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HomeMy WebLinkAbout0100 GREEN DUNES DRIVE r r, W' rc h • , r 1. 1ejxa .# r i t t S t d 3 1 k: , „r r, o d„ ,. i i7 r f / �E 1 !f �� i ( a, �• ! t:'t 7 -n, adk i 7 4.to.r .,.1, , ,+,-, ." :�;: .'!; �. � r .•:' :. .- C,r,: t It, 'J %e. /':t n; 1} � >S, to;, ttj �: -:.. -., „,.,._ , _.. e.; r.:,.,,:,r. ;.,,;" •, f. t < J t 4 t I '�, 11 t.;.�ik y d r :';, ,. .:d -.is::, a.::% ,.i a:;. .:�. ! t k-4':i :kr•, �1 C� r . 1 ,. I, .:,:, ,. '.,,. ,.. .,, ,,.•;i' ,..e. , r, .., t'' n EI i "1. d ''-v. 2,="t.E ,. , r , ,r ,.rn , , .,.;. ,,.; l,r r t, •t"-' t 'k �: �! s a ,t' r r f. :a Yrr"... ,..s, . r �ar .,1 .k : ..t : 't. {. i •:. - ,. 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GAGNON MATT GAGNON ROOFING Approvals Date Issued: 10/29/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 04/29/2020 Foundation: Location: 100 GREEN DUNES DRIVE CENTERVILLE ,.Map ,Lot 245-018 Zoning District: RD-1 Sheathing: Owner on Record: BASHIAN, ELEANOR L TR ET AL ? ., Contractor Narne :' MATT P. GAGNON MATT Framing: 1 a GAGNON ROOFING Address: PO BOX 442 �° 2 WEST HYANNISPORT, MA 02672 Contractor License 154921 Chimney: AEst Description: re-roof-sandwich 1 Project Cost: $13,000.00 Permit Fee: Insulation: $66.30 Project Review Req: " Fee Paid: $66.30 Final: ®ate" 10/29/2019 Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: -F m .. Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorzed by this permit is commenced within six onths after issuance. All work authorized by this permit shall conform to the approved application and`th�e approved construction documents;for which this permit has been granted. All construction,alterations and changes of use of any building and structures shalle in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access streetor roaXnd shall be maintained open for public inspection for the entire duration of the Electrical work until the completion of the same. I ., The Certificate of Occupancy will not be issued until all applicable signatures byAthe Budding§and Fire Officials are prRovided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Per tracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Cq Final: -A - Building plans are to be available on site c_T� All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Toww of Barnstable *Permit#,8-/9-�3��5 0 Expires 6 months from issue date Regulatory Services, Fee 6� IX tans. Richard V.Scali,.Interim Director' 1639. 1� �p n�q BuildingDivision Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 OCT 2 9 2019 www.town.barnstable-ma.us 1 Office: 508-862-4038 TOWN OUARA LE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 'Property Address e a j? A:7u—e Residential Value of Work$ �� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address - ti Contractor's Name (r ' =Telephone Number' Home Improvement Contractor License#(if applicable) 'Email: Construction Supervisor's License#(if applicable) F ❑Workman's Compensation Insurance 2eck one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's'Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Re est(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of.windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. , Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is r ed. K SIGNATURE: T:\IEViN D\Building Changes\EXPRESS PE4M19RESS.doc Revised 061313 • p Commonwealth:of Massachusetts 4� Division of Professional Licensure 4 Board of Building Regulations and Standards Constrgoo r Itb ,%rvisor N o� hcoa`ed CS-069765 ires: 02128/2021 is %c, 0 se Sove 0°vp of e Go�V4�taf a^y us p9 metecsl ��gs 9�c� MATTHEW P6AGNQs- , ,�ted.6�dU is tee sPa�e• 11 OLD COON ( �C U�testt 33p00 EAST SAND WICFf MA \es`oan tip)/RC Ta�� Commissioner of the Mas a`Geese of t eiC%°%�00% se t s a w«e t t0%to loc, ttce s 9°vldp °sses a is cav^ab°' t�s Faa a g0dd°Fo�nt t,alto °t v`s�t'N St ,,,,lr��1�Z to ' 74 �. Office of Consumer Affairs&Business Regulation Registration valid for individual use only k. HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: T 302 Expiration Individual Office of Consumer Affairs and Business - R 1000 Washington Street -Suite 710 Regulation 1r .04/12/2021 j Boston.MA 0211g MATT P.GAGNQ[ —_ DB/A MATT GAO ` N ►1t(; e MATT P.GAGNOK�•, 11 OLD COUNTY Not Vah E.SANDWICH,_MA 02537 UnderSeCreta hout signature ry o� i Town.of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize T�, to act on my behalf, _T in all matters relative to work authorized by this building permit application for. (Address of Job) i Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. T:T,FM MBuilding Changes\EXPRESS PERMPIIEDR.ESS.doc Revised 061313 J cftlrma vmuh Of MMY170asda DPpar&Ent of buhah L a1 Accidar& 1OsttiU,M4 02111 �� ft•'it�FV.aff(L�.&. � Workers'Compensation Lnurance.davit:B ers/Ca 'cian&4%mbers Applicant Nation Please Print I Name City/StJ�.tF: Are you an=gdoyer?cLe&the appropriate ham Type of Project(required): 1_ .I am a Moyer u=itlr 4' ❑I am a geoend c=tractm and I New won employees(ball amdlor past-time have hired the ��I bra a sole gropriet4r�p� listed�t#e att s� 7- ❑Remodeling ship and have no em�l�pees T ss brae 8_ ❑Demolition rooming fax me in any capacity_ �' and 1 was' 9 ❑Hufg addition (goo ,comp_tns�senra 14? Electrical repairs or additions 5-❑ �e are a corporation and its 3_❑ I am a ha]w�r doing all wodc offi�s have Wised IL[]_Q s Plumbing repairs or ada mpseb£[Nowodwe� rigbtnf ou per�lGL 12 D�csfrepairs sndwe have no insansmce rued]` ` ems-� 13_❑Offier corm.inswznre Expired-] *A]XyWUamtfiWsbedisboz*i=LqaJsv ffilawhe smA=bdMdwwMZ1&&vi TH=wwnmwba9dbmit dM mfd"A MXlErtmg they Madmag an wak and Shea b¢e GUtn&cmmftzct=nustsdbnMtzww AM&M ink SWIL that rT,wA fhis box mast Z=rbed M additimm l stet dwrfi a tbe Mme of Eye Sd"MUKtM sad sty y1belbff w 20 20se eon ba e empbsyem If the SMbCvMftw=n lwe 9YMu5t 'comp-pancgnumber- jam an empfujw that is providing wrarkml cow insurance for my yem Bed is thepa&7 and job sag _. itnformaliana Insaramce luny Name: ' Po&T#of .f-im Iic;�- - Iob Site Adds: c'tvfstate,2 p_ Atfacis a cuff of&0 w arkers'c tim p d a Page(Sbo �g°�number and emotion date. Failure to secure covmV as reqtzired under 5ecticm 25A ofMGL c.M can lead to the won ofcriminal penalties of a fine up to$I50 0D and/or iris-pear wgmson meek as-aeI1 as civil pwalties in$ne fD=of a.STOP VMRK DER and a fine of up to$250.00 a day against the violator- Be wised dint a cagy of this s may be brwarded to the Office,of Investigations offfie DIA fax insixance,covera ge _.... _...._ _._. _. I dv hereby certify the • s nn+dpenalfraa afpiry#hatthe itnfa pmviAd abow is trnre corrat Imo: Phone# Official me mly. Do Aot carrier in this area to be camp bded by c rfy or in n afficw City or Town: PeruritUcewe# Issuing Authority(dsrde one): L Board of ldealtln 2.Building Ikpartment 3.QtYffU,WK Clerk 4.Electrical FnsPector ra.Pmmbh g Victor 1 i.tither centactrersan: Ply ' 6 CF)'9J2'711Y CAP" Cad INSULATION M r100 ATTS 'P$_Tjo- 9'"-.5 ' BgiiS .••+�1..+ inSulgTlOn CBi4ln05 1-86 -0'J6-6611 Town of Barnstable Regulatory Services Building Division 200 Main St tn Hyannis, MA 02601 Date: r Dear Building Inspector Please accept this Affidavit as documeniaticm that Cape Cod Insulation,:Inc. performed"& completed the insulation and weatherizaiior, work at the property listed below. Cape Cod Insulation did this in accordance to the sptcitications listed on the building permit application. All work has been inspected t) a certified Building Performance Institute (BPI) inspector. All•work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village / e,�//'er ����iAN /00 G�'CY�✓ kl e-e-S !off Insulation Installed: Fiberglass Cellulusc R-Value:*. Restricted Unrestricted Ceilings (0-0 ) ( ) Slopes Floors (X) Walls ( ) ( ) ( ) } Sincerely`` He y E. Ca sidy r, President Ca e Cod sulation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel-0 1A Application # Health Division Date Issued Conservation Division Application Fe 7- Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address e, Village l�,?� ��,,Ile Owner�'��,�_1-?d,:r4ld,c/ Address Telephone Permit Request .T2 /e Z-2 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 7DG0r 4$ Construction Type W� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach r upporting`d�bcume tation. i Dwelling Type:'Single Family Two Family ❑ Multi-Family (# units) Ua Age of Existing Structure Historic House: ❑Yes(lo On Old King's Highway:: ❑Yk�No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other t 4.� 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 APPLICANT INFORMATION / (BUILDER OR HOMEOWNER) Name �f�f'Pt9 r�e �! /�i1 i�1sG� Telephone Number ,o 7;.s dl21 - Address �� 2� �> !� License # e_-2 d /!&M,e U?/ Home Improvement Contractor# A5 Email Worker's Compensation #GrlrAt ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7, FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAR/PARCEL NO. - ADDRESS VILLAGE f r' OWNER r DATE OF INSPECTION: FOUNDATION FRAME f INSULATION FIREPLACE- ELECTRICAL: ROUGH FINAL I PLUMBING: _ ROUGH FINAL GAS: ROUGH FINAL P FINAL BUILDING; k I t DATEggC-LOSED:OUT w AS O�!ATION,PLAN NO. E" .r r Housing � Assistance Corporation Cape Cod HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. --�t hereby .consent to. and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency" ). on the property locatedat: / The weatherization work done will be based on programmatic priorities and availability of funding and' it may include all or some of the following measures: F, Weather-stripping & caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be done at my home I agree to the following: 1.. I give permission to the "Agency" its agents and employees -to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2 . The Housing Assistance Corporation reserves .the'' right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five. (5) years after the weatherization work is completed. I have read the provisions of this agreement as listed and freely give my consent. ' j . Home Owner: (Signature). s! (r�' r 6J 9 �� Date: Agent: (signature) Date: The Commonwealth of Massachusetts I Department of Industrial Accidents n Office of Investigations - �° 1 Congress Street, Suite 100 - r` Boston,NIA 02114-2017 - www.mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contractors/Electricia us/Plum bers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): { MAU, 6 Address: �l I�G�f/l." C4 V G I �i City/State/Zip: �th( '� U6VWU�(t,'06 Phone#: -71 C2— (2 l Are on an employer'? Check the appropriate box: Type of project(required): I. I am a employer with _2G7 4. ❑ I am a general contractor and I employees (full'and/or part-time). have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [:] .Remodeling ship and have no employees These sub contractors have g: ❑ Demolition working for me Iin any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ q• ❑ Building addition A required.] 5. We are a corporation and its 10.0 Electrical repairs or additions ❑ 3. `officers have exercised their I I.❑ Pltunbing repairs or additions El I am a homeowner doing all work myself. [No workers' comp. right of,exemption per MGL 12.❑ Roof repairs 4 insurance required.] 't c. 152, §1(4),and we have no employees; [No workers' 13.�Other t V d U IU- A&- comp, insurance required.] 'Any applicant that checks box#I must also till 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 state whether or not those entities have entployces. If the sub-contractors have employees,they must provide their workers'comp.policy number. ant an errrployer that is providing workers'compensation insurance for my-employees. Below is the policy and job site- it irrforrnution. r,, ny,�n,� 'n Insurance Company Name: Policy#. or Self ins. Lic. #: Q(JLjz Expiration Dater Job Site Address: 1,,VA 17,P 4fwj?�/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. 1.52 can lead to the imposition of criminal penalties of a tine 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,.toYthe Office,of Investigations of the DIA for insurance coverage verification. I do hereby cer tfy rAwthe pains and penalties.ofperjury that the information provided above is true and correct. - Si"ure: Date: 2 ?' Phone Fi: � Official use only. Don ot 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#: .� . .A Massachusetts -:Departm'snt of Public Safety 4 Board of Bulldi6g Regula#i`ons�hd Standards Cunstniction Supen'isor •� License: CS-100988 r NIENRY E CASSD) 8 SHED ROW WEST YARMOlP11I Q2` Expiration Commissioner. ' 11/11/2015 _ i� �` �_.,, , �.-�`�J �(�c�ry�yuLdlcuea;��L c�� C��i�a�;�ac�� �•. � ;; _ _ a:. Office of Consumer Affairs and Business Regulation r Y 10 Park Plaza Suite 5170 Boston Mass'lchusetts 02116 I Iome Improvement CQ,Rtraqtor Registration' `fr Registration: 153567 1-Ype: Private Corporation ° " r Expiration '12/15/2014 w Tr# 233831 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SC. YARMOUTH, MA 02664 __ .----- --- s Update Address and return.uitrd. Marla reason for change. 7 .. ❑;Address Renewal U Erirployment" Lost Card L� Ulric,of Cousumer Affairs Sc Uusu"less Regul itiou. . '{ � � License or registration valid for iudividul'usc only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: �^ epistration: 153567 Type: Office of Consumer Affairs and Business Regulalioli yExpiration: 12/15/2014 Private Corporation. 10 Park Plaza-Suite 5170 Boston,MA 02116 APE COD INSULA I LON „IMC, �' - EWY CASSIDY Y t 3 I;tARDON CIRCLE 3. YARMOUTFi; MA 02664 Undersecretary of vaf witho t nat re }7 CAPECOD-27 CVANGELDER CERTIFICATE OF LIABILITY INSURANCE [ DATItMM,DOIYYYY( 41112014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1NSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to thu tones and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not center ri0hts to the _certificate holdar in lieu of such endorsement(s). PRODUCEH CONTACT - - NAME; Cape Cod Commercial Roc ars&Gray Insurance Agency, Inc. PHONE ------ — -FAX----^ -- --- 434 Rio 134 A/c No.Exn: _-LNIC- -&-877)816-2156 South Dennis,MA 02660 E-MAIL - ADDRESS: '. INSURERS)AFFORDING COVERAGG NAICH - ------------_-.__ wsURERA:Peerless ►nsurance Compan INSUHEu INSURER R:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C:Evanston InSLIrance COrnpany___ '18 Reardon Circle INSURERD;ATLANTIC CHARTER INSURANCE GROUP South Yarmouth, MA 02664 INSURERE: _.:_- ------- INSURER F: - COVERAGES_ CERTIFICATE NUMBER: REVISION NUMBER: I IRIS IS TO CER1IFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR'I-HE POLICY PERIOD iNDICA I ED NO[*WITHSTANDING.ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH.RESPECT TO WHICH THIS ( CERIIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, f EXCLUSIONS AND CONDITION SO F SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR! _ 1CDbL.SITeR pOLICY NUMBER MM/ODIYYYY MM D YYYY n _ - --_— I TN! rYPE OF INSURANCE- LIMITS A I X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ 11000,00 (AAIM MADE X OCCUR CBP8263063 -OAMA-G-17-T0RENTEC'— ' I , . 0410112014 04/01/2015 PREMISES ka occulloncoZ�_$ 100,000 MED EXP(Any one person) $ _5,000 �• - • - - PERSONAL B.ADV INJURY $ _` 1,000,00 t I N'!-AG(:HLGAI E LIMIT APPLIES PER: GENERAL AGGREGATE - $--_ 2,000,000—_ X I POLICY I JEC 1..._I LOC PRODUCTS-COMPIOPAGG -$_ - 2,000,000 --- - -- - $ I CIUIFR 1AUTOMO8ILEUA8ILITY - - " _ l COMf11NED SINGLE LIMIT $ A- jAN tuyCl��10 NEo 14MMBCKVMK, 0410112014 04/01/2015 BODILY INJURY(Pc�rparson) $ . X SCHEDULED BODILY INJURY tear accident) $ 1,000,000 AL)i AUTOS X X NON-OWNED PI:OPERTYDAMAG - $- - ----- ru!iFD AUT05 AUTOS Par accident T X I UMURELLA LIAO x OCCUR - EACH OCCURRENCE -$ .._._ .1,000,000 excess uAu ^CLAIM5_MADE RIO XONJ453512 04/0112014 04/0112015 AGGREGATE $ IIEu X REIENION$ 10,000 `" Aggregate $ 1,000,000 IOlWKKERS COMPENSATION + 1 PER OTFI . .. _--.-.�_.. ANU MYkRS'LIABILITY STATUTE- ER - D W PRor'RILTOR/PARTNER/EXECUTIVE YIN _WCA00525904, 06130/2013 0613012014 E.L.EACH ACCIDENT— $ _ 1,000,000 0FOCER/MEMUER EXCLUDED? NIA I(Manoatury In NH) ❑ E.L.DISEASE-E_A_EM_PLOYEE $- _- 1,000,000. nu under E.L.DISEASE POLICY LIMIT $ 1,000,000. -UL:,CNIPIIONPIK)N OF OPERATIONS below J. LSCRIP I ION OF OPERAI IONS I LOCATIONS I VEHICLES (ACORD 101,-Additional Remarks Schedule,may be attached It more space Is required) Workers Compensation includes Officers or Proprietors: ' Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE' EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEREO IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved.' 1 CORD 25(2014101) The ACORD name and logo are registered.marks of ACORD . L TOWN OF BARNSTABLE BUILDING PERMIT PARCEL ID 245 018 GEOBASE ID 14805 ADDRESS i00 GREEN DUNES DRIVE PHONE (617)266-0023 Centerville ZIP . 02632-- LOT 25 - BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 23389 DESCRIPTION REPLACE OLD DECK TO IRREG./REROOF 31 SQRS. PERMIT TYPE BADDD TITLE BUILDING PERMIT ADD DECK • 1 CONTRACTORS: RILEY, CRAIG J. Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $77.50 BOND $.00 Okt ME CONSTRUCTION COSTS $25,000.00 434 RESID ADD/ALT/CONY 1 PRIVATE P l.,�:. * BARNSTABM + j MASS. Ij OWNER WELCH, MRS. PETER C, i639. �� I ADDRESS 301 BERCKLEY STREET f ED INIC� I BOSTON, MA BUILD, ° Dry rS' ) N DATE ISSUED 05/28/1.997 EXPIRATION DATE a TOWN O BARNSTAB-Lg •�; , �' ,��: BUILDING PER141T PARCEL „ID 245-018 GEOBASE ID 14805 ADDRESS'-`•-100 GREEN DUNES DRIVE PHONE (617)`66—.t3023 _ Centerville ZIP U 632 LOT 25 BLOCK LOT 3I' 1r _ DBA DEVELOPMENT DISTRICT CO PE44IT 23389 DESCRIPTION REPLACE OLD DECK ,TO IRREG./REROOF 31 SQRS. PERMIT TYPE :BADDD TITLE BUILDING PERMIT ADD DECK CONTRACTORS: RILEY, CRAIG J Department of Health, Safety ARCHITECTS: and Environmental Services I TOTAL FEES: $77.50 BOND $.00 tNE CONOSTRUCTION COSTS $25, 000-;00 >, , 434 RESID ADD/ALT/CONV PRIVATE P`.�*7 MASS. OWNER - WELCH, MRS: PETER; C r`; 1639. ADDRESS 301' BE CKI,E`Y STREET �T ED MA'S w R T . BOSTON, MA BLILDI '`D V N DATA. ISSUED 05/28/1997 ERPIRATION )ATE By THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER:TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY,PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS:THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS,. . MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY: I I BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I _ I 2 2 2 I ' I I J 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT I _ I 2 BOARD OF HEALTH I OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED.UNTIL . PERMIT WILL BECOME NULL AND VOID IF CON INSPECTIONS INDICATED ON.THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION,WORK IS NOT STARTED WITHIN SIX.. CARD CAN BE ARRANGED. FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED At. TELEPHONE OR WRITTENNOTIFICA-' TION. NOTED ABOVE. TION. . ' I __- - I M ,�, "' ;B D IN APmft UIL , �I fns: t at 'F it ..,. K$y"• r � Engineering Dept. (3rd floor) Map Parcel # 'J a2 �S 9 House# Q Date Issued Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) q Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) $EPT� 1ME Defi ' ' e Pla pproved by Planning Board 19 74 U$T BE . PLL41YC TOWN OF BARNSTABLE SHVIRON co��AN© Building Permit Application n Project Street Address_��Q _� j�, Village Owner �,Q, ,, IdiJrI Address Telephone ; a6/ - a a Permit Request ' it& eraw First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ 2 LIZ^ eo Zoning,District Q Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family, ❑ Multi-Family(#units) Age of Existing SHistoric House ❑Yes ❑No On Old King's Highway ❑Yes ❑No ;Eulll Basement Type: ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing_S New Half: Existing New No. 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 - Garage:VA ached(size) Other Detached Structures: ❑Pool(size) ached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name 0 Telephone Number Address a License# 41,5" (4Ja lY 7 40K f Home Improvement Contractor# - Worker's Compensation# 141 &70 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 P SIGNATURE DATE BUILDING PERMIT FOR FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. 3 DATE ISSUED + r MAP/PARCEL NO. ADDRESS . VILLAGE J OWNER R L� DATE OF INSPECTION: !' FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL:, ROUGH FILIAL PLUMBING: ROUGH; FINAL- GAS: AQW- � , � [ FINAL• - 11 FINAL BUILDING lD NV K _ till � t - DATE CLOSED OUT - ASSOCIATION PLANT � Y �k+ C�-'A A'x'K /0//5��/ f �j �/ ' Assessor's l.A.s map and lot number .E�, / j.-ff.......... �i^ { THE �pf Sewage Permit number .. ,� 'SE PTI7C 'SYSTEM House number ..... 'NSTALLED IN COMp 9. WITH TITLE 5 oYPY A,. f. TOWN OF +, BARN`STX ET,IIL ®aAND BUILDING 1SPECTOR - . APPLICATION"FOR PERMIT TO ..�.... u�/ ......�a�s ... . ..... .... TYPE OF CONSTRUCTION ........... ...:....... .... ..................................................... r F :........ ............1..................19.& TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:. , /� tom' Location ....c�C.t.�.`:..........�.�..�......:�.-."�../.c'�.;:£'..�?./.�......D.*/1/eS. .....� .......... .r. .. ........ ProposedUse ....... .................................................................................................................................. Zoning District .........................................................................Fire District Name of Owner .N&R.MAN.....N.. .)V I .........:....Address .,Ql.�...l�l/l.�ldl�l/Q.�?.�r1..�.� ,E�l.Pl°Gf./111./�/ /�� s ' Name of Builder ........Address e.2 6 5 Nameof Architect ............: ................Address..................................... ..................................................................................... Number of Rooms .....GP........ .:.....................Foundation Q..Cl.�ie �1.�!�/.�'le �.1... ............. Exierior BX.i.C..k....Fq ..Roofing � . - .......... .ld Floors ���V�1.�. .�.. C1� ,i'���P /�/.................Interior Heating ......�f/n.T.../ ../. . .,P`:. 1°Q „f'lllK,Q�iPlumbing ....... . ........................................................ Fireplace ..:/. ...E' ...............................................................Ap'proximate Cost ..... D .::. ................... Definitive Plan Approved by Planning .Board _______________________________19_____=__. Area > /�1�.....................:. Diagram of Lot and Building with Dimensions Fee .� SUBJECT TO APPROVAL OF BOARD OF -HEALTH S I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......L.... :. ��f7:U 7MEIER, NORMAN ,� No 23713... Permit for .One..;:.t.QA:Y.......... Snq.... ... :ami1.y. ...Duze�•1• .ng............. r Location ...Lot...#2 5.....�: 4....O�x��n�..�un�s .Dr. �,dest Hyann sZ?ox. ................... Norman Meier Owner .... ...... ............ ...... ................... �. J ...1. .... Type,of Construction ......FAZaXle...................... Plot ........................ Lot ......................... e - �P, t.. ! .. SI n� ' / •ram.. t. Permit Granted ..December. 21.........19 81 r . I Date of Inspection ty................ .19 Date Comple d ........CL!... � .. 9 4 � PERMIT REFUSED' ...... .. ............. ......` ........................................................... •....................................................................... ` ........ . .................................................................. Approved ..................................... 19 1 - ................ ............................... t a • /O/ f N s II , CERTIFI,E D ,,P'L OT , -P;L AN _ L O C A Ta -ON' 1�,cs>'•�syA�!N/.S/00�2T I SS . - S C A t 'E_ D.AT R E F E R'E.N"C.£ Z 7 A E i H'E: RE8Y C,E.R`TIF"Y ` THATf`•T' HE .YWUIL.01NGs R,•EG. .LAN00' SU.RY YOR SHOWN ON THIS ' PL'.A.N' 1'S"_ i_ OC ATE=U ON THE G. ROUN O AS SHOWN H'ER 'E,QN A f} Josm M. p J . M. ,M0,NA.KA N, 'JR a► , ASSOCIATES •" ;:�� der REGISTERED L-ANC -SUFtVEYORS ,d ENGINEERS 651 MAIN srft I EET ,5rDENNI,SPORT..-MA"SS. 0.26�3`9' �13 . pow— „��""'• TOWN OF BARNSTABLE Permit No. --------- »n.x Building Inspector cash 7 �Nl ------------- 'l0 VAI�\ OCCUPANCY PERMIT Bond ----__ --- - "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to t 'x_ { Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department 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. ........................._........................... I9... .__ ........................................................................_....... _........._...._._.. ._._ Building Inspector THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M A�C(� I DATA y r � � fir" ""L- } A w r 4�. �k � ? � � •E1� ,� '� :. .Y �'•.: 4 �c c 9c r tr �!" ®'X. '^.y, i :y Y ti.': r 1 i �, .r y �". ^�,'+4,'� E''4 y P�, r.��, 1.t` •�s+` .`�� s ,�w� yxafi ..,�C v4�d4 .�" �a' z r � 7„yr. � a 1 Y 4 �.. � �.? � "�s�a., �"ya .+lp�,t. � Y t .�X��,�'4.•i'�y}�� k r .. e• a ry,r �� a� +.' SatiR.��-� �� W��"i a; �. � � ,u'.'y* Y ti '- JI+ `(yy g �t•.rah, tG K L C !l * s r a I �; �a..t� "" �+w e�,o �k„ „q, "}a a.,��'•a .��f"�'' �rt��a�,.,�'*"�h�•"a. j i�+- a rkil S- K "„i`''i!3'K y/� - - j _%'+°{ ��=i�N �a�$ scab sue• 9 �..�e 'T�''� A° j d r y.. ,. Qr w v k 7.. - /97 Wr i5 �.' � •� "��r� } s w.A+�'r4�r'�t,4a�'`�r. • .,3 f ''. 'r ��i W!4"4 i.�r. _ • + 'y¢ }� sy - ii ��i���"�',y3 ��.'�Cg;��1.t y� ���,�F^b •k"x'� ..a � '�rro Yx �� j .v t �Y , as't�x,ERTiFiED P � OP LA N . A "Y 40, », FOR. •� �° DATE- REFERENCE: ��/NG� All IE j< � . <.: REE7. LAND .BURY 1 NEI� EOY CERTIFY THAT ,THE 9 U I L 0 1 , tad t ;. SHOWN ,.ON THIS PLAN , IS. : LOC THE f. R0UN O A $ -SHOWN 14fRE.4N. � h F-7- J. U. MONANA Ns .' JR. &r AS50Cl A TES REGISTERED LAND SURVEYORS lE14Cxl(1EER5 651 MAIN STREET DENNISPORTo UASS. 02639 . 8�•y3 � a� � � �_ �1 � Mo �/ get� � �`u� ��� >r a�' X yr� �i0 �,� � � °� � ,�� �� �� � '' r . THE The Town of Barnstable f 9 9. Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph CrossenBuilding Commi: Fax: 508-790-6230 i For office use only 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: �� 4 Est.Cost Address of Work: ��,,�� �► ��/ Owner's Name %"l/�,L Date of Permit Application: 7 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner 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 SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner.• i Date Zoe- ctor Registration No. nR 1 it{, A Y -)s 13 � I,1 fi,-!, {,1 r), iis' 4J t/ ,f �} �. {`< �f�•�{"�Y re_t it, , � 14rq 1 4 t i r) 1 r t ' {' t _-t f; �t 1` t ,�� •. � A{t..' ; Ys s r '�' .f a♦ � } '1 .i s i � t� 1 )a ie� � s`( lat t S'd!e r\.. F { �A. ( { ` 1. 1 nr 1 A , tis 1.♦ /. � 1 7 •1 �. t { t A.t s:tl l 1 1► /) �j{ t }i4 t. fr L `� {t•.rt +,' 1> - It Ara le �.. ,1? 0 1 . _ s, ��—'_ #J"'r�_.,i�. !S� ✓t,rt't-�{t lyy' .t � '1 �s t� �}/ ., �i } - • • - `, �?i .rt...r.,i..•�.r:�..��zr1r..n,.l' ',?�'��4�.2�}�iG:.Y��caB�ts a�rki'���t�°v�1�4'i�.rll.+{i�,.at`al Y ti t _ e`{oomeonm�uo�eal!/a o�./�aaaaa�uaeQ3 '�1 ? DEPARTMENT OF PUBLIC SAFETY, ' 1 ' CONST;R IKON SUPERVISOR LICENS€ f! JluaW4 Expires: ' E AJ J RILEY +. _ �'PU 80X 382 ` - OSTERVILLE, MA 02655 ,' �.. aeree.ems -2m^�t. 'h'."1`•"� r�.T� �'F`rl?• t ' 1 .. t71 .. .. , zo ✓fie &m✓monawaA ol-AwadeuaeCA HOME I-MPROVFME-NT CONT-RACTORS REGISTRATION - i lq—uildir)c r--gulaticari:3 c3.ii q.nciC{rd ,��,uhbi-wton PLac:E; Room 1301 Pi ost on , Massachuse tt 02108 E IMPROVEMENT CONTRACTOR -- ---------- ---- ---------- ---- - ist)-at,j,on 121422 ExP .ration 05/07/98 ----- E -- PRIVATE CORPORATION 1 . HOME IMPROVEMENT CONTRACTOR Registration 121422 R'fL.E`•( CONI---,1 INIC Type - PRIVATE CORPORATION L L E Expiration 05/07/98 � 746 MAIN ST/PO BOX 382 - J�•TL ?�r LLLE I1 , ri"2c���; RILEY CONST INC CgAIG J. RILEY 46 MAIN ST/PO BOX 382 ADMINISTRATOR OSTERVILLE MA 02655 Y, The Continottlrealth of Afassacbusetts Department of Industrial Accitlents OffIC98 lase V921lorns 4 . 600 !f a.vhittrtuit Street Workcrs' Compensation Insurance AlMdavit �iliPiicint infortnatitiri —PRINT' no le: A acnt• �. Z— rihone!� I am a homeowner p rming all wort: myself. j I am a sole proprietor and have no one working in any capacity [1 I am an employer providing workers* o pensation for my employee oricing on this job. a Coot tam• name: cin i�i '�t2� rhnne It• � �'f 1 y� insurnnee co. lice•it p2�W r—, I am a sole proprietor. general contract r• or homeowner(circle one) and have hired the contractors listed below who nz the following workers' compensation polices: mmnlm• nitnc• - 1tlrlrCSS• Ctrs" nhnnC�• nniiCt >� In511r1n000n •i..:•'�. Vim.^. � _ 'Y' - r --- _' -.l. �♦ __ _-���i�r+�.r�� Cnrlr nn%, name: address• Cite.. nhonc ft• incurincc co _ policy it Attach additio_naisheetifnecessary =••�: ^- '^f' ' �SSiv �r����• ~^�� �—�' �'`�C''wa"�'• :.r Faiiurc to secure roreraCe:u requtred under 5ecnon.SA of NIGL IS'_can lead to the imposition of criminal penalties of a tine up to S150U.UU andiu. uric.cars' imprisonment:is well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that cop} of this statement mad be furn•arded to the Once of Investigations of the DIA for coverage c erification. I do herehr certify tinder the paints and p• tics f periun•that the informations prodded above is true and comet 27 _ t Si:nat 0 urr -" Date n / Print name Phone# w - •��"��UIYI.f ' oriicial use unh do not write in this area to be completed by cin•or town official ti ci permitilicense i# t'•tlluilding Department ty or town: ` :3Ucensing Huard C check if immediate response is required ascleetmen's orrice �- C311c2ith Department conrarrperson: phone#: MOther. t Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' ccnnpensation for their employees. As quoted from the "la��". an cmrplitree is defined as every person in the service of another under ally contract of j,vre�, express or implied. oral or written. An enrphnrer is defined as an individual. partnership. association. corporation or other legal entity. or any Iwo or more . the fore._oin�_ cngaued 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. However the ,,xvner of a dwelling house having not more than three apartments and who resides therein. or the occupant of the house of another who employs persons to do maintenance , construction or repair work on such dwelling_ hoes )r on the arcunds 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 sliall withhold the issuance or •ene"111 of a license or permit to operate a business or to construct buildings in the commonwealth for any -hPlicant who has not produced acceptable evidence of compliance iwith the insurance cowerabe required. \dditionall neither tite commonwealth nor any of its political subdivisions shall enter into any contract for the crformunee of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha .een presented to the contracting authority. hhficants '.ease fill in the workers' compensation affidavit compieteh, by checking the box that applies to your situation and applying company names. address and phone numbers as all affidavits may be submitted to the Department of .dustrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affdaviL The Yidavit should be returned to the city or town that the application for the permit or license is being requested. )t tite Department of Industrial Accidents. Should you have any questions regarding the "law- or if you are required obtain a %vorkers* cotnpensatioi; policy. please call the Department at the number listed below. _. -. ;ty or Towns =mse be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of affidavit for you to fill out in the event the Office of Investi?ations has to contact you re_ardin= the applicant. Pleas sure to fill in the permit/license number which will be used as a reference number. 77he affidavits may be returned to Department by mail or FAX unless other arrangements have been made. e Office of Investicatioils would like to thank you in advance for you cooperation and should you have any questions. -ase do not hesitate to __ive us a =11. Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents office of Investigations 600 Washington Street Boston,Ma 02111 fax #: (617) 727-7749 phone ,"': (6I7) 7274900 ext. 406, 409 or 375 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) IM A , - I / �C(�'� L DATA ', Assessor's map and lot number ............................................ pG T N E Tp�o Sewage Permit number ........................................................ Z BA"ST&BLE, i Housenumber ........................................................................ ro MU& psi t639. �0 MAf a TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: f The undersigned hereby applies for a permit according to the following information: Location ....................................................................................................................................................................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner ......................................................................Address .................................................................................... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing ................................................................................... Fireplace ..................................................................................Approximate Cost ......�/ Jam. ..�C�..Q..................................... i Definitive Plan Approved by Planning Board --------------------------------19_______ . Area �s'�Q....................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. T MEIER, NORMAN =245— .- 23713 Permit for O e ory No ................. ...... ...................... Single Family Dwelling Location Lot #25, 100 Green Duns Dr. We u�, m= ort ................................ .... Norman Meier �... Owner ............................................ Type of Construction ?Fr.ama........................... ................................. ....... I............................. Plot . Lot `................................ Permit GrantedDecmber 21, 1q 31 :.. ........... Date of Inspection .......... .......................19 Date Completed ........... . .......................19 i PERMIT REFUSED ' ............................ .. ... .. ...... ............... 19 . . ..... ................................. - ........................... ........................:...:.I....`............. �r .. .......... ................................................ l.:........./:.&a ........... r. t . Approved ..........// ::�: (�................ 19 .....................:.......................................................... ............................................................................... p!r- - - I - - - - — __ I I, I . I . . I I I I . 11 �� � . . 1p � ! ,; - , . ,"! I . I . k ek I, , , - - . I �, "% , .1 o, #,� , , , ��, I i I I ­ , ., . . , . . p If - 1.'i , f, t^). � , - - I , , i , . . r, � , .. . - I f �� . "- t".�,,,�,,�,,;-,,�""�w i �" .g, �, � ­ I.. � . I I I - I . . � -�. 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