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Assessor;s=map and lot number .�...712 �.k:............ �'� FTHET L
Sewage Permit number ...� ... .`.I ..........................
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House number �l rd } ink ° - qpy �+ �y� g /� �gTas E.
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W9T ; TITLE 5 e�0,9.
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TOWN OF �BARNSI ` A�
BUILDING , INSPECTOR:
APPLICATION' FOR PERMIT TO ..... .Ll 1 .J.-�. .........�.1��� ...S.f all �................................................/ C9
1.
TYPE OF CONSTRUCTION G'/ , ! h� :d! , �l?'a l ,Y.................
....... .. S ... ..t`....
TO THE.INSPECTOR OF BUILDINGS:
The.'-undersigned, hereby applies for a permit according to the following information:
Location .... .7.......��- .��.Ti../.r,5,�......... �: i1? Ydi, ....../'�1� ........ ...................................
ProposedUse ...... ...... ...... ......................................... .........................................................
Zoning District .... .... .............. Fire District ...:C e�.7.. / v�.�l C......0 S e,r i/.1.1..1...e
Name of Owner .. .....h��'lrS... G ...................Address .::f. 'Jr. t9{l'!..;. ...�1!.!�� 7c�41�
Name of Builder 1 2i ...... .Address ..2zl. ..o.h76/.!... ...��1
Name of Architect ............?',�./. k. /!...'..... .Address . 2 C'...1,O... �:........./11...::S:S .............
Number of Rooms , ....J...................................i......Foundation
Tem.rs
..... ......
......
Exterior :... ........ ............. � .Roofng ....... •.•. - . ,
? Floors .......0'1. ? .... ��,................... ...... .. .. . ..Interior ......J... „ ......:7�..�'��r�tC':�
� I /L i• f I
Heafing . ..:.��f........ �7. :: .................Plumbing .. ....... .`'�. fJ
t, ..... . Y
Fireplace ..�� .................... ...... ...... ...........................Approximate Cost .....?..��t.®........................... ....... i
7 �•� ''Definitive Plan`Approved by Planning Board ____---------------19_______. Area .............. .: . ....................
Diagram of Lot and Building with Dimensions
,
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.
rName ......r:.....:�... .........`�%'�'���•••............................:.....
Construction Supervisor's License ... ..........
� ._ R.--F. HAYES, INC.
' 25844 Two Story
r 4 No" ................ Permit for ...................
Single...FamiIX..Dwelling...
' Location ... ......290..:Elliott Roac'.
.. .......... .
r Crie ,
-' ... ........................................... ............ ..........
Owner ..R'...F. Hayes, Inc....................:.
Type'of Construction' - - 17
Frame
Plot .: ....................... Lot ................. ,
Dec. 6 , 83 ,'
;t Permit Granted .........................................1.9
' Date of Inspection ..19
` Date Completed � -Z7........... _19�I
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Assessor's map and lot number
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... ............ TE
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Sewage Permit number ...
.....................................
DAUSTAMLL
House number ................................ ........ NAM
........................ 1639.
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TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ..... ........ 0
.. ......... .......... .........................
TYPE OF CONSTRUCTION .... ......F'Mrr:: :........ ....... ..........................
............... ....... ........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Z . . ..... ... ........
Location ..,1n. .. ...... g� .............. ...............................................................
.................
Proposed Use ....... ....... V .................................... ... .....................
7 .........
ZoningDistrict ....i........(",.............................6 ................Fire District ..............................................................................
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Name of Owner .......................Add .91:E.4 ................... W
Name of Builder 1. ...... .....................Address ...
Name of Architect .......Address.... ... ............................................................
.......................
Numberof Rooms ............................................Foundation ... ......................................................
Exterior .... .......................Roofing............... .........
ir ..............................
Floors ...... e�...... .......................Interior .... ....... 0. ........................
Heatin ......... ...............Plumbing ..,_3.......
9 .. ..................P ..... .....................................
Fireplace .............................................................Approximate. Cost �.jq.0.0....................
Definitive Plan Approved by Planning Board -----------—-—--—----------- Area .......
...................................
Diagram of Lot and Building with Dimensions Fee ......
SUBJECT TO APPROVAL OF BOARD OF HEALTH A")
V
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to,,C/O'nform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ....... ....... ...................................
Construction Supervisor's Licensee... Q...........
No ------ Permit" for —' ...—=—=°...........
��e_. _Dvxelligg�____. '
'
.
Location I^ot—17.(...290... ....... `
_
...............�e.nt�e.r}[ille................................... ~
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Owner —..�..�.—�.��������...�I���------'
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Type 6f Construction ----..]7KAJD�-----
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---^''`------^---'-----------'
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Plot ............................ Lot ................................ �
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-
Permit Granted —Deo.�—.��----.—.]g 83 �
'
Date of Inspection ....................................
Dote Completed ---------�---]g ^
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c�TMt TOWN OF BARNSTABLE permit xo. __V:SWITAS 25844_________:_-
{ . f Building Inspector cash,
OCCUPANCY PERMIT Bond
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Issued to R. F. Hayes, Inc. Address.
Lot 17, 290 Elliott Road, Centerville
Wiring Inspector r � � Inspection date
Plumbing Inspector Inspection date ,
Gas Inspector 1�/fI Inspection date
S Engineering Department � �� Inspection date� {7-Z
Board of Health t Inspection date 011f
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.
d �� -1§uilding Inspector
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
sAM S TOWN OFFICE BUILDING
HYANNIS, MASS. 02601
MEMO TO: Town Clerk'-
t
FROM: Building Department
DATE:
An -Occupancy`Permit has been issued for tae building authorized by
-, t
, .� ,� 1
BuildingPermit #......,.. �...........1. ..y. _ .................................. ................... ...._......................... _.................... _.. .....
issued to ................ `�..�!.... ,1,'Jr �k %.. _.... _ .�...�.....
Please release the performance bon
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, . Town- of BarnstableE��T
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KAW 200 Main Street, Hyannis MA 02601 508-862-4038
Application for Building Permit
Application No: TB-16-3042 Date Recieved: 10/14/2016
Job Location: 290 ELLIOTT ROAD,CENTERVILLE
Permit For: Building-Solar Panel-Residential
Contractor's Name: SOLAR CITY CORPORATION State Lic. No: .168572
Address: 24 ST MARTIN STREET BLD 2UNIT 11, Applicant Phone: (508)640-5397
MARLBOROUGH, MA 01752
(Home)Owner's Name: ATSALIS,NIKOLAS J&DAWN S Phone: (508)360-8996
(Home)Owner's Address: 290 ELLIOTT RD, CENTERVILLE,MA 02632
Work Description: Install solar panels on roof of existing house,with any upgrades,if applicable,as specified by PE in Design;
To be interconnected with home electrical system. 8.06 kW 31 Panels JB-0263382
zz
Total Value Of Work To Be Performed: $11,400.00
Structure Size: 0.00 . 0.00 0.00 rn
Width Depth Total Area
I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568).
I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to
accept coverage.
I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the best of my knowledge and belief.
All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: Cheryl Gruenstern 10/14/2016 (508)640-5397
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $11,400.00 Date Paid Amount Paid Check#or CC# Pay Type
Total Permit Fee: $108.14 10/14/2016 X$108.14 3U` {-X?CC{- Credit Card
mm �_.. .,.8975
Total Permit Fee Paid: $108.14
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
M Parcel i, Applicati0
Health Division Date Issued
- F
Conservation Division Application Fee
i .
Planning Dept. Permit Fee (
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address I o D
Village "
Owner `j Address
Telephone
Permit,Request ;4
,;Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District ��1 Flood Plain Groundwater Overlay
Project Valuation �` �/ Construction Type � 10''+W_ -
�Lot Size_ Grandfathered: ❑Yes ❑ No If yes, attach porting`cfocuntation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Da
:2:
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King' Highway ❑ s" ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
S
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 Zo
horization ❑ Appeal # Recorded ❑
Commercial ❑Yes C9 If es site Ian review #
Y p
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
_ QQ
Name AW CAI%MTelephone Number
Address l� l�lA�h ��� License # 6D u
v +, WIC b2b6 Home Improvement Contractor# �� 6
Email Worker's Compensation # 00 511 61
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
L)AVMA it
SIGNATURE DATE I 1
FOR OFFICIAL USE ONLY
APPLICATION#
'r
} : -DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER r
DATE OF INSPECTION:
FOUNDATION
FRAME
3 INSULATION
FIREPLACE
`ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
E,INAL BUILDING
D`R,�&CLOSED OUT
A S§Q01i9- ION PLAN NO. _
y
c_'
OWNER AUTHORIZATION FORM
I,
(Owner's Name)
owner of the property located at ,
a�
(Property Address)
(Property, dress
hereby authorize Got_ C(" 1..nsLk. iw
(Subcontractor) N
an authorized subcontractor for RISE Engineering,to act on my behaff to obtain a building
permit and to perform work on my property.
Owners Sign re
\Data
a
.Massachusetts,- Department of public Safety
.B oard o f Building Regulations and Standards.
Construction Supenisor
License: CS-100988., '
HENRY E CASSIDY' '
8 SHED ROW i
WEST YARMOITfiH i s
Expiration
Commissioner 11/11/2015
Office of Consumer Affairs and Business Regulation j
.10 Park Plaza Suite 5170 °
Boston, Massachusetts 02116
Home Improvement Cntr�-ctor Registration '
Registration: 153567
Type: Private Corporation
Expiration: 12/15/2016 Tr# 259188 -
CAPE COD INSULATION, INC
HENRY CASSIDY
18 REARDON CIRCLE
SO. YARMOUTH, MA 02664 ,1 —
K Update Address and return card.Mark reason for change.
x
Address Renewal Employment Lost Card
SCA 1 0 '20M-05111
Office of Consumer Affairs&Business Regulation License or-registration valid for individul use only
OM
E IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Uyk -
egistration: :1.53567 Type: Office of Consumer Affairs and Business Regulation
xpiration 12/15/201 10 Park Plaza-Suite 51706 Private Corporation _
Boston,MA 02116
CAPE COD INSULATION INC
HENRY CASSIDY
18 REARDON CIRCLE
SO.YARMO_UTH,MA 02664 _ Undersecretary r, NJ/valid wi ut sign e
„ .
Y:
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s
The`Commonwealth of Massachusetts
Department of IndustrialAccidents.
u W - Office of Investigations
W
a
d I Congress Street, Suite 100
Boston,MA 02114-2017
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Or Zzation/1ndividual): Ll, e V -
Address: 414,
City/State/Zip: �, Phone#: 17 "
Are you an employer?Check h 4.e appropriate box:
. Type of project(required):
1.�'I am a employer with ❑ I am a general contractor and I
employees (full and/or part-time).*, have hired the sub-contractors 6. [].New construction
2.❑ 1 am a sole proprietor or partner- listed on the'attached sheet. 7. ❑ Remodeling
These sub-contractors have
- ship and have no employees 8. ❑ Demolition
working for me in any capacity. employees and have workers'
t 9. ❑ Building addition
[No workers' comp. insurance comp. insurance. .
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions -
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.� Other Hot
comp. insurance required.]
*Any applicantthat checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this'hffidavit 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 thepolicy and job site
information.
Insurance Company Name:
Policy#or Self-ins, Lic.#:. 6+� _ 0 Expiration Dater 1 f✓
Job Site Address: City/State/Zip: -�
Attach a copy of thew rkers' 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 DIA for insurance coverage verification. -
I do hereby certify n r pains and penalties of perjury that the information provided a ove is true and correct.
Signature: Date: ' i f I )q
r
Phone#:
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#:
II I
CAPECOD-27 KLIGETT
CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY)
6113/213/2014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Rogers&Gray Insurance Agency,Inc. PHONE Barbara DeLawrence
434 Rte 134 PHONE Ext FAX
Ne, (877) 816-2156
South Dennis,MA 02660 = aI DRIESS:bdelawrence@rogersgray.com
INSURERS AFFORDING COVERAGE NAIC q
INSURER A:Peerless Insurance Company
INSURED INSURER B:COMMERCE INSURANCE COMPANY.
x Cape Cod Insulation Inc INSURER C:Evanston Insurance Company
18 Reardon Circle South Yarmouth,MA 02664 INSURERD:ATLANTIC CHARTER INSURANCE GROUP
INSURER E:
INSURER F:
CO ERAGES CERTIFICATE NUMBER: REVISION NUMBER:
T IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
IN ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
C RTIFICATE 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.
IN SR ADD UBR
LTR TYPE OF INSURANCE POLICY NUMBER MMIDD�YY MMIDD/YYYY LIMITS
t A X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000
{ CLAIMS-MADE OCCUR CBP8263063 64/01/2014 04/01/2016 pREMISES Ea occurrence) $ 100,000
MED EXP(Any one person) $ 6,000
PERSONAL&ADV INJURY $ 1,000,000
NT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00
POLICY❑ PRO- ❑
JECT. LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER:
AUTOMOBILE LIABILITY ! COMBINED SINGLE LIMIT
B Ea accident $ 1,000,000
ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $
ALL OWNED . X SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accident) $
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
AUTOS Per accident $
$
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
(, EXCESS LIAR CLAIMS-MADE XONJ453514 04/01I2014 04/01/2015 AGGREGATE $
DED X RETENTION$ 10,000 . 6-RKERS COMPENSATION Aggregate $ 1,000,000
O
ND EMPLOYERS'LIABILITY STATUTE �RH
D NY PROPRIETORIPARTNER/EXECUTIVE Y/N E.L.EACH WCA00525904 06/30/2014 06/30/2015 ACCIDENT $ 1,000,000
FFICER/MEMBER EXCLUDED? ❑ NIA _
Mandatory in NH)f E.L.DISEASE-EA EMPLOYEE $ 1,000,000
yyes,describe under r
ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
Workers Compensation Includes Officers or Proprietors.
Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate:Holder.
F
CER IFICATE HOLDER CANCELLATION
Assessor's offioe (1st floor): '"
F THE T
Assessor's map and lot number ......a(21.....g...........:. . SEPTIC SYSTEAA oho
Board'of Health (3rd floor): G
Sewage Permit number D zip `STALLED IN CO
.........................I�................. E.
�F
Houlseefnumbepartment (3rd floor). ! ..�,/.j...............?�?.........-4- ENVIRONMENTAL C�o Mb o. \e�
APPLICATIONS PROCESSED 8:30'.-9:30 A.M. -and" 1:00-2:00� P,M. only, TOWN REGULATION
TOWN OF' ' BARNSTABLE
BUILDING INSPECTOR
I 2,
APPLICATION FOR PERMIT TO .., U�1 ...... �X / �J..P .
TYPEOF CONSTRUCTION .....W.CaO.)..........:...................................................................................................
...3-•....................19. �
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information: / �j/�
Location ........�.91�
............le .�.��� !� 2 P� U/ <.. .........'...!.."...................
............. ......................
........ .. ..........
s�,Proposed Use .. u�....... .......�'T.................... .........................:.1..................................................................................
Zoning District ..........................Fire District .......................
Name of Owner .RP71/U �y,P ��,Q � � f0 � L. L G � ��a �Pti��v,�Le
Z i _ '
[./.............�..1.. Address ........../........................./../............................................
Name of Builder "\.........../.:/.U. �. Address .....4. ... L.L�N�...` ..... ..................
�.c�U/LLB
...........
ef
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms ..................................................................Foundation . . ...................... ... ............... .........
Exterior .�� Q....<lG .�...o-? t... �t� .PW��� !......Roofing ... X./-SI.S. / 45...�?. `...
Floors .....a" ...............................................................Interior .VIA74".....1......�d� ................................
Heating ......................................................Plumbing ..................................................................................
op
Fireplace ..................................................................................Approximate Cost ..1..v7�.............. ..........................
.. ..............
Definitive Plan Approved by Planning Board ________________________________19________ . Area ........ ........................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
- Q y
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I herebya to conform to all the Rules and Regulations of the Town of Barnstable re ardin th
agree 9 9 g g e above
construction.
Name ....... . ... ........................... .....................
Construction Supervisor's License 1/�Jr..J.1.U............
KURZBERG, PETER
Build Deck/B cezewallo .... ermor ... ........................... y
...Sin. Fami1v Dwell.ing.......
....... .. .......................................... .....
Location ..... 90 Eliiot Road
..............................................
.....................C.e..n...te....-r..-v..-i. ..l....le.....................I.........
Owner ......Peter.....K.....ur.zb.....f:�K.g.........................
.
Type of Construction .........Frame....................
...............................................................................
Plot.............. ............... Lot ................................
Permit Granted ........Januarv................A .19 87
Date of Inspection 714.......ig
Date Completed ......................................19
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2 M 0 4, 1 .
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Assessor's offioe (1st floor): pYYl�k ._
Assessor's ma and lot number G� of?NFTo
Boa d'of Health (3rd floor):Sewage Permit number ........................................................ 2 IMUSTAXLE, .
lingineering Department (3rd floor): �y °o "639•
House number ........................ 29.'�..:..........��� s� ale
'FO YPY
APPLICATIONS PROCESSED .8:30-9:30 A.M, and 1:00-2:00 P.M. only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
u�.l �� Pc.1 n/ w
APPLICATION FOR PERMIT TO X� �`
TYPE OF CONSTRUCTION. ..... 0.�2.b...:
............ ........ .....................19.
TO THE INSPECTOR OF BUILDINGS: -
The undersigned hereby applies for a permit according to the following information:
o ,P ca ti /P,P u i L L //
Location ........0..1.............. /dT............................................--..... .........................................................................
0-0
Proposed Use ..--?..(/G(�...... ............ ................................................................................
..................:................... ............
Zoning District .......................Fire District ..............................................................................
................................................
Name of Owner .....lT" �y'P .. �.
Nameof Builder ......... .......................................................Address ................ ...........................yy....................................
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms ..................................................................Foundation .. UG �tr s....JZ.....�'
.� ..................
ExleJar .�G69� 17G/� 4�, ��t"t' .P }'......Roofing ...e.X./. S/S `UC............�/,Sl�l��U
�...... >..... / Q�� ............................
Floors ��.(Jl� .. ............................:..................................Interior lJ 0
.................{i...................... .b................................
Heating ................................Plumbing
Fireplace ........................................Approximate Cost .. r� Q"OU, U0
Definitive Plan Approved by Planning Board ------------------------_-------19________ . Area .......... ........................
Diagram of Lot and Building with Dimensions Fee ""
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree a to conform to all the Rules and Regulations of the Town of Barnstable ardin the above
9 9 9 9
construction.
Name .......................`........................
Construction Supervisor's License � � ...........
^`"^`Z"^^RG' P^~T^~^^ '`-227-8" /
N� .�13.O.376. panni/ 6� _Boil�3_Deo]x/Bzeeoeway `
Single Family Dwelling
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290 ]IIIiot Road
Location --------_------ .....
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�
Centerville
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' Peter I{orzlzer '
Owner --------------'��------.
Frame
Type of Construction --------------
����������������^.;............................ �
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P|c» ............................ Lot ----------'
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Jaoo��� I� 87
Permit Granted ----------.�--'lP
Dote of Inspection ------------lP
- Date Completed ------------'l9
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YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate.ONLY REGISTERS YOUR NAME in town (which
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you must do by M.G.L.-it does not give you permissi perate. Business Certificates are available at the Town Clerk's Office, 17'FL., 367
Main Street, Hyannis, MA 02601 (Town Hall)
' w 'DATE O Fill in please:
" APPLICANT'S` YOUR NAME/S: L )yJaf4s
BUSINESS YOUR HOME ADDRESS: "1O /jo fur
f
TELEPHONE #a Home Telephone Number
NAME OF CORPORATION:
NAME OF NEW.BUSINESS 7reosurew TYPE OF BUSINESS' C;l7i IGII- y�'s (`�SYJSiGi�d�t�j7t
IS THIS A HOME OCCUPATION? YES NO
ADDRESS OF BUSINESS a "�i l i� 2ro Z' MAP/PARCEL NUMBER 22 v —(Assessing)
When starting a new business there are several things you must do in'order to be in compliance with,the rules and regulations of the Town of
Barnstable. This form is intended.to assist you in obtaining the information you may need. You MUST GO TO 200 Main St'- (corn'er of Yarmouth
Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your, business in this town..
1. BUILDING COtal
SIO ER'S OF
This individ s b n jr�fQr of a y p rmit requi ements that pertain to thistype of bLMWAI.COMPLYWITH HOME OCCUPATION
1`73RULES AND REGULATIONS. FAILURE TO
- Au horiz Si Hats ** e COMPLY MAY RESULT IN FINES.
- COMMENT .
2. BOARD OF HEALTH r
This individual,has been informed of the,permit requirements that pertain to this type of business.
Authorized Signature* m
COMMENTS: * a
%3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature,*
-COMMENTS:
fZeo f�zrs bus�vcQ (0 � J � w,`l� fA�C� laC� :2t cc. rem
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Town of Barnstable
pw ula Y.Services
e
iHe r
g
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'Thomas F. Geiler,Director
Building Division
* BARNSTABLE,
y MASS. g� Tom Perry,Building Commissioner
i63q. �m prfonnA�a 200 Main Street, Hyannis, MA 02601
www.town.barn.stable.ma.us r
Office: 508-862-4038 n7508 790-6230
APProved:
' Fee: ( r �
Permit# 0`1
HOME OCCUPATION REGISTRATION
Date;
f�
N�lnle: l.� n Plioe #: t1 ' �'�l��/
Address: 2-IO O f OTT /\
Ca Kls'_ e�sccres-_ _
Nanie of Business: T____ --- --- --- --- • -
Type of liustness: l, 1/O-615 .• C.-fJ�'(•SIOJd�V�(Ql��f Map/Lot. l�Cl
INTENT: It is the intent of tliis section to,allo%v the"residents of`tlie Torun 6f Barnstable to:operate a honre occupation
«6tlrin single Finlilydwellin;s,subject to the provisions of Sectiou 4-1.4 of the Zoning orchilauc•e,provided that tare activity .
.shall not be discernible from outside'the"dlvelling: there shall be no increase ur noise or odor; no sisual alteration to tile.
premises which lvoulcl suggest<�uiything other than a residential use;no increase ira traffic above normal residential volunles;
�{ and no.increase in air or groutuhvater pollution.
After registration mith the I3ullcllug Ilispector,a custoniary horiie occupatiou.shall be permitted,as of right.subject to the
L following conditions
• The actMty is carried on by the penuaiient resident of.a single Fuuily residential chl'elllllg unit, located NVAIIIil
that1dwellIlIg unit. . r' -
• Such use occupies no more than 400 square feet Of spire:
There are no external atteratrons.to tlle'c wellilig Idlrch are.not customary ul residential builclings,rind there is
f lao outside e171cleirce of such use.
'S • No*traffic 11n11 tie generated ur excess of normal reside_ntial vohuucs;
• The use does not.in.volve the production of oftenslVe"erase, vibration,smoke, dust or other particular platter,
Q odors,electrical disturbance,heat,glue, litinridity or tither objectionable eflects.
'I'he.re.rs'uo storage or use of toxic or liazai d'LIS Illatenals,or flarmuable or-'explosive materials, in excess of
normal household quantities.
• Any need for parking generated by such use shall he naet on the sarue lot containing the Customary Horne
' Occupatioa,and not witliiii the required front yard.
• There is uo exterior storage oi•display of nlatenals or equipment.
• There are no compaercial vehicles related to [lie Customary Home,Occupatloll,other than one van or one
(� pick-up truck lot Jo exceed one ton capacity,xild one tr<liler not to exceed 20 feet in length and not to.
' exceed 4 tires,parked on[lie same lot courunulg the Customary Home Oc•c upatlpu.
' No sigh shall be displ qed indicating the Custginary Houle Oc•cupatioir.
- If the Custom uy'Honae Occupation Is listed of advertised as a"business;the street uldress shall licit be
inclucled.
• No person shall be employed in the Customary Honre Occupatuili also is not a permanent resident oftlac
dwelling unit,
1, the undersigned, have rea d and agree with the above rki-ic•tious lqr nay holne occupation I"anl registering.
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Date:
C7.
Appheanti
ZAPE COD
. INSULATION
' lIYCP OlA9S SIAMI[53 SP0.AT FOAM'SYSPENDEO -
KAM DY TSf0.f 'NSY 10H CG4NOf - r
1-800-696-6611
Town of Barnstable
Regulatory Services 03
Building Division
200 Main St =�
Hyannis,' MA 02601
Date.-
Dear Building Inspector
jPlease accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & -.
{ completed the insulation and weatherization work at the property listed below. Cape Cod
Insulation did this in accordance to the specifications listed on the building permit
application. All work has been inspected by a certified Building Performance Institute
(BP•I) inspector.All work.preformed meets or exceeds Federal & State Requirements.
Property Owner Property Address Village
1
2)4t,"rt AA::2 14le
Insulation Installed: Fiberglass Cellulose j' Pw-Value Restricted Unrestricted
j Ceilings ( ) T (X_) (35 ( ) O
t
Slopes
Floors
Walls
Alt
Sincerely
LLL /�
He ry E Cas y Jr, President
C e Cod I , ulation, Inc.
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