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0085 FAIRHAVEN LANE
r �� �i t G���. /'� .�'�r�rt��' �,,�ka�j� ��,i�� i ..� 1 o 1 y e (11 5 1 ..r...su.�.,a�r..n ..�..� -. _...m..ln. .,i�.._w� _.,�sn'�...+..'w!„1<ad'�fa. ./tvYJ� - ,....f+++� -�... ►".+•f"� .w..�..r�+�. .. ..�r�,w�4w_�. _:_:='�� J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t (, �' b :,: ',.Permit# Map Parcel �.� � , Health Division 7 Date Issued ` �0 Fr.32-. Conservation Division 2 2s 0 Application Tax Collector C-9 /C Zf��-�fJ 40 - _ Permit Fee e;�O.e� Treasurer C, TIC SYSTEM-MU.ST BE Planning Dept. it STALLED IN COUPUANCS VM TITLE 5 Date Definitive Plan Approved by Planning Board , ®t�ME�9TAL CODE AND Historic-OKH Preservation/Hyannis TOWN REDUL!VFI0 N3 Project Street Address C�3 �i�l�t i9(JP-/l� �`°4A) Village /11j/4`,gsTo vos M ILA Owner To 6 , T-o z-Z o Address Telephone 9 35 15 Permit Request _1 n9S l f� 1 G'V_3�9 / IV Q 4 6 OAS S U-)(lnl Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation AQ,0 00• ed Construction Type S7TCC L yJ A LL, vl rV V� Lj OeD Lot Size (M l I S 4 rr7 Grandfathered: Cl Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family tl Two Family O Multi-Family(#units) Age of Existing Structure g Historic House: Cl Yes $4 No On Old King's Highway: ❑Yes a(No Basement Type: (�Full Cl Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 7 S Number of Baths: Full: existing a new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing 7? new First Floor Room Count 3 Heat Type and Fuel: ( Gas ❑Oil ❑ Electric ❑Other Central Air: * Yes O No Fireplaces: Existing I New Existing wood/coal stove: O Yes �'No Detached garage:O existing ❑new size Pool: O existing 'A new size 41*�-37-Barn:O existing Cl new size Attached garagef4 existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial O Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION NameT(c4q.41-o Yew 0.5,�-/ Telephone Number 5w " Address 3 y13 MAJA) si License# O O R f- 3 5 Home Improvement Contractor# /Z% 0 a 9 Worker's Compensation# 4k,70055?5-01 A00-9 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE ( ' 0 / s FOR OFFICIAL USE ONLY PERMIT NO. } DATE ISSUED 3 MAP/PARCEL NO. ADDRESS VILLAGE OWNER k , DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING e q, { DATE CLOSED OUT ASSOCIATION PLAN NO. _ The Commonwealth of Massachusetts M - =- Department of Industrial Accidents Office oUoyesmadvas t. 600 Washington Street -= Boston,Mass. 02111 Workers' Cam ensation Insurance Affidavit name P.1 CA4/L.b V 6N V i location: 95 FAt2/4404J city WlA-/L�1��5 l�!5 phone# 52 3��- 9 7 �1 ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one worku in ca achy I am an em ItJyer rounding workers' compensation for mp employees working on this job. •K•:,., ;,;.•} t.:3• alai) z+}}y •.};�.w..xha: 4}g}:z2}2>YY}±rx 2;\,Yt's;?C�tiC+y {if Ty ^±=•t•:t•:+:... ..fr;i 4f}y+.:: .:.�:FvE..:.: ?..x•..,... .......�.... .. 9. vry•.v v:•.v:tt•:.vn v.:x••nvY::::fr•:?v=}}Y?^x; .S...�:a�^.,.;.,?n'fin 4 , ....vn.....nfi i:.....;V:v4? { y ,y;,v, :+) :a: ...L:.,. .:w•.,......y .,,L...,"'S,.. .:'S:.«..... y.C+.»t•::y}:;:;5:?.?}{t4}.2•}:•:.r:}:?wa:•f}:Y.y�.r•. .�.... k�•:;r�: ' ::•..at;^.r....f... .a..,..;r.;:..::+ :r .. .^.,..r?. ?•. n:..v}::.:::v.•.... t3}.....{.....n.r.. b h}4:v}... .n..... .: .vn.ft. ... ..vv:vw::v a::•:r:::`!:v'2;?:{•.,v.v:}}r::.}T::::: ^:v:r.]:v}.'•`:?{9••..... .S..r ....,...» ::4:;:•z. .....»+ r .#~•::J,.4.�L:•yiA:.yrr.y: :: '.::•:.:.y:••:.:n. }...... 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't .. :x5}:aitii�''.•ifi::: .....v......:...nyx}...:..:�., r!+.v. :%':•Y....: -.n}+:::•+ ..nn...v.:vx,?:^}....:...:::::: .r n:w.v. . :.>:.n3;rf ,i..r$,r.nf,yt,.r,.tL+.}x•+.t,:•?••:La.:::ny:.y•:+:.r.yA:•r;,.:.......::.:, ,;,.•.,;.}x :inaasat�ce'�a: :'{:n.:C:.�:rr::�..,:,:xAr:2..:,y:?;,..• .:...,....... ,y.:,:.•,. ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the followin workers' compensation polices: xa� n. pp \Y:rhK{.x,};t,y :; :^• , r,c+'.C':Q',''£hd:.;?:oV{ .... ... ..4 ... .. .;,y,. ::•n,•.....•t:n}•r.t•:.,•:r:::•::+++:•}Yty. „•:r„•{{:::{::;•}:r::+5:• .•:5]} ..t....r. .:;G'�2...r:} 2}'•hkx....3:y}?.: ..,4:::$:\Y•::;?y:.h`... y.Ya,L{:;iL^<.f%,..,.rN,:•.y:r:.,v. ,.»., n,nr + ........ r.t:., ,•...::.y..,. ..»,•J+:.,....r.rr.,ua .a?rz•.....4K4T.:..,^. ....::ia:!S3:•::t........:•.:r::::a:•;;.;.n..n::y.....:::•.y.::r:^}n......rv.+i^:a:2,.n ..:x•.v:C.v::•:•.'n E. v, +!�\;:}i}:2•fyi.:..::•:•:•.t•:........ ........ .. ..{... r ......:}r.............r.....r:.:•}::+rr:. ...,... n......{.....r:.:•:•..r..n.r..,.....•3' 2. ..;r•:+5•.,:..:.. :.{ ...{......k:.r♦:...;.,..,.r.,h. ...]......t......... 3'?S i+y }.\,}. +•,{.. n{{v•4•• •.vV:?.:n:v v:yx.):n.::.ar::+::.••::.:.. ..>.:. ..A::{r.;{?% .:4: n.2'.•4v;., v^.., r.....v.:...... n: ,{:?:••,?>:>:r.Y;•}:{{}:?.:.n.»'• ..... ..$..{.,. ::n•}:•::.v ,t.h...:::x.:».;••:).•A' +�?•'•'}i2�}�i:.( } .. } S:) ,r:fi„a. •+•E:nYr,a:..%T3:.t...{iy.x ...{>Tx:{:{....•..:. ,.t ty. .:.t.r.....::.::ny• .nl,.;,. y{.T`:;;}YL';ft, :k C.a'....,.,.•C:'4K\ ....y::. ..f. .r'L.:y.... r..y.n�..C•.,,....ti.. r.:r.., ,.:::]}:'•:^•::f .{ x•:?5}>}:....... .... ....v.•:..:F...v:.......y}:.yfA.t:'•+fi{$.. ... .t. >•yyr,.». .r..,:,•4r ..r. .....ay...... .n•. ..,r.L:::•r. ..,...fi,.....T,...:..::••.>..,t..... y...,:.....$........y•::.......... ....n.. 22 :{::2:+::r.:??r.}:.}Y]•id•:{C•.y:ficx•G:{t{}•t:?�.;f^:•:,.,2•::+r >]f%r� ti ,.]C, ...t.:t. .{a.}Fr:+,'vK,•::z::.. .}.,.... ,..5.,,.d... .:zx• r ��.,v A}:•ti:.:?n••; •.fy;:.: :+.?.t•.,t, yt,.:., h:;• �ti,+,;.,.k'.2. •r.a+ r2r:• 4. .:+.:n:.::a.},'?2•YY•,?•.. •.•r;::{ff}xtt•Yx•• t.. ^•;2;` .). r}r. : {„2%r+}::•+ix�•+.y.., •};ta2'4}r....,. 5::•r+ :. rn• :ti5.•{.�..r:•>]}:•.!r;S: .}C+. :w „o.•r.<y: •SJ ,{a'LaY;•t+,::;:L ..x:.r b.•L2•,•:•L•4 . ,+f:+.• {•.!ay:�. 4r.4: .:t.n .Y..... t�L .£ . ..a.•fti;�L;A2 •.,2, At:.:Sr..... ..f,r....',.✓} - ?y::♦• :r»,:,hhU,.,, r... v i:'+:•...$4: Y ..^t. t. 2�L.2,;3.:,fi.•9E% ,..rfat :••:4•:,y�•:+•rf�,2�{F::.\,..}...}zt•:C4.K•`r�rr.R}.2:}.:•.a4a::..u?..•:::,+r.:.iy:•'E:`-5:ii>.,. :,,;4i?•f}ff r. ,,:•Y•.}.,S.:rt •n•:..• r x,+•. r hK.•:.. ,....*!t4`•. #2?$}:y:}%ri•::::?>..:::L�:.,•Yr:,•.y:n+.•,.y::n•:..y:..... .. r .::{. all name Y 2 t iy '4+ .•t• �f'z:: ' tOIrip V' a ..� t�i ft) K.aJ rT k X' }Ct„+f%K?•:' M \.:x'+Sr:• f .;t...r. 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O��"f/►:4y / runraacg:ce:�i:;y::::d,fn»v;.;�V•2.}K::sKwfx4.?a+,.}4,:y:A..t,.,S:y...,a:«v::J,K4x2i x:.,♦!:y.. ti YY:?�•`.t:Lxt4'3;] ^{:;9::,y}:,. x:{..;}:,.,, .:.,}., 32,.:....... Nis Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fire up to$1,500.00 and/or one years'imprisonment as well as Civil penalties the form of a STOP WORK ORDER and a fine of S100.00 a day against me: I understand that a COPY of this statement maybe forward to the ce of Investigations of the DIA for coverage verification 1 do hereby c under e p and allies of perjury that the information provided above is trw and correct. Date _� L' L/ SigrJature . - - Pfmtname lL��2l> Phone# official we only do not write in this area to be completed by city or town ofHdal City or town: permittlicense# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office _ ❑$ealth.Department contactperson: phone#; ��0r - (mi+ed 9195 PJA) c Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 section 25 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,neitherthe 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. s, Applicants please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,�address and phone numbers along with a certificate-of insurance as all affidavits maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and tk date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is . being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. IN City or Towns 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 pi number which will be used as a reference number. The affidavits may be retained to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. 'The Departiineat's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 0mce 01 invesugations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 . �oF ,E, y Town of Barnstable P.� Regulatory Services anxxsTaace. Thomas F.Geiler,Director y suss $ �prfD MP. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME nAYROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION e "reconstruction,alterations renovation,repair,modernization,conversion, MGL c. 142A requires that the r n, � p 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: . Gq 4 PEstimated Cost � pis }-0'J-1 �-(��✓ �—�¢•al�. Address.of Work: 2n Owner's Name: 1 0 re2 U Z Z 0 Date of Application: D I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law ❑Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME RVIPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 0-6 00 9 Date Contractor Name Regnstration No. OR Date Owner's Name f �oFT►+e ra,, Town of Barnstable ti Regulatory Services aaFuMAM vsznste Thomas F.Geiler,Director 9�ArF ►��� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 t Property Owner Must Complete and Sign This Section If Using A Builder I• 0 l,lii eb-(2U ZZ ,as.O i ner of the subject property hereby authorize 1 C A 1� Servo to act on my behalf,. in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date J)ON J?E72\A ZzJ _ Print Name Q:FORMS:OWNERPERMISSION waD -■r.•esrMM.w+irai uoo.awa�v.■a a.w.. ll^^ _ Jii•aw.aew stti — HIf O.in R'..01D 9f6.B,'M 111NMWI �Yl Mb OWN rrm q � i � � TM-wtomoMax wrn `� •L M t�tPIM _ .1.N a NALN ; bi 1 !�Q tMICIa. as whin aMe _j i t-w o awin"e.MM'il _r MAW r" Lomax MAlu VLOW T . Z e 'lam„M 1 OCTA[3�NFAla C „� wo @ 6'MMP a1 .�9w1k9dD � 1-- 4....- _i MeY r► .Own iC to Yyn v sraro. �I✓ .A( 1 p�J \ �\ f'14 N�� !l i VI. Y aavraaaeaa �N��j-_ y M. 6 awt r law ffPYlP �! I\ r M Low"orlk t V — r t SERIES tQAO ®low_Q R90FR� SEIq 700 e3' L5 TOO 5$!A f7t� yam 1 M"W"'f�. (r oA�M Mt e r VIA r L� •tacMo j e t va`?s Il cam am UK caw.Data ur- - •#iYc. •'r^ fl� -•��M N�Mf 71QI am mow. z 1•Yi Mi�l� •1 °1..P'°'"-°"; o=�: 1 pp yy lJNllMM O/! EMire•L 1RMrt. )) MiO MII�aRQL '� e���� • ra� •a61 91M1L1M --' --�-- • 1171.4M CIMMM CJ '� OM1C. C�MwIIMIr1K CM f1'aXW. M�67M wi°ea�n� :orrrMOOOwt�"t»� �°a�a rrariu. i � w'o a M' tM as waEL MMo 05 6OO 8 p� STA�Z rMMdl�9 _,_ GMR/Z SwT]M Y -1 ---1 I OS® ansaxaQr Motto toM rows m r`W!prQ_� ft.�mrr. 1 vnMOrrsw`ei t"" 4 ` M Pam a lau MwMMt rydNL s woo"LONOW O w.asYiw,1•a �Q �r+c m'�i.�ia"a'.r�MN are— "-� 'A s'wir'n ion ( w ,.. \\ iMew�Ut'Oa sVllt sM +Mrr�a,aaw wmr.s arnr.aw waiwa. WwV +" u�u'�Mo �"a r. "w►o'°ArO "� rme4'1 iSi�"iit 1 v °� IMr°ii o a'�q�`ia�i a�i4i arw7N�' 9XM a ions _._� ._ .. -• itr M�t r n ^q�p amour.aMr veer w uw t•qM a1M �� �--�•- -r',-••� m�-.^. ' a a M►wrMe�M raw Mor mow. lMgPlM,,,ltm t90 w laor. d :...k'...� .-�t e•I /s••�w Z..1G °►.uw�tua�'ar a°+'m.m. a w am ar ae�`�s°r uoa tMr �`n mow ri 1 f r nXvpt+o weal N6.M.w NEW VAM M!f- wIWN ww"M a aeuva.Drat MMa ns.�awrs sxae•e s m rnrr rw4ts•r �Mti M•A Q••u aival^.`. J, 1.A--1 M•,`jiiirb+asY1° u+Maa•-w.a+aaaw Q0'�s"'r $Lw `�a i��i°�o ora�a�n ce�wtr. _ ..—._.._...._—- TYl'»I., M7gEt1 .Ir7VN_ rV1'r_lL Y/0LL 5 a•-a•irArsaa•�±ma.. .. r,twr rMr au. raaa'w uaw�.••�twn auwm wnwaa rw�e+'S w wruarr wa.a as FOF2 2!4 A7 7rPL1, PAfr»L TYP?KA 1M11 L SEG'lYi47 'A—i`!il��+E� . •••• "'m yp•1�o p1 Y1m•I Ilti M 4 Ma4i1I• ��i �— 'T s•1 ROP w�w�rw•. M� fM iy� � I1 ! - M7 r< LN •,gip°•y!� � � 1D w ) .7 ERE S'1� SERIES 850,350 S tOBO_STAIR CORIER._� C� � SERIES 650 650S7A � •dd - - ► -� ►— --►-- --+ � 'S S P •� � 'tuns V- -�' t ran "►----� - - --►--- --� .sear ftl I s •piwrr�ev r.rac T E I 3.«.� a fYpt I •t ns � \lFFll Y� 1 � � �iw�•,•s "I • s ' N 1 r1 m - m ? art 5 sm>r�om.-ewe ra.•e�were�a•rew anus eaa.w�..+., -► ----►--- - - `1 R 2100 A hW-K;ROUND_ a®snow r.r®as orr•�oa at swP ,�_ —.,� y yaw �soar•Mt.UP ' 1 T e'er _ SEWS 2000.A AqU INORWOR i •nre "SUMBLY SHOWN oea.m �eepr K�ssr vr•�rru n►1•.�.w AL10•K11B�L"elO M IfJ lMMltMfl-bpv7O ow-..p. aeA■cq►a7aa art.us 5E�69 210flB21d0 NBROUMD ,:r I i,1', .. ; . . ,•,t.r ,�;,4,tN:-:?h:'t�:ax,•s�:�:,l�ry'•�,1�.�.�: ;<-:•�'';.. : pIP19 FA/RHA1lEN FOR/V Q : 4 := VJ nE '� •T,;;:, �;�',:e•w: ttoA x.: iw xt -'BONE RF. •: 3 60 SF,* :' ,'�•.,... a.., <... ,✓Lip F "Aiw u .30�IVS FT. ACAS CON 0NOTE.. •�' ASSUMED LOT c' • ,y; .�.. : ., '''�'" :.,y,,. ,• . . PROTEC TION PEI %3754%: ART. M SECT37j .11 ,y •`' B YL W OF. CERTIFIED PLOT PLAN o .aoe�rr LOT V MARSTONS MILLS 80ALE, I =40" DATE15 20-86 •I:CERTIFY' THAT THE i CLlN!' •I40MI+! ®N TH!'S P IS toCATI Lo1STERE R 0131 140 ON'. T!!9 $ROUND AS INDIC+�TEO AN! �a.;.Mo► Cds CIVIL 'LAND ,' CoI�IFORMS Tq THE 20NIN9 LANES FI,'; EH INEER URVEYOR OR,IIY��: :�SG : OPP '.SARNSTAdLE, CAB T12 MAIN 'STRE+ET :;."' ;. ClLsvt,�, I.AlN4 8UlRVE1/ow HYA N sal I S, MASS.. SlbERT:.,.O �... DA Z.- . RES. .'......._.. .-. .,.. ...... ._. . rv ;t.�`•.AISirI�)b i.t��.: .:,..� 77 ma•._:..a �- - JtFit41�411�r��I 's'! �79tf � LN U NOTICE NOTICE ,I,® TO EMPLOYEES EMPLOYEES !� !!a I' The Commonwealth ®f Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED INDUSTRIES OF MASSACHUSETTS MUTUAL INSURANCE COMPANY NAME OF INSURANCE COMPANY 11 NORTH AVENUE P.O. BOX 4070 BURLINGTON MA 01803-0970 ADDRESS OF INSURANCE COMPANY AWC 7005575012003 001 11/17/2003 - 11/17/2004 POLICY NUMBER EFFECTIVE DATES PO Box 1013 United insurance Agency Inc Buzzards Bay, MA 02532 (508)759-6595 NAME OF INSURANCE AGENT ADDRESS PHONE Richard T Senoski 3413 Main Street Barnstable, MA 02630-1234 EMPLOYER ADDRESS 11/12/2003 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREA The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physicians. The reasonable cost of the services provided by.the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the:work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO DE POSTED BY EMPLOYER a •, . . a • ✓�ie Toanvrnooxufea.`b�t a�./�aaacic�zuaetla BOARD OF B-UILDING REGIULATIMNS License: CONSTRUCTION SUPERVISOR NumbeL.C,S 009635 Birfhda_tid, 7(2i y 1.953 � , {i ExpUr. 07/26f10b5 Tr.no: 1201 l,r r _ .F,r, RICHARD T SENOSI� 3413,MAI'N ST BARNSTABLE, MA M30�` Adminisf'rator Board of Buililing Regulations and Standards. HOME MOVEMENT CONTRACTOR -_—_—� i Registra:ion:=1D6009 =gin N;EzPf: ion-7/-A2004; ice-l- 0_iwdual . RICHARD T.SEN"S._I Richard Serioski . 3415 MAIN ST. G.L. i BARNSTABLE,MA 0263.0 ` Administrator - >� ..The Town of Barnstable Department of Hehlth Safety axed £nvirown- ental.Services BuildingDivision 367 Main Street,Hyannis,MA 02601 , 8-862-4038 18.790.6230 PLAN REVIEW twner. ���rttizZp Map/Parcel• 1'48 15 Q 1 roject Address: a S Fa-i r Ly Zti Builder. 5'e Vl a s k Che following items were noted on reviewing: b S 4sm - cs �1slmJA �� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION AVlap q Parcel Permit# • , ..r zA yS7r^,BLE Health Division _ 2 03 S` °�� � Gl Date Issued 6'.7 03 Conservation Division /a-7 ^S`a i„v, �' ' '`' j�'3 ;: i Application Fee p b Tax Collector— �� 0 k— �_A d Permit Fee lSl�i� Treasurer_ 8011C SYSM musT 19E Planning Dept. 11 048MIM IN compumv! ONIITf„TITLE 5 Date Definitive Plan Approved by Planning Board EnMRONMENTAL.CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address & r410':ZA0 L eV Village / " A 1 -- /Fly� &,,I LLY l�-"���Owner �D 94 I� �" S/J4V�/� /�C� Address ��i A N6 kF lil 1_,(V. Telephone c'D 1? ,S 1-2 37 Permit Request 1300 P20YV P �-M a rV ® 5 I�� C-;e�� 51J � x gyp , Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 51Tyi2 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: Cl Yes ❑ No Basement Type: ❑Full ❑Crawl ❑Walkout Cl Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing Z new Half: existing new Number of Bedrooms: existing %3 new _ Total Room Count(not including baths): existing new First Floor Room Count r Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use -�* MH P BUILDER INFORMATION y r Name OFle/ZV z� bw��� Telephone Number 20 3J�� Address � �/3 l A W 0u� N 1 License# 3 1 � Q g IQ AS M J LC.�S Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE S-9 9-a3 a f FOR OFFICIAL USE ONLY A PERMIT NO. DATEISSUED MAP/PARCEL NO. r ADDRESS VILLAGE OWNER 6 s DATE OF INSPECTION: FOUNDATION u8'0731 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH,._ FINAL y GAS: ROUGH FINAL FINAL BUILDING 4 �a :OY. � — ; ate• ._ � µ, DATE CLOSED OUT ; _ ASSOCIATION k`�N.NO. r — � 1 The Commonwealth of Massachusetts - Department of Industrial Accidents ` "-- Office of/nsestigatfons . - _ : 600 Washington Street Boston,Mass. 02111 Workers' C xisation Insurance Affidavit name: Pr--ra bl z,2,t location _��►21J� re/ ci lA 1�J / f ✓.S LLS hone# J w v z O 3SI5 I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one wor=ldn in ca achy %/ //%%% �/O%O//////% aI am an employer providing workers' compensation for my employees working on this job.... . :•::rA: r.:r::::: .......................,.::::. 't;84.,+.?e $± 'i.'i> 'asp < . .....` 'I. 'tic > c #i i<` 'i%asc i% . 'i i i?i j >%' S '' i't?Y`' S �'` <? it 'ai'^i f" :rom an >n m �ilttit >::: p :.:.......:..:.....:::.........:.......................:::...:..:. :Cl S$Y$$:{{:;:?+;: ::::"':`$$i:i`v$:!4$:i$:?:$$$$i ''iv:it?•$':;$:v$:}; ''i ::};•:j•?:i•?:!$;??.:;i:;}:r:•?:$$:;$:i:$$::::i:$$$$$ ?$$i::?vv:$$$::$+::isv::ii$}$iiv:$?:+.!}J:?:::isv:ii:::;:i:t:::i?':j::'r$$i:yii%ii$$}:;.?:•?:j;:$;i:;;: .......... ... ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have workers co ensatlo n ohces: the following ..............�.....................................:.........................................::...:::.::::::::.....:.........................................:......,.,.......,.;,:..;. . . : om an.::nam .......:::::.....................::::.............................................:::.:. $$ ;:; ......i....i:'^$$?;:i$$$$:::!i;:;:;:yri$':i$:!:$!i:'?vy: : v$':$$$.....IL.?.... ........................ •i?}}:?•}}:v}?;•}i?}?i:4?}}:•??:•>::$}:;i?:$$:•:4$:j$?:i:i: :;: .. ..... .::}::}::...:................} ::'.{$j }'•:Y;;}v:}:;{•} ::. ...::...::....�:::: ...... ......... :::.::::::•: .. ....: : .........::::... x::::+•: ...5.....::?v??!•:?+{{•:4'4;{:•:C$$i •a4itiesss:::::::::;:::::::::>;::::'• :?:'::::::::::>: 2;::: :::;`:;:;:;i:;:'::;:::::::::: ;::;:;:::':::;:;:;<5::;:$:{:: :;::%:$:;:::::$:'t::o$:::'t:$::i::$$:::% } .:ii a:•: .., $$}j$$$`•ii'?ice^'v>v::,.r:i$$$ ::::.:::•:::•:??::4?}:•:........4$?::$:4$::{:$$i$�:$$$$:::;:$S$:•is:•'t:>$$$:�:5;.'${$$$$:$$:�:C$ii$$iii::::$$i$:Si:$$:$:>$%�:;+9:$$$i$$$'::::::$S{$i$$�:�$::$::$$$$${'.?}:•?�::: .��:•?:?;•}:•;:,$?;r:$x:iii$:'$ii:::':.:i5$::::4::y{4}:?$:{•}:•>:•?.•}:%:$.^::$::;•`.: ....:..:.............:::...:.:r::..:..;.;......r:........................:..?::..;...::.,. ?'4 , {:;:;;>$}'^$:::`�:•':''''•'yv.':::'4.i}�{?ii:ri<::iv:$:Y?Li`�' n. ..4...............v.... .............:............ ,............ ...........:............::�•.:::::v::::.}?ii}:::.: >.4. .:.... .,1:,•.. .k..>••:.v w:n....................:::r:.........r... ......................::::•::::.........................•:.::::?,•:::::;:...,•:. r::........ ......:•.•.x::..................r..,....... Cs..}?y..:.. ..................:...................:f....n.... ......... .-...:. :w::w::::; �{ .....w:. vn•..::...................................4......t......n...f.v •:.: ............... {.;...:.............:.........,.,....n.........................n............ �'.�iMi:::%t%::Iv:{:i$>:}?y}:4:i?:n�:::::::::: ?:.x:::::: �:•n•:. ::v:.�:.�??4i:•i:•?:?4?:;•is4:{i{?.? }}?}::i:il:$:!};•?vv}:::i)::;j::4ii$:i:$i$}:::::<:i>:?::::? � .....-........... ..... :ltr�nranee•:co ............... . rMERNME :.:;•;:.y:.. ; :::+;':`;?«;:E':.'::;:` ':%:y:'::::$':::%``::: ''?:::::: : ` ?` ::::%; :%::: :::::%Y�%:;:::::i.`;:'::%'::;:: :k :^::i:: �:;::::;:�: C:d "''[.............. .... 's [ ."'''` r it%i'`i i i v%i 2i%iy% a? i i Si isi>i'j%i i['`%i' i ii iji• ''i i(iii£[i? i iY ifi': i a:'i :>`:`''•i:i 'ii :?: ?i b� a ..4.. �iri�irir>Y li Failure to secure coverage as required under Seaton 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Ste of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby ce fy nder t hed penalties of perjury that the information provided above is true and correct Si tune4 Date ��'�� y ' Print name c b 13 W PE-7 zw Phone# cbk V o?D 33 J official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Departrnent contact person: phone#; ❑Other I (revised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 section 25 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,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 in the workers'.compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law'or if you are required to obtain'a workers' compensation policy,please call the Department at the number listed below. City or Towns 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 regazdmg the applicant Please be sure to fill in the peiinit/license number which will lie used as a reference number. The affidavits may be returned tr the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a'call. r The Department's address,telephone and fax number: The Commonwealth Of Massachusetts .Department of Industrial Accidents Office of investigatfons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 °FINE, Town of Barnstable ti Regulatory Services BARDISTAHLE. Thomas F.Geiler,Director r►r�ss. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 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: N010 ' SIJ�,Q Estimated Cost C56 0 0 Address of Work: 61J i(2 ,ov'W fin/ aV AV Y9-i1 ow-f Q 1 LLf_ Owner's Name: LTOO(V Date of Application: Jr- 2-7 03 I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law ❑Job Under$1,000 ✓[0 uilding 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: Date Contractor Name Registration No. �:Z-7 03 /a P/ . Date Owner Name The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: � ` 2-7 - J 3 ,,�� JOB LOCATION: 1 c5 ��I�� �� A r�'P(25—fo � ln)L� number street village "HOMEOWNER V D I W PE 1 2-ZD j"4 YZ° 3sl,�_ S'OZT 39Y Oor name 1 home phone# -work phone# CURRENT MAILING ADDRESS: F412/OoLL Ely W /Y�►�r2 si QL/� /)/)i U—s /viv° 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 proced e d re nts. Signa a of 110ineowner 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 pemvt 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. i 14 PRI� FA/RNAVEN z L RI IfE �/p VS/1 DE S 18 28 :36. :E :� � } 137Sp J -77 4. 36 _. �l .3�. >.:.; ZONE RF. 6 �9.g, - _. . 150 FROM .r TA GE O � a� O .r . .:... . . . , > .. 30Z15 /5 F T. SET�ACKS NOT LOT 6 �. E: 2011/-+.' ASSUMED LOT PROTEC i ION PEI 137.54 ART lY SEC T.12 N .. 17000�'37�� W -�E. Tn1�VN BYLAWS . of CERTIFIED PLOT PLAN /r R08EP(T LOT. 6, FA IRNAVEN DRIVE 8. - MARSTONS MILLS 73 ELDREDGE t o. 18367` ,u IN �Cf,,TE i SCALE, / =40 ", DATE 15 20-86 GEE 0/ EE INQ N I CERTIFY THAT THE FOUNDATIC CLIENT SNOWN ON THIS PLAN 19 LOCATE EGIBTERED REGISTERED JOB.N0 1.11 ON . THE GROUND AS INDICATED ANI Cl IL LGINEER 8URVE OR pR�dYij�,�, _ CONFORMS Tq THE ZONING LAWS Of AARNSTAOLE , MA8 712 MAIN S T R E.ET CN.aY�-, i HYA N R I S, MASS.. SHEET f OF.L pA �.' REG. LAND. SURVEYOR i i El 1:1 MINO i6�i iSam i��0 h�w ��{mow; ■ --1�::=1111D�DUDI�DIl�iil�li����fQlii:ll�I�il� �f , �1��il.�..�liii�l�lt�"��;����II��i� lilf��1� iii�l�liiii ■ i�i ioi ii ■i i�©tit] ■�iiiiill iii ® - �; F� ■i VIMf G ! A '2iA1(> t ' ou + I I + i o I pIC ..�- � Z.. Zo ! 1 ! I �-1 i I !�Y-. 1 � ' j � !••-�---�-tom._ �.�-. i ! 4 �I i '• � I I - I ' � I t--'-T-t--;- 7-r- --r---^- III ..... IF { j I I I I I + !! I •it -7 fill I I i j ~I �! I f j+i I i I � ; � ' �1� i I !� � � jl I �I I 1 .-._'-•�•-'--r•_--. t� . ? I � I , , ter=-fir-_^ t -�--e---• { i , ;• { -fir--� 1 � + i ! ' ! + I if I I jam-��-� , , , i '--�-� ----- �•---�-=- ' � t ! � •-_ '. i 1 (o 1 p lie I Z. it A I IL liv.!.!- ! i 1 t j I i + ' I 1 i 1 1 � , � I -i I I � i I I i ► , I + i i '• { I 1 1 I { t I AI1—y►Wbor� ` "—! Wig t>_1 . I jT U! t !I i I S f�t �R; v,4 13 I I ii ff ` G R _ � R A I Ll L 517 o tN slrn I -- ti`^:-"-_"^-_T- I j t-!•^-_ -- r-mot-` r-�, -• A"WMt ';I FIR Y- 1 I � ;r2 R 1i fZ L j I j + 12a-r i Ste' c� M L t i �\1 Y ' V ( pi , II ( � � 1 � I � I I � � ' � �— • �--- i 1 i I 1 i I i t TV I 4 zl j I O i 5 dub i I `� N �'� ' I i - i , i Swav� ^{p n j,�3 o,a?! a►:{� ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0A Parcel 01 Permit# Health Division ff,7,f -✓�� � �` Date Issued Conservation Division 5 34 gip -- Fee 'SL PTlC SYSTEM MIDST DE Tax Collector _ aSTALLED IN COMPLIANCE Treasurer a eel 'ENVIRONMENTAL WITH TILE 5 CODE AND Planning Dept. JOE'l N REGULATIONS Date Definitive Plan Approved by Planning Board - M Historic-OKH Preservation/Hyannis � 1 Project Street Address ` 5 'FAI Q U AVU LIQ . Village M A'R S oN (` )t LLS Owner ToVIN ¢ SNNOY AF.-TR\AZ:Lo Address 5(we Telephone SOS LA20 515 Permit Request T�r4)A'VE- (26(MG E 200-V - ENc,f�oSl✓ Wa7gk my Ff2og I -r, 1?cM'on I-s A, PRAWfJ Square feet: 1st floor: existing "WR proposed 2Z0 2nd floor:existing `762 proposed 37-0 Total new 5\40 Estimated Project Cost 4o i ua a Zoning District Flood Plain Groundwater Overlay Construction Type G OtJVEnTfior4(s L Vvuo�O Lot Size Grandfathered: ❑Yes Cl No If yes, attach supporting documentation. Dwelling Type: Single Family A Two Family Cl Multi-Family(#units) Age of Existing Structure 1'S Historic House: ❑Yes li(No On Old King's Highway: ❑Yes UYNo Basement Type: @(Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) —7 b Number of Baths: Full: existing new U Half:existing new Number of Bedrooms: existing new U Total Room Count(not including baths): existing new First Floor Room Count y Heat Type and Fuel: 110 Gas ❑Oil Cl Electric ❑Other 1�entral Air: ❑Yes VNo Fireplaces: Existing New D Existing wood/coal stove: ❑Yes 51 No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Zexisting ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name- 121-1 N 2E'F IA.Z10 A0mE01Ajt= Telephone Number y2 o 35)5 Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAE DATE S• o . D p 4 ! FOR OFFICIAL USE ONLY PERMIT NO. � DATE ISSUED' r MAP/PARCEL NO. ADDRESS - ,h` - . VILLAGE OWNER- DATE OF INSPECTIO :. FOUNDATION - - i FRAME L&V •} INSULATION - � r FIREPLACE rs ELECTRICAL: ROUG1—+ FINAL PLUMBING: ROU,qIY) ! FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT !- ASSOCIATION PLAN NO. I rrt-`-"._,,'�:�;*t--,f-�-> ....,.�.x,�r3�'ws-y:..;r-Rw�-.='�.�,..:,�;M3Yr,s,; r?.:�r:,��-s�.�.-rm.>:.�.>�y-.....�.�:a-�.--•..�..-�.+..•� Y -' �,.� r �,•,.: . N�P`pFtHE Tp��� The Town of Barnstable Departmen v t of Health Safety and Environmental Services BARNSTABLE. 9 NASS. 0 �J t679' �0 "rFO Mpg Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Y USVI �n o�l\ Location s (F,44- h#- AVN Permit Number t Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: W�- n"I'M 5- Please call: 508-862-4038 for re-inspection. b Inspected P Y` Date r , op FOU --I) pa I 'PLOW E. IJ Cy u X 4 -- ', i I �. .{ ---•___ � i � � — � � c�r�1T1 W t�qu I � I _ 5 A -._ _ � -._.��.-- -- T�dUIO U ?' T��}}o 'Go NC12e 'OUriT Ito1 'j7 1N 10 IA t.?►. UPO� � ( i I IO►IJC.(ZLT�i ' i I �'N �.R � p A t2„ � -• - - --. _.. _. -- --- - ' T�� Ou15 PONQ COW I ` ; Gdr�c �Z - I 1 , 7 T. li G NTINIOIIS O �. ( I .. 404- _ I 0 Ali Q (.-G.. N . a 1 51 Q._ -- --- - !� AV IN F R L o r. �' _ RQ IF 9-0 ST in . P U O '0 IT- -all T1bN illyll N ou it`J , Fv ri E !J •- -!0IE !`,III ( la w. _• F _�' __• t I _ Go c. S g� o R , I -� ._No... D P 1A' y"1 iT I i ! w o I o 10 F �- I Tc 14 A 00A -- P i ouNrER _F 1 _6 OU 5AL. (of bit i ' 2At,w if, o WP --- -- - -- - - - - -- -- - -- — -- _ Q IN 1n1�(r I ( - - 3� 3� it. .t.__. - � -- --- - - --- -- - -- -• --- -_. _. _ _ 01 10 I ! - -_ Jo VA NU � . it, I i { 1 i i { i t go was Ix D F Tv 17-11.4 IIL�� OUI ... _ s • r i ' - - ,_ I i .. . . . ..... .. .... ..... ... .. I 1 em2 �c►�1Tip i I I i I I i i ' ' i j ,;._ �. .. SS s ._ _ • Ilt DEf X I F 7 i iZX to FL OR' - Wilt !L10�QLyou _ SwP16 Z1�4 • Fu FT 11r _ . _ . i i s I�o4i► , 1rt i 9 I + i E T Div NIT I , _ I CPRI FAIRHAVEN :..:DRIVE !./ 0' 'WIDE S 18 2836- :E==-= ' 137501 Ln LLIJ �� ice: ��� IpW 3 T l Sl 32. _ . ,� ZONE` RF. l50' FRON- `r �' � In TAGE,K Z15 /5 T 30 / F : 00 SETBACKS L.OT 6 0. NOT . E ZO llUt.' ASSUMED LOT 137. PROTEC i/ON PER ART. JY SECT.M N - 170 00"37y!. W -- -6 E. TO�V BYLAWS . `H Of CERTIFIED PLOT PLAN poeEFr ti� LOT 6 FAIRNAVEN ORIVE El. MARSTONS M1LLS ELDREDGE .. 4 `:� Na. 1536T ,ca IN 4 �h L SCALE, / =40'' DATE S 20-86 qL-DRiEDGE ENGINEERING CLIENT N 1 CERTIFY THAT THEFOUNDATff E013TERED REGISTERED /�4 • SHOWN• ON THIS PLAN IS LOCATED CIVIL LAND JOd.N0.85 O . THE GROUND AS INDICATED AND ENGINEER SURVEYOR ;. DRY OYra , ,� CONFORMS TQ THE ZONING LAWS I*AE 8TA0LE9 MA8 712 MAIN S T R E.ET CM'GYM ��HYAN IS, MASS. BHEET I OF; REO. LAND SURVEYOR The Commonwealth of Massachusetts Department of Industrial Accidents -- Ix OI/Ice ol/nsestigatioos - 600 Washington Street Boston,Mass. 02111 Workers C m ensation Insurance Affidavit name location �5 ��O NA p- city M.1Q51 D�.� rn i S phone# �1 7-10 ® I am a homeowner performing all work myself. ❑ I am a sole netor and have no one working in any capacity / '////O///'r//Ir %%%%�%% 1 rovidin workers' compensation for my employees•working on this,job. ; : <;: :............ ❑ P :::::::::::.::::...:::.:. :::..:.::...:..: :::.:::...::::.:::::.::::::::::::::....:::::::.::::.:.:::.::.::.::::::::::::::..:::::..:..:::::::::::::...:.::::. ...::::::.... M. cow anv nam >:>"dre s Sm ad h M . ji oiie ci insurance co. .. / ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have orkers' co ensation olices: the followln mP...............P :::...::.:::.::.:::.::.:::::::. g.......::.:.:::::::::.:....:..;... ..:::.:.::::::.::::.:..:.......::.:.. :::.:._.........:.:::::::::..:......::::::..:.:::::.:................:::::........:::.:::::::::.:::::.......:::::. :::.:........:::::::.:.:::::..... cow anv=nam dce .................. on 9t19DTAiiC ca anv dre ne MOM lib :::.::::::::................:.........................:::::::::::::::::::::::::::::::::::::........................::: city= :ry oli in�v�enc Failure to secure coverage as regmred wider Section 25A of MGL 152 can lead to the lmpositlon of ceimiTisl penalties of a fine up to S 1,500.00 and/or one years,imprisonment as well as civII Penalties in the foam ota STOP WORK ORDER and s Sae of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office otlavestigation+otthe DIA for coverage verification. I do hereby ce pains and penalties of perjury that the information provided above is true and coned Signature Date �' l of&D _ J Print name �To 4N AE Two a'a'!) Phone# oflicial use only do not write in this area to be completed by city or town official city or town: permit/license# i ❑Building Department ❑Licensing Board ❑Selectmen's Office ❑check if immediate response is required ❑Health Department contact person• phone#; ❑Other Uevued 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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,pa rtnership, 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 d .becaiuse of such employment be-deemed to bean employer. MGL chapter 152 section 25 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,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until insurance of this chapter have been presented to the contracting acceptable evidence of compliance with the � requirements authority. _ FBI FE le 77 Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be ' submitted to the Department of Industrial Accidents fin�nnation,of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the criy or town that the application for the permit or license is e not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you being requested, ep are required to obtain a workers' compensation policy,Please call the Department at the number listed below. City or Towns and rioted legibly. The Department has provided a space at the bottom of the Please be sure that the affidavit is complete P .ans has to contact you regarding the applicant. Please affidavit for you to fill out in the event the Office of gati be sure to fill in the permit/license number which will be used as a rcfmv=number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions- please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents omce of Invesduadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 ME The Town of Barnstable an'rwsrAsz.s. � g Department of Health Safety and Environmental Services t659. c►9. b�. Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Building Commissior,e- 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: tN`00 LIZI Estimated Cost 0 0 Address of Work: 'R S ViA 1 A I 1 A1/►Al 1A Owner's Name: Date of Application: '1�' I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under S1,000 ❑Building not owner-occupied Owner pulling own permit Notice is hereby given.that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ORK DO NOT HAVE CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT 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: \, Registration No. Date Conn-ac�or Name 3a •oo Date 440wner's Name o:for ms:Affidav The Town. of Barnstable pFtHE Tqk,O Department of Health Safety and Environmental Services Building Division BARNsTani.e. ' 367 Main Street,Hyannis MA 02601 MASS. 9� 1639 AtEO MAC p . Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: • 3®`0,0 `�`,,'. JOB LOCATION: � F��R 14 A VU'V LN , rn(WR STI)N S 4Y1 I I.LS_ number 1 street village c, �/ "HOMEOWNER": 5o "O M QA ZZU 4 ZO 3 S IS a-35N W 0 6 name home phone# work phone# CURRENT MAILING ADDRESS: WO Mp2STuw� fv,11_�,S f`nQ G2b� 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 pro educes uirements. Si a re of Homeo er 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.i 5) 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN 780 CMR Appwdit J Table JS2.1b(continued) Two4amily Raidendal Bnildl°p Heated with FoaW L Fne prescriptive packages for Ong and MAXIMUM MINIMUM Glazing alsang Wall Floor Basement Slab Heating/Cooiing '("j) U-values It value it-value R value' WallPaimeta FgWPmeat Fffi«auy' R vaiuLA It-value Package 5101 to 65M Heating Degree Dar' 13 19 10 6 Normal Q 12% 0.40 38 Normal ' It 12% am 30 19 19 10 6 FUE S t2% 030 38 13 19 10 6 - - N/A Normal T 15% 036 38 13 23 N/A 6 Normal U 15% 0.46 38 19 19 10 13 23 N/A NIA 83 AFUE V 1S'/• 0.44 38 6 85 AFUE W 15% 0.52 30 19 19 10 N/A Nomisl X 18% 0.32 38 13 25 NIA A No/ rmal Y 19% 0.42 38 19 25 N/A N 90 anal Z 18Y• 0.42 38 13 19 10 6 90 AFUE AA 18•/. . OJO 30 FUE 19 19 10 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: / d Q 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): ' S. SELECT PACKAGE(Q—AA-see chart above): ` NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q.{arms_080303a r 780 CMR Appendix J Footnotes to Table JSZ.Ib: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage.Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300 ft of glazing area. =After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test Procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. or oversize ' The ceiling R-values do not assume a raised d truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R 38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-fiatite or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must oned meet the same R-value requirement a�above-gradeB� Windows o must meetslidi glas ng door U-value requires doors of ment ba:ements must be included with the o glazing. dscribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a NOTES: a)Glazing area and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 a��e�• TOWN OF BARNSTABLE Permit No. ..?y432 • BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .........�0 '9'�enuv► HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Greenbrier Corp. Address Lot #6, 85 Fairhaven Drive Harstons :dills, .Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 In'tpector TOWN OF BARNSTABLE BUILDING DEPARTMENT NAM OFFICE BUILDING � . 1079' �� HYANNIS, MASS. 02601 �0 MAY MEMO TO: Town Clerk FROM: Building Department DATE: i An Occupancy Permit�has been issued for the building authorized by .c / Building Permit # , �f ... ....».. �................. _.._..... ........._ ».._......»»......» »»». »»» ..._ ..._ . __ issued to ...».......».».. Please release the performance bond. t . . I.{-,�+ ���-.'.. y..-ti,.Hr+�wnaaiu.a�a.vww�.,nv.,,b,.N.y►� - TOWN OF BARNSTABLE, MASSACHUSETTS PERMIT A=148-158 JOB WEATHER CARD X w Sr. 29 3 �"� S�) 1g �� PERMIT NO. DATE V 11Xj L)wilrr r APPLICANT ADDRESS (NO.) (STREET) (CONTR'S LICENSE nuild dwel?ing 1 S�.IlC;le iYwdly dwelling NUMBERNG UNITS OF PERMIT TO (_ STORY DWELLI (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) of i u 65 jFnirtaavtn .Drive, arstone. Nillr: ZONING ltH DISTRICT AT (LOCATION) IN O.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT' SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) t;I ' Sewage 9r46-r:4_IJ REMARKS: AREA OR 1244 sq. it. ESTIMATED COST $ 45,UUli FEEMIT $ 66••'5 VOLUME )CUBIC/SQUARE FEET) Greerr'urier Corp. OWNER n na, Ca-arervilliZ, BUILDING DEPT. BY ADDRESS _ THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOFJEITHER TEMP09ARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED 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 THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND A FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL • MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. - 3. FINAL INSPECTION BEFORE _ OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING/ASPECTJON APPROVALS PLUMBING INSPECTION APPROVALS ELEECCTR'I)r.AL INSPECTION APPROVALS 2 277 2 3 HEATING INSPEC PROVALS R G AP ALS' i 1 ------ z � 2 OTHER W./1.v i. UT-1 -A�Us G ��$� (� 30 _ w WCRK SnAL: NCT ?ROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION iNSPECTIONS INDICATED ON THIS CASED civ unhimwe nF nATC THE CAN BE ARRANGED FOR BY TELEPHONE CPRI�-) FAIRHAVEN DRIVE (�/0 ' WIDE) S l8 2836E 137. SQ/ IW Z ul) I O Oi i ` Iv T ON 32,, � yo -4 .----7 - O RF• i 40t� 1a56 43560 Sri J l5G FRO� E 53 30Z15 /5 FT T.° SEr. ACKS-vt L_OT 6 Lo 0 NOTE 201111 ASSUMED LOT PROTEC i ION PER - 137.541 ART. J, SEC T RZ N 170 00'37// W . - -6.E. TnWN BYLAWS . QGcwn/�?LS tJi✓lc.•�acv.•� � .`HO CERTIFIED PLOT PLAN LOT 6 FAIRHAVEN DRIVE ° E T y`' MARSTONS MILLS `; ELDRED F - ``' IN `".• Ja. 193E7 J, � SCALE, / =40 ' DATE 1 S 20-86 E E 0/ EE 1NQ CLIEN N" I CERTIFY THAT THE FOUNDATION T SHOWN ON THIS PLAN 19 LOCATED EGI9TERED LREGISTERED JOB N0. SI14 ON THE GROUND A9 INDICATED AND CIVIL ANp ICONFORMS Tq THE ZONING LAWS ENGINEER VEYOR DR.BY, OF OARNSTAOLE9 MAS M j 712 MAIN STREAT "' CH'RYA , c� .G HYANt�IS, MASS. SH99T,_..OF,_„_ DA E REG. LAND SURVEYOR Assessor's office (1st floor): Assessor's ma and lot number .... .... .. . `�� opt"ETo� P '.-..�................... SEPTIC SYSTEM MUST �Q � Board of Health Ord floor): I Sewage Permit number ..... .y.�o :< ...... STALLED IN COIUIPLIA� iT ARNSTODLE. ....:...::........... Engineering Department (3rd floor): ., H TITLES 90o rb 9. 0� IT House number ....................... .............°.... . NTAL CODE AW11 ' 0M APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M,. only 70WN REGULATIONS TOWN OF BARNSTABLE BUILDI G I SPECTOR ..APPLICATION FOR PERMIT TO ...... . .........................f �� �I G,� TYPE OF CONSTRUCTION ....... D1....!..r�� ...................... ..................... ....................... ..............•......�...� .......19....SrJ TO THE INSPECTOR OF BUILDINGS: The undersigned here y 9ppp��lies for —a permit according to the followinggii format*, n: Location ...... / v� . ......................... Proposed Use .�!...... .. .. rrl �^ Zoning District ....................Fire District ....�// �4 .4 �4— J Name of Owner ......���« le Name ... ...vt....S.............. 1�/ ( Nameof Builder ........ •Q.! ....................................Address .................................................................................... Nameof Architect ........../...'....................................................Address .................................................................................... Number of Rooms ........CLI .. ... . .�....... 0 r�......................................................Foundation .... ..... ....... Exterior ....W1.4 5/,1;t .. lk.5........�....C./510 Roofing ... ...... .��c�f 4?��........................ S Floors ...v/.. .. .. .. .......�.Gti" ...�..,...................Interior ........... � ... ... .t...................................... Heating ... ............4 ..9... ...................................Plumbing .................... .... .. ................................................... v Fireplace ............ ....................Approximate Cost .....1—a/J��.... ........................ .... Definitive Plan Approved by Planning Board _ _ -------------197° . Area ...../C......C�.. 5 ... 1 Diagram of Lot and Building with Dimensions Fee // SUBJECT TO APPROVAL OF BOARD OF HE LTH a;12,4 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 ... �.. ...... .. ........... F Construction Supervisor's License .. Ul�, .�'. .. -GREED70RIER CORP. No ...—Z-�-�. Permit for .... ............... ........... ................. Location .....Lgt.. .......85..Fairhaven Drive ............................ Marstons Mills ............................................................................... Owner ...... Greenbrier Corp. .................................................... ....... Type of Construction .......Frame........................ ................................................................................ Plot ............................ Lot ................................ May 30,- 8619 Permit Granted ........................................ Date of Inspection ....................................19 Date Corppletecl .............19 Assessor's office (1st floor): FT NET Assessor's map and lot number....�.' ..`....� ......... Q o off` Board of Health Ord floor): Sewage Permit number .................................. [..f. ...... i HAWSTODLE, Engineering Department Ord floor): r 'oo M69 3 • e0� Housenumbe-r. ...................... ............................................. APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE - BUILDING - INSPECTOR APPLICATION FOR PERMIT TO /�, l ........... .a.................................................. . ........................................ TYPE OF CONSTRUCTION .......vv..DO�.tl,/G, /!L ................... ..................................... 3X_;5........19� TO THE INSPECTOR OF BUILDINGS: ,The undersigned hereby applies for a permit according to the following information: �.� . Cry /�C� i /ar/C1 etc'S P�7s T Location ....../(1.:......................................./!�...... ...................�............................. .................... ........................ ProposedUse .................. ��.......................... ................................................................................................................. Zoning District ........ ..... ...................................................Fire District ....�'/„CI,�.SI.o�S /� l ........................ �� /? �/� r f Name of Owner ......................................................:*.��/�...,.Address .../.............................................. 5 0 Nameof Builder ........... a.. .. .....................................Address ................................................... ............................... Nameof Architect ..................................................................Address .................................................................................,.. Number of Rooms ........6� ...................................................Foundation ...%r..C���F�f Exterior ... C ....Cl'I .. .5.......;Gz..�... .. ` Roofing ........................ Floors v ................... / .. ....................Interior .......... Gr c�e"7-HOC .. ....................................... Heating �C// / � Gf .................Plumbirig ..... .��....... ..... ............................................ .......... .......44.:5 Fireplace .... ...................Approximate Cost .....�w . .. .�� Definitive Plan Approved by Planning Board _-�a-_t--________________19- ------ . Area ..... ...... .... T....... ....... Diagram of Lot and Building with Dimensionsf1 Feer ,x ,� . 6 rv`J SUBJECT TO APPROVAL OF BOARD OF HEALTH �k / r c.aC v 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. <, � , k� Name .... .......................... .......................... 1. Construction Supervisor's License ................. GREENBRIER CORP. A=148-158 29432 Ij Story No.................. Permit for ........................ Single ' Family Dwelling ....................................................................... Location Lot #6, 85 Fairhaven D*4-ma-e ........................................................ 'Marstons Mills . ............................................................................... Owner Greenbrier Corp. ............................ .................................... Type of Construction .....................Frame..................... ............................................................................... Plot ............................ Lot .......... ............... Permit Granted ....�.Ma.y.�..30.,................ ...19 86 Date of Inspection ....................................19 Date Completed ....... ...... .............19