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HomeMy WebLinkAbout0217 ANSEL HOWLAND ROAD 2.tti ANC... AM%XAoD Z� - a Application number ................................. MAS$� Building Inspectors Initials.._._ ..... ............ c263 2018 Date Issued.._._._._._.-ONN (k 6MNSIML� .. . ... M ap/Parcel....... ................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHEPJZATION PROPERTY INFORMATION Address of Project: ,,Z(� �N E?( �� I�,(V(� ,^� (IT NUMBER STREET VILLAGE Owner's Name: mv-x, �tW44.0 Phone Number Email Address: Cell Phone Number 9` 970 9�-41 Project cost $ tat dv— Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application a building permit in accordance wit 780 CMR Owner Signature: Date: TYPE OF WORK Siding Windows (no header change) #—= Insulation/Weatherization Doors (no header change) # Commercial Doors require an inspector's review Roof(not applying more than I layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name -Z�6\4\ 01 Nalsou Home Improvement Contractors Registration (if applicable) (attach copy) Construction Supervisor's License # es 09: 670 (attach copy) Email of Contractor L'i 00-60o &%w�' �"�9FPhone number S05&5:3 2 Ll ALL PROPBU ESTHAT HAVE STRUCTURES OVER 75 YEARSOLD ORIF THE ESUBECT PROPERTY ISIN A HISTORCDISTRCT, YOU M UST OBTAIN HISFORCAPPROVAL BEFOREA PERM 1T0\N BEISSUED. APPLICATION NUMBER ............................................................ *For Tents Only* Date Tent (s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location (s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/ I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature AIL__ Date All permit applications are subject to a building official's approval prior to issuance. V The Commonwealth of Massachusetts Department of Industrial Accidents , Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: 36Sc City/State/Zip: Sv,,�wzl\ U"'o9 D 2-5� 3 Phone#: S5� -3 S -�`( p71 Are you an employer?Check the appropriate boa: Type of project(required): 1.❑ I am a employer with' 4. ❑ I am a general contractor and I 6. ❑New construction mployees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees . These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y aP t3'• 9. ❑Building addition [No workers'comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un er t Siafore: � i e rp�ai�ns an p alties ofperjury that the information provided above is true and correct ��/ � Date: Phone#: Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit1cense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia 1 _ Wealth of Massachusetts Common icensure of Professional Land Standards pivision ulations — Board of Building 1 F1 PJrvispr �e onriirieUrceucer,`C�o��P/l�ao�irc�tt i�LCa I r n Cpnst�;4t= Tl �l pg122120�9 t Office of Con Board &Business Regulallor1 .- ices. HOME IMPROVEMENT CONTRACTOR Re istcafion valid for iniviclual use onl Type: Ind!vidual before the expiration date. If found retii"rn to: )g3670 •r i i Registration Expiration I Office of Consumer Affairs and Business Regulation. / j F f 10 Park Plaza-Suite 5170 W NELSON; r I 152971, 11/02%2018 i Boston,MA 02116 PU BOX 111 ?t:do!ph W Ne,Son SP.NOWICH I+nA Rudolph Nelson i I 107 tQuaker Meeting tipuse F.tl Sandwich,MA �_ 4 . _ -" -- Unddrsepret 01 r} hla valad wi#hsDut s'sgnatur missioner Com ,:iz _ oFrfli tayti T0'P n Of Ba. .rnsta ble',. *Permit# Expires 6 if/is ro�aLis-sue dace Regulatory Sez,vzees Fee r pass �a t � rR Thomas F. Geiler, Director .ate Building Division Tom Perry, CBO, Building Commissioner aIA ( i� 200 Main Street, Hyannis, MA 02601 wwiw.town.barnstable.nia,us r _ Offic e: 508-862-403 8 Fax: 508-790-623-0 " EXPRESS PERMIT APPLICATION - RESIDENTIAL'ONLY Not Valid without Red X-Press Imprint Map/parcel Number iF Property Address _ / ? lqn Scy 0j,, Residential Value of Work 0-0 Minimum fee orS35.00 for work under$6000.00 Owner's Name & Address Contractor's Marne -65'E.ID�� . �{ . 1S e> rt `� Tel Number 6 Home Improvement Contractor License #(if applicabl Construction Supervisor's License#(if applicable) 7� ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I rn the Homeowner ' I have Worker's Compensation Ins an ` Insurance Company Name Workman's Co p.Polic Copy of Insura cc Comp tia e Certificat co ny each permit. . PermitRequesx'(ch k box) Re-roof h ricane nai. c'a �l ( ) (strippt gold hingles) All construction debris will be taken to Re-roof(hurrica nailed) (no ipp g. Going over existing layers of root) ❑ Re-side _ #of a'oors ❑ Replacement Wind owsldoors/sliders. U-Value (maximum .35)#of windows *Where required: issuance,orthis permit does not exempt compliance with other town department regulations,i:e.Historic,Conservation;etc. ***Note:' Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is req'ui d, SIGNATURE: _.. Q:\Wl'GILESIfORMS\buildingpermit formsCEXPRGSS.doc Revised 072110 _ p� Voorinzoaecaectcdd�'�"° License or registration valid for individul use only .\ Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs-and Business Regulation Registration:,-�=1.59942 Type: Expiration 6/1-1,[2012' Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 JO PH RENNIE,-, JOSEPH RENNIE ! / 4 WAYSIDE LN: � -,��� ( ,•,.— SANDWICH,MA 02563 s. Undersecretary Not valid without signature 'Massachusetts-Department of PublicSafet, Board of Building; Rc�o,lations and Standards Construction Supervisor License License: CS 86728 Restricted.to: 00 JOSEPH A RENNIE 4 WAYSIDE LANE; SANDWICH, MA 02563 r Expiration: 12tl612011 ('Donn issioner Tr#: 11347 i ' The C'ortunorrwealtlr of.Massaclrr.rsetts -- r Depart7rrerrt oflrrrlrrstrial.,cciderr.'ts —'` Ojjice of ltrvestigaftons 600 Washington Street .Boston, E,L4 02111 1vivnt,rnass.govl'dia Workers' Campensat on Insurance Affda,,& Builders/Con:tractors/Electlici tns/Pli1mbers Applicant Information Please hint Legibly Nana. (BttscnessrOrgaui�ationllndividttal�: �5 2��,d +� . A:d.dre-ss: i z City/State/Zip: yea 63Pllone#__ .����S 9 59� Are you nrr employer:'Chech the appropriate boa.: Type of project(required), I ❑ I.am a employer with 4. ❑ I am a.general contractor and I �loyeez(full and/or part-time):* have hirer)the sub-contractors 6- ❑.7tilew constzlrc.riou 2. I am a sole proprietor orpartner- listed on the attached sheet_ 7. ❑Remodeling slip and have no employees. These sub-contractors have g. ❑.Deuzolition tivarking for sue in any capacity. employees and lit:ve to on ers' '[No workers' cosup,insurance comp-iasu-auce..7 9• ❑.Building addition re. aired- 5- ❑ Vie area corporation and i0:❑Electrical repairs or additions 3.❑ I am a.hotneowmer doing all work o:fficess have exercised their 11.❑Plumbing repairs or additions myself workers'comp. right of exemption"pet-�,fGL 3 �o workers l_.❑Roof repairs ittsurazice required.] t. c. 152, §1(4),and we have no employees.fNo worlmrs' 110 Other comp-:insurance required_] •Any applicantthstchecks box#1.nwst also fill mirthe section belma'shnsriug:thPiz wor}cers'compmsationpolicy inforumdoo- t Homeovmers who submit this.affidzdt indicating they are doing sll worts and then hire outside contracints muz snhuvt:a irew sffidarit indicating snclr.. gC'ozmac.iars that check this box must etachad an sdditinnal.sheet sbowing the"nsme of the sub-contracmrs and state iabether or not those entities have employees. If the sub-,conintaors:hsve employees,they.must provide their workers'comp.policy number. 1 ast nn eNtplo}er f/tit is provra'irtg rt arkers':cortrp arsrrtian rzsl rrrnae fot my e�rrplaJ ees. Below ix tilt?palicy and job site it forxt nttart. Insurance Company Nance: Policy#nor Self-ins-Lic.#: Expiration Date: Job Site Address: City/State/zip~ Attach a copy of th e w oa leers'cvmpets'ssrtion policy declaration page(shorsdng the"policy number and expiration date). Failure to secure coverage as required under Section 25A ofM.GL c.. I52 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as cizal penalties in the fors of a STOP WORK 40RDER and a fine of up to S250-DO a day against the violat.tor. Be advised that a.copy of this statement may be.fomrarded to the Office of Investigations of the DIA for insurance coverage verification. I do hZV cerGi pdar thopains and pertrsttr'as of perjgry titnt ti�te it forrrtrtt'on pro ided abotta is frtta ttrtrF correct St Date: Phone Offl-r al use only. Do not 1r�rite ht this wren,to be completed by city or town of vial City or Town: Per•mit/License# Issuing Authority(circle one): .1.Board of Health 2.Building Department 3. C ty1To-v n Clerk 4.Elec:tric t].Inspe:ctor 5.Plumuirsg Inspector 6.Otlser c Contact Person: Phone#- L of THE r w HARNSTABLE, . MASS. 9� 1619: ,4,� Town of Barnstable prfD fv1A�° Regu latory YServices ' Thomas F. Geiler, Director r _ ' Building Division Thomas Perry, CBO _ Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstabie.ma-us Officer 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using _A, Builder I, C✓.71 iJtn-� l�")r 1 yl ; as Owner of the subject property 1 hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: l HOW JArvl 0 ' (Address of Job) Signature of Owner Da Print Name If Property ©vvner is applying for permit, please complete the Homeowners License Exemption Form on tiie reverse side. Q:\WPF1LESlF0RMS1building permit formslEXPRESS.doc Revised 072110 Assessor's office.(lst floor): F `Assessor's map'and lot numb r 'le:. �..f.:.Gi/� :. {Board of Health (3rd floor): / � STAUgig Sewage Permit number '...........�1.. .. �.7. ....:. � �� W ENS'Engineering'Department (3rd floor): E IRONHouse number ...............:'............ ••...... �.�.....�. TOW Definitive Plan Approved by Planning• Board _________________:______.____.__19_______ , APPLICATIONS PROCESSED 8:30'-9:30 A.M:.and 1:00-2:00 P.M. only TOWN ;OF ' BARNSTABLE - BUILDING , INSPECTOR APPLICATION' FOR PERMIT TO ............. .......................................... TYPE OF CONSTRUCTION .................. ............�.:� `�...................19..5.� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby. applies .for a permit according to the,followin information:: Location ..:...... �... .....:....... ....;... ... ........ ... .. ...... ........................ ........ .. .................... ���' ....... ....:. ... Proposed Use ....:. .................... Zoning District .......... ............................................ . ire District ............... ........ ................:............................ Name of Owner. ... ...a:..'. ddress 91..../......L,�'..! 00!4�.... n...�....�.� • r AA R ? . Y 'L ! Q. 9 Name of Builder ...........�:':............ ... . ...... ...............Address J..�.... d-�32 Name of Archit t ...... ........................... .:.......Address .......... ........ .................................. Number of Rooms......V..l.�� ................. ..... ......................Foundation . ..:......... . ...... .. ... Exlenor ..... ........................Roofing ....... k/..G...... .. .:.....� .. !! .... Floors ;........,. :...........:.....`..............Interior .......... ........ ................... Heating ......Plumbing ............... .............. ............................... , ` 19. .0 . (�.. Fireplace Approximate Cost ......../ 0............... Area +�.6..�. Q.'.... ...... ° Diagram of Lot and Building with Dimensions Fee .. ......... '. , sall r�N 89 OCCUPANCY PERMITS REQUIRED FOR'NEW.DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding'the above construction. Name ... ....................................... . .................................... Construction Supervisor's License .©......1......../... .., a WELLES , HERBERT J. 15 _ No 32.171 •..rPermit for ....13UUd..Enclose Porch " ' .S1n.g1e ;Faini_l.y....D.w.e.1lix1 ........ 217. Ansel Howland- Road Location`................................................................ r - o.... .. ..Cyente' vil•le .; . ....... .. ;. .. ..... ......... `$ .Owner ......................................................Hrert J. Welles ' Typexof Construetio ,Frame ` ....` .......... Plot, . tot'............................... ' • .......... ... , _ T ' �4.., Y ..�� ' 1..� I� 8f'•�> _ !•' 14 ens � � �, � p ♦. ° -- :W '. - Pe�mit Granted August 15............19 88 Date of Inspection ......`. Date* Completed ...... . ' .19 .................. .n --. � �� 5 -^ �; ; - i r �p 1.. .,{,„.. S' ^a '- • � „� . 7-1 + Qom ' • . Assessor's office (1st floor): -I�0*11,11E Assessor's map and lot number ....... Board of HehIth (3rd floor): Sewage Permit number ................................... ...... ..I....... 13AR"35TAIMLIE. 111"& Engineering Department (3rd floor): t639e House number ........................... ..A ....... ............ DNA Definitive Plan Approved by Planning Board --------------------------------19-------- - APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN -OF BARNSTABLE BUILDING , INSPECTOR APPLICATION FOR PERMIT TO .........(.......X..i. .... ..... Z/....G4ez............................. TYPE OF CONSTRUCTION ....................... ......... ............................................................... 3 ...............1/_11__1_11_11_1_**111..........19JUr TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ........................................................... ....................................Location .........;94...7..................1�.... ..... ......... .................. Proposed Use ...........;...................................................................................................................................................... ............ ZoningDistrict ........................................................ _..rFire District .............................................................................. - 1!0��.........Address9l....7....(.") vV 4 Name of Owner^!:j��_* ..... ......................................................... Name of Builder ...... ............Address R .................................................Q&t.V-I A 0 31 .............. Nameof Architect ....... ....................................Address ..................................................................................... Number of Rooms ..............................................Foundation .............. ... ......... .............................................. Exterior C.........................#,_.........................................Roofing .............. ........ .......I _6 /rNkN av� . ..............................................................Interior .......... Floors ............... ..................................................................... Heating .............. ....................................................................Plumbing ...............41.61.y�.............................................. ..... .. ............ -o. -.r��Z Fireplace ..................................................................................Approximate Cost ........ .............................. Area ............................ Diagram of Lot and Building with Dimensions Fee .............................. -� /-/Ouse OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the- above construction. Name ..................... Construction Supervisor's License ............................. i WELLES, HERBERT J. 32171 Build Encose Porch No ................. Permit for .................................... Sin le, ,Family Dwelling......... Location ...2�.7..Aijael Howland Road ............... .....�etery 1,1e.............................. Owner .......Herbert J. Welles Type of Construction ..........Frame..... ........................... ..........................................:.................................... Plot ............................ Lot ................................ Permit Granted .... ugust.,.l5.............19 88 Date of Inspection ....................................19 Date Completed ......................................19 4 � A essor's ma and lot number ..,•1. 7/.�d� F;�1 t7Ar g number ..................'��rl. 77 + A Sy � Sewage Permit' .' � �. 1 House number .........a ....... � a �� WE TOWN -:OF BARN.STABL DUILDI INSPECTO' • 'APPLICATION FOR PERMIT TO s: ... . ... ...................... ..... ....................................... r. ..�..•. r A ;TYPE OF' CONSTRUCTION .......................................................... ................ ......... :. .....................19.�...1 F � THE INSPECTOR OF ABUILDIKIGS. ` The undersignneddhh reby app11 for"-a-. ermit act�tding to the following infar`i tion: ..................... ................ . . ...... .. .. . 1 ... • . . , ProposedUse . ... .............................. .....:............;....................................... ,,:. ...... .. Zoning District :. f .. ::. .............Fire District ....... C.,�..C :. .....:3.............. .... .. .. .. . . Name of-Owner ....:........ ... .........Address Name" of.Builder. .. .... -. .�............. t . .......................Address .. .......................................................... .... Name of Architect ...... .. ., ....... ...... ....... address .a:..... ..................................... i ,. Number of Rooms ..:......`�...:. ... Fon`datfion ... ......... y l.. .ti. t � Exierior ...................... ... . .... .... . .Odofing Floors . .....L E .................... rtterior ! •i ... a. 1 ;. ....... :,.,.Ar, / 0. a� eating ............................................... ......Plumbing ,.�........ ,. ....tt'r ......... ... ... .,. Fireplace .../.�� �.Qy��....f....... ............... Approximate Cost .. I .+ .` ' Definitive Plan A roved b PlanningBoard __19_______ Aria" . t `; Are Diagram of Lot and Building with Dimensions ",, Fee �...: . �. =SUBJECT TO: APPROVAL OF'BOARD OF HEALTH ' '0016?r 1 I ; I ^ j ! cur A r _i .�t'`� t " 1 l 4 l•I c j�'T vi.� R � s OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 I hereby agree to'conform to all the Rules and Regulations of the Town of Barnstable garding the above construction. ' 4 Name .... ..... ..................................................................... g SMALL, . ALAN E. , One h5 ................. Permit for ...............,Story.................... 1 .....�ingle...F'.ami.ly Dwelling............... II ' Location Lot 3 217 Ansel Howland �.:. Centerville ................ .................... .......... - Owner ...-Alan...E.....Small...............:... _ ... yp T � e of Construction Fra. m.e ..... ....j .. ....... .. ... t ......... .................................... ` Plot .....................: Lot........ ......... ...... Permit'Granted .........arch..:31'......... .119 8 3 <. t Date of Inspection .................................. .1.9 , Date Completed .� . �.Z '..... . s�.19 Assessor's map and lot number, 41 : .. . r � Al ..:. -.. poi rN a Sewage Permit number ..... : .......... �........ ro` .,. .. !!d�P °•► House number ......... .1.1... ��............... ......... ... 039. ...... TORN OF BARNSTABLE BUILDING INSPECTOR APPLICATION. FOR PERMIT TO f � f D� �.. ................... ........... . ............... ............................................................. TYPE OF CONSTRUCTION ..:.� .. ................. . ............................ ... ................................ .......... ..............................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according..to the following information: Location ..................................... .. ......... .. .. ......... ......... ................... ..... .................... ....... ................ . Proposed Use � .. � r ........................ ....:.................................. Zoning District r 1 ...............Fire District ........................� • Name of Owner .. ........ c ... ............�� . `. .... .............Address ..................... . ...:..f .......: . ...:`............................. r Name of Builder' ..................C.................................................Address ................ Nameof Architect .........................:.................................... .Address .................................................... ........................... Numberof Rooms ..........`................... ............................. .Foundation .............................................................................. Exlerior ... ........ ......{................................... .........Roofing .................... ...:`.... ....................... .... f Floors ....... ....f.`.................................................... ..: .Interior ................ ............................................................ t Heating :........�..:...... .............................:............ ........:Plumbing ........................ . Fireplace ........:..... C`.:' s �....... 1..............................................Approximate.Cost ........�.�f . .....` ....................... Definitive Plan Approved by Planning Board _____________ _________________19_______. Area Diagram of Lot and Building with Dimensions Fee ........................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH ���G OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. , Name :. .. ............. rr ........ ............................ SMALL, ALN E. A=171-240 f, 24899 One Story No ................. Permit for .................................... Single Family Dwelling Location .,Lot 3, 217 Ansel Howland Road Centerville Owner Alan...E.'....Small.............................. Type of Construction ....E:name......................... _ F ............................................................................... Plot ............................ Lot ................................ March 31, 83 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 StNG�E� FAM�L`! � Bt=�RooM _ yo GA¢pA.GE G:ct�Nn�2 ,�, D ALL Flow r ►I.O.x Y f SEPT.�c TA�,K =.:a3oxl5o% --A9 .P. o --- --- - - - -- '` USE l o0o GAL. K� LoT 4' �� . 0• ✓j6 -. t o o O GAL. m4Po5AL PIT V4E QI, S 1 t✓t'•i At +5p , 5•F >< 2.5 37 5 G.PQ pliop., a,;,• -TcrrA t t7ESIGN s.4.21j �i G. ` •To,,TAL'DAI�Y� Pl.otN s 33pC,PD, �-� � � � 3s•i, • � vi � ' PE2coLATlo�s .czATEt I'�IN ZMIN •ot`LBSS° .o �d -�I `. FNo .�e0i j Ho, iS o6$OF ljlv� tb -RICHARD o� ACAN.. SAXTER v,� 1s NES (. Lo7 z , W. Q 25 00 t Q/STER 4tip suR`+�� 1. T6��T `tb2o F�y G o �Y� To P FNu= G1 Lo91"1 . loot/ INv• ,I f DIST. INS. �6nt. 78 Su9S•�L @aX S7•f:. TANK I i C. Joao I MV. _ ;� :sRNnY L6 A G ll S'�•c PIT INV. INY. wASNGD I{. - • F1ED 6ToN6 tL.Sl.o . 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