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Town of Barnstable *Permit Q6 0 674
6Y Expires 6 months from issue date
PERMITRegulatory Services Fee
r�nss $ Thomas F.Geiler,Director
5 2006 Building Division
TOWN OF Tom Perry,CBO, Building Commissioner
BARNSTABLE 200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMrr APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
ap/parcel Number L Q Q
operty Address
Residential Value of Work t�10!o. Minimum fee of$25.00 for work under$6000.00
ovner's Name&Address
GJ e4�/ �� •�r�i��� �i4
)ntractor's Name Telephone Number
ome Improvement Contractor License#(if applicable)
onstruction Supervisor's License#(if applicable)
]Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
2rI am the Homeowner
❑ I have Worker's Compensation Insurance
isurance Company Name
Torkman's Comp.Policy#
'opy of Insurance Compliance Certificate must be on file.
ermit Request(check box)
(�Re-roof(stripping old shingles) All construction debris will be taken to It C
f
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value (maximum .44)
*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.
Home Improvement Contractors License is re aired.
IGNATURE:
kForms:expmtrg
.evise071405
The Commonwealth of Massachusetts
Department of Industrial Accidents
! Office of Investigations
ITT / 600 Washington Street
Boston, MA 02111
��� www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legiblv
[dame(Business/Organization/Individual): ��� /n,yk!f
Address: /City/State/Zip: & ent
0I - Phone #: -'7��✓�/
Ire you an employer? Check the appropriate box: Type of project(required):
❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
El am a sole proprietor or partner-
listed on the attached sheet. Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers' comp.insurance. 9. ❑Building addition
[No workers' comp.insurance 5. ❑ We are a corporation and its
quired.] officers have exercised their 10.❑Electrical repairs or additions
[�iI am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.z Roof repairs
insurance required.] t employees. [No workers' 131-1 Other
comp.insurance required.]
.ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
iomeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such.
ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
zm an employer that isproviding workers'compensation insurance for my employees. Below.is thepolicy and job site
formation.
surance Company Name:
)licy#or Self-ins.Lic.M Expiration Date:
b Site Address: City/State/Zip:
ttach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
tilure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
ie up 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
up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
:vestigations of the DIA for insurance coverage verification..
do hereby certify under the pains and penalties of perjury that the information provided above is tru and correct
atur : Date:
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
Contact Person: Phone#:
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CERTIFIED PLOT PLAN
NEW CONSTRUCTION ONLY : L0 S I''Q T-R 0T w,4
TOP OF FOUNDATION -IS
ABOVE LOW POINT OF A_DJACENT I
FEET
ROAD. � dIhs�.�
A &
A ..� A as
..a
�ELOREDGE_ENG/NEER/NG do. IN SCALE: / "�50 DATE :
tE01STERED� REGISTERED CLIENT W��•'wC-- I CERTIFY THAT THE Fp iVD r
CIVIL. SHOWN ON PHIS PLAN IS
LAND JOB N0. _�k'.��� s/ LOCATED
ENGINEER - --- ON THE GRO'OND AS INDICATED AND
SURVEYOR DR. BY: 'A_.�.`/yj. CONFORMS TO THE ZONING LAWS
33 NO. MAIN ST OF BARNST
712 MAIN T. CH. BY: .. , P, /3 , L � MA S, .
30. YARMOUTH, MASS. HYANNIS, MASS•
SHEET1_ Of /`-
REG. LAuh CIIR,�FYn
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Assessor's office(1 st Floor): . �7
7 oCSo � � `
Assessor's map and lot number THE
, SEP WQ o o
Board of Health(3rd floor):
Sewage Permit number r7 9'—-7' b PIN#
Engineering Department(3rd floor): 's=_ s 9rsnL6 J:
House number � /`[/4 � + �e7��� � r' 9.
Definitive Plan Approved by Planning Board 19
co
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only ®� n
TOWN , OF BARNST ' i
BUILDING INSPECTOR DQ1:e
APPLICATION FOR PERMIT TO _ �DCC� /�! �Pf7�/y N i A1G Ricca
TYPE OF CONSTRUCTION
19
b ••
°
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information: / C.C,..o/TY7/�
Location
Proposed Use
Zoning District Fire District
Name of Owner �G L'� Address
Name of Builder 0� C � 'I EILl Address &!f
Name of Architect /y Address
Number of Rooms Foundation �oGK
Exterior P�/V/r100/U ts'l- ,AJ-61,n Roofing — hqlj
Floors �J�/,eJ0U�5 Interior
Heating GEO ��� � �.� r/�S� Plumbing
roximate Cost ��d•
Fireplace APP �.-
Area
Diagram of Lot and Building with Dimensions Fee �y
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.
c
Name
Construction Supervisor's License (y) ' q4
FIELDS;." FLORENCE PYE
c No 34482 -Permit For Remodel & Add:ATo
Single Family Dwelling
Location__ 119 Patroits Way '
Centerville r '
Owner. Florence Py e Fi el ds
Type of Construction Frame
` S
i` Plot Lot
Permit Granted' -July �24, '4 19 91 �^
Date of Inspection' 19 G
Date Completed 19 i
b �. N -es • /. ` .
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Assessors map' and lot number ..../.1.......... . ............ f,
� EPTIC SYSTEM MUST B cF THE Toy
Sewage Permit- number Vie.' ."77i(p.. INSTALLED IN COMPLIAN
WITH TITLE 5
ARNSTAB/ A o L
House number. ...............:.............1.../:.. .:.. .................... NVIRONMENTAL CODE
39-
TOWN REGULATIOI�I� `'�eMAX
TOWN . OF... ,BARNSTABLE
BUILDING INSPECTOR
:APPLICATION FOR PERMIT TO ... ......4FFT....l 1T !?QoU l c rwp b0,e1q��
TYPE. OF CONSTRUCTION ...................0..0.09)...... ......................................................................
........................0........:.....Q......19.. S�
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
location .......1" T � l /4 �� �.C!v2.Y1 LG.��.
........... 455............................................ . ..... ............. ..
ProposedUse ........ / TQ.Q ............................................. ............................................................. ...............
J
Zoning-District ... .. ..........................................................Fire District ..
Name of Owner .... lJ/jE ........f7.V6...........Address ........�f.!���.���...N�.�.�1....4�..F�/.�c
T � '
Name of Builder ......«/ /'f/�...... lL���.�........Address ......�/�T�2�lJ js G(� /......c4r-.z/..lt�nzr
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms .............. ...... ...0....V..�.........................Foundation ..............................................................................
Exterior .......zrkzk ,/ 2C....... ...........................Roofing ........ 5Ph.6x.1- ..................................................
Floors ..........P.. vo.....f.-. .Cyan....................................Interior .....
.S`i0 cJ d�i
Heating ........��.�:C:f�./..C........................................Plumbing �?liV./..��.....'....................�'.�..':... ..� 7L
Fireplace ...........`. e...x-..-1.e..................................................Approximate Cost . ,7Od......... ....... ............................
Definitive Plan Approved by Planning Board ________________________________19________. Area �!. ..:..... .. `(z..
Diagram of Lot and Building with Dimensions Fee /..........®......................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
- y
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
4
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
L .. .
Name �. y ,,Q............................
Construction Supervisor's License ..Q6�! Z1111
PYE, FLORENCE
No ....283.0.4... Permit for .,Build...Dormer
.............. . . .. . ...... ........ . .
'k Sin le D, llin.p
. ............ .. ............Y.. ........................
Location ... 444 Patoits y...Wa...................r.......... .... ........................
Centerville
...............................................................................
Owner .....Florence..�yi�.............
........... ....................
Type of C6nstruc;ion ....Frame......................................
.............................................................................
r
Plot ............ ......... Lot ... ..............
August- 8, 85
Permit Grante
d ......................................
Date of Inspectio. ...19W
Date Completed .........f... 74-4'V .........19
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TOWN. OF BARNSTABLE.. Permit No. ___-- 20838
Building Inspector -
se�rr.n Cash -----
°�pY. OCCUPANCY PERMIT /
' Bond;
"No building nor structure shall.be erected:;And no land, building. or structure shall be
used for a new, different, changed, or enlarged.use without a Building Permit therefor
first having been obtained from the Building:Inspector. No building shall be occupied until a
certificate of occupancy has been issued-by the Building Inspector."
Issued to -Banner Home Corp. Address 76 West Main St. ► Hyannis
lot #15 _ 119 Patriot flay, Centerville
wiring Inspector �' r - Inspection date
V + Y T
Plumbing Inspector�.�� Inspection date
Cras Inspectorf f Inspection date
,+''jEngineering Department !Inspection date-/- -% Y
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.
...................... f` ......_... 19 f ...............
......
..... Z
Building Inspector
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CERTIFIED PLOT, PLAN`
LJ T /S pi4TR/UT t
C —AI7-,�2 r// L
NEW CONSTRUCTION ONLY :
-
,' ' TOP OF FOUNDATION IS FEET .., . 1N R
_ r
° ABOVE LOW POINT OF ADJACENT `l A1l&S ,t_AS I
ROAD.
r ;
SCALE: / — v DATE
'? (ELOR£DGf ENGINEERING CO. IN�C I CERTIFY THAT THE 1�pyyyo!9Tiv/✓
-- - -- -
_..,...._ _ _ C L I,E N T
�tEGISTERED REGISTERED SHOWN ON 'HIS PLAN IS LOCATED ,}
CIVIL LAND
JOB, `N;0,. 1'��y O,N ;T'HE GR0�1WD A9 INDICATED AND Al
,�} CONFORMS Tb THE ZONING LAWS
ENGINEER SURVEYOR DR. BY _—_ OF` BARNST L , MAj�S. f
BY CH.. , _R,
p; /3 • / 0
33 N0. MAIN ST 712 MAIN ST. � ,. 7 tiY
SO_ YARMOUTH. MASS._,.__NYANNIS, ,MASS. SHEET ---
,
Assessor's map and lot number ................ ....................
THE Toy
7X H CTIC -11 S
Sewa Permit number ........................................................
$ANITAF�y CODE AND STABLE, •
House number '//./............................. REGULATIONS. MAO&
............................. .......
00 1639-
tou Ar.
TOWN OF BARNSTABLE
BUILDING 1,111SPECTOR
y
APPLICATION FOR PERMIT TO .... ........... ........... . ...........OA ....... L -41 LvE
TYPE OF CONSTRUCTION ............... ...........
............ . ...... .....................................................
............ ....... ...............19..2F
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .......I,- � ...... .......... ........2 — z\j
.................. . ...
ProposedUse ......................................................... .......................................................................................................
00 V -
Zoning District ................V'41 Fire District
. .........................................
Name of Owner Aw.?9.,Fk... ...(20RAddress ......PC. ..... ..... .........
....YA
Nameof Builder ................. ......................Address ........................... ..............................
Name of Architect .................... .....................:....Address
................... ....Address ............................! / .....................................
Number of Rooms ..............I P..........................Foundation ..... ......
Exierior ....CL4A aoAs P".A....Roofing ................. .......................
............Interior .....................
Floors ... ...R7T. .........................
Heating ......�Ab.,A, .... LE �C. ...Plumbing ....a-0.4)
.2-iF�. �...?.....Y.�................
Fireplace ............................^3c.Z�PE ..............................Approximate Cost ............. ..................
Definitive Plan Approved by Planning Board --------------------------------19---------- Area ............
Diagram of Lot and Building with Dimensions Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH-
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardi the above
construction. ,Zd..i he
•
Name ......... .......... .......r........ .. ... . .... . .....
Banner Home Corp.
- .
m
�---.-3-8 l 1/2..........................
o !�—'No * 288Parm� for ' ~'
� aiugIe fami dwalI
'----------------------~---
~ `
Location ........Il9...Patriut..V0av_______..
,
.-______..0 �........................................................
Dauoer— Boma C . '
Owner ----- —^------oro.^------..
^ -
;
Typo of Construction _---�����------
-----.----.�----'—`--.-------
'
Plot ............................ Lot _--..�#l5____
~
' November 20 78
Permit Granted -------------.l9 [ '
'&� /d 0�7�e�
.
Date of Inspection —. —��—.�.�.�---']V
'
u�'���^� 5� '
Date Completed 'f* �� ,^ . lg
' ^
� .. _.
� .
PERMIT REFUSED
........................................................ ......'~l9
. ^
--.-----..--...--.._---~ ...................
.—_.~--.—.—..—....--.--_.—.---.—.
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—.-.~---.-.~.—...--_....�.....................
.—~—......—.---.~....--~.�~.~^--.—
.
Approved .................................................l9
-------','------~---'-''--'—'--
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