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HomeMy WebLinkAbout0055 LAKE ELIZABETH DRIVE ����, ,, %,, e ��: a �, ,.. n G. c 0 ti TOWN OF BARNSTABLEFBUILDING PERMIT,APPLICATION , Map lG! Parcel • � �Co -`Application # Health Division = `Date Issued Conservation Division ,Appb.catior Fee Planning Dept, "Permit Fee �'� ' C' Date Definitive'Plan Approved by Planning Board CIc I /J - U Historic -OKH Preservation/ Hyannis t VViim�/ , Project Street Address 171K�G &t Z4�ib(!�,�/ , D11 Village le" Owner GV Address nn Telephone �o r!..0 (p IT '' _ � Permit Request �C Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation (4 1s Construction Type Lot Size j D Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 4- Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: XFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)T� Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 5 existing Dnew Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other Central Air: ❑Yes )& 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 N If es, site plan review# Current Use �� Proposed Use. lr_ # APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name a e C✓�%CJ `�,(�.t�CJ�,�t�—� Telephone Number Address 1T�a 61k ( q1 License# (�J" �� � ��' 5�Ss3 Home Improvement Contractor# Worker's Compensation # w s (Dy ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO "Un SIGNATURE DATE i FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER. DATE OF INSPECTION: ` FOUNDATION f t FRAME K 9 ti INSULATION 9 > FIREPLACE `t ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO: k The Commonwealth of Massachusetts Department of Industrial Accidents =1 Office of Investigations k. � 600 Washington Street P Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavits'Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): rawt..t,,( L W-6 I n Address:' �� — City/State/Zip: - �We . AIA 0� Phone #: �27 - '2b06 Are you an employer? Check the ppropriate box: Type of project(required): I am a employer with 4. ❑ i am a general contractor and 1 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ 1 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 in any capacity. employees and have workers' 9. ❑.Building addition [No workers' comp. insurance comp. insurance.'- required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1].❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof rbvairs insurance required.] t c. 152, §1(4),and we have no- employees. [No workers' 13. Other , comp.insurance required.] *Any applicant that checks box#1 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 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. �n Insurance Company Name: Policy#or Self-ins. Lic. 4: Expiration Date: �,z Job Site Address: 1aA,Hi2kLWfi Vilve City/State/Zip04* y/kM)9 020pz 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 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 to the Office of Investigations o he DIA for ins an e coverage verification. I do herehy c ifj? rler tl a sins nd penalties of perjury that the information provided ove ' true and correct. Si nature: Date: I 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): L Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.-Plumbing Inspector 6.Other Contact Person: Phone#: ACID CERTIFICATE OF LIABILITY INSURANCE; °ATE/29/2012 �...� 06/29/2012 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 INSURER(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 the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: German)Insurance Agency PHONE - FAX 908 Main Street A/c No Ext: 508 428-9194 A/c No): 508 428-3068 Osterville,MA 02655 ADDRESS: • INSURERS AFFORDING COVERAGE NAIC# INSURER A:SAFETY INS CO INSURED - -- Scott Peacock Building&Remodelling,Inc. INSURER B P.O.BOX 171 INSURER C: Osterville,MA 02655 INSURER D: Commerce&Industry Ins.Co. - INSURER E: T INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A GENERAL LIABILITY CP00001152 7/5/2011 7/5/2013 EACH OCCURRENCE $ 1,000,000 470M MERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES Eaoccurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ ` GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: . PRODUCTS-COMP/OP AGG $ POLICY PRO- JECTLOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per acc dent) $ HIREDAUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIA OCCUR • + ��,� EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE - AGGREGATE $ DED I I RETENTION$ - $ D WORKERS COMPENSATION WC 005-81-5464 6/22/2012 6/22/2013 VVC STATU-. OTH- AND EMPLOYERS'LIABILITY Y/N r Y FR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH-ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) r E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION 3 4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Scott Peacock Building&Remodeling,Inc. THE EXPIRATION. DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fax#508-428-7625 Scoff—Peacock@verizon.net ' AUTHORIZED REPRESENTATIVE - ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/06) The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supers isor License: CS-094500 ' JAMES S PEACQ(K - ' PO BOX 171 OST.EVILLE MA--02632 4 Expiration Commissioner 07/22/2014 Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991m3)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS i , C1le .................A/1"Cep,C����rddac�ccJeC�J' S, Office of Consumer Affairs&Business Regulation License or registration valid for individul use only qOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration 1511 53 Type: Office of Consumer Affairs and Business Regulation xpiration 7/7/2014-, Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 SCOTT PEACOCK BUILDING&,REMODELING INC JAMES PEACOCK ary r r` 1046 MAIN STREET OSTERVILLE, MA 02655 Undersecretary Not valid without signature 1/9,0 PN 14: 15 4 D VI S --------------------------- CD o ---�' Town of Barnstable � Regulatory. , . Services - ' Thomas V.Griler,Director Building Division Tom Perry, BuRdigg Commissioner 1 200 MWA St MM Hyannis,MA 02601 www-t0wia.barnstable.,ma.ns Office: 508-962-4038 Fax: 508-790-6230 Property Ovmer Must Complete and Sign This Section _If Using A Builders . Prow �'1'� Al ,as Owner of the subject property herebyauthorize �C077 44 Cojrec f iV6 to act on my behalf, in all matters relative to.work authorized by thin 6 perrnir application for; . .Cr e4cC- Rj2,y4 LA-7,y ,�elvLc•, 6Fv7ef2,v1c i.e• ,fY b 4� (Address of Job Signature of Owner / t � fry� �M A-2< •rye f • . . t Print Name I Or �.6 l ( 6 GD-7 oFs r Town of Barnstable *Permit# OExpires 6 months from issue date Regulatory Services Fee r • =ARNS?ABr.E, $ Thomas F. Geiler,Director plEDkb Building Division X77PRESS PER Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 1\10 V --I �011 www.town.barnstable.ma.us AWN OF g�Faa��b� 6230 Office: 508-862-4038 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid witliout Red X--Press Imprint Map/parcel Number ,9a . Property Address 55 . ke je I jwbe�� I\ �_O Al( ( ''�/�l�t P/Plesidential Value of Work- �Q Minimum fee of S35.00 for work under S6000.00 Owner's Name&Address Contractor's Name .j•!J R dLM/,I!� 1hr_Telephone Number (40Y 2 IN 9 ' g Home Improvement Contractor License#(if applicable) ! Q 7 Construction Supervisor's License#(if applicable) �Workman's Compensation Insurance. Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [c/I have Worker's Compensation Insurance Insurance Company Name /�� /� I�S• CQ Workman's Comp.Policy# Copy of Insurance Compliance Certificate must.accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) 0-'Re-side ih l�iv'97 �Q.e- E.4w-C #of doors placement Windows/doors/sliders. U-Value w4a44 (maximum 44)#of windows *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 e ire SIGNATURE: • QA"FILES\FORMS\building p rmit forms\EXPRESS.dDc Revised 070110 • The Commonwealth of Massachusetts Department of Industrial Accidents - `" Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information J / Please Print Legibly _�/Name (Business/Organization/Individual): r•y a Y-/[_/yJl e�— Address: g f�4sz/ City/State/Zip: �/V S /77l9 0260 Phone#: (5-08) .717 ,9 ( l Are you an employer? eck the appropriate box: Type of project(required): 1.LJ 0 I am a employer with a 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 8. F1 Demolition working for me in any capacity. employees and have workers' 9. � Bu [No workers'comp. insurance comp.insurance.$ ilding addition required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions q � 3.❑ 1 am a homeowner doing all work officers have exercised their 1 L Q.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.❑ Other comp.insurance required.] *Any applicant that checks box Of 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. tContractors 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: Bay- A P472�7,FI-?0OL( Intl E Co . Policy#or.Self-ins.Lic.#: �,�yJ� g 90 Expiration Date: OI U/ — Job Site Address: K.c aa—aicC/Zk City/State/Zip:_��iJj, Attach a co of the workers' compensation policy declaration page(showing the policy number and ex iration date . aZ'PY P P Y P g ( g P Y p� ) 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 certi r er he ai�nsg l penalties of perjury that the information provided above is true and correct. Si ature: Date: I oh 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#: l Office of Consumer Affairs and VUSness Regulation 10 Park Plaza -.Suite 5170 Boston, Massachusetts 02116 Home Improvement Contra,✓tor Registration Registration: 110609 • — ;�____ Type: .Private Corporation Expiration: 1 1/312 01 2 Tr/# 205399 E J JAXTIMER, BUILDER, INC ' ERNEST JAXTIMER 48 ROSARY LN. HYANNIS, MA 02601C11K ; { . w j v; ✓ Update Address and return card.Mark reason for change. .Address' Renewal 7 Employment Lost Card 1 DPS-CA1 is 5010-6VO4-G101216 T. Office�&Ain i ai_fffi ines�ano� License or registration valid for individul use only , HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration ]10609 Type: Office of Consumer Affairs and Business Regulation ' 10 Park Plaza-Suite 5170, Expiration: 1L312012 Private Corporation Boston,MA 02116 E TIMER, Bl7tJftf zl t,= ERNEST JAXTIMERS 48 ROSARY LN 4 a HYANNIS,MA_ Undersecretary Not valid without signature - Massachusetts- Department of Public Safety i Board of Building Regulations and Standards R Consiru.ction Supervisor License License: CS 3251 Restrictedto: 00 — i ERNEST UAXTIM:ER 48:ROSARY LANE HYANNIS, MA 02601 Expiration: III 4/2012 Conunissiuner Tr;#• 13122' t s�C R CERTIFICATE OF LIABILITY INSURANCE DA03/07/2,Y1 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 j BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT.BETWEEN THE ISSUING INSURER(S),-AUTHORIZED f REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate.holderis an ADDITIONAL INSURED,the po)icy(iss)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the fcartificate.hoider in lieu of such endorsement(s). 'PRODUCER - NAME:.TT Erica H.O'Connor HART INSURANCE AGENCY,INC. PHONE (508)759-7326 FAx (508)759-7366 243 MAIN STREET AIC No: PO BOX 700 noDREss: BUZZARDS BAY,MA 025320700 INSURE S AFFORDING COVERAGE NAIC C INSURER A. ARBELLA PROTECTION INS CO 41360 'INSURED EJ Jaxtimer Builder,Inc _ INSURER 13: ARBELLA PROTECTION INS.CO - 41360 48 Rosary Lane ARBELLA PROTECTION INS CO 41360 Hyannis,MA 02601 INSURER c - INSURER D- ARBELLA INDEMNITY INSURANCE COMPANY 10017 "INSURER E:" - - INSURERF: . - LCOVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, " EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NTSR ADDL SUBR .POLICY EFF POUCY EXP R " TYPE OF INSURANCE POLICY NUMBER M LIM" A . GENERAL LIABILITY 8500042039 01/01/2011 01/01/2012 EACHOCCURRENCE S 1000000 COMMERCIAL GENERAL LIABILITY - - AGE T ED _ - $OOOOO EMI S . OCCUR - _ �E�— E s eu ns CLAIMSAIADE ®OCC . . MED EXP(Anyone Person) E 5006. . - PERSONALBADVINJURY S 1000000 GENERAL AGGREGATE S - 2000000 GEWL AGGREGATE LIMIT APPLIES PER: - - PRODUCTS-COMPAPAGG S 20000M POLICY PRO- LOC _ _ $ ". B. AUTOMOBILE LIABILITY 2166240DO04 01/012011 01l012D12 Me acciN�tsw LE LIMIT MIT ANY AUTO - - - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accidwt) S NON-0WNED PROPERTY,OAMAGE - .$ HIREDAUTOS AUTOS r C UMBRELLA— OCCUR 460D042D40 01/012011 01/012012 EACH OCCURRENCE S 2.0D0,000 EXCESSLIAB rl CLAIMS-MADE. AGGREGATE. S - 2,0D01000 DED RETENTION s D wORKERSCOMPENSAWN 0053890111 01/01/2011 01/012 w012 T.ATU 1 1.oTH S AND EMPLOYERS LUIBI.RY YIN OFRCERNBOER EXCLUDED?JEXECUT N f A - E.L. 00 ANY rVEEACH ACCIDENT S SOO,O (Mandatory In NH) "- - EL DISEASE-EA EMPLOYEE S - 500,000 tt yaa dem:Ih wafer - DESCRIPTIONe OF OPERATIONS below EL DISEASE-POLICY LIMB $ 500,000 .DESCtIPT1ON OF OPERATION LOCATIONS f VEHICLES(Attach ACORD 701,Addll(onal Remarks Schedule,I mole space Is regWred) CERTIFICATE HOLDER . CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200'NIAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DE MFD IN HYANNIS,MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. . '. AUTMORt2ED REPRESEKTAM .. . ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD I� OF THE l �Y ' + BARNSrAHLE, 9ss, 'Town of Barnstable i639• ♦� r pIFD MA'I A 'Regulatory Services Thomas F. Geiler, Director ` Building Division �. Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.bainstable.rria.us Office: 508-862-403 8 Fax: 50 8-790-623 0 Property Owner Must Complete and Sign This Section If Using .A. wilder ... - 1-m - j, I ' w , as Owner of the subject property hereby authorize lG to act on m behalf, y in all matters relative to work authorized by this building permit application for: i ru 1 (Address of Job) Signature f vner D tte . Print Nameme r 1f Property Owner is applying for permit, please complete the Homeowners License.Exemption Form'on the reverse side. QA WP.FILESTORMSftilding permit formsTXPRESS.doC Revised 072110 Assessor's office Ust floor); ,.= R't Assessor's map:and lot number �5��...,;,... -� THEto`♦ .......................... Board of;41ealth`(3rd floor): Sewage Permit number� ..... '.................................:............. Z 33JBd9T11DLE. i Engineering Department (3rd floor): oo MASIL ♦� House number ........................................................................ �o 39a` 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 .............��............................................................................................................. TYPEOF CONSTRUCTION ..................................................................................................................................... p� TO THE INSPECTOR OF BUILDINGS: ; The undersigned hereby applies for a permit according to the following information: Location ......................................................................... J. ... t, Proposed Use {�Gk-.......1...1. �1.. • Zoning District .....:a....... � ..........................................Fire District`A....................r......... . ..;.. ...... ,Ai Name of Owne .......` (................... .......�...... ........................Address ..................................................................... e............ �� Name of Builder ............ ... ................. .................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing Fireplace p ' ............................Approximate Cost Area x!�'...«.�... . Diagram of Lot and Building with Dimensions Fee o i OCCUPANCYPERMITS REQUIRED FOR NEW DWELLINGS it I hereby-agree to conform to all the Rules and Regulations of the Town of Barnstable regdrag the above construction. - y t -e 6Y44W Name ........................................r....`..................................... V Construction Supervisor's License .................................... METAXES, REV. A. A=226-152 .. � No 32200. Permit for ...Sun. Deck ............... ::mingle Family Dwelling........,. Locatipn . 55 Lake Elizabeth Drive„ Centerville ............................................................................... f Owner ......Rev. A....Metaxes.................... Type of Construction .......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted August 24, 19 88 Date of Inspection ....................................19 Date Completed ......................................19 Alit h"Will"Ace— '" `�17 "Assessor's office (1st floor): Assessor's map and lot number �o1G� �S� ��THE TO Q Board of'--pa'It'R 3rd floor): Sewage Permit number .....,.................................................. i 339HII9TADLE. t Engineering Department (3rd floor): ruse \ House number .......:. : 1639. ♦� Definitive'Plan Approved by Planning Board ---------------------------------19_______ . APPLICATIONS PROCESSED' 8:30-9:30 AM, and 1:00 2:00'P•M. only TOWN. -OF BARNSTABLE - BUILDING INSPECTOR t/ 1V JD (LCe APPLICATION FOR` PERMIT TO .............P.......................................... .............................................................. TYPE OF CONSTRUCTION.......... ................. ..................................................... ............ .;t-i....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ` r //nn Location .....:........................... ..... �S ( vl.....1� f'....... (�.c�C�u/. ..� ....................... .......... . f�........ Proposed Use �{�C..... ..C.1/�!)1Ql C QGft .................................................................................................... C ............................Fire• District .......... ...... Zoning. District ..... ............. .�....:......... .,...,....... *16&0�ril `Nome of Own ....... '.(.......... . ... ........ .... ....,.........:...Address ....4... .. ... .. ..... .. ........... t� Name of Builder .......: .......:............Address Nameof Architect ...................................................................Address ...............................:. Numberof Rooms ..................................................................Foundation ........:. .. .................................:.................................. Exterior ...............................................:................. ............. ....Roofi.ng Floors ............................................................:.....Interior IHeating ...........................................................I.........................Plumbing ........:. Fireplace ....................:.............................................................Approximate Co .. ..Q �..".. .... . Area � .v... ..... Diagram of Lot and Building with Dimensions Fee ........................... OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Ba table re and the above construction. Name .......................................... .. ................................... Construction Supervisor's license .................................... i. r7METAXES, REV. A. -AO ..3.2.2.0.0... Permit for ..S.un....Deck,,,,,,,,,,,,, Cing.�!��...j�amil ...Dw 11jr).g........ ...... ..... ...........Y ..... LocatA 55 Lake Elizab.Q.t:ti.. .................. ................ Centerville . ............ .............................................. ..................... Rev. A.' Metaxes Owner .................................................................. Type of Construction XK'AMO........................... .1. .................................. ............................................ Plot ............................ . Lot.................................. Permit Granted ....A.u.gu.s.t...2.4.!..........19 88 Date of Inspection .............................19 Date Completed .........................................19 Vol s WHERE APPLICABLE-. UNLESS., REMOVE ALL BURRS..9 BREAK r pir� NS. SHARP EDGES TO 1/64. TLE' FRACTION 3 PLACE 2 PLAQ9 1 PLACE MATER.IAI p NEXT AS$Y U399_ APPLICATION f REVISIONS k+ 4 x DESCRIPTION DATE TAPPR611 I 9 �1 1 !'QC9r4 . COhSrS dye t�eckiH�. ;xs _ fx�-c for .Galvaviiz rewS ARE fh rxc L-U V.C 1-)/ M WISE SPECIFIED CONTR NO. IRE IN INCHES S DP `Sun Decks Plus tl KOVAG�.o� f., , �� r;ustow.D:igmdDeef,stmG'i. `. -' CHK DRAWING TITLE ALS AESt A SUN DECK — Iasr'/ki P A ALS t P. mom D SSILf a APPROVED. SIZE CODE(DENT NO. DRAWING N0. o CC I. g S07/�a)ra ,f BY D611ECTION OF A ' SCALE /"=21 SHEET 2 13 ' £