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0102 PINEVIEW DRIVE
c w _ .. 1 �. 1 ✓' E rn � �. ti � I V II P f .1 Town of Barnstable *Permit# 0 �� Expires 6 months from Issue date X-PRESS PERMIT Regulatory Services Fee S, 00 JUN �, 2006 Thomas F.Geiler,Director Building Division TOWN OF BARNSTABtAin Perry,CBO Building Commissioner g 200 Main Street,Hyannis,MA 02601 www.townbamstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number D4a /oci-5 Property Address ►oa Gkz JCS �Ot�1� �rl [Residential Value of Work �Q Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Aec_ 1�l)Sa y-1 1 b3�nv J��A A_. �niu i ► i t Contractor's Named l.l�YL t"L�UVYI lV►)1(y1 �Ik _VAG. Telephone Number�55&"Z ' a414126 Home Improvement Contractor License#(if applicable) t i g AR4 Construction Supervisor's License#(if applicable) iworkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [�I have Worker's Compensation Insurance ` Insurance Company Name �:j�JCx 1 a. Ge _Ell l,,.W t-!ST1_rz. Workman's Comp.Policy# �d S Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows. U-Value •33 (maximum.44) *Where required: Issuance of this pernnit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: P must s, r erty Owner Letter of Permission. o Improve nt ontract s License is required. SIGNATURE: Q:Forms:expmtrg Revise071405 Department of"Industrial Accidents ' Office.of Investigations, ' . 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Planabers Applicant Information Please Print Lezibly Name (Business/Organization/Individual): �ec'- `J�Ora ►0YY1 -IVItAk AC. Address: �t 5-,fox (R-73 City/State/Zip:&, taU j��e 1,1K Oa&ZA - Phone#: "agQS Are ou an employer?Check the-appropriate box:. Type of project(required):. 1. 1 am a employer with Z 4. ❑ I am a general contractor and I 6. El New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet $ El Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. workers' comp. insurance. g, ❑ Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.[l Electrical r ais or.additions required.] officers have exercised their ep 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers' comp.. C. 152, §1(4), and we have no 12, R.00f repairs insurance required.]t employees. [No workers' comp.insurance required] 13. Other *Any appliesat 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 tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. 1 am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site information. Insurance Company Name: A��Ocla�ec� ' YYl Policy#or Self-ins.Lic.#: o��J'�6 �OO S Expiration Date' :- 14, a Job Site Address: �Oo� T1Ytt?Jl�t��r CO'kUe� �� City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,00 and/or one-year imprisonment, as well as:civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby r an pen Ides of perjury that the information provided above is true and correct Si-mature. Date:. Phone#: _11�ko cam- Q-0,1AS Official use only. Do not write in this area,to be completed by city.or town offieiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: y 1 f �. Town of Barnstable Regulatory Services UL t Thomas F.Gefler,Director Building Division Tom Perry, Building commissioner , 200 Main street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must t Complete and Sign This Section If Using A Builder as Owner of the sub)ect property 1 hereby authorize to act on mp behalf, r in all matters relative to work authorized by this building permit application for: (Address of Job) Za e of O et Date �tiSfln� -�J— L T ; Print Name a � Q:FORNS:OWNEMRNn SION i• i ✓ftC C�JdrIt77tl1rtU/CQ�L�;G� (�GCLd1CNA2Ll0@�.6 . Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: . Board of Building Regulations and Standards Registration: 118494 Clem-Ashburton Place Rm 1301 Expiration: 271/2007 Boston,Ma.02108 Type: DB.A BAKER CUSTOM:ALUM&VINYL-INC. MARK BAKER 521 SHOOTFLYING HILL=RDA . CENT�RVILLE,MA 02632 Administrator $ ' Not valid without signature ., f — Let 6/12/2CO6 Time: 2:28 PM TO: @ 7,15087906230 Dowling 6 O'Pleii Page: 002.002 Client#:9742 2BAKERCLI ACORDT,., CERTIFICATE OF LIABILITY INSURANCE a6i�a/os,YYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 222 West Main St.PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. . Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A, Harleysville Worcester Insurance Co. Baker Custom Aluminum&Vinyl,Inc.P O Box 923 INSURER B: Associated Employers Insurance Comps — Centerville,MA 02632-0071 INSURER C: ------- INSURER D: INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIRSMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT,i O WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE PCLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUICN POLICIES.AGGREGATE LIMITS SHOJVN MAY HAVE BEEN REDUCED BI PAID CLAIMIS. POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMJDD,YY DATE MM/DDIYYl LIMITS A GENERAL LIABILITY CB331748 04/19/06 04/19/07 EACH OCCURRENCE $1 00O 000 X COMMERCIAL GENERAL LIABILITY OAMAGE TO RENTED PP.FfAISES I. occu-n>-e' 'i100,0D0_ CLAIMS MADE 51 OCCUR MED EXP(Any ona person] .a5 0QQ X PD Ded:250 PERSONAL.&ADV INJURY 51.000 OOO GENERAL AGGREGATE 12,000,000 GENL AGGREGATE LIMIT APPL ES PER: PRODUCTS-COMPIOP AGG $2 000 000 POLICY PR.O- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT g ANY AU TO (Ea accident) ALL OWNED AUTOS BODILY INJURY � SCHEDULED AUTOS 'Pa.poison) HIRED AUTOS BOfi:LY INJURY � NON-OriRJED AUTOS (Per accident) PROPERTY DAMAGE (Par accidenl) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO FA ACC :� OTHERTHAN • AUTO ONLY AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR r7 CLA MS MADE AGGREGATE a Y DEDUCTIBLE - - REi F.NTION $ B WORKERS COMPENSATION AND WCC5002454012006 D4/23/06 D4/23/07 X Tnwc-RY LI ITS R v EMPLOYERS'LIABILITY AN"PROP RIFT OR/PARTNER/EXECUTVE E.L.EACH ACCIDENT IS100,000 OFF ICER/MEMEEREXCLUDED? E.L.DISEASE-EA EMPLOYEE S100000 If yes,describe undor SPEC AL PROVISIONS bebw _ E.L.DISEASE-POLICY LMIT s5000OO OTHER DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements, Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable-Bldg. Dept. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVORTO MAIL ,JD— DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis, MA 02601 IMPOSE NO 08LIGATiON OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 $43183 LS1 G ACORD CORPORATION 1988 It C ,T Town of Barnstable *Permit 00�56 t Expires 6 Months from 'sue date Regulatory Services Fee 2008 Thomas F. Geiler,Director MAM 9�P 6 q ARKS-fABLF- Building Division Perry,Tom P CBO, Building Commissioner y, 200 Main Street, Hyannis,MA 02601 wwW.town.barnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY - Not Valid without Red X-Press Imprint Map/parcel Number - 35- Property Address t� P,.d c.. l I ti �l�t l u G��� Residential ValucofWork W,40 8. O J Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address S J S A,b! NE-1 L iYri f" j it � Contractor's Narne JASd-4 M W- a Telephone Number Home Improvement Contractor License# (if applicable) ZW O ❑Workman' Compensation Insurance C ck one: 141 I am a sole proprietor `� ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. IPermit Request(check box) . r11 ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ e-roof(not stripping: Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sli.ders. U-Value (maximum..44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:\WPFILESTORMS\building permit forms\EXPRESS.doc valid for individul use only istration 1f found return to: .:ense or reg date. !' iratiop Standards before the exp Regulations and Board of Building 1301 1,•.,r,l of►" shbuCtou Place Rru HGME IMPROVEME� One A N1a 02]08 139369 ,Tr#* 33345 Boston, . Registration� # n- Exp�rat _7 112009 YI-J€ t�:-: _ ithout signature JMMEXTER'OR 'r_ %l NotvalidN S � ~` 'r JASON MARK ti�� f..� % istrator 25 BACKUS RD. E.FALMOU-f MA 02536" r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street �< Boston,MA 02111 W . 'www.mass.govldia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le gib Name(Business/Organization/Individual): . �OVv A'2 Address: City/State/Zip:j • �4L M"IL4 MA. oZ'S 3 b Phone.#: Are you an employer?Check the appropriate bog: :Type of project(required)-.. i.❑ I am a employer with 4. I am a general contractor and I 6 �remodehng construction.. employees(full and/or part-time)•* have hired the sub-contractors `� listed on the-attached sheet 7. 2.L I am a'sole proprietor or partner- These sub-contractors have g• []Demolition ' ship and have no employees 'working for mein any capacity. employees and have workers' 9: ❑Building addition comp. insurance. ' [No workers comp.insurance 10.❑Blectrical repairs or additions required.] 5.. We are a corporation and its 3.❑ I am a homeowner doing all work . officers have exercised their l l.[]Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12•[]Roof repairs insurance.required.]t c. 152, §1(4),and we have no employees. e to workers' 13.0 Other � y [No' comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 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.Lia#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the•violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the t)IA for insurance coverage verification. I do hereby certify unde ain perjury that the information provided above is true and correct: Si attire: Date; -7 Phone#: �d Z Official use only. Do not write in this area, to be completed by.city or town official. City or Town: ' PermitfLicense# Issuing Authority(circle one): :1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and mstructi®ns Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter,152;_§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not pro.duced�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,it necessary,supply sub-contiactor(s)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Comp anies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members*or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town 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 fo any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. e Commonwealth of M.a=chusetts Depart ent of Industrial Accidents Office of Investigations €l�Washin toid!Street B.astonx_MA 02111 TO. #6.17-727-4900 ext 406 or 1-877 MASSAFE Fax#617'-727-7749 Revised 11-22-06 www.mass.gov/dia oFZHF, Town of Barnstable Regulatory Services J Thomas F. Geiler,Director �A 163q �m rFo. �a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize J,45bd MA eug to act on my behalf, in all.matters relative to work authorized by this building permit application for: t AA S (Address of Job) ignature of O net Date Print Name C If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. r- Town of Barnstable of tHE Tp�� y� o Regulatory Services Thomas F.Geiler,Director w BARNSTASM .� t, MASS. i6s9. Building Division �rfD �a Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 vi ww.town.barnsiable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HO]%1TOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as Supervisor. DEFINITION OF HOMEOWNER , Person(s) who owns a parcel of land on•which he/she resides or intends to reside,, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1,1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department mum 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.I-Licensing of construction Supervisors);provided that if the homeowner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor." ware that they are assuming the responsibilities of a supervisor(see Appendix Q. Many homeowners who use this exemption are una Rules&Regulations for Licensing Construction Supervisors,Section.2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. i- N Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 640 Parcel 01 Permit# l ,/Health Division ,;? Date Issued ✓Conservation Division Fee 7T 1/0 ✓Tax Collector.`I � SEPTIC SYSTEM MUST BE ✓Treasurer co `� INSTALLED IN COMPLIANCE _ WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS r Historic-OKH Preservation/Hyannis _Project Street Address Fi IN . View Ov E . 'Comm c — MA: Village /�2s Owner Address 10Z. N€. QtEw DQkuF- Telephone 4 2-0—4 I Permit Request 14 x (y •SC2Er`ro f d 0-c-H A"o l i S%j tj -Drcic Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost 2-4,o o o Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes O No, If yes, attach supporting documentation. , Dwelling Type: Single Family Two Family O Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ).Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new��y—�� Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other r Central Air: ❑Yes ❑No 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 �ZAiQ 13 . KS o Q Telephone Number Address a- 'l [MA iri License# 05-0 8,a9 t-tr Z-0 tCit �1/�A- 6d to K.�_ Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Co 13 , 00 r FOR OFFICIAL USE ONLY ' 1 MIT NO. r i DATE ISSUED r ` MAP/PARCEL NO. f ADDRESS VILLAGE 't 4j :j 'OWNER-, Y �a - r` DATE OF INSPECTIA'N::- FOUNDATION -; . r m FRAME l g 000 + INSULATION 2A 6 - FIREPLACE ELECTRICAL: ROUGM =` _,. FINAL yGH� >+ -FINAL PLUMBING: ROU GAS: ROUGH _ FINAL r _ y -FINAL EUILDING A ' -�,: fir'.` - • � . _ 1 i DATE CLOSED OUT 1 1 ) 1 ob ' ASSOCIATION PLAN NO. �s .a 'and lot number ... Q. . 3 �Ssessr. P �.,... . THE TOE 7 ..:.. . : .. . , e,iage Permit number * Z 13ARNSTADLE, i House -number ................................../.�6.2........................ 9� N 6 0 p Gr c O 1 3 9. o Mix a• rEQW, N OF BAfRNSTABLE jfvt Ti � D� °,� rm � � � TIO nt! I L D I N G I.H S P E C T O R APPLICATION FOR PERMIT TO Construct ................................................................ r TYPE OF^,CONSTRUCTION .......:.............. ................... ... ............19... E 4 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:. Location ..:...Lot 25r Pineview Dr. Cotuitr..Ma• ..............................................' " . Proposed Use ............... .....Residential................................... ..............................................`...................................................... ^... Zoning District ..........RIC:......................................................Fire District ......GQt11Ut,...P ...:............................................ Name of Owner Cedar.Acres„Real..................................`. Address 2A..Gx>✓at..PMd..Dr_.....Sa ..Yai umuth,,..Ma...... Nameof Builder ......Ste.......................... Address ..........:..................:...................................................... Nameof Architect-....NIA......................................................Address`....................................:...:.................. Number of Rooms ....`........................... ...............................Foundation .:.:..poured..COL1Cret�...................................... Exterior ................................Roofing ............alpha1t..Shingle...................................... Floors .........................V-11VOOd.............................. ...............Interior ..............skleet..rock........................................:........ Heating1. s°?..--...gras.............:............................Plumbing ...........I..1/Z..#fatkair................................................ Fireplace ........one................... .........:....Approximate Cost 25"r004 . ............. ................... ....... . . .................... ............ . ... .. . .... Definitive Plan Approved by Planning Board _ p �___�3_r-._----___-19__73_ Area ...../ .. c ....S �..... Diagram of Lot and Building with Dimensions Fee } ...................... SUBJECT. TO APPROVAL OF BOARD OF HEALTH IN 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. Na ........ .... .. . ...... .. .. . ......................... Construction Supervisor's License ...:...016681 CEDAR ACRES REALTY TRUST It . , . No .2.570.8... Permit for .One Story.., . ... f Sin le Famil Dwellin Location ... ot....25,....... ...Drive Cotuit ............................................................................... Owner ..,.Cedar Ac.res...Real,ty...T t Type of Construction ......FraMP....................... ................................................................................ Plot ............................ Lot ................................ Permit Gron'ed .,,October 28 , 19 83 Date of Inspection ....................................19 Date ,Completed ....... .``✓: .........19 7 TOWN OF BARNSTABLE 2570g Permit No. — -----8 - Building Inspector l aus�T�a Cash OCCUPANCY PERMIT Bond ------____-___-_---4 �c� Issued to Cedar Acres Realty Trust Address lot #25 102 Pineview Drive, Cotui.t Wiring Inspector / Inspection date Plumbing Inspector c Inspection date Gas Inspector Inspection date Engineering Department �f, 4�5 ' fir--. Inspection date / � - r Board of Health Inspection date -If f 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. ............................................1 �.` 19.1. s /'....... ..................... :..............................� .........._....... Building Inspector - _ - FROM . S • k TOWN OF BARNSTABL E- B[3ILDING DEPARTMENT' Mr. Francis Lahr 367 MAIN STREET . HYANNIS, AAA Qom! J(��''���������� �(���®�'yyamr�=} [j}�q Q r +�{w{�w■ •6om L• exk (�i\S7 V• '1�-i f 6V • + WRdF•i Ut @e 1eS F?k r99a o 8p L� "may. � - - � • � , SUBJECT: FOLDHERE .DATE. ,. MESSAGE Wo Sk C9©LT7lEt8d3:C11t2J7{�g' r AcrestZPdl ` #ItISt Please release Band. _ �"9-aY.R un.M.M 3•x.N a y..;is x.M 9s+r+r.M�F"f✓r W.iM n'!^••.,p"!�ws M,x M�MF a.v+Y'NF'Y • . 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Y h f 11 ,a} 4: e Mi i �x°" F S 3,. b ' •� r" w � I �7..t. _.,.`.,.»...';»..a..t_..,..�--t..-.,:1.__r___...�r.r...«.»....ta!__•__ll...__ ..r:.'i7v.,..,;a,�....._.� ..•A:a,a. �;.a,...•.`S:.-_.._.', - ...__j..!W1':..C....w.�i...s..�..'- - - .- ___, The Commonwealth of Massachusetts c Accidents 1Er^.i =- Dep6Q0lIIDYe A; • _ _ St%g81/OdS 600 Washington Street ry_ r Boston,Mass. 02111 ' �: •Workers' Com emdon Insurance davit 10! imijul t ►ocation� i city g all work myself ❑ I am a homeoa+ner p in any �I am a sole and havo no one i ///%////,%/ ogees workiag on this job.:.:::::::.:.:.:::::.}.{:::::..::.::::.:::::::..,,:::,:,,,,....,:.:.. l r. 7.... an ,ppr� �{ r'.r } vim. . :::::•._.:.......:::..... .... ,.,c::k•� .r.• >t,.r.. ,..�:�.esEootA. .. � � -• ..{ws.{4w.....:.• q,�o�:.;,.,;-.::::•:::.i:•}is•}};:�::;.:<ir::i::;::>:.:{,;:::•r:.;::;•::;::":•`; IN �..: .....:...:.... .:..� .•} �' •. ,M1.14.};•Y}}r{Yv;h..:::::rh}::}x.,i}}}}v?:•?:}}•:n:::':...:::•..:?::iiii .:.....}.;•..}:w:::::-n:v:::•i.••:::::::,..: snv name.. :..}�.,. .. ....... ......... ....... ..... ..x:�..�.9... :..h .... ....., ♦ ....:i{{:.,{.:::•..........;.',4.vh....,.w:::..::::::...::i:;..i�.v::.::•.:{Li:4::•?ri�i::�•....:i:•}':•i{vi:viY::i..:' .... ♦nr:....,,v,•r•x'n.',}.:$F�::V •.WIN,..r I��De:��..,:� •::.�:..::::::.::::::::•:.�•:•::.4.....:::i:'<>:-:; : .:...7 h,...,.. ,. :. .... ...... ..::.........::............ ..•...,xr�,7,N, .Y�.l...y'"�- uY�r... .. .... .. ... ...........;v., ii+iv:{•}:i:$ij:5{•?!Y•7:L?}-rh�:�.iY::Yj? 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OfaOoeIIPtoS1.S00.00and/or i >mder g�ionl.�!► of of MQ•1St mtbmd to the of erbmdaal pmaltits that e FARM to secure � ��foam a am woo ORDER tad a One of 3100-00 a day against me• I emde� one yeas'imprisonment ssma ns eiva pmoltinjSkVvSjjPjj=of Ore DIA for�osresate vaiSeatlam. copy of this statement ms7 be forwarded to ibe 08]oe of drat the information provided above is true and coned I do hereby certify under the pains aced penalties of p� � p r S ^ o ,- Date Print name do not write in ibis unto be by�y orb om� omcw use only De arnnew peradmeense fl Oland sin P city or town: Dlicensing Board ❑Selemnen's Ofte ❑c"if immediate response is required ❑Health Department phone�h Other contact person. Information and Instructions section 25 requires all employers to provide workers' compensation for their Sassachusetts General Laws chapter. 152 s e�an in the service of another under any come quoted from the"law",an employee is defined as every P :-nplovees. As qu . f hire, express or implied, oral or written co oration or other legal entity, or any two or more of - association, rP :n employer is defined as enterprise,p '' legal representatives of a deceased employer, or the recei�er or �e foregoing engaged in and including 1 emplovees. However the owner of a -ustee of an individual partnership,association or other legal entity, emP Dying house of not more than three apartments and who rmdes therein, or the occupant of the dwelling o - or ;welling house having repair work an such dwelling house or on th. } pother who employs persons.to do maintenaa� bed be an employer. ,uilding appurtenant thereto shall not because of such employment ev state or local licensing agency shall withhold the issuance or renewal AGL chapter 152 section 25 also states that �' in the commonwealth for any applicant who has if a Iicense or permit to operate a business or to construct buildings coverage required. Additionally, ne� iot produced acceptable evithe dence of compliance =9 contract forthe performance of Pubh :ommonwealth nor any of Its Political subc work.until divisions of this chapter have been presented to the contracting acceptable evidence of compliance with the authority. . . E=��//�//r.�������%�� �ppiicants and Please fill is the workers' compensation aff davit co®Pley� ' g the box that applies to your situanon �� address and p�numbers�g wIth a certificate of insurance ash affidavits re its be and supplying company Acci�for.ae of insurance coverage. o be su submitted to the Department, a z �or town that the application for the permit or lic=se is date the affidavit. The y'�have my questions regarding the "law"or if you b eing requested,not the Department of Industrial AccideneQt member listed below. arerequired to obtain a workers' �Pe�On Pam'P��the Dep 11117-7 WRimmmogg City or Towns • Department has provided a space at the bottom of the yit complete and printed lColy the applicant. Please Please be sure that the affi i has to contact you regarding affidavit for you to fill out is the event the Off Ce of giber. The affidavits may be returned t" be sure to fill in the Pie number which will' used e a � the Department by mail or FAX=less other a=&'ern have been made. 'ons would IOae to thank you is advance for you cooPerrtron and should you have any questions. The Office of Investigate please do not hesitate to give us a cWL `07 The Department's address,telephone and fax Cr.memb The Commonwealth Of Massachusetts Department of Industrial Accidents orrice of tmiesnuaUons 600 Washington Street Boston,Ma 02111 faz#: (617) 727-7749 phone#: (617) 7274900 ext 406, 409 or 375 no CMdR Appal s J TjWa.1SZ.lb(eondaaed) Sated with Fossil FaeL • PmaPdu Pa�tar Oae rind TwaF=N l'Rdldmtssl Buuwp MINIMMAXIMUM Hes=B/Cooling Baste may' (}lsang a1a�8 CastE Wall ,E oor Wall Pam Fla Area'('A) U-vaj. R� R•vaiuet Rwald R vgld P=iame _ 6500 Deese DsvO 6 No=sl Q 1Z'!. 0 38 19 10 Norm 19 19 10 6 R - I2% OSZ 30 19 8 12 l0 6 8S AFUE 1 0� ' 38 N/A . Nomrsl 13 ZS NIA Norm T 15% 03- 3= 6 U 13X 0 ` 38 19 19 10 8S AFUE p - NIA - QUA V 1S'A 0 " n 6 8S AFUE W 1SK 30 19 19 10 Normal 25 N/A NM g 18% 3= NIA NIA Nomeal ..38 i9 � 90 y 1VA _ 13 19 t0 6 . Z 18Y. 6 AFUE AA 19 19 10 ti 1. ADDRESS OF PROPRRTY: Am 2. SQUARE FOOTAGROF ALL EXTOR ALLS: 3. SQUARE FOOTAGE OF ALL GLAZING. 4. %GLAZING AREM#3 DIVIDED BY 92): S. SELECT PACKAWQ—AA ' G ENERGY REQUIREMENTS NOTE: OTHER MORT-WV ?fIODS OF D ARE AVAII LE. ASK US FOR THIS INfORMATIO BUILDING INSPECTOR APPROVAL: NO: YES: q-forms-080303a s 780 CMR Appendix J Footnotes to Table JS2.lb: assemblies (including sIidinD glass doors, skylights., and ' Glazing area is the ratio of the area of the leg ace,but excluding opaque doors)to'the grosswall. f,, basement windows if located in walls that enclose conditionedaria may be excluded from theb-value i•equiremetu. area, expressed as a percentage.UP to 1/o of the total glazing des{ with 300 ft of glaiut7 area. For example,3 ft of decorative glass may be excluded from a building gn ; Jan 1, 1999, glaring U-values must be LeSLCd and documented by the manufacntrer;in accordznce' f r After ' Council (NFRC) test Procedure, or taken from Table J1.5.3a. U-values are for the National Fenestration Rating whole units: center-of-glass U-values cannot be used- truss construction. If me emulation achieves the full ' The ceiling R!values d° not assume awed m' oversized , R-30 insulation may .be,S6 i.1ut'',d 'for R-�38 insulation thickness over the a=OT walls Out �Pa d R-38 insulation may be substituted.for R-49 ftw lation• Ceiling R-values represent the sum c miry insulation an Ce•�gs, insulating sheathing must-be'placed'bei,�vilen insulation plus insulating sheathing(if used)• For veatilated the conditioned space and the ventilated portion of the roof sheathing if use Do not' include eM the stint of the wall cavity insulatton Plus insulating g (� Wall R-values represent For example,an R-19 requirement could be met EITHER exterior siding, structural sheathing,and interior�L sheathing. Wall requirements 'apply to insulation plus R-6 insulating S• , by R 19 cavity insulation OR R-I3 cavity om�but do not apply to metal-fraate eonsuuction. wood-fratite or mass(concrete,masonry aces', baserii�etlts, s 1 to floors over unconditioned spaces(such as unconditioned crawlsp` t The floor requirements apply or gsrages).Floors over outside air must meet the ceiling with anrequirements. a stage depth less than 50'%below grade bust •The entire opaque portion of any individual basement Wall c_e the same R-valve requirement above-grade .walls. Windows and sliding glass doors;`'of''conditiohed m Basement doors must meet the door U.value'requireti'ent basements must be included with the other glaring. d_scribed in Note b. Add an additional R 2 for heated slabs. 'The R-value requirements are, unheated slabs{use Compliance approach 3,4, or S. If you:plan'to install�$T1 re ' If the building utilizes electric rrsistaace heating piece of cooling equipment, the equipment with the 164' est than one piece of heating equipment or more than one p' p the selected package. efficiency must meet or exceed the efficiency required by see Table I52.1a For Heating Degree Day requirements of the closest city or town ' 1 NOTES: levels.Insulation R values are minimum acceptable levels. a) Glazing areas and U-values are maximum acceptable and do not include structural components. R-value requirements are for insulation only r than 0.35. Door U-values'must''be't�ested b) Opaque doors in the building envelope must have a U-value no greats procedure or taken from the door U=value and documented by the manufacauer in accordance with the NFRC test p an aggregate U_vaive raring for that door is not available, include'the in Table J1.53b. If a door contains glass door U-value to determine cote;.,—is 1;:of'th6-1dbor. elass area of the door with your windows and use the opaque value greater than 0.35). One door may be excluded from this requirement(t.e.,may have a U- a ceiling,wall,floor,basententwall,slab-edge•or crawl space wall component includes two or mo .e "- as'a to c) If g, _ dial to different insulation levels,the component complies if the area corn onen comply if areweilit d abera' e U- the R-value requirement for that component: Glazutg or door p _1ii value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). , ..; � a 43 �, . . .. r. _. __ 1-1- -----II-,-,.,-;I-%-i;,,,_-.:.I.I%�1-'.-,�-1,I�--,-.--�-E--,;-7�.7-----..,-;.I.,."-7�-:I1,�,�-I_..-�-,,-��--",,.-�-.--..�-.---h"-#:I-.I--,�-1----.,:1-.-�J-,-.i 1-��,----I�--.',�_,1-...------I---,.,--�-�-:—,..i,�.1.-I,-,-----�-,-...g1-..---,,-�:---,I-,,I,,-----�.--7--1,"II�--1,.�:�-I�:--.:.------,,1�-�--.-..�-�-.,I:n--III-:�;�—_,�-,-,--,..,-----..,,,,,,�".--.."-,I,�:--"":--7-,...�77-�-1�,�:�l-.I--..-1-,I--.I,�-.-,-.--�lI-1-'.-. . .._;,"i-7, - _.-.---,.,I--1--.I...�,i-,-7�.,,--,.�.�-,.--�,,.II,.-k--.,----1.-.I.1,,...:.�-.,-5,..-.-1-,-�,.�.-.-�,.I"-1"--�-.�-I--I,,1<.-,,�,�..-1.-.-,:-I,-,-,.,:,-.�.�--..--Io--.-1.,:,--,---�..,-,-..-,1-�w.-.-!,�---.--I..,.�..,1-�--.I�--,:,1,.1--I,.�:_.---1-I.,-1:.,1--.--�,:-I,--,.,_--.I.-.7-,.-_,.,-1--------..�.:-I.I--.---1-1-1",,I,-.I:.,------.;--1,:.----.-�.��-�--I-,.,-:.'--�I.1l, ,..,V,-I.III-z11_l,,�1,1_.-.�,1----.--,.-,�--.,l 1.1-�..I�,-;..-,-.-.---I.-I-,-�,�1:--,,�--.---%.-:.I...,,1,.I-,,--------:-��-I-Il.�-.�-..�--�-.-�"jl.- 1-.'-,��,L_--.-,-:�-,I...1,,,--I----..�---.�---,=��1---,�-1I----...-.-.-,-II,-,...I.�-----:--I I,��1,,,,1�--.,---��1.--I-.^k-�,--:-.,-..-.--I-..:.--.-1-�:1--I-,,----%i,7-."--,1,--I7,�..--1—.,--I.,--l.1..-.1-_,-1---,-1.---..,-,-�-..---1-�-.;-�.--_.-_--:--:"1-;---I..�-.!-l1--.--1..--�-,�,-.L:�.,7, ,,-��..I-11-I�I....-.,--.-..�w�--"..-;---�1�1.l.%.I,�.I--.I-----�.-,-,:--�.�.�--I.l--,-1.,,.,--1.%�-`-..1-,1�--��.-.��:,-1,.-.i,,.�-,..,��::-..I1-II1�-,-.:-...-,l�l,_�,,,.--.I- I,-,-...-.11----,I,—,-11-.—",I,:..--,.-.I-,":,.I-:-,-,-.�,�.I-I�1---.:,.-�-.�..,1 I-,1I-I-,,7..-".I:1",-,-..",�,.,..-,,-l.:.�,I_.—I_-,-�.���1-1.-�::..r.1-.�-:-:-1�-��,.,"-:�",-...-,,�1-,-���-"I",--.I,-I----,.I�.I--...-,",,�1---,.-.,.�1-'.:�-.,.1:.Ie--.I-.-11I��.:-I-.�-.-.-:-..I."-',.,.�.,,-:-"-,,,-.-1c.--..:.�.--"--,...I.-l..--+.--..-�1.�,:--,1.I.,..,.:.,�,..,-,.-..,:�--,,,IZ,,I.,�I,,--��.I,,',,,,o..1�I,�11.1.:I.-,....1-,,-.,.---.--.�"-4..I-.�------�-�--�-,..I-.-,-,�--,---;-1.,-----.,�,�--�-,-"-%�,,�.-�--.--,�,,.,�-:,-��-.I�I,,..I--�i�--.,I:--1-,-.�,--�----I,�...-,.-�z,.-.-1.,,",-�,.1-n�--�-..��.--:--:�.�.--1.-.,r�..-1-.-..I;1-:I�,-..-..,�-II-,.,.; ,�.-:-,,2�—.,.�:.--.,,�,.�l-1---,..�.:-..:.,..!,...-�-ff.-7�7-..,-�--=..,-;-1�.I-�-1,-.,-,.1-.,,.1,-;,.�-,�.,:,�.--:�,....-':�-.,�t,..1-:..-..,.-II,-.-.--�I,.--.,1,.-.,.,,,��2-.--.I..-_..1..�-'--..l��,-,..�.�----".------..l,.-.---..-�-,I��-1-.-.�-,,.--.,,-1.-.-.:.,,�.:-,�.�.-7-,.�1,.r�i,--..,-11-1�,,,--"-..-..---,:-,-�,7-w,,.�-jI:.--;-..--.,I.,�..:.-.-.4��.,�,-..:,-I:,.-,T�----.�,-I.-:-----�-...,I,.-,�-.--,,�,-.-�..1-,..�.-".�,,I-..�,,-:4-1;.�.--,-',,�-.--..-,..-..7�,%._--�7,�1--%�-1t,--.-*1.6.,.-:.�:�.:-,.-:1-�,1-.-;,-.,1,-..--,��,�.�.1:--�-..,,,--:.--.1,.-_.-.-L:-%.-.,----;,..-.�..-�,,,.....l1.-,..-�..--..�--.-z-..,_,-,--:�,-.�.-;.--:.1'1-..1-...:.-�-.—.--�,.�,"-`1,,�.-.----��--,-,,,--.-.-,--,-,�.,...��,..—.,,�-:,I�-,,_-,�.-�---.--.,.":---I,�.-.....1%,,...,1--1,-.I,.--,I��-.l..P,�--.--I,-�,.,�.-----.-.-�-,-,,-.:��--":!1--,.-4--1�',,�.:------�-7-;.:---�-.-o;-I"---_-,,,-�I,�,,-"I-.�---.;�.f;..,.--;:-.--.-,J-.a.,-.--�1-��--�.,`,���.I-...-,-,-.-�,,�.,-�1-,.:,,7-�--.--�--,,-.Iz:.;,'-----;.,,-��,.1.-,,.'-1,-,.-.:::::::.-.:-.,:-I,,,-,-1-.,�..,,--z.----.I%,,l-�.--1������.-�I---"I—:,,-%-.-,�.�,I,,--.-I-:.l�I-.,-.-.,l-.-:-,--�---�� ackson Construction & Electric Co - -.1�-II-,-,,I'...-_,I--�----,--,--..---�1.-7,,;"�,`�-',�;l�--:-1-,,':��-11-,,,;�.]-..I.�-s'�:I I::l--.-:I.�-1,��.---.I4--:f--,--,lI'.-:r I.��..1.-�.---.:--,�7-�,E--1.,--.-----;l I:.-..:..�-��I-"-,-.._�"-,e--,"..1.1..---1!,l�F--,-1--�:--,.,�I..1,-;--U�.--.--'�lI--,.,,.-:.1,-�1-.:',--.,.---I-.�.-��,------�-1�.:-....-I�--I.,--.�-�,,.5---A--,I--"-,,:%��I.-�-�-.-:.-.l�-.:-�-,--�I ,--�--,--:..,�--,-:-,��.1"-..-�-.-.',.-.-;-,1_-I---.l-,,--���..1:�1���-II,.-.:.-�.--.,,,�L.:---,----,,�'�.-_,,-�-._,.E-I 1-'-,.�1-'r7---,..,,,.:-I,-.--",..-�-I-�..�,---I_A--.�-I,.�...,--�.---.�::--,-. 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B;RubR.S 3 te!L4 p,T AA 77 ZXg f I I x tm1 uN P � AN " .I7 _ ID#� ONN �3 r. h: IR I � 7 �° 16w 6Y'P (�� a�• �NOME'IMNUMIEN GON[RACTORl a -' b Regis ti6a• 065 �� I•d�lOD�' �.237G0; i � K n �Ype a t�t gn r u ADPAMSTanTQR Y" #73 MAIN-STREE r un NTCN � 3 •E� ,a, -`fin` .. -n'rtl?&.i`izs"i..1c All T�oryrz�n4�euiea�c o�✓�faaaacllt�teC/ k' DEPARTMENT OF PUBLIC SAFETY a;.. CO.NSTRU-I@M_SUPERWSOR LICENSE Nne�erg Expires: {'F x 273 NAIA'ST N HARWICH, NA 62645 J r I�O. O U --j 4-1 1t 1 Q Fo�x,o, N 3 1 Cl Q N PLAN SHOWING E0'° FOUNDATION LOCATION �WuN C O T UI T, MASSACHUSE T T S o w � _ w F_w '2u ow0 OWNED By:"ll tO Q►2 ca Q z LqW SCALE: = :C0 ' DATE, 6r—T & Z a` �- wo ui NORMAN GROSSM �AN------ REGIStEREOLAND SURVEYOR �4 J J Q I HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED W ` W J ON THE LOT AS SHOWN AND CONFORMS TO THE TOWN ����N ut �RAS'�Cy x < m OF BARNSTABLE ZONING REGULATIONS REGARDING a�. ��, 40 v, U. SETBACKS FROM STREET LINES AND LOT LINES . o NORMAN 4 QRMMAN 12715 Q ST NORMAN GROSSNAN R.L. S. DATE 0 SU�� The Town of Barnstable Department of Health Safety and Environmental Services P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-403 8 Ralph Crossen Fax: 508-790-6230 Building'Commissione: Permit no. Date {o 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. Type of Work: caeern-?C)ncti+ i. Sue LD'c V-- Estimated Cost c-P+{ ,a o C) Address of Work: t-O--a- , Owner's Name: N; t L Cam`'&Q W Q r- Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR 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. C9 �3 (DO 0 LS,) Date Contractor Name Registration No. OR Date Owner's Name q:forms:Afftdav 2t Assessor's map and lot number .. A ......,: of THe to �j Sewage Permit number .............G .. .. ..... ... .. �' d`" o� Z MARNSTSDLE, i House number ......................:...........! .s. .' ..,..................... so rasa O ld C pow 1639. \0� 'F0 MPY p• TOWN OF . BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...............Q nstruct.................................... ..................:.....................:.......:.. I TYPE OF CONSTRUCTION ........................Waod.F'T M. ........... .........c:"L..'.... ..:..... .............. ......................... s `s .19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location : q..?�!..PineviE.w Drr.r..qql U41 C... ?... ................................. ..................... ................................... ProposedUse ............. eSidential.................................... ............ ......................................................... ............... R Zoning District ......,... .........................................................Fire District .......C.Qt.t.,..NAe................................................ .Name of Owner Cedar Fixes Re 1tY. . ......................Address o...S��...yarmuth,..M.a....... Nameof Builder .......SC.. ........................................................Address .................................................................................... Nameof Architect: ....i/A......................................................Address ..:................................................................................. Number of Rooms ....................................................................Foundation ........Aimd..t7DM.Ite...................................... ak Exterior ............:.......... ................................Roofing ............c�2hi!at..Sb1.rg1?...................................... Floors ........................91VW0Q.d..............................................Interior ............sheet-rock................................................. Heating ...................... ..-'.z:C;c S. ................. t .......... _. .Plumbing ?.. ?',/.�:.x; iv?��,.....................:............... • :... Fireplace Me..........:..... r.................................Approximate Cost 5 00a............. Definitive Plan Approved by Planning Board _Sept-__21------------19__73_ Area Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 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. �-� ...................... Construction Supervisor's License 016681 P CEDAR ACRES REALTY TRUST A=40-93 ZYp/�� VVV , 25708 One Story No ................. Permit for .................................... Single Family Dwelling ............................................................................... Location Lot 25, 102 Pineview Drive ............................................................... Cotuit l ................................... ........................................... . Owner Cedar Ac es Realty Trust Frame Type of Construction .......................................... ' ................................................................................ Plot ............................ Lot ................................ October 28 , 1983 . PermitGranted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 i Es-r 4-o ►MI (Is �P tit (I z�