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HomeMy WebLinkAbout0052 HARVARD STREET �� , M ��r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map-�� 7 OF "ARN'S�TA ( �,O�SbsU y Parcel I ✓J Application # Y" " ".' Date Issued 9 y Health°Division � l ;a €► Conservation Division Application Fee Planning Dept. N4 Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address A"Y-U"9— Village Owner Address Telephone Permit Request `f Lc.,L1 4I " Cd 1.) Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family UI/ 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 A'paB-ke A a h3z Constrime ion Telephone Number P® B®x 52 Address �� st 1[1..�.a...',s, AI AD2670 License# Cell (50E) 280-6964 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE AA - FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 30—'5-72?r Town. of Barnstable Regulatory Services = Mchard V.Sesi'i,motor " ¢ Bttilftg DMsloa Tom Perry,Dwlding-Commtsdoner 200 MWu Strt Hyamus,MA 02601 w ww town.bar=tablemaas Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must CompleW.�and:$a s Sec on If Using.AB ear _ as G)a�aer:of rhe:sikJecrpxnpeny hereby authorizeQ�a�)OA) to act on MybeW . in all matters rem to work autho4 this bu&ung.permit application for. Ades§djbb�, ^''`Pool fences and ai = are the respow&ilkyof-the-a p h=t. Pools are not to be:fWed ar util�d before fence is installed and all final inspecrions an pexformed.and accepted. Sigaanue of Ov mer Sipature 0 cant Print Nam Nnt Name 'IDlo( ate i Massachusetts -Department of Public Safety Board of Building Regulations and Standards .Construction Supervisor License: CS-058633 MICHAEL J MCCAR PO BOX 52 W DENNIS MA 0267 .'"7.. Expiration Commissioner 04/10/2016 Office of Consumer Affairs and Business Regulation -- 4 0 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C©at' for Registration Registration: 169393 r = Type: Individual Expiratio /2017 Tr# 264961 MICHAEL MCCARTHY MICHAEL MCCARTHY w P.O. BOX 52 WEST DENNIS, MA 02670 Update Ad ess and return card.Mark reason for change. 20M-05/11 Address Renewal l_ j Employment 7 Lost Card l_ The Commonwealth of Massachusetts Department of lndustrialAcchlents I Congress Street,Suite 100 Boston,MA 021I4-2017 ww►umass.govAlia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Pltimbers. TO BE FILED WITH TITS PrRhimrING AUTHORITY. A Mike c ay Applicant information lease Print Lefyibly Name(Business/Organization/Individual): „O A:zz52 Address: West Dennis, MA 02670 e - 6964 City/State/Zip:_ L-586M#: HIC-169393 Are yor an employer?Check theapropriate box: Type of project(required): I. 1 am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑lam a sole proprietor or partnership and have no employees working forme in $, Remodeling any capacity.[No workers'comp.insurance required.] In I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9• ❑Demolition 4. 1 am a homeowner and will be hiring contractors to conduct all work on m 10❑Building addition ❑ 1; y properly. I will ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5.❑1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp,igsurance.l 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.90(her 152,§1(4),and we have no employees.[No workers'comp.,insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached 9n 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. lam an employer iliat is providing workers-'compensation insrtrance for my employees. Below Is the policy and fob site Information. Insurance Company Name: T M MJi,i —iy,% Co„j2s,.w Policy#or Self-ins.Lic.#: y�L �—b�i �`�(, i`( Expiration Date: 1,1 k- )11 Job Site Address: 1 —�.v� 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 certify tut tl al s nnrl allies hiry that the-information provided ab ve�i trite and correct. Si attire: Date: S/'�- 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#: a- WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMPAGE A.I.M. Mutual Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800)876-2765 NCCI NO 26158 POLICY NO. VWC-100-6017656-201413. PRIOR NO. I VWC-100-6017656-2014A ITEM 1. The Insured: Michael McCarthy Construction Inc DBA: Mailing address: P 0 Box 52 FEIN:**-***3862 West Dennis, MA 02670 Legal Entity Type: Corporation Other workplaces riot shown above: See Location. 2. The policy period is from 12/15/2014 to 12/15/2015 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000..each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 500,000 each employee C. Other States Insurance: Coverage,Replaced by Endorsement WC 20 03 06 B D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTEA 0712979 INTER SEE CLASS CODE SCHEDU E Minimum Premium $550 Total Estimated Annual Premium $29,332 GOV GOV } Deposit Premium $7,748 STATE CLASS MA 1 5479 State Assessments/Surcharges $28,601.00 x 5.8000% $1,659 This policy,including all endorsements,is hereby countersigned by 12/15/2014 Authorized Signature Date Service Office: Bryden&Sullivan Ins Agcy of Dennis Inc 54 Third Avenue PO Box 1497 Burlington MA 01803 So Dennis, MA 02660 J WC 00 00 01 A(7-11) Includes copyrighted material of the National Council on Compensation Insurance, used with its nermtssinn. \, Town of'Barnstable `' �-O& f �9 rmit# Regulatory Services �ee 6r'°" s issue date • s�xsr�sr�, ', • 9Q� i�g. �a� Thomas F. Geiler,Director - pTFD MA't� -B,>laing Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town barnstable.ma_us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMITT APPLICATION - RESIDENTIAL ONLY Not VaUd without Red X-Press Imprint Map/parcel Number (� Property.Address 1 Z ."� ? i� .�✓i j ` �� [residential Value of Work L-(t z) Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 44, J Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) PRESS pEpAfilr ❑Workman's Compensation Insurance Check one: O C T l 0 20 12 ❑ I am a sole proprietor E;�Ofam the Homeowner '.®�� LJ I have Worker's:Compensation Insurance OF BARNSTAB - LE Insurance Company Name ' Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Re t(check box) ` dam 41 Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side #of doors Replacement Windows/doors/sliders.U-Value (maximum 35)#of windows. ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.-. Separate Electrical&Fire Permits required: *where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Cowcrvation,etc, ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement. ontractors License&Construction Supervisors License is required. SIGNATURE: rl•iU7A'G'iTnc�rnDa.�rni._ti1___�yt__�,-.<,,,�.,-..� �_- � . The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeZibly el (N IIle"(Business/Organizarion/Individual): r U$_& Address:"'' z 4 V L4 ter 'Lim 9, !,J i✓D P-144 et City`/St Zip/,/9"� Phone.#: Are you an employer?Check the appropriate box: Type of project(required):. 1.❑ I am a employ er:with 4.�❑ I am a general contractor and I 6. ❑New construction . employees(full and/or.part-time).* (.f. have hired the sub-contractors 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' y p t3' mp $ 9. ❑Building addition [No workers',comp.insurance co insurance. required.]- 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions . I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions V myself. [No workers'comp. right of exemption per MGL 12.VRoof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other 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: Policy#or Self-ins. Lic.M Expiration Date: 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 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 under the pains and penalties ofperjury that the information provided above is true and correct 1 (Sign e• — 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 CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instruction 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 receiver or 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 not because of such employment be deemed to bean 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 T Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation.and, if necessary, supply sub-contractor(s)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. Please be sure to fill 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 current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in__(city or town)."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 to 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, please do not hesitate to give us a call.. The Department's address,telephone and fax number: y` .The Comzx wwealth of Massachusetts -' Department of Industnal Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. 9 617-727-4900 ext 406 or 1-977-MASSAFE � Revised 11-22-06 Fax#617-727-7749 www.masF,.gov/dia I ��s r Town of Barnstable Regulatory Services &UMST"L Thomas F.Geiler,Director y MASS. 1639• A,�� Building Division . Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print JOB'LOCATION:"".' um street village 1 � ..HOMEOWNER"' C�dd ,Jy� �(a�� a �' ' Y� J , J 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. DEFINITION OF HOMEOWNER Person(s)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 he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and regents. 1�7Signature'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 section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(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, Rules&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 homeowner 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 responsibilities 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 fomi/certification for use in your community. Q:forms:homeexempt rA °FZHE ro Town of Barnstable ti Regulatory Services MUWST"r.Fg* Thomas F.Geiler,Director 1639• Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8. Fax: 508-790-623 0 r Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit. (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date QTORMS:OWNERPERMISSIONPOOLS 6/2012 � r APPLICATION FOR PERMIT TO INSTALL AND REQUEST FOR ELECTRICAL SERVICE ~� r� 31149 � r Inspector of c. es a / /�� Wiring Permit # COM/Elect•c # Town of � ��� � Massachusetts. Building Permit # Date Customer: , L- ''� on(Street #) Lot # in the villagrof �S' utility pole number or underground number 1.G Customer's billing address Temporary New installation Change of service Starting date Job description ,40 0 odit4oO Service entrance voltage Amperage /e a Phase l Wire size(cu.or al.) iL Conductor per phase Number of meters_L__!_Water heater Off peak: YesNo— Estimated load: Electric heat kw, lights kw,Range dryer Motors, H.P.&Phase Ready for first inspection _61!!!� Ready for final inspection Electrical Contractor e2ev Lic.#nx -t3U Telephone Address Additional Remarks: Do Not Write Below This Line ELECTRICAL WIRING INSPECTION CERTIFICATE INSPECTOR OF WIRES INSPECTIONS DATE FEE CHARGE Temporary Service Roughing in ^t� Service and Meter i l u I I I 1 Mr—y)n RL�?mL I mp Off Peak Meter U M � U N m Final Approval IZ Disapproved' _ •For the following reasons—GY'oundinq at setyice—aiyd —tiwaI er to 1TP rerIItPd direct to exterior Fw/pr disconnect. Walter will complete later today CERTIFICATE OF INSPECTION4—) r Date To the COMMONWEALTH ELECTRIC COMPANY.The installation described above has been completed and has this da pected and approval granted for connection to your service nspector of Wires WIRING INSPECTOR TO BE NOTIFIED WHEN WORK IS READY FOR INSPECTION Permit Good For One Year From Date Of Issue CA 46 FIRST NOTICE TO COM/ELECTRIC r r > Y o n ►� •Ot 2 •n.0 2 O O O O O O O O O O G G n 41,44 H ro N C 71n . . . ( r• nn Aj•. ra ry A a X 4 r .r+ N z o .. o << 9x o 0 0 0 . o 0 0 0 o n IV � n 0' n n n f21 �• Y Y N b A O n C N A .. l< ►% M ••1 ••. M 1% •.. M ••. r• ry r 4 r - r � a �� .� ►^-~H A" N Q M oa+ 7 Y M O Y 0 O N X, r r p A 4 4 •1 a A O r W! n Y u pO4 a r n 00 W a n ryN m •Age Cl H /� 4 ^ Y C C C NO ( ~ rt r �' n ^ ry SC 4A ry N M 4 4 ? ^ •�+• r.r "' A A < ta G r A a C r < Y n C ?•t A M 4 x 4 Y a a a Z a r r n 4 a A A ry r M ZZ''' A t. 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BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. ---- KTYPE OF ---. . _ _______ ,-----.]�./C./� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for o permit according to the following information: � Location ....... Proposed Use -------.-----.-------~-----�----.---------------__--_______. Zoning District ----------~.------------.Fine District -----------------_________ Nomeof Owner ................................................... � Nome of' Builder .. ----..A66reu ..' ......... Nome of Architect ..........------.---.-------'A66nesu ................... --------'___. °7 Number of Room fr� Foundation ........................................................ Ex1erior -------'RooGng --- -----__--___ Floors '�� / ----,----.-|nxerio, --- _____.. _____. /7 Heating ---� ..... -------'----Mvm6ing ----- . _____.� F),op}oco --------------------------',ApproximoteCox ---.........�1................................................ DH0nitive Plan Approved by Planning Board lA----^ Diagram of Lot and Building with Dimensions , T���� p��OP/)SEF) *�ET�1{)MnF ��[}U�[����[� �\��� SANITARY— — WATER ER S[]PP[y. �E�//\r`E DISPOSAL D � � [] AN 71 TOWN OF` BARNSTABLE, ' BOARD OF HEALTH A LICENSED INSTALLER K4US7 ORTA!N SEWAGE PERMIT, AND INSTALL SYSTEM. � - � � | hereby agree to conform to all the Roles and Regulations o{ the Town of Barnstable regarding the above -construction. � NomeQ(,-Z.A�J��x�r^.. .,--------., � ' Harrington, Norma D. ' � ~^ DEC "� � x�u�� ^� 14424 dormer No ................. Permit for .................................... ^' '~ ----.----~---~-----.—.-----. . � Location ........52..Harvard ..Street ______ . Hnni —,------���.......�--.----------- � . ~ �or�u D� Owner ----..---'�`��������"...----' � Type of Construction --- r�nua -----------' . ----.—^.—.—.-------.--.------- F1o! ............................ Lot _, .. ....................... � Uqtobar 8 7I Permit Granted --------`--.�—'lg ` . . ^ ~ / ^ Date of Inspection — ~ ..�",.]P � l Date Completed ........ --�l9 � . ' . . y ' 1 ' PERMIT REFUSED' �'� ......................................................: �9 -r—— � -----'-------------''—''-----'' .--.--.---------.-----�� �..,—..� ' � � . .--------..--.------~~... �... .��—. � � ,----.-----.------.~—... ..:—.. / VI O/ Approved ................................................. 19 ` ^ � - ` ` ^ -------.------.--.—.---~`—.--- " -------`.--~---------....--..' - � . .