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HomeMy WebLinkAbout0028 CENTERBROOK LANE o�� C�h-�e�c-k��oo d� �.Q.� �, , w � ., .� 4, .. - .. .. � - _ o � �. ,. - � � � o, .. .. - � 4 q / �F1HE roy, Town of Barnstable *Permit# - 19 Regulatory Services ' � '' fee 6 month sro sue date SAMSTABLE, y nsass. � Richard V.Scali,Director i639• ♦� >` 3 p,ED�,tA Building Division< `e F �, Paul Roma,Building Commissioner ��� 10 ?� `'W,N `. 200 Main Street,Hyannis,MA 02601 XV ,® www.town.barnstable.ma.us Office: 508-862-4038 f,�jFax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �� a !, Not Valid without Red X-Press Imprint Map/parcel Number 7 t f !� /Property Address �q raol�. !/ I. .v Residential Value of Work$� 6- 00>. Minimum fee of$35.00 for work under$6000.00 f Owner's Name&.Address 6-(c,k 'Sle�z C ) . 1;9 y C✓l1 nacj K Z_el. Ce ei k✓V i ffe Contractor's Name O �� Telephone Number 9 ^7?6 L Home Improvement Contractor License#(if applicable) 1-4;Q 49q Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: %-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 accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re- ' Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must`sign Property Owner Letter of Permission. - A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: ram. r Q:\WPFILES\FORMS\building permit f6rms\EXPRESS.doc 06/20/16 ' 27w Cominornvealth of-Vassachusetts Deprrtrrierit ef rndrrstrial Acciderds Offficd af1m.wstigatians 60j Washington Street „ Bast-on,M4 02111 ivivin,mass_govfdia 'Workers' Cumpensat an Insurance Affidavit-EmlderslC+nntracinrslElectricimmTlumbers Anplzeant Information Please Print Na=ISusmess�Organizationllnt Anal U ��f 2C Address: Liri Citgf Patel ig �o f�/riGY/" I�v�" c�7'I phonegg �U�f' 2 ? S� (� `,("� f� Are yo'u an ernployer?Checicthe appropriate box: Type of Project(requireq._ 1.❑ I am a employes with 4 ❑I am a general contractor and I New.construction _ employees(full andfor par#-#ime).* have hired the sub-contractors I am a sole gropzie#atr arpartrrer- Usted omthe attached sheet` 7_ ❑Remodeling These salb-cordrac_ors have shili and have as employees. .. S_ E]Demolition: wow for 7tie in any capacity. employees andlm.a wod rs'o Q 9..a Building addition LNa Wodoa camp_insur„re cm requed_] S.•0 We are a-corporation and its 16-0 Electrical repairs cr additions I ElI aura homeoumer doing all work Of'racers have-exercised their. 11_0 Plumbing repairs or additions , myself-[Noworkers'comp_ rightof exfiou per MGL 12.0 Roofrepairs : inc7rranre retldired ( w c.152,§IM andwe have no employees.[No wQrImn' 1 .' 10ther comp_instumm required.] *Any applicsntffiat cherd3bos isl nmst aLsa fillovtthe section beIanvshmeiug theirsuorkes'ca®peme; npnycginoa.=UoL Someasuaerswho subtmt sbis sfddaxru nuErztmg tL?y,are doing allwcA sna thenbim outride coatrsctorsamst submit a neat affidz&mdicaiag sncb ICautzactots thzt chPA t}tis box must ztUdud ur additiand sheet showing the nuke of the sub-cwtWibars x2d state whether air not abase eQtities have empioyees.ifthesub-contxctofshzseemplog-va%tFgrnusrFni&dLe5r work s'-oomp.palicgnumher_ I am art enipLayer that isprotzrIircg imuranceformycHiplayea. Heloiv is tliepoUq and job site information. IstsuranceConipa�Name: ' Policy-"k,or self--im,I.ic_41, RkpirationDate: Job Site Address: CitylStatel2�p: Attach aropy of the workers'compensation policy declaration page(shaving the policy number and expiration date}. Failure to secure coverage as,req*ed nudes Section 25A of V-GL c.157 czm lead to the imposition of criminal penalties of a fine up to$150D.00 andfor one year imprisonment,as well as rivil penalties in the form of a STOP WORK OFMER and a ffne of upto$250_00 a dap against the violator. Be advised'that a copy of this statement maybe fkwaride ,to the Office of Investigations of the DIA for insurance coverage verifca ion_ Ida lwrgby cw tify�rrrtdgr th-a pries and pen ofpeduxy diattire ia,formation vrmi&dabm a is byre aztd carrect itsrature: ."Date- phone ik OB cial use are£y. Do not Fvrite in dais area,to be comrip£eteJ by city i�rtoirn a okial City or Taws: •Fermi fLicense i# Issuing Authority(cn e e onej:. L Board of Hcdth 2.Buff Iing Department 3.Cify-trown Clem 4.Electrical Inspector 5.Phrtmbmg Inspector 6.Other Contact Person Phan#- - --- — - --w y 6 coons ` orm�a�on and ins . M�ccaclinse ifs General Laws cbapt3 a I52 regnaes all employers fn provide wo�eas'compensation for their employees. p to this staff ,an errrployee is defined as.'_.eveay personin the service of another under aoy contract ofhim, express or irrEpliec�oral or written" An employer is defined as"aa mdividnal,partne-shy;association,corporation or other legal entity,or nay two or more Of the foregoing engaged m a Joint enterpase,and inclnding the legal representatives of a deceased emplayer,or the receiver or trustee of an individual,partnership,association or other Iegal entity,employing employees- However the owner of a.dwellmg house having-not more than three apar[m.ents and who resides therein,or the occupant of the - dwelling house of another who employs persons to do mamteaance,constracli-on or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employmeit be deemed to be an employer." MC3L chaptPz 152,§25C(6)also states that every state or local licensing agency shall withhold the issuance or renewal of a Tcense or permit to operate a business or to construct bu77di3-gs in the commonwealth for any of roduced acceptable evidence of cum Iia-nm with the hm ran ce coverage regdix-ed." 'cant ho has a p _ - applL � P P Additionally,MGL chapter 152,§25C(D states'Neithesthe con�onwealtb nor airy ofiispoIitical subdivisions shalt enter ruin any contact for the pmTmmance ofpubIic work uo acceptable evidence of compli�e5 with the.insurance.. regtiireuze±s of_d:i chapter have been presented in the cmfra sofa zity." AgpIicants - Please fill oht the workers' compensation affidavit completely,by cherd.g the,boxes ffiat apply to your situation and,if necessary,supply sob,contractor(s)mme(s), addresses)andphonenumber(s) along with their cerEIFacat$(s) of insurance- LimitedLiabiility Companies(LLC)orLimiterdLiabffity Partnerships(I.LP)withno enTIoyees other than the merabers or partners,are not required to carry workers' compensation insosance- If an LLC or LLP does have empIoyees,apolicy is regnuEd. Tie advised that this affidayitmaybe submith--d to the Department of Industrial Accidents for confirmation of finmra ce coverage_ Also be sure to sign and date he affidavit The affidavit should be retn=d to the city or town that the application for the permit'or license is b eing'reques�not the Department of ; Ldustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department atthenumber listed below. Self-insured companies shouldenterthair self-msur=ce license number on the appropriate line. CRY or Town Officials__.... - -- .. .. ----- --- Please be sere that the affidavit is complete and primed legibly. The Department has provided a space st the bottom of thie affidavit for you to fill out in the event the Office oflnvestigations has to coa actyouregarding the applicant P lease b e sure to fill in the pen;aWlicense nwnber which will be used as a reference number. In addition,an.applicant that must submit multiple penntllicense applications in any given year,need only submit one affidavit isdiratrag cusant p olicy i oibr nation(if neoesealy)and under"Job Site Ad&r-&e the applicant should write"all locations in _(city or town)-"A copy of the-affidavit that has be a officially stamped or marked by the city or town may b e provided to the " applicant as-proofthat a valid affidavit is on file for future pmmifis or licenses Anew affidavlxmvst be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial vie (ie_ a dog license or pew to bum leaves et,-)said person is NOT regmzed to complete this affidavit. The Office of Investigations would SM to thmsk you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Departments address,telephone and fax rmnber: CGj=KMWedtIj Of Massachns� . Depadmmt cif l iduizzal Acckdent% f�it�e of� fio� - �Q4 - Bastou2MA Q�IIF Tt,-1.:'617-727-4900 QXt 406 Or I-977-MA.S ' Fax 617 727'749 Revised�E 24-07 p W W-Mass-gav - Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize �-jC� e, ` GJ to act on my beb4 in all matters relative to work authorized by this building permit application for. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature-of Owner Signature of Applicant Print Name Print Name Date 0YORMS-OWNERPERMISSIONPOOLS Office of ConsurneT✓f/�¢ ac�riiel�i HOME IMPROVE TYPE; &Business Regulation MENT CONTRACTOR \Individual 1 Rei$Q8i39'_on - EX iration JOSEPH E.KIIi. 05/04/2020 J SEPH E.KING',,,-',' ING; 11F U0- 36CHECKERgERR1!.LhF i ,� I WEST YgRMOUTH,MA-p2673 Undersecretary + I Commonwealth of Massachusetts y�( Division of Professional Licensure t Board of Building Regulations and Standards � Ur,� Constructto{L,S�tper�t o�Specialty CSSL-099166 s7 7 E.�Pires 01/24/2020 JOSEPH E KING 36 CHECKERBERRY LANE r ly WEST YARMOUTH MA 02673 a CIL Commissioner Construction Supervisor Specialty — Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpl i, l -1zkl13 _ X®PRESS PERMIT n of Barnstable *Permit# Tow '�. OF ,� 6 O K-vlr monilrs om issue date L 2 Regulatory Services Fe seaivsrABLF4 Thomas F.Geiler,Director �b F BARNSTABLE Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town barnstable.ma us Office: 508-862-403 8 Fax:.508-790-6230 EXPRESS PERAHT APPLICATION - RESIDENTIAL ONLY t eqt Valid without Red X-Press Imprint Map/parcel Number �( �' Property Address Residential Value of Work `s, 9(7®' Minimum fee of$35.00 for work under$6000.00 J Owner's Name&Address C-ka,,r-kA, 5�� L VX ��vt-F�� .mac L . .. . 1A Contractor's Name J O -$ IC t fx Telephone Number ' Home Improvement Contractor License#(if applicable) l ® D Construction Supervisor's License#(if applicable) D q ❑Workman's Compensation Insurance Check one: 0I 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 accompany each permit. Permit Req est(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: n�inrocrr Fe�FnuMc\h,,;lAino Hermit forms S:doc " 1panv�yearetr ealt�2 a.c�/vCtr�.tdaclzuis m License or registration valid for ind►vidul use only Office of Consumer Affairs&Business Regulation g f - before the,exprration:date: If found return to: � ME IMPROVEMENT CONTRACTOR r' Office of."Consumer Affairs and Business Regulation aegistration f150889 To ; xpiration 5/51201_4 Individual 10 Park Plaza-Suite 51Z0: ( f Boston,MA 02116 JOSEPH E.KING ? I JOSEPH KING 36 CHECKERBERRY LN WEST YARMOUTH MA 62673 Undersecretary No ; without s n ure : Massachusetts_Department of Public SafetyBoard of Busldr ` ,. uiat, an.d.:Standards Construction Supervisor Specialty License CSSL-099166 =4 JOSEPH E X DZ 36 CHECREAERRY W.YARMOVTH 1VIA 026,a � rVa �. Commissioner Expiration 01/24/2014 f The Corr moMsealth of assachuseft Department o,f Indust Acrid - ,—, t?, ce erfnvestiafrons 600 Washhvion Street' Boston,M4#2111 . rt my mass-gov./dia Workers' Compensation Insurance-.Affidavit$milders/Contrac#ors/Elec#ricians/Plh mbers bIv Applicant Information ��. Please Print Legi Joeng Name(Bu�tim&dividual): 36 Checkerberry Lane West Yarmouth, MA 02673 Phone. - - Cityfstat&zip: Pone# Are you an employer?Check the appropriate box Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees{full arad/ partxme}- * have Mined the nub-contrac xs 6- ❑New cans�ucfion 2. I am a sole pfnpaet&or partner- listed on the attached she et 7.. ❑Remodeling .and h2we no employees a snb-eantrar ors l ie g- ❑Demolition w ,g forme isc a employees and have wwkers' o nY ty. �. ❑Building addition i . o.wod=s' cogs_ins rra�nce Ct�!_m¢mmarvr�J rewired 5. ❑ We are a corpontica and its 10.❑Flectrical repairs or additions I❑ I am a homeowner doing all wrack officers have exercised their 11.❑Plumbing repairs or additions self o workers, right of exemption per MGL 12. Roof rrR„c egaired]T p pairs c.152,§1(4� and we have no 1 Other re employ-[No workers' commp.insurance repaired.) 'Any applicmd that checim box#1 mast also fill out the section below showing their wodess'compensation policy information. rs I Honmowne who submit this affidavit indicating they asedmag allvUlt and then hoe Ga de cantrar=mast submu a new affidavit indim mg sudL tContmcrors that check this box must attached an additional sheet showing the name of the sub-contractors and state ubetber or not-ffiu5e entities bare employees. Ifthe sub-c m=ocs hare empiayers,the mmmtprnvide&w workere camp.policy numbm f urn an employer that isproviding workers'compensrrtitrtt insurance for my employem Beloty is the policy-and,job site ixforttta(ian. . lusmance Company Name: Policy#or Self--ins.Lim# Expiration Bate: Job Site kddiess: Gityr'StaterZip: Attach a Copy of the workers'compensation policy declaration page(showing the policy munber and eapaation 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-OG and/or one-year imprisonmenu as well as civil penalties in t3ie fcm of a STOP WORK ORDER and a fine of up to$250-00 a day against the violater. Be wh sed that a copy of this statement maybe forwarded to the Office of hmestigaticm of the DIA for insurance ccnmrage verfficatim- ' if do hereby certify under the patens a perina&s ofpPdm 7 Mat the informa&n proilided alum is b a and correct Siim atnre, Irate: Phone#: Sv`6` 7 ©,dal am only. Dv not w6fe in this area,to be coruplated by city or MMJ o,MciuL . City arTown: PermitUcense# Issuing Authority(circle one): . 1..Board.of Head 2.Budding Department 3.CAyffewn Clerk 4.Electrical Inspector 5.Plumbing Inspector ..6.Other.. ']Phone#: . * BARNSTABLE hum q� 9 ,�� Town of Barnstable prEp MA't A Regulatory Services Thomas F. Geiler,Director. Building Division Thomas Perry,CBO_ 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 Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize <ff.r to act on my behalf, in all matters relative to work authorized by this building permit application for: e (Address of Job) 01 Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners'License Exemption Form on,the reverse side. QAWHILESTORMS\building permit fonnslEXPRESS.doC _ °FT°wti Town of Barnstable Regulatory Services BARNSTABLF, " Thomas F.Geiler,Director Mib ATFD3+A Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.m.a.us Office:. 508-862-403 8 Fax: 508-790-6230 HOMEOWNER 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 minimum inspection procedures and.requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 15,000 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. . _..1DVDoccC Anr ... .. .. .. .. Assessor's map and lot number ���.� �' �1 Y f � QyOf THE TDB Sewage Permit number .......... ��:.j.........��.� j " BJB.HSTLDLE, i House number-..........:: :...f:....... ,... ..................................._ 9�� MAO �0 -TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...................... �.................................� ............ TYPE OF CONSTRUCTION ..........................:... . ....Y...J...-................................................... ............. `. ....."..... ....19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............. ...6. �� !� J v "� (� 1��1/ c'?.�:�./r ..................... ...............................;..................... .................................................... T j Proposed Use ............................... C Zoning District ..................&: ............................................Fire District r Name of Owner .........n.,�c.-.lr !t!.(��.%'..::'': :........Address �z.�...: � � Nameof Builder s �"'F' ..........Address.......................... ......:...................... .................................................................................... Nameof Architect ..................................................................Address .................... ................................................................ Number of Rooms .............tl'...............................................Foundation 1 ; �!G'i Y j 0 G tL"`�e . .... ................................................ Exterior ............ ........7..../ S -t ...... ..`Ja.......Roofing ....................f�. ..4 -..r............' �� .. ;............:....3 r. Floors C449/7 r �l- %.'! ..................Interior ......... 5 / ! .©.�.�. ........................... Heating tits i4 '� ......C? ......................Plumbing l-� �LI S�f � p Fireplace ........................... ...... ��...........................Approximate. Cost .......................:C ... ...............................� Definitive Plan Approved by Planning Board __________0_C _---------19 %__ Area Diagram of Lot and Building with Dimensions Fee /4 S SUBJECT TO APPROVAL OF BOARD OF HEALTH F t ; �z I *7X 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. �f �j Name ... _ Construction Supervisor's License .. �l �. GREENBRIER CORP. A=172-1 27584 12 Story No ................. Permit for .......................... ......... Single Family Dwelling Location ...1,0t..13r 28 Centerb ook Lane ......... .......... Centerville Owner .... reenbrier Co Type of Construction .... rame........................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ..March....!.... 1985. Date of Inspection ....................................19 Date Completed ......................................19 / °-� 7 o r r TOWN OF BARNST"LE 'permit No 2 7 5 8 4 x Sullding ,Inspector 1 ia.x.0 yu n .+ ..Cash p { h .. DNA'� .00CUPA`NCY PERMIT . ,Bond X 3I�� " r= . Issued to' Greenbrier -Corp.-_ -,Address Lot 13,• '28 'Centerbro6k Lane; Centerville Wiring Inspector .; !` �`+ / Inspection data.: Plumbing Inspector�� A Inspection date': t Gas,Inspector f" Inspection date yr rn fi✓�'^ , .t- ,�'--. ..sn mot/ ..a.;' }{Engineering Department .'Z � a/ '/, '1 Inspection date; F / , ,.,r.� Board'of Health = 1M� f P ( ay +° Inspection2date j f!eM THIS PERMIT WILL,NOT BE VALID" AND THEa BUILDING SHALL NOT BE' OCCUPIED, UNTIL.: ` SIGNEW.BY '"ME BUILDING INSPECTOR,UPON SATISFACTORY' COMPLIANCE WITH TOWN ,REQUIREMENT$ 'AND IN ACCORDANCE WITH SECTION 119.0,OF THE^MASSACHUSEITB STATE BUILDING CODE > Z ' , „ .._.. ........ . w'.......................................... Building Jnspector Y . r i n .' ! 4 ' 1 TOWN OF BARNSTABLE i °� • °" BUILDING DEPARTMENT TOWN OFFICE BUILDING � rum HYANNIS, MASS. 02601 i MEMO TO: Town Clerk I FROM: Building Department DATE: May 31, 1985 An Occupancy Permit has been issued for the building authorized by BuildingPermit ...........27584 _._._........... ............................. ..................................... Greenbrier Corp. issuedto ..._._...._.... ......_.... .........._........................_...............,..... ..........................._ Please release the performance bond. t; o:T 2 - I J39 EasE,�l 155 L)0 - J C . w Q CISSoc�sr- Y 0 you cwriv,.1 3O'± 0 { ` 00�___ Lo.,7 ZDn/GD Lor ►5 �s,o0o s►= Nlw. Jo o' .MI" I-,/w7-N 20 /I o/)w kz-rEACic L " CERTIFIED PLOT PLAN 4p- RDBER7 � .7 NEW CONSTRUCTION ONLY � g B �QLI� C�aRaoo�LN_ CEnir�e y �u= ELDREDG E: TOIa OF' FOUNDATION IS FEET o No. 19387 Jc i IN ...ABOVE' LOW POINT OF ADJACENT. �ss��crsTr ROAD. SCALES /"= 30' DATE= FEz3 251` 'as GEE CLIENT I CERTIFY THAT THE FOUND��oN EEI'TERED REGISTERED SHORN ON THIS PLAN IS LOCATED r JOIN NO. ON THE GROUND AS INDICATED AND GIYlL LAND CONFORMS TO THE ZONING LAWS F ENGINEER SURVEYOR DR,Sys OF BARNSTABLE, MASS 3 712 MAIN *STREET CH.M HYA N fr I S, MASS. SHEET-J-O.F i LAND SURV OYE It A E REG. 1 I q, j z j13, + f / �tit \ \ :6o '•V3 � D p t ..I _' ' vt IN /// Pf " §tHk OF A14 j /56 ` t, / u U ` �,t//D ?{ ,• . o ORSE N2.10951 ) v .o F e - - 'T"c. GIs l'�- �• - ONAL „i �t LEGEND EXISTING ;SPOT ELEVATION. CERTIFIED PLOT PLAN �extgTIND -;CONTOUR -- 0 FINISNED SPOT ELEVATIONd j� c��lT�r�3��%=�� �sf Vie: FINI$NED:�CONTOUR 0 g, �i,a,� ,, i.. T N(YfE ''The location of. any, existing under�iound sewerage, wells,zxor .other`utilties shown= on�t1 s pl{an is apgrox !N .iscr, zmate `only as determined fxom recoxds andor .verbal IS-fA' nforma.tion. `The contractor istesponsible for_the -Vrs � I �� verification of_the` existing locations in::.the .field_. ':gC + J DATE 00y., Ii. lEd)G� EN(iON�°E'RINO CQ. li4l' C11� ',s, h CI,:I:EIdT I CERTIFY *;THAT THE PROPOSED., EGI ERE ', REGISTERED _: J08NN0. & BUfLDiNO` SHOWN ON` THIS .PLAN *a CIVIL LAND Kr� ;: b CONFORMS TO THE ZONING LAWS,..,,. 4 DR RY s c"¢•'' E OI,.' EER RV �, . r QF BARN$TA.F�L1= MAt9 � „ `7121"MAI.N STREET {' CH.RISYI ' - w WETS,,,. OF � E REG. LANDr' SURVEYOR G" A 77 c r bi .. ,..,...,..:__..:,...... .�>--. ..._.•.,�-.-,,n--..;... _....,..-:_ .. _:_.. -.,,:. _... -------- _. -... ...... .._,.,., _. .,.. -�._..-.-,,,;,..i Assessor's map and lot number .-.. /•• V/ � PT� �`� / STEM MUST BE oFTME,o N T Sewage Permit number ........ t� s r, P .�1 � CP IN COM F , -. TITLE 5 • r Z BAHBnsBTADLE, • House number ....s ..d' t N�19� 0 �`e f' :< 9 •_ ENVIRONMENTAL ........... ... :..............._..... : TOwm y� gA G 039 ♦� TKAIS TOWN- OF BARINSTABLE DMIDING INSPECTOR APPLICATION FOR PERMIT TO ......................C.ONS� '... (../.. . TYPE OF CONSTRUCTION ......................... !w...Q.Q. .....f-k/&.—.- ............................................... t i •............... ...f ....19........ r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 1 C �� LocationC . ....................................................� `. .. ...... .�.... .................... Proposed Use ............................. �1 1f'1..'�........... !:... ...................... .................................I......................... Zoning District L:...........................................Fire District .............................................................................. .................. .. .. ' 4 Name of Owner ........ .(�. ...Address �........................ .... ....................... Nameof Builder .......................:�-Lq.!:!.�............................Address .................................................................................... Nameof Architect ...........:......................................................Address ..................... ........................................................... Number of Rooms ......Foundation .......... Q. ........................................... Exierior ............u/C....�J�iirc�. Y75....... .......Roofing ...................../`,1_4.�r..... ..................... 7 �p (� Floors ............... � ......fi-.. ...?..!t.Lf..................Interior ..................5�. ::..1......k�.Q ..[..\.......................... L C Beating �.:. ..........:.. .....................Plumbing .........`.................�Z..................J....a......................... Fireplace ........................... ...IIJ !� ........................... ...... �............ .. Definitive Plan Approved by Planning Board __________-_��_______19_�__! Area ��! °....................... .......... ........ Diagram of Lot and Building with Dimensions Fee .:�L/� ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH l G ������ L .A �Z' ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barns a reg rdi g the above construction. f "' _ Name. ................ .......... 0 ,,� 3 � 7 • Construction Supervisor's License ..........V.�.......�... .... 4-1 GREENBRIER CORP. No ..275.8.4..... Mrmit for ................ Sin gle........ .. ly..Welling...................... Location Zot..l3,....28..Ceuterbxook.Lane Centerville ............................................................................... Owner ...........Greenbrier.............Corp..' ...................... ..................... Type of Construction, ...frame ................ .................. ........ ............................ ......................................... Plot ............................ Lot ................................ Permit Granted ....March 7,-----•---•---•,-•,1985 4 Date,of Inspection ......................... 19 Date Completed -Xt-51