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Town of Barnstable *Permit z
p� yESS
PERM 3°4� Expires 6 s fi
`R s date
} egulatory Services Fee '
• BARvsresis, •
' .1�$ SEP - 9 2013 Thomas F.Geiler,Director
pfFD MAy�
Building Division
TOWN OF BARNST90nIerry,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 X-Press Imprint
Map/parcel Number C�j
/
.Property Address # �7 0 1 Vr-g 14 I k b i ,fq ( r-rtyt t-f—
esidential Value of W�or"k�$ M-00. Minimum fee of$35.00 for work under$6000.00
Owner's Name&Addresst10!-/yl /T G
Contractor's Name 8t>> Telephone Number I06 .s 6d_M F
Home Improvement Contractor License#(if applicable) Email:
Construction Supervisor's License#(if applicable) ® �(v r
-r
❑Workman's Compensation Insurance
Check one:
P-'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 accompany each permit.
Permit Request check box) ,
e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to V41"AUZN
❑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: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE: fl� k4l
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
Revised 061313
o �ti
of try r `
* BARNSTABLE
039. Town'of Barnstable
�� -
prEO
Regulatory Services
Thomas F. Geiler,Director' .
Building Division
Thomas Perry,CB0
Building Commissioner
200 Main:Street, Hyannis,MA 02601 -
www.towri.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
1, i�c �t � jam„•,.... C as Owner of the subject property
hereby authorize ® .��. � � to aet on my.behalf,
in all matters relative to work authorized by this building permit'application for:
t _
Cg
vie LiNZD d
(Address of Job)
Signature f wner, ate
Print Name .g
If Property Owner is applying,for permit, please complete the Homeowners License Exemption Form on;the
reverse side. ::
Q:\WPFILES\FORMS\buildingpprmitformsTXPRESS.doc.y
oFIME Town of Barnstable
' Regulatory Services
BARNSTABLE• ' Thomas F. Geiler; Director
9 MASS. -
�Arfo 39. Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.ba rnsta ble.ma.us
Office:. 508-862=4038 Fax: 508-790-6230
HOMEOWNER,LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street village
..HOMEOWNER";
name me phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to includ owner- ccu ied dwellings of six units or less and to allow
homeowners to engage an individual for hire who does not possess lice se,provided that the owner acts as supervisor.
DEFINITION OF EO�VNER
Person(s)who owns a parcel of land on which he/she resides or inten o reside,on which there is,or is intended to be, a one or two-
n r farm structures. A person who constructs more than one
familydwelling, attached or detached structures accessory to such us a /o p
home in a two-year period shall not be considered a homeowner. S ch"h eowner"shall submit to the Building Official on a form
acceptable to the Building Official,that he/she shall be res onsibl for all Su work performed under the building permit. (Section
109.1.1)
The undersigned"homeowner"assumes responsibility for co liance with the Sta Building Code and other applicable codes,
bylaws,rules and regulations.
The undersigned "homeowner"certifies that he/she unders rids the Town of Barnstable wilding Department minimum inspection
procedures and.requirements and that he/she will comply ith said procedures and require nts.
Signature of Homeowner
Approval of Building Official
Note:,Three-family dwellings contain' g 15,000 cubic feet or larger will be required to comp with the State Building Code
Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner pe owning work for which a building permit is required shall be exempt from the ovisions of this section(Section
109.1.1 -Licensing of construction Supervisors);pro ided that if the homeowner engages a person(s)for hire to do such work,that such omeowner shall act as
supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendi Q,Rules&Regulations for
Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowne ices 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,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 he/she understands the responsibilities of a Supervisor..06 the last page of this issue is.a form currently.used by several towns. You may care t amend and
adopt such a forrn/urtification for use in your community..
0:\WPFILES\FORMS\building permit:forms\EXPRESS.doc
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
06 -1
Map :: Parcel Application # 6 p
I
Health'Division Date Issued )
Conservation;Division - Application Fee
Planning Dept. Permit Fee �+ S
Date Definitive Plan.Approved by Planning Board
•
�f 23' 09
Historic' OKH Preservation
7
/ Hyannis •
Project Street Address X/V CF_yt 6W "W'-
Village _ ���1 -�/1(,�.�
Owner Address y0 RIP45V/6k) 4A-ALG
Telephone C�g�7 YV949
Permit Request Rnod2 YCr?lYY) a3c C4�7 O� l�l dl�/�.,
9
Cf I�JG S l�She r , PAft 7� , 7IL E 01i7=�"�e��
Square feet: 1 st floor: existing proposed. 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation¢2S, ODy Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family UJr' 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 (�,Aft)
F,,, _
Number of Baths: Full: existing - new Half: existing -new Q t
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor Room Count UJ
Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑Other J
� I
Central Air: 0 Yes 0 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
APPLICANT INFORMATION
l (BUILDER OR HOMEOWNER)
Name C.�.J `1 � �18U1L,619, lRVC. Telephone Number
Address "T CJ /��5, �/ AlUIE License# 0032-SI
�S Home Improvement Contractor# lo 6 0
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE lho
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
V
MAP/PARCEL NO. -
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
' FOUNDATION
-FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
'FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
yE SFiE Tow.of Barnstable
�P�QF E 1p�ro
r�
Regulatory Ser Ices
Thomas F. Geller Director
�. . $ ,
lFD MAC Building.Division
Tom Perry, Building.Commissioner
200.Main Street, Hyannis,MA 02601
[5ce:; 508=862-4038 Fax: 508-790-6230 .
Property Owner Must
Complete and Sign This Section
H Using A Builder
I , as Owner of the subject property
hereb authorize .) jAZ-7Z z� B411- ),a-�`,t
p � o act on my behalf, .
in all matters relative to work authorized by this building permit application for.
050 oc W'ruie rvi Ili
(Address of Job)
S' e o er to
.07
Print Name
Q:FORMS:O�T1v�R.pER2�fiSSION }
TCAWN OF BARNSTABLE
BUILDING PERMIT
PARCEL ID 228 097 GEOBASE ID 13967
ADDRESS A0--R-TFVERV E�1 fKNE PHONE
' CE DER i- LLE� ZIP -
10T 15J-7&35 BLOCK LOT SIZE
DBA DEVELOPMENT DISTRICT CO
PERMIT 86420 DESCRIPTION RENOV KIT/NEW FLOOR/REPLACE EXTERIOR DOORS
PERMIT TYPE BREMOD TITLE RESIDENTIAL ALT/CONY
CONTRACTORS: E.J.JAXTIMER, BUILDER, INC.
ARCHITECTS: Department of
Regulatory Service
TOTAL FEES: $75.00
BOND Of
CONSTRUCTION COSTS . $55,000.00 t1�E
434 RESIT!' ADD/ALT/CONV 1 PRIVATE IF 0 }
* BAMSTAEIM.
MARS.
BU I,WrSII
BY
DATE ISSUED 08/25/2005 EXPIRATION DATE _
k THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN-
CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR
ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE,ISSUANCE OF THIS
PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
f MINIMUM OF FOUR CALL INSPECTIONS REQUIRED
FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE'
1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR
2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU-
(READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH-
ANICAL INSTALLATIONS. , f
3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. f s
4.FINAL INSPECTION BEFORE OCCUPANCY.
i
POST THIS
' • IT IS VISIBLE
k
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 1 1
i
I
{ 2 2 2
vC c/ �C
.I
I
3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT
2 BOARD OF HEALTH
OTHER: SITE PLAN REVIEW APPROVAL
f
,y
k
WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS
THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY
i VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA-
TION. NOTED ABOVE. TION.
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map; Parcel Q% I Permit#
Health Division U. ,3 ' t"" Date Issued �C - U
Df
Conservation Division 2 OS , t 2 4j I. : 15 Fee
Tax Collector _6 A
Treasurer y f,:
Planning Dept. Checked'n By
,TANG SEP IC SYSTEM
Date Definitive Plan Approved by Planning Board Appryed
OF BEDROOMS
Historic-OKH Preservation/Hyannis
pp Project Street Address 40 R t, yir6 Q� _
Village &J,4?XV If,
Owner Address '1'� R.l �W i to
Telephone -/D
Permit Request
J w 1 i ns F 4 H cir
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new``
Valuation 4254� 690 Zoning District Flood Plain Groundwater Overlay
, a
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 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 Ai': ❑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: El 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 ( CJI r:- _ _Proposed Use •
BUILDER INFORMATION
Name -J•Ja,c-h, r� ?,-Y u v , (hL Telephone Number J���71 d " ` ql
Address 4S f\05aru [AN License#
Home Improvement Contractor# pD
Worker's Compensation# k�!, 5QlYXo�1�Of oZOQC
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED _
- i t
MAP/PARCEL NO.
ADDRESS 'VILLAGE
OWNER ~
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL-
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL._
FINAL BUILDING
DATE CLOSED OUT As
ASSOCIATION PLAN NO. f i
Town of Barnstable
Regidlatory Services
Tiir..nnas P,Ccler,Dirt:clatir
Building Division .
Tom Perry, Balding Connuissioner
200 Mair.si-xt: Hyannis,Al 0201
- q'Www,tUl1'd6.htlfP1�18�7�1:.f1)A.119 -- - -
Office' SG9 8G2-4038 fax: 5t;$-?90-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
i�.�✓'' ��. � � � , r�sCJ�arira�i ti;e.c 5j_.c:+.7tc�c.rtj+
}ltnily authorize. to act cm rrr tivhzli;
in Alt cmrters re�C i�c fx>.�,.}rk auts s iirel b dLq b'Edug nv.t �t apjll;ealiL.n Eu-
(Addr"s of Job) .
t?narnrc of Chxn uu<<
Print\a:nC
4:FU1Ltid8:04.4. ERtdfSslo' ..
[�l: SO LOO :7�-'Nd ..oV'-SLL i -y :01 ::P,3 �1,K H4
Kitchen Designed For: �� Er�IF.urc
Design Mashpee cabinet: Date:
Center 508-477-6115 °
Q,D D
11 . 11 IT
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000000 - 00 0
E'�'E 11
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Kitchen Designed For: _--
Design Mushpee Cabinet: Date: Ev �
508-477-61/5. '
Center
69"
��bEEP
bcCS3634 I/S'TG 63 �� W. 18/S I
67
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Andersen Andersen Windows-Abbreviated Quote Report =
Project Name: AGEL -BAY
Quote#: 007399 Print Date: 06/29/2005 Quote Date: 06/14/2005 iQ Version: iQ5.1 Page 1 Of 2
Customer: BJ JAXTINMRIL
- — -
216,Thornton Dr. Biding
Hyannis,MA Address:
508-862-6200 Pbone: Fax:
v Sales Rep: NAOti1I RETSALL _ _ Contact: --
�_
C. Item Qty Item Size(Operation) Location Unit Price Eat Price
-f 0001 1 30-C14 20"-R) S 1233.21 S 1233.21
RO Siie=5'9 if 8"W a 4'2"H Unit Size=5'10"W a 4'1 1/2"II
Group Unit,Casement 30 Degree Angle Bay,EVhiWCiear Pine,HighPerformance Giass,Finelight Grilles-Between-the-Glass,Mulling Location
Distributor.Mull Priority:Veftical
Insect Screen,White
Hardware Pack,PSC,Andersen Classic Series-While
EXT JAAIB,4 9/16 WALL PR .
HEAD AND SEAT BOARD,30 DEGREE BAY 5 114 WALL.
PLATFORM,30 DEGREE BAY
CASING,WHITE AUXILIARY 1Y/SCRFWS RIA
CABLE SUPPORT,SYSTEM
ADD FOR WHrrH PF Adjvatnrent
COMMENT: -- ADD FOR WHITE PT
cn
w
J
- a_ �
Q
U?
w "_' Subtotal _ I224 S
a- ._ _ k TotalLoad Factor Misc:Taxable -- 8.76� .
Customer Signature -- OA85 i Tax(5.000%) 61_b6�
_ -
Misc.NonTaxable 0.00
Grand Total 1294.87:
cL DealerSignature ----- ---
i
All graphics viewed from the exterior
u;
4 _Pro-,sec±Commits:
a� `VEF7CS LEADTIME ---- - - -------- ------- - --- --- ---i
ONCE ORDERED-NO CHANGES
h �TEMS ARE SPECIAL ORDERED&NON-RETURNABLE - _ - _--- _-- -- ----_.--.--- -E
JUN. 14.GUbt) 11;'-,::(HM SHEPLEY SALES N0:242 P.i/2
w� r
SHEPLEY MOOD I PRODUCTS, INC.
216 THORNTON DRIVE
HYANNIS, MA 02601
Phone: 508 862-620 _( } 0 Fax: (508) 862 6012
-------------------------------------'- -------- - - ----- -- -
Page
--1--------_-------SPECIAL ORDER TICKET Ticket# 11488657
----------------------- ------------------------
SPECIAL MTE8 TRIM 04
I '"itpe 111 i Z1:4p
TeM 0410TH/25TH Due Daz0!07/2S/2005
T 172 , P150CB By:TOM InvOiC@ BO:C:p6/14/e0D5
alll
SalRP
---bon -.-Naomi K--------- ----- ---- - -- - ----xE-RINT --^----------- Ship 9-zo 06/03/2005
Sold: E J JAXTIMER Ship:EXT.D00RS/RIVERVIEW LANS 40
To- 48 ROSARY LANE To:AGEL
HYANNTIS, MA 02601 A'1/P 14 GRID K10
CENTERVILLE, MA
Phone: (508) 778-4911 f:2
C'a0tznrr No.: JAXTIME .gob: 000S9 Luszomer p,0• - Ship via : SNEPLEY TRUCK
--------------- -,----
La Crier Ship Vnit Price .Fem No. Deeeriptioa Oty Unie ?ricc Extension
avoccCcc.CSpagp-Mqw-www...........0aapp----wwwpvay.....vavpqp....a-wwev......accavwp-----------.ovvavaaacwpp....ppav,�ppcca»�-�pgMpop
:ALL TOM WMW IN 0 774-239-2Q12
THnMATRU SMWTRI STAR FIBERGLASS 000RS
GRILLES B/T GLASS
4-9/16 PRIMED FU JAMH
NO WING
HIGH PE7t8ORWt28CR ADJ.AL:JMlrI.I SI:,1,
HALDWTN P"%8HSD CYSOME BIAjQr,BDounu BORE
LAMRY ROOM
12 1.00 L EA 3J6.4o INAICDOOQ00006476 B262GBG 206k RHIS 9LITE/2PNi, 4916 PPJJ48 I.000 EA M ,106,40 396.40
N"-SG XPADJSILL BLDWN POLCJOiARm DEL50RE .
GARAGE
16 1.00 L RA 420.79 !N K000000087C79 S262030 2866 LHOS 914I7E/ML 4916 rPJJM5 1,006 RA ns ;20.79 420.70
NOC90 NPADJEI" BLDW DOLLHRMMG DBLBORE
R/Oa 14-1/2^X80-1/2"
FRONTuma
_UN. 14.EO05 11:53AN SHEPLEY SALES 140.242 P.2i2
iEPLEY woo PRODUCTS, xNC.
216. THORNTON DRIVE
HYANNIS, MA 02601
• Phone: (508) 862-620C Fax: (508) 862-6012
------ ---------
Page 2 SPECIAL ORDER TICUT Tick®tit 11488557
SPECIAL NOTEC TRIM 44
-------- ---------
%no;I1tzl:a0
Terma;7tl0:F3/25TH Due Da,e:07/25/2005
T 172 Plaee9 By:TOM Invoice aate,06/14/2005
Eale7poroon NaoMl Ke;pa11 :Acc;!097 REPRINT .snip Datc:06/03/2005
----------_-
Sold; E J JAXTIMER
Ship:EXT.DOORS/RIVERVIEW LANE40------
To; 48 ROSARY LANE ToIAGEL
HYANNTS, Kk 02601 M/P 14 GRID K10
CEN'TERVILLE, . MA
Phone., (508) 778-4911 f:f•2
Customer Re.; JAXTIME .7obt 00058 C•.uzomor P.O. Skip via': SHEPLEY TRUCK
---------------------•--------- -----
:;a Order ship Uni: I+rieo Item No. Depeript4an Qty Unic P;;ico Extenplon
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L EA 374.04 =KQ000000664 77 S236 3068 WS 4LIT2/4PNL 4916 Pe? JMB 1.000 EA M 314.0A 374.04
NOCB6 WADJSILL BLDWN POtCNM? 0 DBLBDRS
DASENfENT (WACE) FIRE DOOR
24 1-00 L CA 511-60 INU000000007062 68R160 2e6G LHIS 6PNL 20MIN 4916 PFJ.JMB 1.000 EA M 5:.1.60 Sn.60
NOCSr- NP;W61 L BLOWN POLCHP14WO DBLBORP
R/0- 34-1/2"X80-.1/2p
ALLOW 1 WEPR LfiAp TIME
2S 1.00 +, PA 37S.92 INAZODOGOOD86350 DY9 ENTRANCE TRIM WITR DY31) DENTIL READ 1:000 EA M 3"5.92 375.82
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11488657 Sub $2068 .75
- Taxable 2068 :75 Tax 103 .44
Nontaxable 0.00
Invoice Total: $2172 .19
ItGni taX: 4.(J, 103.44- -
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map' �'° Parcel d r Permit# 6:ro
Health Division _' Date Issued
Conservation Division Fee � �� UC1
Tax Collector # o�t ✓ �2�j��'
Treasure
Planning Dept. r {
Date Definitive Plan Approved by Planning Board j t
Historic=.OKH Preservation/Hyannis
Project Street Address
� D I2tVi✓ l�. VtG��• �
Village IVT�fit/t (. (e I�-t 4 C� 3 r
Owner (� f L�- A L Address S E '
Telephone
Permit Request ST i �' �G D�
Square feet: 1 st floor: existing Proposed 2nd floor:existing, proposed Total new
Estimated Project Cost Zoning District d Plain Groundwater Overlay
Construction Type
Lot Size Gran athered: ❑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:❑existing ❑new size
Attached garage:❑existing ❑new size"° Shed:❑existing ❑new siie Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
�y �V ALL 2®dF//v kILDER INFORMATION
Name l2 �lEr27 -rVND Telephone Number La 0' A15 L,
Address J� License# 1
Z? SfiE're-✓t L-L-6 I'4 1 . 09-6P 3 5 Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO "T-19
.SIGNATURE �� DATE rr(3� 9
s. FOR OFFICIAL USE ONLY ti
�PERMIT NO. 3
DATE ISSUED g.
MAP/PARCEL NO.
iy •3
ADDRESS VILLAGE
t OWNER �` ti f t • r
i
DATE OF INSPECTION:
FOUNDATION
FRAME
4 t -
INSULATION
FIREPLACE `
ELECTRICAL: ROUGH FINAL t
PLUMBING: ROUGH FINALE s f r N
GAS: ROUGH FINAL
E FINAL BUILDING { r
DATE CLOSED OUT ci
ASSOCIATIONPLAN NO. F
. •'1, The Town of Barnstable
• saxtvsrnsi.E, •
9�A ' Department of Health Safety and Environmental Services
rEDMA'�A 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: 5 1 1�- C- r.D o 1= Estimated Cost T i -7
Address of Work: D IZ I V E V 1 U :9-0
Owner's Name:
Date of Application:
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 owner:
Date Contractor Name Registration No.
OR
Date Owner's Name
q:forms:Affidav
Town of Barnstable
Building Department
Complaint/Inquiry Report
°c
Date: ��%� - Rec'd by: Assessor's No-: � - 7
Complaint Name:
Location
Address:
11R/P
Originator Naine:
Street
Wage: G ,7= State• zip.
Telephone: D/E
Complaint a .
Descripdon:
Inquiry 0
Description:
For Once Use Only
Inspector's
Action/Comments Date: Inspector.
V
Follow-up
Action
Additional Info. Attached
Disaibucron: UG7ute-Dcpar=cnt File
F97 If ,{ .'„c►1�>< t•1 `�,.. w ..yl t~' '� f,M'*'Yae i if+."-, r€.a '{* ) i
",i 4 A,`i; v. . .
n� l:Er ..�!Jd;:"y
�' a! ..ri ". F 'g7 ;a..;..,,j: aw +j rr, i t, t' ��}. •.w ,. �, .4 t 9p r -
RESIDENTIAL PROPERTY _.
e:. -z3ar"'j�.„�._:^--..,i�'.s,�.,�tit u r• - S: ��s °,�I tt s � 1 E .;' " � 'x, - - _ _ f'. ^,��
pMAP NO.Yr LOT;,;NO Y' 6 t s T a ,( . ` : FIRE DISTRICT
SUMMARY
STREET+[No GRi
er View_Lane Centerville
73 LAND s� r
��+ a i ih rp avF2i4 •�> ;,� 4 BLDGS. p—^
OWNER � C--�Q TOTAL O b '0
RECORD'OF TRANSFER DATE elc. PG I.R.S. 7p LAND
REMARKS: LOtS 15,17 & 35.
E
i u BLDGS. ZOD
fr TOTAL39
LAND
Seely,�r.Coleman r C & Seely, Margaret _ 3-3-76 2305 314 ($11 ,50 .
BLDGS.
TOTAL
/�. a LAND
#k a H s l
Op BLDGS.
TOTAL
LAND
¢� $ 0) B LDGS.
ft{9ccty: ` �/PM1t 1C/ 279 GO Mn TOTAL
a=g LAND
WIN�a r � BLDGS.
TOTAL J
r„ p� R + *s LAND
BLDGS.
g7 .",'".r`. TOTAL' -,
'LAND
FINTtERIOR„INSPECTED f ' BLDGS.
„! 0) _
TOTAL I
LAND ;.
"ACREAGE-'COMPUTATIONS #
BLDGS
#yam LAND TYPE T PRICE TOTAL. °bEPR. VALUE b TOTAL ..
f"'. �# OF ACRES " . . r
LAND !
�.�}Ft"•+ — rv, /O - � BLDGS.
TOTAL
$WOODS 8�140ROUT FRONT
LAND
E RONT BLDGS.
IWAST iF 'ttwi. y,�.a"�.daai +'4 - - - t. Y
TOTAL
a #sREAR''ei ? 1
. 11, LAND
BLDGS.
{�
j-` ._e" I TOTAL
LAND
T
rH �
3 BLDGS.
LOT COMPUTATIONS
LAND FACTORS TOTAL
`` }FRONT DEPTH' r STREET-PRICE DEPTH% FRONT FT.PRICE :TOTAL: DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND
y�FL ,,Syr dD'fir t� -�: � ,. .. ., - ., ROUGH BLDGS.
M,r� �M+wlw+ �1? �y'!�pt ,r tTMY •.' ••.. 0)
TOWN WATER
HIGH ", '" GRAVEL RD. TOTAL
LOW DIRT RD. LAND
SWAMPY - � NO RD. � BLDGS. �
UNITED
L6L `Y TOTAL
r '
TOWN OF BARNSTABLE, MASS..; UNIT APPRAISAL CO., EAST HARTFORD,CONN.
one Slab'" 7"e "'; ; Bsmt."Garage�ti"e"" "t -SVShower Ext # Ir .yyalls
4' + PPURCH.PRICE
Bnck Wallsz ''L - a �!" r `Attic Fl:&Stairs • '` Toilet Room; _ w-1 C
s .
=R ENTRoof
,Attie Two Fixt.Bath tone Fn '
_t
Floors #i
'lers + i1NTERIOR FIIUISHsr •Lavatory Extra r
3smt 2- 3- Siak We
tJ f— /
PlasterK VNaterClo-Extra 3r a/
EXT` ' Knu` Pme Water Onl DORM 32•/F at-<��:Q:/ DdVL;pg1
ERIOR WALLS tty y ;°
loub�eiSldmg"y:r. �:a Bsmt Fm:.w
. •, w•.
L >. Plywood# . s No Plumbing: f
Int.Fin. � (o
Angle Siding z�'*, , `• �„^# Plasterboard' ✓' 4 , b
�vxShingles �r �, n.'._ TILING Nt7 a n. 2� /'
anc Blk r r r .., t G F. P Bath Fl..;i Heat 0 ✓� 1l
ace Brk'On �* 1k.1a out , Bath-Fl.&Warns • [S
.+ s. Y Auto Ht.Umt. r. �4Q yz, 1P �. 2l0
`4*;Veneer _ = Int Cond. ` 'Bath FI.&Walls Fireplace,
H EATING "` 1" Toilet Rm. Fl: !qq
Plumbing (� �c0, 20. 3 �ljf• iy oG XS
rolld Corn`Brk ° it i m Hot Air 'w `^� 44 •Toilet Rm.Fl &Warns.`• 3'*
'Steam -, a Toilet Rm. Fl.&Walls-, Tiling .
36,
Blanket-lns ;4 , Hot WaterB,r3- F/AF v St.Shower Z GqR � � y
toot Inar i Air Cond Tub Area Total 8 S
' Floor Fuin.'
' ' ROOFING. sr2'ZDN� COMPUTATIONS_
Osph Shingle +(mac ,Pipeleas Furn. S. F:
rYoodSShmgle g ; , No Heat,., 't. «, S.F.:
o -3
4sbs Shingle r ' bil Burner' S.F. 30.00 tp z r
xlate anyti 'Coal Stoller S.F. 7 -
ROOF• TYPE. Electric 7 . S.F. -2 3,30 1 78 - OUTBUILDINGS
;Flat S.F. / �a ,3 3 5 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASUREI
H1p,.,,x ky�y Mansard, „ 4�FIREPLACES' S.F. 17.8Q 7 Pier Found: floor �.on
Gamb"rei, .0 •? w'e" 'r, Fireplace Stack Wall;Found,. 4 O.'H. Door LISTED
y* FCO RS Fireplace, Sgle Sdg r''' Roll Roofing e_
Conc r a ;k,LIGHTING
k Dble.Sdg. Shingle Roof
Earth v. , a No Elect.' _ _ i _ t DATE
Shingle Walls Plumbing -
Hardwoo ti +� ROOMS 4 # o Cement Blk. Electric `Z 7y/77
AsPh.cTile•+q t' k: Bamt. r 4 1st r� TOTAL ,, 3 �O� �Bnck Int.Finish PRICED
�+ �—•/�
Single ¢ i r yY 2nd`#Z, 3rd s 'FACTOR
_ y
,s= 'i ,.�' ,+ ''�• '.-, ,:P,:..- ,rr ':,. '.:.REPLACEMENT''^. •7:.-dJh. t• `'-c
�, AREA , CLASS 'AGE REMOD. COND.'tT.''REPL;VAL. '4
y,",OCCUPANCY ''„ '„' CONSTRUCTION. :SIZE' 'Phy:.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL.
DWLG"� -./�� -..A+t� Flip - S X -
_s
TOTAL
ROPERTV ADDRESS j ZONING I DISTRICT CODE " SP DISTS.I DATE PRINTED I CSTATE LASS I PCS I NBHD KEY NO.
0040 RIVER VIEW LANE 10 RC 300 loco D1/04/96 1011 00 49CB R228 097. 139674
LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T\, UNIT ADJ'D.UNIT
antl Byroale sae omenson P ACRES/UNITS VALUE Descnplion AGELp WILLIAM 0 & LAURIE A MAP- -
LOC./VR.SPEC.CLASS ADJ. COND. PRICE PRICE #LAN D 1 26 800
co. FF-De mrAcres E CARDS IN ACCOUNT -
10 1BLDG.SIT 1 X .34' =10 197 39999.9S 78799.9 .34 26800 #9LDG(S)-CARD-1 1 140.200 01 of 01
#PL 40 RIVER VIEW LN CENT
BATHS 1 .1 U X B= 100 7600.00 7600.00 1.00 7600 8 #DL LOT 1517335 MARKET 131700
FIREPLACE U X j 8= 100 3900.00 3900.00 1.00 390D 8 +ERR 1376 0150 INCOM£
A USE
APPRAISED VALUE
D i A 167,000 4'
1
U j� !PARCEL SUMMARY
' S ; .1LAND 26800 !
T I ISLDGS 14020C
M I I 0-IMPS
TOTAL 167000
N I I I IN CNST
DEED REFERENCE Type DATE Amorded P R I O R YEAR VALUE
�. T I Book Page Insl. MO. Yr.D Selas Prica LAND 26800
Si 8530/1007EI,04I93 180000 BLDGS 140200
1 I 4510/264: Ib4/85 139900 TOTAL 167000
3 ; 4510/262: Ib4/85 H 1
I BUILDING PERMIT E S T I M A T E D-8 3
jj Number Date Tyne Amount
LAND LAND-ADJ I INCOME SE ( SP-BLDS FEATURES SLD-ADDS UNITS
26300 11500
Class Cnn s1 Total Base Fale Atlj.Rate Vear Built Age Norm. Obsv. CND. Loc. ^h R.G. Re I.Cost New Ad'.Re I.Value Stories Mei hl Rooms ed Rms Baths aFia. Periywall Fac.
us un^s A4 119 DeDr. tend. p p g
018 000 115 115 72.15 82.97 72 80 14 87 100 87 161098 140200 1.5 6 3 1.1 6.0
Desc.iplion Rale Square Feel RepL Cosl MKT.INDEX: 1-00 IMP.BY/DATE: / SCALE: 1/0 0.61 ELEMENTS CODE CONSTRUCTION DETAIL
BAS 100 82.97 936 77660 GROSS AREA 86 SINGLE FAMILY DWELLING CNST GP:00
' FSF 90 74.67 32 2389 N- *---12--*----19----*
FFG 30 24.89 506 12594 *----- STYLE _04CAPE
CO-
D _ _0.0_
t 23-----*------- -36--FSF--*-* fMP ! ESIGN ADJMT 03DES.IGN ADJUST 15_
1SB 100 82.97 210 17424 ! FFG i
1 EXTER.WA 07 WOOD FRAME 0.
FMP 55 5.50 279 153.5 ! 11 17 HLAY/AC _lLS T1fOE 02GA3---------------0-
FSF 90 74.67 72 5376 ! ! ! ! INTER.KIN ISH 00 0.0
815 42 34.85 936 32620 22 20 ! ! AITER.LA�O0 y
_01 _________________ 0-0
I 26 BASE -15--- I NTER.QUALTY 02SAME AS E_X_T_ER. a 0
! ! 1SB ! F100R_STRUC_7 00 _________ 0.0
D W! ! 14 14E LOOR EOVER 00 - ------6=d
E TolalA,eas Aua = 785 Bas 1250 *-----23-----* ! ! bad TYPE---- -00 ------------------ 0_0
e -- -- -----------------
BUILOING DIMENSIONS --S=A
T SAS W16 FSF SO4 W08 N04 E08 .. *- 20*-8-*----16---X---15---* FOUN6ATI6N 00 -----------vq.9
A SAS W20 N26 FFG NO2 W23 S22 E23 ---- 4FSF4 -------------- " --- ---------------------
N20 . . SAS E36 Sll 1S8 E15 S14 *-8-* -----NETNff60kH00D 44C8 CENTERVILIE
L W15 N14 .. FMP E15 N17 W19 FSF LAND TOTAL MARKET
W12 S06 E12 N06 .. FMP S06 E04 PARCEL 26800 167000
Sll .. SAS S15 .. AREA 7363
VARIANCE +0 +2168
STANDARD 25
Assessor's map and'lot 'numbertJ. f.
SEPI4C SYSTEM! MUST BE
INSTALLED IN COMPLIANCe
Sewage Permit number .................... ..:.........}........ . ............ _ WITH ARTICLE II STATE +
SA��i1T�',RY CODE AND TOWIM
TOWN OF` BARNST'A'B� E
_i i BAEBSTAnLE,
Y 9� IAA�9 1RUILD�ING INSPECTOR
71
o wpY A .
m tz E,
ti APPLICATION 'FOR PERMIT TO. " . � Jr'1�`.: •• ` .• •
,z _ �Srh'��..
TYPE OF .CONSTRUCTION .....................1..:...... .......... ......................
�Y ../.Y.kAR.0 rH... _ . .19•747
TO THE INSPECTOR OF.BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ............................:..............2k1` 4v'...... �
.......................
ProposedUse ...........................� �.!�/�.T!�............................../l�ll..—... ................................................ .... .
Zoning District ........�2::1 ....................................................Fire District ...........................
Name of Owner ......� . .........Address ........... i�g... .....................
Name of Builder t ! Gf it
...............�.......:...........................................Address .................................................................,.......:..,.......
Nameof Architect ............../�......................:..... :....................Address ...................9-1 ....................... .................................... •
Number of Rooms ...................... .................•....................::.Foundation ..... .......l...G�ll/.5� f,..:�Qf���.......................
Exterior Vll.'.l�.r.... !g:�itl� ........: Roofing tr1�.......................
...... . ....
Floors ....Interior ........ EtE�!P ....................... .......................
............ :..............:.............
Heating !/i,�:..........................94. .. ............:...Plumbing ........ r ...............................................:..
. ...Approximate Cost
Fireplace ......... ..................................................................... ............... ............yy��
Definitive Plan Approved by Planning Board -------------------------------19________. Area ... ..70..�n.. ..t...............
Diagram of Lot and Building with Dimensions
Fee .... ...... ..
SUBJECT TO APPROVAL OF BOARD OF HEALTH
,L 14N- �l
I�
a 71
�
.3
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ".. . . •. •...:a....... .. . .. .........................
� 18279 4oelman Seely
No A.827.9.... Permit-for .:.1) wall.i. ....... ......
f
LocationD..lt3uru?ex ..Laxae....t..... '=. ....... (a Y
4 - ......Centerville
Owner ...............Coleman•.Se.eLy........................
T' a of Construction� gyp� .....Fr.gme. ... .................
.......... ............. . ...................................................
Plot ............................ Lot .................................
Permit Granted ............. .....Apri.l:.;2....:1976 Z '
Date of Inspectiond .. ..
Date Complete � �. .. ...........:.19
PERMIT REFUSED {'r
................................... •19
........ ............. ........... . ................
`............................................................. ti r . .✓ _/' :s
} ......................... ........ .......................................
....'.:..................................................
Approved ,.�
..................... .........................................................
•
BY N- DATE SUBJECT SHEET NO. OF
CNt�tS. BY DATE _ _ JOB NO.
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