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HomeMy WebLinkAbout0628 SCUDDER AVENUE A,CT :VE TOWN OF BARNSTABLE'BUILDING PERMIT APPLICATION Map Parcel 0/1 / Per # f D� Health Division 0 0 Date Issu , Conservation Division s �jq ©tl Tax Collector, ► PTiC SYSTEM IUY Treasure INSTALLED IN COMPLIANCE WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AN,[) Date Definitive Plan Ap roved by Planning Board TO � �+L s' Historic-OKH A- Preservation/Hyannis i Project Street Address SG U 17 ti BIZ Village A Owner ul A _D C E�L Pry Address S A"e Telephone e b E-S 775 b*s 7 Permit Request 16-6 �. FQ L6_e_--e 1:;�O FT6P f Square feet: 1 si/oor: existing proposed 0 2nd floor:existing proposed Total new /© Valuation l 15, 00 6 Zoning District t-zt Flood Plain ��' Groundwater Overlay �( Construction Type Lot Size 17 2 Grandfathered: ❑Yes g No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family 0 Multi-Family(#units) Age of Existing Structure '415 Historic House: ❑Yes X No On Old King's Highway: ❑Yes No Basement Type: 4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) / °' Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing ( new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas XOil ❑ Electric ❑Other Central Air: ❑Yes A No Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing 0 new size Attached garage:❑existing ❑new size _� Shed:❑existing ❑new size Other: N - Zoning Board of Appeals Authorization ❑ Appeal# ' Recorded❑ Commercial ❑Yes No If yes, site plan review# Current Use Proposed Use 9� C BUILDER INFORMATION Name Telephone NumbeR�' '?_S_ b ((L S_7 -- Address ��j S License# L S Home Improvement Contractor# D `T Worker's Compensation# & GOq J©00&7,4 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ee - SIGNATURE DATE C X ' FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED r MAP/PARCEL'NO.' \ Y ADDRESS t VILLAGE OWNER x- f DATE OF INSPECTION FOUNDATION FRAME ' INSULATION FIREPLACES 4 +. ELECTRICAL: ROUGH FINAL ; PLUMBING: ROUGH- FINAL GAS: ROUGH FINAL - ,F FINAL BUILDING ` DATE CLOSED OUT ASSOCIATION PLAN NO. , • - t The Town of Barnstable ,. ILA, . A.M Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA WSW k Offoe: 508-790.6227 Ralph Crossen Date AFFIDAVTr HOME DISPR0VE?dEWTC0Id17ACMRIAW SUPPLEMENT TO PERMIT AkPPUCA7TDN ' MQ,c 142A rewires that the"reconArucdon,alter3tioas,rrnovatioa, mown,conv=W4 imprtrverttes remrnal, demolition. or construction of an addition to ate►pre-a fisting cw= aocapiea building containing at least one but not mare than four dwelling unks or•to which arc adjaoeat to such residence or building be done by t c&cred contractors,with certain e=eptions,along with other nquirrt�s. T3Pe of Wotic: rst Cost•„_O Address of Work: Owner Name_ l r r Date of Permit Applic2tion; I herein,certify that: Regin ion is not requited for the following rcason(s): Work cxdudrd t3 law Job tinder SLOW Building notcw=-oompied Oa a pulling cwn p=init N`cUct:is hcrcbN pti,cn tlW:: OWE ITRS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISI= CONIRAC?ORS FOR APPLICAELE HOST NgROVO4EIN7 WORK DO NOT HAVE ACCESS TO TE:E �. .%:a r�:;JOB F=.CSC=.:_5 0- GJ, �.?•?�'FI:T� U',"OE,R ? ,GL c. 142A S1G,\ED U11DER PENALTIES OF PETUURY 1 hcrcby apply for a pernit as the zgcnt of the owner: *Aq- (S9KL-jc-t0r rtamc Registration No: OR • - Tlr`c�-CiMun�ttK�cirlllt`nf assQcliusctrs '�j Depariment of Industrial Accidents z t 1.4 =;� Olflced/1M1e- l9allorrs 600 I1 usliin„ran Street Bovan.Af= 02111 Workers' Compensation Insurance AiTdavit A=IicnnnfarmatiTn• Min so ilfNi'is�1L y— �Sas=��—•—� Inaminn- ci;�• _ nhnnc# ❑ I am a homeowner performing all work myself. ❑ 1 am a sole proprietor and have no one workin-a in any capacity �C I am an cm plover providing workers' compensation for my employers-working on this job. • ERNEST B. NORRIS & SON, INC. s^-any nnmc• 385 SEA STREET t '... �tltirc.�• • . HYANNIS 508-275-0457 . EASTERN CASUALTY INSURANCE CCtpANY WCG 1000807 A snnn c co nniics•# 71 ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below wi the following workers' compensation polices: nhone#. eoffey0 ... -, -- .ssrrr-s_ac-+m?�!+.7 -T'rtr�'"SF'_ .•. _ _ `7Tr�*fLTg''r'TaL7.-n t7M v _ try.. nhone#. �u ncece .. noiicr# ;Atlse.ti 1dd1d0A1I'ShC[t irD[[tl�I .•-.�.':..,�,Pe,•,�•...•�•.-.�,/:e:.�+n.+-..:.: S-.w..� • l . .�.•-.•. '�^.��� Failure to secure co►en�e as requrrcd uaJer Section 3J1 of 1►fGL 1S:tsa lad to the impasitioa olainsia�peasJtirs otsi fiat up to S1S00JA une rc=n'imprisonment as wdI ns cirilpenallles is the tors ota STOP IYORK ORDER tad tt Aae ot5100.00 a day ipiast tae: I aadersuac ' cop; of this st:te.ment ma} be forxsrded to the Olrce of Ian ati�atioas ottbe D1A for coYezztt miQatioa. I do lrerrbr cenifj•under the pains and p edties of perjury that the inforn=on pros7ded abort is true and carnet sienuurr are Pr'nt nzmc CRAIG N. ASHwORDi Phone# 508-775-0457 N 0OM6ol•use on1y do not ir•rite io this sm to be completed by ate•or toga ofllcW cln•or to" pcmitAlcense t/_ t 1suildlaz Dep=rtmeat C3LJ=z n D=rd ❑check if immcdiste mpunse is rcquirrd p5deesmra's OtTice _ C311exith DtTra ----- — - Of6cr- l J �� 1 c/f1� �4�1� �i(�2 Q�c�L'GC�'•Q-1C�C/ZGG1Q�l i ` BOARD OF BUILDING REGULATIONS 1 License: CONSTRUCTION SUPERVISOR j ! Number: CS 015851 Birthdate: 09/28/1953 Expires: 0 /28/2001 Tr. no: 5743 Restricted To: 00 CRAIG N ASHWORTH 385 SEA STREET HYANNIS, MA 02601 Administrator Sze "C�o�?�rsursea �2 0�� 11ac1�c��e 1 Of r t.t I .1 l:i rr 1 r 1t, h ..1, c.e 02 Jirlt_ Xr1e1-1t.. C0 Ill t:l ,t.o Y, f-<it<ya:-a"t 'i a1;._toTl _l0 2,0 14, + Xr.?.7: r 0. I y t:)C. P r e C o r r-)o 7-a r C).n _ . —J E IMPROVEMENT CONTRACTORHOME �a Registrati0n: I0201 T" 13 i lCR :[ ',C1N 1` C Expiration 0 D/2002 1 Iat, m t:11 c•\ = Type; Privy F. CorVo 0 t"IA. n 1:1C'I ERNEST B. NORRIS 8 SON INC �ra-ig Ashworth 385 Sea St ADwji_rranior, Hyannis MA 02601