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Home My WebLink About0191 BUCKWOOD DRIVE l9/ �uc�(�moard �iC; 1 Town of Barnstable *Permit# Expires 6 months from a date Regulatory Services Fee Thomas F.Gellert Director QED 1AA� Building Division Tom Perry, Building Commissioner 200 Main Street,.Hyannis,MA 02601 Office: 508-862-4038PERMIT Fax-, 508-790-6230 ; VL EXPRESS PERMIT APPLICATION! - RESIDENTIAL OMFY� 1 2005 Not Valid without Red X-Press Imprint TOWN OF BARNSTABLE Map/parcel Number n property Address (�Reside�al Value of Work�L{ U Minimum fee of•$25.00 or work under$6000.00 //Owner's Name&Address L--CA,6 V 1-e— 40 IZ W 011 '` L Contractor_s_Name �1_ �. '�' G� ;)2!/U • Telephone Number 4 Z to Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑worktnaes Compensation Insurance Check one: [] I am a sole proprietor [:] I am the Homeowner I have Worker's Compensation Insurance /� Insurance Company Name L 0 S � • -6 � / e.Pi r) Workman's Comp.Policy# / �� 6� Z Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to k)rLJ ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side �p ( Replacement Windows. U-Value (maximum.44)- *where requned: Issuance of eis,permit does not exempt compli ce 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. Signature Q:Forms:expmtrg Revise063004 _ c Board of balkUq Ragrlatioas and Sbndards HOME IMPROVEMENT CONTRACTOR Re9t811ret10MI: 126-03 Expl afti= aJ3f2008 Type: Suppwmwd Card THE Hone Depot At-Noma,9"c MARK AUDETTE 3200 GDBB GALLERIA PKWY#20 ILTANTA,GA 30339 Admiabtrater a ' r Lkim"or reg'f raWb vend for Imdividsi on only tiou date. If found return to: before the Rev and Standards Board of gninding e8u. One AAW"Mee Rya 1301 Sates,Ma.92106 -• --Net valid wig��re ti r ti r CF: ME lqr, Town of Barnstable Regulatory Services s Thomas F. Geiler,Director 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, �aU re Y) as Owner of the subject property hereby authorize f \a r i c-- AuiA to act on my behalf, in all matters relative to work authorized by this building permit application for: l� (Address ofJob- ) 30 6 ' - Signature of Owner Date Print Name Q:FORMS:OWNERPERMISSION HE tp�`* TOWN OF BARNSTABLE °� 0 Z 8ARIST"L 2039-ug M� TV ASSACHUSETTS Solid Fuel Stove Permit PERMIT ................... ................. ........`.. DATE OF APPL CATION ............... .1. / .... NAME (owner) r .'. ...... NAME (Installer) .... ....!�4 ......................................................... owner . . ................... .... ... .:...... . �:... . ..... ... ADDRESS ...1. .. .......... ............... �+�+....r.:....... ..... ADDRESS ............. .. ?i.. .' "................................................................. eO /' STOVE TYPE .�.... ........................................................................................ CHIMNEY: NEW ......................... EXISTING ....1 ............. Manufacturer .......... ...... ..Er. .u.....�......t ................................................ CHIMNEY: Masonry I/.......................................................................... Mass. Approval 4_--!;..........1 .71............................................... CHIMNEY: Metal ................................................................................................... This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed address in accordance with an application on file with the ................................................................................................... Fire Department, and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. a Issued By1. v / .......l ..� Date S'/`� ....5.e..............................................Title ..............................�` ............. .................... 1� .............................. ....... Permit to install expires 60 days after issue date Stove �(��r C 4 L,iq i J.v .......................................v.�.�............................. ............................................. .................................................................... ................................................................................. StoveClearance ............................ 1."J.52.rT-.............................................................................................................................................................................................................. FloorA-r`�,..................... ............................................ ..................................................................................... SmokePipe ................................ ..... ! ... .r....... ................................................................................................................................................................................................... SmokePipe Clearance ................................................................................................................................................................................................................................................................ Chimney . ......................................................................................... ............................................................................................. SmokeDetector ..............................'�,(....tlfl.:15..................................................................................................................................... ...................................................................................... The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au- thority of permit dated ...................................................... has been made in accordance with provisions of the Commonwealth of Massachusetts State Building Code now currently in effect and pertaining thereto .................. �.N�..r.............. Installer INSTALLATION APPROVED ......1 /g y..................... By ................................ ...... ........ 4.�' tle: ..................... date WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT