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Home My WebLink About0025 OXFORD DRIVE .as �X � . j Town of Barnstable Building easrtsrn»L& ;Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept Posted Until Final,Inspection-Has Been Made. PermitFownnrt" 'Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until'a Final Inspection has been made. Permit No. B-20-1443 Applicant Name: Edward Fitzgerald Approvals Date issued: 06/09/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 12/09/2020 Foundation: Location: 25 OXFORD DRIVE,COTUIT Map/Lot: 021-046 Zoning District: RF Sheathing: Owner on Record: FITZGERALD, EDWARD F JR&GABRIELLA P Contractor Name:'dam'' Framing: 1 Contractor License: Address: 25 OXFORD DRIVE 2 Cotuit, MA 02635 "` Est. Project Cost: $4,800.00. Chimney: Description: Replace 4 sets of windows with new energy-efficient windows Permit Feb: $ 35.00 t Insulation: Fee Paid. $35.00 Project Review Req: a i f '' Date: 6/9/2020 Final: L_ r — Plumbing/Gas Rough Plumbing: T \Building Official M Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after,issuance. „ All work authorized by this permit shall conform to the approved application an%d the'approved construction documents for 11 which this permit.has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be incompliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. : 3 ��-------� =-� Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:, t: Service: 1.Foundation or Footing 2.Sheathing Inspection _ R m Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final' Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). ,�,,(, Fire Department �,1�' �. Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �d5� Final: r tom, Town of Barnstable *Permit#� of ar, Building Department we res e 6 monthsfrom issue date snIMsTAstt. �mll..`t kr'Ir' llian Florence,CBO J v� , ; ,0� Building Commissioner �0j A EGMp'1 PEAR I 5 2018200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-86TO N OE 8AHNS TABLE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL. ONLY 02 J Not valid without Red X-Press Imprint Map/parcel Number Property Address .2 5" 0X�o�D. [Residential Value of Work$ / DOr D� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address EDVARD �• �j•t2� �1��A 4 0 1)(mP Contractor's Name yox"C'a", Qjij ! hiye.�l: ,rftffeki/-ZV 6 Telephone Number Home Improvement Contractor License#(if applicable) 160'Y# Email: l efqt� ar Construction Supervisor's License#(if applicable) C 5 U� I yoz �Af�a�t� Wworkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner EY I have Worker's Compensation Insurance Insurance Company Name AH 6mri `A[OA4011 Ce Workman's Comp.Policy# .R a C 11�3 a 6 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'"Wiindows/�do9ors/sliders.U-Value 61, (maximum.32)#of windows I;Ullf0l i U jq �/�/�f�� 'l100ttt� CUd1 ivy #of doors: �.,j�d 'P40I y &AI exi ®�. n *Where required: Issuance of this permit does not exempt compliance with other Fown 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 r- uired. SIGNATURE: eJOA. 4 C:\Users\decollik\AppData\LocalUicrosoft\Windows\INetCache\Content.Outlook\9NNOKXYW\RESIDENTILONLYEXPRESS.doc 09/26/17 Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS' LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT UWE,ESQ , OWN THE PROPERTY LOCATED AT 25 14 !� IN MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PE IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING E. SIGNATURE OF OWNER: i OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: - LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE:. APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: r _ I c-+// r9naxrvmraleirSt n C.�r'auar/'rr - �. K a• f Commonwealth of Massachusetts Off lice of Consumer Affairs e�Bugln 5 peguiatlon HOME IMPHOVEtViENT CONTRACTOR ,I ® Division of Professional Licensure TYPE:Supplement Card Board of Building Regulations and Standards k pg/F p18 Consi r'g6fi i.V6b ��rvisor 100740 CAPIZZI HOME IMPROVEMENT,INC. i i Ejpires: 12131/2@19 ""CS-071402 "I p Qom-^ JOSHIIA L 66HEN' 1082 OLD JOSHUA COHEN - ° � ' STA Ell r� u 1645 NEWTON RD. _ GENTERVILLE N1�4026 COTUIT,MA 02635 Undersecretary `^ I _10 Commissioner { f 'Construction Supervisor Restricted to: i Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(99'1-cubic meters)of �` ,I enclosed space. ) ,:r Registration valid for Individual use•only before the ax Iratlon,date if found return toc ulaflon Office of consumer AMa�rs.and'Buslness Reg. 10 Park Plaza.'Suite 5170 Boston,MA 02116 ;�ll Faihjimto,possess-a current edition,of the Massachusetts State Building Code is cause for revocation of this-license. Not var�d without Signatur® DPS Licensing information visit: WWW.MASS.GOV/DPS a 's3 4' y I r DATE WUDDNYYY) AC40 LY CERTIFICATE OF LIABILITY INSURANCE `� 1 12/27/2017 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_ONE - Roger--and GrayProcessing - - - --- -- ----- __._.--- -- --- - ---_- ----- ------ FAX ROGERS & GRAY INSURANCE AGENCY INC PHC No,EMI: (508)398-7980 No): _ E-MAIL ADDRESS: mail @r0 erS r9 ay.com 434 ROUTE 134 _ _viNSURER(S1AFFORl:r cov�ItAGE_...._........ NAIca SOUTH DENNIS MA 02660 INSURERA: AMGUARD INSURANCE CO 42390 INSURED INSURER B: CAPIZZI HOME IMPROVEMENT INC INSURERC: INSURER D: 1645 NEWTOWN ROAD INSURERE: COTUIT MA 02635 INSURER F: COVERAGES CERTIFICATE NUMBER: 225451 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR` ADDLiSUBR; _ I POLICY EFF POLICY EXP �- R TYPE OF INSURANCE ; POLICY NUMBER MIODNYY MM/DD YY LIMITS CO MMERCIALGENERA L LIABILITY f } f EACHOCCURRENCE 1 S I I DAMAGE TO RENTED-_.__..._.-..,-----------------_-._.-- CLAIMS-MADE OCCUR ; k } PREMIS�Eaoccurren� I S._.____— -— -- - --- MED EXP(Any one person) I S I N/A i PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: j GENERAL AGGREGATE I S — i POLICY PE� LOC ± PRODUCTS-COMP/OP AGG S OTHER: 4 i S AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT ?S 1 a accident ANY AUTO 1 BODILY INJURY(Per person) ±S _ ; } j I ALL OWNED SCHEDULED BODILY INJURY(Per accidenq S AUTOS AUTOS N/A I ____y NON-OWNED I 'PROPERTY DAMAGE 1 S HIRED AUTOS ( AUTOS 4 _(Per_accident)__,__-_____________ f s UMBRELLALIAB !OCCUR ; ( t EACH OCCURRENCE—_ 5 EXCESS LIAB -- CLAIMS-MADE 1 N/A ; AGGREGATE I S DED i RETENTIONS I S WORKERS COMPENSATION i I PER X STATUTE ORH , AND EMPLOYERS'LIABILITY 4t ANYPROPRIETOR/PARTNERIEXECUTIVE YIN I E.L.EACH ACCIDENT is 1,000,000 A IOFFICERIMEMBEREXCLUDED? NIA'NIA it NIA. R2WC863728 Y 12/25/2017 12/25/2018 i (Mandatory In NH) ` I E.L.DISEASE-EA EMPLOYEE"S 1,000,000 ,Ifyes.desaibeunder i ,, i ..,...__._..,_.---..-_..._.. _. ...... ._..I _ ......__..... .-. DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT S 1,000,000 I ' i I N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits Will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the Issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage.Verification Search tool at www.mass.govflwd/workers-compensation/investigations/. >y CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POUCY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE .---" r_1 F Hyannis MA 02601-0000 Daniel M.CroXy,CPCU,Vice President-Residual Market-WCRIBMA O 1988-2014 ACORD CORPORATION. All Fights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts o Department of Industrial Accidents Offlce of Invesdgadons 600 TW'ashingion Street Boston,MA 02111 www.mass govIt a y Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Alanlicant Information - Please Print Lea blv Name(Busine$s/Orgm&ation/mvidualy Capizzi Home Improvement,Inc. Address: 1645 Newtown Road City/state/zip: Cotuit MA 02635 Phone#: 508-4284613 Are you an employer?Check the appropriate box: Type of project(required): 1.✓ I am a employer with 40 4. I am a general contractor and I * have hired the sub-contractors b• New construction employees(full and/or part time). - 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' insurance.x 9. Building addition [No workers comp.comp.insurance required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself.[No workers' comp. right of exemption per MOL 12. Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13. Other comp.insurance required.] *Any applicant that checks bax#1 must also fill out the section below showing their workers'compensation ompensadon policy information. t Homeowners who submit this affidavit indicating they are doing ell work and then hire outside contractors must submit anew affidavit indicating such. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'camp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below k the policy and job site information. Insurance Company Name: AMGUARD INSURANCE COMPANY/NAIC#42390 Policy#or Self-ins.Lic.M R2�9�/WC775326 Exp on Dom; 12/25/2016 Job Site Address: O? V I�Y d 1/0 bVI V 4 City/State/Zip: C d%`�1�j ns1 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 MOL 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 may be forwarded to the Office of l Investigations of th DIA for insurance coverage verification. I do hereby c fy nder the pains and penalties of perjury that the information provided above is true and correct Si afore: Date-, ® 3 Phone#: 50 -428-9518 Offidal use only. Do not write in this area,to he completed by city or town q ff eld 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#: �oFr►�rTown of Barnstable *Permit# ti o Regulatory Sel'vlces lFece,•6n10110 nr6-sue dare. � SARVSTABLE, a - " 16j9. N Thomas F:Geiler; birector, Builcling.Division, Tom Pcrry, CBO; Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barns table.ma.us Office: 508-862-4038 _ Fax; 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY /Vn1 Valid wii Ott/Xet/X-Press lInprin/ " Map/parce`I Number Property A c1dress �✓(J[j" T �1�r � � t� ��/� T] Residential Value of Work �, F `? - � � _:Minimum.fee of;635;00 for wo rk1c un.der$6000.00 Owner's Name & Address Contractor's Name_ �%(�vAm \'�_k .Telephone Ntrmber__ (��-��-/� Home Improvement Contractor License #(if applicable)_ _11� rj 60 6 ' Construction S upervisor's License#(if applicable) ❑Workmen's Compensation Insurance H �� ` �Ch cl< one: I am a sole proprietor 0V 1 *7 2010 ❑ I am the Homeotiyner TOWN OF BARNSTABLF ❑ I have Worker's Compensation.Insurance . Insurance Company Name I' Nw,� •��' , Workman's Comp, Policy/1 (J Copy of Insurance Compliance Certificate,must accompany eacll permrt Permit Request(check box) iRe-roof(h urrici Te n,ailcd) (stripping old shingles) All constrbction debris will be taken to �✓ y� Re-roof(hurricane nailed),(not stripping. Going over existing layers of root] Re-side #of doors eR,eplacemenC indow doors/sliders. U-Value lliL t� �f. {maximum .35) # of windows '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 required,;, tit SIGNATUI2L; rl•1 iin r .nrnnaA Cll,.did�.. e_.:__ cvnn rnr• _. � - - The Commonwealth of Massacltirsetts Department of Industrial Accidents l Office of Investigations i 600 Washington Street Boston, MA 02111 c Y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleciricians/Plumbers Applicant Information Please Print Legibly [� Name (Business/Organization/Individual): � wP.� yc o'a c_ (i.Q)✓ Address: 69 City/State/Zip: ej , q l',�t,,,� i Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4.'❑ I am a general contractor and l � 6. New construction 2.�employees (full and/or part-time).* have hi1.red the sub-contractors am a sole proprietor or partner Listed on the attached sheet. 1 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition- working for me in any capacity. workers' comp. insurance, 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their . 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,-§1(4),and.we have no, 12.V oof repairs insurance required.] t employees. [No workers' comp, insurance required.] 13.❑Other *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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. 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. Lie. #: ® Expiration Date: Job Site Address:_L f-O City/State/Zip; ® ✓i✓U(�•�t?AA 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 may be 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 Signature: t%!=i_Aj A 4 �L L1 A I Date: Phone#: 1 . 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#: '� tl Information and Instructions •, f 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 orflocal licensing agency shall withhold the issuance or renewal of a license or permit,to operate a business or to constrdet'bdildings 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 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." Applicants 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 {t 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 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 (i.e. a dog license or permit to burn 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: A , The Commonwealth of Massachusetts. _ ti Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,'MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia — \s t.:•:;�h:u�cr cpo.r—w?? ntof Public <,Frr.� Boar41 6f Buildinnu Rcuulatifms ,tnd•Stantlards` yea { Construction 5upe:.•is6r License License: CS 103199 q Restricted to: 00 - i EDMAR LIMA 68 ABBOTT ROAD SOUTH YARMOUTH, MA 02664X i Expiration: 10/17/2012 Tr-':Y103199 . Office o me 7 rs Viness egu a on Y,r crse t►r ruts ^2"lot� id for^ihpxviduI use only HOME IMPROVEMENT CONTRACTOR before the expiration date: If f6und return to: x Registration �159506 Type;. r Office of Consumer Affairs and Business Regulation. Expiration 5/ 2012 Individual. 10 Park Plaza-Suite 8170 B RIVER CQt�STRUT(ON1r2 K Boston;MA 02116 EDMAR LIMA 1 a' 193 FAWCPT LN f,� HYANNIS, MA 02610 - _ j Undersecretary Not valid without signature. t .. r r - 1 BL;"- t-..i',;�r r'ri 7� I11 ,`1.1'1 `( RIO. Box 1062. 11LAC."'I"" C,onstruct ion �-d Ostervilk, A1,41 02655 Descr•io t w of the jaf) Replacement of exisfin, ' TOi i;rles -with 30 vcat-s archilt--v shingles. Each sb nglo ivill be t7(ar1M)4 i1h FI 117ai s pi.in2r9t'X-gn and g-ables cmd fist lciyer Of paper hcr.s to be Q7 arel a. r e?quired bi; cotk. P' will a1yo provide the ( inehmks labor onci unit. The inside 1,Vor•k doe's not irp-lTu `o pairnti-ig, and(lt�'xs�crll, Charges Labor fop= the roof i..(;nlcu°emeiit..- $4;:?50,00 Skvlr'Vlvt replacement l labor. .lfafer k—ds); $650.00 ll� 7,rer ia/s. 41400;00 Total of. 9,800.00 f1ris price tloe;c no'f inclit le !ide efisposal,feet. t o2- 60W ,ate,[100.0(J fee, the cfe�te'r�f+(r.?.t�r,c=.as -53,8W 00 at tie' end<��`.l�rih �ro�l'alfCetr��t. agree t'o pay Black: River ("ottstru�ta.c�r) all of the: charges, above on the d.es,ignated dates. If fain to pay on clue dates a late fee of $100,00 will lie ptd-ded to the total of the bill for each additio-nal dad' that it exceed the clue date. S;.f�r�ature�f clic�t F7afie t , l j .......... ,,"•,ig►ssture I Engineering Dept. (3rd floor) Map l)0 1 Parcel Permit# g a2� House# v7S.��` = Date Issu d � 17 Board of Health(3rd floor)(8:15 =9:30/1:00-4:30) 7 Fee' als 7 0—b Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Q 3 �'1 i tME 19 - SEPT°I &5UST BE t INSTAL PLIANCE 4 ES ±; r TOWN OF BARNSTABLE ENVIRON L CODE AND Building PermitApplication TOWN REGULATIONS r OXt-a�2J le Project Street Address a,� D - ' Village .,;-! Tt1/T - Owner r I.a+d 11 A-1,691C7"my Address c .5 Z)X !> -21� Telephone .SOS' 'Permit Request '%o a' vAV -76 First Floor square feet Second Floor square feet Construction Type GtJO oP Estimated Project Cost $ t Zoning District Flood Plain Water Protection Lot Size ,IA &.0`' 1 I Grandfathered ❑Yes ❑No Dwelling Type: Single Family a Two Family ❑ Multi-Family(#units) Age of Existing Structure /7 yzS Historic House ❑Yes W No On Old King's Highway ❑Yes JQ No Basement Type: JW Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing 2 . New C') Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil L21 Electric ❑Other Central Air ❑Yes PS No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) 2 Z-x ZZ ❑Barn(size) ❑None ❑Shed(size) - ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ;d No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE d� DATE Q BUILDING PERik DENIED FOR THE FOLLOWING REASON(S) _ FOR OFFICIAL USE ONLY IZ w t PERMIT NO. DATE ISSUED N= MAP'/PARCEL NO. µ € ADDRESS r; a t VILLAGE ow df OWNER f DATE OF INSPECTION: FOUNDATION FRAME %1 0�l��X w�Y { -.• �-' F 3 INSULATION. FIREPLACE ELECTRICAL: a ROUGH ` FINAL a A - k _ ► y T a -- PLUMBING ROUGH FINAL GAS:- ROUrjH FINAL FINAL BUILDINGin me 1 '4 i 1 1a S. DATE CLOSED OUT. • �$ Zo ASSOCIATION PLAN E1 The Cmitttnrltt Health of Atassachusetty Department of Inrlrrvtrial.4ccidurts ^ Y = t . 01fice o1/nvestigal/ors •�\_, ;I..: 600 N'ashhzgton Street Braun, A1axv. 02111 A Workers' Compensation Insurance Affidavit . AliPlic.irit iriforniation: - Please PRINT le ["'"~ name: .✓ f�lYk�i92 y�/ location: city �rul? +'� Do?6 j✓r gone k 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity .. _. •'.-.sw•. s ..+r�.s'��Tl'T�'�+�+*^'/7F.!rr,..:7'�'►+._.+.+!.`�!.'�n+�Y.�.+�...�+R�.w�. ;+�.•..a.�...••--�..�w•.^ .. [j I am an en plover providing workers' compensation for my employees working on this job. contn:tnV name: address: city: phone#• . insurance co. nolicV# _. �._._ —_ _�.-..r.. —_.... w..h—. �..... .�..rr.......�..�..�r��-..+..+.. [j I am a sole proprietor. general contractor, or homeowner(circle are) and have hired the contractors listed below who have the following workers' compensation polices: comnanw name: address: city: nhonc#: insurance ro. nnlicV# i - - •t�:•-... vim- _ - .` .;,...r-c•-- -- - � _ -- ' ... "_' cnmmnrn• nntne: address- citw: nhonc#: insurance co. nolicy# Attach additit'nal sheet if necessary; r,-=°_ -J�' '�• -'T"`;e: '' ''•'""�•' =^�"" �`•'` -' _ ____•. ...._-��._..�_._ .�L_�...��YW�.Lf�'.i�Y.J.�1��'1.iL� -1..�- _ ..a�W�. ._..f..._ �i�Wt'i.�.��/•JIYScwrIL Failur_e to secure cowerat!c as required under Section 25A of i11GL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andior one wears'imprisonment as swell as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand ihat n cope of this statement mny be forwarded to the One of Investigations of the DIA for coverage Verification. 1 do herehr cerrift•under the,"pairs and penalities of perjure•that the information prorided above is true and correct. Si;nature =:::s f2._ `r�t� Q.�y4. Date fit' Print name mot iN I-A fie_0—AC_T t`t Phone# A7L�2.8-99V 57 �ffcial use only do not write in this area to be completed by city or town official *` �• city or town: permit/license# riBuilding Dcpartmcnt—. CLicensin,hoard y' 0 check if immediate response is required 0sclectmen's Office' t E31lc21th Department E t- contact person: phone#: rJOthcr 5: re,ncu 3 ptA Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers* compensation for the; employees. As quoted from the "law". an etnplgree is defined as every person in the service of another under an%• contract of(tire, express or implied. oral or written. An c•nrpinrer is defined as an individual, partnership, association. corporation or other legal cittit}.' or any two or more the foregoing CIILaged in a joint enterprise, and including the le�,al representatives of a deceased cmplctyer, or the receiver or trustee of an individual , partnership. association or other legal entity, employing employees. However the owner of a dN%•ellina-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 dwelliirU' hey or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer MGL chapter 152 section 25 also states that even- 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 i been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers 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 requires to obtain a workers' compensation police. 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. Plea: be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned t , 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 question please do not hesitate to ggive us a call. •---„r..r�w.v++..w�a-ww.w..ws. w—••-•.�+w.-.wr�wnl►."7r+•.. The Department's address:•telephone and fax number: - The Commonwealth Of Massachusetts Department of Industrial Accidents ... Office of Investigations 600 «'ashington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE CATION O!J Q 7 O4d v2/ �.�=� JOB. LOCATION C07U Number Street address Section of town "HOMEOWNER" U;VTN Name Home phone Work phone - - PRESENT MAILING ADDRESS } S /3v�Itt City town State Zip code The current exemption for "homeowners" was extended to include owner-occupies dwellings of six units or less and ,to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, 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 Offic� 'I on a form acGept�able to the Building Official, that he/she shall be responsit for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Stl Building Code and other applicable codes, by-laws, 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. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 38 , 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 01 Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person(s) for hire to do such work, that such Home Owne: shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for • licensing Construction Supervisors, Section 2. 15) . This lack of awarenez often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Rome "Owner*' actir. as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part o€ the permit' application, that the Home Owner 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 to amend and adopt such a form/certification for use in your community. 1 i t c-- -m L i '- - - -_ �-:.J.' - s-vaia�3:.#6:r�rsa- .., v-..s — J��Jr.' �•.•,�.- _�_� .... _ _.__` i ' - , :: ; _ � .a•'•_.�•�.9. �'.rJ.-,c✓ I i f'.e.� Z` i``f� .. �Y /ii�G !1 _ � � �f_'."'�� "`^- Y '�1,'t a `. - t I •r .t r.. Q At pow Ae 0. s'yp S S f;L Assessor's office(1st Floor): Assessor's map and lot number VOM MME e�Q�o��f To�`� Board of Health(3rd floor): VIRONUMIRAL AN Sewage Permit number — �A,Sr CODE ® • Z BARIST BLL TO rasa i Engineering Department(3rd floor): House number °�,.�i639• Definitive Plan Approved by Planning Board 19 C MAI d APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2.00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR x APPLICATION FOR PERMIT TO A?44/L0/sJG TYPE OF CONSTRUCTION �pGJ 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Proposed Use `- Zoning District L Fire District Name of Owner -�O�/lwl�y ® ` /�/CC�4f2�Tdress /�� Name of Builder N76*4OmJ 6W 22N6y Addressdr Name of Architect Address Number of Rooms Foundation Exterior 4t)4o0 -S;AAaW/C4�x Roofing " S°'vCG t.S' Floors Interior Heating Plumbing Fireplace Approximate Cost Area Z� Diagram of Lot and Building with Dimensions Fee T 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 " Construction Supervisor's License .. . McCARTHY, JOHN H. & MARION A. ' No_L 33171 Permit For BUILD UTILITY SHED Accessory tn ndp11ing Location 25 Oxford nr; �e Cotuit Owner John H F, Mares} A- McCarthy Type of Construction Frame Plot Lot ` Permit Granted August 29, 19 89 Date of Inspection 19 1 Date Completed 9 -- •r y f.' Q s l a r. 1 w �}�, TOWN OF BARNSTABLE Permit No. ----.----_--__-__--.-__ } Veil. : Building Inspector cash • ----------- • wV v OCCUPANCY PERMIT Bona Z 7 --- - Issued to Address of #67 75 Oxford Drive, Cotuit Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ....................................................... ............ ......................................................................_.......................................... Building Inspector ,gyp•...r'. ......�..y ..r. r.�: � ;:_' .f,`,...��,...��, Y. y..,.ti .�. ....lY�...kf.r.rl""`� [ lr...�N t '�"��' ... � ' i'r _ }t .1 � .P '6 •�y� T r°�`ow TOWN OF BARNSTABLE G BUILDING DEPARTMENT f . i sseasr TOWN OFFICE BUILDING rua .639. �� HYANNIS, MASS..02601 I: MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has -been issued for the building authorized by Building P mitf. ..... _..:. »........ issued to fir. ..! 1< .<....:/..: .................... __............ ............. Please release the performance bond.. �3lCb a �5. Z2• Zo r D � ♦.`rt 5 tax R z tl�t'. C E tZ T l F 1 EU p L0'l- PL./a.1-J L OCAT I O" mo t V IT . 1 GG3ZTIF=�{ Ts-1AT TI-1� �U��"(`fDt� 5uo+�u1J 1�L�.►•.l '��F tZcti.IC.�. UEQ En�.l 6CMAPLYS W ITN TWE-. Sj DE Lj WG AWE> 'SETOAC4 'C—QUllZGd tF—WT; 01= TNT: 'TOWLJ qF 73An.ti6T pa�s ::C.utSt�'��t� tom,►-tt7 5vev�Yo�.s CA-4 444 US'TE��/1L.LG o tixa�s, {./:�1'iTCZ�J�KEwT 5v�.1c�{ ¢, `Y.IC e�c=G' c_C'S 5�•1�e>�w AP Li c&.-.1T' u5ua 't't.+ LnT L.i --4k= Jc*4 fir••..• - - --� • - • �• • -�• •_'r-C�'T ..-B�/��•`c _. � �•��..S•;l �M J i 1 i I �✓ f f I ¢Lo 4yN f FFTI r / � 2 - zx8xiy i i C.Or�*9s iT A1N, ti i z II a 0�p v 7 7— �v s, 7 � � 7 Ma r � 41 W �v 0) . . , yi w �-7 7-- Assessor's office(1st Floor): �� _ "1 Assessor's map and lot number Q�oF 1Ne TO`♦ Board of Health(3rd floor): Sewage Permit number ?`la- J • Engineering Department(3rd floor): r Z BSBasTSBLc. J rasa House number ��° 039' Definitive Plan Approved by Planning Board 19 �Y0y b APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDIRG INSPECTOR APPLICATION FOR PERMIT TO 01;dk ' TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following /information: Location Proposed Use T,'1• ct; r"� �.^a'x. ( ,1 '.� e�c7 c > ;lrrw,s Zoning District i I Fire District '. Name of Owner /�a/f.�r`> + i �r"• C 2 jddress A%A,;� Name of Builder : a }"J // 1,e< 64,1 Address Ate' Name of Architect ' > Address Number of Rooms Foundation Exterior 442.4 tam .5,�.str` � ,r Roofing e CJrf''.4e.Z Floors Interior Heating Plumbing Fireplace Approximate Cost .. Area >o Diagram of Lot and Building with Dimensions ` - �.� Fee 1 f � C 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 McCARTHY, JOHN H. & --MARION A. A=021-046 No 33171 Permit For BUILD UTILITY SHED Accessory to Dwelling Location 25 Oxford Drive Cotuit Owner John H. & Marion A McCarthy Type of Construction Frame Plot Lot { Permit Granted August 290 19 89 Date of Inspection 19 Date Completed 19 Assr or's map and lot numbe 4.6 (/ wif'L Sewage Permit number ...........(!'..V /.................................. -A} y BAHH9TA.DLE, i House number w, N.-i............................................... �� TITLE 5 sa MAea r t6}9• 9 ENVIRON�+FN7AL .7� OypY A'\ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....�A.U. D....................... ... ....................................................................... TYPE OF CONSTRUCTION ......LO.51.9- ............ [>We��%.�.C................................................................. f cTo t' s.......197.` . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordin4 to the following information: Location �'� 2� J t b'Tv t i /��b tl...................... 5'.... x.......... .1�....... ................................ ........................................... ProposedUse ..... LLB+J C................................................................++....................................................................... ZoningDistrict .......... ... .................................................Fire District ..... V j. .................................................... Name of Owner��N�..F'1' !ARIvN �►441RT1'j�ddress 88 M iXJC S� �&-, ........ ...... ...................MA S oZ t Nameof Builder , ......Address .................................................................................... Name of Architect �.�.4' 'V.. s!.9''u & ,Address ZAS ,051.14A.4 4.4. �.!�At�' Ss.:l,'C �' A�I•rV Numberof Rooms ...... ........................................................Foundation ....40!VCR�T................................................. Exterior ...... W ...... 7G..................................Roofng ...... pp( T..................................................... d S �o 4TFloors 1 OdA.........................................................Interior .(!R T �.�.................... 5... Heating [` T 4�!44"*....b. ..V+ �.�'.........................Plumbing ... ...,}�,ATN.......................................................... Fireplace .......QNC................................................................Approximate Cost SQ. 000 ........ ............... ......... Definitive Plan Approved by Planning Board _____ ___________19________ , Area Diagram of Lot and Building with Dimensions Fee ... . ...�f..... .......... SUBJECT TO APPROVAL OF BOARD OF HEALTH ��• Co . N N N � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ............................. McCarthy, John H. & Marion A.21831 ... Permit for ...... 6-t-OrY—dwetlIng ....................................................................... Location .....I.Qt-1-67.... ........... ......................C.Q.tui.t............................................ Owner ...... -McCarthy Type of Construction ........f-reme....................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ...............Nov. 11........19 79 Date of Inspection ....................................19 Date Completed ....//79.-$?#............19 rrPERMIT REFUSED 4 ........ 19 C .............. . . ......... .... . . ....... ..... ............... m ............. Appro ......................................... 19 ............................................................................... Assessor's map and lot number. ........... : .. �''� Bpi?HE r�� yy b�Q yow Sewage Permit number ....:-.��..z,af. ./:............................... BAUSTADLE, i House number':................ .. .............................................. ro rasa p 1639. `00 D Mix a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... .......:!. TYPE OF CONSTRUCTION p. � ) "' D t.1`"``•` t J 4'. ..................................................................................................................................... .................:..............................19.! TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............. ...........`. .. .:.:`........?........ ..:........................... .... 1.............................................................' ProposedUse ......—..................... � ....c......................................................................................................................................... wo ZoningDistrict ..........:t.:. �....................................................Fire District -r�. !...f..................................................... Name of Owner .........................'..I ::I:5:1 0 a�:.....:r'.�:..........:�?Address .............................................................5 s+r ' ` i `f....:...............:. .. .. Nameof Builder ' ...':.........! ...........,:.....:..:`:..........Address ..................................:................................................. Name of Architect t .j .„.,•: e „ i�1 Address "'.... :...:' :...:.r ?'.. .:.......� ........: :'fi......::..'........ Numberof Rooms Foundation ' ' r....................................................... ......................................................................... Exterior ........!:. ................. ..`.....................................Roofing ....... "!':}......':��...................................................... h Floors " " .Interior °j ' ` ..........:..............:............................................................ ................:.......:........... ............................................. f Heating ...................................................................................Plumbing ....:........:.................................................................... Fireplace .:................Approximate Cost :_a �' '............:r:............................................... ............. ... ..... .. ....................... .... ...... ..... ..... Definitive Plan Approved by Planning Board ---------------_-_____ r'r 19- ----. Area -...................................... ? Diagram of Lot and Building with Dimensions Fee ........, .:.. 1.......:.. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 1 � 1 r S r 1 - /1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name AA : .. "'.c..... ......::':::: ."'.................................... i ' ' � � - � ............................................../ . ...... . PERMIT RE�USED ' 1,f� --^----'—'--''—'^^^~----- � --' Approved `.....°.. � w~ � -----------�[—' '-�'' -----' ................................................... '