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1012 OLD STAGE ROAD
1al.� Dl � � `ice _ �. � r .: � . .. �� „ . _, u . _ � o, .. a z ,. .. �. ,. � �. � a ry TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application J Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ HyannisIlt Project Street Address AO/Z Village Owner W Z%E/ /SS q !Jh u 9 Address �� r Telephone ;Z Z Permit Request ZCT9�/j �' ��/� .�i' B� ,�1 f3�i2 s9/ Z9s'' Square feet: 1 st floo • existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Id®, 6 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family A Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes 4No 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 Firs Floor Robnpiiieount �1qy� � Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Others , 3 ,, Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing?wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: LJ`dxisting ❑ new size_ 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) --- - -�. -,�.. Name Telephone Number Address�fl �C� � �i12 License# 0 f' �Wo/ g Home Improvement Contractor# 43 S22 Email✓�/C�,��/� %�����,/ ,�,�/�� � Worker's Compensation # f�/L'�G ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �y�.3�/ 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 DATE CLOSED OUT ASSOCIATION PLAN NO. r The Commonwealth of Massachusetts Department oflndustrialAccidents Office of Investigations 6 I Congress Street, Sulte 100 Boston, AM 02114-2017 www.mass.gov/dla Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant Information Please Print Legibly Name(Buslness/Organization/Individual): Cape Cod Insulation Address: 18 Reardon Circle City/State/Zip:South Yarmouth, MA 02664 Phone#; 508-775.1214 Are you an employer? Check the appropriate box: Type of protect(required); 1,X I am a employer with 48 4, ❑ I am a general contractor and I employees (full and/or part-time),* have hired the sub-contractors 6, [] New construction 2,0 1 am a sole proprietor or partner- listed on the attached sheet, 7, ❑ Remodeling ship and have no employees These sub-contractors have 8, ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp, insurance comp, Insurance,= 9. ❑ Building addition' required,] 5, ❑ We are a corporation and its 10,❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11,❑ Plumbing repairs or additions myself, [No workers' comp, right of exemption per MGL 12 Roof re airs Insurance required,J t Q. 152, §1(4),and we have no p employees, [No workers' 13ME Other Weatherization ' comp, Insurance required,] •Any applicant that checks box#I 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, tConuactors that check this box must attached an additional sheet showing ft'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 fire policy and Job site Informatio,�,,• Insurance Company Name:Atlantic Charter Policy#or Self-ins, Lie, #:WCE00431902 Expiration Date: 6/30/2017 Job Site Address: 42 le& 9� ,o��o e� ih,/State/Zip: Z Z 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;�00.,00,and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORT{ ORDER and a fine of up to$250,Q0-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, 1 do hereby cerllj, under the pains and penalties of perjury that the Information provided above is true and correct, Signature- Henry Cassidy �� .r...-..,.-V.-.�,.�,r,. .y 508.775-1214 Officlal use only, Do not write In this area,to be completed by city or town offlctal, City or Town: Permit/Ucense 4 Issuing Authority(circle one): 1, Board of Health 2, Building Department 3, City/Town Clerk 4, Electrical Inspector S, P19(abing Inspector 6.Other Contact Person: Phone#; CAPEC06.27 KDOYLE ACORV" CERTIFICATE OF LIABILITY INSURANCE D 03/30//2017Y) 03017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED,the polloy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policieo may require an endorsement, A statement on this certlfloate dose not confer rights to the certificate holder In Ileu of such endorsement(s), PRODUCER 2AJACT ,r Rogers&Gray Insurance Agency,Inc, ore x 134 �r Rte 134 c o q ExI I _ �A/c,N0077)816-2156 South Dennis,MA 02880 .ma IC41ro ers ,a ,com NSURER(S)AFFORDING COVERAGE NAIC a INSURER A;Peerless Insurance Company 24198 INSURED INSURER B 188f0ty Insurance Company 39454 Cape Cod Insulation,Inc, INSURER c,Endurance American Specialty Insurance Company 41718. 18 Reardon Circle INSURER D,Atlantic Charger Insurance Company. 44326 South Yarmouth,MA 028e4 INSURER 9 INSURER p t 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 WHICH TH)S 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, 8R TYPE OF INSURANCE ADDL BURR POLIO :EFP POLICY EXP LIfl POLICY NUMBER A X COMMERCIAL OENERAL LIABILITY LIMITS 1,000,000 CLAIMS-MADE �X OCCUR EACH OCCURRENCE R/O CBP8263083 04/01/2017 04/01/,1018 DAMAGE TO RENTED 100,000 MED EXP(Anyone ereon 5,000 PERSONAL&ADV INJURY 1,000,000 GEN'LAOOR OATELIMITAP IE9PER: GENERAL AGGREGATE S 2,000,000 X POLICY L_jjfT LOe PRODUCTS•COMPIOPAGO 2,000,000 OTHER: 8 AUTOMOBILE LIABILITY ^n COMBINEDd. j SINOLE LIMIT ANY AUTO 6232707 COM 01 04/01/2017 04/O1/f?018 BODILY INJURY Par ereon AIU708DONLY X X8YoN83UyLNEEDp X AV B ONLY X N8V6%ONLY BODILY INJURY Per accldenl 11000,000 Pe�acEcI n1 AMAGE C x UMBRELLA L'IAO X OccUR EACH OCCURRENCE 2,000,000 EXCESS LIAR CLAIMS-MADE R/O EX1I10008838001 04/01/2017 04/01/2018 AGGREGATE $ DED RETENTIONS Aggregate 2,000,000 D gglggpg CAMP NNEATp N < .. X PER OTH• AND EMPLOYERS IIABI1IIY WCE00431g02 ANY CCPRRRO11PReeIETggOEERRp/PgqRTNERIlXECUTIVE 08/30/2018 06/30/2017 E.L.EACHA ACCIDENT ,000,000 WentlelorylnNH)EXCLUDED? N/A 1 Ilyyesdeicribevnder E.L.CISEASE•E EMPLOYEE 1,000,000 DEBG�RIP,TION OF pERATIDNB below I E.L.OISEASE•POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES- (ACORD 101,Additional Remarks schedule,may be attached If more space is required) Yorkers Corripensatlon Includes Officers or Proprietors, lddltlonal Insured status Is provided under the General Liabllity and Auto Liability when required by written contract or agreement with the Certificate Holder, CERTIFICATE HOLDER N L I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Informational Purposes THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE I ACORD 28(2018/03) 01988.2015 ACORD CORPORATION, All rights reserved, The ACORD name and logo are registered marks of AC019D r� Massachusetts Department of Public Safety Board of Building Regulations and Standards License; 08-100968 Construction Supervisor ��511� HENRY E CASSIDY, 8 SHED ROW ol f WEST YARMOU H "1 '2'^+ 1 , l Expiration; Commissioner 1111112017 6 r` Office of Consumer Affairs and Business Regulation 10 Park Plaza • Suite 5170 Boston, Ma ; `ate�i usetts 02116 Home improveme_: :�:C.© tractor Registration Type: Corporation a., ;���;:�� :;:�•:;;' ") Cape Cod Insulation Inc Registration; 153567 ,,� ,.. `` w Expiration, 12/14/2018 18 ReardA Circle ; So, Yarmouth MA 02664 SC�h-1 20M•O6/U Update Address and return card, Mark reason for change. /y _.• __..,. .._____...: ..�...__...._. _ ___..,......_.._.._........._............ C.!!Lz;pioyrnort o%t.Ca.r-d.... �e�a�„mcaiacvo«�C/c v��l�c�odr�c%iwe�i5 • Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only T s., Corporation before the expiration date, If foun urn to; ti.alatretlon Expiration Office of Consumer Affairs and al as Regulation `'� 12/14/2018 10 Park. Plaza. e f3170 ;•,,,1;1.Ags7 ;,, t• `J, {.•sy;,In{I Boston,MA 11 Cape Cod Inswl;ta , 1 ot'r:.. ':' Henry Cassidy 18,Reardon So.Yarmouth, "' "" Undersecretary t al hc�ut sl atu k u , t ' c y bY� a `�;'t�1WI?f�'�":��C31I6y:�II�'C10t • rirO Df'". 104;1vfa St ee y=&i,MA:0260i �,�t� aCas�blama�vs.�` Q$T$624039- Faxf ;QS:790=623.0 x _ z ro e e � . de �s .,...�,� ;.a . •Chun, . �. �1�Jj�I�i'v�ertyrt' ]2 ,. a � peapl;t t wph'all o for, 4 Da CA St a• i. az "`' Qnccs.an€ alms air rsgar�sa� o Szep}zct P` oLs as r t a T : alb c ;t�rur ec : c se c cc: s gn- aaas rb—it and a a_ Seatvre ax: z Pat> cccYYYdddcwu 41VaY i. 1 �JINW, F • 4 pF, Town of Barnstable *Permit# 799A/® �°'�►. p� Erptres 6 months from issue date WIDOW : Regulatory Services Fee l ' 5 MAS , v 63 0�' Thomas F.Geller,Director Building Division ®PRESS E Tom Perry, Building Commissioner RMI 200 Main street, Hyannis,MA 02601 0 C T 5 - 2004 Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Yalid without Red X-Press Imprint 9/parcel Number )perty Address 1 Residential Value of Work Minimum fee of•$25.00 for work under$6000.00 vner's Name&Address �C. n n1ractor's Name Telephone Number ►me Improvement Contractor License#(if applicable) . mstruction Supervisor's License#(if applicable) (Workman's Compensation Insurance Check one: la m a sole proprietor (� am the Homeowner I have Worker's Compensation Insurance .urance Company Name Drkmaes Comp.Policy# ►py of Insurance Compliance Certificate must be on file. rmit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to . -r3rJ ❑Re-roof(not stripping. Going over existing layers of roof) XRe-side '�Replacement Windows. U-Value b� (maximum.44) �—u:4A4_o, / C 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvem Contractors License is required. guature ?orms:expmtrg viseMOM � t i oFtHe, Town of Barnstable *Permit# U Expires 6 months from issue date �.. i Fee--- ��� �D _ -- 9� MAM $ = Thomas F.Geiler,Director .. '�en.r� ---• ... . . . ....._.�.. ...._....Building'Division' - YRRESS PE. �:.�,�� ---• _. '--Tom Perry, Building Commissioner .200 Main Street,- Hyannis,MA 02601..... .. J AN • 2�05 Office: 508-862-4038 WN ®N TA pp Fax:•508-790-6236 :...:....... ... -. -EXP S :PERNII'T�A PLICATION = RESIDENTIAL ONLY. Not Yalid without Red X-Press Imprint Map/parcel Number T 2— Property Address O residential Value of Work Minimum fee of$25.00 for work under$60010.00 Owner's Name&Address Contractor's Name l c.J Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance 1 ' Check one: ❑ I am a sole proprietor �I amthe Homeowner I have Worker's Compensationl surance ' e Insurance Company Name K!16 41 12 fa:6Z— (A Worl=an's Comp.Policy# L) Pyb^ q Copy of insurance Compliance Certificate'mu t be on file. Permit Request(check box) KRe-roof(stripping old shingles) All construction debris will be taken tom, ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (ma)imum.44) *where required: bsuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: perry r must sign Property Owner Letter of Permission. ome ro ement Contractors License is required. Signature Q:Foaas:expmtrg Revise063004 _ The Commonwealth of Massachusetts _ -_- _ �' Department of Industrial Accidents Office oflnvestlgadons _-T 600 Washington Street, 7`h Floor Boston''Mass. 02111 Workers' Co m ensation Insurance Affidavit: Building/Plumbin /Electrical Contractors ica nfor' atifl . sleas g ,• ,le .ib name: address: 7 9&A cQ city i✓D� c -4 lam, u � state: N"l zip: ITt4phone# 7 LLo 4- -,-work site location full address): ❑ I am a homeowner performing all work myself. J Project Type: ❑ ew Construction LJRemodel ❑ I am a sole proprietor and have no.one working in anv ca aci P"Building Addition ❑ I am an employer providing workers' compensation for my employees working on this job f Y _ t � t � '_ x t a'�� ".F''�,,' f.-•� � � 5 ek� rat"� t ,;t �� ' l . � `` pk rt�x'� X N 3 f t z e f � ➢ � � � n.: ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices com--aany nam777 e. address. , diva ulY: one# r uisuranee.co: _. .. _ .,. , oLc #... ,. c inpanNname.,. a'ddress.. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil p alties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement m o a t he Office of Investigations of the DIA for coverage verification. I do hereby cer' and r t pa and a aloes of perjury that the information provided above is true and correct Signat . Date Print name o Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license#'` []Building Department FILicensing oard ❑check if immediate response is required ❑Selector n'Bs Office ❑Health Department contact person: phone#; ❑Other (revised Sept.2003) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' co pensation for their employees. As quoted from the"law",an employee is defined as every person in the service of other under any cz)ntrac 'of hire,express or implied, oral or written. An employ r is defined as an individual,partnership,association,corporation or other leg entity,or any two or more of tree foregoin engaged in a joint enterprise,and including the legal representatives of ad eased employer, or the receiver or trustee of ail individual,partnership,association or other legal entity, employing emp oyees. However the owner of a dwelling house aving nbt more than three apartments and who resides therein,or the ccupant of the dwelling house of another who empl s persons to do maintenance,construction or repair work on suc dwelling house or on the grounds or building appurten t therelo shall not because of such employment be deemed to e an employer. e MGL chapter 152 secti 25 alsb'states that every state or local licensing agen shall withhold the issuance or renewal of a license or p rmit to\operate a business or to construct buildin in the commonwealth for any applicant who has not pro uced acceptable evidence of compliance with t e insurance coverage required. Additionally,neither the com onweaalth nor any of its political subdivisions all enter into any contract for the performance of public work unti ccep ble evidence of compliance with t e insurance requirements of this chapter have been presented to the contracting a only. Applicants Please fill in the workers' compensation affida it c I mpletely,by c ecking the box that applies to your situation. Please supply company name,address and phone numb s along with a c rtificate of insurance as all affidavits may be submitted to the Department of Industrial Acciden for onfirm ion of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returne to th city r town that the application for the permit or license is being requested, not the Department of Industrial Acc ents. S ould you have any questions regarding the"law"or if you are required to obtain a workers' compensation poli ,pl a call the Department at the number listed below. R li men"MEN �rUlm K City or Towns Please be sure that the affidavit is complete and printed legibly. The D. artment�has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations h to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a referenc umber. 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 hesitate to give us a call. The Department's address,telephone and fax number"' `• The Commonwealth Of Massachusetts r Department of Industrial Accidents Office of Investigations 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406 MIKE MONGEAU (508) 778-9797 PROPOSAL 77 Traders Lane Cell (508) 367-2646 W, Yarmouth, MA 02673 Lic, No. 006670 Date: /0 Proposal Submitted To: Mailing Address Work to be performed at: Name: 6 e. Street: Street; City: City, State: Zip Code: State: Zip Code: Home Phone: Work: NOTES/Suggestions: We Hereby propose to furnish the materials and perform the labor necessary for the completion of: ® . er Removing old roof, install new roof with a ® Ica- shingle estimate ( ) sq, This price will include a 5/year warranty on workmanship, new alumi- num drip edge, 15# felt underlayment, roof vent collars, install ice and water barrier around chimney, valleys, nail loose boards, cl an gutters, anp4otal clean up and removal of all debris, Color of roof is to be t 2, Venting - can be critical on certain homes (a) Install ft. of Cobra continuous ridge vent $ (b) Install ft. of Hicks vented drip edge on soffit. $ (c) Do not want to upgrade venting. (d) Other All material in guaranteed to be as specified, and the above work to be performed in accordance with.the specifications submitted for above work and completed in a professional workmanlike manner for the sum of $ with payments to be ma slows: Deposit of $ / ..Raldnce due upon com to . Respectfully submitte ACCEPTANCE OF PROPOSAL we eserve the right to rep cj any rotted or broken roof or trim The above prices, specifications and conditions are boards, This will be an extrcWost above the quote roof price. The satisfactory and are hereby accepted. You are charge for this will be, if needed, $50/hr, plus materials,All agreements authorized to do the work as specified. Payment will contingent upon accidents or delays beyond our control, Outstand- be made as outlined Y e ing balance over 30 days will incur 1.5%finance charge per month. Owner to remove all valuables from walls, Liability Insurance on all Date: above to be taken out by, Signature: Mike Mongeau ' / '7. Assessor's map and- lot number .. .... ......� .... ......... ' - SEPTIC SYSTEM MUST BE,� 'r . ..INSTALLED 'IV 'COMPLIANCE t Sewage Permit number ...........::.. 0'......:. :... WITH A;7;T1CI;E II SANITARY CODE STATE �Q �o TOWN - OF, ..'BA.R A., 0,___TOWIV 1 i BJSHSTODLE, i 'O M639 ,e0� BUILDING" a INSPECTOR G �0 YPY a' APPLICATION FOR PERMIT TO ..�. ✓'/..SIE ..l �' .. .. ...�� ' /....s�! �� ...........:........ TYPE OF CONSTRUCTION .......:... �!' !.Q. .r .:` .... . J./.. .. ! ............................... ,. .........:.... ........... .19 2...: f0 THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: fQ� Location .............................. ......... 2 .....'���",1`�4�. .... ..... .1✓.,lv%��G��.. ................................... ProposedUse ...... ,,5..... ^..1........0:...................................... ..................................................................................... Zoning District / C��!...... �/i���. ....................J................................................Fire District ........ ..... ......................�...... .. ........ Name of Owner u✓ G Address .1�. .: .. .-� J.. � .:... �...... Name of Builder ! f..`?!.'....44�e 4..................Address ..... / ..C'e.&�eev✓</L� Nameof Architect ........... .-:...............................Address —`'.................................................................................... Number of Rooms ................<,,,,...........................................Foundation s/... J Exterior ��'� �f� Roofing .../..I�`',/�/..... ...... _ .. '' ................................ !"J ..................................................... ..... ,�e�/ .Interior >� l/�.�li/r Floors .....: ............................ .... .... ...... .................................................................. ��� Plumbing � � Heating '�� a�....................................... g-.:..... ..........�.�.`�� ....:........................ Fireplace .........Approximate Cost ,� ."0.0 o Definitive Plan Approved by Planning Board __Al ______________19�/_____. Area .. .. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH , b l I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. - Name .k4a..."e.z. l!'�/Y ���/ ................ ;acey, William E. III f . 4�a� 095.......Permit, for I...1/.2...stay. , family...dwel..ling. ............... t Location ........... .1012...Q1 d...S.tage...Road. ............................C.en;t.eru i 1.1'e...................... Owner ..............W.il.l.iam...E......Daoe.T III } . Type. of Construction ...............fr:ame............... r ,Plot ............................ Lot ............#5............... Permit Granted ......A ril...14.............19 78 Date of Inspection ....................................19 Date Completed � � .19................ PERMIT REFUSED ...... .... 19 �..... ... .:.:....' .: .. .. .......... ........... .. &..................... Approved ........ 19 ............................................................................... TOWN OF BARNSTABLE ``.�ilt.•�w Permit No. __ _ i ��n.0 Building Inspector rua Cash ------------------------ --- f6y0. ..N OCCUPANCY PERMIT Bond "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to +-lliam R. Dacey, III Address 112 West Main St., Hyannis$ MA .5 1012 Old Stage Road, -cntnr-„' ' Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Y` Engineering Department i,��f/rr��;�.� `7//•l, / �. 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. ��f ��.•/,,�fir,f .A'- ...................................................... ................................._.................... .:..:...:.......-..� ... ...._- ---w- Building Inspector ,kP "`fk.y^, ^ ; t :S r .. �a .q f' (H,+,'.. ' (p 'Sq': r 'y31 M}t.r +. ..3F1 } N9 t N.�„ �'t'y �, ,'}, 7s M J �f , t h'�; q. (,•.re! t t} "Rr 0 r'�,`r r�` -�, t+{ d ""! Y r� t A,ea r wry tb ,� th,'• 7 -1 y � �iN f• 1 ( F - �,5 f S' It � t. �.: ! { b r t. ��t. ,.Sy � .f. .i?{� f$'' � � :'Y�`[+.f>cY^� rah r y.;.}5ts31 yxi� k /a. 'td ._y nr S(Wg�• ,rf •�.,�r� i��-y<'�f y•d.. 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