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HomeMy WebLinkAbout0008 EBEN SMITH ROAD Z4 il� ,: I M '� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma �. �' Parcel'.: � � � - p Application # Health Division Date Issued Conservation Division_—° f Application Fee Planning Dept. Permit i Date Definitive Plan Approved by Planning Board Historic - OKH Preservation /Hyannis Project Street Address b` E 6en 1 Ymi �k IRO cCCV1�2rV\ Owner �' i P T-G c A Address 0 C keyi Srn 1 ?a Telephone 50 "-cam"y-�0 1 7y 7 Ce-vi teyyd1 r, IVA 0'2&32 Permit Request G✓t eY . S , ew��f h' ��J � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Pro'ect`V o Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Y Dwelling Type: Single Family �k Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No F 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 om Cott Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other _ Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wow coal sf9ve: 21,1,Yes ❑ No o Detached garage: ❑existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ xisting�;❑ nJ9v size_ .� r•n Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# `Current Use �Si PY1 � �^ " Proposed Use rk i 2 APPLICANT INFORMATION n , �/ (BUILDER OR HOMEOWNER) Name !V 4 c I tVsoviJ:krKP_ h1 YZyC wke h t Telephone Number Address TG box ay)( License# o d e(A)1 3 i 4kA OAO S 3 Home Improvement Contractor# Worker's Compensation # ( IC 6 y 1641 ' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO '11ni 2I s ecA.(.)iq C) Pais ,fq. 02(os SIGNATUR DATE t FOR OFFICIAL USE ONLY - APPLICATION# :DATE ISSUED MAP/PARCEL N0. T ADDRESS VILLAGE - Y ; OWNER 4 DATE OF INSPECTION:; } FOUNDATION(cl)Sot-a o►c ►ohof o i FRAME INSULATION FIREPLACE s ` ELECTRICAL: ROUGH FINAL Y - PLUMBING: ROUGH FINAL GAS: • ROUGH FINAL , FINAL BUILDING f DATE CLOSED OUT ASSOCIATION PLAN NO. r 4 LibertX Liberty Alutual Group mutum. P.O.Box 9090 iiLLLL Dover,M3 03921-9090 Telephone(800)653-7893 Fax(603)-245-5330 March 10,2008 TOWN OF BARNSTABLE ATTN:BLDG DEPT 200 MAI-NT STREET HYANNIS, MA 02601- RE: Certificate of Workers Compensation Insurance Insured: MCA"S LLC DBA NICKERSON HOME IMPROVEMENT PO BOX 2476 ORLEANS, MA 02653 Policy Number. WC2-31S-360989-018 Effective 3/1 /2008 `tt Expiration. 3/1/2009 ! Coverage afforded under Workers Compensation Law of the following state(s): MA Employers LiabBity Sole Proprietor/Partner Covera�Election Bodily Injury By Accident $100,000 Each Accident Bodily Injury by Disease: $ 100,000 Each Person Bodily Injury by Disease: $500,000 Policy Limits As of this.date,the above-referenced policyholder is insured by Liberty listed above. Mutual Fire Insurance Co under the policy The insurance afforded by the listed policy is subject to all the terms,exclusions and conditions,and is not altered by any'requireinent;term or condition of any or other documents with respect to which this certificate may be issued. This certficate,is issued as"a matter-of only and confers no right upon you,the certificate holder. Thrs certificate is not an insurance policy and does not amend extend,or alter the coverage afforded by the policy listed above. If this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such cancellation. AUTHORIZED R pRESENTATIVE LIBERTY MUTUAL INSURANCE CROUP This CeRiticate is executed by LIBERTY MUTUAL INS URANCE GROUP as respects such insurance as is afforded by those companies. cc'"Insured: hlC LLC Producer of Record DBA NICKERSON HOME_ alpROVEMENT ROGERS&GRAY INS AGCY INC PO BOA;2476 PO BOX 3700 ORLBANS, MA 02653 PLYMOUTH, MA 02361 3/10/?A08 The Commonwealth of Massachusetts/77 , Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 .� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLribly Name(Business/Organization/Individual): 1 C.TeySa yt Pp 1y. - V0 Q,(b y e ✓~ Address: City/State/Zip: 0r ,S, VA 6269 3 Phone#: 9�- ayG-3��1 Are you an employer?Check the appropriate box: Type of project(required): l6 _I am a employer with to er 4. 0 I am a general contractor,and I � 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition workingfor me in an capacity. employees and have workers' Y P t3'• 9. El Building addition i [No workers' comp.insurance comp.insurance. required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.D-Roof repairs insurance required.]t c. 152,§1(4),and we have no ' employees. [No workers' 13.�Other J)f'c. 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 subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: , Lltec �( Gt Policy#or Self-ins.Lic.M . �J( �- 3}S' 360S�"61 VExpiration Date: 3 h. City/State/Zip: V1 CvU�`I�e, G� 32 Job Site Address: f h S►'1'1 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 certify under the pains-and penalties of perjury that the information� provided red above is true and correct. Sienature — Date: 7,-1 SZ Phone# G D. 'f o- jC k/ 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- x 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 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 grounds 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 compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall 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 Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s) along with their certificate(s)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 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 confirmation 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 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. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant 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 year.Where a home owner or citizen is obtaining a license or permit not related io 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 Department of Industrial Accidents Office of Investigations 6.00 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 4.06 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass..gov/dia i ./1ZE'[grylTTiyllf)9Z6IJ2CL000L 4�✓Yla4aC�dLUde�b .. ,. Board of Building Regulations and Standards License or registration valid for individul use only '- HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: —_ _— Board of Building Regulations and Standards " Registration: 158855 One Ashburton Place Rm 1301 Expiration: -3/10/2010 Tr# 264989 Boston,Ma.02108 Type 'Individual DARYLE C JOSIE_.' DARYLE JOSIE 18 WOODBINE RD. � "`�°""'� No alid witho signature W.YARMOUTH,MA 02673 Administrator J1 x „ L s.n tandw ds GJ �u° m�ntegu anon * `Board of ervisor License t. 4 Construction Sup License: CS' 82304 t Tr 9177 1111812009 s ` Vv DARYL C JOSIE w _ DBINE RD r 18 WOO A 02673, ComTniss�oner f ` ' 6 s i/y YARMOUTH,-Me r n. rr Town of Barnstable Regulatory ServicesMM a Thomas F.Geiler,Director .`� 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 r�J c �t Ica h M 1 V'0 U C_ 0 g to act on my behalf, in all matters relative to work authorized bythis building permit application for. Vye Yx S"wk A'L V�j - Ce- I',- 1/1 (Address of Job) Signature of/Owner ate /c- Print N QTORM&OwNERPERMISSION ' s Dot tom` Low I to -4 S t 33o G.P 7. SE:F-nc TA"V- = 330,r U Ste- t 000 _tA5P05AL PIT uSE i ocao bat.• �r �`-iu,.di"`r ISM• fII -5,aEuJAIL AP-EA = c5o s.i=. i��o S� � 2.S s �"7S G.P.D. =2 O -• •� 0- --�� ��-{-- � __ So 405=. A 1 .4 O TOTAL. -C>ES16W = 42S G.RD. -r-oTA L t7/sI L-`1 FLOW = _ DEtZGDLATIol.1 CZATE (=�IU Zmlw'02 LESS. �•--•-•�� Pk� D iA t tit, M Z � •.l � Tor F•.to a too.o +'. Z 4-poi nlsr _— Iw. &A•L. 4L g I�Iv. !� �x �L'� Sc-�nc t o �' t TA&4K I000 �� 0 1wy ltry LeAc 1 iL L 4G G '. Pi T ,A , . _ �. WASHED STONE . lo.a C�QTtFiEL7 P LC)_r FPL.r4�1 - LOCATIotJ �EJrL-tea/its �.c� kCa L 1Jo � 1 ':0 f,(iaTE31 l CGrzT►P'­1 T1-lAT TNr- gVun, Ttofi 5uow►., :1=E.RatiIca �F-1�'t=Di�.I GcaNt('L�(S W ITF•i 'TI-IL; �jl D� t_lt••�� r Aut>. SC-T ACtC VGQUIQeAAE- T-; OP T1-+(-Z . Tow•w or~ T1 :�tcatJS"{"A� ' tZEGtStt2ct� 1�1.1G Suw�:�(oes TI-{I5 C7LAf-I I WOT Pu,4.SGID 01,J AN Q5TEv-VkL_I.G- A I r'dt__►-r' I i I 2000 SEP 30 AM 10. 10 UIV1S1 NICKERSON HOW, IMPROVEMENT, INC. 13 Cornwcrce Drive. P.O. 13ox 2•176 Urleaw, MA 02653 1'ta<niL;(5US)�aU-3t)K I I ux: (508)?y5-5107 F mail: markl?G�GS?i,r�).yah�ay.c�nn September 30. 2009 Town of Barnstable Building Department C:V -moo RE: Daryl .lii`iC O C To Whom It May Concern: rn This letter is to confirm that Daryl Josie is a lull Limo employee:of our company,that tic is also 'vered under our workman's comp intiurancc and that he is authorized to pull permits on our behalf. 'Thank you. Mark Dickerson Owner Dickerson FIomc lmprovement Z-d zoL9-99Z-905 uC&10)p!N )PeW eSb:OL g0 N de- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' Map / 71 Parcel Permit# � Health Division - Date Issued (V!( 2000 Conservation Division Feeo2S•©Q Tax Colle r Treasurer Planning Dep . ► Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village Owner -� �� �� ��fF W14 6 CCU 1/4 Address g C 6-e vl 5.1i� Telephone N Permit Request 1�®® a-t Square feet:: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation 2 10® Zoning District Flood Plain Groundwater Overlay 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) ' :dumber 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: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use q BUILDER INFORMATION Name Q CEO S Telephone Number Address DR b a License# 09 Co C'e Home Improvement Contractor# Is Io g E D Worker's Compensation.# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE h FOR OFFICIAL USE ONLY s T PEPtMIT NO. DATE ISSUED MAP/PARCEL NO. •°" i r F.Yy� 7 ADDRESS - VILLAGE' s OWNER " ;¢ °~ DATE OF INSPECTIONS , FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts =f=:t Department of Industrial Accidents , ..... -', ....- attics otlovesttgattons 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit �j��/ j ..../r/���� .... // locati n S City C�n C hone# 4 oI D k a 16 I am a homeowner performing all work ms'self. [�I am a sole proprietor and have no one working m anv ca achy %�/%//�%��%/G//�G�//%i '�i,'�'�G'�/1.�,0////l/iti �/////i'/��.�//////%////�//�%%�%%�///�O/�/%/%%///�%/%/%/iii>, I am an empioyez providing workers' compensation for my empioyees tivorldng an this job. comn�nv name: - address: :::-•:•..:•::.::........ ... phime city- insurance cn. I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below wile have the follo«1ng workers' compensation polices: :,._ :.:.. ... comannv name: address: - . :::.......... : :.:•....... ...::,:.:.:. hone city: - ::.:>:•:::::v:::v:.:. ............:?isi::::. •:.:'C:},-...}:}i::{:i:i?i::+::-0:.O:i?ii ii ii :::iii:":•iY....... ... - ................................ .... ..........:: .:}i:•:'t:ti:;k4YY�' i•?<i}:f..:?"YC;?i5:^:^':: insurance co. / ///1/iiir7. :... comnonv name: address: ...fione#:- cih7 _....... in3urnnce MIA co- Failure to secure coverage s,required under Section 25A of MGL 152 can lead to the imposition of criminal penaltin of a 8ne up to S1,S00.00 and/o one years'imprisonment as well as civil penalties in the.form of a STOP WORK ORDER and a tbie of S100.00 a day against me. I understand that a copv of this statement may be forwarded to the Office of Investigations of the DU for coverage vert8eattom. 1 do izereDv eerrify'under the and en es jperjury that the information provided above is true and correct Date Sielianire Vf lff0V �'Vr� x Phone# Print name �iIlci l use oniv do not write in this area to be completed by city or town official petittit/IIcense# ❑Building Department .' city or town: ❑Licensing Board - ❑Sdecanen's Ofnce rl check if immediate response is required ❑Health Department contact person: phone#; ❑Other ;S Information and Instructions assachusetts General Laws chapter 152 section 25 requires.all employers to provide workers' coupe�I for h=r M person in the service of another y employees. As quoted frown the `law ,an employee is defined as every 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 c2 the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receive: trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling 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 grounds c building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter,152 section 25 also states that every state or local licensing agency shall withhold the issuance or reneN of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who h. he not produced acceptable evidence of compliance with the insurance coverag�required.e�ormance of pu,bhn c wo urn.' commonwealth nor any of its political subdivisions shall eater into any contract have been resented to the contract acceptable evidence of compliance with the insurance requirements of this chapter p - authority. .. Applicants F the box that applies to your situation and �` - ► Please fill in the workers' compensation affidavit COmFY,�'checking l" supplying names,address and phone numbers along with a certificate of insurance as all affidavits may be <' Also be sure to sign and submitted to the Departzneat of Industrial Accidents for of insurance coverage. application for the emit or license is date the affidavit: The affidavit should be returned to the city or town that the app P Accidents. Should you have way questions regarding the"law"or if 5 c being requested,not the Departtiient- .Industrial lease rill the Department at the number listed below. are required to obtain* workers c+o®peosa�on PohcY,P City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of t affidavit for you to fiIl-out in the eveatthe Office of hivatigations, . nce has to cm tact you regarding the applicant Please be sure to fill lathe peimit/licease nxamber which will be used as a refere mimber. The affidavits may be rcurned to the Department by mail or FAX unless other arrau8®eats have been made. The Office of Investigations would like to thank you in advance for you 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 InvesUOadons - 600 Washington street _ Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 oft ram, The Town of Barnstable • BARNSTABLE, • 9� " ' Regulatory Services ATED MA't A Thomas F. Geiler, Director Building Division Ralph Crossen,Building Commissioner 367 Main Street,Hyannis MA 02601 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,p; - 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: 7QVfl Estimated Cost Q OQ Address of Work: G QVL �✓4 Owner's Name: Date of Application: qy -� fi 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: f Date , Contractor Name Registration No. OR Date Owner's Name ," q:forms:Afhdav fee � tuiealbi o��/�aaaaetivae� ' {i. BOARD OF BUILDING REGULATIONS : License: CONSTRUCTION SUPERVISOR ` Number:CS O48546 Btrdufate 01/27/1953 res•0 gT2002 Tr.no: 2084 ions on 4:. Restiicted To: l)Ei MARK D, HERBST:, _ ;r 35PEETTOADRD " E• CENTERVILLE, MA 02632 � ! , Administrator '} J 1 ,0 .-. ( 0 e 4... f o�,/l(aoeac>luwella HONE IHPROVEHEHT CONTRACTOR Registration 126480 ° Ezp cation: 06/08/2002 Type: Individual HARK HERBST HARK HERBST �o7 ta/ 35 PEEP TOAD RD. ADMINISTRATOR CENTERVILLE HA 02632, , , a = TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map Parcel ' Permit# I 1 Health Division Date Issued Conservation Division ` P Fee O / Tax Collectorwill Treasurer - Planning Dept. -, Date Definitive Plan Approved by Planning Board f � � Historic-OKH Preservation/Hyannis k Project Street Address Village lew> ` Owner Q i7 19 k ddress c .� ` ► Telephone t Permit Request -s Square feet: 1st floor:existing proposed d floY' o propo Total new Estimated Project Cos Zoning Distr' Groundwater Overlay Construction Type ll12) JCIt— Lot Size Gra fathered: Ye attach supporting documentation. DwellingType: Single Family C Two mil ❑ Multi-F m YP 9 Y YAge of Existing Structure Historic ouse: On Old King's Highway: ❑Yes C3-�d� Basement Type: ❑Full ❑Cra '` ❑Walk t 0 Ot ' Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) ` Number of Baths: Full:existing ew 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 0 Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing } New Existing wood/coal stove: ❑Yes 0 No Detached garage:0 existing 0 new 'size Pool:0 existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Author' ation ❑ Appeal# Recorded❑ Commercial ❑Yes o If yes,site plan review.# � y Current Use Proposed Use _ BUILDER INFORMATION Name J Telephone Number 0/6 . Address License# CO J U4 t; l � 1)o�(v 3 5� Home Improvement Contractor# Worker's.Compensation# 96 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1 . SIGNATURE d DATE _ 7 e - FOR'OFFICIAL USE ONLY P) MIT NO. DATE ISSUED' " ` s f ' •` •. - `, --• _ . " _t . MAP/PARCEL NO. n ADDRESS VILLAGE OWNER r 4z `".` ', • ' { - DATE OF INSPECTION . r , 3.• . r. a - y t�-,r. , ' FOUNDATION - Si y,y - - FRAME '. INSULATION FIREPLACE ` ELECTRICAL: ROUGH ►► FINAL ; PLUMBING: ROUGH FINAL GAS: ROUGH FINAL41 , FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. d --- -- The Commonwealth of Massachusetts Department of Industrial Accidents Office 911flYe5tf9z&9 is ' - 600 Washington Street t � Boston Mass. 02111 Workers' Comyensation Insurraanc�e/davit ////hair fE �F�/�11111M/U�1 �����,.,,,.... 7M name: location. t city � /r� yhone# ❑ I am a homeowner performing all work myself. + ❑ I am a sole proprietor and have no one working in anyMOM capacity (JQ I am an employer providing workers- compensation for my employees working on this job. comnnnv name: HZNE _ to-A INA;r/1 r i address: 1GD city: O Mir ^�� AA 3S phone#: G-.08,) 'll .1F 9S/� insurance co. 1 pniicv# W C $,9,-&(od 1 r ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follo«ing workers' compensation polices: camranv name: address: city phone#: insurnnce cn. Tloli&#.. .::.:;•:;:...... .;;,.:.;... camnanv name: address: city: phone insurance co. olity# . .......... Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tlne up to S1.500.00 and/or one yeah'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tlne of 3100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verilleation. I do herebv certify under the pains anddppennahies perjury that the information provided above is tru:and correct Signaturt��.�fi,-e�— Gam' Date 117"i � —0y - Print name r9 Ef)&icK- V. 1/'ii n A S C H Phone# ' (Q g' /Q SS/9' otticial use only do not write in this area to be completed by city or town otIIt�al sty or town: pertrtit/llcense tf ❑Building Department ❑Licensing Board ❑check if immediate mponse is required ❑Selectmen's OMce ❑Health Department (contact person: phone N; ❑Other (tevuea*95 PJA1. The Town of Barnstable : an A iuvsTasi.L - Department of Health Safety and Environmental Services jEo tips a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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. ' S Type of Work: Estimated Cost `J/�� �/'e� �� Address of Work: Owner's Name: Date of Application: —7 C `y� I hereby certify that: Registration is not required for the following reason(s): 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: o 6 Date Contractor Name (hpiz2i /bm_rxq,*egistration No. OR Date Owner's Name g1orms:Affidav •i t� MPRO,VEMEN � , IA Registration r CONiRACrOR ? Y lYPe 1.00140 BOARD OF BUILDING REGULATIONS ,License CONSTRUCTION:SUPERVISOR ; PRIVATE 'CORPORATI ExPlrath n , ON 23/pp Number GCS 051032 s CAPIZzI HOME:. �` r 4;, lI Birthd�te +09/26/1�9¢3: 'GXe�;� �: as IMPROVEMENT,,'I�VC r°} ;� BzPir�s ,49/26/�POI Tr.,no: .57a2 Aoki � CaPl.zz1, rk } h j NISTRATOR _: 1645:Newton Rd CC °`< R�astricrte +To._'UQ. CQt 7 ? �' i u1 t MA 02b35 t y THOMAS X CAPI7 I JR` ' 280 PERCIVAL W BARNSTABLE, MA 02668' Admmistcator �T `�1, _fee -(7a�rvrna�uued o G��avaac/zuvelYd �� T�i DEPRRTNENT OF°PUBLIC .SAFETY t OEPARTNENT OF PUBLIC.SAFETY CONSTRUCTTON SUPERVISOR`LIC-'NSE, R k CONSTRUCTION SUPERVISOR LICENSE' . ,� Expires.. B rthhte; : Number Ex ices, eirthdate: l' F Number : P i CS B0745 02(24(200@ 02(24(194A r CS 91�149: 0,2104/2002 02/04/1956 . 4 Restricted To: 00 I 1 {f 'yS IZ I .i TIIONA ?-CAP �� V R;9�S�CH�LI�I�- FREOER� •. - ',9 1060 B0000:'00 , :S r' COTUIT'; NR ,02635 . ,I PLYNOUTH, NA f i °Ft Town of Barnstable Regulatory Services r r ` BARNSPAB[.B. " Thomas F.Geiler,Director MASS. 16;o.�A � Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 DATE: September 20,2000 TO: Mary Blake,Assistant Town Accountant FROM: Kathy Maloney,Office Assistant RE: Refund of permit fees Attached is a letter requesting a refund of a building permit fee. The permit was never exercised and has now been voided. Copies of the canceled check and voided permit are attached. Please let me know if you need any additional information. cc: Carol Smith refund l I CAPIZZI HOME IMPROVEMENT 1645 Newtown Road, Cotuit, MA 02635 -(508) 428-9518 1 (800) 262-5060 Fax: (508) 420-2164 September 15, 2000 Kathy Maloney BARNSTABLE BUILDING DEPT. 367 Main Street Hyannis, MA 02601 RE: SALTALAMACCHIA—8 EBEN SMITH ROAD, CENTERVILLE REQUEST FOR REFUND ON PERMIT—JOB NO. 20870 Dear Kathy: I wish to request a reimbursement for the above noted permit issued back in July 2000, due to the fact that the client decided to cancel his roofing job. The total amount paid for the permit was $30.89 via check no. 20335, a copy of which is enclosed. Please note that this check was written for two permits: #1)Mr. Callahan for$25.97 and Mr. Saltalamacchia for$30.89. Please.forward the refund check to my attention. Your help in expediting this refund is greatly appreciated and, as always, it was nice to talk with you. Please feel free to call me with any questions you may have. Sincerely yours, Carol Smith Production Marketing Ass't. /cas Enclosure I ' QUERY PERMITS::, QUERY END QUERY PERMITS PENTAMATION-=-------------------------------------------------------- 09/20/00 PERMIT NUMBER 47514 PARCEL ID 171 153 8 EBEN SMITH ROAD PERMIT TYPE BROOF BUILDING PERMIT ROOFING DESCRIPTION STRIP/REROOF APPROX .26 SQ. CONTRACTOR PERMIT FEE 30. 89 VARIANCE STATUS 0 PERMIT VOID/FEE REFUNDED CONSTRUCTION TYPE 434 GROUP TYPE 1 APPLICATION 07/19/2000 EXPIRATION VALUATION 9964 .00 DATE ISSUED 07/19/2000 COMPLETED DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P)REVIOUS/ (C)ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ FEES/ (A) RCHITECTS/ (V) IOLATION/ (E)XIT This value is not among the valid possibilities PENTAMATION-------------------------------------------------------------09/20/00 PERMIT NO 47514 PARCEL ID 171 153 8 EBEN SMITH ROAD PERMIT TYPE BROOF DESCRIPTION FEE CODE FLAT/BASE FEE TOTAL UNIT COST AMOUNT PAID RESVALUE 0. 00 30. 89 30. 89 TOTAL CHARGES FOR PERMIT 30. 89 CTRL-0 UNITS CHARGED/ CTRL-W PAYMENTS/ CTRL-V VALUATION/OTHER UNITS/ ESC EXIT S CH CK IS IN PAYMENT OF THE FOLLOWING: CAPIZZU HOME IMPROVEMENT, INC. _ 20335 1645 NEWTOWN RD. GOTUR,MA 02635 *(508)428-9518 5-39/110 . BANK BOSTON l 'PAY1 I DOLLARS DATE CHECK'NO. AMOUNT TO THE .��-/C�� /.. /L nZI�33-r ORDER OF AUTHORIZED SIGNATURE 0'0 20 3 3 Sit' 401 1000 3901: S 39,,1 2 LSO SO 000000 S68611' I ', CL C) O .m 1 I to C,.La` o 6bLSQ.C.T T O< .L . Avg 003 3d'd3 O m CIE-0a' R 1 Q - n' �C=3.0 . __ 133"13 WO GArZ7B aC--- <RI�bEJZ TadIL�4 Flow _ tic) x 3 = 330 G-P•D• rL r r Seap"c T41K- = 330,r ISo % * 4-95 6-P0. USA- l 00o Sa L.. -t)ISpoSAL PIT USE loon GAS. for `tl -'UGU 4.LL AIZE.A = l50 A .4 •307TOAA /12FA= E�O SF-. N i o rr 0 SO fOF7. A TOTAL -SIG►.I = 4SS 6..P.D. 'roTo t_ IDAt L>-( FLow = 33D 6.PD. 0 :z 35 =— i Mf1GDLATIOLJ QQTE. : CIU SMiW* oiz LASS.( t v i BAY rFji �� '• t-lOt. z{p s qj?t .. 4- ;T7r�Gr�`T i.`�i.,.. 4 P/vim ITO I ooc� I IW Z -Box SePnc wv T-Aww- 1000 9("o jyy tw. GAL. 9/",- 9G LEAD 6-1 FlT was►aa� STONE 90,0 CE2TlF►Et7 pLC:,-r PL. 4t.3 l t , LOCAT I O" CEIJYI-Z-✓I L LL-T 5-g A L C- I I h ®� b AT t~ r � /so 1 . 4} t I~E ti.t cam. 1 CGtZTtE=-{ T�4AT T14c-- �;)uQ1 Ai"IOa 5uawu J4ZjZLn►J GC�VlPL\(S \A/ IT14 TOi1: 51vEa►-tom - 2.13 .&LIED SETOACV VG4ulQGAA&. iTS OP TNT �ow►.� of ,�rLtJST � 1� �tL ( t�•t L,,4, cZcGISrLIZ�D l:J�\wo 5uzva. oc?S T%415 PLA►-J lam, WOT Z-ASEL7 G o MASS, IIJSfC;JMC_tJ i �iUc_�/t_�{ - Tt{L, UFt=i�=f°► SNGWIn APPLI C_APJT ` r� r xerrx- ►' - t1ra1'I' V tr.Wl.� Le�T l_tWCE:'; ALA IV ;m4- ^, loc.. dip ��'"` • TOWN OF BARNSTABLE 22139 e Permit No. ------------ - Building Inspector 1 lAW"Ao Cash - - -_.— ' !s�9 OCCUPANCY PERMIT Bond ----- ` S/ No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to A.Ian E. Smell Address Centerville r lot #293 8 Ellen Smith Road, ienterville Wiring Inspector ;// .� �"� Inspection date Plumbing Inspector, i. Inspection date y` Gas Inspector 1� 'rf Inspection date Engineering Department p Y � Inspection date lod 4/A i 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. r 19 Building Inspector Asseeisor_s Iinap and lot numb ........ --................................. -• ©e 406z. :� y�F THE TO SEPTIC SYSTEM Q Sewage Permit number ... .....F....... ............................. STEM MU o� INSTALLED IN COMPL sTLBLE, i House number, ..7�.......... ............................................... T v rnea a WITH TITLE 5 00 0 3 q. \00 EAMRONMENTAL CODE aY TOWN OF BARNS11M'!M wno�s a . BUILDING, . INSPECTOR APPLICATION FOR PERMIT TO .... "'............:.... :.....................................................................................:.. TYPEr OF CONSTRUCTION ..................................................................................................................................... �. �......... r.. ........� . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following inf rmatio Location ...Z.. 3 ........ . . .. .... ..4e . ProposedUse ...../y�f ..................... ....................................................................................................................................... ZoningDistrict ........................................................................Fire District •.............................................................................. Nameof Owner I .................Address ............................................... Name of Builder ........Address .Name of Architect ...:..............................................................Address .......... ............... .. ................................................ Numberof Rooms ......,J......... ................................................Foundation .......................................................... Exierior�... ............................Roofing ...... .... ..................................................................... Floors Interior .. ... ... . _ ........................................... ......... Heating /: .- ':'.-/.. ...........................:.::..............:Plumbing-'� : Fireplace .......Approximate Cost Definitive Plan Approved by P Zing Board _______________________________19________. Area ,l.9..o O� Diagram of Lot and Building with Dimensions Fee. . ............ ................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH4. I b IJ� i . I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg ding the above construction. Name r . ..............:.............................................. , SMALL, ALAN E. 22139 Permit forStory One N� . single... amily„Dwel ling........... t Location IaO ... 9. ...$...ki ? ...$lpth„Road s ....Geritexvil.le............... . Owner ..Ala]3...E..... ........ .......: i Type of Construction ....k'rame......................... f ................................................. ........................... Plot ............................ Lot................................. 1_ Zr r Permit �Granted ......... ........19 80 { . Date of Inspection ... ... ........ ..................19 �a ' Date Complet .� 19�� ti PERMIT REFUSED {�� ....�.. ' 19 ....... . ............................................... r I . .. . ............................................. ... ?. ............................................. .................... . R............................................. ' Approved ....:..,,q..................................... 19 ................................................................ . .................... ......................................................... k Assessor's map,and lot number- fOfTHET� Sewage Permit number'. g .................. �..:.............:.............. ro - � i . BARISTADLE, i House number ........ ......... - 9 - MARL .. � pb Ito MO� t A TOWN OF BARNSTABLE , .. . BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...: .....::°. `... TYPE OF CONSTRUCTION ,. .............................................................. ..................................... ... ................ ..19........ TO THE INSPECTOR OF BUILDINGS: li The undersigned hereby applies for a permit according to the following information: Ak- 1 } ° Location ..... ................................ ........ ".... :.. .... � �.'... .�... ....... .........` '.. 1.. . .. ?,.` .................................� r ProposedUse .........� ?:! `'... ....`~ ..................................................................................................................................... Zoning District .:......................................................................Fire ,District Name of Owner ............................................r� ...........................P �f�`;".� , . Address ............ ......... ��'........ ......... f ..�..... ..................................... s Nameof Builder .............'.......................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................Foundation J Exierior .................................................Roofing .....rw. Floors .......... :x.....t,f`.................................................................. Interior ...,��6 ....................................................... If Heating ..... ..... i..'..... ...................................................Plumbing ,. I„ ;........................................... Fireplace ...............Approximate Cost ..... r, 71 Definitive Plan Approved by Planning Board ________________________________19________. Area ..... Diagram of Lot and Building with Dimensions -' "- ��" Fee ...........;� ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...:........................ ................................................... A=171-153 SMALL, ALAN E.; -_ eY Wo _..2 213 9 Perrr4�t for jiP!ae...S PU............ Single Family Dwelling............ . .....................................1....................... Location Jigt...#.2.V 3 8 Ebert Road . ....................... .................... .................!�gX11;,qgville .............................................. Owner .......IATX..g�t....Sm.a.1.1............................ Type of Construction F.KAMP............................ ......................................../....................................... Plot ............................ Lot................................. Permit Granted ....-...Apr. .1...2.2.y........19 80 Date of Inspectio n . .................19 Date Completed . ..................................19 ,P/EIRMIT REFUSED ...................................... ...... ...Y .......... 19 ....... .... ...... j .... .................... ............................................................................... ................................................................... ............................................................:........... Approved .............................................. 19 ....................... .......... .............................. ................................................ �� Assessrs"offioe (1sf floor)- ryry FtN¢ -y Assessor's map and lot number ...�.l�....� �. .. .,.... Pam° Board of Health (3rd floor): a' Sewage Permif number ..... .... ` .. � ... a..1.1 : 13ARNSTADL6, Engineering Department (3rd floor): �i n 'oo rb 9. \0° � . House number . d .. 3 e.•e ............................... O ppV APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only G7Z a9� f TOWN OF BARNSTABLE y BUILDING INSPECTOR 1. APPLICATION FOR PERMIT TO ...�� ..Q .. TYPE OF`CONSTRUCTION ....! .071 .. t......................................................................................... c .............�14 .....................19.ff TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..........g......... L i...... ......W ............6 ProposedUse ...9 ....64................................................................................................................................ Zoning District ............................................Fire District .................................................. (� Name of Owner: ...-Ofit.W.AkI.Address ...e'1....... .......11.1.uw...... .. . Name of Builder .(fir... . Address .... !1..........0".. ,.4[..... Name of Archit ct .. 7\ -.............................................Address ................ Number of Rooms ....CJ.!...................................................Foundation ,. ".... fJi' u .......•�! ' d... ExteriorG......... Roofing .... . .. . ..oft ••......................I.............................. Floors ...........................................................Interior .....G1..Y-?.................................................................... Heating ...../)q 1y1`!............................................................Plumbing Yl ..................................................................... Fireplace ..................................................................................Approximate Cost .J�dr. d„d ..................................... Definitive Plan Approved by Planning Board ---------------------_----------19-------- . Area . .X..�....=... . , ...r7 Diagram of Lot and Building with Dimensions Fee .... ....... ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH T/c. a rl � M 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 . ... ��L-:.Q.....�/r`� � Construction Supervisor's Lice`se, .Q.1 ..7 ... . 5 1 SALOMAKI , DAVID r No .31920. Permit for ..Enclose Porch .....,,.,,Single Family Dwelling Location .....8.,,Eben Smith Road ............................................ .......................Ce,ntervi l le ...................................... Owner ....David Salomaki ........................................... Type of Construction ..,.Frame t ......................... .......... .................................................................... Plot ............................ Lot ................................ Permit Granted .......May...2.��...............19 88 Date of Inspection ....................................19 Date Completed ......................................19 " Y 1' 1=Low _ Ito v 3 = 330 G. �C�T-►;C T -11C = 33�,r (SG % • 4-9 5 6.P.D. � pt5Po5 Ds PtT - USE t o0o Gal-. IL P ( t TOT'J1 C.. hSlGt.l = -,125 ToT6 t_ 7 i 1�.t2GDL�T10tJ t`'AT� C,U Z/v(IU� Otz LI✓SS. �.1 � i--- - t---i.`.__ •1 � �� Ib~UOfI •, I l L` T' I�ST A' ?,e• �;•` rl Tor 1-uo 61 4'PPP- DK•1' / -BOJ( fit/ v SeQrtc WV. J TA�.1K � 4,• r � - . . i 000 �� ' tt.,v. t►rv. LEaca _ PIT �'- (� WASWED - STO.it= C��TtiFtED r° PLOT'" PL./� I_ PQo�I�� LoCATID*J Cc��T ✓ It: :; 4�F_it't=t�1,1 GC�ti�PL�(S _ W MA -SIDE t_1►-►t= �"� -���3 ¢ A1.1D �ETt�>�CbC_ a[Qut�GAAE-. -1Ty GF TNT. C)A r fj,�t '-.s !, .��^ `� f✓` � BQy.TCtZ . It,1G ° r . �+ REGtS ►ZnED t1�IJG 5U2v`�fo� T1��4 C? Ll.tif UUT L'.A->CL7 U�•� A`J aSTEC�/1L<L v A titSS, Ii.1�Ci J •�t=►�t� ��� _.ii_ 1711 y X T+1� c��c., �; Stic;wt� _A1� LIGAtiJT_ ,- _ - ~ lam �7T (_tN •� Assessor's offioe Ost floor): '"M MU HE Assessor's map and lot number ...1../.1..�.11y �� Bodrd of Health (3rd floor): �rnrl - h Sewage Permit number ... ... .._���.. .:t!(l.!.I �11 �i: .-;. . .�. >. v ULE. • E:gineering Department (3rd floor): �/� / 9WIRCH `g =�'�TAL C� ............:1.!.'1.// 1639 0� � House number ................................ . . ..... T � �,EG►UL.�►Tlt� o APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only 9� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...C�X%a !Lu....,..... .. v!... ./ ..Q? L..... �`J�..lt.� ... � � .. .. .... ... TYPE OF CONSTRUCTION c ............. 19. U TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for permit according to the following information: ` , y� 14 Location ...........S......... .. ....... .......' /j/YWVII .............. ..........r... ................................ ProposedUse .... ....& ................................................................................................................................ ZoningDistrict ....yy......................................................................Fire District ..............................)......... ... ................................... Name of Owner'!.:"`:c � ..,719�.Q 1'Address � ...,,,...! .. .. —„G..v .... Name of Builder . .... /J v`' ... .....................................Address �` ...f�.�:........ t ..... .............................. ` Nameof Archite .. � .N .............................................Address .................................................................................... Number of Rooms ....O?,.` ...............................................Foundation . ............. ...... Oj! .r.... .. Exlerior �!!�. .�-........al'4. ,z..........................................Roofing ..... .... . .. ... ......................................................... Floors .......... ...........................................................................Interior ......l f......................................................................... Heating ..... .........................................................Plumbing ................................................................ Fireplace ..Approximate Cost �0- ...............................u.......... 1:7 Definitive Plan Approved by Planning Board ---------------------- --------19________ . Area .. Diagram of Lot and Building with Dimensions �. Fee ..................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH PAC N PIT r S��AN�y i , 1D � 35- r X �SriN MO0,5Z -33 a � M 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 . Q....... Construction Supervisor's license .�.J... .f......p....... SALQMAkI DAVID MR. & MRS. L--f-N'o ,31920 Permit for ..Enclose, Po.r.c.h .. .... Porch . .. .....Sin le....F ami 1 v...DY.e.l.l.i.n.q.......... Locaiio-n .....8...E.b.en...Smith....Road................ .. .. ..... ....... .... .... ..... Centerville ..................................................................... ......... Owner ..Da.V.id....Sa...l.....om.....ak.i................................ .. .... . .. A Type"of Construction, ...Frame......... ...... ................. .. .. . . . ............... . . ...... . . ........... .................................. Plot ............................ Lot ................................ IJ May 20 , 88 Permit,Granted ....... ....................... .........19 601:'te of-inspection .................................. .19 Date Completed ..........L/z'u,/O/**�.......19 e-2 141 LIZ S-rEP e-p* 0(11 01 e J -S T-F,- P 77 tv PLANS BY ORME REIW{ . 20 SOUTH EAST STREETL F.-A,`-,-',-HAM, MA 02642 508-255-W9 &�Ey sly) rtl