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HomeMy WebLinkAbout0121 LOMBARD AVENUE dim— J N IMF, Town of Barnstable Building ' Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept. M Posted Until'Final InspectionMas Been Made. 16 Permit �p • Where a Certificate of Occupancy is,Required,such Building shall Not be Occupied until a Final Inspection~has been made. Permit No. B-16-1639 Applicant Name: Kevin Sylver Map/Lot: 155-005-002 Date Issued: 06/30/2016 Current Use: Zoning District: RF Permit Type: Shed-Residential-200 sf and under Expiration Date: 12/30/2016 Contractor Name: Location: 121L0MBARD AVENUE,WEST BARNSTABLE . _ ,Est..Project Cost: $6,000.00 Contractor License: Owner on Record: SYLVER, KEVIN M&SHERILL E Permit Fee: $35.00 Address: 121 LOMBARD AVENUE Fee Paid: `\$35.00 WEST BARNSTABLE, MA 02668 _ "Date: �.� 6/30/2016 Description: I'm purchasing a new 12x14 shed to be delivered in 6 weeks r y Project Review Req : I'm purchasing a new 12x14 shed to be delivered in 6 weeks �, ✓ f � i Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and strluctures shall be in compliance with the local-zoning by-laws and codes. This permit shall be displayed in a location clearly visible from accesss�treet or road and shall be maintained open-for ypublic inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work' 1.Foundation or Footing (f { 2.Sheathing Inspection 1 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection f 5.Prior to Covering Structural Members(Frame Inspection) r . 6.Insulation y' 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). 011 LirC Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT GI�'1I�zL S£rvT �'- TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 000 000 ,047 GEOBASE ID ADDRESS 121 LOMBARD AVENUE PHONE (508)362-6291 WEST BARNSTABLE, MA ZIP 02668- 1 ILOT 2 BLOCK LOT SIZE i IDBA ( DEVELOPMENT DISTRICT t i PERMIT 7 16740 DESCRIPTION SINGLE 'FAMILY DWELLING (PMT.#14354) PERMIT TYPE BCOO TILE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health Safety and Environmental Services TOTAL FEES: i BOND $.00 pxim CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCYBAMWABM MA83. OWNER NICKULAS BUILDING, i639' ADDRESS EO Mid P.O.BOX 395 ` ' WEST BARNSTABLE, MA BUILD G IVIS BY DATE ISSUED 07/23/1996 EXPIRATION DATE TO',•Nj OF BARtaBTABLE .. ,�. 73[TTLDING l+'Id.]T`i PARCEL ID JOO :700 047 GEOBA8E I1:: A;UDRE2S 121. �L CM rAnD AVENUE .11 _WE:;1 3A: NS ABiaE. MA y �'�CC;,'_ LvT ;� Bi�OCi�. LOT SIZE :)BA C)i;�` 4:r�;IT:. PERMIT U1+CCnTr�TICN 3iNi7:±J` EA�.'.i Y DWELLING ( s)f'V. Pt-1'1: ;�r� i..._; ,; 1)EPL4TT ,I,Y��E ;Yj_L-LD 'fTTLE l`�1!W ,�"'IDENTIAI., GLDG t'MT Department of Health, Safety C0N'PRAC�=."?f:',: ``=`-`-''-_`'-s L;''j'UIc'�u CO. and Environmental Services TO?_'rl.i`, i EECS: $310 . 31 `Ott .t. 00 Qi► (_10iSTS 100 .00 t *�. s L „ a i..��1., �1�1� 1 n'�i i m `� BARNSPABLE, i 101 S' ii,._,� ,i M H0,'. t. DETACHED � t r���,A 1 E' - ) =•i"jM. 039. ("W'NUR NI ::C ';C.?Eya; BU.1_r,DING �/! E�.�I'►l .r; t. ��"` 395 BUIONGI'M SION BY :Z ,.,.,ION THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE THIS CARD KEPT POSTED UNTIL FINAL INSPECTION 1.FOUNDATIONS OR FOOTINGS HAS BEEN MADE.WHERE A CERTIFICATE INSPECTION CTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS S / S �� te1- J Ni Ir: l N C. /7 9 2 2 2 fee 3 1 HEATI G INSPECTIO A PROVALS ENGINEERING DEPARTMENT /t6c 2 BOARD OF T OTHER: fkledL Lk r,L SITE PLAN REVIEW APPROVAL 7 /7 14 J WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. �"a' .� Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept HARIMASM MAS& `� Posted Until Final Inspection Has Been Made. wia+' Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit Permit No. B-16-696 Applicant Name: Map/Lot: 155-005-002 Date Issued: 04/01/2016 Current Use: Zoning District: RF Permit Type: Stove Expiration Date: 10/01/2016 Contractor Name: Location: 121 LOMBARD AVENUE,WEST BARNSTABLE _ _, _ _ _ _ Est. Project Cost: $0.00 Contractor License: Owner on Record: SYLVER,KEVIN M&SHERILL E ; Permit Fee: $35.00 Address: 121 LOMBARD AVENUE + Fee Paid: $35.00 WEST BARNSTABLE, MA 02668 ; Date: 4/1/2016 Description: Solid Fuel Stove Permit Project Review Req Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing t 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed - 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 'Town of Barnstable ermit: j-/' Regulatory Services ate: D Y- o -/6 oFTMErW�ti Richard V. Scali, Director o ee: Building Division vaAM"�M$ Tom Perry, Building Commissioner s639. .0 200 Main Street, Hyannis,MA 02601 rED MA'1 a www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: I�e�? I W S1 k e C 'Phone: -,s-03' 7)b - 7 a Install at: 1 a\ Lam 6o-a Ave. Village: \N - �Oxc -j Spa.16 �c Map/Parcel: Date: S- l (o Stove A. 4!�Used B. Type: adia irculating C. Manufacturer: \t.Tooc-S Lab. No. 01- LtSa D. Model No.: Chimney �G A. Ne Existing (If existing,please note date of last cleaning) B. Flue Size G " 2p t,0i S-Mle-c-ESS SYEEL /0, �� C. Are other appliances attached to Flue? No 10p W D. Pre-fab Type and Manufacturer Vj I A UX\. �, ✓�,p� E. Masonry:L3xt3 ine nlined O Hearth 9�2cP A. Materials: '%P-LC-lc �9 B. Sub Floor Construction: CotjGR-�F-ZE F` Installer l$ P o N►✓��1 C►,', Name--W -ro C}+tllwrby 5EP-v.. li, Address: KA oa6�S Phone: ZS?7$_ Z-.6 - 4111/ Location of Installation: -'54.t-►F- AS A RoV F H.I.0 Registration# W/606 Construction Supervisor# CSSL -0993)1 OR check_Homeowner Installing, no license r uired LICENSED INSTALLERS SIGNA U APPLICANTS SIGNATURE. . APPROVED BY: 8 Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev 11/4/13 T fx Cawymomveah%ofMassachusdit Deparamwt of ludasbi-rrl Accidents - Offlcelofinvestigations 600 Washiagtoa Street Boston,MA 022T11 wtv►v.>r>•aasygtrldi a Workers' Campensatian Insurance Affidavit:Builders/Cann-actors/EiectriciansTlumbers pLH-�nf Information p I 1 Ptease Print Legibly Nan=(lUSIDeS 0 aymi�;rfirvi/Tnriivirh 0:—'0Y �-G - 2 V (.o4 ' m C-k h NCy Sew(C—��c- Address: 1 P t✓WP CU, &N CityfStataelZip: AYZ.P'1av7 7' 4 Phonec�S- Are you an employer"Check the appropriate box: T of project r 3'Iie �. 3 (epire(l)= 1_X-I am a emplo er with + 4. ❑ I am a general contractor and I 6- ❑Ntiou employees�o �* fisted o thect a subcontractors 2-❑ I am a sole propsmetor er- listed on the attached sheet 7- ❑Remodeling ship and hate no employees These�-oontiactass have g_ ❑Demolition w for mein an c ci r_ employees and have workers' od�ng y apa � $ 9_ ❑Building addition [NO workers'comp.insurance comp-�aTl— regn+red l 5_ ❑ We are a corporation.and its 10_❑Electrical repairs or additions �_❑ I am a homat7u ner doing a1I work officers hn-e exercised their 11-0 Plumbing repairs or additions myself [No workers'comp- right of e(empti d per MGL 12❑Roof repairs insurance required.].j C_ 152,§1(4},andwehaz�ena employees-[No workers' 1 Other(,�0y� �tlhtt'� comp_insurance requireid-1 l 9✓�� 1 =� *Amy applictrt that checks boa,#1 mast also fill out the section below showing their woaisere compensatiGn policy in5rrm2tion_ T Homeowners who sabmit this affilsit w c--&g they an dnmg`n Zroak and thb*+hue outside contrKtors mast submit anew affidavit inXr�Yir, sash. =Contractors that check this box mast attached an additianal sheet showing the mope of @re sots-eontxactou and state whether ornot those ertities have employees. Ifthe snb{ontmcturs have employees,they must provide their warkers'comp.policy number. I am arz employ,w the is prmadtag it orke.rs'compensation irm4razrce for my employees. Below is tha po&cy and,job site inforrrzaliart_ Insurance CompanyName- g �`r_rr, � �V( tU,A-iJ lNSli.l?JJ�C� Policy 4 or Self-ins-Lim . lot W t 4 0 a WO/3 I X1 5r4 Expiration Date: '1 -"a q—t b Job Site Address: a[ �t"` QI 4— r-'w b— Cityist,t Zip: Attach a copy of the workers'compensation policy declaration page.(showing the policy number and expiration date). Failure to secure coverage as regtriredunder 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 yearimprison t,as well as ciiii 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 maybe forwarded to the Office of im estigations of for insurance:coverage verification_ I do hereby ce fy r the is aWas nfpedu y that the informofion prini&d abm�e is true and correct Si tore: Date: Phone 0- Offrc&L rise ant . Do not write in flzis area,tv be campleted by city ar town af/SciaL s • . City or Town: PeridtUcense# Issuing Anthoritg(drele one): 1.Board of Health,2.Binding Department 3.Cityff own Clerk 4.Electrical Inspector 6.Plumbing Inspector 6.Other Contact Person: Phone#: 6 Information and lastructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursumt-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)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)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 retuned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/Ecense 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 Goramo wealth of Massachusetts Degaztmmt of hiclustdal Accidents off!Qe of lmvesfigatiom 600 Washington Street Boston.,MA 02111 Tel.#617;727-4900 at 4-06 or 1-977 NiA.SS.AFE . Revised 4-24-07 Fax# 617-727-7749 WV .Mass;gov/dia Q. ho �s re onsible for making application forth :permit? Application for a permit is required to be made by-the owner or lessee or their agent of the building (e.g.; the HIC registrant), if application is made other than by.th•e owner, written authorization of the owner must accompany the application. Such written authorization shall be signed by 'the owner and shall include a statement of ownership and shall identify the owner's authorized agent, or shall'grant permission to'the lessee to apply for the permit. The full names and addresses of the owner, lessee, applicant and the.responsible officers, if the owner or lessee is a corporate body, shall be stated in the application. Please note: It is the responsibility of the registered H)C to obtain all . permits necessary for work covered by the Home Improvement . Contractor Registration Law, M G L c 142Ak An owner who secures his or her own--permits for such shall be excluded from the guaranty fund provisions as defined in M.G.L. c. 1.42A. Back to Top Q. My contractor told me-4 need to obtain the permits fo m construction. . Ma :l obtain the relevant permits from, ,my local building department or is the_contractoj required to do that?l -- While you may certainly obtain your own permits, be aware that if you do, You will fall into a homeowner exemption that will disqualify you from being eligible to-receive recourse through M.G.L c. 142A, the HIC Laity, or the statutorily authorized Guaranty Fund, should a problem arise,. It is the responsibilifil of the registered HIC to obtain all permits necessary for work covered by the Home Improvement Contractor Registration Law M.G,L_ c. 142A. If the HIC you are contracting with refuses, you may wish to reconsider using that-contractor's services. ofTME Town of Barnstable Regulatory Services 11 A♦R NLUMA Muss �, Thomas F.Geiler,Director i63g. ♦� ' a rrw+' Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, v,%f /)j S/Gv--"'W —, as Owner of the ro subject l P PAY Gov(TES 7L> hereby authorize 'Z'rnP -t2 0>, to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. S' e of Owner S' e of Applic 1,41 Print Name . Print Name \ Date WORMs:OWNERPERMBSIOMOIs 0012 �T Town of Barnstable Regulatory Services AAANSZ&B R Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street; Hyannis,J A 02601 www.town.barnstablema.us Office: 508-862-4038 . Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print i DATE:. JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwelling of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such. "homeowner"shall submit to the Building Official on a form acceptable 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 undersigned"homeowner"certifies that he/she understands the Town of Barn table Building Department rnininium inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control.. HOMEOWNER'S EXEMPTION The Code states that `Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assumring 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 prpceed 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 fdrin currently used by several towns. You may care t amend and adopt such a form/cerUcation for use in your community. "Q.•forms:homeexempt , Cl/ae epo�;zmo7u�eall/�o�C�ac�Cuael22 .. Office of Consumer Affairs&Business Regulation koOME IMPROVEMENT CONTRACTOR egistration: ,tea W86 Type:. Expiration���7 Private Corporate. TOP TO BOTTOM GF t1�m- -,: DOUGLAS SHERMAI x'L;c- 18 PINNACLE LN. YARMOUTH,MA 02.675 �- Undersecretary License or registration valid for individul use only before the expiration date. If found return'to:Office of Consumer,f}•airs and Business Regulation :n 10 Park Plaza-Suite 5170 Boston,mA 0 No alid without signature `1Giass _ --: achusetts De art Board of Building PguMent Of Public • 9 Regulations Safety License: CSSL-09937� and Stand Constructi ards On $uPervisor$ Pecialty DOUGLAS p SHER _ 18 PINNACLE MAN H YARMOUT LANE S " . PORT I", 'p � • - ��,� �?`y �e , , Commissioner.- Expiration: 11/08/2017 ---------------- .Copstkti ion Supervisor Specialty . ._ ..... Restricted to: • '�SSL-SF-Solid Fuel Burning Device Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit:.WVVW.MASS.GOV/DPS 1 It I 1 i . Z. L-- Ljll-�q- LT --- P, -- �'� L-011 •f c- I u / I i I 1 i I a c - I < i 7 �c ygU vt y h- I r ; -------1 k ^ m ' 1 _ I 1 I 1A, � 1 1 2 b mR 0 Amhl-Tech Aeeotletee.Inc.hereby A RI H I-TECH A 5 5 0 C I AT E 5 `r o' VIecU��� BUILDING-t Co. eV cwly rew—o uu eopydoht 1 `/ ' tof h them dre tnge eteordlnq to th .. .. .. .. .. .—._____.--_— e 'Archlcee w Wonte - Copydght pr°ut„on Act' fa r c h i t e c t u r a.. I d e 5 i g n, i n c. [. .�_ V .L1�--SZ' B�+.ICN STADLE _ 1990. Arty copy, eKentlon, - _ roprdu vm or Athaleutbutlon of Q - them plane oue the"free. I� - S •> - written comm.t of Archl-Tuh 1550 route 28,unit 4 - tel: 508-771-3900 i EL EVATIoNS of mmtee,Inc.,Ie an Irlfnnge- o - mentmthetecG Cel'ItP.rl/ille,ma 02632 fax:508-775-i9a5 - i I • T o I A I - Ir r19 3 h �j0t� � fiC' 7{�,�_R• v� •� FP ��u I o l .�7) p � ,t I -i -�--- i---- I - ,or i L U r 1 ` 1 e��` I. I _ I J-H L--- I I I i" ' J:•L"'o.°tr.'c..::. I Je-tosrlol rye. -- -- '1 i.., i — - _ cBLL. .A9H - `� t I I -{ --__—._ ---- � I 14-0 IG-o I r�- I . fi1r - l fl I I p • 6l £ )�C ff tiVj n !1 � r� 3 0 8 I i •\ It mV l 11 IU / t r 7-l0= m ro Archl•Tech Aeeocl.tee,Inn.h.reby ... a h—d M.O. h� lq t. 19A R C H 1 TECH P�550CIATE5 .. .. .. .. -... .s_......—.�__-.--__ th thcx er wt eccorolW to - the 'Anchl[ccWr.l Work. Capyn6ht P,ete<uon Act- .t architectural design i n c.1990. My ropy, lwmUo4 r,pW.,uon or el.M Wuon.of i c ° u nan`t'atU I-Tee h 1550 route 28,unit 4 tel: 508-771-3900 ° Four+ps.TIC�N p�.N, SE:"T10hlS A t of of that ct. t Inc.•le.n Infi7r�ge. mcnt centMille,ma 02632 faX:508-775-1945 h a 6b61-9U-B05:xe j zcgz0 ew`alpug3= 'ul ° y 006c-16L-806 p3 b 3lun`8z woj 0991 40 1-114 °•.1I2 1 I .�1m».V suv d oTid 0 400l•I4a+V !o w..uoo ua11VM , I N ....d.oa aro41 w.u.1d...n to uo11^914.1O o uor4wpadL . Dui 'u615ap jeans � a � Iy � ae ".,�. w a Jo my uo,1»IaJ 14BMRdo� W.I ` �1QVL�\�:V9 1531"i .. .. oWM I-41"14-V. .41 S I1`d 10 5 b N I1-I N D�!b q a In on. -wl—P--o 14aWum.y1 co,uzc,p .dn 'O'7 r7Nla-IInQ.._SN ii 1'a I;IV $_° y�+ Fga04•»I'..1.Ioo..V 4»1'14�V �a: I I zr b^ it I I 0 I, • I �a>S I j � I i I I of 1 t 5 fo I I u I a: I f 9 I e . I I 0 8� `•�%R � 91. _ I c Q i 0 r —01 o iFm i �. --------- —— acr o uVAS - -mom • 1 ---- ---�- II ' 0 e Nr.� v0o I I ' _ � I I ri:a� _ lo—lc lo—l� I 1 1�1 I Ic IY. It I" J SG2� 7 j.._- - 8 � ll•'•Lc(U} � I7-I to-I2� (0-15 —� I5-IiI � Io-I5 1 IL-.v I - ob�z alo•�or vylt«at(� =t � EY v' N � z¢en IT+yanL� Z U r dl -p - - all I Lj .� i" Town of BarnstableOWN O1~ RNTI.E Regulatory Services 2012 MAY 10 PH 12: 30 Thomas F.Geiler,Director s + '" ST"IRE ` Building Division 163a Tom Perry,Building Commissioner �"�� 200 Main Street, Hyannis,MA 02601 DIVISION www:town.barnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERNHT# 4z;)-d` FEE: $ SHED REGISTRATION 200 square feet or less 1 L-61n&JrJ Ave- Location of shed(address) Village Property owner's me Telephone number Io xl� IS � o�Z Size of Shed Map/Parcel# Si ture Date Hyannis Main Street Waterfront Historic District? 0 Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THEJURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAYBE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:042911 r •: + i -- ,-------��_ - Elite A-Frame:10'x 16,Light Gray T-111,Dual Gray Shingles, Vinyl Elite A-Frame:19 x 14,Mist Vinyl,Black Shingles,Cream Trim, Dark Gray Trim,Light Gray Doors Red Doors,Black Shutters Options Shown:Transom Windows,Garden Vents Options Shown:Z Shutters,Transom Windows,Wood Trim Package,Half Moon Vents,Ramp PT Erfte=A-Firame-l0tx F1",Christiana GiaTDark-&own Sfiingtes ^" a' Elite A-Frame:8'x 12',Clay T-111,Dark Brown Shingles,Beige Cream Trim,Hunter Green Doors Trim and Doors Options Shown:Hunter Green Z Shutters,Transom Windows Options Shown:Half Moon Vents above Doors,Extra 3'Door,Arch Trim,4"x 16" Vents,Ramp Your i� s - ` Workbench -r- of cusforn heigh{for a " makes a so this 11111 11011 shed "'J new ■� Li eve -`� n more Personali2ed. ' .� 7 r , � fib. ,�ee-Tx^_ • 4� !,r ; Ki+'_ _ ,I " Elite A-Frame:l2'x 16',Almond T-111,Weatherwood Shingles, - White Trim and Doors Options Shown:Transom Windows,Extra 3'Door,Garden Vents A-1,34 `` _. ,, yam•. ro MWA-Fame 1(Y x 16.light C q T-1 u.DtW Gay 5hiagks. Vbiyl}rinMB=m 10r:14,Mist VlayL Bbd 3bg)mCr m Tdm. Dark Gtay Tdm tgrt GrayDo= Red Doors,Mad Shun= Oofts S*m TrAmftbts.Gard %ft O fimshow rZ nab wio mwo aft Padap,H2lfMOOOftmR=p 4 5 , ,yam' 1 K f]ft�A-Rama10x-12';ChtistianirGray,ik►rl8rasr►rShingl - EDekRam rzlT.CbyT:111.Dxdt&m%&O ,Beige Q=Tttm,Hu=Geer Do= Tdm and Doors Opftw Sbowm Hmuca Green Z S mum Trdm m Wittdm Optics Shom wff m m Vents above Doors,Ewa 3 D=AtdUm 4-x lti Vm Axll' ' F Your s} ff °r me Ecr9{h,s Shad my ®v i �( tic yy W �''1 „• +��� "" 18LeA-Finae1Tx16;AEmoadTlll,Weathawood 1 C White Trb3i and Doors r ®PR 3 O Z 04I Sbowm Tmomic Windom F.=T Dom Gorden Vmb- 'y t GROWTI., NIk;N1' r CB �Gf APPROV D MAY 0 9 2012 Town of Barnstabl Old King%Highwa Committee RECEIVED LaT 3 �''' APR 3 0 2012 GROWTH MANAGEMENT 0m.. Zo11►!s` 7?r ab MORTGXGE INSPECTION e t ,"?G Fcogp zova pe DEED REF: ) O1�i�tER:)J_Q �y/��p_�G17/1+�lI,K�,__ .R7[ --_------^_ B i S& ..i..A.AYMiY�fr'iRNi DATE: .�t/l.,l371__ PLAN t HEREBY c FY 7'0 ���__�.. --- owYAME SURVEY .,.._--_THAT THE BUIWI G SHOWN on THIS no is WCATO ON "m ctwum AS tPJA CONSULTANTS 3MIN An 'tom►! M POSIMN DOES ....w.. COMM � 403 (surrE 1) TOWN r ot�xc �* sgrai►cx EA7 MUSTRY ROAD t? D0E8 Far_ us wrrFnx THE sCIIIL FM WO ARD xs > rA. o2aP+e AREA AS = off � TSD�..._ TZL 425-0055 tlii9 UA KDT NO F MI Atf L00/ L00'4 Z56L! JYHO U AM IZI'IKIX 0L0Z'6Z-1nr 14i LOT ! •� •moo- Irk CB ti ���"` rye• i db. fit, • dP �, LOT 2 .ti0 0 LOT 3 ter° W. ZONE 'Rr Thls MORTGAGE INSPECTION aanc un only tzoov ZONE ZONE m REGISTRY OWNER• MRW_M_Gl7IdItY��--------- --.-- DEED REF BUYER AWM l_A_AU&W4'iT1Y_ .1 DATE: OW-------___ PLAN R�`E e.81?_ 1 --�j-- I HEREBY CERTIFY TO YANKEE SURVEY _THAT THE BUILDING PAUL BHOnH ON 'PHIS PLIIK 1S I4CATED ON THE GROUND AS CONSULTANTS SHOWN AND THAT ITS POSITION DOES _-- CONFORM � 40B (SUITE 1) TO THE ZONING LAIF.SE'I'®ACK REQUIREMENTS OF THE 'DOWN OF ---SARNStAM ,�„°.,,�,, .,,,_,,...AND THAT INDUSTRY ROAD IT DOES NOS_ LIE WITHIN THE SPECIAL FIJOOR HMARD Ns Mus, MA. ake4e coAM AS SHOP=ON THE U.��IAP 0 TEb_ .._ TE1P a 0-0055 umn0-5553 Tills PIM NOT MADE Doty AN 10TRU1dM SUMP 30042 DAYF TOO/ T00 d TS61# 0VW9 'daAQED MINIX ZLOLZ9£ 8OS £S:iO OSOZ••6Z• IIIP y Town of Barnstable Old King's Highway Historic District Committee NAM 200 Main Street,Hyannis,Massachusetts 02601 Wd (508) 862-4787 Fax(508) 8624784 CERTIFICATE OF EXEMPTION Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of Exemption under Section 6 and 7 of Chapter 470,Acts and Resolves of Massachusetts,1973,as amended,for proposed work as described below and on plans,drawings,or photographs accompanying this application: Date t%� JC7 l 1 Address of Proposed work, Assessor's Map and lot# 165005006. House# I a Street W,,,- cb .rd Am Village: West' UU.f m4a—bIe- This application is for an exemption of the proposed construction on the grounds that work: ❑ Will not be visible from any way or public place Is within a category declared exempt by the Old Kings Highway Regional Historic District Commission ❑ Other Description of Proposed Work: Agent or contractor(please print): Tel.no. Address Owner(please print): knii n a lff,4' Tel no.v�0$-1 y t(-7 O Owners mailing addiess: Q Signed,Owner/Contractor/Agent .For Committee Use Only This Certificate is hereby Approved/Denied Date: 'S ZO t Z Committee Members Signatures: R,ECENED --�QM�1 APR 3 01012 Cal MAY 0 9 2012 Town of Barnstable _ Old v ��12V � QWTH NIANAGE Comrndtee j Any conditions of approval: i C Womments mid SettingsldecolU"cal SettingslTemporwylnlernet Filesl=l10KX Ezemplion Form 07.doc 000 -000_Oy ,Assessor's Office 1st floor Ma Lot Permit# j L[ 0/ Conservation Office 4th floor 3 - Date Issued _ Board of Health Ord floorIl��/` Engineering Dept. Ord floor House# °R � Y Planning Dept. (1st floor/School Admin.Bldg.): „AMSTARM i KAes. ..� Definitive Plan Approved by Planning Board .S— ems- 19 �1 J - SEPTI t6�a A lication roce 8:30-9:30 a.m.& 1:00-10"do/G L� nP .ENVIRON j ' TALLER I� C®M SST BE 1 WITH TITLE 5 L COS- TOWN OF BARNSTABLE TOWED REn���.� 'Building Permit Application Protect Stre*dre ,,26L Village Fire District (honer ✓ QJ �v !/ Address -7 Tcic hone Permit Re uest: 5•�2 t 5� Zoning District ze Flood Plain Water Protection Lot Size Z Grandfathered Zoning Board of ApMls Authorization Recorded / Current Use Proposed Use Construction Tone Existing Information Dwelling Tone: Single Family Two family Multi-family Age of structure Basement tope Historic House Finished Old King's Highway Unfinished Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name ��L r G, —�GG� Telephone number + Address License# 2 rf? Home Improvement Contractor# Worker's Compgasation # NEW CONSTRUCTION 0R ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Pro'ect Cost C Fee 3i0 �3 SIGNATURE . DATE I/ BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T FOR OFFICE USE ONLY t I, 1 ' ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION _ 9 FRAME INSULATION b FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: DATE CLOSED OUT: ASSOCIATE PLAN NO. J_UN— J- yb W:Se HILHlq[ IU FFE-HUNG DOOR t)"JIC b124 H.U_%/W ' :. �� �8•d S%��6�9S176 �Z:Y T 966 T-ZZ��d =� �tr��P��t+�yi��If'p�� ri 0 1� �'y��A.�a4'+�'�► 1y aer 1 �•�•s�*0�'L`I �``d��°r���f I'I p��..'�`+' w. ��.y: Zo.�y11� `� � 1 L 41F . � � LAY\l �� � � e� � #• A � w H r.� Ti 7 o F4a i .b l/.? ��. is rt •� 1140 V � t1 .F�A77 I.i7 'p CQ ail s � �' sue, • � �. � •♦ 4 � � �{•.`+ ,� w. Its+.� ♦- �` �. ' /�L� 1� w i�a,��8 ��+�. +•�`�= p-Y� 1• 1L 4, ��♦ .u1••i ♦ �"��*�'7���y� _ 4+ �:� �� ♦ram � �. �• ` i l 6 M. �!W[St H91. 1109 �V(]VNVJ"11•VA,11.U MUM, UO'-Gd-y 3S V"JCi 11SVJ:A19 ,1NE t T D i iZ CASTLEGATEO CANADA -INC. th i PR SERIES t 1 w Standard Steel poor Speo i`cations ti steel. 0.015 min.(+.007--000), pre-fini3hW hot dipped galvanized, deep drawing duality, special killed (AS,IM-A642) for embossed dads. 0.018 min, (•r•007-,000), pre_•hnished hot dipped galvanized, commercial quality {ASTM-A526)for flush doors,Steel has rolled formed vertical edges which inter-lock I with wood stiles(see illustration 1)and also incorporates.1/4'metal returns on both the bottom and top of the door panel provieaing additional strength,squareness and rigidity. I Paint Baked on primer cm1posed of nitrocellulose lacquer exceeds the requirements of the Canadian Government Standards Board Standard 822-GP-5M. 1 Foam Polyurethane foam made with Diphenylmethfine-•4.4`-diisocyanatc and blended urethane resin. free rise density i!c between 1.20 - 1.30 lbs/cubic ft.. and f foamed-in-place density is between 2.0 and 2.3 lWcubic foot..K factor is between 0,127- 0.156 BTU-it i/scIA-Hr.-degrees K.R-value of palyurethane foam is 15.15. I i I I + ' Wood Stile and rails are 1-11116" x 1-3116" kiln dried ponderosa pine,fingerjolnted,with l a moisture content of 6%-10%. Lockblock is 2-13/162 x 1-11/160 x 12" kiln dried t white pine. with a moisture content CA 60i0 I1 • i i l i 1 I i i i i i EFFIeMVE:Jonu.ry 1,190 Page 1 FEB-201 I996 19:21 r!f rf:262'335 P.01 :'i�/7n'.., WVTO COC' Of-;)i^ cJnnrt c kh-)LA -IT IKIUu iu .,- qq`QptME T The Town of Barnstable BARnE. Department of Health Safety and Environmental Services Building Division 367 Main Street, Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection PP( L Location 1-2� '(', Permit Number i -ate vG r Owner 1 y—. L C 1w� �� Builder \ t c. One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 0, -Aa�e_ID C2.U�0,, (CeaA 'Y (L I k P-- u r 1/1 kn Please call: 508-790-6227 for reeinspection. Inspected by Date �� ! �' LOMBfIBD AYFivUF N 6�¢ (A w ° o �\ Ex/s riNG , CONGRE� OJ �avoAr%� N its' LDT i1/O, 2 � 43� 72Z s F f C,:SWT/r`Y T.yAT 777E ---*X577/vG C.CY✓C.P TE fVUNOA776W OE5/0700 6W GDT NO. Z CGv✓Foei-lS 70) 77,L':; OF T;Y� z0W1Wev- �YLA�I/ Or" TtiE I-ZWIV 4,1� ,B�9�Pi1�5'T�J�ZE 4 C6M-5/E/) -"'0VNDATAON PG4N f i �9�5-9111Z 7 <cA�IN OF JOHN q��G A11CA-1-1ZA5 AJX,01A16 eD , P. O LE,III 3358 9 `�a c Lp7 N No.335 0. 2 L-61Y94 ,0 19VI—Al(J5 „� �q OFG TER�� �� BARNSTAQGE� /�A. O, SU SALE/"=50 " APR/L g; /996 04Y4E, P L.SS. i M r c LO LO " c .f IU • ~a' Q, �' 4 J r a • f a. ram, .Fd �'� •rp V, 1 �4� I .r r'v... 2q as ac fy � � 'N)1f•N 4Z ff� �4r. r L 1 \ \ r • „c • --: LOAM �SEEb_ _ fib..HouSE a �,; SIHtzL1�S IN �Eb of ' ;Gfzl..lsf-tED STONE WALKWAY I LOMBA A\/r=NUk-� PL-AN LoT #z .4ci - oil I i . i EX/ST t I - \ LEACHiv6 .._• � � � � � k� 20 �ERv�c Q 71 70 '� p Aq i\ o a, tr ` LOT LOGZII: M/91010 SCALE•'%"= ZGY�D ' 1 s/Tc ,qwa sEWA6:F `Z FO/4 `'S'CyNr 17V t//N6 71 L- TiS1,e6i!F ,B�D,[�iQ�1 l�l�/EGG/NG�SEWAG E SYSTEM �ZH OF tij LOT ND, 2 O� JOHN Cy P. �� scA�E= /"=SD " 1--E-e,ea4,ey 27, /9y6 C-3 DOYLE,111 --', i N0.33589 !9 'PFC/STEg ) Q S U y� �/Of/it/ DDYGE L. 2-Z f�96 l30�' S 9S /rt/ /Y/A 02.57� :'r Conunonwpa& ol Maaac1ztL6&tb 600 W.Ja f n S commissioner Woricers' Compensadon I mance Affidavit J with a principal place of business at: J �� �j Jryr� :�•s �' c i n �✓ do hereby certify under the pains and penalties of perjury, th= () [ am an employer providing workers' compensation coverage for my empfoYees w:i this job. Policy Number Insurance Company 0 l am a safe proprietor and have no one working for me in any capadtY- i am a sole proprietor, general contractor or homeowner (circle one) and have hi' contractors Qseed below, who have the following workers' c=2P asation poLaev companylPOficy Contractor COlttraCLOT (nsuimuce Company/Pef cy Contractor Company/FoiicY lnsuraa (, i am a homeowner performing all the work myself. I t:nd=une thIX a coer of&is sr tvMM ti nU be fonmrded to&-c OM=of irtvesdtdons of dta 01A!or anw2ge veriac2lian and dix I ce:C:re ss nG:-'id under Seczicn ZSA of MGL I SZ can lead m the fmaoaiciw+of aimau!pia Of a fine of up w S I'!;' yr:r=> ten;rio- unt as Weil as CM1 venaides in the tour.cf a STO P WORK ORDER;ad 2 flee of S 100.00 a d.3y api=me- Signed tf=is _day of ► 14 — Building Department ticensee/Permittee Licensing Board Seleccmens afffce OLD KING'S HIGHWAY HISTORIC DISTRICT SPEC SHEET FOUNDATION SIDING TYPE 14 .G, . COLOR 'fc-( L� j CHIMNEY TYPE COLOR. �tj ROOF MATERIAL �LI� COLOR PITCH I W I NDOWS S I ZE { _ Girt ow TRIM COLOR DOORS lon j COLOR N6, . SHUTTERS GUTTERS_��1.�}�( � DECK Z X Zn GARAGE DOORS -COLORNI P Notes : Fill out completely. Including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application. along with three copies eac!-) of the plot plan. landscape plan and elevation plan; , when applicable. *Plot plan need not be "Certified" . but snowld sncw all structures on the lot to scale . Old King's Highway Regional Historic District Committee Public Hearing of March so,1996 Summary Of Decisions Continued Horsefoot Holdings of Cape Cod Inc., 121 Percival Drive,W. Barnstable- - Construct new Colonial style home with garage. Approved the Certificate of Appropriateness as submitted. , James & Michelle McDevitt,45 Fieldstone Road,W. Barnstable- New Picket fence to enclose new pool. Approved the Certificate of Appropriateness as submitted. cr, Willialn Nickulas,,Lot 2 Lombard. t ar Avenue,;W.:'Barnstable-Construct. ti _---=ram`'-� cr• .�c2u��� r�neewwyCap -style house with garage and:farmers por�c-h Approved^CCr ifcate of r =Appropr-iateness Modifedwith a- 60'setback from the property ne :. i Abigail Jewell & David Donati, 104o Route 6A,W. Barnstable- New garden shed exterior painting, and various alterations. Approved the Certificate of Appropriateness as submitted. Christopher& Donna Hardy,Assessor's �Lot.2,Cedar--Street,N 1- Barnstable-Construct-'""' new two story Colonial house with attached garage. Approved Certificate of Appropriateness Modified to add trim on windows. Minor Modification Tartan Incorporated Lot#25, Percival Drive, { W. Barnstable to add a skylight. Approved Minor Modification to add a skylight S' 2"x 3'4"to the left of front door. f 'hy `4 Peter L. Freeman Old King's Highway Historic District Committee Planning Department d �M Application to 1996 046 Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application.is hereby made, iri triplicate,, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ® New Building ❑ Addition ❑ Alteration Indicate type of building: ® House Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ .3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: Q Fence ❑ Wall ❑ Flagpole ❑.Other (Please read other side for explanation and requirements). q TYPE OR PRINT LEGIBLY DATE 211 L�o ADDRESS OF PROPOSED WORK �-V� %6*41 ASSESSORS MAP NO. 11[�'5 T of OWNER W 1.1.16.�1 l�l� GLI,IL�l� my, ASSESSORS LOTNO. bb HOME ADDRESS �D 1bDy. n6, .1hTL�'$ TEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). rho AGENT OR CONTRACTOR F'`�NI-�C�(i�-� t� 1uG TEL. NO. -III 3� ADDRESS �� 1e^otl � ?fit Ll,( IT DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). Signed wner-Contr for-Agent ��Stw,Ce below IRine(or Committee use. �tRecciaed by H-D fC. j- ��(I 16 1�7 Iti II . z i n`Date I jiThe Certificate is hereby �i�n . Q 1 )'k,5 Date FEB 2 9 1996 101 /fry. Time f -r N 3F BAF dSiASLE �G, r• G. fJ Approved C 'IMPORTANT If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act 7aF FotYrvDA7-IZW EL. S/.SD SEl4/.9roE 5'XSTEM G,L'Oi�/GE SD/LS 71E5 T ,2E�c/LTS' b �Y i "MAX• G'OM^'; co✓E�%e/S�c' c'a�E�r . , PE�9sTDNE /ao"~ AVlop fL ',Bq9 M/9M/N BOk � tS�MP 3GAX 6 a MA/2 /9//✓, s /r/GYJD LOr4M /Oo" LDAMY /N!/C. ?q ¢S•3P ¢5,/B LLE/✓�E//Ld ¢ /NSC!iN• 4� /P�/C, . 43•GG c=o' o o i D.SD OO GC�. Gf�E CG7 O/ C�//a.4e 41 /DYR G EL. 4,3.S 2-jvrljg-,� 3 3 d o .$TD/VE o o j�IEd/LW1 �'I�/UM i 4 ,- 6"BED of 2'7" ,¢�jp" ;' - Z'7" A AlNe O .9L, S"EidT/G 77�i✓� k//Th/ sravE sr�. D G o c R 5 C �s Eo AND /rVL E�0[/TLE T 7,96 /D D SANO PER T/TGE S. S-9�//T•9/PY oOhE, /OYR/BI6 ICY/8/G JEG, 33,50 �TTOM OF TEST S15WAG E .d E5/6i✓ SAL CUL AT/ONS 4 3 EL. 3,S /56 G,eA"h1, 7—e e NOT ENCDU/✓TE.-ED PEPC .BATE C Z /y/ii/,1/NC// CLAss -Z lI/I/L y FGoic/ AT Ile G/pAY �.e BED.PpOM X 3 ed/Yiy= ,33o G/D. 3o TEST /'ERfOiF'/�/ED ON AL/G. A 7.4 Gl.SF DAY = ¢46 S.F. L S orVI.VG ' WA,THEO .sTo/VF IZ7' USE: 3 ACME FieEC9.TT 500 GEACf/ G5//lryB,5,e,r 4%D"a' X�"x2'EF1� �7/Y� II D ❑ QoTToM; /D ,1 30 = 30o SF { /ID , •. _ & 7YP 2 3„ S/DES • �'Dt60> 4, TOTAL P.�'o!/iS/GW = 30ot/CO = 4G0 SF ,, -#- -016O- 4AG = /4 5,F /N SEts�2�. 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