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Application Number........ )67./.�._..Yu20............
BAMMARLY4 MAS& BUILDING DEPT. Permit Fee.........efl—A.....................Other Fee........................
%63 h
DEC 4 2019 Total Fee Paid............................................................... ......
TOWN OF BARNMANLffiLE Permit Approval by.a. �...............Oa.J.D:4/�(
BUILDING PERNUT
M,V........ .............PML.......a.13.27.................
APPLICATION _J
Section 1 — Owner's Information and Project Location A I
Project Address 414 M A PL6 AVE r4 L)E Village G
Owners Name Ric CRA61PEE
Owners Legal Address 'Z� MAPLi- AVENuF_
9AKqS-TA9LU_ State Xwo
City —zip 0
Owners Cell# 5 CA 2 9 o - 8 2 3 4 -mail M c
--LOA—
SectiO12 —U4 Of 4ticture I
Use GroupCommal. Structure over 35,000 cubic feet
El mmer al Structure under 35,00,0 cubic feet
Sin Two Family Dwelling
C c ci
O=a\
Mier
\Psin�
Section
n 3-MType of Permit
❑ New Construction El M Relocate E] Accessory Structure ❑ Change of use
El Demo/(entire structure ❑ finish
is Basement El Family/Amnesty ❑ Fire Alarm
Rebuild Deck Apartment ❑ Sprinkler System
F] Addition ❑ Retaining wall ❑ Solar
El Renovation ❑ Pool Insulation
Other—Specify
Section 4- Work Description
RQsiden�k gk\ 14)RQ LbV),Z.C,+10 A1Q1rS0!1 A Q. N�O StLULL110A 600�Q,_
Last undated:11/15/2018
_,,
Application Number....................................................
Section 5—Detail
Cost of Proposed Construction Q , n 4 Square Footage of Project
Age of Structure Dig Safe Number
#Of Bedrooms Existing Total#Of Bedrooms(proposed)
110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist Design
Section 6—Project Specifics
❑ Wiring ❑ Oil Tank Storage Smoke Detectors
❑ Plumbing 7 Gas Fire Suppression
❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom
Water Supply ❑ Public ❑ Private
Sewage Disposal ❑ Municipal ❑ On Site
Historic District ❑ Hyannis Historic District ❑ Old Kings Highway
Debris Disposal Facility: I am using a crane ❑ Yes ❑ No
Section 7—Flood Zone
Flood Zone Designation
Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑
Section 8—Zoning Information
Zoning District Proposed Use Lot Area Sq. Ft.
Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site)
Setbacks Front Yard Required Proposed j
Rear Yard Required Proposed
Side Yard Required Proposed
Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No
Last updated:11/15/2018
f
ApplicationNumber........ ................................
Section 9—Construction Supervisor
Name SC o f f 1fEG-a E l3 E 2 G- Telephone Number -'g 1-30 S_ 1�3(q
Address Jpl Station Lgr)L4 • City MG6FOM State -MA Zip azl-�'s
License Number I pS%SZ License Type CSS L Expiration Date 10 1'�12 I
Contractors Email MQW o/l-!En46�%r.o6 Cell # (S 9 p
I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentation required by 780 CUR and the Town of Barnstable.Attach a copy of your license.
Signature Date
Section 10—Home Improvement Contractor
Name HOMQ woi �S Q ('!�v A n a Telephone Number. s 1 -3 o S -
� 3 ( q
-
Address LCA n City fod h f d State M(A Zip O 1
Registration Number ) , 1 1 3 8 Expiration Date 0 9J 0 2' 2 0 2
I understand my responsibilities un the rules and regulations for Home Improvement Contractors in accordance with 780
CMR the Massachusetts State B ' in Code. I understand the construction inspection procedures,specific inspections and
documentation requir ViFt d the Town o ble.Attach a copy of your KLC...
Signature Date
e ion 11 —Home Owners License Exemption
tf
Home Owners Name:
Telephone Number Cell or Work Number
I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the constriction inspection procedures,specific inspections and
documentation required by 780 CUR and the Town of Barnstable.
Signature Date
APPLICANT SIGNATURE
Nil
S ignature d= Date Z
Print Name )V t i L DorJ(SWA4 Telephone Number 4b 1
E-mail permit to: p, , rAro
..,._� . .
0 h'WO
nn
mome rks BUILDING DEPT
rr.
Energy, Inc
JAN
14.2020
Permit Cancellation Re quest TOWN OF BARNSTAB
q LE
HomeWorks Energy is requesting the cancellation of the following building permit:
Permit Number: B-19-4070
Address: - 4-Maple:Avenue� , r assachusetts 02632
Reason:The customer has declined to move forward with the insulation and
weatherization work. We will no longer be planning to perform any of the
originally contracted work at the associated address above at.this time. Please
cancel out this permit that is attached to this notice. Please reach out to the
specified number below if you have any futher questions regarding this.Thank you.
Sincerely,
Scott Veggeberg
HomeWorks Energy Inc.
CSL#103832
HERS Certification#3081658
HomeWorks Energy
101 Station Landing,Suite 110
Medford,MA 02155
wxpermitting@homeworksenergy.com
(508) 216-6497
Town of Barnstable
�OFtHE
�q. Planning &Development Department
Barnstable Historical Commission
z 3
* saxxsz'nsi.E. 367 Main Street,3rd Floor;Hyannis, Massachusetts 02601 •g�.
1639, P(508)862-4787
QED WIA'�A OF BARN54P
Commission Members
Nancy Clark,Chair Nancy Shoemaker,Vice Chair Marilyn Fifield,Clerk
George Jessop,AIA Cheryl Powell Frances Parks Jack Kay
e�a: r�
- gry'�'v 2��ry�Gt J�11 -.2 1_t�'A 3 1 v.�a�
-. CY �fNs.3 2 6 Ai_R.v--.k 'rONy9 vI ES`2P
Chapter 112 Historic Properties, Section 112-3 D. BIAZo/
DETERMINATION of SIGNIFICANT BUILDING N(�'
24 Maple Avenue, Centerville, Map 207, Parcel 07 ✓U� 3�. �pT
Pursuant to Intent to Demolish Structure oF 20Z1 .
B419,
%B�F
The property located at 24 Maple Avenue, Centerville, Map 207, Parcel 037, is
associated with the broad architectural and cultural history of this area.
In accordance with Chapters §112-2 and §112-3 (D), the Barnstable Historical
Commission Chair has determined that these structures are significant buildings.
This determination applies only to the demolition described in the notice of intent
submitted on July 19, 2021. Any future demolition shall require a. new determination
from the Barnstable Historical Commission.
MAY/11/2021/TUE 02:23 PM COMM Water Dept PAX No. 5084283508 P. 001/001
CENTERVILLE-OSTERVII.,LE-MARSTONS MILLS
WATER DEPARTMENT
FO BOX 369—1138 MAIN STREET
OSTERVILLE,MA 02655
WWW.COMMWATER.COM
OFFICE OF
_ag
BOA"OF WATER CONWSSIONERS
WATER SUPERINTENDENT
Tel 508-428-6691 V WATER m
Fx 508-428-3508 40, ' DEPT.
IRS
r0* I.4
y ,
May 10 2021 Fp�
�O,c�9 Zj
Town of Barnstable RtisTge
Building Division <<c
Via Fax-508-790-6230 j
RE: 24 Maple Ave
Centerville, MA,
Acct: 4866
To Whom It May Concern:
On Thursday, May 6, 2021 the water service was disconnected after the
curb stop for the property mentioned above. It is our understanding that the
owner plans to demolish the house, re-build and will install a new water
service at a later date.
If you have any questions regarding this do not hesitate to contact our
office Monday through Friday, 8:OOAM until 4:30PM at 508-428-6691.
Sincerely,
Glenn Snell, ,Assistant Superintendent
Centerville-Osterville-Marstons Mills Water Department
GES/cvb
Town of Barnstable
oCIHE, Regulatory Services
Richard V. Scali,Director
tSTABLE ; Building Division
9cb 16 9. ���' Tom Perry,Building Commissioner
plED MAC 200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Approved:
Fee:
Permit#: .
S�
HOME OCCUPATION REGISTRATION
Date
Name: Phone#:
Address: �'� u�l� e ( Z4 V lk A* Village:
.Name of Business:_ (Lee 0b 1LS d`61 PL1
Type of Business: ncCJ/A -s—Map/I,ot: cZQ 7 ,
I1IT=: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation.
within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity
shall not be discernible from outside the dwelling. there shall be no increase in noise or odor,no visual.alteration to the
premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;
and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located within
that dwelling unit.
• Such use occupies no more than 400 square feet of space.,
• There are no external alterations to the dwelling which are not customary in residential buildings,and there is
no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,
odors,electrical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of
normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There are no commercial vehicles related to the Customary Home Occupation,other than one van dr one
pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lofcontaining the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit
I,the undersigned,have read and agree.with the above restrictions for my home occupation I am registering. ,
Applicant Date: f —�
Homeoc.doc Rev.103113
'!
YOU WISH TO OPEN A BUSINESS? ;
For Your Information: Business certificates (cost$40.00 for 4. ears). A business certificate ONLY REGISTERS YOUR NAME in town (which you
must do by M.G.L.-it does not give you permission to operate. ou must first obtain the necessary signatures on this form at 200 Main St., Hyannis.
Take the completed form*to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law..
DATE: " �� ( Fill in please:
oil ta,b�t'
APPLICANT'S YOUR NAME/S:
BUSINESS YOUR HOME AD RE�y�S-: y a P
�/�13-22/ �l e' Yf!/i Ad/1 D 3
4�
`g gal I's'�'=+�_ TELEPHONE # Home Telephone Number
F 0 :1;x l '4Vj�'�� i C �L /' �' 1121i •LG�u
NAME OF CORPORATION:
NAME OF NEW BUSINESS 00-,POW TYPE OF BUSINESS aM/Jvter ans d ^�
15 THIS A HOME OCCUPATION? YES} NO
ADDRESS OF BUSINESS. 2 a jl 4 32 MAP/PARCEL NUMBER b [Assessing) _ r
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth '
Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally opera a your usiness in this town.
1. BUILDIJCOMSSIO ER'S OFFICE MUST COMPLY WITH HOME OCCUPATION
Thish s e i t of n er it uire rits that pertain to this type of busine44ULES AND REGULATIONS. FAILURE TO
COMPLY MAY RESULT IN FINESA horize gn toOMM NT
r
TV V
2. BOARD OF HEALTH
This individual has been informed of the permit requirements that pertain to this type of business. -
Authorized Signature**
COMMENTS:
3. CONSUMER AFFAIRS(LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
pFtHE Town of Barnstable *Permit# M+q
p Expires 6 months from issue date
BAMSPABLE, : Regulatory Services Fee
v MASS.9. Thomas F.Geiler,Director
�p'fDfA°`a, Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 0?J 31
Property Address MAJ,
2Residential Value of Work S C
Owner's Name&Address i --
Contractor's Name Telephone Number 5 L��7��j _172-7 (9
77/-�� ��
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance `
Check one:am a sole �/ ®®
�J I am the Homeowner r XM RESS PERMIT
❑ I have Worker's Compensation Insurance
MAY 3 20021
Insurance Company Name
TOWN OF BARNSTABLE
Workman's Comp.Policy#
Permit Request heck box)
Re-roof(stripping old shingles)
❑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
Q:Forms:expmtrg
Revised121901
a Izngineenng Dept. (3rd floor) Map U 7 Parcel -n_3 Permit# q
_ House# Date Issued (O
Board of Health(3rdoor)(8:15`9:30/1:00-4:3 �0�.0
Conservation Office(4th oor)(8:30-9:30/1:00-2:00)
P c min. g. SEPTIC SYST ST BE
" INSTALLED 1 NCE
annm rd 19 WIT
ENVIRONME rCo" AN® •
TOWN OF BARNSTABLET®VAN FIE MIS
o� Building Permit Application
Project Street Address
Village
Owner I/ �.�G-ems. Gad 7�L Address ZY A%I�ce 4, 19sz
_Telephone v _v7 L 6--, e C-'1
Permit Request V<c,4-j e
ti
First Floor square feet Second Floor square feet
3.
~Construction Type a�
Estimated Project Cost $ (-0
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single,FamilyUr Two Family ❑ Multi-Family(#units)
Age of Existing Structure &0 yN� Historic House ❑Yes LI'No On Old King's Highway ❑Yes
Basement Type: Elful1 rawl ❑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 51 New
Total Room Count(not including bat ): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other
Central Air ❑Yes `�" o Fireplaces: Existing New �_ Existing wood/coal stove es ❑No
Garage: a'6etached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
p Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
Builder Information
Name 4U i Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
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
F
TUREA4 DATE Z-oING PERMIT DENIED F R THE FOLLOWING REASON(S)
o..
��� 47
-
- FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/.PARCEL NO.
ADDRESS s •,VILLAGE' 4 _
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME _ — ' • ,
INSULATION _
FIREPLACE t ''
ELECTRICAL: ROUGH FINAL -
rp _
PLUMBING: rvROUGH; FINAL
GAS: t5pq FINAL _
FINAL,BUILDINto
G�� ...
DATE CLOSED OWU� -
ASSOCIATION PLAN;NOS
1 !
The Town of Barnstable
WAAW �e�' Department of Health Safety and Environmental Services
1679- Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commission
For office use only
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL a 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: I AJ Est.Cost /L o,)J J-b z,,!�=
Address of Work:— 2 l ��� y 7�L//,'e A,1
Owner's Name tAG CA f`` �� CCP,4
Date of Permit 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 G 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the a t o�the weer.
(VV/ Date Registration No.
OR
i
• TOWN OF BARNSTABLE
• • BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print. . ..
DATE 0
JOB. LOCATION 2 L/ c l'en U c c
Number Street address Section of town
"HOMEOWNER" C�i� 771,E1 3 7 7 " - 2- Z.7,
Name Home phone Work phone . -
PRESENT MAILING ADDRESS �2 /2'IA�G� '2 =''•-
City town State Zip code
The current exemption for "homeowners" was extended to include owner-occuDiE
dwellings of six units or less and to allow such homeowners to engage an in-
dividual for hire who does not possess a license, provided that the owner
acts as supervisor.
DEFINITION OF HOMEOWNER:
Person (sj who owns a parcel of land on which he/she resides or intends to re
side, on which there is, or is intended to be, a one or two family dwelling,
attached or detached structures accessory to such use and/or farm structures
A person who constructs more than one home in a two-year period shall not be
considered a homeowner. Such "homeowner" shall submit to the Building Offic
on a form acceptable to the Building Official, that he/she shall be response:
for all such work performed under the building permit. (Section 109.1. 1)
s
The undersigned "homeowner" assumes . responsibility for compliance with the S .
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 requireinent�
and that he/she will com wit said ro_ced s and requirements.
HOMEOWNER'S SIGNATURE fCI -
APPROVAL OF BUILDING OFFICIAL
ote: Three family dwellings 35 , 000 cubic feet, or larger, will be required
0 comply with State Building Code Section 127. 01 Construction Control.
HOME OWNER'S EXEMPTION
The code state that: "Any Home Owner 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
Home Owner engages a persons) for hire to do such work, that such Home Owne
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a supervisor (see Appendix Q, Rules and Regulations
for ..licensing Construction Supervisors, Section 2. 15) . This lack of awarene
often results in serious problems, particularly when the Home Owner hires
unlicensed persons. In this case our Board cannot proceed against the
inlicensed person as it would with licensed Supervisor. The Home "Owner-' act_.-
as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities, ma:-
communities require, as part of the permit application, that the Home Owner
certify that he/she understands the responsibilities of a supervisor. On th=
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.
s
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Range 30 6111
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123711 131 718
255 3r4'
EDWIN L.MORSE CO,,INC.
2502 CRANBERRY HIGHWAY
WARBNAM;MA. 02571
I-SM295-1170
CUSTOMER RESPONSIBLE FOR
SEP 22 '97 89`:28 P.83
I
i
EDWIN L. MORSE CO. , INC.
2502 CRANBERRY HIGHWAY
WAREHAM, MA. 02571
1-508-295-1170
CRABTREE.DSN 9-22-1997
N
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I I:ij Iii l,:� '�'�f r}`•rig�'�I
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SEP 22 197 09:28 P.02
I
I
EDWIN L. MORSE CO. , INC.
2502 CRANBERRY HIGHWAY
WAREHAMf MA, 02571
1-508-295-1170
CRABTREE.DSN 9-22-1997
SEP 22 197 09:29 P.04
go
y 'I
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1,
EDWIN L. MORSE CO. , INC.
2502 CRANBERRY HIGHWAY
WAREHAM, MA. 02571
1-508-29571170
CRABTREE.DSN 9-22-1997
2-y��st'S
� i t
• � � i � i 4
i
Fw.
1•
c1 V
a
•
y,
' _ ` I • -
��
Engifieering Dept.` r) Map b.,,o l Parcel d r .Permit# 2 GO
House# , Date Issued Q
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) ` � WP— 17 Fe s ,
a n
Conservation Office(4th floor)(8:30-9:30/1:00-2:00)
p . Ist tio c
19
TOWN OF BA1tNSTABLE
u Bu'Iding Permit Applica 'on , -
ti Project Street Address01 /1
V
1 Village
Owner Address
Telephone -
LI
Permit Request oddl-h-'6n
First Floor � square feet Second Floor square feet
Construction Type
Estimated Project Cost $ 0 �--
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 (:>4lo On Old King's Highway ❑Yet�> No
Basement Type: ❑Full El Crawl ❑Walkout ❑Other L "
Basement Finished Area(sq.ft.) �. Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing ew Half: Existing New
No.of Bedrooms: Existing e'1 eew
Total Room Count(not including baths):Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size) � �� sal
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial' ❑Yes ❑No If yes, site plan review# -
Current Use Proposed Use
JC4 � ilder Information JJ
Name �tphone NumberCO �c
Address v" �- License#
Home Improvement Contractor# 7
Worker's Compensation# 1 U V �►G'�
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FRO THIS PROJECT WILL BET N TO
OL
SIGNATURE DATE `. �q, 7
,1 B U I I G PER D NJ�UQLLOWING REASON(S)
I
b l
Amp
FOR OFFICIAL USE ONLY
PERMIT NO.
ATE ISSUED
AP/PARCEL O ti
ADDRESS - - VILLAGE-
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION '
FIREPLACE '
ELECTRICAL: ROUGH FINAL '
PLUMBING: `,;}ROUGH _ - FINAL
GAS: ROUGH FINAL-
FINAL BUILDING-'
DATE CLOSED OUT :`• 't_: f _ ' -
ASSOCIATION PLAN NO. ` r• J!
Suggested Affidavit for Home Improvement Contractor Permit Application'
For OMce Use only NAME OF CITY/TOWN
Permit Na
Date
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGLc.142Arequires that the"reconstruction,alteration.renovation,repair,modernization,conversion,inprovement,removal,demolition,
or construction of an addition to any pre-adsting owner-occupied building containing at least one but not more than four dwelling units....or
to structures which are adiacent to such residence or building"be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: c_c 1SiyvG-hQn o� pmi f B&M st) Est. Cost/
Address of Work v
Owner Name'✓
Date of Permit Application: ►��/
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded bylaw
_Job under S1,000
_Building not owner-occupied
__Owner pulling own permit
Other (specify)
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 age t t n r:
l 7CL ,
Date
itractor Na a Registration No.
OR:
1
Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property:
Date Owner Name
t
a
PLOT PLAN
FOR LOT !�
Indicate location of garage or accessory building
Additions with dashed lines--- M ------
Sewerage disF+osal(cesspool) ®
well o k
1JI 2
;ar
(LoL .................ft."re ar)
l
Abutux's -�' , ,PM Abuttar's
Naxne Uk Name
Lot/ Rear Yard i cam`sP Lot N
...ft.
l
If this is a if this is' 1
u ,
c=cx Im, Corner lot,
write in
Write Inr-=e of .
. �-• - L17De Cf
o be street. SiLe�arc HOUSE e he: rcct.
y
ft. ft.
—•----- � �------ � III
Set Back
..................fT-
(Lot...................fi. i-cntage)
" -- -- - --- ----�._- _ -------------------
(N2rne.of meet)
meet) '
� � � Information ,;
Supplied by
Mark Noah Point
THE)
TOWN OF BARNSTABLE
Z MIST=
'op .UL
6 q. �� MASSACHUSETTS o
Solid Fuel Stove Permit
DDATE //2
OF APPLICATION �...... ....�.........:..................... FIRE DEPT. ISSUING PERMIT .. .p......... r.... jNAME owner .........................................................I NAME (Installer) x:. .............................................................
rA'ne..... ... ADDRESS �.?'`itADDRESS ....................y ........... .............................. ..........................................................................................
STOVE TYPE ................., ................................................ CHIMNEY: NEW ........................ EXISTING ..
Manufacturer ...�.�✓..:.N3r11 d.. ...1. �z '................. CHIMNEY: Masonry ............................ ......................................
Mass. Approval ............................. ........... e�-............................... CHIMNEY: Metal ...................................................................................................
This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed
address in accordance with an application on file with the ................................................................................................... Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
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Issued By: [�-- C �`�'�'�/'S�...............................................Title G'!� .............. Date
... ......... .............................................................
Permit to install expires 60 days after issue date
Stove ......................� ....................................................................................................................................................................................................................................
Stove Clearance ...................
Q�...��..-......:......................................................................................................................................:................................................................................................
Floor .............!�?.r`.Lt ......... e! '�"�� �1............................................................................................................:............................................................................
SmokePipe ....................................F- lti$.ea-7' � . ..:?r.... ''kl.o.,(� .J d....................:.............................................................................................. �.
SmokePipe Clearance ................;�kl*............................................................................................................................................................................................................................
Chimney '^Y
1......!;;�. ........................................................................................................................................................................................................................
Smoke Detector .................I................!�
The undersigned hereby certifies/�hat the installation of solid fuel burning stove and equipment made under au-
thority of permit dated .........,�/../.,1..g �-7..:.....: has been made in accordance with provisions of the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto ��� �'-
Installer
INSTALLATION APPROVED ... � lf/....(3 By• ............. ....................tol Title .......... . ...... ........... .
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT
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