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Home My WebLink About0407 MARINER CIRCLE I i r _ ®..... BUILDING DEPT. Application number ._`. JUL 3 0.2020 Fee............ ....`..... BAMSMOM Building Inspectors Initials................. oe3 TOWN OF BARNSTABLE DateIssued ....::........................................................ Map/Parcel..........4�: ..l....:..O:.M..................... SC NE - . . - 0 TOWN OF,BARNSTABLE EXPEDITED PFAMT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION 'Address of Project: c �- NUMBER STREET VILLAGE Owner's Name: 6--`_fA4 , Phone Number Email Address: ea jac4j,1 A i S Cell Phone Number. C Project cost ${ '3 c2� Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make applicati �n for a building permit in accordance with 780 CM R Owner Si ature(,, iwL . -Date: + 2v/ 46 2-y `TYPE OF WORK': . Siding Windows(no header change)# 0 Insulation/Weatherization - 0 Doors(no header change)# Commercial Doors require an inspector's review ED Roof(not applying more than 1 layer of shingles) Construction Debris will be going to 'T,,,,,, CONTRACTOR'S INFORMATION - Contractor's name Leo,zcr„t �L Home Improvement Contractors Registration(if applicable)# �%`jq3% ° -(a copy) Construction Supervisor's License# 113 toe (attach copy) Email of Contractor leo �G 3 ham;Cry Phone numbe $ ALL PROPERTIES THAT HAVESTRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN JJ 1CT 01C nICTRICT V/11I AAI ICT nRTAIAI NICTnOir ADDDnVAI RrMDC A DCDAAiT rAAI DC ICC►ICn 11 APPLICATION NUMBER............................................................ *For Tents;Only,* Date Tent(s)will be erected' Removed on _ number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X1 A low, _ X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location (s)ofeach tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events_ may require Fire Department approval *WOOD/COAL/PELLET STOVES * , Manufacturer# Model/I.D: Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's.Name: ` Telephone Number f Cell or Work'number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand _the eonstructi if inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. , Signature " Date f - APPLICANT'S�SIGNATURE Signature t�� Date 7-z2oJzo?—o All permit applications are subject to a building official's approval prior to issuance. o - The Coriemonwealth'of Ma s'acli`usetts A Department of Industrial Accidents 13� Office of Investigations xr (Xs:, 100'Washington Street Boston,MA 02111 5 , ., W11►W mass gov�dla ,t,.-:t Yfr M72ti # t..;* i a -. r,< s rt ..- Workers' Compensation Insurance�AtTdavit Builders/Contractors/Electricians/Plumbers. (Applicant Information gk r Please,Print,Ugibly~ - Name(Busines`s/Organization/Indtvidual). L�.� . I ��leQn� e. f ., 'r Z._a�a .:1. ,.t Address: r" a` + ,s£..�•' r <t #' ar< e,i'. €., r,, :;p,rr., 'txr f 7 t% X;r 4>'s. q-t City%State/Zip .-S.,per)n.:s s'n A ,,v.2e�c�a. �Phone#: e S"a S. 3, -des , . .• ,;�«.. Are you an employer?Check the appropriate box; Type of project(required) I. I am a employerwith' ' xl A. Tam a general contractor and I , . :: all ., ,_, 6. New construction. employees(full and/or part-time).* ,'have hired the sub-contractors , - 2. '1 am a sole proprietor or partner- :listed on the attached sheet. 7. ., w_ Remodeling.~, 'e ship and have no employees These sub-contractors have g. Demolition ' .3'. f woiking forme in aci employees and have workers' . . . any 9 Buil ' addition [No workers comp insurance ,comp.msurance.t s Ie uuecl. ` x 5. t We are a corporation and its 40. :Electrical repairs or additions q .] . 3. 1 am a homeowner doing all work. officers have exercised their' 11`'f' plumbing repairs or additions self o workers'co right of exemption.pei'MGL' r myself. [N mP 12. #Roof repairs insurance required]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 sectionbelow showing there workers compensation policy uiformaiion: ., t Homeowners who submit this affidavit indicating they are doing all work and then hire oirt de'contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the naim of the-sub-contractors and state whether or.not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp:policy number. I am an eWloyer that is providing workers'co zpensation insurance for my employee& Below is the policy and job site information Insuranckompany Name: IM /v�tlfiir4-tL Policy#or Self-ins Lic.# JAICL P S`0'O S'aZ I Expiration Date: 31 1212oc;-�; 1" Job Site Address: 4io_ �rc .s, City/State/Zip: /u 4 M a- -07,4.S,7,, 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$1,5.00.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK QRDER'arid a fine of up to$250.00 a day against the violator.i 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 provided above is true and'correct- Signatiue: t+ Date: /Zo j z.o2.o• c. Phone#: eb 13 q-,Og 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:d6frown Clerk 4:Electrical Inspector 5.Plumbing Inspector 6.Other f' - Contact Person: Phone#: z. 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,imo any.contract_for,the performance of public.work untii.acceptabie evidence-of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants ,. . t Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)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 Town 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 permit/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 maybe 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 liusines`s'oi commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. A 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 Commonwealth of Massachusetts _ Department of Industrial Accidents Office of Investigations _ M 600 Washington Street, Boston,MA 02111 Tel. #617-727A900 ext 406 or 1-877-MASSAFE Revised 4-24-07 -Fax#617-727-7749_ www.mass.gov/dia lT7dIR+'1r offlcm Of Consurtx� Sy x HOME i]<IfP'RO'jM - LEONARD R RED -PA �. LEONARD R- 17 ASHIQNS OR T SOUTH DOOM Ui ; IL Commonwealth of Massachusetts Division of Professional Licensure 1 i Board of Building Regulations and Standards ConstP� v+sor 1r 3 , + CS-113102 ti' - � " 5aa,pires: 0212612022 X 4 J 1 r LEONARD R RENOAII !! 1 y 17 ASHKINS GgWE r SOUTH DENNIS;IVIA 0266 C,4 Commissioner Ile Town of Barnstable. *Permit# - / /0WI Expires 6 months from issue da e� b snnxszna> Regulatory. Services ® RE% MAS& Richard V.Scali,Director b�a�� APB 18 2017 . Building Division Tom Perry,CBO,Building Commissione TOWN �- � ��I Ii�� 200 Main Street,Hyannis,MA 02601 f! www.town.bamstable.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 Cry r) ? 6 Property Address V anA V1-'' sl',eclV &� A O(Residential Value of Work$ c./ 7K, � Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address gTerLdC/ �3 h1d WI/Y;// ! am Nd 03�76 Contractor's Name / f(��Q Telephone Number Home Improvement Contractor License#(if applicable)/6 0�6 D 0 Email: o6Q&ffi Construction Supervisor's License#(if applicable) v 7!4/ " AWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 1 have Worker's Compensation Insurance Insurance Company Name Xsw0,1zfj� vars fV�Gr�tcQ Workman's Comp.Policy# WC`s QV W Sw 9 TJ/ ;W I Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value e (J (maximum.32)#of windows/3 #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance ofthis 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 requir SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Intern iles\Content.Outlook\2PIOlDHR\EXPRESS.doc. Revised 040215 r The Col"mornvealth of Massachweft Department of IndusiWal Acclden Offlee of Investlgadons 600 Washington Street Bostonl,MA 11211 X wwwF lirttass<gov/dla Workers' COmPtnsation Insurance AMd&vtt. Builders/ContractorVE Amu'� act ric a aslFlunxbers i a Lgaty Name Mitre pywn 6 s .e jLPAddress: City/State/Zip: tt0.26ont~ Irequirett] n etraployer7 Check the ap J. propriate hot, F a employer with 4. [� I am a gentM contractor and I T�of project{rtgetlred}.oyees(bill and/or part-time).* have hired the sub-contractors 6. C3 Nevi constructiona sole proprietor or partner. listed on the attached sheet. 7: �pp�del�gnd have no employes Theses sta onoutors have n for me in Q Dem6litiong any eapacity. etrtpEayees and hays workers 4. I3ttiEt� additionorkers'camp. insurance comp.inmirstnce. � g 5. We are a c orpartlt%oq and its 10. lec I Cal repairs or additions 3.C1 I am a homeowner doing all work officers have exercised their ` myself. [Into workers'comp. tight of+'xecnptioa per MGL 1 l.�Pltatnbing repairs or additions insurance required.)t c. 152,§10).and we have no l 2,0 Roofrepeirs 3a.(� I am tt homeowner acting net a emplgyees.[No workers' I O other general ccmtreuctoar{refer to#4} comp.inaurat:ce ;Any appUc,tnt that CheckoboZ t!t also Bit Out the section below ehowiag their wmkess'co Homftwncrt who submit this affidavit indicating They ate doing all want aced dials hire od�� tC0nttncton that e:back this box tom attached sit 4"lio(W sheet � rOetreetm nnw subosit a taow Oftvit indicating such. employees, If the sub�aaetm trays showing the mm of the sn&c�a d state why or not those ftutfts have 'strtploY ,ZtaeY isnaat provide ttmn wetsten`camp.policy fir. l am an ereploysrr that is Providing workers'co t ln,formalyon. tltirr tRatrtrarrre jar nay a rspla' Be,&rw b.the polky and job We insurance Company Name: t Policy Al or Self ins..Lie. ; Expiration Cate: Job Site Address. Attterb s copy of the workersf compensation City/States ip: failure to secwn covers o as Pe potlay declarat#otr page{showing the policy number stied expiration date). g rewired under Section 25A of MOIL c. 152 can lead to the imposition of cr nc ex p ation d of a fine up to$1-500.00 and/or one-year irnprisorl amnk as well as civil penalties in the form of a"TUF Off tifn ORDER PeU and a Erne Of up to$250.00 a day ag ainst the violator. Be advised that a copy of this statement tray be forwar4ed to the Office of Investigatiotur of the C}lA for insurance coverage verification. f do heretly c d ptsRatlttsgr Ofp wJ teryry 1/rrrt `dire Inffloro tax pfovwd abanr is dt 4r maid 4wrat V ; t�,;�Glart we only. QD Rift tevr*sr lR tl�i arm to bt eorRpletttrl by cfly or towrlt offlclal E City or Towns Permalt/t.lceitt�e# Issuing Authority(clrele one). 1. 8 he of Health1t.Bu t�.Otherr "ding t?epartmt»t I Clty/'I'owen Clerk 4. Electrical Inspector S. Plum1hi Inspector � p or . Contact Person: Phone 1#, r - Client#:9742 2BAKERAS ACORD,. CERTIFICATE.OF LIABILITY INSURANCE DATE(ktM?DDIYYYY 4120/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE.A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORT+4N1':If'the certificate holder is an ADDITIONAL INSURED,the pelicy(les)must be endorsed.if SUBROGATION IS WAIVED,subject to the terms and conditions of;the policy,certain policies may require an.endorsement,A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Dowling&O'Neil Insurance Ag E%t:508 775-1620 ;aron N5087781218 973 iyannough Rd,PO Box 1990 Hyannis,MA 02601 508 775-1620 ' iN$iJRER$ AFFOROINCa COVERAGE E NAIc� INSURED _ -��,��'NsuReRA�National grange Nlutuai insurana j ...., ...�„ ......„,.a... Baker&Associates,inc. INSURER a,Associated Employers Insurance P O BOX 923 INSURER C: .._. INSURER 0 Centerville,MA Q2632.0071 � INSURER E s I € JNSURERF COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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, IN$R OO SUER; .. ,.....,..:�. ......,,..._ .._._„.,..�...„...„,,.p.. _ LTR GENERAL LIA PE OF INSURANCE POLICY NUMBER 0 EFF MMlDI0 EXP LIMITS M m _ q Blum ;MPJ7223MD4/19/201610411912017 EACH ticcuRRErE 1s1000000 X COMMERCIAL GENERAL LIABILITY 3£ Q Lad E R$NT$0 µ r a r E E t �urrenee $50Q AnA cLAIMy«MADE �X OCCUR ;MED;EXP(AntAnV a L M 10 000 j PERSONAL 8 ADy IN $1' 00 JURY 0 ,000 _.. i__...0 __._..._ ....__ GENERAL AGGREGATE µ �$2,004,0�i0. GEN'L AGGREGATE LIMIT APPLIES PER, PRODUCTS-COMPIOP AGG ?$2,000 000 i PRO- POLICY 1..... CeT AUTOMOBILE LIABILITY C01,08 tivsD$fNGL#0�Y ANY AUTO r - BODILY INJURY(Per person) $. 'ALL OWNED SOHEDULEO AIt10S AUTOS I I BODILY INJURY(Par accident)f$ AUTOS dOWNEO (= HIRED AUTOS 'Is AUTOS UMBREL{A:UAB .� OCCUR I EACH OCCURRENCE $ EXCESS LIAR i CLAIMS-MADE I AGGREGATE $ ___- DED. RETENTIONa 1 I WORKERS COMPENSATION $ B AND EMPLOYERS UAB(LttY WC STATU OTN W,CC5005002A542016A 4/2312016 041;t31201 .X. T RYLlI fT$.._....1ER— ANY PRP MEMBER EXCLUDED?RrETORrPARTNERIEXECUTIVE E,L EACH ACCIDENT $500 000 OFFICE N I A I(Mandatory in NH) N i a E.L.DISEASE=EA EMPLOYEE $500 000 !tf ea,describe under , . z____ .__. DESCRIPTION OF OPERATIONS below ;' E 1 DISEASE-POLICY LiM+Y 1$500 000 1'I i DESCRIPTION OF OPERATIONS 1 LOCATIONS t vEHICLES(Attach ACORO 101,Additional Remark Scho tile,Irmt>ro Space is required) Insurance coverage is limited to the terms,conditions,exciuslons,other limitations and endorsements; Nothing container! In the certificate:of insurance shall be deemed to have altered,waived,or extended the coverage provided by.the policy provisions. CERTIFICATE HOLDER i CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN i ACCORDANCE. WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE _ ; 01988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD .name and logo are registered marks of ACORD 0168706/M168705 CBD F . Massachusetts Department of Public Safety Board'of Building Regulations and'Standards License: CS-009714 ^ Construction Suaervistr .: RCHARQ P GARNEAU,JR t PO BOX 476 WEST BARNSTABI_E ix p ' \ �ZU7 CA- Ex iration Commissioner 04/04/2018 V, V Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home improvemen Contractor Registration Type:e Supplement Card 162600 pp BAKER & ASSOCIATES INC. J" REipiration: 03125/2019 P.O. Box 923 Centerville, MA 02632 Update Address and return card. Mark reason for change. t �gaa ,f " Off Ice of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE Supplement Card before the expiration date. If found return to: i ' RWistrjtion Expiration Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite5170 03r'25,2919 Boston,MA 02116 BAKER&ASSOCIATES WC r RICHARD GARNEAU; 521 Shootffying Htil Rd' � Cr Centerville, MA 02632-: Undersecretary Not valid without Signature BAKER BAKER &ASSOCIATES,INC. &ASSOCIATES,INC. CUSTOM LIVING AWNINGS AND DESIGNBIMINI nN:zumrmn,rnkt:swnwi: PC). Box 92.3 Centerville, MA 02632.Phone 508.362 2445 Fax 508.362.6115 Authorization Form: I G2 -i' Ob' 1�ei d/ , as owner of the subject property, hereby authorize Baker& Associates to act on my behalf, in all matters relative to work authorized by this building permit application for : Address of property: \kSignature of owner Print Name: 7 Date.: � _ Gj y. ` Assessor's map and lot number ......... ...........:. ' P�Of TN E i) ? � Sewage. Permit number ..........,�:�....................................... d� �� 89H33TABLE, i House number ..f.'..... ?::..................................................... 9�O f/ M6 9a\e�0 D MAY TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................ t t ti t^ ........... .`:.? ?. .��.............................. TYPE OF CONSTRUCTION ....... : � 'C:�:........ 't L :..c ZRk I k: U c� ............. � 11...............19�� . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... 1. /. ..... ................. .. ..... ... ProposedUse ......... .(., Pik...... / ................................................................. ................. ..............I......................... Zoning District ................. ..........:......................................Fire District t / Name of Owner/ /...!.. ... .... .....:...!:........ .+:Address ............... .....1 ,� .............. Name of Builder ......`:L.a)/...........f(i......4 f�/ l/.. .....Address .................................................................................... Nameof Architect ..................................................................Address ................................................................................... J Number of Rooms .........................(•2...............�........................Foundation ..... 11: :....... �1f' (?` �.......................... 14- Exterior ... t. ...Roofing r ................... ................... �. �(/ .( Lac` ! i Floors Interior `� .................................................... /1 //4/ ' Heating ..........................................Plumbing ....................:.............................................................. Fireplace ........................ .......................................................Approximate Cost .......:.:: ...00 �...+............. ct ................. Definitive Plan Approved b Planning Board � Tj pP Y 9 --- - ----19 rI -. Area /� f.. Diagram of Lot and Building with Dimensions Fee ..... _ ~- ...�� SUBJECT TO APPROVAL OF BOARD OF HEALTH i• I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. /. � P Name.;-7 ....-r.%r' .... ! P� � �... �/� ✓ CEDAR ACRES REALTY TRUST z _ 24253 " ¢ One Story No ................. Permit for .................................... Sin g:1 Family Dwelling ............. .............................................. Lot #12, 407 Mariner Circle Location ................................................................ Cotuit ............................................................................... Owner .......Cedar..Azres...Rea.1:ty...Trust Type of Construction X aAMP............................ , ................................................................................ Plot ............................ Lot ................................ July 30, Permit Granted 19 8 2 ........................................ Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ..,,�........ �/ ✓ . ............................. ............ ..................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... 4S p �y°J Assessor's map and lot number .7.... ..s./....��...........� , Sewage Permit number ........odas.7,f......................... SEP17C SYS'PEM AR '-- LIST BE Z BAHHSTADLE. i House number .. �� '! ....:.........:....................... ........"...... IIVSTigLLED IN ��COMPL NC 90 " a WITH TITLE 5 0 MAY E o tb 9 Ely �E a` TOWN OF B AR l ' s e � E AND J: BUILDING INSPECTOR J (Ak _ �� < APPLICATION 'FOR PERMIT TO ........................5..1............................... ....� ? ......... .............................. TYPE OF CONSTRUCTION ....... ...........................�� ................................R..�`...�....... ............... ....cm............... 19. . TO THE INSPECTOR OF BUILDINGS: The undersign d hereby applies for a permit according to the fall wing inform ion• Loca ion ..� .... .. Q....../V L/.. �' ... ....... Proposed Use ... r C/.1.�. M . ......................: ................. ................. ........................................ ,,.... /o Zoning District ��........'.....:::................ ............Fir District ..........L.67 �. . .............................................. C Name of Owner(. !.... �..1....... .. .,.. .�rAddress .................,1� a..... ' :�............. Name of Builder. /�U.... C� Q . .�.5.....Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....................v.............. ..........................Foundation .... ......... u� �......................... ... ad e0 Exterior v �� ..........Roofing ....... .............. Floors .k � '� �% ....................Interior ...._.. .. Heating1. ./.1.:..%!(..•..../..�...... :. . ................::...:::.`Plumbing ................ ..................................................... V Fireplace .......Approximate Cost �� ...................... ..................... .. .�.. .... . ................... ... Definitive Plan Approved by Planning Board _____ _1L/_ __�3____19 f- Area Diagram of Lot and Building with Dimension Fee ........... ..................... ! � SUBJECT TO APPROVAL OF BOARD OF HEALTH /j A. I hereby agree to conform to all the Rules and Regulations of the To�a of Barnstable re ing the abov,e construction. Name .. ... ... . ......... .. ......... ................................. , ^ ' . ` . . . . ~ ~~ ~ - / ' --- 24253 , One Story Lot #12, 407 Mariner Circle Cotuit � . . . , - � . � - ^/ . ' - - ' - ' ' , ' - - ' ' . . . ~ ' ' ' . . Sly a. o. asa-o 10 0 3 —a 7 i8 = .� 4 -30 , •9.2;�v E,2 c W � �o 0 j.. PLAN.,..-SHOWING w5 p FOUNDATION LOCATION P�W - ghz �- --G OMIT "SS, CHUSE TT S---- �W� o w .So vA.E' oy7'f� 0 o ow SCALE:- ..54 " DATE �j-v�v<S /�-,�9�'�-, a� ?wz NORMAN GROSSMAN- ----,REGISTERED LAND SURVEYOR �� till m W J z z a LL w a0 I HEREBY CERTIFY THAT THIS .FOUNDATION IS LOCATED- � of A,,,� ON VHE .LOT AS SHOWN AND CONFORMS TO THE. TOWNNORMAN OF BARNSTABLE ZONING- REGULATIONS REGARDING GRossr�AOSSMA, a � . SETBACKS FROM STREET LINES:AND, LOT LINES .. �[ ,P No'I2775�0 �. ftORMAN GROSSMAN R.L.S. DAT€ r 24253 • 'TOWN OF BARNSTABLE permit No. --`------------ - g biaesrm Bwldw ,':Inspector'` Cash ` ' •.. OCCUPANCY PERMIT Bond Issued to Cedar Acre6, Realty , �-TrusA'ddress. - k` Lot l2. 4 U Mariner cifrcle', Cotuit t Wiring Inspector s , /'� R'a� r`'Inspection Gate Plumbing Inspector f *. Inspection date Gras Inspector Inspection date Engineering Departmentz" f r Inspection date a �l Board of Health e ,• ° lft 2 If �` (9 In pection date~. 1, .f � THIS PERMIT-, ILL:NOT E VALID, AND THE BUILDING:SHALL NOT BE OCCUPIED UNTIL . SIGNED- BY THE-BUILDING: INSPECTOR. UPON SATISFACTORY; COMPLIANCE WITH TOWN REQUIREME] AND.IN. ACCORDANCE, WITH,SECTION 119.O.OF THE MASSACHUSETTS:STATE BUILDING CODE. . �9.. - . ............... �: !f Building tinspector 5