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0321 W BAY ROAD - CERTIFICATE OF INSPECTION
I I�+ +I i111i�r1+ = + ' 1iIJj'� • +I � St1�rt`r ''b 'j� rJ. 1 + - � � j Irl. + lit+ GJiStJf Ii1� ri`�� lk � - - _- - - --- - �•.'..•',r Ij��i ai.l,:._+„J�i1 f^1'�t 1�11;a + I1� zr '�"� �r �IC..j r ittii =i',,' •r� ii ,"+ ,�., ` -� .:i: .; r; ,`.;• � r ;.:� i .,,'� .i, �Jl,j ,i:.lip+�j �"i;j^fl ,.i;.:j. t r+ r�} f;Lji ,=y',1� 11,�'l; .N}, f1 +li; - _- - --- -� - - _ -- _ _ _ _ __ __ � _ _ T r"� _ T._..a fix-,_ '_ - �'-x- _-1-ri_ --.s_ - __ 'y_._. _, . _ _ _---- a- �.- - - _.._ _ - - - _ �- - _ a- - _ - _ _ __ .. - _: - - - ._- vim-- _ _ _ - _ ......_ -. ..- .._-a __ --1 _ _ - y+' 1+ _ a _ _ �� - -.n - T+- _ ^may '.. _ _ _ _ -- �.� .. - _ �� ��`-'�' -�..u"j. -_ +.--'r.._? 'sue _- -= _ .'�� -�.o-�a�' "`. +:.�-• .""_'1'" -_- TT ii --.�...fir- - _ +:-�_� 3+-- - :u-.r-- _ --� ' ''_ --r--- - s s�- -- ?-- - _ __ �� ;..ram -;;_� _ .. �. > --}-- - iiE M- _ . ---r. :�---S� --tea' t .ate_- L-,. rye _�y..� ' i- - +-��.1� "'�-a�-�^- k CYa.-°`�Y.. -aG-+nv'�i t .J.� r►` K^- -�+,► . 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Bay Road ^ Osterville, MA 02655 • _ The Commonwealth of Massachusetts TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 110.7, this CERTIFICATE OF INSPECTION is issued to RICHARD P. CALLAHAN, TR, BRIDGE ST REALT Certify that have inspected the premises known as: 321 WEST BAY ROAD MULTI-FAMILY located at 321 WEST BAY ROAD in the Village of OSTERVILLE County of Barnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): R2 The means of egress are suff cient for the following number ofpersons: Location Capacity Location Capacity 5 UNITS 1 STUDIO 3 TWO-BEDROOMS 1 THREE-BEDROOM Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 201507207 11/7/2015 11/7/2020 11 Oil The building official shall be notified within(10)days of any changes in the above information. Building Official r COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION MULTI-FAMILY FIVE-YEAR CERTIFICATE Date ? '' (X) Fee Required$95.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 110.7, I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: Ale/ 5_j Q/a IQ Name of Premises: oZ 1i(J S Purpose for which premises is used: MULTI-FAMILY RESIDENTIAL TYPE OF UNITS NUMBER OF UNITS TOTAL r,- STUDIO ] BEDROOM 2 BEDROOM 3 3 BEDROOM OTHER Certificate',tcv:be Issued to: Rk" 'A/,4 AHAlU "t RL DeI- 5 f j,QEAL7 '/7,01gl Address: Telephone: Name and Telephone Number of Local Manager,if any: �/_=/lI y571 Owner of Record of Building: CAA1-A H&U, R 16A ALO 0 A T Q. If Address: G ® v'(,1 uJ — Name of Prese Holder of Certificate: AT RE OF PERSON TO WHOM CIARTIFICATE /.eAF Sj!F /J2A& D—Q IS SS OR AUTHORIZED AGENT �---- I /(/AUT7G0S y7-q PLEASE PRINT NAME 1,wA Dab 5 , La: INSTRUCTIONS: /L 1)Make check payable to: TOWN OF BARNSTABLE Sd8 ��� y93'® 2)Return this application with your check to: BUILDING COMMISSIONER, 200 MAIN STREET,HYANNIS,MA.02604 PLEASE NOTE: I)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: / I CERTIFICATE#Q�t�� EXPIRATION DATE: coiappmf f TOWN OF BARNSTABLE INSPECTION WORKSHEET CERTIFICATE NO: 1 201507207 1 CANCELLED: MAP: 116 DBA: 1321 WEST BAY ROAD MULTI-FAMILY PARCEL: 011 NAME/MANAGER: IRICHARD P.CALLAHAN,TR, BRIDGE ST REALTY TRUST STREET: 1321 WEST BAY ROAD VILLAGE: JOSTERVILLE STATE: FMA I ZIP: 02655- SEQ NO: ❑ BUSINESS TYPE: MULTI-FAMILY CONSTRUCTION TYPE: STORY1: CAPACITY: USE1: R2 Capacity Under 50: ❑ STORY2: CAPACITY: USE2: Outside Seating: ❑ STORY3: CAPACITY: USE3: BY PLACE OF ASSEMBY OR STRUCTURE CAP1: LOC1: 5 UNITS CAPS: LOC8: CAP2: LOC2: 1 STUDIO CAP9: LOC9: CAP3: LOC3: 3 TWO-BEDROOMS CAP10: LOC10: CAP4: LOC4: 1 THREE-BEDROOM CAP 11: LOC11: CAPS: L005: CAP12: LOC12: CAPE: LOC6: CAP13: LOC13: CAP7: LOC7: CAP14: LOC14: INSPECTION: DATE ISSUED: EXPIRATION: Ip 0m ILA 091207Z0 N I- 1 11/07/2015 11/07/2020 COMMENTS: Town of Barnstable Regulatory Services Richard V. Scali, Director Building Division MUMSTABM v� MAS& Thomas Perry, CBO, Building Commissioner 101en Nu►+" 200 Main Street, Hyannis, MA www.town.bamstable.maxs Office: 508-862-4038 Fax: 508-790-6230 October 8, 2015 Ken Galt 339 W. Bay Road Osterville,MA 02655 Re: 321 W. Bay Road, Osterville,MA Certificate of Inspection Multi-Family (5-year Certificate) Attached is an application for a Certificate of Inspection as required by Section 110.7 of the Massachusetts State Building Code,Eighth Edition. Please complete the application and return it to this office with the required fee for the five-year Certificate of Inspection: 5 units- 321 Main Street units - $95.00 The fee has been established by the Massachusetts State Building Code (Table 106), and amended by the Barnstable Town Council effective 8/6/01, and must be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5 of the State Code. Sincerely, Thomas Perry Building Commissioner jcoiletinf I COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION MULTI-FAMILY FIVE-YEAR CERTIFICATE Date (X) Fee Required$95.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 110.7,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: Name of Premises: Purpose for which premises is used: MULTI-FAMILY RESIDENTIAL TYPE OF UNITS NUMBER OF UNITS TOTAL STUDIO 1 BEDROOM 2 BEDROOM 3 BEDROOM OTHER Certificate to be Issued to: Address: Telephone: Name and Telephone Number of Local Manager,if any: Owner of Record of Building: Address: Name of Present Holder of Certificate: SIGNATURE OF PERSON TO WHOM CERTIFICATE IS ISSUED OR AUTHORIZED AGENT PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER, 200 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE# EXPIRATION DATE: coiappmf r TOWN _OF BA_ RN_S_TABLE INSPECTION WORKSHEET ;Close CERTIFICATE NO: F 20110016 CANCELLED: F MAP: Ell 16 l DBA: 321 WEST BAY ROAD MULTI-FAMILY 1 PARCEL: F 011 NAME/MANAGER: RICHARD P.CALLAHAN,TR,BRIDGE ST REALTY TRUST STREET: 321 WEST BAY ROAD VILLAGE: OSTERVILLE _ STATE: L MA ZIP: 02655- — SEO NO: BUSINESS TYPE: MULTI-FAMILY CONSTRUCTION TYPE: _J STORYI: CAPACITY: USE1: R2 Capacity Under 50: ❑ STORY2: CAPACITY: USE2: Outside Seating: ❑ STORY3: CAPACITY: USE3: BY PLACE OF ASSEMBY OR STRUCTURE CAP1: LOC1: 5 UNITS CAPS: LOC8: CAP2: LOC2: 1 STUDIO CAP9: LOC9: CAP3: LOC3: 3 TWO-BEDROOMS CAP10: LOC10: CAP4: LOC4: 1 THREE-BEDROOM CAP 11: LOC11: CAPS: L005: CAP12: LOC12: CAP 6: LOC6: CAP13: LOC13: F I CAP7: �� LOC7: CAP14: LOC14: I INSPECTION: DATE ISSUED: EXPIRATION: Print This'Screen IF 11/07/2010 11/07/2015 0/-10_1) PnntCertificate of Inspection COMMENTS: r My .Fife Edit Tools Help _y6w/Type/13111 No. ttt stomer,account i formati6h History......... ZtY11 Ri=-R 32� fcy Detail w CALLAHAN,RICHARD PTA _ Property information _- � .._ . ,� �. - � 1601 FORUM PL-SUITE 1002 17rig Bill Parcel 1 D 116 411 'l' L11 t CH' L?�3 0 lilt Parc �EffectirPea#e �� e Prop Loc 1 VUESTBAY ROAD ° Lien - i ,n ," Sale Special Conditinsfidotes Sean Bill _ , Qdck Entry 3rt.Dt Billed Abf rA PmtJtrd Interest Unpaid bal' ` 7,8668 s 2, 78 1 �` 7.83:. Utility Acct �'11;fd}Zy1B 8S6 7r oo Bf6 �7 47 - nA a Rer Cua s' >. 4 f}S/I;3�11 3 BB 00 €ldb fIf}. Name - - - Fees/Pen $Ib' Parcel Tdtals 73�S5 2 856 78 19 Z$74 36 h Prop GC e - - Nbtes/Alerts Due 10/13 14 77 2 874,%, "011Irng dates Per, llem .00 v ,tr'N 1 Owner: CALLAHAN,RICHARD P Bilf Audit _ Drat Paul77777.70 Reprint - - Vrieivr3runpaiddills, i4 ter., � Preferences DiagnostiCS isplay transactionhistory f6r.the cUrrentbill:: l Co'tulmoubjeortb -of 1.o'q'5arbUq;ett5 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to RICHARD P. CALLAHAN, TR, BRIDGE ST REALT Q�Prtifp that I have inspected the premises known as: .321 WEST BAY ROAD MULTI-FAMILY located at 321 WEST BAY ROAD in the Village of OSTERVILLE County of Barnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): R2 The means of egress are sufficient for the following number of persons: Location Capacity Location Capacity 5 UNITS 1 STUDIO 3 TWO-BEDROOMS 1 THREE-BEDROOM Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 201 10016 11/7/2010 11/7/2015 1 The building official shall be notified within(10) days of any changes in the above information. --- Building Official r. 01-06-11 ; 11 . 12 15087906230 # 1/ 1 COMMONWEALTH OF MASSA -CIIUSrTTS � TOWN OF BARNSTABLE APPLICATION FOR CLRTIFICATL OF INSPECTION ® MULTI-FAMILY I Date _����^ - r',IV.f;-YEA11 CERTIFICATE (X) the Required ( ) No Fee Required In accordance with ilia provisions of the Massachusetts State Building Code, Section 106,5, 1 hereby apply fora.Certificate of Inspection for the below-named promises located nt the following address: Street and Number; Name of'.Premises: Purpose for which premises is used: MULTI-FAMILY RESIDENTIAL TYPE Or UNITS PRIMBER OF UNITS TOTAL STU.D10_ --- - IBEDZQOM 28EDROOm 3 BEDROOM O VIER Certificate to be lasued to: �jd,A T reet�p- Address: /dp � /�/PU�! r�p.C1=.��1�r p — Telephone: Name and Telephone Number of Local Manager, if any:_ ifWA02 p Owner of Record of building: Address: llcz,L � tl _4zi i or Name of Present Holder of Certifieatc:�,���►y� _, C A,(1,�/� �c.l - T� uS,tT Si NA, URE OF PERSON TO 1IOM CI;RTII�ICATE 1S ISSUED OR AUTHORI7,E)D A :1JNT PLEASE PRINT NA E. M NSTRI CTIONS: 1)Make check payable to: 'TOWN Or 13ARNSTABLL 2)Return This application with your check to: BUILDING COMMISSIONL'R, 200 MAIN STREET,HYANNIS, MA 02601 PLE- SE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued, 3)The building oilicial shall be notified within ten (10)days of any change In the above informatlon. FOR QI' 1CI; U ONLY: CERTIFICA'fr 11 �i d I� d d/ 6 EXPIRATION DATE: / -7 /S ---- cuioppmrr PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT a ;� 200 MAIN STREET HYANNIS, MA 02601 DATE: 01/03/11 TIME: 13:11 -----------------TOTALS------------------ PERMIT $ PAID 95.00 AMT TENDERED: 95.00 `AMT CHANGEPLIED: 95.00 APPLICATION NUMBER: 20110016 PAYMENT METH: CHECK PAYMENT REF: 3565 COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION MULTI-FAMILY � FIVE-YEAR CERTIFICATE Date � T' O (X) Fee Required d ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 106.5, I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: J 0J Name of Premises: Purpose for which premises is used: MULTI-FAMILY RESIDENTIAL TYPE OF UNITS NUMBER OF UNITS TOTAL UD STUDIO ' ] BEDROOM 2 BEDROOM 3 BEDROOM OTHER Certificate to be Issued to: Address: 1601 lcc" AUV1 P 210 ems.��Jjp� /y®® Gt/U Jam°1�✓! f� CGd FL�jy�f Telephone: 9 Name and Telephone Number of Local Manager, if any: .00t>:Pl !e/ Owner of Record of Building: R)CI-J Ape /p �;cpL1,a4/-pi�tcJ_ T,E°ySTE�a f� 4Zi' �Y T iJ�((� Address: O.0 10AAni 6eAC�., AL 3f�/eJ�Name of Present Holder of Certificate: A_ 6 A N V z L/s 1� � C SI NA URE OF PERSON TO OM CERTIFICATE IS ISSUED OR AUTHORIZED A ENT C. c z PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER, 200 MAIN STREET,HYANNIS, MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: CERTIFICATE#ff� t�� �O�� EXPIRATION DATE: coiappmf TOWN OF BARNSTABLE INSPECTION WORKSHEETosr CERTIFICATE NO: 49849 CANCELLED: MAP: FIT6 DBA: 321 WEST BAY ROAD MULTI-FAMILY PARCEL: 011 NAME/MANAGER: CENTURION RESIDENCE SERVICES STREET: 1321 WEST BAY ROAD VILLAGE: JOSTERVILLE STATE: MA ZIP: 02655- SEQ NO: BUSINESS TYPE: MULTI-FAMILY CONSTRUCTION TYPE: STORY1: CAPACITY: USE1: R2 Capacity Under 50: r STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: BY PLACE OF ASSEMBY OR STRUCTURE CAP1: LOC1: 5 UNITS CAPS: L005: CAP2: LOC2: 1 STUDIO CAPE: LOC6: CAP3: LOC3: 3 TWO-BEDROOMS CAP7: LOC7: CAP4: LOC4: 1 THREE BEDROOM CAPS: LOC8: � `£Print ThisScreen INSPECTION: DATE ISSUED: EXPIRATION: iv_—U 11/07/2005 11/07/2010 y Pririt Certificate ofinspection, COMMENTS: The Commcoubjealtb of '41azzarbu.5ett.5 TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to CENTURION RESIDENCE SERVICES 3 Certify that I have inspected the premises known as: 321 WEST BAY ROAD MULTI-FAMILY located at 321 WEST BAY ROAD in the Village of OSTERVILLE County of Barnstable Commonwealth of Massachusetts. Construction Type: Use Group(s): R2 The means of egress are suff cient for the following number of persons: Location Capacity Location Capacity 5 UNITS 1 STUDIO 3 TWO-BEDROOMS 1 THREE BEDROOM Certificate Number: Date Certificate Issued: Date Certificate Expired: Map Parcel 49849 11/7/2005 11/7/2010 116 Oil The building official shall be notified within(10)days of any changes in the above information. Building Official w. COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION MULTI-FAMILY FIVE-YEAR CERTIFICATE Date 1 I�I��� (X) Fee Required$ 9�� C7� ( ) No Fee Required In.accordance with the provisions of the Massachusetts State Building Code, Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: S Z- 1 WE S T R q y O S T E 2 V)'I_1t' Name of Premises: - 1!V e S i 6,f IX4-f%AI EN>J' Purpose for which premises is used:MULTI-FAMILY RESIDENTIAL TYPE OF UNITS NUMBER OF UNITS TOTAL t STUDIO / 1 BEDROOM 2 BEDROOM 3 BEDROOM OTHER Certificate to be Issued to: 6C gA/Z O P CAL(A11Airl, -1Xad7F_6- J7X(-6-7 /l6,44Ty I--XGl,fr Address: /_(Q / aRtnn•� ?e/�C ,U1 i7� 1,Vd 0 t)j• i�/1 CAI ,(��_�fCy,�L �f�(JJ Telephone: .5-6/- Pz- V.70 6 Owner of Record of Building: JCl//�iz/I P C'��c•a� ,�/, �/l�s 4--1e1069 J'7!1f;6_r /1F T� �Lcl✓j Address: .60/ J= oi1u,-1 i41,1CF1 fW17E 0 C-'i/ Name of Present Holder of Certificate: fR/C1-xyD l'41jodF f r/1 F r i lI F✓ iy WJ 7- Nameme of Agent,if any: R"Iwx 6 C'4 C L V SD a -Z 8 SIGNATURE OF PERSON TO WHOM TIFICATE -; IS ISSUED OR AUTHORIZED AGENT o M,t21L C. , C R-C.E PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE, . 2)Return this application with your check to: BUILDING COMMISSIONER, 200 MAIN STREET,HY IS,M41260pg PLEASE NOTE: ry 1)Application form with accompanying fee must be submitted for each building or structure or part thereof t lbe certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. FOR OFFICE USE ONLY: / CERTIFICATE# y� p� EXPIRATION DATE: / 7/ //n 6 coiappmf Town of Barnstable FIKE r Regulatory Services x x Thomas F. Geiler, Director x x * BARN3fABLE, MASS. Building Division s6g9. �0 Arf039 A Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MAma.us Office: 508-862-4038 Fax: 508-790-6230 November 23, 2010 Richard P. Callahan, Tr. 321 West Bay Road Osterville, MA 02655 Re: 321 West Bay Road Certificate of Inspection Multi-family (5-year Certificate), Dear Property Owners: Attached is an application for a Certificate of Inspection as required by Section 106.5 of the Massachusetts State Building Code, Sixth Edition. Please complete the application and return it to this office with the required fee for the five-year Certificate of Inspection: 5 units - $95.00 The fee has been established by the Massachusetts State Building Code (Table 106), and amended by the Barnstable Town Council effective 8/6/01, and must be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5 of the State Code. Sincerely, Thomas Perry Building Commissioner Enclosure jcoiletmf r �tr rti Town of Barnstable 0 Regulatory Services M 4 BAM nssU`E'� Thomas F. Geiler, Director �p i639. ♦0 Te039 p 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 October 13, 2010 Richard P. Callahan, Tr. 1601 Forum Place, Suite 1002 W. Palm Beach, FL 33401 Re: Certificate of Inspection 321 West Bay Road, Osterville Multi-family (5-year Certificate) Attached you will find an application for a Certificate of Inspection as required by Section 106.5 of the Massachusetts State Building Code. Please complete the application and return to this office with the required fee: 5 units - $95.00 The fee has been established by the Massachusetts State Building Code (Table 106), and amended by the Barnstable Town Council effective 8/6/01, and must be paid before the Certificate of Inspection/Capacity Card may be issued., A copy of said Certificate shall be kept posted as specified in Section 120.5 of the State Code. Sincerely, Thomas Perry Building Commissioner Enclosure jcoiletmf Town of Barnstable Regulatory Services M # BMWSTAB 1 # „ASS. Thomas F. Geiler, Director �A .s6;q �0 rFn 39 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 October 11, 2005 Mr. Richard P. Callahan, Tr. 1601 Forum Place, Suite 1002 W. Palm Beach, FL 33401 Re: 321 West Bay Road, Osterville Certificate of Inspection Multi-family Dwelling (5-year Certificate) Dear Property Owner: Attached you will find an application for a Certificate of Inspection as required by Section 106.5 of the Massachusetts State Building Code, Sixth Edition. Please complete the application and return to this office with the required fee: 5 Units - $95.00 The fee has been established by the Massachusetts State Building Code (Table 106), and amended by the Barnstable Town Council effective 8/6/01, and must be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5.2 of the State Code. Sincerely, Thomas Perry Building Commissioner Enclosure jcoiletmf i o i i File- Edit 'Fools Help � � ` ,., q Action Year/Type/Bail No. - Customer Account Information P elk�11 . - H�tory s a. tt � ' Detar� CALLAHAN, RICHARD PTRSi u� Property Informatmn —— _ - �I601 FY?RUM Pt-SUiTf 1002i , I W PALM BEACH' FL 33461 Orig BBl° Parcel ID 11f� q i „....,, •k .� - Effective Date Aft Parc e I T r a a"Prop Lac 321 WEST.BAY RO1tD �`: I. - ji a; Sp"l6nditions/Notes s� FQL�k*Scan Specific Bill ; Int Dt Billed ` A[3t/Add .Pmt%Crd x _ Intermit Unpaid balms j 11/15/03 2,073.47-1 00` * 2,073.97 00 Utirtty Acct 05/04,f04 73.94{ 000 �3�U73.94 #IUj 0t1' ' Gu Comer Fees[Pen. E 0 00 Totals: 1 I�amex e d� ._ Notes Alerts g � / t?ue 10/S1 Bdit g Dates y x Diem . JAM 1 Owner: CALLAHAN;itICHAftD P � �� u li °4 .° Int Paid' 27.84 Preferences Ie a r DBC BILL HDR Uaew;Prt©rUnpald Bills. E ��$ � �" ` s U 454 &,M1, « 1.; �'x ��� .:. a C u 4 t pr �^* k s. k.. ".y.. �� �`av �a, r��'ti� .F'•': 4 11 I .1 of 12 a ,+ -- i Display transaction history for the current bill. F 1s The commonwealth of hlth Massachusetts �s TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 106.5, this CERTIFICATE OF INSPECTION is issued to CENTURION RESIDENCE SERVICES Certify that I have inspected the premises known as: 321 WEST BAY ROAD MULTI-FAMILY located at 321 WEST BAY ROAD in the Village of OSTERVILLE County of Barnstable Commonwealth of Massachusetts. The means of egress are sufficient for the following number ofpersons: Use Group Construction Type Location Capacity R2 5 UNITS 1 STUDIO 3 TWO-BEDROOMS 1 THREE BEDROOM 49849 11/7/00 11/7/05 Certificate Number Date Certificate Issued: Date Certificate Expired: The building official shall be notified within (10)days of any changes in the above information Building Offi ' 5;0 a.. i COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE APPLICATION FOR CERTIFICATE OF INSPECTION MULTI-FAMILY FIVE-YEAR CERTIFICATE Date 6/13/00 (X) Fee Required$ O ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 106.5,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number. 321 West Bay Road, Osterville, MA. 02655 Name of Premises. N/A Purpose for which premises is used:MULTI-FAMILY RESIDENTIAL TYPE OF UNITS NUMBER OF UNITS TOTAL i f Five STUDIO One (1) I BEDROOM 2 BEDROOM Three (3) 3 BEDROOM One (1) OTHER Certificate to be Issued to: Centurion Residence Services, Inc. Address: 1601 Forum Place, Suite #1002, West Palm Beach, Florida 33401 Telephone: 561-242-0653 Owner of Record of Building: Centurion Residence Services, Inc. Address: 1601 Forum Place, Suite #1002, West Palm Beach, Florida 33401 Name of Present Holder of Certificate: ©)(6D() R6,4c7-y Name of Agent, if any: C SIGNATURE OF PERSON TO WHOM CERTIFICATE � -C O `�t� IS ISSUED OR AUTHORIZED AGENT -1-0 Ste' '_Up l N dl f-e-T7&N C C 'S-06 eZ o PLEASE PRINT NAME INSTRUCTIONS: 1)Make check payable to: TOWN OF BARNSTABLE 2)Return this application with your check to: BUILDING COMMISSIONER, 367 MAIN STREET,HYANNIS,MA 02601 PLEASE NOTE: 1)Application form with accompanying fee must be submitted for each building or structure or part thereof to be certified. 2)Application and fee must be received before the certificate will be issued. 3)The building official shall be notified within ten(10)days of any change in the above information. CERTIFICATE# Q f�_ EXPIRATION DATE:1742 Sd The Town of Barnstable • sexivsTnBt.E. Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner September 12, 2000 RICHARD P CALLAHAN OXBOW REALTY, INC 725 CANTON S NORWOOD, MA 02062 SECOND REQUEST Re: Certificate of Inspection Multi-family Dwelling (5-year Certificate) 321 WEST BAY ROAD, OSTERVILLE 116 011 5 Units - $85.00 Dear Property Owner: We have not received a response to our letter of May 15,2000 requesting you to return the Certificate of Inspection application with the required fee to this office. The Certificate of Inspection is required by Section 106.5 of the Massachusetts State Building Code, Sixth Edition. The fee must be paid before the Certificate of Inspection can be issued. Your failure to respond indicates that you are not interested in maintaining your multi- family status with this office. Please submit the application and fee immediately or contact Lois Barry of this office (862-4039)to clarify your situation. Sincerely, Ralph M. Crossen Building Commissioner RMC/lbn j000906a Ft�ram, . .�°� The Town of Barnstable • sM WSTnBM 9� MAM Department of Health, Safety and Environmental Services '°TEor a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen in Commissioner _ _ Building Fax: 508 790 6230 May 15, 2000 RICHARD P CALLAHAN OXBOW REALTY, INC 725 CANTON S NORWOOD, MA 02062 Re: Certificate of Inspection Multi-family Dwelling (5-year Certificate) 321 WEST BAY ROAD, OSTERVILLE 116 011 Dear Property Owner : p d you will find an application for a Certificate of Inspection as required by Attache pp Y Section 106.5 of the Massachusetts State Building Code, Sixth Edition. Please complete the application and return to this office with the required fee: 5 Units - $ 85.00 The fee has been established by the State (Table 106) and must be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5.2 of the State Code. Sincerely, Ralph M. Crossen Building Commissioner RMC/lbn j990428e VE . � The Town of Barnstable • s,►iexsrnBte, • 9MAS& Department of Health, Safety and Environmental Services riro 9. 1, Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner CERTIFICATE OF INSPECTION CAPACITY INSPECTION MULTI-FAMILY DBA M&P LOCATION ✓��-/ �,(��� 0.���� OWNER I)r-7 ADDRESS, `'� �� .�a �� : -7-7- 5— I'i ZONING NO. OF • � UNITS/FEE S GLORIA URENAS APPROVAL O/C fir- U 5 a'tt��V- DATE 9 INSPECTOR DATE OF INSPECTION J980309A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map i1to Parcel 1011 Application # Q 6 0 )a Health Division Date Issued Z ` Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village V1 'n &Aotrilbei nOwner ( _�t:dt� �QI� Address G 7�'"rCli TO Telephone Pod M 0-C41. r 1 33`FO 1 Permit Request wt igdt,( a0 m 1 SUM,,, 6mi I VV4!5 LJ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ® onstruction Type Lot Size l�c� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family: ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ 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: Ui'Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes WH<o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: Dxexisting ❑;newer ize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ X Commercial ❑Yes ❑ No If yes, site plan review# Z16 Current Use Proposed Use -= APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 560#- C ry>b�A To 0, Telephone Number �0!1 PLI'AAddress Ij�i St � License # (34e i( Iy i k Home Improvement Contractor# Worker's Compensation # q9,--Jn*i>an as ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO uwyL ®f Nit 061W k, (::::S�ii�. NATURE- , r'"DATE 1 FOR OFFICIAL- USE ONLY t APPLICATION# S ' DATE ISSUED + �t µ ,MAP/PARCEL NO. ADDRESS VILLAGE OWNER i i DATE OF INSPECTION: FOUNDATIOMA +=,'r FRAME INSULATION`-,'. ' FIREPLACE i ELECTRICAL: ROUGH FINAL 3 PLUMBING: ROUGH FINAL r -GAS:- ap.- ROUGH if!o4•Y; r 4 FINAL INAL BUILDING'' ; _Wl�L k.DATE CLOSED.OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street y Boston,MA 02111 - www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �� P-6n �1 tC. t� Address: Ma [ City/State/Zip: ( M Phone#: — oq© Are u an employer?Check appropriate box: 1. I ❑am a employer with 4. I am a general contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. F0 Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance.$ 9. ❑Building addition 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.[1 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: f auf o Policy#or Self-ins.Lic.#: Lfl al ;)'" Expiration Date: J;aalI- Job Site Address: f City/State/Zip: 04 Attach a copy of the workers'compensation polla declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Sienature r"Date-- a Phone Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person:- Phone#: �� � Office of Consumer Affairs&B smess Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: :151882 Type: Office of Consumer Affairs and Business Regulation Expiration: 711.312012 Private Corporation 10 Park Plaza-Suite 5170 ® _ S E CROSBY:BUI'LDER'ING-7. Boston,MA 02116 - i SCOTT CROSBY 1112 MAIN ST UNIT#7, OSTERVILLE, MA 02655 Undersecretary Not valid without signature'Z- 'Tassachusetts- Del). tment of PU1711C Safch Board of Building Rc<ulations and Standards Construction Supervisor License License: CS 43556 SCOTT E CROSBY 62 CROSBY CIR OSTERVILLE, MA 02655 t , Expiration: 12/13/2012 ('ummissiuncr Tr#: 7837 Ae R® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDrNw) 09/13/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Germani Insurance Agency PHONE FAX 908 Main Street c o E 508 428-9194 A/C No): E-MAIL ADDRESS: Osterville,MA 02655 PRODER C UC S E INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Essex Ins.Co. Scott E.Crosby Builder,Inc. INSURER B: Scottsdale Ins.Co. 1112 Main St.Unit 7 Osterville,MA 02655 INSURER C: INSURER D: INSURER E: Hartford Ins.Co. 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 SUER POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY) (MMIDDIYYYYJ LIMITS A GENERAL LIABILITY 2CL2173 01/12/2011 01112/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ POLICY PRO- JECTLOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ B X UMBRELLALIAB OCCUR XBS0010814 1/12/2011 1/12/2012 EACHOCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DEDUCTIBLE $ RETENTION $ $ E WORKERS COMPENSATION 4727P238 UB 6/23/2011 6/23/2012 WC STATU- oTH- AND EMPLOYERS'LfABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? n (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 . 7 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Scott E.Crosby Builder,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fax#:508-428-9080 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Town of Barnstable MMSrABL& MASS 039. Regulatory Services Thomas F.Geiler,Director 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 Property Owner Must Complete and Sign This Section If Using A Builder c 1,„a/kp ✓U.1 12 I, , as Owner of the subject property hereby authorize �V s 0, to act on my behalf, in all matters relative to work authorized by this building permit application for: 32a-i WeZ c1 S rU , (Address of ) a �Z Signature of Owner D Ito a baw Print Name ` Q:Forms:expmtrg r Revise071405 f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION , Ma Ito Parcel � I � �- p _ Application# Health Division Date Issued 1 za ,b9' Conservation Division Application Fee Tax Collector Permit Fee Treasurer Planning Dept. t. �J Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address W Md C Village OSNl I �� Owner �l y ► �• kLhM 11�' I r. Address �UL Telephone - ® 3 Permit Request o-nd rgchinnle, bhalbn Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District_ Flood Plain Groundwater Overlay Project Valuation f�i • `construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑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 C; Total Room Count(not including baths):existing new First Floor Room ount a �L Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other 00 Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/cM.stove: t-Yes . 3❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑exi ting ❑Few see Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: r' Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use _ BUILDER INFORMATION Name J Telephone Number - 9 � Address V . WxN License# o-nn IS o Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE t FOR OFFICIAL USE ONLY 4 APPLICATION# DATE ISSUED MAP PARCEL NO. { ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL Y PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. C I , OFWEA Town of Barnstable. Regulatory Services r r r + BARNSTABLE, MA & �' Thomas F.Geiler,Director �FDMA'IA,� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I CV) Q al, a-kCLO as Owner of the subject property hereby authorize J to act on my behalf, in all matters relative to work authorized by s building permit application for: (Address f b) Si ature - Owner Dat l(, C� Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. i Q:FORM&O WNERPERMISSION Town of Barnstable �p,*fHE t, Regulatory Services � RN5rABLE, Thomas F.Geiler�Director BA ' 9 MASS. q,A 163g. per+ Building Division TfD � 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 verformed 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. Q:forms:homeexempt I . The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street <y Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): Address: U. 11WX 93 City/State/Zip: S N 0- COW kone.#: ez�) Are you an employerl eck the appropriate box: Type of project(required): 1.❑ I a employer with 4. ❑ I am a general contractor and I 6. ❑New construction ' loyees(full and/or part-tim.e).* have hired the sub-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 8. ❑ Demolition workingfor me in an capacity. employees and have workers' y p �'• $ 9. ❑Building addition [No workers' comp. insurance comp.insurance. 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its 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' 13.1 Other wV t comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.. Lic. M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure,to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un r t p ns and enalties of perjury that the information provided pbove is true and correct Signature: Date: ` CJ _ Phone#: 4 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 'y 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 representative's 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, 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 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 a Boston, MA 02111 Tel. ## 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-774R Revised 11-22-06 www.mass.gov/dia TOWN OF BARNSTABLE BUILDING P IT.APPLICATION Map I Parcel Application# v Health Division Date Issued 41 0 Conservation Division Application Fe Tax Collector Permit Fee Treasurer Planning Dept. qlo� Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Sal Wp_!� Village Owner i Ch W a P. QI I 0-VI M) Address 01 f�yurn P(• rr.. 11 .��hf) Telephone rr��-- Permit Request Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District r�Flood Plain Groundwater Overlay Project ValuatioS�; onstruction Type r r Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. 7- Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yeses❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No li yes, site plan review# Current Use Proposed Use _ BUILDER INFORMATION Name J ms It q- Telephone Number 4 V - Address Q• 0• 90y �31 U License# s I► Il I U(D 0 1 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE L �y. FOR OFFICIAL USE ONLY APPLICATION# G _ DATE ISSUED I` -,MAP/PARCEL NO. Y t: , ;his N ADDRESS VILLAGE OWNER 3 A DATE OF INSPECTION: FOUNDATION FRAME r INSULATION _ FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. '1 { 1 oe 'Jj PAYMENT RECEIPT idgl4.bF BARNSTABLE BUILDING DEPARTMENT 200 'MAIN STREET HYANNIS, MA 02601 DATE: 07/16/07 TIME 11 :29 ------=-----------TOTALS----------------- PERMIT $ PAID 96.35 AMT TENDERED: 96.35 AMT APPLIED: 96.35 CHANGE: .00 APPLICATION NUMBER: 200704350 PAYMENT METH: CHECK PAYMENT REF: 1731 • t 1 Town of Barnstable Regulatory Services � BARNSTAbI.E, 'o y Mass. Thomas F.Geiler,Director �{j 1699• ♦0 ppEo �' 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 bust Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize Wis to act on my behalf, in all matters relative to work.autho ' ythis building pen-nit application for: 3AJ a0�9&q C&, 0K4uV1JJ-e (Add s of job) U1 n WSi;naofner Date �ICk)Wa COA6.hW ' Print Name Q:FORM&O WNERPERMISSION The Commonwealth of'Massachusetts Department oflndustrial Accidents Office of Investigations ' 600 Washington Street Boston, M4 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information _ Please Print Legibly Name (Business/Organization/Individual): �� 5 Lu rle Address: P. 0 . kx �3 � City/State/Zip: 0 Phone#: q d - Are you an employer? Check the appropriate box: 'Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6' ❑ New construction 2.2 I am a sole proprietor or partner- listed on the attached sheet $ 7. ❑ Remodeling ship and have no employees These sub-contractors have 8i. ❑ Demolition working for mein any capacity. workers' comp.insurance. g. ❑ Building addition [No workers' comp,insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10•0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions jr myself.[No workers' comp, c. 152, §1(4),and we have no 12.ZRoof repairs insurance required.] t 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 infomration: 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 their workers'comp.policy information. I am an employer that is providing workers'cornpensatdon insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a file of up to$250-00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties of perjury that the information provid dab ve is true and correct. Si afore: Dater �� V� Phone#; I 0- `f 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 iaspe or 6. Other Contact Person: Phone#: .; 1)-r. t ') r :r: -::M 6 r.t Y1 :4 'F.:TI^•'a 't 9. 9. " 3JYis. .;�:,.... , -.:.. .'...�F .{ . ,. .,. 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S:C:9' bt _ II r ..1 b d r4 J,.,,.„ ..,:..,.;. ,;r.,. :i Y ,.. titl '., ,n. .::: ,,.l..... ::� P 5 wtr�' i .1 t (! k -.'[,.:•. f:C., .-,+ ,...,: Y.:, ....r., I .... y.,..-e ••s 4 a 2 i A I +1. ;I VlL :r4 j,: Fy t ! _ , - • • • 1' 1 1 1 1 1 1 1 • • 11• /� C 1 1 ' 1.. r of r Town of Barnstable Regulatory Services BAMSTAMAS& Thomas F.Geiler,Director as.�. 9`bA,fo 39�a`�� Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 CERTIFICATE OF INSPECTION CAPACITY INSPECTION DBA pq, LOCATION OWNER o��a USE CAPACITY&FEE DATE OF INSPECTION IN RECTOR COMMENTS J990125a F Town of Barnstable *Permit# S g(P �.e Expires 6 months from issue date susrt , ' Regulatory Services Fee 2 S, � Thomas F.Geller,Director Building Division Tom Perry,.Building Commissioner 200 Main Street, Hyannis,MA 02601 X-PRESS PE, n Office: 508-862-4038 Fax: 508-790-6230 JAN 1 3 2005 EXPRESS PERMIT APPLICATION - RESIUQL L IAL ONLY i Not Vaud without Red X-Press Imprint N N 6 LL)L Map/parcel Number Property Address_ j ( � CZ;s'✓� �� ❑Residential Value of Work Minimum fee of-$25.00 for work under$6000.00 Owner's Name&Address_CkSMALA.CJ1i1 VU,&1DW C.0 C C"%CX t AJ C,— Contractor's Name V11�c.t't/�¢r: "7 _ Telephone Number 4'� Home Improvement Contractor License#(if applicable) 3? Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance cf Check one: ❑ I am a sole proprietor Board of Building Regulations and Standards ❑ Tamthe Homeowner i HOME IMi' OVEMENT CONTRACTOR I have worker's Compensation Insurance ReVistra d a p 3,32564 Expiry bn, �/�/2005 �t ,�. f f�1,a 'v ` Insurance Company Name � = Type individual , Workman's Comp.Policy# F.MICHAEL DWYEI L Copy of Insurance Compliance Certificate must be on file. F.MICHAEL DWYR ST MAIN 772 Permit Request(check box) OSTERVILLE MA 02655 Administrator ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of rood K(Re-side 2/Replacement windows. U-Value (maxhm .44) -41 i i L 'Where required: Issuance of this perrnit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. ome7men,Contractors License is required. Signature Q:Forms:expn*g Revise063004 °FTME,�ti Town of Barnstable Regulatory Services snaNsrnB Thomas F.Geller,Director bun Building Division '�fD NiA'I a 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 ABuilder I ,as Owner of the subject property hereby authorize 101/�rc �- to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address ofjob) f ' to S' nature of er ate Print Name Q:FONY cOWNP.RMEPIMSION l r The Commonwealth of Massachusetts -__ Department of Industrial Accidents Office eflnuestigatfons 600 Washington Street, 7`h Floor Boston,Mass. 02111 Workers' Compensation Insurance Affidavit:Building/Plumbing/Electrical Contractors name: '�/�n LtM ( (�1LllXi S4�c� f address: rzp city 03 rc t-- state: zip: 0&6 a phone# work site location(full address): ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction[Remodel ❑ I am a sole proprietor and have no one working in any capacity. ❑Building Addition O�am an em loyer�roviding workers'compensation for my,employees working on this job. +..ram � &., 'F•. +M ..7, � - .a. a.n 5'�t K.•M�. 'Ttyi�+ �°,� _+"` ?,a r � .x3I"�Fj • .� V�. Y 4 011 .. _ ` '" "11 '•'" .. F ."�'d�}y'. ,7 .i •£ ay �; •a'fi. '� " l •+ '.. �"`i<9+f.;•'r...' .: uti �ns�trah�cew0.. .�.c, �a:'aa.�• ;�.a� �as a. .e.d. uc�a. r.:c. n..:. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices K ,yY- 9 "' •F;#t''P�i� �iA°M}G `.n. .s q +x „J s f� ¢' f .u rs - lramti�ny-rtBrtYe;r .,.:.. _.,. ,,._ ...._..., �.z_„x............ .....:_.,_ s u _.,..iY...w.. a ♦..!».C._.:3.....,i..d.-. <..ucY...x••'atr f•f..r-C1'FraLR ar...x... L . G r NU� � J -'T. ! i ).�.a� >:C V. .N 3:. fi5 [4.:j.ftc" .i. �s J•t R - `4 �' l F 'h C S I f f Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby cer' un r t i and penalties ofperjury that the information provided above is true and correct Signature Date Print name Phone# — cJ�� C use only do not write in this area to be completed by city or town official town: permit/license# ❑Building Department❑Licensing Board ck itimmediat,response is required ❑Selectmen's Office ❑Health Department t person: phone#; ❑Other ept.2003) - Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",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 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext. 406 . '-."Engineering Dept.(3rd floor) Map J j Co Parcel , 611 ` Permit# :a 5- 34 3 r- House# J)ate Issued Z- Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) •10- 9•10 i 1-nn= 2•nrn - . �E' TSYSTEM MUST BE floor/ coo nun. INSTALL LIANCE D 1,9 ENVIRON DE AND TOWN OF'BARNSTABLE TOWN ONS Building Permit Applicat'on t Project Street Address I Village Owner /G`j �. .4 14 6� j Ti�S Address �� � 72s C4w AISf- Telephone 49/7" 761- 2ZZ2- ° / - lune J , /W'CV4Z Permit Request iQ 67g:Am;1- 'o i M1 j t--loor square feet Second Floor square feet - Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name /v �/ /`T�v Telephone Number Address /c� �JIJ,�-f,,1 �/2- License# rnA . 00526 / Home Improvement Contractor# Worker's Compensation# A, NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ad Sq Ivy ,4- d SIGNATUREa—/"- DATE �' Z 9 7 BUILDING E IT DENIVD FOR THE FOLLOWIN REASON(S) . -� is • • FOR OFFICIAL USE ONLY PERMIT NO. s`o ,,.: 1"i ` -' - - - 1 � • i ' DATE ISSUED: f _ - MAP/PARCEL NO. ADDRESS , VILLAGE OWNER i r f DATE OF INSPECTION: i ' FOUNDATION FRAME , INSULATION { s FIREPLACE ; ELECTRICAL: ROUGH FINAL : r PLUMBING: tOU.GH FINAL C = _ "•' GAS: tOL"I' FINAL FINAL BUILDhl rn kgy t DATE CLOSED=OW— IV a'! c i M ` ASSOCIATIONF, N= m O ; i - r • ,THE r, The Town of Barnstable 'M- �0�' Department of Health Safety and Environmental Services Eon" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissione: For office use only Permit no. Date : AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: 204r06VA PA)VqrJ Au,, LQ t.Cost �OU — ,� �c�46iw�t t5�►EIv n / Address of Work: ?�21 (.vas�" ✓✓1�+l /2d 0- iC I Owner's Name /I'IG/ Anal CJ4Z1 A,4xJ T/ZS, Date of Permit Application: Z �9 -7 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL C. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the ag of th o a Date Cont ctor Name Registration No. OR Tlic• Contntonivealth of Massachusctts W71 -_--. 1 Dc artnunt of Industrial Accidents 6 Office ol/noestigallms 600 If'a.vNin on Street Bocton, Mass. 02111 ` Workers' Compensation Insurance Affidavit .-.x �t�nlicant information: Please PRINT nam `j t►✓ �J �J - e. location: 3 • Z 1 UOS J9A-j �Ct city ©t7��i�✓ � w- nhone#6Do r%1Zt7 7�Z I am a homeowner performing all work myself. ��I am a sole proprietor and have no one working in any capacity _,,,. .�... — .._...�. I am an emplover providing workers' compensation for my employees working on this job. comnam name: address: city: phnne 0• - insurance cn. poiicv# I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the followin! workers' compensation polices: company natnN. i I address: city: Shone#• insurance rn. nolicv# ._..__._.... .._ ...�_—....._. _I_L....r Y...�._ raw_J.r'.rr.1�:____ __ -- ___- _— - _•1••~ __ _� - r—ti_ai�Y`_. .Y.�—� con►nany namr: address: city: phone# insurance co. policy# Attach additional sheet if neccssaty.-=•..� =;—`�- r :— """"' W�..��YWa.[!�'+�..✓.w`Z.�' +-. .:>_ ..�:1_.......--_�.'� --._ i'•Wt'ii��l!•.11NG'wr�L Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a line up to 51.500.00 andiur one N cars'imprisonment:is well as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. I understand that a cope of this st:ttemcnt mac be for4,rd the Office of Investigations of the DiA for coverage verification. /do berth► ccni r ut r the enalties of perjure•drat the information provided above is true and correecct. Signature Datc / Z / 7 Print D k < <L/ P— hone# �Z 7 7 Z T ♦rI �'.I..LlY - official use univ do not write in this area to be completed by tiny or town official cttN.or town: permitlliccnse# riBuilding,Department E C3Liccnsing Board - kt 0 check if immediate response is required Selectmen's Office k Uticalth Department hone#: rnOthcr : contact person: p . r Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all ern plovers to provide workers' compensation for the: employees. As quoted from the "law". an emp/nree is defined as every person in the service of another under any contract of hire, express or implied. oral or written. An empl( rer is defined as an individual, partnership, association. corporation or other legal entiiy. or any two or more the fore`,oing en,,aued in a joint enterprise. and including the lei-al representatives of-a!deceased.einpIover. or the receiver or trustee--of an individual , partnership. association or other_legal entity, employing employees. Ho��eyer the owner of a dwelling, house haying not more titzn 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_ ]IOU or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even-state or local licensing agency small 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 in coverage required. Additionally. 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 hL been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits 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 tine 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. Citv or Towns 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. Plea be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned tl FAX arrangements have been made. the Department by maxi or FAa unless other rr The Office of Investigations would like to thank you in advance for you cooperation and should you have any question. please do not hesitate to give us a call. 't , r t, ^` ... ..—.—..-i..,.�.-.�a.w.v rir!-r.^......�+e.,.w.. 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 fax ff: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 UPYCONSpRUCr p 12Nr OF PUBLIC Nader: UPERVISOR SEfP LICENSE CS 009961 Expires: Restricted 0411411998 Bl hdate: To., 00 0411411952 JohW J DELASEP v 36 RAINBOW DR CENPERVILLE, 01631 i �I BAILIWARM. The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227A r,.. * - Ralph Crossen Fax: 508-790-6230 Building Commissioner /y 7 August 4, 1997 Richard Callahan,TRS Oxbow Realty 725 Canton Street Norwood,MA 02062 RE: M-116 P-011 Dear Property Owner: Our records indicate that your house at,321 West Bay Road,Osterville,is currently being used as a six family home contrary to Barnstable Zoning Ordinances. You must contact this office as soon as possible to either. 1) apply for a building permit to restore the property to a five family home �- 2) apply to the Zoning Board of Appeals for a variance 3) prove that this is a legal six-family You must contact this office immediately to tell us what direction you wish to take. Sincerely, Gloria M.Urenas Zoning Enforcement Officer GMU:lb CERTIFIED MAIL-P 339 592 321 t970311a �THE i * BARNStABLE, • A,E A�•�' The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner August 4, 1997 Richard Callahan,TRS Oxbow Realty 725 Canton Street Norwood,MA 02062 RE: M-116 P-0 I 1 Dear Property Owner: Our records indicate that your house at,321 West Bay Road,Osterville,is currently being used as a six family home contrary to Barnstable Zoning Ordinances. You must contact this office as soon as possible to either: 1) apply for a building permit to restore the property to a five family home 2) apply to the Zoning Board of Appeals for a variance 3) prove that this is a legal six-family You must contact this office immediately to tell us what direction you wish to take. Sincerely, Gloria M.Urenas Zoning Enforcement Officer GMU:Ib CERTIFIED MAIL-P 339 592 321 f970311a I TOWN OF 3 Alm NSTA13LE REPORT OPPLEMMNTAILY/CONTINII�ON REPORT NAME (LAST RST. MIDDLE) DIVISION /D1PT NOTE DETAILS t OHSER ATIONS-ITEMIZE EVIDENCE. SERIAL IS ETC. c Q �r 15 A uu u ( P'6 _ _ . o No.. = 7 FR$..... . Q...._. HE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ✓����� � 3�1A WN OF BARNSTABLE .4pliratiuu for Diripasal Worku Towitrurtiurt Funfit Application is hereby made for a Permit to Construct ( ) or Repair (.\) an .Individual Sewage Disposal System at: - - C /! -------------------------- Loca iou-:1ddr� '""'-"- ------x-' o\c.!-._ C_o k~ 2 S CAS r Lt_.No.C� ----------------•-----•-•------- ------ -------- N ,r ----- �.�orQXA '�? Owner '----------------- - -----------•---- ------_._ Ap �- --- - vv === S � v`Ad f r Listaller Address �I Type of Building .�Qo�cL�-- '-Y�tvTS Size Lot_. � ---_-_ Dwelling— No. of Bedr%oms.__..__1?---------------•- ......- q• t l� ------------Expansion Attic (tko Garbage Grinder (P Other—Type of Building __________ ______________ o. of persons---------------------------- Showers ( ) — Cafeteria ( ) Other fixtures .. Design Flow--------------------- - - ------------------gallons per person per day. Total daily flow..`__V'6Zn Septic Tank—Liquid capacity.? -gallons Length________________ Width................ Diameter--..._ - •- '--gallons. Disposal Trench—No. -•--•---•--•-• - Depth ----- . Width-__---- -_•--- Total Length_._g_'�__-___-- Total leaching area.Z._�.1-77•_...-sq. ft. Seepage Pit No..................... Diameter--------------- Depth below inlet_._ _ --------------- Total leaching area---------------•-.sq. ft. Other Distribution box Dosing tank (�kc) Percolation Test Results Performed by..--. PtT�-:- _ - -•- 1-- q`1-C---,A)C------------------- Date..._ Test Pit No. 1:.L -------minutes per inch Depth of Test Pit------6----------- Depth to ground water.....(,.,.A._.._...... Test Pit No. 2_.LZ_..__._minutes per inch .Depth of. Test Pit.......IE.t__.._ De th to round water_.__..p g �_ L --------------------------------------------------------------------------- -- -• .- .-- S �s�Description of Soil....... � A�� ............................ Nature of Repairs or Alterations—Answer when applicable________ _ ______________ .--•- . ----•- greement: The undersigned.agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Com lia e issued b, the boa of health. Signed t .. .. g - .. Application Approved By - Da,, - . .. ..-..-1. fe..:.... Application Disapproved for the fo lowin reasons; g . .......................................... ................ ............... ...... Permit No. . Issued ' Dare I � - x, � a -�, ��+�.�-...,.�:,,.,,,�.......�,.�,,,,--.,,.+�_,. -^-�».-.-•..._,s„y;ti.-.,.,..,..�,_..;�„r""`�'���.,.:- ,yr� are:r- !i - : C _ " ;� 7 [ ] [R116 011 . , ] • LOC10321 COCKACHOISET CTY111 TDS] 300 CO KEY] 55807 ----MAILING ADDRESS------- PCA] 1111 PCS] 00 YR] 00 PARENT] 0 CALLAHAN, RICHARD P TRS MAP] AREA125AB JV1375178 MTG10000 -.BAYER, CHARLES M JR SP1] SP21 SP31 OXBOW REALTY, INC UT11 UT21 . 62 SQ FT] 4464 725 CANTON ST AYB] 1900 EYB] 1962 OBS] 75 CONST] NORWOOD MA 02062 LAND 131600 IMP 119600 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 251200 REA CLASSIFIED #LAND 1 131, 600 ASD LND 131600 ASD IMP 119600 ASD OTH #BLDG(S) -CARD-1 1 119, 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 321 WEST BAY RD OST TAX EXEMPT #RR 0330 0217 0182 0113 RESIDENT'L 251200 251200 251200 #SR BRIDGE STREET OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE105/86 PRICE] 725000 ORB15084/263 AFD] I LAST ACTIVITY] 04/19/94 PCR] Y i R116 011 . P P R A I S A L D A T KEY 55807 CALLAHAN, RICHARD P TRS LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RC 131, 600 119, 600 1 A-COST 251, 200 B-MKT BY 00/ BY /00 C-INCOME 220, 100 PCA=1111 PCS=00 SIZE= 4464 JUST-VAL 251, 200 LEV=300 CONST-C 0 ----COMPARISON TO CONTROL AREA 25AB -- TREND EXCEEDS STANDARD NEIGHBORHOOD 25AB OSTERVILLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 1316001 LAND-MEAN +Oo 2512001 240055 IMPROVED-MEAN -500 250 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 9001 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R116 011 . • P E R M I T [PMT] ACT* [R] CARD [000] KEY 55807 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT [B17350] [10] [74] [ ] A ] [ ] [00] [00] [000] [NEW ] [OS RMODGAR] [B17968] [10] [75]. [ ] A ] [ ] [01] [76] [100] [NEW ] [OS DORMER ] [B18779] [10] [76] [ ] A ] [ ] [01] [79] [100] [NEW ] [OS DORMER ] OPERTV ADDRESS ZONING I DISTRICT CODE SIP-DISTS.I DATE PRINTED I CSTATE LASS I PCS NBHD — KEY NO. 0321 COCKACHOISET 11 R LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORSTI 'D ale S:e D ,soon UNIT ADJ'D.UNIT ACRES/UNITS VALUE Descripron CALLAHANo RiCHARD P TRS MAP— CD. FF.oepinJ.—I 1LOC./YR.SPeC CLASS ADJ. CO PRICE PRICE #LAND 1 1600800 CARDS IN ACCOUNT10 1BLDG.SIT 1 X .62E=11 1317999 ..9 259379.9 .62 16080J #BLDG(S)-CARD-1 1 132P600 01 OF 01 #PL 321 WEST SAY RD DST (COST 934BATHS 6.0 U X B= 10026500.0 26500.0 1.00 2650C 3 #RR 0330 0217 0132 0113 (MARKET • 4SR BRIDGE STREET (INCOME 220100 A USE DI I !APPRAISED VALUE JI i A 293,400 � i PARCEL SUMMARY g LAND 160800 T I IBLDGS 132600 M ! 0—IMPS E I ! �TOTAL 293400 �N CNST nl DEED REFERENCE Ty— DATE Recortletl PRIOR YEAR VALUE ook '— T B Page I : MO. Yr Seina Pr ce -�D LAND 160$00 b 5084/263, 1,05/36 725000 IBLDGS 132600 5084/254; Ib5186 450000 TOTAL 293400 1686/271: 00/00 BUILDING PERM.!T Number Dale Type Prncun 160L AN 800 LAND—ADJ i INC ME SE I SP—BLDS FEATURES BLD—ADJJ UNITS 26500 818779 10/76 ennl TnInI vea o�,Il �.la ss Rase Ral e• AJI Relt 1 q Norm. Obsv. U n,ts Unls A � 1 9c Depr. Contl. CND. Loc. 4b R.G. Ra pl.Cost New Arlj Rnpl Vnliir .Slnrins Hniljftl Rroms e0 Rms.Balt•s I a Fib. I Pertywall Fec. 2 000 100 100 71.90 71.90 00 65 29 66 75 95 45.7 289554 132600 2.0 1 1 :+mlion Rale Square Feel I Repl.Cost MKT.INDEX: 1.00 IMP.BY/DATE: / SCALE: 1/0 0.5 1 ELEMENTS CODE CONSTRUCTION DETAIL 100 71.90 1795 129061 GROSS AREA 4464 SIX FAMILY CIVST G0:00 FSf 0 64.71 154 9965 N 9 *-9--*---17--* STYLE JD 9_0 FSF s'0 64.71 24 1553 1FSF 10 ! DESIGN ADJM7 JO ---------- -0= --- - ---- - ---- ------- - fSf 9 64.71 90 5$24 FSF ! ! ! EIiTER.SiALLS TIWOOD SHINGLES 0. FSF 90 64.71 56 3624 *6—*---18---* ! HEATIAC TYPE OG --------------- FSF 90 64.71 550 35591 *-----------50--------*6—* 29* INTER.fiNISH --- -- ---- - G- 820 60 43.14 1795 77436 ! BASE ! INTER.�AYOUT _OD-- - - - .----60 14 INTER.4UALTY 02SAME_ AS EXTER 0�=0 22 ! ! FLOJR Mu CT _00----- --- -----------0_ W! *-7-*--29------X-----26---*-FSF EFLoLO COVER- -OG---- ----- ----------0.0 T pl al Are as Ap. 2669 ! 7 ! ! ! RDOT TYPE---- -01 GABLE-ASPH SN--- 0-0 T BUILDING DIMENSIONS *------30-14--* 12 + ELECTRICAL OD 0.0 SAS W29 S07 FSF N07 E07 S12 W21 5 FSF ! ! ! FOJy6AfiI0N -02CONCRETE BLOCK �9.9 A N05 E14 .. BAS W30 N22 E50 FSF *----21----* 25 25 -------------- -. -------------------- W06 N04 E06 SO4 .. BAS N04 E18 ! ! - - NET�N80R 6Ob �SAB 6STERYfCL L N10, FSF •W09 S10 E09 N10 .. BAS ! ! LAND TOTAL MARKET E17 S29 FSF E04 N14 W04 S14 ! FSF ! PARCEL 160800 293400 BAS W26 .. FSF S25 E22 N25 W22 *----22----* AREA 30006 VARIANCE +0 +878 STANDARD 25 tUU1VUH11UIV COIv11. CX HI Ill. rLUlvltiuVV PRICINIa LAND.COST - Cone.WaIW Fin.Bsmt.Area Bath Room J Base ZC i BLDG.COST Cyry Cone.Bilk.Walls Bsmt. Rec. Room St. Shower Bath Bsmt. C7 PORCH. DATE 1 7 / 2 Conc.'Slab'. Bsmt.Garage St. Shower Ext. Walls PORCH. PRICE Brick Walls Attic FI. &Stairs Toilet Room Roof RENT II�Q 5� BIZ Z�r Stone Walls Fin.Attie Two Fixt. Bath Floors Piers INTERIOR FINISH lavatory Extra - 2� �(�. �► Bsmt. F 1 2 1 3 Sink S /= I Plaster Water Clo. Extra Attie Zy / 9 (/ /7 s/ /4 EXTERIOR WALLS Knotty Pine Water Only 1° t ` Double Siding Plywood No Plumbing Bsmt. Fin. _ y` 9 Single Siding Plasterboard Int. Fin. 00�_Shingles TILING Conc. Blk. G F P Bath FI. Heat Face Brk.On Int.Layout Bath#&Wains. I-' Auto Ht.Unit 3�Q 2 Z z 0 CJ Z(o Veneer Int.Cond. Bath FI.&Walls Fireplace Com. Brk.On HEATING Toilet Rm.Fl. 3 O Plumbing Solid Com.Brk. Hot Air Toilet Rm.FI.&Wains. Z S /2 Tiling .] S _ Steam - V, Toilet Rm.FI.&Walls Blanket Ins. Hot Water St. Shower Al&j r Roof Ins. Air Cond. Tub Area Total — Floor Furn. ROOFING COMPUTATIONS ' Asph. Shingle Pipeless Furn. S.F. Wood Shingle No Heat 15 S.F. Asbs. Shingle Oil Burner S'sO. S.F. �5 i O' 7 ' //I'j1- CoNv• 2 /7/Z �p 1S F)� t/3lA/ Slate Coal Stoker Tile Gas S. F. / 70 OUTBUILDINGS ROOF TYPE Electric Gable Flat f S. F. Sb S�3 1 2 3 4 5 6 1 7181 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED Hip Mansard FIREPLACES (� S.F. Zg,/D ��' Pier Found. Floor Gambrel Fireplace Stack Z A S-0 3:J Wall Found. 0.H.Door LISTED FLOORS Fireplace 2 Z 7 Sgle.Sdg. Roll Roofing _ Conc. LIGHTING — Dble.Sdg. Shingle Roof Earth No Elect. DATE Pine Shingle Walls Plumbing Hardwood / ROOMS Cement Bik. Electric Asph.Tile Bsmt. 1st TOTAL Brick Int.Finish QED Single 2nd 3rd FACTOR REPLACEMENT ,Q 7 !Vj iC.QG OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. -5 40 �'ti S� — _T_ o /CC- I,�S G /o(o�ls• 28U- I , 2 3 4 5 1 6 7 8 9 10 I TOTAL RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT ' STREET 321 West Bay' Rd, Osterville SUMMARY 116 11 C-0 LAND `) BLDGS. �.) ..... OWNER TOTAL RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: H-7r LAND Oi BLDGS. 7 3 rw.,.�.. y� '`�Mcingrne T311iati wF:` Tr. TOTAL 3 9S G 3J�J69. ,d.3.393:..vt B fi2a � LAND .Reynolds I, Charles A. & Constance•M _ 1686 271 BLDGS. 5 4/o 0 TOTAL Qj S�C//v ti 1. 7y LAND 3 �(OO o ?x O ODD ° 1/T r Ol BLDGS. .5—,ry j 6 G .91 / 1 7 G TOTAL O 90 U 7 L'0/7 g CO M 7(, LAND 3 1 tp 6 0 -7 a((C) BLDGS. 6 3 o O s 12.P TOTAL LS S/97 LAND 76' 6 1�.5 rssmr v,- 0PrX, S'717t K rn BLDGS. TOTAL LAND BLDGS. TOTAL r— ��1 oR �SSfSSA�yy/ Sz " 'vol P r�(E /�tii -// :LAND INTERIOR INSPECTED: D BLDGS. TOTAL DATE: LAND ACREAGE COMPUTATIONS M BLDGS. , TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL 7-5 HOUSE LOT' 74 s QCXj;� 3 O O LAND CLEARED FRONT BLDGS. REAR �' • y TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. rn _. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND li f 01 BLDGS. LOT COMPUTATIONS D FACTORS 7. TOTAL FRONT DEPTH STREET PRICE DEPTH q4, FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND �2/t ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND c.. SWAMPY NO RD_ BLDGS. Assessor's map and lot number .... �,� SEPTIC SYSTEM MUST BE ' .. �j h-:STALLED :IN COMPLIANCE :T ICLE Ii STATE Sewage" Permit number ........ .1 ,�.,/),,�i�'�C`� � �... VITH A ` 0 SANITARY CODE AND TOWN u QyO�?NE.r��t TOWN OF BAR � � Xf3E BARNSTA➢LE. 1639. Py� 639- 131.11 DING INSPECTOR 90� `e0� .. . e YPY a' APPLICATION FOR PERMIT TO ... ..... 'J.................7.0 TYPE OF CONSTRUCTION TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... .... ...,../ ....... ..... ........ ............I......./.�..,................ .........;... ........,............................. ProposedUse /V' ............ ,/(/.........r ........�..• ....�f................................. ZoningDistrict ...............................:....................................;Fire District .............................................................................. Nameof Owner ...... ...................... ..... N��..�!.SAddress . .................... .......... ............................. Name of Builder .....".� ��LiT...Address ... .... �. .. ,I....... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....5. ...........Foundation Exterior .............7..�.. ...............................Roofing ....... ..... .7.. ....�C......................... U - � '�,-C.�' Floors , �....................................................................Interior ...... HeatingPlumbing ....7'........................................................................... Fireplace .....Approximate Cost .......1 v Definitive Plan Approved by Planning Board ________________________________19________. Area .. ..........4�. ......�.. ............ Diagram of Lot and Building with Dimensions /t V Fee ......../A... ..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the To of Barnstable r ing the above construction. Name ............ .............. ` Reynolds, Charles . . . . ° � dormer �� add ' J..-PE?... Parmnhf�r .---.-------- _ . ^ 'to dwelling � ......................... Location --..J��..�emi�.�a�..����__.__.__ ' . ` -------.��09�TY��]��-------.---.. ' � ' Ovvner ---. ...................... Type ofConstruction ..........f.r.mmom..................... ' -.---.~..-�-----.-..-.----'�-.--- - ' ' - Plot .-----.---. Lot .---_-----.- � . . - . Permit Permit �~ron,a6.. 2 -l� 76 ' ( _ . ~ Dote of | ................................... --- ---.�.lA � . . ~ � . � i Dote Completedo| .... �}�-----l� . . . ^ �����0[ '������� . ........................................................... 19 . . . . , . , . ` . . . .------...^..-.--~----.-.-------.. . . . . ` . -'---~-^^^'-''------^^^^^^------- _ .-.~......-..---.'........---.-.---.-. '~~--..---.-..---...-...~.,....---.- . , ^ . . . - . . . . . . . . A -------------'-- l� � � , ^ , . -------.-------.----.~-.----. ` ^ . - . ................. . ' , ' U Assessor's map and lot number ... U�l f i r. Sewage Permit number & 411�-,-eact... 0`711ET°� TOWN OF BARNSTABLE • BARNSTABLE. i oYa.•�° BUILDING INSPECTOR .. r APPLICATION FOR PERMIT TO % � C •. r� l'!/, �fJ TQ 1t11; �`/,eV-,J �.�17,?1/ r• ... ............ ............................................................. TYPEOF CONSTRUCTION ............ ...................................................................................................... .... ..............19.,W r la TO ,THE INSPECTOR OF BUILDINGS: ;The undersigned hereby applies for `a permit according to the following information: ' Location .. ...r. T„T"> `/ .� ................ ,......../��1//....1� ..;f�,�.........................................: r Proposed Use t/ �ocL Tii�G".. �7/4)A.. ../.r 1„� f? ...! ' ......................... F .. . .. .. ZoningDistrict ................................................ ..........................Fire District ...............�............................................................. Name of Owner ......................... //JC. Address :. �.�.` .:. .. '.��.4 / ���i'/Gl Name of Builder // ��� G/c�T...Address ... � _ "� ��� t / Nameof Architect ...-............................................................Address .................................................................................... Numberof Rooms ....5......................................................Foundation .............................................................................. i T Exierior ..... ............................... .7 Floors — .........................................Interior ....�'.�a//��?�- Heating ........Plumbing ...`............................................................................. Fireplace "r .......................Approximate Cost ( �'J Definitive Plan Approved by Planning Board ________________________________19________. I Area ...-..... ..:.../.......... Diagram of Lot and Building with Dimensions f Fee " t. .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH c r J f Cw a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg ding the above construction. Name .............. !^ ... n< ................................. ....�_� ifs .�.: Reynolds, Charles' A=116-11 18779 dormer No ................. Permit for .................................... add to dwelling ..................................................................... Location .........321 West Bay Road ....................................................... Osterville ............................................................................... Owner Charles Reynolds ........................................................ Type of Construction frame Plot ............................ Lot ................................ Permit Granted ........�cto'ber 28..........19 76 Date of Inspection ...............\...............19 I4 Date Completed ................ .............19 PERMIT REFUSED ............................... ............f ...... .................. ... ./ ... �. ........ ... . .................. ................ Approved 000 ..................... ........ ....... .......... Assessor'sp ma _ and. +n lot umber ...�� 7 `— t 4 SEPTIC 'SYS-E" F1-UlT BE INISTALLED IN CC Is!, MINCE J yc w, Sewlage Permit number .. .. .... f/..fir' 1�11T!-I F,=?i,. . II 1T/',?1' COD A;;© TOWN CF711ET� 0 0 - TOWN_ OF BARNSTALBLE w O� r i tQ i BAHBSTABLE. i G tT wa .w 'BUILDING ' 11SPECTOR' �o r°" � c� , F t ; APPLICATION`FOR cPERMIT TO .. ......... ...... ...................... . TYPE OF CONSTRUCTION .... ................................................ . ................................................................. t „ ....... /.............. ......19....1. } TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accord' to the following information: Location �....:....!f!�.r. .. J.7 ........................................................................... ............... y.... ..... ... ProposedUse ...... .... ............................. ....................................................................................... r . c� a Zoning District .........1 .. ...................... .. .........................Fire District ............................... Nameof Owner ... ....... ... ...............Address .....sJ... ..l.................................................................... o . Name of Builder 5r................ ����......�T................Address ...........�/........✓../���..�J...............�.:.���� Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ............................................................................... Exterior �/` ` a . Roofing ........f��/ s :...................................................:..... ................................................................ Floors ..............................................................I.....................Interior .................................................................................... ` Heating _ ...................Plumbing .........................A roximate Cost ... �?/ter....:............................................ Fireplace ......................................................... PP Definitive Plan Approved by Planning Board _______________________________19________. Area No bvr� .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. i `c•K LGGt4� ����G2i�4�� ,LC.�� Name ......................................................... .................... Charles Reynolds 17968 No ..1.79.68......Permit forr..,...WKIRAT.................. .................... ..........:.... :...:............ Location ..... W. �w" .. ✓J -• .. � _ .,i21.. ....Ba. R&........................... f.t OstezuilLe.................. .......... Owner Ghar•Les...ReyaaLds.................... r '. !� '� •,.......... u st• ; Type of Construction ...........Fran..................... Plot ............. Lot ................................ Permit Granted ....OGtQber.........3.....•..t.1975 Date of,lnspection � { Date' Completed~... a� ,7�... .........19 • y -- t PERMIT REFUSED .................... :... .........rt............. .I.�1 .................. f, , ern ,. ................................ ............................. .................:........ ..................... '? ...................... ff,• r; ., Approved ...................... ..... 19 ,,`•` � ,�''r,r .........................................................? .............. .................... .....................................................�.`..: f 'r Assessor's map'and lot number .......................................... Sewage Permit number °*THE T TOWN OF BARNSTABLE Z MAUSTOIlLE, i "6 q . BUILDING INSPECTOR 'F0 M �'' APPLICATION FOR PERMIT TO ......� ......-....................t2'...........=..................................................... TYPE OF CONSTRUCTION ........!..:.'� �� �``= ...................................... ......19.... !�.� F TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... ............................................................... ................................................. ProposedUse ...... .... .............../��C7 7........................................................................................................................ (7- U In ZoningDistrict ........./r.. ...........................- ......................Fire District ............................................�.... Name of Owner ... „/Ii���/ U J...`....Address .......................................................... Name of Builder cRW��J�.".. r��'���T................Address ../��7.. ��'... �����J'.�,..! � Rl Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .........:........................................................Foundation .............................................................................. Exierior ....................................................................................Roofing ............................................................................... Floors .. ...................................................................................Interior .................................................................................... . Heating ...............................Plumbing .....:.......................................................... 6? Fireplace ........................................Approximate Cost .......................................... ............................n........................................ Definitive Plan Approved by Planning Board ________________________________19____'___. Area ............................................ J � 1 Diagram of Lot and Building with,Dimensions Fee .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name .................................................................................. Charles Reynolds 17968 17968 No ................. Permit for ......P�qMgX�................ ............................................................................... Cocation ...3.2.1...W.....BaX ............................ ............................... .......................... Owner .......qhA2j4.'-JRe)rMlds......................... Type of Construction ....FKAPAP............................ . ................................................................................ plot .....1-16-11 ....................... t .................... Permit Granted ..... ...... ......19,75 Date of Inspection ................... ................19 Date Complet d .................... e .....................19 E'P /E RMIT REFUSED ................................................................ 19 ......... ..................... — �Ip............ . ... ....... ........ ............ ............................. ............... ............................................................................... Approved ................................................ 19 ............................................................ ................... ............................................................................... Assessor's map and lot number Ma. ........ ................ ..... ..... � � — O - �� �Y SST BE Sewage Permit number TOTLIA..� .. .................. ... x 'f�l : i d � STATES UNITARY CODE �A � *7111E �o TOWN OF BARNS ` ME:_ • 8ARISTME, i "6 9 M BUILDING'. INSPECTOR pY a• APPLICATION FOR PERMIT TO .a ....�. ..�%�?r... .......... ......... �.:. . :. ...... .tif/J`�Z'?�� TYPE OF CONSTRUCTION ....1�1!.< ........................................................................ � . .............. . .........19./... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...Al..11.. !4�.. ......./..�� .....f f .`. r' .......... �.� ............................:.................................. . %':..... ..:................................................................................................................................ Proposed Use ..... Zoning District .......Fire District .....:........................... ................................................................. ............................................. Name of Owner ' Add.............. ress . ?�� Name of Builder ` .I.7.�...............................Address ./...?. . .. Nameof Architect ..................................................................Address ..............................................................6..................... 41 Number of Rooms . .�?......:/ 1�t. �...:.... ..:. Foundation Exterior ....... e ..................6.......................................Roofing .................................................................................... Floors ....... ..................6...........................................Interior ........... ................................................6....................... HeatingPlumbing ....... .............. ... ............................... Fireplace ..- '?r! ......................................................................Approximate Cost ........... `I ......................................... Aj Definitive Plan Approved by Planning Board -------------------—-----------19--------. Area v�...... .. . Diagram of Lot and Building with Dimensions 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 :2"-V. ' Name �!L..... ... �.......... Reynolds, Charles A. No ..17350 Permit for remodel ara e .........tq„£amilv,..o!:n. . A peal ��1974-39� Location .M..W As ..DAY: RQ kd................. nc#Qvx:vl ?.p................................ Owner .............. .......... Type of Construction ............ ° *!1'................... Plot ............................ Lot ................................ Permit Granted ..Octobe. . r...1...........1974 ` .... . ........ .. Date of Inspection ;.... Date Completed .. �'1. ..........19 PERMIT REFUSED ................................................................ 19 ............................................................................... ° E : ................................................................................ .............................................................................. ............................................................................... Approved ................................................ 19 ............................................................................... .................... ......................................................... I 4.�_ s .. � � ` � •�:� , FEE ���#��•y}`s � j�. ��e ' "_ «. a # � TOWN ,OF BARNSTABLE,I£ ,MASS. . .•rOC �.�:; _ • ' ,Yi t '�c�.s i�1:t3�1:*.i A it`�� a' `�i '.1.9� :i�.F�.J�_ SIC f eti THIS IS TO CERTIFY THAT A`PERMIT fS HEREBY GRANTED',TO,I> S i_ p re }.. . 1p. O � M (PROPERTY OWNER) } � ♦ R 'T+r' H. (BUILD)_ ii(REPAIR)�. �.0 ».�.....» �r /w�..y..�..» k a_ fi ., .}"�• .pq ''.c �;)" .r „#y, +p� �cy:-.eax„@ /yy N,�°te .fig` ' a. O V 43mi4i '� '�'�s '0. 'e`� h a �d' ikM his?`r,.x �{ A t k`t• a5 - )TYPE OF BUILDING) IA_PPROXIMAT6 O Q ' $� / ��y A LOCATION hey ' ' ♦$; 9•44 rybA?'(STREET AND NUMBER) ' t.f'4 5+ a»J „�`� - (VILL'A66) 'wz's. .� S�T+ • ,�}..,,y ,. - NAME-,OF BUILDER OR CONTRACTOR. - ^ .: 7 4�` �.1..�`.t�`:., �r' b r -t•a x,;- y J" � '�i'F Yf '",��N t' ' - APPROXIMATE COST IQb °' r" ,�'w e` `-r �` SFr' y,,. n•,..s +'Y": ,,.eaa.'' � ,� "T � �ry. I HEREBY,AGREE TO CONFORM TO,ALL THE RULES AND REGULATIONS OF THE STOWN OF�BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION ol t _ y - .; 9 2l R 3' 72i�° btu# (OWNER) fCONT-RAGTOR) c. a )..• ,y v "cIP,r. "e`i. a ':0. c ., tv Ii..y , n,. 1F.� f K3 3 l`1 :'.y M Y ..... b e• '1'Y h i l I�UILDIN;G INSPfiCTORT ' •��� � �' r' �ta-e �• r. t �� �� � 7Y� r� :t�+ {''Sk."'�� •,•� (z a? � �° t �+a Z�r,c> h r�}- � ����� � ` Subject fo.Approvil of Board of Health; a. _. r .. ,.., =.. -:>.: .. n,�?. .h .. •.t .Asa � 3�.""w� . _:.,:'i,.a..F, ',� — � c. ., :, :, .,. -:.-.r .. . '- .,d.:.. _..� ...jwrvr..a.yfs++-r+r. +raro. �w+racw...►.,a.q,b+.,waw,.. +. .w;...-.nl�wew...rw .... . .. _ . +++++. _ _..�,w,.... .,,....,y,,, .- ...w.wyr,...r.....+we� i..r.:.w.._,..._............... "i"'+'+^' .x 'w;' '' y.4•_,+%ti...r.:r�.....r.:..... .. ;. , j; } PROPOSED Pf-A NIA _ !' L.- >� =r' f � i ...! . «.� s i ''«+ I if '4 ti + IN fill L P 0 '' '' it it r E i - yEliJ .fLlr!c� r / {{{ yr. Oilx� � 1 `' •�-_s—= �s� 1 1{r fit, ,! ' 6 _ 1 - < 'tip�a Fill fi cr i J it ,. I