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Town of Barnstable *Permit# ;zW76(a-784
Expires 6 m onths from issue date
Regulatory Services Fee get . Z
Thomas F.Geiler,Director
Building.Division
-Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstablema.us
1
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERA UT APPLICATION - RESIDENTIAL ONLY
/n Not Valid without Red X-Press Imprint
Map/parcel Number ll l
Property Address I �n r�. low' &N la o I l
( J Residential Value of Work ' Minimum fee of$25.00 for Work under$6.000.00'
Owner's,Name&Address &M &111M
Contractor's Name V et�Y Telephone Number
Home Improvement Contractor License#(if app icable) 14 31 Q
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one: � w
[�I am a sole proprietor �� PERM
❑ I am the Homeowner Q C T 2 5❑ I have Worker's Compensation Insurance 2007
Insurance Company Name T ( Ia' .o ,`; -
E
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
VRe-roof(stripping old shingles) All construction debris will be taken to' 0saa Ow
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side -
❑ Replacement Windows/doors/sliders. U-Value (maximum.44) _
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ,
***Note: Pro Own must.sign Property Owner Letter�of Permission.
A op y of e H e Improvement Contractors License is required.
SIGNATURE:
Q:Fonrz:expmtrg
Revise061306
The Common-wealth afMassachusetts
,A Deparfnrent oflndustrialAdcidents
Office of Investigations
600 Washington Street
Boston,MA 02111 ,
www.m ass.gov/dia
Workers" Compensation Xnsursnee.Affidavit: Builders/Contractors/Electlicians/Plumbers
Applicant Information Please Print Le 'bI
Name (Business/Organization/Individual):.
Address:
I✓ V _
• •
City/State/Zip: #�WUUA (fiR QZ(00) PhoneA o -
Are you an employer? Check the appropriate box: -Type of project(required):.—]
1.❑ I am a employer with 4. ❑ I am a general contractor and I
❑New construction
,employees (full and/or part-time). have hired the slab-contractors
6.
2.[ 1 am asole proprietor or partner- listed on the-attached sheet 7. ❑Remodeling
ship and have no employees These sub-contractors have g• ❑Demolition ,
working for me in any capacity. employees and have workers' 9 ❑Building addition
[No workers'comp.insurance comp,insurance.$'
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 11.❑Plumbing repairs or additions
myselL [No workers' comp. right of exemption per MGL 1Z[V]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(heir wvrkm'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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 providh 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 6. 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 unde pains• nd enaldes ofperjury that the information provided abov is true d correct+
Signature: Date: 0�1
Phone#:
Official use only. Do not write in this area,Yb be completed by city or town offciaL
City or Town: Permit/Lice'nse#
Issuing Authority(circle one): .
1.Board of Health 2.BuildingDepartmeut 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
Town of Barnstable.
Regulatory Services
i 1ARNGWLE, + .
Mn $ Thomas F. Geller,Director
Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
"w.town.barnstable.maxs
Office: 508-862-403 8
Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
. 1, . 1brl m , as Owner of the subject proper
ty
hereby authorize to act on my behalf, -
in all matters relative towork authorized by building permit application for:
10.3
( ss of Job)
Signature of Owner Date
:�nao 601-W
Print Name
Q10PUN :OWNERPERMISSION
- � ��ie;T�omzneovwsealCl'oj��/�aaac�/auaeli'a _
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Board of Building Regulations and Standards
Registration 124310 One Ashburton Place Rm 1301
Expiration 6i1/2009 Tr# 130873
Boston,Ma.02108
2.7 Individual
James Curley ,
James Curley .
287 Fuller Rd.
Centerville, MA 02632 Administrator Not valid without re
e 4 .
....op
Assessor's map and lot number
�- 22q
............................... I E
tO
Sewage Permit number
33A"STAMLE,
House number .........143........................................ ..........
ro roes
W. 1039-
TOWN ' OF. BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO .......
6?�Kreie 36- 0
..........................................................................
TYPE OF CONSTRUCTION ............09A.....6&0-M. .....................................................................................
.
19.......... .e.......................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ..... V9 �Xevl .....Ave.. ......aenz n.vdze, /ya..............................................................
Proposed Use .........6vasgo.... .cljl e
..........................................................................................
ZoningDistrict ........................................................................Fire District ...............................................................................
AName of Owner .......................................Address AaA1drA4.t9!.t411 -XIAP111 e
V ..........
Name of Builder'O.,�YMPY-j......40.;��S..................Address
Nameof Architect ...................................................................Address .........................................................................I...........
Number of Rooms ..................................................................Foundation ...&6.hVq...
................................Exierior ........... .................. .....................................................Roofing ...... 5. ........................
Floors .......................................................................................Interior ....J h! ? .............
....................................................Plumbing......... ................... ................................................Heating ................ .......... ....................................
V
.Fire' lace ......... .....W14..........................................................Approximate Cost
P ...... ........................./...............
Definitive Plan Approved by Planning Board -----------------------------19--------- Area AK.77.. ........................
Diagram of Lot and Building with Dimensions Fee .......=i�.e. ........................... .
SUBJECT TO APPROVAL OF BOARD OF HEALTH
r�, All,
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.
Nameti. .. .. . .... ... ...........................
MRS . PATE, A.
No .... Permit for ...En C.1.Q.5.e...P.ati.o
Single Family Dwelling
.............
103 Blantyre Avenue .
Location ................................................................
Centerville r
...........................;...................................................
Mrs . A. Pate
Owner, ..................................................................
Type of Construction ...Fr.aMe...................
.................................................................
Plot ............................ Lot ................................ i
A
Permit.Granted ........Jund 22 ...........19 82
...................
Date ?Y/s:pect%n7..................................19
Date Completed 19
Assessor's map and lot number .......... ................................. �oFTHEro�
Sewage Permit number
kp Z BA"STADLE, i
House number / Z
,per 39• �0
'Fp OR a
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ..............i?Ju�1.;.. .....�......6 2! r. ....... ............... ........................................
TYPEOF CONSTRUCTION ! Ok4 � � ........................................... ....................................................................................
..�u tv 21 19 2-
............... .... ......................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location �Q�� ?94wt vr.(e-.....4v P..�.....Lam `?, "r,11/L, ...!r t�............................................................
Proposed Use .........ez,lC'hn�t? ...
ZoningDistrict ....,...........................1............................................Fire District ......................................................... ...........................
Name of Owner l:�rg.� ... f Z ........................................Address Ai..�.�,f,�,J`1,4�4;'�/,,,s.7..e . ,W 8".l t/f�' z
Name of Builder'(��?, �,?/I,1}/^q.. r.... (V?Z4 ,)..................Address /fk'JQCI'...���
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms Foundation !¢%
..
..................... ......'..........:.....
Exierior ....................................................................................Roofing ...... r
Floors ......................................................................................Interior ...al !
............ ...... ..... ..........
Heating 1�`r Plumbing a '
4............................................................
�/ 0 d
Fireplace ..............A11A...........................................................Approximate Cost ........... .........................................................
� � ,
�
Definitive Plan Approved by Planning Board ________________________________19________, Area '�........................
Diagram of Lot and Building with Dimensions Fee .......5z.. �
.........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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. V
Name . ... ...........................
MRS . PATE, A, A=229-8
Not !1 Permit for ,Enclose Patio
Single Family Dwelling
...............................................................................
j Location 10. ...
3 Blantyre. . . . . ...Avenue. .. ............ .. .. .... .. .... .. .. ....... ....... .
Centerville
................. ...........................................................
Owner ., Mrs . A. Pate
............................................
lFra e
Type of onstructiof.
.................. .......................
................. ................ ....................... .....................
Plot ......... ................ . Lot ........... ....................
Permit Gra ted .J.. 119... .......... ...... "19 82
Date of Ins ection ............................. ......19
Date Competed ..... ......................... ......19
�o
;e
Assessor's office(1 st Floor): 4J
Ass(ssor's map and lot number Gf
Boar�4of Health(3rd floor):
Sewage Permit number 2 11ABd9TSDtL
Engineering Department(3rd floor): rasa
House number t639'
Definitive Plan Approved by Planning Board 19 �0 MAY a.
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 "j-�O re— yam,r ems- �o ram.cx {'2S +&f1C_R— '
TYPE OF CONSTRUCTIONS�(� ('rf.YltixL
19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location
Proposed Use
Zoning District !`�� Fire District C
Name of OwnerM rs• Address i 0.3 n
Name of Builder J C .r r,N, C�11% Address 1 l3l e w'�w n lL�t, `� •�
Name of Architect Address
Number of Rooms Foundation
Exterior �-` ��car�- L' 1`� tom' Roofing c SC2�
Floors Interior Z,"A rook
Heating a A-f , Plumbing
Fireplace w.wS()-r`V-r-" Approximate Cost
Area QY1
Diagram of Lot and Building with Dimensions Fee
+
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 onstruction.
1 Name
Construction upervisor's License 0 t 6 �
PATE, ELIZABETH
i00 32845 Permit For REPAIR FIRE
DAMAGED/Single Famil)z Dwel4lincJ
. t
r Location 103 Blantyre Avenue
t
Centerville
Owner Elizabeth Pate
j' Type of Construction Frame
Plot Lot
Permit Granted April 28 , 19 89
Date of Inspection ®'S 1
Date Completed ��7/� 19
I
t
i
r
Assessor's office(1st Floor): yy 9400 o 0
Ass ssor's map and lot number o
Board of Health(3rd floor):
Sewage Permit number
BAIU S?ADLL
Engineering Department(3rd floor): rasa
House number G°�t639. ®�
Definitive Plan Approved by Planning Board 19 YAv d
APPLICATIONS PROCESSED 8:30-9:30 A.K and 1:00-2:00 P.M.only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO�C Cj'�'O t'Q>— �,r e.,-. �(y p^p ky t e S t 0e, /�C P--
p
TYPE OF CONSTRUCTION /� �� !��!1r'k_
L+ - 19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following(information:
Location t C) 1 c n i t d 1 r'.,e e +� �t'A�
Proposed Use
Zoning District l��� Fire District C.- r'l ►A
Name of OwnerY'"1 rs. F--V%'%-w�eA� c-�@. - Address 0 -
1� �~ t n
Name of Builder� 1Z. in, v.j l n "Address 11`�l �ew'4-nw n K�C� cD�+
Name of Architect Address
r
Number of Rooms / Foundation
Exterior C�c, 1��0-If �-4- Roofing 0,S�� �
Floors \A w 11-0 Interior
� t
Heating Plumbing
Fireplace vim.a <3.r-,vs _ Approximate Cost 1 •��
Area ��
Diagram of Lot and Building with Dimensions Fee
{ Ili +:Nit• l ',k.
J F
I t.zJt�!
e
„ t
1
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
4
t
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 .� �>
PATE, ELIZABETH A=229-008
.t
No 3�2 8 4 5 Permit For REPAIR FIRE
DAMEGED/Single Family Dwelling
Location 103 Blantyre Avenue
r
centerville
Owner Elizabeth Pate
Type of Construction Frame
Plot Lot
Permit Granted April 28_, 19 89
Date of Inspection 19
Date Completed 19
�� MP