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'Cape Save Inc.
7-D Huntington Avenue
South Yarmouth, MA 02664
Tel: 508-398-0398 Fag: 508-398-0399
3/25/19 `
Brian Florence CBO
Town of Barnstable
Building Division 00 ;CP
200 Main St.
Hyannis,MA 02601 w
N
RE: Insulation Permit 19-472
Dear Mr. Florence:
This affidavit is to certify that all work completed for 117 South Main Street, Centerville has
been inspected by a third party Certified Building Performance Institute(BPI)Inspector.
tI
All work performed meets or exceeds Federal and State Requirements.
Sincerely,
0.
William McCluskey
a
. . Town of Barnstable
i+: �A8�N"Gt7'aC Ap BLEt�. .•._.:. WPo"h,s.,.t-..:.$T haU£s C,sC`"e'ar" hall..N.ok t.b' ez�O�c c:u� iedh Building
un�ti l,a,F';:i n�a,l I�n'spa e,.c��tTi�on.�h'„za.s.v.•r'.b`"se.'-;.e�n• mad.;
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Permit NO. B-19-472 Applicant Name: William McCluskey Approvals
Date Issued: 02/14/2019 Current Use: Structure
Permit Type: Building-Insulation-Residential Expiration Date: 08/14/2019 Foundation:
Location: 117 SOUTH MAIN STREET,CENTERVILLE Map/Lot 22228\129 Zoning District: RC Sheathing:
Owner on Record: BRENNAN,TIMOTHY Contractor NamehWILLIAM 1 MCCLUSKEY Framing: 1
Address: 117 SO MAIN STREET ContractortLcen se CSSL-102776 2
I :,. .
CENTERVILLE, MA 02632 Este Project Cost: $5,000.00 Chimney:
01
Description: Add R-38 fiberglass, R-10 rigid insulation, andiF 37"cellulose to the Per in ,e: $85.00
Insulation:
attic.Add R-10 rigid insulation to the crawlspace Air seal the attics
,: Fee Paid: $85.00
plane and basement with expanding foam. General weatherization. Final: y Q
( I � Date 2/14/2019
Project Review Req:
. Plumbing/Gas
i Rough Plumbing:
� % Building Official
. � .. Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months^after issuance.
All work authorized by this permit shall conform to the approved appl ci aYion'andthe approved construction documents for which this permit has been granted. Rough Gas:
max' ..
alterations and chan es of use of an buildin and structures,'shallgbe in compliance with the local zoningby-laws and codes.
All construction, g Y g P ,. � '
Final Gas:
P displayed Y
This permit shall be dis la ed in a location clear) visible from access street or roa&5nd shall be maintained open for,public inspection for the entire duration of the
work until the completion of the same. ,
" Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are providetl)on this;permi_t.
Minimum of Five Call Inspections Required for All Construction Work: ` Service:
1.Foundation or Footing
`�
Rough:
2.Sheathing Inspection .,
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:
6.Insulation
7.Final Inspection before Occupancy Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
Work shall not proceed until the Inspector has approved the various stages of construction.
Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).
Fire Department
Building plans are to be available on site
s
Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
"FAR mm um
IV
TOWN OF BARNSTABLE ��r""a ,t t , .•
BUILDING DIVISION
367 MAIN STREET,.,
HYANNIS,MA 02601 "{
P 015 496 606
,rohd
�4.
�E ;OrEq 1 st NOTICE 1211-7
SENDER
end NOTICE MIN DECKED RETURN
Unclaimed,✓Refused
Attempted-Not known
Insufficient Address '
No such street Number r }
Box Cksed-10i Order _
Atoned,Lek No Addrt,-
D SENDER:
I also wish to receive the
y • Complete items 1 and/or 2 for additional services.
m Complete items 3,and 4a&b. following services (for an extra m
` Print your name and address on the reverse of this form so that we can V '
(1) return this card to you. fee):
m • Attach this form to the front of the mailpiece,Kor on the back if space 1. ❑ Addressee's Address N
j does not permit.
t Write"Return Receipt Requested"on the mailpiece below the article number. 2. ElRestricted Delivery 9 I
_` " • The Return Receipt will show to whom the article was delivered and the date d
c delivered. Consult postmaster for fee. d
j o 3. Article Addressed to: 4a. Article Number
j o �Jje�oarf paeciglists
P 015 496 606
out in 4b. Service Type
M E Centerville, MA 02632 ❑ Registered El Insured
I j y C cm
Certified ❑ COD y
\ j W ❑ Express Mail ❑ Return Receipt for
( G Merchandise
7. Date of Delivery
i Si ature (Addressee) 8. Addressee's Address (Only if requested Y
and fee is paid)
eo
• /— - .. ._Signature (A§ent)
•---.. -- —moo c'
- P orrm_3.8 D_:eciemtierrb991 a��._c r��t DOMESTIC RETURN RECEIPT
18
-1.3 RC, RD, RF-1 and RG Residential Districts
1) Principal Permitted Uses: The following uses are permitted in
the RC, RD, RF-1 and RG Districts:
_.. _. A) Single-family residential-dwell ing .1detached)
2) Accessory Uses: The following uses are permitted as accessory
uses in.theRC, RD. RF-1 and RG Districts:
A) Keeping, stabling and maintenance of. ,horses subject to the
provisions of Section3-1.1(2) (B) herein.
3) Conditional Uses: The following uses are"permitted as
conditional uses in the RC, RD, RF-1 and <RG..;Districts, provided
a Special Permit is first obtained from ihe 'Zoning Board of
Appeals subject to the provisions of Section -5-3.3 herein and
-subject to the specific standardsfor such conditional uses as
._ required in this section:
A) ' Public or private regulation golf 'courses"'
subject to the
provisions of Section* 3-1.1(3) (B) herein.
B) Keeping, -stabling and maintenance of- horses in excess of
t .., - ^Vlc1 I1t^a r t CFI '( !1 ? � fl ) !"ere;
either on the care or adjacent lot as the principal
building to which such use is accessory.
Family Apartment subject to the provisions of Section 3
1.1(3) (D) herein.
D) Windmills and other devices for the conversion of wind
energy to electrical or mechanical energy, but only as an
accessory use.
4) Special Permit Uses: The following_ uses are penrt+2_taea a .
special permit uses in the RC, RD, RF-1 and RG Districts,
provided a Special Permit is first obtained from the Planning
Board:
A) Open Space Residential Developments. subject to the
provisions of Section 3-1.7 herein.
5) Bulk Regulations:
ZONING MIN.LOT MIN.LOT MIN.LOT MINIMUM YARD MAXIMUM- BLDG.
DISTS. AREA FRONTAGE WIDTH SETBACKS IN FT. HEIGHT IN FT.
Q
. AS .FT. IN FT. IN FT. -------
.. FRONT SIDE REAR
1
RC 43560 20 100 20 # 10 10 30 *
RD 43560 20 125 30 # 15 15 30 *
RF-1 43560 20 12.5 30_ # 15 15 30 *
RG 65000 20 200 30 0 15 15 30 *
4r $
t r aL' NAME'OF6FFEN ,ER r.: r �,�;� �` t '., W ..
Jyr' Ir < r'O,�% r/yi V o ¢o
•- TOWN OF ADDRESS OF OFFENDER
BARNSTABLE CITY.BT ZI�CODE `h r I j ti W m c,
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MV/MB REGISTRATION NUMBER •� r
RA
NSIA OFFENSE I i.jn rf+
Ir MASS
t679 `I
TIME AND DATE VIOLATPIr
� I P.M. O ,�' LOCATION OF`VIOLATION - - w - I m rn
NOTICE OF;, /� '/.5' ) N �-' �' is - -,�fr .: Q Z i
�i SIGNATUflE•OF'ENFORGI ERSON+',• - ENFO CING DEPT:•, BADGE NO. Lu
VIOLATION'. r. ./. �/ fr'rl._«2✓ �.... . }'
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OF,TOWN r.HEsv ACKNowLEDG RECEIPT OF CITATION X a Q o
ORDINANCE It=Tunable to obtain sig ature of;offendec; 4` - I o
THE NONCRIMINAL' FINE FOR THIS OFFENSE IS $, � mil' o a o
} Date mailed J' w x
ORj YOU HAVE THE FOLLOWING ALTERNATIVES.WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPITON(1)OR OPTION(2)WILL OPERATE AS,A FINAL ,, r a o n
1, DISPOSITION WITH NO RESULTING CRIMINAL RECORD. - o — o
REGULATION, , You may elect to a the above fine either ti a earin in person between 8`.30 A M.'and 4:00 P.M.,Monday throw h Frida legal s excepted, w R.
1) Y pay, Y'appearing P Y 9 Y� 9 Y P
before: The Barnstable Town Clerk'367*Main.Street, Hyannis, MA.02601,�br by.mailing a check, money order or postal note to Barnstable Clerk, �' < m <
P.O.Box 2430,Hyannis,-MA 02601',WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE T. I
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^ (2),If you desire to contest this matter in a noncriminal proceeding, yyou'may do so by-making written request_to.DISTRICT COURT DEPARTMENT,
I FIRST BARNSTABLE DIVISION•COURT.COMPOUND,MAIN STREET BARNSTABLE,MA02630'Att:21DNoncriminalHearingsandenclose'acopyofthiscitation 1 a �, 3'
�I far a hearing. S oC o
(3)If you fall to pay the above offense or to request a hearing within 21'days or if you fall to appear for the hearing or to pay any fine determined'at the
hearing to be`due,criminal complaint may be Issued against you. : l I z z
V m
0 I HEREBY ELECT the-first option ab*6e confess too the offense charged and.enclose payment in the amount of.$
If} "Signature .. r •.Y - r -2 ` w:t ' _ •- S- s :,-� N -. _, _
TO OFFENDER: �
Failure to obey this notice within 21 days
after the date of violation may result in a Stlam
criminal complaint being issued. DO NOT - :,.,r. `Here
MAIL CASH. Post Office I `'
will not deliver
without stamp
MAIL TO:
BARNSTABLE CLERK
- -__�.- P:Oe-BOX---2430-- -
HYANNIS, MA 02609-2430 .... i ,
C ' r ea NAME OFEENBEH Lot!
m
_' (, %_15_C!_f,'a='yr g*`' + �ar%f ✓t�..1�an'-/ ®
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TOM O � ADDRESS'OF0 E DER
BARNSTABLE CITY,STp 0 r 'R `'� 5� Ir ;O ¢O
Larne vEui X.
tME Q
ipw MV/MB REGISTRATION NUMBER O
'. 00 0
•y I'IAH\tiI AY .. OFFENSE
FFENSEe r ' . � LL
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TIME AND DATE OF VIOL LOCATION OF VI UATION zo
NOTICE OF... ,? (a. .i Pk)oN .l W 3
SIG~ URE OF ENF.ORCI ERSON ENFORCING DEPT ( E NO.; - W o
VIOLATION BADG---""' .> O
f OF TOWN : I FjEREBY,ACKNOWLEDGE RECEIPT OF CITATION X. ,1 ii `.
f ORDINANCE Unable to`.'obtalq sl nature of offend �•, W.
THE NONCRIMINAL FINE FOR-THIS'OFFENSEIS S "Ga �4'J �'
OR 'Date rnailed — .S _ .. w ; I ' o a o
YOU:HAVE THE'FOLLOWINGALTERNATIVES,WITH REGARD TO DISPOSITION OF THIS MATTER.:EITHER OPITON(1)OR:OPTION,(2)WILL OPERATE AS'A FINAL CL it m w r" i
DISPOSITION WITH fV0 RESULTING CRIMINALRECORD? ' w
v.o.v ,
REGULATION Q : •A X'y.
u 111.You may'elect to:pay the above fine,either by.appearing in person between 8:30 A M and 4:00 P:M.,.Monday through Friday,legaILholidays excepted,
before:,:The Barnstable Town Clerk'-367 Main.Streel, Hyannis,,MA 02601,or by:mailing a check, money order-or postal note to-Barnstable Clerk,
P.O.Box 2430,Hyannis;MA 02601,WITHIN'TWENT.Y-ONE(21)•DAYS OF THE DATE..OF THIS NOTICE D o
0
(2I If you desire to contest this matter in",a:noncriminal proceeding,you may do so by written request to DISTRICT,000RT,DEPARTMENT; H ~ ti '
FIRST BARNSTABLE DIVISION,COURT,COMPOUND,MAIN STREET,BARNSTABLE,MA02630,Alt:21D Noncriminal Hearings and enclose acopy,ofthis"citation
l for a hearin — z m 1
P ;131,lf you fail to pay the above offense or to request a hearing within,2f,days;or if you fail'to appear for the heanng'o�topay any fine delermmed at the 7 m
;hearing to be due criminal complaint_may be.issued"against you:
K ❑FI HEREB ELECT the first option ab
Y ove confess to the.offense charged and enclose payment in the,amount,of$
3 j
1 4 Signature - ;.. u�• a. Y•�; -a , ,,. .. `�� ,�i � r � r 1
k5 1,'Z Z
TO OFFENDER:
Failure to obey this notice within 21 days Place
after the date of violation may result in a scamp
criminal complaint being issued. DO NOT Here
MAIL CASH. Post Office
will not deliver
without stamp
MAIL TO: i
BARNSTABLE CLERK �
---- ----- T- P:O.-BOX-2430-
HYANNIS, MA 0.2601 2430
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P 015 496 618.
Receipt for
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Am= Do not use for International Mail
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m. Return Receipt Showing to Whom,
C. Date,and Addressee's Address
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TOTAL Postage
C .&Fees
0' Postmark or.Date
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STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front).
N
1. If you want this receipt postmarked,stick the gummed stub to the right of the return address �
leaving the receipt attachtld and present the article at a post office service window or hand it to
your rural carrier(no extra charge).
1. If you do not want this receipt postmarked,stick the gummed stub to the right of the return
address of the article,date,detach and retain the receipt,and mail the article. 00
3. If you want a return receipt,write the certified mail number and your name and address on a C
return receipt card,Form 3811,and attach it to the front of the article by means of the gummed .y
ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT
REQUESTED adjacent to the number. C
4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M
endorse RESTRICTED DELIVERY on the front of the article. E
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5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL
return receipt is requested,check the applicable blocks in item 1 of Form 3811. 0)
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6. Save this receipt and present it if you make inquiry. 102595-93-Z-0478
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P 015 496 , 606,
3 Receipt for
Certified. Mail
® No Insurance Coverage Provided
Do not use for International Mail
(See.Reverse)
San,"Blueboard Specialists.
.Street a�d1NP`South Main S t.
P.o.:stt&In�6PVlelle, MA 02632
Postage
Certified.Fee -
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing
p� to Whom&Date Delivered
m Return Receipt Showing to Whom,
C Date,and Addressee's Address
TOTAL Postage.
C &Fees
0 Postmark or Date
M,
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STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front).
1. If you want this receipt postmarked,stick the gummed stub to the right of the return address y.
leaving the receipt attachbd and present the article at a post office service window or hand it to
your rural carrier(no extra charge).
CC
2. It you do not want this receipt postmarked,stick the gummed stub to the right of the return —
address of the article,date,detach and retain the receipt,and mail the article. 0>
3. If you want a return receipt,write the certified mail number and your name and address on a c
return receipt card,Form 3811,and attach it to the front of'the article by means of the gummed
ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT
REQUESTED adjacent to the number. C
4. If you went delivery restricted to the addressee,or to an authorized agent of the addressee, M
endorse RESTRICTED DELIVERY on the front of the article. E
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL
return receipt is requested,check the applicable blocks in item 1 of Form 3811. a•
6. Save this receipt and present it if you make inquiry. 102595-83-z-0478
w TOWN OF BARNSTABLE BUILDING PERMITAPPLICATION
Map Parcel Permit# ✓
Health Division /u0 A� 000)5 Date Issued l 9
Conservation Division l / Fee ��
Tax Collector
S PT S�STEW"119EE
Treasurer Lam- / ���S'9� IN T LLED IN COMPLIANCE
Planning Dept. WITH TITLE 5 ONMENTAL CODE AND
Date Definitive Plan Approved by Planning Board n ; T® bWN REGULATIONS
• 4 ,�y 1U
Historic-OKH Preservation/Hyannis
Project Street Address L,(�laI� Ij 14 �. CL
Village
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Owner �� �O�l`� (��,� �• � N i��CIV Address %7
Telephone I "I ��o �O Cloak
' .-
Permit Request
(/ ✓ - 0" w�
_Square feet: 1 st floor:existing proposed S:f2nd floor":'existing proposed Total new
Estimated Project Cost 301 o 0 0 Zoning District f Flood Plain Groundwater Overlay
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 N 1012Historic House: ❑Yes bmo On Old King's Highway: ❑Yes kNo
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
" t Type and Fuel: ❑Gas , Oil 0 Electric ,' ❑Other
Central Air: ❑Yes p XNo Fireplaces: Existing • New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing new size a4 Pool:❑existing ❑new size Barn:❑existing O 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 `
r
BUILDER INFORMATION
Name Telephone Number
Address I t SnIA i N MA, S'1 License#
Cit✓1� V LL j& N Qj(�L Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTI OM-THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY t '
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a' L
PERMIT,NO.
DATE ISSUED .,,. a t L
MAP/PARCEL.•NO. w�� `• r «.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTIfO14: �'• ' : _
FOUNDATION r . l/ G /C 91
• FRAME =` .C'
_� fir•.^ ,{�'�.� t � f� ;' t�(/J�N/1, ���`i ,t� �- '- j 7`• r y ` - • -. ` fa r.'
INSULATION' 1 _ 1 2 '✓ y d
FIREPLACE
E_LECTRICAL: -ROUGH ' FINAL'
PLUMBING: R0UG.I�-•� FINAL ;
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT : '
ASSOCIATION PLAN NO03 ` �' ;•� % '
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•'•.•.. Remember Lujean Printing
for all your printing needs!
4.28-8700 0+507 Falmouth Road (Route 28),Cotuit
TIMOTHY D. BRENNAN ;a :
117 SOUTH MAIN STREET
CENTERVILLENA 02632
(508) 771-3098.
September 10, 2001
To: Mr. Richard StevensfT.O. BARNSTABLE- BUILDING DEPT.
This letter is an affadavit concerning my intended use of my newly
constructed garage, approved by the T.O. Barnstable Building
Department in July 2001. `
The room in the downstairs will be used as a mudroom/ breezeway/
hallway/ cleanup area. It is not now, nor will it ever be', used as a
bedroom. The upstairs area will be used as a gameroom with home
theater.
This letter is intended for my file as requested: If there are any
questions, please call the above listed telephone number.
im Bren n
x
i
Parcel Detail Page 1 of 3
1 f
SMOG/'
Logged In As: Pa r Tuesday,J
Parcel Lookup
Parcellnfo
.......
Developer i
Parcel ID�22 8-129 Lot
Location 117 SOUTH MAIN STREET Pri Frontage,100
Sec:
Sec Road PHEASANT WAY i 150
Frontage
......... ............_................................................................... ......................... ......... ..... ....
village CENTERVILLE Fire District IC-O-MM
............... ....................................................... ......... .........
Sewer Acct• Road Index 1507
-
Interactive
Map s
Owner
__
Owner E BRENNAN, TIMOTHY Co-owner
................................ ..................................
Streeti .117 SO MAIN STREET Street2
City jCENTERVILLE state MU zip,02632 Country US
Land Info
.. .........
Acres 0.34 use Single Fam Mn-01 Zoning RC Nghbd 0108
_.....
Topography:Level' Road Paved
utilities'Public Water,Gas,Septic Location E
Construction Info
Building of
Year 11950 Roof Gable Ext-Wood Shingle J
Built Struct Wall-
Effect .-...... . Roof - _... AC
Area 12229 ,.,. _.. ._...... ,,,,.
Cover?Asph/F GIs/ Type None
Int. Bed
Style Cape Cod Wall;Drywall Rooms:3 Bedrooms
Int- Bath
Model IReslde' .,, Floor Carpet Rooms 12 Full
Heat _._...�._._ Total
Grade Average Type;Hot Water Rooms 7 Rooms
http://issql/intranet/propdata/ParcelDetail.aspx?ID=16094 7/3/2007
Parcel Detail Page 2 of 3
ray 7 il��1j r � iP 9
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....... _. Heat Found-
stories 11 1/2 Stories Fuel;Oil ation!Typical g (
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Permit History
Issue Date Purpose Permit# Amount Insp Date Comir
11/19/1999 Out Building 42527 $30,000 1/1/2001 12:00:00 AM DET C
12/11/1996 Remodel 19901 $5,000 9/8/1997 12:00:00 AM Redo [
8/7/1996 Remodel 17097 $5,000 2/15/1997 12:00:00 AM
Visit ................_,_.. ..............._.-__......_......__.
Date Who Purpose
1/30/2001 12:00:00 AM Martin Flynn Meas/Est
9/8/1997 12:00:00 AM Lloyd Kurtz Meas/Listed
6/1/1997 12:00:00 AM Lloyd Kurtz Meas/Listed
2/15/1997 12:00:00 AM Lloyd Kurtz Meas/Est
Sales History_ . _. -
Line Sale Date Owner Book/Page Sale P
1 1/15/1996 BRENNAN, TIMOTHY. 9998/152
2 BUCKLER, CHARLES W& ELAINE 779/60
Assessment History
Save# Year Building Value XF Value OB Value Land Value Total Parcc
1 2007 $187,000 $2,600 $41,400 $221,600
2 2006 $178,900 $2,600 $42,300 - $203,300
3 2005 $159,300 $2,500 $43,100 $186,400 ;
4 2004 $128,000 $2,500 $43,600 $155,400
5 2003 $113,400 $2,500 $44,500 $61,700
6 2002 $113,400 $2,500 $44,500 $61,700
7 2001 $96,400 $2,600 $0 $61,700 ;
8 2000 $82,700 $2,800 $0 $33,500
9 1999 $82,700 $2,800 $0 $33,500 ;
10 1998 $82,700 $2,800 $0 $33,500
11 1997 $94,400 $0 $0 $26,800
http://issgl/intranct/propdata/ParcelDetail.aspx?ID=16094 7/3/2007
Parcel Detail Page 3 of 3
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12 1996 $94,400 $0 $0 $26,800
13 1995 $94,400 $0 $0 $26,800
14 1994 $87,700 $0 $0 $30,100
15 1993 $87,700 $0 $0 $30,100
16 1992 $99,900 $0 $0 $33,500
17 1991 $102,700 $0 $0 $53,600
18 1990 $102,700 $0 $0 $53,600
19 1989 $102,700 $0 $0 $53,600
20 1988 $73,900 $0 $0 $32,500
21 1987 $73,900 $0 $0 $32,500
22 1986 $73,900 $0 $0 $32,500
Photos
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ty • Complete items 1 and/or 2 for additional services.
N • Complete items 3,and 4a&b. following services (for an extra 4;
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4) return this card to you.
d • Attach this form to the front of the mailpiece,or on the back jT sQace 1. El Addressee's Address y
Les not permit. x°\S •,
t Write"Return Receipt Requested"on the mailpiece below the article number. 2. ❑ Restricted Delivery 0.
• The Return Receipt will show to whom the article was delivered and the date
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The Town of Barnstable
• anxxsrnsr.E, . .
1M6A39.4� `0�' .Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
PLAN REVIEW
Owner: P�� 2 �►`-� . Ma /Parcel:
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Project Address: ` ` J Ai Builder:
The following items were noted on reviewing:
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Inspected by:
Date:
q:building:forms:review
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BUILDING SETEdACK LINES(n'T')
ASSESSOR'S MAP 228 -
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- IA:O ��/ \ DATED FEBRUARY 20.19FO AND-RESUBMVMOM AN a LOTS N CEN?'ERVILLE.MASSACHUSEI TS
P VRCII 45.0' PROPERTY OF JO N COLLINS'BY HEARSE 3 KVUC)r CIVIL ENGINEERS CFNTER4LLE.MASSAFHUSTFTS
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ARA SEPTEYBER.1952.CAR AGE �/ S. PROPERTY IS LOCATED IN FLOOD ZONED PER SARNSTABLE 1
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EX. _ s. EASTINC CONDITIONS AS SHOWN ARE TAKEN FROM A GROUND SHOT%RVrN
511Eg1 2t"O AS PERFORMED BY ATLANTIC DE9GN ENGINEERS.LIC ON AUGUST 11. 1999.
'
1 SEsA\�OD \ EXISTING SEPTIC SYSTEM SHOtAN IS APPROXI4 ATE VnLr AND TiIE CONIRACTMt
%'ALL BE RFSPONS113LE FOR VERIFICATION V ALL LOCAUQNS AND
RIM AND INVERT ELEVATIONS. I
6. IT IS DIE CONTRACTORS RESPONSI91UTY TO NCTIFY DIGSAFE. THE TOWN OF?ARNS'TABLE DPW, f(
AND ALL UTLITY COMPANIES A MINIMUM OF 72 HOURS PRIOR TO CONSTRUI:TION ACIIVO7IES
\ _ FOR LOCATION Of'ALL UNDERGROUND UTILITIES AND UTILITY CCU-MY ANDOPW APPROVALS- T
7. SI 7 IS NOT IN A WATERSHED PROTECTION DISTRICT. {
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9� � : �' Department of Health Safety-and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
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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: 6te5-tAnn&'( n Est.Cost 36 nb0.
Address of Work: �� S0LI-1A M aN 1�s_\ffLL6
Owner's Name ll0A1jjjl d Nlam!
Date of Permit Application:
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
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
_ The Commonwealth of Massachusetts
......... Department of Industrial Accidents
Oflleeol/otrestigatioos
600 Washington Street
Boston,Mass. 02111
Workers' C�om ensation Insurance Affidavit
name '" -T
location: I �!OIA T t✓ X 1 t 5-1�
v 1, Ac hone# SQ9 211 ' a
I am a homeowner performing all work myselL
Cl I am a sole roprietor and have no one working in anyca
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❑ I am an employer providing workers' cens�tion for mq employees working on this job. :::::::::::::
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FaOa:e to seeore coverage as requited meder Section 25A of MM 152 eau lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of luvestigadons of the DIA for coverage veriSeation.
1 do hereby certify under the p 'is pmakies of perjury that the information provided above a iruo and correct
Signs Date 7
Print name Pt�t Phone# `1 R
ofncw use only do not write In this area to be completed by city or town official
city or town: pern t Ilene# [I Mding Department'
❑Licensing Board
❑eheckif Immediate response is required ❑Selectmen's Office
❑Health Department
contact person: phoebe#; - ❑Other
r
Wvvmd 9/95 PJ4
Information and Instructions
Massachusetts General Laws chapter 152 section,25'requires all employers to provide workers' compensation for their
employees. As quoted from the`law",an employee is defined as every person in the service of another under any contract
Of hire,express or implied,oral or written.
An employer is defined as an individual,partaetship,association,corporation or other legal entity, or any, two or more of
the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,'or the receiver or
trustee of an individual,partnership,association,or other legal However the employing employees. Howe the owner of a . _
dwelling horse having not more than three apartments and who resides therein, or the occupant of the dwelling house of
another who employs persons to do maintenance, construction,or repair work on such dwelling house or an the grounds or
butiming appurtenant thereto shall not because of such employmcat be deemed to be an employer.
MGL chapter 152 section,25 also states that every state or local licensing agency shall withhold the issuance or ircenewal
of a license or permitto operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the
coanu Ion nor any of its political subdivisions shall carter into any contract for the performance of public work until.
acceptable evidence of compliance with the insurance requires of tbis chapter have been presented to the contracting
au thorhy _
Applicant
Please fill in the workers' compensation,-affidavit zm apletely,by.checlang the box that applies to your situation and
supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of lndustnal Accidents-for-won of insurance coverage:- Also fie sui�e'to sign and
date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is ,
being requested,not the Department of Industrial AccideWL -Should you have any questions regarding the"law"or if you
are required w obtafi i woz ' p policy,plaise run the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a,space at the bottom of ilie
affidavit for you to fill out in the event the Office of Investigations,has to contact you regarding the applicant. Please
be sure to fill in the p r ih mumbar which will.be used is a reference number. The affidavits m-ay be re amR-io
the Department by mail or FAX unless otter aurangemeats have been made; - .._. _..
The Office of Investigations would lu'ke to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call. .
IWE
The Department's address,telephone and fax number: -
Ile Commonwealth Of Massachusetts
Department of Industrial Accidents
Me of Investigations
600 Washington Street
Boston,Ma 02111
fax#: (617)727-7749
phone#: (617) 727-4900 eat. 406, 409 or 375
I
RIGHT-J SHORT FORM
Entire House
E.F. WINSLOW PLUMBING & HEATING Job: 1118199
8 REARDON CR.,S.YARMOUTH,MA 02664 Phone:394-7778
For: TIMMOTHY BRENNAN
GARAGE-117 SOUTH MAIN ST, CENTERVILLE, MA 02632
Htg Cig Infiltration
Outside db(OF) 0 90 Method Simplified
Inside db(OF) 72 72 Construction quality Average
Design TD(OF) 72 18 Fireplaces 0
Daily range - M
Inside humidity(%) - 50
Moisture difference(gr/lb) 25
HEATING EQUIPMENT COOLING EQUIPMENT
Make n/a Make n/a
Trade n/a Trade n/a
n/a n/a
n/a
Efficiency n/a Efficiency n/a
Heating input 0 Btuh Sensible cooling 0 Btuh
Heating output 0 Btuh Latent cooling 0 Btuh
Heating temperature rise 0 OF Total cooling 0 Btuh
Actual heating fan 379 cfm Actual cooling fan 379 cfm
Heating air flow factor 0.024 cfm/Btuh Cooling air flow factor 0.043 cfm/Btuh
Space thermostat Load sensible heat ratio 79 %
ROOM NAME Area Htg load Cig load Htg AVF Clg AVF
(ft2) (Btuh) (Btuh) (cfm) (cfm)
LOFT 552 15303 8027 361 347
BATHROOM 35 763 717 18 31
Entire House d 587 16066 8744 379 379
Ventilation air 0 0
Equip. @ 0.95 RSM 8306
Latent cooling 2381
TOTALS 587 16066 10688 379 379
Printout certified by ACCA to meet all requirements of Manual J 7th Ed.
wrightsoft Right-Suite ResidentialTM 5.0.14 RSR20811 1999-Nov-08 16:45:53
F:V IEATLOSS\OFHA.RSR Page 1
f N Building VivisiOn
f 367 Main Street,Hyannis MA 02601
t�
Office: 508-862-4038 Ralph Crossen
'p Fax: 508-790-6230 Building Commission:
HOMEOWNER LICENSE EXEMPTION
G Please Print
DATE -1 ,,t� l,
JOB LOCATION: I I 1 �O I"�Q u, `-7/4 C-e K � R'VL "
uturnber street village
"HOMEOWNER": W-0 3'L ���(/� 7 /
ttame home phone# work phone s
CURRENT MAILING ADDRESS: `7 zz wx e O, �y to
city/town stare zip code
The current exemption for"hors"was extended to include ow�r er-occupied dwellings of six units
or less and to allow homeowners to engage an individual for hire who does not possess a license,
that the owner acts as cry_
DEFIIVTT'ION OFHOMEOWNEIt
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 resoonsi'ble for all such work performed under the building permit.
(Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and
other applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building
Department minimum inspection procedures and requirements and that he/she will comply with said
procedures and irements.
Signanae of H er
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
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
person(s)for hire to do such work that such Homeowner shill act as supervisor."
Many homeowners who use this exemption a unaware that they are assuming the responsibilities of a supervisor(see
re
Appendix Q.Rules&Regulations for Ltcctsing Construction Supervisors.Secdon 2-15) This lack of awareness often results in
serious 'problems. arti when the homeowner hires unlicensed persons. In this case.our Board cannot proceed against the
s pro p �Y
unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor's 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. On the last page of this issue is
a form currently used by several towns. You may care to amend and adopt such a formicertification for use in your community.
QXORNIS:EXENIMN
BgSTO l SAYS® & GRAVEL CO.
227.9000
FAX (617) 523.7947
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77 5 3
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"FIRST AND FINEST"
10ST0N SAND & GRAVEL CO.
227-9000
FAX (617) 523.7947
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"FIRST AND FINEST"
TOWN OF BARNSTABLE
DEPARTMENT OF HEALTH SAFETY AND
ENVIRONMENTAL SERVICES
BUILDI
NG DIVISION
i
STOP WORK
THIS STRUCTURE AND/OR PREMISES HAS BEEN
INSPECTED AND THE FOLLOWING VIOLATIONS
OF THE BUILDING CODE AND/OR ZONING
ORDINANCE HAVE BEEN FOUND:
1)
2)
3)
4)
YOU ARE HEREBY NOTIFIED THAT
NO ADDITIONAL WORK SHALL BE UNDERTAKEN
UPON THESE PREMISES, OR THE PREMISES
OCCUPIED UNTIL THE ABOVE VIOLATIONS
ARE CORRECTED.
ANY PERSON REMOVING THIS NOTICE WITHOUT
PROPER AUTHORIZATION SHALL BE LIABLE
TO A FINE OF NOT LESS THAN FIFTY, NOR
MORE THAN ONE HUNDRED DOLLARS.
Address
C
/ ( �
Date _�1-2—
Building Commissioner
i
_�J
BRIDGE BRIDGE 5IRTAC
° d M
STRIPTAC
PRESSURE PRESSURE
SENSITIVE.SHEET SENSITIVE SHEET
PRODUCTS PRODUCTS
A, 0 Kimberly-Clark a e 0 Kimberly-Clark
Brown-Bridge BROWN-. Brown-Bridge
r BRIDGE
A
r
Ac
i
ST R I PTA C
r
j PRESSURE
:EET SENSITIVE SHEET
PRODUCTS
0 Kimberly-Clark ,L 4
-Bridge BROWN Brown-Bridge B _
BRIDGE
BRIDGE
A is
I Engineering Dept. (3rd floor) Map `` Parcel -Gc C�rmit# 1
House# Date Issued
Board of Health(3rd.floor)(8:157 9:30/1:00-4:30) '' �' '`
3 � Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) � jahol%%
Planning Dept. (1st floor/School Admin. Bldg.) T BE
DefinitivMTan A roved by Planning Board 19 dN�E
TOWN OF BARNSTABL AND
IOWN ONS
Building P it Application
Project Street Address
Village
Owner �- Address
Telephone
Permit Request
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $ , 5,0y-y
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family p�Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No
Basement Type: ❑Full rawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing �ew Half: Existing New
No.of Bedrooms: Existing -3 New
Total Room Count(not including baths): xisting New First Floor Room Count
Heat Type and Fuel: ❑Gas it ❑Electric ❑Other
Central Air ❑Yes U_NO Fireplaces: Existing I--- 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 ❑No If yes, site plan review#
Current Use Proposed Use
Builder Information
Named Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
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 ATEt..Z
BUILDING PERMIT DENIE R THE FOLLOWING REASON(S)
i
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
f
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME �� y
INSULATION
i
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: OU FINAL
GAS:. O FINAL
FINAL BUILD
DATE CLOSE - 2
I _
ASSOCIATIO, N
tea
�FTFIE raY �'
The Town of:Barnstable
i 1ARNSTABM #
Department of Health Safety and Environmental Services
ATFo �A 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 excepti704�,W�
long with other requ' ements.
c _
Type of Work: Est.Cos
Address of Work: /
Owner's Name
Date of Permit Application:
I hereby certify that: ,
Registration is not required for the following reason(s):
Work excluded by law
Job under$1,000.
Bu' of 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
A -
The Commonwealth of Afassachusetts
Department of Industrial Accidents
OlficeOf100SM921f0ns
�•.�_'.'I'. i,`'` 600 fVdAing ton Street
Balton, Ma.cv. 02111
Workers' Compensation Insurance Affidavit
Applicant Information• Please PRINT;Iebi y_._4J�_ ___._.._ _... _ :._�......_ ..:_:_ _._._
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location:
am a homeowner performing all work myself.
rj I am a sole proprietor and have no one working in any capacity
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.I am an employer providing workers' compensation for my employees working on this job.
company name:
address:
city phone#•
insurance co. police#
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1 am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have
the following workers' compensation polices:
company name
address:
ci phone#•
insurance co. policy#
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company name:
address:
city: phone#•
insurance co. policy#
'Attach additional shcef if necessary"' "' + - ;,�-� =r�; w "te ��"'"";�,�'�' � �• �=
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or
one pears'imprisonment as well as civil penalties in the form of a STOP R'ORK ORDER and a fine of$100.00 a day against me. 1 understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
1 do hereby certi under the pains and pelf It* of per•ut),that the information provided above is true and correct. /
Sicnature Date % l 0 — 9/,`-1
Print name Phone#
,.
'official use only do not write in this area to be completed by city or town official �+
city or town: permit/license# MBuilding Department
oLicensing Board
check if immediate response is required OSclectmen's Office
C]llealth Department '
contact person: phone#; MOther
(revised El95 PJA) .
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' coiii tnsation for their
employees. As quoted from the "law", an empinree is defined as every person in the service of another under any
contract of hire, express or implied, oral or written.
An enfphover is defined as an individual, partnership, association. corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwellin, house of another who employs persons to do maintenance , construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chanter 152 section 25 also states that even,state or local licensing agency shall withhold the issuance or
rencival of a license or permit to operate a business or to construct buildings in the common-svealth for any
applicant-who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the
performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have
been presented to the contracting authority.
t
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and
supplying company names. address and phone numbers as all affidavits may be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The
affidavit should be returned to the city or town that the application for the permit or license is being requested,
not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required
to obtain a workers' compensation policy, please call the Department at the number listed below.
77,
City or Towns
Please be sure that the affidavit is complete and printed legibly. Tile Department has provided a space at the bottom of
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made.
Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any questions,
please do not hesitate to give us a call.
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The Department's address. telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,Ma. 02111 j
fax#: (617) 727-7749
phone #: (617) 727-4900 ext. 406, 409 or 375
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The Town of Barnstable
�TME Permit#�
Massachusetts
BAR �.�� ; Date o 9�
�e 9`. SOLID FUEL STOVE.PERMIT _
ram" Fee s ,, --V 01
This constitutes an official stove permit after inspection and approval by the building inspector.
Owner Telephone no. '7 /— 3 D 9
Address of Property 4Village o -fieA � p
Location and Stove Type r
Date:
Building Inspector
aap The Town of Barnstab�
Permit
Massachusetts
Q; Date
• aABNUABM •
UMM SOLID FUEL STOVE PERMIT _
61 "`�
� Fee
This constitutes an official stove permit after inspection and approval by the building inspector
Owner - Telephone no. 7 7 1— 5 O 9
Address of Property Village
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Location and Siove Type
Date:
Building Inspector
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EngineeringDept. (3rd floor) Map Parcel Permit# ] Q l Q
_ House# �_ Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) - - O-5 JOf Fee �1 0-7
.Conservation Office(4th floor)(8:30- 9:30/1:00-2:00)
Planning Dept. (1st floor/School Admin. Bldg.) oF1NE
Definitiy Ian proved by Planning Board 19
BARNSTABLE. '
MARr-
TOWN OF BARNSTABLE
Building Per ' Application
Project Stre Address / 7 t,.S;
Village l
Owner c Address
-T
Telephone
Permit Request AC-,-� C.t> �
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $ �J::/F �
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 �CrAvl ❑Walkout ❑Other
Basement Finished Area(sq.ft() Baseme t Unfinished Area(sq.ft)
Number of Baths: Full: Existing v2 New Half: Existing New
No.of Bedrooms: Existing New
Total Room Count not including baths): Existing New First Floor Room Coun
t �
Heat Type and Fuel: ❑Gas LOil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing / New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Att ed(size) �Zed
)None (size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
Builder Information
Name ��-� Telephone Number 2:1 / Id 1
Address License#
Home Improvement Contractor#
Worker's Compensation#
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)
J FOR OFFICIAL USE ONLY
PERMIT NO. '
DATE ISSUED
o
MAP/PARCEL NO. -�
i
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
?
FRAME ?
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL >
GAS: !; ROUGH FINAL "
FINAL BUILDING `
Y, r
t 1
DATE CLOSED OUT
ASSOCIATION PLAN NO. '
s , 1
� d
�Z11E� '• • `'i
The Town of Barnstable
a Department of Health Safety and Environmental Services
P Building Division
367 Main Street,Hyannis MA 02601
Ralph Crossen
Office: 508-790-6227 Building Commissioner
Fax: 508-190-6230
For office use only
Permit no..
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERNUT 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 long with other requirements.
Type of Work: . t.Co
Address of Work: / -
Owner's Name
Date of Permit Application:
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
Notice is hereby given that: DEALING OWN PERMIT OR
OWNERS PULLING THEIR APPLICABLE HOME II"ROVEMENT WORK DORNOT HAVE
CONTRACTORS
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.
Contractor Name Registration No.
Fate—
OR
Date 0 's Name
�'`•'` Tllc• Conrnwirlrcaltll of Atassacllusells
;. .._ •a;,: •� .�+ Department o)-hid Accidents
_ ,. :1� Ofllceollm�s�I�at�oas
p:. `•lip
-_:;a� 6flp ff irxliin;inn Strcct
.`may BOSIOR.Afam 02111
�•�' Workers' Compensation Insurance•AMdavit
- a
•1 am a homeowner performing all work myself.
1 am a sole proprietor and have no one working in any capacity
1 am an employer providing workers' compensation for my employees wori:mg on this job.
. .
phone#•
._s--__ "olio#
ram.. r s r r TAr•"���.•'/Y. � •.._. ♦. ....... ... . i
1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contactors listed below who t1z
the following workers' compensation polices: v
.. yf.' .. •y. . '
phone#�
_� �r.�_ �,,,-T:�.. «. ..rsnrort+�....s�•+��*�"v""T�•�"�„'�F"�es� - ss�1�e!°g'.�•�"�'1�a� - -.
m r e•
.r phone#!
t noiiev#
Atfach addltionai'sheet if oeeessar���'•�'�•"�''�'"•�"""'�'`` ' 'T`�'�-�rt�`
f aiI* to secure coverage as required under Section 3A of AIGL 151 can lad to the imposition oleritaiaal Peaaities ota floe nP to 61300.00 and/or
one ran'imprisonment as well as civil penalties in the form of a SPOT AVORK ORDER and a iiae of S100 00 a day against me. 1 understand that.
eopn.,of this statement may be forwarded to the Oiftee of Investiptions of the D1A for t orerap veriBeation.
I do hemebr urtijj•undo t/ie pains and penaltles ojperjur3•that the injormation prorided above is true and coffem
01,
J- - 5- - 94
Sic MUM
owe
Print name E one# 77 / — 3 0
official use only do not write in this area to be completed by aty or town oMcial
permitAitxme# r'111uiddin0 Department
city or town: [3Lieensing Board
cheek if immediate response is required 05deetmm's O1fia
(3Ilaltb Department
contact person•
phone gat MOtber__
-Information and Instructions
Massachusetts General Lars chapter 152 section 25 requires all employers to provide workers' compensation for tl
employees. As quoted from the"law".an empliti ce is defined as every person in the service of another under any
contract of hire.express or implied,oral or written.
An emplityer is defined as an individual, partnership.association.corporation or other ;.gal entity, or any two or m
the foregoing engaged in a joint enterprise,and including the iegal iepresentatives of a deceased employer,or the
receiver or trustee of an individual ,partnership.association or other legal entity, empioying'empioyees. However
owner of a dwelling!rouse or the occupant of t
having not more than three apartments and who resides therein.` he d%Vclling house of another who employs persons to do maintenance,construction or repair wort:on such dwellitia 1
or on the mounds or building appurtenanme d to be an emnio:
t thereto shall not because of such employment.be dee
MGL chapter 1'52 section 25 also states that cvcry state.or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant w ho has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally.neither the commonwealth nor any of its political subdivisions shall enter into any contract for the
performance of public work until acceptable evidence of compliance with the insurance requirements of this chapte
been presented to the contracting authority.
.p.:i•�f.'f;n;'. .� •�,.,;�nc.'.t���..;.:i�tt��'I•;` `�;i�•.�� :.µ.�..w.72.'.w4+'t��y'�w?:.-•�c:_�. ,•i-
Applicants
Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation anc
supplying company names.address and phone numbers as all affidavits may be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The
e application for the permit or license is being requested.
affidavit should be returned to the city or town that th
not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you arc requir
to obtain a workers' compensation policy,please ca11 the Department at the number listed below.
.Aww•.� -,-•;iw.v: ' ".i�:� .+.rY.» ..- Lan'�'�•" ,,,,},,,•�fE7 �•v ir4„itiiy•:,�i. .r... . ..
't 0. .t:'.? ...1•..» 7::. :'� ..i• f��.Mr. .tAi7!!+'!fS37q �►••.•"•f•R1•
.YI=•SC.:ter..��:N(•• /y::•
City or To�,%•ns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. P
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returner.
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would Iike to thank you in advance for you cooperation and should you have any questi(
please do not hesitate to give us a call.
�.. ., ... ... rM..�-.�iw.••,••,•�Y: :L•..w f:t�:'•'�:t u'•.s�' mow:�•"w.:•.
The Department's address,telephone and fax number. r .
The Commonwealth Of Massaclusetts
Department of Industrial,Accidents ,
Office of luestl9edons '
�• ,asr.
600 Washington Street
Boston,Ma. 02111
fax M (617)727-7749
phone M (617) 7274900 cat. 406, 409 or 375
' - '. .. .... .,, .. .... 71'.•... • 1' .r....•...\ ..IY,.tom'•:.•.J'.\ ..:\�... .. .:,...., .1•.. l.• •. ..\. V .1.'_
• . TOWN OF BARNSTABLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print.
DATE
JOB• LOCATION ( �
"Number Street address Section of town
"HOMEOWNER" Ll L�
• Name Home phone Work phone
PRESENT MAILING ADDRESS
City town State Zip cc
• The current exemption for "homeowners" was extended to include owner-occ"
dwellings of six units or less and to allow such homeowners to engage an
dividu .al for hire who does not possess A lice ,
P license,
provided that the owns_
acts as supervisor.
DEFINITION OF HOMEOWNER:
Person(sj who owns a parcel of land on which he/she resides or intends tc
side, on which there is, or is intended to be, a one to six family dwelli
attached or detached structures accessory to such use and/or farm structu
A person who constructs more than one home in a two-year period shall not
considered a homeowner. Such "homeowner"• shall submit to the Building Of
on a form acceptable to the Building Official, that he/she shall be resuo
for all such work performed under the building permit. . (Section 109.1.1)
The undersigned "homeowner" assumes ,responsibility for compliance with th(
Building Code •aad other applicable codes, by-laws, rules and regulations:
The undersigned "homeowner" certifies that he/she understands the Town of
Barnstable Building Department minimum inspection procedures and requireme
and that he/she will comply wi said procedures and requirements.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
\
.Note: Three family dwellings 35,000 cubic feet, or larger, will be requir
to comply with State Building Code Section 127.01 Construction Control.
HOME OWNER'S EXEMPTION
The code state that: "Any Home Owner performing work for w#j#— bur3
permit is required shall be exempt from the provisions of this section
(Section 109. 1. 1 Licensing of Construction Supervisors)
Provided tl
Home Owner engages a persons) for hire to do such work, that such Hon
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assu
the responsibilities of a supervisor (see Appendix Q, Rules and Regula
for .licensing Construction' Supervisors, Section 2.15) . This lack of a
often results in serious problems, particularly when the Home Owner hi
unlicensed persons. In this case our Board cannot proceed against the
inlicensed person,,as it would with licensed .Supervisor. The Home"Ovine
as supervisor is ultimately responsible. :.�. .f.
To ensure that the Home Owner is fully aware of his/her responsibiliti
communities require, as part of the permit application, that the Home *,
certify that he/she understands the responsibilities of a supervisor.
last page of this issue is a form currently used by several towns. Yot
care to amend and adopt such a form/certification for use in your commi.
i
7 -7
A/�
1�
'Ll d
Assessor's map"and lot number ........................... . . ...` ��_ �� ���
i SEPTIC SYSTEM MUST BE s
Sewage iPermit number .: - - STALLED- IN CoMfOLIANCE; '
t., ........................._....... WITH -;
H ARTICLE 11 STATE
�:_; . .. "11 GOOD AND TOWN
TOWN OF
BARSTA
y�FTHEr��y :m . Stu r.A 1Q'
i BBHBSTADLE;
"um�.e - BUILDING f INSFECTOR
9Oo G A39 0�
:= APPLICATION FOR PERMIT To. .............................................., �.............................................
TYPE OF CONSTRUCTION ................ i/V £ ?.../ l .... .��L�/V..�..........:
jt
� . . ,9 ..
...................... ....... ...
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the Orin information-
/ A� r _
Location ........�Q(f?�/ /"/�}/N / �/UT�2 �1��
.. .......... .......................... .`..................................................... ...
ProposedUse .......................................................................... ................. ........................................... .................................
ZoningDistrict .........................................................................Fire District ..............................................................................
�ff1/2L£'S' LJ � ......Address
Nameof Owner .................................................. ...........
Nameof Builder ......L........................... ���J .............Address ..... ... .1. ..................................................................
Nameof Architect .................. ............................................Address ....................................................................................
6/v
Numberof Rooms ..................................................................Foundation ..... .................... ........,..........................................
n �1911� �.
Exierior ....................................................................................Roofi g .........................../............. .......:.....................................
Q�/C �4�•YW/ � �--
Floors .........................................................:............................Interior ....................................................................................
Heating ..................................................................................Plumbing .................................................G. ..........................
el 20 o
Fireplace ..........77777 -...........................................................Approximate Cost ............/.................................... ................
Definitive Plan Approved by Planning Board ---------------_----------------19________. Area ... .........5....:..................
Diagram of Lot and Building with Dimensions Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
t
�X I SV NP-IZI ZS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ... ..e.. . ...,.
r�
Buckler, Charles
18225 add to si le �
No Permit. for
1umily .
'
��vwsll'
--* .�
.......................... ------ -----. .
' � / ` � L/ `
v Sobtb Main Strmec
^"`"= .-----------~----�:---..
. . ` .
Centerville
---------..---.------------.�
- . �
Charles Buckler
{Jvvnar -----__________..______. ' `
.
-
' frame
Type of Construction -------_----.—..
_ . .
-----'^--_^------------'�---''
.' .
Plot ............................ Lot ...........t...................
^ ,
^ .
Permit Granted lV 76 ' '
— —
. /
Dote of Inspection 1—.lV , '
' ~
Date [omp�to6 ..� ��.��—�..�--]9 � ' . ' . o
` .
PERMIT REFUSED
.......................................'- lV '
--------. .
� .......................................... .,___________..
� - - .
� - �
�. -----..~�----.—..-----..�--..—
^. _
~,--.---. �—~-------..—..—.--..
.~------..��.-----.—..^..`.—.----.
^
� Approyed .................................................lg
-----------'-----'--'-^'r----''
............. ................... .
—
` .
-
g+�!row;.a.[�a� "..may; Y.r •i;���"•1+.'wC rJ ;'F'i'""Aa_..�^••+'�,.Assessors ma an !�+7 ..,e � �n.c�r,v..r.,'i:r"t �c r::,l 'N :;n"„ `9f'•.x...a�;�C ..•'ir ...ems ,r,.�f. € i ;a-•, xi-e_�",:-..r;
iCO A
in
Sewage Permit number ./ ti
t
7HE7., �4, 0 V.V N t {� �L r tliRN'ST"*A BL
Y 'BAR3TfAFILE.
MA86 I I�
`j
/ Ct �/ ' `
G 0 : APPLICATION FOR PERMIT' TO ...' .... �... .....
TYPE OF CONSTRUCTION
............................ 19.. E..
TO THE INSPECTOR OF BUILDINGS 1
The undersigned�hereby 'applies for a permit according to thle following .information:
• Location ....:. .... ..
Proposed Use .......
zoning. District ...... ........................................................... ..Fire. District .. .. ...... .
Name of Owner S.'..... .. ... . ..... ......Address ............................................................... .......
�j
Name of 'Builder ,... 166V Address
4'
Name of Architect ......... ,Address'
Number .of Rooms ......... ......... ......... ..... :. : .......foundation
t
I
Exterior. ....... �.... ........ ......... ......... ......... ... ..Roofing ... •........ �..... ......... .....
Floors ..... ..
Heating :. ...... ....:.... .. . ..... ...,...Plum Bing ....................................................... .
Fireplace ..:.. ^� ....... ... .............. .. .... .....Approximate Cost ...... ....
Definitive Plan Approved by Planning Board . _ ____ - f___19_ Area
Diagram.of Cot an' g d Building with Dimensions': .... •..
�• Fee � ..
SUBJECT TO APPROVAL OF BOARD OF HEALTH
l
L Li
J S7;�tl %f�vie ,25r .
I hereby agree to,conform to all',the Rules and Re'gulations of:the Town of Barnstable regarding the above .
construction.
Name !x �� ^'.....................
.._.-,Z................................
A 22 1 9
- - -
h r'L 8 rt k1 r C a es ,Buc e ,
_18'22:5 r �.. ._'. .:�-'.:add ,to ..in le_ -
p - u
N : . P
( o ,ermit-for,.... ........ x
-.. '._ -._,.. •._. ._a.--.-.,._� �tea. ',._ -3.� F_ _ -, -._-a>_�a._._- �-„ ...:—y r:a _^�"-a� ..,,r.L'r- -
_ -., : ... mce : ,,.::,,,�` h �..r� ._ ..spit-.-_.',-#'=x3=w- ,s• _
,•�d a , .
Y .g I
11 .
ou.th a .. . :;. :F, K
sy • J
.._Location. ..:..::........................ .c...:... ......,. ..:....
ty�- , .;•, a.;,<.x't r-F. Y ,.....a. r - ,..,.• � �,.: r.,..{, - �YM ,vj�'�, .1M�y
:n
.. ,.. ,_ Centerville_ ,
._
J
. ... . .......................:......: .::.: ..
Charles Buc le
S.
W
y F
frame: . ct
}
T5 e of Construction. ....:.:.............. .. . r, ., -.. .. _- ,, :..... :, :- � ... -, . ;. t k
3c -f
.. 7-' ..0 .. - -_ - ,. .. , ., .. : .t -, ...... .,'rv, .... ..: i s .: :'.;:. ,fit. 1 -9. •tom
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Plot' - .,. •,a ... ..,.. ... „ w-, '._ .. "f:. _.�:,,:.
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........ .... .....,:. Lot :...............:....
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, -.... ., -.• --•:. ..:. - :._ ,,. , -.. ....., -'4 a {. .- _. ?- 1, � a�'
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, ,. mit Grante .: .:........ .....:... ...Per d ..... s r r
, .. ate::of dns ection....:...�.......... ...............19 X - n
t
. - i .. .. ,,,,. .-.,. ., ,, \.- .. .., ,y. • �" ,".-,:-.w.,.-.a,U I '.� .vim
,
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.. .Date _Go ... .. . .. . :.......... .. .. . ... ., _ . . ...r ,.. !. ,f., �' �.
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PERMIT.REFUSED -
"..
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Assessor's map and lot number ..: ............ ... .......... .. SEPTIC SYSTEM MUST 8E
1..4 1,"J COMPLIANCE
` ;"1-B P..-i,C'_- II STATE
a Sewag Permit number . . ... ... . Sr�;P
.. _ � DB 1Ai'l Y CODE I11VD TOWN
BAR A PEO
F' ULAT10
Py�fTHE T ' OWN OR NSTA E
Z EAflMTADLE.
9� 1639.
ae�� BUILDING INSPECTOR
APPLICATION FOR PERMIT TO �J ICJ . .0 u.c .L.L I t�
�. ..........................................
TYPE OF CONSTRUCTION ..... �.......................................
...... ..........19-)4
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby appliesfor a permit according to the following information:
Location ....... ......... P.:... .�4.�.1`�. a :. 4..� ! ,.IZvL.L L.,. ...... ........ ...............................................................
ProposedUse .............................................................................................................................................................................
ZoningDistrict .........ii.........f................ .....................................Fire District ...................:..........................................................
Name of Owner .V1G1. 1 - .......ls .............Address .... .
Name of Builder �►� �a�.F - ........................Address .. !g. S��s I '.I�.L. .
..................... ..................... ... ...........................
Nameof Architect ........``..........................................................Address ....................................................................................
Numberof Rooms .........1.........................................................Foundation ..............................................................
Exierior .......k1N),Ie .....................................................Roofing .....C1.5..j?&t ....................................................
Floors ...:..................................................................................Interior ....................................................................................
Heating ..................................................................................Plumbing ....../f� .............................................................
Fireplace ........XiP.......................................:..................................Approximate Cost
Definitive Plan Approved by Planning Board ________________________________19________. Area ...............N/.........................
Diagram of Lot and Building with Dimensions Fee '
SUBJECT TO APPROVAL OF BOARD OF HEALTH
61 /Z
70
I-hereby agree o conform to all th-e/Rules`and-Regulations-of, Name.-the_Town of- rn ble regarding the above
construction. 7U21U TaN
� -Buckler, Charles
No ... Permit for .......add..to...single
familY dwel
..................... ............ ...... ..
Location ........;��7...South Main Stree.,/
..............................................
............. Vji V I Ik- i I-- 1. .- .
........... ......
Owner Charles .Buckler
..................................................................
Type of Construction ....f.rame...........................
.. ........
................................................................................
Plot ............................ Lot ................................
N
Permit Granted .........J!�mary...29.�-.. -Ig 74
.......... .... ..
Date of Inspection J.q/
Date Completed . ..... 9�,,
J
PERMIT REFUSED
......................................................... .... 19
k %
...............................................................................
.......................................................... .................
....................................................... ..................-.
.......................................................... ....................
4�
Approved ................................................ 19
.............................................................I.................
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