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Engineering Dept. (3rd floor) 'Map .3 Parcel�QJa7 l` Permit# 3`7tQ'2
House# 4L) Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee ,
Conservation Office(4th floor)(8:30-9:30/1:00-2:00) h SEPTIC SYSTEM MUST BE
Planning Dept. (1st floor/School Admin. Bldg.) INSTALLED LIANCE
Definitive Plan Approved by Planning Board 19 ENVINOW AND
TOWN
TOWN OF BARNSTABLE
Building Permit Applicatioo'n \
Project Street Addressd
Village
Owner AddressO
Telephone t3G Z :2
Permit Request i,4/,*04Lt. /7
�}��r/�1�.✓Ur� T�i/Yl �4�ir/G�'8a'G 8 ,�.d�-moo��ic..
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $ Z_ —, 67c?o
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family lld' Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway I'es ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No.of Bedrooms: Existing New
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No -
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
(None Ll Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review# -
Current Use Proposed Use
Builder Information
Name /e;/1y L".¢/J/�z2,/ i//� Telephone Number
Address �G Ef-/UL-�✓�"l/e�//+�/�7 �i> License# D6-j0_F2
��2_2, ��..�r�0/lot/ls �r� Home Improvement Contractor# /o076**d
_27 �7`—�� i 7'�y10 Worker's Compensation#6115�G(/ 9 13 e2_6
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
/hpdF�
SIGNATURE DATE
BUILDING PERMIT DE91kD FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY
1
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE a
OWNER
DATE OF INSPECTION:
FOUNDATION _
FRAME'
INSULATION
FIREPLACE '
ELECTRICAL:' ROUGH FINAL,
�. vi
PLUMBING:M c4 ROWH ' FINAL
GAS: " ROMP FINAL �
FINAL BUIL ,'
DATE CLOSED ) 7-1) '
'' z arty ,
ASSOCIATION'PEALN NO.
i
i Application to 997
%'fF' q
_A`s 0Vg' .NPP 6PN'
Old Kings Highway Regional Historic District Committee
in the Town of Barnstable for a
CERTIFICATE OF APPROPRIATENESS
Application is hereby made, id 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 E2,"Alteration
Indicate type of building: [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 —13 —J7
ADDRESS OF PROPOSED WORK /202 ernes//�,*IxAr l A1,8A*210 ASSESSORS MAP NO. �3�✓
OWNER L7� //��2.r��2�G�`� ASSESSORS LOT NO. Q
HOME ADDRESS'fU AIIJA,/KIlltlA/J 6-4 TEL. N0. 2-
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary).
AGENT OR CONTRACTOR 21 TEL. N0. 12l"IS Z
ADDRESS � W �y Zz/�
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). .2/ Sotav 4,1, 17W— t/iN�L
�cG��GA�L��d►-tom GtIJ�,ZIGcu�/.J�OL/1� r,,i yG J-V XA-Y*rt .r1.2>1 ilk y
q
-8 0 8 v✓iS�rlF �i o ��.�/��✓YL /� ?/tl7reat-r a W,,�r/v rW %R�.a GaTlcns
Signed
Owner-Contractor-Agent
Space below line for Committee use.
Receiv
oe Certificate is reby D ate
im
i . . 0 RIM
LD HIGHWAY
Approved' ❑ IMPORTAN : If Certific e-is a proved,approval is subject to the 10 day appeal period
provided in the Act.
Disapproved ❑
/H 132 0 2-7 G%�1�i x v_�tl � /'�aA31 —..
r
�7✓ �O -& 11A//Ki9jn/&nJ
- OTown of Barnstable
Old King's Highway Historic District Committee
SPEC SHEET
FOUNDATION
.Srxr� v/.✓yG y���c��!S�wA
SIDING TYPE 51blde tL&�o V t WOVIM,7Y COLOR LjNew
CHIMNEY TYPE COLOR
ROOF MATERIAL COLOR
PITCH
WINDOW 44f'V/7ZF�- SIZE
TRIM COLOR �/��E'�Gcin'!/i✓Vlrl
DOORS /—,�S0G $ COLOR A/v —
SHUTTERS COLOR
GUTTERS �vTT � t ��v✓aJS��tJ� r oc1/f %�
DECK .
GARAGE DOORS COLOR
I
SIGNS COLORS
► F31'� �r' i�
FENCE Fir COLOR
NOTES: , Fill out completely, including measurements and materials/colors to be used. Three copies of this
form are required for submittal of an application, along with three copies each of the plot plan,
landscape plan and elevation plans, when applicable. Site plan should show all structures on the lot
i to scale.
SPECSHT
I
oil a7 .
SPEClrl :____ -- ---._./ -- ----.._...------ -- )F 1
CAPIZZI HOMt IMPROVEMENT PROPOSAL
Established 1976, Serving the Cape for 21 Years
1645 Newtown Road
Cotuit, MA 02635
508-428-9518 1-800-262-5060 Fax 508-428-1547 Date: y�9 '9,
Name•/ ' r fi��` e Pe �e h. { Job Address:
3 G
Address: �� �� N ij e h I Town:
City: �, A I Home Phone:
T9 bl l� I Other Phone
I
i
_ { Estimator: P1311Job
1 No. :
I
1 . Furnish and install solid vinyl white replacement windows with 7/8"
insulated glass, 1/2 screens using the Harvey Tech 2000 welded sash window.
a Double hung 1 Picture unit _
Single casement - Double casement
Triple casement - 2 lite glider
3 lite glider
LABOR & MATERIALS $
2. Same as above except using the Harvey Classic vinyl replacement window.
LABOR & MATERIALS $,
3. OR same as above except using the 5/8" Thermopane Slimline replacement
window.
LABOR &MATERIALS $
OPTIONS: ,
a. Low E glass �L;/
b.
c. Colonial grilles $
No touch--up painting included.
Some touch-up may be required on interior and exterior casings.
Any work above and -beyond the specifications outlined in this proposal will be
performed at $40.00 per man hour plus materials or priced on request. All
addi-tionalwork, including travel, time and lumberyard runs,. will be subject to
extra charge.
There will be no 'refund for special-order windows , doors or any other
nonstocked materials after three- days from approved proposal .
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"'OrE . TMpROVEI`tENT CON T P.ACTORS P_CZS?RATIOH t
'�aa;d off ' 8uildins ResLlaticrs and standards .
Ashburtor Place — Roca 1302 '' • t •.
Bcsto r, t;assachusetts a'LZOS t
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Iur�OVEMEN T CON i P.AC►OP, t
s��a_ioR 100740 Expiration
Pa)VATE COR90RA►ION
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C�-.:- 77: _MpoQVEi ENT., INC. t LL3'�3a tLI=I/ca
roar„„as Cap iz-i , Sr
6~5 Ne to CT Qd ( r14-�� FQ.C Li�
C P•;A 02635 t itc;,S C;QtT', Sc.
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i DEPARTMENT OF PURL
ONC ASHBURTON PLA•
BOSTON, MA 021
CONSTRUCTION SUPERVISOR LICENSE
Number : Expires: eirthdaw.
Lt 0570g2 09/26/1997 : 09/26/190'
' Restricted lu: U0 — ! _
'40CInL' SECURITY K: 030•50-7494
TIIOMAS X CAPILZI JR '
:CO PERCIVAL OR { -
W DARNSTAOLLs MA 02660
The Commonwealth of Massachusetts
Department of Industrial Accidents
9
_— - VMV Of/oyestlgatlans
600 Washington Street
�i Boston,Mass. 02111
Workers' Compensation Insurance Affidavit
nam Zz E
��
ca' /G�
GDP!//T .��� �Z13� ohonee �ZB'-9S/B
I.am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
I am an employer providing workers' compensation for my employees working on this job.
m anv nam • ..:•:•..:... . : . . . ..
addre
r
phone T:
:.
insurance co % rya.. 201icvu d� .3�3
.-,::�
I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have
the following workers' compensation polices:
company name-
addre
city: :. h ne :
insurance
m anv name-
address:
itv hone
n uran Co.
icy to
.a*r:..�—.. --•�.`�--r_�..,..rr.-.ram . _ - ._ •..:,�S-'� .:.t:;.._ice .7 - --�_
Uttich addidorialsheet if aecrssa� '' �._ - ,•.,-'-_- -"
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51-500.00 and/or
one vears'imprisonment as-CH as civil penalties in the form or STOP HORS:ORDER and a fine or 5100.00 a day against me understand that a
i oClnvestigations of the DI.>for coverage rerifieation.
Copy or this statement may be forwarded to the Once
I do herebt•certify u pains4apertaines ojperjury that the injormatiorr provided above is tree and correct
Date
Siennturc
G
Print name Phone
oRcial use only " do not rite in this area to be completed by city or town otricial
cin'or town.
permit/license —Building Department
Licensing Board
[]Selectmen's Office
0 check;if immediate response is required Health Department
phone At —Other
contact person: _
Ire.nal 1-Ili P1A1
°= The Town of Barnstable
9eb 16 9.. Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02661
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
For office use only
Permit no.
Date la—moo
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.
t/M Tw—/,1J ✓/"V yZ_ dJ �jjNG `/��/L Gt///✓A�/Ut�=f'
Type of Work:j7i!5�r/y ;,6n Est. Cost Z:S cpo 4
Address of Work: yV A/idEdV ljl/l
Owner's Name V Z,,V
Date of Permit Application: G �,
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 INWROVEMENT 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 oft a owner:
�—Gr97 /ZZ l�--� /��✓ ��r OPl�SBO
Date �2 ntractor Name Registration No.
OR
Date Owner's Name
Assessor's map and lot number .:�.:1..................................
EPT[C CY
g its a � IMSTALLE6 IN COMPUA
Sewage Permit number .�. ... v�� � '1�llTH � �dCE
ARTICLE ►! STATE
THE T��O TOWN OF BARB . . N
:.A�V1tN
A Sd ~ \
i MA"STODLE, i
D�Y•ae0� BUILDING INSPECTOR
APPLICATION FOR PERMIT TO .....e:L ..................................................
TYPE OF CONSTRUCTION +Gl .
.9...........19,�d
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for,,a// permit according to the following information:
Location ..............4(, ,C.G/,t2 %lL. .. .........LiC!..Ff .
ProposedUse .... ..... L•�C/`� . . . ........................................ .......
Zoning District ..... .. ...............................................................Fire DistriclL.�/
Name of Owner .........64!!;� .....................Address ....4.. .... ..............
Name of BuilderotOAR I....l.. . .................Address .. ............. .A � .................
Name of Architect ...... z - ddress ....... . .......................................................
Number of Rooms ...................C;9.........................................Foundation .. ..... ' r
Exterior ........... ... ......Roofing ....... :..... ........ ..... ... ..................................................
Floors `2_112"U Interior ......
......................Plumbing ........./., ...................................................
Heating .. C............� �,�
Fireplace �.................................................Approximate Cost. .� ..O-e.........
p ��. ............................
Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area K3.(o...a..........................
Ca
Diagram of Lot and Building with Dimensions Fee ��
....... .............. ..........
SUBJECT TO APPROVAL OF BOARD OF HEALTH
— N }
r o s SS
f
!� Mell,
`5 yrt
i
I hereby ag _ own of Barnstable regarding the above
construction: _
Namet�,. . r.......!��.J......................
Ellis, Robert
17741 a d o sin le
No Permit for
family dwelling
.............
.......... ...............................................
Location ....
WiiniVainen Road
West Barnstable
b Owner
Robert Ellis
I `
r frame Type of Construction e'
............... . ............................................................
Plot r
................. Lot ............:...................
Permit Granted .........June 12 . ._..,_._19 75
r
Date of Inspection '•r
Date Completed /
.��!........... 19
.
r PERMIT REFUSED I
....... ...................... 19 •, f
`.............................................................................
............................................................................
.......................................................................... ✓
.Approved. ....... ........................................ 19
y .............................0. ............................................ t �'
a
................ ................................... ..................
l
Assessor's map and lot number .. ......... 7S"�
Sewage Permit number 1 .Gr'.-r.!.Y... .'.t..l.�/!.�.;..c.. !�/ i%•�%j
/ 7 � l
TOWN OF BARNSTABLE
9JH39TS13LE, i
1639- ,e� BUILDING INSPECTOR
�'0 YpY G•
APPLICATION FOR PERMIT TO ...�� �� ?�::.:.....`>'/I � '.......... ...............................................................................
i
TYPE OF CONSTRUCTION ....err '.
•
...................................................................................................................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location /. ..:. ��...'�7........ ..�!.� 'r �t
........................................,........................................................................... ........... .. .. .. -r
Proposed Use • .. `.�. ....'•s'�::....?' ........ ? -�"....::�- .....�;{•...:.`.!........:.. = ...................................................
.. .... ..... ...,..
t
Zoning District /..Fire District�LsY: !A�J...............L- ..'
...................................................................... ..............................................
Name of Owner .................. - ........................................
.r-F �i f !�/ ....................Address G l i
Name of Builder ..i��r f�vrsr>.� .. i�i1�!� ��-Cl/.L /"l'. .....
Address ...,................................................................................
Name of Architect f'< !> ..• ... �/,fA,5f Address .......r> i�'T�ei
:.:...................................
Number of Rooms �...........................................Foundation .. ? .;(r� v, r.?/a
......................... ...............................................:.....................
Exlerior .... ' 1 ....Roofng ........ � .............................................................
Floors �� -%:�' Interior ........../��is..s�L''
...................................................
j
Heating / f Plumbing //a rL�cUE�--
!- .............................I....... ..... .... ............ ...................................................................
Fireplace ................ :-r�.................................................ApproximateCosti`�YI, . n
. ....................................................................
Definitive Plan Approved by Planning Board -------------------_-----------19________. Area 2r0................................
Diagram of Lot and Building with Dimensions Fee '
SUBJECT TO APPROVAL OF BOARD OF HEALTH �t
J
i
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name i» ...... ?%'Y....... (h...................
Ellis, Robert A=132-27
17741 add to single
No ................. Permit for ....................................
family dwelling
...... . . .. ......... . . ....
. IJA
Location JV...Wiin.i.ka.in.e.n..Road.
. ... ........ . .... ... . .. .. ...... ..................
West-Barnstable/
...............................................................................
Robert Ellis
Owner ........................................ ......................
Type of Construction .........fgame.... ............................
.
........................................... ..................................
LPlot ............................ it
une 12 75
Permit Granted .......:................................19
Date of Inspection ................................19
Date Completed 19
PERMIT REFUSED
.............. ....................................... 19
................ ............................................................
................................................................................
.......... ....................................................................
........ .....
.......... ......Approved .................................. ...... 19
...............................................................................
...............................................................................