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HomeMy WebLinkAbout0140 PATRIOT WAY to a � .. r: t... •� - .. .' :' W,i. Y 9 .. a �. � • - ,. < x- ` 0 s r _ ' 1 : P s I < n - : .. .: .. a .. , - r o a U .x o: r r. , ` r ^ 9HE ApplicationNumber..... ......................... ......................... ...1110 o MASS. Permit Fee .........3.......o.....................Other Fee........................ 03 TotalFee Paid................................................................ ...... TOWN OF BARNSTABLE Permit Approval by.................................on........................... BUILDING PERMIT Map......... ...............................Parcel:.......© rz......................... APPLICATION Section 1 — Owner's Information and Project Location Project Address 11/0 Jl�9r,<107 401Y Village�__ Owners Name. Owners Legal Address z4hfwl fi> City �- State Alf zip C276-?e Owners Cell# E-mail C O"K Section 2 —Use of Structure Use Group F-1 Commercial Structure over 35,000 cubic feet ' El Commercial Structure under 35,000 cubic feet Single)Two Family Dwelling Section 3 —Type of Permit &New Construction ❑ Move Relocate E] Accessory Structure ❑ Change of use Demo/(entire structure) El Finish Basement El Family/Amnesty El Fire Alarm .. Rebuild Ell Deck Apartment El Sprinkler System Addition E] Retaining wall E] Solar El Renovation ❑ Pool El Insulation Other-Specify Section 4 - Work Description &2,0 Aleal ItDD 16>(,?2 6,4,91966 11/1 v7ni R Application Number................................. , ` Section 5—Detail Cost of Proposed Construction 2:�_oco Square Footage of Project (}ice C' Age of Structure (o Dig Safe Number i i # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method MA Checklist ❑ WFCM Checklist ❑ Design i Section 6-Project Specifics VWiring - ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ .Gas„ ❑ Fire Suppression ElHeating System ❑ Masonry Chimney ❑ Add/relocate bedroom i Water Supply D9 Public ❑ Private Sewage Disposal El- Municipal �K—On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: }�� a✓ram I am using a crane ❑ Yes M No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No . 9 Section 8—Zoning Information 4I Zoning District Proposed Use p—C, JK� Lot Area Sq. Ft. Total Frontage _Percentage of Lot Coverage \O�� #of Dwelling Units (on site) Setbacks Front Yard Required Proposed t A N' Rear Yard Required Proposed Side Yard Required !Proposed <FC Has this property had relief from the Zoning Board in the past? ❑ Yes No t 1 Last updated: 11/15/2018 2018 IECC Energy IN Efficiency Certificate Above-Grade Wall 21s00 Below-Grade Wall 0.00 Floor .30.00 Ceiling/ Roof 49..00 Ductwork(unconditioned spaces): Window 030 Door 0.30 Heating System:. "NX C Cooling System: Water Heater: Name: Dater- ' �d Comments Section ,..€' ,; �, �, # Plans Verified Field Verified ' Final Inspection Provisions Compt�es� Commer►ts/Assumptions,. & Re =_,Value. : Valuer 403 6 1 "fAll mechanical ventilation system '§ '^ rg N ❑Complies. [FI25J2 ;fans not part of tested and listed � � r ' s � �*� ❑Does Not HUAG equipment meet 60;cacy �1 s r � � ❑Not Observable ; ;and ai'r flow limits per Table { ❑Not Applicable 111403..6.1. � ' �s." _ �. �.x'•-��crr- ?�'� 403 2 ;Hot water boilers supplying heat ;r = ❑Complies [FI26]2 ;through one-or two-pipe heating "I '❑Does Not ;systems have:outdoor setback. � � � control to lower boiler water ; ❑Not Observable based on outdoor M � '�� '❑Not Applicable j w ,.:.;temperature. 403 5 1 1 ;Heated water circulation systems fz - ❑Complies i. [FI28]2 4x ahave a circulation pump.The. ���� '❑Does Not ;system return pipe is a dedicated vti " return pipe or a cold water supply Applicable i e:Gravit and thermos- 1 . ,❑Not:App.licabte p P Y. � / syphon.circulation systems are: ;not present.Controls for � } C "circulating hot water system umps start the pump with signal� r a .; ;for hot water demand within:the arg, i roccu,pancy.Controls i. automatically turn of:the pump ,when.water is in circulation loop is at set-point temperature and k ,no demand for hot water"exists. r " ' f16❑Co.m lies [O62,21 2 comtJc w th IEEE 515 I or "r p systems } P Y UL ;� ❑Does Not 515.Controls automatically adjust the energy input to the ` ❑Not::Observable t heat tracing to maintain the: Ila " ❑Not-Applicable ;desired wateYtemperature in the • -" a I Y x 403 5 2 Demand recirculation water a a` � ❑Complies .. ........ [FI30J2 systems have controls that � ❑Does Not ; r tmanage operation of the pump � �f �'� �s �,� �.a�� � � ' and limit the temperature of the ❑Not Observable ❑Not Applicable water entering the cold water7 ; ;piping to< 104°F.. ]" rl 403 5 4 .Drain water heat recovery units el� Y r � ❑Complies [FI31]2 tested in accordance with CSA rf ❑Does Not `> rB55.1. Potable water-side ❑Not Observable j pressure loss of drain water heat '" �s � j ,� ❑Not Applicable recovery urnts< 3 psi for T. individual units connected to.one. � �� 1 or two showers. Potable water- � �� t rside pressure loss of drain water heat recovery units<"2 psi for s A individual units connected t0. R + N =;three or more::showerS. * s 404.1 `90%or more of permanent g r' ❑Com lies P fixtures have high efficacy lamps ,} ❑Does Not � t �, []Not Observable .M '[]Not Applicable { ;; '; } " �� a❑Cord lies 404 1 1 ;-,Fuel gas lighting systems have � .� �'�� P [FI23]3 trio continuous pilot light. , ❑Does Not; g at � ❑Not Observable ' X ❑Not Applicable .. .,... °. v�1'-.��',.. .snits. M..�.,li •4sd.'.�hr"� .a M�•` 'dx»r`47 401 3 tComp liance:certificate posted:, �❑Complies , ❑Does Not: s � � �� �• ,� �-❑Not Observable []Not Applicable _ " •;.:G _ ��•�.�� . lip._. �,. ._�„a:�.. �.��. � _ 1 High impact(Tier 1) 2 (Medium Impact(Tier 2) 3' Low Impact(Tier 3) Project Title: 140 PATRIOT WAY, CENT ERVILLE, MA Report date: -12/01/2:0' Data filenanne: Page $ of 9 Sectwn 3 a ans.,Verified Field Vefied;_ # F'nal Inspection Provisionsriik Comp6es� Comments/Assumptions A Value^ Valuef 303.3 ' ',Manufacturer manuals.for �� � UComplies [FI18]3 imechanical and water heating £ ' ' t Does Not systems have been;provided.. ' CINot Observable ot:Applicable . Additional Comments/Assumptions 1 High Impact(Tier 1) Medium Impact(Tier 2) 3'Low Impact(Tier 3) Project Title: 140 PATRIOT WAY, CENTERVILLE, MA Report date. 12/01/20 Data filename:. Page 9 of 9 f MORTGAGE INSPECTION PLAN (THIS PLAN WAS NOT CREATED FROM AN INSTRUMENT SURVEY AND IS FOR MORTGAGE PURPOSES ONLY, MACDOUGALL SURVEY WILL NOT ASSUME LIABILITY FOR ANY OTHER USE). / PARCEL ID: 193/081 8 / 98� #140 !� �Rq v� PARCEL ID: \ %.1>. 4F 193/085 / t f PARCEL ID: j 193/082 i PARCEL ID: 192/170 I i 6' PARCEL ID: t 192/135 \ P PARCEL ID: 192/169 I CERTIFY THAT THIS.MORTGAGE INSPECTION PLAN WAS PREPARED IN ACCORDANCE WITH 250 CMR SECTION 6.05 OF THE MASSACHUSETTS RULES & REGULATIONS FOR THE PRACTICE OF LAND SURVEYING. THE BUILDING SHOWN IS NOT AFFECTED BY A SPECIAL FLOOD HAZARD AREA AND DOES _CONFORM TO THE LOCAL ZONING BY-LAWS IN EFFECT ATIE TIME OF CONSTRUCTION WITH RESPECT TO SETBACK REQUIREMENTS OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASGSACHUSETiS GENERAL.LAWS CHAPTER.40A,SECTION'7. REFERENCED DEED SUBJECT TO AND WITH THE BENEFIT OF ALL RIGHTS, RIGHTS OF WAY, EASEMENTS, RESERVATIONS AND`- RESTRICTIONS OF RECORD,1F-ANY THERE BE AND INSOFAR AS THE SAME ARE OF LEGAL FORCE AND EFFECT. TOWN: CENTERVILLE DATE: 03/05/20 APPLICANT(S): DEAN F. STANLEY �+ _ CERTIFY T0: ;EMERALD FUNDING, INC. SCALE: 1"=30' TITLE REF: 2706/038 MacDougall Surveying ° uA g PLAN REF: 197/127 & & Associates EDWARD yes 327/25 P.O. Box 2428 A. %�, FLOOD ZONE: "X ST NE - COMMUNITY PANEL: Mashpee, Ma. 02649 0 2 25001C0561J PH. (508)419-1086 DATED: 7/16/14 CELL. (774)327-0617 11,011 �s o email: macdougallsurvey JOB# 11281 ftomcast.net L s` gQk The Commonwealth of Massachusetts Departinent of Indust6dAccidents Office of Invesfigations 600 Washington Street Boston,MA 02111 - www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/C..ontractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Orgmization/Individual): / ,,,C AA-4 y e $off Address: City/State/Zip: CEtircevfc�E" Phone#: 7Y7 0996 Are you an employer?Check the appropriate box: a of project(required): I general contractor and I � P roJ ( � �� 1.�I am a employer with 4. ❑ am a "6. g—New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These subcontractors have g, -E]Demolition worldng for me in any capacity. employees and have workers' t 9. El Building addition:.. . [No workers'comp.irorrance comp.insurance. required.] 5. 0 We are a corporation and its. 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work. officers have exercised their I LE]Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repair insurance reqtfir ed.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#I 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 a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name: � f/ LteS Policy#or Self-ins.Lic.#: ��� T �7t�3 �.Q Expiration Date: b ellJob Site Address: Ida Ael—l-1 �t/�Y City/State/Zip _aV1"&_/w, ddavz Attach a co of the workers'compensation policy declaration page(showing the policy number and expiration date). PY P Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the fiorm.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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby under enalties of perjury that the information provided above is true and correct Si mature: Date: Phone OJ)Mal 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#: Information and Instructions 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 anoth under ate+contract of hire, express or. .plied,oral or written." An employer is fined as"an individual,partnership,association,corporation oE'Ploym er legal entity,or any two or more of the foregoing ed in a joint enterprise,and including the legal repres s of a deceased employer,or the receiver or trustee o individual,partnership,association or other legal entity g employees. However the owner of a dwelling h use having not more than three apartments and who r 'des therein,or the occupant of the dwelling house of another who employs persons to do main/n, ntra on.or repair work on such dwelling house or on the grounds or bu>7 ' appurtenant thereto shall not such ployment be deemed to be an employer." MGL chapter 152,§25C(t7 o states that"every state or ' agency shall withhold the issuance or renewal of a license or perm to operate a business or tw7dmgs in the commonwealth for any applicant who has not produ acceptable evidence of with the insurance coverage required"Additionally,MGL chapter 152, 5C(7)states"Neither thweahh nor any of its political subdivisions shall enter into any contract for the perfo ance of public-works table evidence of compliance with the insur ce, requuerients of this chapter have presented to the conthority." Applicants Please fill o the workers'compensation davit coin etely,by checking the boxes that apply to your situation and,if necessary,sup ]y sub-contractors)name(s),address( and phone number(s)along with their certificate(s)of insurance. Lp ers are not required to' Liability Companies(LL or L' ' Liability Partnerships(LLP)with no employees other than the members or , carry o 'co pensation insurance, If an LLC or LLP does have employees,a poli is required. Be advised '+affi �vit may be submitted to the Department of Industrial Accidents for con. ation of insurance cov Also sure to sign and date the affidavit. The affidavit should be returned to the city r town that the applic on; or the p or license is being requested,not the Department of Industrial Accidents. S)i uld you have any estio g the law or if you are required to obtain a workers' compensation policy,pleaze call the Dep ent.at th num listed below. Self-insured companies should enter their self-insurance license number on the line. - City or Town Officials /da s Please be sure that the affilete and printed le bly. The Department has provided a space at the bottom of the affidavit for you to event the Office of ve 'gations has to contact you regarding the applicant.Please be sure to fill in these number which be ed as a reference number. In addition,an applicant that must submit multiple e��lications in any en ear,need only submit-one affidavit indicating current policy information(if necder Job Site Address the pplicant should write"all locations in (city or town)"A copy of the affi been officially stamp �or ed by the city or town may be provided to the applicant as proof th .a valid that is on file for future perm o 'censes. A new affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license or p it of related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NO\ to complete this affidavit. The Office of Investigations would hike to,thank you in �Vce for \o cooperation and should you have any questions, please do not hesitate to give us a call. I The Department's address,telephone and'fax number: e Commonwealth of M \hurtts Department of Industrial A d, Office of Investigations 600 Washington Street Boston,MA 02111 �. Tel.#617-7127-4900 ext 406 or 1-877 MASSAFE Fax#617-727-7749 Revised 4-24-07 www;maw.gov/dia �� ITOtai I $3,560.00 A6 6 CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DDIYYYY) 01/29/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAM,. Kathleen Geddis SULLIVAN GARRITY&DONNELLY INSURANCE AGENCY INC PHCNE Ext): (508)681-6049 ac No AffiL. : kathleen.geddis@sgdins.com 10 INSTITUTE RD INSURER(S)AFFORDING COVERAGE ( NAIC# _ WORCESTER MA 01609 INSURERA: TRAVELERS PROPERTY CAS CO OF AM 1 25674 INSURED INSURERS: f DEAN F STANLEY BUILDING CONTRACTOR INC INSURERC: INSURER D: 359 CAPT LIJAHS ROAD INSURER E: I CENTERVILLE MA 02632 INSURERF: COVERAGES CERTIFICATE NUMBER: 499347 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR I TYPE OF INSURANCE '?DOL SUBRI POLICY NUMBER ( MMIDO EPP I POLICY M XP I LIMITS 'COMMERCIAL GENERAL LIABILITY i I I EACH OCCURRENCE S DANKGE TO RENTLIJ j CLAIMS-WADE I_j OCCUR PREMISES Ea ocamern e S MED EXP(Any one person) I S t { N/A PERSONAL&ADV INJURY S 1`—GEEN'L AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE Is ; 1 PRO- I PRODUCTS-COMPIOP AGG I S F-_ji POLICY JECT 1 LOG Is 1 1 OTHER i I COMBINED SINGLE LIMIT I S _ .. AUTomoin ELIABILITY I ( Ea acrid PANY AUTO I I BODILY INJURY(Per person) is ALL AUTOS F- I SCHEDULED N/A I BODILY INJURY(Per accident)1 S AUTOS i I 4= NON-OWNED 1 PROPERTY DAMAGE Is i HIRED AUTOS �AUTOS ! I Per accident �S j (UMBRELLA LIAB OCCUR ' I EACH OCCURRENI I I CE S EXCESS LIAB I I CLAIMS-MADEI N/A AGGREGATE 5 I I i I I DED I !RETENTIONS I I i s WORKERS COMPENSATION I X I STATUTE ER !AND EMPLOYERS LIABILITY Y I N A �ANYPROPRIETOR/PARTNER/EXECL(TIVE I EL EACH ACCIDENT S 50�,��� OFFICERIMEMBEREXCLUDED? WA NIA NIA 7PJUB4N77832320 01/15/2020 01/15/2021 E.LDISEASE-EAEMPLOYEE S 500,000 (Mandatory in NH) r i If ye describe OF OPERATIONS below describe under I f E.L.DISEASE-POLICY LIMIT 5 1,080,000 D I � 1 N/A III DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-compensationfiinvesfgations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE,,EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Bamstabl-e 200 Main Street AUTHORIZEDREPRESENTATIVE Hyannis MA 02601 Lj .1 Y I Daniel M.Crawley,CPCU,Vice President—Residual Market-WCRIBMA ©1988-2014ACORD CORPORATION. All rights reservet ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Reaistration Expiration 1321.49 = 11/27/2020 J DEAN F.STANLEY = i ,r_- f DEAN F.STANLEY -i�` 359 CAPT.LIJAH RD, ;� CENTERVILLE,MA 02632 Undersecretary } Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards C o nstrudliioniSUpprvisor CS-035037 j E'xpires:01119/2022 DEAN F STANLEY , 359 CAPTAIN'LIJAH RD ; CENTERVILLE�,MA 02632- .r', f 4 . Commissioner i a y✓ Application Number........................................... Section 9- Construction Supervisor Name Telephone Number ,t& 737OW6 Address ?jT (2p'l. &I N Qv City State 1W Zip dzz7Z License Number a-0550 37 License Type CS Expiration Date //Y/4z Contractors Email sr Al b¢h •C��► Cell # Z37 66 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 r aired by 780 C d th Town of Barnstable:Attach a copy of your license. Signature Section 10—Home Improvement Contractor Name l ,4, t� Telephone Number .SrS 737 CITC Address;971 L-ogH �� . City�Et/z oUfGC� State QA Zip 0.26 3 Registration Number l T21 q y Expiration Date 11410 7Z60 I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 7,0 and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date �� (— O ZO R) 11.......................... Section 11 —Home Owners License Exemption 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 construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date Print Name ti �/��C�y Telephone Number S?i6 75� f E-mail permit to: _02,1-331 Last updated: 11/15/2018 Section 12—Department Sign-Offs -_ Health Department Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to Moiqk authorized by&is building permit application for: a o �� � (Addy of job) JIM I Y '90 Si ature of Owner \ date ! _ I Print Name • i Last updated: 11/15/2018 �oF Town of Barnstable *Permit# K 5" Eepires 6 months from Issue date Regulatory Services Fee i . 8'U �0� Thomas F.Gefler3 Director � Building Division Tom Perry, Bolding Commissioner 200 Main Street,.Hyannis,MA 02601 Office: 508-862-4038 X-P ES Fax: 508-790-6230 ' ,:17 ' EXPRESS PERMIT APPLICATION - RESIDENTIAL Q= 1 g-2005 Not Valid wMout Red X Press Imprint Map/parcelNumber C�3d TOWN OF BARNSTABLE Prop Address ��J��v� RY6 esidential Value of Work �5 C nimum fee of$25. 0 for work under$6000.00 Owner's Name&Address /�� r Contractor_s_Name ' Telephone Number ���6Y^� Home Improvement Confractor License#(if applicable) l Constructi ervisor's License#.(if applicable) Workman s.CompensationInsurance Check one: ❑ I am a sole proprietor ° ❑ I e Homeowner have Worker's Compensation CInsurance Company Name ' Workman's Comp.Policy# � Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) / Re-roof(stripping old shingles) All construction debris will be taken to �✓ `� ❑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 Pro Owner Letter of Permission. Home rovement ctors License is required. Signature Q:Forms:e Revise0630 ofT Town of Barnstable Regulatory Services satuvsrnB , _ Thomas F.GeUer,Director F Building Division Tom Perry, Building Commissioner 200 Main Street, Iiyannis,MA 02601 www.town.b arnstable.ma.us office: 508-862-4038 Fax: 508-790-6230 Property Owner Must. ` Complete and Sign This Section If Using ABuilder I, as Owner of the subject property hereb authorize: _� � y � � � to act on mybehalf; Y in all natters relative to work authorized by this building permit application (Address of Job) f Owner Date Print Name 4 ''�'� •�ro�� of::�,� Board of Handing RwWatteas and Stmadank HOME iMPRCNEMENT CONTR^CTM RegWrMlon: 12W3 ExpNallms &3=06 TYPO. Supplement Gard THE Hone Depot At-Nome S*Mc ffMK AUDETTE 3200 GOBB GALLERiA PMY 020 ALTANTA,GA 30339 Adr�nlstrator a a License or ,,ytratm vsild for aund rld*L ORIY ate the exdon dole. gesrd f Bmm�0 Reguhdnes ent! neltrds r Oae Ashburt""act Rm 1301 Woo,My 92108 ti ' ptA,TA q t.10 Garzsa�� Gtzt�tb� 09 -ses—rtC. TAt-IK. = 33o' ISo % • 4-95 - U•S4E l C>OC� C=AL.: 1POSAt �'IT I�SE tr>00 ICJ c/at_l_ AeE.A 150 CS.t= I�Jp Sr= 2.S 3.jS G.P.•U. t Fes% - c>T&L. 330 � r�rlc�t_aTto� C2ATE :. t"to 2ht t�• otz.l.�sS. . � " . t TN } r t� TO 4 ...� �.. �.. G- } +j :'`-` 4 �s GCS' .uAv P)r r�l f r' ALA�k CN . to fit•, JC:�;<a �.�i j� , r � �W&24OUQ •� , ' r is•. .:.1"t1� 1 //--11 , '�4 rut�� 4.�s' �`',�•�r_i,�r�4��a' • Tor.>-wa s Ioo.o 4. P , tuv� 9`t,a LoQra "PEE �000 INV ' � 4,pPFs 'btSr t►N" G,o•t... �'i•1 - . '. Sepr+c i c5 •' 1TAkv- G•�AY loco `i5•l. wv. . 't►w: GAL. Lt=Ar, n SAA/•{,� WAS41D fi STONtr el i C.EtZTt�tED pl.o•T• �./-au v. F'tzc�t'1 L� • • ' •. .�_..�. LoCATI'o" -l2 ;• uo Sca.�. - ScnL -- (III St? .pA-r it.A /1-1 l CutZTii=-4 `r1- r T1-G— t �u+J'DATiDI.I .'St�Q"u►`� pE=_At:l 1Z�1=' tZ 1.1GC. t-l�t'i tat.l c�,n�lrat �(S W i Tt,i Tt•-►i 'ToviQ , aun . � 197 i • osT�,evtt�t� o M�•s��, Tt.A1S P-LA�-1 1 IS WUT tJA-jt_D . Ua .► f1cN ' lt.lsr[:J1✓1E�+.t �,U:.�1t y' Tt1Lt'�, Sta�t�J Iwpt-i GA.I�IT_ J O'i_ U'r>Gn i"C,�t�r:'1 is iKtwJl". LO—V . 1-1we5 � �' �4ergL)e Asse s�or's -map.and:lot number .... g:. . ..&`6..,,.:...... ! SEPTIC SYSTEM MUST Be 77. _ INSTALLED IN COMPLIANCE.. {r ; WITH ARTICLE II STATE 41 ; Sewage Permit number ..:..................................................::... f SANITARY CODE AND TOWN N , t rEGULATIONS, ' °fT"ET° TOWN OF BARNSTABLE Z 9AEBSTAXE,T� n 9 "6 BU11DIN'G INSPECTOR APPLICATION_FORt;PERMIT TO} .. .: .tlGil:;. .......................................... ' ........................... ............... TYPE OF CONSTRUCTION .. ..? .'/!!" ................................................................................ � �...197.7 ` TO THE INSPECTOR OF BUILDINGS: The u'ndersig Jr eA jereby applies for a permit according to the following information: Location ................. ..lip .... ..P (Stmt.o. ..... 9R...... ProposedUse St.AJ.;9./R......t..A0.411..r. . .................................................................................................................. Zoning District ..........l1.�... '.:..............:.............................Fire District..:.e4!60P ,V�l/�......(�..3i/..1Krl��f.`. ...... Name of Owner .... � �?' 1�1`.. LtILI.!/!!is./rl�4r.Address ....0%vAl-00o e..... Nameof Builder ............S4*.•Vt•!^............................Address .................................................................................... , Name of Architect .............A..04O.A,e.w..................................Address Number of Rooms K .............�.`.'.Gt.tr-�................................Foundation ....:l4....... ...*4�!'ac/ �e9,cr.4.Ws....I........ y Exterior ....0.. ,....�b.i �R ................................Roofing ��r....� __...._............. Floors .........a.i- ...r.........-..................:........................Interior ....... ....................................... Heating ...... ...........................................Plumbing ......A40.e..... ....1A!. .. ................. Fireplace ............A/--�.Ce ..2...........................................Approximate Cost ..........a�, ter.. ................................. Definitive Plan Approved by Planning Board -------------------_-----------19________ . Area ....9YO....S.F........... Diagram of Lot and Building with Dimensions Fee .......a.'..196................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Si 'V ¢tom i 9- JoSF I � �e✓d J wr - t � a . I;hereby agree to conform to all the .Rules and Regulations of the Town of Barnstable'f garding the above construction. 11 o �i✓� of Name ..16. Williams, R. Arthur. . f N19 19-7-54...... Permit for .RIMeAU49................. Location .....140..Patxi.ax..Wa -• t,. .......................C=tervilie................................. Owner .Arzhur..W1lliama -• - ..�`". �. . . _ ..._...._.__ Type of Construction .. ` ...................E.... ................................ ............... Plot Lot`v.i.9.3.....$Q.......... , ;• ,Permit Granted November " 16-19 77 J t t Date of Inspection ,/. Date Completed . .4//� ............ l9 PERMIT REFUSED r ..` .............................................. 19 t ' ........................................................... r .• . ..:� ............................................. Apprwed ............................................ 19 ..............................................................................y y t ............................................................................... � 10�0" IS.q,: .,-. .. � I - � :z `• - ,_�cTtJ2'SCL�pS---- - zwu r o- � zra s uvn a _._. _—' 'R R-f7iG" IZ I 5 1. — �L__P--_I•+T�r R�/a£ �--9C+L'EfT 5 NT 6 _ - c'�FtftnlN csi.,'y 'cN-v&nor,rS,RR.iai 1 _.�zrtrnTmiNz1 _._ n D— —� 35TrrFvnlu Ci_ i i .c, N -� � r I - _� tduze' -h su. -q=5r�.,c 1 � . . ryu>-.:tCtFe�Tr.A'4xlSn+: - '•T G,SU's.RU�rij2.8•S I _ �.-.,-SLIS. _ Ci _ - s-sca-w/_7-11 �usr, ' R a&Iusu�Tlyti F�E,1iT/-C�SO1�—('>L6.t�f L/4:',��o•� Q ,• �. � � - 6 T611<fW,o.-t4 Uv , I al -t,•r - 2 s^ y:0..lo'.nrtup..':._...._. I- ' w�"i"r` fs_T`S t µWL wtiLl_. u3 a7 c, _ I - �5ww'4LL5 TO I \ I _ \ - 1 I , rI I I I .6;D,.LXISTI,.1C.1 kJ-.o•�..trn,-Tvn N. 140.,. ..._ 4,ML5=_ ....... j �L. �, P; i \ .I I V•I I - 2"-w Af1A III ...... ..... ._....... _ - ..