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Home My WebLink About0035 AMES WAY _ _ _ _ _. _ _ 1� � � 2-i/,/o-7 Town of,Barnstable *Permit# ° 0,e- c?0 7e� 7 S,{ Expires 6 months from issue date > �r�M l Regulatory Services Fee >, 6 q MAM ' Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioners 200 Main Street,Hyannis,MA 0260,1 FEB www.town.barnstable.ma.us 12 2007 Office: 508-862-4038 Fax:'50 - EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number /?pjg 06 6 Od 3 �" Property Address a, *esidential Value of Work � ) '7 t0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name E../lQ,� Cifyt✓, ��. c �,,,� Telephone Number 50 q 01 P_4 Q. Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) Zworkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# aC(� („ 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 permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: ro Owne ust sign wner Letter of Permission. Home ense is required. SIGNAT RE: t Q:Forms:expmtrg Revise071405 r, Board of Building Regula ions and Standards One Ashburton Place - Room 1301 y Boston. Massachusetts 02108 :. Nome Improveme _ .ontractor Registration Registration: 112536 Type: DBA Expiration: 3/23/2007 FRASER CONSTRUCTION co DEAN FRASER -- 71 TARRAGON CIR COTUIT, MA 02635 Update Address and return card.Mark reason for change. � DPs-CAI so soon-oaioa-Gioizis•. ❑ Address Renewal ❑ Employment Lost.Card J The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 b� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): J/(a)3,� Address: CD e:� 0-y 1 gq_ City/State/Zip: Mc-. U 9,63rj Phone#: 5°O g-qA - a q D_ Are you an employer?Check the appropriate box: Type of project(required): 1.LK I am a employer with j 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. # ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.Q'Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 13.❑ Other *Any applicant that checks box#I 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 an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: T Policy#or Self-ins.Lic.#: 1 `T U tql) Expiration Date: q - -),6 Job Site Address: W City/State/Zip: P 6— 6 ,266 3 Attach a copy of the workers' compensation p cy 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 hereb er t s an s o per ry that the information provided above is true and correct. Sign Date: Phone#: 5-0 o� 02 v25' '02 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# 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#: � r ®® PA\ PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE, WISE & QUINN INS AGCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR, 449 PLEASANT ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. BROCKTON MA 02301 COMPANIES AFFORDING COVERAGE COMPANY 24WCB A HARTFORD UNDERWRITERS INSURANCE COMPANY INSURED COMPANY FRASER CONSTRUCTION CO B PO BOX 1845 COMPANY COTUIT MA 02635 C COMPANY D .'.fit..... := ....::::....:::::::::: >;::::::::r::: ::: :'::::::: ::::::::::::::::::::::::::::::::':::::::: :::::::::: ::::::::::::%:::::::::>:::::::::::::::': :.::::::::::::::;::::::::::: ::2::::;;::::::i::::::::::;:: 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. CO TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LTR POLICY NUMBER LIMITSDATE(MM\DD\YY) DATE(PAPA\DD\YV) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ CLAIMS MADE F—]OCCUR. PERSONAL&ADV.INJURY $ OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per Accident) PROPERTY DAMAGE $ TEXCESS LIABILITY AUTO ONLY-EA ACCIDENT $ O OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $' LITY EACH OCCURRENCELA FORM AGGREGATE $HAN UMBRELLA FORM WORKER'S COMPENSATION AND A EMPLOYER'S LIABILITY (UB-794XG 19—1—06) 09-26—OG 09-26-07 STATUTORY LIMITS EACH ACCIDENT $ THE PROPRIETOR/ INCL PARTNERS/EXEC ITIVE X DISEASE—POLICY LIMIT $ OFFICERS ARE: EXCL DISEASE—EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. i FIA..:E.:HOL " .....................::::::. .............DEk ..................:::::;:::.;:.;:;.;;;:;:.;:::.;:.:;:..;:.;;::.:.:::::: :.:::::: ......;;:.;:.::.:: ::.:IiR. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE FRASER CONSTRUCTION LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR PO BOX 1845 LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. COTUIT MA 02635 AUTHORIZED REPRESENTATIVE V- '/ af-P- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � Map I � � Parcel Ob Io d QZ �` - PerMital 2 9 INSTAL Health Division' lit ., '., Date Issued Conservation Division f ci ENVIROWTowt�lV, Fee Tax Collector:. % Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 3, " _Y4 ' , Village Owner �'P,- '0:?,00_e AZ Address E Telephone `2 Z 7 Permit Request ,n-72 9 I mo -, P '. -CA97 X /7Z � quare feet: ls�fioor: existing_4' proposed 2nd floor: existing G c y _ proposed Total new ,KO Estimated Project Cost A* A10" Zoning District Flood Plain Groundwater Overlay Construction Type 14 i_-7 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, V' Two Family ❑ Multi-Family(#units) Age of Existing Structure ❑Historic House: ❑Yes o On Old King's Highway: ❑Yes No U Basement Type: ull ❑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# Current Use Proposed Use !'lr Q BUILDER INFORMATION Name (7�' J f 4 Telephone Number ��l s Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A 11 e If ti SIGNATURE DATE �� te_.; ` FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED ' r J MAP/PARCEL NO. ADDRESS _' t 'VILLAGE OWNERMc DATE OF INSPECTION: t FOUNDATION r FRAME ' , INSULATION FIREPLACE r ELECTRICAL: ROUGH FINAL ; f PLUMBING: ROUGH FINAL GAS: - ROUGH FINAL FINAL BUILDING''` DATE CLOSED OUT M - ASSOCIATION PLAN NO. ' - 1r_ —. , e ommonwea e - F. ....- ....— .I .--,- Department of Industrial Accidents ' ' == Office oflaYestigations -' _ __y- 600 Washington Street . . - - Boston,Mass. 02111 —" Workers' Com ensation Insurance Affidavit /, name: . �4 Y,2420%iii- xff"-7� �¢ u9 location: ✓ S �^ t^ city Z_ ,./iW lr_ V-e`�� phone# 9 I am a homeowner performing all work myself. I am a sole rietor and have no one worku in any ca achy %%%%//%%%%/%% /%%/%///��%%��/%%/%%%%/%%%%%///%%//%//G%%%l��/%%/%%%%%%%%/%%%%/%/%/%%%%%%%%/%%�%%%/%%�/�%%%%%%%%%I%%�%%%%//J Q I am an employer providing workers'compensation for my employees working on this job. :: ::::.::::::::::: pares »:: ::.;«:>;-. shone#. :•.:.::..........:.:.::::.:... :...:::...:..::.:.:.:..:...:: ...: ..... . insurance co ....::... ....... 11 ❑ 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: :;::.:.:..:>>;>::: ::> ...... .... >:......::. :::.:::.;; ..:....:. ::.: :: comyanv riamt. ::::> :;.:::;;..:::.::.:;.;:.:::;::.:::.::..;:.>:;.::.;:.:: 1. addr ::::.:;<:.::;::::.::::;:;:.::..::: . ......... .......................:::.::: ......:.. ::::.::.>::::;;>::::.::..:. :: a..,. ..........:... ....................................................................................... .............................. ......... ...............:....................... ..............-.............:: xa:. �"#::::;.':;'t<`?:::; i yii:?;:::: j F:<i? ;:;:ci;:: .;3 ;f..:;>;;';c;:`;.,. '..... :. ......"'::i..:i: city' . . .... .:::::..:.... . ::::. ::::.::.:. t:.::...:.::::.:..:::.:::::::::.:...::::::::::::..::::::.::::::::::::. :...................:::.:::::::::::::::.:.......:....................................................:......... Insurance..ca ... ._. .......... ........... . . . . ohcv ::,:...:.:::. ....:.:..::.:.:.:.::::.......;.:.:::;:::::>:;::::::.: -;.:;......." company namtn.:.:::::>:<:>:::...I.:«<:::<.....:::> :..;::.,.;:;•::<; . ..:::.:;:.... >,.:.::; address- ::..:: ;:::::.::..:..:...::....;....::::.::.:...:...:..:. .:::.::..:.::.::::..... ............ .::::.::.:......::. :::.::::..:::::.:.:..:.:::::.:::.::: .::.::.:::.:.:.:::::.:;:.::::::.:::>....::.;.::....::: city' ................. ::::. ...... ::::.:.:............:::.:::.:: . ........:::.::::::::........... ... .......... ....:.... ... ................ ::.,.. ::. :::•::::::.::::::.:::::::................... :Wi..::i::-::i:::::��i.::�:i:::i�i.::i:i::;��..,:!::...,!��:::��i..:;i insnrencc co.._. . ........ ......... ... ............ Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Hue up to$1,500.00 snd/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Hne 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 !do hereby certify wider the pains and penalties o ei jury that the information provided above is true and correct - Signature Date 140 e 92-jL1 M°� f = e �l b '3 �� Print name >-- / Phone# s official use only do not write in this area to be completed by city or town official city or town: permitlllcense# ❑Building Department . ❑Licensing Board ❑check if immediate response Is required ❑5electrccen's Office . _ ❑Health Department contact person: phone#; ❑Other (revised 9195 P1A) 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. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, 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 rednmed 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 Imlesugadens 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 The Town of Barnstable Department of Health Safety and Environmental Services. Building Division 1AMSPABM ' 367 Main Street,Hyannis MA 02601 Muss. 9 1639. . ��fED MA'I A `Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street _. villager "HOMEOWNER": 4001a✓�.� � name home phone# work phone# }, CURRENT MAILING ADDRESS: Jam$ P�7�,r a t7 city/town state zi6 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,provide d 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 F (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 g k Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirementpq _ 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN r : I I ! 1 f q �II ! I li Ijli III I ( I � ii j � il ! II j Iofvi,i i I j � I , i - j oo� v I f � ++ ol I ' IColI i I II I I ' Ii ! i I L it II I I ! II I I I i iI ►, ' ! j Fri I it I ( II jll ! i I iAl + The Town of Barnstable 9 1659w � Department of Health Safety and Environmental Services Eo max" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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 adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. o Type of Work: k &tg PP_ Estimated Cos 3' O Address of Work: Owner's Name: 1V7 Date of Application:I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied VOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IlVIPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date r Name Registration No. OR Date Owner's Nafne t q:fomms:Affidav *J,�SI - 11?f - d.'G may,,..,:,:->r - ..._.... - .. - f. TOWN OF BARNSTABLE Permit No. ___29165 ------------------- s. _ Building Inspector cash ------------------ iO�N OCCUPANCY PERMIT Bond Issued to S L S Trust Address Lot #3, 35 Ames Wav, Centerville Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector ` Inspection date ' Engineering Department �� Inspection date Board of Health � Inspection date 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 9.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Ile ........... 19"14, . /Z, �'Oe, e Building Inspector t •�y��'. TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING rua �g i659 � HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by Building Permit �fl ............ .. ................................... .................._................. issuedto ............... ) .v../.................................. ............................... ...._ _......... Please release the performance bond. J THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m ^�c� C DATA no:lz AIS ii 8'-, 6 r- ftMIT TOWN OF BARNSTABLE, MASSACHUSETTS JOB WEATHER CARD DATE 19 PERMIT NO. 29165 APPLICANT ADDRESS 1- �i,'.i•.: i . . (N0.) (STREET) (CONTR'S LICENSE) f .`�;(.:.i..'• __ . ,t-,•.•; NUMBER OF PERMIT TO STORY ' DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING ! AT (LOCATION) (NO.) (STREET) DISTRICT 1 i 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 I TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION i (TYPE) REMARKS: AREA OR VOLUME ESTIMATED COST $ PERMIT�' ' FEE v, (CUBIC/SQUARE FEET) OWNER,- d BUILDING DEPT. ADDRESS — BY i THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OF ( ® 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 OBTAINEE FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITION'_ ' OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. - i I MINIMUM OF THREE CALL INSPECTIONS REQUIRED FOR APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 1 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD S® !T IS VISIB`E - amOlm" STREET I BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I L)`�' U y�y`/ 1 �C I� V VVV c ({{j 2 2 2 r� f �w wwl- 3 HEATIN' ' PECTING APP OVALS REFRIGERATION INSPECTION APPROVALS � I OTHER .2 f WORK SnA.LL NCT PROCEED UNTIL THE PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION iNSPECTIONS INDICATED ON THIS CAR: NSRECTCR HAS APPROVED THE VARICUS WORK 15 NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHON: STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION. p 0 rn :e � 3 /s 937S. A:� M CERTIFIED PLOT/ PLAN L O CAT( ON: CEA17c'1/IGL" /t/J,od?SS . F O R:L46—=C3 6L-S otcows Gy� ar7 �•vTCo2p. S C A L E: — D A T E: 142G12/L'3, /-9 R E F E R E N C .51640,k)A/ 8� � ALE o A E ,o,�..av l3oo.rG `�vSL ,O.qU E 3 8 1 CERTIFY TO THE BEST OF MY KNOW ED E G. LAND 5U VEYOR AND BELIEF FROM INFORMATION ACQ ED, THAT THE�;n0A-OA770 ✓ SHOWN ON TH15 PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. SN OF JOSEPH s9cy� M. MONAHAN, At J. M . M0NAHAN, JR . & ASSOCIATES I N°' '3No PROFESSIONAL LAND SURVEYORS .& ENGINEERS l,99fCtSTER�yO� T.OWNE. 'PLAZA - 900 ROUTE 134;" SOUTH D.ENNI_S SUR,� , MA_55. ICEAssessor's map and lot number .............................. ... ....:.... SEPTIC ��'�{�M MUST THE @` f rot a Sewage Permit number ..............`.?�.6.�...�.1.I...................... INSTALLED IN CO WIPLIh►i�IC WITH TITLE 5 :.....3..5....... !...�'.�..�................... ... ENVIRONMENTAL CODE AN t BABMAM LE. 4 House number . ... .. - TOWN REGU'ATIO NS 639. TOWN OF BARNSTABLE ' y , BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................. �D.....:.I............. ... ... . .................................................... TYPE OF CONSTRUCTION ......:................�Q!Z0A.......F**** Y!h5 ............... ................................:............... ........ a 1:.....14..... .19.2 IG TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .................( .........3............a 4..........w. . ........... Cl............................ ProposedUse ................ .. �1�.................................................:.....:......,...:............................................................... Zoning District ................Fire District ...:..................... ....................... .................................. + .............I..................................... Name of Owner ....J -.S ...........................Address ....1.J........��..... .....3..... `t�M,.S?...... "` Name of Builder .6.. �t U�W�.....1"'��`�.t......Address ............................ ................................................. h f Name o Architect ...1 !. .1. ..... u�........Address ... e ..�+ ..........�V�.Q. Iv v ....... Number of Rooms .....................5............................................Foundation ................ ............. Exterior ........Roofing Floors ......................................Interior ............ ,,�h'�C� ...........:........................ ........................I . ......... Heating Plumbing ............. U� Fireplace Q.................................................Approximpte. Cost ................ .3 .................:............... ..... .......... 6. p Definitive Plan Approved by Planning.Board _ ?_ ^ n_I �_____19§__J_. Area :/.��..� ...... . ..`... Diagram of Lot and Building with'Dimensions ` Fee ..... � SUBJECT TO APPROVAL OF BOARD OF HEALTH r 3 , Z/ A , OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... . ............... Construction Supervisor's License .....40.el(9 ............. SLS TRUST A=189-6 M'oY 2.916.5.... Permit for 1 z„st9ry„•single r ..jAf ?,1y..aWp�ainJ.................................... Location ..Lo.t...4.3......35... iTI�S..WA Y Centerville ................................................................ ........... y Owner SLS Trust ........................:.......... Type of Construction f.rame. ......... - .. ....... .. ....................................................... ........................ F Plot ............................. Lot ................................. Permit Granted April..'.8 86 Date of Inspectiorfp -f ...... !319 � Date Completed ..... .�` :+' - s p 19 q S Y 1 L L O V tr ArEs K } , 4 P, WITNESSBY : / . / L �/ ✓ �. 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D i>fT. �.�t *• ,. { �► . i c+ v E tR t b A t>L 61 li C1>I •® o f p 3/4 1 1�2 D t1:'x3f' 'x � 1NvaItT SE PT ICTANIC "�' 1' Q :0 wASHE0 STONE L �/►C N ,,. /�F -" , '►�� I N V E R T R 7 ALL AROUND GA R D A t1 E Q _ rL _Ca PIT . I LE BOTTOM i MtN. iR1NDER "' � rR � �E O1' 4 r ol d , '•- R u N WATER TABLE '�.c3`T✓=,T. / s' PROFILE OF o D �41 0 _ SAN tTARY DISPOSAL SYSTEM C. NOT TO SCALE 1 G N D l4 bo. •` . . ._ BEDROOMS E4r +� GO►N5T" R UCT10N OF SAN ItAR Y Di5 POSAL DESIGN FLOW 3 �% GALJDAY SYSTEM SHALL CONFORM TO MASS. LEACH RATE `� MINJINCH ENVIRONMENTAL CODE TITLE 2: (REVISED 7- 1 - 77) PROPOSED LEACH CAPACITY ' AND THE TOWN OF 2^1rysT.•� LSi.ee` ' HEALTH REGULATIONS. tr: a SEPTIC TANK] DISTRIBUTION BOX AND LEACHING # PITTO BE OF REINFORCED CONCRETE : GAL/DAY MIN. CONCRETE STRENGTH 3000 PSI MIN. STEEL STRENGTH 2O,0 OOP 51 H 10 DESIGN GOADING DRIVEWAYS NOTTO BE LOCATED OVER SYSTEM UNLESS H - 20 DESIGN LOADING IS USED. e ALL PIPES AND FITTINGSTO BE WATERTIGHT AND r TO BE OF CAST IRON OR SCHED 40 P.V• C. IT E P 1. A N SHOWING PROPOSED CONSTRUCTION sH.. oFsHs ? C AT I O Nc .S LEisEND � 0, APPROVED 19 OR = 3 � DATE: 20 G BOARD OF HEALTH SCALE .. .. t !'� E R E N C E t 4.: o �" � �� .�r-t�vv'r�,/ �.+✓ BUILDING SETBACK REGULATIONS PER EXiSTI NG CONTOUR ......+..iQ.." "`- "Lr9+�f � f: + C�. '`Ci, 38 AGENT BUILDING INSPECTOR OR BUILDNNG DATE COMMISSIONER . `�"� c- PROPOSED CONTOUR d MIN. FRONT SETBACK 20 • EXISTING SPOT ELEVATION 17. e PROPOSED WATER SERVICE ._._...W..,..,.....• MIN. SIDE SETBACK �► � + 'VEST HOLE LOCATION $ oRt MIN. REAR SETBACK ctv{4 o 1" size i%c 004* �-�►.�k C. R i SHORT r � � � . .poF PAOFtb.81dMAL -LA1�1D SURVEYORS t ENGINEERS Ess{aam. E V 1566 MAIN STREET (mire. GA) EAST DENNIS, MASS. 02641 �►