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HomeMy WebLinkAbout0841 PITCHER'S WAY £�111 �'��cA��-s ��� s Town of Barnstable Building Department Brian Florence, CB 0 Building Commissioner. 200 Main Street, kyannis,MA 02601 www.town.bamstable.ma ns Pre-application for Business Certificate Da te l0 l Map�O Farrel Applicant Information licants NameNR kk 7—c-Fft k KNNIs Cb�G o Applicants-Address.Email Address ?TA Y�i.►� —POW S 0_400;of S , A,,,1 TelephoneNumbert3-0,K" rrR 7' �J'3� Listed[Unlisted ❑ Business Information NewBusiaess? ----------------------------------------- Yes No Business is a registered corporation? "___-_"_:_-__-_____-____. Yes if yes Name of Corporation Does business operate under the registered corporate name? Yes No Is the busine a sole proprieto or home occupation? --------40 No if yes then aSj� ome Occupation Registration is required—See Building Division Staff Name of Business 7 ?". S 9 L-0 A Business Address 7�� l y� ,`�" �� � • OW 0, Type of Business w Bmlding Commissioner Office Use Only 4 n o n U Building Commissl D e U Clerk Office Use Only Town of Barnstable Building _ �.i MIA `az ��w...`. ?.�."�..;'; .•�'" a�..�' ,v� 4. `.*� .`i.t.. �� ���, m�v:r �s.�....;:_ �,. ...r; t �PostThis Card SoThat t�sU�sible From the Str:.eet�A rouedPlans Mustbe Retained onaJobaandthis Card Must be:Ke t h, .� eARNSTAB18 r .. . ;� ;.a"i� .;'<x,� �, � x .P p v . ns a �,:. o�, .,u.. ;'.. M,+ss PostedUntll Final lnspectionHas BeenIVlade a ,,,, , 1639 bk.. ;r ' .:k' ✓. :" a fl �'' x ` a r; h m n .k. t,,.,z a Where a Certificate of�Occu anc is Re "aired such BtildinshallNb"eOccu ieduntila'Final�Ins�ection hasybeen;matle Permit Permit No. B-18-1547 Applicant Name: CAPE COD INSULATION, INC Approvals Date Issued: 06/07/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/07/2018 Foundation: Location: 841 PITCHER'S WAY,HYANNIS Map/Lot 271 163 Zoning District: RC-1 Sheathing: CAPE COD INSULATION INC Framing: 1 Owner on Record: KALIL, MARK E&BUCKIUS, BRETT M ��a �; Contractor Name_ Address: 841 PITCHERS WAY Contractor License 153567 2 HYANNIS, MA 02601 Est Project Cost: $4,900.00 Chimney: Description: Weatherization PermitvFee: $85.00 7 _ Insulation: Fee Paid'; Project Review Req: � $85.00��` Date-',-, 6/7/2018 Final: IN fPlumbing/Gas a � � _. Rough Plumbing Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work author zed y is permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and theapproved construction documentsfor whichthis permit has been granted. All construction,alterations and changes of use of any building and structures ll be in compliance with the local zohing by laws and codes. Final Gas: sha This permit shall be displayed in a location clearly visible from access streetiorroad and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. g , Electrical The Certificate of Occupancy will not be issued until all applicable signatures by th$BUJi"Id in Fire wTngals are provided on th is permit. Service: Minimum of Five Call Inspections Required for All Construction Work: T mow^ Rou h: 1.Foundation or Footing �, ,•, , , . �• g 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 "Per ns con ting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department 3�` Building plans are to be available on site Final: ' All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # 64-5 L Health Division Date Issued 6 eg7 / df Conservation Division MAY Application Fee 17 2018 Planning Dept. Permit Fee OWN OF 8/1�1us,��u� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address G ,s 441ol Village ,��ii,� Owner �A �� Address Telephone Permit Request ice f ji C`-k� ZZZ' %,l l'ellz, /Zs 1 `e Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation f o . v Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0� Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 2-f�o On Old King's Highway: ❑Yes U 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 Ll Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name l'2,J f2,1J42 1,2T®1 Telephone Number 9(- Address �', .�u��A100/,5 a/ Gilt License# ae dF r.� 73�dia Home Improvement Contractor# / 137� 7 Email Worker's Compensation # GUele'�b ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WALL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # r DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE 4 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t i DATE CLOSED OUT ASSOCIATION PLAN NO. HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: � The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: i Weather stripping; air sealing; attic& basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to Housing Assistance Corporation to access the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5)years after the weatherization work is completed. I have read the provisions of this agreement and give m consent. Home Owner(sig to Home Owner email: Date: Agent:(Signature) Date: Agency Approved Weatherization Company (bra _ ra's �y�-- All Cape Energy Alternative Weathen ation Cape Cod Insulation Cape Save Cazeauit ron ier Energy Solutions Lohr Home Improvement Agency Signature: Date: For-Natural Gas Customers: I have received the National Grid Discount Rate Application form from my auditor. Customer Initials - �� The Commonwealth of Massachusetts Department of Industrial Accldents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www,mass,gov/dla Workers' Compensation Insurance Affldavit; Builders/Contractors/Electricians/Plumbers, ul TO BE FILED WITH THE PERMITTIM AUTHORITY. Applicant Information - Please Print Lezibly Name (Business/Organizadon/Indlvldual); Cape Cod Insulation Address; 18 Reardon Circle City/State/Zip; South Yarmouth,MA 02664 Phone#; 508-775-1214 Are you sn employer?Mock the appropriate boxt Type of project(required); 1,211 am a employer with 48 employees(fbll and/or part-time),* 71 ❑ New construction 2,0 I am a sole proprietor or partnership and have no employees working for me In $, Remodeling any capacity,(No workers'comp,Insurance required,) 371 am a homeowner doing all work myself,TNo workers'comp,Insurance required,)t 91 ❑ Demolition 4,F11 am a homeowner and will be hiring contractors to oonduot all work on my property, I will 10 ❑ Building addition ensure that all contractors either have workers'compensation Insurance or us sole proprietors with no employees, 11,❑Electrical repairs or additions 5,[]I am a general oontraotor and I have hired the sub•eontracton listed on the amohed sheet, 12,0 Plumbing repairs or additions These sub-contractors have employees and have workers'comp.Insurance,t 13,[]Roof repairs 6,[]We are a corporation and Its officers have exercised their right of exemption per MOL c, 14,M Other Weatherization 1"I 1111),and we have no employees, [No workers'comp.Insurance required,) *Any applicant that cheeks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit Ne'Midavlt Indicating they an doing all work and then hire outside contractors must submit a new affidavit indicating such, tContraotors that check this box must attached an additional sheet showing the name bf the suh-eontmotots and state whether or not those entities have employees, if the sub-contractors have employees,they must provide their workers'comp,policy number 1 am an employer that is providing workers'compensation Insurance for my employees. Below Is the policy and Job site ,' t�ormatton. Insurance Company Name; Atlantic Charter " Policy#or Self-Ins,Lio,#; WCE00431902 >rxpiration Date 06/30/2018 S'Job Site Address /��.� _`�S /�t� ,/fit/.!//S ; City/State/Zip;__ fI a Z IC.�:r Attach a copy of the workers' compensation policy deciara on page(showing the policy number and expiration date), Failure to secure coverage as required under MOL e, 152, §25A Is a criminal violation punishable by a fine up to$1,500.00 and/or one-year lmprisonment, as well as olvil 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 verifloadon, 1 do hereby cot nder/ p s and pepnalt�lees oyfyperJury that the tgbrmadton provided above is true and correct) 1 H ryVV I O''/�YiIA{111N1`I jaw iM lvNMM WMWWwrMWMRM411M , r one , 508- 75-1214 1 Offletal use only, Do not write In this area, to be completed by city or town offlelal, City or Town, Permit/License# Issuing Authority(circle one); 1,Board of Health 21 Building Department 3, City/Town Clerk 41 Electrical Inspector-51 Plumbing Inspector 6,Other Contact Persons Phone#, ' >' , Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Ma �iusetts 02116 Home Improveme . : .(a tractor Registration -Type: Corporation Cape Cod insulation Reg(gtratbll; 153s87 Inc n pl Expiration: 12/14/2018 18 Reardon Circle n° - So, Yarmouth, MA 02664 _ tl `"�•—� Update Address and return card, Mark reason for change, _• �s _,. .. — ----..... _- r7rA�lrizs� _.J .L',�nrul_��. tploynas�nt.�'1• rlst.rr�.r �Do��r�ocontuea�CL a c���icoaao�tt4¢tld• Office of consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only Rlh- Corporation before the expiration date, If foun urn to,, e'"gls.tratlon Expiration Office of Consumer Affairs and 181 se Regulation 12/14/2018 10 Park Plaza• e 8170 Boston,MA 11 Cape Cod Insu� Henry Cassidy ' ``` :.� 18 Reardon Clrc�l,\` :t.�� ���,•C Q,�—.� So,Yarmouth,MA; Undersecretary t al hout sl at Commonwealth of Massachusetts l� Division of Professlon'al Llcensure ;Board of Building Re ulallons and Standards • Cons1�,�L����(tp��rvlsor CS•100988 w S rrs > fires: 11/111201.9 HENRY E CA 8IDY• t O SHED ROW; K WEST YARMO � �' tJ,Tr'��•�.� 1 l • '` Commissioner ' • J CAPECOD-27 KD YLE CERTIFICATE OF LIABILITY INSURANCE DATE 0 410 3/2 0 11 8Y) 04/03/2018 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(les)must have ADDITIONAL INSURED provisions or 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 endorsements. PRODUCER C CT Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 Alc No,Ext: A/C,No:(877)816-2156 South Dennis,MA 02660 E- AIL ,mall@rogersgray.com INSURERS AFFORDING COVERAGE NAIC p INSURER A:Peerless Insurance Company 24198 INSURED INSURERB:Safe Indemnity Insurance Company 33618 Cape Cod Insulation,Inc. INSURER C:Endurance American Specialty Insurance Company 41718 18 Reardon Circle INSURER D:Atiantic Charter Insurance Company 44326 South Yarmouth,MA 02664 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 BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR INSO POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE FX]OCCUR BKW53328281 04/01/2018 04/01/2019 DAMAGE TEMISESO REaoocu D 100,000 MED EXP(Any oneperson) 51000 PERSONAL&ADV INJURY 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY❑PPET LOC PRODUCTS-COMP/OPAGG 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,-lEa accident) 000 ANY AUTO 6232707 04/01/2018 04/01/2019 BODILY INJURY Perperson) �OSSCHEDULED AUTOS X AO 11000,000 ED � oyyNEp BODILY INJURY(Per accident) X AUTOS ONLY X AUTOS ONLY Pfge�acc I AMAGE C UMBRELLA LIAB M OCCUR EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE R/O EXC10006635002 04/01/2018 04/01/2019 AGGREGATE DEC) RETENTION$ Aggregate 2,000,000 D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N CE00431903 06I30/2017 06/30I2018 1 000,000 �Ka ERIMEMgE�EXCLUDED? ❑N N/A E.L.EACH ACCIDENT Nandato'y In NH) If y E.L.DISEASE-EA EMPLOYEE 1,000,000 DESCRIPTION OF OPERATIONS below E.L. 11000,000 .L.DISEASE-POLICY LIMIT � DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. 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. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD „�•""'. TOWN OF BARNSTABLE i e Permit No. Building Inspector Cash ___--- YPY ` OCCUPANCY PERMIT Bond _._ No building nor structure shall be erected, and no land, building or`structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector.” Issued to :*r. ` t Vim,u l t Address 841 Pi.tcIfters '!ay Hyannis Wiring Inspector ` f�J r��. � Inspection datep� t Plumbing inspector ,r r ,�t r �' �• Inspection date�� 4, Gas Inspector Inspection date Engineering Department ,' y Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ..... . ......... . ... Building Inspector ,s.. r RKi�< d'• C8- '•u? ` `<{+L 1 A'w..� s:•.<.�: --�, ..f :;t".: f.-psw` .. �I- (a,0 '�••t._t 7.d'.,. .?y `Y n.� .c, J. .r-„.-W'.S..k t: t WtF: ." 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'.,� .. .,. ;. i. e.. ._.� .,�n.�xi�K..h .: .:., a. 1tYr;su`::- -„,,..'a.,'e enr5-'„-„--'iFvH:iw.%1�'ex,..rM`•.ey'e.�rav-„-*x`.='tt r '.'t'sr w.,�ra-.&`'�.:,t tt�k't,�;,,::N�'.,u.�:; .r.,t�^,. ..s�gpL _ H�4 ::,�jV�A. _- .. r' �.,...'�..`� ..'�-fit-;$.1!"'SJa?ri.A3' ... �,�Y.., .. .. � •�'L .. e,Nx- �''� ..W'; fS f 'J f AL 5-.... p -7./... .. .G. ..� WITH w ARTICLE iOMPUANCE Assessors ma anct-46t' number p/z ./�, —/o- 7 7 SANITARY CODE STATE REGULATIONS AND T9UVI� N Sewage Permit number , --g I Er TOWN- OF BARNSTABLE Z 38SH9TADLE, i r 9O�p,T 4639 0 N RU:IL I, GINSPECTOR 'E a 1"� :c APPLICATION FOR PERMIT TO ..............................:+........................................................................................... V TYPE OF CONSTRUCTION ' ................Deaemb$r••29.......19..7.6.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following infor Location ... .1�........... ,/... { ? .`5.....�. .�j�........................ ... .../................. :.......... o Proposed Use ..............Residential...........................H.........use.......................................................... .....................................................:......... Zoning District .....RC..1.........................................................Fire District ...........Hat=i.s......:....................................... :.... Name-of OwneFr.os.t..Ca a-.Co.d ...Inc r...........................Address .?_1. I;LYiTgtQlx.RdA.....,�haxCza..Kas.....Q2A67 Name of IAQ0......Address .21...Ljvi.ngatQn...Rd......Shar.Cn...Mass.....02067 Name of Architect ..George E Ross. .......,Address ...Braintree,,,,Mass ................................................ ......................... . Number of Rooms ..................5.........ROOIDS .....................................Foundation .....99ACrAi=e........................................................ Exterior Wood............... ....Roofing ...Asphalt„Shingles............................................. Floors Finished Car,sting...................................Interior ...Dry.Wall,,,,,,... ....... ..................................................... Hot Air t Heating ......... ................................................................:......Plumbing ....�.�..Da')ahS............. ............................................. Fireplace ............Approximate. Cost .....3 Definitive Plan Approved by Planning Board ________________________________19________. Area .................................. Diagram of Lot and Building with Dimensions j4 ......�. Z Fee .. ..................... ..... SUBJECT TO APPROVAL OF BOARD OF HEALTH L©7' 6 ` �y�6 7'7 sY Fy' • lJ' . 2 ao I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .y... . ..... .... ........... Frost Cape Cod, Inc. , ,No .................18940 894 0 Permit for ....................................one s tory singfe family dwelling ..................................................... f�� �itchers WaLocchion .... . ......................y. .... ............ ...... Hyannis .� �' h +� _� � �1 ...................... ...... ............... Owner ......Frost Cape C, d, Inc. ..................I........ ..................... .. .. Z4 Type of Construction .........frame............ ... �a c ..... ... ................ 41' ................................................................. ............. � _ e Y' i 'Plot ......................... ... Lot .......... 6 .................... February 10...19 77 Permit Granted ..................................... Date of Inspection ............ ........19 Date Completed .... ............19 Z2110 0 PERMIT REFUSED ................................................................ 19 ............................................................................... -z' 0 ..................................................................:............ ........................................................................... ............................................................................ Approved ................................................. 19 .............................................................................. 1. .............................................................................. Town of Barnstable P "o Regulatory Services srwsi e. Thomas F. Geiler,Director saxx MASS.9g, : �0� Building Division �Eo Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www,town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623( 1. � PERMIT# W70 t y�C/ FEE: $ SHED REGISTRATION 120 square feet or less CTGr�{L�/�S r CSC/ �,UIS Location of shed(address) Village Propefty owner's name telephone number Size of Shed Map/Parcel# . i SI' gnature Date Hyannis Main Street Waterfront Historic District? OId King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) I` Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM. MUST ZE-A�0-00-MPANILD BY A PLOT PLAN Q-forms-shedreg �81 ^r r 4 REV:042506 n f } ,) i - �• S r 9 f r' d J t Ax t> 7 :. . 4 ' ' N ems. . � d y P r. hJs B L S C> n WAC:p7..a,: ? ' a —� /C�c7 Z> h�/;7c_ . Is ,'$"` -- /J/5� x A-1 p 4f4c9iilA✓ C?.4/ T„�;//S �LFaa/ /S LOGF�TEU O.V 7-JW4C- i m �T C7C1itdTa 'Qs s SsNO WA-1 HE�'EOa/ FJ,vD 7-"o=?r /T . COa/FO�A9 7'O 7A/E �� ��' �RL✓S O� Tf-,/E 7'bWN OF Q���r,J.� 's3.�'e � � � { ifw n G aJ Al C> .fit/2V6 YO BS r � / ��...`+ �'MoLo 7 /s _ ...-y� ...-s-�. � ...+.'.-.n..�= ...-.a..,,,f`�t^s-}r.as.ac r%d,:,.,-,.. `.^.��i..r�'..»'r�a�g"raw'r�.*'S�'Sr�l [ti'"'.a^''5.�,.,Jauw"'j... �,«...:,M,...a..a::31�.,.✓^a-"s'i.,ro-=ii%f..,,r �..�^ Assessor's map and loth number � �2 —/0 - 7 7 Sewage.PParmit number ............"'........................................... - E.T°��� TOWN OF BARNSTABLE Z B9HB9TADLE, i "6 9® BU,ILDING INSPECTOR �� APPLICATION FOR PERMIT TO ........::.......................................:..:.. ....................................................................... TYPEOF CONSTRUCTION ..................................................................................................................................... .............. .....19.'?C . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location L-. 5 �17-c4 cql'5..... � �` U �f' T. ..........\................................ . ............ .... ......................... Proposed Use .............Residential. . . . ..House........................................................................................................................... .......... . ...... . .. ........... Zoning District .....RC 1.........................................................Fire District Hvsnns 1 Name of Owner Frost Cane„0od. lAq, Address ?_l T, u�r►v tr�z+ 12 Skaarcara klaa� tad F'j .......... ...:.... 1.............-...:9..... ....... ..............5.......:....... s Name of Builder''X'A$t.. ..CAd,. t�i dsr :...zr ::......Address ..,:... h.f n Name of Architect .. e0r a E� Ross ,,,,.,......Address ...Brai,ntree�, Hess- ...................................: .................... .�......................................... Number of Rooms Rooms...............................Foundation ....!g1Rf1?,tP........................................................ ........................... Exierior Mood ............Roofing ... ?ht Skaneies ........................................................................ ..................................................................... Finished Carpeting...................................Interior ...pxy.1,R " Floors ................................................................. ........................................ Heating Hot A�?C..........4...............................................Plumbing ..... TEA*ha............. Fireplace ......Brick................................................................Approximate. Cost ..... ,/ 2: O Definitive Plan Approved by Planning Board ------- - 19 - - Area ... � ............................. ........... Diagram of Lot and Building with Dimensions Fee Zs SUBJECT TO APPROVAL OF BOARD OF HEALTH a 77 1 2- tr �• 6 Q I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ....F..1-.. ,• .^-" ,f ly -ram Name ..... .::�+:�:'............... .... ....................... Frost Cape Cod, Inc. =27l~l�� ~ ^ ^ . ' � ' ^ � No -l894O_ Permit*for _.00a..otory____ _ ___ ly..dwall ______.. � Location 841 -__. ..��.�c�erm ��y .. ______ ' . ' � � ----^----'~-- .......................................... � Ovvne, -_Frn!�t.. e Ca� ..Cod�..Iom�_____ �. Type of Construction frame . -------------- ^` � -�-------------------------. �~ . ^ - � � `p� #6 Plot ---------. ���^.---------. � � � , . . ~ ' ' Permit Granted ...........Febr�nary_lD_.]V 77 . Dote of Inspection ------------lg , . Dote Completed ------------.]P ^ � ^ � PERMIT REFUSED � -----_---'.-.--------- 19 ..-------.----_-----------.- . ~ ' ~ -._--.-~-.---.-----.-----. ."" � ^ ' ............................................................. .................... ---.-.~.----. ' ' Approved ................................................ 19 � ........................................................... . � ---------------------.~.---.. - � . . | - ' | f �t r Town of Barnstable *Permit# ,a 66 y( Expires 6 n .nths from issue date d Regulatory.Services Fee _ ;ca0 MRNSTABM Thomas F.Geiler,Director MASS. 039. .0 Building Division lED MA'1 s Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barmtable.ma.us Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number c 22Z 1 6-3 Property Address esidential Value of Work Z 71 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address /Y Contractor's Nae � L� ��� 7 ��Telephone Number 17 7 S 0 *7 �a 3 Home Improvement Contractor License#(if applicable) orkman's Compensation Insurance Check one: �, I ❑ I am a sole proprietor ❑"I am the Homeowner APR 15 2008 ave Worker's Compensation Insurance Insurance Company Name TOWN OF BARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum. *Where required:.Issuance of this.permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGN. TURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A.PpUcant Information / Please Print Le 'bl Name(Business/Organiz bon/Individual): Address: _ 6 S �=�-.—,J LCJ - City/State/Zip: Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 4. I am a general contractor and I 1. I am a employer with 6. ❑New construction . employees(full 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, E]Demolition ' working for me in any capacity. employees and have workers 9 0 Building addition [No workers' comp.insurance COmp'insurance t iequired.] 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself-[No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.0 Other employees. [No workers' comp,insurance required.] *Any applicant that checl:s 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 entitirs have employees. If the subcontractors have employees,they must pravi dD 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: ��'Glh'�T� JT� �s r — Policy#or Self-ins.Lic.#: 1; c2 _7 46 O (O Expiration Date: / Job Site Address: 197 erS 111-4 City/State/Zip:OE 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 rrimi,;al 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 Jhve9tigMtiMS of the DIA for insurance coverage verification. I do hereby c un 4rlAe -and penalties of perjury that the information provided abov is true d correct: 1 Si mature: Date: ° _ Phone k —? 77 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 hue, express or implied,oral or written." er is defined as"an individ partnership,association,corporation or other legal entity, or any two or more An employ �,P P, rP 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 work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,i.f 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 regrired 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&,Office of-Investigations has to contact you regarding the applicant i. ate. Please be sure to fill in the permittlicense number which will be iiin, ;�as a reference number:IA addition,an applicant that`m'ust'submit"nmiltiple penmiUlicense applications in any given year,need only,submit ono.affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicanf should write'"all locations in (city or 4 town): A copy of the`a�idavit that has been officially stamped or marked by the eity`oMown maybe provided to the applicant as proof that valid affidavit is on file for future permits or4li6enses. 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 (Le. a dog license or permit to burn 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 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 4-06 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia II __ °FtHEro,,� Town of Barnstable Regulatory Services HMNsSBl'E8, Thomas F. Geiler,Director i6 3 _ 'OrF16 9. a 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 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 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. Town of Barnstable ��FtHE Tpk� Regulatory Services " Thomas F.Geiler,Director sAxtasrAst g. �. MASS. q, 1639. Building Division pTfDVp Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 wmv.town.barnstabl e.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 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 form/certification for use in your community. �fre U�orvnzooz�uPa�/z a� czc�u�drd Board of Building Regulations and Standards I HOME IMPROVEMENT CONTRACTOR 1 i Registrai n 4158587 Expiration 2/8/2010 Trtt 264153 Type PnYate Corporation. I T.L.HITCHCOCK SERVICES TED HITCHCOCK ` Erjs 105 FERNDOC RD HYANNIS,MA 02668 _ Administrator c License or registration valid for individul use only i before the expiration date. If found return to: i Board of Building Regulations and Standards s, One Ashburton Place Rn,1301 . 1I' j I Boston,Ma.02108 Not with t signature I + i • 105 FERNDOC ST. - WANNZ,MA 02601 3/25/2008 (508)775-7763 (508)775-7763 FAX T.L. 131 1 CHC0CK a TEL# 508-423-9227 Mark Kalil 851 Pitchers Way Hyannis,MA 02601 i FURNISH AND INSTALL MATERIAL AND LABOR TO RE-ROOF PROPERTY AT 851 PITCHERS WAY, HYANNIS, MA 02601. o REMOVE AND DISPOSE OF EXISTING ROOF. CHECK ALL BOARDING-AND NAIL WHERE NECESSARY. _ REMOVE EXISTING DRIP EDGE AND SOIL PIPE FLASHING. INSTALL NEW ALUMINUM DRIP EDGE. INSTALL NEW ALUMINUM AND NEOPRENE SOIL PIPE FLASHING. INSTALL ICE AND WATER BARRIER ON ALL EAVES. PER. ,�_.�.,�� C �L� INSTALL 15 # FELT PA INSTALL 30 YEAR CERTAINTEED WOODSCAPE�HINGLES(BIRCHWOOD). ING AT HIGH/LOW ROOF SEPERATION INCLUDES REPAIR/REPLACE RAKE BOARDS AND FLASH IF REQUIRED WITH WHITE PVC OR EQUIVALENT- REMOVE ALL DEBRIS FROM JOB SITE. NOTE: PERMIT FEE AND DUMP FEES FOR CEGOVAL ARE INCLUDED BOR IOR Y THISAROTE T•L. HITCHCOCK CONSTRUCTION SERVICES,I S. AND MATELS ACCORDANCE WITH THE WE HEREBY PROPOSE TO FURNISH LABOR FOUR THOUR AND 5IX H NDRED AND 00/00 ABOVE SPECIFICATIO S FOR THE SUM 0 DOLLARS PAYME NT TERMS: 1/3 DUE UPON ACCEPTANCE; BALANCE DUE UPON COMPLETION ACCEPTANCE OF PROPOSAL: THE AB PPAYMENT WILL BE MADECATIONS . ND CONDITIONS D E S OUTLINED ABO E. SATISFACTORY AND ARE HEREBY AC DATE: SIGNATURE OF CONTRACTOR DATE: SIGNATURE OF CUSTOME y . . . . . . . . . . . . . . . . . . . . . . . . . . HOME IMPROVEMENT LICEN5E#15857 04/14/2009 15:15 508-790-0249 GOLDMAN 9 ASSOC. PACE 02/82 A90RD_ CERTIFICATE OF LIABILITY INSURANCE C � E_ zA 04 4 08 v> TlSS CERY04CATE 18 ISSUED AS t XlkTTM OF N4sIFJWATlOM G LDIQK & AS8OC1=3 INSURUNC E ONLY AND COWERS NO RIGM9 "")N IM CEIMMATE FINANCIAL SERVICES INC. HOLOEW THIS CERTIFICATE DOE NOT AMEND,EXTEND OR 933 FAT•bDDUM RD. ALTERTFE COVERAGE AEFOREEIDBYTHEPORtCIESBELOW. HrAtam MA 02601 Phone:508-775-6010 T au:509-790-0249 INSURERS AMRDING,COY ,SE NAIC# mum aasUl"N ESSEX INSURANCE CO T. L. I HITCHCOCK Z� $mama PSG IIi =m CO. lO ER>'1 8T GRAIgrm .IPMTR xtigTntAt� CO 8TAm; 02601 COVERAGEIC THE FoucmS OF KSURANM LISTED BELOWHAVE BM ISMMO TO THE KSUFtED NAMED ABOVE fM THE POLICY PEtm ONOR: am NOT 4T11STAN00NG ANY REQUIR0VA M Te"OR CQM IOH OF ANY CONTRACT OR OTHCN DOCUMENT WITH RESPECT TO NMICH TNIS CER FICATE MAY UE E;Xe D OR MAYPERTIt T ilEAAM EAFFOWEDEIY7MPM OE VAMWHVMSSUSMDTTOAELIHSTW^VWU BAMO0Okl1 tfF9liCH POUt�S.A8[�GA7'E taitii$ tdMII WBIE I8�79Y V/bD Ah� Vot MUSURII TWeOFVWWAVZ POUCV NUMB 9t DAT t f�f8 GGIMMAL UASLITYECHO CCIRRFNCE 11000000 A X X t ALGm%mft Amwv *3CP2332 07129/07 07/29/08 P� s 50000 CLAI3 smms l+i i omm tA»E Pt?t*Yawptire" $5000 PEW VA&ADVPUURY $1000000 GamiltsmartemE 32000000 a MAGGIMMTEUROTAPPUESPt7C P ;i!-SJ Ams2000000 POLICY PRO. LOC AUTONDIMEUAR IM ` GMW-9DWXKEUMlT S 8 AIKAafTO Pa=0008214230 12/20/07 12/20/08 010®a•sms AIL OUTA 8 D AUTOS _ p: MURY SC141A.EDAUT08 owps lim.. $250000 Sam*wiuw Z tERt97AUT08 '-' IC twatav�NebAvroB 5-300000 all CAM" 4250000 GARIAGEIJAXIM 1NDTOtfB- EAAa iT' 3 ANY AUTO O EAACC 3 Atttb��ll•. A.. B t>AO�pIY (/qYf+SOS t OCCUR MANS MUM ArrM;Alf _ $ OEOl - i flETEHTEON $ 3 1N610tEEMCOMOD39AIMANto .B ENFLOYEW UABLM TC Y tJAOTS ER C 2246868 03/29/09 03/28/09 "wA;mjccmoff S 500000 y� ILA JE-rA :s00000 BPfCM1LPAOVtBtONStulmn LLor Met-POLOCYma s500000 onfim DE9t?RR'SEOt'r10FOPEMTfOa1SlI.00AtIpN>:IVEIiCLEst gY lSt,P -" THE C8RTIFICm amimm IS LZBm AS AWI9!ICfm IMSURSD A2MM ACCORDING 10 THE POLICY PRODISIONB CERTIFICATE HOLDER CANCELLATION • .' 8a�f$DAM1rc�7NeAeDvfDPm�seER�E6LEDetI�EJfP80AT�N • ugmlwww ImammamwommL mwmaTaPA& 30 amo mTl m NGTF0ETOTNECEMWAMHOUWtNANM TD THE UWr WF FAB.EW TO DO 90 9NAU - a�+�EaO�IOATMN OIt tfA051?YOFAIr•�M i�ON Tam utreAGadTB OR AtARD M) OACOR DC:ORPORATIMIgW Assessor's map and lot number .... .. f TN E Sev/a a Permit number -.�Z : iz-,.....,...":,:.. BARNSTABLE. i use �number ........................................................................ 90o MU&i639- �e �a Apr a�• TOWN OF BARNSTABLE r BUILDING INSPECTOR APPLICATION FOR PERMIT TO .: ✓-?+�� =� �'% ' � %'� !'f. .r�. .............. ............................................................. TYPE OF CONSTRUCTION ......;�4 ............ ................................................................... ............................ ......19..: .� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .............. .......... %,/c•t..,Y r...:......... u ................................................................. .................... .. .. ProposedUse ...-.......U :f.!...rL:......... .�.r�..:�`�.............................................................................................I......................... ZoningDistrict .......................................................................Fire District /.....................................................................�.......... Name of Owner Z f Ga !EAZ` ,1416V...........Address .............. a a; a Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms Foundation .��-! � s?y. ,:.. C ,�� �0-5 .................................................................. ............................................... Exterior ..::..... .n?L�iy�C/.................................Roofing /r �r�:...;�Y' �i„�d� ..................... ............ C .Interior ..... �?Floors �t ate. . �?✓,� � .................................................................... Heating �i�.ik-...:.........................................................Plumbing... :11�1 -:.................................................. Fireplace .... ?n,;, •...................................................................Approximate Cost{d /..:.......",.......................... Definitive Plan Approved by Planning Board ________________________________19________. Area ...........� ..� Diagram of Lot and Building with Dimensions .mac 9 g Fee..............�......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....A...;......!�,d.?�,,,...... ,T�r�—:1,— ................ TEVADLT, CHARLEG .D.'^ A=271-163 No Permit for � ----- - ^ Location .{}�l..]7itc{ler.a...WA��------.. ................HloAaz1ia............................................ Charles R. 5�evaolt Owner --------.�-------------. � ',- of Constr__n ..... Plot Permit Granted S - Date of Inspection ...................................19 � ^ ^ `~� | � PERM T REFUSED � ___ . lg | --- ' --7' J.. ''7['' -----'' � / i/ I] /-------.. ---.. —.�--- -----' . � '—'---~--' ---'—'--^—^^~—'---'—'' -------- ----^^^^----^^~'---- � Approved ---------------- lQ ' ' —...----------.---.—..----..---. - ----------`----^-----^^^^`'~—^ � " . Assessor's map and lot number ... 7/....'.�!-�, �:k.:..... ® /C= �C . THE Sewage Permit number. ........U0.V7 � L. i SE'PwT,IC, SYSTEM M INS•AUGD IN COM ABLE, i ,,yuse number. ... r......:....................................... WNTN TITLE 5 'o, 1639 00� ENVIRONMENTACCOr - oyara� TOWN OF ..BARNSTA UE BUILDING IHS,PECTO , APPLICATION FOR PERMIT TO ............. ..�................................ ......µ.................. TYPE OF CONSTRUCTION ......2�6:V)..24..�........... .°�t�.!'.::�U..............: ...:!.. ......IC....19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........... .I ........../ ...'...nl..`' „Y,,.-S...... �` ..................................................................: ... .. ........ ... ProposedUse .............'. ...... ........ .................... ................................. ....... ........ .................................... ZoningDistrict ........................................................................Fire District ...............................:..................................:. Name of Owner ././..:..4Z"a, ..........Address ....fl..l.� Amv :�:�A -�... Nameof Builder ....................................................................Address .................................................::................................. Nameof Architect ..................................................................Address ...........................:................. ...................................... fob Number of Rooms ..................................................................Foundation ....... ............ , O bExierior ................................Roofng . ........ .Interior Floors ? '.............. ..................................................................... � F s -w �C_-- hieating [[ Plumbing ...........'..4-4..`......................................................... Fireplace .... LD <................................................................Approximate Cost Definitive Plan Approved by Planning Board -------------------_-----------19________. Area / {!4J./� .. � �� ... = Diagram of Lot and Building with Dimensions g g Fee ......... ........................ ./� SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of. Barnstable regarding the above construction. Name . .. . �,�.: .� a����.............. TEVAULT, CHARLES R. No 'Permit for .)�T�g)�OSE DECK ........................ TE N V No Single Family... ................ .................................... ..... Location 841 Pitchers Wa r I ocation ..........................................Y................... . ..................HYanni.s....................... ................... CharlesR.O Teva 1 wner ............................................�A.&.............. Type of Construction ....TKAMe......................... ............ .................................................................... Plot .............................• Lot ................................ Permit Granted ......S.eptemiaer..'.1 a,,19 80 Date of Inspection ....................................19 Date Completed. ....... f..iv 19 PERMIT REFUSED ........ dW .......................... ...... 19 ................................................. ............................................ ..... . ax ...................................................... .......................................................... (r 19 Apprq .....�5ed�........ ................................. ..... ! '� �� .......................................................................... .................... ................................................. ......