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0189 LONGVIEW DRIVE
Town of Barnstable Building �rr hat it is Visible From the Street A roved Plans,Must be Iteta N This Card So T v. ned on"Job and this Card'Must be Kept i `Post Posted Until Final,lnspection Has Be!na ade Permit 1M ,16 Where a Ce" ' p Y. q4 .Y „g 1 el mit rtificete,of.Occu `enc is Re cared, uch Buildin shall Not be Occupied until a'Final Inspection has been`made. Permit No. B-18-1051 Applicant Name: Dana Pickup Approvals Date Issued: 05/01/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/01/2018 Foundation: Location: 189 LONGVIEW DRIVE, HYANNIS Map/Lot 251-083 Zoning District: RC-1 Sheathing: Owner on Record: HALL, RICHARD M&LAUREN E WOLK - Contractor Name: DANA J PICKUP Framing: 1 Contractor:License CS-095228 Address: 189 LONGVIEW DR 2 CENTERVILLE, MA 02632M a - � Est;Project Cost: $9,440.00 Chimney : Description: roof strip and reroof Permit Fee: $48.14 A' ;� Insulation: AN Project Review Req: Fee Paid $48.14 �._ Date. 5/1/2018 Final: " ��° �� �+ Plumbing/Gas * Rough Plumbing: r Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzecl bythis permit is commenced within sizironths after`issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which thi's permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures`shal[be in compliance with the local zoning by-lawsrand codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. *" " -, Electrical nntrEThe Certificate of Occupancy will not be issued until all applicable signatures by the Bu1ldmg and Fire Officials ares provided on thi permit.The Minimum of Five Call Inspections Required for All Construction Work: n W q ' 1.Foundation or Footing mh. Rough: 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT I Town of Barnstable Mnlffl � ,y 4 KAS S 200 Main Street, Hyannis MA 02601 508-862-4038 s439 .. Z, �a A lication for Building Permit ' �� pp g Application No: TB-18-1051 Date Recieved: 4/10/2018 Job Location: 189 LONGVIEW DRIVE,HYANNIS Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: DANA J PICKUP State Lic. No: CS-095228 Address: Fairhaven, MA 02719 Applicant Phone: (508) 997-1111 (Home)Owner's Name: HALL,RICHARD M& LAUREN E Phone: (508)862-2699 WOLK (Home)Owner's Address: 189 LONGVIEW DR, CENTERVILLE,MA 02632 Work Description: roof strip and reroof Total Value Of Work To Be Performed: $9,440.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Dana Pickup 4/10/2018 (508)997-1111 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $9,440.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $48.14 4/10/2018 $48.14 XXXX-XXXX XXXX Credit Card ....._._-... . 1508 Total Permit Fee Paid: $48.14 Town of Barnstable *Permity( C7�3 ° ��� Regulatory Services Fee 6 "` MIT 39, ��� Thomas F. Geiler,Director l 8 2012. _ Building DivWon Tom Perry,CBO, Building Commissioner TOWN OF BARNSTAB� 200 Main Street,Hyannis,MA 02601 www.town barnstable.ma us Office: 508-862-4038 Fax: 508-790-6230 E_URESS PERMIT APPLICATION - RESIDENTIAL ONLY. Not.Valid without Red X-Press Imprint Map/parcel Number J Property.Address l T �idential Value of Work _ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address C-04 A Contractor's Name Telephone Number !;I—ll// Home Improvement Contractor License#(if applicable) S Construction Supervisor's License#(if applicable) "oran's Compensation Insurance .Check one: ❑ I am a sole proprietor ❑ I am the Homeowner have Worker's Com nsation Insurance Insurance Company Name Workmen's Comp.Policy Copy of Insurance Compliance Ce cate 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) �e-side' - #of doors ❑ Replacement Windows/doors/sliders.U-Value (maxmnun 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,Conservation,etc. ***Note: operty Owner must sign Property Owner Letter of Permission. A copy of the Home ro ment Contractors License&'Construction Supervisors License is i require SIGNATURE: Q:IWPFIIMV Slb U&g permit forms02RESS.dec The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations + d 600 Washington Street Boston,MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leizibly Name(Business/Organization/Individual): . frZY- Ad&ess: iJ� City/State/Zip: i%m Phone.#: Are you an employer?Check the appropriate box.: Type of project(required):_ . . 1, 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 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. modeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY• $ 9. ❑ Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their + 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof 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. 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 wo ers'compensation insurance for my employees. Below is the policy and job site information.. Insurance Company Name: Policy#or Self-ins. Lic.#: C 3 -7 Expiration Date: Z / G/� Job Site Address: Q 7 `' 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. a d y against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investi a ' ns of We DIA for insurance covera cation. I do reby ce r nand a ' s erjury that the information provided above is true and correct Si ature• Date: one#: 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 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 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 wont until-acceptable evidence of compliance azth 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. 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: The Commonwealth of Massachusetts Departmimt of Industrial Accidents Office of Investigations 600 Washington Street Boston, lA 0211.1 Tel. ## 617-727-4900 ext 406 or 1-$77-1VIASSAFE Fax##617-727-7'749 Revised 11-22-06 www.mass.gov/dia Town of Barnstable ti Regulatory Services 9 I E'�* Thomas F.Geiler,Director s639 1m Building Division Tom Perry,Building Commissioner 2.00 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 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 Q:FORMS:OWNERPERMISSIONPOOLS 62012 tKKE ray, Town of Barnstable Regulatory Services ' sz�s Mr.s, Thomas F.Geiler,Director snxtv 9 p g Building Division . TfD MA't Tom Perry,Building Commissioner 200 Main 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. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to xeside,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 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 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 y 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 forn-/certification for use in your community. Q:forms:homeexempt Client#:33723 CAREF ACORD. CERTIFICATE OF LIABILITY INSURANCE gi,;,012 rn 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 CONSTn UTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:Nthe cerliflaW holder Is an AD INSURED,the pol"Iss)must be endorsed.If SUBROGA17ON 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 llau of such andore ment(s). PRODUCER Herlihy Insurance Group Inc. NAM ENE .508 756-5159 51 Pullman Street c No:508-T51�747 Worcester,MA 01606 ADDRESS: 508 75"159 cuslw�R ID t INSURERS AFFORDING COVERAGE MAX:• INSURED Care Free Homes Inc INSURER A:Peerless Ins.Comp. 239 Huttleston Avenue INSURER B:Interguard insurance Company Fairhaven,MA 02719 INSURER C:Safety Indemnity Insurance Comp INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER- 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 SEEN REDUCED BY PAID CLAIMS. INM TYPE OF INSURANCE :F POLICY NUMBER MMDNYM MMWfYM LIMITS A OENERAL LIABILITY CBPO929704 /01/2012 0910112013 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREMLSES $100 000 CLAIMS-MADE Fx]OCCUR MEDEXP(My aro n) $15 000 X BVPD Ded:250 PERSONAL&ADV INJURY $1000 000 GENERAL AGGREGATE s2 000r000 GEML AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPlOP AGG s2,000,000 POLICY PROJECT- LOC $ C AUTOM081LE LIA84J Y 6213850 7101/2012 07/01=13 COMBINED SINGLE LIMIT (Ea accido t) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(PeraocWeM $ X SCHEDULEDAUTOS PROPERTY DAMAGE s X HIRED AUTOS (Perms) X NON-OWNED AUTOS s s UMBRELLA LIAR OCCUR EACH OCCURRENCE s EXCESS LIAR CLAIMS-MADE AGGREGATE s DEDUCTIBLE f RETENTION Ss B AND COMPENSATION LCAWC359478 /01/2012 09/01/201 X PR OT" ANY PROPRIETORIPARTNER/D(EC AGILITY YIN NI E.L EACH ACCIDENT $1 000 000 OFFICERIMEMBER EXCLUDED? (Mande m in NMI E.L.DISEASE-EAEMPLoYEE s1.000 000 I ae or&umnONSbelow E.LDISEASE-PoucYLIMIT s1000000 DESCRIPTION OF OPERATIONS I LOCATIONS)VEHICLES(AfhM ACORD 101.Addlllaial Remarks Sdadele,R mwa apses In nquked) CERTIFICATE HOLDER CANCELLATION 30 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIWNS. Building Department 367 Main Street AMORNZED REPRESENTATIVE Barnstable,MA 02601 0 00811400 Aj5ORD CORPORATION.AN rights reserved. ACORD 25(2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD 111856621/M56619 P82 OFFICE: (508) 997-1111 ;; MA. Builders Lic. #021330 FAX: (508) 997-1297 RE FREE Home Improvement TOLL FREE: 1-800-407-1111 floWmesinc. Contractor's License WEBSITE: #100503 MA. www.carefreehomescompany.com 239 HU17LESTON AVE. (RT 6) • FAIRHAVEN, MA 02719 #15179 R.I. NAME W dx •,� r4&, L( DATE ADDRESS .LL ,14e-4 �E � ' ` 1at�✓1��-� ZIP CODE z ADDRESS OF JOB,_ JOB DESCRIPTION S rioff -` �I Lo %lc Scheduled Start / �6�5 Scheduled Completion_&'k A. Replacement of missing or rotted lumber is not included unless specified. B.All start&completion dates are approximate and could change due to weather conditions. C. Stripping of roof includes removal of up to two(2)layers of shingles, ch additional layer to be charged @ . ft2. D. Replacement of rotted roof boards/plywood to be charged @ ft2. E. Exisiting chimnet flashings will be reused; replacement, if necessa , is not included. F. Care Free Homes, Inc. is not responsible for mold/mildew conditions that are pre-existing or result from leaks not brought to the attention of C.F.H., Inc. promptly. The Company hereby proposes to furnish labor and material to complete the above work for the amount herein. Fulfillment of this order is contingent, however, upon the want of strikes,fires, and any natural disasters,the ability to obtain materials,or any other conditions beyond the control �of�the Company. Cost of Project$ PAYMENT TERMS Date 1. You,the Owner may cancel transaction at any time prior to midnig of'the third business day after the date of this transaction. 2. You,the Owners agree to pay any and all expenses incu y Care Free Homes, Inc: in collecting money due under this contract and enforcing the terms of this contract, includin not limited to, reasonable attorney's fees, interest and court costs. NOT SIGN THI NTRACT IF THERE ARE ANY BLANK SPACES CARE FREE M INC. CEPT Buyer acknowledges Owner: Aa By: receipt of fully completed copy of this Areement Owner: All contractors and subcontractors shall be registered by the director and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration One Ashburton Place, Room 1301 Boston, MA 02108 Tel. (617)727-8598 Massachusetts-Department of Public Safety f Board of Building Regulations and Standards I Construction Sulicrn isor License: CS-095228 s E DANA J PICK 19 HAMLETS- T. Fairhaven M 02119 I Commissioner Expiration03/22/2014 • � �e eporr�nyeaizcuea�C�o�6�aac�uaetG� I , ffice of Consumer Affairs&Business Regulation License or registration valid for uitllvidul use only ME IMPROVEMENT CONTRACTOR f before the expiration date. If found re&,trn to: . _ I Office of Consumer Affairs and Busmess'll'egulation egistration:100503 a T e YP 1.0 Park Plaza-SuiW5170 Expiration�j61'9/201'.4 Supplement and H i -., Boston,MA 02:1f6 CARE FREE HOMES GNC i, I DANA PICKUP JR (,s ! 239 HuWeston ave i Fa.irhave'h, MA 02719 Undersecretar y Not valid.without sig a _e h - i Q O 10 O ' -70 Town of Barnstable *Permit# Expires 6 mon[ rom�ssue date anxxszner.E, : �1 6 ILA Regulatory Services Fee ,MASS ,��' �RNCJ' ABL�� Thomas F. Geiler,Director ,eT E A pF Building Division Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address—M Y1 vi b F. P [Residential Value of Work /` -1f0vt k-10 Minimum fee ofJ$35.00 for work under$6000.00 Owner's Name&Address lyq CCn&-f-VI lie Contractor's Name daA4 Telephone Number S-09 - qq 7 Home Improvement Contractor License#(if applicable) r'©('�Wit) Construction Supervisor's License#(if applicable) [(Workman's Compensation Insurance Check one: ❑ I am a sole proprietor Ham the Homeowner , have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# CAVtl e 11?q`Za 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) ❑ Re-side #of doors Replacement Windows/doors/sliders. U-Value c (maximum .35)#of windows Cr 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. L ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the H Improvement Contractors License& Construction Supervisors License is req fired. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 072110 I r� The Coninwirwealtlr of Massachusetts - --- Depa7rtme7rt of Industrial Accideir_ts r= Office of Investigations ' 600 Wa 5hingtort Street Boston 314 02111 Nwhmniass govIdia Workers' Compensation Insurance AffidaNit: Builders/❑ontractors/EIectiicrtIIsfPl,umbers Applicant Iuf€rmatian Please hint Legibly . NaMe.(BMjness/Orgxuzation/lndividual): ( /fire-. /'rr e- f[O/Me Address: 7-01 &IdleSkn 14ye- CitylStatelZ p- �Qi f l AA Vif Phone#_ 6-0,ff 9qr71111 Are you an employer?Check the appropriate box.: Type of project(required) 1.IM I am a em p '� ❑ I am general contractor and I p 5 6. ❑New construction employees(felt and/or part-time).* have hired the stab-contractors 2..❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition avorking :for me in any capacity. employees and have workers 9. ❑Building.addition' [No workers' comp.insurance comp.iiasurance,t required] 5: ❑ We are a corporation.and its 10.❑Electrical repairs or additions 3.❑ I am a.homeowner doing all work afficers have exercised their 11.❑Plumbing repairs or additions o workers'co right of exemption per��GL ml'self. [N mP• 12.0 Roof repairs insurance required.]T c. 152, §1(4),and we have no employees.[No workers' 13.❑ Other comp. insurance:reguuired.] •Any apphicaw th si checks box#1 must also fill out the section belm showing ih eir wor&ers'compensation policy infonmtean- Y Homeowneu who submit this affidavit indicating they are doing all work and then hire outside contractors artist submit a new affidavit indicating such: ;Contractors the r cback.this box must attached ant additional sheet shtomag the name of ilia sub-cormtractors and stage whether or not those eadries have employees. If the sub-€ontzactors have employees,th<eyurust.pmuzde their workers'comp.policy number, I atn. art elnplc0 r r tdiat is pro nd rug rtrorlrers'a aiirpertsrrtieart iatsttrattce for rr y eratpdarj=ees. Be'lott is trite policy avid job.site informatiom 1 Insurance Company Name: In TEI'- Vn Policy iftor Self ins.Lic.-9: CAW C Expiration.Date:: Ibo job Site Address: trl Vt e j,S City/state/zip: t i4 rr-V a lie z /44. 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?5A of MGL c. 1.52 can lead to the imposition of criminal penalties of.a fine tip to$1,500.00 andior one-year imprisonment,as well as civil penalties in the forum 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 c9xVage verification j'do herekyi c tandem e pains a en as a ury that the irtf®rruation provided aboire is trace and correct Si, lure: Date: Phone#: i Offi-ciatd use only. Do not write in this area.,to be completed by cioF or town offildiaL City or Tomm: Permit/fAcense Issuing A.uthw ity(circle:one): 1.Board of Health ?.Building Department 3.Cityllo-vim Clerk 4..Electrical Inspector §.Plumbing Inspector d.0ther Contact Person: Phone#: OF ZHE Tp� > BARNSTABLE, MASS. Town of Barnstable i639• ��+ ' plfD MA'S A 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 , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized-by this building permit application for: ` (Address of Job). Signature of Owner Date 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 070110 i 1 V 11 Al Va LLLa aavILI94 aV SHE x " Regulatory Services v sAxrrsrasre Thomas F. Geiler,Director MA & �639. A��� Building Division TED MP'1 Tom Perry,Building Commissioner 200 Main 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. 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 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 section(Section 169.1.1 -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 form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC Massachusetts- Deparhncnt of Public S;fetY Board of Btiildin!- Regulations ;in([ Slandards. . Construction Supervisor License License: CS 83166 Restricted to: 00 NATHAN J PICKUP 239 HUTTLESTON AVE FAIRHAVEN, MA 02719 Expiration: 1/18/2012 - ('ununissiuncr Tr#: 13584 :..�.. ✓lze 1�o7nmzomurea`Cl a�,/f/�aaeag�u�aetCa _.___—__ ._. -------- Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: Registration sx 100'503 T . ' Office of Consumer Affairs and Business Regulation Type: 10 Park Plaza-Suite 5170 Expirafions ,gj191212 Supplement Card CARE FREE HOMES„WC Boston MA 02116 NATHAN PICKUP.. ' ,'t 239 Huttleston av� _ At Fairhaven,MA 02719 Undersecretary Not valid without signatu e f!� Client#: 33723 CAREF +' DATE(MWDD/YYY`/) ACORD- CERTIFICATE OF LIABILITY INSURANCE 09/02/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Herlihy Insurance Group Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 51 Pullman Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester,MA 01606 508 756-5159 INSURERS AFFORDING COVERAGE NAIC# INSURED Care Free Homes Inc INSURER A: Acadia Insurance Company INSURER B: Interguard Insurance Company 239 Huttleston Ave INSURERc: Travelers Insurance Company Fairhaven,MA 02719 INSURER o: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MWDD Y LIMITS A GENERAL LIABILITY CPA026567411 09/01/09 09/01/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEPREMISES(Ea occu ncel D $250 OOO CLAIMS MADE N OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $Z OOO OOO POLICY PROJECT LOC C AUTOMOBILE LIABILITY BA7011NS4709SEL 07/01/09 07/01/10 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000. ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSfUMSRELLA LIABILITY EACH OCCURRENCE $ :. OCCUR CLAIMS MADE .. AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND CAWC917429- 09/01/09 09/01/10 X WC STIATUMIT HER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1 00O 000 OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE 0,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1 000 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL .1 Q_ DAYS WRITTEN Building Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 367 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Barnstable,MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #M38934 B2 0 ACORD CORPORATION 1988 OFFICE (508) 997-1111 ®° MA. Builders Lic. #021330 FAX: (508) 997-1297 CARE FREE Home Improvement TOLL FREE: 1-800-407-1111 Contractor's License WEBSITE: eS Inc• #100503 MA. www.carefreehomescompany.com 239 HUTTLESTON AVE. (RT 6) e FAIRHAVEN, MA 02719 #15179 R.I. NAMEl1n - 1r4l DATE ADDRESS v ZIP CODE Q ADDRESS OF JOB TEL JOB DESCRIPTION clime lJ�-�/L, /tom c S 1 Sf <A5 -4/,- C f: (A"a"J C,4��rt,& Scheduled Start _Art,�� Scheduled Completion A. Replacement of missing or rotted lumber is not included unless specified. B.All start&completion dates are approximate and could change due to weat er conditions. C. Stripping of roof includes removal of up to two(2) layers of shingles, eac diti0nal layer to be charged @ ft2, D. Replacement of rotted roof boards/plywood to be charged @ ft2. E. Exisiting chimnet flashings will be reused; replacement , if necessary, is of included. attention of C.F.H., Inc. promptly. F. Care Free Homes, Inc. is not responsible for mold/mildew conditions that are pre-existing or result from leaks not brought to the The Company hereby proposes to furnish labor and material to complete the above work for the amount herein. Fulfillment of this order is contingent, however, upon the want of strikes,fires, and any natural disasters,the ability to obtain materials, or any other conditions beyond the control of the Company. Cost of Project$ �� PAYMENT TERMS Ceil Date 1. You,the Owner may cancel transaction at any time prior to midnight of the third business day after the date of this transaction. 2. You, the Owners agree to pay any and all expenses incurred by Care IF Homes, Inc. in collecting money due under this contract and enforcing the terms of this contract, including but not limited to, reasonable attorney's fees, interest and court costs. DO NOT SIGN THIS CONTRACT THERE ARE ANY BLANK SPACES CARE FREE HO S, INC. CCEPTED: B Buyer acknowledges y receipt of fully completed _ copy of this Areement Owner: All contractors and subcontractors shall be registered by the director and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration One Ashburton Place, Room 1301 Boston, MA 02108 Tel. (617)727-8598 eft " Town of Barnstable *Permit# L s 9'2 P Expires 6 mantis from Issue date ti Regulatory Services Fee MAM �08 Thomas F.Gellert Director QED!AD'` Building Division Tom Perry, Building Commissioner 200 Main Street,.Hyannis,MA 02601 office: 5os-862-4038 fopRESS-PERMWT • . Fax: 508-790-6230 EMPRESS PERMIT APPLICATION - RESEDENTIAILD 2005 Not Valid without Red X Press Imprint MapiparcelNumber TOWN OF BARNSTABLE Property Address LOV16 1°(z 1 V &�6L44-4. [ Residential Value of Work `�®®® � Minimum fee of•$25.00 for work under$6000.00 Owner's Name&Address �GIJy�t✓l7 l�l�!� �L- f) i C ?rQ V-,C, yX eLb r Contractor_s_Name . '�` 1 C e.) Telephone Number CU 8 6 Z G l Y Z- Home Improvement Contractor License#(if applicable) 1 Z G 21-3 - Construction Supervisor's License#(if applicable) [$�Workman's Compensation Insurance Check one; I am a sole proprietor ❑ I amthe Homeowner I have Worker's Compensation Insurance Insurance Company Name -1-- o s' Co - y4 Pe,m h Workman's Comp.Policy# 5-� 9 9 L(k 2- Copy of Insurance Compliance Certificate'must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be takers to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ?� rV( Replacement Windows. Value -3 Sr (maximum.44)• O� 000 Y, *Vhere required: Issuance of this permit does not exempt compliance- vnth other town department regulations,i.e,Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature QForms:expmtrg Revisc063004 i .06 9 � r �N An zn x ff D m 16 t . oFET Town of Barnstable Regulatory Services an MASS. Thomas F. Geiler,Director 9�A ,eg 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 1, 1-e'- 46 LZ (IV 01( ,as Owner of the subject property hereby authorize mric —A-VC'(�"e- to act on my behalf, in all matters relative to work authorized by this building permit application for: �11 6L)c iL-(-A.)6ad �� : (� � ►�hi�s (Address of Job) Signature of er Date L&L)Y-(-e rat 12 R CN , Print Name QTORMS:OWNERPERMISSION 1 7/2-do y n a� Town of Barnstable *Permit# �FTHE TpJf� Expires 6 mouths frolic Issue date Regulatory Services Fee �xrtsresr�e. Mnes. $ Thomas F.Geilers Director Ea;p�°'�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 -����� PERMIT f��IT Office: 508-862-4038 /e Fax: 508-790-6230 2004 EXp ZESS PERMT APPLICATION - RESIDENTIA3. N' �C Not Valid without Red X-Press Lnpritst TOWN OF BARNSTABLE Map/parcel Number �'ll _ Property Address i Value of Work esidential Owner's Name&Address Contractor's Nam Telephone Number Homeimprovement Contractor License#(if applicable) ,/ 32& Construction Supervisor's License#(if applicable) []Workman 's Compensation Insurance Check one: I a sole proprietor m P. the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance ertificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to 0 Re-roof(not stripping. Going over existing layers of roof) VRe side �_placement Windows. U-Value `� (maximum.44) issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. *Where required. ***Note, Property Owner st sign Property Owner Letter of Permission. ome ov ent Contractors License is required. Signature Q:Forms:expmtrg Revise053003 Town of Barnstable p4tN�Tp��o p,egulatoxy Services Thomas F.Geller,Director q� s639• A,� Bundling Division AT�D � Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 yrWW,town,b arnstable.ma,us Fax: 508-790-6230 pffice: 508-862-4038 pxopert r Owner Must complete and Sign TI-Is Section If Using A Builder as Owner of the subject property 'to act on my behalf, hereby authorize Matters relative to work authorized by this building pernut application for: in (Address of Job) Dat ignature of Owner Print Name i f LArn 047 Mi enovations Ifni Hunq -- Vinyl Low E SC � F e E e UU- NridW 0 . 3 mom 0 .2 0 . 4 �1tiB�tnq�jsoddamb���P1�rd P IiAC r�o�s an 4eb�ned taa dad sA of�f �tand�e�tlI1C�IS�S t-� h > IIRtx WE" +UWCAA-.s; Lit' Ocder 0.336722g410001 Ao199 HS .�, �► Qa� r9/. 17.aJ�inlW�� � z>� � ud Suw pp�ylr�slww^�' bsds HiP mW NTRACTM • -��' �.1� ' RagfstrNlofr. 126893 &piraMom 8r$r2004 yry 1 s V4 At.HoMe$ i MARK AUDE M kTAMAA GA 30M AdmimkO~ SEPTIC.!SYSTM Assessor's office (1st floor): 51...D.1f� .�1�. - t3 COMPLIANCE T E,o� Assessor's map and lot number .. . ......./ Board of Health (3rd floor): �, TI e�Q ♦� YLE 5 '�ekage Permit number ........�v. ...:. sl.71�k, "° = �� a TAL .ODE AND t B9Hd9TODLE. : TOWN RE O MAe Engineering. Department (3rd floor): c �b}q• \0 k House number. - oo maY a• Definitive Plan Approved by Planning Board ----- -----------------------19__.---_- . APPLICATIONS .PROCESSED',.8:30-9:30.:A.M. -and 1:00•2:00 P.M. only ,TOWN .OF •BARNSTABLE f BUILDING .~INSPECTOR t a� • APPLICATION FOR PERMIT TO ........................ ............:...............................................::......:.................�..:.......... TYPE OF CONSTRUCTION Y f ................................ .......`.......:..........`........... .............................. ......... ..............19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin_g information: - Location ...... ..r '...... Nl�ell............. .'. evhi/ /j G<lv..1.G%6 /;......................... Proposed Use l �.✓C< ................ ... .............. . ............................................................................................................................................ ZoningDistrict ........... ......... ..............................................Fire District .............................................................................. Name of Owner ..... ! C. -...!�<v�G '� � f G(/yt r/l C�s�/TfiN/�/ 9 ................. ........Address Name of Builder&-4-44.......C "1 f.....................Address Name of Architect ........................... . ............Address .......` Numberof Rooms ....................:.................:...........................Foundation. ........'.................................................................... . a7s� d? ..............................Roofing ........CL.�s ...................................... Exterior ... „ Floors ............ .................../...........IL L...............................Interior Heating ........................................................................ ...Plumbing ......................................... . ................... C/LJ Fireplace ...................................................................................Approx•imate Cost ........./�r000..............:....,............................ Area ".1•�••�.. ... (7. Diagram of Lot and Building with Dimensions• Fee ........... ....d- ........... OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations o4,o f Bar table regarding the above ;� construction. %N 'e ........... Q /3Construction Supervisor's License .................................... MUELLER, JACK G. Ak No 319 91 Permit for .Conye,z,t...Veo.k...to Sun Room ....Single Family...DW.e . ' Location ~..18.9 rL4ng.V.i.ev,�..Dxvo. .......... Jack- t Owner ..... - " Type of .Construction k x.ame.4 ,. Plot'-:"....,. ........... Lot ........... v ...... ......... w. Y Permit Granted; ..• June 14, ? 88 ....... 1,9 Date ofwlnspection .... ...... ... ..............19 III Date CopJeted ...... j......... ....... ` ,19 ' M - z 00 tTI : r Assessor's office (Ist floor): TM E Assessor's map and lot number 13�qercl of Health (3rd floor): -Se.wage Permit number ........4e.................Y. DAWSTAXLE. Engineering Department (3rd floor): o MAS& k1hiouse number .......................... 1639- ..........................................Definitive Plan Approved by Planning Board --------------------------------19-------- - APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPE OF CONSTRUCTION ......0".0......../7D........CLI ............................................................ ................ ....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: d. Locationp- . V 0: 611 f t.o.... .. . ......A . 9...... ................... ProposedUse ............................................................................................................................................................................. r . Zoning District ............ Fire District ........................ ........................... ....................... ........................................................... Nameof Owner ... �7......6...............................................Address . ...................................................... Name of Builder(��_R,./........ ......:...............Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ....................w......................................................... Exlerior k1 4 .. . ..............................Roofing ....... ...................................................... Floors ......... pp..."Y.7774E...............................Interior .................................................................................... eating .............................................................................. P I u m b-i nb......... ...................................................... ...........X�A Fireplace ............ pproximate Cost .... ................................................ Area 0......&M....C*61 Diagram of Lot and Building with Dimensions Fee ..............!�........................... -OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town I of Barnstable regarding the above construction. ........................................................ ...... Name ........... ....... 0 Cz Construction Supervisor's License ............................................. MUELLER, JACK G. A=251-083 3t991 Convert Deck to Sun Room No ................. Permit for .................................... Single Family Dwelling ................................................................. Location 189 Longview Drive ................. .................................. ................................ .. Gtv� nfS Owner Ja.ck. ...G......Mueller. . . . ........................ .. .. .. . ....... .. . .. .. Type of Construction Frame .......................................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ...........June 14.,.........19 88 Date of Inspection ....................................19 Date Completed ......................................19 V u U U