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HomeMy WebLinkAbout0040 BAYBERRY LANE 71C/ .416iV it:A All, V.- , g� 5 --gN, '46 Tj W "Up 41 A, ...... k1l: OWYM % x Y. M1,IT I �"X (ty, ,pw ta W WIN MR 'k"�;nmx, ILI 2 0 RNA Zk �z ME 4W0,11-1 tR411 g.q�"!�Ot Y i"w 86 so MIN Ailp 0. f,RM 2 M -!X" ;z! 00 'All lg,q W, I'Vi g PIK, ;m A 'N i ,- � % Dill all uw 'g- p 6, "a'I Ali P"cl- ;�g,!',-, gm ffl;V 'W 44 0 �il"Pg� o", gwn OY14 RINI, 1,WK dr,v. e)cg, R RM A -013 "11 ey i, T9 �,QW-4" A A q 1.10 I M W P, NOW P gz lgw Wn , i NOW `�E t 'V ARM 'A t1w '16 VS, 5 1.0 ,i� g, Xtv KQ AA -yet w 0Z Was I Oil me Vverw5a gum --wW — ;W 'R A 7""f4i 'ff.IN Its .R1 A, t "T I zz X- VIM rg 1"'54, -I %W Ix, 41- MR 3,til vas, f, PRY of 1HE T Town of Barnstable *Permit Ooo0(�`Z f� p� Expire 6 mo it s from issue date � Regulatory Services ` y Mass.ggF_ Thomas F.Geiler Director 03 rf0 MA A T Q 5 20D Building Division �A ) /6� ��//V Tom Perry,CBO, Building Commissioner 0 $ 200.Main Street, Hyannis, MA 02601 �- www:town.barnstable.ma.us 'Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Nfap/parcel Number a6D Property Address ° � '�� �Q��Ln� \� CG?,XI Residential Value of Work `6 D (7 (� Minimum fee of$25.00 for work under$6000.0.0 Owner's Name & Address Contractor's Name-..------ Telephone Number {j�j`�'t�b 6, (r) f Ionic Improvement Contractor License# (if applicable)___ A,-�_(ems q Z3 Construction Supervisor's License'#(if applicable) Qlkorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [�I have Worker's Compensation Insurance Insurance Company Name VV\J A l?}o�` Workman's Comp. Policy# ( to 4_ , I Copy of Insurance Cornpliwice Certificate must be on file. Permit Request(check box) to-roof(stripping old shingles) All construction debris will be taken to CMS ❑ Re-roof(not.stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. 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: Property Owner must a' n Property wrier Letter of Permission. A copy of We Home prov me ntractors License is required. SIGNATURE: Q:`WITIf.ESTORMS\building permit forms\EXPRESS.doc Revised 100608 I NOTICE NOTICE TO v TO EMPLOYEES EMPLOYEES i The Commonwealth ..of Massachusetts DEPARTMENT OP INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 .617-727-4900 .As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I(we)have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED INDUSTRIES OF MASSACHUSETTS MUTUAL INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY AWC 7016215012008- 01/10/2008 - 01/10/2009 POLICY NUMBER EFFECTIVE DATES P O Box 494 Leonard Insurance Agency.Inc Osterville, MA 02655 (508)428-6921 NAME OF INSURANCE AGENT ADDRESS PHONE Mark Herbst 35 Peep Toad.Road " Centerville, MA 02632 EMPLOYER ADDRESS . 01/04/2008 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT . The above named insurer is required in cases of personal injuries arising out of aqd in the course of employment to furnish adequate and reasonable hospital and,medical services in accordance with the provisions of the Workers Compensation Act. A Lth copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician._ e reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary d reasonably connected to the work related injury. Incases requiring hospital attention,employees are hereby notified that e insurer has arranged for such attention at the EARESTAND BEST MEDICAL FACILITY AME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER .fG { \ ss� r = r asF ��I'4 3 b ,r l a i.F ['' L r � - .- ! i rY +{".»1'.,JR't'� j u� ,.�` r`:_ +r �f ,,.w + rra,' ;xt. +n �� :i { l F j r�.4-a;�� "f :, .1_µ3 �`':4,'t y j� efy. vi .3[ " yt`4�' h-'� Irv., �' ti• ` wn t t r F r a iu ras 8 E�k# { t r air E r r a t Y a t r l }:dt�d-1 1.:, Y f d ni,f. -i1 4 r .2 l i hb«'r�r L+ ;.s J FS 4, x. r i L l.,"4" T3} a # { 9l a"` y; iK f F i a t,Ftsf 2��r .�4 `ei r, yr r i , 4 9 s v y ✓ h= MARK HERBS i g� , .t � '�y[h.,, i C ` {, E`5 -7 fi ✓f 4 S ) }T(, ( a"'Ev ' .b it � - '0. � t Y ek 00 CENTERVILLE MA.03632 r � f ` ,� 508-420-6216/774-238-293 � ' (/y�y r 4 t www.markherbst.com J PROPOSAL SUBMITTED TO: WORK PERFORMED AT:, x t Sat4i, i`j Y r g Dick Cole/la K 40 Bayberry Lane same r � '. 508-771-6903 �1} We herb propose to furnish the materials and perform the,labor necessary for the completion of: �'. Y New Roof Remove 1 laver of existing shingles Install ice&water shield at edge&in valley areas Install 151b.felt paper fi' f`r Install Certainteed Shingle of choice Replace plumbing boots ` Storm nail all shingles E v Vent ridge with cobra vent <F k, All debris cleaned daily ` Price includes material.labor&dump fees �F Main roof Certainteed XT 25vr.shingles $4 250:00( ) - Entire roof Certainteed XT 25 r. /shin les 7 650.00 Entire roof Certainteed Woodscape 30yr 8100.00( r y 1 ' y 4� _ ! Please check&initial choice above,Thank You a w th the s All material is guaranteed to be as specmed. The move work Will be performed in accordance �....h_ pecificat�ons submitted x and completed in a substantial workman-like manner for the sum of:as specified above.&verified with your initials ) r Dollars( )with,payments as follows:full amount due upon completion S r y �l *Any alterations from above proposal involving extra costs will be added under a separate written agreement and become an extra charge over and above sai' 'proposal RESPECTFU S � l 10118108 r �s Mark Herbst 'h r ACCEPTA, NCE OF PROPOSAL. The above price,specifications and conditions are satisfacto .I herby accept this proposal, You are authorized to do the work an+ 4 r 2h - payments will be as ec'' ab ` f "r SIGNATURE: IV ry *This proposal may be withdrawn by said company`tf not accepted within 30 daysA. a I 1 I: 'Su eririsor License i, Construction P Uc nse CS '48546 l Tr#. 14362 f< iratlau :12712010 j Restriction r i --MARK HER D ✓��- i 1 % 35 P4�T TOAD RD II Comm►ss�one� CENTERVILLE; • �� U�OI77/Il9b/2CIJP� �L✓vG[ZOOCLC/LCCdP.�6 I . _ Board of Building Regulations,and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR I before the expiration date. If found return to: Registration 126480 Board of Building Regulations and Standards ! ExPWAUQP 6/8/2010 Tr# 267766 i One Ashburton Place Rm 1301 3' Boston,Ma.02108 ( p'ype I diuidual. ` MARK HERBST i,", � i, i MARK HERBST x . 35 PEEP TOAD RD`�4 CENTERVILLE,MA 02632 Administrator Not valid without signature I The.Commonwealth of Massachusetts Department o Industrial Accidents Office of Investigations a 600 Washington Street Boston,AL4.02111' °,K ,�•�' www.massgov/dia ' 4Yorkersr.Compensatiion Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Nate (Business/Organization/Individual): ' •Address: �?� �ee� ��Q-� C� � - City/State/Zip: Ce �� Phone:#: `fib h Are.you.an employer? Check the appropriate box: .Type of project(required):. " �' 4. g I 1.I�1 I am a employer with�_. _ � I am aeneral �contractor and 6. El New construction . employees(full and/oxgart-time).* have hired the sub-contractors 2.[l I am a'sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, n Demolition for me iu an capacity. employees and have workers' 'working y P h' 9. El Building addition [No workers' comp,insurance comp.insurance.$ required.] 5. We are a corporation and its 10.n 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 12 [ loaf repairs insurance.required.]t c. 152,§1(4), and we have no 13 Other employees. [NO,workers' comp,insurance required] *Any applicant that checks box#1 must also fill o.ut 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 state whether ornot those entities have employees: If the sub-contractors have employees,.they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site' information. Insurance Company Name: Policy#or Self-ins.Lic.#: �Z3 l '� 1.5� l,:�kDnS Expiration Date; lob Site Address: VIC City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy.number an expiration date). Failure,to secure coverage,as required under Section 25A of MGL c. 152 can lead fo 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. e.advised that a copy-of this statement maybe forwarded to the Office of Investi ations of the DIA for incur ce coo ra e v on. I do hereby certify under the p s-a naltie o ury that the information provided above is true and correct. • _ . Date: Signature: Phone# 1f1� r0ff7.clal use only. Do not write in this area, to be completed by,city or town official 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#: Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute, 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 to stee-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, §25C(6)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 pro.duced.acceptable evidence of compliance with the insurance coverage.required." Additionally,MGL ehapterA 52, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter work until acceptable evidence-of cornplianee with the insurance into any contract for,the performance of public requirements of this chapter have been presented'to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contzactor(s)name(s), address(es) and phone number(s)along with their certiftcate(s)of insurance. Limited Liability'Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members'or partners, are not required to carry.workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that ibis affidavit 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. Self-insured companies should enter their self insurance license number on the appropriate-ad. City or Town Officials 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. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city'or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be felled out each year.Where a.home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person.is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. o Cozri oRwwth of musarhusetts DQpart=ct Qf Indus al Acci& .ts WE."of la-Vest gatious 600 Washinatari I Street Boston,_MA 02117 Tf1. 617-727-4900 ext 406 or 1-977-MASSAFE Fax#,6.17.727-774 _ Revised 11-22.06 www.mass.gov/dia t ) Assessor's Office(lst floor) Map / p e Parcel 661 rmit� Conservation Office(4th floor)(8:30- 9:30/1:00=.2:00)'V'� "a��c. Date Issued /o2 96 Board of Health(3rd floor)(8:15 -9:30/1:00-4:45)/A%7•1 1 � Fee 3®1 Engineering Dept.(3rd floor) House# SE C'Slf ST.BE rovedIN LE ANCE lvkl y ammng Board - 19 U MHONLII ®E AND TWA� h t TOWN OF-BARNS-TABLE. Building Permit Application ;t- =� ' x,�_ Project Stree ess � (,� illag a /Owner) t.. e, ' Address . D Telephone 0(6- '? io c(0 : / I'ermit Request MO & A L4,4()kJc&q' 4—W11 Ca 4— d-sej*le, First Floor /,PO sQ�� pal square feet Second Floor square feet ZEstimated Project Cost $ 000• 6 d Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family I/ Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House N Unfinished Old King's Highway fl Number of Baths No. of Bedrooms Total Room Count(not including baths) 6 First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder� Information am y Telephone Number ddress /0 l�eep Toc License# 9 J� C- ome Improvement Contractor# !b(a O�G Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /J Ile- 0/5 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. Ile - DATE ISSUED F MAP/PARCEL NO. ' e f ; t ADDRESS f. f ! VILLAGE +. OWNER � '• - . DATE OF INSPECTI(TI FOUNDATION FRAME '! • h —��"(�.� �,�� INSULATION FIREPLACE ELECTRICAL: ROUGH e FINAL PLUMBING: ;ROUGH FINAL _ ` - 'A GAS: 'ROUGH FINAL FINAL BUILDIN}G U as //a ll tz DATE CLOSED ASSOCIATION PEAK NO:'' ' it ! p t ! The Conttnontrealtlt of Massachusetts A• 1_( I - %!�: L�..tv Department of Industrial Accidents tOflfceol/IW959gat/oos 600 11 a.vNize ton Street- ` �--1 x Bi stun,Mass. 02111 Workers' Compensation Insurance.AlMdavit r ..,••rr- -—•,-- tc �. 96n,r7s�� / l'o P,e tovao 1 am a Homeowner performing all wort:myself amysaa sole proprietor and have no one working in any capacity. I am an emplover providing workers' compensation for my employees working on this job. company name: address: cotv" phone#• insurance co. olicy# 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: comnanv name: atidress• city phone#• insurance co. Rolicv# 1._.:..'r"..-- ••'-- - _..-. acne:rr..�..:aye+—?Tr,;'<•'eTtce; .xR;?w• �F✓'-*4"7� - "�:�� ctimnan•name• address: city: phone#• insurance co. nolicy Al :Attach additional'sheet itriecasary ._• »::.•r s � �t;'c:.fr rWt ". o. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to SI.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification. I do hereby cc iffy u tier t wins of peduq•that the information provided above is true and c7Xq I Signature ate 1 5� Print name �i � cC 5-NUS,6/ Phone# ✓ S V e—8-5 9-7 FC do not write in this area to be completed by city or town official permit/license# rIBuilding Department Licensing Boardate response is required C3Seleetmen's Office �licalth Department phone#; nOthcr (revised V95 PJA) 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 e►aplitt,ee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An empl(�yer is defined as an individual,.partnership, association.corporation or other ;cgal entity, or any two or more of the fore-oing engaged in a joint enterprise, and including the legal representatives of a deceased emplover, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. Flog+ever the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwellin, 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 1'52 section 25 also states that even,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 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 affidai it. 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. r•+•.:•1P•M+��1OR �1�^•CL.�'.�ww,.,,i.•�•�1•�F-'1a-7" , - _ r,�T t•iF...�Y ♦ _. ... Citv 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 full 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 lnvestications 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 Washinaton Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 r . _ The Town of Barnstable ;P Department of Health Safety and Environmental Services1� Building Division 367 Main Street,Hyannis MA 02601 Offi= 508-790-6n7 Ralph Crosses F= 508-775-3344 Building Commiss. For ace use only Permit no. Date AFFIDAVIT HOME MoROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERBUT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,rt: *,modernization,conversion, improvement,.nnncn-4 demolition. or construction of an addition to any pre-etasting owner occupied building containing at least one but not more than four dwelling units or to saucWres which are adjacent to such residence or building be done by registered contractors,with certain eroctptions, along with other �v �s►pe of Work: 41111-d� - 4rhltl-4421�lfL Est Cost O�q.10 Address of Work: �0 &q BeOq 4/'Date of Permit Application: 4 ASA 5" I hereby certify that: Registration is not required for the following rcason(s): Work excluded by law Job under S1,000 Building not owner-occupied Owner pulling own permu Notice is hereby Shen that: OWNERS PULLING'THEIR OWN PERMIT OR DEALING WII'II MWXGISIED CONTRACTORS FOR APPLICABLE HOME "ROVEMENr WORK DO NOR' HAVE .ACCESS TO RITE 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: lit A5-- 'an No. Date Contractor name u OR Awal DEPARINENi Of 4UBlIC soul CONSTRUCTION SUPERVISOR LICENSE Number D7/26/1157 , Restricted to .00 . F s SENOSKI • RICNARD i r � (6t1►`" Q' .;. :.{ 10-PEEP IM RD CENiERVIIL, MA 02632 � ` kIOME.;IMPROVEMENT��ONTRACTOR � U6009a `t�eg`strationMW c�� • - � �TYPe `���INDI�j1DUAL� �r�� X. r'�07/21 9�6 k ira1.0n iEp '� ;i a use tt1c � 9PIT , Tcar� TjSenoski' ` AIM, Ogg Toad Rd� r� �1�.�'L'. � Centerville MA 02632�,d"boa,s ' 5 t4'sADMINIS TOR *, i b Ltd. A AfttrrQ f i ' t �t Gr+a . �;( p• .y PLY, o ^ � t 6 ou." P,3D u 19 f: ^ r • r. {ill ' It: { 77 `PleT— j I F - , ' re ro4c c , w C�,, o -- Q� �� d 1. : 1 d• �� I ��� � t � � � � :. .� • � � ,rim � /I �d+tea i�� �`♦ ,��I� + � ,�.• , �•� Assessor's map, and `lot 'number Sewage Permit number v�� . !� j • .y,. G�F� °`?"ET°�� TOWN OF BARNSTABLE BARNSTABLE.'i , "�` 039 B�URDING INSPECTOR 9�p . 9� t . i!, t' r APPLICATION JOR PERMIT TO t: TYPE OF "CONSTRUCTION ............:......! y�,,,,, ....... .......... ................. . ......rr t/ ........1. �................19..-7�... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .................& li t'✓.K. ...............L.�..�-................ � �r�l;�.l.C...... ( sS..................................... ProposedUse .........................Y........ ........................................,.............................................................................................. Zoning District KC_ .......................................Fire District .... eK'C'erv�llL © s�e✓,,: I (� Name of Owner A1........1.!IA.Y.i.C.........4 .�H. �t�/.......Address .........G.a. .L.?t'e!7........� `X9tV+V!:9).fe J 3 I n r� 1 Name of Builder ...!./.vv.. �C.!?1.�i e' ...............Address . o.......... Q�1. ✓V�.........!.!........:... ✓.Y. ... Nameof Architect ./.................:...:............................................Address .................^ ......................................................... - INumber of Rooms .................Foundation .?-0.,Lk .......... ........................... Exterior .......................- .......................................................Roofing ........1t?s. .k.e.�..l..............sL.kLs e:..................... Floors ........ Y1. '! ..............................................................Interior ...........d!."'`. .......................................................... Heating ...... I...............................................................Plumbing ..............• �L. .!................................................................. Fireplace ..... �+... � .....................................................A Approximate Cost ...... ..... p in•........:........... PP I ..........,........................................ Definitive Plan Approved by Planning Board -----------_--------------------19________, Area ..... ......s Diagram of Lot and Building with Dimensions Fee (I.5a SUBJECT TO APPROVAL OF BOARD OF HEALTH 1a0, 7 4 00. ,n46 r G E . o (0�. 6 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name `....I►A�.................. .. ........ i •i Campbell, Mrs. Marie No ...17219.,. Permit for ......carport ............. .1.. :.................................................. �/ �.'•/ ti Location ......... .....Bayberry....Lane................... B ' Centerxdl le - Mrs. Marie Campbell ` .�_ Owner .................................... ...P..................... •� frame r Type of Construction t f ....... ............................................. ................... Plot .......*.................. .. Lot ................................ i r 3ZB ,July 17-- 74 Permit Granted ...................................:....19 ._ ' ,Date,of,Inspection ......................... ..........19 Date Completed S ..: u... ' 19 • 4 PERMIT.REFUSED . ....................................................... ..... 19 ........................................................................ ... ....................................................................... _.r•� ..-- ...,ter � r ............................................................................... ............... ............................................................ •, -_ - Approved ............................................. 19 wt Assessor's map and lot number ......:... .�...... . f Sewage Permit number .. °FT"Er°�� TOWN OF BARNSTABLE Z BARNSTABLE, i p� "b 9 a. BUILDING INSPECTOR 'Ep ypY . APPLICATION FOR PERMIT TO � ov i TYPEOF CONSTRUCTION ................... r........:4-r................................................................................................. ....................�................19....../ l TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following,information: t ' Location k ProposedUse .............. :✓............. .................................................................................................................................... Zoning District- ........Fire District rr- '"p'/')Ic Q J r''' Ile i...................r..................... (....................................... ..... ..............t..........i..... Name of Owner .� K' ......... ........1...G e I1.......Address A?F:..`.� A✓r-�, � r%t. ....... .........:. .......... .................................... Nameof Builder .. ...r.::.:................. ....................Address ......................�..:. ..... ............................................. Name of Architect ....................,..'......................................Address .................:..^.......................................... Number of Rooms ..................................................................Foundation (.�'.^..(.v r......:........................... Exterior ...Roofing o s ik 4............ Floors ' .Interior ✓1 �- r Heating '! ert f Rlumbi.ng...°':..........................Stn ........ ......... ..................................... ............ Fireplace ..... ...........................................................Approximate Cost ....... 03...!ro ........................`............ Definitive Plan Approved by Planning Board ________________________________19________. Area ..... ........ ... .:....... y 4/ Diagram of Lot and Building with Dimensions Fee a ff SUBJECT TO APPROVAL OF BOARD OF HEALTH /F1 25 T � lot. b I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. U Campbell, Mrs. Marie q `6o r No ...17.219... Permit for ......build carport .................I................................................. ...... Location ..iPBayber.u...�Fane....................... t Centerville ............................................................................... Owner Mrs. Marie Campbell ................................................................. Typemof Construction ...........-frame ................................................................................ Plot ........................ Lot ................................ Permit Granted ..........quly...17..............19 74 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ................................................................:.............. Approved ................................................ 19 ............................................................................... i