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HomeMy WebLinkAbout0010 DOGWOOD LANE / � i Town of Barnstable 113 THE � Regulatory Servieft OF 'BARNSTABLE Thomas F.Geiler,Director ry RMWSTA PM 27 i6g9. , Building Division? 3 �- ArFp �A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma s it g�.I =a, l °ps3 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# � � (0 C) FEE: $ SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less a bO L� , .F Location o ed(address) Village Property er's name Telephone number /0 `)e-l ZA) rLo S - 01CC07- Size of Shed Map/Parcel# 03 ignature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is,required)Sign off off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN 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 Q-forms-shedreg REV:052813 .Map Page 1 of 3 Town of Barnstable Geographic Information-System ' Parcel Custom Map­ .Abutters Zoom 64000.000a In Viewer Au yr Ra 040081. _ � ' N24 17, Al 29eA / 040 .d •Vim( ' .. 040074zf 040082 lP J • , ;a b�i3 4: : { 40 Feet y � . . 040123 Y y ♦ N 25 P Copyright 2005-2010 Town of Bamstable,MA All rights reserv, http://66.203.95.236/arcims/appgeoapp/map.aspx?propertylD=040082&mapparback=040082 9/6/2013 artment of.Nuojj.'-�,.,•- , I. Massachusetts -Rgulations and Standards 0 Board of Building u t,rcisor Construction S p License: CS-079358��� ' I A MACALPSWWRIK 64 EBENF zFR RD " # j OSTER'% 1VFA 02� ' a Exp#ation wO ` OBI12/2014 I J Commissioner �� �Pammoasiuecrl/� Office of Consumer Affairs&Business lat on m -- ME IMPROVEMENT CON T Regulation -License or registration valid for d►v►dul.use only egistration RACTOR before the expiration date. If found return to: 133744 xpiration: 8/3/2015 Type Office of Consumer Affairs and Business Regulation DBA 10 Park Plaza-Suite 5170 MA LUSTER BUILDhNG tw ' Boston,MA 02116 a MARK MACALLISTER 64 EBENEZER ROAD <= OSTERVILLE,MA 02655 �``� Undersecretary Not valid witho ut u t signature ur gat e e THE rp� awsxsTws�:, « 9� is ,e� Town of Barnstable MAC h Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder L�c�.,. , as Owner of the subject property hereby authorize m ol-k mamtl'64-v to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print N e If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\P.ppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012. ACOOREPCERTIFICATE OF LIABILITY INSURANCE 9/9/2013"'"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES,NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ° • IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kathy Silvia' The Fair Insurance Agency Inc. PHONE ; (508)775-3131 FAX C .(508)790-1677 619 Main Street ADS as:kathy@thefairagency.com Suite 7 • y INSURERS AFFORDING COVERAGE NAIC# Centerville MA 02632:• _ , r INSURER Western.World RTBO18 INSURED , *� INSURERB:CitatiOn Ins'. . CO: (MA)e- `,' 0274 Macallister Building LLC A INSURERC:Star-Insurance'Com an 18023 64 Ebenezer Road , "_ INSURERD:Peerless .Insurance 124198 INSURER E Osterville MA 02655 - INSURERF: COVERAGES CERTIFICATE NUMBER-CL139900587 REVISION NUMBER:. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN; THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF,SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR �+,. POLICY EFF POLICY EXP - LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY) (MMIDDIYYYY1 LIMITS GENERAL LIABILITY ' �` "`�•` EACH OCCURRENCE _ $ 1,000,000 DAMAGE TO REED COMMERCIAL GENERAL LIABILITY ` ' PREMISES Ea occurrrrence $ 300,000 A CLAIMS-MADE OCCUR PP1318574 C /11/2013 8/11/2014 MED EXP(Any one person) $ _ 5,000 } PERSONAL&ADV INJURY ' $ 1,000,000 r GENERAL AGGREGATE r $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC r $ AUTOMOBILE LIABILITY :> I 7< COMBINED SINGLE LIMIT t 4 Ea acc dent d. B ANY AUTO + ^ BODILY INJURY(Per person) $ rr ALL OWNED X SCHEDULED X2082 9/7/2013. 9/7/2014 BODILY INJURY(Peraccident) $ ; AUTOS AUTOS HIRED AUTOS NON-OWNED f. PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR e ` , EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE r ..; : 'AGGREGATE $ �. DED RETENTION$' $ C WORKERS COMPENSATION WC STATU- OTH- x d AND EMPLOYERS'LIABILITY 'r " ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N �. " `.' .r OFFICER/MEMBER EXCLUDED? NIA + ''' ,W, �' E.L.EACH ACCIDENT $ 100 000 (Mandatory in NH) �_ C0632030 u, /1/2013' ' /1/2014 E.L.DISEASE-EA EMPLOYE $ 100 000 If yes,describe under '[• 4" DESCRIPTION OF OPERATIONS below "` E.L.DISEASE=POLICY LIMIT $ r 500,000 D - i Y IM8492273 /11/2013 . /11/2014 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION c SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ' THE EXPIRATION DATE THEREOF, NOTICE WILL•BE .DELIVERED IN Town Of Bannstabl@ ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE " ^ Jackie Stewart/FAIJS2 �� �� ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INsn25 rgninnet m Thn arnan name onri Innn om mnicMrorl mmorc of Arnpn TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map J0 V Parcel_ Application #C26 a3 �C Health Division � �� Date Issued p Conservation Division Application Fee Planning Dept. Permit Fee 60 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 10 4wqo l L.N Village CC 4214 r Owner Mr. C�Q_ A46i4cvv oy� Address /O �Q! .Woa CA 1, 'A. Telephone 753 ' 0297 Permit Request F,-f) ;Sl, Aq S P o1E 6gs gm R,+ Square feet: 1st floor: existing /130 proposed Q 2nd floor: existing Q proposed _Total new d Zoning District Flood Plain Groundwater Overlay Project Valuation o Oup Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 30`25 Historic House: ❑Yes 2 No On Old King's Highway: ❑Yes C_No Basement Type: mull LJ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing_ new O Half: existing new Number of Bedrooms: 3 existing& new Total Room Count (not including baths): existing _ new First Floor Room Count Heat Type and fuel: &<as ' ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes �o Fireplaces: Existing_ -New �_ Existing wood/coal stove:'❑Yes U No Detached garage: 0 existing ❑ new size Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new -she_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: C=4 MM ta Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ j Commercial ❑Yes E No 'If yes, site plan review# Current Use Proposed Use tl 9YI APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name A �IdAcp�aLsm _ Telephone Number Address (a q License # CS i Home Improvement Contractor# �23375�y Worker's Compensation # QC_ c:6 3/ 2o3d ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 00,,k iso,L' lv icto SIGNATURE DATE r 4 FOR OFFICIAL USE ONLY ` APPLICATION# DATE ISSUED MAP/PARCEL N0. i I b ADDRESS VILLAGE OWNER' C DATE OF INSPECTION: FOUNDATION R FRAME tglri?04 Gc- INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL x FINAL BUILDING DATE CLOSED OUT t } r ASSOCIATION PLAN NO. t r t 'l rs--- r The Commonwealth of Massachusetts `' ' Department°nf Industrial Accideitts i : Office of Investigations e Washington W. rSDD Street . c a ra Boston,MA OZIII www,mass gov/dia ` Workers' Compensation Insurance Affidavit: Biuiders/Contractors/EIectricians/Plumbers Applicant Information Please Print Le_gibly Name (Business/organization/Individual) Address: City/State/Zi P� phone Are you an employer?Check the appropriate box: ° T e of project re uir yP . p- I ( 4 �L[� aam_a employer with A 4: ❑ I am ageneral contractor and I employees(full and/or.part-time)..*, have hired the.sub-contractors 6• [],New constrvchon, 2.❑ I am a sole proprietor,or partner- ,. `� :listed on the attached sheet t �. �7 L�'1 Kemode-9 ship and have no employees These sob-contractors'°have 8: ❑`Demolition working forme in any capacity. : workers' comp, insurance ' o workers' com insurance 9• ❑ Building'addrtion p. 5.>❑ We area corporation and its w required] ' officershave exercised then 10.❑ Electrical repairs or additions 3.❑ I am a homeowner,doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.'[No workers' comp. _• c. 152, §1(4), d we have no . ' , ,12.❑ Roof repairs". insurance t e,required] . employees.[No workers *V comp. insurance required.) 13.❑Other s Any applicant that checks box.#I must also fill out the section below showing their.work='compensation policy information t Homeowners who submit this af5davit,indicating they air 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 end their workers'comp:policy information: I am an employer that is providing workers'compensadon.insurance for my enipZoyees. Bela•w.is the policy and job site f cn orrnatzon. job Name. ' - ,£ Policy#or'Self-ins Lic.#. 'L jj[9a D 0. Expiration Date, Job Site A-ddress:_%o BOG Lyi d 61 City/State/Zip:('/:�7„fi �luS ' Attach a copy of the workers' compensation policy declaration page(showing the,policy number and exptration date), Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal enalties of a Erne up to$1,500:OQ and/ one-year,imprisonment, as_well as civil pena}ties in the form of a'STOPNORK ORDER and'a fine of up to$250•DO a day against the violator. Be advised that a copy of this statement may lie forwarded to the Office of Investigations of the DIA for,insurance coverage verification, I do hereby certify under the acrrs and `naities o P P, f perjury that the information provided above is;true and correct S i afore: . .; Date: " 1 . Phone#: Offtcial'use only, Do not write. in'#as area;to be camp leted by city or town o tccal ki City or Town: Issuing Author cite Permit/Licease# ty(circle one): . I. Board of Health 2. Butlding,I3eparfinent 3:City/TownWCIerk �.4. Electrical Iaspectur 5.Plumbing Inspector• 6. Other' . Contact Person: ' PhoneL# { Information. and Instructions l Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not becau se of such emp loyment be deemed to be an employer. MG c •�L chapter 152, §25C(6)also states that every state or local licensing agency steal[wuthhold the issuance or renewal of a license or permit to operate a.business or to construct biuildings in the.commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL not 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the ia�r nce requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of . insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Deponent at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure thatthe affidavit is complete and °p printed legibly. The,Departnent has provided a spa ce at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact yod regarding the applicant Please be sure to fill in the perrnit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or Licenses. Anew affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. ~ Th(�Commonwealth of Massachusetts Department of Industrial Accidents Gffiee of Investigations 600 Washington Street &oston,MA 0.2111 Tel. # 617-727-4940 ext 4G6 cur 1-977-MASSAFE Revised 5-26-05 Fax# 617-727-7749 ww-W.mass.gov/dia R Workers Compensation and Employers Liability Insurance Policy N S U R A N C E C D M P A N Y 26255 American Drive A member o/Meado:abroo0 Insurance Group Information Page Southfield, Michigan 48034-6112 Policy Number Renewal Of Policy Period, Agency WC0632030 --TNew 03/01/2011 to 03/01/2012 0000750 Item Named Insured and Address Agent . , 1. Macallister Building, LLC Renaissance insurance Agency, Inc. 64 Ebenezer Road 981 Worcester Street Osterville, MA 02655 : Wellesley, MA 02482 i FED ID Number: 025687818 NCCI Carrier Code No.: 24562 Risk ID No.: 0196263 Other workplaces not shown above: None Entity: (LLC)Limited Liability Company 2. 'Policy Period: 03/01/2011 to 03/01/201212:01 am standard time at the insured's mailing address. 3A. ' Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation law and any occupational disease law of each of the states listed here: MA 3B. Employers Liability Insurance: Part Two of the policy applies to Employers Liability Insurance for work in each state listed in Item 3A. The Limits of Liability are: Bodily Injury by Accident $100,000 Each Accident Bodily Injury by Disease $500,000 Policy Limit Bodily Injury by Disease Y$100,000 Each Employee . 3C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All states except ND, OH, WA, WV, WY and states designated in Item 3A of the.Information Page. 3D. This policy includes these endorsements and schedules: See attached schedule. 4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans. All Information below is subject to verification and change by audit. Adjustment of premium shall be made at: Policy Expiration Classification of Operations: See attached schedule Minimum Premium _ Expense.Constant: Deposit Premium: Total Estimated Annual Premium: t Countersigned 03/10/2011 B DATE Authorized Agent This Information Page'with the Workers Compensation and Employer's Liability Insurance Policy and Endorsements, if-any, issued to form a part.thereof, completes the above number policy. Date of Issue:03/09/2011 Insured Coov RENCE1 WC 00 00 01 (12/98) - Nlassachusetts- Department of Public Safety Board of Buildinit, Regulations and Standards Construction Supervisor License License: CS 79358 _ 4 MARK A "MACALLISTER 64 EBENEZER RD: OSTERVILLE, MA 02655 t ' �- - -! Expiration: 8/12/2612 ('ununisinner Tr#: 907 • -'a%�P iUClJ7tAYL[1?CCUCC/���P��U��RdJILL'�[CJf I�S Office of Consumer Affairs&Busihess Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: .133744 Type: Office of Consumer Affairs and Business Regulation xpiration: ..8/3/2013 - DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 MACALLISTER BUILDING. ' MARK MACALLISTER - 64 EBENEZER ROAD OSTERVILLE,MA 02655 'Undersecretary Not valid without signature oFr MASS. Town of Ba.nnstable Y Regulatory Services Thomas F. Geifer,Director Building Division Thomas Perry, CBo Building Corrimissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable ma:as Office: 508-862-403 8 - Fax: 508-790-6230. Proper QWner must Complete and Sign This Section If Using A Builder # as Owner,of the subject property hereby authorize-,�JQ,r/C to act on my behalf, in all matters relative.to work authorized by this building permit application for (Address of Job) 12 Signature of Owner Date Print acne .- If Property . . ', Owner is a I"in_ for PP Y g permjt,please complete the Homeowner License Exemption Form an the reverse side, C;IUsersldccollik�AppDatzV-ocaRMicrosoftlWindowslTcmporuy Inicmct FilcslConant.DutlooklDDV87AA.ZlEXPPESS.doc Revised 072110 Town of Barnstabie Regulatory Services = a,�artsrtsrts. Thomas F. Geiler,Director r,uss Building DileiSiQn Tom Perry,Building Commissioner 200 Main Street, Hyannis, ARIA 02601 www.town.barnstab le.m a.us Office: 509-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print . DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town ' state zip code The current exemption for"bomcowncrs"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 Iicense,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Persons)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 fans 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 5e responsible for all such work performed under the building permit..(Sectio❑ 109..1) The tmdcrsigned"homeowner'assumes responsibility for dompliance 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 minimum inspection procedures and requirements and that he/she will comply with-said'procedures and requirements. Signature o f Homcowner 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 EXLMPTTON The Code states that: "Any hbgreowner performing work for whicb a building permit is requirrd shall be exempt from the provisions of this section(Section 109.1.1-Liccnsing•of construction Supervisors);provided that if the bomtowner angages a person(s)for hint to do such work,that such Homeowner shall act as mpavisor." Many homeowners who use this exemption-are unaware that they am assuming the responsibilities of a supervisor(see Appcndfx Q,, Rules&Regulations for Licensing Construction Supervisors,Section 7-15) This lack ofawarm=s often results in sarious.problcros,particularly when the homeowner hire unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a ficrnscd Supervisor. The homeowner acting as Supervisor is ultimately r=ponsrblc. To enz=that the homeowner is fully aware of hislher responsibilities,many communities require,as part of the permit application, Cher the homeowner certify that he/she understands the responsibilitics�of a Supervisor. On the last page of this issue is a form currently used by several towns. You may cart t amend and adopt such a rorn/eertification for use in your community. Q:forms:homccxcrnpt Assessor's .map and,lot number .... .:.:... ... ......... .. Sewage Permit•number , Qyo.. .... ... . .... ....... . u Z B 9TSD , i House number ............:. .Y.... �, y �nea LE c ..........'.............. yy[[�,,gg�a :.{ti�a�a?q,F1;� {�ryyS t...:! �O t639. 00 'V iEVn3 GA1..i..GD 'ii� 4.d ftr. ~Lcl'i•` ..a,_ oN TOWN i OF B AFR T vB hiEf- ; R NMENTAL REGULATIOW BUILDING INSPECTOR- Cohstruct v APPLICATION FOR PERMIT TO ..............................:................:................................: TYPE OF CONSTRUCTION ,,,,,,,,,,,,,Wood Frame , ............................. ............................................. '" O Jam. ..................19. TO THE INSPECTOR OF BUILDINGS: l The 'undersigned hereby applies for a permit according to the'following information: • Lot 14,, •Pineview Dr.-, Cotuit,. Ma. Location ..........................................................................................................:. ............................................................................ ProposedUse ............Res.identi.a.l.............. ................... .................. ....... ............................................................... Zoning District ...............PC.....: ...........::.....:..................'.......Fire District .....Cotui.. - ....................... Theo Construction Co 24 Great Pond Dr. ,' So. ..Ysrmouth, Ma Nameof Owner ...................................................................'.....Address .................................................................................... same Nameof Builder ...........:.......Address '........................:........................ .................................................................................... NANameof Architect .......Address.........:................................................. .....................................:............:.............:................... 5 p oured concrete ., Number of Rooms ...................................................:..............Foundation .............................................................................. Exieriorcedar shingle asphalt shingle .............Roofing Floors plywood Interior ...........sheetro. . . ck... .............................................. ....... .. .... ....... . . F11W gas- � ] /2 baths Heating :.. ........ .. .................................'.................::. ........Plumbi:ng ..:.,:: ......:................... .... - .. Fireplace . ± .........one........ .............. ........ .......Approximate Cost 25.,000......... .... o ...... . ... ... ... ..... ......................... /// y' g Se t' �l 73 ..•7� 2 , Definitive Plan Approved b Planning Board ___________P _____ _______19 _ __: Area ........... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ' 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 ... ... ... ..... ........ 016681 Construction Supervisor's License .................................... �. THEO CONSTRUCTI0 co.!. r' 24697 One Story No ................. Permit for .................................... Single Family Dwelling - - < t Location ....................i........ Xe-V=�I�..DrlVe Cotuit ' .......................................................... ............ i Owner .:.Theo...Cons.tX1iGtion...Cca_........ Type of Construction .......................................... r .. ..............,............................................ Plot .........:'...`....... . Lot ................................ January 6, 83 Permit Granted .................:......................19 Date of Inspection' ...............19 r Date Completed '.. .... �ev.l ne I t it t M 0 • S Assessor's map and lot number .... ..... . THE Sewage Permit number .......... ......... ..C.^.i.... . Z PARISTSDLE, i > House number .................................. MAO& 00 C O 1639. \00� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO Construct .................... ............................................................................................. TYPE OF CONSTRUCTION Wood Frame A.................................................................................... ...................... TO THE INSPECTOR OF BUILDINGS: 1 The undersigned hereby applies for a permit according to the following information: Lot 14, Pineview Dr. , Cotuit, Ma. Location ....................................................................................................................................................................................... ` Proposed Use ...........Residential.............................................................. .... ................................I..:............ ...... ;I PC Cotuit Zoning District .............................................Fire. District .................... Theo Construction Co. 24 Great Pond Dr. , So. Ysrmouth, Ma. Nameof Owner ......................................................................Address .................................................................................... Barite Nameof Builder ....................................................................Address .................................................................................... Name of Architect ................. A............................................Address ................................... Number of Rooms .................5...............:.................................Foundation .....poured ................."...'c.oncrete............................................:....... cedar shingle asphaltihingle Exierior ....................................................................................Roofing ...................................................................................... e Floors plywood sheetrock 4 ...:...............................................................Interior .................:........... . .....:.............................................. Heating, -'-EHW::ga.. ..................................................... ........11/2 bath.. '. :......................................... Plumbing ' Fireplace ..............On@......... ..................................................Approximate Cost ............. ? ...d�................................. °? .. pp Y g Sept_ 2l 73 Definitive Plan Approved b Planning Board ___________ _________________19________. Area .......................... ............... Diagram of Lot and Building with Dimensions Fee '�- SUBJECT TO APPROVAL OF BOARD OF HEALTH t i v 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 ..Ce •.. 44!... .......c: '? ........ ! .....:... 016681 £*• Construction Supervisor's License .................................... ,5. THEO CONSTRUCTION V A=40-82 24697 One Story No ................. Permit for .................................... Single Family Dwelling I® 1"�o'3LOC< 6 In. Location Lotl #14, 3*—Ti�+ew-�r-ive ....... ................................................... Cotuit Owner .,Theo Co.nstruction. . . . . . ...Co. .. .......... .. . .. ....... .... .. .. .. .. . Type of Construction Frame .......... ............................ ................................................... Plot .................. ..... Lot ................................ Permit Granted . J.anu. ary. ...6..., 19 83 .... ....... .. .. Date of Inspection ....................................19 Date Completed ......................................19 i -LL �Q ro _� 3" AV o � . �t so•� a o - a tl N 144 ZD n G won co n L/4.w,!!� PLAN SHOWING wilz o� FOUNDATION LOCATION .� w Lro 4 7-U/7" MASS. Sao o 0 OWNED BY' /��U \ -- ---_ { � QQW SCALE / " `�C9 ' DATE: DEC. ;Z 6 90z, �r�f,w Z>>: ►a NOR(MAN GROSSMAN --------REGISTERED LAND SURVEYOR S x _ q z, w I HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED P`t �F'N4�. 3 ON THE LOT AS SHOWN AND CONFORMS TO THE TOWN OF610A ri90467 ZONING REGULATIONS REGARDING f ORfbfAu�l a z VS a CROSS""MIAN U. w SE T8AC 1GS FROM STREET LINES AND\ LOT LINES . 0 wo. tz»s a ti \'9✓l;�GiSTO 1U�s Sr U RJ �F NORMAN GRVSSMAN R.L.S. DA7-E TOWN OF BARNSTABLE Permit No. 24697------------- ------------- ���� Building Inspector cash. .Y` ------------- _ �D■�Y� OCCUPANCY PERMIT Bond -----____------5 Issued to 1heo Construction Co:. Address lot 014 10 Do9wo03 Driv,-, Cotuit Wiring Inspector Inspection date Plumbing Inspector, � .� Y ` Inspection date Gas Inspector s,�� � ° , Inspection date NO 1)8` Engineering Department�� A �l-�l -t .//d✓/ /�,� /'. � Inspection date,/ l 11 r�^"�. Board of health } t^R- Lc Inspection date 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. 'ff,..�CC...... '.......... 19 f ......................... � � - Building Inspector " �, /�/a�✓ N[J � - '-�-��'uJryC.cs '7i; �Y.. -TX"K w��C!'f,r,fC,:t'�= An_c F .:1z r.. '.__fv Vs •..i t>;—& 6 DA (r r + .F rs. 3 S•. . 3.y4 ....._._. Lt: l if, ! 71)!)'?t & ' 1 / NJ1i;J _tl..- lP-S r�:rJ]Llr.s(q•' ._ .— � 1 I Jaw $o,LE N IYr ._ -, io0. 36>_0� i I 'APPROVED BY. - 4 - 6CAlE: � ,J'-:i..p II DRAWN BY {A.`f r + DATE: REVISED .. - Cr'ECJ.i-cTN A3�:C11•�rnJ),Su� - !"v .v tuck %N. +ltF /•'IR u a_ ['t I!>.\)a r`3 f.j(� DRAWING NUMBER 1