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TOWN OAF BARNSTABLE BUILDING PERMIT APPLICATION
11 ,
Map C;Q Parcel 60� Application # o���� d/YS
Health Division Date Issued �--
Conservation Division ` <Application Fee
Planning Dept. _ f Permit Fee
Date Definitive Plan Approved by Planning Board ro I-A
Historic OKH Preservation / Hyannis
Project Street Address
Village c8i���V 1 LA.,E _ Y
Owner GH lf'l ��� ��� Address ST
Telephone
Permit Request '1 NSU LA NJ mmC CAL kA)�
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Z�Zd O Construction Type C.44
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family- ❑ Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
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
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑new size__Pool: ❑ existing ❑ new size _ Barn: O�existing �U>new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size Other: _ = 5
NO
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
.,Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name _ CoN0(Z b ��') Telephone Number 33>n- !K32- 2,91,'3
Address S VC License # t1 D2�A
5 --� 9' __ MLAIr — Home Improvement Contractor# 160 264
Worker's Compensation # N D 17,0 ►2
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
�Dyi�IV L PAN D F!LL
SIGNATURE DATE � fill) 1 2
i
?,4
FOR OFFICIAL USE ONLY
APPLICATION#
xr �:,��DATE ISSUED.. :::.;_+:-� .,_r �.r.> •.
<,JMAP/PARCEL NO.-
,ADDRESS - k VILLAGE
OWNER
DATE OF INSPECTION:
ti •_^,FOUNDATION',U/_,` . !!
FRAME
INSULATIONas
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: -w ROUGH �.+ , i FINAL
I.FINAL_BUILDING �` .•`
:DATE CLOSED OUT
ASSOCIATION PLAN NO.
r '
OWNER AUTHORIZATION FORM
t
I
(Owner's ame)
owner,of the property located at
•
(Property ss)
(Property A r ss)
hereby authorized �(
(Subcontractor)
an authorized subcontractor for RISE Engineering, to act o y behalf to obtain a building
permit and to perform work on my property.
Owner's i nature
Date
oFt�rq�, Town ofBarnstable *Permit#
♦ ~ Expires 6 months fsom issue date
'+ )AltNscABLE, •
Regulatory Services Fee I
v HAM . �� Thomas F.Geiler,Director
t639•
lED MP't
Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-8624038,
Fax: 508-790-6230 � �F,
EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY � 6�
Not Valid without Red%Press Imprint
Map/parcel Number
Property Address
Residential Value of Work
Owner's Name&Address -,&2CL 4ZZ�
Contractor's Name � iC'U�'1' Telephone Number �,S'�/�.Q'77� t �/l
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
j] I am a sole proprietor
I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name l(l�
Workman's Comp.Policy# ze
Permit Request(check box) f
❑'Re-roof(stripping old shingles) All construction debris will be taken to
tle-roof not stripping. Going over existing layers of roof)
Re side'
❑ Replacement Windows. U-Value (maximum.44)
J
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. i
***Note: Property Owner must sign Property Owner Letter of Permission.
Home Improvement Contractors License is required.
av
Signature
i
Q:Forms:expmtrg
Revise053003
Poi row�o Town of Barnstable
Regulatory Services
3 B LA ' Thomas F.Ge-Her,Director
puss.
Building Division _
6D MA .
Tom Perry,, Building Commissioner
issioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508 790-6230
Property Owner Must
Complete and Signs This Section.
If Using A Builder
/�4*,;��jjn .;as..Qaccner..of the.subject propett-7 -
hereby authorize d = ._.to-act on sny..behalf,.
in all matters relative to wotk authorize.by.this building.pe=3it.application for:
(Address of Job) ;
Signature of Owner Date
Print Name
•
y Ms.Charlotte Bockmann
422 Pine St '
Centerville,MA 62632-3263
�zA9, � ' Cab•
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TO ALL NEW BUSINESS OWNERS X\
Please Fill in:
APPLICANT'S NAME:• jA& o P
HOME ADDRESS: -Sy -R 'Prt,69 2t-
TELEPHONE NUMBER: yZ
(Please give us a number where you can be reached)
I
NAME OF NEW BUSINESS �a�Kr1�NN �r.9' C s-t'gt'� TYPE OF BUSINESS �g� s�si'T�
IS THIS A;HOME OCCUPATION?�E� � �i.r?-ADDRES �F BUSINESS S >-�� ras �o y�
i
r ins ou must'd o in order to be in compliance with the rules and regulations of the Town of
When starting a new business there are several th g y {
Barnstable- This form is intended to assist you in obtaining the infy(mation you may need. Once you have obtained the required signatures,
listed below, you may apply for a business certificate at the Town : lerk's Office (Ist floor-Town Hall).
F
1. GO TO BUILDING INS ECT R' FICE (4TH FLOOR TOWN HALL)
This individual ha for of y permi equirem is that pert ' to this t o business.
e Si atu ;
COMMENTS: l5sj
2. GO TO BOARD OF HEALTH (3RD FLOOR TOWN HALL) „ F °
This individual has been informed of the permit requirements that pertain to this type business.
Authorized Signature 4. A 9"�
6..
COMMENTS: f
3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY) ->(3RD FLOOR-SCHOOL ADMINISTRATION BUILDING)
This individual has.been informed of the licensing requirements that pertain to this type of business.
Authorized Signature
COMMENTS:
After obtaining the required signatures you must return to the Town Clerk's Office to obtain your business certificate (cost $20.00 for 4
years). A business certificate ONLY registers your name in the town of Barnstable - it does not give you permission to operate -you
Must get that through completion of the processes from the various departments involved.