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HomeMy WebLinkAbout0070 POINT HILL ROAD UPC 12543 No533L^ORR HASTMOS. AN I OF'ME r � Town of Barnstable *Permit.;�?p t (D f the ires 6 ro Regulatory Services Fee sue date s�exsTwat.e, 9� 16�39, ,0� Thomas F. Geiler,Director Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.b arnstab le.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 136 A3 ,0 Property Address ��fd(f 1 �� / L /Z U,+:b (� Residential Value of Work Q I Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Ce L E1" . iIt E L Z21C Contractor's Name U li�q)7-0 y Telephone Number L/I —(s 3,7-- o Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor X-PRESS. PERMIT 19 I am the Homeowner ❑ I have Worker's Compensation Insurance AUG > 9 2011 Insurance Company Name TOWN OF BARNSTARLE Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\ 'ding permit forms\EXPRESS.doc Revised 070110 i i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0bly Name (Business/Organization/Individual): Cw/�-t2Le r meeoz_L a cc)A-) Address: P�//� / City/State/Zip: / S J3L Phone #: 67 —6 3 3 - 2,90 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4•' ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' insurance.x 9. ❑Building addition comp.[No workers' comp. insurance required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. I am a homeowner doingall work officers have exercised their myself. [No workers' comp. right of exemption per MGL 11.❑Plumbing repairs or additions insurance required.]t c. 152, §1(4), and we have no 12.❑Roof repairs� employees. [No workers' 13. Other comp. insurance required.] jU l6 ff IMA- *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the pains and penalties of perjury that the information provided above is true and correct. Signafore: �t 2 Qe . Date: 12,? Phone#: (0 ( 7 — 6 3 J - 1i3O [[60ther icial use only. Do not write in this area, to be completed by city or town official y or Town: Permit/License# uing Authority(circle one): oard of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S. Plumbing Inspector ntact Person: Phone#: THE rq Town of Barnstable Regulatory Services BnartsTMEIM Thomas F.Geiler,Director nsnss. 0 19. A � 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 2g JOB LOCATION: �V 1 OZ4 % `���) 10, number street �}/�/ / �/f f� % � 'J / 2 > village "HOMEOwNER": C/ S &F1 /�G��/�L�[ [ 63 L�0'7 name home phone# work phone# CURRENT MAILING ADDRESS: city/town 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. 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 Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and re q ' % & Signa re 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 assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt �,NE, � Town of Barnstable Regulatory Services s�stvsreaL[., ass g. Thomas F. Geiler,Director s67p. �0 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Sect on If Using A Builder as er of the subject property hereby authorize to act on ray behalf, in all matters relative to work authorized by this building ermit (Address of Job) **Pool fences and alarms are the res onsibility of the applicant. Pools are not to be filled before fence is in alled and pools are not to be utilized until all final inspections a performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date :FORM&O W NERPERMISSIONPOOLS Q , Town of Barnstable *Permit# Expires 6monihsJrom issue date Regulatory Services Fee Thomas F.Geiler,Director �� -�Building Division Ok ®����� ���omarry,'CBO, Building Commissioner �� 0 C T 2 4 .2007 200 Main Street,Hyannis,MA 02601 www.town.barnstab le.ma.us Office: 508-8fab OF BARNSTABLE Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number L Property Address i U ✓J f S/ DNS/A 3✓/5ioao �sidential Value of Work IU� �U Minimum fee of$25.00 for work.under$6000.00 Owner's Name&Address (..�'I'A5 / w'V e t; s1tiu Contractor's Name 04?y W a 0 d T Ory LAL r 'rr/29i-36aoTelephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑'I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Worl man's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side �-�✓�'�sG,� h�aDs��s Replacement-Windows/doors/sliders. U-Value (maximum.44) 'Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: ✓1 � Q:Fomss:expmtrg Revise061306 The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 , www.rn ass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): e4171e/fs Address: �D �a�'ti T /,/ ,6}1"YSf �E l� Phone.#: li/�-ASS-7/`7 City/State/Zip: UyfS� /� Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and T 6. ❑New construction . employees (full and/or part-time). have hired the sttb-contractors , 2.❑ I am a'sole pioprietor or partner- listed on the-attached sheet. 7. ®Remodeling ship and have no employees These sub-contractors have g. EJ Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.$ 9 ❑Buildtng addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. am aliomeowner.doing-all`work officers have exercised their 11. Plumbing repairs or additions - - =-- right of exam tion per MGL 12. Roof repairs myself [No•workers comp. P P �insuiance sequir`ed]Tt- c. 152, §1(4),and we have no 13.❑ Other �- - employees. [No workers' comp. insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing theirworkers'campensation policy information. t Homeowners who submit this affidavit indicating tbcy are doing all work and then hire outside contractors must submit a new affidavit indicating such. 1C6ntractors that check this box must attached an additionalshect sbowi ng the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors Izve employees,they must providt:their workers'comp.policy number. lam an employer that isproviding workers'compensation insurance for my employees. Below isihe policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date), Failure,to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the IDEA for insurance coverage verification I do hereby certify under the pains•and penalties of perjury that the information provided above is true and correct: Sienature: `6 Date /o%ate/O7 Phone#: U l7 Official use only. Do not write in this area,'tb be completed by city or town official City or Town: Permit/License# Ir6. uing Authority(circle one): Board of Health 2.Building Department 3. City/Town CIerk 4.Electrical Inspector S.Plumbing Inspector Otherntact Person: Phone#: P�OFTHE Tp Town of Barnstable Regulatory Services BARNSPABt.B, Thomas F.Geiler,Director 9 MASS. q,A i639• pie Building Division lFv � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: /D .2 7 7O 04 r�9 /SJOB LOCATION: r t$•V/F number street —7�t- village '.HOMEOWNER': �� ////�f�I/F� i�/'` name �j home phone# work phone# CURRENT MAILING ADDRESS: �h �.S%;t,, 7 7 city/town T 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. 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 Barnstable Building Department minimum 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 assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner'is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt oFTNE r Town of Barnstable o Regulatory Services • BAIM BLE. Thomas F.Geiler,Director �A s6gp. `0 rFo,r,NrA 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 ction If Using A Build as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authoriz b this building permit application for: ' ess of Job) Signature of Owner Date Print Name If Property /Oer is applying for permit please complete the Homeowners License Exemptionn the reverse side. Q:FORMS:OWNERPERMISSION TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. .. < Map � Parcel 030 �0� Application#� �-76LI Health Division Date Issued Conservation Division � Application Fee ? �d Tax Collector Permit Fee J 0. -� Treasurer Ok �— Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address �� 1901^11- 14,�l 11,�• Village GIJ, �niJs�;✓� � Owner %/ rcy , t1,4WIt _,c —Address_:_{�o��rr �i�� , //VA0&V Telephone ' Permit Request X�;g— ,�.�r a,�,�, �G,� ,ram AA/A d-14f.4ZW 149 109 fi� S(,/ e711L61 "i tr7fsiaw of owSr16(4 Juak Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation OD 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: k1yes ❑No Basement Type: W Full ❑Crawl UWalkout ❑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 Heat Type and Fuel: ❑Gas ❑Oil 9 Electric ❑Other I c� Central Air: ❑Yes "o Fireplaces: Existing New Existing wood/coallstove: C9�Yes ❑No c Detached garage:❑existing ❑new size Pool:❑existing. ❑new size Barn:❑existing ❑new s zze Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: :X cn Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ - - CD co r-- Commercial ❑Yes Mo If yes, site plan review# Current Use S-r/�- Proposed Use J �� BUILDER INFORMATION Name i `-4 geno ) Telephone Numbery�J� %. O Address 3� 4ql License# & Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO O C.l - SIGNATURE DATE 7� �G .' w .. FOR OFFICIAL USE ONLY_ ��; _ � -. ;• . yam: t APPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS y VILLAGE OWNER R DATE OF INSPECTION: , ' FOUNDATION FRAME ! INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH r FINAL j GAS: ROUGH - _ FINAL FINAL BUILDING DATE CLOSED OUT' ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a ' 600 Washington Street Boston,MA 02111 www.massgov/dia Workers'Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):,-7>,-!"!/ pt1DQ.B Address: .3 *�w 0110aie City/State/Zip: 6L,7VIN Zd���t�. 11-W Phone.#: (57i7 S' 9411 IO-6 Are you an employer? Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. I am a general contractor and I . employees(full and/or part-time).* have hired the sub-contractors 6. El New construction . 2. I am a"sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 Building addition [No.workers' comp.insurance comp.insurance.$ required.] 5. We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3.❑ I am a homeowner doing all work 11.❑Plumbing repairs or additions myself: [No workers' comp. right of exemption per MGL 12.D Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' . 13.® Other comp.insurance required.] . *Any applicant that checks box#1 must also fin out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees •Below is.the'policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the WA for insurance coverage verification. Ido hereby certi - der the pains-andpenalties ofperjury that the information provided above is true and correct: Signature: Date: Phone#: es-�, � Official-use only. Do not write in this area,tb be completed by city or town offciaL 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#: t i Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two.or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee-of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the' dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean 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 inLIZUrance 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,it necessary,supply sub-conti:actor(s)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 regiured to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete•and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the. applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to 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 Depai tment's address,telephone-and fax number:: The Commonwealth of Massaehusettts Department of Industrial Accidents OfSce of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 vElww.mass.gov/dia E, � Town-of Barnstable P °^ Regulatory Services '+ snarrsr�i.E. _ Thomas F.Geiler,Director i639 Building]Division b Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax; 508-790-6230 Permit no. Date . AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, -improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. /\ Type of Work: Estimated Cost ®U Address of Work: • Owner's Name: �E7��/LGt(� � /1/��i1GC7 ��[�t`G�[ Date of Application• I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law []Job Under$1,000 QBuilding not owner-occupied ❑Owner.pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a permit as the agent of the owner: /ri hec=�7 l/IJl9lJ Dat� Contractor Name Registration No. OR Date Owner's Name Q:f=whameafndav r Town of Barnstable. Regulatory Services BnBr.E' Thomas F.Geller,Director SATES°,� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www-town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign. This Section If Using A Builder I, art , as Owner of the subject property hereby authorize .1)6417 Ar/00- to act on mY behalf, in all matters relative to work authorized bythis building permit-application for; , (Address of Job) a.q-C)7 Signature of Owner Date /Y/fi//C.y A-1 Print Name Q FOP.M 5:0"VINE'RP ERMIS S ION oF, E Town of Barnstable * BA�t SMBIX, Department of Health,Safety,and Environmental Services MASS. Conservation Division i639. �0 ArE p MAC a 200 Main Street,Hyannis MA 02601 Office: 508-862-4093 Robert W.Gatewood FAX: 508-778-2412 Conservation Administrator MINOR ACTIVITY REGISTRATION Property Owner Telephone number 7O 1120 i Iv T AW. Mailing address Project location Map/Parcel# I Project description The following minor activities will be reviewed,under Art.27,by Conservation staff instead of the Conservation Commission,as long as they are constructed at least 60' from a wetland resource area or top of a coastal bank. * Pathways 4' in width * Fencing that does not create a barrier to wildlife movement,6"above grade * Conversion of lawns to decks,sheds,or patios that are accessory to single family homes,as long as: -house existed prior to August 7,1996 -alteration within the buffer zone is less then 250 sq.feet. -sedimentation and erosion controls are used during construction * Stonewalls(this does not include stonewalls for retaining wall purposes,grading and/or fill) l3c•lc..D�i'L 7/z 1/(3 1 Signature Date Revie ed by Date _GIS Plan Attached(fee charged for plan) Q/WPFiles/Form/MinorAct -Apr 17 2007 6: 16PM HP LASERJET FAX p. 5 O� Z ram./38 ti cl� �� d L tD t �r' ai 5-�- (- °b l l� C ot ,1.4> eCIO 2=z5. _ Jai WE5'r 3r�2tJ5T�13L ,455. 1 GCTZTt^Y �S v13 L oG�-ria:v�; - x�,�r�: to-z�-sL �E{o w rt r4 n�o ri� H�Y.a2� IN c6l. .� 'MOO171 t•c. 24q ZO t`l t r _ J r�,�v. P 2�1�sL2 E7 �q, : Ja�.1�.1, t-Ia i.1cV CAPuT t x ,�-��ce�a�/ C�tTtFY, TH•4T _T6IE l3U�L�3��c1� :_, 5�O bV.t! O•V TN/�' �L pN 1 S L OG p YG�Z7 �� T'y.J� �.�oc�.va .a.3 Oslo w�v f-s��'�du✓. a •,�,:., �n cam cr79ir>�t"�r�9 0 teli.l4�'o�G-cEET'- .. � ILo�l'.' 3'1 l i l O J=' � �S bit• ' /ze -Poop•..� .. -----....�_ Board of Building Kegulations and S;anda�ils License or registration valid for individul use HOME IMPROVEMENT CONTRACTOR before•the expiration date. If found return to: Registration L.152773 Board of Building Regulations and Standards Expiratlori^ g/2g>2008 One.Ashburton Place Rm 1301 Type tDBAr` Boston,Ma.02108 J GROUP ' s R> DANIEL WOOD 38 EVELYN CIRCLE CENTERVILLE,MA 02632 _ -. Deputy Administrator Not valid without signature -------------- OTe -ea�r�nzoouvea/� o�✓�aaoacfucaafta _Y BOARD OF BUILDING REGULATIONS i I License: CONSTRUCTION SUPERVISOR f Numtie ~CS 062822 r 'Buthdate 0348/1965 i Expires 03/28/20�-(;)08 Tr. no: 14037?i - - Restricted:=1G' ��� ••i DANIEL C WOOD�M?ai� 38 EVELYN CIR CENTERVILLE, MA'"02632' Commisslorier j C i U u iA , N to o IA kin �N c � Q N ' Application to ®Y� ►iTCg'.q ioigbwap Regional 9�iotorit Aliotrict (committee In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS Application is hereby made, with four complete sets, 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: o CHECK CATEGORIES THAT APPLY: co C =-� 1. Exterior building construction: ❑ New ❑ Addition ❑ Alteration U Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ -' 3. Signs or Billboards: . ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign � . -X 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole &Other � ZIL .f D 60-9 TYPE OR PRINT LEGIBLY: DATE f0`7 ADDRESS OF PROPOSED WORK 70 rb/NT Y,// /a . ASSESSOR'S MAP NO. i3(0 OWNER ASSESSOR'S LOT NO. CAW HOME ADDRESS-�ZQ A-11 d2l 720. �1/-QI S Z3L� TELEPHONE NO. � G/7 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) AGENT OR CONTRACTOR ' TELEPHONE NO. ,�� ' /�•.�(��p ADDRESS �1/ LNiJ 6//96IC C�L'A/T2�ZI/IIIZr z22Z. DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. Signed Owner-Contractor-Agent Fqt-GOrnM1ttee.-Use-O.n.ly__ I I n I n 11 11 1l-:f I �- This Certificate is hereby Date j Approved/D ie 3 2007 JUL o ( Committee Members, Signatures: f Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOWS COLOR SIZE TRIM COLOR DOORS rn6�L'� //UQO� GZ, Qt_X- COLORS MAY'L-d SHUTTERS COLORS GUTTERS COLORS DECKS �CS J�/�I�- MATERIALS T GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS v SIGNS COLORS FENCE COLOR / ) ,� 2007 �1•! NOTES: Fill out completely, including measurements and materials/colors•-to be,useC! JL-.Four:copi of this form are required for submittal of an application, along with Four copies of the plot p1:'-,C aadscape plan and elevation plans, when applicable. . ^7/'`r SPECSHT Revised 11/98 J � v J 1 z i% E It�js � D JUL 0 2007 `� �,, f ' ! I t 1 1 ! i i S V ' r� 1 S Fes. U z , ®p�p+ ppy[��+�{1 qm rya .yt S/ ��y 11..1 \♦ !' 4. �r� tl�gCi Ij 4 0 _milli Q _ K l td r f c N S _ C9 r _ •r� w� � ";,7 •5 ?• - _ ©���®Q���Q�® r 1 ..r F �� 6�a�L,��;: i}'iF' Wit `` i� t-ll�lYi•�.F.. QIge�i��®� ,i � �5 ' \et' L'. r=^ ���m����y9:•e � j a�-+ail t• +' Mom ' .� d�'•! 9'�.��,d vin� C � i. w-Wiz:-w...1.•-...�::K�' _ `eta �tl� ��1�'L '210- r=nG} �`• +6•l�' l _ _" t .+ -, r4 @ h���l rL t° 0b� UP ia fig Jig _-- #' P r F r� -. "r F �' � r �-�-iJ }•� R 4 �1..'�!�$ �h.4 7r•�': ~� -ti¢'.�'a�att +•*I+'S,-"�'a �. t•t i 1 §� •k�,k�i w t l dt ��� n"fir".�t�� .r.,`tr;-fir"�••z�y¢�.��dt;r��r,�r�r � �i�: �: ® � ��j - :..ri.� \� � �. Y �"„�fr`r> "1_F p & r' iSt�•�Arc Y�ar 6¢,f, o; i$" ���y�ICr®9j }� �q Fri k.> ���,iF arn,:.?nA�.i��.a...:Ti:(:.Y� .pry f.,<...kr. .(a.....a�a :�F;'. �••+h I�i Ei r .�• ,�:�.• p.��; 6��71�1 le.f�.a` cc .c �-F Town of Barnstable *Permit# do? 5 Expires 6 months from issue date X-PRESS PERMIT Regulatory Services Fee c�S Thomas F.Geiler,Director JUL - 2 200t Building Division 3 p5 (Q . - ." Tom Perry,CBO, Building Commissioner �NN O' BARNSTABLE 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number / Irs 1�3 nI J Property Address O `�O/NT /Ti�/ 12C1. ZAA 6&4*1$/`2�1L6' .Residential Value of Work O 0� �� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address.yA thkv Contractor's Name / JFhj t�/lJrlh� �r/ ✓F' Telephone Number .�J 'E(ig' 6 -l"® Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Re e/(check box) e✓L f 7eLs!*r'& //�e''/c 7L=7� /i��/✓I 1�-!G `s C2'[9N/J /Y1i1c'lYI�cSX5� �/�C%/rT ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. i i ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 �C.�✓c�c'�`_ t� a ✓l/lcz�sfu�aetta registration valid for i /ze �ar�7n'ion�uea� License or reg 1 before the expiration date. if fou i Board of Building Regulations and$tandards� s ar Board of Building Regulation, 1 lugHOME IMPROVEMENT CONTRACTOR One Ashburton Place Rm Registration:_- 1527. 73 Boston,Ma•p2108 Expiratiorii`.912812008 ,c_Type: •DBA., GROUP DANIEL WOOD Not valid without signat J 38 EVELYN CIRCLE MA 02632 Deputy Administrator CENTERVILLE, i i f ��°F�►,E, y : Town of Barnstable Regulatory Services $ Thomas F.Geiler,Director �pIFDMA�p1�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,NIA 02601 w w.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize J 61g,6 Rio - .Z/frJ 1AVqoJ to act on my behalf, in all matters relative to.work authorized bythis building permit application for; (Address of Job) Signature of Owner Date Print Name I Q FORMS:OWNERPERMIS S ION ,per The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):e= 71� �iUOQ(� -Address: �Zyyt/ CCiZ'-Zf � ,�1�x-�/4 u; �' �� City/State/Zip: Phone.#: Are you an employer? Check the appropriate bog: -Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I * have hired the sub-contractors 6. El New construction . . employees(full and/or part-time). 2:R,I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an i employees and have workers' Y capacity.tY• $. 9. ❑Building addition comp, insurance. [No workers'comp.insurance required.] 5. We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11. Plumbing repairs or additions 3.❑ I am a homeowner doing all work ❑ g eP myselL [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' . 13.❑ Other comp. insurance required_] , *Any applicant that checks box#1 must also fin out the section below showing their workers'compensation policy information. t Homeowners who subffit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M ExpirationDate: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c "der the pains•and penalties of perjury that the information provided above is true and correct Si a e: Date: 7 � G Phone# ` 712 '3 to V-U 7flicialy. Do not write in this area,to be completed by city or townofficiaL Permit/License# ity(circle one): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal 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 bean 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 compl%arice with the in_c1rance 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 certificates) 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 workeis' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their Self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all-locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Depaj tment's address,telephone-and fax number:. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. 4 617-727-4900 ext 406 or 1-977-MASSAFE Revised 11-22-06 Fax 4 617-727-7749 www.mass.gov(dia 1 — Board of Building Regulations and Standar`ils HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use Re ' . before the expiration date. If found return to stration.-1527,73 Board of Building Regulations and Standards Expiration g/28�j2008 'One Ashburton Place Rm 1301 r e " Boston,Ma.02108 J GROUP DANIEL WOOD 38 EVELYN CIRCLE CENTERVILLE, MA 02632~L Deputy Administrator Not valid without signature Z ' �• � Assessor�s, ma and lot number • �'/' / Sewage Permit number ....l ............................................ r L House number BAHd9T�BtE Apo,NAM i639. ♦� 'F0 YPY f►` TOWN OF 'BARASTABLE BUILDIAG "INSPECTOR APPLICATION FOR PERMIT TO ....:C.onstruct a ' new residence Wood frame ' TYPE OF CONSTRUCTION ..................................................................................................................................... ti y. ......................-2 0.................19...8 2 •z a o TO THE INSPECTOR OF;BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Point Hill..=Jtd. & Holway Rd. Assessor' s 136/30 ...................................... ................................................................................................................................................ Proposed Use .....detached......ingl......family..dwelling.........................................................I......................... Zoning District RF West Barnstable .......................................................................Fire District .............................................................................. Name of Owner .John & Nancy Caputi .Address •Longmeadow, Mass . John B . Lebel Const. Co* , In°' Osterville`� `'1 `s. Nameof Builder' ......................................................'............Address ................................................................................... Nameof Architect Lebe....................................................................Address .................................................................................... Number of Rooms ........... 6....................:..................................Foundation ...Concrete..................................................... Exterior ... White Cedar Shingles Roofing .......••Red Cedar Shingles ........................... ..................... Floors Wood Interior ..............Sheetrock. . . . . ... .. . .. .. ....................................................... 0 Heating 'Hest...PumP......................:.............................:..Phumbirig':......2.:bathg.......................................................,.._ Fireplace ...Y..eS.......................................................................Approximate Cost A80.e.000...................................... ... 1st fl . 1 • 176•.... A Definitive Plan Approved by Planning Board ----------_____—-----------19______. Area Pao a re...........552.... \�E 2nd' fl.. 0648 V Diagram of Lot and Building with Dimensions Fee �"`�''}... �.s. ........ SUBJECT TO APPROVAL OF BOARD OF HEALTH //z. 00 Z49 � r l . • G b .. • 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. CAPUTI, JOHN & NANCY A=136=30 24776 12 Story No ................. Permit for .................................... dingle Family Dwelling ............................................................................... 7 Location ....................................................0 Point Hill Road............ West Barnstable ............................................................................... Owner .......J. ....&....Nan.cy. ....Ca.p.ut.i......... .. ....... . ....... .... .... . .... .. Type of Construction ....F.r.ame........................... .. ....... ............................................................................... Plot ............................ Lot ................................ February 2, 83 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 Lo 4 7,,,o � �4ssess or's map and lot number ...... ........� fin.• Y� lJ�c �*TN E t0 Sewage Permit number � •. ,,, 4i4`-tic 4L kSil 8v, > 33AW9TLUz House number M a� . .. i co w•a��' ON r1r, TOWN OF BARNST � C cZm BUILDING INSPECTOR APPLICATION FOR PERMIT TO ,...,Construct a new. residence TYPE OF CONSTRUCTION Wood frames' ....................8-2 0.................19...8 2 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Point Hill Rd. & Holway Rd. Assessor' s 136/30 ......................................................................................................................................:................................................ detached single family dwelling ProposedUse ............................................................................................................................................................................. RF West Barnstable ZoningDistrict. .......................................................................Fire District .............................................................................. Name of Owner John & Nancy Ca put i Address Longmeadow, Mass. .. John B. Lebel Const . Co. Inc. Osterville Mass. Nameof Builder .......................................................'............ Address .................................................................................... Name of Architect Lebel Address .................................................................................... Number of Rooms .................................................................Foundation ...Concrete...................................................... Exterior White Cedar Shingles ...Roofing .......,Red Cedar Shingles ................................................................................. ..... ............... Floors Wood Sheetrock .......................................0........................................Interior .................................................................................... g Heat Pum g 2 baths Heating ........................�?.......................................................Plumbin .................................................................................. Fireplace ...Y.a 5........................................................................Approximate Cost , 80 t 000.......................................... 1st fl. 1 , 1T6 Definitive Plan Approved by Planning Board -----------______-----------19_______. Area ...gara,ge.......,ob,52..... 2nd fl 48 Diagram of Lot and Building with Dimensions Fee --- ...... . * .A ....... ....... SUBJECT TO APPROVAL OF BOARD OF HEALTH V ACE)I fi ell OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree ree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. �,� 1�z - ,*--APUTI, JOHN & NANCY 24776 1-1-2 Story No ................. Permit for .................................... '8ingle Family Dwelling ............................................................................... Location ...7.0....Point...Hi.1.1...Road ..... .. . ....... .... ..... .. .. .....*.11-1-11", Z, C cJ West Barnstable 0 ............................................................................... Q) C C 1c, 1C. G John t Nancy Caputi L r- Ic C, Owner .................................................................. Type of Construction ..............Frame............................ ................................................................................ Plot ............................ Lot ................................ 0 0 0 d-! February 2i., C 83 z; Permit Granted ............................... ....4.19 Date of Inspection .................................... Z, Date Completed ....... ��O 19 ........... .. H CC. CL) 0 0 Z_ C b 0) L7 C, C L In is V. �F r • "��o� TOWN OF BARNSTABLE :I77� �r . . Permit No. -------------------------- Building Inspector 2AM"AU : Cash ,639 ` --- --- -- �0Y"y� OCCUPANCY PERMIT Bond -------______ Issued to irlul ,,ICY Caouti Address 7Z) .'Gi ut Hill Road, ,,mt Barnstable Wiring Inspector f �r Inspection date Plumbing Inspector r �w Inspection date Gas Inspector Inspection date ;�Engineering Department Inspection date' •- Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ................................................... 1 19......_._ ................................................_..........................................................._._ Building Inspector FROM -� TOWN OF BARNSTABLE W. Francis Lahteine BUILDING DEPARTMENT Cler'k���Y•.�'�x �����- yam«"'Y�''"'�� y" A'lIV Tum STREET H.YANNIS, MA 02601 -•e.s�..y r�+B�v9�i.;..,ss n..rar�.s•a.o.t,^.a.ar4��s Phone: 775-1.120 . L SUBJECT: FOLDMERE DATE - January 21, 1985 ..a.�Y,:.�. -, ...•. kESSAGE Work has been P cQl tied c=1er Buildincr Pennit #24776 (Joh µ&Nar= Ca n?t )p Please release Bond. aM'A.+eyc9!'ndr:c•s•+Na B•m+er.r-s.�yrq I Eh DATE - REPLY •SIGNED Ne7-RMI ' - ' y!RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY • PRINTED IN U.S.A. SENDER'..SNAP OUT YELLOW COPY"ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT: .w �� " ►�. TOWN OF BARNSTABLE r Permit No. ------------------------- N Building Inspector case -----------__--- �`°""��' OCCUPANCY PERMIT Bond Issued to . cy-ul "lancy C r'`1I Address Wiring Inspector (`� /t. ,- _ Inspection date Plumbing Inspector �i_ Inspection date Gas Inspector .� Inspection date Engineering Department 1 _ Inspection date' Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ................................:?.............�. , 19..':.... ..........::..........:..........:�*:.. ............-............................._..........._ Building Inspector I I-o r 14� a 'G l�? V - O j 4z,:i J u Lc -T- od 35,g 405f tob Z v v' V.o L ASV. WEsr j Loc•4Tio.v , �1s-r�,►3L�� tv�55 r P4C,T> Irt a TNgT TLIE BUJ/LZ�/.Vy `-45AV OH/.c/ CM-1 -7/-,I/S PL i.V /S LOCAE'7^ a OAV �!E ��B4�f✓.c/D� fiS�sNCYVN NE:G6G71�/.,� _. _ .w .._ pc ���tli Of ARNEH. U � N I OJALA N wn j cr�9�necrir�y f26348 G47�yp scitV�Yoea I o�Z(o_gz- c{ t. E 6A ou7-s-11,�MWSS ^afara