................. Type of Construction ...........f r.amp................... ................................................................................ Plot ............................. Lot ................................ April 14 19 78 Permit Granted ........................................ Date -of Inspection ....................................19 Date Completed ...............I........................19 PERMIT REFUSED ............................................... ... '9 f. .1. .............. .............. .. . . ............................ .................................. ............................................................................... Approved ................................................. 19 ............................................................................... ................ Assessor's office(1st Floor): Assessors map and number SEPTIC SYSTEM MUD {L3WE conservation )w A 93 INSTALLO IN COMP Board of Health(3rd /fbor)����� WITH TITLE 5 ` w Sewage Permit number ENVIRONMENTAL Engineering Department(3rd floor): ���J TWInt m r'*C-Q,0��IC1 ¢ ie39 House number (J o mill Definitive Plan Approved by Planning Board 19, APPLICATIONS PROCESSED 8:30-8:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO en t RrC� lAc�e�,�-low 1 TYPE OF CONSTRUCTION _ AJQeab 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 0,3 W�P e\eC a1ArSo>7S a � Proposed Use i Zoning District Fire District A ll i Name of Owner fara2 4rSYNr�) Address 0 w . c� er �' n1 Ac�-tE✓1 h1�,15 Name of Builder `bAf V--- iic 6`\0es,L Address 5(A Q A►n i) O l-eC�n,e t Name of Architect Address Number of Rooms ' Foundation ®nc•C e iC Exterior k9c3 Di7 Roofing 4 Floors e 8 hC T Ae Interior t'A ryr Heating Plumbing Fireplace Approximate Cost Area 4010 00 Diagram of Lot and Building with Dimensions Fee 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 nstruction. Name Construction Supervisor's License OAi9 5-q (a r MARSHAL, JANE " No Permit For ADD TO GARAGE Accessory to Dwelling Location 83 Wheeler Road Marstons Mills Owner Jane Marshal Type of Pons.truction Frame Plot Lot I • Permit Granted May 7 . 19 93 Date of Inspection t 19 Date Completed 1 19 , I I I �^�-..��..,y.•� .^!�-•!.!�•+�•�iF• i i i �.r--.y - � Ij" J �wr..W..r. •' ' _�- . .. ! ' ..; •t '..,mot+ 1 ., � �. `" -• "Q, Ake �.: i.�-1 ` a s�•� `i{ar�• ;�r ! tr�i� ' ,f s ' _ Al �'; ' .., c t. ." ,� .{; •�. .F_ � '. � sue; �!. ,, •a� •� 1 'I ,�,f-:�G•1.4 ��'f 1 a. � � S r w��F t;� rf F i s �i! � $ � '• .' ,. �� ) (i Fes] �ti7,�'A't { 4 . A i ', i S ,+3 h 41 •F!'c 1, ps1P 1 /u�� IL- ,•`1 1'^ ,.3 e, 9/ { C' �' • + I t ��,r.r. t- , , v $ t 14 y7�'],YF .r { I Y 1. K 1'. • ~ .. •� i ti {, 6• !• d � 1 •� _ '�, � 1 fit r ,�( 75�•�1��� i T .�i � � t , � ' ^�. .. a,. �-. �,, ! d Jet :.•+ 4SIfr�t~��� rZi *; • {{ y{t'� , ''.5. 1 Y, r� .1. � I.«.'!^M. j - ► y ..,r.� ';• �1��`+ 'J#1 F '� t ` r r, yf r L:=i f / •^'!1� M •i, �+r /.'t1 ��i ,n` .�•1f e1 ,F 1� ' �.-._-_�_-�'i:l�- � ti• 1 ` f� .. 1 �__�-+�—�i _ •,p`�r'�,fk 1'` f g4 \.. •k - ! i �- i i' '' t Ny r ���� '� i ��!'•1#�� i� ! tL �` X A't J _ •�. '� t� � - iylI' rid i f i1 i .. . � - : �, _ S pry f •+1'vSl t Y: �'y' - s� i ', t' 9 THE COMMONWEALTH OF MASSACHUSETTS Home Improvement Contractor Registration Registration No. One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Check numbers o ' Effective Date Application for Registration as a Home Improvement Contractor or Subcontractor Expiration Date MGL Chapter 142A, CMR 780-6 FOR OFFICE Use ONLY Date �- `;; 1: Applicant name Yh k,IL �>i Pant the name of the individual or business applying for the registration 2 Applicant type: Individual ❑ DBA ❑ Partnership ❑Trust ❑ Private Corporation ❑ Public Corporation 3. ,- -:'_ Number of Employees 4. Address11,E C',a.ti�� ��-r'(1-et' C'C t�r�', —C Im 63L3 ( 5_6 ) ?go -_16E�L _Print street and Number P.O. Bok not acceptable) City State Zip Telephone Number. S. Individual responsible for Home Improvement Contracts Last First MI !. 6: Title of Individual responsible for Home Improvement Contracts '17. ;Does the applicant or responsible individual hold any other construction related state,city,town licenses or registrations? �❑ If yin,complete the table below. Use additional paper if necessary. Yes No V. Type license or registration Issued By License or Expiration Name of-License Holder �; 11 registration number Date �1��,�,:,•.'� C �� CG erg t' � t \� O � C 7 Y • l�r�c s Q. List all partner - a:}.~a' additional pape : .9.' as the applicant claiming exemption from the registration fee? (See the instructions on the back) _ �O If yea,include a copy of a current Construction Supervisor license or motor vehicle repair shop license or registration. Yes No tis:,10. Registration fee enclosed. S Guaranty Fund fee enclosed. $— \00 .O Pursuant to Massachusetts General ws Chapter 62C section 49A, 1 certify under the penalties of perjury that 1, to my best kn ledge and bell ,have nil all state lax returria and paid all state lazes required under law. Signature of applicant or applicant's mpresennttaativc Title held with applicant A false answer to any question In [[it- applicallon a,nsillules grounds fur su.st tri or revocation of the applicants'registration. Assessor's map and lot number ..� .J .YQ(......�,. (� a �"` C�''�!G --7�j. SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Sewage Permit number .... �i :...... ..Ll! ..i P ? l�. /f! �v WITH ARTICLE II STATE SANITARY CODE AND TOWN y�T"ET°�. TOWN OF BARNS- WRL- E EAWST"L8, i 9 .� BUILDING INSPECTOR I APPLICATION FOR PERMIT TO ............................................................................................:................................ TYPE OF CONSTRUCTION .....:................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby , applies for a permit according to the following information: Location s w .....� P cb �1 c1Y r�'h 11 L a ..... . .................. ProposedUse ....!....'Y,'F,7P7;.....W....Y..........A...... ...a... .A.7. ............................................................................... ZoningDistrict ....�.........................................................:.........Fire District ...../................./..................................................... n� Name of Owner �I l b . a.i�. .,5(!�j..................Address � J. w (....r RA Name of Builder .....:...W.A.-Y.A...............................Address ......... I?q.....!r` Name of Architect ..IT.. .......................Address .... .S..L..P7' [!/..`.�.1'°.......' " t�S� ..... ...........:.................... Number of Rooms ..................................................................Foundation ...)...�!.�Cly. c A...........c..a. ..�.�..1°. .. ......... Exterior .......NA...1.1 9.QA.........Roofing ....CI...S..r .���....................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .............. Fireplace ..................................................................................Approximate Cost ..................... .. Definitive Plan Approved by Planning Board -----------______-----------19_______. _ Area ........... ..... .............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH o ti I � � v C,vvi I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ...... ..... '•'•F,.1....................... � ^ ' Larson, RO]/ D. ' » ����6~ �� No -----..-rermh for -----��������v � . . ao� ..................................................... ` � Location ...........8.3... e.r...RoAd----. - / .......................... ................ �^ R�n D' �� - vvner ----..",°.~—..-~r.son................... Type of Construction ------ftamp........... ` � ~ ---------.----.,------------ Plot ............................ Lot ................................ � - - Permit Granted .......... ` .i.l-1.4.........lA 78 . � Date � of Inspection ................. ..................l9 _ Dote Completed -----.�� ]go �^ � v - ^ _ . � PERMIT REFUSED ~ lA----.---~--....--------. ..------'...------.~.'.-------- ^-...---..~..-...--.---..--.----.- . -..-----..----.---...-.--.-..--.. '- - .--------------....---~-,-.-~. '- .- ---------------- lV Approved - ' - ' -------------.-~----......-.. ` . . - � ------------------~--.---... ' ' -` | ` � 1'ss sorbs office (1st floor): ,l p /� D D XXV.C.S,VSTE�1 FAUST 13E oFI ETo Assessor's ma and lot number Q.A � t � •, � p cop C�. ,r. .." ' Q Board of Health (3rd floor): ..<.E Sewage Permit number ............ -$.g.. E�1tCJ ' � t BAaa9rAnLL, i ,r "NTAL CODE Age® rya Engineering Department (3rd, floor): TOVI/s11 REGULgTIONS oo ,b39.6\000 House number ................................. ....1...... ......cr - 0 YAY Definitive Plan Approved by Planning Board _____ _ ____19________ . APPLICATIONS PROCESSED 8:30'-9:30 A.M. and 1: only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............. L�I../..?T .O..N..................................................................... TYPE OF CONSTRUCTION ............ Q 0 .�1�...•................................................................................... sT TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to theee�(following information: l Location ...... G; F, �. ! .... /i'/ / 5././.,/l�/ .1.-�y.�/% ,5 S.. /... . .. ... ......... Proposed Use ......./..../ ......c�. . . ...1. .. �..G7..QI?�J i y Zoning District ............�...'.�.............................................Fire District / / 1 Qr ,/ Name of Owner/�J. 6.. ......�'/.;....Z��/�.►041)%ddress V..� . ..f..����L Ody63f A, Name of Builder tf!'1 .. �✓ �'1 q� Address y ✓l/�Ccli.v ST So. J�i�.. J .................................................................................... Name of Architect( .V..�lf7' ... / !(�N��.!��..............Address !?/»J.?Sr6v(t G.1iLv Number of Rooms .................../............................................Foundation '47.......(AM �T�........................... Exlerior ..(/ .+ .. ...........................................................Roofing .. l..S y .L.. ............................................. ep z ec r Floors ......................................................................................Interior ............................................. rieating .L.. .... l�I�a..T..11... .��.....................Plumbing /9.. ...................................................... U t, Fireplace ...................../! .0..................................................Approximate Cos' ... u.. . ............................................... J6IX2, 01 • Area .......................................... Diagram of Lot and Building with Dimensions Fee 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. Nam .... ................................................................ a�y6 �s� Construction Supervisor's license .........e.............:........... LARSON, ROY D. 322�.� Permit for ..Auild Addit' .......... ..........................�gn ..._.Single.. Family...Dwell i.n.g.......... ....... .. .... .. .r Location 8.3...Wheeler Road. .. .. .... .......................................... . .....................Mars ton s...Mill.s..................... Owner ...Rqy...P.t....Larson............................. Type of Construction ........FKAMIP..................... ................................................................................ Plot ............................ Lot ................................ September 21 , 88 Permit Granted .........................................19 41 Date of Inspectio 1�9 txDbte Completed ....... ................19 g3 c�l�eple4 ��D la� io 14� � 3 � a�s" g3 C�keele�-��( �2 �l � 8a/cap �(d� �«� Ala i��g A -6 `- " c -------------------- -------------- G)oOTW l..AF.A[4e ATTIC,srOp./.[4o . wW.f s t min. O L • I--- -------- ------•-- f opJn IL------ox ------••______ -- --------------- TWt,910 I� ______ Al AnAw—rwt4y 1O I Q -C..i.•::0).E.. 1/4 New oerloe ...o0 17 . , AnA--.TWt,910 A r .t-ave s,•-1 1/,.•�.00 — -----------------f-- -- w,oa O f E 0. 1 I. 0. d � u �..£ E s r I \ �eGONl7 FLOOD FLAN — ---- —. --- g s 1 d - • � pRAWING MF." ' .J:i 1,1P _ : ►��1/t' - bacon)PIOOr Plan 1�IP IA.-rl//• ISe 1%t• 11�11/%' ... 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