HomeMy WebLinkAbout4351 FALMOUTH ROAD/RTE 28 � _.
i�
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel - `: Application #4
Health Division Date Issued
Conservation Division Application5pe -'
Planning Dept. Permit Fee r
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation/ Hyannis
Project Street Address 4351 ��►-.�� 'Zo0.�1
Villaget-
Owner 4�+kz K-C (�Lu4.*q Address �•�. 1�7c ►'13i �r
Telephone (5oro)
Permit Request V�lae.'M -�Sh�.� C6Qk,.
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 1006, 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 I a Historic House: ❑Yes Ud"No On Old King's Highway: ❑Yes ❑ No
Basement Type: dFull ❑ Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing I new Half: existing I new ,
Number of Bedrooms: 3 existing _new
Total Room Count (not including baths): existing 6 new First Floor Room Count b
Heat Type and Fuel: 5(Gas ❑Oil ❑ Electric ❑ Other
Central Air: ❑Yes E(No Fireplaces: Existing l New Existing wood/coal stove Tb Y4s:"dNo
Detached garage: ❑existing 0 new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing D newsize_,
Attached garage: Coexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: E0 ` T�
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 7-
Commercial ❑Yes ❑ No If yes, site plan review# 01
Current Use Proposed Use
APPLICANT INFORMATION _ -- --_
(BUILDER OR HOMEOWNER) 14)- S(,Al _ 515 31 i(CeA l
Name .Ka-�G�e.►-,,,,L A • ooww-, Telephone Number 650tQ - 426- 3 I
Address 4351 License#
-y B ►�3�-- Home Improvement Contractor#
NAA 02,63S Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
�3t �.�-►ems�ln L�d� , �1
SIGNATURE l� - t�e�cw DATE .�pv�� y3va, 20ot
FOR OFFICIAL USE ONLY
a
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
' OWNER
:R
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
t
FIREPLACE
ELECTRICAL: ROUGH FINAL -
i PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
ri
FINAL BUILDING
r
DATE CLOSED OUT
ASSOCIATION PLAN NO.
5 -
F
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.govldia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): ���-Qn.l-✓►✓�- (ac.
Address: 435 l t wt C,,.� t'13 z
City/State/Zip: 4 IUt1
•.u,� A 6263 5 Phone.#: o5)
Are you an employer?Check the appropriate bog: Type of project(required):
L❑ 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.❑ 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 _
working for me in any capacity employees and have workers' 9 Building addition
[No workers' comp.-insurance comp•insurance.#
equired.] 5. We are a corporation and its 10.❑Electrical repairs or additions
3.a(,am a homeowner doing all work officers have exercised their 11.1 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12:❑Roof repairs
§insurance regtired.]t c. 152, 1(4),and we have no 13.❑Other
employees. [No workers'
comp.insurance required.]
'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are:doing all work and then hire outside contractors must submit a new affidavit indicating such.-
xContractws that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: .
Policy#or Self-ins.Lic.M 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 WA for insurance coverage verification. -
I do hereby certify under the pains-andpenalties of perjury that the information provided above is true and correct
' Sienature a �•��-t,: 1� ��stn Date: ���1 �3vrl 2eo _
Phone# '
Official use only.-Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
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 because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced-acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall
enter into any contract fok the performance of public work until acceptable evidence of compliance with the insurance
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 Department at the number listed below. Self-insured companies should enter their
.self-insurance license number on the appropriate line.
City or Towu Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permittlicense 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. A new 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:
The C6mmonwealth of Massachuseas
Deparkment of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel. #617-727-4900 ext 406 or 1-977-MASSAFE
Fax# 617-727-7749
Revised 11-22-06
www.mass.gov/dia
Town of Barnstable
THE Tp��
y� o� Regulatory Services
` Thomas F.Geiler,Director
BAaxs°rwBLE. �.
MASS.
'Building Division
�1f0 FM'1 A
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.b arnstabl e.ma.us
Office: 508-862-4038 .. Fax:. 508-790-6230
' HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: ?zjts: ,
JOB LOCATION: 35t . ✓ Kpg,A ( ,t
number street village
HOMEOWNER': 4rF1'1CJ✓I k*.
name home phone# work phone#
CURRENT MAILING ADDRESS: .�7ufG' 11�Z
62,635 _
city/town state zip code
The current exemption for"homeowners"was exiended 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.
r ' 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
requirements. i
Signature of Homeowner
Approval of Building Official y -
p' Note Three-family dwellings containing 35,000 cubic feet or larger will be required to complywith the
State Building Code Section 1.27.0 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 persons)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.
i
oF1HEI Town of Barnstable
Regulatory Services-
" HAS& x Thomas F.Geiler,Director
ArFo �A 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
mplete and Sign This S tion
If Using A Builde
as Owner of the.subject property
hereby authorize to act on my behalf,
II in all matters relative to work autho ' ed by t 's building permit application for:
(Address of Job)
Signature of Owner Date
Print Name
If Property YOwner is applying for permit please complete the Homeowers Licens
e
Exemption Form on the reverse side.
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TOWN OF BARNSTABLE Permit No. .,27385
BUILDING DEPARTMENT
""'T TOWN OFFICE BUILDING Cash
7 ■Yl•D'�oy�Y X
u HYANNIS.MASS.02601 Bond ................
CERTIFICATE OF USE AND OCCUPANCY
Issued to Cedar Acres Realty Trust
Address Lot #8, 4351 Ea lmouth Road
Cotuit, Massachusetts
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED. UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
February 23, 19 90
....................... .
Buildi g Inspector
BUILDING PERMIT NO -7 3 DATZ T—,- -_�-73
ASSESSORS PARCEL NO.
CONTINUATION OF ROAD BOND
The undersigned owner/contractor hereby agree to maintain their road bond in .
force until the following work items are completed to the satisfaction of the
Engineering Section of the Department of Public works:
' l/ loam and seed shoulders as soon as
weather permits:
v other (explain)
.J �--�--
LOCATION: 7/..
SIGNED FER/CONTRACTOR) (print name )
a
f
El-Nr AUTHORIZATION
I
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
I M A�C(, I
DATA
P. 7rlwwm
WWI
COPY,/WHITE„'FIELD.COPY/YELLOW-APPLICANT Copy,
OPY O
R
VUILDING,,,
�OF BARNSTABLE, MASSACHUSETTS PERMIT .
. A�24-6
6
,�
.) VA LID ATION
January 3 85 i f e3�
J� @YO Theoharidi3 DATE .19, ER IT 0
P �ou armouth 1 L 016681
APPLICANT ADDRESS
y - (NO.) - -- (STREET) (CON2R S LICENSE)
Build dwelling 1 Single family dwelling NUMBER of 1
PERMIT TO (_) STORY DWELLING UNITS
• (TYPE.OF IMPROVEMENT) :NO. (PROPOSED USE).
i 710 a mout oa s Gotll t ZONING. RF.
AT (LOCATION) 'DISTRICT
.(NO.) (STREET)
BETWEEN AND
' - - (CROSS STREET) ,'(CROSS STREET). -
' SUBDIVISION. - LOT' BLOCK-.SIZE -
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN,CONSTRUCTION'
TO TYPE USE GROUP BASEMENT WALLS.OR.FOUNDATION.
I REMARKS SOWS�e3
k 1
BOND
AREA`oRf, 1596'3C1. ft. 33,0.00 71.75.:
PER
OLU E ,
ESTIMATED.COST. F
- EE "
..
,(CUBIC/SQUARE FEET1._. .. . ' •. :... - . ,; r -I -..
OWNER' ` Cedar Acres Realty Trust
011t armout y BUILDING DEPTr
e:• BY )
. .:THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR
PERMANENTLY.. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE"AP-
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
-FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS'
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
k:. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE:"_';`
! INSPECTIONS REQUIRED FOR
ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED..'FOR>t{ F ELECTRICAL, PLUMBING_.:AND!:-':.'•;;,,
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS
2..PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTILMEMB g.
b FINAL INSPECTION
TI TO LATHE FINAL INSPECTION HAS BEEN MACE.
I 3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS,
&M
2 2 ,,�[ i.oG a 2
�� � �� �
4V:*/
3 _ HEATING INSPECTING APPROVALS REFRIGERATION INSPECTION'APPROVALS- " .
f
O''HER 2 l TCbN I.c,&rb 2
WORK SnALL NCT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD
INSPECTOR 4AS APPROVED 714E VARIC 1S WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE t
STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION,
,rih EBY"R710Y Ti Wr
. .46 !�N,4V,.T,M�`FEAE/�Afd• F44QoF� �E RATE FOR rmc
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GiircuMsr.�NCES A4�' OFFS�T.S TO B�' 1
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No.21583 Q0 I ,(�Dv /8 j �o A1�MM�Y/AV Y. C EP �f P,PR 1 , + R e1N AO
c'}i.na:rl/C -..w.::.?n... ... ..�..+ AY.i,..�: - ...ILY�....�'1. 8. .'t41S�iS.6..1.+...�a.l. ...�.Ltia.u,..:. •'�..�:-:....
Assessor's'map and lot number .. Y.......................... y�F THE
Sewage Permit number'... ......... ...................�277..�4.J7
House number .....:.:...........3....'�.�.................. ............. t 1 .3�T Sr 9 Baaa9 E.
.TABL
1639.
,. ,y g
1ST
TOWN OF BARNS `,AJULE;
TOWhl
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ............. . ..1/... ......:.............................................................:..
TYPE OF,CONSTRUCTION � .i+..f..A......�!AA ...... .............
............... . �y�,, .....19�/
TO'''THE INSPECTOR"OF BUILDINGS: Al
The undersigned hereby applies for a permit according to the following information:
Location .....4 .......9... k./.An. �P......... .0.1..1.�.r6�.��.......(..�Q....�.�.J.}.T..............
ProposedUse .......... .: !.. /,.1 .Ln....:....................................................................................................................
L4
ZoningDistrict ...............................Fire District ......a..................................................................
Name of Owner ....CE-19. ..../���.�� �..6A11yAddress ..............�....Y14. :.i? ...........
Name of Builder ....:, q.e_-2L1'... l'1.�.'G2 l dress .............-d../••, kn.a. re..................
Nameof Architect .............................::...................................Address ....................................................................................
Number of Rooms ..... •f��.J��.....KAf.,O.I.IV...Foundation ....... c........................
-' T........ 1. ..�.G ..
Exterior .....�,A/.:.J�:.L..��.....Y..C;r..�--�.�':.�....�./..NLt'.��..�oofing ....�:. . ..�.�L .fir.
Floors .................CA ...PL�:./.f.:...........:..................Interior .........�..�...'�/...�tt�i�J<l .G.1............................
Heating: �.......Plumbing,..........'.. ... 7� .........................
Fireplace .. .. .........................................Approximate. Cost ...........3..3.E .....................
Definitive Plan Approved by Planning Board --------------------------------19--------. Area ............: :6
Diagram of Lot and Building with Dimensions Fee .... /`�� qq?�..........:
SUBJECT TO APPROVAL OF BOARD OF HEALTH
AAA6 HO U.16
�5
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 ... .. . ....... .. ...
Construction Supervisor's License
.r`
CEDAR ACRES REALTY TRUST
27385•••. Permit for Qne..Story.. ............... _
�' ? Single Fam .1y..I?Wn.J ling.......................:
Location Wt...$.. 4351. .F.almuth. .-�' ,> _. _�_<._ _,w-•«4
......... _ CQitlkhi~................
�ci, Owner .Qd4)? .ACre.5..Feal.ty...Tj Lmt...........
Type 7of Construction
...... "..'....................................................................
Plot ....................... Lot .............................
i Jan r r..• ,~ r � ,
�s Permit,,Granted ........................................1985
Date ofe Inspection ............. ..:719
Date Completed � ��C ......19 f
dz
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Assessor's map and lot number . ..............`.... .�........ ........., THE
tOf`
Sewage Permit number !K,� �� ��Q R ♦�
l�P Z SAUSTADLE. i
House number ............. " ..' .....................:......,......::...... �= r rasa
i �p 039. `00�
0 MOX a'
t = TOWN OF BARNSTABLE
E Ci
BUILDING ..INSPECTOR_
APPLICATION FOR PERMIT TO
? 1
TYPE OF CONSTRUCTION �� 1 D G ,l`9's,� ,,,.,(,;,,, �, \� � ' N............
............... V..........
TO THE INSPECTOR OF BUILDINGS:
The.undersigned hereby applies for a permit according to the following information:
Location .....y �Q. ...... ..... Akh)...C?..,�I- AA........ E.1. ........ ..............
ProposedUse .......... ..t�A 1.���c... A.L ................................................ ........... .... ....
ZoningDistrict .................... �. ....................................Fire District ......1.. ...............................`...................................
Name of Owner ..`.r. .f/. .... �. ... G �T Address ............ �•, ye../ J/?,f/.. ...........
Name of Builder ... . ' ./Address ............ �.�. .T. .................
0
` Name of Architect ..................................................................Address .........................................................:..................:.......
:C .. 1 ��.....K�3, J 1�/ ,Foundation ...... .0 /l� -Ai T T
Number of Rooms ............... .................,,,........•.............................................
........... �.. ..fin........,.. p
Exierior .....�n'.j4*..1..��. .?....Cl�l�la 1� .,l.. /. .L ._Roofing .... n... ..P ... 1✓1��./T+��..-..'..��./�%/..Floors % ............................... Interior .........
.:.........
..... .
Heating .. ...a�l./.. � . F ....�'�.. .. . .� .. .......Plumbing ............. ......................... 1
Fireplace` ....................... .. .. ........................................Approximate. Cost ......... •� ..e9../,,P,D W....... ...........
/ ( i
Definitive Plan Approved by Planning Board ________________________________19________. Area `.,...;:.............'...............,......
Diagram of Lot and'Building with Dimensions Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
s" .
D'
I
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`......!:.b ;.r. .......
Construction Supervisor's License ...
CI
CEDAR ACRES REALTY TRUST A-24-66
No ...27,85... Permit for ....One..Stosy.............
Sing • i,7 y..Duel ling.:...................
Location .....Lot„$,j,,,,,4351„Falmouth Road
................... ..tl=................................................
Owner ...... ?r,P,cres..R�altY...? St........
Type of Construction .Fr,5M..............................
................................................................................
Plot ............................ Lot ................................
i
Permit Granted .......JanuarX 3 19 85
....!.........
Date of Inspection ....................................19
Date Completed ......................................19
12
PER 0 D 1/1/ Q
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