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HomeMy WebLinkAbout0048 AUDUBON CIRCLE . u A-4u4v��n . I � T Town of Barnstable *Permit# 1 aD (13 `f S Fxpires 6 months from issue date. Regulatory Services Fee ` , 1AENUMBIA s 1630. Thomas F.Geiler,Director Building Division X•RRE$S PERMIT Tom Perry,CBO, Building Commissioner 200 Main Street,.Hyannis,MA 02601 www.town.barnstable.ma:us J U L 19 2 012 Office: 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION RESIDENT Not Valid without RedX-PressInWrint. I UYVIN Ur BARNSTABLL Map/parcel Number l � Property Address `10 AkdL /Jn, L'Residential Value of Work' S Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address l l Ca t't�� `�jQ 2�YY1Gi I i `de_ fit r��A711� �l�' ��CA_ ✓1'I e f ? rLA Contractor's Name �gC(C,�C L'44 Telephone Number ` t�j Home Impiovement Contractor License#(if applicable): 1 7� Construction Supervisor's License#(if applicable) ��7��'— �l,Sri S ❑Workman's Compensation Insurance Chk one: Di I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each,permit. Permit Req st(check box) t Re-roof hurricane nailed (strippingold shin les i'( ) shingles) construction debris will.be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) 0 Re-side #of doors i ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S.and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this 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 requ` SIGNATURE: i i QAWPFTLES\FORMSIbuilding permit for sTXPRESS.doG Revised 053012 " t � License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 i �. Boston,`MA 02116 I � i r i 'I Not valid wit out signature dsioes i ecP+ a�cs&N�Rp•CoR type Dice PBpVE A 2 \n O 4 ( \ y g 5ttac�on �Xp�rat\9n � o F, K 000 ' Public Safety m ent of _ art , �. s Dep ds ;. Massachusetts Regulations and Standards Board of Building ssuper,•isgr.Specialty �^ Construction 105951 ' License: CSSL1\:� PAIR CL1FF9" ire' 12 BALDWIN ROAD Dennis MA.0263� a� Expiration cJ.�.•^ J1f '` 0610212016 . commissioner j + BARNSrAELE ' 9 `.� Town of Barnstable �o ro►A't� Regulatory Services Thomas F. Geiler,Director Building:Division Thomas Perry,CBO. Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder. I, _Fcaf\k We' }°PWCAO ; as_Owner of the subject property hereby authorize �U�l 1 C,�C l . 'a��as to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Fdaaw We54 fwlc,r1 , Print Name If Property Owner is applying for permit;please complete the Homeowners License Exemption Form on the reverse side. , �AWPFILESTORMSIbuilding permit forms\EXPRESS.doc. Revised 051811 n f �t Town of Barnstable Regulatory Services sAMSTMIX # Thomas F.Geiler,Director y MASS. $ 1659. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA.02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:._ 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include`owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. , The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION - The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as--supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFU,ES\FORMS\building permit fonns\EYPRESS.doC Revised.051811 AL\ 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 ff Please Print Legibly Name(Business/OrganizatiorAndividual): I taoc or erns v Address: /Z E City/State/Zip: ,,1 J c):2C;3 1 Phone#: 77" ?-22 05 a / Are you an employer?Check the appropriate box: Type of project(required): j 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I Viam ployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling These sub-contractors have ship and have no employees � 8.. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp. insurance. $ 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.Elofcers have exercised their I am a homeowner doing all work 11.❑P bing 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' 13.0 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, tContractors 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.Lic.#: 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under aims and e ties of ry that the information provided above is true and correct. l Si afore: bate: -7 Phone#: 771 /�� C-25. a � Official use only. Do not write in this area,to be completed by city or town official City.or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Town of Barnstable *Permit Expires 6 months from issue dote Regulatory Services Fee KAM • sntuvsr�, • 1639 Thomas F.Geiler,Director T I Building Division dill- Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address 40 iJU 8Ym &,►rcU, (?/1 L"r U,If, O Residential Value of Work vm Minimum fee of$/35.00 for work under$6000.00 Owner's Name&Address f fiaa 6 :L d(46-lk 14 Ot s 1-Vpn/4/I t/L�- 4ujoyr3Un �n/zfj-L)t 1/t, W,4 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: -PRESS PERMIT ❑ I am a sole proprietor I am the Homeowner A G ❑ I have Worker's Compensation Insurance Insurance Company Name TO WN OF BARNSTABLE, Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) tq'lRe-side #of doors Replacement Windows/doors/sliders.U-Valuezo o' Yl� (maximum.35)#of windows _ *Where required: Issuance of this 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 Im rovement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\decollik\AppData o icrosoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 _i 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 ,n, n Please Print Le ibl Name(Business/Organization/Individual): Address: 1 4a)0 6 au C°l(C City/State/Zip: �L Y1)C It N 65hone #: s Off-9S 0'090-76 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6, ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑,Remodeling. ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.$ ❑ g 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 I I.❑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 isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 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 hereb alties of perjury that the information provided above.is true and correct. erlify under e 'ns a?pen Signature Date: /� Z Phone#: 6 y s ow 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#: T-C ppI ET�Y Town of Barnstable o� Regulatory Services &MMSTASLE. y MASS. g, Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 x Property Owner Must Complete and Sign This Section If Using A Builder as Owner.of the subject property. hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION I oFZHE ram, Town of Barnstable ti Regulatory Services BARNST,mLE, : Thomas F.Geller,Director y MASS. �b i63o• ,0 Building Division 'DrEo n�a'� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print TE: (( „� n f C"HOMEOWNEX LOCATION: ku (� �r rC•�IIC/ ''Cin YVl l nu burpp� �p street nn ,q village �i / ": tlC.t3- 1A S, wf s V V I Y 1 S��'7 S 00-1. name home phone# work phone# RRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedur and requirements and that he/she will comply with said procedures and r ements. Signature of omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supenzsor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with.a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. lj` To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used-by several towns. You may care t amend and adopt such a fomn/certification for use in your community. Q:forms:homeexempt Town of Barnstable *Permit# P� Expires 6 months from issue date Regulatory.Services Fees, * sniuvsTnsi E 9� Mass 03 Thomas.F.Geiler,Director q� PERMIT q. �0 �EOµprA a Building Division Tom Perry,CBO, "Building,Commissioner APR-. 3 02.010 200 Main Street,Hyannis,MA 02601 TOWN OF BARNTA.BL www.town.barnstable.ma.us Office: 508'-862-4038 ry Fax: 508-790-6230 EXPRESS PERMIT APPLICATION 'RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number !91 %8 Property Address �{ 40/D tJ SS 0�1 0 V����. � (� t f ►d 1 [(Residential Value of Work Minimum fee of$2.5.00 for work under$6000.00 a Owner's Name&Address. V jI(sf n (0 I,e��S k--) Contractor's Name Telephone Number 0 I'r(S -d-076 Home Improvement Contractor.License#(if applicable) ` Construction Supervisor's License#(if applicable,) ❑Workman's Compensation Insurance Check one: ❑ 1 am a sole proprietor 1 am the Homeowner ❑ -1 have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ®m Replacement Windows/doors/sliders.U-Value s I. (maximum.44)#of windows *Where required: Issuance of this 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. _ r A copy of the Home Improvement Contractors License&Construction Supervisors License is l required t ICJ i _ SIGNATURE: 1V C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS`doc Revised'090809 Town of Barnstable Regulatory Services RAM M ' Thomas F.Geiler,Director Building Division Tom Perry;Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION p Please Print DATE: q'�t, lQ 'f/ o JOB LOCATION: "t ) A O O G dy\ number street village "HOMEOWNER": V D!&VI I YT S . W f_5 f f e W0, l �-o rl�'(?S'7 07 name home phone# W-Lpb--# ' CURRENT MAILING ADDRESS: �(1',} O 1&r'1 6'VG4e1 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building-permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proc dures and requi a t if that he/she will comply with said procedures and requirements. Signature offfomeowner Approval of Building Official Note: Three-family dwellings containing 35;000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application;that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 The Conunomvealth of Massachusetts Deparh►tent of Indnshzal Accidents Office.of Investigations 600 Washington Street Boston,MA 02111 irovru etas&gov/dirt Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information �" Please Print Le gib Name(Busioess/Organization&dividual)- I J�L� !`I f 14 S, !.(1�—S7"C Ae yn 4 Address: y iJ U UYl 6✓G C� City/State/Zip.-eei�lf,`V, 4 E_ O R6 4Aone# Aree you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I employees(full and/or part-time)-* have hired the sub-contractors 6. ❑Neu,construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. [K Remodeling shipand have no employees These sub-contractors have �P 3 S. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp-insurance comp-insurance.= required.] 5. ❑ Ate area corporation and its 10-❑Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp- right of exemption per MGL 12.❑Roof repairs insurance required.]i c. 152,§1(4),and we have no employees-[No workers' 13-0 Other comp.insurance required.] ' 'Any applicant that checks boat 01 must also fill out the section below showing their woilrer'compensation policy information- I Homeowners who submit this affidavit indicating they we doing all work and then him outside contractors mast submit a new affidavit indicating such =Contractors that check this boot must attached an additional sheet showing the name of the sub-canuacturs and state whether ar not those entities have employees. If the subcontractor have employees,they in=provide their workers'comp.policy number- lam an employer that is proviarg nrorkers'compensation insurance for my employees. Below is the poGry and job site information Insurance Company Name: Policy#or Self-ins.lit.#: 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 S 1,500.00 and/or one-year imprisonment,as well as chril 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 fommided to the Office of Investigations of the DIA for insurance coverage ui'erification- I'do hereby ..erttfytun er to ns and p ahies ofperjury thatthe information providee�d above is true and correct Si tre:V Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/Ucense# 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 0: 6 Town of Barnstable Regulatory Services • Thomas F. Geiler,Director s�x�vszes�. 139. Building Division Ar f p►�� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www,town.barnstable.m a.0 s Office: 508-862-4038 Fax: 508-790-623( PERMIT#-�6 FEE: $ � - ���J o7 SHED REGISTRATION 120 square feet or less 4opo&& Circles (finlefLll lba Location of shed(address) Village ' Property owner's name Telephone number Size of Shed Map/ParcelCD # . Signature Date rc; ~? Ln j Hyannis Main Street Waterfront Historic District? OId King's Highway Historic District Commission jurisdiction? ; c�€ r c.x Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM. MUST BE ACCOMPANIED BY A ' +') PLOT PLAN Q-farms-shedreg REV:042506 i Assessor's--map and lot number ... ��.1....a.. .....:...... " t l• �,,• ,; x SEPTIC SYSTEM -MUST BE r Z�o •. INSTALLED INCOMPLIANCE Sewage Permit number � '�1.......... ..... V+ITH ARTICLE II STATE ......... ..... ............ �> SANITARY CODE AND TOWN y �FT_NEtO TOWN OF BARNSTARhtENS. 1� fti Z BARISTADLE, • Y i Mf1B6 r ,9.�,,� 4� 0; Its.DI = � I -S E 0 R a. . A r:• itti - (-� •mot �'1 C.2 42 i APPLICATIONS FOR PERMIT TO .......... .C �...1:....(p�/........................ TYPEOF CONSTRUCTION ..................... .YS :........................................................... ........................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location "......... .,.....14.�....V......G...........................:...........................:........................................... ..........................f................. ProposedUse ...... � i.L N.C"_ ............................................................................................................................... Zoning District �. ....................Fire District C' .........................41.... .......c........................... Name of Owner ..r .....!��`l.t"Q.... ..........V�t$S...r^�`--....Address .......1.�1(... . .! C��............!&A.4�................. Nameof Builder ..........v...................... .... ....Address ................. ..................5.......... ................................ Nameof Architect ........... ...........:.........................................Address .................................................................................... Number of Rooms ............. .......................................Foundation .......... 11 ......... ........... ................... Exterior .......... � 1�........................................Roofing ................!.... .. Floors ` ........Interior ........... Z �.�t--mod.. ...... p �....��. .............. ....... . .. .. Heating .........L.!.....'.......V.�.�: ..................Plumbing .....................I. l` 2`.......................................................... Fireplace ........� 7:?A.10�' P-i....................................Approximate Cost Definitive Plan Approved by Planning Board _____________________________19________. Area /V7 ........ ............... Diagram of Lot and Building with Dimensions Fee °............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH hereby.agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .. .... ..........A......,................... ............. Kershaw, Stanley L , 1860E3 ': one story, No ................ Permit-for single -family dwelling . .. ;...ti. . ...................................... ' Audubon Circle _ Location ...................:........................:.....:. enterville ............................................................................. Owne� S tat�ey Kershaw -1 4 t. frame Type of.;Construction Plot ............................ Lot ................................ - ,,4,* �s Permit Granted Au ust�2b.� �•-1 q 76 Date of Inspection Date Completed. ..1�. Z�:677.....�.19 PERMIT REFUSED 57 { ............................................................................... �fi..........................................................................ti.. ................................................... .. ................................................................... ,. ( A Approyed ........................................... 19 vrf. � ..... v .y. ................................... ................ .;' ~, C/ 3 • Assessor's map and lot number t r Sewage' Permit number ......... .:.> '��.................................. ��Qy�FTHE'TD�Sw TOWN OF BARNSTABLE l 8AHH3TADLE, i "6I �MPY BUILDING INSPECTOR �E a' , APPLICATIONFOR PERMIT TO ........... ..................................................................................... TYPE OF CONSTRUCTION .................. .............................................................t....................................... ................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location `= /6 � J (" V G "'L tR C . ........:......................4. ..f..........11........... .....................................,............... ............................................................... ProposedUse ..... .t^:.:'e. .` .. .G-.................................................................................................................................. Zoning District .................................................Fire District ............. �� -� r �Q �.- Name of Owner .. I�h.l`. . ... �.......... �C n�.�....Address ......."^..�.(�I c �� l Vi Name of Builder .......... ;-� '�- ......................��^..`..`...'....�.....Address ................:...�`.:�...... ... '...................... Nameof Architect ....................................................Address .......:........................ . ............................................................... fc Numberof Rooms .............:.....................................................Foundation a/� -............................................................... Exterior .......... ... ......"E?. ......................................Roofing ................!.:...n........................................................ Floors .................. / Z ........ .................................Interior ......... A e'G... Heating .........��� .........!..!.'..:......!p.tt.�..................Plumbing .....................). ( 2........ ✓�� ................ .................................. Fireplace ........ ..x...::......�......................................................Approximate Cost ............................ .. ..................:. Definitive Plan Approved by Planning Board ------------------------ � ' 19 - Area ...............n.................. Diagram of Lot and Building with Dimensions Fee � ' '' as . . ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..............................'.............. ..�........ ............ Kera6aw^ Stanley A=191-180 '18608 one story, No ........ Permit for ------------ - 1ogl family dw Iling Location ' ~ Centerville Stanley ' °-."= frame ....................................... ` ' � .= . ' � . . . ' ' re,m/, G,onuyz ...........19 76 - ` Dote of Inspection ' � uuta Completed PERMIT REFUSED . � � � . ' ! lg .......... '--. --------.. ' � 7°�._' � ^�. . � � ' .-----.----. ........................................ � . \ ---------^---.-------..----.. ! � . ' ` � ' Approved ................................................. lA \ ' � '---. ------.--.. . ---' ---.—.—.. ......... . . ~ . . _ J / l V -;jq �J� t 6134 C�r . all CS'E2v6 prT- a . . i, .,� ..... .... .. matt S/LL SLE✓- --FEET 46OVE POAD PL07� PLAN PLAN 2EF&.2EA/C4 :.9E/rVG .CAT 14 44; s•yowni ✓n/ 1a,4N OOX 272 P 46E 58: c+ LOI — " I AIZ-R46Y CE4?7/FY 7A-IA T ZY4 EXIS r- /N& FOUND. r/ON LOC'A1 T/OA/./5 O AS 5WOWAI AN0_P_Qom__C'OA1X-O.BM Wlrq OF 7-,416-TOPVAI OF -LZ34 STAt ;�E6.�.d'rvs �ur�✓E y�2 ✓TYf - 3GZ cLorvE�c: C7T4YZ.OAZ Assessor's office(1st Floor): // /( � i �ac�..� ~Assessor's map and lot number / �oS THE>o� Board of Health(3rd floor): e Sewage'Permit number' --�� _ (� SEPTIC SYSTEM M INSTALLED IN COMA LL Engineering Department(3rd floor) L j • N&M House number, ` - t•'�7"���i'Yt IH TIT`.E , °o 16 Definitive Plan'Approved by Planning Board ti 19 I ENVIRONMENTAL APPLICATIONS PROCESSED 8:30-9:30 A.M.;and 1:00-2:00 P.M.only pr,,*F1 TOWN OF , BARNSTABLE { BUI`LDING INSPECTOR - sxa �,�. APPLICATION FOR PERMIT TO eNit 1.3N Px r 0 tA \ czy V TYPE OF CONSTRUCTION l/ ool>tv&) ti.V cam/ 19 _ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ap,lies for a permit according to the following information: „ Location / � / Y U 11�S:Jr r_ C&07,--6z-V1 L—l--_E _.._ Proposed Use OA.)Z,00 fL _ /) 0, Zoning District >� C Fire District �> 0 It, X Caw"leo f/L.LX (c� p� , w f Name of OwnerJ����� � '�""1 I' �� �tJAddress � � �l�.C.1�..� IQs� 1 Name of Builder i�iT �'G �� ®�I.� IJ Addresses �/ / ��-��/� � � AA4Xt Name of Architect Address Number of Rooms / Foundation &,444 d r• Exterior Roofing Floors w aopej Interior r Heating Plumbing Plumbing wo Fireplace Approximate Cost IP Roo Area o-�7 ®0 Diagram of Lot and Building with Dimensions Fee c . I h o -40+ 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnsta ding the above construction. Name t lea 1020 Construction Supervisor's License i ERSHAW,�y S 1TANLEY C. & MAY a i No 34014 Permit For Build Sun .Room• Single Family Dw 1 1 i ncr Location Lot #14 48 AudLhhn Circle f f" �* Centerville Owner_ S t a n 16 Y C. & M a•4 K P r a h a ca Type of Construction r. Frame 4' - Plot Lot- Permit Granted' Qc tober "19 , !19 90 Date of Inspection ¢.sue✓, E' �r? 19 ; Y Date Completed j i� 19 -4 air µ 1 s I \ � - a "E7't .:.�. i ?'a %.4. ..,,F�+ •:n'4 !'t:-. rry ti� r.. . ..}.. A; x 4 1 Assessor's office(1 st Floor): Q / 1,5P 0° Assessor's map and lot number Board of Health(3rd floor): /M Sewage Permit number i Z Engineering Department(3rd floor): 'DMUSTAXE L/ r 7 rua House number T�tl/ oo 039• PP Y 9 Definitive.Plan Approved b Planning Board �0 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN - OF. BARNSTABLE C- BUILDING INSPECTOR APPLICATION FOR PERMIT TO C L�� ( �(�jtoo In, S }S0\.�C � ` TYPE OF CONSTRUCTION Loom g;A-) 19 r /., m TO THE INSPECTOR OF BUILDINGS: ,The undersigned hereby applies for a permit according to the following informatioon�, Location a /�-qt � . ,v .� _U `it�.�r�__ C5,oTe �.. Proposed Use V�Tc:OD f�'�., �f�1�1477"* ' Zoning District >C. C Fire District d0, ` ( ' Name of Owner�rb Jl e rl Address v� ) �! �',l Name of Builder �� X ��C. .M DO Address Name of Architect f1( .V 1S )O Address Number of.Rooms / 3 FoundationNl� Exterior . Roofing A d 10#4 ,f < 9J(30a Floors wt .ew�� Interior Heating. Plumbing �� Fireplace �'v "'" p � pproximate Cost o " . f N Area 3� of z 41 Diagram of Lot and Building with Dimensions Fee ' OO / x; fr 39- \t4 rs' 40+ 1 e os OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable-Fe ding the above construction. a • � Name G4 a r` Construction Supervisor's License�010 KERSHAW, STANLEY C. & MAY A=191-180 No 34014 Permit For Build Sun Rr,nm Single Family Dwellinq Location Lot #14 , 48 Audubon Circle Centerville Owner Stanley C. & Ma)z Kt--rghe.w ' Type of Construction Frame Plot Lot ' Permit Granted October 19, 19 90 Date of Inspection 19 , Date Completed 19 r PERMIT COMPLETED 1/1/--'1 -. [:F:O =G & GiVRE Rt'DGE VENT A S H PH ALT C p X3/8_ BOLTS t HICKS 'EN S ' Tf-f( . . TYVECK f2 CQX i 2X4 7 _ 12 W 0 L FLY 2X I O 2X 10 t 6 OC UNDER 600 4+ FG N G O 34 T1G m o - 00 J , J FOX BU:FALMOUTH, DING & DESIGN P.Q. 8$1 (617) 477-9665 EAST MA. 02536 -- 5r !2 . — u 4 ) !o o - 9G s� FT FOX BUILDING & DESIGN P.Q. BOX 881 (617) 477-9665 EAST FALMOUTH, MA. 02536 12 19 3 5 � '� -- — ---- —-� A S H P H A L.T _ — 7 I 12 FT - D Doe')") oQ READ O NOTE CHANGE n 12 ,2 0 N 01:BARS ABIk Buil ding Inspection n e " De ,� 9 P partment _ 132 =� COMMONWEALTHDEPARTMENT OF PUBLIC SAFETY i OF i 1010 COMMONWEALTH AVE. � BOSTON,MASS.02216 '� • I MASSACHUSETTS ENCLOSE CHECK OR MONEY ORDER I LICENSE j EXPIRATION DATE 00443 CONSTR. SUPERVISOR FOR REQUIRED FEE, i R6,430(1991 MADE PAYABLE TO _ r ERICTNS f EFFECTIVE DATE UC-NO. a NONE 06/30/1989 021090 c "COMMISSIONER OF PUBLIC SAFETY" 03 ; F 4 i (DO NOT SEND CASH). 96 WATERIAINE DR RASHPEE MA 02649 PLEASEPkIDEE INCREASE I PHOTO(BLASTING OPR ONLY) FEE: 100.00 �EFFECMAYE �� 1, 1989 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: ]AM11PED-o SIGNATURE OF THE COMMISSIONER _ D.P.S. d y - THIS DOCUMENT MUST BE 1 SIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON THE PERSON Of SIGN LIRE OF LICENSi:£ " or - THE HOLDER WHEN ENGAG- � OY1fhR5 RIGHT THUMB PRINT ED IN THIS OCCUPATION.F 20OM-2-87-81429 E THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) MIAUG L DATA I ✓E 1 + ,2 S/GL ELF✓_ Ff�T, 9 � O.aD L O CA —/ON. �:E/tl rLE L.:t 5 C A 7'& -6�3_7� fir• � yy.� T N—AR65Y C-5r-?r1 FY rA IA r ;rA/E EXi--S7= /NG F04AVDA T/ON 4OCA7/ON/..5 Q?8 445 5H0IVNigNA_T:��F --C®it/F®. 'Mb�/TH L'�MLit/� O.= 7,4./46 MAIl/n/ O c F-1 . GdvS SuevtY©e ... 7Aa X401a CO 6' kt/1440 r/. YA/2MOa7AIAO 7 ��J. i� iH ' 13 - � sn•c+.ips..r:iwa..a:`J'•"'.'i'd/M.... ..'.M'r:.JJIY•.... `� yy m MORTGAGE INSPECT ION PLAN k ' I ADDRESSi 48 AUDUBON CIRCLE ( CITY/TOWN ofiBARNSTABLE (CENTERVILLE), MA ' SCALE, 1" = 30, DATEi JUNE 14, 2007 1 f DEED AND PLAN REFERENCE /F- CROSBY # _. AaRNSTA��...._ Registry of Deeds Deed Book 27-1 , Page �. 3�.,3 N Plan Book 272 Plan 58 M, 211.05 —'(/ Certification is hereby made -toi OD ODPATRIOT FUNDING LLC • The permanent structures are approximately located on -the ground as shown, and they I LOT g � � /x l etther conPormed to the setback requlrenents 4 14t/ , of the local zoning ordlk7ances In e�`fect at T U L El the tlMe of constructlon or are exempt from el- enPorceMent action under M.G,L„ Chapter 0A, 20417 :S.P CrN �p•x t2� x � ON Section 7, uniess otherwise rioted a t `•>NEO 30 LOT 15 I Certiflcatlam Is hereby Made that the s1ructure shown on this plan Is riot Located within a Special Flood Hazard Area as delineated on the w �,' p� Map of v Community Panel Nok 25000L 00MC F Effective Date, JEJLY 2, EM s �� X ;I By the US, Deportment of Mousing & UrbanIt yt Y 9' v` k6Development, Federal Insurance Adminlstrotlon, N �ti R=52,50 b.. MITE, ThIs Inspection was prepared In accordarme wM the technical standards for � 'r F LOT 13 i; Mortgage Loan Inspections as adopteol by the q a 04�ALD �` ! Commonwealth of Nassachusetts, and use for W P A U D U B ❑ N a any other Aurpose Is prohibited. T4 3 v 7i� I SSI D w ti . fl10�.1W �o�fi �FQ CIRCLE � HUB SURVEY ASSOCIATES INC H V EY 10 I HELPS PLACE 'WEST B]YLSrON, 14A ossss ti FILEJEFERr—Ma- �I F _ d