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HomeMy WebLinkAbout0355 WIANNO AVENUE .�. � � �. ,� o a „� � o a � o � � o o � � o o n' ., e o 0 a _ .. o - ��"� ., a .. o� o o o o. � � .. � � � o o n a � �. o - � a 0 o � o o o � � -, � o �.. i .. a. o - � .. r. �� - ,. .. _ o " � - o o o o 0 o o ry i c p' n �. o i � a � � o o O - ., a�4� a� _ o _ �� D � � 4 � o o 6 �.� ,, ��". � - o �' ,� ,. ,: o n � o o � � .. � �, , � .. .. o _ a ,o ., a o o a �. � o o � - ,' � ., �. 4 0. n e � n a � o a �o _ .. ., o o .. .., o _ a ., a e _ f a - � o ., o ', a ° � ., o v a � � .. � � n �� � � � o �. � ,' ., �, o a _ �o � o .. � � _. � � � � .. ., ,. �, a a o �,. , r � - � � ,. o _ 3 _ e o e a o o � n o � � o .,, o n r a �. = o � , ., � - ..`A �, � � � u � o � � �, � � ., � o � .. � � o ,, � ,. ���, o o o o oo _ .a �- o � 9 .. ,. � �. e � ,� n ,:, - _ e ,_ a � o� o o � o c � o �. � j R � � y c � � o i q o u oo c � a � ., v a � o, � � o L .,, o ,� e - a '� _ o _. �� .,. - ,, o � ., �� n 1 0. � o,. ?� � n � �' � � n � �� o v � �. o .. o � � ,. o, o � f a � � u b u � (�, ° ti n a c. o � o ,. � � � ., a .� o a o n � a <, o a� a . a ,�+�'�' ,. • 'own of Barnstable *Permit# ' o �y Expires 6 months from issue dateee . Regulatory Services Fee Thomas F.Geiler,Director Building Division �(v1ll�cs Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address P ` residential Value of Work ��Q, QQQ Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name LA�- Telephone Number Home Improvement Contractor License#(if applicable) Cons 'on Supervisor's License#(if applicable) or:=Is Compensation Insurance off"" SS PERMIT Check one: JUN _ 6 2008 ❑ I am a sole proprietor uam the Homeowner have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Worlaan's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) �Re-roof(stripping old shingles) All construction debris.will be taken to s ❑ Re-roof(not stripping..Going.over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) . 'Where required: Issuance'6f this permit does not exempt compliance with other town department regulations,i.e.'Risfbric;6saservation,etc. I ***Note: Pro rty Owner must sign Property Owner Letter of sjq�. 9+ o y of the Home Improvement Contractors License is reT e �f�('8091 SIGNATURE: Q:Forms:expmtrg Revise061306 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information �/,, Please Print Legibly Name(Business/Organization/Individual): K� c Address: 1" Id Sam City/State/Zip: S. Phone.#: 'ya/ '/t O T 49 l Are yyoou an employer?Check the appropriate bog: Type of project(required): 1.U 1 am a employer with 3 d 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.ElI am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' Y P t3'• $ 9. ❑Building addition [No workers'comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.21oof repairs insurance required.]t c. 152, §1(4),and we have no 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 who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have errrployees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: l rn Policy#or Self-ins.Lic.M ,���1 U� 1)4102 dW C7 Expiration Date: Job Site Address: 3� ��!e� �"'�` City/State/Zip: &4 (10 r` Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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 n er the pains and penalties of perjury that the information provided above is t ue an4 corrJrect. Si ature: Date: (J O Phone#: Official use only. Do not write in this area,to be completed by city or town official, City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 representative's 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-moire than three apartments and who resides therein,or the occupant of the dwelling house of another,who employ's,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(7)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 certificate(s)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 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 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. 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 tfie 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 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 Department of Industrial Accidents Mee of Investigations 600 Washington Street a Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia Date: 2/20/2008 Time, 4,04 PM To: N 9,15087754909 Pages 002 Client*2093 2JAXTIMEREJ AC6RD- CERTIFICATE OF LIABILITY INSURANCE �012008 tM=DNYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE AND,EXTEND OR Agency ALTER THE OVERAGE AFFOD DED YT HE POLICIES BELOW. 973 lyanough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIL#. 04SURED IAA: Acadia Insurance E.J.Jaxtimer Builder, Inc. INSU RER B: Fireman's Companies Emest J.&Marie T.Jaxtimer INSURERC: 48 Rosary Lane INSURERD: Hyannis,MA 02601 INSUREkE: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR C.ONDRION 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.AGGREGATE LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY emwnw POLICY EXPIRATION LIMITS LTR YPE T OF INSURANCE POLICY NIDNBER DATE DATE A cENeRAI LIABDlrY CPA010264814 01/01/08 01/01/09 EACH OCCURRENCE. $1 000 000 RNTED X COMMERCIAL GENERAL LIABILITY PREMISES OHMAGE TO a amyr $250 000 CLAIMS MARE 51 OCCUR MED EXP&y one parson) $5 000 PERSONAL&ADV INJURY $1 00Q 000 GENERAL AGGREGATE s2.000.000 GEM AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2.000.000 POLICY JERID- LOC B AUT0MOBUEUhB/JrY MAA010395M14 01/01/OS 01/01/09 COMBINED SINGLE LIMIT ANY Auro (Eaaafd9M) $1,000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per pemon) X HIREDAUTOS BODILY MURY X NON-0WNED AUTOS (Per acddent) $ PROPERTYDAMAGEdACC $ (Per acddent) GARAGE LIABLnY AUTO ONLY-EA AC $ ANY AUTO 07HER THAN $ AUTO ONLY: AGG $ A EXCMAA%RELLA LIABMnY CUA010264914 01/01/08 01101/09 EACH OCCURRENCE s2.000.000 X1 OCCUR M CLAIMS MADE AGGREGATE s2.000.000 $ DEDUCTIBLE $ X RETENTION $O $ A WOOMM COMPENSATION AND WCA020455011 01/01/08 01/01/09 We srATu ER EMPLOYERS'LUIBILRY E.LEACHACCIDENT $500000 ANY PROPRNETORIPARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? NO EL DISEASE-EA EMPLOYEE $500 000 II dasaft UnderAL PROVISIONS b E.L.DISEASE-POLICY LIMB $5O0 000 SPECI QTNER DESCWPnON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is named additional insured for general liability. E.J.and Marie Jaxtimer are included under the workers compensation policy. Operations performed by the named insured subject to policy conditions and exclusions. I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLK30 BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE TNEtEOF.THE ISSUING DSURER VAM ENDEAVOR TO MAIL I_ DAYS wmrTa+ 200 Main.Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,TT8 AGENTS OR REPRESENTATIVES. AUnWRHED WMENTATIVE AORD 25(2001108)1 of 2 #S50995/M50595 LS1 0 ACORD CORPORATION 1988 _�e & Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 110609 Type: Private Corporation Expiration: 11/3/2008 Tr# 124739 E J JAXTIMER, BUILDER, INC. ERNEST JAXTIMER -- -- - -- --- -- - 48 ROSARY LN -------- -- --- - - . HYANNIS, MA 02601 Update Address and.return card. Marls reason for change. — Address Renewal Employment Lost Card DPS-CAI 0 50M-05/06-PC8490 ---- - - � ' �/ZC Z/JO�I7l/IILlYItCU6[LGUL � �CILCCOCQ� { •• Board of Building Regulations and Standards j Construction Supervisor License I + License• CS 3251 Expiration •;1/14/2010 Tr# 13629 � �eSf�il�tlOn Q1QtC`K � i t= ' I ERNtST J JAXTq gRti �* i 48 ROSARY LANE HYANNIS,MA 02601 �����- C ' ommissioner o-THE To 'of Barnstable Regulatory Services 9 $ Thomas R:Geiler,Director 2639. `�"QED►+�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 ffice:. 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize •.J •�J R�G�YILe , �Glf ��ij(D� to act on my behalf, in all matters relative to work authorized b7 this building p e=it application for: (Address of Job) /C'1d° signaturl of Owner ate Print Name Q:FORMS:OWN-ER.PF-RMISSION Engineering Dept. (3rd floor) Map Parcel /_7 S Permit# 7;� House#, —I ate Issued 0 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) / / Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) iU 124 jinDept.(1st floor/School Admin. Bldg.) ^-j� ofn+e ST SE Plan Approved by Planning Board 19 ` "- 1 1ANCE NM' ' DE AND TOWN OF BARNSTABLETOWN REBuilding Permit Application reet Address 355 Wianno Avenue Village Ostervi l le Owner Mr. & Mrs. Peter McCusker Address P.O. Box 187, Ostervi l le Telephone 428-6036 Permit Request Add a bedroom over existing sunroom. (No change in footprint. ) First Floor square feet Second Floor 192 square feet Construction Type Wood Residential Estimated Project Cost $ 36,000.00 Zoning District RFl Flood Plain No Water Protection No Lot Size 1 Acre Grandfathered ❑Yes ]No Dwelling Type: Single Family ® Two Family ❑ Multi-Family(#units) Age of Existing Structure 35 .yrs. 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 1 New 1 Half: Existing 1 New No. of Bedrooms: Existing 4 New 1 Total Room Count(not including baths): Existing 9 New 10 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 Residential Proposed Use Residential Builder Information Name E. J. Jaxtimer, Builder, Inc. Telephone Number 778-4911 Address 48 Rosary Lane, Hyannis License# 003251 Home Improvement Contractor# 110609 Worker's Compensation,# WC1-204239 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 Maco e s D r SIGNATURE _ DATE �OI22-I� BUILDING PERMIT 6dIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. l f, ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING _ O 'I til� use DATE-CLOSED OgT. '- ,.Y i2-13-oS r ii'e ASSOCIATION PLAN NO 1� ` Tlie Cunrnxiir►realtli of Alassacbuscttc Department of Industrial Accidents " ` _• �-�1� Ofllceollavesilgadoas 600 Jf•usliitrtton Street Boston.Af=. 02111 Workers' Compensation Insurancc.ARdavit -- -.-� •�-n-• Anniic—mot nformation Pleflse PRiIVT"le7+thIV E. J . Jaxtimer , Builder , Inc . 48 Rosary Lane city Hyannis , MA 02601 nhoncl! 77R-4911 0 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity ® I am an emplover providing workers' compensation for my employees working on this job. m SAME Idr • phone#• insurance co Liberty Mutual nolics# WC 204239 - I am a sole proprietor,general contractor, or homeowner(dude one)and have hired the contractors listed below who have the following workers' compensation polices: Comilany n cit phone#• - incurnncc co polio•# �;y,,'�_ :...--_!::-• - .,- rsn�r-+c.�.scwr.-a-n"�-•�'�•����� �74FF°'�°q'y"ai''�"T,�'S�i�'3"'•:•�y_qT,—�i�!�'":'-'•�� '. m e• a•lress- city phone#• - insuc•tnce co. polies# ;Atiach'additiond•shce't if riee ••i = ~�~ V- F•nilurc to secure coverage as required under section 25A of b1GL 152 an lad to the imposition of criminal penalties of a fine up to SI,500.00 and/or unc,cars'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against ma I understand that a copy of this statement may be forwarded to the Office of Investigation of the DIA for co t t. ge yerifiation. ' t do herebt•cerrifj•un airs and penalties ofpcdury that the information pnn7ded above is true and correct Sicnature E. Jaxtimer -Phone# 778-4911 Print name official use onlg do not write in this area to be completed by city or town official citg or town: permitAicense# r iBuilding Department Licensing Board (]check if immediate response is required C3Seleetmen's Otfice ptialth Department contact person• phone#;, nOther r'Ifr.�+•J�`YT^�- - i.• .-. •Y _ w'ytK(trT.. .!tY,.•I/•� ok THE The ` 'own of Barnstable MASS. Department of Health Safety and Environmental Services rug" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: :5087. .5. 34. Building Commissioner .For office use only Permit no. Date.. AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair, modernization,conversion, improvement, removal, demolition, or construction of an addition to any pre-cxisting 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: 5e6 rbo rn fAdv�i"1(3?'t Est. Cost Address of Work: 355 1 axi no 054 f-,v v °L-, Owner Name: V1?'k(r' Date of Permit Application: 0 1 as L(o I herd certifv that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000 Building not owner-occupied O%vner pulling own permit Nnticv is herf-hv given thai- OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hcreb}•apple for a permit as the agent of the owner: Io�aa .J. irrlr IlobO�t Date Hart Registration No. _ vri Date Owner's name 40742 DEPARTMENT �OF PUBLIC SAFETY 40742 ONE ASHBURTON PLACE , RM 1301 BOSTON , MA 02108-1618 �l CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Restricted To. 00 �- � —= ERNEST J JAXTIMER Detach bottom, fold sign on 48 ROSARY LANE lack, and laminate license card. HYANNIS , MA 02601 'r /wKeep top for receipt and change t� of address notification. --- -- - -- -- ---- - -- ---- — ---I-------- ----------- I 'fie cow o��� HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standards) One Ashburton Place — Room 1301 Boston , Massachusetts 02108 I I HOME IMPROVEMENT CONTRACTOR I - ° Registration 110609 Expiration 11/03/96 I Type — PRIVATE CORPORATION ilu4 o�,�aaaac�ivaeQa HOME IMPROVEMENT CONTRACTOR I Registration 110609 E J JAXTIMER , BUILDER I Type - PRIVATE CORPORATION ERNEST J . JAXTIMER i a Expiration 11/03/96'�-, 48 ROSARY LN HYANNIS MA 02601 E J JAXTIMER, BUILDER I � ERNEST J. JAXTIMER' &ygtok8 ROSARY IN II ADMINISTRATOR HYANNIS MA 02601 N Assessor's map.and lot number ..1.../��.. ...... .. !n o THE o � F t� . w O Sewage Permit:number !f....... <.. ...........:::.... d House ��� BAHMaSBTeDLE. number .......:'......................................... ............ >; .... q 6 039. GYAV 4 a` TOWN OF BARNSTABLE BUILDING INSPECTOR t �. . .APPLICATION FOR PERMIT TO. ..... ( lS ...��.r' .t ICJYI.................................................................... TYPE OF CONSTRUCTION � � �.. , ........... ....... ... ................................................................................................... ................ ! / :.... ? ....19. � TO THE INSPECTOR OF BUILDINGS: The undersigned herebyL applies for a permit according to the following information: U 7f �5 /Gt✓")r�U C_ Location f.0 '/'L..... � $1 UL SCJ.` ................................................... .................................±..................................................... .......... ................... ProposedUse Y?�JJC�J�"l�eGLJ ............................................................................................................ ZoningDistrict ......... ..............................................Fire District .. ..................................................... °...... � �/. G G Name of Owner �J�'/�.. 5��� � Cl./117��.......„!,I„P„/,2,!„� .................... .............................:....... ...........Address ...........1........... .............. . Name of Builder 5..:..:..��.:...�1.%}X.. .1.. �. '��,..................Address l�i� � � ..4..`(2Gc) J(/Q.........eIZfth'.1.Udc Name of Architect ..... ..................Address .......` ?-Pi1, � ................................................... Numberof Rooms .........�....................................................Foundation ........................................................ Exterior ... �...-..: )U7 G Roofing ...... ....I(.i.►GY /. ... . .................. .................................................................. Floors �CQpcC............................................................Interior �!„llU' d......................................... HeatingV i. .C,P(�rf„i„70. ... tX Y�..............:..:....::..Plumbing ....... )�_- .. .. ...................... ... ........ . �� n�c �r..: 7 Fireplace ... .........y................ ...............................Approximate. Cost .�.......1 .. C..CX7. ,G� 0 P Definitive Plan Approved by Planning Board _^__ _______________°_______19_______. Area :... ........................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF. BOARD OF HEALTH • �z i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to'all the Rules and Regulations of the Town of arn.sta' file regarding the above construction. Name ... .�/ .. ... . . .................................................. Construction Supervisor's License GG 3.'S� MCCUSKER, PETER A=140- 75. 26947 :S ADDITION No ............ Figmit for .................................... Singie Family Dwelling ......................I......................................................... Lot 175, 355 Wianno Avenue Location .................................................... ........... ............ PStqr.yille........................................................... Owner .....PPtg?�.MCVS.% .......... .................. Type of Construction ................Frame.......................... ..................................................1:............................ Plot ............................ Lot ... ................. Permit Granted S6ptembex 10,.......19 84 September Date of Inspection=....................................19 Date Completed .... .................................19 Assessor's map and lot numb ,_ lyl!. �......-..f .. TNE?o� Q Sewage Permit. number ... 0 .... ... ..... .... 2 ............. Z BABMAO&LE, i 1 House <WCJmbef' ..wr��.........:.. ... ....... q�O Mb e0� 'E9. G mo a' { TOWN OF -BARNSTABLE BUILDING ""INSPECTOR `APPLICATION FOR PERMIT TO [ GL... !l/1!L............t.. :..# ....................... P!Q .TYPE OF CONSTRUCTION ........... ti•� ' ........................................... • ............... .. ......J�...19. T i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ll applies for a permit according to the following information: Location L-0�7� 17Jr.. �.C�Jcv) D...... ......... ���+`!!'l .LDS,�G ................................................... ProposedUse ....... ................................................................................................................................... Zoning District R ..............................................Fire District ..� �.. .1 '. ........U�9& -..�.�.......... Name of Owner Pilr Te/.Z....'...!. C.U-5-�.�i ...........Address ....WIVA11D....a ...... .+ Name of Builder .................Address .. ... !<!.e.........0/. UL' Name of Architect ..f�� �T. ...`.-��.!....................Address u!�f.{......:. ..... . ............ ........................................... Numberof Rooms ..........A.....................................................Foundation ....w.K�........................................ ................. dsa Exterior ....l t ...- .>S�P�u�.�jl e .............................Roofing ...... ...'�' '...................................................... Floors C!1.�dC: ..........................................................Interior .......���:..'�GI�f.�L? G(........................................ Heating .. tCied... L�. ..�� r.........................Plumbing ....... ........................................................ Fireplace ... . .4..... '1A4.4M.ry ..............................Approximate. Cost .���J/. �..�Q................................. x7 Definitive Plan Approved by Planning Board -----------_______-----------19_______ . Area ..... I .. ................. .. D Diagram of Lot and Building with Dimensions Fee _ . ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH iA •-. 3 1 i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I , I hereby agree to conform to all the Rules and Regulations of.the Town of n a e regarding the above construction. _ } Namet. ............................................ Construction upervisor's License ....................................0 °��1 ' .F �. MCCUSKER, PETER 26947' ADDITION No ........... Permit for .................................... ._ SinglW Family Dwellinqf .... .`. ....5. .... ..... .................. ................ Lot 175, 35 Wianno Avenue Location ........................................ OSterville Psi .. . ...�J......................................................... Owner, Peter. ........ ........ Type of Construction .......FXaIM........... = %• k %� /..... ................. ....................................... F Plot ............................ Lot ............:.........:......... Pennit�Granled .,. September: 1M `hq 84 F r Date of• Inspection1eq- � .....:;± .. �19 Da� Completed ........ .. 9 :r i, 'W• � T' IA II/-rVn/O � 1 / I ICI 72t q I • I W r-- �k/sl�yv�► Q 00. I �► i Dw�zu.vG 0 � l 1 � 1 � 1 j �r,sT 1 \� /oo.00 LvCC>5 - H.9p /4o 'Rf1?ZcEL /7S CERTI HE' D PLOT PLAN LOCAtION SCALE , � ��.�. .... bAt� SEPT 4/9 PLAN• REFERENCE . .s« PZ, Book. 4s. •P.9c�. ��. . �?-sa. . . . . . a�z>i of spy D 7-> I•v 13oo c. 7�Z ED R l ii gym+ No.26100 H ` O t` i CERTIFY THAT THE .. SAD Avn�nd�! 1 G/STEP e `4N0SUB4Evo SHOWN ON THIS PLAN IS LOCATED ON THE GROUND i AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF B�?44SPW4e .... . . . .WHEN CONSTRUCTED. bATE - ���� /7cEvs,� Z P�'TirlaN�� REGISTERED LAND SURVE OR