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Home My WebLink About0040 PATRIOT WAY r, 6 - o o n� ., � ,. J! '. 11 .. .. I I� .. .. , .. Q .. _ .. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel 1 36 ' Application t v(�✓7 �l P Health Division ��— Date Issuedto Conservation Division Application FeeR Planning Dept. ; Permit Fee Date Definitive Plan Approved by Planning Board 1D f 9 3 Historic.- OKH Preservation/Hyannis Project Street Address ekre IQ T 0&4 Village Li`iYTE KV I LL- Owner -/10 5Q L. �"fU RI u Address 40 � T21�T W Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation I-3" Construction Type -------------------- Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Id Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes 4 No On Old King's Highway: ❑Yes )dNo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other N Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal{tove: LVYes O No o Detached garage: ❑ existing ❑ new size—'Pool: ❑existing ❑ new size _ Barn: ❑ ex'Ting ❑ rnr size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 00 Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed-Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 9_05A:i5 L. 6-M PAL0 Telephone Number Address '40 ki License # CIRT-e-GI LLE 0 21P 52 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO &-(Z.I 6 i ALE 1--A,)D-F(LL SIGNATURE C. bil O QJ LLL DATE ,y ;i FOR OFFICIAL USE ONLY APPLICATION# R DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER i fi +DATE OF INSPECTION: FOUNDATION FRAME j INSULATION FIREPLACE _. ELECTRICAL: ROUGH FINAL { PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING j DATE CLOSED OUT ASSOCIATION PLAN NO. The Gommonwecdth of Massachusetts Department of.1-ndustrialAceidents Office of Investigations 600 Washineon Street Boston, M14 OZXXX www.m.ass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors[EIectricians/P.lumbers Applicant Information Please Pant Le�iblY Name (Busincsslorgazization/individual): PJ1�JA—r� �- 671) .Address:--- ` City/Sta-te/Zip: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4.. ❑ I am a general contractor and I 6 0 Now construction employees(full and/or part-time).* have hired the snb-contractors 2.❑ 1 am a sole proprietor or partncr- listed on the attached sheet. 7. ❑Remodeling ship and have pn employees These sub-contractors have g, ❑ Dcmolition employees and have,workers' working for me in any capacity. 9. ❑Building addition [N o workers' ins, ncc comp.insurance.$ canes.� 5. ❑ We arc a corporation and its 10.❑Electrical repairs or additions zPmrircd] � officers have exercised their 11.❑].'lambing repairs or additions 3. I am a homeowner doing all work myself[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance rr quired.]t c:152, §1(4), and we ha"no 13.0 Other employees. [No workers' coutp.insurance required.] *Any aFpiicznt that chcckc box#1 must also M out the section below showing their work='corupmsoAm policy information- t Hm-n=wners who submit this of davit indicating tbcy arc doing all work and thrn hi-outside cmtiaet m must submit a new affidavit indicating such. $Contractors dixt cbccicthis box must attambcd an additional rkct showing the name of the sub-cmtractors and stale wbctl,cr scoot thosd rntitirs haver employers. If the sub-cnnhaetors have mnploycu,they must providb their workers'comp.po'bey nurnbar. I arcs an employer that is providing workers' compensations insurance for my employees. Below is the policy and jab site information Instrrancc,Company Name: Policy#or Self-ins.Lie. #: Expratiou 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 crina al 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 WDRK ORDER and a fine of up to$250.00 a day against the violator. ,Be,advised that a copy-of this statcmerit may be forwarded to the Office of LayCstigZti0uS of the,DIA for insurance coverage verification. I do hereby certify under the pains-andpenalti.es-ofperjury that the information provided above is true scud correct Sitrnahuc• nti �JI'La D�L Date: Phone - Ofjzcw use only. Do not write in this area, tb be completed by city or town of)'XcW City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Towu Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 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 hue, ` express or implied, oral or written-" An emproyer is defined as"an individual,partnership, association, corporatiJr- d other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal represves of a deceased employer, or the receiver or trustee of an individual,partnership, association or other Iegal cnemploying employees. However the owner ofq dwelling house having not more than three apartments and who rs therein, or the occupant of the iwclling hbuac of another who employs persons to do maintenance,construeor repair work on such dwelling house )r an the gro ds or building appurtenant thereto shall not because of such cymcut be deemed to be an employer." vIGL chapter 15`2, §25C(6) also states that"every state or Iocal licensing ay shall withhold the issuance or -enew�al of a lice a or permit to operate a business or to construct buildin the commonwealth for any applicantwhohas otproduced•acceptablc evidence of compliance withnsurance coverage required." �dditionaIly,MGL o ter 1- §25C() states'Neither the commonwealthny of its political subdivisions shall ;fir into any contract. the perform ncc of public work until acccptsble c dcnee of compliance R'ith the in-mane equircmcnts of this chap have been presented to the contracting authorityP' LPPlicants lease fill out the workcrs' compe ation affidavit completely,by chcc the boxes that apply to.your situation and, if sary,supply sub=contractors) e(s), address(cs) and phone numb s) along with their ccrtificatr(s)of �sruancc. Limited Liability Companies LC) or Limited Liability P hips(LLP)with no employees other than the icmbcrs or partncis, are not required to c workcrs' compensation cc. If an LLC or LLP dots have nployccs, a policy is required. Be advised t this affidavit may be mittcd to the Department of Industrial ccidcnts for confirmation of insurance covcra Also be sure to s' and date the affidavit The affidavit should returned to the city or town that the application the pcmoit or ense is being requested, not the Department of idusUW Accidents. Should you have any questions ding the w or if you are required to obtain a workcrs' ,mpensation policy,please call the Department at the er lis cd below. Self-insured companies should enter their lf-insuranca license number on the appropriate line. ity or Towm Officials ease be sure that the affidavit is complete and printed Icgibl E. The cpariment has provided a space at the bottom 'the affidavit for you to fill out in the event the Office of InvJzstigatio has to contact.you regarding the applicant ease bn-sure to fill in the permit/license number which will lie used as a crence number. In addition, an applicant rt must submit multiple permitEcense applications in any given year,nred y submit onp affidavit indicating current lacy information(if necessary)acid under"Job Site Addresk" the applicant sh d write"all locations in (city or un)."A copy of the aff davit that has been officially is; red or marked by the c or town may be provided to the plicant'as proof that a valid affidavit is on file for fiitnrc p rmits or licenses. A ne davit.must be filler$out each u:.Where a home owner or citizen is obtaining a license r permit not related io any b iness or commercial venture a dog license or permit to brim leaves etc.) said persora NOT required to complete tivffidavit e Office of Investigations would h1w to thank you in ad ance for your cooperation and should�yqhave any questions, ase do not hcsitatt to give us a call Department's address, telephonc•and fax number. The Commonwealth of Ma ssaGhusett Dept anent of ladustrial Accidents Office of Investigations 600 washin n Street Boston, 02111 Tel. # 617-727-490.0 ext 4.06 or 1-877-MASSAFB Fax# 617-727-774g 11-22-06 www.mas,-,.gov/dia Town of Barnstable h��F-[HE TQLyyT _ Regulatory Services Thomas F. Geiler,Director BAItNStABLE, MASS. 16jq_ ,1b Building Division, w.T PIED �a Tom Perry,Building Commissioner . 200 Main Street; Hyaffiis, MA 02601 wvmY.town.b arnstabl e_ma.us fice: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: A �J r \ 10B LOCATION: 4 P k a i�E W Ay number street village "HOMEOWNER": work hone# name home phone# p CURRENT MATC.ING ADDRESS: 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. DEFINITION OF HOMLON'Ylr'ER person(s) 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 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 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) The undersigned"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 ninimum.inspection procedures and requirements and that he/she will comply with said procedures and requirements. �1�O,Q,II ;ignaturc of Homc cr .pproval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the tate Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions 'this section(Section 109.1,1 -Licensing of construction Supervisors);provided that-if the homeowner engages a pason(s)for hire to do such irk,that such Homcowmer shall act as supervisor." Many homeowners who use this exemption an:unawart that they arc assuming the responsiibi)iLies of a supervisor(see Appendix Q, des&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly icn the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would With a licensed pervisor. 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, t the homeowner certify that he/she understands the rtspormbilitics of a Supervisor. On the last page of this issue is a form currently used by rcral towns. You may care t amend and adopt such a form/certification for use in your community. �oFmEl TOWn of Barnstable yo Regulatory Services • Thomas F. Geiler, Director. o 16 9• �$ °rfbr4w�a - Building Division Tom Perry, Building Commission r 200 Main Street, Hyannis, MA 02 1 www.town.barnstable_ma.0 Office: 508-8 2-4038 Fax: 508-790-6230 Property Owner ust Complete and Sign 'I' is'Section If Using A. B der l , as Owner of the`subject property hereby authorize to act on my behalf, in all matters relative to work authorized s building permit application for: t (Address ofJob) iP Signature of Owner Dat Print Name If Property Owner is applying for pe' it please complete the Homeowners License Exemption Form on tEc reverse side).. °`•� 6 IVA �5 r 3 a. X'urue6 644 CJ TF�JY �csGN 4--:-XP,2v iah% Of" D 3 Cr' /O Oi r G zq ' :J z s ► 3 z. , T� a. �� ._✓L r c R-T iF 1 Fti'J PLO Sri L OCAT lGii\4 eh L _ PLAN FEP�EP cam: L l 9 Y'+. .•. .' Lai' sir'oa � " � , 13i�.X T NY E INC , REGISTER D L.AND SU.R\,/F: ZG.�t�'l eq/G Z., 9�:S u% 7-11e 7-0Al,.-y 0,� O5`E :E"�1/1 UL E M A S S ;� 1 U)bk �'�► - � ��-168 0fIKE T Town Of Barnstable *Permit 4)0( Expires 6 mo e date Re ulator Services Fee d� g Y srnaLe; Thomas F. Geiler, Director 1634. Building Division rf�t��a Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERA11T APPLZCAMN - RESIDENTIAL ONLY Not valid f+,ithout Red X-Press Imprint Map/parcel Number U_ 0 Property Address . 40 e" AM— Residential � [ Value of WorkTt Minimum fee of$25.00 for work under$6000.00 Owner's Name&.Address 40 eATLIOT k/A-1 LE6R E V ILLS OZOZ Contractor's Name _Telephone Number Home Improvement Contractor License# (if applicable)_ ❑Workman's Compensation Insurance Check one: ES PERMIT ❑ I am a sole proprietor �]( I am the Homeowner AUG 2 1 2008 ❑ I have Worker's Compensation Insurance Insurance Company Name TOWN OF BARNSTABLE Workman's Comp. Policy# `- Copy of Insurance Compliance Certificate must be on file. Permit Request (check box) , t [� Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) 11 ® 1 Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) ; , *Where required: Issuance of this permit does not exempt compliance with other town department regulatior� .e.Historic;Conseration,etc. L4� ***Note: Property Owner must sign Property Owner Letter of Permission. tt� k A copy of the Home Improvement Contractors License is required, y SIGNATURE: Q:\WPFILESTORMSIbuilding permit forms�EXPRESS.doc r , The Corntnonwealth. of Massachusetts Department of Industrial Accidents office of Investigations 600 Washington Street Boston, MA 02111 wwlv.mass.gov/dia Workers' Compensation Xnsurance Affidavit: Builders/Contractors[Electric' Pr plumbers A l�cant Information Please Print Lezbly Addre kb -I"4kq - City/state/Zip: UFKITF U i LLE LA A OZ to ZPhone.#: Are you an.etnglayer? Check the appropriate boY: Type of project(required): 1.❑ I am a cuzploycr vrith 4 ❑ I am a general contractor and I 6 ❑Ncw const[uction employees(frill andlorport-time).* have hired the shb-contractors 2❑ I am a sole proprietor or partner- listed.on the attached sheet 7. ❑Remodeling Dr- ship and have no employees Thcse sub-contractors have 9. ❑Demolition employees and have workers' working for ms in any capacity. 9. ❑ Building addition [No workm-a, cz�.-ins,rrance ��.,ncrrranGG.� S. ❑ We arc a corporation and its 10.❑-Electrical repairs or additie rt�tured ] officers have exercised their 11.[]Plumbing repairs or addi-tic 3.W I am a homcownsr doing all work myself: [No workers' comp. right of exemption per MGL 12 []Roof repairs inarnanco r t c. 152, §1(4), and we have no �� employees. [No workers' 13-❑ Other comp,jn=ancc required.] "Any zpplicant that cbccls box#1 mast also fill out the section below showing their wor as'carn}xxuation Pokey iafr rn-mtim- t Hm-cowncr%who eubmit this affidavit indcating if ey arc doing all work and thrn trct hin:outside canaors awst submit a new affidavit indicating cvch t-,Mtractors that cbmv this box must attached an additional sheet showing the name of the suh{nnttactots and sfafn whctbcr ar not thosd mtibm have anployccs. if the sub-contiactrna have employmr,they must ptavi&their warkrrs'cyan.policy number_ I arm. arc employer that is providing workers'cornpensat an i_resurance for racy amplayees. Below Gs the policy and job site information. Innn-ancc Company Name: Policy#or Self-ins.Lie_#: Expiration Date: Iob Sitc Address_ City/StatcMp: Attach a copy of the workers' compensation policy declaration page(showing the policy number and e)opiratioa date Failure to srmwc coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penaltics of firm tip to S 1,500,00 and/or one-year imprisonment, as well as eivrZ penalties in the form of a STOP WORK ORDER and a of up to$250.00 a day against the violator. Be advised that a copy of this statr merit maybe forwarded to the Office of lavrstigations of the DU for incrtranr_c cov c verification I do hereby certify ander the pains-and penalties of perjury that the information provided arbove:Gs true and correct Si c: Datn: Phone# �J�g ql� UN 0 use only. Igo not write Gut this area, tb be corrrpleted by city or fawn offcciaL faint City or Town: Permit/License# IMtIng Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5:P.Ilambing Inspector 6. Other Town of Barnstable of THE ropy Regulatory Services Thomas F.Geiler,Director sAtzxsrAuEz, Q MASS q, i659. Building Division prF0 Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 www.town.b arnstabI e.ma:us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION �i �+ Please Print DATE: b o -OO f-p� n JOB LOCATION: �a' VE07-e `��LL� number street village "HOMEOWNER": ��S/rN C 5�� 5NMS- b30S 50g-ggS-01 name home phone# work phone# CURRENT MAILING ADDRESS:_ 0 P- tO I ki k UA- 02632 city/town state zip code The current.exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and dual for hire who does not possess a license,provided that the owner acts as to allow homeowners to engage an individual supervisor. DEFINrrION 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 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 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) The undersigned"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 procedures and requirements. Si turc of Homeowner Approval of Building Official Note: Three-family dwellings.contairting 35,000 cubic feet or larger will be.required to comply.with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of thii section(Section 1o9.1,1-Licensing of construction Supervisors);provided that if the homeowner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption ale unaware that they are assuming the responsrbilitics of a supervisor(scc Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2,15) This lack of awareness often results in serious problems,particularly when the homcowncr 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 respmstbilitics of a Supervisor. On the last page of this issue is a farm currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. YHEt, Town of Barnstable r Regulatory Services EL` & r rush. Thomas F. Geile.r,Director T�13 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-40 8 Fax: 508-790-6230 Property Owne Must . Complete and Sig his Section ff Using under as Owner of the subject property hereby authorize to act on my behalf, in all.matters relative to work autho ed by s building permit application for: ddres s of rob) Signature of Owner f �t Print Name 1 If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Assessor's map and lot 'number ............... ............................. .� � ' SEPTIC SYSTEM MUST BE TNEt�� Sewage,Permit number./p'.?.I. 1.... ...". INSTALLED,IN COMPLIANC r `3 WITH TITLE 5 t BAaasTanix ............ :.....: :..House number .. .. EI!!0/19 ®9V EfV� M a M AL CODE�AN �p i69 6�. TOWN OF BARNSTARLE ' _ t BUILDING INSPECTOR R APPLICATIONFOR ;PERMIT TO .... a �. ..............................�....................... ................. ....... .. .............................. TYPE OF CONSTRUCTION ....................t �00 ................................................... . ....S�siMC-GG... .... ................................................... ..............5....................' ....19....../ 'TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..........4.o...... ,1.'./q/0.�.............ln_��.�............................................................ ................................................. ProposedUse ....... .. 'Q ..........`S H.�. ..........................................................................................I......................... ZoningDistrict ........................................................................Fire District ............................................................................... Name of Owner ...... ..�C...!�..LL........... ...............................LL��s Address ........`f. ......�.11�.c9i......... 1........I.................... Nameof Builder �.�`� ~ . `.. .........................'.......................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....................... ...../.............................Foundation ........................ ...................................................... Exterior ............................,........................................................Roofing .................................................................................... Floors I�`/�0 j .Interior 1'� n Heating � :.Plumbing /`.... M.. ................................................................................ ......................................................I............................ Fireplace N� ®~`.............................................Approximate Cost /OCJ " .........o.......................... .�7..... Definitive Plan Approved by Planning Board ------------------------- �........ -------19--------. Area .................. .........:. Diagram of, Lot and Building with Dimensions Fee SUBJECT TO APPROVAL.OF BOARD OF HEALTH �QpM7 ' S�?r. C. T ' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... .�N `0^^............ ..... ........ ELLIS, !]AICHELE 23125' ADDITION No ..............7�. Permit for ............................... .... . ............�O ea -Shed to Dwelling .............................................P. .......... ............. 4 0 Patriot aLocation .................................... .................... Centerville ............................................................................... Owner ...Miche le Ellis............................................................... Type of Construction.' Frame . ........................................... . ................. iA Plot ............................. Lot ................................ 4ray .19.. ....... 91 Pgrmit Cranted ............................... .19 Date of.'Inspection ......................................:-19 Date Completed ................... 19 > PERMIT REFUSED .... ................................................ 19 r ............................I............. ......... r.4 .............. ........................................... 11., Id V co ......................................................... - I L Approvecl ...........;:..................................... 19 ................ ..........;................................................... ............................................................................... Anuesom/m mop bm] lot number §evvoge Permit nom6a, kl............................................... . BARNSTABLE� � number --.------_----.----------` � ' | " | ' TOW'�� T|�J �l�0� 0�� Jk �� l�T�� r�� l� �� N n�� '��|�� _�� . ^ BUILDING � NN N �� N �� N0 N N_ 0� �� ` =~ =� p ��~ � �� w mm ��m wm � ��PPKUC^&TK�� FOR PERMIT T�� —..�v�( ../y.. 61 —.��^.�� —.. ' TYPE OF CO��S3R0CTU�� --.—�--..^--/��.��.��—. .L��—..J��J� [,^/"�~�1/—.--.— . ............. -------l�l~�' TO THE INSPECTOR OF BUILDINGS: ' The undersigned 6ene6v applies for o permit according to the following information: | � 0 ��T�/ �T �/� `/ �� 4�� Location ' '' �: .� ��' � ---'`---'—'-----^^^^—^�— 7^--------'' ' --^'..`—^^---''--'^-------'—^---' ` �' Proposed Use .................. .'Kt .^....................................................................................................................................... � ~ Zoning [Vu�� ------ --------------.Rvo D�h�� --.��.��..�_--________________ � Nomeof Owner ............................................. ------.A66emx ........................................................... ................ Name of Builder ................. ..................................................Address -------.---------.----------.. Nome of Architect ----.-----------------..A66res ----------------------______ ~ {� Number of Rooms ----.��----------------�Foun6ohon —_—�[��^��.�---.��/5--_____._ GUehor ---------------.,—.--'--------.RooGng -----.------_.—___.____,--___,.. Floors — ' ~/° | &!��Y Heating ---'`=.'..:--._.......—.----...._------..F1um6ng .........................................^' — ~ � Fireplace .--------!.,....-----.----------ApproximoUa Coo ..... ............................................. /� � � Defnh�e �on by Planning Board lQ----' Area —. .][-- —. ----- Diagram of Lot and Building with Dimensions Fee ............ ....... ...................... SUBJECT TO APPROVAL OF BOARD Of HEALTH \ � \ ` / / ' / ^ | � ' _---------~ [ | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' Name .^�&��|�� k��!��.-----. SHIELDS, MICHELE 23035 ENCLOSE No .................. Permit for ........................ppau & .ADD DECK ................................. Location ..4....0' Patroi ................... ......... ..... ........... Centerville ✓ .................... Owner '..Michele Shields.,...................... ............t....... . Type of Construction. .......Er.ame....................... .................................................................................. Plot ............................. Lot ............:%.................. I Permit Granted ...Ap.r.il .2.3 .....19 81 1 ..... .. .... ...... Date of-Inspection ......................................19 -Date Completed .............................Y—.... ..7Z.._ 1-0 PERMIT REFUSED ................................ .................................. 19 lee ................... ..................................... ......... . ................................ ....................................I ...................................................................... . ............................................................................... Ap a' ,pr Ved ........................................ _19 .....................I........................................................ ............... ............................................................. a `I lam'7i y'1"1• .r - `, . 4 A- 13 a. -7 a /Qoo a / � 8• �urvca V Q Ta64. ''� &U4AI &X,04143,AA I J Mr Pir ID p 0 roomP 10 1 A4 N W y W 0 i 13 CE.R'T IF i L=r> P LOTOF LAN ga'+, L.GGAT/GN L� NT�iz�IILLE . 1�� PASS. t, RICHAR D BNCTt=R yid 40' bA'tE. 4�t4 f 76 Na 2'.Ot3 PL A N R E F E RE A c E PLAK 13K-19-7 PG. iZ•7 /G ESE'T>fY 7H,!T TH,E 0&W P,97-1aW BAXT ER � NYF- INC , -�X®�✓/u �1Ek'�o n1 Co�v, c�. Ms 7-4P T,f e REGISTERED LAND SURVEYORS Z0,A114Vl a L,37AYS 0,1=' r1le ToWW 0,0= OS-r E RV t LL E, MASS, e19RW57f, 464,E RIA" ,6 PET 1 r RTHUR. -R. WiLLtAM � ^=' Assessor-is map, and lot .number ...�.�/ Sewage;Permit number I . - _ i . ..... / u �aFTHEtp� TOWNS OF BARNSTAB-LE. 7, ni 2 BasasTsnLE. : �. n} I .W1'r11:,g13T C� 'qNk 9� 0 pY.a�O� BUILDING I H S P E C T 0 �1TAFy D�1 STATe CE fi r'®j_. -- - TOWIV CA APPLICATION FOR PERMIT :TO ....`. .o./a/................................................................................................. � TYPE OF 'CONSTRUCTION ......... . 0......... ............. ............................... .............. V � /..7....... ....7.............19 7 r^J TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .� ®--yamL � / t Location ........ r .......y./j....... ?/"...5./......�p.��G........."'. �f`j�..t.fYi✓C� �.......(..—.Ftcl �e� �d� ......... Proposed Use .... L�?�!`.�-.... ��.e ..:... e�Xi�—cv114� .� ... ' ..........................................................:.................... 4 Zoning District .....-F' a.......' ...........................Fire District ..... ... 5 Name of Owner . . . .r��t�.c�..t!Yillrr .l. ......Address ...... o7 ,�err'e.��' .�............................................. Name of Builder ............... !YP..C± .v-..........................Address ..................................... Nameof 'Architect ............ Utp.,L. ..�..-............................Address ..................................................................................... Number of Rooms ............ .raz :fp' .........................:..........Foundation ......��.. .../. i�� eel.... �. -...... Exterior ....... .. ........Ch.o j(4&.................................:Roofing ........ �...��... �.��r�.................... <. r �. Floors1 .r.: ..................................................Interior ......... .. .iW ..., ................ Heating �s 1rf.�' -1 Plumbing ... .•• ......... rx Fireplace ,�, .:............................................... Approximate Cost jz..(..•.�'..� V . GQ r Definitive Plan Approved by Planning Board ---------------____-----------19___-____ . Area ...... ..l..a�....5 ............ Diagram of Lot and Building with Dimensions Fee ... �.......... SUBJECT TO APPROVAL OF BOARD OF HEALTH { 91 I rB� r. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name R. Arthur Williams, Inc. 187004 1 1/2 story, No ................. Permit f;r .................................... f -ainglelfamily dwelling .................................................oad 19...................... S Location ......................:.................... Centerville ......................................................................... R. Arthur Williams, Inc. Owner .................................................................. Type of Construction ........frame .......fr.a ...me ...................... .... . .... Ile .................I............................................................... TkI #4A 'Plot ............................ Lot ................................ September 20. 9 76 Permit Granted ....................................... Date of Inspection Date Completed ..... ........19 1',:PERMIT REFUSE.D ......................................... ...................... 19 ........................................ ..................................... tj ............................................................................... ....................... ............... .............. ................... ............... ................... ................ Approved ................................................ 19 ............................................................................... ................ ..........................................I................... j I �xIST. ttov5� W. °c�61JT TF.-1916T 19 6-31x 8Ibf��. xsT l� 5 . �Awt✓ � �-ti��5t Doug oo� St�INC�t.�,� oN + )M►AGDO PuJD �� M�cTC�lk �iG 14T.. I2 2 RF x8 � & Wl c. o- 5�► iz iz Ito�r z Rf PlTc�k To GF. aY-4 SOFFIT J• }— �t� l x T9.i IYl - 12tI 121 ALJnh. 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