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0048 MASTHEAD LANE
ay `:, c ,.�k�'S "4 f '�.;?•p ar'� a ,.,fs :w:�,�•',;. u f ° J , aas:� �• ',� �S�. .. � ,r 7 �r �}¢` R - 5. o r`- - u.g;;'- 'hS ..`_.� ;'... '�:�. -:ry �.{.<.`,S. _ - ,n �y-x �& � •�.. y,> ^ A o�` �1y113 .. o 0 Town of Barnstable ¢Per t# 3 6 a 43 Regulatory Services Fee ,3!5- ThommF.Geller,Director XPRESS PERMIT 'Building Division • Tom Perry,CBO, Building Commissioner APR - 2 2013 200 Main Street,Hyannis,MA 02601 `www.town.barnstable.ma.us ,-TOWN OF BAF�S ,qR Office: 508-862-4038 • - - -Tax: 508_79 JAgLE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X Press Imprint _ Map/parcel Number 6 Property Address e. A L r'• esidential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Z-wGI t1 �het w ! Telephone Number `Contractor's NamepG}�i(.,)c �.� �,� + ' 4• Home Improvement Contractor License#(if applicable) y 7 7, Construction Supervisor's License#(if applicable) I(l 5 I S ! ❑Workman's Pompensation'Insurance Che one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each'.perm�t p. Permit Reques check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken tom/�G�✓n� L���c� �� ❑Re-roof(hurricane nailed)(not stripping Going'over 7-existing layers of roof). ❑ Re-side" F. . #of doors Replacement Windows/doors/sliders.U-Value (maximum 35)'#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doe Revised 053012 ` License or re F before t hstration valid for - � — O fee of a expiration date. mdiVidul use;onl rr..; .10. °nsumer,Aairs and and refurn.to: Y.ark-PI Bostou;Mza Suite 5170 BAsiness Regulation 02116. Not daid'wit outs f; gnature EE ( i, Office of.;Cousumer�1f{?� B srn�esReg a O° of j HOME.IMPROVEMENTCONTRACTOR .Type Registration ya172472 ,y Expiration 5l27.L�014 Indwidual p ICK•CLIFF U � ' `I P'ATRICK CLIFFC�R 12 BALDWIN RD . DENNIS,:MA 02638 Undersecretary Massa chusetts Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Spe.cia110 License: CSSL-105951 - PATRICK CLIFFQRD 12 BALDWIN ROAD Dennis MA 02639. l Expiration 06/02/2016 Commissioner '"R ' Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street,'AHyannis,MA 02601 www.town.bainstable.ma.us Office: 508-862-4038` Fax: 508-790-6230 t . Property Owner Must- Complete-and Sign This Section If Using A Builder a I, lIUfJlc� sylaui , as'Owner of the subject property., hereby authorize � \C 1\ to act on my behalf, in all matters relative to work authorized by this building permit application for: 4 a Agco (Address of Job) JL Signature of Owner DateAnJ-A . .: 3 Prin ame If property Owner is applying for permit,`.please complete�the Homeowners License Exemption Form on the reverse side. 5 C:\Users\decollik\Appl)ata\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 ; The Comrmioniveakh of Missaclouseffs Department of Industrial Accidents Office. of Investigations 600 Washington Street Boston,M4 02111 if wnW.mtass gov/din. Workers'Compensation lnsurance Affidavit:l4a&rs/Contractors/Electriceans/Plumbers , Applicant Information Please Print Y.edbiy ' Name(Business!Organization/Individual): A+&,IC Address: City/Statemp: Ulori r,3-6- Phone# 7 7et 7�;? 0 5, Are you an employer?Check the appropriate box. Type of project(required): , L❑ I am a employer with 4- ❑ I am a general contractor and I s have hired the sub-contractors 6. []New construction(full and/or purr-time)_ _ 2. I am a sole proprietor or partaer- listed on the attached sheex 7. ❑Remodeling and have no 1 These sub-contractors have slip employees . . S. ❑Demolition " working for me in any capacity. �1°�and have workers' g [-]Buddingaddition t [No workers'comp.insurance comp.insuraaee.I j 5_ We area corporation and its 10_�Electrical repairs or additions require3.Q I am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions ' myself[No workers'comp- rightof exemption per MGL 12_ f insurance�ir]j c. 152,§1(4),and we have no employees-[No workers' 13_❑Other camp.insurance required] °Any applicant that checks boa#1 mast also MI our the section Mom shoving ha wgskers'compeownim policy WmntiaL t Homeowners wbo submit this affidavit imitating they ace doing all wont and thm hue aamde cmtracoors mnst submit a new affidavit indicating sash konnctors thin clock this boa ttmst attached an additional shm showing the name of the sob-cam®aci rs nd state whedw or not those entities have employees. If the sub-coamctors have employees,they must provide then workers'comp-policy sum. I ant mt employer that is providi»,g'workers'conipeitsation insurance for my employees Below is thepolicy and job site , information. Tnvvanrw CompsnyName: iE Policy#or Self Iic.4 `j ExpirationDate: 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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a hone 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 Iirvestigations of the DIA for insurance coverage veQification. I do hereby certify t!!yler the s an pe (Perjury flint the information provided above is hue and correct: Si tore: Date: Phone#: 77-1 72Z 6-i 2-9- Official rise only. Do not write in this area,to be completed by city or town official. ' City or Town.- PermitUceaw# _ Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/rown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: I y Town of Barnstable P�0*'(HE>p�� o Regulatory Services = sw�wsTee(.e. Thomas F. Geiler,Director 9 M"S& BuildingDivision 4> 1639- .eTFo , Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 0201 www,town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623( PERMIT# S�"� FEE: U $ 0 SHED REGISTRATION 120 square feet or less Location of shed(address) Village A� Cl�M,) '301 -1-1 �acz �GQ\\� Sol. '1�`� 79 ? . Property owner's name Telephone number Lk Size of Shed Map/Parcel# . o 5i ture Date ' r co C) Hyannis Main Street Waterfront Historic District? Old Icing's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WI=THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN 4 1 , Q-forms-shedreg o/ REV;042506 S! Map Page 1 of 1 Town of Barnstable Geographic Information System Parcel Viewer FCustorn Map Abutters Map Size Zoom Out UIn yr R.r FOP E m= JPG Map: 193 193127� Location: r' N 73 i Owner: 193128 193126 193126 k212 k65 k55 Location In .. Map & Parce �. Location Acreage d Current 0% Mailing Addl J•193D$8 �' t193089 {, �. ) LAppralsed +. Extra Featur Out Building Land Buildings Total Apprai I MASTHEAD LANE -.. !Assessed V ....... ............ ,.r.1. ,. cC„�1 �.� Extra Featur 193D91 J Feet 193090 Out Building «F� a � 193063 Land 036 i_...._._ �--- . Buildings - ---- Total Assess Set Scale 1" = 54 I April 2001 Hi Res I MAP DISCLAIMER Copyright 2005-2008 Town of Barnstable, MA All rights reserved.Send questions or commf BarnstableMA v1.2.3083 [Production] http://www.town.barnstab]e.ma.us/arcims/appgeoapp/map.aspx?propertyID=193089 10/1/2008 IME Tp� Town of Barnstable Regulatory Services • BARNSCABLE, y MASS. �a Thomas F. Geiler,Director EOMArA�O Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 September 30, 2008 Lynda A & Deane F Shaw 48 Masthead Ln. Centerville, Ma. 02632 RE: 48 Masthead Ln., Centerville, MA, Map193 Parcel 089 Dear Property Owners: It has come to the attention of this office that a shed was built on the above referenced property without the benefit of a shed registration as required by the Town of Barnstable. Additionally, the property is located in the RC Residential District which requires a ten foot setback from the rear and side property lines, and the shed appears to encroach into these setbacks. You are hereby ordered to bring the property into compliance or be subject to fines levied in the amount of no more than three hundred dollars per day for each day the violation continues. Compliance may be obtained by: 1) Obtain a shed registration and move the shed to meet the required setbacks, or: 2) Remove the shed from the property. Thank you for your anticipated cooperation in this matter. Please call (508) 862-4034 with any questions By Order. #14 Y I. Lauzon . Local Inspector Q:zoning5 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ap_d' �530�� Parcel �� 2-0 Permit# Health Division' � 2�-y �`� Date Issued "� 3 2 2 r Conservation Division �o �3 Application Fee Tax Collector ll�-- Y' /3 h2 Permit Fee,,ZPP6 4rn-11 ,,a e 7— Treasurer 7 kpdvs"TE6 MUST QE�n �. Planning Dept. INSTAL'LED IN CONIRLIANC Date Definitive Plan Approved by Planning Board W"TITLE 5 ENVIRONMENTAL CODE ANL Historic-OKH Preservation/Hyannis TC1MI REGULATIONS Project Street Address ylz WkC_SVe Village ��-v-��-�v�t�4.. Owner �2e-tiQ - �- ���- ���� Address Telephone Permit Permit Request A yo ` �o w.4� o�•• \V,�C�c\e o� 0—SJZ_ k o" izx r 1:&.� ^S Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay -Project Valuation 3, a© Construction Type Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family/rg Two Family ❑ Multi-Family(#units) a ltw Age of Existing Structure ZS -N Historic House: ❑Yes )(No On Old King's Highway: 0 Yes No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) "� Z Number of Baths: Full: existing \ new Half:.existing new , - r-n Number of Bedrooms: existing Z new �' Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: XGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name �� Q�� Sc Telephone Number (_50s\1 os C Address �S -9 Q `-� License# Home Improvement Contractor# Z_ Worker's Compensation# ALL CONSTRUCTION DEBRIS RE TING FROM THIS PROJECT WILL BE TAKEN TO i� SIGNATURE G DATE FOR OFFICIAL USE ONLY PERMIT NO. 'DATE ISSUED ' MAP/,PA NO.1 • t � 1 .. �'` i.. ' ti _rz�' s , �.. e . �• .� t:' :v.;` 'L' .. .. ._ Y "�•� .. - . .. is u , ;`' .. _ •_ i.. ADDLES , `VILLAGE ^= OWNIr°R ' F ! <` DAT>J Gl``INPECTION: - - FOUNDATION FRAME INSULATION `:t )'D I "q FIREPLACE a ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH € FINAL GAS: ROUGH- FINAL ' FINAL BUILDING elf DATE'CLOSED OUT ASSOCIATION PLAN NO: -, ., f ' } X .'� Y ` IHEt The Town of Barnstable RARNE.MASS. Department of Health Safety and Environmental Services G 7� t6)9 `00 i pfEOMp�a +� Building Division - `'' 367 Main Street,Hyannis, MA 02601 e � _ Office: 508-862-4038 . Fax: 508;790-6230 r -- PLAN REVIEW Owner: -Pt 0 6 4 v N o40-; S w Map/Parcel: / g 3/007 - L o T ;L o Project Address: Builder: rOS - 7775-- 7o so The following items were noted on reviewing: i C { . s Reviewed by: Date: 9:building:forms:review e: L °ZIME r° Town of Barnstable ti Regulatory Services r � * BAMS'AsLE. ` Thomas F.Geiler,Director 319. A, Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 v Fax: 508-790-6230 Permit no. Date oz AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations, renovation,repair,modernization, conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: "Ioz Estimated Cost Address of Work: Owner's Name: Date of Application: `L OZ— I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied 'Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. ZOR Date er's Name I Q:forms:homeaffidav =, The Commonwealth of Massachusetts Egg ^ ' — Department of Industrial Accidents Office WINFOSM ARMAns 600 Washington Street Boston,Mass. 02111 Workers Compensation Insurance Affidavit location: ci ����SL. ASS hone# 17 am a homeowner performing all work myself. I am a sole r rietor and have no one workin in ca achy I am an em 1 er roviding workers'compensation for my employees working on this job.: ... :: ><«« .. , � .. ......... .. . ................ _ phone,# ;. insurance co;:� ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have thefollowin workers' co ensation polices: g mP.........:.:.::.:.:::::::::::...............::..:::: :::::...........:::..:::::::::::::::::::........................:.:.:.::::::::::.::.:.:::: .............::.::::: ::::::::::::::::::::. 0. cnm an .Warne. ; ............ :.:.: c > Y .. ............. ............................. :.......:._........... K. ���`� �i? ii:? ; ���ii?[; ii:i�ii`�'o`•2oi'Si` EEE"�;;; ' iYi:::.::.:::.;y-c•:..;:. '`fltirit: a1 :',•'6:: Nox an:.name.::....................................:... :c X. address . one: .:..:::... ... ..................:.::::::............. Fafiure to aecore coverage as required mrder Section 25A of MGL 152 can bad to the imposition of criminal penalties of a fine up to S1,500.00 and/or one yeah'imprLtonment as wen a,dvn Wallies in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded the Office of Investigations of the DIA for coverage verification. I do hereby certify the p ' es ojperjury that the in provided above is true and corned Signature Date Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other Ormed 9/95 PJA) . r r r Information and Instructions Massachusetts General L ws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted fro the"law", an employee is defined as every person in the service of another under any contract of hire,express or implied, ral or written. An employer is defined as an' 'dual,Partnership, asso)iation, corporation or other legal entity, or any two or more of the foregoing engaged in a jo' enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partne hip, association or other legal entity, employing employees. However the owner of a dwelling house having not more three apartments d who resides therein, or the occupant of the dwelling house of another who employs persons to d maintenance, co ction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall n because of suc employment be deemed to be an employer. MGL chapter 152 section 25 also sta es that every tate or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a b siness or t construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of omplianc with the insurance coverage required. Additionally,neither the commonwealth nor any of its political bdivisio shall enter into any contract for the performance of public work until acceptable evidence of compliance with a ce requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affi completely,by checking the box that applies to your situation and supplying company names, address and phone n bers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Acc idea for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be re turned the city or town that the application for the permit or license is being requested, not the Department of Indust id Acci ents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensatio i policy, ease call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete an l Printed legibly. Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations to contact you regarding the applicant. Please be sure to fill in the permitllicense number which will be used as a re ence number. The affidavits may be rebrad to the Department by mail or,FAX unless other arrangements have been e. investigations would like to thank�you in advance for The Office of Investig you co eration and should you have any.questions. please do not hesitate to give us a call. The Department's address,telephone and fax rum er: The Comm nwealth Of Massachuse s Departme of Industrial Accidents 0MC of lnaestlpadons 600 hington Street Boston, Ma. 02111 fax#: (�617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 Town of Barnstable �pQ 1HE tp� Regulatory Services * Thomas F.Geiler,Director • BAxtvsTAs�. * 9 MASS. �* 16g9. Building Division rBn � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: �2- ' �L JOB LOCATION: G n tuber < street r c- village"HOMEOWNER': GHQ. J�G.� CA U - �17 name home phone# work phone# CURRENT MAILING ADDRESS: .�0. � (:zs Q_'S 0,j Q city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellines of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building pemut. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"home er"certifies that he/she understands the Town of Barnstable Building Department 7require spection pr ce ures and requirements and that he/she will comply with said procedures and ts.omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger.will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in.your community. Q:forms:homeexempt ' O�resor/All R000- • � r4 t7 2 � ' { ' - - CNRN6r:1� ao.z�nE•f TO ES::�t�/Gf 70.�' � _ LLLI E J SCALE: APPROVED BY: DRAWN BY • q 4 _ DATE: �./ /_ O REVISED V - - - - DRAWING NUMBER T F OWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map \� 0 �°i Parcels Zd Permit# ® Health Division Q-5 Date Issu fj � -per Conservation Divis' n 7" ,/dam— Fee Tax Collector. c� P � $ 50 Treasurer !� (q "°''�,nlvip Bifs a' Planning Dept. V Is,lG A'L L E D I q C0Mir-:=�....; WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE- AN- 0 Historic-OKH Preservation/Hyannis TOWN REGULA ICNIS l Project Street Address y1 ) �M0.S �►.Q � 4-c vsL Village C-o v.. \ SS Owner , Q _ ,ti�a` �i,.�LJ Address Telephone LSOSti `t`I S 7 oc Permit Request .C"cC_ 0_ a-d ���oh �':2�Z��� o v- C,..0 C. aQ.Z - '�r �� �: �� (�.� Stems � ��c►�� � Q_Y�l � .J r / Square feet: 1 st floor: existing lo06S� proposed 5b8_ 2nd floof. existing ov proposed_5SS 0 ' Total new 1%6 0 Valuation :�D, 0 -Zoning District Flood Plain Groundwater Overlay Construction Type , Lot Size "31 Ac.Ze.S Grandfathered: Cl Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family X Two Family ❑ Multi-Family(#units) Age of Existing Structure 7S :GCS Historic House: ❑Yes �d No On Old King's Highway: ❑Yes A No Basement Type: W Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) SAS Number of Baths: Full: existing 1 new Half: existing new Number of Bedrooms: existing Z-- new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: J 1 Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes A No Fireplaces: Existing New Existing wood/coal stove: ❑Yes X No Detached garage:❑existing ❑new size r1111A Pool: ❑existing ❑new size lA Barn:❑existing ❑new size A►A Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial_❑Yes )9 No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name �LC4VlE_S\,�-.� c� � Telephone Number _CSOS) `7`1 S -TbS Address AS W`c�s�c � ��- License# Home Improvement Contractor# Worker's Compensation a'$�� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 4� 4 SIGNATURE L,Sz SJ2 C-3 DATE t FOR OFFICIAL USE ONLY PeRMIT'NO. " DATE ISSUED MAP/PARCEL NO: ADDRESS VILLAGE OWNER PATE OF OF INSPECTION: FOUNDATION FRAME aA/ INSULATION & FIREPLACE 4 ELECTRICAL: ROUGH FINAL Y PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDING: ` r DATE CLOSED OUT r ASSOCIATION PLAN NO. t i 7 Sin' .- ;N�P .0-p-iHE The Town of Barnstable Y RNS , \ Di partment of Health Safety and Environmental Services pIFOMP'�a Building Division - `� 367 Main Street, Hyannis, MA 02601 _-. Office: 508-862-4038 Fax: 508-790=6230 PLAN REVIEW Owner: Map/Parcel:,, Project Address: �'- -.� Builder: �- . The Iollowing items were noted ,n reviewing: .S.4c-t6W 0.1 Vk S�Jr I C-O, W\r\c::k { ) � � G•c1� i/ �1�Yam' � tom,-- `� ���-- � ��. i Reviewed by: UC • � Date: � `lam,_ ��-- • q:building:forms:review t RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 - Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING'SPACE square feet x$96/sq.foot= x.0031= � 2� p us from below(if applicable) ALTERATIONSIRENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= - J (number). Fireplace/Chimney x$25.00= . (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) permit Fee - projcost •• "' _ _ The Commonwealth of Massachusetts Department of Industrial Accidents - OIfICC 01/HY8599 llOOs : _ - 600 Washington Street T Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit :atian: 61-9-1 -Q-!C'�a\�'X-. v V s s- phone# k'�a-ma�hoi=ow=perfonningallworkniyself. : //%I am L a sole rietor and have no one worlan in a///ca actty ///%////r////%//%///%///////%%///i%a%%//%%%%/%///%%///////%/%%%%i/G%/////%/////i/////%%////%/a/i//%/ em 1• �er rovidin workers compensation for my employees working on this job. an g o an.•:n .... .......... ,vv;;.....ti{{•^v:.• yr::;v'{•}:4}}}:::::....,.:..:: v::::':::::.i}:..:•,:..{4:v::.v:::::...:::::::.v.,v r.::�.;.}Y::::::.:i;4r ...^:.:.v.v:}:v;}}}::}:};•• ........... v...:• �v....{::::+{':!•7:.v.:::i:+:•;:v:.. 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I understmd that a copy of this statementmay be forwarded to the Office of Investigations of the DU for coverage verification. I do hereb the p 'es of perjury that the information provided above is ow.and correct Hate �s r \ o Z Sig*=t re print name Phone# igdal use only do not write in this area to be completed by city or town bfncial dty or town: per�it/ficense ❑Bu # ilding Department ❑Licensing Board ro d 0 checkif immediate response is required ❑Selectmen's Office OHealth Department contact poison: phone#; Other li�ad 9/45 PJ� ' Information and Instructions sachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their lovees. As quoted from the 'law". an employee is defined as every person in the service of another under any contract ire, express or implied, oral or written. !mployer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of Foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or tee of an individual, partnership, association or, other legal entity, employing-employees. However the owner of.a Y fling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of ther who employs persons to do maintenance construction or repair work on such dwelling house or on the.grounds or .ding appurtenant thereto shall not because-of such employment be deemed to bean employer. rL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal L license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has produced.acceptable evidence of compliance with the insurance coverage required. Additionally,.neither the unonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until eptable.evidence of compliance with the-insurance requirements of this chapter have been presented to the contracting hority. plicants zse fill in the workers'.compensation'affiidavit.completely,by checking the box that applies:to your situation and )p lying.compagy.names, address and phone numbers along-with a.certificate of insurance'as all affidavits may be emitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and. to the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is sig requested, not the Department of Industrial Accidents. Should you have any questions regarding the'law'or if you :required to obtain a"workers' compensation policy,.please call the Department at the number listed below. ty or.Towns rase be'sure that the affidavit is'complete and printed legibly. The Department.has provided a space at the bottom of the iidavit for you to fill out.in the event the Office of Investigations has to contact you regarding the applicant. Please sure to fill in the permit/liceisse number which will be used as a reference number. The affidavits may be returned t� Department by mail or FAX unless"otliei`arrangeriments have"been'made: ie Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. ease do not hesitate to give us a"call. 0/011 he Department's address,telephone and fax number: . _ The Commonwealth Of Massachusetts' Department of Industrial Accidents OBlee of Investinuons 600 Washington Street Boston,Ma. 02111. fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409..or.. 375. I , The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date ` �Z ®� AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing.at least one but not more than four dwelling units or to structures which are adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: `Estimated Cost Address of Work: Ag Owner's Name: Date of Application: �s AV'A I hereby certify that: Registration is not required for the following reasou(s): MWork excluded by law []Job Under$1,000 MBuilding not owner-occupied M6wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR q:forms:Affidav :rev-122001 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village"HOMEOWNER': �f2�v.Q SL.�. , �070 %og � name home hone# work phone# CURRENT MAILING ADDRESS: �GW - aS Cl,.. c`�►`� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minim inspection procedures and requirements and that he/she will comply with said `pro ures and ments. Q C.V ac.� Si ature f Homeo er Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction.Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN . j Cu� P/v 8+5ctF 1`' uell7— OO ENTtD DiiP EDG[, /HOLD I /XS ST z.•.//'iNG /6��OC. �/Y�T96 9.l_<L�bUO .(6L��_ - 9" 3toCK /113o:Ii STert. - 11 Ftz zs.coc.z � � � �zyx�P":-ATE ' III ��5...__..— Ii .0 ON!✓G C?/�L_J"9 r,c � fr'I/•NC+ � � - !� a i ........... . S ------ �. I %so� Trs -10 royJ.lD. e-ioc,7s W/ PAY SCALE: / / APPROVED BY: DRAWN BY CY_ax/a GAt'ncs�': .[7Qv�. /-/t/•;�tjL- D• �.<. DATE' O 'j/3 4 REVISED t • DRAWING NUMBER.- I 1 I - unite �r:Y v 1-O C' n SCALE: APPROVED BY: WN BY DRA y •O Zee DATE '� / REVISED -i7 DRAWING NUMBER - i Y'X/6 t°=v�•r^iG I .ki I I tJ SP MCP ,.,�sl I !'• "7 F7/-^ i . APPROVEDBY: Ml ,/ /aZ.�v�T 2/Y C!-/E",S SCALE: '. j- DRAWN BY �C� DATE:,3 y C,C REVISED / DRAWING NUMBER —] is _77- ULL . ... �. OII I 8`"- -- SCALE: O APPROVED BY: DRAWN BY DATE: REVISED _b / 7 DRAWING NUMBER � i __(.�.'N—T� __�C:,•'�.: __.-.ASH//.GI,e: —.._-_•--- sr.. 1 ! 10 Jill Jo 7// i SCALE: APPROVED BY: ��1 U ' ORAWN BY Z7`C-C DATE REVISED DRAWING NUMBER 6 . 6✓'t/I 7.� C C U r.�Z d r/Sig•'� .='$ ' __._- -�_��-_-..___.__._�.._.._N_ ...._-__- --__— •- SCALE: / n APPROVED BY: DRAWN BY >- 1_ DATE: 3-. -Q;. REVISED 1/77 DRAWING NUMBER tl38Hn1 `JNIMtlHO ' oO%'_ r "�✓Cis 4351A3M i. :31WO 1�C: AB NMVUa :AB O3 AOtlddtl co O4 0:s r _ ,' •, 1�� ovn C�S!„�' �c'a�� C �l�.u�2 � �F l,U'l' LOT 40 4 —-----� S86 35 �20 'IL' LO7' 20 . � o 34 LOT 33 ___--_- xl F• �l cB S36 38 35'L' I UU. 0U' _ � As THEAD A IVF �. RLS. ZO-IVE.• "RC" Thic MORTGAGE INSPECTION 1'I,�r, is` ► of 1 Bank Use Only 1%LOOD ZONE.' "C' OWN: _CUlLVEUL' __ __ REGISTRY OWNER: AfAle6A1zL_l'__V._FIS11G7R _ DEED REF: _2�0-QZL5j-----------[3UYEFZ: �.��N_�_.f - - ��v -- llA'IE: _11/29�94 ____----_—_ PLAN REF: _��7415 SCALE:1"= _30' _FT. I HEREBY CERTIFY TO PLY90-UM -CO. YANKEE SURVEY ___THAT THE BUILDING SHOWN ON '['HIS PLAN IS LOCATED ON THE; GROUND AS ���AN OF ��c CONSULTANTS SHOWN AND THAT ITS POSITION wrO ,:S _ -. CONFORM off` 6Ak L y� 40B (SUITE 1) TO THE ZONING LAW SETBACK .REQUIREMENTS OF THE __ _ __ _ IT INDUSTRY ROAD TOWN OF BARNSTAf3LE —_AND THAT 1'f DOES_AQ _7L_ LIE Wl'I'H1N THE SPECIAL FLOOD 13AZARll Q m . �'�,- MARSTONS MILLS, MA. 02648 ` p AREA AS SHOWN ON THE 1-LU, D. MAP llA'1'L;D 8/�,��-�_ ``��J, ,Crl�i�,�� ,Q� TEL: 428-0055 Cor mun"t — •a el ,250001 0015 C %< �� FAX: 420-5553 •.... �___� -- ------ THIS PLAN NOT MADE; F'IzOhf"ANt;•i�l'RUMENT PAUL A. MERITHEW PLS SURVEY, NOT TO BE USED F'OR FENCES ETC. 6013 DPG 1 TOWN OF BARNSTABLE i = seRIFST' , 'moo r6 q. MASSACHUSETTS Solid Fuel Stove Permit DATE OF APPLICATION ..........?/f R flc�...��................... BHT. ISSUING PERMIT .....: .. ........ .. ��� NAME (owner) ....................... ` ................................................,�............................. NAME (Installer) .........................`....................:. ............................................. ADDRESS ............... ADDRESS yV e � e STOVE TYPE ................................../............................................................................... CHIMNEY: NEW ........................ EXISTING ....... A.... Manufacturer .............................l.`........................ ................................. CHIMNEY: Masonry .............k.................. .. ..X.....3........................ Mass. Approval .............�.�.........................1............................................................. CHIMNEY: Metal ................................................................................................... This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed address in accordance with an application on file with the .../.. w?..... °1. '^^.5.. �:' .�Q... Fire Department; and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. Issued By: ............................... /�'............P' Y' �.:........................Title ........ .................�.......+L. .%✓.... ......:........... Date ........��..` .��/Z Permit to install expires 60 days after issue date Stove ..................................................................................................... ......................... .....................t� .... .�N�.. .�.................el.t,e,eie..�'...... ,7.......1..... �,�;� ' .J I ,ate e StoveClearance ...................... ....................:.::..........:...........................�t...................................................... ............................ �.i................................... FloorQ/'Le, ........ . .�..L�.............................................................................................................................................................................................................................. Smoke Pipe ............................Sf.`"P5.� ......W?'L............................................................................................................................................................................................................ ..e Smoke Pipe Clearance .................................j�. ........�..................................................................................................................................................................................................... Chimney _/Zt8�. /�.T' Smoke Detector .................................y The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au- thority of permit dated ................. ............................. has been made in accordance with provisions of the Commonwealth of Massachusetts State Building Code now curren 1 in effect and pertaining thereto .4................................................................. Q n ��� S i I staller /Xre� e �S-. Cod� C j®17 INSTALLATION APPROVED ........ 1 151 k.... By:. ..... ....................... Title: f) WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT 1 Assessor's ma.p and lot'number .:..�.:I:...L'.1..................1�� SEPTIC SYSTEM MUST BE " C Sewage Permit number ... . . .. � I INSTALLED IN COMPLIAN E WITH ARTICLE I I 'STATE NIT Y 0 AND TOWN �FtHEtO� ' TOWN OFBARNSS i -- t i $d$$9TAHLE, i � .. ... ' J 039 BU.ILDINGI INSPECTOR u �p i63gr\00� v . l em APPLICATION FOR PERMIT TO ..:. �. TYPEOF CONSTRUCTION ...... ..................... ...................................................................... ` $ .. .(.�a.../.7...........19. h TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ` a...... -.... .. .......................y........................:... ProposedUse ........ L�'? ir?.,�� -�3 -........................................................................................................................ Zoning District ............. .( ...........................................Fire District ..... ......i/............... .......................... ................. Name of Owner � . . ...... ... ...... s 2avt.�......Address ./.c.hcMs Ica. d.....� .... ... Nameof Builder ... 6.,d1: L- ?'1. --......Addeess ......................... .......................................................... F . Nameof Architect ..................................................::...............Address .................................................................................... Numberof Rooms ..........................................:.......................Foundation ..........:................................................................... Exierior ..................................................................................:..Roofing .................................................................................... Floors ....................................................1.................................Interior ..................................................................................... Heating ............. ............. .. ................:........ ...........Plumbing ................. ........................ Fireplace ...........................Approximate Cost � 000 pp , ....................................................... Definitive Plan Approved by Planning Board --------------------_---------__19________. Area ....//.,.- . ................... Diagram of" Lot and Building with Dimensions Fee ...... • SUBJECT TO APPROVAL OF BOARD OF HEALTH A3 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. g' n , ~, Name .� .. 4:,b.. a a�X- Luechauer, Margaret 1 18748 greenhouse ' > No ...... .... Permit_-fora ................................ ' 1 .......................... .... ...:... ............................. - ' - t Masthead Lane � - Location-.......... ........:................................. r Centerville .�............ ................................................ Margaret Luechauer ..............• Owner ................................................... ........... -; Type of 'Construction ............................................ ................�...... •........................... ......... t ''� ,✓/' - +` `} a3 Plot ... ;.... ............. Lot .......... . .................. Permit Granted {....,October.l9 i'19 76 Date of Inspection ........:...:... ............ 19 r _ • -_ ^� 1 _ Date Completed t. .l� Q� /„ . ... .19 - "1 J .PERMIT.,REFUSED .......................... .................................... -19 ........................ ....:............ .................... < �.. =; i • . ,, r fj w App'roved ....... 19 ...... , ..................... ........... - - 0 r � ry.� s CC S/Z- fL6 K FEET 460✓E ZPO.Q.D PL O r PL. A Al LOCA7-/0/V: ff7" /LL. SCALD _ / =30—nAT& 6- 21-74_ PLAN r2E F&,Q6NCE: 861A/5 &o r 20 4- Ili OF A, 6 nil y1I AIL-QE$Y CE.?T/FY T/-/AT 7,qk EXIST /NG FOUNDAr/ON LOClITipN /-5CVee ` su Gy AS SHOT VN gNL7_ � __CONF0o2^J i�Y1rq - T/-/E 8U/LD/NG SETdAC.L�QEQUil9E 1�,vT Z S 1,9 7 OF TNT 7�jDN/N O/a .7�vN / - L ------ .OF-9. ZZA/S 3U'.72 t/ -Yoh e 4 4Os YOwWr "O n��r AA. _ _ i Assessor's:map and;lot(number -'' r o - 0 Z I SEPTIC SYSTEM MUS ti ". T BE " 2 7// ; INSTALLED IN' Sewage kP-.ermit number ..;.........................f............. ,.,........... COMPLIANCE -� �z WITH ARTICLE II STATE r THE T tr. ` TOWN OF BARN AEuT,KED ND TOWN "' &a.� a BUILDING INSPECTOR, pp i6:3q. 00 1.: O.YPy ,• r` y APPLICATION-'FOR PERMIT Ti0 • .. •• :1� ��wuun. q. TYPEOF CONSTRUCTION ........... ........................................................................ .................. ...5..... ......19. .ta TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... .......M 'f.C.l4aAr..... ,....................... ProposedUse ......, 1. Y1Q. ....................................................................................................................................... Zoning District ................R. ...............................................Fire District ... 1!I .QP�r.:...-:..1.1��.. ........... Name of Owner��.Q,Qk,(�.Q/t!) Nameof Builder ..CA/YY . ................................................Address ................. 1Y1'lA. .............................................. Name of Architect ..)..CVY.y.t. ..............................................Address ................. 6.a kis....................................... �........ Number of Rooms ...........b....................................................Foundation ....I.Q.........Pckl.!�i.f.CI ...... . ... .. . .2.. Exterior ...... N.,.......&&CR.tI(.......1._updbo.G-vct .......Roofing ....s 1�' ..0.........A6P.b.aA- .r..................... Floors .............:... .),,,IY.UI.. ...................................................Interior ........ .o2.. .....,.,0-.h.�.Kj•A kk.,.,ock.,............................. Heating ..........Ft .A. (��,✓�.........................................Plumbing ...........�..�� ..:.,Ll. .................................... Fireplace ...........00-,,7.nrq.,....qa---�.............................Approximate Cost .......... ............................... Definitive Plan Approved by Planning Board --------------------------------19x1-------: Area .............. ................. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH w�5— Y 4 hereby agree to conform to all the Rules and Regulati he Town "rnsta arding the above construction. �_ Name ............................................. .................................. Tellegen-Ferrone.Associates 18491 ` �" 1 1/2 story, i• No ...................Pe.r_mit#or ....................... ......... - - single family dwellin .. ....... . ...... .. ... .......................... i L6catio0vX Masthead Lane........ ..................... Centerville ............ ....................................... .................. n ..... ..... Telle en-Ferrone Associates Owner .................. ............... ..... : ...... .... Ty-p.\.;..F..: f Construction fram :. . ...................................................�............................. PIOt �i. .. ................ . Lot ................................ 76 r Permit Granted June 29 Date.of Inspection .L/� ...0 ...19 r. Date Completed ...?/V ' t PERMIT REFUSED 4- 17 n ................................................................ 19 ! s ..................'. ................ ................... .7............................................................. ...... . ...................................:................ .......................................................... ................. N - Approved . ..... ............... . ....................... ................. .. .. ..... ..... .................................................. �1 ;