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0633 MARINER CIRCLE
1 �U� `fir? cv�;� C'i� c� . . � , ., , i �, ., a .� � Ali ^A. oK (1y1��a4 Town of Barnstable *Permit# Expires 6 months from issue date yT Regulatory Services Fee `?S-:RAWMAIRA — i s MASS,16,19. Richard V.Sca6,Director Building Division IT Tom Perry,CBO,Building Commissioner JUN 02 2015 206 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us TOWN OF BA R N STA B L E Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number �D Z_303C Property Address�,33 lu R-R-I/juL �t�2 Residential Value of Work$ ';'ti_�0C9•Vl Minimum fee of$35.00 for work under$'6000.00 Owner's Name&Address 01 CA0 Cits X �c,�,t ctx(S Contractor's Name b 1A l [4-�V&IwvI uA Telephone Number p Home Improvement Contractor License#(if applicable) I101 91 Email: 00 CC) yA4.t00, Co we Construction Supervisor's License#(if applicable) to26to a EWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 21'1 have Worker's Compensation Insurance Insurance Y Name �� � Company S P Workman's Comp. Policy# 2 2GSt g y Copy of Insurance Compliance Certificate must accompany each permit. Permit Req (check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to PST-ejL ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side . . - ❑ Replacement Windows/doors/sliders.U-Value . (maximum.32)#of windows - #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S:and--inspections required.. . Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. ' SIGNATURE: QAWPFILESTORMS\building permit formlXPRESS.doc Revised 040215 ?'he Commomweafli ofMassaclrusetts wit o,f Industrid Accidents tO)rke ofluveshgadons 600 Waslringtomi greet. � y Boston,MA 02111 wr mwassgov/dia Yorkers' Compenssahan Insurance Affidavit:B ers/C.nntmckws/Elect6danslPlambers Applkaut Information Please Print Lemb y Name I,: At.&Iukzir,��� ��- L -� �A&Iress: G2 01h�s6VJ city/sta&Z p: U-`<*e"Ovor, L02 o Phonea, AFl an employer?C ieck the appropriate boa: T of project, 1. m a with 4. ❑ I am a general contractor and I Type �= constuction employees�andlor F�s have hired the sub-contractors 6. ❑New 2.❑ I am a sole proprietor or partner- listed on the attached sheet. T- ❑ Ramodeling ship and have no employees These sub-,contractors h2we 8. ❑Demolition wcddng fin me in any capacity. employees and have wvarkers' 9. El Building addition [No workers'pomp.insurance comp.insura Y d-] 5. ❑ We are a cmporaticm and its 10.❑Electrical repairs or additions 3.❑ I am a her doing all wodc officers have exercised theff I LE J Plumbing repairs or additions myself[No workers'comp. fight of exemption per MGL 12.❑Roof repairs insurance require&]T c-152, §1(4),and we have no employees [No workers' 13.0 Other camp.insurance rupired.j •Any applicsttt Beat checks box#1 mast also fill mat the section below showing aw wtakexe coropmmmm palky WfamudoiL , Hoo>eoamers who submit this of ul-t uArafing they are doimg 0 work and then hire oatode to=actms amst submit a new affidavit Mica- studs_ ZCoaltacttus that check this boa must attached w additiooai sheet showiQmg the name of the�and state whether cw zM dose w hies base eoaptoyees. If the sub-coattaam have employees,&ey muatp wd&thav wmtms'comp.pabry number. lam an employer that is proiiding naorkers'compensation iinwance for my employees. Below is the policy and job site infot�rtatiorr. . Ins*rmcp C�mpany Name: Ai hktmw ) Policy#or Self ins.Lic.#: Q`� G 1 g�� I Expiration Date: 12 Y 00 Job Site Address: G Gityistawzip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under sectien 25A of MGL a 152 can lead to the imposition of csiminal penalties of a fine up to$1,500.00 andfor one-year imprisonned,as well as civil penalties in the forte of a STOP WORT ORDER and a fine of up to$250.00 a day against the violator. Be advised that a cagy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance co-v age verification. I do hereby as fy raider the pains and penalties ofpeditty that Ae inforination provided above is true and correct e' -AJUtDate: Phone#: Official use only. Do not write in this area,to be completed by city or town ofciat City or Town: Permit/License it Issuing Authority(circle one): 1.Board of Health 3.Building Department 3.City1rown Clerk L Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone 9: -- 6 0 ,4co rca CERTIFICATE OF LIABILITY INSURANCE O1DATE /06/1/06/M/DDlYYYY) 2015 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 NAME: HUB INTI NEW ENGLAND LLC PHONE Fnu 4 West Mill Street a/c "° Ext: A/C NO: P.O. Box 250 ADDRESS: Medfield, MA 02052 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: INSURED Roofing &Siding Of Cape Cod LLC INSURERB: AmGUARD Insurance Company 42390 j INSURER C 68 Winslow Gray Road INSURERD: West Yarmouth, MA 02673 INSURERE: INSURER F 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 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. "SR ADDLSUBR POLICY'eFF POLICYEXP LTR TYPE OF INSURANCE POLICY'NUMBER M0L c@ly MM/DDIY LIMITS ' GENERAL LIABILITY EACH OCCURRENCE $ 0 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED -- PREMISES Ea occurrence _ $ 0 CLAIMS-MADE F OCCUR %1, MED EXP(Any one person) $ 0 PERSONAL&ADV INJURY _ .$ 0 GENERAL'AGGREGATE $ 0 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 0 PRO- $ POLICY LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION - WC STATU- OTH AND EMPLOYERS'LIABILITY Y/N X TORY LIMITS ER ANY B OFFICERIME BEREXCLUD DF7(ECUTIVE� N/A R2WC519541 . ;12/20/2014 12/2012015. E.LEACHACCIDENT $ 100,000 Mandatory in NH) If yes,describe under E.L DISEASE-EAEMPLOYE $ 100,000 - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT '$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) M Exclusions: Dimitri Labkozich; CERTIFICATE HOLDER CANCELLATION. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of Harwich THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 732 Main Street Harwich, MA 02645 AUTHORIZED REPRESENTATIVE lk ©1988-2010 ACORD CORPORATION, All fights reserved. . ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD ' 1 ` P R®0fing and Siding BBB of Cape Cod,LLC 68 Winslow Gray Rd West Yarmouth, MA 02673 508-360-2749 e-mail:. rsocc@yahoo.com HIC REG 4170787; LIC#102600 Job Address: 633 Mariner Cir Name: Nickolitsa Angelakis Town: Cotuit,MA Address: 28 Jason St Job Phone: 781-646-7473 City: Arlington Other Phone: State: MA E-mail: ZIP: 02476 Estimator: Dmitry Labkovich 03/14/15 We hereby submit specifications and estimates to furnish and install new roofing as follows: 1. Strip existing roofing and remove debris. Calculated(I layer).Anymore layers of roofing needed to be stripped will be additional. 2. All gutters will be cleaned out, grounds cleaned up and nails extracted with magnets. We utilize magnets so as to minimize your exposure to personal injure and/or property damage from nails left behind at the job site. 3. After removal of roof, wood deck will be inspected for splitting, rot or other deterioration. Owner will be advised of need for wood replacement prior to commencement of wood replacement work. 4. Along all eaves of house. Ice & Water Shield waterproofing underlayment (36 " wide) will be directly adhered to the wood deck. Waterproofing underlayment is installed to eaves to protect against interior leakage and subsequent damage from wind-driven rain; ice and snow dams, and freeze back conditions. 5. Install waterproofing underlayment in full width(36 wide)to all valleys and 6"to all rake edges. Install waterproofing underlayment at all vent pipe collars and any other projections and skylights. Underlayment adds additional protection against leakage at critical terminations. Over remainder of house. 15-lb. felt paper wi11;be';installed and nailed to the wood deck. Accepted by date THIS PAGE IS'PART OF AND IN CONFORMANCE WITH PROPOSAL No 5 Acceptance of Estimate The above prices, specifications and conditions are satisfactory and are hereby accepted. ROOFING AND SIDING OF CAPE COD, LLC is authorized to do the work as specified. Payment will be made as such: 1/3 Deposit1�1 1/3 Beginning of work 1/3 upon completion Lk Date: S Signatures: Note: No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract. You, the buyer may cancel this transaction at any time prior to midnight of the third business day after the day of this transaction. , Accepted by date THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL No - , yC/ uc�uaetr jr-- e' arrvrnaracaea 7 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only P0ME IMPROVEMENT CONTRACTOR ;, before the expiration date. If found return to: egistration: 170787 .Type: Office e of Consumer Affairs and Business Regulation xpiration:--°12f1 ko15 . LLC. 10 Park Plaza-Suite 5170: — Boston;MA 02116 . ROOFING AND SIDING OFCAPECOD,LLC. . -� DZMITRY LAB KOVICH T` 68 WINSLOW GRAY RD:: g a c W.YARMOUTH;MA 02673 Undersecretary Not valid withou si attire use•group ah ch Unrestricted- Buildings of any 991m)of." contain less than 35,000 cubic feet enclosed space. Failure to possess a N went edition of the Mauachusetts State Building bode is cause for revocaL1On of this license.. s S . Mass Gov/DP$ For DPS Licensing information visit: W'�^N a Massachusetts rtrnent of Public Safety s,and Standards ` -- DeP Board of Building, egulationr supe i5vi .. CS-1 Licenser 02C �oF D�TR... 68 winslo �a ouh 1VIA • WestYsT� tv ,yy . EXpiration I , rf TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION / Map �� Parcel Permit# Health Division a 0 -5 r' `` '1*Date Issued JtfiC"j` Conservation Division U 2Z (?`� 4,) 10 Application Fee jj . / lJ[J• " 37`�` °o Tax Collector ---.�..,.,� � Permit Fee In Treasurer V ``4 # j. • ---_FISTING SEPTIC SYSTEM Planning Dept. LIMITED TO - - #OF BEDROOMS i11,1Date Definitive Plan Approved by Planning Board Nad�dS �,^ 0i�"n (given CPf UI c. _�Z foCrn�7un`�yt best. Historic-OKH Preservation/Hyannis Project Street Address) I 03 Village ►�'T� C" Owner A" �i L Ls eld w-s 1 ,a o) oV4 S Address 12 TA S 0 S t � P, Telephone 7 0 d 1 3 Permit Request )V S g Bn S I, It,) Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total news Zoning District Flood Plain Groundwater Overlay IPA Project Valuation , ddO,()U 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 Ig l4j,%4S Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl 4 Walkout ❑Other Basement Finished Area(sq.ft.) 1 a 0b:S p: = Basement Unfinished Area(sq.ft) ISO S (' Number of Baths: Full: existing new Half: existing I new Number of Bedrooms: existing 'S new Total Room Count(not including baths): existing ''� new First Floor Room Count Heat Type and Fuel: , Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes WNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new- size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 6b4 CSC SIGNATURE r" DATE Y FOR OFFICIAL USE ONLY f � + f `PERMIT NO. t DATE ISSUED 3 MAP/PARCEL NO. ADDRESS VILLAGE OWNER y 4' DATE OF INSPECTION: J FOUNDATION ' I } FRAME A 3/31105 INSULATION FIREPLACE ELECTRICAL: ROUGH 5 FINAL ' PLUMBING: ROUGH 0 FINAL !- O GAS: ROU -p ! FINAL FINAL BUILDING co fr DATE CLOSED OUT ASSOCIATION PLAN-NO. 0 'v The Commonwealth of Massachusetts ' Department of Industrial Accidents' 660'Washington Street Boston,Mass. 02111 �4'orkers' Com ensation.Insurance Affidavit-General Busfneskis • i/,�iaor�iriiiiyir �aai r�raG / ,,,�. , r.,�t�.•,ri name: address: p rVol. �d �'rT stateR ap v 33 work site location fall address : ❑ I am.a sole proprietor and have no one Business Type: ❑Retail❑RestaurantrB fi/ ating Establishment working in any capacity. ❑Office[] Sales('including Real Estate,Antos etc.)* ❑I am an en to er with etn loyees(full& art time: '❑Other ' I am an .ployer providing workers compensation for my employees worlQng on this Sob. � F:4•' :T:•!•.• �•P'•�• .S!'' rt.' , �'' :`t' avt:.7 ;.":i,s:+.: •t :7i r. •f' �, • i.,:ii• r•a^r• :4 i' .'i:• 4'•}`', '«�i'•t^ t.1'• •tt•`:',�• ,�i•: 'rr .. : .t i. '4 ,tin! 3.1: •f� YL, ^i�,��d:: '''• .�4>�d� •'1"•• „ �. •l �.._ •.ft,`. ,.{. �.,;:,c.f:7:rt:i:St>•" t.Y yS,�; }r,',..•::-t..R• i:J. a.;tat. �,•!t.'�.:. :.p•,.. G }!•'t` .ki n.1':'.Vr•.t;••r •+fi^5i 'i:{' •' rr'• � •'C..7: :Yi''t'_7�:::^�•i:� .. rk4;,•j� ;.••'`;;4' hone'.W Ci' ` •';�; _r4;yr .J�.•• t .:J'• •r It;. „�: ,.r.j 4•'i;:.•t. .. .'1'r•r y� ^!' -:'4" "i.w.l iIIsiira3ice.ca:' r::: I am a sole proprietor an6have hired the independent contractors listed below'who have the following workers' .compensation polices: _ n,T••:>':i d :h"•:e;' ..!'• •is'L t. r: _t' t i> ':'.t'! ':� e..tyi:�'�n:' ..y��Y ih'p..a(6.r',?E• :is:`:1:•w�L. COID18II names: i.t. :y; , et•ra ':':;i^ r;� :rar•• t• '1' �3' .i:t1'N`•pir .°,t• ..s'• ,':it:f,,• ,t�'. '1•.`:i ... , -:�:. :t°�'.. ::q�r.: 7, ,*.,� .. addressd. '• .1, :L;: ,t•.r,..::. �•;• ',:•� •• r� `4'.,+' .u�,S•:•::s;'•ra:''�.• 'ifs h��• ',., t'�i' '..i=i• ii :r"::.,;.el: ;,� .t .:7:• .7r ''"' 1'.'7t7"' r;,.e`t•:'+�'' •-t .{, ? •:l: 7.::t;• _ r a t',: •'r,+ ��r'•.' .'C.':•'••r -�.•5i:i%r`�,�.,%.`fit"t,t.•e,•' :•?edq :':;i':... ••i• r01iC s#': ilt,,d•:•:.:}7:'.i,.. .' "Y'f.,:��' :•.• . insur %///%%%///////////• +t.:t•. :.a•r.t: ,;yfit 't'. •*:. ,•'i::• •+r !'i.n.,ti:4:.M r ':t.!•:t. ,i-t.:? �d', il:.'.. .•�:.'j• 7•� :.C:: ?'AL;./'�.:.ytT.:i'.L' �+'�' t•Yi•.�Y��,'•:.�`~..:i .i^ .f:'a:•.r. �` - COID'813 Do e:+'.ir . .l { %i;:`•'•' ' .. ' .r .rG.., .N� '!j•7.:H r'}•'I.' is^i 1! •'r4Ytt<,�' .•+ :'4: ' 'done.* .. . 'r uq..,L. •,i.. >,'�k:zei'' '7" :�5�'.;. ':1:?•i7••.' - '+fF .•,r :•. ::1t. '�i.:,ii; f",. •_!,: !'"'. i't 7'R'�:FC.r:.!•. ,�:: 1 , ME •• fit . •.•.!' •'•+• ('!''t.:1;_."•f :;.Ir•: '•y.. '.•::T' i.;>:a, ; a0'�Cv i'.'''•. d:S'.• f•: i'i: 1IISnL8nC�C0:'" Faffui a to secure coverage as required Hader Section 25t�of MGL 152 caa lead to the imposition o[criminal penalties of a fine up to$1,500.00 and/or one yea,-s+imprisonment as weIl as civil penalties�a the form of a 6TOP WORK O�2DER sad a fine of$100.00 a day against me, I understand that g • copy of this statement may be forwarded to the Office of Investigations of the DIA.for coverage verification. I do hereby certify t ains pen ' 'es per' chat the information provided above is true and�c�ar ect tf ` `Date 7 J'� Si&natvre .. '�• • • � � �/— `� 7e( '7.•, , •. V` print name 4 ir A,S pw N� Phone# Official use only do not mite in this area to be completed by city or town ofiicisl city or town: permit/license# ❑Building Department ❑Licensing Board [I-check if immediate response is required ❑Selectmen's office OEealthDepartment , contact person: phone#; ❑Other (revised Sept 20 3) i Tower of Barnstable Regulatory Services BAB MBM Thomas F.Geller,Director HAM 9`bp1659. a,�� Building Division TfD MIA's Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 *nyw.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no.- Date-- AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. - ' Estimated Cost Type of Work: Address of Work: Owners Name: Date of Application: I hereby certify that: Registration is not required for the following reasou(s): []Work excluded by law ❑Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: UNREGISTERED PERMIT OR DEALING WITH APPL CONTRACTORS FOR OWNERS PULLING THEIR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. An Da 0 er s Name Q:forms:homeaffidav RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE 7 p4 S square feet x$96/sq.foot= x.0041= plus from below(if applicable) AI,TERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus frombelow(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50,00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: x.0041= square feet x$96/sq.foot= STAND ALONE PERMITS Open Porch x$30A0= (number) UQ OD Deck x$30.00= (number) Fireplace/Chimney x$25.00 (number) Inground Stivimming Pool $60.00 Above Ground Swimming Pool $25,00 Relocation/Moving $150.00 a d (plus above if applicable) permit Fee pro v: st pe0 PVB f)-e, � Rev, 63004 O e t Town of Barnstable . Regulatory Services Thomas F.Geiler,Director MM p eel Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma:us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION ' Please Print DATE: 0 y OB LOCATION: d33 number street age ("HOMEOWNWI:�ONSya��;b ,bt �A �r�S 7 l- � ?� q name home phone# work phone# CURRENT MARINO ADDRESS: I A city4slwm 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_pernut. (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 64 he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and (� requir Signature of flomeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions Of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/cm tification for use in your community. :fonns:bomeex Q �Pt �.�� L_ -_- i i 1 y tIt f l;; If � t • � ... I t., 1 � ' ' .I I I i � arir ' f �t � y k + f �� - , F , t r• i j � 1 ,r { � i r M1 r . is E m _ r I 1 I + Al l X6 . raw, vt, t „a lit i if � '.�• 1. r vw- f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map - "Parcel ® 3� A/ Permit# V q3 V I Health Division 0 —�53*9 � Date Issued Conservation Division �5 ZS n`S Application Fee Tex Collector D Permit Fee �o,�Z Treasurer Planning Dept. EXISTING C SYSTEM Date Definitive Plan Approved by Planning Board LIMITED To OF SEDROOMS Historic-OKH Preservation/Hyannis Project Street Address//� /_63 rnhR ,�lrL e+r 4 Village e0 AlT I P�t Owner ejt sT�4,4,-V D 7�/.3 ��%/a Address Telephone Permit Request ri'a1eSl4 903 ' Ada vy, M Square feet: 1 st floor: existing proposed 2nd floor: existing proposed TRal Q& r— Zoning District Flood Plain Groundwater Overlay co M Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family) Two Family 0 Multi-Family(#units) Age of Existing Structure 0 Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full 0 Crawl 4A Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) S'dD Number of Baths: Full: existing new _ Half:existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths):existing 6 new First Floor Room Count c� Heat Type and Fuel: X. Gas ❑Oil ;d Electric ❑Other Central Air: ❑Yes )Q No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage: ❑existing 0 new size Pool:❑existing ❑new size Barn:O existing ❑new size Attached garage:O existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded 0 Commercial `O Yes- No` "If yes,site-plan review# Current Use Proposed Use ' 1 BUILDER INFORMATION r7v_�q F— 6 9 Name Agri (1wifuz Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY 7- a PERMIT NO. DATE ISSUED KAIP/PARCEL NO. r ADDRESS VILLAGE , OWNER r DATE OF INSPECTION: r^ FOUNDATION FRAME INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL �s GAS: ROUGH N FINAL Tw :. FINAL BUILDING co DATE CLOSED OUT ASSOCIATION PLAN NO. a Town of Barnstable 1 of swe roy� _ . _ N Regulatory Services l eaxrtsrnsr. , Thomas F.Geiler,Director c 9$p 165 ��� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Tax: 508-790-6230 Office: 508-862-4038 Permit no` Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,withc��exceptions,along with other requirements. . 0 /l EstimatedTyp of Work: m S�✓/ Y Ested Cost - U:�v Address of Work . J Ov'ner's Name: I`d a�571�i14i' p C l Date of Application: I hereby certify that: // ^ Registration is not required for the following reason(s): ❑Work excluded bylaw []Job Under$1,000 []Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNEgS PULLING THEIR OWN PERMIT OR DEALING ROVEMEN WORK 0 NOT HAVE CONTRACTORS FOR APPLICABLE HOME]MP CONTRACT THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c.142A. ACCESS T SIGNED UNDER PENALTIES OF PERNRY I hereby apply for a permit as the agent of the owner: ' a Contractor Name Registration No. }. Dat d/uS �ati� OR �s. 4DeOwner's Name Q:forms:homeaffidav -= -- The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600.Washington Street, ;In Floor Boston, Mass. 02111 �— Workers'Com ensation Insurance Affidavit:Building/Plumbing/Electrical Contractors r � �.�y .r .. �N . , seh, ,� � W.N. � �.�,.. ..m ,:��.;;���.... �r`�, .� . �..-:.f.:... name: /'c>NSiA&iq AID5 n/ o L ®►' AV)S' address: �.�S l ?0 ' 52 city A RLI6-7o}V M state• zip bag76 phone# 7 kq,6-7434 wdrk site location full address): am a homeowner performing all work myself. Project Type: ❑New Construction[]Remodel �+ I am a sole proprietor and have no one working to any capacity. ❑Building Addition _ IG tfi.T:."'.a�s�`�..:i ��-C[ '-.r J•�j� ...• ".iM .... n.. ... .3 .e. .. .. ,r .. ......., ...a. .. ..._ r ❑ I am an employer providing workers' compensation for my employees working on this job. company name: address: + city phone#' insurance co. lic # ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers'compensation polices: cool Y name: address: city: phone#• insurance co. olic # }„yF"7• %.. '. �.1n ul io-' ., ,. .. ... ' L ..! r :'..:; ''7 m'-q,r �A` ,f,,� � .��...e. •F.f�,''n.e.''°d�S�.�:d. Yn'f�n4?.d.' company name: address: city: phone#: insurance co. Dolicy# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up ton$11,,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under thepains and penalties of perjury that the information provided above is true and correct Signature Date Print name Phone# [contact se only do not write in this area to be completed by city or town official own; permit/license# Building Department ❑Licensing Board k if immediate not is required ❑Selectmen's Office 1 ' ❑Health Department person: phone#; ❑Other pt.2003) - _ Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",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 section 25 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,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 insurance requirements of this chapter have been presented to the contracting authority. I Will Applicants Please fill in.the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 600 Washington Street,7te Floor Boston,Ma. 02111 fax#: (617)727-7749 phone #: (617) 727-4900 ext.406 I Town of Barnstable ypFZHE rp�� y� o� Regulatory Services • Thomas F.Geiler,Director s +`* BMWSTAS E, • . a6g9039 Building Division a 9� ,��'. ArfD MA'1 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Il Please Print DATE-- )Sl o s JOB LOCATION: 01 3 AA h njhl 3n Gt•11 t l ('oAu i'7 number street village "HOMEOWNER": name home phone# work phone# CURRENT MAMING ADDRESS: d .� S� 5�►1�t 1 L) I y city/to state zip code The current exemption for"homeowners"was extended to include owner-occurred dwellings of six units or less and to allow homeowners to engage an individualhr hire who does not possess a license,provided that the owner acts as supervisor. DEFINMON 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. 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, serious problems,particularly Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lank of awareness often results in s pr ,p Y 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 ultirnatelyresponsrble. 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/certificationfnr use in your community. Q:forms:homeexempt 633 M4rlle,- c-1'riCXUP'C C ®�Sa�lfrnoS �n�Q�4,(�/S CO�ner ) ri C5n fs1 5�� e r , je z � 4, �1 n-F,n 15� e� O 0ov-11036 2 Ole, j '• � �. �F� ��� ` � � =�- =� -� � � a � W V� er _ ^— G;'�i �� 1 �.r f tl 1 i '�� � ., 1 I +' �- "�„�Y ������� �j-p�-xj"r.N f� } 1 n0 CUR Appwdis J Table JS.Z.Ib(eoatinaed) prescriptive rsdmga for due and Two-Family Residential Buildings Hated with Feud Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Heating/Cooling perimeter ertt Efficiency' Area'(Y.) U.value= R-valud R-value' R vatuet wallRrvalue` �R value Package 5701 to 6500 Hating Degree Days Q 12/° 0.40 38 13 19 . 10 6 Normal e 6 - R 12% 0.52 30 19, 19 I0 g E S 12% 0.50 38 13 19 10 6 -38 13 25 NIA N/A ormal U •15% 0.46 38 19 19 10 6-'-------Nomrai-- ----- --------..- - y 13 25 N/A NIA SS AFUE 15% 0.44 38 W 15% OM 30 19 19 10 6 SS AFUE X 18% 0.32 38 13 2S NIA N/A Normal Y 18% 0.42 38 19 2S NIA NIA -Normal Z 18'/a 0.42 38 13 19 10 6 90 AFUE AA I S% 0 50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: '1 w 3. SQUARE FOOTAGE OF ALL GLAZING: +�s 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): ; NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL:' YES: NO: q-forms-080303 a 780 CMR Appendix J Footnotes to Table J8.2.1b: 4 Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned.space,but excluding opaque doors)to the gross wall o the U-value re uirement.. total glazing area may be excluded from q_ are expressed as a percentage.Up to 1/o of the to g g Y a' p design with 300&of glazing area. from a building g For example,3 ftz of decorative glass maybe excluded g gn g 2 Auer January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. construction. If the insulation achieves the e full truss constru ' The ceiling.R-values do not assume a rased or oversized _._ insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R 38 Insulation and R 38 insulation-may be substituted for R-49 insulation: Ceiling Rvalues-represent the sum of cavity--. ---... insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 4 Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing(if used). Do not include exterior siding, structural sheathing, and interior drywall.For example,an R 19 requirement could be met EITHER by R-19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,Iog)wall constructions,but do not apply to metal-frame construction. s The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. " If the building utilizes eleetric resistance heating use compliance approach 3;4, or 5.• If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment,the equipment with the lowest .efficiency must meet or exceed the efficiency required by the selected package.. For Heating Degree Day requirements of the closest city or town see.Table J5.2:1a NOTES: a) Glazing areas and.U-values are maximum acceptable levels. Insulation R-values are minimum acceptable-levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,of crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- windows or doors is less than ore equal to the U-value requirement(0.35 for doors). eofall q Yalu . 43 Asse and lot numb ....-..� ......: C� CF T E Tod. H • y Sewage Permit number .�...........�r .3 ..........:.................. $E MUS _ SEPTIC SYSTEM d-6 33' INSTALLED IN COMPLI STABLE, Housenumber ........................................................................ WITH TITLE 5 '° 1639. e� "ENVIRONMENTAL CODE 11 MAI a� A TOWN OF BARNST"49ELATIONS BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..................... ... ..... ........................ . r j TYPE OF CONSTRUCTION ...4N40.0(... ... ......... ... ........ .................................................. ` .. .f 19.3d TO THE INSPECTOR O�, BUILDINGS: e i The undersigned hereby applies for a permit according to the following information: i�)�4 Location G"' ' .... .............C ! 4 ..: ........ . .................. '.......................... ProposedUse ........ ...................... .......................................................:.......................................... .......................... ZoningDistrict " ' ...................Fire District ........ �.............................................................. ........................................ Name of Owner .. '... .. i...../ .r..Address ................. Nameof Builder ... /. .......... .............Address .................................................................................... Nameof Architect ...i..............................................................Address .................................................................................... .......Foundation T4�-(Number of Rooms ..................... ........................:............ .... ... ...... .......(..O-tGCr7/L� � Exterior ....W ...C .. Roofing .... ..<- ....... '................................ Floors .................Interior ......... w`�` ......G��!.. ............ ............ ...... .................................. Heating ......?A...1 Y....................... /...................Plumbing .................. . . .. ............................... Fireplace /...................................................Approximate Cost ............Q:`Yr. ................................... Definitive Plan Approved by Planning Board _____19_ U. Area .........13.99............. Diagram of Lot and Building with Dimensions g 9 Fee .................../...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 I hereby agree to conform to all the Rules and Regulations of the Town ofBarnstable regarding the above construction. Name . .... :.. . ....... .............................. ........ CEDAR ACRES REALTY TRUST 0 22625 Permit for................. ..... i.ncj-1 e--F.atu.i-1-y...Dwe-1-11n�g................... Lot #29 633 Mariner Circle ,.Catiori ................................................................ Cotuit ............................................................................... • Owner . ,,Cedar Acres Realty, Trust .... ......................................7..................... Type' of C6nstruction ..........Frame................................ -7- .............................................:.................................. Plot ............................ Lot ........... .............. 80 Permit Granted ........................................19 c 0 ber to 0, 3 - 9 Date of Inspection ..2.. �*2................. .1 Date Completed ,.19 FERMIT REFUSED >.. ................................ — P. ..-. 19 C; ................e........... ............ .......... t................................................ ........................................... .......................................... S; -ApproV-e-d',C, ..... 19 ................................ ............................................................................... ...... .. . . ......Ger . ................... Assessor's*map and lot number cx�.:R..........? I .................... Sewage Permit numb& ............................. MARNSTABLE, (House number ......... ................................................. NAG& ... .. ...... t639- QED M TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...................... .......................................................................................... TYPE OF CONSTRUCTION ..Z�Oe ...................... ..........2i . ........ ................................................ z, ................................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... A—?............ ..... .. ... "67, ..................& .... . ................... I.................................................. 2 . ......Proposed Use ........... ...... .. .............................................................................. .................................................... Zoning District ................... .................................................Fire District ........a4�z................................................. Name of Owner Zru4t-,(-1 e�ztt6 'leAl A ................................... ....�Z�:..Adclress .................�7........ ................... Nameof Builder .........................Address .................................................................................... Nameof Architect ...... .... .. .......... ...................................Address .................................................................................... Number of Rooms .................... ............................-Foundation ................................. ................................. ...... ........ Exlerior .... Ik .... �. ('Zc �y �6...........Roofing ng .... -i..../W—//.... ..(/....t. ti101.4............................................................ .. . Floors ....... .................Interior ......... .......... ................................. ...................................................... Cj .............Plumbing ................. .........................................................Heating ......7-1-1-V , 44 .................................... Fireplace .........................../...................................................Approximate Cost ............. ............................................... I .tefinitive Plan Approved by Planning Board -----19-70. Area ......... -.-.......................... 6/ & 4�1 Diagram of Lot and Building with Dimensions Fee .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. f / Name ... ................... .......... .............o......... CEDAR ACRES RRALTY T ST(`, —123-.-35 No 2.262.5.... Permit for ..One„Story......... Single„ FamilX Dwelling ......................... Locatiori ....Lot....................................................Circle Cotuit ............:.................................................................. Owner ......Cedar Acres Realty Trust .......................................................... Type of Construction ...Frame......................... .. .... .. .. ................................................................................ Plot ............................ Lot ................................ Permit Granted ..........Octo�be 30,...19 80 Date of Inspection ....................................19 Date Completed ............./...................19 PEIIIUFUSWD�— .................................................... ........... 19 ................................. .............. ........... .... .. ... ........... . ....... ... f ......................................... .. . ............................. ............................................................................... Approved ........ ...... ... .... .. .... .......... 19 ........................... ............... ... .............................................. ... ................. W G QLrt Lr O T , r PL AN -SHOWING D AT FOUNDATI 4 loc ' _' '_ �C ih; ry #.'k' bpi• � T r ,T. !yW��:t CHU -GO' VA'S,--' a4 r t OW*E V 8- `r!ITT' !V'Mt!!' '{ M.6 • tt^L x �+5 •.* r 44 -• ', . ':. f• -�r y ,� t,f wed 1 1 i ! i - , 4. �. • � { s � ?� .,.tM f r•t � r=+r k• Y+ tf`�.�L4 t kt 1 ♦� .. 7 1. .. 1 +t ,{: y t $ h' t s ♦y-,,. ' ij � '.YS bs- f 1, WER 'SY CERFJ Y TNA7" TNfS� FD At �ff(�1+i' 0600#&t L M { } �» 7xHf 1„OT- AS BSI QWN.ItAitJ.-GOMFORMS WTO-7 PfE . 8ARN5TABtE 'xONOVO Re�Ui.APflft N�= � TBACKS.r. �' BAR T 1W�' > '� �`i. ..1c_',tx 'R�t.. ,.>' " i ,fistiR O i `off ! .r `* s4 aP s �3 lc ��lY ti'� `* K' A, � `A p'; •Pv2, r'p� t ` s- N � t _ i I ta, '�+ r'- /Y l� .��J >�'�P+� µ +H -� 'p n �fa's+�.�- �i a 1+'4�: f J g;°v •q,,h .. ,a '� ' .:, .. .may t -�' sue' `� a ,� 1'��� Y ` ux � ^A7}� s� e�• & _; �>. �._ -�'3. '� y�,P� +1 rt•'" 2��s *. -.h, .. }•.+•`I ` d F� e R`s �'� .y. VN , it •�' �,$ a yy i t>L`� ♦ � '�Mtil'�,'� ,�• :.. r r .n - ., b ,a: � `'a r: ,':-3 t-°r4 � _ + Wi�Ft.�t..s � Br ra�x � A Ft t; Gjt .� ``p '#. . -Y ;•. 't i Y •' ;�' + rt ':,: t w..r, a'R< a t,F .. � � r F.Ru.r.C':'K'�,i�`... ,K,. + c ,7�: s c�'s' a: i:, n i �� �•.t 7 t .�. y .:'i P .� <..* '. �{ ":a Y Fs*' 4 ; '�, r>} �'sf u� ,.d'� -:.6°y, ,�#..f:. S -„i +' � �«y x - — F -6 � w t x g .'�„ Y' v3 e x+� K a• �s$,tom 7.�� y.., ? 4�:1 ^ _�... 5��• .jy � t a r�' s ar r > �Y �:yt ¢�„.r',r, • k�ettr �¢1 � �a itJ � ,.-�ax t� i�-1 f a.. t xb•��>nr � ;,. t t h ! ��,;�hy:�r,,y' �ikr1$•+'4 r paf:-1:�.i'h'f .�c:.%�' .t,+.` cAA..t.` r, f +F .W`_.h�t �...' .-. { TOWN OF BARNSTABLE 225 Permit No. -----------.....----------- ya e i »n.Y� •= Building Inspector i MAILCash -— — eO�O YPY OCCUPANCY PERMIT Bond x j A0-1�1 "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 Cedar Acres Realty `I'ruStAddress Lot 429 033 Mariner Circle ,Cotuit Wiring Inspector / y "'"~ Inspection date Plumbing Inspect/ Inspection date ~ Gas Inspector Inspection date Z7l ,Engineering Department �r�/ ��L �'�//�(�'/' i Inspection date -z _ 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. 21 ... .............._... .. . y Building Inspector