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M __,__, . _____, .___ iii Assessor's office(1st Floor): /-� DI° Assessor's map and lot num Q --6W O'r SEPTIC,$@IS Conservation(4th Floor): '" � '' NSTALLS® �E "USA'a Board of Health 3rd floor �� 94- Sewa a Permit number E 3 co ,TIT rua g L!� �1/�lc/ S' P771' S'Y��,�iyt Engineering Department(3rd floor): ROMMk�TAL co�,b�o House number - CODS AND �r�r Definitive Plan Approved by Planning Board 19` ��� �� �l APPLICATIONS PROCESSED 8:30'-9JOWM:and 1:00-2-00 P.M.only c.4 , TOWN OF BARN•STABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF,CONSTRUCTION L�r F 199 4-' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following-information: Location Proposed Use L d0A(D 1? y mil-�}f9Z.F i3 r Zoning District R b Z Fire District -C Ems.. 017Y. )V/[.LL Name of Owner, F��l�l , cr- ek o 0 a Address /9. ei Ap� L fi ALA,. C°C=&L4�2 I/i[! j- Name of Builder (`F 8 (,/ 7_ Address ?,62;4 `L ()(Lr-191).,.t&�'�IC CNffCR/N F4I-L-!?, OW/b Name of Architect a"P /,V X n Address LL �'�j /t�G RNI 4 62 Number of Rooms 49t.W 0[2 X 4- //CF Foundation PUU .,47 rO c' L7.ci n jR� r f. Exterior W O d /J Roofing .13 Floors W G O D ,t- H/yI.Va Interior Heating / f 1'7 ' Ofn� cL7 Plumbing d/�� -f' Rke Fireplace /V 6/ls/C Approximate Cost !� Area Diagram of Lot and Building with Dimensions Fee ®� ' o. r t ! �J l t l -A i 53 / `� OCCUPANCY PERMITS REQUIRED FOR NEW.DWELLINGS - -- - I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name p))zoo) '! Construction,Supervisor's License JACKSON, JANE No 3r T75- Permit For BUILD ADDITION SINGLE 'FAMILY DWELLING Location 19 Hornbeam Lane Centerville _ Owner.. Jane Jackson Type of Construction i Plot Lot Permit Granted June 9 19 94 Date of Inspection: Frame - 4 V19 Insulation 19 i 4 Fireplace. 19 Date Com leted i 19 p 4 . • 1 - `; 'COMMONTWTALTHOFLle A _— DErAR,MENT OF INDUSIRLAI&ACCIDF�7'IS 600 WASHINGTON S T James BOSTON, MASSACH JSITS 02111 � n pmnss O e: WOR FERS' COMPENSATION INSURANCEAFFIDAVIT , Y.�. _�' i _•.i y lQIliCL -. r _ 'kt'�.^t`r ♦ f �Y vwnm a pnnapal lace of bunnas/rrsidenoc 7. hexer '„M. \.r •J��{,,,,�/�-� s F. do hereby comfy.under the pains and peaalc=of perjury,tlnc x t= [J I am an employer providing the following workers'compensation coverage for my employees we ng on this job. ''' Insurance Company Policy Numbs l am a sole proprietor and have no one working for me ( ) I am a sole proprietor,gcncr-al contactor or homeowner (circle onc)and have hired the contractors listed below who have the following workers' compensation insurance policies: - - Name of dnzr2aor Insurance Company/Policy Number Name of Contrao'r Insurance Company/Policy Number Name of Contnaor Insurance Company/Policy Number, Q 1 2m ; homeowner performing all the work myself. NOTE.Please 6c aware tiv while homeowner:wco employ persoas to 6 caictcamcc.construction of repair-work on a dwcliinc of not rzorc thaw t rcc units in waicb tic horyco•mcr use resicu cr oo tic Frouacs appurtenant thereto are not rcacrall}' consiccrcd to 6c employers unacr tic"—"orL-crs'Compersatioa Act(Cl-C 152.seer 1(5)),application by a bomeowocr for a license or permit may cvit:encc 6c lccal sutus of as employer under the Vorkcrs'Corapensatioa Act ` 1 uadr._,z1d t . .car• c:t� .5t:.c-1c:.will be forwrdcd to ti:c r'ico::-:c.t of i:cus:ra.'Acadcncs'Ofricc of Insurance for corcra�c -Cr:-J=-icr. �.^.0 .-.. .:..�.. -0 sc::..:c c-O�c—_rc:s rccu::cl cn&.-Sccoio7 C.r.ic:d to ti._ irnpoiidon ormTa:1Z1 per"Ji== cc.^.sis:!-[of- i:-c C. t:c tc S SnG.GG._-.do: •= Work Ordcr 1M:;rLor-- .t or uc to orc ye: nd c ..pcn_:ncs i.-1 tre form of a Stop fine of S 1 GO.OG: d:v zz ns:rnc. Sicncd this day of . 19 i COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY _-ONE ASHBORTON.PLACE_._..,- .__._. MASSACHUSETTS ,�'r' t BOSTON MA 02108 LICENSE CAUTION EXPIRATION DATE CONSTR. SUPERVISOR 09/30/1 995 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB NONE 0 6/3 0/1 9 9 3 0227101 PRINT IN APPROPRIATE OEORCE E MAR0IUXT —� RnX ON LICENSE. ° 267 FALL OUTH RD ° r z HYANNIS MA C2601 Z tjAl�/j STI��UPERAT�iS m m •( PHOTO(BLASTING OPR ONLY) FIf C,0.00 ���•••/// r r �) is 43 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER ✓% D.P.S. ) THIS DOCUMENT MUST BE - « SIGN NAME IN FULL ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF GNATURE OF LICENSEE ` - THE HOLDER WHEN EN. . OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATION Oi10 l II I HOME IMPROVEMENT CONTRACTORS' REGISTRATION Soa'rd of ESU1lC:jinC; Rv �UiFtL.J..C;.r..l 1rlCf t. :.;1i<:iF1YCi:a , . One F° shbu)—ton Place f:o :yiri 1:30'I I Go toll , ilzac _iac("iUw•c;tt,,> 02100 E 10ME IMPROVEMENT CONTRAC`l-OF: _ 53i.. strati Ur1 111175 E%X i-rat.i.on. 1,2,/ I/9Zll ) TY ae - INDIVIDUAL. °T e..&'a�,l�,�r�l,.,ear I HOME IMPROVE�!-N. �,U,i;�,CTG�, Registration 11117 GEORGE E MARQUIT Type - INDiVID'JAL GEORGE E . MAROUII" Expiration 12/09i94 267 FAL.MOUTH RD HYANNIS M.A 02601 GEORGE E MAROUIT GEORGE E. MAROUIT ADMINISTRATOR 267 FALMOUTH RD HYANNIS MA 0260; • I. 't 4Hc-IV , � r . i0lt IRvtJ -- � • �TEPs /.D CD - NEW Wow>D DEGtt t�c►.�N i A�. vG©alC� i3�K. G7� - ^jbAS�ME�J"( F N D. A 5 t f= c o c P { g t t jI,,C- I�ITeHE►.1 LAYOJ-f • NEW f'UGK--r,T T�Ofz NEW WAIL �r W IIJDv�-I Ti P 'io E x I ST'G-►. I�I N�ot� l MA, ICH F7� i i i ter- -II Ir1--�7 I I I r-r--t r r Ff�