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HomeMy WebLinkAbout0040 APOLLO DRIVE Cape Save Inc. 7-1) Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 11/11/2014 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for 40 Apollo Drive(#201404047) has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey r. NOISIf1I0 �17 Gi lid ' 1 319UMV9 AO Nh 01 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 I Parcel 645 Application #L, D/ T D Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 4r Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 40 Aptio UriYe Village W�s4_ `Orn S'hl& Owner FmA exh kK 06con C I o.vkse n Address S 0.lhC Telephone_ 5 0 8 3 ba Permit Request PrAj Ra 1 , R= �R CeI Ilk I 0s0. - -0 -tie ailc. 41� R- 15 cell : lose: �I-�e �,�aL(�5 . �1�r �I-I�a� � e�- i`c pla►le anon Square feet:. 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay :Project Valuation O Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supRo"rting clod-Onenta-tion. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) a -, -n Age of Existing Structure [ Historic House: ❑Yes ❑ No On Old King's Highway: ❑,Yes 03No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other 2 Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) tin Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: . Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes XN 0 If yes, site plan review # Current.Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name LAI 1,11 tlam -l Telephone Number 508 M8 031N Address - ' gc iyA A-ye License # 7 C [ 00% 116 S e 1AA )�-CM.pwik . Mk oa 669 Home Improvement Contractor# Email Worker's Compensation # W 0$S 6 33 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO (n_('n #&4 SIGNATURE DATE 4 FOR OFFICIAL USE ONLY r APPLICATION# DATE ISSUED- MAP/PARCEL NO. - ADDRESS VILLAGE - OWNER _ _ DATE OF INSPECTION: FOUNDATION FRAME F I• INSULATION ' j FIREPLACE R ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: . .ROUGH FINAL FINAL BUILDING , DATE CLOSED.OUT ASSOCIATION PLAN NO. . 'i Building Permit Authorization I, �`;, Frederiick/Sharon Clausen r as owner - hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Office:508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 40 Apollo Dr West Barnstable, MA 02668 Signed Date The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): Cape Save Inc. Address: M Huntington Ave City/State/Zip: South Yarmouth, MA 02664 Phone#: 508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): 1. 1 am a employer with 4. ❑ I am a general contractor and 1 P 6. ❑New construction employees(full and/or p rt-time).' have hired the sub-contractors 2.❑ 1 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 tY• 9. ❑ Building addition [No workers' comp.insurance comp.insurance required.] 5. ❑ We area corporation and its ME] Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑✓ Other Insulation comp. insurance required.] "Any applicant drat checks box#1 must also fill out the section below shoving their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for miy employees. Below is the policy and job site information. Insurance Company Name: Wesco Insurance Company Policy#or Self-ins.Lic.#: WWC3085633 Expiration-Date: 04/09/2015 Job Site Address: Li Cf Pr0 ''0 rt City/State/Zip:w, hfllS46 b C 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 ttp to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of er' that the in ortnation provided above is true and correct. Signature: Date 6 Phone#: 50$-39$-039$ Official arse 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#: '4�® CERTIFICATE OF LIABILITY INSURANCE 4/14/20 4' THIS CERTIFICATE.IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: Colleen Crowley Risk Strategies Company PHONE : (781)986-4400 AICNo:(781)963-4420 15 PaCella Park Drive ADDRESS. Suite 240 INSURER S AFFORDING COVERAGE NAIC f Randolph. MA 02368 INSURERA:Selective Ins. OF America INSURED INSURERB:Safety Insurance Couipany 33618 Cape Save, Inc INsuRERc:Wesco Insurance Company 7 D Huntington Ave INSURERD: INSURER E: South Yarmouth MA 02664 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1441475243 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. LTRR TYPE OF INSURANCE POLICY NUMBER MM1DD EFF MMIOD EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X MTEG- COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE ❑X OCCUR 1994480 0/16/2013 0/16/2014 MED EXP(Any one person) $ 10,000 ..PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY X JECT PRO X LOC $ AUTOMOBILE LIABILITY Ea acciCOMBII�ident L LIMI 1,000,000 B ANYAUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 6208200 1/6/2013 1/6/2014 AUTOSBODILY WJURY(Per aadanq $ NN-ORI HIREDAUTOS NANIJJTOTOOSSVkNED Perracciderd DAMAGE $ I X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION Nit S1994480 0/16/2013 0/16/2014 $ C WORKERS COMPENSATION - Officers Included For X I 'ACSTATU- --OTH- AND EMPLOYERS'LIABILITY YIN TCRY LIMIT ANY PROPRIETOR/PARTNER/EXECUTIVE Coverage El EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? NIA. (Mandatory In NH) 3085633 /9/2014 /9/2015 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yas describe under DESG`RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Issued as evidence of Iris ranee. Issued as evidence of :insurance. Thielsch Engineering, Inc. is listed as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION msong@capelightcompact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISION& Attn: Margaret Song PO Box 427/SCH AUTHORIZED REPRESENTATIVE 3195 Main Street Barnstable, MA 02630 �� ichael Christian/CLC ACORD 25(2010I05) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are.registered marks of ACORD r d� (22 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. _ WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 '�. Update Address and return card.Mark reason for change. sCA 1 0 20M-05/11 - Address Renewal Employment Lost Card Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 171380 Type: Office of Consumer Affairs and Business Regulation Expiration: 3/14/2016 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH,MA 02664 Undersecretary Not vali rthout signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License: CSSL-102776 I Is WILLIAM J MC C'LUS 37 NAUSET ROAD West Yarmouth iVZA 0 Expiration Commissioner 06/28/2015 I Town of Barnstable �t�#teams Expires 6 ionihsfroni issue e * ~' Regulatory Services Fee r + BARNSTABLE, �cb 6 9 ,�� -Thomas F. Geiler,Director �rFD MPt A Building Division Tom Perry,CBO, Building Commissioner ,gyp 200 Main Street,Hyannis,MA 02601 'v www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 -EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ` � Property Address 0 0#0 �. M, /� `�' 1 Wizesidential Value of Work / 000 —" Minimum fee of$25.00 for work under$6000.00 J Owner's Namd&Address r'f e A r-j a ywy Contractor's Name�� /n r �f�',/?/ Telephone Number ��"-r-21-(` 4ey . Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 0/workman's Compensation Insurance X-PRESS PERMIT Check one: ❑ I am a sole proprietor MAY — 5 2010 ❑ I A the Homeowner ❑"i have Worker's Compensation Insurance TOWN OF Bp►RNSTABLE Insurance Company Name d om.1 A Workman's CoiMp.Policy#_ �5 9C Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) VRe�placement-Windows/doors/slid side #of doors ers.U-Value o ,s (maximum .44)#of windows_ *Where required; Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. SIGNATURE: Q:IWPFILESTORMS\building permit forms\EXPRESS.doc Revised 090809 The Commonwealth of Massachusetts Department of Industrial Accidents 1 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 Lelzibly Name(Business/Organizatio div/iduu�al): 001A k SIT INC Address: .� ,�.11 /V � /��o City/State/Zip: ��� V � � Phone #: �< �C1/_ b Are u an employer?Check the appropriate box: Type of project(required): 1.U I am a employer with 10 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its I O.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 LEI Plumbing repairs or additions myself. o workers' com right of exemption per MGL Y � p• 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] 'Any applicant that checks box#I 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. 1Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation ins ranee for my employees. Below is the policy and job site information. / Insurance Company Name: Policy#or Self-ins.Lie.#: �$ `� �� Expiration Date: Job Site Address: G&O City/State/Zip: & ly, 1"/tc .Q d D 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 up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains andpenalties ofperjury that the information provided above is true P41correct. Signature: Date: v Phone#: `7/�0— 67/ . POO 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#: i i I 4 MI rig tigh AMEg . -: — K° UuOer ecre#airy pu . . M- 8 -9 � � From:Shaunna Robinson, Hunter Insurance At:Hunter Insurance,Inc. FaxID: TO:Denise Glode Date:9/23/09 09:45 AM Page:2 of ACORD CERTIFICATE OF LIABILITY INSURANCE OPID S DATE(MM/DD/YYYY) PR06UCER MOONA-1 0 9/2 3/0 9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hunter Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON-THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 389 Old River Road, P.O. Box 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Manville RI 02838-0001 Phone: 401-769-9500 Fax:401-769-9502 INSURERS AFFORDING COVERAGE INSURED Moon Associates Inc. NAIC 9 DBA Gutter Helmet INSURER A: National orange Insurance co 14788 DBA Renewal by Andersen of RI. . INSURER B: DBA Gutter Helmet Roofing Beacon Mutual insurance co. DBA Moon Works INSURER C: 1137 Park East Drive Woonsocket RI 02895 INSURERD: INSURER E: i 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 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 HE IS SUBJECT TO ALL THE TERMS,E POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. XCLUSIONS AND CONDITIONS OF SUCH LTR INSR1. TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) -DATE(MM/DD/YY) LIMITS GENERAL LIABILITY g A X COMMERCIAL GENERAL LIABILITY MPS26619 EACH OCCURRENCE $ 109/16/09 09/16/10 PREMISES(Eaoccurence) $ 5CLAIMS MADE OCCUR MED EXP(Any one person) $ 1 PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMITAPPLIES PER: POLICY PR0_ LOC PRODUCTS-COMP/OP AGG $ 2 0 0 0 0 O O AUTOMOBILE LIABILITY - A X ANY AUTO COMBINED SINGLE LIMIT B1S26619 09/16/09 09/16/10 (Ea accident) $ 1000000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIREDAUTOS NON-OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) ffWORKERS ABILIT!AAB UTO AUTO ONLY-EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ BRELILITY CLAIMS MADE CUS2 6 619 QD RENCE $ 1 0 0 0 0 O O 09/16/09 09/16/10 $ TIBLE $ TION 10 0 0 0 $ NSATION AND $ B EMPLOYERS'LIABILITY ITS ERANYPROPRIMBEIR XCLUD/EXECUTIVE 28586 10/01/09 10/01/10 CIDENT $500000OFFICER/MEMBER EXCLUDED?If yes,describe under -EA EMPLOYEE $5 0 0 0 0 0SPECIAL PROVISIONS below -POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION BUILDIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Building Cont. Reg. Board Dept, of Administration NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL One Capitol Hill IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Providence RI 02908 REPRESENTATIVES, AU D REPRESENTATIVE ACORD 25(2001/08) ©ACORD CORPORATION 1988 FR.r^D GIA v c. S 140 AP01 (0 a tt w• 8A1ZNS%A816 MA Ua GGg' Renewal Customer Name: Year omen Renewal by Andersen of Rhode Island& Sales Agreement A ~b A a o\� a TD er Customer IDtF: `Cod RA.��1� � City,State,Zip: IL y CZ e.1--'-c *'►� Order Number. l 1 7 Park East Drive /1rWe Phone-Home: 5ot., t.L— �w�iti6�1 Woonsocket.R102895 WIN9OtI N&PLACEM[NT Andrrsa[Cmyyrr (/� Phone-Work- page.�of_Date license#RI-30839 R!-12259 MA- 10� Email: b� U 119535 CT-%2725 In UNITS \v p GRILLES �v Ckmissoft a µr Raw., s � iz { j c is $s bil A pt Am. c :ems � )))� { S• ajig ••�s � � u.t s s SSSIIt `o � e t d SSSS At[ V x �• Tro hO W. , X3 l(3 1f10 Go1Y S.►tJ 3 X3 1-0 S o e t �,, 3 3 s w 3 x3 5 (-o H -3 a 3 t� Sun Taus ew.q PibpoYab AO of the duaro ai.drra.s and for mbe ymrrlded 6.the nxal&onus snrnl in the ncenrnr.Thr SCC�I C [8 Or ft ment tilOd pnq.rml aA rcrnsn valid fix W Jays atd'a suf.jcc[nr a,[c by both I:uansrrllr uul Rnxoal by Ankrvn htanzF,ct a (�eNn$.w'nP.Rota[r.�t+n n.Kc) Q SubroTo wVAw,a Dwcd1!Nqa 0 } Tl e r r��( l✓a' —may >..lao U Suk Total w tas.t IAte Rrn .vi:: Arulmm Sakx ltrtrrprnnnvc S�nsturc .n r L C.vetornU tanGe: ru arc hotry•web.aucrl en furnish.G ,.rW.►. ey.urcd u.v-p) c IN, 5 L xArv—y O r *w O�s.��n.GLrcRI ��00 G d Mist.creme or¢KWWS npremu:nt Gx vhidt unfengtneJ ry{rces en py dr smrnnr vunl n this ytre�mcm and a ndirGt U.the n ms K--f. TOW See Reverse Side for Terms and Condition&of Sale.You,the buyer,may cancel t70G, this tratteattlon at any time prior to tttldnight of the third burrin�aa day after son ym,p� the date of this transaction.-Ma&e see attached notice of eantxl Ion for an explanatiou ofi this right TonlMlscdlanroasC.rodloaE><peosea A&abona0dwfanaAtddW Amr.ewl �1�i0�/ lorry wzr tosJ ro mise.uedit!a.pms a�lumn n r1�.0 Walk Ppalft Co11 ��OpD PNer tlMr k Cusumer Appnnal S;ytnaouc spodal Order Notes ToTal MMOIetTdAgr&ealeat t Y Aeeapn l ter. _ _ p&pasN RepYKd dr bw om ---- -- {>..r R.+x,.aJ hf Amkvxn Matta)tav S1Rtutwe ^t'W r. ��sYttt��D++t►& eqa tttt..athy Ansu,an sataaral tatlwenntauott tlw tttaerp•a an tttumatanmtepspi.g jT..T.��.. — {a/` Wane Due an Completion a0it7t4ttY&.AtA tew does ata qs" dtare aa�uuao sag.lb..,et&aq tttewttdrasps 4 mdsdk medadta matsgw°t��w sdMf e.A. r- . b�ceMgda¢np lnsmaio.«..+t ta0ysn t&N�i�ss��eesammwwtt twalr�attttnwrttteb taaastOtaNatM1S aaaekesQyoa 1MenpaYsspsayevatpgawt Pdcelndud"Ltbor.maretials,butalluion. M>aadaatr aura oho ara stew M asu,ebneprd. At N•tl deM lak d to Yo-r w ek 4 Ml tr �eo��et mnuval.and dtVp J of products mv6ced. nmatl atdvw,.A atw yts,r nesv wY+does rtl Yinik.Raftewat -tnstalatbn VY#-� •eautoneer CatgO/xf rLSSowar ♦e Matatationatta. • kdtlal� � ttaats: .ic o,a a o ..� . .•,,Q �',o a J C a►4 It. �. Cc,.S 13 3 o 0 IOOIA Rom./b,A.11-1, • 0 41 C) On ,���"�,°�ti Town of Barnstable *Permit# Expires f . issue date Regulatory Services Pee + BARNSCABLE, 6 q ��� ��� ��Thomas F. Geiler,Director \ Epp • Building Division MAY A 0 2010 Tom Perry,CBO, Building Commissioner 00 Main Street,Hyannis,MA 02601 TOWN OF BARI�ISTAB►�. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number !' Property Address �_1 1 � 93 �. �a� ❑Residential Value of Work `4 0-0. Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address /1-2P Contractor's Name Telephone.Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance X- ESS PERMIT Check one: ❑ I am a sole proprietor MAY 10 2010 I am the Homeowner I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roo (not stripping. Going over existing layers of roof) ❑ Re-side #of doors 0 Replacement'Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. copy of the Home Improvement Contractors License & Construction Supervisors License is equired. SIGNATURE: i ��. The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigations I' 4 600 Washington Street c. ! Boston, MA 02111 wfvw.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: ��� So L</i ZZAM.J �1r�e� �/_est �trr�s7`C3+(�� AId e City/State/Zip: Phone M Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. I am a general contractor and I have hired the sttb-contractors employees (full and/or part-time).* 6. ❑New.constntction listed on the attached sheet.. 7, ❑ Remodeling 2.El I am a sole proprietor or partner- ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition (No workers' comp, insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or addition 3.❑ I am a homeowner doing all Work officers have exercised their I LE]Plumbing repairs or addition myself. [No workers' comp, right of exemption per MGL 12.DN Roof 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. Uthe sub-contractors have employees,they must provide their workers'comp.policy number, - I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: — Policy# or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 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 fin( 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 c der the ppains p lties ofperjury that the information provided above is trice and correct. St attire: InG��'�.^-e�� Date: 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 ofNealth 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other 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(7)slates"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 full 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 pen-nit 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 permit/license 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. 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 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 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASS Fax # 617-727-7749 Revised 4-24-07 www.inass.gov/dia �YHErp� Town of ]Barnstable Regulatory Services I"R''�"B Thomas F. Geiler,Director � 9. fo Ak. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4 8 Fax: 508-790-6230 Property er Must Complete and Si n This Section If Usin Builder 7 , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorize this building permit application for: (Add ss of Jo Signature of Owner- Date Print NamZ' Owner If Pro is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable pf VE Ip� o . Regulatory Services Thomas F. Geiler,Director snartsrnste, - "`"9. Building Division 9� s679• ��� - PrfDI^A�� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 mvw.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: J /g T�xr`e JOB LOCATION: JdZL /�IBN ✓ et ��5� / S number street village "HOMEOWNER": ?� �J��� z'�p/pZZ na a home phone# work phone fl CURRENT MAILING ADDRESS: mfta /0l &, city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to a91ow 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 sball 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 undersi d"homeowner"certifies that he/she understands-the Town of Barnstable Building Department minimum' s /ection proced nd requirements and that he/she will comply with said procedures and requirem n . i Sign re of Ho owner Approval of Building Official Note: Tbree-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 dQ 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. i....mr. r`(•\Cl1DlAC\1.r..,.onvmm�l nnr The Commonwealth of Massachusetts Department of Industrial Accidents Aff Office of Investigations 600 Washington Street c Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly ' Name (Business/Organization/Individual): .S c ._( 6W,-YQ 1\ Address: 13 6 ( e- o..vr S City/State/Zip: 09-6;L 6? Phone M 5 08 - 50-M Y6 Are you an employer? Check the appropriate box: Type of project(required): 1.ElI am a employer with 4. Q I am a general contractor and I _ ._._ 6_❑New construction eiiiployees(full and/or part-time .* have hired the sub-contractors --—^- � - ---- --- - - �- 2. I am a sole proprietor-or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] ' 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a bomeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [Nonworkers' comp. right of exemption per MGL 12.[2f Roof repairs insurance required.]t c. 152, §1(4), and we have no 13.❑ Other employees. [No workers' 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. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must 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: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: ° Date: Phone#: 0-9- l9 a 2, Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: >l The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / / Please Print I.,egibly ' Name (Business/Organizati orAndi vi dual): �>ZLA10ra aA/ " Address: �24 &n SSA 4�i/ • City/State/Zip: G' Phone #: 3 85 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I 6 New construction mpl6yees(full and/or part-time).* have hired the sub-contractors _. 2.Vle, am a sole proprietor.or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 Building addition comp. insurance.$ [No workers' comp. insurance 5. ❑ We are a corporation and its ME] Electrical repairs or additions required.] 3.❑ I required.] a homeowner doing all work officers have exercised their I LEJ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 Q oof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.0 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 employees,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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 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 certi it d t e pain nd enalties of per' that the information provided above is trice and correct. Signature: ° Date: Phone#: Official ctse 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 S. Plumbing Inspector 6.Other Contact Person: Phone#: as Assessor's office (1st floor): i3 J_O ¢,5- Ta FtNET � Assessor's map and lot number ...........................................L� d�'S P o o 25K a.ADC, -I-o Board of Health (3rd floor): roD,,,, Sewage Permit number 5 "'g ............................�..�.��............. 1� T !�O"( Z BdSII9Tl�DLE, i ocs)9Y, cifphc� rasa Engineering Department,(3rd floor): ef, S«1-(L s ys�Cwn oo 1639. \0m House number .... f e-� S f e o APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only Ctl'-rEI;i I ; Bc, TOWN OF B A R N S T A B L F SEPTIC SYSTEM MUST BV NSTALLED IN COMPLIANC BUILDING INSPECTOR WITH TITLE 5 -, ENVIRONMI511TAL CODE A v l ��cT%ClN EGILATIONS APPLICATION FOR PERMIT TO ...... ........................ �1..... ...... .................................... TYPE OF CONSTRUCTION ... .... � .!"/. ...................................................................................... `7 ----PRIZ.............,92 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for as permit �according �to` the following information: Locationd ...."........................................................................ ProposedUse rcil ( .,......................................................................................................................................... r �R �� Zoning District ...../.i...............................................................Fire District � r ���. Name of Owner F`.�y... � Qr ..q.,.�410V..E!�!Address 7�!.:...............N'�' .INx...V.. `...(..7V! H4 Name of Builder ... .. ......... ................Address 4 Y 4, be Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...................Foundation . ' ................................................... ............................................... Exterior �.�iS✓.Qr..`�.....�}... .�.... ........�, 2 .. �... ...Roofing ... ........p................ ...(..... .. .ZI,. ......................... Floors "`'. ................................................................Interior ...... ............................................. Heating �Q�I .................................................Plumbing ............ Fireplace .................................................................Approximate Cost t,� Definitive Plan Approved by Planning Board __ " "� :-�_'a________. Area p.. 2.`.,..`.r: S� Diagram of Lot and Building with Dimensions Fee .....�........................ SUBJECT TO AP 4-20 N' 1 A � 1 �� a Ole) Xmcnvians OCC ANCY PERMITS REQUIR D FOR NEW DWELLINGS J I hereby gree to conform to the Rules and Regulations of the To s e n Peal ove constr tion. . Name . .;k7�.......... .... .....Cy�E� �...... glow tar 12 19�� ons visor's License ........ CLAUSEN, SHARON R. F. H. 2 1 8 Add Gara e ' No 9...f?..... Permit for ` .........S.ingjg... sqmily..Dwelling..................... t Location ....4.0..Apo.1.J.Q..1?. 7,Re............................ I�.esz..Sins tab .�.............................. Owner ............j5ha :RT?..R,. F.H....Clausen Type of Construction ........F amP........................ ................................................................................ Plot ............................ Lot ....._.......................... Permit Granted .......Apri1... ...................19 86 Date of Inspection ....................................19 Date Completed ............. 19 p , . F V7 L w i I f� 07- // 'O wiz �oT io ry 2 sr'd�y . A CERTIFIED PLOT PLAN L O C A T I O N i �i1�i�cS - S 3 C A L.E: C:� 4� DATE: R E F E R E N C E_ 47f' z7E-45_zxs - 1 HEREBY CERTIFY THAT - THE BUILDING RE LAND SURV ': YOR SHOWN- O-N THV5 PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND . THAT IT ����` CONFORM TO THE ,"OFnA�ss�c ZONING GY - LAWS OF THE TOWN OF � $� t A.el�57' .BJOSEPH LEB WHEN CONSTRUCTED . NAHAM. MONAHAN,JR. 13660 H AS S_ O C _I_ AT_ES _ Ifd_ C ._ �___ �Fci OL REGISTERED ENGIIaEE'RS A LAND SURVEYORS �Mp�gTj�y��° � MID -CAPE OFFICE BUILDING - I Z65 ROUTE 28 N 1 SOUTH YARMOUTH) MASS. 02664 ` As`sessor's map and lot. number .. .� .....'�. '........... Q/�� pG - 3 `'7—�T 0 _ f SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Sewage'Permit number................J�.L✓...................................... WITH ARTICLE II STATE SANITARY CODE AND TOWN TOWN OF ..BARNSrPA LE ! BaHasTAEVE, S 19a��� BUILDING INSPECTOR APPLICATION FOR' PERMIT TO ..... .U.1..4U........:.......:..............Z.. O�`....................................................... j!�odf1.... te�7!I�...........................: TYPE OF CONSTRUCTION ...:...... . .. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to 't-h/e following information: T!W o L a v . h/„ NSlftD Location ......�P......................�... .P......0......�te.....4r..................��5.?..'... .19.�s;'..............��'..................................................... Proposed Use ..... 4e.... Zoning District ../t ES(.D..�N..�� � ......................Fire District .................. .. .... . .................. ............................................................ Name of Owner (./c'/S/,SIf�.Q� :..1!✓ sr.. O.C./.�1i7.r-(.Address ........4C410G...6492.....P.0L/ ^ ,,..AIV1 W �/ C Name of Builder AIM-A...ON.JTip.XllD.N....CO..:.:..................Address .:...... 4vp...... Name of Architect ..../1.:7- :...Address ........4 W,' � ..l'DO..../.4Lf Ci AA-5/f 4E 7 Numberof Rooms ........ .......................................................Foundation .......00/vex&—/W.............................................. Exterior ...... /7!9>1 ....c�h!/!�Cp/. -5...........':........................Roofing ...........1 ......................... Floors .......X!!.BgO A0,0.................................................................... ........../7!Q`!lU9L ...................... Heating AO.L'C.aQ....!yQl....(� T ...LZZW147.)...........Plumbing ......lf 07.1Z2 .. ..AdC„C��?�E>Li ............................ h� 4� 4 Fireplace ....../..........................................................................Approximate Cost .............. ....../..........1l..../............................... Definitive Plan Approved by Planning Board -----------_------_-----------19________. Area ..... .............. Diagram of Lot and Building with Dimensions Fee ...... ... . SUBJEC TO APPROVAL�AF BOARD OF HEALTH hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...........................✓elf......t/....... ................. Barnstable West Assoc. lNo 0.95lPermit for .....WA..; tR. Y . ............ .................. tZ Location lQat—#-k+.ApRaxo..Drive.................... .................Wes.t.Asx.as istole............................. Owner ..�arm�table..W�st..As.�Q� a>te;�....... 7 , Type of Construction frame...................... ' .......................................................................... Plot ............................ Lot ............A11............. Permit Granted ......F.ebruary...17...........19 77 ' Date of Inspection ... .. ..................19 `� .Date Completed ?.............19 PERMIT REFUSED ....................................................... ...... 19 1 ........................................................... .................. .....................................................'/.................. .. ............................................................................... .. - .................................................................. ......... r Approved ..........................................t.... 19 �. ............................................................................... ............................................................................... 1 TOWN OF BARNSTABLE Permit No.18951 2/17/77 Building Inspector Cash 7 �YL OCCUPANCY PERMIT Bond _ N/A _ "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 Frederick H. Clausen Address lot #11 ppolo Drive, West Barnstable Wiring Inspector Inspection date L Plumbing Inspec Inspection date Gas Inspector Inspection date Engineering Department N/A 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 „M'”' • TOWN OF BARNSTABLE Permit No.18951 2/17/7 1 1pp3"lxnu I Building Inspector Cash -- 9. '+o YPY OCCUPANCY PERMIT Bond _ h/A_—____ "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 Frederfek H. Clausen Address lot #11 Appolo Drive, West Barnstable Wiring Inspector Inspection date 2_ f� Plumbing Inspe9t03 Inspection date ! Gas Inspector V Inspection date z Engineering Department WA 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»»__ 4 ...........................................__....................» Building Inspector „�•'"`*• TOWN OF BARNSTABLE lfi9�1 2�1''��7 Permit No. sA"n.a Building Inspector Cash _-- — �YL 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 r rGcierick 11. G'Lz:U:8n Address lot !•11 r ppolo Drive, '.est Pr.mt oteble Wiring Inspector l /. Inspection date Plumbing Inspector ' Inspection date Gas Inspector Inspection date Engineering Department gip, 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 TOWN OF BARNSTABLE �.•` �`e Permit No. -------------------- { ���� Building Inspector rua Cash -------------- oO'FOY0.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 Address Wiring Inspector Inspection date Plumbing Inspe 6 _ Inspection date Gras 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 TOWN OF BARNSTABLE Permit No. ----___—_________ { NAUSTA z Building Inspector Cash _--------__-- �Ob �aso• 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 Address N$, Wiring Inspector l /// - Inspection date A, Plumbing Inspector, /f nj „l s Inspection date Gras 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 "`'�. TOWN OF-BARNSTABLE Permit No. --------------------- t VAU>r.� Building Inspector cash .... --------------- 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 Address j Wiring Inspector Inspection date , 4- Inspection date a � Plumbing Inspector �� /a r �0 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 THE TOWN OF BARNSTABLE 89SHSTL NAB BI E, S. 16 3 9-0,•, BUILDING . INSPECTOR M YV APPLICATION FOR PERMIT TO ... ....%l ..!..�....... .................................... TYPE OF CONSTRUCTION ..........\1)Pi?. ......vkwm.f�—........................ ............................................................ ............................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby aRpplie for 0 a permit according to the following information: 91 Location ..... ......... Ile .. ...... ProposedUse ....Hp,�qA.,!mW .................................................................................................................................................... ZoningDistrict ..... A I......................................Fire District ................................................................................ Name of Owner .:..............Address ......S(77..... Name of Builder VeA.y... ..................Address :?�p..... .......W. qD?O6yq...... Name of Architect 16OK;14).....................Address ...... .H�.N.t. ro. -e..... .....19.z..:................................. Numberof Rooms ..................................................................Foundation ...... ...........� P...... Exterior ........ ...... ......................................Roofing ...... .................................. Floors ...........W.bb � .....................................................................Interior .......... Heating ......K(a.....W.A}.e-y-.........................................Plumbing ..... Asi- ............................................. . .................................................... Fireplace ...........'BSAOA�........................................................Approximate Cost .......... 00 .............................. Definitive Plan Approved by Planning Board -----------—--—--—----------- Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH ry _j Ld NeW 0 W L.L (D 0 r4 < (Zn 4-1, 22- 0 > < Z 0 z - z 0 M 0- cl LL- 0 M 0 Q LL1 vsoo C) 3: Z >: < ('r) M M, tj CL LLJ I. k - M W ::D LJJ X (a IV-1- LLS C) '2 LLJ Ld (.X..F— Uj V)0 < Z 4 z(f ,Z, C)- 'el 0 >- �� \' C) 0� C(f < �4 0 LIJ CL < U) < Lij wry. 0 0 < 7 < CL I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .. . .. . . ........ ........ .. ... ....................... < x� WeJln, Construction Co., Inc. ' ' one storymo —�����— Permit for .................................... . single family dae -----'...^--^^—'`�------��^'^~^^''.—^ } � Location —..������.�������—.^.-------- West -Barnstable- .................................... ��������--------' � Owner ....... .. ..Co.��_I�o. ' \ Type of Construction ............�����—.----.. . ----,^^—`—^^--''-----^----^---^ ~ | Plot Lot ^�^ ' --`--'—~--'' ----------'' ' | ' ^ � i } Permit Granted .......June ..2 lg 73 | / � \ . wu/e of Inspection . , � ^ -~~-- | W. Como�+e6 .A ' ' / .. \ PERMIT REFUSED � ----`-�--...—...-----.—,. 19 ^ .—.-.—.~—.--.---.—.---....--.----- ^^'~--_.—....--..—.—......--......—.... 1 ' ......................... —^^^'—^^^^—'—``^^'^---'`'— � p � \ / ,,___.__._,.,,__.,,,,,,__.,_,,..^.___,._ Approved ................................................. 19 ' ! -----------------..—.--~..—.. � ............... | '