HomeMy WebLinkAbout0030 OLD HARBOR ROAD r
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Assessor's office(1st Floor): ' c'
Assessor's map and lot number aZ S 3 ,q^
Can pi TM E t
Conservation(4th Floor): .
Board of Health(3ro floor): ' `= 1 Dea»rast c
Sewage Permit number _
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Engineering Department(3rd floor)--' , o 0639:
House number �o Yry
Definitive Plan Approved by Planning Board ( 19
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF BARNSTABLE
BUILDING - INSPECTOR
APPLICATION FOR PERMIT TO
R_uju�
TYPE OF,CONSTRUCTION " 01
19—�
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location id -:
Proposed Use
Zoning District Fire District
Name of Owner > Address p,/ /� ✓/�' �j
Name of Builde Address
Name of Architect Address
.._.Number of.Flo.oms _Foundation
Exterior Roofing
Floors Interior
Heating Plumbing
Fireplace Approximate Cost ,t
Area Ale KL
.. .Diagram of Lot and Building with Dimensions Fee ..
506
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.
A
Name
Construction Supervisor's License 0��2�
+�, HAMBLIN, MARGERY
414?5`2>
No 36800 Permit For RESHINGLE
ROOF '?
Location-
Old Harbor Rd.
Hyannis �
Owners Margery Hamblin
Type of Construction ;tea
Plot Lot
Permit Granted June 15 " 1 g 2 94
Date of Inspection: .
Frame 19
Insulation 19" r'
Fireplace •19%'�
Date Completed 19' f ^ 1 ^
1
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COMMO 'M OF MA$6ACHUS4jFTS
�`^ R D EPAR--A F-N7 O F LIVD USTRtAY irACCIDE NTH
600 WASHINGTON STREET
James. Cammei: BOSTON, MASSACHUSETZ 02111,
Cor•:n:sstone
WORKERS' COMPENSATION INSURANCEAFMkT ?IT '`g f� �'
with a principal place of business/residence at:
,,/ �
h l.,
do hereby certify,under the pains and penaltici of perjury,these
sr zr a - R
j] 1 am an employer providing the following workers'compensation coverage for my employees working on this .
job.
Insurance Company Polity Number
1.am a sole propricror and have no one working for me
(] I am a sole proprictor,gcncr�l contractor or homeowner(cirde one)and have hired the eontraaors listed below
who have the following worker compensation insurance policies:
Name of Conrnaor Insurance Company/Policy Numbs
Namc of Contractor Insurance Company/Policy Number
Namc of Contracror Insurance Company/Policy Number
Q 1 :m a homeowner performing all the work myself.
1N'0 .Plcue be aware that while homeowners wbo,eruploy persons to des euintenanee,eonstructioc or repairworlc on a
dwcliing of not rzorc than tjjrcc units in which tic horrcowacr aiso resices or on the grounds appurtenant thereto are cot�cncrally
considered to be erralovcrs tmd.cr the workers' Corn :oc satioa Act(Cl- C 152,sec 1(5)),application by a homeowner fora license
or permit may eviccncc tic lcral sutus of an errploytr under the' orlcers'Compensation Act
l u^dc. ;:nd t ;:core c:t :sstc race.;wiL be forw:rdcd to the ..racm of i.dus; :1 Acadcnts'Ofncc of Insurance for coverage
^•c -::::. r: ;o sc=re eo-e:�e ss recc;:ee cnde:Seek'_'S:.'at�;G: '.;_ :1 per.:ltie_:
co^s- y �.ic:d to ti.c irtposiuon o.r crir::in
�s^-c of: r:::c C. err cc S'500.00.r.d!or imz;ruon...tnt o; uc to ore y . s -
c:-r:nd c :=::tics in the form of Stop Work Ordcr.ad
fine of Sl00.00:d:v.;=sc nc.
dad•ofS1 this � 19 -
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Liccrs:_i Pc• .�--- �iccaor;P
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HOK IMPROVEMENT CON C4r OF
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/i/�^j'(10D-✓0e :.cr_ i1V'ill4 Jf '_1� Ci:Vi$
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ADMINISTRATOR
gdBC S KA 0260