Loading...
HomeMy WebLinkAbout0374 PLUM STREET UPC 12543 �a No. 53LOR HASTINGS. MN P 2 8 2012 Town -of Barnstable *Permit# d � O„ Expires 6 from isle ' Regulatory Services Fee+ a 9 � � �� Thomas F.Geiler,Director . TFD MA't A Building Division Tom Perry,CBO, Building Commissioner O 200 Main Street,Hyannis,MA 02601 www.town.bamstable ma us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTTA-L.ONLY � �r Not Vafid without Red X-Press Imprint Map/parcel Number'I Property Address 011 Residential Value of Work Minimums fee of$35.00 for work ender$6000.00 ST�i4S?/r�/�l .Owner s:Name&Addres;s 4E1,�� �� iV LAffI 141f f-V -1.34�h'AJ}�D4/�fN�P�. l�l`l��e�a4 Contractor's Name�c�"a�2 �{Q �cl�CAIJ���1! Telephone Number$4?&2 Home Improvement Contractor License#(if applicable) ZOCrQ ,�_3 Construction Supervisor's License#(if applicable) 9 9 ❑Workman's Compensation Insurance Check one: �am a sole proprietor EJ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name ' Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ 'Re-roof(hurricane nailed)(stripping old shingles) All construction debris Will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing-layers of roof) ❑ Re-side #of doors [�Replacement Wmdows/doors/sliders.U-Value o= (niaximtun,35)-#of windows_f� ❑:smoke/Carbon-Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not excerpt compliance with other town department regulations,i.e_Historic,Conservation,etc ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Constraciion Supervisors License is required SIGNATURE: �,�v� Q:IWPFILFS\FORMS\burldina nermii forms\EJTRES.S.doc r .. y iYlassachusett.s= Department of Public Satch- 9 Board( Btpildinl• Red•ulations'an(I Stiindiird.s Construction Supervisor. License License: Cs 998: VICTOR WIINIKAINEN PO BOX 69 3 W BARNSTABLE, MA 02668 { Expiration: 9/29/201.3 Commissioner Tr#: 2436 r � MY License or registrat n date`If found return to*. before the'expiratio � Regulation-.: Uffice of Consumer:Affairs and Business 10'park Plaza-Suite 5170 , Boston,IyIA 02116 " 1� Not valid without signature 1 _ - e of Cpas4meo�,-ea PegMElMPRO�E Affairs ��ratiotion:. ,,�000NT CONr siness 12egula on��G✓ '. l V I CTC ;n. p::14 3 �CTCR. KA"iN Ty Victor l�dividual pe. Wi' 58 CgpF Inikainen B R COD N MA 0263pr _g f l --_— Underse ` cretary i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ,• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly. Name(Business/Ocganization/Individual): Vt Cto Address: rg eAp,9 CO-V 16AIr . City/State/Zip: RN5rA13Z-4 0210 3Q Phone.#: 3-c-i S 3/2- Are you an employer? Check the appropriate box: Type of project(required):. 1.El 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.U�Tam a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• � 9. ❑Building addition [No workers' comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 L❑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 q ] employees. [No workers' 13.[�OtherQ£P��rZ 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. lContractors 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: Policy#or Self-ins. Lic.#: 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 statemetit may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the ppai)ns andpenalties of perjury that the information provided above is true and correct Si ature. .o -ti Date:O l -7 Phone#: J O Official use only. Do not write in this area, tb 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 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 representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the ...dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(s)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 Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-M-MASSAFE Fax#617-727-7749 Revised 11-22-06 vrmmass.govfdia °FIMEra,. Town of Barnstable ti Regulatory Services y MAss. g, Thomas F.Geiler,Director i639- �0 '���,,r•+'' 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 Must Complete and Sign This Section If Using A Builder I, , as Owner of the e ro sub ` / J P P rY hereby authorize C--ro2 i + W.4 iv to act on my behalf, in all matters relative to work authorized by this building permit: •7 L v r+1 / 117Y Qr (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. V Signature of Owner Signature of Applicant'. Lc. NIF#, p > rrr� <<� �,r V l � P ' t-Name Print Name 25 i Date Q:FORMS:OWNE.RPERMISSIONPOOLS 62012 tK�E r Town. of Barnstable Regulatory Services LALMSTAB14 : Thomas F.Geiler,Director Mnss. 039. A Building Division . i �AlEG � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 -www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name J -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 xeside, 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 m;r,;mum 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 4„ 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 Town.:of.Barnstable,: *Permit Expires 6 months from issue date. Regulatory Services Fee- MASS. Thomas F.Geiler,Director Building Division X-PRESS PERMIT Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 S E P 17 2012 Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION — RESIDENTIA&MMF BARNSTABLE / Not Valid without Red X-Press Imprint Map/parcel Numbef `y l?(,- A-RCs 4 ©j ` Property Address 3 7f' flPr�� Residential Value of Work 7 Owner's Name&Address C,4P74 Wg71—i zly zf�f g/tsrx, 0- 114A6 gN�tRTf ly V 1 91. t vlR 'lUu�aN h y��f►R�+'�-7 46!- t CZ e��3 c Contractor's Name l tit twx,/Y z a Telephone Number,�—,j 342 916 Home Improvement Contractor License#(if applicable) Construction Supervisor's.License#(if applicable) C d ❑Workman's Compensation Insurance Chec one: U211 am a sole proprietor ❑ I am the Homeowner ❑. I have Worker's Compensation Insurance. Insurance Company Name Worktnan's Comp.Policy# Permit Request(check box) ® // �Re-roof(stripping old shingles) All construction debris will be taken to , t�i/�y ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signaturee;l,— n-Fnrm,z-P.Ynm" License or registration valid for individul use only before the'expiration date. If found return to: / Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Not valid without signature . f Office of� iuea Consumer Affairs&Business OME IMPRpV °�R�aao /u�aeCra EMEN Regulafion egistration:. ,r� T CQNTRACTOR .00053 xpiration:__6%8 �"'` TYPe:_ Qt4 VICTOR J• ___ Individual WIINII<AINE 'ti~ (.� Victor Wiinikainen s � 58 CAPE COD LN ' BARNABLE ST A 0 ,M 263°0M ' I. Undersecretaryar - t(rtmcnt of public Safet) ivlussuchusetts- Del ' ding Rc'-ulatio Board of Buil ns and Standards' Construction Supervisor License License: CS 998 VICTOR.J WIINIKAINEN PO BOX 69 02668 W BARNSTABLE, MA Expiration: 912912013 Tr#_2 r o6VEr TO'wnl-of Barnstablo. Regulatoty Services MizrrsresY.e, Thomas F. Geiler,Director . auas. Building:Division Tom Ferry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable_ma.us' Office: 508-862-403 8 Fax: 508-790-623 0 Ptopierty Owner Must �. Complete and Sign This Section If Using A Builder as Owner of the-subject property heresy authorize L C.TU rt f to act on my behalf, in all.matters relative to work authorized by this building permit,application for: 3 7-'1 LL,v✓� fin!S rn� (Address of rob) 17 12 Signature-of Owner Date LLAnf 12rA�t� Print Name ."If l ase complete-the Honzeo:vmcrs License Property Owner is applyuig for permit p e .Exemption Form on the reverse side. Town of Barnstable y��opvMe Regulatory.Services ! Thomas F.Geiler,Director i swxttsrwtat.�, ' BUHding DiViSiOn Pl�o MAC a Tom perry,.Biiilding Commissioner 200 Main Street; Hyannis,MA 02601 WWW.tow.n.barnstabl e.ma.us . Office: 508-862-4038 Fax: 508-790-b230 HOhIkOWNER LICENSE EXEMPTION Please Print DATE: JOB IACATION: village number street "HOMEOVMER work hone# name home phonz# � p , 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 HOMEO\'VNER Person(s)who owns a parcel of land onwhich 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 iwo-year period shall not be considered a hommeowner, 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 workperformed 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 Homebwner 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 1.27.0 Constr6ction Control. HOMEOWNER'S EXEMPTION Tire Code states that; "Any homeowner preforming work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1,1-Licensing of construction Supervisprs);provided that if the homeowner engages a person(s).for hire to do such work,that such Homeowner shall act as supervisor." Many.homcownas who use this exemption are unaware that they are'assurmng the responsrbilities of a supervisor(sec Appendix Q; Rules&Regulations for Licensing Construction Supervisors,Section 2,1 ) This lack of awareness otters 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 horrwowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities mquim,as part of the permit application, bilitics of a Supervisor. On the last page of this issue is a tone currently used by that the homeowner certify that he/she understands the responsr several towns. You may cart t amend and adopt such a form/certification forusc in.your community. ,per The CoYnntan•weaxth of Massachusetts Department of Industrid Accidents Office of fn'vestigations 600 Washington Street Boston, MA 02111 www.rnass:gov/dia Workers' Compens 'ad onrnce Affidavit: $adders/ConiTactors/Ele�cl ascianPs rintLe er� Applicant informatatnn Name(Buewms/Organizaiiounn vidua�:V,C l g J. City/State/Zip: AfSTA £, / 0 2 3o Phone.#: g Are you an employer? Check the appropriate box: F pe of project(regnired): 1.❑ I aai a employer with 4- ❑ I am a general contractor and 1 ❑New crnostxuction 1 ecs fall and/n►r art tiwe .* . have hired the sbb-contractors,tp uy ( P ) jistza . KLvaodelnng 2 I am a'sole proprietor or parhner- on the aitachcd sheet ❑ These sub-conlxactots have $, ❑DcmDiit on ship and have no cmployees employee. ers' 9 Btsildm�addit working for me in,any capacity. ees and have work$ [] ion comp,inarrrance. [No watdtcrs' con�i:imsnrances 10.[]Electrical repairs or additions S. [] We are a corporation and its rt gnxrtxl] officers have exercised their 1L[]Phxrnbing repairs or additions 3.❑ I am a homeowner doing all work t of a tion Per MGL fftyselfi [No workers comp. rigb xemp R 12.❑Roof repairs a fi jr. 152, § [ and we have no ins>sra 13.WOthcrRZ S G� ncc r � employees5.. [No workers' comp.insurance required.) •Auy appli®t that ehs3x box#1 mutt also till out$sr-section below showing their wmia=v eo an-p s buit motion t Homeowoas wtto submit this affidavit indicating 93ey aft doing 21 worlcand this+hire outside contractors must submit a 7oew aff davitindimts h vo 1contiactors that ebeck this box mnat altaehed an additimm]sheet showing the mane of the sub-eanh_t=and stair-wbrtha or not those entili have employees. If the sub-contr=b=have employees4-they smut provide thew workers'comp.poiiry mmnber. jam an employer that is providing workers'compensation insurance far my employees. BelotiM is tkeP°may and job site information. lnsni-,L�ce Company Name: Policy#or Sclf--ins.Lic.#: Expiration Date: rob Site Address• City/Statt:/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to scevrc covcmge as required under Section 25A of MGL c.152 can lezA to the imposition of cbim al penalties of a find tip to$1,500.00 and/or one-year imprisonmmi> as well as civil penalties in the form of a STOP WORK ORDER and a f nt of'up to$250.00 a day against the violator. Be advised that a copy of this gtatr* .mit may be forwarded,to the Office of Irrtresti of the bIA for inurance cov c verification. jtdohzereby nder the p and en of perjury that the information provided above is true and correct Date O use only. Do not write in is area,lb be completed by d. or town offtrlaL 0 City or Town: Permit/License# Isodng.kuthority(circle one): 1.Board of Health 2.Building Depai-tment 3.City/Towu Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other r....�, ,vo..,.... Phone#: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 'EJ1s'�t OFB��,R��S►",BLE Map y(� Parcel ® � � Application# Health Division UQ _I a`� t . b FEB - i i n: a 6 Conservation Division a Permit# Tax Collector ���/O/ is+��' �—�Date Issued Treasurer �� Application Fee Planning Dept. Permit Fee EXISTING SEPTIC SYSTEM Date Definitive Plan Approv d by Planning Board LIMITED TO�_ OF BEDROOMS Historic=-OKH�I Preservation/Hyannis Project Street Address 7 P1'Z-1 S Village A/ (gJ t- 9 A 19A(` S 7- Z' �_ A4 Cog A C OZ/4/1 A4A eft S _WS5; Owner C,4A 1,. + H IW,'a-M Al EEC Telephone C°D¢�< S-e% "342 -?�)k7 19LC_LN !�_G(; 3(C� 2 -j ,g 72. Permit Request. (F 8 0 S -,� 1,4 (2) N 16��A-Al Square feet: 1 st floor:existing �`� proposed 2nd floor:existing proposed CJ Total new Zoning District Flood Plain Groundwater Overlay Project Valuation .3 Construction Type 1 Lot Size -� Grandfathered: ❑Yes /No If yes, attach supporting documentation. Dwelling Type: Single Family TWO Family ❑ Multi-Family(#units) Age of Existing Structure WAO Historic House: ❑Yes dilro On Old King's Highway: ❑Yes ®'No Basement Type: 6rull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 4 Basement Unfinished Area(sq.ft) 1�?a_ Number of Baths: Full:existing new Half:existing d new Number of Bedrooms: existing new 0 Total Room Count(not including baths):existing new First Floor Room Count^ C� Heat Type and Fuel: ❑Gaas� it El Electric ❑Other /` Central Air: ❑Yes 616o Fireplaces: Existing � New Existing wood/coal stove: ❑Yes ®'No Detached garage:❑existing ❑new size O Pool:❑existing ❑new size O Barn:❑existing ❑new size <3 Attached garage:Ming ❑new size/I-X;Z26hed:❑existing ❑new size 0 Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 3No If yes, site plan review# Current Use /,V,/ / L. Proposed Use 54d _ BUILDER INFORMATION G Name VICCo �� �-� t� tc �GQll1�'� � 4 3 2 l ( 1` Telephone Number Q Address S� C APE (2p D LAVIV 8 License# S Home Improvement Contractor# 1 c)d 0 Worker's Compensation# ��d N,0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE t FOR OFFICIAL USE ONLY •5c. ~ PERMIT NO. Y DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER f DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL H rn Q PLUMBING: ROUGH FINAL r 4 GAS: ROUGH FINAL FINAL BUILDING �� 3rV � —® - 0 � to DATE CLOSED OUT 1- 0 f O . ASSOCIATION PLAN NO. S 1 f 1 °Fz t Town of Barnstable Regulatory Services 9BAM L& Thomas F.Geiler,Director KAM i639' �0 ,F%6 9.�p Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 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. Type of Work:�� �lc� cs Estimated Cost Address of Work: 3 7 T / 4 e//rf :5 7. Kxs 7�vl"g C /X c Owner's Name: c� �C �' Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law E]JOD Under$1,000 uilding 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: Date Contractor Name Registration No. OR Date Owner's Name Q:fomis:homeaffidav RESIDENTIAL BUILDING PERMIT FEES PLICATION New Buildings $100.00 ' Residential Addition $50.00 AltamfiO s/Ronovations $50.00 • Change of Contactor/Builder $25,40 , ,E VALUE•WORKSHEET LW LIVING SPACE are _squ feet x$96/sq.foot a x.0041= ' plus$ombclow(if applicable) LTEgATIONSWNOVATIONS OE MMTING SPACE - sgnare feet x$64/sq,foot= x,0041= plus frombelow(if applicable) . ;ARAGES'(attached&detached) square feetx$321sq.fL x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 if-500 sf $35•.00 >500 sf-750 sf 50.00 . >750 sf-1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new buildingpe:mib . square foot $96/sq,foot= x,0041- STAND ALONE PERMUS Open Forch �x$30,00= (number) . Deck .--x$30.00 a (number) • FireplacelChimneY .-%$25.00 , (number) . IngroundSw4m1n1ngPo01 $60.00 Above Ground Swimming Pool $25.00• RelocatiouNaTing $150.00 (plus above if applicable) Permit Fee Town of Barnstable Regulatory Services BAMv S $ Thomas F.Geiler,Director o u,+a�0 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 Must Complete and Sign This Section If Using A Builder !� 1 as Owner of the subject property hereby authorize C o - �,(��(j,( GQI/� to act on my behalf, in all matters relative to work authorized by this building permit application for. IA �s� (Address of Job) L Signature of-Owner- Date /4- Print Name . Q:FORMS:OWNERPERMISSION ✓�L6 V/O?77/Ilt4� � P�✓��II.JNLC/CUJE�d k !. s v BOARD OF'BUILDIN,G REGULATIONS o, License: CONSTRUCT,CON SUPERVISORI f Number CS 000998 p x c ryxl Birthdate 09/2911'940 y � J7 Expires` 09129l2007 Tr.no: 371.9:0 1i i'zk V�- i.> � Restncted y 00 �, VICTOR J WIINIKAINEN ` -W BARNSTABLE, MA 02ti68 CommYssioner -may r' h:�;v a,�y /,T � .•).tn-rt;, t/a, - a 5 r���v».R'��-+5„a+w, "..��tC't;OfYl)L77LONl6II6lLLl� I1�✓�( � ., Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 100053 j Expiration: 618/2006 :+ Type: Individual j VICTOR J.WIINIKAI'NEN, Victor Wiinikainen 58 CAPE COD LNe�, r�✓ i BARNSTABLE, MA 02630 Administrator r I CA -1—� N�� r�Trc. £ VIrAGG i r7£ ya�E w - p rR►�� vtN� I I� — • 1 1 CAA A EH \nteA 1 N Fnr ur�vrrrG ,� �f�c�•'' Pes--s f . ly • I f 1� cRass SfcTjo�r lc��, L i .rx' �• cf�ss sFc�-?di`r �.z , ,,,1 r 3. Cot t . �IfR`s I 11f 6� �-I follNL Del rv_-t,O�T E i I isca i,e VAJ = �' ac k eC-Pv 10, 14 - 6, i c . . �-IUVv1 S-c lP5 0 -- .fix,�+►�� 3 �N� �Q�- Neuj �oc�� Ltiy ov t o� Dow n P�oM" a i I . o { �►" 'uqft x,t 4-1 .a t (-IOU5-e Sca le Ito'. Co11 V I h U/I l Application to JPaEG�`E Jt�• A" Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in 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 Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑jCommercial ❑ 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 .3741 / , 1JWX-1VS7ff-deCCASSESSORS MAP NO. OWNER El 2:2M ��T 7!//1/DOD ASSESSORS LOT NO. a HOME ADDRESS 7V /-92- 1/In S7 TEL. NO. JZQ- 3-5!Z1:— FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). 1./ r7,T ozG68 iJ�A 'J7 .mot- s4� Ar�y_/rWA 4;L / o.v, /s-42 A.1 � ' 30 • AGENT OR CONTRACTOR L` I/CJz,�a/-s TEL. NO. 3 ADDRESS 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). r Signed O ner_Contractor-Agent Space below line for Committee use. Received by H.D.C. Date The Certificate is hereby Dnte �Wd'*a Time Q By Approved IMPORTANT- If Certificate is approved, approval is subject to the 20 day appeal period provided in the Act. Disapproved ❑ ADDITIONAL INFORMATION FOR MAKING AND FIL[NG AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four'categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light etc., .that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings; where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. I 9 2. EXTERIOR PAINTING: An application is required for any portion of,a building, structure or sign to be painted that is visible from a public street, way'or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an approved Certificate of Appropriateness. b. Temporary signs for use in.connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter any.structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS 5..Work on projects requiring approval shall not be started.until the Certificate of Appropriateness has been filed with the Town Clerk,by the Committee. Approval is subject to the 20 day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications*without advance approval of the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of."Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, .j chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters—leaders, roofing and paint color. 9. .Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. e i Assessor's map and lot number ....................... THE t0 Sewage Permit number ...................70 ............................. 33AM35TAXLE. i House number J�. 1. ...................................................... "6 9. 00 �0 �D mix a' TOWN OF 'BARNSTABLE BUILDING INSPECTOR Q APPLICATION FOR PERMIT TO ...... f!l L p .A-A�O-ate ............ .......................... TYPEOF CONSTRUCTION (41o4....................: -................ ... .... . ................................................................................. ........................ . ,l.. .9....19. Q.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .�. ......... / ...........................................!4� .R/ .5. , ..... ....... ........... ................................................... ProposedUse ..........8,4,0..... , oa.M.............................................................................................................................. ZoningDistrict .......W. .. ..................................................Fire District ...... ....................................................................... Name of Owner ./47. ...../.4:���®�..............AddresS . ���!�' Name of Builder i...JAA*.S.!q#....Address 2.7 /I 1./....... .Name of Architect ..................................................................Address .................................................................................... Number of Rooms .......................�........................................Foundation .... U 1V CR.674.............................................. Exterior ........Y.V ........ DO,O�/v.. �/" � s...Roofing ......... .S�A�l�yt .......................... Floors .. ..,r�'.............................................Interior ........ . lea/. ®� Wdu07'-RIA/! ....................................................... Heating ' % a7rG���Es CA* / W........Plumbing ............................................................1........... Fireplace ............Approximate Cost ................................................... . Definitive Plan Approved by Planning Board -----------------------------19 ----.. Area `- - /! S- ...... .. Diagram of Lot and Building with -Dimensions p Fee f o SUBJECT TO APPROVAL OF BOARD OF HEALTH 33 l 00 ADDIrIdAl 16 0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..G% a .. W) tq AltWOOD, BERTHA Y No ,•„ Permit for ...Addit,ipa........... 0 k,S nc l.�..F.?dri?.1.Y..AW�.�,l. ?. g............ e Location 3.7.4...R.1.UM...S.tx.Qet......................... ...............V.e at;... ......................... Owner ..$ 7: a...Atw4R.4.............................. a;. Type of Construction .,Fr.a e........................... Plot ............................ Lot ................................ Permit Granted Ma.X...l.i...................19 80 Date o Inspection .....................:� '.....19 � Date Completed ZXJ PERMIT REFUSED y ............................................................. 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ............ ............................................................................... ............................................................................... Assessor's map and lot number ............... ............................. �Q of Too j . e I$ermit number re Seyva g Z EAHBSTADLE, House number ..., ;. .� I 1 . ........................................................ y Mns6 0 � Apo,1639. \00 „r" r 4 w •t a MAI TOWN OF BARNSTABLE' ' BUILDING INSPECTOR_ APPLICATION FOR PERMIT TO ............................................c!f �� D /7A?-' ; :'��.......................................................... .. .......... TYPEOF CONSTRUCTION ........................:...:............................... ..::..........................................:......................... , }.. ..4.-- . ....... ...... TO THE INSPECTOR OF BUILDINGS': The undersigned hereby applies for a permit according to the following information: Location...... ....!J,v4....`..�.........l,V47: ..... . .: .!..... ..`:.. .......;..i.ir..... :................................................... ProposedUse fDi t?....../ .. ............................................................................................................................... Zoning District ......11� � .............................Fire District .W :........................... 12 ....................................................................... Name of Owner ..!�:�t�.. .y�:.....!�:��`"� ���.�..............Address ...r��a�...� l..S..........................................................' ' y ` �' ' Name of Builder .... a „,tM%"'...! ^� ;lfr �, aJ....Address �:.�-d . ::: .`: ..'"..�r..........'....................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....................... .......................................Foundation '<J t�l�.l' ;>ra+= . ............ .............................................................. Exterior ........j'd`..!�........jf1.GC:z7.hr rV.... f11f Fi....Roofing ....... ...................................................... f s � 1 Floors .U.r.. ................................................Interior r•� A, I f C r .................................:............ Heating ...........................Plumbing ....:............................................................................. Fireplace ..................................Approximate Cost ......... .. ..............:................................ ........................................................ Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ........................^ . l ........ Diagram of Lot and Building with Dimensions � ,, � !� Fee ................. ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH i � 1 r •I r i • I I , f 1.1 �• 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ...................................... ..�� .... }l ATWOOD, BERTHA _ . A=196-19 No .22.1.64.... Permit for Addition.............. �. nJl ... 'amx].y...Awel.l. ........... Location ..3.74..Plum Street . ..... .................................................... WestBarnst...�� ........................................................ .�,C. ....... Owner .Bertha Atwood ...................................... Type of Construction/Lot :�x'Ame....................... � ........................ ..................................... Plot ........................... . ... ........................... r Permit Granted ........MaY:..l'.................19 80 lv Date of Inspection/..... .........................19 Date Completed ..................................... PERMIT REFUSED .......... ..... 1 q ........... ....... . .. .......................................... ....................... .. ................................................... ......................... . ................................... _ Approved ................................................ 19 ............................................................................... .................... ......................................................... E Application to , dePP�+PENPS`E P�\C 5 6PE�Hpp�S�PM E� Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in 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 Buil ng ❑ Addition ❑ Alteration Indicate type of building: El House In 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 September 27, 1984 ADDRESS OF PROPOSED WORK 374 Ptum Street ASSESSORS MAP NO. 196 OWNER Bertha J. Atwtood ASSESSORS LOT NO. 19 HOME ADDRESS 374 Plum Street, W. Barnstable TEL. NO. 362-3549 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). EcDard F. Johnson 378 Plum Street West Barnstable, Ma. 02668 James R. Kurra 388 Plum Street West Barnstable, Ma. 02668 Margaret Johnson 350 Plum Street FJest Barnstable, Ma. 02668 Peter E. Johnson 362-9230 AGENT OR CONTRACTOR TEL. NO. ADDRESS 302 Church Street West Barnstable, Ma. 02668 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). A Signed Bertha J. A Wood owner Owner-Contractor-Agent Sa1ce¢eJow_,line for Committee use. Received L~y�Hf!i Cj TOWN OF BARNSTABLE VateN"fllii\IP_ OnAng The Certificate is hereby nat Time 6oe\% Approved IMPORTANT: If Certificate is approved,a val is-subject to the 10 day appeal period provided in the Act. Disapproved ❑ t ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an.approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications without advance approval of the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of.the Act establishing the Regional Historic District may be obtained at the Town Hall. i ,r _... A7-Mbab ss. 17 li�I �_ � ti 33dd � ,:` � •.: may. ' 'l%'%/ , , .... .. .... . ' � - - - --- --- .:. t7—Assessors map.,and lot number ....... .. :............} (7 OF1ME01 t0 �. T p a Sewage Permit number ..... M'....7 ` -7 �' , �� �� ��� w �� 111��:111 TIAC ED IN COMP E.1 �! L B° 9TLB E. i House number .....: ...:. WITH TITLE 5 9 "b IL ........... ............ ................................. 0 9. ENNI"rR(%N EN TAL CO;'?` ���oyaY Ar TOWN OF •BARNSTABLE BUILDI G INSPECTOR -� APPLICATION FOR PERMIT TO ........ ........ . may 9 ................... ............. TYPE OF CONSTRUCTION. ........ G'�S�Q - . �.....................1./.. J .............................. .......................�0 ..........1- .. .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applie or a permit accordi t ;Tnh fol ing infoationn�: location . e4il ......� f! 5741. � 5. `" ./J4.rr.:....................:......:............:......... .............. �y.. ....... .. .................... ProposedUse .................................................................................................................................. Zoning District .......:.. ..................Fire .District /'V ....... .. .. . .................... ....... . Name of Owner .... .... /!.Q�... !..,.. ..... ...:Address ...5..7./... ... .. ... .... . .......: r .. 1.: .� Nameof Builder ....................................................................Address ......................................................:....::....................... V!� Nameof ArchitectL...................................................:......... 4'ddress ................................................................................... f Numberof Rooms .........../....................................................Foundation ........ .................................................................... Exterior .........Paw -rkN. ..!.eS............................Roofing ........ .... Qom/ .. ��1glS. . :............... Floors Q ����.. ..� ; . ........ :.............. Heating .......:..........................................................................Plumbing . .................0 0........................... Fireplace ......................-r'. ..............................................Approximate. Cost .......cv ............................... ...... Definitive Plan Approved by Planning Board ---------------____-----------19________. Area ..................................'....... ®o Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH l 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. Construction Supervisor's License ....... ... -' 'kT,100D, BERTHA J. Ni 27094..... Permit for AM.J3WZZEWAY...... & / ......................Gar..a..q.e......Single..Fam:Lly..Dwelang Location .....37A.211=..Stxpaet.......................... ...................YPP.t..BaMatable.......................... Owner ......B.e..x..-.t.h....a....J...,..A .......................... Type of Construction ......I-rage........................ .................................................................................. Plot ............................ Lot ................................ Permit, Granted .....Oc.tobex..16.,..'`..........19 84 .... ........... Date of lnspection:.�r...--.F•.".............. 9 Date Completed ....... ... --19 Assessor's map,and lot number .../.7..h ..... / 1 .� • THE Sewagge Permit number .... .K .........7 .......9............ U ?' 10 • Z BABB9T/►DLE, i House number ......................................................................... so rues 0 YAK a' TOWN OF BARNSTABLE BUILDI G INSPECTOR APPLICATION FOR PERMIT TO. ZCGVO� ......... ..................... J�-1. aO�.. .�9 .,.................................. TYPE OF CONSTRUCTION ........ . /f ��........................................... ........................ .,.................. �9. ..,... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies-for a permit according �to, the following information: Location .............. ... � ..... ........1i. 7�1.� y�S�./(a J/. ............. .......I........................... ProposedUse ..................4.'..Q�eC�. . ................................................................................................................................... >� Fire District Y .Zoning District .......... .................. ...... !......... . .... ...... Name of Owner"..... /�Q�... ..;.. .... .........Address ...� . / I 1`-' It Nameof Builder ....................................................................Address .................................................................................... Name of Architect "�� ........Address Numberof Rooms ............/....................................................Foundation ......... .............................................................. Exterior .........u! .... ! �..'.� . ..:/e-�............................Roofing ............./-� �Q?/C ................ FloorsQ I.L............................................... .................................................................................... Heating . .. .............:.....:...........Plumbing ..........................................�...................................... Fireplace ..................................................................................Approximate. Cost ...........�.. ........................ ............. .... Definitive Plan Approved by Planning Board ---------------____-----------19_______. Area `� S-/.......................................... Diagram of Lot and Building with Dimensions Fee /� oa ............................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH i" 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. Name .. .0.. ........... Construction Supervisor's License .......� �� ............ ATWOOD, BERTHA J. A=196-19 No 2.7Q ...... Permit for ...Add Breezeway ................................. & Garage/ Single Family Dwelling .................. ......................................................... Location .....3.7.4,..P119n..5t;r9(Pt.......................... .................... 4bIQ.......................... Owner ....... J....Atv()C)d........................ Type of Construction FrWM.............................. ................................................................................ Plot ............................ Lot ................................ Permit Granted ....October 16, 19 84 Date of Inspection ....................................19 Date Completed ......................................19