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Postal
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Postal.Service
fO+ii N Of BARNSTABLE
BUILDING DIVISION
200 MAIN ST
'4yANNIS, MA 02601
d,Jj,1f'111,11-III'Ih,JI.110i'I'�l� iii��ljtfi� �1aa�� j11'11�
:
YOU WISH TO OPEN A BUSINESS?
For Your Information: "Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you
must do by M.G.L.-it does not give you permission to operate.) You'must first obtain the necessary signatures on this form at 200 Main St., Hyannis.
Take the completed form to the Town Clerk's Office,.1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
R Wii;tttetF4Y 8 DATE: Z7 L Fill in please:
'' ►tom' j APPLICANT'S YOUR NAME/S: i OA o 1n L us
TOM c
BUSINESS_ YOUR HOME ADDRESS: Lou
RA
TELEPHONE # Home Telephone Number_ -o — Z{k
NAME•,pF'CORPOf�AT14 - .. ...
N�
NAME OF:NEW
dS T H 15,A HO
.......... .: .M�.00CIJPl� YE p ;...
PE OF'BI�SINESS
:ADD
R SS.OF BU5 ESS.a.
:'i1_k?/PARCEL.NUMBER �. •.. l.J�
'•�(Assessing] ....
When starting a new business there ere several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth
Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
1. BUILDING COMMIS TONER'S OFF
This individual ""'be i d�f ny er it re uire ants that pertain to this type of business.
u horiz d SiGnatu -
COMMENTS: , � '
2. BOARD OF HEALTH
This individual he infor he p t re uir fnents that pertain to this type of business.
Authorized ignature*
COMMENTS: MW COMPLY WITH ALL .
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature
COMMENTS:
1I1
0
�, TOWN OF BARNSTABLE
�� .T Building
Application Ref: 200901897
K Permit� BARNSTABLE, } Issue Date: OS/07/09
y MASS.
QpAr16 339. A Applicant: SIMMONS,JONATHAN H&LESLIE W Permit Number: B 20090708
Proposed Use: SINGLE FAMILY HOME Expiration Date: 11/04/09
Location 85 TIMBER LANE Zoning District RF Permit Type: DECK/PORCH RESIDENTIAL
Map Parcel 149053 Permit Fee$ 60.00 Contractor PR RTY OWNER
Village MARSTONS MILLS App Fee$ 50.00 License um
Est Construction Cost$ 2,500
Remarks OVED PLA MUST BE RETAINED ON JOB AND
8'X12'DECK T RD MU BE KEPT POSTED UNTIL FINAL
NSP ON S BEEN MADE. WHERE A
CERTI T OF OCCUPANCY IS REQUIRED,SUCH
Owner on Record: SIMMONS,JONATHAN H 81:LESLIE W BUILDI G S ALL NOT BE OCCUPIED UNTIL A FINAL
Address: 85 TIMBER LN INSPE I HAS BEEN MADE.
MARSTONS MILLS, MA 02648
Application Entered by: RM Buil ing Pe it Issued G
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,A Y OR IDEWAL•K OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY.
ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIF[CALL ERMI TED UNfDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.
STREET OR ALLY GRADES AS WELL AS DEPTH AND LOCATION 0 UB IC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS_.
THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE T-Hk APPLICA OM T E CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FO ALL CON T CTION WORK:
1. FOUNDATION OR FOOTINGS.
2.ALL FIREPLACES MUST BE INSPECTED A THE ROA EVEL BEF FIRST FLUE LINING IS INSTALLED.
3.WIRING&PLUMBING INSPECTIONS TO COMP ETED P OR TO FRAME INSPECTION.
4.PRIOR TO COVERING STRUCTURA ME BERS( ADY TO L TH).
5. INSULATION.
6.FINAL INSPECTION BEFORE OCCUPA C
WHERE APPLICABLE,SEPARATE PERMIT A UIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS.
WORK SHALL NOT PROCEED NTIL THE PE OR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION.
PERMIT WILL BECOM NU 11 ID I CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF
DATE THE PERMIT IS SSU D AS NOT
PERSONS CONTRACTING WITH NREGISTERED ONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(asset forth in MGL c.142A).
BUILDING INSPECTION�APROVA/
PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 1 1
2 2 2
3 1 Heating Inspection Approvals Engineering Dept
Fire Dept 2 Board of Health
�a
���
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION O? 0
.07
Map Parcel: 3 rApplication`# ik
Health Division 'Date Issued 5 7`
Conservation Division -"Application-Fe
Planning Dept: Fee `�'
Permiit
Date Definitive:Plan Approved by Planning Board `.
Historic ;OKH. Preservation/Hyannis
Project Street Address ZS 5 ( \,,A e S
Village
ft k�
� t`
Owner V"f)Via(y flt iAkyk;0 S Address es S : 4 SOD
Telephone L1�L-
Permit Request 6GC
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District' Flood Plain Groundwater Overlay
___;p Project Valuation D 500,0 0 Construction Type
Lot•Size �� kre Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(# units)
Age of Existing Structure Historic House: ❑Yes 0 No On Old Kings Highway: ❑Yes ❑ No
Basement Type: Wull ❑ Crawl ❑Walkout ❑ Other F
Basement Finished Area(sq.ft.) Basement Unfinished Areaq.ft) j
Number of Baths: Full: existing new Half: existing v' —newer ,
Number of Bedrooms: 3 existing _new
Total Room Count (not including baths): existing new First Floor Room Cognt w
r Heat Type and Fuel: ❑ Gas J1410il 0 Electric ❑ Other rn
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 0 Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name flULG� �M N 04 a h 'S Telephone Number 0 - `���-� DO( ��
Address �Yvl�� fu License #
AA t I I� . � � Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO kQ
SIGNATURE DATE
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED -
MAP/PARCEL N0. .
ADDRESS VILLAGE
OWNER
s
-•DATE OF INSPECTION:
FOUNDATION
FRAME
:-INSULATION
FIREPLACE ..
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING r
,DATE'CLOSED OUT,`
ASSOCIATION PLAN,NO.
la
Tlie Comrnonwealttt of Massachusetts
Department of lit dustr•ia[Accidents'
Office of Investigations
600 Wash.ineon Street
Boston, AM 02111
www.mass.gov/dia
Workers' Compensation Yinsnrance Affidavit: Builders/Contractors/Electricians/Plumberg
A licant Information Please Print Le gib
Name(Busi.ness/Organizadowindividual): C� � tYL4 IA&M S
Address: I_!;T A .er-
11l�
City/State/Zip: M Ct( tews �(�1 i Phone.#: 2�3
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 6. ❑New construction
. employees (full and/or part-time).* have hired the sub-contractors
2.❑ I am a•sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling
ship and have no employees These sub-contractors have g• ❑Demolition
working for me in any capacity. employees and have workers' 9 Bt,l�„g addition
[No workers'.comp.-insurance comp• instr-ance.t
required.] S. ❑ We are a corporation and its 10.❑-Electrical repairs or additions
3.I'I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
in.c=ce required]t c. 152, §1(4), and we have no 13.❑ Other .
employees. [No workers'
comp,insurance required_]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compcns4on policy information.
t Homw oonen who submit this affidavit indicating they are doing all work and then hire outside contractors inust submit a new atiidavit indicating such.
(Contractors that check this box must attached an additional sheet showing the nano of the sub-conhactors and state whcthcr ar not those entities have
employees. If the sub-contractors have employees,they must pravidt 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.#: Expiration Date:
Job Site Address: City/StatcMp:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date)
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to-the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Officc of
Investigations of the bIA for insurance coverage verification.
Ido hereb ce ' under the pains•andpenalties ofperjury that the information provided above isgtrue and correct.
Si mature: Date: 7 I lI Z) 1 _
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 S. Plumbing Inspector
6. Other
Contact Person: Phone#:
Information and. Instructions
Massachusetts General Laws chapter 152 requires all employers to provide'workers' compensation for their.ernpIoyees:
Pursuant to this statute, an employee is defined as "...every person in the service of another under aby contract of hire,
express or implied, oral or written."
An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more
of the foregoing,engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual,partnership, association or other legal entity, employing employees, However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall 1,rdhhold 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."
AdditionaIly,MG 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(cs) and phone numbers) along with their certificate(s) of
insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(LL.P)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 Bq 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 Lumber listed below. Self-insured companies should enter their
self-insurance license number on the appropriatr,line.
City or Towp 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 cbpy 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 now affidavit must be filled out each
year.Whcro a home owner or citizen is obtaining a licens a or permit not related to any business or commercial venture
(Le, a dog license or-permit to.burn leaves etc.) said person is NOT required to complete this affidavit.
The Office of Investigations would hlce 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,tclephone•and fax number:
The Cbmmonwff, lth of Massachusetts
Dep.az me-,nt of IndusWal Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tcl. # 617-727-490.0 ext 4.0-6 or 1-M-MASSAFE
Fax# 617-727-7749
Revised 11-22-06 wwti�r.mass,gov/dia
Town of Barnstable
�opTHe r��
Regulatory Servzces
? Thomas F. Geiler, Director
-ARNSTABLE, .
MASS
Building Division
PlfD �a Tom Perry,Building Commissioner .
200 Main Street, Hyannis., MA 02601
wwtv.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
v HOAIEOWNMR LICENSE EXEMPTION
(' Please Print
DATE:
IOB LOCATION: �� �j\1AA P � IMCPrS nS kNA,
number ��p street �L p village
"HOMEOWNER":_,"NQ �i U�1 tl4 S
name home phone# work phone#
CURRENT MArLING ADDRESS: a\0e)\j l
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 HM'EOWNER
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 struchrres. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
homeowner shall submit to the Building Official on.a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes, bylaws,rules.and regulations.
The undersigned "homeowner"certifies that he/she understands the Town of Barnstable Building Department
muurnum.inspection procedures and requirements and that he/she will comply with said procedures and
r qu' ments.
S ature 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.
H0O 0OWNERIS 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 1o9.1..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 ai a unaware that they are assumi Appendix Q,
ng the responsibilities of a supervisor(sec
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.
�oF'(HFr�y Town of Barnstable
Regulatory Services
r r
�
LE'8r Thomas F. Geiler, Director
�prfD �a`� Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis, MA 02601
www.toivn.barnstab1e.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property ®wrier Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
herebyauthorize to act on my behalf,
� /
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owner Date
Print Narne
If Property Owner is applying for permit please complete the Homeowners License
Exemption Form on th•e reverse side.
LK
C,y.
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tME Town of Barnstable -
' Regulatory Services BARNSTABLE. • -
MASS.
t639. 6
6
6,0r Building Division
„ PrFp MPy
200 Main Street,Hyannis,MA 02601
Office: 508-8624038
Fax: 508-790-6230
Inspection'Correction Notice
Type,of Inspection
�E
Location (r -4r-�, Ak VIAL Permit Number
Owner Builder
One notice to remain on job site, one notice on file in Building Department.
The following items need correcting:
�Lo C."�4- )�>—�-k -
'r
P k s-t c�tiT7 rs o i� �N a� Lk�s
i,
0
Please call: 508-862- for re-inspection.
Inspected by � k
� e
Date 9 I
s
64c hb
QJ,
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, F
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BUSINESS:(508)778-4005
® TOLL FREE:(800)339-BKRE
Q� 7OR' RESIDENCE:(508)771-7032
ML-S AFFILIATED - fA
j.j508L7ZUL11
PAGER:899-2406
BERNARD W. KI,OTZ
Realtor
BAYBERRY SQUARE UNIT-113
(� 1645 ROUTE 28
CENTERVILLE,MA 02632
email:bkreinc®capecod.net
s •
. .- � ,
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-
_ _ _ I.
• epartment of Health Safety andEnvironmental Services
5 Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
TOWN OF BARNSTABLE Permit:
'36 9,3-3
SOLID FUEL STOVE PERMIT Date:3-9_y�
Owner. �Q Fee:
U I D� G?�', P N Phone: �a - S S2
Address: l�r. 4,e,— 4n,-P Village:
Map/Parcel: J Date: 3 �'
Stove
A New/ sed
B. Type: dit% irculating an
C. Manufacturer: Lab. No.
D. Model z,L
Chimney
A. New/' =)�dsting (If existing,please note date of last cleaning)
B. Flue Size
C. Are other appliances attached to Flue?
D. Pre-fab Type and Manufacturer
E. aso Line nlined
Hearth
A. Materials: ►/c:
B. Sub Floor Constriction: (A>-s.,e.-r -
Installer -ly r c'�f,tr R u//Iev-
Name: i Address:
Phone:
Location of Installatio
APPROVED BY:
Please make checks payable to the Town of Barnstable
*This constitutes an official stove permit after inspection,photographed and approved by the
Building Inspector
Stove.doc
WE The Town of Barnstable
STAB M ' Department of Health Safety and Environmental Services
Building Division
b
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
SOLID FUEL STOVE PERMITTING PROCEDURE
Applicant fills out application and pays fee
2. Application is given to inspector
3. Inspector enters permit in Pentamation, enters permit number on application, and returns
application to Louise
4. Louise posts fee
5. Karen files original
6. When applicant calls for inspection, inspector makes copy of permit application for applicant,
inspects and photographs stove, and files completed permit application in street adress file
PERMIT 8
Rev 10/14//98
TOWN OF BARNSTABLE Permit No. ----------—------------------
Building Inspector
" ML Cash
e0 ,e79. O c
�9 n+
OCCUPANCY PERMIT Bond ----____-_-_9
"No building nor structure shall be erected, and no land, building or structure shall be
used for a new, different, changed, or enlarged use without a Building Permit therefor
first having been obtained from the Building Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
Issued to JZii Le Iti1S2Ii Address
Wiring Inspector / /�' -e n+2 Inspection date
Plumbing Inspector Inspection date
Gas Inspector Inspection date
Engineering Department Inspection date
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
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........................„............................, I9...„.....„ .... .................................»......»...»............................».....„.„
Building Inspector
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k�s55esor's map and lot numb ..1.../..�..- !
OfTNE TO
7
Sewage Permit number .....Q..... .......... .. .... ...,................... 13
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BARNSTABLE,
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House number Q -"""Y �.I�N "^sue ft
WITH TITLE 5 moo MA-f 00
-CDE AND
TOWN OF BARNSTAB,t
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO
v�`.... � ' ............. .............. ............ ... ........ ...... . .............................................
TYPE OF CONSTRUCTION .......S.1.AI .1..`.e'....... :i!Yt.�,G.�...........:..ar?�'4 �. �-...- .W.OAI ....
.` t:......J...........19. .l..
-- — TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies —four a permit according to the following information:
Location L O ��...........�.!.. !G.14`?�r .......I-,.t!t.`�..............s g s.$. ate r.,. ....................................................
..............................
ProposedUse ....... .......................................................................................................:
Zoning District ........!.`.... .............................Fire District
Name of Owner ...GA.V.4...... .:....Haq �7............Address .. otl1(f!p,:r.....Rd:......`-`�4iLJ..�!►lEP ..............
1. -
Name of Builder ...... .�:.�.G'......E..U.Y..Z.Ir'R�1.....................Address �.5.(14'r.B'.?�..C�.I.:t.....��!!!-:.......1.d Ga:5,52. .............
.Name of Architect ..................................................................Address ....................................................................................
�i
Number of Rooms ..... .....F... . .Rtk.................................Foundation .��........110(9 -Ae' ....CO.U.?X:r1a2�..../.......
Exlerior ...........Roofing .....t'45YPK.Q]
Floors Wl�C. ..�J�l.p�..l. !a.! Qs .l..�....V1.k11..1............Interior ..J'W.pP,7..I'4tJ.......pl S ..................................
Heating . .......................Plumbing PK...96 i-.S — (�qp .5
Fireplace ..... R .Qv. '.................................................Approximate Cost0X1j.VP_:.U::�...............................
L,L
Definitive Plan Approved by Planning Board -----------_-------------------19________. Area /
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH To "
�IK !-2-
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. o
Name ............................ ......................
S
Hansen, David E.
N�.="21821..... Permit for ...9.'?- :st.ory..dWej:-1ing
:.........................................................................
Location ....lot..#28..8a-Timber?..Law..............
..............Maisons.Mills..................................
J
Owner .....D7.vid..E....Hatlsen...............::...........
Type of Construction ............frame•••••••••••••••••••
........................................................................
Plot ............................ Lot .....:..........................
Permit Granted .................NOV .........9......19 79
Date of Inspection .............................. "....19
Date Completed ....................... .. {.90
RPERMIT REFUSED
............................................. 19
........ ....
........ . A&eddo.of—
......... . ........................................
............ .
'rrn
M
;Prl
ved .................................. ............. 19
..... . ..... . ..................
Assessor's map and lot number ... ...... .. (i h,.. �/ � FTHET
�o o�
Sewage Permit number .....:..7!............. �. .................:`.. ��P ��
(J Z BARNSTMA8a LE, i
House number ................. ...... ..................................... 90o 16 9. m�
3 �e war a'
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATIONFOR PERMIT TO ..........................................................................�.....................................................
TYPE OF CONSTRUCTION ...... ..L.!..�.'!.��).�. ........ u:.l'!✓1. !..!......... ..... .. .`c.;t�'c
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies -for
a permit according to the following information: _
Location L eJ .... . I t a/s� �R r L-a n� / a,�S 1.�v, .....� �.(!.. '...............................
:...................................................................
'. Proposed Use ....... r ............................!�..�':.�.�.4*..�?:.!!�. -�-„L�.-.-;; ..................................................................................................
Zoning District � -J.-.D..............................................Fire District .....................................: ....................................
-Name of Owner ...IA:.!/(C!. r. 144,n S 9t?............Address k� � q.?".... (
. :
Name of Builder !�(�.��.� ......!0.x-�, nfi� Address �� 1�,�a to r,.r-.... :!'!. l dGQ S{ ...........
,...............
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms ...
:5.....r...f.. G.. :.t^. ...............................Foundation ./................7........:.............,....:..................................
Exterior �iiCt.r!l Ir. n( .T. .... ..:...1!kI.tol57 .7'�...........Roofing ...../!.< la,�r,rJ./,T, ,1 f'rtze�;.
%....;
G��,��� P ✓i P �.a M i1Pr 1 /�ra �i I Interior �!+� P , �a ! ,+, 5 � #
Floors l......... I',...... ..... . �1. .-r.fA. ............. .... ..........................
;- Heating - ... .: :..'::.. `gip...: .�.:............../...............:Plumbing .PVC, A-CLILZ.�. ::.r k.....r. .. `:.......
' Fireplace /"{ .................................................Approximate Cost
Definitive Plan Approved by Planning Board -----------___ "_4__----------19_______. Area / v .
Diagram of Lot and Building with Dimensions Fee ..3
t' SUBJECT TO APPROVAL OF BOARD OF HEALTH
Y,
F
'i
h
f}
hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
f construction.
Name .... ............ ..... ......l ............................
Hansen, David E. `
No,�1821 i' stor
Permit for a -dwe-.ring
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•.. •"1.....•............•.••.•••...............•....•.••.•.•.•.••.•...•..••..•.
Location ....1pt.42a....85...T:imtber..L;a.;............
................... .............................
Owner ..........David..Z....Hansen.......................
Type of Construction ......frame•••••••••••••••••••••••••
L ..............................................................
Plot ............................ L/ot .....................I...........
Permit Granted ........Nov,.....9................19 79
Date of Inspection .
Date Completed ......................................19
PERIT REFUSED
................. 19
f;!;•;D.... . ....f...... ......!..:. �. t...�.,1...
...............................................................................
i
Approv . ..... ......... .... ......................... 19
...............................................................................