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':. •�.,i.�a _.. fs f i.1+ret 1 dlnrs(rm t�, u�tL� •' a; Town of Barnstable Building t 'Post This Card So.That it is Visible From the Street-Approved_Plans'Must bez`Retained on Job and this Card Must be Kept STAB" . MAqSL Posted Until Final Inspection Has Been Made. �� _ � � Permit 639 cea Where a Certificate of Occupancy is Required,such Building shall Not be Occupied-until a Final Inspection has been made Permit No. B-18-4141 Applicant Name: Henry Cassidy Approvals Current Use: Structure Date Issued: 12/20/2018 , Expiration Date: 06/20/2019 Foundation: Permit Type: Building-Insulation-Residential P Location: 48 HITCHING POST LANE,CENTERVILLE Map/Lot: 173-041 Zoning District: RC Sheathing: i .•.. Owner on Record`. HAYFIELD,SUSAN M Contractor Name:' HENRY E CASSIDY Framing: 1 Address: 48 HITCHING POST LANE Contractor License CS-100988 2 i CENTERVILLE, MA 02632 $ L Est Project Cost: $ 144.00 Chimney: Permit Fee: $85.00 faced fb to cooling and heating du cts . Description: R8 g I; g Insulation. I ' Fee Paid:` $85.00 Project Review Req: ' Final: I Date: - � 12/20/2018 a Plumbing/Gas Rough Plumbing: g { y-.Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within ssix,months aft erjssuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for.public inspection for the entire duration of the work until the completion of the same. ' '' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided.on thfspermit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health " Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department _ Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT U.S. Postal ServiceTM CERTI IED iIIIAILTM RECEIPT e r (Domestic Mail■Oni ---I-.urancelCov_erage Provided)° IFo%delivery,i6formation,visit our w`ebsite at www.usps.com® OFFICIAL USE PS_Form M0 August 2006 See Reverse forLnstructions Certified Mail Provides: 0 o A mailing receipt o A unique identifier for your mailpiece e A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mailt�i. o Certified Mail is not available for any class of international mail. . a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or' addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 30289 Ma Parcel' i M1 3 P c ` # _ ,'Application Health,Division - Date Issued " �. Conservation Division Application Fee Planning Dept. ;,Permit Fee Date Definitive Plan Approved by Planning Board Historic -. OKH. _ Preservation / Hyannis Project Street Address g tti+r,h ni Q s.s Village CeAJe('y'i11e Owner Sv's0o wNi� ►e Address Telephone C7 0B Permit Request �r�� 1Z'�� Q016 )e to + e, A.r, a�V� seal :N:�e o&l c . IN��'� CxPanaZny �o�m Square feet: 1 st floor: existing proposed _ 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 315,00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ,❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new _ Half: existing new Number of Bedrooms: existing __new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas Oil ' ❑ Electric ❑ Other ,� Central Air: 'AYes ❑ No Fireplaces: Existing New Existing wood/dal stove:=❑Ye§ ❑ No C0 Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size Barn: ❑w'exPsting ❑..new Sze_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes *No If yes, site plan review# Current Use _ Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) NameLcitokevTelephone Number �� ` 39$ b 3 9 — Address 4 A+(N 6) License # C 6 7-7 6 Home Improvement Contractor# Worker's Compensation #►U1 C 3 l ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 5 15 FOR OFFICIAL USE ONLY ` APPLICATION# l t } DATE ISSUED f MAP/PARCEL NO. x ADDRESS VILLAGE OWNER �1 t� { . ar DATE OF INSPECTION: k FOUNDATION, `A t'l'i FRAME 'INSULATION'!. ' -FIREPLACE ,A ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL a GAS:u ROUGH . :E+: FINAL ,FLNAL BUILDING-- DATE CLOSED.OUT ASSOCIATION PLAN NO. a 60 `eldest Main Street SOUSING Hyannis, MA 02601-3698 ._ S S I S TA�I CE EPJERGY & , HOME REPAIR >= T (508) 790-7106 F• (508) 790-- �r: CORPORATION 2425 HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: lVr-ll 1�I'1 I'\ _ la l j THE APPLICANT HOMEOWNER. hereby consent to and agreethat weatherization work may be done by the Weatherization Program of Housing Assistance Corporation ( hereinafter referred as "Agency" on the property ed at: 1(4 The weatherization work donewill be based on programmatic priorities and availability of funding and it may include all or some of thefollowing measure Weather-stripping& caulking of windows and doors, insulation of attics, sidevalls& basements, attic and other ventilation measures and possibly replacement of badly deteriorated window& In consideration of the weatherizati on work to bedone at my home I agreeto thefollowing 1. I give permission to the"Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The H ousing Assistance Corporation reserves the right to inspect the fuel or uti lity bill for the weatherized unit on.an ongoing basisfor no more than five(5) years after the weatherization work is completed. I have read the provisions this r t as listed and freely give my consent. Home Owner: (Signature) \ j Date: Agent: (signature) Dater HAG approved Weatherization Company: C& Ali Cape Energy, Caliber Building&.Remodeling, Cape Cod Insulatio Cape Save Creswell Construction, Frontier Energy Solutions, Lohr&Sons, Peter Smith, Resolution Energy, Rock Solid Construction ` x SAVE'CAPE1Wea erization i 08-39 -039 August 22, 2010 To Whom It May Concern:" William J. Mcauskey is an employee of Cape Save. He is authorized to negotiate contracts and building permits for our.company.- I Michael McCluskey Cape Save—owner s 919-593-5939 cell ', X Huntington-Avenue,South Yarmouth,MA 02664 • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,AM 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers _Apalicant Information � r Please Print Le•�l,bly !& ��Name(Businesorganizaton&(Iividuai): TMI[' ,U.Ait AACC1 5411) Address-. 1-L.' A-Aor-4.11nio" se3 ANOE City/State/Zip: • �Pog-hto mi- 1�i 7D(0 Rorie#: - 3 �" 3 . Are you an employer?Check the appropriate box: Tvpe of project(required): 1. I am a with employer a` 4. ❑ I am a general contractor and 1 6. ❑New construction eloyees(full and/or part-time).* have hired the sub-contractors mp 2.❑ 1*am a sole.proprietor or paRner_ listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have $. []Demolition =working for me in any capacity. employee 1.s and have workers' 9 ❑ Building addition comp.insuraticc [No workers cotiip. insurance 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its .3.❑ I ant a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers`comp. right of exemption per MGL 1.2.[] Roof repairs insurance re wired } c: 152,j 1(4),and we have no Sit �� q ]. employees. [No workers' 13.®Other comp. insurance required.]. *Any applicant that checks box#l.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 him.outside contractors must submit a new affidavit indicating such. tContractors 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 are an employer that is providing workers'compensation insurance for pity employees. Below it the policy and job site information. , -�. - Insurance Company Name: I IBS "I� o m f1 Policy#or Self-ins.Lie..M '7 W C 3 9 Expiration Date: a l 9.0 Job Site Address: 0 � e n La nL cityistate/zip:C�h4-dfv 4 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$25.0.00 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 under the paiirs d nalties erjury that the information provided above is true/and correct. Signature: f Date: Phone# 9 Ilk- Official onlp. Do not irrite 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.CityfTown Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Phone#: Contact Person: ACCO V CERTIFICATE OF LIABILITY INSURANCE D0/20/DD011 `�- l /20/211 THISr 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 NAMEAC Shannon Sperrazza Risk Strategies Company PHONE FAx (781)963-4420(781)986-4400 C o: 15 Pacella Park Drive Epp IL .ssperrazza@risk-strategies.com Suite 240 INSURE S AFFORDING COVERAGE NAIC# Randolph MA 02368 INSURERA:Selective Insurance INSURED INSUR RB:Safety Insurance Company 3618 Michael McCluskey, DBA: Cape Save INSURER C:Technology Insurance Company 7 C Huntington Ave INSURER D: INSURER E South Yarmouth MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBER-CL11102041451 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER MMIDDY/YYYY MMIDD/YYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES T(Ea oR RENTED S 100,000 A CLAIMS-MADE ®OCCUR CPPS1994480 0/16/2011 0/16/2012 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY JFCTPRO LOC $ AUTOMOBILE LIABILITY BINED INGLE LIMIT E accident $ 1 000 000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 6208200 1/6/2011 1/6/2012 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS N AUTOS Paracciden1 X Underinsured motorist 81 split $100000 300000 X UMBRELLA LIAB X OCCUR PPS19944801 0/16/2011 0/16/2012 EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION$ $ C WORKERS COMPENSATION Executive excluded X WCSTATU.MT- OR AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECLITIVE YIN Nfrom coverage E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? a NIA C3297972. 0/21/2011 0/21/2012 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Issued as evidence of insurance. National Grid Corporate Services LLC d/b/a National Grid, d/b/a Boston Gas Company, d/b/a Essex Gas Company, Action Inc. , and Housing Assistance Corporation are listed as additional insureds as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION (508)7 90-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Housing Assistance Corp 484 Main Street Hyannis, MA . 02 601-3 6 98 AUTHORIZED REPRESENTATIVE Michael Christian/SMS ACORD 26(2010106) 01988-2010 ACORD CORPORATION. All rights reserved. INS02EI9ninmmni Tho Arne l namo zinri Innn aro ronicforori mar4a of Or_npn ' �� O ce o Consumer A air and Business Regulation . 1.0 Park-Plaza - Suite 5170 Boston, Massachusetts 02116 Home lmproveij nt4'Contractor Registration Reoistration: 164432 . Type: Supplement Card CAPE SAVE Expiration: 10/6/2013 WILLIAM McCLUSKEY 8201 S. HOURD CT CHAPEL HILL, NC 27516 Update Address and return card.Mark reason for change. )PS-CAI 0 60M-04/04-G10I216 —11 Address CC] Renewal ❑ Employment ❑ Lost Card Sze�a�rv»wnuleall�d�✓l�crclzuae/�s _ _ - . _.- Office of Consumer Affairs&Business Regulation g" License or registration valid for individul use only •, :,HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 1a Office of Consumer Affairs and Business Regulation L g r Registration._;.164432 Type: 10 Park Plaza-Suite 5170 �� / Exp)ration 10/6/2Q13 Supplement Card Boston,MA 02116 CAPE SAVE -- WILLIAM McCLUSKEY=_- 7C HUNTING AVE: S.YARMOUTH,MA o26S4.. tindersecreta ' rY Not valid without nature ''= `1assuchusctts- Dcl►artmcnt of Public Safct. ' Board of Building► ,. Regulations and Standard. Construction.Supervisor Specialty License License: CS SL 102776 a Resiricted to: IC � � WILLIAM Mc CLUSKY 37 NAUSET.ROAD WEST YARMOUTH; MA 02673 � " Expiration: 6m2o13 (��nuni�siuncr Tr, 102776 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 6-3-12 Town of Barnstable - Thomas Perry CBO ; Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, r This affidavit is to certify that all work completed for 48 Hitching Post Lane,Centerville has been inspected by a certified Building Performance Institute(BPI)Inspector.. Ceiling: R-19 & R-38 cellulose Ventilation: 10,U16 soffit vents with air chutes All work performed meets or exceeds Federal and State Requirements. Sincerely, ` ., , F.. . William McCluskey ` • , a .. .., .. ! TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel, ��/� Application6�Z! Health Division Date Issued zd Conservation Division c.' Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board &?12.40 Y Historic - OKH Preservation /Hyannis V Project Street Address Owner ,e�� '� Address ' Telephone ' Permit Request` r' Q� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay vo Project Valuati Zonstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) r4-8 Number of Baths: Full: existing new Half: existing new _ Number of Bedrooms: existing _new `J CD c� Total Room Count (not including baths): existing new First Floor Room Count cr9 Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other ' Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stoves Y&❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Z Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) n 7t<4" Name L. F� 7 7KTelephone Number rJ 7 Address License # ' I Home Improvement Contracto # Worker's Compensation # �� c fi`� �U ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WI B TAKEN TO c7 7 D SIGNATURE DATE Z / FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 23JI2- DATE CLOSED OUT ASSOCIATION PLAN NO. i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information z 4 Please Print Le ibl Name (Business/Organization/Individual): H Y Address: City/State/Zip: U ✓�I�?�/� Phone#: Are you an employer? Check the appropriate box: Type of project(required): 1.K I am a employer with / 4. ❑ 1 am a general contractor and I T* have hired the sub-contractors 6. ❑ New construction rt employees(full and/or pa -time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.$ . d.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 4<a"uim a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions yself. [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' 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. tContractors that check this box must attached an additional sheet showing the name of the subcontractors 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. ^ /_ 1 b Insurance Company Name: V'e�-� Jo rt r G � O C o ' 0 O O Policy#or Self-ins. Lic. #: l Expiration Date: U ry Z Job Site Address: 4 gt ate/Zip: Attach a copy of the workers' compensation policy de laration 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 Yof p to$250.00 a day against the violator. Be advised that a copy of this statemerit may be forwarded to the Office of vesti ations of the DIA for insurance coverage verify do hereby certi un er the ins an enalties of irry that the information provided above is true and correct. Si atur Date: 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#: zro�ti Town of Barnstable Regulatory Services • �xxsusr� • KAss: $, Thomas F. Geiler,Director Q7 1639. �Eo�a Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town_barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1, �� G� , as Owner of the subject property hereby authorize �ij W&Ia/ to act on my behalf, in all matters relative to work authorized by this building permit application for. OY 0{Je y 54'd -tom- hi lL 144ea his G1'P(� Pb -r i Ck f , 0 (Address of ) L A" * ignature of Own -._ Date rPrint Name - - If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. - n.rnnitn_ntr ntr_nnanrrnnin�.t - tt+e Town of Barnstable yw�yoE r��� Regulatory Services r gAgjVCTARi� Thomas F. Geiler,Director Building Division prFD Tom Perry,Building Commissioner 200 Mairi:Street,—Hyannis;MA 02601 vr%w.town.barnstable.ma.us Office: 508-962-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION ; Please Print r t. DATE: JOB LOCATION: f number street ` village "HOMEOWNER" ` name home phone# ! work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended o include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire does not possess a license,provided that the owner acts as supervisor. ' DEFINITION OF MEOWNER Person(s)who owns a parcel of land on which he/she resides o intends to reside,on which there is, or is intended to- be, a one or two-family dwelling, attached or det�hed stricture accessory to such use and/or farm structures. A person who constructs more than one home in a, o-year period s all not be considered a homeowner. Such "homeowner"shall submit to the Building OWcial on a form accep ble to the Building Official,that he/she shall be res onsible for all such work performed um4 the building permit. ( ection 109.1.1) The undersigned"homeowner"assumes r onsi for compliance the State Building Code and other applicable codes,bylaws,rules and re lions. The undersigned."homeowner"certifies that.he/she understands the Town of. arnstable,Buildipg Department minimum inspection procedures and//equiremtnts and that he/she will comply th said procedures and requirements. Signahn-c of Homeowner Approval of Building Official Note: Three-f y dwellings containing 35,000 cubic feet or larger will be req ' ed to comply with the on State Building Code Se ' 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code sta 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 ad as supervisor." Many homeowners who use this exemption arc unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the bomeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that helshe 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 f6rrn/=-tification.for use in your Community. Q:for rns:hommxempt JOB t o �� 5d�PG15 G0L0wi1Af4w T�c.6 co TAYLOR DESIGN ASSOC., INC. SHEET NO. OF 1 P.O. Box 1313 (� Forestdale, MA 02644 CALCULATED BY T DATE � O� Tel./Fax: (508) 790-4686 CHECKED BY T SCALE YAYLJOA ............... ._ vy ..... `fl1.�. ./4, .... �7 . .CAD. : ..?.. .....:.�':.��TIc��..._ .. . .:.. :.. .. ... .... PST l`etc A•c_.. ... F'E .�.c.c `�aEssvric� .. to 1 . �iSF..... t6�Ll . 4 ,... . .... . ......_ ... . .. :. ,,...�,......._.. .. .�y A A .. d, _ . . . .. .. .. ...... ... .. . . y Aw ... .... ........ . .... r _ Z '1.. .Ps R.... t . . .. ` ` .. .1A•��.�.: .. .. Y ._► 1C�. _ . r ...... PJc.: .... .. ... � _. ; . ,. . . ... .... . ............:. ..........a•r ............. ..... :....... ....... .. .... .9Z.8 �F. goy 1.. a o �,k, .. .. ..... .... ..... _...... .. . .... . ... `Zm > tJ[ .L.. .�.1.. rn L'' �r rr t. : . .� �... _ E ,. w� �- f ' , . . , i O I' f/ (GJ VV�' � � �-o�, � t � . � � . � � i r-�/ F 77 t ]a��t(hu;�cttti-`t)epartm(rt�1t'Pubt1�s f Boud OI-BULIOIp;s I€tc,r �ulattOns and Constructioti.SupervtsoT.. License, ' License: Cs 60855 Res,•. icted to: 00 MICHAEL A HEALY h " I 72:0L,D MAIN STD} ( ` SO YARMOUTH MA 02664 ;:i . . ,. Expiration: fid-2010 (ummisti,nner - Tr#; 7116 Bdarde$ui7c1 '.. S B�ga1a(Wn and y*�ndati;s r MQP.AE IMPROVEMENT 401iTR�lCTtt4 G Registt°ation 1606(i9 Explratiaan g��4�2010 ! > 17 Tr;X 272383 j'1YA� ,� I�retp Cc,* ton tO `xUl Wy,tT;0,OU1 H FJIA'664 A- 11't�iJtr71'(1 ' ti , ACORD CERTIFICATE OF LIABILITY INSURANCE 6/30/2o o' PRODUCER (508)775-4559 FAX: (508)775-4577 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Marshall R Lovelette Insurance Agency NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE g y Inc.. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 396 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 836 West Yarmouth MA 02673 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:Hartford Ins Co 0006 Healy Brothers Construction Corp INSURERB: 72 Old Main Street INSURERC: INSURER D: South Yarmouth MA 02664 INSURER E: OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY ATEYMM DD/YYE PDAITE MM/DDIYY CY EX N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS MADE OCCUR MED EXP An one person) $ PERS NAL&ADV INJURY $ GENERAL AGGREGATE $ GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AG $ PRO- POLICY LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND 6S60UB0670L49709 06/21/2009 06/21/2010 1 WCSTATU- oTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100000 A OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ 500000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 100000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER. CANCELLATION (5 0 8)7 9 0-623 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town of Barnstable EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Building Department 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 367 South Street Hyannis, MA 02601 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE John McShera/JOHN ACORD 25(2001/08) ©ACORD CORPORATION 1988 INS025(0108).08a Page 1 of 2 I If STANDARD LEGEND .1.not all rymbals will appear an a map GOLF COURSE FAIRWAY. 7 DECIDUOUS TREES MAP17 ; : " EDGE Of BRUSH I \ �� MAP �l 73 t L�� .ORCHARD OR NURSERY a j J` CONIFEROUS TREES MARSH AREA /7 EDGE OF WATER 31 - — DIRT ROAD # 29 DRIVEWAYS } �� PARKING EOF PAVED ROAD DITCHES n — -_.—___.._.... - i• / — T RAIL PROPERTY LINES 1 __.__........ ..._..._—._.._._. .._.-._..:.! P� PRO UMBER NUMBER 1 CONTOUR LINE+E-00 ' i ID Foolcoxi0uauxE I _ i SPOT ELEVATION J STONE WALL - • A� �� � "�r�y� // FEHCF - .. ....._ y . r .._... 7 - --'� RETAINING WA IT RAILROAD RACKS STONE 1TIYMAP . : SWIMMING MAUN POOI PORCH/DECK I i _ — J• BUILOIXGS/STRUCTUR ES � DOCK/PIER/TET _ MAP_ 173 _( � ASSESSOR'$IMP BOUNDARY YALYE O XANHOUS • I /A'� - I 0 POST O, FLAGPOLE #. .4 8 ' —� .n smPoll m STORM OURS Tom 9 LIGHT O EU(SBOK r I I I i I ( 1 I r r -_ SITE MAP I ;I I 7.0 B 6F069APNIC INFORMATION SYSTEMS UNIT SCALE:in feet --__ 0 1}NCH 20 40 — = 40 FEET I I , r I I r I I I I I —'- r I r I I I? I I r I r r . I I IIDm IXf rAKEi UN[S NM NIn G[APN¢REPRFS[mV10M OP nroTtAn eounouoEs,mFrwF xoT TRDE Iaurorts r•IN a3.94- I r S46EIMNNI MOIOPOEAIXII NIAIANtlRiFO IAOM N89 MRIMPN alai . i I F NgIppMIYY I.-Bor.PIMVJf7IX01M IKRRME7ED R IN. .l At PWK NpT091MT AT P=600'.ROtn AMMD M r=IN. _ I• / , ) ?ARCO DATA BIGOTED FROR V-100•ENGNEERING ASSESSORSAUS ITT7. \ i I 'OMAAIVMD Al I--10P.KOIJUCY OF MAPS FATED AT A OTHUNT . !• �• SUU.V.AYIREKEME � 1 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map j�..3 Parcel Permit# ' 3 MY�t� ---'Health Division �U9 A?g9T,?(Ae Issued f 5L? - Conservation Division 0-Al Fee 0, 7 Tax Collector... , " � L � SYSTEM MU . Treasurer" SEPTIC MUST BE S� INSTALLED IN COMPLIANCE annmg D a t. WITH TITLE 5 -5ate-84A"Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOWN REGULATIONS vatronMTa-nnis Project Street Address q 8 [ ' Village "CV e co% e— Owner g,<`nAr Address Y l� Telephone Z50tg' 990 C> Permit Request Al JA a �V v✓�— r v ` Den Square feet: 1st floor:existing 19'W,1 proposed 2nd floor:existing proposed Total new 3�$ Estimated Project Cost IL 03100 Zoning District Flood Plain Groundwater Overlay ' F Construction Type Lot Size / 16�x 120� Grandfathered: ❑Yes /No If yes,attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes �No On Old King's Highway: ❑Yes o Basement Type: 10 Full ❑Crawl ❑Walkout ❑Other 0��wl am Aew Z t0'�e Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) / 2 O Number of Baths: Full: existing~ new Half:existing new Number of Bedrooms: existing_ new Total Room Count(not including baths):existing U,1� 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:AN existing- ❑new size' Barn:❑.existing ❑new. size Attached garage:12 existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name__ Telephone Number t Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE _ 1 FOR OFFICIAL-USE ONLY, Ar ' PERMIT NO. DATE ISSUED + _ MAP/PARCEL-NO, ADDRESS " VILLAGE OWNER F P DATE OF'INSPECTIOf:: FOUNDATION FRAME INSULATION FIRfiPLACE ' s - ,� -_ • J r .. rt ELECTRICAL: ROUGH • FINAL PLUMBING: ROUGHS i j FINALS GAS: ROUGI G ? FINAL ' FINAL BUILDING ® m tc - ' Z0 -f m r< ' cr : t DATE CLOSED,OUT . ` ASSOCIATION PLAN NO Q i ' bull ><ng Livision ' 367 Main Street,Hyannis MA 02601 ; & i. Office: 508-962-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE.: `, i JOB LOCATION: `f V jq t 4(L Ce n-e lVI J number strut village "HOMEOWNER": �r ao9 iG"AD `- ao A 4 ao T 71 v�5y/ name / ( home phone# work phone# CURRENT MAILING ADDRESS: `l H GGP(.6 3 city/towrn 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,=vided that the owner acts as su ems. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (,Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements- Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply, with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EI(ENI MON The Code states that: "Any homeowner performing work forwhieh 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 ate assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problem 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 hislher responsibilities,marry communities require,as part of the permit application, that the homeowner catify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may cum to amend and adopt such a form/certification for use in your community. ffs. MAScheck COMPLIANCE REPORT Massachusetts Energy Code - Permit # MAScheck Software Version 2 .0 Checked by Date CITY: Hyannis STATE: Massachusetts „ HDD: 5973 , CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 6-23-1999 DATE OF PLANS: TITLE: COMPLIANCE: PASSES Required UA = 107 Your Home = 107 n Area or Insul Sheath- Glazing/Door �' Perimeter R-Value R-Value U-Value UA -------------------------------------------- CEILINGS 485 38.0 0.0 15 WALLS: Wood Frame, 16" O.C. 467 15.0 3.0 31 GLAZING: Windows or Doors 109 0.320 35 GLAZING: Skylights 16 0.600 10 FLOORS: Over Unconditioned Space 432 25.0 16 'COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other ., calculations submitted with the permit application. The proposed building has been designed to meet the•. requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate 'has. .been determined using the applicable Standard Design Conditions found :in "the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections ,780CMR 1310 and J4.4 . Builder/Designer Date '7Eo 111 1IIg ivision 367 Main Street,Hyannis MA 02601 ffice: '508-862-4038 Ralph Crosses ax: 508-790-6230 BuiIding'Comtsissio-e- Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,.alterations,renovation,repair,modernization,conversion, improvement;removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. d Type of Work: C&^ t om tsj� i+rss4, Estimated Cost X<) ,t*d Address of Work: 4-42 9asl Lc�ae �c'tJt��O iHa�gS ® 1�03 Owner's Name:X,C h In P Date of Application• I hereby certify that: Registration is not required for the following reason(s): [3Work excluded by law C]Job Under$1,000 Building not owner-occupied okowner pulling own permit Notice is hereby given that OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. O Date.- O ame q:forms:Affidav 600 Washington Street Boston Mass. OZlll Workers' Comyensadon Insurance Afridavit %r ���i.?---------------------------------- �//��////%!/• '�"•�". location- 49k 0 1 4 Gk f.A-(► b�; I n r tin• t, - Acme 0 4�0 ! ��V I am a homeowner ner brm ng all%vy k myself. M I a�ma sole proprietor and have no one wo ridna fn any a Q I atn an emplrnez providing workers' compensation for tap emplwees tivorking oa this job. comnnnv name: address:Citv- hone#: 'insurance cn. I am a sole proprietor, general contractor, or homeowner circle one and have ati•e � � � breed the contractors listed belotiv who the follo%�ing workers' compensation polices: omnanv name: .... ..wrry. .. ddress: �• .. .. .. - :•' ..A..•. ;�'• •w4\ ri•••�.:'.$:. •�7•'.kt6'nw04' ''''wI:EOCifw M... phone#' [Yurnnce Cn. i%I(/I�U//s4GL'G(�!w/�%G .(/.((G�/ M<• �..�.�QR.�.smoa�:w'w:. r ii anv ttsnte- 6 - phone N! io ❑rnnce CO. r r:._ . �'s+:+ ;: y..�•:..•titre."'':•.`•: .. ^•.::. .: .:...}.U�S•. r "44.ivw•y'ynw6 IREIR ::re to secure coverate as required under Section LSA of MCL 152 can lead to the Imposidon of tstinioat =•rar V imprtsottment as well as civil penalties in the form of a STOP WORK ORDER and a MIS of SI00.00 ad of a Ste up to Sldtl0.00 andlor r of this statement may be forwarded to the 0Mce of Investigations of the DIA for eoveaage verb• ?' mz I understand that a hereby terrify the pairs=d penalties of perjury that the infonnadon pravided above tr g mdcvffea q�s mature ^t name Ph=� McW use only do not write in this area to be completed by city ortmm oividat is or town: petmitNts use q QBttiIding Department check if intinediate response is required CILlcensing Board ❑seleetmeres 0Mce ntact person: CHeaith Department phone#-. ❑Other�� r95 F/AI _ . employees.. As quoted from the "law", an employee is defined as every person in the service of another under=V c;.--- 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--:e the foregoing engaged in a joint enterprise, and including the legal repress of a deceased employer, or the:�c:-•e- trartee of an individual, partnership, association or other legal endty, employmg employees. However the on=r of a dwelling house having not more than three apartments and who resides thereia, orthe accupant ofthe dwelling house another who employs persons to do maintenance , cons racdon or repair work an such dwelling house or on the building appurtenant thereto shall not because of such employment be deemed to be an employer. MGi, chapter 152 sermon 25 also states that every state or local licensing agency shall withhold the issuance or rere,7r of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neishe,-thae commonwealth nor any of its political subdivisions shall eater i=any contract for the performance of public work,,:: acc--,table evidence of compliance with the insurance requiremeaLs ofthis chapter have been presented to the c � authority. Applicants PIe:se fill in the woricers' compensation affidavit compieteiy, by cbeciang the box that applies to your sitantian and suppiving company names, address and phone numbers along with a cmtficate of fim=n=as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of iMMM=cOVerage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city ar town thatthe application for the permit or license is being reque.-ted, not the Department of Industrial Accidents. Should you have any questions regarding the `law"or if;•c : are required to obtain a workers' compensation policy, Piece call the Department at the number listed below. (City or Towns Me:se be sure that the affidavit is complete and printed legibly. The Deparuneat has provided a space at the bottom of afl;dzvit for you to MI out in the event the ME=of Iavesdgadems has to cema=you regarding the applirtat. Please be sure to fill in the permiVUccase number which wM be used as a reference number. The affidavits may be Maned io the Deparmuent by maul or FAX unless other arraagemeats have been made. The Office of Investigations would like to thank you in advance for you epope:ation and should you have nay questions. ile=e do not hesitate to give us a call. the Deparnneat's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Once of IMSUOMMS 600 Washington Street ' Boston;ML 02111 ' far#: (617) 727-7749 phone #: (617) 7.27-4900 a= 406, 409 or 375 i MAScheck INSPECTION CHECKLIST n Massachusetts Energy Code MAScheck Software Version 2 .0 DATE: 6-23-1999 Bldg. Dept. Use CEILINGS: j [ ] 1. R-38 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-15 + R=3 Comments/Location f` WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.32 For windows without labeled U-values, describe features: #Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location I SKYLIGHTS: [ ] 1. U-value: 0.60 ` For skylights without labeled U-values, describe features: #Panes Frame. Type Thermal Break? [ ] Yes [ ] ` No Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-25 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings. in the building envelope that are sources of air leakage must be "sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0.5 clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. - MATERIALS IDENTIFICATION: " [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and' service water heating equipment must be provided. Insulation •R-values and glazing U-values must be clearly . marked on the building plans or specifications. x z DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous` backing.:tape. Pressure-sensitive tape may be used for fibrous 'ducts. The HVAC ' ' t system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone "or' floor shall be provided. HVAC EQUIPMENT.- SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4 .4 . MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 For-chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only) --------------------- / STANDARD LEGEND am all,ymbd,Trill appam on a map GOLF COURSE FAIRWAY MAP DECIDUOUS TREES \�/. 1 = x3 EDGE OF BRUSH �—_ AtW ORCHARD OR NURSERY i MAP ti CONIFEROUS TREES % l j MARSH AREA x 1 =�*• EDGE OF WATER 31 ! # GIRT ROAD r J RIVEWAYS -' " " �� tiPARKING LOT # 29 PAVED ROAD DITCHES PATH/ .. - PROPERTYLINES iRA1l v._:_. _. ..... - 2:�v=PARCUMBER HOUSE NUMBER - - . 1 F001 CONTOUR LINE tF '—^•`�• �' i ; i �'\ w. _.___ +. 10 FOOT CONTOUR LIKE � .......... SPOT._ .. SP0I ELEVATION T. STONE WALL X.. ..� - F f ._..... .:� ... i _....+ RETAINING WAIL \ FENCE ` T I. ? 1-�//y ! S i , RAIL ROAD TRACKS /\ MAP, 1 / 3 .. ti T • Al.At..A �' _ .� STONE JETTY SWIMMING POOL j - J PORCH(DECK id• BUILDINGS/STRUCTURES 1 y M DOCKS MAP JETTY BOUNDARY ' SESSORS MAP BOUNDARY -� AP 173 6 Y4YE O MANHOLES I o POST O" FLAGPoU SIGN m STDRN DR R - r If __'--- �.� (•Iy U 1 ms O POLL TDIYEI _ 9 LIGHT O EI£08011 # 60 _ SITEMAP y r , I i _ "-- - . � T.O.B.6E061APN1C INFORMATION SYSTEMS,. r` E•in feet SCALE: = 0 FEET '' 4 N -- r r r r , J` r 1 . : 41 r , ._ - _ .. NofE IX[RAINH UNF$ARE OIIIYGRAFNIE RFPRf5fN1UlOM Oi - . It ri(r I'R0/[PJY BOIINOARIES, 1MEl AR[NOT TRUE IOCATIOXS u:A&6 94 I—��� YFNIMONM UIO.W.OATAMURPR.FIEDFRON19R94R14PHOIOS ' MOIOGNNIYIITOGILI'.NMIM[IRI(0A11M1 MBAl I.-MN. S {1 NRPIIOIOS NIOIOERAPXT4I'_/R0.9 0 1X MMNONI'-1a0'. P Ol 04AlYP1FAII'-A H D M IN.ACCUWOF MKTEAIAWHREM SCALE AUTOEEREA4. i Y ' 1 � Ks i`r6 +u•r yam. � . rVJ , A���o I „N-c'� '��' � ✓� ��,� � �'� +� eves7. Olt ��"� j t JaA,�'S •- AA, �! ! I I o D� - - 7�i77 tf (a .,+d%At Al 10 ----- .'` dw char t Sic _ t 2 �t Qf y �4Ye� a� v@1C ix o e, 1 1 t r�euta�lev�k � l rr �_ 5,11 Seas �• -Tr. ; - e ow IET g - g 'x I '9 5 :Fw 10 s i a i KY '�. amL42 tX si i On 2�3 !, uj4 Rao i � Assessor's office(1st Floor): t 3 _ SEPTIC SYSTEM MU Assessor's map and lot number 1 _ ,_ .. 9 T J INSTALLED IN COM Conservation(4th Floor). '�'' ''' `f WITH TITLE Board of Health(3rd floor): ,G ENVIRONM4 4TAL C LE Sewage Permit number ' R `j _ Engineering Department(3rd floor)' T01'4mf iN �.,-6---.ULATE '639. House number Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only {. TOWN ' OF BARNSTABLE BUILDING iNSP,,CTO, �, L �1 Z��rJ✓lavnr� ocrC y�s� APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION #V L- fl C1UIN-r) `1ry 2 1 19 'T TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 4 B I4L",uy c, Pac,C Proposed Use f JN ; Zoning District Fire District Name of Owner SUSri,j ]`Ar,6C 1-0 Address 4V-) �� '�c-(.,�+�s"�s�S� t�ub,0 Name of Builder , ` ,yt ,�srp6 Address Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost ��i U UC1 Area X 3 Diagram of Lot and Building with Dimensions Fee �® j t Y o f=�a- 3-2, Ef6 C, t (, 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 Name -5�JL,8PA C ense '�-�• -1!ATFIELD, SUSAN Y.�- 3� No Permit For BUILD PRIVATE SWIMMING POOL _ Location- 48 Hitching Post Rd. Centerville Owner Susan Hatfield Type of Construction f � Plot") Lot i i l Permit Granted June 17 19 94 Date of Inspection: I Frame : 19 Insulation 19 I ! Fireplace 19 - Date'Completed - 19 - ` w z i t I 1jMp� S •�� e i ! el' COMMONWEALTH OF MAW-SACHUS 'Art. `c DEFAR',','M NT OF INDUSTR2'A &ACCIDENTS 600 WASHINGTON STREET fames.: Catnooei: BOSTON, MASSACHUSEM 02111 Cor•:m.:ssione , WORKERS' COMPENSATION-INSURANCEAFI~TDAVIT`; ; �V,'s` 4 CiornfCC!'pCRAlttee) Cl with a principal place of busm r. ess/rrsrdence at: b. Itr k f _ K= do hereby certify,under the pains and penalties of : � Au perjury,that: py j] I am an employer providing the following workers'compensation coverage for my cmplovecs working on this job. Insurance Company Polity Number (J l am a sole proprietor and have no one working for me. I am a sole proprietor.general contractor o :h.:m:�e.:w:,.:c)rcirc1e one)and have hired the contractors listed below who have the following workers' compensation u surance policies. Name of Contmaor Insurance Company/Policy Number w Name of Contnaoi Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number 0 l :m a homeowner performing all the work myself.- - N0M-.P1casc be aware that while bomco-mcr who ctaploy persons to do taaintcoance.construction or repair wort;on a' dwcliinr of not more than t rcc unit, in which the borncowacr also resiccs or oa the grounds appurtenant thereto arc not gcccrally considered to be ermalovers tinc:rr the'Workers' Corr vc=ation Act(CL C 152,sec 1(5)),application by a homeowoer for a license or permit may eviccs cc tic lcr:1 surus of an eravlowr under the Gorkcrs'Corn?cosatioa AeL l unecr_.:nd - •sr:.c:ncr - t. - cn�. c:t:-. :wil! be forty: ccd to tic:rcn.:-ca Accidents'Ofncc of lnsuranc: for coverage Yc:. =:ion �'c icc:.:c cove:-rc:.s tceui:ec under Scc;oa?5:'ci%;G* 151 e:r,cud to tnc i apozition of mminal perdu co•^•=isor.c of:tine ct uz� a S'SGG.GG: .61or ir-priso,^.-"t of uc to orc vc:.:�.c c-;;:=--iJ;S Ln tl c form of a Stop Wort:Ordcr ind fine of S 1 GO.oG a cav a€:ins:Inc. Sicncd this dati•of . 19 i.c^sot;F:rr.:1—=41 I t ! [ l ! SQIMMING POOLS: ! All heated svinmi.ng pools must have an on/off heater snitch.and ! require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. { [ l ! H9AC PIPING INSULATION: HOAC piping conveying fluids above 120 F or chilled fluids ! belov SS F must be insulated to the following levels (in.): ! PIPE SIZES (in.) ! HEATING SYSTEMS: TEMP (F) 2° RUNOUTS 0--1° 1.25-22 2.5-4" ! Lov pressure/temp. 201-250 1.0 1.5 1.5 2.0 a ! Low temperature 120--200 0'.5 1.0 .1.0 1.5 ! Steam condensate any 1.0 1.0 1.5 2.0 ! COOLING SYSTEMS: ! Chilled eater or 40-55 0.5 0.5 0.75 1.0 ! refrigerant below 40 1.0 1.0 1.5 11.5 ! [ ] ( CIRCULATING HOT DATER SYSTEMS: { Insulate circulating hot eater pipes to the following levels (in.): ! ! PIPE SIZES (in.) ! NON-CIRCULATING ! CIRCULATING MAINS & RUNOUTS ! HEATED DATER TEMP (F): RUNOUTS 0-1° j 0-1.25" 1.5-2.0' 2.0+8 ! ' 170-180 0.5 ! 1.0 1.5 2.0 ! 140-160 0.5 ! 0.5 1.0 1.5 ! 100-130 0.S ! 0.5 0.5 1.0 -NOTES TO FIELD (Building Departnent Use Only) a y � a w R ( ] � S@�IMMING POOT�: All heated svinning pools must have are an/off Beater switch and require a cover unlm- over 20% of the heating energy is fron i non-ftletable sources. Pool pumps require a tine clock. { ] ; HVAC PIPING INSDLATION: HVAC piping Conveying fluids above 120 F or chilled fluids } belay 55 F nest be insulated to the fallowing levels (in.): PIPE SIZES (in.) { HEATING SYSTEMS: TEMP (F) 2' RUNOUTS 0-1 1.25-2' 2.5-4' low press►ure/terp. 201-250 1.0 1.5 1.5 2.0 Loy temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any i3O 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water. or 40-55 0.5 0.5 0.75 1.0 i8frigerant below 40 1:-0 1.0 1.5 1.5. [ ] # CIRCULATING HOT EATER SYSTEMS: Insulate circulating hat water pipes to the following levels (in.): J PIPE SIM (in.) NON-CIRCUITING CIRCULATING MAINS & RUROUTS HEATED DATER TEMP (F): RUNOUTS 0-1' ( 0-1.25' 1.5-2.0' c.0+' j 170-100 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 f 0.5 0.5 11 -NOTES TO FIELD (Building Department Use Only) a--- ------- l 1 i ! installed in the building envelope, reed lighting fixtures ! shall neet one of the following requirements: ( 1. Type IC rated, manufactured with no penetrations between the } inside of the recessed fixture and ceiling cavity and sealed or } gasketed to prevent air leakage into the unconditioned space. } 2. Type IC rated, in accordance with Standard ASTM E 283, with no ! pore than 2.0 cfn (0.944 I/s) air movement fron the the } conditioned space to the ceiling cavity. The lighting fixture } shall have been tested at 75 PA or 1.57 lbs/ft2 pressure ! difference and shall be labeled. } } VAPOR RETARDER: I I ! Required on the warn-in-winter side of all non-vented framed } ceilings, walls, and floors. { MATERIAIS IDENTIFICATION: I I ! Materials and equipment must be identified so that conpliance can } be determined. Manufactures manuals for all installed heating and cooling equipment and service water heating equipment oust be } _provided. Insulation R-values and glazing U-values nut be clearly } narked on the building plans or specifications. } } DU&INSULATION: I ] ( Ducts shall be insulated per Table 34.4.7.1. } DUCT CONSTRUCTION: I ! All accessible joints, leans, and connections of supply and return } ductwork located outside conditioned space, including stud bays or } joist cavities/spaces used to transport air, shall be sealed l ! using nastic and fibrous backing tape installed according to the } manufacturer's installation instructions. Mesh tape nay be ! onitted where gaps are less than 1/8 inch. Duct tape is not ! pernitted. The HYX system nest provide a means for balancing } air and water systems. � I f ! TEMPERATURE CONTROLS: � I I ! Thermostats are required for each separate A9AC systen. A nanual or autonatic means to partially restrict or shut off the heating ! and/or coaling input to each zone or floor shall be provided. { 1 } HVAC EQUIPMENT SIZING: I I ! Rated output capacity of the heating/cooling systen is "not greater than 125i of the design load as specified . } in Sections 780CHR 1310 and J4.4. ( installed in the building envelope, recessed lighting fixtures ( shall meet one of the following requirements: ( 1. Type IC rated, manufactured with no penetrations between the ( inside of the zl fixture and ceiling cavity and sealed or ( gasketed to prevent air leakage into the unconditioned space. ( 2. Type IC rated, in accordance with Standard AM E 283, with no ( nore than 2.0 cfm (0.944 I/s) air movement from the the ( conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure ( difference and shall be labeled. i ( VAPOR RETARDER: [ ] ( Required on the warm-in-winter side of all non-vented frames ( ceilings, palls, and floors. ( ( MATERIALS IDENTIFICATION: I l ( Materials and equipment must'be identified so that compliance can ( be determined. Manufacturer manuals for all installed heating ( and cooling equipment and service water heating equipment must be ( provided. Insulation R-values and glazing U-values must be clearly ( narked on the building plans or specifications. ( DUCT INSULATION: [ ] ( Ducts shall be insulated per Table J4.4.7.1. ( DUCT CONSTRUCTION: ( ] ( All accessible joints, seams, and connections of supply and return ( ductwork located outside conditioned space, including stud bays or ( joist cavities/spaces used to transport air, shall be sear using mastic and fibrous backing tape installed according to the ( manufacturer's installation instructions. Mesh tape nay be ( onitted where gaps are less than 1/8 inch. Duct tape is not ( pernitted. The RVAC system must provide a meads for balancing ( air and water systems. ( ( TEMPERATURE CONTROLS: I l ( Thermostats are required for each separate ROAC systen. A manual . ( or autocratic means to partially restrict or shut off the heating ( and/or cooling input to each zone or floor shall be provided. R6AC EQUIPMENT SIZING: j l ( Rated output capacity of the heating/cooling system is ( not greater than 125% of the design load as specified ( in Sections 700CMR 1310 and'J4.4. r in the Code. The BVAC equipment selected to heat or cal the building - shall be no greater than 125% of the design load as specified in Sections 780CNR 1310 and J4.4. Builder/Designer Date 1 NASchesk INSPECTION CHECKLIST Massachusetts Energy Code MDScheck Software Version 2.01 DATE: 11-21.-1999 , Bldg.} Dept.} use } } } CEILING: [ l 1. R-30 1} Conents/lmation 1 VA :'(T� i } [ ] 1. Vood Frame, 16' O.C., R-21 } Conents/locatlon [ ] } 2. Vood Frame: 16' O.C., R-13 J Conents/location 3. Vood Frame, 16' 0.C., R-19 } Comments/Location } VINDOVS AND GLASS DOORS: [ ] } I. U-value: 0.31 ( For windows without labeled B-values, describe features: } I Panes Frame Type Thermal Break? [ ] Yes [ ] No } Comments/Location f } SKYLIGHTS: [ ] } 1. U-value: 0.31 } For skylights without labeled U-values, describe features: } # Panes Frame Type Thermal Break? L ] Yes [ l No ! Comnents/Iocation } FLOORS: [ ] } 1. Over unconditioned Space, R-19 } Comments/1ocation } AIR LEAKAGE: [ ] } Joints, penetrations, and all other such openings in the building } emvelope that are a of air 1p=•age must be sealed. Vhen ` N MAScheck COMPLIANCE REPORT Massachusetts Energy Code ( Permit MAScheck Software Version 2.01. ( Checked by/Date CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 11-21-1999 DATE OF PLANS: 11/19/99 PROJECT INFORMATION: HATFIELD RESIDENCE 48 HITCHING POST IA. CENTERVILLE,MA COMPANY INFORMATION: INSULATION SPECIALISTS 675 OAK ST. U.BARNSTABLE, MA (508) 362-8807 COMPLIANCE: PASSES Required UA = 136 Your Hoge = 132 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value OA CEILINGS 520 30.0 0.0 18 VALIS: good Frame, 16' O.C. 480 21.0 0:0 28 VIES: Vood Frame, 16' O.C. 110 13.0 0.0 9 VALLS: Vood Frame, 16" O.C. .90 19.0 0.0 5 GLAZING: Vindows or Doors 123 0.310 38 GLAZING: Skylights 40 0.310 12 FLOORS: Over Unconditioned Space 440 19.0 0.0 21 COMPLIANCE SIATEMT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the pernit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The hihAing load for this building, and the ding load if appropriate, has been deterained using the applicable Standard Design Conditions found . j. I I MAacheck COMPLIANCE REPORT hassachusetts Energy* Code Pernit s MAScheck Software Version 2.01 Checked by/Date i CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Mon-Electric Resistance) DATE: 11-21-1999 DATE OF PLANS: 11/19/99 PROJECT INFORMATION: d HATFIELD RESIDENCE 48 HITCHING POST LA. CENTERVILLE.MA COMPANY INFORMATION:' INSULATION SPECIALIS 5 675 OAK S1. 4.BARNSTABLE, MA (500) 362-0807 COMPLIANCE: PASSES Required UA = 136 Your Hone = 132 Area or Cavity Cont. Glaxing/Door Perineter R-Value R-Value U-Value UA CEILINGS 520 30.0 0.0 18 i VALI.S: Vood Frame, 1f►' O.C. 480 21.0 0.0 28 VAILS: fbod Frame, 16' 0& 110 13.0 0.0 9 VALIS: Vood Frame, 16° O.C. 90 i9.0 0.0 5 GLAZING: Vindows or. Doors 123 0.310 38 4 GLAZING: Skylights 40 0.310 12 FLOORS: Over Unconditioned Space 440 19.0 0.0 21 COHPLIA.NCE 5TATEKENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to neat the requirenents of the Massachusetts Energy Code. 'The haling load for this building, and the coolingi f aB�,:oprWhe.;v w kip has been determined using the applicable Standard Des��en�ConditionsFfound 4+ f 1GJ in the Code. The HVIC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CHR 1310 and J4.4. Builder/Designer Date I MAScheck INSPECTION CHECKLIST Massachusetts Energy Code UScheck Sof tvare 'version 2.01 DATE. 11-21-1999 Bldg. 1 Dept.1 Use I I I CEILINGS: R.'-30 I C mnents/Ixation I I �ALLS:4 [ ) 1 1. Vood Frane, 16° 0,C., R-21 I CoBnents/Ixatim C ) I 2. Vood Frane, 16' O.C., R-13 I Connents/Locatlon C ) I 3. Vood Fraue, 16' O.C., R-19 I Connents/Locata.on I I VINDOVS MD GLASS DOORS: [ ) I 1. 0-value: 0.31 I For windows vithout labeled H-values, dewribe features: 1 I Panes Frane Type � Thermal Break? C ) Yes C ) No I Conents/Location 1 I SKYLIGHTS: [ ] I 1. U-value: 0.31 1 s 1 For skylights wl.hout labeled U-value, describe features: I # Panes Frane Type Thermal Break? C ] Yes [ ) No I Connents/Location _ [ ] 1 1. Over Unconditioned Spam, R-19 I Cmuents/In ation _ I AIR LEAKAGE: [ ] 1 Joints, penetrations, and all other such openings in the building j I envelope that are sm-ces of air leakage xust be sealed. When ) 1 a J Assessor's map°'and lot number .....1#73.~ ..........:............ KPTIC SYSTEM T" BE INSTALLED IN COMPLIANCE Sewage -Perin-it number � � 'LE Ib STATE ITH ART!" t SANITARY CODE AND TIM yoFTHEr TOWN OF BARN ;E�. . BUILDING INSPECTOR 0 M r ` . APPLICATION `FOR'PERMIT TO. A ...........!�.�.....�7 t.............................................................. .�QTYPE OF CONSTRUCTION .................. ..... . ................................. ..........:-�I-.yY.....,P.. . ....19...'& TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....4it; /-.......�..X .� ....A.(+ &......................................................................... ProposedUse s/�E/yC'E .................................................................................................. Zoning District .......��.� l�S7—Ek'-t/�l.�E Fire District /. ..Q ........................... .... 9// ^ Name of Owne�:��E1•-�:a.../�..��y�1�...�-.j.....•-�...7...Address��...H.�...U�..�...�.(1.�..+i�i.��..�..��...n�. �' ........... Nameof Builder .................................................Address .................................................................................... Name of Architect ��. ��/ -�' s�/........Address ... Number of Rooms........ ........................................................Foundations.�n�E�IJ... o��i�� .......................... Exterior ....�'.Y.�.�� e..c� t' Roofing Roofin ......................... Floors .............................Interior GL. Heating a..l..... . ..®.1Cr ..............................Plumbing .... arl.:.lEf l ................................ Fireplace .. if' :t .....................................................:.....Approximate Cost . �?� C� .............................................. Definitive Plan Approved by Planning Board —'-T'A-A/ _________19 Area Diagram of Lot and Buildin g Building.With Dimensions Fee .......... .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH cd (q 4c S 31 ;30, 11V N i e h IN G- `PEST I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. -�/'�': Name . .:.. . .. . .. .. .... ... . ................................ � e Daniel A. Brown Jr. , Inc. No 17198 Permit for .....one stor.y,................. ... ingle family dwelling Location itching Post Lane C L ' Centerville .•- ` •� " ' .............................................................................. ..- wi Owner Daniel A. Brown .......................................... �-- Type of Construction ..............frame................ •- r✓ • _ _._ �r-- -- ---� -- --•• r rPlot-''.-....................... .. Lot .....#15..................... •* ; �-� !� Al Permit Granted .......Ju1y..I.4.................19 74 ram, � ;h ,, � � - r-• Date of Inspection /� . ....717 Date Completed - PERMIT REFUSED ..................... ....................................... 19 t - -' •' *� ;f - + �. ✓ .*f r ` .......................................................................... !" 't t't 1 _ -- f •_- .-- ....................................................................... f i '' 'i✓ �.a Approved ................................................ 19 .......... ................................................................... Assessor's, map and lot r number ..... ..............:.............. Sewage Permit number ..... 7:.........:............................. 1 1 TOWN OF BARNSTABLE i i BAHB9T"LE, i Mb °° BUILDING INSPECTOR am a' . .+y i r Z APPLICATION FOR PERMIT TO 4 A �.....� V�.......S77-:``'�, .. .! vl ;�..... Lt! .................. s t TYPEOF CONSTRUCTION ....................................................................................................................................... -.re �� ......-.7......19.../1. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ^ Location ....e P.7...... ../,5 ... ..........................................:............................... Proposed Use ..` .{7E/YC Zoning District ....... .....................................................Fire District .(.::�. / , ........................... Name of Ownerf3/✓l�1. .:. �� JGt/y ,.: ��' ..Address � •• Cl✓. 1 .......... ................... .......................... Nameof Builder ..............................................................,.....Address .................................................................................... Name of Architect�FO.?V'V'�. � 1 ! ,........Address ..//R 0�'<....Inty .... .... ............................................... Number of Rooms ' Foundation Exierior , ...r1` l/1/ G�� .............Roofing ...i ,` f'17 !/Yt��C�...................:...... Floors ......n• �f�F � 6..'.............................................Interior ... ��.il'��L4...................................................�............... .......... Heating Jlp T g7G�R-e©,/C.........................:.......Plumbing ... C� l�>..... �� ....................:........... Fireplace ;7A!( .Approximate Cost ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Definitive Plan Approved by Planning Board--7-AI✓--_ �_ ----------19�o`Z . Area Diagram of Lot and Building with Dimensions Feed ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i �. O I # E � C I �2y IiouSc-- d� / P �A,R, 31 s 0' -P65T I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. A ---^^--- N� (, /(/r�/' ' Name,,,l '..i f�............................�...... f Daniel A. Brown Jr. , 17198 one story, } No ................. Permit for .................................... s.Agle family dwelling . . ............................................ Hitching Post Lane Location ................................................................ Centerville ............................................................................... Daniel A. Brown Jr. , Inc. Owner Type of Construction frame ................................................................................ Plot ......................... .. Lot .......�k15................. Permit Granted ..........July 10 19 74 i Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ................................................................................ ..............................................,.................................. ............................................................................... .............................................................................. Approved ................................................ 19 ............................................................................... ...............................................................................