HomeMy WebLinkAbout0038 WHITMAR ROAD (+T-n
�vt Town of Barnstable Building
e,aa = Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept
KAM Posted Until Final Inspection Has Been Made. Permit
i63P ��
,wurs Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.
Permit No. B-20-2048 Applicant Name: BRIAN DENNISON Approvals
Date Issued: 07/31/2020 Current Use: Structure
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 01/31/2021 Foundation:
Location: 38 WHITMAR ROAD, MARSTONS MILLS Map/Lot: 057-111-T00 Zoning District: RF Sheathing:
Owner on Record: HIRST,JONATHAN W&WALLACE, Contractor Name: SOUTHERN NEW ENGLAND Framing: 1
WINDOWS LLC
Address: 38 WHITMAR RD 2
MARSTONS MILLS, MA 02648 Contractor License: 173245
Chimney:
Description: INSTALL( 2 ) REPLACEMENT WINDOWS NO,STRUCTURAL Est. Project Cost: $3,654.00
IPermit Fefle: $35.00 Insulation:
Project Review Req: GLAZING REPLACED IN HAZARDOUS LOCATIONS AS DEFINED { Final:
IN 780 CMR MUST BE TEMPERED OR EQUAL. Fee Paid: $35.00
Dater 7/31/2020
Plumbing/Gas
Rough Plumbing:
B;uilding Official
Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas:
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted.
1 } Final Gas:
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open fog public inspection for the entire duration of the
work until the completion of the same. i �— `� Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service:
Minimum of Five Call Inspections Required for All Construction Work: Rough:
1.Foundation or Footing ._
2.Sheathing Inspection Final:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Final:
7.Final Inspection before Occupancy
Health
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
Building plans are to be available on site Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ON�za E
i
Town of Barnstable Permit#
Expires 6 monthsfront Lm a dote
Regulatory Services Fee
s t�►rtnsrnats,
� Richard V.Scali,Interim Director°�°��
BuRding IDIV1sioII X-PRESS PERMIT ,
Tom Perry,CBO,Building Commissioner NOV 2 5 1014
200 Main Street,Hyannis,MA 02601
www.town.barnstablc.ma.us TOWN OF B�,ARTF�
Office: 508-862-4038 ax:
EXPRESS PERMIT APPLICATI N - RESIDENTL4L ONLY
t T Not Valid without Red X-Press Imprint
Map/parcel Numberd 1 1 1
Property AddressNpv-pps Kit"
®Residential Value of Work S (a C Minimum fee of$35.00 for cork under$6000.00
Owner's Name&Address JJonaAfi440t , d W ftoa n Rd 1 p 1aithn a
Mi 11 Y,,t4 Qa&4g
Contractor's Name Uft WTelephone Number` i -&a R— 16D
l
Home Improvement Contractor License#(if applicable) I7 3y r 'I EmaUVil(:
Construction Supervisor's License#(if applicable) (')a F-77QI
MWorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name Artim— 11±i }(Q i1(
Workman's Comp.Policy# 9.�� q ? q4
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ 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 root)
Re-side
Replacement Windows/doors/sliders.U Value , (maximum.35)#of windo
#of doors:
Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
'Where required: Lzaance of this permit does not exempt compliance with other town department regulations,Le.Hisroric,Consen-At n,etc.
`**Note: Property Owner must sign Property Owner.Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
requ'
SIGNATURE:
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Soairrl of SuAding Reaulations and Standards
77
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CS-09S?07
BRIAN D DJZNNI!ON 7
7 LANM POND CI1RC:jLF,
Chariton NU 01507
irn-0
_n C 09I0812016
a--J�k Office of Consumer Affairs and Business Regulation
w
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 173245
Type: Supplement Card
SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 911912016
DENNISON BRIAN
26 ALBION RD
LINCOLN, RI 02865
Update Address and return card.Nlark reason for change.
SCA 1 0 20;�-05fii Address 0, Renewal r—! Employment Lost Card
/;c
_�ffice of Consumer,'iffairs&Business Regulation License or registration valid for individul use only
4-g 'ttOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
' _
Office of Consumer Affairs and Business Regulation
7 Wt-Y:;;Registration: 173245 Type 10 Park Plaza-Suite 5170
Expiration: 9/1912()16 Supplement-'�a rd
_ Boston,MA 02116
SOUTHERN NEW ENGLAND WINDOWS LLC.
RENEWAL BY ANDERSON
DENNISON BRIAN
26 ALBION RD
LINCOLN,RI 02865 Undersecretary �4o;tva L* ithout signature
r
The Commonwealth of Massachusetts
Department of IndustnalAccdents
_ O `ice of Investigations
1 Congress Street
Suite 100
Boston,MA 02114 2017
www.massgov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information
Please Pr><nt Le�ably
Name (Business/organization& ividual): SOUTHERN NEW ENGLAND WINDOWS LLC
Address: 26 ALBION ROAD
City/State/Zi : LINCOLN, RI 02865 Phone#: 401-228-9800
Are you an employer?Check the appropriate box:
1. I am a employer with 20 4. [l I am a general contractor and I Type of project(required).
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
working for me in any capacity. employees and have workers' g' Demolition
[No workers' comp. insurance comp. insurance.* 9. ❑Building addition
required.] 5. (] We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their
myself. [No workers' comp. right of exemption per MGL 11.El Plumbing repairs or additions
insurance required.] t c. 152, §1(4),and we have no 12.0 Roof repairs
employees. [No workers' 13-[@ Other DOOR REPLACEMENT
comn. insurance required.)
Any applicant that checks box n1 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 pro.7de their workers'comp_policynumber.
I am an employer that is providing workers'compensation insurance for my employees
information, Below is the policy and job site
Insurance Company Name: ARGONAUT INSURANCE COMPANY
Policy#or Self-ins. Lic. #: WC927938352394 08/21/2015
a Expiration Date:
Job Site Address: WtJZQ_t City/State/Zip:rW hS ry,
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
. f rn
Failure to secure coverage as re )
g 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 under the pains and penalties of perjury that the information provided above is true and correct.
Si e:
Date:
Phone#. 401-228-9800
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):
L6_
Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
Other
ontact Person: Phone#:
'4`� CERTIFICATE OF LIABILITY INSURANCE FOATEGIRIMIlY.08/12/20142/2014 .
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY'AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, 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 THE CERTIFICATE MOLDER.
IMPORTANT. H the Certificate holder Is an ADDITIONAL INSURED,the policy((es)nwst be endorsed. K SUBROGATION IS WAIVED,sub)Set to
the terms and conditions of the policy,Certain Polices may require an endorsement A statement on this certificate does not conW rights to tiT6 certificate holder In Riau of such aftdorsemgnt(SJL
PRODUCER Willis of Saw-T
erser, Lac. CONTACT
C/o 26 Century Blvd PHONE F
P-O. SM 305192 -EAIALL 77- 5-7 78 _8 _ P-2370
Nashville, 2N 372305191 DSA cartificateserillis.ccs,
INBURERIG)AFFORDING COVERAGE NAR•
INSURERA:8alactivs Insurance of BY 39926
tNsuRmsouthern New angland Windows LLC
D/B/A Renewal by Anderson TFINSUREBRt
'The Beacon Una �'�"n� 24017
26 Albion Road ' lbs+uuea 19601
Lincoln, RI 02665 :
:
COVERAGES CERTIFICATE NUMBER--9529160 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ISM R TYPE OF INSURANCE POLICY NUYHER P D EFF POLICY Elm LJi4r8
X COi91ERCULLGENERAL LIABLIITY
CL4MIS4AA*DE OL:cIIR EACH OCCURRENCE S 2,000,o00
X
A Commw"I S 200,000
MED DP(kWoneomm) S 20,000
8 2029459 08/10/2014 08/10/201S PERSONALBADVINJURY S 1,000,000
GEIfPGGAECA1PRO.TE APPLIES PER. GENERALAGGREGATE S 3,000,000
OTHER:POLICY jECT LOC PRODUCTS-COMPIOPAGG S 3,000,000
s.
AUTOMOBILE LIABS.RY LDLIT
py
1,000,000
X ANYAW E A ALLOWNED SCHEDULI�AUTOS AUTOS 8 2029459 08/20/2014 08/20/201S (Pereodd" S
HIREOAU►OS X UTOS"ED MAGE
S
S
A X UMBRELLA LIAO X OCCUREXCESSLIAB OCCURRENCEEACH S 51000,000
CIAWS-MADE F8 20294SS 08/10/2014 09/10/2013 AGGREGATE
DED � j s,000,000
WOR109tS ATNIN S
B AND EMPL DYERS LIABILITY' r/N X PETtrrE oTH
]ANYPROPRIETORIPARTNEIVIDIECUTliM EL EACH ACCIDBYr j 1,000,000�N EXCLUDED? a NSA 0000068028 00/22/2014 08/21/2015
yyees5,, I - I EEL DISEASE-EA j 1,000,000
OESCRIPTR7NOFOPERATIONSbdow El DISEASE-POUCyLMT S 2,000,000
C or
Coep/BL Cava: NC927938352394 08/21/2024 08/21/201Si-L
.L Ea. Accident - 61,000,000
Latntory LSmits - WC
.L. Disease Policy lot - $1,000.000
Disesse its. amployes - $1.000,000
DEWRIPrON OF OPERATIONS I LOCATNITZ I VBRCLES(ACORD IOI.Mfto na)Romafs SeMdWe,imy be taadud a tan space Is R
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL Be DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Boutbera NR LLC
AUTHORIZED REPRESENTATIVE
26 Albion Road
cola, RI 02665-0000 RM1K16�J
0 1988 2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
SR IDt6629625 BATPB,Raicb !, 79657
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
L4 C8
Map. V Parcel Application #
Health Division Date Issued (A6 M
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
i
Project Street Address r11n1 n0C )ej_ //If,rS 4 f 111.,`,_S h9�, b26�/p
Village
Owner T An Address . 4)A/lc" L✓ &/-Lf ll)?
Telephone ,7�8a$ 7.16
F .
Permit Request 'Ivt 0d�ie` � ?,�t � r 'C—I.
S o ivy �-�
66
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total _
s
Zoning District Flood Plain Groundwater Overlay
Project Valuation 7 60 Construction Type11P 'r
C.:)
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ,❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
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 1604yt'_ Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name � h Telephone Number 97?` / - 7•3&1'
Address d 4 (pL33 License # a--67&VSJ .
-/aGI-P Mlq-q d `� Home Improvement Contractor#
Worker's Compensation # L ciu
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ke CSA�
SIGNATURE DATE (.0- to
FOR OFFICIAL USE ONLY'
x
APPLICATION# -
DATE ISSUED }
MAP/PARCEL N0.
3 ADDRESS- VILLAGE
OWNER
DATE OF INSPECTION: '
FQUNDATIO&. . ., : . .
FRAME
INSULATION -
FIREPLACE
ELECTRICAL: ROUGH FINAL
E
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL '
FINAL BUILDING
y ,
DATE CLOSED OUT
ASSOCIATION PLAN NO.
The Commonwealth of Massachusetts __ Prictc Form.
Department of Industrial Accidents
Office of Investigations
I Congress Streg.Suite 100
�. Boston,MA 02114-2017
www massgov/dia
`Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers -
A plkant Information -Please Print Leidblv
Name;(Business/Orgamzation/Individual): �lr� LL
Address:
P D
City/g`tate/Zip: :Ji j(,Ib lmk a�bL Phone#:
Are ou an employer?Che k the appropriate box: Type of project(required):
1. I ain a employer with (l.e_) 4. I am a general contractor and.I
employees(fiill and/or part-time).
have hired the sub-contractors 6. 0 New construction
2.El I-abi 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'
• comp.insurance.* 9. Building addition -
[Nonworkers comp.insurance .P• •� .
required:] 5. E] We'are a corporation and its 10TTElectrical repairs or additions
3.❑ I.am a homeowner doing all work officers have exercised their. 11.❑ Plumbing ipairs or additions
myself. o workers' co , right of exemption per MGL
cinsm-aneN equired] +' . c. 152,§1(4),and we have no 12.0. f reP�
employees. [No workers 13. er
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating"they are doing all work and then him outside contactors must submit.anew 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-contactors have employees,they must provide their workers'camp.*policy number.
lam an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
information.
Insurance Company Name: Alavi c— Maf-Je-i��
Policy#or Self-ins.Lic.#: W C.VO0 /39�Qb Expiration Date: n ou j
Job Site Address: � &ak &A,1 City/State/Zip:t�4,r3h-OTj�
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date)Jzj6ye
Failure to'secute 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 S.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 under the arms and enaldies o p ry that the information provided above is true and correct
Si afore:
Phone# c7Cd
r
Officid use only. Do not write in this area,.to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(ci cle dire):-
1.Board of Health Z Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
!"'nntnnt rDnrcnos• D1.......Ji.
03/31/2014 03.53 9787778415 PAGE 01
GATE(CERTIFICATE OF LIABILITY INSURANCE 3/31/2014
THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.7111E
CERTIFICATE DOES NOT AFCIRMATIVELY OR NEGATIVELY AMEND, O(TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELAW- THIO CERTIFICATE OF INSURANCE ODES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURMgah AUTHORIZED
REPRESENTA7NE OR PRODUCER.AND THE CERTIFICATE HOLDER.
IMPORTANT: If the 9Mft9ep h~is on ADDITIONAL INSURED,the pogc&s)must be arhdorsec M SUBROGATION 19 WANED,s*jW to
the terms and condlttons at the pol)ry,hx Wn policies map requIrs an erldursOmdMiL A StOtement on this hbrdllcib does Rot hmnTir right to Me
certif(cete mew in Beu of eu1;11 eaderee ef.
PRODUCER
COUNTY INSURANCE AGENCY INC WO"E rm, (978)774-2463 „�•(978)777-flats
.123 Sylvan St
Danvers, MA 01923RIM
elMMI)A►ROWNG COVERAIM time
INSUmR A:Commerce Ina. Co.
INSURED Building Performance Contracting, LLC MURER 9:Essex Ina. Co.
wmRER c:A antic Charter
P.O. Box 633 wwRER O:RB Jones
Truro, Ma 02666 ►NSURERE:
F-
COVERAGES , CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY Tw►T TnE POLICIES OF INSuRANCE LISTED 8ELOW HAve BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
HVDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEW 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.
EXCLUSIONSAND CONDITIONS OFSUCH POLICIES.LMTS SHOWN MAYHAVE BEEN REDUCED BY PAIDCLAIMS.
ADDL
Arne YPE OF INSURANCE Barb rws POLICY M WER UMRS
GENE EACH OCCURRENCE s 1 000 000
R co*ahERO,AI OCPdPAL uABlLrnr Lit To mmizu
PFUMOM 9 fEm eowrrwtw s 50,000
CWMSMADE nZ OCCUR IUEDOW one mm S 1.000
B 3DE9441 11/19/1311/3.9/14 PEEMNALaAOVMUURY s 1,000 000
GENERAL AGGREGATE f 2,000 000
GENL AGGREGATE UNT APPLIES PEA: PRODUCTS-COMMOP AM i 1,000,000
POLICY JECTPRO-
tAC $
AUTOMOVIE L03;UTY eeaee,uLHWF S 1,000,000
BODILY MURY(Per person) S
AOwK0 sAhEOULF_� B6DDGK T/2/14 2/2/15
A LAUTOS: E AUTOS BODILY INJURY(Per ewaerd) S
-1, NON43MMIFn
"11DAAUTOS AUTOS edd er m:ddme =
s
X UMBRELLA LIM [__FCUR
D EXCESS I" CUB�W3904112 5/1/13 5/1/14 EAON OcaURRt Ntr s 2,000,000
""CWAME AGGREGATE s 2,000,000
OSD RMWIONS s
WORKERS COMPENSATION
AM IYE3M ILITY IN T= ER
C oFl �,�n,"cum2m? E •y MIA ii/23/23 31/23/14 E4 EACH AMMENT s 500,000
ey� IwIMF) WCV00939900 Ea_DISEASE_EA IAaPI s 500,000
DESCRIPnON OF OPERATt0ti4 Below' EL O18EASE•POLICY LIMIT S 500,000 �
DESCRIPTION OFOPERATIONS I IDCATIONSI Y MIcLES(AIIAM ACOM tat.AdMonel Renmrke SeReCWe.lf more apeoe to rmlmd)
CERTIFICATE HOLDER CANCELLATION
Town of Barnstable
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE O(PIRATION DATE THEREOF, NOTICE WILL BE OaAffiRED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTNO ! A
9B -22010 A RD CORPORATION. All fights reserved.
ACORD25(2010/O5) The ACORD name and 1090 are registered marks of ACORD
Massachusetts-Department of Public Safety
Board of Building Regulations'and Standards
Construction Supeisisor
License:-CS-078815 Q s
JOSH irKO"
POBOX 633 ` ;Ig s
Truro MA 026W- N:a
WW
Expiration
Commissioner 03amis"
�!e�pamanamrwlealbi g�� ad License or regish�tion valid for individul use only
Office of Consume Affairs&Baseness Regahtion before the expiration date. )Tfound return to:
IIAE limp YEl1AENT CONTRACTOR Office of Consumer Affairs and Business Regnlatio }
jisbation: 4255 � 10 Park Plaza-Suite 5170
irat Ion:�7 5-- LL-C Boston,MA 02116
BUILDING PERFO
` 1�-- TING.0 -C-—
JOSH EDMOND
;_ Qo
8 KINNIKINNICK RD
TRURO.MA 02666 Underseerenry of valid without signature.
Town of Barnstable
Regulatory Services
t AMASS g Thomas F.Geiler,Director.
16596
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnsta ble.ma us
Office: 508-8624038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
L , as Owner of the ro subject
l P PAY
hereby aut rize act on my behalf,
in all matters relative to work authorized by this building pet7nit
AL
±fU �6 Q
(Address of Job)
Pool fences fences and alarms are the responsibility of the applicant. Pools
are not to be filled or utilized before fence.is installed and all final .
inspections are performed and accepted.
Signer _ e of Own Signature of Applicant
Print Name Print Name
Date
Q:F0RW:0WNERMERWSS10NP00IS 62012
Town of Barnstable
Regulatory Services .
r
""""IS''BI= Thomas F.Geiler,Director
. g Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-ti230
HOMEOWNER LICENSE EXEWnON
Please Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
cityltown 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.
DEFI MON OF HOMEOWNER i
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.
Signatine of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code
Section 127.0 Construction Control.
HOMEOWNER'S F.XEWTION--�--s_
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 serions 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.
C:\Us=\d=MIAAppData\IAcaI Mcrosoft\Wmdows\Temporary InternetFdes\Content0utlook\QRE6ZUBN\EXPRFSS.doc
Revised 053012
Town of Barnstable
oFt"E►anti Regulatory Services TOWN OF B5Bl.E
Thomas F.Geiler,Director 7-M9 JUL 21 PH 3: 38
'^ MASS. ` Building Division
t 1639. � Tom� Perry,Building Commissioner pFOMAp ,
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us DIVISION
Office: 508-862-4038 Fax: .508-790-6230
PERMIT#t�DaT FEE: $ 6,5 c�
SHED REGISTRATION
120 square feet or less
Location of shed(address) Village
--�0 Yl\a�,, 14--t-r4 6 g-
Property owner's name Telephone number
Size of Shed Map ar
Sie re Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?
i
Conservation Commission(signature is required) JlJ
Sign off hours for Conservation 8:00-9:30&3:30-4:30 -
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
i
THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN
6y
Q-forms-shedreg
REV:042506
,. •• . . ... ' -:-• Lei//. -
a^/
WILL AM tiG,P� C-S ZTlr-lEU PLC7-rC.
{�--•%lam:
to [rl Y E
19334 LbCATIOI -a
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Auto SE=rt',AC4 1ZC-Qu jzsmaWTS 01= Tb-ltly L CC• ���{/� �' ;1 :✓G��f�=
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REG(S t'CtZi_.D LA W'o •5uevc%.fo
`("t-1lS C7 LAF-J ' t S LIOT SASEE� p►-t A�1 OSTE2V1t_LG o ACASS•
T,;.IPA t=1.ir 40evc-! �T:lE= U��Si:T'S S�loeilt� novI i r4►-i
� 1 '
Town of Barnstable *Permit# o�DbCo of l
Expires 6 months from issue dat
Regulatory Services Fee' P
Thomas F.Geiler,Director
Building Division
X-:PRESS PERMIT
Tom Perry,CBO, Building Commissioner
200'Main Street,Hyannis,MA 02601 JUL 3.1 2006 i1 �/
Y W
www.town.barnstable.ma.us LL
Office:'508-862-4038 TOWN OF ff - 3�
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY i
Not Valid without Red A=Press Imprint ,
1
Map/parcel Number mG,`��nS 1 I�
Property Address .2A6 %-T%A &-Q
[/Residential . Value of Work l9,0600 Minimum fee of$25.00 for work under$6000.06
Owner's Name&Address- t
S �,o i�
Contractor's Name l�nJ Telephone Number�$
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner.
�I have Worker's Compensation Insurance
Insurance Company Name
Worlm&s Comp.Policy# L,)c, t S 33-4 O Li O,Ls
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)QAe-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value (maximum.44)
'Where required: issuance of this pemtit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
Home Improvement Contractors License is required.
' SIGNATURE:
Q:Forms:expmtrg
Revise071405
Department oflndustrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
. www.mass.gov/dia
Workers' Compensation•Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information i t Please Print Le 'bl
Name (Business/0rg nization/Individual):
Address: Q
City/State,/Zip: Cho< flJ Phone#: So% -YI S Z-1 _0 6
A�r!Y1 an employer? Check the-appropriate box: Type of project(required):
1.LJ I am a employer v�ith 'L 4. ❑ I am a general contractor and I 6. ❑ New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet # [] Remodeling
ship and have no employees These sub-contractors have 8: ❑ Demolition
working for mein any capacity. workers' comp,insurance. g, ❑ Building addition
o workers' Damp.insurance: 5. ❑ We are a corporation and its
� 10.0 Electrical repairs oY additions
required.] officers have exercised their
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs ox additions
myself.(No workers' comp. c. 152, §1(4),and we have no 12.jRoof repairs
insurance requited.] t . employees.(No workers' 13.❑ Other
cam.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information:
t Homeowners wbo submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating,such
iContractom that_check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for.my employees. Below is the policy and job site
information.
Insurance Company Name: P;b AC' ,r_x
Policy#'or Self ins.Lic. #: [ C'2`2 1 !S 317�> 16$(C 07 S Expiration Date: J O
Job Site Address: V)1A i%AA A-Q_ y"l -.A`U.S City/State/Zip:
Attach a copy of the workers' compensation policy declaratfolt 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$1,50Q.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 under the pains and penalties o erjury that the information provided above is true and correct.
Si aturel Date: 1 O
Phone#: Oat �A
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):
I.Board of Health 2.Building Department 3.City/Towu Cleric 4.Electrical inspector..5.-PlLm.bina Inspector
6. Other
Contact Ferson: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to.provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as "an individual,partnership, association, corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the .
receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or.on the grounds or building appurtenant thereto shall not because of such employmentbe deemed to be an employer."
MGL chapter 152, §25C(6)also states.that"every state or local licensing agency shall withhold the issuance or
renewal of alicense or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone mmrber(s)along with their certificates) of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not iequired to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The-affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials .
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at.the bottom.
of$re 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 winch will be used as a 7eference number. In addition, an applicant
that must submit multiple permitAicense applications in any given year,need only submit one affidavit indicating current
Policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in . (city or
town)."A copy of the affidavit that has been officially stamped or markedby the city or town may be provided to the
applicant as proof that.a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture .
(i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit
The Office of Investigations would hike to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. #617-727-4900 ext 406*or 1-S77-MASSAF'E
Fax #617-727-7749
Revised 5-26-05 www.mass.gov/aia
Town of Barnstable.
Regulatory Services
= Thomas F.Geiler,Director
m�
'ArEo►, +�1 , Building Division.
Tom Perry, Building Commissioner
200 Main Street, FJyannis,MA b2601
www.town.b arnstabl e.ma.us
508-862-403 8 Fax: 508-790-6230
Properly Owner Must
Complete and Sign This Section.
if Using A Builder
I, F>"1 t�� '�C%�- , as.Owner of the subject property
hereby authorize C)trL y Q to act on my behalf,
in all matters relative to work authorized by this building permit application for.
ZZ W Ul M QQRfl 4-
SzOKIS I,AUJS
(Address of Job)
F4, dRa
1 3 .
Signature of Owner Da
Print Name
Q:FORMs:owNERPERM7s s1DN
lug Boar YMB�ui ing Regula ions an tan ards�
One...Ashburton Place - Room 1301
Boston. Massachusetts 02.108
Home Improvement'Contractor Registration
Reafetrdon:•=.128967
Typo: individual
Expliatlon; 6/14/2007
Oliver.Kelly -
Oliver' Kelly
9 Peregrlrigllane
S. Yarmouth, MA 02664
' Update Address and return card.Mark reason for change.
DP8-0Ai Q BDM44/04-0101$18
0 Addren. 0 Renewal 0 Employment Lost Card.
aolsa3quoupV
AIIA)I JQAIIO
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as
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Y'.�... - —.., a..-w . . .i-.•..r; .1...,r. ...-..-+•.-ti.. a'Rr..l---• .\. i. .- r• •v. ..-----�.. . -r.�..-T . .. .�.s ..r--.� „-a ..':.=1•�/'"'t^r"1.-.7+P- -,
Q�TNEro TOWN OF BARNSTABLE Permit No. ....:..._.. ,..... '
BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
'�0 uY�" �J,•Q v/�/f
HYANNIS,MASS.02601 Bond ......X..../
CERTIFICATE OF USE AND OCCUPANCY
Issued to
Address i•upelo-wnitinar Trust .
Lo-c .Li , 38 whitmar Road
marstons tvillls, !+lass.
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT-BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH.TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
April 3U ^Ii I BuildingInspector �'
„�`� �•. TOWN OF BARNSTABLE
BUILDING DEPARTMENT
TOWN OFFICE BUILDING
rua
t6sq �� HYANNIS, MASS. 02601
s”
MEMO TO: Town Clerk ?
FROM: Building Department .
DATE:
An Occupancy Permit has been 'issued for the building authorized by
BuildingPermit $k.. ......_............... %................................ 1........................................................... .. ... .__
issuedto ... .. ........._..........._..................._
Please release the performance bond.
i
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
IM A
DATA
PINK c DEPT. FILE COPY/WHITE-FIELD COPY/YELLOW-APPLICANT COPY D-
BUILDING04
TOWN OF BARNSTABLE, MASSACHUSETTS PERMIT
VALIDATION
24, 80 295�9
DATE 19 PERMIT NO. _
�I iCi�l. 1' .:c lic'.I'.da1� iJUYf: - ;l0022.1i6
PPLLCANT ADDRESS , 1 }
(NO.) (STREET) (CONTR'S LICENSE) ,
ERMIT'TO hi.;'i.i.;: ilKU.c..L_L:!;:' (_) STORY_ ilt; il? L'ca ''•' J�'CS..L=n NUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) _
I ZONING
AT (LOCATION) f..C,C it' 1, jZ :li1L,I—r c:f'+ A1, :'i :L"'�::l.sii':; DISTRICT
(NO.) (STREET)
BETWEEN , AND
(CROSS STREET) (CROSS STREET)
LOT
UBDIVISION LOT BLOCK SIZE
UILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
10
0 TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
EMARKS: caREA OR
: irCiiJ--4.5:
Mond '
OLUME L C• 1 i�1,OL)U. FEE
s
ESTIMATED COST $
(CUBIC/SQUARE FEET) _
•WNER ,.Uj)�:.lU—iiil.lt.::_ .�,.ill�i, '•. `` •_1..`., r1
"i ` .
1• .I an Li I i:G:i
, .+
a Y::(.: ii: a! . -I B I'2 BUILDING DEPT.
DDRESS . , i l(: BY ,1
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THOREOF. EITHER TEMPORARILPC
pop,. PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE. BUILDING CODE, MUST BE Al
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINE
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIOf
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREF. CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD-)KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE PLUMBING-
FOR
.- .•�+-,r. ALL CONS-TRUCTION-WORK* ELECTRICAL, PLUMBING- AND--
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL gUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MINAL INSPECTION
TI To BEFORE
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 ELE-CTRICAL INSPECTION APPROVALS
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9 yF.nT'ti F'.T iNr APPROVALS REFRIGERATION INSPECTION APPROVALS
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----=----- —---- —=1 �,1 -:.,` - BOARD F HEALTH
N.Fs _,AL_ NCT CPC-EFL UNT L T E PERMIT 'W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON,THIS CA
vS=EC,�F :=-5ctis� -`iE - c WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE
CAN 9E :.RPANGED FOR BY•TELEPHO
_-.ACPr �F ,.OHS alir�,�l'' PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION.
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o WILLIAM PETER
C.. SULLIVAN ��. 3•j1 X
: . I'l Y E y No. 29133
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Assessor's office (1st floor): ' $EPTIC SYSTEM! MUST EE F�NET
Assessor's map and lot number ........ . .............................. . LED IN COMPLIAf� Q o
Board of Health Ord floor): WITH TITLE 5
Sewage Permit number �3•�•• ;DNMEN t, 9AWSTODLE,
......................... .............. .
Engineering Department (3rd floor)- �1 9 AL CODE �'� r039,
asa
House number ........ '°�tc�aYa'
APPLICATIONS PROCESSED 8:30-9:30 A.M. and: 1:00-2:00 P.M. only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
f
APPLICATION FOR PERMIT TO ...'.
TYPEOF CONSTRUCTION ....... DD...1,�..-r lL...........................................................................................
................................................I9..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following infor 4atn,Location r/ /'<<- ''`' ......
.............................................. ...j.... .... ... ..................... .... .�.................... .......... ...................................
ProposedUse ..... I ..�..��!...`�............................................................. ...............................................................
Fire District ..
Zoning District ....... ....v...........................................................
Name of Owner !.YJ . �WKI. r �`'�. .Address ,.. (!uS7��V` ..F..III`.�SY�'v �,�� W4
Name of Builder (V .(v..... . . .. (41f..........................Address ...?....
Name of Architect � r .... .....................Address .../*...A40. '.r.....VAO. W.. . 0*4-
Numberof Rooms ..........1......................................................Foundation ..............................................................................
�A�/f��/�y� / `G�
Exterior ....�`...c: `'i i!!Y......T..!`�!!`'.�........`''�l/.IN"f. ..clrf�j .Roofing ..........f� -p vqL!. ...................................
..........
Floors ..... ....fLIZ/W ......................Interior ....� �......................................................
Heating ' ..... )'W �'�/;J................................Plumbing Z
...... t�......... . `... ......� J-........................................
Fireplace .� �/I�...........................................................Approximate Cost ..........l. f.®.`..l;J........... �..................
Definitive Plan Approved by Planning Board I 19 Area /.... ......... ..°... „?,,,
Diagram of Lot and Building with Dimensions Fee / .
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I Ko ,
60-0
4ew.z2-
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 . .. ..............................
00
Construction Supervisor's License .............................
r
TUPELO-WHITMAR TRUST
No .... Permit for ... .............
Sin
. ...........
.... .... .. ....................
Location ....... ...3.8..Wh.i.tma.r...Road
.....
. .. .... . ...... . ...... .
Marstons Mills
..................................................................... .........
Owner ......:Kupeljq�-Whitmar Trust
..............................................
Type of Construction ..F.r.a.me.............................
. ................................................................................
Plot ............................ Lot ........................
Permit Granted .......June...2.4...................19 86
Date of Inspection .............................:.,......19
Date Completed 4(............... .. ..............1,91
Assessor's office'(1st floor): OF THE to
Assessor's map and lot numberry.'
Board of Health (3rd floor):
Sewage Permit number .................................... ........
L �. �(..... Z 33AWSTODLE,
(J OlJ G/ 9 MA06 0
'Engineering, Department (3rd floor) o
House'`number p t63q. 9�
3.................................. .o,�0 MA-4 a�
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATIONFOR PERMIT TO .............................................................................................................................
TYPEOF CONSTRUCTION ...... 7601 .1�... .............................................................................................................
.................................................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ...................... .............,...l................................................................................................................................................
ProposedUse ..... .!,���tl..l..`.. ............................................................................................................................
...................Fire District ..............................................................................
Zoning District .................................................... '
Name of Owner Y,f .......1 rv57 Address +.... �1.(/ltOt VI iCQI it 7TU/ Y�!((ls [lrR
Name of Builder .i. KN r! ` ....... .........................Address ....7........ .......L.....'.....'GN....
Name of Architect ...�!'`.....................Address ... D...... . . ......... . '
. .......................................
Numberof Rooms ........ ......................................................Foundation ..............................................................................
�d ,,per� �•' -- , �p
Exterior ...0 l � ... !`'''! .......C'�►! .Cf��C..�j(4-Roofing .......... �Z ...Le ft' ...................................
Floors .....Cyf� �L�G ��' Interior ..... L ...................:
.. .................................
rieating ..... ... ...............................Plumbing ......�.....Z........... .......................................
Fireplace ...,�....`...... .........................................................Approximate Cost ........... . !. .`. ..:...... :.J
Definitive Plan Approved by Planning Board -----------
Diagram of Lot and Building with Dimensions Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH !'
/ A/
i
{
( -2, .L
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
TUPELO-WHITMAR TRUST A=057-008
29559 Two Story
No .............. Permit for ............................ .......
V
Single Family Dwelling
...............................................................................
Location Lot #11, 38 Whitmar Road
................................................................
Marstons Mills
.....................................................................I.........
Owner Tupelo-Whitmar Trust
..............................................
Type of Construction ,.,.Frame
. .................................................................................
Plot ............................ Lot ................................
Permit Granted June 24, 86
i
Date of Inspection ....................................19
Date Completed ......................................19
06
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