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Map/Parcel — 001 TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 220 0 Na e (Ci 9 r S Tdz �i e NUMBER 1,y STREET VILLAGE Owner's Name: L eS /i e /t a zpf Phone Number Email Address: /Aaripf 2p a 0/ C d rvi Cell Phone Number Ct73/3_1/C Project cost$ i'S qs-() Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK El Siding El Windows (no header change)# c Insulation/Weatherization El Doors(no header change)# Commercial Doors require an inspector's review L6 Roof(not applying more than 1 layer of s ' gles) >� Construction Debris will be going to ` arH c c. % 0�c� ✓gy p CONTRACTOR'S INFORMATION Contractor's name CoP 02.41 e( C i ey Home Improvement Contractors Registration(if applicable)# J,3 a.Z (attach copy) Construction Supervisor's License# /0( '/© . (attach copy) Email of Contractor �cow „c% ry Dr o E tQ k' hone number g03'7 73 P.24O ALL PROPERTIES THAT HAVE STRU RES VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN r /ll 1 LI VI' I IVY• �VI.IYLI\ *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 a separate piece of paper. Purpose of Event 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 If food is being served at your event please obtain a Health Department 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 left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for 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 APPLICANT'S SIGNATURE • Signatur - Date /0, 3. i 3 All permit applications are subject to a building official's approval prior to issuance. u ram. Massachusetts Department of Public Safety \ It o, Board of Building Regulations and Standards .License: CSSL-106102 Construction Supervisor Specialty • ARMEN SAFARYAN 4) ' 67 SEA STREET APT A4 . 1., HYANNIS MA 02601 }, - . . ! -rz e,i.--' - . ;,eZ...� Expiration: Commissioner 10/02/2020 glib C69VeC of g/i/a/i Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvementontractor Registration _ ,, Type Individual e�; -•-. 1}' Registration: 183202 ARMEN SAFARYAN Yl to �iration: 09/13/2021 D/B/A COREY AND COREY r t/ igist= k�. ti 67 SEA ST APT A4 HYANNIS,MA 02601 � � ," Update Address and Return Card. SCA 1 0 20M-05/17 (g2e (7ogmntmezie€z//A olCo/amacktoe is _.-— Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:.Individual before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 18320 �_ 09/13/2021 1000 Washington Street -Su'te 710 ARMEN SAFARYAN " I Boston,MA 02118 D/B/A COREY AND COREY-- i� t 4.‘ s-7 ---- j. 4 ) _ WI ARMEN SAFARYA 3N•'{ q / W' . 67 SEA ST APT A4� ,Y=:a/ *,.emir HYANNIS,MA 02601 : = Undersecretary Not valid t ignature " The Roofers " POSSIBLE EXTRA CARPENTRY:Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing,Missing Metal Flashing,Side Walling or Any Other Carpentry Needing Replacement will be done and charged for as an Extra:Materials Plus Labor at the Rate of$50.00 per Hour(For Each Laborer Involved). PAYMENT SCHEDULE: A Deposit of One Half is due at the Signing of this Roof Proposal and the Final Payment for the Balance is Due Immediately Upon Completion. WORK SCHEDULE:All the Roof Work is Scheduled for Completion Within 60 Days of Acceptance and the Deposits Received are Non-Refundable After a Three Day Cooling Off Period from the Date of Signing. Please Make Checks Payable to: ( (0 COREY & COREY COREY& COREY Warranties the Shingles and Labor for 5 years. CERTAINTEED Warranties the shingles and labor 100%for the First 10 Years and the Shingles your LIFETIME if the shingles becomes defective. CERTAINTEED Warranties the Shingles up to a CATEGORY IH HURRICANE-130 MPH WIND WARRANTY. CERTAINTEED Warranties the Shingles to be Algae Resistant for a Full 10 Years. COREY & COREY carries Workman's Compensation and Public Liability Insurance on the above work DATE OF ACCEPTANCE: I ACCEPTED BY: SUBMITTED BY j tit/ --• ' LESLIE KARPP / / ARMEN SAFARYAN HOMEOWNER COREY&COREY HIGH#183202 CSSL#106102 ACCRD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ki.....----- 9/13/2019 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 I 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 NAMEACT Ashley Paiva Eastern Insurance Group LLC PHONE (800)333-7234 FAX (A/C.No.Ext): (AM,No): 233 West Central St A�ES :apaina@easterninsurance.com INSURERS)AFFORDING COVERAGE NAIC# Natick MA 01760 INsURERAArbella Protection Ins. Co. 41360 INSURED INSURER B Associated Employers Insurance Armen Safaryan, DBA: Corey and Corey INSURER C: 67 Sea Street INSURER D: Unit A4 INSURER E: Hyannis MA 02601 INSURERF: COVERAGES CERTIFICATE NUMBER:2019-20 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 TYPE OF INSURANCE ADDL SUBR POUCY EFF POUCY EXP LTR jkISD WVD POUCY NUMBER IMM/DDIYYYY) (MMIDDIYYYY► OMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS MADE X OCCUR DAMAGE TO RENTED PREMISES PREMISES(Ea occurrence) $ 9520046441 9/18/2019 9/18/2020 MED EXP(Anyoneperson) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JEC LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OS OWNEDSCHEDULED BODILY INJURY(Per accident) $ AOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS _ AUTOS (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ 1 DED RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A B (Mandatory in NH) WCC50050150912019A 9/18/2019 9/18/2020 El.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Display Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE John Koegel/APAIVA c ACORD 25(2014/01) The ACORD name and logo are registered marks1988-2014 of ACORD ACORD CORPORATION. All rights rese rved. INS025 nrt+dmt 7 i The Commonwealth of Massachusetts `—' . Department of Industrial Accidents J• ±� Congress ';, F; I�� 1 g ess Stree4 Suite 100 r� ''� Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly / 9 1 Name(Business/Organization/Individual): r., e.-t/ ��u h1 4C Cc J 5-j y/ Address: e -._.c i^ ' ii / • ,7. g/ , City/State/Zip: _ /1 Phone#: -5 0 2 7 '7 cd 0 a 2 Are you an employer?Check"the appropriate box: 1.NII Type of project(required): I am a employer with .g employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.] 8. El Remodeling 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 11.0 Electrical repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12.❑Plumbing repairs or additions These sub-contractors have employees and have workers'comp.insurance.: 13.0 Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14 Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :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 insurance for my employees. Below is the policy and job site information. Insurance Company Name: Ile &// 8'o 4-cf A-C y) a rS 1-iit2 C Policy#or Self-ins.Lic.#: -3 2 D 0 C'4r fl 7 O 1' Expiration Date: 3. .=27) Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. - I do hereby certi jinde lie, a'ns and penalties of pedury that the information provided above is true and correct Signature: / `` Vf; � 1'�'" i , Date: Phone#: f/1 v 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#: { • oFr O� Town of Barnstable45.62/00110S0 ' ermit# 1 'f Regulatory Services Expires 6 moi Itsfrom issue d snrlvs7ai.e, Fee _-cib' loss.4- `t� Thomas F. Geiler, Director pp__ Building Division .-P �� PERMIT • Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 AUG - 2010 www.town.barnstable.ma.us TOWN OF BARNSTABLE Office : 508-862-403 8 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Fax: 508 790 6230 Not Valid without Red X-Press Imprint Map/parcel Number Property Address w800 Pr [ , Residential Value of Works, opt) Minimum fee of$35.00 for work under$6000.00 Owner's Name & Address es- Contractor's Name 1)11/ 06:)(6 /," Telephone Number(` cC� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ??,6' gWorkman's Compensation Insurance Check one: n I am a sole proprietor • ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name —Fa, Workman's Comp. Policy# yc3 35-- p 3,7 013 • Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ❑ Re-roof(hurricane nailed) (stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed) (not stripping. Going over existing layers of roof) SLRe-sid/e,r- .m. ❑ Replacement Windows/doors/sliders. U Valtte (maximum #of doors .35) #of windows *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. A copy of the Home Improvement Contractors License& Construction Supervisors License is requ' d. SIGNATURE: -fit Q:\WPFILES\FORMS\building permit Forms\EXPRESS.doe Revised 072110 • 1 Of the r°4 i •• BARNSTABLE, + ,, .6 • <bc Town of Barnstable lFD MA� Regulatory Services . Thomas F. Geiler, Director Building Division Thomas Perry,CBO 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, (-6-.'7-SCle- 4//yfrP , as Owner of the subject property hereby authorize cJI:J.4( 6. , 1(t2t1 ac. -- to act on my behalf, in all matters relative to work authorized by this building permit application for: • /P-7. . (Address of Job) / ' cf/r/ze ignatu £ V "ner Date t ?-1.46J-- Zia Print Name . If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the ..reverse side: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 072110 o �01HETOis Town of Barnstable ti �' _4*".. 9% Regulatory M ::r: g y Services IBAI% BLE, Thomas F. Geiler, Director �'e,e 9ai ,� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us . Office: 548-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: , JOB LOCATION: number - street village "HOMEOWNER". name home phone# work phone# ' CURRENT MAILNG ADDRESS: city/town state - zip code The current exemption for"homeowners"was extende.,to include owner-oc•upied dwellings of six units or less and to allow • homeowners to engage an individual for hire who does no,. possess a license, provided that the owner acts as supervisor. . DEFIN t ION OF HOME I'WNER Person(s) who owns a parcel of land on which he/she reside`.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 ch use and/sr farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowne Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsib',- for all;'uch work performed under the building permit. (Section 109.1.1) , The undersigned"homeowner"assumes responsibility for complianc- w"h the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the To n of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said proc.dur:s and requirements. Signature of Homeowner Approval of Building Official , Note: Three-family dwellings containing 35,000 cubic fee,'or larger will be requir-'3 to comply with the State Building Code Section 127.0 Construction Control. ,/ HOMEOWN ,"S EXEMPTION The Code states that: "Any homeowner performing work for which . .uilding permit is required shall be exem i from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeown,' engages a person(s)for hire to do such wo ,that such Homeowner shall act as , supervisor." - • Many homeowners who use this exemption are unaware that they. re assuming the responsibilities of a supervisor( e Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness ' en results in serious problems,particularly when th homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it Fuld with a licensed Supervisor. The homeowner acti as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her respon ibilities,many communities require,as part of the permit a plication,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On t e last page of this issue is a form currently used by several to ns. You may caret amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 072110 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION - Map s .•19 Parcel 0 0 1 Permit# -: 0 99 Health Division - Date Issued _ $ Conservation Division Fee T66,2 - Qo i :::tor /,,` CmE �7091/ / wc2fr ? Planning Dept. 4/. • • . Date Definitive Plan A Droved by Planning Board A14. "F, Historic-OK - Yv/9/ Preservation/Hyannis , Project Street Address c>R $OZD M /14-1 S71- (.6/f� Village lnac.A n 5 ,21/4 Owner X/9110, a b,bs Address ,Telephone Permit Request Re'ow esicv� jc e--C No Cka,v . ,s-c- '-�-e C"cr Z, S �•e sh1els c cs- cQ f _e_ SO O' , Square feet: 1st floor:existing ' proposed 2nd floor:existing proposed Total new Estimated Project Cost a63 000 Zoning District Flood Plain Groundwater Overlay Construction Type . Lot Size • Grandfathered: ❑Yes 0 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 0 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 1 ^vll� Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas 0 Oil ❑ Electric 0 Other - Central Air: ❑Yes 0 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No • Detached garage:0 existing• 0 new size Pool:O existing ❑new size . Barn:0 existing ❑new size Attached garage:O existing 0 new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# I Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use , • BUILDER INFORMATION Name FRASER CONSTRUCTION Telephone Number Address 71 TARAGON CIR. License# COTUIT MA 02635 (508) 428-2292 • Home Improvement Contractor# // 2ST36 • Worker's Compensation# -46/C/8/S/5' 36'3()/7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ycc azJ/ • ---) SIGNATURE q5 ,� S� t DATE_ ' 5�� 6-1 I 1 . i T - - FOR OFFICIAL USE ONLY -- - _ - • ' , ' _ - .. t E, 1 • _ fe". a .. 3 • 1 ` PERMIT NO. .. . ,, i c- `., DATE ISSUED , ...t ' .' •, • #, , , ; t - 4-~': `9 , 1 r. t '� - _ r% •• - rig, :— -y MAP/PARCEL'NO. .,. •-� 4 r..-'' . ' : t , _; { a z... , :. ' +A' + v _ • *• i s` t -.. `•` - Ste p"'°. 5""�°° +t t' ADDRESS VILLAGEra - nor . `' , v f i i OWNER • t • ; .. - f W _ - + 9. ,a Q E# r s is -! m Y ' . 41 DATE OF INSPECTION: ... , - r % FOUNDATION _• ii .. • FRAME j ., INSULATION t . .4 _ -F •FIREPLACE t _ ' J J_ aa. ELECTRICAL: ROUGH FINAL, •` PLUMBING: ROUGH" ' FINAL - - •GAS: ROUGH ', FINAL• - - FINAL BUILDING 1 4 I. - - ' DATE CLOSED OUT `? - . . • .- t� ' ' ' 4 4 ± ASSOCIATION.PLAN NO. " , I ` • •-4- • A t 1 } t t i f , • - ` , . 1 • - . , ,, . . r The T• '_ :�:►,5'- N. own of Barnstable mAgs• <- Department ofHealth Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 3084624038 Ralph Crossen Fax: 308.740-6730 Building'Commissioner Permit no. „ , • • AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the won,abortions,renovation,repair,modernization,conversion, improvement,removal,denolidon,or construction of an addidon to erg pre-existing owner-occupied building containing at least one but not more than fbur dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Rei Estimated Cost fir) -r7 Address of Work D 0--c) /27 i 591- ✓i,'1eiv.si-0�, • 6d c Owner's Nantes ��v j e� M , Date of Application: "-A-A-, I hereby cat*that: • Registration is not required fbr the fbllowing reason(s): (Work excluded by law °Job Under S1,000 °Building not owneioccupled (Ownw pig own permit Notice is hereby given that: OWNERS PULLING TAEm OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME nveRovEmENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. • SIGNED UNDER PENALTIES OF PERJURY I hereby ly for a permit as the agent of the owner • • Contractor Name Registration No. • OR Date Owner's Name a:tbnns:Aoadav BAEISTASLE KABS. 639 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION / TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for c permit according to the following information: Location Qtr.CA Proposed Use .^(r.,^.....aL 19.Z«?^ Zoning District 5 Fire District Name of Owner Address .A.^. Name of Builder w.T*..T TA .....Address Name of Architect Address Number of Rooms ...<^Foundation ...S. Exlei-ior yf.h^...S.!:A^.r..Roofing Floors Interior Heating .K Plumbing ..l....^.....^?..5...?^. Fireplace Approximate Cost Difinitive Plan Approved by Planning Board .... Diagram of Lot and Building with Dimensions K Ok ...19 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name -fc £37^ .J 00 "0 a «^^ C; 0 CO :aJ * I'.i r—!.!j ' J i 3 i_ :3 or. ^V, -:scl 'j [—a -z:Q-:^ <^ :d u a:U3 Q PLU^ (/3 < ^. LlI h- U —J tz OJ <c Q- Hobbs,R.G.A ISC i 11970 No ....1??52_add_to_si^le__ fauiily dwelling Locati^^.^....;?^^^!!^..0.i?j.?n....Sdr.?ei: Barnstable Owner 5:...?:! Type of Construction Plot Lot Permit Granted ....?®^1:....?.19 Dote of Inspection 19 Dote Completed 19^^ PERMIT REFUSED 19 Approved 19