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Home My WebLink About0278 BUCKSKIN PATH ci 1 - . a » F+ r n S r,. ' n f r .• a e r r F ,. ,. .. .,� .. ,,: . . ,, . . . r .. .. .. .. .. :' �" ,. ,. ... '. o � '' ,. - a .. _ .: � .' .. n ;., _ .. '.:c _.. c' .. .. ,. v � - - � '. ,. ... :. - „> n .. ., .. .. ,. . .., �� .. a -- s � ,_, .. 17Iq .5 0? SO Town of Barnstable *Permit # Expires 6 months from issue date Regulatory Services Fee 5 • anRxs'rnsM MAS& �639- Richard V.Scali,Director A` N1A'I Building Division plies Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 JUL 02 2015 www.town.barnstable.ma.us Office: 508-862-4038 TO VVN OF@Ago , -6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY V BLE Not Valid without Red X-Press Imprint Map/parcel Number /J n�`�� Property Address c;�7 i.C.L.�.cS�/�n J�'aV k L.3 2- n Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address (244--C31Gj n `'✓- Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: 0__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 4ist(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to r ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side I ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ 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 required. SIGNATURE //'dj/ i &Ak. C:\Users\Decollik\AppData\Local\Micro \Windows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doe Revised 040215 f Town of Barnstable Regulatory Services 4oFTKE rOty,� Richard V.Scali,Director Building Division * Tom Perry,Building Commissioner , mass z639. 200 Main Street, Hyannis,Na 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION RATE: Please Print // ! � L JOB LOCATION: 6UC tSk1/] number street p village "HOMEOWNER": Cak-6 I(,n ayy 5DO 9v q p DU !.e— 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 o�),edures and requirements and that he/she will comply with said procedures and requirements. gnanS bfHom46wncr / 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:\WPFILES\FORMS\building permit fonns\EXPRESS.doc Revised 061313 . THE rq�, Town of Barnstable Regulatory Services �snxr'S.„ Richard V.Scali,Director 163;ac16 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 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 dais building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM&O WNERPERMISSIONPOOLS f ne Commorrivealth of Vassachusetts Department o•f'Industrial Accidents Q -ce o,(In,vstrgations 6001Pashington Street Balton,41A 02111 4 }4'fpn%masm..govIdia . Workers' CompensatiGn Insurance Affidavit: Bmldei-slContractursJEIectHcians/Plumbers' Applicant Information Please.Print LegibIy Naive(Basinessi0rgmizat onnm " =i)_ civ-0 1ci h Address: 02 CitylSt,,1&Zp_ C,enkVV1We Ml�UZ(av2.Phone q OCR `� Are you an employer:'Check appropriate box— Type of project(required): 1.❑ I am a employer with 4. ❑1 am a general contractor and I employees(full andlor pant--time). 6.* have hired the sub-contractors ❑New construction. . 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling slip and have no employees These sub-contractors have g- ❑Demolition wod-dng for ine in any capacity_ employees and have workers' [Nfl workers'comp.insurance comp.insurance-1 g ❑Building addition. ; rF&ed.] 5. ❑ We area corporation and its to.❑Electrical repairs or additions 3. am a homeowner doing all work officers have exercised their 11.❑Plucbiag repairs or additions myself o workers' right.of exemption per MGL F insurance required.]T camp c.152, §1(4X and we have no 12. ofrepairs employees.[No workers' 13-0'Other comp.insurance required.] *Any appFicant that checks box K unit also fill out the section below shoring their workers'compensation policy information- Hamemners who submit this affidaOt indicating they are doing all weak and then hire outside contmctars nmst submit anew affidavit indicating such IConttactors that check this bade must attached an additional sheet shouting the name of the sub-contrs6o s and state whether or not those entities have eaaployees. If the sub-contactors have employees,they=aw provide their workers'romp.policy number- I am au erreploy�rrr drat is proxzdirrg it�orkers'con eresatrivlr irisaira�rce for Ni,}*errrplo}�es. Below is the policy anti joh site i�rforrrration . Insurance Company Name: Policy*'or Self-ins..Lic.9: Expiration Date: Job Site Address: City/StawZip: 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 anrVor 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 izolator. Be ad,,ised that a copy of this statement may.be forwarded to the Office of Investigations.of the DIA for insurance coverage vecifs loon. I do Iieraby A. under the pains and,penaWes ofpegWy—that the ircjorazation pros drd above.rs trtrere and correct Sisaature: Date: 7 Z j Phone 4: Offleial use only. Do not asrite in this.area,to be completed by city or toir n of rate City or Town- PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cit+ylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector G.Other h Contact Person: Phone#: Information and Instructions :. . s Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. pmsuant'to this statute,an anployee is deed as."-"every person in the service of another under any contract of hire, express or implied,oral or writt]n." An errpTzyer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged ia 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 dweIIing house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on.the grooms or building appurtenant thereto shall not because of such.employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of complian—with the insurance.coverage required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor airy of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the iusm anCB. requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to you sitnation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s) along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation iI sz=ce. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retumed to the city or town that the application for the permit or license is being requested,not the Department of Ldusfrial Accidents. Should you have any questions regarding the law or if your are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-m sarance license number on the appropriate line. City or Town Officials t - Please be=a that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fiIl out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the pem ifllicrose number which will be used as a reference number. In addition, an applicant that must submit multiple pe=tllicense applications m any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should�.vrite"all locations in (Gitty or town)"A copy of the affidavit that has b=a 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 futnre permits or licenses A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or pemut to burr-a 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 DepartmenfS address,telephone and fax number. The CGmmQaWwealttr of Massa.Ghusatts Degariznent Gf liidu&tdal Accidents OffiiCe ref f gvestfgatiawi 6Q-��ashin�an S'f�t ��an=�E1�111 T(1,4 617 727-4900 ext 4€6 car 1-9 -MAS9AFE Fax 9 617-727-7749 Pevised 4-24-07 .mass-gavldia M Town of Barnstable ; ,oF °wti Regulatory Services Thomas F. Geiler, r Director { } 7 f;F�! a � MASS. ' Building Division y aiA9s �'prEn39. t Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 0 s/31h, www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# .C;)®IZ SHED REGISTRATION _ 120 square feet or less al 7 Location of shed address Village - C e y 9 .3 Property owner's name . Telephone number Size of Shed Map/Parcel# 2 Si e Date ..,1 Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission�g'nature,is_required) Sign off hours for Conservaton0-9:30&3:30-4:3U PLEASENOTE IF YOU AREr 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-forms-shedreg REV:042506 r ��- z.� �� 6 �. /�c� 1 Z� �, r Map Page 1 of 1 Town of Barnstable Geographic Information System New search Home Help Parcel Viewer Custom Map Abutters Map Size ® °' Zoom Out In Rr C- Turn map layers on/off,by JPG selecting check boxes below MEE a F Town Boundaries - a :kwµ r Road Names'. - -�., � r Voter Precincts Map&Parcel Numbers F Parcels OLD r FEMA Q3 Flood Zones(Old Maps) - Will be Superceded in 2010. AE(100 yr flood) ' t � AO(100 yr flood) VE(100 yr flood w/wave action) X500(500 yr Flood) jjj${(a F Nerighboring.Towns r r Water a 60 F F Streams Set Scale 1" 60 Aerial Photos MAP DISCLAIMER Copyright 2005-2010 Town of Barnstable.MA All rights reserved.Send questions or comments to GIs BarnstableMA v1.2.4113[Production) } e http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=191122 4/22/2011. o S-r apt Xu Assessor's map and lot `numb . ..... . .. ....... .. . ... . 'fNE t01� Swage Permit number ......... .. .... .. f �o� 33ARNSBTAX i House number ........................ .........\�....... . ..................... vo ° u O 1639. 00 �ftMOa� TOWN OF BARNSTABLE- BUILDIHG ' INSPECTOR APPLICATION FOR PERMIT TO ... ........ A0.0, vo. �/c�.x..z6........... :............................. TYPE OF CONSTRUCTION ........... . .-C).. ........... ............................................................ ......................I..........................19.. .. TO THE INSPECTOR OF BUILDINGS: The undersigned her �eba plies for a permit according to the following info ation: I Location .........................�, C.....0 ... '�i�" .. .... ...................... ProposedUse ..... Q ?�, ............... ... ............. .......... ............................................ .................................... ............ Zoning District ..............................................Fire District ............... .... Name of Owne /` ��:...C�.........�v�•.� �1............Address .1. U.C� .f^1 � �.iu jiy Name of Builder �t-C ....,!Y.ST.Address ... / �.� �'° ....... .... ....................... ..9........................ Name of Architect ..........:..............Address ......V.!rc. `... �.....V.V.!.. .21�1.w.� �:Y?P� Number of Rooms .........................,/.....................................Foundation 1,.,,J em .Exterior ................... .... .... ....................................Roofing .................... .... .............. .............. Floors ................. '' �r'. ................................Interior .................................................................................... Heating ............................................Plumbing ........... f :../ (.....! o�c..�/' Fireplace ..........................N.. ........................................Approximate Cost .....................7 .... ................. .....9 Definitive Plan Approved by Planning Board --------------------------------19--------. Area ...... ......�..5.. .............. Diagram of Lot and Building with. Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH t 4 PAD/ea,j 1 i f 1 c I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable Trer,4ingj,..thh.e ab.ove construction, Name . .. ....... ............. G.0 2— O'COiTV=, HERBERT ' No �68....(Permit for ... D..I'�.. � .... , r Accessory to Dwellinig.......................... 278 Buckskin Pam, u Location ........................... ...................... ; n v E Centervi � ............................ Owner w ..Herbert 0'Coi?fl��,l............. Type-of Construction ......Fxame,... ................ ............................................................... ................ Plot .. ................. i .. . Lot .......... ................ Permit-Granted .... X..l ..................� .19 84 Date of,lnspecti . . ..(f......19�� 'Date�Completed ...........�¢...............:... ...19j C,o L PERMIT REFUSED _ { .. ........................................................ ::.... 19 , ......................................................... !.................. ............................................................:................... F ............................................................................... / L . A.............. Approved ....................................... ........ 19 s /L'i --- -- ......... ................................................................ ................. ......................................................... 'i Assessor's map and lot number .... r16 ................. *THE TO Sewage Permit number ................... ................................ EARAS'TAXLE, House number .........................W..... ........................ NAM ............. 163 0 MA TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... ........ TYPE OF CONSTRUCTION ............ ...... .............................................................. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby_opplies for a permit according to the following information: Location ........................ .......... ...................................7""" ....................... 1 * ProposedUse ............6........K!........................................................................................................................................................ Zoning District ................ ..............................................Fire District ............... ..........(3 ................................................ r i Name of Owner .... ................... .......... .....................................%.. ..... Address Name of Builder ..... ........(.....................Address ...... ................ .4 Nomeof Architect ......................... .........................Address ..................................................................................... Number of Rooms .......................... ....................................Foundation ................... .....!........................ Exterior ............Mg.. , 01�- - r........................................Roofing ...................4-S........... ................ Floors ................ �t.................................Interior .................................................................................... Heating ........................... ............................................Plumbing ...........k%k� ..............I..... .. ... ..... .....z Fireplace ...................................................................................Approximate Cost .....................2"......................................... J Definitive Plan Approved by Planning Board --------------------------------19 -------- - Area ............( .4F........ ............. Diagram of Lot and Building with Dimensions Fee ............ .'/....17. ................. SUBJECT TO APPROVAL OF BOARD OF HEALTH /01 134 f -- ---------------------------- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction, Name .................................................................................. ' PPPP- � Acces ---'--- -- ' '— —' Location ?7& �ath' ---.. --'—'-------------'— \�r-----. Owner ........Be4:l*y�t 0'CcMP-11______.. Type of Construction ....Z%am........................... --------------------------' Plot ............................ Loo ___________ Permit Granted --.8 lc-a/..l'....................lg 84 Doteof |nupection ------------lg Date Completed 19 �� -----------_.. PERMIT REFUSED __.____________------- lV | _ _��.'_..��-...-.. ________.. —'' ....................................... ---'- -----.. ................................................ Approved ......................................... lQ -------''--'---'--^^---^^^----' -------------'-------'—^^^^~^'' (Ass essor's map and lot number ��' ,,,,,,.. , SINE 1 Sewage Permit number .....................................:.................. d� 0 . s Z BA"STABLE, y i House number .f -77 1�,</K /1��'. � �`f 'oo N 9 .off Q Mar a' TOWN OF BARNSTABLE SUILDIHG INSPECTOR APPLICATION FOR PERMIT TO ....,A N6 - ..... aP" ...5 � "�....................................... TYPE OF CONSTRUCTION .... ..WIM yP.... ..... ................................................................... ........................ +5...�. ..........19.. :t-5 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:.( � Location !'!. Proposed Usef:...:., ! ................................................................................................................................ d... Zoning District �. C Fire District . ..... ........................................ .............................................................................. Name of Owner ............Address ....... ................ Name of Builder"Tt� rP.7Addr ess.. ..1.. .t � Nameof Architect ..NaA-p....................................................Address .................................................................................... Numberof Rooms .....i.............................................................Foundation .............................................................................. - Exlerior ..... ................................... Floors ./e!l-"I r. Interior .... I t e t Heating ...................................................................Plumbing .. ,................................................................. Fireplace ... F .a�. ..:........:.....................................:............Approximate Cost 1-7 i` ............................................. Definitive Plan Approved by Planning Board ________________________________19________ . Area ........ ZJ�r`Q ?f?�......... Diagram of Lot and Building with Dimensions Fee /!'.3� SUBJECT TO APPROVAL OF BOARD OF HEALTH / (; }' j I �----- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . „< . . ................................ Construction Supervisor's License �� ............ CONNELL, HERB O. A=191-122 No :rAermit for ...?:ld Sun Porch. ..........S. ngle„Family..Dwelling....... Location 2 7 8.„BurXgXin...Pa.t .................. ....................Cen terv„ l 1.�............................. Owner .....Herb O.. Conne.1.1..................... Type of Construction .....TKMlle........................ ............................................................................... Plot ............................ Lot ................................ Permit Granted ....June.........................19 $5 Date of Inspection ....................................19 Date Completed ......................................19 ;yr ;.a Y yh ' "Jt Assessor's map and lot 'number ... 'Z..A............. ��lD�- � y F THE t0� Sewage Permit number .. SEPTIC SYSTEM MiUST B �Q o INSTALLED IN CC3{d PLIANC t BABBSTADLE, House number �(! !. . ...� .. WITIA TITLE 5 90 t639- ENVIRONMENTAL CODEta�! °'�oMpYa�e TOWN OF BARNS' AaNS BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....4.c�N�J ...0 `�C� ...................................... TYPE OF CONSTRUCTION ......Ww. ..... ...... .T!....................................................................... ................... .... ..1�..........19�� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following inf r�� G . Location .... . . f�� /�:( ..y�� ................... ................................................................. ProposedUse ..�y`7U .. .....:...................... ................................................................................................. F ZoningDistrict ....................../`-..c.....................................Fire District ........:.....Cr......®............................. Name of Owner :. ...nC-. Nr -}................Address .. ............................ `7.Vl�.k��-.51. W.Ct?.,Address ......``.... Name of Builder .. y .M ,.. T3 � Nameof Architect Ct l.r....................................................Address .................................................................................... Numberof Rooms ....t............................................................Foundation .............................................................................. Exterior ....................RoofingJY.. ................................ FloorsL �G;�)Interior ( �'�....`��, .. - I.C�l. �J.... Heating ..-.............................`.................................:.Plumbing ..!..`{ .......................................................1...... Fireplace .._.............................................................Approximate. Cost 1.7.yn............................................. Definitive Plan Approved by Planning Board ________________________________19--------. Area .......................................... ,5-V Diagram of Lot and Building with Dimensions Fee ��............ .... ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH L o • Z� 6( 1 c, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .944. :. ............................... .......... Construction Supervisor's License ......f ............... CONNELL, HERB O. 23010 ..Build Sun Porch. No ................. Permit for ............................... Single Family Dwelling ............................................................................... Location .....2.7.8.....B.......k uc ......sk...i .....n ...at Ph ............ .............................. qenterville.......................................................... Herb O. Connell Owner ...................................... ............................. Type of Co" Frame Construction ................ ......................... ........................................................................... Plot ............. .............. Lot ................................ , ..Permit Gra nted .....June................12 .......... ........�19 85 Date of Inspection ............ 9.................. Pate Completed ..... .....................7 Ile" � a 3—/z�17-3 r' ma and lot numberA—I ,Fd — tzl SEPTIC SYSTEM MUST BE Or(/� Assessor's p .................................... N I I N CO. PN CL "I I Sewage Permit number .......`... y..................................... S I NI ARY CODER ® TOWN REGULATIONS, r--" QyoFTNEro�1 TOWN OF BAR.NSTABLE • BA$BST"LB, i 9� oMU&gY'ae�m ' �� Id® 9C INSPECT® w APPLICATIONFOR PERMIT TO .......................................................................................... ............................... TYPEOF CONSTRUCTION ........ ................................................................................. ........19........ s N TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to he ol.l.ow nformati on: Location .................. ............... ... ........ .... ............... ProposedUse ....... :`: '.... .. ....................' . ........... ................................................................................................. Zoning District ..........................................� Fire District ....... *................................... Name of Owner ......Address ......... .................... jO Nameof Builder .............. ................................................Address .................................................................................... 4 Nameof Architect .............. ........................... ...................Address .................................................................................... Numberof Ro s ........... .................................................Foundation ......... .. . . ..:. :.. ............................... Exieriori ... ..............................................Roofing ............................::.: .. .: ...... Floors :..:.......... ........................................................Interior ....... . .........:.. ...... .: .... .._:...... ................................ 0 ............... d...................................................Plumbing ......... ...... .. Fireplace .......... ,....... ... ...............................Approximate Cost ....... . .:.... ........ ...... Definitive Plan Approved by Plannin Board ________________________________19_______. Area Diagram of Lot and Building with Dimensions Fee ..........�./... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r L4� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable rega png the above construction. NameA............: ...................................... Small, Alan E. No . 16211.... Permit for .....one story ....................... single family dwelling Locatio97 Buckskin Path n g ki ............................................................. Centerville Owner Alan E. Small ... .............................................. Type of Construction frame Plot ....................... . .....Lot ..........#'1 .............. } Permit Granted .........May..22..................19 73 o Date of Inspection 19 ; Date Completed ......�./.$t ............19 Co t-0 ow L- PERMIT REFUSED „ ................................................................ 19 .............................................................................. ............................................................................... ............................................................................... r I Approved ................................................ 19 ............................................................................... ............................................................................... J7