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HomeMy WebLinkAbout0024 LIGHTHOUSE LANE a� �.���►+tio�se I.�,� - - - - �: � - - - - - - i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION AR Map�� Parcel G! '- Application #d �- J 7(p q Health Division Date Issued Conservation Division Application Fee U Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 6 Village (a' Owner, j Address d Ix Telephone Permit Request � � �� C,Gir°r� le o yW,, / -- /ri9G�Dla/ /'e yyJ�� 12of � 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 2" Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 2lo On Old King's Highway: ❑Yes Flo Basement Type: Zfull ❑ 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: 2es ❑ 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) Names JCo�`/ �6d�P1 Telephone Number_-5'G?(F- Zzi $�f�2. Addresse8elg' License# /D.��� Home Improvement Contractor# Email � Il �C Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO'-5�,;,Ola SIGNATURE-= DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER .r DATE OF INSPECTION: c FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING G DATE CLOSED OUT ASSOCIATION PLAN NO. r4� CERTIFICATE OF LIABILITY INSURANCE 1/2i` i5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONMT NA EACT 1 The Oceanside Insurance Group PHONE (508)775-0500 aC „(508)7e0-7e55 EMAIL AD DES : 52 West Main Street INSURERS AFFORDING COVERAGE NAIC# Hyannis MA 02601 INSURER A Nautilus Ins Co INSURED INSURER B.Amguard Insurance Company RS Jones & Associates, Inc. INSURERC: 206 Cedric Road INSURER D: INSURER E: Centerville MA 02 632 INSURER F: COVERAGES CERTIFICATE NUMBER-CL151203603 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 D L S SR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence % 50,000 A CLAIMS-MADE OCCUR 508088 12/18/2014 2/18/2015 MED EXP(Any one person) $ 10 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ Include X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINEDccident SINGLE LIMIT Ea a ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Paraccident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ B WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICERWEMBER EXCLUDED? N/A (Mandatory In NH) 2WC526'115 12/11/2014 2/17/2015 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. "For Insured Purposes Only" AUTHORIZED REPRESENTATIVE C Murray CIC/MC ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS095 r�n�nn�t m Tha Arnion noma anil Inn^mra raniafararl mmAre of ArnDn CERTIFICATE OF LIABILITY INSURANCE �ATz� -' i2/.23/2ala THIS CERW(OATE is Is$URC .AS A AMAT701 OP INFORMATION ONLY AND CONFERS *0 RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OIL .NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICE BELOW. THIS CERTIFICATE: OF INSURANCE DOES .NOT CONST[fUTE A CONTRACT BETWEEN' THE ISSUING INSURERiS), AUTHORIZED � REPRESENTATIVE GR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; ff..the certiRca" holder 19 an P DOITTONAL fN9URE0, pDiieyl1081 must be ettt941'e c!• If' :kUBROGATION 15 WAIVED, suUJaet to �(( the terns FT114 Conditions of the policy, Geftdin policies may rBrlUire an endorsement. A stetemsnt On this cetHficate does not confer dgfiffi to tnt cortiNcato"alder in lieu of such ondor e.mengs), PRODUCrn - gAWK10'. FAaL. SCHLXGEI, SCHLEGEL, INSURANCE BROKERS I1 C S:OtI-7?1-83@l "c Mon5Q8-771-11&63 r 3C8LEt`yELT.pT$tiR1AtQCEa6tIL,COM WEST YAfMtYTK ba 02673 _ I�i1RLRIRnA�ogt�0=souaRAaE Nnrte 4aMW RA.PR>>: XX MUTUAL, INSURED— llisunt a eACE AMERICAYt• ' F'l*vl.o Figueiredo g4WERe: -. 20 Reed Sg�t u+aurtrRc, Ik3UR8R l:: _ West Yasmou�4, MA 02673 r+suRERr; COVERAGES. CERTWCA i E;.NUMBER: REVISION NUMBER; THIS 6 T.O: CERTfFY THAT TH PQUCIES:.OF-1W}URANCE USTEO SVLO HAW BEEN ISSUED TO THE INSURED- fZWED ABOVE ;;OR THE POLICY PERIOD INDICAMD, NOTWITHSTANDI" ANY. REQUIMFMuNTi TERM OR CONO;TION OF- ANY CONTRACT OR OTHER DOCUMENT' Ain.4. RESPECT TO I>NGN THIS CERTIFICATE AlAY D@ ISSUED OR tAlAY PERTA�l�. THP INSVRANCE A<fORDED BY THE POUvF,B Qd_$CR(EEO HEREIN SS SUBJECT TO All 1i TERMS. EXCLUSIONS AND CONUMCINS OF SUGH PUL;CfES,IiviTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAJMII , FfA3R ampa3ir'� `" tlklnT'r lTR rYPE OF NrrWSAP'CE tN9q•1rPfD{ - POUCYfi WWII p'MUfY" Ih7+4�f afr(w] t CENERAL LIASIL" # CPF8"119262 08/10/201 08/z012015�Ea.N� t.RECICe a 1,000,000 p n SIl,a00.. t.g�COAEt,4ERotMaRNEgaiunBkrTY t ' *�Mu^GSt'nanmre, _ y r� �.. It�LXp4Ar"arN+„c�m � 5;fl00 (an,tas•lwAaE 1�..1 ocCUR ; � -� � , w _ E �pE_FaorLenDVitaRY a 1,000,000 . # � (aEs�P�u: s:eirE s 2.000,000 e ff•M.A[3OR64��h"`TE C12f#T AFP:IE6 P'>;R: � �l7UCT9•C.QPAflOP Ano 9 2,4Oa T 000 - POLICY I:�PRP... El 4 .. .. y AUT01MOILC UAIIJIM S t i aA:t`ANni _ S . —ANY AUTO 3 SOMY iN URY Pill persoat t ntlOalNfD p' ��CNEDLIIlrtD 3 � � � i E�32+7tt>It.YHfPJRYIPn<nsflufmm� ` 1 AUTOS i 7 a, 1 I ti0tti.4YiltlLD I v FeFfiO AUTOS .i AL'TCf mat acdd;nt! EISCEG8 LUIB _. ."1�A1khi•Tt� y ,. t]ED R&tKtt>a S -��^-��� $ wDRK FiN9ATfO51 j6s62UB-8P83268-9-13 11/26/2014111/2d/201 ioR"I'll s `fa 9 1 AND EMPLOYER,'LiADiRITY VIM # 1 - - . AWPfWRl6TO"ARTNERMX9W NT j Eel EACH.AcG+Ge s 100,000 r c,x D�R>aaEs lB q F.XMUDE07 . i n�4t to !' fatmato.Ttnn+q �111f 11 `.l.�ls'AaE eAEuvwYEE s 100,000 If 5l dusanm unG t y - DEr,C-Sl IONOFOPERATIONSImim .� ..� - �. _ ; E1,DiSrAsp Poll VtLi,17 �s 500,000 DEG:RIPT!ONOs•OPERAT/ML9JLOb.ATKlN9/VEa.Rd.E9 tAtWh 40;00 fol.Ad>f3AoilalRamnlP{.3ehnJtRn.Irmma sDsw is'M- Itmfll - - i3LAZTIO E'TGEIREDO' RAS EX.EC'd'1~D t;OT T:) BE COVI R;ED I MDER HIS CURRENT WORKERS MWENSATION POLICY . I CET471FICATE HOLDER. . CANCELLATION A.S. ions s ASsocu►TS SNAfJi.D ANY OF TNk ABOVE DESCftiB[D POLICIf.9 8E CANCflILED BEf-0RS 2.06 CEARXC ROAD TN@ EXPIRATION DATE TMERE13F, NOTICE WILL Be DEWERED IN . R .. ACCMANCE VA"T"E POLICY FRf1 UORS, C$tiyTERviLd+$ � 02632 . . - AUT110RRED gE'PRGDCNTATNE - 77a-228-2458 t 0170' i A D CORPO - N-•A tights t"Mod. ACORD:25(201010 , The AC.ORP.Mme and Logo'ara,M91stered marks of ACORD * snsxsrnsis, 9 3-9. Town of Barnstable Regulatory Services Richard V.Scali,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 k as Owner of the subject property hereby authorize -T o ric-s to act on my behalf in all matters relative to work authorized by this building permit application for. i (Address of Job) } Stgnature of Owners Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 j . f -\ 2Tie C'omrRoyriveakh of- assachnsetts Deparhme it�t,f r'xr&zsfrial Accidents Office of Inveshkations. 600 Washhzeou Street Barston,MA.02111 4 i BR at nias g4vvldla Workers' Campens3lion Insurance Affidavit:Bmldei-s/CantractarsJEIectricians/Plumhers Applicant Inf n-matiGn / Please Print I.eaffily Tame(Bus�eesst�drganQatianffndzlual 310�7` L DO /7��" Address:A�4- Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4 [y I am a general contractor and I 6. ❑New consttuc ic'm employees(full andlorpart-time).* /` 'have lrired the sub-contractors 2.❑ I am a sole proprietor orpartner listed on the attaphed sheet, ?_ IffRemodeliqg ship and have no employees . These sub-confractars have S. ❑ emolition working fear lYie_in any capacity_ employees and have woad:ers' [No worb--rs' camp.insurance camp-insuran # �. El Building additioas required.] 5. ❑ We are a corporation and its 16 0 Electrical repairs or additions 3.❑ I am a homeommer doing all viwk offaceas have exercised their IL 0 Plumbing repairs or additions myself-[No workers'tip. right of exemption per MGL 12.0 Roofrepairs inmrranre required.)1 c.152,§1(4)6 andwe have no employees-[No workers' 13-0 Other camp_insurance required_] `Any spp&zrit:that checks box R mast also fill out the section below showing tree woAere compensation pufhcy informsdom a:,me..M wbo submit this afS hnif=&cxtag they axe doing all wal snA then hie outside contractors most subxuit a new afHda indicating sa[b.. ICo I tors that check ibis boat must attached an.additinhml sheet showing the muse of the sdb-contractom and state whether ar not these entities hme employees.Ifthesi b-coattrachnshave employees,they must provide tlak workers'camp.policy cumber- I ant ait erliploy�rr flea#is pra><aziing workers'catrt tsrrft'art i�rstuattce for wry*enrplvj�ees $etov is the plrlicy and1ob site tttforrrra om Insurance Company Name: Pahcy-or Self--ins.Lic.A: F-Kpiration Date: Job Site Address: City/StaW2e p: Attach a copy of the workers'coampeansationpolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required.under Section 25A of MGL c 1572 can lead to the imposition of criminal penalties of a fine up to$l,SOD OD and+'or one-3,cairimprisonruenk as well as civil peualties.ui the form of a STOP WORK ORDER and a,fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations o€the DIA.for insurance coverage i,uffiscation. 1 de itt'retiy c acid�OfperjhtytJie ir>fenrratiei><ptm-irTedai�imra is trtr$a�td arrrert Si Date- Phone 0. 7 Z_ 1jokid use anly D747 net ovate ut this area,to be arrnpfeted by city artoc4w rjokiat City or T'awn: PermitUcense# Issuing Anthar€ty*(cn de one):. L Board of Health 2.Building Department 3.City1rown.Clerk 4 Electrical Inspector S.Pimral>mg Inspector 6.Other Contact Person: Phone#: ormation and Tastructions Massachusetts General Laws chapter 152 rcqunes an employers to provide wormers'compensation far their employees. ptD this statate,as employee'is defined as`�-.every person in the service of another under any contract of hire, M=texpress or implied,oral or wrhtm" An e2rprQye2-is defied as"an individual,partnership,association,corporation or other Iegal enthy,or any two or more e foregoing is a joint enterprise,and including the legal representatives of a deceased employer,or the of th egomg engages - - rmeiver or trustee of an individual,pmt ership,assoclaison 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 occ¢pant of the - dwelling house of another who employs persons to do mainfenaace,construction or repair work on such dwelling house or Oj:L the grounds or building appmtena:nt thereto shall not because of such employment be deemed to be as employer" MGL chapter 152,§25C(6)also staf�s that"every state or local Rcens$g agency shaII'e�ithllold the issuance or renewal of a Hcense or permit to operate a business or to construct bufldings itt the commonwealth for any applicant Who has not produced acceptable evidence of compliance with the insurance cove7rage required." Additionally,MGL chapter 152, §25C(7)states-Neither the commonwealth nor any of ifs political subdivisions shall enter m.io any contract for the performance ofpnblic wozic uafil acceptable evidence of compliance with the insurance._ requi mments of this chapter have been presented to the con[acfmg aothozity_" Applicants Please fill out the wormers'compensation affidavit completely,by che+-ld:ag the boxes that apply to your sitnatron and,if necessary,supply sob-contractor(s)name(s), address(es)and phone number(s) along with their certificates) of i nu-,ice. Liznite-dLiability Companies(LLC)or Limited LiabMtyPartmerships(LLP)withno employees other than tine members or partners,are not required to catty wormers' compensation insm-ance. If an LLC or LLP does have employees,a.policy olicy is required. Be advised that this affidayit may be submitted to the Department of Industrial Accidents for conffimalion 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 En-d stri ai Accidents. Should you have any question regarding the law or ifyou ace requited to obtam a workers' compensation policy,please call the Department at the number listed below. Self-fimnz-ci companies should enter their self-fi sora•nce license number on the appropriate line. City or Town Otfirials . t Please be sore that the affidavit is complete andprirted.Ieginly. 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 m frill in the permit/license,number which will be used as a reference n=ber. In addition,an applicant that must submit mvltrple permit/Iicense applications in any given year,need only sobmit one affidavit indicating cuLent policy ia. mation(if necessary)and under"Job Site Address"the applicant should write"all locatives in (city or 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 fufine permits or licenses. Anew 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 76ntnm (Le. a dog license or permit to bum.leaves etc.)said person is NOT reqahed 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 -'Iae Deparfinemfs address,telephone and fax number_ 'fie of Massarh se±#s . Degarfinent cif Iudutciat AocZents �Q��as�ingtan St�e� Fax 9 617-727 7749 Revised 4-24-0 7 i R.S.Jones &Associates inc. PROPOSAL 206 Cedric Rd Centerville,%4A02632 Ph.508-221-8572 Fax,774-228-2458 DATE:8/6/2015 TO: FOR: DIANE MONTGOMERY KITCHEN REMODEL 24 LIGHTHOUSE LANE HYANNIS,MA 02601 Description: Units Amount Total Kitchen demo and remodel $23,000.00 1.Demo entire kitchen at 24 Lighthouse Lane&Re frame as needed. 2.Install New the flooring in kitchen area 3.Install windows in new locations 4.Install cupboards and cabinets per plan by Botello Lumber Company 5.Install all appliances and make ready for countertop by others 6.Install trim to windows and kitchen 7.Finish all affected sheetrock and paint all in owners choice of color. *R.S.Jones&Associates Inc.to supply:Plumbing/Electric/Insulation/ Sheetrock/trim/paint/framing materials/dump fees/permit fees and all labor. *Homeowner to supply:Tile/All Kitchen materials/appliances/fixtures and any other items to be installed. *All workers covered by Workman's Comp and Liability insurance Terms: 10%deposit along with signed proposal 2300.00 50%of balance at commencement of Tile 10350.00 50%of remaining balance at commencement of kitchen 5175.00 Balance due upon completion to customers satisfaction. 5175.00 Total proposal T°arR you for choosing R.5.1o^es&Associates 1-1c. $23,000.00 Accepted by Date: �o � � � � � � Assessor's map.,and lot number .............:......e.................,,.... yoFTNEro� SEPT Sewage Permit number .... L». INSTALLED�YSTEI�A ��� d �� IN COMPL Z f WITH TITLE sTanLa, House number .............................................. rasa � ENVIRONMENTAL CO[DE eAra`� TOWN OF BARNSTTABU BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................. �'`'`'.... ... ..................................... TYPE OF CONSTRUCTION G -'r......... .......... ................ ........................................................... . ....... .... ..... ... .............. 19 /�............ . :� ! TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �6.. 3Location ......... ..... ...�,..: ............ i..... .. ............. ProposedUse ......... �G �! "6k'';-.........................:................................................................................................... ZoningDistrict ......If................................:......................Fire District ..../ ........................................................... Name.of Owner ��- ' ........................Address .l'.:.`�......... .79 �........ Name of Builder ............ .. ............Address ........ ...... art :....................................... 104 Nameof Architect ..................... ........................................Address ......................... ...:.........:................................. Numberof Rooms ....... ........................................................Foundation ...........................................`..�...:........:-:.......... Exterior ......°..l�!� t `-aP ............Roofing .... ................................................................. Floors .............Interior ..... .. .. ... ?( :4.!.............................................. Heating ... ., ......................................Plumbing .......... .................................................................... Fireplace .......................................................Approximate Cost ..........� �.................... ........................... ............... Definitive Plan Approved by Planning Board -----------_______-----------19________. Area ....r���...................... Diagram of Lot and Building with Dimensions fee .... .. -e.......................... SUBJECT TO APPROVAL'OF BOARD OF HEALTH . V' d13 ��qj r * 4 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 01 Name ..... ........................ ....................................... Construction Supervisor's License ......... ROGERS, JOHN No 25546 for .ADDITION....... . . . r S.ingle..Family...Dwelling.............. , Location ...........................o ghth9use..Lane.•. ................. Y.annis.......... ......... ........ ............ Owner., Johns Rogers.......... r �• Y'. ~ el Frame Type o, .Construction .................... , r. j ...........r ... .................. t ..... ........ Plot ... ....... . ......:. Lot.- ..... .... Permit 'Granted ....15.,`............... 19 83 Date of,Inspection_ ........ .�...........; ....19 ° Date Co 19 . .e' �' 204 c,2 //� Assessor's map and lot number ..................................... ..... Sewage Permit number } Z BARNSTABLE i r House number ....... ...�................................ 9� 639 �o MAI A, 0 TOWN OF BAR T . NS ABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...........j't ? �::'.�� : :.��::.......:�:....:: ��. .:............................................. TYPE OF CONSTRUCTION ....., .f:''. ...................................... .................................................. r y f ....::`.: ::: :............... ........19..... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... ............ :ir -[....... C:e :................. '.::..::: :`.::: rj .:.` ..... !7... ............. � Proposed Use ..........;� b: ....:." .-::. `..::...c.,.............................................................................................................................. Zoning District ...... .............................................................. ... .._....................... ......._Fire District .... ...,.�........ .......... .:............ Name of Owner �:r...... :: ........................Address `...... . ��• '..........4......f.........` .............!......... Name of Builder %` ` ..''.. "��" `/ �' �` � Address !. ..... :!� `. �` i � r t x l ............I.. ............. .............. . .. . } r Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation .. :. . .`.......`............. ... r.......... L`....................... Exterior .........: ...................... .... . .................Roofing ....i....... .. ................................................ 1 / t ' Floors .... {.:� ..............................................................Interior ..... f cd•....sL ( :............................................... P Heatingfir`::'....... .. r.:...... .:.....................................Plumbing .....................................:...........................................: Fireplace ..................................................................................Approximate Cost .......... /.'1�0, r .................... ............... Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ......-� .✓� ...... Diagram of Lot and Building with Dimensions Fee . ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ,L p t OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. _ Name ..... f cft.............. h.:�: . ` ` '.:`:... ............. t Construction Supervisor's License ..................................... ROGERS, JOHN A=306-245 No -.2.5.5.4.6.,.. PP I.t for .APIUTTQN............. Sin le a XY...aw.e.I.I;Ln.g........... g ....................................... -g 214 Location ...Ljot-.37...Li.glithous&...L -ne— ..................Hyaxlaiz.............................. ....... .... John Roger Owner .............................s..................... ... .. .......... Type of Construction ......Frame....................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ... ..............19 83 Date of Inspection ....................................19 Date Completed ..... .................19 7e �� � .