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Home My WebLink About0069 EMERSON WAY EPon, r WWII MOM1, 51 f '4 wwkoof WWI A,jo Nsl TIPWOv t a J R P•� � 1 �' Yy� 9 o V� [ ' n s r ° u op n s ,p ".. o , ,� w c i• " Town of Barnstable *Permit# ti � Expires 6 months from issue date Regulatory Services FeePE ��s ' snanrsrns%E #' Richard V.Scali,Director . Building Division TOWN OF BARNSTABLE Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 1 � � U�� Not Valid without Red X-Press Imprint Map/parcel Number/��1----�x�� Property Address (0 9 A�% °e f_j //,0 0 Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address "A P 7 A lA,� Q IV Contractor's Name /� p � L* 16 2LD Telephone Number �� ,' 9 Home Improvement Contractor License#(if applicable) Email: - Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner �I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must.accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/door_s/sliders'U-Value (maximum.32)#of windows #of doors: Vsmoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation;etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Impro ement Contractors License&Construction Supervisors License is requir SIGNATURE: - Q:\WPFILES\F0RMS\building permit forms\EXPRESS.doc Revised 040215 On ED ,My File Edit Tao1s ' 3elpR f� - d -ME- M If 'qr. Ilk AA ame Tradesmen Name and, �B__ ELECTRIC .. � ' s '� '810$Y A Address .; AI [3f�LEY SHD . a .h c6 .« .'. �/85 � 'fit^ . *n�47J'7. 7. a,p�a�.="a k `� _ �* _ '.`n y, `x 4• ° � �.a�3k � r,e7 "'4 m� # �"`:�a L -�a�a$r;; " sry�: ', .` c '��',.� �� L a5TER'u'ILLE�„ �� '' � �.'�^i � t��655• ! ��-�� , �"� �� ` ``��` �u. �� v^ Tide have Y 177 Mr ontractw. '^srig .- Ir1Slayr ICe Pt7l a"a ' � a r surartee T+pe suranc xGorr� arty , E �Da N alved� ' , WCAFFADAU`IT, i EMPLOYER ,' �` ©2f182A16` N S /® y C'b �'a: WCI .1r1'k ,p $Rw QBECCKU6758 . ,'CPC * s�a32AELERS Id+IS GO � a> �'` h�'„ -17 Cartact MAHONEI' SkP .. .(JU _ . Ilk ,C p � t Llcense)pald Ce11+ hOne � �TT"!'�T ,gg InVOICe� -. �'" g t a ', "> g i `,°dS 3 b 4 , k HQddermlts 41, x ''a�'°' ydp ce• ➢+ d _$ ,w^' '¢�' eCt t0 lIMO sr ' ?. .� rep+ �q,� y. .r°� tla �_ �j rt�l'> � "•"d ups {Yue � 4'i ��"�3-r'..u,`��,.y �� .� .*.: ':�:.>.�,� !Viewthe tradesmen far#►e,mrrent COnt!'acto( >sg ` �sl, s r�,`^xa,�'' .�.I u�` ��fi r. �r .. a } ' I The CalarmaxweaUh cof Massachusetts , Dgmrbnent of Industrid Accidents Office gfinmtga7ons 600 Washing#an.Street Boston,MA 02111 n+ masmgov/dia Workers' Compensation Insurance .davit-Biffitiers/Contractu slEiectrii:a=s/Plambers Applicant Information Please Print IA bIy Name l)- 9,E,6 City/State/Zip- OS�'�U11 ILIA Phone 4-- -77 ?,3Z, Are you an employer?Check the appropriate box: Type of project(required): 1.U-fam a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction emptoyem(fail ardfarpmt-tam)* have hired the sub-contra.ck s 2.❑ I am a sole prflprietor or partner- listed on the attached sheet. 7. ❑erode+ ing ship and have no employees These sub-contractors h2me g_ ❑Demolition . working for me in any opacity_ employes and have workers' 9- ❑Building addition [No work ors'comp-insurance comp-insurance-1 required-] 5. ❑ We are a corporation,and its 10-❑Electrical repairs or additions 3.❑ I am a homeowner doing all wow officers have exermsed deff 11-❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Rnof repairs incrrrnnce r' ]T t:.152,.§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance requkea.1 •flay appfit Ott mat checks lox fI mast also fill out the section below showing their woskere compeasatimpolicy infatmatlan T Snmeoaners Wbo submit this affileviit inbcfft®g they are doing all vu&and then hire outside contractors mast submit anew affidavit indicating such ' ZCaomactors tbsr check ibis boa must sttarhed as additional sheet shooing the rime of the sub-camtriictors s nd state Whether ormrt those entities bate employees. Ifthesnb-cantractors have empleyees,tlseyimmp¢avidetheir workers'comp.policy number. I om an employer tliatisproiiding workers'coniperisizdon insurance for my etrrployiees. Below is the poUry and job site informadom Insurance-Company Dame: % 2)b Vf-t Policy#or Self ins.lie. 06 L 6 Expiration Date: Job Site Address: tate/zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number.and expiration date). Failure to secure coverage as required under Section 25A o€MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andfor one-year impnsoninezit,as well as civil penalties in the form of a STOP WORK:ORDER and a Eno of up to$250-00 a day against the violator. Be advised that a copy of this stat6nent may be ftwarded to the Office of Investigations of the DIA for insurance coverage v+erifrcation- I do hereby carh.6,under the pains and na 'es of , thatthe information provided above is true and correct Signature: Date: d r �� I Phone#: Official use only. Do not it-rite in this area,to be completed by city or tonan ofciat City or Tomm: Peruutff icense# Issuing Authority(circle one): 1.Board of Health 2.Building Degariment 3.City1rown Clerk 4.Electrical Inspector rr.Plumbing Inspector 6.Other Contact Person: Phone#: 06/09/2015 07:16 2034588877 PAGE 03/03 t 4 Town of Barnstable Regulatory Services Mcbard v.3ea%bbrector Building Division Thomas ferry,CRO Baildiag Cotambsiotaer 200 Main(red, Hymmb,MA 02601, www.town.barnataBie.ms.ua Office: 508-862-4038 Fax: 508-79M230 Property Owner Must i Complete and Sign This Section If Using A Builder �('i'.a_�_t L�1� ,as Owner of the subject proprrcp hereby authotize to act on my behA _--.y _.i. i^-•- --- ��-r in at matters zelative to work authotized by this btildiag permit applitation.for. (Address of Job) kjn2=C of Owner z7ate Print Name if Property Owner is applying for permit,piease eumplete the Homeowners License ZxemptEen Perm on the reverse side. Q.-NWPr1LFST0kM9\W1dinR P fbnnslFJ(FRFSS.dae Revised 0Q215 t0•d 8bT90Zb�OS �iauoueyl itdZ�S�EO Stf90f9U s Y � 9 iSXY e:7e-60Pwe We# More, bo'c� S E SMOKE DETECTORS R L .BUILDING DEPT. DATE FIR DEPAR MENT DAB E BOTH SIGNATURES ARE REQUIRED , 4�(U�F1 NHS � ? (�.e(i F ,i- f � ,; `€ ';�rwv �. '+f�.,-:" ,�, .' x.'x` ,f7."`r 9 . _� -'L"+�- r` t.. ,y y' _f'� fit., - 1. i. c _ _ ' iiEZ .mac -s � ::.+ -�"- $ zr C" '� 's' r'L� • .`_ lh�-. <h M12 fE v .-c`.y�t A`x` li. _}: x ` - '"` _oc. Z ; ,t _tiy c -_-n r-. i - x, yk t ?T.z "`r e ' ; Tir '1} ''k'" 4 �^ .11, , � ��-.- 1� �—V. . , -7,.' - - .-I � - ..I�I - t a 4! � . .4, -. � j :�.� . ;, ".s � k � .#t� - . .-- , I I - � I - 1, . . .. , -;% — - -, - I , ` - _ ' r - _ x 33 r - - � � -- a �(�� 1 \- T - - - w- y.. �4- - r-s: -- J �. �. "" ,`y j_ �_ �R ...�' —� ,�}�.: '' 1" '- .. ** a "�"j ta` _.1 �J"i �"�r�^+1 Y el ,� ..t 'k,r �5.,a N'f- _1. '�" zr, -r - r/ sF.= - - s �\ 4. r i 4 It, O tT�( `� j•1 t µ _ ,^ d y? ,a � n Z SS - �O_/7 (� - ; - � i T u v t_ o, `a_T.(LLb N• Fs[tt�t,F� . I'll - . -mrs a" Ys - 'iu,, s A'.L E• i'`_ a , '�E; FB '�' �q�t5 1. .a F E R E- N C.E �E t 0 ZT�, , ►-1C9�h { $ Ir fto " s 1. x �c-� %5; t�7S .. ��;,; .- -.. ; .. R"EG 1. A Nb' Su 1� 0 R ; `t H "E-R."E$ Y C`E R T l F - F .A T '`THE: B-U;t L b'1:`N G r B;H.aWN ON., THt-S P,LAN 15` LOCr� TyEfl . ON THE GR © U .N4 AS 'SHOWN HERE "0tv-r A°tiD . _. ;' C -H-A T ,k,r _D S C O N F (3 R . T O T H " flN [ N RX l. AwS OF -T HE: TO-:wN' OF ,�P�Zw . - 'p c�� WHE l C :0N5TAl1CT.E [5 r �d�* �� 3 .. 1 ^t,L - GEORGE ' Ede, }R 7 < ar �' { F s x s, - j E * _ A i © . -Z t?! to A u t� _• fL - r r �44 1 . - -��-'.`�t-l"--- � "> �, _.:fir ^ .— I,�.Y} Assessor' rgap and lot number 5,.,. SEPTIC -SYSTL7.21 'M T BE INSTALLED I CU,0i AI'�CE 2 Sewage Permit number r WITH ATIC--%E 11 STATE SANITARY COD, AN) TOWN t TH E TOWN OF BARN s T�� BARNS WA � Z BARNSTUL$1639. i D M BUILDING INSPECTOR 'EPY a' APPLICATION FOR PERMIT TO .....................................................................:....................................................... TYPEOF CONSTRUCTION .................. .rA.0 . --............................................................:....................... �J J /.. ..`.. .................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �� p Location ......... I �"'.......... ' "S..........°y' w�^� � .`>.�.P'.lvt.�... ............ ProposedUse ....... ` ..L.t.. ..ly.. ............................................................................................................................. ZoningDistrict .......................................................:................Fire District .:..... ...�:`:....�S........................... Name of Owner ... .?^�l"�:... ..........I�.f..�...1�'........Address ...........f�.(..1.. ��- .. ......C..l.. ...5................ Name of Builder ... !^.e. ..........s.?.��"-`..1. .........Address .................... -2. . .......................................... ` ................................. j ! .. Nameof Architect ................ ..........c..Address .................................r................................................. Number of Rooms C..............�................ ....:............Foundation ............ ......:..............`4 .................: ...........1..... Exterior .................�:� ....... .kt. IX � ,,}...........Roofing .................... � Floors J Interior ........................C..zL:.1.. .............. .�' 1! '� �1................ ...........\ .... ........ Heating ...........0.�k........ ... 'e.:...1...........Plumbing ......................... ....�1....... .............. Fireplace ................................�..........:......................................Approximate Cost .....................�� .. . .. .. ........ 1 Definitive Plan Approved by Planning Board ______________________________19 _______. Area ........1.q00...Sr Diagram of Lot and Building with Dimensions �q x Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i Y oa I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. < Name ... ................. ..... Lamb, Stanley No .A7942... Permit for .... one story, ................ ....... tr single family dwelling ... ... .................................................................. LoeiptA.-Emerson Wap Centerville ............................................................................... Owner .............Stanley..Lamb ......... .................................. Type of Construction .....................frame ..................... ................................................................................ JPlot ........................ Lot ................................ d September 19 75 Permit Granted ..........19 S' ion Date of Inspect ... ........19 ��.. .. Date Completed I .., ...............19 r 1 PERMIT REFUSED ........................................................... 19 s ' ............................................................................... i ............................................................................... II Approved ................................................ 19 u .............................................................................. ............................................................................... 4 Assessor's map and lot number .. ....... �, Sewage Permit number ...................:�...�`.............................. r , yof7HETo�♦ TOWN OF BARNSTABLE Ii 33A"ST"LE, i "6 9 .e0� BUILDING . INSPECTOR iAPPLICATION FOR PERMIT TO 1....'"�``....... `''............................................................................................................. eTYPE OF CONSTRUCTION ; `.. '.."^ —.........................................................................................,............................................ ............/ ...... ..................19 TO THE INSPECTOR OF BUILDINGS: E _ The undersigned hereby applies for a permit according to' the following information: Location - F !�, Z "`...` 2 A+-� 1 A r r l 5 .. . ........ .... ........................ �4............................... Proosed Use ` .`� �..f.!..�..! �...�.�....... .. ... ....... ........................................................................ ......................... p .. -7oning District ......................................................::.:..............Fire District ....... -P"•:..� .....k........�`".. .c?..�.....`.................. j�a/, Name of Owner ... .t.''.,r �.-................r..::,.�"........Address ...........� .!..........I�.....(. f ....... .......�............... ................... Name of Builder � tN - ` 7 —........Address A �`-- � v ....::1.:�..--:... ...........'.................... ................... . ...... ......... . ......................... X. �. t t I r r Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .......... ................................ c. C .... ........................................... ..Foundation ............................ ............... ,1 Exterior .................. ...:...fi.........I...........................Roofing ................................I.................................................... Floors _- f1/3�?......�":r.'�'............`....................Interior ..........................�.. ...............:'.�!..G ................1,- ...;. r f Heating )t �- :.�.....fr��/x �-�''A..........Plumbing D1 - t- g �.... 7........... ............................ Fireplace ..................\.......Approximate Cost .G..-.>.i.. ---.................. Definitive Plan Approved by Planning Board ________________________ ______19________ . Area ......... � t....� r ................... Diagram of Lot and Building with Dimensions rf Fee �.. ' SUBJECT TO APPROVAL OF BOARD OF HEALTH � fe {a L) .J i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... t /'` ':..... ..... r ...................... . Lamb, Stanley A=188-23 17942' on s ry, No ................. Permit for ........ ..... ..................... single family dwell,' g .............................................................................. , �� Emerson Way ry Location ... _ Centerville ............................................................................... Owner .........Stanley Lamb .......................................................... Type of Construction frame ......................................................... ......... .......... Plot ........... Lot #52 Permit Granted ........SAptmber... 9.....19 75 Date of Inspection ......................................19 Date Completed .......!..............................19 r PERMIT REFUSED ....................... !....................................... 19 ................ . ....................................................... .............. . ........................................................... ............................................................................... Approved ...... ...................................... .. 19 ............................................................................... ...............................................................................