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I , '. � .1 ,� -W", I I 11 , I M 11 1", W I IN 'a I r7l F-l� Town-of Barnstable Finaf Inspection-Affidavit r Date: e4 A4 hf, Thomas Perry, CBO Building Division 200 Main Street . Hyannis, MA 02601 RE: Insulation,Permits Dear Mr. Perry, This affidavit is to certify that all work completed at: Street .Village: 'has been inspected by a certified-Building"Performance Institute (BPI) Inspector. All work performed meets or exceeds federal and state requirements. Permit application numb er: Issue date: Ln Sincerely, 4 M Francis.Sheehan Presitlent Frontier Energy Solutions, Inc. 502.Harwich Road . Brewster, MA 02631 Office: 774-237=0410 E-mail: fssfrontierenergy a&mail:com TOWNOF BARNSTABLE BUILDING PERMIT APPLICATION T�UJ,Map Parcel , r TA 8LE Application # Health Division r 13 2 Date Issued 3I3 u I6 Conservation Division Application Fee Planning Dept. Permit Fee S !✓�•0-0 U its a 4� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis .SE• J Project Street Address 3l aw 4kx- Village � 4 Ownerl X6 IV Address Telephone, �"31(4-0 R Permit Request ;2Va 12,4 Pea/ ,-ra �/�s [' ��. A i - & Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation akOM Canstruction Typ , 1 / -tYOA--) Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new 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 ❑-PdII If es, site plan review# Current Use Proposed Use � ' 'k, APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name f/1 Telephone Number Address �'6� 1l License# lcp7z, Home Improvement Contractor# 'Ikom Emailf4fi CADV-�Worker's Compensation AAA, 1�l ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AMA SIGNATURE ADATE r' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED f MAP/PARCEL NO. ADDRESS VILLAGE 'r OWNER h' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 'k PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r f� ,o Town of Barnstable, , RegulatoryServices ASSa 12iC6af�i'V". birector 16 Tom Perry,Biding Cprniaussioner. 200 Main Stieet,Hyannis, ik.02601 www.townlarnstable nia.us Office'.50s-862-4038 Fax:,509=790-62 0, Property Qwner Mush Complete and S.iEon!Ns Secti.oll. -if UsxnA l�udg C ft b(.'Ifk1 6tS'rFbI`ZD_.�_:� a;�C? er cif the subject grope tty lrexcbS authorize to acc.on mybehalf, in,all matters relative,to work authmized by this'buildin eumk application:for- t I �L�IL Mll; ,Lr ante � bl,`"i 12 t 1(. CC K-t {Address;ofjob) "Pool fences and:alarms are thin respon.5�ility oI-the applicant.Paths ` ate.mot to be fikd,or utilised before fe e I installed aria all finaJ- mspecuons are perfom a*ed and:accepted; Signature grOkner L Signatule,of-Applicant Pirint lwnz Pant Nairn, Date Q:FORB4S:O1VNF-RPE'UvTJSSLONPOULS The Coaonwealtle.of Massachuse� , �> Departi'nen6 Industrial Acc Aft. .�� 1 Congress`Stree�Suate 100 Boston,NIA 02114 2D17 � - , :. w►t�w.mass gov/dr , 1�"o_rkers'Compensation Insurance Affidavit Btulders/Contractors/E!ectncianslPlumbers '' TO OIE.FILED VYITH THE PERiriTl'1, 6, AUTKORITY Applicantlnformahon. .. rr Please Print Legibly:. Tlarne($.ustness/Orgatuzation/Individtial} ��d l``��( .�✓tQ��aN�. \[� tJ'RO n C ��C Address': C ty/State/Zip.: tQ 1� 0 Z:C� 3 ( Phone 1 � _ c\►re'ou au;em to er.Check fhe.a ro nate boz_- . Of ro eCt' C¢ aired is i, am a.;em 1 er=month ' em:lo ees full and/or; P Y ( P No construction l;. 2.: I am a sole,propiietor or rshi and have:no em to ees world for ' 8 RemOdeiing. Rye P.,. P Y,.. anY cap*nY [No worke '.vomp insivance re jitired] 3 I atn a homeowner dom all work m self o=workers:co r 9 Q Deli101itlOR g. Y [M mp tnsurance requiied j 4 I am a homeowner and will be ha iitg contractors to conduct a[t work on,m (:will t 13uildmg add►tiotr Y ptoperty. ensure=that all contractors"either have'.workers'compensation mn4oce or areso(e:. 1 l;❑EleCfltCal repairs Or:addlttOti§ proprietors wnhpo employees l2.❑Plunbing.repairs or`additions s' .[am a general contractor and[have lured the sub--conttactors Iisted oa the attached sheet These sub contractors have employees and have workers comp insurance l 3 a Roo repairs. { (j 6: We are a co ration and its office "have exercised thetr.ri l4 (�l�ther rP° grit of ezemptton per MGL and=we have no'employee5 lNo workers_,comp insurance regiiired,j. Any applicant that checks box#l.must also fill out ttie:secdon bi low showing their workers"compensation policy inffoematiori t Homeownt is who submit this affidavtt tndcatuig they.aze doing;all work ark th11. en he outstdecontractors must:smrt a new=affidavit'.ndicating such;' ;Contractors that check this box mint attached an additional sheet`showirig the;tame of the sub conttactorsandstate;wheiher oi:not thoseentiues have. employees., ie sub-contractors have;employees they`must p�ovtde their workers,comp.,potiey numbe r 1 ai ail employer that rs pro�workers'campe�rsakon insurance or a to ees Below ts,the of mid'ob site infor►xatron t Insuran � .9 o_ om .a , A. - Policy#oc;Self ins;,Lic # O 1 , 2Date ( Job$ite Addre ,n n r �. - 0 _AtIatea- Ag��M,4 Attach a copy of the workers''com.pensat on pnlicydeclaration page(showing the policy:;dumber"and egpirahoa date); Failure to sectue couerage,as required underMGL c 152,§ 5A!s a.ertminai::wtolation purustable by a fine,up to$1 Sq0 00! and/or one-year unprlsonmeit as well as civil penalties in the form of a STOP WQRIC ORDER and'a fine ofup to$250.00 a day:against tl;e atotator. A copy of this statement may be forwardezl fo the Office of Investigations.of=the D[A for.irisurance: coV.erage verification . l.`do:hereb :eerti 'under.the orris" eso; a '_ j r - Y h'_ F f,p rlury�that the:rn ormatton provided fib ve is'_" and correct:' , si `ature` Date Oda[use only. Do ntitwrt7e in thus area,to be CO by city.or town,offecat City or T-own Permit/L rcense# Issmng:Authority(circle one): lc Board`of Health 2-Building Department 3:.City/Towo Clerk 4.Electncal.iiispector 5.Plumbing Iiispecfor. 6:Other ,. Contact:;Persan: Phone#� , - � o 33 SS .O g p }}J}} •;� z S;: C�ii fl- • I - .. .. ,2 Z O_m -10 3 '�Am .�lt w, to 7 "a A O'c x.. 3/ 16/2015 12 : 35 :•39 PM 8626 02/02 .• 1 0 - - e. DATE(MMfDD/YYYY) - CERTIFICATE OF LIABILITY INSURANCE -, 03/16/2015 ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND,CONFERS NO'RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,,EXTEND''OR ALTER THE COVERAGE AFFORDED,BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CGNTRACT BETWEEN THE,fSSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) 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 00509-001 CONTACT Jeffrey Ford Rogers Sr Gray insurance Agency PAfC.No.Ext: {800)553-1801 A1C.No.: (508)398-0246 434 Route 134 EMthSS: South Dennis,MA 02660 AD INSUREEUSIAFFORDINGCOVERAGE NAIC INSURERA: A.I.M.Mutual Insurance Company 33758 INSURED INSURER B Frontier Energy Solutions Inc INSURER C 502 Harwich Road INSURERD: Brewster, MA 02631 , INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ` THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT-'WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY.THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE - 15k S B POLICY NUMBER POLI(MMIDgAf Fn. PMIDD/YYYY .LINKS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ _ _ PREMISES Ea occurrence CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ OUCY ER& OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR - EACH OCCURRENCE $ EXCESS LIAB CLAIMSMADE AGGREGATE $ yy��opR DEEED CCppppqq RETENTIIONNN $ WW H $ AtVD EMPLOYtR3�LIABILITY X TORY IMITS OER ANyy PRROoPRII��77ooR1PARRTNE RIEXECUTIVE Y f N E:L.EACH ACCIDENT $ 1,000,000.00 A OFFICERtMEMBEREXCLUDED? y] NIA VWC-100-6015315-2015A 3/14/2015 3/14/2016 �(fManddatory ipn OPERATIONS E.L.DISEASE EA EMPLOYEE $ 1,000,000.00 UMCRIP'��ON On�OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000..00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION Town of Sandvdch 16 Jan Sebastian Drive SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Sandwich,MA 02563 'THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. U AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 2630 3/14/2016 Print Page " Print this page a Owner Information - Map/Block/Lot: 173 /077/-Use.Code: 1010 Owner . Map/Block/Lot• Gl►S MAPS BESTFORD, JAMES P'& 173 f.077/` Owner Name as of CAROLYN Property Address 31 CONANT LANE 1/1/15 31 CONANT LANE CENTERVILLE, MA. 02632 Village: Centerville Co-Owner Name Town Sewer At Address: No GIS Zoning Value: RC a Assessed Values 2016 - Map/Block/Lot: 173 /077/- Use Code: 1010 2016 Appraised Value 2016 Assessed Value Past Comparisons Building Value: $ -136,200 $ 136,200 Year Total Assessed Value Extra Features: $ 37,700 $ 37,700 2015 - $285,500 2014 $ 2851200 Outbuildings: $ 4,600 $ 4,600 2013 - $285,400 2012 - $291,800 ` $ 110"200 $ 110 200 Land Value: 2011 - $ 274,100 2010 - $ 273,000 2009 $ 314,200 $ 288,700 2008.- $ 326,400 2016 Totals ' $ 288,700 2007.- $ 356,300 Residential Exemption Received= $90,000 Tax.Information 2016 Map/Block/Lot: 173 /077/-Use Code: 1010 Taxes C.O.M.M. FD Tax = (Residential) ' $ 459,03 Community Preservation Act Tax $ 55.50 . T $ ' Fiscal Year 2016 TAX RATES HERE http://www.townofbarnstable.us/Assessing/printl6.asp?ap=0&searchparcel=1730 .,"' 1/4 3/14/2016 Print Page Town Tax (Residential) 1,849.90 2,364.43 • Sales History-Map/Block/Lot: 173 / 077/-Use Code: 1010 History: Owner: Sale Date Book/Page: Sale Price: BESTFORD, JAMES P & CAROLYN 2003-07-15 17262/94 $1 BESTFORD, JAMES-P 1999-12-28 12751/158' $145000 VIRK, SOM P 198.6-09-15 5280/161 $140000 DEVEREAUX, PHILIP &LORETTA 1980-04-23 3086/190 $0 Photos 173 / 077/-Use Code: 1010 • Sketches - Map/Block/Lot: 173 /077/ Use Code: 1010 WDK, 1 32: U --BAS., 28 BMT' q 22'` AsBuilt Card N/A Constructions Details -Map/Block/Lot: 173 /077/-Use Code: 1010 " Building Details Land http://www.townofbarnstable.us/Assessing/printl6.asp?ap=O&searchparcel=113077 214 3/14/2016 Print Page Building value" $ 136,200 Bedrooms 3 Bedrooms USE CODE 1010 Replacement Cost $172,421 Bathrooms 2 Full-I Half Lot Size (Acres) 0.41 -Appraised Model Residential. Total Rooms 7 Rooms $ 110,200 Value Style Cape Cod Heat Fuel Oil Assessed Value $ 110,200 Grade Average Heat Type Hot Water Year Built 1978 AC Type None Effective 21 Interior Carpet- depreciation Floors _ , Stories 1�3/4 Interior-Walls Drywall Stories Exterior Living Area'sq/ft 1,709 Wood Shingle Walls Gross Area sq/ft - 3,556 Roof Gable/Hip S uct ur e Roof Cover Asph/F GIs/Cmp • Outbuildings & Extra-Features - Map/Block/Lot: 173 1 077/-Use Coder 1010 Code Description Units/SQ fi -Appraised Value Assessed Value BMT Basement- 1036 - $ 22,700, $ 22,700 s Unfinished , - Wood Decking W DCK 448 $ 4,600, $ 4,600 w/railings Fireplace 1.5 FPL2 stories 1 - $ 4,400 $ 4,400' BFA Bsrnt Fin-Avg 780 "S 10,600 $' 10,600 • Sketch,Legend Property,Sketch Legend 132N Barn-any 2nd story area FPC. Open Porch Concrete Floor REF Reference Only BAS; First Floor,Living Area FTS Third Story Living Area(Finished)SOL Solarium BMT; Basement Area FUS Second Story Living Area SPE Pool Enclosure , -.(Unfinished) (Finished) BRN Barn GAR 'Garage TQS Three Quarters Story (Finished) CAN Canopy GAZ. 'Gazebo UAT Attic Area (Unfinished) CLP Loading Platform GRN Greenhouse OHS Half Story(Unfinished) ; http://www.townofbarnstable.us/Assessing/printl6.asp?ap=0&searchparcel=173077 3/4 r - 3/14/2016 Print Page, FAT Attic Area (Finished) ' GXT Garage Extension Front UST Utility Area (Unfinished) FCP Carport KEN Kennel UTO Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,-Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola ,UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Microsoft VBScript runtime error'800a01a8' Object required: /Assessi6g/print16.asp,.line.151 http://www.townofbarnstable.us/Assessi ng/print16.asp?ap=0&searchparcel=173077 -4/4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 113 Parcel'- -Application # MIA 19 Health Division Date Issued �AtC7 Conservation Division �� O%' � Application Fee �V Planning Dept. , J >.}', Permit Fee Date Definitive Plan Approved by Planning Board \ w taj5 Historic - OKH Preservation / Hyanni ', c' Project Street Address Co N6 7- Village v.T LLB n Owne��jvl,CS -4' CI+R 1 L_YAA ,8Ef F09nAddressd/ �f'J,_A17 L AI ld/ Telephone Permit Request 1*q,6 Q V& 6 9Q VILID T 00 e /�I A 3 0 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain_ Groundwater Overlay Project Valuation i q,•p6b Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, Two Family ❑ Multi-Family(# units) 035 Age of Existing Structure _ Historic House: ❑Yes UNo On Old King's Highway: ❑ �Yes No Basement Type: &'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing .3 new Half: existing new Number of Bedrooms: -3 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 WNo Fireplaces: Existing New Existing wood/coal stove: Y 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ,_, ��'��� � L'ARVLYA1 B—ES% O elephone Number 'la L5r- L Address 31 cps/1A)T LA License# C E N 11l 0 LL E A4 6 0 Z 63 2— Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU E DATE / D l i FOR OFFICIAL USE ONLY APPLICATION# 4 J DATE ISSUED. > E: MAP/PARCEL NO.- = t ' ADDRESS _ VILLAGE OWNER 4 DATE OF INSPECTION: �J FOUNDATION t FRAME I INSULATION F FIREPLACE s ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL z GAS: „„ ;L ROUGH -d.JA,' �ii.zX = FINAL' FINAL BUIL_'DIN_G Q�'�dSllo r f DATE CLOSED OUT, } k j ASSOCIATION PLAN NO. t i.4 ' Tfie C`0rnlnot( vu6R'f of nldssdcfsure>YS Depar'Merrl of lit dusfrig-fAccidex{s Offxce of rrrvesLcgaltons . 600 }�cc,�hinglon Sfree'! � _ • 0,21"11. . . I3osto�i., obtractors/ Iec �Vorkcrs' Compensation rns ranee Affidavit: Builders/C ease pr t X,eb 1 PI Appticant Znf'ormatton Name (ausin cis s)or` iigtionla--dividpal):. .. Address: L i�te/Zi l� �AJ7 1�( � � "°ne. Cl y/S P• . . F Arc you as employer? Check the appropriate box: roj'ect(required):4. I•am a general contractor?and 1,1.[�. T asn a caZploycr with constrictioncs (full and/or part-limn); the sr�b-contractorsodcliuglisted on th.c attached shcct7 am a'sole proprietor orpartncr F ' T'hcsc `sub-contractors have oliiionship and Lz. c ub cmployccs cmployccs and have �V.Drkc•rs ding additionworlang for mo in any capacity' corrrpf]r3nc0,[No workcrs',co�ap,•inauraacc rr�I tricalrepairs oT adrsquired] 5, d yy t.arG-a corporation and itsl am a homeowner doing alb ivorl officers have exercised thcixbing repairs or adc It of excm tion per 1viGL oof r airs mys d1, [No workers' comp. right p 12.[] cp. G, l5� l(4): tiDd WG l]2YG]10 13: thcT&V�!e inc�,rancc rcqu rccL] cmployccs. No workcrs i�l comp, ix�stuanec rcquirtd-] tpy applieanl thzi ehccl?box t/1 mustalso fill out the reckon bGIDW ihowing their workers'cottip� �-i}on Policy inf°rrrza.bon. t[�omcowncrT arf�o rubn>il.tiiis affidavit indcaling fiicy arc doing all work and that hire DUtsidc contractors inns(submii a new a�davitindicxiing Nc •ciai�pficther or not(hose e�ititi rs have tConlr,Lclflrs fiat chock Lhi1 boX must atlachcd.ui ndditiorial nc�et rho�ring L}1c name of the suh-eontraitrn� znd emplo)C-s. Iffhc sub-conb-aetorr have nnploycef„theymurl proY db their workers'comp. po06y ninribcr, nj� cmpCoyees. oCiry artd�ob si faincux errzp(oyer Zhrrl ls provtduig porkers' compeltsalw,rt insuraiiceJ`or r BeCakp >s flte p iAfo rm rrd on Insura.ncc Company Nazoc: Expiration Datc_ Policy#'or Sclf-ins, Lic, #; City/5tatc1Zip: Job Sitc A.ddres;q: Attach a copy of the�vorlcers' compensation ppUcy declaration page (.9b0Y ff the policy number and exp'iraiion ds Failure to sccnra covcrag0 as requirtd.undcr Section 2.5A ofMGL c. 152 can Icad to'tholcoposition of c-im al penalties Eno iip.to 31,500.00 and/or one-ycax imprisonment, as Well as civil pcnalti'cs in the formof a'STOP WDRK ORD$R and day against the Vaolator. 'D6 advised that a copy of this sta of up to S250.D0 a tement may bo forwarded to the O�ee.of InYcsti ati of the ID IA for'in�ct coXDraLxc vcrifcation Z do her by c rttfy under lhep.ins• ted pen es a per'ury (real the irff rrrcah'orr provided above [s(rue airdcoirec� D a tr,; !� Si a J Pbonc #: Offtrivl ure only, Do nol write in lh_Lr arco .lo be•compLeled by oily or lo,wn officiaC City or Town: 15Y.uiog Autborlh/ (circle one): 1, Board of Health 2• Building Department 3 City/DWD Clerk Electric�l rnspecfor S. Plumbfog Znspec{or Istru Information and 11 to 152 r uires all employers to provide workers' compensation for (hcir,cWp)oycos: Massachusetts General Laws cha p iD the scrvicc of anotbcr under any contract of biro, pursuant to this statute, an employee is defined as '...cvcry pers.on express or implied, oral or written co oration or other legal cntlty, or any two or more ar:acrsbi association rp to cr Of the An errcplDyer ij dL fancd as "an individual, p P the lc al rc rescntativcs of a deceased cmp y , of the foregoing engaged in a joint cntcrprisc, and including g P c to ccs. How�vcr Chc receiver or ftl steo of an indzV?d'�al Pa °G��p, '�sociation or other legal entity, employing �P Y o a dwelling.bOusc baying not more than three apazimcats and wb° resides therein, or the occupant of tho bousc owRcr f c ,bousc`of anotbcr who cmpinys persons to do rnaintcnanec cozu h m°)o°r cat be deemair Work cd to ben SuLch den e pgoyer." dw ll�ng % I-ti t k 1 or on the gzo,-w6 or bvildUng appurt�na°t t5crcto shall note ecauc of P 25 also statrs thal ,every stn+fe or to al liccnsing agency shall j'�ithhold the issuance ar' MGL chapter l52 § O{� , -1 *1 -1 + 1 N �• P �+ \ rege•PYal�o'f license or;perm.ii io o ezatc a business oof o co om li nce:Ys'i� th�si suzancoe�c�on a����quJz any appl.icantWho ,has notproduced•acccptable cYidcn� � � �P� 1 4 (� % ofits olitical subdivisions Shall Additionally; MGL ohaptcr 152, §25C(7)states "Neither the conuaonwcalth`nor any; P Adds ion any contract foz,ncc performance ofpublic work until acceptable evidcncc of eonspliencc g2th�D ura�cc roqulrrmcnt=s of this cbaptcr bavo bccn presented to the contracting authority. Ap pl!ca.n ts• rf` Please fll out the workers' compensation aff davit completely, by chcc)dng th c boxes that apply to your sibati"a and, ncccssazy, srxpplyWith sub-coatracto s) namc(s), address(cs) and pbono numb cz�s) along p c oyccs thcr than the insurance, )✓united Liability Cor_IIpanics(LLC) or Limited Liability 1'astncrships (LT n L mombcrs orportnors, axon to carry wozkcrs' comp ah�n DSUrubmmitt d to If e D artm nt Of Xnduftnal czaployccs, a policy is rcquixcd B3 adyisrd that tbis affcavj y or�pfirmatioA of insurance covcrago. Also be sure to sign and date theuc not the D cntof Accidc,nts f bo rcturnad to the city Or town that the apphcatiort for.the permit or bconso is o �c rq uizcd to obtain a WDfkcrs' Inds trW Acci:dcnts. Should you hav c any questions regarding the law or if y cow ensafion obey,please call the Depaztmcnt at the DurRber listed below. Sc1f insured cou�a�es sho!tld enter tbcix self insuranGo license number on the a ropriate line.' City or TOTfP OfIlc(nIs it the bOttDM Plcasc be sure that the of davit!s complete and printed legibly. 'bc Dopartmcat has pro adze Epa--- lit ant ' of tho afE&'VIt for you to fllcromuti �Dsc nnt the umbcrOf cc)ch will be usod as a h fcrcneoc number. Ln addition, an aPPdcant vcn car, need only subrr it°nP al�darit indicating curront Plcaso bo sure to E].l in the p . that roust submitmUlttPlD P° �ccasc applications is any gl 7 , catiozo in e' ormation(if Poeessary) and under"job Site Address" tho applicalit Should city wor trItaown Imay b pmYided to tb—(city oz Po)1 Y� cd or marked by y , � ) A copy°f the af�daYit that has bccn off crally stamp a 4cant as pzoof that a valid aSr affrdavit is on file for (ut�izo Pc 'r�tS °t not r latcd o any in ss or cotbmm al Ycnhuxa PP a Eccns c or ycar_'Whero a borne owner or citizen is obtaining P. this a�da Yit (i.e. a dog)i��c or'Pcrmlt to bum)caves etc.) said persoA is NOT required to complete Y uGeons 'Z'hp p ee of Lnvcstigabons would lrke to thank you in adyance for your cooperation and should you have an 9 plcasc do not hcsitafo to&C us a call Th6 Dcpaxflncnt's address, tcicpbonc•and fax number; Al �= Tha Commonv><e-alth of Massnhustrtts40� c . ,..- 1 AGciof Idd' d�nis' 0-ffiCC 01'1DYCS(7g-gt.oCls 600 Wash�V BQX0n, MA 02111 TG1; # 617-727-490.0 ext 406 pr 1-877-1\,.[ASSAFE Fax# 617-727-7749 Revised 11-22-06 wv vr.mas.5..gov06 MBASSADOR - . OOLS - 78 Astor Avenue, Norwood, Massachusetts 02062/Telephone: (781) 440-0420 (800) 752-9000 Buyer(s) ml I`t `,}. '(� ` ( "t�11 4 hYn . .»*i Sri, Date Phone Address € t�t'!`fT f .�7 ' City `.. ~r��� fit - State Zi A'r Who covenant that they are owners of the above property,agree to purchase according to specifications: p SEANStEr SWIM AREA 24'x24 26'z31,'O:D. ALL ALUMINUM-PRIVACY SAFETY FENCE 20 MIL.WINTERIZED VINYL LINER ALUMINUM IN-POOL LADDER 15"EXTRUDED ALUMINUM WALK DECK SELF-LOCKING ALUMINUM EXTERIOR LADDER AUTOMATIC SAND PURIFICATION SYSTEM HEAVY GAUGE ALUMINUM WALL HAYWARD 1 H.P.PUMP&MOTOR 17'6"xV31"O.D.EXTRUDED ALUMINUM PATIO AUTOMATIC SKIMMER AND RETURN APPROX.4FT.DEPTH VACUUM CLEANER FACTORY 30 YEAR LIMITED PRO RATED WARRANTY CUSTOMER TO SUPPLY WATER AND t , ELECTRICAL'HOOKUP r 17 Payable$ '� per month � installments,beginning w days after completion. ,'t 't' ;SC11EDULE OF,PAYMENTS In the event that this contract is to be paid in more than(4)installments,or is to be financed,the Seller shall have #1 PnCe t '$ the right to arrange for financing in which case the Buyer(s)agree(s)-to execute all instruments required. If the Buyer(s)fail(s)to execute and/or deliver said instruments required for financing, then the fulliamount of this $ 2 'Pald with order contract price shall forthwith become due upon completion.The terms of this contract and of any instrument a 44 referred to above shall be cumulative and not exclusive and together shall constitute on contract. 3: Payable on start —The Buyer,shall,be solely-responsible for.poo6;focation,;inclu0ing without limitation,compliance with all zoning _ requirements, set-back requirements or other restrictions, and location of`pool within p?operty'lines. Buyer wilt provide access to the pool site for delivery,and Seller shall not.be responsible for any damage caused by ingress Payable on Completion $` - or egress of equipment,supplies or motor vehicles.The Seller shall not be responsible for any delays occasioned ` by reason of weather conditions,accidents,act of god or any other contigencies beyond its control. 30%DOWN REQUIRED ON CASH ORDERS Buyer shall supply sufficient water to fill pool.Buyer will also provide for electricity to the filter,and will provide all proper electrical appliances as required-by all codes.Buyer warrants that he owns the premises where the pool is to be installed and that there are no zoning limitations or restrictions preventing the performance of this agreement.Buyer agrees to supply for and obtain and deliver any necessary building permits. The following items shall.be supplied by and/or shall be the sole responsibility of the Buyer, and the Seller shall have no responsibility for:grading,fill,change of,grade,landslide,setting of land or landscaping, concrete work,sidewalks,fences, lawns, shrubbery,driveways or patios, any part of the electrical system, drainage around the pool area, and building permits zoning and zoning changes. Buyer shall grade the area around the pool so that the surface and subsurface water and drainage shall pitch and-flow away from pool, construct any necessary or desirable retaining walls,and shall comply fully with the instruction manual. i The credit of the Buyer shall be subject to review and consideration,and if the,opinion of the Seller or any financing institution,the Buyers credit shall be found to be Inadequate,then and in that event the Seiler shall have the option of cancelling this contract. DAMAGES: If,after we accept your offer to buy your pool,you cancel this agreement;you refuse delivery of your pool or we are unable,through our fault to assemble your pool,you will pay us for our loss and our expenses.Our loss will be equal to 20%of the total price of the pool,unless a lesser amount is stipulated by law. { i Upon completion, Buyer,at Seller's request,will sign a completion certificate which will be conclusive evidence that the pool and/or other installation is in all respects satisfactory and that the work has been fully and satisfactorily completed. Use of,the pool by the Buyer or his family or guest shall constitute evidence that the pool is in:all respects satisfactorily completed.This contract and agreement contains the entire agreement between the parties hereto,and all prior negotiations, representations,agreements and understanding of every name,nature and description have been merged into or superceded by this contract. Seller warrants the pool against defective parts for one season at no charge for labor and materials.The pool carries a-0 year transferable pro rated replacement policy in addition to the limited warranty. y ALL MATERIALS SUBJECT TO MASSACHUSETTS SALES TAX 4 - - Witness our hands and seal this day of By Accepted: Signed -tiw.--� _,,,,, ,_ R_•--• .�•,�..r.w's-=,. Owner .. - r , o a i CONA A'7 Ak i LEI NE AS off' I I _,SS EA 190. ---- ACCtE 12oa4 5 , LOT 16 �- i� .............„ H SE ! OT 1 S88'38'50'EE, T 156.25 ) LOT 13 LOT 14 RES.. ZONE.- "RC" This MORTGA ' ii E INSPECTION Plan is For FLOOD �ZO.NE.--, y;Ib Bank Use Onl t, 'FOWN: _c T—TRULLE- __---_- REGISTRY OWNER: DEED REF: 5 q-0 -L61___-___--BUYEIR: _AAfE .P_&_Q&QZ31V 9_9.ES'TF02gD . J----- - - - - DATE: _I'ti ''99 ---------- PLAN,!' REF: _3581 - 1--=- SCALE:1 ! 30'------.FT. . I HEREBY CERTIFY TO OL�_f 'NZ'_108�C � QQ.—____ _____ __ ___ _ _______THAT THE BUILDING - �N Of. YANKS SUR\`E1 SHOWN ON THIS PLAN IS LOCATED ON THE GROUND ASPAuI �„ CONSULTANT SHOWN AND THAT ITS POSITION DOES __ :CONFORM i P. ,! A. 40B (SUITE I) TO THE ZONING LAW SETBACIi REQUIREMENTS OF THE MERITHEW t.- ; f TOWN OF ___B 1R1US_T.�BLE_—_--__-- — P!f AND THAT No. 32M INDUSTRY ROAD IT DOES__N_0_�— LIE WITHIN THE SPECIAL FLOOD HAZARD q�r�, REos s.'' `MARSTONS �M�[LL,�,. MA._0264tl AREA A ' •HO N ON THE H.U.D. MAP 'DATED i1244!67 TEL �68- con i t — P ?50001 0015 C i­11,,!f — J FAX: =t!20-.5a5::; _ _ �� � THIS (PLAN NOT MADE FROM AN INSTRUMENT If f':1tt 1 - `9�F::11L T'f. ---- SL'R\'F,l''. NOT TO BE USED FOR FENCES. F.TC. '��fit? %F _ - Or Town 0f BarustablE, of�J{E ro Regulatory Services . Thomas X+', Geiler, Director t BrlANSTAH[..fi, . _ Mtiss. Bnfldiag Division "eo µre", Tom Perry,wilding Cotnrrussioner' 200 Main Strcct, Hyannis, MA 02601 )i yjy,town,barustoble.rna.us Fax; 508-790-6230- Office; 508-862-4038 ROh4EOWNER LICENSE EXEMPT10N picase Print DATE: ,V1 JOB'LOCATJON: 3/ ��<��/v � 1.��. � Ylllagc _ GQ st cct �D /S OU / number _ - C31 4_ �l l� 6-e-5 work phone I "IIOMEOWNLR":� ;�I)f,�� home phone H Hama & , / CURRENT MAIANO ADDRESS; v/ zip code sLalc cityltown e em lion for"homcdWPCEC was extended to include ownerso a jpen alyrolnded th t thelowner acts d jhe current x p to allow homeowncxs to engage at�r individual for hire who does not posse , superYisor. pEFWITIDtq OF HOhfE01I'NER ' a arcel of]alid on'which he/shc resides.or intends to residec o us hanAefarm stiuctvres dA to Pcxson(s) Who owns p ch bc, a one or two-fa�iY d�vel than g one hondeo da t o yea periodsshall not be to consid-red O m i°ht,ai heS he sha]1 be person who constructs more "homeowner"shall subrnit.to the Building Official on.a form ca Pt(Sectionr109 lr,'1) g res onsib]e for a]l such work crformcd under the buildin The undcrsrgn cd homeowner" assumes responsibility for cornpliancc with the State Building Code and other applicab]c codes, bylaws, rules.and regulations, undersigned bomc owxlcr'I certifies that he/she understands the Town of Barns Saba hc,d' 9 axrd bent mum]nspeclion proced and require e is and that he/she will comply wi P. rcq cmcnts, Signature of Homco cr f PPs•oval of13uilding Official Note; Three family dw,Uings containing 35,000 cubic feet or larger will be required.to comply with [be State Building Codc Scction 127.0 construcHh trot.OMEO EXEMPTION homeowner crforming work for which a building perrntC is required shall be cxcmpl from[he provisions The Codc slatrl that' "AnY P a cs a crson(s)forhirc to do such or this sect on (Section 109,J,1 -Urcn,.ing of eonrtrucbm SuperYisors);provided hal if the homeowner eng g P the res onsiIII'lics'of s supcMsor(scc 1ppcndi-x Q, work, Thal such)fomcowncT sha)1 act ss suPCry'S f," nri(cularly sari;Section 2.15) This lack of)warcncss often results in scnous problems,p Many homeowners Who use this exemption uc unxwxrc Thal they arc assuming P Ru)cs &'Rcgbla'tions for Licensing Construction Supcm _cnso when the homeowner hires unlicensed personr.. In this.cuc,our Boafd eac not proceed against the unlicensed person Ls it would �nflh shc.tion,d• Supervisor. me homcowna acting as Supen'isor is ullimalc)y responstbrequire$ current) used by To ensusc that the homeowneris fUfly INV;LTC Of the r spolnsib;lBess ofsa S�upery or.y0n the lulupsgc of this issue slue Iso alform permit p Y that the homeowner eerlifylhal hdshe understands (cation for usc_in yourcommuniry. 0fTHCroN Town of Barnstable Regulatory SerVrces w LU'J1St'ABLE, t Thomas F. Geiirr, Director - `bprE 6 Building Division Tom Perry', Budding Commissioner 200 Main Street, 14yannis, MA 0260) www.town,birnstable.MA,us Ofce: S08-862-403.8 Fax: 508-79C � �� t _ ,� •, 'rop erty'O�n.tt'' YZust ; t CompZ'ete 'a.p� Sign Tits S ection If s i, g A Builaei ` . S as Ow11Cr of the subject property hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit applicatioti for: (Adcttess of Job) Signature of Owner Date , Print Name if Property Owner is applying for permit please complete the HOm cow ncts License Exemption Porrn on t17'e reverse side. 0 © t � ' ¢#� .(9 ssa � Y � � r r " .O 0 .coo[ ` r, 10 E`C4FICAT�IONaSe A D FEATURES ® � oil t1 �� � ' Swirn Areal X sib r Q4e1 6" 0 D Aluminum°Patio Deck i3 .r o�rd �n�azurefblue and whit e ummu construe ion 10111­1 � �, ., uall" rnainterarce-free #,,"' max rrfirtum walk aro"und:�deck surrounds entlreipool ffit minurn fence�utiith privacyp els � - ^ extrude, ag{u'inum�vertical supportsDw " y gum siydewalls that neverneed pamtmg � �� r� acrylid inrs�, "In wall automatte skamrner F .. Self locking aluminum extenor�ladder _ Q autge vine f erTerrazzo Design bottom _ purificetionisystem �� �--5 k �3 ear transferale limited factory warranty ° .r m z The Space Age Swimming Pool Filter A TOTALLY NON - CORROSIVE FILTRATION SYSTEM The new Regal Ambassador filter system is the key to a clean sparkling pool, day after day. It sets a new standard of performance in home pool filtration, offering features previ- ously found only in commercial systems. " • Permanent media sand filter =' ' • 2,100 gallons per hour filter capacity • National Sanitation Foundation Testing Laboratory approved • Fiberglass reinforced tank completely y� corrosion resistant N� • Easy to clean strainer pot for maximumOil . r'' T pump protection • Fingertip control, 6 position multi-port valve " • Filter and 1 h.p. motor and pump assembled on non-corrosive base 01 The Regal Ambassador Water Purification System cleans pools fast; removes even the most minute particles the first time through. Filter and pump work together in perfect balance. as I 3 'r � ma u � ' k t� � I ` � W 4 , r ' II x e „�*••,.. .. .e a ate004 a Ott s ` Nor— a Yv W The unique design of., fhe all'alum�►n_um Regal Ambassador laces i#among the world s mos P �rhr beautiful pools Based/on lthe aonf►gUrfa,tron of tleP artist's ellipse, it combines spacious swimming area 4 with full size patio- A'n all'alurninurn walk e around'deck andffencef with privacy t ¢ � deck. �, I� t J panels'surround ,yF the entire pool New construction techniques utli�lze w the exceptional strength my durabrJ�ity nd uirtuaHly �. and unusual beauf�of th of'alutnmum�� The s�se maintenance- e R freef� aracter egalA�mbassa'dor , Iif, funJ1 herald endless mf, da sof, fa f � i Ir j�°t�,y� NN cY ; i �uwae...mwaa..wr�.w.+.a.rwr B , .. 4 aft+ -EU= .q; +"6CP G 19 w ' v i "df � jx� V t/ E .. 1 U oA Yll NV 6M / ode Ti W.r��aa1 c,�•��e� W�� �W eco� 1- 00 �' S4cp 4 b 03 _ A k 4 r i oFtME T Town of Barnstable Regulatory Services saxtvsras[E. y . Mass. Thomas F. Geiler, Director ArE i639•MA 0 Building Division - Tom Perry,Building Commissioner 200 Main.Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 March 4, 2010 Carolyn Bestford 31 Conant Lane Centerville, MA 02632 RE: 31 Conant Lane, Centerville Dear Ms. Bestford, This letter is to inquire as to.the status of your project at the above referenced address. As you may recall you were issued a permit on May 25`h 2005 to finish the basement, open 2 . existing walls, and eliminate three existing closets to bring the house to code. There haven't been any inspections since the frame was passed with conditions on April 5`h 2007. You must contact this office at (508) 862-4034 to explain the lack of progress. Thank you for you attention in this matter. Sincerely, Lauzon Building Inspector Q:zoning5 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel_d Permit# 4 Health Division 'D 0 5 A 46 A&D, �V-J Date Issued " 2 Conservation Division �� �� to �`r Application Fee l O✓1 0'1 �`oc�!' i Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved b Planning Board U STEM PP Y 9 MtTE�� OF BFpR00MS Historic-OKH Preservation/Hyannis Project Street �Address Q 1 3 Conant Lzia Village Owner j4mn t-CAn)N rl _6e_Sf_fYVA Address 3 I Comty?i L�Ir)e Cjep-�CI'VI'l 1-e Telephone Jib g'Ll a? -I ?Lq Permit Request N i S j+ NSE E N T , P C-Pb)9GE_ I S F FL-Dole /,(ill JdO W S OPEN C2 E YIS J/_' � LLtI� r- -6L-1M ,'1V 1� 3 6XiSf V6 clad I _n 6RTC4 .[_ cOOS-F roce)16 ,=1__, Square feet: 1st floor:existing proposed 2nd floor: existing 73,,f proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type WOO-5 Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family , Two Family ❑ Multi-Family(#units) i Age of Existing Structure Historic House: ❑Yes XNo On Old King's Highway: ❑Yes ANo Basement Type: Full ❑Crawl ❑Walkout ❑Other ~ Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 2 new Half:existing new l Number of Bedrooms: existing 3 - new r Total Room Count(not including baths): existing / new First Floor Room Count Heat Type and Fuel: ❑Gas Oil ❑ Electric ❑Other Central Air: ❑Yes O'No Fireplaces: Existing _� New Existingwood/coal stove: XYes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shedlo existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes )§,,No If yes,site plan review# Current Use Pro osed Use = BUILDER INFORMATION Name('14R0 /Vi. Br'STFOrw Telephone Number 50 L- d k'� � Address License# CAN o C-j2Va LZ.�, �- D 2b3� Home Improvement Contractor Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE q1)6 log FOR OFFICIAL USE ONLY 7 xy a. e PERMIT NO. DATE ISSUED =f MAP/PARCEL NO. {' , ADDRESS- VILLAGE OWNER ' 1 DATE OF INSPECTION: ' FOUNDATION FRAME INSULATION. ' v FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL MCI GAS: ROUGH I FINAL FINAL BUILDING DATE CLOSED OUT A O ASSOCIATION PLAN NO. N O d1 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WO. BEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE vl� r1rlo (�S12 7 _square feet x$64/sq.foot= -3�'9 S x:063 plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft. ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALON E PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) . Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) J�'�; Permit Fee Regulatory Se mices eIIer,•Diirectoc 039. �0 ' RFD MA't A ,Building Division . • ' ' . .�.. .. ...'-ToriiPerry;'Bfiilding C-ommissi'oner •� ..._ _.. •• .. 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: I ) JOB LOCATION: 3 I C® mw i— l.,(.l►' l 1° �►�-�{/U)l L number street village "IoMi owNSR":_ JGQ yne-C, i s t VbY cl `L name home phone# work phone# CURRENT MAILING ADDRESS: 31 L 0e 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,thathe/she shall be responsible for all such work performed under the buildin 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 Tovmn of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. • M� - re of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required-to comply with the State Building Code Section.127.0 Construction Control.. HOMEOWNER'S EXEMPTION The Code stites 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 persons)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/cerdflcation for use in your community. Q:forr s-homeexempt The Commonwealth of Massachusetts Department of Industrial Accidents effice ofloyestigat/oos t 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance davit name Ca r01vr) S am location:- \31 6 n i2 1 '""Y7 i Ccn /if✓)'I AA F hone#m a homeowner performing all work myself.m a sole rietor and have no one world in ca achy /%%%%/%/��%%///% %%%%/G%/G/%/%%%%%%%%/%/%%/%%///%%/////%///%%/%/%%/%%% am an eta to ravidin workers' compensation for my employees working on this job.::::::::::::::?):::}:):::):::::::))::):`::::::):: ::::::::: :::: n :nam N. :coma .,.:....::..:..:::.:.:....:. �:: :;% ii::�ii::ii:iii'•i'ri:h'i}:'�%:? 1 'cn hn #>`ox !?c +jyY}` k <' 'vii( yf< '`'ry{'c2`'yi '`' ? ? i' }'suranc ` v I am a sole proprietor,general contractor, o omeowner circle one)and have hired the contractors listed below who have the followin mP ..........................:.....:::. r ••n�'81iY D •::•}.y�..::.4:.::;.?::.•i.:.::•.::::;::::::?:tro�y+:.�T::.::;.?.•ii::.:s.Y•.:.:.:i..:::..::•.::?..�:r.i.:-::i.::.::.?::.:•:;.:..:;::::.:::.:;•4}.y}..:.:.)i.}.:.�.}.::)::.:�.•:"r.::.::':d••$�:j-:v:•�•::�•:i:��::..i••!::,,•::�•�..'.::.:::..•:.:�.:.v...:.::L.��.:F...}�(..:Sy.!.v.r..!J:'.::.?.:;.i:.v.:..:,.{�:..L..:.:?::M...:�.!v!.v.�..l:i•..:.....:::.: ...r......:.:..... ..w.%;.::.:..........i.:-.:::;.:%.:::;..:%.::.::.:v;..:.�;.%.:.;:...:..::.:�:::._.:.:.�:::a}:::::n:.��........:.....}.F;.:4..:.::G..::4....:?..4....)..:4....:4....:?..••.y •})}:4i:4::4):•}:.`?;.4;.:::.:.$:.:..:;.:-::.n:f�^::iw:::;%:i:.ii':4�%:T•i%ii,:.'?•i?::vii%%:'{>{%?>Lti})'.:;:i..: :--v::..w: :{4:t.4.;::::.:-�) ':• : %.................. % r ' . $ ? :{ yS:: ;;;; :: . $ ... iQ ?.:?! >.?.i.?i.•.4:)v::::••}v:•.i):.•iY$:•:4:i::::::::•:i;::)..: ' •address........ .. .....•: :::::•........................:.:;........................J................. 4„ .;v.}:v.:�::.:?:::::n•;..:.�:.:Y;•}}}:•}:•:r:}})iii)}:??�:in?:':i??:�''4:•::'??):. :?'•)):•):?•}.'•:4:w:::;..}.......:....;. ON �t ..:'•rill}�':.... IL �furaitte�ca:::: .«. �:.....�.. ::,:<;;:;:;}:;,.;.:4;?::�,:,:::)•;::: :.;:.;,;>.:::.:.;,.;.;•<.:4::.))•.:<?.:.;;�:?.::,...::.:... b'lice#........ .................... . . ........ :)x • sn :nam :.. . :.. ..... ��`�x�'Syi <�?ti' ' '<' > ; '% `%};::;:;:'firs'<•�'� � :'<`".:' "dines ..e �y .....-...... .................... ............... i 1lSIIZR12ce'iCO o-�:;:s`z':N%:;�'s}%:;;:r :•}:::;:;•}:;:�:•:;?:<;•?;•)):.:}:•>:?o:???•::-:•;):-;::n<>:.,>::•;:.:;.:.>;r:.�:<?;•;::::»:;:.:•>:-:;:.,.. ji. gee to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine to S1400.00 and/or one years,imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby c [ under the pains and penalt77" that the information provided above is im.--and correct. tune /� Date - Signa o 1� Print name G •� Phone# official use only do not write in this area to be completed by city or town official d or town permittlicense# ❑Building Department city ❑Licensing Board ❑checkif immediate response is required ❑Selechnexes Office ❑Health Department contact person: phone#; ❑Other.— (rmad 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or an individual,Partnership, association or other legal entity, employing employees. However the owner of a trustee of dwelling house haurns' not more than three apartments and who resides therein, or the occupant of the dwelling house of III another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and ' supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and . date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is Accidents. Should you have any questions regarding the`9aw"or if you being requested, not the Department of Industrial are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retaraed to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. �Departznent's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 �oftHE r � Town of Barnstable Regulatory Services '* snaxMBLA • Thomas F.Geiler,Director KAM v� 019. Q Bu11C11II Division b Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 P ermit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type.of Work: 16 oqS EMEAI r RE 4 DVJ 7-11)I i '/-U)IlV b 0 tOistimated Cost ASK n Address of Work: �1 C0i'1(Ln'f�" Cane GenkrvlIV1 Owner's Name: Date of Application: ��6 I hereby certify that: Registration is not required for the following reason(s): excluded by law Work x ❑ Y , ❑Job Under$1,000 (]Building not owner-occupied ®Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT WORK DO NOT HAVE ACCESS TO TEE-ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. - SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. O y � �� Date Owner's Name `OFTHE�pr,� The Town -of Barnstable 'O� WP . T1_ L l Health T 1 L Safety � • r� MASS a ,�r�►atiLrnen� of Health Safety and Environmental Services �Eo►Ap�° ' Building Division 367 Main Street,Hyannis,MA 02601 U6: 508-8624038 e: 508-790-6230 PLAN REVIEW Owner: Map/Parcel: 5 G%6 Project'Address:•.J( 1 ��� i7<: (._�"i uilder: t� L ti 1 The following items were noted on reviewing: Q)a ri� �� �- .: C p•� i _C1) 4� l`�'1 1 1 C',, i C 11 ^f 1 U;n +�.1 ..L_ �•�i j V C. -Tcb 5 u r-, v Reviewed by: Date: ., Y :. PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 03/29/07 TIME: 10:59 ' -----------------TOTALS---- ------------ PERMIT $ PAID 50.00 AMT TENDERED: 50.00 AMT APPLIED: 50.00 CHANGE: .00 iAPPLICATION NUMBER: 84371 'PAYMENT METH: CHECK PAYMENT- REF: 2544 �:... ...................... Town of Barnstable .--• THE °p Regulatory Services • a►xxsTi►ns.E, 1 Thomas F.Geller,Director " 3 sa Building Division �. � p�ED Tom Perry,Building Commissioner f 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 QUEST FOR ELECTRICAL INSPECTION ELECTRICAL PERMIT NUMBER F/ ,37/ (Permit required in order to process inspection) . Requested Date of Inspection(.� Toda}%s Date � � � �� . hereby request an inspection under Massachusetts General (Electrician) . Law chapter 143,section 3L,and 237 CMR 4.02(3). The installation will be ready for inspection at (Property Location) Type of inspection.requested: 'F ervce Re-inspection, ❑ Temporary Service i � � ❑ Excavation ❑ Rough c n - ❑ Service Inspection ❑ Final Re-inspection Fco-agh ins-pecton for / r T/act r 5,�1 �.C�PAP-insper-tigm Fee) CD ❑ . Final Inspection for ❑ Other ; Nr (21 Owner or tenant -. e's name address and hone t� / �✓ "�' `�jo "! ' ' D License P rr F YU-Y -02 License number a 7`/gZ Licensee's Signature This section to be compl a st le Inspector of Wires Inspection ',-, d� PProved []Not Approved This work was not approved for violation of the following Articles and Sections of the MA Electrical C ode: Q:WPnes:formvelectrequest Rev:102604 `.. Com w weaf k o�Maddacl etb . Official Use Only .t � ( Permit No. a aClePartm¢nl'o��ire�ervic¢e �—T 71 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: �iLlt��`/��:��%/h To the Inspector of Wir s: By this application the undersigned gives notice of his or her intention to perform the electrical work described below: Location(Street&Number) 31 C©Ac,',4 x .Owner or Tenant rJ/�'t�S f3 `�1 Jb Telephone No. $'OF L�2? /c?`(f Owner's Address Is this permit in.conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building /` jVoV4J,QAJ Utility Authorization No, Existing Service/D U Amps yj D I Volts Overhead Undgrd❑ No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number.of Feeders and Ampacity . Location and Nature of Proposed Electrical Work: (20WVfA,_5 k,`ov'- //✓7"b /o, 23/`ot -J3v-/y o-wA- 4//< I/, L'/G s h r— If, Completion o the allowing table maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- o.o Emergency Lighting No.of Luminaires (� Swimming Pool rnd. El In- ❑ Battely Units No.of Receptacle Outlets 3 No.of Oil Burners. FIRE ALARMS No.of Zones o.No.of Switches No.of Gas Burners o Detection anInitiatin Devices S'Moge'.S No.of Ranges No..of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons. W.......... No.of Self- ontained Totals: ""' """"""" Detection/Alerting Devices z«, z No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other CDQ o Connection nz No.of Dryers Heating Appliances Key Security Systems:* ' S2 ,Q No.o Water No.of o.of No.of Devices or E uivalent = Heaters KW Ballasts Data Wiring. Signs No.of Devices or E uivalent 1'? Telecommunications ... irin `x T z No. Hydromassage Bathtubs No.of Motors Total HP gg No.of Devices or=Ehuiva-lent s o OTHER: tea c3 im n_ ¢ f 9 Y x P f — - Attach additional detail i desired,or as re aired b 1he'Ins ector o Wires. Q ' � m Estimated Value of Electrical Work: (When required by municipal policy.) it _ M1 ­ o g Work to Start:' 7 Inspections to be requested in accordance with MEC Rule 10,and upon completion. � 3'T ¢ INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical woik may issue unless o' � .L the licensee provides proof of liability insurance including"completed operation"coverage or its s-ibstantial:equivalent. The Q undersigned certifies that such cove ge is in force,and has exhibited proof of same to the permit i§suing off ce, ME Cr CO CHECK ONE: INSURANCE [BOND ❑ OTHER ❑ (Specify:) I UJUl Cc — o a wa I certify, under the pains and penalties of<perjury,that the information.on this application is true and complete. FIRM NAME: 1\/e 17/N l� �[J 54 6 C; _G,1��T�Ct�Iti• LIC.NO.:a 37 i Licensee: V UtYw P, / y 5,4 Signature s�- / ,,c./, LIC.NO.: (If applicable,enter "exempt"in the�e�.se number line.)) Bus.Tel.No.: Address: /s,'�'i f f o / /''P�� OS �✓r`/(� . �t/f 0�6S b Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department 6f Public Safety"S"License: Lic,No, OWNER'S INSURANCE WAIVER:. I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)D owner ❑gwner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ r od 3 ��� s0I$•Ery BC CALC® 2003 DESIGN REPORT - US Tuesday,May 24,2005 11:25 Double 1 3/4" x 9 1/2" VERSA-LAM® 3100 SP File Name: BC CALC Project: FB01 Job Name: Bestford Residence Description:2nd level beam replacing bearing wall Address: 31 Conant Lane Specifier: City,State,Zip:Centerville, Ma Designer: Bill Campbell Customer: James Bestford Company: Shepley Wood Products Code reports: ICBO 5512, NER 629 Misc: Standard Load-40 psf 1 10 psf Tributary 15-00-00 BO 131 2400 Ibs LL 2400 Ibs LL 637 Ibs DL 637 Ibs DL Total Horizontal Length-08-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 08-00-00 Live 40 psf 15-00-00 100% Member Type: Floor Beam Dead 10 psf 15-00-00 90% Number of Spans: 1 Left Cantilever: No Controls Summary Right Cantilever: No Control Type Value %Allowable Duration Load Case Span Location Moment 6075 ft-Ibs 43.5% 100% 2 1 -Internal Slope: 0/12 Neg.Moment 0 ft-Ibs n/a 100% Tributary: 15-00-00 End Shear 2436 lbs 37.9% 100% 2 1 -Left Total Load Defl. U686(0.14") 35.0% 2 1 Live Load Defl. U868(0.111") 41.5% 2 1 Live Load: 40 psf Max Defl. 0.14" . 14.0% 2 1 Dead Load: 10 psf Notes Partition Load: 0 psf Design meets Code minimum(U240)Total load deflection criteria. Duration: 100 Design meets Code minimum(U360)Live load deflection criteria. Disclosure Design meets arbitrary(1")Maximum load deflection criteria. Minimum bearing length for BO is 1-1/2". The completeness and accuracy of Minimum bearing length for B1 is 1-1/2". the input must be verified by anyone Entered/Displayed Horizontal Span Length(s)=Clear Span+112 min.end bearing+1/2 intermediate bearing who would rely on the output as evidence of suitability for a User Notes particular application. The output Floor load only above is based upon building code-accepted design properties Connection Diagram and analysis methods. Installation of BOISE engineered wood Consult project design professional of record or BOISE technical representative for connection design products must be in accordance Member has no side loads. with the current Installation Guide Connectors are: 16d Sinker Nails and the applicable building codes. To obtain an Installation Guide or if -2" you have any questions,please call a b_3-1b d (800)232-0788 before beginning c=2-3/4" a product installation. d- 12" BC CALC®, BC FRAMER®, BCI®, BC RIM BOARD-, BC OSB RIM C BOARD-, BOISE GLULAM- VERSA-LAM®,VERSA-RIM®, VERSA-RIM PLUS®, VERSA-STRAND'rm, VERSA-STUD®,ALLJOISTO and AJSTm are trademarks of Boise Cascade Corporation. Page 1 of 1 soisw BC CAM® 2003 DESIGN REPORT - US Tuesday,May 24,2005 11:32 Triple 1 3/4" x 14" VERSA-LAM(g) 3100 SP File Name: BC CALC Project: FB02 Job Name: Bestford Residence Description: replacement basement girt Address: 31 Conant Lane Specifier: City,State,Zip:Centerville,Ma Designer: Bill Campbell Customer: James Bestford Company: Shepley Wood Products Code reports: ICBO 5512, NER 629 Misc: 7 s 1 3 2 4 Standard Load-40 psf 110 psf Tributary 15-00-00 A n""' BO B1 8400 Ibs LL 8400 Ibs LL 2520 Ibs DL 2404 Ibs DL Total Horizontal Length-14-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 14-00-00 Live 40 psf 15-00-00 100% Member Type: Floor Beam Dead 10 psf 15-00-00 90% Number of Spans: 1 1 wall 1 st fl Unf. Lin. -Left 00-00-00 05-00-00 Live 0 plf n/a 90% Left Cantilever: No Dead 60 plf n/a 90% Right Cantilever: No 2 floor 2nd Unf.Area Left 00-00-00 05-00-00 Live 40 psf 15-00-00 100% Dead 10 psf 15-00-00 90% Slope: 0/12 3 wall Unf. Lin. Left 13-00-00 14-00-00 Live 0 plf n/a 90% Tributary: 15-00-00 it Dead 60 plf n/a 90% 4 floor 2nd Unf.Area Left 13-00-00 14-00-00 Live 40 psf 15-00-00 100% Dead 10 psf 15-00-00 90% 5 FB01 Conc. Pt. Left 05-00-00 05-00-00 Live 2400 Ibs n/a 100% Live Load: 40 psf Dead 637 Ibs n/a 90% Dead Load: 10 psf 6 FB01 Conc. Pt. Left 13-00-00 13-00-00 Live 2400 Ibs n/a 100% Partition Load: 0 psf Dead 637 Ibs n/a 90% Duration: 100 Controls Summary Disclosure Control Type Value %Allowable Duration Load Case Span Location The completeness and accuracy of Moment 34840 ft-Ibs 80.0% 100% 2 1 -Internal the input must be verified by anyone Neg. Moment 0 ft-Ibs n/a 100% who would rely on the output as End Shear 9076 Ibs 63.9% 100% 2 1 -Left evidence of suitability for a Total Load Defl. U335(0.501") 71.6% 2 1 particular application. The output Live Load Defl. U433(0.388") 83.2% 2 1 above is based upon building Max Defl. 0.501" 50.1% 2 1 code-accepted design properties and analysis methods. Installation Notes of BOISE engineered wood Design meets Code minimum(U240)Total load deflection criteria. products must be in accordance Design meets Code minimum(U360)Live load deflection criteria. with the current Installation Guide Design meets arbitrary(1")Maximum load deflection criteria. and the applicable building codes. Minimum bearing length for BO is 2-1/2". To obtain an Installation Guide or if Minimum bearing length for B1 is 2-3/8". you have any questions,please call Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing (800)232-0788 before beginning product installation. BC CALC®, BC FRAMER®, BCI®, BC RIM BOARD-, BC OSB RIM BOARD-, BOISE GLULAMM VERSA-LAM®,VERSA-RIM®, VERSA-RIM PLUS®, VERSA-STRANDTM', VERSA-STUD®,ALLJOIST®and AJSw are trademarks of Boise Cascade Corporation. Page 1 of 2 Roisw. BC CALL® 2003 DESIGN REPORT - US Tuesday,May 24,2005 11:32 Triple 1 3/4" x 14" VERSA-LAM® 3100 SP File Name: BC CALC Project: FB02 Job Name: Bestford Residence Description: replacement basement girt Address: 31 Conant Lane Specifier: City,State,Zip:Centerville,Ma Designer: Bill Campbell Customer: James Bestford Company: Shepley Wood Products Code reports: ICBO 5512, NER 629 Misc: Connection Diagram Consult project design professional of record or BOISE technical representative for connection design Nailing schedule applies to both sides of the member. Member has no side loads. Concentrated loads are not considered in side load analysis. Connectors are: 16d Sinker Nails i a=2" d b=3" c=3-3/8" a d=12" ° e=3" ° �b Page 2 of 2 ,tom pp, Town of Barnstable *Permit# PROF °l• Expires 6 m onths front issue date pERM�� Regulatory Services Fee s�� � ` Thomas F.Getter,Director - ' 1 $ 2002 Building Division �F BpRN E STAB� Tom Perry, Building Commissioner X-PRESS PERMIT TpWN 200 Main Street, Hyannis,MA 02601 J U L 1 ��— Office: 508-862-4038 ZU02 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDEP?RW&1ft[ARNSTA13LE Not Vafid wNwat Red X-Press Imprint Mapfparcel Number ' 7 0 � I Property Address t�D t'�a�1 �`di 1'� e► Residential Value of Work 7 J 0 d 0 U Owner's Name&Address ► W1 �C & TG r' /� 1 1 t 3 eanan4 � n,c enTery► Contractor's Name i Cj<e it j o r., {0 r ri .1.�� . Telephone Number 56 . Home Improvement Contractor License#(if applicable) 13 3 Q S I O Construction Supervisor's License#(if applicable) e� c_ ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor u' W ❑ I am the Homeowner g , I have Worker's Compensation Insurance _ y L j � Insurance Company Name Workman's Comp.Policy# w C l — ''.S( S- 3 l Y 102 Permit Request(check box) Re-roof(stripping old shingles) 5 4 MC. G v cor 4-.1 ❑Re-roof(not stripping. Going over existing layers of roof) ¢. ❑ Re-side ❑ Replacement Windows. U Value (maximum.44) ❑ Other(specify) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.historic,Conservation,etc. Signature Q:Fomts:expmtrg _ it , n &� Aft SENDER: Complete items 1 and 2 when additional services are desired, and complete items 3 and 4. Put your address in the"RETURN TO" Space on the reverse side. Failure to do this will prevent this card from being returned to you.The return Me t fee will provide you the name of the person delivered to and the date of delivery. For additional fees the following services are available. Consult postmaster for fees and check boxles)for additional service(s) requested. 1. ❑ Show to whom delivered, date, and addressee's address. 2. ❑ Restricted Delivery (Extra cha4e) (Extra charge) 3. Article Addressed to: F* 4. Article Number P 317 333 812 Som Virk Type of Service: c/o P-Delta, Inc. ❑ Register d ElInsured 42 St. Anne's Road ❑ Certifie' ❑ COD MA 02170 ❑ Express Mail ❑Return Recent Quincy, for Merchandise Always obtain signature of addressee or agent and DATE DELIVERED. 5. Si ature — ddre a 8. Addressee's Address (ONLY if X requested and fee paid) 6. Signature — Agent X I 7. Date of Delivery PS Form 3811, Apr. 1989 .u.S.G.ea.19e9-238-815 DOMESTIC RETURN RECEIPT UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS SENDER INSTRUCTIONS Print your name,address and ZIP Code in the space below. • Complete items 1,2,3,and 4 on the U � reverse. O • Attach to front of article if space J permits, otherwise affix to back of article. PENALTY FOR PRIVATE • Endorse article "Return Receipt USE, $300 Requested"adjacent to number. RETURN Print Sender's name, address, and ZIP Code in the space below. TO Mr. Joseph D. DaLuz, Building Commissione TOWN OF BARNSTABLE 367 Main Street Hyannis, MA 02601 P 317 333 '812 RECEIPT FOR CE&IFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) N N Sent lr a C/O P-Delta Inc. N Street and No. 42 St. Anne's Road a P.O., tate and ZIP C 02170 0 Quincy, N a Postage 5 Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt showing to whom and Date Delivered L rn Return Receipt showing to whom, Date,and Address of Delivery a>' TOTAL Postage and Fees S ` o � Postmark or Date A E 0 u. a STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front) 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier. . (no extra charge) 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of-' the article,date,detach and retain the receipt,and mail the article. r 3. If you want a return receipt,write the certified mail number and your name'and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space per- mits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT RECIUE.$TED adjacent to the number. 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee,endorse RESTRICTED DELIVERY on the front of the article. 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make inquiry. a u.s.G.P.o.1989-234-555 I _ ,�- /73- 077 JOSEPH D. DaLuz 747�WA t�Iffy?�C7�7 Hxx Building Con�mittiontr XXX>eJ16tQ{Xn7 TELEPHONE 508-790-6227 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS. MASS. 02601 June 4, 1991 Som Virk c/o P-Delta, Inc. 42 St. Anne's Road Quincy, MA 02170 RE: A=173-077 31 Conant Lane, Centerville Dear Property Owner: This office is in receipt of a written complaint re the use of your dwelling located at 31 Conant Lane, Centerville. Please contact this office immediately re the above matter. Peace, l Joseph D. DaLuz Building Commissioner JDD/gr Certified mail: P 317 333 812 R.R.R. Z May 13, 1991 Mr. Joseph DaLuz Building Commissioner 367 Main Street Hyannis, MA.02601 Dear Commissioner DaLuz am filing a written complaint with regards to 31 Conant Lane in Centerville, a single family dwelling, that currently houses 12 to 15 adults on any given night, as well as several small children. Every night there are between 9 and 12 cars parked at that residence and all of the home owners in the immediate area are very concerned about the health and safety of the neighborhood. In the past few months we have observed their septic system being pumped every 3-4 weeks, each time by someone different, we have also seen adults leaving the house in the early morning hours carrying a pillow and blanket. On April 13th, one of the automobiles was on fire at 6:00 AM, I reported it to the Fire Department, they responed, put out the fire and left without anyone coming out of the house to investigate. Instead, they waited until the fire truck left, then they backed the car into the yard and it is still there today. We are very concerned this situation and would appreciate an inspection at your earliest convenience. Please contact me if you have any questions, need more information, or have any problems. Thank you for your help in this matter. Sincerely, 1�� William A.Cartmill 33 Conant Lane Centerville, MA. 02632 420-0242 f jfR173 077= COCIO031 CONANT LANE Clypo TVs] Soo Co KEYj 103925 ----MAILING ADDRESS------- FCA]1011 FCS100 YR100 PARENT] 0 SOM VIRK MAPI AREQ37SC 0137309 wG10000 % P-DELTA INC Sp1j, SP2.j SP3j 42 ST ANNE'S RD Uri] UT2j .41 SQ FTj 2072 QUINCY MA 02170 AYQ197S eYej!97S OSSI CONST.j 0111,00 L AN 0 56700 IMF 93400 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 150100 REA CLASSIFIED KAND 1 56,700 ASO END 56700 ASO IMF 93400 ASO OTH #BLVO(S)-CARV-1 1 93,460 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #FE 0031 CONANT EA CENT TAX EXEMPT ODE LOT 17 RESI DENT'L 150100 150100, 150100 #Sl 04/00 21 000040900 1 OPEN SPACE ORR 0341 0020 COMMERCIAL ZNVUSTRIAL EXEMPTIONS SALE]09/06 PRICE] 140000 ORS152001161 AFVJ LAST ACTIVITY]07120IS7 FCRjY JOSEPH D. DpLuz Building Commissioner XXX1fMXR27 TOWN OF BARNSTABLE TELEPHONE 508-790-6227 BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 June 4, 1991 Som Virk , c/o P-Delta, Inc. 42 St. Anne's Road Quincy, MA 02170 RE: A=173-077 31 Conant Lane, Centerville Dear Property Owner: This office is in receiptcf a written complaint re the use of your dwelling located at 31 Conant Lane, Centerville. Please contact this office immediately re the above matter. Peace, l Joseph D. DaLuz Building Commissioner JDD/gr Certified mail: P 317 333 812 R.R.R. � I 1 °FtME r Town of Barnstable Regulatory Services r • WXNSTM " QQ Thomas F.Geiler,Director rE1639.3.A Building Division Ralph Crossen,Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 SHED REGISTRATION Location of shed(address) Village 4A .-,N , Property owner's name Telephone number Size of Shed Map/Parcel# rim 4 Signature Date Hyannis Main Street Waterfront Historic District? 00 Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg m�Qom, l HOOK , �f � zA7 e N { z 6r G vI 36 fi LFM' ► "'� ' ' CERTIFIED PLOT PLAN ,J" Syl OF , I � ROr�L•ft))Vq' NEW CONSTRUCTION ONLY ;r P. �`" �BUIVSKITOP OF FOUNDATIOV IS . FEE Na.842 IN ABOVE LOW POINT OF ADJAZENT 'ar. b� r�Jolh. S A.P31r1,, �1,�1;�iS. SCALE: - VOr DATE :NGy/S/� �1; �L DRED c,E ENGI_NEE-RING CO. IN /� 'Gvc /` � I CERTIFY- THAT THE�� �� EGIS7ERED�� rREGISTERED CLIENT %23- SHOWN ON THIS PLAN IS LOCATED CIVIL LAND JOB N0. _ ON THE GROUND AS INDICATED AND ENGINEER I LSURVEYOR DR. BY .,CONFORMS T0; THE ZONING LAWS QF BARNSpB4 ,jAASS� 33:NO M SIN ST 7i2 :'A! S�. CH. R`' Lo. YARMOUTH, MASS. HYANNIS, MASS. SHEET—OF - DATE REG. LAND SURVEYOR i dt"rv',t[ ���:I'n � .t4 =. i;+ _`_ Y ` f t . ` � r .,•� € l �f r �i}'{ s�'j* 'Srr,-r' 3 r'w.t'�., - t � - i '� - lj �� �f � 'Y! rx�"" yf.• � ', *• , • .o i7 � n•/-rr. '+ R .fin r�;4 , ' _ R ,,. 1 .,f- � ._. .+.x fir.._, F'?".• 'i t f -f 7 s"-/ '"C"'171. , r'#" - I sF I,(t5ti+. r b 1-' y° f .... T.. �� J:, r ,r a i� {.�4�/` } t - r_�, ry1 � 4 .ea• # d J­ t's 'R 1 , ._ •..s-�-7. t ass. ' h•q` �' •� � :e..� Ut:1A � O t �e _ _ ( � - ) la 6a� .1� ., .I #t' x'y'y t•,b,�'�'tixp�,{ � . } w ¢ 4 } P - ,._�. Ott �, C... � C_ .•. C`(/: �+I./ , ! i +F,�, .•SY + q,�i. t g;of CERTIFIED PLOT PLAN ROBED. NEW, CONSTRUCTION .,ANCY + sI` sunircas ' 3 8 TOP OF FOUNDATION IS •FEE \ �" B:zD IN ,. ABQVE LOW POINT OF ADJACENT TA Aj 3 � ROAD.. . DATE:.-Ale, /S>f � EL DREDGE ENGINEERING CO. lNr~ ��� �' -----_ -- - --_--� CLIENT I CERTIFY- THAT THEM + ------1 - �- - SHOWN ON THIS PLAN IS LOCATED EGISTERED REGISTERED . 7 r/23 CIVIL LAND JOQ, N0. ON THE GROUND AS 1NDICATEu. 'AND 'a ENGINEERS SURVEYOR DR. BY � CONFORMS T0, THE: ZONING,LAWS . , aj — *-, t F BARNS T 1 A S R 33N0 M�?�N_ S.T� �.►. i 50. YARMOUTH, MASS, HYANNIS, MASS. SHEET_ OF DAL/T—/E�j REO. LAND SURVEYOR ? s` /73 a7_7 � As es s`gor's map and lot nu m . 7� 7�'3 � SEPTIC THE Sewage Permit number ........................................................ PTIC SYSTEM MUST d INSTALLED IN COMPLWA NAuSTABLE, Maas. House number ...............:...7_ . /................:................... WITH ARTICLE If STATE 'oo 039 ♦� SANITARY CODE AND T� 101OR TOWN . OF -'BAR.NS'I''A`91ffE BUILDING. INSPECTOR APPLICATION FOR PERMIT TO ....: .1.✓N 1 I t.l .... .�m b.t�.. ............................................ TYPEOF CONSTRUCTION ...... .a0. ................................................................................................................. ll .............5. ... �.................197.R. TO;THE INSPECTOR OF BUILDINGS: - The undersigned hereby applies for a permit according to, the following information: Location LA.-- ..!...( � ....... OV!�...... . .�y). . � !� r.V\�.1 �.........HA.....................................................- ProposedUse ............................. ............................... ................I......................... Zoning District .... ..1 ,........................................................Fire District .....r..v.:`S.. �f '1.................. Name of Owner Z r t. !\.......COW ..0............................Address Name of Builder .B.a. ......�t?V{�.�..........................Address �G11 � Name of Architect ......1"...n� ...Address Numberof Rooms ...................................................................Foundation ......................r.....rd{....................................... Exterior ..�,�Qr....�.�.1.'^�,�A..........................................Roofing ...P1.S.�.r9.�.u. . rf Interior ..��. �t r �K Floors .............................................................. ...... ...................................................... .................. Heating .`. ..... '? tleet.....�� ... �..1:.......................Plumbing ... .�� �s... ... � .1c......................... Fireplace ..: r�.L..................................................................Approximate Cost ... ..Q.QO.:.......................................... Definitive Plan Approved by Planning Board ----------� �a_.....9 __D. :Area ....�..0® ................ Diagram of Lot and Building with Dimensions 1111 � �*�� Fee ................. ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH C., yr --To W-0-y h- I hereby,agree to conform to all the Rules and Regulations of the Town of Barnstable egarding the above construction. Name ... / ...... ............................................... . . . . � , \ o| ^ � / ` � � . . + . r ' U � j� . / � � ^ � � - ^ ! | ' Covell, Brian single family dwelling Conant way Brian Covell frame r ' ! � ""= C" "p'==" --+''='+^°~----'' ' ~ / ' PERMIT REFUSED | ' ____--__—.---.--...----.. 19 ^ ! ,/—..-----..-----.-----.---.--. � . . ,—'~----^'--^^^'-----'''—^'r-----'' I ~ �—.,.---.---~.--.—..~...--...--.--' ^ . . | Approved ................................................ l! ..--------.----.—.'--^---.—.--.— � \ ............... ...................................................r'—.— ~ � ' ^ � Assessor's' map.and lot number ..,/ . `. ...../.. .,X / / ' I oF YN a rot o r D 3 Sewage Permit number ...�........ /0--........ ... Z MARBSTLBLE. i House number ................................�.�3....................... ..... 'o MA86 z 0q�1639, . TOWN '0F;,,,BARNSTABLE - BUIL- DIHG{,/,. •INSPECTOR APPLICATION FOR PERMIT TO .LI ehs l.l!.'4. .f. .�� e'l..t!:...... ..'!��..Y..�!�`,4Q -.5... .:.1...."'.;�4....... . TYPE OF CONSTRUCTION ... � 0�: �:`a?1M �7.�!'.�Gf�................. ................................................ . ..I ..............................19.A.3 TO THE INSPECTOR OF BUILDINGS: The.undersigned hereby applies for,ci permit according to the follringi information: , Location 31. K.EI..h. ... 41 Ll�le.rM!.l./1. ......: .......................................:.................................... Proposed Use ...( ).:��!i56t.....t/ .�a `es.��'.5............ .. Q4. 7.......4 ...it..:.. /ea K .................................. Zoning District ' ................................................... l ...... .......... .............. ... ...............................................:Fire District ....�L' 1'l. t!f..Y..I.Ile......!e..dS7—Err/ °L Name of Owner '4 .11.A.......................Address $ ...4(.C%.... 1✓(.//1 Name of Builder �Q!f4.r7.;:.. .....1 .1,�!JGG>.�.............Address ... 7. �!!r�✓ G .... CiS.:.......16�.E!'C.+�S. �.!! ./...!7+S L Name of Architect ` 1C ..........'....................Address .......................... ................ ....................................... ...............:...qP . . .Number" of Rooms . �l .0op....�.....ld.9........... Foundation ..... . .................................:........................................ Exierior Roofing ..........:.. ........................................................ ..:. ..... ..... ......... ..... LFloors ( '✓T/G/e... lC:....Y... �,..t�O�G�.. ......................:Interior ...(�/j.GG + .4. ....... .�!. ..�.. .......... ......... Heating f•/•10/...I ?.'(Cr..... ....P..�.G��R:71!'�...............�.Plumbing ...J....►..11l.t.��.�.�!................................................... Fireplace ................................................. .......,....................Approximate Cost ... .� .0.�. ...................... ...... .................. Definitive Plan Approved.by Planning Board ____________________ _____1'9--------. ; " Area ou.X-31.,,=. Ar-A Diagram. of Lot and Building with Dimensions Fee ... .� .... ... ............... SUBJECT'TO APPROVAL OF BOARD OF HEALTH _ OCCUPANCY PERMITS REQUIRED•FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations,of the Town of Barnstable regarding the above construction. Na s:. ..�!�✓Yl Construction Supervisor's: License,..�. ............. ....... DEVEREAUX, PHILIP } 25083, .,-.Finfs--h-.-2hd Floor No Permit for .......................................• ' Single Family Dwelling }� ... .............:.................................................... Location 31 Cohant bane . ....... ......Centery ................................ `r Owner 'Phil ,n:..Devera . .................... # Type of.Construction .....EraMP....f r, 'Plot ..... ,................ Lot.... '........................... t Permit Granted ....May...18 1'9 83 ' Date of lnspe -1 • t•...........3 19 or-J Date 'Completed ......::.... s�: ....19 _ f It * Assessor's map and lot number .. ...... ..... . 7 *THE 3' Sewage Permit number 7-............................. 898B9TSDLE i l House number ................................ -°. C.........................., 'moo 639 M Du a•6 TOWN OF BARNSTABLE �E ti BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................:. ... : ? ......: ......... ' ...f...::.............. ........................ ' .......... : .:. TYPEOF CONSTRUCTION ':............... .................................................................................................. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following1 information: i ` Location .....�...... ............... ............. F::........ ... f. 4:.?.�:..1.. .... .. ................................... ProposedUse .....................:....................... ............................................:;................!................ .?:................I......................... ZoningDistrict w Fire District w '` ' it...................................... .... .................. .............. . .......................................................... Name Of Owner .� .'.. . r...... "P..::. .. ..t .......... .......Address ........ ... ...' ............ .:F .` ?:. :.{.:jJ Name of Builder �.. > t .... .. yG C. ..'.............Address .................................................. .. Name of Architect { `. r ...............................Address ......:......... Number of Rooms ............ `r.= Foundation ............ .. ........................................................... Exterior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .......................:............................................................ Heating .............................................:. ..................Plumbing , • r; ................ ................. .... . ..................................................... Fireplace .......................................Approximate Cost ..... :; Definitive Plan Approved by Planning`Board ---------------_--__-_ - k =-19- --- Area . :.....:.. ............. ..............: Diagram of Lot and Building with Dimensions Fee / SUBJECT TO APPROVAL OF BOARD OF HEALTH I F 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. t , Name . :' '�.:rjP:e .. ................................................. Construction Supervisor's License ..+'.t.. ..� DEVEREAUX, PHILIP A=173-77 25083 Finish 2nd Floor No ................. Permit for .................................... Single Family Dwelling Location 31 Co nant Lane Centerville ............................................................................... Owner .....Philip. . . ...Devereaux..... .. .... .. .. ........................................ Type of Construction ,Frame ............................ ................................................................................ Plot ............................ Lot ................................ Permit Granted „.May 18.....................19 83 Date of Inspection ....................................19 Date Completed ......................................19 I i Assessor's map and lot number ...... f Sewage Permit number ......:................. I BA"STABLE, i House number / ro Hann ......... ........................................... p 039 9� �-0 MA-4 a� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....(_ ........................ ................. `ti Inn �C .....PCAm.t.I \�....T)=U„(itnGt..................................:.......... TYPE OF CONSTRUCTION + ! nr--. ..........................................`............................................................................ .......................=�u.................192 0 t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �` .... + I /'. AA+ � 0 V i A\• r V�'� � t�'7 A ..........................d: l........................ .. .................................................................. ........................... ProposedUse . ( C Ir.!t^i..:1'..1............................/....................................................................................................:...... Zoning District , ` Fire District `..-.Av VN��t ?�...................................... ............................................................... Name of Owner ........C.n .1... ............................Address r....... ..... � ... ... . ; . . .r..-..!....i t Name of Builder ..!:�T..`..........�. �....`.............................Address .................................................................................... � 1 Nameof Architect ......�l!.�. ...............................................Address ............................:....................................................... Number of Rooms .......... �....................................................Foundation o � Q 0!1( r LA{ Fv I j ... r ............. ................ . ................................. Exterior 4:�C►r �.►.nr+ .........................................Roofing +... ..t...Y1r..tJ Floors ...........0 r fit Interior .. .k.1� ..rill ..................................................... ................................................... . �Orl' :A Y1O Vj,4-1 C nLJ,�JCr T h �J�'Mt. Heating ...',a.t...`.L\ .....................................:.......................Plumbing }/� � .•-�-- Fireplace ............................. . ........................ .....................Approximate'Cost....`.`t.:?' ..:�t7.............................................. .... .... c� 1l ... Definitive Plan Approved by Planning Board 7 19 Area% Diagram of Lot and Building with Dimensions Fee ". ................. .......... . ............ SUBJECT TO APPROVAL OF BOARD OF HEALTH i Y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable, regarding the above construction. t' Name ......I.......... ✓�....1 !t L........�'......................... Covell, Brian - _« 2083(� - 1 112 story No ................. ermit r .................................... single family dwelling ............................................................................... Location ,.....R/ Conant'' 'a'!`� Centerville ............................................................................... Owner Brian Covell ' ................... ............................... Type of Construction ......... ..........frame..................... ...................................................... ...... ........... Plot ............................ Loth.......... Permit Granted .. ....November 17.........19 78 Date of Inspection ............ ........................19 Date Completed ............................. ........19 PERMIT REF U D ................................... .. .. ........... 19 n ... ...... .. . .. . ................ !� ...` .r.�.. . ................... ....... .. ...... .. ...... 1 � ! �.......................... I . ............................................................................... . Approved ................................................ 1 ............................................................................... ...............................................................................