HomeMy WebLinkAbout0004 DUNASKIN ROAD ! 4
Town of Barnstable *Permit# )" 0
Expires 6 months from issue date
Regulatory Services Fee n , . or
• Thomas F. Geiler,DirectorXPRESS
Building Division l
m � Tom Perry,CBO, Building Commissioner
mAY 14 2007 200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
T&NNeC}` WkNMABLE Fax: 508-790-6230
EXPRESS PERMIT APPLIOATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address 4 D u n ag K l n �j
[Residential Value of Work }�T D• r " Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address I c I a Pctkf5
Contractor's Name 'j Telephone Number
Home Improvement Contractor License#(if applicable) I J 10
.Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Che one:
[�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 be on file.
Permit Request(check box)
Cl/Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof]
❑ Re-side
❑ Replacement Windows. 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: Propery Owner sign Property Owner Letter of Permission.
Home Ir�tprove ent ontractors License is required.
SIGNATURE:
Q:Forms:expmtrg
Revise071405
Town of Barnstable
ti
Regulatory Services
sn � � Thomas F.Geiler,Director.
� nss.
MASS. �
�A 039.
PfDMP�°' 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 bier lust
Complete and Sign This Section
If Using A Builder
as Owner of the subject.property
hereby authorize 11 I X-A to act on my behalf,
in all matters relative to work authorized by tu building permit application for.
(Address of Job)
Signature of Owner Date
Print Name
Q:FORM&OWNERPERMISSION
1 he Commonwealth of*Massachusetts
Department oflndustrial Accidents
Office of Investigations
600 Washington Street
Boston, M4 02111
nq w.Imas&gov1dia
Workers' Compensation Insurance Affidavit:.Puilders/Contractors/Electricians/Pluffibers
Applicant Information Please Print Leg ibl
Name (Business/Organization/Individual): J
Address:
City/State/Zip: TNUVU, F N f' NjA l .Phone#:
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
loyees (full and/or part-time).* have hired the sub-contractors6. New construction
2. I am a sole proprietor or partner- listed on the attached sheet. t 7• ❑ 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 are a corporation and its
10.❑ Electrical repairs or additions
- required.] officers have exercised their -
3.❑ I am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs oT additions
s myself. (No workers' comp, c. 152,§1(4),and we have no 12,02-froof repairs -
insurance required.] t employees. [No workers' 13.0 Other
comp.insurance required.]
*Any applicant that checks box.#1 must also fill out the section below showing their workers'compensation policy information:
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information.
I am an employer that is providing workers compensation insurance for my employees. Below is the policy andjob site
inforrnatioi
Insurance Company Name:
Policy#or Self-ins.Lic. #: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500,.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby- ify Land r th pai an penalties of perjury that the information providedb'oIv is tram and correc
Signature: Dater
Phone#: -"OOP
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.Boprd of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing Insp r
6. Other
Contact Person: Phone#:
✓2ce Z°�rrvrr�aizur
Board of Building
Regulations and Standards
HOME lTmOVEMENT CO License or registration valid for i
Re Istratioh CONTRACTOR before the expiration date. If found,retuvidulrn to only
24310
trQn Board Of Building Regulations and Standards
rf One Ashburton Place
t�i4idual I Boston Pn
1301
ames Curley =� _, i l I ,Ma.02108
Imes Curley /� �
`, t�17
17 Fuller Rd.
mterville,
MA 02632
Administrator
Not valid without signature
I
l
�: . . The Town of Barnstable
9.
Department of Health Safety and Environmental Services
h
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
SHED REGISTRATION
V-
Location of shed(address)` v%1% a e-
Property owner's name Telephone number
Size of Shed Map/Parcel#
Signature Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?
Conservation Commission(signature required) 311h 5
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
Q-forms-shedmg
Assessor's offioe (1st floor):
A sessor's map and lot number .............. .................... ��` iC[ �r,eFTHE
toy♦
�ard of Health (3rd floor): �• a t!:,," 1 f �� s�f.�Ab o�
ewage Permit number ........... '
..............•.........• •....... ... WiTt`;"I TITLE 5 >; BABasTABLE, i
Engineering Department (3rd floor): r63q. \0��
House number ................................. .........�..�L
�f'..� ... TCr'jv69q REGULATIO'N,1 �o
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-,2:00 P.M.. only
TOWN OF BARNSTABLE
BUILDING INSEPECTOR
�� P �. o pc.� 10,A
APPLICATION FOR PERMIT TO .....�1 ?.................C?......:K...."......... ..................................................................
TYPEOF CONSTRUCTION .... .................................................................................................................
............. O..'2-. .................. �.. ..19...
TO THE INSPECTOR OF BUILDINGS: ,
The undersigned hereby applies for a permit according to the following information: CZ
Location ..... ....y.... ?.....AsvF 1...G��x ..................................................................................
ProposedUse .... ti,........................................................................................................................................
Zoning District .................................Fire District
Name of Owner �4►�4..P4tT c ....................Address ... V.►.,4S�4-0...
1q�,? ..r.4 v1 :.
Name of Builder ... ...................Address ...t-19... -C?4��-.0.A.�l,t..�(l.'..CIE�!(��44?.lu�.......
Name of Architect ..aA!4kE1.4..... ..............Address ......USjEfWNA. ..................................................
Number of Rooms ........k.........................................................Foundation ....u?.` ' .......5.(9.! �C>...'tti.11 1.111.4.....
Exterior ...V.1�4y—L-..S.1Ptr.--Av...............................................Roofing ....�kS�. 3!--�
Floors ...F>IyA j-OOD............................................................Interior .....I�r�?vQ.L..............................................................
Heating ...h.10.!J-Q ................:.............................................Plumbing
1 ........C�... h� 1J.-�.r............................................................
Fireplace ... Y' ............................................................Approximate Cost ....................
........................................
Definitive Plan Approved by Planning Board ________________________________19________ . Area t4. �5.1..=..�. �......
Diagram of Lot and Building with Dimensions
SUBJECT TO APPROVAL OF BOARD OF HEALTH
f�
01
I
Z�ota►V9�C _ � ,Q �
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.
SQ4Tt m. Name ...t. ... . ..... ............ .............................................
M lti34l eq1�
Construction Supervisor's License .................
PATTERSON, PATRICIA
z. 31358 Build Porch '
;. No ................. Permit for ....................................
Single Family Dwelling r-
¢. ..........................................................................
4 Dunaskin Avenue (Lot A�-1)
Location .............................................................. `
Centerville
` Owner
Patricia Patterson
Type of Construction Fr.ame
.... ............................
r. ....................{ ......................................................
Plot ........................... Lot ................................
� I
E` " 9 --4
� Permit Granted ...................October..........:�....�....19 8 7 1 =• .
Date of In p ction ....................................19
Date Completed ......................................19
C.
R
n
Assessor's offioe-(1st floor): ` _ �- � y
p�/ C*THET0
Assessor's map and lot number .... ....`.... . /...:..—
e
Board of Health (3rd floor): --7 .�� � o�
Sewage Permit number .......................................... ..... .. .. >; Baaa9TABLB, S
Engineering Department (3rd floor): �o MAO& ♦�
House number 0 39 �0
l_^ 0n ,sues6
.........................................y.....`�.!.."�.....: CEO YPY a'
APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00' P.M. only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
i
APPLICATION FOR PERMIT TO .....�W.kA......p���-kA....-.... ?.p v............���
. ...........................................
TYPEOF CONSTRUCTION ..... .................................................................................................................
O....�-C-� 19 .7
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
`1 (�4)u , i�Ctii.� 4.W. e... ... +--�'�R-�� st. ................................................................................
Location ..............n..............� .....................� p ................ ...
ProposedUse ... .........................................................................................................................................
Zoning District .... "....�............................................................Fire District ....�r.��..^JTE�'i;a.,l.!R.,�-�:.�.C?iXC^s)%L-f►.c.........
Name of Owner .0L'tCPLiI.C.,4.A..PAI.[.e 1(1 ....................Address ... .-i..�Ue to :t.�...IA�J :.y. ��•��T v�l��
r
Name of Builder �. ``- o..1^.,v#. �:..,. ., ►r
...�-.:......°..��x'�"t.... .. ......................Address ...�'r.A..... ..,(.. .....��.�.+6►...+�d..�!�,.y.�,.1i<.<..�`'� ...{rr...-.......
Name of Architect ..QLl.'t4%.o ........ ..............Address ......0.5 ..................................................
Number of Rooms ........ ........................................................Foundation .... r......... 11, J� ......
Exterior ...4/.i►: f 1-.. ,1..1C�.................................................Roofing Sid !- Ir......
Floors ..... .......f�.i �.
/d.:.1,rlf'�D...................................i.........................Interior c.t�
Heating ..lr ,.? !,? 2 ...... ..........Plu.mbing ...: .t�;.i: A,.....4r.............................................. \ ............................... ...
Fireplace ..........Approximate Cost 1S(1T)
.... - .................................................. ....,.........................................
1
Definitive Plan Approved by Planning Board --------------------------------19____ �.��
___ . Area ...� ..) ...=. ..I�p......
.v v.....................
Diagram of Lot and Building with Dimensions Fe . �..t
SUBJECT TO APPROVAL OF BOARD OF HEALTH
Q
I
7
Ac►G
pivo s
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.
tr�
I L �"�tAi''1i 1 kMo Name ... .............................................
� - C
1
Construction Supervisor's License 3 ................
PATTERSON, PATRICIA A=228- 5 `
'6
Q..3.1. 58 permit for ...Build P9rch
r
Single Family r-D-we .1 nq
Location .....4....Dunaskin (Lot lA)
Centerville
...............................................................................
Owner .....Patricia Patterson-
.............................................................
' 0
Type of Construction ....F.rame.........................
...............................................................................
Plot ............................ Lot ................................
Permit Granted ......October.,29.......19 87
Date of,Inspection .....................................19
Date Completed ......................................19
/6n/, �� �
b�Qy�F.THE?��yw TOWN OF BAR.NSTABLE
Z BARNSTABLE. i
D 9 BUILDING INSPECTOR
RFD MPY a'
APPLICATION FOR PERMIT TO .....Ago....6..N....... T�....�K�/��.......
TYPE OF CONSTRUCTION .....LA.O.0.b.....t l&Al SFr.. ..................................................................................
/`711.2 C.lf....s5Aj...........19..7.4
TO THE INSPECTOR OF BUILDINGS: _
The undersigned hereby applies for a permit according to the following information:
Location ......
..'�1............-1�11/V.�.Sa�I�K........f?.v�...............�'..,`nl.T� ........J �P,S.S.r.....................................
Proposed Use
ZoningDistrict ........................................................................Fire District ..............................................................................
Name of Owner ........ )z z
. ...�.:i'P.t.�..l.� Address ..�.:.......17 .......U.J.5/.l4?.SAC.I/.'� h�.(�,�.......4'�/.Y...T�le.V
Name of Builder
W4.I, aP..K...j4Er....StAt: ..1).C%-g-...001`"/'Address ... 014LI..,....la"-T. .......�l�.l�l�l1��.../`r(�ss.
Name of Architect ( .1 /- .......... .�N`LD... .............Address ...QU.R it..... NGs!... ..............fff4. �►ltC .../�69tS.
j
Number of Rooms ... ...... 0-.../,3�...1�D.2.S`1�.:................Foundation 4?Pe
Exterior YLLJAOD....5AV446.44: ..............................................Roofing /9.5 /{t�?4 ....5?' J.d....., ...........
FloorsVil.O.Pb........................................................................Interior .�y....kY. .fir ....................................................
Heating f�o..l.:...: f9✓.f4T. ? ...........................................Plumbing
.t.% ......!'Jl/4�51f Fr .. ...P y.� .�..
Fireplace ... /.4./ .G..s.............................................................Approximate Cost .. /�f3.'.
................................................
Difinitive Plan Approved byAu"& 18Eg_M-EM40D-O OVIDING FOR � ►
Diagram of Lot and Buil,$VjjAWirrWrrAiji SUPPLY,SEWAGE DISPOSAL _
AND DRAINAGE IS HEREBY APPROVED _/`� e a
MI -OF BARNSTABLF,
\ 2
� .. +t4
77
EX►$TINE DWEIl�.111( `
`SAD 1TIaM (�
O .
y3`-6" �ouE vK�
�100
64 . 71
Dv NA 5�l 1 N AVC-
hereb agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
NaG. ...............
Patterson, Patricia
DEC-311970
No ....1�97O.. Permit for .. a..to single...........
f
family dwelling
...............................................................................
Location 4 Danasldn venue
...............................................................
Centerville
............................................... ,
Owner Patricia..Patterson. . ...............
r '
.................. ............. . ....
Type of Construction frame + r
................................................................................
Plot ............................ Lot ...............................
f
(
Permit Granted ......... ?? .6................19 74
Date of Inspection . V ...........�.1...19 70
V.
Date Completed ......................................19 \
i
PERMIT REFUSED
j
.............................................................. 19
................................................... . ....................... i
............................................................................... ,
...
Approved ..............................................._}9 ,
...............................................................................
.,
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