HomeMy WebLinkAbout0229 CASTLEWOOD CIRCLE o�c�� Cczs�l ec�o Ci'r,
a
of r Town of Barnstable *PermitD 107 la
Expires 6 mosrtfs n i sse d t
i •
RegnlAtOI'y ,Semites Fes ,
+ =AHNhTAHLE,
MASS
Thomas F. Geiler,.Director
k
- Btuldin.g Drvislon
Tom Perry, CBO, Building Commissioner
--
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma us
Office: 508-862-4038 Fax 508-790-6230
EXPRESS PERMITI`'APPLICATION - RESIDENTIAL ONLY
Not Vafid without Red X-Press Imprint
Map/parcel Number4 '� 94\
Property Address C�_g 7 014 15J t. -11-6TZ_ C t'�, `
c,� O L
IKResidential Value of Work /t�(�� Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address ARZ,L '�jzg Se
Z2d '( 15iCW..CL�. �c � AKntS O�c� 661=�i3�
contractor's Name-NCW"Pl2ci / J� �AC_0 Telephone Number f qf)1���// C 0
Some Improvement Contractor License#(if applicable)_ /y.4 � / s.
,onstruction Supervisor's License#(if applicable) G 6?3
]Workman's Compensation Insurance,,, `4""REU >
Check one:
El I am a sole proprietor ��
❑ 1,am the Homeowner. - MA R.2 2 2012
I have Worker's Compensation Insurance
isurarice Company Name c kr.1 4r2C To
SARNsTABLE
orkman's Camp. Policy# C ?6 Y S e717 y
opy of Insurance Compliance Certificate must accompany each permit
:rmit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will betaken to
❑Re-roof(not stripping. Going-over existing layers of roof)
El Re-side
#of doors C1
Replacement Windows/doors/sliders.U-Value 043 (maximum.44)#of windows K
*Where required: Issuance of this permit does not exempt compliance with other town deparnnent regulations,i e Historic,Conservation etc.
***Note: Property 0 must sign Property Owner Letter of Permission.
A copy a Home Improvement Contractors License& Construction Supervisors License is
re
S1 NATURE: -
PFMM\FORMSIbuilding p=mit forms\EXPRESS.doc
f
Department of Industrial Accidents
d Office of Investigations
d 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): �-
Address: Z 6 GC J_ A 4, S i
City/State/Zip:W030Y:� H P'14. 01�b I Phone.#: 1 06 3yZ
Are you an employer? Check the appropriate box: Type of project(required):.
[9y
1. am a employer with Jy i -4. I am a general contractor and I
_ have hired the sub-contractors
6. '�Ne construction .
employees(full and/or part-time).* .
2.❑ I am a sole proprietor or partner- listed on the,attached sheet.. 7. emodeling
ship and have no employees These sub-contractors have g; 0 Demolition
working for me in any capacity. employees and have workers' 9. 0 Building addition
[No workers'comp.insurance comp.insurance.$'
required] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. o workers'co right of exemption per MGL ;
Y � comp. 12.0 Roof repairs
§
insurance required.]t ,152 `1 4 O;and we have no
� c.
employees.-[No workers' 13.❑ Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees Below is the policy and*'b site
information.
Insurance Company Name: /4 k"X- -I Su t2
Policy#or Self-ins.Lic.#: W C 6 q 5°I 7 y Expiration Date: —l Z .
Job Site Address: 22'� 04-7.ZC W 60 C l Q, City/State/Zip: t4HaC
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 olator.-Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA 5 4 urance c verifloiffion.
I do hereby certify de a pains.a d pen ies o jury that the information provided above is true and correct
Simafore:
Phone#: s7 2Z l
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
A .
Contact Person: Phone#:
,
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as "...every person.in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the-'
receiver or trustee-of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to 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-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit.or license is being requested,not the Department of
Industrial Accidents. Should you have any,questions regarding the law or if you are 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. 4
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 io any business or commercial venture
(i.e.a dog license or permit to bum leaves•etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any.questions,
please do not hesitate to give us a.call.
The Department's address,telephone-and fax number:.-
The Commonwealth ofMassaehusetts
Department of Fudusffial Acoidcnts
Office of Investigations
600 Washingtcai Street
Boston,ll<TA 02111
Tel.##617-727-4900 ext 406 0-1-877-MASSAFE
Revised 11-22-06 Fax##617-727-7749
www.mass.gov/dla
Massachusetts- Deparhnent or Public Satct%
Board or$uildinu Re,—,ulatioo and Standards
Construction Supervisor License
License: CS 96093
Restricted to: 00
THOMAS PEACOCK JR
3
38 OAKLAND AVENUE
SEEKONK, MA 02771
Expiration: 4/8/2012
Tit: 20816
0 fice of Consumer Affa and&Bus Regulation
10 Park Plaza - Suite 5170
M yvvy ..
Boston, Massachusetts 02116
Home Improve atContractor Registration
�- Registration: 146589
5— Type: Supplement Card
Expiration: 5/5/2013
NEWPRO OPERATING, LLC
TOM PEACOCK
26 CEDAR ST.
WOBURN, MA 01801
Update Address and return card.Mark reason for change.
--DPS-CA7 w SOM-OM04G101216 Address Renewal Employment Lost Card
QQ
�\ ✓fie i�anLnzanu�ealf� o�,Pi✓awac�uieP,�
Office of Consumer Affairs&Business Regulation 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
Registration—1Ab589 Type: 10 Park Plaza—Suite 5170
'' Ex iratrtzn p 51b�24�'3_ Supplement Card_ PP Boston,MA 02116
NEWPRO OPERXfiR. PLC
TOM PEACOCK
26 CEDAR ST
WOBURN,MA 0180T Undersecretary Avalidout signature
_ aOOUCEp SIIa;366.6161 t`AX 508,366.5202 THIS CERTIFICATE IS IS8UEp A5 A MATTER OF IN ORMATION
Mackinti re Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
11 West Main Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
Westborough, MA Q1581.1931 ALTER THE C VERAOR AFFORDIR BY THE POLICIES 9ELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED Newpro Operating LLC INSURERA; Peerless Insurance Co. 24198 _
26 Cedar St. INSURERS:
Woburn, MA 01801 INSURERC:
INSURER 0:
INSURER 8: '
C V
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTYNTH3TANDINC,
ANY REOUIREMENT,TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RL'SPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I5 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS Of SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR DD' TYPE OPINBURANCE POLICY NUMBER POLICY FECTIVE POLICYExPIRATIpN LIMITS
GENERAL LIABILITY COP $588370 12/31/2010 12/31/2011 EACH OCCURRENCE S 1,000.00
DAMAGE TO aENTEO lOp OO
X COMMERCIAL GENERAL LIAf1RITY, .PIJFMIgFbIELaGG11 S
CLAIMS MADE a OCCUR MED EXP(Any one pereun) 3 1S 10Q
A PERSONAL 6 AOV INJURY 3 1 000.0
GENERALAGOREGATE $
Z OOp.O
GEN'L AGGREGAT@ LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S Z 00010,01
POLICY PRO•
JECT f—ILOC
AUTOMDBILE LIABILITY BA 8594174 12/31/2010 1.2/31/2011 COMBINED SINGLE LIMIT S
ANY AUTO (Es eocidem) 1,000,0.0
ALL OI&NEO AUTOS BODILY INJURY
X SCHEOUL60AUTOS (Porperson)
A X HIRED AUTOS BODILY INJURY S
x NON•OME-0 AUTOS (Per emlCenil
PROPERTY DAMAGE I
(Per occldeny
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S
ANY AUTO OTHER THAN EA ACC 0
AUTO ONLY: AGG S
EXCESS/UMBRELLA LIABILITY CO 8S82578 12/31/2010 12/31/2011 EACH OCCURRENCE S 5 00O O0
OCCUR CLAIMSA-ADE -AGGREGATE I S,000 00
A _
DEDUCTIBLE
- x RETENTION S 10,00 S
WORKERS COMPENSATION AND WC8645974 OS/01/2011 OS/01/2012 wCsTATu- nTH•
EMPLOYERS'LIABILITY E.L.EACH ACCIDENT I SOD O00
A ANY PROPRIETORIPARTNERIEXECUTWE
OPFICERIMEMSER EXCLUDED'! E.L.DIBEABE-EA EMPLOYEE S S001 000
aftscribe un
S"PYyE43AL PROWS
oelowCm 028
eN E.L.DISEASE-POLICY LIMIT S SO0 00O
OTHER
DESCRIPTION OF OPERA ONs I LOC4TIONS VEHICLES I EXC USIONS AP ED BY ENDOR6E MENTi SPECIAL PROVIS NO
The City of Mar�lbora Ts additional insi Nith' respect to Genera Liability as required
Dy written contract
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESP.NTATIVE
Timthy Mo na h
!CORD 26(2001109) OACORD CORPORATION 1989
0 Quelffled
NEWPRO MANUFACTURING
NfRc SUPERMAX DOUBLE HUNG -
Cellular PVC frame, Double glazed, '
L'ow.E coating(e-0.027,S2;0,149,S4)
Neflonel Feneftgon
WrVCouncnq) Krypton/alr filled
DEV-K:27•0004S•00001
ENERGY PERFORMANCE RATINGS.
U-Factor(U.SJI-P) Solar Neat Gain Coeffident
a.23 0,27
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance Air Leakage(U,S.A-P)
0,48 0. '1
Condensation Resistance P
47
Menuhctuter etfpultlee Mdthxe ntlnpe co*nn to appllabfe NFAC procedures fordeformfnlrtp whore
mll Cumett1N11RCdeeeawt commend ry�prod�uet�wrdodoeieot= ttheriutfeDUNNy my r
Product totrany eoedrto ure.fbneuftmenu►acwrer a iMnlhn forotAerproduct petformena fMorareUon,
• rnvw.nfrc.org
BIKE Town of Barnstable.
Regulatory Services
# RARNBrANZ s ,
MASS Thomas F.Geiler,Director
Fc► Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
0ffice: - - Fax:508-790-6230------- -
Property Owner Must
Complete and Sign This Section
If Using A Builder
15�L CGrc{yzr�T
as Owner of the subject pxoperty
hereby authorize �lz� ►�� %C J 4-Co f�
to act on ray behalf,
in all matters relative to work authorizedkby this building pertnit
(Address of Job) `
**Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled before fence is installed and pools are not to be
utilized until all final inspections are performed accepted.
i
Signature of Owner Signature Applicant
Print Name Print Name
/Z
Date
QTORMS:OWNERPERMISSIONP001 S
of T"E rq�,
Town of Barnstable
Regulatory Services
RMMSTABLE, # Thomas F.Geiler,Director
KAsa
1639• .m� Building Division
ArED MA'I�
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street
village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:.
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwelling of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
.DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to
be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
03-21-'12 15:42 FROM-Newpro-Wheeling Ave. 1-781-932-0860 T-516 P0001/0002 F-248
C;I keg#0605216 � �
RI Reg#26463 , „ �,� 64334
Corporate Headquarters,26 Cedar St,Woburn,MA.(P)800-342-2211 (F)781.933-9626,www,newpro.com
THIS CgMTRACT MADE THE (9 day of 1 20. >Z between_
fk ZeL i Y A-2sC
�l ir1 ir
(hlbma owners)1 q (Home Phone) (SuslCell Phone)
Of cx l ��a wog f� f��G`Gl9 ✓4l dcc�
(Address) CAsiTLwooL Cik (City) (State) (ZO)
the"Owner"and NEWPRO Operating, LLC, "NEWPRO"_ The job address is a condominium.
NEWPRO hereby agrees that it will for the consideration hereinafter-mentioned,furnish all labor and material necessary to install the following
described work at the premises located at
(Job Address) (E-Mai for proprietary use only
TOTAL jvfc�M<'S Additional Model TOTAL
Windows Purchased q NEWPRO Work Number CASH
Window Color In, 1,1 Out: G.1 Sliding Glass Door PRICE
Capping Color ' Steel Securi Door
DoorCplor n: out: DEPOSIT
Model Name Model Numbers CRY Sidelites WITH
Double Hung New Construction Unit ORDER fiW
Picture Window Storm Door BALANCE
Casement S Obscure Glass T BO M DUE AT
2 Lite/3 Lite Slider Screens kqAL FUL INSTALL
.13ay I Bow Frame Please Initial:
Roof- ❑ soffit: ❑ Customer understands that NEWPROO does not
Garden Window do any painting or staining. (ie:when removing Balance paid to insteiier at insianstion
Awning or replacing interior stops or trim)
Hopper NEWPRO®is not responsible for conditions or
Shaped circumstances beyond its control including con- FINANCE
Other 4, Stdensation resulting from or due to pre-existing Bank comotdon form signed at inswilatkin
GRIDS Ionia SDL Euro conditions.
DESCRIBE WORK: 21 t L �/Q, er L .5 -1 G
c a G G✓s�-
Est.Start Date: Customer understands this is an"estimated date" Est.Comp.Date: ?
nm a
Initials LiCustomer understands all steel security doors will have a 3I4-aluminum threshold installed over existing threshold.
It shall be the obligation of NEWPRO to obtain any and all permits necessary under this agreement,as the owners Agent. The Owners who secure their
own construction-related permits,or deal with unregistered Contractors will be excluded from the guaranty fund provisions of MGLC,142A, All Home
Improvement Contractors and Subcontractors shall be registered by the Director and any inquiries about a Contractor or Subcontractor relating to a registration
should be directed to: Director,Home Improvement Contractor Registration,One Ashburton PI,Room 1301,Boston,MA 02108,(617)7274698. 0the
Owner is obtaining financing by way of a Retail Installment Sales Agreement,such Agreement shall Include a time schedule of payments to be made under
said contract and the amount of each payment stated in dollars.Including all finance charges. The Retail Installment Sales Agreement shall be incorporated
herein by reference. If the Owner is obtaining a revolving credit line to pay in whole or in part,for the contract amount herein,the terms of the revolving
line of credit including interest rate and payment terms,shall be d0trly set out on the credit application. The portion of the credit application referencing
a time schedule of payment,to be made under this contract,and the amount of each payment stated in dollars,including an finance charges,shall be
incorporated herein by reference.
NEWPRO represents that it carries Workmen's Compensation and Public Liability Insurance in the amount of$100.000-$300,000.
if the Owner refuses to permit NEWPRO to proceed with the work herein,or in the event of any breach of the Owner of this agreement,for any reason
whatsoever shall cause the owner to pay NEWPRO a sum of money equal to thirty-three and one-third percent of the price agreed to be paid,as fixed,
liquidated and ascertained damages,and not as a penalty,without further proof of loss or damage.
NEWPRO shall not be held liable in damages for delays in the performance of this contract due to causes beyond its reasonable control.
Owner warrants that he is the owner of"property on which the work is to be performed or that he is otherwise authorized on behalf of the owners to enter
into this agreement
This contract represents the entire agreement between Owner and NEWPRO and cannot be changed except in writing signed by both the Owner and
NEWPRO.
You are entitled to a copy of the Contract at the time you sign. Keep it to protect your legal rights. We,the
aforesaid owners, certify that immediately after the signing of the aforesaid agreement,a copy was fumished to us.
You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the
seller,which may be his main office,or branch thereof,provided you notify seller in writing at his main office or
branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the�third business day
following the signing of this agreement. (Saturday is a legal business day). See the attached notice of cancellation
form for an explanation of this right.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
The owner has seen"sample"warranties that will be provided by NEWPRO upon Installation. Sample warranties provided to Owner,
IN WITNESS WHEREOF,the parties have hereunto signed their names this day of
EIN# Signed
Marketing Rep va dad Owner
Accepted: PRO Operating,LLC
By Signed
Owner
CORPORATE OFFICE WARWICK BRANCH OFFICE
26 Cedar St Office of Consumer Aftaics and Business Regulation 24 Minnesota Ave
Woburn,MA 01601 Ten Park Plaza,Suite 5170 Warwick,RI 028N
(P)800-242-9974(From NE) Boston.MA 02116 (P)800-3W3312(From NE)
(F)781-933-0717 Phone: (617)973-8700 (F)401-732-1371
WHITE: Brand,Copy __... a wpy PINK: File Copy GOLD: Finance Copy
us-is R0500
Assessor's offioe (1st floor): I
Assessor's map and lot number
Board-of Health (3rd floor):
Sewq;�e Permit number
rah
......................:.................:.................. *p Z 31AHII9TADLE. i
Engineering Department (3rd floor): q moo rb 9•
House number .� 5 / .).qr 3 �e
...... .............................. CFO V0 a
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M.,.only
TOWN r OF BARNSTA ME
_.BUILDING INSPECTOR
Luc Lose
APPLICATION FOR PERMIT TO ..:......�..........................���:..�.E?.!'..�-.................................................
TYPE OF CONSTRUCTION ...........i�J Q.� ......� ���or �..........................................................................................
............
TO THE INSPECTOR OF BUILDINGS: i o
The undersigned hereby applies for a permit according to the following information:
Location Z2 �l�v I L� �V Gc�(7 C...�..1..�.e............'"f. ..Y�/V/U�. .. ../ .1%5 ......................
ProposedUse .............................................................................................................................................................................
...........Fire District L{ U V t'S
Zoning District :. 1.:... ................................................
Name of Owner C�J.r.. - ./..! �j'/.... :..13t'.! .. ........Address .. Z.9.....C.4.s.7.e.. .!'jn..�.)..... zkr..........
Name of Builder S ✓ ✓� o v �-..................Address�....l �►?. ..........5........... ... ,..................................................
Namerchitect ..................................................................Address ....................:: ............................................................
Number of Rooms ............/...................................................Foundation .....0 2A/ ,11.P..2 e.............................................
Exterior ..... .V!..!.N��'. . '�5............................. Roofing !.... `..�T.t? ...�e'.ca......................................
Floors e t.Interior .. {'��.<r..�.?G. .................................................
.............(.......................................................................
nJd..!�.G.........................................................Plumbin 4.Heating g �� ./1/.................................................................
..............
Fireplace ........vg N.'�........................................................Approximate Cost' ' ✓ .i....
Definitive Plan Approved by Planning Board _______________________________19-------- . Area .... ........ ... '�jtivCj L`
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 ....................................
8EADSE, WILLIAM A~272-042
Np�'2.9.314`.. Permit for ......Enx�Q.9n...Carport/Deo
.......ainyle'Fomily..Ibxe lldzxg------. -- -
Location ...... 29'{astlev.uod-.�ircle............ .'
.......................Hyajmis-------------'
. '
Owner ..........Willi4mJ�e.4r.9.e.......................... '
-
`
Type ofConstruction ......Fzanu�--------�
. . .
------ .......................................................... .
Plot ............................ Lot ----------' _ '
. �
'
P&mit Granted ......... oJ-Y'24.................lV 86 '
-
^
Dat6 of Inspection ------------lP
Doh* Completed ------------'lA '
^ ,
'
`
`
~
^
. ,
'
,
. .
'
. .
'
^
'
. `
/ ��2 -
� '
Assessor's offioe%(1st floor);. 7 ` ` r/I(, �� � E 9 EM RAUST EL
�.^! IN COMPLIA THET f►
Asses or's mop,_and lot number ..
Board-of Health -(3rd floor); hh # ' MTH TOILE 5 fO�
Sewage Permit,number �1J..>......:... .. .: ? NIiNTAL CO 1; , "a�asTdDtEa
Engineering Department (3rd floor) a ^ �� IL �� f •oo ♦�
House number, y.. i rb3
..._....... ... L.• ... .✓••....... e/•�.. sOYPYp�
APPLICATIONS PROCESSED 8 30'9:30 A.M. and" 1 00,-2 00'=P.M. only
TOWN 'OF B.A.RfNSTABLE ,
BU I LD I NGA NSPECTOR
APPLICATION FOR PERMIT TO ..... .........UC.LI..SG• . .. C... 2.�.1'Tl
lt,t,�.G.C?. .............................................
TYPE,OF' CONSTRUCTION ...........
.........................................z.................
y
....................... 9....Y....
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a,permit according`.to the following information:
Location ..Z2..7`......(;q�L-e W.C{c0 • C/ �..�a.�.�........ :�-�:�.Y�rU/��.>5. �.�.��......................
Proposed Use ......i5✓L� t�tlJ............... ................ ` .. ..............:............................
Zoning District ....... ... ...Fire Distrit ................. ....��. .............................' �V
Name of,Owner ........Address `. Z�..... .5% ..�.�,1.�!0.�... . 1 .�. .........
s
Name of Builder .. C
JY�txl.�.....! .5...:I ow.e- .... :...Address ..:....:.'`? .................. . .............................
r
Name of Architect ............`. . °..'.Address
Number of Roonis .....:...... ...................:................................Foundation .......C.0.4rC.Re.fe.............................................
Exterior ..WmA.6.....S.�!►..� .�. �....... ..:. :.......:....Roofing .�:Xe..3-.7."/-. .W. .., a.Q.i..... .........................
h, .�. -...... . �' .::
Floors• ............. ..............................:.......:...:...................:.........Interior �i ............................................
j
Plumbin .. . .::� ...
Heating 1V.Q ...... ........................................................................................................... g . N. ..............................................:......
Fireplace t.,......!!/.Q..!{ 'e *..........:.. ..:....Approximate Cost ... /... :•v,v`.
4 q J 'Q'. ....
Definitive Plan Approved by Planning Board ________________---------------19-______ : Area .... .0........ ` ... '4
Diagram of Lot and Building with, Dimensions Fees. ....................
SUBJECT TO APPROVAL OF BOARD OF.HEALTH M
• .• • y, . N
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
n tr cti n cos u o
/Name :.��4J � td.` x-= ...........
- III
Construction Supervisor's, License :..................................
BEARSE, WILLIAM
Enclose Carport/Den
29'/.14 Permit for _
• Sin ''le Family Dwelling...................
� y. - r
229 Castlewood Circle
Location ... ," r €'
f Owner .......'William. Bearse................ .........
` .. Frame i• t �• _ y ;, - � .� ,. � � - � . `� � _ .
Type of Construction ...................................... _..
r
low
Plot ............................. s Lot' .............................
Permit Granted ..........,T1kly:::29z.... :19 86
D'to of Inspection ..............11a..n......19
:Date Completed ..... .l.L < .19g1P
elf