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1230 SANTUIT-NEWTOWN ROAD
,/ -� �r ^' f 7 f i f • e, Application number ....,� �.�, �. ®� .... BAR•wsrABL Date Issued........ . .� ..8 ......... �� � Fo s �0 Building Inspectors Initials............ Map/parcel. . Sip _ - ��--� �`3�• �t A OF BARNSTAPLE ETEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 12 3(3 NUMBER STREET VILLAGE Owner's Name: Phone Number 781 - 7 7 S- 6 eg S Email Address: n�(�eU L+,,,Q •t �o,,., Cell Phone Number Project cost$? ��p _ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Sep �-{�Q�� C'�.- �-�- Date: TYPE OF woRK ❑ Siding Windows (no header change)# 3 ❑ Insulation/We atherization ❑ Doors (no header change)# Commercial Doors require can inspectors review Roof(not applying more than I layer of shingles) Construction Debris will be going to GPI.1 4/74 q Piy/P// _ 51.--- I CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# 17 3 2-q (attach copy) Construction Supervisor's License# yg S 7 07 (attach copy) Email of Contractor Phone number0/" ALL PROPERTIES THAT HAVE STRUCT REs OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. T APPLICATION NUMBER *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X: , X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent df food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4.30pnL Commercial events may require Fire Department sapprowaL YWOOD/COAL/PEL L11ET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXLI2TION Homeowner's Name: Telephone Number Cell or Work number I understand any responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date FLICANT'S SIGNATURE Signature o Date '� - 19 - 4 All permit applications are subject to a building official's approval prior to issuance- Renewal Agreement Document and Payment Terms Andersen. dba:Renewal B Andersen of Southern New England y A. gl Rozana Andieu VA' ♦��♦ Legal Name:Southern New England Windows,LLC 1230 Santuit Newtown Rd. ♦ ♦ � Coturt MA 02635 ♦� RI#36079, MA#173245,CT#0634555, Lead Firm#1237 , . . . . . WINDOW RE wcernERr- 1.0 Reservoir Rd I.Smithfield,RI 02917 : • H:78.17756883 Phone:'866-563-2235 1 Fax:401-635-6602 1 sales®renewakrie:com''. " . d. Buyer(s) Name: ROxana Andrew Contract Date: 09/07/18 Buyer(s)Street Address: 1230 Santuit Newtown Rd.; Cotuit, MA 02635.` Primary Telephone:Number: 7817756883 Secondary Telephone Number: Primary Email:reandreu@hOtmailxom Secondary Email: Buyer(s)hereby jointly and. severally'agre'es to.purchase the products and/or services of Southern.New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor'),in.accordance with the terms-and conditions;described in,this Agreement . Document and Payment Terms,any;documents listed in the Table of Contents,and any other document attached to this Agreement Document, the terms of which are all agreed to b the parties and incorporated herein by reference_(collectively,this "Agreement): Buyet(s)hereby,agrees to sign a completion certificate after Contractor has-completed all work under.this Agreement. Total Job Amount: $7�490 By.signing this Agreement;you acknowledge that the;.Balance Due,and:.ihe Amount: Financed must be'made by personal check;.bank check,credit card,.or cash. Deposit Received; : .$2496 Balance Duet $4,99.4 Estimated Start: - Estimated Completion: Amount'Financed: : 8 to 10 weeks 8 to 10 weeks $0 Method of Payment. Credlt.Card We schedule installations.based on the date of the signed contiact.and secondarily on. the date in which:we complete the technical*measurements..The installation date"that we are providing at this time is only an estimate.We will communicate an official dale , and time at a later date.'Rain and extreme..weather are the most common`causes for:. delay: Notes: Taxes paid.in Bar.nstable;;Ma . Buyer(s)agrees and understands that this Agreemert constitutes the entire understandings between the parties and that there are no.verbal understandings changing or modifying any of the.terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,'written consent of both the Buyer(s) and Contractor. Buyer(s)hereby acknowledges that Buyer(s) 1).has;read this Agreement, understands the terms of this Agreement;and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,;on the date first written above and:2)was orally informed of Buyer's right ro cancel.this Agreement: NOTICE TO BUYER: Do not sign this contract if blank.You are;entitled to a copy.of the.contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANYTIME NOT LATER THAN MIDNIGHT. OF 09/11/2018 OR THE THIRD BUSINESS.DAY AFTER THE DATE OF THIS TRANSACTION; WHICHEVER DATE'IS LATER:SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT Legal Name:Southern New England Windows,LLC- dbai Renewval/By Andersen of Southern'New and Buyers) Signature of Sales Person Signature Signature F , Gino Montesi Roxana Andrew Print Name of Sales Person. Print Name Print Name UPDATED:,09/07/18 r Page 2 / 11 Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement-C,antractor Registration Type: Supplement Card `•° Registration: 173245 SOUTHERN NEW ENGLAND WINDOWS,LAC_ , Expiration: 09/18/2020 10 RESERVOIR ROADS }x SMITHFIELD,RI 02917 Update Address and Return Card. SCA 1 G 20M-05/17 .f�.P. �cvnin,Cnc��.,z�cy�•�/�a:-iac���eCGs Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Sapplement Card before the expiration date. If found return to: Reaistration Expiration Office of Consumer Affairs and Business Regulation _=1Z_3245-== 09/18/2020 1000 Washington Street-Suite 710 �` — SOUTHERN NEW_ENGLAVES!NINDOWS,LLC Boston,MA 0211 BRIAN DENNISON �1? CGQ --- 10 RESERVOIR ROAD' C, SMITHFIELD,RI 02917 Undersecretary N without signature A Commonwealth of Massachusetts Division of Professional Licensure 1. Board of Building Regulations and Standards . Constrain �pervisor x �� Awe CS-095707 E> p i res: 09/08/2920 BRIAN D DENNISON * T 8 BLACKWELL--PRIDE " CHARLTON MA 1507 y Commissioner The CommonweaRh o Massac f h usetts Department Of Industrial_4ccidenis 1 Congress street,suite 100 BOs104,MA 02114-2017 www massgov/dia Workers, Compensation Insurance Affidm it:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMTTTI1t'G AUTHORM. A licautInformation h- }� Please Print Legibly NaAle (Businesslorganiza on/lndiviaual)_ Address City/State/Zip: e� ( I Phone : 4-rc you an employer?Cbeck the appropriate box: F,.XL12maernplovervithType of project(required): 1 2z® employees-(fulland/orparc-timej' . ]l New cons7uttion i I am a sole Proprietor or pmmershiv and hzve no empinyem woriinc for me ir, arry capw-ity.lldoworJ;era'comp.ansurartbe reouireG.i E. D Remodeling I -�I am a hometrwner loin all�nrl myseL*" f' i e 1 Demolition i € [Nr-wa* ors comp.insmm. ce rrzui*ed7 t 1•D I air,a hornwv me*and wt@k be hiring contactors to conduct aP wori or,My to upend•. I v;il ' i('[J Building additioz iensure dw a1 contactors either have workers'compensation it urine or ze sole ! '1_D Electrical 7epairI additions PmPnetom wits no emnlnye-s, S D i IZ.aPlumbing repak-or additio-w' 5.0 I am a ger"!conwcta*and I have hired the suh contmcto s listed an the a'-m-Ated sbeet nest sub-contaamors have emakn� W End It-ve worker_'romp.ittsw-rT)Ce -�R0 1 repast ET I-We are c corporation ant its o5m,have exercised taei right of exenpaor.pe IJ.,G ' -'�•C ibex (�/ n t�(J�/ I 35_,ci(LA anc we ii<veat etnnioyeet[.No woti ec'comp.inset-sce zquired.? I Peetare-i<-7 L Am-,applicm,that checker b="!must 21se Ell our the section below Showing their wo — 1 'compensa6m Polir•intwmaaon. 'Homeowners who submik this a5-dsvit indicating tbel-are doing art wort:and thet hire outside c0=-- ors Pus submit a new 25di vi;indicminf such. 'Comractom flrar check this box_mus attachea an addition'-shed shoeing the rtame of tat sub-con vactor and suat vinethe-or not:hose entities have employees 1 the sub-contractorsheve employees,they mus provideineir woricer-'comp.policy number. I air,err. employer inn;is providirg workers'campensafon insur4rce for ma:empiovees. Beiox•is the poli_r rlr,G joy sir£ srformarion. , 1MUT8nce Compazy?tame: �Irf pie n S Co j C�1 Policy-_or Sells ins.Lie. Z a ao2d� L D2tE: f — sob Site Address: Croy/Su-ce Ziv: Attach a copy of the workers'compensation policy declaration page(sbovving the policy number and expiration date)_ Failure fi secure coverage 2r required under IdIGL C.152.F2.,is a criminal:irioIatior.ptiaishabie by a 5ne up to sI�OC_i)G and/or one-vcar imp ris onmeirL as aveE as ci%dl penalties in the form of a STOP WORF ORDER and F fine oru_r•le.S25C.OG a dey against the taolator_A cop)..ofth is statement may be forwarded to the Once of Inv esrigations of-the D1A for inSUM3CE coverage veri5cation.. 1 do hereby certtfj under yh Wins and penalises ofperjun•than the ir<formatinr,provided abov£in rrue and corrEC1_ Sitmature: q i1nE: pbonET: CID�-�Ti `�— f ' Official use oni. Do no:wrhz ir.this area,to be compiered by tit or town of ciai Citt-or Town: PermiA icense Issuing Authority(circle one)_ 1.Board of Health 2.Building Department 3.City,Tv;tm Clerk 4.Fiectrical Inspector. 5.Plumbing inspector l 6.Other Contact.Person: Phone 1: ' t ACIORV® CERTIFICATE OF LIABILITY INSURANCE JDATE(MM/DD/YYM 12/29/2017 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 CoBiz Insurance, Inc.-CO NAME: 1401 Lawrence St, Ste. 1200 PHONE 303-988-0446 AIC No:303-988 0804 Denver CO 80202 nDORless: COMaiI cobizinsurance.com INSURE S AFFORDING COVERAGE NAIC p INSURER A:Acadia Insurance Company 31325 INSURED ESLERCD-01 there New England INSURER B:Firemens Insurance Company of WA,D.C. 21784 dba Renewal by Andersen of Southern Southern New England Windows, h INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1252851165 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" INSRLTR TYPE OF INSURANCE ADDL SUER - POLICY EFF POLICY EXP POLICY NUMBER MM/DD MM/DDIYYYY LIMITS A X ICOMMERCIAL GENERAL LIABILITY CPA3158728 1112018 1/12019 EACH OCCURRENCE $7,000,000 DAMAGE TO RE CLAIMS-MADE �OCCUR -- PREMISES-(Ea occurrence) $30D,000 MED EXP(Any one person) $10,000 I PERSONAL&ADV INJURY $1.000.000 GEN•L AGGREGATE LIMIT APPLIES PER: X PRO 1 GENERAL AGGREGATE $2.000.000 POLICY JECT LOC PRODUCTS-COMPIOP AGG $2,000,000 OTHER $ A AUTOMOBILE LIABILITY I N CPA3156728 ! 1112111 1/12019 COMBINED SINGLE LIMIT Ea accident $1 000 000 X ANY AUTO i + i BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS - BODILY INJURY(Per accident) $ UTOS X NO AUTOS ? PROPERTY DAMAGE X HIRED A $ Per accident $ A X UMBRELLA LIAB X OCCUR CPA3158726 / 1/12u16 1/12019 EACH OCCURRENCE $10.000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10.000.000 DED I X RETENTION In F $ B WORKERS COMPENSATION WCA3158729-20 1/12018 1/1/2019 AND EMPLOYERS LIABILITY YIN X STA UTE ERH ANY PROPRIETOR/PARTNER/EX" ' TTE MB OFFICER/MEER EXCLUDED? NIA i I EL EACH ACCIDENT $1.000.000 (Mandatory in NH) EL DISEASE-EA EMPLOYEE $1,000,000 IF yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1.000.000 C Pollution Liability I 7930073340000 1/1/2018 I 1/12019 Each Occurrence $1,000,000 Claims-Made Policy Aggregate S1,0D0.000 Retroactive Date 06202013 Deductible $10.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For InfOmlatlOrlai PUrpOS2S AUTHORIZED REPRESENTATIVE ©19BB-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD WER iiiR .0 c, .,. m>• .. r R a€ M:y -Fie Edik -Tools.-Help 21, C zi t, 1. D etarol �►PPlrcat�an; 2001010653 r ; ..:.. r s .. Applroc OVJ nk `. f~J PROPERTY OWNER Status r A ! ;. A TIV s 3 C E_ .,.,.. . O; ner 217516$ . - Collect, r , e ' c; _ts xAZI _De artmeni'. -, 6300 IJILDING'DEPARTMENT r p CAt:1CHON„ THOM�S W& .4��� . .: t ProectlActrvit '434 .RESIDENTIALADDfTI0N1ALTERATIO - 1 3' a t _ _.. _..�. _ _ . �. ; :, Cantractar I�`;V�orkfl6W =I Description' ;' BATHROOM AND-HOT,TUB ROOM REIUOVATION �� _ _ Busroness .., . 1..:Descra tian;2 - ; r p ,. �. Fees effective 02126120t]1 Parking!M isc = - _ _ = If .: - . Assigned d Property; _ _ ... UJ .,�--v � a � PropertylUse Non-Canformm DateslMiscfr Permits ? = C�_ 9 . - j "14 fim „d Busmess.Mast .9 p s & E t ; f-3 e y z__ yam,. ',�,, .Location. 1230 - Unit �:.. . Ezxrostmguse 101;0 ,. SIhJGLE FAMI'LYHOME .:�, , -.. Skreet :SANTUIT-NEWTOWN ROAD Adjust Fees zarn RF�RESID F ' Parcel 026031002 memo _® f R= M'urnci alit COT=COTUIT _ Escrow , - P 5' i n A l dz • y x t R-Subdivisian f o0 one, `Misc h 1010' SINGLE FAMILY f` LotfSectroonlPhase 0As _ t _ �4 j Proposed use HOME t P ymt.History„ x $e weep µ zonm � RF. RESID',F a r . - ,- f , and 'memo t _ �.�.. Audit H istory LL s ". a Location de LO 2 + _ r T }t SummvPermit yµ , flood zone, _ I 77 few CopyApP , Per Alerts Prerequisites [ HazrdlResf� ti (� �> ,Names Bands LQ Su6Addrs [ �Teitt (�Plan Review p # Link lns s „ Prior History �Insppotionsarnmgs Find Related 4 pVialatiaris (. ReviewsOpenitems ; r � . .-. - -� �.e� _, . - w•�kae ..„..` .:�s ,.oxa:::;s,..w�. ': .�..,..�.,s-a »-r. =,�,.w',a:.:,. ....�...�.r.,»:� _,..w.•�.":uaM„ - ._ s.-;��:�.� :,.:.-.€r. �;.� �__.�.� ..cam �+r,rr � Maintain projectlactivity detail for the current application. I' F l3 r l�/�'( �" �3�Ns W�� �� ��� `� E I { TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel .V � 00 Application# _ C)7 0(66 Health Division Conservation Division Permit# �' 6� Tax Collector Date Issued Treasurer Application Fee �V Planning Dept. Permit Fee ;�S•00 Date Definitive Plan Approved by Planning Board J� Historic-OKH Preservation/Hyannis �v 'Project Street Address iz 3 0 Scs„t L. ,, tie-, C J Village ro--. v o Owner TL.ti:��t C� ��LPti_ Address i ` / L Le..,. ?1A CZ453 Telephone o— 3 sue;._ s z it. Permit Request ,t ;to.—.; -rz ki s ke. t r ;Le Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay �, Project Valuation Construction Type k Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. m 0,,., ?_ Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) CD r Age of Existing Structure_zz:U�fs Historic House: ❑Yes 5a No On Old King's Highway: ❑Yes `i'_No Basement Type: M Full ❑Crawl ❑Walkout ❑Other - Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing .3 new Half:existing new Number of Bedrooms: existing N new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas M Oil ❑ Electric 001 Other sdL, Central Air: D Yes 0 No Fireplaces: Existing 2 New Existing wood/coal stove: ❑Yes p No Detached garage:0 existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:)d existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes X No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name C." Telephone Number --?tio Address License# y4 G l TL�c* o-+a a z 4 ;3 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE'—— DATE -; 3' r FOR OFFICIAL USE ONLY i l I PERMIT NO. I DATE ISSUED i MAP/PARCEL NO. i I - I ADDRESS VILLAGE i > OWNER t ' DATE OF INSPECTION: ' FOUNDATION I ilk FRAME INSULATION FIREPLACE h 7 ELECTRICAL: ROUGH FINAL 5 s PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i FINAL BUILDINGS f i DATE CLOSED OUT i ASSOCIATION PLAN NO. ' t S i `r The Comnionyvealth ofA assachusetts Department'q flndustrial,accidents Uffa Office of Inves'tigatiotzs• • 600 Washington,Street . Boston,AM 02111 M W.mass gov/dia ' Workers''Compensation Insurance Affidavit; Builderg/Contractors/Eleetrzciaus/P1u�ers' A licant Information Please'Print Le R)l �N3nle($usiness/Orgamzation/Individual):, -�o �, Address:3S f b G RU4,J D 2 City/state/Zip �, �C,����,� Phone � 1•�t A4 J 3' .#: Are you an employer? Check the appropriate box; 1;Q I am a employer with 4, ❑ I am a general contractor and I :Type of project(required);. employees(full and/orpart time),*. have hiredthe sub-contractors 0. ❑New construction . 2. I am a'sole proprietor or partner= listed on the-attached sheet; 7. ❑Remodeling ship,andhave no employees These sub-contractors have g, ❑Demolition:, ''4Yorldng for me in any capacity, employees and have workers' [No workers' comp,insircmce Comp, insurance.$'• 9, ❑Building addition required] 5: ❑ We area corporation and its 10.❑•$lectrical repairs of additions =3 I-am a lzomeo_wner doing-a73-_�york,:-- 7—ofcers-have exercised then ' ,_ 11:❑Plumbing rep airs or additions myself,jNo�wozlcers com�,� right bf exemption per MGL � rns I!-,— e-re`gwred]t--�" c, 152,§1(4),and we have no 12,❑Roof repairs-. employees,[No workers' 13.F—I Other comp,insmanee regtured,] *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 woik and then hire outside contractors must submit a new affidavit indicating such $Contractors that check this box must attached an additional sheet shewIng thename of the Sub-contractors and state whether arnot those entities have employees, Ifthe sub contractors have employees,theyrnustprovidb then•workers,comp,policy,number. rani an am ployer•that is providing workers'compensation insurance for my employees. Below is.the'policy and job site' information. Insurance Company Name Policy#or Self-ins.Lic,A. ExpirationDate: ,ob Site Address' ' City/State/Zip; Attach a copy of the workers'•cornpensation pglicy declaration page'(showing the policy number and expiration date); Failure,to secure coverage as required under Section 25A:of McTL c. 152 can lead to the imposition of criminal penalties of a fine up tb$1,500.00 and/or one-year imprisonment,as well as civil Penalties in the farm of a STOP WO Investigations 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 Investi ations of the CIA for insura ce covera a verification, ' I do hereby certify un pains-and aloes Of Perjury erury that ' P . / the information provided above is true an'd correct. Phone 4; Official use only. Do not write to this area,to 6.e completed by,city or town official City or Town: ' Bermit/License# . Issuing Authority(circle One) J.Boud ofHealth 2,Building Department 3., City/Town Clerk 4,Electrical Inspector 5. Plumbing Inspector 6 Other Contact Person: Phone#,, Massachusetts General'Laws chapter 152 requires all employers to provide workers' compensation for than employees• Pursuant to this statute, an employee is defined as",.,every person in the service of another under any contract of bite, express or implied, oral or written" An emp layer 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 dwelliug 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." IvIGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced•acceptable evidence of compliance with the insane coverage required,','. AdditionaIly,MGL chapter-152,§25C(7)states`TIe ther 6a commonwealthnor any of its political subdivisions shall enter into any contract for.tho performance of pubkiu work untii acceptable evid�e•of•complL,�t�e t t}stlie in. co- requirements of this chapter have been preseated'to the contracting authority,."- Applicants • , r Please fill out the workers' compensation affidavit completely,by checking the boxes t3iat apply to your situation and,if necessary,supply sub-contiactor(s)name(s),address(es)and phone number(s)along with their car ficate(s) of • insurance. Limited Li.ability'Companies'(LLC)or Limited Liability Partnerships(LIP)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 thus affidavit may be,submitted to theDeparbi ent of Industrial ' Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit, The affidavit should be returned to the cityor town that the a 'lication for the ermit.or license is-being requested,not the Department of PP P Industrial Accidents, Should you have any questions regarding the law-or if you are required to obtain a workers' compensation.policy,please oa11 the Department at the number listed below. Self-insured companies should enter their . self-insuranca license number outhe appropriate-kind City or Town Officials Please be sure that the affidavit is'complete'and printed legibly, The Departrneiit 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 refereiice number: In addition,an applicant that rmst submit multiple pemrit license applications in any given year,need only submit ono affidavit indicating current policy information(ifnecessary)and under"Job Site Address"the applicant should write"all-locations in.'(cityor town)."A.copy of the affidavit that.has been officially stamped or marked.by the city or town maybe provided to the applicant as proof-that "must a valid affidavit is on file for idare permits or licenses, A new affidmustbe{riled out each year.Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture (La. a dog license or permit to bum leaves•eto.)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 youhiave_an.1i questions, please'do not hesitate to give vs a call The Deparhnent's address,telephone•andfax number.. R cn, 02111 TO.0 617-7274kO ext 406 a 1-M-MASSAFB Pax#1617r•.' 7-770 Revised I1-22,05. ��� � '1 V TT it V1 J.7"JL AAP&64M A%J I Regulatory Services t ue,$ Thomas T.Geller,Director iasL 9�pr�n► ��� Building Division Tom.Perry,Building Conunissioner .200 Main Street, Hyamus,MA 02601 www.town.,barnstable,ma.us face: 508-862-4039 Fax; 508-190-6230 permit no. Date , AFFifMAYU HOME MROYEMENT CONTRACTOR LAW -SUPPLEMENT TO PERMIT APPLICATION MGL "reconstruction,alterations,renovation,repair,3hodernization, conversion, a 142A requires that the improvement;removal, demolition,or construction of an addition•to any pre-existing owner-occupied big containing at least one but not more than four dwelling units.or to Structures which'are adjacent to such residence or budding be done by registered contractors,with certain exceptions,RIM$Rzth other requirements. ype Ofw011C:11Lr+� �-¢tn r.l.e Sc na\ Est]-mat 0.0 Address.o"fwOIk: 1230 Sw„•ru ,r �e�•—v.. auuJ �a'�' �� Ov'mer's Name Dateo cati �f_Applion I hC� by certify that Registratign is not required for the following reason(s): (]Work excluded by law ❑Job Under$1,000 OBuilding not owner-occupied C�Ownar polling.own pennit�-- . Notice hereby given that: OVVEgS PULLING THEIR OWN PERMIT OR DEALING WITH iTNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROYEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL a 142A. SIGNED UNDER PENALTIES OF PBRJURY I hereby apply for a permit as the agent of the owner; Date Contractor Signature, Registration No, � R ��N 2to 206� �J �• Date r—."`0-wner's-S �atuze . Q;y���,{5rn�s:homeafudaY Rev: 060606 RESIDENTIAL BUILDING PERMIT FEES - APPLICATION FEE New Buildings $100.00 Residential Addition $ 50.00 Alterations/Renovations $ 50.00 Building Permit Amendment S25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) — ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$641..sq.foot= .0041= plus from below(if applicable) GARAGES(attache. &detached) care feet x$32/sq,ft. x,0041= ACCESSORY STRUCTURE>12 >120 sf-500 sf $ 0 >500 sf-750 sf >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new buildin permit: square feet x$9 /sq.foot= 041= ; STAND ALONE PERMITS Open Porch x$30,00= (number) Deck x$30.00= ' (number) Fireplace/Chi=ey x$25.00=' (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25,00 Relocation/Moving S150.00 (plus above if applicable) Projcost Permit Fee Rev:063004 1 Table J3 lb(continued) Prescriptive Packages for dne and Two-Family Residential Buildkngs"Heated with Tvstil Fuels M iwum MINIMUM (ilaang Glazing Ceiling Wall Floor Basement 81ab Headng(Cooling Area'(�) U-value= ltvalu ' R ' Rval- e -value - ue° Wall Perimeter Equipment Efficienq� Package R value° R-valucy 5701 to 6500 Heating Degree Days' Q 1Z%. 0.40 38 13 19. 10 6 Normal R 12°/. 0.52 30 I9 19 IO 6 Normal S 12% 0.50 38 13 19 10 6 85'AFUE T 15'l. 036 38 13 25 N/A N/A Normal U 15% 0.46 38 19 19 10 6 Normal V 15°/ 0.44 38 13 25 NIA NIA 85 AFUE w 15% 0.52 30 19 19 10 6 .85 AFUE X 18% 032 38 13 23 N/A NIA Nomal Y 19% 0.42 38 19 25 NIA NI.A;l Normal t 18% 0.42 38 13 19 10 90 AFUE AA 18% 0.50 30 19 19 l0 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF AL XTERIOR WALL : 3. SQUARE FOOTAGE OF ALL G G: 4. %GLAZING AREA(#3 DIVIDED BY#2 . ' 5. SELECT.PACKAGE(Q—AA-see c above): NOTE: OTHER MORE INVO ED.METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-0803 03 a 780 CMR Appendix J Footnotes to Fable A2.1b: ' Glazing aiea is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage.Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300 ft of glazing area. =After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceffing.R-values do not assume a raised or oversized truss construction: If the insulation-achieves-the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-S insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned craw4aces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding. glass doors of conditioned basements must be included with•the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. use compliance approach 3.4 or 5. If you plan to install more eb 'cresistance eatin , � Y P If the building utilizes el, to heating p pp than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. For Heating Degree Day requirements of the closest city or town see-Table J5.2.1a NOTES: a) Glazing areas and U-values are maximum acceptable levels.Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque. doors in the building envelope must have a U-value no greater than 0.35.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC•test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 �ozrtE;�� Town•of Barnstable P °+ Regulatory Services , RAANSr $ Thomas F.Geller,Director En ;;� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Tice:. 50&862-4038 Fax:_ 508-790-6230 Property Owner Must Complete and Sign This Section If Using .A. Builder as Owner o the subject property herebp authorize to act on m7 behalf, in all matters relative to work rized b7 this bull ' g permit application for: (Address of Job) Signature of Owner Date Print Name 0:F0RMS:0Vnq R ERMISSION Town of Barnstable OFZHE�O� . " Regulatory Services aP O� BARNSTAUM : Thomas F.Geiler,Director y MASS. g 039• ,� Building Division rED MAC a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 1 a r 2 i. Zoo JOB LOCATION: tZ3O 2,o-, C „r number street village "HOMEOWNER': Tto..,. S, \.,/ C._- L, , `781 - 3T4— S Li c,. (oi')- 3t•i6- (,02.3 name home phone# work phone# CURRENT MAILING ADDRESS: %Zo4 j MA T-3 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. Barnstabl ——- - - minimum inspection procedures and requirements and that he/she will comply with said procedures and require tS. J Signatur omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:fomms:homeexempt F �t►+E r Town of Barnstable Regulatory Services ` 8A MAS& Thomas F.Geller,Director TED ►`off ►aa Building Division Thomas Perry,CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: ze e H oitj Map/Parcel: 637 0 0 , Project Address I Z-3-0 ��azulPO(&�ox,,X Builder: The following items were noted on reviewing: �A/SiO19 TrIOAI-C d;e 4-r /2-7,<. 1 u s V- AE ���✓ Reviewed by: Date: Q:Forms:Plnrvw i' b � 1 THE TOWN OF BARNSTABLE Permit No. ........ BUILDING DEPARTMENT EAU TOWN OFFICE BUILDING Cash ............. .. 7 i63V '�tn�ur►� HYANNIS,MASS.02601 Bond ......x CERTIFICATE OF USE AND OCCUPANCY Issued to R!chard & 1 P_hrR. Dahl s Address Lott #2� 1230 Santuit—Netwon Load Naxsto-ns Mills. Massachnseitts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119:0 OF THE MASSACHUSETTS STATE BUILDING CODE. 19... ±5.......... ........................?.................... Building Inspector. �`�..� °�•'. TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING rua 039 HYANNIS MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: �Q—;7-- An Occupancy Permit has been issued for the building authorized by BuildingPermit $k.. .. ......... :<.....: ................. ............................ ..............................................................»»... issued to � �` l�/I ,;l,»/ ,......� -� /.�.......... . . _._.._»... ...» ..._»».»......».»».»»» Please release the performance bond. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M A-- -1 DATA B U I L D I N 1 TOWN OF BARNSTABLE, MASSACHUSETTS .. Aa2 _37PER11� IT JOB WEATHER CARD DATE ` ' 19 PERMIT NO. GYrtq-Ory J. L.3 ADDRESS l APPLICANT (NO.) - (STREET) (CONTR'S LICENSE) Build lh.we11.7 "+r; f '` NUMBER OF PERMIT TO (_) STORY - DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) - 1.- i;ftL 1230 San-Li3'd.T:.^C�r.''.i,J..l_',.I:. .0 ,c..a..'c �` ZONING AT (LOCATION) DISTRICT IN0.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT { SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TQ TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: sPC6Ji 1}i36� c 03 1366 Svj• Fc .AREA OR • s VOLUME PERMIT ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) .1 Richard & Debra W. Davi.s OWNER I Lc core t,1 BUILDING DEPT. ' ADDRESS s u.�(:.y ) . BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OF PERMANENTLY...ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEC FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITION' 7' 'OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.- . MINIMUM OF .THREE CALL APPROVE ALL CONSTRUCTION WORK: D PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF. OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2.'PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALLNOTBE OCCUPIED UNTIL MEMBFINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. - 3. FINAL INSPECTION BEFORE - <j OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET _^ UILDING I PECTIO APPROVALS ' PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVAL54 Kr!� 2 2 - n ) 2 ' Q 4 f .� 3 HEATING INSPECTING.APPROVALS REFRIGERATION INSPECTION APPROVALS STAD AT -) tLE r - � ,Tp/} S A Orr; Z I I: .; f 4 15 1 WORK SHALL NCT =ROCEED UNTIL THE PERMIT WILL BECOME NULL AND*VOID IF CONSTRUCTION iNSPECTIONSVR&CATED ON THIS CAR( NsaECTOR aAs aaaRcvED T +F JARICUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHANE } STAGES OF CONSTRUCTION. I' PERMIT IS ISSUED,AS NOTED ABOVE. OR WRITTEN NOTIFICATION. I , . . O � 43 6.6 I o'o 396.4 s :FO nl.RAi.l.O r -, n 2.O A C-R E.5.._:-' PR£PAR�D fOR R�c�fA�eo cv, pAv�s _._ . L Ov t LG'S __ PoiJ v -"-------.._L cL-R TF/ED PL 0 T PL AN LOCATION ��lZS7?�Ns M/Lts MA. SCALE: / 6D' DATE 4-r2- e6 REFERENCE' LOT 2 P B. 33/ /? 93 L. C. FLOOD ZONE 'q F B o�� HEREBY CERr/ Y THAT THE BOIL DING SHOWN ON THIS PLAN /S LOCATED ON THE 867 GROUND AS SHOWN HEREON AND THAT IT ores CONFORM TO 7'H£ZONING �rst� BY-LAWS OF THE TOWN Of Q•9reSrAB[E suR�� WHEN CONSTRUCTED. LOW A W£L L£R, INC y TI4 MAIN .STREET YARMOUTH, MASS. DA Tt go-Z/7 436.61 i1 396.4 s GaynlDXrib } +1 +1 m q O r • n 2.0 PR£PARtD MR— RIC#Azo W. DAVIS L.Ov E LU5 pow]) CER T/rIE'D PL 0 T PL AN ' LOCATION- o4. II SCALE: 1"= 60 DATE 4-i2- 96 I R£fER£NCE. LOT 2 P. B. 33/ p 93 L.C. P. A FLOOD ZONE I HEREBY C£RT/FY tHAT THE BUILDINGS JR; SHOWN ON THIS PLAN /S LOCATED ON THE U 867 H . GROUND AS SHOWN HEREON AND THAT I T _ems CONFORM tH£20N/Nl. BY-LAWS OF THE TOWN OF E3AgS'rAB[E SURJ� . WHEN CONS TRUC T£D. LOW d WELL ER, INC. 714 MAIN STREET YARMOUTH, MASS. DA TE go-z 17 Assessor's office (1st floor): o�TNEro Assessor's map,and lot number ....... .. ..``........ /.,....�. Board of Health (3rd floor): 6 � A SEPTIC SYSTEM Mus 'Sewage Permit number ............... ... • INSTALLED IN COMPLI t E, 39 LE, . Engineering Department (3rd floor): c te39° 0� House number 3.0.................:..:.......................... WITH TITLE 5 0 Mar a -APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only ENVIRONMENTAL CODE A APPROVED TOWN REO�ILATIONS bier°nser°ati°n N O F B A R N S T A B LE s geed Date ILDIN6 ANSPECTOR APPLICATION FOR PERMIT TO ............ ........ ... .................. ...........: TYPE OF CONSTRUCTION �CtC1!�'Lp�...:.................... ................190� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit.according to the following information: Location ... 6.!......2.... ?.(.Ztl. .:'.!llf1 � 1o...! .e.r.: 4! ¢l!1 ..!.'.1.1.1t.�.r. G� . Proposed Use .....leesIc%Q1.4:#m(.......ECI...44.1...:'..0011�7C'?Y.l/y...................... ...................................E.................... _-',Zoning District ........1.9,!.r.......................................................Fire District ..C��'j7 'dJ2 � QS �Y`VO.I c........... Name of Owner 11.1C11ar6.-&br ...4f!r...lJk�[�1. ............Address ..!!.Y'(..IS'r ...W.G�. • Name of Builder GneqO.vn j..f.A)1. ....Address Name of Architect RC�.�.tsd .6r'......................:.....Address .......... ................. r.............................. Number of Rooms ....11/ff�ne Foundation Cuc �2v Exterior ..> �> ✓.�...!(� Lf)4 ... ? 1C......... oofing ......... ............... Floors C ( .,. t . .....rI11 `...�'j? ....l.l.(.Q.. ( ..Z-49 . ,4�' ��as�e�'..... ........... J1 / j..............Interior ........... Heating h11��� ../ `.... G' �1^...bt�..��C................Plumbirig .... r' '��,... ......................................... Fireplace ..C(�CIr. /1��r. !/w??f1e!�.. .. rP �!lld CS....Approximate Cost .. QOOoQo�1_3 .... ......... l Definitive Plan Approved by Planning Board ----------------_---------------19--------. Area /.. ............. .................. Diagram of Lot and Building with Dimensions Fee . ...► ...a ............ . 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. R Name . .. ....W. - .... ................... Construction Supervi. '.'s License o2q7l.7........... - � a-_._ DAVIS, RICHARD & DEBRA q, 0 2.9195...... Permit fi8; ..Two tqKy.............. '14 V P3 Siiijzle Famil1v e ..� W...................... Location ....Lg�t...#.2-t.....P230 ;antuit-Newtown Road ........ ............................ > � Marstons f4illsl ... .................. Debra Owner ........Richard & Debra Davis i a Type of Construction .........Fr .. ......................... . ................................:.................. ........................... 4 Plot ............................ Lot ................................ Permit Granted ....Apr.H....1.4."..z................19 86 ...... ... . . . Date of Inspection ..................................19, Date Completed Ao.:7:7 .. ................19 IL tv ur M M cr rj A j e Assessor's office (1st floor): Assessor's ma and lot number — TNETO ro Board of Health (3rd floor): Sewage Permit number `. � © 2 MMUSTABLE NAGEngineering Department (3rd floor): 'oo 39 House number �� :. s, 0 APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only �` r `TOWN OF BARNSTABLE w BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............ l�.L<'k? �. ....... r tJ, . C,1. ................................................ TYPE OF CONSTRUCTION �.n . ...... f!. ... .................................................................:............. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... �� 2.... ��3i? ( .^. ��I UY�...!` a.r.y.. 7c�iV (�✓i.S.... ��.�.�,.." i r�S�,a.... ....................... Proposed Use ..... P...S./,1� .�1 1.! .t...1JC(/2L.1.i. �....�..�� 7`�" L?`.�......................................................I......................... ...s. TV'............. ... .�.�...S...t....r...U... . l..........................................................Fire District ...........Zoning District .......... .> Name of Owner rl.!f ./.lr7l f7.��..4j" .. r. /. .... .............Address ............ �.. �.....::�.:.�f. ................... ,. ........9 Name of Builder ..... �"?J' ... !. ��.�L.!5`.......................Address Name of Architect Ckk .Il �h�, [ Ir' ....Address ..........................Jele4?1 s. ...!.:' ........................,.. N Number of Rooms .... (! /�r�. i'y�; .f1r3G� 'C;��!!1. FounclatioR 4(1X.P�l. l.!l��C��2. ""7`�1 ... ............... .. . d' 64, � Exterior �X t 5� �S►l !/C !C� Lt)0 ...1&TICd-I Sfdl PC AS 0 CZ K-1 dl/ r�/t S............... ....... .......... Roofing ............. ....r.....<a.............. ... Floors (-�I" •. IY1i/ .. 1? !..../.. .0................Interior ....bk?e...Z,10 • „T.LG�S( ..................... r. rr / �..f.. �.�.. Heating :4v..i.:!/�L.�................Plumbing Y!•y' Q... /!/. ......................................... Fireplace .....2.. Approximate Cost ......................................... Definitive Plan Approved by Planning Board ________________________________19-------- . Area Diagram of Lot and Building with Dimensions Fee , SUBJECT TO APPROVAL OF BOARD OF HEALTH rI 1 4 J f f 7 . 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 .. !. ! . ... f ....................... Construction Supervisor's License . .1............. DAVIS, RICHARD & DEBRA A=26-37-2 No 29195 Permit for TW.o...St.o r.y.............. ........_Sin le: ...........Family Dwelling................................ Location ..Lot #2, 1230 Santuit—Newtown-n Road .............................................................. ............ .................................................................. Owner ....Ri.q.h.ard...&...Debra Davis................ Type of Construction Jr.a.me............................. ........................................... .................................... Plot ................... ........ Lot ................................. Permit Granted .......April -14,.................................19 86 Date of Inspection ....................................19: Date Completed ......................................19 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0260�3 0 0 2- ` Map Parcel Application# Health Division 50F_ f�OC��D f-It>F fr Conservation Division tj Permit# Tax Collector Date Issued D Treasurer Application Fee of Planning Dept. Permit Fee , Date Definitive Plan Approved by Planning Board f� Historic-OKH lv 10 Preservation/Hyannis go Project Street Address 1230 N P--" f4 R Village M Pr(L5-t-aN S K.T1 S q-�t Ci°� tJ ^ Owner -to c Address Y 2 3 0 N a�� Telephone Permit Request 3. W 8 o S.F, '50LA-9 A-wq- W A�-9. AtL p N of Square feet: 1 st floor:existing_ proposed 2nd floor:existing proposed Total new Zoning District ! Flood Plain Groundwater Overlay LProject V�1� 2-01 00 0 ' i Construction Type r N Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting doc mentatir C Dwelling Type: Single Family ❑ i Two Family ❑ Multi-Family(#units) ._ Age of Existing Structure { Historic House: ❑Yes ❑No On Old King-s Higr y: ❑Yes SNo ( = Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) i Basement Unfinished Area(sq.ft) Iv Number of Baths: Full:existing new 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 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 Cor4f-" Gf—VSVt l Co4v_vy- _50LA-i2 Telephone Number~ Address P. ® � +fax 81 License# sv �r e4 A Home Improvement Contractor# 14 d Z 74 Worker's Compensation# ?7` 4 '7? 6 ALL CONSTRUC N DEBRIS RESU TING FROM THIS PROJECT WILL BE TAKEN TO 6A1Ws )C SIGNATUR DATE b-) / 0- FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE t _ OWNER T DATE OF INSPECTION: FOUNDATION z f e FRAME INSULATION z FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL V GAS: RO FINAL - I ,F FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. s Nov- 15 06 12: 23p Cotuit� Solar 5084288450 p, 2 �. IN f,OOIAil .$� y�l• � ,.'' 1' 'L .i.� .. � ';. Y� -� .. ^•fin '.7�tY{lw..iC ,� ' �+ Sa ♦ "„f a tii :���,...,; ONLY ANO C4 CONFERS NO RIONTS UPON TWIJ Wq CMR7 PICA oe�Btrresen 1� A9�Y., HOLDER.TMfS'CERTPFICATE G© NOT,4it�ENDr Tft OR' { 920 Wm ill»9{r ST Nmrwsll,MA 02097•241C ALTER THE COVERAGE APFe3R[9FR BY THE P6LiCIL6 BEL0W APi Dddi N3E COMPANY A OFiANIFlE STATE INSURANCE C;oMpANy i CQiIrad i Po Box Y j ! 86Old Shor6,Rd j Ccmk MA 02etlB�1o'�Q f h+tale?mCZ'tS1fvTAAT'Wp-POUCIeaCW14URV4CELf9TlnleELOW+1AiraselEN TrIE FOI,Ct'PkRltlp a q q7 EQ NO? OSIiBb TO TH&IhOURED WASD MOVS .r . wJITM&rM51N®ltNrRtAuiJ McIVT, R.nsx uwpEM➢WTM RESUCT TO VVi gCll TM TPRA•.OR 06WITiON UP ANY CONrRACT OR eTl ` �°06lCJES Q tS CERTIFfCWYF ANY IeR1sUE0 DR WAY Pfft AIN T P«ertReY!>31$fla,E{ H5 I KSuUNOF APPOKEO Fi5 J N I&s►1id6CT TO AL L Ta{�T>ERMS,EXOLUSICKS AND co"Dr noNS OF SLICH POLICIES U ?M lJid WAY MAVI BEF?4 ItFQLoCEO BY?J11p C W t p� TEE It f i tar ellel a tietll � ,� � I A LxPO EW4..1�18 6ANIcIv T;+3�1 -. �H°+�EIJ!Y1nIW1 :at UP ypR,UIwe �:� :n`�•r �"t��?.tl�{�•'fr ` imFAHE!'OUYIIYNacm E'BDG i I----- I L'ERTIFlCA11!ko6CBR. CELLAPON TOWN OF FALMCUTH llCulO AMY OF THE—V'[4'Q04I 60 OCA"®WC o$ERAS" i I � b�TOWNFfALi.B�JRE I m°" 'Io+�+e+xe,oeor�a�wn;r��uve�urKlutHowvosttO�ew�m . �A6MOUrFI,MAO2540 !'a»wwTtent�Tee to tNE:A�ATJFtM!'reolraea�TorMi':t�r,iut' ! ' � �vae Tn uut s{Ic„IOI u7!ew.,l JY10ee JYG Dei:6ATJ0N ee wtlUTv OF iMwa�aUr+WTlili�►rranr.rTe+aeare.ael�JleAar,� j j j Atl1'N0RIa<ED�RESEnt�anve ..._ . 1 w^ ar l Irn i The Commonwealth ofMassachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 wniy.mas&gov/dia- Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeWbI ly Name (3usiness/0rganization/1ndividuQ,' Ca q"� °c- Address: p.o, b®x 911 City/State/Zip: • Ce Tvs'cr- M A 0 2G 3 5 • Phone#: S s Are ou an employer? Check the-appropriate bog; Type of project(required): vi 1, am a employer with y 4. ❑ I am a general.contractor and I employees (fall and/or part-time).* have hared the sub-contractors 6, New construction ❑ 2.❑ I am a sole proprietor or partner- listed on the attached sheet # 7. ❑ Remodeling ship and have no employees These sub-contractors bane Sc El Demolition working for me in any capacity, workers' comp,insurance, g, (] Building addition (No workers' Gasp,insurance S. ❑We are a corporation and fts required] officers have exercised their 10,❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑j Plumbing repairs or additions myself.(No workers' comp, e. 152,§1(4),and we have no 12.[]Roof repairs insurance required.]t , employees.(No workers' 13.❑ O$aer comp.insurance required.] *Any appliceat that ebecim box#1 nsust 4lso fill out the section below showing their workers'eampensatioa poHcYinformation: `. t Homeowners who submit Ibis affidavit indicating they are doing sU work and than hire outside cautmaters must submit anew afidevit indicating'such tCoatractvrs that check Ibis box mast attached an additienel sheet showing the name of the sub-eoatraators sad their workers'comp.policy inform ae4 . I am an employer that is providing workers'compensation Insurance for.my employees. Below Is the policy and jab si't� Information r Insurance Company Name: Poly#or .Lie.Tr: 97 y y-1 6 I a s 2 0 7 i 3a S�wg �(A-i�S +Ns CZ lob Site Address: — `R' G ,%5tate/Zip• PIA 026 3b ---'- i Attach a copy of the workers' compensation policy declarWan page(showing the policy number and expiration date). Fame to secmx-coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,SOQ.00 and/or one-year amgriscnmmrt,as well as civil penalties in the form oi'a STOP WORK ORDER and a fore of up to$250.00 a day against fire 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 ce under the Ins an Ides of perjury that the information provided above is true and correct; Sr tore: Date: !o r LOt Phone#; S t1 8 y 2 `d •- 2 I iia;43E onl j.. Do Ad M*6 fig.0is rya,fe be ca d b'cry,or mm eft ' �I City or Town: PermtVLicense# Issuing Authority (circle one); 1.Board of health 2.Building Department 3.City/TI own Clerk 4.Electrical Inspector 5,Plumbing Inspector 6. Other _ Coutatt.Persau: Phone#: oFINEZ Town of Bar' astable �Y Regulatory Services UARMAMA ` Thomas F.Getler,Director mss �p�F �►�0� s Building Division. Tom Perry, Building Commissioner 200 Main Street, Eiyannis,MA t2601 wwr.town.b arnstabl e.ma.us office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If Using ABuilder I, W. C as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. i MA (Address of job) s 1 ZV016 Signature of Owner Date 1 i y Print Name I V QF0 WiS:oWNWERM1S 10N i Town of Barnstable ti Regulatory Services A A sexNsaABLE, ' Thomas F. Geiler,Director y MAss. ` 0 bA,16.39..,►` Building Division Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date , AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units.or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along v�dth o*?per requirements. Type of Work: f V A 5 0LP P_ [ 1- W Estimated Cos 2° Oc9 0 Address of Work: 1 2-3 0 Owner's Name: ` e-WoCO Date of Application: k t 1'Z___I o� I hereby certify that: Registration is not required for the following reason(s): 7Work excluded by law []Job Under$1,000 OBuilding 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 UNDE PENALTIES OF PERJURY I hereby apply for a ermit s the ages of the o 1z t� l� 1�71 Date Contractorkgnature Registration No. OR Date Owner's Signature Qmpfiles.foT=homeaffidav Rev: 060606 f e -P Board of Building Rego a ns and tandar s One Ashburton Place Room 1301 Boston. Massa usetts 02108 Doane Improveffien%Tractor Registration RegWmtion: .146276 Type: Individual x� `; Expiration: 4/8/2t>07 { - � CONRAD GEYSER =.. t CONRAD GEYSER p P.O. BOX 89 �? COTUIT, NIA 02635 q' - �c �.:.. . . .Update Address and return card.Mark reason for change. SW0044101216 Address E] Renewal [) Employment Yost Card • NA.�o no�uaea c o�./�raaaQ as Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the-expiration date. N found return to: Reg W \-1'146276 Board of Building Regulations and Standards Expt2n007 Boston,Ma.OZ108 One Ashburton Place Rm 1301 � uai AD GEYSE �7 .-t AD GEYSE D SHORE RD` ; i � IT,MA 02635 Administrator Not valid without signature t r1Hy_.Z1+-eb br :Se WM TRLANIAN BUNKER INS AGCY 781 659 2499 P. 01 i { C4 AiU o iqewe'! ! NOTICE OF ASSIGNMENT P OYER: COMBO I.D. STATUS OF EMPLOYER CONRAD GEYSER DBA COTUIT SOLAR 000055549 Individual P 0 BOX 89 COTUIT, MA 02635 COVERAGE GROUP I 0055549 i Coverage under this assi ant The Waiver of Our Right to applies to Massachusetts Recover from Others Endorsement operations only. For cove age : j is available on Pool policies. outside of Massachusetts, ontact Contact your agent for details. the appropriate Pool or PI n for that state. 1 Nr DON BUNKER INS AGENCY INSURANCE COMPANY: R_IIL 320 WASHINGTON ST GRANITE STATE INS CO UCER- NORWYLL, MA 02051 RESIDUAL MARKET OPERATIONS P 0 BOX 409 i PARSIPPANY, NJ 07054-0409 (800) 645-2259 NCYFEIN:028343479 FI ATI F U TY LASS ESTIMAT D ! CODE TOTAL ANNUAL PREMIUM a ;I REMUNERATION {------------------------ ----------------- ----- -------------- ---------- -- --- HINERY OR EQUIPMENT ERECT OR REPAIR NOC &DR 3724 $60,000 6.88 $4,128 ; ; ET METAL WORK-SHOP & OUTSIDE-110C & DRIVERS 5538 $0 6.72 $0 . i T BUILDING OR REPAIRING & DRIVERS: MA ACT 6834 $0 4.15 $0 . L BING NOC & DRIVERS 5183 $0 4.80 so LOYERS LIABILITY 100/100/500 9845 T ARD PREMIUM $4,128 j X ENSE CONSTANT 0900 $284 ! E RORISM CHARGE 9740 $18 i S IMATED ANNUAL PREMIUM $4,430 I ASSESS. 4.4% OF STANDARD PREM. $182- - . 9 ANNUAL PREM. PLUS ASSESSMENT $4,612 ' DEPOSIT PREMIUM: $4,612 �. ALLMENT BASIS: Annual T}I1818 NOT A BILL .i .. NTS erage effective 12:01 AM on 05/05/06 :I i A OFNOTICE: 05/05/06 PREPARED BY_ Paulette Hoffman EXT 514 i } • VOLUNTARY DIRECT ASSIOXMNT • a i r '•ER ID: 1008555 COPY: AGENCY f .I i 1 a The Workers' Compensation Hating and Inspection Bureau of Massachusstts 101 Arch Street-Boston,MA 02110 (617)439-9030-FAX(617)439.6055-www.wcribma.org - 'gin Installation Manual 214 SolarMount Code-Compliant Planning and Assembly T E C T 4 N :; : ._: 29 March,2004 Mr.John Liebendorfer . lsnn °aria avFd,: • °haF kY\III E Un1Rac,Inc. C.ALIfUflN A 3201 University Blvd SE,Suite 110 a Albuquerque,NM 87106-5635 - - TEL5-0 740 2400 •FAR 510 710 2405 Subject: Engineering Certification for UniRaCs SolarMountTM """`eCi°"�''P`°" Universal PV Module Mounting System Dear Mr.Liebendorfer, Attached is the OniRac Calculation worksheet and installation Manual 4214,Pub. 040316-1u, Copyrighted by UniRac,Inc.,Much 2004,20 pages. I have reviewed these calculations, and certify their reguhs are accurate.. The calculations determine the design level forces for wind, as prescribed in the California Building Code- The adequacy Qf the UNIRAC structure is demonstrated by the calculations. The calculations also correctly determine the"anchorage requirements for the itstallation, this requirement is properly represented in Installation Manual.#214. The calculations are based n: I.- "The 2001 California Building Code,California Code of Regulations",based on the 1997 "Uniform Building Code,Volume 2:Structural Engineering Design Provisions",by International Conference of Building Officials,Whittier,Ca, 1997,and California Building Standards Commission,Sacramento,California,2001. 2. `Manual of Steel Construction: Load Resistance Factor Design",3rd Ed,Ame-rim Institute of Steel Constriction,Chicago,IL.,2001. 3. "Aluminum Design Manual:Specifications and Guidelines fbr Aluminum Structures':, The Aluminum Association,Washington D.C.,2000 4. Mechanical Properties of UNIRAC extruded rails and related components based on data - obtained from Walter Z-ierstle,PE,Department of Civil Engineering,University of New Mexico,Albuquerque,NM. With this letter, I certify that UniRac SolarMount products will be structurally adequate and will satisfy the building codes listed above when they are installed per the "SolarMount Code- Compliant Planning and Assembly", Installation Manual #214, Pub. 040316-1ii, topyrigbted by UniRac,Inc.,March 2004. Please call me i q�%questions`or concerns..- Sincerely S Brian Spri Architects _ TECTONICS :s'• . tr. = �q• .••Q`e Z nginrcrs Architects!Planners ' - Ittii ttYtA� SAN FRANCISCO EMERYVILLE 2 SAN o1CGU .. . Q 16 (Q54) GROUNDING HOLE;` 25 69 (b53) 1 25 (31 75) . <. 20 03(509J o°o 3 26 (83) b 27 (159) Ir . :. ... t JUNCTION BOX . . • o :. -(: _- 026 (: 6b) X10, N FOR 1/4" (bmm} BOLT 0 MODULE DATA AND_ ►n SAFETY LABEL o M O c� ao -�.: tc,; o. . 1 CABLES '.` ter: • a M M -..: �: � M N C ONNECTORS , .. STANDARD EVERGREEN < __ AAN DIZED L UMINUM FRAME_ _ . ,.:'.. .. .... , .. a 0 l b (. 4) X 4 a .:..:.: GROUNDING HOLE S�0 16 N GROU DI G HOLE 2Q 03 (509) PROTRUDE 08 {2mm) . 1 39 24 40 (b20) EC-94/102/110/115-6 Weights 281b�12.7Kg) Dimensions: Inches [mm) - C t. P Qo LY F s t3 0 `�"� `yam'" `•�* -ry F scok L- COTUIT SOLAR P.O. Box 89 • Cotuit, MA 0.2635 • 508-428-8442 • Fax 508-428-8450 MAPP�-ft 6;Z.6 6 37 O o L T o M CA -u G,M..Q�l z rt f a )c d i I } i j 1 i 3a - E 2 = 4 x 10 5vr.11EART 4 d ' "f fz-M kL P Ate,:F c.S . Z..S LB 5 .As Ar, 3. 6 c-8 5. l Z 3 a N Vwj'T caw rJ P-D S 0LA-F- P"*i4 (-.A-a s 07 c/, _ �- Maloney Kathy To: Schlegel Frank Subject: Cotuit or Marstons Mills Pentamation says 026 037 002 (1230 Santuit-Newtown Road) is in Cotuit. My old building permit says it's in the Mills. What do you say?? Page 1 ���i PINK-"DEPT.FILE COPY/WHITE-FIELD COPY/YELLOW-APPLICANT-CO ~` 5° BUILDING Oar TOWN OF BARNSTABLE, MASSACHUSETTSI : _ PERMIT` .. ��� - - VALIDATION A=,"o f —3:7_ DATE Aar)' 14,: 19 86 PERMIT ND . e ; APPLICANT' Gre2ort: J. t'dl_LI?3 ADDRESS 162 # i3i S As'humet Lye • - - (NO.)_ - (STREET) . - (CONTR'S LICENSE) PERMIT TO pllIICI 11?4t�1_�_a n;r 2 NUMBER OF ( ) STORY cii11�� - F inl��T .TA� $nbr DWELLING UNITS _ (TYPE OF IMPROVEMENT NO. (PROPOSED USE) ZONING AT (LOCATION) Lot Y,`L 1230'"Samitui t—Newtnma Roach a s orR Mi I I D.IISTR ICT `?� I (NO.) (STREET) .. BETWEEN. AND j. (CROSS STREET) (CROSS STREET) G.. LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO:BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION `. TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION . I (TYPE) I REMARKS: I - i . AREA OR 1368 Ft. 13LL,J00 �� FEE �B01Q �. 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