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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
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Map Parcel Application #�1
Health Division Date Issued
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street Address Yy I,.Aik 6`t,
Village
Owner Address S�
Telephone
Permit Request c•�_�rvc�rr.. )d` CC_to,,, k ,
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
r Q
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach�pprj porting documdhtation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway:" J Yes, ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft). ,, ~
c,n
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
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name Mike McCarthy Construction Telephone Number
I'® Box 52
Address West Dennis, MA 02670 License # 6586 33
Cell (508) 280-6964
CST.-58633 HIC-169393 Home Improvement Contractor# 1 9,373
Email Worker's Compensation #
` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
Yllf^- Y21
SIGNATURE DATE
I`
' FOR OFFICIAL USE ONLY
"APPLICATION#
DATE ISSUED
MAP`/PARCEL NO. r`u
ADDRESS VILLAGE
s
OWNER
I
DATE OF INSPECTION:
!s FOUNDATION
ilf ?t FRAME
t INSULATION
!t' FIREPLACE }
ELECTRICAL: ROUGH FINAL
j= PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
'I DATE CLOSED OUT,
ASr§OCIATION PLAN NO.
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DOWNER AUTHORIZAT16N FORS
CI 4r0 rt §.
(Owner's. ame)
owner of the property located at .
VV
17P -D c!�r l
(Property Address)
Ce4er 1 �/P rl'�9'SS f� y ,
o 3�
(Property Address)
hereby
authorize' /Pik
(Subcontractor)
,
an authorized subcontractor for RISE Engineering, to act on my,behaIf to obtain a building
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p d tope permit an work on my property;`
e?s Signature K .
Date _
9
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October 21, 2014
Town of Barnstable
Thomas Perry CBO
Building Commissioner
200 Main Stret =w
Hyannis, MA 02601
RE: Insulation Permits
Dear Mr. Perry,
This affidavit is to certify that all work completed`for permit application#O at 84 WHITE OAK TRAIL has
been inspected by a certified Building Performance Institute(BPI) inspector.All work performed meets
or exceed Federal and State requirements
Sincerely,
Michael McCarthy
McCarthy Construction
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06,, 31
Town of Barnstable *Permit#
�{. Expires 6 months from issue date
Regulatory Services Fee
sextasresi.E, : Thomas F.Geiler,Director
Mass.
Building Division (a alI)og
PIED MP'��
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address / kil
Residential Value of Work zo, Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address � r$ '✓�
Contractors Name Telephone Number
Home Improvement Contractor License#(if applicable) 2�
❑Workman's Compensation Insurance
Check one: . ®PRESS PERMIT
I am a sole proprietor
I am the Homeowner
❑ I have Worker's Compensation Insurance MAY 2 9 2008
Insurance Company Name TOWN OE RARNISTA LE
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stripping old'shingies) All construction debris will be taken to
❑ Re-roof(not stripping. Going over existing layers of roof)
Re-side
Replacement Windows/doors/sliders.U-Value ' � (maximum
*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 coley of the Home Improvement Contractors License is required. Q, Aug
32
SIGNATURE:
Q:\WPFILES\FORMS\building permit forrns\EXPRESS.doc
Revise020108
,
4.
Town of Barnstable
Regulatory Services
SrABLE' Thomas F. Geiler,Director
Fo �9. Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office:. 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I w�'� as Owner of the subject property
hereby authorize s- to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
2�
Signature o t Owner Date
Print Name
If Property Owner is applying for permit please complete the Homeowners License
Exemption Form on the reverse side.
\Main
of Barnstable
OF THE tp�� � }
atory Services
t � st�B s F. Geiler,Director
MASS $ J
16jg. ding Division til
�rED try A Building Commissioner
2eet, _Hyannis,MA 02601
ay.t n.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
^--_—_--_ ^HOMEOWNER L CENSE EXEMPTION �---+- ---�
Pleas Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town �to zip code
The current exemption for"homeowners"was extended to inclu e owner-occupied dwellings of six units or less and
t posses-Nalicense provided that the owner acts as
to allow homeowners to engage an individual for hire who doe no po s� ,p
supervisor.
D-FINTTION OF OMEOWNER
Person(s)who owns a parcel of land on'which he/she resid s or intends to reside, on which there is,or is intended to
be, a one or two-family dwelling,attached or detached s ctures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-ye period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on form acceptable to the Bi ilding Official, that he/she shall be
responsible for all such work performed under the b dingy permit. (Section 109.1`1)
The undersigned"homeowner"assumes responsi ility for compliance with the State.\Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that e/she understands the Town of Bamstable'Building Department
minimum inspection procedures and requir ments and that he/she will comply with said procedures and
requirements. +
i
Signature of Homeowner .
L
Approval of Building Official
Note: Three-family wellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Sectio 127.0 Construction Control
HOMEOWNER'S EXEMPTION
The Code states th : "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109 .1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowrier 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 of this issue is a form currently used by
several towns. You may care t amend and adopt such a forinkertification for use in your community.
Engineering Dept. (3rd floor) Map Parcel Q40"'? - Permit# 2- 7-"T T&
��i9 .�
House# g�- Date Issued t—
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) ,,. Z- !��ee
Conservation Office (4th floor)(8:30- 930/1:00-2:00) °� �
Planning Dept. (1st floor/School Admin. Bldg.) OF1HE 1�y;_
Definitive Plan A by Planning Board 19 � ��
SEPTIC SYE
IIVSTAL,LEQ I ANCE
�� TOWN OF BARNSTABLE w h TI 5
Building Permit Application ENVIR®NMENTAL,CObE AND I�—--
Project Street Address d :1 t{�, t VIM',
�I M n �LLD T .3 Z
Village Q WO A�P
Owner GtAa4M Address �kym e-
Telephone 7`1.5-- 025o
Permit Request 126_�i r4
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $ 7i XYZ_1 _
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family a"- Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes �ahlo On Old King's Highway ❑Yes ❑No
Basement Type: dFull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No. of Bedrooms: Existing New
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial .❑Yes I No If yes, site plan review#
,Current Use I esc�p,,c.e. Proposed Use -94mV
Builder Information
Name fLme-t 9�%okrM n1e► f,,I X n(f Telephone Number 77T/50 d
Addrresss7a [p(0!i License# ifS WO 16 qB /
06,/�Jt e,. 'VI. 0246 37 Home Improvement Contractor# II I Ito 5
Worker's Compensation# 0C Poo 1 Sl 4
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 -TbL0Yy1
SIGNATURE DATE
BUILDING PERMIT JENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY �; ;•
PERMIT NO. F
_ t
DATE ISSUED
MAP/PARCEL NO'
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION: "?
FOUNDATION
wrr:.
FRAME
INSULATION
FIREPLACE
4
ELECTRICAL: ROUGH FINAL "
t !`
PLUMBING: XbJ@JGH FINAL
GAS: ' ' ``' FINAL
FINAL BUILDING
a,
DATE CLOSED OUT:
ASSOCIATION PLAN"NY,
.i"s
3
:= wnof BarnstableThe To
£ Department of Health Safety and Environmental Services
Binding Division
367 Main Street,Hyannis MA 02601
Ralph Cmsseu
Office: 508-790-6n7 Building Commissioif
Favc 508-775.3344
For office use only
Permit no.__
Date
AFFIDAVIT
HOME n"ROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL C. 142A requires that the-==strttction.aiteradons,renovation,repair, modernization,°0nvers
unproveraertt,. wner o=lpied
rertt .4 demolition, or construction of an addition to which
building containing at least one but not mote than four dwelling units
to such residenoe or building be done by tegmtcred contractors,with certain cooeptions'along with other
Type of Work:IZ 00 �� �j g r S Est.Cost `� bo o
Address of Work: 8 LA �- �c"� � Ile
-
Address
Date of Permit Application:
I hereby certify that:
Registration is not required for the following rcason(s):
Work cminded by law
Job under S1.000
Building not owtrer-o°arptad
Ow=puning Own pamit
Notice is hereby green that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING
NOT WrMHAVE
CONTRACTORS ACCESS
$ 'I'O
FOR APPLICABLE HOME D�R0'%ra1 NT' 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.
Z
y�FTNEt���
TOWN OF BARNSTABLE
MARN9TAI LE,
"6 9
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ...A�...... ......... ............................
.... .. ..... ..........
TYPE OF CONSTRUCTION ....... .........opt-`,.I.......................................................
-.4 .... . .......... .
. ........
J0................19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
.O,t C<f
LocatLocation�qt..�3.Q......... e. K 7.
......... ....... ........... ............................................................................................................
Proposed Use ..........7i, e//)
.................. .h9...........................................................................................................................................
lfl�
Zoning District ...........- / .7z,
1.e...........................................Fire District ...6e.K-� r
.. ...... .....................................................
Name of Owner ....................................1.4.9,.'n......................Address ....7:4..QA,.q.�n....�1;....A�.. .............
Nameof Builder ....................................................................Address .................................................................................
. I 1
Name of Architect ...........................Ir (r ...............Address ......................................IC ( 0..............................................
Number of Rooms 8
..................................................................Foundation .......... ......................................................
Exteri or ....... ...Roofing.. . . . ............... ............ - 4�-
.......................................................
Floors ...........Q;��7pql:..................................................Interior .......... V—
............ ............... ........................................
Heating ........1—It C M,
...................................................................Plumbing ............................. ...................................................
Fireplace .....................;D - "50 (2 0 0
.............................................................Approximatt- Cost ....................................................................
.Difinitive Plan Approved by Planning Board --------------------------------19---------
Diagram of Lot and Building with Dimensions
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ...................... ............
i................................................
Graham, Harold
g 1 19r7 '
No ..14228 Permit for two...story
.............. ...........
i
single family dwelling
......... . ........................................... ..............
Lo4t� +.......ite Oak.Trail ..................... I ' '1
......................Centerville................................ t
...................................
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Owner .........Harold M. Graham
.. .........
Type of Construction frame c
................................................................................ y
4 Plot ............................ Lot ........... 2.............. a
September 8 71
Permit Granted ........................................19
Date of Inspection ................. ..................19
.�4� °�/
Date Completed �... ..............19 `
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PERMIT REFUSED ` --
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.................................. . .......................... 19
...............................................................................
................................................... ........................ r,
............................................................................... -•
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...............................................................................
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Approved ................................................ 19
2.
...............................................................................
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