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Sl LRRCN Lfl ME gl14`1 TOW" of Barnstable g d 4 pp� RegWat®rV ServicesFee IB dwd V.Sm%Interim Director TQm%"2 C241 111ildin Commissioner Ii 210 Man sneer,Hymnis,MA 02601 APR 14 2016 Mown barnstablemaus Office: 508-862-4()3� T WIRA i�9u�� BLE CRESS P�APP�CA�®�T m ESWENTU O 06,1 NotYalid trithontRedX-Pr w--m_prdrst Nwprparcel Number 0 Property Address Residerrtial Va1ne of Work$ ` Idmum fee of$35.00 for work under S6000.00 Owner's Name&Address b Contra,ctor'sName Telephone Number Y 1c� Home Improvement Contractor License#(if applicable)Za 1p �'% � Construction SUPervisor's License#(if applicable) 0/-7 ©0 7 7 W01imm's Compensation Insmance �^ Check one: 111 am a sole proprietor ❑ I am the Homeowner I have Worker's compensation kmrance insurance CompanyName be/o Workman's Comp.Polic Copy ofladinranee Comphanee CerhffeatemuA accompany each permit' Permit Request(check box) -- ❑ Re`)f(hmT!eme assailed)(stripping old shingles) All construction debris wgl be taken to r ❑Re-roof(hurricane mled)(not stripping. Going over existing layers of root) ❑ Re-side Replacement Windows/doors/cliders..LT Value v (maximum 35)#of wind ws #of doors: ..❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with fired Sand sous required. Separate lileeftical&FIM Permits requfred. ° Issaanceaf8iispeimitdoesnntegea�ptcflmPliaz�cewidi�ataw�depacementnlatinnsie> e,Conservatioa,e2, *+*Note: Property er sign Property Owner Letter of Permission. A copy of H Improvement Ceintractaas License&Construction I Su rs IkAM is rere Pao ut -q d. SIGNATURE: i T:IKEVIN Mudding Ch'g Rt3S &c Revised 061313 HOME IMPROVEMENT CONTRACT r � PLEASE READ THIS a 11 l r Sold.Furnished and Installed by: Branch Name:New England Date:_14/ }r THD At-Home Services,Inc. d/b/a The Home Depot At-Home Services Branch Number:31 908 Boston Turnpike,Unit 1,Shrewsbury,MA 01545 Toll Free 977-903-3768 Federal lD 4 75-26984%,ME Pc#C 92439;R1 Cont.i.ic#16427. Cr Lie"ICA565522;MA flume Inrinow ecnt Contractor Reg.#126893 Installation Address: ��� L Q ( QI7-(e?fUt�i '4�11a��'x,-7- -City State a Pureheser(s):. Work Phone: Home Phone: Cdl Phom I Ow [ 7 [ 1 [ J Home Address; (if different from Installation Address) City Stare Zip E-mail Address(to receive project communications and Home Depot updates): ❑f DO NOT wish to receive any marketing emails from The Home Depot Protect Information: Undersigned("Customer"),the owners of the properly located at the above installation address,agrees to buy, and TIID At-Home Services,Inc.("lire Home Depot")agrees to furnish,deliver and arrange for the installation("insinuation")of all materials described on the below and on the referenced Spec Sheet(s),all of which are.incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract"): Job#:(oemKn 4 Spec Sheet(s)#: Project Amount Roofing❑Siding mdmvy( lnsularion❑carters/c�cm❑Fmtry Doors❑ / 0 3oo,2t 6 Roofing❑Siding EJ Windows inwlation ❑Gtmers/Covers❑entry Doors[7 ❑Roofing❑Siding 0 Windows❑Insulation ❑Gutters/Coves❑FAury Doors fl '�' ❑Rooting Siding❑Windows❑Insulation - ❑Gutters/Covers❑Entry Doors n Matinwm25%Deposit of Contract Amount dee up"cr of this ooutract TotalContradAtmant s MamePurdtasees may net deprr9t more desire ooe4had tithe Contract Anntmt Customer agrees that,immediately upon completion of the work for each Product,Customer will execute.a Completion Certificate (one for each Product as defined by an individual.Spee Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at ' its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns,pricing orrors.or because work required to complete the job was not included in the Contract a Payment Summary, The Payment Summary# f oZ J�j 1,included as part of this Contract,sets forth ate total Contract amount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign,Do not sign a Completion Certificate(notei there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. IA the event of termination of this Contract,Customer agrees to pay The home Depot the costs of material[s,labor,expenses and services provided by The home Depot or Authorized Service Provider through the date of.termination,plus any outer amounts set forth in this Agreement or•allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE tfOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acce Lance nd Authorizatio : Customer agrees and understands that this Agreetrrent is the entire agreement between Cusmmer an The Home Depot with regard in the Products and Installation services and supersedes all prior discussions and agreements,either oral or written,relating to said Products and Installation.Tltis Agreement cannot be assigned or amended except by a writing signed by Customer and The Home Depot.Customer aclwowledges and agrees that Customer has read,understands,voluntarily accepts the terms of and has received a copy of this Agreement Acce y: son ed by: Clrst r s Srgnaturc Dalc Sales C %ultant's Signature: ' 1 ate X Telephone No. " Customer's Signature Date Sales Consultant License No. CANCELLATION: CUSTOMER MAY CANCEL THIS (as ppticablc) AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE 7'0 THE HOME n,EI — —M—k-W V1N T= InIRD BU5MEM 4�0 Ima su& �� 11 www. To AFTER MMETO STATE SUPKL MENT ATTACH$" ONE IS CONTAINS A FORM To US BYE LAW IN SPECIFICALLY PRFSC�� y>pE AND ARE PART or 1ALS CONTRACT SPECK t STATED ON TM-REVERSE' CI1ST0o R���c�anL'fERMS AND cvxurr►oNs A>� _CUsl�er Y� i i Id WiL0:8 ZIOZ 8i '100 TLZZZ9£80S: 'ON XdJ p26tupt: W021_j i JOSEPt C DUARYK i fS FALL ST WAREHAM MA=IYLS t)ftTr a of t�n�anrer?►ftaire 8c� Haw IMPROVEMENT Registration; 149. Expiration: lA llW f:,can-�� .as '•� � � �4SAG+'1 cuarie 15 Fell Sty , ma 02,571 The Co twitwealth of Massachusetts Department of Industrial Accidents G All Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114 2017 www.massgov/dia Workers' Compensation Insurance'Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizatiou4ndividual): Address: 1 S W/1-66 A.3 City/State/Zip: t 60 0 OZJ Phone#: 7 Nl 766 L3 25 Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ .1 wh a employer with 4. ❑.I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑N.ew 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. ❑Demolition, workingfor me in an capacity. employees and have workers' Y P ty 9. ❑ Building addition [No workers' comp.insurance s= comp.insurance.t required.] ' 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.E 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#t 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 anew affidavit indicating such. xContractors 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. Insuray Company Name: A j fj�L�- Policy#or Self-ins.Lic.•#: Expiration Date: Job Site Address: City/State/Zip: \ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 certift,4nder the a' s and en 'es?Leffju that the in ormation provided above is true and tarred Signattire: Date Phone#: -7 7fi r 74-L 32-5 ' Official use only. Do not write in this area,to be completed by city or town official -City or Town: ` PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector b.Other Contact Person: Phone#: Ili � Office of Consumer Affairs-and Business Regulation 10 Park Plaza - Suite 5170 -- Boston, Massachusetts 02116 Home Improvernent Contractor Registration. _ Registration: 126893 Type: Supplement Card THD AT HOME SERVICES, INC Exp'iratian: a>3►2Q16 ANDREW SWEET _ 2690 CUMSERLAND PARKWAY SUITE73.Q0 -- ATLANTA, GA 30339 Update Address and return card-Mark reason for change. S::., aoM-osni I _; Address ILI `Renewal Employment Cl Lost Card 097iedrrcnsoazcc eal� a�✓lltc acfico eG�y . Office of Consumer Affairs&Business Regulation, License or registration valid for individul use only IVOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: -1 Office of Consumer Affairs and Business Regulation Registration 12-6g93, Type: 10 Park Plaza-Suite 5170 Expiratia-. g/ g, ? Supplement Card Boston, MA 02116 THD AT HOME SERVES;INCH },I THE H 0 M E DEP8,,kf�OI S6ktVICES ANDREW SWEET`rt 2690 CUMBERLAND PARKV1lAY S XfL'AIWA,GA 30339 Undersecretary Nov i with ut signature The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 t Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(BusinesslOrganization,qndividual): The Home Depot At-Home Services — Address:908 Boston Tpk City/State/Zip:Shrewsbury,MA 01545 Phone#:508-962-6942 Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 200, 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors + listed on the attached sheet. 7. ❑Remodeling 2.❑ I am a sole proprietor or partner- These sub-contractors have ship and have no employees 8. ❑Demolition employees and have workers' working for me in any capacity. 9. ❑Building addition . [No workers comp. insurance.comp. insurance 5: ❑ We area corporation and its 10.❑Electrical repairs or additions required 3.❑ I am a homeowner doing all work officers have exercised their 11. ' Plumbing repairs or additions > right of exemption per MGL myself. [No workers comp. 12.❑Roof repairs insurance re uired. t c. 152,§1(4),and we have no WINDOW REPLACEMENT q ] employees. [No workers' 13.■❑Other comp.insurance required.] *Any applicant that checks box#1 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. New Hampshire Insurance Company Insurance Company Name: _ WC 015519215 Expiration Date:3/1/2017 Policy#or Self-ins. Lic.#: p� / Job Site Address: G �f"L)/ r� � v� City/State/Zip: l lP 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 VIA f surance coverage verification. I do her4certi�f&y a pains and penalties of perjury that the information provided ab veis uue and correctSi atuDate:"Phone# 9 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#: ® DATE(MMIDD/YYYY) A'►`R 0 CERTIFICATE OF LIABILITY INSURANCE 02/18/2016 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). CONTACT PRODUCER NAME: MARSH USA,INC. PHONNE E FAX TWO ALLIANCE CENTER ac No 3560 LENOX ROAD,SUITE 2400 -MAIL ADDRESS: ATLANTA,GA 30326 INSURE S AFFORDING COVERAGE NAIC# 100492-HomeD-GAW-16-17 INSURER A:Steadfast Insurance Company 26367 INSURED INSURER B:Zurich American Insurance Co 16535 THD AT-HOME SERVICES,INC. INSURER c:New Hampshire Ins Co 23841 DBA THE HOME DEPOT AT-HOME SERVICES 2690 CUMBERLAND PARKWAY,SUITE 300 INSURER D:Illinois National Insurance Company 23817 ATLANTA,GA 30339 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-003746646-14 REVISION NUMBER:6 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 NUMBER �p EFF M LICM/DD� _ LIMITS _ LTR A X COMMERCIAL GENERAL LIABILITY GLO4887714-06 03101/2016 03/0112017 EACH OCCURRENCE I$ 9,000,000 DAMAGE TO X❑OCCUR PREMI ES(aE NTED CLAIMS-MADE occurrence) $ 1,000,000 LIMITS OF POLICY XS MED EXP(Any one person) $ EXCLUDED OF SIR:$1M PER OCC PERSONAL&ADV INJURY $ 9,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 9,000,000 X PRO ❑LOC PRODUCTS-COMP/OP AGG $ 9,000,000 POLICY ElJECT OTHER: B AUTOMOBILE LIABILITY BAP 2938863 13 03101/2016 03/01/2017 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident) X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS (Peracciderd $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESSLJAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ Is C WORKERS COMPENSATION WC015519215(AOS) 03/01/2016 03/01/2017 X I STATUTE ER AND EMPLOYERS'LIABILITY WC015519217(AK,KY,NH,NJ,VT 03/01/2016 03I0112017 1,000,000 C ANY PROPRIEfOR/PARTNERIEXECUTIVE YIN N ) E.L.EACH ACCIDENT $ OFFICERWEMBER EXCLUDED? N/A D (Mandatory in NH) WC015519216(FL) 03/01/2016 03/01I2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under Conitnued on Additional Page E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION THD AT-HOME SERVICES,INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DBA THE HOME DEPOT AT-HOME SERVICES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2455 PACES FERRY ROAD ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukher)ee 'LaLv�ao�+.. ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by.M.G.L.-it does not give you permission to operate.] You must first obtain the necessary signatures on this form at•200 Main St. Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: Fill In please: APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: 5 d Aft�.]F L A/V C e A) re f�l!�'c j��—��a ate.1 y TELEPHONE ## Home Telephone Number 3oS o2 a 3© 6 NAME OF CORPORATION: . NAME OF NEW BUSINESS SPAS KLE MA I O'S TYPE OF BU51NE55 IS THIS A HOME OCCUPATION? 2!�- YES NO /\/1/1 Y� ADDRESS OF BUSINESS 5 L a C( A/�- 2 Car 2cJf CC Oa63 MAP/PARCEL NUMBER �lS oo (o I D [Assessing] When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form m is intended to assist you in obtaining the,information you may need. You MUST GO •T❑ 2OO Mai n St. - [corner of Yarmouth Rd. & Main Street] .t❑ make sure you haave the appropriate permits and licenses required to legally operate your business in this town. y 1. BUILDING COMMISSIONER'S OF I This individual has been i r d of any e it requirements that pertain to this type of business. oriz d ignature* COMMENTS: 2. BOARD OF HEALTH This Individual has.been informed of the'permit requirements that pertain to this type of business, r Authorized Signature** - COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY] This Individual has been informed of.the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: Town of Barnstable Regulatory Seridees o Richard V.Scab,Director• F Building Division r RARXST"IF t _ p6 MISC $ Tom Perry,Building Commissioner . 'Of�b ray° r 200 Main Street,Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: 3�- 4 Permit-#: HOME OCCUPATION REGISTRATION Date: Name: ��q /�t�x 1a01 Phone#: :J -7e 25 '?,//$ Address: C I{QCA Zj/ (c---m /L—�I' (ZP AIA Village: Name of Business: !!!5 p/+ 11 e- l/hO-Ai 1 5 Type of Business: (�,4 wr n�cr �i P 2�/ �F Map/Lot IN`T=: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit •. Such use occupies no more than 400 square feet of space. •' There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. •" There is no storage or use of toxic or hazardous materials,or flammable or explosive materials;in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment • There are no commercial vehicles related to the Customary Home Occupation,other than.one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I,the undersigned,haw d agree with the above restrictions for my home occupation I am registering. Applicant Date 0 y Homeoc-doc Rev.103113 , YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not giveyou permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office,1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. lt� ' , ,r�� a DATE: /2rliy Fill in please: n APPLICANT'S YOUR NAME/S: _ 61-- A04e, v c% BUSINESS YOUR HOME ADDRESS: S! z ;x TELEPHONE. #. Home Telephone Number .NAME-'OF CORPORATION.71 „ NAME OF NEW BUSINESS _N.,. emu`/. i i �d// .TYPE OF:BUSINESS IS THIS A-HOME OCCUPATION? YES NO Rli ADDRESS OF:BUSINESS Sl'::. Hi�' LN GC- fc7Z�/i//- /�9 . �.�O Assessin Cif [ MAP/PARCEL NUMBER �� When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable..This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St..- (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate.permits and licenses required to legally operate your business in this town. ....,1 1. BUILDING COMMISSION.ItR'S OFFICE This individual has bee i,for 13diiofftny per it requirements that pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION b-, jn RULES AND REGULATIONS. FAILURE TO Authorized ignatune.. COMPLY MAY RESULT 1N FINES. `rOMMENTS _ ,` f% ,' fA f� 2. BOARD OF`I�(��EALTH This individual has been' �r h permit requirements that pertain to this type of business. MUST COWY WITH ALL Authorized Signature' HAZARDOUS MATERIALS REGULATIONS COMMENTS: 3. CONSUMER AFFAIRS (LI ENSING A AM This individual has b n infor ing requirements that pertain to this type of business:. u horized 13inatur COMMENTS: I - Town of Barnstable _ Regulatory Services �ZHE 1p� o Richard V. Scali,Director =naxsrnsr.E. Building Division V, `�$ Tom Perry,Building Commissioner iDlF1 39. ° 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: ]Fee: Permit#: HOME OCCUPATION REGISTRATION .............. Date: Name: Phone#: 0 (� U `7 .Address: � !�� ( 1�-�I / >� �! Village: Name of Business: 1( C-L k:— V //T/ D X K9 Type of Business: V ,..///� / l N G Map/Lot: // 9 00(� INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4.1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. •. - No sign shall be displayed indicating the Customary Home Occupation. - • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling.unit: I,the undersi d,have read and agree with the above restrictions for'my home occupation I am registering. � 4 Applicant Date:o� Homeoc.doc Rev.103113 Town of Barnstable Regulatory Services Richard V.Scali,Director snaxsrnsrr:, Building Division 9� 163 `0$ Tom Perry,Building Commissioner 1°rFDt�tl6. 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: 0' HOME OCCUPATION REGISTRATION Date: Name:Ak Phone#: O� Address: Village: Name of Business: `� I G�-�� l/ ,//]/Y' L/ f X K- ~ Type of Business: 1� � / % N Map/I.ot: M/ --006 01 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity'^2 shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to.xhe premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. - • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. = • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersi d,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Datea�T ( y' Homeoc.doc Rev.103113 i Date: ' /Z(// ;(./ I TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS - NAME OF BUSINESS: �Fwr�c=w� 11 �R�w �� � G�S�t72, 7dY� 1 �(ZVYI j BUSINESS LOCATION: _1-/ ,Pj P 4h-wvi/le�7 /4,4 oZ,d? INVENTORY MAILING ADDRESS: C TOTAL AMOUNT: j TELEPHONE NUMBER: CONTACT PERSON: S.9aijr.Zj01'i EMERGENCY CONTACT TELEPHONE NUMBER: /S �oq e9 MSDS ON SITE. I TYPE OF BUSINESS: _ ��A�.✓�i�i� INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No i NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material Use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. 1 LIST OF TOXIC AND HAZARDOUS MATERIALS '1 The board of health and the Public Health Division have determined that the following products exhibit toxic or 1 hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum 1 Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides; rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑.USED Miscellaneous petroleum products: grease,. Photochernicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines g g and metal . Printing ink Degreasers for driveways &garages Wood preservatives (creosote) , Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash.detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints,varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer.thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, I Paint&varnish removers, deglossers hydrochloric acid, other acids) I Miscellaneous.Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes 1 Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) 1 Other cleaning solvents Bug and tar removers / , Windshield wash f WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Ap licant's ianature Staff's Initials i. Town of Barnstable Regulatory Services Thomas F.Geiler,Director • Building Division TOWN OF BARMTABLE * &axxszesn.e, v g Tom Perry,Building Commissioner � � lED Mp h�' 200 Main Street, Hyannis,MA 02601 9 l?'`1 39 www.town.barnstable.ma.us Office: 508-862-4038 "" "�" flax. 508-790-6230 APprov ,, 1 '�£61/ ^<-yu Fee: .gam Permit#: HOME OCCUPATION REGISTRATION Date: Name: I C S O/(/ I ��S Phone#: Address: 54 2—A Village:_ i Name of Business: V AS Type of Business: Map/Lot: INTENT: It is the intent of this section to allow the residents of the Tome of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zonuig ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no nicrease in noise or Odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase ii air or groundFc•ater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the followuig conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located w7tlnun that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to,the dwelling which are not customary ui residential buildungs,and.there is no outside evidence of such use. • NO traffic�vzll be generated'in excess-of normal residential volumes. • The use does not involve the production of offensive noise;vibration,smoke,dust or other particular matter, odors,electrical'disturbance,heat,glare,Humidity or.other objectionable effects. • There is no storage or use of toxic or hazardous materials;or flammable or explosive materials,m excess-of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required fi-ont yard. • There is no exterior storage or display of materials or equipment. There are no conunercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet ni length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No signs shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed it the Customary Home Occupation vvlio is not a permanent resident of the dwelling unit. I,the undersign ,have read and agree with the above restrictions for my home occupation I an registering. Applicant: Date: Homeoc.doc Ree.01/3/08 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost OD for'4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G,L.-it does not give you permission 1 operate.] You must first obtain the necessary`signatures-on this form at 200 Main St., Hyannis. Take the completed form to the Town Cierk`s Office, 1 st Fl., 367 Main%St., Hyannis, MA 02601'(Town Hall).and get the Business Certificate thafiis required by law. .. DATE: ?o / {� Fill in please: APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: .TELEPHONE # Home Telephone Number . 5 NAME OF CORPORATION: NAME OF NEW BUSINESS OL-%Vi,9S 71 TYPE OF BUSINESS !/ti./ IS THIS A HOME OCCUPATION? x YE NO ADDRESS OF BUSINESS C' MAP/PARCEL NUMBER /��O06 O/D (Assessing). When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you'in obtaining the information you may need. You MUST GO TO 200 Main St. —. (corner of Yarmouth Rd. &,Main.Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has bee 'nformed of permit requirements that pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION Cn S -. thori ed Sign ure** RULES AND REGULATIONS. FAILURE TO C- COMME TS: J Del U�l ( ✓✓yyv 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSI NG NG AUTHORITY), This individual has b inf d of th ens'mng requirements that-pertain to this e of business. P type Au horized Signature* COMMENTS: e Asseupr!s=,;&ap'and lot number ..�..8.C�....... a!t..o f �q,rc �o SUBJECT TO APPROVAL OF ....... . BARNSTABLE CONSERVATION ypF'THE to ffy Sewage Permit number ':............... . ... cQ, CONuwISSlOfd } DESIGNING ENGINEER MUST TAXE, House number ,.,, .. NSTALLATI � r� ON AND CERTIFY Rv �jf6Is9. ` Y THE SYSTEM WAS INSTALLED INd A a A P P R 0 Y E ��A� G WN OF BARNy9 �u ��. Bae table conservation � TEM MUST BE INSTALLED IN COMPLIANCE . gA°$ D°L° BUILDING INSPECT4 IRON MENTAL ITHTITLE LE5 L CODE AI13 WN REGULATIONS APPLICATION FOR PERMIT TO ....:..........:...d ' 1�C. :......... ..................................................... TYPEOF CONSTRUCTION ............:............ . p�.......��.. .................................................................... ...�1... ' .19? TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a p�ermii�t accor ing to the following information: l-.rr Location ..........Q ....1.V Gr��c��,�Y.l. .......� �...................................... ........... .... C19t�dCf... ProposedUse ............. . . .............................................................. ...... ................................................. Zoning District Z ...................Fire District .................. .T..................................................,.. C......................... Name of Owner ....S. .S...... .. ................................Address .....I3.� O7� e � � (Y � r( « r• rr Nameof Builder ....��..Address .................................................................................... Name of Architect ....M.Q7.11A.1!n4 .....1D 1.Covk'` ....Address ..�1 Y e.....�D ...... Q ( ( .................. Number of Rooms .........................f........................................Foundation ........... ....: �?: ... G � �— ................. Exterior ...Roofing n ..................... ?............................. �` .... Floors .......................... F !�"v..................................Interior ............................... ..i..1.. Heating .....................`....A.s...............................................Plumbing .... Y....��! �� /... .....✓......". ... r Fireplace ...............................y.. ..............................................Approximate Cost ......... Definitive Plan Approved by Planning Board -------- 19_ J`.r Area .............. .'.�........................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Q 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 ........ ✓.✓::' Q ``�,...... Construction Supervisor's License ......t ° o....... T i;�A S- S i RUST N� ..30282.. Perm ifor .. . e...14 Story.......... , � as �inrle arnil elling {, .............................. Lot #1'�00 51 Larch Lane rLocation ........... ... ....!..... .................................. - :.................Centergvil-Le ..........:..... -} S L � q..Tr .st -- ; Owner ....................4........ ................................ , rime T e of Construction w 6 YP ,v. ............................. ; ` ....... ................................. - f Plot ............................. Lot Deceidlber 12 86 Permit GrantJd A.................. 19 2 Date of Inspection ... 13.................... ......19P .......:,� ......:.19 L� Date ,Comple�e ..: ...... � - Q i CL - r 0 N rri G a N O Co r 1 ' Jf A !� ` e rG�V�, ' � - � !r • O�THE�+ TOWN OF BARNSTABLE Permit No 30282 . ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond X40 CERTIFICATE OF USE AND OCCUPANCY Issued to S L S Trust Address Lot #10, 51 Larch Lane Ceziterville, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. F April 15 , 87 t-�' . �-¢-<Z 19................. .......................................... Building Inspector �.i TOWN OF BARNSTABLE BUILDING DEPARTMENT _ SARESTAU ' TOWN OFFICE BUILDING MAM raj t63q. `� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by pe— Building Permit # ... �--:�...:�._ ._.............. ............................................._....................................._................. issued to Please release the performance bond. i THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) M A�Gl DATA ' TOWN OF_BaRNSTABLE, MASSACHUSETTS BUILDING PERMIT DATE NN9 19 � ` PERMIT • APPLICANT �•±=3c:;. .�1 1!'✓. ADDRESS i-�1 !)lti C+'. .i. j. , "I'7clJMaf3 IN0.) (STREET) (CONTR'S LICENSE) PERMIT TO Jiuild klwt:.�. 1! i ..1•:y i-• ( " ( NUMBER OF (_) STORY - •i.<< i,!ITI.i",. t..:t•±:...i....!).}:, DWELLING UNITS (TYPE OF IMPROVEMENT) N0. (PROPOSED USE) ZONING101.. 51 rcAT (LOCATION) DISTRICT (NO.) (STREET) BETWEEN AND .(CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BYFT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN.CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR 9'6 ;;C), t i.;. �Ji.Jp(J(✓!.� PERMIT �I).Di1 VOLUME ESTIMATED COST FEE (CUBIC/SQUARE FEET) 5 TruSL OWNER pf BUILDING DEPT. I ADDRESS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY, ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE 3UDDIVISION RESTRICTIONS, MINIMUM OF THNEC CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS 'EQUIRED FOR CARD KEPT POSTED UN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. - POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS ffLUMBING I SPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 01 z 2 -- 2 lucs � � -jag D(J� {n •�� llijj\, I 3 If• HEATING INSPECTION APPFIOVALS ENGINEERING DEPARTMENT 1 Q �� BOARD OF HEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN' CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. F e.51PG.-,t Asses sor's•map and 'lot number ...�.. ... . ...... THE Sewage Permit number L2.#Rs.....r7 ....... ..... ,}� BAHB9BTa LE. House number ........!".....................!' ...��.....m..^-... 900 NAM �a `0 - !, TOWN, OF BARNSTABLE r r i BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................... ....U). ......� ............. ...................................... TYPE OF CONSTRUCTION ..................... ?.......F-A-4 Y,.Z' :..................... ............................ . —T-........'� . ":; TO THE INSPECTOR OF BUILDINGS: The undersigned/hereby applies for a permit according to the following information: Location ..........nLl ....J...©......... ( /.....:i%�_ ....... xr ....... �e- ................................ ProposedUse ............. . ° ,:tM:.........................................................................................................I......................... Zoning District ........................................Fire District ............... ;fl Iz (Z.... C��........................ Name of Owner ...........................�1.. .. ...........................'..Address ....................:....... ` la.M! ..:......... Name of Builder . ......-.�j.... .. 0[:��4c%..l.... IdIC.......Address ......I ....................... .................... ..... ..... . ....... r Name of Architect [��l 0? h '�P_ /1" �' ,/ [. �,,,,,,,,,,,,,,,,,,,, n.t.:............ C'!� c.hrt .....Address ..I . ............... Y.,/...l..... (! opt Number of Rooms )zv . G� �2 5......................................Foundation ........... ..... .4.._.............:r. ?1r/L?.................... f ` Exterior ........................ �................................Roofing ...................(..?......... ................................................... :..........................1,......................,�........................... ......Interior ........................ ...................................................... Heating .....................�./..:`...5...............................................Plumbing ..........1. I�.< L-.......... ......Pi._. / 1 �.. 1 .. �o Fireplace ............................... ' .........................................Approximate. Cost ...........mot.. ..........,...:....................... Definitive Plan Approved by Planning Board ________ 9 Area .... ................. Diagram of Lot and Building with Dimensions Fee s .. SUBJECT TO APPROVAL OF BOARD OF HEALTH j� 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 ............. .y .... ...... 4 /J�f / Construction Supervisor's License ......�... ....................... S L S TRUST A=189-& o6 .jlo A=1 V89.-.& No .... Permit for ....ONe tory ........... .... ..... ....... Single Family Dwel in ........................................................... ..... ............. Location ...Lotk...#.i.o.l ...--,.-51,.',,.Larch Lane ............................................................. Centerville ............................................................ .................. S L S _ Trust Owner .................... ............................................... Type of Construction ..F.ra.m.e............................. .. .... .. ................................ ............................................. Plot ............................ Lot ................................ - .December 12, 86 Permit'-Gran ted .................t.:%....................19 Date of Inspection ....................................19 Date Completed .................. ....................19 Y, PS 71 t 10 /d v/ % CE R T I FI ED PLOT PLA N LOCATION: C' A/7�E/2U/GGALw-jt9 F 0 R: A&E-6 HG•SoGL4:n 6v3 SCALE: /"= 30" DATE -��• g, :f98 � R E F E R E N C E �E/"vf� GcoT/p ,45 S.you� v o,`i �'42'`�ETA�3G E .E?�G ISTiZY 6•� ,Q�-CE OS I CERTIFYTOTHE BEST' OF MY KNOWLEDGE AND BELIEF FROM INFORMATION RCQUI RED THAT THE SHOWN ON THIS PLAN IS LOCA ON THE GROUND AS SHOWN HEREON . 41 DATE P FESSIONAL LAND SURVEYOR' JOS G J . M . MONAHAN, JR.. & ASSOCIATES � cwo�aawN;�aH No. 13sso PROFESSIONAL LAND SURVEYORS & ENGINEERS TOWN PLAZA 900 ROUTE 134 SOUTH DENN.IS, MA. 02660 asu J. N . 8.S-/S8