HomeMy WebLinkAbout0143 NOTTINGHAM DRIVE ,_
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+ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
i
Map 1 Parcel Application'# 06 70 T�
Health Division Date Issued. -
Conservation Division Application Fee
Tax Collector Permit Fee S�-22'G 1 t
Treasurer
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address i113 /46 M 16 AIA
Village eo ts-rtvl LCe
Owner 6iko L RZDam,-! Address XE3 ma r F- Mtr� 4�wr-tigl*-
Telephone 4 Z 7 r o2 7 7 — S 9 � f/
Permit Request I"6nZI Lw l!&4Wo E'Z.1 '6 NOS ET ��aIIA
[-?/D? �U3vtS o kto" 91TAW
Square feet: 1st floor:existing 1600 00 proposed 44 2nd floor:existing proposed Total new��
Zoning District Flood Plain Groundwater Overlay
Project Valuation 37 7 LAC) 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 .2!Cqcs Historic House: ❑Yes �tNo On Old King's Highway: ❑Yes AN
Basement Type: tYFull ❑Crawl ❑Walkout '':0 Other
Basement Finished Area(sq.ft.) M!/� Basement Unfinished Area(sq.ft)
Number of Baths: Full:existing t' new Half:existing new
Number of Bedrooms: existing 3 new
Total Room Count(not including baths):existing new First Floor Room Count
Heat Type and Fuel: b,Gas ❑Oil 0 Electric ❑Other
Central Air: ❑Yes ` Oo Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes )i(No.
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑ex sting L@w size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: cj-f r
-r
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
a'.
Commercial ❑Yes ❑No If yes, site plan review#Current Use - Proposed Use
y,
/� t—w-s BUILDER INFORMATION
Name �L(r Bc�c.t� ��vr Z*0J&VAl Telephone Number S03-77l- 06b�—
Address 1 b 4(o ��LM Du..�H �= License# 145 W y 9
674�1 uc j , 04• U d(c 3 d— Home Improvement Contractor# I S3 SS%
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Akl,4`I G3 V P1 M4
SIGNATUR DATE Z/0 s0 7
t j
FOR OFFICIAL USE ONLY
L
APPLICATION#
r
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
Skz
DATE OF INSPECTION: I
FOUNDATION
FRAME
_
INSULATIONC Sou
--j
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
t
GAS: ROUGH FINAL
FINAL BUILDING.
ti
DATE CLOSED OUT
ASSOCIATION PLAN NO. -
r
i
,k
'The Comnionwealth'ofMassachusetts
Department of Industrial Accidents '
Office of Investigations -
_ 600 Washington Street
t. Boston,MA 02111'
wrdw.mass.gov/dia '
Workers"Compensation Insurance Affiddvit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): hU, Rd l'�I.r3 ein fba./S
Address: A Ut'I'o U Rd
City/State/Zip: ( 5 rMlij,j-•'er + Phonet SOb -771 -0 6&7-
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,
employees(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 -
in an capacity. employees and have workers' 9. Buildin addition
• 'working for me $ •
[No workers' comp.insurance comp.insurance. g
5. ❑ We area corporation and its 10.❑•Electrical repairs or additions
required.] officers have exercised their 11.❑Plumbing repairs or additions '
3.❑ I am a homeowner doing all•work .
myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance.re t c. 152, §1(4),and we have no
required.] .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.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating'such.
$Contractors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether ornot those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
1 ani an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site
information.
Insurance Company Na'me: �fi Ft7� 1
Policy#or Self-ins.Lic.#: (6 W E 6 TU 1 it -7 . Expiration Date: f t/w/y 7,
• C'��.c r�-rc ucLc.E
lob Site Address: 143 14 b Jtlb[t3om City/State/Zip: tj& -0j-& 3 �—
Attach a copy of the workers'compensation policy declaration pa;e'(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 tip 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 maybe forwarded to the.Office of
Investi ations of the CIA for insuran a coverage verification.
I do hereby certify under the pains aid enalties o perjury that the information provided above is true and correct.
Si Date 0 7 Phone 4: -�-Ok 77/
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
Phone
Contact Person: #:
12/05/2007 WED 12:22 FAX �001/001
,Dec 05 07 10:17a All Points Kit & Remodels *VO-f I-UUW
Town of Barnstable
Regulatory Services
MAft TbomavF Geiser,Director
a Building Division
Tom Perry.Building Comiaissioner
200 Main Street;14yennis,MA 02601
w%,w.tnwo.bxmtabte,mq.us
Office: 508-862-4038 Fax 508-790-623D
Property Oa►ner Must
Complete and Sign This Section
If Using A guilder
I,.- _Caf o tgjdAQA _,as Owner of the subject property
hemby autho&x AL—i. p2jA:-PK b Trk;u's 4 Wt-ww w,4 to act on tnybelailf,
is all matters relative to`vodcaucboriaed byrbis build penny application for.
Jt0Mjq&AiAf _ 170AA, 4V?Z7eV(GCE
(A,ddress of Job)
Sig i=re of Owner Date
d n�an
Print Name
If Propea Chvner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
Q,M RMS:OWM1U-OunssrOH
' ✓/�:C/JO�JI7i!IZ002G�E�LU2 O�i/l�GC7Q6Q�lLCIbP.�b � ` _-_.- .•: ,.`.,rc-•• .—r .-•--.., ..t -
Board of Building Regulations and Standards
License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR befoFe the expieation date. if found return to:
Registration 153551 Bosied of Building Regulations and Standa,i•ds
One Ashburton Place Rm 1301
Exp Catron 12/14/200.0 Tr# 253604
$ fie a�nuate Cscporapon: _ Boston v1 i.U210S";
t
ALL POINTS KITCHENS&REMODEL'ING'tLC
FREDERICK RASCH
1646 FALMOUTH
'CENTERVILLE,MA 02632 Administrator Not valid withUuYsignature
Sj fi�s*"�`wait C �ILG
k
ti; , ,Board of Building Regulation"sand Standards
Construction Supervisor License y
Ircen a CS "'72749
fif . .'$' Birthdate21 /1956
µ 5167 4 ?
E.xp rats ion 2/(J/2008 TO
�� Restriction O01, .I
�m; - i _"J
i FREDERICK V RASC�tl'I
36 CATSKILL RD a,4 m i.
� .�.
BUZZARDS BAY,MA 02532s
Commissioner I'
lNSULAiING- '
Thermal Performance Data WINDOWS
Harvey Replacement.Windows & Patio Doors a =& DOORS
U-Factor in accordance with NFRC-100-2004,based on whole window value.
To calculate R-value,divide 1 by the U-Factor(example: 1 div.by.35=2.86 R-value).Test results subject to change due to periodic re-testing.
Window Glazing U-Factor SHGC Visible Light ENERGY STAR®
Transmittance Compliance
Classic Double Hung Clear 0.48 0.57 0.61 ---
-Welded sash &frame Low-E 0:35* 0.30 0.54 All Zones
Low-E/Argon 0.32 0.30 0.54 All Zones
2X Low-E/Argon 0.31 0.28 0.48 All Zones
'0.35 value for Classic DH w/Low-E Clear w/Contour Grid 0.48 0:51 0.55 ---
effective for windows Low-E w/Contour Grid 0.35 0.27 0.4.8 All Zones
manufactured after 12/01/06 Low-E/Argon w/Contour Grid 0.32. 0.27 0.48 All Zones
2X Low-E/Argon w/Contour Grid 0.31 0.25 0.43 All Zones
Slimline Double Hung Clear 0.49 0.59 0.63 ---
Welded sash &frame Low-E 0.36 0.30 0.52 NC, SC, S
Low-E/Argon. 0.32 0.30 0.52 All Zones
2X Low-E/Argon 0:32 0.28 0.50 All Zones
Clear w/Contour Grid 0.49 0.53 0.56 ---
Low-E w/Contour Grid 0.36 0.27 0.50 NC, SC, S
Low-E/Argon w/Contour Grid . 0.32 0.27 0.50 All Zones
2X Low-E/Ar on w/Contour Grid 0.32 0.26 0.44 All Zones
Slimline Single Hung Clear 0.49 0.59 0.63 ---
-Welded sash &frame Low-E 0.36 0.30 0.52 NC, SC, S
Low-E/Argon 0.32 0.30 0.52 All Zones
2X Low-E/Argon 0:32 0.28 0.50 ' All Zones .
Clear w/Contour Grid 0.49 0.53 0.56 ---
Low-E w/Contour Grid 0.36 0.27 0.50 NC, SC, S
Low-E/Argon w/Contour Grid 0.32 0.27 0.50 All Zones
2X Low-E/Argon w/Contour Grid 0.32 0.26 0.44 All Zones
Signature Double Hung Clear 0.50 • 0.56 0.60 ---
-Mechanical sash &frame Low-E 0.37 0.29 0.53 NC, SC, S
Low-E/Argon 0.34 0.29 0.53 All Zones
2X Low-E/Argon 0.33 0.27 0.48 All Zones
Clear w/Contour Grid 0.50 0.50 0.53 ---
Low-E w/Contour Grid 0.37 0.26 0.47 NC, SC, S
Low-E/Argon w/Contour Grid 0.34. 0.26 0.47 All Zones
2X Low-E/Argon.w/Contour Grid 0.33 0.25 0.42 All Zones
Vinyl Awning Clear 0.45 0.51 0.55 ---
Low-E 0.34 0.26 0.48 All Zones
Low-E/Argon 0.31 0.26 0.48 All Zones
2X Low-E/Argon 0.31 0.25 0.43 All Zones
Clear w/Contour Grid 0.45 0.46 0.49 ---
Low-E w/Contour Grid 0.34 0.24 0.4.4 All Zones
Low-E/Argon w/Contour Grid 0.31 0.24 0.44 All Zones
2X Low-E/Ar on w/Contour Grid 0.31 0.22 .0.39 All Zones
Vinyl Casement; Clear 0.45 0.51 0.55 ---
L6w t �0.34 _0.26 0.48 All Zones
Low-E/Argon . 0.31 0.26 0.48 All Zones
2X Low-E/Argon 0.31 0.25 0.43 All Zones
Clear w/Contour Grid 0.45 0.46 0.49 ---
Low-E w/Contour Grid 0.34 0.24 0.44 All Zones
Low-E/Argon w/Contour Grid 0.31 0.24 0.44 All Zones
2X Low-E/Ar on w/Contour Grid 0.31 0.22 0.39 All Zones
N=Northern;NC=North Central,SC=South Central,S=South Rev.7/07
I
ENERGY STAR Information
Windows and doors with .35 U-Factor or lower are ENERGY STAR qualified in New England, NY and PA.
Visit www.energystar.gov for details.
The use of tempered Low-E glass may effect ENERGY STAR qualification in your region.
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WOM,MML,�E=iJlAJlii��L�� o
® Northern
Mostly Heating
❑ North/Central
Heating&...Cooling
oath/Central
Cooling&Heating
❑ Southern
Mostly Cooling
Alternative
Criteria Allowed
Windows & Doors Skylights -
Climate Zane U-FactarI SHISC', U-F'aclntt
2i49lf AG' RES57 SHGV
0,35 Any C6tnateZaota ntadat ' rawdatsr'
i — r-r
WarthJCentrel� 10,40 {0,tr0 <-0,45 Any
0.40 <.0.40 Prescriptive
NattfilCentrei '5 p,60 —<0:45 S 0.40
<0.41 <_0;36 Equivalent <,&60 s 0:45 a 0.40
Performance '0.75 5,035 t 0.40
I <_0.d?. g th,31 (�xciardvrg CAl
0.24 for 4xJa me�twy
— Nxrae r,frt�re .
At,^p yraA�mii1B �BrWJr:f:`.."�
'�4'.IIfIQfA i�TB.
'Irracl8wa or nactefa,7t safar,radiarion
I0 a 0.65 t 0.40 Prescriptve
�tl•F'acravGeratrtr`cati�r�crrter%ataasadu7Ztftr/r>J',�i�
`-'0 66 Equivalent simulation and corf lka lon procedures that rate
<_0:tti7 <_0_39 Performance sk6l u'hfs at a 2L+ Wree angle.Although raparfad'
tl X ctor is higherthaR NES97rated,produets,enaig-y
perfnrotarrca at ifra EWEAG r StAR mininumn qualifying
levaF is egcdvarerd.
y 50 37 a V'.FAUcadif caflan using ttrr,1997N.FtXprozedures for
residential wwdows#?ES 4T)that rated sktn'4.Flts.at a
I 5 0.7'1 5 0:36 90-degraa anylp..Skylights rated undertlfis yrocodi,
may be presenf in the marketplace u.rtifAfarch 31.2CW
N.WC labels for products using this procedure state:
<0:7� 0.35 "fiES97 raf ed ar 90 degrees."
5
-
1 10.74 cO.34
<—0.33
N=Northern,NC=North Central,SC=South Central,S=South Rev.7/07
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All dimensions-size designations given are PO1 This is an original design and must not be Designed: 8/23/2007
subject to verification on job site and v ~� released or copied unless applicable fee has Printed: 10/31/2007
adjustment to fit job conditions. been paid or job order placed.
7C Z
REM0O�v
Feldman.kit A11 Drawing#: 1
3" F;+59'7AW 60" 115" 54 7/8" 39" 8 1! 0 5116"z9 518" 3 13/16"z9 5/8" , 65 3116" 1 62 1/2" 54"
64 5/1oo
6"
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117 1/8" 59 1/4" 5711 ,116" 781/8" 9 113/16" �9 5/8"; 144 15J16" 29 518" 62 7/16"
I a _
870"
ADP 12/21/2007 9:48 AM PAGE 2/003 Fax Server
DATE(MMIDD/YYYY)
QCORQM CERTIFICATE OF LIABILITY INSURANCE 12/21/2007
PRODUCER (800)S24-7024 FAX (800)S24-4013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Automatic Data Processing Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1 ADP Boulevard HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Roseland, N7 07068
INSURERS AFFORDING COVERAGE NAIC#
INSURED ALL POINTS KITCHEN REMODELING- INSURERA NorGuard Insurance Company
1646 FALMOUTH RD INSURER B:
CENTERVILLE MA, MA 02632 INSURER c
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CCNDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR DD TYpE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $
CLAIMSMADE QOCCUR MEDE)P(My one pasm) $
PERSONAL&ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER" PRODUCTS-COMP/CPAGG $
PCLICY PERCT LOC
AUTOMOBILE LIABILITY
• COMBINED 9NGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS - BODILYINJURY
SCHEDULED AUTOS (Per pawn) $
HIRED AUTOS
BODILY INJURY $
NON- WNED AUTOS (Pa acddeH)
PROPERTYOAMAGE $
(Per accident)
GARAGE LIABILITY AUTO CNLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR ❑CLAIMS MADE AGGREGATE - $
$
DEDUCTIBLE $
RETENTION $ - - - $
WORKERSCOMPENSATION AND ALWC811081 12/20/2007 12/20/2009 X WCSTArUT OTH-
MI R
EMPLOYERS'LIABILITY
A ANY PROPRIETOMPARTNERIEXECUTIVE EL.EACH ACCIDENT $ 2,000,00
OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMPLOYE $ 2,000,00
IfyyE�deWbeunder
SP_ AL PROVISIONS below EL.DISEASE-POUCYLIMIT $ 2,000,00C
OTHER
DESCRIPTICN OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES,
Insured's Copy [AU.THCRIZEDREPRESENTATIVE
�j
chard Gossett/VAL
ACORD 25(2001108) 0ACORD CORPORATION 1288
Assessor's map and lot number ..... ...7. "....Q.y.� ... . fTNety
P
Sewage hermit number `" ► d� �y�
` Z SAWSSeTADLE. i
j
House number. .........:/ ..... .. .. .. ............................... '
NAIL
j 9�p 1639.
• � .. �0 MAY a`
TOWN OF . BARNSTABLE . ,
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO .... . J1. .... ..................................
TYPE OF CONSTRUCTION ....WQQD.........................
�/ ........ ......................,9. .
TO THE INSPECTOR .OF BUILDINGS:
The undersigned hereby applies for a permit according to the following informatio
Location ......���, '. 1..4.` .............a( .: ..A0.77................./.-/./.... ..Q.l..l.l .6. ...........` . `.........., ^'
Proposed Use .d.G !' J....'.......5.1.4r�r�? ��. .,� / ..... .... . ........ ................................ .........I.........................
.. . . .... .... .. .. ....
C4 a
ZoningDistrict ..................."...0........................................Fire District ..............................................................................
l� j!/.l. 1.t/� .F'/�/�?........Address .I.q,3 1.U..�?t-! ��./!im...
Name of Owner ...... .
k .. ��� ...C�. ..... l.4� i b, ..T �........I ...1�1 5•
Name of Builder . ... .. ........... ...Address .... ..
Nameof Architect ..................................................................Address ......................................................:.............................
Number of Rooms ...DN1.........1�.,.��«.. ..�.�o...:...........Foundation x x.. ....../&��..................................
Exterior ....... .�I..I..............................................................Roofing ......ko/J
I...�0.0 m)x`.........................................
-
Floors .......... ................................'Interior .......lr ��.... ti!C1� '..................................
Heating ....../V.¢!�4....::......................................................Plumbing ..... FU ...........................................................
Fireplace ...... Q.b ............................................................Approximate Cost .. ..1,� .� .......................
Definitive Plan. Approved by Planning Board _______________________________19_______. Area ....Aq............... ................
-Diagram of Lot and Buildingwith Dimensions //
Fee .........f.Q,�._.Q. .............
SUBJECT- TO APPROVAL OF BOARD OF HEALTH
. .j
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.
Ncl
e .. C!w......... 0. �.1 Gt•
Construction Supervisor's License �c�� . ..GO. �..........
1FELDMAN., MIM ETTA
c
.� No 2 U.9 Permit for .... U D PORCH
..�..... .. ...........................
wing elF-amilX Dwelling
.. Y ... ........... "
143 Nottingham Drive
Location ...................................... .......... ,
:......Centerville............................... r y �
tr Owner Mim Etta Feldman
Type of Construction ....Frame.........................
tir _ .
.4 a
....................... Lot ................................ -
Perm it,,G anted ...uly...12. .... ...:....`1.9 84
f
' Date of Inspectio Ic-'t-!I /...........19 - '
Date Completed 14.
r r .
r
�........
Asse`sor's map and lot number .......,li„(.. ... ......�..... {� BE
INSTALLED IN COMPLIANCE
WITH ARTICLE II STATE
Sewi a Permit number :.... .. . �GhC4G.. Gr .��lP�C�` SANITARY CODE AND
� REGULATIONS. TOWN
TOWN OF BAR.NSTABLE
*'THE TO
i VARNSTABLE.
s� o 39. tnUILDIRG I NS"P CT® R
APPLICATION FOR PERMIT TO �GT ............................................
TYPE OF CONSTRUCTION ........ :-=-- :..............................
r-
........................4.. G ..... „
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ..1/1 ....L!!.�1. � U�X/..�.1/l�l.....� '. C�,t4<.... �'.��..............
/ I h�p'• ��4�7`�.�.s...4r.�U S�i/...,5. J/.A..!?i. . L .� �.v jOI!�.........
Proposed Use .l..d.�lJ.......�.......�...,�......�... .......... � ....
Zoning District ............ ...�...............................................Fire District �4..h..et.6!x. .. P.1,Ae.r'rl..... ............
/ .
7- /tee�G� It�ia v� / /�o
Name of�Owner- .a.! !.h..Y...:................................................Address ........ ........... 1.✓t.�'!.CAS.f'h...rl�!/ ...CCK...�kl!t���.
Name .a f Builder 1�.i�.�! 40.c4... ..-�A...!'!............Address/ s...a..Q� . �1`a/�'.4 /���.<...:.
Nameof Architect ............ `..........:........................Address .....................................................,..............................
Number of Rooms ... ..��ul'�t e.s....S..��s£'... .5.....Foundation .P....... P..n.C.��'.<.. --.�✓�oG/[5......................
Exterior d4-/ ?Qi�:j—i4...T4:71e-C7--�-y'.c...../:.f/...........Roofing .......................................................
Floors /?.Y..7, o /oo. ....1�/�G...............................Interiord1.t47�r�.4.eK. ill.y .�l..r-c?'le ..>'�'�..lc!ct��-S
Heating ... ✓. ?..h.. ...........................................................Plumbing ...../`/o tv!.eT-. .....................................................
Fireplace ..../ya.b..<.�..........................................................Approximate Cost 6-5-100 so
........................................
Definitive Plan Approved by Planning Board ________________________________19________. Area .............
Diagram of Lot and Building with Dimensions Fee '....�. ........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name.... ........ ....................
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No .. — Permit for — ...................
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Location z��.. .Ibr......................... / '^
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Type of Construction —.Clapboard.................
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Plot ............................. Lot ___________
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Permit Granted —
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Date of Inspection —'lV
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PERMIT REFUSED
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Approved................................................... lA
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FEE
cl c TOWN OF BARNSTABLE, MASS.
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o�•� THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO
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[�•7 b (BUILD) (ALTER) (REPAIR)
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.q A A ........................................................................................................................................................................................... .................................................................................._...._..........
C ccC (TYPE OF BUILDING) (APPROXIMATE SIZE)
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1 o p LOCATION ........................._..............................................................................._..... ..._....................................................................................................................._.._............ ..__
V d (STREET AND NUMBER) (VILLAGE)
mR NAME OF BUILDER OR CONTRACTOR _._.... ...___..__......._.._..._.._.................._............................._........_..............................._........... _.
APPROXIMATE COST
d mas I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN
491 OF BARNSTABLE, GARDING THE ABOVE CONSTRUCTION.
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F
' O BUILDING INSPECTOR
Subject to Approval of Board of Health.
M-CST Exc. 6
THE COMMONWEALTH �F MASSACHUSETTS
REGISTRY OF MOTOR VEHICLES
100 Nashua Street
BOSTON, MASSACHUSETTS 02114
ASSESSOR - COLLECTOR REPORT
OF RECORD CHANGE
TO REGISTRY OF MOTOR VEHICLES
CITY/TOWN Registration No. —
i
DATE `t Owner
Address
Attach a copy complete
(or Photo Copy) OR information Year, Make of Vehicle— _
of tax bill in items on
question right
Vehicle Ident. No. —.
Information has been received to our satisfaction that the following changes should be made
in the excise tax record.
I. ( ) Massachusetts plates returned — Date
(Please supply photo copy of receipt from Registry of Motor Vehicles)
2. ( ) Massachusetts plates surrended — Date
(Please supply photo copy or affidavit explaining where and how surrended.)
3. ( ) Vehicle sold — Date -
(Please supply photo copy of bill of sale.)
4. ( ) Vehicle removed from Massachusetts — Date —
(Please supply photo copy of new state registration)- -
5. ( ) Correct residential address
(If different from address shown on your excise tax bill)
6. ( ) Correct mailing address _
(Fill in only if different from #5)
7. ( ) Correct place of garaging
(Fill in only if different from #5)
8, ( ) Correct valuation
(In order to correct the valuation you must give us the name of the person in the Corp. & Tax Dept. who
authorized a change in the valuation of this motor vehicle)
9. ( ) Other
This form approved by Commissioner of Corporation and Taxation
PLEASE NOTE: If the information requested above is not supplied the computer records
cannot be changed.
Signed
Authorized Signature
Assessors/Collector
FORM 830 Hobbs &Warren, Inc.— Rev. 1977
/ �� - P/ 7