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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Ma Parce'I �� Application ! VZ��
p — pp o
Health Division Date Issued
Conservation Division Application Fee R
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board {
Historic - OKH _ Preservation / Hyannis
Project Street Address
Village Cey\��_L I
Owner Amn Address Q;
Telephone
Permit Request A
Qom- S
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
JProject Valu� Construction Type
.Lot Size Grandfathered: ❑Yes ❑ No' If yes, attach supporting documentation.
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: ❑ Full ❑ Crawl XWalkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new Half: existing A new
Number of Bedrooms: existing —new
Total Room Count (not including baths): existing new First Floor Imo m Count:
Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other Ca
4 N
Central Air: ❑Yes NQNo Fireplaces: Existing, New Existing wood/coal stovd: ❑Yes ❑ No
Detached garage: ❑existing. ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ misting new-0size_
Attached garage: xisting Li new size _Shed: ❑ existing ❑ new size _ Other: 0 .
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes Flo If yes, site plan review#
Current Use �fS��e r� Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
3 P ' I
,Name zy\ vtowo"a Telephone Number O 1 ��0L � I,J
`AddressAo� License # CS '0 M l
�-Oow_ Home Improvement Contractor#
Email A jjo On @0\- CAM, Worker's Compensation # SO\e, Pa0_?
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CC• �•
�, SIGNATURE _DAT-E—__=z.=S/S/ -J�4
s
FOR OFFICIAL USE ONLY
v APPLICATION#
r ' t
DATE.ISSUED
i MAP/PARCEL NO.
ADDRESS, VILLAGE
OWNER `
;. 1
DATE OF INSPECTION:
FOUNDATION '
11' !
L FRAME
!, INSULATION
FIREPLACE
r
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
I
FINAL BUILDING
[ATlEaCLOSED OUT
ASSO�MTION PLAN NO.
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The Commonwealth of Massachusetfs
Department of IndustrWAccidents
Office of Invesfigations
600 Washington Street '
Boston,MA 02111 ,
www.mass gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers
Applicant Information Please Print Lepribly
Nan10(Business/Organization/Individual): �Tnkmj%d(.Z
Address:--
. �---,----_--_ _
' Are you an employer?Check the appropriate box: '- Type of project(require:
1.❑ I am a employer with 4. �'I am a•general contractor and I -
ployees(full and/or part time).
* have hired the sub-contractors 6. ❑New construction
2. I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling
ship and have no employees These sub-contractors have g. ❑Demolition
working for me in any capacity, employees and have workers'
9. El addition
[No workers'Comp.insurance comp.insu'anee.
'$
required_] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
officers have exercised their
11. Plumbing repairs or additions
3.❑ I am a homeowner doing all work ❑ g p
myself. [No workers.'comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]t c. 152, §1(4),and we have no _
employees.[No workers' 13.[`�O er <-
comp.insurance required.]
*Any.applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such.
tConttactors that check this box must attached an additional sheet showing the name of the sub-contractors and.state whether or not these entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lie'.#: Expiration Date:
• Job Site Address:---=— E• ' - =------City/StateLZip:�_ � Vic/ �_"~w � ��
Attach a copy of the workers'compensation po cy declaration page(showing"the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine 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$256.00 a day against the violator. Be advised that a copy of this"statement may be forwarded to the Office of
Investigations of the DIA for' ce coverage verification.
I do hereby ertify nd a and penalties ofpcdury that the information provided above is true and correct
�Si atzu•e:-' Date:,'----"
Phone#:
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.EIectrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone M.
Information and Instructions
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 hire,
express or implied,oral or written."
An employer is defined as""an individual,partnership,association,corporation or other legal 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 the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local 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 acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call.the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submif multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to buns leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of lavestigations
600 Washington Street.
Boston,MA 02111
Tel,#617-727-4900 ext 406 or 1-877-MASSAFB
Revised 4-24-07
Fax#617-727-7749.
www.mass.govfdia
Massachusetts -Department of Publ
i
Board of Building Regulations s Safety
9 �o
ns a
Construction
.Supervisornd Standards
License: CS-033941
PAUL PIO
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Town of Barnstable
. Regulatory Services
NAM Richard V.Scali,Interim Director
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable maxs
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete.and Sign This Section
If Using A Builder
as Owner of the subject propertT
hereby authorize to act on my behalf,
in all=tiers relative to work authorized by this building pertnit
(Address of b)
**P001 fences and alarms are the responsibility of the applicant. Pools
are not to be filled or.utilized before fence is installed and all final
inspections are performed and accepted.
Signature o Signature of A,pphcant
rq O•.- -
Print Name l Pant Name
Date
�;.�„• �',,;., - t....� is � � r� �v
�{
i
m �
R
ny,q
Town of Barnstable *Permit# d(%
` Expires 6 months from issue date
Regulatory Services Fee ZS. 00
X-PRESS PERMIT Thomas F.Geiler,.Director
JUL e 2 2007 Building Division
Tom Perry,CBO, Building Commissioner
TOWN OF BARNSTABLE 200 Main Street,Hyannis,MA 02601
www.town.bamstable.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�,1�� dd ljo o2
Property Address e . t
❑Residential"X Value of Work! 'ds1stV — Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address
IPM
�' 11 G"` Te�h�e NumbeFx
Contractor's Name �' � TP ✓P '1 eP / c
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) i9
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name Ca.4�rU' ..L..r1 j Ueam L e
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 to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
[ 'Replacement Windows/doors/sliders. U-Value +3� -� (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 Improvement Contractors License is required.
SIGNATURE:
Q:Forms:expmtrg
Revise061306
�. The.Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
' 600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers'Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Lezibyy,
Name(Business/Organization/Individual) 6*yryae r5 (DtlJ
Address:
City/State/Zip: �U�' Phone.#: d64V— 1 r7f
Are you an employer? Check the appropriate bog: Type of project(required):.
1.❑ I am a employer with 4. I am a general contractor and I
6. El New construction .
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a'ole proprietor or partner- listed on the-attached sheet. 7. &<emodeling
ship and have no employees These sub-contractors have g, ❑Demolition
workingfor me in an capacity. employees and have workers'
Y P tY• �. 9. ❑Building addition
[No workers'comp.insurance c .insurance.
required.] 5. re ate a corporation and its 10.❑Electrical repairs or additions
officers have exercised their ❑Plumbing repairs or additions teir 11. bn
'3.❑ I am a homeowner doing all work , P
myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' . 13.0 Other
comp.insurance required.] .
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must providt;their workers'comp.policy number.
lam an employer that is providing workers'compensation insurance for my employees Below is.the policy and job site
information.
Insurance Company Name: &L4�,,/ `
Policy#or Self-ins.Lic.#: W&QV 1 Fa�7 ExpirationDate: 9
Job Site Address: 4p3_ lCmW449e City/State/Zip: W% 4vAwk
Attach a copy of the workers' compensation policy declaration page(showing the policy number an expiration date).
Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine 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 statement may be forwarded to the Office of
Investigations of the WA for insurance coverage verification.
I do hereby certify under t�heepains-andpenalties ofperjury that the information provided above is true and correct
Signature i�/IM�6tM Date• 7Lc� !P7 _
Phone#
Official use only. Do not write in this area,tb 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 CIerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Informnation and Instructions
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 hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,asso6iation, corporation or other legal 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 ov 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 the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall`withhoId"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-acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for,the'performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented'to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contiactor(s)name(s), address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 'The affidavit should
be returned to the city or town that the application for the-permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate-line.
City or Town Officials ;
Please be sure that the affidavit is complete'and printed legibly. The Department has provided'a space at the bottom
of the affidavit`for}bu to fill out in the event the Office of Investigations has'to:contact yoii regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
thaf must submit multiple pei-mit/license applications in any given year,need,only,submit one affidavit indicating current
policy information(if necessary) and under"Job Site Address"the applicant should write"all-locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture
(i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call. -
The Department's address,telephone-and fax number:.
w hu = b'.
lee Commonwealth of Massa' setts
Nparument of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. #617-727-4900 ext 406 or 1-877-MASSAFE
Fax# 617-727-7749
Revised 11-22-06
www.mass.gov/dia
-
ZHE 'down of Barnstable.
�pky
y Regulatory Services
9$ MASS. Thomas F F.Geiler,Director
�'OIfDNip`tN, Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
v ,w-town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using ABuilder
L iq n n as Owner of the subject property
herebyauthorize
s fb to act on my behalf,
in all matters relative to.work authorized by this building permit application for: .
3
(Address Job)
lvl.2? /0 7
Signature of Owner Date �—
Ln rya du
Print Name
Q:FORA!S:OwNERP ERM IS S ION
✓fie 7�o�n�rrwmtiuecrlCfi �/�aaaacfu�arlld II
Board of Building Regulation and Standards
License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registrations. 155618 Board of Building Regulations and Standards
Expiration 4/26/2009 Tr# 255171
One Ashburton Place Rm 1301
•;: 'Boston Ma.02108
p
e
T e: Private Corporation
'
Yp
CREATIVE CONTRACTORS GORP
STUART BAKE
162 QUAKER MEETING HOU
R � n
S E R
SANDWICH, MA 02537 Administrator Not valid without signature
, BET°♦ TOWN OF BARNSTABLE Permit No. ....30545,,,,
° BUILDING DEPARTMENT
{ B°g"` Cash
TOWN OFFICE BUILDING
1639
°�Eour►� HYANNIS,MASS.02601 Bond
CERTIFICATE OF USE.AND OCCUPANCY
Issued to BAYSIDE BUILDING CO.
Address lot #lA 63 Kearsage Avenue, Hyannisport
USE GROUP FIRE GRADING OCCUPANCY LOAD
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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING`CODE.
August 21.......... 19.87............ .hr:............... .. .............. �
Building Inspector
r
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
_ »0T TOWN OFFICE BUILDING
out
HYANNIS, MASS. 02601
'�o cur►•
MEMO TO: Town Clerk
FROM: Building Department
DATE:
An Occupancy Permit has 'been issued for the building authorized by
BuildingPermit #.. .......... ........,....................................................._.............................................................._
issued to/ t/. /...aP.... ....... -/.�............... ........... .. . 1�'S�SC„ �yL�r.. ��_
Please release the performance bond.
y��r�
G PERMIT,=.
TO
! PERMdIT NO�
DATE R)L • . �7 I-,, 7.'..., .,
1 '-
ir•.•t ADDRESS S •.• 9 }, / ''_�.. (CONTR'S LICENSE)
APPLICANT INO.) (STREET)
-NUMBER OF
;.t: STORY _. ,. ,':DWELLING UNITS
PERMIT TO (PROPOSED USE)
,(TYPE OF IMPROVEMENT) NO.
ZONING
�'� ....;.. l. i.-/ .•.j t. `.�"uJ.. ...•ir•_.�'�- DISTRICT
AT (LOCATION) (N0.) (STREET)
BETWEEN AND .
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK
SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG By FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
`TYPE USE GROUP BASEMENT WALLS OF. FOUNDATION
x (TYPE)
REMARKS: -
- 4
p
�,...J PERMIT $ f
AREA OR / FEE
VOLUME ESTIMATED
9 ,(CUBIC/SQUARE FEET)
OWNER BUILDING DEPT.BY
C;
ADDRESS
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY.OR SIDEWALKOR ANY PART THEREOF. EITHER TEMPORARILY ORt'
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP—>,
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED.
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
'OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS PERM PERMITS HERE *APPLICABLE
REQUIRED FOATE
R
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL.INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND s,y
ALL CONSTRUCTION WORK:
- GS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS �R E- MECHANICAL:INSTALLATIONS.
I. FOUNDATIONS OR Foon N
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET ; r
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APP VALS ELECTRICAL INSPECTION APPROVALS
`
2 -- 2
Ilk
3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT
1 ` !
OTHER Z BOARD OF HEALTH
,y.` a
e ,
!�¢ PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BI
WORK SHALL NOT PROCEED UNTIL THE INSPEC-
;i "! TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT ij RTpp D WITHIN'SZ.'. MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEI
PERMIT iS ISSUA X NOTED ABOVE. NOTIFICATION.
: . CONSTRUCTIOF s
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rp. ' WILLIAM yG
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27, 1701
,4PlJLl��Y���is �
�T ` Ire-
a S T
Asseskor's offioe,(1st floor): 4. `
' SINE
*- Assessor;s map and lot number ...Z .."—� `_
t0
TALLATION_ AND G i-wy 111 W �WQ11,
Board of Health-(3rd floor): ] A.
� THE SYSTEM WAS INSTALLED IN
Sewage Permit number ::.. ......W.V.....l.::l ...... _ sntB, .
t Engineering Department (3rdAloor): f �F FJS CCO j y E �
l0 ,. RDAND� ,,.,Ba�a
House number ...........................:....................................:�......:. "��, . •. ,.r t�,l, ® IN COMPL
APPLICATIONS PROCESSED- 8:30-9:30 A.M.:_and! 1:00 2:00 P.M. only' WITH TITLE 5 " y
`: yA ��®N�PIENTAL CODE AND
TOWN OF . B AR N S T ` EIR"LATIONs
r . : BVILDI-NO INSPECTOR
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APPLICATION FOR PERMIT TO
TYPE OF. CONSTRUCTION ... ....:.................
TO THE INSPECTOR OF-BUILDINGS:
The' undersigned hereby applies for a permit according to the following•information: '
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Location .......L -T.....�:�........J--C—A.. ,` �-� .... . ............�� ?tl�l1V{ h ..:..............
.... .... ...............
Proposed Use .:... .—,0.5 .e4- C.`P }.
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Zoning District .....� _ L. ...Fire District ........ cl� .. ........... .. ........
Name of Owner :....!� !��..t. .,`e.......:.............:.................Address ...........A ...
Name of Builder ....... .Am .�. .Q,..................................Address ^ .............................:......
Name of Architect �'�41c�C1'.c�. .......4 `` ......`.:......Address :..'::......:'.`.:`. F�M ......r.'..1�:��5................:.
Number-of Rooms .......(.Q............................................ .....Foundation ........ 43?r,.P.-Le `:....CS}?�1C:�. `�, ...............
Extei .......( , .. ?J�c9'��. ...��.D . .�: 1��`t,5�'.S. .Roofin ......., ................................ ...
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Floors ' .......(J.64.1_......L�..�t.:....... r. ... V. �. :.�...Interior.�... y :.P,. . ....... �. . .� ..................................
Heating ..... t...�........} t:.1.1!.il !...x............................:.:...Plumbing .�4...�S.C......t...C.I. Pam:...... .. ,�`......�..a�2.,
Fireplace' .:... u. ... ... ,..4��f��a! .............:.:.:............:....Approximate Cost ............3. .:.
............. ..................
Definitive Plan Approved by Planning Board A __________ '___19 Area C�. � '
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//QQ. .............. ........
Diagram of Lot and Building. with Dimensions Fee=.:..: ................................
SUBJECT TO APPROVAL OF BOARD OF 'HEALTH
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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 . .... ... . ..... :..
Construction Supervisor's License .....� .
7,
BAY5IDE 'BUILDNG CO.
' t,�.' 3054.5; 1 z Story
.. ... ...... Permit for ................................... h �`
FS Single, Family Dwelling ... _
t ... ........,.........................................._..... .....
Locatic� .. `Lot 1A, 63 hearsacge Avenue _
4............................................................ i.,� - . .. F
...... (�
Bayside .Building C :
-Owner ......... ......... . .............. o...........
Type of'Construction ...Frame... ..................
} � Plot Y" ............ ... Lot.................................. �*
Permit"fGranted ........ .....;19 87 r r > { t =
Date of-Inspection .............. Z.............19 7 ..
Date, Completed ...... ��.. ....- .19!" ► " �t j.
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Assessor's;offioe (lsOfloor):
Assessors map and lot number ...2Z ��... i �oFTNETO�
Q �
Bird of Health 43rd floor): o"
Sewage Permit number ........
Engineering Department (3rd floor): = -�3 �.fS moo NAG&
Housenumber ........................................................................ o Ma'I
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 .�'�' ?,: ?Via . ....A,..
TYPE OF CONSTRUCTION �... ?. {✓ �
............... ....-----......19.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .......1 UDC'......(A ....... - 1 — ....Ave.............. Yidt 1Q.IS,IO ................
ProposedUse ..................................................................................................................................
yFire District .. ��Zoning District ...`...................................... .............?<r.,......,.............._...........................................
Nameof Owner ..... ...................................... .................�.......r�
Name of Builder .......u. .t!�,.<.1. .��...................................Address C` c��`e9cJi �
Name of Architect' �'r?,. �� s�?�. ?- ............. .Address .............',', l/�^, Y ' 1J.`.`....................
Number of Rooms ....... n....................................................Foundation .......� ................
` r -
Exlerlor ....... .<<<.,t.?x��r4.y?. ... .. ?C,,....�.::7.�'?1N!�..� Roofing 4-SA 1A. ........... �._ .! V . . ... ......................................................
Floors ......6.ti?!., -.......f � � r. �er.,����..... a,iJ.��..(....Interior ....... . .!.fQ<........� Px�..................................
� a U - -
_ -
r 4 f/
Heating .... {.:r.1 ........ ".r..Ni .. ......... ..............................Plumbing .-??,!1 ..... ... z' .... ..ti:�?."......�. �6...
Fireplace ..... .�.% ...`�...t`KC'..�h....................................Approximate Cost
A ' / .....
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Definitive Plan'Approved by Planning Board AP 9---19 Q- . Area ......... .-.9. .��3..............
Diagram of Lot and Building with Dimensions Fee /.�l�.~
:. `.... ....................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
V
7 I
R
t
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnsfdble regarding the above
construction.
Name .. i.�. ��..... �!. -
.......
Construction Supervisor's License ...... S..C.?. ..........
BAYSIDE BUILDING CO. A=225-1$
a � S - I% _a
'30545 11 Stor
No ................. Permit for ....?.............. '..............
Single Family Dwelling
............................................................
Locatiof, ..,, Lot 1A, 63 Kearsage Avenue
.. .......I.................
UVaQa c.r,n,—�
....................�-......- _.:......................................
Owner Bayside Building Co.
Type of Construction ....Frame
............................
...............................................................................
Plot ............................ Lot ................................
;F 7
Permit Granted .....March 24 , 19 $ ,
Date of Inspection ....................................19
Date Completed ......................................19
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