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200 Main Street, Hyannis MA 02601 508-862-4038.
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� a Application for Building Permit &014®jAI
Application No: TB-17-3953 Date Recieved: 11/13/2017 . 0 ,YOV<n
Job Location: 81 ANSEL HOWLAND ROAD,CENTERVILLE �NQP 2Q,J
Permit For: Building-Solar Panel-Residential
Contractor's Name: NEAL F HOLMGREN State Lic. No: CS-088921
Address: EAST SANDWICH, MA 02537 Applicant Phone: (508) 744-6284
(Home)Owner's Name: THOMAS,JOHN&SUSAN Phone: (508)463-8417
(Home)Owner's Address: THOMAS LIVING TRUST, CENTERVILLE,MA 02632
Work Description: Installation of 26 Lg 335watt solar modules flush mounted on existing roof. 8.71kw. 910sgft
Total Value Of Work To Be Performed: $28,308.00
Structure Size: 0.00 0.00 0.00
Width Depth Total Area
I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568).
I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required.to have coverage unless he files his intent to
accept coverage.
I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained withimis true and accurate to the best of my knowledge and belief.
All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: Neal Holmgren 11/13/2017 (508)744-6284
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $28,308.00 Date Paid Amount Paid Check O or CO Pay Type
Total Permit Fee: $194.37 11/13/2017 $144.D iXXXX-XXXX-XXXX-I Credit Card
2197
Total Permit Fee Paid: $194.37 11/13/2017 ; $50.0o i xxxx-xxxx-xxxx Credit CardLL G G
I 2197_ I
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F1 �ram,
Town of Barnstable *Permit#.
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'bp Expires 6 months from issue date
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tinnrrsrnst.r;, Regulatory Services Fee t
Mass.1639. Thomas F.Geiler,Director
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Building Division ®�
Peter F.DiMatteo, Building Commissioner .PER ®p'r
367 Main Street, Hyannis,MA 02601w
Office: 508-862-4038 2002
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Fax: 508-790-6230 TOWN OF EMRNST
EXPRESS PERMIT APPLICATION ABLE .
Not Valid without Red X Press Imprint
Map/parcel Number
Property Address I?/
(Residential OR ❑Commercial Value of Work
Owner's Name&Address /yl?gy Cd'THE�ItitC A &JF
(e(,�
Contractor's Name A1V1W,— Telephone Number
Home Improvement Contractor License#(if applicable) L 91 100�d 3
Construction Supervisor's License#(if applicable)
N(Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
1dI have Worker's Compensation Insurance
Insurance Company Name 2 UP I C 1 /A/
Workman's Comp.Policy# wXI 3 r?9gA1.5,
Permit Request(check box)
❑ Re-roof(stripping old shingles)
ERe-roof(not stripping. Going over existing layers of roof)
i .
❑ Re-side
❑ Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
Signature
Q:Forms:expmtrg:rev-070601
Assessor's map and lot number .. ..... �' �.'° •�'. �.Y� 7 SINE t0
Sewage 'Permit number ............................. ...
y .1.._�l s ! _ sasa�ssr
House number ........ J
1639
IINSTALLED 1 0 AIDLIANCE" c r
`= TV ,,N ®F ��A1 NST .
+'v ENVIRONME TAL CODE AND
TOIA t+9 REGULATION
BUILDI. . 'INSPECTOR
Af
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APPLICATION FOR PERMIT TO .:.. ................................................
..............................................
TYPEOF CONSTRUCTION ...:. .:..... ........... :.:.��.:.....:.:....:.:.:................,.,......................................................
• .1:4_ + ... .....................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit~according to the following information:
Location .... ......................... ...... ...... ... ............
Proposed Use ... ./.!!! .- .. _ ......... .........................................................
ZoningDistrict .........:..............................................................Fire District ...................... .
Name of Owner .........................
�� �
..f�:..................... ...................................A'ddress ..... . .......,.................................
Nameof Builder* ...........s.e .................................................Address ........... ... .. ..................... ..............................
Nameof Architect ............. ................................ ..... .Address .:.............. .......................................................'.
Number of Rooms ....................... ........ .Foundation ...�'...®AV44-4 2 "....................................
E.xierior .............. .............................Roofing . �� tC.1 l e.,X....................................... . ....
Floorsp K............................. ......... ..::...... . .....::Irtterior ...a' ...Ar ....................................................
Heating .. ., .e..h/.! ....................................... ......... ....:. :Plumbing\ .............. ............................................................
Fireplace ... 7............................... ....Approximate Cast .... , .............
Definitive Plan Approved by Planning Board __________________.____ 19___'__:_. A 'rea ..!....a...
~....Dfagram of Lot.and Building with Dimensions .
..Fee ....�f;.�• .��
SUBJECT TO APPROVAL OF BOARD OF HEALTH
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
- ols 7 51 7
Name .....:.... . : ?:...... . ..;&. .. ........:................."
SMALL, ALAN _.
24616 One Story y
No ................. Per hit for ............ `
:. .......Single FamilY...Dwelling..........
Location .LOt #15,. 81 Ansel Howland Road `
Centerville :=
I� •.�. ..............................................
Alan -Small
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Owner ..................................................................
Frame
Type of Construction
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.............. .......... .... ....................................................
a,
Plot .............:......... Lot<........... ................
-Permit.Granted December; 7.:.........19 82 .
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[ Date of Inspection ....................................19
,t Date Completed ., ...........19
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P
SI►JGL,E FAM«Y - � BEORvoM _
uo GARBo►bE Gwnto62 -....:,_...�, f.' /G a
DA1L.y F%-0W a 110 X 3 3306.Pp
SEPTLG TANK a• 330x15o% =a956.PR
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I o�5Po5�L_ PIT v4E l000 GAL.. .�
150 5.F x �•5 3?5 G.�`o.
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-TdTA I- D 6.516N * .4.25 G.P DL (
-TOTAL T>A1l-'? FLOVf = 330(-,.PO, 1 .----� �'
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`"" TOWN OF BARNSTABLE
. ; Permit No. _. --------------------
1
Building Inspector.,a"& : Cash
OCCUPANCY PERMIT Bond __ _
Issued to t 1 Address (A-2ntc'rvi L iF:
Wiring Inspector Inspection date
Plumbing Inspector Inspection date
Gas Inspector Inspection date
Engineering Department Inspection date
Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
.................................................... 19......__ .....................r......... ------��.�slf�c_!�
Building Inspector