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HomeMy WebLinkAbout0035 NORRIS STREET � �r000l U-") '�- BUILDING DEPT. _ MAY: 0 5.2021 TOWN OF BARNSTABCE h � T f ner Signature Total Score: 100 TOWINYOFFBAR STABLE, 1 3 CSC 2 3 RM I= # 6 U G� L v o; �p11HE r Town of Barnstable *Permit# ? d Expires 6 months from issue date wvs Regulatory Services Fee .� saxrrsTnar.E, q� ,'�; `0� Thomas F.Geiler,Director Ar fD ,�s Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 pp� EXPRESS PERMIT APPLICATION - RESIDENTIAI; QNL k904 Not Valid without Red X-Press Imprin `TOWN OF BARN Si- Map/parcel Number 30 U 3 Property Address 3 S— A) `Y`Y-\1,S 4r EXesidential Value of Work % -Owner's Name&Address - . f( �' -c Telephone Number �U ' 77621 Name Kit _S � Contractors P E .. - or License;# if a licable L Home Improvement Contract. ( pp ) Construction Supervisor's License#(if applicable) r, l 3 - _ ❑Worlanan's CompensahonaInsurance. Check one. I am a sole proprietor.---' '' ❑ I am the Homeowner - - _ *- _ Q^I have Worker's Compensation Insurance Insurance Company Name 1 k/O Y-C c S - l �C� $ ci V c� Workman IsComp.Policy# '1^f C _Copy. Insurance Compliance Certificate must be on file. Permit Request(check box) = �e-roof(stripping old shingles) All construction debris will be taken to s - __ - .___ =_ ❑Re-roof(novstripping. .Going over existing layers of roof) ❑ Re-side El Replacement Windows. U-Value . (maximum.44) *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 P, perty Owner Letter of Permission. me Impro me t nt r tors License is required. Signature Q:Forms:expmtrg Reviseo53003 T%wn ®f Barnstable Department of Public Works Technical Support Division 382 Falmouth Road Hyannis, MA 02601 6 3 39 , o 4 44 -_ 8 .. _ - ....................... NORR- I IREEI ............... . .. I S7 - MAP 30 ' r I'AP 06 O - 3- 5 062 4#31 CI } MA 0 Tr =j = 6 \ basemapsAgn 10/28/2014 9:51:10 AM Property lines shown on this place are for assessing purposes onilf and do not represent actual relationships to physical objects. y � YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required by law. /� v� DATE: � Fill in please: APPLICANT'S YOUR NAME/S: GLEE eT I`r,;;451VDiWll t.r£ t BUSINESS YOUR HOME A DRESS.` N _ TELEPHONE-# Home Teleph ne Number NAME OF CORPORATION: ' . F. NAME,OF NEW BUSINESS �' T� �T��'C� cirzd(= �.. ' cam- � � °TYPE OF BUSINESS cd`k^LT cyct IS THIS A.HOME OCCUPATION?, - ADDRESS OF BUSINESS LS �,' 6 _ _' MAP/PARCEL NUMBER36(0 Ll - .(Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GQTO 200 Main St. - (corner of Yarmouth. Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate yoar-- si"ess in this town. 1. BUILDING COMMIS§'10NER'S OFFICE j; This individual_.s b errinf Frr�e of any/permit requirements that pertain to this type of business. MUST COMPLY WITH HONK OCCUPATION l�v{_ RULES AND REGULATIONS. FAILURE TO (` Authorized Signature** _.. ____...��__. �r?V1PL`! MAY RESULT IN FINES, COMMENT l l. I� �, i 2. BOARD OF HEALTH U This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) , This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: a- Town ®f Barnstable VE Regulatory Services Richard V.Scali,Director rt anaxsrasr a Building Division 7 MARC $ Tom Perry,Building Commissioner i639. �0 �'OTEo a ZOO Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Approved: 7 L-I Fee: T� Permit#: HOMY, OCCUPATION REGISTPATION Dater Name: U t' 6 CUA d Phone y Address: .:` �d r rl 5 �� Village G�r l� 5iz O— Name of Business: e�.� ��e e an J ha17 dSG Type.of Business: F �Ul � � l Map/Lot: `30 INTENT: It is the intent of this section to.allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to the- premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. - After registration with the Building Inspector,a customary home occupation shall be permitted as of-right subject to the following conditions: o The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. ® Such use occupies no more than 400 square feet of space. o There are no external'alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. e No traffic will'be generated in excess of normal residential volumes. ' The use does not involve the production of offensive noise,vibration,smoke, dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities: o Any need for parking generated by such use shall be met on the same lot containing the Customary Home; Occupation,and not within the required front yard. There is ho exterior storage or display of materials or equipment. ® There'are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked-on the same lot containing the Customary Home Occupation. No sign shall be.displayed indicating the Customary Home.Occupation. : a If the Customary Home Occupationds listed or advertised as a business,the street address shall not be included: ® . No person shall be employed in the Customary Home Occupation who is not a permanent resident of the, - dwelling unit I,the under ' e ,have read and agree with the above restrictions for my home occupation I am registering. Applicant Date: Hnmexnr-rinr. RrX.I(MI1$ Town of Barnstable Regulatory Services o 'Richard V.Scali,Director s . . r snxrrsrasi.E. Building Division * « � - MAS& Tom Perry,Building Commissioner �iD�Eot a 200 Main Street;Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approve Fee: Permit#: HOME OCCUPATION REGISTPATION -------------- - - - - - Date. Name: O�G'�' Phone#: Village::` Address: v i Name of Business: Type of Business: / -P ( �'� �l. / Map/Lot: o d��+ INhEN I': It is the intent of this section.to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling-'there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normat residential volumes; and no increase in air or groundwater pollution. , After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit-,. a Such use occupies no more than400.square feet of space. a There are no.external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. ® No traffic will be generated in excess of normal residential volumes. e The use does not involve the production of offensive noise,vibration,smoke; dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. e;. There is no storage or use of toxic or hazardous materials, or flammable or explosive materials,in.excess of normal household quantities. o Any need for parking generated by such use shall,be met on the same lot containing the Customary Home Occupation,and,not within the required front yard. . ® _ There is no exterior storage or display of materials or equipment.' a There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. m No sign shall be displayed indicating the Customary Home.Occupation. ' If the Customary Home Occupation is listed or advertised as a business,the street address shall not be ° included: - ®: No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I, the undersigned,4ve read and agree with the above restrictions for my home occupation I am registering. Applicant Date w ' i - . i Hommr_dar. Rev..l ORT 1.1 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate.ONLY REGISTERS YOUR NAME in town (which you. must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form;at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 .(Town Hall) and get the Business Certificate that is.,.. : required by law. DATE: r7� l�` Fill in pl as IF11M , W 6yru yet rr � APPLICANTS YOUR NAME/S: )_ a7Cr.. BUSINESS YOUR HOME-ADDRESS: ,< ° 1rx � TELEPHONE # Home Telephone Number 8T NAME OF_CORPORATION. ' NAME OF NEW.BUSINESS ;- Y� '`.TYPE`OF:BUSINESS r r IS THIS'A MOME OCCUPAT N? YES NO' 3 ADDRESS OF.BLISINESS MAP/PARCEL,NUMB,ER - (Assessing) When starting anew business tfierer several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO"200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town: 1. BUILDING COM ISSION RIS OFF MUST COMPLY WITH HOME OCCUPATION This individ al has a inform d an p r t r quire nts that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO 'hut orized n t COMPLY MAY RESULT Its FIIIIE�i: CMMMENTS / I n b 6 J 71 2. BOARD OF HEALTH F This individual has been informed of the permit requirements that pertain to this-type of,business: ...- Authorized Signature** . COMMENTS - 3. CONSUMER AFFAIRS [LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION m q Map Parce f . . Permit# T' gai,. ti:r Health Division s� q V L . Date Issued 3 c Conservation Division f2 . Application Fee Tax Collector Permit Fee CR Z S'• 0- 8` Treasurer "Mew IfUgr 08RAW A$MR Planning Dept. � � 1 ?AOPtH THE Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis e T-M- Project Street Address X 6 T41 k A Village 14VAt0t I S Owner 4 )101 V Address 3 5— AJ 47V Y`I Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing 0c) proposed 9W Total new Zoning District Flood Plain Groundwater Overlay Project Valuationo�� r 040 Construction Type Lot Size 90 ,/ 7 + Grandfathered: 4 Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family f�� Two Family ❑ Multi-Family(#units) # Age of Existing Structure ,s P�kv Historic House: ❑Yes V60 On Old King's Highway: ❑Yes U/No Basement Type: ❑Full ❑Crawl , ❑Walkout ❑Other ` 2 �� t�� 2. Gyot w Basement Finished Area(sq.ft.) Basement Unfinished Area(sq•ft) Number of Baths: Full: existing --- new Half: existing new Number of Bedrooms: existing .3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: W/Gas 0 Oil ® Electric ❑Other -Central Air: 0 Yes Ql o Fireplaces: Existing ✓ New Existing wood/coal stove: ❑Yes ❑No Detached garage:existing 0 new size X?,6 Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:O existing O new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded 0 Commercial O Yes 0 No• If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name C�C�"d es VV Telephone Number ac Address 3 19 A Pb t�iiA s License# 4 Lq 14 t Pam'"t a/ Home Improvement Contractor# 12, q 7C9 7 6 2 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S + �' � ���t..g SIGNATURE DATE 04 2/_ C9,1-r t FOR OFFICIAL USE ONLY 4 PERMIT NO. DATE ISSUED MAP/PARCEL NO. 1 J- k r ADDRESS VILLAGE ` i z OWNER j DATE OF INSPECTION: } FOUNDATION FRAME LF JC/Z07 /' h � a 7/0 T INSULATION //i/S U D /c. e/%94 y �? FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH"' FINAL II1 GAS: ROUGH FINAL FINAL BUILDING _ ' lk f DATE CLOSED OUT ASSOCIATION PLAN NO. S I � The Commonwealth of Massachusetts Department of Industrial Accidents _ 600.Washington Street Boston,Mass. 02111 workers'.Com ensation.•Insurance Affidavit-General Businesses r'. name address: ci •2 V� S state: ' '�'1,+^ zi : 0Z'&3 hone# 6el 4 A(A(� �" v� v �/ n work site location(full address): 3 oz1 ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑RestaurantBar/1 ig Estabh sbm0' working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.)' 0'I am an em lover with ( em to ees(full&part time): Other �] I am an employer providing viorkers' compensation for my employees working on this job.: . - :'S'•.. e "an Il �.e OIitA V eaaT A �tJ C1LY- I am a sole proprietor and have hired the independent contractors listed below'who have the following workers' compensation polices: M. con an name: addressi. e'. ci tihon #t' �,.. e bh irisursnce co. - = MEEMjMj '.. ll coin an. ha'aie:.;:.. ... address•. ci�• TY one# e;. insdr$neeso' - Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that g copy of this statement maybe orwarded to the Office of Inv tigations of the DIA for coverage verification. I do hereby certify, nd the pai and t' s of er' that the information provided above is true and correct Signature Date �- •� ¢ . Prins name •l i VI � j S y�1r/ llq Phone# v official use only :noe in this area to be completed by city or town official city or town: permit(license# Buildingent ❑ ❑check if immedis required ❑ ce❑ ent .contact person: phone#; ❑ (revised Sept 2003) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for�their employees: As quoted from the f`law", an employee is.defined as every person in the service of another under any contract of hire; express or implied, oral or.written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a�joint enferprise, 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 bean employer, MGL chapter 152 section 25 also states that every state or local licensing agency shall 'withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting . authority. y Applicants Please fill in the workers' eornpensafm affidavit completely,by checking the box that applies to your situation., Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regardii41he"law"or if you are required to obtain amorkers.'compensation policy,please call the Department at the number listed below. . City or Towns . Please be sure that the affidavit is complete and.printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number.which will be used as a reference number. The.affidavits maybe returned to the Department by.mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department.of Industrial Accidents BMW of Invesdomns 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 eat.406 oFTMEr 'down of Barnstable Regulatory Services r SAMSTs�.s i,E,$ Thomas F.Geiler,Director qjp 019• �,� Building Division rED MAC Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no- Date AFFIDAVIT HOME IlaROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMU APPLICATION MGL c.142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, -improvement,removal,demolition,or construction of an addition to any pre-existing ow3.er-occupied building containing at least one but not more than four dwelling units or to structures which are adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work ��Nl'�— Estimated Cost .. Address of Work: �3 ( •1-.� �J� DUo,rv��S S � fey-� dl ��'l`s �dl �•�CQ O Owner's Name: r+ Date of Application: 2 I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []lob Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice i$hereby given that: OWNERSPULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED RK DO NOT CONTRACTORS FARBITRATIO PRO GRAM OR GUARANTY FUNDUNDER MGL c 142A. ACCESS TO . SIGNED UNDE PENALTIES OF P R7URY I hereby apply foi a permit as the agent of the wrier: Contra rName RegistrationNo. Date OR Date Owner's Name RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NENV LIVING SPACE Q 0 square feet x$96/sq.foot= b �G® x.0031= plus from below(if applicable) ALTERATIONSMENOVATIONS OF EXISTING SPACE square feet x$64/sq. foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30,00= . (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost f na c:,tR Appmdh I Txbte JM1b(oaatL4"d) acted with Fama Fullpi LterlptlYe pxrktges far 06 xad Txa•1{saw F-It"AntW Huildla�S MrnxM1:mI •Hca�tr,g/Coating h1AXfMYfM � RC-eYislltnct8c� RF-Yloalure! u a quPmEMcwncy' twdn% 8 Vial � �� Aal(/�) R-Y;d t jA Ydltser R-vxt� Pr�3c 57oi to 6500 Hat1,a�Dim pxY�' Nannal 38 13 I9 10 6 Nacrosl 12`/1 a.40 t9 19 10 15 AFUS R 121/0 a.52 30 13 19 In 6 Namsal 5 12`/, a.sa 38 13 21 NIA N!A NarnW 15`/. 0.36 31 19 19 10 U IS*/% a.46 3a NIA 3Z.a 3E 13 25 NIA 6A IS AFJE Y 15 1 19 19 10 Nocmai 15,18 W 18`!. a3Z 38 13 2i NSA N/A I`lamtal S3 19 25 NIA 6 90 AFM Y 18'/, 0.42 13 19 10 gO.AFUE x 18;/. O.SO 3a 19 1C 19 6 3 Ajc'\t 1• ADDRESS OF PROPERTY: s �-� drq �S 2. SQUARE FOOTAGE OF ALL EXTERLOR WALLS; 3• SQUARE FOOTAGE OF ALL GLAZING; 4. °/a GLAZING AREA(#3 DIVIDED BY 42): . 5� S-SLECT PACKAGE(Q--AA'see chart above); VOTE; OTHEI,MORE INVOLVED METHODS OF DETERMINII`t a ENERGY REQUjREIv1EN'TS ARE AVAILABLE. ASK US FOR TMS TNFORMA'n0V' BMDING INSPECTOR APPROVAL: N0: YBS, q-focrns-fl8o303a 2-26-04; 3=48PM; ;617 248 0813 # 1/ 1 �f e Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 129797 Type: IndhMual Ex iratbri: 11/4/2005 Charles J Doherty Charles Doherty 319 A MAIN STREET DENNISPORT, MA 02639 Update Address and return card.Mark reason for chang Address p Renewal Employment Lost card ✓�e'�ismio9u ��aaaacleua� Board of Building Regulations and Standards License or registration valid for individul use only HOME NPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 129797 Board of Building Regulations and Standards Expiration: 129797 5 One Ashburton Place Rm 1301 T Ind-Widual Boston,Ma:02108 Type.- Charles J Doherty Charles Doherty 319 A MAIN STREET DENNISPORT,MA 02639 Administrator Not valid wi ut s na re i Ulf f Ae -Cammoxavaa � � R€€ DF T°�ti Town of Barnstable Regulatory Services f s, xsreste. ' Thomas F.Gefler,Director KAM 'gyp>163 .i� Building Division - Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 508-8624038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Builder Z <-C. �a:-yzs.,Ow'net•Af the.subjectproperty hereb authorize C�l%1. . . .to`act on my..behalf,. y in all matters relative to work authoiized•hy this building.permit-applicationlor: (Address of Job) 1 tyre of Owner ate print Name y - I Dames I '4 F.L�r.en.r. 1 �yYr(1 iILI f R • is �L �c y'�jyrr•!� .SCE �lYY.,',`s� I - ;go2-. �c:. �� Wit, �• y;� Kikld t i li t> f - - - - - --a- p.3 08/28/2003 15:17 FAX �j008 Z7�wwE - iV0�211/S ST2E�T -- rows✓way �--- x x ,SOT 8 7Z00 c 1 - m h � v - Z sroRy ls' 3S y " N P �osEPN //1vrr�z,gY NOrr. -War$1//44/X'fS 4WF4'B NV*-XlSrf"e' ON r#e Lor ,'ALO�7V Me A�DoPl/ov O00 ZOVOC-BY Thie c,�+o.0ysrAecv, CERTIffEO PLOT PLAN _.NO?r: 7#VE PIMMOZ 3+ pots WOr Aft,, ivtrN,'n/ y. LOCATION 3_{-3tNo is sf:f1 a�v_rsj f/h!�SS• ff/GN NAZ.#RD Aevvp 2oNa, (Zowre 11c *S-T*oo&d SCALE. ../'= Zo' OK CO M MV4V" p AM&/✓o. ZS-000i- 4006 a . ' PLM REFERENCE��itl&3'rB;NO.Q!..DES -7b#p RfW1.SAD AVrl-&3T /9,/9Bs"�Y� .o. 047;sc�ac�iN� �3K.S6Pc 9s, • LfjND iy Ny�c/Vi3=�ia�!5f,-��Ig•Ifd/ZyQt,L.r . 4y{✓n/o/1¢�s- N of Aov lq•C.297 PL.. . . . .. . . . I CERTIFY THAT THE jwzwk!9w&vzq!FT SHOWN OM THIS PLAN IS LOCATED ON THE 6R000 . . N A A3 SHOWN HEREON . . . . : . . : •. . . . . • o ,»a su PETITIONER: - _ 1✓E;S�Jd4R/10(!!�/�OV*-fS• REOISTSRED LAND SURVEYOR r t 15. 2(!03 10:52FM No.1d2T F• 11 Pngc 14 of 11 uFlf(3AY.INSPEMON FORK—NOT FOR VOLUNTARY ASSE�1TM suBW FACE 5EIyAG"BPO� �r PART E gysrm E FORMAMN-(cowwwd) Property Addressa YA a./ Qnrner. !i DSBe of Iaspeetioa:_ - SMC1I OF SMAGE DISPOSAL SYSTL,N+i' Provide a slodt of the sewage g4osal system inchuiing i=to ark=woj==mrcfcrem Lmdmiks or beac madm Locate aiTwelE w6"1(10 feet Locate whampubbe watersapp*tnWm tb-beikft 4 A" A J) p or 31 J 8£9Z0 b'W'sluuaq , , aaJtg 614M b91, % �fc rayon salaeyO 18lieyoQ f salaeyD 1 , . lenpinip'ul adrCj� idx-3E ? L6L6Z,1--�o; �;SEBab 2I0J.0,G21 .NODAjIN3AO24d i 3W40H 1spti¢gS pQg slaopetnSaa Naipting;o pieog ' ���� �vam2coxciruiorii j • P �.�.n'`:' - .✓fie io y _._..'W ---.-.�..:. -`= ..`��_ - - anznuynu�r�-a�`i�%ui�a c�ecaP.Cla ' _ BOARD OF BUILDING,REGULATIONS 'a a License CONSTRUCTION SUPERVISOR- Number S 075632 .. I' ,I Expires 0�1/20r©5. fh' iM nor 12316 Tr b Restncted CHARLES J DOHERTY�'�� 319A'MAIN ST' DENNISPORT, 3 Administrator. r ol / NEW SMOKE DETECTOR REQUIREMENTS ARE NOW LAW. EVEN THE ADDITION OF A NEW BEDROOM WILL TRIGGER AN UPGRADE OF THE SMOKE DETECTORS F O7ACORDINGLY PlO tE-H U".�O Sfi--_.�_ PL AND HAVE YOUR ELTAKE OUT THE APPROPRIATE PERMIT hT THE FIRE DEPARTMENT. ®co W �.._...� .r ca t0 w 4lui & CIO m �e xt s r j 40. 3 1 4 11 . A f sJI t VA 10 k i .� 1c — - V�v G -� E ® �- n \ - 1 t G . i . i i i . VA i Z S ti Q'I 9 y t y r