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04/f 20C,; 12:57 FAX 7742370381 DOWNEAST FAX I�j007
fall
Town of.Barnstable � �
r A
o*t Regulatory Services d�,rAkE
�^ Thomas F.Geiler,Director Z0�8 JIJN _5 P
s BARNe�rAwx. Building Division 3' 46
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
•www.town.barnstable.ma.us
9
Office: 508-862-403 8 Fax: 508-790-6230
C)ODG 03O3-1
PERMIT#,,f0 FEE: S
SHED REGISTRATION
120 square feet or less
Location of shed(address) Village
.s RGuy cis �� �ru,- 00".
Property owner's name Telephone number
L)
Size of Shed Map/Parcel#
w , f CYV
Signature - Date
Hyannis Main Street Waterfront Historic.District? AO
Old King's Highway Historic District Commission jurisdiction?
r
> Conservation Commission(signature is required) Aff
Sign off hours for Conservation 8:004:30&3:30-4:30
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS,
THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN
Q-forms-shedreg
P EV-042506
°Ecivl
SfF 7 239 1 N6�r 5 Q �;
C,9rt;: .;„ �N N Yd
AEGIS*-- �F J NTY
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3718 00 P,
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APPROVAL NOT REQUIRED UNDER
THE SUBDIVISION CONTROL LAW.
C!� TOWN OF BBARNSTABLE
^� PI AN.j191 B. Q
DATE-Noy.
_PL1^N ` of LA:N0, ....IN .:.
..4DF. CENTERYILLEf,BARvsrA SSA. SS.
BEtom.olt4o...To....
.JANET- � PAUL L:FOLSO ..
'lk
i NEL90N o� Gp
EARS � RICNARD � v
F �o ti _5cAm l l 4oFr . 0cT.25,1971---
4 SUxI��p yQ'STERyoN NFG{.60►.1I3EAR86�RIGHARQ:LAW^S�7R�(EYORS
1UR�F _ C�tl M.-rP RV 1 L L E
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File Edit Tools Hey
;Needed roved R Status Ins Comment _ =comment
Prerequiste" -Action _ Dept � . Approved BY ,p -
��.£it�tWS
A�d�t Plista� T:X APPROVAL 6300
�fl1ORi4 APPROVAL 63.{14 i
1
�v .. 7R
`Perequlsr�e SONS-CONSE: VATIOf! EPARThENT c 'Needed by- 1
�.
A- tJc n fi pe" APPRO Inspeetcr FSTE ST PA3JIS, D
" ..
F$espc+nsible dept7(}1 EFdV4TION Inspeetionte
` #erence .,Status PPRO�fED
n.,
k I pl cant resp tt date E�30
5= :
Ctirrrrnent"ccacle t' ''A;s roved :r - 061 5r' k8 ( 1 .42 �#tP6. is approved' -
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a
Tend _
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� � 2, Er
{
ak<j '0v40� ��
�► r Town of Barnstable *Permit# S�3
Expires 6 months from issue d
• Regulatory Services Feel
aUntszest.e,
v� truss. Thomas F.Geiler,Director
QED"a` Building Division
Peter F.DiMatteo, Building Commissioner X.P R E S S PERMIT
367 Main Street,.Hyannis,MA 02601 w
Office: 508-862-4038 J U L 6 2001
Fax: 508-790-6230
EXPRESS PERMIT APPLICATIONTOWN OF BARNSTABLE
Not Valid without Red X-Press imprint
Map/parcel Number. a 09 q O
Pro erty Address d� — ' O K4 41 I I
Value of Work 4 4 t 3C o ' co
Residential OR ❑Commercial
Owner's Name&Address cC� fist
Contractor's Name 1i Telephone Number
0 UFT Q)
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
C k one:
I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Permit Request(check box)
Re-roof(stripping old shingles) a 3 ,
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
Signature
g'
Q:Foms:expmtrg:rev-070601
✓fze �o�svma�aarea�e o�./�.avaaclu�aP,lta
Board of Building Regulations and Standards License or registration valid for individul use only
before the expiration date. If found return to:
HOME IMPROVEMENT CONTRACTOR
Board of Building Regulations and Standards
Registration: 124310 One Ashburton Place Rm 1301
Expiration: 06/01/2003 Boston,Ma.02108
Type: Individual
James Curley
James Curley
PO Box 231/98 SyNan
Osterville,MA 02655 Administrator Not valid without�signafWre
lip
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel 017 Permit# _ � 7
Health Division / �Z�7a�rd� Date Issued 20�
Conservation Division Fee �,�
Tax Collector __.... � " -M1� SYSTEM
/tad !: e �.l MUST EE
Treasur ED IN COMPLIANCE
Planning Dept. WITH TITLE 5
P E�RO ANENTALCODEAND
Date Definitive Plan Approved by Planning Board N REGULATIONS
Historic-OKH Preservation/Hyannis ;.
Project Street Address � nog� �
Village cait-auyk f
_Owner "QkL C6L" p Address �r ULY� � iv C(kca;
Telephone Sbi -Ilk, 019
Permit Request 0 a_ etL 0 21 Ft.W 4t 1tr_TL*(4 Au o
kJ &LL 5, U"2 c)U7 i(q C U 9 S i�+ S H"l- rc�c% -- r su 0_rA4rl UJ i loL
Square feet:�1st floor: existing 6oy'►' proposed 2nd floor: existing - proposed Total new
Valuation LVJ M-(-t4`4J' Zoning District Flood Plain Groundwater Overlay
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: O Yes V No
Basement Type: Wfull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existingnew Half: existing ti new
9
Number of Bedrooms: existing 'new
TotalrRoom Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: [ 'Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes l�Ko Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes N No
Detached garage:❑existing ❑new size_ Pool: ❑existing ❑new size Barn:0 existing. ❑new size
Attached garage:❑existing O new size Shed:❑existing ❑new size t Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑ No If yes,site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name 0 Telephone Number
I' Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY r ,
' PERMIT NO.
DATE ISSUED n -
r f
MAP/PARCEL;NO.
ADDRESS '. ' ,Y VILLAGE y 'y r. • - � _ � "'� '
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME _
INSULATION l
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH ' "'` FINALy
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO-? ">)
b,
of THE
The Town of Barnstable
• BARNSrABM •
9�A MASSS. a��g Regulatory Services
59
rEn . Thomas F. Geiler, Director
Building Division
Ralph Crossen, Building Commissioner
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 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: _ Estimated Cost
Address of Work: AA
....-l�6dLQ 0 -_. _.`^'�0�-9' �^x.��Q%��► �'�i
Owner's Name: �"`"�A W�
Date of Application: I �P
I hereby certify that:
Registration is not required for the following reason(s):
[3Work excluded by law
E]Job Under$1,000 • .
QB3jlding not owner-occupied
JjOwner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date Contractor Name Registration No.
Date O ei's Name
q:forms:Affidav
f
The Commonwealth of Massachusetts
Department of Industrial Accidents
':= Office atiorresti9atfoos
Alt- =_�. Z, 600 Washington Street
; Boston,Mass. 02111
- Workers' Com ensation Insurance davit
Y nnt.c.^ut-tttfoinitin
name:lr
location:
city U atone#
I am a homeowner performing all work myself:
I am a sole yr rietor and have no one working in am► acity
I am an employer providing workers' compensation for my employees working on this job.
comnam•name:
::::...
address:
one#:....:.:. ..::....: �;..>...:, ..::,.':.
city:
insu rn n ce co. Rol kv
I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who
have ..
the follo«ing workers' compensation polices:
-
:-
...::•::::..:.
comnanv name: -
-address: .;:.:....
�.�.�,:......... ..: .. ..:�. :;:;;,:. hone:#=::>:>::c•:<•::���`:>�::<::v:
City:
............ ................ ........N. ..... .... .... ...n.,}. .r......v,.... �± ....v.}:w:i:?;>:?y.;{•;xr{{{•`•'v%v'•i'}'.:+?ii{:;i}: :5:}?::�:::%�:�:`�4i:�iti:::
msurnn ce co.
, .::. v: .� .. %: i^
....:.:.........x.......v.. .....:.Jn...a..•-::: •.:::. "vti:...:x:::?i}. i::•i:•:'�:ti"•.L:i�i{ii:ti,::;}:4::j�vi:•?{{ii{:;ii:::�ii:??y:.•:•:�ii:?y'.�:::::::••:::.:.....v..:...
.y�/�.,.. ....rr•..:::.....::::.::4}}:•}.:•:}Fri i}:•Y:rev'.:::.'$ii}:}}1:}:}:,::v:,v0:^::v:�.�::.:::::%v�i:>.'.vi:I :i:::.`:.�i:i>':i:+> .<.,.: ..
.... ..✓-s..}6'.... .. '•ice'.
comnanv name: >: :::'>'::
:..
_.
•.
......:_:.::•::•:i::•::.....
address: »•;....•:-
...:.'.
..; ;.� ., . :'::': .:i•....�::.: atone# :..::::::.:. •::.::::::
city: :::•...:
......:::................:.
:,:,. .:::::::
xx
msurnncc co Zx
Failure to secure coverage as required under section 25A of MGL 152 can lead to the imposition of criminal penalties of tine up to 51,500.00 and/or
one years'imprisonment as well as dull Penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I understand that a
copy of this statement may be forwarded to the OMce of Investigations of theDIA for coverage veriftation.
I do heretiv certify under the and penalties of perjury that the`information provided above is intp and cored
Date
Paint name �
c>~ wilciazl use only do not write in this area to be completed by city or town official
.a• permit/license# ❑Building Department
city or town: ❑Licensing Board
❑Selectmen's Of$ce
M check if immediate response it required' ❑Health Department
- phone#; Oth01�—
contact person: r
Information and Instructions r
all employers to provide workers' compensation for their
Massachusetts General Laws chapter 152 section.25 requires emp. Ye to ee is defined as every person in the service of another under any coon~-
employees. As quoted from the"law an�P y
of hire, express or implied, oral or written-
An employer is de as an individual,partnership,
association, rporation or other legal entity, or any two or more c
`'the foregoing engag a Joint enterprise,and including the legal �entatives of a deceased employer, or the receive:
trustee of an individual partnership,association or other legal , the owner of a
employing employees. However
house having more than three apart I who des �� ' or the occupant of the dwelling house of
dwelling another,who employs pens to do maintenance, cant rucam reps work on such dwelling house or on the grounds c
shall not because of such empI be deemed to be an employer.
building appurtenant . . .. ...._ .. _ .... . . .
issuance or renev
MGL chapter 152 section 25 o states that every state or 1 can licensing agency shall withhold the issua who h:
of a license or permit to op a business or to constru buildings in the commonwealth for any applicant
not produced acceptable evidea of compliance wither coverageco o r the required. Additionally,
ublinw until
cor<nnnonwealth nor any of its po ' subdivisions into any _
have been resented to the co*�**a�'""c
acceptable evidence of compliance^__. _
the of tl�chapter p
authority. - - __..._ --
_
Applicants
by checiang.the'box that applies to your situation and
please fill in the workers' compensation with a certificate of insurance as all affidavits maybe
company��address aad,pho� Also be sure to---sign and
supplying of insurance--coverage. -Ili
= .•
submitted to the Department of-Indastoai _-.--- -=--- or town that the application for the permit or license is
date the affidavit. The affidavit should be to Should YM have�,moons regarding the"law"or if yc
being requested,not the Department o�Industnai ____call the Dep
artmezrt-at the number.Iisted below.
are required to obtain a workers' csmrpwsocil
Poh _. .
City or Townscomplete
1 The Department has provided a space at the bottom of t
please be sure that the affidavit is. and has to contact you regarding the applicant. please_
affidavit for you to fill out in the event the Office number. The affidavits may be retuned t^
be sure to fill in the peimrtlIicense ms�berwhich be used as
the Department by mail or FAX unless other have b made•
Atois adva�e fincooperation and should you have any gn�ons-
TeOffice of Investigations word thank
please do not hesitate to give us a cap l _
The Department s address,teiephone_aad_.._ -:_�__
The Commonwealth Of Massach setts
Department of Industrial Accidents
emce of Invesduadons
600 Washington street -
Boston;Ma. 02111.
fax#: (617) 727-7749
Phone#: (617) 7274900 eat. 406, 409 or 375
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The Town of Barnstable
GF tHE T !
`Department of Health Safety and Environmental Services du
Building Division
BARNSTABLZ ' 367 Main Street,Hyannis MA 02601
9� MASS.
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
HOMEOWNER LICENSE EXEMPTION
(� Please Print
DATE: 1 1 ! \ 00 '
JOB LOCATION:
number ' /? street village
�`1,�1
"HOMEOWNER": S R `' GV03 JV 0 11110R9
name home phone# work phone#
,, pp
CURRENT MAILING ADDRESS: U L3 Cs `(o) Cl Zc-Le
7 /t IUA
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. Y
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 , n
intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or
-- farrnkructures=`�A-pe`rson-who-constructs,more.than;one"home ura-_two_year period shall not be considered
- �a'a'homeowner "Stich--"homeowner"''shsllsubmit 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)
w
"' -- =The3undersigned`'homeowner,!-assumes responsibility for compliance with the State Building Code and
other applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building
Department minimum inspection procedures and requirements and that he/she will comply with said
procedure requirements.
Signature of omeowner
Approval of Building Official .
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply
- - with theState Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
y 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 109.1.1 -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 to amend and adopt such a form/certification for use in your community.
... - %
Q:FORMS:EXEMPTN ,
e ,l
a
Assessor's office(1st Floor):
Assessor's map and lot number TNt
Conservation �'� w °►Board of Health(3rd floor): 1 s�sr�ncc
Sewage Permit number
Engineering Department(3rd floor): 0 16 o•
House number �o air
Definitive Plan Approved by Planning Board 19
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF BARNSTAB LE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO J��- }I cpJr
TYPE OF CONSTRUCTION
19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location S �div4 Foek C.r- Cealr, ,,,lb AAi f
Proposed Use
Zoning District Fire District
Name of Owner II k c�A-1 co°ff--eAl Address
Name of Builder Address
Name of Architect Address
Number of Rooms Foundation /
Exterior Roofing V Re f of ot j44:—
Floors Interior
20yeILs
Heating Plumbing
Fireplace Approximate Cost
Area A10 41e :A (ff qG
Diagram of Lot and Building with Dimensions Fee �—
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the onstruction.
Na
Construction Su ervi or's License
COHEN, RICHARD
` No Permit For RESHINGLE ROOF
Single Family Dwelling
Location 25 Long Pond Circle
Centerville
Owner - Richard Cohen
Type of Construction Frame
a -
Plot Lot
, Z
June 1 , 93 '
Permit Granted 19
Date of Inspection 19
Date Completed /a� ��( �� 19
-71719
+ t ,
t
lr
4
TOWN OF BARNSTA.BLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please tint _
p
DATE
x JOB LOCATION —z �� pwtp C c 2
I^ Number /�' Street Address ^ !� Section Of Town
Name Home Phone work Phone
X PRESENT MAILING ADDRESS IP VC�t�O
e
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 such homeowners to
engage an individual for hire who. does not possess a license, provided that
the owner acts as supervisor.
DEFINITION OF HOMEOWNER. .
Persons) 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 to six 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 nermit. (Section 109. 1 11
S
The undersigned "homeowner" assumes 'resn. orsibil.ity., for compliance with the
State Building Code and other applicable codes; by-laws, rules and
regulations.
The undersigned "homeowner" certifies that he/she understands the Town of
Barnstable Building Department minimum inspection procedures and
requirements
HOMEOWNER'S . SIGNATUAE
APPROVAL OF BUILDING `OFFICIAL
Note: . Three family dwellings 35,000 . cubic feet, or large=, will be
required to comply with` State Building Code Section 127.01 Construction
Control
NISCS
HOME OWNER'S EXEMPTION
The code states that: "Any Home Owner performing work for which a
permit is required shall be exempt from the provisions of this sectionlding .
(Section 109. 1. 1 - Licensing of Construction Supervisors); provided that if
Home Owner .engages a -persons) for hire to do such work, that such Home
Owner shall act as supervisor. "
Many Home Owners who use >this exemption are unaware that they are assuming
the responsibilities of a supervisor see A ing
for Licensing Construction Supervisors, Sectond2.{155j .Ru This alack eoflations
awareness often results in serious problems, particularly when the Home
Owner hires unlicensed persons. In this case our Board cannot proceed
against the unlicensed person as it would with ' '
HomerOwner acting as supervisor is ultimately responsibleuPervisor. The
To ensure that the Home Owner is fully aware of his/her responsibilities
many communities require, as part of the permit application, that the Home
Owner 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 to amend and adopt such a form/certification for use in your
community.
A.
FTIC Cc(")rTE �sT BE-Okl
INSTALLED STATENC7= ^ a C5 l
� a�_e WITH A
SANITARY CODE AND TOWN
REGULATIONS-,
��PyOFTNE'r TOWN OF BAR.NSTABLE
EAHB9TABL"6 9 ,•� �; DUILI G ILN.SPECTOR,
'EO MPY a• t '
APPLICATION FOR PERMIT TO ..
TYPE OF CONSTRUCTION ...: �1. ...I.......... .Gl .....: . .fir :... .
.................................................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .... .... .......................... """""'O ' s.• :. ............. ..........................
ProposedUse .................. .... ......................................
Zoning District ....... . .............................Fire Districts .... e �:. ...... .......
Name of Owner/.Q:`...... ......:...... .: Z". ..............Addresse'.1.1..........P. ................. . . . ../.... ......... ........................
Name of Builder�.. ..- .0 '?' � -° .. ..... `...Add'ress.5' . .:.,...... ..... .........
Nameof Architect .......... .......... ......................._..................Address ............................................ ......................................
Number of Rooms ............� .....Foundation. .....
Exterior "�`
�''� ...... ........................ Roofing ... ... ...............
Floors ' Interior........_........ ...... ..... ..... .................. -........... . . . : .................. ............................
Heating �. ....................: ................... ...Plumbing '`r ". .
. :......
...:_.......................................
Fireplace �. ..................Approximate Cost .....4/2,� C�� ,,,,,,
�
Definitive Plan Approved: by Planning- Board- ________________________________19 ______. ' _
Diagram of Lot and Building with Dimensions cep c
SUBJECT TO APPROVAL OF BOARD OF RE' LTA H
.l
a
3 G /:S
1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .................... "' .......
/
Mullin, Hugh
� t
162~- two story--'--' Pe,mh for ------- �
�\ �
^ - �
— ~ dwelling
-_-`~_' _��~ .
—. — ^ ------------
^°ong ^v^°d. -i^�'le
^~^..~~. ---,-----------------' �
. , \
Centerville
' � .
----'---- ..
l6uoh Rzl]i n
Owner ----------------------
'
' frame
Type of Construction
..........................................
k�^v
.------------------._------.. �
Plot ................ Lot ----------'
'
. .
. /
Permit Granted ---���rms8lA 73 . 2� '
. ..............................
Dona of Inspection / . lV
Date Completed � . -
`
' PERMIT REFUSED
--------'--...--------'— lg - z, /
/-p-
.-------------------------.. �
—
'
- ..
—.------.'---.-------.-------.
'
^.------.-------------.----...
^------'----^~^---'-^^'—'—'---^''
Approved ................................................. 1.9
` (
---------------.----....—~—~—. � ^
...................
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