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HomeMy WebLinkAbout0684 PITCHER'S WAY la8'F �i�d�eb �� / -- — \ J e i 3 2�14 Town of Barnstable *permit# daft Regulatory Services F Thomas F.Geller,Director Building Division Tom Perry,CBO. Bedding Commissioner 200 Main Street,I•Iy=Ws,MA 02601 vwvw.sowa.baznstabte.aaa.t�s Fax: 509-790-6230 _QfFice: 508-862.4038 p ATIO - RESMENT NAY Not VaUd wltUW Ra X-1FFW MapJparcal Number�. pzoperty,Address G � Minimum fee of S3'3.04 for worn under$6000.40 "� V�of Work Owner's Name&Address Telephone N=ber,,, Home Improvement Contractor License#(if applicable) /C�®' � Construction Svpw lsor's License#(if applicable) Dt - --- 0wodmais Compermdon Insurance Check ow: I am a sole propictor i ann the Homeowner i have'Worlrer's CompOMadon insurance bsuraacx Company Namo -- Wadmun's Camp.Policy Copy of lour&=Compihmee Cerd2cate mast seeompauy each permit. Pwn*RMW(duck box) Rwoof(harrtcim mtDd)(Mppin8 old dies) All construction debris will be taken to ❑Re-coot(kurrirsm a 11204(not stripping. Going ova existing layers of roof) Q Re-aide #of doors ❑ Replaoemant WWdowdd=Vs.Mom U-Value (maximum 35)#of windows ❑ SMkelCarbon Nio:soxide detectors d fbor pleas marked wfth red S and inspections required. gate Eldetrieal&Fire Permits requbvd. odm tomdeparamemt e�ute�as,i e Hialorie.Cocamtvstion.etc. awhate to pim: Lsttaaoa of this PM&does not axopuffime with ***Note, Property Owner must sign Property Owner utter of PerseWon. A am of the Home Improvement Contractors License&Construction Supervisors License is wired. SIGNATURN. J y 'I , KAM Town of Barnstable Regulatory Services Thomas F.Geiier,Director Building Division Thomas Perry,CBO Building Commissioner 200.Main Street,'Hyannis,MA 02601 www.town.barnstable.ma.us O&ice: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder , 1 1, .Ilw '"✓"AOV /`51 1z z a22'f ; as Owner of the subject'property hereby authorize zuzz7 �. _ to act on my behalf, in all matters relative to work authorized by this building permit application for (Address of job) Sigaature of Occmer Date J-a/m - Peh.--oA-i . Print Nfane If Property Owner Is applying for permi4 please complete the Homeowners License Exemption Form on;the reverse side. `� �\ ?.tte CG�:rTtOnweal.�:k Gf It2�S`sack:'�E�}s Departiment of In f=rldAccizents \ Office oflnuesb g�fiotr� 600 Washington Street Boston, A 02111 wraw.mass,gov/dia Workers' Compensation Insurance Affidavit: Builders/Cant:act-ors/Electricians/Plurabe,s i3 IicacttInfo mat:iat. `. Plet:se Print L,e�ibty 1\1t3Me(Susiness/Organizalioollndividuat); .77 \ J City/Srate/Zip:9:9:4k&r.2 22&� , Phone#: Axe ou An employer? Check the appropriate boz 1.. I am a etnployor witb 4. ❑ I am a general taa6racto I Type of project(required): employers(full and/or Part-time),* have hired the sub-contanat�orsl t'• ❑ NOW constmiction � 2.❑ 1 am a sole proprietor or partzier- listed on the adacbed sheet. t 7. []Remodeling i ship acre have no employees These sub-contractors have 8. ❑Demolition working forma In any capacity. workers, corttp,insurance. i [No workers' comp, insurance S. ❑ We are a corporatioa and its 9' ❑BuildLig addition I 3.❑ raguired.j officers have exersissd their 10 ❑Electrical repairs or additions I am a h NO workers, doing allp,work right of exemption per MOL. i l.❑Plumbing repairs or additions rayselir [No eked ra'comp, c. 152,§1(4),'and we bWo no la of r„ trs iestussaoe rcgttlred.j t entplayaes.[No wo~iczars' -p$ COMP.iustrx&e requirerl.j 13.❑Other "Any 4ptloam that ohe:d*box#1 nest else 51l out theiasclon baiow she tt,sir tgoslta�s'cam�,aysatlan Aolioy:nfacmatlou t}d amaawnoes vaho submit this+�tdavit ladieating they arc doing Ili wort and d=iur ar�ido mpammctors moat suhrndt a now afiidevh indicating such. =-_Onvxom that Cho ok Odi ban must saachad an addtd=W sh:st ahowiag the neau elho sub-eftowm and their mvd,-_=I comp, oii P A CY tnfvrBnetinn. ,r,mm an employer that u providing workWr 'compensation irssurarueformy e�rrploys:s; Below is thepeliep andlab site tnforntatlon, Iri uranee Company N=e: Polley#or Salf-itss.Lie.# a�piratifm Date; : Sob Sits Address: 2 Attach a copy of the workers' compeasatioa policy declaratioc page(showwg the policy numbor and expiration date), F",' ure to secure coverage as requited under Section 25A oflvlOL C. lit can lead to the imposition of criminal penalties of a fine ltp to$1,500.00 and/or one-year impriso=ant,as well as civil peaaldes in the form Of a STOP WORK ORDER and a &ns of up to$250,00 a day against the violator, Be advised that a copy of ttas statement may be forwarded to the Gfflce of Lnveitigadons of the DIA for in=aace coverage veri#icatio,& I do hereby certify utt er the pains attdgenaltYar of nerfury that Lhe infarmatian proNided above Lr true curl correct: s .,� �s. 51 F t crpe only, Do not write in this area, to be completed by city or town offlciai; 1 Taws: PermltlLicer�se Authority(circle one); IE d of I�ealtli 2Building Department I Clty/Towa Clerk 4.r—lectrical Inspector 5. Plumbing Inspector�t Person: r _ Phon.e:� i Fr=.KaOy Geddis FsxID: DAVID.2 OP ID' KG 1111� CERTIFICATE OF LIABILITY INSURANCE DA�1MWY YYI THIS CERTIFICATE 18 Ia&U2D AS A MATTER Of INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TM3 CERTtrIcATE Can NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY 7WE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETIA'EEN THE ISSUING INSURER{S1 AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: the cenlflcate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. It SUBROGATION IS WAIVED,Subject to the terms and condltIons of the policy,certain policies may require an endorsemant. A statement on this certl8cate does not confer rights to the eerdleste holder In Ileu of such endorsements. GT Csoddis Northwacid Ins.Ap� ,Inc. P .771.4B92 igts for 5Q8-393 29M N�ySanMNs,MA xb0�ulte -- —_— Bs: W9URE B A"OFPNO:OVE1tA09 MAC I tNsunRA:Travelers Insurance Company mum— DSvld Cox, InC, INSURERS: P.0..Box 401 3 Yarmouth,MA 02664 weuRtaRD INSURER E: t COVERMES gERTIFICATE NUMBER: REVISION NUM®ER: THIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE Lt3TED BELOW HAVE BEEN ISSUED TO THE INSURED NA•.MEO ABOVE FOR THE POLICY PIE MOD INDICATED. NOTWrrHsTANDINt3 ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT YVrrH RESPECT TO WHICH THIS CERTIFICATE MAY OE'ISSUED OR MAY PERTAIN,THE INSURANOE AFFORDED BY THE POLICIES DESCRIBED HEREIN la SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS._ TPPG Op INIP.IRANCE Irma POSY NUMBER IMAM'D_ D_/YYY19Id�6100/YYYY1�_�_ LIkl1Ts_ 61NOtALLIABILITY I I I EACH CC--J:z eG A I I MLI_'RCIAL rANERAL:,L1ABI.IT',' f6801481M796 03NQ/2014 03(94l2045 1l REti111--s a oc.c:,rren.a_ S__ • CLA VIS-MADE a Wq I n;ED ExP(A y one x�rsen) > 51 �1-3;-Ualnsas OLwnera ', I PERSONAL&AC•:INJLFY `,000,00X '71I , 'iiENFRAL AGGREG?Tc S Z000,00 GMN'LAGGREGA-EJIVI-kPPLIESPop j FF.ODU:TS•GOM-iIFA�r, S 2,000, MO FOL!C I'Mr r r71 LOC AUTOMOBILE LIABILITY I eatcidentl _ ANY AU-0 I I ( BCuLY'IN.UR't(r^ac p!+yor.) ; ALL OWNED �-'SCHEDULEC I i - BOD:_Y iN-UR`r(Par xu06;c.,p'> ALTOS AUTOS kON•CVlNED HIREDAUTTO$ kUT09 —=-----fS— 's UNGROI1.LAUAe OICUR i E.CH O^CJORE excise LU® I MANS MAD: j I AGiaTE 5_ D 4:Tt -I N S W W.M C PGIWATION rjk L ITS I I EP _ AND R�1IPL"VW LIABILITY vim 0711612013,07/18/2014 E,L EP.'M.iOCtDENT 5 ,00 A ANY PROPRI PWARTNEZ'F.IECJnv! NIA WILL FOLLOW FROM CO -Y — 101 CF=K.1RASMS"ER"eJ(CG, 79 :11 E L.DoSEASE•EA EMFLq+EE g 1D0, ITHIN s DAYS i Rk it dory Im NH) Ity9S.McriteJnd' E.L GfSEAS'c.FDL!.YLIMIT 500,00 �55 TION OF OFERATI N9 ! 'JEBCRPTION OF OPWTI"I WCAnON91 YI40LEe (AttachACOM 101,Addldonal Remarks Schedule,Inman spame Is req.4 ERTIR T ER CANCELTION TOWtiy 8A R SHOULD ANY OF THE ABOVE DESCRIBED POLICES OR CANCELLED BEFOR@ THE EXPNtATION DATE THEREOF, NOTICE WILL OF. DELIVERED IN Town of earnts"ble ACCORDANCE WITH THE PCLJCYPROVINONS. 230 Main Street Hyannis,MA 02001 ASPRfiOSWATNE $1980.2010 ACORD CORPORATION, All rights reserved. ACORD 25(2019195) The ACORD name and logo are registered marks of ACORD C�/te�ovr•r�aascrc��l(/a'o�'��iivac/c�ael(r Office of Consumer AfWrs&Business Regulation License or registration valid for individul use only MOREBMME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: LatMdon: 100497 Type: Office of Consumer Affairs and Business Regulation p1milon: 312SM16 Private Corporator 10 Park Plaza-Suite 5170 Boston,MA 02116 DAVID COX,INC. om David Cox 19 LAVENDER LN gas=—x W,YARMOUTH,MA 02673 --� Undersecretary � Not valid without signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction supen'isor License: CS4063$37 DAVID R COX PO BOX 401 South Yarmouth 14IA 02 . Commissioner 1lJ11512015 ` e TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ( — Parcel , `13 Application # C Health Division Date Issued 1 Conservation Division Application Fee _ Planning Dept. Permit Fee S Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation /Hyannis Project Street Address 1TCMEP-S WAY Village H Yp Nil S Owner J RMPA RELZ.OM Address M) GQAl G V1 U-9 _96AC-14 K Telephone 50$ — 53 y —�1�-D ► l,D. J-1 yA v�1S �oR T M.� o��7,� Permit Request Nsuc, �,nN ,�- Are ��Aua�, ��q Sc�F�` OZ-1�do CELLVLOs 1 N I�0 547�i 1!1 SPGL , fZ001 v6Wr5 . bEal_±� T2rP Doon5, ��- 1r�� , v�►�i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay a Project Valuation ' D c� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, ❑ Two Family ❑ , Multi-Family (# units) Age of Existing Structure l 9 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing nevv m Number of Bedrooms: existing new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove:•❑Yes ❑ No n �,n Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing L ew`�size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name STe:✓E_N C. /,J H 1 T6 Telephone Number 50 O - Address (Q4L4 901-T Lbc- } (-EM a-c t-I >s G- License# TS D 3 9 SC-fSRST)An► 1 D Home Improvement Contractor# �Sy Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO f�ffi2,57"oN5 `'"i i L-t-S XfE >z 57.prr) oof SIGNATURE DATE /oil � 11 FOR OFFICIAL USE ONLY APPLICATION# ' i DATE ISSUED ►' :"" _1 -MAP/PARCEL NO.y t ADDRESS VILLAGE III OWNER _ DATE OF INSPECTION: FOUNDATION I!, FRAME I � S FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH - FINAL !GAS ROUGH R_- FINAL - { +�;FINAL BUILDING'. i -,_..:,DATE CLOSED OUT. r 4 ASSOCIATION PLAN NO. f ' s The Commonwealth of Massachusetts Department of Industrial.4 ccidents Off ce of Investigations 600 Washington Street Boston, M4 02111 11 1V)V)v.nzass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): CAL/SE e 73U1C.D/N + 'REMODELING L LC Address: AN SEt3A-s-riAJ DEIVE- UNI? / I _ City/State/Zip: SANPWICR N 19 D0510 3` Phone#: Are you an employer? Check the appropriate boa: 4. I am a general contractor and I Type of project(required): 1. I am a employer with�_ ❑ g • employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in.any capacity. employees and have workers' [No workers'comp. insurance comp,insurance.: 9. ❑Building addition 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 I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.7 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.eOther_'5J9ULA71b11,) comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing theirworke.rs'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 thepolicy and job site information. Insurance Company Frame: P Policy 4 or Self-ins. Lie.#: �{Gl Lf gt f Lf Expiration Date: .3—a "o�olc Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a Fine up to S 1;500.00 and/or one-year imprisonment, as well as civil penalties in the forrn of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. I do herehy certifj% der the pains and p nalties of perjury that the information provided above is true rrnd correct. «nature: - - Date: o 1� Ufrcial use nnit%. Da rent write in this area, to he completed by city or tm+lir ofjrciaL !j " I City or Town: Permit?LicensA jl Issuing Authority(circle one): i 1. Board of Health ?. Building Department 3. CirV/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector iI 6. Other Contact Person: Phone ACCW?F CERTIFICATE OF LIABILITY INSURANCE DATE(MMiDD/YYYY) 9/14/2O11 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. j IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to 11 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 CONTACT NAME: David Crawford Eldredge: & Lumnkin Insurance Agency, Inc. PHONE (508)945-0393 FAx --- -- --- AIC No:(508)945-404 ff g7 MaT.n Street_ E-MAIL ADDRESS:david@elinsurance.com 1 INSURER(S)AFFORDING COVERAGE I NAIC t _ - -- -------- ---------- `atharn MA 02633 INSURER A National Gran a Mutual Ins Co 114788 _ •'r1SURE171 INSURER B:COmmerCe Grou r j::a3-6e,_ Building and Remodeling LLC, wsURERcAce American Ins. ARWC _ I Co.. _- 122667 E YiCient Build]_ngs, LLC. INSURER D c jan Sebastian Drive #10 INSURERE: Sandwich _ MA 02563 INSURER E l'---- ------- ----- COVERAGES CERTIFICATE NUMBER:Housing Assistance Corp REVISION NUMBER: T E:.RTI;Y i HA THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD tdOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MA.Y BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, _..b. AND('.ONDIT!ONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS `-------------�TADDL SUER----'-- I '>k TYPE OF INSURANCE POLICY EFF POLICY EXP INSRI POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS �- GENERAL LIABILITY I I EACH OCCURRENCE - S 1,000,000 I } C 'r.A1E1.'CI=,L GFp,1rn:.L LiF.BP,.frr I 1 DAA4::Gr E TO RcNTED PREMISES(Ea ocairrencel S 500,000 x OCCUR �'IP027360 9/15/2011 9/15/2012 MEDEXP n one _--�----- 10,000 (Any Jerson; S__'--- i PERSONAL&A,GV IIJJURY $ 1,ODO,00O 1 -�—------- - GENERAL AGGREGATE 's 2,000,000 i J I PER i I I PRODUCT, Cor,IP/CP a.Gc�S 2,000,000 - I �cC. COMBINED SINGLE LIMIT I L.IABILiTY j I I iEa accident) i BODILY INJURY IE i person) 0..00 IT3BNVCS /16/2011 /16/zolz aCDILYIN.URY,P_racocentI)�-;, -- — r____-�„iOr.i_O�q:Ngp I PROPERTY C=•.Ib'.A(E_____. _-_—_ '=' I----�%•.t rI�J5 I I_(Per ent) __ � s accid { I I UMBRELLA 1_IAB i -. 11q - I EACH OCCURRENCE 5 1,000,000 EXCESS UAB I i I � _ -_ i — _-- ---. •ccREGATE 1,000,000 Cu 2736p 9/15/2011 9/15/2012 I :r_ � I REIE '0:ic s C I WORKERS COMPENSATION - WC STATU- AND EMPLOYERS'LIABU TY Y L IT$ E L EACH ACCIDENT---- $ 500,000 l•u...:a ,• 4494P844 /2/2011 /2/2012 E.L.DISEASE EA EMPLOYE- S - ----500 O0O E L.DISEASE I?OI IGY LIMIT - • - - 500�000 I I _. -_ES IA tacn:.CORD 101,Additional Remarks Schedule,if more space is required) Wea_herization Assistance Program, the following entities are named as erage under Pol #b—fD027360: National Grid Corporate Services LLC DBA _=_ Co. & NSTAR Electric. _ -- L O=R CANCELLATION I ( SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE III i THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN s na Ass 1SLance Co � � ACCORDANCE WITH THE POLICY PROVISIONS. z—,: Ruth Bechtold AU 460 West Main St. THORIZED REPRESENTATIVE vannis, M_A. 02601 id Crawford/ELDDCi . ORD 25(2010105) 1988-2010 ACORD CORPORATION. All rights reserved. .=.i175 �.r� r'. 'n� -_•+-.,o�r..ro:.nv.;,�. —ict—H m roc of Arr)p l r 1 11a.,alini.e[t• - Drpartnunt ��f Puhlic tiafct� 13tiard:44, Buildin, Reutilation. and `t:uxlart '- Construction Supervisor License License: CS 95038 Restricted to: 00 STEVEN WHITE 147 RIDGEWOOD AVENUE HYANNIS, MA 02601 Expiration: 2/28/2012 1 :,�iuni.•i,�ior Tr:;: 19311 � ✓�e i�amvawoatuea,�,�C �✓�craaac�iuGe%�d Office of Consumer Affairs&B smess Regulation HOME IMPROVEMENT CONTRACTOR Registration :•'154359 Type: Expiration: 2/28/2013 Ltd Liability Corpoi, CAL�BER BUILDING:ANDV7EMODELING,LLC. I f' I STEVEN WHITE 8 JAN SEBASTIANtkA UNIT;1`0 SANDWICH,MA 02563 �— Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation ati 10 Park Plaza-Suite 5170 Boston,MA 02116 Not valid without signature i T C N'A NC- 0 6. TT)' -J. COR 0RA 1I HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE 'IHE APPLICANT HOME OWNER. r hereby consent to and agree that weathenization work may be done by the Weatherization Program of Housing Assistance Corporation herein after referred as "Agency") on the property located at: t J, c, The Nveatherization work done will be based on programmatic priorities and availability of funding and it rnay include all or some of the following measures: Weather-stripping & caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work.to be done at my home I agree to the following: 1. 1, 'I've permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatberization work is completed. I have read the provisions of this agreement 4s listed and freely give my consent. ............ Home Owner: (SignarurO X Date: 4 Agent: (signature) Date: T.JAC approved Wcatherization Company : tr--lodelinQ Cape Cod Insulation Cape Save Creswell Construction Frontier Ene-L-1 S o-h t`o n s Loh-r& Sons Peter Smith Resolution Energy Rock Sol 11 All Cape Insulation 4� a.� I I13 G 4 7- �o,od` • 1.060 GAL.,Pir Oct, 4GAu $�9 Ti G TANK F 1 1 i i 1 �© Ag ' • • Y LOCATIOW. HYA N N I � MASS b'AT1= 3/if../ 7-. I C-MRTtl=V TNA-r -cl4r-- FOOADATsoN5440WQ A�•l R F'E�ZE�.tC. WrW%01J. COAAPLVS WIT 4 TWG: AWt> SETBACK 19EQUIIZGAA-= TS 6P T"C L O T I -7 -TO W U OI~ tD AR N S T p.'5 L- B�4 XTEt� u`f'E IUC- i REGIS'I'E.iZBD 9..A,I.1"p SvevcYo2S THIS at..A1-1 15 WOT sA.Sev OW A,&J osTEZVILLa #t�ISt'IZcJME�•tT SuQ+��Y TIE oF�S�T4 SNowt-a 6E USED To De:TE2M1%4& LCM LlWa5 APPLICA:"T Assessor's map and lot,nu . er ::... ...�. o ��✓'.�� �• r, 77 ` 6,.jEPTIC SYSTEM MUST Bl � F�LL�D IN! COMPLIANCE G1 Sewage 4permit number ...... .................... t cWITI1 A"TICLE 11 STIATE SANITARY CODE AND TOWN "Er��� TOWN. OFBARN TABLE Z IAIBSTAILE; ry 9p�1'6 UUILD,ING INSPECTOR i. ru r+ . ram• . y ,s + -- APPLICATION?',FOR PERMIT TO ............:... ........ . . � � .% .......... .......... ... TYPE OF CONSTRUCTION !.. ...... .... ... ............ L r :..... . ....�. .........19 . TO THE INSPECTOR OF BUILDINGS: . The undersigned ereby applie for a ermit according .to the' following infor ation: Location . �. ............:.,.. ........ ..................'��.......................................... Pro' posed Use . ...... ............ ....... .................... .............................. ................................................................ p .... Zoning District• ......... j ..................................:Fire District .......................... Nameof Owner ....... ......0 ....................Address ............. .. .. ............................................................. Nameof Builder ........:........:..................................................Address .................................................................................... Nameof Architect ...........:.......................................................Address ............................................:...................................... 5 Numberof Rooms ..................................................................Foundation ..........ra......................e...................................... . .4 Exterior -", ....Roofing' ......... Floors ....................Interior ? Heating6-� 4f/ / / ...........Plumbing `� .........�.......................... ................�'dC� .....................................;. Fireplace .....:........:.. .............................................................Approximate Cost ..... .................................................... . Definitive Plan Approved by Planning Board ________________________________19________. Area .......'.j............................ Diagram of Lot and Building with Dimensions Fee �!' ... SUBJECT TO APPROVAL OF BOARD OF HEALTH '-7) I hereby bgree to conform to all the Rules and Regulations of the Town of Barnstable Vgarding thh"bove construction. fGc Name ......... .. ..... ....................... Capewide Development No 1901a.:.... Permit for ...an,e...l./.2...stoiy..... ....single..Family..dwelling........................ s &84 Location P.itrhers.:Wa. ................... ......Fiiy ann is..................................... ................... Owner, ..Ca.pewide..D:evelA.pmeat".......:........... Type•of Construction .........£ramp........................ Plot ......................... .. Lot J1.7................... A Permit Granted ....March..15..................19 77 /17?.`. Date of Inspection .�.%,,�. ..............19 ' Date Completed ..............19 PERMIT REFUSED ........................ ..........+................. ... 19 ' .....................:.................. ...................................... .. ... .... ..... 1 ...................................................... ................... t Approved ..........r.e..:....... 19 � • 4 .................................................... Assessor's map and lot,number ��✓ �� �� r' Sewage,.Permit number`. ............................................:........... TOWN OF BARNSTABLE 4 yDi tH E l� w Z BAHHSTADLE, i ` 16 9 BUILDING INSPECTOR APPLICATION FOR PERMIT TO .:......................... .........::.� ...:.:................... TYPE OF CONSTRUCTION .........1� :` - .............................................................. .......................{ ... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: `Location .:'. :.'`!.....f.7. .... ............................... "P,/'�'-' ..............................�•;z.... ............................................... Proposed Use �-� ^`J-�`" '� Zoning District ........... ! ' ................................................`rFire District .. F- �/.?@. /1sf` :i1 �i :its✓r�7:..................................... Name of Owner ........................ ............. ....Address ............................................. y Nameof Builder .....................:..............................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .................................Foundation ................................. .......................................:...................................... Exterior ............... �!........ .................................................Roofing .................rt�. . "-':... . ...................... .......... �` .Interior ., rfi ?r".. v Floors .............. -:-. -..:...................................... P Heating ' .................................Plumbing "..^ ........................................................ .............................. ................. Fireplace ���.............................................................Approximate Cost ......;M i7tJ � ..................... _ Definitive Plan Approved by Planning Board ________________________________19________. Area ............................................ i r Diagram of Lot and Building with Dimensions Fee ( A..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH S I hereby agree to conform to all the Rules_ and Regulations of the Town of Barnstable regarding the above construction. Name .............. .. ...... dam,• �� y- -.. Capewide Dev' elopment M-271 L173 No ....L9.013... Permit for ....oue..1J2..s.t.0.r.Y... ....single...famIly..duall ng......................... Location Lat..#17..PLtChex.&..Wa.y.................. .....ILyanuis................ ........................................ Owner Capewidp-Wexelopmetit....................... Type of ConstructiS� ............on ..-f rame................. ................................................ ............ Plot ............................ ............ Permit Granted ........Ma" rch 15 19 77 ......................... Date of Inspection ..................................19 Date Cornpletet ......................................19 .-PERMIT REFUSED 19.......A17. . .......................... ................................................... ......................................................................................................... ..... ............................................................................... Approved .................................................. 19 ............................................................................... ............................................................................... Request Parcel Number 684 AND 694 PITCHER'S WAY AT Map: 271 Block: „73 Lot: 00 THESE ADDRESSES (694 IS A PORK CHOP LOT), TREES ARE CLEARED Parcel Lookup WITH A MINIMUM OF 6-8 TRUCKS AND CAPS RIGHTALONG 684'S LOT LINES RIGHT UP TO THE HOUSE. (BEHIND 684), CALLER THINKS 101 WINDSHORE HAD THE PROPERTY CLEARED FOR MORE PARKING NOT SURE, 101 WINDSHORE IS ONWED BY A TOMAS TOSCANO. http://issgl/IntemalWRS/WRequest.aspx?ID=20387 9/1/2006 O t ' hA l .el. �� Ls kor 6 CC'(S1 Dulc o Y. ( V c W-a Assessor's office(1 st Floor): erg• / ® SAC SY& MUST BE Assessor's map and lot number G�/��,L � '"STUL�W COMpUAN pi TH E TO``. Board of Health(3rd floor): � �J ` rn' Sewage Permit number — ;.•:.,MNPJENTAL C07 A ST&BLL Engineering Department(3rd floor): �1 *,^ ;La Q .A a�= ,s;: �a rues e House number 4 (-ge-tf' A/Gf*Z � ���� a�^°,,, c 1639. . 4b Definitive Plan Approved by Planning Board 19 �o rav d APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN -: OF BARNSTABLE BUILDING INSPECTOR ' APPLICATION FOR PERMIT TO1C.�1c>>/C3 TYPE OF CONSTRUCTION 19 $9 . t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies f6r a permit according to the following information: Location Proposed Use CJL.w\c\;2LU Zoning District R B Fire District 14!(AIU A3 1 S Name of Owner \C�c1.�c� BUJ�e 1 Address��V�E/*C 1*4 Name of Builder SZ .Q_ Address -S Name of Architect Address Number of Rooms Foundation (?OAJ C Exterior Roofing Floors Wo d� Interior Heating Plumbing Fireplace Approximate Cost GOO W Area �� o0 Diagram of Lot and Building with Dimensions Fee 6J— 6AILAGe Hc vs t A°' �J uSe S7_1Z C£ i 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 GCRRELLS RICHARD ADD DECK TO No-32858 Permit For DWELLI-NG Single Family Dwelling Location 684 Pitchers Way Hyannis Owner Richard Gorrell I Type of Construction' Wood Frame Plot Lot r..« May 1 19 89 Permit Granted r Date of Inspection 19 Date Completed �� � r 19 Aft P- _. ti . . ^� •� tik y,� :. - °f• �t.°''tir�.'Y✓.:3 .�"+:t "rs-\ r, ;r��.r'- ,.^{F...� t I,�.. .. •A. .u=..yr ._r,^. •.•n;U <-°-,t+oi°.r+"' � Assessor's office(1st Floor): /�� / -� t� c THE o Assessor's map and lot number Qy � Board of Health(3rd floor): Sewage Permit number Z BABd9Y11DLL i Engineering Department.(3rd floor): �a rnea House number ?-4 i1 1639• \®�' 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 TYPE OF CONSTRUCTION e::7� r-�dx C�bc e Le)r2oD Pr/t AmP 1 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location t�$4L�c L.QrS �1.1c��, ►-,�5 Proposed Use 5L.{v-,cA- c-k-- V r Zoning District Fire District 14`/AA)Al►5 Name of Owner R\clnc",-'rl 60,( -r-e_\ l Address I/ fr/.Ira Name of Builder. 5?N jP- . Address 5 A N1 e- Name of Architect Address Number of Rooms Foundation Co C, Exterior wo Roofing Floors 6-0 Interior Heating Plumbing Fireplace Approximate Cost GOO Area 00 Diagram of Lot and Building with Dimensions Fee 6A,2 Abe A0 Y• /-/Ous77 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 t-o� Construction Supervisor's License GORRELL , RICHARD A=271-173 ADD DECK TO No 32858 Permit For DWELLING Single family dwelling Location 684 Pitchers Way Hyannis Owner. Richard Gorrell Type of Construction Wood Frame a Plot Lot Permit Granted May 1 19 89 Date of Inspection 19 Date Completed 19