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0070 FERNBROOK LANE
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I • ,, ,.° ,. - d r '.�i Wl , e ,t ,. t 4.:.. R .:1 „d < ) ) t,v" t A. aa. i l yr. „ n #,;; �a £ f 8 't,. *rk' aad f. .e..4<, 6 µ % +t t" t 2 t §, "` . I. „.,; r 6 > .. , :� n ' ,K a ��{ ._ e.,' a ;a a:-: et r " ,:; w,' .. .rl{ n'. ,�. x n: tF , q_� +��.m.J d ,y 'd q (�E'43 f 3# ily �,,, ts. ,ar dd.}..r a ,•q a y yer+ F,.,.,., , ��$ 1` to Owl ,Yi Fet v.i.r s:3 0 o?•3sy'' - ° ,. . ' Y,". , >`.i.: Y r is ,.: „ .x. F, .. ,, �F ( /Johst /�1Z °F'TK.r Town of Barnstable *Permit �. Expires 6months from issue date Regulatory Services Fee STABLE, .' Thomas F. Geiler, Director pg� SS PERMIT Building Division '°rea ray a Tam Perry, CBO, Building Commissioner JUN 2 2OO$ 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number e2M OR 61 Property Address 70 �N GOQ-1-i�I� U t Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �{��� N�LL- `70 k tN Contractor's Name Telephone Number Home Improvement Contractor License# (if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor -PRESS PERMIT tam the Homeowner ❑ I have Worker's Compensation Insurance JUN 2 7 2008 _ Insurance Company Name TOWN OF BARNSTABLE Workman's Comp. Policy# Copy of insurance Compliance Certificate must be on file. Permit Request(check box); [�] Re-roof(stripping old shingles) All construction debris will be taken toBENSi Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum..44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. **.*Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improveme t Contractors License is required. SIGNATURE: QAWPFILES\FORMS\building permit form_s\EXPRESS.doc Revist020108 The Commonwealth of Massachusetts Department of Industrial Accidents 137. Office of Investigations 600 Washington Street Bostorx, MA 02111 www.mass.gov/dia Workers' CompensationInsurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leffibly Dame(Business/OrganinHonllndividuan: Address: -110 City/State/Zip:�e� �J�1\i�SC M� ��6J7- Phone.#: ° 0 01K Y3 Are you an employer? Check the appropriate bwc Type of project(required): 1.❑ I am a employer with 4_ I am a general contractor and I 6. ❑New construction employees(M and/or part-time).* have hired the sub-contractors 2_❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑R�emodeIing ship and have no employees 'These sub-contractors have g, 0 Demolition working for me in any capacity. errployees and have workers' 9 ❑Building addition [No workers' comp'.-instn-ance C°� tn�'$ required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.[ I am a homeowner doing all work officers have exercised,their l l.❑Plumbing repairs or additions mysr-E [No workers' camp. right of exemption per MGL 12_❑Roof repairs ir,crrranCC required]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp,insurance required] *Any applicant that check box#1 must also fill out the section below showing their vAA=r,'compemraiion policy information t Homeowncn who submit this affidavit indicating they a=doing aD work and than hire outside contractors must subn it anew affidaritindi�g such t(_orrtractars that ebxk this box waist attached an additional chat showing the name of the sub-cmhacunt and stdr whether or not those rntities have mnployecc. If the sub-contracton have cnr ploycee,they must provi&their workers'comp.policy number. I am an employer that is providing workers'compensation insurance far my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/Sbte/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requimd under Section 25A of MGL c. 152 can Icad to the imposition of criminal penalties of a Eno rip to$1,500.00 or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.)0 day t the violator. Be cd that a copy of this statcmcrit may be forwarded to the Office of Invest' tions the D for insr►ranee cow erification Ida hereby c fy unAr the pains- n of perjury that the information provided above is true and correct Si c: Date: Phone Ofj7dW use only. Do not write in this area, to be completed by city or town offroiaL City or Town: PermitfLicense# IspEngArrthority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Town of Barnstable Regulatory Services swxxsrests MASK �, Thomas F.Geiler,Director 059. 1' Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must a Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize E- � to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address of Job) I �tD�Q (R Signa'ture of Qbirr 1 4ate Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable %10,t SHE Tp . Regulatory Services Thomas F.Geiler,Director BArtxszABrs, b ra Building Division �jED �a Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 vrwvv.town.barnstabl e.ma.us Office: 508-862-4038 Fax: 5.08-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE:_ 0 !OB LOCATION: 11 nnuuombbeer�� street village ..HOMEOWNER name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip 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 possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)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) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersi ed"homeowner"ce 'fies that he/she understands the Town of Barnstable Building Department minim ins'ction procedures nd re irements and that he/she will comply with said procedures and requir ents Signs e f Homeo e Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be.required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section iou*,1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. 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, that 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 several towns. You may care t amend and adopt such a form/certification for use in your community. Asors ma a ssesij �� � (:A,p and lot number .l„�',t�,.�. 11?�T�.K, N Sewage Permit number ....... .................::...... row o� SEPTIC TES INSTALLED IN U, Z �BARNSTULE, i MAGIL House number ...................... .... ,, WITH TiTLE p MAX TOWN OF B ARNS 00sr .. ` Bfi q BUILDING 1N9PECT0R� % s� q _ APPLICATION FOR PERMIT TO ...�..........: �� ..........:.. TYPE OF CONSTRUCTION ..l F'&?.f. ..t t.......... ....... ... �....... ...... ................ .?�+v......:.3.0.............. TO.THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... ..... .....: !` .P..�.?2.4 .k ...... —. }:I ........... l. ProposedUse ... .......................t `............. ........................................................................................................................ `y . Zoning District ............T. ........................................................Fire District .......... CAE Name of Owner .... ....0�..: �} .................Address ......... ^ .......... ................................. . Name of Builder .........�.J :k ^� ,..........................................Address 4- ............... .................................................................... Name of Architect S �` t���.` ..:...................Address ........ ....................... ......... `+ .............. .... ... ....................................... .:.. Number of Rooms ......... .......................................... «-,,- .Foundation ......�5 G2�-?��.�................. :.. Exierior ....�t.L��...1?. ?z.kC Roofing ........... .Sp.'�4c�4. .............................................. U /+ - p -�.c^ti '''' 4 Floors C. >.1 I ............V..I.Q-�.`t,( ............................Interior ......... . .............. Heating .......F:. r..w............ ..........................Plumbing ............ .......................................... c� pp /,, Fireplace ..... ./?1.G. _ �.......L�..�.t?.GV�......................Approximate. Cost .......... . lt.�t. ..........:... ................... Definitive Plan Approved by Planning Board -------__-----------------------19________♦ Area ?/....................... ( Diagram of Lot and Building with Dimensions Fee /9z...--......... ........... SUBJECT TO APPROVAL OF BOARD OF HEALTH ' h k 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 . ,,.. .�. ................................... 11!7= Construction Supervisor's License 1�G. . .BZ0 SjDE BUILDING CO. o 27.819� Permit for P Story ................. ................ Single Family Dwelling Location ......Lot....20 , 7.0....Fe.rnbrook Lane . ................Centerville............. ..................... Owner ..Baysi.d.e...Building ........... Type of Construction ..Frame........................... ..... ....... ............................................................................... Plot ............................. Lot ................................ Permit Granted ... April -29,.........I......;....................19 85 Date of Inspection ....................................19 . Date Completed ..... 19 ...................... /4/ Assessor's map and.lot .number �' `� -'`� k 5F-� i i OF?H E �s- J ©� Sewage Permit number �Q v 1i BABISTADLE. i House number 'j . r ""3a ............................... ....... OO i AG 9� 639- mo TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... 07 u n U CA....... 4a?.('. : `::... .:.2c: ............. a TYPE OF CONSTRUCTION .....�.�. t?.` ...... '?.. .yti' .•P......................................................................................... !, ?.'.�)........5 o..............19A 5 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby appliesafor a permit according to the following information: Location .... ..�.�}......: .t'........ .....:'. ..?�:?.: . �....:. .K.......?....:a..tU. ............. . .....f..: ,. ......� ................................... ProposedUse .....k...... .!4 ..............f....................................................................................................................................... Zoning District .. L..............................................Fire District .......�...t=�^= .............. ...... .._..... ...................................... r Name of Owner ....._.....;j. ........................�.............................Address ...............:. :................................. .............................. Name of Builder St.. .,ti: ..........................................Address •...�....:� ...................... ..............:..................................................................... Name of Architect " � ` �C v `� �` .....................Address ��................................... . `.:......................... , ................................. Number of Rooms ......... a.....................................................Foundation ....... .'? ..............................l� c f Exterior ..... .. a F� L �. ...... ...� `.. , .��.t�,c�'.p ..............Roofing `>v� �1Ai -f Floors �c,_�.j _l:...............�I�,t� .... �................ a .. M .�... ...•,. .............:... � , t.............................Interior ............ �,r ..�,..,............ . Heating . . :.. N , ,�?.. ................................................. g ...:...... ,..............................Plumbing .............................. Fireplace �: ......................Approximate Cost {, a r' ,) Definitive Plan Approved by Planning Board ________________________________19________. Area Ag.n2 .................... Diagram of Lot and Building with Dimensions Fee ............................................. c SUBJECT TO APPROVAL OF BOARD OF HEALTH � . Y Y {j 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 i'?; :.... . ' ... y ? r....................................... Construction Supervisor's License ./.:: �...,.!l'....�..�........ I BAYSIDE BUILDING CO. A=208-85-16 No —278.19.. Permit for ......1 Story Single Family Dwelling ................................................................ Location ....Lot 20 70 Fernbrook Lane ........................... Centerville ............................................................................... `Owner ......Bayside Building„Co. Type of Construction Frame ............................. .............................................. 1I Plot ............................ Lot ............................ Permit Granted Apr.i 1 2 9, 19 85 Date of Inspection ....................................19 Date Completed ......................................19 l ... - � 1ir n • e ~Assessor's offioe (1st floor): �' , o — l Assessor's map and lot number, ........ P ........... THE ro Board of Health (3rd floor): $ 51 30- f{IC SYSTEM bus Sewage Permit number .�?..,.......1. .. .. .... TALLED IN COMPLI rasa LE. . Engineering Department (3rd floor): WITH TITLE 5, °o i639• 0� Hoarse number ...... .................:. •....•..•.....:•.•.•................. 'NiVIRONMENTAL CODE APPLICATIONS PROCESSED g:30-9.305_A.M. and 1:00-2:00` P.M. onlyl TOWN REGULATIONS A P P R O V E D - stable Conservatiour�'4 'N _ -OF B A R N S T A B L E• SUBJECT �$ L D I N G I N S�P E C t O R _BARNSTAg TO APPROVAL OF pea t A LE CONSEriVATION COMM ISSION APPLICATION -FOR ,`PERMIT TO ......:s�o�. "r4............................................. TYPE OF CONSTRUCTION ...... \!c.....................................................................................: ..............[47.. ..1 -.................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................. .......'�.�? v'� .K.......�-!'` ?� :................. ( v� p _ ProposedUse ...........!11.if.. ✓ C..`Z�.........................:: .........................................................:....................................... . ............ Zoning District .......:... ... ..�..:............................................Fire District ......�`�^-�\:...... .......:............................: Name of Owner ......T--CL.>* ......!��.�.���. ......................Address ...........7 s � , Nameof Builder ........... ... : ..... ....................Address .........................?.'g ........................................... f _ " Name of Architect ...... ..1--.....S.a-.' .e:! ....Address f/`t �? N.4.�:� .......✓..... -........:.. Number of Rooms ...............1..................................................Foundation .......... Exterior ..............cb�� ...6....... ....:. ..Roofing ............. .L.. .......................................... Y Floors ................ .La...(: ........................................................Interior rZr6$•SJ ^A Heating �. .............Plumbing '6'7......::7Ntx.......................................... .............Approximate Cost ......:......3.�.�.1� '� Fireplace ..........:.....: .1 .. ......:.......................... ............................ Definitive Plan Approved'by Planning Board ______________------ ------19_______ . Area fP .S.... ....... .............. ..:. Diagram, of Lot and Building with Dimensions© Fee .............................`............... SUBJECT TO APPROVAL OF BOARD OF HEALTH . t 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. rName ,.............��/U ......................... -tonstructior Su ervisor's License r WILLIS, FRED ` ` a �` •30070 � DITION jNo Permit 4r .:-. , + 0 i. �... ............ "Sin le Fam' Dw min Location .70 Ferrbrook_Ane „., ;.,,,,,,,,. r Centerile ........ r �. ......`...•..''Fre d Wz'� s I� .... ......^.......... Owner ....... .. ..... , Type of'Construction.� ......................'.............. . ..... Plot ....._ .. ........... Lot ................. ......... t ;Permit Gran'ed 'October 22, $6 w �� ...............................tY. ....19 Date of Inspection ...................................'19 ' Date Completed .................... ...:19 VS M " 1 FacC! 1 0 - r f Assessor's offioe (1st floor): _ /� O.P. ! CF THE TO Assessor's map and lot number .....)�.............-. .......:... ...r�..�`. ? Board of Health (3rd floor): _ � '0 may/ ,. fO�Q o� Sewage Permit number ... ... .. . ..........`........ i 33lHd9TODLE, S Engineering Department (3rd floor): �U ��/$ oo MA31L \e� House number ........................................................................ '°gyp YAy a' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...................................................................... TYPE OF CONSTRUCTION ......W„t7n ..... 1 sltry�k=........................................................................................ ............[ ..i. ..... 19. E- .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 7�....... :? ` ........ -. :IJ --f - t-1 -!- !-� ProposedUse ........... .t°. i.: �5: ..`(.1.............................................................................................................................. ZoningDistrict .&,..�-...............................................Fire District ......C.. - .................. .. .............................................. { d Address ......+ . !1 t�> s4�.?�` Name of Owner �.!.... ......GtJ t.....�.:�................... ...........7.... ............................. ............. Nameof Builder ........................ .....:,.:...:..::: .................Address .........................a'4.!' .. ....................................... Name of Architect ............................. .........Address 05,. '...................................... Number of Rooms ............... ......................................r..........Foundation ...........�;r ...C'. '......1c?'a.r.1�. t; f............ Exlerior .............. ..�'.. ,��,c�`�JZ 1...........-�1 Nb,. ...........Roofing .................. ..,......................................... Floors ).{..("........................................ .Interior ..................6g..61.P..`�q.n- Heating 4: �.- ..........................Plumbing 1-4T�..�........!..I).?z>.......................................... Fireplace ............. 0 ',..............................................Approximate Cost .............�� Definitive Plan Approved by Planning Board ---------------------_----------19________ , Area .....!a! ..... .6 d C7v Diagram of Lot and Building with Dimensions Fee ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 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. LName ........ ...... /' `..1„fit, � �Lt................................... Construction Supervisor's License .................................... 1 WILLIS, FRED A=208-85-16 30070 Permit for ..ADDITION No ............. ................ Single Family Dwelling ..................... ............................................ . Location 70 Fernbrook Lane ................................................................ Centerville ............................................................................... Owner Fred Willis .................................................................. Type of Construction ......Frame. ......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .........O.ctobe.r...22.........19 86 Date of Inspection ....................................19 Date Completed 19 k ,o �a -� .` '}_ .,1�..-. '-,rz:,;. �;„, G�� e i.ab."•.�t� .'.'.t.:;a. t.,."«:.:'*. ,.r_..";.f ='.'�:`'YF- �t,�_v.. -_�'T. ri..%k.s,;.:—+:.-er,,...,-w '. y�y;.�.k5r s u ' o TOWN OF BARNSTABLE Permit No. __27819 ----------------- �. Building Inspector Cash +639. X 't QY . OCCUPANCY, 'PERMIT Bond -------- --_-----1� ? Issued to Bayside Building Co. Address Lot 20, 70 Fe�rnnbjrook Lane, Centerville Wiring Inspector "' - Inspection date ��1 � Plumbing Inspector2_ '( s i .,� Inspection date �f«• r � r �,p n - Gas Inspector s #� ✓ i� ,��Z it s2 v Inspection date C, X Engineering Departn ent • Inspection date Board of Health BUJ (� Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTORY UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Building Inspector t l TOWN OF BARNSTABLE BUILDING DEPARTMENT 2 saaasr = TOWN OFFICE BUILDING rwa A39• �� HYANNIS, MASS.. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued 'for the building'authorized by"` t Building Permit t �/ issued to .. Sf `�l.. Zl� � 4a � ......... 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