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INSTALLED I ICE WTH Definitive Plan Approved by Planning Board 19 ENIVIR®NME N s• . t ' AND TOWN RE . TOWN OF_`BARNSTABLE, Building Permit Application Project Street Address 79 AMA, /�, �� ���f el-P/Ile Village e&1111116 Owner t 1 r Address / Telephone "Permit Request (u,ZeQ le d Si, rro`11 First Floor square feet Second Floor square feet Construction Type 4&rd Estimated Project Cost $ / Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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: Z(Full . ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing_ _ New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing ''I New First Floor Room Count S Heat Type and Fuel: [ Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing / New Existing wood/coal stove ❑Yes ❑No Z Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) f�Attached(size) / f ❑Barn(size) ❑None ❑Shed(size) _ ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No, If yes, site plan review# Current Use Proposed Use Builder Information Name �� v __ Telephone Number 77S 3 70 9 Address 11)r 19DACPA ko Z4° License# 3 3 g Home Improvement Contractor# /f a�7 7 Worker's Compensation# )rS oeQQ 19ty 3 D 39 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. / ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ba/1.0S hA�u L✓�i l� SIGNATURE DATE U�A2 BUILDING PERMIT DENIED FOR THE FOL OWING REASON(S) Lr �� FOR OFFICIAL USE ONLY y ERMIT NO. w '^ DATE ISSUED.- MAP/PARCEL NO. ADDRESS VILLAGE'' OWNER • — ,. �: ,} _- �� _ d � _ , � ;r } . _ ,_, '� . DATE OF INSPECTION: FOUNDATION FRAME I INSULATION FIREPLACE ELECTRICAL:� ROUGH FINAL ; n.t PLUMBING: ' COROUGH FINAL M i GAS: j GH FINAL, t ; FINAL BUILDIN.(g °DATE CLOSED OUT «~ "` let i F r ASSOCIATION PLAN NO;- t r , U ►' ell S •ij e r� I � � w j i , !N - `I-N _�,--�---�-- �- ! I I . Ov o 11 -�- --1- - i role ZZ, , , i I r i f i I � - ', r. �_ f . �, 'i-d! ' ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ME■E■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ No MRm MMm* No 0 SEEMS EMMEMEMIGIMEMOMMI wommonow MEN Emmommim ■t ■■■summ■■mo■■■■■ ■■■■■■■■■■■■�� ■ �■ONE■i■EE■EMM■■E■■I MEMO■■■■■E■ SMI■MOOD ■loo■■MEME■■MM■IMEMEM■E■■M ■MtMEE MEMMEMMEEE■EME■■IE■■I MEMO■■EEEv■■■®■ E■EE■E■■■■■®■■■■■■■■E ■ME MWEE ME■EME■■■EE■■EEMEREMEMEM■EME EI■EE■EMEE FUME■ ULM ORION in ROME 1"Umma ■uWOMEN IN �■ ■e SEE■■■■ �eE MEMEMEMEM IN-MEEE -No so WON - ' I ' I - I I i I � - t I I I � TheTown ®f Barn stable •• •� $�. D.epartment of Health Safety and EnvironIneIItal Services Building Division 367 Main StMC4 Hyannis MA 02601 ' Raiaiz C Office: 508-;90-62277 Buildiuz Cz Fax: 508-7,90-6730 For office-rise oniy Permit no. Date AFFMAVIT HOME MOROVEMENT CONTRACTOR LAW SUPPLEME:'YT TO PERMIT APPLICATION ` ! air, modernization. MCL c. 14ZA requires that the �,reconstruction, alterations, renovation, rep conversion, improvement, removai, demolition, or construction of an ditton to any our dwelling preuni arito owner occupied building containing at least one but not moret structures which are adjacent to such residence or Building be done by registered contractors, wit:: certain exceptions.along with other requirements Type of Work: /a"�'/�/ ��� dh Est. Cust L l ct _ Address of Work: Owner's Name Date of Permit application: / 1V � I hereby certify that: Reavistration is not required for the foilowing resson(s): Work excluded by law Jots under 51,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTE = CONTRACTORS FOR APPLICAB GUARANTYFUNDWORIC Do UNDER MG' I42A � ACSS TO TBE NITRATION PROGRAM OR GUARANTY SIGNED UNDER PENALTIES OF PERJURY . I hereby appIy for a permit as the agent of the owner: Cnat czar iYattte Registrarioa No. Date The Communivealth of Atassacbuscits Departnrrnt of Inrlustrial.4ccirlerrts t _ � Office oflnyesMatians 600 !f'ashirr�tun Street Boston.A1aax. 02111 \Porkers' Compensation Insurance Affidavit .. �1liplic•tnt information• Please PRI1VTlebul name• location- tits nhonc# I am a homeowner performing all work myself. [1 1 am a sole proprietor and have no one working in anv capacity • .. _ r0_. ...._.ww-.A:ll�vl+.�.f'w�T+:T��.1.7►fr:.ATPwa►+...+..�..�..��w.�.�.w.w.�.�.w..�n++�f•...ww�...,.w!..--^. _.... .. Cj II am an employer providing workers' compensation for my employees working on this job. enomans• n• roe: address: cih phone#• insurpnce co �►olics# I am a sole proprietor. general contractor. or homeowner(circle one) and have hired the contractors listed below who have the following workrs' compensation polices: comn'tm• nnmc• /6/`,ar L ll /h lddress: zys- tits•• nhonc#• / /3_ 37,06 incurnncr ro ��dW/��'1G � / -- _- - Holies # s 000D00 30 391/ - cnnipinv nnmc• — nddresc- nits i hone#- incurnnce co noiics# .Attach additiOnai sheet if n[CCSEary�• .. ':��y;,�;�;'- --^' ,;' `'.,•c:Z:,vri==- ��=a/a '=��" ^�"�'�w ��'"-�� ^�'� r'"�"•.ws:.�:+s. Failure to secure coverage as required under section SA of 111GL in can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur one cars' imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. 1 understand that n cope of this statement mat- be forwarded to the Office of Ins•estigations of the D1A for coverage verification. I do hereby certify under Nte parr and penalties of perjury that the information provided above is true and correct. Si^_nature Date4�&l _ T— /� Print nnmc i �J. e� Phone# 7-/ " 3 7�17 ' ofrcial use unit- do not write in this area to be cumpleted by tits or town official - citv.or town: permit/license# rIBuiiding Department Licensing Board C] S t' check if immediate response is required - ❑ •electmen's office �.' c31lcalth Department . phone#• t�Uthcr t contact person: �.- i P�'�`jNE•T��+ TOWN OF BARNSTABLE I BARNSTABLL i "b 9 BUILDING INSPECTOR am APPLICATION FOR PERMIT TO P�..... .... ...... . . .. TYPE OF CONSTRUCTION ........ .... ..... ....:. ......................... ............................................. M ........... ...........19..�® TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............. 6�.d...F.�e f -......../ ��.e ....... cgew..7........1 in P.............l�,�s�����s'�����....... ProposedUse .................. /....................................................................................................................... Zoning District ............... .....................................Fire District .f�J.A"� !?�✓.. .�. °6 � , r1'..........:....... C°'xt .. Address ...... Name of Owner sQ.L ....... !`'�. V.....�aOK Name of Builder ... � e ...... '�as'�'- '.........Address ......... .... .:.��C..rs. .... �`f?!A�!er�/®, ............... ...... .. . .... .... Name of Architect .............Address ....C?,Ve5........ 4a ! .......�4......7 .�.,f/,.Ei Numberof Rooms ...................... ...........................................Foundation ..........��.........�'''..4�T........................... ........... Exterior le...t. .d.t .......! .. ..:.....................Roofing ...............4 .l...r ; ........................................... Floors ��.......................................................Interior ................ 1��?.f*.l!gj' ...................................... Heating ............ ® .6e�.4>F.a�'........!P447.�4 -40PIumbing Fireplace .....................47 ............................................:.Approximate Cost ...:........ ..�.�,ll........�................. .......... Difinitive Plan Approved by Planning Board ------f'oCa-------------19 Diagram of Lot and Building with Dimensions LU c� O W_I w S op U) n ® f.a zQ : ., Et" w O v �< = O LL. o � m ,,4T Qom `" � v7 Ln (1) CL < z 7 Or d O z I w H _ �q = Q U � / 0 1i'L0-ao l 117 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg rding the above construction. ja Name .. ...... . . ..4i9Y.. .�. .r: ^. -_ '___-^ Corp. . No ..... Permit for ......—txa2--A�217.v --. ............ . .................. . Locoi on —.'.�_. . ..Ioxad_____. � ............................ --------- } ' | � Owner ��� � ^ ---- '``°�°"�—=�^m~------ Type of Construction .............fzanma-----.- -----^--------'------------' p� �75 Plot ---------. Lot ---��.�.�-----. ^ � _ ,-. Permit Granted ..... ...IO.................lg 70 Dote of Inspection �� ~~ ."—^.~^��--—�`--.1976 / Dote Completed ------------..l9 ( ' ' ^� PERMIT REFUSED, \ ' l�-------^-----^-------' - | . . .-----------------------.--. ^ � ) � ( ' � ..------.-----.----.--------.. ' - —..--_.--------.-----..................... � ---------.------.--..-------. pr lg ' ', ~`~~ .—.-------------' | � ' > ` -------.------------------- � ................ --- .................................................. � ' i 1 G 054 .78 � .32 0.' 6 C #293 ' 68,` f r: 2A 0.36129 A i 0.39 AC 0.3 43 ' #273 : Cry;sor ass==s_�,n�purposes only AC_ t� Cr 0.39 AC - - r .3 � ( 2 A scale:1"=50 j ., t _y