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0015 SQUARE RIGGER LANE
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION T Map s1 Parcel — Application N Health Division Date Issued 7-17r. ISLl e Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village H`�<y�►.�;, Owner ��.Q�I� 2�r� Address Telephone t L Permit Request 1/`f "��c�l7�T-L 4- jo`t ce-11, Ic,1 Square feet: 1 t floor: q s oo existing proposed 2nd floor: existing proposed Total new � Zoning District Flood Plain Groundwater Overlay Project Valuation Imo' Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Lke' Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King'sv ghway:v0 Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other s - Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) 1 ` ? m Number of Baths: Full: existing new Half: existing i nevv 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 Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new 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 Mike McCarthy Construction Telephone Number PO Box 52 Address West Dennis, MA 02670 License# Cell (508) 280-6964 CSC 55633ul16-9-3-9-3 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7 S^ .u- r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE z ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL :v FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 07/07/2015 1:94 PM FAa 5085681933 RISE ENGINEERING CAPE 0003/0003 • •y Town of Darm3table � , �. ��eg�tory v�rvlees 32fs�''V.Sc�A9roetor Tom Perry.Batmagcum oaar 244 Sh'tCt,��r�raaic;MA.p2b0] w�tw�lopVu.�►ara�iabiespas r Qifu= So&852.4038 Fhx: 509-7004230 Property Owner Must Cbnpkte'.and Sip This Sectiom Us' o AIguxlder r-- ._. . • • v ••.• • • r .rr�• tin.. � .. . r •• •• rY.rr.rn�__r•. ..�.__•_..�• • •.. 7? ! UO B+Q.p331YiprbCbt�, . is ai[xda=mW"to v0A au ' byrEa bufl&g periait Wpkation for. ate/ "Too i=4 and *athe msponuWqoixhe aiplicam Poob at+e matzo be d or umlimd'bdom fence Isla sm d f;xW ivas1 -1- s aye pez(a=ed,sna aeftp*& A /1. ZvA Pat a• xaoou dt Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-058633 L MICHAEL J MCCAR .. PO BOX 52 W DENNIS MA 0267t IN "` Expiration Commissioner 04/10/2016 I Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C6ntr ctor Registration Registration: 169393 Type: Individual Expiratio /2017 Tr# 264961 MICHAEL MCCARTHY � MICHAEL MCCARTHY - P.O. BOX 52 WEST DENNIS, MA 02670 Update Ad ess and return card.Mark reason for change. Address Renewal Employment Lost Card 20M-05/11 The Commonwealth of Mnssaclittsetts Department of InthistrialAcchlents I Congress Street,Suite 100 Boston,MA 02114-2017 ' www.massgov/ilia Workers'Compensation Insurance Affidavit:Bit ilders/Contractors/Electricians/Pl timbers. TO BE FILED WITH THE P>'RN ITTING AUTHORITY. Applicant Information lease Print Le ibl Name(Business/Organization/Individual): Mike C a y Address: West Dennis, MA 02670 e - City/State/Zip: C4L-5$6M#: HIC-169393 A7reyoa an employer?Check the a rrite boz: Type of project(required): 1. m lama ern with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.] 8. ❑Remodeling In I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9• ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ]0 E]Building addition ensure that all contractors either have workers'compensation insurance or are sole I].[:]Electrical repairs or additions proprietors with no employees. 5.❑I am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 12. Plumbing repairs or additions These sub-contractors have employees and have workers'comp,insurance.? 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. M.W01her 152,§1(4),and we have no employees.[No workers'comp.•insurance required.] *Any applicant that checks box#1 must also fill out the section below showing'their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ?Contractors that check this box must attached hn 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. lam an employer that is providing workers'compensation insurance for my employees. Below is lute policy aml job site information. Insurance Company Name: T 114 ,,4, Policy#or Self-ins.Lie. ku-�,Oi`7C�6 - aa[Y Expiration Date: )�l Job Site Address: `(- City/State/Zip: Attach a copy of the workers'compensation policy, Celaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine tip 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.A copy Of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un tl a/ s an allies rjrtry that the-information provided above is trite and correct. Si nature: Date: Phone#: [E- 7 only. Do not write in this area,to be completer!by city or town official. n: Permit/License# hor711e one) Ileilding Department 3.C[ty/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: s � � WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMPAGE A.I.M. Mutual Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800)876-2765 NCCI NO 26158 POLICY NO. I VWC-100-6017656-2014B PRIOR NO. VWC-100-6017656-2014A ITEM 1. The Insured: Michael McCarthy Construction Inc DBA: Mailing address: P 0 Box 52 FEIN:**-***3862 West Dennis,MA 02670 Legal Entity Type: Corporation Other workplaces riot shown above: See Location.. 2. The policy period is from 12/15/2014 to 12/15/2015 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000:each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease. $ 500,000 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTEA 0712979 INTER SEE CLASS CODE SCHEDULE Minimum Premium $550 Total Estimated Annual Premium $29,332 GOV GOV Deposit Premium $7,748 STATE CLASS , MA 5479 State Assessments/Surcharges $28,601.00 x 5.8000% $1,659 i This policy,including all endorsements,is hereby countersigned by 12/15/2014 Authorized signature Date Service Office: Bryden&Sullivan Ins Agcy of Dennis Inc 54 Third Avenue PO Box 1497 Burlington MA 01803 So Dennis, MA 02660 WC000001 A(7-11) Includes copyrighted material of the National Council on Compensation:Insurance, n V� used with its nenisainn_ \ 'DoV Town of Barnstable Permit# Expires 6 months from issue date Regulatory Services Fee • snxxsrwsM 9 'A Richard V.Scali,Interim Director ArEO MA't� Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number � I o�C ,� Property Address /,5'1f a L OeA 91 V/014 *'1V1 J residential Value of Work$ ��6)- 4'D Minimum fee of$35.00 for work under$6000.00 I Owner's Name&Address 4--y iWo Zvi K, 0/44 /Al4 Contractor's Name4J,1 1WTd'IS/G/,0/ rl jr) e'Q'_hone ber p Home Improvement Contractor License#(if applicable) 17o�J Email: Construction Supervisor's License#(if applicable) C f ❑Workman's Compensation Insurance MAR - 4 2014 Check one: ❑ I am a sole proprietor ❑ I am the Homeowner TOWN OF BARNSTABLE •WI have Worker's Compensation Insurance � Insurance Company Name /�S J �t°`T��` C r.�t�/!/��'�s �-✓S Workman's Comp.Policy# W C C ,jr0U �- Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Q Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to CR va S n 42,, o,foul ❑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: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Impr went Contractors License&Construction Supervisors License is y required. SIGNATURE: `"' ' " ' - Q:\WPFILES\FORMS\building permit forr&EkS.doc Revised 061313 The Commannwakh�o�f Massa rrs Deparhnent ofIndrastrial Accidents Office oflni estigations 600 Washington Street y Boston,MA 02111 r mv.massgov1dia NVorkers' Compensation Insurance Affidavit: Builders/ContsactorsTlectricianJPhunbers Applicant Information Please Print Legibly Name cBusine_ ,,�njndit,'iduat)ka 9."-It�IArlv-v /,?y x1P72hs,611 Ay-P_Z_ Z�edo6k� Address: City/Sta&Zip_ ✓-01 u/tA/u? Phone lk 7 6 Are u an employer?Check the appropriate boa- Type of project(required): 1. I am a employer with / 4. ❑ I am a gentral contractor and I T* have hired.the sub-contractors 6_ ❑New consfnuct on etnpioyees(full andforyarr-time).. 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.insuraum, 9. ❑Building addition. required-] 5. ❑ We are a corporation and its ME]Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LE]Pluming repairs or additions myself ' right of exemption per MGL �o workers �- 12 .00frepair:� insurance required.]F c. 152,§1(4),and we have no employees.[No workers' 13..0 Other comp.insurance required_]: '?tuy applitsnt that checks box Rl most also 5ll our the section below shovring ihea woakets'comperF�fiM+policy iaivrmafia� ffomeowmers who subunit this affidasv indicating they are doing an wank aid then hire outside con=mrs m=subtait anew affidarit indicating such. rContractors that check this boa roust attached an additional sheet showing the nme of the sub-contractors and state whether or not tbnse entities have employees. If the sub-contractors have employees,they must provide their workers'camp.policy number. her. 1 am an empkywr that is protfd*workers'congmisation insurance for my enrplojwes. Betorp is tha policy andlob site inf'ormadon. Insurance Company Name: /¢ S�L �L•�1°tJ' /v t o/u�/z/� policy 4 or Set€ins.Lic.4: r S�-�� �� �z / Expiration Date-.-- Job Site Address: ✓CU/f /ei G� Zr. CitylStatelZip:_�1`Val'OV L i. 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 for one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine ofup 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 Ike DIA for insurance coverage verification. 1 da hereby r. Trtr under the pains analpenalties of pe my.Meat the it formation proviied above is true acid correct I � C S- Date: Phone#: d /�P S� 7-0 Official use only. Do not sprite in this area,tr,be completed by city or town officiat City or To%m: PermitUcense Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 0: 6 Client#:39680 2NORTHSIDEHO ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYI') 03104/2014 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 endorsement(s). PRODUCER CONTACT NAME: Dowling&O'Neil NE PHO 508 775-1620 FAX 5087781218 A/C No Ext: A/C,No Insurance Agency E-MAIL ADDRESS: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A:Safety Indemnity INSURED INSURER B:Associated Employers Insurance Walter Warren DBA INSURER C Northside Home Improvement INSURER D 40 Alexander Drive INSURER E: Yarmouthport,MA 02675 INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY BMA0020465 D910412013 09/04/2014 EACH OCCURRENCE $1 00O 000 X COMMERCIAL GENERAL LIABILITY PREAGE SES Ea oNcur ante $1 OO OOO CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $1 O 000 X PD Ded:250 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 JECT POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WCC50050124112013A 9/01/2013 09101/2014 X I WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500 OOO OFFICER/MEMBER EXCLUDED? ® NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 I 1,T DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Walter Warren is excluded from the workers compensation policy. Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Angelo&Carol n Zona SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 15 Square Rigger Lane ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S126484/M126483 LS1 �1HE rqy� Town of Barnstable Regulatory Services * MASS. Richard V.Scali,Interim Director 'OTF1639. ,�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, �'� f y Zo✓��^ , as Owner of the subject property hereby authorize A/0 A51� /AM,? Ta� O ff't to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility applicant.onsibili of the Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applic X%'q'd6 '4-- Print Name Print Name Date Q:FORM&OWNERPEPMISSIONPOOLS 10113 Town of Barnstable Regulatory Services OFTtIE lqy� Richard V.Scali,Interim Director Building Division BAM NsrnaM Tom Perry,Building Commissioner MASS. 9� 1639, `0�. 200 Main Street, Hyannis,MA 02601 ArED ,I www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB.LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied 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. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s) for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,.particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 i Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 d Bostori, Massachusetts 02116 Home Improvement Contractor-Registration C'r>J:3a r Registration: 176505 t � Type: DBA Expiration: 8/27/2015 Trt> 244259 NORTHSIDE HOME fMPROVEMENIT7. WALTER WARREN JR: 40ALEXANDER DRIVE YARMOUTHPORT, MA 02675 Za Update Address and return card.Mark reason for change. - CJ Address Renewal ❑ Employment Lost Card { scA 1 Co 20M-05/11 - y� �e�pomirr`ZeouueczLC�a�C �ac�ivaeC�r �\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration =176505` Type: Office of.Consumer Affairs and Business Regulation, ' xpiration 8/27/2015; DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 NORTHSIDE HOME I ROVEMENT' N. WALTER WARREN JR 40 ALEXANDER DRIVE ��� _ YARMOUTHPORT, MA 02675 r Undersecretary Not valid without atur . Massachusetts -Department of Public Safety Board of Building Regulations anc standards . - 9 Construction Supe`ry isvr ' r Y License`. CS-091653 WALTER R WARAN i L 40 ALEXANDER-ZR', 'YARMOUTH ORT P 2 Expiration Commissioner 09/30/2014, . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2731 Parcel Soo Application #(S)o Health Division Date Issued _ Conservation Division Application Fee V Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board p Historic - OKH _ Preservation / Hyannis f� Project Street Address L)A 1Z Rd LI EdL- <AkZ:; Village - 11�1r4 N/>JG,� Owner Aw C—Lo `2 oAjA Address IT 5111v42S;_ R116(5�:YL ( YU Telephone Permit Request �ZyyjoAL oP S 4g�oC_.JU, A6uJ =.taSL,AX-,,nP A&oerbg—c� fir- :M Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation aQ b Qa Construction Type WtdD r Lot Size P O _sQ FT Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) I Age of Existing Structure a►4 JltS Historic House: ❑Yes A No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) 1 4-62�!�4 �:T" Number of Baths: Full: existing_ new - Half: existing new Number of Bedrooms: �3 existing —new Total Room Count (not including baths): existing 7 new First Floor Room Cc nt Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: kYes ❑ No Fireplaces: Existing New Existing wood/co 30 Yes:a❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ r�ew side_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: I Q Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ =� w Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name iM 1'1,mow. 'w9 LLcw Telephone Number TOE ">60 I l / Address laa ( Nip License # 15 9 o) �r- t��c��.�.► (��i®�����,J Sc'ri��.c 5 Home Improvement Contractor# /d 2 a 9q Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO _tOwN o t y AeWA® rtk Ur2�� SIGNATURE U��J'� DATE /k S FOR OFFICIAL USE ONLY - APPLICATION# ' DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE F ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH '.. FINAL ` r GAS: ROUGH FINAL FINAL BUILDING I DATE CLOSED OUT r ASSOCIATION PLAN NO: i � t } T"Er°�ti Town' of Barnstable , Regulatory Services � uxxsrAS[.E, ` 4 v uAss g Thomas F. Geiler,Director `�� Building Division Tom Perry,Building'Commissioner 200.Main.street,Hyannis, MA 02601_ Y www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property bier Must' Complete, and Sign Tbis' Section If Using A Builder I, 1qn►&5,L<)` 0164 , as Owner of the subject property hereby authorize Gt3 al�ry �u �o 5 to act on my behalf, M all matters,relative to work authorized'by this building permit application for�Z k-k>OYL-, l:,a C uYu tSM_v t V 1 c (Address of Job) - - Signature of Owner Date Print Name If Property Owner is applying fo r.perrmt please complete the Homeowners License Exemption Fonn.on the reverse side. Q:F0RMS:0WNEUERMI9SION. - ��of•cry r�� Town of Barnstable H� o Regulatory Services r = Thomas F. Geiler,Director < s,�xxsresc.e, � � 165p. Building,Division PrED MA't - Tom Perry,Building Commissioner 200 Mairi.Street, Hyannis,MA._02601 vvww.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOI dEOWNER 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 super visor_ DEFINITION OF HOMEOWNER !.L 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 constrticts 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)- � 'cam i 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 r1 n=um 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 EXEMFTION .The Code states that "Any homeowner perforrning work for which a building permit is required shall be exempt from the provisions of this section(Section ID9.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption arc unaware that they are assuring 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 cast,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. T hr homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her icsponsibilitics,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 fomr/ccrdfiration for use in your community. Q:for Ms:homccxcmpt I s. Restoration Services Inc. Fire, Smoke,Soot,Water Damage&Mold Remediation Services Cleaning Deodorization. • Reconstruction Specializing in Fire Restoration All Work Guaranteed Access, Authorization and Direct Payment Request Form I (we) authorize WHALEN RESTORATION SERVICES to perform work as per estimate at•property located at 15 Square Rigger Lane, Hyannis, MA 02601 to repair damage caused by fire on 3/31/12 I As owner(s) of this property, I (we) understand that I (we) must authorize this work. I (we) hereby authorize WHALEN RESTORATION SERVICES to perform this work and accept responsibility for payment upon completion. I (we) authorize and direct my Insurance Company Lloyds Policy No. P1107713060411 , to make payments directly to WHALEN RESTORATION SERVICES, Insurance Claim Specialists,.for doing this work and to that extent I (we) assign the benefits applicable to this loss to WHALEN RESTORATION' SERVICES. I (we) acknowledge receipt of a copy hereof: ////V- OWNER f DATED SIGNED t OWNER EN RLSMRATION REP. SIGNED 22 American Way,South Dennis,MA 02660 Phone: (508) 760-1911 Fax: (508)76079995 • 1-800-244-2598 •E-Mail: restore@whalenrestorations.com Web Page: http://www.whalenrestorations.com OFFICE COPY - �l;a.>actiu.rii� t)i'17;t;'[itictii of Public Board of Buildiw Rc�-Yui;itiim[ and 'itandardv' ' Construction Suoervssor License License: IS 74928 WILLIAM WHALEN 122 POND STREET BREWSTER, MA 02631 �- - -� -� Expiration: 8/10/2012 '���c Tfn,�7i��ann.rut'trll�n�C'�!`lcr:,.ninfrr.;c//1 ^_. Office of Consumer Affairs&Business Regulation License or registration valid for individul use only AJOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation I, 5 egistration: 129244 Type: 1 expiration: 7/30/2013 Private Corporation 10 Park Plaza-Suite 5170 � Boston,MA 02116 Whalen Restoration Services Inc. William Whalen 22 American Way South Dennis,MA 02660 N�— Undersecretary Not valid without signature _ i:Theresa Cahalane-Norkus To:Kathleen @ Whalen/Angelo 6 Carolyn Zona/Whalen (15087609995) 14:51,04/02/12 EST Pg 3-3 Client#:245206 WHALENREST ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) : 4/0212012 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 pollcy(les)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 endorsement(s). PRODUCER CONTACT NAME: International New England HUB International New England PHONE 508-945-0446 508-945-9136 265 Orleans Road (AIr. No Fill EMAIL ADDRESS: North Chatham,MA 02650 508 945-0446 INSURER(S)AFFORDING COVERAGE NAIC11 INSURER A:Arbella Protection Ins Co.. - INSURED - INSURERB: Whalen Restoration Services Inc.; - - • Whalen Services Inc. INJURER C: 22 American Way INSURER D: South Dennis,MA 02660 INsuRERE: ' INSURER F CAVFRAGFS CFRTIFICATF NIIMRFR- RFVISIAN NIIMRFR' 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 1S SUBJECT TO ALL THE TERMS, CXCLUCIONC AND CONDITIONC Or CUCI I DOLICICC. LIMITC Cl TOWN MAY I IAVE DCCN nr_DUCCD OY PAID CLAwC. LT RR TYPE OF INSURANCE DDL SUER POLICY EFF .POLICY EXP 1 INSR WVO POLICY NUMBER MMIDDIYYYY) (MMIDDIYYYYI LIMITS A r;FRFRAIIIARulTr 9600040299 0410V201204101/301 rncnoceunricnor= z1000000 X COMMERCIAL GENERJFL LIABILITY - - - - �AVMGEE TO RENTED n,o $100 000 CLAIMS-MAUL UGGUR MEU tAP(Any One person)- $5 000 - PERSONAL&AOV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN-L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OP AGG s2,000,000. - POLICY1:1 JECT SECT LOC $ A AUTOMOBILE LIABILITY 58243400004 0410112012 04101/2013 COMBINED SINGLE LIMIT Ea'eccident $1,000,000 ANY AUTO BODILY INJURY(Per person)" $ ALL OWNED X SCHEDULED BODILY INJURY Pecacudent $ AUTOS AUTOS ( ) NON-OWNED X HIRFn Al IT( PROPERTY DAMAGE 1S X At IrnS Par arridont $ $ . UMBRELLA LIAB OCCUR F - EACH OCCURRENCE 8 EXCESS LIAR CLAIMS-MADE AGGREGATE $ A woAXER¢coMPt;NcnnDN 9091320411 410'11Z012 t)410112t1'I wr sTOTu OTH AND EMPLOYERS'LIABILITY N TO LIMIT E ANY FRUPRIt IUHIF'AH I NtWtAtL1U IIVt - - E.L.EACH ACCIDENr. $�SOO OOO OFFICER/MEMBER EXCLUDED? N l A " C.L.DISEASE-CA CMPLOYEE of 00 000_ It yes,describe under .DESi,RIPTIGN OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 3600,000 nrFCnlPTinN nr nrlrnATInNr.11 nr.ATInN61 VriIICI rG(J1Mneh ACnnn 10q,AKAiliAAAI f)PMMPu'I rPhrAldr',it MAA-JpRrp 1+IrgnirrA) PFRTIFH'CTF Hf11 nFR CONr'FLI OTIr1N Angelo Ar C;arolyn Iona HH1111113 ANY(IF I HF AHnVF IIFYCHIHFI)Fill I{:IF:i HF"I.AN(:I-1 1 FiI.HFF(IHF THE EXPIRATION DATE_ THEREOF, NOTICE WILL J E DE LIVE'RE_D.IN: 15 Square Rigger Lane ACCORDANCE WITH.THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE 0'1988.20`I0 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05j 1 of 1 The ACORD name and logo are registered marks of ACORD #S703270/M703151 TC002 The Commonwealth ofAfassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street. Boston, MA 02111 wwW-m=gav1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le�bly Name (BMSin d,0q Ui2Z iMdndivicmai): Whalen Restoration Services Address: 22 American Way, C�/Stat /�P� South Dennis, MA 02660 Phone#: 508 760 1911 Are you an employer? Check the appropriate box. 12. .9 I am a 1 with Type-of project(required): . employer 4. ❑I am a general contractor and I . * have hired the sub-c 6. New construction employees(flu and/or part-time). onttactox� 0 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling slip and have no employees These sub-eonfractors have 8. [j Demolition working for me,in any capacity. employees and have workers' [No workers'comp. I2SLn3Iice comb,in&===.t 9. []Buildingaddition . requured] 5. [] We are a corporation and its 10.❑$'lectacal repairs or additions 3.❑-I am a homeowner doing all work officers have exercised their 1 I. Plumbing ❑ mg repairs or additions myself- [No workers' comp. right of exemption per MGL 12 Roof repaim instammce mqun-ei j t c. 152, §1(4), and we have no ❑ cmPloyees. [No worirerc' 13.❑ Other comp.ins mce required.] `Any appfi®t that ehech box#I —st also fin out tho sc:dou below showing their wo i=, t comp info ensation policy rinadoa Homeowners who submit this affidavit ina5cating they axe dmug an work and thus hue outside coatract=mart submit a new&Mdayh indicating such. xCann acto rs that du= aria box must ariscbed an addifiono shoat showing the name of the sub-contractors and state whether or not those eatities have employees. If @xe sab-aahactors have employees,tixey must pxvride their waj3='camp.policy Cr.mmlb lam an emrployer that ispruvufpzg workers'cvmrpensatiorz insurance for mly employees Below is thepoficy andjob site information. Instuance Company Name: *Arbella Protection Ins Co Policy#or Self-ins.Lic.#: 9091320411 Fop nation Date: 4/1/13 Job Site Address: /� tax tp►2 9Z is[�slit, < a�sG Ci /S t[te/Z : cu)ur--YLUe Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration gate). Fame to secure coverage as regtzffed tinder Section 25A of MGL c. 152 can lead to the imposition of Qininal pe�ti�of a fine up to$1,500.00 and/or one-year imprisommetit, as well as civil penalties in the farm 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 the DIA for insurance coverage verification. I do hereby certify under the paurs and penahi a ofPwYraY dud the inform zaion provided above is true and correct Sianat ue: u J Date Phone# 508 760 1911 Official ase only. Do not write in this area to be completed by city or town offztial City or Town: Permit/Ucense# Issuing Authority(circle one): L Board of Health 2.Building Deparbnent 3. City/Town Clerk 4.Electrical Inspector 5.Plnmbing Inspector 6. Other Contact Person: Phone#; FRIEDUNE&CARTER ADJUSTMEIVO& 1 Hy Mam' Street, P. se 8 Hyannis, Massachusetts 02601 l : Tel. (508) 771-3232 FAX (508) 790-2344 TO: O Building Commissioner or Inspector B1 ildmgs ( ) Board of Health or Board of Selectmen ( ) Fire Department TOWN OF Hyannis TOWN HALL BARNSTABLE,'MA RE: Insured: ZONA, Angelo&Carolyn Property Address: 15 Square Rigger Lane Hyannis, MA 02601 Policy Number: P1107713060411 Type of Loss: Fire Date of Loss: 3/31/2012 File#: 114856 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of this writer and include a reference to the captioned insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by First Class Mail S. W. HARDY Adjuster 4/9/2012 el Town of Barnstable *Permit# ,7 7 �3 Expires 6 nrartiis from issue date i RArNBTABM • Regulatory Services Fee ` 0� .� KAM• �� Thomas F.Geller,Director �prFo i9.'�"� Building Division Tom Perry, Building Commissioner X-PRESS.PE IT 200.Main Street, Hyannis,MA 02601 J U N 11 2004 Office: 508-862-4038 Fax: 508-790-6230EXPRESS PERMIT APPLICATION - RESIDENTITR"Lf BARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number A Property Address ���2.¢� �ICOGZ�- O Residential Value of Work 2,QO�o�d uk Owner's Name&Address Contractor's Name Telephone Number , U�—��.� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance *� Check one: ❑ I am a sole proprietor [il I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows.,U-Value + _(maximum.•44) *Where required: issuance of this pprmit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature Q:Forms:expmtrg Revise053003 ' 'DOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �-�a, -- ll Permit# Health Division 53115 �1 bQ Date Issued rL Conservation Divisions Application Fee Tax Collector. Permit Fee Treasurer , APPLICANT MUST OBTAIN A SEWER Planning Dept. CONNECnON PERMIT FROM THE ENGINEERING DMSION PRIOR TO Date Definitive Plan Approved by Planning Board CONSTRUCTION. Historic-OKH Preservation/Hyannis Project Street Address Village kmVV15 Owner �{fFC(_ /4- � - 64koe Address P-(L`!— Tele hone Permit Request z G Square feet: 1 st floor: existing f2-56 proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type , Lot Size o ���� � Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family Cl Multi-Family(#units) Age of Existing Structure /ffoo - If Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes Cl No Basement Type: Full ❑Crawl ❑Walkout ❑Other . Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) I2J�d _ Number of Baths: Full:existing new Half: existing f new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: AGas ❑Oil ❑ Electric ❑Other Central Air: *Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ?I No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing 0 new size Attached garage:[existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded 0 Commercial 0 Yes XNo If yes, site plan review# --.Current Use T Sf ?►,� Proposed Use- BUILDER INFORMATION Name -z 4• Zy Telephone Number ! --'bR 779 -0�'!3 Address License# Home Improvement Contractor# Worker's Compensation -- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO / 42 SIGNATURE DATEZai(a,,2,--2,ocA- FOR OFFICIAL USE ONLY rl PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS t VILLAGE i OWNER ' DATE OF INSPECTION: FOUNDATION - FRAME - INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL• FINAL BUILDING F„ ` �t DATE CLOSED OUT �` = ASSOCIATION PLAN NO. . - ��� M . • it ._ • ' .'fit,. .. ...,• .. • . The-Com�;n�ea1th of.?Massachusetts ; ` atAccidents' Department of IndUSH r r ;- •4R16J�/lrJl�7r�si�B�tY9�s' - •. 6Q0'Wastiington street _ Boston;Mass• . 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'•1�. r 1 r '�. •.: I 'r r.•.. 4. +•tt •�';t6:•^. ::1':;•1+1�•L\,,,.f ,•.t��;:isT .i,• • 1•:r..,4!'., •'' t: •'� .ar• •' "t. 5,�•• .•� A}1•'�'i'�".' '!•. �Yi+�,l:t+l. .ti,. i'r{it t:•a.•;t: y 1_ I.i t 4 ,.i CI 4• ,r-,�? DUCA , :,•'•y:r^':�i/;;;;, ; .s; ,f. }: •t+. i, ,5:.4 •L•1 v.'.i41;m 17rtiM. •+'i�..w5f,..:.t +'i e••" �''-f�•.. '��.,..4 �•.t'•7' 't,' t•::it::;r�•r, �':�::�t�.,)J t:t,' Rome in'siiraried�b+'{"`•'Failure to secure coveragNONAe as required under Section 25A of MGL 152can lead f Grim fnal penalties of a Tine up to 51,500,00 an or i ant as Well as ciyilpenalties#n the form of a STOP WORK o"BR and a fine of$100.00 e'day against me. X understand that} one years imprisonm . copy oT sty{ement maybe forwarded to the Office of Xnvestigations of the DTAfor coverage Verification. I do hereby eerti nder the ains and penalties b er u that the inform above is free and code SiPatura ' Al6LO VA hone# r print name - y official We only de not write in this area to be completed by city or town afficw • permit/iicense# _ [3Bu1ldin9Department • _ []Licensing Board city or town: ❑selectmen's Office [}'theekif immediate respowe is required ❑Reahb Department other. phone#; contact person: (teviud Sept 2003) • Inf0rMat1011 and Instructions' ` ett$Gefleral Laws, pier 152 section 25=quires all employers top workers' compensAtion for'thear. Ivlassachiis, oted'fromthe °1W7 an employee is.defined as every person m the service o another under any contract employees: ,As qu . of hir.e'express or imptie oral or written. ' artners association, corporation or Other legal entity, or any two or more of An employer is defined as an in"dual,p hip, the foregoing engaged-in ajoint enterprise'and including the legal representatives of a deceased,employer, or the-receiver or trustee of an individual,par6aershipx association or other legal entity, employing tmployees. 'Howevei-the owner of a dwelling house jaymg'not'inore than three apartments•and-who resides therein, or the:occupa&bf th6Ad yelling house bf another who emplbyspersbs to do maintenance, construction or repair work on such$welling liou�e.ctr on the grounds or taufiding app errant thereto shan not 1i'ecause of such_employment be deemed to be ari employer,,.. ' • r ' - lyiGL chapter 152 section 25 also"slates fhat'every state or local Rcensing•agency shall withhold the issuaneb dr renewaI Of a license Or permit to operate a business or to construct buildings in the.con=onwealth for any applicant who has not produced aceeptable*evidence•of c6implian6e with the insurance coverage reilufi°ed.' Ailclitionally;neither'the' co,.nmonwbalthnor.any.of it's political subdivisions shall enter into any contract for the performance of public work uni: acceptable evidence of compliWe with t�e insurance requirements of this chapter have been presented:to the contracting authority: Applicants please iu thcW°rkers"eompensafm a€fxdavit cornpletely,by checking the box that applies to your situation..Please supply y n " hze� address and phone numbers along with a certificate of insurance as all affidavits may be submitted compan to the companent'of industrial A6"dents-for confizrna.tion of insurance coverage. Also'be sure to sign and•date the affidavit. The affidavit should-be-returmdto the city or town that the application for the permit or license is being re"ardifi'`the'"W'or if you are have an estions y o f) jttmeit 6f Industrial kccideuts, Should youv y qu g $ . requested, not th eP ' t at the nhrnber listed below• S the az•tmen edto obtain a workers. •compensationpplicy,please callDep , requir �. . .. . . . City or Towns . Please be sure that the affidavit is cbmplete andpriated legibly. The Department has provi4ed a space at the bottom of the affiilayit for you to fill out in-the event the Office of Investigations has to contact you regarding the applicant. Please be-sur e to fill- in the pernut/licensa number which wM be used as a reference number. Tile.affidayits maybe returnedtq, • • mail�Tx�,X•unlessothe'r'arrange?nentshavebeenmade, the • .: . D' artnaen. .tb y. ons woi ld hike to thank y'ou in advance for you cooperation and should you have any 4uestions, The Office of Investigati please do nothesitate to give •• ' ' ' The Dep mends address,telephone and fax number. . , The Commonwealth Of Massachusetts Deparhnent.of Industrial Accidents . , Bye of taussti�ena _ 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 , - r - it • E► Town. of Barnstable . Hof cky Regulatory 5ervides Thomas F.Geiler,Director � 1659. Building Division pIFD MA'S k . Tom ferry,Building Commissioner 200 Main Street, Hyannis,MA 02601 , Fax: 508-790-6230 pf{ce: 508-862-4038 Permit no. Date A"MAVIT 1T0ME IMTP OVEMENT CONTRACTOR LAW . SUPPLEMENT TO PERMIT APPLICATION MGL c.142A requires that the"reconstruction,alterations,renovation,repair,modernization,cu ied ion, demolition,or construction of an addition to any pre-existing owr� P • •improvement;removal,demo n, t to biding containing at Least one but not more than four dwelling units or to structures which are adjacent ctors,with certain exceptions,along with other such residence or building be,done by registered contra requirements, Estimated Cost Type of Work f of Work 1j 'w�'Qj�e- _ 4 Address . dxle owner's Name' f� �- Date of APp I hereby certify that: F egistration is not required for the following real on(s): []Work excluded by law []lob Under$1,000 []Building not owner-occupied downer pulling own permit Notice is hereby given that: OARS PULLING THEIR OWN PERMIT RyUROYEMENT W11 SNTER gAV CONTp,kCTORS FOR APPLICABLE HOME ACCESS TO THE ARBITp kTION PRO GRAM OR GUARANTY YUND UNDER MGL c.142A. SIGNED UNDERPENALTIES OF PERJURY Thereby apply for apermit as the agept of the owner: Contractor Name Registrationl�io. Date OR r- e Owner's Name oFsNE,� Town of Barnstable Regulatory Services swvsTns�, : Thomas F.Geiler,Director E ,,•� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - Fax:.508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: �-20 ed . 70B.LOCATION: �S J .(��� �1ylY� ��Ilva-z-rw�, O 266 number street j village "HOMEOWNER": &7646 �ZI A. �� '77d` 15 .. -:77�19z00 name - home phone# work phone# ` CURRENT MAILING ADDRESS; - _._. . ... . /17 7&0/ _. 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. DEFINITION OE 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 inspe o procedures and requirements and that he/she will comply with said procedures and = requirements. n - �dU- _. ... . Signature of Approval of Building Official -Mote:.-Three-family dwellings containing 35,000 cubic feet or larger will be required to coinply-with the State Building Code Section 127:0.Construction Control . - HOMEOWNER'S EXEMPTION - - The Code states-that;_"Any homeowner performing work for which a-buildingperridt is required shall be-exemp.-frornthe provisions-.. .;of.ttris section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(sJ 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 -weral towns. You may care t amend and adopt such a form/certification for use in your community. I I e ` D L42 op r Wo r_ T Vic« 640 i i l i i I I i ^� • ��� C 4 tea, � + �.d �� ..^/1 �,.- i �� The Town of Barnstable Department of Health, Safety and Environmental Services = _ Building Division 1619•��� 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Cross Fax: 508-790-6230 Building Commissio: Home Occupation Registration Date: CD 25 C� Name: A)(�l-o 7-z,4) Address: /�j S-�Oon/26:,'- ONOC--R. village: X&A�'24 Type of Business: ���y'`121Fcw-r;0.4 7)AT2/6utai 76 Map/Lot: 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: • 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. • 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. • 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. • 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 from yard. • There is no exterior storage or display of materials or equipment • There is 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. • 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,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: Asse'ssor's map and lot number ...a�. o�:...... .............. . . 7HE M 7 w:` l L S ,� Vub'u��tLT TO TOWN SEWER Quo F Sewage Permit. number .............................................. . ... .. d� y� o�c K r - Z 33,HB9T11DLE, i House number .......................... , MAB& . of p 1639• \e0 e } am 'ia• TOWN OF BARNSTABLE BUILDING INSPECTOR 'APPLICATION FOR PERMIT TO ...Qn..tlzuq.;... ...dwPlling................................ TYPE OF CONSTRUCTION .........,wood frame ................:....:.......................................................................................... a :...March................1.......... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......Lot....#1.24..........................SUAX:q...Ri.g.geX...Lane............................Ry.aurlia'.-MA....................... ProposedUse ............................................................................................................................................................................. Zoning District ..... f...............................Fire District ......Hyanni ........................ ......... ........................................ Name of Owner .Capra.,q,QX;11,,,Re,lty....ME.S.t..........Address .265...F.almai th..Rczad.....Hyanais.,...MA.. Name of Builder ..Franco...R...E.......Dev.Co j .U..Fa1 Ac.......Address . nQuth„Fgad�... �7aXlA7..S.....MA... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms Elcht Foundation ......P P.C. ............. ....................................... ................................................................ Exierior .,Clapboard and/or shinale.s........ ......Roofing ....as.phalt shingles,,,,,,........................... Floors carpet ..........................................••..Interior sheetrock ........................................ .................................................................................... W rieating .............GAs—F..........A...........................................................Plumbing .....`r.WQ-.QORPe. .........................................:.......... , Fireplace ........Yes..................................................................Approximate. Cost .......$.SO.,..QQ.R...Q.Q.... .......j .........,f/ Definitive Plan Approved by Planning Board -----------_-_—_-------------- Area .:.� Cl .f..t........... Diagram of Lot and Building with Dimensions Fee J Q.. .. � . ...... ... ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of t ryof Barnstable regarding the above construction. Na ......... ............... • f Construction Supervisor's License ...Q.0QM.9,,,,__„•......... r _ I CAPRICORN REALTY TRUST I Na ...32005. 11 Story ............. Permit for ......K............................ Single Family Dwelling .............................................................................. Locatton . Lot...#..1..2..4...,........1..5......S..c Rigger Lane ............... i s................................................. Owner ..Capricorn Realty Trust ............................. ....................... Type of Construction .......Frame ................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ....J:une....1.6..................19 88 Date of Inspection ....................................19 Date Completed ...C-5........) :7.. .:.....19 ag el Assessor's map and lot number ..caC..l. ...'" ®. ....... ; C%TH E t0 Sewage Permit number .....�............. ............................... e� ~� Z BABb4TABLE, i House number .1-�.��. 9 "^°a ........................... ....................................... �p t6}q• 9,0�0 MPY TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO f4M.Uy„awol;,lina TYPE OF CONSTRUCTION ..,.,,,,,,wood frame .......Marhh................1.......... 198.�... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......Lat„#124..........................Sq :.r ggox...L4x1e............................Hy..ax1ai's.*0...MA........................ ProposedUse ............................................................................................................................................................................. Zoning District ............ R, +...... . ............Fire District .......HyaX1T.li.x..................................................... Name of Owner .CaprlCOrn...Roalty...,1^,Rti t..........Address ...7..6.5...FaIM01..th..R.Oad,...�'�tc��??1._i.�. MA..F... "Name of Builder ..Franco...R.E....Dev.CO.jnc......Address 765 . 'almouth Road�,,,Fy4K!!A ,Q,.. !�A,,, Nameof Architect ..................................................................Address ......................................................., Number of Rooms ..........Eight..........................................Foundation ..............................................C. -: .............. ..........::. Exterior ,:Clapboard and/or shingles Roofing .,..,asphalt shingles ............ ............... Floors ......Carpet................................................................Interior ....sheetrOCk........................................................ % g GAs—F.W.A. Plumbing .....Two-CoDoe.r.................Heating ................................................................... , Fireplace ........Yes .........................Approximate. Cost ....... ........................... -° Definitive Plan Approved by Planning Board -------------------_-----------19________ . Area ...I198 sq, ft. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH a .R OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of t wr�.of Barnstable regarding the above construction. Nam ....... !' — ............/. Construction Supervisor's License ..9.00.989................... CAPRICORN REALTY TRUST A=272-200 No ...32005 Permit for ...1 ...Story............ S.ingle..Family..,Dwel1 ing........ ... Location ...Lot #12 4.,..... 15 Square Rigger Lane ............. Hyannis................ Owner .Capricorn RealtX Trust Type of Construction .Frame ................................. ................................................................................ Plot ............................ Lot ................................ Permit Granted ..... June...l 6..............19 88 Date of Inspection ....................................19 Date Completed ......................................19 70 //j l0 �4 cf rwr ro TOWN OF BARNSTABLE 32005 Permit No. . BUILDING DEPARTMENT } "`:w I TOWN OFFICE BUILDING Cash r i6jq �� 9�ronr HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Capricorn Realty Trast Address Lot #12 4, 15 Square Rigger Lane Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. February2$ 8.9 ........................................... Build,, g Inspector ��..� °•yew TOWN OF BARNSTABLE BUILDING DEPARTMENT _ DARISTAU �ra r TOWN OFFICE BUILDING � g 1659' HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit $k. ...... �r ...5^._ �. . ........................ ....................._.........._........................... ........................... issued to ................... -------- l.L �...... f� C: /Llt'......../../L. f/L ... ... .... 4 1 Please release the perfor�amance bond. R THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m DATA b U I L 1pU PERMIT TOWN OF BARNSTABLE, MASSACHUSETTS l. N� j .19 PERMIT NO ', DATE e6 C2 11 Aae. ADDRESS 13 APPLICANT L o.co i�. E. �!V. C :5 2a-mmo u rli n, (N 0.) ISTR E ET) (CONTR'S LICENSE) PERMIT TO F STORY DWENUMBERLLINGO UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) NG AT (LOCATION) u, 4 DIZONISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT-BLOCK SIZE BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR PERMIT ic-b clo VOLUME ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) c. ;rn cv u G OWNER A D'OlAl;iL ku�4 BUILDING DEPT. ADDRESS e -j I By THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR > PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES As WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE, OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT C-F T-3 OTHER BOARD OF HEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIOLIUS STAGES OF i WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHO.NE OR WRITTEN CONSTRUCTION. lI PERWT ;S I'SSUED AS NOTED ABODE. NOTIFICATION. - DATE 19 PERMIT NO. - �1ipr APPLICANT ADDRESS (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO STORY- - NUMBER OF (_)(TYPE OF IMPROVEMENT) NO. DWELLING UNITS 'I'(PROPOSED USE) 1; AT (LOCATION) ZONING DISTRICT - (N0.) (STREETI BETWEEN AND (CROSS STREET) (CROSS STREET) " SUBDIVISION LOT - LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM-IN CONSTRUCTI ^ TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPEI' REMARKS: ., AREA OR VOLUME -._ ESTIMATED COST PERMIT FEE (CUBIC/SQUARE FEET) OWNER ADDRESS - BUILDING DEFT. BY _ 4 THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY popPERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A . PROVED BY. THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINE FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIOI OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL. INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR PLUBING 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.D 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECT N PE TI TO LATH)BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. BOOST THIS CARD SO IT Is VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 = -- /,f✓�s'� z � . � -Z' S HEATING INSPEC PION APPROVALS ENGINEERING DEPARTMENT OTHER n�t� -- __-- -_ --'------ — ;Lv_"lA(py, 9 BOA DOFHEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'v!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRIT' CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. / NOTIFICATION. DATF CONTINUATION OF ROAD BOND BUILDING PERMIT ;; U'- The undersigned owner/contractor hereby agree to maintain their road bond in force until the following work items are completed to the satisfaction of the Engineering Section of the Department of Public Works. loam and seedshoulders as soon as weather permits. other (explain) LOCATIO,� .� U�� t'�!? �. ;� ( �� i� L�n.✓!`L l��I��' ( �� n SIG-NE Q,gner/Con tr for ENGIt; ikl NG AUTHORIZATION 3 etwr R8 4Z5 N Z9 •' S yND LOT - Lot` i z 3' 1b93 � s.F �`�'•°� � 00 O.1$: AC-- K 8 (N o C.er . V c . 7 A/ U LA r Pga'P. ^� V R, eo ia.o3 v QQ� LN 41 V C7 ` � Q .44 of { it f� P a Az5 N.7-9 � o �S • 9 !, •99 � 23 y LOT )?-+ � �b93 � s.F M�•�o 0-lb 0-lbi AC. x o° (1Q 6 er Ql t 0 . - I v U In PROV %4 tM y (U� • � aQ ol 1 i o _ (sc P C k ) h i ea e ! OF S 'FRANK WHITING NO. 20 Go �_ £crst�R�°� q TOWN OF BARNSTABLE ZONING BY-LAWS DATED SEPT 14 1987 LONE. R C- I i -ems- it g SETBACKS ; Copeo SPflCE� FRONT - 20' SIDE = 7.5' REAR - 7.5' PROPERTY LINES SHOWN HEREON WERE COMPILED FROM PLANS OF RECORD AND DO NOT REPRESENT i PROJECT NO. 3.3035.20 AN ACTUAL SURVEY ON THE GROUND. THE STRUCTURE DEPICTED ON THIS PLAN WAS LOCATED PLOT PLAN I ON THE GROUND BY SURVEY ON JUNE 13 1988 in AND EXISTS AS SHOWN AS OF THE DATE OF LOCATION. BARNSTABLE MASS THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND SCALE: i" - 20' JUNE 14 1988 SHOULD NOT BE USED FOR ANY OTHER PURPOSE. --- ---- ---- �_ THE BSC GROUP-CAPE COD INC (BARNSTABLE) 3236 MAIN STREET �PROFESSIONAL LAND .SURVEYOR BARNSTABLE VILLAGE, � MA. 02630 (60) 362-8133 s t5v- V i Gam•ti�w-sa r 9 ram.. 1�• (�vt' vwl w,�►1ly E �L••�..s `- G��4 w� y i t"hNl7�.�h O J� IIN�i R.C'Ce►N'�!►TK ue.`R�:is l N ot,,L`F a Aae,6*S alb Tr'�, tN•w.q I�.uea+w�w ri lb�1�L1�V►J`. 'a.�►d ��rL. •'ri��a►�R.�o