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> Town of Barnstable *Permit#
Regulatory Services ��6nwnths
• anxt�sr�.E, •
n .ss. Thomas F.Geiler,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us -
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
��jj gyp Not Valid without Red X-Press Imprint
Map/parcel Number 1�p V`7
Prop rty Address 6-4' O IeD
[Residential Value of Wor 0 Minimum fee of 35.00 for$ work under$6000.00
Owner's Name&Address
NNE
Contractors Name Telephone Number j56C_9a$_C7,s Y
Home Improvement Contractor License#(if applicable) /l,i/`/✓ �/
Construction Supervisor's License# if applicable)
PERMI
❑Workman' Compensation Insurance
S'Y
Ch ck one: • �• ::- .-..
I am a sole proprietor TOWN OF BARNSTABLE
❑ I,am-the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
n j #of doors
Replacement Windows/doors/sliders.U-Value l (maximum.35)#of window
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
req7uedW
SIGNATURE: �
C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZTEXPRESS.doc
Revised 072110
The Comnaonrvealth of MaNsachusetft
Depaa hnmt oflnd'tstr al Accidents
Office of Investigations
600 Washington,Street
Boston,MA 02111
iv►vw.H1.ass.gov1 daa
Workers' Compensation Insnrance davit:Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Nwm(Businew,/orgmi zaiion&&v.idaao-
Address: PID,
City/State/Zip- TUl E. Phone
Are you an employer?Check the appropriate boa:
T1 of project(required):
=
1 ❑ Iamaemployerwith 4_ ❑ I am ag general and I
6. ❑New construction
doyees
(full and/or part-time).* have hired the sub-conttactors
2. a sole proprietor or partner- listed on the attached sheet, 7. ❑Remodeling
ship and have no employees These sub-contractors have S. ❑Demolition
working for me in any capacity. employees and have workers' 9. ❑Building addition
[No workers'comp-insurance comp_insurance I
required] 5- ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work deers have exercised their 11_0 Plumbing repairs or additions
' right of exemption per MGI
�'�1£[No workers'comp- 12.❑Roofrepairs
insurance r I c.152,§1(4X and we have no ,�,�
mod) employees_[No workers' 13_l.J'Odw
comp_insurance required_]
;Any apptic�rt dmt checks box#1 must slim fill out the section below sbovriag shear vvorkers'ommpe�tion policy informatiru.
1 Homeowners who submit this a€Edaavat hu catiag they are doan all woA and dhen}sire outmie eoutxactoss woof submit a new affidavit indicabag Bach.
Contractors t as hat chEa this h must attached sa additional sheet showing the name of the sub-conuactors trod state whether at not those®titled have
employees. If the sub-conttadnrs:have Employees,they nmtst tprovide their workers'romp.policy number.
lain an wnploysr that isprovidiaag markers'coeeapearstriioae iaasaaraeace for Div eorplo sex Beloddp is tleepolicy Brad job wife
information.
Insuarance.Company Name:
Policy 4 or Self--ins.I.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 MGI,c 152 can lead to the imposition of CT=' gal penalties of a
fine up to S 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$250.0 a day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of
Investigations of the DLL for insaurance coverage verification.
T ado here/y ceo t;fp aarr ae ae rlpeaera ldes of pednry that the luafarrmsi onpdr► ded'asias��e tnw aged confect
S tire: �� Date:
Phone#: � �`c�J
Offleial use only. Do not write in this area,to be completed/by city or Im m o ici aC
City or Town: PermitUcense 9
Issuing Authority(circle one):
1.Board of$ems 2.Budding Department 3.City/Town Clerk A.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone 9:
oFTMe
t snttxsrns�.
Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I. eICNIVP 1 r%0T� ,as Owner of the subject property
hereby authorize WK A t to act on my behalf,
in all matters relative to work authorized by this building permit application for:
1$6 NYE ikfl 0MT0Y1l "
(Address of Job)
Si ature of Owner Date
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\Users\decollik\AppDataU.ocal\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc
Revised 072110
Massachusetts.- Department Of Public.Sxfet'
Board of Building Regulations and Sf-�-Idards
Construction Supervisor License` r�
Y
.License: CS 47667 ..�-
Restricted to: 00
PHILLIP M VOLLMER
PO BOX 64 .
COTUIT, MA 02635
"Expiration: 9/1/2011
('unuui�sioncr
Tr#: 2260
Pian�n ,�lrtieaao � 2 � License or registration valid for individul use only
Offce o onsuer airs A. u ahgg
HOME IMPROVEMENfi CONTRACTOR
• before the expiration date. if found return to:
Registration 4055$ T���z
t 'Office of Consurn Affairs and Business Regulation
10 Park Plaza=-Suite 5170
Expiration. 06.12 InHiin ual '` I Boston,MA 02116
M VOLLMER t 't.
ti '4
MARK VOLLMER M
1455 SANTUIT NEW170WWR 7
COTUIT, MA 02635 Undersecretary Not valid without signature
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!Assessor's office st Floor): 917 � SEPTiC SYSTEM MUST of toy
Assessor's map an
o
d lot n ber /? INSTALLED IN � 'tME `
Conservation S— C®MP o�
Board of Health(3rd floor): WITH TITLE$ • •
Sewage Permit number. -- � ENVIRONMENTAL CODE t ssas�rantt
rua
Engineering Department(3rd floor): f ��J� TO" R5GULA,1-,,zS
House number (� o��v
Definitive Plan Approved by Planning Board 4219
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00- • P.M.only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO Sf/y!cze 5.�Iylz �D 1/ (f ZG lIZ1G
TYPE OF CONSTRUCTION
/!>'Iy (=;,2 s 19 .9
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applielpy a permit according to the following information:
Location ( oT fob? N Y-e IN CeN7-0- !//LL -e
Proposed Use �W�PLC//1/
Zoning District // Fire District
Name of Owner A�4111 4—: SI?W6 Address/ // lmlk BS' no-&/4�.iA 0-165
Name of Builder To/!��V 7 �&Xle� Z-44-Address
Name of Architect X Address
Number of Rooms Foundation
Exterior%�/�0� ��/ s'1111 Ua- Roofing Sl��i9L�
Floors Interior ��Gr/,�L,
Heating 1 �P` y �/ltS Plumbing C2
o 1001�
Fireplace /y!,,9/110 T1/Y Approximate Cost41
Diagram of Lot and Building w th Dimensions Fee
117, 75
golvd- %006 1 z
7`/Z s��y
60
t�yo
gc�
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barns ble regarding the above constru ion.
Name
o struction Supervisor's License
o
L SMALL, ALAN E..
No- 36383 permit.For 1 2 Story
Single Family dwelling --
Location Lot #669 , 186 Nye Road
Centerville ^, °
Owner `�-°Alan E. Small
Type of Construction• Frame
Plot Lot f ,
Permit Granted December 13 , , 19 93
Date of Inspection °z Y/ 9`l� 19, t• ` _ -i r
Date Completed r 19'vj
- . ~ - � i E ..F � e , ' '�e� -�ITS .,d' .• ~ mac..
` yl'eYn.. i .. .',• .'l...-'.._..'tTaP:R'y'+w.Y c"�r'..�,__. ...a -
J ti
till
�.:-:-:t'.Y h! �L/�T.�..:T�-+M:�-./..".7.-.V-r..�T^Y.-h'X' . ... ,- f -. "-. _ .•.• a- .. .. _.
SOWN OF BARNSTABLE, MASS/ACHUSETTS % BUlLD11ND~ "p ERM IT
93 4u 383
AL147 097✓ llcc.mbar i3 '
DATE 19 PEDri ,
ve
APPLICANT
John J. Baldner, Jr. ADDRESS y 'EY �.ei1 rive, ... .�. A
INO.) (STREET) (CONTp•S LICEASE)
PERMIT TO Build dwelling ( iq J1�„ j`I111'j dwelli NUMBER OF 1
) STORY DWELLING UNITS
(TYPE Of IMPROVEMENT) N0. (PROPOSED USE)
lot #669 186 Nye Road, Centerville ZONING RC
AT (LOCATION) DISTRICT=
(NO.) (STREET)
AND
:BETWEEN I
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT-BLOCK.-SIZE
'BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM !N CONSTRUCTION
'°TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
Sewage #93-234 i
REMARKS:
BONDPER C
AREA OR 1008 sq. f t. ESTIMATED COST S
FEE
MIT 117.75
VOLUME i
(CUBIC/SQUARE FEET)
OWNER Alan E. Small it 3
749 Main Street, USL"eryllie, NIA BUILDING BUILDING DE PT. %
ADDRESS BY j
{
r i g7y
ZN—D ING CODE. MUST BE AP- .$
�Y—fiRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEI`
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITION. -
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR 1
ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REC UIRED FOR
ELECTRICAL, PLUMBING AND
I. FOUNCATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. MEM.EPRIO TO COVERING STRUCTURAL QUIREO,Si1CH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMB_IoS IRE ADO TO LATHE FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
11 BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APP=OVaLS
i
- HEATING INSPECTION APP=O AL ENGIt,EE G DEFAPT.v_N-
UTMER, _C•RD OF HEALTH
I
". _'V APA S:AGES.Of 1 WORK IS NG- >,..n ... .�. .� 4 r}=s`"s.•.
TOWN OF BARNSTABLE,,Two
� Permit N . ......:.........
BUILDING DEPARTMENT
I TOWN OFFICE BUILDING Cash
� .Yl
6TV•
HYANNIS.MASS.02601 Bond
CERTIFICATE OF USE AND OCCUPANCY
Issuedco Alan E. Small
Address 186 Nye Rd, Centerville
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
... ... ... . 14y..7.1. ...... 19..p4........... ........ .. .. ..... a
Belding Inspector
IUD •. TOWN OF BARNSTABLE
� e
a w
BUILDING DEPARTMENT
TOWN OFFICE BUILDING
rua
HYANNIS, MASS. 02601
MEMO TO: Town Clerk
FROM: Building Department
artment
DATE:
An Occupancy Permit has /been issued for the building authorized by
Building Permit �$.c ....s /!� ....... ..._._..................................................................»............_.....
»...... ».. ...»..» »..»»__
issued to ......... ....»..........................................................
_....__._._»...»...»
Please release the performance bond.
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FRONT ELEVATION
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Ff4Tl0 DOOR
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46 16 X 12 O
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FAMLY ROOM O
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16K12 140C16 136 X 12
. O 32OQ.4 DOUiLlNYNc O 2oDC16 D WINUINYN40 O 94704 DOUWNUNO
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1298 SQ FT FIRST FLOOR 660 SQ FT SECOND FLOOR GARAGE AlbQ4
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4 8 12 16
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Q LINNEN
O 323C24 .DOU ISLE HUNG C 243C76 DOUBL.EHUNO A� 24X24 .DOU8LEHUN6
1298 SQ FT FIRST FLOOR 660 SQ FT SECOND FLOOR
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ALGER & SCHILLING
ATTORNEYS AT LAW
886 MAIN STREET
P. O. BOX 449
OSTERVILLE, MASS. 02655-0449
TELEPHONE 428-8594
JOHN R. ALGER AREA CODE 508
THEODORE A. SCHILLING TELECOPIER 420-3162
December 20, 1993
Mr. Joseph DaLuz
Building Commissioner
Town of Barnstable
367 Main Street
Hyannis, MA 02601
Re: Map 147 Parcel 97 Lot 669 Centerville Highlands
Dear Mr. DaLuz:
At the request of Alan Small, I have examined briefly the title to his
property shown as Lot 669 on a plan in Plan Book 386 Page 90 and I find
that all but a very narrow strip was conveyed by Alan E. Small, Inc. to
Skunknet Realty Trust on October 23, 1978 in Book 2806 Page 68. Thereafter
on February 7, 1986 Alan E. Small, Inc. conveyed all of Lot 669 to White
Pine Lot Realty Trust. In order to clear the title thereof, I am drawing
and recording a deed from the White Pine Lot Realty Trust to the
Skunknet Realty Trust, but as a result of my examination I find that
prior to the time the protection of the plan expired on August 20, 1991,
none of the lots adjoining Lot 39 stood in the same name or under the
control of any adjoining owner. I therefore believe a building permit
should issue.
Ver truly yours,
JRA/,db