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0191 JAMES OTIS ROAD
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In .1 "i �,.,..����i',,�.""",��',,'!,��','�".�,,��;", - I;:l � Whimmp, =,`,' � i, '�� 7 �` :-,!,:i,,,,li`�,��!�,�', ,;", ;, I'Ylk_ . ,�.........�, ,riI , , .____W o,r.�'����,,,���:�,�-�'.�t""�-,:�'�:�i�--�r,'�,;,i�'- 4i�t,,I!1 Iii -'li r- i - ; '�"') " - 11" IAI�l�;","f�ll"�l,'C�,,�,tLgik�j�%,e,l,,'�,'6'u,�flfk'�,"J,4�'i�'L,"Yti,iim,� ��14,' ,��, !"� -� .. 11 .- � ,�,j;�j,!,,� A'41', �,�� �"41;f�,,i��!�,�,-,,'�ti,�,,,,, ���( ,�i",!""i!",I,�,�--,,�,,,,,,i,""";""i�i�k",�,.z,4� �,�i���i,',��ll,�,�,,�"4,A*.A���-��I I'�."""��'k",.,,�l".""�',�5,11'�;,- k . ,f AENitlivTnve I'll i'll. , ,.'Fr-A.�1 0 7/1'7)1 rti Town of Barnstable YPermit#ZOO �'�(00� Regulatory Services Fee ira Gmondisfromissrredate 3 9BARNSMMg Yj i MASS,. Richard V.Scali,Interim Director, � V 1 '• Oq Building Division Tom Perry,CBO,Building Commis 200 Main Street,Hyann'''� ���0AA2�'60? 1 s 2015 www.town.batnstable���6L�V OF BA Office: 508-862-4038 RNSTABLEax: 508-790-6230 --= EXPRESS PERMIT APPLICATION - RESIDENTIAL NTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 170 1 Z 0 Property Address M e S O TC S &ttA Residential Value of Work.S „? Minimum fee of S35.00 for work under$6000.00 Owner's Name&Address_ L c/a S 1 q ( �✓h 2 S QT i� l�(��L f'/1T,e/•✓i•��/"IJ1 Qo�n��� Contractor's Name—lAUVA&II,e,Q,'r�� S / fir,,, `lorl,�i inn Telephone Number( 01)22 R_q zo Home Improvement Contractor License; (if applicable) /7 7 t S Email: Construction Supervisor's License-4,1(if applicable). 0 ci.S 7 p 7 2�Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name _ A elo n ia—ut 1.nsucg vice ruG n v v Workman's Comp.Policy Ir WC cl 7-80 5 S 3$2.3 c1 t-1 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ e-side [V Replacement Windows/doors/sliders.U-Value . W (maximum.35)7 of windows 9 of doors: -- ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. '`Note: PropertyLHome gn Property Owner Letter of Permission. A copy provement Contractors License&Construction Supervisors License is require a • SIGNATURE: Q:AWHILESWORAMbuilding permit formsT MRESS.doc Revised 0613 U 0813812015 12:33 17813453664 HENJNE'6SY f'E PAGE 06/06 Kart a � nit��n jLN M.rent eeoueRYur a.,l;�.�ara a��4rote�1}p41.+ Cirus�lx:47r�+.�,urmcnP,R RI C1TJIlx9 eadfv,nf?t23 khune`FI[f5 5ErY 22Y.5-k7sUt 4IFl.6.'$UO2' SofiaStn 11tw ' r&:,as.:,2emsG rw,1 tSeaa+ca-tJl�ly dadit e f S�'Y'pdow�y,Y$,d5 dFa�laNd Sbattrece US7Q�WIIIT.... AND DQaR1 E NP ti >, -: AOx. D �wild s�va. �b fib' r :ees !— f•.: JC�owl . �'alamTdt�Farchb.p�- F-'a auv,-f0henhYjwna�'as�{�c�llp�rccauy by Andfentivarsmd p !ase1PIe.g�r urtmS8lifdar� ,�r,f ,admrsa7 vE,igf�ndFJtaxluwa.&�CdIb/aR Baal t her a a�rw Sng6icrtD'� s� �rcY;ndrarice.ndem.�xl;��uiiadans"dc�;aiibcd an�l;a a�nrs#and ti_re;�„e4sC i ' ? ie�auanclrawl�a�ttisl�rdyxxifirnFhrirtSij(izilla� rEti, hia�lgrriut�ell - P-9 Y3fft0�C'.❑ catMp'❑a6f�llY'S Taae+Job RrAounG f S�1/u1 set S�aldirt Di oil of Pay le 5 4rl1Qt�♦fS aQQ. l Balance ax SiarCgf (339�1c ''"�rar d .rt anp��, m Pl3 ad cFse tae i .; Eearlem]tiroprblom CONLI�em>8y si n Bl" �dIP GdRhat dll�f eCaf & - .Ild riilliG Ilfld:bJt9t die®c bAflAt ekes#,w ndL"� tldy �lKt Q0 " +> a ab vevYlal ��t1te gxde •a fie¢e 'paderytesfi�llcc�ocea tLr it g'and tlyat r (1}�.s auad t�ja Ng.nem �'' �ed't1a'tri"m&of t6his+1c�a'astmt;B�jcri>c�acltno�v that H L O°PY Doty a d9 tSe tomes oB t and has d a ea u! ed -. Clal6ngHte $ifachbd Y45ce: o1PlCEe�v Wined;sad dyetrdl formedJf Hn >,r+g�i iu etuto, t8,s1>obom;oa ifi�t d feat srri pa above a,zd Gx oeal}g 3 d�eeIs"W l??50rS NtEn0*At'R crIF.'rAHkg:AR�+ GfYH �alsird dales Qr) de Q)I-)Zla not s ffiis 41 y is �9P+7d:BSi tn dse�eeto5el,eanc�,ldt.nEaayoanf, } oftlDeq #nerndedf�t8.* em6dticenty` mow!ffieN't flare�r ilia fntl 6 Sae der t&a s4 a t!! emsat ai tfe tfaie yPyo sign`• I?ar>b�l t elute:al"dws Hnn.iee,;nd rn¢e mt�`aetd m 44 IUto , ?>snnwatit Mat Ilt�asl,�flue oe ee l :'�7 teller 1�as'�y 6 eP Y P'eRosatroaa genderrr4�[esd�;ide thins&ven sign, 1. t maa pfSce or a,hrnae6 u> c a of t8r at3[elr f � � `emw6>� ante ar trr+ar�o$se�oasi�9q The tnnegt Pon»iy f s saber n bls ae her oP the thil" " aT'oerd6ed., catenAafrclayaflerti� ouw3.t t�bager�•' dke tea', .—I ch5ka11bcp #id:i6t acer *e to ma f dali #es a*s ii•at titnd:'See t Aeao 'f''"OeQI" a� _01 �vboc6' s :.•> ��n& �neellan� alr rxgLlaaatl�o 1lie mdc Y�lannd C imtracga� ' ` _ s t ti `EL41l i}_h6n R�etwalby. f .4pmd't5 - �,. Al A'Eutac d'�'IUdac 1�isr�aa s._ �: WA OM ER 0 N ASAY ��C�L Y•rvn Name Y47ru,lYsame ° 5 i `I'4918':'PH.'�P�iCTiIQ1V A'>G'�l�II17C;,'�tli�': g S I AYAFfEI V-"IIdIIE OF lg OR: ��dY[�H7 rUF Tf TBIRD ' API5ChCTEOA�9= fiffip OF.G'1rNCEF7gQ :F [S R, Q YA TQ O Tf 1�1tIGBT lake oFTransa M h "1 U •'ok- *?` ofTrarrsaeteoet r w+tl{o a►MY ��pr ob17�t�ony WGthln f t#h3 tr>Df�Aexln (R ar n@9 u `48ncd, 91nec bltsGbmim 'fibm ride agoye iti # 1 fl;:wlt#taut efl,wldljq. tr+Operlir t> �ed n4 airy,pftnetdz;made.by"U 4 ,I '^°bush ee iT+am.the atiuve ate "IP.ytru ranr.4 artla k �o++traet p 'g >�d 1 eeg#6>nble iwnent t+r a jttd 'f 9tRaet�• '4�Y.POY!1lentr hladp by'you.under tile, pall nri10 j rt{ jryKd vwf 'i►y °per t 4 " Sdj,'ad mlx jIavucblo lini6i atlene fvn business fodlarviflg , y pal,war ha.et7trftod vwthtn n hliu s d i;11WIkI ,Gn9 otaipk 6ir tthtller'afl"pa'asneallstcame nod and eggana► ,'.'rt9m�ps,b�j tlln Shcrr of _mar eloelFatraia t11 mrest tiavi� cut" flee tlraivaelari vr171 baee,un' n°r' %. � .arising:oot of':tYsa transat�ala,vslll.I�ek anteledlsEyoutfaty �ro ulnitl$o+�e.aystl�!atoehi*eRer • caflcal4a,lfprru�iical yourll.�gt wilk'wetr,thteSellet" s1' r t+ealdetroe;m,suhrtaFyyaiir e5ld cendiory lvhtal I at*Ow rmsidealce,in as -r a> �G4da:dell�rerctp.[feu lieu�tid tl4Tti:Cat raft ar I whim. Ifs!Qr luau_ ii .." hedyal*Scads��Mtafifld t.0 YOU[ lYtide Genti'act4�.'. ^* l w4S1h + It w tRe insa+rttiting o1 I Bah;or i nt�„if pau vrislt„®amplli.>ndl:theoritctions of wa 5tller regatvT L e r:tu►v�=enrof the g6pds st Rlw f , SQIII Fr$mwin ttee rtEurnu shlprnealk�f dhi$nods at t#e axpe a risk,H pall do rrlaidie the IaysfE�ie ° SORO ®lj��fi9p r r.If da+mire the en►aik1lyfc;' o tl,e Se1ler;and the'So1Cor dmei not,plek up arrf lwkll to Cite Wei and'filo Seer does»ot pieli'thtm"uP_.�tllln"vrengr of file dada of ca»raetlaloot4l�.tnw retain ar I twenLX tt d4 t .®R•cancelht6on,'7oQf' "reaqut or I !�a the gqo ter+ nu anF further o�tlegaoan Itrou I Vic' flra govilSF vdlitt an turtltpr id ttt ntal�fl.m :�r�ilabla to tl+e'.5eliet of dll a&T�1 1 'FatO ba mho goads taysifmhle In Etea S ller�a. ,5 ra®•f e -titr+s tlne' ?tl�to tlsi`Selkt:slid CaD tB dv t0.ehea tourvi tb: d 0tt18e%iiabio foP Yatt I" gnn,F.bo gft®Belles and W to d o lea thm tau i per[otl► nee bf all oblig feoris under-tlaB r41n n-'li®boe k' form'ants;oi.'all a9l nns` rtckr tfle;< .nrtEi f.T4'C�flt: ttli6 te�i elan,tmil d�d l°a`sFdr ed�I• Coats t�Te"cancel flt3s Miry rimil ar d+ltger B Alru~d;+ , rtd''dated`°cold oftf�lt< Iroa�;�stiar.'or aYtt: other ! aimd datai! copr:af his toeRci "+ ito ¢r` q:ot�rrar non riatie,eu send grmelegstel ReRee�u®I tr�;Anulersetl Of I vili�E1 nyce:or`setud a tole alri Eltne,.bf h7 e f naltl ri.l�6ar rag a ax TTb�a�w�ofl Ri: �� oaea s, , l*mN[cwAnfww at 2fibian #OPT I.A11ER'11# MiD#dlGt t1P r - 'I r IMOT LA�ERTFIljiN MIY>Y+IGHT OF H YCAf!tC .THISTLiANSRCTtON {lQ tNHREIfYCAMa', , ' s • .eat Rai 1�grne Bnyea Cap1P'Ys11aw -"l lWN Y 1pSr Fmk t Southern New England •windows d.b.a Renewal by Andersen of SNE Massachusetts-Departtl emit of Public Safety i Board of Building Regulations and Standards Conitt-ur,tion Supen-i-or ': N License:CS-095707 # BRIAN D DEMG N . .--- r , 7 LAMBS POND CIR.: Charlton MA 01507 ,1 1, Expiration Commissioner 09/08/2016 r _ Office of Consumer Affairs end Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration P Registration: 173245 , Type. Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration silsnolB DENNISON BRIAN - • - to 26 ALBION RD - - LINCOLN,RI 02865 Update Address and return card.Mark reason for change. SCA I G 20M.W1I - Address `Renewal rL-I Employment ❑Lost Card , �/.n'(iconm_a_H.c:�l!/rcf"S�%�?'a�rsc%urlts mce of Coum acr Affairs&Business Regulation License or registration valid for individul use only E IMPROVEMENT CONTRACTOR before the expiration date. If found return to: "�Registratlon• 1732g5 Type Office or Consumer Affairs and Business Regulation yp 10 Park Plaza-Suite 5170 Expiration: 9/192016 Supplement:,ard Boston,MA 02116 SOUTHERN NEW ENGLAND WINDOWS I.I.C. RENEWAL BY ANDERSON DENNISON BRIAN 26 ALBION RD �- — UNCOLN.RI 02865 Undersecretary v Not valid without signature The Commonwealth of Massachusetts Department of IndustrialAccidents 2!5 + Office of Investigations ' - I Congress Street, Suite 100 Boston,MA 02114 2017 www mass.gov/dia Workers'Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibiy Name (Business/OraganizationfIndividual): SOUTHERN NEW ENGLAND WINDOWS Address:26 Albion Rd City/State/Zip:Lincoln, RI 02865 Phone#:401-228-9800 Are you an employer? Check the appropriate box: Type of project(required): 1.❑0 I Mtn a employer with 20+ 4. ❑ I am a general contractor and I employees(full and/or part-time). have hired the sub-contractor 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 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 I I.❑ Plumbing repairs or additions myself.. [No workers' comp. right of exemption per MGL 12-R Roof repairs insurance required.] t c. 152, §1(4),and we have no q ] - 13.01 Other Window Replacement employees. [No workers' comp. insurance required.] *Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information. ' 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 xvorkers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is tl:e polies and job site information. Insurance Company Name:ARGONAUT INS. CO. Policy##or Self-ins. Lic.#:WC 928058352394 Expiration Date:8/21/2016 Job Site Address: / I 04-i S 20J City/State/Zip:re1i1e-V;11f MA 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=ofMGL 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\nsurance coverage verification. I do hereby certi under the ' s and penalties of perjury that the information provided above is true and correct. Signature: Date: qZZ620 / Phone#: 4012289800 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#: SOUTNEW-01 PARKERNATHCO CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS', CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES i 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 poiicy(ms)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). °DR ; cT Willis Certificate Center Willis of New Jersey.Inc. 'PHONE c16 26 Century Blvd i unit Na E,ar.(877)945-7378 Nor(M)467-2378 •, P.O.Box 306191 }_ADDRESSc Nashville,TN3723Q{t1a1 INSURER(S)AFFORDING COVERAGE I NAM# i tNsunix A:Setective Insurance Company of Southeast 139926 j INSURED INSURER ;One6eacan Insurance Company 21970 Southern New England Windows LLCI INSURER c:Argonaut Insurance Company 19801 MA Renewal by Andersen 26 Albion Road INSURER D: Lincoln,RI 02865 1 INSURER E: 1 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO'AHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES-LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY 17CP I I LTR TYPE OF INSURANCE { POLICY NUMBER MMJDD LIMITS A X COMMERCIAL GENERAL LtABILRY _ i EACH OCCURRENCE $ 'I,OOO,OOO: AI CLMS-MADE OCCUR x 12029459 08/10/2015 j 08/1012016 I pR T e $ 100,000i4 l ) MED EXP(Any or'A Ae m) is 10,00o PERSONALBADV Wf.JRY $ 1 : GEN'L AGGREGATE LWIT APPLIES PER: I j i I GENERAL AC REGATE t$ 3}OQQIQfW} i POi1CY®� E LOC i j PRODUM-S-COIAPJOPAGG i OTHER: f I s AUTOMOBILE LIABILITY 1 } COMBIN®SWGLE LIMIT S II t EaacciGent 1st X +ANYAuro j x S 2029458 O8110/2015`Oe/1o/201s 4 BODILY INJURY(Per Person) s t ALL 01SMVEO SCHEDULED ` i I i UOMLYINJURY(Per�tlent) S itx 1 PROPERTY DAMAGE s j X HIRED AUTOS x AUTOS � I i Perac'tdent) }� I I J 1 1 S 1 }UfVI$RELLAL4k8 OCCUR } EACf1OCCURRENCE S i EXCESSLlAB CLAIMS-MADEI f AGGREGATE 1 S I DED RETENTIONS B �WOR""COMPENSATION ER AND EMPLOYErts'UABILI TY Yin, } } i X STSTATUTE j ANYPROPRIETORIPARTMER/EXECUTTVE r----ii 1 801B 08a'112015j09121/2011i E.L.EACH ACCIDENT S 11=1100 T OFF In NE EXCLUDED? �W t N J A _ If yyeess descrbe under ! EL DISEASE-EA EMPLOYEES 1,000,00 i DESCRIPTION OF OPERATIONS belaw ? EL DISEASE-POLICY LIMIT $ 1 IYV V,ww C Workers Compensation ! C92RDSM523N 08121/2015108/2112016 See Attached DESCRIPTION OF OPERATIONS J LOCAT10NS I V94MUM(ACORD 1ai,Additional Reawks Schedule,may be attached U more space Is required) THIS CERTIFICATE VOIDS AND REPLACES THE PREVIOUSLY ISSUM CERTIFICATE DATED:0111/2015 Auto Policy includes additional insured when required by written contract/agreement as per policy form. KW Holding Corporation,Inc.and any subsidiaries are included as an Additional Insured as respects to General Liability when required by written contract/agreement as per policy form 1 •I CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i THE EXPIRATION DATE THEREOF, NOTICE MILL BE DEMEREO IN ACCORDANCE WITIi THE POLICY PROVISIONS. 1 } I AUTHORIZED REPRESENTATIVE - I t ©198&M4 ACORD CORPORATION. AR rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 'Town of Barnstable pf1HE t�� Regulatory-Services, , TVV`64���O li i S L Thomas F. Geiler,Director Building Division i� _ ,: pt My. 1-17 w BAMMBLE, • f y Mass• Tom Perry;Building Commissioner m �'Arfot�` 200 Main Street, Hyannis, MA02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Tee: rS — Permit#: ) 1 G I a� HOME OCCUPATION REGISTRATION Dale: Naule:. �D�z fit���y. Phone #:,5�� �� 03 (.9 Address: 'Ta Village: 6PnTeyVll.�� Name of Business:__S "' - � � �� - ----------- --=----- Type of Busiuess:fklo �211v� COhs�iry/f r�;� Map/Lot: 170 a O 6 INTENT: It is the intent of this,section to allow,[lie:residents of the"Poaa•n.of Barnstable to operate a home occupation caitlrira single family dwellings,subject to the provisions cif Section 4-1.4-of the Zoning ordinance, provided that the activity slaallnot be discernible froim outside the dwelling: there shall be no increase in•uciise or oclor;no visual si1tC1Rti0n to the premises avlaicla Would suggest aiaytlaiiag other tliaia a residential use;aio increase in lraflic above nornial,residential volumes; and no increase in air or grouiuhiaterpollutio r. y After registrration.nitla the Building Inspector;a customary laoime occupation shall be permitted as of right subject to the Following conditions: •_ `Pile activity is carried oil by the pernianenC resident of a single family residential.dwelling unit,located withiir - diat dwelling unit. • ,Sucli use occupies ao more than 400 square.feet of.space, - • There are no external alterations to the dwelling which are not customary in residential buil(ings, there is no outside evidence of such use. .. No traffic r+rilt be generated iii excess of normal residential voluimes. • '!'lie use sloes not.involve'the production of ofI•ensaa e noise, vibration,smoke, dust of ther lru•ticubW mat(er, Mors, elect iml.disturl)'ice;heat,ghue, humidity or other 01)ectiouable effects. There is uo stor if,*e or use of toxic or harlrclous materals,or flanualable or explosive materials, ii excess of nornaal laouselaold qu,uitities: • Any need For parking generated by sucll use shall be met on the sarme lo.t containing the Customary Home Occupation,wid not mitlaira the required front yard. There is no exterior tor;age oi•display of materials or equipment. • There.are no commercial vehicles related to [lie Customary Home Occupation,other than one wan or one, pica:-up tnack.not to exceed.one toll capacity,and one•traller not to exceed 20 feet in lerigtla and not to exceed 4 tires,p;u-ked on:the same lot containing the Customary Hotlae OCTLIp atioaa. • No sigai sliall be displa}edYintlicating.tlre Customary H(31lae Occupation. • If the. Custona;uy Hmaae Occupation is listed or adveriised as a business,•the street address shall not be ins hided. • No person sha11 be employed in the Custommuy Home Occupation who is'not a penraaaient resident of[lie dwelling unit. I, the undersigned, have read and agree milr the above restrictions for Illy home occupation I am regioering. Appliianli Date; �z2s- l i l Ay 4 1 YOU 1/VIS0-1 T0 OPEN A 8IJS((VESS. j r � r ' For Your Information: Business certificates (cost$40.00 for 4 years). A'business certificate.ONLY REGISTERS YOUR NAME m town which ria� .you must do by M.G.L.-it does not give you permission.to operate.) usiness Certificates are available:at the Town Clerk's;Offrce, 1°`AFL{ 367 kR' Main Street, Hyannis, MA 02601 (Town Hall) DATE: s / a . Fill in please. a, y �M� � � APPLICANT'S YOUR NAME/S: s . : `x "yF BUSINESS YOUR HOME ADDRESS: i s°� 367 !9Y/ Cp v / 6 u n'tJkPf4 `` TELEPHONE # Home Telephone Number i r ' NAME OF.CORPORATION: 7 NAME OF NEW BUSINESS SA ea Q TYPE OF'BUSINESS 'h41h��lrlL1� ' IS THIS A HOME OCCUPATION? ADDRESS OF BUSINESS_]? O�G. „r f jMAP/PARCEL NUMBER f �:� 2p6 �: _(Assessing)" - b When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the TbWh"D Barnstable. This form is intended to assist you in obtaining the information you may need. ,You MUST GO TO 200 MainSt [currier ofYa'rmouth r i Rd. & Main Street] to make sure.you have the appropriate per and licenses required to legally operate your usiness in thisYtowri 1. BUILDING COMMISSIONER'S OF E �. l r i k` This individual has bee d of any p it requirements that,pertain;to this type.of business i i M4ST COMPLY WITH NOME`OCCtJPATIUN Authorized Signature. * RULES AND REGULATIONS: FAILURE TO COMMENTS: © a , I, I 2. BOARD OF HEALTH , This individual has e i orme e mit r i rp m enLXtjaat pertain to this type of business Authorized Signat * COMPLYWIMUSCOMMENTS: TH ALL r - S* s 3. CONSUMER AFFAIRS (LICENSING_AUTHORITY] I i This individual has been,informed of the licensing requirements that pertain to, typ.e.of business: j ��tt �GnQ,OlJ1ak.� I Authorized Signature* COMMENTS: Y a. 4 aa �� J d Assessor's Office(1st floor) Map . / I/0 Lot e�errmit# f bd Conservation Office(4th floor) Date Issued 9 ao� Board of Health(3rd floor)(8:30.-9:30/1:00- 2:00) !Engineering Dept.,(3rd floor) Hous,e#1 �� CIE Planning Dept. (1st floor/School Admin. Bldg.) PTIC Definitiv Ian roved by Planning Board 19 WI � ENIVERO ENT Eu E AANO TOWN OF BARNSTABLE,,'� RSSULATIONS Building Permit Application Project Street Address 9� _zt4&eS ®T`/s Village Owner o Uc �'e /VAtic y y7' e q Address L` Telephone 7 C?, Permit Request z /to /,Ox `e. - Total 1 Story Area(include 1s19Z7gauges&decks) square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ � �Da a-a Zoning District Flood Plain Water Protection Lot Size /� �// Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use 0yy e I L/IZ16 Proposed Use Construction Type mil'!�SSU�-e �r -P#78D 61/00 0 Commercial A/® Residential Ye S Dwelling Type: Single Family y-es Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic Housed Unfinished Old King's Highway Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel '41 ,41p p 6 g&ntral Air A/0 Fireplaces Garage: Detached 4/0 Other Detached Structures: Pool 6 Attached Y PS Barn None -- Sheds Q Other Builder Information C� gy /, Name W� �J9�J�j �� .�(r` Telephone Number f b —/ ®�(� Address ZLD 4 j/f E 1 (&(-iu ' f/1;4e License# "d O XI-5 oV !, 1/�/ C /41 Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDIN MIT DI IED FOR THE FO OWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. 10460 PE 7DATEISSUED Sept 20, 1995 y w. r• MAP/PARCEL NO. 170.206 ADDRESS 19/ �AM ES OT15oR� VILLAGE Centerville, MA';02632 OWNER Douglas & Nancy Butler DATE OF INSPECTION: FOUNDATION �. , 1 FRAME > INSULATION FIREPLACE _ + ELECTRICAL: ROUGH:. .FINAL PLUMBING: R"(b H`~~ FINAL- GAS: ✓ ''ROi;7(�I� i ,FINAL FINAL BUILDING- DATE CLOSED Ot I ASSOCIATION P f CRC . The Tow n of Barnstable RAWWW" Department of Health Safety and Environmental Services P Building Division 367 Main Street,Hyannis MA 02601 Ralph C== Office: 508 790-6227 Building Commissioner Fax: 508 775-3344 For office use only 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,.nerrrrn'a1, demolition, or construction of an addition to airy pre-existing owner Occupied building containing at least one but not more than four dwelling units or to structureswhich am adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements- Type of Work: z Est.Coss�� d� v ress o � /Addf Work: J &s O r/S II ner.Name: �B U C 9r-' Ad�c Y 9 7L'� Date of Permit Application: -P J I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000 Building not owner-ooanpied Owner pulling own permit Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING WI'ITIt?NREGIST'ERED FOR APPLICABLE HOME IMPROVOMgT WORK DO NOT HAVE ACCESS TO 'III 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 0%%ner•. Registration No. Date "onctor name OR ' _nit-._ Owner's name The C(1/ttnl(1nN'ealth of Afassachusetts ' De'partlnent of Industrial Accidents Y } t olficeof/Mes#9211oas 600 ►l<'ashbigron Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit Please PRINT,e ,�Rphcant information• _ . - s Lb]Y-�a� j 177 I / ' AA I am a homeowner performing all work myself. I am a sole proprietor and have no one working manyapacity I am an employer providing workers' compensation for my employees working on this job. comply name!- address: cit).. nhonc#• insurance co Policy# Cj II am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name- address: city. phone#• insuMCC co policy# 4 �+: STY'r'S' e't'••y'Ft'. .,?. .TF'.'�atK�+�R:�i9gRa �'i•�77�W4 _ _-..'.g7` ..w�''�S' cdmpam•name- address: city: phone#• insurance co oR l!SY# 'Attach sdditiorial'shce[itaecessa Failure to secure coverage as required under Section 25A of I11GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification. �I do h } rtif}} rnder the p s and p Dies of perjure•11tat the information provided above is true and correct. pq Sienatur G ✓Date �� //� /// 14 tint ame /V �C Phone# �U I 0flici26use onh• do not write in this area to be completed by city or town official 4' city or town: permit/license# nBuilding Department Licensing Board O check if immediate response is required OSelectmen's Office s= (]liealth Department contact person: phone#• r•IOther 4 Imtsed 3l95 PJA) information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an entpinree is defined as every person in the service ofanother under any contract of hire, express or implied, oral or written. An cmrphger 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 representati�cs 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 dweiIing 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 cha.pter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or rene,wal of a license or permit to operate a business or to construct buildings in the common-vvealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. t .. A ,�^T.�^r'.'�.�e+-••�!�.,p ?"J .r, .a.:•,i::w..4.,u. S Yts `• ` Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do,not liesitate to save us a call. rrs�r.-a..�....+.•...��,.-,r-..,,,, _........ .le.,-.w.�-,..:-"vs;va.�•.-.+,...r+rPw_ _ 777 r.-ow+.�7►,n.f..•w...� The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents .mot Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 // x �x 1v1S7� /G C 3r T�/}lLS 0 H �19��1 E�1� i /l�� SSA OP Cam/, ov Vy AFC w A y Cx�sr;,�t �CliDfe pj fa i!r SING-LE. FAN11.1.� -3 f3Co�Z.c�o,(`� No �A�Z�AGE G-IZ(QDC- tZ. SZ L.T DAtL-Y FLov l I Io x 3 = 33o G.P. I . - t 1-7 SEP-n C. TA NJ IL. = 3 3 o x Solo S ( ' - 4� G-.p• p, � � USE 1 oc5o CAL. TAKt Yr 16 N OISPos�l_ P,.-T- vsE C�) (000 &Al-. w S,DEwA�I. Ar�A z . �So s. r=. Q 3 75" G-- P. o B oT'-oM AP-CA = So, s. tr. — _ o ry TOTAL OESI&Q = 4zs- G, P. D. To T iA Lr t C_y t L..c \/ = 3 3 o G-. P. D. / �� _ 3 Z'�-. :2 RA-ice, • I" JAJ Z a. . C SULLIVAN " r RICHARD No. 25133 � A i r. o BAXTER K - , is z4I S. F 37 ". v 9 , �O,r �o�sTsa�`� �`"Q 0 Na 240484 FSS�QN Et�G\`\ • tip Cif - AN T•E sT- H o U�: 'Q Z 779 tz-�Q-83 EL. SL,o FG• $! Z t �G SZ.o - 673 s�gSc /coo ��•� O/sr, O OO /iW. :i... , G.4 L� /HY aox 3 �4 q4.8 _ ,..• . CE,9 G N '' 49.0 49.6 SE.orrG P,T- A 7;:gA4 v M� o - ,•: W R s H c-D 44•Z 49.4 .b _ •�,� G,�f'� �Z.43,o' LoG,GT/ot/ C'E�J t�IZVi (�L� / G�',2r/,cY Tf•/.4T T•�,/E' fu.v ogTo�stiow,v Cenci vi cE iiG�Lvv S .yE�Eo.v ,a.vo .eEQIJ/,eEH1�iVrS off' Th'� ,C�.EGisr�.ec=�LQrJo.SU,e vEy�,�S Tox%v oFg,�.evSTAt�LL ,Q.va /S ,vaT- G�S�,2Y/,GL.c' �. �4 ,G/ce,tcf— A C-4A/ Si`1A Dic. T.S'lt�t ,ti /.s �YoT a.4sEo oN - ' S'i�GS�if/,�j/E,e�4�✓.S��UG IJ�S/p7--•Q� U��p • n C V1 n(l � (11.\t ���- ' TOWN OF BARNSTABLE permit No. __--- ` Building Inspector � n■sx,m, Cash --------------------------- OCCUPANCY PERMIT Bond _-_-__-_n------ /°b____ Issued to Alan Small Address Lot; #16. 191 James oyi s Road, Cen renri i ;_N Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 1 .................. ... .. ......... ....... Building Inspector _ s� TOWN OF BARNSTABLE BUILDING DEPARTMENT 3 EST TOWN OFFICeBUILDING 1639' HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department��/fir DATE: An Occupancy Permit has been issuedjor the building authorized by BuildingPermit #.... ?�.5� ... . ....._......................................................................................_... ...................._ issued to , lG ,rJ / ''' ...........L�.'l�........... 9✓;/f3 icS ll��.r'„J _r��<J Please release the performance bond. BUILDING TOWN OF BARNSTABLE, MASSACHUSETTS PERMIT a JOB WEATHER CARD DATE 29058 ,PERMIT NO. "< l:a%_tr ..�..._�.::: Div:, APPLICANT ADDRESS '4N0.) (STREET) (CONTR'S LICENSE) u1 ild Dwe'Ll1Av I i.,u:rlr. Yrma'il-, Inc ellir1?, NUMBER OF PERMIT TO ( ) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) :.OZ srLU, si jLUm;:c: (-)L'1:.: 17.177, l.f9iilf_'rVZi/r: ZONING v AT (LOCATION) DISTRICT (N0.) (STREET) BETWEEN AND (CROSS STREET) - (CROSS STREET) LOT SUBDIVISION LOT "BLOCK SIZE 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) REMARKS: AREA OR ? PERMIT VOLUME ESTIMATED COST $ FEE + ` ((CUBIC/SQUARE FEET) OWNER BUILDING DEPT. ADDRESS BY , THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. - - MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH).3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. , OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 g LIEAT:NG INSPECTING APP{�j.V A L 5 REF. IGERATION INSP CTION APPROVALS tWF B`4RNSTABLE u' "'" """�'4 INE G DIVISION lit. �-y � At wCnK 3MAL'_ NCT DPOCEE_ UNTIL THE PERMIT 'N!LL BECOME NULL AND VOID IF CONSTRUCTION iNSFECTiONS INDICATED ON TH!S CARD NS?Ei.T�DF -+AS AP?ROVE:. Ttil �? WORK IS_NOT STARTED wI.THIN,SIJ(,.MOI:Uli.�.pl_.DATE_.Tk1E. I AN 3: '=°ANC, era gY TELEPHONE _'AGES JF CONS'' #JLS).hi�_....-,�+.$-. TPERMIT 15ISSUED AScNOtED ABpvf '" ' - R paJrrN ' '�� � ��"' SINGLE FAMIU? 3 P�Co12.ant`� No FsA�Z�A G--E Gt2�N D EIS.. SZ L.T- DA►L.Y FLovJ = 1 to x 3 = 33o G.P. 1�. 1-7 SEPTIC TANK. = 3 3 o 7,, 1 So7a z 49 S C-.h• D• 1 .i' ,, A. USE 1000 GAL. TANSY-. � bg4 N CASPOSAL- Per vse W t000 GAL.. IrP: �.' . : -.9 1 s'o e- F. 2 .s - 3 75' G.P. O. y S o-TroM A 2.EA So 5.q. Tfz-r 'T'o T l.K I�ESIG�1 ` J 42S G. P. D. . t>A t Y FLoW - 33o G-. P.. D. �� 8� Nlr ���. •E. .: /. 3Z_ ? . __oN R.ATt : r-moo � ��q iN Z 1y,n.1 .o2'L£SS r Of PETER SUILfUAN RICHARD ��' Ib ' A. .� .o ' �No. 29133 BAXTER6Pj/ lS/241 s.F o , �0,e• FC/ST�Af� ���.. N0.2404$® �. �^ 'qM s n , 'SLR a•� s f� T'E sT" H o LE -179 t:L..SL.o Fr• s 6I'2 p so�sc, /coo /rvK G.4L, 11A1 :• So.0 _ "• /.t�Y Box • . _ 3 �t..4 l.�AaN '• 49•0' �' /it/Y. / M .. �¢�s 1" ,' •• . 41.7- 49.4 G'.E.2T/F/.E.O PGor G;q . ,47,E J'L8-8t; F t 1.E 1Jo SCALE TH.4T`Ty.E' f ONb,4rvA1SheoWA1 .yE.�Eav coi�lfPLY.s Wir�/7 �•Sio�•,r�,�� .e�'Qu/,eEkl�3vrS ZM4 ,2,E6isrB.eEY>.�r�vo.S�,e �S ToW.v oF/3."�.2,v5TAl�G(� Avv /.S vor- 4s .2Y/,ct c' FG�pPG•4lit/. A .4/ca ter- 4 1,4N � Sr�J,g�(,�:L.AIG 1-Z S•86 74W" t A'e /s iYoT-a��O 4.-A,,V/iY.Sl.?Z-- - —d�f.EiYT.sv,21/EyA�S/O Trs/E aGF.S.oj; S'�7dGY�fj�E,eE4N�,ypvG�it/�T-Q,EI�S�p i yE,s j Assessor's map and lot number ....1...... ....r. o ..® SEPTIC SYSTEM MUS'T��� INSTALLED IN COMPLIANCE .,o`THE C1 Sewage Permit number - WITH TITLE 5 S ENVIRONMENTAL CODE AN[ Z BASHSTAnLE, House number .....? /.. x......................... ! rna ........................ Tn%VN REGU AT10�1r) s6}q. 0� C.-. 'F0 M TOWN ' OF . BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..:.:.... .... ..............................................................................:.......... TYPE OF CONSTRUCTION ........ .................................................... .............................. ...7 ...........19.. : TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies f - permit actor i g to the follow' in mation: , Location ..� Y./.......... �P..... .. . .... ... .... ........................................................... ProposedUse ..i!4/. .. . .. '.. ............................. ........ .. ...... ... Zoning District :. .r.. .Fire District ) ........... Nameof Owner . ...................................................................Address .................. ..... Nameof Builder .....................b t ....Address........................................... .................................................................................... Nameof Architect .........`........................................................Address .................................................................................... (D Numberof Rooms ..................................................................Foundation ........... ......................,. ........................................ Exterior .. Roofing .:........ ,.... :... ....................................... Floors ........... ..:: . ...... ........................................................Interior ............. ................. ......i............................. r— Heating - �`T'•........................................................Plumbing ........., Fireplace ....... ... ....... ... ....:...... .....Approximate. Cost ...... .. .. -/...tl'WV........................... Definitive Plan Approved Board oo// . pP b Y PI nin 9. - � - - -�-�-----19 4__�. Area .................... Diagram of Lot and Building with Dimensions Fee a........,....... .......... SUBJECT TO APPROVAL OF BOARD OF HEALTH �. • . e OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardin a above construction. Name ... ....................... • Construction Supervisor's License 0.1677 '0 . SMAL,"ALAN iTJ029058.... Permit for One Story .................................... . Single Family Dwelling ............................................................................... Location ...Lot...#.1.6 1.9.1...James. ..Otis- - ...Road . .. . ........ . .... . . ...... "Centerville ..................................................................:............ Owner Alan Small ............................................................. Type of Construction ...Frame........ ....................... ...... ................................................................................ Plot ............................ Lot-...,:............ Permit Granted .......Yjargji..20......... ......19 86 J Date ofInspection .....................................19 D rnpleted 011-,. ........19 ate Co Gil) k Ij fi • r n >23 /�/ c^ } `^`- Assessor's map and k» number .. -.-- / / / f.1 HE | Sewage Punni/ number ---, --.�����.--.���'-/'\�... House number ......... ---_----.-------`^` \J 1 ^ ' 039. Po LY TOWN � � N�� �� ]�}�2r0� /� ��^ �` �� � �� �� l� ��J� BARN STABLE � ���� ���� / INSPECTOR �� �� / ' BUILDING ' N �����N� 0 0N�� � �� ~r� ���~ � �~ == � APPLICATION FOR PERMIT TO --- ........................................ / �'TYPE OF -----.._---..�—L.:--------.----.----'_---.------- . � � | ............................r~..r^."....lA....�, � | TO THE-|NSPE[TOO OF BUILDINGS: The undersigned hereby applies for a permit according the following i ' . y � ' ,/y�\ Location ---r- - �=��-----���-�..`--'�-"=—.=..=r�c--.'''.—....�,---.�r:.-.'�, ........._,. _-----.:�y . / Proposed Use -/--'./i�/���/ /....+`.. .;-----.,..-.-..------.--..-..-.........--..--.--.----.-- / / ~ Zoning District --_--..--------.--------.Rve District --.-----_-._-.--.-~_.._._--.-- � . � . | Nomeof Owner ------.-_---------------A66reo ................................................. .................................. � ' Nomeof Builder ---------------.-------A66,es ----------...-.-.....--.------- Nome of Architect ------------------.---.Ad6res ------------.--_-.----.._---- Nonn6er of Rooms ----------------------Foundoticm ---_--..--.--.....^--------.--._- ' ' . Ex|ehor ----..^----------------------'RooGng ...............................................-----�..--_-_.' ' 1 �� Floors ---'�'��-.�----'------_--------..|n�hor __----_----�'-_---_............................. - Heating --.--...---.'------------------.Plumbing ...............................,......-----._----.. � Fireplace ----'-^.....-'....!......._---.---------.Approximate Cost -----.----_-...~-.,,....r..._.._ � Definitive Plan Approved 6v Planning Bop lV1l�i, A,eo /.'__'.��'------- � . Diagram of Lot and Building with Dimensions ' ' _________________ � ' SUBJECT TO APPROVAL OF BOARD OF HEALTH � ' � ' � � � | �| /^ ~r ^ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ^ | henebv:ognee to conform to all the Rules and Regulations of the Town ofBarnstable regarding the above construction, /^ Name ,,.... ../..r..�.-...----.r---.--'-----` ' Construction Supervisor's License .............. ' / SMALL, ALAN A=170-206 No ... 9058... Permit for .,One Storx.............. ........... Family Dwelling ................. Location 191 James Otis Road ........................................ .....................Centerville.................................. Owner A.lan. . ...Small .. . . .. ............................................ Type of Construction ....Fume........................... Plot ............................ Lot................................. Permit Granted March. 20,. 19 86 t .... ...... .. Date of Inspection.....................................19 Date Completed .