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0010 MINTON LANE
u a 0 7ford NO. 152 1/3 ORA ESSELT 10% . .� Town of Barnstable �u . Building Post This Card So That it is Visible From the Street-Approved Plans,Must be- Retained on Job and this Card Must be Kept u►�xsrwat8, = Posted Until Fin:-al Inspection Has Been Made. Permit .es¢�� � Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-18-1718 Applicant Name: Mike McMahon Approvals Date Issued: 06/19/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/19/2018 Foundation: Location: 10 MINTON LANE,WEST BARNSTABLE Map/Lot: 174-032 Zoning District: RF Sheathing: Owner on Record: FARLEY, RICHARD T JR&KATHLEEN EATON Contractor Name. MICHAEL T MCMAHON Framing: 1 Address: 10 MINTON LN Contractor License: CS-068111 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $2,300.00 Chimney: Description: Weatherization,air sealing,and insulation Permit Fee: $85.00 Insulation: Project Review Req: , Fee Paid: $85.00 Date: 6/19/2018 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: t This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. '~ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: Q A ermit Cards are the property of the APPLICANT-ISSUED RECIPIENT i TOT OF BARNSTABLE , R I S E Division of Thielsch Engineering,Inc. 2013 MAY 10 HI{ i f: 19 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island 02910 DIVISIOpq May 1,2013 Thomas Perry, CBO V Town of Barnstable Building Division 200 Main Street Hyannis, MA 02601 Re: Insulation permits. Dear Mr. Perry, + This affidavit is to certify that all insulation work completed for 10 Minton Lane has been inspected by a Building Performance Institute (BPI) certified Professional. All work performed meets or exceeds Federal and State requirement. Sincerely, Erik Nerstheimer Supervisor of Installations, BPI certified Building Analyst Professional and Envelope Professional, RISE Engineering, a division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 r y � � J 401-784-3700 •800-422.5365 •Fax 401-784-3710 110676 " TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map y Parcel.-, Application # Health Division Date Issued Conservation Division `. -.Application Fee Planning Dept. Permit Fee': 3 Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street.Address 10 Mimon Lane Village C LJes� Bczrnlb�� Owner Richard Farley Address same Telephone '508-428-3325 Permit Request air s aling- attic insulation and soffit vents Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 2367 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family •❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Ca 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 ❑ Electric ❑ Other .1 _ ram-' 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: I Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION - - - -(BUILDER OR HOMEOWNER) Name RISE Engineering Telephone Number 401-784-3700 Address 1341 Elmwood Ave, Cranston License # 100459 Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 4 SIGNATURE DATE Erik Nerstheimer for RISE Eng. FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP./PARCEL N0. :. T I ADDRESS VILLAGE y OWNER i DATE OF INSPECTION: 3` FOUNDATION: ' FRAME 4 ll� INSULATION_ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ,- FI:NAL'BUILDIN.G `. -- - DATE-CLOSED'OUT r ASSOCIATION PLAN NO. w _ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations -UIV 600 Washington Street Boston, Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contracto rs/Electri cian s/Plu in bers Applicant Information Please Print Legibly Name(Business/Organization/Individual): RISE Engineering a division of Thielsch EngineaXing Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 Phone#: (401)784-3700 or 1-800-422-5365 Are you an employer? Check the appropriate box: Type of project(required): 1. N I am an employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part time).* have hired-the sub-contractors 7. ❑Remodeling 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance. $ required] 5.❑ We are a corporation and its 10. ❑Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised•their 11. ❑Plumbing repairs or additions myself [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4),and we have no 12. ❑Roof repairs employees. [no workers' 13. i& Other Insulate comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: The Preston Aeency Policy#or Self-ins.Lic.,#: 3 7 30 9 61-0 E Expiration Date: 1/1/12. Job Site Address: lIll City/State/Zip: F 11� 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 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 $250.00 a.day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I.do herby certi and the ins enalties of perjury that the information provided above is true and-correct. Sign ture: Date: Print Name: Erik Nerstheimer Phone#:(401)784-3700 or 1-800-422 5365 Pxt ill Official use only Do not write in this area to be completed by city or town official City or Town: Permit/license#: Issuing Authority(circle one): 1.Board of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: OP ID: 31 CERTIFICATE OF LIABILITY INSURANCE 7TE12/3 D/YYYY) 0/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER 401-886-8000 CONTACT NAME: The Preston Agency,Inc. 401-886-1700 PHONE I FAx 1350 Division Rd Suite 303 A/CE-MA IL Ext: A/C No PO Box 810 ADDRESS: PRODUCER East Greenwich,RI 02818-0810 CUSTOMER ID N:THIEL-1 INSURER(S)AFFORDING COVERAGE NAIC p INSURED Thielsch Engineering,Inc INSURER A:Zurich-American Ins Co. Thielsch Group Inc. INSURER 13:American Guarantee&Liability Tech Realty Inc. 1 INSURER American Capacity 95 Frances Avenue p ty Cranston,RI 02910 INSURER D:Hartford Insurance Company INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE PLICPOLICY NUMBER MMfDDYIYYYY MMILDDY/YYYY LIMITS - GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 3730962-01 01/01/11 01/01/12 PREMISES(Ea occurrence) $ 300,00 CLAIMS-MADE FXI OCCUR MED EXP(Anyone person) $ 10,00 PERSONAL BADVINJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO- LOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,00 A X ANY AUTO 3730963-01 01/01/11 01/01/12 (Eaacddent) BODILY INJURY(Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY(Per acddent) $ PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 EXCESS LIAB CLAIMS-MADE B. AGGREGATE $ 10,000,00.. AUC-0857188-00 01/01/11 01/01/12 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X VbC STATU- OTH- AND EMPLOYERS'LIABILITY YIN-A ANY PROPRIETOR/PARTNER/EXECUTIVE r- 3730961-01 01/01/11 01/01/12 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 C JProfessional Liab -TTIDVL000026800 04/01/10 04/01/11 Prot Llab 2,000,000 D Leased/Rented Eqp 02UUNTD5678 01/01/11 01/01/12 Equipment 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) + CERTIFICATE HOLDER CANCELLATION TOWN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD i NOTEPAD THIEL-1 PACE 2 INSURED'S NAME Thielsch Engineering,Inc OP ID:31 DATE 12/30/10 Al T RIK EQr. n9ineerin a division of Thielsch En ineerin9 Inc. a kell gssocial es ad'visio filsicehI h kn Ineeri i' ,Inc. A aboratory,a jvjsjon o n )n erin , r�c.EEabo to a iv I n.o Isch n meer Inc.A �Ipn Inee in g divlsio� higl ch nginee�in ,Inc. ater Ma�ageme�f ervices,a divlsion of hleisch Engineering,Inc. t 3 ce nsr fain usmes�aPationOf = o g 10 Park Plaza - Suite 5170 Boston, ssachusetts 02116 Home Improve ontractor Registration Reqistration: 120979 M Type: Supplement Card Z W Expiration: 3/25/2012 THIELSCH ENGINEERING ERIK NERSTHEIMER J 1341 ELMWOOD AVE. a CRANSTON, RI 02910 A h� f a 0w Update Address and return card.Mark reason for change. Address Renewal ❑ Employment ❑ Lost Card PPS-CAI 0 50M-04/04-G101216 �le 'Pamrmzovubea�! a�./�aaoaclzuae�a . Office of Consumer Affairs&Business Regulafion License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registrati6nQ79 . Type: 10 Park Plaza-Suite 5170 Expira 12 Supplement Card Boston,MA 02116 THIELSCH EN&� —l ERIK NERSTH _ 1341 ELMWOOD CRANSTON; RI 029 � �` Undersecretary Not valid without signature Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License# 100459 Restriction WS,IC Name Erik Nerstheimer City,State,Zip North Scituate,RI,02857 Expiration Date 3/28/2012 Status Current No complaints found for this Licensee. Back To Search http://db.state.ma.us/dps/licdetails.asp?txtSearchLN=CSL100459 1/7/2011 i ♦F � s9 is tiA � � NAT-24531 - 1 .01/27/2011 19:58 FAX 401 784' 3710 RISE ENGINEERING U 005/006 RISE ENGINEERING RI a Regi 6e29 - RI Contractor Registration No 8188 A division of Thielscb En ineeri MA Contractor Registration No 120979 E nS CT Contractor Registration No 620120 1,341 Elmwood Avenue,Cranston,R10291.0 (401)784-3700 FAX(401)784-3710 CONTRACT Page 2 R .1 S -E - T"CONTRACT IS ENTETffD INTO BEIYYEBd RT6a . ENOINEMU*G AND THE CUSTOMER FOR WORK AS ENGINEERING .• DEseRIBEuaELow. CUSTOMER PHONE DATE CfkM 9 Richard T Farley (508)428-3325 06/08/2010 110676 SERVICE STREET MUMO STREET . 1.0 Minton Lane 10 Minton Ln SERVICE CITY.STATE,ZIP - BILLING CITY.STATE ZW [E ^ a V Centerville,MA 02632 W Barnstbl,MA 02668 0 JOB DESCRIPTION OCT _ `nTU 1 5.00 RISE Engineering-will provide labor and materials to insulate the back of 3 existing kneewall access hatch(es) ith 2.5"rigid fiberglass oarT ' insulation,and seal the edge of the hatch with weatberstripping. RISE Engineering will provide labor and materials to install 4. 4" X 16"white rectangular aluminum soffit vents to increase ventilation in attic areas. RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. $2,072.10 VfE AGREE HEREBY TO FURNISH SERVICES..COMPLETE IN ACCORDANCE WRH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Two Hundred Ninety-Five&201100 Dollars $295.20 UPON FINAL INSPECTION AND APPROVAL BY R®E ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL HE CHARGED MONTHLY ON ANY UNPAID EALANCE AFTER 70 DAYS- FOR rAPORTANY INFORMATION ON GUARANTEES,RXWTS OF RECISION.SCHEOULM;AND CONTRACTOR REGISTRATION. NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SP C �. cus 10.0 flR8 T4IAY IM WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE -- ACCEPTANCE OF CONTRACT-THE ABOVE PRICES.SPECIFICATIONS AND CONDITIONS ARE L..- SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORED TO DO THE WORK DAYS. AS SPECIFISO.PAYMENT WILL Be MADE AS OUTLINED ABOVE Map /7 4 Parcel 0 Permit# 2- �- House# 1 d Date Issued 0- 8 -/ Board of Health(3rd floor)(8:15 _9:30/1:00 ee .� Q Conservation Office(4th floor)(8:30-9:30/1:00-2:00) 4 4- l�i I0 & S r Planning Dept.(1st floor/School Admin. Bldg.) z��10 IUST BE Definitive Plan Approved by Planning Board /r 19 1NETALL . UANCE M ODE AND TOWN OF BARNSTABLE�N�TowN R ATa®Ns Building Permit Application Project Street Address 4� Village Owner" /`b�P/�'Gc Address Telephone Permit Request .First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ �?,O, daa Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ar Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes *No Basement Type: dFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing eF New 991—� Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size)2 `lXa Other Detached Structures: ❑Pool(size) Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes t-*No If yes, site plan review# Current Use Proposed Use Builder Information / Name 4�yWzl �ii�riiy� � Telephone Number Address t-s /`ieo-e— G-�iL.� License# O '`5 4a Home Improvement Contractor# LOG Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) •- FOR OFFICIAL USE ONLY PERMIT NO. DATB ISSUED - 6 MAP/PARCEL NO. ADDRESS VILLAGE OWNER a DATE OF INSPECTION: FOUNDATION G� F FRAME t INSULATION b r FIREPLACE ELECTRICAL: ROUGH FINAL 1 PLUMBING: ROUGH FINAL GAS: ROUGH t... FINAL f , FINAL BUILDING' : CAP'— e� � DATE-CLOSED OUTR „7 1 ; rr 0 . + ASSOCIATION PLAN NO.® s str t i r °F THE j he Town of Barnstable : . . : T _ • �rrsTaete. • ' Department of Health Safety and Environmental Services HAM '°rFor " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only: 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: ,/��•a��fi ooee�� Est. Cost r Address of Work: /tea:— --�� Owner's Name Date of Permit Application: 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 CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGIRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY '1 hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name `�- The Commonwealth of Massachusetts Si —_ _ fl^ _- - Department o Industrial Accidents 1 =� p f =, office of/nsestigations �� -. -z_� 600 Washington Street _- �;� s% Boston, Mass. 02111 Workers' Compensation Insurance Affidavit name: G04!//10 ZI J>y r location: ,/ city . phone# Q���2—/..) 7? ❑ I am a homeowner performing all work myself. ❑ I am a sole ro netor and have no one workin in any capacity I am an employer providing workers' compensation for my employees working on this job. com_Zf ......X..1:.::,:J - . ........:.:.......:.....:...:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.: . anname:::. _ AM ...-....-.-..-.............'�.....,.........,.,.,..�.�:., . -::.:-': _...... . ..", . ..... . address:>:.. ., - AV -.... ,:;phone#. . ./ � . :. : .:. .. ........ _. ...: .. tnsuranca co.: ohev#.,: C .. .': `4 ...... '7�'.. %/ ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have . the following workers' compensation polices: cotnaany name::, ;.::... _,:..:...... . .:..:::..::..::.: ;:;;:. . .....:.: .... W. address:> . . ..................... .....:.::::::::::.. . .<:::;:::::<r ......::::::.::::.. .<:::::::::::....;:.;:.;::.;::.::.;:. :iW ;:c.:: ;:.-"-;.;..::::::::....... ..:::..... :.:.;;;:::phone:#: city .....: 2. of�cv# :.>:;. :..::::.::::.. ansnrance.co.: . ;:a::>::: ,>;:.<;;; .....;.; :....,. ,>;;::::::.;I::..; :...:..:.;.: .: an :mame::., ....::::.::::::::..::::..... .::...:.::::::.... .:.;;:.::.r: .:..::...:.:::.:.::;.:::. Xx ....::::.....s:: .camp V :::..:.::::.:.:. _... _.. .. ; :aI I- ddress.:.. . :<;;:.;»:. ::<::>:;... .:..:::.:.... hone#. U1 ..: p _....: :........ insurance:co:.. :.::: .::>::>:::<::::::: ':.>:.:>`'>< >>:'> >':<::: olio # :: ':>:=<:>:>s:' . _ ::.... ....... :... Failure to secure coverage s,required under Section 25A of MGL 152 can lead to the Imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine 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 certify under the airs and pe ies of perjury that the information provided above is true and correct/ Signature Date ���/�y _ IRM Print name AJ�v� Phone# Got —�, �9T ti official use only do not write in this area to be completed by city or town official I • city or town: permit/license# � ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑health Department contact person: phone#; ❑Other s . . • .. . (revised 9/93 P1A) . Information and Instructions sr . 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 regarding the applicant. Please be sure to fill in the peraiitllicense number which will be used as a reference number. The affidavits may be rearmed io 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 Department's address,telephone and fax number: The Commonwealth Of Massachusetts _Department of Industrial Accidents Office of Invesdoadons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749. phone#: (617) 727-4900 ext. 406, 409 or 375 FILE # MIP 8967 CEP, ;US TRACT # 128 CL I ENT: Forman.a. Kirrane & Terr DEL•:!) - BOOK 5255 PAGE 295 OWNER: & Kathleen E. Farley PL/1:'? I300K 383 PAGE 41 ' LOT APPL I CANT : same ASS;,SSOR S PLAN PLOT. 25 MORTGAGE INSPECTI0T PLAN OF LAND LOCATED A* T 10 MINTON LANE SCALE : 1 = 60' W. BARNSTABLE, MASSACHUSETTS . JANUARY 20, 1998 'IF ROLAND R. EL•DPIDGE 66.80, II - II II LOT I I Z5 I�I < 2_73.G2 43,538 S.F �3 I � LOT 2-4 i I J of I J PAro *'o Z STORY � � DRA'rJAGE I �� LEASENIEW � 1270 S•F I ! I MINTOKJ LANE I I II I I CERTIFY TO DUNNING, FORMAN, K I RRANE, &TERRY, NORTH AMER I CANMORTGAGE, AND ITS TITLE INSURANCE COMPANY, THAT THERE ARE NO VISIBLE ENCROACHMENTS OR EASE- MENTS EXCEPT AS SHOWN AND THAT THIS PLAN WASPREPARED UNDER MY IMMEDIATE SUPERVISION . THE LOCATION OF THE DWELLING AS SHOWN HEREON ✓' ':- \� :A/4 IS IN COMPLIANCE WITH THE LOCAL APPLICABLE . ;%-�- ZONING .BY-LAWS WLTH RESPECT TO HORIZONTAL_ �(' 'KENN DIMENSIONAL REQUIREMENTS . R. FERR "la THE DWELLING SHOWN HERE DOES . NOT FALL WITHIN rii td A SPECIAL FLOOD HAZARD ZONE AS DELINEATED ON F ?Fclste ; . -A MAP OF COMMUNITY" #250001-0015C DATED s'�"��ny� ' 8/19/85 BY THE F. I .A . '^ Kcnneffi R. FeriCi>.a w Engineering, Inc. Yh .+ ' Ro. 13ox 1903 'New l3cdf01'c1;.MA 027-11-1903 503 992-0020 A lax:503 992-3374 GENERAL NOTES: (1) The declarations made above are on the basis of my knowledge, information, and belief as the result of a mortgage plot plan tape survey inspection made to the normal standard of care of registered land surveyors practicing in Massachusetts. (2) Oeclarations are made to. the above named client only as of this date. (). This plan was no('• made for recording purposes, for use in preparing deed descriptions or for con— structions. (4) Verifications of property line dimensions, building offsets, fences, or lot configuration may be accomplished only by an accurate instrument survey. I 2�, I I 12-4' NEW OA14AGE F❑UNDOTIOM 8' C❑NC, WALL i 2AIX $' X 1 AIR VENT I I N5W RdWL EXISTING CRAWL SPACE. 6-4. 20' kJO 61 b§R ❑N LIL dN 21 CUT A ESS Ta EXISTING OASE$ I CRAWL 9'-4' 2' AIR VENt Ian 6' X 8' FOOTING THRUOUT F-EUNDATIIJN PLAN SCALE 1/8"=1'0" 166.ft I F I - -I Q 3 al Z r-1 U Q ^ NEV A=rr [LJ' ro a J _~ Z E7QSTIIVG� { I �14' 5v IK4742 a-= 39.34 118.86 MINTON LANE I 4PPPFIY PE IT I AY(11 [T (: �rAl � I 4-n, ) I I I I I \ LJ / \ 1 1 " VJ I L_ 1 I 1 6-1 `/ I \ VJ `/ I I L_ L_ J. V I� If II I VERIF,Y ALL DETAILS •WITH OWNER AT SITE II GARAGE II 3 2 X QO NEAM ON ILA Y I` � [IN V X 2' Xi' PAD • II I HOUSE EXISTING NEW CGNST. 126' II I l II II . I I, II II II W I II to II II �� I' i i i F- MUD ROOM W N J BUILT IN u B(=fVCH 1M' SKYLIGHT ABOVE FLOOR PLAN r (SCALE 1/8"= l'o') L__- ,' --- 14' X - SECTION AT HUD ROOM (SCAL� 1/4'-1'b;) 2 X ld RIDGE 2 X 8 16" ❑,C, RAFTERS 2 X 8 CL'G J❑ISTS 16' D.C, 12 2 X 8 RAFTERS 16f D.C. 12± MATCH EXISTING SKYLIGHT MATCH FXISTING EAVE AND SAKE TRIM 11' 4'+ 5/8' PLYWOQI SUBFL❑❑R 2 X 8 16' Q.C. J❑ISTS MATCH LXISTINGFRAMtNG 2 k 4 STUD W/ Ril INSUL_ ' CRAWL SPACE 8" C❑NC. WALL 2" CONC. DUST COVER f. X- SECTJ�N �AT GORAG.E 2 X 10 RIDGE CSFALE 1/8f-110'5 COLLAR TIE$ 16 O.C. 12 1� 2 k 8 16' O.C. RAFTERS NOTE HE GHr OF RIDGE TO MATC EIGHT OF EXISTINd V. MIILY ROOM RI G TIE INT� HgUSt�: TO BE DETERMINED ON SITE 8 X 8 IV O,C, JOISTS .� Xd CAM N 1+ ,BASE 2 X 4 STUB 40 CpNC. FLOb� I* AAtkFIL4 0' CONC WALL w RIGHT SIDE ELEV, (SCALE 1/8"=1'0") O } EXISTING NEW CONST, MOUSE EXISTING CH$MNEY FRONT ELEV , t rzo- r� z m m �, ���• Px G 0n�"7tTr�rat �`'•^,'i' _ y�g� ,y� v,, .�•�'t�iCk\ S,'a7d W'S W ¢ •i ."� •� Wa` ! ' W W'Cu LLJ z G•� � W � I^ � .ice = s r,�d �F� •"� ....L_. • = S. , o `'" 5�1 I.mn� o =. -'s rti "�+•••Sa a+}SI c., .x. ... H �i '1 m:.���5 1J-Y' c o y� 5 W•�•n -w�5} Z u. - sZCR ^ d•' ¢ r_{+r n ...s 11 i �a.s o 1 b� '�% =M..�.•..d'{ W.,.f J y �- W N •o I I.li �a+.t�. r� W s_ LW S, o Coa i u�t� j �y{�q„ i, F ✓'iA } Pk' J I r •I s t_ l',:xs"._.s tl..: is j�`'�,�� . i .Assessor's map and lot number ........ �-- ' THE Sewage Permit number �. Z B9SB9TABLE. i House number �....' 1... t�4i�4 CJi�.s�" V� r ° t ,�a ro SAM ...........:.........1�.�... } Oq,1639 0� YP-4 4'. TOWN OF , BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... �STiG(.ly! ...� �1�� TYPE OF CONSTRUCTION ...... ..Z77 .If............................................................................ . . ...... . ....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .................................................... ..........C .................................................. ProposedUse ..... /... .. L.......<....�� ��............................................................................................................... Zoning District ......... .... .........................................................Fire District ....�lo......................................................... �e � / Name of Owner ...... . .. /..�'� .............Address ,�oe S �� C...... �Or/( Nameof Builder :...................................................................Address .................................................................................... Nameof Architect ..................................................................Address ............�....�../.....................�...................................... Number of Rooms ........ ...............................................Foundation ../.... '�/. ,L. C �......... Exterior .,............................ ..... .....................Roofin ................�.%7.... .. ...G,-.l....� .5..................... Floors ll...r! .. ......�.. /� .. . . .Interior .................... 1 .. ........................ ` Heating ...................... /t/ff{-:.` ... .��..............Plumbing ......................�,0. ..... ..... ........................ G Fireplace ....................................! .................Approximate. Cost .....................C.,...�j,.......................... . ..... Definitive Plan Approved by Planning Board 19 _ Are a ........./..lG. .... �...•........ Diagram of Lot and Building with Dimensions Fee "' SUBJECT TO APPROVAL OF BOARD OF HEALTH �1 oil OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town aoarnsta.Dleegarding the above construction. Name ..........`•� .. ... .. . . ................ Construction Supervisor's License ....U.�l., �� ........ GREENBRIER CORP. 268.....48.... Permit for A..��q. -ry.................... ....... Single Faunily..p��q,� .................................. Location .....10 Minton LaLp ...................... ............ Centerville ............................................................................... Owner ...G.rberib.rier...Co.rp............................. .. .......... ........ Type of Construction- .Frame.............................. ................................................................................ Plot ............................ Lot ................................. Permit Granted ....August 16...............19 84 ................... Date of-Inspection, ........19 Date Completed ..........19 P J�- SEPTtC SYSTEM MUST BE Assessor's offioe Ust floor): /T- IN COMPLIANCE (�SAs$essor!s map and lot number .....�..7... 1....�... IOSTALL.ED 5 oFTHEtoy♦ ...... ...... WITH o t Board of Health (3rd floor): q _C MEN�TpL COD. Sewage Permit number .................................................� ENVIFION l�Lp►TIO B6B39TODLL. S r tngineering Department (3rd floor): 'TOWN REG � rasa House number W!! °o �b}9• \0� APPLICATIONS PROCESSED 8:30 9:30 A.M. and 1:00-2:00-P.M. only i TOWN - OF . . BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...put on an addittion .......................................................................................................... TYPE OF CONSTRUCTION •••••••Wood Frame ,$ tember 26, 86 ... ...................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies-for a permit,according to the following information: Location Lot 25 10 Minton Lane W. Barnstable, Ma. 02668 Proposed Use Family Room .......................................................,......................................................................................... W. Barnstable Zoning District .................................Fire District ............................................... e if Richard T. Farley, Jr. 10 Minton Lane W. Barnsttable, Ma. 02668 rNameof Owner .......................................................................Address .................................................................................... Nameof Builder ....................................................................Address .................................................................................... Name of Architect ...Joseph P. KelleySmith Farm Rd. Eastham, Ma. Address .................................................................................... Number 'of Rooms ...••• One borviSpn( Poured.Concrete _ Foundation .............................................................................. Exterior ...Wood Frame Asphalt Shingles .............:...............................................................:...Roofing .................................................................................... Floors Wo.od. ,Carpet- and t Interior he Sheetrock ... . ........ :.................................................................... Heating Forced Hot Air .........................Plumbing None Fireplace Bri Approximate Cost ......... QQ�' .......ck. ........................................................ .............................................. Definitive Plan Approved by Planning Board 19 0__ _ . Area 20 X 22 Diagram of Lot and Building with Dimensions Fee ........ SUBJECT TO APPROVAL OF BOARD OF HEALTH 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 .. ... .......................... Construction Supervisor's License ..!V....� ............ OPP— FARLEY, RICHARD .iR It • 1;No ...29M7... Permit for ....HILD..ADD.ITION. ................. Location .....LQt.12.5....... Lane...... ...................... ............................ Owner .........Rj,a .rd..��XJ ey.,....iz................. Type of Construction ........Erame........................ ............................................................................... Plot ............................. Lot ................................ Permit Granted ......Septzmher...Z6. .....19 86 L f� Date of Inspection ........... .......................19)� Date Completed ........... ...........19 ,1F fx M i •y CQ It 3' '� I _ i NI j •U{ o r J i r N � j .4 I ._ ._. _ -i v w _—'� � Imo-- —— -� "1•9 � _ i I c ly r •' y I� ,� `'i tom'- a oo f ,.'.:._._RFt�DJ.��ZS.�ST,>,I4 4118E In,l D.o�J•'.-.�.'.I�EF1'.a.ovJ:"'G�:,'.ftE'VtSE'::S.��E_:: . j y Et Ll u \ 1 'd : .. ... QI��c1' S�OE E L EVR7lU.�". 1 —• • I�t-,.�. <� _--- ._.. DL60.1v0 of W Al FT 77 ( 1 W4. I 1 ,IJFb'L.j IFx.PJ -'V• 1- l�- _ `` . 44Yi. O4FunT. Gam... \ • .: � i � --- fir-::c •_Ist;�fv.:x.c- I .._. -- CcaJ.il�i (AnD z'2'ry MIL oven 09k> -- iF or1�y I l'04e Jo„,l tr-% — ' 1t 5T,ul OUA- • 1 REl�W -.>=:xSSTY*14 41Fe�E 6aI�Do�J•'.:.(.'. EEI'.'1o.�J R.:;:�L�ISSE_S.r "_rf..�EZt.o --- - I res.�� �L 7 :.v ?-I 6O j::"%D1 f VE1tiPy ALL beTAAS w/owA AT Job Stv¢ __.._........ w',; -.. ..._.._...": ._..• ....A"PPIzoX�:--•S�.or.--1�+�-��t'- .:.'�srA�k'-�r�:QA'�-::�`:.�_', DQ.oP.'NP Of whL 15_:6Etow:Tov .o'F-'+rif5n'r�•... HA�-aa q:u` t PAL ut ..._.. I I I {.B`..t.oiY:.w,w- , i CUT- :'G{o:F�v,;'` je:i.�i•�-ti'_�r�.i�• i ,',\': 5� ' ,� r ;— r � 1 --!- _ 12+�" :F'til'.spA,tk'L.i1f�-� ....ib.,.9•racTIL arc!vb1f. -�—.- • � 'i i I I I I�0 NIP.FS b? f ,f k�1.. ITrja qLJ" be,t kP'(1A L:Q, A w.,,t, riro"IZIS�nzs•u>04,, nj , - t 1 : :_. f 'flydPrcl�o (C1 ! .. V�E:I:?�..•A�c._:.:¢tV,I;tK,•. .A.iiCl..luv.G.{�yJ..atyN�,l'• •IIONF., w 9! WrAI\S WOWµ hT Job SITE - I - - I' r i *3grs4 --8h - ••�i1�T�h�... :LArI�.`. ::pCtNli�.wA� �.501 /`v• > A�fZAX:-..-.Rod__L.Ail:-ti�.. .-..(SrAir..:r:-.d�.}_..:.:::--,.--_::::_::::.:_._-_.._ I ..��z''vLyf,�_..s���•,�Lv;:..:.'...:_ . :ow ToP 'or"r• Isn-4.._ t 2Y8�AfSE�S�lba,c \ SPI,YE Yo1NT.•SUf,tp .7-.-- ..... 74 .. . -oPT.'.EXf?'DSED:4ltSo��C.bT$(-M1�. sce:_.ac Jots. a6S". �•.. BkIDW_Fi8:W1iS:Lkl' '- PALu �..8'•C.oii,U,ni1. . . 4,,,. -\F116� SlnPtrlC� .ii' u IF'r -Pub --- SIM �.�w:ca- e � j1 •?_LF.'!6VG�E-Dt't�J'c:l.iKa:l. cuT t I ;Isucr -_ _snfS11r16__ktlno�... :u6vEt.j $F1:v'�d, Pr-IJE:f Ell tfj1 4:.GEI.tiVC_ .IL:•r9 rt7:TffG f•'A f i •' j-�15 STEP DJww1 __ 51P::.'PL�iSDQQ::ABFlOt1Z i--- I —y : - .. _ . _. •s:•.,a: a, .� _...2Y8._JOai'[;.. 11,':a:4_ i1T.N6� 2-0 . . � RiC�vC.'i�.� • �.. 1 2xf."cL'af's1f P, .. . : C- -m)�. I,. fly="11 S9.:r1 -•�� �•:::.YL-n.�._....(..�n�� ../e�-1.0 , _c.R4uJ�._S.RA2 —_ Z.LJNC...Qii:j;D\J Alt• I(o k8 NIN•T1 65 ` , f ------__�__...... ..... 14 rp� LU Ol -..g--: j a d7 ZA 2 VI vm :�, • p'� o .-.r--its•-- - -- � - ' �• _4It L r ( �n P k U li Assessor's offioe (1st floor): oFfNE 0 / t _ Assessor's map and lot number ..... LI�...�t....... ......... ... ............ •, Q ��. v, o Board of Health (3rd floor): � � ,-��� • -d Sewage Permit number .................................I................ Z BAUSTADLE. Engineering Department (3rd floor): ' oo ,"b 9. D 3 �0 House number .....................................��............................. �oraY°• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only ANN" _ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ,put on an addittion TYPE OF CONSTRUCTION .......Wood Frame .............................................................................................................................. ,.'S�tember 26, 86 ....................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...Lot 25 10 Minton Lane-W. Barnstable, Ma. 02668 ...........................................................................................I........................................................................................ Proposed Use .. Family Room ................................................................ ................................................................................................ W. Barnstable Zoning District .................... .. .........................................Fire District .................................. ............. Richard T. Farley, Jr. 10 Minton Lane W. Barnstable, Ma. 02668 Le,kV I e, Nameof Owner ......................................................................Address .................................................................................... Nameof Builder ....................................................................Address .................................................................................... • I Name of Architect Joseph P. Kelley_ Smith Farm Rd. Eastham, Ma. Address .................................................................................... One ` oomspn(1 Poured Concrete ......................... Number of Rooms ...................... .....`�......,.....,........�...`�....Foundation ........... Wood Frame Asphalt Shingles Exterior ........................................................................Roofing .......................................................................:. Wood,Carpet and tile Sheetrock Floors .....................................................................................Interior .................................................................................... Heating For.c.e.d..H.o.t..Air...............................................Plumbing None ................................................................... . . .. .. . .. .... ........ Fireplace ...Brick...................................................................Approximate Cost ......... (y 20 X 22 Definitive Plan Approved by Planning Board X 19 2S Area '/"!rt/ Diagram of Lot and Building with Dimensions / Fee ........ SUBJECT TO APPROVAL OF BOARD OF HEALTH `r l , 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. s Name ...v .r1,.- ..1...... . ......� .......................... Y Construction Supervisor's License ..r ,.I............... FARLEY, RICHARD JR. A=-174-32 No 29967... Permit for ....Build Addition ............................ Single Family Dwelling ........ ........................ ..................:.................... Location .....Lot #2 ............. l.q..Mqnton...Lane...... W. Barnstable ..................................................................... ......... Owner ..........Richard T.. Farley.jr,........... ................... ............... Type of Construction ..:Frame ............................ .. . ...... ............................................................................... Plot ............................ Lot ................................ September 26, 86 Permit Granted ........................................19 Date of Inspection ...................................J9 Date Completed .......................................19 Assessor's,map and ,lot number. THE ,. f roe` Sewage Permit number .....j.. ..........s.�!?? BARNSTABLE, i k House''number " . ern q rb a ....... TOWN - OF .- BARNSTABLE BUILDING INSPECTOR / r APPLICATION FOR PERMIT TO .... TYPE OF.CONSTRUCTION ......t! !„d„ ........1..:...��� ............................................................................. ..... /. . ./..: . �....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......................................................................... ?............................................................ ................................ ... ProposedUse .......................................�-......../j............................................................................................................... ZoningDistrict ......... ..............................................................Fire District ....l..M.,, ......................................................... ��Name of Owner ...... .�..... ..... .�(..��..........................Address ...l..r.�r.....�5.2�2..........0 �... Nameof Builder ..:.................................................................Address ..................................................................................,. Name of Architect Address ............................Foundation ../,�J� ,Lv����/ Number of Rooms ........t,..�......................... ....................... .......... Exterior v`� �: 7. ....... ...G. ...................Roofing ................. ................ ���`7( �/1/.%� / .Interior ............... . ?1--..t-�. /�`� _ Floors ................ ............... ...-. ....�........ ..... ..,,................. ..,.. .................-........................... , ...;�..../..�I��.............Plumbing .....................:0.....,.....�.... Heating ... � .. Fireplace ..................................... (` �.....................Approximate Cost ................. v � C' Definitive Plan Approved by Planning Board /�—� — ,='--19_ _ Area Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH � 2 ��o�� s X14) 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 ......... / ilti.. �................ ' xx i Construction Supervisor's License .....C...Q................. ..... GREEMRIER CORP. A=174-2 No ..... Permit for .1 z Story................................... Single Famj.l ................... ................................. Location ... .......... ....................... ................................ Owner ..9'P K..Q,QA I?............................. Type of Construction Fram.............................. ................................................................................ Plot ............................ Lot ... ............................. Permit Granted August...16, 19 84 Date of Inspection ............. .......................19 Date Completed .......................................19 7ae FROM TOWN -OF BARNSTABLE BUILDING -DEPARTMENT Mr. Francis Lahteine Town Cleric 367 MAIN STREET HYANNIS, MA 02801 Phone: 775-1120 SUBJECT: FOLDHERE DATE - - October 12, 1984 M E S S A G E . F Work has been completed under Building Permit #26848 & #26849 (Greenbrier Corp.) Please release Bonds.. SIGN :6 DATE �7 P 1 - - SIGNED - _ N87-RMI, - 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. �,�• "�*. TOWN OF BARNSTABLE 26848 � e Permit No. ------ -------------------- ���� ,•1 Building Inspector -cash ----------------------------- °" -OCCUPANCY- - PERMIT Bond ----_ Issued to Greenbrier COrD. may.^" � Address Lot 25. 10 Minh am. Centerville Wiring Inspector � Inspection date Plumbing Inspecto /�' ' Inspection date / Gas Inspector Inspection date X Engineering Department � 1 � �_ Inspection date/0 Board of Health----, � �;� �••��,ii1� �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. .� ..................................................... e ... ........_..:.....: ` Building Inspector 1 v . -__30'36 �AS lk J •a y3,s�8 sF � ' :Y 3 ZOr Zy I ti I a' 0 `1 1 o .t a a i o � q ,o i 32.a CIA 89*--- - -— o v ft A- 39.Sy 78,G 3 S 790 Ail t nQ�V/4TF_ ropy ` �• So Z o NE X F A c,c c- ;5 CERTIFIED PLOT PLAN /11 i oa - rz. vie z 'r— 4 " I N r SCALE, / ���o " DATE 7 /g 8y ' a _ LDR£DGE ENGIIYEERI,�VQ C4 /N �� CL�l�IT 1 CERTIFY THAT THE !-�ov�&q TioN t ti SHOWN ON THIS PLAN IS LOCATED EGISTERED REGISTERED ,. :� RoaeRr oN t CIVIL LAND d0•A M0� 320 BRUCE ON THE GROUND AS INDICATED AND ENGINEERSURVEYORo �aK H CONFORMS TO THE ZONING LAWS . pfi.SY; OF BARNSTAB Ev MASS. 712 ,M A I N 'SST R E$T CM.',pY� s ► YE�yo� /B� -� °�—�% ;_.$ HYANRIS MASS ,. BNE.ET.�, Q1�.�.. DATE REG. LAND SURVEY®X.