Loading...
HomeMy WebLinkAbout0629 CEDAR STREET M1 —,V///A/A �J IV��/ C.r.�� ��/ h � r, �Y v y. .. � �. ��:, F ': e q '�.�._... �� 'fit. lye•. 0 s, Oxford NO. 1.52 ORA ESSELTE 10% t y R 40 a W:P P- rn AA THE.Ty^/', 'Town of Barnstable *Permit y�P:;,'"� �"':. p� ;r•��.'r Expires 6 nrauhsJrom issue date Regulatory Services Fee ar> Z • IT Thomas F. Ceiler, Director TO tF. y, ,W► M w1 Building Division f , L0Vb� Tom Perry, CBO, Building Commissioner `t TOWN OF BARNSTASLE 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us 90 o Office: 508-862-4038 Fax: 508-790-623Q:::7 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 0 Property Address �q l ,1� �L4� .,7f • ��. 1' 1�1�(l� "( �P� �J� �(��F�!, Residential Oalue of Wort. o C) G� Minimum fee of$25.00 for work under$6000.00 Chvner's Name & Address v Im Contractor's Name 7(0() -��1��� Telephone Number I lome Improvement Contractor License#(if applicable) 7La 1) Construction Supervisor's License# (if applicable) r) ❑Workman's Compensation Insurance Check one: ❑ I-am a sole proprietor ❑ 1 am the Homeowner 1 have Worker's Compensation Insurance Insurance Company Names Workman's Comp. Policy# 1)6DAQ 7 tI N-o (>� 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 ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side S !S • C+aYe cFf Uvnt+,p ejci r r-gicLu V$60L`()Co rep►aC& Y-0 UCIO-f ❑ Replacement Windows/doors/sliders. U-Value (maximum .44) 00C100C'rCt w/ 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: ).'N 1'1-11.1.SU:()RM.S\hail mg permit forms\EXPRESS.doc Revised 100608 c� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations, 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r 'Tic Print Ledbly Name(Business/Organization/Individual): n c Address:w 6 egjaya .. City/State/Zip:�b0f , bie_ MA (-�2kloB Phone.#: 6Otd- Lot? 4Q(oat Are you an employer? Check the appropriate box: Type of project(required): 1.® I am a employer with—'�j 4• ❑ I am a general contractor and I 6. ❑New construction employees(full and/orpartftim.e).* have hired the sub-contractors 2:❑ I am a sole proprietor or partner-' listed on the attached sheet 7. .0 Remodeling ship and have no employees These sub-contractors have 8. '[] Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers'-comp.•insurance comp.insurance.$ 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 I LE]Plumbing repairs or additions myself. [No workers' comp. right 6f exemption per MGL 12.❑Roof repairs insurance required-) t c. 152, §1(4),and we have no employees. [No workers' 1 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. YContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors haveemployecs,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 l►van — Policy#or Self-ins.Lic.M U e2 4 u— m•`C" &5 —u Expiration Date: --,5 Q Q 9 Job Site Address: 10a6) WAY, L% City/State/Zip: i.0 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure io secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of erimirial penalties of a finq 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 certify under t h e pains r id penalties of perjury that the information provided above is true and correct Si tore: Date: Phone# D�� ( Official use only. Do not write in this area,to be completed by city or town offu laL 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 M Information and Insttuctions l Massachusetts General Laws chapter 152 requires all cmployers 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•engag m alom -en rpnse�=mlOing•the legal-represen-fatiire3r6f- deceas�'empi'oyer,oirthe 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 I pplicant 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 adth 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 1r ter__.c_______ C11 a:- A.e ..e 1—M rrn fl t•rnvi reanrrUnv the.apnj1: ajlt. of the auldaVit fO yvu t3 auu out ua atta Cv%iaa...V VuaVV vt"LT v g. -�- - — — r Please be sure to fill in the permittlicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Sile 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 maybe provided to the applicant as proof that'a valid affidavit is on file for future permits or licenses. A new affidavit most be filled out each year.Where a home owner or pitizen is obtaining a license or permit not related to any business or commercial venture (Le.a dog license of 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 Cornmonwealth of Massachusetts Department of Industrial Accidents Office of Iavestigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-49-00 ext-406 or 1-$77-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www.mass.gov/dia TME Town of Barn-stable Regulatory Services • BARNsiABLF- Thomas F.Geiler,Director A6. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town-b arnstab I e.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder I, ( ca 46 11� , as Owner of the subject property hereby authorize e l 80 qC k e K to act on my behalf, in all matters relative to work authorized by this building permit application for: C, . Coda <- 5� UJ• ba�-ns44.ble -(Address of job) SiFutux o er Date UJo a;r a `C ter Print Name If Property Owner is applying for permit please complete the Homeow-ners License Exemption Form on the reverse side. n.anu i A V.nsi MTV V oto%KTCK 1nld Town of Barnstable THE Regulatory Services E Thomas F. Geiler,Director - �xsrwsrE. . tdess g . �bs9.. Building Division PrFD Tom Perry,Building Commissioner _.... _. .200-Mairi=Street�Hyam3is;Mao 026-01 _.._. . .. _._.._..... www.town-barnstable-ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOh'IEOWNER LICENSE EXEMPTION Please Print DATE JOB LOCATION: -- number street village "HOMEOWNER:" name home phone# work phone# CURRENT MAII.ING ADDRESS- eityhown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINMON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that be/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned."homeowner"certifies that.hr/she understands the Tpwn of Ba=table,Buildi..g Department minimum inspection procedures and regtriremcnts and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35;000 cubic factor 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 perfomring work for which a building permit is required shall be cxmnpt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall ad as supervisor." Many homeowners who use this exemption are unaware that they are assuming the rtsponsibrlities 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 hirr-s unlicensed persons. In this cane,our Board cannot proceed against the unlicensed person as it Mould with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her rtsponnbilities,many communities require,as part of the permit application, that the homeowner urtify 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 fonnIccTtification.for use in your community. Q:fomns:homccxcmpt ACOR®. CERTIFICATE OF INSURANCE DATE(MM\DD\YY) 10-02-08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BRYDEN&SULLIVAN INS AG HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 FALMOUTH RD ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HYANNIS,MA 02601 COMPANIES AFFORDING COVERAGE COMPANY 232MY A TRAVELERS DIRECT ASSICNNIENT INSURED COMPANY LEIF BOTTCHER HOME B WROVEMENT INC. COMPANY 825 CEDAR STREET C WEST BARNSTABLE,MA 02668 COMPANY D COVERAGE THIS IS TO CERTIFYTHAT 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. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM\DD\YY) DATE LIMITS GENERAL LIABILITY COMMERCIAL GENERAL GENERALAGGREGATE $ CLAIMS MADE OCCUR. PRODUCTS-COMP/OP AGG. $ OWNER'S&&CONTRACTOR'S PROT. PERSONAL&&ADV.INJURY $ EACH OCCURRENCE $ FIRE DAMAGE(Any one tire) $ AUTOMOBILE LIABILITY MED.EXPENSE(Any one person) $ ANY AUTO ALL OWNED AUTOS COMBINED SINGLE LIMIT $ SCHEDULE AUTOS BODILY INJURY(Per Person) $ HIRED AUTOS BODILY INJURY(Per Accident) $ NON-OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGREGATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE $ WORKER'S COMPENSATION AND AGGREGATE $ A EMPOLYER'S LIABILITY UB-0407MS63-08 07-30-08 07-30-09 STATUTORY LIMITS X THE PROPRIETOR/ PARTNERS/EXECUTIVE X INCL EACH ACCIDENT $ 100,000 OFFICERS ARE: DISEASE:POLICY LIMIT $ 500.000 EXCL DISEASE-EACH EMPLOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS TIRS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,13UT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE acoRD zs-s(3/93) Charles J Clark .> 61Te i�omvnza�uveal� a�,/�aaaac�u�aelta Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registrat n: 111950 t One Ashburton Place Rm 1301 -iratio—"=J8/2011 Tr# 279079 Boston,Ma.02108 6' LEIF BOTTCHER'.HOME,I P_ O.TRACTOR ...... LEIF BOTTCHERaF_ j 825 CEDAR ST �'<t �4��-°^"'� 5, ,tl" of alid without signature W.BARNSTABLE,MA 02668 Administrator 4r.K"� :: ✓./e.�aiivncoau�ectl.���'�aJu Board gf�3uil�d ng RegulaonsaandiStandards iii ;,�Gonstru-ct�o�S�ijperv�so��lcen�e: - rl D �3 r License: CS a"760nn- 8`5 ate�/,30�1969 r 2 l�Rct� 051 LEIF E,BOTTGHER r 82S GE:DANWSTd2EET- .�f?� W BARNSTABLE.MA 0266,8 '� fir— t= COIIlInlsslOner o: 07-7 Boar o uil in #gu la�nsan gan ar s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement-Contractor Registration Reqistration: 111950 _ Type: DBA Expiration: 1/8/2011 Tr# 279079 LEIF BOTTCHER HOME IMP. CO'NTRACT�O" W LEIF BOTTCHER , > --- 825 CEDAR ST - 0 W. BARNSTABLE, MA 02668 -^ a 'e Update Address and return card.Mark reason for change. PS-CA7 is SOM-07/07-PC8490 Address Ej Renewal Employment Lost Card �CQ D- CERTIFICAT _ OF UABILITY INSURANCE DATE,MMfDD/ /0 e/2g 08 PRODUCER THIS CB2TIFICATE IS ISSUED AS A MATTER OF INFORMATION Divir ilio insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE g O EXTEND ALLTEP TTHE COVERAGE A FORDED BY THE POUCIESBBaOW. 270 Broadway P.O. Box 8065 Lynn, MA. 01904 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:WestOrn World. LEIF BOTTCHER HOME INSURER8: IMPROVEMENTS INC INSURER C: 825 CEDAR ST INSURER D: , WEST BARNSTABLE, MA 02668 INSURERF-: EEI COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVI: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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 5 7NWPOLICY NUMBER POUGY EFFECTIVE POLICY EXPIRATION LIMITS GF?JERNIYEE1Lrrr EACHOCCURRENCE a 2,000,000 8/27 OB 8/27/09 TO RENTED $ 1,000,000 A X COMMERCIAL GENERALLIABILRY tba 1KVJM-(Ea=Moe CLAIMS MADE FixOCCUR MEOEXP(ArVere on) 3 L,000,OOO PERSONALAADVNJLRY $ 1 ,000,000 _ GENCMLAGGR93ATE t 50,000 GEN'L AGGREGATE UMIT APPLIES PER: PR COUCTS-COMPpPAM $ 5 000 POLICY PRO ),OC AUTOMOBILE LIABILITY CCMBINEDSNG.EUMIT $ (FE ooddem) ANY AUTO ALL OWNED AUTOS O LLY IN JURY $ SCHEDULED AUTOS HIREDAVTOS BODILYNJURY $ (Fer BDdd1) NON-OWNED AUTOS PR CPERTY DAMAGE S (Per OW dart) GARAGEUA➢ILTTY AUTO OPLY-EAACCDINT S HANYAUTO OTFFR THAN-- EAACC S AU TO 0 N-Y: AGG $ ExCE55NrnBRELLALIP3wTY EACH MUURRENCE 3 OCCUR CLAIMS MADE /Gc�iEnATE E S b DEDUCTIBLE S RETENTION t A�N7U WORKERS COMPENSATION AND TbFty LIDd1LS 0 H- FMPLOYERS'LIABILITY - ELFACI•IACCI DIE NT S ANY PROPRIETORIPARtNERIEXECUTIVE EL,D12n�-EAEIdPLWEE S OFFICERIMEMBER EXCLUDED? rtyyeeee d�.atlOUMer EL.DI�Ag-POUCYLMIT 5 SPECIAL PROVI8IONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I FXC LUSION S ADDED BY EN DORSENIENT I SPECIAL PROVISIONS CarpentrV- roofer fax 508-171-0384 CERTIFICATE HOLDER CANCELLATION SHOULD ANYOF THE ABOVE-DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER W ILL ENDEAVOR TO MAII- 0 DAYS W RITTEN NOTICE TO THE CERTIFICATE HOLDER NAMFO TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED RPPRESENTATIVE Elizabeth Antonio 0/CORD CORPORATION 1988 ACORO 25(2001/08) L WIN gay - 4 �� I A —.maim Aft IWO ,�� `� .�' ,�e'�►ate. 'all m�WHO FAW, ��r ►�� SI j�If� (,t,�; �s �+P'. �-Im go s Ji � < ���' ma's•a'!-��� .i �`...'������ � :N%'��Sr�l >��o� � �e, jai rad pF NA ' i; 4Y` E1 rr SP Jai 441 now r 7 I V, „�''"� • TOWN OF BARNSTAB E 21264 ------ --- -- � � Permit No. ,. t �,.�n. Building Inspector to . , g Mao � _ .. ;Cash ------ 1 ,OHO f "�to rar►. s OCCUPANCY PERMIT- Bond f — 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, Buildings-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.” 4 Robert D, Gritz 52 Hastings Ave. ,W,Yarmouth Issued to Address - lot #87 629 Cedar Street, hest Barnstable` Wiring Inspector " a Inspection date Plumbing Inspector(^ .�.. Inspection date r � Gas Inspector �.� �1. �,' ��: Inspect on date , Engineering Department i{r/,(" .-_Inspection date f 4 3 THIS PERMIT WILL` NOT BE VALID,ANDYTHE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE ,BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. '.. ............. ..v. 19_ . .............................. ..._._. 'Building,Inspector __ . Y STHE As a sor's map and lot 'numb'er. ...lo Sewage Permit number ..... 9.....:. a / ................ House number .....,. ro•&as B, . / �.�. TODL i (".. rasa p t639. `00� MAC Ar TOWN OF BARNSTABLE BU1101NG '. INSPECTOR APPLICATION .FOR PERMIT TO�...............................................................n.....................................:.................... TYPE OF CONSTRUCTION ........................................ / ??,�I/Y) /. J�;?C?4 c 6Ar a;! � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: F�aT �iS '7 ( F1�A� \ .� (./�FST' ,�.f?f�/tJ,S lLIG 'l Location .. ................................... :......;/ .......................................... . Proposed Use r ..........Fire District ......Ef�.:. Zoning District ......`............. ...................................... ................................................................ 7� 77. /J (�o1ii z �� ,�1�i f i•it/�� Hv f liv �r�rYI vTf/• /`� Name of Owner .............:..�............:.....•...................................Address .:............... ,.................�.....Y �I Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................. .......................................................... Number of Rooms ..............7........................................:...........Foundation ......1Ov�Zr7.....5.�.!v i? .0................ ............................. Exierior H!n!Gc.F...y/ cL?n� �!`�.�rG�.........................Roofing ...... 15 !Yfl. .T........................................................ i Floors ?w....... .�..../lrJ4�..s....7?�... 4VA,�.i...K/41? Interior ....................................... Heating ......?1.....r<€...............:.....Plumbing-_:./ ? !?..:G? ....?q'-i�:..:.. %.............................. Fireplace ....................Approximate Cost 000 . . . ....................................... ... ....... Definitive Plan Approved by Planning Board _______19_=2!F_. Area /✓V..... i...... Diagram of Lot and Building with Dimensions Fee .: ...... ....................... ' -� SUBJECT TO APPROVAL OF BOARD OF HEALTH ,, 40 �6 0 211 s�+ 77 � �. I hereby agree to conform to all the Rules and Regulations o�he Town�f Barnstable regarding the above r construction. i Name ../, r.....o K ...41' ........... _ < ../....... Gritz, Robert D, /IC=169-83 V"* ,;No ......212.......A4 Permit for .....� .AS (?ry.......... .............s.ing.l.e..family...dwel-1:kpg.......:............ . ...... . .. ............. ........ . Location ...........629..-.Ceda.r..Str.e.et................... ...... ........ .. ...... . ... ............................West........Barnstable.................... Owner ............ ..................... Type of Constr ction ..........frime..................... . .................. ............................................................ Plot ..... ...................... Lot ........#8.7................. Permit Granted ............May-.2................�'9 79 Date of Inspecti n ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ...... .................... ....... ....... . .. ........................... .......................................... ....... . .... ......................................................................... ............................................................................... Approved ................................................ 19 ............................................................... ............................................................................... lit or's map and lot number .... / C y� - 'b ' '!'�2 y-�2-7c� Q�oFTNero�f v. o Sewage Permit number ... 79.......... a.FJ C SYSTEM STEM MUST $E w � INSTALLED IN COMPLIANCE BAWSTADLE, House number ..................... ... .. . ........ WITH ARTICLE II STRiE 'oo M & � SANITARY CODE AND TOWN TOWN OF BARNKT"LE BUILDING IN' SPECTOR APPLICATION FOR PERMIT TO .......... ................................................ .................................... / cs��Fs✓��[ / n TYPE OF CONSTRUCTION ........................................( �/YIE/...J��K4F:.��� 1.�,Y......................... ! !4' . ..............................192�- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit;,according to the following information: Location ..!Lo'T... rf....lr. <� 2... /.. !/ .............................................f.... . ProposedUse .................................................:........................................................................................ ZoningDistrict .............. c�. ...............................................Fire District ...... !...........:........................................................ Name of Owner ....................Address .5..' .�!f/,�T./✓.. .���: !�'�:. �4' <?�! ...`��`!'� �l Nameof Builder ....................................................................Address .................................................................................... ar �` Nameof Architect ..................................................................Address ..............��.....................��............................................... Number of Rooms ...........(......................................................Foundation ....../..o.mo L.G.fYGI:?f.TF......./Q................ ExieriorH{n/�� .. ecAf� �/Ai: l�................. �' ........Roofing ..... .. .S�.tYff:..l.......................................................... Floors /Y.........7. .... .... !✓94F....7.Za...(!4�RG.4...G� l T..Interiar .................................................................................... -_ --:-Heating -_-..!-�?;?,i.fA.l111T..lr��!?......k......oiA ....................Plumbing ../OO9... 9. ............................... Fireplace ...................Approximate Cost 614`00©J. pp ...... ........................................ . Definitive Plan Approved by Planning Board _ 2r�___,[________19 Area .......:I..l. ..... ....-........ Diagram of Lot and Building with Dimensions Fee �_ . ........... ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 'BOND• v _ 3 so w 0 � Sa+ 3E x ay H CN O .9 Cl /7� t I hereby agree to conform to all the Rules and Regulations o�be-fowndf Barnstable r garding t ove construction. Name ..1... Y ?�r.S,F ..... ..... ` ' i ' ^ . ` | ' ..21264—. Permit for ---t=.:mtory....... - dv*���' -----.~-----_-----.._.-----' ' Location ...........A2g.. . .................. .......................... .................... � . Owner ............. .................... . . ` Type - ' of Construction ........... r.we.................... ' .`-------------------------' - ^ '.-------- Lo� ---.�� A7----� , --at . _��� ' . .Permit Granted ..........May. ------lV 79 - Dote of Inspection . .. —. ' . ---]g ' . . . Dote Completed^-./��'»�� �~��~ --]g �^ ~ . PERMIT REFUSED . - ...'___.._—_—'_----------- lQ ~ . ~^ . . ° — - . —. . -- - . . .."—=== --..~~�"«.°`—=`�~�~.~--.. - », ` . . ................................................. lV -------.--------~..----.---.. ' . ' � . ------...`-----------.......—..—.. ° { � ^ Lo r 197 t\ o , N I I I I CERTIFIED PLOT PLAN EDWARD F. XELLEY LOCATION M�J7-. .44 ! 7. ?8 `; F �'�', ► 45 . �? � SCALE . /."�'60. ' SATE Mf►y .; .lf 7. PLAN REFERENCE .ol Lode7 Ate, OF Al OA 7-A-1414 VA6W . ... IqA-�D . ��=o.P f7P 1" c 4EpWARD ,G r ELEY - H c. O` tl ,� FCISTE�`y0 t I CERTI FY THAT THE SHOWN ON THIS PLAN IS LOCATED ON THE�OROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF . . . . . . . . WHEN CONSTRUCTED. --- --;-��zo a Fz 7 D. GP_/_TL PETITIONER: A1�E- l z ��7 WEST Vi9�i'-iau7�, i`'IA S3 . REGISTERED LAND SURV OR N59345 i