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0120 PRINCE HINCKLEY ROAD
14' 'nccfe .y . c" t Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstab le.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTLAL ONLY j q Not Valid without Red X-Press Imprint Map/parcel Number 7-7a l l n Property AddressP&Ive/c Residential Value of Work `l ' 06 Minimum fee of$25.00 for work.under$6000.00 Owner's Name&Address O Igo Pgrw ffPN 1,C eY /�O' Contractor's Name Il y trKT &�w (— Telephone Number `W116 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compens 'on Insurance Check one: ❑ I am a sole roprietor ❑ I am the Ho eowner 2-1 have Wor er's Co nsation Insurance Insurance Company N L G�i`/t?z Workman's Comp.Policy WOy06 # -7 302 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) El"Re-roof(stripping old shingles) All construction debris will be taken to c4wo;LG ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Impro oAt-2ontractors License is required. SIGNATURE: ` Q:Forms:expmtrg Revise061306 of 1HE T Tows of �B$rnstablc *permit# P� ti Expires 6,months front issue dat-e y� °y Regulatory Services Fee 9ARNsrABLE, : Thomas F. Geiler,Director 9 MASS. 1"9• A,0 -building:Division Tfb'MA� 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 PERMIT APPLICATION - RESIDENTIAL ONLY- Not Valid without Red.Y-Press Myrint . Ma arcel Number . p�p . ----- / l 1`—C. Property Address. � / /(/ l��Lz- V 0 Residential Value of"Work Minimum fee of$25.00 for work under$6000.00 Owner's Name & Address Contractor's Name _.Telephone Number home Improvement Contractor License#(if'applicable) __ Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: -P PERIN IT, ❑ I am a sole proprietor [O I am the Homeowner OCT ❑ I have Worker's Compensation Insurance Insurance Company Name 'OWN OF BARNSTABLE- Workman's Comp. Policy# _ Copy of Insurance Compliance Certificate must be on tile. Permit Request (check box) .Re-roof(stripping old shingles) All construction debris will be taken to (/d�/J�(� ❑ Re-roof(not stripping..Going over .` existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders: U-Value (maximum ,44)' "Where rCcUired: Issuance o,'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 Pernymghnr- A copy of the Home Improvement Contractors License is required. HE Q:WPI'll_ES\FORMS\building pen-nit forms\EXPRESS.doc Revised 100608 y , Town of Barnstable Of THE ram,o Regul atory Services uxtvsrwsre, Thomas F.Geiler, Director qj ib5q. �� Building Division PTED �a Tom Perry,Building Commissioner . 200 Main Street:, Hyannis,MA 02601 Rww.town.barnstable.ma.us Office: 508-862-4038 Fax: 5.08-790-6230 HOMEOWNER LICENSE EXEMPTION Q Please Print DATE: /4 JOB LOCATION: !2 �/YC� iiVC Ly ��—C'fN%page . number /street village"HOMEOWNER" O /{l_�/��/(`��/� /71 J t (1 1/�J name home phone#�// work phone# CURRENT MAUNGADDRFSS:� clo 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 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) ility for compliance with the State Building Code and other The undersigned"homeowner"assumes responsib applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that be/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requir ents. Signature of Homcowncr Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be.required to comply with the .State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION 4 The Code states that: ,Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, .Rules&Regulations for Licensing Construction supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would Hith 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 hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fom✓eeriification for use in your community. �oFTHE r Town of Barnstable Regulatory Services s 'MA E S& Thomas F. Geiler, Director 9�A 039. S.9. � rE10) Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 026 www.town.barnstable.ma.0 Office: 508-862-4038 . Fax: 508-790-6230 Bt erty Ova e:r Must Complet and Si This Section If ing Builder r , as Owner of the subject property hereby authorize to act on my behalf, in all.matters relative to work au rized by this b ding.permit application for: (Address of Job) Signature of Owner Date Print Name If Property Ovmer is applying for permit please complete the Homeoamers License Exemption Form on the reverse side. �� « ��2g� 7�• c, ,Assessor's map and lot nu e ,C.��r . �.�9 - �'e�. P THE �pF tp�y : a Sewage Permit number ........'.:.... 1..k.L.......................... C. n, • �', SEPTIC SYSTEM MUST BAB39TABLS, i INSTALLED IN COMPLIA,�;�v; NAM Huse number ...... .. : � ...............................:......:........ o x wf WITH ARTICLE II STATE ; °'°�0MaYa`�� ' r• �., r� - AND T®W(1( fTOWN OF BAIRNSVG { to • DURDING'- INSPECTOR APPLICATION FORS PERMIT=;TO .... .1..�. .. .......................................................... ................. zw...... TYPE OF CONSTRUCTION n........ .................................... ........... ................................................. ..............2:....................1 . _ , TO,THE_INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: 12� Location .... . .................................... .... . ................................................................. ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner .... ...............................................................Address .................................................................................... Nameof Builder ....................................................................Address ..........................................:......................................... Nameof Architect ..................................................................Address .................................................................................... Number of.Roo s ......./.R......................................................Foundation ... .... ..... ............................................ ...........Exierior ......�� ...............................................Roofng ................ ...................................................................Floors ..................................Interior ...........,,rL`J Heating / .........Plumbing Fireplace ..:. .................................. Approximate Cost ........................................... ........................ Definitive Plan Approved by Planning Board ________________________________19________. Area ....,l /9..................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ®� � •L. ...f r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. !. Name .............: ..... . ... . . ......................... Small, Alan 20352 one story N&................. Permit for .................................... single family dwelling ............................................................................... C6cation ......120 20..Prince Hinckl!q..�q!�4..... . .... ............................. Cent-erville ............................................................................... Alan Small Owner ................................................................... lit frame Type of Co6struction .......................................... ...............................................I.............................. #126 Plot ............................ Lot ................................. Permit Granted .............June 29...........................19 78 Date of Inspection ...... ?4......19 Date Completed ... .............19 , PERMIT REFUSED . ................................................................. 19 ............................:.................................................. ................................................................................ ................................. ............................................. ............;............................................... ................... Approved ......................................... 19 .................:............I................................ ................... ............................................................................... ►•10 UA2�tQG� �r21 ti1T�� .. � , �abl ti*•! FL�w � ttb.,c 3 .: 33Q G.F'•T,�. G S 'jF '�t5Po5�u- ■mow �I/I/1�� I/14�IIFI111�1 //C I/�llll I�lii■gIYIII l�l�Ip�l�rb ` • [ • - /SCUWAL.L AtZ'-E^l� ,. t5'f� '��.�'. _ • t3 s6 s '. t .o.. r5o r=-,.PA. TOTAL ��SICGt.I =.425 !s•R33. � PMfGC.0UST, ta U u' oiz lass. a ��/����{'� resat Rit ifs cr3•i.( nf1-r1/1P{./ �i+ '•�' Mir 1}N#�• '� £ A HA7CT N .t '�. Y) I QQ•C �Sy4t5��� � J t �! `' • ♦ i t • A • - - tl 3 o. t•1Gx. . �dPaotL a'p,P� i�N. s.aL. ct("I' Z iuv. J -BoxqG TK tp r_osasa SA „ GAL. PIT f s VA Meo wsuuaxs C.I iTtFtt Pt.bT L off.T l c7 t...l. -- ' e`�. �"�. �O !_s- G A..1..�•' G.1 � ��s Jij.+Gd� 1. r��... � ,t.�/Z�J'I . t 't't F=`�! .f�A'I" 't'M ot„1�T�t'�(`tDti� St-1cr.u►J A►.1 S_PaV,ewGS N��ill n .II GCAAAPt. VS W ITN Tt- E: 10E- LI►-i A�.JC> 5E't'�'sACK WCgvIQE�Vtr►-1T4 AF T W C .o1'ktL.!'o PL.. �BK. 3L1'o PG 'c'.3 -'ow t-) at-- ' ,l�tLa:1�1`Q�t.g CGATEtLOU-a 01!. ALA*3S AA"i C '� ..�..° ,'t �f L ..;,.,� ✓ (..lam t LZEGIS IGtZatD ►-.A.l. o SU'eVal(o b Tt-1 t 5 P E-A t I, Wok' �.�;f: v� ► aN © -TEczvt ° t4.1,rCJ;,nc_�JT '�iU►-`tt`sy' �. 7ia�: i:Fc=��<<, ,Nawts� APi?t_I GA.ti_.IT' L � i .TOWN OF BARNSTABLE Permit No. --------20352 !»n.M Building Inspector`.- $400.00 1 ma Cash ------ �,h ,Ey9• 1OCCUPANCY 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 Alan Small Address Centerville lot #126,r 120 Prince• Hinckley Road, Centerville Wiring Inspector Inspection date Plumbing Inspector »„ - _ Inspection date Gas Inspector � � � Inspection date Engineering Department Inspection date//--,/�)— i THIS PERMIT WILL NOT BE VALID,4AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. INTfS. � &4t - .............................Y................. , 19......__ Bu%lYdng Inspector................„...._._. V