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0123 COTTONWOOD LANE
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E �, �� ° � a ,i p � r 4 o . , a '. � � _ � � Town of Barnstable *Permit 0,10' ('17 `1 Erpires 6 oaths from issue date ELAMNSTASM Regulatory Services Fee s 013 Thomas F.Geiler,Director Building Division ro�N OF Tom Perry,CBO, Building Commissioner SARNS7-ABLE 200 Main Street,Hyannis,MA 02601 www.to,wn.barnstabIc.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid trithout Red X-Press Imprint Map/parcel Number 252//_�_� 3 Property Address 123 E�Rcsidential Value of Work$ �60/i0, Minimum fee of$35.00 for work under$6000.00 C G( Owner's Name&Address (L© �f/��(�'[e le— Contractor's Name ��,t�f¢ V e7'*e, Telephone Number Home Improvement Contractor License#(if applicable) (7J 7©q Email V/Z/T�)2_T Ya[IOot Weq Construction Supervisor's License#(if applicable) orkman's Compensation Insurance Check one: ❑ 1 am a sole proprietor ❑ I am the Homeowner ® I have Worker's Compensation Insurance Insurance/Company Name^ 41," l✓1 S Workman's Comp.Policy Copy of Insurance Compliance Certificate must accompany each permit. Permit R (check box)Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)4 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 ner st sign Property(hvner Letter of Permission. A copy o e me Improvement Contractors License&Construction Supervisors License is requir SIGNATURE: C:%UserAdecolliktAppDataNl_ I'U4ficr 114'indowiffemporary Internet Files'tContent.OutlooktHR76BDVATXPRESS.doc Revised 061313 r, The Commonwealth of Massachusetts Department of Industrial Accidents r�? Office of Investigations 600 Washington Street _ Boston, MA 02111 ` www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ff // Please Print Le 'bl Name (Business/Organization/Individual): T If II ZY( Address: City/State/Zip: 6Vt 1,26U�_!�d-0,,b If 144 Phone #: gw Are you an employer?Check the appropriate box: general contractor and I Type of project(required): 1.[�1 am a employer with� 4. ❑ I am a g employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1.1.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL ]2.❑Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.� Other 440r_ comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. n I Insurance Company Name: /j�1�q 1/iS , Policy#or Self-ins.Lic.#: WC -- S0122 1?� Expiration Date: A1�ak Job Site Address: /2 &#VM 41Orc City/State/Zip: ©2o132 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DI or in ance coverage verification. ; I do hereby certify u ains and penalties of perjury that the information provided above is true and correct. Signature: Date: l0 z2 /3 Phone#: S qT B� Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an.individual,partnership,association or other legal entity, employing employees.,However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es) and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials' Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A.new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax# 617-727-7749 www.mass.gov/dia I .•� r�� • (rrtTlil►�sIioirfi�/� re j�,l�ri.air�Ii.;r��i , Office of Consumer Affairs.4c Busiss Refutation License or registration valid for individul use only I s. t.OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to. ' egistration• 173?09 Type; Office of Consumer Affairs and Business Regulation xpiration: 11/1/2014 LLC 10 Park Plaza - Suite 5170 1 Boston, MA 02116 TULEIKA BUILDING COMPANY LLC. VIKTAR TULEIKA �125 BERKSHIRE TRAIL W. BARNSTABLE, MA 02668 '�— Undersecretary Not valid ,�ithout signature Xi tcs:►chuct:tts- Department of Public�afct. ' Board of Buildin,,p Re�4ulatifm>and titandard% _ Construction Supervisor License License: CS 91854 VIKTAR V TULEIKA 125 BERKSHIRE TRL. W BARNSTABLE, MA OM8 Expiration: W01=3 f"mm�ii�ciFrnrr Try:: 13464 http://elicense.chs.state.ma.us/Verification/Details.aspx?agency_id=1&Iicense_id=280929& Page 1 10/13/13' Details [r The Official Website of the Executive Office of Public Safety and Security(EOPSS) Mass.Gov Home State Agencies Demographic Information Full Name: VIKTAR V TULEIKA Gender: er Name. LicenseAaaress InTormation Address: Address 2: City: . West Barnstable State: MA ipcode: 02668 o nt : Un' ed tates icense inTormation License No: CS-091854 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 3/18/2013 Issue Date: Expiration Date: 2/20/2015 License Status: Active Today's Date: '10/13/2013 Secondary License: Doing Business As: tus Change: 18 Prerequisite inTormation No Prerequisite Information iscip ine No Discipline Information ocumen um Close Window ©2011 Commonwealth of Massachusetts Site Policies Contact Us elicense.chs.state.ma.usNerification/Details.aspx.?agency_id=1&license id=280929& 1/1 1 To-,.•n of Barnstable �` RegulatoryServices �� � Th.—F.Ceiler,nireeloe �"" ,r „f.�• Building Division Tom Perm,Building Commissioner 700 S13u Sleet.I I)a-nis•NIA 0:601 —.tow o.b e ro su bl o mn.0 Fax: 508.790•6230 Property Owner Must Complete and Silm'This Section If Using A Builder I t cep _ ,as Omer of the subject p:ope:-y ' herebyau ham: (,l✓f l4Cf .L�vl l.D171Qo On-to act on my bd=Y. all.:i:-ws='zy- c to coot-1&autho zcd by this b/uild�iag pc=Iit. - ���l n7fOtJu!&t3Y� GT/t� 'NtLo7�VCl,a.��4AA (Address of Job) **Pool fences and alarms arc the responsibility of the applicaat. Pools are not to be filled or utilized before fence is installed and all final inspections arc performed and accepted. w s s p:Oeac Signature of Apphant p^r-Name Punt lame . �o �• Dat: C-"JR.SSOa\Z.. 1^S49S900u 67Al2 - i Generated by CarnScanner F i CERTIFICATE OF LIABILITY INSURANCE DATE(VMD0Nrn 1.10/10/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TI CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLCCI BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZ REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the ceAificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WANED, subject the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to I certificate holder in lieu of such endorsement(s). PRODUCER NAME JAMES R HINDNM Schlegel 3 Schlegel Insurance Brokers Inc PHONE 508-771-8381 508-771-0663 WC,No.Ext): IA/C.No). 34 b9kIN STREET E-MAIL s: SCHLEGELINSURANCE@VERIZON.NET PR C CUSTOMER 10 0: West Yarmouth, HA 02673 INSURER(S)AFFORDING COVERAGE NAICI INSURED suRERANGM INSURANCE 14788 Vikt-ar Tuleika Dba Tulei g ��ka Building an LLC m Y• 1Ns(IRER sAIM INS. 125 Berkshire Trail INSURER C: INSURER D ` West Barnstable, MA 02668 INSURERE: 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 PERT INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TI CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERI EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE 1111SR WVD POLICY NUMBER (MMfODfYYYY) (MM(DDIVYVY) LIMITS A GENERAL LIABILITY MP16593Q 09/30/201309/30/2014 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $500,00.0 CLAIMS-MADE Fx—]OCCUR MED EXP(Any one person) $10,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE S2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ . ANY AUTO BODILY INJURY(Per person) S ALL OWNED AUTOS _ BODILY INJURY(Per accident) S SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Peraccident) $ NON-OWNED AUTOS S $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ I EXCESS LIAR CLAIMS-MADE AGGREGATE $ I DEDUCTIBLE _ i RETENTION S S WORKERS COMPENSATION ST OTH- AND EMPLOYERS'LIABILITY X' TORY LIARS ER B ANY PROPRIETOR/PARTNERIEXECUTNE YIN WC-5012398 08/26/201 08/26/2014 EL EACH ACCIDENT $ 100,000 OFFtCERWEMBER EXCLUDED?- a N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 100,000 It yea.describe under DESCRIPTION OF OPERATIONS below I E.LDISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS t LOCATIONS/VEHICLES(Attach ACORD 10/,Additional Remaft Schedule,V mac space is required) VICTAR TULEIKA HAS ELECTED COVERAGE ON HIS WORKERS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BUD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED ACCORDANCE WITH THE POLICY PROVISIONS. t AUTHORIZED REPRES n i ©1988-2009 ACORD ORPORATION. All rights re: ACORD 26(2009109) The ACORD name and logo are registered marks of CORD Town of Barnstable fNE'1p,- Regulatory Services Thomas F.Geiler,.Director Building Division - Tom Perry,Building Commissioner rFa►at•�' 200 Main Street, Hyannis;MA 02601 www.town.barnstable.ma.as Office: 508-862-4038 5OS-790-6230: Approved: Fee: s Permit##: ,2 o o ?o a PY Z. HOME OCCUPATION REGISTRATION Date: / Name: I / ( Phone#i .Address: I�� Olr-ii�e717"� (L/N ' Name of Business: )J E gZ QJ D l.7 Type of Business: VGIL ( 'Lr (�i2p/Lgt; INTENT; It is the intent of this section to allow the.residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the.provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling there shall be no increase in noise or odor;:no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above.norinal'residendal volumes; and no:increase in air or groundwater pollution. After registration with the Building:Inspector,a customaryhome occupation shall be permitted as of right subject to the. following conditions: • The activity is carried:on bythe permanent resident of a single:family residential dwelling unit,located within that dwelling unit. • Such use occupies-no-more-than 400-square feet of space. There are no external alterations to the dwelling which are not custom. � customary in residential buildings,and there is no outside evidence of such use. • No traffic will:be,generated`in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects.. • There is no:storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use:shall be met on the same lot containirig.the Customary Home Occupation,and not within the required front yard. -' • There is no exterior storage.or display of materials or equipment. • There is no commercial vehicles:related to the Customary Home Occupation,other than one van or one. pick-up truck not to exceed one ton.capacity,and one trailer not to exceed 20 feet,in length and not to exceed 4 tires;parked on the same lot containing the:Customary Home Occupation. • No sign shall be displayed'indicating the Customary Home Occupation. • If the Customary Home Occupation islisted or advertised as a business,the street:address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a,permanent resident of the dwellin&:unit T,the undersigned,have read and agree with the above restrictions for my home.occupation I am registering. . Applicant Date: 5 . G Han=ch .Rev.5130108 s MICHE .E. CONSULTINEER 123 COTTONWOOD71-7601 CENTERVILLE, MA comC 63COMCAST.N ET Message Page 1 of 1 Anderson, Robin From: Anderson, Robin Sent: Monday, December 22, 2008 9:07 AM To: 'mcudilo@comcast.net' Subject: Home Occupation Dear Ms Cudilo, It's been pointed out to me that you are including your residential address on your business cards. According to the home occupation registration and our local zoning ordinance, identifying and utilizing your street address is a violation. I'm sure this is an honest error of interpretation on your part hence my email to request that you cease this activity. It is imperative that you make the necessary changes to your stationary in order to avoid future violations and possible citations. Please be aware that the approval of a home occupation restricts the occupant to an administrative office only in order to preserve the residential character of the neighborhood and not adversely impact the quality of life of your neighbors. I am confident that you will take immediate measures to correct this situation. I will be happy to offer clarification should you have any questions. Thank you. Wy6in Andenon Robin C. Anderson Zoning Enforcement Officer 9'awn of Barnstable 200 Main Street Hyannis, NA 026oi 5o8-862-4027 12/22/2008 Town of Barnstable Regulatory Services �p4 ZNE"1p�� P Thomas F.Geiler,Director snaNsT . Building Division - WAS& Tom Perry,Building Commissioner a.b 200 Main.Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 508-790-6230 Approved: - fp 7z�,& Fee: J .s Permit#: c?,00 7 peg gLc HOME OCCUPATION REGISTRATION i� Q Date: Name: C,-J b I L'0a, Phone#:_ �(�U / / j Q Address: ��� LCV-,l,`f o Lli Village: Name of Business: Type of Business: t: 2 3 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no-more-than-400-square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration, smoke,dust or other particular matter, . odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by.such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. t r r Applicant• — Date: G Homeoc.d c Rev.5/30/08 Town of Barns table ApGV proved _ Regulatory Services Fee Thomas F.Geiler,Director �� ' Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Home Occupation Registration Date: Name: l I i.C �� I (�iLY��'rr�' Phone#: -7 -7 1 7((2 0 Address: m �'�� ° Village: 1 � Name of Business: "ii C �k� �° Tt Type of Business: -�t7 Map/Lot: INTENT: It is the intent of this section to allow the'residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4,of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. The use does not involve the production of offensive noise,vibration, smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. There is no storage or use of toxic or hazardous materials, or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. •. If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: %' /03 T-r--p Ann - . Assessors map and lot number ..A_5A .......................... - THE Sewage Permit number ............ 1 MAMSTAMLE, i House number ........r..y '".3........... a` ................................ p ML 6 r �0 M03 a\ TOWN OF BARNSTABLE t BUILDING INS PECTOR APPLICATION FOR PERMIT TOE..1 .. .............. TYPE OF CONSTRUCTION ...............19. �'�"" TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a.permit according to the following information: , 1 Location ........... ..1 .......... ............. ...... .Proposed Use ................... .7 �; .1:.�J1✓ ........................................................................................... Zoning District ................ ..:-z>.......... .................................Fire District ..... 'CAI. ....... . '�..e� � � ............. Name of Owner :.......T� „A.............'.....Address ................. ,.(.�....... ........1.!4!.....:.. r. Name -of Builder ........ ...........ZA.7.-:?0, .................Address .................................................................................... ,L�c. ilJo. 2 o i Nameof Architect ..................................................................Address .................................................................................... Number of Rooms 5?.......................................Foundation � �11 .; .....:. . .......................... ............. ....................:: Exterior ......:.......�.F7�r4.<! .......�R..A&Ak:2 15. ......Roofing .......✓l9'X.AUZA.2,. ".....:..r's /. ��.�t . (�........ Floors 7��T 524.�:. .Interior ............ 1�� .a�..:......................................... 4 , Heatirig �'"" .11.�.�'...:�.. ? 1 ✓...1� ...Plumbing .:...:. ......... .::T.�4 .. �� .........................::.:.. Fireplace .. , .... .��.v. .—�1�<J TC�t!4 ..........Approximate. Cost`............. . A. . .. Definitive Plan Approved, .. . ....... P.• by Planning Board ------ --—------------19 rS Area ......................... ..... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH J - 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. OOW Name ............ .............................p.......................... Construction Supervisor's License ........... TUDOR, TIM A=252-153 T. • 'No ,27463.... Permit for 12 Story................ Single.Family...Dw�].ling...................... Location Lot 156 123 Cottonwood Lane ............................................................... CenterMlle Tim or Owner .............`....5............................................... Type of Construction ..Frame Plot ............................ Lot ..................... .� January 24, 85 Permit Granted ........................................19 T Date of Inspection ....................................19 Date Completed ......................................19 r) J . -. SEPTIC �� .�.....3..... � se spaTE r map and lot num r ........... �� �„� 3 . S-ALLED IN �� ' ` e . Sewage Permit number ......... r'`�:. /.. ........:..:...... E$iJ'" � 'r�TL>I' r 4 T House number ........ 6 0 YPY Ord TOWN OF BARNSTABLE BUILDING •., INSPECTOR APPLICATION FOR PERMIT T ... / ............................... ... . TYPE OF CONSTRUCTION ............ . ........ .1............................................ ...... PeP } ......., y -.. ............19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location................ 4...........�i. .T.. ,�.1...........� '.etl1 /.1! :4C...... TProposed Use ............... �4✓.e..�"�:.1_41..�. ............... ................................................... ...... .......... Zoning' District ......Fire District C"4V.::V: "..`.c�X.77;�..Q'l0.0:?."l_ .......... Name of Owner .........T. ,,'V,. ...T..0 ?,Qi ......... ....Address ............... r� iIJ.T.....?�1. Name of Builder ....... .WO.C/.........T. �U..�7Q .................Address .................... .....................................`. .4:/c. /VO. 2a Name of Architect .........Address .:.............. :......................................... :.......................... Number of Rooms .......................�.................:.....................Foundation ............. .... ............................ ........... Exterior ................Cr..E'�?. ?A.12....... ......Roofing .......11 , 'G�1 w'y'4.r.....SA#411W,90:4 15X...: ... Floors ............... ........ ;..:'Interior ......... ..rZ? ' Lai!ik.41........................................ Heating ...................... ...... ..Plumbing ....................p........enx7../. ...P...............:............... ..:.. Fireplace ........................A..lV-.45:.. ..........Approximate. Cost ...............`l�,G/.,Q.4.... •. Definitive Plan Approved by Planning Board ------ ____________19 T-6. Area ...:..: ... .... .... .................... Diagram of Lot and Building with Dimensions Fee SUBS E1T-TO APPROVAL OF BOARD OF HEALTH .. V 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. �1 • Name ............ :............................. ......................... - " Construction Supervisor's License './1/ ... .Ct..J............ r r} t, JUDOR, TIM f: x No^:..�7463,.. Permit for ....1 z Story ................ 1104, r ws w _ # /0 Single Family Dwelling ........................................................ *` Location Lot 156, 123 CottoM,wood Lane Centerville 'r ............. .................................... �'r Owner ....... ... Tim Tudor.......................................... FJ + Type of Construction ..Frame............................. -i rsv ft ; :......................•........................ .................. INPlot Lot ................................ L Permit Granted Janua 24 �1 9 85 �? of. do . ...`c'y�r.�':....�r�19��' Date of _ 4 , �= Date Completed 19307 /c OVAIzao09 Tidy✓ ,14C lo9 7/40,4/ g� NOR AN <n GROS C"7zz— Y�LL L C�BaI�P/VS'T�81GE) o M No v, ,T;A/1/ 1985 �f ISTER SUR��y° oulw6i¢ = T/M 7-&=PW . LOT/63 iz9.5' w 1� 0 I1 19 by a�� 3 yJs �JL O 04 I� 1 w N lw r :w E f k f LOT 157 1 HEREBY CERTIFY THAT THIS FOUNDATION 1S LOCATED ON THE.LOT AS SHOWN AND CONFORMS TO THE TOWN OF 64NA14 41a ZONING ,REGULATION$ REGARDING SETBACKS kROM STREET ONES AND LOT LINES. R. TRIO'PLOT PLAN WAS NOT MADB FROM AN INSTRUMENT SURVEY AND 19 rOR?HE USE OF THE SAVX— ONLY,. UNDER NO CIRCUIYN STANCES .ARE OFFSETS TO BE USED FOR FENCES, WALLA, HEDGES, LTC, + :..._:.. -.. .. .. - r'S.�q.�. •Y x a rwF,. �`_.. ter: vy,,. PINK-DEPT.FILE COPY/WHITE FIELD COPY/YELLOW-APPLICANT COPY o :. BUILDINGCL <TOWN OF BARNSTABLE, MASSACHUSETTS PERMIT VALIDATION LIDATION rn - DATE 19 PERMIT NO. C7 )t. APPLICANT ADDRESS (N0.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO (_) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION), DISTRICT (NO.) (STREET) _ BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE ;Y BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTIO TO TYPE USE GROUP BASCMENT WALLS OR FOUNDATION (TYPE) ` REMARKS: AREA OR PERMIT VOLUME ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) - � OWNER BUILDING DEPT. ., ADDRESS BY THIS PERMIT CONV-EYS'NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINE FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONOITIOI OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. }+ MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE -' INSPECTIONS REQUIRED FOR - CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: - ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. ;WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERSIREADY TO LATH). FINAL INSPECTION HAS BEEN MADE. -3. FINAL INSPECTION BEFORE w ; OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET .- BUILDING INSPECTION APPROV LS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS rl 2 2 �yif' �✓•`• arc 2 - .3 HEATING 'N P CTING APPROVALS REFRIGERATION INSPECTION APPROVAL'. l/ 2 ,O.HER / '2 2 r , R dJGRK SnP.U_ NCT ?ROCEED UNT;L TI+E PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON TH!S G INSPECTOR AAS APPROVED T'IE VARICUS WORK IS NOT STARTED WITHIN-SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPH, STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION. • 1 TOWN OF BARNSTABLE ` BUILDING DEPARTMENT TOWN OFFICE BUILDING out °� i639• `� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: /�Z U/?7 An Occupancy Permit has been issued for the building authorized by BuildingPermit #............2,.7..Ole _..__......................................................................................................_.................�. issued to ...�'..........�1J.doY... ........ .......... 1 ... .....Z...7..........Co7roc)�Lao6.( ........�„� `'�� Please release the performance bond. O�THE}� TOWN OF BARNSTABLE Permit No. ...27463...... BUILDING DEPARTMENT { Bow TOWN OFFICE BUILDING Cash � � •67q. HYANNIS,MASS.02601 Bond ......X........ CERTIFICATE OF USE AND OCCUPANCY' Issued to TIM .TUDOR Address lot #156 123 Cottonwood Lane, Centerville USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL .NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. February b 19.... �................................... ..............BuldingInspector ............. t