HomeMy WebLinkAbout0128 CAMP STREET /1 P C' An�� ST
� � _ _ �
, �
-'
I
�'1
� II
i
i
i'
t
I � -
� `� "�
...
V �.� -
V
��
Town of Barnstable
� Building
fi y a ro : � _
Post is Card So That it:is V�sible.From the Street Approved Plans Must be Retained on Jo Th b and this Card Must be Kept
{AItNB'CIiSLE,
Posted-
Mn ` Until Finaa) Inspection Has Been Made
� aWhe a aECeitificate of Occupancy�s Required,such Build�ng,shall Not be Occupied until a Final Inspection has been made erm��
Permit No. B-19-3565 Applicant Name: DAVID COX INC. Approvals
Date Issued: 10/23/2019 Current Use: Structure
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 04/23/2020 Foundation:
Location: 128 CAMP STREET, HYANNIS Map/Lot: 328-158 Zoning District: GM Sheathing:
Owner on Record: MAHONEY, RICHARD G&MAUREEN J Contractor`Name DAVID COX INC. Framing: 1
Address: PO BOX 242 Contractor License: 160497 2
WEST BARNSTABLE, MA 02668 Est:Project Cost: $5,000.00 Chimney:
Description: re-roof Permit Fee: $85.00
Insulation:
Project Review Req: g Fee Paid:`' $85.00
Date: 10/23/2019
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 si arnonths afterwissuance.
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 in compliance with the local zoning by laws and codes.
This permit shall be displayed in a location clearly visible from access street or''road,and shall be maintained open for publieJnspectionfnr 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 41" provided on this,permit.
Minimum of Five Call Inspections Required for All Construction Work: ' s ,,; Service:
1.Foundation or Footing Rou h:
2.Sheathing Inspection ,; , "a_� g
3.All Fireplacesmust be inspected at the throat level before firest flue lining is installed Final:
4.Wiring&Plumbing Inspections tote completed prior to Frame Inspection
.Prior Covering Structural Members Frame Inspection)5 o to Co g ( p ) ,
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
� R '
3 S; S
Application number..... . ..................................
Fee .
..................Q.. ...................................................
KAM Building Inspectors Initials...............
OCT,2 3 2019 o 1
'• Date Issued.:.........
TOWN OF B=ARNSTABLE ................ ......�.........................
Map/Parcel........?..........LS .................
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WIND O W S/DOORS/TENTS/STOVES/WEATHERIZATION
PROPERTY INFORMATION
Address of Project:
NUMBER STREET VILLAGE
Owner's Name: 22ZV�✓6r� Phone Number
Email Address: Cell Phone Number
Project cost'$. �ri& Check one Residential_ Commercial
3 OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize �-Twv ojk�,
to make application r a uil ' ermit in accordance with 780 CMR
Owner Signature: _ Date:
NJ
TYPE O ORK
Siding Windows (no header change)# Insulation/Weathenzation
❑ ' Doors(no header change)# Commercial Doors require an inspector's review
j�(Roof(not applying more than I layer of shingles)
Construction Debris will be going to• &a2nV
CONTRACTOR'S INFORMATION'
Contractor's name
Home Improvement Contractors Registration(if applicable)# 14Wt:� (attach copy)
Construction Supervisor's License# al,2C�f7 (attach copy)
Email of Contractor' - � Phone number
ALL PROPERTIES THAT HAVE STRUCTUR OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY,IS IN
A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED.
APPLICATION.NUMBER ...... ... '
..................................................
*For Tents Only*
Date Tent(s)will be erected Removed on number of tents total
Does the tent have sides?Yes No (If yes please'attach floor plan with exits marked)
Dimensions of each Tent X X X
Additional tent dimensions can be attached on a separate piece of paper.
Purpose of Event
Check one: this event is a: for profit non-profit event
Check one: Food served Yes No
Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent
Fuel source being used LP tank 20 lbs. or>Yes No____,if yes, a gas permit is required.
Natural Gas Yes No , if yes, a gas permit is required.
If food is being served at your event please obtain a Health Department approval between the hours
of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval,
*WOOD/COAL/PELLET STOVES
Manufacturer# Model/I.D.
Fuel Type Testing Lab
Offsets from combustibles: front back left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name:
Telephone Number Cell or Work number
I understand my responsibilities under the rules and regulations for Licensed Construction
Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand
the construction inspection procedures, specific inspections and documentation required by 780
CMR and the Town of Barnstable.
Signature Date
APPLICANT'S SIGNATURE
Signature If-
Date
All permit applications are subject to a building official's approval prior to issuance.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA'02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): ,�lr�,d1 �� � ��
Address: 1V zu2>A2iZ 1 1V
City/State/Zip: LAZI Phone#:
Are ou an employer?Check the appropriate box: Type of project(required):
1, I am a employer with 4: I am a general contractor and.I
6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
-
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g, ❑Demolition
working for in an ca aci employees and have workers'-
g Y P ty. 9: ❑Building addition
[No workers'comp.insurance comp:insurance.$
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
] officers have exercised their 11.[]Plumbing repairs or additions .
3.❑ I am a homeowner doing all work � g P
myself. [No workers'comp. right of exemption per MGL _ 12�Roof repairs
insurance required.]t c, 152, §1(4),and we have no
employees. [No workers' 13.❑Other
comp. insurance required.]
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: �.��i'l� IT�'�'
Policy#or Self-ins.Lic.#: . ,-�2 DC �� Expiration Date:
Job Site Address:_/ME,41As' City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penald of perjury that the information provided above is true and correct
Signafore: Date:,i
Phone#:
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 Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trusteb of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority.".
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should `
be returned to the city or town that the application for the permit or license is being requested,not the Department of
IndustrialAccidents._Should you have any questions regarding the law'or if you are required to obtain a workers' -
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington.Street
Boston,MA 02111
Tel.#617-727-4900 ext 406 or 1477-MASSAFE
Fax#617-727-7749
Revised 4-24-07
www.mass.gov/dia
i
C'`�TeF:�Cxmvnoruu�;�il/fix o�C?�f�.rrbaao�4eoellb
Office of Consumer Affairs a Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only
TYPE:Corooration before the expiration date. If found return to:
Realstratbn,., EggiraLion Office of Consumer Affairs and Business Regulation
100g87 03/24/2020 10 Park Plaza-Suite 5170
DAVID COX INC ;`;, Boston,MA 02116
DAVID R.COX -
19lAVENDER W
W.YARMOUTH,MA 02673 Undersecreta Not valid without sl natuf e
N !
- i
comsnoriwealth of Massachusetts
Division of Professional Licensure
Board of Building R ulations and Standards
Cor;s`1r'4 N*rvisor
CS-063537 �r 1 spires: 10/15/2021
DAVID R COt
PO 80X.,441 C
SOUTH YARMg?UTH r
01'"mA �
Commissioner
r
vMv tv-c
r„�■sue DATE(MM!DDNYYY)
CERTIFICATE OF LIABILITY INSURANCE 0711MO19
THIS CERTIFICATE IS NOTUAFFIRMATIVELYER OF OR NEGATIVELYON AMEND, EXTEND OR ALTER T AND CONFERS NO IGHTS UPON THE RER. THIS
E COVERAGE AFFORER THIS
DEDABY THETE DPOLICIES
CERTIFICATE DOES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(fes)must have ADDITIONAL INSURED provisions or 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 508-771-1632
SGBD Insurance Agencies,LLC AICTrc,Ext:508-771-1632 �� No):
540 Main Street,Suite 9 �, � INBURER
Hyannis,MA 02t301
AFFORDING COVERAGE NAIC Y
I INSURER A:Travelers Insurance Com 723 _
fl
INSURER B:Norfglk&Dedham Mutual Ins. 23865
�BOK 4.010�rmoUm,MA 42fi84 INSURER O
INSURER E: -
INSURER F:
A 6S CERTIFICATENUMBER: 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 _I
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.
N6R DL UBR POLICY NUMBER POLICY EFF POLICY EXP - LIMITS
T.
TYPE OF INSURANCE 1,000,000
A COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE I$
DAMAGE TO RENTED 30O,Q0U
' J cLAIMs-MADE n OCCUR I 1680-1481 M796-19-42 103/i4/2019 03/14/2020 �Cf(F�o n,rrFrw nl„�s _
5,OW
X I Business Owners I I I MED EXP iM aiw arson $
"_ I PERSONAL&ADV INJURY 1'�0'�
I GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 2,000,000
POLICY JiCOT �� I.00 PRODUCTS-COMP!OP AGG 2'000'�
I
OTI4 R:
B I AUTOMOBILE LIABILITY 1 i (Fa accidew COMBINED SINGLE LIMIT I$
ANY AUTO i .. 91561469A 04/19/2019�04/19/2020 BODILY INJURY PerPerson) is 250,000
I ALTOS ONLY SCHEDULED I RODiIY INJURY Peracciaent $ 5�'
WO
��p K AUpTNOpSy�NEp I PROPERTY DAMAGE 100,000
(�J AUTOS ONLY AUTOS ONLY I Per acc dent
i
UMBRELLA LIAR OCCUR EACH OCCURRENCE is
ri
EXCESS LIAB CLAIMS L .
� � gGGREGATE Is
DED C RETENTION$ I
A WORKgRfi C APENSATION X PEALS rR
OTH-
ANO EMPLOY S'LIABI TY Y/N 16HUB-91 OX742-2-19 O7/ifi/2019 07/16/2020 100,000
ANY PROPMETORIPARTNER!EXECUTIVF. I E.L.EACH ACCIDE�EMP4LOYE
�FFlCER ry%W)EXCLUDD? N�A(bFandatory In NN) E.L.DISEASE-EA,descrbeurWer500,00DESCRIPTION OFOPE TIC) E.L.DI S -PO
I I
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
CERTIFICATR HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
200 Main St
Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE
ACORD 25(2016/03) 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
•. . �I zg Caw,p s�
I p .
r • ► ► .. • . .-r
rD '
ru
r•u EG E _E. ., G41
tti
ru Postage $ 0.44 067i
Certified Fee 04
Return Receipt Fee Postmark
C3 Endorsemen cared 30 Here
t Re
q ) __
Restricted Delivery Fee
O (Endorsement Required) $tj,od
co
Total Postage&Fees $ crc rat Q?121 20 0
Q. Sent To
` T
p StrAp ( -•- -•••••••
.................................
City,State, IP+4
D,_� s MA �� 3
Certified Mail Provides:
e A mailing receipt r 1
o A unique identifier for your mailpiece
e A record of delivery kept by the Postal Service for two years �.
Important Reminders:
o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®.
e Certified Mail is not available for any class of international mail.
a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
a For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is
required.
o For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery'. r
o If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office,for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail. '
IMPORTANT:Save this receipt and presentlt:When making an inquiry.
PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047
.,... Y. .-t ..,,.-.-., .-. ... ..•.,..r..-.w,...rn.."s*'*..--....,...Y:,fi_..k..,,.-.s,-„-,rµF..y....Y-••.,-y- .. _ .x....2:y ..^.-.. ....tr"'"_ -..m•:..r•^..?T-^ ,-
e
TOWN OF -BARNSTABLE BAR-W 3060
a.• Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager I �, a �~
Address of Offender + , - f My/MB Reg.#
Village/State/Zip : a' �
-
Business Name � /pm, on -7 20 6
Business Address
kl%4.,
Signature .of Enforcing Officer
Village/State/Zip 14. Y.,# ovir�.
Location of Offense SA
Enforcing .Dept/Division
Offense C q a
FactsQ ! `
This will serve only as a warning. At this time no legal action has been taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the' Town.
WHITE-OFFENDER` CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.
F�wr
WASW
• Aull"
ff If You Can Read This..::
i y� • s® VI ®u i us
t®riser m
C t �
• .1 - � '`y ,ti��'`4�fru��v it;�° •.. �� t'!- 't""f��nT A�,s` -��'Sy�� 7,� t"I4�"
� '�y+✓'Y -\ ,> 'y y •�. r :!£ t y�y� � y- - r !t..�• 4 yy v mac., !�-�``•�.Y �t+.. -..1..
__4 wro� [ �e � a � Au $a�t ;\C 8/ .�i�` x.4 � `k'ar••e�/�., s'"r LM1�
�.� � ";,cg i � :.a er.•. .�try„ zit ra4 r`1; `a '.w : �ti.;� !�. '�`• ,
p. i .'�rlr'.'1�$�.� v. .� � .Fve•`.;sr 4�al�yt?a s�`•�t 5� ����1 � 'r. 0; v 'r Z ~. 9_�
�� ..__. �tF �- f � :.������� ��' r �.�",Si 1�+, "... .. � t i•� ��,��t.•����ia�rt�����5���tr s •_.,, _, ...a� �-. �.,� .:
a
: �, ti�4. �vtj (a ri4`7 `°�,�• ����'� V'tt„k , ,� ,f
n,��.Tta-. .,:� , yy r�r� t�'S2tfy c," '�'V;'F�'Fr; -� 1 e:;v'�.�'�� ',�+, • .� �''�{ .+AID, ,!� ,at1+r"°� k��'> ,i 'It^iC `.
'+.r"l ftr-'. ^i'�el./•�'�'�iy7 #r �� �+7C"'-'�� r4°,a"r+.f �.�� � 'ry r,'m's,� �( .t 'Sy,. � -t •��•., i °'
:.w _ ,Sy eq �^4�,pj1�• } t`i,.r. !" 1 � �^,.. may' y "� �';"b- '� _\ .. _ .`, _ "f•.c,r.,r
-�t�e1.�_• Z '+'!„�,•'�C1 - ,.,�c. r.. ;^. i 1 y••j�, .t l�y�at., -�i1. +.r�. ' •
+ f Q y
}�• .�Y,�.-. /..d:-�^a r +. rii:.,•w: •�1c -'yy#� �k.,, ^ `� . ,'E tst. F ;,S�, '. 'A' .k'• .., -+,aPw-'f� '-'!'�C - s.i' i' t •;s ^�1. ''a
� .,i s^;, �,.` .y�,'uf C•W,t�_ '*K Jrtt•�`G^ .ylfh t� �1,r Y �y•,71�t�, .'v�. y� ',it � •�.z. s. ;;C�� 1••e,� y9 c✓ .,y i,apV '`-Q vt. ,i[a�
5 -! ♦ is � �� A �
- �F1 n.XR+=`"••-t ��" a;L�.I7•. �r'4h�n• �. :J:.:�:: ,. !��"�. rt� ,�F� r, "'c.'�tE''J:+.S�'bl .�,,i e�Y�S `� f ,�"�r*. wo+'��<,: -F�.. tti ;�'- ..,�»+
4•� �':,N�!°7,<3 :1 �,, .a _rv. � •��.'+�Yt t ";C" ..��- .t�. ��j7lq' `t v��'' k' ,!'I�s�'Jr�as.y ..H ,'r *a �X l +, .-:. .�k�-�.'a'ix. Fl£�
•. ;a-t ;tr}'h' ,�.: ,� "� �{`, �`47"�f f. :�` Y �ylr� ;4•,t• .. 1 a..�q';� �'� a^���l...r � :�;z:<te, � 1 ?.y�`t .t44���r � �*` .,
t
w�Fa.�# [:i a �w�(t( i t}�, 33 'r - ( c • ci�C ��;f t 5 -lr� xb p,waa a, i'.. - �:
kp,�j ��,r ,tt..�rr 4:kti� •. aS t.-. ' ' t'" .., �. j"`v `- u-k'�` 'J�•IS�. 14 •-
k t`(£:: ,'�"lr.:'�'ti:+,}.t'"sA'y,''S�,I.;A. �� ���' .•Y.r'�v �1.r. 7 Y ry«„�7�"�ir��'$'iw,/,x� ti:a*(v `�y F��j`.,� t,.,kar*, S' .�4�r.a a _�.�t., 'i„L t.:�+ ... ..
.74�v` 1c _ ':�'"•la r 2,n'F_�. .krlK,-�i '.- w"mar••e >: �..y{�'� '1,. -°? ''�rfi� .,.,n-+y 4 ,4 ,ate, _ F ti
7 ` o;f/- ��;- -�, 'ai4 ,� ::� d =tee i �}a'�4h' �,.(�� t i'ti',�;xµi k- :�-� sa�.17-:.`p'�'��."'b�!y�tit �,.1 �,�, t,� .•t-,. ,:_j a1� •1
. ��'qnr� ,: .� .R. �:., i :�•� -�, .. :.,.� k�'.r -a,t���+��,.� SJ`�. �:y.ry��S' ?' r'�f�?:,. •Orw, �,1'Sv.,+i�,.i� fL� .'t'Z.6ij�t..• r�� rfvw'",a.�, ..'1-�a. �,es" i�.
..:i [ 1a ✓�'�`�X+t,.+ yY�' is 1 _. .i,'�;2 - 3F .�+,... .� ��i '£'.'�, �`' f� r§ d,_. `iaf "1 F ,� .
'�'F.e,�?c` ��y�7[�:. ,yea rik�, �c.r,�y t�c�;:�a�„• S.� ,�' _ �W:Ifa >�4, �'K S,,fT.•3"rl
��--^�.V:'' 3't.�: .. tGs ..-., ��-.. ..;._ t• �1ss-•dr�r_v. ,! ,+.4C�, ;t i' ti�' �'sw.Ita� 1�{. - 'u +ter'•" _�"'+F� `-+�,
-raP
i!
4
Town of Barnstable
,
Regulatory Services
' saWsz"BLE Thomas F.Geiler,Director
1639.
iOrEn M,r a Building Division
Elbert Ulshoeffer,Building Commissioner
367 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
O �
SHED REGISTRATION
120 square;feet orless)
Location of shed(address) Village
Property owner's name Telephone number
Size of Shed Map/Parcel IF
Signature Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction? N
Conservation Commission(signature required)
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
Q-forms-shedreg
l -
I UNITED STATES PqvcfE rf. �F e�. -� y jx. Naa
I • Sender: Please print your name, address, and ZIP+4 in this box •
M
I
C0 W to 0.�7-
Z U(� �0.�v� � • 1
kc
I
I
I
I
' II
__ 111
SENDER: JOMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. ❑Agent
■ Print your name and address on the reverse X ❑Addressee
..so that we can return the card-.to you. B. Received by(Printed Name) C. Date of Delivery
I ■ Attach this°card to the back of the mailpiece,
or on the front if space permits. G
E D. Is a very address d'r�F erent-from item 1? ❑Yes
1. Article Addressed to: �— r n
If YES,enter d Yoadi rJ�esselow: ❑No
A S l T� ®26�0�s
O Q��{ ✓tS r / 'A— 3. Se T !eob
Certified ac111 ❑ `Mail
❑Registered g' etu Receipt foW handise
❑Insured Mail -C:O:D.
4. Restricted Delivery)(Extra Fee) p Yes
2. Article Number 1 I
,s 1I 1b `I;t iL 82};i h hU1 132721d 521
_transfer rm service label) i
PS Form 3811,February 2004- -._ Domestic Return Receipt 102595-02-M-1540
j .
AS. MAP PARCEL 157
889 50 4 0 W 86. 90 \�
o / I*IGHBORING
ILDING
/
28
23
C31 -=HSE//12B_--=--A
zw LOT B
36,20. E
LOT A
NOTE.- BUILDING APPEARS TO BE PRE—EXISTING NON_CONFORMING.
RES. ZONE.- HB" This ' MORTGAGE INSPECTION Plan is For
Bank Use Only FLOOD ZONE.- "C"
THE DISTANCES AND MEASUREMENTS ON THIS PLAN SHOULD BE VERIFIED BY AN INSTRUMENT SURVEY.
TOWN ,ffYANNtSt REGISTRY OWNER: IsRIC J. _�� E_N.1J,�1 S—,CG DEED ___--
REF _10 �4,L0 _____ -- BUYER: -R�ELIV _-- -----------
DATE: _---_—_- -
____ PLAN REF:._78,�3__ _ `_SCALE:I"= 30 -FT
I HEREBY CERTIFY TO HOMETOWN MORTGAGE________
--_THAT THE BUILDING >�� C' YANKEE SURVEY
SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS o �'At�l tip. CONSULTANTS
SHOWN AND THAT ITS POSITION DOES CONFORM MERE HEW L 40B (SUITE' 1)
TO THE, ZONING LAW SETBACK REQUIREMENTS OF THE No 82098
TOWN OF _; _BA_RNSTABLE_______ _____AND THAT. ,� INDUSTRY ROAD
IT DOES_ NOT LIE WITHIN THE SPECIAL FLOOD HAZARD 'QUffSS;O�PQ MARSTONS MILLS, MA. 02648
AREA AS SIOWN ON,.TIIE H.U.D. MAP DATED 8�1985 _ �qN� y0 TEL: 428-0055
.Co unit -Panel. 250001-0005-C SURVF FAX: 420-5553
THIS PLAN NOT MADE FROM AN INSTRUMENT SURVEY
PA L A. MERIT `IN�PLS ------ NOT TO BE USED FOR FENCES, BUILDING PERMITS, ETC. 30757 L1Y1
Town of Barnstable *Permit#` 7
SME Tp�� �pir 6 months from issue date
50
.,,Rt,,sz,►e�.� : Regulatory Services Fe'
Thomas F.Geiler,Director ��y�2«��
•i619 ♦0
�Eo 59 Building Division x �y
Elbert C Ulshoeffer,Jr. Building Commissioner R'
367 Main Street. Hyannis,MA 02601w �y9
Office: 508-862-4038 Tp�N JUN .1 3 200 j
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION FeARNsTqFC�
Not Valid without Red X-Press imp �`v
Map/parcel Number `
Property Address
G
[E
sidential OR ❑Commercial' Value of Work/ .
Owner's Name&Address
Telephone Numbe
Contractor's Name ��-�
Home Improvement Contractor License#(if applicable)
� C
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
(-�iave Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy
Permit Request(check box)
e-roof(stripping old shingles)
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
*Where required: Issuance oft his permit does not exempt compliance with other town department regulations,i.e.Historic.Conservation.etc:
h
Si-nature
expmtrg