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TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION 1P1f6PERTY INFORMATION_._ Address of Project: 116 o 7/7f 1 ,-- /in E S ET :VILLAGE Owner's Nam i Phone Number Email Address: Cell Phone Number Project cost$ D 0 ° db Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE,OF-WORK Q Siding ❑ Windows(no header change)# ❑ Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than I-layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# . (attach copy) Construction Supervisor's License# 4.. �` t ti (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR/F THE SUBJECT PROPERTYIS/N A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. r' APPLICATION NUMBER............................................................ *For Tents Only* , Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No , if yes, a gas permit is required. Natural Gas Yes No ,if yes,a gas permit is required: If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side ;HOMEOWNER'S LICENSE EXEMPTION t Homeowner's Name: .,, Telephone Number Cell or Work number -Sa J/-_T 6 o _ 1 I.O I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature RQ -- G6 C _Date 0..2• �6 APPLICANT'S SIGNATURE Signature o G/`'/ f ze— 4q'y Date -6-;7 • `6, 1 Y All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/duz Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information flleease-Plriint Legibly Name(Business/Organization/Individual): - ;Address: City/State/Zip: /e d Phone#: 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(full and/or part-time).* have hired the sub-contractors 2.❑ 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. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. insurance.: re ire d.] 5. ❑ We are a.corporation and its 10.❑Electrical repairs or additions 3.' m a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL . 12.❑Roof repairs insurance required.]t c..152,§1(4),and we have no employees. [No workers' 13.0 Other' comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: - Expiration Date: Job,Site Address: il6 � 0�� i City/State/Zip: I� �i���61�1_ t - 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance.coverage verification. I do hereby certify under the pains andpenaldes ofperjury that the information provided above is true and correct. ,Signature:' r4&:z leo �� p CDate:- 'C� • f Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M 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 orimplied,oral or written." c 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,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage 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 of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: - - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFB Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia 1� Town of Barnstable Buildin7, g PostThisrGad�So Th ' °°=V 'b1eF the St`r et_ I Mu be Retained ori'obandthi ar at rt is, isi rom Approved P ans st J s C d Must be Kept , .,...• ,pTABH.. .. Lf �' • ,Posted Until:vFinal-Inspection Has Been Madero t Whew Cert�fi�ate of O.ccu ant: °is Re wired such'Build�n shall Not:beOccu red until a Final lns ection..has�beenmade ,. Permit Permit No. 8-18-75 Applicant Name: Brien Langill Approvals Date Issued: 02/13/2018 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 08/13/2018 Foundation: Location: 116 KNOTTY PINE LANE,CENTERVILLE Map/Lot 91 096�� � Zoning District: RC Sheathing: Owner on Record: PRATTS, MARVALEE PARES F Con"tra�ctoNeme � BRIEN LANGILL Framing: 1 Contractor Licens CS,106675 Address: 116 KNOTTY PINE LANE h 2 CENTERVILLE, MA 02632 Est Protect Cost: $24,244.00 Chimney: Description: Installtion of roof mounted photovoltaic solar systems,38 panels PermitFee: $ 173.64 Insulation: 11.020kW � FeTw Paid $ 173.64 Project Review Req: Date 2/13/2018 Final: o S Oz Plumbing/Gas 3 Rough Plumbing: � y g .. 3.. , .. . ... Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withm six months afterssuance. All work authorized b this permit shall conform to the approved a I co it o6and_the a roved construction documents:for which this permit has been ranted. Rough Gas: Y P PP PP Pp P g g . !' All construction alterations and changes of use of an building and structures�shall-be in compliance with the local zonin"` b -laws�nd codes. g Y g >< P g Y r This permit shall be displayed in a location clearly visible from access street or toad and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. : z es Electrical The Certificate of Occupancy will not be issued until all applicable signatures b the Budding and Fire®fficiais are provided on thisepermit. v . J Minimum of Five Call Inspections Required for All Construction Work:' Service: s ,' 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final:4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: 4 (` WWI @- own of Barnstable *Permit#vl©d 6 2008 Expires 6 months from issue date MAYRegulatory Services Fee (p OWN OF BARNSTA4 as F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www:town.barnstable.ma.us Office: 508-862-4038 Fax: 508=790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address I 1�✓1 J+ hi f n Gn if it lm� Residential Value of Work 6, [� fl�'J . Minimum fee of$25.00 for'work under$6000.00 Owner's Name&Address SQ4n ►' c M uii t n Contractor's Name Telephone Number Home,Improvement Contractor License#(if applicable) L17j Q S 3 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner © I have Worker's Compensation Insurance Insurance Company Name 01/A Workman's Comp.Policy# r i r� 7305A 62 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) [� Re-roof(stripping old shingles) All construction debris will be taken to &C2121A cl✓�/� ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expm.trg Revise061306 f of ►�,,, Town of Barnstable Regulatory Services * BARNSrastE, 9 MASS. g Thomas F. Geiler,Director 0;,9. pie Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 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 e prop n rtY hereby authorize KI _ a- V)! ► l/�S� D» to act on my behalf, in all matters relative to work authorized by this building permit application for: `P '" icy (Address of job) hoa Signature 9f Owner D to RCP,)/,0 Print Name Q:FORM&OWNERPERMISSION Department o f Industrial Accidents Z Office of Investigations d 600 Washington Street y` Boston, MA 02111 - - ' M s� www mass:gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers applicant Information = - Please Print Legibly " flame (Business/Organization/Individual): �(et. address: SY Lower Baa�u _'ity/State/Zip: So /clmyyff, ►V0 D Z 6AI Phone#: 76d- 27;o Z re you an employer? Check the appropriate❑b I am a eneral contractor Type of project"(required) - I am a employer with- g actor and I: 6.:❑ New construction employees(full and/or part-time):* have hired the sub-contractors - ,�] I am a sole pioprietor or partner- listed.on the attached sheet 7•. © Remodeling ship and have no employees _ These sub-contractors have 8. O:Demolition working for me in any capacity. - workers' comp. insurance. 9. Tj Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] ' officers have exercised their 10.❑ Electrical repairs or:additions 1] I am a homeowner doing all work right of exemption per MGL. 11.0"Plumbing repairs or additions myself o workers' co c. 152, 1(4),and we have no Y comp. § _ , 12.❑ Roof repairs. insurance required.] t employees. [No workers' co.mp. insurance required.] 13.0 Other ry applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: 'z :)meowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit at new affidavit indicating such. ntractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy inforTnatim. m an employer that is providing workers'compensation.insurance for my"employees., Below is the policy and job site 4rmation. urance Company Name: icy#or Self-ins.Lic. #: 230514 -G Expiration Date. 3 4 Site Address: ilk 4Qahf P'nr Lei - City/State/Zip: rile'-.4te al UZ 3 L-- :ach a copy of the workers' compensation policy declaratiod page.(showing the policy.number.=and expiration date). lure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a-STOP WORD ORDER and a fine - gp to$250.00 a day against the violator. Be advised that a-copyof this statement.may be.forwarded to-the Office of -estigations of the DIA for insurance coverage verification. 9 hereby certify under the pains and penalties of perjury that the information provided above is true and correct. ,nature: h�o�- Date ane#: Ofcial use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): Y.Board of Health 2.Building Department 3.City/Town.Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information .and Instructions Iassachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. ursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, cpress or implied,oral or written. m employer is defined as"an individual,partnership, association, corporation or other legal entity,or any two or more f the foregoing engaged in a joint enterprise, and including.the legal representatives of a deceased employer,or the ,ceiver or trustee of an individual,partnership; association or other legal entity, employing employees. However the Aver of a dwelling house having not more than three apartments and who resides therein,or the occupant of the . .welling house of another who employs persons to do maintenance, construction or repair work on such dwelling house- appurtenant thereto shall not because of such employment be deemed to be an employer." r on the grounds or building 4GL chapter 152, §25C(6)also states that."every state or local licensing agency shall withhold the issuance or ,enewal 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." kdditionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall inter into any contract for the performance of public work until acceptable evidence of compliance with the insurance equirements of this chapter have been presented to the contracting authority." kpplicants ?lease fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if iecessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s) of nsurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners; are not required to carry workers'compensation insurance. If an LLC or LLP does have ymployees,a policy is required. Be advised that this affidavit maybe submitted to the Department-of Industrial Accidents for confirmation of insurance coverage. _.Also be sure to sign-and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,-not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please-call the Department at the number listed below -.Self-insured-companies should enter their_ self-insurance license number on the appropriate 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 permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given-year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in. (city or town)."A copy of the affidavit that has been officially_stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new"affidavit must be 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 like to thank you in advance for your cooperation and should you have any questions, - please do not hesitate to give us a call. The Department's address,telephone and.fax number: The Commonwealth of Massachusetts . Department of Industrial.Accidents Office of Investigations 600 Washington Street ° Boston, MA 02111: Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 rvised 5-26-05 www.mass.gov/dia RE" - �g7 Board of Buiiti 10 Regulations and Standard N„ .NONE IMPROIEMENT CONTRACTOR 3�8�8226� , ! ° r Registration •' � ; 1<.: 53 Expiration. 6i14/^008 n"�sr, G } kEATING NST CO x. t I a' �CEATI,t� TIM HY TING OT .n q t' KEF .�. TIMO S-YARMOU, u z f SO YARM0UTH,,MA 02664 Deputy Administr ator OWERBROOKRD. A-CORD CERTIFICATE OF LIABILITY INSURANCE DA,El�eN1°°YYYY► 03/04/2008 O° THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SCHLEGEL INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 34 MAIN ST HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WEST. YARMOUTH, MA 02673 INSURERS AFFORDING COVERAGE t-+ NAIC# INSURED Timothy Beating Dba Beating Construction INSURERA: COLONY INSURANCE _ INSURER B: CNA INSURANCE 54 Lower Brook Rd INSURER C: INSURER D: ` South Yarmouth, MA 02664 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY. PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY NBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLNMS. LTR RM TYPE OF INSURANCE POuCy NUMBER DA EY EFFECTIVE POLICY EIwRARON TE(IrmIDDrYY) OATE(wwDDrrv) uWTs A cEIERALuaeluTr GL3326876 03/06/2008 03/06/2009 EACH OCCURRENCE $1,000,000 X COMMERCIAL ENE GRAL LIABILITY PREMISES(Ea ocwerrce) $100,000 CLAIMS MADE Fx-1 OCCUR MED EXP(Any one person) s5,000 PERSONAL&ADV INJURY i 1,000,000 GENERAL AGGREGATE s2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG 52,000,000 POLICY " LOC , AUTOMOBILE UANUTY COMBINED SINGLE LIMB f ANY AUTO (Ea acdeert) ALL OWNED AUTOS BODILY INJURY f SCHEDULED AUTOS (Per person) HIRED AUTOS - BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE f (Per accidert) GMMELIAHLITY AUTO ONLY-EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG f ... EXCESINU ERELLA LIABILITY EACH OCCURRENCE $ OCCUR El CLAMS MADE - AGGREGATE s _ f DEDUCTIBLE - $ RETENTION $. S WORKERS COMPENSATION AND X TORY LIMITS ER - 8 ANY 1 EORIP EMPLOYERZ �ARINERAD(ECU IVE 7305A-6-07 03/09/2008 03/09/2009 E.L.EACH ACCIDENT $100,000 OFFICERIMEMBER EXCLUDED?If ym, E.L.DISEASE-EA EMPLOYEE $ ZOO,OOO SPECIAL PROVISIONS er YE$ E.L.DISEASE-POLICY LIMB S 500,000 SPECIAL PROVISIONS 4ebx OTHER. DFSCW PTILTN OF OPERARONS I LOCATIONs I VEHCLES I EMLUSONS ADDED BY ENDORSMENT I SPEO/LL PROVISIONS THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE WOKERS COMPENSATION INSURANCE FOR TIMOTHY BEATING CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE AM" DESCRIBE) POLICIES BE CANCELLED BEFORE THE EXPIRATION .. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 21 DAYS WRITTEN NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO gjALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY MN; THE INSURER, ITS AGENTS OR REM(ESE NTATTVES. - - AUTHORIZED ACORD 25(2001M) ©ACORD CORPORATION 1988 p 1 Gvb/� ✓o Assessor's office(1 st Floor): /. • t b a'� Assessor's map and lot number ✓ f! lilt INSTALLED IN C���b�����4 Board of Health(3rd floor): WITH TITLE 5 Sewage Permit number ,� - a ,� ENVIRONMENTAL CODE ' ' Engineering Department(3r8 floor 'r('1 Q �!�.. �5 !' 2 DAHd9TAXE r AX& House number ` °o 163o Definitive Plan Approved by Planning Board 19 I 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 TYPE OF CONSTRUCTION C� b .� 19 ' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: *zz/,Location Proposed Use Zoning District Fire District Name of Owner Address Name of Builder � f�l�` �' `J Address Name of Architect y� Address j Number of Rooms �— Foundation Exterior bQ Roofing ie&'(49 Floors �' � Interior Heating Plumbing Fireplace Approximate Cost i Area 3 U O Diagram of Lot and Building with Dimensions Fee f ) OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License � �� McGONGLE, TERRY fy • No ^—'-Permit For Build Garage Accessory to Dwelling Location Lot #2 7 , 116- Knotty Pine Rd. Centerville s Owner Terry McGongle Type of Construction Frame - ^ Plot Lot ` Permit Granted April 23 , 19 91 ` Date of Inspection 19 Date Completed 19 s• S Up i r " . ,..ram.-u•n+'y-/ .r:r+�r.:...a`4i;-.Y r'n.r..,F,:��wr.✓vvy.y4}•4„r..,....i"'l.+.r..�i""s«..;�,...ru i7+i4.. V iai,.y.,. „ v'«..�r�+....^,.ee-r:^d t..`r.�-77 � ,,..,nr;,,vv�FrM"�ayo tr.�p..p.n.>.-....,...+..r ^e.,l Assessor's office(1st Floor): /�/_ n/ �+ Assessor's map and lot number (J7ry (� �oi tN.E To` Board of Health(3rd floor): Sewage'Permit number Engineering Department(3rd floor '`'' -asaas9Tsntc S }r-A5 a House number Aoo a6-39• Definitive Plan Approved by.Planning Board 19 1 YEr APPLICATIONS PROCESSED 8:30=9:30 A.M.and 1:00-2:00 P.M.only ` TOWN OF BARNSTABLE "' BUILDING INSPECTOR { 1 Cry APPLICATION FOR PERMIT TO �tr TYPE OF CONSTRUCTION -[ 19.E �I I i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Ae Location - i Proposed Use Zoning District Fire District Cat Name of Owner t' - ` CV Address I� z ! _. _.. Nameof Builder l'� � CJ -� Address %)"D 6V. Y"l-. �� �.5`,> Name of Architect Address Q I Number of Rooms ' _ - Foundation - J� Exterior ��® zS� � Hoofing J _ LG Floors Tz6 d ���r""' Interior � � -- Heating Plumbing �• /'Y� - fireplace �— Approximate Cost Area 3 U Diagram of Lot and Building with Dimensions Fee �� L I ti 1 f � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS i I hereby agree.to conform to all the Rules and Regulations of the Town of,Barnstable regarding the above construction. Name (/v/U Construction Supervisor's:License i McGONGLE, TERRY �.- s 761-096 t No 34289 Permit For Build Garage Accessory to Dwelling' Location Lot #2 7 , 116 Knotty Pine Road Centerville Owner Terry McGongle Type of Construction Frame Plot Lot Permit Granted April 23 , 19 91 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1/1/�� i ' I ' f ! i A✓:J by �it�'���+! � - ! AvJ N, C:U��G�. �-fa%v-�;n��� � 1 r i i - �f Y:�_ ='r`-'s.p��,iCa � ys► � I:YI v:dye^1Y7 i i vE � t I I Co CA - .._._..:.�..._�_...._..—..-- -�... .._..,.__.,-_._-.�. ___ _�....__— •_---'---• -__.__.. i _ -..� .� �:�L .mow F�.'-::,1�"`:�,r°.�z3�:.M••'�"ry.�-.,i, . ...._..___._.__... ......._-_. ...a_ �....._.,.» .� .�f�. ••�(,i _ _ � _� - �...... _ _.. ... .4 GCtVG.'SL01� - ..� __ .� .____ . j�.� (��s t _ ..._ :.. �...,a � ...�- 1 � 4 . - � i E.�- a ., .., �`, ;�.., ,�" ems,,.-� e may �•�w.....��. k �=0" pp) ---. —_— ---T 9 y e t. ,. ,�'aY �,,� ..:.,�, ryw.. Y ,;,... .� ., i. � .a.„ - ..y :w. .iw. , '�, i�,{" ,+�,.', :»••u9 '.:r n;? +. � �.a �.' - G'• .� .. � ... �h"i ".� Q ..1 f �.�� - �...ri{', xt i i�. �: r k., !�`.�r} ph�� �,.�t 'µ.. �$P`u•r, �,6 ' -'F1 .�. ~ ... .._,« 4J -...s` T:._, .. - _ .M,. .r •,ry...• i `,V,aF.+. _!`+ g sr ^'..j...w+�Y g, ! s •'. 1 L ��'`�`'� --�,►9y i 2`-C I0-0'-Cx7'-o"o.H. Doo�� v 'I 3: r• m -- "'* , `.".r.. a� , "'` S ..rf .......,. - ., :._!'.,; J :;•yam •.}' +it._ io-s.�- h - .vw� .� --.+*.« -. _ ^...;�: w, ors�' .-» .,. - ..- w .,�,..,. 'w',..:r- ,,...•n 'a, ..... «.w-.`3. .. -.;.., «..a '?:, r x� � ..y,v ..�,. ..,.:r: `.a '4.'�-.w"` .".".;y. w _ 4 7: fe IA-5 14A I4f '- V - 'xpJ — — �--- C O C. AP�'AN I i I - --- - - - - ,1 _ _ _ } w , i X ,x'ti .'.PC.. +a y,...d*,y�9[„��'^ "F „'k„ M ti ^v 4_f t �.� - •. - . x.S .a�'3 F�L -.c.ma.. '��,. .e'a.'!_e c�"Sh..�%- " - n .�- ^1,"•n 'ti -!^ ._. - . .. i. .. � ` _ - - - ► ______-_- _ ___ IIzv6- - r---- _ (` - ------- ---- M - _ -- .�---- f AT.H Haus ) ' �� .—"5!. r�-_ - '4 LOT 28 LOT 29 W Z S 78'28'20"E Q 272.38 . 2 ---� W W / ti : Lij O -j p LOT 27 0 2 26, 970 S. F.lu y 25. 267. 02 N 78"28'20"W © LOT 26 O PLAN REFERENCE* LOT 27 LAND COURT PLAN 328988 (SHEET 2) PLOT PLAN OF LAND "TO THE BEST OF MY KNOWLEDGE, THE DWELLING LOCH TED IN SHOWN ON THIS PLAN IS AS IT ACTUALLY EXISTS ^.`r BARNS TABL E - MASS. ON THE GROUND. e PREPARED FOR DATE: FEBRUARY 26, 1991 _:►:;;: � i TEPPA NCE Mc GONA GL E DATE.•FEBRUARY 26. 199/ SCALE. 1 0-40 FT. • ":.��ar� <ao�/a CAPE 6 ISLANDS SURVEYING FLOOD ZONE C FALMOUTH — MASS. D-38 b�Qy�fTNET��yn TOWN OF BARNSTABLE i • i BAHBSTAHLE, i 9� D 39-Ar BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........ ....... ............ .... ......... . ..... . . ................. .......... . ..... TYPE OF CONSTRUCTION ..... ..... . ... . . . ........... .. . �'P . ../ PtE!�, .. ,�{e�/ .. ...�tr .................19. . TO THE INSPECTOR OF BUILDINGS: The undersigned `hereby applies for a Ipermit cording to the following i fo�matio, : Location ..P^�..1... `. !'........ . - ........................................................... ..Proposed Use �a fir... �1 p .. ..... . ... ..... ...... ................................................. .. ......................... Zoning District c." Fire Di tri to Nameof Ownerv�:: ,.v �. ........ .....�+:. .........Address ..................................................................................... Name of Builder l l:G4 , ..�d.. ..............Address ... V... .� .P.1!� ..... .. .tiO / Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..............^..o./.............................................Foundation .............................................................................. Exterior ...................................Roofing Floors ... ..................................................................Interior ..' .....'•" . ..a�.�A.:l!'� ............................ Heating Jr':.. ..................................Plumbing `...... ...............el .. . .. j, ...................................... Fireplace ... ..............................................................................Approximate Cost ..... ..0.0.J................................. ?.. Difinitive Plan Approved by Planning Board -----------_______-----------19________. _ Diagram of Lot and wilding with Dimensions 0d W w LL U) c� cn -a a /6 � W � w� 1 _ �o °' � ELL O: : : oo L- w i - .: z cr to -jm�? Q � o _ Iz- a� LLJ o ma � w Z-w - � ® d �...,�. � ---' - �' O Q LLI a � Q 04 ~ D � Q ry < cn < w i- w LVye - pews I 1vE I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..Wk:; 60.1%4,.:Q .. ... ......... McGonagle, Terrance 14682 one story No ................. Permit for .................................... _ single family dwelling ; ............................................................................... Location Knotty.. . Pi. .. ................. ne Lane ............. .. . .... ......... .o Centerville ....... ................................ ` terrance McGonagle Owner .................................................................. frame t Type of Construction .......................................... �- ................................................................................ Plot ........................ Lot ................................. A)o Permit Granted January 5 72 I .................................19 Date of Inspection ...... . ...... Date Completed .... .. .... ....t�......✓... ... 9 r. I � 'V PERMIT REFUSED ............................................................................... ................................................................................ ............................................................................... aU Approved ............. 19 ............................................................................... z ...............................................................................