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HomeMy WebLinkAbout0137 STRAIGHTWAY ACTIVE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION' Map '010 Parcel Permit# Health Division K Date Issued c2 2- _ Conservation Division �< G Fee Tax Collector �.t k�, (�l/d'�l l� SEPTIC SYST00 MH IST BE INSTALLED IN COMPLIANCE Treasurer. WITH TITLE 5 I ENVIRONMENTAL CODE AND Planning TOWN REGULATIONS Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hya6nis , S - Project Street Address t Village Owner Nyvfiv Address Telephone Z J 7 752- Permit Request s lLUL 1 '1 [if+10 "G /46 x SR Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuations s. ® Zoning District Flood Plain Groundwater,Overlay I � O Construction Type - t Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: O Yes ❑ No On Old King's Highway: ❑Yes ❑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 Number of Bedrooms: existing n.F new ._6� Total Room Count(not including baths): existing new First Floor Room Count 2 Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other ' Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Cl No Detached garage:❑existing ❑new size Pool:❑existing Efiew size Barn:❑existing ❑new size Attached garage: ❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name COW C, Telephone Number Address J�� License# ��"✓ ���` Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIG NATURk - DATE 1 , FOR OFFICIAL USE ONLY, PERMIT NO. DATE ISSUED MAP/PARCEL NO. ati I r �� � •ram. ... , l,,y• rr ± - ,;� l t -. - . � � ++ ADDRESS VILLAGE OWNER � � •? � t � . • - `�... ' �° 1 _ - - -.;,.�, , , DATE OF INSPECTION FOUNDATION FRAME t- INSULATION r FIREPLACE ELECTRICAL: ROUGH � FINAL PLUMBING: ROUGH � FINAL � 1 GAS: ROUGR = FINAL 4 Y FINAL BUILDING ; + DATE CLOSED OUT - 4 v" ASSOCIATIOMPLAN NO. d r r _ Board of Building �` W'1111114 Regulations and Standards HOME IMPROVEMENT CONT - Registration: RACTOR 133141 xpiration: 05/15/2003 TYPe: DBA PICTURE PERFECT POOL` )`;' EDWARD INSOGNA 14 GOLDEN AVE. MEDFORD k MA 02155 �►.-. ✓ ?' Admini . ,.--r• strator i = The Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Elbert Ulshoeffer,Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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. Type of Work: ( v V Estimated Cost 1✓/" Address of Work: wner's Name:O da Date of Application: G 0 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 TIIDIR 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 agen of the wrier. klo D to , ( Contractor Name Registration No. OR Date Owner's Name q:fomu:Affidav 1;1" The Commonwealth of Massaci:usens ' Department of Industrial Accidents "^► r 600 Washington Street Boston,Mares 02211 Woritt:ra' Comntassatiou Insurance Afridavit ff—V �r / locationIc- P LZ /cl, �� 1 V `liV �� �`�v�� O�1Cit� !lICCC/// I aM a homeownerpaaorming ail svotic=7aif Gl I am a sole moariesar and have ao one vvoridaa is wr r=acitr ❑ I ata as ezap3opar providing woZi=l ®Pmerrirm for my emgioye�s vvaraaag oa this job. va•.}xw w :x•}}�aewr. xeae.. .; .... axe. :.. :.:., wv }, n:." ?R:;.x•}}.}:... ....... .:sw;.. ....how..:..:•.:., .... ;.,.;;.,":w.•.. ::....:,,......, ....... ....�Y.�•.�'wk.s. : ... .. :•.xsi:.}:-..•..:�••.•....{ •;•nidw�n.. $.... �•r •:,:}'-•:•:v:n::w.:vwwnv.-..:::.Oi, ..:..::::.v:.,nn.IX?�C:v........................... .wn.-. : r r. .•.. ^C?,iJi•AY�,:?} )�)eb: .ti.l......... i ....,........n..v.......... ::.•w..:....,........ fix:...: na❖w •.v. : ��•• ..'� ...... ... }Ak...... ....................:?„} +:i}v::::::v:•: •. •..n•. s'r.?}•:: ^n .7„£w'"'♦Jw,a' ... - - `si'iVk .:•:...}-.}w:.:.......v...:'. xfi:w•:};?. �1Ck2::^: ..'r{'}}.r. ��ii?'^ -- �'i6�•D3,C•r{` Nk7�» }'�kN}`'w:.K^^.b :. •:'.a:�r.:w' .Fk}.... w,. ��ak}?ca w::v a:.,::•.;..vrk:;.:•»+ai'rr : :r?::; • LOtQDEIIY.TfatIIC:' f ;:.,.•:;::}•?cRc<�s:;F. 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