HomeMy WebLinkAbout0133 ARROWHEAD DRIVE ,,
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Town of Barnstable Building
ost This Card So That it is Visible From.the Street-Approved Plans Must be Retained on lob and this.Card Must be Kept .
� Posted Until Final Inspection Has Been g ^� 1�
Required,such Buil be Occupied until a Final Inspection has been made. C
Made.
Where'a Certificate°of Occupancy is din shall Not r
Permit No. B-19-2958 Applicant Name: Elvis Verdezoto
_ Approvals
Date Issued: 09/10/2019 Current Use: Structure
Permit Type: Building-Insulation-Residential Expiration Date: 03/10/2020 Foundation:
Location: 133 ARROWHEAD DRIVE,HYANNIS Map/Lot: 270-082-002 Zoning District: RB Sheathing:
Owner on Record: LOHBAUER,JO-ANN BISCEGLIA Contractor Nan SCOTT VEGGEBERG Framing:' 1
Address: 133 ARROWHEAD DRIVE Contractor License- CSSL-103832 2
HYANNIS, MA 02601 _ ,. ...,m�.,� '
Est Project Cost: $2,049.00 Chimney:
Description: Residential weatherization/air sealing. No structural changes. II Permit,Fee: $85.00
i Insulation:
Project Review Req:
- - Fee Paid $85.00
Date- 9/10/2019 Final:
l Plumbing/Gas
- Rough Plumbing:
-• -.. Building Official
Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within`s.x months afterr'issuance.
All work authorized by this permit shall conform to the approved application and the'approved construction documents for which,this is permit has been granted. Rough Gas:
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:
st This permit shall be displayed in a location clearly visible from access reet 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.thispermit.
Minimum of Five Call Inspections Required for All Construction Work: ? Service:
1.Foundation or Footing A Rough:
2.Sheathing Inspection - -
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
S.Prior to Covering Structural Members(Frame Inspection) Low Voltage,Rough:
6.Insulation
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
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
All Permit Cards are the property.of the APPLICANT-ISSUED RECIPIENT �e� �C Final:
Town of BarnstableBuilding
Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept
spa.�rers� �
�$ Ass. �Qr, Posted;Until Final Inspection Has Been Made.
� ,ess•�0
.y1650- � Where a Certificate of Occupancy is Required, such Building shall Not be Occupied until a Final Inspection has been made.
Permit No.' B-17-4301 Applicant Name: Approvals
Date Issued: 12/14/2017 Current Use: Structure
Expiration Date: 06/14 201R Foundation:.:.
. Permit Type: :Budding-Siding/Windows/Roof/Doors . p /----
Location:'.133°ARROWHEAD DRIVE, HYANNIS Map/Lot 270-082-002 Zoning District: RB Sheathing:
Owner on Record:. LOHBAUER,JO-ANN BISCEGLIA Contractor Name: DANIEL EIZENBERG Framing: 1
Address` 133 ARROWHEAD DRIVE Contractor License:. 138679 2
HYANNIS, MA 02601 Est. Project Cost: $ 16,000.00 Chimney:
Description:, Replacement Windows,(16) Permit Fee` $81.60
Insulation: -
Harvey Fee Paid: $81.60
Project Review Req: Date: 12/14/2017 Final:
Plumbing/Gas
Rough Plumbing:
Building Official Final Plumbing:
This permit shall be deemed abandoned and'.invalid unless the work authorized by this permit is commenced within.six months after issuance.All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: "
All construction,alterations and changes of use of any building and structures shall be incompliance with the local zoning by-laws and codes.
This permit shall be displayed in,a-location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas:.
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.
Minimum of Five Call Inspections Required for All Construction Work: Service:
1. Foundation or Footing Rough:
2.Sheathing Inspection
ection
3:All Fireplaces must be inspected at the throat level before firest flue lining is installed
Final: .
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5. Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:
6. Insulation
7. Final Inspection before Occupancy _ Low Voltage Final; .
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
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:
All Permit.Cards are the property of the APPLICANT-ISSUED RECIPIENT
Town of Barnstable *Permit#
Building Department Services Expires 6monFte from issue doe
anxivsresc,E, : Brian Florence,CBO J 'n
Building Commissioner
lFD MA't 200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
EXPRESS PEP MIT APPLICATION - RESIDENTIAL ONLY
without Red X-Press Imprint
Map/parcel Number
Property Address
[Z'Residential Value of Work$ ft�o�Qa7��O Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address
Contractor's Name ,(01 /,eo% � Telephone Number
Home Improvement Contractor License# if applicable) h
p ( pp ) ���� Email:
Construction Supervisor's License#(if applicable) C-3 94/3(e 3
❑Workman's Compensation Insurance
0 k one:
am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
® Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows
#of doors:
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.SIGNATURE: �24,11 0/�j (/��, -a4l
Q:IWPFILESTORNIMbuilding permit fonns\EXPRESS.doc
08/16/17
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27m ComtrzarnrreaWt ofMassr djusetts
Depart maut crfrndustria1Acdde7ds
. . 600 Washington&treet
_-- Bastan,MA 02111
i-mviu7fJasngavId is
Wur mrs' Camp ensaf mInsn-anceAffidavit:Bufldets/Cantractars/EIeciri "gns Im:Lhers
Applkant Iuftt=tiuu Please Prat Ere Y
P no
Are you an employer?Cheektheappropriatebom ' T of project r
I-❑ I am a 1 u� 4 ❑I am a general contractor and I Y e 3 rru �bn }:
employees(:Cuff an�dfor part time)* bzve hired the sir-cones 7 ❑Ide4v canst cii
•2-z I am a sale p�rugrietar orpartaw- Usted oathe.aftarhed sheet, I- ❑ modeling
ship and have no employees Theme�-c°a'tractors have Demalififla
wadzing forma is any capacity. employees mdhare wodners' 9. ❑RWIdiug addition
etu ttiaders' camp.insummo comp-ksurm l
. 'red �. We are a cotporationand ifs 10.0 Ele#ical repairs,or adcEtions
I F1 I am.a homemmer doing all work officers have exercised timir 1 L 0 P3umbingrepairs or additibns.
myself o workers' aEd of eMMPfion per MGL
- c-152,§1(4) and hwe no L�7
❑Roafrepairs
;a�anre rued�Y 1�_❑other '
employees.(No wo&ess'
comp_insurance require&&
r�appfim��ac cbed3bas;*1 nmst aL�ffio�the secHoaheLowsTrLnang Hie¢wo�cexs'mmpeasa[inupaTrrgiafarmanaa
gOaleDWrlerSWhD sat�it dais daS7E im caiiag f3wy YI�+�m'alFvro�c gadt5mhaeo d9COIItmcmrsamst mBmlt axmwaffidxed Smcb
fCoatrsc[nis�z[d�ec' *B6mcm arftd, inadditimal shad dwvdngdenmueof[tesnb-r�zcdsfxtevrhe mornot$mseeaff&shwe
employees.If thesuhtMI-but mhaveemploys,9heg�s�g��their nnrlce�'•romp.galiryatmnbeL
I=art elspb r tl[rrf isprat'idrirg u�arkets'can [tsru`fati iasriranca for rrr}*empplay�ee $eIap9 is f7[epaficy�arrd job sfta
€nrforurafiom
ItssuranceCau�ganyitEaffie: '
'Po,r,cy 41.or Self-ms.I ice. 1zauDate:
Job Sif e Address Citylstawrw:
A##ach a copy of the workers'caa[peusationpolicydeclaration page(showing the poUcy number and ezpn-ation date).
Fare to secure coverage as requiredunder Section 25A of MGL m 1577 can lead to the imposition of esimsnal penalties of a
flue up to$1,5Q0:4U awYor one year imprisonment,as wL�U as civd penalties in the form of a STOP WORK OBDERaud a fire
of up to$250-00 a dap agaimst the violatur. Be adi'ised fiat a cagy of this statement maybe fxwarded fn the Office of
Inestigatiom of the DIA for iistrrancf coverage yeriffbation_
Ida her-eeby ceiiF;fy'nuderr thapaaiins_m[d psr=h&s of
.pajiu7 flurtflis hcfarmatiauu p[c[ rleJd abate is trim rrii^d cavrrect
O&-id aw cr 9. Da irat rsrite in thh area,to be crrttspFeteJ by city artown oJOL-at
Chy or Town: PerrmtUcense g
Bsting Aufherity(ca de floe):
L Board of$•eA i 1 RuMing Departm.•errt S.C ty1rown Clerk 4,Electrical Iuspectur 5.Plumbing rmspecimr
CL Other
Contact Person: Phang#:
-- — - - 6
Information and Instructions
A �� efts Cyr--=al Laws cbapt=M requires all empIoy=in provide worker ='Peosutiou fur their eurployees. j
Pffrs-a�tto this sf ,an wq kyee is defined ar¢:ev�ypeasanin$fe servic ct ofhire,
e afire m ar implit-A,oral ar writtc -
An.employer is d�fined as man mdrvidIIal,psrinexship,association,corporation or offier Iegal ty,or any tW or more
of the foregoing=V ged is a joint =•and including the legal of a deceased employes,or the
recei4er or trastee of an h Hvidaal,per,association or otherIegal entity,Moployiog CM3p10y=9- However the
owner of a dweII>ng house having not mom tl=three mtnents mdwho resides ffi=h:,or the occ¢pant oftbe-
dwelIing house of anodrar who employs pemons to do ,caaskac i rn,or repair work on such dweIImg house
or on the grounds or building agpir�thereto sbannotbecanse of such emplaymeatbe deemed to be an employs°'
MCs`L cbapt�r 152,§25CC6)also sues that¢every sf�or local iicen�agency shall wifiihold$te issuance or
renewal of a ficeuse or permit to operate a Dusines.s or to construct bwldings iu fire commoawealtii for any
applicantwho has not produced acceptable evidence of complimm n the ftsttrance.coverageregalr
Addi donalb,MCTL chapter 152,§25CM sfatrs-Neither the connnaawrM nor;�ny ofifs poIifical subdivisions Shan
ester inb any contract furthe performance ofpnblic wolf-uubl acceptable evidence of mmpliancevlith$e insurance.
reqmreni of this d2BPtEr have 1; e preseElt-_d to the codractmg.audioii yf
Applicants ,
Please El o-ot the worker'compeasafion affidavit complet4n by ch=jci g the boxes that apply to your sifnation and,if
n=essazy,amply Snb-00ntracf1r(s)nsme(s), addresses)andphonenumber(s)aIongwrththea certffi[r± (s)of
ice. Lmmited Liahiy Conrpames(LLC:)or LmitedLiabUityPer=shiFs(I I P)verfhno employees other ihau he
members or parfnel-,are not rtgoired to cagy wmkm-e coonpensaiion msoranca. If an LLC or LLP does have
empIoyees,apolicyisrequ�d. BeadYisedf3�thisaffida�rtmaybesnbmittedtatheDepa-3nentofIndustrial
Ao cider for con�on o f b=an a coverage. Also be sere to sign and date ire aflydavif The affidavit should
beretamed to the city or town that the application for the permit or license is being reques►�,not the DeparEmenf of
Lnj±stfiaj_A dm s. Shouldyou have any question rega ing the law or ifyon are regoaed to obtain a workers,
compensa±ion poHcy,pimse caR tho Deparfineot at the nu bes lisfad beIOW- Se1f-R0 red co�anies sTi°vld en t the ir
self-mince liceme number on the app-gaHate li e:
City or Town OfftCials -
f
Please be sate that the affidavit is complete andprit ed.legrfly. The Departmenthas provided a space at tiie bottom
of the affidavit for you to fM out in.the event the Of oflnvesdgations has to rontar-tyouregmTUng&m applicant
Please be sure is t771 in the pe�mit/Hcease nttmbex which.wdI be used as a reference nmmbes In addition,an applicant .
chat must submit multiple p=itlI C=M applications in any givea year,need.only submit one affidavit indicating=mt
policy information.[rf nece ssary)and under°Tob STz Ad d r c ss'°the applicant shorld"rife ban locations in (C i tY or
town)."A copy of tho aff davitt3iat has been officially sim3:Pe;d or maimed by tho city or town may be provided to fho '
applicant as proofthat a valid.affidavit is on file for foinre peMm43 or Hc=es. Anew atlidavitmust be��Dirt ninth
year.-Wh=a home owner or citizen is obia ing a license or permit not related to.any business or comet scial y�'n�
to Iete this affidavit
etc. said person is NOT retlah �
ie.a do license or .' to bumleaves , )
(' g P� .
' The Office of Ind wouIdhke to thank you in advance for your cooperation and should You have any gaesfzans,
please do nothesi to givens a call
The Departmmfs a d&=.,irlepbme and fax r=ber: -
Depaxtneut ofliid� AQdenU
Tf,-L:14617- -4 C.t 4€6 car 1-9' 1S-��
Fax#6.17-727 7M
R=ised424-07
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4
Town of Barnstable
Building Department Services
` KAS& Brian Florence, CBO
Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section. -
If UsirLa- A Builder
I ,as Owner of the subject property
hereby authorize ���, � ( _ to act on my behalfy
in all matters relative to work authorized by this building permit application for:
r3� l[If0LJ/LM-01 all We,
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
SIgnaiure of Owner Signature of Applicant
Print Name Print Name
Date
Q:F0RMS:0VR4WERMISSI0NP00LS
Rev:0&/16/17
Town of Barnstable
Building Department Services ,
Brian Florence,CBO t
Building Commissioner
200 Main Street, Hyannis,MA 02601
RUMSTAMA
www.town.barnstable.ma.us
a639.
�p Mla
Office: 508-862-403 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
DATE: Please Print
JOB LOCATION: 1,33 y—rvuJhxa� A"o S
number / street village q
-HO.OwI ER �o - fi n n 6h&.ute ' 77/ ,2/ a S W- S7 6 - A L 7/
name home phone# work phone# .
CURRENT MAILING ADDRESS:
cityhown 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.
she undersigned"homeowner"certifies that he/she understands the.Town of Barnstable Building Department minimum inspection
procedures and requirements and that he/she will comply with said procedures and requirements.
r
Sigdature of Homeown
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code
Section 127.0 Construction Control
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt
from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner
engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor
(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often
results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot
proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is
ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the
permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page
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:\WPFUES\FORMS\building permit forms\EXPRESS.doc
09/16/17
1 ,
s i Office of Consumer`"Affair's 6 Business Regulation
> HOME.IMPROVEMENTCONT.RACTOR'
TYPE Individual
s Recistration t iration.
138679 05/01/20y 9
DANIEL EIZENBERC3�
DANIEL A EiZENBERG
114 MAIN STREET, , � e+� s� t
s ° CHATMAM MA 02633; x
Undersecretary
u':
t *�
.. `:� M ~rsaotuset#s Department oi`,Pt�biie� afet��'*;
.Board of48ij lding:Regulations arjq,76tandardfi
� .
QOnstrUttlon Supervisor
DANIEL A EIZENBERG
e 114 MAIN STREET a 1p ,.
CHATHAM MA 02633' '
7
X r Expiration ='
d .
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Registration valid for�individual use only _ `,
before the expiration date. If found return to:
tfi '
tlf � Ccro'of surner Affairs and Business Regulation
10 Park Plaza-Suite,51M,
-.Boston,MA 02116-
## ' ,Not=vajirrwithd6t sig y inure
B
r Construction Supervisor£;
Restrictedpfo
ryUnrestricted -Buildings otany use group which-contain"
F less'than 35,000 cubic feet(991 cubic.meters)of
enclosed space. '
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_ Failure to possess a current edition of the Massachusetts
1 *State Building Code is cause for revocation of this;license. „
DPS'Licehsing information visit: W 1iW MASS GOV/DPI
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t: 77
r Town of Barnstal
Y . 777 11■■ 77ee
A .W� 5;. axs..t..£ -af s':.xt rk,! ':.Ky- �Jl� i1n
; .. .,ter„ m xr .r ..a;:... t 'i..,;... ^; - n
�..,T. . -1-1 - -, r
.. ,�, ,.E._.._.s:�;.: .. .. �s - � i- � z. .. '
, .. P ;,dnJo ..an rthi t Must,be K '
3 rdS ,vT F, it ., roved,PlansMust,be,•Retained b d. s Ca ad e t
� � S e C14_n'i�_ ..�_ __#A,.,.. ,...' 1. . ,. .. ...... ..,�W ...... ... .:....... .... $ „ ,....,..3ai ,. /,'n. .. `:;.
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... .� ♦. �......fir ,..._. . ,. ,..._> 4' .,' ... �,,. ,.,�':..... ,.,,,.� ,�. .::.-._ _.a �....„ .�,�,. ,.. ..� ,��..,' ,
.:...�.<., � � . ., , • : ;,.� .._ dun#ika:,,E�nal�ans eetiFl�s:been-made.. s.�.,::. . . :._ - 0".
'Applicant Name. Craig Blshop,
Permit-No., 8-17 3262 Approvals
Date Issued. "10/11/2017.
Current Use Structure
Permit..T.ype: 'Building'=Insulation-Residential Expiration Date': 04/11/2018
Foundation:
Location:,,133 ARROWHEAD DRIVE HYANNIS :. Map/Lot 270-082 002 Zoning District:; RB. Sheathing:
Owner on Record: LOHBAUER,JO-ANN BISCEGiIA � .! Contractor Name Craig P Bishop Framing: 1
Address: 133 ARROWHEAD DRIVE Contractor License; CS 109777 2
r Al, ., t
Ata
HYANNIS, MA 02601 Est P�roi, ct Cost: $1,499.00 Chimney:
Description: 8 hours air sealing xPermrt fee: $85.00
7 Insulation:
Insulate 2 kneewall hatches with 2" rigid boardw�
Install 192 square feet of 2" rigid board in kneewall': Fe�ePaid $85.00 _
q g ; Date ... 10/11/2017 Final:
j q: Plumbing/Gas
Project Review Re
_ ..
Rough Plumbing:
6 Building Official
{ � Final Plumbing:
16
. .'
:•, Rough Gas:
This permit shall be deemed abandoned and invalid unless he work authorized by this permit is commenced within six months afterassuance. g
All work authorized by this permit shall conform to the approved applcatlon�andhe approved construction documents.€or which thls permit has been granted.
All construction,alterations and changes of use of any building and st uctures shall be in compliance with the local zoningiby Paws and codes. Final Gas:
This permit shall be displayed,in.a location clea.rly_visible from,access street or�road and shall be maintained open f pu "I taspectlon for the entire duration of the
work until the completion of the same. » Electrical
. F Service: .
The Certificate of Occupancy will not be issued until allapplicable signatures by theBu11d1ng and Fire Officials areprouided onythis permit.
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
Wh r lic ble s its are required for Electrical Plumbing,and Mechanical Installations.
e.a app a . ,-.eparate perm q g,
;:,,Work.shall not proceed until the Inspector has approved the various stages'of construction
Final
. .. _ n ..... - - ;; . .
a.P: .rs s•contracti: . wi unr� istere.d contrar torsdo:no :hVe access to the uaran"';fund as setforth:i'n fVIGC c:142A : Fire'Departm�nt
..th .. g . t g tY ( )
Final:
Building plans are to be available on site.
All Permit-Cards are the property of the APPLICANT-ISSUED RECIPIENT
S
�T
11/02 94 17:02 *C61772T7122 DEPT IN'D ACCID a
l..onunoruueaftli of Y&I-lachusetti
. ..UaParfinenl o�.�iiduaf�ia[.�cci�en�
600 Wwk-kylon&mel
James J.Campbell Mon, Mamaguulb 02111
Commission!
Workers' Compensation Insurance davit
with a principal place of business at:
(owlst"izlo)
do hereby certify under the pains and penalties of perjury, that:
() I am an employer providing workers' compensation coverage for my employees working on
this Job.
Insurance Company Policy Number
O I'am a sole proprietor and have no one working for me in any capacity.
() I am a sole proprietor, general contractor or homeowner (circle one) and have hired the
contractors listed below who have the following workers' compensation policies:
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
I am a homeowner performing ail the work myself.
I under_<tard ti,st a copy of&,is statement will be forrzrded to the office of Investirations of the DTA for coverage verification and that failure to SKU.
coverage:s ree it ed under Section 25A of MGL 152 can lead to the Imposition of criminal penalties consisdne Of a fine of up to s 1,500.00 and/or
years' impri<onr;ent as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me.
Signed this day of ��i� J/. 19 i
Li ense-e/Permittee Building Department
Licensing Board
Selectmen Office
Health Department
TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375
TOWN OF BARNSTABLE _
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print.
DATE . • � ....... ... ..
J
JOB LOCATION l .3 2 ® ff�ig GZ �/l4il/l,�
Number Street address Section of town
"HOMEOWNER" �'o-�� .� d yaJ4�/�� 77�s=��'�F/ � .•.. . .:
Name Home phone Work phone
PRESENT MAILING ADDRESS
City town State Zip code
The current exemption for "homeowners" was extended to include owner-occupied
dwellings of six units or less and to allow such homeowners to engage an in-
dividual for hire who does not possess a license, provided that the owner
acts as supervisor:.
DEFINITION OF HOMEOWNER:
Person(sj who owns a parcel of land on which he/she resides or intends to re-
side, on which there is, or is intended to be, a one to six family dwelling,
attached or detached structures accessory to such use and/or farm structures.
A person who constructs mo
re than one home in a two-year period shall n Y P of be
considered a homeowner. Such "homeowner" shall submit to the Building Officia
on a form acCept'able to the Building Official, that he/she shall be responsibl
for all such work performed under the building permit. (Section 109. 1. 1)
The undersigned "homeowner" assumes .responsibility for compliance with the Sta
Building Code dhd other applicable codes, by-laws, rules and regulations.
The undersigned "homeowner" certifies that he/she understands the Town of
Barnstable Building Department minimum inspection procedures and requirements
and that he/she will comply with said procedures and requirements.
✓HOMEOWNER'S SIGNATURE Q-
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings 35, 000 cubic feet,. or larger, will be required
to comply with State Building Code Section 127. 0, Construction Control.
--1
L
HOME OWNER'S EXEMPTION
The code" state that: "Any Home Owner 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 a
Home Owner engages a person(s) for hire to do such work, that such Home Owner
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a- supervisor (see Appendix Q, Rules and Regulations
for .licensing Construction Supervisors, Section 2. 15) . This lack of awarenes
often results in serious problems, particularly when the Home Owner hires
unlicensed persons. In this case our Board cannot proceed against the
inlicensed person as it would with licensed. Supervisor. The Home 'bwner- actin
as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities, man
communities require, as part of the permit application, that the Home Owner
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.
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Assessor's Office(1st floor) Map 4-70 Lot ermit#
Conservation Office(4th floor) Date Issued 0 7 �;7
Board of Health(3rd floor)(8:30-9:30/1:00- 2:00) -116 7 GW �g6 ,keee
+
Engineering Dept. 3rd floor House#1
Dept.(1st floor/School Admin. Bldg.) ? ,
Definitive Plan Approved by Planning Board 19 SEPTI UST BE
INSTALL PUAINC
TOWN OF-BARNSTABLE VITHTITLE15
ENVISOMMENTAL OD c��
Building Permit Application �Eyyt�ft ,
Project Street Address 2 ze A 2® W P LKA A Z A
Village y Ny / S
Owner 7-d- Y41 ?3 Add
r ss Ji4 ram'
Telephone
Permit Request To , C O/i/--r7-2 U C T A ! L 'X r 6 ' D c C /c i o (Z 4 i'c- 4-c c=
6�_X/J'TGaCl- to ' �c is ' �LJ-CCc
Total 1 Story Area(include 1 story garage &decks square feet 9A
Total 2 Story Area(total of 1st&2nd stories) square feet
Estimated Project Cost $ 2d o l 0o
Zoning District Flood Plain Water Protection
Lot Size Grandfathered?
Zoning Board of Appeals Authorization Recorded
Current Use Proposed Use
Construction Type
Commercial Residential
Dwelling Type: Single Family Two Family Multi-Family
Age of Existing Structure Basement Type: Finished
Historic House Unfinished
Old King's Highway
Number of Baths No.of Bedrooms
Total Room Count(not including baths) First Floor
Heat Type and Fuel Central Air Fireplaces
Garage: Detached Other Detached Structures: Pool
Attached Barn
None Sheds
Other
Builder Information
Name Telephone Number
Address License#
Home Improvement Contractor#
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 BETAKEN TO ,9
SIGNATURE DATE
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY
PERMIT NO. #83�$5
DATEISSUED July 7, 1995
MAP/PARCEL NO. 270.082.002
ADDRESS 133 Arrowhead Drive VILLAGE Hyannis, MA 02601
r a
OWNER Jo-Ann Lohbauer
a
L
DATE OF INSPECTION:
r '
FOUNDATION _
FRAME
4
INSULATION
FIREPLACE _
ELECTRICAL: ROUGH FINAL
PLUMBING: " ROUGH FINAL
GAS: ROUGH ' FINAL `
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
•
f p COMMONWFA_LTH OF NLA.SSA.CHUSETTS
JEI'AT MLNI OI I?�FDUST RLt�L ACCIDENTS
600 WASHINGTON STRi!tT
lames Canooet BOSTON, MASSACHUSETTS 02111
�c"-nas�one WORKERS' COWENSATI0N,INSURANCEAFFIDAVIT
(licensee/permirtcc) _
With a principal place of business%rc Idcna at:
7 7- r
(City/StarC/Zip) .
do hereby certify, under the pains and penalties of perjury, that:
O I am,an employer providing ncc folfowing workers' compcnsation coverage for my employees working on this
job.
'Insurance Company Policy Number _
I ) 1 am 2 solc,proprietor and have no one working for me.
1 am a sole proprietor, cne ral contractor omen ow u,cirdc one and brut hired the contractors listed below
P P �g .
Who have the following workers' compensation insurance politics:
Name of Contractor Insurance Company/Policy Number
'2mc of Contractor Insurance Company/Policy Number
Name of Conuaaor Ins=nce Company/Policy Number
Q l am a homco,.X�ncr performing all the work myselh
OTE Plcasc be awsic that wbilc bomcowncrs wbo employ m
ploy persons to do aintenance,cc structioc or repair work
V on a
lwclling of not more tbam three units in wbicb the bomew mer also ruides or on the grounds appuruaant tbcreto arc oat EeaeraD
considered to be employers under the Wooers'Cornpcnsation Act(GL C 152,sect.. 1(5)).application by a borocowner for a l;cCcSC
or permit may evidcocc the legal status cram cr_ploycr under the Workers' CoMpeosation/let
1 CaOGrStanG tna(a Copy OI tnJf-Sraemfnl wlli ix fon+•ardcd to the Dcpa:::-.:cnt of JndustriaJ/,eadents'OGiee of Inwrancc for.eovera,-
vcdfiution and that failure to secure coverage as rquircd under Scction 25A of MGL 152 can kad to the imposition of ttiminal pcnalucs
I conisdng of a Gnc of up to S1500.00 and/or imprisonment of up to one ycu and civil penalties in the form of:Stop Work Ordcr and a,
fine of S100.00 a day against mc.
Signcd this '?h' � day of -U o �/�..lH / &T"OL- 19
Licensce/Permincc Licensor/Pcrmittot
_ E.
COMMONWEALTH OF MASSACHUSETTS
DEI A ZT),, E OF INDUS]:�RiAL ACCIDFNTS
.L 600'WAS HrNGTON STRUT
Barnes Gamooen BOSTON, )`'iASSACHUS=S 02111
�c-m.ss�one C�70RK£RS COMT,Ei�ISAT ION INSURANCE AFFIDAVIT
1, �U '-fn/.+/ 13ISGeFL //a GOff//.3 4y-6:F-6- I
(licensee/pernti acc)
with a principal place ofbAa&iu=s/residcnee at:
/ 33 4 2 f2 0 W Ale---A 2 (Z Ay `/A-•r/.�/l r . !mot /} o t3 G a I
(City/State/Zip)
do hereby certify, under the pains and penalties of perjury, that:
i j 1 am an cmpiovcr providing tic following workcrs' com ��crs..�ion covc:-agc_ for my employees worlang on EhIS
job.
Insurance Company Policy Number
j J I am a sole proprietor and havc no one working for mc.
I am a sole proprietor,general eontraaor or omeowncr circle one) and have hired the contraaors listed below
who have the following workers'compensation insurance policies:
&"tea .9k"' gAe-ir-R G Al v 9 k -7 z12 — 93
Name of Contmaor Insurance Company/Polia-Numbu
N-amc of Contraaor. Insurance Company/Policy Number
Name of Contraaor instuarcc Company/Policy Number
Q 1 am a homeowner performing al;the work myscl£
NOTE: Plcasc be awase that while homeowners who employ persons to do maintenance,eoostruetioa or repair work on a
dwelling of not more than three units in wbicb the homeowner also resists or on the grounds appuneaant thereto arc not gcaerzlly i
considered to be employers undcr the Wonccri Compensation Act(GL C.1$2,sccL 1(5)),application by a boracowocr for a license
or permit msy evidence the legal sutus of:.a cr`ploycr under the Workers'Coropensation Act.
i vnocrstand that a.copy of iris statement will ix forwudcd to t'r,c Dcpa:trscnt of Industrial Acadcnts'Ofticc of Insa:ancc for.covcr>Yc
wrifseation and that failure to secure coverage as rcSuired under Section 25A of MGL 152 can lead to the imposition of-timinaJ pcnaJucs
consisting of a fine of up to Sl 500.00 and/or imprisonment of up to one y=and civil penalties in the form of a Stop Work Order and a I
fine of S 100.00 a day against me.
Signed this l RSA day of
�9�
iccnscc/Pcrmittcc Licensor/Pcrmittor
Y
TOWN OF BARNSTABLE
BUILDING DEPARTMENT -
HOMEOWNER LICENSE EXE14PTION
• a
Please print.
DATE Al o ✓�f�f3 ! . l 9 5,3
JOB LOCATION 13 3 1¢!2.2 a(JC L,b -2) a -J
Number . Street Address Section Of Town
"HOMEOWNER" Lo14dgy&-A- 77j __v S-�,Fl
Name Home Phone Work Phone
PRESENT MAILING ADDRESS / 33 14dZ&06,y/f A D D/Z ,
N XA Al
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 such 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 to six 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
1--,t , a; norm;t (Sect:on 109.1.11
The undersigned "homeowner" assumes responsibility for compliance with the
State Building Code and other applicable codes, by-laws, rules and
regulations.
The undersigned "homeowner" certifies that he/she understands the Town of
Barnstable Building Department minimum inspection procedures and
requirements
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings! 35,000 cubic feet, or larger, will be
required to comply with State Building Code Section 127.0, Construction
HOME OWNER'S EXEMPTION
The code states that: "Any Home Owner 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'
Home Owner engages a person(s) for hire to do such work, that such Home
Owner shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a supervisor (see Appendix Q, Rules and Regulations
for Licensing Construction Supervisors, Section 2.15) . This lack of
awareness often results in serious problems, particularly when the Home
Owner hires unlicensed persons. In this case our Board cannot proceed
against the unlicensed person as it would with licensed supervisor. The
Home Owner acting as supervisor is ultimately responsible.
To' ensure that the Home Owner is fully aware of his/her responsibilities,
many communities require, as part of the permit application, that the H�'me
Owner certify that ho;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.
(aoAssessors office(1st Floor). r� - ��°�TIC � �g� ��T��
Assessor's map and lot number /d �d � O lI SOT THE
�LLE® IN COMPLIANCE
Conservation(ath Floor): c/ ;f .� _q.3 WITH TITLE 5
Board of Health(3rd floor): _ l� ENVIRONMENTAL CODE AND S sssiSUBLE
Sewage Permit number ��i -7 �� TOWN REGULATIONS 'co %639.
Engineering Department(3rd floor): ' a_
House number �o err
Definitive Plan Approved by Planning Board 19
APPLICATIONS PROCESSED 8:30-9:30 A.M and 1:00-2:00 P.M.only
TOWN OF BARNSTABLE
6UILMA , INSPECTOR
APPLICATION FOR PERMIT TO ti I&TOTL1 a rL p-
TYPE OF CONSTRUCTION _� X/�/�i✓J!� a L cf} ��',
Alo Ve_i�r;3�9t / 19 J 3
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location,�-' 123 Z) fZ s,r Al+ O-2_6 6
Proposed Use �S 1 D �C
Zoning District R6 Fire District
Name of Owner J'O 11-ALAI P3 t S C 4ff-G 4,1-/9 4 0t1A, 0e'A Address C',' .
Name of Builder StZ s'VP6 A VZdo(L Address
Name of Architect Address
l
Number of Rooms Foundation
Exterior Roofing
Floors Interior \
Heating Plumbing
Fireplace Approximate Cost
Area _ /� l:fr�/►t
Diagram of Lot and Building with Dimensions Fee\i
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 -
67
Construction Si ipervisor's License
LOHBAUER, JOANNE BISCEGLIA
No "3 Permit For Complete Interior
Single Family Dwelling
Location 133 Arrowhead Drive
Hyannis
Owner• Joanne Bisceglia Lohbauer .
Type of Construction Frames - -
r
Plot - Lot
Permit Granted November 3 , 19 9 3
Date of Inspection:
Frame 19
Insu_fation
4= Fir&pl ce 19 s r
�^ -
Date Completed 19 -
a a rE a
t '
E
J'�'rs
P �•Y- `, e 5+ �.,yEf u(� -o-
�i r3j st�,� •?'4�'�'' �.,,-�r__ ' -.. z', .%;. F'i -n �,�.�'3�.�., ,' v"Y.kipf. +y"/ .p -; .+.g, 7
L .
* -• TOW OF BAB.NSTABLE e 27643 '
-
= BII11 ZIIspedor,
ermit No.
t s,. �: Cash; ($80 e 00)
y
OCCU'PANChY g E �� Bond
P RMIT 5. ---_
r- Issued to l'artc flaai rm Aers Address x
�" Wiring Inspector '7 �/' inspection date.
_Plumbing,Inspector Inspection;date
V
5 Gas Inspector, �� rL Inspection.date
A 2-4 -�'
_
_.
En ieerin De r � gin g partment l� �
� .•• �ss./�®f ° `IILSpeCtiOII.(late�r' Y U V c
r 4% r Board of�Health- ` " -C i IIIspec`tion4 date c i
a ;V yJr. Pi: . �$
-THIS PLEB,MIT WILL NOT BE
VALID E SHALL.,NOT,BE OCC -UNTIL
SIGNEDBY THE BUIIDING INPECTO$ IIP TOWN SATIS PLIANCE '
, -
-- +;SEQIIIREMENTS.A %,� ACCORDANCEWITH,SECTION 119.0 t.,OF 17 'MAS$ACHQSETTS STATE
� 3 BUILDD G CODE
Building"Inspector _
� .-c ., z _, .,.� _ � �•Y '��r��.a -t'��'17�r� Y..Y-_', rR'`_ - J"`-:��4i :_.h _4_. Y�sl'T- .�.�.... .c ,...,�� -J c . s __,... � .,g .-T-. _. _ ��,.... '�..`I
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yCQvA.10 i93 3N0N/N NEC�@ON RAID TNgT /T .<;?� S
o�r.3 cOA/FOG.N TO TNE' Z'O.V/�l/Gr �`
BY++LA/1/S OF,. rAw 727ivA/ OF BA?(/STiILdGE w? GE
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�` ,As e'ssor's map and'lot'number ..G�. �.."..��8v2..`. �a �
"j . - ak f3 H• 36.c.. 0*?NE ropy
Sewage Permit number s �Q o
BA
A TITLE
-y�.. . Z HB9TAML
• I WITH House number.'f ...J j 7 s
NVIRO MENTAL CODE �,��,o��M6 -
• -'FO YpY a'
y� m.g
TOWN •'OF BARNSrX
BUILDING INSPECTOR 12 5oR
APPLICATION-FOR PERMIT TO .,w./a <�x 3C Ex�,AR!�/1J/ C.�P�.. s/�.................................
TYPE OF CONSTRUCTION .....`✓lie � ....'�-
. ........................................................................................................
---
� 19'.. ... .............191
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit ccording to the following information:
Location ���... .. ......"7.a!t°." ..... !��.......?!rye......�!.r�:''.vie......�.........................................:............................
Proposed Use /,.v/ fJ wesid€e"t
... ....................................................................................................................
Zoning District . ............Fire District .......17 '►^�r
' . .......................................... /1.....................
Nameof Owner .........:..............�1.!Y:.... ...........................Address .........................................................`�.:....... �............
Name of Builder .... /?j0 ......�Si nr /✓Sf�t:.........................Address ....7.7?..1.!'�r+o�7� �d . ��,✓..�d ...............
.......... ............................. .. ............
Name of Architect . ................Address ........................50,7,e" -
............................................................
Number of Rooms .............t/.................................................Foundation ....... ....ce.!cat�l �d laefft't:....
�D..+2 C.9 $aA 0, Bowl' ckaAd fL' Au//, r
Exterior ' " � ,...
Floors �'!9a!'Er• �.✓../i.................................................Interior S 4rX1001.,
Heating `I�9�..... o�a¢D r v .. Q.Q._ Plumbing /..! v !.. O" Q l
�,/ /� 1
Fireplace va Approximate. Cost /.....r��'
..................................................................... .............. . ....................:....................
Definitive Plan Approved by Planning Board ________________________________19________. Area ...... 6`�`
Diagram of Lot and Building with Dimensions Fe
.V.. !...........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH �Q�
o RLDPf
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.
Nam ...LXL
Construction Supervisor's License ...',2v 43V ...............
CAPE DESIGN ASSOC.
27643 13-, Story
,No ................. Permit for ....................................
P- I
Single Family Dwellia�r.....................
.....................................................
tocation ..Lot..2........1.3.3-Arrowhe.ad-Drim.
. . . . .. ............... .... .. ....
Hyannis
...........................................................................
Owner-....CaPe..Des'gn..Assoc..............
..........
Typeof Construction .......Frame........................
Y ...........
........... ...............................................................
Plot ............................ Lot ................................
Permit Granted ........ .........J9 85
Date of Inspection ........ ......19
Date- Completed AY-14
.... ....1..5, ... ......1-go
7
Assessor's map and tot number .............
TNF
OK
Sifwage Permit number ........ '...A.C.,.......................... d�
Z BA]USTAMLE, i
Housenumber ......................................................................... 90� NAM
039. 0�
\e
�p YPY a'
TOWN OF BARNST ABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ".... .`.�x• C "s��iq ! ..... sr. (r .....'rie-,�.
TYPE OF CONSTRUCTION .....° ........!l�.'.�... "' -.......................................................................................................
1..,...........
�.......7....................19. 5..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a �p/ermit according to the following information:
Location ^ �... �irQo w Hii,gp CJRrd,,z �f yA,wN/'....../4
f.............................................. ,
Proposed Use ��N�yZ�....,1,,—111y. ��srdf�<� ,
p . ...................................................................................................................................
f Fii✓iC
Zoning District ............�:�....................................................Fire District ........,!`:/�::.
Name of Owner � !,�'� ss�,y.!! .. s,o� ,.................Address ���^`a� � �0. /�,n+r•vr,t
.... ..... .... . .
n t. ESryer101. >� �M�i�.YCb . fiHs✓..��
Name of Builder .....—. .........................................................Address ....7............ ...................................�. .. ..... ..................
Name of Architect °
n$.a�� .......................Address .......................5... ?P..................................................
...........................................
Number of Rooms .................................................Foundation f C A LR'f!P ap f6r.CAS.
.............��. ................�. �
Exterior ... F 1+.Q2 /,00. � �. �n.r�....e e: Pn'��1,,.*k!,4f r,Roofing ....A�.i.1•R!o./ :...........................................................
.......
Floors C' ''r' ... /i.�.f.. .ti . Sn/t�. . rtoc ,
..........................................Interior ............................................................................
Heating ......���? t...:../..oac�3 1fa� ...... ...� . ..Plumbing .:f..;��� -�:.� ;�s�a .� (..........." `•rr j��vc
f, ..� �...{` ,... ....�............
Fireplace ao a Approximate Cost .............. ............................................
Definitive Plan Approved by Planning Board ________________________________19________. Area ..........................................
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 .................
CAPE DESIGN ASSOC. — 2
oo�i
No .A643..... Permit for ...1,a..Stoxy.................
..........
t
Lpcation Lot 2, 133 Arrowhead Drive
................................................................
Hyannis
...............................................................................
Owner ,_,Capr Design Assoc.
Frame
Type of Construction
................................................................................
Plot ............................ Lot .............................
Permit Granted .......Max'ch 26, 19 85
..........................
Date of Inspection ....................................19
Date Completed ......................................19
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