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0035 PINE TREE DRIVE
era r� f•��""�' • > ''�.����a�� `.a'. � r efi N U k r � r �r r r, 3 l ,j + 5b ;t R: Ir F., .k Id� '> r�,J `fit sy...•. , f i7 ,r fir t 4 { k' lfri+r NASA , 1 cola a ,rr s .F3z p ONO, I I 4r qn s ES(r Mfit; `r,• � c ' 'F 'r r', "N, j, Ww— f, TA w 1, I TWA" 01M cost TV,' „ .,y Application number....».».».»..»»....».......»...........» Fee...;. k L KAM 3_ r �+ ` Building Inspectors lnitialsw .». .»... ..........»... 91 �� ' Date Issued.. »o !o l S ..»»»». . ..».. . . s's.�• �4��'�/. �• Map/Parcel '.............:........»..»......».»... TOWN e f BARNSTABLE . y EXPEDITED PERMIT APPLICATION: _1="� 'M ROOF/SIDING/WINDOWS/DOORSnENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION- Address of Project: "' 1� °- t Jfn g. � vi � ,.V _� h _ STREET ')''j°=VIU AGE' Owner's Name:Car 4rot F � =- IV Phone.Number Email Address: A''�CCt m LON �"�tl"�1�3Q` ell Phone berD '2 12 . 6. ,ur '.. .RYh _ `a{. .tom. •Fr i+ _.�, _ `,!,':f .'�;-[:'. � .a FL'a s:.a .r� �t�,+, ,. "�a.s. . s - - Project cost$ j ;_ ("-G C' Check one Residential -Commercial T OWNER'S AUTHORIZATION As owner of the above property-I hereby authorize -r g r,r ! -•A c to make applicatio a p 't in accordance with 780 CMR A�t Date:Owner Signature: ..�. -. .._ _. _ b � r 8� - _ TYPE OF WORK - CA Siding d .PyWindows(no header change)# 1 Q „Insulation/Weatherization, ;, ; ,- t, .0 ,. �'. - Doors(no header change)# `JCo»Imercial Doors require an inspector's review ❑ Roof.(not applying more than l layer oWses) ConstructimDebris will be going tot: s �. .��G fif37 CONTRACTOR'S INFORMATION 'Contractor's name ,,�� ,._•-�".... .C t . R .�'. r _ Home Improvement Contractors Registration(if applicable)# Al� _ (attach copy)-,-- Construction Supervisor's License# © attach co Email of Contractor. ► e numb ALL PROPERTIES THAT HA STRUCT6RES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS 1N A HISTORIC DISTRICT. YOU MUST OBTAIN MLSTnRI[APPRnm RFFnRF A PFRM►T rAiv RF IM►Fn F- *For Tents Only* Date Tent(s) will be erected Removed on number'of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X �- X X Additional tent dimensions can be-attached on i separate piece of paper. Purpose of Event I Check one:this event is a:for profit non-profit event Check one: Food served Yes• No ..', Flame Spread Sheet of each tent must be-attached!Provide-,a site,plan with'the location(s)of each tent Fuel source being used LP tank 201bs. or>Yes No ,if yes,a gas permit is required Natural Gas,Yes No - ,if yes,a gas permit IS required. If food is being served at.your event please obtain a Health Depdrbnent.approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# - Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front.' ,._:. } back, 7- -left side right side r HOMEOWNER'S LICENSE EXEMPTION . =•F,, 1.•. . a I _ Homeowner's Name: Telephone Number a •,r, ' `', p „R rCell'o•Work number I understand my responsibilities under the.r.ules and regulations Ior Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code; ,I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date I APPLICANT'S SIGNATURE Sigika tore Daze �7 ( All pe at ns ub to a building off w al's approval prior to issuance f - The Commonwealth of Massacliusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 MwM.mass.gov/dia Workers' Compensation Ins_u_rance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): � Address: City/State/Zip: Phone#: 5045 Ar�yan employer?Check the appropriateType of project(required): a employer with .4. F `1T'am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑N construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling tors have c ship and have no employees These sub-contractors 8. ❑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 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.❑Other 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insura cr for my emp ees. Bel is the policy and job site information. 1t Insurance Company Namb: � U J �(� 1V� ° �Z� Policy#or Self-ins.Lic.#:_I P,__TL9 5 Zt. 0 C Expiration Date: Job Site Address: 3,5 P (Ayfi�l ®/`—t'"� City/State/Zip:CPA) 1UU 1 LL C_ ✓" `rl I Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). 6.�,6 32_ Failure to secure coverage as required under Section 25A of�4PL c.j02 can lead to'the imppsitipn of craminal penalties of a fine up to$1,500.00 and/or one-year imprisons een'as'well as civil penalties in the form of a STOE,WORK;O.I DER and a fine of up to$250.00 a day against the violator., Be advised that f;cpp)y of this stAten1ent tray be forwarded to the.Office of. Investigations of tbo,DIAsfor insurlhc&'verage verification. I do hereby under t ains n enalti Of perjury that the information provided above is true and correct Si afore: Dater A 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#: • I i Information and Instructions Massachusetts General Laws chapter 152 requires all emplo ers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every erson in the service of another under any contract of hire, express or implied,oral or written." An employer is de fin\aenan "an individual,partnership,ass ciation,corporation or other legal entity,or any two or more of the foregoing enga a joint enterprise,and inclu ' g the legal representatives of a deceased employer,or the receiver or trustee ofividual,partnership,associatio or other legal entity,employing employees. However the owner of�a°dwelling ving not more than three ap: euts And who Tsides therein,or the occupant of the dwelling house of anw employs persons to do m ' tenance,construction or repair work on such dwelling house or on the grounds or ng a urtenant thereto shall n t because of such employment be.deemed t0 be a;',en*loyer." MGL chapter 152, §2 )arso s es that"`every state or local licensing agency shal�twithhold the issuance or renewal of a licensermit too erate a business r to construct buildings in the commonwealfli"for any applicant who has noduced ac ptable evident of compliance with the insurance coverage required." Additionally,MGL cr 152, §25C )states"Neith r the commonwealihnor any of its political subdivisions shall enter into any contrathe,perform a of public rk until acceptable evidence of compliance with the insurance requirements of this r have been pr ented to th contracting authority." Applicants e fill out the workers' compensation affid it co letel b checking the boxes that apply to our situation an if Pleas p P Y� Y g PP Y Y � necessary,supply sub-contractor(s)name(s),ad dr s( )and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or ' ited Liability Partnerships(LLP)with no employees other than the members'or partners,are not required to carry worker compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this a davit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. A o e sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for e p it or license is being requested,not the Department of Industrial Accidents. Should you have any questions r gar the law or if you are required to obtain a workers' compensation policy,please call the Department at the umbe isted below. Self-insured companies should enter their self-insurance license number on the appropriate line. q� City or Town Officials Please be sure that the affidavit is complete and printed legibly. T\han partment has provided a space at the bottom of the affidavit for you to fill out in the event the Offic of Investihas to contact you regarding the applicant. Please be sure to fill in the permit/license number whit will be ua eference number. In addition,an applicant that must submit multiple permit/license applications' any givenn only submit one affidavit indicating current policy information(if necessary)and under"Job Site dress"thcant hould write"all locations in (city or town)."A copy of the affidavit that has been officially tamped ord by a city or town may be provided to the applicant as proof that a valid affidavit is on file for fu " -permitenses. new affidavit must be filled out each year.Where a home owner or citizen is obtaining a lice se or per related to y business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said per on is NOired to com ete this affidavit. The Office of Investigations would like to thank you in vance fr cooperation'an should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonw\Itu: Massachusetts Department oi.al Accidents Office ogations 600 Wa .Street Bosto2111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www,mass.gov/dia Jau0lsslwur03 0 VW. r. 3NOSA3NNIHNd Y r--NO.L:ndt(,l3 a d N321f1Vi O.ZOM0/90:saltd3 . • - "� Z8L6S0-gO sP�e ue rosin iadnsi U910hrj;suoo P. Is Pup suoi e' 1 In6aa 6 ainsuaor 1 leuoi§sa1oj w PIIng 1O P�eog sb.J:= f sltas4 y�ess 10 4li aMuotuuio 0 �•f p ; Office of Consumer 4ffatrs a Business Regulation HOME IMPROVEMENT.CONT RACTOR TYPE:IndMdua► ; R tv eaistratop;__; . 1769;;y 10/14/2019 LAUREN F.STAPLE-.TpN LAUREN STAPLETQIV. >: 414 PH INNEYS LN CENTERVILLE,IIAq';0�632 r Underscore _ =� ry IdPIAo6•ssew•MMM PsiA 7O 00M-LU(µ9)Ile9 asuawl spa Inge uolleuuo;ul Jod 1 siylr uogg�ona�aQ#asne�II-0pgp 6uiplin9 alelS saasngaessm WU10 uoglpa;uaLno a ssassod of ainged a •awds pasolaue jo(siaptu aigna M)laal aigna 000`9£uegl ssal uleluoo golgen dnoj5 asn Aue;o s5uiplin8-paiaulsajun josuuadng uoipnjpuoO '�-Riiistratidn valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,IAA 02116 Not valid Sri hout signature en Rabesa MurrayandMacDonald ( 1/ 1 ) 10/09/2018 09 : 34 : 52 AM -0400 C�� DATE(MM/DD/YYYY) ✓. CERTIFICATE OF LIABILITY INSURANCE 10/09/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR,NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT NAME: Sharen Rabesa MURRAY & MACDONALD INSURANCE SERVICES INC a/c°No Ell: (508)289 4160 aC N, ADDRESS: sharen@riskadvice.com 550 MACARTHUR BLVD INSURERS AFFORDING COVERAGE NAIL# BOURNE MA 02532 INSURER A: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B LAUREN F STAPLETON RENOVATIONS LLC INSURERC: INSURER D:. 414 PHINNEYS LN INSURERE: CENTERVILLE MA 02632 INSURERF: COVERAGES CERTIFICATE NUMBER: 322817 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 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 ADDTYPE OF INSURANCE L BR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE DOCCUR D G ORENTED PREMISES Ea occurrence MEDEXPAnypneperson) N/A _ PERSONAL&=ADVINJURY $� GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5s POLICY 0PECOT- LOC PRODUCTS CAMP/OP AGG $ OTHER: l AUTOMOBILE LIABILITY COMBINED SINGLE LIMI _ -�•�' Ea acddent 4 �3 BODILY INJURY Per person ANY AUTO x t ) SS�, ALL OWNED SCHEDULED N/A BODILY INJURY Per acddent AUTOS AUTOS ( `y� HIREDAUTOS NON-OWNED PROPERTY DAMAGE "& C1�J AUTOS Per acddent UMSRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE 9 DED RETENTIONS S WORKERS COMPENSATION PER OT /� STATUTE ERA AND EMPLOYERS'LIABILITY Y/N - ANYPROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT S 100,000 A OFFICE R/MEMBEREXCLUDED? N/A N/A N/A 7PJUB2E86759418 05/09/2018 05/09/2019 (Mandatory in NH) E.L.DISEASE-EAEMPLOYEF4 S 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT I S 500,000 I N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool atwww.mass.gov/lwd/workers-compensationfinvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Bamstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St AUTHORIZED REPRESENTATIVE Hyannis MA 02601 Daniel M.Croin!�jey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD > [COIRE0 n Rabesa MurrayandMacDonald ( 1/1 ) 10/09/2018 09 : 33 : 20 AM -0400 f CERTIFICATE OF LIABILITY INSURANCE DAT0/09/2018 Y) ��• 1 oros/2o1 a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 NAME CT Andrew Roth FAM Murray&MacDonald Insurance Services,Inc. AICDNo E t: (508)540-2400 (AIC,No: (508)2894111 550 MacArthur Blvd. AMAIL DDRESS: andy@dskadvice.com INSURERISI AFFORDING COVERAGE NAIC rt Bourne MA 02532 INSURER A: Evanston Insurance Co. INSURED INSURER B: Lauren F Stapleton Renovations LLC INSURER C: 414 Phinneys Lane INSURERD: INSURER E: Centerville MA 02632 INSURERF: COVERAGES CERTIFICATE NUMBER: 18-19 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TH E POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYY) (MMIDD(YYYY) LIMITS X COMMERCIAL GENERALUABIL17Y EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Fx�OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) g 5,000 A 3AA168839 05/04/2018 05/04/2019 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE UMITAPPUES PER GENERAL AGGREGATE $ 1,000,000 POLICY j�7 LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER: I $ AUTOMOBILE LIABILITY Eaaaident $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULE BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED AKAUt $ AUTOS ONLY AUTOS ONLY Per acddent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DE I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN STATUTE EH ANY PROPRIETORIPARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICEWMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATION SI VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space 1s required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St AUTHORIZED REPRESENTATIVE Hyannis MA 02601 ,o_�, f 1rx1{r, rr�p �� ©19888--2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD r Town of Barnstable ernut: tHE A Regulatory Services Date Q, Thomas F.Geiler,Director AsL& Building Division ee DO HAM fD 3 ��m� Tom Perry, Building Commissioner 200 Main Street, Hyannis,NjA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTA.BLE SOLID FUEL STOVE PERMIT Owner: 0'�q el,4- '2h Rc i Phone: -1-7 b(3 a Install at: 35 iP►WET Village: CtNTCaAGL: C=) h' l Map/Parcel: c)<� Date: U " ( .Z Stove A. Oe /Used ? B. Type: adi /Circula ' g C. Manufacturer: eG 5 �Q Lab.No. D. Model No.: 8 -14 - 4 Chimney A. New/ xi§tin .(If existing,please note date of last cleaning B. Flue.Size . C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer E. asoUnlined Hearth A. Materials: b Vic 1<, B. Sub Floor Construction: vP o oV Installer , Name: b0%iy QI<%4 S Address: R�� 0�5 �(•o►?� (� �l c��/S Phone: y Location of Installation:. S Co(Z �}OOJI 5 J APPROVED BY: - 2,(2 S all e .� m S 1rQ � e 1 u� Please ma chec p3able to the To i of Barnsta Pe *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector 0:fhrmc0nve r a r .w., .-,.n •� .., K a . + _ ,sig�GC v �w;iNW:a1W" .. www:w.u.,w:r..-+.a.....w..s'i+•++eMr+.,.-ww.+yrn.w...,:. ti...-,..�� ...�. - .- .. +.e+ •, w T reW r, , fi , R c 4 v.4 _4Q.-44 1011 4l;OO5 PINE TRrie RADIANT 1 � ,Rw�m. �: a '` 'j6 .aa.�• �. a' .:�, ran .+,�+G' !�,,� + d', kk � } r _ a �. irc+i.^x _ - � r L: .t �..:_ r. s,�'�wi—..,Lr��._^f•,��,..--��rt., y a.l.� ..'�, a .� � � � ,� n ..a�"' - ";":��..r.w rx t 77 PM .6YC'� [i... P- x WisllMlp•' 1. .. j �41 16/14/2005 s P RE STQVE - W � Ppw�•wWl4MyyaMf' . -, H ,.. ... 0lkllyYiMp Z�. yM11Mn!ilYl.lrwMNM as m v� k Town of Barnstable ennit: Regulatory Services ate: Thomas F.Geiler,Director Building Division ee: QU y MASS' 163 s`�� Tom Perry, Building Commissioner ens 200 Main Street, Hyannis,MA 02601 www-town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTA 13LE SOLID FUEL STOVE PERMIT Owner: �k lam. 0-14 e-U+-A4+aka ila,E i Phone: `J US.-1-7$. b 6 Install at: 35 e►t,)t T D2�vl: Village• Map/Parcel: � � Date:__ Stove A. e /Used all B. Type: t /Circulating C. Manufactureq& S�un1e Lab.No. D. Model No.' � - 4 ktp 1-1 Chimney A. New/ xistin (If existing,please note date of last cleanings V �/1 v-4 B. Flue Size C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer E. 1aso . JL;lUnlined Hearth ffR A. Materials: �1 c B. Sub Floor Construction: v-P o oV Installer Name: bo J l �,A1 k►j S Address: �� Hof Phone: Sak"-7 7i� `�-1 q� 5 I Location of Installation: 95 C.og pj k- tole , ,��►��5 APPROVED BY: A2 F ee4 Q I l Please make checks payable to �he owno�f�Bar siae���q *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove 1 _ r MaP O&- Parcel rermlit# - House# Date Issued Board of Health(3rd floor)(8:15 =9:30/,1:00-419M `3 , y Fee' �� -4Sonsoivatefffice(4th floor)(8:30-930/1:00-2:00) v,ti FUaaiag-Dept. (1st floor/School Admin. Bldg.) TKO SYSTEM Pl,13LP n Approved by Planning Board 19 LED 11 ®'N COUP �' L COO i A TOWN OF.BARNSTXRL GULAT1C�?�8 ' Building Permit Application Project Street Address J S �Vy_ Time,, Village C eki frud l-e Owner O Gt--l {� C,��c -- ,� Address �j�ce_ Telephone Permit Request p — ;'�e c eS,l�,r C°P%J First Floor{ square feet Second Floor S-Co Lf square feet Construction Type Estimated Project Cost $ _�,6610 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: p Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes -kNo Fireplaces:Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) Pone ❑Shed(size) �1 ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ANo If yes, site plan review# Current Use Proposed Use Builder Information q �` Name �;�� Orrb,1 Telephone Number Address l k// 4 3La License# 0 6 Go) 6 `�Or t(r4 -Mg 0-1 Gyy Home Improvement Contractor# /a 1 4I/ Worker's Compensation# G(/ C a 6//7 63 1/ 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 &0 SIGNATURE DATE)/(4/70 BUILDING PERMIT DENIED FOR THE FOL ING REASON(S) 0 l - FOR OFFICIAL USE ONLY PERMIT NO. x i DATE ISSUED - d MAP/PARCEL NO. ADDRESS VILLAGE OWNER F _^ Ilk • t DATE OF,INSPECTION: # FOUNDATION ` FRAME INSULATION FIREPLACE ELECTRICAL: 'ROUGH_ FINAL PLUMBING: "?ROUGH- FINAL , GAS: FINAL - FINAL BUILDING r • ' a , `,w�F� gyp•4.. 4 - , ; * . F i _ . , ,. = , • DATE CLOSED OUT i ASSOCIATION PLAN NO. . { i 30 �rSJ a S 0�� v-e ILS d Engineering Dept. (3rd floor) Map Parcel oZ �..1J Permit# House# Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30)v •-r3 �Fee Conservation Office(4th floor)(8:30-9:30/1:00 7 2:00) Planning Dept.(1st floor/School Admin. Bldg.) SEPTIC ; MUST E INSTAL IPLIANCE Definitive Plan Approved by Planning Board 19 A M ENVIRO CODE AND TOWN OF BARNSTABLE T0WV :� L T ^Y]r Building Permit Application ' r Project Street Address _;_3 S e Tr ee v e Village Ce i e-,r V'k I 1 e Owner o (cc Address /a Telephone (o 1-7 - 9- o,i 3 Permit Request p� o��_��. I (,- D o L.b 1 e L 1 L t_v a Lo i i d o w S w ,+l H A e v V1 Coca 66p - -719 Tn5,,L GJuSS - /yo SlZ-c ( ketoge First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ C,, S o n, Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family p Two Family ❑ Multi-Family(#units) Age of Existing Structure _ ;�v u r 5 Historic House ❑Yes LiVNo On Old King's Highway ❑Yes ®/No Basement Type: ❑Full ❑Crawl ILa Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing Tc o o New Half: Existing New No.of Bedrooms: Existing 14 New Total Room Count(not including baths): Existing 7 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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name d�6T _ Telephone Number Address License# 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 � Q SIGNATURE �� ;d"�/� -- ��J�'.�%(r'.�. DATE � BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. _ r DATE ISSUED MAP/PARCEL NO: ADDRESS ► VILLAGE' r .' OWNER DATE OF INSPECTION: - - FOUNDATION ' FRAME 9 INSULATION - - FIREPLACE ELECTRICAL: ROUGH 4 FINAL PLUMBING:. ROUGH FINAL GAS: RPUGII, FINALIwo - - FINAL BUILDINGa'1tl DATE CLOSED OU10 F- ; ASSOCIATION PLA i NO r-, F Assessor's Office(1st floor) Map Parcel it# 3 (� Conservation Office(4th floor)(8:30-' 9:30/1:00-2:00) ,�°aYA�11G ' Date Issued 3 ' —7.V Board of Health'(3rd floor)(8:15 -9:30/1:00-4:45) Z�s Y n ' Fee ?'.5 01 t .. Engineering Dept.(3rd floor) House# `• SEPTIC ST 82 Planning Dept. (1st floor/School Admin. Bldg.) .��@�T�'`' PLIANCE N Definitive Plan Approved b an 'n oard 19vV6011� ®DE AND TOM R OWN OF BARNSTABLE = - Building Permit Application Project Street Address Village 1 Owner �(�- r //���io� L�Sr��` [•"/Address A0 ce" ; i Telephone -7— - Peel-0 ►.� .�,��' 4 �i,�/7, •Permit Request , l . �;. - C- First Floor square feet Second Floor square feet Estimated Project Cost $ Dy_119 Zoning District Flood Plain Water Protection, Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other P. Builder Information Name r �,�, ���/��, r< f�2c� Telephone Number Zl I Address /gym,,� _ - License# rs Home Improvement Contractor# 16 P&7 Worker's Compensation# Q 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 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. 3/� e DATE ISSUED MAP/PARCEL NO. _ S ADDRESS , .E ' VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION IV 6 S FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: S ptOUGH- FINAL kr FINAL BUILDIt4.Qb 7 __`; 1A, On } `,��• ra .� tat E _ ' _, ` � _' '" DATE CLOSED QUI j r y pi C) ASSOCIATION PLgA AiO t k f j F t t f � - ij N A e� q , O rr. I Yy I 01 i S W-W O i r r i n PROJICCT — Replace 12'z 14' Deck : R.ARTHUR 1MILUAA�5,''INC. TERMLLE d �; Dome. dt Ntillarn Grlerrold� Centerville DESIGN 2 OAKSTBU�C CONTRACTOR -4 UJ� LLJ Z --j J J CO ww �NW m � a m ww rl �m1 • m *iAt Cover deck surface wth 5/4°x C Prenaun grade pressure treated 5outhem Yellow Pne Railing to have 4x4 upright posts. 2x6 top rails, and 2x4 intemediate rails. BalusLera are 5/4 x 5/4 x W wtfi 45% cut at the top of balusters 4" on centers. SCALE 1/4"=1' r SHEET `R p _� r h- 5 �m �N( F o� ?ai �p nl 2e4 rrrtnm"m rd f!t'x 5/4' OebmHrs _ M ntmaclow wi 40 pea& to ti .' . 24 now 4ts k*&r- $ Q Z - 'bdO ledger bona p 2 - lift .mm L� .w 4xL I North Elevation View a SCE 1�4"mil• ' SHOT Assessor's map and lot number'..: d.d ...... CZ ' _ �fR 76 SEPTIC SYSTEM MIST BE /( l INSTALLED INCOMPLIANCE Sewage Permit number ..................... .................................... y',;IT,y ARTICLE 11 STATE SAt''ITf\Rv .� THET� TOWN_ OF �BARNST` i ` LEND TOWN r • . ` "AUS`J DUILD116 INSPECTOR MPYa' r >� APPLICATION FOR PERMIT TO .:....... .�`.. ....... i....................................:.................................. TYPE OF CONSTRUCTION a7 eA.... .......... .........19.�L TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...PZ,; t....../„L4....... ................ ........................................................................................................... Proposed Use Sic Via. ....... ZoningDistrict ...... ..Q........................................................Fire District ........... ............................. ....................... as o �� Name of Owner Hi.e.':-r�E�}/Q..........:`................................Address be4.g,/ !Q�� .. .olgx............ Name of Builder ... !.... y....... .....Address ..........fr. .-... a ............................... Nameof Architect ..... .........................................Address .................................................................................... Numberof Rooms .......,....3).................................................... ..................................................... Exterior ... . ................................................Roofing ........ ....................................................... Floors ........ ............................................................Interior ......... ............................:...,.......................................... ....................... Fireplace ....... ................................................................Approximate Cost ....... ..�1��..�.�:a/ Definitive Plan Approved by Planning Board --------------------------------19--------. ` Area ...1... .. ..... �'.....:...... Diagram of Lot and Building with Dimensions r Fee ........ ..�(................................ SUBJECT TO.APPROVAL OF BOARD OF HEALTH -71 �- 6rA I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .....0.,rP...... .. .............................. Hia-Pearl Corp. 18563 1 1/2 story, r � ' ti No ................. Permit,for .... _ �. L...,:_�srngle family -dwelling 1 i .... ............................... Locution .... Pine .Tree Drive V Centerville ; c ,. . ............................... i ` .....................................I......................................... �f • ; t Owner ...... Hia-Pearl Corp. ............................................ r, S 4 frame- Type of Construction Se ..............C ............................................................ Plot Lot ................................ . y y Permit Granted Date of Inspection ..........1 q Date Completed fd� ..19 PERMIT REFUSED . _ .... . ............. 19 ............................................................................... ... .................. . ......................... ..............1....... ................ . ............................................................ Approved ................................................ 19 . ............................................................................... y� 1 1� + LOT �- '•. �7-S (f .L -CC. 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