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0048 WOODCREST ROAD
� 'rn � � ,�� �� 8' �'� aQ' �s�- _ _ . .. ��� ��. _ -�-� Town of Barnstable Building s � Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must.be Kept M"M Posted Until Final Inspection Has Been Made. i63p. � Permit ° Where a Certificate of Occupancy is Required,such.Building shall Not be Occupied until a Final Inspection has been made. Applicant Name: Stephen Dickinson Permit No. B-19-1193 Approvals Date Issued: 04/11/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/11/2019 Foundation: Location: 48 WOODCREST ROAD,MARSTONS MILLS ? tl_Map/Lot: 030-077 Zoning District: RF Sheathing: Owner on Record: BITNER, DIANNE D TR Contractor Name- .STEPHEN T DICKINSON Framing: 1 Address: 48 WOODCREST ROAD I Contractor License: CS-081843 2 MARSTONS MILLS, MA 02648 + Est. Project Cost: $8,414.00 Chimney: Description: Same for same,replacing 13 wide entry door sidelight u factor 0.18 Permit Fee: $42.91 Insulation: Project Review Req: ;, Fee Paid: $42.91 Date: 4/11/2019 Final: Plumbing/Gas F Rough Plumbing: Building 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. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough 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 for,public inspection for the entire duration of the Final Gas: work until the completion of the same. r Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection v Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: it ersons con cting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department � � All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: i Town of Barnstable Regulatory Services ` Thomas F.Geiler,Director '`'RIMAMM""s'g Building Division 659. � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Yv www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 /PERMIT# 4 / FEE: $ C---- �� SHED REGISTRATION 200 square feet or less Wtldfl Cc2 r` R l'Yl S i 19dSL U-0 Location of shed(address) Village j@1MP-S A of Cgs 0 L1 Property owner's name Telephone number �o xl� ZZ Size of Shed Map/Parcel# z i � co ature Date U N rn H s Main Street Waterfront Historic District? Old Kings Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required)—___, Sign_off-hours-for-Conservation-8:00=930-&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. T-IRS FORM-MVS_T-BEA_CCOMPANIED-BY A� PLOT--P—L ANC Q-forms-shedreg ' REV:05201 I r LOT 121 �g5 LOP 613 2�a 122 a5 SHED w LOT 115 - O 2 _N LOT LOT 114 ��. 113 yti s C0_ pp. 0 RES. ZONE- "RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.• 'C" Bank Use Onl TOWN: _M�1R��'O� _ ZLI�'--_______ REGISTRY OWNER: DQjHQ W.- &9AT1YY_M._H1EEERD_____- DEED REF: -M-521-ZZ3-------------BUYER: 8---------------- DATE: _3115194---------------- PLAN REF: _22,_2 -57 - ______---_-_SCALE:1"= 40= FT. I HEREBY CERTIFY TO PB1 �lYF �_P-________ _-_ _ ___ ___ __________THAT THE BUILDING `tH OF MA YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS o�' PAUL �9cy� CONSULTANTS SHOWN AND THAT ITS POSITION DOES --__ CONFORM A. `'' 40B (SUITE 1) TO THE ZONING LAW SETBACK REQUIREMENTS OF THE � MEAITHEW H TOWN OF _ BARNSTABLE-------------AND THAT 4 No. 32088 INDUSTRY ROAD IT DOES_NOT_ LIE WITHIN THE SPECIAL FLOOD HAZARD 9�� q o MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED_V-L9 0-_ Fssio�t,`ANosoo TEL' 428-0055 _aa_- 250001 0015 C FAX 420-5553 THIS PLAN PAL A. MEWT-fl PLS SURVEY, NOT OTOMBE USED FOR FENCES. ETC. 14368 DPG ,�'�,, l ��� ,�� � � �` �� Town of Barnstable *Permit.# 8S 13 Fspires 6 monUu from issae date s Regulatory Services Fee AS ' Thomas F.Geller,Director 'Eon Building Division Tom Perry, BuildingCommissloner X-PRESS PERMI 200 Main Street, Hyannis,MA 02601 J U L 19 2005 Office: 508-862-4038 _ Fax: sos 790-6230 -��-pp��NN � BB�RIVST�BLE EXPRESS PERMIT A.PP16ICATION - RESIDENTIA-L�NL"Y' Not Valid without Red%Press Imprint Map/parcel Number 0-7 Property Address L4 UJ�ls• - eo �'�,s�, m r/A t�esidential Value of Work �U C ("0AYMlL" 9>4Ap '� Owner's Name&Address ��✓�S Contractor's Name �n n K I �t)►�(te ���i~rou-e -�e-,t+ Telephone Number SO7 IS- 17 7 R Home Improvement Contractor License#(if applicable) 103 15 7 E' r ibv� 7 ' Construction Supervisor's License#(if applicable) f [Workman's Compensation Insurance 1 Check one: ❑ I am a sole proprietor ❑ lam the Homeowner M-fhave Worker's.Compensation Insurance Insurance Company Name N On Workman's Comp.Policy# y�.� y I -� Permit Request(check box) ❑•Re-roof(stripping old shingles) IAll construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side V i r%Y I GJap6ock,rd s ❑ Replacement Windows, U-Value (mum•44) yWh required Issuance of this permit does not exempt compliance with other town department regulations,Le.Historic,Ci mservatim etc. ***Note:` Property Owner must si Property Owner Letter of Permission. ome rev n o ctors License is required. Signature Q:Forms:expnurg Revise053003 is - The Commonwealth of Massachusetts Department pf Industrial Accidents Office of Investigations > 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Busmess/orpmzation/Individual): S r (A1LI+= hn w\p,-o,1 e me Address: 14c( 3e�en��ble Rock — City/State/Zip: lam,a n.n s m�} o o Phone#: 50 k- 7�S- Are you an employer?Check the-appropriate box: Type of project(required): 4. ❑ I am a general contract New construction , or and I 6. 1.�-I am a employer with ❑ employees(full and/or part-time).* have hued the sub-contractors 7. Remodeling- ship 2.El am a sole proprietor or partner- listed on the attached sheet t ❑ g ship and have no employees These sub-contractors have 8. ❑ Demolition 9 e i 'workers comp.insurance.working for me in any capacity. • ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their right of ex lion per MGL 11.❑ Plumbing repairs or additions 3.❑ I am a homeowner doing all workp myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.]t . employees. [No workers' 13.❑ Other comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information t Homeowners wbo submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContactcos 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: Policy#or Self-ins.Lie. M -7W4 9 '4 301 a oCaS Expiration Date: 5 / / 3 / aao(p Job Site Address: Y 4 UiJ C✓�S� IQo�c� A City/StateJZip:�1�A•-S" s /Yl�/�c A1✓>' D Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to segue coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c under a pains anal pe of perjury that the information provided above is true and correct: Si afore: Date: Phone#: J`-(��" -7 _)5- Official use only. Do not write in this area,to be completed by city.or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2..Building Department 3.City/Town Clerk A.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M 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 employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C( )states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(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 required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents.for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of -Industrial Accident. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition, an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"'the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation And should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts �T Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111. Tel. #617-727-4900 ext 406 or'l-,877-MASSAFE Fax#617427-7749 Revised 5-26-05 vAwmass.gov/dia JUN. 9.2005 9:54AM A.I.M. MUTUAL INS. NO.802 P.2i2 n CERTIFICATE -01F INSURANCE LSSUEDAT]L(MAVDD�Y + 4 :-RODUCER THIN CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL qp Bryden&+S1111ivan Ins Agency DDOOE�arRS NA0if1 ENGHTS D,,EXTEOI-N THE OR AL ALTER THE oxv�GE AFFORDED SY THE POLICIES BELOW. Inc 88 Falmouth Road COINRANIES AFFORDING COVERAGE Hyannis, MA 02601 i INSURED i Sprinkle Horne Improvement Inc COMPANY A.I.M.Ivlutual Insurance Co 199 Barnstable Road LETTER A Hyannis,MA 02601 i COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POT' PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO VHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS$UBJECT TO ALL T�E TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POT FM . L.II.IT$SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. c0 TYPE OF WSM164NCE POLICY NLTtBER POLICY EFFECTNE POLICY E)WIRATIC1 LIDOTS LTA DATE(MMIDD/YY) DATF.(MM/DDHT'T') GENERAL LIADILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY RODUCTSCOMP/OP AGG. $ IMS MADEC O R PERSONAL&.ADV.INJURY S OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE S FIRE DAMAGE(Airy One fin) S MED.EXPENSE(AIV One Potmh) S AUTOMOEILE LWtILITY COMBINED SINGLE y AUTO MITS OWNL•D AUTOS BODILY INJURY CEDULED AUTOS (Rr POrrnrdE S RED AVrOS BODILY INJURY ONOWNED AUTOS Per=wmu) S 1 ARAGE LIABILITY PROPERTY DAMAGE f FWMSS LIABILITY EACH OCCURRENCE S MBRELLA FORM AGGREG4713 S HER THAN UMBRELLA TARM WORKER'S COMPENSATION M77 klllluX TKUK 7004943012005 OS11312005 05/132006 EL RACH ACCIDENT S 5f10,000 A E PROPR16701U INCL EL DISEASE-POLICY LIMIT S ARTNERSIEXECIPiIV6 5C1� RFICERSARF• ErCL EL DISEASE-EACH EMPLOYEE S S00 000 OTHER I DESCRIPTION OF OI ERAT4tlYSILOCATIONS/YEHICLES/SPECIAL ITE WS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAIgCFLLED BEFORE THE BRAD SPRINKLE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL F.NDYAYOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATEHOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH]NOTICE SHALL TIaOSE NO OBLTfiATION OR 199 BARN$TABLE ROAD LIAII=Y OF ANY KIND UPON THE COMPAVY, ITS AGENTS OIL REPRESEMATrVES. HYANNIS,MA 02601 IZED AUTHOR REPRESENTATIVE ) :f,L 1 x•W...,M....fr:.�,b.'.r..H.,ar[, ✓�.G°: r}»n/ut/`-((�:.�.6r�w BOARD OF BUILDING REGULATIONS o�l- 8n r0 of tlail'u•y Rea•tatiwu. dNu,.dant. Ucense:CONSTRUCTION SUPERVISOR • ,. HOME IMPROVEMENT CONTRACTOR g Number:CS 006643 Ra9Uln0on: 103757 BlMdnlo:10=1955 EaPlwf—7192006 Expims:Iorm0D5 Tr.no: 5711 1 Typo:Pd WS COrpmetke, 1 Restricted:00 SPRINKLE HOME IMPROVEMENT,WC. BRAD K SPRINKLE Brad SMm1e 190 LOTHROPS PANE '99 Barmmbl0 Rd. ..- W EARNSTABLE.MA 02668 AdminBtmlol Hyannh.MA 02801 ,\dmtnbtnwr I 8 r 1 HOMEOWNER: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES I authorize Sprinkle Home Improvement to act on my behalf in all matters relative to the work to be performed on this job (i.e. permits, applications etc.) if.necessary. Owner signature / Contractor Signature 05 e--l. 3 a� Date Date I I t ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 4 3 d .' _ 'Parcel O 7`1 r Permit# UFTAR"S ABLgate Issued Health Division `'A -03 HA Y Conservation Division 6S 6 di $: application Fee Tax Collector Permit Fee �/" . 6V 1l,, _...._.�-__... —z° Treasurer G� L�Eyf��f� 6"aYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. SMTK TM.E 6 Date Definitive Plan Approved by Planning Board EiTl'--"�t 7E�9TAL CODE AND iOVWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address 4® W00 D C4 S i &I i6AAk g`ib&( C OA t LL S MA n' L fp``f< Village Owner J A Y14 E S OA , * � f A XKF i3 tTn(� �Address SA VIA Telephone 50 a Permit Request 7r- c G 6Q I&OY4S a 'TA C_ .A!A.&Wf7 Square feet: 1 st floor: existing I 4-1 S proposed 2nd floor: existing 14?S proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1 G.0 o6d Construction Type 91 SE k Gu6SS POb L (ZAA•-S20 Lk u Lot Size 0- GI A mE S Grandfathered: ❑Yes O< If yes, attach supporting documentation. Dwelling Type: Single Family a"- Two Family ❑ Multi-Family(#units) Age of Existing Structure 1 Historic House: ❑Yes al to On Old King's Highway: ❑Yes ❑ No Basement Type: &fuII ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) '4 0o Basement Unfinished Area(sq.ft) SPA d Number of Baths: Full: existing 3 new Half:existing I new Number of Bedrooms: existing new Total Room Count(not including baths): existing 9 new First Floor Room Count Heat Type and Fuel: C8<as ❑Oil ❑Electric ❑Other Central Air: f9'es ❑No Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes ❑ No Qsy, IA) Detached garage:0 existing ❑new size Pool:❑existing fnew size 111 Barn:❑existing ❑new size Attached garage:Ule�isting ❑new size Shed:V existing Aw size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 0'I oo If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION &RF ��V � Name Telephone Number ( - { Address i License# /41iZ_tV/X © O Home Improvement Contractor# Lz Xz _ Worker's Compensation# ALL CONSTRUCTION rftBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR 1111A e Ltz, DATE � FOR OFFICIAL USE ONLY PERMIT NO. a DATE ISSUED MAP/PARCEL NO. 41 ADDRESS VILLAGE i ` OWNER DATE OF INSPECTION:FOUNDATION 9;P60L thl,® T'/r1o3 7i FRAME ,, r INSULATION ` FIREPLACE ELECTRICAL: ROUGH; ' FINAL C ' PLUMBING: ROUGH-' FINAL GAS: ROUGH-4 ! FINAL u FINAL BUILDING tutu DATE CLOSED OUT ASSOCIATION PLAN NO. I The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION , / r Please Print DATE: s-( s- It,3 JOB LOCATION: -z fA ZQ e_:RE P, nia Z`Ina [M(LL,S number street t� village "HOMEOWNER": \JAMEJ WI_ J3 11M S-0�[9 "0Gd44 S'O % Ly 9 R NS1 name home phone# work phone# CURRENT MAILING ADDRESS: �(� k-3J G OliC&f- S f iQ L, dV1 d ol�Z Q 1d�C�' iM L S /1/� ©k.(n 4 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 hue 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 Dep ent minimum inspection procedures and requirements and that he/she will comply with said pro a es and migirernelL ate Ho e A pBuilding Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building pemvt 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. 1 _ The Commonwealth of Massachusetts r "Department of Industrial Accidents office offnyesti9ations 600 Washington Street r Boston,Mass. 02111 Workers' Co mpensation.Insurance Affidavit a Longo name: J A m r- S M a i Z I A AM-E C7_ a%T �C_� location city �4`��� 1N(L� a M ��—'(PLA Phone# I am a homeowner performing all work myself. ' [] I am a sole proprietor and have no one working in any capacity [] I am an employer providing workers' compensation for my employees working on this job. �• v-'-c- u s"Yr ""r""t;5:�'t°F a .r,•+i'r NSF^"T0 0 '7't"kt ... a'. ,-,t-•r �t ,l '�'g- ,f '' °,3�F_ br ,.a. ass: ,�;sT q4 7 "5+'' .,y'{'inrrSSoi 't- �a w4ans"Yi t. 1C "�•. 'cl Y r•5 s'pp"— ,•,, 51 i' ''�'�`� to"mAanV�aule r� �`�Y� 1`9"'.cx�f- �r----ga 1 i1a 4.i�• 5:S..w•f353> .���- `m.�:t�a•S •till ;y£ N' t::. 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'a,Ffr:,.`.�ra�;��,{� S!� w�k Lv-'^Fl�N' 'Bf�S.H !b;$$��?,t'- � �F'r't;3e'Y,�.•'".- '•_F: x'? r i�rJ is 'r4,1't''�.1.•i.�Jfi '�'t�'..'''�•v,4`.Y�..fisi .ltrsa ,i�i,Yn'�c"t- •}a,p;:}?..jitr"�SF'�'�- sa. c� 7•• � �i r.. �.3'+ � n, �F„S rn.,,c f} •X e a�yj 6�'�+� �r '' .`t �F�S ,.c 2{�, 11 L 3 J r � ,�-y �� a�r'��s ,r; � .....„a trot a.w, �t� -r 1, u '7 .t•,ae r 1 )s � Kt} V• x, s � y m `,:,...dJ.w,.g�'-&.�' V�„wQ�`A'�S�"� vs'�; s• a�rY}�`•rr q '�a v.. "Y' `:>�'x ha (J.'r`tr7 $J�'� s r`5"' tis 'hrv`�,:3sL�t•?•1 �r ry:'?•,C4r�`•C� .,�y,!>� °' ilnsurance co �.,�,i+J w� x Hi `F �s+`M1 5•"t'xc - ,� y 3�..-�,cPOIIGY,t a_- 5 .r,_ v<u_rv_, .,.., r.A_.....'�iTi''ai��'v�tw��.�.-7.F4''':,'S:1 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$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement ma be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify un er he pains a d enalti per' ry that the information provided above is true and correct Signature Date Print n eL Phone#_ _'�{`� !'(�Ca y Icial use only do not write in this area to be completed by city or town official city or town: permit/license# F—Building Department ❑Licensing Board check if immediate response is required ❑Selectmen's Office []Health Department contact person: phone#; FlOther i (revised 9/95 PIA) i 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 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 of 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 employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out.in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, Please do not hesitate to give us a call. 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 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 °F,NE�o Town of Barnstable Regulatory Services snxivAT& Thomas F.Geiler,Director v Huss. �* ' 1639. �0 Building Division plED AM'�A Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must.Complete and Sign This Section If Using A Builder I, 6 Vvl f S n1 C�, t—rN E J , as Owner of the subject property hereby authorize T t_Oa i a)A /\(n&N --Z Ns C Q to act on my behalf, in all matters relative to work authorized bythis building permit application for(address of job) 'I Qp �,Ooo6 cVLc S?' 2 7� r�l 0-4 S i o A(S wi t L S fM A 0 2 cog Ani►�a —_. S�S��3 . tore of Pr Date I Print Name i �Qp IME r Town of Barnstable Regulatory Services $AR''UML ' Thomas F.Geiler,Director MASS 9`�pr16119- 01 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 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. _rA—Cs 1110%lA(rb Type.of Work: �1 C�1�GLASS Su►I IM iM t A[C �l°O( Estimated Cost �Ce / �� Address of W ork: L( % W 0(9 fl CJZL S l IQ_J� Vh eA d�S TV AB 101 LLS Q 1 rot U Owner's Name: J fIz 1M E A 2S/,4 A(A(E �}1 2 tTA1 CD Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []Building not owner-occupied weer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME UTATROVEMENT 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 e Registration No. 0 Date Owner' Name LOT 0 121 lg5 0 LOT 613 2�a 122 a5 SHED w LOT = 115 a 0 vc 31� i LOT LOT 114 113 CO- 00. • 00• RES. ZONE. RF This MORTGAGE INSPECTION Plan is For FLOOD ZONE. C Bank Use Only TOWN: ---------- REGISTRY OWNER: DAYID---W._ dc-KATHY _M.-HIBBERD--_--- DEED REF: __,3.8W2 Z3_------------BUYER: �AM�'S'_M�_&_111A�LYE_1J_-81TN_ 8------------- -- DATE: _3115194________________ PLAN REF: _222 157-------------SCALE:1"= 40=__FT. I HEREBY CERTIFY TO --------- OF YANKEE SURVEY ___THAT THE BUILDING MAC, SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS o�'� PAUL q�yG CONSULTANTS SHOWN AND THAT ITS POSITION DOES ____ CONFORM A. 40B (SUITE 1) TO THE ZONING LAW SETBACK REQUIREMENTS OF THE MERITHEW H INDUSTRY ROAD TOWN OF ___BARNSTABLL'-------------AND THAT 4 No.32088 IT DOES_NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD 90 9 o MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED_6,d91_0_ 'rsioN�'S�At�►osoo TEL: 428-0055 Q-- 250001 0015 C FAX 420-5553 PA1,IL A MERITH PLS SURVEY NOT TO OMBE USED FOR FENCESMETC. 14.36E DPG FL Or�lI�A 1{�Or�'I'f��'l�,�i�'CL�SS COOLS Piseco Size 13' x 29' Depth 3'6" to 5'6" 291 13" t, +� fi 3 fi �w6 Approximate Dimensions 1� J DoL o � a:♦ ORIGINAL DOCUMENT; S•I-AMP IS RED INK, SIGNATURE IS BLUE INK. c:...� `.•' of i I NC• INCLUDES ALL MODELS 1803A State Highway 5S - Amsterdam, New York 12010 All Florida North Inc. models are made of rib reinforced 1/4 -1/2" fiberglass laminate with the following properties: Manufacturers & Distributors of One-Piece Fiberglass Pools & Swim Spas Density . . . . . . . . . . . . . . . . .1.33 GMS/CC Glass Content . . . . . . . . . . . .23% Specifications for the use of Interlaminar sheer . . . . . . . . .1800 PSI (Avg. Value) Ultimate Tensile Strength . . .9600 PSI Florida North Inc. pools only ;:R. p y Flexural Modulus . . . . . . . . .1,010,000 PSI � ao t.. - Note: Ha ward Pool Fittings 1. Stone dust or sand floor compacted with plate tamper Y 9 NSF 2. Rock drain bed and 11/2" PVC suction line with hydrostatic relief valve only necessary if ground i✓r'; jf� '' Pumps UL Approved - water is present ® 3. Pools must be filled with water to act against buoyant SPA023 FEAT and lateral forces GASKET ��� THIS DESIGN AND SPL-CLFICATIONS HAVE- 13EEN EYE Wall Skimmer RL.VIEWED FOR STRUCTURAL STABILITY 1:N I 5" + I BALL CON]=ORMANCE WTI-H NY STATE- AND CITY CODES. RETURN POOL,MUST RL-MAIN FILLED w1TH WATER TO ACT ISO-MPG Gel Coat AGAINST 13UOY/81lj 6',ND LATE RIAL FORCES 28 — 35 mil. LOCKNUT wide ?� Vinyl _ SP1023 Ester with Ruse 1: aoeOEFk Wall Fitting T + BU t Chop Glass 2 1/2 GASK,E GPSKe Hayward 3'-3" to 4' Steps 1/8"to 3/16" — POOL Safety Deep & Seats WALL Grate Standard Return Fitting Wall For All Fiberglass Pools Fitting SPI026 Two Layers Water Line 7+ 24 oz.Woven 24 oz. Woven 3"-6" Stonedust with Chop with Chop Glass FILTER LOCATION- Hayward Pumps & Filters or Glass 1/4"-5/16" II 12" Down from --- ABOVE WATER LINE 1 PRESSURE _- AIR RELIEF Sand Top Of Pool Coping P 9 GAUGE VALVE j, 14' to 44' long FILTER l PUMP I RIB STIFFENER I NO BdCkWBSlling _ POOL RETURN I l Needed l (FILTERED) I @ 4 O/C TYP I I 5'-3" to 8' r !l i I I I i I Deep To Bottom Wall _....._.� __...__ -- --� --- - • -- - 3"-6" Stonedust Fitting I To Skimmer or Drain Plug Sand THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^�C(, I DATA p�`�`Mt*•. TOWN OF BARNSTABLE Permit No. �.- Building Inspector �aunw Cash ------------ � rua AOA o Y►Y`\� . !! OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to ior, ur, L a L>inIIG Address i 1'ille Lane, 114 Woodcrest Drive, i-iarstons fills Wiring Inspector Inspection date Plumbing Inspector Jl �� Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. 19..... __ ..................................... ..............................._................_.......... Building Inspector S/lve2 E' AW9I-1/L Y - USE /oo G,9G. f - O�5 faos9� P/T - loco 6w1_ v sPy�. 00 `A N rz N TOTAL Ohs/e, ° 1977 I '^J/ /'� ^ , _ L2 / 4. /y/V N.r�'V�M iN CS DrNTIER 4 Si1 •r :f�� �i:r�r � t3.1..E V. I O o.o a t=G�9�• FG 9e 0P. =y7. 7 r �,•vv, 9G.S /Nv 94 .g ' �cec. M� 9�•a � I U a sp eo rr• --eq. 7 C.�C''TtFIED PL®LPL./�.►..� e. x C. ,oiT _ 1 LOCAT1o.�-J IA Fw-ro +/ N;I c�- 85 S Sc.�yy NoTrp bATt� �`'�`t• /77 � 1; CGtZTt��/ Tt•-lAT TNT. DWe�..�t N v �t-1o�v�) @��-A�.I R��Ct�C�G� NCtZ L o4-a fCCVv\,PLYS W I TI-A Tt-tG 51 UrE L1►-tt= L O.T /at`Ila S�Tc3hCt; �7C-QUtP_trM t.1TS DF TNT �a k. ,+?' c. Z- Pr5- i.t", 7 To uJ Q o� L O S t7A.TG ►- 1 Nil t�-1G_ _ REGIS tt►•Z�D LAt,1t� �Ur�v�.YotzS 014 �P-W os.TE�v►t_t.1= o MCASS, { ttl�stCtak.`t=�.tT SUveY �tt�c or-�5 ��> �t�Gt,t1x� APPL.tCI�.t�IT GciROa ri LC +-/►.iyE. 1,`� hl0-t- fsir Ul cQ Tc.> t7crr-_�titt�`.- Lo'c. t_t tit�S 1 Assessor's map and lot number 3 �� Q ` �G -�— 77 : ' SEPTIC SYSTEM MUST BE ° (Z�, INSTALLED IN COMPLIANCE r< Sew6ge,Permit number S WITH ARTICLE If STATE ................................................... SANITARY CODE AND TOWN eV �`:T"Er TOWN OF BARIV9'ff LE i B�Ha9TAA i ` A� BUILDING INSPECTOR �p s639•- Q M f►• .r APPLICATION FOR PERMIT IO .... ..,,��.�1,>�.r .»�?...�., r�!i rd. ..... ! ? ... .... . ................... TYPEOF CONSTRUCTION'..................................................................................................................................... !' ..........................4 ........19./. z TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a� permit according to the following information: / Location ...... .... y....... ....t .!d ............................ Proposed Use .......v. ..... :. �!fa,.. *..A.: .,� aA,� _. % 1,-.1............................. .......... 6�, Ur ZoningDistrict ........................................................................Fire District ................................................. ........................... Name of Owner ` i).,.4J!►�. Pc! ./�.. �c. ............Address '........6. ... Name of Builder/ / j ..��. ...............Name of Architect .....�............... .............,I.....................Address ...............��..............� ..�/ .................l............... Number of Rooms / .r .: ........ ..., ........n.... . .^A...............................Foundation ... . ,...v.. .. '. ._... Exterior ..... t°FP:.,lf a. .........................Roofing .......... ....................................... Floors ��� .+ ........................Interior .... ._ �Q:Ql -... 1........................................... _.... _ _ Heating T ....6a..1.1.�.:..... Plumbing ........... " .............................. Fireplace .............nl j - ...................................................Approximate Cost .............L� Aod.......... . ,:.. ...... /J/ Definitive Plan Approved by Planning Board ---------------—_---------19______. ''I6Areo Diagram of Lot and Building with Dimensions Fee .:...... .. ... ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH � qq� " 1 L �l " I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Qp Name ..,,l 1...... ... . .. �►./..�?4� .................... -T LaBlaneg Gordon Noy 19466 two story Permit for .................................... ti s Va g le family dwelling ............................:....................................... Location ............................................Wooderest -Drive..........:............ Marstons Mills ............................................................................... Owner ..........Gordon. . L.aBlanc . ...... . .... .. ................. .................... Type of Construction ........frame .............. ............. ti ............................................................................... # 114 Plot ............................. Lot ............................... Atigust 3 77 Permit Granted ............. ....... ..................19 Date of Inspection ..... ..............19 ,7 Date C -19 pleted' ... . ................. PERMIT REFUSED ................................................................ 19, .............;............. ...................................... ............................................ ................................ ........................................ ................................... . ............................................................................... Approved ................................................ 19 ................................................................................ ............ ................. ................................................. Assessor's map and lot number .......................................... '. � 7 i. ............................. .. ' Sewage "Permit number �/l .� T"ET°�`� TOWN OF BARNSTABLE EARNSTSDL8, i 9. BUILDING INSPECTOR � a j v APPLICATION FOR PERMIT TO ..................-. 1:............t.p Y. �a:................ TYPE OF CONSTRUCTION ................................... ' ........19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for aL permiiit`according to the following information: Location ....... .�....,` ... /� ......./�j r.�.. y.:�..:. `.a: ,...... ..CJ.......^...`.::.:..... . /.. .......!............................ / � 1 Vn / a 1, � t �Y l n ProposedUse ..... ... ... ............. . . . . ............... ................................................... ZoningDistrict ...................... ..........!/..................... ........Fire District .............................................................................. Name of Owner �,,. .':J!--: .'. -...... '��. :!.-...............Address ....! .. �J r o.............................................. pro Name of Builder .``�:^.- �/�.. .. �!i are tt�. .........Address �.` Il.. �.�. y ........... .... ..... ...... ......... ........ ..... .... ..... Name of Architect ..........................� ..........................................Address .................................................................................... Number of Rooms 1 !l r fib!?? ................................Foundation ..........................................................^''`• , - i `.. 1'n.-.*a? t .................... ' .Q --. Exterior .......l..i.sw.,a-a d �f ....Jr4�► ...Roofing ......... .. �Q.....,.............................................. R n n Floors r :, r . �:I t N n �\ ��........................Interior ..............!!..n n Yet nR� 1i!........................................... .................................., ........., Heating ...:f!l .. .........!.......................................................Plumbing ...........^�: ........� +..... .......................................... Fireplace ...............:c..?:.`:�-'.....................................................Approximate Cost .............�' (3G'4........... ..... ...... 3.%a Definitive Plan Approved by Planning Board ---------------—-----------19_ . i'''AArea ..... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH _J �r v ' - a I hereby agree'to conform to all the Rules and. Regulations of the Town of Barnstable regarding the above construction. Name .. LaBlanc, Gordon -A=30-77 No 19466... Per-imit for ........two story ..................... single family dwelling ....................... Location 4g-......Wood'crest Drive ...... :................................................... .......................M....arstons Mills .................................................... Owner ..........Gordon LaBlanc ........................................................ Type of Construction ..... . frame...................... . . .... .............................................. ........... ..................... 4114 Plot ............................ L t ................................ Permit Granted ......./Atigus t...3 .1977 ............. . Date of Inspection ... ..............19 Date Completed '. ............ ..................19 PERMIT REFUSED ....................................... 19 ........ .... ........ ..... ................................... .... .......... ............................................. *5j4 ...........(... .......... ............ °i`'/' f S-A/7y Approved ..... .......... . ... ...... ... 1-9 ............................................................................... ............................................................................... '+' •!1,.'1 ! i •.'i Il :'l 14 1 • i + '�. ,...;-._"1-�'1-.;,-_..--'I,..--.I.�.-'.-l!.'.-.-.'l..-,',j�.'.��",..-.1.,.-? 1 f I GiJ' ,1 �.'I �,1 1• :D Avg - � Y ..a��8sE'' ..;.,,.,-.--....`-,,,.�,...: l �A Q G i�..t r r2,C. rr. Itr G f. r 4 -y / k 1. t/ .e l t.r 1 ��� � �,'ti, r J,�rt1. h{. JI W`�', ' �Ft;: ,: �1 sl ,\ j IA r 1 t)� I' I n \ i 4� `r ;� , 1 h .. .. ! !J ` f.f } F .. .Y I'' 1' ) r 5 + It 'r f I Jl- -)+ 1. 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Board of Health(3rd floor): @ ����®�� ® � WQ o Sewage Permit number *�9.�i'°"9„ p�`�'��rf��ri� BASd9?I►DLL i Engineering Department(3 fl or): ���.s 'OHME A U rnee House number 0WH REGULAT10- °o 1639. \e�" Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF B_ ARNSTABLE BUILDING INSPECTOR ; d� ' -n � � APPLICATION FOR PERMIT TO � t TYPE OF CONSTRUCTION 19 �� ' I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location - t 1111 Ut 0 C��iS T y� ( � I'LS�IJ 1V u—S lk-t Proposed Use ist pv�' Zoning District Fire District �4/,) Name of Owner ( 141 gb Address LR 0kI,L7FL _I✓irL�S Name of Builder ��S7P��� �� Address DtNAA.E=::S-F Name of Architect ��N Address Number of Rooms 1 Z Foundation Exterior �C• t � Roofing T� Floors Interior l75 -_h Heating r J Plumbing v 0- Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Feed r Zo I-a.c�Y� �s OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re rding the above const uction. Name Construction Supervisor's License ���3 q HIBBERD, DAVID r No 33279 Permit For BUILD ADDITION Single Family Dwelling Location 48 Woodcrest Drive T _ Marstons Mills Owner. David Hibberd Type of.Construction Wood Frame t' Plot Lot ?' Permit Granted October. 12 19 89 Date of Inspection /—24 v 19 Alz Date Completed % 19 It r i o f { - k • I Assessor's office(1st Floor): Assessor's map and lot number Board of Health(3rd floor): Sewage Permit number ���' � + f • t BAHd9TGBLL i Engineering Department(3rd floor): Mass House number °o %639. e0' Definitive Plan Approved by Planning Board 19 �o MR(d� APPLICATIONS-"PROCESSED 8:30-9:30 A.M.and 1:00-"2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO Lt. J / \ Ayp,t -n p V — , o TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location DD S T , TProposed Use Zoning District Y. / Fire District Name of Owner � ( � 41 Address Oki oc Name of Builder co 1R(4 01014 Address NC1�lF(.t iC� C Imo^- I Y Name of Architect C-- Address Number of Rooms TwC) ( Z Foundation Exterior (A) C• K �� Roofing j Floors �`J ' Interior C� �� ' `Q � Heating r- �� ` t Plumbing Y C � ' a - t Fireplace Approximate Cost o oOf> Area, - rf o Diagram of Lot and Building with Dimensions Feel Ji g • Cam. 20 I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above const uction. Name Construction Supervisor's License HIBBERD, DAVID A 030-077 No 33279 Permit For BUILD ADDITION Single Family Dwelling Location 48 Woodcrest Drive Marstons Mills Owner David Hibberd Type of Construction• Wood Frame • r Plot Lot _ Permit Granted October 12 19 $9 I , Date of Inspection 19 Date Completed. 19 . I F PERMIT COMPLETED 1/1/-111- 1U