HomeMy WebLinkAbout0014 GREENBRIER LANE ail
d
PP-
0�
v( 30 3 cQ
Town of Barnstable *Permit# I
4�' �� V• Expires
months from issu date
�T Regulatory Services Fee
ELAM
039, Thomas F.Geller,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax:508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Map/parcel Number Ov Not Valid without Red X-Press Imprint
N 19 D
Property Address f'l t
M Residential Value of Work$ , 5 J wo Minimum fee of 835.00 for work under$6000.00
Owner's Name&Address 1LK16i 'T1 ,W D 'S C(� ! \ %g7 \1 W S 1
Contractor's Name -�� �G (i�,}a Telephone Number pn- :l*3 6
Home Improvement Contractor License#(if applicable) 1(g9i '1 Email: �� ����5 lj �L• �jf�
Construction Supervisor's License#(if applicable) CS `Q V�� (��•�����
❑Workman's Compensation Insurance - �PRESS PERMIT
Che one: X
I am a sole proprietor
❑ I am the Homeowner `
❑ I have Worker's Compensation Insurance NOV 13 202
Insurance Company Name
Workman's Comp.Policy# TOWN OF BARNSTABLE
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to,
Re-roof(hur 'cane nailed)(not stripping. Going over existing layers of roof)
e-side VC4,.�
Replacement Windows/doors/sliders.U-Value • ')0 (maximum.35)#of windows I�
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.'
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission. \
cop of the o�e Improvement Contractors License&Construction Supervisors License is
1 r u ed.
SIGNATURE:
C:\Users\decollik\AppData\Local i oso d ws\Te orary Intemet'Files\Content.Outlook\8R76BDVA\EXPRESS.doc
Revised 061313
The'Conintoarnwalth 4qf Massachrrse-tts
Drrr°Prra,errt oflrri9'rrstailccirlPrrrs
Offwe of Invesfigadons
600 Washington Street -
Boston,M4 02111
#nvjv.mas&gm,1dk
i;�92
Workers' Compensation Insnramce Affidatizt-.BlW$ers/Contractors/Electnc'ians Plumber
Applicant Information Please Print Legibly
Name(Hussinesvorvani� ;duet -lam iS• �G�E1 Ca[.LIrJ
Address: •0• �� �c
City/State/Zip: Phone#:
Are you an employer?Check the appropriate box: (required):
J Type.of project
•�_ I am a general contractor and I � P �uued):
i-El I am a employer u^ith ❑ g. . ❑6 New oonstruction
6ployees(full and/or part-time).* have hired the sub-contractors
�,/
2. I.am a sole proprietor or partner- listed on the attached sheet 7., modeling
ship and have no employees Tliese sub-contractors have g. ❑Demolition
working for me in anycapacity. employees and have workers'
I 9. ❑Building addition
[No corkers'comp.insurance comp.insurance.
required.) 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
I.❑.:I am homeowner doing all uromk officers 1have exercised their; I LR Plumbing repairs or additions
myself [No workers'comp: right of exemption per MGL- 12.❑Roof repairs"
insurance required.]11, c. 152,§1(4),and we have no
employees.[No workers' 13.❑Other
comp-insnrsanee required-]
'Any applit:sat that checks box ftl atrw^t ak o fill am the section bel4m showing die-srworkers'ODMPOsation policy infar�an.
Homeorwners whn submit this dffid nrit indicating they are doing all w t and tPmbireoutside contnutors submit anew afFdmIt indicating sacra_
rContractors that check this box must attached an additional sL•eet shaming the name of the sub-contractors and state whether or am those emeties have
employees. If the sub-coutractoas have employees,the*,most provide their x o keTs'comp.policy number. '
I am an employer that is prosidfng workers'courpensadon i€esnrane4 for irry eurpioyees.. Below is the police rued job site
hif formadore
Insurance Company xlsame:
Policy or Self-ins.Lie.4: Expiration Date:
Job Site Address: Cityl taatelzip--
Attach a oop1;of time tsorkers'compensation policy declaration page(showing the policy number and expiation date).
Pail a to secure coverage as required tender Section 25A of MGL c.. 152 can"lead to the iliposition of criminal penalties of a
fine up to S 1,500.00 andfor 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 statement may be forwarded to the Office of
Investigations o e forfislklee coverage verification.
I do hereby cent; ruder pains realties of pe my t�hot.the irlforinwion prondded abm,e s f nieAand correct
Si tore: Date:
Phone#: CI IV, 0 ' "V40
Offl anal rase orals. Do not wrRe in this area,to be completed,kv,cety or town of ciaL
City or Town: Permit/License
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#.
IM Massachusetts-Department of Public Safety
�✓ Board of Building"Reg
ulations and Standards
Construction Supervisor
License. GS-058598���
ERIK T SCMCKL,PG
PO BOX 727 � -
W NEWBURY W�' 009
"•r` ������� Expiration
J .�1 1012812015
Commissioner
i
s:
use group which
Unrestricted Buildings of any 991m )of
�ntain less than 35,000 cubic feet(
enclosed space.
f the Massachusetts
Failure to possess a current edoiti n ocat o of this I license.
State Building Code is cause f Mass.Gov/DP5
information visit:
For DP5 Licensingwww.
Re ulation
_= Office of Consumer Affairs and Business g
- 10 Park Plaza- Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: .162779
,.i Type: individual
/ Expiration: 4/6/2015 Tr# 238158
ERIK J. SCHICKLING `
ERIK SCHICKLING F
P.O. BOX 727
WEST NEWBURY, MA 01985
�'I"Update Address and return card.Mark reason for change.
0 Address [] Renewal Employment Lost Card
SCA 1 Co 20M-05/11 - -
License or registration valid for individui use only
Office of Consumer Affairs&Business Regulation i before the expiration date. If found return to:
OME IMPROVEMENT CONTRACTOR Type Office of Consumer Affairs and Business Regulation
registration 162779 10.Park Plaza Suite 5170
expiration 4/6l2015 Individual Boston,MA 02116
ERIK J.SCHICKLING;}
1
r-ro-
ERIK SCHICKLING
12 BRIDGE ST r gam/ i���2�--
^.WEST NEWBURY,MA 01985
Undersecretary Not valid wit signature
i
snxivsrnsu, = .
9 39. Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
Building Division
Thomas Perry,CBO
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
nuUoNV! ,as Owner of the subject property
hereby authorize G�� 3 � .�irJ V to act on my behalf,
in all matters relative to work authorized by this building_,permit application for:
(Address of Job) .
s
10 13
Signature of Owner Date
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\8R76BDVA\EXPRESS.doc
Revised 061313
C
6 7d' aa
�L ) Map Parcel #ep�- y Permit# ✓
House#. Date Issued -
B d of Health(3rd floor)(8:15 -9:30/1•DA�+39) Fee
Conserva Office(4th floor : 0- 9'30/1:00=2:00) '
Planning Dept.(1s hool Admin.Bldg.)
Defi ' ' an Approved by Plammn 'and 19
_ BARNnABLE. '
A.
TOWN OF BARNSTABLE
Building Permit Application
Pr ' reet Address
Village
Owner �� �a S Address
-Telephone /
Permit Request 00 AL r—
-First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $ c,7S'oo
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
/ Dwelling Type: Single Family 3__100, Two Family ❑ Multi-Family(#units)
�( Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No
PPPccc��� Basement Type: @dull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing oZ 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 ❑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 s1_76
xj"IV Telephone Number rO
Address� ��_/�:�i _S-/Lr' License#
4�_ �t✓r s / C> �a/,�� A Home Improvement Contractor# 2 2 IZ -
T' .
Worker's Compensation#
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
SIGNATURE r DATE_ 1194
BUILDING PERMIT DENIED vREASON(S)
W4
O
I
.. I F•
_ . FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED.
MAP/PARCEL NO.
ADDRESS I VILLAGE'
« OWNER ' ' ' r
DATE OF'•INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ; ROUGH : FINAL
PLUMBING: ROUGH FINAL .- t
GAS: ROUGH FINAL -
f
FINAL BUILDING ' - - r
DATE CLOSED OUT
ASSOCIATION PLAN NO. ' e
pFtt+e A -
The Town of Barnstable
K AM Department of Health Safety and Environmental Services
� "9. Building Division
367 Main Street,Hyannis MA 02601
Ralph Crossen
Office: 508-790-6227
Fax: 508-790-6230 Building Commissione
For office use only
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.
Gt�
Type of Work: t`)Z Est. Cost
Address of Work:
Owner's Name-2
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000:
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS. PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c- 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date Contractor Name Registration No.
OR
Date Owner's Name
The Commonwealth of Massachusetts
Sj
Department of Industrial Accidents
Olflce 9"flyesli9at/oos
600 Washington Street
Boston,Mass. 02111
Workers' Compensation Insurance Affidavit
name: 'rlJ fi e,/
location
city S hone ii 27 —Lo
❑ I am a horficowner performing all work myself.
[9/I am a sole proprietor and have no one working in any capacity ,
%%% //% %EMEM%//////%//:�,,,,.
❑ an employer providing workers' compensation for my employees working on this job.
tom anv name: iY
cri.cam e" c f si
address:
city hone#:
insurance co. ohcv#
❑ I am a sole proprietor, general contractor, or homeowner le one) and have hired the contractors listed below who
have
the following workers' compensation polices:
company name:
address:
city
phone#•
insurnnce ca.
cam anv name- ,>:;;....:<.;:....::..:. .
address:
city
hone#:.
insarance co. olicv#
Failure to secure coverage as required under Section 15A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or
one veers'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of Sloo-00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
1 do herebv certify under he airs and penalti of perj t t e information provided above is try.-and correct
Date
Signature •
Print name
Phone
ofncial use only do not write in this area to be completed by city or town official
city or town: perntitlllceroe# ❑Building Depatmtent
❑Licensing BLL
❑Selectmen'
❑check if immediate response is required ❑HealW Dept
contact person•
phone#; ❑Other �
l7Tvum 9,95 PJA1 -
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law", 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 o:
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 section 25 also states that every state or local licensing agency shall withhold the issuance or fenewa
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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and
supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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.
City or Towns
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 pi number which will be used as a reference number. The affidavits may be returiR io
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you 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 levestigadens
600 Washington Street
Boston,Ma. 02111
fax#: (617) 727-7749 .
phone#: (617) 727-4900 eat. 406, 409 or 375
•
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- —--— MPROVEMENT 'CONTRACTORS -REGISTRATION S>`
F YaBoar'.d of Burad�°n9, Regulati`onsr�andbw5tandar.ds
k y i..,Y Ate•X' 4 ''h: F S <
* aOne Ashburton4Pla'cev - Room 1'301 '4�a a
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�
PROVEMENT, CONTRAC�TbR ,
Re istr:atlan ." ,- 83 � l4
€� ��xpiratio d�9/27/99 star f � �
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q'a�1
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L-yF'Dy+iA�; I x`N' l � U�LAE P6SON A;iSCiOFIEDHORIEL
..
NAMPSHIREAVE�
HY;ANNIS`4MA'_`02601
-A
. i '�Fi L s+X,t- �p•}t r't i -e i 3,i-, 3���S>I� x�x.�o.
da z a °',,•r r3#'h�r 't!" t •£ #t � t i � yu�t.'-`�5.�„S'�
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RE-ROOFING
If located in OKH or Hyannis Historic District-Certificate of Appropriateness required unless same
color/same materials specified on application
Map/parcel number
Sign-offs from
Tax Collector
#of squares of shingles or square footage of roof to be shingled
specify stripping old shingles or going over old roof.
If going over
how many roof layers existing now
what size are rafters? What is span?
Complete dwelling information for the Assessor's Dept.-if known
Workerman's Comp.form /
Home Improvement Contractor Affidavit(RESIDENTIAL ONLY)
Home Improvement Contractor's License OR Homeowner's License Exemption(RESIDENTIAL ONLY)
COMMERCIAL WORK-No License is required.
Fee
q-forms-PERMITS 1
Rev 2/10/98
TOWN OF BARNSTABLE 21503
Permit No. _-_--___--- _
Building Inspector
swn.m, a Cash _----
��...0A p
OCCUPANCY PERMIT-- Bond —x � 79
No building nor structure shall be erected, and no land, building or structure shall be
used for a new, different, changed, or enlarged use without a Building Permit therefor
first-having been obtained from the Building Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
Issued to dress
Greenbrier Devi, Corp. Box 510 Centerville
A��dii " �
lot #4 14 Greenbrier Lane, He8nnisport
wiring Inspector Inspection date °�f {
r..
Y
Plumbing inspector s, Inspection date
Gas Inspector 77
Inspection date
f. .
AEngineering Department �i� / ,� / `- Inspection date -
THIS PERMIT WILL NOT BE VALID, :AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
jl'
............... ............. 19 z� .....___
........ y ......
�� Building Inspector
r 1 ,
PC .-t-6.-3.s
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�- �''''` -s-.��tl .�k�w'�z- :""'*+.:sieta-wr-....,--"'�..t-gym,—'- -.�.-:es..�>�. {„ '`, '•.. - - -� ,p `._. „�'� iF. 4`t' �r"F�j <'
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. o �,� �� CERTIFIED PLOT ' , PL�BV
r -73
Al
S I NElt� ..CONSTRUCTION ONLY : '` �M
Y 12 OF, FOUNDATION' 1S .FEET
ti. A:PCVE ,,LOW POINT OF ADJACENT �� �� L
h� RVA0
SCALE: �',.,` 3 ®ATE'=
DR ®I�i°(�' Ed�GlA4LLF4/SIG .iAl cLiNT wEn.r P I CERTIFY THAT THE' vv /o�4 TLV
SHOWN ON THIS PLAN. 09 L®SAT�k n E�oS�7 ESE® RE®DSTERED , � ✓h
Q�Id. I LAN® " Jo® No. n z 6 ON THE GROUND AS I�1®9OAT ® AIM' 4
t t. ,y .•��. CONFORMS TO THE ZONING
ENGINEER
k111EER SURVEYORDR. ®Y= _
OF BARNS T ®LE , m 4 T
} ry �� �.• � �fAl�y.'„1`_"`_ '`"'r_70�L:4A A'i'N uxT--=+= CH- IB Y•
t ESQ r�°A ,MOUTH, MASS. HYANNIS, MASS. SHE(i:T ! OF
i — DATE R 0 LAN®°'SUISVIr
t}�lip F r ' a .. � � } -' r. t. t� CFI �. < }M�..'•
.ItZ�
r ^
Greenbrier Den, Corp.
n
�
* ,
mo,2150I~.. Permit for .....
`
--......~-.--....—.~.� ..���� .~-~...-����^,
' � ������
Location
...—~-^^^^^~. .~ ~^^^^~—^— �
Owner ... ~Dev Carpr^^^~^
Type of Construction ........fpsaae~^^^^—^^^`.
....... ^^^^...^^^^^^^~.....~^^^^^^^...^~^^...~^^—
Plot .............. Lot ....................._.
�
Permit Granted ................jUy........26.19 79
Date of Inspection ................................. �
Onhe Completed _����A���^��.....—]9
' y
PERMIT REFUSED
__, ...... ...................................... 19
.......................................
u� �
"" «c
� ..........-.................~
.E1 '.���� ................................................
� 0 �
-
�
_. _ ..........................—....... lQ
.........................................................
^`'^^^^^~'—^^—~~—~~^'--^^--^^~~~^-^`
-
• L Agsessor's map and lot number Y.. ........Ao /� �(, Q� THE
o� o�y
79 �q7,3-....................... SEPTIC SYSTEM MUS
Sewage. Permit number ............ . ............
INSTALLED IN COMP BI$3STI➢L6.
House number .......... ... . ................................................ WITH TITLE 5 rnea
ENVIRONMENTAL COD pY
TOWN OF BARNSTA`B' a LATIONS
BUILDING INSPECTOR
dAPPLICATION FOR PERMIT TO ......4�(�/.4!v��r�.. ��`//ram
. ................. ...........................................................
-TYPE OF CONSTRUCTION ... ✓d.C1 ... •Hai()/?��.. f/ .................................................................
.......................9
TO THE INSPECTOR OF BUILDINGS: y
The undersigned hereby appli�'iforKa, peerrm�it ac o dingy to/the ffoolllo—wing/ information:
Location .<t... ..:.... .......... ......................_ ...., j...4..�..��../...1.. t�/ !?/. �� .�............................
Proposed Use ....A3sI �P.���L
......................................................................... ........................................................................
Zoning District ....../.`:...6....................................................Fire District ....1...4��ll!� ��J..............I.............................
Name of Owner � Ft✓�it/f.2:.. • C I�eG'.. ' (cf�� C� l� 4�1r'rr��� .`....................
. .... / / �.... .. ... .... ........Address .. . .........................................
Name of Builder ..I 7.✓11� ....`:.V`.X1 ..................Address ......, AII?7.cl..........................................................
Nameof Architect ................ ................................................Address ....................................................................................
Number of Rooms ............../.....................................................Foundation ..o0alzat.....................................................
Exterior .................................Roofing ..... ,(�� / .i..............................................
AIV
` ........Interior ...... .....................................Floors ....
Heating .......... 0 .............................................Plumbing. / ..
Fireplace ........./.'.E3/! .......................................................Approximate Cost ...... .......................................
Definitive Plan Approved by Planning Board __ !1__G___._______19 Area .... ........................
Diagram of Lot and Building with Dimensions Fee !. .. 7—�•......3... .. .
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name
1
pp `
Assessor's m prand lot number r �4 ��....
Sewage `Permit number ......................�.�..��.�................:.....: �`` , � �+►
Y Z BAHBSTADLE, i
House number 1A8a
...::...................................... 90
pp t639.
�FQ No a'
TOWN OF BAR.NSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ............... ......... .....................
TYPE OF COPfSTRUCTION ... ...................................../ 1�. ..........................................................
` TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location
ProposedUse ..... .....t`.. fGt... ." .. �................................................................................................................................
Zoning District ...... ....................................................Fire District f J"Lit!N!/•....
Name of Owner ;a• ' t�?rvf. !Jt�+�s �• 1(�GN••'.......Address ../ 1 '•„?% ... ....................................................
Name of Builder ..5 ).79fl,!.... '. X&P(-..................Address ..... G �.......................................................................
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms .............�./..............................................Foundation .� �!� r ......................................................
&14
Exterior ...... ........ ..............................................Roofing ...........' ..,...:..
Floors : 1 . / �!/...............................................Interior .......� C. `` ...........................................
Heating .........zoZee774 <.............................................Plumbing ... % �
.............. ..... .
Fireplace / �1v�.' .............,.Approximate Cost /�s-1�'' .......................................
........................:..............................
.
Definitive Plan Approved by Planning Board __Al,1�____________197?____. Area .... e< .Q....................... J
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ...............,.............................................:....................
Greenbrier Dev. Corp A_268_78
No .2.1r-,W..... Permit for ....12...story •dwe23ing
�x
Location
. ...............W ..H70ni•sport.....-t......................
Owner ......
s��nb�i•er• �ev:'•Ccrrp:•••�• .
Type of Construction
.................. .. ................ ....... .. ' .........
Plot ............................ Lot, .................:
e
Permit Granted ................ ...Ju.]y.......:26.1979
Date of Inspection ........ ............... .......19
z
Date Completed ......... .................v.......19
PERMIT REFUSED '
............ ...... `. ...... 19
.1..../.$. ......................
............ ............. .............. . .......................
............ ............ .............. . ........................
Approved ................................................ 19 _
............................................................................... l/Q t C?