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TOWN OF BARNSTABLE BUILDI.NG PERMIT APPLICATION
Map Parcel l( O` y Application.
Health Division Date Issued 1 O -C),5 -'.l
Conservation Division Application Fee
Planning Dept. Permit Fee S e ' .00
Date Definitive Plan Approved by Planning Board COK ' p 1Z.S-1)I
Historic - OKH Preservation/ Hyannis_
Project Street Address 3'00 ► IA C► I-C I-R
Village OE�er"y I I _
Owner 0T-P- a Address y L 1 V1 C)(-e- B S f�jl�c1C
Telephone SQ v "�°Z qb
Permit Request fleq yes-b r m I L ` 0 Conye-A, (U r reA b34 r0o
►Y4D CceSSI C)rY1 . nJ"r 2 e- d N�
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District A Flood Plain Groundwater Overlay
Project Valuation �01 (�� Construction Type- - �
Lot Size r-73 III Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family �6• Two Family ❑ Multi-Family(# units)
Age of Existing Structure Historic House: ❑Yes IANo On Old King's Highway: ❑Yes )kNo
Basement Type: Full ❑ Crawl ❑ Walkout ❑ Other
Basement Finished Area (sq.ft.)__c Basement Unfinished Area (sq.ft)_
Number of Baths: Full: existing CJ� new Half: existing -,a new A
Number of Bedrooms: existingl#tlnew
t�� a
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other w
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stoves ❑a ❑ No
Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ' new;size_
Attached garage:Xexisting ❑ new size _Shed: ❑ existing ❑ new size — Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION - -
(BUILDER OR HOMEOWNER)
Name _I I rdr��U a W� i_6e DS elephone Number
Address C l of VI �Qnd V-0-a A License # C,IS Is 014 10
Home Improvement Contractor# '�J
I Worker's Compensation # $1N
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOa/�1uF.
i
SIGNATURE DATE
FOR OFFICIAL USE ONLY
APPLICATION#
rl
DATE ISSUED
Wiwi
„�► r
MAP/PARCEL NO.%
's ADDRESS- VILLAGE, ' ;
OWNER ,
DATE OF INSPECTION:
a
",, FOUNDATION' A`� --
FRAME
`INSULATION; ATt, f,1l
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
=s
GAS::.,L ��. ROUGH::&:, FINAL,
'r .nFINAL BUILDING, *-j4m6,vr=
_DATE CLOSED,OUT, i
'? ASSOCIATION PLAN NO:
t
The Commonwealth of Massachusetts
Department of irndustrial Accidents
Office of-nvestigations
600 Washington Street
Boston MA 02111
www massgov/dia
Workers' Compensation Insurance Affidavit: guilders/Contractors/Electricians/Plumbers.
AVVficant Information
Please Print Le 'bl
Name (Business/0rganization4ndMduaI): 1 1 lav*-
Address: \—I ), (—�of
City/State/Zip: 6Nr('e M PC Oa�3�. Phone
E
an employer? Check appropriate box:
a employer with 4. I am a general contractor and I Type of project(required):
loyes (�and/or part-time).* have hied the sub-contractors 6. ❑New construction ,
a sole proprietor or partner- listed on the attached sheet. 7• ,Remodeling
and have no employees These sub-contractors have
ing for me in any capacity, employees and have workers' 8 �Demolition
workers' comp, insurance comp,insurance.# 9.'0 Building addition
red.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
a homeowner doing aIl work officers have exercised theirlL [No workers' comp, right of exemption per MGL11.0 Plumbing repairs or additionsnce required]t c. 152, §1(4), and we have no 12.0 Roof repairs
employees. [No workers' 13.0 Other
comp. insurance required]
Any aPPlicHomeowners
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 thm hire outside contracton must submit a new affidavit indicating such
tCoatractors that check this box mast attached an additional sheet showing the name of the sub-contractors s m state submit
whether w not those entities have
employes. If the sob-contractors have employees they mast provide their workers'coand
mp,Policy number.
I am an employer that is providing workers'compensation insurance for my employees, Below is the poFscy and jab site
information,
Insurance Company Name: r kbrA I��*)r hCQ
Policy#or Self-ins.Lic.#: g C A S
Expiration Date: a 1 1-0-Job Site Address: GOq t
Attach
City/State/Zip- r10 `�. rn
a copy of the workers' compensation policy declaration page(showing the policy number and expiration date)
AF
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine .
Of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify and the p enalties a
.fPeriury that the information provided ab ve is
Sitore: ue and correct
U /
Phone
v l7 Date:
#: � f
r7ffzcial use off. Do not write in this area, to be completed by city or town o cial
City or Town: Permit/I,icense#
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3. City/Town
oven Clerk 4.Electrical Inspector 5.Plumbing Inspec
6. Other tor
Contact Person:
Phone#:
ACORQ CERTIFICATE OF LIABILITY INSURANCE DATE`S'°"""")
M 10/19/2011
PRonuCER 791.948.7652 FAX 791.380,8793 THIS CERTIFICATE IS ISSUED All;A MATTER OF INFORMATION
Dowling Insurance Agency, Inc. ONLY AND CONFERS NO RIGHT;UPON THE CERTIFICATE
HOLDER.THIS CERTIFICATE DC ES NOT AMEND,EXTEND OR
44 Adams Street ALTER THE COVERAGE AFFORI IE;D BY THE POLICIES BELOW.
P 0 Box 850962
Braintree, MA 0218S-0962 _ INSURERS AFFORDING COVERAC E NAIC P
INSURED Mark TVleja ;1NSURERA: Western World Insu•ante Co.
DBA. MTI Houle Designs, LLC INSURERS: Travelers Insuranc! CO. 25666
171 Clay Pond Road INSURERc: Hartford Insurance Co, The 21922
Bourne, NA 02532 INSURER-0: _
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY F ERIOD 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,EX':LUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
rjR FCIICT EXPIRATION
TYPE OF INSURANCE POLICY NUMBER PO
DATE MMID 11 DATE IAIM LIMIT'S
oENERA(.UABILITY N P1300154 05/31/2011 05/31/2012 EACH OCCURRENCE S 1,000,
X COMMERCIAL GENERAL LIABILITY PREMj IE6 , $ 50,0
CLAIMS MADE ITOCCUR tJ1ED E tP(Any we perSOn) S 5 oftej
A PERS(NAL&ADV INJURY i 1 0,0
GENET ALA6GREGATE ___.._.zJ 0
GE.RL AGGREGATE LIMIT APPLIES PER: PRODI CTS-COMPJOP AGG E 2 OOO,
X POLICY 0 JECf F7 LOC
AUTOMOBILE UAMLlTY BAf 22M3065 12/13/2010 12/13/2011
- MY AUTO amdent COMB dam)
SINGLE LIMIT S 1,000,00
(Ee )
ALL OWNED AUTOS BODIL-INJURY S
X SCHEDULEO AUTOS (Per Ix 7On)
B X HIRED AUTOS SODIL'INJURY X
Per ac wm) $NON-0OWNED II(
PRODI RTY DAMAGE
IIIII(Per et adept) 14
flARAOB LIABILITY I AUTO )NLY•EA ACCIDENT ;S
ANY AUTO OT)IE! THAN
EA ACC S
AUTO )NLY: AGG S
EXCESS I UMBRELLA LLAMUTY EACH 1CCURRENCE S_
OCCUR n CLAIMS MADE AGGR.LATE 8
S
DEDUCTIBLE --_ _ —_ S
RETENTION 8 _ S
NnORKERB COMPENSATION OSWECAA4015 02 01/2011 02/01/2012 _X r�RY_LIM ER
AND EMPLOVERV LIABILITYANY PROPMETORIPARTNERIE)(ECUTNEYIN E,L,EICNACCIDENT• Is 1000000
C OFFICERIMEMBER EXCLUDED? -- ---
(Mandet"in NH) E.L.DI IEASE•EA EMPLOYEE g 100,00
II des0be under _
SMIAL PROVISIONS below E.L.DI LEASE.POLICY LIMIT S 500.000
OTHER
DRBCRIPTION or OPERATIONS I LOCATIONa l VENICL 9 I EXCLUBIONB ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED PO ICIES B@ CANCELLED BEFORE THE EXPIRATION
DAYS THEREOF.THE ISSUING INSURE!WELL-4DEAVOR TO MAIL �0 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAME I TO THE LEFT,BUT FAILURE TO 00 80 SHAM.
Town of Barnstable IMPOSE NO OSUGATN3N OR LIABILITY OF AN'KIND UPON THE INSURER ITS AGENTS OR
200 Main Street REPRESENTATFME
Hyannis. MA 02601 AUTNOFMO REPRJ MYNTTYE
aohn 0mlinglop
ACORD 25(2009101) (D19 -20 9 ACORD CORPORATION. All Eights reserved.
The ACORD name and logo are reglabBred marks of ACORD
TUTt
MA 02532
Massachusetts- Delturtment of Public Safet> .
Board of Building Rc,uiatioits and Standards
Construction Supervisor. License`.
License: CS 80410
Restricted to: 00
MARK F T:
62 DRPO BOX 1505
CASSET,MA 02559 --
Expiration: 1 011 1/201 1
('ommissionrr Tr##: 8728
(33fllee awmer airs&B _,-h Reid
HOME IMPROVEMENT CONTRACTOR
Registration:.,,AW553 Type:
Expiration: Aq.2013 DBA
jam=-_.�.._-
E WOMDESI i_ ,
t = 9 F,
—�W-4
MARK TULEJA
270 BARLOWS
POCASSET,MA 0255 p=: Undersecretary
License or registration valid for individul use only
before the expiration date. If found return to:
Office.of Consumer-Affairs and Business Regulation
it 10 Park Plaza-Suite 5170 j
k=N Boston,MA 02116
i
I
of v d without signature. i l
IVlassachusctts- Dcparhncnt.of Public Safcty
Board of Buildinl� Rc!�ulations an(I Shuulards
Construction Supervisor License
License: cS 80410
MARK F TULEJA''. I
62 LAKE DRPO BOX i1505 '
POCASSET MA 02559 I
t
I
Expiration: '10/11/2013
('unnnissiooi.�• Tr#: 4565
y
O�0�1 DESIGNS V O�
�/ Niv-cvinivc,Nw riic
A MUNtf
171 CLAY POND RD BOURNE MA 02532
PHONE 608-563-1115 FAX 50"63-7930
KITCHENS,BATHS AND MOREIIII
PROPOSAL
Wrovosal submitted to: I THEODORE BERIAIJ Phone: 508-428-4035
Street: 1138 WEST WIND CIRCLE I Job Name:
lCfty,State,Zjp Code: IOSTERVILLE MA 02655 Sal rson: MARK TULEJA
MTI TO FURNISH AND INSTALL THE FOLLOWING
PER ATTACHED PLANS
REMOVE EXISTING,VANITY,SHOWER,TOILET
REMOVE EXISTING TILE FLOOR&SUBFLOOR
REMOVE 2 EXISTING WALLS
REMOVE EXISTING BATHROOM DOOR
RELOCATE ELECTRICAL SWITCHES BY DOOR TO OUT SIDE OF BATHROOM
INSTALL NEW 6 PANEL PINE DOOR TO MATCH EXISTING 36"
CUT OUT FLOOR IN NEW AREA FOR SHOWER
CUT EXISTING FLOOR JOISTS TO ACCOMMODATE PITCH FOR SHOWER&REINSTALL FLOOR
REFRAME NEW WALL FOR WASHER DRYER CLOSET
RELOCATE DRYER PLUG
RELOCATE PLUMBING FOR SHOWER,TOILET,SINK,WASHER
INSTALL NEW ALLURA SHOWER VALVE WITH HAND SHOWER SLIDE BAR
INSTALL WATER PROOF MEMBRANE,WALLS& FLOOR OF SHOWER AREA
INSTALL TAPERED MUD/MASTIC FOR SHOWER PITCH
INSTALL NEW UNDER LAYMENT
INSTALL 2 X 2 TILE IN SHOWER AREA FLOOR
INSTALL MATCHING 12 X 12 TILE IN THE REST OF THE BATHROOM FLOOR
(Florida Tile,Style:Fontana,Color.Navona Sand)
INSTALL TILE ON BACK AND SIDE WALL OF SHOWER 4A Lty
INSTALL GREAT NORTHERN VANITY WITH HP ACCESSABILITY(y. 14 11-/0
INSTALL NEW GRAPHITE CULTERED COUNTERTOP WITH UNDERNfOIINT SINK
INSTALL 2 24"GRAB BARS
INSTALL 1 48"GRAB BAR IN SHOWER AREA
INSTALL NEW MANSFIELD ALTO SMART HGT TOILET WITH SLO CLOSE SEAT
HOOK UP SINK,WASHER,DRYER,SHOWER
INSTALL GREAT NORTHERN CABINET OVER WASHER
(Great Northern Cabinet Wood:-Maple,Color.Praline)
INSTALL GREAT NORTHERN MEDICINE CABINET
INSTALL 1 ADDITIONAL RECESSED LIGHT FIXTURE IN SHOWER AREA
REMOVE MIRROR AND RELOCATE VANITY LIGHT(NO CHARGE)
FYI CABINET AND MED CABINET $ 1,350.00
NEW TOILET $ 250.00
NEW LIGHT IN SHOWER $ 250.00
TOTAL PRICE: $ 10,916.26
NIC PERMITS,FAUCET,PAINTING,SHOWER CURTIN
FINAL PRICING BASED ON APPROVED DRAWINGS
AND FINAL SELECTIONS ON ALL PRODUCTS
THEODORE BERIAU 2
DESIGNS V��A Af!!R!S
171 CLAY POND RD BOURNE MA 02532
PHONE 508-563-1115 FAX 508-563-7930
KITCHENS,BATHS AND MOREIIII
TERMS:
$ 3,274.88 DEPOSIT
$ 3,274.88 UPON START
$ 4,366.50 UPON COMPLETION
Al matmkt Is guamntmd to be spec fle"wort to be canpkted In e wabnmfike mmtner eworat k simtdard pmdkes PM egerdm m devbftn from above spedgcab"kwdft am
twsm w0 be mevAed only upon wwtnm orders,mid vA btxome m ems drmge ovm mid above bw estimate.All agreement corekWO ttpon sb*w.eccldertb,a dekysbaryM w oormd.Ow
to eery fh.tomado.mat othm rwoes my k�Ow wakes we hsj covered by Workers CornpdtsOm hwa oe.
Acceptance of Proposal The above pnoes,speadcation,and aondiaion are satisfactory and are
hereby aooW ou ar atNmrize to wroth as specified.Payment will be "Wined above.
S Data 9
MEMBER OF BU I G TRADES ASSOCIATION #A40122
BUILDING UCEN # CS 0804 10
MA HOME IMPROVEMENT #156533
MEMBER OF BETTER BUSINESS BUREAU #114203
THEODORE BERIAU 2
f
�T"E' Town of Barnstable
s s Regulatory Services
�ST"M r3' es
MA&& Thomas F. Geiler,Director
1639. 10g
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038
Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject
`e j ct property
hereby authorize a`r -TV o� yrn +-6w �� hs
to act on my behalf,
in all'matters tela.ttve to work authorized by this building permit
3S V S�11��✓1d Cj r-�(Q C�2ry V'MP+
(Address of Job)
**Pool fences and alarms are the responsibilityof the applicant.e app ant. Pools
are not to be filled before fence is installed and pools are not to be
utilized until all final inspections are performed and accepted.
ture wner SP., ekA -
Sent
Print Name
Print Name
Date
QTORMS:O WNERPERMISSIONPOOLS
THE
Town of Barnstable
Regulatory Services
BnaNMABM *' Thomas F.Geiler,Director
MASS.
16yg. � Building Division
Tom Perry,Building Commissioner .
200 Main Street, Hyannis,MA 02601
www.t6m.barnstable.ma.us
Office: 508-862-40 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street
village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state- zip code
The current exemption for"homeowners"was extended to include owner-occ ied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to
be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable tb 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 P P requirements and that he/she will comply with said procedures and
requirements.
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
• HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required 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."
j 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.
i
i
i
Q:forms:homeexempt
t �
TOWN OF BARNSTABLE permit No.31789
BUILDING DEPARTMENT
l SA AZ } TOWN OFFICE BUILDING Cash 7 '63
679. f U
ur HYANNIS.MASS.02601 Bond .....�,...
CERTIFICATE OF USE AND OCCUPANCY
Issued to Randolph Harnois
Address Lot #27, 138 West Wind Circle
Osterville, Massachusetts q
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.
March 22 .... ........ .....
,
Buil.ing Inspector
L}
�. 1
��..� °•. TOWN OF BARNSTABLE
BUILDING DEPARTMENT
_ »sSTA TOWN OFFICE BUILDING
rua
i639' �� HYANNIS, MASS. 02601
MEMO TO: Town Clerk
FROM: Building Department
DATE:
An Occupancy Permit has been issued for the building authorized by P
BuildingPermit $k. ...........�317 �. .................................... ............................................................................_....................................
issuedto s.... �R 7�� ..................................... .............. . ... ..._ ..... ........._.._.._
Please release the performance bond.
: .'
"TOWN 0 RNSTABLE, /v1A55ACHU
Rf SETTS g LDING"
APPLICANT ) ; DATE 19
<• PERMIT! 17
ADDRESS�� 7 jv);lirl ET) , 1 Vz)_.Xe .#006b88
IN0.1 (STgEHT1• PERMIT TO .ICONTq'S LICENSEI
T OP 0 MENT) (4) STORY NUMBERr�r)1 «� F':elni 1 ,r NUMBER OF
N
PROPOS y ' DWELLING UNITS
( ED'd9E1�'�
• AT (LOCATION) - '7 `
ZONING
(STREET) DISTRICT--1((-�r�
BETWEEN
(CROSS STREETI AND
SUBDIVISION ----------
(CROSS STREETI ,
LOT BLOCK 9 LOT
SIZE
BUILD MG IS TO BE ;•kT _,,.(�
FT, W(p
(
E BY FT. LONG BY S
pp �" FT, IN HEIGHT AND HALL CONFORM IN CONSTRUCTION
E•. ', TO TYPE. {l,F
7-7 USE GROUP
t ! ' _ BASEMENT WALLS OR FOUNDATION
tt[ REMARKS: .F, i r?'� ,� ) �. ,•(TYPE) Z
AREA OR
VOLUME 7 q 130,11cl
(CUBIC/SO UARE FEET) ESTIMATED COST $ PERMIT r
OWNER"
ADDRESS
y - � ., r � � .i.l BI�ILQ(NGDEPT. �I �,„tit, •'
- FROM- - (,
T H E DEPARTMENT O F-P U B L I C S T R I C.IO��I"$"�j''Jr`'C '-"a�°•'•Y H I S'Pre-o rr 0 0 ES'IJ'CT'k'��-E I15E�`Y FI't A'}+•F'•�L ice" ivy-yG .�,t �,+h
)(
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS, �'��'' +•�Z''r�ag�•,�T;'��a (
MINIMUM OF THREE CALL {oJTYR '
INSPECTIONS REQUIRED FOR APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED -'FOR
I )`VUIV U7i-T'TO'N'S'VYTTO'O'T"fNG�, - MADC. W11G'tr A .:EIT??r-,r-�..-
2. PRIOR TO COVERING STRUCTURAL ''� '��cI.lrANCV_I.,q._.R.E_ ELECTRICAL, PLUMBING AND
MEMBERS(READY TO LATH). OUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MecHON.ItAL.;�I.TeLLgTIpNS-^-�ti_r
3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET •
rt 13UII_DING INSPECTION!PPOVAI.S -
PLUMRING INSPI(IION,lPPIIUVAI:;
°= -•:=: _____._-_,-._.._ _-. -_ _ @LCT ERICAL-INSPECTION APPROVALS
z Z !�Z
HEATING INSPI(:I ION APPROVALS ) ,.
- _.
------------------
ENGINEEF{SNG.DEPARTMENT
OTHER __ 3--�/-90
2 ,
_-- --Y- BOARD .HEALTH N
WORK SHALL NOT PROCEED UNTIL THE INSPEC. PERMIT 'N!LL BECOME DULL AND VOID IF CONSTRUCTION
TOR HAS APPROVED THE VARIODU.SSTAGES OF WORK 15 NOT STARTED WITHIN SI MONTH$
CONSI RUCI10N INSP[(;TIONS INDICATED ON THIS CARD CAN BE
PERMIT IS ISSUED AS NOTED ABOVE OF DATE THE ARRANGLD FOR BY TELEPHONL ORkVRI1TEN
NUIIFICAIIUN,
r
r
I-6 ��G 6
/tit
2G. S' oa
f,U/11atone
!Ueat 'U.ind .
end o C-vule =i•-
pave (� 3z—S
Z7Z ass L10 wide
36.7 V
1-6 i�G 6 pit I 3G z Ig
!U/I atone U 33.0 pao jite
o0 o No Sca&
= 201 a £xp.
�t2 7' 'd .. - 39.s C75
��s 0" ) 40.0
o 33.4
9T
3o P I i 1500
3a3 I_ A 0 •'.a
34.5
�O £X;
� 90 und. 4i
A2 m 33.7 .
Pot 26
.Cot 27 39.7
�
18,872 S f 3a.z
d
f
rrd.
I.a Cape r
' 35. �Iq Idaicl�o4, 96ad
lgavtvz iA, Ma. 02601
3� 9 C Scc
34.4 . 117./3 Jcte 9-I !-87
Data Sk tcA /-'.tan og .Pa ld in 04tezu-i,1.G-, Pia.
No, bedzoonr� 2 got ,'hand ph ka&nai.
g
Ca2bac�e d i,�. no e i nq tot 27 as ahown on a ptan teco tc e .in
.
„Peach i.� a 201 r3�Ce l�� bl� 290 pg SS. I
�eae�rue " 201 R wat i ovh. ahown aiae on an ad umed dam. 1
Capac� 427 qpd
_ i
Seat I'i t#1)-66 39 �G te:------Aden ---13 �e oaz o?Nam
('Made 8-19-87
Wit. g. Dun" f
No watch enco c%n tehl, p eh in She owula tion ahown on thi i p.tan iA to ca ted i
35.3 3¢.5 on �� a,,, 4hown he�teon, and nto..etas. the,
& top .�etback .�e cyuihexevrti o the Jown o% r3a�c .tal�te.
topdab date 4-14-88 ;
3z.3 3�.5
t.
)eAc.
OF
i ;come coavtlj.e `` ED .nRn "
KE RN 1� y�y
41ajsd 6 1 1
• i ��No.3d�t�if d� ,o ,p a `.F,l
ST
LA
2Z.k zI.S
///
1 Assessor's offioe (1st floor): // , r �c� MUST FtNEr
Assessor's map and lot number .......f /...........9. 1� Q /.� ,F� ��� SYSTEM Q..°
Board of Health (3rd floor): e�� •
Sewage Permit number .................. . WITH TITLE 5 •
"" Z BAUSTODLE,
Engineering Department (3rd floor): n"' ��L CCU�_ rnea
,��n
g g P ) \! .. .�Jl�.,tJo�ou oa 039 °
House number /3 ' fin a�em
...................oHe d•.,,,... RE IS" YAr
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
1---
! J)
APPLICATION FOR PERMIT TO .... ! l e.........�-??n . .,......Lde.[(. .... ...............J�...................
TYPE OF CONSTRUCTION ...(,1L�f D.,O. ........: e // 11 •6 e/��r1
Y'. .!!?1............. .......... ... ?.. .. .......................................
. . ...........19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ..... ..
qq ,, `e p
f�-a.................crC..7 ,WPC nr ...... .t.�'. �............ ... v 5 ..... ........... �.5... .............L. ...�-.
r
Proposed Use Q' i}.L...............�.t.N.. .l e......... ..13 X14
Zoning District D t' I-l..f. ..............�....
g Fire District ..... ... .S...l��:..S�.r.l
n / t` I
Name of Owner ... A!?.dlQ. �.Ga............ .. .dgrlu01 -5 ......Address .'Y. .......G O' ij (� r'�. r
4..P...S....... ..�...... ,. . .
Name of Builder 16. •� �. 1. ..� „!. .. ........ DN�S:.V.!^.1�.�. /..0.�..Address .��Z....../.�::/.1�'.l.iJ........ ..�.�...... ./.1J.�. .�1..
Name of Architect lvel,h.L'.... ...Q�� ...`�`..tl..Jed,?!�.....Address .•..�1..4..."..E .��...... NS
Number of Rooms ...........J..........&POP.c,. ............Foundation ..........�aIV..C.I .�. e-..........
Exterior aJ.......5.A.I.41P............ ...Roofing . S.h��[..!'.........�.h.r.AJ.�!.e.s.
Floors !?J. ........J.../...!.l.'r�(CIDocJ�................lnterior ........�4 �" .� .. ` LtJOV
P ............
Heating .... ...........Plumbing ...... .-,a ...!......... d & J! 9r �4'v�✓�f'r
r ( i
Fireplace ... ... f�s.O..N/ J`............... r`�C... ..............Approximate Cost .........�J..O�.D..D...�.
Definitive Plan Approved by Planning Board -Dac— 1D._ /9 Area .......................
Diagram of Lot and Building with Dimensions
Fee ..... .................. ..................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
\ 1�
1
4`
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.
(:�24
Nam ........... . ...............
Construction Supervisor's License .....OP(o..6. lJ
HARNOIS, RANDOLPH
No Permit for .....1.12... Y. ..........
Sin le Fa
..........
Location §.t....Wi.nd...Circle
................O.s.t.e.rv.i.l.l.e.....................................
Owner ..... ...................
Type of Construction ........Fr?M.Q..................... -7
...............................................................................
Plot ...... ....................... Lot .....................
............
Permit Granted ..............................April 11 ,...........19 88
Date of Inspection ....................................19
Date Completed .................... 19
�. � � 9d
V I
"Engineering Dept.(3ra floor) Map:', 1 0� I Parcel Permit# S �)�
a`/o
• House# - i 3� �1 a Date Issued � 7
�� 7
Board of Health(3r o or)-(8:15 -9:30/1:00-4:30) �— .3� Fee . ��'� • /
11LJ Conservation Office(4th floor)(8:30-9:30/1:00-2:00)
�� Planning Dept.(1st floor/School Admin. Bldg.) THE
Definitive Plan Approved by Planning Board 19
BARNMOLE. '
TOWN OF BARNSTABLE
l3iiilding Permit Ap lication
Project Street dress
Village
Owner �Q Sq!-(.� 'l.� �Tr- Address l 3 1„/e_Ec �i✓t,, E �
Telephone Lf d 5
Permit Request iv ZnJ 4Po.VA ,,a,-e 1,- 6
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $ 0 p0 .6
I
Zoning,District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
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
No. 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
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review# -
Current Use Proposed Use
/,� Buflder I/n�ermation ,J
✓ Name l gite_& lephone Number
ddress 19 -ro/hs ense# 0 3 3 Al 3
Hgme Improvement Contractor#
Worker's Compensation#
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE V,,J DATE 0 / — ,9 7
Bj.J�I MG P RM.IT I}ENIED FOR;THE FOLLOWING REASON(S)
w^, FOR OFFICIAL USE ONLY
t
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE ;
OWNER
DATE OF INSPECTION: '
FOUNDATION '
FRAME
r _
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL -
i
PLUMBING: ROUGH FINAL
GAS:- ROUGH FINAL
FINAL BUILDING -
. f .
DATE CLOSED OUT
ASSOCIATION PLAN NO.
•
r .. .. .. .. ...�: :;; .::. ,.••. . ;... ..
The Town of Barnstable
NAM Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissi.
For office use only
Permit no.
Date'
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units or to
structures which are adjacent to such residence or building be done by registered contractors, with
certain exceptions,along with other
/requirements.
,,-�-,TYpe of Work: N i'LJ1 ) b i'o 4,L)
vP Est.Cost / 0 Ud
Address of Work• / 3 �- U10 54- ru t b� Mi 0i 55
Owner's Name --T�n
ate of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000.
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME MWROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL r— 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner.
Contractor Name Registration No.
Date
OR
Tlrc• Cunrnrurrl��CQlllr n� r3fuscaclruscttt
•
DeIMMIX111 of ludurrrial Accideirts
w
•:s �. :1 OxceOf/M zff allods
;�_\_+"i • %• �` 6111111 aslun„tan Street
%larkers' Compensation Insurance Affidavit
—' Please PR1 atirilic:tn`t inrot•mntinn•• _ _ NTie:�tb V
name
lt-+rttion�
cis• nhnnc if
M I ant a homeowner performing all work myself.
I am a salt:proprietor and have no one workim_ in any opacity
I am an empiover providing workers* compensation for my employees working on this job.
rnmnanv n•rmc• 1C �'1 C�.l A l I� I Oct
/" atltlrccc• 1 ,� �� 1'�� 1
hnn th
i ll
(.iwmrnncern. �CrAJ �II f ith•t! PN.v� ax �� �i� - -ti `7
[� I am a soie proprietor. ,encral contractor, or homeowner(circle one/and have hired the contractors listed below who
the following workers' compensation polices:
cmmnanv n ttnc�
:rtltirccc•
cite- nhnnc t►•
incirr�ncc rn nnlicvlt
cmmn.1n n*Itnct
�tltlrccc-
-ir.• nhnnc Ih
ncornnee cn nniitry a
%teach additional sheet if neeaiary !;•c • --+ .» -,i.. .....,., _.:.._'�._:�_-_-
'ailure ttt secure coverage as required under Section•3A of A1GL 152 can lad to the imposition of criminal penalties of a li up to 0.5ne 00.00 andiur
nc y cars•imprisonment as well as civil penalties in the form of STOP WORK ORDER and a line utS100.00 a day against me. 1 understand that a
GM of Phis statement may be furwarded to the Olnec of investi0ations of the DIA for coverage verification.
rlv ltercht•ccrr/j• uu/er t/rc•paitrs acid prnnllic7 ojperjurr t/tat t/tc iajormotion prodded above is tare an correct
nature oats ` I " I?
'Tint name Phone 0
ofliciai use only do nut write in this arcs to be completed by city or town omcial
city or town: pertnit/alcense it r'tl3uildin;;Department
❑Ucensin0 Board L.
►-check if imm 5eleetmen's Oberediate response is required C311ealth Uepattmeot
contact pertnn: phone0: MOther_��
r
. .. .+ .._r. .. >! .• 1. ....1v r.y 77INa':✓r;t� •l:r.• r�•t:••iLr�. . �`!•: tia••. �'... ..i '1:.:•. ..
Information and Instructions
Massachusetts Getterni Laws chapter 15'_ section '15 requires all employers to pm�►ide workers• campertsatiatt
employees. As quoted from the "ta%v"•an entphtree is defined as every person in the service of :ituotltcr undo:
contract ofhire, express or implied. oral or,%witten.
An cnrplm•rr is defined as an individual. partnership, association. corporation or other legal antitt, or any two
tide fomaoims en.uaged in a joint enterprise.and including: the legal representatives of a deceased employer, or t
rcccil•er or trustee of an individual . partnership. association or other I' ' I emity, employing emplovc s. Howt
m«•ncr of a dwelling 11ousc haying not morn than three apartments and who resides therein. or the occupant of ti
da cllitr_ house of another who cmplo?'s Persons to do maintenance, construction or repair work on such dwelI
or oil the grounds or building appurtenant thereto shall not because of such employment be deemed to be an err
ncL
MGL chapter 152 section 25 also states that ever%•state or local licensing agt;ncy shall nithhuld the issun
rert01•stl of a license or permit to operate a business or to construct buildings in the commonwealth for sr
applicant who has not produced acceptable evidence of compliance wt ith the insurance coverage required
Additionally neither the commonwealth nor any of its political subdivisions shall enter into any contract for du
performance of public work until acceptable evidence of compliance with fire insurance requirements of this clip
been presented to the contracting authority.
r �—..�_.�..�.�—..� ...»���.���: .�. 4:.. ... ,. .,... :a.. to•.:+:..:y\.. .�Y..,:�� -�«','.7!".�—. .
App icants
Please fill in the workers' compensation affidavit completely, by checking the boa that applies to your situntior
hone numbers as all affidavits may be submitted to the Department of
supplying company names. address and p
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the al'tdavit. 771c
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 re:
to obtain a workers' compensation policy. please =11 the Department at the number listed below.
City or •rowi•tts
Piease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bor,
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant
be sure to fill in the permittlicense number which will be used as a reference number. The affidavits may be retu:
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 quc
please do not hesitate to _sire us a ►::11,
r••araw-�— _.r,�..,,.—. .ww+�'• .. ..a..r._.w. wry—si.. .. •.�— T ' .
The Department's addresso telephone and fax number. •-;�
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of 1QYeStfgatfoas
600 NVashington Street
Boston,Ma. O2111
f-tY o- «t 71 727-7749
r IVIDlITUAULA IN 5PnulluN PLAN
4 NORTHERN ASSOCIATES, INC.
342 N. MAIN STREET ANDOVER MA 01810 TEL: (508) 474-4410 FAX., (508) 474-5067
MORTGAGER: THEODORE F.. JR. & BARBARA BERIAU DEED REF. 9216 / 51
LOCATION: 138 WEST WIND CIRCLE PLAN .REF. 280 / 69
CITY, STATE: BARNSTABLE (OSTERVILLE), MA SCALE: 1" = 30'
DATE: 6/27/97 JOB #: 97/3404
N/F JOHN B. LEBEL
CONSTRUCTION COMPANY
117.12
+ 1
l
1
LOT 27
18 ,87 S. .T
Rn-r
to P
wa 0M Z
LOT 26 ,` e m °'
1 W M
34t d0 38Y 201 J O
ZZ
—r OR Z .2
P •- 2
0 U
.� N
,y Z Z
' 10 0
1
14
vv�
S71
vV� �
N '
C4
E
CERTIFIED TO: DREW MORTGAGE
NOTE: This mortgage inspection was prepared This mortgage inspection was prepared in accordance
specifically for mortgage purposes only and with the Technical Standards fortHortgage Loan
is not to be relied upon as a land or property N OF bq Inspections as adopted by the Hnssachusetts Board of
line survey, used for recording, preparing deed ��P lf9 Registration of Professional Engineers and Land
descriptions, or construction. No corners were �'y Surveyors 250CMR 605.
set. Building location and offsets are o CARMEN G I further state that In m
approximately located on the round and ✓ y professional opinion that
PP Y 9 g � the structures shown conform with the local zoning horizoNtal
are shown specifically for zoning determination T Imnsional setback requirements at the time of construction
only and are not to be used to establish propert e are exempt under provisions of M.C.L. Cit. 40-A Sec. 7.
lines. The matters shown hereon are based on -04
client-furnished information and may be subject O� �a MIf1.Property/House is not in a Flood Hazard.
to further out-sales, takings, easements and rights �J+ fCISTERE QJ 02.Property/House is in a Flood Hazard Area.
Of way, and other matters of record and prescriptive �i J p 3.Information is insufficient to determine
or other rights. Northern Associates, Inc. assumes no DNA( LAND S Flood Hazard.
responsibility herein to the land owner or occupant,
accepts no responsibility for damages resulting from said / r— /!f 7 Flood Hazard determined from latest Federal Flood
reliance by anyone other than the said mortgagee and its assigns s Insurance Rate.Map Panel r�`i��+'•/ a A;: / C:
in connection with its proposed mortgage financingto said mortgagor. Date_ ice.. 1 Y''T Zone_��_
'A' F II 10
,F TYPICAL WHERE SHOWN 3 3
4
� 3
.. ................
9p
3
�..
.; .
SHADED PORTION
REPRESENTS
A AREA FLAT
I
ST AI
OPTI
SIZE SHOWN i9x32' 4% S.F. SURF. AREA a 1779a- GAL. CAP.
ALSO AVAILABLE 16'x34' 530 S.F. SURF AREA a 18476 GAL.CAP
19 x36' 634 S.F. SURF AREA a 21148 GAL.CAP
20'x4d 766 S.F. SURF. 'AREA er 27670 GAL.CAP.
V
4 RAMUS..-RECTANGLE '
'A' FRAME ASSEMBLY
TYPICAL WHERE SHOWN 2
� 3
of;.,►•- � �i
R
IIW
3 {/�
•1 W O �
5•
w
co
ffi
►=
0
7
W W
u ae
W
3 �
d.V.
N
y.
• I
•1
STAIRS ARE '
OPTIONAL
.p
IRF. AREA a 26910 GAL.CAP.
iRF. AREA a 26910 GAL.CAP
r. SURF. AREA a 22045 GAL. CAP. �.
F. SURF. AREA a 20822 GAL.CAP.
N�
>IS• �
0
1h
3
��.
mu
I
• l • •
r'
THE FACE OF THIS DOCUMENT HAS A BLUE•BACKGROUND ON WHITE PAPER
�,,..
MNN
SS
hece.e. "Ose\.e a i.,.r'9•ei•,w ♦a.
1-WIRS \ �..
`� ♦♦M. .i. \e.
ER
THE BACK OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK-HOLD AT AN ANGLE TO VIEW
•
L THE FACE OF THIS DOCUMENT HAS A BLUE BACKGROUND 0� N1 WHITE� PAPERSENSE
-
WINE
�..1
.�� � ��
THE BACK OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK•HOLD AT AN ANGLE TO VIEW
Assessor's offioe (1st floor): // J
"Assessor's map and lot number ............ ....._........7.tff�2 �11 FTMETo``
Board of Health .(3rd floor):
n d �
Sewage Permit number ............... ..F...— .. ^^�... L Basa9?snLL,
Engineering Department (3rd floor): . °o 0b 9• \e`�
House number .......................... ....7 �3g.......................... a.
0 NOR
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00• P.M. only,
TOWN OF BARNSTABLE
BUILDING INSPECTOR
le J �
APPLICATION FOR PERMIT TO .... ( . .le........�h'?,. .......Low I.L. .....................�................
TYPE OF CONSTRUCTION `
.W.0.D. .......... V'.d9r??'! .........' ..........!''�.�.-5... ......:.......�2/..........
� I
�-�/............. ...........19.R
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ..... .t? mac....... . ................l f.e. .....w.!.!v...........C1.rC ............ SS. U.�1 ... ................
r �
Proposed Use 5...!.M-t�? 42
f►..!................J.i..et�. ..(.c......... . / �.1. ..................................................... A...........
05.6�r!V.L/..........
Zoning District ........................................................................Fire District ..... 1...!..f."e-
Name of Owner ..... A ........... .. Address .. .. .......... ......... ........ ..P........y E.........
Name of Builder y � ..... !!-5.�.►':.J..C. 1..A.4v.Address ..���Z...../r�/
�/..rs�................:. /V. ..... .. .....
Name of Architect 0,1.0.e.......��.�....�...&4i!,J....Address ..•. ...... d.f?/;!V.S..................1.�'
y .�'. c....G.�!...........Number of Rooms ........... ..........!C� .6� Foundation" .U.r. .. ......... ............
Exterior .( C/�oC ...... ..f1.r.rUr..le.......................................Roofing .. S.h. .! .[.!!......... f'!. ...................,...
i .C� !y..L/....... .../.,Y„/t/ GQJDO ..............Interior ........C� ...e...v.......` ... Wa4.. ..................
Floors / /
Heating ..... � X �
� ...........Plumbingf I
...... ..e..5.............
1-::9r4U.Q.........�
Fireplace ...A?.s.D.N/ Yr!...............r .r.!C.. .............Approximate Cost .6 (9(90 , ......
Definitive Plan Approved by Planning Board _-V)�___10--------19 73__ . Area ......./Vt ...................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
�•
e
9
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 Suplervisor's License .....,00.<?.6 ...........
i
HARNOIS, RANDOLPH Z121-011-012
c 1�21
No 317 8 9 Permit for ..1 z StorX.. ... ......
Single Family Dwelling............
...................................... ...
Location i......1.3.q..Yest Wind Circle
.......................
.................O.S.t.er.y.i.1le....................................
Owner ....RApjpjph....Ha.r.no.i.s......................
.. .... .. ... .. .
Type of Construction ......Frame.......................
.. .. .......
..............I....................................I...........................
Plot ............................. Lot ................................
Permit Granted ..... 1.1..".............19 88.
Date of Inspection ....................................19
Date Completed ......................................19
ti
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All dimensions _size designations 2® 20 This is an original design and must Designed: 9/19/2011
given are subject to verification on TECH N O L O G I ES ,
not be released or copied unless Printed: 10/20/2011
job site and adjustment to fit job applicable fee has been paid or job
conditions. order placed.
-�- - ETHEODORE BERIAUI Print Drawing #: 1 Scale : 0 1/2" = 1'