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Tom Perry,CBO, Building Commissioner
iiXl 1A3iti;�ttrrt _Hvatmi�, MA fi 601
www.townbarnstable.ma.us 4
Office: 508-8624038 Fax: 508-790-6230
8��3 .CS 1�F.3c l;'>: v_gi2T_.rr_o'�'i:_Z1LT _ l�F�);�L AT'�'iA:. l�lT .
Not Valid without Red X-Press Imprint .
Map/parcel Number Z Z L9/
Property Address .7 (C � � ic� iPLa
Residential ValueofWork ]JO&O Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address G76-tP-C?d U)a f izS "
Home Improvement Contractor License#(if applicable) t 01 2"z z
Construction Supervisor's License#(if applicable) C S ( ( r
❑Workman's Compensation Insurance . S PERMIT . .
�]I am a sole proprietor w APR 05 2-0 j 1
_n I atr the Ii��tnrnum�r.
❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE
Insurance Company Name
Workman'sComp.Policy#. U l0 1
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 I-esc, L
❑Re-roof(hurricane nailed)(not stripping. Going over existing.layers of roof)
❑ Re-side
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❑ Replacement Windows/doors/sliders.U-Value (maximum :35)#of window
*Where.required:.Issuance of this permit does not exempt compliance with other town department regulations.,-i.e...9storic Conservation,etc.
---Note: Property Owner must sign Property Owner Letter of Permission: -
_s 1- en . CoB trtastinn Surser�risors License s
requ red-
SIGNATURE:
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Revised it i211U
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Dou W�lliuu�s Custom Bu ldm' g Co.
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508-775-1500 508-737-5400
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e-mail homebuilda@comcast.net
mis. uertrude'V a ers, or 2- end V ew wive,Leritery i e give Doug as �.
Williams permission to acquire a building permit for my house.
......... .................................................. 3/22/2011
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%THE TOWN, OF BARNSTABLE
33AUSTABLE,
M MAM 9,63 .
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO .........A.04?....... .
.7-0 —'0"X1S7-11V(r1- -'91414 41416
............................................................................................
TYPEOF CONSTRUCTION ......................................................................................................................................
................................................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
4-9- C,6�1117r,*?UIZZ-C
Location .........11001W omlclz-
...........................................A..................................................................................................................................
Proposed Use ............. 5.41r-i5................................................................................................ ....
.......... .. ...........................
Zoning District ........................................................................Fire District ......qF�reg??� ........................................
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Name of Owner .... ....../ ...... ..........Address ...... ......1. V
................. 4
t/Name of Builder ....A�q.4. x/V x.x'vev.............Address ....7 ...... ...........................
Nameof Architect ..............................................................Address ............. ............................................................
Number of Rooms ..................................................................Foundation ..... ........e4.4pc'it
Exterior ............W.0.P..P.......5; xe
... ........................Roofing .........A� r.......... 2-�.................
Floors ........ .................................................................Interior ...........
Heating ....... ..................................................................Plumbing ..................................................................................
Fireplace ......... ..5..r.i.N�9...............................Approximate Cost ..............01",....'9...0....4> ...el.................................
Difinitive Plan Approved by Planning Board --------------------------------10--------- 400-7
Diagram of Lot and Building with Dimensions
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .........�; ...................
Waters, Sherman.H. '
No J 8.... Permit for .......add to single
t
fami:LY dwelli �.....................................
Location2—T.Pond View give........................ I
.emerviLld................................ 1
Owner Sherman H. Water.s
... .....................
Type of Construction ..............game
............................
................................................................................ t
Plot ......................... .. Lot ................................
December 14 ?1
Permit Granted 19
Date of Inspection ..............19
Date Completed ...` Z-........9 g
6
PERMIT REFUSED `
................................................................ 19 E
...............................................................................
................................................... ........................ t
...............................................................................
...............................................................................
i
Approved ................................................ 1
...............................................................................
..................... ...............................................
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