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E; .. s .: --, rti QP• 4/_.- l .. i,r_.A.. ik r ti 9i:: e ' Town of Barnstable *Permit#,;2Ly649QSyz Expires6mnths from issue date X-PRESS PERMIT Regulatory Services Fee Thomas F.Geiler,Director AUG 16 2006 Building Division Tom Perry,.CBO, Building Commissioner TOWN OF BARNSTABLE 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel NumberZ Illy Property Address P esidential Value of Work t Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address h,�r` IIJJ/j� 4 Contractor's Name Telephone Numbeic;S — Home Improvement Contractor License#(if applicable)� �� Construction Supervisor's License#(if applicable) Vorkman's Compensation Insurance : e0he one: 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 heck box) - . Re-roof(stripping old'shingles) All construction debris will be taken to MJ1t/ �PYTP ❑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: Pr f erty Owner s ign Pr erty Owner Letter of Permission. e Improv a Contr ors License is required. SIGNATURE: Q:Forms:expmtrg Revise071405 r °FINE� Town of Barnstable Regulatory Services 9anxx S. Thomas F.Geiler,Director Eo;o. 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 I, �.,{, as Owner of the subject property hereby authorize ? (j' /i to act on my behalf, in all matters relative to work authorized by this building permit application for. 61AI,4—�ICIAJ (Address of Job) z�. nature of Owner PTte / SG , O /V Pnnt Name Q:FORMS:O WNERPERMISSION The Commonwealth of Massachusetts Deparhnent ofhidrts6i d AecMents Office of Investigations 600 Washington Street Boston,MA 02111' • www.mas&gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electrid=/Plumbers knnlicant Information _:._ _ Please Print Legibly Tame(Buess/Chgaaizatioa/lnciividnal): . Wdregs: 1 ©c ty/State/Zip 11hone#: ,re you an employer?Check the appropriate box:. Type of project(required). [] I am-a•employer with 4. 0 I am a general contractor and I _6..0 Now construction gees(fall and/or part-time).* have hn:ed the sub-contractors 9- am a sole proprietor or partner- listed'on the attached sheet$ 7. Remodeling s and have no employees These sub-contractors have S. Demolition • or workers' co insurance. ' working forme in any capacity. comp. 9. ❑ Building addition o workers' comp.insurance 5. We are a corporation and its - [N 10.0 Electrical repairs or.additions � ] officers have exercised then ❑ I am a homeowner doing all work . right of exemption per MGL lY.[� Phunbing iepairs or additions e. 152,§1(4),and we have no. 12. oof r airs myself [No workers comp• i ep insurance required.]t employees.tNo workers cow.insurance required.] 13:❑ Other guy applicant thatched m box#1 must also fill out the,section below showing their workers'compensation policy information: - 3omeowuers who snbmitfhis affidavit indicating they ate doing all-work and then n hire-outside coutagkws must submit a new affidavit indicating such ontractors that check ibis box must atffiched an addiSonal sheet.showing the nano 6f the sub-contractors cad their wort ml,comp:.poUq aformatioiL am an employer that is providing workers compensation insurance for my employees.'Below is the policy and job site. rformadon. _ isurance•Company Name: o'licy#or Self-ins.Lic.#: Expiration Date: ob Site Address: - City/State/Zip: ,ttach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). . awe to.secure coverage as required under Section 25A of MGL c. 152 can:lead to the imposition of(a fininal penalties of a ine up to$1A0Q.G0.and/or one-year imprisonment, as well as.civil penalties in le form of a STOP-WORK ORDER and a.fime �f up to WHO a day against the violatdz: Be advised that a copy of this statement may to forwarded to.the Office of . nvestigations of the DIA for insurance coverage verification. do hereby certi der the p d p ahies of perjury that the information provided at ove is _ and correct. 3i tare: Date: Phone#• 1.�0�'-7_�,�—7 2•�� . official use only. Do not write in this area,to be completed by city or town offickl, City or Towne PermitUcense# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• 'y ... F 1 • Boacd,of Buifdi T� g I!atioris and Stand, MQME IA�p r, �ROVE NTRACTOR MEVT Cp x „;'� �tegistrabon 1494j5 '-_ , E Expiration; j` FJ12-2008. J � Type. pBA'` . I ER1CS COlvSTRUCTiOy ENGELSEN"" !r; g SP OLD 4 YANNIS; I r • ' t Assessor's map and lot number Sewage Permit number�,1.„ r` Z BARNSTADLE, i House number .................................... ' •MAB& OD i639.- 9� a Uri TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............................................( 1 Lam. ................................................... TYPE OF CONSTRUCTION '1 !. ............................19. r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for }a permit according to the following information: Location ............. �h.... Jrll.�',4.k�.'..! ......!�o......1.< /- Proposed Use ,...........�'.tl/ /_. (i, G� y72--.act .............................................. ........ ....................................... . ........ ... ... ........ r .!! Zoning District -7 4............................................Fire District "- �....`... t ............. :....:�.................................................. Name of Owner tA�. ......5e-li l!. .:t .............Address UnJla-5 1 Name of Builder" f?. .�%.. I > j�t�')f<1.��.............Address �l a C�qI(%Name of Architect- .:....................................................Address .................................................................................... Number of Rooms ..................................................................Foundation J0 ri ( t17........,��►• .: - ....... �. / ,{ ............ Exterior �4 . 41-� .. 0,5 C�L,C. .................................Roofing ,f 1 � T'*��-T 1 ��- i.................. .................................................... Floors lG,^.................................. Interior �✓G ..'1� !Y ....... .. � ...........-..........�r :... .... Heating � .: `!:.............C'?C1 i. �� ...................Plumbing .I�.Gw.. :..'..�.! ..... t .�L' L1�. ....... Fireplace f..A/ ................................................Approximate Cost �I_d ................................. .................. ........ .....r.............................. Definitive Plan Approved by Planning Board _________________________ 7, ,_. ............. - ------�9--------• Area Diagram of Lot and Building with Dimensions AMAC , Fee ...................... .. .................... SUBJECT TO APPROVAL OF BOARD OF HEALTHr � /7, it 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 .............. ....... SCANLOU, WAYNE A=2.29-7 23938 ADDITION No ................. Permit for .................................... Single Family Dwelling , ............................................................................... Location . ..98 Dunaskin Road Center ille ................ .................. ................ ......................... Owner ayne S. anlon ................. ................ .......................... Fr me Type of Construction .............. ........................... Plot .... ................ Lot .......................... Ii A ril 5 82 Permit Granted ..... ................. ................19 Date of Inspection I Date l ompleted ... ................ .................19 l � I5( Assessor's map,and lot number .........:..:...........:.:................. SINE to�f cC Sewage Permit number0.... ,.. IMSTODLE, i House number ............ f ro . Asa i639' ��Yt►Y Or" TOWN OF BARNSTABLE BUILDING , I.NSPECTOR ' APPLICATION FOR PERMIT TO �Q I L lam!.P12.l 1 f d TYPE OF CONSTRUCTION .L /...........................19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........:.. ?....��JIJ........�... �N......���.�:......(..lL ,��1 I ...1..944... ................................... Proposed Use ............ 'V. try ................. Lo,. ?.M......��? !'t. . !IU. yI............................. . ............. Zoning District —1. ..........Fire District � —� Name of Owner ...��bl .kl .... Q...............Address ....1. ..VV.! Name of Builder" l�oM�... .Rd�l(�. �/ . ............Address ..: Cb�... !!..1 ?.4�C�.W... r....Nt�.�.�,J�J!.1�'✓ Nameof Architect ..�Q.q ..................................................Address. ...............................:.................................................... Number of Rooms ..................................................................Foundation :....ID....... �7..... Exterior .. !k'.e...... .'.. .�j4� ................................:..Roofing ....C1 ?..!`�. . ......` �Ill" .......... AFloors .....©:�.�................................... .Interior St ...... . .... ............ Heating 'T ��AA��• CXl O.C1....................Plumbing 1`I EJVY � ft !:�f2 fv ....... Fireplace p �.! ...... ...........................................Approximate Cost ���.�� Definitive Plan Approved by Planning Board ________________________________19________. Area ......�.:77i... Diagram of Lot and Building with Dimensions Fee ca!':. SUBJECT TO APPROVAL OF BOARD OF HEALTH ? / /z AA;, 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 Lz"".4; ... .. . .... ................................ SCANLON, WAYNE 3 R ADDITION . ......... Permit No for .................................... Single Family Dwelling ............................................................................... Location 98 Dunaskin Road ................................................................ Centerville ............................................................................... Owner.......Wayn.e...Scanlon I... .. .. ....... .... ........................... Type of Construction .)�?�ame...................... . ................................................................................. Plot ......................... Lot ................................ April, 5, 82 Permit'Granted ........................................19 Date of,Inspection14-40-9-?....................................19/ Date Completed ..................... ....