HomeMy WebLinkAbout0038 HARBOR HILLS ROAD �� �
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Town of �ilrllSt�l��e ermit#
OExpires 6 months from issued to
Regulatory Services Fee
Y' Y
r BARNSTABL.E, • - -
v� 1639.
,�$ Thomas F. Geiler,Director -
ArFD MP't A
Building Division
Tom Perry, CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid.without Red X-Press Imprint
Map/parcel Number 2Y7 0 7,1.
Property Address " Rd,I C,3�
�d�`
0 Residential Value of Workav
y Minimum fee of$25.00 for.work under$6000.00
Owner's Name&Address cf�1�6 ( Ji tJ o
Ce"�eKJdtr VIA
l Tele hone Number k�' > Q ' S S-29—
Contractor's Name tP(c �J .M E l P
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) I ( p ® �m
OWorkman's Compensation Insurance DEC' — Z009
Che k one:
LJ I am a sole proprietor
❑ I am the.Homeowner TOWN OF BARNSTABLE
❑ I have Worker's Compensation.Insurance
Insurance Company Name
Workman's Comp.Policy# LJ C j 3( vS 3 24 ( ZQ
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
�Re-roof(stripping old shingles) All construction debris will be taken to T Ewa ti �A�afS�oa��L�
❑ Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors
F Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required..
SIGNATURE: '
J
QAWPFILESTORMSUildingpemiitfo AEXPRESS.doc
Revised 090809.
f
The Commonwealth of Massachusetts
Department oflnditstrial Accidents
Office of Investigations
f= 600 Washington Street
Boston, MA 02111
yr www.mass.govldia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):
C,
Address:
City/State/Zip: JM �'t'�J t fl D�i�3 Phone #: 56 3 `L ;s'
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ am a employer with 4. ❑ I am a general contractor and I 6 New construction
employees (full and/or part-time):* have hired the sub-contractors
2. I am a sole proprietor or partner
listed on the attached sheet. 7. 0 Remodeling
ship and have no employees These sub-contractors have g. ❑ Demolition
employees and have workers'
working for me in any capacity. 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.
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 11.❑ P1 bing repairs or additions
myself [No workers' comp. right of exemption per MOL 12. Roof repairs
insurance required.] t C. 152, §1(4),and we have no
employees. [No workers' 13.❑ Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing thcir 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.
Insurance Company Name: L I b p&' JAB —
Policy# or Self-ins.Lic.#: UJ(-9_?1 32 (e 2.D Expiration Date: ['I 10 to
Job Site Address: I:kk� �`�t S" �G� City/State/Zip: cetil p2 J1,
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 MOL 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 c �i ' under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date: I Is
Phone#: S6 sx, - 4 g
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 emplo}gee 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 bum 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
Fax # 617-727-7749
Revised 4-24-07
www.mass.gov/dia
I
�YHErg,, Town of Barnstable
T Regulatory Services
sn"NSMBLE, Thomas F. Geiler,Director
M S&
e 639* ►. Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I
I, as Owner of the subject property
hereby authorize ;� f to act on my behalf,
in all matters relative to work authorized by this building permit application for.
(Address of Jo
Signature of Owner Date
z?'ie 3
rev
Pruit Name
If Propedy Owner is applying for permit please complete the
Homeowners License-Exemption Form on the reverse side.
oF,t�ram,
Town of Barnstable '
o Regulatory Services
i
BARNSTABLs Thomas F.Geiler,Director
Mass.
Building Division
ATfD MP't a
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790=6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to
be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such - j.I
. "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/slie shall be'Y
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often resu]ts 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 hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:\WPFILESTOR-MS\homrexempt.DOC
Massachusetts-Dcpurtincnt of Public SafetN
Board of Building Regulations and Standards
Construction Supervisor,Specialty License
License. CS SL 99486
Restricted to: RF,WS t
PETER SMITH `
3925 MAIN STREET
CUMMAQUID;"MA 02637
Expiration: 11/1/2011
('nnuuissiuncr Tr#: 99486
VLicense or registration val►d for individul use only
Board of Buildmg'Regulations and Standards
before the expiration date -If found return to,
io
g ulatus`and Standards:
HOME IMPROVEMENT CONTRACTOR Board of Buildin Reg
log Regist[ation4 150950 I One Ashburton Place Rut 1301
p
lf6tioW S'/812010 Try 267093 i Boston,Ma.02108
iinr Type DBA
PETER J.SMITHS ME IMPROVEMENT
{ SMITH C }` PETERS y !
Not id without signature
I. u
3925 MAINS
i MA 02637 ` Administrator
CUMMAQUID
Anderson, Robin
From: Niemi, Maureen
Sent: Wednesday, November 25, 2009 10:51 AM
To: Anderson, Robin
Cc: Niemi, Maureen; Snowden, Laurel
Subject: 38 Harbor Hills Road, Hyannis Parcel 247-072
Dear Robin,
Re: Lynne E. Bohne, Tr Carol V. Bohne Trust
38 Harbor Hills Road, Hyannis, MA
Parcel ID#247-072 .
Per our telephone conversation on this date, November 25, 2009, please be advised that the above named is delinquent
on real estate taxes; however, 1 will give permission for a building permit
to be issued for a new roof due to the poor condition of the existing roof.
The new roof will be funded through a grant from the Housing Assistance Corporation.
If you have any questions, please advise.
Very truly yours,
Maureen E. Niemi
Maureen E. Niemi
Town Collector
Town of Barnstable
P.O. Box 40
Hyannis, MA 02601
Tel: 508-862-4055
Fax: 508-790-6310
Email: Maureen.niemi@town.barnstable.ma.us
i
1
lop
Assessor's map and lot number.. ....... .......
THE
Sewage Permit number .......... ...............
BARNS'TABLE,
A
House number .......J..t............. .. .......................... S1639M
a OR Or 6
TOWN OF. BARNSTABLE,
a. 131.111DINQ INSPECTOR
APPLICATION FOR PERMIT TO ....... rl.Z!? ..........l..G
...............
TYPEOF CONSTRUCTION ......... .........................................................;.....................
....... ...... .................19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
...... .... ............ ... ... ... ......... ........................
Location
. . ............
ProposedUse .................... . . ................................................. ...................................................................... .........................
ZoningDistrict ...... ...................................o.................Fire District ........................................................................
60, 2V
Name of Owner .. tom' 0. ....15A.". iZ ... .Address............ . ......e�
.... ... ...... ... .......
Nameof Builder .....................................................................Address ... ........ ..............................................................
Name of Architect ..................................................................Address .............k1k
.......................................................................
'7 1�1 , 1 -41. ' N
2 (S G�Fk UVXIF/D
Numberof Rooms ...:�..Kppin...........................................Foundation ....................................�.Tlk.......................
Exterior ...... ...... . ........:.............Roofing.............Roofing .......................................................
Le....wo...L!��...................
Floors ........r.... ...... nterior ...... .............................................
Heating ..................................Plumbing.
............... .. P 16 b i n,g. /
...... C.. ........to<'_......................................................
/(�....... . ........
Fireplace ............ .......y 5.................. ............Approximate,Cost ........
Definitive Plan Approvecl by Plahning Board --------------------------------19--------- Are ........
1
1 11 77
Diagram of Lot d-i n g,—w n- i-qns�_
an Buj D i.me'-s-i Fee ......
d .............................
SUBJECT TO'APPROVAL OF BOARD OF HEALTH.
Wyyz
q01
3q
YJ
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
1 hereby agree to conform to all the Rules and Regulations 6f the Town of Barnstable regarding the above
construction. -
Name,...... c. .......... ...............................
✓
.............Construction Supervisor's License.................AlFle.......
SHEARER, KEVIN A=247-072 /
No ...29jaU... Permit for ......One 5. r
o...X. .....
snSe..Fa?►t�. y..�W�.�?,74H�........ .............
Location ..........Lot...#.14......38...Uarbox..Hz.l.7.s Road .
CC .n. ...
Owner .......KP,.vin... honX:PX..............................
Type of Construction .....Frams..........................
...............................................................................
Plot ............................. Lot .................................
Permitranted .........March..21 . 19....... ...... 86
G
Date'of Inspection .................:..................19
Date Completed ......................................19
• i
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eo � ! G7
�71 -y. .....,��•-
Assessor's map and lot number ......... .... ..... ......... ... .�.. THE T
,L SEPTIC SYSTEM MUSS' � ,,o*
Sewage Permit number .............. .9................ INSTALLED IN COMPLIAN
WITH TITLE 5 i 33aEb9TABLE,
House number ....... .. ..............; .a
ENVIRONMENTAL CODE .o Mb 9 Ar
\e��
.'< T N RECULftT10NS o�aY
TOWN OF BA.RNSABLE
. 7
BUILDING INSPECTOR . .
APPLICATION FOR PERMIT TO ....... ..... �!..�! ........................... ..............................
QQ. ....: .........................
TYPE OF CONSTRUCTION ............ .. . .
/. Q..-1 ..................19.....
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following or ation:
y / .............. .....�l S......7.......
.� �. �`.......Lire
Location .. *OW�
ProposedUse .............. .......................... ....:.................................................................. ..................
ZoningDistrict ...... ..........................................'...............Fire District :............�..-D......r.............................:...............
Name of Owner ....................................�2 �,1G G`/Z Nl�,. .4/61J����
.Address ..................... .. ...............................
Nameof Builder ...................5...........E...............................Address'...................... u.......................:...................................
Nameof Architect ......................--.—.................................Address .............................-.--::...........................................
Number of Rooms ....4... oa^1..........2.....5C_tk ( U✓L�,TJ C6nrC2£
Foundation ... ............................................ ...
Exlerior ....... ....... l C'6 ...........Roofing ...... ...........................
�r / Interior ...... ........... ............... .....................
Floors ......(. tl..C(lxz ... ..� f%�.................... ����
Heating ........ 5�!. :.... .` ..... ...................Plumbing .... . ......... ..... �
Fireplace .....................ty'D....................................................Approximate Cost ........�.d.00,
Definitive Plan Approved by Planning Board ________________________________19________ . Area ... ........... .. i ... ....
Diagram of Lot and Buildng-.wi.t.h._D..imens_ions _,___,�_ Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
s �
til
�.
-
. QUA
fig . I�
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
p
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg a-rdino the above
construction. /
Name V..... .... ...............
License 04..�, �-• Construction Supervisor's license . ..... .. �' ....
-----
A
SHEARER, KEVIN
=�i No ..29068 Permit for ....One Story............An
Y
Single Family Dwelling A r
.............. ............
Location . ,,;Lot #14, 38 Harbo ,'Hills Road.. ......................................
n
Owner Kevin Shearer
.. ........-
Type of Construction ........Frame
......... ,u <
.................................................................................
Plot ........................ Lot..................................
r{ March 21, 86
. Permit Granted .... ............19
rzt ° Date of Inspection � r.
' Date.-;Completed [ .../.Q ..... c19
Or
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C`: e qolijuF
OF BARNSTABLE Permit No, �_ 22D68_._.-_.._.
Inspector
Cash
ANCY PERMIT Bond --------_---
API
r Issued to Kevin Shearer Address
PE _
IF' Lot #14, . 38 Harbor Hills Road, Hyannis
[< A
Wiring Inspector Inspection date
8 _
Plumbing Inspector Inspection date
st Gas Inspector Inspection date
e: Engineering Department Inspection date ON
i r Inspection date
Board of Health
I i.. THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
j - RI SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
F Al /�
t: V ../M...._............ 19 ...... ....., u _
..
a
I3i ding Inspector
A
-b. i. 'Mw} �'.e+,a�+1 'rr ,M a+aW tA}a11taw-ti.Abcxm.u+�i;�'y M'A 'st+�b,�' ::w+f �1N.arJa•ei-P M.,�.n,i[:•w .s5b:�.;.x+�t...mx.r_,M._.:_�..:.._"�`__`.__��..,3:.:. �..:n-.•, Y...e-:y:^�._.�_::al.._._;.L::..:
TOWN OF BARNSTABLE' MASSACHUSETT$
<47-07' EIRMIT
.JQ9 -Wt,:ATHER .;CARD
DATE ., 19 uG PERMI,T'VO ,,`ti 4a a74/�17
UW:I r 1
APPLICANT ADDRESS' ��11;CF_(�
.,(NO.) (STREET)' I (LONTR'S LICENSE)
build OF
;iWt ilSli^ .� 11?,STORY 1` 'F � r• � DWE3LLRNG UNITS
NU PERMIT TO �.!'1L:...:;'. lt:�].... I)•'P. I i4",.,.
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
G
ZONING ;
•AT (LOCATION) )' t, 141 38) t1 ..,r 14111's Ticad fN'uh)li. DISTRICT
(NO.) a";;!'... .(STREET) .r. .
BETWEEN AND _
T (CROSS STREET).;, • (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE :t'
BUILDING IS.TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN;CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
• - (TYPE)
�•
-9019
REMARKS: �.
AREA OR 1{43c pL. •.....
f yt C � �1VL).��0 . ♦.. PERMIT' ")W.
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET) - -
a
OWNER
ADDRESS S/ £1Ke ;_1I_uactl? t)Y'1Vc, �dli', . BUILDING DEPT.L; ;., ';:✓�/ �1 1
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK. OR ANY PART THEREOF. EITh{ER TEMPORARILY OR
itPERMANENTLY. ENCROACHMENPS O,AL PUBLIC PIROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING'-CODE,4AUST BE AP-
s PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES -AS WELL AS DEPTH AND-LOCATION OF PUBLIC SEWERS MAY EYE OBTAINED
FROM THE DEPARTMENT OF PUBLIC WORKS. THE:ISSUANCE.-OF THIS PERMIT DOES NOT RELEASE THE•APPLJC-ANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION REST IkJ;CTIONS*. -
MINIMUM OF THREE CALL APPROVED PLANS-MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD-KEPT PT POSTED FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I 1. FOUNDATIONS OR�oOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUC.H BUILDING SHALL NOT BE OCCUPIED UNTIL
MINAL IN (RE INSPECTION
TOtEFORE FINAL INSPECTION HAS BEEN MADE.3. FINAL INSPECTION BEFORE "
J OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
( 1 1
2 2 20OZ1145e
3 EATWG INSPECTING A-PPRO-VALS R E I' F 10 .APPROVALS
41,
_ 2
OTHER I OARD IPF EALTH
Cw
C(ezav!
S I6 QG
WCFK SnAL°_ NCT PROCEED UNT,L THE PERMIT WILL-BECOME NULLAND VOID IF CONSTRUCTION MSPECTIONS INDICATED ON TH: CARE
NsaECTCR HAS APPROVED 714E vA=!cos WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE caN BE ARRANGED.FOR BY TELEPHONE
STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION.
'I
Pcr
RaCH RARA DA.
t��:.f''.
BNKTER.
c:1 i
CERTIFIED- PLOT PLAN
-57 LOCATION �. .�/�//5
CERTIFY THAT T HE
SHOWN HEREON COM_PLYS WITH SCALE f �.= 3v� DATE
THE SIDELINE 'AND SETBACK
REQUIREMENTS OF THE TOWN OF PLAN REFERENCEi
2�f5T.4�t� AN D AS
LOCATED WITHIN THE FLOODPLAIN,
/5Z4 / 13---� /03 127
4
DATE : BAXTER NYE, INC.
THIS PLAN IS NOT BASED ON AN REGISTERED LAND SURVEYORS
INSTRUMENT SURVEY AND THE OSTERVILLE^- MASS.
OFFSETS -SHOWN-- SHOULD-. OT_BE' _ 5?
USED TO DETERMINE LO NE APPLICANT
i
t
-
���> 46
lho
Per
'} RICHARD
A.
S BAxTE11• v. ;
No.2;-y'3 )
Qf c i
CERTIFIED_ PLOT PLAN
LOCATION
- CERTIFY THAT THE
SHOWN HEREON COMPLYS WITH SCALE f �.= 3v� DATE
THE SIDELINE AND SETBACK PLAN REFERENCE
REQUIREMENTS OF THE TOWN OF i
/, l2.vr57-4gt�c AND IS
LOCATED WITHIN THE FLOODPLAIN, �� �'� �03 �� �07
DATE : -� BAXTER NYE, INC.
THIS PLAN IS NOT BASED ON AN REGISTERED LAND SURVEYORS
INSTRUMENT SURVEY AND THE OSTERVILLE^- MASS.
OFFSETS SHOWN SHOULD NOT BE
USED TO DETERMINE LO NE APPLICANT � �� �