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HomeMy WebLinkAbout0187 WHITMAR ROAD 1 �� �� �� �� � �' ,1 m� �3��� { z TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Z4 [ / Map 6�� Parcel ; .Application # Health Division Date Issued Conservation Division oy" Application F Qe Planning Dept.t. Permit Fee0 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street'Address / -'7 k: Village Owner ;T 0 C a Address l F7 �- Telephone Li` �oF c tt c Permit Request Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total�new I'M Zoning District Flood Plain Groundwater Overlay Project Valuation- a 000 ' Construction Type s Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ 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 �$co.,�.�. ,,gib Telephone Number Y7 7-6-59F Address W JC.. License # GS Y moo Home Improvement Contractor# /2�/546 `S Worker's Compensation # I , N . ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 7. Ao SIGNATURE mil DATE �/�a FOR OFFICIAL USE ONLY - APPLICATION# t DATE ISSUED : . MAP-/PARCEL NO. ADDRESS. VILLAGE OWNER c DATE OF INSPECTION: s _-'FOUNDATION `— FRAME `INSULATION.: FIREPLACE ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL :iW NAL"BUILDING 4 DATE CLOSED`0UT. ASSOCIATION PLAN NO: The Commonwealth of Massachusetts - " Department of Industrial Accidents SIM r' Office of Investigations 600 Washington Street c `F" Boston, MA 02-111 yy www.mass.gov/dia Workers Compensation Insurance Affidavit: Builders%Contractors/ElectricianslPlumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): c�1sj�lne? �� yTu Address: City/State/Zip: �lr a oa6y Phone #: y Are you an employer?Check the appropriate box: Type of project(required): ❑ I am a employer with 4•.[] I am a general contractor and I 6. []New construction have`hired the sub-contractors.., _ ._._ and/or'part-time).2. �Kployces-ffull 1 ama sole proprietor:or partner- listed on the attached sheet. Remodeling ship and have no employees These sub-contractors have g, O Demolition working for mein any capac ity. employees and have workers' 9 [J Building'addition [No workers' comp. insurance, comp. irsurance. 5. '� We are a'corporation and i required.] ts 10.0 Electrical repairs or additio i ns officers have exercised their 1 LE] Plumbing repairs or additions 3.0.I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs 152 §1 insurance required:] t c:. (4), and we have no employees. [No workers' 13:❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill.out the scction below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of thc'sub-contractors and state whether or not those entities have. employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. - I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: Policy#or Self-ins,Lic. #: (,)('(' Y�9 07K /�6�F' Expiration Date:. Job Site Address: /Y7 �i� City/State/Zip: Attach a copy of the workers' compensationpolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c• 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as.civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. *Be advised that a copy of this statement may be.forwarded to the.Office of Investigations of the DIA for insurance coverage verification. _ I do hereby certify.tinder the pains and penalties of perjury that the information provided above is trice and correct. Date' Signature �i g Phone#: 6 11-2 7 0/.l` Official use only.'Do not write in this area,to be completed by city or town officikt" City or Town: Permit/Lcense# Issuing Authority (circle one): - 1.Board of Health 2. Building Department,ICity/Town Clerk 4.Electrical Inspector'S. P16mbirig,Tnspector• 6. Other Phone# Contact Person: `. information and fnstructiODS Employees- Massachusetts General Laws chapter 152 requires all employers to provide workers' co ePenn�eToanf ocontrac or their hi e, the service of another Y er arson m Pursuant to this statute, an employee is defined as '.,.ev y p •express or implied, oral or written." An employer is defined as "an individual, partnership, association,al representativesora ' of aedeceased employegal chtity, oi�any r, Or the of the foregoing engaged in ajoint enterprise, and including g ' receiver or trustee of an individual, partnership, associalIon or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance construction employmenpt be deemair work oed to be n Such anelmpl ving erse or on the grounds or building appurtenant thereto shall not because of employment Z MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required,", Additill onally,MOL chapter 152, §25C(7) states"Neither the conunonweaethh noon any Ofits of co pl c political wibh'the]ionssrranace enter into any contract for the per of p ublic work until accc.ptabl requirements of this chapter have been presented to the contracting authority." Applicants Please fill out.the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), addresses)and phone numbalong w hItheir employees Cher than the of insurance, Limited Lability Companies (LLC)or Limited Li�bih yPartnerships oes have members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP d employees, a policy is required. Be advised that this affidavit may o sisnbanidted date the athe ffidavit,Department of lodustrl. The affidaviilshould Accidents for confirmation of insurance coverage, Also be sure e i b be returned to the city or town that-the application for the permit or license s eing requested,not the Department of Industrial Accidents. Should-you have any questions regarding the law or Blow,you.arc required ed to obtain sho]d enter their compensation policy,please call the Department at the number listed b self insurance license number on the appropriate line. City or Town Officials ete and printed legibly. The Department has provided a space at the bottom Please be sure that the affidavit is compl of the affidavit for you to fall out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in thd.permit/license number which will be used as a.reference number. In addition, an applicant Plea must submit multiple permit/license.applications in any given year, need only submit one affidavit indicating current D policy information(if necessary)and under Job Site Address the applicant shou ld waste all locations in town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A.new affidavit must be filled out each or commercial venture year. Where a home owner or citizen is obtaining a license or permit not related to any business (ix. a dog license of permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of lnvestigalions woiil�hke to Cli�nkyov-in-advare for—year cooperation and should you have any questions, please do not hesitate to give us a call. The Deparlment's'address, telephone and fax number: The Commonwealth of Massachusetts Department of IndustTial Accidents Office of investigations 600 Washington Street Boston, MA 02111 Tel 4 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617427-7749 Revised 4-24-07 www.lrlass.gov/dia Y.. -THEr Town of Barnstable Regulatory Services.' • BARNS-rABL.E, y uAB& g Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner: 200 Main Street, Hyannis,'MA 02601 www.town.b arnstab.l e.ma.us. Office: 508-862-4038 Fax:~ 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder I, Jo ,a as Owner of the subject property ^ hereby authorize Die to act on my behalf, - :3 in all matters relative to work authorized bythis building permit application.for 14? ALA (Address of Job) nature of Owner Date Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:F0RMS:0 WNERFERMISSI0N t. Town of Barnstable pf z"e toss Regulatory Services y T BAMST.,BLY- ; Thomas F. Geiler,Director ttAss. � t63q ,�� Building Division PlFD µAy A Tom Perry,Building Commissioner 200 Mairi Street, Hyannis,MA_02601. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. , DEFINIT MOF$OMEONVNER. Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official,on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that.be/she understands the Town of Barnstable Building Department rrinirr,um inspection procedures and requirements and that he/she will comply with said procedures and requirements. ` Signature of Homeowner. Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this scc6on.(Section 109.3.1 -Licensing of construction Supervisors);provided that if the homeowner engages a pmon(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Ru)cs&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homcowncr acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the msponnbilitics of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexcmpt \ Wig.:���—`�- -• _ ax Y ' OD ? � 1 .Z7z p- - / / Y :: p= WILLIAPA �.►' C. f\ p Ro. 19334 O .LdCAY�+ q 4 E � �vIST �(GQ� � l n / -s� T t-I R r P t--a kl ca. AWa sr--rt3 C- `WTs Lori rr-t> . W A XTC P, ' w'CRX SrR-i NC? �R V EED U VA: = PERMIT W! IF CONSTRUCTION INSPECTIONS INDICATED ON TH!S CAR 'VS?ECT�R AS APPROVED �4� �i ? _;;c , - Massachusetts- Depai-tment oY Public Sdtct� ' Bon d of Building Rc!ulatwns:and S`tundards ' Co,nstructio,nr. upervisor License 42403. E j License: CS k Restnctetl to 00 " GEOR6E L LgMBROS YT ° 3'FABOR RDA. . FORESTDALE', MA 02644 Expiration: 1/11/2012 �. Tr#: 14U6 l Office of"co meory�? res _ smess: e u a ron t •HOME IMPROVEMENT CONTRACTOR Registration.. 121463 TYpe Expiration: 5l10/2012 `.DBA LR OS CONSTRUCON ' , .* $ GEORGE LAMBRQS� 3 TABOR'RD_ -FORESTDALE, MA 02644 Undersecretary. . � •- _ - . r i �r /01�' Id s Town of Barnstable y� ,PRESSPERMIT Permit# V0-7b;05 ) Regulatory Services Fxpires6monthsfrou:issu date APR 0 5 2007 Thomas F.Geiler,Director Fee TOWN OF BARNSTABLE Tom Per Building]Division ry,CBO, Buildin 200 Main Street,H annig Commissioner Y ,MA.02601 Office: 508-862-403 8 www.town.barnstable.ma.us 0 EXPRESS PERMIT APPLICATION Fax: 508-790-6230 Not Va1id wft1,0utRed X--Press rRESIDENTIAL QNLy Map/parcel Number ,5( 0 Property Address g r Residential Value of Work . Minimum fee of$25.00 for work under.$6000.00 Owner's Name&Address JL.V Contractor's Name b L Home Improvement Contractor License#(if applicable) Telephone Number Construction Supervisor's License#(if applicable ' ❑Workman's Compensation Insurance Che�,lc one:. I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance nsurance Company Name Vorkman's Comp,policy# -opy of Insurance Compliance Certificate must be on file, ermit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to a`E]Re-roof(not stripping. Going over existing layers of root) `jkke-side ❑ Replacement Windows/doors/sliders. U-Value ---- �(maximum.44) Where required: Issuance of this permit does not exempt compliance with other town department re —atons;l:e:_H jstorrc,Conservation,etc.***Note: Property Owner must sign Property Owner Letter of Permission. A co of the Home Im pLovemen Co actors Licen NATURE red. se is requi; - _ ._ ::i ms:expmtrg e061306 s.� The Commonwealth of Massachusetts �} Department of Industrial Accidents _ Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): . �?i" •P Address:_ 0 J'✓ Sh City/State/Zip: n ;lr IJ !1 ZPhone.#: (b 4J fa Are you an employer?Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. E] I am a general contractor and I 6 New construction.. ployees (full and/oipnrt-time).* have hired the sub-contractors listed on the attached sheet. 7. Remodeling 2.lJ 1 am a•sole proprietor or partner- These sub-contractors have ' ship and have no employees 8. Demolition ees and have workers' working for me in any capacity. employ 9 Building addition [No workers'comp.insurance comp.insurance. , 5. We are a corporation and its 10.❑Electrical repairs or additions required.) 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 ] employees, o workers' 13.❑ Other mPees,Y CI`j . 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 anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: —6AA )71V1&rZ— City/State/Zip: /^ Attach a copy of the workers'compensation policy declaration page(showing the policy number an4 expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investi ations of the DIA for insurance coverage verification. I do hereby certify der,the p 'ns• d e al ti s of perjury that the information provided bov is true and correct. Si afore: Date: Phone Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions y Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiv os_trustee:of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every,state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced;acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until-acceptable evidence of compliance with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents.. Should you have any questions regarding the law or if you are required to obtain a workers.' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom �'�.. of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding.the applicant. lease be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant .thatmust submit multiple permit/license applications in.any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or �tovGn)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e, a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions i please do not hesitate to give us a call. The Department's address,telephone-and fax number: hi ,,Commoewealth of MassadhuSl�tts Depart=.ut of Industrial Adoi€lents Office of Investigations 600 Washington Street E.Qston,IOTA 0.2111 TO. 617-727-4900 ext 406 or 1-$77-NIASSAFE Revised 11-22-06 Fax 4 617-727-7749 vAvw.mass.gov/dia �FTHE 1pk, Town of Barnstable Regulatory Services BAMSTABLE,MASS. Thomas F.Geiler,Director 9 g' rEo,r,p�A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized bythis building permit application for: (Address of Job) Sig nr of Owner Date Print Name Q:FORMS:O W N ERP ERM IS S ION a F �\ Board of Building Regulations and Standa & HOME IMPROVEMENT CONTfACTOR Registration, 14?99? Expiration 3%3/2003 . � Type DBE^=- , I' HARBORSiDE REMODELING ROBERT WALSH" 250 CAPTAIN CROSBY ROAD`' CENTERVILLE,MA 02632- �� , c:� Administrator ✓�ze i�omvnzair�wea�,�t j �.�aaaacfticGell4 BOARD OF BUILDIN REGULATIONS License: CONSTRUCTION SUPERVISOR i Number- CS 057394 BirtfiSlafe061021962 xptres 06i602D07 Tr.no: 12084 Res�tdct d 1 G l ROBERT G WALSH V 101 ROSEMARY LM � CENTERVILLE, MA`02632 Commissioner ! 1 . M - 'x' wn of Barnstable *Permit# PRESS P� Expires 6 months from issue date SEP 11 2006 Regulatory Services Fee Of j Thoma �C7 TOWN OF i3MNS7. ,gS B s F. Geiler,Director ` Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Officer 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTL4L ONLY Not Valid without Red X-Press Imprint Map/parcel Number <55'60 Property Address residential Value of Work / cJ 4� Minimum fee of$25.60 for'work under$6000.00 Owner's Name&Address J �� �� Contractor's Name �A Telephone Number — Hometlmprovement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 25V_orkman's Compensation Insurance- Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance n Insurance Company Name c� Workman's Comp.Policy#_ Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) b�-Re-roof(stripping old shingles) All construction debris will be taken to Re-roof(not stripping, Going over existing layers of roof) ❑ Re-side ry ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) . *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. copy of th a Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 i `t Department of Industrial Accidents ' Office of lnvestigations: 600 Washington Street Boston,AM 02111' www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers kpplicant Information Please Print Legibly .1�21ne (Business/Orgamzationadividual): Udress: V ,ity/State/Zip: Phone#•-- �3'� ►re you an employer?Check the-appropriate box:: Type of project(required): 9::�am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full'and/or part-time).* have hired the sub-contractors Remodelin ❑ I am a sole proprietor or partner- listed on the attached sheet t 7. ❑ g ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any'capacity. workers' comp.insurance 9. ❑ Building addition [No workers' comp.insurance 5• ❑ We area corporation and its 10.❑ Electrical r airs or.additions required.] officers have exercised their . ❑ I am a.homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions -myself:[No workers' comp.' c. 152,§1(4),and we have no. 12, ❑ Roof repairs insurance required.]t employees. [No workers` comp.inc ,-�n,, ce required.] 13.❑ Other ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: fomeowners who submitthis affidavit indicating they an doing all-work and then hire outside contractors must submit a new affidavit indicating such. mtractots that check this box toast attached an additions]sheet showing the name of the sub-cont:abtors and their workers,comp.policy information. - !m an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site formation. •• � . mrance•CompanyName: yfC/l46C' 'L. licy'#or Self-ins.Lie.#: 4 `j , Expiration Date: ( � b Site Address:_ -C.'?- 7 City/Sta*zip:_ tack a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ilure to.secure coverage as required under Section 25A of MGL e. 152 can lead to the iiaposition of criminal penalties of a e up to$1,500,00 and/or one-year impr%sonment; as well as civil penalties in$ie form of a S7'OP'WORS ORDER and a one up to$250.00 a day against the violator. Be'advised that a copy of this statement maybe forwarded to the Office of restigations of the DIA for insurance coverage verification `o hereby c under 51�hipains m .peg o perjury that the information provided above is true correct attire:. 'Date: one#: — Official use only. Do not write in this area,to be completed by city,or town offui'aL City or Town: Permit/License# . Issuing Authority(circle one): 1.Board of Health !..Building Department 3.'City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and. Instr' ctions y 'de orl;gs' compensation for their employees. fassachusetts General Laws chapter 152 requr<es all employers to provide w . . mP , ursuant this statute,an employee is defined as"...every person in the service of another under any contract of hire, xpress or implied,oral or written." M employer is defined aS."aa?zed auA.•P P,:association,corporation or other legal entity,or any two or more f the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the' partnership,association or other legal entity,employing employees. Howcver:tbe ,ceiver or trustee of an individual,p hip, . wner of a dwelling house having not more than three apartments and who resides therein,or.the occupant of the welling house of another who employs persons to do maintenance, construction or repair woik-on such dwelling house I on the grounds or building appurtenant thereto shall not because of such employment b e deemed to be an employer." ,2GL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or •enewal of a license or.permit to operates business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence•of compliance with the insurance coverage required." kdditionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its-political subdivisions shall ,rater into any contract for the performance of public work until acceptable.*evidence.of compliance with the insurance .equiremmts of this chapter have been presented to the contracting authority. kpplicants ?lease fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if. necessary,supply sub-contractors)name(s),address(es) and phone number(s)along with their certifieate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(L•LP)with no employees other than the members orpartners; are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retamed 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' compens ation policy,please call the Department at the numberlisted below.. Self-insured companies should enter their. self-insurance license number on the appropriate line. r City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to corktaetyou regarding the applicant Please be sure'to fin in the permit/license number which will be used as a reference number. In addition, an applicant' that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating can ent policy information(if necessary)and under"Job Site Address"'the applicant should write"all locations in (city or town)."A copy-of the=aflMavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that•a valid affidavit is-on-file for:future permits.or-liicenses..A.new affidavit must be filled out each year.where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i e a dog license or peanut to burn leaves etc.).said person is NOT required to complete this 24davit. The Office'of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call.. The Department's address,telephone and.faz number: The Commonwealth of Massachusetts . Department of Industrial.Accidents . . .. . . . .. .. ..Office of Ituvestigations .600'Washington Street V Boston,MA 02111.• . ••h Tel.#617-727-4900 ext 406 or•1-877-MASSAFE r Fax#617-727-7749 evised 5-26.0 www.mass.gov/44 Fraser Construction Roofing & Siding Specialists P.O. Box 1845, Cotuit MA. 02635 Email: fraser constructionnverizon net www.fraserToofing.com Phone 1-508-428-2292 & FAX 1-508-428-0123 RE-ROOFING PROPOSAL DATE: July 11, 2006 NAME: Mr. John Callahan PHONE: H 508-420-2093 W 508-540-1764 ADDRESS: 187 Whitmar Rd. Cotuit, Ma. 02635 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install - GAF TIMBERLINE ULTRA: Lifetime Warranty, 10 year Smart Choice protection, CLASS A FIRE & WIND RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10-year Warranty against ALGAE Containment. Color: G!/z4t Supply and Install - GAF WEATHER WATCH (The Ultimate Leak Barrier) Waterproof Underlayment System (3ft. on eves and valleys, 18" on rakes, walls, and skylights) Supply & Install - GAF SHINGLE MATE Underlayment Paper (as recommended by GAF) Supply & Install - Hick's Ventilated Drip Edge. Supply & Install - Aluminum & Neoprene Soil Pipe Flashing Supply & Install-COBRA Ridge Vent (as recommended by GAF) Clean & Remove - Debris from work area daily. .: START DATES -� AUGUST 21,2006 O SEPTEMBER 19,2006 OR AFTER (All Availability based on weather) TOTAL INVESTMENT: GAF TIMBERLINE ULTRA $13,485 2.5% discount if paid by cash or check 2.5% Senior Discount Payable immediately upon completion NO MONEY DOWN- NO Payment at the start or part way thru Payments accepted are: CASH - CHECK- MASTERCARD -VISA-AMERICAN EXPRESS *Any.payments not made within 30 days of completion will,be charged 1 '/2%for every 30 days the payment is late. Possible Extra -After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not.up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. Possible Extra -Any rotted or otherwise deteriorated trim boards,plywood - sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$45.00 per hour, plus materials, plus 20% overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 10 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. GAF Warranties the shingles and labor 100% through the SMART CHOICE Warranty duration. GAF Warranties the shingles to be ALGAE resistant for the duration of the SMARTS CHOICE Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work. DATE OF ACCEPTANCE: s�C�� SUBMITTED BY: omeowner Fraser Construction ✓JLP.V��� / befoi t the expiration date. If found return Board of Building Regulations ds and Standards License or registration valid for indietul use only of Building Regulations and Standa HOME IM $OVEMENT CONTRACTOR BeajOne Ashburton Place Rm 1301 �� Restist`_ _._r-a• D-n.�,12536 Boston,Ma.02108 lug 312007 FRASER CONST?� - DEAN FRASER \� 71 TARRAGON CI R`5~ � -� ~' Not valid without signature COTUIT,MA 02635 Administrator � w f _ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYY PRODUCER (508)588-1250 FAX (508�588-r236 iD9/22/200s 1 THI, CEP:=IFICATE IS ISSUED AS A MATTER OF INFORIVIAT)ON Wise & Quinn Insurance 'Agency Inc. ONLY AN?,CONFERS NO RIGHTS UPON THE CERTIFICATE 449 Pleasant St. k HOLDEr?, PhIS CERTIFICATE DOES NOT AMEND}SEND OR Brockton, MA 02307 ALTER mt COVERAGE AFFORDED BY THE POLICIES RELOW- CISR, Paul Crowley I INSVRERS AFFORDING COVERAGE INSURED Dean Fraser NAIC 4 INsuaERA; H.aTtfortl Insurance Company DBA: Fraser Construction Co. IINsuRSRB: 71 Tarragon Circle I INsu - - Cotuit, MA 02635-2443 f INSURER e: I INSURER E! cavERAaEs ---- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN( ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W'TH RESPECT TO WHICH THIS CERTIFICATE&4AY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHO`NN i,AY HAVE BEEN REDUCED BY PAID CLAINts, INSR OD' TYPE OF INSURANCE POLICY NUMBER POLICYICY EFFECTIVE I POLITY EXPIRATION GENERAL LIABILITY LIMITS E COMMERCIAL GENERAL LIABILITY { EACH OCCURRENCE DAMAGE TO RENTED CLAIMS MADE D OCCUR ! , S MED EXP(Any one pereom) 3 PERSONAL&ADV INJURY y GENERAL AGGREGATE g GEN'L AGGREGATE LIMIT APPLIES PER; POLICY RO-CT LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY — 411A AUTO I CO BINED SINGLE LIMIT(Ee $ OWNED AUTOS I EDULED AUTOS �, BODILY INJURY $(Per Person) D ALTOS OWNED AUTOS BODILY INJURY $ (Per acclden!) I PROPERTY DAMAGE (Per accident) $ ABILITY AUTO AUTODNLY-EAACCIDENT $ OTHER THAN EA ACC S AUTO ONLY: AGG S X BRELLALIABILITY EACH OCCURRENCE $ M CLAIMS MADE AGGREGATE g TIBLE S TION S . NSATION AND 6560UB-794X519-1-05 09/26/200S 09/26/2006 X WC sTATU-S LIABILITY ANY PROPRIETOCER(MEMBER/PXCLUDE EXECUTIVE E.L.EACH ACCIDENT 3 500,000 OFFICERIMEMBER EXCLUDED? S yes,describe under r E.L.DISEASE-EA EMPLOYE S 500 0Q0 SPECIAL PROVISIONS elow OTHER I E.L.DISEASE-POLICY LIMIT -S 500,00 iCRPT10N OF OPERATIONS I LOCATIONS I VEMCLES I EXCLUSIONS ADDED BY ENVORSEMENTI SPEI;IAL PF—to-,lONS the operations usual to carpentry, RTIFICATE HOL_, DE11 QN L N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 D;ws WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Fraser Construction Co. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION,OR LIABILITY 71 Tarragon Ci rcl a OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Cotui t, MA 02635 AUTHORIZ-D vE C i )RD 25(2001108) FAX: (508)428-0123 ©ACORD CORPORATION 1989 i Assessor's office (1st floor): ,h Q �� p— krzrQ.t ( C`l� yo%THEtO� Assessors map and lot number .(.... . .................................... �Q o ' K Board of Health (3rd floor): Sewage Permit number ....................... n........ ....?•�•• Z B9SHSTeDLE, Engineering Department (3rd floor): 90o 1639 \00��6 Housenumber ......................................... ............... O�pYa b iI G APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only • TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... ...l,.y� l�a .l.> ..... ...........- 'V TYPEOF CONSTRUCTION .......T,-�, .A.Y.Y,1c. ................................................................................ ........... .............. .......19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: � �� a� C<+ ... ..b^ i.•!,�1' •...... ..il� �.r ................... ..1, ............................................ Location ....... ...0.............5;.............. Proposed Use wZ �a.>`. .?.�V C .................................................... Zoning District Fire District .......... -� Name of Owner ......... A�X ...... 1.......N...c....?�.........Address ...............C.�z.�..�...........1. . 7 ,h;::�.v)k... .z..... � U Name of Builder ............. ..rn .................................Address S !!y , Name of Architect ........S.... .CE... ........ ..�. .. . .................... .. .. ... . r (C........................... U , Number of Rooms ..... ` '` !!>.........................................Foundation ....... i�-+i%7...A.. .... r�1(s�.!".�.............. Exlerior ..L�,�R§...?.Z� t............�a ..... ...Roofin ......... �s '.....e,,J (...F.:!.�E.�..,d1.`:........... Floors ..... , �......... .1.1 C;.........Cam. -ti }�� ...Interior (ter e�..0_r!!y��._,.....5� .a.`.e..... ........ . . . ..... . , _ O r �{ Heating '.. ...� ............�s. .`.`................................Plumbirig ........ ..�� ... � � .1�. g ` .... ... ti _ ........... . .. ........ .5 Fireplace .... a�.t.G..!! ..... ...... 3�_.?...... ................................Approximate Cost ...... /1 ..........—1................... Definitive Plan Approved by Planning Boar ----------------- < . Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1'I zYIQ N , lkq OCCUPANCY PERMITS REQUIRED FOR NE. DWELLINGS � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above / construction. Name .. ./v %`............ .. ...... .. .� k } Construction Supervisor's License . .. .....A.......... }} Li � i BAYSIDE BUILDING CY A=5ir-i- No 25981 Two Stor .................. Permit for ............. ..Y....... ............ Single Family„Dwelling Location .....Lot 4t31,,,,,, 187..Whi�jna. Cotuit Owner ........Bayside....Building_ Co.... Type of Construction ...FramIP Plot ............................ Lot ................................ Permit Granted June .27 j..,-. .............19 86 ...................... Date of Inspection ....................................10 Date Completed ........................................:19 a Assessor's office floor):" .o �FTHErO� �A sessor's map and lot number... ....... .... K . Q Board of Health (3rd floor): SEPTIC S ��� Sewage Permit- number ........:............. Q...... .1. - NSTALLED IN (��M =9'8►SB9TOIILE. : Engineering Department (3rd floor): �LI F69 House number .........................................�.�.�. .....:.:,.... r C 'IrO�@�'I.3 �'1TLE' � °°moOMpY as APPLICATIONS PROCESSED .8:30=9:30 A.M. and 1:00;2:OOyP.M. only aq���� � L CO® &V �yC�G9� � � oJ TOWN OF 'BARNSTARLE G BUILDING ' INSPECTOR APPLICATION .FOR PERMIT TO ..�'.C�?°l;�r�!a��:1... .�..�.l.l�L. .��:....`�l� °!`1 L. TYPE OF CONSTRUCTIONCj:.... t. ................................... ......................................... : 111 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........4,8.1........?. .......... .1. ►'l•�1 .....:{ \l ................... ....... .. ............................................ Proposed Use ................. ..JU ....Fire District ....... .. .................................................. .. S.p. ........................................................Zoning District .......... .. . .... ... Z)........Address ...............0 Name of Owner .......... � � ............. .......... Name of Builder s`'4�'� ..............................Address ........................................ ..................... ..... ........................................ C - r Name of Architect ....... ..rv�... (� e..................Address ....................... ..tl(t........................... Number of Rooms ..... `V1. ......................................Foundation ....... ,.................. Exterior ..�� lF �r�G:'� ........6 .(..................Roofing :.......: .... .LJZ .......... Floors ......94K...... .�., ..Interior .......... .r,(l�'!L�..:.. ....!!...d.'d.. � ...................... Heating . .. ..0... l ".•4 .............................Plumbing .........i.. .`w .. ..... ............�Y. Fireplace .... ....g....�1�� .S!t_ ...........................Approximate Cost ...:... �l. .... ......../.....:. .......... Definitive Plan Approved by Planning Board..-L __I__________19n Area ' ` � .0... `. . z '... .. ...... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ®N� Aa ZC OCCUPANCY PERMITS REQUIRED FOR DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... ............. ............. za Construction Supervisor's License ..�� .. .. t� .. 1 -,: -; BAYSIDE BUILDING CO. No' -29581 Two Sto Permit for Y..... _................. - x Sin le Famil Dwellin d Location ......L..o.t t3jr.....187 Whitmar Road .................................. f _ �rF � ♦ r 1 K , T ... .•.......Co}l.ult..................................................e. .1 ' r- •. • - _ ." •l - -+. ,.• ! «... .r Owner ......._Bayside.•Building..CO.�.. �i .. _ ........ .... Frame......................... �' f ;; y ` -•- .� Type of Construction .... Plot=............... 'Lot ................`..... ....... Permit Granted June..27.'................19 86 ~ t r " Date of Inspection :.............. .....................19• Date Co "let d .............� `' r;� ... . ..19 �,k' -. r�� .. y ' r� if,} .�'• • r �� •� .ter � _ .. 9 TOWN OF BARNSTABLE Permit r�o. ...`lY...... . BUILDING DEPARTMENT, TOWN OFFICE BUILDING Cash . ........... HYANNIS,MASS.02601 Bond ......:;. ' n CERTIFICATE OF USE AND OCCUPANCY Issued to Address isayside building Uo. i Y.V L YY.➢Y, 1C7/ YLlt�lilri Y. lrl�du I Y.rU LYl 1.Y., liY.�i:i�iYC:lYYA:i�l.IL:S USE GROUP FIRE GRADING OCCUPANCY LOAD 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. 19...:.............. . ... gI . �Buildrn ns ector P v TOWN OF BARNSTABLE BUILDING DEPARTMENT _ ��1°T 1 rua TOWN OFFICE BUILDING � � 9 i639' �� HYANNIS; MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: /Q ©— . An Occupancy Permit has been issued for the building authorized by Building Permit #. ..... !................ ............. .................................................................»..�...................................... ......... .. . ........ ......... issued to ........................ .`..... ` ( .. ' ......................................................» .................. .. .. _. �, Please release the performance bond. •�\ -*"{i.." ''t�?'�r'1�. R4"ihP� ry Y!( _ � .. yt�' � g• :".yq "' t}% ;7. t' y :.. _ - »gbh -•. or. ow" UILD1 •zA`• ( l TOWN OF BARNSTABLE, NIASSACHUSETTS PERMIT �,. JOB WEATHER CARD DATE 19 PERMIT NO: APPLICANT ADDRESS FI IND.) (STREET), (CONTR'S LICENSE) NUMBER OF PERMIT TO (_) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. ` I 1 e�f( /�'�1 PROPOSED LUSE) C") ' AT (LOCATION) �b� ✓� � �Y1I xar 4 ( I+ ZONING (l. (N0.) (STREET) " DISTRICT =i BETWEEN AND F� (CROSS STREET) (CROSS STREET) 1 � LOT (. SUBDIVISION LOT BLOCK SIZE _ 4 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT.AND SHALL CONFORM IN CONSTRUCTION rr # TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION H (TYPE) REMARKS• AREA OR VOLUME ESTIMATED COST FEEPER - (CUBIC/SQUARE FEET) i OWNER f i ADDRESS BUILDING DEPT. 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 ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND 1. 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 MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. J 3. FINAL INSPECTION BEFORE - OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS �• 1 1 / 2 2 OX 3 HEATING NSPECTIQ4 APPROVALS REFRIGERATION INSPECTION APPROVALS i. BOA D OF ffHAILTH a - -------' -- 1 10-l u—�d 12 2 Fi - .I 'WORK SnA.LL NCT PROCEED 'UNTIL THE PERMIT Wl IF CONSTRUCTION iNSPECTIONS INDICATED ON THIS CARE NS?ECTOR :-!AS AP?RCVEu T`+E 'jA?•.OUS WORK IS No :�-- THS OF DATE THE CAN 9E ARRANGED FOR TELEPHONE 1 STAGES OF CONSTRUCT,i�N' oco.nr ,e OR WRITTEN NOTIFICATION I G OD 52. . C/s' z72 a N' l i o WILLIAM Fez-•%�.1 p m 19334(� 1-OCATt OV-3 Wen y� l,�'sTEy�yo� 5cl�Lt� aT� - ��D suR / =� •�-----_ � /fir- �',l CMRZTIt=Y T.14AT At l IZs1:' ZaV,Ica Nt Et�4,3 -OrV%PLYG AWC> SETBACK VC-aU11ZSAAE: tTc, Di= rwe TOwQ of 't,�/Z / - L A�1D tS �i L--C.-L . Lob AT>✓b W I Ti-1 l ] 1�rLooD PLA t K1 'aAYTG-P, YtZEGIS"tic=i2�t>, . 4�.11L�. SU7VaYok.S Tt-tl5 VLAW 15 WOT SA51Eo Aw 0STE2VVU G- o f�,"T�cJ,c�EI.lT �cJQV>`�{ Ti�� UFf~5 fir, Stdp?sJLD APP t_iy- ,; ' gL U5LD To �erE��t,tc�.1� �~c' Lt,..�5 A1> . A. 1 v II