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Toa of Barnstable *Permit#
t p��
THE law
�" Expires 6 months from issue date
10 , , egulatory ServicesMASS F
r
16 9 Richard V. cali,Director Y
��"�� puG 31 i, �
koo Bu Bding Division
® Perry,C O,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-.790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 2.2 7 — OS/� /
leProperty Address `J Z l ed r Y �!a��l 2�l �Q/7�iP�l/� I
[Residential Value of Work$ / Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address Al -e en t �P
aL 1deGl 111r 2,4 QO ( ,71� rd,l�e l`(� Z
Contractor's Name 'n vJ f ,l //r;56/7 Telephone Number NO( �R ff Q 0
Home Improvement Contractor License#(if applicable) 3 4157 Email:
Construction Supervisor's License#(if applicable)��'� 7 a 7
D3Crkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ m the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name a,17&;LOA / (��Lfl''
Workman's Comp.Policy# d
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
M
-side
Reeplacement Windows/doors/sliders.U-Value • 30 (maximum.32)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property wner must sign Property Owner Letter of Permission.
A copy the Home Improvement Contractors License&Construction Supervisors License is
require
SIGNATURE:
C:\Users\Decol lik\AppData\Local\Microsoft\Windows\Temporary lntemet Files\Content.Outlook\2P1O l DHR\EXPRESS.doc
Revised 040215
Renipw1. Agireem ent D c' ume t and: Payment Term s
U L-62L!Rawval IW ail®firmit at Saea$eru 6Xpw Emig" €'+'Cabala
LaiMi",SoutNrn New Eoa4 t'W y LLC 52 Red Lire pond Pd
ECI i�36t]�f9,0:9J �173Z415 'CT �053fS'S55,'Ltied E�irrrtilli!1 3 Cffrilwlle.MA02632
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C1 mer()Street Mdim 5.2L Red LIN Pond:R "tenvilllle, IM-A 02612
lit mzr,,v T Imhoute Number S>'c+sm 'Tel�ahr�ne f�'rnii<[�r•r.(9790W.2915
Rli nw, lE[rmail- "20,1001 1161 00 "151 SeComdiznfi Emalln
8u )hEreby jailitty mndl9z► s$By ses to pamc6asa k1w jwodutim aBr91ciz vivv�o 6nihrfil New. EnjAind uaelr15a:5 'LLC:dlWa
Rcmevml Rv:kiidersen of'SaujitmNim Ella race°: ,m,reer�ci�il1 Ln amnAni lae with ithe mermg as d 6clndilia deswA iin this mepaerL'a
. �rcm and paymem[`res¢rss; %Nbdce of(Umodhri+on,iiaerat�cd Oar Necelpa SNE�mns-y PD10 Lx ��[t10+��� !?.1�-13�i9�'pelf,
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®ihasdimcLlaneaLc axtached crxa3iir,AgraELr+eeiR T vela eliu;
" rYcerls nxaiL ae a a caI the and hlgvrp amxe3 herein;
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knsim r�arRa rra evectlwelp this an mkas�nnlaLece9n �ae ► 0k%nn-da'nh c
under ills Agrement.
`f6l16Amount: �e 41 rsign e4ds:agreeaiiens,Armmrate�aLa>:Ls that the iriv :Dbr and,alleAin.uunj:
FAan d anlnsi be:ale by persccial ask,hank dteck,,credli caad.,or CMh_
ll6laaa�'i 3+ �.1 Fsuacrraae� u�rna EStimaud mpletlon:
8 to, 10 Week- 8 to, 10 Weeks
►ahad df''Paym ms; IF CIFIM a sChcdsa�iAsullatwhri.S h ised 0D d he dare of Ae sigraed':amneract.anrl sicalmaVar-1 gym. '
N Che&=in.whA we'C010'IYIECIE the III A C31�IneMLIM..1a1.�1° b Mile iAad'a�lla CL'Iili 4611!'2laad'
+ 1i2 Molothsndl spa+mtn rnihs n Q Nix 'ding s r i€ m �ai9 drampr� ma emvaWln . r
176 Qit€ t, and:dimse 3c'a lla ea date. �kaiel.ama➢•emtceaLir�iS*eam�can'EFae'�r 'a�elrib 'im camms fir
Taxes paid In Uneirvillfe dlaay_
9uyev l a rees:ancl under-stain&dur ckla f't aneralend'txanscciwces t11e eiaLlrx aunrlaesias ita s Qt+etV`iE�'JL C-6 p'zadies arlr,tliaEhvre me.novwW.
u n kersun i m 5:13�n n! or a� ,�jrr��ar�,��fl ildc`teems���iis,�,�r��►a�ein[. No;Jmi zflan[o msr,dr.ra[icint feam&is,�.bmux a v-Q c v-�ilid.
dliou �re's;i,6�;d..�[!cc cmroqnT c,f'bmtM [he it3u� sy me ra�r. eu��o�s�ll�;relrl{�kr crual�6�s.rasa �rtc��� 'G��Ias�ea,�9i�
t�,plessai;sne;M.bderstan.d%apse VMM of;thia;h a elalenie asill Ines aa,oei +esl a ti�Itm y taal„� aed,a slated �Q.a$ilhLs.}4 eelale►ac inclL�lr
il6
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Agawmarm.
U110E OOWNER;Donol up this contract ifbbuciL)oil a v.erl[ifled;tam cawofthr c4ai[tm n ifie fimeyou skip.
YOU,THE BUYER, 'l+ 'CANCEL THI TRANKSAMMON a!z�l a� � : E N 1 L" '' . T MIDNIGHT
H
OF�lll f2T11'6 OR THE"p°B�I RD.RUSI ESS D�t7P lk`d'ER LT E DATIIE,IOT THIS T 1�ru� 4�"T[ LN,
X.Q -DATE,IS IATER.SU THE.AXTACHED ND'I l;d-'.L! F,CA CEILLATION FORM FOR Al
nlohIr :'�m,Enp�ndri
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Si4Amsref S I I�crsr5rs Sinrurpe Simtui
6146I Mon,tesi Noreen re au 'tocle
�me,of&_g1b.s C'cmu
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Town Of Barnstable *Permit
~per Etp' ontJrs ram issue date
CIPRESS p � ory Services
snxtvsrnac.E,
gib t ,KAMM h d V.Scali Interim Director
ADMA't°� OCT '
TOWN OF �A wilding Division
, O,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barostable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL NTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 7��Z45:2
vk
:w
Property Address S2- Qej 1-i lY�dnd �d L°/ Pl(�t� �✓�
%esidential Value of Work S ,�j �'y Minimum fee of S35.00 for work under$6000.00
Owner's Name&Address /e
Contractor's Name-5xr44ern Q I.C.Q' n.S / &,c1.j '(-1r a j\i Snn Telephone Number( 0l1T Z g-q k l70
Home Improvement Contractor License'M(if applicable)_ /7 3j t�. 5- Email:
Construction Supervisor's License (if applicable) 0 Cis 7 n 7
GgWorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name A ut 1nSue- C�
Gny
Workman's Comp.Policy Y WC 112.8b 5$ 3.S 2 3 9,4
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
❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
ZReplacement Windows/doors/sliders.U-Value ,30 (maximum.35)r of windows 7
9 of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
X`�Note: Property�Owner must sign Property Owner Letter of Permission.
A copy o the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE:
Q:IWPFILESIFOU0building permit formsEXPRESS.doe _
Revised 061313
0 Lki #sots
ruceeax Ker9a55
RENEWAL BY AivDEME��4(- aur a,Am CTtioeCnftXIM45
erros.-aVuaam tdeaoaaar° 26 Albion Road � Lincoln.RJ_0.2865'& two se2s�
Phone 866.563.2235-Fax 401.63346 rat rmc m a46 oscssso
Solid—New England Window.LLC dA f s (�
Aanewal by Ande r ea of Sontlteea New England
CUSTOM VAC .DOW.,AND:DOOR RRMODEMG AGREEMENT
. .
eiryer(r);ttime Q.ftJ4 t dAgreema,e
anr¢l,SoeicAddim.C+4�tt.udLV ieae� � GL -
cG��C2 OR6 a�
rrrsn .f/Q O%C1t7(a;(v IlA�'%T�/f•.U�, ,,,,,r r i„, ,t lL T v�e�r ►t ubw -
BuYer(s),hereby jointly and severally agrees to purchase the products and/or services of Southern New England Wendows,LLC d/b/a Renewal
by Andersen of Southern New England("Contractor");in accordance with the ierms and conditions described on the front and the reverse,of
this agreement and on the attachedd sppecicififcation.sheets}(collectively,this`Agreemene7;. O Historic. O Condo O HOAT
ToolJobAmourre �v ,/aD °�Snro'rs `ra, Method of Payment OCheck OCash j marked
Deposit Relieved(33%k
Cred'tt Cards art tirxepoed for Qeposteonly=maxkntm 173 OF rive•
Balance at Start of job(33%): Estimed proitxc oast iPkpse see Gedt Card Ftry►"a't form)By sigetireg the
'Agreement you tulntowtedge that the Balance at Start of job and rive;
Balance on t6starte>zl �Q-/� Balance on subsondol Comoedan of job car"be rtade br aedit
Comi*tlon of job(339ii:' earl and mun be made a Persoo cltedt,bank tirade or cash
Bayer(+)agrees read mderetaads.that tLis Agreement corasdtotes the enttse undeataading between the parr ey sad that
there,aria no verbal undesatisdiigs changing any,of the sgrma of.than Agreement.;Bayer(c);acknowliedges that Bttyer(a)
(l)has read this Agreement,mderstiands the'"of this:Agreement,and has redeived it completed,signed;and diated
copy of this Agreement;iacladi ig:the two attached Notices of Cancelladon,on the.date first written above tad(2)was orally
informed of Bayer's r
i
g
ht,
to cancel this Agreement.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BI.ANKSPACES.
(Riodt l ii'and Soles Only}Notice to Btiyert(1)Do not rain"'A' greement d a4 of the tiptoes iatended for the agreed terms
to the latent of then avoilahle informadon.are lift lilaala.(2)Yon ire endued to a copy of this Agreement at the time you sip
it:'(S)Yoa may at'gay three payoff the Hill aa,t"batant e.due under this Agreements;and in so doing you may be entitled to
receive a partial rebate o 'the finance and insurance charges:(4)The:seller has no right to ttalawfaByenter your P+'endses
or commit say latest b of'the peace to repos}sesp gouda pgrrhaared under this Agreement(S)Yon rosy cal et ,Agrecmeat
if it.bar notbet3n signed at the main ogee or a iranrh office of the selletr,provided you notify the seller tt his or her main
oiitiiee'- branch office shown is theAp Bement by.registered or ceseifsed m il,.which shall be posted not4ter than midnight
of the µthird calends:day aRer the day ou Mhroh the,bayer rrigas the llgreemeat,e:clnding Saaday aand'aay.holiday on sv6ich
regular mail deIiveeietace sot a de Bee flee aoeompadgiagfiodoe of eaaeeUatioa fo:m for as esplanadon of btayer'e eights:
Biryer(s),cecerved the consumer,education materials'provided by the RM&Islatia Contiadors Regisuaoon-Board., (Berygr_'s Iniriglr)
Renewal'. tiers' S ern New England Bu (s) .Buy"N
of t ct Manager;. signature signature
&5V NOREE/V A. D'
Prurt Marne o£Paoduct Manage.: Prim Name PM 44ame.
YOU;THE BUYER(S),:MAY CANCF.T..THIS TRANSACTION AT ANY TIME PRIOR TO.MIDNIGHT OF THE THIRD.
BUSINESS DAY AIfiER THE DATE OF THIS:TRANSACTION:SEE TIM ATTACHI D NOTICB'OF CANQELIATION FORMS.
FOR AN EI�LANATION OF THIS RIt3BT.
NOTICE.OF•CANCELLATION
Draw otranracdon,vrrdeout' or oT may cancel: I Oaw'of Transaction You may cancel
NOTICE O
am ponatt)r gado%wathiii thls transacdo- without any penalty'or obl gatlan,within
three business da)rs from the above date H you cancel, I titres business days from the above date If you canal,arty
properly:.traded m.any paymenp_made by you.under"the 1 property traded n;stay payments made by'lion under tine
Caatraet or Sale,and any otiabkr anettrument erroeubed I Contract or;Sale,and arty neggotiable tnstrtament eeoeeuted
M you,will tie returned win ben business days tollarwirig• i ba you will bo returned widein care tiuttiteess days kllowing
roealpt by tiro $rile:of'your cancellation notice,and any I receiptby lire Sella►of your sancdladon notice,and,wry
seeuriq ntereslt aridng out of the transaction will be' security interest. arising out of the eransacdon' will.ba
aaKel -Nyou epncel, ` muait nialae availab�to the Seller 1 ciukoled WOO cancel,you must:mako avia'labj too tied Seller.
at yourriawdence,in se dallyas good eonditloti as.when i at your residence.In substantially as good condition as when
teesk%4"'a�delivered to'lioaa under thb Contract or i reiihod,arty,good-doll Bred to you under thls.Contrae6or'
Safa;oryiou may,NyoaawNh,compip.with`tfie instrve8ons. i Tale;or you m. ,if u with corn with the innruetions of
due Selle'rogarding the return shipement of the goods at tine` the Seller rega di rtho r`eturirskipment of the goods tie the
SelkrRam_cpense and risk.if you do rraaioe the atrailable Selktrts and rick.N-rou do make the s available.
w the Seller ark.tha Seller does not pick;Jsem sip within do tite S�eaaid tiro.Seller does jwt`pick tlriettt up witliin°
ertrentyr:drays of tine dew of concellation,.you mr rataM or i twenty of the date of cantellatioN you may retain,or
dispose of!the Qoods without anjr further.,obggadot►.if you 1, dis'' Mlle goods without arty fitrNter,obligation.if jrou
Fait to tnalm,rive Scotia avoilabk tic'tiro.Seller,or it you agree I hil w make fire goods available too dte Seller,or if you agree
to riWrn the'Roods to tlin Seller and hfl,to do so,.dten you I •to return dfrs 5 do the Seller and fait to do so,firers you
remain liatble for performance of all obligations;sander tier I remain liable for pesformance of all.obNgstions under rive
Cantnect To cancel this.trtrasaoceon.map or,'deliver a signed ContractTo cancel this eransaetion,mail or delivor s signed
and da0ed copy of this eikellation t-o'dce or am other I a►ed dated copy of this cancellation notice:on any other .
weitben tiwtiee,ok.send a teal w Ranetwal Arderseri of I written notice,or send a wlagram w Reimawal byAndersen of
Soudrorri New and.aE:2biiin 5, I Southern.INew En and aE 2bAlbion Rood;Lincoln,R101865,
NOT LATER T MIDNIGHT OF I NOT'LATER TH MIDNIGHT:OF"
f HEREBY CANCELTHISTRANSACTiON.. f DI
ate)
HEREBY CANCEITHiSTRANSACTIO H.
ROG slit.:.se�saeu tvetta ttrurw:
MA Cope White BtW Copy yli c r Buys:Cwy Plnk..
P
�IME Town of Barnstable *Permit#
Expires 6 mont fr m issue e
Regulatory Services Fee
�i;�vsTasiE. i
16 9.
`j,Q�3 Thomas F.Geiler,Director'
�O Mp,•l:A�� Q�
Building Division 1-71)
�P��� Tom Perry,CBO, Building Commissioner
AlA`0 200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 , Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
2 2 7 0 5 4 . Not Valid without Red X-Press Imprint
Map/parcel Number ,
Property Address 52 Red Lily Pond Rd (t
®Residential Value of Work$ 8 5 7 5 . 0 0 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address Noreen O'Toole
40 Washington St .Ayer, MA 01432
Contractor's Name Richard Tupper Telephone Number (5 0 8) 7 7 8-0111
Home Improvement Contractor License#(if applicable) 12184 5 Email: admin@tupperco.com
Construction Supervisor's License#(if applicable) CS-0 6 9 0 5 8 '
aWorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor "
❑ I am the Homeowner
QC I have Worker's Compensation Insurance
Insurance Company Name AE I C -
Workman's Comp.Policy# WCC 5005593012012
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
Re-roof(hurricane nailed)(stripping old shingles)All construction debris will betaken to 7 9B Mid Tech Dr,
W.Yarmouth, MA
❑Re-roof(hurricane nailed)(not stripping. Going'over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: PropeoWw er must sign Property Owner Letter of Permission.
op of the H me Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE
C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\8R76BDVA\EXPRESS.doc
Revised 061313 `
r T'U3P3PE3E:L C01%T8'I°3E:LUCrrX01V Cc), LLC'
79B Mid-Tech Drive West Yarmouth, MA 02673 (508)778-0111
Date: G7 i/ f e}0I 3
Town of
Attn:Building Department
I hereby authorize Tupper Construction Co.,LLC to pull the permits necessary to complete the project described
on the attached permit application form. ,
t
Thank you,
Owner's Signature
Print Owner's Name: ,-,
Street Address: ��" GGi �D n`d --Ral
r A r
F
,
T U P P E P �: � ;� ���
CONSTRUCTION COiiE
ABLE
79B MID—TECH DRIVE,WESTYARMOUTH,MA 02673
PHONE' _778-5010
VV .UPPERCO.COM M 313 DEC 10
P__ ,112_ 2
c
l DID{1 e v=N1
Date:
Town of Barnstable
Thomas Perry CBO
200 Main Street
Hyannis, Ma 02601
(508) 790-6230 fax
Re: Insulation Permits
Dear Mr. Perry
This affidavit is to certify that all work completed for permit application
Issued on // �/� %�3 has been inspected by a certified
Building Performance Institute (BPI) inspector. All work performed meets
or exceeds Federal and State requirements.
Sin rely, �� Tel)
Richard Tupper
License # CS-69058
s TOWN OF BARNSTABLE BUILDING PERMIT.APPLICATION-
�y t
Map �/ Parcel ®� Application#�� j
Health Division Date Issued ..
Conservation Division Application Fee v
Tax Collector Permit Fee
Treasurer
Planning Dept.
p
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address__s Z R-e A L. 1 1%1
Village
Owner ko t-�etr. 'boaIc Address 10 WAA, cv MA OW31
Telephone `772 - 7.7 ' -7 2 f
Permit Request Y'fp cc. S1, Its
\\I." ?o /Xyo' IX17�"aw�
CihrQ 11n �1ya1�5tGLil�vr+1 1rs.01e4Cc Wa)1�0a/'dk r'Cw,DVC, 2411 �►��.aQow3
0yX t ack .. 1 "Kf 11ah W1ebbLOS wi*n IVV KSaM "Our-
Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new(
Zoning District Flood Plain Groundwater Overlay
Project Valuation / Construction Type
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure 17 VeA,rs Historic House: ❑Yes ®No On Old King's Highway: ❑Yes 22 No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other to o v-..,—
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full:existing new Half:existing new
Number of Bedrooms: existing new
f
Total Room Count(not including baths):existing new First Floor Room iount
Heat Type and Fuel: ❑Gas ❑Oil ;d Electric ❑Other .d `
Central Air: ❑Yes No Fireplaces: Existing New Existing woodlc gal stove M Yeses ❑ No
Detached garage:❑existing ❑new size Pool❑existing ❑new size Barn:❑ xisting Id new>—size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
_Zoning.Board of Appeals Authorization _❑ _.Appeal,# Recorded 0
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name_I/ k-So L, Telephone Number 7 7 y�
p �
Address /� f o�ya�. 1� License# �D l
{'-LA 5 1� 016 S 1 Home Improvement Contractor# l o 18 7
Worker's Compensation#
ALL CONSTRUCTION DEBRIS YRESULTING FROM THIS PROJECT WILL BE TAKEN'TO �'f�� EKCO
SIGNATURE DATE b/ 6
,e,*i4
r FOR OFFICIAL USE ONLY
APPLICATION#
j,. DATE ISSUED
4 MAP/PARCEL NO.
t . .
ADDRESS VILLAGE
OWNER
a
' DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
�s
GAS: ROUGH FINAL
FINAL BUILDINQ SIG lib
s
DATE CLOSED OUT
L-
ASSOCIATION PLAN NO.
P
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
A , 111
I m / IL
DATA
f
i ,
Town of Barnstable
0: Regulatory Services
BARNSTABLE. Thomas F.Geiler,Director
,* MASS.
16.19. A`` Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
` www.town:barnstable.ma.us
...
Office: 508-862-4038
� 1 . .
�,'
or „ ,Y,
I,
1 I Y �J/. J •/�
hereby authorize ems ' (/' 4`
in all matters relative le-
P
Signature of Owner
f
Print Name
52 RED LILY POND ROAD-POST OFFICE BOX 511 TEL.(508)7.75-4836
if Property Owner is WEST HYANNISPORT, MASSACHUSETTS 02672
Homeowners Licens
Q:FO RM S:O WNE RP ERM IS S ION
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�pIHE t Town of Barnstable *Permit#,�4OgD0�05�
xpires 6 nmm is jroindssue date
Regulatory Services Fee /-E }.
I BARNSTABLE, Thomas F. Geiler,Director'
9 MASS u
1639. .0 Building Division
lFo �A PRESS PERM rltsl�s
Tom Perry, CBO, Building Commissioner n� .
200 Main Street, Hyannis;MA 02601 JAN 16 2008
www.town.barnstable.ma.us
Office: 508-862-4038 t TOWN OF 5#,JR -T79�90
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not valid wit/rout Red X-Press Imprint
Map/parcel Number A,;� 7 0�7
Property Address -, a }��e� L� �(y PO�2cg RA 1.U; Y&I t k
Residential Value of Work' 06 CJ Minimum fee of$25.00 for work under$6000.00
t i ,
Owner's Name& Address1 �, �
S ' ., ,,. (� C)1 j 3 z
Contractor's Name DF%A,,-1,A-S 11�C'. Telephone Number__
Home Improvement Contractor License#(if applicable)_ /e�Z 1 29 7
❑Workman's Compensation Insurance
Check one:
f I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance 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/doors/sliders. U-Value d '33 (maximum .44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. j
***Note:` Property Owner must sign Property Owner Letter of Permission
A copy of.the Home Improvement Contractors License is required.
:SIGNATURE: "
Q:Forms:build i ngperm its/express
Revisel 12807
e7 t i✓e2in5�26�� ��ci�C�i/�9 �e pl.
9CtllGZQ�' � �QG� do ,-may �ro/�er�y ��
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✓J �
52 RED LILY POND ROAD-POST OFFICE BOX 511
WEST HYANNISPORT, MASSACHUSETTS 02672 TEL.(508)775-4836
Town of Barnstable
Regulatory Services
yBA ssBi'E M $ Thomas F.Geiler,Director
�p 1639. ♦�'
rEn�.ts Building Division
Tom Perry,Building Commissioner
t
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
r
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work authorized by this building permit application for:
j
(Address of Job)
r -
Signature of Owner Date
Print Name
If Property Owner is applying for permit/please complete the
Homeowners License Exemption Form on the+reverse side.
Q:FORM&OWNERPERMISSION
OF
THE 1p Town of Barnstable
Regulatory Services
" Thomas F.Geiler,Director
BARNSfABLE, « a
MASS.
1639. 6.0� Building Division
rEn � Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 �i Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER':
name home phone# work phone#
CURRENT MAILING ADDRESS: 7
city/toV� dn
state zip code
The current exemption for"homeowners" ded to nclude owner-occupied dwellings of six units or less and
to allow homeowners to engage an indivire wh does not possess a license,provided that the owner acts as
supervisor.
ION OF HOMEOWNER
Person(s)who owns a parcel of land on we r sides or intends to reside, on which there is,or is intended to
be, a one or two-family dwelling,attachee structures accessory to such use and/or farm structures. A
person who constructs more than one hom - ear period shall not be considered a homeowner. Such
"homeowner"shall submit to the Buildinga form acceptable to the Building Official, that he/she shall be
responsible for all such work performed uildin ermit. (Section 109.1.1)
The undersigned"homeowner"assumes responsi 'lity or compliance with the State Building Code and other
applicable codes, bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/ he unders nds the Town of Barnstable Building Department -
minimum inspection procedures and requireme is and that h /she will comply with said procedures and
requirements.
a
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings co taining 35,000 cubic feet or 1 rger will be required to comply with the
State Building Code Section 127.0 Cons ction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowne performing work for which a building pe 't is required shall be exempt from the provisions
of this section(Section 109.1.1-Licensing of con ction Supervisors);provided that if the ho eowner engages a person(s)for hire to do such
work,that such Homeowner shall act as superviso."
Many homeowners who use this exem tion are unaware that they are assuming the respo sibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction S pervisors,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 with a licensed
Supervisor. The homeowner acting as Supervisor t ultimately responsible.
To ensure that the homeowner is fully a e of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands , e 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-Vicertification for use in your community.
Q:forms:homeexempt
TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION .
Map 2V-1 Parcel Application#. 19 .��.��
Health Division Date Issued 10 I-1 67
Conservation Division , / ...Application Fee
Tax Collector Permit Fee .
Treasurer AA
PU
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address 45 _e 0 0 IoQ Roc.CQ
Village
Owner VOK 2 e XA Too I�e Address Ib QJc.s NJ dig a
Telephone
Permit Request Y'e-w ou e old L(A x 1 l' S".
Y-e-P 14e e k°+a,e,%^ CC-S e V11 e- t W c"-Oslo W 1 CD M
� E
Square feet: 1 st floor:existing proposed 2nd floor:existing proposed I Total new';:'
Zoning District Flood Plain Groundwater Overlay co s
Project Valuation Construction Type r
Lot Size �1 0 Grandfathered: ❑Yes ❑No If yes, attach supporting locumentation.
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:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes *No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION c
Name' T)c.)Lxskt.s C v-v c;k5o ri_ Telephone Number
Address 4 0!�! A--olsn, PoyJ R4 License# _ 16013
Mh OD-63I Home Improvement Contractor#
Worker's Compensation#
ALL +CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
If 5
i SIGNATURE DATE /0 L ®�
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION u l°t Z�
o -
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
- � Town of Barnstable.
tioF �ti
Regulatory Services
ws ,$ Thomas F.Geller,Director
Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-62.3 0
Property Owner Must
Complete and Sign.This Section
If Using A Builder
I , 4, 10 e> as Owner of the subject property
. vie �•n
hereby authorize I 117 1Z rf p to act on my behalf,
in all matters relative to work authorized bythis Bi iLding permit application for, ,
(AdcVcss of Job)
�' �` �� o
Signature o Owner e
ore • O'`� � /-e:_-
Print Name
Q:F0RMs:0 NERPERMISsI0N
01) , . ok;A cn i
16
. ��;•�{�,,.,, SYP ` s is .g rr II
2x6 sy� g 7 �
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/o � aON to Posh
8
Wow cl
�r
r
S� Rea L� !y Fa-A Rc�.
sccalc %y"= I' �11D 07 CIS
�arcln I�i�o� L ' he @x x6
- -- 41- -{-o h eaa4e�
a6o ve
n(ew 'D
Assessor's map and lot nu . ...... .j447 ..f.....+3......... 7 „2— sTHE
Sev;Lage-Permit number .... ....9....7.///................................ SEPTIC SYSTEM MU
WSUL L ED IN COMP
- 9
STABLE
Housenumber ..... .................................................................. V4M TNL ra E MARL
1639.
IK CODE
tM
TOWN OF BARNS LWA*iS
BUILDING -INSPECTOR
APPLICATION FOR PERMIT TO ...........................................
TYPE OF CONSTRUCTION .............W.00.x..........................................................................................................
... ..... ....
................. .................19.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to. the following information:
Location .....Ifed....4i4..V.....6v 4d.....ed...........O)A..gvtq.&A�4.100'e.r.....................................................................
I-Am�q ZOOM
5..::�A q r
Proposed Use ........ 4.4 40. ...........
ZoningDistrict .............................................................. ---Fire District ..............................................................................
Name of Owner ......................Address 16...
Name of Builder ... ..................Address .............. ......
.Name of Architect ...Mc �f...... 0.qJ)1.:r4:A........Address .....?.16.).V.(V X.6.................................
Number of Rooms ....................................Foundation APOR.6"Id..........dolid.&T ..:9T.0k.0M.......
Exterior ......1.14move..."uoug. ....&fi&.+,0AkRoofing ......... ....... ...43.,
9'd............
-PX Aj C
Floors ....4.X....8... ..h. C
... .................. .......................Interior ............. .................................................................
Heating ............ ..0.47),V............................
91-10.......................................................Plumbing ....... ....
Fireplace ............................a44-5.rl*�. ............................Approximate Cost .............-3Q1..000.g.(?(,7....................
A0.05�
Definitive Plan Approved by Planning Board -----------------------------19--------- Area ..........................................
<P--
Diagram of Lot and Building with ,Dimensions Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
7-6-
L-O'T 57--
it
4 LO-T z.
LoT
vow W/O.
too$
�,,tLL4 &IJ8 VcA6
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction:
Name %64e&V(—�.........
.................... .............
O'Toole, Richard J.
21979 ad t frame
N011-111 .... Permit for ............ .....................
.;dwelling Appeal #1979-88
.......... ................................................?...................
• '51�\Red Lily Pond Road
Location .....................
Len
. ...............................................................................
Richard J.. O'Toole
Owner .... ti
-frame
Type of Construction ..........................................
7
......................................................................
Plot ............................ Lot ................................ E .4-
February 11 80
Permit Granted ........................................19
Date of Inspection ...... ................19
Date Completed .......) .... ................19
PERMIT REFUSED
..... 19
.. ............ ....................................
...... ... .. . . ................................................
............................................
. ...............................................
fin
S
rA pprQYL K ....... ....................................... 19
.................................................................. ...........
................ ..........................................................
O
Q
O
Z2g.9• 2�5.
O _ Exist.
Q Dwell.
EXISTING FROM BOH - -
p ¢) SEPTIC RECORDS
ST
Exist.
PROPOSED Deck \LP;
NEW DECK /
EXTENSION
Exist.Goroge LOTS 43 & 44
19,088 SF±
ass 52 1�� PLOT PLAN
OF
52 RED LILY POND ROAD
CENTERVILLE
PREPARED FOR
DOUGLAS ERICKSON.
off 508-362-4541
fox 508 362-9880 ,. OCTOBER 5, 2007
� �,�H OF Mgss9
down cope engineering, Inc. ono ARNE yG�H. c Scale: 1"- 20'
Cl VIL ENGINEERS ALA -'
LAND SURVEYORS .2634
939 Main Street - YARMOUTHPORT, MASS. lV L� � J 0 10 20 30 40 50 FEET
07-257 DAT 1 stbv A, P.L.S.