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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION,
Map �L Parcel 6 �' z Application
Health Division " = Date Issued
Conservation Division a17 Application Fee "
Planning Dept. ' Permit Fee
Date Definitive Plan.'Approved by Planning Board E12 `0,rev_
Historic - OKH Preservation/Hyannis
'
Project Street Address e) e-2 r
Village /�
Owner LT /" Address��
Telephone J 6 D
Permit Request rW r P-X0 kh 61�
Square feet: 1 st floor: existing op proposed 2nd floor: existing proposed Total hew
Zoning District Flood Plain Groundwater Overlay
.�1 J Type
T e
-- Project Valuation
/ N
Lot Size 6 hHS Grandfathered: ❑Yes ❑ No If yes, attach suPr portin0-documentation:
Dwelling Type: Single Family, 9/ Two Family ❑ Multi-Family(# units) '
Age of Existing Structure Historic House: ❑Yes L<o On Old Kin Highws�: ❑des ®-N6"
ail �Tll
Basement Type: l ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) /3 6 Basement Unfinished Area(sq. )
Number 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 3
Heat Type and Fuel: 91Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes Uglb Fireplaces: Existing_LNew Existing wood/coal stove: ❑Yes R-11-0-1
Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new. size_
Attached garage: W16XIIi0sting ❑ 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,
APPLICANT INFORMATIO
(BUILDER OR HOMEOWNER �®
i Name 6 � 6��-dv Telephone Number O-6 L �1�
r Address I -& License#
,
Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE X DATE
- FOR OFFICIAL USE ONLY
' APPLICATION#
DATE ISSUED I ;
<n MAP/PARCEL N0.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
� 1
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL J
PLUMBING: ROUGH FINAL -
t
t
GAS: ROUGH FINAL '
FINAL BUILDING
,k DATE CLOSED OUT
ASSOCIATION PLAN NO. -
The Commonwealth Of Afassachusetts
Department of lndustrial.Accidents
Office of Investigations
600 Washington Street
Boston, AM 02111
www.mass.gov/dia
Workers' Compextsation Insurance Affidavit: Builders/Contractors[E]ect�riciansMumbers
A licant Information Please Print Le 'bl
Name (Businessf3rgutizalion/Individual): ��`� -
• Address:
Phone"#:
City/State/Zip. t/i
Are you an empidyer? Check the appropriate box:, Type of project(required):
1.❑ I am a employer with I am a general contractor and I 6. Kew constrmtion
employees(full'and/or part-tame).* baFc Hired the stub-contractors
2.❑ I am a sole proprietor or partnez- listed on the attached&beet 7. ❑Remodehng
These sub c m
onizactors bavo g, D eolition
ship and have no employees ;
workiag for mom, any capacity.. employees and have workers' 9. C]Building addition
cow. in�„rancc �mP-insurance.t
[No orkers'
ea] 5.'[] We am a corporation and its 10.0 Electrical repairs or additions
3. I am a homeowner doing all work _ officers have exercised their 11.❑Plumbing repairs,or additions
myselL[No workers' comp. right of exemption per MGL 12.[]Roof repairs
incrrrance required_] t c. 152, §1(4), and we bavt no
err>ployees. [No workers' 13.0 Other
COMP.insurance required-]
*Any applicant ahat chccke box#1 must also fM out the scctin below&bowing their workca'cornpsusat}on policy infUTTMiim-L
t Ilomoowncn who subrait thin affidavit indicating tbcy arc doing all work and then hire outside contractors must wbrmt a new affid avit indicating such.
xcuntractors that check this box mnat attached an additional rbcct abowing the name of the sub-contrattors and atom wbcther ar not thmt!catilim have
employees. If the sub-contractors have mnployccs,they muEt prvvi&their workers'comp.policy numbrs.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site
information.
Inslnance Company Name:
Policy#or Self-ins. Lic. #: Expiration Date:
Job Site Address: City/5tite/Zip.
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to&CCUre coverage as requirod under Section 25A of MGL c. 152 can lead to the imposition of c-rimirial penalties of a
5no 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 sta-tc=rrit may be forwarded to the Office of
jUVCStig&tiOM of the DIA for insurance coverer c verification.
I do hereby ce fy under the pain d pen of perjury that the information provided above is true and correrl.
cSi ahue: - Datc: —
Phone#
Offzcial use only. Do not write in this area, tb be completed by city or town offtcW
City or Town: Permit/License#
T&suiag Authority (circle one):
1.Board of Health 2.B_wilding Department 3. City/Towu Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
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 hue,
express or implied, oral or written-"
An employer is defined as "an individual,partnership, association, corporation or other Iegal 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 tbt grounds or building appurtenant thereto shall not br-causc of such employment be deemed to be an employer."
MGL chapter 152, §25C(6 also states that"every state or Iocal 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-a cceptable evidence of compliance with the insurance coverage required}"
AdditionaIly,MGL chapter 152, §25C(7) states'Neither tic commonwealth nor any of its political.subdivisions shall
enter into any contract for the performance of public work until acccptable evidence of complianet with the inuuame
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by chrcking the boxes that apply to your situation and, it
necessary,supply siib-eontractor(s)mme(s), address(cs) and phone numbers) along with their certificates)of
insane. Limited Liability Campanies'(LLC) or Limited Liability Partnerships (LLP)with no-employees other than the
ncmbers or partners, arc not required to carry workers' compensation insurance. If an LI,C or LLP dots have
:mQloyecs, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
4ccidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should
>e returned to the city or town that the application for the pcnnit or license is being requested, not the Department of
ndi strial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
:ompensation policy,please call the Department at the nurgber listed below. Self insured companies should enter their
:clf-innrranw license number on the appropriate line.
.y or Towle Officials
'Iczse be sure that the affidavit is comPlctc and printed legibly. The Department has provided a space at the bottom
Ithe affidavit for you to 0 out in the event the Office of Investigations has to contact you regarding the applicant
Ilaase be sure tD fill in the permitllicense number which will be used as a reference niunbcr. In addition, an applicant
hat.must submit multiple permitlliccnsc applications in any given year, nccd only submit onp affidavit indicating current
oliy information(if necessary) and under"Job Site Address" [he applicant should write"all IOcatlons in (city or
)wn)."A ebpy of the aff davit that has becn officially stamped or marked by the city or town may be provided to the
pplicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit,must be filled out each
ear.Whero a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture
.c. a dog liectzsc or ponmit to brim leaves etc.) said person is NOT required to complete this affidavit
he .Dffice of Investigations would like to than you in advance for your cooperation and should you have any questions,
cast do not hesitate to give us a call
ie Department's address, teIrphoac•and fax number.
The C6mmonwclth of Massachusetts ,
Depa.rtment of Industrial Accidents
Office of Investigations
6.00 Washingtan Street
Boston, MA 02111
TeI. # 617-727-4W.0 cxt 4.06 or 1-$77-MAS.SAFB
Fax# 617-727-774!�
;d 1.1-22-06
vnvw.mas2.gov/dia
E'NEAGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR
ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION •(780 CMR 61.00)
Applicant Name: �' /� Site Address:
lr P_g
_q- Town: /- l m Aq
Applicant Phone: f�Q U 33 .
.Applicant Signature; Date of Application:
NEW CONSTRUCTION: o.ose ONE of the owing two options)
780 CMR TABLE 6107.1
PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA. FOR
NEW ONE-AND.TWO-FAMILY BUILDINGS
MAXIMUM = MINIMUM
-v - --. Ceiling or . Slab
❑ _Option 1: Basement
Fenestration exposed Wall Floor Perimeter
Wall AFUE FISPF S I�ER-
U-factor floors. R-Value R-Value R-Value
R-Value R-Value and De th
National Applialicc Energy
35 R-3 8 R-19 R-19 R-10 R-10, Conservation Act(NAECA)of
4 frt. 1987 as,amended, minimums or
renter as a licable
Note; This form is not required if you choose either of the.two versions of REScheck.as,listed below.
❑ Option 2: Scheck..Version 4,1.2 or later variant software analysis must be completed
(780 CMR.6107.3.2
REScheck—Web which can be accessed at http://wwww.encrgycodcs.goy/rescheold
AD)DiTIOrVS=0it.-'.I�TERA:;TXONS.TO:EXISTINGBUf-LDINGS.--bVER-S:.YE.AIRS OLD*
*Buildings under 5 years old must use option #1 or#2 in New Construction section above. .
Complete the following formula to determine the % of glazing:
(a) Gross Wall & Ceiling Area equals EFo7ula: 100 x b,- a) .
SF — _ % of glazing
a
(b) Glazing area equals SF _
f glazing is'<,40-%o•use.the chart beld.w..` If.,glaziri is>:40`Q/oProceed to "SUNROOM" section
780 CMR TABLE 6101'.3
PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING
LOW-RISE RESIDENTIAL BUILDINGS
L��J'MAX19MUM MINIMUM
Ceiling and Slab Perimeter
Fenestration Exposed floors Wall Floor Slab R-Value
U-factor R-Value R-value R-Value and De th'
R-Value
R-37 a R-13 , R-19 R-10 R-10, 4 feet
R-30 ceiling insulation may be used in place of R-37 ifthe insulation achieves the full R-value over thcentire ceiling <�
area(i.e, not corn ressed over exterior rYalls, and includingan access openings).'
SUNROOM—An addition or alteration to an existing buildink/dwelling unit where-the, total
glazing area of said addition exceeds 40% of the combined gross wall an ceiling area of the
addition,
Note:. Owner to fill out Consumer Infbrmatzon Form(found in Appendix 120,P)
Town of Barnstable'
��op YHE Tq�yo
Regulatory Services
N
" Thomas F. Geiler,Director
gARN&TABL'E,
MAss i63q- Building ivision
Y� ti�� +
PrFD �� Tom Perry,Building Commissioner .
� Y
200 Main Street Hyannis, MA 0260I
• ,
www.town.barnSt2ble.ma.us
face: 508-862-4038 Fax: 508-790-6230
HOhEOWNER LICENSE EXEMPTION
Please Print
-DATE
JOB•LOCATION: r
number 7 Street Village
•`HOMEOWNER":
name 4Y.mCPh6n_FN.-W work phone# `
CURRENT MAILING ADDRESS:
city/town state - ap code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possessa.license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEO NVXER
Per who owns a parcel of land on"which he/she resides or intends to reside, on which there is,or is intended to .
be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
esponsibility for compliance with the State Building Code and other
The undersigned"homeowner" assumes r
applicable codes, bylaws,rules and regulations. -
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures requirements and that he/she will comply with-said procedures and
requir is
Signature of Home
'Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
;torte Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code statrs that "Any homeowner perfomring work for which a building permit is required shall be exempt from the provisions
.f this section (Section 1,09.1,1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s),for hire to do such
pork that such Homeowner shall act as supervisor," `
Many homcownen who use this exemption are unaware that they are assuming the responsibilities of a supervisor(sec Appendix Q,.
.ules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
,hen the homeowner hires unlicensed persons. In this case,our Board cannot procccd against thc unlicensed person as it would WIith a licensed '
upervisor. The homeowner acting as Supervisor is ultimately responsible..
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
at the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
Verai towns. you may care t amend and adopt such a fon✓certification for use'in your community.
i
r 'xE tom,- Town of B arns table
Regulatory Services
i,+xxsT.tSM f
Muss $ Thomas F. Geiler, Director.
$A i63p. `4 jFnr.,ata - Building Division .
Tom Perry, Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable_ma.us
Office. 508-862-403 8 Fax: 508-790-623 0
Property Owner Must
Complete and Sign This'Sectio
If Using A Builder
I , as Owner of the subject property
herebyauthorize
to act on ;toy behalf, ,
in all matters relative to work auth ed by s building permit application for:
(Address of Job)
Signature of Owner Date
Print Name
If Property Owner applying fox pe it pleas complete the Homeowners License
th
Exemption Fo n e reverse side.
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CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT
DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES
1875 Route 28•Centerville, MA 02632-3117
1926 508-790-2375 x1 • FAX: 508-790-2385
John M.Farrington,Chief Martin O'L. MacNeely, Fire Prevention Officer
Craig E.Whiteley,Deputy Chief Francis M. Pulsifer, Fire Prevention Officer
July 22, 2008
Mr. Thomas Perry
Building Commissioner
200 Main Street
Hyannis, MA 02601
Dear Commissioner Perry:
Pursuant to MGL Chapter 14.8 Section 28A, I am making you aware and request
your interpretation of a finished basement with bedroom without proper egress at:
Eben� oa� d �►
0ofeOfflIT MA
AO
During a r"', inspection at this address, I observed a finished room .n the
basement resembling a bedroom and no secondary means of egress. This room was not
present during an inspection completed by our department yin 2005, and there are no
outstanding permits for alterations to the structure.
There is an outstandingpermit for sale and transfer pending following r
p p g gY
interpretation. Contact information for the property is Foley Real Estate, Erika c
Capobianco 508-509-4610 or 508-548-3415. Please call me with any questiorns�ou _
have relative to this issue at 508-790-2375. Thank you for your anticipated assta nce Ln
70
with this issue.
c-n .
Sincerely,
Francis M. Pulsifer
Fire,Preyention Offrcer;:Et.
"Commitment to Our Community"
P�OpTHE roy� Town of Barnstable *Permit#6222
�, O^ Expires 6 months from issue date
H
&UMSTABLE : Regulatory Services Fee d
9 ,'39 �01% Thomas F.Geiler,Director
m
�plEDN1A`p Building Division
Tom Perry, Building Commissioner
t 200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
n Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address
❑Residential Value of Work �6 7 C)O G®
Owner's Name&Address R\ CKCG� Z_
Contractor's Name S' �Zvi '� 5 P►1 Telephone Number YZ O
Hgme Improvement Contractor License#(if applicable) l3 y-16o O
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
LI am a sole proprietor
I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name /y!�,
Workman's Comp.Policy#
Permit Request(check box)
0Re-roof(stripping old shingles) All construction debris will be taken to Q5!±1P
❑Re-roof(not stripping. Going over existing layers of roof)
Re-side
❑ Replacement Windows. b-Value (maximum,44)
❑ Other(specify)
*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.
Signature
Q:Forms:expmtrg `
Revised121901
��e �afrvnzo�z.,ueall�i�✓t� �
Board of,Building Regulations and Standards
HOME IMPRQVEMENT CONTRAC'110
Reg!'-%Gf 184160
3
iIzp'raior� �Qk
�,
VICTORY ROOFf .
STEPHEN SMITH I ; -
w \
33 PARK AVE
CENTERVILLE,MA 02632 pditunistrator
Wage a� pages
`A
Yibn ()S— ,
6ep hers
72)3
Proposal S fit1ted To: Job Name Job#
C
Address Job Location
✓sene7er'
Date Date of Plans.11kol" M 14 o o�6-.57;- all;;2
Phone# _ ` O Fax# Architect
We hereby submit specifications and estimates for:
e ;n
pvf:P - - And ad,1ne
pni- d fi-p'w sh
UA
7ffpr.oposehe to furnish material and labor—complete in accordance with the above specifications for the sum of:
end �tind�ed
_ — .:, Dollars
with payments to be made as follows d
Any alteration or deviation.from.above specrflcat oms involving axtra costs wilf.;be Respectfully
executed only upon written order, and will become an extra charge over and Submitted
above the.estimate.All agreements contingent upon strikes,accidents,or delays
beyond our control. Note—this proposal may be withdrawn by us if not accepted within days.
n Xcreptance :of J)ropo at
The above prices,specifications and conditions are satisfactory and are Signature
hereby accepted.You are authorized to do the work as specified. .
LDate
nts will be made as outlined bove.
of Acceptance �-� a�� 4� Signature
NC3819 MADE IN USA
--
' •vosbu :, TO®PrT OF BARNSTABLE. . Permit No. "s fl f.
t D Building Inspector
,�n.& ,- cash -__--
C 6�9• P _.5 >..� 7
OCCUPANCY PERMIT ;,Bond;.,!
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 �.�reenbriet Corpe Address Centerville
Lot # 25-12 Ebenozez � � Centerville
Wiring Inspector +-� r Pe
f/ -- Ins ction date
Plumbing Easpector-DA Inspection date
Gas Inspector "KI ra Q rY j ,�* Inspection date ° 30 t t �,
Engineering Department` r�% _ Inspection date
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.
I l 19.fj »..
i », - `' U Building Inspector
-�
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CERTIFIED PLOT PLAN a
ROBERT. Li/ �r! /A
NEW CONSTRUCTION ONLY = f 0 BUNIiIS IN
o
TOP OF FOUNDATION IS FE No.22162 C A �
ABOVE LOW POINT OF ADJACENT "'CIS�E
F�SIONA\-
ROAD. SCALE.. VOe DATE: Y�
LOREDGE ENG/NER/NG 'CO.IN �'�� I CERTIFY THAT' THE
CLIENT ��"� SHOWN ON THIS PLAN IS LOCATED
EGISTERED LEGISTERED JOB N0. IF,10 3 ON THE GROUND AS INDICATED A:0
CIVIL AND CONFORMS TO THE . ZONING LAWS
I R DR.BY: MASS.
ENGINEER VEYO OF BARNSTA LE ,
712 MAIN ST. CH.BY: !G /
HYANNIS, MASS. SHEET / OF DATE REG. LAND SURVEYOR
Al
A'ss s�'3e>'r's -inap and.lot 'number � � � `_'
z•
E
Sewage,Permit numbe ..... SEPTIC SySTgM M � o�
/�7 IIVS'r a nSTADLE,
House number ......... .......( ......... r �-"- r a
y� �
y� 6 1fLE 5 �4p�163 e00
'�/1INT.A MPY a
TOWN OF :BA'-R TA�B1 ,rE-�Ta��
N,S L S
10
BUILDING INSPECTOR
'APPLICATION FOR .PERMIT TO .......... /Vi�//...........�./. �/..... ......................................:..
,TYPE.OF CONSTRUCTION ..................Lam................� ................................
............:..19.&
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby appliesfor a permit according to
-the followinng�i formation: l
Location ..........:...' r:..a� ....� i � .� .�'�( .../ G .,. L.� .......:............
ProposedUse ...... .... �, r ..................�/.�`'.. ..................................... .......... ........................
Zoning District ............ L ................:............................Fire District sn77..........................
Name of Owner ... :........Address ....i�� �j. . L. ! �.11...!� .......
Name of Builder . ....... .... :.....:.... . - ..... .:....Address ................ �..................:.........:/�:..........:
Nameof Architect ..................................................................Address ....................................................................................
�4 ,p
Number of Rooms ..................................................................Foundation / ! . ......:...........................:................
Exterior ......... 1 �.................................... :.............. .........Roofing /�' ,r/'�C .... ..................................
� ,�. Interior ...:...
/'!�••••Floors ..... .. .. .................i�!��.1.:.�..�.......... � .......
ing .........eow ,/Heat .fr
................................Plumbing ......�.�. .............................
Fireplace ..:....� :.::.....:........:.............::.Approximate Cost ......... ..............................
Definitive Plan Approved.by Planning Board ._ � ______�� _____19 � Area l /1 ( .
C" .00
Diagram of Lot and Building with Dimensions Fee /........... . ... ........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
t � ,
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ...................P,,J...D5;,..
- � __��%'
', REENBRIER CORP. '
1 '
31 ..430.3,$„ Permit for ..2'.WQ...Stoxy..........
.
s i g.IP—FaMi.ly...D e1. J. g.............
Lot #2 5 -4 1• Rd. f- �
Lbcation ............. r -
Centerville
........................................................... ..........
Greenbrier Develop Corp
Owner .......................................... . . 4 �,
Frame
Type of Construction }
............................................................ ...................
Plot ......................... . Lot .. ........................ r I • i
x' April 23, 81
Permit Granted ............I.............. . ..........19 h" !
Date of Inspection d
PERMIT REFUSED
•.• ?'.�. ..............................................................
.... .yS.w' ............................................................. • .� r,. -.I'�
.......... :...........................................................
f,
..........t,v ............................................................
Approved`.................
............................................................................... ,
Vim 2���,� �•///�i/�
Assessor's map and lot number .......^✓..� ��• +�
.� p*114Etp
Sewage Permit numbs ✓ 9 d�P�� �♦�
Z 9JflB4TADLE, i
House number ..................`...:.`................................................ 9 rasa
16 3 q. \0�
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ..
..J,, i` r''✓..�......................................
"
TYPE OF CONSTRUCTION ................... ......... ........................... ..............................
F�::..../�
.............. 19..C..r ..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for as permit according to the following information:
Location ..............: .. �, . s%..r... ..a' �:'.�'�.. f ! ... i'�.t,. ( ..: :' �......................
ProposedUse ....... ... ..................................... .... ............................................... ... ............. .........................
Zoning District ....... ...Fire District
w�7� � j, °�i '
Name of Owner ... r! {... �' '` � , '; ✓/�'�/.! ` fir" `
Address ......... .:......-:........
. ......... . .
Name of Builder .............Address `""'"•�
Nameof Architect `..................................................................Address .............. ..................................................................
Number of Rooms ...... ............Foundation '""s "�''✓✓..
-.................................. ,. : .................,.�........................................... ...
Exterior ....... .................................................Roofing .....`../�;51`s �dl..... � �.........................
.
Floorsr1, ..r.............. ..r................lnterior ................................................
Heating. r)' f' ✓ . ..................................Plumbing ......: ..........................................
Fireplace ......... /�' .�.................:................Approximate Cost .... �7 ........... .....................
Definitive Plan Approved by Planning Board __ ____________________19 °__. Area
r''
,r .. .... .n .........................
Diagram of Lot and Building with Dimensions . f
9 g Fee ✓. ...........'............
SUBJECT TO APPROVAL OF BOARD OF HEALTH
`r,
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. _
Name ............................................... ... .n ..................
GREENBRIER CORP. �,--�' lA 47-74 ~�
23038 Two Story
No ................. Permit for ....................................
§ingle Family Dwelling
....................................;.......�..1,el?.
Location ,,,Lot #2 5' _� — l l Ltd.
Centerville
.........................................
Greenbrier C�`�
.................Owner .:........Fra..�..�?.....................
Type of Construction ..........?fie..........................
I�.............. ............................
Plot ............................ Lot ,...............................
Permit Granted ....Agri 2 3, 19 81
Date of Inspectio ...
Date Completed ............... .....................19
I
r PERMIT REFUSED
19
.............................. .......... .....................
.......................... ....... .............
Approved ................................................ 19
...............................................................................