HomeMy WebLinkAbout0531 CEDAR STREET;y
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Cape Save Inc. TO��<<,��� OF
E
7-D Huntington Avenue
South Yarmouth, MA 02664 L�-n pr T �6 ,u 06
Tel: 508-398-0398 Fag: 508-398-0399
DIVISION
9/29/14
Town of Barnstable
Thomas Perry CBO
Building Commissioner
200 Main St. Hyannis,MA 02601
RE: Building Permits
Dear Mr. Perry,
This affidavit is to certify that all work completed for 531 Cedar St,West Barnstable has been
inspected by a certified Building Performance Institute(BPI) Inspector.
Ceding: 11-18 cellulose
Kneewall: R-7 FSK
Basement: R-19 fiberglass blanket on box sill
All work performed meets or exceeds Federal and State Requirements.
Sincerely,
William McCluskey
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map V Parcel 063 Application
Health Division Date Issued
Conservation Division Application Fe 3076
Planning Dept. Permit Fee
45
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation/ Hyannis
Project Street Address �✓
Village Wp_,,� �'1S
Owner E6 V✓CLV-& -a Address S q`� a-S Q r) °
-e
Telephone So? _-3 C Q 0
Permit Request ►✓' Sea a // /c d /cl-ic a&,w_, S ' w IY 4, �c� foedy
a
Add �4,0 f-c
Square feet::1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
"Project ValuatioR-k V�)0 Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing —new
Total Room Count (not including baths): existing new First Floor Room Count
N - {
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woo`' /coal stogy: ❑yes ❑'No
� w
Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn:`OPexisting--O neY size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ �
m
Commercial ❑Yes ❑ No If yes, site plan review #
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name V1fvi4'M N'6141�01 A4,V4PS Telephone Number
Address u � � License# '�
SO qo_ImUT� OQ66 y Home Improvement Contractor#
Worker's Compensation #
TWC33.S3W b
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO / W4LVLt�—t7
SIGNATURE DATE La o 3
`4
t FOR OFFICIAL USE ONLY
?' APPLICATION#
DATE ISSUED ,
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION: _
+aj,aFOUNDATION
FRAME
INSULATION
E ,
FIREPLACE
ELECTRICAL: ROUGH FINAL.
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL r
FINAL BUILDING
DATE CLOSED OUT _
u
ASSOCIATION PLAN NO.
S
Building Permit Authorization
I, Edward Jay , 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
531 Cedar St
West Barnstable, MA 02668
Signed
I Date /
i
Print.torm�
s, The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
� 1 Congress Street, Suite 100
'f Boston, MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electric'e Print mbers
In bl—Y
Applicant Information Pleas
Name (Business/OrganizationMdividual):
Cape Save,Inc.
Address: 7D Huntington Avenue
City/State/Zip:
South Yarmouth, MA 02664 Phone#: 508-398-0398
Are you an employer?Check the appropriate box: F
e of project(required):
1.❑✓ I am a employer with 1 4. ❑ I am a general contractorand I ❑New construction
employees(full and/or part-time).* have hired the sub-contractorslisted on the attached sheet. ❑ Remodeling
2.❑ I am a sole proprietor or partner- These sub-contractors have g. ❑ Demolition
ship and have no employees employees and have workers'
working for me in any capacity. comp. insurance t 9. ❑ Building addition
[No workers' comp. insurance 10.❑Electrical repairs or additions
required.] 5. [] We are a corporation and its
3.❑ I a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions
right of exemption per MGL l2.❑Roof repairs
myself. [No workers' comp.
insurance required.]t c. 152, §1(4), and we have no 13 ❑ Other Insulation
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 rise policy and job site
information.
Insurance Company Name: Technology Insurance Company
TWC 3353968 Expiration Date: 04/09/2014
Policy#or Self-ins. Lic.#: � p �W.'. 4<tJob Stte Address: 3 1 C� ,, City/State/Zi
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 ains and penalties of perjury tl at the information provided above is true nd correct
Signature]
- .-- Date - - - -
Phone#: 508-398-0398
EBoard
only. Do not write in this area,to be completed by city or town officiaL
Town: Permit/License#
ority(circle one):
Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
son: Phone#:
DATE(MMIDDAP"
ACC)RU CERTIFICATE OF LIABILIW INSURANCE 4/9/2013
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(les)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 endorsement(s).
PRODUCER HaME cT Colleen Crowley
Risk Strategies Company PHONE . (781)986-4400 FAC No:(781)963-4420
15 Pacella Park Drive AIL
Suite 240 INSURERS AFFORDING COVERAGE NAIC#
Randolph MA 02368 INSURERa Selective Insurance
INSURED iNsuRmS:Safety Insurance Ummany 33618
Cape Save, Inc iNsuRERc.Technology Insurance Company
7 D Huntington Ave INSURERD:
INSURERE:
South Yarmouth MA 02644 1 INSURERF:
COVERAGES CERTIFICATE NUMBER:CL134960509 REVISION NUMBER:
THIS IS TO CERTIFY THAT THEE 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.UMrrS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE 0 POLICY NUMBER M IDFULID EFF MDDrrPOLICYE r LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DA-mAGE TO R 100 000
X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence $
A CLAIMS-MADE 5_1 OCCUR S199448001 0/16/2012 0/16/2013 IVIED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GENL AGGREGATE LIMIT APPLIES PER: - PRODUCTS-CONIP/OP AGG $ 2,000,000
PI- $
X POLICY LOC Eaaoies� LM�AUTOMOBILE LIABILITY ( cdriii 1,000,000
8 ANY AUTO BODILY INJURY(Per person) $
ALL OWNED N SCHEDULED 208200 1/6/2012 1/6/2013 BODILY INJURY(Per abadent) $
HI TOS AUTOS
�� PPOP�r GE $X RED AUTOSAUTOS edea)j{ Undennsumd motorist BI s Gt $ 100,000
A X umsRELLA LAB X OCCUR 399448001 0/16/2012 0/16/2013 EACH OCCURRENCE $ 1,000,000
EXCESSLIAB CLAIIAS-MADE AGGREGATE $ 1,000,000
DED I I RETENTION$ $
C IWORKERSCOMPENSATION fficers Excluded from X T1tC ST.41TU I ER
OTH-
AND EMPLOYERS'LIABILITY
ANY PROPRIETORlPARTNERIEXECUT)VE YIN overage El.EACH ACCIDENT $ 500,000
OFFICERIM MBER EXCLUDED? ® NIA 353968 /9/2013 /9/2014
(Mandatory In NH) E.L.DISEASE-EA EMPLOY $ 500 000
it yes,describe under EL.DISEASE-POLICY LPA(T $ 500,000
DESCRIPTION OF OPERATIONS be;ow
1 Y-1 - I I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is requ)red)
Issued as evidence of insurance. Issued as evidence of insurance. National Grid Corporate Services LLC
d/b/a/ National Grid, Action Inc., Colonial Gas Company and NStar Electric are listed as additional
insureds as respects General Liability as required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Cape Light Compact
PO Box 427/SCH AUTHORMED REPRESENTATIVE
sign Main street
Barnstable, MA 02630
.chael Christian/CLC ��
ACORD 25 p010/05) O 1988-2010 ACORD CORPORATION. All rights reserved.
INS025 poiomwi The ACORD name and logo are registered marks of ACORD
v
1 idfassacnusei-:s -Depar-rnent of ?ublic Safety
Board of Building Regulations and Standards
CJonstructiun Supervimr Specialty
License: CSSL-102776 -
WHIJAM J MC CLUSIKEY..-
37 NAUSET ROAD
West Yarmouth MA 02673
„1;` Yiratio .
Commissioner 06/28/2015
rt
Office of Consumer Affairs and eusness Regulation
M ' 10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration'
Reoistration: 171380
-_ - Type: Corporation
- Expiration: 3/14/2014 Tr# 222184
CAPE SAVE INC. - -
WILLIAM McCLUSKEY
7-D HUNTINGTON AVENUE - - -
SOUTH YARMOUTH, MA 02664 = -
Update Address and return card.Mark reason for change.
- j, Address Renewal ❑ Employment 17 Lost Card
DPS-CAI•Co 50M-04/04-G101216
✓j "(�a�rwnaoz lCl c�•lr'a5sac/zude� .. _ _ __ . _.. _
_S\ Office of onsumer Affal &BZiness Regulation License or registration valid for individul use only
ra _. HOME 1 PROVEMENT. ONTRACTOR before the expiration date. If found return to:
`7_ Regist 'on: ..171380 Type: Office of Consumer Affairs and Business Regulation
Expiratt n: -3/14/2014 Corporation
10 Park Plaza-Suite 5170
Boston,MA 02116
CAPS SAVE INC.'.`...'..._;__;`:
WILLIAM McCLUSKEY:
7-D HUNTINGTON AVENUE=;','
SOUTH YARMOUTH;-MAt02664 Undersecretary Not valid wit d signa
Town of Barnstable *Permit#
OF THE r, Fvpires 6 months from issue date
Regulatory Services Fee
v`'Huss g Thomas F.Geiler,Director g4cf
59. Building Division ' e-
Elbert C Ulshoeffer,Jr. Building Commissioner 1.
367 Main Street, Hyannis,MA 02601w
Office: 508-862-4038
Fax: 508-790-6230
EXPRESS-PERMIT APPLICATION
Not Valid without Red X:Press Imprint n
Map/parcel NumberCA-
Property Address 3
Value of Work
�n
❑Residential �—
Owner's Name&Address
-4 '�
�� e `A G
.sz Telephone Number
Contractor's Name
��'rilome Improvement Contractor License#(if applicable)
cable) 0 � Z i
-�� onstruction Supervisor's License#(if app 'lt X-PRESS P
i ERX11T
❑Workman's Compensation Insurance
Check one: SEP 1 8 2001
❑ I am a sole proprietor
❑ lam the Homeowner TOWN OF BARNST
❑ I have Worker's Compensation Insurance AB(-�
Insurance Company Name NL--
Workman's Comp.Policy#
Permit Request(check box)
Re-roof(stripping old shincy
in_. Going existing layers of roof)
❑Re-roof(not stripping. g over .
❑ Re-side
►2 le:-c YM
❑ Replacement Windows: U-Value (maximum.44)
�1 1 „ 1 k, i I S X l 5 / 1K( y
❑ Other(specify) ,1'�' J
Hance.with other town department regulations.i.e.Historic.
*Where required: Issuance of this permit does not exempt comp Conservation.ttc.
I
Signature
expmug
-z
Town of Barnstable
TME T Regulatory Services
OF
o Thomas F.Geiler,Director
z�
Building Division
rrsTnai.e,
v� 1 , Tom Perry,Building Commissioner
i0rF0 Mp'l 639. A 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Approved:
Fee: 2L00
Permit#: _ten 9 G ( _
HOME OCCUPATION'REGISTRATION
Date: ZQ 5
Name:_ ✓8 G,/fig�I l� �/�y t�//(� Phone#:-CD 0
Address:_ Village:
Name of Business:�h� 1,41e b
Type of Business: /iC�/_//9�A(A.r,2-16472'0/►XS Map/Loi b I
INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual 1�
alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential volumes;and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located
within that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings,and there
is no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular
matter, odors, electrical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials, in excess
of normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There is no commercial vehicles related to the Customary Home Occupation;other than one van or one
pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
I, the undersigne , ave read Mewile above restrictions for my home occupation I am registering.
Applicant: wit Date: a� U
Homeoc.doc Rev.5/30/03
TO ALL NEW BUSINESS OWNERS
DATE:
Fill in please: +�
R' "'`` 1'' €e✓ YOUR NAME: h �
APPLICANT'S
5giA"R "`"k YOUR HOME ADDRESS: 3
BUSINESS
liA!D r
TELEPHONE f' " ;,' Telephone Number Home D D
NAME OF NEW BUSINESS l✓rf .0 a✓ TYPE OF BUSINESS
IS THIS A HOME OCCUPATION? YES NO
Have you been given approval from the building division? YES NO'=
ADDRESS OF BUSINESS.S3/C6b MAP/PARCEL NUMBER
When starting a new business there are several things you must do in order to be.in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed
below,you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall). You MUST go to the following office to make sure you
have all the required permits and licenses..
GO TO 200 Main St. - (corn f Yarmouth Rd. Main Street) and you will find the following offices:
1. BUILDING CO I IONER'S OF
This individual ha b info ed of i equir ments that pertain to this type of business.
or' d Signature** `
lw�
COMMENTS:
2. BOARD OF HEALTH
This individual has b inform d f the permit requirements that pertain to this type of business.
Authorized Signature *
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L.
-it does not give you permission to operate-you must get that through completion of the processes from the various departments involved.
**SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE Oft Y.
Assessor's map and lot number,.--,� 7-n... ............ Bpi TM E
Sewage Permit number ......................
..................................
33 STIBLE,
House number ......................15-1-LI........................................
163
a M
TOWN OF BARNSTABLE eK
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ..... ............ ...... .......5. . ................................................
. ... .. .
TYPE OF CONSTRUCTION ..........................................................................
.................................................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ... ...... ...... ...... ...........................................
ProposedUse ..... .............. 7............... ............................................................................
Zoning District ................................................... Fire District ... ��:r.... ........................................ A.
Name of Owner ...li-, -�t�.e a
...... ...... ......................Address ....................................................................................
-7. 4,K.,.#.........Address Name of Builder ......C, it PX' 11;fA
.... ... ... .................. ...
.Name of Architect .........7�7................................................Address `"."""
..................................................................Address
Number of Rooms ............................................Foundation .......? ............
.�Ay'SR6ofin ....................
Exterior ........ .. .... 9
Floors ....... Jr..................................Interior .......................
Heating ...... ........................................Plumbing ...... .......... ...................................................
Fireplace f .......... Approximate Cost .......if�. r is ......
Definitive Plan Approved by Planning Board ------------------------------ Area ...........Y,..........................
Diagram of Lot and Building with Dimensions Fee -3-3-
.............................................
SUBJECT TO APPROVAL OF BOARD Or HEALTH
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. --
7. 1; 11-- -;?,11 1.
..... ........Name ....................&4 ............
.. ........
Jay, Edgard .10 9-6 3"
Sewag-e° 79 671
No ..2,1.7.6a... PerO itefor -DwP-11ing.................
...............................................................................
Location .......lo-t-67.....53.1-49dar•..St;
.......................W.,...Barn&tab-le............................
Owner .............Edwar. . Ja.y...............................
Type of Construction ...nood...Frame.................
................................................................................
Plot ............................. �at ................................
Permit Granted ...........ILer......26.....19 79
Date of Inspection .......�.........................19
Date Completed ................I.....................19
PERMIT REFUSED
............. ... k. ..... 19
......... .... ......... . ...
V.............
.. . ........... .................. ............. ....................
..... .................. ........... ... .. ..........................
............................................................... .........
Approved ....... .............. ............. 19
...............................................................................
...............................................................................
TOWN OF, BARNSTABLE 21768
e
Permit No.
I Building Inspector Cash
■... �; -)
Beal OCCUPANCY PERMIT Bind
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 Edgard Jay Address
l,++ Af,7/�rll r.aA=» Q�r•not ,. WnQt RflrnQ#ahl n
Wiring Inspector �"� ��-w' Inspection date
Plumbing Easpect�or Inspection dater
Gas Inspector Inspection date
1'Engineering Department; j,r� ��f,��r� � 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.
4/3..__._�. 19� ......................
/ae-4
-�
�• - •�Building Inspector
f
i
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CE tZ T i F t Ed p L-C>,r P2-.. A.
� GGRTtI=�( Tt-dAT T14G qVtlDArfOQ51-l0wu
Pt_4►.1 R�FC��►.lc_E
ti tEQEr�►.3 GcaNLPt_YS W tTN Tt-t� �${DE Lt►-�E �� 401
Ati.ID SETi3AC4C t~'C-4uttZE�tit uTS OP -rw
-row ia A 7zA( L ti!f E v l
PA.TGc. S A xTM.Q- 1c.
• RcGtSt�JZi=� 1-AtJE7 Su2v�Yoks
7Mt5 67L.At--! 15 ynT E3ASC-'D VN At-1 OSTEV-V%L-LC o MASS.
tt�!•iCdGiJ.v�t=OJT �,U�v��{ �T:•IC-. uFG,�'T"S St•la!:�t� �.4�Pt_t GAti1T /�
Kki' BU-% useD tG (.-c�Jo4Qlz t.e`�'
►.Ao or's map and lot number ArwaG /
SYSTEM MUST pf IN
/ D IN COMP Sewage Permit number ........7......... (.............................. INSTi4LLE (,Iq
WITH TITLE 5 = BAWSTABLE,
House number 5 3 (. ENVIRONMENTAL CODE
TOWN RE MA�a
,r�f 0
-G'ULd0.TI0N i63q.
S �a wav a•
TOWN OF BARNSTABLE -
BUILDING INSiPECTOR
APPLICATION FOR PERMIT TO .......x ...................... ......... ................................
TYPE OF CONSTRUCTION ........ .&P..,tP..... .' P:' . ................................................................................
................................................19........
i
TO THE INSPECTOR OF BUILDINGS:
TJpe undersigned hereby lies for a permit according to the following information:
Location .... .T..' .�..... .. ? ... ...... .,.. _ .......................................
ProposedUse ..... .P. .i,: ........ .e9.!` .tti.. .......... :. ...6 -...........................................................................
Zoning District ................................................Fire District ... C. .�h ... ...............
Nameof Owner ... .......: �.........................Address ................'..............................................................
Name of Builder 0H-.le.1.....1........... .........Address M..D.el.MI 1 Ptit- tj....�....�1�1�!?�ts�tP�h!
Nameof Architect ..................................................................Address .......................:............................................................
Number of Rooms .................-..........................................Foundation �� { ��!r :! ��...cm�+a .......
............... .........
Exlerior ...6U..a.. '.0,494!!z:.. ng ... .,14. ....................
Floors .......E..It. �... '...�.�?:►'G1�1 :. ..............................Interior .V ..JET' .. r' fr�rrsC........................
Heating ..r:.1-Y 0..ki!.. 11....:.............................Plumbing ...... !.('S........................................
i
d.
Fireplace .���..........P!. .P..5...-z........�.V....5171—�. ....Approximate Cost
G.P. 6,�� '-`fit............. ................
Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area .... ...................
Diagram of Lot and Building with Dimensions Fee 35-
. .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH 9
q�y�y
I hereby agree to conform to all the Rules and Regulations of the Town of arnstable regarding the above
construction.
Name ...... 2� f�., .............
Jay, Edward 109-63
sewage 79 671
Ao .21768.... Permit for ....iNeUi0g.............. ..
...............................................................................
Location 1.91A.7.....53.1... ................
...................W.....Barlaabablp................................
1
Owner Edward..JaY...........................................
Type of Construction ...........WApd..Frame.........
.............................................:..................................
Plot ............................ Lot ................................
Permit Granted ...............0Gt0.bQr..26...19 79
Date of Inspection .......... ...... ..................19
Date Copleted .. 19
m .. II. . . . ......i.
a 00 8�
F '. ERM EFUSED
...... 19
F ' "n j
}. Fa. . . ................................
�. ...... ... .......................
......... . ..............................................................
. �`A. ...................................................
F+P
Approved ............................................ 19
...............................................................................
...............................................................................