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0545 SCUDDER AVENUE
Gt�9�- r�`�3. ?, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o2 �� Parcel 0 Permit# t5 d� 4' y Health Division 91COP-39 ', 6i�D 1 3 d 10 s-- �' # Date Issued a 3 0 S it.V`� Yet n F Conservation Division S t L '`' ;�� v P„ ;: j ] Application Fee Tax Collector Permit Fee 2,S Treasurer I + f '�Ii `'"---- SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plan Approved b Planning Board ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH A) � Preservation/Hyannis J Project Street Address �3� AVZ::' J® j Village /�A—XJ N 45 Owner Jo �� / !GL 4 54,P / Address �0 5T Telephone c ��-5 G 4t .L9 Z E6 Permit Request U/LP A40eM&_AJT-- Square feet: 1 st floor: existing /D// proposed 101 / 2nd floor: existing _� proposed _f2 Total new Zoning District .&. Flood Plain Groundwater Overlay Project Valuation ✓' �r�D Construction Type Lot Size CAAJWWAJ/!JM Grandfathered: ❑Yes XNo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure / A. Historic House: ❑Yes - No On Old King's Highway:`.❑Yes CkNo Basement Type: )j Full ❑Crawl /Walkout ❑Other �' eeL0V41 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) d Number of Baths: Full: existing 2 new 1 Half:existing new Number of Bedrooms: existing 2 new Total Room Count(not including baths): existing new First Floor Room Count 7 Heat Type and Fuel:X1 Gas ❑Oil ❑Electric ❑Other Z' J Central Air: Xj Yes ❑No Fireplaces: Existing 0 New Existing wood/coal stove: •❑Yes Js(No Detached garage:❑existing ❑new size� Pool: Elexisting ❑new size ;,+ Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: N Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes /VNo If yes, site plan review# Current Use Proposed Use � � BUILDER INFORMATION NName— 6 A18 RF/,S s -52.AJ G- Telephone Number -77 5 0 �Lj Address B'5 ��� 7� �/�i�J�l!S License# l 5'S'S/ Home Improvement Contractor# /d 2 l e Worker's Compensation# `UCC R60 67,56 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO , 2 —, SIGNATUR Z� - DATE 3� d FOR OFFICIAL USE ONLY f *PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: - FOUNDATION FRAME ���� s`C INSULATION 1 S V FIREPLACE f ELECTRICAL: ROUGH FINAL `• PLUMBING: ROUGH FINAL.' GAS: ROUGHS t... FINAL FINAL BUILDING _ • r- ' DATE CLOSED OUT X 3 ni ASSOCIATION PLAN NO rf r % j{ r r I� I01/27;/2005 15:26 FAX 508 775 7877 EB NORRIS 0 002 o f Town-of Barnstable Regulatory _ � Services . tAiuverAei.�, Thomas F.-,-,Geller.Director Tompery, BuUdlug Commalaaioner •• . . • • 200 Main Stroet,•$yannis,N!A 02601, • ,,.:'•: ;, , • '..,'._, . -. '.. • - www.town.barnstab1e=.us Office: 508.862-4038 - Fax: 508 790-6230 • Property Owner Must Complete and Sign This Section ' If Using ABuilder Q tr Ygam f i rot l C- Y", has Owner of the sub'e m l P P ' � �/� � he�ebT autbAnze:- act oabeh , r • is all matters relative to work authorized bythis btu4mg permit application for, 5�� 6�acHC-4 AW f Viol"7-119 (Address of Job) Signature of Owner Date Print Name —� t I RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE �90 New Buildings,Additions SS00 Alterations/Renovations S)3�5.00 �'oo $D•BO Building Permit Amendment $25.00 FEE VALUE WORKSHEET LIVING SPACE square feet x 596/sq.foot= x .0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE _square feet x$64/sq. foot x .00¢1= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ftf >120 sf-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 building permit: square feet x S96/sq. foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney. x$25.00= (number) Inground Swimming Pool S60.00 Above Ground Swimming Pool $25.00 Relocation Movang $150.0.0 (plus above if applicable) Permit Fee projcost _ i�. Board of Building Regula ions and Standards r One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvemelio ontractor Registration Registration: 102014 Type: Private Corporation 'Tt ; E xCG Expiration: 6/30/2006 ERNEST B. NORRIS & SON INC,Rja'� - Craig Ashworth 385 Sea St °�r` ti � 4 ix ,= i Hyannis, MA 02601 � -__ .� � /r;' Update Address and return card.Mark reason for change. Address Renewal ❑ Employment ❑ Lost Card ' 61ze �ai��reoouuea a�✓�aQaaclzuael�a Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ` " = Registration: 102014 Board of Building Regulations and Standards One Ashburton Place Rm 1301 - Expiration: ,6/30/2006 Boston,Ma.02108 a'Si3 , j Type:_Private-Cor oration ,,._� ; YP P ERNEST B. NORRIS&SON INC,:} dy{k: Craig Ashworth 385 Sea St 2601 d Hyannis, MA 0'i Y Administrator Tqot valid without signature 1 f i � �FTHE 1 Town of Barnstable Regulatory Services DA"SrasLs. Thomas F.Geiler,Director Mass. 039. 3�p1` Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date / 0 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. o7r Type of Work: )FFFA.So ✓A--rvm A-) ?a a�-�E Estimated Cost of Work— Owner's 437 _`5c,-V_v�1Z Avg- Address Owner's Name: Date of Application: /31 I hereby certify that: Registration is not required for the following reason(s): E]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 IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF ERJURY I hereby apply for a permit as the agent f the o //W` Date Contractor am Registration No. OR Date Owner's Name Q:forms:homeaffidav -✓�e iorynvrruvruueaul o/�:��waar�uaeCld BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 015851 Birthdate: 09/28/1953 Expires: 09/28/2005 Tr.no: 6861.0 Restricted: 00 CRAIG N ASHWORTH 385 SEA STREET HYANNIS, MA 02601 Administrator _ The Commonwealth of Massachusetts EPP ='� -= Department of Lndustrial Accidents n = eflice of/asestigadoos 600 Washington Street ...... - Boston,Mass. 02111 `?=��} workers' Compensation Insurance Affidavit name. �8 � i� ,S l,f C location city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one workiz in ca achy gam an em 1 rounding workers' compensation for my employees working on this job. con an ;name... .... ........... . .... -98 IN NX aar�ss: ;cites hilt ::::. . . :.:. .}::::: : :>:........, .}>:: J C. :::. .£.# :4.b. :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: ><« ::........:.::......:......::...... .. i;:�:<:;::: :�:::;::%::%::;:;::<:;�i::::ii;�:�::::�.';:;':�i`:2:;;;:R:: :%:�:�:::�:�:;::i :�:%;:::::�; �::;:;;:i•::%::�::?;;:;::;s.:;::::};;;:; ;L a fi $ <x �•��:T/i:i�%:::�':;iY�i:;:;:;i:::i;:;%ri .;, ;:;:%f;;;`<:.<' :j;:;L:nlj:C?%;:;i:%;:;i:ii•$:'.,:;i?:, rity` .nn............... ....r....n.,}......n...... r.nr........... : ::::::::::::-InG c ....................... ..........<.....................:vv.:......................:.............:: .:......................: ,.:•:•}?}:::• •wv..JJ Atilt.......:..:. �:#Ji:';i:;ii:;i}:;.ter::ry;;;.r;n;.}::...:.::::.:`.�:;:%%:;:?>;::;';:;;^}:j:: }�}}:?..;.;;.:;:y.}:•i}:�?{):;•:}<. ;C and:name:;:::..:,:::::,:•;.;,:.},::,..:....::....: . ON . . ......im ............. 'A ae"fib b 4 wi:Sv:r:::`:i:r:•: •}}}r:::.�.;v..•.;::::.:::.};:.:}.:.;::::::::i::•}:•:}....v:::iY•}:w:i:;:::'::.i vi:-}}:}�:<n}}:h:;n;:.;v:::;;;4:•}::::::}•.v::::.:............:.;�.......: .. .. ::::�•::.�::::::.�::.}:•::.;.;}};;;•i}y}i:;•::;;.};vi}}}:;J}:'}:i4}ii:;4T<•ii}:vi:';iiii:i.ilJi}}}:%? `}:^:i:':;;%y}i}j:;•}:iti{}:•)Xvtv:}:{.iii)i}ii}:::}i:{+.<•iii}:{i<:}})}}iji:^}}+:}•i}i}:;S:t<Ci�:ti?:i�ii v:iii'rii:;.;:}:;q};.}}-L:ii?:i;:j}}i}ii:0ii'+:iiii}}'}}ii)i}i:4:;:} Failure to secure coverage.as required under Section 25A of MGL 152 csa lead to the intpositioa o[crtanisml penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Hue of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Oice of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties ojperj at the information provided above is trw and correct Signature prlatname Craig N. Ashworth phone# 508-77.5-0457 C&he-&kff ly do not write in this area to be completed by city or town official town: pen,dt/license# ❑Bultding Department ❑Licensing Board mediate response i9 tegaired ❑selectmen's Office ❑Health Departmentn: phone N; _ ❑Other UrAsed 9195 PIA) I '(%Is S,kU-)0- �x IN pusT-- 0,141D - _ ._. S S►'Q�r+w4� H%Ap �. I gN4�uS5 /RPp SP '� Cj p -A 5 , � f E w�t4scor To! Q RC-CiS5 GAS +N.,� . i93ovc-. C�/ai�!G� . A9/�+T, f � 4 �2GiN/Sf} . fit' 1f7"yci Sr- DEv�cts. 0 R EJ�ocr4-r4 O v c Fc o uJ Aa2R�d-/ �� } m R fib' SCE tCS . S�f eFAC£. Pq yf}.SANI c '� /wo"oE ,6oT/c/ U TifnfSN`d60 , Inr-D Act.. pj-A S7-f t2 70 B� six o0 771 F + ��G Td 'L �v f XIR'y7Yt C�47- 12EAD�DAt21� G /yoSi�tG SCOT/� . SCALE: 3 p'_ / ' APPROVED BY: DIRAWN BY S/cr7T�oI2 n G�ASJXI� 1 DATE: © S.C, m�asoar/rt boons//�n�t�ts (�2A-5s ,r�,pW P/zo�6ssd �o�.1F OFF/ff V m 1^eoR o�f2 (�/-�+,t/r/ - Wn.0�.n 01 cunt. NG NUMBER DRAWI - - r _......_ .. .,_:.- - °----- ............. _.,- _..,_. ..._:: ,. -• =-'fir, i