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HomeMy WebLinkAbout0151 BUCKSKIN PATH - n� u Town of Barnstable _ _ Building t mit[Where,a ost This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept 59. osteck Until Final Inspection=Has Beeu� ( lade. .' �� f ccup _Y_...Req .: �....r uildi g all ..-..t,be��, ..�.-_ ._. p���.. .as b Certificate of Occu anc is Re uired,such Buildin shall Not be-OccupieduntiI a Final ln�s ection has been-made=, Permit NO. B-19-2477 Applicant Name: James Curley Approvals Date Issued: 08/01/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/01/2020 Foundation: Location: 151 BUCKSKIN PATH,CENTERVILLE Map/Lot: 170-065 ti Zoning District: ' RC Sheathing: Owner on Record: SABO, DONNA L TR Contractor Name "�JAMES P CURLEY Framing: 1 Address: PO BOX 533 Contractor License: CSSL-099138 2 CENTERVILLE, MA 02632 { Est. Project Cost: 8 550.00 =� 1 $ Chimney: Description: Strip and re-roof approximately 23 square of sphalt roof shingles " Permit Fee: $43.61 Insulation: Project Review Req: Fee Paid:- $43.61 „. Date: F 8/1/2019 Final: Plumbing/Gas g g Rough Plumbing: \ Building Official t Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within`six months after`issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures,shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for,public inspection for the entire duration of the Final Gas: work until the completion of the same. r Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this.permit. Minimum of Five Call Inspections Required for All Construction Work: Service: . 1.Foundation or Footing A� Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed priorto Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site /�./ All Permit Cards are the'property of the APPLICANT-ISSUED RECIPIENT ,��' Final C`�'" mgp . jC3 �. • I I'iJ I � M Postage $ U o , Certified Fee 5 O Return Receipt Fee o M (Endorsement Required) He�� , Restricted Delivery Fee 0 (Endorsement Required) OAR 25 2015 O - M Total Postage&Fees r� Sent To S P a No.JIJNnJ- SAG,- - -------------------- - -----------------=------------- 0 Street Apt. ; / or PO Box No. City State.-- __4 g07yr e Ind O Z la3 MI �� Certified Mail Provides: . j u A mailing receipt o Aunique identifier for your mailpiece 0 A record of delivery kept by the Postal Service for two years t Important Reminders: a Certified Mail may ONLY be combined with First-Class Maile or Priority Mail& o Certified Mail is not available for any class of international mail. e NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For, valuables,please consider Insured or Registered Mail. e For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpieoe"Return Receipt Requested To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. ;1 r o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery'. o If a postmark on the Certified Mail receipt is desired,pplease present the arti- cle at the post office for postmarking. If a postmark�on the Certified Mail receipt is not needed,detach and affix label with 00'siage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map / V Parcel ® _ Application# 3 Wo Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application FeeSa Planning Dept. Permit FeeZS, Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address /iz �� Village 1/7 4f -7 L, "ItIc Owner P 0 4 y"? S �� Address 1-5e, II Ih Telephone Permit Request/ Ila C r r,, 7, ,� �'t—,e � Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) \ Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full" ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing ewe_ Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Counf'*j 93 Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other !� wco Central Air: ❑Yes ❑No Fireplaces: Existing New Existing woo icoal stogy Os ❑No Detached garage:0 existing ❑new size Pool:Cl existing ❑new size Barn:O existing ❑new size Attached garage:0 existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name rel Telephone Number Address ��t� /4 i��o� License# ' l � Home Improvement Contractor#_ Worker's Compensation# e 14 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE OKl tom` FOR OFFICIAL USE ONLY j r PERMIT NO. DATE ISSUED is MAP/PARCEL NO. 4 ADDRESS VILLAGE OWNER I DATE OF INSPECTION: FOUNDATION i FRAME INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL fi r GAS: ROUGH FINAL FINAL BUILDING 07 D�v�-y GOw�P DATE CLOSED OUT ASSOCIATION PLAN NO. s Department oflndustrial Accl enis L' C, Office.of Investigations- 600 Washington Street Boston,MA 02111 . www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Conti-actors/Electricians/Plumbers kpplicant Information Please Print Legibly Name (Business/Orpnization/In&vidual): (i�✓��S ��° 1�: tit0� <� Address: A/ City/State/Zip: . , �S I L7�. Phone#: .re y an employer? Check the-appropriate box:. Type of project(required): 7I 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 ❑ I am a sole proprietor or partner- listed on the attached sheet t ?• ❑ 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_mp msurance 5. ❑ We area corporation and its — cers-hams- k rdsed 10.❑ Electricals airs or.additions• required:}----- --- _ ❑ I am a homeowner doing all work right of exemption per MGL 11.0-Plumbing repairs or additions myself[No workers' comp.' c. 152, §1(4), and we have no. 12.❑ Roof repairs insurance required)t employees. [No workers'' 13.L�d Other comp.insurance required.] oy applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomration: ` omeowners who submitthis affidavit indicating they an doing all work and then hire outside contractors must submit anew affidavit indicating such mtractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information . :m an employer that is providing workers'compensation insurance for my employees.•Below is the policy and job site Formation. ;urance-Coinpany Name: e—,_zr,•o licy#or Self-ins.Lie.#: Fxpiratio�Dat€ -,� -Site Address: ,/ / �` i 1 0�* /' City/State/Zip:_ /I°e", �� - tach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). lure to.secure coverage as required under Section 25A gfMGL c. 152 cam:lead to the imposition of criminal penalties of a e up to$1,500,.00 and/or one-year imprisonment, as well as civ�penalties in the form of a STOP"WORK ORDER and a.fine up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of restigations of the DIA for insurance coverage verification. o hereby certify un r the pains and penalties o perjury that the information provided above is true and correct afore:. Dater / )ne Official use only. Do not write in this area,.Ao,be completed by c or town offu iaL City or Town: PerralMicense# Issuing Authority(circle one): L Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical In .6. Other spector 5.Plumbing Inspector Contact Person: Phone#: Information and�Instructions I , iassachusetts General Laws chapter 152 iequires`all employers to provide workers' compensation for their employees. arsuant w this statute;an employee is defined as ...every person in the service of another under any contract of hire, xpress or implied,oral or written." �n employer is defined a�:`&a�..individual,:parmership,:association,corporation or other legal entity, any two or more f he foregoing-engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the ec.eiver or trustee of an individual,partnership, association or other legal entity,employing employees. Howev..er Az caner of a dwelling house having not more than three apartments and who resides therein, or.the occupant of the welling house of another who employs persons to do maintenance, construction or repair woiY'on such dwelling house a on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." v1:GL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or enewal 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." kdditionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its-political subdivisions shall inter into any contract for the performance of public work until acceptable'evidence.of compliance with the insurance -equirements of this chapter have been presented to the contracting authority. Applicants Please fi'h-out-the"'- oQdavit completely,by checking the boxes that apply to your situation and,if. aecessary,supply sub-contractor(s)name(s), address(es) and phone nimiber(s)along with their certificates) of assurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members orpartners; 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 confinnation 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 he 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' mber listed below.. Self-insured companies should enter their compensation policy,please call he Department at the nu self-insurance license number on the appropriate lime. 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 im out in ihe event vmtiga:,_4-_hs-haste-.gin%etyoq,-mga g-the appli(-ant— Please be sure to fill in the pennit/license number which will be used as a reference number. In addition, an applicant that moist 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"llie applicant should write"all locations in (city or town)."A copy.of the:affidavit that has been officially stamped or marked by fife city or town may be provided to the applicant as proof that-a valid affidavit is-onfile for.fixture permits•orlibenses..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 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 . . : pep"ent of Industrial•Accidents ..Office of I�nvestigations . ' 600'Washington Street 4 Boston,MA 02111. " Tel. #617-727-4900 ext 406 or-1477-MASSAFE Fax#617-727r7749 . cursed 5-26705 www,mass.gov/din r `` FT►� ,, Town of Barnstable Regulatory Services + lARMSTABLE +�� y MAN. $ Thomas F.Geiler,Director o;p. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize C,47 J r7`y 1 1•" �r"A to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) /d Q Signatdre of Owner bate av?�7-147- Print Name Q:FORM&OWNERPERMISSION °F'THE�°� ' Town of Barnstable Regulatory Services S'ABM ' Thomas F.Geiler,Director 9 MASS. �* 039..E N, 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 wi n of er requirements. /r Type of Work: c� 7 le,G e;-7 t`v Estimated Cost Address of Work: 16-1 ' � K L.-I Ile Owner's Name: 2>0 k".-r 4- S� Date of Application: elt:9 —t�v 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 ae7r. Date C96tractor Signature Registration No. OR Date Owner's Signature Q:wpfiles.forms:homeaffi d av Rev: 060606 Table JS=b(eonelnned) Prescriptive Packages for dne and Two-Family Residential Bnlldings Heated with Fv" Fuels. MAXIMUM MINIMUM GIaang Glazing Ceiling wall Floor Basement Slab Hczdng/Cooling Arran(%) U-value= R-valuer R-value' R-value° wall Pesimeter Equipment EMrieacy' Pam'age R-value' R-value' 5701 to 6500 Heating Degree Days' 0.40 38 13 19 10 6 Normal R I2°!. 0.52 30 19 19 10 6 Normal S 12%. 0.50 38 13 19 10 6 15-AFUE T 15%. 036 38 13 25 NIA NIA Normal U 15% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 I3 25 NIA N/A 85 AFUE W 15% 0.52 30 19 19 10 6 85 AFUE X 18% 032 38 13 25 N/A NIA Normal Y 18%. 0.42 38 19 25 N/A N/A Normal Z 18% 0.42 38 13 19 16 6 90 ARM AA 19% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION, BUILDING INSPECTOR APPROVAL: YES:. NO: q4orms4980303 a o .raa�r'rescs �t. t BOARD OF SU1LDlAlG 1GUI.A�IONS + � _ s!. '� �� : lict3nse CONSTRUCTION SUPERVISOR ' s ' Number CSt 085, 0:, , Birth lafe�11_1211963: ' € >; = 4 . Expi 1114212008Tr no 85940 Result f HER P WEEKS ,_' x CHRISTOP 162 SO YAtMOUTFI �,Y. DEiVNIS i�7A 02638�4 �`� `� Atlminisitatt�ir � . • R. ........... ...v:.... ....... ..,........ ... ................w...r.. �� x yam: Boar.•of Building Regina ions an. Stan.ars One Ashburton"Place doom 1301 Boston, Massachusetts 02-1.08. Home.Improvement:aCoontractor Repzistration- Registration: 150864 Type: PriMe.Corporation., Expiration: 5/412006 CAPEWEEKS,_REMODE�ING&RENOVATIO : M HRISTOPHER WEEKS t 162 SOUTH.YARMOLITH RD. DEN(UaS, MA 02638 _:. �T iJpdate Address and return;card.114ar1c'reason for'ehange U Address !J;Renew I C1;Eipptol merit � Lost Card •. e� ...._. ✓f!£ CL`[")tY73lCitll�ff! r�iy���t7.kiC[fJtflf�3 _ . Board U Building Reguiahods and Standards; License or registriiti0n yalid for in&vldul use only " HOME1MPR0VEMENT CONTRACTOR: before the expiration date It found return to:. Board of Building Regulations and Standards — Registration 150864 Une Ashburton Ptace'Rtn.1301 Expiration 5/42008 - Boston,Ma.02108 Type Private Corporation ' CAPEWEEKS REMODEUNGgRENOVATION INC: t' CHRISTOPHER WEEKS: ]62 SOUTH YARMOUTH AD. DENNIS,MA 02638 Depvt�^Administrator Not':�ali ��itttoutsignature' u,•' j 1.� { �1 'f 10/12i06 .12:13 FAX 5087900249 GOLDMAN ASSOC zol AC�R ��TiFi��►TE �F L.11e►�iLiT'1� i�V�lJi il4�� CSR AB ""E(MMIDD(YYYY) WEEKC50 10 12 06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GOLDMAN & ASSOCIATES INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FINANCIAL SERVICES INC. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 933 FAIMOUTH RD. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HYANNIS MA 02601 Phone:508-775-6010 Fax:508-790-0249 INSURERS AFFORDING COVERAGE NAIC S INSURED — — INSURER A GRANITE STATE INSURANCE CO _ INSURER B: T P�'p PE WEEKS REMODELING INSURER C: 162 S YAg�gp7�r�H ROAD _..._....--------------....- ------- DENNIS MA 02 38 INSURERD: FINSURER E: COVERAGES THE POLICIES DF-INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Auwu-- LTRINSRC TYPE OF INSURANCE POLICY NUMBER POLICYDATE MIDDFU DDAATTE M 1 DO Y LIMITS GENERAL LIABILITY — EACH OCCURRENCE $ COMMEPCIAL GENERAL LIABILITY PREMISES(Ea oc-rence) CLAIMS MADE OCCUR MED EXP(Any one pwson) _- PERSONAL&ADV INJURY $ GENERAL AGGREGATE S GEN'I_AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG S - POLICY PR O• -- -' -- JECT I LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ! ANY AUTO (Ea aetidanQ $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Per ecclaenl) _---- _ PROPERTY DAMAGE $ (Par accident) GARAGE LIABILITY _ AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S I AUTO ONLY: AGG S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE— $ -` _ s _ DEDUCTIBLE S RETENTION S -_-_--Y $ -_ ---- WORKERS COMPENSATION AND — — TORY LIMITS ER ___ EMPLOYERS'LIABILITY A ANY PROPRIETORIPARTNER/EXECUTNE 1 *#8736143 01/12/06 01/12/07 E.L.EACH ACCIDENT 1$100000 -- -- OFFICERIMEMBEREXCLUDED7 E.L.DISEASE-EA EMPLOYEj 100000 H yyae,describe under ( —' SPECIAL PROVISIONS below I E.L-DISEASE-POLICY LIMIT500000 OTHER ------ -- ---- �w DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION TOWNOF lI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN TOWN OF BA NSTAELE NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT,BUT FAILURE.TO DO SO SHALL FAX 50 8-7 90-62 30 IMPOSE ND O IGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR SALLY SHLA +200 MAIN ST REPRESENT E BYANNIS- MA 02 601 AUTHORIZE;r;: N TIAM I.0L EL ANGER ACORD 26(2001108) CACORD CORPORATION 1908 w� T011N u BARNSTABLE °Ft► Ta,� Town of Barnstable Regulatory Services 2006 NOV. 16 AM 8: 40 9MAM Thomas F.Geiler,Director rF1639. A Building Division Tom Perry,Building Commissioner DIVISION 200 Main Street,Hyannis,MA 02601 - Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FROM PROJECT , Construction Supervisor License # GS © f, ereby certify that I am no longer the Construction Supervisor listed on the application for the project under construction as authorized by building permit #�1L O ,issued to (property address) /--/on 260c I also certify that on ly� , 200�, I notified the property owner, that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. LICEN E HOLDER DATE q/forms/newcontr reference R-5 780 CMR %THET���n TOWN OF BARNSTABLE Z 13ARISTAB 1. i 9� OMvae�� BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ..............�, .................................................................................................. TYPE OF CONSTRUCTION ............... "'vd ' .......................................................:............................... ?i....... �t.................19. .�.. 00P TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: t4O Location ....... .. ............. Sw ... %,,, '"�,_ .................................................. Proposed Use ........ '" ! .......... . ...................................................................................................................... ZoningDistrict .......... .........................,..................................Fire District .............................................................................. � r/ Name of Owner ...-.......- ... �, . ............Address ..................... .! ....... ........................ ' r Nameof Builder ........�..�..............................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... .w Numberof Rooms ...........�� ....................................................Foundation .................: •¢ ?- a....................................... �.�., , Exterior .......�..; ,;.....,.........e ..:....k................................Roofing ......... .........:.........� ......� Floors .................................Interior ...... 7t*yI�� ....... -- . ................. Heating ...... .......�� ` .5 ......................Plumbing .... .......... ................................ _ Fireplace ... " "a'� .........................Approximate Cost .. � � Difinitive Plan Approved by Planning Board ________________________________19________. Diagram of Lot and Building with Dimensions WLjj C) —j C'J O m �<„ Ic N . _ cn > Li.1 L�I L� Lad d O � mX KC {Y L d, O n Lj- OW Cl-. O Q t-' � QIQ: U7 + ❑ � � < H_ Ld - (DQ- w Ld ul \19 ~ < jA U) hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..r ........... Small, Alan DEC 31 1971. No ....142,13.. Permit for one story single family dwelling �.. ........r��....Buckskin Path -location ...............................................Centerville................................. �► 3 Omer ........Alan Small..... YJ 4 Type of Construction frame ............................... t .............. ................................................................. Plot .......... ............... Lot ........#2................... Permit Granted ........V-gu-51-3 ......... 19 7 Date of Inspection ..................................1.19 Date Completed PERMIT REFUSED �-^ .................................. ........................... 19 i ............................................................................... ( �* ................................................... . ........................ r r' .............................................................................. y ...............................................................................s. U J Approved .............................................. 19 r ' ........... ` ................................................................ ............. . .................. ' y