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Application number 3....... ..�
Fee......... ao ..................... .................
Building Inspectors Initials............ . .................
.e39. Ak NOV ? 9 2018
Date Issued............. .. .. ....1..`. ........................
TOWN 0� bAHNS-[ABL1-.- 0� 03-1
Map/Parcel.............:...................................................
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION
f o1 U- PROPERTY INFORMATION
�A of Project: l c I
NUMBER STREET VILLAGE
Owner's Name: M A R V ��9 B�— Phone Number ,j'D ZE 7 2 0"
Email Address: Xri ,J AOI(,DMCell Phone Number (/7 3
Project cost$ �L/O Check one Residential_>C Commercial
OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize
to make application for a building permit in accordance with 780 CMR
Owner Signature: Date:
TYPE OF WORK
E3 Siding 0 Windows (no header change)# 0 Insulation/Weatherization
0 Doors (no header change) # ,` Commercial Doors require an inspector's review
MiRoof(not applying more than 1 layer of shingles)
Construction Debris will be going to
CONTRACTOR'S INFORMATION
Contractor's name
Home Improvement Contractors Registration(if applicable)# (attach copy)
Construction Supervisor's License# (attach copy)
Email of Contractor Phone number
ALL PROPERTIES THAT HAVE STRUCTURES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN
A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED.
APPLICATION NUMBER............................................................
.w
*For Tents Only*
Date Tent(s)will be erected Removed on number of tents total
Does.the tent have sides?Yes No (If yes please attach floor plan with exits marked)
Dimensions of each Tent X X X
Additional tent dimensions can be attached on a separate piece of paper.
Purpose of Event
Check one: this event is a: for profit non-profit event
Check one: Food served Yes No
Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent
Fuel source being used LP tank 20 lbs. or> Yes No____,if yes, a'gas permit is required.
Natural Gas Yes No , if yes, a gas permit is required.
If food is being served at your event please obtain a Health Department approval between the hours
of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval:
*WOOD/COAL/PELLET STOVES
Manufacturer# Model/I.D.
Fuel Type Testing Lab
Offsets from combustibles: front back left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name:
Telephone Number 5-0'0- qJ�� o Ok Cell or Work number /7 3 7� -
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 fLd /
APPLICANT'S SIGNATURE
Signature Date
All permit applications are subject to a building official's approval prior to issuance.
P
2
Application number....... ..................
............ ......
5-O(D
S ®w� �� Q�EI�Fee..............................................................................
9
2013 Building Inspectors Initials........... ........................
f NOV � 9 r� lA�� l j� BARNS--41Ate Issued.............. 1.Z�. �.1. .
Map/Parcel........ �...........0 .............
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
RO IDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION
b bi tIS PROPERTY INFORMATION
Addr Project:
NUMBER 'STREET VILLAGE
Owner's Name: /�n O R V �f� ,;r on— Phone Number �0,F 75 7 �00.6
Email Address: MCI o / /o Av f?0�2 a C,,MCell Phone Number /7 72 C 6-5-
Project cost'$ /� 00 Check one Residential Commercial
OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize
to make application for a building permit in accordance with 780 CMR
Owner Signature: Date:
TYPE OF WORK
Siding 0 Windows(no header change)# Insulation/Weatherization.
F-1 Doors (no header change)# Commercial Doors require an inspector's review
Roof(not applying more than 1 layer of shingles)
Construction Debris will be going to 6/A 01—
CONTRACTOR'S INFORMATION
Contractor's name
Home Improvement Contractors Registration(if applicable)# (attach copy)
Construction Supervisor's License# (attach copy)
Email of Contractor Phone number
ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY'IS IN
A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED.
APPLICATION NUMBER...........................................................
*For Tents Only*
Date Tent(s) will be erected Removed on number of tents total
Does the tent have sides? Yes No (If yes please attach floor plan with exits marked)
Dimensions of each Tent X X X
Additional tent dimensions can be attached on a separate piece of paper.
Purpose of Event
Check one: this event is a: for profit non-profit event
Check one: Food served Yes No
Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent
Fuel source being used LP tank 20 lbs. or>Yes' No___,if yes, a gas permit is required.
Natural Gas Yes No ,if yes,a gas permit is required.
If food is being served at your event please obtain a Health Department approval between the hours
of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval.
*WOOD/COAL/PELLET STOVES
Manufacturer# Model/I.D.
Fuel Type Testing Lab
Offsets from combustibles: front back left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name: p Co 6 / D/-L�
Telephone Number _1�0 7—�Kok Cell or Work number 6 17 ,3 79 r-(o 65 3
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'S SIGNATURE
Signature Date
All permit applica ' ns are subject to a building official's approval prior to issuance.
Town of Barnstable
•, °FTME�°"�° Regulatory Services
P ow
Thomas F. Geiler,Director 91�
• BARNSTABI.E.
v� 16 9 ,0� Building Division
Alfpy° Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www,town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-623(
PERMIT# o6�6so '1 FEE: $
v
SHED REGISTRATION
120 square feet or less
ao
Location of shed(address) t Village
amv 77 51-- C-)�
Property wner's name Telephone number
I
Size of Shed Map/Parcel# .
Signatur Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission 'urisdiction?
Conservation Commission(si ure 's required)
Sign off hours for Conservation 8: 0-9:30&3:30-4:30
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. j
THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN
Q-forms-shedreg
REV:042506
L®CA-'1ON OF RR® PER-TY LIcolES MAY NOY BE ACCURA rE
- ------------ STANDARD LEGEND i
ONOTE:not all symbols will appear on a map
5` GOLF COURSE FAIRWAY
# 449
EDGE OF DECIDUOUS TREES
EDGE OF BRUSH
_ ORCHARD OR NURSERY
I-_ - -
M f P 22/ v-V-V-V EDGE OF CONIFEROUS TREES
' v MAP ' MARSH AREA
-"
2 — EDGE OF WATER
ir`• ,~ r O s 'rp " - -'= DIRT
ROAD
77� =-Y` DRIVEWAY
_PARKING LOT
PAVED ROAD
— DRAINAGE DITCH
MAP 227
6 PATH/TRAIL
PARCEL LINE
s MAP 326 MAP#
- 02,E
#367 � PARCEL NUMBER
HOUSE NUMBER
2 FOOT CONTOUR LINE
MAP 247
t® 10 FOOT CONTOUR LINE
O �� *.MA Elevation based on NGVD29
\/ ` i' 4.9 SPOT ELEVATION
—�\ F # 465 +� \ i STONEWALL
j -X—X- FENCE
RETAINING WALL
/ TT-r RAIL ROAD TRACK
I M { c� STONE JETTY
\ aD SWIMMING POOL
466 , PORCH/DECK
---- ----
/ BUILDING/STRUCTURE
DOCK/PIER
HYDRANT
-----------
AP 247
e VALVE O MANHOLE
o POST pP° FLAG POLE
T O W N O. FL B A R N S T A B L E G E O G R A P H i c 1 N F O R M A T 1 O N` S Y S T E M S U N 1 T
N PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The portal lines are only graphic representations DAIA SOURCES:Planimetria(man-made features)were interpreted from 1995 aerial photographs by The lames SIGN ® STORM DRAIN
w e 1"=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.`:ewoll Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD UTILITY POLE a TOWER
o 25 50 National Map Accuracy Standards at this do not represent actual relotionships to physical objects Con.orotion. Planimetria,topography,and vegetation were mapped to meet National Map Accuracy Standards
s t INCH=SO FEET* enlarged scale. on the map. at a scale of 1"=100'.Parcel lines were digitized from FY2004 Town of Barnstable Assessor's tax maps. ¢ LIGHT POLE o ELECTRIC BOX
err ap Paicel : ® Permit
" House# OIL � " Date Issued
Board of Health(3rd floor)(8:15 -'9:30/•1:00- )ry) Fee' a2S� y y
Conservation Office(4th floor)(8:30-9:30/1:00-'2:00)�
Planning Dept. (1st floor/School Admin. Bldg.) t _ . �THE
Definitive Plan Approved by Planning Board 19 ;
BARNSTABLE.
619.
t TOWN OFBARNSTABLE 'E° '�' '
Building Permit Application r
Project Street Address .
Village ��
OwnerfU t�t y . �']7°r�/L C Y Address r SAt`"
7?�^ 5 ?3 Telephone '
Permit Request K- o� .S
'First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
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
No.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
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes I'No If yes, site plan review# -
Current Use Proposed Use
�I Builder Information
Name ' �1 � �` �{�� Telephone Number J �7 ( / 3��
Address 0-f J AI License# ( S C(4 (J
LE ���i � Y � Home Improvement Contractor# l` 10 0
Worker's Compensation# to Altf&c /cY K 60 4
EW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
ROPOSED STRUCTURES ON THE LOT.
L CONSTRUCTION DEBRIS-RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE 1k" 9WU4DA C �S
BUILDING PERMIT DENIED FOR T FOLLOWING REASON(S)
Jil sea fl/I• a2/
06 ,s&�
FOR OFFICIAL USE ONLY
i
PERMIT NO. -
t• ewt
DATE ISSUED'
+
MAP/PARCEL NO.
ADDRESS ~' VILLAGE' t +
E 4
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
t FIREPLACE
ELECTRICAL: ROUGH FINAL , +
PLUMBING: ROUGH ' FINAL
GAS: ROUGH FINAL
FINAL BUILDING l !/ - a k
DATE CLOSED OUT, r
ASSOCIATION PLAN NO. - I
t � r
4
"E A
The Town of Barnstable
• Department of Health Safety and Environmental Services
rEc ' Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building'Commissioner
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: 57501 t' `1 /\ koo P Estimated Cost a t;b
�Ad ess of Work: ad l co L
Owner's Name: L � �-
✓ Date of Application: g11�f c
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job Under$1,000
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the own r:
Date Contractor Name Registration No.
OR
Date Owner's Name
q:forms:Affidav
" Map �-R Parcel �� hermit# '
�a. House# ' o2D 3 Date Issued
+ - - Fee 2CD
CARNM
19
RARNSTABLE•
MASS
TOWN OF BARNSTABLE
Building Permit Application
T ,
oject Street Tess
r—
Village - ` f� ��/-��
Owner L(.ZebC7-t 19 N OF "- AAAAd AJ Address /Q tX 0 L` Aa lyo /V/,)(
Telephone - 5 -�3 ri
Permit Request M9 I P E ��, y'� A100 IR (^13136—x
First Floor square feet Second Floor square feet
Construction Type S 19 I /0,C)d i
Estimated Project Cost $ )-000 .
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ' Two Family ❑ Multi-Family(#units)
Age of Existing Structure Ll' lk-� Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No
Basement Type: ❑Full ktCrawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No.of Bedrooms: Existing New
r Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other
Central Air ❑Yes KNo Fireplaces: Existing New Existing wood/coal stove ❑Yes )kNo
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None 14Shed(size) (1? X /0
❑Other size
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
Builder Information / *�
Name./ I (C-H- 1 cc � - 0 LV E Telephone Number �U�r �� �—/ J 0 6
Address d O E 1 L dV f�6 6 O X License# CC-) 06n y y611 cp
dR esw C .,Al ®, Home Improvement Contractor#
Worker's Compensation# V 41j ���( x
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE ", _DATE
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
A` FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED=
MAP/PARCEL•.NO:
ADDRESS ` VILLAGE.
OWNER
DATE OF.JNSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE '
ELECTRICAL: , ROUGH FINAL
-
PLUMBING: ROUGH FINAL ,
GAS: ROUGH FINAL t _.
FINAL BUILDING -
DATE CLOSED OUT
ASSOCIATION PLAN NO.
Y"
v;
°. The Town of Barnstable
• EARIMnaM •
9eb HAM �m�' Department of Health Safety and Environmental Services
ATE1619. Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
For office use only
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units or to
structures which are adjacent to such residence or building be done by registered contractors, with
certain exceptions,along with other requirements.
-,--,Type of Work: ' SI K f a 0 ob.
t Est.Cost f
,,.-�Address of Work: �� ��C Ootyo IQn
;/caner' -Name��i
ate of Permit Application: C'
PP —_r
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000.
Building not owner-occupied
Owner pulling own permit
r
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGZAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I he apply for a permit as the agent o the ow r:
Date ontractor'Naine Registration No.
OR
Date Owner's Name