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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
'q Mapes 2 Parcel Permit#
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Health Division �M " �1��b2 Date Issued
Conservation Division Y� S' 3/7 Fee
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Tax Collector v�DD 1 0 !y�-- �3 7SEPTIC
Treasurer
INSTALLED IN COee;PLIANCE
Planning Dept. WITH TITLE 5
Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND
Historic-OKH Preservation/Hyannis TOWN REGULATIONS
Project Street Address .3f A//b:p (I l2C�E
Village
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Owner t �1 0) 4 �1ZXhIl1'r' AOF—tS Address k jol 94P C/i2C E�
Telephone no 14-0
`Permit Request %� Plkjt ZU #X/S&4/0— V#4404-tD
,/6 x z
Q Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new . .
Valuation /4.0 6 Zoning District Flood Plain Groundwater Overlay
Construction Type
Lot Size Grandfathered: ❑Yes O No If yes, attach supporting documentation.
Dwelling Type: Single Family t/ Two Family O Multi-Family(#units)
Age of Existing Structure Historic House: O Yes ❑ No On Old King's Highway: -O Yes O No
Basement Type: ❑ Full Cl Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
i
2 Number of Bedrooms: existing_ new
Total Room Count(not including baths): existing new First Floor Room Count
2 Heat Type and Fuel: O Gas O Oil ❑ Electric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: O Yes ❑ No
Detached garage:O existing ❑new size Pool:O existing ❑new size Barn:O existing O new size
Attached garage:O existing ❑new size Shed:❑existing O new size Other:
Zoning Board of Appeals Authorization O Appeal# Recorded❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
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Name.fl7WAIrD 67'1t4/�biX_ Telephone Number �6�'y y r S3
Address �d 0X -116 v 61) S 7D License# 1�S OSrF2,b Yw�
S Home Improvement Contractor#
Worker's Compensation# 00
Aa
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY
PERMIT�NO.
DATE ISSUED
q MAP/PARCEL NO.
ADDRESS VILLAGE
OWNE
DATE OF INSPECTION:-
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH t f— FINAL
GAS: ROUGHS FINAL
FINAL BUILDING
� 0 -
tj
DATEKCLOSED,OUT * KA
ASSOCIATION PLAN NO. y t
s •
r
r
RESIDENTIAL:
SHEDS - POOLS -DECKS-OPEN PORCHES- GAZEBOS
DETACHED GARAGES
FEE VALUE WORKSHEET
ACCESSORY STRUCTURES >120 so.ft.(Sheds,detached garages,gazebos,etc.) 00
>120 sf-500 sf $35.00 $
>500 sf-750 sf 50.00 $
>750 sf- 1000 sf 75.00 $
>1000 sf- 1500 sf -100.00 $
>1500 sf—USE NEW BUILDING PERMIT APPLICATION
DECKS x$30.00= $
i r
(Number)
PORCHES x$30.00= $
(Number)
IN GROUND SWIMMING POOL $60.00 $
ABOVE GROUND SWIMMING POOL $25.00 $
RELOCATION/MOVING $150.00 $
(Plus above fee if applicable)
PERMIT FEE $
Q:forms:dkcost
eff:082301
OF rM r.
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° The, Town. of Barnstable
• aUsxsrABLL
,�: g Regulatory Services
ib?9• �0
4�ArEo,ut� Thomas F. Geiler, Director
Building Division.
Peter F. DRMatteo;Building Commissioner
367 Main Street,Hyannis MA 02601 .
fce: 508-862-4038 Fax: 508-790-6230
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..
�17 , hV e,OM 67V 1 Type of Work: Estimated cost
Address of Work: a e4 A)V 61 f-d 5k U r
Owner's Name: �� t �i , 0�
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
[]Work excluded by law
❑Job Under$1,000
[]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 agent of the owner. 1013
I
Date Contractor Name Registration No.
OR
Date Owner's Name
�._•_ _ The Commonwealth of Massachusetts
— Department of Industrial Accidents
OBlce ol/arestiffmagos
_ 600.Washington Street '
Boston,Mass. 02111
Workers' Com ensation Insurance Affidavit
sLme '!57y ,wp-� eer"e�llt( 7t
location: 144190
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❑ I am a homeowner perforiaing all work myself ..'
�I am a sole p 'etor and have no one worid m' p/aci
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❑ I am as employerrovidmg.workers'oompensa�iva for my:eatployees-worldng on this job.
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❑ ,I am a sole proprietor,general contractor, or homeowner,(circle one)and have hired the contractors-listed below who
have
the following workers'compensationrolices:
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Fame to seco a coveaar ss requited m der iae c6 25A of MGI:152 can Ind to the f upo Wm of criminal pensIda of a f e up.to S1,M0.00 and/or
oae lean'fmptisommt as well as civil penalties in the form of a STOP WORK ORDER and a floe of 3100.00 a day against me. I understand thud a
copy of this statement may be forwarded to the Ofnce of Investigations-of the DIA for coverage vetfseatina,
I do hereby certify pane and penalties of perjury that the information provided above is b►t a attd correct
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Board of Building Regulations and Standards
HOME IM*QVEMENT CONTRACTOR
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Reg-��-- "'o�3834
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hEzpi `on=0 / 2003
bj XP -1_¢l�idual
EDWARD H G EDWARD GRAN'
IPO BOX 716/50 JONS
MARSTONS MILLS,MA 02648 "`
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Administrator
BOARD-,OF BUILDING REGULATIONS
License- CONSTRUCTION SUPERVISOR
Nwmbek C- 058261
Brrthd e)12 -17
946 !
xPir x12003 Tr.no: 9773
'EDWARD H GRANGES"
PO BOX 716
MARSTONS MILLS,ill%(=02648 AcJrninis4rator
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RES. ZONE.- "RC" This MORTGAGE INSPECTION Plan is For FLOOD ZONE "C"
Bank Use Only
TOWN: _QS_TE,&9L1�' __________ REGISTRY OWNER: CRAIC A._&_ICRISTI_M. _TAMASH_____.
DEED REF: _ 76ff�,�5---- -BUYER: �1�1LI�1� �1JZ98TH_J9 'Q$K,S_____------
DATE: _I_2�24�97__----____— PLAN REF: -290 —5 __—__--__-SCALE: 1 —
30'
FT.
I HEREBY CERTIFY TO PLYYV_U1L'_"8_TG.I2E -CO OF YANKEE SURVEY
___THAT THE BUILDING ��� 'SAS
SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS o��� pAUL So�yG CONSULTANTS
SHOWN AND THAT ITS POSITION DOES _--_ CONFORM A. 40B (SUITE 1)
TO THE ZONING LAW SETBACK REQUIREMENTS OF THE o MERITHEW H
TOWN OF ---RARNSTARLE-------------AND THAT �, No. 32098 Q INDUSTRY ROAD
IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD °g� GISTERE� �y MARSTONS MILLS, MA. 02648
AREA AS SHOWN ON THE H.U.D. MAP DATED�/�9,�8�_ Si�'N4c i.nwoso TEL: 428-0055
=__Kf__eF1E_W
nit —Pane 250001 0015 C — FAX: 420-5553
__ _______ THIS PLAN NOT MADE FROM AN INSTRUMENT2�3�3 DPG
. ERI PLS SURVEY, NOT TO BE USED FOR FENCES ETC.