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Home My WebLink About0017 EBEN SMITH ROAD — � (7� v V — i 1 'N ��{ '° .� . .: .. .a . . u . � � . . �� _ 4., .. � y. .. �u .:. ., � .. ..� `.. .{. .,� .o ,..a♦„ e l .. � .: ,. 11 .. � ,. V . � � � .. I� a .. � .. ,. o .. a o ;, „� n J. «t _ ... r t r Town of Barnstable *Permit 4"�1660 q 5) 8 Expires 6monthsJj issue date Regulatory Services Fee MASS as F.Geiler,Director ' 165 ESS PERN91iding Division NOV o g 200§ Tom Perry,CBO, Building Commissioner 00 Main Street,Hyannis,MA 02601 N OF SARNSTA`�town.barnstable.ma.us Office: 508-862�®S� Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint p/parcel Number/7/ — A 1,01W Periy Address 17 Residential Value of Work /`J- Minimum fee of$25.00 for work under$6000.00 mer's Name&Address �.�D n/r~ �::LrL2 1 Z 0 IF� ntractor's Name LF Telephone Number ")OFF me Improvement Contractor License#(if applicable) nstruction Supervisor's License#(if applicable) Workman's Compensation Insurance Check one: VI am a sole proprietor am the Homeowner ❑ I have Worker's.Compensation Insurance urance Company Name Aman's Comp.Policy# py of Insurance Compliance Certificate must be on file. .-mit Request(check box). ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Mooie-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: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contras License is required. GNATURE: 'onns:expmtrg dse071405 The Commonwealth of Massachusetts [ [ Department of Industrial Accidents i �,"'11 f Office of Investigations Uri! g {rrr J 600 Washington Street � r 4 Boston, MA 02111 «f-V4 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Larne(Business/Organization/Individual): �jJ� y'121 /72q Address: 17 695A] 7# A6 ;ity/State/Zip: ' _7APF_0Lh&_r tVZ&1 Z Phone#: Si* !�2 — 7Z/2 ire you an employer? Check the appropriate box: Type of project(required): ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the•sub-contractors ❑ I am a sole proprietor or partner- listed on the attached sheet. $ ❑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 aired.] officers have exercised their 10.❑Electrical repairs or additions 211 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp.insurance required.] ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. [omeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Dntractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. rm an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site formation. surance Company Name: dicy#or Self-ins.Lic.#: Expiration Date: b Site Address: City/State/Zip: ttach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). d1ure to secure coverage as required under Section 25A of MGL c. 152.can lead to the imposition of criminal penalties of a ie 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 up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of vestigations of the DIA for insurance coverage verification. to hereby certif er the pains and penalti f perjury that the information provided a ove is rue and correct. ature: Date: O lone#: 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 Contact Person: Phone#: °FIle, � Town of Barnstable *Permit Expires 6 months fro issue date Regulatory Services Fee 9� KASS• �� Thomas F.Geller,Director s639• AIEo �� Building Division Tom Perry, Building Commissioner �� d 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 F E B 2004 Fax: 508 790-6230 EXPRESS PERNIIT APPLICATION - RESIDENT- &bOff&ARNSTAB Not Valid without Red X Press Imprint Map/parcel Number t 7 1 16 1 c Address �� 4e Property Ad . Residential Value of Work 10/o�)S-+ b . �- cal tV1 -t'h� Owner's Name&Address ►, Ct e \ C� eA Contracto is Name_ 1��L e��S� Telephone Number 6 b5X 4 4 D Home Improvement Contractor License#(if applicable) a,ID 4�d2) Construction Supervisor's License#(if applicable) C>HISS S A b ❑workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner G-Thave Worker's Compensation Insurance Insurance Company Name Workam's Comp.Policy# Permit Request(check box) a6 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: Pro rty 0 er m t si Property Owner Letter of Permission. H e Imp vem t C actors License is required. Signature . Q:Forms:expmtrg Isg ..',w,}x'S xs-..f y MARK HERBST 35 Peep Toad Rd. r '� `g � ' Centerville MA 02632 zil (5 08) 420 62 -64 PROPOSAL SNRT1'EO :,,, PERFORMED AT: Florence Smith r . SAME 17 Eben Smith RdM Centerville 11IA 02632 T y 11 5 �K,508-428-7219 We herby propose to furnish the;materials and p t orthe�la o pecessary for eyr� completion of the following; ty a ` " RuA=e all j:z�ping boots t ridges install cobra vent to r Counter All debris cleaned daily Price includes m t rial, labor dt�mn .p.c � - All material is guarnateed to be as specified,and above o ed.i �{ accordance with specifications submitted for above,and cp tec� a substna workmanlike manner for the sum of Six-Thousand Two-Hu'ndred�&Seven Five=: Dollars($6,275.00)with payments as follows;full amount due upon compleV. tions Any#gteration(s)from above.involving extra costs will be added under w n '� ��agreemeht4 and becom n extr c e over and above signed estimate/ag�e��me � W RESPECTFU S R N� r y -Signature ,r Y5 1 S'T} .�... CCEPTANCE OF PROPOSAL yr' The above prices specification& conditions are satisfactory,we herby aceept r you are authoriz do the work, and p meats will be as specified above. Signature(s) Date: a * This propo al may be withdrawn by said company if not accepted within 30 days 9 F� - r v4 ai- O I 6T i�o'n�na�u a/�C a�✓ aaaac�ucae d BOARD OF BUILDING REGULATIONS License STRUCTION SUPERVISOR . Num!be 048546 BarWdate37219J3 _' Wllpa.W ft,q fiv- 06 Tr.no: 13404 ResSkfe r MARK D HERBS ' 35 PE ET TOAD RD � � CENTERVILLE, MA 02--3'L' Administrator i . Board or dia SOME/MRb;V Regulations a ti nd Sta RiSftra rb 1 MEIyT CANT d$rds r f 6 64g0 RgCTpR MARKHERBSTdu j divi• a!35pFEP REST i. CF NTERVILLE.Mq 02632> `- Ad�u�strat or Assessors map and lot number A r D .�i!'�.�M�t.. .....�. .......... THE 7- rr �pf toy Sewage Permit number ....�✓. ...................................... �,`` � a� I Z 33A"STLELE, i House number ....................... .... �.!............................. 90 rhea r q oe�1639. 00' 'Fp MAY a\ > TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ?'. 1................................................................................................... r TYPEOF CONSTRUCTION ........... .................................................... ................................................. .... 19 ..::... TO THE INSPECTOR OF BUILDINGS: _4 The undersigned hereby applies for a permit according to the following information. Location .....1�?` �: ........ •. .... f.......{: ? ? �� ?. .................... r T .............................................................................. Proposed Use ...... ZoningDistrict .......... ................... .....................................Fire District ....... ... ..... ...................... / ! •• �. � Name of Owner ... l !!( lz '�-�" ....................... .Address ........: .... �� !r ! ... . ...... ............................................ . Name of Builder ........ ...:...............Address Nameof Architect ..................................................................Address_..................................................................................... / r Number of Rooms ..........:�..................................................Foundation l - .,!a°' r.................................................. Exterior ....,. ......................Roofing .....j ` ' ................... ...::.......�� - Floors .................. ......,.... .Interior A/ Heating ..........................................................Plumbing Fireplace ......... :?. r , �.��? 1................................Approximate Cost .....� f i %f�. ............................. Definitive Plan Approved by Planning Board ________________________________19________. Area ... ..'?`..................... Diagram of Lot and Building with Dimensions Fee -p �� s SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. I Name ......... ...... / -:, ........... '..:�:.. .-<_.::...:..a,3L.':.1ai1..Y«{U.•�:._.v.e,..1.a......rs..z.i�:�ir:�...,.�i r.�'w ...\.="'1L.�.cJ .._D.� ,ate%� ...,..L.-�.:.:. ��..;....,.-..c_�,.:..-.t.. -...-... .. ......,_ .....:...... _-..1�:..._... ... i I SMALL, ALAN No ..2.2.3.6.7.-Permit for QAQ..35.t.S?rY............. ........singLe...Family. ..Dw.e.11.ing............. Location Lat...2.6.R...#17... Centerville ............................................................................... Owner ...Alan...Small....................................... .. ....... Type of ConstructJh Frame............................ .................I............./... .......I.................................. Plot ........ ...... Lot ................................ Permit Granted ......July....24 , 19 80 Date of In I tion ...pec .................................19 Date Coi7rpleted ......................................19 PERMIT REFUSED ......................./.................... . 119 ............................. ............................................ ...............I................................................"*"******* .............I............................................................... Approved ................................................ 19 .......... ................................................................ .................... .........I................................................ TOWPT.OF BA°RPTSTABLE permit iNo ----� c E Buil du Inspector x � f 9�aarr.ac x : .; Cash n t: log OCCUP CY PERMIT -- — Bond _ X >' .,.``No ,building'nor structure.shall .b'e erected and'no`lai i ' buildiii structure ahal be' used`for a new; different>changed,.'or enlarged ruse?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 tli�e:Building Inspector r, t Issued to Alan Small r Address ' Lot 268' ,#!T.:Eben Smith jRoad Ceftterv%l]e Wiring F ._ Inspection date Ile Inspector �. r ' f.G s''. �f inbin Inspector gP� Inspection date Plu Gas Inspector " �; Inspection date Engineering Department, Inspection date THIS PERMIT'WILL' NOT-BE.VALID,-,AND' THE BUILDING.SHALL NOT BE OCCUPIED UNTIL. SIGNED BY THE--BUILDING:YINSPECTOR UPON", SATISFACTORY COMPLIANCE WITH TOWN -. REQUIREMENTS 19 .._ .............. ...... ... . ' Building Inspector l7�-�i�=•tom! '[�s1�`1`1-�,---___..._.._-----• - • �� r,r"„�., �=jll �L� Gl�M.tL4 - �� r?�iZLaf>AA „ OCy ��`��jjj � Iadlt_•�•( e=Lc:w _ It0 x 3 _ �3co G.P•t). 975=� .��. . _ r N + •PA U5�- l OcOC� tS�S.L � may, L\ 9 T v Y bISPCxA� PIT - uSE I0000 G� . 4� ✓y li `• . 1.1 �{17E1C/dt� AeLLA = (S0 S.F. _ { ,., `� GiIA \� ��M 97 ti,Z rJ¢a4 I�j•J �jrfiC 'Z..S • �S �'.P.D. `�� cJG.$ �"'w garro�st Ae� —SP. TOTAL �ES16tJ = 425 G•P.D. ``LCp� pDU� 91•& t7Ef1GDL&TXOLJ tZ&TE Ct" SM11J. OCZ LF-SS. 114� . 91?I Ter 17'.4 o L 4 to o.c, - FG• 9B -, - � o= 77 0 44 Prv� .. ..aiin tuv 4&o r + t4" S IW 6^L. Qs8 .; ��esol -Box 95 G SEvncjwQy,Z QS4 Q. w S,a.cXy f LAN A PIT e, WAs,•+ED r, ,�,aa1� Ct=C�TIFtEC7 pl_bT' PL./11� - P2.o>~'t L� L hGA T i U tJ �E�T�•/�C..i-� F =65 IZ. Uo Sc[aLC— SCALC— do WjkTgZ pt AI_I Ri_t=t---V_aV lc� t; Gt;tz-rn=,{ TtAAT TI-iC= FoutilUil-�'Iat�i 54tc�v►.1 1 IF.I:t_r5�,1 GclPt_�l5 W tTC� TC-1`: StD .Lit-�E; LaT 'ZCo3 aun {cTt�>nclC �'r4t,t�CNc�uTS o� -rN� -ro w w oF' PA'TC , to ea B/t)(TcVZ_ I."C- tze I S rci,EU tJ�tJ D StJ eve=`(o lzS `(�1dlS I7t_A1�I I LJOT A$2 L_t GA.b.J_r' C ; r e,t l •C_�'� 'j"�, t7 r.: l L��rVl t�.l�, t_n c l._I F�t _ l�LA a G �'AA A 1-4- G.tC. /2 sor's map and lot num r ......./. ... ...................... ee A s QuoF Te o�y , Sewage Permit number .... .. � _7 SEMC SYSTEM MUST INST®��' p� � J �i�•o 'N COIYI�LfA • �HH9T1►DLE, i :•'} House number ....................... ....�7............................ WITH TITLE 5 'moo 1639 ENVIRONMENTAL CODE OM TOWN OF B:A R N S'PAj3qqqK,4TIONS BUILDING 1I.NSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ........ ................................... ................ ................................................. .. ..... .................9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit acco ing to the following info ation: Location ..... .. 1� ......... .. ........... p....... .... ....... ..... .......................; ......... ProposedUse .....` .......... .................................................................................................................................... ZoningDistrict ........ .... ......................................Fire District ...... ..........�.................... .............................. Nameof Owner ....�ZL..............................................Address ......................... ............................. Name of Builder ......... .....................................Address .Name of Architect ..................................................................Address ..................................... .............................................. Numberof Roo ........�..................................................Foundation ....... . .. ...... :. ............................................. Exterior ... ... ....................................Roofing ..... .... . ........... d_� .................. . .................... Floors ........�!%Lei''` ............................................................Interior .. . ... ... .. .... .... .:.............................. ... ....................................:......Plumbing .....71.. . ................. ........................................ Fireplace .......... .. Approximate Cost ..... . .................. ................................ `` Definitive Plan Approved by Plannin Board ________________________________19________. Area fP.J r- Diagram of Lot and Building with Dimensions Fee `? SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg ing the above construction. Nam' . .. .................................... SMALL, ALAN "�~- '"Permit— for { 119...5.t�r.Y............ ' r � . ^ - ` ... ' ..Dwelling................. Location ..L.ot...2G8....#l.7...Ebe��_ d'S� tb_I�»ad Centerville --------------------------. Alan Small Owner ------.--.------------. ^ nu Type of [onc,rudion --Fr�---e----_----. ' ' > --------------------------. . . - ( Mct`--.—'�----. Lot ................................ ` ' ' ' Pannh Granted ......... ...2.4............. P 80 � Date of Inspection - ---iA ~ ^��_�� .` Done Completed ..�.�v�'��.��-�---'lg ~ \ ' f*IPERMIT REFUSED lV ' 0 _ ........ .- � ~~ | / .................................................. �= ................... ` ` ' | ' . 0' --~-' ' / FZ �� lg ' p`pprove�^-- ------------. | ---------------.-----~-..--, ' | ............................. ....-.-.. / . ~ . � �,