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0015 WARREN AVENUE
� � tc��..-r-�--�h �9•r�, ,. �� Town of Barnstable *Permit g, egulatory Services fee 6 mont��s from issue date snexSiam ice. ,�, f l 1 6 2D18 chard V.Scali,Director 9. ��"'� --��� � Building Division \'� �' r ® P�ul Roma,Building Commissioner ®L000 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Numbe pte Property Address 15 Warren ave Hyannis *Residential Value of Work$ 7,800 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address KEEFE, STEPHEN 702 LINDEN STREET BOYLSTON, MA 01505 Contractor's Name Anatoli Slvitski Telephone Number 617-710-1001 Home Improvement Contractor License#(if applicable) 168043 Email: capecodinc@gmail.com Construction Supervisor's License#(if applicable) 106040 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [� I have Worker's Compensation Insurance Insurance Company Name AmGuard Workman's Comp.Policy# R2WC918542 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) [g Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to $&J EXCO Dennis ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *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 Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\decollikWppData\Local\Microsoft\Windows\INetCache\Content.0utlook\L7U69LF2\EXPRESS(2).doc 01/25/17 oF� + ■ANiSfABtb. • 9. Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Paul Roma 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, Stephen Keefe ,as Owner of the subject property hereby authorize Anatoli Sivitski to act on my behalf, in all matters relative to work authorized by this building permit application for: 15 Warren ave Hyannis, MA 02601 (Address of Job) 7/16/2018 Signature of Owffer Date Stephen Keefe Print Name If Property Owner is applying for permit,please complete the.Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 a The Commonwealth of Massachusetts Dgarhnent of In&nhial Act de►& 09we of Inmfigations 600 Washington Sheet Boston,MA 02111 u rnass govv/dia Workers'Compensation Insurance Affi&vit:Builders/Contractors/Electricians/Plumbers Anolicant Information Please Pant L.eidbly Name8usiaesslOnizatiaatlo�ivi�ai}; Anatoli Siyitski Address_ 27 Mill Pond rd CitytStatetbp_ West Yarmouth, MA 02673 Phone#- 617-710-1001 Are you an employer?Check the appropriate bow Type of project(required): 1-0 I am a employer with 4. ®I am a general txntmctor and I. employees{full ancVor partrrtimej* have hired the mb-c omttactms. 6. [—]New 2.❑ I am a sole proprietor or partner listed m the attached sheet. 7. ❑Remodeling slug and have no employees These sub- ractors have g. ❑Demolition woticing for me in any capacity. employees:and have wodoers' 9. ❑Building addition. [No workers comp.insurance coup-insurance 1 required-] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all wodc officers have exercised their 11.❑Plumbing repairs or additions nzywIf oworkers' right,ofesemptioaperldGl. insurance required.]t c.152,§1(41 andwe haveno 12 Roof employees-[No work=' 110 Other comp-insurance raequire&] *Any q@tk=datcbecks burs#1—st AU our tbe section below showing tb*wwkere eompensadou policy mftmaium wbo submit Ws affidavit intimating dwy ire doing all wal and thw bee outsi&catitutammm submit s new affidavit iwha tigg sarh. £G'aauactot AW check this burl Est attached an additional ibm ftwingibe name of The sub-w�and smte whalbu or not dwse entities bm employees.If the ab<onuactots haae employees,tky must ptovide tWff walkers'camp.pdUcy cumber. I am an employer that is prov(ditrg workers'congwnsation insurancefor my empletyees. Belowisthepoficyandjobske ,formation. . Insu amcecomPffiYName: AmGuard Policy#of Self-ins.Uc.#: R2WC918542 Expiration Date: 02/06/2019 Job SiteAddtress: 15 Warren ave City/statetZip: Hyannis, MA 02601 Attach a ropy 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 iWosition,of criminal penalties of a fine up to S 1,500--00 and/or one-year as well as civil penalties in the form of a STOP WORK ORDER and.a.fie 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 linw igat ams of the DIA for insurance coverage ve ification. I do hereby csrhfy under tics pains and penalties ofpedW7 that the information protdded above is true and correct Date: 7/16/2018 pie#: 617-710-1001 Offleid use only.. Do not write i t this area,to be completed by city or town official City or flown: PermiitUcense# Issuing Anthomity(circle one): 1.Board.of Health 2.Building Department 3.Cityffown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person:- Phone* AC V DATE(MMIDDIYYYY) �,- CERTIFICATE OF LIABILITY INSURANCE 03/16/2018 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 have ADDITIONAL INSURED provisions or 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 NCON AME: Victoria Sharapova ALD Insurance Agency Inc. PNONE 617-787-7877 FAX 617-787-7876 60A Brighton Avenue arc No Allston,MA 02134 In : comm@aldinsurance.com INSURER(S)AFFORDING COVERAGE NAIC 0 INSURERA: ATLANTIC CHARTER INSURANCE COMPANY 44326 INSURED Belcape Construction LLC INSURERS: AMGUARD INSURANCE COMPANY 42390 42 WOODBURY AVE Hyannis,MA02601 INSURERC: INSURER D: INSURER E: 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 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. ILA TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER MM/D MIWD LIMITS A COMMERCIAL GENERAL LIABILITY L270000577 01/14/201$ 1/14/2019 EACHOCCURRENCE $ 1,000,000 CLAIMS-MADE V OCCUR AMA E TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑PRO ❑LOC JECT PRODUCTS-COMPIOPAGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) 8 HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION R2WC918542 02/06/2018 02/06/2019 STATUTE ERH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If es,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addttlonal Remarks Schedule,may be attached If more space Is required) r CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN -- ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD Or Office of:Consumer Affairs and Business Regulafion �.One Ashburton Place ='Sulte-1301 Boston, Mas ` kiusetts 02108 Homellmpmvemerit o actor Reglstratlon . ` fiype Corporation :.. Regisirabon -:`168043 CAPE COD HOME-IMPROVEMENT INC Expiration -12/06/2018 -27 MILLPOND RD WESTYARMOUTH,MA 02673 4 Update Address and Return Card. - scA9 a'.st >• . Yl�ea9sr�rarsrsrleia/( "p�laysacfu{sel/a Office of Consumer Affairs&Business Regulation .' valid for Individual use only., Registration ` 'HOME IMP'130VEMEfdTCONTRACTOR" _ Y'. TYPE:Cirnoration befog®,the expiration date. If found return to `E n Office of Consumer Affairs and Business Regulation 1 - 2/06/2018 10 Park Plaza=Sui CAPE COD HOM ti „! _EIT INC.: Boston;MA; ANATOLI SIVITSKI � _ i� -27 MILL:POND RD :WEST YARMOUTH'MA` 2�73 `. Not-Valid without signature <UnderaeCretary �S f mar w /R'� k r { - y - 3 .3 �r y. „�-;s� E � 5^E.�"rtT w � '' � , ,M `"Yf •4�. t# -;� :✓ *m a '� 4 � � E�199Qt1IA� H Ol�I2lVA 1S3f�1 ` T T I)I%L IS11��1111 gay, t S � tSO € $ } T . t3dxs � tl . ..sal ` Yz '�'. trc • ; z'a i %c f ffsj3.4 e .. .� _sr5�"S� s t .�1 r - Assessor's map.and lot number ...... .... .... ! / rSTEM MU T �° SEPTIC S -- ... Ep IN COMP Sewage Permit number ................................ g I ,NSTA WITN TITLE Houfse number �, ....:�'n...............:. .....� INVIF�ONMENT�� C ............ J1B OYPY `00 �E 6• TOWN ' OF BARNSTABLE f BUILDING INSPECTOR APPLICATION FOR PERMIT TO �� V.... �.lv.(' ......................... TYPE OF CONSTRUCTION .......... ...........'J /............................................Ly ... .. . LLG.................. TO THE INSPECTOR OF BUILDINGS: t The undersigned hereby applies for a permit according to the following information: House is currently located at 167 South Street, Hyannis, Ma. and is to be moved to Location ...Lot.12...W.arren..Ausnue.,...Hy;annis.,..Ma............................................................................................................ To be used as a single family dwelling. ProposedUse ............................................................................................................................................................................. ZoningDistrict Fire District ....HY.annis.......................................................... .... .�....................................... Name of Owner Jeanne S. Carey ...Address 658 Scudder Ave: , Hyannis�ort, Ma. Mover................................... P. 0. Box 657, ' , ... ........ .................... Name of ....Kenneth..Kline. . ..............'.....................Address ..Soul?.. Xk?�,g�}.�,.. .....Q �?4.�,..... .... .... . Name of Architect Ny. .........................Address .......... Number of Rooms .....8...........................................................Foundation ....TQ..be... ns:W:1ed....�1.�'.uR.. �....C� Exierior ..Wood..AP.d..5.tU.C.CQ................................................Roofing ....asphalt.................. , ........................................... Hardwood S/fE�T/<'o�•• Floors Interior .......................... ....................................................... Heating New system to be installed •,•,,,....Plumbing Tew plumbing to be installed ...................... ........................................... Tob ...b.e. r.e buil.t...i.f...ne.c.e.ssary 6-7-d Fireplace .... . . .. .. . ........ .. . . .... . . ..... 1........... ......Approximate Cost ........................................................... Definitive Plan Approved by Planning Board _✓____ t-z___-----------19_Q__ Area ,........-) Diagram of Lot and Building with Dimensions EGO. ........ /o SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations a Tow of Barnstable rega ding a above construction. - Nam . ...... ... . .................................... �`' Construction Supervisor's License .. T CAFEY, AANNE S. �No 28 -.W Move D , • e .� ...: :. Permit for W�.?,�.zg.i.... .. ` Sin le Famil Dw .• $.............. Y.......� � r F Location .....Lot• 2, 15••Wazx.2zl.•A.venue...... --. - ......................Hyw STi;.....................:................... Owner Jeanne S = + ......................r...�rs3. �,V...:........................ r` Type of Construction ..........Frame Frame..................... f r Plot ............................ Lot ................................ g Permit Granted •...••February 18,........19 86 V Date of Inspection ....:19 Date ,Completed' :......... . ! � f......19 } :1 ? { !! •y t ,i - Assessor's map and lot number '` o? A*u...L': �:.... . -1 % EPTIC SYSTEM I�uST Q" o S ED C EP `o �3F� !INSTALL �N OM —II - Sewage Pe3mit number ......... ................................... ..... WITH TITLE NTpL C House number � ...: .........................................� �NVIRON�'1E'�,a.� o'`�'b 9 0� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... a..✓..�...... Z-L.!./.V..0........................................................ J/ ✓ i� / ell it,Q L L/�� TYPE OF CONSTRUCTION '.. `.. 3........... . .........191i. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: House is currently located at 167 South Street, Hyannis, Ma. and is to be moved to Location ...Lo.L..#2..Warren..Avenue.,...Hyannis.,..Ma.......................................................................................................... To be used as a single family dwelling. ProposedUse ............................................................................................................................................................................. Zoning District R.B..............................................................Fire District ....Hyannis................ Name of Owner • Jeanne S. Carey 658 Scudder H�annis�ort, Ma. Address Ave.A ... ort Ma 3 Mover P. 0. Box•657, Name of M1d�* ....Kenneth Kline...................................Address ..$9Htkl.. s Xk?J,gkt. .. `13.....02667.............................. Name of Architect Address .............................................:........ ..................................................................................... Number of Rooms ....8................................. .......................... ....T.9.. Exterior ...Wo9d.And..SLU-C-QQ.................. . ........Roofing p ....... _ ....as bra].t................................................................. Hardwood Interior .. . !....' . .. ....................................................... Ali Floors � c L r �. . Fieoting New system to be installed ................Plumbing New plumbing to be installed Cos To be re-built e. t(='::./ ' Fireplace ....................................if.......necessary................. ....................•Approximat ........................................................... p - Definitive Plan. Approved by Planning Board __✓ 19_a_ Area. . .....,::......... Diagram of Lot and Building with Dimensions fee- •......•• ••.. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW-DWELLINGS I hereby agree to conform.to all the Rules__ and Regulations a To of Barnstable reg ding..the above construction. „� \ Nam Lis 9,�sr t C ........� " ................ 0 9-o-2'l) - C��`'7 onstruction Supervisor's License CAREY, JEANNE S. A=306-172-2. No-=----- 28946--Permit for---Move Dwe irig (J ------- ------------- , ^ Single Family Dwelling Location Lot #2, 1 Wa en Avenue Hyannis Owner Jeanne S. Care 1 Frame Type of Construction------------------------- -------------------------------------------- Plot---------- Lot--------------------- ----- Permit Granted_----February-18,-------- -;-19 86 Date of Inspection 19 Date Completed 19 ; . 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't. , .' .}-.,N,f ro..-.t�1 i.R --><I , .. {' NO Wa•/lael'i ,' RUB.______ __�._..___._-• -� --- �..._._._----�— - zo.i ?own wide a tu s t _ { 1 t2 2r6 '�G l0,` n 1500 ,402 a _ 1 12,01�1 �� NO 32.0 14 o o�ed 4 J 1 ? j z© at 12-18-85 •�• '/ , �o.oa . ins i~l.!C Cape 6ruij2ep� ! k c)d+) 1da2jio )�nad Sketzh Ptan o Zand :in kyam;4, l'vi'a. i is . :13eZnq tot,2 as diwwn opt .a pt- rx-ticle. eoa ii 30 Aic 94ombe.ttta Gy, 9Aajd?, Coneac! elated 14-�-89 ' Cieua.tLov�a �fwwn ate bad&d on U.S `. .datwu. 7�c✓uzo.#`cliZe-� l y ji � I . $,e 2 pet, 1 ! Jop aean I x' l � i I o FARDIE No. 8995 O �.__•.___,._,_�G�Z ,' . _ _ �lei-...�l'�-y��z,. �� � � � r. .� � , /' 3� �\ �� -..5 � /d �"� I i G �� � � ,:� i� 1 PINK DEPT. FILE COPY/WHITE-FI,ELD COPY/:YELLOW-APPLICANT COPY Z �_.. BL<Ola UILD[NGTOWN•OF B,ARNSTABLE,`MASSACHUSETTS' PER@lil� .::. A=306 . 172. 2 V'A LIDATION DATE February 18, 86 1 19-- PERMIT NO. n �TCANrDennis M. Car ADDRESS 658 Scudder Avenue, Hyannisport t 38074 - _ (CONTR 5 LICENSE) (STREET) PERMIT:To- Move l�Il.inQ "Sin le 'Family Dwellin (;_� STORY y g" NUMBER'DWELLLIING UNITS (TYPE OF IMPROVEMENT) INO. (PROPOSED USE) AT (LOCATION) Lot #2, 15 'Warren;Avenue, /Hyannis zoNING. (NO.) (STREET) DISTRICT' BETWEEN AND (CROSS STREET) . SUBDIVISION j LOT (CROSS STREET) LOT BLOCK. SIZE ' ——?f r i BUILDING ISTOBE FT. WIDE BY AFT, LONG BY T IN.HEIGHT AND.SHALL CONFORM INCONSTRUCTLOt T0.TYPE ... USE GROUP BASEMENT WALLS OR FOUNDATION . (TYPE) REMARKs ' `Sewage #85-1188 AREA OR _108H.3q ft. Bond VOLUME ESTIMATED COST 25j 000,.00 PERMIT ' 76.25 } (CUBIC/SQUARE FEET) ,. F:EE owriER Jeanne S. :Caryy cu er venue annis ort ADDRESS y:' y._. P f 1. BUILDING DEPT. By* 1'nvm--i'�tc`utYi�rtlMENT'OF•PUB LIC WORKS. THE ISSU'A'N<.c OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. !' MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR i ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURALMEMB QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL I FINAL I S(RE INSPECTION TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. i POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I J 2 2 �/v er 0v� 2 i • k 3 _ y H"E'ATIN"G INSPECTING APPROVALS REFRIGERATION INSPECTION APPROVAL INE INGv OTHER 2 ARD OF HEALTH 7bC&J_j/v WORK Sr+ALL NOT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS,INSPECTOR HAS APPROVED THE VARIOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPr STAGES OF CONSTRUCTION, PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION. TOWN OF BARNSTABLE 28946 �TNE Permit No. ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash uv►" HYANNIS,MASS.02601 Bond ..... ..J .. e CERTIFICATE OF USE AND OCCUPANCY Issued to ,Jeanne S. Carey Address Lot #2, 15 'Warren Avenue 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. ' January 14, 19...$ :...�..... c ............................ Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT RANN°T ' TOWN OFFICE BUILDING out HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: ,//�/ An Occupancy, Permit has been issued for the building authorized by BuildingPermit $ .......... .. ./...�JJ.......,........................v................................'......................................................................_............_..... f issued to :. s.....�: 42:.a�........... ........�./...3—./,!/ �"1 �' .. v ....._ _..... Please release the performance bond. ��' ��a - ��� � �� �m �, d o�- � � �� � � � � 0 : _.___ r-U11111L MR: o.1uper�o u All other structures (not specified) Permit fee $8.10 per$1,0 PLUMBING PERMITS Residential—per unit $25.00/first fixture plus$12 each additi Commercial—per unit $45.00/first fixture plus$15 each additi GAS PERMITS Residential—per unit $25.00/first fixture plus$12 each additi Commercial—per unit $45.00/first fixture plus$15 each additi ELECTRICAL PERMITS Residential New construction per unit Additions/renovations <500 sf > 500— 1500 s >1500 sf Minor alterations/appliances Change of Service/meter Accessory structures (garage, barn, etc Temporary service Meters per unit Smoke detectors/alarms mmercial New construction per unit $1 Additions/renovation < 100 sf ` '�� >1000—25 3 w��� l�5 (,���erl �� � �o� '' BUILDING PERMS: PARCEL, ID �0 a 17' 002 GEOD SE ?D, 21549 4 NY kNk,IZS ZIP M LOT 2 BLOCK LOT SIZE I7 jA DEtJt,%:OP EMIT DI.S`J'h E{OT HY Pr_tj'jT°L, 932'32 DESCRIPTION IOU'{' BECK 12 X 12 REROOF HOME Rlh, i;'Ii TYPE B Mi x SC TITLE A t1,;,,ELANE0U j 40ERMfT CONTRACTORS:: PROPEREY OWNER Department of Regulatory Services TOTAL FEES: $91.00 CCxNO-C UC:C IOC COSTS $1.0,000,00 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE * * R"NKABLE, MASS. BUILDING DIVISION-, BY �CI �' '' �:fe;�� � DATE i SSI;ED 04/07/2005 :EXP LRAT iON DATEMAE .ram TOWN .OF BARNSTABLE BUILDING PERMIT PARCEL ID 306 172 002 GEOBASE ID, 21549 ADDRESS 15 WARREN AVENUE PHONE HYANNIS ZIP I LOT 2 13LOCK + LOT SIZE I DBA DEVELOPMENT t ,N DISTRICT HY PERMIT 83232 DESCRIPTION ROOF DECK 12 X 12—REROOE HOME. PERMIT TYPE BMISC . TITLE MISCELANEOUS PERMIT CONTRACTORS: PROPERTY OWNER Department of AcHxTECTS: I� Regulatory. Services TQ TAL- FEES: $91.00 BOND $.00 CONSTRUCTION COSTS $:LO,000.00 753 MI SC_ NOT CODED ELSEWHERE 1 PRIVATE * &UMSTABLE, MAW . RFD IrIP�A , BUILD NG,DIVISION BY /r / //l1 DATE ISSUED 04/07/2005 . EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASETHE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.- MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. I a I:I M a I llffeTm 1:171 Lij 1-.1113 a Us m 0 1 0-1::a 41 BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS c•✓_; yy �r yi l �� �.� I I 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: . SITE PLAN REVIEW APPROVAL Persons contracting with unregistered contractors. do not have access to the guaranty fund (as set forth in MGL c.142A) WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. BUILDI b:. PERM .IT �,..+v ...r �. :''.`�:-:�:ya..m��__. ¢.r„•,; -_.�-____,�..r-"r_'�'>-;�'rsa.—..,. - � .►v.�..e-�—��ti,,.,�..y.� . e I �1 l I •4s, BUILDER INFORMATION '] --= j-7 —7 Telephone Number _ Name p Address / License# 1i'—�0.41 Home Improvement Contractor# '` U Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE T/ /--J�v3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION , . 3a3 a Map' 3:" Parcel / 7 0, Permit# Health Division ( 1� I �f"' ��_' OF BPsi? Date I 7 6.� TABLE Issued � Conservation Division M1 n Application Fee PH Tax Collector Permit Fee 4`0. Treasurer -�--�- _ . D�V'IS60f�+ Planning Dept: CONNECT T' Date Definitive Plan Approved by Planning Board #, Historic-OKH Preservation/Hyannis Project Street Address Villageon 0 P Owner G _ s l'-)1 , Address j Telephone :2-2 S---�3� ��-- Lc�1� ®9---7 1--/ -,7 Permit Requestd 0 N' ®oecr-1- �. `r am-�zis� iL)rt-;,f- 4&c_�Es S u fe feet 1s`t'I��ex`�isst g �r pose° C'` 2nd floor: existing 'J proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio Construction Type AV t-" Lot Size c�2�ff 6Lt-t-st.— Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 0/ Two Family ❑ Multi-Family(#units) Age of Existing Structure C Historic House: ❑Yes R(No On Old King's Highway: ❑Yes &I No Basement Type: M Full ❑Crawl ❑Walkout ❑Other - Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) G Number of Baths: Full: existing o;2- 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: GGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes U040 Fireplaces: Existing 'Y� New Existing wood/coal'stove: ❑Yes 0 No Detached.garage:'W/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 ❑ es �No If yes,site plan review# Current Use L oposed Use BUILDER INFORMATION Name dc �L-G� l �C Telephone Number `7 Address G io K,4!�-t e 14n License# t� CYn 1 .9-©.ewe , Jam ~ a2� d/ Home Improvement Contractor# ;;2 Z(� Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS'. PROJECT WILL BE TAKEN TO Y"?4-,X /J 4(tt- SIGNATUR DATE / /� FOR OFFICIAL USE ONLY PBRMIT NO. DATE ISSUED - - MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: - FOUNDATION R1 ' FRAME 1A-C le INSULATION -C FIREPLACE ELECTRICAL: ROUGH, FINAL r PLUMBING: ROUGH !t? ' FINAL GAS: ROUGH V FINAL - FINAL BUILDING 'f I ' DATE CLOSED OUT ASSOCIATION PLAN NO. r ` RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00- : : _ Residential Addition $50.00 _. Alterations/Renovations $50.00- Building Permit Amendment $•25.00: FEE VALUE WORKSHEET g NEW LIVING SPACE square feet x$96/sq.foot plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= D D Q x.0041= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.8.= x.0041= ACCESSORYSTRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf. 75.00 >1000 sf=1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck.._. ... :_ )x$30.00= (number) I, Fireplace/Chimney . x$25.00= (number) -' Inground Swimming Pool $60.00 Above Ground Swimming.Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fe4 C Projcost Rev:063004 • Town of Barnstable • y��OFtHE fpw,yo� Regulatory Services * - Thomas F.Geiler,Director BAMMBLEMASS • 6 19. Building Division 9� 639 .m� ArFD tip Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE-.--l JOB LOCATION:. \5_ f number street village "Fi0ME0VJNER": 053 Q %1 name home phone# work phone# CURRENT MAnJNG 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 SU13ervisor. 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 structuies. 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 jit menu. . 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 ultimatelyresponsible. ibilities,many communities require,as part of the permit application, To ensure that the homeowner is fully aware of his/her respons that the homeowner certify that he/she understands the iesponsbilities 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:forms-.homeexempt i 14 ---= -- The Commonwealth of Massachusetts . .'^_; Department of Industrial Accidents Office of Investigations �3 600 Washington Street, ;� Floor ?� Boston, Mass. 02111 Workers'Cog ensation Insurance Affidavit Building/Plumbin /Electrical Contractors Moll s name: ,1 S address: /g city t S 41X state: ��'�` zi : q7 hone# 7 wor site location full address): I am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel C❑ I am a sole proprietor and have no one working in any capacity. ❑Building Addition ..i_r. ...�'..:: ❑ I am an employer providing workers' compensation for my employees working on this job. company name: address: city phone#• insurance co. licy# ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address: city: phone#: insurance co. policy# 4'�3r�ii3C'g",:i, '.,�:; dn"S'e. '`t :[ :wd' company name: address: city: phone#• insurance co. oli Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Tine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby ify under the pains and nalties of perjury that the information provided above is true and correct r , Signature Date Print name Phone# [Iri, :1only do not write in this area to be completed by city or town official permit/license# ❑Building Department ,❑Licensing Boardimmediate response is required ❑Selectmen's Office❑Health Departmentson: phone#; ❑Other 03) - .. w Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract of hire,express or implied,oral or written. An employer is defined as an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds ` or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. MONISM Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7`n Floor Boston,Ma. 02111 fax#: (617)727-7749 phone #: (617) 727-4900 ext. 406 no CMR Appadis J R Table JS=b(continued) E pmcrip&e packages for doe and Two-Family Residential Buildings Heated with Fossil Fuels MAXfMUM MINIMUM Wall Floor Hasemeat Slab Hearing/Cooling (Hazing Glaring Ceiling Wau Perimeter Equipment Efficiency' Area'(%) U-valoer R-value' R•value R•value' • R-value° R-Value Package 5701 to 6500 Heating Degree Days' 6NormalQ 12% 0.40 38 13 l9 10 6Normal R 12% 0.52 30 19 19 10 - 85 AFUE S 12% 0.50 38 13 19 10 N/A Normal .------...38 13 25 N/A U '15% 0.46 38 19 19 10 N/A 89 AFUE p 15% 0.44 38 13 25 N/A ft 85 AFUE w 15% 0.52 30 19 19 10 rm N/A Noal X I S% 032 38 13 25 N/A Normal y 18% 0.42 38 19 25 N/A N/A g0 AFUE Z 18% 0.42__f___.38 13 19 10 690 AFUE AA 18% 0.50 30 19 19 10 1. ADDRESS OF PROPERTY: oo 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): QL t,,.?q�� w NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-f0rms-f980303a 780 CMR Appendix J Footnotes to Table J5.2.1b: d Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and t basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area, expressed as a percentage.Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 fe of decorative glass may be excluded from a building design with 300 ft=of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center -of-glass lass U=values ca nnot be used. ' The ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R 38 -.._ _._. .- - _......_..-... _- . sti .. -insulation: Ceiling R-values-re resent-the sum of cavity.- insulation and R-38 u�sulahon may be substituted for R-49 g P insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between ) the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall.For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frariie or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. S The floor requirements apply to floors over unconditioned spaces(such as unconditioned cmwlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. f The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement de-scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ° If the building utilizes elebtric resistance heating use compliance approach 3;4, or 5.. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package.. 'For Heating Degree Day requirements of the closest city or town see.Table J5.2.Ia NOTES: Glazing areas and U-values are maximum acceptable levels.Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted avenge U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 Vows Town of Barnstable y Regulatory Services l snRxsrns , i Thomas F.Geller,Director XAM 9$� 1619, a Building Division • rEb NIP' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. • Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, + improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adj scent to ' such residence or building be done by registered contractors,with certain exceptions,along with other requirements. ��� 20 G� „� %��� •• Type of Work: DWF •Estimated Cost Address of Work: %� '� � , Otivner'sName: Date of Application: Z.! ��� I hereby certify that: Registration is not required for the following reason(s): E]Work excluded bylaw ❑Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNRE T WORK EGO NOT HAVE CONTRACTORS FOR APPLICABLE HOME IMP ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Contractor Name Registration No, • Date • ' i OR Date Owner's Name • Q:forms:homeaffidav - y I °FTMe�w Town of Barnstable Regulatory Services snx arm :t Thomas F.Geiler,Director D ,� Building Division TomPerry, Building Commissioner 200 Main Street, liyannis,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 as Owner of the subject property' he authorize:' to act on my behalf, in all matters relative to work authorized bythis building permit application for: - r (Address of job) • � � Signature of Owner Date Print blame. «. y tTCCTn P ✓�ZC T/�Q'I72filLCIdf!/P.GCLClL O�c/4'7,C7.ddCC.4Yllltleu0 t= _ Board of Building Regulations and Standards { HOME IMPROVEMENT CONTRACTOR Y Wyk_ Registration: 136003 ``�' Expiration: 5/30/2006 Type: Individual BRUCE P.MILLS BRUCE MILLS 16 CROOKED POND RD- � HYANNIS,MA 02601 Administrator J PZ� It� Ala _ } OR BOARD OF BUILDING-I�C3ULA�1(3hFS I License: CONSTRUCTION SURERVIS Number::GS_ 078687 Biithtat8t.(?519'=.1960 _ . 00460006 Tr.no: 21638 Reskcdc-U0 BRUCE<P MILLS 16=CROOKED PON6'RD. 7- HYANKIIS, MA 02601 Actlrig C" �tnls" oneP R Roh6p took. ak�c Wig kop II, CL o P.T. ...__. �-_T, _ � .. - r.... LS, Utau\m Ai.4 - .tot I Airflac I putI QQ so Is F I it A4+ec -UcCam . Ac& � � d � i PU A ............. 'AL . L-1 i D p vzr4L.J