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HomeMy WebLinkAbout0072 CROOKED POND ROAD /-� �7 i �� / o� _ , ._ �� �� rr ��'�� i ��`� r L _ '`....... ". .3 oa � x d � R �� r Q ¢ O 36'G ao � � n Ln EYI ST. L S W O w t r Z �CtlillY�. U ZO a � = v, 00 N tar 6 C,Pao .6Z�' Rc v r> ;e(v A-D , NORMAN GROSSMAN v°r 12775 h/J'/4st/-t//S e-,VR �,,sr.4,4E) 1 SCALE: / " I977 No,P,tiAN GQcSM�4i✓ z L. S. Town of Barnstable *Permit#A15 6 biqgq g y Expires 6 m rom issj e Regulatory Services Fee snxiasxeBM « 16 9. Richard V.Scali, Director Building Division Tom Perry,CBO,Building Commissioner ' �¢ 200 Main Street,Hyannis,MA 02601 OCT 1 www.town.bamstable.ma.us TQ�nI o 5 2015 Office: 508-862-4038 'UU F'Rq ax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL�ABLE Not Valid without Red X-Press Imprint Map/parcel Number Property Address n e/Z @.*Cc r-)o R 13 k(VaLno/s- HA [A Residential. Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ' /O 12 W NN011 - Contractor's Name SV,4/U �UA N/rer'SHQ�/GCS Telephone Number OF WY 6 909 Home Improvement Contractor License#(if applicable)_'7,?L 76 Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check no e: ❑ I am a sole proprietor ❑ I am'the Homeowner [ i I have Worker's Compensation Insurance Insurance Company Name 02.y`oJ2dc' 9L1611/AIV Workman's Comp.Policy# Copy of Insurance Compliance Certificate.must accompany each permit. Permit Request(check box) ' FA Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to_ 0GC9/n/'elZ- ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: Smoke/Carbon Monoxide detectors 4 floor plans marked,with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic'Conservation,etc. " ***Note: Xr' eOwner must sign Property Owner Letter of Permission.of the Home I rovement Contractors License&Construction Supervisors License is . JSIGNATURE: Q:\WPFILES\FORMS\b ' ' er'rnit formS\EXPRE oc „ e Revised 061313 The Commonwealth o Massachusetts ' ' � f h 1 Department of Industrial Accidents f 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/OrganizatiorL4ndividual): e.��S lands_ f✓/C���. 1j'�h12- , Address: r,f R01) City/State/Zip: Phone t S"08 36Y 00 Are you an employer?Check the appropriate bog: Type of project{required): 1.El am a employer with . 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2.. 2J 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 me in any capacity. employees and have workers' comp. insurance.$ 9. ❑Building addition [No workers' comp.insurance P• � required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l l.❑Plumbing repairs or additions 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 41 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 isprovidinj workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name. /3 IDClt) 5,, ffl V /V- Policy#or Self-his.Lic.#: Expiration Date: Job Site Address:' 9�i2esZ,�ecj,a0evb 2O City/State/Zip: �-/ hnt 5' 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 IA for insurance cove a verification. I do hereby lliderthepainsan en es of perjury that the information provided above is true and correct Si ature: Date "of 0/5— ' ' Phone#: 5 DY 361� 6 90(7 Official use only. Do not write in this Brea,to be completed by city or town official -Pecmit%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#: ' t _ t C 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-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 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. 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 permitilicense 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 bum leaves etc.)said person is NOT required to complete this affidavit. . The Office of Investigations would lice 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 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www mass goy/dia Town of Barnstable Regulatory Services _ Richard Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,"MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 .F Property Owner Must Complete and Sign This Section If•Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address.of Job) g p Signature of Owner r Date 4 Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. c t 3 ce Q:\WPFILES\FORMS\building'permit forms\smokecarbondetectors.doc Revised 050412 4 < •k r � l'own of Barnstable Regulatory Services Richard V.Scali, Director ` Building Division �xivsresr.� Tom Perry,Building Commissioner s 9. 0� 200 Main Street, Hyannis,MA 02601 '°rEc www.town.barnstable.ma.us Office: 508-862-403 8 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 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. DEFINFFION 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. 9/9/2015 7:58:05 AM PST (GMT-8) FROM: 100005-TO: 15087901414 Page: 2 of 2 r ATE(MMIDD11'YYY) CERTIFICATE OF LIABILITY INSURANCE 9/9/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER BRYDEN &SULLIVAN INS _ NAME: A EE T 88 FALMOUTH RD PHONE FAX HYANNIS, MA 02601 E4YIAIL °!C "°' ADDRESS: INSURER 9 AFFORDING COVERAGE NAIC p INSURER : LM Insurance Corporation 33600 INSURED INSURER B ANDREI YARMALOVICH DBA BEL ISLAND HOME IMPROVEMENT v4suRERc: 204 CINDERELLA TERRACE INSURERD: MARSTONS MILLS MA 02648 INSURERE: I4SURERF: COVERAGES CERTIFICATE NUMBER: 26321423 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER - POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD/YYYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ CLAIMS-MADE OCCURAMAGET Ff�E occurrencal $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ RD- POLICY❑ LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY I 1 $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Peracddant UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION WC5-31 S-384176-025 2/25/2015 2/25/2016 srEA uTE I I ER_ AND EMPLOYERS'LIABILITY — Y ANY PROPRIETORIPARTNEWEXECUTIVE — N!A E.L.EACH ACCIDENT $ _ 100000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 100000 If qes,describe under DESCRIPTION OF OPERATIONS below E1.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. ANDREI YARMALOVICH IS COVERED BY THE WORKERS'COMPENSATION POLICY. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TO TO N: BUILDING DEPT. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AT MAIN ST r ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601 f • AUTHORIZED REPRESENTATIVE LM Insurance Corporation ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 26321423 1-384176 15-16 WC yogesh.patil@Libertymutual.com 9/9/2015 7:55:21 AM (PDT) Page 1 of 1 ✓r£eomnoou�eaGtla a of .: -,.: flee of.ConsuRterrAffatrs&;Buem e � 8;oard of B'uilc{'tn Re utations a. Sta r gu[ahnn _ ! g.. nd nda cls ::•. OM • 1. `� Curt�truGt ran Su 'cn�xur �"!:IMRRQVEIYIEfUT G �11 CT012 t �_ '° Lcense:'CS 105l�64 eglstration w e 78 Type ,er:t , r Ex �•. '�; � Plementt BEL ISLAN G•• M� M1.NAN V IVANxCTIr t 11, 174 IIpperCounitd ' . 1. ; , +� ;:; s Apt 1 14 IVANIUSN _ IDenms Port MA• 063 9'MILL?OP1D if i f.: .'� .' ' < r `c'` I S \� 1h. ARM-1 FT-w,MA' 6rf . i./�l ` � '' :�. rr-.•�.•-..r1,c c. ii is� Expiration i ndersecretary I Cornmiss�oner 01/01YZ01G . iw . . . . . .. 1. . " c . . . 1. . , . . . . ,. .. . . .. .. .'f I -`"- ` :-' k _ CGf.L!'t Q�i.�C�/NGp.Cl1d2C/ZC[6 ', . . ,: - tflaP3,i4C BUBInCS$"`•Sw�a'tlOD,' - '` . 1. YJeenn OC re istra1.g: t<o.,.IV id for mdividui use onl t 11 E I..' b M NT CONTRAG7OR nefore:the expirat�on;date: If,fuund return to ` Y. ReglsEration 17476 Office of Consumer Affairs and Business Re ulat�on Tv.... I 14 —..Piaza-Suite 5170 g . Expirat(on �/ti201� 8uaplemFt�t' BuSMn MA 42116 BEl IS1.LANDS HOA1E1NfpROVEMENTT. . `x IVAN1. tVANIUSF(EN.. i' ^.jNn ` �4I . -, ,�V��'�:' -�..._ ''.. ^ 0: ' �- CTode Becre;-I. f.:: Not valid wi. Data at . , e . .. .. .. . ,,,, :..: u re -. _:- _. . 1. W%,� : - . .'- .. .� - :.,: � -'.- . � �'.-.::���'-i'w .��-, , � - ':i�:�;.': � � . .:,:..:�.: '� ;��'-', ..... ('.'. y :::: .'.: } S {.' r(: C , 4 e . A "' S ra • Assessor's map and lot number �L— 3 Z) CIE PTIQ SYSM,i ,' /�- 7 7 e NITHQAP® IN COMPLIANC10. CLE H STATE, r) �ewa a Permit number i &-ANI ° 1 g 1.�..... ......................... A$ Ir®� As� P � TEftB�Sa --- a °FT"Er TOWN' OF }BARNSTABLE `fMARNST "6 9 � BUILDING ', INSPECTOR APPLICATION FOR PERMIT TO ..:.......... .................................................:.................. TYPE OF CONSTRUCTION 6 � ... , ./ ..... ......... . ...1,9 TO THE INSPECT F BUILDINGS: The undersigne hereby applies for a permit according tothe following information:/ Location .....I. ... 5�.c1<-�.. C: ........1. .. �........ .. t Proposed Use ......... ,..J::I/'v% :P �f� ...................................................................................................... ................ ZoningDistrict ........................................................................Fire District ........ .................................................................... Name of Owner .`.�Z4t-,.�Address ............ Name of Builder ......... �� at .... .Address ......... Nameof Architect ....... ..P.--..............................................Address .................................................................................... Number of Rooms :.C .. ?..........�..................................................Foundation ..... ... .a� �/d.�-��!�/ Exterior ...�y!! ..AA t��..... Roofing ....���• !L�.��..:. ..��.Jrl�"��.............. Floors ....... . .... ... ...f9-�i .. ...........................................Interior ............ �::: Heating .' . .. .� .- NFL' .a.�."y�✓. ...Plumbing ........r� d/.: :. . '1... /�....................... • .. ..: L' ..... Fireplace .............. .1.`1. ..................................................Approximate Cost ....... .��f.0 .....e ........................... Definitive Plan Approved by Planning Board -------/__^-=_� ______19 Area ....... Diagram of Lot and Building with Dimensions Fee .'c "�� � ................... .. .............. SUBJECT TO APPROVAL OF BOARD OF HEALTH 3 e a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name A Cedar Acres Reil ty� .: NoA..W770. ` ` ` Dwellin ;permit for:..... .... $. ; f,..�. ...............�2'6 ..:....2•`croo>�ea•pd....Rd®.... • � _ .. - Location ...IrO....... .....7......................................... ............ ........;{J.7flmi T:................... .................. - - Owner ...GedA»..Ares„ ......... Type of Construction .......... .9.94 r� .. ....................... ................... ............ ...... ........... Plot .......' ..... ....... Lot ...291 .Z4%........... �4. Permit Granted ............................. Nov .. 19 77 e b Date of Inspection .1 7�.?4.......19Qr Date Completedd ... ................................19 - _ - " •� y.-, •- "PERMIT REFUSED ....................................... .................... 19 .......................�.................... ...................................... /• P•t ..................... •... ....... rt ................................ ~ ` .. n ... .. ..................... ................................... • _ -. ............................ .................................................... S2 Approved ......... .................... 19 is ........ ....................,............. . ............... 7.......:j. Assessor's map and lot number . .. ......S3,1.............. . ... ...... /1- 77 - le )Ove �66vage Permit number .......................................................... TOWN OF BARNSTABLE BARNSTABLE 039. BUILDING - INSPECTOR APPLICATION FOR PERMIT TO .............. .............. G....................................................................................... TYPEOF CONSTRUCTION ................................................... ................ ............................................ ................................ ..........19......... TO THE INSPECTOR OF BUILDINGS: The undersigned O'hereby applies for a permit according to the following information: Location .........................................../ .................................................. ...................................................................... .... .............. Proposed Use ..................LLi..... ................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ................. c1dress ................................... ................................................ Nameof Builder ...........y Address .......................................................................... ...................................................... Name of Architect .................— .................................................Address .................................................................................... Number of Rooms ............... .................................................Foundation ..... ...Foundation ...................................o A ✓ ............a............................... Exterior .....1 f, V-1, /j, ............................................................ ...Roofing ...../..................... ........................rrf.......... Floors ........ .....................................................................Interior .................................................... ............................... -Heating------ ...... ...Plumbing ............................... ................ ... .............................................................. Fireplace ........................ .................... .......... ...............................Approximate Cost ......... ......................................................... F Definitive Plan Approved by Planning Board ---19 -7 J9 Area ......./...2...-..0....Q......... Diagram of Lot and Building with Dimensions Fee ........ .=)- �, 1) o . .................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................... ................. ..... .............................. Cedar Acres Realty i 19,7;70 Dwellin t ` No ................. Permit for ....................$.............. • ............................................................................... Location Lot 62 7. ...2 Crooked„Pd..,.Rd...... .. . .. ...........................Fiyanai s.............. ..................... Cedar Acres Re eft Owner ........................................Y........................ Type of Construction ......... odd ......................... ... ....................... ............................................. i Plot Lot ......29..._..321........ Permit Granted .......................... .....2.1...19 77 Date of Inspection ..................... ...........19 Date Completed ................. ....................19 PERMIT REFUSED , ......... ..................... .......... 19 .......J ...... . ......... .... . ........................................... .... ........ ...... ... ... .....� .. . Approved ................................................ 19 ............................................................................... ............................................................................... F� Assessor's map and lot numberJ. • / ;�- /,'U�y—�� yp%r T E tp� Sewage Permit nuiiber .. . SEPTIC `SYSTEM MUST BE d� o �� C� l,l . ... .a:.,r / 'INSTALLED IN COMPLIANCE Z 33A"ST&BLE. : WITH ARTICLE `il STATE 90 r�ea House number ................................. ................................ 00�i639 SA"Nt'fWA ZY +CODE,AND TOWN 'EO MPY Of- TOWN OF BARI ' '� BLE BUILDING I,NSPE-CTOR APPLICATION FOR PERMIT TO ................ .fx- -........... ........................ ..................................................... TYPEOF CONSTRUCTION ................. .. ... .... . ....... ................................. .... _ ................. ....... ............19� . TO—THE INSPECTOR OF BUILDINGS: The undersigned hereby qpplie for a permit co ding t the following information: v Location ...tx... �`QG .. ......� ....... GQ.h. ............................................................... Proposed Use ... .'ti"�Aiy.....!!`i�0.?'1.................................................................................................................................... Zoning District .............................................................. .... ....Fire District ................................. ... ............. Name of Owner .`�C'�.1sa.d+.� �...... . ..0......c.. Address G. � a.N.:C P6' 1 , .. ... L'►.!�h.1S r Name of Builder ................Address ............................... Nameof Architect ..........................:.......................................Address .................... .le.1............................................................ Numberof Rooms`........../....... .. ......................................Foundation ` ..... ............ ..................................................... Exterior ................... .V....!...'.:.................:. ..............................Roofing ..................... . ' Floors Interior .....................................................................:.............. ......(T!„ -�........ ..... ..... Heating '� g Plumbin ...................................:............ ....... .. -- - T 1 - _ 00 Fireplace !l.................................... .....................Approximate Cost c ���� .-..... .. . Definitive Plan Approved by Planning Board -----------_-_____-----------19________. Area .....1. ........................... Diagram of Lot and Building with Dimensions Fee a� ..... .................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name.:..,.✓. . .. ..................... � Brbdu, David & Carol [20886 add to dwelling No ---_— Permit for ----_---.--_.. i | � IV --/�--._----.---------~-----. � \ ' k ` ^ 72 Crooked Pond Road � Loconog ----------------.----- --- -.—.�. ......................................... _- — -- . ' - ' . . David & CaroI Brudd Ovvnar ---------------------- � . ' frame ` | Type Of' Construction ................................_--- , , . � . ^' --.----------------. _---. .. —' ` Plot ..,�-------.. Lot ----------' \ . ' / ^ � ' ' | � ^ December 4 78 Par��h`{�ronna6 ` —lV -----� �------' ^ � Date of Inspection -----------']P Dote Completed lV —.—..,—,'`=,---.. ~� '-_- _',__ ' - . ` PERMIT REFUSED ,._..�. __�_ —_-.--....�--..~-- 19 ' - ' ^ ' -----.--.—....—.----.—^~---_-- ' . ~, ^ —.--'—.~...,.—.-----..--...-----.,.— . . . ........................ . , ` . .----~—..~--^.—.~—........—.—...~..,- - ................................................ lg ' . . ' ` . ` ` ...................... .......................................................... � ' . . ` —.~--...—...--...--...—.^... ..................... ' J j� Assessor's ma and lot number � r � /� �`l y`7 ` THE Sewage Permit nuber .� ......... °0, Z EARNSTADLE, i House number / M6 a ` 9. TOWN OF BAR.NSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......................:...... ...........................�.r:......................... ............................:.......... a TYPE OF CONSTRUCTION ............................................................ifllli " f . rf.. ... �:�J! :.... ? ............................ C' ?� �, ................................................. 19........ TO THE INSPECTOR OF BUILDINGS: r The undersigned hereby applies for a permit according to the following information: Location ...�....'.'Y'.),Ji.........................................tl t � yr.:�.......`...........................:........:... Proposed Use ... IV .. rr,.........................................................:...................................................................::..... ZoningDistrict ..............................................................:....`:..Fire District .......................................................:..................... Name of Owner .. `^.:...X....i ^:.r ' .... J.4....Address ..� ........ .. ...........r< Name of Builder J ! tt ee!? A dr /... ... .............. . ....... d ess ......... ......... ......... ...... ................. .......... Nameof Architect .................................................................Address ......................:............................................................. , Number of Rooms r ..............................Foundation ... .t~z � _ . Exlerior '), 'F '•f �` r r� �#h{.;? i'. . .r ....:. -f.................•..........................................Roofing ............................. - ...... .......................... Floors ................... "'...?� :{•.....................................................Interior ................. e.''�?..'a..: ............................................. Heating .. ......................................................Plumbing ....°. ....• e� .:........... .............. Fireplace .....................-0'. ......................................................Approximate Cost ..:............. R' .... :... f!—)....�...�.�..................... 1 Definitive Plan Approved by Planning Board --------------------_---------19 . Area ..... ... :........................... Diagram of Lot and Building with Dimensions Fee ' - SUBJECT TO APPROVAL OF BOARD OF HEALTH F E e A 1 � 1 • i r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. � ,,� .: 1��t•.............................. Name,. Brodd, David' Carol, A=29I~32I . � 20886 NoL----.. Permit for ---.--.������g� ' -� . ----..-----------.---------. __' ..Pond.�k�Ad---- � .......... �����-------------- . ' David C ' ' Type of Construction ..........)rame...................... ^ F1c» ' Permit er 78 Granted _ ` Date - -''__n --......... ° Comp--- le .... . ^ ' PERMIT REISED � 9 - ^ ` .................... .� � . ;�~. ................ —......... ........, .....�............... . t ...^—.---..� —.. .—..-----, ^ --... --`-Y...^~.---~—.---- ^ / / \�.'`^ 0 / i K ' v � Approved ................................................ 19 � ` --------.-----�_.....—..,...--.— . -------.----.--------.~...... . � '