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,� J U .�� ``- ._�. _�. _�. I 4 I i P o Ir i v I 7 t I T —_ _ �r-a �_ _� — -- _. ___— -T T-r _. — _._ ' Town of Barnsta,>flees o *Permit ;Iq - �f. a Tres 6 months from issue dale ' Regulatory Services . YP saxxszaBM ` OCT Mass �� Richard V.Scali,Dire �r�� ?Q16 SS5. 06 i639. 1 tVV Building DivisionA � Paul Roma,Building Commissioner r48LE 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 williout Red X- ess Imprint Map/parcel Number. �/� .-O U� Property Address 1c�' ba A f_W r c K Itj `i y liTe, 2.0 L Z- ❑Residential Value of Work$ 35 0 V Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ll 3 z-- Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping.'Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum;32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the.Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: ` QAWPHILESTORWbuilding permit forms\EXPRESS.doc 06/20/16 ` ?Tie Coznmomreaitis azf MasYack=etts Depa rt meut of1mfusfrid Accidents Office ofrMWdkafiarns. ` 600 Washington Street Bastm,MA 021-II wmmumamgovldia Warke& Cun3pensafian I ce Affidavit S.gildeis/Cantractars/Flect r cians(Phmibers AppHcan#Iufarmafran Please Print lly -agar �� l.�' Y� 1� � � � • ant: Are YOU an emiployer?:Checkthe appropriate box: Type of project(required): L❑ I am a employer with 4- ❑I am a general codrsctor and I 6. ❑New consf di•ng employees(fullandkr part-timer* have huedthe sob-co�acfors 2.❑ I am a sole prqpzietor orpartuer- listed on the attached sheet. I- ❑Remodelin s4:£p and have no employees • These stab-contractors have 8. ❑Demolitiba wag for employees and haver o&arrs °emu � �y�tY- � 9..❑B.uilm addition [No woodmrs comp.insurance omP- reguired] 5. ❑ We are a•corpomfim and its 10-❑Electrical repairs or ad4tions c _ 3111 am a homeowner&a ng all wcu k officers have exercised their 1L❑Plumbing repairs or additions mysdf[No workers'oamp- right of esempfiou per MGL 13.❑Roofrepairs insgganrereq ire ]1 c-•152,§1(4)6 andwehaveno employees.[Nowod=s' 13_❑Other comp_inmrarice required-] $Any WMcsntd=t cheftbos#1 maast also flloatthe secticabelaWshmimg the wa&exe compensidanpaycyinffinn dau- # 4S WbD Submit rbiL aifidac u iudy[ati�g they axe ijm�all W�SII$fhea hirn orxtsid9 ccralxa�*+�mnst submit anew afdsviCmdieabno such- fCaat<actasiff=checictiusboat roostattar3h smadditiamsl sheet shou•iagthensmeofthewandstatewhethetornotthaseeadtiesbxm eaxplupees.Ifthezah-can:�bsceemployw-%theymusrpxmridedw*tradEeW comp.policyzu er- 1 am an $etaly is trie pa cy curd job sate hzfor matian Insurance Company Name: Policy 4",or Self-iris.Lic-ll ExpiafionDate: - Job Site Addre= CitylState ZiO1 - Attach a-copf of the workers'compensationpolicy declaration page(showing the policy,number and respiration date). Failure to secure coverage as requiredunder Section 25A of MM c-157-can lead to the imposition of criminal penalties of a fine up to$L50UOD anilor oriii y&ir imprism=aetd,as we11 as civil pemnIfies in Ihe foua of a STOP WORK ORDER and a fihe of up-to 0-00 a day against the violator. Be andsed the a copy of this ztatement noy.be Enwar ded fn the Office of Iavestigatiom oftle DIA for msmamce coverage serfrcahon- I d'a herAy cart fy raider diepairrr and pirnalties a.Fet ry atthe iafat�tx sprmitieilaba��ig[iris acid ctrrrect Sit tature: G lam/ JDaate- Official ai m only: Do not write in Bib mwa,to be evrripfeted 5y city artown o,o`iaral City or Town: PeraatUcense g Issuing Aaf1aritp(toile one): L Board of Health I BTring Department 3.Cfty1Tawn Clerk 4 Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#- - — - 6 laformation and lasta.c-ioaas Mass-, r—fS CTCtcral Laws chapter M requires all eucployers to provide Walla&co=PeuSSflon for fheg employem. t p to this side,an employW is defined as"_.every person in a srdvice of another under a¢y coact ofhirey expre,ss or mrpHbc%oral or wrifi=." An eznployrs is defined as"air individual,partners 4,assocudion,coiporaiion or ot3er legal edify,or any two or more of the foregoing engaged is aJoint entmPas5,and inching the legal repres mt@iIves of a deceased employer,or the receiver or trustee of an individual,parftim3hip,association or of =legal entity,euiploymg e03ployees_ However the owner of a.dwelling house having not more than�ffi=aparlmeahs-and who resides therem,or the occupant ofthe - dwtMag house of mother who clugloys persons to do mamma m,c•„,starf;on or repair walk a a such dwelling house or on the gzvunds or bu17dmg app $hereto OuR not because of each employment be deemed to bean employer." MGL chapter 152,§25C(6)also states that"every state or local Iicensuig agency shall withhold$ie Zssuaace or renewal of a ficense or permit to operate a Duchess or to construct buildings in the corumcawealth for ray applicant-who hzS not produced acceptable evideace of compliance with the insurance coverage required-" Additionally,MGL chapter 152, §25C(7)states"Neither the==mwrzl&nor Et'ofifs political subdivisions shall enter int,aay contract for the performance of public worlcuaZ acceptable evidence of compliapcewiiji the insurance.. ?e q=emeats of this chapter have been presented to the cant l:tiog anihoay." A-PPlicaafis _ Plea e fill oi>f the wows'compensation affidavit completely,by checking e,boyces tat apply to yo=s tnatio and,if necessary,supply sub-canfrac-tor(s)name(s), addresses)and Phone xlitnber(s) along With then ceatificaf e(s) of sn mince_ Limlte-dLiability Compames(LLC)orLmzited.Lmbtiity-Partnerships(LIP)wifiino employees other fhanthe merhbem or partners,are not rt�m ed to cant'wo�ecs'oompensafron Dance If an LI�C or LLP does have employees,a policy isregoired. Be advised ihA this affidavit maybe mh fttndtoth.eDepartmentoflndusfrial Accidents fur conformation of fin= .ee coverage. Also be sure to sign and date the affidavit The affidavit should be refzilned to!he city or town that the applicafion for the permit or Iic=e is being requested,not the Deparfmcat of Tr dens tat A ccidm-ts. Should you have any gnestions regardin g the Iaw or ifyou are regmred to obtain a workers' compensation policy,please call the Department at the number listed.below. Self-insured companies should enter their self-fijm - ce licence number as the appropriate line. City or Town Officials f _ Please be sane that the affidavit is complete and prhted.legibly. The De par(menthas provided a space at the bottom of the affidavit for you to fill out in the event the Office oflnvmtiga has to cordaot yonr%m ding the applicant Please be sure fn fill in the pen�iVlicease number which will be used as a referemce number. In-addition,an applicant mat must submit multiple pennhlIicmse apphtations in any given year,need only submit one affidavit indicating Cu= Mt policy information if necessary)and umes`rlob Site 1A-idrror the applicant should write"all locations iLt (�5'or• P � town)"A copy of the-affidavit that has been officially steed or marked by the city or town may be provided to the e�ifs or licenses. A new affidavitmitst be filed Olt each applicant as�proofthat a valid affidavit is on file for fufine p - year.Where a home owner or citizen is obtaining a license or putt not related to any bn ���or commercial vevttn e Iete this affidavit: or ' in burn leaves etc. said person is NOT req�zed to comp . (Le. z�g hwse rrt , ) r The Office of Ind would Ike to fhauk you in advance for your cooperation and should you have any questions; please do not hesitate to give us a call- The Departm mfs address,telephone and fax number: T wealth of Massachnscm ' Dqartinmt c6f�Accident% . �tce of�ve�g�fio� �4�a�Ziog�an S - M&oil11 Ta 4 617' -49W=t 406 or I-V Fax 617 727 7M Revised 4-24-07 - w - �-T�dia f 1 3 • Town. of Barnstable Regulatory Services MABELt Richard V. Scali,Director &63s~ �� 39. Building Division Paul Roma,Building Commissioner x 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must E , Complete and Sign This Section If Using A Builder AL L ,as Owner of the subject property hereby authorize to act on my beb4 in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature-of Owner Signature of Applicant Print Name Print Name r Date QTORM&OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services p1FT Richard V.Scali,Director Building Division Paul Roma,Building Commissioner ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: / �h Z./ a G/lv s f JOB LOCATION: /el UJA e/,J/�K U A Cd e—1V�,e V i /l e— number street village "HOMEOWNER":F� A P_Q >�,Cl9Q6Z& cJ�/���d AW �C���.V -39& name I home phone# work phone# CURRENT MAILING ADDRESS: ? d[' 40J4- K &2A C/ Ze e=vz//&- 43 9 - city/town state zip code The current exemption for"homeowners"was extended to include owner-occuQied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 requirements. Signature of Homeowner 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 shall-act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing.Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it'would 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. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 ., TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 4? Permit# Health Division Date Issued �S Conservation Division Fee 01 o a Tax Collector L Treasurer. oa Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address /.v/�►2 i,�ick� G�/� Village C 2 - f Owner /E o 6 -2 E LL /o 17— Address L 21;R 4,.1 cA- Jn f P/LG� Telephone Permit Request Rg/P00% T,7; 4P 4AI) Q3 sq AsPXa) 7— S'AxiQvs Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost%//1 5-0 Zoning District 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 Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ 'Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name F'7kX 9F-4tic- I �r iyv Telephone Number S�f�— �S Y Address 3 /NFRR ln-G Rt-r l License# )iF-: u.i c M,4 02 33,7 Home Improvement Contractor# 1114100 Worker's Compensation# 41—A ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �iS-,905A� SIGNATURE DATE FOR OFFICIAL USE-ONLY '- P13RMIT NO. o , DATE ISSUED f MAP[PARCEL NO. T ADDRESS VILLAGE E � , OWNER ) F jyiT u DATE OF INSPECTION: FOUNDATION '• FRAME 4 r .. INSULATION FIREPLACE _ r , K ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. ; r _ c , e Commonweaan al Accidents • ��j- .:- Department of Industri ,� =�_=`, ; 3 , OfBca allanestfgatioos s - 600 Washington Street Boston,Mass. 02111 - �_``�;� Workers' Compensation Insurance davit location: phone city ) # eft- of C r/ ❑ I am a homeowner performing all work InYssCIL I am a sole p�roprietor and have no one worldn I In aIIV�capacity w on this ob workers ensation for my empioyees acting:.::•:;.:.};::�:.;:job. anem lover eimg .... ...... .::: ,:...:< :::::::::.;.::::::::::::::::::.:...::..:::.::::.::::::.:::.::::::::::: ❑ ::::::......:..::::.:::::.::..::.:::.::::::::::::::::..::...::::::::.::::....::::::::::....:::.:.::......::::.::: c m an v na me: ...........add-re ...:....:.... ss. . :.....................:..::::.::::..... :..:.:..:..:: ri,.:.. ::::::::.•.:.:::::::.::::::::.:..::::.:.:::::.::.:: ci insurance co. ❑ I am a sole proprietor,general contractor,or homeowner(circle one and have hired the contractors listed below who have thefollowing workers mP ....P°........::.:::.:.:..:.::-:::.:<:..::::::::: ...:...:�::. .::::::::.�::::::::.:::,.;':.;;•.:�:::.::.�.:.�:::.:....:::::::.�::..;.:::::::::::..:..:.::::::::::::..::::: e; :. :at .add a ............ ...... .....................:v.i•i:i}:i:.:.........r..fi'•.fi::::......::::::q;:?{x:v:::•.:v}"•i:i+4•i:•..... v:.............. A..:.t4•. }•esSi:. •''::>F.S�::i::iiv::::::ti}i::i::ii:ntiCiti�{iy(:.;. 3:. .................. . ........ :........ Y......:............ ..n............................. - .......:.:............. .................... ......-.............>::::.... aw ........................................::.:....:.........:... :. an .. :::..:.................... 7...........•.......::: ..::.::::.::::.:.::::::. :•::....... ..: ... ad dress: ...:::.::.;:..:..:.:..:. :.::.:..... :...:.::.:::.::....... atv: .......... ............................................................................ ......... :.:. . in,urance-co.. :::.:.:.::.::.::::.::::::::::.:.::. :.::::.:,.:..:::.:.:.:.:.:. . der Section ZSA o[MGL 152 tan heal to the imp°s�°n of erbaioal penalties of a fine up to S1,s00.00 and/or Failure to secure coverage as required ce_ one years'imprisonment as well as civil in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the omee of investigations of the DiA for coverage verlfieatlon. 1 do hereby certify under the pains and penalties of perjury that the information provided above is trw and coned Date signature n, Ph on Print name D !Z �6f7yc� e# official use only do not write in this area to be completed by city or town official permitNcwe# aMuilding;Boa ent city or town: te❑Selectmen's Office ❑chuck if immediate response is required ❑Health Department ' phone#: Other contact person: (Mmmed 9/95 PIA) / - . :.11:• • . � • •11 i\ 1 ( �+ I i1111 • � • • • • • • � . 11� :1/ .1• 11 . �1- :/N . . . . i1 . •I/1 11 � .11 :� / . \�4111 i/ •a • .H fN U 11 N . 1 . 1 a 1/ .�/ •11 •IH . 1 i►.. w. . 1/11• i• . . . i11 1 / / • - • 1 i• 1 1 • 606kino 1/;,1 1 • •M ,U 111 •1 • • Ir.11 011 • • 11 1 w#to w•r.1 lg;,4/11I IVMOI .11 • • •.• • • • • 11 • �lI • - • 1 • 11 all - • •tl • 1 • 11 11 •11Qwlojt 1 -tII1/ • Ml •1 I 1 - • I 1 I •1 I \/a 1 1• •M ,U •11 • • 11:•i �•% i11.1 I • 11 • :.III\ • • • - a 11 - • ••/w •1 1 • 1 • 1• 1 11 • 1 • /I • 1 / 1 / •11 III/. .0 1 ' 1 • �:1 1 � 11 -t -t11 11 11 • 11• J11 • 11 • • I 11 • 1 • • / • 1� . • :1111• • /:.l •11 • • • 11 111 III 1 111 \ 1 w• •II 11 .�• 1 ' •I•. •II 1 1 1 • I 11 • 1 • •) •11 11 •J ••11• 1 1 1 • • • :I/ 11 11�•/ • 1 I 1 • /iV5 • 1 1 :+/11• • 11 �.11 • 1 �-•1/ i• \ • .11 .+111\ • :I 1 • �/ iM1 •I/ • Y.11:.� 11 .1 1 1 JI 'l ll it 1 I 1 1 1 1 1 1 1 Y' 1 • 1 / I 1 11 I 1 1 1 1 1 1 1 Y I 1 • I Y I I I I I I J. 1 I I Y I III 1 1 1 1 1 1 1 / 1 1 16 1 1 / 1 1 • • 1 1 1 1 1 11 1 1 1 11 1 11 1 Y- 1 :.. 11 i1 / 1 11 •11 I I 1 -toll-I •1 •IIt11 111 • �'% 1 1 1 • .11 • II. / • 11 w 11614 kk.J L'i 111 i I ill l- I it I*IV.tl • r•I/1• M I• II - •••I 11.11 .1/ •I IASI III II.Wlispoo-ml , ••• • /: • •m-10 •1 V111111 .11 111 -tII �.11•. •1 /11 MI .II 1�1 1 •�-•1 • i111�• /• 11 V•1111 •• • 1 ✓'% i11 1 /1 • •1•. a V•IIIII i1 W.11 •11It•• I 1 Y•II III U/' 1 ' w1 i ..11 ' 11 I •I' 11 .1 .11 / 1• •• 11 Yt11 .1\ •11 ,11• • / 11 • 011111,Ilk IY,111 I •1 .. .11 / I 1 111 - 111111 \- •II ' 111 V,.I 11/ M:11' •1 11 11 .t1 « i 11 I 1\. 11 / • 11111 i• • 11 ' i• I11 w/1 00,1M I i11•. 1.1 V•I1111111 ,1■ \II •1 11 11►:11 « «• •-tY• '1 1 1 1 11 Y :JI 1 1 1 I 1 1 11 1 I 1 • 1 / / i11111 iI 1\ 11 � MI 'V /1 1\ •' 1 11 .1 11 .II I V:II •II •1 11 / -t11111 11 \'.•I 1 II • i• 1 i. i• 1 1 11 1 • .1 111 �•11 •1 1 111 1• M \ ill•. 11 \ 1 . • • 1 1 •11 ' 1 1 I \II ..•Y.1 \111 ' 11 • i• 1 iI • • 1 •'. 11 '•II.•-t .'•1111•.+/ Y:1I •11 I • I 1 Y ✓• I /1 1 -•✓.1 ■1/.••11 .1 /1 I11111 I -t triIi/ ► • ' ONE rC • II II .1 /•I� Date k • I I jf)(m-iwjv,II 1 1 •III/i•f �.'1 1 I It ^IY.1 I11 -t11 I II \ . i/ I V .1 II • • / /1.1 • •• 1 • • \ itl • 11 11 /1 -t11 11 , •1 • 1 • .� I •I:11 all 1 11 V\I11 V. M • 1 �.•r;l \111 1/ .11 • ✓•111 r I 1 • air vT4 1 11 1 .I ■1 , t1 1 MIA I L-4 II va/ 111/1�• 11 - I] • I11 illl • • 11 •I 11 • 11�/ .1• ,11 • :ell.e 11•. 1 • ��•1 11✓. I / •• • 1 .+ • Y11 •II 1• I • - • II ,11 • 1 1 • -1 « •I • 1 q[%;osTOj6j-sr.41 •II jr.to If 1 • 1 IfIlLojelts wi r.l. • 1 1 •I / �•S •• 1 • 1 i.V I Y.1 • J W. I 1 - � - • •N III 1 • I / 1 •1/ .11 / Y•► 11 111 •�/ ' 1 li11 1 I 1 1 • 1 1 •.' 1 1 I , 1 1 ' 1 1 • 1 1 I I 1 1 'ME t� The Town of Barnstable • n#,aivsreais. • 9� 'M �0 Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 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: I?rr. J?C1 o r Estimated Cost Y Address of Work: 9 it Owner's Name: Au F-, l= LL 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 ARBITRATI PROG R GU FUND UNDER MGL c. 142A. f'' SI D UND ALT1E OF PERJZJR. 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 r. t HONE IMPROVEMENT CONTRACTOR ' = Registration: 121400 Expiration . O510612001 T➢Pe .Individual.,-,, t �� �. PETER BEAUCHEMIN 6�, : C ;„ 'PETER. BEAUCHEMIN ADMINISTRATOR 1 E. SAND"CH. MA 02537 I ; TM`' TOWN OF BARNSTABLE* 2 3 b 8 Permit No. 1 Building Inspector r Cash _($88 0 4.0 3) PAIL Y OCCUPANCY PERMIT Bond "No building nor structure shall be erected, and no land, building or structure shall be- used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Lewis Gordon Address � T.^+- lcAd. AR L3aYFo1 nk G7adr t`�nf-aYEsi 1 l�a Wiring Inspector ��f� Inspection date Plumbing Inspector Inspection date Gas Inspector L rt } �,. �U �. i. Inspection date ill!,a IPP.9 X Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS, ...........- ...................................., ...�ita� . .................._.........._...._......, 19......_..., - ` Building Inspector , - J f *cam f ©T 44 , . 1 /6, 737 S:f ti . N GohG• 2� ,noun i 2 Clo-l- 45 00 43 O 1 LocRT'io�v' G TAP-VtLG..e ` BE'/!VG G.o 44 �- PLr91V 30 p 55 MR rr H. 2 NCCG�BY 4CO&ffr1FY 7N097' 7WO BV/1-01.10- '� �}( Il ' 3.yOM/•V.O.t/ 7—AVI- oL L . .4A./ /S OCATeD CA/.7W& .. 4 1 �O4G/Nt1 ' g3.ENO W.V N@C@OK/ RJ t11� 7 W4Q r /T •Q C �r ti 01 YAK'_M!?UTH, NlA,S S. �"'oAT i a _ r Assessor's ma a`nd IW�riumber .../...7....�:. �� t..p ..... .... ... .......,... /31� 3//f/�Z--:,. _ THE IC SYSTEIi� MUST BE � g ................:.85-..�-0...................... : INSTALLED IN COMPLUANCE � Sewage Permit number , . WITH TITLE 5 = 33ARN 'NABa LE, Rouse numbee .....� ? ..........................................:........ ENVIRONMENTAL CODE"--*,' ''cep 6 9. TOWN REO�I.ATI0,N-,1j 'E'YPY°'' TOWN. ,OF BARNSTABLE , BUILDING INSPECTOR, S I TO / / l01� APPLICATION FOR PERMIT TO .................. �:....r.. .....69.��.Izy. ..... .. ... .. TYPE OF CONSTRUCTION 1/t�o.0 ..... .......................1�. � .................... ................................. J�. .. ......................19� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... !' .'T !w � �✓�lJ� /'� y ��/��l N/2 vI ... .................................. ................ ............ ......... ../`................................................. ........................... ProposedUse ............. r . .J..//`J......................................................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ....? 1:f.......-C�...../!.'!!..<-:.....................Address J�..J...............�Ll. ... +....... Nameof Builder' ....................................................................Address ................................... Nameof Architect ..................................................................Address ....................................... .`..........................1............... Number of Rooms Foundation /O�'� ..... .................................................... .......... ................................. Exterior�... �f �. .(d. . ........ ..... .......1 .. ........ . oofing ...... . -� G� Floors .............................Interior ... ......f'f7.. !Y�i20G Heating ... ................................Plumbing .... f? �..................................................... Fireplace ... ., .... �! Z.................Approximate Cost 80v ` Definitive Plan Approved by Planning Board -------------------_-----------19--------. Area 6.E0...© ....... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL*OF BOARD OF HEALTH oL0 X c 100, 66 /��f�: � x z� X zz le / /0k / Z�� b c OCCUPANCY r t V,10lTS rJLQ a10 kr)q Ntw '�+' •ai iGs 1 hereby cgree to cor?f.:rr„ M ci1? .'ent "16fes dhd `�,§Obla jbnt bf to T'o n of •Cat:ristable'regaf6ing Yf�e ba�sre construction.. GORDON, LEWIS No .2.3.8.6.8.... Permit for ..,One...Story.......... .. .... .... Single Family Dwelling.............. . ................................................................ Location ... 98 Warwick Way ..... .... ...... Centerville ............................................. Owner ...Lewis ....................................... .. .. ....... .... Type of Con'itruction ....Frame........ ....................................................................................... Plot ............................. Lot ................................ �.Kc.h....1.2.c..............19 8.2 Permit Granted ... Date of Inspection........................... ...—19 Date Completed .......... ......19 IF cr" s; + x^ .^-� 011o 1-,PG I l ltlz' 1 Assessor's map drid number �` /„ �,,,,,,,, (f} ��I r� Z 1� �`..:............... 0 Sewage Permit Aumber .......... Z BA"STAXE, • Housenumber ......�..... .,.:................................................ r 6 a 1 �O 39• �0 TOWN OF BARNSTABLE BUILDING INSPECTOR >-orb'' ,/� r2 r APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION �/1�0 ? ......... �1......... .......................................... ............... 19........ 2- TO THE INSPECTOR CF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location I `��1 �AA? �� ........ ProposedUse ............. ..................!,; r / dy..............................................................................,......................... ZoningDistrict ........................................................................Fire District .............................................................................. �Pwy S r r2�•�v Ste/ ,) �'t�; —r/�G�'--�1� . �G.•i'. Nameof Owner ............................ .......................................Address .................................................................................... tt Name of Builder' ............:.......................................................Address .................................................................................... Name of Architect Address Number of Rooms .....:. ....................................................Foundation ...................................A................................. Exterior ...r �J!`.+...1!-...�?. ....... ., ✓ ... �!f .�� f:-Roofing ...A .-..C........... �� H / G Floors .............................................................Interior ..G^ G�%?DG �. .... > .................................................. Heating .. T ^ `f/' lam/`�"y ��/ Plumbing %7 !/J f Fireplace .... .5.. , It ...9.. T ................Approximate'Cost .. .:f' a. ..v..:... ................................ Definitive Plan Approved by Planning Board -----------_--____-----------19-------- . Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 i hereby a r e to . rrfL�rm 3 c tbfttbht ` fi t of ornstoble ata ash'2f� e ss.. . GORDON, LEWIS A=148-73 No 2 3 8 6 8.... Permit for ,.One Story.......... ......... i g;� (e...Fami.ly. Dwelling............ Location .Lot.. #A 4 9 8 Warwick Way,,, ...........Centery..11e.................................. Owner .........Lewis Gordon ......................................................... Type of Construction F Mle ........................ .................................................... Plot ............................ Lot ................................ Permit Granted .....March 12, 19 82 Date of Inspection 19 Date Completed ......................................19 F . u 1