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HomeMy WebLinkAbout0043 BRALEY JENKINS ROAD �3 r : r n A O f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map L I Parcel <�® Permit# l7 Health Division �- os 2 ar 30�' Date Issued Conservation Division _ 05 j PM 4: 4 if Fee � Tax Collector 0 �� �- b0 Treasurer l ( OZ �J ��'�r' ; ��UfaOpp, . Check n'39 �G SEPTIC SYSTF Planning Dept. UVW T EK)TO=#® R 6�IS Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address 43 FiZAL.�C tag►V-11AS Village Ce '��'S!1 I I t=— Owner K1)(A);K% )U66 AUI_-x­ Address ��A,L," � �r��ILIS Telephone -©� Permit Request 5 Square fegt: 1st floor: existing proposed-160 2nd floor: existing proposed Total new (aO Valuation T ®� Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: Cl Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 541/ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes & o On Old King's Highway: ❑Yes 1'10 Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area'(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count _ Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:Cl existing. ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial-❑Yes _❑No if yes,_site_planreview#_ - Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation#. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE, DATE . R c FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL-NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION p vI (� -� - FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH>. FINAL ` GAS: ROUGH FINAL FINAL BUILDING �1 DATE CLOSED OUT 1 ASSOCIATION PLAN NO. r� i V I The Commonwealth of massacnusetts Department of Industrial Accidents s_ Office of Investigations 600 Washington Street Boston,MA 02111 .•�° J, wivw.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Alp,plicant Information Please Print Legibly Name (Business/orpnization/Individual): G V6, Address: � I Z,��% t✓ i A Phone 8 ' � 3� Ci /State/Zi lei f7r 1: � Are you an employer? Check the appropriate box: Type of project.(required): 4. ❑ I am a general contractor and I 1.❑ I am a employer with. 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor orpartner-, listed on the attached sheet$ ❑ Remodeling ship and have no employees These sub-contractors have 8.,❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers'comp. insurance 5• ❑ We area corporation and its 10.❑ Electrical repairs or additions ] officers have exercised their 3.'VrI aimT a homeowner doing all work right of exemption per MGL 11:❑ Plumbing repairs or additions c:152, 1(4),and we have no myself.-[No workers' comp: - § 121-1 Roof repairs t employees. [No workers - .insurance required.]. .❑ COMP.insurance ' 13 Other ance 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 their workers'comp...po-informatim 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. . I do hereby certify,under the pains an nalties of perjury that the information provided above is true and correct ' Si afore: Dater ® Phone#: - ,3 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 or the occupant Of the not more than.three apartments and whoouress resides therein,work on such dwelling house dwelling house of another who employs persons to do maintenance, repair or on the grounds or building appurtenant thereto shall not because of such employment be deePlo3'�" MGL chapter 152;§'25C(6)also states that"every state or local licensing agency shall withhold the issuance or ermit too erate a business or to construct buildings in:the commonwealth for any renewal of a license or p P applicant who has not produced acceptable evidence of compliaonwealthmor an nce with the insurance political subdivisions shall Additionally,MGL chapter 152,§25C(7)states `Neither the comet y 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 workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if e fill out the worke mp f Pleas it certificates o necessary;supply sub-contractors)name(s), addresses)and phone number(s) along with the ( ) insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(I LP)with no employees other than the members or partners; are not required to carry workers' compensation insurance. If an LLC or LLP does have required. Be advised that this affidavit may be submitted to the Department of Industrial employees a policy�s q; Accidents for confirmation of insurance coverage. Also be sure to.sign and date the affidavit. The affidavit should be returmed 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 er which will be used as a reference number. In addition, an applicant Please be sure to fill in the Perimt/hcense numb that must submit multiple permit/license 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 or citizen is obtaining a license or permit not related to any business or commercial venture year.Where a home owner (i.e. a dog license or permit to bum 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 Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia oF,Her Town of Barnstalble °�' Regulatory Services BAWgrnsi.E, ' Thomas F.Geiler,Director 9 MA89. i6S9' �� a 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 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: L� �_!� l Estimated cost O 06 Address of Work: 43� `�. Z t-' L e1 1`� v Owner's Name: �`12.�e' a c Date of Application: A F• I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR �-17, -CS- Date Owner's Name Q:forms:homeaffidav Z3 E RC �}=+ 1'5=a SOP. 2o1/1 ho sErzA . N dv s . Ld7r 7'7 LoT h q78 �. O 0 4) AV cg, t 3s 0 V Jv. << ;�Q S " ASsu nieO . -ppOmP c7pt j Ana 4g I¢', $trT jo ti 3 , CTE or,VV- � k S �w� log .k �i � p`�MocM,��,ar CERTIFIED PLOT PLAN PAUL A. ` Lo7` 279 IAA uS ! 77- 0 o LEVY GF-,I�(TFIV I LLE No. 10617, y \ �a�q� IN v/ �.�SST F� 3�1p21,15 7i4 BL F_ lvll�- SCALE: � ���� DATE: BA,PAIS7748tF- 1 CERTIFY THAT THE to � ' ..EVY & ELDREDGE ASSOCIATES, INC. CLIENT lrbLta'�r- SHOWN ON THIS PLAN IS LOCATED LANDSCAPE ARCHITECTS JOB NO, l)/ ON THE GROUND AS INDICATED AND aLANNERS-LAND SURVEYORS CONFORMS TO THE ZONING LAWS DR. BYs t4-M' OF " , MASS. 712 MAIN ST. CH. BY: HYANNIS, MASS. SHEETA_OFL DATE E LAND- BURVE Town of Barnstable Regulatory Services sanrtsTasz,E, ? Thomas F.Geiler,Director Building Division ArfO�.iA 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: ' (Z JOB LOCATION: 4� number street village "HOMEOWNER": �UG L W3_ ��l 6bo- ZO A _04b - J►�"'ti 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. S' atu75mowner 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 perfomung 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:forms:homeexempt txE> TOWN OF BARNSTABLE 30023 of o� Permit No. ....:.......... BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING ) Q, HYANNIS,MASS.02601 Bond .....X.(, CERTIFICATE OF USE AND OCCUPANCY Issued to Charles R. Thomas Address Lot #278, 42 Lazarus Lovell Read Centerville, Massachusetts USE GROUP FIRE GRADING_ OCCUPANCY LOAD 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. December 12 86 ............................ 19................. Building Inspector Y �'fy�••: TOWN OF BARNSTABLE BUILDING DEPARTMENT = rs8a°TAEL ' TOWN OFFICE BUILDING rua HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: ec 1 Z An Occupancy Permit has been issued for the building authorized by BuildingPermit�$k.... .. ---..........................................................................................................................»................................ issued to / srsA /�- .. i57ru�Cve �C Please release the performance bond. t i THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) IM ^�c� C DATA TOWN OF BARNSTABLE, MASSACHUSETTS BUILDING PERMIT DATE .�,,r �. - 19 PERMIT APPLICANT ADDRESS '(STREETI " �' `� "'`""`-• ICONTR'S LICIENSEI PERMIT TO ijltild, ;)`,:r 1 9.;. .T (�_) STORY .t, NUMBER OF (TYPE OF IMPROVEMENT) NO. (`P OP SE U5E)• OWE LING UNITS -_ n .a;�...,.........; I ZONING .. AT (LOCATION) ICT ( } (NO.) (STREET l BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) �cA' .is f}IJO—z7i O �EMARKS: �gREA OR viti ;'i L PERMIT VOLUME L• ESTIMATED COST `.titl':1.U;f FEE (Cu I 0 OWNER ADDRESS ADDRESS BUILD.ING DE PT. y' BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY ''PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY', NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP I ,PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED • `.FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT- FROM THE CONDITIONS .OF .ANY APPLICABLE SUBDIVISION RESTRICTIONS. 'MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE. :,INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR •ALL CONSTRUCTION WORK: ELECTRICAL., PLUMBING AND -1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. . 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. FINAL INSPECTION BEFORE OCCUPANCY. .POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS of 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT �T OTHER BOARD OF HEALTH A , YY)) WORK SHALL NOT PROCEED UNTIL THE INSPEC- .'PERMIT 'W!LL BECOME NULL AND VOID IF CONSTRUCTION_ ._INSPEr_TIONS-INDICATED'ON THIS CARD-CAN BE— - -- TOR HAS APPROVED THE'VARIODUS'STAGH-OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION: PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. 1-7 2o1f/ SE�- , N � 279 -278 �. 0 •�, MOfJU.S f a n i z � v �TccL�=71 s.�T to N 3 , CT6, dF IVIF Ttiw,�1 a7-LAw-s t"°cMq. ^ry CERTIFIED PLOT PLAN 4 � PAUL A. 1�1` Z07 2_'7 72 US �.ovr- No. 10617. y GF_l�(TFI�'VILLE IN n SST' SCALE: d"SDI I CERTIFY THAT THE �v�toe--1 DATE : g,=y�pnchbi-zl LEVY & ELDREDGE ASSOCIATES, INC. CLIENT ffa�A��- SHOWN ON THIS PLAN IS LOCATED ENGINEERS-LANDSCAPE ARCHITECTS JOB NO. �J/ ON THE GROUND AS INDICATED AND PLANNERS- LAND SURVEYORS CONFORMS TO THE ZONING LAWS DR. BY: 4,41M' 0E-4. , MASS. 712 MAIN ST. CH. BY: �� _ !!YA"JNIS, MASS. - SHEET _ OFL DATE y E LAND SURVE �• .. r _ 6 a�Y 1 ' Assessor's offioe •(lst,floor): /)0 4v✓ • oFTHE Assessor's map and lot number ..L ! ''.�. ......Q......r.... ,SEPTIC SYSTEM MUST BE, • Sewage' Permit number r ..` ... b..6 q �� f aaasTenteo� Board.of Health ,(3rd floor): 0 1S "NSTALLED IN COMPLIANCE Engineering. Department (3rd floor) 1y` TMYI�CNMENTAL CODE Am 7o rb 9 \� House number ...:................ ........:... rr H•r O 'E p VWf APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN ' 'OF f*.'BARNSTABLE BUILDING" INSPECT-OR r APPLICATION FOR .PERMIT TO ..:......: ......... ....... . TYPE OF. CONSTRUCTION .. :...... ..r. ....` �a .......................................:.. t ( e TO THE INSPECTOR OF BUILDINGS: The n iinformation:u ders gned hereby applies for a permit according to the following , _ r� o� a Location ...4L9 . : . :.... �.!...... �1. ��+ k �Pd ��.`�!'1.6-.1.'03 t ` prr t2, r~ �n. c......&Y,Pro osed Use ..... �< r-�........ q..............,.... _ ...................... ..............................:............:......; Zoning District ..... .. .�' �r .:.....:....!.......Fire District ..... Q'h !) . ........................ ...................... ... 9 .......# .... .... .. •Name of Owner ./�(��ti,t��....6�....!. r ...............Address .:. '`a ►�n1?'l�y .....!','t..... �• Name of Builder e... � .. 4 ,4� .c-..Address ... 1 ...... �9!?7 !l�✓)�r�i� Name of Architect :........ .....I4.C:..;.:....................Address ....1 .r-. N .. .....:t.' 1<.T..................... ......... Number of Rooms ............. ..............`.........:.................... Foundation ........ '�v..... ... � .. ..... ....Eo t-I xlerior �`-� , ...Roofing .......V .......... ...... ........Floors .... ........ .. i!�.......... : ..`............:.....Interior .............. . .............. .S._, .......................:..... LA" Heating :... ..� :4. .1L......... .....Plumbing .............�........... ......................... , eA Fireplace ...........!t ...:�...................;.......:............:......... ....:.Approximate Cost ..:... . ........:..................... Definitive Plan Approved by Planning Board -----------------------------------19-------- Area .......:.. ..f. Diagram of Lot and Building with Dimensions Fee �• Z ............. ........................... SUBJECT TO 'APPROVAL OF BOARD OF HEALTH A OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ` I hereby agree to conform to all the Rules and Regulations of the'Town of Barn bl reg rding the above construction. t . Name .. .. ..................... .. ...................,............................ r — Construction Supervisor's License HOMAS, CHARLES R. rr � No 30023 Permit for ...One StorY.............. - ` Single Family Dwellin - ; ._.......... ..........................$.......;............ _s - Location Lot #278,...�:2 a �ovei� Ro' - a r < - Centerville l - 1 ......................................................." CharleR . .,.........,�......... - :�. y �• - _ `. Owner .Thomas Frame .... t ..a•. r { ' - �.-: • Type' of Construction ,.................................... iN '� ... ................................ - .. Plot .... .'�.............^" Lot ... f....... ......... •^ ._ � ,_ e � � � ' October .,' 8b Permit Granted .... ....hh.........10�C"f.. :19 Date of Inspection':.. /AX9 ........19Af _ ,Date Complete . ... •'�'...............19A r�'" L.. ;. ! a ...• � - . - "-f � � r E ' � Fad C'r � ` 1` � � . •a! s 7. .4 Assessor's offioe (1st floor): THE Assessor's map and lot number ............. Board of Health (3rd floor): q jb Sewage Permit number ........................................................ I STABLE, Engineering Department (3rd floor) 0 16 LOL 39- Housenumber ................................: ......... ...... . .... ....... 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......—,....................................................... TYPE OF CONSTRUCTION ..................W.... CY.)...............................g.............................................................. ........................ ........19-9- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... .......... 6 3AT4 ....L1D.V.e.((...... Zk. A. -0 I . .. .. .......... ........... . ri Proposed Use ..... ........................................................................... N��....... ................... ..... Zoning District ........................5.. ..... ....................Fire District .... 4Y...w .......................... Nome of Owner ......9... ................Address ... .....�5 ...k:�)...... Nome of Builder &Avj,... ..... ...Address ... ...... Name of Architect ...T 7 .............. .....................Address ....H4.+qt�'�................................................. Number of Rooms ............. .............................................Foundation ........pz>j.........CJ,.....C t7!A............. Exterior .... ........C ......... .1,L" Roofin .... .............................................. Floors .... ............. .........pf-I......................Interior ............; :. . . ... . ................. Heatingtr ...........................................Plumbing ............/..�......... ....................................... Fireplace ............N..-t>.........................................................Approximate Cost ......... ........................................... Definitive Plan Approved by Planning Board --------------------------------19-------- rea ..... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL), OF BOARD OF HEALTH it OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and? Reguldiions of the Town of Barnstable regarding the above construction. Name ........... ................................................ 1 -1 Construction Supervisor's License .......0...................)........ THOMAS, CHAR-LES R. A=171-150 No 30023.... Permit for .....One„Story........... Single Family dwelling .............. Location ....Lot #278,. LQvgj1 Road ................... Centerville ......I............... . . . . . . .........................I......... Owner .........C.h.a r 1.e.s...R......T.homa.s..................... .. . ........ . Type of Construction ......Frame......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .......Qc.tabex...10...........19 86 Date of Inspection ....................................19 Date Completed ......................................19 lot- 16P-O P�� �5 2xg e-'oL,�AEl TiE� 2xa NE�.d�I� O DEjAIL aF SD�IAP-- SoORr 'rUU OT tl l� GaX �?T o5 5/4' T46r- wC b 7'- 4 x" 51'0 ID 47 L . A Fl0O � � F FA AL �r-1 n �a. A d �5A Lj-'5