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0102 EISENHOWER DRIVE
i�� -�su�hv�v�- d: L , I LOT 3 LOT 2 14 9. 96 N ; 21 997 S.F. " Cr r ' W LUG -33 �r L OT / 2 Prop Sed C O r-` ai p l2•7 0 c» 38.o 43, O - 12 S.0 0 _ EISEIVMO ER DRIVE . PLCAI OF L AND /M COrU/ T M1q�S . I certify that the dimensions of the concrete foundation :and ,off. sets to . the lot lines are correct a's shown, and. conform to the zoning by-laws of the Town of Barnstable, Mass, • ����� OF M�Ss7� . JAEs y kale: 1" 40' -June .21; '1p80 C VAFI BE�_ !. R V En 7 gineering Associates M� N .003�/ STE�yo� 255 Worcester Lane I j Waltharn, .,MA. 02154 P Town of Barnstable .*Permit# Expires 6 months from issue date Regulatory Services Feej Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner " 200 Main Street,Hyannis,MA 02601 rrr!!! www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number n 10 x Property Address L1V� d ❑Residential Value of Work 2, V 0 G•OU' Minimum.fee of$25.00 for work under.$6000.00 Owner's Name&Address A � N ` Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor,® I am the Homeowner X-PRESS PER ❑ I have Worker's Compensation Insurance �YI�� Insurance Company Name NOV 27 2007 Workman's Comp.Policy# N pF BARNSTA Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) " ❑ Re-roof(stripping old shingles)All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side J.) ; (� eplacement Windows/doors/sliders: U-Value (maximum.44) y�rQ,e�So'n �04 �e/YpJt *Where required:Issuance of this permit does not exempt compliance with other town department regulations,`i.e,Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission, A copy of the Home Improvement Contractors License is required. ` I SIGNATURE: $ • i P Q:Forms:expmtrg Revise061306 ' ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' wNOw.mass.gov/dia ' Workers'Compensation Insurance Affiddvit: Builders/Contractors/Electricians/Plumbers _Applicant Information .Please Print Legibly Y— Name(Business/Organization&dividual): a 2 Y le—s •-l'.B..l 1 Address: rFll tX City/State/Zip: l_•P� �26� Phone.#: rF � Are you an employer?Checkthe appropriate bog: :Type of project(required):, 1.❑ I am a employer with 4. (] I am a general contractor and I 6. ❑New construction . employees(full and/or part-time). have hired the sub contractors 2.El I am a'sole proprietor or partner- listed on the-attached sheet. . 7. ❑Remodeling ship and have no employees. These sub-contractors have g• []Demolition avorkin for me in an capacity employee;?and have workers' g y p t3'� $. 9. ❑Building addition [No workers' comp,insurance comp.insurance. 10.❑Electrical repairs or additions required] 5. We are a corporation and its (^� '3.[�I am a homeowner doing ill-work . officers have exercised their 11:❑Plumbing repairs or additions ' �! myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance.re uired t c. 152, §1(4),and we have no 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 anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. jam an employer that is providing workers compensation insurance for my employees. Below is.the policy and job site. information. Insurance Company Na)ne: 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 maybe forwarded to the Office of _ Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains•and penalties of perjury that the information providad above is true and correct Siafor Date: /"d� �7 07 �. e: — Phone#: Official use only. Do not write in this area, to be completed by city or town:official, City or Town: ' .Permit/License# Issuing Authority(circle one): A.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector 6. Other Contact Person: Phone#: THE Town of Barnstable OF Tp� Regulatory Services t BARNSTABLE, Thomas F.Geiler,Director y MASS. 16.19• ,• Building Division lEO �a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print X DATE: JOB LOCATION: num er *`' `. street 9 n village [� y )C "HOMEOWNER": ��YL- /Q � a &I � Jyt� / Ef-O name (home phone#• /9�w werk phone# CURRENT MAILING ADDRESS: LJf IY4 CP,?635-nV 1/ 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 minimum inspection procedures and requirements and that he/she will comply with said procedures and req - ents. a X Signature of Homeowner 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 forn-LIcertification for use in your community. Q:forms:homeexempt r_ F�HETg,,, Town of Barnstable tia Regulatory Services yBA ASAIRM S. Thomas F.Geiler,Director TE1 39. Building Division Tom Perry,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 Secti If Using LA Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work utho ' by this building permit application for: (Add s of Job) Signature of Owder Date Print dame If Propedy Owner is applying for permit lease complete the r r r Homeowners License Exemption Form on the reverse, side. QTORMS:OWNERPERMISSION I TOWN OF BARNSTABLE Permit No. -----------_--------- 1 Building Inspector cash -----------------------_-� �A rua oO'r0 YPY OCCUPANCY PERMIT Bond ----___--------___-_---_ "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to C�varl es Angel?- Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department 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. ...................................................... 19 .... ........................................................................................_......_......._._ Building Inspector �yAssess`oMs. map and lot number .................. ..............'.,........ THE Sewage Permit number . ............................................................d SEPTIC SYSTEM MCI " 9TN1LE, i !! House number . .. ... 639- ' TA, , c D IN /^�/A� pp pea 1! L . .�7 MA a\ TOWN OF BARN +�7i LCODEAND TOWN REOULAT.IOi9S BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPEOF CONSTRUCTION .....................................................:.................................................,.............................. ........`....... .. .................19..4.lJ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according-to the following �(information: Location ...(.0 ....v..�`..... '. $ %1... a.uL: r ... ...... �: .�....�.�...:.` !-...... !...: .... ..!l(i .��! .... .............................................:.......:.......................................................................................... Proposed Use Zoning District ......................................... Fire District .............................................................................. .. Name of Owner e�...(..........�..................................AddressV O. ...1.... ... .fl..,l.���'.I.sf: Name of Builder k/�`/. GtS��?'1 �t4"/J1?/J.Address ..C.... �1r�.... Q ��. �!f...�.1..�.!.�fN. Nameof Architect ......................................................Address .................................................................................... Number of Rooms 1.................................................FoundationaPG( eDnG/`2 Exterior 9A.Xt.....110d a . . . . . ......... .Roofi�ng. a soSh t'17�A . ...r : . Floors ...... .a..!. .................................................................Interior ....Nm...,In" a �S/� '�f /�1�1. ✓....... Heating ...ell�C,/,/, 4......... ... .f... . .......................Rluvbing �.. .:............. i'Ju: ................................ Fireplace .A.i�W. ....:I�n,CK................................Approximate Cost .. •?.�... ................ Definitive Plan Approved by'Planning Board __________ �_________ 19 ._= Area I .. ...:................... Diagram of Lot and Building with .Dimensions ... ��; � Fee ........ .... .... ................. SUBJECT TO APPROVAL OF BOARD OF HEALTH �� Z �n L Gd a s A L I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. I ..:.. I ..... .. _NGELL, CHARLES No).22,3.3.3... Permit for .... ........... Single Family D elling .............................................. .............. ................ ♦ Location .,Lot #34 102 VE�i.'qnh�.oq�wver Drive ............................... ...... ...................... -'Cotuit ............................................................. Owner. Charles...Angell..... .. ......................... . ....... .. .... .. ....... Type 'of Construction ....)Frame............................................. ................................................................... Plot ............................ Lot ................................ 80 Permit,Granted ..............................July 10,.........19 - Date of Inspection .............. /0/t .14-1....19?d- Date Com lete4 ...................... PERMIT REFUSED M . .............. ......... .. ...............0............ 19 '^ Atz............ . ............ .... . N4. . ........ ........................................ ............. y .. . ......................................... nr .... ......... ApproveEfi,.��:,�:t .................... 19 . . . ........ ............................................................. ............./.r................... Assessor's map and lot number .........!..`-3.. .. . ...../ O3. ....... THE Sewage Permit number ��.-. ? C�•.�.:..�.. . ....... �iz�80 •O Bas 0• Housenumber.. ................................................ i639- >; NAGL e� / O E MAI TOWN " OF BARNSTABLE BUILDING INSPECTOR y APPLICATION FOR PERMIT TO `�'�.. TYPEOF CONSTRUCTION ..................................................................................................................................... ........... !z.rZ..................... TO THE INSPECTOR OF BUILDINGS: The undersi/gned/hereby applies for a permit according to the following information: Location ...(�OT....�J..�... �..:...�f7.. 1(� P.r......../—'/. e.... d.. ..�... .i... ........ ............................ •� ProposedUse .. J��J..P...��!..r ............................................................................................................................................... ZoningDistrict ........................................................................Fire District ..............................n............................................... Name of Owner!!.�tr,�PS....f/..! .�1.�°..��..........................Address /GY..,�& T .��a Name of Builder .>>.1..�.�f`/......C....G(,5. 1./ U!�(�r?rS.Address &.f ...3.,oz.... iJ Nameof Architect ..................................................................Address ........................._............................................................ Number of Rooms Foundation ?D64/ fo �DnC/`2 Exierior ...:.......:............................:...........11.�..........................Roofing .........� ......... .... .....!......%....... Floors ...Interior ... ��!� hOG �' r�/P( 1, C.:.: ...Plumbin ............. ......Heating ......... ................ ................................................. g ......................................................... Fireplace .. .f'/al..../l;:�Pr(... ?Y,L.(:! .................................Approximate Cost ......... . .. IJ.lJ..................... Definitive Plan Approved by Planning Board --------------------------------19--------. Area ..f.SJ. j........................ r Diagram of Lot and Building with .Dimensions Fee � �7?x ............... SUBJECT TO APPROVAL OF..BOARD OF HEALTH G c CP I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ) n Name ...:! �>.l.r� c,. �, r� .......���� .. =A=3�9-103 ANGELL^ b r / No 2.2.3.3.3—. Permit for ...IK9—St9�KY......... ......... .Q...F ' lv—D�Y� ---.. Location Lot;...��3.4...I.Q.2...E' Q.Tibqw.e��..Drive ----..<�otz�it................................................. � Owner --------- - Type of Construction —.F.r.a0Q.-------- � P| July 10 Pe "". Granted ....../ ........19 80 oo*e Completed � . PERMIT REFUSED � ................ 19 � / ................ � / | —.---..— . ---.-- ------ ...................... � n ----------'' '' '' '' ' ^—'---'— Approved ---------------- 19 -------------------------- � ' ---------------------'---~— ' � | y . : EL 9 5. 3 f o ,. ol �ToaS U '' F TE DE I-0 C. 2Co I - F/Ni ro FINE To PC RSONS /A/ ATT_r_A1OA"Ct : Jq&IFS C._VAF1A067S PE. nnQ w',� v c-61 MR. MURRRy OF THE _SARNSrAgLE HEALTH DFPT- -_ 9� 01 C P. 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T•9hf Joir�� N/ah ho% FiYrrn� Joi Pipe _ cove,- i-,-t .9� Mni�nvm Diarh.. 18I o� t° of + \ e D /s'7RI.BtI7,/ON ` � .° 4 Q to l �orcecl Cor�cre`ffe " SEPTIC TANK -� - 'szx. 1 s Prec�.sf Rein-rvrced Carlo-eke LE pcH/n/(:; P/ 7" PLRN VIEW 0F• SYST'En17 (NOT 7"o SCHGt S lSTEIVI DESIGN E✓ SENHOWER +EL. 97,G DRIVE +EL, 97.2 +trt-. E S TJ A-1`147-EU FL OW 300 GALLONS $ENCNMARK SP`'"OLj_Z CIF NYDRAAJ7" SEPTIC 7`/4NK REQc_l/ICED 45'0 GALLONS Et.EYAT'/aN = 100.00 A55qmEr> SEPTIC TgNK PROvIC)EID /DO O ' GAGL DNS L £ACNlNG ARFA 14E©(!/KEl.� 300 SO. FT LEAc'f//NG AREA PRoV/oEv 376 SO. � T. 4FFE c T/vE ,D/A MET'F,4 E FF£G'r/vE L7EY7-N 7� p PZ_ 0 % FL AN PROPOSED -SEWAGE OISPo SAL s Ys TEM FOR PROPOSED S/m6t E *FAAWL Y VWX-L(IN(; 5CALE : 1 20 01v LoT 34 E ! S.ENNawER DRhvE Cora/T 'WASS. JUES . : VAFIADEs Scale / = 20 ri'/ 30, • -1 9 80 £, �. ,� >� ie.+ 1 ,x 2s30i STERE ��`4 O WIVE R pAL R V Engineering Associates A Ot• C'f�f1RLES �' 256 Worcester ster lane Waltham MA. 02154