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HomeMy WebLinkAbout0027 WAGON LANE of Application number...4—zE 439 JDate Issued...........V/3 rr ................................... BARN 8 MASS. Building Inspectors Initials... . .............................. RFD MP'�A u Map/Parcel.............2-.7 o......./�O TOW? OW BARNST"ABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: ?-_7_ L4la4 nil Z,2/1 e, 4A t NUMBER STREET VILLAGE Owner's Name: iC 0/.f 5 qel?e Phone Number 7 7V 3a — D V 0 7 Email Address:���ola S Yann: i��fc�u�.Co r►-� Cell Phone Number Project cost$ 3, 1-5 — Check one Residential Commercial r q�T��� AUTHORIZATION THORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: See a,-ffa c_k4 an,-6, Date: TYPE OF WORK ❑ Siding EZWindows (no header change)#_❑ Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to , !A CONTRACTOR'S INFORMATION Contractor's name A ��/ Pe� o� e l ✓S Home Improvement Contractors Registration(if applicable)# //Z 7 8- (attach copy) Construction Supervisor's License# If .0:7 DO 7-7 (attach copy) Email of Contractor Aswc-e-�q ri s-e tea,'1.(oM Phone number -4/6/- 7IV 6 3' 9 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. f APPLICATION ' NUMBER............................... ``For Tents Only* Date Tent(s) will be erected Removed on Does the tent have sides?Yes number of tents total No - (If yes please attach floor plan with exits marked) Dimensions of each Tent Additional tent dimensions can be attached on a separate piece of paper.. Check one:this event is a:for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent If food is being served at your eventplease obtain a Health Department approval befveen the la®v_rs ®f 8r04am-9e30 as or 3e30 pm-4o30pr. Commercial events may require Fire Department appvova l. YW®®JU1/C®AL/JCJL't)l../L�L'r JL STOVES ®�JLI:J Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back__left side a n�ht side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the wales and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific iaispectioans sand documentation required by'ig0 CMR and the Town of Barnstable. Signature Date A PP LI[Cl'11N u 9 S SIGNATURE Signature Date All permit applicati are subject to a building official's approval prior to issuance. Home Improvement Agreement: Page 1 _ Home Depot License Number(s)• Visit www.homedepot.com/c/SV_HS_Contractor_License_Numbers for latest license info MA: 107774, 112785 Salesperson Name: anice Campbell Registration No. (if applicable): Home Depot U.S.A., Inc. ("Home Depot") or service provider named below ("Service Provider") will furnish, install or service the equipment listed below at the price, terms and conditions as outlined on this form. Reney Nicolas New England South 1-6EH04M7 Customer Last Name Customer First Name Store #/ Branch Name Lead/Customer Order# 27 Wagon Lane Hyannis MA 02601 Customer Address City State Zip (774) 327-04 1 nicholas@hyannisportclub.com Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT HOME DEPOT USA INC., 2455 PACES FERRY ROAD, BLDG. B-3, ATLANTA, GEORGIA 30339 or EMAIL he Home Depot @ customercancellationnortheast@homedepot.com BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT.CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENTS WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOU GHT TO CANCEL. Acknowledged by: F 08/20 2018 Customer's Ignature Date Contract Price and Payment Schedule : Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: 3825.00 Includes all applicable taxes. Excludes finance charges.* Sales Tax: 10.00 - (If applicable) *Maximum deposit ONLY applicable in MD, MA, ME(33%), NJ, Wl(99%) Dep. 25.0 % Deposit Amount 956.25 Remaining Contract Balance 2868.75 The Home Depot-2455 Paces Ferry Road,.N.W. Bldg. B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 Customer Agreement(C,E,I)(31 Jan.18) v 50.1.2 I -��� `�7"�gsra A' - ..F (+3'�� ✓ Al The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' a I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly L UARM Name(Business/Organization/Individual): -Me Address: f Jr f47 a l City/State/Zip: A 01-7 I Phone#: 77,el- 746 - a�aS Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. El New construction 2. 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.❑ 1 am a homeowner doing'all work officers have exercised their I LE]Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 11M Other 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. tContractors 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 ntunber. I am an employer tit at is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby cer 'y unde the paint/rzd penalties of perjury that the information provided above is true and correct. Si n ture: ! e: Phone# Official use only.Do not write in this area,to be completed by city or town official. City or Town: Permit/License if Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: The Commonwealth of Massachusetts Department of IndustrialAecidents Office of Investigations l 1 Congress Street,Suite 100 Boston,,IL4 02114-2017 www mass.gov/dia Workers'Compensation Insurance affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ` Please Print Le 'blv Name (Business/C1*ga untiooiTndividual): Ho Pi J/�� D _ Address: * f 90-$ b&N Citv'State/Zip: . o,,s yr Phone#: 7 / -/ �s Are you an employer?Check the kopropriate box: Tvpe of project(required): ]. I am a empioyer with_ 'r L 1 am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction (_; I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have i g, ,Demolition working for me in any caps emoiovees and have workers' C '• 9. `,j Binding addition [_tio workers' :omp. insurance comp.ircnrance.= required.] 5. ❑ We are a corporation and its I0.❑Electrical repairs or additions ;.[ I am a homeowner doing all work officers have exercised their 11_7 Plumbing repairs or addi:ions myself. 1Io workers' comp- right of exemption per 1�SGL 12.❑Roof repass insurance required.]t C. 152,§1(a),and we have no ,i ,O /I employeez. [No workers' i 13•lv� Other �1 0 comp.insurance required] -Ar% applicant iha:checks box i'_must also fill out the section below showing the: workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing a0 work and them hire outside codnactnrs must submit anew affidavii indicating such_ :Cont,actors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have =pioyea. 1 the sub-contractors have employees,they most provide their workers'comp.policy mmnber. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job sire information_ jnsurance Company Name: Pohcv#or Self-ins.Lic.#: W (ti 7 7 o % Expiration Date: 3 " Job Site Address- .27 Za/i e— CityJSiateiZip: /1/1 i'S� 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 M2 GL c. 152 can lead to the imposition of criminal penalties of a fine on to$1,500.00 and/or one-yeg imprisonment,as well as civil penalties in the farm of a STOP WORK ORDER and a fine of up to$250.00 a day ag st 4elator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DLS re coverage verification. I do hereby certify un a at the information provided above is true and correct Si attne: Date: - Z — Phone 4: Official use only. Do not write in this area,to be completed by city•or town off;ciaL Croy or Town: Permit'L,icense n Issuing Authority(circle one): L Board of Health 2.Building Department 3.CityPTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Supplement Card HOME DEPOT USA INC Registration: 112785 2455 PACES FERRY RE)C-11 HSC Expiration: 04/2212019 ATLANTA,GA 30339 Update Address and return card. Mark reason for change. El Address ❑ ReneWa! 0 Employment C Lost Card - - Office of Consumer Affairs&Business Regulation ---— HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:SuDolement Card before the expiration date. If found return to: - Registration Expiration Office of Consumer Affairs and Business Regulation i 12755 04/22/2019 10 Park Plaza-Suite 5170 HOME DEPOT USA INC Boston,MA 02,15 ANDREW SWEET ` a-- 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 3033Q Undersecretary d ithou signature n l 1 DATE(MWDDIYYYY) /�C>R CERTIFICATE OF LIABILITY INSURANCE 0212=8 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. T141S 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,subject to the terns 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 endomemerd(s). CONTACT PRODUCER NAME: MARSH USA,INC. PHONE FAX TWO ALLIANCE CENTER ac No 3560 LENOX ROAD.SUITE 2400 E-MAIL ATLANTA.GA 30326 ADDRESS INSURER(S)AFFORDING COVERAGE NAILA CNI0i642069-HaneD-GAW-1&19 INSURER A:Old Republic lnstmliceCo 24147 INSURED THE HOME DEPOT,INC. INSURER 8:New Hampshire Ins Co 23841 HOME DEPOT U.S.A.,INC. INSURER C:HomeRisk Captye Insurance Company 2455 PACES FERRY ROAD INSURER D: BUILDING C-20 ATLANTA.GA 30339 INSURER E: INSURER F- COVERAGES CERTIFICATE NUMBER: ATL-DD4353439•i6 REVISION NUMBER: 3 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POUCY Eff POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER fMMfDOryyYY1 (MwDDTYyYY1 A X I COMMERCIAL GENERAL LIABILITY MWZY 312717 D31012018 J03101/2019 EACH OCCURRENCE Is 9.00D,DOD A E ED t.OD00D0 CLAIMS-MADE 7 OCCUR PREMISES Eaocwnence S LIMITS OF POLICY XS I MED EXP(Any one person) ;S EXCLUDED OF SIR:S11V.PER OCC PERSONAL 8 ADV INJURY S °000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 9.00G.000 X POLICY PRO LOC PRODUCTS-COMPIOP AGG S 9,000.000 JECT S OTHER: A 'AUTOM0131LE LIABILITY MWTB312718 031012D18 03/012019 (Ea accident SINGLE LIMIT 5 1.000,001) X ANY AUTO BODILY INJURY(Per person) s OWNED SCHEDULED i SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PR DAMAGE S AUTOS ONLY AUTOS ONLY i Perr accid ccdent S I UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR �'c DE AGGREGATE S TIED RETENTIONS S B =,=RS COMPENSATION WC 014122577 (AN,NH,NJ,VT) 0310112018 03+012019 X PER OTH- STATUTE ER B AND EMPLOYERS'LIABILITY Y 1 N WC 014122578(WI) 031012018 03/D12D19 5,000,GM AWMROPRIETOR/PARTNER/EXECUTNE D NIA E.L.EACH ACCIDENT S OFFICERIMEMB£REXCLUDED7 5.000.000 (Mandatory in NH) EL.DISEASE-EA EMPLOY S D yes,describe under Continued on Ad�tional Page EL.DISEASE-POLICY LIMIT S 5,0D0.000 DESCRIPTION OF OPERATIONS below C Excess Aulo 297-1-10011-0D-2018 031012018 031012019 1-11fo1: 4.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1D1,Additional Remarks Schedule,may be abaehed if more Space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLCIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA.GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Multherjee Llti.�a aa'" ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ' AGENCY CUSTOMER ID: CN101642069 LOC#: Atlanta .alc R®' ® ADDITIONAL REMARKS S AGENCY _ SCHEDULE Page 2 of 3 MARSH USA.INC. NAMED INSURED THE HOME DEPOT,INC noucY NUMBER HOME DEPOT U.S.A.,INC. 2455 PACES FERRY ROAD CARRIER BUILDING G20 I NAIC CODE ATLANI-A.GA 303399 ADDITIONAL REMARKS EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER 25 FORM TITLE: Certificate of LiabilityInsurance Workers Compensation Continued: Carrier Indemnity Insurance Company of North America Pdicy Number WLR C647631$i(AL,AR,FL,Ip IA KS,KY,LA,MS MO.NE.Nf:;,ND,OK.SC,SD.TN,WV!NY) Effective Date:031011201a Expiration Date:0310ii2019 (EL)Limit:S 1.00D,000 Carrier iNm,Hampshire Insurance Company - - Policy Number.WC 014122576(DC,DE.HLIN.MD.MN.MT,NY,RI) Effective Date:0310112018 Expiration Dale:031012D19 (EL)Limn:S1,000.000 Carrier ACE American Insurance Company Prltcy Number.WCU C64783221 fQSI)(Q.CA,IL,NC.OR,VA,WA) Effective Date:03/Di/2018 Expiration Date:03/0112019 (EL)Limit:S1,00D,000 SIR S1,000,000 SIR for the states of AZ.CA,IL,NC,OR VA,WA Carrier.National Union Fire Insurance Company - Policy Number.XWC 4595580(OSI)fCO,CT.GA,ME,MI,NV,OH,PA.UT) Effective Date 03/D1/2D78 Expiration Date:0310112019 (EL)Limit:S1.050,000 S1,D00,000 SIR for the states of COME NV,fdl,OH,f A,UT S750,000 SIR for the state of GA S350,000 SIR for the state of CT Cartier.National Union Fire Insurance Company Policy Number.XWC 4595581(QSI)(MA) Effective Date:D31012018 &I iralion Date:03/012019 (EL)Limit:S1,000,000 SIR:S500,000 TX Empoyers XS Indemnity. Camiaralinios Union Insurance Compam; Policy Number.TNS C4916693A(TX) Effective Date:03101f1015 Expiration Date:03/012019 (EL)Lirnit SIQ0D0.000 SIR..S i,000;000 rCORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD 2008 ACORD gCORDCORD CORPORATION. All rights reserved. •„•'�� TOWN OF BARNSTABLE Permit No. -----_-------__ -----_._. •ten Building Inspector cash • .era OCCUPANCY PERMIT Bond ---------___.___� Issued to LliL Address Wiring Inspector Inspection date Plumbing Inspector %� �� n Inspection date Gas Inspector Inspection date Engineering Department �� Inspection date Board of Health ),' Inspection date THIS PERMIT A'ILL 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. 'F' ✓ �s _� .j✓ fir' ! .,. Building Inspector 5►NGt_c-. FAM►�Y � �- gEDR�oM r' No GARBAGE v!a►�.�( F+-0 W z 11 O x 3 = 3 3 v G.P c) SEPTIG TP►JK = 330x15o'/• = -49/F6.P. Q. U5E• l000 GAtr. 223 i Ot5Po5At- P►'T- vSE IvoO COAL. 5%DCLWALL A2-SA. = ►50 5'.ri BOTTOM AREA= ., 1O 5o S.F.• x 1• a = •�•o G.P o� � t ,` �a �•- .. ( . -TOT A 1.. t7 E 51 GN = .4 2 5 G.P�• \` Q. Q 0 _ ,�, ,o I -TOTA%- DA►L`( FL-C>W = S.7' PEZcot_AT►oN RATE s I"IN 2MIN OR:L:55• ?N , ij OF :; tit Ur m •3 1 MC HARD Y� AWN G� 99.3 . 11, $39 9 SAXTER H 10NcS Isju.2I.o48Q 2/4 su TESTA/G�yG• yq, S N, To FNp='oo.o , �� 1ao� INQv. ,;. , •�. SUt�Sa/L p15T. �Fp71G %T Z ' If�PO INY• 6v� 97.5 •rANFG •.�\ ,NV. INS. WITW I 1��3/9•I�i. •� WASNGD ' c� CE2TIFlGp P�-o'T' P�AIJ •'� s PRUFIL� �o � ol ► O SGP.I.E ScA�E/'_yo.', VATS .2�✓ 7• /3 �3 ![' R E F Sze c.l= �. CER'r►FYOMPI.. Tµ TN�OHE•D�1DE� h•�i��N N Ect Eo tit G Y 5 YJ ,C vim-- �• AND SETe.GK R.6C?UIR.EMEN'1':�- oF ^fNE- 'TO W N O P �i�r tSTA3E.�- A N U 1 S tlI4T LOGAT A 'WITN 'T .E G: .-Ooo P AIN IT 11 cA 13- 3 BP•x-rE2e t�YE INC• ' `�- • REG 1 S'T faSZ.6.U'LAIJ o 5 u Q.Y EY�e•s I ,I aN 1 WOrT 4> d AN OSTE2.VIl-L� • N�ASS• �Tu►S P�. 5 IN5-TI?uM6NT 5u2Vey 4-rHE 0Fr5E75 6uou►.'D ►.lo-t D E U S E O Th D ET E R/,\I N G L.o'r L I►-I E."j Q P P L.-I C P.N T BrP�Q A%L` 9ssoc;/irG'` Assessor's map and lot number ....... ........... • � , . �ypF?HE 1p Sewage Permit number �3 �� ...!..1 'ZI�1�• �S+y� �+� Q�{+j „ � f r,�' ��°► g ................... tY,•Cy' L�1ifi! ik. 'i.��I • •".. r itii�T��L�1L I COMPUA 98H4TODLE, t House number ................. .r�......................................... i TO 1: 9� „6 9 WITH A AV TOWN OF . BARV_6qt. ABLE BUILDING, INSPECTOR c A .......: : ..,APPLICATION F8R'PERMIT TO ........ .. . ...... ........... ....... .. ....... ......... TYPE OF CONSTRUCTION .......... an"o....... ............... ............................................................. .......... ...... .�z..............19. . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according .to the following information:- .. Location ..,.. ....••(T .. . < ',; v Proposed Use ... �.. . . 4: . ........��'. .... �j .... ` 4 Zoning District .� Fire District ..... ..�f"�!'- .... ...... 'Name of Owner ,:, .. .. .... . ..... !.., ........Address ...... � =lJ- ..` .. Name of Builder v ... . ..I�.:.-...Address ..:......... ` ........ Name of Architect /." .Addr'ess: .. . ......... .. ...... Number of. Roo ' S' ::........ ... :...Founda`tia'n .......lo.��Cu ro. „�%e T JZ .. - ` ...........................................` . Exterior ..........t�-�.©.p..l�l... ,?. 1.!V. � e-. �.:Rogfing . :�:� ......................................................Ll .... .'g.d ./ - ........... ........... ........... Interior ...;...... .................... . Floors .... ....... ,per ... Heating ........cf,�.e. '.Y... ......................................P.lumbing �....�..... .................................... Fireplace ..................... ......?........................................Approximate. Cost ....... . Z.. ..&`'�/....................... . Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ....... ........ Did 'ra'm of Lot-and. Building .with...Dimensions ' •, g g . Fee. ........ ............................. . SUBJECT-- TO APPROVAL OF BOARD OF HEALTH )Aw 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. RAName ... :... .... .i.. Construction Supervisor's License ��Q BRADGATE BUILDERS, INC. + 25328 ' One Story No ...:::.......... Permit for .............. Location Lot 23B� 27 Wagon Lane„ ...............H�'.annis................................ , t Owner Builders,i•.•Inc•••..• Type of Construction Frame.............................. . .... ................... ... .............. ............................................... Plot ......�...... ............ Lot................................. Permit1Granted ...July...l.9.'.. . lt9 83 Date of i Inspection ............................. ....19 Da e.Comple ed l.Z ' `." J 9 ti - � ram• TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel AO Application Q4 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address „9,Z, % �.�f0 ,G,V Village e��,�/ S Owner ��� - Address -5A- Telephone ti v 77,�/4 I Permit Request / ����i�' Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain -Groundwater Overlay Project Valuation „Td, P 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 Historic House: ❑Yes >,�Jo On Old King's Highway: ❑Yes XNo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new 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# OW-h ,o[ Current Use Proposed Use r' f APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C af ��a f.41 flJ J.4b Telephone Number 7 )Z h4- Address /� /�G�9�2�d 4,P Cla� .License # ��®,� lff Home Improvement Contractor# /C5'736--�� 7 Worker's Compensation i9 d._162 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I SIGNATURE DATE I _ I q' FOR OFFICIAL USE ONLY • _-' A APPLICATION# DATE ISSUED E'- MAP/PARCEL NO. s ADDRESS VILLAGE F OWNER ii S DATE OF INSPECTION: ", ,RFQUNDATI0:N�s...tiz�r;L•�:��:.���u+ FRAME -- ''" ,INSULATION .._. ;;. FIREPLACE z ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING - DATE CLOSED OUT ASSOCIATION PLAN NO. r OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at 7 c�C9- v� �•CR � � O (Prope ddress) (Property Address) herebyauthorize cowe-Gj. 0 `Q I aAj , (Su bcontra t r) an authorized subcontractor for RISE Engineering,to.act on my behalf to obtain a building permit and to perform work on my property. - v�r Owner's. Signature //d Date .1 tie Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectricianslPlumbers Apolleant Information Please Print Legibly Name (Business/Organizadon/Individual): 4 Address: n / City/State/Zip: 2 �� In.4 o �,Ahone #: Are you an employer? Check the appropriate box: 1. I am a employer with 4• ❑ I am a general contractor and I Type of project(required): 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' I [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 . 11.❑Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no 12'7 Roof repairs 3a.❑ I am a homeowner acting as a employees. (No workers' 13.0 Other/,2/'�,� general contractor(refer to#4) comp, insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensatiot#policy information. t Homeowncn who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and stato whether or not those entities have employees. If the sub-contractors have employees,they must ptvvide their workers'comp.policy olic number. I am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. 'Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address:_a7 /��/s� ,(, Aalljtil! City/State/Zip:_/f,,,d ,:y Z 4 e / Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator: Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un�W the pains andpenalties ofperjury that the information provided above is true and correct Si a Date.• 6 Z Z Phone#: Official use only. Do not write in this area, to be completed by city or town official MCity or Town: PermitJLicense# Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4, Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: r CAPECOD-27 KLIGETT REYA ��rr CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DDIYYYY) 611312014 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 BI"LOW, 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(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), :ODUCER CONTACT agars&Gray Insurance Agency, Inc, P ORIh Barbara DeLawrence 4 RW 13A 1AIC.No.ExIJ_ aIc N 77 816 2156 ,uth Dennis,MA 02660 Dp ES :bdelawrence ro ers ra ,com INSURERS AFFORDING COVERAGE NAIC H - - - ---:------ -- INSURER A;Peerless Insurance Company INSURER 8:COMMERCE INSURANCE COMPANY j Cape Cod Insulation Inc INSURER0:Evanston Insurance COrn _ 16 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth, MA 02664 INSURER E; - ` INSURER F; — 7 ERAGES CERTIFICATE NUMBER; REVISION NUMBER; T_f IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELQW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS R;TIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, C USIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY-HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER MO DD EFF PMI I D1YExP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE II X OCCUR CBP6263063 •. _..._. L__� 04101/2014 04101I2015 PREMISES(Ea occurrence) _ $ 100,000 J... _-....._._...__.___... MED EXP Any one person) $ 61000 PERSONAL&ADV INJURY $ 11000,000 G N'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE �! $ 2,00.0,000 POLICY ll PRO. (� _ T_ 0 L_.:..I JECT l_.] LOC PRODUCTSTCOMPIOP AGG $ 2,000,000 .� OTHER $ AurOMOBILE LIABILITY COMBINED SINGLE LIMIT a acci en! $ 1,0001000 ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2016 BODILYINJURY(perparson) $ ALL OWNED x SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS X NON•OWNED. A71TOS ROVE!'DAMAGE $ �( UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,--- --- ExCESS LIAB ___ CLAIMS-MADE XONJ463514 04101/2014 04/i)112016 AGGREGATE _ $ DED X RETENTION 10,000 A gregata $ 1000,000 WORKERS COMPENSATION , ANp EMPLOYERS'LIABILITY PTA TE OFFICERIMEMB R EXCLUDED?PROPRIETORIPARTNERXECUTIVE YIN N/A WCA00626904 06130/2014 06/30/2015 E•L,EACH ACCIDENT $ 11000,000 (Mlmdatory In NI•q L--l III Yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 O!SCRIPTION OF OPERATIONS below I - E.L.DISEASE-POLICY UMIT $ 11000,000 I t i l 9RIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarke Schedule,may be aHached If more apace le required) Kerb Compensation Includes Officers or Proprietors, I Io al Insured status is provided under the General.Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. i 1 Massachusetts -Depal"tm$nt of Ppblic Safety D .Board of Building Regula;ions nd Standards a p Constnrction Supemsor .; License: CS-100988 HENRY E CASSIi) a` 8 SHED,ROW _ WEST YARMOLM-1 ,Q2 Expiration Commissioner 11/11/2015 d 'C-��``GCY:I�•G�%C%�'1",G1:1•E'C�;l• Of fice of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MassachUsetts 02116 .Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2014 Tr# 233831 CAPE COD INSULATION, INC HENRY CASSIDY ._., -----___-_- 18 REARDON CIRCLE --- - - SO. YARMOUTH, MA 02664 Update Address and return card. Marls re awn for ch,mgc, ti I] Address Renewal Employment Lost Card '���; `�(�ancrieu.ceec:rrll�cf�C?�C�udae�cuett• i�. 01licc ofCunsumer Affairs& Business Regulutiou License or registration valid for individul use only ` F OME IMPROVEMENT CONTRACTOR. before the expiration date. If found return to, egistration: f; 153.567 Type: -Office of Consumer Affairs and Business Regulation xpiration: 12/1-55/2014 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 APE COD INSULATIQNq',IMCr IENRY CASSIDY 8 REA 'DON CIRCLE O YA MOUI FI. MA 02664 Undersecretary Abtalwitho t nat rc Town of Barnstable *Permit# 'g�OFtHE tqy� Expires 6 months from issue date Regulatory Services Fee—b s,,Rrrsrnsr,�, = t+�►ss g Thomas F.Geller,Director Eo►v{" Building Division Tom Perry, Building Commissioner - � � r�{" �"", 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 F E B 2004 Fax: 508 790-6230 w- EXPRESS PERMIT APPLICATION - RESIDE ARNL : ._. Not Valid without Red&Press Imprint Map/parcel Number b� 0 Property Address Value of Work .Ig Residential . owner's Name&Address Ea v. Contractor's Name Telephone Number .� 13 %gyp Home Improvement Contractor License#(if applicable) n �j Construction Supervisor's License#(if applicable) 0-7 q � 7 ❑Workman's Compensation Insurance u ' Check one: �• _ �. - �. ' r �I am a sole proprietor dim �R ❑ 1 am the Homeowner ❑ I have Worker's Compensation Insurance Will, Insurance Company Name arorknian's Comp.Policy# > ^ r Permit Request(check box) o ❑ Re-roof(stripping old shingles) All construction debris will be 4 ❑Re-roof(not stripping. Going over existing layers of roof) . ❑ Re-side' $Zeplacement Windows. U-Value ©s 3< (maximum.44) *Where required Issuance of 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. Home jqrovement Contractors License is required. Signature o:Farms:exDmtr9 t °� Teti Town of Barnstable Regulatory Services Thomas F.GeHer,Director NAA '`b,�T sa?� �•`� Building Division _ TomPerry, Building Commissioner 200 Main S'tcee% Hyannis,MA 02601 Office: 508-862-4038 Fax: 508 790-6230 } Property Owner Must Complete and Sign This Section. • If Using A Budder I j V} i � L .;as.Osvne�.of the.subjectpropetty- ...._. ._. .: hereby authotize 1,� ",L'1 '� - � ' �" r � � :, to:act bn tny..behalf,. k all tnattets relative to work authoisze:A•by this building.pe=k-applicgllon,f0t: (Address of job) 1 (L6 0' C sign Lute of Owner Date Print Name Assessor's map and lot number ?! ` . ..... l....... L� Sewage Permit number ......-j......................C....:::.::`�.. .i....... 7 Z BARNSTABLE, i MAl6 House number ........................:%?. ........................................ 90p 1679• 00� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO - 'L - f............... .r, �rs.,..... ........ " � 1.. ......L.�........................................... :TYPE OF CONSTRUCTION ........... � t)f'ti: .......'.0 ? x.: .......... :t............................................................. ........... ......:�...................19. c . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......... �: 2Y' : a:_. ._:!' ......-S{:: ,.�r,:.....r? .......'..... �( .: :............................... .. �f'Proposed Use ..... ` ..... . �.1 �...1..:� . .._ ........ ;'..ac;°.. >. r....,. .....4- . r-` '.............................................................. Zoning District .. ....... .......................................Fire District ........ . ........ . .P . ......................... Name of Owner � �:^. :.... .. a r'... .........Addressj` 2.`. . "C 1 . ./ �: � ............. i Name of Builder ' QT.......Address �,d Nameof Architect ............ .. .........................................Address ...............1 ....................................................... Q Pay a Number of Rooms ..........................................Foundation .......... r ........................ f........�.. Exterior .......... ............................Roofing .............�......�....................................................... .... r ` f, T` .Interior .-� /� ` ' ,c' / %,�-ca� Floors ............... .. . .! ............:........................................ .................................. ` ................................. Heating - -� f r l C ......................................Plumbing .......... . . ........................................ .............................. ..... ............................... Fireplace .......................... ..i'•�....`..........................................Approximate. Cost .... .�i" � . 1 ................................. Definitive Plan Approved by Planning Board -----------_-------------------19_______. Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH �rai�ry 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 ... . .1.... ...... .. :.c- ............ `J:....� � .... ..... Construction Supervisor's License ...................................0 BRADGATE BUILDERS, INC. A=270-190 25328 One Story No ................. Permit for .................................... Single Fami.1X Dwel.li. ......... Location ... ot...2.3B,..._„27. Wagon„Lane, .................Hyannis........................................... Owner .Bradgate Builders, Type of Construction ......EKAIRe...................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ........ uly 19 , 19 83 Date of Inspection ....................................19 Date Completed ......................................19 p mop and lot number ...... /''�o ' .gewage ^ ~ Permit number ............................. «{ ',—^—. SAWSTABLE, � ' Hobme number c�| / �\�} `^ j ------^—f----~^---------'` 039, ' MA�� ' ������� ��� � � ��� � � � � � TOWN ���� ������|� �� �� �������� tr ` �� NN0N �� N ' �00N0N_0� N 0m 0 N0 �� �� =� � ���~ � �°, �� � =� �� ' ^1 � ��/ ��� (~/ r��'�� ^�PPLKCATK��0@ FOR PERMIT TO —...:.. ..�..:�.�[!�4r�..�.�=--�°—..-----��..��/�����/ .......................... . TYPE OF CONSTRUCTION ............................... ' ............... ....................... � , . TO THE INSPECTOR OF BUILDINGS: � The undersigned hereby applies for o permit according to the following information: ' Location ---..'l[]—.\ �\ .� .6� '--..`_~i\!J/�_.y�Y\.� ___,,,,.,.________________.. y u . . Use -----.�--.-------..--..�—..!....�.—.—..--.—_...i.�—.l.-----.---.--.—'---. Proposed ~ � � Zoning District .......... ........-..—.---.---------.Rne District --------.—.-----~—_-------.. � ^ C ~' A66 ��� | / \° �� D � �� Name ofOwner .��\�42il��.!'��..�..�����J--~----. rmu ..��..�..�/^��\��x���..^.^,".----...�:�. � / �J `1 ~ ~ Name of Builder ----------------------'A66re» -------.—...-------...—...�------. ` ' / Nome of Architect ----------------------A6Jres -------------------.—.------- ' [ Number of Rooms ----------------------Foondohon ---..----- ------------------ ~ , _------ Exierior -----------------------'r---.xoofing --------_---................. ---- ................ �.�77� 6 {�/�' - Floors ----��./�/!.���..�..----------------.menor --..��/. --.�.`----...�.................................... _ Heating __._.�`/ �.(�.7�+�f.(~_____________..p)umbing ____.. Fireplace -----.............---.--------------^ Cou —.---�' ^~����" Definitive Plan Approved by Planning Board 1Q--------- . Area Diognom of Lot and Building-- with Dimensions ee ................ .............. SUBJECT TO APPROVAL OF BOARD Of HEALTH / /. . ' \ \ ~'� . \ ` � OCCUPANCY PERMITS RE�U|R `_FOR N` DWELLINGS^ ' ' ~ . . ~` . -- y | h by to conform to all the Rules and Regulations the Town of Barnstable regardingthe above /construction. \ ' ' | / ( � Nome ..�~��.. ./z��^��! ---. ` ^ Construction Supervisor's License —(����.������---. DAY, STEPHEN C,. A=270-190 v No 26-0-64 REMODEL .';�............ Permit for .................................... 2f1d Floor ................................................................... ............ Location ...... 145-me......................... Hyannis ............................................................................... Owner .......S.'9!;!PbPR... ...................... Type of Construction ....F.r.ame.......................... .. .. ....... .............................. ................................................ Plot ............................ Lot ................................ Permit Granted .........February....9 ...19 84 .. ....... .... Date of Inspection ....................................19 Date Completed .......................................19 ?,30SO Assessors map'and lot number ......a. �..` O o YNe o� Sewage Permit number ................... ....:..�.�.. ........' ......... re ` ., r -. r • • _ £,� T T Z 339H33T4DLE, •_ House number .............. ��.......:.... ...:.....} 1 a • ? r 9�0 9 \0 MAX a' TOWN ' OF BARNSTABLE I t BUILD I , INSPECTOR APPLICATION FOR PERMIT TO 1"F. .�.� /44fc2 TYPE .OF CONSTRUCTION .. j ............. c� ................... . 'TO-THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location. ........... ..`.... . ...��...�q>................. ................................ ................................... ProposedUse ....................................................................................................:.......:...,...............::........................................... ZoningDistrict ..........l.............................................................Fire District ............................................................. ....... Name of Owner .: (�.!..1 n..C..:..�'�rl ....................Address a.a:.w. .. Nameof Builder ....................................................................Address......................................................._ Nameof Architect ........................... .................................Address ........................ ..........`............... ..................... Numberof Rooms ....................................:..............................Foundation ......:..:...............:.................................................... Exlerior Roofing: .:°........... Floors �� ..7"��.��� ................................. :.....................................................................................Interior ............. ... ............ ... Heating' ...............................T ...... ........................... ....... ..Plumbing ...A. P...................................................... Fireplace- ..... "`....... ...............`.............. . ....Approximate Cost ............ ". ... ... ;.. 1/ Definitive Plan Approved.by Planning Board _________________�:___-____l9k___`____... Area . . ...... ... '?�� Diagram of Lot and Building with Dimensions Fee G 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 the:Town of Barnstable regarding the above construction. ......... ............ Construction.Supervisor's License .................................... ` DAY, STEPHEN C. 21 2 6 0 6 4 - Permit for • REMODEL No" ... = .. _ _r s ?mod..Floor................................................ G �' 27 Wagon Lane - Location .............................................. ............ jt - fd fHyannis ........................................... ........ `l.. ✓ ./ t;, Owner Stephen C. Day — � •� .- �� ,� l":• �: T, (, ...........................r. ....: ........ C c.ti?. Type of Construction .......EK.a e.. ......... = ...............................•................:4. .... ...... Plot ... Lot'-...',............................. • � � :,;;• • is � , l Februar 9 ti. 84 C Permit Granted ......... .......,Y .....�..........19 --• Date of'lnspection ..................... ......19 Date ..Completed du ._ r� ....19 � r f 1.,i ��.." .x?rt..•� ' � �j4• _ f. � e 'r' f i €, a�• ; .h *�; P: ,�7; ,�, � . w�. — ti / -