HomeMy WebLinkAbout0007 MARINER CIRCLE � �?��� C��c�
F t Town T
of o Barnstable
#
�n ReExpires 6 inn fr issue date
gi11at0I'y Sei'VICeS Fee
saatvsr.�ar.E, .
MASS
i6 b Thomas�y. �� F. Geiler,Director
Ep `l
AAA
Building Division
Tom Perry, CBO, Building Commissioner
200 Main Street, Hyannis,MA 02601 .
www.town.barnstable.ma us
Office: 508-862-403 8 Fax: 508-790-623 0
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address ,,!�Cd.i ' C' 'co
f •:
[Residential Value of Works U Minimum fee of$35.00 for work under$6000.00
Owner's Name &Addressin boo l,t;,
Contractor's Name V @✓� o`L #iL' Telephone Number S O - ��'— � S 2
Home Improvement Contractor,License#(if applicable)
Construction Supervisor's License#(if applicable)_ �''J�t� ,M
�z $ 1111
❑Workman's Compensation Insurance
Check one:
I am:a sole proprietor - SARNSTA5�'F_
�] 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(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping.` Going over existing layers of roof)
Re-side
#of doors
[7 Replacement Windows/doors/sliders, U-Value. (maximum .44)#of windows
*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.
GNATURE: % .'
WPFILESTORMSIbuilding permit formSIEXPRESS.doc
vised 070.110
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass,gov/dia `
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/IniiMdual):. 7�
Address: Z L,_.
City/State/Zip: Phone#: S `_ Z 3 �� ,
F2.
e you an employer? Check the appropriate box:
.I am a employer with 4. [] I am a general contractor and I Type of project(required):
employees (full and/or part-time).* have hired the sub-contractors6, DNew construction
I am a sole proprietor or partner- listed on the attached sheet.. [7, ❑Remodeling
ship and have no employees These sub-contractors have g, D Demolition
working for me in any capacity. employees and have workers'
[No workers' comp.insurance comp,insurance,# 9. []Building addition
required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions
3,❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers' comp, right of exemption per MGL
insurance required.] t C. 152, §1(4), and we have no 12.0 Roof repairs
employees. [No workers' 13,D Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information,
t Homeowners who*submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such,
#Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees, If the sub-contractors have employees,they must provide their workers'comp,policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic. #: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby cer" under the.pains and penalties ofperjury that the information provided above is true and correct
Signature: I . Date:
Phone
Official use only. Do not write in this area, to be completed by city or town.off�ciar
City or Town: Permit/License#
Issuing Anthority.(circle one)
1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact.Person: Phone#:
�I"E' ,, Town of Barnstable
Regulato Service
• »,vsre,is,
• r3' s
Ms Thomas R Geiler,Director
s639 �
Fo►��' Building Division
Tom Perry,Building Commissioner
200 Main Stree4 Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8
Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Usin A Buylder
-
// , as Owner of the subject property,
hereby, authorize-�/ e-" fa,c,,, i]`-"'. to act on m bhlf
Yea ,
in all•matters relative to work authorized by this building permit
(Address of Job)
Pool fences and alarms are the responsibility of the applicant. Po
ols
ools
are not to be filled before fence is installed and pools are not to be
utilized until all fimal inspections are performed and accepted.
Signature Owner Sig-naffire of Applicant
Print Name Print Name
Date
1
Q:FORMS:OWNERPERMMSIONPOOLS
4C
�T„E Town of Barnstable
�* Regulatory Services
BABNSTABLE, Thomas F.Geiler,Director
� MAss•
�A i639. Building Division
Tp0�y A
Tom Perry,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:
JOB LOCATION:
number street
village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied 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 i.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.prnsor. the last page of this issue.is a form currently used by
several towns. You may care t amend and adopt such aform/certification for use in yourr community.
Q:forms:homeexempt
r _ �lu;.achusctts - Department Of.Public Suleh
ti Board of Builtlim, Re--ulatio�ns anti Stantl:tr Is
Construction Supervisor License �' ✓` a1..6 ilnik ��,,,
Oflice of ons r'� irs nes"s Regu�a w_n a
License: CS 50790 � - -- HOME IMPROVEMENT CONTRACTOR E
iF Registration 1.48900 Type: t
~ — Expiration _A113/2011 DBA
STEPHEN L BENOIT 1
ENOIT
•8 LINDENfl _
RD
I
_._ .
E'SANDWICH, MA 02537
STEPHEN BENO(T
c,,G iy Expiration: 5r23f2013
8 LINDEN RD.
6.SANDWICH,MA 0253
Tr:°12 Undersecretary i
t"ununisiuncr
for individul use only J
n .� valid d return to*
License or registration If foun Ite ulation i.
iration date. Business
g
s before the eXp er,Affairs and B
f j pffice of Consu Suite 517U .
t: parltYlaza-
0
� � 1 A 02116
i-Boston,M
t out signature j-
lid with.
ot�a, z ;
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �6
Map Parcel Permit#_ 7 90 /A
Health Division Date Issued
,Conservation Division o 7/I ® Application Fee S
Tax Collector — i ^ Permit FeeV/
Treasurer
Planning Dept. SEPTIC��ST EM MUST BE
INiA ,wL ,a� COMPLIANCE
S �-t,..
Date Definitive Plan Approved by Planning Board WIT H TITLE 5
Historic-OKH Preservation/Hyannis ENVIRONMENTAL CODE AND
TOWN REGULATIONS
Project Street Address
Village
Owner ;asia Address
Telephone
Permit Request R�v � • " �� ,� ��
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Typew3
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting doc mentatiop.
'Dwelling Type: Single Family iA Two Family ❑ Multi-Family(#units) CD
_
Age of Existing Structure ® Historic House: ❑Yes ;(
g g t�,No On Old King's Highway: ❑Yet °�(No
Basement Type: W Full ❑Crawl iQ Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area I(sq.ft)
Number of Baths: Full: existing �I, 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 O Oil ❑Electric ❑Other
Central Air: ❑Yes 7 No Fireplaces: Existing New Existing wood/coal stove: %M ❑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-0 Yes O`Nd—If yes;site plan review#
`Current Use Proposed Use
BUILDER INFORMATION _ S�%- 7>7 &Op,
i'Name P71 S Telephone Number SAP „3
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE d��
FOR OFFICIAL USE ONLY -
E. /J
PERMIT NO. </
y DATE ISSUED
MAP/PARCEL-NO. `
r
ADDRESS VILLAGE
OWNER
-DATE OF INSPECTION:
4
FOUNDATION '
FRAME
INSULATION
FIREPLACE
1
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH ` `.,= FINAL '•
r
t � O
GAS: ROUGH n FINAL
FINAL BUILDING STr
�-
_
G :vpfi
1 -- 00
DATE CLOSED OUT � d m S �1 m11
< ^
ASSOCIATION PLAN NO. ® � ,-
i,
The Commonwealth of Massachusetts
Department of Industrial Accidents'
- - 600'Washington Street
Boston,Mass. 02111'.
Y Workers'. Coin ensation.Insurance Affidavit-General Businesses 1 raw
// / , '• r✓'C>zs�.# /"r:i••�°L4;-e�atr.�•. .;fir.-,`.fr•`Tw. .. .,.• 'tip .. .•'1' �.: Ss°§3 /
71
ad dressc
a hone
state: #• .. - -• � . . . __
OI
work site locatiosi full address
�] I am.a sole proprietor and havd no one Business Type. []Retail❑Restaurant%Bai/Eating•Establishment '
working in any capacity. ❑ Office[] Sales(mcluding.Real Estate, At etc.)'
tc.
[]I am an em to er with eta to ees(full& art time), Other —
% %i? /ll///%/// %//////////////m%%///n%S'/oI/� ��oye%s working on this job..
I am an-cWloyer providing-workers' compensation Y P , ,,
COI7I-aIl •]larIIe: ,;'1: .'l:: ., ,�.. •.:�t: , ,. :1+i���., `:'l:i,;•�`.;?•y,•;, �+ •�i
t :9 .5::•f,t'• .,•f• .r• ',�`.i:• - + +�°' ii�'4{+i.�:nti.. ,'{•^i%:,:ifa:.�'',• f t .. '
eddTessc` ..,• •;.. ip
;• :.tom;. .t.:''. ,5;•,,•'•n'r;a �!' •r; "^`
e.
it }�
OlIMINE
C. •�'
L' •
s4 4
r .
.0 I am a sole proprietor and have hired the independent contractors listed below who have the following workers'
.compensation polices:
•wares ''>.• ��' ••�''.• 'r: :` ;•� �':• ,•,' :i `..:'
L: ! '��• .l, yY. t110ne'iti•'. •.,A.' ''�' •:i'
�,y:..• -::�r'4••�' ti,y-t3:(.':.. :{"{ :. .l_t•:`r:l•�::'
1:,:• .1 'rt, :'{!•., •,y,`. :1. rr✓4••(-:.�,. 'e'};i�%' .,.• �I:. r i n C�: •.
ldsurance'co. :*:' -.,>' :'r:- :: 0111=///G//%%///
- •:I•'� ,f'i t,:~:�.••4' fit. •,•,.s ir. f;:.•.;' S,,;.
coin an• nenie:•,w:, ,• '��� "t, '.,�, :•• .. .i: -,. .•
address: ;
- Cl - ,i .p :',,:. �h St •^"• - •. Yl..v,..ar •a•. -,y'..t. ! .5V'�, •�,•..�.,:1.'� •,
'+i -' •7. ,:5: ;�: •� ,f,f �' mac.: �,• :'e:�'.. ,: `.,;.,•.
gsurancet
't.' :."•":?:•. .•�, . .'r,. t:` din•!.: •}i:+: ..,r.
oll
gapure 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 andlor
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a
copy of this statement maybe forwarded to the Office of Investigations of the DIA.for coverage verification.
I do hereby certify nder thepains andPenaltie erjury that the information provided above is true or cG
Date p
x Signature -14 low �Iel S Phone# d�f•' �'II
Print name
official use only do not write in this area to'be completed by city or town official
permit/license# []Building Department
city or town: ❑Licensing Board -
�, ❑-check if immediate response is required ❑RtectiDepmen's rtmOft-lee
�Health Department I
contact person:
hone#; ❑Other _
1f (rev�edSept2M3)
Information and Instructions
viassachusetts General Laws chf pter�152 section 25.requires all employers to provide workers' compensation for'their.
loyees: As quoted from the law', an employee is.defined as every person in the semee'of another under any contract
,nV)f hire; express or imp .lie�d; oral or written.
An employer 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,enVloyer, or the receiver or
trastee of an individual, partnership, association or other legal entity, employing employees. 'However the owner of a
dwelling house bavii1g'n°t-More•than three apartments and who resides therein, or the.occupant of the dwelling house bf
to do.maintenance, construction or repair work m such dwelling house 6r on the grounds
another who employsFe1sbiis or
building appurtenant thereto shall not because of such.employment.be deemed to be:an employer..
IviGL chapter 152 section 25 also'states That'every state*or local licensing agency shall withhold the issuance or renewal
of a license or permitto operate a business or to construct buildings in the.cbmmonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neithez the
coinrnonwealth nor.any political subdivisions shall enter into any contract for the performance of pub
.of its plic work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting
authority.
Applicants
s''compensati
Please fill in .the worker on affidavit completely,by checking the box that applies to your situation.;Please
supply company name, address and phone numbers along with a certificate of insurance 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'liste�d below.
City or Towns .
Please be sure that the affidavit is cbmplete and printed legibly. The 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 perrn tllicense number.which will be used as a reference number. The.affidavits may.be.returned to
the DepartmentV r�of F?,X unless other:arrangements have been made.
The Office of Investigations would lile to thank you in advance for you cooperation and should you have any questions,'
Please do nothesitate to give us a-call.-
The Department's address,telephone anti fax number: . . . :• . . '.. '
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Me of leifesnPtiens
600 Washington Street
Boston,Ma. 02111
fax#: (617)727-7749
phone#: (617) 727-4900 ext:406
of E Town of Barnstable
Regulatory Services .
pa sr aM Thoma F,Geller,Director
Budding Division
• Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601 '
Office: 508.862-4038 Fax: 508-790-6230
Permit no.
A MAYIT
HOME R01? O'YEMENT CONTRACTOR LAW
SUJ?PLEMENT TO PERMrx APPLICATION
MGL e,142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
•improvement,removal,demolition,or constriction of an addition to any pre-existing owner-occupied
binding containing at least one but not more than four dwelling units or to structures which ara adjacent to
suoh residence or building be done by registered contractors,with certain exceptions,along with other
requirements, ,
• Type of Work,. f)V-r k Rstim4ted Colt
- Address of Wo dfl-•;-l&44 ,
Ovmer's Nerve• �lSlev/A
Date of Application• it
I hereby certify that: - A
Registration is not required for the following reason(s):
❑Work excluded bylaw
[]lob Under S 1,000 '
❑Building not owner-occupied
WOwner pulling own permit
Notice is hereby given that;
OWNERS PULT VG TEEIR OWN PERMIT OR DEALING WITH UMEGISTERED
CONTRACTORS FOR AYPMCABI;EHOMEMPROYEMENT WORK D0 NOT HAYS
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY F[Ft�(D UNDER 1YIGL c,142A�
SIGNED UNDFRPENALTIES OF PERJURY
Ibereby apply for a permit as the agent of the owner; -
Data Contractor Name RegistrationNo.
• OR I
f fli 'I
wner's Name . '
{
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a
l i3 w..il�� ��r�.•Q•yi .
L* it s� Gi Ile �4
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L? < <
qg FOUNDATION LOCATION -�
r COT
T MASSACHUSL T T S � �
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y z a�i, OWNED SY: .,T"}i cn fv`
-
, cyc 1 �`
o s ui SCALE } °'z OATE J(10C Z-7 1 °��l. 0 _
O
NOR MAN 6ROSSMAN------ REGISTERED LAND SURVEYOR
l HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED . ' T
ON TINE LOT AS SHOWN AND CONFORMS TO THE TOWN
OF BARNSTABLE ZONtIO 'REGULATIONS REGARDING ! i QR:MAN `' ' L.
-�
rl
SETBACKS FROM STREET LINES AND LOT. LINES .
S,!R
MOR1 AN GROSSMAN R.L.S. DATE > .
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oFtNE h Town of Barnstable
Regulatory Services
•ARNSTABM : Thomas F.Geiler,Director
'b 1639. ,•� Building Division
ATFp�.la
Tom Perry,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`. l O
JOB LOCATION:
number street village
"HOMEOWNER': /✓ Tet/5'Lcg Ltit g
name home phone# work phone#
CURRENT MAILING ADDRESS: ///�(/Ii�e-•t t.-�. � �, rp
�Ue�� /3%la CJ�Io 3S'
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied 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.
Si ature of omeowner
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 of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
4 '
TOWN OF BARNSTABLE
` ••� Permit No. -- - ------------
Building Inspector
Cash -- -----------
"'Y� OCCUPANCY PERMIT Bond _---------
414S11
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 Address
Wiring Inspector Inspection date
Plumbing Inspector Inspection date
Gas Inspector Inspection date
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.
.....................................................1 19......--- _. ..... ._
Building Inspector
Assessor's-Map and lot number .....................
.......................'
` t 56PTIIC Si(;TEM Mi.9ST R �P��SINEro�o
Sewage Permit number ....�....�.. .tf............................... INSTALLED IN COMPUAN
WITH TITLE'5 = SAWSTADLE,
House number ..................................�I.....:......................:..:. ENVIRONMENTAL CODE M639 \e��
TOWN REGUI ATIONS �0 Mix a.
TOWN OF BARNSTA. BEY
BUILDING INSPECTOR
APPLICATIONFOR PERMIT TO ..................... .........................................G ' ...............................................
... .... ..
zAle
TYPE OF CONSTRUCTION ......0 4</..... -.. .. ..... ... ......................... .............................................
61/
............. �.. �1,Z5..............19.. 6
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby appliesfor a permit according,
to the following iinformation-
Location .. .. �( ....../........ '!/1(.!C'...C'' ` . ....... . IJDL �.. ....I......................................................
ProposedUse ............................ .................... .................. .................................................. ..............................................
ZoningDistrict, ...........f'`.......�..........................................Fire District ...... .............................:...................................
Name of Owner .... .. ...............Address ......�� ............
Name of Builder ... ...../...'�`�' ..........Address ....................................................................................
.Name of Architect ..................................... .........Address
................................
Number of .Rooms .....................t.� .........Foundation ..............................................................................
Exteriorf .... ... . . ....... ............................Roofing ...... ......
.. ... ........... ............................. .....
Floors W/.........C ........................................Interior ...... .. .... .
Heating .... 17........... . ... ................................:..Plumbing ...........f.. .. ........................................~*
...............
Fireplace ................................................................................Approximate Cost 1�1 to
Definitive Plan Approved by Planning Board ____ If- _ ,
---------- Area ... �Ll.�........
Diagram of Lot and Building with Dimensio s � '
g Fee ....... t.. ..... ...................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
l
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
` Name J.....
^
!
TBEO CONSTRUCTION/
�
Permit for ..{)A9...StPKY.......... ` '
^ *
9 ' ��.. ..J�����l �n�___��
� x - - - .
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Location .1ot_�34_7_ _Circle
^ .
Cotoit '
--------~------'-----------
Theo Construction '
Owner —.--------------------. . `
'
Frame '
Type of Construction ..........................................
�
July 28,
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PERMIT REFUSED
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Pt
Asse.vgr rFnap and lot number THE
t01r
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Sewage Permit number ............�;............................:.............
Z 33AWSTABLE, i
House number ...................................41.................................... 9 NAM
r �p 16 3 9. `e0
0mo�'
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATIONFOR PERMIT TO ...........................!.............................................................................................
...
TYPE OF CONSTRUCTION / 1 ... --GCS LG�����
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies fora permit according to the following/information:
Location ...... �.......0,/' Q I,G�(G C ... `� .......f.. c.� .. :..'` .......:............ ...
ProposedUse ................, ..G....... !itl......................................................................... .....
f
ZoningDistrict ✓......... ...........................................Fire District ...... .................................................................
Name of Owner f�: jt��% r,,`c'G ...............Address ................C. ...... /. .......... a ...............
Name of Builder ... .. A60 ..........Address ....................................................................................
Nameof Architect - .......................................Address .................A..............................................................
f 11V Z -
Number of Rooms .....................( �
........................................Foundation ... ..................................... ...............................
Exterior ,// .... r� 'h � s1 Roofing ( �/1=u!l ., L:L L�� :: .........................
J .......... . ...... ........... >....... ..
Floors ....
l�J.�
...Interior
1l �'�
Heating `f:.... .....:!` :.....................:............Plumbing .......:.. .. .........:..........:.........:..:...':.....'..:...:...
Fireplace ......................... ...................................................Approximate Cost ... , .......................................................
Definitive Plan Approved by Planning Board ___-L,- _L ---------19_� . Area
Diagram of Lot and Building with Dimensions Fee. .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
BID
4 \
l
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. f
Name �........ 1 �.. .. .-.....:.:1'�42... '1.
��A—=23-40
THEO CONSTRUCTIIN
Nr Permit for ..........
y...D:Wg.j.jinC
..........
Lot #34 7 Mariner Circle
Location ................................................................
Cotuit
...............................................................................
Owner
Theo Construction
..................................................................
Type of Construction ......Frame,,,,,,,,,,,,,,,,,,,,,,,. .
.. ..
...............................................................................
Plot ............................ L ............................
Permit Granted July 28 , ...19 81
..... ..............19.
Date of Inspection
Date Completed ................*./.................19
PERMIT /EFUSED
.............. ..... .. ........ 19
............
rp....... .......................
...............................................................................
...............................................................................
...............................................................................
Approved ................................................ 19
...............................................................................
.............................................................................
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PLAN SHOWING
v y FOUNDATION LOCATION S-
�0 T U I T j M ��
CHUSE T T S
f'eS SA1 J• ,U'' �'1 �' f •. _'_ . -<
a OWNED BY: ..r"� �°r, i�-3-T � 0. �'{:: (� F-
,qCC
x r� SCALE DATE J U�..)t� ''Z:"I, 1 g�,l
IA
NORMAN GROSSMAN-----—REGISTERED LAND SURVEYOR C
l HEREBY CERTIFY THAT' THIS FOUNDATION IS LOCATED
ON TWE LOT AS SHOWN AND CONFORMS TO THE TOWN ;, ,� Ile
` -
OF BARNSTABLE ZONING REGULATIONS REGARDINGGR
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SETBACKS FROM STREET LINES AND LOT. L►NES . � �'` AN
J t"�9 p k(o !7.775 a (f f1(
NORlGlAIY GROSSMAN R.L.S. DATE
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