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t` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
4 Ma 1 69 0 I pp
p— _ Parcel a A lication#
Health Division
Conservation Division r Permit#
Tax Collector Date Issued
Treasurer Application Fee *.50i
Planning Dept. Permit Fee `
Date Definitive Plan Approved by Planning Board 19I2//b
Historic-OKH Preservation/Hyannis
Project Street Address
Village ---e,t�7`�e
Owner 1"r,9�Vk Address
Telephone G f 964 _3 2 ?S ,•�/
Permit Request ge-pl4e e ��.(� [/mac k 12. >2 0e,C r c
f L-.
Gj
Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new =
cry
Zoning District Flood Plain Groundwater Overlay
Project Valuation 0 00 Construction Type r
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing StructureR a Historic House: ❑Yes /Q"No On Old King's Highway: ❑Yes kNo
Basement Type: 4Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) ZOO 0
Number of Baths: Full:existing new 46 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: 0 Gas ❑Oil ❑Electric ❑Other
Central Air: ❑Yes U No Fireplaces: Existing New Existing wood/coal stove: ❑Yes kNo
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:V existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# _ T_ = Recorded❑Y�
Commercial ❑Yes �No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name e4AZ3fAll 61,ele-4' Telephone Number �64-0 36
Address 7 7 License# 9 72
L_4"v,,,r C9 2a 2,5— Home Improvement Contractor# l/DWs s-6
Worker's Compensation#,/L
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 61g
SIGNATURE DATE
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION �'•f, N o CJIF`} !V 71 -
FRAME
INSULATION
FIREPLACE
A=
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING4 rz
"
DATE CLOSED OUT ,-
ASSOCIATION PLAN NO'.
r
y of,Kk, Town of Barnstable
Regulatory Services
Thomas F.Getter,Director '
BuRding Division.
Tom Perry, BuUdfng Commissioner
200 Main Street, $yannis,MA b2601
www.town.b arnstable.ma.us
office: 508-862-4038 Fax: 508-790-6230
Property.Owner Must
Complete and Sign This Section.
If Using ABuilder
icy A eo ,as.Owner of the subject property
hereby authorize h . � �.�� to act on mybehalf,
is all matters relative to work authorized by this building permit applica'tion'for.
(Address of Job)
tore of Owner Date
4- � � a
Print Name
q:Foxr�s:owrr��ssmN •
°F"E r Town of Barnstable
Regulatory.Services
BARNSTABM ' Thomas F.Geiler,Director
y '?"Ss. g
1.19. Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: 5UX,- � G� Estimated Cost ®�
Address of Work:_ �te�� 4 &4/v/`�
Owner's Name: T' �[/f`s Ale 4�
Date of Application: `®
I hereby certify that:
Registration is not required for the following reason(s):
[]Work excluded by law
[]Job Under$1,000
[]Building not owner-occupied
[]Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent a owner:
Date Contractor Signature Registration No.
OR
Date Owner's Signature
Q:wpfiles.fomwhomeaffidav
Rev: 060606
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Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.govIdia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plurnbers
Applicant Information Please Print Ledbly
Name (Business/organization/Individual): 5_4f!-e li�✓� ��
Address: `7 7 el,'fLe t��e�� �- . 0 A,
City/State/Zip: /6-e —eg- Phone#:
Are you an employer? Check the-appropriate box: Type of project(required):
❑ general contractor and I
1.❑ I am a employer with4. I am a g 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2. 1 am a sole proprietor or partner- listed on the attached sheet $ Remodeling
s4 and have no employees t These sub-contractors.have S. ❑ Demolition
working for mein any capacity. workers' comp,insurance. 9. ❑ Building addition
[No workers' comp.insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
required.] officers have exercised their
3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.7 Plumbing repairs or additions
myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs
insurance required.] t . employees. [No workers' 13.❑ 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 wbo submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
lContractors that check this box must attached an additional sheet showing the name of the sub-contrabtors and their workers'comp,policy information.
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.Lic. #: Expiration Date:
Job Site Address: City/State/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 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 DIA for insurance coverage verification.
I do hereby certify under the pains andpen�alt/aes ofperjury that the information provided above is true and correct
Si ature: 5/ Date: _
Phone#: 3
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.Electrical Inspector.5.Plumbing Inspector �
6.Other
Contact Person: Phone :
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 thefforegoing 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-contractors)name(s),addresses) 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 permitlicense number which will be used as a reference number. In addition,an applicant
that must submit 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 maybe provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. Anew 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 burn leaves etc.)said person is NOT required to complete this affidavit
The Office of investigations would hike 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 Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MA SSAFE
rax# 617-727-7749
Revised 5-26-05 www.m.ass.ao m"a
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Ucense: CONSTRUCTION SUPERVISOR
Number 046972
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STEPHEN M G-
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COTUIT,EISENHOWO 63 �, � Commissioner
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\ Board of Building Regulations and Standards
HOME IM�
OVEM ENT CONTRACTOR
Re istratio110650
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STEPHEN M WtL,E[tDr �
tt&HEN WHALEN� 7
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. 77 EISENHOWER UR = Administrator
COTUIT,MA 02635
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G/igYE¢yOQ rn T. j+S��
ND SUR��
YR L_ AN E
LEGENI® .
CERTIFIED PLOT PLAN
MISTING SPOT ELEVATION --..0,10
EXISTING CONTOUR --- ® ......•,. ti"
rINISHED SPOT ELEVATION' o? -e
INISHED CONTOUR --- 0 ---M- o a Lo-
0 1095b-Q IN
4PPROVED BOARD OF HEALT*M
DATE AGENT SCALE= /' - 50' DATE
"'L.DREDGE ENGINEERING Cd CLiLTr ��
1 CERTIFY THAT THE PROPOSED.
EGISTERE REGISTEq`tE® JOB H®. ���.�.. BUILDING SHOWN ON THIS PLAN
CIVIL LAND' �- D] CONFORMS TO THE ZPNING LAWS
E GINEER U.RVE R DR B'V``;-.�..------ OF BARiVSTAS E, ;S.
712 MAi N STREET C .'� � J 4 „ -I ...
HYANNIS, MASS. -
�. SHEET-1 OF DATE Rf'G. LAID SURVEYOl'i _
Town of Barnstable *Permit# /5b17
Expires 6 months from issue date
Regulatory Services Fee , �0
Thomas F.Geiler,lDirector,
Building Division CA
erry,CB®, Building Commissioner
X*RMSPOD0 Main Street,Hyannis,MA 02601
Office: 508-862
qq 10 2006 www.town.bamstable.ma.us
Fax: 508-790-6230
TOWN PkAgRATAN& APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address Z/ Z, �AWE: C29�n1 7- �!/!�
Residential Value of Work 4�161, 700 Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address 22� ��xfd2dJ0
Contractor's Name Telephone Number =��
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
EWorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ Iam the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name t
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
6
❑ Replacement Windows. 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: Pro Owner musts' ope Owner Letter of Permission.
me provem on ct s Li se is required.
SIGNATURE:
Q:Forms:expmtrg
Revise071405
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 Legibly
Name (Business/organization/Individuai):
Address: - s o L0 7-0 r2,P . z ������ �
City/State/Zip: ��1 �r/ 5 /�,,9� Phone#: �--
Are you an employer? Check the-appropriate box: Type of project(required):
1.91 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.El am a sole proprietor or partrter- listed on the attached sheet $ ❑ Remodeling
ship and have no employees These sub-contractors have 8: ❑ Demolition
working for mein any capacity. workers' comp.insurance. g, ❑ Building addition
[No workers' gomp.insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.❑ Electrical repass or additions
3.❑ I am a homeowner doing all work right of exemption per MGL I LEI bing repairs or additions
myself.[No workers' comp. c. 152, §1(4),and we have no 12. Roof repairs
insurance required.] t employees.[No workers' 13.❑ Other
COMP.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policyinfonnation: '
t Homeowners who submit this affidavit indicating they are doing an work andffien hire outside contractors must submit anew affidavit indicating such
tContract m that check this box must attached as additional sheet showing the-name oftbe sub-contractors and their workers'comp.policy information.
I am an employer that Is providing workers'compensation Insurance for my employees. Below is the policy and,yob site
Information.
Insurance Company Name: j/1il
Policy#or Self-ins.Lie. #: Bxpiration Date:
Job Site Address:- G/-1747 City/State/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 of MGL c. 152 can lead to the imposition of crinrinal penalties of a
fine up to$1,50Q.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 DIA for insurance coverage verification.
I do hereby certify and th pains and pe�dilliesf pe ' that the information provided above 1 true a correct
Signature: Date: � v ,_5
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 Heakth 3.Building Departmeztt. 3.City/Town Clerk e.Electrical Inspector 5.P'lumhing Inspector
6. Other
Contact Person: Phone#:
Information and Instructions �.
In �.
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 li 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 orbuilding appurtenant thereto shall not because of such employment be deemed to bean employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the Issuance or
construct uildin s In the commonwealth for an
permit too operate a business or to b Y
renewal of a license or p pg
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 ofpublic 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-contractors)name(s),address(es)and phone number(s)along with their certificate(s) of
insurance. Limited Liability Companies (LLQ 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 eater 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 submit 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
ff
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. Anew affidavit must be filled out each
year.Where a biome 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 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:
The Commonwealth of Massachusetts
Department 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 5-26-05
wW'W.?IlaSS.aOV/Qta
t
I� Board of Building Regulations and Standaii d
ROME IMPROVEMENT CONTRACTOR .
Registration 149475
EXOR.at.W 11-2,12008
F�
i! s T.ype D:BQ
ENGECSEN CONST�UGTION'',r,.yi
ERIC.ENGELSEN
85 OLD TOWN_RD�
• HYANNIS,MA 02661 . Administrator .
9
°FZH�r Town of Barnstable
Regulatory Services
9 KAM Thomas F.Geiler,Director y `
�ApEa �N Building Division.
Tom Perry, Building Commissioner
T 200 Main Street, Hyannis,MA 02601
wQvw.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Property bier lust
Complete and Sign This Section
If Using A Builder
I, u�lU� � ,as Owner of the subject property
hereby authorize �� ��,5 � to act on my behalf,
in all matters relative to work authorized by dais building permit application for:
�� L/ter . ✓E .24
(Address of Job)
Ignature o e Date
Print Name
Q:FORms:owNERPERMISSIDN
y'
See-- 2
i
��,
'or's map and lot',�number .. �`�! ` �!� E9' ,��,1��. g t� c, 1 THE
of To
age Permit number ....c ,�� ...Ll�..`/...�.............. " ?aT�ll rid (0MFLIAi,
." WITH TITLE 5
9T4DL8 • "
ENVIRONMENTAL CODE � .
House number .....:#.3.....:.��...:....'..............:........:............. . RE�l11.ATw� 4�°'�
TOW REGULATIONS o aY a
i TOWN 'OF 'BAR...., BLE
~ :
' K �
B U It I N G'..,,IJAS RECT0 R
APPLICATION FOR PERMIT TO .......................................::.e................................................... .......................
�
a
TYPE OF CONSTRUCTION .......:..:..........��.o.: L :...:..........i�af -:............... . . ......
....... ...`P '..� 3.................19.. �
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following.information:
Location ...... ......... ................ ..1. ........... .1........C. �. .................
ProposedUse ........................ Nil l..'C............. !`� .r. � ...................................................................
Zoning District ......... . ....... . .(•`:. .............................Fire District ...................� ..10.....................
Name of Owner ...........(.�.Cl� �� ��� �: �,Q�.Address ..........:... ..11. .�`...5 a.. :...... ~'Z9¢r
•F
Name of Builder. ....... l� ....
. : .................................Address ...............................:...............................................::...
,5.!�
........ !t
Name .of Architect ..................................................................Address ....................................................................................
Number of Rooms ..................................................................Foundation fit ........
Exterior ..:......... ......Roofing ........ .lr'd (.......�...�r.,�..............................
Floors ................. /L : ...... .........Interior �. . ...............................
Heating ................... . !:t.�.4�....�a ,S......................Plumbing ................... v.C:..... f:.f .in ' ............
'Fireplace ......................................................................• .......Approximate Cost .. ............. ... C�. .:u.......... .............
Definitive Plan 'Approved by Planning Board -------_ __-----------19_______. Area ....� R. .....................
Diagram of Lot and Building with .Dimensions Fee .......:.1•�.............................
SUBJECT TO APPROVAL OF BOARD OF HEALTH3VY
�. `
.-
OCCUPANCY PERMITS REQUIRED ,FOR NEW DWELLINGS
I hereby agree to conform to"all the Rules and Regulations of the Town of Barnstable egarding the above
construction.
Name ...... ' �........ ...................
G
F'IER CORP.
31 . Permit for 1 2...StorX................
Single -Family, Dwelling..................
Location ...Lot 10, 34 Liam„Lane
Centerville
t .. ................................. .............................. r
Owner' .. Greenbrier Corp....... ......... .
Type of Construction Frame...............
r ........................... ... ...... ........................*..
Plot .. R ........ Lot ...:............................
August 30 , 8 2
Permit Granted ��
Date of 'Inspection .............. .................19
Date Completed ,l Q .....19
K f
Assessors map and lot number
CTNEo�
Sewage Permit number ....f'J c�?r. �� .`!................ 4............ d`` ♦�
f li SAUSTAIILE. i
House number
�y MMa
7.F-
�E YPY a\
TOWN OF BAR-NiS'TABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO c.o/t/
...... .... ..... ,
TYPE OF CONSTRUCTION .......................!:' v U f J� } -?•e_...............................................
/ .. .................19.......
.�
TO THE INSPECTOR OF BUILDINGS: l i
The undersigned hereby applies for a permit according to the following information:
Location ........................... :.Y~ �....... . .. ............. . r .L, .... ...............T ,' /? .: C�Z :!` . ...................
ProposedUse ................................ . - ........ ...... .... ............................. .....:......................... ...............
.. t
Zoning District .. .............. . ! .........................................Fire District ..... ..... . . ... ).........................................
Name of Owner ........... . ....?....f� .... .'.......... ........'`Address ..................int...........................................................�. F ,.
Name of Builder' .................
..............................Address ....................................................:...............................
Nameof Architect .............:.. :........................................'��-,Address ...................................:................................................
Number of Rooms ........................ ......................................Foundation-,,. .......'} ........................ f
Exterior ..... .. !�? ' ...'......".�.. ...... ..f...'i %'`.`...........Roofing ........ (.�... ....5... �. � ....... ................
..
Floors .................:te_...-. ...:.......: :.........c....(..........,:.......Interior ................,,.. -r�: .2. f� ....1................................
Heating ..................... ......:�.....?...`'.... :�r f........................Plumbing ............................ice.. ..... f.. .sr '` ....................
l F"
Fireplace ..................................................................................Approximate Cost 576....��
.:.. .................................
Definitive Plan Approved by Planning Board - ! 19_______. Area ZY? ...............
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 j
I hereby agree to conform to all the Rules and. Regulations of the Town of Barnstable-regarding the above
construction.
Name,: . '•..' . ................. 4 .......... ......... ...
GREENBRIER CORP.p A=167-16
1s'
224331 1 Story
No ................. Permit for ....................................
'Single Family Dwelling
...................................................
Location ...,Lot....#.10. .,.... ... ...
34 Liam Lane. .. .. .. . .... ........... .... .. ......
Centerville
...............................................................................
Owner Greenbrier Corgi?....................'
.............. .... ......
Type of Construction ...Frame
............................
................................................................................
Plot ............................ Lot ...........................:....
Permit Granted ..Au us.t... 19 82
Date of Inspection ....................................19-
Date Completed .................19
O/�
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TOWN OF BARNSTABLE Permit No. ----------_------
Building Inspector cash
�'l0■PY�'`�
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 Gr�:enbrier. Corp Address
.4� � 1 r,� .t-,r Y �. -entervil.l.e
Wiring Inspector Inspection date
Plumbing Inspector ,! ' Inspection date
Gas Inspector f Inspection date
Engineering Department ' 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.
...» 041 I9—_» .. ................... .....»»...... .«... . ��»__
Building Inspector
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CERTIFIED PLOT PLAN
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NEW CONSTRUCTION ONLY , A� �`�o� Ca ���IL"�
` TOP OF FOUNDATION IS 3,4., FEE �D suR�� IN
ABOVE LOW POINT OF ADJACENT ,� �,;,� � ��,� ,,glASS*
ROAD. }
SCALE: I " _ DATE
LO D E EN GI �E ON C .1 1 CERTIFY THAT THE Fdu�DAlto�-►
CLIENT_ SHOWN ON THIS PLAN IS LOCATED
EGISTERED REDISTEREID JOB MO. ��I� ON THE GROUND AS INDICATED AND
CIVIL LAND
ENGINEER SURVEYOR '®Y�. � CONFORMS TOJHEMZ INO LAWS
OF BARNSTA , S.
712 M A I N 'S.T R E.E GM.SY�7 , ... -R�-----�-- 8�2� s✓'L'
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HYANRIS MASS., SHEET !,,OF
DATE R LAND SURVEYOR
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JI XOSTING SPOT ELEVATION '.0 0` of CERTt�IED PLOT PLAN
P1,(N M yss
EXISTING CONTOUR
FINISHED SPOT ELEVATION'
FINISHED CONTOUR 0 o Low 'IO P/7 VIL-i-E
APPROVED BOARD OF FIEALtil p o icss1-q'w
IN
DATE AGENT r SCALE: /' = 50' DATE: 8 �i: figz
DREDGE ENGINEERING Cd! IN �7rPprr�rrp n�
CL� ENT_�.r_..____ 1 CERTIFY THAT 'UHF. PROPOSED
EGISTERE REGISTERED i BUILDING SHOWN ON THIS PLAN,
17
CIVIL LAND J®® PIO. •
CONFORMS TO THE Z• NING LAWS 1
ENGINEER URVE 4R OR.eY' J j OF BARNS E, ASS. I
712 MAIN STREET CH. a�_ :1Q
HYANNI S MASS, 6- av� ,
SHEET OF 2 DATE 'G. LAND- SURVEYOR ?