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Engineering Dept. (3rd floor) Map Parcel it# 02,6 L/L�9
House# sy ,d
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) ��. ' �'a/izD `/� e*. '0. ;Ik._� # 3 wZm
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Conservation Office(4th floor)(8:30-9.30/1:00-2:00) k 141
Planning Dept.(1st floor/School Admin. Bldg.) �°��°��°q
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lan Approved by Planning Board 19 ��®
' ® STABLE.
TOWN OF BARNSTABLE
Building Permit Application
et Address 'To P-->y=—Y �c —
Village 4 Y s Fe9,-T-
Owner 'le-TF-;rK 4' gmg4! M- Address ' s,k ME'
Telephone to 2-7 5 —o 4-5 7
Permit Request AKe1-L-t5ce' 39Q21-
1 n1 raT b L(< V-� i
First Floor �A a CA4 aYaG r square feet Second Floor square feet
Construction Type oo C;1 F=rzA/At5-
Estimated Project Cost $
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes IXNo On Old King's Highway ❑Yes ❑No
Basement Type: 0 Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) fJ 0 CA A)-�r Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing 3 New Half: Existing 1 New- o
No.of Bedrooms: Existing 4New 00
Total Room Count(not including baths): Existing_ New 00 C{r. First Floor Room Count
Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other
Central Air ❑Yes �Q No Fireplaces: Existing New O Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑ ar�n(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
r
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
. `` Builder Information
Name -t R Telephone Number 775 "0 L�S7
Address 33.6 f&A n 7 License# 0 l 6 8 51
14 YQ f4 5 I m Home Improvement Contractor# 1 D 2 O 1¢
Worker's Compensation# KfC Q /600,897
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 BETAKEN TO YQ KM oUT1(
I-AiQ Q=r L L
SIGNATU DATE fo
BUILDING PERMITPERMIT DENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY s
PERMIT NO.
`t
DATE ISSUED '
:J _
MAP/PARCEL NO.-'
ADDRESS VILLAGE'.t
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION - -
FIREPLACE
ELEK SAL: ROUGH.• FINAL
IyLUMBING:a ROUGH'. FINAL
GAS: --.,,'TROUGH + FINAL + $
FINAL BUILDING- ;
DATE CLOSEDOI +
ASSOCIATION PLAN NO. r
• + f 1: ti
H f
j
. �� 4 ✓fie v�a�n�nsaruaeaf� o��.�a�c�uaseG�is
Y
:DCMURENI OF PaLIC SAFE'
CONSTRVAN77.SUPERVISOR LICENSE
Expires:
Restricted To: 00
,4
L CRA 1 G N ASHWORTH
385 SEP, STREET
HUM, RA 02601
t..
HOME. IMPROVEMENT CONTRACTOR
y 102014 ,
.Registr ation
3 o
F :Type - PRIVATE CORPORATION
iration 06/30/98
Exp
x T
ERNEST 8. NORRIS & SON INC
Ashworth
385 Sea St
° ADMINISTRATOR
H
MA 02601
yannis i
��=• The CunrJtruaN•caltli of?1 tasracht�sctts
p� 'I '�..�1 •`• • Department ojludustrial Accidents
. z' ly _-,l ofcE1J1/QYtSD98IlODS
600 f t ashi"N'"M Street
0 111
�•k`: -,'
�. Workers' compensation insurance AffidavitMan
,
cit
❑.I am a homeowner performing all work myself.
❑ I am a sole proprietor and have no.one warkin, in any capacity
_,,..
1 am an employer providing workers' compensation for my employees working on this job.
ERNEST B. NORRIS & SON, INC.
385 SEA STREET .
• 508-7.75-0457
HYANNIS
EASTERN CASUALTY INSURANCE CCMPANY WCG 1000897 A
curt 17
I am a sole roprietor•genera!contractor,or homeowner,(circle one)and have hired the contractors listed below wht
❑ p
the following workers' compensation polices: . . ....
y n
address! _
x
city-
nolicy
N
- -: --- yenran r..s '! r!•r--ram'
•n..
Attach aJditional'shcet irtisressa
'�" ""t `-•~ � �. ties of a fine up to S1.500.00 a
Failure to secure cavcrnge as required under Section 3A of AIGL 1S3 can lead to the impoatttoa of enmsaal penal
one}ears'imprisonment as��ell as civil penalties in the form of a STOP NVORK ORDER and a� nnoa0.A0 a day against me- I undtastand t
copy of this statement mad•be forwarded to the Once of Ins estigatioas of the D1A for coverage
1 do ltenbr crrtif}}•tanrlcr rbc pain:and Pyraides ojpedurr that the iafornmtion pnv►ddtml above it trot and correct
ate
Sienaturc'
A one# 508-775-0457
CRAIG N. ASHWORTH
Print name
Fimmediatc
only do not write in this area to be completed by city or town otlicisi
itRtcettse# r1guilding Department
C3Ljcensiag hoard
• '
Dydeetmea s OtRce
response is required �tlealth Department
�►other�_
phone#•
son•
• rjjKE .. �•y.,a •{.•:�,'Wi.�,y .•i�t ;•1��4r"f:i.'f•
The Town ,of Bam*stable
Department of Health Safety and Environmental Services
Building Division
367 Main Street.Hyannis MA 02601
Office: 509-790-6227 Ralph
Date
AFFIDAVIT
HOME.nWROVENMNT OONTRACMR LAW ,
SUPPLEMENT TO PERIVIITAPPUCN710N
MGL c- I42A requires that the"reconstruction,altecuions,won.tep*moda b2tio t.eonv=oa,
I irnpmvement, remmmi, demolition, or oonsmxtion of an addition to any pm-ads&g v9vaer occupied
building containing at I=one but not more than four dwelling waits or to which at a adjacent
to such residence or building be done by te&crtcd contractors,with uEn cmVdm along with ether
Tjpe of Work: 1cs®F �W t N POO est.Cost �12,ooa
Address of Work: 15 otS>r- -. .C
Owner Name_ f::�C-rm dr r
Date Of Permit Appli=tion: l l6 117
I heidn•tettiN that:
Registration is not required for the follotxing rc=n(s):
Work e�xdudcd by law
.lob wxkr sl.000
Building not oww-oompied
Owner pulling own permit
NG.cc is hcrcb) giwn t}'.=
OWNZRS PULLING THEIR OWN'PERMIT OR DEALING 1VTM UNREGISTERED CONTRACTORS
FOR APPLICAELE HOST I}9ROV1?.4ENN'T WORK DO NOT HAVE ACCESS TO THE
�s"sr :T10�F=0G � ;11tId7tR � e� TFLW
SIGNED UNDER PENALTIES OF PERJURY
1 hereby apply for a permit as the agent of the Owner:
16117 L IoZOI
I7ai C� tractor name Registration No.
OR
D::,c Owner's name
Assessor's map and lot number ....:.....�........f......
Sewage Permit number
��Q�D�THET�bgoa TOWN N OF BARNST1y11BLE
b BAHH9TODLE; o
1639.
APPLICATION FOR PERMIT TO .....4'7 �caR � • '..... .
1:a TYPE OF CONSTRUCTION ....... ................. ......................�.
........... " ................:.................
............20" ........:.......... .19........
TO THE INSPECTOR OF BUILDINGS: .
The undersigned hereby applies for a permit according -to the following -information:
Location ...e.......'7`o'89c%+ C9 l�c 1 @ ...:...P,/- ,�7 f� d 5 .: :}r........................
r ...... . .................. o �..... 0,
ProposedUse ..:..►.: ;C e1%-T ca,A 9 A O ..............CjVAA:5..........A/o............................? ........................................................
t
Zoning District p Fire District ...... nn...............................................,
...... ... ... ............................
Name of Owner ....>.......�<......a v+�.��esr+ .........Address .......Vic.... Cl 2 c„�C�, ... �/�.......................• t
J.......... y•
Name of Builder ......�^a•w•ld 2n c e.....`� . �•And Address ...M. ... ...6:.'ln;�'"f 12...:• I.......!...�r...../..
. .... .
Name. of Architect ............. ..... .....�'...................................Address ......:............5 . C
Number of Rooms ® :.Foundation. X �r/^C4
a.... .................................................................................. ... ..J. .........
Exterior C�', rr R �!ln,J�^r�.F'........................Roofing _ ...... .. c...?.. Y.........:..................
Floors C.4•R •�� T r Interior F� ,n e_'}r n r� ....................... ............ o..
. ........ ...:...........Plumbing ..... ..... .........................................Heating a5 L/0e...... VO ^JC- A roximate Cost / 0 0 6
Fireplace ........ ...................................... PP ........ .. ....... .............................
:.
Definitive Plan Approved.by 'Planning Board ________________________________19________. Area ... ....:.. •
Diagram of Lot and Building' with Dimensions FeeA.`� +
SUBJECT TO APPROVAL OF BOARD OF HEALTH
' tom•--3c�-�-•-�� ' � •
A?Z
I hereby agree to conform to all the Rules nd Regulationsof the Town of Barnstable regarding the above.
construction.
Name ....... ........ .. ,.... ................. ......... 1
� Lawaoo , Steve A=325~156 & I57
20545 dormer
No -----.. Permhfor ------------
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'
15 Tobav Circle
Location ........ '
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Hyannis
----.---------------.------.. �
Owner 3teve--Law000——--- ........ .-- ---------'
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Type ofCons� � -----rame
Construction ----'---_.
. .
--------------------------'
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Plot ............................ Lot ...................... �
'
Permit Granted .....September
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I 78 �
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~~'~ of Inspection^ ^
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. PERMIT REFUSED �
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' 19
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.—.—..—.-----.---- .....................
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. Approved ................................................. lV
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