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Home My WebLink About0215 CHURCH STREET 216- C' urc -) CT� h n 0 e ° • e i i i I; j ENT W �Z u t d QO 1� O C) Z N r2 M zzz U`n o.o N �z TOWN OF BARNSTABLE CAPE COD NSULATION2013 APR 29 At', 9: 24 FIBERGLASS SEAMLESS SPBATEGAM SUSPENDED RAM GUTTERS INSULATION CEILINGS ®IVISIOfd 1-800-696-6611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: �0 /�.� I Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village '::5��L Jv�e,S �.I�Cl� vch S - sz�/ Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( ) ( ) ( ) ( ) Slopes ( ) ( ) ( ) ( ) ( ) Floors V3a4X),Lft ( 3c) ) ( ) (X) Walls ( ) ( ) ( ) ( ) ( ) .,4W Sincerely hECasJr, President on, Inc. 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel V�^ 1� li bn :0 . 1 ., Pp , Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 2i C5 ON.L 1✓AAnnnn Village Owner d 1 N.P/`� Address Telephone AAA LJ21 Permit Request he / -y 5 I't bad _ CQ.�lr Square feet: 1 st oor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3/50�' Construction Type i mm Q h , Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family etl 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 _ ►-' w q Basement Finished Area(sq.ft.) Basement Unfinished Area(sf7) ,A Yz Number of Baths: Full: existing new Half: existing is r g o w Number of Bedrooms: existing _new Total Room Count (not including bathe): existing new First Floor Ro m Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other N 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 ❑-40 If yes, site plan review# Current Use Proposed Use _ APPLICANT INFORMATION fl�Bj� ER OR HOMEOWNER) Name J44 o Telephone Number ✓vU' �5�' �2�"I Address 1DAY&II, 6vde, License # / ' '``� �26 L Home Improvement Contractor# ��J '7 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Y $7 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ' MAP/PARCEL N0. .,ADDRESS VILLAGE OWNER � • s . - �•_ • DATE OF INSPECTION: -_FOUNDATION ,a FRAME 0 INSULATION ?° FIREPLACE t ELECTRICAL: ROUGH FINAL 1 i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL. FINAL BUILDING ' DATE CLOSED OUT`• ASSOCIATION PLAN NO. - ' iN'lass(chusctts - Depal-ttncnt of Public SafctN Boar(I'of Buil-tlin-, Regulations and Standards m construlction Supervisor License Licenr CS 100988 HENRY CASSIDY + 8 SHED ROW WEV 1tARMOUTH, MA 02673 �— —� Expiration: 1 1 11 1/201 3 ('unullissiucr -- Trm: 7620 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration ' k • Registration: 153567 Type: Private Corporation Expiration: 12/15/2t14 Tr# 233831 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE - -------:--_..-._-__......._....-__.... .. .___..._...-- SO. YARMOUTH, MA 02664 Update Address and return card. Mark reason for change. Address ❑ Renewal [�] Employment I..._I L.ost Card, SCA I (i 2Ufv1-Uti;l l —�iGr•�(rn�rrrir-rwtcucrr'il/�f/�L•<(:ct'UJn(Y'[lrJc'CFJ Office of Consumer Affairs& Business Regulation License or registration valid for indivitlul use only _ t�OME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: F egistration: 153567 Type: Office of Consumer Affairs and Business Regulation ,7Expiration: 12/15/2014 Private Corporation t0 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATION,','-INC: HENRY CASSIDY 18 REARDON CIRCLE -- SO YARMOUTH• MA 02664 Undersecretary Aotv,,alr* witho t nat re ` N The Commonwealth of'Massachusetts Print Form --- Department of'IndustrialAccidents 17' �- `� _ f O 'ice o Investi ations 1� f.� .f g � I I Congress Street, Suite 100 ^�r Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): I a Address: 1I k�cvdo�. ( Vta City/State/Zip:_ Ua MA' Phone #: J10� IZ I Are you an employer? Check t deappropriate box: Type of project(required): I.� I am a employer with M 4. ❑ I am a general contractor and 1 employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction '.❑ 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 rr:e in any capacity. employees and have workers' 9 ❑ Building addition J No workers' comp. insurance comp. insurance.x required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.ElI am a homeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof reppiIrs �insurance required.] .t c. 152, §1(4), and we have no ` hj) employees. [No workers' 13Other W& Q comp. insurance required.] 'Any applicant that checks box#1 inust also fill out the section below showing their workers'compensation policy information. t I lonteowners 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 chose entities have cmployees. Ifthe sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ``�� CkAvkv Insurance.CompanyName: (tvl�c, 1HrMV-aC46& Policy #or Self ins. Lic. #: W6A DD/ 2, qol Expiration Date: Job Site Address: I � f1k l)r 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 tine 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 tine Of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certif n#er the ains�d penalties of er'ury that the information provided above is rue and correct. Si i�atur'e: % Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City tar'Town: Permit/License# Issuing Authority (circle one): t. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: IOU'! I ACORD_ GlIc--flW: 4507 C'C INS L)I- CERTIFICATE OF LIABILITY INSURANCE U A I'L(KINIft I I tv III... ,Hly'CIF0A 11-:1 CA0 TEI:- I:; IS:WE-)AS A MATTEN OF INFOii�M-60N ONLY CO—NFFR9 NO RIGITS- _u 070 2120-12 UCKITE 0F N0'I"A`iVJIt4AIVCLY ORNEGAJ '11-115 CEWHFICATC 0F INSURANCE DOES NOTCON� POLICIES NEGATIVELY ANIVIII).EXTEND OR ALTER'141E COVE'RACQ AFFORDED UY Till POL 1"1 tl 1 F A CUN-1-RACT BF I WLEN l."L 1$;5UING IN,-,URI: R'F Pf"Eoi 1:N I A[-I VI_:: 1--).14 0J_K)DLIC:V-_R, AND THE URI-11:1CATE 1161-0o,t. ALVI I IQK14LLI INTORT.gNT.:-Ir ........I — N (I*(hw—ouiicy(Ie;) Ilf, UP thc pullcy,cartaIll livilicicis I Must p ell(0130d.11'sUOR0 to lclldul-;L;ZiWAUDTI�00NAL M�U" I fj I I I I'!I, ,I., Ilay 1 .11 IIjI(k:kjjjj,;j-(IU11j.j 1u the K(7;I1--Iy -So . 0orill1k; NAn1E MZII*ECIIC1 YIJL 11 13 0-fj I d.2 1.)6 f-h AIL ....... IfILWttlal LYLDr�IMIIT ......— .......... .. ....... tN,LAI?6I.j,:Peerl,�.5s IfISUranco I_ 16 333 :ap%?. cd t� o lnu(atfoll Inc lwmEka:EVL1114LO11 111j;ul-arwo coflm,tlly IN)UR61c Moil ic tj I—t(::171 1.41.iful Ict, IIVIIIi1i,, IVIA 026o'l (:oIjjjj�jIjV1.175.1 t.-LRl'IF)CAfL NUMUER: ihO- .,i 1;, llt R F'V IS I I)N N 1.1 Im w ou,-{v I LAVE BEEN ISSUEO T01 HE INSURED NAhlI-.D ABOVE 101 t I I IC, J-)()j.ICy pj lzl() I.'JI'ANj)jIq(, ANY NECII-MCNIeNT, I�NIVI OR 0j"L,11101,10F ANY CONTRACTOR OTHER OO(;Uml-_-.NT WITH \1;1 k-Al I 10 AY L31: ILS2,J:C 01-1 MAY P ORTAIN, THE INSURANCt \D�D fy TH POUCICS DESCRIBED IIff EA N IS SUIIJEC I'0 All (111'ISKINS ANO k;0N0H10NS Q7 SUCjPOLICIES. LIMITS sFovij ,,y MAVF BEEN REDUCED BY PAID CLAIMS. j YI-10-I AnOLWLR POLICY VFF Pl ......q LLf. o . IIhlewyyyLJ'\ �U.LIIAL LIALIIL.jI)- 141)I'a CGP82630u, 04/0'1120,12 ElkCHOCCUR xj%:QMMI7ri0AL(A-M-J(At.HABIL11'Y _L11MLuL1q.__ :I AIM')MAU14 x OCCUR 6 A0V INJLII4Y o 000 000 noucl-! a M I!1Aj s .Lml CLI III qce 12MM8CKVmi\ __KI SINCE t I IIJIT 1. ), . , A/01120,12 04/ 1 211 11OD10,INJURY(P,, !t;i lul co A x x 1.116.11nuI U�, PROP E FITY 0mvi 0W____ XONJ45351 000_ ACCRECATt y1 uuu U(IU ...L:—.U.- c I.:kIMI'LNdA I IVN 1614.1, VVGAOU525�10_' 061301_'JolWC STA'I'LI. I.N L-NJ NIA r.L.CA01 I AC-C-10i'NT ffiitj-_ASYc ILI,CNWUWGC I'll"`1t4 Ul-ON-RA I IONN I L0 CA I'M N S I V6i4ICLI:S(AI(-1,ACOAL)kQ 1,AJJhI.,. 4VI'V4.10,11111910 opgco III wilill vu) V1.1odwr% C'Jillp Inforl-flatiulk uddilion a i"s L""',.110u, 1;........al Li,ldil,wfloll ro,,Ilro(j 0,wrIllon CANCELLATION ("i1j)U (;(.ILI IAI6LJIJh0jI,j(jC qHOULO ANYOF TdE ASQV6 I3Ft4CRII'3F0 PE GAM't-,111`0 1*1 Oil; THE EXPIIWrION DATE THEREOF. NOTICE WILL kW UEUVf-kttl IN ACCORDANCE WITH THE I"CiLiCY ("ItOV13ION:1. A011-10HU10 REMESENIAIIIE '1011 -2 0'10 AC 0 14 0 C 0 N 1:1 0 1:1 ATI 0 N.All 0910 w-joiyod, U 4 9 1 M 8 3 8,1(1 1 Ur'I Hie ACORL)Mahn and IQQo iru rughaufod marks UACORD mky i i OWNER AUTHORIZATION FORM Jo:-vs (Owners Name) owner of the property.located at (Property Address) r'✓. 13�•�s7`��/e . /h O2 (Property Address) hereby authorize ��ae Cc U at 4-;o (Subco actor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a'building permit and to perform work on:my property. • I Owner' ignature Z7, Date I ry r 11 IS z � S M r � / y k jo k. ------------ S�T I arr r s rR.r� .F a a .w h !.y l - 111 '�q7 '�k9►i'.arYr.t�`. 77 iv at T 9<v&exe-1"e S� GU`/3 i �0�3o /0 � Town of BarnstablePermit:� Regulatory Services ate: p4"E Thomas F.Geiler,Director Building Division MUMSrnBIZ = Tom Perry, Building Commissioner Mass. 039. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: JC�ldl l JmLs Phone: C607) -7(4q__7,�.L(9 W Ins all aPZIS. S4. Village: (J). yyl lij k, Map/Parcel: rj 3 Z� Date: /D I2$IOS .Stov Use o _'B. Type: adiant Circulating W C. cManufacfu�r: 4jeA.- ( s4bk9— Lab.No. ' D,C Vlodel No.:ICJ"dGSd aL-2.. &qg p Chimney A. New Existin )(If existing,please note date of last cleaning B. Flue Size C. Are other appliances attached to Flue? yIn D. Pre-fab Type and Manufacturer E. asonry: Line nlined Hearth A. Materials: &ck_ B. Sub Floor Construction: Installer Name: Address: Phone: Location of Installation: H.I.0 Registration# Construction Supervisor# OR check Homeowner Installing,no license required APPLICANTS SIGNATURE APPROVED BY: Please make checks payable to the Town o Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev103107 Town of Barnstable- �of SHE tpk� Regulatory Services BA MI Thomas F.Geiler,Director trinss. Building Division ATfo �a Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 www.town.barnsiable.ma.us Office: S08-862-4038 Fax: 5.08-790-6230 HOMkOWNFER LICENSE EXEMPTION G Please Print DATE: I 6 /,, c (� r JOB LOCATION: 2 15 � i y c l J'{- nulmber,/ l / street village „HOMEOWNER": name home phone# WG*plione# CURRENT MAILING ADDRESS: 2 t S l f'LftirCi� l city/town state zip Bodo The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on'which he/she resides or intends to reside; on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department miniri,um inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signa a of Hom er 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 Constriction 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 persons)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 woith 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 for/certification for use in your community. �oFT"ErO . Town of Barnstable Regulatory Services enxr'HASS. Thomas F. Geiler,Director 'Vqj i639 �� 'OrEnnt�.�a Building Division Tom Perry, Building Commissioner I 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must y Complete and Sign This Section If Using A. Builder 1 , as Owner of the subject property hereby authorize to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property.Own&t is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Assessor's map and lot number .....� .. -............ Sewage Permit number .......................................................... TOWN OF BARNSTABLE ii • L EAWSTADLE, i M q :e� BUILDING INSPECTOR 0 M a• ........... ........... APPLICATION FOR PERMIT TO ...... .:. .: ........................ . .......... ..................................................... TYPEOF CONSTRUCTION ........ ... .Q-C.2." .. ..... ....................................................................................... .......................sue.......... ........19..73 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... ....... t..�.f !....... ...................................... f.. ....... . ....�7............... ProposedUse .............0.. ...... ....... ...................�............. ............. . ...................................................... Zoning District ......... `................ .:........... '...........Fire District ..... . Nameof Owner ..........................................Address .l ! ................ ........... .�. ..�L Name of Builder .. ...Address Nameof Architect ......................777=..............................Address ......7=.................................................................. Numberof Rooms ........................ ......................................Foundation ........................... ................................. Exterior ...... .CI.S.._......................................Roofing ...... 4�? ......... ......... ............................................. / d Floors .............. ........... .. . -c.. X.�..�6.Interior .......... -....... ..X..`��........ ......... .` iOC Heating ........................................Plumbing Fireplace .............................................................Approximate Cost.....f.d ........................ ............ ........... ..................... Definitive Plan Approved by Planning Board """""""_"""_""_""_-----------19"___""". Area ...... .. ............................. Diagram of Lot and Building with Dimensions Fee O SUBJECT TO APPROVAL OF BOARD OF HEALTH � o r � 3 � _ o i11-n- Louy N z � N � ,• I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam ..... . ..................................................................... Crowell, John N. No ...16269... Permit for ......shed..................... - Location Church Street .... ............................................. Uiest Barnstable- ............................................................................... ; Owner ..............ohn... Crowell ......................................... Type of Construction .frame j �i ................................................................................ Plot ............................ Lot ................................ a . j _ Permit Granted June 4 ... 1 q 73 .......... ..... s .. ..�,.�Date of Inspection .....19 Date Completed ..... ......�i►A64. U PERMIT REFUSED ................................................................ 19 = ............................................................................... ................................................................................ . � J ............................................................................... d Approved ................................................ 19 .................. ......................................................... ............................................................................... 1 Assessor's office(1st Floor): ��MIMIC SYSMM RIUST BE o`THE To Assessor's map and lot number — INSTALLED N C M_ g Board of Health(3rd floor): Sewage Permit number � Oi� Tn TH • �ri.ea��7 n Z SMUSTODLL i Engineering Department(3rd floor): _ `�` `t"� �:� �. riva House number vZ�S � N R n`;;-,:. � ' °o +boo• Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BAR.NSTABLE BUILDING , INSPECTOR APPLICATION FOR PERMIT TO (2 e rn o ale, TYPE OF CONSTRUCTION Q a i 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location O� ��5� ��?/l� YG h ' �(/, l3r�n �v s � 6-oFS 13y 15) Proposed Use Zoning District Fire District 6) &/f&g� Name of Owner 14 D /C a m '0 1 e=� Address oR ��S^ c �� Yc�� J /% �,3;jyi, 11e Name of Builder ��ou i Address Name of Architect Address Number of Rooms Foundation�P 047?-e c G dl?e2 DTP Exterior w C- / Roofing �'��G Floors Interior Heating �� v Plumbing Fireplace Approximate Cost Area Z T' Diagram of Lot and Building with Dimensions Fee - I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardin bove construction. Name Construction Supervisor's License PA.TOKA, JUDE & `:ABRAHAM DIETZI r No 3 3 7 28 Permit For REMODEL ' Single Family Dwelling Location Lot 3, 4, 14, & 15, 215 Church Street i West Barnstable Owner Jude Patoka & ;Abraham -Dietz e Type of Construction Frame r f Plot Lot Permit Granted May 3 , 19 g 0- R ' Date of Inspection 19 Date Completed 19 _4z, � f gyp, i 6 ' K-L ° r. y Assessor's office(1st Floor): �� .. a Assessor's map and lot number R Board of Health(3rd floor): Sewage Permit number, Z i 'Engineering Department(3rd floor): DARBiTAXLL �J a�S S �a MAS House number =ft o 1639-" Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE Y^j BUILDING INSPECTOR r� APPLICATION FOR PERMIT TO /�P rn O d(2 ii TYPE OF CONSTRUCTION 6_/1r 19 J y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location /.S� Lr �y� r c G� ' Cif/. / y l`l !y "G C l L o F 5 q 1, 15 l Proposed Use Ci'C(J 2 /// /U Zoning District ' / Fire District yy//✓/�cc�r f✓.c1 t a .f1'/fir / Name of Owner /`t /J p 4l Q i � / ? Address Name of Builder ��0Q1�.I/Y ni ),7 Address ��f� �� . J/ • � �y� ��.� � Name of Architect ? 44 e Address Number of Rooms Foundation y Exterior � C d '�`"�� Roofing r Floors Interior Heating /? �� U ^/ Plumbing Fireplace Approximate Coster Area 3 1 Z Diagram of Lot and Building with Dimensions Fee 0 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the-above construction. t f� Name ;-r_I. _ s Construction Supervisor's License G� 7 PATOK.A,. DUDE & ABRAHAM Di.ETZ T,. 153•--026 No 33728 Permit For RtMIODEL Single Family Dwelling Location Lots #3 , 4 , 14, 15 , 215 Church St. West Barnstable Owner Jude Patoka & Abraham Dietz Type of Construction Frame Plot Lot 1 Permit Granted M<<Y .3 , 19 9 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1/1/-L Application to ` Yam'P Oe E�`��•PS�°� .. Old King's Highway Regional Historic District Committee in the Town of Barnstable for a - CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building tZ Addition ❑ Alteration Indicate type of building: �9 House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign [] Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other.side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK Z S_ li. I?-C t\ �A W R_,-,, hl ,ASSESSORS MAP NO. IS- OWNER Ia. �r1 L� i.�y> ASSESSORS LOT NO. Z HOME ADDRESS , S, TEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if nnecessary).t I\�\ 1`L \C1 \/1��1 1 \-�(J SA.✓. .j`� l .h, r;.h �� 1A k9*tGe U� , CI'_• �S \ 1 i• �tY:•,;. .\j Q . LJ✓1� AGENT OR CONTRACTOR TEL. NO. -? G?..- `49 L/-,-'> ADDRESS -:;,,`2 f,L•,L_-`..,0IL (� I DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,'other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). Sc LUn 9 2• \ / Signed CI OwoeL Contractor-Agent Space below line for Committee.use. A Received.by H.,D__C. - 0KHRHDC Date R E n a �� _� The Cer , ' ate is hereby Date d- dv:u-_2 r Time APP i0a Byh1 i1 1anH WAt— Approved ,..:,.,,.:. IMPOTANT: If Certificate is approved,approval is subject to the 10 day appeal period provided in the Act. Disapproved ' ❑ • - Form "A-l" OLD KING'S HIGHWAY HISTORIC DISTRICT Sped S1-ieet i r Foundation Type `�;�., ,�:_ �t ;•>, r-; :• Siding Type i i\, ; r i..__ �i.. ::_T r. Chimney Type k rTy-; Color T Roof Material �; ,.,G, 1-1- Color \��r,�,�. • .ram. Pitch f`�__ A-r Windows ov��r�. ��:. ��r;> ( ....;.,.,.Size Trim Color Doors -. l Color Shutters Gutters Deck r✓ j ' �:. ,¢l f.: } 1 �.`. c.( Y �;,: ' 1 �.J Garage Doors Color APPROVED Notes: Fill out completely, includ f,ng measurements and mate-vials/colors to be used. Three copies of this form ale required for submittall1of an application, along with three copies each of PPE �r -i�f fed ;p of plan, landscape plan and elevation.plan, when applicable. APR 3 1990 ;. Judith J. Patoka 8 Land la BARNSTABLE Abraham P. Dietz - . Belonging to ................................................. Deed an Book ................ Page .. eD e b k a 9 8Z4 69 Barnstable District Land Court Certificate Tdo. 100989.•.. in gook Pa a In Registry g ............ Land Court Plan 36078 filed with Cert. 84 184 Sept. 4, 1981 RecordedPlan ................................................................................. mate of Plan .................................... in Barnstable.. Registry,,District: in ........... Book..684........ No. �}4...... Filed Plan No. ................................ . ...................... *ALSO Land Court Plan 36078-C flied with Cert. 51741 in bk. 413 pg. 101 June 1971 *ALSO Land Court Plan 36078-B filed with Cert. 50986 in bk. 407 pg. 66 December 1970 MORTGAGE INSPECTION PLAN DONALD F. HENDERSON, P.C. Loan No. 215 Church Street, Barnstble . -- O _;�'71 , /(00 �. T LoT i 7 Uo O� N N ° � N HrooOcv _ - v JJ 11 GAR 1 .71 � (16.75) � ��.55)' (99 72)I - G /G3.ro) 2k` g. June 24, 1986 3?4 48973 � R E APPROVED CHU RCH . ¢ RHOG If, EiVED A 3 1990 RIMINI CLD k";z,'S'S HIGHWAY I CERTIFY THAT THIS PLAN WAS PREPARED '. ( �'� k,: '''"•� ;a IN ACCORDANCE IYITH THE COMMONWEALTH ` :5 �rtyk.;;.:•;i01: : �.w '� ` r�Y7 Or MACCArmi1gPTTC PanrPni1PA1 ATIn dwM I CERTIFY THAT THIS PLAN WAS PREPARED �! IN ACCORDANCE WITH THE COMMONWEALTH OF MASSACHUSETTS PROCEDURAL AND TECHNICAL STANDARDS FOR THE PRACTICE OF LAND SURVEYING 250 CMR 6.05 AND WITH --r' - THE SPECIFICATION SHEET ATTACHED HEREI : OF 6IgS ia IN IN a H y✓ - - _ =1 ANDERSON , No. 31298 0 al, 9ECrST4RF� � L LAMS S i APPROVED.. �. OKHR OC i. 6� . E i V E D A% 3 ig0 i roof,, ,— — — — — -- — — I go EX 15T 1 N K IT C-HEN _ (xj SINE GEILINCa Eni- %"rING Hovsr. ' I I I ExIS �iv�w \►uc�0 PAT\o pooch 'C' 1NG FOuNDA'T 1ota� � c A 1f L *a- 6XIVT K& ASPHA<_-T. SHINGLES To MA.TGK CX1SrlNG e � \0 I I I- I- O DOWN / C'XI sTIN CG. Ho V SE „ wHt�-� c.cvp,a SNINGLrS /, � U vl �2> E' UP lel ; I CP L L& MASTER I � _ NEW QATN - I QTl LE S r+ow Er; 2- 7 6�/0 ( - 7 ING.w,Naow ' i EktST/NV f-/OUSE VEo �- - - - - - - - - - - - - - - -- - --f - - -- - - - t 01sHRHOC o 'L 0UC-) HL l-N L N c_ ' APPROVED N a.I�O L(� ST N b•R W 1 C.H P O f�'T" M A O Z 6 N 6 f�UtLnEg REMoflEL-TR og- �6 - y9y2 NOTE CHANGES SCALE: \ILI �.,. ' �' APPROVED BY: DRAWN BY: O, DATE: v�z d REVISED IR��'.. SELONI� F1-00R PLAN ,, T N OF BARNSTABLE LI ��pT; Ns _ cRoss s��-r Doff 0&lding Inspection Department .7 U C) \_-H U_ Pp\TO K A Y A�RAEIA.M P, D1ETZ DRAWING NUMBER 2�5 CKVRC.t-� ST 53 ,RNS-7ABL.E t�F 1