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0021 BEECHWOOD ROAD
o 11 �/ .���- V n ; �. { � . _ a 1 .. Y ' - � 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION fV/ Map es Parcel (y Application# &)d 66 06 6 He Ith Division 042 C rvation Division Permit# Tax Collector Date Issued Treasurer Application Fee Planning Dept. Permit Fee bib Z. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 2— Village Owner' s Address -2-Iic- s�� mac-, r 1 Telephone -, -I Permit Request t Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total.new Zoning District Flood Plain Groundwater Overlay ;: Project-ValUation o�' �4 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting-,_documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure `74) +a�cr Historic House: ❑Yes allo On Old King's Hig, way: 0-Yes r .14 No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes . O No If yes, site plan review# Current Use Proposed Use /- -' BUILDER INFORMATION / Name Vcc ' /&&JL -Telephone Number Address �a� di cS /Q'-Z-� License# VLSI /ylo+kc Home Improvement Contractor# Worker's Compensation# 7s1//.2 `00 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 6 C SIGNATURE DATE ?Y Ofe FOR OFFICIAL USE ONLY PERMIT NO. I .TE ISSUED _.�P/PARCECNO. i R - ADDRESS VILLAGE OWNER x DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 15.9-Pr-2Elj DATE CLOSED OUT ASSOCIATION PLAN NO. i . C1 N a RA =59.7G 2' X 4' SUPPORT RAIL 2' X O' PLATFORM EXISTING GROUND 4' X 4' PT POSTS •�e� 2' X G" PLANK STEPS C2) �x/Sr�NC 2' X 10' STAIR SADDLE RUNNER C3) G G ANCHOR BOLT IMBEDDED IN CONCRETE FOOTING Q��O and 2' X4O R RUNNER SADDLE RUNNER SUPPO WITH REGULAR 5IMP50N POST BASE. 7 RISER 1' X 5' GUIDE O owner must re i� R P-59.76 \\ Z �► EIUSTNG�ROUMD \\\ G RISERS � N w W •snu�u pAE \ _ O �D RAMP.53 r��' f� R WOOT SYSTEM \\ p • W V 1 '+� MODCI Dr]O•USE \ \ DS RNO DI•METER I1J \\ O\\ Q tLa J C� J BEACH o 8' SAUNA TUBE n /�n� a O W �► z 0 0 o a� BIFOOT SYSTEM QZ a MODEL BF20; USE D5 RING DIAMETER Q� o co Z v Ga co GROSS SEGTION OF STAIRWAY FOR JOHN GONSALVES wad HORIZONTAL AND VERTICAL SCALE: 1'=4' �z 11 NO VERTICAL EXAGGERATION .1 ;., E-F E U Jo&eph ;DaLuz Telephone: 790-6227 Building Commissioner TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE. BUILDING HYANNIS , MASS . 02601 DATE: T O: 9� �J Ott e S ��t7 u1 fi.tl /✓�9 �e A � 1�'��� % Trie inspection at ec4IAend � does not comply with MA Building* Code no. -3 Please contact this office for reinspectian. Trunk you , Building Inspector AEM:km HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of 'auilding Regulations and Standards One Ashburton Place - Room 1301 Easton , Massac�lusetts 02108 HOME IMPROVEMENT CONTRACTOR Registr a.tion 104236 Expiration 07/13/94 Type INDIVIDUAL HOME IMPROVEMENT CONTRACTOR Registration 104236 Type - INDIVIDUAL James T . McGowan Er,piration 07/13/94 I 139 Sea St . James T. McGowan Hyannis MA 02601 139 Sea St. Hyannis MA 02601 ADMINISTRATOR I Assessor's office(1st Floor): 77 Assessor's map and lot number A'�a'.O©� THE Pao Conservation Board of Health(3rd floor): t t+�srAni Sewage Permit number Engineering Department(3rd floor): e %6 o• House number �o Hsr Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN - OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO "Re t"OO"F p r -H O TYPE OF CONSTRUCTION _ k0 l / 19 9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according tothe following information): I A ,( Location at BQ-Q�tuOOC4 Road C{�V)+Zryib[eT IVIf+- C) 3 2 Proposed Use ' Zoning District .p Fire District B r II Name of Owner D R. LOB E Kce -+EAa d2 S1 a vt Address Re� u1 i T►rc;i ee 1�' c n � Name of Builder J GtMeS - l���t a'►.`- Address_SQa S-6-r-efOVA Name of Architect Address Number of Rooms Foundation Exterior Roofing , Floors Interior Heating Plumbing �J Fireplace Approximate Cost / 0 Area Liu'PA aL8�-� Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS T r . 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstabl regarding the above construction. Na Construction Supervisor's License ioa�.l LeSHAN, DR. LAWRENCE & EDA Cr r No 3 5 5 9 4 Permit For Re—ROOF PORTION _ ► - Single Family Dwelling _ Location 21 Beechwood Road ' u i ~, -c . 3 -• `. t, _ , r j Centerville Owner Type of`Construction' Frame ., I , ! Plot Lot _ ? { 71 C Permit Granted January 4 , 19_- 93 k - � Date of Inspection -19 j ` Date Completed 19... - - ._... + +. ` '-! ' ��j?' fT a ~y�.`y\ •� •t a _- ..' �,� .......' � '� r�s.,1 {y Ill. \ Assessor's map and, lot number ........................................... SEPTIC SYSTEM MU ST Sewage Permit number �.c�%i,.. , .�• / iS INSTALLED N COMPLI rem �♦'► 0 0 WITH ARTICLE II � S STRT Z BASB9TeFILE, • House number ............... SANITARY CODL AND mum 1639p 9� REGULATIONS. TOWN OF _ BARNSTABLE BUILDING' INSPECTOR z APPLICATION FOR PERMIT TO ..:.....V�.! 6' .0...�'�`..................... .. TYPE OF CONSTRUCTION ............... 1+�� ................................................ TO THE INSPECTOR OF BUILDINGS: y The undersigned hereby applies for a permit according to the following information: Location ............�9 �......S .GN woo- b... Ifc�--...........�F—Al7W0,V/L�� ProposedUse .....................n.....1........................................................................ ............ .......................................... ZoningDistrict ........................................................................Fire District ........................................................................:. Name of Owner ��F 2C,3 . ...............Address NE ✓ Name of Builder Address f 7T �/i/ y92/A1P re .... .... eG ....... ........................ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms / .............Foundation ...�p..v.2U ................................. ......................... Exierior ............. ..C c.aE ... /!Y. ��.......................Roofing ............64 i?►',A- ] ................................................ Floors ......................................................................................Interior ........V!�X ?,! dl ............................................... Heating �r'/9-J ks�.i`:�!vsr7-G/..................Plumbing ...........Mp-V'F.......................................................... ................................... .. Fireplace .................../............................................................Approximate Cost .... ............... ............................. Definitive Plan Approved by Planning Board ---------------_---------------19_______. Area .........................................:,�'`� Diagram of Lot and Building with Dimensions Fee ,'1t ®0 . ............................... ...... SUBJECT TO APPROVAL OF BOARD OF HEALTH let 40 o ' I� road Naw I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. .Name .. .. .. .... ....... ....................... . ,............ LeShan, Eda a . 20920- remodel No ................. Permit for .................................... ...................................... LScation ............21...Beech.wood...Ave................. .... .......... ........ ...... . �7 Centerville ............................................................................... Eda LeShan Owner .............................................I.................... Type of Construction .........................frame................. ................................................................................ Plot ..............I.............. Lot ...... .................... Permit Granted ..........De-cemper..20.......19 78. ,. Date of Inspection ... 7 19 ...7 Date Completed ..........19 PERMIT REFUSED ................................................................ 19 .............................. .................................................. ................................................................................ ............................................................I.................... ............................................................................ Approved ................................................. 19 1. .......................................................... ................. ................. ........................................... Asseszip, M - and lot number ................... - Sewage Permit number / Z 89flH9TABLE, i House _number ' 111"oc 1639. IL ♦� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO .......... ........." ............................................................................................:......... TYPE OF CONSTRUCTION F" .. ` I'� ..................................................................................................................................... ..............................r................19........ TO THE-INSPECTOR OF BUILDINGS: The undersigned hereby 7applies for a permit according to the following information: } Location ............. ......... : x .-.. ....... :'..': !.. ... `✓ .:...........(.j .:�!`......� .:`..'.E.1.E. . . ProposedUse ..................... ti.. .......................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ..' !` ......''..�'...... N n/di`................Address ..3.... t?...fir f.aa.. f+........ ... .....:........... Name of Builder ..... ....ClJ ....... ..................` ..!.`..'.....Address 6.-4*:`....Jv.:............................ .........r....................... .. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms Foundation ..:?.::..:: °?. �'.r� ' .. r . �- j .... ,............................................. Exterior '"✓ ! fi.. + r f,rirr�_ Roofing 9 ! �•�, t,c i ............................................................................ .................................................................................... Floors ...................Interior ......-�:!rr� r cr Heating ............... .........:............:'.�...�' ...........:`................Plumbing ............1....'..:............................................................ r� .. i p ..............................Approximate Cost ........:.... Fireplace ..:................................................. -....................................................... Definitive Plan Approved by Planning Board -----------__-_---------------19--------. Area ....`.::......:..:......:................ Diagram of Lot and Building with Dimensions Fee `............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 ! � u I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / { Name ............... ..t........................................................... LeShan, Eda, 9 A=252-2 < No .......20920 Permit for remodel ........................................................_ ................ Location 21 Beechwood��. � Centerville Owner Eda LeShan ............... .................................................. frame Type of Construction .......................................... ............................................ ................................ c Plot ............................ Lot ................................ t Permit Granted ..... ecpmber..20.......19 78 , Date of Inspection ....................................19 Date Completed .. ...................................19 i PERMIT REFUS ± ........ .............,//..... ............ 19 i 4 ' ....... ................. . ..................... ....... .. .I. .! ..................... ....................... . ............................ .................. ! Approved ................................................ 19 ............................................................................... ............................................................................... �) 67 � V1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel oo r Permit# Health Division 2-52 002 `�- 0 3 Date Issued' 6 3 Conservation Division 1 10-3 /L a r 15 FM 2 Application Fee Tax Collector a Oda 0 k - ML — /S/D3 _ ,Permitfee, Treasurer 0 � iN L- _ 9h��LSIPM 3" SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board 1AM TITLE 5 ENVIRONMENTAL COOS AW Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address -Village C,OAC�cN,)I Owner AVp C0dhS'a`Q'Q-S Address -2,) ) Telephone Sy`�-? 7 ci-190'7 Permit Request Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation LLkom Construction Type ys�;� Lot Size. I+ 1<3 Grandfathered: ❑Yes ❑ No If es attach supporting documentation. � � � yes, PP 9 I Dwelling Type: Single Family X Two Family ❑ Multi-Family(#units) Age of Existing Structure 304 Historic House: ❑Yes 50o On Old King's Highway: ❑Yes *0' Basement Type: 14 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) (eoo Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 1 new Half: existing new Number of Bedrooms: existing new + Total Room Count(not including baths): existing S" new First Floor Room Count Heat Type and Fuel: gGas ❑Oil ❑ Electric ❑Other Central Air: RYes ❑No Fireplaces: Existing S 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-_ 5�1"; - -Proposed-Use- BUILDER INFORMATION Name V _ Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE 4 13" 200''S FOR OFFICIAL USE ONLY i PERMIT NO. ` r DATE ISSUED MAP/PARCEL NO. " ADDRESS VILLAGE OWNER l � DATE OF INSPECTION: FOUNDATION F FRAME INSULATION FIREPLACE r .. ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH f FINAL 1 FINAL BUILDING '> DATE CLOSED OUT - " r ASSOCIATION PLAN NO. N t I . - KGNCY, MUKAN I IVNAN, IN(,_ 01 REGI5TERED LAND 5UPVEYOR5 NAME JOHN GONSALVES 75 HAMMOND STREET WORC>=5TEK MA 0161 o LOCATION 21 BEECHWOOD ROAD 508-752-8885 (PHONE) CENTERVILLE. MA 508-752-8895 (FAX 1) RMT@CONVERSENT_NET(EMU SCALE 1" 30 DATE 05-14-03 REGISTRY BARNSTABLE am eowow 14838/261 Mm NPQN ooamodrod+r�tpaoE0. �vw w ei iE wIOaQASE Aao aoom OFrtiAaa eooaNRAN 567/30 ON IRIS%mrAm dmtip MAL a am Al vmz owom ARE EI I AM 106E ARE NO YwAm16 ■E cvmrr DYQ Tw ofto m ARE Nw WHIN im OF ZQKM RUMONISM REBVOIW SOiuCMn i0 PNOPlNTY NNE WSM Oft=OalE MSE NONE N�pOpY�A�NMG BMW*. Am"m spom nm IMew NUJ►Sm no No: RUM OR �1 IW FM 6• AMUMM L ofspecmn�Nor m oo mw USE m 5 C am 8-19-85 OW FDCE.01H R BOUNU r aQ To ftma SHRUBS LWJMM OF I E s Is one% NO.2M Rm Nmm LmE ME am oE�n w so"we IN ooNvugm NON uru"m PIeDpERM vE OP�5E1 a Nm v 140^E NNa e�pwo ARE ao�ou Nrs,an�a momm MGM%11 moN owancom a Acn00 v WaL e-ME W CWP-40k SIX-7 was$ we ANa s wmm►.mmm so"a om6ra E mum 7m SON a NON- E /� per,ii�F1�C 4W BE OE10M L!NNW as wee MR ma wormoN iNQ IRE*#*M ►WN!poomm a AmmaMY t w�6D o xw L 711E YFI\W/lE- owaaaaea ANag tN� Certaf' led to: Washington Mutual Bonk FA , John Gonsobes r Z A SH `n LOT 39 b :v a 14,209 SQ Fr* op ti pp r _ law / w _ Q LOT 39A 2 HOUSE s #21 - 7 3.57 Fr i L � � 8 00 SO.65 FT R :1 R 130.03 FT BEECHWOOD ROAD Town of Barnstable Regulatory Services MUMSTv "B 34 Thomas F.Geiler,Director y6. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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. Type of Work:����� < Y (J�C C. 11nn \\ r Estimated Cost 29,OO O Address of Work: _2- Owner's Name: C�V\S2�Je S Date of Application: 7_r"Z�3 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 FIBuilding not owner-occupied 540wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. 4 SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Dad Contractor Name Registration No. OR ( c I S 2eo Jd� Ga Datd Owner's Name Q:forms:homeaffidav I cs�r-1� The Commonwealth of Massachusetts -- -== Department of Industrial Accidents 8=8 OURVOSAY Mans _ 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance davit �w��li����� ��a�iaiiiiiiiaiiaiiiiiiiimiii��im�����������/ � ////%%%///%%I/�%%%%% name location city phone# J-0000 -77Z 1 0-1 I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one worku in ca achy % /GOO/�G/%%%/%/%%/��%%%/O/%///......%%%//%/%/%/%%/%%%%%///%%/%/%%/%��/%%%%%////% I am an eroplqrr.prqyiqing workers' compensation for my employees•working on this job. : :::: ��1`isa���ye$'>3?>^i?%%3i' '%??� n! t t?i2>2�+'' sys!�`t? iayji%{?%`i?� ±:i ?'':':+?:?:%>ii;j:j.;.;�;jki%:i;?a;: :�:i2:i::iY::?:isisi<2"�`i::;:::;:'.?:i':isi::a>•t`�i:Y:i::;:j:�;'2:>;:::;::?`;`:::::?;>.<;::;:<y:22•}:•}a:;}:.;:.:•::.::;.:;<;_ ?�::• .... :itiin'4}ii :eyy :dt:. .w. e NCO > ?'> <ci>'>`:>>>?JG% z>:`«:<<:>>:<'<`. ' > ;<<: >` < `> : alit=v riseraac /j I am a sole proprietor,general contractor, or homeowner(circle one) and have hired the contractors listed below who have thefollowin workers' co ensation polices; :..:.::::::::.:::::.:.:..::.:::::.::.:::.::..:::::::.::::.:::::::.::::::::.::::.::•::.:.::.:.::::::..,.::.:,:•h-:�,v. ;•t..;.:t. .�.`riain }F.:i'.ii:�ii'`ii<.'?:;!;i�i i:�:2:i}i%iy:: iii::�ii:: ri:v}: ivy";:;:y?:. .....................::.�:::::•::::::v:.........•;: ...... v::.:� •::.:..:.�:: .ry•:;• ' -XXj. .•s.S::i j�Y';i'"$iiiii"i`i`:i;::Fi.',:}isi:'tr:ti;:;:;:::;i::::.;:is�`:::;`?:�i:2�::;:i::}< <;:v:}::.i;<}:::;i:;:::::;:;i:;::;:;:::::n:?;:;}'r:;:;:j:y:::::'.';:i�ji::::::?.:>;i:�:i$i i:4i::y v:{:}:}:...... :;:: :addre ......... "4 n}v.}.•{t{.}p};::v.}v:p;::::•}':•h;.}:•::.r.,�}•::::�{•}:::''::;ti?•>yv.:v;?.Ott:.,;{.},:;t.}v:::.....•;•::....::....:::......�:.....:......:..:.................. :::::::...:...::.�.:.�..:n�:..:...:•:.•....;w::.;::.•±i:•.:�::.�:4:;::•it4•:?v:t::w'•:;i:•:}:t?v;:vii::::::,:v:}i'::.tv.:::}:.;�:v.}:v;}:;•;;j:::':••i':•y,:::::.•. .. :::.�.:..�.: ::tvi}}:?•:i}:•::0:^::vi`:j?jiiiifi:viii:;%:invi::ii;;}:y�i>:�i:({:';:j:>:!v5((:;:};:•:'iii.i�i�i�2�j::::::i:;:y}:ji}iii:iiSrii::y+:::iiii::i4:�iii: � �i;:{::#:yi;:y;:y:;:#;t:j iivii:`vivi •:S:+Z�:t.. ��':o:`•;.. ..chi... , '{��,�':#.'i:;:��i: t{i;}:y{?�; }:y�:±:::i:;:;:y.?i::i?i:::::::y;:;q;:••:•.yw•:'4;:yi}iii^>}•tea}i•.}:.v}:q}}:v:?C::}:{:.;;:: ... .................. ... .:.:....:::...:::.:.:::.....:•:.•}:.:::.::aat •::.:......... Olt ... .... .........:.:.:rsa > «: ::isi4:•r.:'S:%:;:;?%S:%iy:::+.::::L::i:<:�:.';::y::::;:;::;;:;.`;:.,;::;<?;::<:y�.'•5::;:;:;:%;;:�:;:; i:::;<:;�:;:�:y:;:a�:::;>::;:;;'.�S:�i:�S:;::;:;4:i ;:::::::...... iii;i:�:;}>:;;::;.>:•:?;'>:-: �:::>�:'}:->:::'{.}:•...::.;....;..::;:�:,!j•:?y:�i:�i:•i:.:-:::F•}:':::':::vii:ii:.i:•:::•.. gdclres :.::;:•: n :. ......... .......:.:..::::................... :.......................:........... r » '»»': ....w '•�'''�''i"E } ;i? j;i ;` 2 ':'•, i "E"i2�i?�`?is=::i:+�i' `iji'?` uli •riinr$ace Failure to secure coverage as required under Section 25A o[MGL 152 can lead to the irllpositioa o[ertminal penalties of a ftne to SS,SOO.QO and/or one years'imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a Sae of SIOO.oO a day against and I mndetst�d that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify the pains and penalties of perjury that the information provided above is true cu/d correct Signature Date `1! 1ZI200'� Print name Phone# Official use only do not write in this area to be completed by city or town official city or town: pernritilicense# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectrnen'a Office El Health Departrnent contact person: phone#; ❑Others_ (devised 9/95 PIA) 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,neitherthe 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 in mrance 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 phone numbers along with a certificate of insurance as all affidavits supplying company names, address and may e or confirmation of insurance coverage submitted to the Department of Industrial Accidents f . 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. V 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 penmtllicense number which will be used as a reference number. The affidavits may be retained 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 Invesugatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 Town of Barnstable �F tME T� Regulatory Services • Thomas F.Geiler,Director • BAMSTABIZ 9q, 16 9. �• Building Division AIEo �s Tom Perry,Building Commissioner 200 Main Street,`Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ISL)�� JOB LOCATION: number street- village . '�IOMEowNEx': �o�v� GOvIS�� S �oQ,77 -190'7 50P1-3�?-2�42 name home phone ��# work phone# CURRENT MAILING ADDRESS: 2 I 1 o - 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 su ervisor. 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 yermit. (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 ofBarnstable Building Department... minim inspection procedures and requirements and that he/she will comply with said procedures and Si 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 Coded 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." A 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 pemnit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a farm/certification for use in your community. I • 2 `�, mot . oa� `�- C js�hl tin - ' - -poSTs'. 4`",c4#' �2�SSUR� a�'• p��w S �Yh•v w �5 F1111c\ 1-2• Sow ATvg ___ 41 ZSC�` '2—`�c 8 '7 • i-.�� E, To Ex�s��uU St.�2V�cTi�R� (�4G� 1� 1Tc� kl PtTC�Et F X �ST�1�C-� S-TR:V►.CTIJ��E F • s W-t TI�Q • Ja�'S L b2,us3 � qcac�,e 21 -�,F fE C"W OGV, ��b, 3/� SCALE Q-- i c.',a 7 PT�t� �oF it t3 ArL1-�5`�E QS Ty Q . slyls�� Town of Barnstable *Permit# 73s/ Expires 6 months from issuq date ST„BI.e, : Regulatory Services Fee s639. Thomas F.Geiler,Director � Building Division Tom Perry, Building Commissioner c 200 Main Street, Hyannis,MA 02601 �° Office: 508-862-4038 JUL 2 6 2004 Fax: 508-790-6230 TOW EXPRESS PERNHT APPLICATION - RESIDENTIAL; RN Not Valid without Red X-Press Imprint �rAQL Map/parcel Number 'Z, A le- Property Address -2- Residential Value of Work �Z.S��. Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) WWorkman'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# '7,y 2A+~7`7 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) jQ Re-roof(stripping old shingles) All construction debris will be taken to S'�'e_ �,vet•, S nA a©S�e ` ❑Re-roof(not stripping. Going over existing layers of roof) Re-side . Replacement Windows. U-Value •3R (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 sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature Q:Forms:expmtrg Revise063004 Town of Barnstable FTHE T°i,_ Regulatory Services Thomas F.Geiler,Director * anxxszasM • MASS. Building Division s639• ,0� AlE p '�A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 $Iv10y Uv- PERMIT# '7 R 3 SJ- FEE: $ SHED REGISTRATION 120 square feet or less Location of shed(address) Village C� saw--7 Property owner's name Telephone number Size of Shed Map/Parcel# 4-_ Signa Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) c .�• �� �� �c�°��� �'L�N PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 KCNCY, MUKAN 4 IIVNAN, IN(;_ IVEvn url�ac nv�rcv Ev�v rE1+Mv REGI5TERED LAND 5URVEYOR5 NAME JOHN GONSALVES tZ HAMMOND STREET W LOCATION 21 BEECHWOOD ROAD ORCESTER, MA 01610 c 508-752-8885 (PHONE) CENTERVILLE MA 508-752-8895 (FAX I) RMTQCONVER.5ENT.NET (EMAIL) SCALE 1 = 30 DATE 05-14-03 i REGISTRY BARNSTABLE DAD wmlpmc 14838/261 ' al►4ED UPON DOOUMENfi►71ON vaohoEo�. MrFASURE- �;, MEM WEK MADE aF THE FROMnA�AIA SrgrN P1AN GOOK&UM 567/30 OF vMmE E ARE smw ON THUS MORWAM MWM AM 7m ANE NO wam s OF ZONMEC ItEOW&MMIS RE6AR M SlIkIMRES TO PMOPE117Y ME row 711E elm onam ARE NOT wum THE UNE OPFSM (JM M OIMMM MHO Q! WMWM". AMUR SPECIAL FUM NA7ARD A" SEE MO MAR NOTE NOT OE IM ARE AflWEXitMM P00l3, DRN M V& OR SHM MIDN NO FOUNUMOWL 7W IS A MMQW USE TO SL gpUtkY cm 5 C aro 8-19-85 RilEC M PLAIk NOT AN MM MaM f ea V-Do NOf ETI m FENCE$OTM ampm r SIRuCTU m oR TO FLAW SNRUDS. LOCATION OF 7W SIRUCTt S)snorN NOlEON Is ER►IER NQ. n=NAZARD ZOW NAS BMW OE7EbMW of SCOU AND IN COIOLMV m Wm LOW.a0111N1' PRDPERIY lME OP T IS NOT NQ LY ACCM7E IAiIR 0E37►QfIVE iWfS ARE REOUYIfYYF1!lI9, OR 19 EKWK FROM VMMA710M ENFORCOMH AC9w 1111DEA MASS.O.L MU VIL CHAP.�SEC_7.UNUM 6511Fa[1Y Ni10 AND/DR A YE7a1GL CONTROL SURVEY 6 ODONNSE NOIETI.TIME CO FRA710N C NON-7RANSiERA LF- PERFOMAED6CANIWT BE DOERWAM 1W AM&CFmIF1f WO ARE WOE WITH 7NE PROV19►ON TNAT THE WORAKIM PROu1OED IS AOCMW AND IMT THE MEASURE- MEWS USED ARE ACCURATELY LWA7FO IN RUATiON TO 1W PROPERTY LINES. Certified to: Woshington Mutual Bank FA John Gonsalves z • SHE 'a a H. 4 LOT 39 b N 14,209 SQ FT 40 b 772�, N CO LOT 1 O JUL 2 6 2004 A 39A 2 ` BARNSTABL E CONSERVATION HOUSE#2r �S6 z - � I � w •�. � � r 83.57 FT FT L 50.65 FT R 388.00 R 130. 03 FT BEECHWOOD ROAD RSQUZMWr# 0MCE7 MCANUS. 14MON & MACNAMM TOTAL P.01 ✓2ze C�am�n�� wea a�� act .'fir ` BOARD OF BUILDING REGULATIONS i License: CONSTRUCTION SUPERVISOR # i ,.ax ti Number CS 093431 + t� Birthdate 11/03/1969 w sj Expires 11/03/2009 Tr.no: 93431 y Restricted 00' % $ SCOTT C ROWLAND ,Y 124 ORANGE ST NANTUCKET, MA 02554 Commissioner e . Liberty Mutual Group • Llber7 PO Boa 7202 Mutu 1. Portsmouth,NH 03802-7202 Telephone(800)653-7893 - Fax(603)431-5693 May 3, 2006 , HVAC CONCEPTS 30 CIT AVE #9 HYANNIS,MA 02601- RE: Certificate of Workers Compensation Insurance -Insured: SCOTT•ROWLAND; DBA CARPENTRY&MECHANICAL SPECIALTY 124 ORANGE STREET R2 NANTUCKET, MA 02554 Policy Number: WC2-31S-332745-016 Effective: 2/12/2006 Expiration:. 2/12/2007 , Coverage afforded under Workers Compensation Law of the following state(s): MA Employers Liability: Bodily Injury By Accident: $ 100,000 Each Accident Bodily Injury by Disease: $ 100,000 Each Person Bodily Injury by Disease: $ 500.000 Policy Limits As of this date. the above-referenced policyholder is insured by Liberty Mutual Fire Insurance Co under the policy listed above. The insurance afforded by the listed policy is subject to alI'the terms, exclusions and conditions,and is not altered by any requirement, term or condition of any or other documents with respect to which this certificate may be issued. This certificate is issued as a matter of information only and confers no right upon you, the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage afforded by the t ,- policy listed above. - If this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such cancellation. ` _1i AUTHORIZED REPRESENTATIVE LIBERTY MUTUAL INSURANCE GROUP This Certificate is executed by LLBERTY.Nn1-rU�V.INSURANCE GROUP sus respects such insurnce ass is adtorded by those companies. - cc: Insured: Producer of Record: SCOTT ROWLAND CONGDON& COLEMAN INS AGCY INC DBA CARPENTRY&MECHANICAL SPECIALTY P 0 BOX 1199 124 ORANGE STREET R2 NANTUCKET, MA 02554 NANTUCKET,MA 02554 5/3/2006 The Commonwealth of Massachusetts Department of Industrial Accidents .w Office of Investigations 600 Washington Street .Of# Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electrf cians/Plumbers _ADDlicant Information Please Print Legibly Name (Business/organization/individual): vCOf oW/AtJ ` ai Address: /4 09A S R f City/State/Zip: /vANI4'vc4%i 0 W557 • Phone#: 0 -00,3 Are you an employer? Check the-appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction employees(fall and/or part-time).* have hired the sub-contractors, IN I am a sole proprietor or partner- listed on the attached sheet $ 7. ❑ 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 S. ❑ We are a corporation and its 10.0 Electrical repairs or additions rimed,] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repays or additions myself.[No workers' comp. c. 152, §1(4),and we have no 12.❑ oof repairs insurance required.] t . employees.(No workers' 13.1Other N&O comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'ocmpensation policyinforrnation: t Homeowners who submit this affidavit indicating they are doing all work aadthen hire outside contractors must submit a new affidavit indicating such %Contractors that check this box must attached an additional sheet showing the name ofthe sub-contractors sad 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: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,50Q.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un r the pai s and penalties of perjury that the information provided above is true and correct. Signature: Date: �1012 Phone#: Official use only. Igo 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.Cityl—lowu Clerk 4.Electrical Inspector 5.Flumbina Inspector 6. Other Contact Person: Phone#: Information and Instructions 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,.offal 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,,personslo do mainten nce,-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 lieiimit to:operate a business or to construct buildings In the cornmonivealth for any applicant who has not produced acceptable^evidence,of compliance with the insurance co-Verage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance 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-contractors)nanae(s),address(es)and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLQ 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 this affidavit may be submitted to the Department of Industrial '+Accidents'foi 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 Deparf rent 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 eater their self-insurance license number on the appropriate line. 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 perry t/license number which will be used as a reference namber. 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 pemuts or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lie 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: - The Commonwealth of Massachusetts D ad meet of Industrial Accidents eP , Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-IUMASSAFE Revised 5-26-05 Fax#, 617-727-7749 w-*r v3Ilass.aov/C1ia °Fr Town of Barnstable Regulatory Services 1STA8 Thomas F.Geiler,Director fo 5.s p`'� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME MROVEMENT 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. Type of Work: Estimated Cost Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 OBuilding not owner-occupied DOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME EWPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: _14 Date Contractor Name Registration No. OR Date Owner's Name Q:for=-homeaffidav vaFtH�roy, Town of Barnstable p tip . w Regulatory Services 9 MASS,I'E$` Thomas F.Geller,Director �'ApED 39. Building Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner bust Complete and Sign This Section If Using A Builder I, '.1 C1MNSZ4U'-' ,as Owner of the subject property hereby authorize �C eA ���`�,� to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Sig `a a of Owner Da e Print Name j Q:FORMS:OWNERPERMIS SION Town of Barnstable *Permit.# �P� pr Expires 6 tlu from issue to . �"U. . Regulatory Services Fee (o gib 1 MASS. ��� Thomas F.Geller,Director ArfDMA'lA Building Division X Tom Perry, Building Commissioner �p�E 200 Main Street, Hyannis,MA 02601 _ S Office: 508-862-4038 To EP 510�3 Fax: 508-790-6230 WJV EXPRESS PER UT APPLICATION - RESIDENTIAL ONL�F BA/�N l�L Not Valid without Red X-Press Imprint STABLE Map/parcel Number Z O 0 14 Property Address Residential Value of Work Jr— Owner's Name&Address L 21 )6ff_8A vim'\CXY� CP�✓1 \-Ce�1\�� Contractor's Name -J o_0 Z&e S. 0`33NJLZ- Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) EWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name 7-:A SU C2N.C� Workman's Comp.Policy# Permit Request(check box) Re-roof(stripping old shingles) All construction debris will betaken to VA&� ❑Re-roof(not stripping. Going over existing layers of roof) RRe-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: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature Q:Fomis:expmtrg Revised121901 Bill Ryan 03 REALTOR' -,,00 C;BR®, a-PRO L Shoreland 1220 lyannough Road,Suite 8 Hyannis,Massachusetts 02601 Business(508)771-2008 Cell(508)360-6937 u Fax(508)778-2423 ?y. E-Mail billryan@c2lshoreland.com Web Site www.homesalescapecod.com Each Office Is Independently Owned And Operated Q yofTHE T TOWN OF BARNSTABLE i • i BARNSTABLE. i "6 9 BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. . ..,-...........A ....:.... . ........... ................... TYPEOF CONSTRUCTION .................... ! ......................................................................................... ............ .e.......'...�.Ye.... .19.M 01 TO THE INSPECTOR OF BUILDINGS: `F The undersigned hereby applies"?for a permit° according' to the following information: Location ....... -77..: .X...........:..� 99.ft b....'o°::....... .;-0^4-r�t-e'................. ® . ........... .. ProposedUse ...... ........... ................ ...................... ......... ZoningDistrict ... (.1. � r Fire District ".. ..... .. ... ............ Name of Owner VL �. ....P�...........�1.'...........4;'� �c.'��`�. ��'9.� dress�!°.�....��:�':'. !�. ..,�.� :�.OV................. Name of Builder .1..]C.! .. ....: ..........................Address .�. ... .��. � .........� ......ion......... Nameof Architect ..................................................................Address ......................................................................:............. Number of Rooms ..................................................................Foundation ... :.........:....... Pw ........... Exterior ......,-0..�Njo AA..t(;.............�...............................Roofing ............. ... .. Floors .............................................................Interior ............ ... ....................4.:............................................ Heating ` ' ................................................Plumbing Fireplace .............:777,.""............................................................Approximate Cost .....�..7......................... ....... ................... Definitive Plan Approved by Planning Board ________________________________19________. 6 ® Diagram of Lot and Building with Dimensions ; SUBJECT TO APPROVAL OF BOARD OF HEALTH t ; Coln ,co F�MAO I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .....2�........e :.................... LeShane, Dr. &: Mrs. Lawrence No ...157D... add to single , ........... Permit for ..................................... family dwelling 4� remodel (...... .Bea.......c............................................... hweed Road Location ............................................i................... Centerville ............................................................................... Dr. & Mrs. Lawrence LeShane Owner .................................................................. Type of Construction .......................frame................... ...............................................................i................ Plot ............................ Lot ............�".k................ ' �- li Permit Granted .........1.). e ...7.........19 72 Inspection ...Date of I ..... .... Date Completed ........ . . ....�g7-3 ...............19 PERMIT REFUSED ................................................................. 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... • CENTER VILLE J, WEQ UA Q UE'T I _ N71g 3 A.M. 252/3 0p co I C A i ,.. NECK I \ o ,7 11 LOCUS 7B/DH `A 36, 99' CB/DH S��yL?, G_� c I I / I / / / •;� 41 �� 0 N89°37'30"E'er,� `'�5 49' WEQUAQUET I LAKE 11 1 I l /l I / /l �9��. AK 60 //I 6 BLOCK RETAINING ; i - cif 2 L / I \ 666 LOCUS MAP PINE , SHED OAK OAK PLAN REF 480128 & 567130 L ,yti �, . I I/ /. / - / ' If ____A__68 J' DEED REF• 148381261 & 145271173 CISoo I I y�Q'/ \ / ----(--- '� ' ZONING.• RD-1 I i GROUNDWATER PROTECTION "GP" - w 1 �/� I - �, r ASSESSORS MAP 250 PAR. 2 It / �j l I I SHELL , k _ I I I J O/ / J DRIVE ,/ W/ ' c5 's�� /I / / / // / Q I / 10 / G-' , A. ,252/,2 0 � q EXISTING CON ! �0 �0 / ARE =14,209f SF I r` T CONDITIONS PLAN -, � � LOCATED A A21 BE'ECHWOOD ROAD 70 - -. - - ; IN , CENTERVILLE; MA. F F. ELE . _ PREPARED FOR. �. C.7 71.9' � _ ; .�. , I W JOHN & ALICIA L NDSCAPE G,ONSAL VES TIES a O JAP SCALE' 1 »=,20' MAP. I W MAY 27, 2005 REV.• REV' CONCRETE• - • - - - . "RETAINING WALL �� _ _-- `cv� J REV.• 0 YANKEE ULTA�. SURVEY CONS NTS UNIT 1, 40 INDUSTRY ROAD P. 0. BOX 265 MARSTONS MASS. 02 64 r� 252 1 �C, ° i 1 MILLS 8 � � TEL• 42 4 � •-'pit / •C' l 8 0055 FAX. 20 5553 UPOLE SHEET 1 J# 53854 GM ZIAJ� kJo ZI/ca'a dQD � W CENTER VILLE UE'T WE'Q UA Q #29 , ,;;;; � �; wLAK I I 1 A.M. 252/3 -�.�" i HUCKINS 11 ECK Co.Oo cfl W \ �Q ;/,. �i7J \ � LOCUS I \ , rjoAT �o CB/DH CB/DH 36. 99 - 34 51 �, N89°37'30 O9' �� WEB QUET O 0 / p K 69 � A 6� 66 - LOCUS MAP / i \ , l �` � PINE x� OAK OAK I i PLAN REF 480/28 & 567/30 �HED � S -- _ — � DEED REF 148381261 & 145271173 Q W . �� ' I ZONING-• "RD_I � � � � \ ,� ,- _ ____ ----•�---�4 . -� � � ; GROUNDWATMAP 252 PAR. :,2 GP i O I O I aw '�C ASSESSORS h �, I ► SHELL DRIVE Wi �✓ r l / -'' --► A. M. 252/2 q EXISTING CONDITIONS PLAN_ D6 � / �cP� I 1 ` AREA=14,209E S.F. ' r,`` LOCATED AT / I _-__- O ;0(21 BEECHWOOD ROAD s � o� ► / / / �,�v = - - ___—_- - 70 - - - - —; CENTER VILLE, MA. F.F., ELEV. ,A\ PREPARED FOR. 71.9 (C.I.S.f) _ ` 1, _ ' , ;4 JOHN & ALICIA olf GONSAL VES LANDSCAPE __ �� __ _ • o Q TIES —_ / .l. 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